Lap Apojual 01.frx PDF

RS BALIKPAPAN BARU LAPORAN PENJUALAN OBAT
Jln. MT. Haryono, Kompleks Balikpapan Dari Tgl 01-12-2019 S/D 31-12-2019
Balikpapan Pasien Jaminan+Perorangan
Telp: 0542 877330 Fax : 0542 877331
Penjualan resep dan bebas
Hal : 1 dari 266
ASAL RAWAT JALAN
TR No Tanggal No. Reg/Rekmed Nama Pasien Resep Dari Kode Obat Nama Obat Qty Satuan Disc% Harga sat Total
DEPO/COUNTER : FARMASI DEPO-2P
R2019-0000069942 01-12-2019 201900066978/098855 MUHAMMAD REVAN Eko Dian Syafitra OD00077 Dumin Rectal 250mg 1.00 Tube 29,254.50 29,754.50
R2019-0000069942 01-12-2019 201900066978/098855 MUHAMMAD REVAN Eko Dian Syafitra OC00120 Cortidex Tablet 5.00 Tablet 430.65 2,653.25
R2019-0000069942 01-12-2019 201900066978/098855 MUHAMMAD REVAN Eko Dian Syafitra OE00018 Epexol Tablet 5.00 Tablet 1,232.55 6,662.75
R2019-0000069942 01-12-2019 201900066978/098855 MUHAMMAD REVAN Eko Dian Syafitra OS00029 Sanmol Tablet, 500mg 5.00 Tablet 430.65 2,653.25
R2019-0000069942 01-12-2019 201900066978/098855 MUHAMMAD REVAN Eko Dian Syafitra ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 17,079.00
R2019-0000069942 01-12-2019 201900066978/098855 MUHAMMAD REVAN Eko Dian Syafitra OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000069946 01-12-2019 201900066975/032317 AISYAH FITRIANTI,NY Eko Dian Syafitra ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000069946 01-12-2019 201900066975/032317 AISYAH FITRIANTI,NY Eko Dian Syafitra OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000069946 01-12-2019 201900066975/032317 AISYAH FITRIANTI,NY Eko Dian Syafitra OA00064 Amlodipin 5mg (OGB) 1.00 Tablet 1,555.00 2,055.00
R2019-0000069946 01-12-2019 201900066975/032317 AISYAH FITRIANTI,NY Eko Dian Syafitra ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000069947 01-12-2019 201900066980/089802 SANDY SETYA Eko Dian Syafitra ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000069947 01-12-2019 201900066980/089802 SANDY SETYA Eko Dian Syafitra OP00011 Paracetamol 500mg 1.00 Tablet 387.36 887.36
R2019-0000069947 01-12-2019 201900066980/089802 SANDY SETYA Eko Dian Syafitra OI00051 Infus Otsu-NS (NaCl 1.00 Botol 9,388.17 9,888.17
R2019-0000069949 01-12-2019 201900066981/051315 GHAZY ZHAFRAN K Eko Dian Syafitra OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000069949 01-12-2019 201900066981/051315 GHAZY ZHAFRAN K Eko Dian Syafitra OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000069950 01-12-2019 201900066981/051315 GHAZY ZHAFRAN K Eko Dian Syafitra OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000069950 01-12-2019 201900066981/051315 GHAZY ZHAFRAN K Eko Dian Syafitra OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000069950 01-12-2019 201900066981/051315 GHAZY ZHAFRAN K Eko Dian Syafitra OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000069950 01-12-2019 201900066981/051315 GHAZY ZHAFRAN K Eko Dian Syafitra OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000069950 01-12-2019 201900066981/051315 GHAZY ZHAFRAN K Eko Dian Syafitra ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000069951 01-12-2019 201900066975/032317 AISYAH FITRIANTI,NY Eko Dian Syafitra OA00064 Amlodipin 5mg (OGB) 10.00 Tablet 1,555.00 16,050.00
R2019-0000069951 01-12-2019 201900066975/032317 AISYAH FITRIANTI,NY Eko Dian Syafitra OC00034 Cefadroxil 500mg (OGB) 6.00 Capsul 1,633.50 10,301.00
R2019-0000069951 01-12-2019 201900066975/032317 AISYAH FITRIANTI,NY Eko Dian Syafitra OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
R2019-0000069951 01-12-2019 201900066975/032317 AISYAH FITRIANTI,NY Eko Dian Syafitra OA00052 Ambroxol Tablet, 30mg 6.00 Tablet 445.50 3,173.00
R2019-0000069951 01-12-2019 201900066975/032317 AISYAH FITRIANTI,NY Eko Dian Syafitra OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2019-0000069952 01-12-2019 201900066980/089802 SANDY SETYA Eko Dian Syafitra OC00034 Cefadroxil 500mg (OGB) 6.00 Capsul 1,633.50 10,301.00
R2019-0000069952 01-12-2019 201900066980/089802 SANDY SETYA Eko Dian Syafitra OA00052 Ambroxol Tablet, 30mg 6.00 Tablet 445.50 3,173.00
R2019-0000069952 01-12-2019 201900066980/089802 SANDY SETYA Eko Dian Syafitra OS00009 Salbutamol 2mg (OGB) 6.00 Tablet 213.30 1,779.80
R2019-0000069952 01-12-2019 201900066980/089802 SANDY SETYA Eko Dian Syafitra OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000069952 01-12-2019 201900066980/089802 SANDY SETYA Eko Dian Syafitra OM00046 Methyl Prednisolon 8mg 6.00 Tablet 965.25 6,291.50
R2019-0000069956 01-12-2019 201900066960/111495 ALSAVA ADE RAHMAH OS00010 Salbutamol 4mg (OGB) 2.00 Tablet 249.48 998.96
R2019-0000069956 01-12-2019 201900066960/111495 ALSAVA ADE RAHMAH OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000069956 01-12-2019 201900066960/111495 ALSAVA ADE RAHMAH OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000069956 01-12-2019 201900066960/111495 ALSAVA ADE RAHMAH OC00132 CTM 4mg 2.00 Tablet 157.41 814.82
R2019-0000069956 01-12-2019 201900066960/111495 ALSAVA ADE RAHMAH OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000069956 01-12-2019 201900066960/111495 ALSAVA ADE RAHMAH ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 12,079.00
Total 415,670.15
Tgl ce tak : 10-01-2020

HOSPITAL MANAGEMENT SYSTEM
Telp: 0542 877330 Fax : 0542 877331
Hal : 2 dari 266
ASAL RAWAT JALAN
R2019-0000069956 01-12-2019 201900066960/111495 ALSAVA ADE RAHMAH OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000069957 01-12-2019 201900066948/111489 ATIMAH ADE RAHMAH OK00027 Ketorolac 3% Injeksi 2.00 Ampul 40,500.40 81,500.80
R2019-0000069959 01-12-2019 201900066940/111487 BEVERLY ALEXANDRA ADE RAHMAH OC00132 CTM 4mg 2.00 Tablet 157.41 814.82
R2019-0000069959 01-12-2019 201900066940/111487 BEVERLY ALEXANDRA ADE RAHMAH OS00009 Salbutamol 2mg (OGB) 2.00 Tablet 213.30 926.60
R2019-0000069959 01-12-2019 201900066940/111487 BEVERLY ALEXANDRA ADE RAHMAH OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000069959 01-12-2019 201900066940/111487 BEVERLY ALEXANDRA ADE RAHMAH OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000069959 01-12-2019 201900066940/111487 BEVERLY ALEXANDRA ADE RAHMAH ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 12,079.00
R2019-0000069959 01-12-2019 201900066940/111487 BEVERLY ALEXANDRA ADE RAHMAH OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000069960 01-12-2019 201900066939/073509 ABRI ADRIJANTO,TN ADE RAHMAH OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000069960 01-12-2019 201900066939/073509 ABRI ADRIJANTO,TN ADE RAHMAH OV00080 Vitamin B Compleks 6.00 Tablet 241.79 1,950.74
R2019-0000069960 01-12-2019 201900066939/073509 ABRI ADRIJANTO,TN ADE RAHMAH OL00017 Lameson 4mg 5.00 Tablet 5,049.00 25,745.00
R2019-0000069962 01-12-2019 201900066986/108185 MUHAMMAD ALIF ADE RAHMAH OM00097 Mucera Drop 1.00 Botol 54,945.00 55,445.00
R2019-0000069962 01-12-2019 201900066986/108185 MUHAMMAD ALIF ADE RAHMAH OS00030 Sanmol Drop, 15ml 1.00 Botol 23,314.00 23,814.00
R2019-0000069962 01-12-2019 201900066986/108185 MUHAMMAD ALIF ADE RAHMAH OB00091 Biovitan Syrup, 60ml 1.00 Botol 8,019.00 8,519.00
R2019-0000069962 01-12-2019 201900066986/108185 MUHAMMAD ALIF ADE RAHMAH OL00001 L - BIO Sachet 10.00 Sachet 10,395.00 104,450.00
R2019-0000069963 01-12-2019 201900066985/111501 NAFISA ZAQIYATUL ADE RAHMAH OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000069964 01-12-2019 201900066985/111501 NAFISA ZAQIYATUL ADE RAHMAH OS00030 Sanmol Drop, 15ml 1.00 Botol 23,314.00 23,814.00
R2019-0000069964 01-12-2019 201900066985/111501 NAFISA ZAQIYATUL ADE RAHMAH OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000069964 01-12-2019 201900066985/111501 NAFISA ZAQIYATUL ADE RAHMAH OS00010 Salbutamol 4mg (OGB) 2.00 Tablet 249.48 998.96
R2019-0000069964 01-12-2019 201900066985/111501 NAFISA ZAQIYATUL ADE RAHMAH OA00052 Ambroxol Tablet, 30mg Tablet 445.50 500.00
R2019-0000069964 01-12-2019 201900066985/111501 NAFISA ZAQIYATUL ADE RAHMAH OC00132 CTM 4mg 2.00 Tablet 157.41 814.82
R2019-0000069964 01-12-2019 201900066985/111501 NAFISA ZAQIYATUL ADE RAHMAH ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 17,079.00
R2019-0000069972 01-12-2019 201900067000/032599 ANIS SAJIDAH ADE RAHMAH OO00074 Ondansetron Tablet, 4mg 10.00 Tablet 4,455.00 45,050.00
R2019-0000069972 01-12-2019 201900067000/032599 ANIS SAJIDAH ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000069972 01-12-2019 201900067000/032599 ANIS SAJIDAH ADE RAHMAH OA00085 Antasida Tablet (OGB) 10.00 Tablet 284.30 3,343.00
R2019-0000069972 01-12-2019 201900067000/032599 ANIS SAJIDAH ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000069977 01-12-2019 201900066998/053415 ARKAN ZIQRIE ADE RAHMAH OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000069978 01-12-2019 201900066997/038823 AMELINDA,AN ADE RAHMAH OA00088 Antiza Tablet 3.00 Tablet 1,633.00 5,399.00
R2019-0000069978 01-12-2019 201900066997/038823 AMELINDA,AN ADE RAHMAH OS00009 Salbutamol 2mg (OGB) 3.00 Tablet 213.30 1,139.90
R2019-0000069979 01-12-2019 201900066996/111504 REYNALDI YUDHA ADE RAHMAH OA00015 Acyclovir 400mg (OGB) 10.00 Tablet 1,262.25 13,122.50
R2019-0000069979 01-12-2019 201900066996/111504 REYNALDI YUDHA ADE RAHMAH OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000069979 01-12-2019 201900066996/111504 REYNALDI YUDHA ADE RAHMAH OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000069982 01-12-2019 201900066992/111503 DARWIN,TN ADE RAHMAH OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000069982 01-12-2019 201900066992/111503 DARWIN,TN ADE RAHMAH OS00009 Salbutamol 2mg (OGB) 4.00 Tablet 213.30 1,353.20
R2019-0000069982 01-12-2019 201900066992/111503 DARWIN,TN ADE RAHMAH OA00088 Antiza Tablet 5.00 Tablet 1,633.00 8,665.00
R2019-0000069985 01-12-2019 201900067011/111506 AL ZAHRA PUTRI ADE RAHMAH OA00016 Acyclovir Cream 5gr 2.00 Tube 4,893.00 10,286.00
R2019-0000069985 01-12-2019 201900067011/111506 AL ZAHRA PUTRI ADE RAHMAH OA00015 Acyclovir 400mg (OGB) 12.00 Tablet 1,262.25 15,647.00
R2019-0000069985 01-12-2019 201900067011/111506 AL ZAHRA PUTRI ADE RAHMAH ATKK031 Kertas Puyer Handbond 20.00 Sachet 207.90 29,158.00
Total 1,001,720.81
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 3 dari 266
ASAL RAWAT JALAN
R2019-0000069985 01-12-2019 201900067011/111506 AL ZAHRA PUTRI ADE RAHMAH OC00038 Cefila Dry Syrup 1.00 Botol 123,255.00 123,755.00
R2019-0000069985 01-12-2019 201900067011/111506 AL ZAHRA PUTRI ADE RAHMAH OS00079 Sirplus Granula 5.00 Granula 297.00 1,985.00
R2019-0000070006 01-12-2019 201900067013/091452 SITTI NORSIAH ADE RAHMAH OA00180 Acetylcyst ein 200mg 10.00 Tablet 1,485.00 15,350.00
R2019-0000070006 01-12-2019 201900067013/091452 SITTI NORSIAH ADE RAHMAH OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000070006 01-12-2019 201900067013/091452 SITTI NORSIAH ADE RAHMAH OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000070010 01-12-2019 201900067010/090017 ERNAWATI,NY ADE RAHMAH OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000070010 01-12-2019 201900067010/090017 ERNAWATI,NY ADE RAHMAH OB00016 Betahistine Mesilat 6mg 5.00 Tablet 1,500.00 8,000.00
R2019-0000070010 01-12-2019 201900067010/090017 ERNAWATI,NY ADE RAHMAH OG00009 Gemfibrozil 300mg (OGB) 3.00 Tablet 811.18 2,933.54
R2019-0000070011 01-12-2019 201900067010/090017 ERNAWATI,NY ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000070012 01-12-2019 201900067005/086293 I GEDE SUJANA ADE RAHMAH OO00074 Ondansetron Tablet, 4mg 3.00 Tablet 4,455.00 13,865.00
R2019-0000070012 01-12-2019 201900067005/086293 I GEDE SUJANA ADE RAHMAH OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000070012 01-12-2019 201900067005/086293 I GEDE SUJANA ADE RAHMAH OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000070014 01-12-2019 201900067009/111505 SITI NUR ADE RAHMAH OO00074 Ondansetron Tablet, 4mg 3.00 Tablet 4,455.00 13,865.00
R2019-0000070014 01-12-2019 201900067009/111505 SITI NUR ADE RAHMAH OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000070014 01-12-2019 201900067009/111505 SITI NUR ADE RAHMAH OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000070013 01-12-2019 201900066997/038823 AMELINDA,AN ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000070013 01-12-2019 201900066997/038823 AMELINDA,AN ADE RAHMAH OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000070015 01-12-2019 201900066992/111503 DARWIN,TN ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000070015 01-12-2019 201900066992/111503 DARWIN,TN ADE RAHMAH OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000070016 01-12-2019 201900067009/111505 SITI NUR ADE RAHMAH OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 Botol 22,542.30 23,042.30
R2019-0000070016 01-12-2019 201900067009/111505 SITI NUR ADE RAHMAH OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000070016 01-12-2019 201900067009/111505 SITI NUR ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000070016 01-12-2019 201900067009/111505 SITI NUR ADE RAHMAH ALI00004 I.V Catheter No. 20 2.00 Pcs 36,808.20 74,116.40
R2019-0000070017 01-12-2019 201900067005/086293 I GEDE SUJANA ADE RAHMAH OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000070017 01-12-2019 201900067005/086293 I GEDE SUJANA ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000070017 01-12-2019 201900067005/086293 I GEDE SUJANA ADE RAHMAH ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000070018 01-12-2019 201900067019/111509 RAHMI ALAWIYAH,NY Dwi Astuti, dr OP00116 Pronalges Supositoria 1.00 Suppo 19,824.75 20,324.75
R2019-0000070018 01-12-2019 201900067019/111509 RAHMI ALAWIYAH,NY Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 5.00 Tablet 415.80 2,579.00
R2019-0000070018 01-12-2019 201900067019/111509 RAHMI ALAWIYAH,NY Dwi Astuti, dr OT00148 Tablet Tambah Darah 5.00 Tablet 742.00 4,210.00
R2019-0000070022 01-12-2019 201900067023/056189 MARIA THERESIA Dwi Astuti, dr OK00030 Ketricin Salep 0.1%, 5gr 1.00 Tube 66,825.00 67,325.00
R2019-0000070022 01-12-2019 201900067023/056189 MARIA THERESIA Dwi Astuti, dr OI00001 Ibuprofen 400mg (OGB) 6.00 Tablet 682.00 4,592.00
R2019-0000070022 01-12-2019 201900067023/056189 MARIA THERESIA Dwi Astuti, dr OL00017 Lameson 4mg 6.00 Tablet 5,049.00 30,794.00
R2019-0000070023 01-12-2019 201900067021/077934 HAVELIN KANINE,NY Dwi Astuti, dr OL00080 Loratadin 10mg (OGB) 3.00 Tablet 520.00 2,060.00
R2019-0000070023 01-12-2019 201900067021/077934 HAVELIN KANINE,NY Dwi Astuti, dr OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000070023 01-12-2019 201900067021/077934 HAVELIN KANINE,NY Dwi Astuti, dr OA00180 Acetylcyst ein 200mg 4.00 Tablet 1,485.00 6,440.00
R2019-0000070023 01-12-2019 201900067021/077934 HAVELIN KANINE,NY Dwi Astuti, dr OB00017 Betametason Cream 1.00 Tube 5,049.00 5,549.00
R2019-0000070024 01-12-2019 201900068641/111507 ENDANG ADE RAHMAH OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000070024 01-12-2019 201900068641/111507 ENDANG ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
Total 1,650,862.32
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 4 dari 266
ASAL RAWAT JALAN
R2019-0000070024 01-12-2019 201900068641/111507 ENDANG ADE RAHMAH ALI00005 I.V Catheter No. 22 5.00 Pcs 27,324.00 137,120.00
R2019-0000070024 01-12-2019 201900068641/111507 ENDANG ADE RAHMAH OC00019 Captopril 25mg (OGB) 1.00 Tablet 267.35 767.35
R2019-0000070024 01-12-2019 201900068641/111507 ENDANG ADE RAHMAH ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000070042 01-12-2019 201900067029/041762 MANORAN Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000070042 01-12-2019 201900067029/041762 MANORAN Dwi Astuti, dr OM00045 Methyl Prednisolon 4mg Tablet 792.99 500.00
R2019-0000070042 01-12-2019 201900067029/041762 MANORAN Dwi Astuti, dr OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000070042 01-12-2019 201900067029/041762 MANORAN Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000070042 01-12-2019 201900067029/041762 MANORAN Dwi Astuti, dr OA00180 Acetylcyst ein 200mg 6.00 Tablet 1,485.00 9,410.00
R2019-0000070041 01-12-2019 201900067022/037377 MUSTAMING,TN Dwi Astuti, dr OA00086 Antihemoroid Supositoria 3.00 Suppo 4,975.00 15,425.00
R2019-0000070041 01-12-2019 201900067022/037377 MUSTAMING,TN Dwi Astuti, dr OL00108 Lexatrans 500mg 6.00 Tablet 1,871.00 11,726.00
R2019-0000070041 01-12-2019 201900067022/037377 MUSTAMING,TN Dwi Astuti, dr OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000070041 01-12-2019 201900067022/037377 MUSTAMING,TN Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000070043 01-12-2019 201900067028/020495 RASEL JULIAN Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000070043 01-12-2019 201900067028/020495 RASEL JULIAN Dwi Astuti, dr OM00045 Methyl Prednisolon 4mg 5.00 Tablet 792.99 4,464.95
R2019-0000070043 01-12-2019 201900067028/020495 RASEL JULIAN Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000070043 01-12-2019 201900067028/020495 RASEL JULIAN Dwi Astuti, dr OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000070044 01-12-2019 201900067026/111511 BUDDY Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000070044 01-12-2019 201900067026/111511 BUDDY Dwi Astuti, dr OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000070044 01-12-2019 201900067026/111511 BUDDY Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000070044 01-12-2019 201900067026/111511 BUDDY Dwi Astuti, dr OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000070046 01-12-2019 201900067027/105479 ZALEHA,NY Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000070046 01-12-2019 201900067027/105479 ZALEHA,NY Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000070046 01-12-2019 201900067027/105479 ZALEHA,NY Dwi Astuti, dr OB00050 Braxidin 4.00 Tablet 1,648.35 7,093.40
R2019-0000070046 01-12-2019 201900067027/105479 ZALEHA,NY Dwi Astuti, dr OA00063 Amlodipin 10mg (OGB) 5.00 Tablet 2,743.00 14,215.00
R2019-0000070047 01-12-2019 201900067031/035408 EUIS YUNIASTUTI,NY Dwi Astuti, dr ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000070047 01-12-2019 201900067031/035408 EUIS YUNIASTUTI,NY Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000070047 01-12-2019 201900067031/035408 EUIS YUNIASTUTI,NY Dwi Astuti, dr OG00018 Gitas Injeksi 1ml 1.00 Ampul 38,201.62 38,701.62
R2019-0000070047 01-12-2019 201900067031/035408 EUIS YUNIASTUTI,NY Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000070047 01-12-2019 201900067031/035408 EUIS YUNIASTUTI,NY Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070047 01-12-2019 201900067031/035408 EUIS YUNIASTUTI,NY Dwi Astuti, dr ON00047 New Diatabs 10.00 Tablet 767.13 8,171.30
R2019-0000070047 01-12-2019 201900067031/035408 EUIS YUNIASTUTI,NY Dwi Astuti, dr OS00176 Scopma Plus Tablet 5.00 Tablet 2,090.22 10,951.10
R2019-0000070047 01-12-2019 201900067031/035408 EUIS YUNIASTUTI,NY Dwi Astuti, dr OL00021 Lansoprazole (OGB) 5.00 Capsul 2,230.00 11,650.00
R2019-0000070047 01-12-2019 201900067031/035408 EUIS YUNIASTUTI,NY Dwi Astuti, dr OO00074 Ondansetron Tablet, 4mg 5.00 Tablet 4,455.00 22,775.00
R2019-0000070047 01-12-2019 201900067031/035408 EUIS YUNIASTUTI,NY Dwi Astuti, dr OA00064 Amlodipin 5mg (OGB) 10.00 Tablet 1,555.00 16,050.00
R2019-0000070047 01-12-2019 201900067031/035408 EUIS YUNIASTUTI,NY Dwi Astuti, dr OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000070048 01-12-2019 201900067032/015217 AGUNG ASWAR Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000070048 01-12-2019 201900067032/015217 AGUNG ASWAR Dwi Astuti, dr OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000070048 01-12-2019 201900067032/015217 AGUNG ASWAR Dwi Astuti, dr OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
Total 2,468,412.48
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 5 dari 266
ASAL RAWAT JALAN
R2019-0000070048 01-12-2019 201900067032/015217 AGUNG ASWAR Dwi Astuti, dr OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000070048 01-12-2019 201900067032/015217 AGUNG ASWAR Dwi Astuti, dr OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000070048 01-12-2019 201900067032/015217 AGUNG ASWAR Dwi Astuti, dr ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000070048 01-12-2019 201900067032/015217 AGUNG ASWAR Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000070048 01-12-2019 201900067032/015217 AGUNG ASWAR Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070045 01-12-2019 201900067033/111484 JEFRI,TN Dwi Astuti, dr OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000070045 01-12-2019 201900067033/111484 JEFRI,TN Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000070045 01-12-2019 201900067033/111484 JEFRI,TN Dwi Astuti, dr OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000070049 01-12-2019 201900067034/089672 ANDI MEGA,NN Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000070049 01-12-2019 201900067034/089672 ANDI MEGA,NN Dwi Astuti, dr OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000070051 01-12-2019 201900067040/111514 ROHMAN EKA Dwi Astuti, dr OA00068 Amoxsan Capsul, 500mg 10.00 Capsul 4,752.00 48,020.00
R2019-0000070051 01-12-2019 201900067040/111514 ROHMAN EKA Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000070051 01-12-2019 201900067040/111514 ROHMAN EKA Dwi Astuti, dr OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000070052 01-12-2019 201900067039/111513 MUHAMMAD Dwi Astuti, dr OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000070052 01-12-2019 201900067039/111513 MUHAMMAD Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000070052 01-12-2019 201900067039/111513 MUHAMMAD Dwi Astuti, dr OC00120 Cortidex Tablet 3.00 Tablet 430.65 1,791.95
R2019-0000070052 01-12-2019 201900067039/111513 MUHAMMAD Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000070052 01-12-2019 201900067039/111513 MUHAMMAD Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 17,079.00
R2019-0000070053 01-12-2019 201900067038/044416 MEI LINA Dwi Astuti, dr OC00120 Cortidex Tablet 10.00 Tablet 430.65 4,806.50
R2019-0000070053 01-12-2019 201900067038/044416 MEI LINA Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000070053 01-12-2019 201900067038/044416 MEI LINA Dwi Astuti, dr OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000070053 01-12-2019 201900067038/044416 MEI LINA Dwi Astuti, dr OA00180 Acetylcyst ein 200mg 10.00 Tablet 1,485.00 15,350.00
R2019-0000070053 01-12-2019 201900067038/044416 MEI LINA Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000070056 01-12-2019 201900067041/109931 ANDRA ARKAN,AN Dwi Astuti, dr OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000070056 01-12-2019 201900067041/109931 ANDRA ARKAN,AN Dwi Astuti, dr OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000070056 01-12-2019 201900067041/109931 ANDRA ARKAN,AN Dwi Astuti, dr OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000070056 01-12-2019 201900067041/109931 ANDRA ARKAN,AN Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000070056 01-12-2019 201900067041/109931 ANDRA ARKAN,AN Dwi Astuti, dr OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000070056 01-12-2019 201900067041/109931 ANDRA ARKAN,AN Dwi Astuti, dr OB00091 Biovitan Syrup, 60ml 1.00 Botol 8,019.00 8,519.00
R2019-0000070058 01-12-2019 201900067042/111515 ADRYA GHASSAN Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000070058 01-12-2019 201900067042/111515 ADRYA GHASSAN Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000070058 01-12-2019 201900067042/111515 ADRYA GHASSAN Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000070058 01-12-2019 201900067042/111515 ADRYA GHASSAN Dwi Astuti, dr OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000070058 01-12-2019 201900067042/111515 ADRYA GHASSAN Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 17,079.00
R2019-0000070058 01-12-2019 201900067042/111515 ADRYA GHASSAN Dwi Astuti, dr OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000070061 01-12-2019 201900067049/084132 ARSYAD SYAWAL Dwi Astuti, dr OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000070061 01-12-2019 201900067049/084132 ARSYAD SYAWAL Dwi Astuti, dr OS00029 Sanmol Tablet, 500mg 5.00 Tablet 430.65 2,653.25
R2019-0000070061 01-12-2019 201900067049/084132 ARSYAD SYAWAL Dwi Astuti, dr OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
Total 3,204,387.48
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 6 dari 266
ASAL RAWAT JALAN
R2019-0000070061 01-12-2019 201900067049/084132 ARSYAD SYAWAL Dwi Astuti, dr OP00184 Neo Protifed Tablet 5.00 Tablet 1,263.73 6,818.65
R2019-0000070061 01-12-2019 201900067049/084132 ARSYAD SYAWAL Dwi Astuti, dr OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000070062 01-12-2019 201900067051/111519 MUHAMMAD AKMAL Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000070062 01-12-2019 201900067051/111519 MUHAMMAD AKMAL Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000070062 01-12-2019 201900067051/111519 MUHAMMAD AKMAL Dwi Astuti, dr OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000070065 01-12-2019 201900067045/44585 ROMI YANTI,NY Dwi Astuti, dr OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000070065 01-12-2019 201900067045/44585 ROMI YANTI,NY Dwi Astuti, dr OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000070065 01-12-2019 201900067045/44585 ROMI YANTI,NY Dwi Astuti, dr OI00001 Ibuprofen 400mg (OGB) 5.00 Tablet 682.00 3,910.00
R2019-0000070065 01-12-2019 201900067045/44585 ROMI YANTI,NY Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000070065 01-12-2019 201900067045/44585 ROMI YANTI,NY Dwi Astuti, dr OA00068 Amoxsan Capsul, 500mg 10.00 Capsul 4,752.00 48,020.00
R2019-0000070065 01-12-2019 201900067045/44585 ROMI YANTI,NY Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000070065 01-12-2019 201900067045/44585 ROMI YANTI,NY Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000070065 01-12-2019 201900067045/44585 ROMI YANTI,NY Dwi Astuti, dr ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000070063 01-12-2019 201900067044/111516 MURDJOKO,TN Dwi Astuti, dr OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000070063 01-12-2019 201900067044/111516 MURDJOKO,TN Dwi Astuti, dr OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000070063 01-12-2019 201900067044/111516 MURDJOKO,TN Dwi Astuti, dr OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000070063 01-12-2019 201900067044/111516 MURDJOKO,TN Dwi Astuti, dr OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000070072 01-12-2019 201900067022/037377 MUSTAMING,TN Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000070072 01-12-2019 201900067022/037377 MUSTAMING,TN Dwi Astuti, dr ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000070072 01-12-2019 201900067022/037377 MUSTAMING,TN Dwi Astuti, dr OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000070072 01-12-2019 201900067022/037377 MUSTAMING,TN Dwi Astuti, dr OI00051 Infus Otsu-NS (NaCl 1.00 Botol 9,388.17 9,888.17
R2019-0000070079 01-12-2019 201900067060/111518 I KADEK ADI Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000070079 01-12-2019 201900067060/111518 I KADEK ADI Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070079 01-12-2019 201900067060/111518 I KADEK ADI Dwi Astuti, dr ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000070079 01-12-2019 201900067060/111518 I KADEK ADI Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000070083 01-12-2019 201900067055/105814 HENUR AYU INDAH Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000070083 01-12-2019 201900067055/105814 HENUR AYU INDAH Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000070083 01-12-2019 201900067055/105814 HENUR AYU INDAH Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070083 01-12-2019 201900067055/105814 HENUR AYU INDAH Dwi Astuti, dr ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000070083 01-12-2019 201900067055/105814 HENUR AYU INDAH Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000070076 01-12-2019 201900067057/111512 ACHMAD,TN Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000070076 01-12-2019 201900067057/111512 ACHMAD,TN Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070076 01-12-2019 201900067057/111512 ACHMAD,TN Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000070076 01-12-2019 201900067057/111512 ACHMAD,TN Dwi Astuti, dr ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000070085 01-12-2019 201900066861/033392 NURUL FAIZAH,NY ROY , Dr.Sp.OG OB00029 Biosanbe Capsul 7.00 Capsul 1,596.37 11,674.59
R2019-0000070085 01-12-2019 201900066861/033392 NURUL FAIZAH,NY ROY , Dr.Sp.OG OA00106 Asam Mefenamat 500mg 15.00 Tablet 415.80 6,737.00
R2019-0000070085 01-12-2019 201900066861/033392 NURUL FAIZAH,NY ROY , Dr.Sp.OG OL00108 Lexatrans 500mg 15.00 Tablet 1,871.00 28,565.00
R2019-0000070086 01-12-2019 201900066849/111343 ISMIATUN,NY EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
Total 4,250,375.92
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 7 dari 266
ASAL RAWAT JALAN
R2019-0000070086 01-12-2019 201900066849/111343 ISMIATUN,NY EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000070086 01-12-2019 201900066849/111343 ISMIATUN,NY EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
R2019-0000070086 01-12-2019 201900066849/111343 ISMIATUN,NY EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000070086 01-12-2019 201900066849/111343 ISMIATUN,NY EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000070089 01-12-2019 201900067055/105814 HENUR AYU INDAH Dwi Astuti, dr OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000070095 01-12-2019 201900067037/075839 SITI SAPRIAH,NY Dwi Astuti, dr OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000070097 01-12-2019 201900067059/111517 M JUMADI,TN Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000070097 01-12-2019 201900067059/111517 M JUMADI,TN Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070097 01-12-2019 201900067059/111517 M JUMADI,TN Dwi Astuti, dr ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000070098 01-12-2019 201900067044/111516 MURDJOKO,TN Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000070098 01-12-2019 201900067044/111516 MURDJOKO,TN Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000070098 01-12-2019 201900067044/111516 MURDJOKO,TN Dwi Astuti, dr ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000070101 01-12-2019 201900067046/018134 HAFSYAH MAIZA,AN Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000070101 01-12-2019 201900067046/018134 HAFSYAH MAIZA,AN Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
R2019-0000070101 01-12-2019 201900067046/018134 HAFSYAH MAIZA,AN Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 4.00 Tablet 623.70 2,994.80
R2019-0000070101 01-12-2019 201900067046/018134 HAFSYAH MAIZA,AN Dwi Astuti, dr OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000070101 01-12-2019 201900067046/018134 HAFSYAH MAIZA,AN Dwi Astuti, dr OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000070101 01-12-2019 201900067046/018134 HAFSYAH MAIZA,AN Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000070101 01-12-2019 201900067046/018134 HAFSYAH MAIZA,AN Dwi Astuti, dr OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000070100 01-12-2019 201900067043/049688 WANIY,NY Dwi Astuti, dr ON00009 Natrium Diklofenac 50mg 5.00 Tablet 955.84 5,279.20
R2019-0000070100 01-12-2019 201900067043/049688 WANIY,NY Dwi Astuti, dr OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000070100 01-12-2019 201900067043/049688 WANIY,NY Dwi Astuti, dr OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000070102 01-12-2019 201900067052/111520 M SYAFII,TN Dwi Astuti, dr OC00054 Cendo Xitrol T etes Mata 1.00 Botol 46,800.00 47,300.00
R2019-0000070107 02-12-2019 201900067063/080259 ASWINA Eko Dian Syafitra OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 Botol 22,542.30 23,042.30
R2019-0000070107 02-12-2019 201900067063/080259 ASWINA Eko Dian Syafitra ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000070107 02-12-2019 201900067063/080259 ASWINA Eko Dian Syafitra ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070107 02-12-2019 201900067063/080259 ASWINA Eko Dian Syafitra ON00039 Neurosanbe Injeksi 1.00 Ampul 8,122.95 8,622.95
R2019-0000070107 02-12-2019 201900067063/080259 ASWINA Eko Dian Syafitra OP00011 Paracetamol 500mg 1.00 Tablet 387.36 887.36
R2019-0000070115 02-12-2019 201900067063/080259 ASWINA Eko Dian Syafitra OI00134 Imunos Plus Tablet 5.00 Tablet 14,107.50 71,037.50
R2019-0000070115 02-12-2019 201900067063/080259 ASWINA Eko Dian Syafitra OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000070115 02-12-2019 201900067063/080259 ASWINA Eko Dian Syafitra OV00107 Vosedon Tablet 6.00 Tablet 3,452.63 21,215.78
R2019-0000070125 02-12-2019 201900067074/111521 KATIRIN,TN Eko Dian Syafitra OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000070125 02-12-2019 201900067074/111521 KATIRIN,TN Eko Dian Syafitra ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000070125 02-12-2019 201900067074/111521 KATIRIN,TN Eko Dian Syafitra ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000070125 02-12-2019 201900067074/111521 KATIRIN,TN Eko Dian Syafitra OI00097 Isosorbide Dinitrate 5mg 1.00 Tablet 311.85 811.85
R2019-0000070121 02-12-2019 201900067074/111521 KATIRIN,TN Eko Dian Syafitra OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000070121 02-12-2019 201900067074/111521 KATIRIN,TN Eko Dian Syafitra OI00097 Isosorbide Dinitrate 5mg 6.00 Tablet 311.85 2,371.10
R2019-0000070133 02-12-2019 201900067075/111498 KENZO RURI Eko Dian Syafitra OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
Total 4,950,429.72
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 8 dari 266
ASAL RAWAT JALAN
R2019-0000070133 02-12-2019 201900067075/111498 KENZO RURI Eko Dian Syafitra OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000070133 02-12-2019 201900067075/111498 KENZO RURI Eko Dian Syafitra OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000070135 02-12-2019 201900067078/056051 BILLY DJUANDA,TN Eko Dian Syafitra OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000070135 02-12-2019 201900067078/056051 BILLY DJUANDA,TN Eko Dian Syafitra OS00176 Scopma Plus Tablet 6.00 Tablet 2,090.22 13,041.32
R2019-0000070139 02-12-2019 201900067088/21475 JUMIATI,NY Eko Dian Syafitra OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000070139 02-12-2019 201900067088/21475 JUMIATI,NY Eko Dian Syafitra OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000070139 02-12-2019 201900067088/21475 JUMIATI,NY Eko Dian Syafitra OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000070139 02-12-2019 201900067088/21475 JUMIATI,NY Eko Dian Syafitra ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000070141 02-12-2019 201900067075/111498 KENZO RURI Eko Dian Syafitra OD00077 Dumin Rectal 250mg 1.00 Tube 29,254.50 29,754.50
R2019-0000070134 02-12-2019 201900067070/44585 ROMI YANTI,NY Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000070134 02-12-2019 201900067070/44585 ROMI YANTI,NY Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070134 02-12-2019 201900067070/44585 ROMI YANTI,NY Dwi Astuti, dr ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000070134 02-12-2019 201900067070/44585 ROMI YANTI,NY Dwi Astuti, dr OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000070143 02-12-2019 201900067074/111521 KATIRIN,TN Eko Dian Syafitra OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000070150 02-12-2019 201900065374/103853 SUSYLAWATY,NY Dameria Sri OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000070150 02-12-2019 201900065374/103853 SUSYLAWATY,NY Dameria Sri OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000070150 02-12-2019 201900065374/103853 SUSYLAWATY,NY Dameria Sri OS00173 Simvastatin 20mg (OGB) 7.00 Tablet 1,782.00 12,974.00
R2019-0000070150 02-12-2019 201900065374/103853 SUSYLAWATY,NY Dameria Sri OG00057 Gabapentin 300mg (OGB) 5.00 Tablet 8,168.00 41,340.00
R2019-0000070150 02-12-2019 201900065374/103853 SUSYLAWATY,NY Dameria Sri ALK00037 Kapsul No.1 10.00 pcs 200.00 7,000.00
R2019-0000070155 02-12-2019 201900067106/016060 SABINUS GADUT,TN Herika dr. OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000070152 02-12-2019 201900067088/21475 JUMIATI,NY Eko Dian Syafitra OB001002 Betahistine 10.00 Tab 5,940.00 59,900.00
R2019-0000070152 02-12-2019 201900067088/21475 JUMIATI,NY Eko Dian Syafitra OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000070152 02-12-2019 201900067088/21475 JUMIATI,NY Eko Dian Syafitra OD00065 Domperidon Tablet (OGB) 10.00 Tablet 750.00 8,000.00
R2019-0000070159 02-12-2019 201900067106/016060 SABINUS GADUT,TN Herika dr. OP00138 Pumpitor Capsul 10.00 Capsul 20,092.05 201,420.50
R2019-0000070159 02-12-2019 201900067106/016060 SABINUS GADUT,TN Herika dr. OC00097 Codein 15mg 10.00 Tablet 1,665.87 17,158.70
R2019-0000070157 02-12-2019 201900067118/111526 HATTA,TN Herika dr. OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000070157 02-12-2019 201900067118/111526 HATTA,TN Herika dr. OA00068 Amoxsan Capsul, 500mg 15.00 Capsul 4,752.00 71,780.00
R2019-0000070157 02-12-2019 201900067118/111526 HATTA,TN Herika dr. OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000070157 02-12-2019 201900067118/111526 HATTA,TN Herika dr. OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000070161 02-12-2019 201900067136/111529 ISWANTO,TN Herika dr. OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000070164 02-12-2019 201900067125/111528 MAULITA,NY ROY , Dr.Sp.OG OD00078 Duphaston Tablet 10.00 Tablet 24,495.74 245,457.40
R2019-0000070162 02-12-2019 201900067121/102910 JULKIPLI,TN Herika dr. OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000070162 02-12-2019 201900067121/102910 JULKIPLI,TN Herika dr. OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000070156 02-12-2019 201900067133/103846 USMIN,TN IQBAL OA00001 AB - Vask 10mg 20.00 Tablet 14,850.00 297,500.00
R2019-0000070169 02-12-2019 201900067136/111529 ISWANTO,TN Herika dr. ALB00001 Bactigras (10cmx10cm) 1.00 Pcs 22,720.50 23,220.50
R2019-0000070169 02-12-2019 201900067136/111529 ISWANTO,TN Herika dr. OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000070169 02-12-2019 201900067136/111529 ISWANTO,TN Herika dr. OA00068 Amoxsan Capsul, 500mg 10.00 Capsul 4,752.00 48,020.00
R2019-0000070165 02-12-2019 201900067086/072746 SYARIFUDDIN,TN Dameria Sri OG00057 Gabapentin 300mg (OGB) 20.00 Tablet 8,168.00 163,860.00
Total 6,630,358.44
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 9 dari 266
ASAL RAWAT JALAN
R2019-0000070165 02-12-2019 201900067086/072746 SYARIFUDDIN,TN Dameria Sri OA00062 Amitriptyline Tablet, 6.00 Tablet 252.45 2,014.70
R2019-0000070165 02-12-2019 201900067086/072746 SYARIFUDDIN,TN Dameria Sri OL00021 Lansoprazole (OGB) 10.00 Capsul 2,230.00 22,800.00
R2019-0000070174 02-12-2019 201900067143/111323 IKA NUR Angie Renatha , OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000070174 02-12-2019 201900067143/111323 IKA NUR Angie Renatha , OH00026 Hydrocortis on Cream 1.00 Tube 11,880.00 12,380.00
R2019-0000070175 02-12-2019 201900067142/061561 NURUL HIDAYATI,NY ROY , Dr.Sp.OG OB00029 Biosanbe Capsul 7.00 Capsul 1,596.37 11,674.59
R2019-0000070177 02-12-2019 201900067090/094765 SIMON ANAN,TN Dameria Sri OS00173 Simvastatin 20mg (OGB) Tablet 1,782.00 500.00
R2019-0000070176 02-12-2019 201900067090/094765 SIMON ANAN,TN Dameria Sri OS00173 Simvastatin 20mg (OGB) 7.00 Tablet 1,782.00 12,974.00
R2019-0000070176 02-12-2019 201900067090/094765 SIMON ANAN,TN Dameria Sri OB00016 Betahistine Mesilat 6mg 15.00 Tablet 1,500.00 23,000.00
R2019-0000070176 02-12-2019 201900067090/094765 SIMON ANAN,TN Dameria Sri OA00062 Amitriptyline Tablet, 6.00 Tablet 252.45 2,014.70
R2019-0000070176 02-12-2019 201900067090/094765 SIMON ANAN,TN Dameria Sri OE00057 Eperisone Hcl 50mg 20.00 Tablet 2,286.90 46,238.00
R2019-0000070179 02-12-2019 201900067089/081228 ARBAYAH,NY Dameria Sri OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000070179 02-12-2019 201900067089/081228 ARBAYAH,NY Dameria Sri OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000070179 02-12-2019 201900067089/081228 ARBAYAH,NY Dameria Sri OS00173 Simvastatin 20mg (OGB) 7.00 Tablet 1,782.00 12,974.00
R2019-0000070179 02-12-2019 201900067089/081228 ARBAYAH,NY Dameria Sri OF00095 Furosemide 40mg (OGB) 3.00 Tablet 315.26 1,445.78
R2019-0000070179 02-12-2019 201900067089/081228 ARBAYAH,NY Dameria Sri OM00017 Meloxicam 15mg (OGB) 8.00 Tablet 2,079.00 17,132.00
R2019-0000070179 02-12-2019 201900067089/081228 ARBAYAH,NY Dameria Sri OG00057 Gabapentin 300mg (OGB) 6.00 Tablet 8,168.00 49,508.00
R2019-0000070180 02-12-2019 201900067089/081228 ARBAYAH,NY Dameria Sri OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000070180 02-12-2019 201900067089/081228 ARBAYAH,NY Dameria Sri OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000070180 02-12-2019 201900067089/081228 ARBAYAH,NY Dameria Sri OS00173 Simvastatin 20mg (OGB) 23.00 Tablet 1,782.00 41,486.00
R2019-0000070180 02-12-2019 201900067089/081228 ARBAYAH,NY Dameria Sri OF00095 Furosemide 40mg (OGB) 12.00 Tablet 315.26 4,283.12
R2019-0000070181 02-12-2019 201900067087/111121 DARTI,NY Dameria Sri OG00057 Gabapentin 300mg (OGB) 7.00 Tablet 8,168.00 57,676.00
R2019-0000070181 02-12-2019 201900067087/111121 DARTI,NY Dameria Sri OM00018 Meloxicam 7.5mg (OGB) 14.00 Tablet 1,287.00 18,518.00
R2019-0000070181 02-12-2019 201900067087/111121 DARTI,NY Dameria Sri OO00014 Omeprazole 20mg (OGB) 8.00 Capsul 1,169.98 9,859.84
R2019-0000070181 02-12-2019 201900067087/111121 DARTI,NY Dameria Sri ALK00037 Kapsul No.1 20.00 pcs 200.00 11,500.00
R2019-0000070182 02-12-2019 201900067101/070858 ITJE POLII,NY Dameria Sri OC00092 Clopidogrel 75mg (OGB) 23.00 Tablet 14,701.50 338,634.50
R2019-0000070182 02-12-2019 201900067101/070858 ITJE POLII,NY Dameria Sri OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000070182 02-12-2019 201900067101/070858 ITJE POLII,NY Dameria Sri OT00156 Telmisartan 40 mg 64.00 Tablet 6,534.00 418,676.00
R2019-0000070182 02-12-2019 201900067101/070858 ITJE POLII,NY Dameria Sri OS00173 Simvastatin 20mg (OGB) 23.00 Tablet 1,782.00 41,486.00
R2019-0000070183 02-12-2019 201900067187/023030 AFRIYANTI,NY Herika dr. OE00006 Eflagen 50mg 10.00 Tablet 3,044.28 30,942.80
R2019-0000070183 02-12-2019 201900067187/023030 AFRIYANTI,NY Herika dr. OB00007 Becom - C 5.00 Tablet 2,123.55 11,117.75
R2019-0000070183 02-12-2019 201900067187/023030 AFRIYANTI,NY Herika dr. OO00022 Opicef 500mg Capsul 10.00 Capsul 14,850.00 149,000.00
R2019-0000070185 02-12-2019 201900067198/033197 DANIEL CHRISTIAN Herika dr. OA00071 Amoxsan Forte Dry Syrup 1.00 Botol 47,520.00 48,020.00
R2019-0000070185 02-12-2019 201900067198/033197 DANIEL CHRISTIAN Herika dr. OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000070189 02-12-2019 201900067100/079094 SAI IN,TN Dameria Sri OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000070189 02-12-2019 201900067100/079094 SAI IN,TN Dameria Sri OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000070189 02-12-2019 201900067100/079094 SAI IN,TN Dameria Sri OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000070189 02-12-2019 201900067100/079094 SAI IN,TN Dameria Sri OS00173 Simvastatin 20mg (OGB) 23.00 Tablet 1,782.00 41,486.00
R2019-0000070190 02-12-2019 201900067175/111538 AMBRAN,TN Herika dr. OS00027 Sanmag Tablet 10.00 Tablet 1,321.65 13,716.50
Total 8,822,826.02
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 10 dari 266
ASAL RAWAT JALAN
R2019-0000070205 02-12-2019 201900067217/111543 NADHEA ISLAMIA Herika dr. OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000070205 02-12-2019 201900067217/111543 NADHEA ISLAMIA Herika dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000070200 02-12-2019 201900067204/072396 ARISTYA CITA Herika dr. OA00068 Amoxsan Capsul, 500mg 10.00 Capsul 4,752.00 48,020.00
R2019-0000070200 02-12-2019 201900067204/072396 ARISTYA CITA Herika dr. OS00029 Sanmol Tablet, 500mg 12.00 Tablet 430.65 5,667.80
R2019-0000070200 02-12-2019 201900067204/072396 ARISTYA CITA Herika dr. OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000070200 02-12-2019 201900067204/072396 ARISTYA CITA Herika dr. OA00125 ATS (Anti Tetanus 1.00 Ampul 222,750.00 223,250.00
R2019-0000070191 02-12-2019 201900067157/111533 ABDUL SAMAN,TN LUSY E. Dr.Sp.PD OP00167 Proliver 20.00 Kalpet 7,574.00 151,980.00
R2019-0000070207 02-12-2019 201900067192/107477 DIERA AJENG Nafon Zaitun, Dr. OB00068 BioCal-95 30.00 Tablet 7,128.00 214,340.00
R2019-0000070207 02-12-2019 201900067192/107477 DIERA AJENG Nafon Zaitun, Dr. OF00071 Folavit 400mcg 30.00 Tablet 1,329.07 40,372.10
R2019-0000070207 02-12-2019 201900067192/107477 DIERA AJENG Nafon Zaitun, Dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000070208 02-12-2019 201900067217/111543 NADHEA ISLAMIA Herika dr. OS00029 Sanmol Tablet, 500mg 12.00 Tablet 430.65 5,667.80
R2019-0000070208 02-12-2019 201900067217/111543 NADHEA ISLAMIA Herika dr. OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000070208 02-12-2019 201900067217/111543 NADHEA ISLAMIA Herika dr. OP00138 Pumpitor Capsul 10.00 Capsul 20,092.05 201,420.50
R2019-0000070210 02-12-2019 201900067107/111525 ABDUL HALIM,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 20.00 Tablet 371.25 7,925.00
R2019-0000070210 02-12-2019 201900067107/111525 ABDUL HALIM,TN LUSY E. Dr.Sp.PD OG00021 Glimepiride 1mg Tablet 10.00 Tablet 1,245.00 12,950.00
R2019-0000070210 02-12-2019 201900067107/111525 ABDUL HALIM,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 10.00 Tablet 1,662.00 17,120.00
R2019-0000070209 02-12-2019 201900067085/059301 ALBERTUS PUTRA FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 4.00 Capsul 28,957.00 116,328.00
R2019-0000070209 02-12-2019 201900067085/059301 ALBERTUS PUTRA FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 4.00 Tablet 430.65 2,222.60
R2019-0000070209 02-12-2019 201900067085/059301 ALBERTUS PUTRA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000070209 02-12-2019 201900067085/059301 ALBERTUS PUTRA FREDRIK, Dr,Sp.A OM00100 Mucera Tablet 4.00 Tablet 1,782.00 7,628.00
R2019-0000070209 02-12-2019 201900067085/059301 ALBERTUS PUTRA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000070209 02-12-2019 201900067085/059301 ALBERTUS PUTRA FREDRIK, Dr,Sp.A OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000070209 02-12-2019 201900067085/059301 ALBERTUS PUTRA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000070214 02-12-2019 201900067186/111540 JOYSIS ZILVANYA FREDRIK, Dr,Sp.A OA00069 Amoxsan Drop 1.00 Botol 33,264.00 33,764.00
R2019-0000070214 02-12-2019 201900067186/111540 JOYSIS ZILVANYA FREDRIK, Dr,Sp.A OS00030 Sanmol Drop, 15ml 1.00 Botol 23,314.00 23,814.00
R2019-0000070216 02-12-2019 201900067182/076608 ACHMAD SYIEN,AN FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 7.00 Capsul 28,957.00 203,199.00
R2019-0000070216 02-12-2019 201900067182/076608 ACHMAD SYIEN,AN FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 5.00 Tablet 430.65 2,653.25
R2019-0000070216 02-12-2019 201900067182/076608 ACHMAD SYIEN,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 5.00 Tablet 1,173.15 6,365.75
R2019-0000070216 02-12-2019 201900067182/076608 ACHMAD SYIEN,AN FREDRIK, Dr,Sp.A OM00100 Mucera Tablet 6.00 Tablet 1,782.00 11,192.00
R2019-0000070216 02-12-2019 201900067182/076608 ACHMAD SYIEN,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 5.00 Granula 297.00 1,985.00
R2019-0000070216 02-12-2019 201900067182/076608 ACHMAD SYIEN,AN FREDRIK, Dr,Sp.A OD00006 Damaben Syrup, 60ml 1.00 Botol 14,701.50 15,201.50
R2019-0000070216 02-12-2019 201900067182/076608 ACHMAD SYIEN,AN FREDRIK, Dr,Sp.A ON00004 Naprex Syrup, 60ml 1.00 Botol 59,251.50 59,751.50
R2019-0000070216 02-12-2019 201900067182/076608 ACHMAD SYIEN,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000070217 02-12-2019 201900067206/100948 TATAP HOTMAIDA LUSY E. Dr.Sp.PD OT00135 Thyrozol 5mg 7.00 Tablet 2,188.89 15,822.23
R2019-0000070217 02-12-2019 201900067206/100948 TATAP HOTMAIDA LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000070217 02-12-2019 201900067206/100948 TATAP HOTMAIDA LUSY E. Dr.Sp.PD OM00045 Methyl Prednisolon 4mg 6.00 Tablet 792.99 5,257.94
R2019-0000070218 02-12-2019 201900067286/111550 ZUNAIROH,NY IRMA SARI OS00029 Sanmol Tablet, 500mg 8.00 Tablet 430.65 3,945.20
R2019-0000070218 02-12-2019 201900067286/111550 ZUNAIROH,NY IRMA SARI OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
Total 10,632,652.79
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 11 dari 266
ASAL RAWAT JALAN
R2019-0000070218 02-12-2019 201900067286/111550 ZUNAIROH,NY IRMA SARI OE00008 Elkana Tablet 5.00 Tablet 1,247.40 6,737.00
R2019-0000070219 02-12-2019 201900067260/050807 MUHAMMAD KENZIE FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 7.00 Capsul 28,957.00 222,699.00
R2019-0000070219 02-12-2019 201900067260/050807 MUHAMMAD KENZIE FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 5.00 Tablet 430.65 2,653.25
R2019-0000070219 02-12-2019 201900067260/050807 MUHAMMAD KENZIE FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 5.00 Tablet 1,173.15 6,365.75
R2019-0000070219 02-12-2019 201900067260/050807 MUHAMMAD KENZIE FREDRIK, Dr,Sp.A OM00100 Mucera Tablet 5.00 Tablet 1,782.00 9,410.00
R2019-0000070219 02-12-2019 201900067260/050807 MUHAMMAD KENZIE FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 5.00 Granula 297.00 1,985.00
R2019-0000070219 02-12-2019 201900067260/050807 MUHAMMAD KENZIE FREDRIK, Dr,Sp.A OO00062 Ottopan Syrup, 60ml 1.00 Botol 29,700.00 30,200.00
R2019-0000070219 02-12-2019 201900067260/050807 MUHAMMAD KENZIE FREDRIK, Dr,Sp.A OA00094 Apialys Syrup 100ml 1.00 Botol 49,005.00 49,505.00
R2019-0000070223 02-12-2019 201900067292/035268 YAP RAENAL M,TN IQBAL OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000070223 02-12-2019 201900067292/035268 YAP RAENAL M,TN IQBAL OE00008 Elkana Tablet 10.00 Tablet 1,247.40 12,974.00
R2019-0000070223 02-12-2019 201900067292/035268 YAP RAENAL M,TN IQBAL OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000070226 02-12-2019 201900067318/111552 DESI RATNA SARI,NY ADE RAHMAH OB00007 Becom - C 10.00 Tablet 2,123.55 21,735.50
R2019-0000070234 02-12-2019 201900067247/111546 SAMSIAH,NY Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000070234 02-12-2019 201900067247/111546 SAMSIAH,NY Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000070234 02-12-2019 201900067247/111546 SAMSIAH,NY Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000070234 02-12-2019 201900067247/111546 SAMSIAH,NY Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000070234 02-12-2019 201900067247/111546 SAMSIAH,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 19,000.00
R2019-0000070236 02-12-2019 201900067270/111068 REGINA PUTRI Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 15.00 Tablet 965.25 14,978.75
R2019-0000070236 02-12-2019 201900067270/111068 REGINA PUTRI Ismail dr. Msc. OC00039 Cefixime 100mg (OGB) 20.00 Capsul 4,266.70 85,834.00
R2019-0000070236 02-12-2019 201900067270/111068 REGINA PUTRI Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000070236 02-12-2019 201900067270/111068 REGINA PUTRI Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000070236 02-12-2019 201900067270/111068 REGINA PUTRI Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000070232 02-12-2019 201900067313/111554 NABIL ASYRAF Eviwati ALD00003 Disposable Syringe 1ml 1.00 Pcs 3,500.00 4,000.00
R2019-0000070232 02-12-2019 201900067313/111554 NABIL ASYRAF Eviwati OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000070232 02-12-2019 201900067313/111554 NABIL ASYRAF Eviwati OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000070232 02-12-2019 201900067313/111554 NABIL ASYRAF Eviwati OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000070232 02-12-2019 201900067313/111554 NABIL ASYRAF Eviwati OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000070232 02-12-2019 201900067313/111554 NABIL ASYRAF Eviwati ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000070239 02-12-2019 201900067315/078010 ANNA ANDINA,AN Ismail dr. Msc. OM00045 Methyl Prednisolon 4mg 15.00 Tablet 792.99 12,394.85
R2019-0000070239 02-12-2019 201900067315/078010 ANNA ANDINA,AN Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 15.00 Tablet 623.70 9,855.50
R2019-0000070237 02-12-2019 201900067311/110404 DAVID FADILAH R,BY Ismail dr. Msc. OC00173 Cetirizine 10mg/ml Drop, 1.00 Botol 37,125.00 37,625.00
R2019-0000070237 02-12-2019 201900067311/110404 DAVID FADILAH R,BY Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 5,049.00 5,549.00
R2019-0000070237 02-12-2019 201900067311/110404 DAVID FADILAH R,BY Ismail dr. Msc. OK00022 Ketoconazol Cream 2% 1.00 Tube 11,000.00 11,500.00
R2019-0000070237 02-12-2019 201900067311/110404 DAVID FADILAH R,BY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000070240 02-12-2019 201900066597/078422 IRDAYANTI,NY Hendra Dr, Sp. OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000070241 02-12-2019 201900067302/110918 AMARA SHEZA Ismail dr. Msc. OG00045 Griseofulvin 125mg 15.00 Tablet 561.38 8,920.70
R2019-0000070241 02-12-2019 201900067302/110918 AMARA SHEZA Ismail dr. Msc. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000070241 02-12-2019 201900067302/110918 AMARA SHEZA Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 5,049.00 5,549.00
Total 11,475,164.02
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 12 dari 266
ASAL RAWAT JALAN
R2019-0000070241 02-12-2019 201900067302/110918 AMARA SHEZA Ismail dr. Msc. OK00022 Ketoconazol Cream 2% 1.00 Tube 11,000.00 11,500.00
R2019-0000070241 02-12-2019 201900067302/110918 AMARA SHEZA Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000070242 02-12-2019 201900067304/107118 SYAFIYA NURUL FREDRIK, Dr,Sp.A OE00024 Erysanbe 200mg Ceweble 3.00 Tablet 2,272.00 7,316.00
R2019-0000070242 02-12-2019 201900067304/107118 SYAFIYA NURUL FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 2.00 Tablet 1,173.15 2,846.30
R2019-0000070242 02-12-2019 201900067304/107118 SYAFIYA NURUL FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 2.00 Tablet 208.00 916.00
R2019-0000070242 02-12-2019 201900067304/107118 SYAFIYA NURUL FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 1.00 Granula 297.00 797.00
R2019-0000070242 02-12-2019 201900067304/107118 SYAFIYA NURUL FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000070243 02-12-2019 201900067314/097928 EKWAN PUTRA HASDI ADE RAHMAH OF00039 FG Troches 6.00 Tablet 1,730.02 10,880.12
R2019-0000070243 02-12-2019 201900067314/097928 EKWAN PUTRA HASDI ADE RAHMAH OC00096 Codein 10mg 6.00 Tablet 924.80 6,048.80
R2019-0000070245 02-12-2019 201900067256/062707 LIES MARIA,NY Eviwati OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000070244 02-12-2019 201900067202/090650 HABIA,NY Hendra Dr, Sp. ALD00005 Disposable Syringe 3ml 2.00 Pcs 2,272.05 5,044.10
R2019-0000070244 02-12-2019 201900067202/090650 HABIA,NY Hendra Dr, Sp. OL00063 Lidocain HCl 2% Injeksi 2.00 Ampul 2,376.00 5,252.00
R2019-0000070244 02-12-2019 201900067202/090650 HABIA,NY Hendra Dr, Sp. OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000070244 02-12-2019 201900067202/090650 HABIA,NY Hendra Dr, Sp. OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000070246 02-12-2019 201900067267/00013759 SRIYANI,NY Eviwati OM00044 Methyl Prednisolon 16mg 15.00 Tablet 2,632.50 39,987.50
R2019-0000070246 02-12-2019 201900067267/00013759 SRIYANI,NY Eviwati OD00072 Doxyciclyn 100mg (OGB) 20.00 Tablet 650.00 13,500.00
R2019-0000070246 02-12-2019 201900067267/00013759 SRIYANI,NY Eviwati OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000070247 02-12-2019 201900067120/110284 JULAIHA SYAHRAN,NY Eviwati OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000070248 02-12-2019 201900067301/062551 RUWAIDAH,NY Angie Renatha , OK00023 Ketoconazole 200mg 10.00 Tablet 774.24 8,242.40
R2019-0000070248 02-12-2019 201900067301/062551 RUWAIDAH,NY Angie Renatha , OL00021 Lansoprazole (OGB) 10.00 Capsul 2,230.00 22,800.00
R2019-0000070249 02-12-2019 201900067124/046833 ARIE WIBISONO,TN DYAH, dr Sp. OC00096 Codein 10mg 10.00 Tablet 924.80 9,748.00
R2019-0000070249 02-12-2019 201900067124/046833 ARIE WIBISONO,TN DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000070249 02-12-2019 201900067124/046833 ARIE WIBISONO,TN DYAH, dr Sp. OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000070249 02-12-2019 201900067124/046833 ARIE WIBISONO,TN DYAH, dr Sp. OS00132 Symbicort Inhaler 160/45 1.00 Botol/6 412,776.54 413,276.54
R2019-0000070250 02-12-2019 201900067239/044656 EKA RATIH Eviwati OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000070251 02-12-2019 201900067147/103300 MARDIAH,NY DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000070251 02-12-2019 201900067147/103300 MARDIAH,NY DYAH, dr Sp. OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000070253 02-12-2019 201900067340/076795 WIWIT WIDAYATI,NY ADE RAHMAH OS00014 Sanadryl DMP Syrup, 60ml 1.00 Botol 17,820.00 18,320.00
R2019-0000070253 02-12-2019 201900067340/076795 WIWIT WIDAYATI,NY ADE RAHMAH OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000070253 02-12-2019 201900067340/076795 WIWIT WIDAYATI,NY ADE RAHMAH OI00134 Imunos Plus Tablet 10.00 Tablet 14,107.50 141,575.00
R2019-0000070254 02-12-2019 201900067342/111559 NONI YOSPIKA ADE RAHMAH OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000070254 02-12-2019 201900067342/111559 NONI YOSPIKA ADE RAHMAH OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000070254 02-12-2019 201900067342/111559 NONI YOSPIKA ADE RAHMAH OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000070255 02-12-2019 201900067342/111559 NONI YOSPIKA ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000070258 02-12-2019 201900067355/094472 ERWIN SUSILO,TN ADE RAHMAH OP00184 Neo Protifed Tablet 10.00 Tablet 1,263.73 13,137.30
R2019-0000070258 02-12-2019 201900067355/094472 ERWIN SUSILO,TN ADE RAHMAH OL00041 Lasgan Capsul 10.00 Capsul 21,000.00 210,500.00
R2019-0000070258 02-12-2019 201900067355/094472 ERWIN SUSILO,TN ADE RAHMAH OC00151 Codipront Capsul 10.00 Capsul 13,649.35 136,993.50
R2019-0000070258 02-12-2019 201900067355/094472 ERWIN SUSILO,TN ADE RAHMAH OI00134 Imunos Plus Tablet 10.00 Tablet 14,107.50 141,575.00
Total 12,943,925.15
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 13 dari 266
ASAL RAWAT JALAN
R2019-0000070259 02-12-2019 201900067268/107468 RINI SARDJONO,NY Hendra Dr, Sp. OB00028 Bioplacenton Cream, 15gr 1.00 Tube 25,245.00 25,745.00
R2019-0000070264 02-12-2019 201900067321/111481 CHANDRA ADI Hendra Dr, Sp. OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000070264 02-12-2019 201900067321/111481 CHANDRA ADI Hendra Dr, Sp. OG00073 Glucosamine 250 Mg 10.00 Tablet 1,633.50 16,835.00
R2019-0000070267 02-12-2019 201900067323/111372 MUHAMMAD Hendra Dr, Sp. OS00077 Simprofen 10.00 Tablet 8,984.25 90,342.50
R2019-0000070267 02-12-2019 201900067323/111372 MUHAMMAD Hendra Dr, Sp. OM00158 Mevrabal 500 Mg 10.00 Tablet 2,100.00 21,500.00
R2019-0000070267 02-12-2019 201900067323/111372 MUHAMMAD Hendra Dr, Sp. OF00056 Flamar Emulgel, 20gr 2.00 Tube 24,354.00 49,208.00
R2019-0000070272 02-12-2019 201900067344/111560 ABDUL RAUF,TN ADE RAHMAH OA00088 Antiza Tablet 5.00 Tablet 1,633.00 8,665.00
R2019-0000070272 02-12-2019 201900067344/111560 ABDUL RAUF,TN ADE RAHMAH OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000070271 02-12-2019 201900067272/018012 MUHAMMAD KHOIRUL Hendra Dr, Sp. OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000070271 02-12-2019 201900067272/018012 MUHAMMAD KHOIRUL Hendra Dr, Sp. OM00158 Mevrabal 500 Mg 10.00 Tablet 2,100.00 21,500.00
R2019-0000070274 02-12-2019 201900067275/074114 ANISA ULYANA Ismail dr. Msc. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000070274 02-12-2019 201900067275/074114 ANISA ULYANA Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 5,049.00 5,549.00
R2019-0000070274 02-12-2019 201900067275/074114 ANISA ULYANA Ismail dr. Msc. OG00066 Genoint Salep Kulit 2.00 Tube 7,350.75 15,201.50
R2019-0000070274 02-12-2019 201900067275/074114 ANISA ULYANA Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000070277 02-12-2019 201900066685/108016 HARRY FUJI R,TN Hendra Dr, Sp. ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000070277 02-12-2019 201900066685/108016 HARRY FUJI R,TN Hendra Dr, Sp. ALH00020 Hypafix 10cm x 5m 1.00 Cm 400.00 900.00
R2019-0000070277 02-12-2019 201900066685/108016 HARRY FUJI R,TN Hendra Dr, Sp. OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000070279 02-12-2019 201900066760/107209 MUHAMMAD ALWI,TN Hendra Dr, Sp. OC00010 Calcium Lactat 500mg 7.00 Tablet 302.37 2,616.59
R2019-0000070275 02-12-2019 201900066760/107209 MUHAMMAD ALWI,TN Hendra Dr, Sp. OC00010 Calcium Lactat 500mg 23.00 Tablet 302.37 7,454.51
R2019-0000070281 02-12-2019 201900067241/048194 GHAZY AHMAD Herika dr. OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000070281 02-12-2019 201900067241/048194 GHAZY AHMAD Herika dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000070281 02-12-2019 201900067241/048194 GHAZY AHMAD Herika dr. OO00040 Oralit 200 5.00 Sachet 706.00 4,030.00
R2019-0000070281 02-12-2019 201900067241/048194 GHAZY AHMAD Herika dr. OZ00005 Zinc Tablet (OGB) 10.00 Tablet 1,000.00 10,500.00
R2019-0000070281 02-12-2019 201900067241/048194 GHAZY AHMAD Herika dr. OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000070282 02-12-2019 201900067191/086639 JUMIAH,NY Maulin Nikmah OM00017 Meloxicam 15mg (OGB) 4.00 Tablet 2,079.00 8,816.00
R2019-0000070284 02-12-2019 201900067181/056487 SALMA,NY Angie Renatha , OA00106 Asam Mefenamat 500mg 15.00 Tablet 415.80 6,737.00
R2019-0000070284 02-12-2019 201900067181/056487 SALMA,NY Angie Renatha , OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000070284 02-12-2019 201900067181/056487 SALMA,NY Angie Renatha , OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000070284 02-12-2019 201900067181/056487 SALMA,NY Angie Renatha , OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
R2019-0000070285 02-12-2019 201900067195/100044 MOHAMMAD LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000070285 02-12-2019 201900067195/100044 MOHAMMAD LUSY E. Dr.Sp.PD OG00021 Glimepiride 1mg Tablet 7.00 Tablet 1,245.00 9,215.00
R2019-0000070285 02-12-2019 201900067195/100044 MOHAMMAD LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000070296 02-12-2019 201900067339/108349 RIFKY BIMA Riyanti Puji dr. OS00098 Sporetik Dry Syrup 1.00 Botol 123,923.25 124,423.25
R2019-0000070296 02-12-2019 201900067339/108349 RIFKY BIMA Riyanti Puji dr. ON00004 Naprex Syrup, 60ml 1.00 Botol 59,251.50 59,751.50
R2019-0000070296 02-12-2019 201900067339/108349 RIFKY BIMA Riyanti Puji dr. OE00007 Elkana Syrup 1.00 Botol 34,303.50 34,803.50
R2019-0000070296 02-12-2019 201900067339/108349 RIFKY BIMA Riyanti Puji dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000070296 02-12-2019 201900067339/108349 RIFKY BIMA Riyanti Puji dr. OS00009 Salbutamol 2mg (OGB) 10.00 Tablet 213.30 2,633.00
R2019-0000070296 02-12-2019 201900067339/108349 RIFKY BIMA Riyanti Puji dr. OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
Total 13,750,394.03
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 14 dari 266
ASAL RAWAT JALAN
R2019-0000070296 02-12-2019 201900067339/108349 RIFKY BIMA Riyanti Puji dr. OP00184 Neo Protifed Tablet 3.00 Tablet 1,263.73 4,291.19
R2019-0000070296 02-12-2019 201900067339/108349 RIFKY BIMA Riyanti Puji dr. OT00142 Trilac 4mg 5.00 Tablet 5,200.00 26,500.00
R2019-0000070296 02-12-2019 201900067339/108349 RIFKY BIMA Riyanti Puji dr. ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 17,079.00
R2019-0000070299 02-12-2019 201900067365/111566 NASRUL,SDR ADE RAHMAH OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000070299 02-12-2019 201900067365/111566 NASRUL,SDR ADE RAHMAH OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000070299 02-12-2019 201900067365/111566 NASRUL,SDR ADE RAHMAH OF00039 FG Troches 10.00 Tablet 1,730.02 17,800.20
R2019-0000070286 02-12-2019 201900067238/070773 FITRIA NUR FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 5.00 Capsul 4,266.70 21,833.50
R2019-0000070286 02-12-2019 201900067238/070773 FITRIA NUR FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000070286 02-12-2019 201900067238/070773 FITRIA NUR FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000070286 02-12-2019 201900067238/070773 FITRIA NUR FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
R2019-0000070286 02-12-2019 201900067238/070773 FITRIA NUR FREDRIK, Dr,Sp.A OS00009 Salbutamol 2mg (OGB) 3.00 Tablet 213.30 1,139.90
R2019-0000070286 02-12-2019 201900067238/070773 FITRIA NUR FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000070286 02-12-2019 201900067238/070773 FITRIA NUR FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000070286 02-12-2019 201900067238/070773 FITRIA NUR FREDRIK, Dr,Sp.A OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000070289 02-12-2019 201900067246/049474 NINING SUNARSIH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000070289 02-12-2019 201900067246/049474 NINING SUNARSIH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 10.00 Tablet 10,617.75 106,677.50
R2019-0000070289 02-12-2019 201900067246/049474 NINING SUNARSIH,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 10.00 Tablet 240.30 2,903.00
R2019-0000070289 02-12-2019 201900067246/049474 NINING SUNARSIH,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000070289 02-12-2019 201900067246/049474 NINING SUNARSIH,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000070300 02-12-2019 201900067338/074224 ZAIRA NADIA Riyanti Puji dr. OS00009 Salbutamol 2mg (OGB) 10.00 Tablet 213.30 2,633.00
R2019-0000070300 02-12-2019 201900067338/074224 ZAIRA NADIA Riyanti Puji dr. OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000070300 02-12-2019 201900067338/074224 ZAIRA NADIA Riyanti Puji dr. OP00184 Neo Protifed Tablet 4.00 Tablet 1,263.73 5,554.92
R2019-0000070300 02-12-2019 201900067338/074224 ZAIRA NADIA Riyanti Puji dr. OT00142 Trilac 4mg 5.00 Tablet 5,200.00 26,500.00
R2019-0000070300 02-12-2019 201900067338/074224 ZAIRA NADIA Riyanti Puji dr. OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000070300 02-12-2019 201900067338/074224 ZAIRA NADIA Riyanti Puji dr. ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000070301 02-12-2019 201900067363/111565 NI WAYAN KESA ADE RAHMAH OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000070301 02-12-2019 201900067363/111565 NI WAYAN KESA ADE RAHMAH OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000070301 02-12-2019 201900067363/111565 NI WAYAN KESA ADE RAHMAH OB00007 Becom - C 3.00 Tablet 2,123.55 6,870.65
R2019-0000070302 02-12-2019 201900067364/107122 AZRIL ALFARIQ,AN ADE RAHMAH OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000070302 02-12-2019 201900067364/107122 AZRIL ALFARIQ,AN ADE RAHMAH OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000070280 02-12-2019 201900067274/056272 SAYYID AHMAD JAKY Hendra Dr, Sp. OE00007 Elkana Syrup 1.00 Botol 34,303.50 34,803.50
R2019-0000070305 02-12-2019 201900067237/111350 ADZANAYAH FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 2.00 Capsul 4,266.70 9,033.40
R2019-0000070305 02-12-2019 201900067237/111350 ADZANAYAH FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 2.00 Tablet 208.00 916.00
R2019-0000070305 02-12-2019 201900067237/111350 ADZANAYAH FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 2.00 Tablet 1,173.15 2,846.30
R2019-0000070305 02-12-2019 201900067237/111350 ADZANAYAH FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000070305 02-12-2019 201900067237/111350 ADZANAYAH FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000070305 02-12-2019 201900067237/111350 ADZANAYAH FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000070306 02-12-2019 201900067309/044797 MU'MIN,NY Ismail dr. Msc. OM00044 Methyl Prednisolon 16mg 15.00 Tablet 2,632.50 39,987.50
Total 14,291,663.09
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 15 dari 266
ASAL RAWAT JALAN
R2019-0000070306 02-12-2019 201900067309/044797 MU'MIN,NY Ismail dr. Msc. OG00057 Gabapentin 300mg (OGB) 30.00 Tablet 8,168.00 245,540.00
R2019-0000070306 02-12-2019 201900067309/044797 MU'MIN,NY Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000070306 02-12-2019 201900067309/044797 MU'MIN,NY Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000070306 02-12-2019 201900067309/044797 MU'MIN,NY Ismail dr. Msc. OG00066 Genoint Salep Kulit 2.00 Tube 7,350.75 15,201.50
R2019-0000070306 02-12-2019 201900067309/044797 MU'MIN,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000070307 02-12-2019 201900067312/111553 ADENA ZAHRA Ismail dr. Msc. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000070307 02-12-2019 201900067312/111553 ADENA ZAHRA Ismail dr. Msc. OA00027 Albendazole 400mg 5.00 Tablet 625.05 3,625.25
R2019-0000070307 02-12-2019 201900067312/111553 ADENA ZAHRA Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 5,049.00 5,549.00
R2019-0000070307 02-12-2019 201900067312/111553 ADENA ZAHRA Ismail dr. Msc. OA00027 Albendazole 400mg 2.00 Tablet 625.05 1,750.10
R2019-0000070307 02-12-2019 201900067312/111553 ADENA ZAHRA Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000070307 02-12-2019 201900067312/111553 ADENA ZAHRA Ismail dr. Msc. OH00026 Hydrocortis on Cream 1.00 Tube 11,880.00 12,380.00
R2019-0000070307 02-12-2019 201900067312/111553 ADENA ZAHRA Ismail dr. Msc. OK00022 Ketoconazol Cream 2% 1.00 Tube 11,000.00 11,500.00
R2019-0000070307 02-12-2019 201900067312/111553 ADENA ZAHRA Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000070308 02-12-2019 201900067299/034799 GATOT HERI Hendra Dr, Sp. OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000070308 02-12-2019 201900067299/034799 GATOT HERI Hendra Dr, Sp. OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000070311 02-12-2019 201900067350/111562 KINAR ASSYIFA ADE RAHMAH OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000070311 02-12-2019 201900067350/111562 KINAR ASSYIFA ADE RAHMAH OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000070309 02-12-2019 201900067337/098554 HIKMATUL ADE RAHMAH OC00060 Cetirizine 10mg (OGB) 6.00 Tablet 623.70 4,242.20
R2019-0000070309 02-12-2019 201900067337/098554 HIKMATUL ADE RAHMAH OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000070310 02-12-2019 201900067219/078939 TINI SUKARTINI,NY Hendra Dr, Sp. OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000070310 02-12-2019 201900067219/078939 TINI SUKARTINI,NY Hendra Dr, Sp. OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000070310 02-12-2019 201900067219/078939 TINI SUKARTINI,NY Hendra Dr, Sp. OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000070313 02-12-2019 201900067314/097928 EKWAN PUTRA HASDI ADE RAHMAH ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000070313 02-12-2019 201900067314/097928 EKWAN PUTRA HASDI ADE RAHMAH OI00050 Infus Otsu-NS (NaCl 1.00 Botol 22,542.30 23,042.30
R2019-0000070313 02-12-2019 201900067314/097928 EKWAN PUTRA HASDI ADE RAHMAH ON00039 Neurosanbe Injeksi 1.00 Ampul 8,122.95 8,622.95
R2019-0000070313 02-12-2019 201900067314/097928 EKWAN PUTRA HASDI ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070314 02-12-2019 201900067317/110951 KHARISMA PUTRI ADE RAHMAH ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000070314 02-12-2019 201900067317/110951 KHARISMA PUTRI ADE RAHMAH OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000070314 02-12-2019 201900067317/110951 KHARISMA PUTRI ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000070316 02-12-2019 201900067297/029087 FATIMA SYAM,HJ ADE RAHMAH OC00019 Captopril 25mg (OGB) 1.00 Tablet 267.35 767.35
R2019-0000070316 02-12-2019 201900067297/029087 FATIMA SYAM,HJ ADE RAHMAH OI00051 Infus Otsu-NS (NaCl 1.00 Botol 9,388.17 9,888.17
R2019-0000070316 02-12-2019 201900067297/029087 FATIMA SYAM,HJ ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 2.00 Ampul 15,365.00 31,230.00
R2019-0000070316 02-12-2019 201900067297/029087 FATIMA SYAM,HJ ADE RAHMAH OP00136 Pulmicort Respules 2.00 Ampul 33,802.98 68,105.96
R2019-0000070316 02-12-2019 201900067297/029087 FATIMA SYAM,HJ ADE RAHMAH OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000070316 02-12-2019 201900067297/029087 FATIMA SYAM,HJ ADE RAHMAH ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000070316 02-12-2019 201900067297/029087 FATIMA SYAM,HJ ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070315 02-12-2019 201900067326/105200 MAHARANI DWI ADE RAHMAH OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000070318 02-12-2019 201900067344/111560 ABDUL RAUF,TN ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
Total 15,264,294.18
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 16 dari 266
ASAL RAWAT JALAN
R2019-0000070317 02-12-2019 201900067337/098554 HIKMATUL ADE RAHMAH ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000070317 02-12-2019 201900067337/098554 HIKMATUL ADE RAHMAH ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000070317 02-12-2019 201900067337/098554 HIKMATUL ADE RAHMAH OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000070317 02-12-2019 201900067337/098554 HIKMATUL ADE RAHMAH OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000070321 02-12-2019 201900067351/096438 AGNES AWALIYAH ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000070320 02-12-2019 201900067362/111564 TIARA PUTRI ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000070322 02-12-2019 201900067363/111565 NI WAYAN KESA ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000070325 02-12-2019 201900067370/092538 MAULIDAH TSABITA ADE RAHMAH OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000070326 02-12-2019 201900067369/111567 YOGI NUGRAHA,SDR ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000070328 02-12-2019 201900067633/104328 RAMADHANIA,NY ADE RAHMAH OE00055 Ecosol RL 500ml 2.00 Botol 19,305.00 39,110.00
R2019-0000070328 02-12-2019 201900067633/104328 RAMADHANIA,NY ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070328 02-12-2019 201900067633/104328 RAMADHANIA,NY ADE RAHMAH ALB00132 Blood Set 1.00 Pcs 33,976.80 34,476.80
R2019-0000070328 02-12-2019 201900067633/104328 RAMADHANIA,NY ADE RAHMAH ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000070328 02-12-2019 201900067633/104328 RAMADHANIA,NY ADE RAHMAH OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000070330 02-12-2019 201900067330/071581 SAMSIAH,NY Maulin Nikmah OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000070330 02-12-2019 201900067330/071581 SAMSIAH,NY Maulin Nikmah OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000070330 02-12-2019 201900067330/071581 SAMSIAH,NY Maulin Nikmah OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000070330 02-12-2019 201900067330/071581 SAMSIAH,NY Maulin Nikmah OG00066 Genoint Salep Kulit 2.00 Tube 7,350.75 15,201.50
R2019-0000070330 02-12-2019 201900067330/071581 SAMSIAH,NY Maulin Nikmah ALP00029 Pot Salep, 30gr 1.00 4,000.00 4,500.00
R2019-0000070353 02-12-2019 201900067190/058334 RUDY LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 10.00 Tablet 2,525.00 25,750.00
R2019-0000070353 02-12-2019 201900067190/058334 RUDY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 20.00 Tablet 371.25 7,925.00
R2019-0000070353 02-12-2019 201900067190/058334 RUDY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000070353 02-12-2019 201900067190/058334 RUDY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 10.00 Tablet 7,425.00 74,750.00
R2019-0000070354 02-12-2019 201900067112/086565 ROMY DARMAWAN,TN LUSY E. Dr.Sp.PD OV00080 Vitamin B Compleks 10.00 Tablet 241.79 2,917.90
R2019-0000070351 02-12-2019 201900067160/111534 SUSILOWATI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000070351 02-12-2019 201900067160/111534 SUSILOWATI,NY LUSY E. Dr.Sp.PD OB00016 Betahistine Mesilat 6mg 15.00 Tablet 1,500.00 23,000.00
R2019-0000070355 02-12-2019 201900067109/111449 ARZELINGGA LUSY E. Dr.Sp.PD OC00134 Curcuma Tablet 20.00 Tablet 1,336.50 27,230.00
R2019-0000070355 02-12-2019 201900067109/111449 ARZELINGGA LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000070357 02-12-2019 201900067170/111305 RUDI SEJAHTERA,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000070357 02-12-2019 201900067170/111305 RUDI SEJAHTERA,TN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000070357 02-12-2019 201900067170/111305 RUDI SEJAHTERA,TN LUSY E. Dr.Sp.PD OM00143 Metoclopramide 10mg 20.00 Tablet 211.95 4,739.00
R2019-0000070356 02-12-2019 201900067104/076373 MUKMINAH,NY Dameria Sri OG00057 Gabapentin 300mg (OGB) 14.00 Tablet 8,168.00 114,852.00
R2019-0000070356 02-12-2019 201900067104/076373 MUKMINAH,NY Dameria Sri OK00002 Kalium Diklofenac 50mg 14.00 Tablet 1,100.00 15,900.00
R2019-0000070356 02-12-2019 201900067104/076373 MUKMINAH,NY Dameria Sri OG00073 Glucosamine 250 Mg 15.00 Tablet 1,633.50 25,002.50
R2019-0000070356 02-12-2019 201900067104/076373 MUKMINAH,NY Dameria Sri OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000070356 02-12-2019 201900067104/076373 MUKMINAH,NY Dameria Sri OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000070359 02-12-2019 201900067110/109676 ALI AFIFI,TN Dameria Sri OG00057 Gabapentin 300mg (OGB) 20.00 Tablet 8,168.00 163,860.00
R2019-0000070359 02-12-2019 201900067110/109676 ALI AFIFI,TN Dameria Sri OA00062 Amitriptyline Tablet, 4.00 Tablet 252.45 1,509.80
Total 16,236,497.75
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 17 dari 266
ASAL RAWAT JALAN
R2019-0000070359 02-12-2019 201900067110/109676 ALI AFIFI,TN Dameria Sri OT00063 Tramadol 50mg Tablet 4.00 Tablet 1,113.75 4,955.00
R2019-0000070358 02-12-2019 201900067096/097422 BAHARIN Dameria Sri OG00057 Gabapentin 300mg (OGB) 20.00 Tablet 8,168.00 163,860.00
R2019-0000070358 02-12-2019 201900067096/097422 BAHARIN Dameria Sri OM00154 Mecobalamin 500mg 20.00 Tablet 1,118.00 22,860.00
R2019-0000070358 02-12-2019 201900067096/097422 BAHARIN Dameria Sri OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000070360 02-12-2019 201900067113/110107 YANTI ANA Dameria Sri OK00002 Kalium Diklofenac 50mg 8.00 Tablet 1,100.00 9,300.00
R2019-0000070360 02-12-2019 201900067113/110107 YANTI ANA Dameria Sri OA00062 Amitriptyline Tablet, 4.00 Tablet 252.45 1,509.80
R2019-0000070360 02-12-2019 201900067113/110107 YANTI ANA Dameria Sri OE00057 Eperisone Hcl 50mg 10.00 Tablet 2,286.90 23,369.00
R2019-0000070360 02-12-2019 201900067113/110107 YANTI ANA Dameria Sri OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000070360 02-12-2019 201900067113/110107 YANTI ANA Dameria Sri OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000070361 02-12-2019 201900067116/107885 ERNAWATI,NY Dameria Sri OB00016 Betahistine Mesilat 6mg 20.00 Tablet 1,500.00 30,500.00
R2019-0000070361 02-12-2019 201900067116/107885 ERNAWATI,NY Dameria Sri OF00065 Flunarizine 5mg 14.00 Tablet 2,970.00 42,080.00
R2019-0000070361 02-12-2019 201900067116/107885 ERNAWATI,NY Dameria Sri OE00057 Eperisone Hcl 50mg 15.00 Tablet 2,286.90 34,803.50
R2019-0000070361 02-12-2019 201900067116/107885 ERNAWATI,NY Dameria Sri OA00062 Amitriptyline Tablet, 4.00 Tablet 252.45 1,509.80
R2019-0000070363 02-12-2019 201900067115/065468 TUMINAH,NY Dameria Sri OK00002 Kalium Diklofenac 50mg 10.00 Tablet 1,100.00 11,500.00
R2019-0000070363 02-12-2019 201900067115/065468 TUMINAH,NY Dameria Sri OG00057 Gabapentin 300mg (OGB) 5.00 Tablet 8,168.00 41,340.00
R2019-0000070363 02-12-2019 201900067115/065468 TUMINAH,NY Dameria Sri ALK00037 Kapsul No.1 14.00 pcs 200.00 10,300.00
R2019-0000070363 02-12-2019 201900067115/065468 TUMINAH,NY Dameria Sri OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000070363 02-12-2019 201900067115/065468 TUMINAH,NY Dameria Sri OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000070364 02-12-2019 201900067168/033580 DEDY MULYADI,SDR Dameria Sri OK00002 Kalium Diklofenac 50mg 14.00 Tablet 1,100.00 15,900.00
R2019-0000070364 02-12-2019 201900067168/033580 DEDY MULYADI,SDR Dameria Sri OE00057 Eperisone Hcl 50mg 20.00 Tablet 2,286.90 46,238.00
R2019-0000070366 02-12-2019 201900067241/048194 GHAZY AHMAD Herika dr. OD00077 Dumin Rectal 250mg 1.00 Tube 29,254.50 29,754.50
R2019-0000070365 02-12-2019 201900067229/015728 ANDI AGUS Herika dr. OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000070365 02-12-2019 201900067229/015728 ANDI AGUS Herika dr. OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000070367 02-12-2019 201900067252/12731 CINDY FITRIANI,NN Herika dr. OA00085 Antasida Tablet (OGB) 10.00 Tablet 284.30 3,343.00
R2019-0000070367 02-12-2019 201900067252/12731 CINDY FITRIANI,NN Herika dr. OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000070367 02-12-2019 201900067252/12731 CINDY FITRIANI,NN Herika dr. OP00184 Neo Protifed Tablet 6.00 Tablet 1,263.73 8,082.38
R2019-0000070368 02-12-2019 201900067199/111542 KIKI AMALIA TJAN,BY Herika dr. OM00097 Mucera Drop 1.00 Botol 54,945.00 55,445.00
R2019-0000070368 02-12-2019 201900067199/111542 KIKI AMALIA TJAN,BY Herika dr. OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2019-0000070370 02-12-2019 201900067172/39133 RILAWATI,NY Herika dr. OP00011 Paracetamol 500mg 1.00 Tablet 387.36 887.36
R2019-0000070370 02-12-2019 201900067172/39133 RILAWATI,NY Herika dr. OV00057 Ventolin Nebules 2.5mg 2.00 Ampul 15,365.00 31,230.00
R2019-0000070370 02-12-2019 201900067172/39133 RILAWATI,NY Herika dr. OP00136 Pulmicort Respules 2.00 Ampul 33,802.98 68,105.96
R2019-0000070369 02-12-2019 201900067121/102910 JULKIPLI,TN Herika dr. OL00063 Lidocain HCl 2% Injeksi 2.00 Ampul 2,376.00 5,252.00
R2019-0000070372 02-12-2019 201900067262/077213 JUMIAH,NY Herika dr. OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000070371 02-12-2019 201900067172/39133 RILAWATI,NY Herika dr. OA00058 Aminophylin Injeksi, 2.4% 1.00 Ampul 8,354.00 8,854.00
R2019-0000070371 02-12-2019 201900067172/39133 RILAWATI,NY Herika dr. OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000070371 02-12-2019 201900067172/39133 RILAWATI,NY Herika dr. ALN00002 Nasal Canule 1.00 Pcs 25,245.00 25,745.00
R2019-0000070371 02-12-2019 201900067172/39133 RILAWATI,NY Herika dr. ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000070371 02-12-2019 201900067172/39133 RILAWATI,NY Herika dr. ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
Total 17,312,808.83
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 18 dari 266
ASAL RAWAT JALAN
R2019-0000070371 02-12-2019 201900067172/39133 RILAWATI,NY Herika dr. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000070374 02-12-2019 201900068029/111499 HAFIZAH,AN Herika dr. OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000070374 02-12-2019 201900068029/111499 HAFIZAH,AN Herika dr. ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000070374 02-12-2019 201900068029/111499 HAFIZAH,AN Herika dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070374 02-12-2019 201900068029/111499 HAFIZAH,AN Herika dr. OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000070373 03-12-2019 201900067401/111573 JONATHAN PITER,SDR ADE RAHMAH OT00149 Toramine 10 Mg Tablet 10.00 Tablet 8,167.50 82,175.00
R2019-0000070373 03-12-2019 201900067401/111573 JONATHAN PITER,SDR ADE RAHMAH OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000070373 03-12-2019 201900067401/111573 JONATHAN PITER,SDR ADE RAHMAH OC00034 Cefadroxil 500mg (OGB) 10.00 1,633.50 16,835.00
R2019-0000070375 03-12-2019 201900067401/111573 JONATHAN PITER,SDR ADE RAHMAH OE00056 Ecosol Nacl 0,9 % 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000070376 02-12-2019 201900067199/111542 KIKI AMALIA TJAN,BY Herika dr. OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000070376 02-12-2019 201900067199/111542 KIKI AMALIA TJAN,BY Herika dr. OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000070377 02-12-2019 201900067229/015728 ANDI AGUS Herika dr. OA00125 ATS (Anti Tetanus 1.00 Ampul 222,750.00 223,250.00
R2019-0000070377 02-12-2019 201900067229/015728 ANDI AGUS Herika dr. OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000070378 03-12-2019 201900067405/111574 RICARD WILMAN ADE RAHMAH OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000070378 03-12-2019 201900067405/111574 RICARD WILMAN ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000070379 03-12-2019 201900067176/111043 UTAMI TAMBAH TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070327 02-12-2019 201900067141/051780 MUSRINI,NY TEDDY OC00290 Cendo LFX ED 5ml 1.00 Botol 102,836.25 103,336.25
R2019-0000070327 02-12-2019 201900067141/051780 MUSRINI,NY TEDDY OC00274 Cendo Noncort Minidose 1.00 Strip 62,741.00 63,241.00
R2019-0000070382 02-12-2019 201900067165/111536 SUKARTI,NY TEDDY OG00068 Glauseta Tablet 15.00 Tablet 6,563.70 98,955.50
R2019-0000070382 02-12-2019 201900067165/111536 SUKARTI,NY TEDDY OK00040 KSR Tablet 3.00 Tablet 3,883.17 12,149.51
R2019-0000070382 02-12-2019 201900067165/111536 SUKARTI,NY TEDDY OC00264 Cendo Timol 0.5% ED 1.00 Botol 70,908.75 71,408.75
R2019-0000070383 02-12-2019 201900067163/111535 DEWI TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070383 02-12-2019 201900067163/111535 DEWI TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070380 02-12-2019 201900067130/069459 MUHAMMAD TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070380 02-12-2019 201900067130/069459 MUHAMMAD TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070387 02-12-2019 201900067197/111541 ERWIN RAHMADI,TN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070388 02-12-2019 201900067111/075529 HAJJAH HARTATY,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070388 02-12-2019 201900067111/075529 HAJJAH HARTATY,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070386 02-12-2019 201900067284/110796 SURIANTO,TN TEDDY OC00264 Cendo Timol 0.5% ED 1.00 Botol 70,908.75 71,408.75
R2019-0000070390 02-12-2019 201900067119/078049 TATIK ASMANIYAH,NY TEDDY OC00290 Cendo LFX ED 5ml 1.00 Botol 102,836.25 103,336.25
R2019-0000070390 02-12-2019 201900067119/078049 TATIK ASMANIYAH,NY TEDDY OC00274 Cendo Noncort Minidose 1.00 Strip 62,741.00 63,241.00
R2019-0000070391 02-12-2019 201900067146/108772 ROCHANI AM,NY TEDDY OC00290 Cendo LFX ED 5ml 1.00 Botol 102,836.25 103,336.25
R2019-0000070391 02-12-2019 201900067146/108772 ROCHANI AM,NY TEDDY OC00274 Cendo Noncort Minidose 1.00 Strip 62,741.00 63,241.00
R2019-0000070389 02-12-2019 201900067162/063468 MARLIYANTI,NY Nafon Zaitun, Dr. ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000070392 02-12-2019 201900067167/058797 HASRIANI,NY Nafon Zaitun, Dr. OA00106 Asam Mefenamat 500mg 20.00 Tablet 415.80 8,816.00
R2019-0000070392 02-12-2019 201900067167/058797 HASRIANI,NY Nafon Zaitun, Dr. OL00108 Lexatrans 500mg 20.00 Tablet 1,871.00 37,920.00
R2019-0000070393 02-12-2019 201900067180/110942 NUR AINI,NY Nafon Zaitun, Dr. OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000070394 02-12-2019 201900067184/098554 HIKMATUL Nafon Zaitun, Dr. OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
Total 18,945,527.72
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 19 dari 266
ASAL RAWAT JALAN
R2019-0000070394 02-12-2019 201900067184/098554 HIKMATUL Nafon Zaitun, Dr. OL00108 Lexatrans 500mg 10.00 Tablet 1,871.00 19,210.00
R2019-0000070395 02-12-2019 201900067370/092538 MAULIDAH TSABITA ADE RAHMAH OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000070395 02-12-2019 201900067370/092538 MAULIDAH TSABITA ADE RAHMAH OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000070395 02-12-2019 201900067370/092538 MAULIDAH TSABITA ADE RAHMAH OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000070396 02-12-2019 201900067372/096877 ADEEB FAYYADH ADE RAHMAH OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000070396 02-12-2019 201900067372/096877 ADEEB FAYYADH ADE RAHMAH OC00132 CTM 4mg 5.00 Tablet 157.41 1,287.05
R2019-0000070396 02-12-2019 201900067372/096877 ADEEB FAYYADH ADE RAHMAH OS00010 Salbutamol 4mg (OGB) 5.00 Tablet 249.48 1,747.40
R2019-0000070396 02-12-2019 201900067372/096877 ADEEB FAYYADH ADE RAHMAH OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
R2019-0000070396 02-12-2019 201900067372/096877 ADEEB FAYYADH ADE RAHMAH ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000070396 02-12-2019 201900067372/096877 ADEEB FAYYADH ADE RAHMAH OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000070397 02-12-2019 201900067381/099528 LA ROI,TN ADE RAHMAH OB001002 Betahistine 5.00 Tab 5,940.00 30,200.00
R2019-0000070397 02-12-2019 201900067381/099528 LA ROI,TN ADE RAHMAH OF00148 Flunarizine 10mg (OGB) 5.00 Tablet 5,940.00 30,200.00
R2019-0000070397 02-12-2019 201900067381/099528 LA ROI,TN ADE RAHMAH OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000070398 03-12-2019 201900067390/111570 ALVIN AMBAR ADE RAHMAH OU00022 Urotractin 400mg Tablet 6.00 Tablet 7,189.03 43,634.18
R2019-0000070398 03-12-2019 201900067390/111570 ALVIN AMBAR ADE RAHMAH OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000070398 03-12-2019 201900067390/111570 ALVIN AMBAR ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000070399 03-12-2019 201900067396/111571 MIRANDA M.W,AN ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000070399 03-12-2019 201900067396/111571 MIRANDA M.W,AN ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000070399 03-12-2019 201900067396/111571 MIRANDA M.W,AN ADE RAHMAH OA00085 Antasida Tablet (OGB) 5.00 Tablet 284.30 1,921.50
R2019-0000070399 03-12-2019 201900067396/111571 MIRANDA M.W,AN ADE RAHMAH OO00074 Ondansetron Tablet, 4mg 5.00 Tablet 4,455.00 22,775.00
R2019-0000070403 02-12-2019 201900067372/096877 ADEEB FAYYADH ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000070403 02-12-2019 201900067372/096877 ADEEB FAYYADH ADE RAHMAH OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000070404 03-12-2019 201900067409/107683 DAMRAH,NY ADE RAHMAH OL00076 Lodia 2mg 6.00 Tablet 1,485.00 9,410.00
R2019-0000070404 03-12-2019 201900067409/107683 DAMRAH,NY ADE RAHMAH OS00176 Scopma Plus Tablet 5.00 Tablet 2,090.22 10,951.10
R2019-0000070404 03-12-2019 201900067409/107683 DAMRAH,NY ADE RAHMAH OA00085 Antasida Tablet (OGB) 5.00 Tablet 284.30 1,921.50
R2019-0000070404 03-12-2019 201900067409/107683 DAMRAH,NY ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000070405 03-12-2019 201900067376/039886 MOCH ISLA ALVAREZ ADE RAHMAH OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000070410 03-12-2019 201900067396/111571 MIRANDA M.W,AN ADE RAHMAH OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000070410 03-12-2019 201900067396/111571 MIRANDA M.W,AN ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000070410 03-12-2019 201900067396/111571 MIRANDA M.W,AN ADE RAHMAH ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000070412 02-12-2019 201900067381/099528 LA ROI,TN ADE RAHMAH OB001002 Betahistine 1.00 Tab 5,940.00 6,440.00
R2019-0000070414 03-12-2019 201900067409/107683 DAMRAH,NY ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000070411 03-12-2019 201900067408/107122 AZRIL ALFARIQ,AN ADE RAHMAH OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000070415 03-12-2019 201900067390/111570 ALVIN AMBAR ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000070442 03-12-2019 201900067454/096624 ERMA AFRIANI Herika dr. OM00017 Meloxicam 15mg (OGB) 6.00 Tablet 2,079.00 12,974.00
R2019-0000070442 03-12-2019 201900067454/096624 ERMA AFRIANI Herika dr. OV00080 Vitamin B Compleks 4.00 Tablet 241.79 1,467.16
R2019-0000070442 03-12-2019 201900067454/096624 ERMA AFRIANI Herika dr. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000070441 03-12-2019 201900067430/095446 SYAHIDA AISYAH Herika dr. OM00097 Mucera Drop 1.00 Botol 54,945.00 55,445.00
Total 19,651,863.24
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 20 dari 266
ASAL RAWAT JALAN
R2019-0000070441 03-12-2019 201900067430/095446 SYAHIDA AISYAH Herika dr. OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2019-0000070441 03-12-2019 201900067430/095446 SYAHIDA AISYAH Herika dr. OB00091 Biovitan Syrup, 60ml 1.00 Botol 8,019.00 8,519.00
R2019-0000070447 03-12-2019 201900067455/041896 JIAH SEPTIAWATI,NN ROY , Dr.Sp.OG OF00090 Fucilex Cream, 5gr 1.00 Tube 14,850.00 15,350.00
R2019-0000070450 03-12-2019 201900067471/111578 HERU AKHMAD,TN SEPTIA NOVITA OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000070450 03-12-2019 201900067471/111578 HERU AKHMAD,TN SEPTIA NOVITA OV00107 Vosedon Tablet 6.00 Tablet 3,452.63 21,215.78
R2019-0000070450 03-12-2019 201900067471/111578 HERU AKHMAD,TN SEPTIA NOVITA OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000070450 03-12-2019 201900067471/111578 HERU AKHMAD,TN SEPTIA NOVITA OI00134 Imunos Plus Tablet 4.00 Tablet 14,107.50 56,930.00
R2019-0000070452 03-12-2019 201900067473/19679 HASAN,TN SEPTIA NOVITA OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000070452 03-12-2019 201900067473/19679 HASAN,TN SEPTIA NOVITA OS00026 Sanmag Syrup 1.00 Botol 37,125.00 37,625.00
R2019-0000070452 03-12-2019 201900067473/19679 HASAN,TN SEPTIA NOVITA OI00134 Imunos Plus Tablet 4.00 Tablet 14,107.50 56,930.00
R2019-0000070453 03-12-2019 201900067498/109500 MUHAMMAD UMAR SEPTIA NOVITA OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000070453 03-12-2019 201900067498/109500 MUHAMMAD UMAR SEPTIA NOVITA ON00047 New Diatabs 10.00 Tablet 767.13 8,171.30
R2019-0000070453 03-12-2019 201900067498/109500 MUHAMMAD UMAR SEPTIA NOVITA OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000070454 03-12-2019 201900067496/042645 DEWI MAGDA ROSSA, OM00052 Metronidazole 500mg 10.00 Tablet 525.39 5,753.90
R2019-0000070454 03-12-2019 201900067496/042645 DEWI MAGDA ROSSA, OS00027 Sanmag Tablet 10.00 Tablet 1,321.65 13,716.50
R2019-0000070455 03-12-2019 201900067507/096075 SETYA NINGSIH,NY SEPTIA NOVITA OC00144 Cefila Capsul, 100mg 10.00 Capsul 28,957.00 290,070.00
R2019-0000070455 03-12-2019 201900067507/096075 SETYA NINGSIH,NY SEPTIA NOVITA OC00057 Cerini 5.00 Tablet 5,093.55 25,967.75
R2019-0000070455 03-12-2019 201900067507/096075 SETYA NINGSIH,NY SEPTIA NOVITA OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000070458 03-12-2019 201900067526/111589 DEMSI GANI Herika dr. OA00085 Antasida Tablet (OGB) 6.00 Tablet 284.30 2,205.80
R2019-0000070458 03-12-2019 201900067526/111589 DEMSI GANI Herika dr. OI00001 Ibuprofen 400mg (OGB) 6.00 Tablet 682.00 4,592.00
R2019-0000070460 03-12-2019 201900067484/111581 FRANSIN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070460 03-12-2019 201900067484/111581 FRANSIN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070464 03-12-2019 201900067489/111058 RESNANDA RADIAN,NY EDO, Dr.Sp.B OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000070464 03-12-2019 201900067489/111058 RESNANDA RADIAN,NY EDO, Dr.Sp.B OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000070461 03-12-2019 201900067468/083042 ZAINAL ABIDIN,TN TEDDY OG00057 Gabapentin 300mg (OGB) 10.00 Tablet 8,168.00 82,180.00
R2019-0000070461 03-12-2019 201900067468/083042 ZAINAL ABIDIN,TN TEDDY ATKK031 Kertas Puyer Handbond 20.00 Sachet 207.90 11,658.00
R2019-0000070461 03-12-2019 201900067468/083042 ZAINAL ABIDIN,TN TEDDY OM00154 Mecobalamin 500mg 15.00 Tablet 1,118.00 17,270.00
R2019-0000070467 03-12-2019 201900067442/102359 HALIMAH,NY Dameria Sri OG00057 Gabapentin 300mg (OGB) 7.00 Tablet 8,168.00 57,676.00
R2019-0000070467 03-12-2019 201900067442/102359 HALIMAH,NY Dameria Sri OC00017 Kapsul No. 00 14.00 Capsul 200.00 10,300.00
R2019-0000070467 03-12-2019 201900067442/102359 HALIMAH,NY Dameria Sri ON00009 Natrium Diklofenac 50mg 10.00 Tablet 955.84 10,058.40
R2019-0000070467 03-12-2019 201900067442/102359 HALIMAH,NY Dameria Sri OM00154 Mecobalamin 500mg 14.00 Tablet 1,118.00 16,152.00
R2019-0000070472 03-12-2019 201900067511/110852 HAFSHOH,AN FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 4.00 Capsul 28,957.00 116,328.00
R2019-0000070472 03-12-2019 201900067511/110852 HAFSHOH,AN FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 3.00 Tablet 430.65 1,791.95
R2019-0000070472 03-12-2019 201900067511/110852 HAFSHOH,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000070472 03-12-2019 201900067511/110852 HAFSHOH,AN FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 3.00 Tablet 1,232.55 4,197.65
R2019-0000070472 03-12-2019 201900067511/110852 HAFSHOH,AN FREDRIK, Dr,Sp.A OI00077 Inolin Tablet 2.00 Tablet 1,900.00 4,300.00
R2019-0000070472 03-12-2019 201900067511/110852 HAFSHOH,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000070472 03-12-2019 201900067511/110852 HAFSHOH,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 200.20 23,003.00
Total 20,775,353.83
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 21 dari 266
ASAL RAWAT JALAN
R2019-0000070472 03-12-2019 201900067511/110852 HAFSHOH,AN FREDRIK, Dr,Sp.A OA00093 Apialys Drop 1.00 Botol 59,400.00 59,900.00
R2019-0000070474 03-12-2019 201900067558/097041 MULYANI,TN Herika dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000070474 03-12-2019 201900067558/097041 MULYANI,TN Herika dr. OB00007 Becom - C 10.00 Tablet 2,123.55 21,735.50
R2019-0000070474 03-12-2019 201900067558/097041 MULYANI,TN Herika dr. OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000070473 03-12-2019 201900067514/052869 SALSABILA AULYA FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 5.00 Capsul 28,957.00 145,285.00
R2019-0000070473 03-12-2019 201900067514/052869 SALSABILA AULYA FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 4.00 Tablet 430.65 2,222.60
R2019-0000070473 03-12-2019 201900067514/052869 SALSABILA AULYA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000070473 03-12-2019 201900067514/052869 SALSABILA AULYA FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 4.00 Tablet 1,232.55 5,430.20
R2019-0000070473 03-12-2019 201900067514/052869 SALSABILA AULYA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000070473 03-12-2019 201900067514/052869 SALSABILA AULYA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 23,118.50
R2019-0000070476 03-12-2019 201900067516/111587 DEY JILLIAN FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 5.00 Capsul 28,957.00 145,285.00
R2019-0000070476 03-12-2019 201900067516/111587 DEY JILLIAN FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 4.00 Tablet 430.65 2,222.60
R2019-0000070476 03-12-2019 201900067516/111587 DEY JILLIAN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000070476 03-12-2019 201900067516/111587 DEY JILLIAN FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 4.00 Tablet 1,232.55 5,430.20
R2019-0000070476 03-12-2019 201900067516/111587 DEY JILLIAN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000070476 03-12-2019 201900067516/111587 DEY JILLIAN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000070479 03-12-2019 201900067553/086828 TARA FLAVIA FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 5.00 Capsul 28,957.00 145,285.00
R2019-0000070479 03-12-2019 201900067553/086828 TARA FLAVIA FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 4.00 Tablet 430.65 2,222.60
R2019-0000070479 03-12-2019 201900067553/086828 TARA FLAVIA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000070479 03-12-2019 201900067553/086828 TARA FLAVIA FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 4.00 Tablet 1,232.55 5,430.20
R2019-0000070479 03-12-2019 201900067553/086828 TARA FLAVIA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000070479 03-12-2019 201900067553/086828 TARA FLAVIA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000070485 03-12-2019 201900067565/39082 MARWIAH,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 30.00 Tablet 445.50 13,865.00
R2019-0000070485 03-12-2019 201900067565/39082 MARWIAH,NY LUSY E. Dr.Sp.PD OA00140 Atorvastatin 20mg (OGB) 15.00 Tablet 6,534.00 98,510.00
R2019-0000070485 03-12-2019 201900067565/39082 MARWIAH,NY LUSY E. Dr.Sp.PD OA00001 AB - Vask 10mg 30.00 Tablet 14,850.00 446,000.00
R2019-0000070485 03-12-2019 201900067565/39082 MARWIAH,NY LUSY E. Dr.Sp.PD OC00045 Celebrex 100mg 30.00 Tablet 15,295.79 459,373.70
R2019-0000070485 03-12-2019 201900067565/39082 MARWIAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 30.00 Tablet 10,617.75 319,032.50
R2019-0000070485 03-12-2019 201900067565/39082 MARWIAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 15.00 Tablet 5,197.50 78,462.50
R2019-0000070485 03-12-2019 201900067565/39082 MARWIAH,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 30.00 Tablet 240.30 7,709.00
R2019-0000070485 03-12-2019 201900067565/39082 MARWIAH,NY LUSY E. Dr.Sp.PD OK00022 Ketoconazol Cream 2% 2.00 Tube 11,000.00 22,500.00
R2019-0000070483 03-12-2019 201900067513/111586 ILHAM DWI SEPTYA Ismail dr. Msc. OD00072 Doxyciclyn 100mg (OGB) 30.00 Tablet 650.00 20,000.00
R2019-0000070502 03-12-2019 201900067557/070034 ARFA YANI Ismail dr. Msc. ON00101 Noroid Lotion 1.00 Box 212,355.00 212,855.00
R2019-0000070502 03-12-2019 201900067557/070034 ARFA YANI Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 965.25 19,805.00
R2019-0000070502 03-12-2019 201900067557/070034 ARFA YANI Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000070502 03-12-2019 201900067557/070034 ARFA YANI Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000070502 03-12-2019 201900067557/070034 ARFA YANI Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 19,000.00
R2019-0000070510 03-12-2019 201900067557/070034 ARFA YANI Ismail dr. Msc. OK00050 Kloderma Ointment, 10gr 2.00 Tube 60,580.00 121,660.00
R2019-0000070512 03-12-2019 201900067559/069956 SURATI,NY Ismail dr. Msc. OL00080 Loratadin 10mg (OGB) 20.00 Tablet 520.00 10,900.00
Total 23,296,997.28
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 22 dari 266
ASAL RAWAT JALAN
R2019-0000070512 03-12-2019 201900067559/069956 SURATI,NY Ismail dr. Msc. OZ00005 Zinc Tablet (OGB) 20.00 Tablet 1,000.00 20,500.00
R2019-0000070505 03-12-2019 201900067601/055482 FITRALIANY DR. BISMA SP OB00068 BioCal-95 30.00 Tablet 7,128.00 214,340.00
R2019-0000070521 03-12-2019 201900067603/111547 RISDA HAULIANA DR. BISMA SP OF00099 Folda Tablet 30.00 Tablet 6,661.65 200,349.50
R2019-0000070521 03-12-2019 201900067603/111547 RISDA HAULIANA DR. BISMA SP OU00008 Utrogestan 100mg 30.00 Capsul 17,820.00 535,100.00
R2019-0000070525 03-12-2019 201900067604/078665 HANA RIA FITRI,NY DR. BISMA SP OB00068 BioCal-95 15.00 Tablet 7,128.00 107,420.00
R2019-0000070525 03-12-2019 201900067604/078665 HANA RIA FITRI,NY DR. BISMA SP OH0046 Hb-Vit Tablet 15.00 tablet 5,197.50 78,462.50
R2019-0000070526 03-12-2019 201900067619/027177 RAHYUNI RAHMAN,NY DR. BISMA SP OS00026 Sanmag Syrup 2.00 Botol 37,125.00 74,750.00
R2019-0000070526 03-12-2019 201900067619/027177 RAHYUNI RAHMAN,NY DR. BISMA SP OB00068 BioCal-95 15.00 Tablet 7,128.00 107,420.00
R2019-0000070526 03-12-2019 201900067619/027177 RAHYUNI RAHMAN,NY DR. BISMA SP OH0046 Hb-Vit Tablet 15.00 tablet 5,197.50 78,462.50
R2019-0000070526 03-12-2019 201900067619/027177 RAHYUNI RAHMAN,NY DR. BISMA SP OF00099 Folda Tablet 15.00 Tablet 6,661.65 100,424.75
R2019-0000070529 03-12-2019 201900067617/111599 ARKAN ALTAF PUTRA Niki Juniar OC00038 Cefila Dry Syrup 1.00 Botol 123,255.00 123,755.00
R2019-0000070529 03-12-2019 201900067617/111599 ARKAN ALTAF PUTRA Niki Juniar OB00058 Bufect Suspensi, 60ml 1.00 Botol 21,681.00 22,181.00
R2019-0000070529 03-12-2019 201900067617/111599 ARKAN ALTAF PUTRA Niki Juniar OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000070529 03-12-2019 201900067617/111599 ARKAN ALTAF PUTRA Niki Juniar OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000070531 03-12-2019 201900067618/111600 SRI Niki Juniar OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000070531 03-12-2019 201900067618/111600 SRI Niki Juniar OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000070531 03-12-2019 201900067618/111600 SRI Niki Juniar OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000070532 03-12-2019 201900067611/111490 YENI AGUSTINA,NY DR. BISMA SP OU00008 Utrogestan 100mg 30.00 Capsul 17,820.00 535,100.00
R2019-0000070532 03-12-2019 201900067611/111490 YENI AGUSTINA,NY DR. BISMA SP OF00099 Folda Tablet 30.00 Tablet 6,661.65 200,349.50
R2019-0000070534 03-12-2019 201900067616/080259 ASWINA Niki Juniar OS00029 Sanmol Tablet, 500mg 6.00 Tablet 430.65 3,083.90
R2019-0000070534 03-12-2019 201900067616/080259 ASWINA Niki Juniar OV00107 Vosedon Tablet 6.00 Tablet 3,452.63 21,215.78
R2019-0000070537 03-12-2019 201900067639/111603 ALFIN,AN Niki Juniar OI00117 Imunos Plus Syrup, 60ml 1.00 Botol 136,620.00 137,120.00
R2019-0000070537 03-12-2019 201900067639/111603 ALFIN,AN Niki Juniar OC00291 Cerini Syrup 1.00 Botol 59,103.00 59,603.00
R2019-0000070537 03-12-2019 201900067639/111603 ALFIN,AN Niki Juniar OM00099 Mucera Syrup 1.00 Botol 34,155.00 34,655.00
R2019-0000070537 03-12-2019 201900067639/111603 ALFIN,AN Niki Juniar OC00038 Cefila Dry Syrup 1.00 Botol 123,255.00 123,755.00
R2019-0000070538 03-12-2019 201900067625/111602 ISNOMURTI,TN Niki Juniar OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000070538 03-12-2019 201900067625/111602 ISNOMURTI,TN Niki Juniar OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000070539 03-12-2019 201900067625/111602 ISNOMURTI,TN Niki Juniar OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000070542 03-12-2019 201900067642/109924 AISHADARA HAVVA Riyanti Puji dr. OP00074 Pralax Syrup, 100ml 1.00 Botol 103,950.00 104,450.00
R2019-0000070542 03-12-2019 201900067642/109924 AISHADARA HAVVA Riyanti Puji dr. OL00001 L - BIO Sachet 5.00 Sachet 10,395.00 52,475.00
R2019-0000070541 03-12-2019 201900067643/098254 SITI ZASIYAH,NY Niki Juniar OC00060 Cetirizine 10mg (OGB) 4.00 Tablet 623.70 2,994.80
R2019-0000070541 03-12-2019 201900067643/098254 SITI ZASIYAH,NY Niki Juniar OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000070544 03-12-2019 201900067624/107237 MERRIANI Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000070544 03-12-2019 201900067624/107237 MERRIANI Niki Juniar OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000070544 03-12-2019 201900067624/107237 MERRIANI Niki Juniar OL00076 Lodia 2mg 3.00 Tablet 1,485.00 4,955.00
R2019-0000070545 03-12-2019 201900067560/107429 SARI WAHYUNI, ST,NY Angie Renatha , OK00022 Ketoconazol Cream 2% 1.00 Tube 11,000.00 11,500.00
R2019-0000070545 03-12-2019 201900067560/107429 SARI WAHYUNI, ST,NY Angie Renatha , OK00023 Ketoconazole 200mg 10.00 Tablet 774.24 8,242.40
R2019-0000070546 03-12-2019 201900067561/111486 MAURA ATHALIA,AN Angie Renatha , OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
Total 26,431,793.58
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 23 dari 266
ASAL RAWAT JALAN
R2019-0000070546 03-12-2019 201900067561/111486 MAURA ATHALIA,AN Angie Renatha , OH0045 Hexadol Solution 60 Ml 1.00 Botol 18,562.50 19,062.50
R2019-0000070546 03-12-2019 201900067561/111486 MAURA ATHALIA,AN Angie Renatha , OD00031 Dexamethasone Tablet 15.00 Tablet 208.00 3,620.00
R2019-0000070547 03-12-2019 201900067539/100144 ABILA PUTRI Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000070547 03-12-2019 201900067539/100144 ABILA PUTRI Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000070547 03-12-2019 201900067539/100144 ABILA PUTRI Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000070547 03-12-2019 201900067539/100144 ABILA PUTRI Ismail dr. Msc. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000070548 03-12-2019 201900067593/048983 DEDI JHONNER Niki Juniar OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000070548 03-12-2019 201900067593/048983 DEDI JHONNER Niki Juniar OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
R2019-0000070548 03-12-2019 201900067593/048983 DEDI JHONNER Niki Juniar OC00060 Cetirizine 10mg (OGB) 2.00 Tablet 623.70 1,747.40
R2019-0000070550 03-12-2019 201900067469/097743 HARTONO,TN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070550 03-12-2019 201900067469/097743 HARTONO,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070552 03-12-2019 201900067594/078048 NOR JANNAH,NY Niki Juniar OS00176 Scopma Plus Tablet 3.00 Tablet 2,090.22 6,770.66
R2019-0000070552 03-12-2019 201900067594/078048 NOR JANNAH,NY Niki Juniar OO00014 Omeprazole 20mg (OGB) 3.00 Capsul 1,169.98 4,009.94
R2019-0000070552 03-12-2019 201900067594/078048 NOR JANNAH,NY Niki Juniar OP00011 Paracetamol 500mg 4.00 Tablet 387.36 2,049.44
R2019-0000070554 03-12-2019 201900067579/087733 RULYANA,NY Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000070554 03-12-2019 201900067579/087733 RULYANA,NY Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000070554 03-12-2019 201900067579/087733 RULYANA,NY Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000070554 03-12-2019 201900067579/087733 RULYANA,NY Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000070554 03-12-2019 201900067579/087733 RULYANA,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000070557 02-12-2019 201900066667/111458 NURLIANSYAH,TN Hendra Dr, Sp. OC00091 Clonidin 0.15mg (OGB) 1.00 Tablet 359.37 859.37
R2019-0000070555 03-12-2019 201900067640/049188 MUHAMMAD HASBI,AN Ismail dr. Msc. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000070555 03-12-2019 201900067640/049188 MUHAMMAD HASBI,AN Ismail dr. Msc. OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000070555 03-12-2019 201900067640/049188 MUHAMMAD HASBI,AN Ismail dr. Msc. OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000070558 03-12-2019 201800059461/095683 AGUNG BO RO Maulin Nikmah OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000070558 03-12-2019 201800059461/095683 AGUNG BO RO Maulin Nikmah OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000070558 03-12-2019 201800059461/095683 AGUNG BO RO Maulin Nikmah OO00014 Omeprazole 20mg (OGB) 3.00 Capsul 1,169.98 4,009.94
R2019-0000070559 03-12-2019 201900067589/022837 WARSITA,TN Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000070559 03-12-2019 201900067589/022837 WARSITA,TN Niki Juniar OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000070559 03-12-2019 201900067589/022837 WARSITA,TN Niki Juniar OB00007 Becom - C 3.00 Tablet 2,123.55 6,870.65
R2019-0000070560 03-12-2019 201900067470/061368 SUKARNI,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070560 03-12-2019 201900067470/061368 SUKARNI,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070562 03-12-2019 201900067647/108360 FITRIANSYAH,TN Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000070562 03-12-2019 201900067647/108360 FITRIANSYAH,TN Niki Juniar OB00050 Braxidin 6.00 Tablet 1,648.35 10,390.10
R2019-0000070562 03-12-2019 201900067647/108360 FITRIANSYAH,TN Niki Juniar OD00065 Domperidon Tablet (OGB) 4.00 Tablet 750.00 3,500.00
R2019-0000070563 03-12-2019 201900067651/032573 MUHAMMAD Niki Juniar OC00153 Cendo Gentamicin 0.3% 1.00 Tube 54,016.87 54,516.87
R2019-0000070563 03-12-2019 201900067651/032573 MUHAMMAD Niki Juniar OI00128 Ibuprofen Syrup, 60ml 1.00 Botol 8,497.17 8,997.17
R2019-0000070563 03-12-2019 201900067651/032573 MUHAMMAD Niki Juniar OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000070564 03-12-2019 201900067646/086416 YOHANIS RAGA,TN Niki Juniar OG00057 Gabapentin 300mg (OGB) 6.00 Tablet 8,168.00 49,508.00
Total 26,912,277.07
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 24 dari 266
ASAL RAWAT JALAN
R2019-0000070566 03-12-2019 201900067641/111604 LAODE MARVEL Riyanti Puji dr. OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000070566 03-12-2019 201900067641/111604 LAODE MARVEL Riyanti Puji dr. OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000070566 03-12-2019 201900067641/111604 LAODE MARVEL Riyanti Puji dr. OP00184 Neo Protifed Tablet 2.00 Tablet 1,263.73 3,027.46
R2019-0000070566 03-12-2019 201900067641/111604 LAODE MARVEL Riyanti Puji dr. OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000070566 03-12-2019 201900067641/111604 LAODE MARVEL Riyanti Puji dr. ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000070566 03-12-2019 201900067641/111604 LAODE MARVEL Riyanti Puji dr. OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000070566 03-12-2019 201900067641/111604 LAODE MARVEL Riyanti Puji dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000070567 03-12-2019 201900067574/111595 ANDI MUHAMMAD Ismail dr. Msc. OG00071 Griseovulfin 500 mg 15.00 Tablet 2,509.21 38,138.15
R2019-0000070567 03-12-2019 201900067574/111595 ANDI MUHAMMAD Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 15.00 Tablet 623.70 9,855.50
R2019-0000070567 03-12-2019 201900067574/111595 ANDI MUHAMMAD Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000070567 03-12-2019 201900067574/111595 ANDI MUHAMMAD Ismail dr. Msc. OK00022 Ketoconazol Cream 2% 1.00 Tube 11,000.00 11,500.00
R2019-0000070567 03-12-2019 201900067574/111595 ANDI MUHAMMAD Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000070569 03-12-2019 201900067647/108360 FITRIANSYAH,TN Niki Juniar ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000070568 03-12-2019 201900067666/081363 CAESAR FAUDZAN Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000070568 03-12-2019 201900067666/081363 CAESAR FAUDZAN Niki Juniar ALI00006 I.V Catheter No. 24 2.00 Pcs 38,900.00 78,300.00
R2019-0000070568 03-12-2019 201900067666/081363 CAESAR FAUDZAN Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070570 03-12-2019 201900067646/086416 YOHANIS RAGA,TN Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000070571 03-12-2019 201900067667/12971 KUNTARI DWI N,NY Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000070571 03-12-2019 201900067667/12971 KUNTARI DWI N,NY Niki Juniar ALB00132 Blood Set 1.00 Pcs 33,976.80 34,476.80
R2019-0000070571 03-12-2019 201900067667/12971 KUNTARI DWI N,NY Niki Juniar ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000070572 03-12-2019 201900067607/111597 WIMYASARI FISTIA Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000070572 03-12-2019 201900067607/111597 WIMYASARI FISTIA Niki Juniar ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000070572 03-12-2019 201900067607/111597 WIMYASARI FISTIA Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070572 03-12-2019 201900067607/111597 WIMYASARI FISTIA Niki Juniar OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000070572 03-12-2019 201900067607/111597 WIMYASARI FISTIA Niki Juniar OO00074 Ondansetron Tablet, 4mg 1.00 Tablet 4,455.00 4,955.00
R2019-0000070573 03-12-2019 201900067665/101497 DAVID,TN Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000070573 03-12-2019 201900067665/101497 DAVID,TN Niki Juniar ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000070573 03-12-2019 201900067665/101497 DAVID,TN Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070574 03-12-2019 201900067594/078048 NOR JANNAH,NY Niki Juniar OG00018 Gitas Injeksi 1ml 1.00 Ampul 38,201.62 38,701.62
R2019-0000070575 03-12-2019 201900067650/111606 JORDY MAHARDIKA Niki Juniar OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000070576 03-12-2019 201900067651/032573 MUHAMMAD Niki Juniar OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000070577 03-12-2019 201900067589/022837 WARSITA,TN Niki Juniar ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000070577 03-12-2019 201900067589/022837 WARSITA,TN Niki Juniar OP00011 Paracetamol 500mg 1.00 Tablet 387.36 887.36
R2019-0000070575 03-12-2019 201900067650/111606 JORDY MAHARDIKA Niki Juniar ALH00028 Handscoon Non Steril S 2.00 Pcs 1,069.00 2,638.00
R2019-0000070579 03-12-2019 201900067650/111606 JORDY MAHARDIKA Niki Juniar OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000070579 03-12-2019 201900067650/111606 JORDY MAHARDIKA Niki Juniar OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000070579 03-12-2019 201900067650/111606 JORDY MAHARDIKA Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000070579 03-12-2019 201900067650/111606 JORDY MAHARDIKA Niki Juniar OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
Total 27,723,023.43
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 25 dari 266
ASAL RAWAT JALAN
R2019-0000070579 03-12-2019 201900067650/111606 JORDY MAHARDIKA Niki Juniar ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000070578 03-12-2019 201900067624/107237 MERRIANI Niki Juniar OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000070583 03-12-2019 201900067654/098062 MAHENDRA,SDR ADE RAHMAH OA00180 Acetylcyst ein 200mg 10.00 Tablet 1,485.00 15,350.00
R2019-0000070583 03-12-2019 201900067654/098062 MAHENDRA,SDR ADE RAHMAH OP00184 Neo Protifed Tablet 10.00 Tablet 1,263.73 13,137.30
R2019-0000070583 03-12-2019 201900067654/098062 MAHENDRA,SDR ADE RAHMAH OB00007 Becom - C 10.00 Tablet 2,123.55 21,735.50
R2019-0000070583 03-12-2019 201900067654/098062 MAHENDRA,SDR ADE RAHMAH OF00039 FG Troches 10.00 Tablet 1,730.02 17,800.20
R2019-0000070582 03-12-2019 201900067657/107704 NIKI JUNIAR ADE RAHMAH OS00014 Sanadryl DMP Syrup, 60ml 1.00 Botol 17,820.00 18,320.00
R2019-0000070585 04-12-2019 201900067662/083367 SUTRINI,NY ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000070585 04-12-2019 201900067662/083367 SUTRINI,NY ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000070585 04-12-2019 201900067662/083367 SUTRINI,NY ADE RAHMAH OA00085 Antasida Tablet (OGB) 10.00 Tablet 284.30 3,343.00
R2019-0000070585 04-12-2019 201900067662/083367 SUTRINI,NY ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 1.00 Capsul 1,169.98 1,669.98
R2019-0000070585 04-12-2019 201900067662/083367 SUTRINI,NY ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000070597 03-12-2019 201900067541/110820 ZAHFIRA FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000070597 03-12-2019 201900067541/110820 ZAHFIRA FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000070597 03-12-2019 201900067541/110820 ZAHFIRA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 5.00 Tablet 1,173.15 6,365.75
R2019-0000070597 03-12-2019 201900067541/110820 ZAHFIRA FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000070597 03-12-2019 201900067541/110820 ZAHFIRA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 5.00 Granula 297.00 1,985.00
R2019-0000070597 03-12-2019 201900067541/110820 ZAHFIRA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000070598 03-12-2019 201900067527/098123 M AFDHALUSH FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000070598 03-12-2019 201900067527/098123 M AFDHALUSH FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 2.00 Tablet 208.00 916.00
R2019-0000070598 03-12-2019 201900067527/098123 M AFDHALUSH FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 2.00 Tablet 1,173.15 2,846.30
R2019-0000070598 03-12-2019 201900067527/098123 M AFDHALUSH FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000070598 03-12-2019 201900067527/098123 M AFDHALUSH FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000070598 03-12-2019 201900067527/098123 M AFDHALUSH FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000070600 03-12-2019 201900067530/051780 MUSRINI,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070601 03-12-2019 201900067488/111582 SIMON F TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070599 03-12-2019 201900067521/108016 HARRY FUJI R,TN Restu OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070599 03-12-2019 201900067521/108016 HARRY FUJI R,TN Restu OC00054 Cendo Xitrol T etes Mata 1.00 Botol 46,800.00 47,300.00
R2019-0000070602 03-12-2019 201900067443/098908 DIAH AYU EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000070602 03-12-2019 201900067443/098908 DIAH AYU EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000070602 03-12-2019 201900067443/098908 DIAH AYU EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000070602 03-12-2019 201900067443/098908 DIAH AYU EDO, Dr.Sp.B ALH00020 Hypafix 10cm x 5m 1.00 Cm 400.00 900.00
R2019-0000070603 03-12-2019 201900067452/110974 TRI HANDAYANI,NY EDO, Dr.Sp.B OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000070603 03-12-2019 201900067452/110974 TRI HANDAYANI,NY EDO, Dr.Sp.B OD00031 Dexamethasone Tablet 15.00 Tablet 208.00 3,620.00
R2019-0000070604 03-12-2019 201900067458/071885 HARIYANTO,TN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000070604 03-12-2019 201900067458/071885 HARIYANTO,TN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000070604 03-12-2019 201900067458/071885 HARIYANTO,TN EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
Total 28,306,514.56
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 26 dari 266
ASAL RAWAT JALAN
R2019-0000070604 03-12-2019 201900067458/071885 HARIYANTO,TN EDO, Dr.Sp.B ALK00005 Kasa Hydrofil New DRC 12.00 lembar 816.75 10,301.00
R2019-0000070604 03-12-2019 201900067458/071885 HARIYANTO,TN EDO, Dr.Sp.B ALH00020 Hypafix 10cm x 5m 1.00 Cm 400.00 900.00
R2019-0000070606 03-12-2019 201900067461/111353 MUHAMMAD Angie Renatha , OP00184 Neo Protifed Tablet 15.00 Tablet 1,263.73 19,455.95
R2019-0000070606 03-12-2019 201900067461/111353 MUHAMMAD Angie Renatha , OD00031 Dexamethasone Tablet 15.00 Tablet 208.00 3,620.00
R2019-0000070607 03-12-2019 201900067472/081806 SAMSIAH,NY EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000070607 03-12-2019 201900067472/081806 SAMSIAH,NY EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000070607 03-12-2019 201900067472/081806 SAMSIAH,NY EDO, Dr.Sp.B ALK00005 Kasa Hydrofil New DRC 12.00 lembar 816.75 10,301.00
R2019-0000070607 03-12-2019 201900067472/081806 SAMSIAH,NY EDO, Dr.Sp.B ALH00020 Hypafix 10cm x 5m 1.00 Cm 400.00 900.00
R2019-0000070605 03-12-2019 201900067481/059214 ANISA OLIVIANTI Niki Juniar OF00150 Fukricin Eye Drop 1.00 Botol 102,762.00 103,262.00
R2019-0000070605 03-12-2019 201900067481/059214 ANISA OLIVIANTI Niki Juniar OK00023 Ketoconazole 200mg 10.00 Tablet 774.24 8,242.40
R2019-0000070609 03-12-2019 201900067466/111313 DEBORA KAY Nafon Zaitun, Dr. OE00008 Elkana Tablet 10.00 Tablet 1,247.40 12,974.00
R2019-0000070610 03-12-2019 201900067421/084385 SUDARYANTI,NY Dameria Sri OG00057 Gabapentin 300mg (OGB) 3.00 Tablet 8,168.00 25,004.00
R2019-0000070610 03-12-2019 201900067421/084385 SUDARYANTI,NY Dameria Sri OK00002 Kalium Diklofenac 50mg 14.00 Tablet 1,100.00 15,900.00
R2019-0000070610 03-12-2019 201900067421/084385 SUDARYANTI,NY Dameria Sri OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000070611 03-12-2019 201900067479/101657 SAFANAH RAHADATUL Angie Renatha , OA00166 Azithromycin 500mg 1.00 Tablet 14,850.00 15,350.00
R2019-0000070611 03-12-2019 201900067479/101657 SAFANAH RAHADATUL Angie Renatha , OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000070611 03-12-2019 201900067479/101657 SAFANAH RAHADATUL Angie Renatha , OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
R2019-0000070611 03-12-2019 201900067479/101657 SAFANAH RAHADATUL Angie Renatha , ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000070611 03-12-2019 201900067479/101657 SAFANAH RAHADATUL Angie Renatha , OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
R2019-0000070613 03-12-2019 201900067475/111579 HARDI, ST,TN Herika dr. OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000070613 03-12-2019 201900067475/111579 HARDI, ST,TN Herika dr. OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000070613 03-12-2019 201900067475/111579 HARDI, ST,TN Herika dr. OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000070612 03-12-2019 201900067486/111580 FATMAWAT I,NN Herika dr. OC00097 Codein 15mg 6.00 Tablet 1,665.87 10,495.22
R2019-0000070612 03-12-2019 201900067486/111580 FATMAWAT I,NN Herika dr. OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000070612 03-12-2019 201900067486/111580 FATMAWAT I,NN Herika dr. OC00060 Cetirizine 10mg (OGB) 4.00 Tablet 623.70 2,994.80
R2019-0000070616 03-12-2019 201900067418/069369 SAWIJAN MADEWI,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070616 03-12-2019 201900067418/069369 SAWIJAN MADEWI,TN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070614 03-12-2019 201900067465/110944 WAHADANIA,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070614 03-12-2019 201900067465/110944 WAHADANIA,NY TEDDY OC00054 Cendo Xitrol T etes Mata 1.00 Botol 46,800.00 47,300.00
R2019-0000070617 03-12-2019 201900067501/031096 RAIHAN ADRY FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000070617 03-12-2019 201900067501/031096 RAIHAN ADRY FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000070617 03-12-2019 201900067501/031096 RAIHAN ADRY FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 5.00 Tablet 1,173.15 6,365.75
R2019-0000070617 03-12-2019 201900067501/031096 RAIHAN ADRY FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000070617 03-12-2019 201900067501/031096 RAIHAN ADRY FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 5.00 Granula 297.00 1,985.00
R2019-0000070617 03-12-2019 201900067501/031096 RAIHAN ADRY FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000070617 03-12-2019 201900067501/031096 RAIHAN ADRY FREDRIK, Dr,Sp.A OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000070621 03-12-2019 201900067545/092503 HERU PATMANA Herika dr. OA00063 Amlodipin 10mg (OGB) 1.00 Tablet 2,743.00 3,243.00
R2019-0000070618 03-12-2019 201900067562/087247 BUDHI LUSY E. Dr.Sp.PD ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
Total 28,841,278.30
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 27 dari 266
ASAL RAWAT JALAN
R2019-0000070622 03-12-2019 201900067475/111579 HARDI, ST,TN Herika dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000070622 03-12-2019 201900067475/111579 HARDI, ST,TN Herika dr. OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000070622 03-12-2019 201900067475/111579 HARDI, ST,TN Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000070622 03-12-2019 201900067475/111579 HARDI, ST,TN Herika dr. ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000070623 03-12-2019 201900067478/111577 AHMAT,TN Herika dr. OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000070623 03-12-2019 201900067478/111577 AHMAT,TN Herika dr. OI00051 Infus Otsu-NS (NaCl 1.00 Botol 9,388.17 9,888.17
R2019-0000070625 03-12-2019 201900067545/092503 HERU PATMANA Herika dr. OL00063 Lidocain HCl 2% Injeksi 5.00 Ampul 2,376.00 12,380.00
R2019-0000070625 03-12-2019 201900067545/092503 HERU PATMANA Herika dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070625 03-12-2019 201900067545/092503 HERU PATMANA Herika dr. OE00055 Ecosol RL 500ml 2.00 Botol 19,305.00 39,110.00
R2019-0000070626 03-12-2019 201900067482/100656 NAJEMIAH,NY Herika dr. OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000070626 03-12-2019 201900067482/100656 NAJEMIAH,NY Herika dr. OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000070628 04-12-2019 201900067669/108360 FITRIANSYAH,TN ADE RAHMAH OS00176 Scopma Plus Tablet 3.00 Tablet 2,090.22 6,770.66
R2019-0000070627 03-12-2019 201900067550/111542 KIKI AMALIA TJAN,BY FREDRIK, Dr,Sp.A OA00177 Amoxicillin 100mg/ml 1.00 Botol 20,790.00 21,290.00
R2019-0000070627 03-12-2019 201900067550/111542 KIKI AMALIA TJAN,BY FREDRIK, Dr,Sp.A OC00173 Cetirizine 10mg/ml Drop, 1.00 Botol 37,125.00 37,625.00
R2019-0000070627 03-12-2019 201900067550/111542 KIKI AMALIA TJAN,BY FREDRIK, Dr,Sp.A OE00047 Epexol Drop 1.00 Botol 55,836.00 56,336.00
R2019-0000070621 03-12-2019 201900067545/092503 HERU PATMANA Herika dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000070630 04-12-2019 201900067671/073160 RIFADINA EDO, Dr.Sp.B OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000070630 04-12-2019 201900067671/073160 RIFADINA EDO, Dr.Sp.B OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000070630 04-12-2019 201900067671/073160 RIFADINA EDO, Dr.Sp.B OP00184 Neo Protifed Tablet 5.00 Tablet 1,263.73 6,818.65
R2019-0000070630 04-12-2019 201900067671/073160 RIFADINA EDO, Dr.Sp.B OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000070587 03-12-2019 201900067647/108360 FITRIANSYAH,TN Niki Juniar OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000070632 04-12-2019 201900067669/108360 FITRIANSYAH,TN ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000070634 04-12-2019 201900067671/073160 RIFADINA ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000070634 04-12-2019 201900067671/073160 RIFADINA ADE RAHMAH OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000070634 04-12-2019 201900067671/073160 RIFADINA ADE RAHMAH OS00057 Scopamin Plus Caplet 1.00 Tablet 3,712.50 4,212.50
R2019-0000070635 04-12-2019 201900067679/099217 WA KAMBA,NY ADE RAHMAH OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000070635 04-12-2019 201900067679/099217 WA KAMBA,NY ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000070635 04-12-2019 201900067679/099217 WA KAMBA,NY ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000070635 04-12-2019 201900067679/099217 WA KAMBA,NY ADE RAHMAH OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000070645 04-12-2019 201900067691/111607 DARREN,SDR ADE RAHMAH OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000070645 04-12-2019 201900067691/111607 DARREN,SDR ADE RAHMAH OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000070645 04-12-2019 201900067691/111607 DARREN,SDR ADE RAHMAH OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000070655 02-12-2019 201900067127/108044 DINA TANDILILING,NY Ismail dr. Msc. OL000131 Leparson Tablet 69.00 Tablet 5,917.35 408,797.15
R2019-0000070662 02-12-2019 201900067099/068834 MUHAMMAD RUM,TN LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 23.00 Tablet 811.18 19,157.14
R2019-0000070663 02-12-2019 201900067102/42305 USMAN UDIN,TN LUSY E. Dr.Sp.PD OT00046 Thyrozol 10mg 46.00 Tablet 2,913.41 134,516.86
R2019-0000070663 02-12-2019 201900067102/42305 USMAN UDIN,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000070665 03-12-2019 201900067432/080802 ASRI Dameria Sri OC00092 Clopidogrel 75mg (OGB) 23.00 Tablet 14,701.50 338,634.50
R2019-0000070665 03-12-2019 201900067432/080802 ASRI Dameria Sri OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
Total 30,507,594.46
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 28 dari 266
ASAL RAWAT JALAN
R2019-0000070665 03-12-2019 201900067432/080802 ASRI Dameria Sri OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000070665 03-12-2019 201900067432/080802 ASRI Dameria Sri OA00140 Atorvastatin 20mg (OGB) 23.00 Tablet 6,534.00 150,782.00
R2019-0000070668 04-12-2019 201900067722/096404 KRISTANTO,TN Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 5.00 Tablet 1,113.75 6,068.75
R2019-0000070668 04-12-2019 201900067722/096404 KRISTANTO,TN Dwi Astuti, dr OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000070668 04-12-2019 201900067722/096404 KRISTANTO,TN Dwi Astuti, dr OA00088 Antiza Tablet 5.00 Tablet 1,633.00 8,665.00
R2019-0000070666 03-12-2019 201900067417/098505 SABARSI,NY Dameria Sri OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000070666 03-12-2019 201900067417/098505 SABARSI,NY Dameria Sri OS00173 Simvastatin 20mg (OGB) 23.00 Tablet 1,782.00 41,486.00
R2019-0000070666 03-12-2019 201900067417/098505 SABARSI,NY Dameria Sri OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000070666 03-12-2019 201900067417/098505 SABARSI,NY Dameria Sri OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000070671 04-12-2019 201900067523/086999 ESTI SULASTRI,NY Restu OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000070671 04-12-2019 201900067523/086999 ESTI SULASTRI,NY Restu OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000070671 04-12-2019 201900067523/086999 ESTI SULASTRI,NY Restu OB00036 Bis oprolol 5mg (OGB) 23.00 Tablet 5,197.50 120,042.50
R2019-0000070671 04-12-2019 201900067523/086999 ESTI SULASTRI,NY Restu OH00025 Hydrochlortiazide (OGB) 12.00 Tablet 240.30 3,383.60
R2019-0000070673 03-12-2019 201900067576/00013699 ROSMANI,NY Restu OL00056 Levemir Insulin 1.00 Flexpen 287,330.88 287,830.88
R2019-0000070673 03-12-2019 201900067576/00013699 ROSMANI,NY Restu OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000070673 03-12-2019 201900067576/00013699 ROSMANI,NY Restu OD00047 Diamicron MR 60mg 23.00 Tablet 8,420.00 194,160.00
R2019-0000070673 03-12-2019 201900067576/00013699 ROSMANI,NY Restu OB00036 Bis oprolol 5mg (OGB) 23.00 Tablet 5,197.50 120,042.50
R2019-0000070673 03-12-2019 201900067576/00013699 ROSMANI,NY Restu OL00021 Lansoprazole (OGB) 23.00 Capsul 2,230.00 51,790.00
R2019-0000070677 03-12-2019 201900067598/111289 ADE PRIMARJANY,SDR Restu OL00021 Lansoprazole (OGB) 23.00 Capsul 2,230.00 51,790.00
R2019-0000070679 03-12-2019 201900067491/087019 NGADINEM,NY Restu OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000070683 04-12-2019 201900067758/060749 GINANJAR PUTRA Angie Renatha , OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000070684 04-12-2019 201900067727/066862 HATTA GOBEL,TN Angie Renatha , OF00150 Fukricin Eye Drop 1.00 Botol 102,762.00 103,262.00
R2019-0000070684 04-12-2019 201900067727/066862 HATTA GOBEL,TN Angie Renatha , OK00023 Ketoconazole 200mg 20.00 Tablet 774.24 15,984.80
R2019-0000070684 04-12-2019 201900067727/066862 HATTA GOBEL,TN Angie Renatha , ALD00003 Disposable Syringe 1ml 1.00 Pcs 3,500.00 4,000.00
R2019-0000070686 04-12-2019 201900067189/074460 INDRAWATI DEWI,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070686 04-12-2019 201900067189/074460 INDRAWATI DEWI,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070685 04-12-2019 201900067751/083562 FAISAL REZA,TN TEDDY OC00283 Cendo Oculenta Eye Oint 1.00 Tube 135,877.50 136,377.50
R2019-0000070685 04-12-2019 201900067751/083562 FAISAL REZA,TN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070687 04-12-2019 201900067703/046305 RUKINI,NY Angie Renatha , OA00013 Avamys Nasal Spray 1.00 Botol 237,451.50 237,951.50
R2019-0000070687 04-12-2019 201900067703/046305 RUKINI,NY Angie Renatha , OK00002 Kalium Diklofenac 50mg 10.00 Tablet 1,100.00 11,500.00
R2019-0000070687 04-12-2019 201900067703/046305 RUKINI,NY Angie Renatha , OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000070681 03-12-2019 201900067535/37715 SRI SUGIARTI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000070681 03-12-2019 201900067535/37715 SRI SUGIARTI,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 23.00 Tablet 14,701.50 338,634.50
R2019-0000070681 03-12-2019 201900067535/37715 SRI SUGIARTI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 23.00 Tablet 5,197.50 120,042.50
R2019-0000070681 03-12-2019 201900067535/37715 SRI SUGIARTI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 46.00 Tablet 371.25 17,577.50
R2019-0000070681 03-12-2019 201900067535/37715 SRI SUGIARTI,NY LUSY E. Dr.Sp.PD ON00075 Novomix 30 Flexpen 2.00 Flexpen 226,917.80 454,335.60
R2019-0000070690 04-12-2019 201900067769/111515 ADRYA GHASSAN Dwi Astuti, dr OD00077 Dumin Rectal 250mg 1.00 Tube 29,254.50 29,754.50
R2019-0000070690 04-12-2019 201900067769/111515 ADRYA GHASSAN Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
Total 34,330,463.14
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 29 dari 266
ASAL RAWAT JALAN
R2019-0000070690 04-12-2019 201900067769/111515 ADRYA GHASSAN Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000070692 04-12-2019 201900067683/110346 HAFID,TN LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 23.00 Tablet 445.50 10,746.50
R2019-0000070692 04-12-2019 201900067683/110346 HAFID,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000070692 04-12-2019 201900067683/110346 HAFID,TN LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 23.00 Tablet 206.41 5,247.43
R2019-0000070692 04-12-2019 201900067683/110346 HAFID,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000070692 04-12-2019 201900067683/110346 HAFID,TN LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 12.00 Tablet 315.26 4,283.12
R2019-0000070697 04-12-2019 201900067779/096755 AQIFA FAYO LA Dwi Astuti, dr OC00144 Cefila Capsul, 100mg 2.00 Capsul 28,957.00 58,414.00
R2019-0000070697 04-12-2019 201900067779/096755 AQIFA FAYO LA Dwi Astuti, dr OC00120 Cortidex Tablet 2.00 Tablet 430.65 1,361.30
R2019-0000070697 04-12-2019 201900067779/096755 AQIFA FAYO LA Dwi Astuti, dr OE00018 Epexol Tablet 2.00 Tablet 1,232.55 2,965.10
R2019-0000070697 04-12-2019 201900067779/096755 AQIFA FAYO LA Dwi Astuti, dr OC00057 Cerini 2.00 Tablet 5,093.55 10,687.10
R2019-0000070697 04-12-2019 201900067779/096755 AQIFA FAYO LA Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 200.20 22,002.00
R2019-0000070697 04-12-2019 201900067779/096755 AQIFA FAYO LA Dwi Astuti, dr OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000070698 04-12-2019 201900067778/038761 AQIL OMMAR Dwi Astuti, dr OS00098 Sporetik Dry Syrup 1.00 Botol 123,923.25 124,423.25
R2019-0000070698 04-12-2019 201900067778/038761 AQIL OMMAR Dwi Astuti, dr OA00087 Antiza Syrup, 60ml 1.00 Botol 26,730.00 27,230.00
R2019-0000070698 04-12-2019 201900067778/038761 AQIL OMMAR Dwi Astuti, dr OP00101 Proceles Syrup, 60ml 1.00 Botol 51,975.00 52,475.00
R2019-0000070698 04-12-2019 201900067778/038761 AQIL OMMAR Dwi Astuti, dr OI00117 Imunos Plus Syrup, 60ml 1.00 Botol 136,620.00 137,120.00
R2019-0000070699 02-12-2019 201900067114/00012743 RICKY E J WELAN,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000070701 04-12-2019 201900067786/027396 YULIYANA M,NY Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000070701 04-12-2019 201900067786/027396 YULIYANA M,NY Dwi Astuti, dr ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000070701 04-12-2019 201900067786/027396 YULIYANA M,NY Dwi Astuti, dr ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000070701 04-12-2019 201900067786/027396 YULIYANA M,NY Dwi Astuti, dr OI00051 Infus Otsu-NS (NaCl 1.00 Botol 9,388.17 9,888.17
R2019-0000070704 04-12-2019 201900067711/076097 LISA,NY LUSY E. Dr.Sp.PD OT00135 Thyrozol 5mg 23.00 Tablet 2,188.89 50,844.47
R2019-0000070700 04-12-2019 201900067777/061926 AQIF TSANI DIZZA,AN Dwi Astuti, dr OC00144 Cefila Capsul, 100mg 3.00 Capsul 28,957.00 87,371.00
R2019-0000070700 04-12-2019 201900067777/061926 AQIF TSANI DIZZA,AN Dwi Astuti, dr OC00120 Cortidex Tablet 3.00 Tablet 430.65 1,791.95
R2019-0000070700 04-12-2019 201900067777/061926 AQIF TSANI DIZZA,AN Dwi Astuti, dr OC00057 Cerini 3.00 Tablet 5,093.55 15,780.65
R2019-0000070700 04-12-2019 201900067777/061926 AQIF TSANI DIZZA,AN Dwi Astuti, dr OE00018 Epexol Tablet 3.00 Tablet 1,232.55 4,197.65
R2019-0000070700 04-12-2019 201900067777/061926 AQIF TSANI DIZZA,AN Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 200.20 22,002.00
R2019-0000070700 04-12-2019 201900067777/061926 AQIF TSANI DIZZA,AN Dwi Astuti, dr OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000070700 04-12-2019 201900067777/061926 AQIF TSANI DIZZA,AN Dwi Astuti, dr OI00117 Imunos Plus Syrup, 60ml 1.00 Botol 136,620.00 137,120.00
R2019-0000070700 04-12-2019 201900067777/061926 AQIF TSANI DIZZA,AN Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000070700 04-12-2019 201900067777/061926 AQIF TSANI DIZZA,AN Dwi Astuti, dr OI00051 Infus Otsu-NS (NaCl 1.00 Botol 9,388.17 9,888.17
R2019-0000070710 04-12-2019 201900067719/111525 ABDUL HALIM,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 90.00 Tablet 371.25 33,912.50
R2019-0000070710 04-12-2019 201900067719/111525 ABDUL HALIM,TN LUSY E. Dr.Sp.PD OG00021 Glimepiride 1mg Tablet 30.00 Tablet 1,245.00 37,850.00
R2019-0000070710 04-12-2019 201900067719/111525 ABDUL HALIM,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 30.00 Tablet 1,662.00 50,360.00
R2019-0000070712 04-12-2019 201900067786/027396 YULIYANA M,NY Dwi Astuti, dr OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000070712 04-12-2019 201900067786/027396 YULIYANA M,NY Dwi Astuti, dr OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000070712 04-12-2019 201900067786/027396 YULIYANA M,NY Dwi Astuti, dr OL00076 Lodia 2mg 2.00 Tablet 1,485.00 3,470.00
R2019-0000070712 04-12-2019 201900067786/027396 YULIYANA M,NY Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
Total 35,931,291.60
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 30 dari 266
ASAL RAWAT JALAN
R2019-0000070713 04-12-2019 201900067808/111617 NURAMALIA,AN Dwi Astuti, dr OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000070713 04-12-2019 201900067808/111617 NURAMALIA,AN Dwi Astuti, dr OA00070 Amoxsan Dry Syrup 1.00 Botol 33,412.50 33,912.50
R2019-0000070713 04-12-2019 201900067808/111617 NURAMALIA,AN Dwi Astuti, dr OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000070723 04-12-2019 201900067829/111621 JERRY MOLINA Dwi Astuti, dr OS00183 Sporetik 200mg Capsul 14.00 Capsul 42,396.75 594,054.50
R2019-0000070723 04-12-2019 201900067829/111621 JERRY MOLINA Dwi Astuti, dr OP00138 Pumpitor Capsul 10.00 Capsul 20,092.05 201,420.50
R2019-0000070732 04-12-2019 201900067834/067684 SRI RUMAWI,NY Angie Renatha , OC00095 Co-Amoxiclave 625mg 15.00 Tablet 7,840.99 118,114.85
R2019-0000070732 04-12-2019 201900067834/067684 SRI RUMAWI,NY Angie Renatha , OD00031 Dexamethasone Tablet 15.00 Tablet 208.00 3,620.00
R2019-0000070732 04-12-2019 201900067834/067684 SRI RUMAWI,NY Angie Renatha , OA00106 Asam Mefenamat 500mg 15.00 Tablet 415.80 6,737.00
R2019-0000070732 04-12-2019 201900067834/067684 SRI RUMAWI,NY Angie Renatha , OA00013 Avamys Nasal Spray 1.00 Botol 237,451.50 237,951.50
R2019-0000070732 04-12-2019 201900067834/067684 SRI RUMAWI,NY Angie Renatha , OP00184 Neo Protifed Tablet 15.00 Tablet 1,263.73 19,455.95
R2019-0000070734 04-12-2019 201900067835/110497 MONIKA HELENA Angie Renatha , OK00023 Ketoconazole 200mg 10.00 Tablet 774.24 8,242.40
R2019-0000070740 04-12-2019 201900067832/111222 MARIFATUL H,NY NOVIANA, Dr. Sp OE00008 Elkana Tablet 10.00 Tablet 1,247.40 12,974.00
R2019-0000070741 04-12-2019 201900067788/111417 SUMITHA,NY TEDDY OC00076 Ciprofloxacin 500mg 15.00 Tablet 1,039.50 16,092.50
R2019-0000070741 04-12-2019 201900067788/111417 SUMITHA,NY TEDDY OA00106 Asam Mefenamat 500mg 5.00 Tablet 415.80 2,579.00
R2019-0000070742 04-12-2019 201900067828/37109 IRFA DIANITA,NY NOVIANA, Dr. Sp OE00008 Elkana Tablet 10.00 Tablet 1,247.40 12,974.00
R2019-0000070743 04-12-2019 201900067757/111536 SUKARTI,NY TEDDY OC00054 Cendo Xitrol T etes Mata 1.00 Botol 46,800.00 47,300.00
R2019-0000070745 04-12-2019 201900067812/111618 RUKMAN,TN Angie Renatha , OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000070745 04-12-2019 201900067812/111618 RUKMAN,TN Angie Renatha , OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000070746 04-12-2019 201900067809/105865 NURJANNAH,NY NOVIANA, Dr. Sp OE00008 Elkana Tablet 10.00 Tablet 1,247.40 12,974.00
R2019-0000070747 04-12-2019 201900067827/111219 TIARA OCTAVIANY NOVIANA, Dr. Sp OE00008 Elkana Tablet 10.00 Tablet 1,247.40 12,974.00
R2019-0000070749 04-12-2019 201900067822/057495 NURLINAH,NY Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000070749 04-12-2019 201900067822/057495 NURLINAH,NY Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000070749 04-12-2019 201900067822/057495 NURLINAH,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 14,000.00
R2019-0000070725 03-12-2019 201900067580/080792 MISGIANTY,NY LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 23.00 Tablet 811.18 19,157.14
R2019-0000070752 04-12-2019 201900067743/099100 SITI RO SANA,NY LUSY E. Dr.Sp.PD OT00046 Thyrozol 10mg 69.00 Tablet 2,913.41 201,525.29
R2019-0000070752 04-12-2019 201900067743/099100 SITI RO SANA,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 23.00 Tablet 315.26 7,750.98
R2019-0000070752 04-12-2019 201900067743/099100 SITI RO SANA,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000070752 04-12-2019 201900067743/099100 SITI RO SANA,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000070752 04-12-2019 201900067743/099100 SITI RO SANA,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 23.00 Tablet 5,197.50 120,042.50
R2019-0000070751 04-12-2019 201900067842/103870 YURICKE ESRA,NY Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000070751 04-12-2019 201900067842/103870 YURICKE ESRA,NY Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000070751 04-12-2019 201900067842/103870 YURICKE ESRA,NY Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000070751 04-12-2019 201900067842/103870 YURICKE ESRA,NY Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000070751 04-12-2019 201900067842/103870 YURICKE ESRA,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 14,000.00
R2019-0000070761 04-12-2019 201900067874/100641 TUTY HARIYATI,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 15.00 Tablet 8,168.00 123,020.00
R2019-0000070761 04-12-2019 201900067874/100641 TUTY HARIYATI,NY Windy Krisanti OM00154 Mecobalamin 500mg 15.00 Tablet 1,118.00 17,270.00
R2019-0000070761 04-12-2019 201900067874/100641 TUTY HARIYATI,NY Windy Krisanti OT00063 Tramadol 50mg Tablet 15.00 Tablet 1,113.75 17,206.25
R2019-0000070762 04-12-2019 201900067878/111494 BOBY FAJAR Herika dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
Total 38,310,051.91
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 31 dari 266
ASAL RAWAT JALAN
R2019-0000070762 04-12-2019 201900067878/111494 BOBY FAJAR Herika dr. OT00059 Toramine 30mg Injeksi 1.00 Ampul 56,500.00 57,000.00
R2019-0000070762 04-12-2019 201900067878/111494 BOBY FAJAR Herika dr. OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 Botol 22,542.30 23,042.30
R2019-0000070762 04-12-2019 201900067878/111494 BOBY FAJAR Herika dr. OC00058 Cernevit Injeksi 1.00 Vial 256,905.00 257,405.00
R2019-0000070762 04-12-2019 201900067878/111494 BOBY FAJAR Herika dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070759 04-12-2019 201900067680/082001 RESMIATI D LASUT,NY Windy Krisanti OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000070759 04-12-2019 201900067680/082001 RESMIATI D LASUT,NY Windy Krisanti OC00092 Clopidogrel 75mg (OGB) 23.00 Tablet 14,701.50 338,634.50
R2019-0000070771 04-12-2019 201900067680/082001 RESMIATI D LASUT,NY Windy Krisanti OB00016 Betahistine Mesilat 6mg 15.00 Tablet 1,500.00 23,000.00
R2019-0000070771 04-12-2019 201900067680/082001 RESMIATI D LASUT,NY Windy Krisanti OM00035 Metformin 500mg (OGB) 7.00 Tablet 371.25 3,098.75
R2019-0000070771 04-12-2019 201900067680/082001 RESMIATI D LASUT,NY Windy Krisanti OG00021 Glimepiride 1mg Tablet 7.00 Tablet 1,245.00 9,215.00
R2019-0000070771 04-12-2019 201900067680/082001 RESMIATI D LASUT,NY Windy Krisanti OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000070771 04-12-2019 201900067680/082001 RESMIATI D LASUT,NY Windy Krisanti OC00092 Clopidogrel 75mg (OGB) 7.00 14,701.50 103,410.50
R2019-0000070771 04-12-2019 201900067680/082001 RESMIATI D LASUT,NY Windy Krisanti OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000070772 04-12-2019 201900067811/108131 SUDARI,TN Windy Krisanti OG00057 Gabapentin 300mg (OGB) 15.00 Tablet 8,168.00 123,020.00
R2019-0000070772 04-12-2019 201900067811/108131 SUDARI,TN Windy Krisanti OV00046 Valis anbe 5mg Tablet 15.00 Tablet 579.15 9,187.25
R2019-0000070772 04-12-2019 201900067811/108131 SUDARI,TN Windy Krisanti OA00062 Amitriptyline Tablet, 7.00 Tablet 252.45 2,267.15
R2019-0000070772 04-12-2019 201900067811/108131 SUDARI,TN Windy Krisanti OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000070773 04-12-2019 201900067833/095258 WANTI,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 5.00 Tablet 8,168.00 41,340.00
R2019-0000070773 04-12-2019 201900067833/095258 WANTI,NY Windy Krisanti OM00018 Meloxicam 7.5mg (OGB) 15.00 Tablet 1,287.00 19,805.00
R2019-0000070773 04-12-2019 201900067833/095258 WANTI,NY Windy Krisanti ALK00037 Kapsul No.1 15.00 pcs 200.00 10,500.00
R2019-0000070774 04-12-2019 201900067870/111623 AZARIA KAYANA Windy Krisanti OC00182 Citicolin Tablet 500mg 15.00 Tablet 10,098.00 151,970.00
R2019-0000070774 04-12-2019 201900067870/111623 AZARIA KAYANA Windy Krisanti OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000070775 04-12-2019 201900067867/091038 DWI CAHYONO,TN Windy Krisanti OE00057 Eperisone Hcl 50mg 15.00 Tablet 2,286.90 34,803.50
R2019-0000070775 04-12-2019 201900067867/091038 DWI CAHYONO,TN Windy Krisanti OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000070777 04-12-2019 201900067864/064523 HANNA YULISTINE,NY Windy Krisanti OM00046 Methyl Prednisolon 8mg 10.00 Tablet 965.25 10,152.50
R2019-0000070777 04-12-2019 201900067864/064523 HANNA YULISTINE,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 14.00 Tablet 8,168.00 114,852.00
R2019-0000070777 04-12-2019 201900067864/064523 HANNA YULISTINE,NY Windy Krisanti OG00073 Glucosamine 250 Mg 14.00 Tablet 1,633.50 23,369.00
R2019-0000070777 04-12-2019 201900067864/064523 HANNA YULISTINE,NY Windy Krisanti OM00154 Mecobalamin 500mg 15.00 Tablet 1,118.00 17,270.00
R2019-0000070777 04-12-2019 201900067864/064523 HANNA YULISTINE,NY Windy Krisanti OC00010 Calcium Lactat 500mg 10.00 Tablet 302.37 3,523.70
R2019-0000070777 04-12-2019 201900067864/064523 HANNA YULISTINE,NY Windy Krisanti OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000070778 04-12-2019 201900067694/088678 MARCYLIA MAUREEN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070778 04-12-2019 201900067694/088678 MARCYLIA MAUREEN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070780 04-12-2019 201900067693/090241 ALFONSO DIMITRI LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000070780 04-12-2019 201900067693/090241 ALFONSO DIMITRI LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000070780 04-12-2019 201900067693/090241 ALFONSO DIMITRI LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000070781 04-12-2019 201900067693/090241 ALFONSO DIMITRI LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000070781 04-12-2019 201900067693/090241 ALFONSO DIMITRI LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000070781 04-12-2019 201900067693/090241 ALFONSO DIMITRI LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 23.00 Tablet 445.50 10,746.50
R2019-0000070782 04-12-2019 201900067792/090149 BACO SIDE,TN Windy Krisanti OP00011 Paracetamol 500mg 8.00 Tablet 387.36 3,598.88
Total 40,043,614.94
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 32 dari 266
ASAL RAWAT JALAN
R2019-0000070782 04-12-2019 201900067792/090149 BACO SIDE,TN Windy Krisanti OT00063 Tramadol 50mg Tablet 8.00 Tablet 1,113.75 9,410.00
R2019-0000070782 04-12-2019 201900067792/090149 BACO SIDE,TN Windy Krisanti OG00057 Gabapentin 300mg (OGB) 5.00 Tablet 8,168.00 41,340.00
R2019-0000070782 04-12-2019 201900067792/090149 BACO SIDE,TN Windy Krisanti OG00073 Glucosamine 250 Mg 15.00 Tablet 1,633.50 25,002.50
R2019-0000070782 04-12-2019 201900067792/090149 BACO SIDE,TN Windy Krisanti ALK00037 Kapsul No.1 15.00 pcs 200.00 10,500.00
R2019-0000070782 04-12-2019 201900067792/090149 BACO SIDE,TN Windy Krisanti OC00017 Kapsul No. 00 15.00 Capsul 200.00 10,500.00
R2019-0000070783 04-12-2019 201900067797/086639 JUMIAH,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 5.00 Tablet 8,168.00 41,340.00
R2019-0000070783 04-12-2019 201900067797/086639 JUMIAH,NY Windy Krisanti OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000070783 04-12-2019 201900067797/086639 JUMIAH,NY Windy Krisanti OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000070783 04-12-2019 201900067797/086639 JUMIAH,NY Windy Krisanti ALK00037 Kapsul No.1 15.00 pcs 200.00 10,500.00
R2019-0000070784 04-12-2019 201900067857/111622 CINTIYA MITA Herika dr. OF00065 Flunarizine 5mg 4.00 Tablet 2,970.00 12,380.00
R2019-0000070784 04-12-2019 201900067857/111622 CINTIYA MITA Herika dr. OS00027 Sanmag Tablet 4.00 Tablet 1,321.65 5,786.60
R2019-0000070784 04-12-2019 201900067857/111622 CINTIYA MITA Herika dr. OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000070785 04-12-2019 201900067885/048289 SUSEPTY DR. BISMA SP OF00099 Folda Tablet 30.00 Tablet 6,661.65 200,349.50
R2019-0000070785 04-12-2019 201900067885/048289 SUSEPTY DR. BISMA SP OB00068 BioCal-95 30.00 Tablet 7,128.00 214,340.00
R2019-0000070786 04-12-2019 201900067896/111626 NUR ARIFIN,TN Herika dr. OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000070786 04-12-2019 201900067896/111626 NUR ARIFIN,TN Herika dr. OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000070788 04-12-2019 201900067894/060036 FATHIR AL Herika dr. OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000070788 04-12-2019 201900067894/060036 FATHIR AL Herika dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000070788 04-12-2019 201900067894/060036 FATHIR AL Herika dr. OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000070790 04-12-2019 201900067898/107711 FAKHRI ZHAFRAN Rianti dr. Sp.A OC00291 Cerini Syrup 1.00 Botol 59,103.00 59,603.00
R2019-0000070790 04-12-2019 201900067898/107711 FAKHRI ZHAFRAN Rianti dr. Sp.A OE00007 Elkana Syrup 1.00 Botol 34,303.50 34,803.50
R2019-0000070790 04-12-2019 201900067898/107711 FAKHRI ZHAFRAN Rianti dr. Sp.A OS00007 Sagestam Eye Drop, 5ml 1.00 Botol 42,768.00 43,268.00
R2019-0000070791 04-12-2019 201900067886/111625 MICHAEL H. F Herika dr. OM00035 Metformin 500mg (OGB) 10.00 Tablet 371.25 4,212.50
R2019-0000070791 04-12-2019 201900067886/111625 MICHAEL H. F Herika dr. OG00023 Glimepiride 3mg Tablet 6.00 Tablet 3,164.00 19,484.00
R2019-0000070791 04-12-2019 201900067886/111625 MICHAEL H. F Herika dr. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000070791 04-12-2019 201900067886/111625 MICHAEL H. F Herika dr. OM00052 Metronidazole 500mg 10.00 Tablet 525.39 5,753.90
R2019-0000070791 04-12-2019 201900067886/111625 MICHAEL H. F Herika dr. OS00026 Sanmag Syrup 1.00 Botol 37,125.00 37,625.00
R2019-0000070791 04-12-2019 201900067886/111625 MICHAEL H. F Herika dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070791 04-12-2019 201900067886/111625 MICHAEL H. F Herika dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000070791 04-12-2019 201900067886/111625 MICHAEL H. F Herika dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000070791 04-12-2019 201900067886/111625 MICHAEL H. F Herika dr. OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000070791 04-12-2019 201900067886/111625 MICHAEL H. F Herika dr. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000070791 04-12-2019 201900067886/111625 MICHAEL H. F Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000070767 04-12-2019 201900067902/12534 ATIKA ROFIAH,NY Herika dr. OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000070792 04-12-2019 201900067836/015236 TRI MURTINI,NY HENDRA, dr.Sp.S OG00073 Glucosamine 250 Mg 10.00 Tablet 1,633.50 16,835.00
R2019-0000070792 04-12-2019 201900067836/015236 TRI MURTINI,NY HENDRA, dr.Sp.S OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000070794 04-12-2019 201900067841/111405 YOHANA MINGGU,NY Hendra Dr, Sp. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000070795 04-12-2019 201900067899/27581 Yudha Iswara,TN Dwi Astuti, dr OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
Total 41,354,571.33
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 33 dari 266
ASAL RAWAT JALAN
R2019-0000070795 04-12-2019 201900067899/27581 Yudha Iswara,TN Dwi Astuti, dr OF00039 FG Troches 4.00 Tablet 1,730.02 7,420.08
R2019-0000070796 04-12-2019 201900067816/111619 TARMIJI,TN Hendra Dr, Sp. OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000070796 04-12-2019 201900067816/111619 TARMIJI,TN Hendra Dr, Sp. OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000070797 04-12-2019 201900067794/101734 IBRAHIM,TN Hendra Dr, Sp. OC00010 Calcium Lactat 500mg 10.00 Tablet 302.37 3,523.70
R2019-0000070799 04-12-2019 201900067902/12534 ATIKA ROFIAH,NY Herika dr. OE00018 Epexol Tablet 10.00 Tablet 1,232.55 12,825.50
R2019-0000070799 04-12-2019 201900067902/12534 ATIKA ROFIAH,NY Herika dr. OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000070799 04-12-2019 201900067902/12534 ATIKA ROFIAH,NY Herika dr. OP00138 Pumpitor Capsul 10.00 Capsul 20,092.05 201,420.50
R2019-0000070799 04-12-2019 201900067902/12534 ATIKA ROFIAH,NY Herika dr. OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000070799 04-12-2019 201900067902/12534 ATIKA ROFIAH,NY Herika dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000070799 04-12-2019 201900067902/12534 ATIKA ROFIAH,NY Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000070804 04-12-2019 201900067900/101588 HATIDJAH,NY Herika dr. OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000070804 04-12-2019 201900067900/101588 HATIDJAH,NY Herika dr. OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000070804 04-12-2019 201900067900/101588 HATIDJAH,NY Herika dr. OA00063 Amlodipin 10mg (OGB) 3.00 Tablet 2,743.00 8,729.00
R2019-0000070805 04-12-2019 201900067831/034868 SUPANDI,TN Hendra Dr, Sp. ON00009 Natrium Diklofenac 50mg 10.00 Tablet 955.84 10,058.40
R2019-0000070805 04-12-2019 201900067831/034868 SUPANDI,TN Hendra Dr, Sp. OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000070809 04-12-2019 201900067909/111628 JATI PAMUNGKAS,AN Herika dr. OA00071 Amoxsan Forte Dry Syrup 1.00 Botol 47,520.00 48,020.00
R2019-0000070809 04-12-2019 201900067909/111628 JATI PAMUNGKAS,AN Herika dr. OM00099 Mucera Syrup 1.00 Botol 34,155.00 34,655.00
R2019-0000070809 04-12-2019 201900067909/111628 JATI PAMUNGKAS,AN Herika dr. OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000070809 04-12-2019 201900067909/111628 JATI PAMUNGKAS,AN Herika dr. OC00291 Cerini Syrup 1.00 Botol 59,103.00 59,603.00
R2019-0000070817 04-12-2019 201900067911/110420 AQILA ARSYAH,AN Herika dr. OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2019-0000070817 04-12-2019 201900067911/110420 AQILA ARSYAH,AN Herika dr. OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000070826 04-12-2019 201900067919/111629 MUHAMMAD AZRIEL Niki Juniar OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000070826 04-12-2019 201900067919/111629 MUHAMMAD AZRIEL Niki Juniar OM00097 Mucera Drop 1.00 Botol 54,945.00 55,445.00
R2019-0000070826 04-12-2019 201900067919/111629 MUHAMMAD AZRIEL Niki Juniar OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000070826 04-12-2019 201900067919/111629 MUHAMMAD AZRIEL Niki Juniar OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000070840 05-12-2019 201900067930/090149 BACO SIDE,TN MAGDA ROSSA, OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000070843 05-12-2019 201900067924/111631 RIA NOOR Niki Juniar ALM00020 Masker Oks igen 1.00 Pcs 54,334.67 54,834.67
R2019-0000070843 05-12-2019 201900067924/111631 RIA NOOR Niki Juniar ALM00016 Masker Oxygen Non 1.00 Pcs 100,980.00 101,480.00
R2019-0000070843 05-12-2019 201900067924/111631 RIA NOOR Niki Juniar OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000070849 05-12-2019 201900067976/111526 HATTA,TN Niki Juniar OA00064 Amlodipin 5mg (OGB) 5.00 Tablet 1,555.00 8,275.00
R2019-0000070849 05-12-2019 201900067976/111526 HATTA,TN Niki Juniar OM00014 Mefinal 500mg 5.00 Tablet 1,982.48 10,412.40
R2019-0000070850 05-12-2019 201900067943/105536 MUSLIK,TN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000070850 05-12-2019 201900067943/105536 MUSLIK,TN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000070855 04-12-2019 201900067640/049188 MUHAMMAD HASBI,AN Niki Juniar OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000070855 04-12-2019 201900067640/049188 MUHAMMAD HASBI,AN Niki Juniar ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000070855 04-12-2019 201900067640/049188 MUHAMMAD HASBI,AN Niki Juniar ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000070855 04-12-2019 201900067640/049188 MUHAMMAD HASBI,AN Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070855 04-12-2019 201900067640/049188 MUHAMMAD HASBI,AN Niki Juniar OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
Total 42,448,524.02
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 34 dari 266
ASAL RAWAT JALAN
R2019-0000070857 05-12-2019 201900068010/084200 YOHANES ANDIKA EDO, Dr.Sp.B OC00071 Cif lon 20.00 Tablet 12,622.50 252,950.00
R2019-0000070857 05-12-2019 201900068010/084200 YOHANES ANDIKA EDO, Dr.Sp.B OO00022 Opicef 500mg Capsul 10.00 Capsul 14,850.00 149,000.00
R2019-0000070857 05-12-2019 201900068010/084200 YOHANES ANDIKA EDO, Dr.Sp.B OT00149 Toramine 10 Mg Tablet 10.00 Tablet 8,167.50 82,175.00
R2019-0000070859 05-12-2019 201900067984/103138 DJUNDAH Alvarez Sp .OT OD00102 Dexketoprofen 25mg 15.00 Tablet 4,290.00 64,850.00
R2019-0000070859 05-12-2019 201900067984/103138 DJUNDAH Alvarez Sp .OT OE00022 Eprinoc Tablet 15.00 Tablet 5,093.55 76,903.25
R2019-0000070860 05-12-2019 201900068020/054602 ANDI RAHMATAN,TN IQBAL OC00057 Cerini 10.00 Tablet 5,093.55 51,435.50
R2019-0000070860 05-12-2019 201900068020/054602 ANDI RAHMATAN,TN IQBAL OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000070860 05-12-2019 201900068020/054602 ANDI RAHMATAN,TN IQBAL OB00007 Becom - C 5.00 Tablet 2,123.55 11,117.75
R2019-0000070863 05-12-2019 201900068003/103533 SAIMAN,TN Alvarez Sp .OT OO00041 Osfit 30.00 Tablet 2,474.99 74,749.70
R2019-0000070863 05-12-2019 201900068003/103533 SAIMAN,TN Alvarez Sp .OT OO00078 Oscal 0.5mg 30.00 Capsul 14,633.66 439,509.80
R2019-0000070863 05-12-2019 201900068003/103533 SAIMAN,TN Alvarez Sp .OT OF00007 Farbion Tablet 30.00 Tablet 1,782.00 53,960.00
R2019-0000070864 05-12-2019 201900068001/098693 JUNI RAHMAN,TN TEDDY OC00300 Cendo Hyalub Minidose 1.00 Strip 84,645.00 85,145.00
R2019-0000070864 05-12-2019 201900068001/098693 JUNI RAHMAN,TN TEDDY OR00060 Retivit Plus Tablet 5.00 Tablet 10,343.02 52,215.10
R2019-0000070865 05-12-2019 201900067949/085073 KIAGUS AISYAH,NY TEDDY OC00054 Cendo Xitrol T etes Mata 1.00 Botol 46,800.00 47,300.00
R2019-0000070865 05-12-2019 201900067949/085073 KIAGUS AISYAH,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070868 05-12-2019 201900068000/108016 HARRY FUJI R,TN TEDDY OC00054 Cendo Xitrol T etes Mata 1.00 Botol 46,800.00 47,300.00
R2019-0000070868 05-12-2019 201900068000/108016 HARRY FUJI R,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070869 04-12-2019 201900067754/111612 HARDA NINGSIH,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070870 05-12-2019 201900067974/111417 SUMITHA,NY TEDDY OC00054 Cendo Xitrol T etes Mata 1.00 Botol 46,800.00 47,300.00
R2019-0000070870 05-12-2019 201900067974/111417 SUMITHA,NY TEDDY OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000070872 04-12-2019 201900067705/109908 RUSITAH,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 14.00 Tablet 8,168.00 114,852.00
R2019-0000070872 04-12-2019 201900067705/109908 RUSITAH,NY Windy Krisanti OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000070872 04-12-2019 201900067705/109908 RUSITAH,NY Windy Krisanti OV00046 Valis anbe 5mg Tablet 4.00 Tablet 579.15 2,816.60
R2019-0000070872 04-12-2019 201900067705/109908 RUSITAH,NY Windy Krisanti OA00062 Amitriptyline Tablet, 5.00 Tablet 252.45 1,762.25
R2019-0000070872 04-12-2019 201900067705/109908 RUSITAH,NY Windy Krisanti OC00016 Kapsul No. 0 20.00 Capsul 200.00 11,500.00
R2019-0000070872 04-12-2019 201900067705/109908 RUSITAH,NY Windy Krisanti OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000070874 05-12-2019 201900068012/090606 SUKARTI,NY Maulin Nikmah ALK00024 Korset TLSO (Thoraco 1.00 Pcs 455,000.00 455,500.00
R2019-0000070875 04-12-2019 201900067780/109601 HOTIK LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000070875 04-12-2019 201900067780/109601 HOTIK LUSY E. Dr.Sp.PD OG00024 Glimepiride 4mg Tablet 23.00 Tablet 3,869.89 89,507.47
R2019-0000070875 04-12-2019 201900067780/109601 HOTIK LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2019-0000070875 04-12-2019 201900067780/109601 HOTIK LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 23.00 Tab 7,425.00 171,275.00
R2019-0000070877 04-12-2019 201900067712/101638 RACHMATULLAH,TN LUSY E. Dr.Sp.PD OT00046 Thyrozol 10mg 23.00 Tablet 2,913.41 67,508.43
R2019-0000070879 04-12-2019 201900067766/108595 NINUK LUSY E. Dr.Sp.PD OT00046 Thyrozol 10mg 69.00 Tablet 2,913.41 201,525.29
R2019-0000070880 04-12-2019 201900067714/046065 SURIYANA NOOR,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 46.00 Tablet 371.25 17,577.50
R2019-0000070880 04-12-2019 201900067714/046065 SURIYANA NOOR,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000070880 04-12-2019 201900067714/046065 SURIYANA NOOR,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000070878 05-12-2019 201900068054/111642 HARIS INDHARTO,TN Dwi Astuti, dr OA00125 ATS (Anti Tetanus 1.00 Ampul 222,750.00 223,250.00
R2019-0000070878 05-12-2019 201900068054/111642 HARIS INDHARTO,TN Dwi Astuti, dr OL00063 Lidocain HCl 2% Injeksi 5.00 Ampul 2,376.00 12,380.00
Total 45,672,380.51
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 35 dari 266
ASAL RAWAT JALAN
R2019-0000070873 05-12-2019 201900068043/096781 MARTINUS,TN Dwi Astuti, dr OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000070873 05-12-2019 201900068043/096781 MARTINUS,TN Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000070873 05-12-2019 201900068043/096781 MARTINUS,TN Dwi Astuti, dr OS00057 Scopamin Plus Caplet 5.00 Tablet 3,712.50 19,062.50
R2019-0000070873 05-12-2019 201900068043/096781 MARTINUS,TN Dwi Astuti, dr ON00047 New Diatabs 6.00 Tablet 767.13 5,102.78
R2019-0000070873 05-12-2019 201900068043/096781 MARTINUS,TN Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 6.00 Tablet 445.50 3,173.00
R2019-0000070873 05-12-2019 201900068043/096781 MARTINUS,TN Dwi Astuti, dr OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2019-0000070884 05-12-2019 201900068028/097740 SUSENO DOBY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070885 05-12-2019 201900068054/111642 HARIS INDHARTO,TN Dwi Astuti, dr OP00194 Perban elastis 4" 1.00 roll 29,700.00 30,200.00
R2019-0000070883 05-12-2019 201900068054/111642 HARIS INDHARTO,TN Dwi Astuti, dr OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000070883 05-12-2019 201900068054/111642 HARIS INDHARTO,TN Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000070883 05-12-2019 201900068054/111642 HARIS INDHARTO,TN Dwi Astuti, dr ALB00001 Bactigras (10cmx10cm) 1.00 Pcs 22,720.50 23,220.50
R2019-0000070883 05-12-2019 201900068054/111642 HARIS INDHARTO,TN Dwi Astuti, dr OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000070886 05-12-2019 201900067967/081351 MUHAMMAD HANIF,TN TEDDY OC00054 Cendo Xitrol T etes Mata 1.00 Botol 46,800.00 47,300.00
R2019-0000070886 05-12-2019 201900067967/081351 MUHAMMAD HANIF,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070888 05-12-2019 201900068005/082394 JONAN WERBIN FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 4.00 Capsul 28,957.00 116,328.00
R2019-0000070888 05-12-2019 201900068005/082394 JONAN WERBIN FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 4.00 Tablet 430.65 2,222.60
R2019-0000070888 05-12-2019 201900068005/082394 JONAN WERBIN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000070888 05-12-2019 201900068005/082394 JONAN WERBIN FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 4.00 Tablet 1,232.55 5,430.20
R2019-0000070888 05-12-2019 201900068005/082394 JONAN WERBIN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000070888 05-12-2019 201900068005/082394 JONAN WERBIN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000070888 05-12-2019 201900068005/082394 JONAN WERBIN FREDRIK, Dr,Sp.A OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000070887 05-12-2019 201900068079/111373 ANDRE WIJAYA,TN Dwi Astuti, dr OM00014 Mefinal 500mg 5.00 Tablet 1,982.48 10,412.40
R2019-0000070890 05-12-2019 201900068043/096781 MARTINUS,TN Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000070890 05-12-2019 201900068043/096781 MARTINUS,TN Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000070889 05-12-2019 201900067993/107237 MERRIANI Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000070889 05-12-2019 201900067993/107237 MERRIANI Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000070892 05-12-2019 201900068092/094879 AXLE BENNEDICT G FREDRIK, Dr,Sp.A ON00082 Nymiko Drop 1.00 Botol 48,856.00 49,356.00
R2019-0000070892 05-12-2019 201900068092/094879 AXLE BENNEDICT G FREDRIK, Dr,Sp.A OL00001 L - BIO Sachet 10.00 Sachet 10,395.00 104,450.00
R2019-0000070891 05-12-2019 201900067999/074706 YUMNA ZALIKA Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000070898 05-12-2019 201900068049/072114 LIM GIOK ING,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070898 05-12-2019 201900068049/072114 LIM GIOK ING,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070898 05-12-2019 201900068049/072114 LIM GIOK ING,NY TEDDY OT00150 Tim Opthal 0.5% ED 1.00 Botol 70,834.50 71,334.50
R2019-0000070900 05-12-2019 201900068007/109389 MIKHA STEFANIA FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000070900 05-12-2019 201900068007/109389 MIKHA STEFANIA FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000070900 05-12-2019 201900068007/109389 MIKHA STEFANIA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000070900 05-12-2019 201900068007/109389 MIKHA STEFANIA FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000070900 05-12-2019 201900068007/109389 MIKHA STEFANIA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000070900 05-12-2019 201900068007/109389 MIKHA STEFANIA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
Total 46,649,683.19
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 36 dari 266
ASAL RAWAT JALAN
R2019-0000070901 05-12-2019 201900068047/37175 KWE JOE KWAN,TN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070901 05-12-2019 201900068047/37175 KWE JOE KWAN,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070903 05-12-2019 201900068052/045485 SITI FAUZIAH,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070903 05-12-2019 201900068052/045485 SITI FAUZIAH,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070904 05-12-2019 201900068006/069184 YATINEM,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070904 05-12-2019 201900068006/069184 YATINEM,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070907 05-12-2019 201900068077/111647 RUDI HARTONO,TN Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000070907 05-12-2019 201900068077/111647 RUDI HARTONO,TN Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000070905 05-12-2019 201900067955/109679 SYAMSUDIN,TN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070905 05-12-2019 201900067955/109679 SYAMSUDIN,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070908 05-12-2019 201900067957/111301 SETIONO,TN TEDDY OC00054 Cendo Xitrol T etes Mata 1.00 Botol 46,800.00 47,300.00
R2019-0000070908 05-12-2019 201900067957/111301 SETIONO,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070912 05-12-2019 201900068107/111651 NINDI AULIA,AN Nathalia dr. OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000070912 05-12-2019 201900068107/111651 NINDI AULIA,AN Nathalia dr. OV00080 Vitamin B Compleks 10.00 Tablet 241.79 2,917.90
R2019-0000070913 05-12-2019 201900067993/107237 MERRIANI Dwi Astuti, dr OL00076 Lodia 2mg 2.00 Tablet 1,485.00 3,470.00
R2019-0000070913 05-12-2019 201900067993/107237 MERRIANI Dwi Astuti, dr ON00047 New Diatabs 4.00 Tablet 767.13 3,568.52
R2019-0000070913 05-12-2019 201900067993/107237 MERRIANI Dwi Astuti, dr OS00176 Scopma Plus Tablet 5.00 Tablet 2,090.22 10,951.10
R2019-0000070913 05-12-2019 201900067993/107237 MERRIANI Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000070913 05-12-2019 201900067993/107237 MERRIANI Dwi Astuti, dr OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000070916 05-12-2019 201900068051/095301 AMSI DRS,TN Eviwati OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000070915 05-12-2019 201900067946/094996 ARISMAWATI,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070915 05-12-2019 201900067946/094996 ARISMAWATI,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070918 05-12-2019 201900067925/111632 AMELIA FUTRIAYU,AN Niki Juniar ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000070920 05-12-2019 201900067924/111631 RIA NOOR Niki Juniar OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000070920 05-12-2019 201900067924/111631 RIA NOOR Niki Juniar OV00057 Ventolin Nebules 2.5mg 2.00 Ampul 15,365.00 31,230.00
R2019-0000070920 05-12-2019 201900067924/111631 RIA NOOR Niki Juniar OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000070920 05-12-2019 201900067924/111631 RIA NOOR Niki Juniar ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000070920 05-12-2019 201900067924/111631 RIA NOOR Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070920 05-12-2019 201900067924/111631 RIA NOOR Niki Juniar OC00041 Cefotaxim 1.0gr Injeksi 1.00 Vial 60,885.00 61,385.00
R2019-0000070919 05-12-2019 201900067969/088916 ALI AKBAR UMAR,TN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000070919 05-12-2019 201900067969/088916 ALI AKBAR UMAR,TN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000070919 05-12-2019 201900067969/088916 ALI AKBAR UMAR,TN EDO, Dr.Sp.B ALH00020 Hypafix 10cm x 5m 1.00 Cm 400.00 900.00
R2019-0000070919 05-12-2019 201900067969/088916 ALI AKBAR UMAR,TN EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000070922 05-12-2019 201900068114/061052 SITI SHALIHAH IQBAL, dr ON00004 Naprex Syrup, 60ml 1.00 Botol 59,251.50 59,751.50
R2019-0000070922 05-12-2019 201900068114/061052 SITI SHALIHAH IQBAL, dr OV00106 Vosedon Suspensi 1.00 Botol 43,213.50 43,713.50
R2019-0000070922 05-12-2019 201900068114/061052 SITI SHALIHAH IQBAL, dr OC00038 Cefila Dry Syrup 1.00 Botol 123,255.00 123,755.00
Total 47,681,939.61
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 37 dari 266
ASAL RAWAT JALAN
R2019-0000070923 05-12-2019 201900067999/074706 YUMNA ZALIKA Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000070923 05-12-2019 201900067999/074706 YUMNA ZALIKA Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000070923 05-12-2019 201900067999/074706 YUMNA ZALIKA Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000070923 05-12-2019 201900067999/074706 YUMNA ZALIKA Dwi Astuti, dr OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000070923 05-12-2019 201900067999/074706 YUMNA ZALIKA Dwi Astuti, dr OS00009 Salbutamol 2mg (OGB) 3.00 Tablet 213.30 1,139.90
R2019-0000070923 05-12-2019 201900067999/074706 YUMNA ZALIKA Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000070924 05-12-2019 201900068081/103422 DANINGSIH,NY NOVIANA, Dr. Sp OF00099 Folda Tablet 30.00 Tablet 6,661.65 200,349.50
R2019-0000070924 05-12-2019 201900068081/103422 DANINGSIH,NY NOVIANA, Dr. Sp OB00068 BioCal-95 30.00 Tablet 7,128.00 214,340.00
R2019-0000070924 05-12-2019 201900068081/103422 DANINGSIH,NY NOVIANA, Dr. Sp OU00008 Utrogestan 100mg 20.00 Capsul 17,820.00 356,900.00
R2019-0000070925 05-12-2019 201900068008/093771 TINI,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070925 05-12-2019 201900068008/093771 TINI,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070926 05-12-2019 201900068016/079664 YUSNIAH,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070926 05-12-2019 201900068016/079664 YUSNIAH,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070927 05-12-2019 201900068087/107046 ANNA NOVIANA, Dr. Sp OF00099 Folda Tablet 30.00 Tablet 6,661.65 200,349.50
R2019-0000070927 05-12-2019 201900068087/107046 ANNA NOVIANA, Dr. Sp OA00134 Asta Plus 30.00 Tablet 12,623.00 379,190.00
R2019-0000070928 05-12-2019 201900068035/089687 NURIYAH,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070928 05-12-2019 201900068035/089687 NURIYAH,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070929 05-12-2019 201900068040/100990 MASTURI,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000070929 05-12-2019 201900068040/100990 MASTURI,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000070931 05-12-2019 201900068106/090989 BACHRANI,SDR Angie Renatha , OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000070932 05-12-2019 201900068086/54952 AGUSTINA PARESA,NY NOVIANA, Dr. Sp OE00008 Elkana Tablet 7.00 Tablet 1,247.40 9,231.80
R2019-0000070933 05-12-2019 201900068097/040877 DEWI IDAMAWATY,NY NOVIANA, Dr. Sp OB00007 Becom - C 7.00 Tablet 2,123.55 15,364.85
R2019-0000070934 05-12-2019 201900068118/059214 ANISA OLIVIANTI Angie Renatha , OA00106 Asam Mefenamat 500mg 15.00 Tablet 415.80 6,737.00
R2019-0000070935 05-12-2019 201900067963/092475 JULIANUS,TN LUSY E. Dr.Sp.PD OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000070936 05-12-2019 201900068038/109283 NOR RABIAH,NY Eviwati OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000070936 05-12-2019 201900068038/109283 NOR RABIAH,NY Eviwati OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000070937 05-12-2019 201900068082/111649 ERNANY PUSPA,NY Ismail dr. Msc. OT00147 Trilac 10mg Injeksi 1.00 Vial 148,500.00 149,000.00
R2019-0000070937 05-12-2019 201900068082/111649 ERNANY PUSPA,NY Ismail dr. Msc. ALD00003 Disposable Syringe 1ml 1.00 Pcs 3,500.00 4,000.00
R2019-0000070948 05-12-2019 201900068022/080109 SRI WIDJAYANTI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000070948 05-12-2019 201900068022/080109 SRI WIDJAYANTI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000070948 05-12-2019 201900068022/080109 SRI WIDJAYANTI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000070948 05-12-2019 201900068022/080109 SRI WIDJAYANTI,NY LUSY E. Dr.Sp.PD OM00154 Mecobalamin 500mg 20.00 Tablet 1,118.00 22,860.00
R2019-0000070947 05-12-2019 201900068061/111643 MAISARAH,NY Windy Krisanti OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000070949 05-12-2019 201900067983/023279 NOOR LIYANA,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000070949 05-12-2019 201900067983/023279 NOOR LIYANA,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000070949 05-12-2019 201900067983/023279 NOOR LIYANA,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000070950 05-12-2019 201900068068/041214 LUCIA LIKURABI,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000070950 05-12-2019 201900068068/041214 LUCIA LIKURABI,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
Total 49,773,531.86
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 38 dari 266
ASAL RAWAT JALAN
R2019-0000070950 05-12-2019 201900068068/041214 LUCIA LIKURABI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000070950 05-12-2019 201900068068/041214 LUCIA LIKURABI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000070950 05-12-2019 201900068068/041214 LUCIA LIKURABI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000070950 05-12-2019 201900068068/041214 LUCIA LIKURABI,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000070950 05-12-2019 201900068068/041214 LUCIA LIKURABI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000070950 05-12-2019 201900068068/041214 LUCIA LIKURABI,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000070952 05-12-2019 201900068133/110642 WAHYUNI,NY Nathalia dr. OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 Botol 22,542.30 23,042.30
R2019-0000070952 05-12-2019 201900068133/110642 WAHYUNI,NY Nathalia dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000070952 05-12-2019 201900068133/110642 WAHYUNI,NY Nathalia dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000070952 05-12-2019 201900068133/110642 WAHYUNI,NY Nathalia dr. OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000070954 05-12-2019 201900067979/025054 GUSTI SJACHMUDDIN LUSY E. Dr.Sp.PD OS00029 Sanmol Tablet, 500mg 15.00 Tablet 430.65 6,959.75
R2019-0000070954 05-12-2019 201900067979/025054 GUSTI SJACHMUDDIN LUSY E. Dr.Sp.PD OL00059 Levofloxacin 500mg 5.00 Tablet 1,793.00 9,465.00
R2019-0000070954 05-12-2019 201900067979/025054 GUSTI SJACHMUDDIN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000070954 05-12-2019 201900067979/025054 GUSTI SJACHMUDDIN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000070962 05-12-2019 201900068127/093401 DWI NILLA LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000070962 05-12-2019 201900068127/093401 DWI NILLA LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 23.00 Tablet 14,701.50 338,634.50
R2019-0000070962 05-12-2019 201900068127/093401 DWI NILLA LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 3.00 Flexpen 226,917.80 681,253.40
R2019-0000070962 05-12-2019 201900068127/093401 DWI NILLA LUSY E. Dr.Sp.PD OL00056 Levemir Insulin 2.00 Flexpen 287,330.88 575,161.76
R2019-0000070972 05-12-2019 201900068133/110642 WAHYUNI,NY Nathalia dr. ON00039 Neurosanbe Injeksi 1.00 Ampul 8,122.95 8,622.95
R2019-0000070972 05-12-2019 201900068133/110642 WAHYUNI,NY Nathalia dr. OB00016 Betahistine Mesilat 6mg 10.00 Tablet 1,500.00 15,500.00
R2019-0000070972 05-12-2019 201900068133/110642 WAHYUNI,NY Nathalia dr. OF00007 Farbion Tablet 10.00 Tablet 1,782.00 18,320.00
R2019-0000070982 05-12-2019 201900068147/111655 YULIANTO ,TN Nathalia dr. OC00160 Codipront Cum 10.00 Capsul 19,305.00 193,550.00
R2019-0000070982 05-12-2019 201900068147/111655 YULIANTO ,TN Nathalia dr. OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000070975 05-12-2019 201900068145/090509 MEIVA CHELSEA Nathalia dr. OA00106 Asam Mefenamat 500mg 6.00 Tablet 415.80 2,994.80
R2019-0000070975 05-12-2019 201900068145/090509 MEIVA CHELSEA Nathalia dr. OV00080 Vitamin B Compleks 6.00 Tablet 241.79 1,950.74
R2019-0000070975 05-12-2019 201900068145/090509 MEIVA CHELSEA Nathalia dr. ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000070985 05-12-2019 201900068112/110680 SUTRISNO,TN Ismail dr. Msc. OA00027 Albendazole 400mg 1.00 Tablet 625.05 1,125.05
R2019-0000070986 05-12-2019 201900068149/071594 AZKA AL Riyanti Puji dr. OC00038 Cefila Dry Syrup 1.00 Botol 123,255.00 123,755.00
R2019-0000070986 05-12-2019 201900068149/071594 AZKA AL Riyanti Puji dr. ON00004 Naprex Syrup, 60ml 1.00 Botol 59,251.50 59,751.50
R2019-0000070986 05-12-2019 201900068149/071594 AZKA AL Riyanti Puji dr. OE00017 Epexol Syrup 1.00 Botol 25,690.50 26,190.50
R2019-0000070986 05-12-2019 201900068149/071594 AZKA AL Riyanti Puji dr. OP00184 Neo Protifed Tablet 1.00 Tablet 1,263.73 1,763.73
R2019-0000070991 05-12-2019 201900068152/111502 NAZWAN ARMAN Riyanti Puji dr. OA00093 Apialys Drop 1.00 Botol 59,400.00 59,900.00
R2019-0000070992 05-12-2019 201900068151/111491 UWAIS ABDILLAH Riyanti Puji dr. OA00093 Apialys Drop 1.00 Botol 59,400.00 59,900.00
R2019-0000070994 05-12-2019 201900068156/015538 WARYO NO,TN Nathalia dr. OE00018 Epexol Tablet 10.00 Tablet 1,232.55 12,825.50
R2019-0000070994 05-12-2019 201900068156/015538 WARYO NO,TN Nathalia dr. OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000070994 05-12-2019 201900068156/015538 WARYO NO,TN Nathalia dr. OO00022 Opicef 500mg Capsul 6.00 Capsul 14,850.00 89,600.00
R2019-0000070996 05-12-2019 201900068144/066564 DIKA ADITYA,AN Riyanti Puji dr. OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000070996 05-12-2019 201900068144/066564 DIKA ADITYA,AN Riyanti Puji dr. OE00007 Elkana Syrup 1.00 Botol 34,303.50 34,803.50
Total 52,563,828.02
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 39 dari 266
ASAL RAWAT JALAN
R2019-0000070995 05-12-2019 201900068127/093401 DWI NILLA LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000070995 05-12-2019 201900068127/093401 DWI NILLA LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000070995 05-12-2019 201900068127/093401 DWI NILLA LUSY E. Dr.Sp.PD OB00016 Betahistine Mesilat 6mg 20.00 Tablet 1,500.00 30,500.00
R2019-0000070995 05-12-2019 201900068127/093401 DWI NILLA LUSY E. Dr.Sp.PD OF00065 Flunarizine 5mg 10.00 Tablet 2,970.00 30,200.00
R2019-0000070995 05-12-2019 201900068127/093401 DWI NILLA LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 14.00 Capsul 1,169.98 16,879.72
R2019-0000070995 05-12-2019 201900068127/093401 DWI NILLA LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000070999 05-12-2019 201900068157/111508 ANDI AAFIYAH Rianti dr. Sp.A OA00093 Apialys Drop 1.00 Botol 59,400.00 59,900.00
R2019-0000071000 03-12-2019 201900067426/060604 YAFAO LAROSA,TN Dameria Sri OK00002 Kalium Diklofenac 50mg 10.00 Tablet 1,100.00 11,500.00
R2019-0000071000 03-12-2019 201900067426/060604 YAFAO LAROSA,TN Dameria Sri OG00057 Gabapentin 300mg (OGB) 14.00 Tablet 8,168.00 114,852.00
R2019-0000071000 03-12-2019 201900067426/060604 YAFAO LAROSA,TN Dameria Sri OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000071002 05-12-2019 201900068116/095989 ATIKAH,NY LUSY E. Dr.Sp.PD OG00025 Gliquidone 30mg (OGB) 11.00 Tablet 1,967.44 22,141.84
R2019-0000071002 05-12-2019 201900068116/095989 ATIKAH,NY LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 3.00 Tab 7,425.00 22,775.00
R2019-0000071002 05-12-2019 201900068116/095989 ATIKAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000071002 05-12-2019 201900068116/095989 ATIKAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071002 05-12-2019 201900068116/095989 ATIKAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071002 05-12-2019 201900068116/095989 ATIKAH,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000071002 05-12-2019 201900068116/095989 ATIKAH,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000071003 05-12-2019 201900068116/095989 ATIKAH,NY LUSY E. Dr.Sp.PD OG00025 Gliquidone 30mg (OGB) 34.00 Tablet 1,967.44 67,392.96
R2019-0000071003 05-12-2019 201900068116/095989 ATIKAH,NY LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 12.00 Tab 7,425.00 89,600.00
R2019-0000071003 05-12-2019 201900068116/095989 ATIKAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2019-0000071003 05-12-2019 201900068116/095989 ATIKAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000071003 05-12-2019 201900068116/095989 ATIKAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000071003 05-12-2019 201900068116/095989 ATIKAH,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 23.00 Tablet 240.30 6,026.90
R2019-0000071003 05-12-2019 201900068116/095989 ATIKAH,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000071004 05-12-2019 201900068111/17180 YULANI,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000071004 05-12-2019 201900068111/17180 YULANI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000071004 05-12-2019 201900068111/17180 YULANI,NY LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 7.00 Tablet 3,164.00 22,648.00
R2019-0000071005 05-12-2019 201900068111/17180 YULANI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 46.00 Tablet 371.25 17,577.50
R2019-0000071005 05-12-2019 201900068111/17180 YULANI,NY LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 23.00 Tablet 3,164.00 73,272.00
R2019-0000071006 05-12-2019 201900068109/111452 LA RIHA,TN LUSY E. Dr.Sp.PD OC00134 Curcuma Tablet 20.00 Tablet 1,336.50 27,230.00
R2019-0000071007 05-12-2019 201900068155/085493 MUHAMMAD SALMAN Nathalia dr. OC00057 Cerini 5.00 Tablet 5,093.55 25,967.75
R2019-0000071007 05-12-2019 201900068155/085493 MUHAMMAD SALMAN Nathalia dr. OE00017 Epexol Syrup 1.00 Botol 25,690.50 26,190.50
R2019-0000071007 05-12-2019 201900068155/085493 MUHAMMAD SALMAN Nathalia dr. OS00029 Sanmol Tablet, 500mg 5.00 Tablet 430.65 2,653.25
R2019-0000071011 05-12-2019 201900068104/099010 TAUFIQUR LUSY E. Dr.Sp.PD OT00046 Thyrozol 10mg 7.00 Tablet 2,913.41 20,893.87
R2019-0000071011 05-12-2019 201900068104/099010 TAUFIQUR LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 7.00 Tablet 5,197.50 36,882.50
R2019-0000071012 05-12-2019 201900068104/099010 TAUFIQUR LUSY E. Dr.Sp.PD OT00046 Thyrozol 10mg 23.00 Tablet 2,913.41 67,508.43
R2019-0000071012 05-12-2019 201900068104/099010 TAUFIQUR LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 23.00 Tablet 5,197.50 120,042.50
R2019-0000071014 05-12-2019 201900067978/082001 RESMIATI D LASUT,NY LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 7.00 Tablet 811.18 6,178.26
Total 54,164,600.10
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 40 dari 266
ASAL RAWAT JALAN
R2019-0000071014 05-12-2019 201900067978/082001 RESMIATI D LASUT,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000071014 05-12-2019 201900067978/082001 RESMIATI D LASUT,NY LUSY E. Dr.Sp.PD OG00021 Glimepiride 1mg Tablet 7.00 Tablet 1,245.00 9,215.00
R2019-0000071014 05-12-2019 201900067978/082001 RESMIATI D LASUT,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 7.00 Tablet 371.25 3,098.75
R2019-0000071014 05-12-2019 201900067978/082001 RESMIATI D LASUT,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 7.00 Tablet 315.26 2,706.82
R2019-0000071015 05-12-2019 201900067978/082001 RESMIATI D LASUT,NY LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 23.00 Tablet 811.18 19,157.14
R2019-0000071015 05-12-2019 201900067978/082001 RESMIATI D LASUT,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 23.00 Tablet 445.50 10,746.50
R2019-0000071015 05-12-2019 201900067978/082001 RESMIATI D LASUT,NY LUSY E. Dr.Sp.PD OG00021 Glimepiride 1mg Tablet 23.00 Tablet 1,245.00 29,135.00
R2019-0000071015 05-12-2019 201900067978/082001 RESMIATI D LASUT,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 23.00 Tablet 371.25 9,038.75
R2019-0000071015 05-12-2019 201900067978/082001 RESMIATI D LASUT,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 23.00 Tablet 315.26 7,750.98
R2019-0000071013 05-12-2019 201900068093/069070 RACHMA,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071013 05-12-2019 201900068093/069070 RACHMA,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071013 05-12-2019 201900068093/069070 RACHMA,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 7.00 Tablet 5,197.50 36,882.50
R2019-0000071013 05-12-2019 201900068093/069070 RACHMA,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000071016 05-12-2019 201900068084/111427 YOEL ALAN LUSY E. Dr.Sp.PD OG00024 Glimepiride 4mg Tablet 7.00 Tablet 3,869.89 27,589.23
R2019-0000071016 05-12-2019 201900068084/111427 YOEL ALAN LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 3.00 Tab 7,425.00 22,775.00
R2019-0000071016 05-12-2019 201900068084/111427 YOEL ALAN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000071017 05-12-2019 201900068084/111427 YOEL ALAN LUSY E. Dr.Sp.PD OG00024 Glimepiride 4mg Tablet 23.00 Tablet 3,869.89 89,507.47
R2019-0000071017 05-12-2019 201900068084/111427 YOEL ALAN LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 12.00 Tab 7,425.00 89,600.00
R2019-0000071017 05-12-2019 201900068084/111427 YOEL ALAN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2019-0000071019 05-12-2019 201900068161/083170 SYUKRI,TN Nathalia dr. OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000071022 05-12-2019 201900068161/083170 SYUKRI,TN Niki Juniar OR00041 Rhinos SR Capsul 10.00 Capsul 9,581.00 96,310.00
R2019-0000071042 06-12-2019 201900068193/062487 MUHAMMAD HAFIDZ Niki Juniar OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000071042 06-12-2019 201900068193/062487 MUHAMMAD HAFIDZ Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000071042 06-12-2019 201900068193/062487 MUHAMMAD HAFIDZ Niki Juniar ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 10,579.00
R2019-0000071042 06-12-2019 201900068193/062487 MUHAMMAD HAFIDZ Niki Juniar OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000071051 06-12-2019 201900068184/111663 SANTI PRATIWII,NN Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000071051 06-12-2019 201900068184/111663 SANTI PRATIWII,NN Niki Juniar OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000071051 06-12-2019 201900068184/111663 SANTI PRATIWII,NN Niki Juniar OU00022 Urotractin 400mg Tablet 6.00 Tablet 7,189.03 43,634.18
R2019-0000071052 06-12-2019 201900068172/111659 SUSANTI,NY Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000071052 06-12-2019 201900068172/111659 SUSANTI,NY Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000071052 06-12-2019 201900068172/111659 SUSANTI,NY Niki Juniar OB00050 Braxidin 4.00 Tablet 1,648.35 7,093.40
R2019-0000071052 06-12-2019 201900068172/111659 SUSANTI,NY Niki Juniar OE00057 Eperisone Hcl 50mg 3.00 Tablet 2,286.90 7,360.70
R2019-0000071054 06-12-2019 201900068175/111660 LELONO Niki Juniar OC00019 Captopril 25mg (OGB) 1.00 Tablet 267.35 767.35
R2019-0000071054 06-12-2019 201900068175/111660 LELONO Niki Juniar OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000071054 06-12-2019 201900068175/111660 LELONO Niki Juniar OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 Botol 22,542.30 23,042.30
R2019-0000071054 06-12-2019 201900068175/111660 LELONO Niki Juniar OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000071054 06-12-2019 201900068175/111660 LELONO Niki Juniar OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000071056 06-12-2019 201900068177/090592 PITRIYANI,NY Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
Total 55,057,036.90
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 41 dari 266
ASAL RAWAT JALAN
R2019-0000071056 06-12-2019 201900068177/090592 PITRIYANI,NY Niki Juniar OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000071056 06-12-2019 201900068177/090592 PITRIYANI,NY Niki Juniar OB00050 Braxidin 6.00 Tablet 1,648.35 10,390.10
R2019-0000071058 06-12-2019 201900068187/111666 KSHATRIYA Niki Juniar OD00077 Dumin Rectal 250mg 1.00 Tube 29,254.50 29,754.50
R2019-0000071058 06-12-2019 201900068187/111666 KSHATRIYA Niki Juniar OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000071059 05-12-2019 201900068162/098937 ISLAMA STROMY Nathalia dr. OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000071059 05-12-2019 201900068162/098937 ISLAMA STROMY Nathalia dr. OP00011 Paracetamol 500mg 4.00 Tablet 387.36 2,049.44
R2019-0000071064 06-12-2019 201900068186/111665 MUHAMMAD ZAYYAN Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071064 06-12-2019 201900068186/111665 MUHAMMAD ZAYYAN Niki Juniar ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000071064 06-12-2019 201900068186/111665 MUHAMMAD ZAYYAN Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071066 06-12-2019 201900068180/111662 SATRIANI,NN Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071066 06-12-2019 201900068180/111662 SATRIANI,NN Niki Juniar ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000071066 06-12-2019 201900068180/111662 SATRIANI,NN Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071066 06-12-2019 201900068180/111662 SATRIANI,NN Niki Juniar ALB00132 Blood Set 1.00 Pcs 33,976.80 34,476.80
R2019-0000071076 06-12-2019 201900068213/098229 DIAN CITRA Niki Juniar OS00014 Sanadryl DMP Syrup, 60ml 1.00 Botol 17,820.00 18,320.00
R2019-0000071076 06-12-2019 201900068213/098229 DIAN CITRA Niki Juniar OP00184 Neo Protifed Tablet 10.00 Tablet 1,263.73 13,137.30
R2019-0000071076 06-12-2019 201900068213/098229 DIAN CITRA Niki Juniar OL00041 Lasgan Capsul 10.00 Capsul 21,000.00 210,500.00
R2019-0000071076 06-12-2019 201900068213/098229 DIAN CITRA Niki Juniar OI00134 Imunos Plus Tablet 10.00 Tablet 14,107.50 141,575.00
R2019-0000071079 06-12-2019 201900068243/095291 NOVITA FEBRI ADE RAHMAH ON00009 Natrium Diklofenac 50mg 5.00 Tablet 955.84 5,279.20
R2019-0000071079 06-12-2019 201900068243/095291 NOVITA FEBRI ADE RAHMAH OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000071079 06-12-2019 201900068243/095291 NOVITA FEBRI ADE RAHMAH OB00007 Becom - C 10.00 Tablet 2,123.55 21,735.50
R2019-0000071079 06-12-2019 201900068243/095291 NOVITA FEBRI ADE RAHMAH OF00039 FG Troches 10.00 Tablet 1,730.02 17,800.20
R2019-0000071067 06-12-2019 201900068214/069911 ANISA APRIYANTI,NY ROY , Dr.Sp.OG OB00029 Biosanbe Capsul 15.00 Capsul 1,596.37 24,445.55
R2019-0000071081 06-12-2019 201900068202/111344 SUPRIYANTO,TN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000071081 06-12-2019 201900068202/111344 SUPRIYANTO,TN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000071081 06-12-2019 201900068202/111344 SUPRIYANTO,TN EDO, Dr.Sp.B OB00028 Bioplacenton Cream, 15gr 1.00 Tube 25,245.00 25,745.00
R2019-0000071083 06-12-2019 201900068206/111668 ADE BERLIAN,NY ROY , Dr.Sp.OG OP00128 Prothyra 10mg 10.00 Tablet 6,855.50 69,055.00
R2019-0000071084 06-12-2019 201900068232/111673 BUDIONO,TN Angie Renatha , OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000071082 06-12-2019 201900068208/095808 ANUGHRAH ZALDY Niki Juniar OG00057 Gabapentin 300mg (OGB) 1.00 Tablet 8,168.00 8,668.00
R2019-0000071082 06-12-2019 201900068208/095808 ANUGHRAH ZALDY Niki Juniar OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000071082 06-12-2019 201900068208/095808 ANUGHRAH ZALDY Niki Juniar ALK00037 Kapsul No.1 pcs 200.00 7,500.00
R2019-0000071082 06-12-2019 201900068208/095808 ANUGHRAH ZALDY Niki Juniar OE00057 Eperisone Hcl 50mg 3.00 Tablet 2,286.90 7,360.70
R2019-0000071082 06-12-2019 201900068208/095808 ANUGHRAH ZALDY Niki Juniar ON00009 Natrium Diklofenac 50mg 3.00 Tablet 955.84 3,367.52
R2019-0000071085 06-12-2019 201900068215/110683 RAFI TAMARA,AN EDO, Dr.Sp.B OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000071085 06-12-2019 201900068215/110683 RAFI TAMARA,AN EDO, Dr.Sp.B OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000071086 06-12-2019 201900068233/111376 SAMARIA,NY EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000071086 06-12-2019 201900068233/111376 SAMARIA,NY EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000071086 06-12-2019 201900068233/111376 SAMARIA,NY EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
R2019-0000071086 06-12-2019 201900068233/111376 SAMARIA,NY EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
Total 56,035,157.01
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 42 dari 266
ASAL RAWAT JALAN
R2019-0000071086 06-12-2019 201900068233/111376 SAMARIA,NY EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 1.00 Cm 150.00 650.00
R2019-0000071090 06-12-2019 201900068253/063193 FAIZ ANAS NUFAIL,AN ADE RAHMAH OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000071090 06-12-2019 201900068253/063193 FAIZ ANAS NUFAIL,AN ADE RAHMAH OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000071092 06-12-2019 201900068226/088663 ANDRA IRVANI MAGDA ROSSA, OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000071092 06-12-2019 201900068226/088663 ANDRA IRVANI MAGDA ROSSA, OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000071100 05-12-2019 201900068119/111215 SRI ERMA Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 23.00 Tablet 965.25 22,700.75
R2019-0000071102 05-12-2019 201900068124/052146 BUDHI SANTOSA,TN Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 23.00 Tablet 965.25 22,700.75
R2019-0000071103 06-12-2019 201900068268/111675 RAYA ALESHA,AN ADE RAHMAH OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000071103 06-12-2019 201900068268/111675 RAYA ALESHA,AN ADE RAHMAH OB00091 Biovitan Syrup, 60ml 1.00 Botol 8,019.00 8,519.00
R2019-0000071107 05-12-2019 201900068034/074998 PARTIAH,NY LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 3.00 Flexpen 226,917.80 681,253.40
R2019-0000071107 05-12-2019 201900068034/074998 PARTIAH,NY LUSY E. Dr.Sp.PD OL00056 Levemir Insulin 2.00 Flexpen 287,330.88 575,161.76
R2019-0000071107 05-12-2019 201900068034/074998 PARTIAH,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000071107 05-12-2019 201900068034/074998 PARTIAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000071108 06-12-2019 201900068235/082650 SANARIA,NY ROY , Dr.Sp.OG OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000071114 06-12-2019 201900068211/073386 HASNAH,NY LUSY E. Dr.Sp.PD OG00024 Glimepiride 4mg Tablet 23.00 Tablet 3,869.89 89,507.47
R2019-0000071114 06-12-2019 201900068211/073386 HASNAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2019-0000071114 06-12-2019 201900068211/073386 HASNAH,NY LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 12.00 Tab 7,425.00 89,600.00
R2019-0000071114 06-12-2019 201900068211/073386 HASNAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000071115 06-12-2019 201900068236/110464 KASINING,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000071119 06-12-2019 201900068266/111400 ZAM ZAM YUSNITA,NY LUSY E. Dr.Sp.PD OU00022 Urotractin 400mg Tablet 10.00 Tablet 7,189.03 72,390.30
R2019-0000071118 06-12-2019 201900068277/069091 KURNIA,NN LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000071118 06-12-2019 201900068277/069091 KURNIA,NN LUSY E. Dr.Sp.PD OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000071123 06-12-2019 201900068307/086454 SULTAN AFLAH ALI FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 5.00 Capsul 28,957.00 145,285.00
R2019-0000071123 06-12-2019 201900068307/086454 SULTAN AFLAH ALI FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 4.00 Tablet 430.65 2,222.60
R2019-0000071123 06-12-2019 201900068307/086454 SULTAN AFLAH ALI FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000071123 06-12-2019 201900068307/086454 SULTAN AFLAH ALI FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 4.00 Tablet 1,232.55 5,430.20
R2019-0000071123 06-12-2019 201900068307/086454 SULTAN AFLAH ALI FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000071123 06-12-2019 201900068307/086454 SULTAN AFLAH ALI FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000071124 06-12-2019 201900068318/109654 ADZKIYA NAHLA,BY FREDRIK, Dr,Sp.A OS00030 Sanmol Drop, 15ml 1.00 Botol 23,314.00 23,814.00
R2019-0000071126 06-12-2019 201900068316/074869 HABIBURRAHMAN AL FREDRIK, Dr,Sp.A OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000071126 06-12-2019 201900068316/074869 HABIBURRAHMAN AL FREDRIK, Dr,Sp.A OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000071121 06-12-2019 201900068314/098882 KHANZA AYUDYA FREDRIK, Dr,Sp.A OF00141 Farizol Suspensi, 60ml 1.00 Botol 18,532.00 19,032.00
R2019-0000071127 06-12-2019 201900068297/095574 DEASY DEBORA ADE RAHMAH OD00065 Domperidon Tablet (OGB) 3.00 Tablet 750.00 2,750.00
R2019-0000071127 06-12-2019 201900068297/095574 DEASY DEBORA ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000071127 06-12-2019 201900068297/095574 DEASY DEBORA ADE RAHMAH OA00085 Antasida Tablet (OGB) 5.00 Tablet 284.30 1,921.50
R2019-0000071128 06-12-2019 201900068313/111683 MARIANI PIPII,NY ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000071128 06-12-2019 201900068313/111683 MARIANI PIPII,NY ADE RAHMAH OA00074 Analsik 2.00 Tablet 2,264.63 5,029.26
R2019-0000071128 06-12-2019 201900068313/111683 MARIANI PIPII,NY ADE RAHMAH OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
Total 58,586,475.90
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 43 dari 266
ASAL RAWAT JALAN
R2019-0000071129 06-12-2019 201900068296/092295 NURAINI ADE RAHMAH OS00176 Scopma Plus Tablet 5.00 Tablet 2,090.22 10,951.10
R2019-0000071129 06-12-2019 201900068296/092295 NURAINI ADE RAHMAH OA00085 Antasida Tablet (OGB) 5.00 Tablet 284.30 1,921.50
R2019-0000071130 06-12-2019 201900068301/20861 FIRDAUS ADE RAHMAH OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000071130 06-12-2019 201900068301/20861 FIRDAUS ADE RAHMAH OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000071130 06-12-2019 201900068301/20861 FIRDAUS ADE RAHMAH OM00045 Methyl Prednisolon 4mg 6.00 Tablet 792.99 5,257.94
R2019-0000071130 06-12-2019 201900068301/20861 FIRDAUS ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 3.00 Capsul 1,169.98 4,009.94
R2019-0000071131 06-12-2019 201900068273/111676 NURUL KOMARIAH,NY LUSY E. Dr.Sp.PD OG00021 Glimepiride 1mg Tablet 6.00 Tablet 1,245.00 7,970.00
R2019-0000071131 06-12-2019 201900068273/111676 NURUL KOMARIAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 20.00 Tablet 371.25 7,925.00
R2019-0000071131 06-12-2019 201900068273/111676 NURUL KOMARIAH,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071131 06-12-2019 201900068273/111676 NURUL KOMARIAH,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000071133 06-12-2019 201900068275/050188 RENITHA DHIA AYU LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000071133 06-12-2019 201900068275/050188 RENITHA DHIA AYU LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071133 06-12-2019 201900068275/050188 RENITHA DHIA AYU LUSY E. Dr.Sp.PD OC00134 Curcuma Tablet 10.00 Tablet 1,336.50 13,865.00
R2019-0000071132 06-12-2019 201900068249/072450 SHELVI HONG,NY LUSY E. Dr.Sp.PD OL00021 Lansoprazole (OGB) 10.00 Capsul 2,230.00 22,800.00
R2019-0000071132 06-12-2019 201900068249/072450 SHELVI HONG,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071132 06-12-2019 201900068249/072450 SHELVI HONG,NY LUSY E. Dr.Sp.PD OB00050 Braxidin 10.00 Tablet 1,648.35 16,983.50
R2019-0000071134 06-12-2019 201900068274/098041 VINCENSIUS ARKA FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000071134 06-12-2019 201900068274/098041 VINCENSIUS ARKA FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000071134 06-12-2019 201900068274/098041 VINCENSIUS ARKA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000071134 06-12-2019 201900068274/098041 VINCENSIUS ARKA FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000071134 06-12-2019 201900068274/098041 VINCENSIUS ARKA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000071134 06-12-2019 201900068274/098041 VINCENSIUS ARKA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000071134 06-12-2019 201900068274/098041 VINCENSIUS ARKA FREDRIK, Dr,Sp.A OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000071135 06-12-2019 201900068295/106632 HAFIZAH NADHIRA ADE RAHMAH OM00097 Mucera Drop 1.00 Botol 54,945.00 55,445.00
R2019-0000071136 06-12-2019 201900068262/076249 ARIK LUSY E. Dr.Sp.PD OG00057 Gabapentin 300mg (OGB) 5.00 Tablet 8,168.00 41,340.00
R2019-0000071136 06-12-2019 201900068262/076249 ARIK LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000071136 06-12-2019 201900068262/076249 ARIK LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071137 06-12-2019 201900068254/107410 ELISABETH NOOR,NY LUSY E. Dr.Sp.PD OS00176 Scopma Plus Tablet 10.00 Tablet 2,090.22 21,402.20
R2019-0000071138 06-12-2019 201900068265/111411 HASTIAH,NY LUSY E. Dr.Sp.PD OM00045 Methyl Prednisolon 4mg 6.00 Tablet 792.99 5,257.94
R2019-0000071138 06-12-2019 201900068265/111411 HASTIAH,NY LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000071138 06-12-2019 201900068265/111411 HASTIAH,NY LUSY E. Dr.Sp.PD OA00166 Azithromycin 500mg 3.00 Tablet 14,850.00 45,050.00
R2019-0000071139 06-12-2019 201900068258/57229 PONITI,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 3.00 Tablet 315.26 1,445.78
R2019-0000071139 06-12-2019 201900068258/57229 PONITI,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000071139 06-12-2019 201900068258/57229 PONITI,NY LUSY E. Dr.Sp.PD OI00097 Isosorbide Dinitrate 5mg 21.00 Tablet 311.85 7,048.85
R2019-0000071140 06-12-2019 201900068258/57229 PONITI,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 12.00 Tablet 315.26 4,283.12
R2019-0000071140 06-12-2019 201900068258/57229 PONITI,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 23.00 Tablet 14,701.50 338,634.50
R2019-0000071140 06-12-2019 201900068258/57229 PONITI,NY LUSY E. Dr.Sp.PD OI00097 Isosorbide Dinitrate 5mg 69.00 Tablet 311.85 22,017.65
R2019-0000071141 06-12-2019 201900068257/111456 ROBIYAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
Total 59,560,318.60
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 44 dari 266
ASAL RAWAT JALAN
R2019-0000071141 06-12-2019 201900068257/111456 ROBIYAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071141 06-12-2019 201900068257/111456 ROBIYAH,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000071142 06-12-2019 201900068255/094298 SUHARNI,NY LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 7.00 Tablet 3,164.00 22,648.00
R2019-0000071142 06-12-2019 201900068255/094298 SUHARNI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000071142 06-12-2019 201900068255/094298 SUHARNI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071142 06-12-2019 201900068255/094298 SUHARNI,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000071142 06-12-2019 201900068255/094298 SUHARNI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071142 06-12-2019 201900068255/094298 SUHARNI,NY LUSY E. Dr.Sp.PD OV00080 Vitamin B Compleks 20.00 Tablet 241.79 5,335.80
R2019-0000071142 06-12-2019 201900068255/094298 SUHARNI,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000071143 06-12-2019 201900068251/075346 ERWIN LINGGI LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000071143 06-12-2019 201900068251/075346 ERWIN LINGGI LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071144 06-12-2019 201900068247/076579 EDY RAHMAD,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071144 06-12-2019 201900068247/076579 EDY RAHMAD,TN LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000071144 06-12-2019 201900068247/076579 EDY RAHMAD,TN LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000071144 06-12-2019 201900068247/076579 EDY RAHMAD,TN LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000071145 06-12-2019 201900068236/110464 KASINING,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000071146 06-12-2019 201900068227/111467 CINDI EKA TIANA,NN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000071146 06-12-2019 201900068227/111467 CINDI EKA TIANA,NN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071146 06-12-2019 201900068227/111467 CINDI EKA TIANA,NN LUSY E. Dr.Sp.PD OV00080 Vitamin B Compleks 10.00 Tablet 241.79 2,917.90
R2019-0000071147 06-12-2019 201900068234/073716 SUKATMI,NY LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 7.00 Tablet 3,164.00 22,648.00
R2019-0000071147 06-12-2019 201900068234/073716 SUKATMI,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000071147 06-12-2019 201900068234/073716 SUKATMI,NY LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000071147 06-12-2019 201900068234/073716 SUKATMI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071147 06-12-2019 201900068234/073716 SUKATMI,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000071147 06-12-2019 201900068234/073716 SUKATMI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000071148 06-12-2019 201900068234/073716 SUKATMI,NY LUSY E. Dr.Sp.PD ON00075 Novomix 30 Flexpen 6.00 Flexpen 226,917.80 1,362,006.80
R2019-0000071148 06-12-2019 201900068234/073716 SUKATMI,NY LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 23.00 Tablet 3,164.00 73,272.00
R2019-0000071148 06-12-2019 201900068234/073716 SUKATMI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 23.00 Tablet 5,197.50 120,042.50
R2019-0000071148 06-12-2019 201900068234/073716 SUKATMI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2019-0000071149 06-12-2019 201900068231/057638 WINDAWATI,DRA,NY LUSY E. Dr.Sp.PD ON00075 Novomix 30 Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000071149 06-12-2019 201900068231/057638 WINDAWATI,DRA,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000071149 06-12-2019 201900068231/057638 WINDAWATI,DRA,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071149 06-12-2019 201900068231/057638 WINDAWATI,DRA,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000071149 06-12-2019 201900068231/057638 WINDAWATI,DRA,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000071150 06-12-2019 201900068212/111670 NOOR JANNAH,NY LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 10.00 Tablet 3,164.00 32,140.00
R2019-0000071150 06-12-2019 201900068212/111670 NOOR JANNAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 20.00 Tablet 371.25 7,925.00
R2019-0000071150 06-12-2019 201900068212/111670 NOOR JANNAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000071150 06-12-2019 201900068212/111670 NOOR JANNAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 10.00 Tablet 10,617.75 106,677.50
Total 62,551,651.20
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 45 dari 266
ASAL RAWAT JALAN
R2019-0000071151 06-12-2019 201900068223/111378 ARIFIN,TN LUSY E. Dr.Sp.PD OC00134 Curcuma Tablet 14.00 Tablet 1,336.50 19,211.00
R2019-0000071151 06-12-2019 201900068223/111378 ARIFIN,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000071151 06-12-2019 201900068223/111378 ARIFIN,TN LUSY E. Dr.Sp.PD OM00045 Methyl Prednisolon 4mg 4.00 Tablet 792.99 3,671.96
R2019-0000071152 06-12-2019 201900068222/111671 ERNA,NY LUSY E. Dr.Sp.PD OL00106 Lisinopril 5mg (OGB) 10.00 Tablet 457.60 5,076.00
R2019-0000071152 06-12-2019 201900068222/111671 ERNA,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000071152 06-12-2019 201900068222/111671 ERNA,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071154 06-12-2019 201900068224/096465 FERDINANDUS LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000071154 06-12-2019 201900068224/096465 FERDINANDUS LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071153 06-12-2019 201900068640/111678 SYAHRIL S,TN ADE RAHMAH OB001002 Betahistine 5.00 Tab 5,940.00 30,200.00
R2019-0000071153 06-12-2019 201900068640/111678 SYAHRIL S,TN ADE RAHMAH OF00065 Flunarizine 5mg 5.00 Tablet 2,970.00 15,350.00
R2019-0000071153 06-12-2019 201900068640/111678 SYAHRIL S,TN ADE RAHMAH OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000071156 06-12-2019 201900068211/073386 HASNAH,NY LUSY E. Dr.Sp.PD OG00024 Glimepiride 4mg Tablet 7.00 Tablet 3,869.89 27,589.23
R2019-0000071156 06-12-2019 201900068211/073386 HASNAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000071156 06-12-2019 201900068211/073386 HASNAH,NY LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 3.00 Tab 7,425.00 22,775.00
R2019-0000071156 06-12-2019 201900068211/073386 HASNAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071156 06-12-2019 201900068211/073386 HASNAH,NY LUSY E. Dr.Sp.PD OK00022 Ketoconazol Cream 2% 1.00 Tube 11,000.00 11,500.00
R2019-0000071156 06-12-2019 201900068211/073386 HASNAH,NY LUSY E. Dr.Sp.PD OK00023 Ketoconazole 200mg 5.00 Tablet 774.24 4,371.20
R2019-0000071155 06-12-2019 201900068640/111678 SYAHRIL S,TN ADE RAHMAH OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000071155 06-12-2019 201900068640/111678 SYAHRIL S,TN ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000071155 06-12-2019 201900068640/111678 SYAHRIL S,TN ADE RAHMAH ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000071157 06-12-2019 201900068952/055670 FAYZA ZAFIRAH ADE RAHMAH OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000071157 06-12-2019 201900068952/055670 FAYZA ZAFIRAH ADE RAHMAH OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000071157 06-12-2019 201900068952/055670 FAYZA ZAFIRAH ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071157 06-12-2019 201900068952/055670 FAYZA ZAFIRAH ADE RAHMAH ALI00006 I.V Catheter No. 24 3.00 Pcs 38,900.00 117,200.00
R2019-0000071158 06-12-2019 201900068637/111677 SURYA ADE RAHMAH OI00036 Infus Otsu-Asering, 1.00 Botol 29,700.00 30,200.00
R2019-0000071158 06-12-2019 201900068637/111677 SURYA ADE RAHMAH OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071158 06-12-2019 201900068637/111677 SURYA ADE RAHMAH ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000071158 06-12-2019 201900068637/111677 SURYA ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071158 06-12-2019 201900068637/111677 SURYA ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000071159 06-12-2019 202000001246/111684 HALIJA,NY ADE RAHMAH OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071159 06-12-2019 202000001246/111684 HALIJA,NY ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071159 06-12-2019 202000001246/111684 HALIJA,NY ADE RAHMAH ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000071160 06-12-2019 201900068296/092295 NURAINI ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000071161 06-12-2019 201900068455/095970 ERWI DYAS HARIANTI Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071161 06-12-2019 201900068455/095970 ERWI DYAS HARIANTI Niki Juniar ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000071161 06-12-2019 201900068455/095970 ERWI DYAS HARIANTI Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071161 06-12-2019 201900068455/095970 ERWI DYAS HARIANTI Niki Juniar OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000071161 06-12-2019 201900068455/095970 ERWI DYAS HARIANTI Niki Juniar OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
Total 63,583,618.02
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 46 dari 266
ASAL RAWAT JALAN
R2019-0000071161 06-12-2019 201900068455/095970 ERWI DYAS HARIANTI Niki Juniar OM00047 Metoclopramide Injeksi 1.00 Ampul 10,395.00 10,895.00
R2019-0000071162 06-12-2019 201900068208/095808 ANUGHRAH ZALDY Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000071162 06-12-2019 201900068208/095808 ANUGHRAH ZALDY Niki Juniar OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000071162 06-12-2019 201900068208/095808 ANUGHRAH ZALDY Niki Juniar ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000071162 06-12-2019 201900068208/095808 ANUGHRAH ZALDY Niki Juniar ALI00004 I.V Catheter No. 20 2.00 Pcs 36,808.20 74,116.40
R2019-0000071164 06-12-2019 201900068200/111667 NATASYA SUCI Niki Juniar OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000071164 06-12-2019 201900068200/111667 NATASYA SUCI Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071164 06-12-2019 201900068200/111667 NATASYA SUCI Niki Juniar ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000071164 06-12-2019 201900068200/111667 NATASYA SUCI Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071164 06-12-2019 201900068200/111667 NATASYA SUCI Niki Juniar OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000071173 06-12-2019 201900068284/111680 MASRI,TN Ismail dr. Msc. OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000071174 06-12-2019 201900068280/111593 HJ HALIMAH,NY Ismail dr. Msc. OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000071174 06-12-2019 201900068280/111593 HJ HALIMAH,NY Ismail dr. Msc. OP00022 Pehacain Injeksi 2.00 Ampul 4,202.63 8,905.26
R2019-0000071174 06-12-2019 201900068280/111593 HJ HALIMAH,NY Ismail dr. Msc. OZ00005 Zinc Tablet (OGB) 20.00 Tablet 1,000.00 20,500.00
R2019-0000071174 06-12-2019 201900068280/111593 HJ HALIMAH,NY Ismail dr. Msc. OB00061 Burnazin Cream, 35gr 1.00 Tube 79,447.50 79,947.50
R2019-0000071175 06-12-2019 201900068291/110883 GHAITSAA AZZAHRA Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000071175 06-12-2019 201900068291/110883 GHAITSAA AZZAHRA Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000071180 06-12-2019 201900068347/104133 NI'MATUL DYAH, dr Sp. OS00132 Symbicort Inhaler 160/45 1.00 Botol/6 412,776.54 413,276.54
R2019-0000071180 06-12-2019 201900068347/104133 NI'MATUL DYAH, dr Sp. OB00094 Berotec MDI 1.00 Botol 130,000.00 130,500.00
R2019-0000071183 06-12-2019 201900068321/106015 JUSMAN,TN Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000071183 06-12-2019 201900068321/106015 JUSMAN,TN Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000071176 06-12-2019 201900068271/102853 DILLA REIFINA Ismail dr. Msc. OT00147 Trilac 10mg Injeksi 1.00 Vial 148,500.00 149,000.00
R2019-0000071184 06-12-2019 201900068367/111688 EKA AYU SEFTYNA,NN Dwi Astuti, dr OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000071190 06-12-2019 201900068288/110391 M SAAD,TN Windy Krisanti OV00080 Vitamin B Compleks 23.00 Tablet 241.79 6,061.17
R2019-0000071194 06-12-2019 201900068288/110391 M SAAD,TN Windy Krisanti OV00080 Vitamin B Compleks 7.00 Tablet 241.79 2,192.53
R2019-0000071194 06-12-2019 201900068288/110391 M SAAD,TN Windy Krisanti OA00175 Afolat 400mcg 7.00 Tablet 206.41 1,944.87
R2019-0000071194 06-12-2019 201900068288/110391 M SAAD,TN Windy Krisanti OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000071196 06-12-2019 201900068324/029200 MUHAMMAD SALEH,TN Windy Krisanti OC00092 Clopidogrel 75mg (OGB) 23.00 Tablet 14,701.50 338,634.50
R2019-0000071196 06-12-2019 201900068324/029200 MUHAMMAD SALEH,TN Windy Krisanti OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000071203 06-12-2019 201900068310/103221 YACOB,TN Windy Krisanti OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000071214 06-12-2019 201900068249/072450 SHELVI HONG,NY LUSY E. Dr.Sp.PD OL00021 Lansoprazole (OGB) 10.00 Capsul 2,230.00 22,800.00
R2019-0000071214 06-12-2019 201900068249/072450 SHELVI HONG,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071214 06-12-2019 201900068249/072450 SHELVI HONG,NY LUSY E. Dr.Sp.PD OB00050 Braxidin 10.00 Tablet 1,648.35 16,983.50
R2019-0000071217 06-12-2019 201900068398/106927 ALFARO Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 2.00 Capsul 4,266.70 9,033.40
R2019-0000071217 06-12-2019 201900068398/106927 ALFARO Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 2.00 Tablet 623.70 1,747.40
R2019-0000071217 06-12-2019 201900068398/106927 ALFARO Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000071217 06-12-2019 201900068398/106927 ALFARO Dwi Astuti, dr OD00031 Dexamethasone Tablet 2.00 Tablet 208.00 916.00
R2019-0000071217 06-12-2019 201900068398/106927 ALFARO Dwi Astuti, dr OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
Total 65,572,820.71
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 47 dari 266
ASAL RAWAT JALAN
R2019-0000071217 06-12-2019 201900068398/106927 ALFARO Dwi Astuti, dr OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2019-0000071217 06-12-2019 201900068398/106927 ALFARO Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000071218 06-12-2019 201900068401/047618 ABDULLAH,TN Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000071218 06-12-2019 201900068401/047618 ABDULLAH,TN Dwi Astuti, dr OP00184 Neo Protifed Tablet 10.00 Tablet 1,263.73 13,137.30
R2019-0000071218 06-12-2019 201900068401/047618 ABDULLAH,TN Dwi Astuti, dr OC00097 Codein 15mg 10.00 Tablet 1,665.87 17,158.70
R2019-0000071218 06-12-2019 201900068401/047618 ABDULLAH,TN Dwi Astuti, dr OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000071218 06-12-2019 201900068401/047618 ABDULLAH,TN Dwi Astuti, dr OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000071216 02-12-2019 201900067353/077756 ERNA ISYAHLIWANTI, HENDRA, dr.Sp.S OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000071216 02-12-2019 201900067353/077756 ERNA ISYAHLIWANTI, HENDRA, dr.Sp.S OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000071216 02-12-2019 201900067353/077756 ERNA ISYAHLIWANTI, HENDRA, dr.Sp.S OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000071210 06-12-2019 201900068399/090640 NURLELA,NY Dwi Astuti, dr OM00017 Meloxicam 15mg (OGB) 5.00 Tablet 2,079.00 10,895.00
R2019-0000071210 06-12-2019 201900068399/090640 NURLELA,NY Dwi Astuti, dr OE00057 Eperisone Hcl 50mg 4.00 Tablet 2,286.90 9,647.60
R2019-0000071215 03-12-2019 201900067540/108772 ROCHANI AM,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000071220 03-12-2019 201900067562/087247 BUDHI Herika dr. OT00063 Tramadol 50mg Tablet 10.00 Tablet 1,113.75 11,637.50
R2019-0000071220 03-12-2019 201900067562/087247 BUDHI Herika dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071222 03-12-2019 201900067441/111576 SUROY O,TN LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000071223 03-12-2019 201900067571/093902 AL FAJRIL Angie Renatha , OK00023 Ketoconazole 200mg 10.00 Tablet 774.24 8,242.40
R2019-0000071225 03-12-2019 201900067531/075743 ALVARO GAVRIEL Angie Renatha , OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000071225 03-12-2019 201900067531/075743 ALVARO GAVRIEL Angie Renatha , OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000071226 03-12-2019 201900067692/078049 TATIK ASMANIYAH,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000071227 03-12-2019 201900067424/090417 RABIATUL ULFAH,NY Angie Renatha , OA00013 Avamys Nasal Spray 1.00 Botol 237,451.50 237,951.50
R2019-0000071227 03-12-2019 201900067424/090417 RABIATUL ULFAH,NY Angie Renatha , OL00021 Lansoprazole (OGB) 10.00 Capsul 2,230.00 22,800.00
R2019-0000071227 03-12-2019 201900067424/090417 RABIATUL ULFAH,NY Angie Renatha , OP00011 Paracetamol 500mg 15.00 Tablet 387.36 6,310.40
R2019-0000071227 03-12-2019 201900067424/090417 RABIATUL ULFAH,NY Angie Renatha , OH0045 Hexadol Solution 60 Ml 1.00 Botol 18,562.50 19,062.50
R2019-0000071229 02-12-2019 201900067174/50922 MULIANA Z ABIDIN,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000071229 02-12-2019 201900067174/50922 MULIANA Z ABIDIN,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000071219 06-12-2019 201900068376/099237 ANITA RINI Windy Krisanti OM00154 Mecobalamin 500mg 14.00 Tablet 1,118.00 16,152.00
R2019-0000071219 06-12-2019 201900068376/099237 ANITA RINI Windy Krisanti OC00010 Calcium Lactat 500mg 10.00 Tablet 302.37 3,523.70
R2019-0000071219 06-12-2019 201900068376/099237 ANITA RINI Windy Krisanti OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000071230 06-12-2019 201900068394/111692 MUHAMMAD ENDY Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000071230 06-12-2019 201900068394/111692 MUHAMMAD ENDY Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000071230 06-12-2019 201900068394/111692 MUHAMMAD ENDY Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000071230 06-12-2019 201900068394/111692 MUHAMMAD ENDY Dwi Astuti, dr OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000071230 06-12-2019 201900068394/111692 MUHAMMAD ENDY Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000071230 06-12-2019 201900068394/111692 MUHAMMAD ENDY Dwi Astuti, dr OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000071232 06-12-2019 201900068368/111687 NURUL TRI Windy Krisanti OG00057 Gabapentin 300mg (OGB) 5.00 Tablet 8,168.00 41,340.00
Total 66,662,764.06
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 48 dari 266
ASAL RAWAT JALAN
R2019-0000071232 06-12-2019 201900068368/111687 NURUL TRI Windy Krisanti OM00154 Mecobalamin 500mg 15.00 Tablet 1,118.00 17,270.00
R2019-0000071232 06-12-2019 201900068368/111687 NURUL TRI Windy Krisanti OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000071233 06-12-2019 201900068332/074128 NOORSIAH,NY Windy Krisanti OM00154 Mecobalamin 500mg 20.00 Tablet 1,118.00 22,860.00
R2019-0000071235 06-12-2019 201900068360/099528 LA ROI,TN Windy Krisanti OB00016 Betahistine Mesilat 6mg 15.00 Tablet 1,500.00 23,000.00
R2019-0000071235 06-12-2019 201900068360/099528 LA ROI,TN Windy Krisanti OV00080 Vitamin B Compleks 10.00 Tablet 241.79 2,917.90
R2019-0000071234 06-12-2019 201900068363/107160 ASWAD,TN Windy Krisanti OG00057 Gabapentin 300mg (OGB) 20.00 Tablet 8,168.00 163,860.00
R2019-0000071234 06-12-2019 201900068363/107160 ASWAD,TN Windy Krisanti OT00063 Tramadol 50mg Tablet 15.00 Tablet 1,113.75 17,206.25
R2019-0000071234 06-12-2019 201900068363/107160 ASWAD,TN Windy Krisanti OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000071236 06-12-2019 201900068375/065736 BAGONG,TN Windy Krisanti OG00057 Gabapentin 300mg (OGB) 5.00 Tablet 8,168.00 41,340.00
R2019-0000071236 06-12-2019 201900068375/065736 BAGONG,TN Windy Krisanti ALK00037 Kapsul No.1 15.00 pcs 200.00 8,000.00
R2019-0000071236 06-12-2019 201900068375/065736 BAGONG,TN Windy Krisanti OE00057 Eperisone Hcl 50mg 15.00 Tablet 2,286.90 34,803.50
R2019-0000071237 06-12-2019 201900068403/111696 FENDY CHANDRA,TN Dwi Astuti, dr OA00067 Amoxicillin Dry Syrup, 10.00 Botol 9,652.50 97,025.00
R2019-0000071237 06-12-2019 201900068403/111696 FENDY CHANDRA,TN Dwi Astuti, dr OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000071238 06-12-2019 201900068404/097414 SARINA,NY Dwi Astuti, dr OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000071238 06-12-2019 201900068404/097414 SARINA,NY Dwi Astuti, dr OF00065 Flunarizine 5mg 4.00 Tablet 2,970.00 12,380.00
R2019-0000071239 06-12-2019 201900068372/111689 NANI SURYANI,NY Hendra Dr, Sp. OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000071239 06-12-2019 201900068372/111689 NANI SURYANI,NY Hendra Dr, Sp. OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000071239 06-12-2019 201900068372/111689 NANI SURYANI,NY Hendra Dr, Sp. OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000071240 06-12-2019 201900068396/111693 SIMON SANI Dwi Astuti, dr OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000071241 06-12-2019 201900068397/111694 LUGARDIS GUNU Dwi Astuti, dr ON00009 Natrium Diklofenac 50mg 10.00 Tablet 955.84 10,058.40
R2019-0000071243 06-12-2019 201900068361/111399 ILHAM ADE Hendra Dr, Sp. OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000071243 06-12-2019 201900068361/111399 ILHAM ADE Hendra Dr, Sp. OB00016 Betahistine Mesilat 6mg 10.00 Tablet 1,500.00 15,500.00
R2019-0000071242 06-12-2019 201900068358/11804 MAYA NATALIA,NY Windy Krisanti OE00057 Eperisone Hcl 50mg 15.00 Tablet 2,286.90 34,803.50
R2019-0000071242 06-12-2019 201900068358/11804 MAYA NATALIA,NY Windy Krisanti OL00021 Lansoprazole (OGB) 10.00 Capsul 2,230.00 22,800.00
R2019-0000071242 06-12-2019 201900068358/11804 MAYA NATALIA,NY Windy Krisanti OL00012 Lafalos Cream, 20gr 1.00 Tube 17,394.00 17,894.00
R2019-0000071244 06-12-2019 201900068383/111690 NAUFAL HANIF S,AN Dwi Astuti, dr OA00015 Acyclovir 400mg (OGB) 10.00 Tablet 1,262.25 13,122.50
R2019-0000071244 06-12-2019 201900068383/111690 NAUFAL HANIF S,AN Dwi Astuti, dr OA00016 Acyclovir Cream 5gr 1.00 Tube 4,893.00 5,393.00
R2019-0000071244 06-12-2019 201900068383/111690 NAUFAL HANIF S,AN Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000071244 06-12-2019 201900068383/111690 NAUFAL HANIF S,AN Dwi Astuti, dr OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2019-0000071244 06-12-2019 201900068383/111690 NAUFAL HANIF S,AN Dwi Astuti, dr OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000071245 06-12-2019 201900068328/110590 SALBIYAH,NY Hendra Dr, Sp. OE00008 Elkana Tablet 7.00 Tablet 1,247.40 9,231.80
R2019-0000071246 06-12-2019 201900068340/062379 PORMAN HOTMA S. Hendra Dr, Sp. OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000071246 06-12-2019 201900068340/062379 PORMAN HOTMA S. Hendra Dr, Sp. OE00008 Elkana Tablet 7.00 Tablet 1,247.40 9,231.80
R2019-0000071246 06-12-2019 201900068340/062379 PORMAN HOTMA S. Hendra Dr, Sp. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000071246 06-12-2019 201900068340/062379 PORMAN HOTMA S. Hendra Dr, Sp. ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000071247 06-12-2019 201900068292/110936 JUNAIYAH,NY Windy Krisanti OT00147 Trilac 10mg Injeksi 1.00 Vial 148,500.00 149,000.00
R2019-0000071247 06-12-2019 201900068292/110936 JUNAIYAH,NY Windy Krisanti OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000071247 06-12-2019 201900068292/110936 JUNAIYAH,NY Windy Krisanti OA00062 Amitriptyline Tablet, 7.00 Tablet 252.45 2,267.15
Total 67,577,241.36
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 49 dari 266
ASAL RAWAT JALAN
R2019-0000071247 06-12-2019 201900068292/110936 JUNAIYAH,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 14.00 Tablet 8,168.00 114,852.00
R2019-0000071247 06-12-2019 201900068292/110936 JUNAIYAH,NY Windy Krisanti OM00158 Mevrabal 500 Mg 15.00 Tablet 2,100.00 32,000.00
R2019-0000071249 06-12-2019 201900068319/31907 HADIJAH,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 3.00 Tablet 8,168.00 25,004.00
R2019-0000071249 06-12-2019 201900068319/31907 HADIJAH,NY Windy Krisanti ALK00037 Kapsul No.1 10.00 pcs 200.00 7,000.00
R2019-0000071249 06-12-2019 201900068319/31907 HADIJAH,NY Windy Krisanti OM00154 Mecobalamin 500mg 15.00 Tablet 1,118.00 17,270.00
R2019-0000071249 06-12-2019 201900068319/31907 HADIJAH,NY Windy Krisanti ON00009 Natrium Diklofenac 50mg 5.00 Tablet 955.84 5,279.20
R2019-0000071248 06-12-2019 201900068408/105436 SITI RAMLAH,NY Dwi Astuti, dr OM00045 Methyl Prednisolon 4mg 5.00 Tablet 792.99 4,464.95
R2019-0000071248 06-12-2019 201900068408/105436 SITI RAMLAH,NY Dwi Astuti, dr OF00039 FG Troches 4.00 Tablet 1,730.02 7,420.08
R2019-0000071248 06-12-2019 201900068408/105436 SITI RAMLAH,NY Dwi Astuti, dr OL00080 Loratadin 10mg (OGB) 3.00 Tablet 520.00 2,060.00
R2019-0000071248 06-12-2019 201900068408/105436 SITI RAMLAH,NY Dwi Astuti, dr OA00088 Antiza Tablet 5.00 Tablet 1,633.00 8,665.00
R2019-0000071250 06-12-2019 201900068386/111691 TAUFIK ISBULLAH,SDR Dwi Astuti, dr OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000071250 06-12-2019 201900068386/111691 TAUFIK ISBULLAH,SDR Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000071250 06-12-2019 201900068386/111691 TAUFIK ISBULLAH,SDR Dwi Astuti, dr OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000071250 06-12-2019 201900068386/111691 TAUFIK ISBULLAH,SDR Dwi Astuti, dr OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000071251 06-12-2019 201900068359/052054 LAUW SIN LAM,TN Hendra Dr, Sp. OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000071251 06-12-2019 201900068359/052054 LAUW SIN LAM,TN Hendra Dr, Sp. OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000071252 06-12-2019 201900068298/066857 ARIANI,NY Windy Krisanti OP00011 Paracetamol 500mg 8.00 Tablet 387.36 3,598.88
R2019-0000071252 06-12-2019 201900068298/066857 ARIANI,NY Windy Krisanti OT00063 Tramadol 50mg Tablet 12.00 Tablet 1,113.75 13,865.00
R2019-0000071252 06-12-2019 201900068298/066857 ARIANI,NY Windy Krisanti OC00017 Kapsul No. 00 15.00 Capsul 200.00 10,500.00
R2019-0000071252 06-12-2019 201900068298/066857 ARIANI,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 20.00 Tablet 8,168.00 163,860.00
R2019-0000071252 06-12-2019 201900068298/066857 ARIANI,NY Windy Krisanti OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071252 06-12-2019 201900068298/066857 ARIANI,NY Windy Krisanti OL00021 Lansoprazole (OGB) 5.00 Capsul 2,230.00 11,650.00
R2019-0000071254 06-12-2019 201900068342/102445 JAVIER IRSYAL Ismail dr. Msc. OG00045 Griseofulvin 125mg 20.00 Tablet 561.38 11,727.60
R2019-0000071254 06-12-2019 201900068342/102445 JAVIER IRSYAL Ismail dr. Msc. OH00026 Hydrocortis on Cream 1.00 Tube 11,880.00 12,380.00
R2019-0000071254 06-12-2019 201900068342/102445 JAVIER IRSYAL Ismail dr. Msc. GK003 Ketoconazole Cream 10 1.00 Tube 8,019.00 8,519.00
R2019-0000071254 06-12-2019 201900068342/102445 JAVIER IRSYAL Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000071254 06-12-2019 201900068342/102445 JAVIER IRSYAL Ismail dr. Msc. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000071253 06-12-2019 201900068355/102368 MUHAMMAD FADHIL Ismail dr. Msc. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000071253 06-12-2019 201900068355/102368 MUHAMMAD FADHIL Ismail dr. Msc. GK003 Ketoconazole Cream 10 1.00 Tube 8,019.00 8,519.00
R2019-0000071253 06-12-2019 201900068355/102368 MUHAMMAD FADHIL Ismail dr. Msc. OH00026 Hydrocortis on Cream 2.00 Tube 11,880.00 24,260.00
R2019-0000071253 06-12-2019 201900068355/102368 MUHAMMAD FADHIL Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000071255 06-12-2019 201900068354/111264 ALUNA DIANDRA Ismail dr. Msc. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000071255 06-12-2019 201900068354/111264 ALUNA DIANDRA Ismail dr. Msc. GK003 Ketoconazole Cream 10 1.00 Tube 8,019.00 8,519.00
R2019-0000071255 06-12-2019 201900068354/111264 ALUNA DIANDRA Ismail dr. Msc. OH00026 Hydrocortis on Cream 2.00 Tube 11,880.00 24,260.00
R2019-0000071255 06-12-2019 201900068354/111264 ALUNA DIANDRA Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000071256 06-12-2019 201900068346/098419 ISLAMIYAH,NY Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000071256 06-12-2019 201900068346/098419 ISLAMIYAH,NY Ismail dr. Msc. OK00023 Ketoconazole 200mg 20.00 Tablet 774.24 15,984.80
R2019-0000071256 06-12-2019 201900068346/098419 ISLAMIYAH,NY Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 5,049.00 5,549.00
Total 68,316,199.81
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 50 dari 266
ASAL RAWAT JALAN
R2019-0000071256 06-12-2019 201900068346/098419 ISLAMIYAH,NY Ismail dr. Msc. GK003 Ketoconazole Cream 10 1.00 Tube 8,019.00 8,519.00
R2019-0000071256 06-12-2019 201900068346/098419 ISLAMIYAH,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000071259 06-12-2019 201900068338/081608 ISMAIL,TN DYAH, dr Sp. OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000071259 06-12-2019 201900068338/081608 ISMAIL,TN DYAH, dr Sp. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000071257 06-12-2019 201900068329/072991 NORSEMAH,NY EDO, Dr.Sp.B OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000071257 06-12-2019 201900068329/072991 NORSEMAH,NY EDO, Dr.Sp.B OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000071261 06-12-2019 201900068327/111619 TARMIJI,TN Hendra Dr, Sp. OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000071261 06-12-2019 201900068327/111619 TARMIJI,TN Hendra Dr, Sp. OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000071260 06-12-2019 202000001246/111684 HALIJA,NY ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000071262 06-12-2019 201900067723/051780 MUSRINI,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000071263 04-12-2019 201900067695/111608 HARIYONO,TN ADE RAHMAH OA00125 ATS (Anti Tetanus 1.00 Ampul 222,750.00 223,250.00
R2019-0000071263 04-12-2019 201900067695/111608 HARIYONO,TN ADE RAHMAH OL00063 Lidocain HCl 2% Injeksi 2.00 Ampul 2,376.00 5,252.00
R2019-0000071265 06-12-2019 201900068723/110951 KHARISMA PUTRI Dwi Astuti, dr OC00043 Ceft riaxone 1.0gr Injeksi 1.00 Vial 53,460.00 53,960.00
R2019-0000071265 06-12-2019 201900068723/110951 KHARISMA PUTRI Dwi Astuti, dr ON00047 New Diatabs 2.00 Tablet 767.13 2,034.26
R2019-0000071265 06-12-2019 201900068723/110951 KHARISMA PUTRI Dwi Astuti, dr OE00055 Ecosol RL 500ml 3.00 Botol 19,305.00 58,415.00
R2019-0000071265 06-12-2019 201900068723/110951 KHARISMA PUTRI Dwi Astuti, dr OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000071266 06-12-2019 201900068302/083226 BAMBANG DYAH, dr Sp. OS00160 Seretide Diskus 250 mcg 1.00 Botol 322,681.59 323,181.59
R2019-0000071268 04-12-2019 201900067806/108950 RAYYAN AMMAR FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 2.00 Capsul 4,266.70 9,033.40
R2019-0000071268 04-12-2019 201900067806/108950 RAYYAN AMMAR FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 2.00 Tablet 208.00 916.00
R2019-0000071268 04-12-2019 201900067806/108950 RAYYAN AMMAR FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 2.00 Tablet 1,173.15 2,846.30
R2019-0000071268 04-12-2019 201900067806/108950 RAYYAN AMMAR FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000071268 04-12-2019 201900067806/108950 RAYYAN AMMAR FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000071268 04-12-2019 201900067806/108950 RAYYAN AMMAR FREDRIK, Dr,Sp.A OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2019-0000071268 04-12-2019 201900067806/108950 RAYYAN AMMAR FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000071269 06-12-2019 201900068302/083226 BAMBANG DYAH, dr Sp. OV00085 Vitamin B6 Tablet (OGB) 10.00 Tablet 199.80 2,498.00
R2019-0000071267 04-12-2019 201900067763/088832 IQBAL MUHAMMAD,TN ADE RAHMAH OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000071267 04-12-2019 201900067763/088832 IQBAL MUHAMMAD,TN ADE RAHMAH ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000071267 04-12-2019 201900067763/088832 IQBAL MUHAMMAD,TN ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000071267 04-12-2019 201900067763/088832 IQBAL MUHAMMAD,TN ADE RAHMAH OI00051 Infus Otsu-NS (NaCl 1.00 Botol 9,388.17 9,888.17
R2019-0000071270 06-12-2019 201900068324/029200 MUHAMMAD SALEH,TN Windy Krisanti OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000071270 06-12-2019 201900068324/029200 MUHAMMAD SALEH,TN Windy Krisanti OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000071270 06-12-2019 201900068324/029200 MUHAMMAD SALEH,TN Windy Krisanti OG00073 Glucosamine 250 Mg 15.00 Tablet 1,633.50 25,002.50
R2019-0000071270 06-12-2019 201900068324/029200 MUHAMMAD SALEH,TN Windy Krisanti OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000071272 04-12-2019 201900068158/095778 HERY HERMAWAN,TN Nathalia dr. OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000071272 04-12-2019 201900068158/095778 HERY HERMAWAN,TN Nathalia dr. OA00106 Asam Mefenamat 500mg 5.00 Tablet 415.80 2,579.00
R2019-0000071272 04-12-2019 201900068158/095778 HERY HERMAWAN,TN Nathalia dr. OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000071272 04-12-2019 201900068158/095778 HERY HERMAWAN,TN Nathalia dr. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
Total 69,705,252.68
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 51 dari 266
ASAL RAWAT JALAN
R2019-0000071273 04-12-2019 201900067753/108772 ROCHANI AM,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000071275 04-12-2019 201900067742/100988 TAMRIN TAHA,TN TEDDY OC00054 Cendo Xitrol T etes Mata 1.00 Botol 46,800.00 47,300.00
R2019-0000071275 04-12-2019 201900067742/100988 TAMRIN TAHA,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000071274 04-12-2019 201900067803/108016 HARRY FUJI R,TN TEDDY OC00054 Cendo Xitrol T etes Mata 1.00 Botol 46,800.00 47,300.00
R2019-0000071280 04-12-2019 201900067692/078049 TATIK ASMANIYAH,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000071271 06-12-2019 201900068335/090931 ESLINA LUMBAN Windy Krisanti OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000071271 06-12-2019 201900068335/090931 ESLINA LUMBAN Windy Krisanti OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000071271 06-12-2019 201900068335/090931 ESLINA LUMBAN Windy Krisanti OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071271 06-12-2019 201900068335/090931 ESLINA LUMBAN Windy Krisanti OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000071282 04-12-2019 201900067744/111160 SITI MAIMUNAH,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000071282 04-12-2019 201900067744/111160 SITI MAIMUNAH,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000071283 04-12-2019 201900067801/111616 AURA NAJA Dwi Astuti, dr OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
R2019-0000071283 04-12-2019 201900067801/111616 AURA NAJA Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000071283 04-12-2019 201900067801/111616 AURA NAJA Dwi Astuti, dr OB00018 Betason Cream 5 gr 1.00 Tube 11,805.75 12,305.75
R2019-0000071281 06-12-2019 201900068335/090931 ESLINA LUMBAN Windy Krisanti OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000071281 06-12-2019 201900068335/090931 ESLINA LUMBAN Windy Krisanti OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000071285 04-12-2019 201900067763/088832 IQBAL MUHAMMAD,TN Dwi Astuti, dr OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071285 04-12-2019 201900067763/088832 IQBAL MUHAMMAD,TN Dwi Astuti, dr OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000071286 04-12-2019 201900067798/075755 DIRMAWATY,NY Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 1.00 Tablet 415.80 915.80
R2019-0000071286 04-12-2019 201900067798/075755 DIRMAWATY,NY Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 5.00 415.80 2,579.00
R2019-0000071286 04-12-2019 201900067798/075755 DIRMAWATY,NY Dwi Astuti, dr OF00065 Flunarizine 5mg 2.00 Tablet 2,970.00 6,440.00
R2019-0000071286 04-12-2019 201900067798/075755 DIRMAWATY,NY Dwi Astuti, dr OC00019 Captopril 25mg (OGB) 5.00 Tablet 267.35 1,836.75
R2019-0000071288 04-12-2019 201900067768/111452 LA RIHA,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000071288 04-12-2019 201900067768/111452 LA RIHA,TN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071290 04-12-2019 201900067715/091659 LIKE MAKI LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000071290 04-12-2019 201900067715/091659 LIKE MAKI LUSY E. Dr.Sp.PD OL00059 Levofloxacin 500mg 5.00 Tablet 1,793.00 9,465.00
R2019-0000071290 04-12-2019 201900067715/091659 LIKE MAKI LUSY E. Dr.Sp.PD OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000071291 04-12-2019 201900067746/110665 SALEH,TN TEDDY OC00054 Cendo Xitrol T etes Mata 1.00 Botol 46,800.00 47,300.00
R2019-0000071291 04-12-2019 201900067746/110665 SALEH,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000071292 04-12-2019 201900067708/111610 SRIYONO,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000071292 04-12-2019 201900067708/111610 SRIYONO,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 10.00 Tablet 10,617.75 106,677.50
Total 71,022,495.13
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 52 dari 266
ASAL RAWAT JALAN
R2019-0000071293 04-12-2019 201900067802/104699 ALVINO RASYA FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000071293 04-12-2019 201900067802/104699 ALVINO RASYA FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000071293 04-12-2019 201900067802/104699 ALVINO RASYA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000071293 04-12-2019 201900067802/104699 ALVINO RASYA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000071293 04-12-2019 201900067802/104699 ALVINO RASYA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000071293 04-12-2019 201900067802/104699 ALVINO RASYA FREDRIK, Dr,Sp.A OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2019-0000071294 04-12-2019 201900061175/110492 LUKMAN,TN Niki Juniar OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000071294 04-12-2019 201900061175/110492 LUKMAN,TN Niki Juniar OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000071294 04-12-2019 201900061175/110492 LUKMAN,TN Niki Juniar OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000071295 04-12-2019 201900067734/109930 KASMINA TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000071295 04-12-2019 201900067734/109930 KASMINA TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000071296 04-12-2019 201900067740/064068 MASRI,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000071297 04-12-2019 201900067701/110704 SANUSI,TN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000071297 04-12-2019 201900067701/110704 SANUSI,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000071298 04-12-2019 201900067689/095937 HASAN,TN LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 10.00 Tablet 2,525.00 25,750.00
R2019-0000071298 04-12-2019 201900067689/095937 HASAN,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 20.00 Tablet 371.25 7,925.00
R2019-0000071287 06-12-2019 201900068334/093440 HOTMAN M Windy Krisanti OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071287 06-12-2019 201900068334/093440 HOTMAN M Windy Krisanti OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000071287 06-12-2019 201900068334/093440 HOTMAN M Windy Krisanti OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000071299 04-12-2019 201900067826/095778 HERY HERMAWAN,TN Dwi Astuti, dr OL00063 Lidocain HCl 2% Injeksi 2.00 Ampul 2,376.00 5,252.00
R2019-0000071299 04-12-2019 201900067826/095778 HERY HERMAWAN,TN Dwi Astuti, dr OI00051 Infus Otsu-NS (NaCl 1.00 Botol 9,388.17 9,888.17
R2019-0000071301 06-12-2019 201900068334/093440 HOTMAN M Windy Krisanti OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000071302 04-12-2019 201900067623/111601 AGUNG ANUGRAH,AN Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071302 04-12-2019 201900067623/111601 AGUNG ANUGRAH,AN Niki Juniar ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000071302 04-12-2019 201900067623/111601 AGUNG ANUGRAH,AN Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071300 04-12-2019 201900067798/075755 DIRMAWATY,NY Dwi Astuti, dr OA00063 Amlodipin 10mg (OGB) 1.00 Tablet 2,743.00 3,243.00
R2019-0000071284 06-12-2019 201900068310/103221 YACOB,TN NOVIANA, Dr. Sp OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000071284 06-12-2019 201900068310/103221 YACOB,TN NOVIANA, Dr. Sp OB00016 Betahistine Mesilat 6mg 15.00 Tablet 1,500.00 23,000.00
R2019-0000071284 06-12-2019 201900068310/103221 YACOB,TN NOVIANA, Dr. Sp OV00080 Vitamin B Compleks 10.00 Tablet 241.79 2,917.90
R2019-0000071303 06-12-2019 201900068370/091423 TARNINGSIH,NY Windy Krisanti OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071303 06-12-2019 201900068370/091423 TARNINGSIH,NY Windy Krisanti OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071303 06-12-2019 201900068370/091423 TARNINGSIH,NY Windy Krisanti OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071303 06-12-2019 201900068370/091423 TARNINGSIH,NY Windy Krisanti OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000071303 06-12-2019 201900068370/091423 TARNINGSIH,NY Windy Krisanti OG00073 Glucosamine 250 Mg 15.00 Tablet 1,633.50 25,002.50
R2019-0000071303 06-12-2019 201900068370/091423 TARNINGSIH,NY Windy Krisanti OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000071303 06-12-2019 201900068370/091423 TARNINGSIH,NY Windy Krisanti OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000071303 06-12-2019 201900068370/091423 TARNINGSIH,NY Windy Krisanti OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000071307 06-12-2019 201900068409/111697 KAFI KURNIAWAN,AN Dwi Astuti, dr OC00291 Cerini Syrup 1.00 Botol 59,103.00 59,603.00
Total 71,867,282.50
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 53 dari 266
ASAL RAWAT JALAN
R2019-0000071307 06-12-2019 201900068409/111697 KAFI KURNIAWAN,AN Dwi Astuti, dr OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000071307 06-12-2019 201900068409/111697 KAFI KURNIAWAN,AN Dwi Astuti, dr OM00099 Mucera Syrup 1.00 Botol 34,155.00 34,655.00
R2019-0000071307 06-12-2019 201900068409/111697 KAFI KURNIAWAN,AN Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000071306 06-12-2019 201900068370/091423 TARNINGSIH,NY Windy Krisanti OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000071306 06-12-2019 201900068370/091423 TARNINGSIH,NY Windy Krisanti OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000071306 06-12-2019 201900068370/091423 TARNINGSIH,NY Windy Krisanti OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000071306 06-12-2019 201900068370/091423 TARNINGSIH,NY Windy Krisanti OC00092 Clopidogrel 75mg (OGB) 23.00 Tablet 14,701.50 338,634.50
R2019-0000071306 06-12-2019 201900068370/091423 TARNINGSIH,NY Windy Krisanti OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000071306 06-12-2019 201900068370/091423 TARNINGSIH,NY Windy Krisanti OA00037 Allopurinol 100mg (OGB) 23.00 Tablet 445.50 10,746.50
R2019-0000071308 06-12-2019 201900068407/21422 KIKI,NY Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071308 06-12-2019 201900068407/21422 KIKI,NY Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000071308 06-12-2019 201900068407/21422 KIKI,NY Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071308 06-12-2019 201900068407/21422 KIKI,NY Dwi Astuti, dr ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000071308 06-12-2019 201900068407/21422 KIKI,NY Dwi Astuti, dr OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000071309 06-12-2019 201900068398/106927 ALFARO Dwi Astuti, dr OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000071311 06-12-2019 201900068400/111695 KARMILA,NY Dwi Astuti, dr ALI00004 I.V Catheter No. 20 2.00 Pcs 36,808.20 74,116.40
R2019-0000071311 06-12-2019 201900068400/111695 KARMILA,NY Dwi Astuti, dr OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000071311 06-12-2019 201900068400/111695 KARMILA,NY Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000071311 06-12-2019 201900068400/111695 KARMILA,NY Dwi Astuti, dr OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000071310 06-12-2019 201900068402/059950 AL FAKHRI Dwi Astuti, dr OP00011 Paracetamol 500mg 1.00 Tablet 387.36 887.36
R2019-0000071231 06-12-2019 201900068632/111652 DEDY AZWARI,TN LUSY E. Dr.Sp.PD OP00011 Paracetamol 500mg 1.00 Tablet 387.36 887.36
R2019-0000071231 06-12-2019 201900068632/111652 DEDY AZWARI,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 1.00 Capsul 1,169.98 1,669.98
R2019-0000071386 02-12-2019 201900067193/111361 MANSYUR,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071386 02-12-2019 201900067193/111361 MANSYUR,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071389 02-12-2019 201900067173/039328 ABDUL RAHMAN,TN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000071389 02-12-2019 201900067173/039328 ABDUL RAHMAN,TN LUSY E. Dr.Sp.PD OH00026 Hydrocortis on Cream 1.00 Tube 11,880.00 12,380.00
R2019-0000071389 02-12-2019 201900067173/039328 ABDUL RAHMAN,TN LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000071388 02-12-2019 201900067161/104716 LAIU,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071388 02-12-2019 201900067161/104716 LAIU,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071388 02-12-2019 201900067161/104716 LAIU,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071388 02-12-2019 201900067161/104716 LAIU,TN LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000071388 02-12-2019 201900067161/104716 LAIU,TN LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000071390 02-12-2019 201900067135/074807 ASMIATI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 7.00 Tablet 371.25 3,098.75
R2019-0000071390 02-12-2019 201900067135/074807 ASMIATI,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000071390 02-12-2019 201900067135/074807 ASMIATI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071390 02-12-2019 201900067135/074807 ASMIATI,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 3.00 Tablet 315.26 1,445.78
R2019-0000071390 02-12-2019 201900067135/074807 ASMIATI,NY LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000071390 02-12-2019 201900067135/074807 ASMIATI,NY LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
Total 73,602,237.95
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 54 dari 266
ASAL RAWAT JALAN
R2019-0000071391 02-12-2019 201900067194/078007 MISJEM,NY LUSY E. Dr.Sp.PD ON00075 Novomix 30 Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000071391 02-12-2019 201900067194/078007 MISJEM,NY LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000071391 02-12-2019 201900067194/078007 MISJEM,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071391 02-12-2019 201900067194/078007 MISJEM,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071391 02-12-2019 201900067194/078007 MISJEM,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 3.00 315.26 1,445.78
R2019-0000071391 02-12-2019 201900067194/078007 MISJEM,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000071393 02-12-2019 201900067188/080417 ANDI MARHUMI,NY LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000071393 02-12-2019 201900067188/080417 ANDI MARHUMI,NY LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000071393 02-12-2019 201900067188/080417 ANDI MARHUMI,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000071393 02-12-2019 201900067188/080417 ANDI MARHUMI,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000071393 02-12-2019 201900067188/080417 ANDI MARHUMI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071393 02-12-2019 201900067188/080417 ANDI MARHUMI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071393 02-12-2019 201900067188/080417 ANDI MARHUMI,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000071393 02-12-2019 201900067188/080417 ANDI MARHUMI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071353 07-12-2019 201900068484/111706 IDAM AZKA Dwi Astuti, dr OC00144 Cefila Capsul, 100mg 4.00 Capsul 28,957.00 116,328.00
R2019-0000071353 07-12-2019 201900068484/111706 IDAM AZKA Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
R2019-0000071353 07-12-2019 201900068484/111706 IDAM AZKA Dwi Astuti, dr OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000071353 07-12-2019 201900068484/111706 IDAM AZKA Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 4.00 Tablet 623.70 2,994.80
R2019-0000071353 07-12-2019 201900068484/111706 IDAM AZKA Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 17,079.00
R2019-0000071353 07-12-2019 201900068484/111706 IDAM AZKA Dwi Astuti, dr OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000071353 07-12-2019 201900068484/111706 IDAM AZKA Dwi Astuti, dr OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000071352 07-12-2019 201900068463/111700 UMI PRIYANTINI,NY ROY , Dr.Sp.OG OP00128 Prothyra 10mg 10.00 Tablet 6,855.50 69,055.00
R2019-0000071392 02-12-2019 201900067128/043578 NETTY HERWATI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071392 02-12-2019 201900067128/043578 NETTY HERWATI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071392 02-12-2019 201900067128/043578 NETTY HERWATI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071396 02-12-2019 201900067208/44464 MUJIIN,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071396 02-12-2019 201900067208/44464 MUJIIN,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071396 02-12-2019 201900067208/44464 MUJIIN,TN LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000071395 02-12-2019 201900067169/109897 TRI SUTIANI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071395 02-12-2019 201900067169/109897 TRI SUTIANI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071395 02-12-2019 201900067169/109897 TRI SUTIANI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071399 02-12-2019 201900067273/027019 ASBINTIANI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071399 02-12-2019 201900067273/027019 ASBINTIANI,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000071399 02-12-2019 201900067273/027019 ASBINTIANI,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000071399 02-12-2019 201900067273/027019 ASBINTIANI,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000071397 07-12-2019 201900068498/075635 I KETUT CANGUK,TN Dwi Astuti, dr OC00144 Cefila Capsul, 100mg 10.00 Capsul 28,957.00 290,070.00
R2019-0000071397 07-12-2019 201900068498/075635 I KETUT CANGUK,TN Dwi Astuti, dr OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000071397 07-12-2019 201900068498/075635 I KETUT CANGUK,TN Dwi Astuti, dr OE00018 Epexol Tablet 10.00 Tablet 1,232.55 12,825.50
Total 75,335,982.43
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 55 dari 266
ASAL RAWAT JALAN
R2019-0000071397 07-12-2019 201900068498/075635 I KETUT CANGUK,TN Dwi Astuti, dr OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000071397 07-12-2019 201900068498/075635 I KETUT CANGUK,TN Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000071400 02-12-2019 201900067103/072114 LIM GIOK ING,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071400 02-12-2019 201900067103/072114 LIM GIOK ING,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071400 02-12-2019 201900067103/072114 LIM GIOK ING,NY LUSY E. Dr.Sp.PD OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000071401 03-12-2019 201900067428/028068 SUGIMULYAWAN,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071402 03-12-2019 201900067518/103027 BUNGA,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 7.00 Tablet 371.25 3,098.75
R2019-0000071402 03-12-2019 201900067518/103027 BUNGA,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000071402 03-12-2019 201900067518/103027 BUNGA,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000071402 03-12-2019 201900067518/103027 BUNGA,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000071404 03-12-2019 201900067533/111590 HAERULLAH,TN LUSY E. Dr.Sp.PD OC00018 Captopril 12.5mg (OGB) 14.00 Tablet 180.00 3,020.00
R2019-0000071403 03-12-2019 201900067522/082878 KUSMINI,NY LUSY E. Dr.Sp.PD ON00075 Novomix 30 Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000071403 03-12-2019 201900067522/082878 KUSMINI,NY LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000071403 03-12-2019 201900067522/082878 KUSMINI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071403 03-12-2019 201900067522/082878 KUSMINI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000071403 03-12-2019 201900067522/082878 KUSMINI,NY LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 7.00 Tablet 2,525.00 18,175.00
R2019-0000071406 03-12-2019 201900067554/062552 DANIK ANGGRAENI,NY LUSY E. Dr.Sp.PD OD00066 Dopamet 250mg Tablet 21.00 Tablet 2,776.95 58,815.95
R2019-0000071405 03-12-2019 201900067524/025237 DEWI MURNIATI,NY LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000071405 03-12-2019 201900067524/025237 DEWI MURNIATI,NY LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000071405 03-12-2019 201900067524/025237 DEWI MURNIATI,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000071405 03-12-2019 201900067524/025237 DEWI MURNIATI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071405 03-12-2019 201900067524/025237 DEWI MURNIATI,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 3.00 Tablet 315.26 1,445.78
R2019-0000071405 03-12-2019 201900067524/025237 DEWI MURNIATI,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000071405 03-12-2019 201900067524/025237 DEWI MURNIATI,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071409 03-12-2019 201900067552/046305 RUKINI,NY LUSY E. Dr.Sp.PD OG00025 Gliquidone 30mg (OGB) 21.00 Tablet 1,967.44 41,816.24
R2019-0000071409 03-12-2019 201900067552/046305 RUKINI,NY LUSY E. Dr.Sp.PD OA00167 Acarbose 50mg (OGB) 14.00 Tablet 1,695.70 24,239.80
R2019-0000071409 03-12-2019 201900067552/046305 RUKINI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000071409 03-12-2019 201900067552/046305 RUKINI,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000071407 04-12-2019 201900067702/081037 HALIJAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071407 04-12-2019 201900067702/081037 HALIJAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071407 04-12-2019 201900067702/081037 HALIJAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 7.00 Tablet 5,197.50 36,882.50
R2019-0000071407 04-12-2019 201900067702/081037 HALIJAH,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 7.00 Tablet 315.26 2,706.82
R2019-0000071407 04-12-2019 201900067702/081037 HALIJAH,NY LUSY E. Dr.Sp.PD OC00091 Clonidin 0.15mg (OGB) 14.00 Tablet 359.37 5,531.18
R2019-0000071407 04-12-2019 201900067702/081037 HALIJAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000071410 04-12-2019 201900067704/074768 MUHAMMAD JAFAR,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000071410 04-12-2019 201900067704/074768 MUHAMMAD JAFAR,TN LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000071410 04-12-2019 201900067704/074768 MUHAMMAD JAFAR,TN LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 7.00 Tablet 2,525.00 18,175.00
R2019-0000071410 04-12-2019 201900067704/074768 MUHAMMAD JAFAR,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
Total 76,648,744.95
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 56 dari 266
ASAL RAWAT JALAN
R2019-0000071410 04-12-2019 201900067704/074768 MUHAMMAD JAFAR,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071398 07-12-2019 201900068500/111709 INRI MONALISA IRMA SARI OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000071398 07-12-2019 201900068500/111709 INRI MONALISA IRMA SARI OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000071411 04-12-2019 201900067706/063468 MARLIYANTI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000071411 04-12-2019 201900067706/063468 MARLIYANTI,NY LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 7.00 Tablet 3,164.00 22,648.00
R2019-0000071411 04-12-2019 201900067706/063468 MARLIYANTI,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000071412 04-12-2019 201900067739/059027 NOR ASIAH,NY LUSY E. Dr.Sp.PD ON00075 Novomix 30 Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000071412 04-12-2019 201900067739/059027 NOR ASIAH,NY LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000071412 04-12-2019 201900067739/059027 NOR ASIAH,NY LUSY E. Dr.Sp.PD OP00184 Neo Protifed Tablet 10.00 Tablet 1,263.73 13,137.30
R2019-0000071412 04-12-2019 201900067739/059027 NOR ASIAH,NY LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000071412 04-12-2019 201900067739/059027 NOR ASIAH,NY LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000071412 04-12-2019 201900067739/059027 NOR ASIAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071412 04-12-2019 201900067739/059027 NOR ASIAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071412 04-12-2019 201900067739/059027 NOR ASIAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000071412 04-12-2019 201900067739/059027 NOR ASIAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071413 04-12-2019 201900067741/097962 YUSUP,TN LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 3.00 Tablet 315.26 1,445.78
R2019-0000071413 04-12-2019 201900067741/097962 YUSUP,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000071413 04-12-2019 201900067741/097962 YUSUP,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071413 04-12-2019 201900067741/097962 YUSUP,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071413 04-12-2019 201900067741/097962 YUSUP,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071413 04-12-2019 201900067741/097962 YUSUP,TN LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000071415 04-12-2019 201900067755/016246 ESTY YUNIATI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000071415 04-12-2019 201900067755/016246 ESTY YUNIATI,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000071415 04-12-2019 201900067755/016246 ESTY YUNIATI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071415 04-12-2019 201900067755/016246 ESTY YUNIATI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071414 04-12-2019 201900067688/075933 SUPRAPTI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071416 04-12-2019 201900067737/099237 ANITA RINI LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071416 04-12-2019 201900067737/099237 ANITA RINI LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071416 04-12-2019 201900067737/099237 ANITA RINI LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000071416 04-12-2019 201900067737/099237 ANITA RINI LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 7.00 Tablet 5,197.50 36,882.50
R2019-0000071417 04-12-2019 201900067687/065560 SUDIBYO,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000071417 04-12-2019 201900067687/065560 SUDIBYO,TN LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000071417 04-12-2019 201900067687/065560 SUDIBYO,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071423 07-12-2019 201900068512/046287 SAIFUDDIN HAKAM,TN Dwi Astuti, dr OF00055 Flamar Tablet, 50mg 10.00 Tablet 2,710.13 27,601.30
R2019-0000071423 07-12-2019 201900068512/046287 SAIFUDDIN HAKAM,TN Dwi Astuti, dr OC00120 Cortidex Tablet 10.00 Tablet 430.65 4,806.50
R2019-0000071423 07-12-2019 201900068512/046287 SAIFUDDIN HAKAM,TN Dwi Astuti, dr OT00044 Thrombophob Gel 1.00 Tube 73,688.67 74,188.67
R2019-0000071424 07-12-2019 201900068506/111711 NURINDAH SARI,NY IRMA SARI OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000071424 07-12-2019 201900068506/111711 NURINDAH SARI,NY IRMA SARI OI00134 Imunos Plus Tablet 4.00 Tablet 14,107.50 56,930.00
Total 78,098,989.28
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 57 dari 266
ASAL RAWAT JALAN
R2019-0000071418 07-12-2019 201900068503/111710 RIDWAN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000071418 07-12-2019 201900068503/111710 RIDWAN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000071419 04-12-2019 201900068476/111539 H .H NASRUN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000071419 04-12-2019 201900068476/111539 H .H NASRUN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000071419 04-12-2019 201900068476/111539 H .H NASRUN EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
R2019-0000071419 04-12-2019 201900068476/111539 H .H NASRUN EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000071419 04-12-2019 201900068476/111539 H .H NASRUN EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000071429 07-12-2019 201900068479/111583 HASTATIE HASMAH EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000071429 07-12-2019 201900068479/111583 HASTATIE HASMAH EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000071429 07-12-2019 201900068479/111583 HASTATIE HASMAH EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000071429 07-12-2019 201900068479/111583 HASTATIE HASMAH EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000071430 07-12-2019 201900068474/111611 DEA SAHFITRI,NN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000071430 07-12-2019 201900068474/111611 DEA SAHFITRI,NN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000071430 07-12-2019 201900068474/111611 DEA SAHFITRI,NN EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
R2019-0000071430 07-12-2019 201900068474/111611 DEA SAHFITRI,NN EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000071430 07-12-2019 201900068474/111611 DEA SAHFITRI,NN EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000071434 07-12-2019 201900068493/078669 WAHYUNI IRMA SARI OL00041 Lasgan Capsul 6.00 Capsul 21,000.00 126,500.00
R2019-0000071434 07-12-2019 201900068493/078669 WAHYUNI IRMA SARI OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000071434 07-12-2019 201900068493/078669 WAHYUNI IRMA SARI OE00022 Eprinoc Tablet 6.00 Tablet 5,093.55 31,061.30
R2019-0000071434 07-12-2019 201900068493/078669 WAHYUNI IRMA SARI OA00140 Atorvastatin 20mg (OGB) 3.00 Tablet 6,534.00 20,102.00
R2019-0000071435 07-12-2019 201900068496/111707 YONI KUSUMAWI MAGDA ROSSA, OC00033 Cefadroxil 125mg Syrup, 1.00 Botol 13,283.32 13,783.32
R2019-0000071435 07-12-2019 201900068496/111707 YONI KUSUMAWI MAGDA ROSSA, OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000071437 07-12-2019 201900068467/111517 M JUMADI,TN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000071437 07-12-2019 201900068467/111517 M JUMADI,TN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000071437 07-12-2019 201900068467/111517 M JUMADI,TN EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
R2019-0000071437 07-12-2019 201900068467/111517 M JUMADI,TN EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000071437 07-12-2019 201900068467/111517 M JUMADI,TN EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000071438 07-12-2019 201900068465/111702 GUSTI ERLYN Dwi Astuti, dr OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071438 07-12-2019 201900068465/111702 GUSTI ERLYN Dwi Astuti, dr OB00016 Betahistine Mesilat 6mg 5.00 Tablet 1,500.00 8,000.00
R2019-0000071439 06-12-2019 201900068289/109908 RUSITAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071441 07-12-2019 201900068514/10555 NAKIR,TN IRMA SARI OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000071442 07-12-2019 201900068453/015881 ASWAD,TN Maulin Nikmah ALK00024 Korset TLSO (Thoraco 1.00 Pcs 455,000.00 455,500.00
R2019-0000071440 07-12-2019 201900068423/111119 BEDDU,TN LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 30.00 Tablet 14,701.50 441,545.00
R2019-0000071440 07-12-2019 201900068423/111119 BEDDU,TN LUSY E. Dr.Sp.PD OA00038 Allopurinol 300mg (OGB) 30.00 Tablet 580.00 17,900.00
R2019-0000071440 07-12-2019 201900068423/111119 BEDDU,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 30.00 Tablet 1,662.00 50,360.00
R2019-0000071440 07-12-2019 201900068423/111119 BEDDU,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 30.00 Tablet 10,617.75 319,032.50
R2019-0000071440 07-12-2019 201900068423/111119 BEDDU,TN LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 15.00 Tablet 315.26 5,228.90
R2019-0000071440 07-12-2019 201900068423/111119 BEDDU,TN LUSY E. Dr.Sp.PD OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
Total 79,846,355.87
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 58 dari 266
ASAL RAWAT JALAN
R2019-0000071443 07-12-2019 201900068515/052345 SHAFA ZHAFIRAH N IRMA SARI OE00017 Epexol Syrup 1.00 Botol 25,690.50 26,190.50
R2019-0000071443 07-12-2019 201900068515/052345 SHAFA ZHAFIRAH N IRMA SARI OC00291 Cerini Syrup 1.00 Botol 59,103.00 59,603.00
R2019-0000071445 07-12-2019 201900068534/111714 HIDAJATUNNIKMA,NY Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000071445 07-12-2019 201900068534/111714 HIDAJATUNNIKMA,NY Dwi Astuti, dr OT00077 Tremenza Tablet 10.00 Tablet 2,160.68 22,106.80
R2019-0000071445 07-12-2019 201900068534/111714 HIDAJATUNNIKMA,NY Dwi Astuti, dr OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000071445 07-12-2019 201900068534/111714 HIDAJATUNNIKMA,NY Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000071427 07-12-2019 201900068430/44585 ROMI YANTI,NY LUSY E. Dr.Sp.PD OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000071427 07-12-2019 201900068430/44585 ROMI YANTI,NY LUSY E. Dr.Sp.PD OA00166 Azithromycin 500mg 5.00 Tablet 14,850.00 74,750.00
R2019-0000071427 07-12-2019 201900068430/44585 ROMI YANTI,NY LUSY E. Dr.Sp.PD OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000071427 07-12-2019 201900068430/44585 ROMI YANTI,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000071427 07-12-2019 201900068430/44585 ROMI YANTI,NY LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000071444 07-12-2019 201900068425/055666 ASNAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000071451 07-12-2019 201900068425/055666 ASNAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071453 07-12-2019 201900068505/071893 FERI SOEGIARTO,TN LUSY E. Dr.Sp.PD OL00056 Levemir Insulin 1.00 Flexpen 10 287,330.88 259,097.79
R2019-0000071452 07-12-2019 201900068457/19616 HENNY,NY LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 7.00 Flexpen 226,917.80 1,588,924.60
R2019-0000071452 07-12-2019 201900068457/19616 HENNY,NY LUSY E. Dr.Sp.PD OL00056 Levemir Insulin 2.00 Flexpen 287,330.88 575,161.76
R2019-0000071452 07-12-2019 201900068457/19616 HENNY,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 23.00 Tablet 315.26 7,750.98
R2019-0000071452 07-12-2019 201900068457/19616 HENNY,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000071452 07-12-2019 201900068457/19616 HENNY,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000071452 07-12-2019 201900068457/19616 HENNY,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000071452 07-12-2019 201900068457/19616 HENNY,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 23.00 Tablet 14,701.50 338,634.50
R2019-0000071452 07-12-2019 201900068457/19616 HENNY,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000071456 07-12-2019 201900068573/034952 DINDA ASTERINA,NN Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000071456 07-12-2019 201900068573/034952 DINDA ASTERINA,NN Dwi Astuti, dr OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000071456 07-12-2019 201900068573/034952 DINDA ASTERINA,NN Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000071458 07-12-2019 201900068460/111445 SARIP HAYA,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000071458 07-12-2019 201900068460/111445 SARIP HAYA,TN LUSY E. Dr.Sp.PD OG00021 Glimepiride 1mg Tablet 23.00 Tablet 1,245.00 29,135.00
R2019-0000071458 07-12-2019 201900068460/111445 SARIP HAYA,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 46.00 Tablet 371.25 17,577.50
R2019-0000071459 07-12-2019 201900068538/074723 SANTOSO,TN Dwi Astuti, dr OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000071459 07-12-2019 201900068538/074723 SANTOSO,TN Dwi Astuti, dr OL00041 Lasgan Capsul 10.00 Capsul 21,000.00 210,500.00
R2019-0000071459 07-12-2019 201900068538/074723 SANTOSO,TN Dwi Astuti, dr OB00050 Braxidin 10.00 Tablet 1,648.35 16,983.50
R2019-0000071459 07-12-2019 201900068538/074723 SANTOSO,TN Dwi Astuti, dr OO00074 Ondansetron Tablet, 4mg 6.00 Tablet 4,455.00 27,230.00
R2019-0000071460 07-12-2019 201900068437/111689 NANI SURYANI,NY LUSY E. Dr.Sp.PD OL00056 Levemir Insulin 2.00 Flexpen 287,330.88 575,161.76
R2019-0000071460 07-12-2019 201900068437/111689 NANI SURYANI,NY LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 3.00 Flexpen 226,917.80 681,253.40
R2019-0000071460 07-12-2019 201900068437/111689 NANI SURYANI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000071460 07-12-2019 201900068437/111689 NANI SURYANI,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000071463 07-12-2019 201900068543/059600 ATHALLAH ULAYYA Dwi Astuti, dr OB00017 Betametason Cream 1.00 Tube 5,049.00 5,549.00
R2019-0000071463 07-12-2019 201900068543/059600 ATHALLAH ULAYYA Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
Total 85,533,230.81
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 59 dari 266
ASAL RAWAT JALAN
R2019-0000071463 07-12-2019 201900068543/059600 ATHALLAH ULAYYA Dwi Astuti, dr OM00045 Methyl Prednisolon 4mg 5.00 Tablet 792.99 4,464.95
R2019-0000071461 07-12-2019 201900068457/19616 HENNY,NY LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 2.00 Pcs 3,690.00 7,880.00
R2019-0000071461 07-12-2019 201900068457/19616 HENNY,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 7.00 Tablet 315.26 2,706.82
R2019-0000071461 07-12-2019 201900068457/19616 HENNY,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071461 07-12-2019 201900068457/19616 HENNY,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071461 07-12-2019 201900068457/19616 HENNY,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071461 07-12-2019 201900068457/19616 HENNY,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000071461 07-12-2019 201900068457/19616 HENNY,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000071461 07-12-2019 201900068457/19616 HENNY,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 14.00 Capsul 1,169.98 16,879.72
R2019-0000071461 07-12-2019 201900068457/19616 HENNY,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071465 07-12-2019 201900068440/090355 MIRA SUFIANA,NY LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 2.00 Pcs 3,690.00 7,880.00
R2019-0000071465 07-12-2019 201900068440/090355 MIRA SUFIANA,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071466 07-12-2019 201900068440/090355 MIRA SUFIANA,NY LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 3.00 Flexpen 226,917.80 681,253.40
R2019-0000071466 07-12-2019 201900068440/090355 MIRA SUFIANA,NY LUSY E. Dr.Sp.PD OL00056 Levemir Insulin 1.00 Flexpen 287,330.88 287,830.88
R2019-0000071466 07-12-2019 201900068440/090355 MIRA SUFIANA,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000071467 07-12-2019 201900068437/111689 NANI SURYANI,NY LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 2.00 Pcs 3,690.00 7,880.00
R2019-0000071467 07-12-2019 201900068437/111689 NANI SURYANI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071467 07-12-2019 201900068437/111689 NANI SURYANI,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000071467 07-12-2019 201900068437/111689 NANI SURYANI,NY LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000071467 07-12-2019 201900068437/111689 NANI SURYANI,NY LUSY E. Dr.Sp.PD OE00056 Ecosol Nacl 0,9 % 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071467 07-12-2019 201900068437/111689 NANI SURYANI,NY LUSY E. Dr.Sp.PD ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000071467 07-12-2019 201900068437/111689 NANI SURYANI,NY LUSY E. Dr.Sp.PD ALK00008 Kasa Perban 10cm 1.00 Pcs 3,267.00 3,767.00
R2019-0000071468 07-12-2019 201900068472/087840 MASDAH,NY LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 7.00 Tablet 3,164.00 22,648.00
R2019-0000071468 07-12-2019 201900068472/087840 MASDAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000071468 07-12-2019 201900068472/087840 MASDAH,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000071468 07-12-2019 201900068472/087840 MASDAH,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000071468 07-12-2019 201900068472/087840 MASDAH,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000071469 07-12-2019 201900068468/097550 LELY,NY LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 10.00 Tablet 2,525.00 25,750.00
R2019-0000071469 07-12-2019 201900068468/097550 LELY,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 20.00 Tablet 371.25 7,925.00
R2019-0000071470 07-12-2019 201900068460/111445 SARIP HAYA,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071470 07-12-2019 201900068460/111445 SARIP HAYA,TN LUSY E. Dr.Sp.PD OG00021 Glimepiride 1mg Tablet 7.00 Tablet 1,245.00 9,215.00
R2019-0000071470 07-12-2019 201900068460/111445 SARIP HAYA,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000071471 07-12-2019 201900068551/072461 MARFUAH,NY Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 6.00 Tablet 415.80 2,994.80
R2019-0000071471 07-12-2019 201900068551/072461 MARFUAH,NY Dwi Astuti, dr OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
R2019-0000071472 07-12-2019 201900068464/087372 SITI KAROMAH,NY LUSY E. Dr.Sp.PD OA00166 Azithromycin 500mg 5.00 Tablet 14,850.00 74,750.00
R2019-0000071472 07-12-2019 201900068464/087372 SITI KAROMAH,NY LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000071472 07-12-2019 201900068464/087372 SITI KAROMAH,NY LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 10.00 Tablet 3,164.00 32,140.00
R2019-0000071472 07-12-2019 201900068464/087372 SITI KAROMAH,NY LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 5.00 Tab 7,425.00 37,625.00
Total 87,340,395.78
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 60 dari 266
ASAL RAWAT JALAN
R2019-0000071473 07-12-2019 201900068513/109275 RINI LIA SARI,NY Maulin Nikmah OG00057 Gabapentin 300mg (OGB) 6.00 Tablet 8,168.00 49,508.00
R2019-0000071473 07-12-2019 201900068513/109275 RINI LIA SARI,NY Maulin Nikmah OB00016 Betahistine Mesilat 6mg 6.00 Tablet 1,500.00 9,500.00
R2019-0000071473 07-12-2019 201900068513/109275 RINI LIA SARI,NY Maulin Nikmah OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000071477 07-12-2019 201900068518/21710 SUWARRY,TN LUSY E. Dr.Sp.PD OL00108 Lexatrans 500mg 10.00 Tablet 1,871.00 19,210.00
R2019-0000071477 07-12-2019 201900068518/21710 SUWARRY,TN LUSY E. Dr.Sp.PD OC00076 Ciprofloxacin 500mg 6.00 Tablet 1,039.50 6,737.00
R2019-0000071464 07-12-2019 201900068524/070773 FITRIA NUR FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 5.00 Capsul 4,266.70 21,833.50
R2019-0000071464 07-12-2019 201900068524/070773 FITRIA NUR FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000071464 07-12-2019 201900068524/070773 FITRIA NUR FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000071464 07-12-2019 201900068524/070773 FITRIA NUR FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
R2019-0000071464 07-12-2019 201900068524/070773 FITRIA NUR FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000071464 07-12-2019 201900068524/070773 FITRIA NUR FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000071474 07-12-2019 201900068562/111717 ABDUL LATIEF, H,TN LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 23.00 Tablet 206.41 5,247.43
R2019-0000071474 07-12-2019 201900068562/111717 ABDUL LATIEF, H,TN LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 12.00 Tablet 315.26 4,283.12
R2019-0000071479 07-12-2019 201900068520/018288 DALA ULENG, HJ,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000071479 07-12-2019 201900068520/018288 DALA ULENG, HJ,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071483 07-12-2019 201900068530/094240 TASMIRAH,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 12.00 Tablet 315.26 4,283.12
R2019-0000071483 07-12-2019 201900068530/094240 TASMIRAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000071483 07-12-2019 201900068530/094240 TASMIRAH,NY LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000071484 07-12-2019 201900068521/111488 RUSNADI,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2019-0000071486 07-12-2019 201900068562/111717 ABDUL LATIEF, H,TN LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 7.00 Tablet 206.41 1,944.87
R2019-0000071486 07-12-2019 201900068562/111717 ABDUL LATIEF, H,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071486 07-12-2019 201900068562/111717 ABDUL LATIEF, H,TN LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 3.00 Tablet 315.26 1,445.78
R2019-0000071486 07-12-2019 201900068562/111717 ABDUL LATIEF, H,TN LUSY E. Dr.Sp.PD OC00091 Clonidin 0.15mg (OGB) 21.00 Tablet 359.37 8,046.77
R2019-0000071486 07-12-2019 201900068562/111717 ABDUL LATIEF, H,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071486 07-12-2019 201900068562/111717 ABDUL LATIEF, H,TN LUSY E. Dr.Sp.PD OA00043 Alprazolam 0,5mg (OGB) 5.00 Tablet 996.50 5,482.50
R2019-0000071481 07-12-2019 201900068567/111718 KARNI,NY Dwi Astuti, dr OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000071481 07-12-2019 201900068567/111718 KARNI,NY Dwi Astuti, dr OB001002 Betahistine 10.00 Tab 5,940.00 59,900.00
R2019-0000071481 07-12-2019 201900068567/111718 KARNI,NY Dwi Astuti, dr OF00065 Flunarizine 5mg 6.00 Tablet 2,970.00 18,320.00
R2019-0000071481 07-12-2019 201900068567/111718 KARNI,NY Dwi Astuti, dr OM00014 Mefinal 500mg 5.00 Tablet 1,982.48 10,412.40
R2019-0000071481 07-12-2019 201900068567/111718 KARNI,NY Dwi Astuti, dr OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071481 07-12-2019 201900068567/111718 KARNI,NY Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000071481 07-12-2019 201900068567/111718 KARNI,NY Dwi Astuti, dr OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000071481 07-12-2019 201900068567/111718 KARNI,NY Dwi Astuti, dr ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000071481 07-12-2019 201900068567/111718 KARNI,NY Dwi Astuti, dr ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000071487 07-12-2019 201900068517/033454 DJAUHARI ALWI,TN LUSY E. Dr.Sp.PD OA00038 Allopurinol 300mg (OGB) 7.00 Tablet 580.00 4,560.00
R2019-0000071487 07-12-2019 201900068517/033454 DJAUHARI ALWI,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000071487 07-12-2019 201900068517/033454 DJAUHARI ALWI,TN LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 3.00 Tablet 7,425.00 22,775.00
R2019-0000071488 07-12-2019 201900068517/033454 DJAUHARI ALWI,TN LUSY E. Dr.Sp.PD OA00038 Allopurinol 300mg (OGB) 23.00 Tablet 580.00 13,840.00
Total 88,191,953.79
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 61 dari 266
ASAL RAWAT JALAN
R2019-0000071488 07-12-2019 201900068517/033454 DJAUHARI ALWI,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000071488 07-12-2019 201900068517/033454 DJAUHARI ALWI,TN LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 12.00 Tablet 7,425.00 89,600.00
R2019-0000071490 07-12-2019 201900068511/110583 HARYONO,TN LUSY E. Dr.Sp.PD OG00025 Gliquidone 30mg (OGB) 20.00 Tablet 1,967.44 39,848.80
R2019-0000071490 07-12-2019 201900068511/110583 HARYONO,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 20.00 Tablet 371.25 7,925.00
R2019-0000071489 07-12-2019 201900068508/091017 NURASIAZAMIL,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071489 07-12-2019 201900068508/091017 NURASIAZAMIL,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071489 07-12-2019 201900068508/091017 NURASIAZAMIL,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000071489 07-12-2019 201900068508/091017 NURASIAZAMIL,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071489 07-12-2019 201900068508/091017 NURASIAZAMIL,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000071491 07-12-2019 201900068510/105814 HENUR AYU INDAH LUSY E. Dr.Sp.PD OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000071491 07-12-2019 201900068510/105814 HENUR AYU INDAH LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000071492 07-12-2019 201900068509/109996 HUSAINI,TN LUSY E. Dr.Sp.PD OC00134 Curcuma Tablet 21.00 Tablet 1,336.50 28,566.50
R2019-0000071492 07-12-2019 201900068509/109996 HUSAINI,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071492 07-12-2019 201900068509/109996 HUSAINI,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071492 07-12-2019 201900068509/109996 HUSAINI,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071492 07-12-2019 201900068509/109996 HUSAINI,TN LUSY E. Dr.Sp.PD OM00045 Methyl Prednisolon 4mg 20.00 Tablet 792.99 16,359.80
R2019-0000071493 07-12-2019 201900068509/109996 HUSAINI,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000071493 07-12-2019 201900068509/109996 HUSAINI,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000071493 07-12-2019 201900068509/109996 HUSAINI,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000071494 07-12-2019 201900068560/111716 MUHAMMAD NAUFAL Dwi Astuti, dr OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000071494 07-12-2019 201900068560/111716 MUHAMMAD NAUFAL Dwi Astuti, dr OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000071494 07-12-2019 201900068560/111716 MUHAMMAD NAUFAL Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 3.00 Tablet 1,113.75 3,841.25
R2019-0000071494 07-12-2019 201900068560/111716 MUHAMMAD NAUFAL Dwi Astuti, dr OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000071485 07-12-2019 201900068522/029965 SUGIANTO,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071485 07-12-2019 201900068522/029965 SUGIANTO,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071485 07-12-2019 201900068522/029965 SUGIANTO,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000071485 07-12-2019 201900068522/029965 SUGIANTO,TN LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000071485 07-12-2019 201900068522/029965 SUGIANTO,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071496 07-12-2019 201900068507/102932 SITI RAHMAH,NY LUSY E. Dr.Sp.PD ON00009 Natrium Diklofenac 50mg 10.00 Tablet 955.84 10,058.40
R2019-0000071497 07-12-2019 201900068495/111708 M SYAFI'IE HASAN,TN LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 10.00 Tablet 2,525.00 25,750.00
R2019-0000071497 07-12-2019 201900068495/111708 M SYAFI'IE HASAN,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 20.00 Tablet 371.25 7,925.00
R2019-0000071497 07-12-2019 201900068495/111708 M SYAFI'IE HASAN,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000071497 07-12-2019 201900068495/111708 M SYAFI'IE HASAN,TN LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 10.00 Tablet 7,425.00 74,750.00
R2019-0000071495 07-12-2019 201900068522/029965 SUGIANTO,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000071495 07-12-2019 201900068522/029965 SUGIANTO,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000071495 07-12-2019 201900068522/029965 SUGIANTO,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000071495 07-12-2019 201900068522/029965 SUGIANTO,TN LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000071495 07-12-2019 201900068522/029965 SUGIANTO,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
Total 89,918,623.92
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 62 dari 266
ASAL RAWAT JALAN
R2019-0000071499 07-12-2019 201900068489/085737 AYULIA NINGSIH,NY LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000071499 07-12-2019 201900068489/085737 AYULIA NINGSIH,NY LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 15.00 Capsul 4,266.70 64,500.50
R2019-0000071499 07-12-2019 201900068489/085737 AYULIA NINGSIH,NY LUSY E. Dr.Sp.PD OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000071499 07-12-2019 201900068489/085737 AYULIA NINGSIH,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071500 07-12-2019 201900068480/045912 SURATIN,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000071500 07-12-2019 201900068480/045912 SURATIN,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071500 07-12-2019 201900068480/045912 SURATIN,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071500 07-12-2019 201900068480/045912 SURATIN,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000071501 07-12-2019 201900068530/094240 TASMIRAH,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 3.00 Tablet 315.26 1,445.78
R2019-0000071501 07-12-2019 201900068530/094240 TASMIRAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071501 07-12-2019 201900068530/094240 TASMIRAH,NY LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000071502 07-12-2019 201900068521/111488 RUSNADI,TN LUSY E. Dr.Sp.PD OD00065 Domperidon Tablet (OGB) 10.00 Tablet 750.00 8,000.00
R2019-0000071504 07-12-2019 201900068573/034952 DINDA ASTERINA,NN Dwi Astuti, dr OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000071504 07-12-2019 201900068573/034952 DINDA ASTERINA,NN Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000071504 07-12-2019 201900068573/034952 DINDA ASTERINA,NN Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000071504 07-12-2019 201900068573/034952 DINDA ASTERINA,NN Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071504 07-12-2019 201900068573/034952 DINDA ASTERINA,NN Dwi Astuti, dr OE00055 Ecosol RL 500ml 2.00 Botol 19,305.00 39,110.00
R2019-0000071498 07-12-2019 201900068574/067430 GABRIEL Ismail dr. Msc. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071498 07-12-2019 201900068574/067430 GABRIEL Ismail dr. Msc. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071498 07-12-2019 201900068574/067430 GABRIEL Ismail dr. Msc. ALI00003 I.V Catheter No. 18 2.00 Pcs 29,744.00 59,988.00
R2019-0000071505 07-12-2019 201900068571/111701 DAVID CHRISTIAN Dwi Astuti, dr OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000071505 07-12-2019 201900068571/111701 DAVID CHRISTIAN Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071505 07-12-2019 201900068571/111701 DAVID CHRISTIAN Dwi Astuti, dr ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000071505 07-12-2019 201900068571/111701 DAVID CHRISTIAN Dwi Astuti, dr OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000071506 07-12-2019 201900068572/079342 ADZKIA NUR Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071506 07-12-2019 201900068572/079342 ADZKIA NUR Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071506 07-12-2019 201900068572/079342 ADZKIA NUR Dwi Astuti, dr ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000071508 07-12-2019 201900068569/111187 RISKA AJI IRAWAN,TN Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000071508 07-12-2019 201900068569/111187 RISKA AJI IRAWAN,TN Dwi Astuti, dr OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000071508 07-12-2019 201900068569/111187 RISKA AJI IRAWAN,TN Dwi Astuti, dr ALI00003 I.V Catheter No. 18 2.00 Pcs 29,744.00 59,988.00
R2019-0000071507 07-12-2019 201900068575/111719 HARI PURNAMA,TN Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071507 07-12-2019 201900068575/111719 HARI PURNAMA,TN Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071507 07-12-2019 201900068575/111719 HARI PURNAMA,TN Dwi Astuti, dr ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000071507 07-12-2019 201900068575/111719 HARI PURNAMA,TN Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000071512 02-12-2019 201900067369/111567 YOGI NUGRAHA,SDR ADE RAHMAH OS00176 Scopma Plus Tablet 3.00 Tablet 2,090.22 6,770.66
R2019-0000071512 02-12-2019 201900067369/111567 YOGI NUGRAHA,SDR ADE RAHMAH OA00085 Antasida Tablet (OGB) 3.00 Tablet 284.30 1,352.90
R2019-0000071513 04-12-2019 201900067884/081866 IWAN MOHAMAD Hendra Dr, Sp. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
Total 91,074,572.01
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 63 dari 266
ASAL RAWAT JALAN
R2019-0000071513 04-12-2019 201900067884/081866 IWAN MOHAMAD Hendra Dr, Sp. OC00096 Codein 10mg 5.00 Tablet 924.80 5,124.00
R2019-0000071513 04-12-2019 201900067884/081866 IWAN MOHAMAD Hendra Dr, Sp. OP00184 Neo Protifed Tablet 6.00 Tablet 1,263.73 8,082.38
R2019-0000071517 04-12-2019 201900067857/111622 CINTIYA MITA Herika dr. OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000071517 04-12-2019 201900067857/111622 CINTIYA MITA Herika dr. OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000071517 04-12-2019 201900067857/111622 CINTIYA MITA Herika dr. ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000071518 04-12-2019 201900067884/081866 IWAN MOHAMAD Herika dr. OP00011 Paracetamol 500mg 1.00 Tablet 387.36 887.36
R2019-0000071520 07-12-2019 201900068580/073973 SRI SUGIARTI,NY ADE RAHMAH OA00015 Acyclovir 400mg (OGB) 15.00 Tablet 1,262.25 19,433.75
R2019-0000071520 07-12-2019 201900068580/073973 SRI SUGIARTI,NY ADE RAHMAH OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000071520 07-12-2019 201900068580/073973 SRI SUGIARTI,NY ADE RAHMAH OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000071520 07-12-2019 201900068580/073973 SRI SUGIARTI,NY ADE RAHMAH OA00085 Antasida Tablet (OGB) 5.00 Tablet 284.30 1,921.50
R2019-0000071516 04-12-2019 201900067910/111565 NI WAYAN KESA EDO, Dr.Sp.B OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000071516 04-12-2019 201900067910/111565 NI WAYAN KESA EDO, Dr.Sp.B OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071516 04-12-2019 201900067910/111565 NI WAYAN KESA EDO, Dr.Sp.B OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000071519 07-12-2019 201900068569/111187 RISKA AJI IRAWAN,TN Dwi Astuti, dr OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071519 07-12-2019 201900068569/111187 RISKA AJI IRAWAN,TN Dwi Astuti, dr OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000071519 07-12-2019 201900068569/111187 RISKA AJI IRAWAN,TN Dwi Astuti, dr OF00065 Flunarizine 5mg 5.00 Tablet 2,970.00 15,350.00
R2019-0000071522 05-12-2019 201900068148/33975 TWIN PRIBADI,TN Nathalia dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071522 05-12-2019 201900068148/33975 TWIN PRIBADI,TN Nathalia dr. OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000071523 05-12-2019 201900068009/111641 AYSHALINA Angie Renatha , OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000071523 05-12-2019 201900068009/111641 AYSHALINA Angie Renatha , OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2019-0000071525 05-12-2019 201900068102/107429 SARI WAHYUNI, ST,NY Angie Renatha , OA00185 Akilen Ear Drop 1.00 Botol 90,139.50 90,639.50
R2019-0000071526 05-12-2019 201900068023/105833 MAWADDAH,NY Eviwati OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000071527 07-12-2019 201900068584/017879 PAUL BRY AN ADE RAHMAH ON00013 Nebacetin Powder 1.00 Pot 30,442.50 30,942.50
R2019-0000071528 05-12-2019 201900068046/039586 MUHAMMAD ADDINA Eviwati OM00052 Metronidazole 500mg 10.00 Tablet 525.39 5,753.90
R2019-0000071528 05-12-2019 201900068046/039586 MUHAMMAD ADDINA Eviwati OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000071528 05-12-2019 201900068046/039586 MUHAMMAD ADDINA Eviwati OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000071529 05-12-2019 201900067925/111632 AMELIA FUTRIAYU,AN Niki Juniar OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000071529 05-12-2019 201900067925/111632 AMELIA FUTRIAYU,AN Niki Juniar OC00085 Clindamycin 150mg 10.00 Tablet 981.59 10,315.90
R2019-0000071531 05-12-2019 201900068131/110793 SAMIAH,NY TEDDY OC00274 Cendo Noncort Minidose 1.00 Strip 62,741.00 63,241.00
R2019-0000071531 05-12-2019 201900068131/110793 SAMIAH,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000071533 05-12-2019 201900068126/111654 TRI UTARI,NY Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000071533 05-12-2019 201900068126/111654 TRI UTARI,NY Ismail dr. Msc. OG00066 Genoint Salep Kulit 2.00 Tube 7,350.75 15,201.50
R2019-0000071533 05-12-2019 201900068126/111654 TRI UTARI,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000071533 05-12-2019 201900068126/111654 TRI UTARI,NY Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000071534 05-12-2019 201900068064/068486 BURHANUDIN,TN LUSY E. Dr.Sp.PD OA00074 Analsik 10.00 Tablet 2,264.63 23,146.30
R2019-0000071534 05-12-2019 201900068064/068486 BURHANUDIN,TN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 10.00 Tablet 1,555.00 16,050.00
R2019-0000071534 05-12-2019 201900068064/068486 BURHANUDIN,TN LUSY E. Dr.Sp.PD OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000071535 05-12-2019 201900068078/111648 RIZAL HIDAYAT,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 20.00 Tablet 371.25 7,925.00
Total 91,735,326.38
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 64 dari 266
ASAL RAWAT JALAN
R2019-0000071535 05-12-2019 201900068078/111648 RIZAL HIDAYAT,TN LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 5.00 Tab 7,425.00 37,625.00
R2019-0000071535 05-12-2019 201900068078/111648 RIZAL HIDAYAT,TN LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 10.00 Tablet 3,164.00 32,140.00
R2019-0000071536 05-12-2019 201900068158/095778 HERY HERMAWAN,TN Nathalia dr. OM00052 Metronidazole 500mg 15.00 Tablet 525.39 8,380.85
R2019-0000071538 07-12-2019 201900068585/016458 MANOSSA JAVAS ADE RAHMAH OA00180 Acetylcyst ein 200mg 10.00 Tablet 1,485.00 15,350.00
R2019-0000071538 07-12-2019 201900068585/016458 MANOSSA JAVAS ADE RAHMAH OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000071538 07-12-2019 201900068585/016458 MANOSSA JAVAS ADE RAHMAH OT00077 Tremenza Tablet 10.00 Tablet 2,160.68 22,106.80
R2019-0000071538 07-12-2019 201900068585/016458 MANOSSA JAVAS ADE RAHMAH OI00134 Imunos Plus Tablet 10.00 Tablet 14,107.50 141,575.00
R2019-0000071537 07-12-2019 201900068586/090262 TUGIMAN ADE RAHMAH OS00014 Sanadryl DMP Syrup, 60ml 1.00 Botol 17,820.00 18,320.00
R2019-0000071539 07-12-2019 201900068587/086743 INNAYA ALZAHRA,AN ADE RAHMAH OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000071544 07-12-2019 201900068587/086743 INNAYA ALZAHRA,AN ADE RAHMAH OB00058 Bufect Suspensi, 60ml 1.00 Botol 21,681.00 22,181.00
R2019-0000071544 07-12-2019 201900068587/086743 INNAYA ALZAHRA,AN ADE RAHMAH OM00097 Mucera Drop 1.00 Botol 54,945.00 55,445.00
R2019-0000071544 07-12-2019 201900068587/086743 INNAYA ALZAHRA,AN ADE RAHMAH OT00076 Tremenza Syrup 1.00 Botol 30,442.50 30,942.50
R2019-0000071544 07-12-2019 201900068587/086743 INNAYA ALZAHRA,AN ADE RAHMAH OI00117 Imunos Plus Syrup, 60ml 1.00 Botol 136,620.00 137,120.00
R2019-0000071552 07-12-2019 201900068589/063515 TANTRI DIAN ADE RAHMAH OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000071559 05-12-2019 201900068128/053675 KUSNADI,TN Nathalia dr. OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000071559 05-12-2019 201900068128/053675 KUSNADI,TN Nathalia dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071558 05-12-2019 201900068160/34207 ARDIARFAH Nathalia dr. OL00076 Lodia 2mg 10.00 Tablet 1,485.00 15,350.00
R2019-0000071561 05-12-2019 201900068159/079509 SUPANGATDI,TN Nathalia dr. OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000071561 05-12-2019 201900068159/079509 SUPANGATDI,TN Nathalia dr. OC00132 CTM 4mg 10.00 Tablet 157.41 2,074.10
R2019-0000071561 05-12-2019 201900068159/079509 SUPANGATDI,TN Nathalia dr. OB00009 Bedak Salicyl, 60gr 1.00 Botol 8,108.00 8,608.00
R2019-0000071560 07-12-2019 201900068590/111722 GATOT WINARTO,TN ADE RAHMAH OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000071560 07-12-2019 201900068590/111722 GATOT WINARTO,TN ADE RAHMAH OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000071560 07-12-2019 201900068590/111722 GATOT WINARTO,TN ADE RAHMAH OT00149 Toramine 10 Mg Tablet 10.00 Tablet 8,167.50 82,175.00
R2019-0000071566 05-12-2019 201900068128/053675 KUSNADI,TN Nathalia dr. OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000071567 05-12-2019 201900068148/33975 TWIN PRIBADI,TN Nathalia dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000071567 05-12-2019 201900068148/33975 TWIN PRIBADI,TN Nathalia dr. OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000071567 05-12-2019 201900068148/33975 TWIN PRIBADI,TN Nathalia dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071567 05-12-2019 201900068148/33975 TWIN PRIBADI,TN Nathalia dr. ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000071567 05-12-2019 201900068148/33975 TWIN PRIBADI,TN Nathalia dr. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071567 05-12-2019 201900068148/33975 TWIN PRIBADI,TN Nathalia dr. ON00039 Neurosanbe Injeksi 1.00 Ampul 8,122.95 8,622.95
R2019-0000071568 05-12-2019 201900068159/079509 SUPANGATDI,TN Nathalia dr. OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000071568 05-12-2019 201900068159/079509 SUPANGATDI,TN Nathalia dr. OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000071568 05-12-2019 201900068159/079509 SUPANGATDI,TN Nathalia dr. ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000071575 07-12-2019 201900068591/111723 HAERANI,NY ADE RAHMAH OE00022 Eprinoc Tablet 3.00 Tablet 5,093.55 15,780.65
R2019-0000071575 07-12-2019 201900068591/111723 HAERANI,NY ADE RAHMAH OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000071575 07-12-2019 201900068591/111723 HAERANI,NY ADE RAHMAH OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000071586 07-12-2019 201900068596/111725 ARIESTANTO,TN ADE RAHMAH OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000071586 07-12-2019 201900068596/111725 ARIESTANTO,TN ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
Total 92,963,104.31
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 65 dari 266
ASAL RAWAT JALAN
R2019-0000071588 07-12-2019 201900068593/8063 AZHAR RIZQULLAH ADE RAHMAH ON00009 Natrium Diklofenac 50mg 6.00 Tablet 955.84 6,235.04
R2019-0000071588 07-12-2019 201900068593/8063 AZHAR RIZQULLAH ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071588 07-12-2019 201900068593/8063 AZHAR RIZQULLAH ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000071587 07-12-2019 201900068593/8063 AZHAR RIZQULLAH ADE RAHMAH OK00027 Ketorolac 3% Injeksi 2.00 Ampul 40,500.40 81,500.80
R2019-0000071590 07-12-2019 201900069215/111721 MUT MAINAH,NY ADE RAHMAH OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071590 07-12-2019 201900069215/111721 MUT MAINAH,NY ADE RAHMAH ALI00003 I.V Catheter No. 18 2.00 Pcs 29,744.00 59,988.00
R2019-0000071590 07-12-2019 201900069215/111721 MUT MAINAH,NY ADE RAHMAH ALB00132 Blood Set 1.00 Pcs 33,976.80 34,476.80
R2019-0000071589 07-12-2019 201900068592/111724 MUHAMMAD IHSAN ADE RAHMAH OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000071589 07-12-2019 201900068592/111724 MUHAMMAD IHSAN ADE RAHMAH OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000071591 07-12-2019 201900068596/111725 ARIESTANTO,TN ADE RAHMAH OD00065 Domperidon Tablet (OGB) 10.00 Tablet 750.00 8,000.00
R2019-0000071591 07-12-2019 201900068596/111725 ARIESTANTO,TN ADE RAHMAH OA00085 Antasida Tablet (OGB) 10.00 Tablet 284.30 3,343.00
R2019-0000071591 07-12-2019 201900068596/111725 ARIESTANTO,TN ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000071591 07-12-2019 201900068596/111725 ARIESTANTO,TN ADE RAHMAH OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000071591 07-12-2019 201900068596/111725 ARIESTANTO,TN ADE RAHMAH OF00055 Flamar Tablet, 50mg 6.00 Tablet 2,710.13 16,760.78
R2019-0000071593 07-12-2019 201900068595/066579 HENDRA ADE RAHMAH OC00076 Ciprofloxacin 500mg 15.00 Tablet 1,039.50 16,092.50
R2019-0000071593 07-12-2019 201900068595/066579 HENDRA ADE RAHMAH OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000071593 07-12-2019 201900068595/066579 HENDRA ADE RAHMAH OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000071593 07-12-2019 201900068595/066579 HENDRA ADE RAHMAH OS00014 Sanadryl DMP Syrup, 60ml 1.00 Botol 17,820.00 18,320.00
R2019-0000071597 07-12-2019 201900068598/109151 KEZIA GABRIELLA ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071597 07-12-2019 201900068598/109151 KEZIA GABRIELLA ADE RAHMAH OP00138 Pumpitor Capsul 10.00 Capsul 20,092.05 201,420.50
R2019-0000071602 08-12-2019 201900068601/111727 RUDY,TN Nathalia dr. OB00016 Betahistine Mesilat 6mg 10.00 Tablet 1,500.00 15,500.00
R2019-0000071602 08-12-2019 201900068601/111727 RUDY,TN Nathalia dr. OD00065 Domperidon Tablet (OGB) 10.00 Tablet 750.00 8,000.00
R2019-0000071629 08-12-2019 201900068603/111728 MIKAEL Nathalia dr. OF00007 Farbion Tablet 10.00 Tablet 1,782.00 18,320.00
R2019-0000071629 08-12-2019 201900068603/111728 MIKAEL Nathalia dr. OA00015 Acyclovir 400mg (OGB) 56.00 Tablet 1,262.25 71,186.00
R2019-0000071629 08-12-2019 201900068603/111728 MIKAEL Nathalia dr. OG00057 Gabapentin 300mg (OGB) 10.00 Tablet 8,168.00 82,180.00
R2019-0000071629 08-12-2019 201900068603/111728 MIKAEL Nathalia dr. OD00031 Dexamethasone Tablet 30.00 Tablet 208.00 6,740.00
R2019-0000071634 08-12-2019 201900068604/096903 EKA FEBRIANA,NY Nathalia dr. OE00018 Epexol Tablet 10.00 Tablet 1,232.55 12,825.50
R2019-0000071634 08-12-2019 201900068604/096903 EKA FEBRIANA,NY Nathalia dr. OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000071656 08-12-2019 201900068611/077023 SANITA DUWI Nathalia dr. OS00176 Scopma Plus Tablet 10.00 Tablet 2,090.22 21,402.20
R2019-0000071656 08-12-2019 201900068611/077023 SANITA DUWI Nathalia dr. OP00138 Pumpitor Capsul 10.00 Capsul 20,092.05 201,420.50
R2019-0000071656 08-12-2019 201900068611/077023 SANITA DUWI Nathalia dr. OD00065 Domperidon Tablet (OGB) 10.00 Tablet 750.00 8,000.00
R2019-0000071656 08-12-2019 201900068611/077023 SANITA DUWI Nathalia dr. OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000071656 08-12-2019 201900068611/077023 SANITA DUWI Nathalia dr. OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000071656 08-12-2019 201900068611/077023 SANITA DUWI Nathalia dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000071657 08-12-2019 201900068602/079811 MAKRUF,TN Nathalia dr. OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000071657 08-12-2019 201900068602/079811 MAKRUF,TN Nathalia dr. OS00176 Scopma Plus Tablet 10.00 Tablet 2,090.22 21,402.20
R2019-0000071658 08-12-2019 201900068602/079811 MAKRUF,TN Nathalia dr. OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000071658 08-12-2019 201900068602/079811 MAKRUF,TN Nathalia dr. OS00176 Scopma Plus Tablet 1.00 Tablet 2,090.22 2,590.22
Total 94,363,347.83
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 66 dari 266
ASAL RAWAT JALAN
R2019-0000071659 08-12-2019 201900068610/111729 SAMSUDDIN,TN Nathalia dr. OB001002 Betahistine 6.00 Tab 5,940.00 36,140.00
R2019-0000071659 08-12-2019 201900068610/111729 SAMSUDDIN,TN Nathalia dr. OF00065 Flunarizine 5mg 6.00 Tablet 2,970.00 18,320.00
R2019-0000071659 08-12-2019 201900068610/111729 SAMSUDDIN,TN Nathalia dr. OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000071659 08-12-2019 201900068610/111729 SAMSUDDIN,TN Nathalia dr. OO00014 Omeprazole 20mg (OGB) 3.00 Capsul 1,169.98 4,009.94
R2019-0000071662 08-12-2019 201900068617/111731 ZEUDRIS STEVIANTI Niki Juniar OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000071662 08-12-2019 201900068617/111731 ZEUDRIS STEVIANTI Niki Juniar OA00180 Acetylcyst ein 200mg 6.00 Tablet 1,485.00 9,410.00
R2019-0000071662 08-12-2019 201900068617/111731 ZEUDRIS STEVIANTI Niki Juniar OB00007 Becom - C 4.00 Tablet 2,123.55 8,994.20
R2019-0000071661 08-12-2019 201900068614/075188 MUHAMMAD Niki Juniar OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000071661 08-12-2019 201900068614/075188 MUHAMMAD Niki Juniar OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000071661 08-12-2019 201900068614/075188 MUHAMMAD Niki Juniar OS00010 Salbutamol 4mg (OGB) 5.00 Tablet 249.48 1,747.40
R2019-0000071661 08-12-2019 201900068614/075188 MUHAMMAD Niki Juniar OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000071661 08-12-2019 201900068614/075188 MUHAMMAD Niki Juniar ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000071661 08-12-2019 201900068614/075188 MUHAMMAD Niki Juniar OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000071665 08-12-2019 201900068618/099478 MUHAMMAD Niki Juniar OC00038 Cefila Dry Syrup 1.00 Botol 123,255.00 123,755.00
R2019-0000071665 08-12-2019 201900068618/099478 MUHAMMAD Niki Juniar OB00058 Bufect Suspensi, 60ml 1.00 Botol 21,681.00 22,181.00
R2019-0000071665 08-12-2019 201900068618/099478 MUHAMMAD Niki Juniar OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000071666 08-12-2019 201900068613/111730 IDAYATI,NY Niki Juniar OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000071666 08-12-2019 201900068613/111730 IDAYATI,NY Niki Juniar OA00074 Analsik 10.00 Tablet 2,264.63 23,146.30
R2019-0000071666 08-12-2019 201900068613/111730 IDAYATI,NY Niki Juniar OI00134 Imunos Plus Tablet 5.00 Tablet 14,107.50 71,037.50
R2019-0000071666 08-12-2019 201900068613/111730 IDAYATI,NY Niki Juniar ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000071666 08-12-2019 201900068613/111730 IDAYATI,NY Niki Juniar OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000071666 08-12-2019 201900068613/111730 IDAYATI,NY Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071666 08-12-2019 201900068613/111730 IDAYATI,NY Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000071674 08-12-2019 201900068620/111732 PARULIAN Niki Juniar OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000071674 08-12-2019 201900068620/111732 PARULIAN Niki Juniar OA00106 Asam Mefenamat 500mg 6.00 Tablet 415.80 2,994.80
R2019-0000071674 08-12-2019 201900068620/111732 PARULIAN Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000071674 08-12-2019 201900068620/111732 PARULIAN Niki Juniar OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000071683 08-12-2019 201900068630/049275 KAHAR,TN Niki Juniar OS00029 Sanmol Tablet, 500mg 8.00 Tablet 430.65 3,945.20
R2019-0000071683 08-12-2019 201900068630/049275 KAHAR,TN Niki Juniar OI00134 Imunos Plus Tablet 5.00 Tablet 14,107.50 71,037.50
R2019-0000071677 08-12-2019 201900068619/088426 KHAIRINA SILLA Niki Juniar OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000071677 08-12-2019 201900068619/088426 KHAIRINA SILLA Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000071677 08-12-2019 201900068619/088426 KHAIRINA SILLA Niki Juniar OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000071677 08-12-2019 201900068619/088426 KHAIRINA SILLA Niki Juniar ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000071677 08-12-2019 201900068619/088426 KHAIRINA SILLA Niki Juniar OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000071686 08-12-2019 201900068628/100677 AHMAD GAJALI,TN Niki Juniar OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000071686 08-12-2019 201900068628/100677 AHMAD GAJALI,TN Niki Juniar OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000071686 08-12-2019 201900068628/100677 AHMAD GAJALI,TN Niki Juniar OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071686 08-12-2019 201900068628/100677 AHMAD GAJALI,TN Niki Juniar OB00016 Betahistine Mesilat 6mg 6.00 Tablet 1,500.00 9,500.00
Total 95,081,288.66
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 67 dari 266
ASAL RAWAT JALAN
R2019-0000071692 08-12-2019 201900068652/111734 MUHAMMAD REVAN Niki Juniar OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000071692 08-12-2019 201900068652/111734 MUHAMMAD REVAN Niki Juniar OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000071692 08-12-2019 201900068652/111734 MUHAMMAD REVAN Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000071692 08-12-2019 201900068652/111734 MUHAMMAD REVAN Niki Juniar OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
R2019-0000071692 08-12-2019 201900068652/111734 MUHAMMAD REVAN Niki Juniar OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000071692 08-12-2019 201900068652/111734 MUHAMMAD REVAN Niki Juniar ATKK031 Kertas Puyer Handbond 6.00 Sachet 207.90 8,747.40
R2019-0000071687 08-12-2019 201900068653/020466 WAHYUNI,NY Niki Juniar OB00050 Braxidin 4.00 Tablet 1,648.35 7,093.40
R2019-0000071687 08-12-2019 201900068653/020466 WAHYUNI,NY Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000071660 08-12-2019 201900068649/106054 MUHAMMAD NADHIF Niki Juniar OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2019-0000071660 08-12-2019 201900068649/106054 MUHAMMAD NADHIF Niki Juniar OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000071695 08-12-2019 201900068619/088426 KHAIRINA SILLA Niki Juniar OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000071695 08-12-2019 201900068619/088426 KHAIRINA SILLA Niki Juniar OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 Botol 22,542.30 23,042.30
R2019-0000071696 08-12-2019 201900068614/075188 MUHAMMAD Niki Juniar OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000071696 08-12-2019 201900068614/075188 MUHAMMAD Niki Juniar OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000071697 08-12-2019 201900068656/091708 SARTIKA,NY Niki Juniar OB001002 Betahistine 1.00 Tab 5,940.00 6,440.00
R2019-0000071697 08-12-2019 201900068656/091708 SARTIKA,NY Niki Juniar OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000071698 08-12-2019 201900068653/020466 WAHYUNI,NY Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000071699 08-12-2019 201900068672/083104 ABRAHAM Niki Juniar OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000071699 08-12-2019 201900068672/083104 ABRAHAM Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071699 08-12-2019 201900068672/083104 ABRAHAM Niki Juniar ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000071700 08-12-2019 201900068620/111732 PARULIAN Niki Juniar OD00031 Dexamethasone Tablet 1.00 Tablet 208.00 708.00
R2019-0000071701 08-12-2019 201900068652/111734 MUHAMMAD REVAN Niki Juniar OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000071702 08-12-2019 201900068649/106054 MUHAMMAD NADHIF Niki Juniar OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000071703 08-12-2019 201900068610/111729 SAMSUDDIN,TN Nathalia dr. OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000071704 08-12-2019 201900068667/111733 JUMIATI,NY Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071704 08-12-2019 201900068667/111733 JUMIATI,NY Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071704 08-12-2019 201900068667/111733 JUMIATI,NY Niki Juniar ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000071704 08-12-2019 201900068667/111733 JUMIATI,NY Niki Juniar ALB00132 Blood Set 1.00 Pcs 33,976.80 34,476.80
R2019-0000071704 08-12-2019 201900068667/111733 JUMIATI,NY Niki Juniar OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000071704 08-12-2019 201900068667/111733 JUMIATI,NY Niki Juniar ALF00007 Folley Catheter No. 14 1.00 Pcs 37,125.00 37,625.00
R2019-0000071704 08-12-2019 201900068667/111733 JUMIATI,NY Niki Juniar ALU00007 Urine Bag 1.00 Pcs 19,305.00 19,805.00
R2019-0000071704 08-12-2019 201900068667/111733 JUMIATI,NY Niki Juniar OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 Botol 22,542.30 23,042.30
R2019-0000071704 08-12-2019 201900068667/111733 JUMIATI,NY Niki Juniar OC00043 Ceft riaxone 1.0gr Injeksi 2.00 Vial 53,460.00 107,420.00
R2019-0000071707 08-12-2019 201900068656/091708 SARTIKA,NY Niki Juniar OB001002 Betahistine 6.00 Tab 5,940.00 36,140.00
R2019-0000071707 08-12-2019 201900068656/091708 SARTIKA,NY Niki Juniar OF00065 Flunarizine 5mg 4.00 Tablet 2,970.00 12,380.00
R2019-0000071707 08-12-2019 201900068656/091708 SARTIKA,NY Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000071708 08-12-2019 201900068673/051395 NUR RAMADHANI Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071708 08-12-2019 201900068673/051395 NUR RAMADHANI Niki Juniar ALB00132 Blood Set 1.00 Pcs 33,976.80 34,476.80
Total 95,852,406.08
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 68 dari 266
ASAL RAWAT JALAN
R2019-0000071708 08-12-2019 201900068673/051395 NUR RAMADHANI Niki Juniar ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000071708 08-12-2019 201900068673/051395 NUR RAMADHANI Niki Juniar OC00041 Cefotaxim 1.0gr Injeksi 1.00 Vial 60,885.00 61,385.00
R2019-0000071710 08-12-2019 201900068675/111735 ATIYA,AN Niki Juniar OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 Botol 22,542.30 23,042.30
R2019-0000071710 08-12-2019 201900068675/111735 ATIYA,AN Niki Juniar ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000071710 08-12-2019 201900068675/111735 ATIYA,AN Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071710 08-12-2019 201900068675/111735 ATIYA,AN Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000071711 08-12-2019 201900068610/111729 SAMSUDDIN,TN Nathalia dr. OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000071712 08-12-2019 201900068670/111738 INEU SENTHIA,NN Niki Juniar OT00101 Trovensis Injeksi, 2.00 Ampul 50,237.55 100,975.10
R2019-0000071712 08-12-2019 201900068670/111738 INEU SENTHIA,NN Niki Juniar OT00107 Topazol Injeksi, 40mg 1.00 Vial 218,295.00 218,795.00
R2019-0000071712 08-12-2019 201900068670/111738 INEU SENTHIA,NN Niki Juniar OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000071712 08-12-2019 201900068670/111738 INEU SENTHIA,NN Niki Juniar ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000071712 08-12-2019 201900068670/111738 INEU SENTHIA,NN Niki Juniar ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000071712 08-12-2019 201900068670/111738 INEU SENTHIA,NN Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071712 08-12-2019 201900068670/111738 INEU SENTHIA,NN Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071714 08-12-2019 201900068670/111738 INEU SENTHIA,NN Niki Juniar OO00074 Ondansetron Tablet, 4mg 5.00 Tablet 4,455.00 22,775.00
R2019-0000071714 08-12-2019 201900068670/111738 INEU SENTHIA,NN Niki Juniar OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000071714 08-12-2019 201900068670/111738 INEU SENTHIA,NN Niki Juniar OL00041 Lasgan Capsul 4.00 Capsul 21,000.00 84,500.00
R2019-0000071715 08-12-2019 201900068676/022582 SYAFRUDDIN,TN Dwi Astuti, dr OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000071715 08-12-2019 201900068676/022582 SYAFRUDDIN,TN Dwi Astuti, dr ON00009 Natrium Diklofenac 50mg 5.00 Tablet 955.84 5,279.20
R2019-0000071715 08-12-2019 201900068676/022582 SYAFRUDDIN,TN Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000071720 08-12-2019 201900068663/9278 RENO RIYANDI,SDR Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071720 08-12-2019 201900068663/9278 RENO RIYANDI,SDR Niki Juniar ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000071720 08-12-2019 201900068663/9278 RENO RIYANDI,SDR Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071720 08-12-2019 201900068663/9278 RENO RIYANDI,SDR Niki Juniar OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000071722 08-12-2019 201900068674/111739 AHMAD HABIBIE Dwi Astuti, dr OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000071722 08-12-2019 201900068674/111739 AHMAD HABIBIE Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 3.00 Tablet 1,113.75 3,841.25
R2019-0000071722 08-12-2019 201900068674/111739 AHMAD HABIBIE Dwi Astuti, dr OS00180 Salfenal Forte Syrup 60 1.00 Botol 10,400.00 10,900.00
R2019-0000071717 08-12-2019 201900065305/106727 NAOMI SALSABILA ADE RAHMAH OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000071717 08-12-2019 201900065305/106727 NAOMI SALSABILA ADE RAHMAH OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000071717 08-12-2019 201900065305/106727 NAOMI SALSABILA ADE RAHMAH OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000071726 08-12-2019 201900068684/084370 SAFWAN FAEYZA Dwi Astuti, dr OT00076 Tremenza Syrup 1.00 Botol 30,442.50 30,942.50
R2019-0000071726 08-12-2019 201900068684/084370 SAFWAN FAEYZA Dwi Astuti, dr OP00101 Proceles Syrup, 60ml 1.00 Botol 51,975.00 52,475.00
R2019-0000071726 08-12-2019 201900068684/084370 SAFWAN FAEYZA Dwi Astuti, dr ON00004 Naprex Syrup, 60ml 1.00 Botol 59,251.50 59,751.50
R2019-0000071732 08-12-2019 201900068682/111740 FABIAN AXCELLO Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000071732 08-12-2019 201900068682/111740 FABIAN AXCELLO Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
R2019-0000071732 08-12-2019 201900068682/111740 FABIAN AXCELLO Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 4.00 Tablet 623.70 2,994.80
R2019-0000071732 08-12-2019 201900068682/111740 FABIAN AXCELLO Dwi Astuti, dr OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000071732 08-12-2019 201900068682/111740 FABIAN AXCELLO Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
Total 97,118,282.78
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 69 dari 266
ASAL RAWAT JALAN
R2019-0000071732 08-12-2019 201900068682/111740 FABIAN AXCELLO Dwi Astuti, dr OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000071735 08-12-2019 201900068685/052032 YULIA ERNAWATI,NY Dwi Astuti, dr OS00176 Scopma Plus Tablet 5.00 Tablet 2,090.22 10,951.10
R2019-0000071735 08-12-2019 201900068685/052032 YULIA ERNAWATI,NY Dwi Astuti, dr OL00108 Lexatrans 500mg 5.00 Tablet 1,871.00 9,855.00
R2019-0000071735 08-12-2019 201900068685/052032 YULIA ERNAWATI,NY Dwi Astuti, dr OA00086 Antihemoroid Supositoria 2.00 Suppo 4,975.00 10,450.00
R2019-0000071706 08-12-2019 201900068688/073373 FRIDA AGUSTINA,NY Dwi Astuti, dr OC00144 Cefila Capsul, 100mg 10.00 Capsul 28,957.00 290,070.00
R2019-0000071706 08-12-2019 201900068688/073373 FRIDA AGUSTINA,NY Dwi Astuti, dr OE00018 Epexol Tablet 10.00 Tablet 1,232.55 12,825.50
R2019-0000071706 08-12-2019 201900068688/073373 FRIDA AGUSTINA,NY Dwi Astuti, dr OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000071706 08-12-2019 201900068688/073373 FRIDA AGUSTINA,NY Dwi Astuti, dr OT00077 Tremenza Tablet 10.00 Tablet 2,160.68 22,106.80
R2019-0000071706 08-12-2019 201900068688/073373 FRIDA AGUSTINA,NY Dwi Astuti, dr OI00126 Interhistin 50mg, Tablet 10.00 Tablet 1,173.15 12,231.50
R2019-0000071706 08-12-2019 201900068688/073373 FRIDA AGUSTINA,NY Dwi Astuti, dr OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000071739 08-12-2019 201900068689/111741 ZAHID ABDULLAH,AN Dwi Astuti, dr OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000071739 08-12-2019 201900068689/111741 ZAHID ABDULLAH,AN Dwi Astuti, dr OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000071739 08-12-2019 201900068689/111741 ZAHID ABDULLAH,AN Dwi Astuti, dr OL00001 L - BIO Sachet 5.00 Sachet 10,395.00 52,475.00
R2019-0000071739 08-12-2019 201900068689/111741 ZAHID ABDULLAH,AN Dwi Astuti, dr OP00101 Proceles Syrup, 60ml 1.00 Botol 51,975.00 52,475.00
R2019-0000071739 08-12-2019 201900068689/111741 ZAHID ABDULLAH,AN Dwi Astuti, dr OM00099 Mucera Syrup 1.00 Botol 34,155.00 34,655.00
R2019-0000071739 08-12-2019 201900068689/111741 ZAHID ABDULLAH,AN Dwi Astuti, dr ON00019 Neo Kaolana Syrup, 120ml 1.00 Botol 18,414.00 18,914.00
R2019-0000071743 08-12-2019 201900068690/111742 AFIFAH MUMTAZAH Dwi Astuti, dr OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000071743 08-12-2019 201900068690/111742 AFIFAH MUMTAZAH Dwi Astuti, dr OM00099 Mucera Syrup 1.00 Botol 34,155.00 34,655.00
R2019-0000071743 08-12-2019 201900068690/111742 AFIFAH MUMTAZAH Dwi Astuti, dr OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000071743 08-12-2019 201900068690/111742 AFIFAH MUMTAZAH Dwi Astuti, dr OP00101 Proceles Syrup, 60ml 1.00 Botol 51,975.00 52,475.00
R2019-0000071752 08-12-2019 201900068692/082095 HUSNUL Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000071752 08-12-2019 201900068692/082095 HUSNUL Dwi Astuti, dr OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000071752 08-12-2019 201900068692/082095 HUSNUL Dwi Astuti, dr OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000071752 08-12-2019 201900068692/082095 HUSNUL Dwi Astuti, dr OC00057 Cerini 5.00 Tablet 5,093.55 25,967.75
R2019-0000071754 08-12-2019 201900068693/111629 MUHAMMAD AZRIEL Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 10 15,365.00 14,328.50
R2019-0000071754 08-12-2019 201900068693/111629 MUHAMMAD AZRIEL Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 10 33,802.98 30,922.68
R2019-0000071754 08-12-2019 201900068693/111629 MUHAMMAD AZRIEL Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 2.00 Capsul 10 4,266.70 8,180.06
R2019-0000071754 08-12-2019 201900068693/111629 MUHAMMAD AZRIEL Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 2.00 Tablet 10 623.70 1,622.66
R2019-0000071754 08-12-2019 201900068693/111629 MUHAMMAD AZRIEL Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 10 445.50 1,301.90
R2019-0000071754 08-12-2019 201900068693/111629 MUHAMMAD AZRIEL Dwi Astuti, dr OD00031 Dexamethasone Tablet 2.00 Tablet 10 208.00 874.40
R2019-0000071754 08-12-2019 201900068693/111629 MUHAMMAD AZRIEL Dwi Astuti, dr OS00031 Sanmol Syrup 1.00 Botol 10 17,374.00 16,136.60
R2019-0000071756 08-12-2019 201900068687/091095 MUSTAPA,TN Dwi Astuti, dr OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000071756 08-12-2019 201900068687/091095 MUSTAPA,TN Dwi Astuti, dr OS00057 Scopamin Plus Caplet 5.00 Tablet 3,712.50 19,062.50
R2019-0000071756 08-12-2019 201900068687/091095 MUSTAPA,TN Dwi Astuti, dr OL00021 Lansoprazole (OGB) 5.00 Capsul 2,230.00 11,650.00
R2019-0000071757 08-12-2019 201900068687/091095 MUSTAPA,TN Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000071757 08-12-2019 201900068687/091095 MUSTAPA,TN Dwi Astuti, dr OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000071757 08-12-2019 201900068687/091095 MUSTAPA,TN Dwi Astuti, dr ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000071759 08-12-2019 201900068696/111744 MUHAMMAD WAHYU Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
Total 98,456,561.13
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 70 dari 266
ASAL RAWAT JALAN
R2019-0000071759 08-12-2019 201900068696/111744 MUHAMMAD WAHYU Dwi Astuti, dr OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000071759 08-12-2019 201900068696/111744 MUHAMMAD WAHYU Dwi Astuti, dr OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000071760 08-12-2019 201900068694/15826 AZMI RIZQI Dwi Astuti, dr OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000071760 08-12-2019 201900068694/15826 AZMI RIZQI Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000071760 08-12-2019 201900068694/15826 AZMI RIZQI Dwi Astuti, dr OM00045 Methyl Prednisolon 4mg 5.00 Tablet 792.99 4,464.95
R2019-0000071761 08-12-2019 201900068698/015876 YAHYA HANAN,TN Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000071761 08-12-2019 201900068698/015876 YAHYA HANAN,TN Dwi Astuti, dr OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000071761 08-12-2019 201900068698/015876 YAHYA HANAN,TN Dwi Astuti, dr OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000071761 08-12-2019 201900068698/015876 YAHYA HANAN,TN Dwi Astuti, dr OE00018 Epexol Tablet 10.00 Tablet 1,232.55 12,825.50
R2019-0000071761 08-12-2019 201900068698/015876 YAHYA HANAN,TN Dwi Astuti, dr OI00126 Interhistin 50mg, Tablet 5.00 Tablet 1,173.15 6,365.75
R2019-0000071761 08-12-2019 201900068698/015876 YAHYA HANAN,TN Dwi Astuti, dr OC00171 Candesartan Cilexetil 10.00 Tablet 7,425.00 74,750.00
R2019-0000071763 08-12-2019 201900068699/083334 SALAMUN,TN Dwi Astuti, dr OA00043 Alprazolam 0,5mg (OGB) 3.00 Tablet 996.50 3,489.50
R2019-0000071763 08-12-2019 201900068699/083334 SALAMUN,TN Dwi Astuti, dr OE00022 Eprinoc Tablet 10.00 Tablet 5,093.55 51,435.50
R2019-0000071763 08-12-2019 201900068699/083334 SALAMUN,TN Dwi Astuti, dr OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000071768 02-12-2019 201900067101/070858 ITJE POLII,NY Dameria Sri OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000071768 02-12-2019 201900067101/070858 ITJE POLII,NY Dameria Sri OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000071768 02-12-2019 201900067101/070858 ITJE POLII,NY Dameria Sri OT00156 Telmisartan 40 mg 14.00 Tablet 6,534.00 91,976.00
R2019-0000071768 02-12-2019 201900067101/070858 ITJE POLII,NY Dameria Sri OS00173 Simvastatin 20mg (OGB) 23.00 Tablet 1,782.00 41,486.00
R2019-0000071768 02-12-2019 201900067101/070858 ITJE POLII,NY Dameria Sri OC00060 Cetirizine 10mg (OGB) 6.00 Tablet 623.70 4,242.20
R2019-0000071767 02-12-2019 201900067100/079094 SAI IN,TN Dameria Sri OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000071767 02-12-2019 201900067100/079094 SAI IN,TN Dameria Sri OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000071767 02-12-2019 201900067100/079094 SAI IN,TN Dameria Sri OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000071767 02-12-2019 201900067100/079094 SAI IN,TN Dameria Sri OS00173 Simvastatin 20mg (OGB) 7.00 Tablet 1,782.00 12,974.00
R2019-0000071770 02-12-2019 201900067127/108044 DINA TANDILILING,NY Dameria Sri OL000131 Leparson Tablet 21.00 Tablet 5,917.35 124,764.35
R2019-0000071770 02-12-2019 201900067127/108044 DINA TANDILILING,NY Dameria Sri OL00021 Lansoprazole (OGB) 10.00 Capsul 2,230.00 22,800.00
R2019-0000071769 02-12-2019 201900067114/00012743 RICKY E J WELAN,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071773 02-12-2019 201900067099/068834 MUHAMMAD RUM,TN LUSY E. Dr.Sp.PD ON00075 Novomix 30 Flexpen 2.00 Flexpen 226,917.80 454,335.60
R2019-0000071773 02-12-2019 201900067099/068834 MUHAMMAD RUM,TN LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000071773 02-12-2019 201900067099/068834 MUHAMMAD RUM,TN LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 7.00 Tablet 811.18 6,178.26
R2019-0000071773 02-12-2019 201900067099/068834 MUHAMMAD RUM,TN LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 7.00 Tablet 2,525.00 18,175.00
R2019-0000071773 02-12-2019 201900067099/068834 MUHAMMAD RUM,TN LUSY E. Dr.Sp.PD ALN00005 Needle Novo Twist 32G 1.00 Pcs 3,690.23 4,190.23
R2019-0000071772 08-12-2019 201900068703/079978 MUHAMMAD RIFQI Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000071772 08-12-2019 201900068703/079978 MUHAMMAD RIFQI Dwi Astuti, dr OC00120 Cortidex Tablet 10.00 Tablet 430.65 4,806.50
R2019-0000071772 08-12-2019 201900068703/079978 MUHAMMAD RIFQI Dwi Astuti, dr OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000071774 02-12-2019 201900067102/42305 USMAN UDIN,TN LUSY E. Dr.Sp.PD OT00046 Thyrozol 10mg 14.00 Tablet 2,913.41 41,287.74
R2019-0000071774 02-12-2019 201900067102/42305 USMAN UDIN,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000071774 02-12-2019 201900067102/42305 USMAN UDIN,TN LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000071779 08-12-2019 201900069236/086494 PUTRI AHDA Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
Total 99,944,301.16
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 71 dari 266
ASAL RAWAT JALAN
R2019-0000071779 08-12-2019 201900069236/086494 PUTRI AHDA Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071779 08-12-2019 201900069236/086494 PUTRI AHDA Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000071779 08-12-2019 201900069236/086494 PUTRI AHDA Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000071777 03-12-2019 201900067432/080802 ASRI Dameria Sri OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000071777 03-12-2019 201900067432/080802 ASRI Dameria Sri OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071777 03-12-2019 201900067432/080802 ASRI Dameria Sri OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000071777 03-12-2019 201900067432/080802 ASRI Dameria Sri OA00140 Atorvastatin 20mg (OGB) 7.00 Tablet 6,534.00 46,238.00
R2019-0000071777 03-12-2019 201900067432/080802 ASRI Dameria Sri OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000071777 03-12-2019 201900067432/080802 ASRI Dameria Sri OF00007 Farbion Tablet 10.00 Tablet 1,782.00 18,320.00
R2019-0000071777 03-12-2019 201900067432/080802 ASRI Dameria Sri OA00175 Afolat 400mcg 10.00 Tablet 206.41 2,564.10
R2019-0000071782 03-12-2019 201900067523/086999 ESTI SULASTRI,NY Restu OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071782 03-12-2019 201900067523/086999 ESTI SULASTRI,NY Restu OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000071782 03-12-2019 201900067523/086999 ESTI SULASTRI,NY Restu OB00036 Bis oprolol 5mg (OGB) 7.00 Tablet 5,197.50 36,882.50
R2019-0000071782 03-12-2019 201900067523/086999 ESTI SULASTRI,NY Restu OH00025 Hydrochlortiazide (OGB) 3.00 Tablet 240.30 1,220.90
R2019-0000071781 08-12-2019 201900069464/096903 EKA FEBRIANA,NY Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071781 08-12-2019 201900069464/096903 EKA FEBRIANA,NY Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071781 08-12-2019 201900069464/096903 EKA FEBRIANA,NY Dwi Astuti, dr ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000071781 08-12-2019 201900069464/096903 EKA FEBRIANA,NY Dwi Astuti, dr OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000071781 08-12-2019 201900069464/096903 EKA FEBRIANA,NY Dwi Astuti, dr ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000071783 03-12-2019 201900067576/00013699 ROSMANI,NY Restu OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000071783 03-12-2019 201900067576/00013699 ROSMANI,NY Restu OD00047 Diamicron MR 60mg 7.00 Tablet 8,420.00 59,440.00
R2019-0000071783 03-12-2019 201900067576/00013699 ROSMANI,NY Restu ALN00005 Needle Novo Twist 32G 1.00 Pcs 3,690.23 4,190.23
R2019-0000071783 03-12-2019 201900067576/00013699 ROSMANI,NY Restu OB00036 Bis oprolol 5mg (OGB) 7.00 Tablet 5,197.50 36,882.50
R2019-0000071783 03-12-2019 201900067576/00013699 ROSMANI,NY Restu OL00021 Lansoprazole (OGB) 7.00 Capsul 2,230.00 16,110.00
R2019-0000071786 03-12-2019 201900067598/111289 ADE PRIMARJANY,SDR Restu OL00021 Lansoprazole (OGB) 7.00 Capsul 2,230.00 16,110.00
R2019-0000071786 03-12-2019 201900067598/111289 ADE PRIMARJANY,SDR Restu OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071784 03-12-2019 201900067491/087019 NGADINEM,NY Restu OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000071789 08-12-2019 201900070147/111436 CICIK WIDI Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071789 08-12-2019 201900070147/111436 CICIK WIDI Dwi Astuti, dr ALB00132 Blood Set 1.00 Pcs 33,976.80 34,476.80
R2019-0000071789 08-12-2019 201900070147/111436 CICIK WIDI Dwi Astuti, dr ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000071787 03-12-2019 201900067535/37715 SRI SUGIARTI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000071787 03-12-2019 201900067535/37715 SRI SUGIARTI,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000071787 03-12-2019 201900067535/37715 SRI SUGIARTI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 7.00 Tablet 5,197.50 36,882.50
R2019-0000071787 03-12-2019 201900067535/37715 SRI SUGIARTI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
Total 101,319,804.39
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 72 dari 266
ASAL RAWAT JALAN
R2019-0000071787 03-12-2019 201900067535/37715 SRI SUGIARTI,NY LUSY E. Dr.Sp.PD ALN00005 Needle Novo Twist 32G 1.00 Pcs 3,690.23 4,190.23
R2019-0000071791 08-12-2019 201900068674/111739 AHMAD HABIBIE Dwi Astuti, dr OL00063 Lidocain HCl 2% Injeksi 2.00 Ampul 2,376.00 5,252.00
R2019-0000071791 08-12-2019 201900068674/111739 AHMAD HABIBIE Dwi Astuti, dr OI00051 Infus Otsu-NS (NaCl 1.00 Botol 9,388.17 9,888.17
R2019-0000071790 08-12-2019 201900068691/40999 METY ASTUTY,NY Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000071790 08-12-2019 201900068691/40999 METY ASTUTY,NY Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000071794 08-12-2019 201900068694/15826 AZMI RIZQI Dwi Astuti, dr OP00011 Paracetamol 500mg 1.00 Tablet 387.36 887.36
R2019-0000071793 08-12-2019 201900068691/40999 METY ASTUTY,NY Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000071793 08-12-2019 201900068691/40999 METY ASTUTY,NY Dwi Astuti, dr OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000071793 08-12-2019 201900068691/40999 METY ASTUTY,NY Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000071793 08-12-2019 201900068691/40999 METY ASTUTY,NY Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000071793 08-12-2019 201900068691/40999 METY ASTUTY,NY Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000071793 08-12-2019 201900068691/40999 METY ASTUTY,NY Dwi Astuti, dr OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000071795 08-12-2019 201900068695/111743 MUHAMMAD Dwi Astuti, dr OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000071795 08-12-2019 201900068695/111743 MUHAMMAD Dwi Astuti, dr OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000071798 08-12-2019 201900068702/094055 MARIDJAN,TN Dwi Astuti, dr ON00009 Natrium Diklofenac 50mg 5.00 Tablet 955.84 5,279.20
R2019-0000071798 08-12-2019 201900068702/094055 MARIDJAN,TN Dwi Astuti, dr OM00045 Methyl Prednisolon 4mg 5.00 Tablet 792.99 4,464.95
R2019-0000071801 08-12-2019 201900068704/099785 MUHAMMAD RIFAI Dwi Astuti, dr OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2019-0000071801 08-12-2019 201900068704/099785 MUHAMMAD RIFAI Dwi Astuti, dr OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000071802 08-12-2019 201900068706/073123 IMAM SUWONGSO,SDR Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000071802 08-12-2019 201900068706/073123 IMAM SUWONGSO,SDR Dwi Astuti, dr OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000071802 08-12-2019 201900068706/073123 IMAM SUWONGSO,SDR Dwi Astuti, dr OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2019-0000071797 08-12-2019 201900069632/106495 MUHAMMAD FAKHRI Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071797 08-12-2019 201900069632/106495 MUHAMMAD FAKHRI Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071797 08-12-2019 201900069632/106495 MUHAMMAD FAKHRI Dwi Astuti, dr ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000071805 08-12-2019 201900069338/106496 NAIFAH NUR Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071805 08-12-2019 201900069338/106496 NAIFAH NUR Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071805 08-12-2019 201900069338/106496 NAIFAH NUR Dwi Astuti, dr ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000071808 09-12-2019 201900068714/054735 KUMALASARI,NY ADE RAHMAH ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000071808 09-12-2019 201900068714/054735 KUMALASARI,NY ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000071808 09-12-2019 201900068714/054735 KUMALASARI,NY ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000071808 09-12-2019 201900068714/054735 KUMALASARI,NY ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071808 09-12-2019 201900068714/054735 KUMALASARI,NY ADE RAHMAH OA00085 Antasida Tablet (OGB) 10.00 Tablet 284.30 3,343.00
R2019-0000071808 09-12-2019 201900068714/054735 KUMALASARI,NY ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000071808 09-12-2019 201900068714/054735 KUMALASARI,NY ADE RAHMAH OT00149 Toramine 10 Mg Tablet 5.00 Tablet 8,167.50 41,337.50
R2019-0000071809 09-12-2019 201900068715/047889 TUNGGUL NATARIS,TN ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000071809 09-12-2019 201900068715/047889 TUNGGUL NATARIS,TN ADE RAHMAH OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000071809 09-12-2019 201900068715/047889 TUNGGUL NATARIS,TN ADE RAHMAH OC00096 Codein 10mg 10.00 Tablet 924.80 9,748.00
R2019-0000071809 09-12-2019 201900068715/047889 TUNGGUL NATARIS,TN ADE RAHMAH OF00039 FG Troches 10.00 Tablet 1,730.02 17,800.20
Total 101,989,699.68
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 73 dari 266
ASAL RAWAT JALAN
R2019-0000071809 09-12-2019 201900068715/047889 TUNGGUL NATARIS,TN ADE RAHMAH OL00080 Loratadin 10mg (OGB) 5.00 Tablet 520.00 3,100.00
R2019-0000071810 09-12-2019 201900068726/077462 HAFIZAH DZAKIAH ADE RAHMAH OV00106 Vosedon Suspensi 1.00 Botol 43,213.50 43,713.50
R2019-0000071810 09-12-2019 201900068726/077462 HAFIZAH DZAKIAH ADE RAHMAH OL00001 L - BIO Sachet 10.00 Sachet 10,395.00 104,450.00
R2019-0000071804 08-12-2019 201900068710/085280 NAYSHEILA ADE RAHMAH OI00001 Ibuprofen 400mg (OGB) 3.00 Tablet 682.00 2,546.00
R2019-0000071804 08-12-2019 201900068710/085280 NAYSHEILA ADE RAHMAH OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000071804 08-12-2019 201900068710/085280 NAYSHEILA ADE RAHMAH OD00065 Domperidon Tablet (OGB) 3.00 Tablet 750.00 2,750.00
R2019-0000071811 08-12-2019 201900068711/063601 MUHAMMAD YAFIQ ADE RAHMAH OI00001 Ibuprofen 400mg (OGB) 3.00 Tablet 682.00 2,546.00
R2019-0000071811 08-12-2019 201900068711/063601 MUHAMMAD YAFIQ ADE RAHMAH OM00097 Mucera Drop 1.00 Botol 54,945.00 55,445.00
R2019-0000071811 08-12-2019 201900068711/063601 MUHAMMAD YAFIQ ADE RAHMAH OT00077 Tremenza Tablet 2.00 Tablet 2,160.68 4,821.36
R2019-0000071811 08-12-2019 201900068711/063601 MUHAMMAD YAFIQ ADE RAHMAH OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000071812 08-12-2019 201900068713/103131 SITI NUR AZIZAH,NY ADE RAHMAH OA00085 Antasida Tablet (OGB) 3.00 Tablet 284.30 1,352.90
R2019-0000071812 08-12-2019 201900068713/103131 SITI NUR AZIZAH,NY ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 3.00 Capsul 1,169.98 4,009.94
R2019-0000071812 08-12-2019 201900068713/103131 SITI NUR AZIZAH,NY ADE RAHMAH OS00176 Scopma Plus Tablet 3.00 Tablet 2,090.22 6,770.66
R2019-0000071813 09-12-2019 201900068721/111747 IBNU PRASETIO ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071813 09-12-2019 201900068721/111747 IBNU PRASETIO ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000071813 09-12-2019 201900068721/111747 IBNU PRASETIO ADE RAHMAH OA00085 Antasida Tablet (OGB) 5.00 Tablet 284.30 1,921.50
R2019-0000071814 09-12-2019 201900068718/111163 RIDWAN,TN ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071814 09-12-2019 201900068718/111163 RIDWAN,TN ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000071814 09-12-2019 201900068718/111163 RIDWAN,TN ADE RAHMAH OA00085 Antasida Tablet (OGB) 6.00 Tablet 284.30 2,205.80
R2019-0000071814 09-12-2019 201900068718/111163 RIDWAN,TN ADE RAHMAH OS00176 Scopma Plus Tablet 3.00 Tablet 2,090.22 6,770.66
R2019-0000071815 09-12-2019 201900068724/111748 FATIH ATHAYA ADE RAHMAH OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2019-0000071815 09-12-2019 201900068724/111748 FATIH ATHAYA ADE RAHMAH OB00091 Biovitan Syrup, 60ml 1.00 Botol 8,019.00 8,519.00
R2019-0000071817 08-12-2019 201900068713/103131 SITI NUR AZIZAH,NY ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000071818 09-12-2019 201900068718/111163 RIDWAN,TN ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000071818 09-12-2019 201900068718/111163 RIDWAN,TN ADE RAHMAH OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000071818 09-12-2019 201900068718/111163 RIDWAN,TN ADE RAHMAH ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000071818 09-12-2019 201900068718/111163 RIDWAN,TN ADE RAHMAH OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000071819 09-12-2019 201900068721/111747 IBNU PRASETIO ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000071819 09-12-2019 201900068721/111747 IBNU PRASETIO ADE RAHMAH OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000071820 09-12-2019 201900068725/019334 MARIZKA HARDINI,AN ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000071821 09-12-2019 201900068725/019334 MARIZKA HARDINI,AN ADE RAHMAH OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000071821 09-12-2019 201900068725/019334 MARIZKA HARDINI,AN ADE RAHMAH OA00085 Antasida Tablet (OGB) 6.00 Tablet 284.30 2,205.80
R2019-0000071821 09-12-2019 201900068725/019334 MARIZKA HARDINI,AN ADE RAHMAH OL00076 Lodia 2mg 5.00 Tablet 1,485.00 7,925.00
R2019-0000071821 09-12-2019 201900068725/019334 MARIZKA HARDINI,AN ADE RAHMAH OS00176 Scopma Plus Tablet 5.00 Tablet 2,090.22 10,951.10
R2019-0000071831 09-12-2019 201900068762/028429 SETJEN WILMAR P Niki Juniar OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000071831 09-12-2019 201900068762/028429 SETJEN WILMAR P Niki Juniar OE00056 Ecosol Nacl 0,9 % 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071839 09-12-2019 201900068789/086513 INDRA PUJIANTI,NY ROY , Dr.Sp.OG OP00112 Promavit 30.00 Tablet 4,900.50 147,515.00
R2019-0000071842 09-12-2019 201900068751/090121 SAFA NAZWA AZ Angie Renatha , OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
Total 102,882,085.52
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 74 dari 266
ASAL RAWAT JALAN
R2019-0000071842 09-12-2019 201900068751/090121 SAFA NAZWA AZ Angie Renatha , OE00056 Ecosol Nacl 0,9 % 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071842 09-12-2019 201900068751/090121 SAFA NAZWA AZ Angie Renatha , ALD00002 Disposable Syringe 10ml 1.00 Pcs 3,800.00 4,300.00
R2019-0000071846 09-12-2019 201900068790/43626 SAHAT MANGATUR Angie Renatha , OH0045 Hexadol Solution 60 Ml 1.00 Botol 18,562.50 19,062.50
R2019-0000071847 09-12-2019 201900068791/111752 YHUANA AGUSTIN Angie Renatha , OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000071838 02-12-2019 201900067317/110951 KHARISMA PUTRI ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000071838 02-12-2019 201900067317/110951 KHARISMA PUTRI ADE RAHMAH OO00074 Ondansetron Tablet, 4mg 6.00 Tablet 4,455.00 27,230.00
R2019-0000071838 02-12-2019 201900067317/110951 KHARISMA PUTRI ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071849 02-12-2019 201900067295/093401 DWI NILLA Maulin Nikmah OG00057 Gabapentin 300mg (OGB) 2.00 Tablet 8,168.00 16,836.00
R2019-0000071849 02-12-2019 201900067295/093401 DWI NILLA Maulin Nikmah OC00016 Kapsul No. 0 4.00 Capsul 200.00 5,800.00
R2019-0000071849 02-12-2019 201900067295/093401 DWI NILLA Maulin Nikmah OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000071850 02-12-2019 201900067326/105200 MAHARANI DWI ADE RAHMAH OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000071850 02-12-2019 201900067326/105200 MAHARANI DWI ADE RAHMAH OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
R2019-0000071848 09-12-2019 201900068796/111323 IKA NUR Angie Renatha , OK00023 Ketoconazole 200mg 1.00 Tablet 774.24 1,274.24
R2019-0000071848 09-12-2019 201900068796/111323 IKA NUR Angie Renatha , OF00150 Fukricin Eye Drop 1.00 Botol 102,762.00 103,262.00
R2019-0000071848 09-12-2019 201900068796/111323 IKA NUR Angie Renatha , ALD00003 Disposable Syringe 1ml 1.00 Pcs 3,500.00 4,000.00
R2019-0000071852 09-12-2019 201900068795/111753 MF EVY Angie Renatha , OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000071852 09-12-2019 201900068795/111753 MF EVY Angie Renatha , OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000071853 09-12-2019 201900068794/095372 KEYLA ELISABET,AN Angie Renatha , OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000071854 09-12-2019 201900068804/075973 MARIA,NY Niki Juniar OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000071854 09-12-2019 201900068804/075973 MARIA,NY Niki Juniar OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071854 09-12-2019 201900068804/075973 MARIA,NY Niki Juniar OB00007 Becom - C 5.00 Tablet 2,123.55 11,117.75
R2019-0000071855 09-12-2019 201900068782/087375 ALI KARSANA,TN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000071856 09-12-2019 201900068732/111749 SUNARDI,TN Dameria Sri OH00017 Hexymer Tablet 10.00 Tablet 520.00 5,700.00
R2019-0000071857 09-12-2019 201900068728/071581 SAMSIAH,NY Dameria Sri OG00057 Gabapentin 300mg (OGB) 10.00 Tablet 8,168.00 82,180.00
R2019-0000071857 09-12-2019 201900068728/071581 SAMSIAH,NY Dameria Sri ALK00037 Kapsul No.1 20.00 pcs 200.00 9,000.00
R2019-0000071857 09-12-2019 201900068728/071581 SAMSIAH,NY Dameria Sri OM00154 Mecobalamin 500mg 20.00 Tablet 1,118.00 22,860.00
R2019-0000071858 09-12-2019 201900068746/089751 NURALMIAH,NY MAGDA ROSSA, ON00009 Natrium Diklofenac 50mg 955.84 500.00
R2019-0000071861 09-12-2019 201900068828/111759 RUSDIANA,NY IQBAL OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000071861 09-12-2019 201900068828/111759 RUSDIANA,NY IQBAL OS00016 Sanadryl Expectoran 1.00 Botol 14,701.50 15,201.50
R2019-0000071861 09-12-2019 201900068828/111759 RUSDIANA,NY IQBAL OE00008 Elkana Tablet 5.00 Tablet 1,247.40 6,737.00
R2019-0000071861 09-12-2019 201900068828/111759 RUSDIANA,NY IQBAL OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000071873 09-12-2019 201900068775/111751 ALFRED FREDY Angie Renatha , OH0045 Hexadol Solution 60 Ml 1.00 Botol 18,562.50 19,062.50
R2019-0000071878 09-12-2019 201900068865/111764 ALI,TN Niki Juniar OS00029 Sanmol Tablet, 500mg 8.00 Tablet 430.65 3,945.20
R2019-0000071878 09-12-2019 201900068865/111764 ALI,TN Niki Juniar OI00134 Imunos Plus Tablet 5.00 Tablet 14,107.50 71,037.50
R2019-0000071878 09-12-2019 201900068865/111764 ALI,TN Niki Juniar OC00120 Cortidex Tablet 6.00 Tablet 430.65 3,083.90
R2019-0000071878 09-12-2019 201900068865/111764 ALI,TN Niki Juniar OC00144 Cefila Capsul, 100mg 6.00 Capsul 28,957.00 174,242.00
R2019-0000071873 09-12-2019 201900068775/111751 ALFRED FREDY Angie Renatha , OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000071894 09-12-2019 201900068797/091095 MUSTAPA,TN LUSY E. Dr.Sp.PD OU00028 Ursodeoxycholic Acid 20.00 Tablet 9,147.60 183,452.00
Total 104,002,330.14
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 75 dari 266
ASAL RAWAT JALAN
R2019-0000071894 09-12-2019 201900068797/091095 MUSTAPA,TN LUSY E. Dr.Sp.PD OB00050 Braxidin 20.00 Tablet 1,648.35 33,467.00
R2019-0000071894 09-12-2019 201900068797/091095 MUSTAPA,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000071892 09-12-2019 201900068857/072210 ZAYN KELLEN AHMAD EDO, Dr.Sp.B OC00144 Cefila Capsul, 100mg 4.00 Capsul 28,957.00 116,328.00
R2019-0000071892 09-12-2019 201900068857/072210 ZAYN KELLEN AHMAD EDO, Dr.Sp.B OC00120 Cortidex Tablet 4.00 Tablet 430.65 2,222.60
R2019-0000071892 09-12-2019 201900068857/072210 ZAYN KELLEN AHMAD EDO, Dr.Sp.B OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000071892 09-12-2019 201900068857/072210 ZAYN KELLEN AHMAD EDO, Dr.Sp.B OM00100 Mucera Tablet 4.00 Tablet 1,782.00 7,628.00
R2019-0000071892 09-12-2019 201900068857/072210 ZAYN KELLEN AHMAD EDO, Dr.Sp.B OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000071892 09-12-2019 201900068857/072210 ZAYN KELLEN AHMAD EDO, Dr.Sp.B ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000071896 09-12-2019 201900068792/111167 MASRIANSYAH,TN LUSY E. Dr.Sp.PD OA00038 Allopurinol 300mg (OGB) 30.00 Tablet 580.00 17,900.00
R2019-0000071896 09-12-2019 201900068792/111167 MASRIANSYAH,TN LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000071896 09-12-2019 201900068792/111167 MASRIANSYAH,TN LUSY E. Dr.Sp.PD OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000071897 09-12-2019 201900068887/078439 MUHAMMAD DHAVA FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 4.00 Capsul 28,957.00 116,328.00
R2019-0000071897 09-12-2019 201900068887/078439 MUHAMMAD DHAVA FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 3.00 Tablet 430.65 1,791.95
R2019-0000071897 09-12-2019 201900068887/078439 MUHAMMAD DHAVA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000071897 09-12-2019 201900068887/078439 MUHAMMAD DHAVA FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 3.00 Tablet 1,232.55 4,197.65
R2019-0000071897 09-12-2019 201900068887/078439 MUHAMMAD DHAVA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000071897 09-12-2019 201900068887/078439 MUHAMMAD DHAVA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000071898 09-12-2019 201900068892/00013388 DEVA MUHAMMAD FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 6.00 Tablet 430.65 3,083.90
R2019-0000071898 09-12-2019 201900068892/00013388 DEVA MUHAMMAD FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 6.00 Tablet 1,173.15 7,538.90
R2019-0000071898 09-12-2019 201900068892/00013388 DEVA MUHAMMAD FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 7.00 Tablet 1,232.55 9,127.85
R2019-0000071898 09-12-2019 201900068892/00013388 DEVA MUHAMMAD FREDRIK, Dr,Sp.A OI00077 Inolin Tablet 5.00 Tablet 1,900.00 10,000.00
R2019-0000071898 09-12-2019 201900068892/00013388 DEVA MUHAMMAD FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 5.00 Granula 297.00 1,985.00
R2019-0000071898 09-12-2019 201900068892/00013388 DEVA MUHAMMAD FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 200.20 23,003.00
R2019-0000071898 09-12-2019 201900068892/00013388 DEVA MUHAMMAD FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 8.00 Capsul 28,957.00 232,156.00
R2019-0000071898 09-12-2019 201900068892/00013388 DEVA MUHAMMAD FREDRIK, Dr,Sp.A OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000071900 09-12-2019 201900068893/027264 APRIANI IQBAL, dr OC00144 Cefila Capsul, 100mg 10.00 Capsul 28,957.00 290,070.00
R2019-0000071900 09-12-2019 201900068893/027264 APRIANI IQBAL, dr OL00039 Lasal Expect Syrup, 1.00 Botol 55,687.50 56,187.50
R2019-0000071900 09-12-2019 201900068893/027264 APRIANI IQBAL, dr OL00017 Lameson 4mg 8.00 Tablet 5,049.00 40,892.00
R2019-0000071900 09-12-2019 201900068893/027264 APRIANI IQBAL, dr OP00184 Neo Protifed Tablet 7.00 Tablet 1,263.73 9,346.11
R2019-0000071903 09-12-2019 201900068870/111766 MEGA NOVITA LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000071903 09-12-2019 201900068870/111766 MEGA NOVITA LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071903 09-12-2019 201900068870/111766 MEGA NOVITA LUSY E. Dr.Sp.PD OB00050 Braxidin 10.00 Tablet 1,648.35 16,983.50
R2019-0000071903 09-12-2019 201900068870/111766 MEGA NOVITA LUSY E. Dr.Sp.PD OC00134 Curcuma Tablet 20.00 Tablet 1,336.50 27,230.00
R2019-0000071904 09-12-2019 201900068929/103142 ISNANI,NY - OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000071904 09-12-2019 201900068929/103142 ISNANI,NY - OL00041 Lasgan Capsul 5.00 Capsul 21,000.00 105,500.00
R2019-0000071904 09-12-2019 201900068929/103142 ISNANI,NY - OI00001 Ibuprofen 400mg (OGB) 8.00 Tablet 682.00 5,956.00
R2019-0000071904 09-12-2019 201900068929/103142 ISNANI,NY - OS00014 Sanadryl DMP Syrup, 60ml 1.00 Botol 17,820.00 18,320.00
R2019-0000071921 09-12-2019 201900068920/051480 ADITYA ADE RAHMAH OT00077 Tremenza Tablet 10.00 Tablet 2,160.68 22,106.80
Total 105,375,271.45
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 76 dari 266
ASAL RAWAT JALAN
R2019-0000071921 09-12-2019 201900068920/051480 ADITYA ADE RAHMAH OA00074 Analsik 5.00 Tablet 2,264.63 11,823.15
R2019-0000071921 09-12-2019 201900068920/051480 ADITYA ADE RAHMAH OI00134 Imunos Plus Tablet 5.00 Tablet 14,107.50 71,037.50
R2019-0000071923 09-12-2019 201900068919/069470 ADELIA MARYAM ADE RAHMAH OM00099 Mucera Syrup 1.00 Botol 34,155.00 34,655.00
R2019-0000071927 09-12-2019 201900068894/110801 SARFIA WALI,NY Eviwati OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000071928 09-12-2019 201900068845/111760 ZAINAB,NY Eviwati OC00086 Clindamycin 300mg 10.00 Tablet 2,700.00 27,500.00
R2019-0000071928 09-12-2019 201900068845/111760 ZAINAB,NY Eviwati OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000071929 09-12-2019 201900069276/039586 MUHAMMAD ADDINA Eviwati OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000071929 09-12-2019 201900069276/039586 MUHAMMAD ADDINA Eviwati OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000071930 09-12-2019 201900068903/111772 MASKUNI,TN DYAH, dr Sp. OC00096 Codein 10mg 10.00 Tablet 924.80 9,748.00
R2019-0000071930 09-12-2019 201900068903/111772 MASKUNI,TN DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000071931 09-12-2019 201900068864/111765 TEGUH JUNIARTO,AN DYAH, dr Sp. OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000071931 09-12-2019 201900068864/111765 TEGUH JUNIARTO,AN DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000071931 09-12-2019 201900068864/111765 TEGUH JUNIARTO,AN DYAH, dr Sp. OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000071932 09-12-2019 201900069274/111768 RONALD HADI Eviwati OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000071932 09-12-2019 201900069274/111768 RONALD HADI Eviwati OM00154 Mecobalamin 500mg 15.00 Tablet 1,118.00 17,270.00
R2019-0000071933 09-12-2019 201900068840/42164 JUSMALIANI,NY DYAH, dr Sp. OS00132 Symbicort Inhaler 160/45 1.00 Botol/6 412,776.54 413,276.54
R2019-0000071934 09-12-2019 201900068907/034197 MUHAMMAD JAFAR,TN DYAH, dr Sp. OL00021 Lansoprazole (OGB) 7.00 Capsul 2,230.00 16,110.00
R2019-0000071934 09-12-2019 201900068907/034197 MUHAMMAD JAFAR,TN DYAH, dr Sp. OT00030 Teosal 10.00 Tablet 282.15 3,321.50
R2019-0000071935 09-12-2019 201900068907/034197 MUHAMMAD JAFAR,TN DYAH, dr Sp. OL00021 Lansoprazole (OGB) 23.00 Capsul 2,230.00 51,790.00
R2019-0000071936 09-12-2019 201900068891/086183 NOVITA SARI,NY Eviwati OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000071937 09-12-2019 201900068886/111770 YOEL BONDAN Eviwati OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000071938 09-12-2019 201900068869/083042 ZAINAL ABIDIN,TN Ismail dr. Msc. OG00057 Gabapentin 300mg (OGB) 14.00 Tablet 8,168.00 114,852.00
R2019-0000071938 09-12-2019 201900068869/083042 ZAINAL ABIDIN,TN Ismail dr. Msc. OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000071938 09-12-2019 201900068869/083042 ZAINAL ABIDIN,TN Ismail dr. Msc. OV00080 Vitamin B Compleks 10.00 Tablet 241.79 2,917.90
R2019-0000071942 09-12-2019 201900068855/111762 SITI NAURA Ismail dr. Msc. OA00015 Acyclovir 400mg (OGB) 20.00 Tablet 1,262.25 25,745.00
R2019-0000071942 09-12-2019 201900068855/111762 SITI NAURA Ismail dr. Msc. OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000071942 09-12-2019 201900068855/111762 SITI NAURA Ismail dr. Msc. OI00053 Infus Otsu-NaCl 3%, 1.00 Botol 20,000.00 20,500.00
R2019-0000071942 09-12-2019 201900068855/111762 SITI NAURA Ismail dr. Msc. ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000071942 09-12-2019 201900068855/111762 SITI NAURA Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000071944 09-12-2019 201900068901/074781 FACHRUL GUNAWAN Ismail dr. Msc. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000071944 09-12-2019 201900068901/074781 FACHRUL GUNAWAN Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000071944 09-12-2019 201900068901/074781 FACHRUL GUNAWAN Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000071944 09-12-2019 201900068901/074781 FACHRUL GUNAWAN Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000071943 09-12-2019 201900068734/16470 MARINI HIDAYAT,NY Dameria Sri OK00002 Kalium Diklofenac 50mg 10.00 Tablet 1,100.00 11,500.00
R2019-0000071943 09-12-2019 201900068734/16470 MARINI HIDAYAT,NY Dameria Sri OE00057 Eperisone Hcl 50mg 14.00 Tablet 2,286.90 32,516.60
R2019-0000071943 09-12-2019 201900068734/16470 MARINI HIDAYAT,NY Dameria Sri OA00062 Amitriptyline Tablet, 3.00 Tablet 252.45 1,257.35
R2019-0000071943 09-12-2019 201900068734/16470 MARINI HIDAYAT,NY Dameria Sri OF00007 Farbion Tablet 6.00 Tablet 1,782.00 11,192.00
R2019-0000071943 09-12-2019 201900068734/16470 MARINI HIDAYAT,NY Dameria Sri ALK00037 Kapsul No.1 6.00 pcs 200.00 8,700.00
Total 106,448,844.02
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 77 dari 266
ASAL RAWAT JALAN
R2019-0000071945 09-12-2019 201900068908/085917 EDWARD VIANDY Ismail dr. Msc. OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000071945 09-12-2019 201900068908/085917 EDWARD VIANDY Ismail dr. Msc. OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000071945 09-12-2019 201900068908/085917 EDWARD VIANDY Ismail dr. Msc. OE00056 Ecosol Nacl 0,9 % 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071945 09-12-2019 201900068908/085917 EDWARD VIANDY Ismail dr. Msc. ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000071945 09-12-2019 201900068908/085917 EDWARD VIANDY Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000071946 09-12-2019 201900068917/064352 CHIKO Ismail dr. Msc. OS00053 Scabimate Cream, 10gr 1.00 Tube 59,400.00 59,900.00
R2019-0000071946 09-12-2019 201900068917/064352 CHIKO Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000071946 09-12-2019 201900068917/064352 CHIKO Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 5,049.00 5,549.00
R2019-0000071946 09-12-2019 201900068917/064352 CHIKO Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000071946 09-12-2019 201900068917/064352 CHIKO Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000071947 09-12-2019 201900068935/080537 IRAWAN Ismail dr. Msc. OM00045 Methyl Prednisolon 4mg 20.00 Tablet 792.99 16,359.80
R2019-0000071947 09-12-2019 201900068935/080537 IRAWAN Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000071947 09-12-2019 201900068935/080537 IRAWAN Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 5,049.00 5,549.00
R2019-0000071947 09-12-2019 201900068935/080537 IRAWAN Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000071947 09-12-2019 201900068935/080537 IRAWAN Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000071948 09-12-2019 201900068936/090811 HAIBAH KHUSNUL Ismail dr. Msc. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000071948 09-12-2019 201900068936/090811 HAIBAH KHUSNUL Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000071948 09-12-2019 201900068936/090811 HAIBAH KHUSNUL Ismail dr. Msc. OG00066 Genoint Salep Kulit 2.00 Tube 7,350.75 15,201.50
R2019-0000071948 09-12-2019 201900068936/090811 HAIBAH KHUSNUL Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000071949 09-12-2019 201900068949/111774 MOHAMMAD FAUSI ADE RAHMAH OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000071949 09-12-2019 201900068949/111774 MOHAMMAD FAUSI ADE RAHMAH OC00096 Codein 10mg 5.00 Tablet 924.80 5,124.00
R2019-0000071949 09-12-2019 201900068949/111774 MOHAMMAD FAUSI ADE RAHMAH OF00039 FG Troches 10.00 Tablet 1,730.02 17,800.20
R2019-0000071949 09-12-2019 201900068949/111774 MOHAMMAD FAUSI ADE RAHMAH OL00080 Loratadin 10mg (OGB) 3.00 Tablet 520.00 2,060.00
R2019-0000071951 09-12-2019 201900068956/042329 MUHAMMAD ADE RAHMAH OB001002 Betahistine 4.00 Tab 5,940.00 24,260.00
R2019-0000071951 09-12-2019 201900068956/042329 MUHAMMAD ADE RAHMAH OF00065 Flunarizine 5mg 3.00 Tablet 2,970.00 9,410.00
R2019-0000071951 09-12-2019 201900068956/042329 MUHAMMAD ADE RAHMAH OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000071951 09-12-2019 201900068956/042329 MUHAMMAD ADE RAHMAH OA00085 Antasida Tablet (OGB) 6.00 Tablet 284.30 2,205.80
R2019-0000071952 09-12-2019 201900068958/107795 ENDANG WINARSIH,NY ADE RAHMAH OP00184 Neo Protifed Tablet 5.00 Tablet 1,263.73 6,818.65
R2019-0000071952 09-12-2019 201900068958/107795 ENDANG WINARSIH,NY ADE RAHMAH OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2019-0000071952 09-12-2019 201900068958/107795 ENDANG WINARSIH,NY ADE RAHMAH OA00180 Acetylcyst ein 200mg 6.00 Tablet 1,485.00 9,410.00
R2019-0000071952 09-12-2019 201900068958/107795 ENDANG WINARSIH,NY ADE RAHMAH OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000071953 09-12-2019 201900068986/021757 NURDIANI ADE RAHMAH OA00106 Asam Mefenamat 500mg 6.00 Tablet 415.80 2,994.80
R2019-0000071953 09-12-2019 201900068986/021757 NURDIANI ADE RAHMAH OO00074 Ondansetron Tablet, 4mg 6.00 Tablet 4,455.00 27,230.00
R2019-0000071953 09-12-2019 201900068986/021757 NURDIANI ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071954 09-12-2019 201900068737/097422 BAHARIN Dameria Sri OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000071955 09-12-2019 201900068974/107867 ENDANG ADE RAHMAH OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
Total 107,149,346.87
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 78 dari 266
ASAL RAWAT JALAN
R2019-0000071955 09-12-2019 201900068974/107867 ENDANG ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000071955 09-12-2019 201900068974/107867 ENDANG ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071956 09-12-2019 201900068944/111773 KHALISYA VIOLETTA Rianti dr. Sp.A OE00047 Epexol Drop 1.00 Botol 55,836.00 56,336.00
R2019-0000071956 09-12-2019 201900068944/111773 KHALISYA VIOLETTA Rianti dr. Sp.A OC00173 Cetirizine 10mg/ml Drop, 1.00 Botol 37,125.00 37,625.00
R2019-0000071957 09-12-2019 201900068983/102114 AL LUTFY Rianti dr. Sp.A OL00001 L - BIO Sachet 5.00 Sachet 10,395.00 52,475.00
R2019-0000071957 09-12-2019 201900068983/102114 AL LUTFY Rianti dr. Sp.A OV00204 Vomis top Drop 10 ml 1.00 Botol 59,400.00 59,900.00
R2019-0000071957 09-12-2019 201900068983/102114 AL LUTFY Rianti dr. Sp.A OA00093 Apialys Drop 1.00 Botol 59,400.00 59,900.00
R2019-0000071960 09-12-2019 201900068991/111775 LOLITA AULIA,AN ADE RAHMAH OK00030 Ketricin Salep 0.1%, 5gr 1.00 Tube 66,825.00 67,325.00
R2019-0000071961 09-12-2019 201900068988/077320 MUHAMMAD ABID Rianti dr. Sp.A OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000071961 09-12-2019 201900068988/077320 MUHAMMAD ABID Rianti dr. Sp.A OF00141 Farizol Suspensi, 60ml 1.00 Botol 18,532.00 19,032.00
R2019-0000071961 09-12-2019 201900068988/077320 MUHAMMAD ABID Rianti dr. Sp.A OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000071962 09-12-2019 201900068990/091374 RISKA HELMINA ADE RAHMAH OL00041 Lasgan Capsul 10.00 Capsul 21,000.00 210,500.00
R2019-0000071962 09-12-2019 201900068990/091374 RISKA HELMINA ADE RAHMAH OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000071962 09-12-2019 201900068990/091374 RISKA HELMINA ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000071963 09-12-2019 201900068932/10555 NAKIR,TN Hendra Dr, Sp. OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000071963 09-12-2019 201900068932/10555 NAKIR,TN Hendra Dr, Sp. OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000071963 09-12-2019 201900068932/10555 NAKIR,TN Hendra Dr, Sp. OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000071965 09-12-2019 201900068989/111605 DASTAN ALDRIC Riyanti Puji dr. OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
R2019-0000071966 09-12-2019 201900068884/111458 NURLIANSYAH,TN Hendra Dr, Sp. OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000071968 09-12-2019 201900068964/100081 SUMARNI Hendra Dr, Sp. OE00008 Elkana Tablet 10.00 Tablet 1,247.40 12,974.00
R2019-0000071967 09-12-2019 201900068997/111777 IDA ROSYIDA,NN ADE RAHMAH OA00088 Antiza Tablet 4.00 Tablet 1,633.00 7,032.00
R2019-0000071967 09-12-2019 201900068997/111777 IDA ROSYIDA,NN ADE RAHMAH OD00065 Domperidon Tablet (OGB) 3.00 Tablet 750.00 2,750.00
R2019-0000071971 09-12-2019 201900068963/074224 ZAIRA NADIA Riyanti Puji dr. OE00024 Erysanbe 200mg Ceweble 15.00 Tablet 2,272.00 34,580.00
R2019-0000071971 09-12-2019 201900068963/074224 ZAIRA NADIA Riyanti Puji dr. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000071972 09-12-2019 201900068986/021757 NURDIANI ADE RAHMAH OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000071972 09-12-2019 201900068986/021757 NURDIANI ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000071972 09-12-2019 201900068986/021757 NURDIANI ADE RAHMAH ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000071973 09-12-2019 201900068974/107867 ENDANG ADE RAHMAH OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000071975 09-12-2019 201900068993/086965 RAFFASYA MILANO Rianti dr. Sp.A OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000071975 09-12-2019 201900068993/086965 RAFFASYA MILANO Rianti dr. Sp.A OP00184 Neo Protifed Tablet 2.00 Tablet 1,263.73 3,027.46
R2019-0000071975 09-12-2019 201900068993/086965 RAFFASYA MILANO Rianti dr. Sp.A OT00142 Trilac 4mg 5.00 Tablet 5,200.00 26,500.00
R2019-0000071975 09-12-2019 201900068993/086965 RAFFASYA MILANO Rianti dr. Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000071975 09-12-2019 201900068993/086965 RAFFASYA MILANO Rianti dr. Sp.A ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
Total 108,394,331.91
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 79 dari 266
ASAL RAWAT JALAN
R2019-0000071974 09-12-2019 201900068956/042329 MUHAMMAD ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000071974 09-12-2019 201900068956/042329 MUHAMMAD ADE RAHMAH OB001002 Betahistine 1.00 Tab 5,940.00 6,440.00
R2019-0000071976 09-12-2019 201900069005/036183 RATIH FEBRIANI,NY ADE RAHMAH OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000071976 09-12-2019 201900069005/036183 RATIH FEBRIANI,NY ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000071976 09-12-2019 201900069005/036183 RATIH FEBRIANI,NY ADE RAHMAH ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000071976 09-12-2019 201900069005/036183 RATIH FEBRIANI,NY ADE RAHMAH ON00039 Neurosanbe Injeksi 1.00 Ampul 8,122.95 8,622.95
R2019-0000071976 09-12-2019 201900069005/036183 RATIH FEBRIANI,NY ADE RAHMAH OM00047 Metoclopramide Injeksi 1.00 Ampul 10,395.00 10,895.00
R2019-0000071977 09-12-2019 201900068958/107795 ENDANG WINARSIH,NY ADE RAHMAH OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 Botol 22,542.30 23,042.30
R2019-0000071977 09-12-2019 201900068958/107795 ENDANG WINARSIH,NY ADE RAHMAH ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000071977 09-12-2019 201900068958/107795 ENDANG WINARSIH,NY ADE RAHMAH ON00039 Neurosanbe Injeksi 1.00 Ampul 8,122.95 8,622.95
R2019-0000071978 09-12-2019 201900068999/023566 MAEMUNAH,HJ ADE RAHMAH OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000071978 09-12-2019 201900068999/023566 MAEMUNAH,HJ ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000071978 09-12-2019 201900068999/023566 MAEMUNAH,HJ ADE RAHMAH ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000071979 09-12-2019 201900068943/085772 ARDIANA,NY Hendra Dr, Sp. OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000071979 09-12-2019 201900068943/085772 ARDIANA,NY Hendra Dr, Sp. OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000071981 09-12-2019 201900068779/090650 HABIA,NY Hendra Dr, Sp. OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000071981 09-12-2019 201900068779/090650 HABIA,NY Hendra Dr, Sp. OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000071982 09-12-2019 201900068787/080658 NELLI PUSPAYANTI Hendra Dr, Sp. OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000071982 09-12-2019 201900068787/080658 NELLI PUSPAYANTI Hendra Dr, Sp. OG00073 Glucosamine 250 Mg 10.00 Tablet 1,633.50 16,835.00
R2019-0000071982 09-12-2019 201900068787/080658 NELLI PUSPAYANTI Hendra Dr, Sp. OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000071984 09-12-2019 201900068999/023566 MAEMUNAH,HJ ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000071984 09-12-2019 201900068999/023566 MAEMUNAH,HJ ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000071984 09-12-2019 201900068999/023566 MAEMUNAH,HJ ADE RAHMAH OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000071983 09-12-2019 201900068994/111776 YOSUA SALMON ADE RAHMAH OA00180 Acetylcyst ein 200mg 6.00 Tablet 1,485.00 9,410.00
R2019-0000071983 09-12-2019 201900068994/111776 YOSUA SALMON ADE RAHMAH OA00064 Amlodipin 5mg (OGB) 5.00 Tablet 1,555.00 8,275.00
R2019-0000071983 09-12-2019 201900068994/111776 YOSUA SALMON ADE RAHMAH OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000071983 09-12-2019 201900068994/111776 YOSUA SALMON ADE RAHMAH OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000071986 09-12-2019 201900068735/018288 DALA ULENG, HJ,NY LUSY E. Dr.Sp.PD OU00022 Urotractin 400mg Tablet 10.00 Tablet 7,189.03 72,390.30
R2019-0000071985 09-12-2019 201900068994/111776 YOSUA SALMON ADE RAHMAH OC00019 Captopril 25mg (OGB) 1.00 Tablet 267.35 767.35
R2019-0000071988 09-12-2019 201900069003/111779 MUHAMMAD ADIFA ADE RAHMAH OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000071988 09-12-2019 201900069003/111779 MUHAMMAD ADIFA ADE RAHMAH OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000071989 09-12-2019 201900069003/111779 MUHAMMAD ADIFA ADE RAHMAH OL00021 Lansoprazole (OGB) 10.00 Capsul 2,230.00 22,800.00
R2019-0000071989 09-12-2019 201900069003/111779 MUHAMMAD ADIFA ADE RAHMAH OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000071993 09-12-2019 201900068744/104053 SRI MULYATI,NY LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000071993 09-12-2019 201900068744/104053 SRI MULYATI,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000071995 09-12-2019 201900068740/041239 HAPPY MUHAMAD LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000071995 09-12-2019 201900068740/041239 HAPPY MUHAMAD LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000071995 09-12-2019 201900068740/041239 HAPPY MUHAMAD LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
Total 109,221,346.73
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 80 dari 266
ASAL RAWAT JALAN
R2019-0000071995 09-12-2019 201900068740/041239 HAPPY MUHAMAD LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000071992 09-12-2019 201900068793/058334 RUDY LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 12.00 Tab 7,425.00 89,600.00
R2019-0000071992 09-12-2019 201900068793/058334 RUDY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000071998 09-12-2019 201900068793/058334 RUDY LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 3.00 Tab 7,425.00 22,775.00
R2019-0000071998 09-12-2019 201900068793/058334 RUDY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072000 09-12-2019 201900068847/8783 HARUNA,TN LUSY E. Dr.Sp.PD ON00075 Novomix 30 Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000072000 09-12-2019 201900068847/8783 HARUNA,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000072000 09-12-2019 201900068847/8783 HARUNA,TN LUSY E. Dr.Sp.PD ON00009 Natrium Diklofenac 50mg 10.00 Tablet 955.84 10,058.40
R2019-0000071999 09-12-2019 201900068871/56179 ABDURAHIM,TN LUSY E. Dr.Sp.PD OS00173 Simvastatin 20mg (OGB) 7.00 Tablet 1,782.00 12,974.00
R2019-0000071999 09-12-2019 201900068871/56179 ABDURAHIM,TN LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000071999 09-12-2019 201900068871/56179 ABDURAHIM,TN LUSY E. Dr.Sp.PD OM00045 Methyl Prednisolon 4mg 6.00 Tablet 792.99 5,257.94
R2019-0000072001 09-12-2019 201900068882/111507 ENDANG LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000072001 09-12-2019 201900068882/111507 ENDANG LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000072001 09-12-2019 201900068882/111507 ENDANG LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000072004 09-12-2019 201900068879/111534 SUSILOWATI,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000072004 09-12-2019 201900068879/111534 SUSILOWATI,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000072007 09-12-2019 201900068851/090180 NADIA UTAMI,NN Niki Juniar OI00001 Ibuprofen 400mg (OGB) 6.00 Tablet 682.00 4,592.00
R2019-0000072007 09-12-2019 201900068851/090180 NADIA UTAMI,NN Niki Juniar OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000072007 09-12-2019 201900068851/090180 NADIA UTAMI,NN Niki Juniar OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000072009 09-12-2019 201900068889/061368 SUKARNI,NY Niki Juniar OL00076 Lodia 2mg 7.00 Tablet 1,485.00 10,895.00
R2019-0000072009 09-12-2019 201900068889/061368 SUKARNI,NY Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000072009 09-12-2019 201900068889/061368 SUKARNI,NY Niki Juniar OZ00005 Zinc Tablet (OGB) 10.00 Tablet 1,000.00 10,500.00
R2019-0000072028 09-12-2019 201900068851/090180 NADIA UTAMI,NN Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000072033 10-12-2019 201900069010/111780 JUBAIDAH,NY Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000072033 10-12-2019 201900069010/111780 JUBAIDAH,NY Dwi Astuti, dr OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000072033 10-12-2019 201900069010/111780 JUBAIDAH,NY Dwi Astuti, dr OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000072033 10-12-2019 201900069010/111780 JUBAIDAH,NY Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
Total 110,729,786.17
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 81 dari 266
ASAL RAWAT JALAN
R2019-0000072034 10-12-2019 201900069007/057265 MUHAMMAD Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 3.00 Tablet 1,113.75 3,841.25
R2019-0000072034 10-12-2019 201900069007/057265 MUHAMMAD Dwi Astuti, dr OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000072034 10-12-2019 201900069007/057265 MUHAMMAD Dwi Astuti, dr OA00087 Antiza Syrup, 60ml 1.00 Botol 26,730.00 27,230.00
R2019-0000072035 10-12-2019 201900069008/095099 MUHAMMAD ARSEN Dwi Astuti, dr OZ00005 Zinc Tablet (OGB) 10.00 Tablet 1,000.00 10,500.00
R2019-0000072035 10-12-2019 201900069008/095099 MUHAMMAD ARSEN Dwi Astuti, dr OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000072035 10-12-2019 201900069008/095099 MUHAMMAD ARSEN Dwi Astuti, dr OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000072037 09-12-2019 201900068806/098206 SUKILAH,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000072037 09-12-2019 201900068806/098206 SUKILAH,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072036 10-12-2019 201900069020/110852 HAFSHOH,AN Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000072036 10-12-2019 201900069020/110852 HAFSHOH,AN Dwi Astuti, dr OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000072036 10-12-2019 201900069020/110852 HAFSHOH,AN Dwi Astuti, dr ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000072036 10-12-2019 201900069020/110852 HAFSHOH,AN Dwi Astuti, dr OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000072038 10-12-2019 201900069010/111780 JUBAIDAH,NY Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000072038 10-12-2019 201900069010/111780 JUBAIDAH,NY Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000072039 10-12-2019 201900069019/111781 FELICYA SITORUS,AN Dwi Astuti, dr OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000072039 10-12-2019 201900069019/111781 FELICYA SITORUS,AN Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000072039 10-12-2019 201900069019/111781 FELICYA SITORUS,AN Dwi Astuti, dr ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000072039 10-12-2019 201900069019/111781 FELICYA SITORUS,AN Dwi Astuti, dr OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000072041 10-12-2019 201900069016/071623 NURUL LAMRIA Dwi Astuti, dr OP00011 Paracetamol 500mg 3.00 Tablet 387.36 1,662.08
R2019-0000072041 10-12-2019 201900069016/071623 NURUL LAMRIA Dwi Astuti, dr OD00065 Domperidon Tablet (OGB) 3.00 Tablet 750.00 2,750.00
R2019-0000072041 10-12-2019 201900069016/071623 NURUL LAMRIA Dwi Astuti, dr OA00085 Antasida Tablet (OGB) 3.00 Tablet 284.30 1,352.90
R2019-0000072045 10-12-2019 201900069018/028724 HAMSURI,TN Dwi Astuti, dr OF00055 Flamar Tablet, 50mg 5.00 Tablet 2,710.13 14,050.65
R2019-0000072045 10-12-2019 201900069018/028724 HAMSURI,TN Dwi Astuti, dr OE00022 Eprinoc Tablet 5.00 Tablet 5,093.55 25,967.75
R2019-0000072044 09-12-2019 201900068818/084866 HUKMAH,NY EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000072044 09-12-2019 201900068818/084866 HUKMAH,NY EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072044 09-12-2019 201900068818/084866 HUKMAH,NY EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000072044 09-12-2019 201900068818/084866 HUKMAH,NY EDO, Dr.Sp.B ALU00002 Ultrafix Onemed 1.00 Roll 22,275.00 22,775.00
R2019-0000072048 10-12-2019 201900068748/109676 ALI AFIFI,TN Dameria Sri OB00016 Betahistine Mesilat 6mg 15.00 Tablet 1,500.00 23,000.00
R2019-0000072050 09-12-2019 201900068819/107618 SRI PUJI ASTUTI,NY TEDDY OC00264 Cendo Timol 0.5% ED 1.00 Botol 70,908.75 71,408.75
R2019-0000072050 09-12-2019 201900068819/107618 SRI PUJI ASTUTI,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072052 09-12-2019 201900068772/078814 ZAINAL,TN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000072052 09-12-2019 201900068772/078814 ZAINAL,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072051 09-12-2019 201900068776/015349 NURDAWATI,NY ROY , Dr.Sp.OG OB00029 Biosanbe Capsul 7.00 Capsul 1,596.37 11,674.59
R2019-0000072054 09-12-2019 201900068786/081809 SAFANAH AMEERA EDO, Dr.Sp.B OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000072054 09-12-2019 201900068786/081809 SAFANAH AMEERA EDO, Dr.Sp.B OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000072054 09-12-2019 201900068786/081809 SAFANAH AMEERA EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
Total 111,744,730.05
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 82 dari 266
ASAL RAWAT JALAN
R2019-0000072054 09-12-2019 201900068786/081809 SAFANAH AMEERA EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 1.00 Cm 150.00 650.00
R2019-0000072053 09-12-2019 201900068800/00012743 RICKY E J WELAN,TN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000072053 09-12-2019 201900068800/00012743 RICKY E J WELAN,TN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072053 09-12-2019 201900068800/00012743 RICKY E J WELAN,TN EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
R2019-0000072053 09-12-2019 201900068800/00012743 RICKY E J WELAN,TN EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000072053 09-12-2019 201900068800/00012743 RICKY E J WELAN,TN EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 1.00 Cm 150.00 650.00
R2019-0000072055 09-12-2019 201900068820/105085 HAPSARI,NY EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000072055 09-12-2019 201900068820/105085 HAPSARI,NY EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072055 09-12-2019 201900068820/105085 HAPSARI,NY EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000072055 09-12-2019 201900068820/105085 HAPSARI,NY EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000072058 09-12-2019 201900068778/072483 INSIAH,NY Dameria Sri OM00018 Meloxicam 7.5mg (OGB) 14.00 Tablet 1,287.00 18,518.00
R2019-0000072058 09-12-2019 201900068778/072483 INSIAH,NY Dameria Sri OG00057 Gabapentin 300mg (OGB) 7.00 Tablet 8,168.00 57,676.00
R2019-0000072058 09-12-2019 201900068778/072483 INSIAH,NY Dameria Sri ALK00037 Kapsul No.1 14.00 pcs 200.00 7,800.00
R2019-0000072058 09-12-2019 201900068778/072483 INSIAH,NY Dameria Sri OC00092 Clopidogrel 75mg (OGB) 6.00 Tablet 14,701.50 88,709.00
R2019-0000072058 09-12-2019 201900068778/072483 INSIAH,NY Dameria Sri OS00173 Simvastatin 20mg (OGB) 6.00 Tablet 1,782.00 11,192.00
R2019-0000072058 09-12-2019 201900068778/072483 INSIAH,NY Dameria Sri OC00172 Candesartan Cilexetil 6.00 Tablet 10,617.75 64,206.50
R2019-0000072058 09-12-2019 201900068778/072483 INSIAH,NY Dameria Sri OH00025 Hydrochlortiazide (OGB) 3.00 Tablet 240.30 1,220.90
R2019-0000072058 09-12-2019 201900068778/072483 INSIAH,NY Dameria Sri OB00036 Bis oprolol 5mg (OGB) 6.00 Tablet 5,197.50 31,685.00
R2019-0000072069 09-12-2019 201900068821/111757 ANNARIA TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072069 09-12-2019 201900068821/111757 ANNARIA TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000072070 09-12-2019 201900068785/110107 YANTI ANA Angie Renatha , OK00002 Kalium Diklofenac 50mg 10.00 Tablet 1,100.00 11,500.00
R2019-0000072070 09-12-2019 201900068785/110107 YANTI ANA Angie Renatha , OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072070 09-12-2019 201900068785/110107 YANTI ANA Angie Renatha , OA00062 Amitriptyline Tablet, 4.00 Tablet 252.45 1,509.80
R2019-0000072070 09-12-2019 201900068785/110107 YANTI ANA Angie Renatha , OO00014 Omeprazole 20mg (OGB) 14.00 Capsul 1,169.98 16,879.72
R2019-0000072070 09-12-2019 201900068785/110107 YANTI ANA Angie Renatha , OB00050 Braxidin 4.00 Tablet 1,648.35 7,093.40
R2019-0000072059 03-12-2019 201900067534/015236 TRI MURTINI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000072059 03-12-2019 201900067534/015236 TRI MURTINI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072059 03-12-2019 201900067534/015236 TRI MURTINI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072076 10-12-2019 201900069050/095668 MUHAMMAD NABA IRMA SARI OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000072076 10-12-2019 201900069050/095668 MUHAMMAD NABA IRMA SARI OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000072074 03-12-2019 201900067580/080792 MISGIANTY,NY LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 7.00 Tablet 811.18 6,178.26
R2019-0000072060 04-12-2019 201900067683/110346 HAFID,TN LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000072060 04-12-2019 201900067683/110346 HAFID,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072060 04-12-2019 201900067683/110346 HAFID,TN LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 7.00 Tablet 206.41 1,944.87
R2019-0000072060 04-12-2019 201900067683/110346 HAFID,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072060 04-12-2019 201900067683/110346 HAFID,TN LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 3.00 Tablet 315.26 1,445.78
R2019-0000072060 04-12-2019 201900067683/110346 HAFID,TN LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000072077 04-12-2019 201900067711/076097 LISA,NY LUSY E. Dr.Sp.PD OT00135 Thyrozol 5mg 7.00 Tablet 2,188.89 15,822.23
Total 112,515,398.29
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 83 dari 266
ASAL RAWAT JALAN
R2019-0000072078 04-12-2019 201900067710/072991 NORSEMAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000072078 04-12-2019 201900067710/072991 NORSEMAH,NY LUSY E. Dr.Sp.PD OG00024 Glimepiride 4mg Tablet 7.00 Tablet 3,869.89 27,589.23
R2019-0000072078 04-12-2019 201900067710/072991 NORSEMAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072078 04-12-2019 201900067710/072991 NORSEMAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000072079 04-12-2019 201900067743/099100 SITI RO SANA,NY LUSY E. Dr.Sp.PD OT00046 Thyrozol 10mg 21.00 Tablet 2,913.41 61,681.61
R2019-0000072079 04-12-2019 201900067743/099100 SITI RO SANA,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 7.00 Tablet 315.26 2,706.82
R2019-0000072079 04-12-2019 201900067743/099100 SITI RO SANA,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072079 04-12-2019 201900067743/099100 SITI RO SANA,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072079 04-12-2019 201900067743/099100 SITI RO SANA,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000072082 04-12-2019 201900067780/109601 HOTIK LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000072082 04-12-2019 201900067780/109601 HOTIK LUSY E. Dr.Sp.PD OG00024 Glimepiride 4mg Tablet 7.00 Tablet 3,869.89 27,589.23
R2019-0000072082 04-12-2019 201900067780/109601 HOTIK LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000072082 04-12-2019 201900067780/109601 HOTIK LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 7.00 Tab 7,425.00 52,475.00
R2019-0000072084 04-12-2019 201900067766/108595 NINUK LUSY E. Dr.Sp.PD OT00046 Thyrozol 10mg 21.00 Tablet 2,913.41 61,681.61
R2019-0000072084 04-12-2019 201900067766/108595 NINUK LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000072086 04-12-2019 201900067712/101638 RACHMATULLAH,TN LUSY E. Dr.Sp.PD OT00046 Thyrozol 10mg 7.00 Tablet 2,913.41 20,893.87
R2019-0000072087 04-12-2019 201900067714/046065 SURIYANA NOOR,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000072087 04-12-2019 201900067714/046065 SURIYANA NOOR,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000072087 04-12-2019 201900067714/046065 SURIYANA NOOR,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072088 03-12-2019 201900067434/074128 NOORSIAH,NY Dameria Sri OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000072088 03-12-2019 201900067434/074128 NOORSIAH,NY Dameria Sri OS00173 Simvastatin 20mg (OGB) 7.00 Tablet 1,782.00 12,974.00
R2019-0000072088 03-12-2019 201900067434/074128 NOORSIAH,NY Dameria Sri OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000072088 03-12-2019 201900067434/074128 NOORSIAH,NY Dameria Sri OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000072088 03-12-2019 201900067434/074128 NOORSIAH,NY Dameria Sri OL000131 Leparson Tablet 14.00 Tablet 5,917.35 83,342.90
R2019-0000072090 05-12-2019 201900068119/111215 SRI ERMA Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 7.00 Tablet 965.25 7,256.75
R2019-0000072090 05-12-2019 201900068119/111215 SRI ERMA Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000072090 05-12-2019 201900068119/111215 SRI ERMA Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000072090 05-12-2019 201900068119/111215 SRI ERMA Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000072090 05-12-2019 201900068119/111215 SRI ERMA Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000072093 05-12-2019 201900068124/052146 BUDHI SANTOSA,TN Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 7.00 Tablet 965.25 7,256.75
R2019-0000072093 05-12-2019 201900068124/052146 BUDHI SANTOSA,TN Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000072093 05-12-2019 201900068124/052146 BUDHI SANTOSA,TN Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000072093 05-12-2019 201900068124/052146 BUDHI SANTOSA,TN Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000072093 05-12-2019 201900068124/052146 BUDHI SANTOSA,TN Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000072094 05-12-2019 201900068034/074998 PARTIAH,NY LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000072094 05-12-2019 201900068034/074998 PARTIAH,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000072094 05-12-2019 201900068034/074998 PARTIAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072094 05-12-2019 201900068034/074998 PARTIAH,NY LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
Total 113,586,148.31
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 84 dari 266
ASAL RAWAT JALAN
R2019-0000072094 05-12-2019 201900068034/074998 PARTIAH,NY LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000072071 10-12-2019 201800033592/089740 ERMI JOHANSYAH,TN THRISIA dr. Sp OA00037 Allopurinol 100mg (OGB) 10.00 Tablet 445.50 4,955.00
R2019-0000072071 10-12-2019 201800033592/089740 ERMI JOHANSYAH,TN THRISIA dr. Sp OT00149 Toramine 10 Mg Tablet 8.00 Tablet 8,167.50 65,840.00
R2019-0000072095 06-12-2019 201900068347/104133 NI'MATUL DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000072098 10-12-2019 201900069049/089740 ERMI JOHANSYAH,TN IRMA SARI OA00037 Allopurinol 100mg (OGB) 10.00 Tablet 445.50 4,955.00
R2019-0000072098 10-12-2019 201900069049/089740 ERMI JOHANSYAH,TN IRMA SARI OT00149 Toramine 10 Mg Tablet 8.00 Tablet 8,167.50 65,840.00
R2019-0000072099 10-12-2019 201900069050/095668 MUHAMMAD NABA IRMA SARI OL00039 Lasal Expect Syrup, 1.00 Botol 55,687.50 56,187.50
R2019-0000072099 10-12-2019 201900069050/095668 MUHAMMAD NABA IRMA SARI OP00101 Proceles Syrup, 60ml 1.00 Botol 51,975.00 52,475.00
R2019-0000072099 10-12-2019 201900069050/095668 MUHAMMAD NABA IRMA SARI OO00023 Opicef Dry Syrup, 60ml 1.00 Botol 66,825.00 67,325.00
R2019-0000072099 10-12-2019 201900069050/095668 MUHAMMAD NABA IRMA SARI OV00057 Ventolin Nebules 2.5mg 3.00 Ampul 15,365.00 46,595.00
R2019-0000072099 10-12-2019 201900069050/095668 MUHAMMAD NABA IRMA SARI OP00136 Pulmicort Respules 3.00 Ampul 33,802.98 101,908.94
R2019-0000072097 10-12-2019 201900069464/096903 EKA FEBRIANA,NY LUSY E. Dr.Sp.PD OI00054 Infus Otsu-RL, 500ml 1.00 Botol 17,820.00 18,320.00
R2019-0000072097 10-12-2019 201900069464/096903 EKA FEBRIANA,NY LUSY E. Dr.Sp.PD ALD00005 Disposable Syringe 3ml 1.00 Pcs 2,272.05 2,772.05
R2019-0000072097 10-12-2019 201900069464/096903 EKA FEBRIANA,NY LUSY E. Dr.Sp.PD OS00029 Sanmol Tablet, 500mg 1.00 Tablet 430.65 930.65
R2019-0000072097 10-12-2019 201900069464/096903 EKA FEBRIANA,NY LUSY E. Dr.Sp.PD OF00071 Folavit 400mcg 1.00 Tablet 1,329.07 1,829.07
R2019-0000072102 10-12-2019 201900069039/111753 MF EVY Angie Renatha , OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000072102 10-12-2019 201900069039/111753 MF EVY Angie Renatha , OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000072103 10-12-2019 201900069059/079563 ANASTASIA ROY , Dr.Sp.OG OB00029 Biosanbe Capsul 7.00 Capsul 1,596.37 11,674.59
R2019-0000072108 10-12-2019 201900069054/090924 SUMIATI,NY Herika dr. OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000072108 10-12-2019 201900069054/090924 SUMIATI,NY Herika dr. OA00063 Amlodipin 10mg (OGB) 2.00 Tablet 2,743.00 5,986.00
R2019-0000072108 10-12-2019 201900069054/090924 SUMIATI,NY Herika dr. OC00171 Candesartan Cilexetil 2.00 Tablet 7,425.00 15,350.00
R2019-0000072108 10-12-2019 201900069054/090924 SUMIATI,NY Herika dr. OL00021 Lansoprazole (OGB) 4.00 Capsul 2,230.00 9,420.00
R2019-0000072111 10-12-2019 201900069060/061945 ENDANG ROY , Dr.Sp.OG OB00029 Biosanbe Capsul 7.00 Capsul 1,596.37 11,674.59
R2019-0000072113 10-12-2019 201900069072/027712 TRI HANDAYANI,NY Angie Renatha , OK00023 Ketoconazole 200mg 10.00 Tablet 774.24 8,242.40
R2019-0000072113 10-12-2019 201900069072/027712 TRI HANDAYANI,NY Angie Renatha , ALD00003 Disposable Syringe 1ml 1.00 Pcs 3,500.00 4,000.00
R2019-0000072113 10-12-2019 201900069072/027712 TRI HANDAYANI,NY Angie Renatha , OF00150 Fukricin Eye Drop 1.00 Botol 102,762.00 103,262.00
R2019-0000072114 10-12-2019 201900069079/111353 MUHAMMAD Angie Renatha , OA00013 Avamys Nasal Spray 1.00 Botol 237,451.50 237,951.50
R2019-0000072114 10-12-2019 201900069079/111353 MUHAMMAD Angie Renatha , OP00184 Neo Protifed Tablet 10.00 Tablet 1,263.73 13,137.30
R2019-0000072115 10-12-2019 201900069057/071439 WA OPO,NY Herika dr. OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000072115 10-12-2019 201900069057/071439 WA OPO,NY Herika dr. OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000072115 10-12-2019 201900069057/071439 WA OPO,NY Herika dr. OL00021 Lansoprazole (OGB) 4.00 Capsul 2,230.00 9,420.00
R2019-0000072116 10-12-2019 201900069055/111782 DIAN WULANDARI,NN Herika dr. OC00076 Ciprofloxacin 500mg 6.00 Tablet 1,039.50 6,737.00
R2019-0000072116 10-12-2019 201900069055/111782 DIAN WULANDARI,NN Herika dr. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000072116 10-12-2019 201900069055/111782 DIAN WULANDARI,NN Herika dr. OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000072116 10-12-2019 201900069055/111782 DIAN WULANDARI,NN Herika dr. OU00022 Urotractin 400mg Tablet 6.00 Tablet 7,189.03 43,634.18
R2019-0000072119 10-12-2019 201900069017/065038 USMIATI,NY Dameria Sri OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000072122 10-12-2019 201900069062/111619 TARMIJI,TN Maulin Nikmah ALK00024 Korset TLSO (Thoraco 1.00 Pcs 455,000.00 455,500.00
R2019-0000072125 10-12-2019 201900069103/106347 ERIENTA TEDDY OC00255 Cendo Tobroson Eye Drop 1.00 Botol 68,681.25 69,181.25
Total 115,242,720.18
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 85 dari 266
ASAL RAWAT JALAN
R2019-0000072125 10-12-2019 201900069103/106347 ERIENTA TEDDY OC00300 Cendo Hyalub Minidose 1.00 Strip 84,645.00 85,145.00
R2019-0000072125 10-12-2019 201900069103/106347 ERIENTA TEDDY OM00046 Methyl Prednisolon 8mg 20.00 Tablet 929.50 19,090.00
R2019-0000072096 10-12-2019 201900069029/091658 ANIDA SALSABILA,AN Dameria Sri OP00036 Phenytoin Capsul 46.00 Capsul 816.75 38,070.50
R2019-0000072128 10-12-2019 201900069121/037439 RETNO DEWI IRMA SARI OA00140 Atorvastatin 20mg (OGB) 30.00 Tablet 6,534.00 196,520.00
R2019-0000072128 10-12-2019 201900069121/037439 RETNO DEWI IRMA SARI OA00134 Asta Plus 10.00 Tablet 12,623.00 126,730.00
R2019-0000072130 10-12-2019 201900069029/091658 ANIDA SALSABILA,AN Dameria Sri OP00036 Phenytoin Capsul 14.00 Capsul 816.75 11,934.50
R2019-0000072132 10-12-2019 201900069139/111797 PUJI FITRIANI,NY IRMA SARI OC00039 Cefixime 100mg (OGB) 15.00 Capsul 4,266.70 64,500.50
R2019-0000072132 10-12-2019 201900069139/111797 PUJI FITRIANI,NY IRMA SARI OA00153 Alco Plus DMP Syrup 1.00 Botol 62,370.00 62,870.00
R2019-0000072132 10-12-2019 201900069139/111797 PUJI FITRIANI,NY IRMA SARI OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000072132 10-12-2019 201900069139/111797 PUJI FITRIANI,NY IRMA SARI OB00007 Becom - C 5.00 Tablet 2,123.55 11,117.75
R2019-0000072133 10-12-2019 201900069145/076455 ALZENA ZAYBA FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 5.00 Capsul 28,957.00 145,285.00
R2019-0000072133 10-12-2019 201900069145/076455 ALZENA ZAYBA FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 4.00 Tablet 430.65 2,222.60
R2019-0000072133 10-12-2019 201900069145/076455 ALZENA ZAYBA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000072133 10-12-2019 201900069145/076455 ALZENA ZAYBA FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 5.00 Tablet 1,232.55 6,662.75
R2019-0000072133 10-12-2019 201900069145/076455 ALZENA ZAYBA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000072133 10-12-2019 201900069145/076455 ALZENA ZAYBA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000072134 10-12-2019 201900069109/102696 ABDURRAHMAN FREDRIK, Dr,Sp.A OA00096 Apolar N Cream, 10gr 1.00 Tube 53,014.50 53,514.50
R2019-0000072134 10-12-2019 201900069109/102696 ABDURRAHMAN FREDRIK, Dr,Sp.A OF00036 Ferlin Drops 1.00 Botol 49,005.00 49,505.00
R2019-0000072138 10-12-2019 201900069113/111789 AISYAH,AN FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 4.00 Capsul 28,957.00 116,328.00
R2019-0000072138 10-12-2019 201900069113/111789 AISYAH,AN FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 4.00 Tablet 430.65 2,222.60
R2019-0000072138 10-12-2019 201900069113/111789 AISYAH,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000072138 10-12-2019 201900069113/111789 AISYAH,AN FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 4.00 Tablet 1,232.55 5,430.20
R2019-0000072138 10-12-2019 201900069113/111789 AISYAH,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000072138 10-12-2019 201900069113/111789 AISYAH,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000072137 10-12-2019 201900069163/042361 NEYRA SASKIA A,AN FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 6.00 Capsul 28,957.00 174,242.00
R2019-0000072137 10-12-2019 201900069163/042361 NEYRA SASKIA A,AN FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 5.00 Tablet 430.65 2,653.25
R2019-0000072137 10-12-2019 201900069163/042361 NEYRA SASKIA A,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 5.00 Tablet 1,173.15 6,365.75
R2019-0000072137 10-12-2019 201900069163/042361 NEYRA SASKIA A,AN FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 5.00 Tablet 1,232.55 6,662.75
R2019-0000072137 10-12-2019 201900069163/042361 NEYRA SASKIA A,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000072137 10-12-2019 201900069163/042361 NEYRA SASKIA A,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 200.20 18,003.00
R2019-0000072137 10-12-2019 201900069163/042361 NEYRA SASKIA A,AN FREDRIK, Dr,Sp.A OO00062 Ottopan Syrup, 60ml 1.00 Botol 29,700.00 30,200.00
R2019-0000072139 10-12-2019 201900069063/111783 MUHAMMAD FARHAN Dameria Sri OP00036 Phenytoin Capsul 46.00 Capsul 816.75 38,070.50
R2019-0000072140 10-12-2019 201900069063/111783 MUHAMMAD FARHAN Dameria Sri OP00036 Phenytoin Capsul 14.00 Capsul 816.75 11,934.50
R2019-0000072140 10-12-2019 201900069063/111783 MUHAMMAD FARHAN Dameria Sri OA00175 Afolat 400mcg 14.00 Tablet 206.41 3,389.74
R2019-0000072140 10-12-2019 201900069063/111783 MUHAMMAD FARHAN Dameria Sri OV00085 Vitamin B6 Tablet (OGB) 14.00 Tablet 199.80 3,297.20
R2019-0000072149 10-12-2019 201900069099/078900 ADYTIA MANDALA Angie Renatha , OR00041 Rhinos SR Capsul 20.00 Capsul 9,581.00 192,120.00
R2019-0000072146 10-12-2019 201900069207/00012388 AHMAD SABIQ Herika dr. OF00090 Fucilex Cream, 5gr 1.00 Tube 14,850.00 15,350.00
R2019-0000072146 10-12-2019 201900069207/00012388 AHMAD SABIQ Herika dr. OK00022 Ketoconazol Cream 2% 1.00 Tube 11,000.00 11,500.00
Total 116,810,150.47
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 86 dari 266
ASAL RAWAT JALAN
R2019-0000072146 10-12-2019 201900069207/00012388 AHMAD SABIQ Herika dr. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 19,000.00
R2019-0000072152 10-12-2019 201900069196/054586 ARIEF SETIAWAN,TN Herika dr. OI00133 Imunvit Plus Tablet 10.00 Tablet 13,365.00 134,150.00
R2019-0000072152 10-12-2019 201900069196/054586 ARIEF SETIAWAN,TN Herika dr. OS00029 Sanmol Tablet, 500mg 12.00 Tablet 430.65 5,667.80
R2019-0000072152 10-12-2019 201900069196/054586 ARIEF SETIAWAN,TN Herika dr. OT00077 Tremenza Tablet 10.00 Tablet 2,160.68 22,106.80
R2019-0000072152 10-12-2019 201900069196/054586 ARIEF SETIAWAN,TN Herika dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000072155 10-12-2019 201900069117/111790 FARIDA AMALIA,NY Angie Renatha , OC00144 Cefila Capsul, 100mg 10.00 Capsul 28,957.00 290,070.00
R2019-0000072155 10-12-2019 201900069117/111790 FARIDA AMALIA,NY Angie Renatha , OC00120 Cortidex Tablet 15.00 Tablet 430.65 6,959.75
R2019-0000072155 10-12-2019 201900069117/111790 FARIDA AMALIA,NY Angie Renatha , OH0045 Hexadol Solution 60 Ml 1.00 Botol 18,562.50 19,062.50
R2019-0000072154 10-12-2019 201900069153/111318 ROVINUS IRVUS Eviwati OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072156 10-12-2019 201900069277/111169 JAMHARI,TN Eviwati OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000072156 10-12-2019 201900069277/111169 JAMHARI,TN Eviwati OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072157 10-12-2019 201900069169/019214 MARIYA OLFAH,NY Angie Renatha , OF00150 Fukricin Eye Drop 1.00 Botol 102,762.00 103,262.00
R2019-0000072157 10-12-2019 201900069169/019214 MARIYA OLFAH,NY Angie Renatha , ALD00003 Disposable Syringe 1ml 1.00 Pcs 3,500.00 4,000.00
R2019-0000072157 10-12-2019 201900069169/019214 MARIYA OLFAH,NY Angie Renatha , OK00023 Ketoconazole 200mg 10.00 Tablet 774.24 8,242.40
R2019-0000072157 10-12-2019 201900069169/019214 MARIYA OLFAH,NY Angie Renatha , OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072158 10-12-2019 201900069199/047518 NABIIL ASYRAF Angie Renatha , OH00026 Hydrocortis on Cream 1.00 Tube 11,880.00 12,380.00
R2019-0000072160 10-12-2019 201900069278/060229 KHAFID NUR Eviwati OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000072160 10-12-2019 201900069278/060229 KHAFID NUR Eviwati OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000072159 10-12-2019 201900069219/062551 RUWAIDAH,NY Angie Renatha , OF00150 Fukricin Eye Drop 1.00 Botol 102,762.00 103,262.00
R2019-0000072162 10-12-2019 201900069206/076249 ARIK Eviwati OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000072162 10-12-2019 201900069206/076249 ARIK Eviwati OC00086 Clindamycin 300mg 10.00 Tablet 2,700.00 27,500.00
R2019-0000072163 10-12-2019 201900069194/097596 ANDI RATNAWATI,NY Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000072163 10-12-2019 201900069194/097596 ANDI RATNAWATI,NY Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000072163 10-12-2019 201900069194/097596 ANDI RATNAWATI,NY Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000072163 10-12-2019 201900069194/097596 ANDI RATNAWATI,NY Ismail dr. Msc. OG00066 Genoint Salep Kulit 2.00 Tube 7,350.75 15,201.50
R2019-0000072163 10-12-2019 201900069194/097596 ANDI RATNAWATI,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 14,000.00
R2019-0000072165 10-12-2019 201900069202/111804 LUDIA REDE,NY Ismail dr. Msc. OG00071 Griseovulfin 500 mg 20.00 Tablet 2,509.21 50,684.20
R2019-0000072165 10-12-2019 201900069202/111804 LUDIA REDE,NY Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 30.00 Tablet 623.70 19,211.00
R2019-0000072165 10-12-2019 201900069202/111804 LUDIA REDE,NY Ismail dr. Msc. GK003 Ketoconazole Cream 10 2.00 Tube 8,019.00 16,538.00
R2019-0000072165 10-12-2019 201900069202/111804 LUDIA REDE,NY Ismail dr. Msc. OH00026 Hydrocortis on Cream 3.00 Tube 11,880.00 36,140.00
R2019-0000072165 10-12-2019 201900069202/111804 LUDIA REDE,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 19,000.00
R2019-0000072166 10-12-2019 201900069221/044756 AHMAD SIHAB,AN Ismail dr. Msc. OA00015 Acyclovir 400mg (OGB) 20.00 Tablet 1,262.25 25,745.00
R2019-0000072166 10-12-2019 201900069221/044756 AHMAD SIHAB,AN Ismail dr. Msc. OA00068 Amoxsan Capsul, 500mg 10.00 Capsul 4,752.00 48,020.00
R2019-0000072166 10-12-2019 201900069221/044756 AHMAD SIHAB,AN Ismail dr. Msc. OZ00005 Zinc Tablet (OGB) 20.00 Tablet 1,000.00 20,500.00
R2019-0000072170 10-12-2019 201900069231/111806 MUHAMMAD ADE RAHMAH ALF00008 Folley Catheter No. 16 1.00 Pcs 29,329.00 29,829.00
R2019-0000072170 10-12-2019 201900069231/111806 MUHAMMAD ADE RAHMAH ALU00007 Urine Bag 1.00 Pcs 19,305.00 19,805.00
R2019-0000072170 10-12-2019 201900069231/111806 MUHAMMAD ADE RAHMAH OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000072173 10-12-2019 201900069091/082794 JUNAIDI,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 30.00 Tablet 2,743.00 82,790.00
Total 118,091,560.17
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 87 dari 266
ASAL RAWAT JALAN
R2019-0000072173 10-12-2019 201900069091/082794 JUNAIDI,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 30.00 Tablet 10,617.75 319,032.50
R2019-0000072173 10-12-2019 201900069091/082794 JUNAIDI,TN LUSY E. Dr.Sp.PD OP00167 Proliver 60.00 Kalpet 7,574.00 454,940.00
R2019-0000072176 10-12-2019 201900069193/111488 RUSNADI,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000072177 10-12-2019 201900069189/111802 JUARSIH KARMITA,NY LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 23.00 Tablet 206.41 5,247.43
R2019-0000072177 10-12-2019 201900069189/111802 JUARSIH KARMITA,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000072179 10-12-2019 201900069225/090117 ARI YULIANA,NY ADE RAHMAH OT00149 Toramine 10 Mg Tablet 10.00 Tablet 8,167.50 82,175.00
R2019-0000072179 10-12-2019 201900069225/090117 ARI YULIANA,NY ADE RAHMAH OL00041 Lasgan Capsul 10.00 Capsul 21,000.00 210,500.00
R2019-0000072181 10-12-2019 201900069246/083270 FRANSISCA NATALIA ADE RAHMAH OT00077 Tremenza Tablet 10.00 Tablet 2,160.68 22,106.80
R2019-0000072181 10-12-2019 201900069246/083270 FRANSISCA NATALIA ADE RAHMAH OA00180 Acetylcyst ein 200mg 5.00 Tablet 1,485.00 7,925.00
R2019-0000072181 10-12-2019 201900069246/083270 FRANSISCA NATALIA ADE RAHMAH OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000072181 10-12-2019 201900069246/083270 FRANSISCA NATALIA ADE RAHMAH OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000072181 10-12-2019 201900069246/083270 FRANSISCA NATALIA ADE RAHMAH OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000072180 10-12-2019 201900069238/077033 NISA ASRO DINA,NY DR. BISMA SP OB00039 Blesifen 10.00 Tablet 18,696.15 187,461.50
R2019-0000072180 10-12-2019 201900069238/077033 NISA ASRO DINA,NY DR. BISMA SP OR00016 Regumen Tablet 10.00 Tablet 5,613.30 56,633.00
R2019-0000072184 10-12-2019 201900069257/111808 PUTRA GISWA ADE RAHMAH OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000072184 10-12-2019 201900069257/111808 PUTRA GISWA ADE RAHMAH OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000072184 10-12-2019 201900069257/111808 PUTRA GISWA ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000072184 10-12-2019 201900069257/111808 PUTRA GISWA ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000072185 10-12-2019 201900069255/101646 FAJRINA HIKMAWATI DR. BISMA SP OR00016 Regumen Tablet 10.00 Tablet 5,613.30 56,633.00
R2019-0000072185 10-12-2019 201900069255/101646 FAJRINA HIKMAWATI DR. BISMA SP OB00039 Blesifen 10.00 Tablet 18,696.15 187,461.50
R2019-0000072186 10-12-2019 201900069270/111812 SRIATUN,NY ADE RAHMAH OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000072186 10-12-2019 201900069270/111812 SRIATUN,NY ADE RAHMAH OB00007 Becom - C 10.00 Tablet 2,123.55 21,735.50
R2019-0000072186 10-12-2019 201900069270/111812 SRIATUN,NY ADE RAHMAH OC00018 Captopril 12.5mg (OGB) 1.00 Tablet 180.00 680.00
R2019-0000072188 10-12-2019 201900069250/065918 ANITA YULIANI,NY DR. BISMA SP OF00099 Folda Tablet 30.00 Tablet 6,661.65 200,349.50
R2019-0000072188 10-12-2019 201900069250/065918 ANITA YULIANI,NY DR. BISMA SP OB00068 BioCal-95 30.00 Tablet 7,128.00 214,340.00
R2019-0000072188 10-12-2019 201900069250/065918 ANITA YULIANI,NY DR. BISMA SP OH0046 Hb-Vit Tablet 30.00 tablet 5,197.50 156,425.00
R2019-0000072191 10-12-2019 201900069273/054026 ELVI MARIA DR. BISMA SP OF00099 Folda Tablet 30.00 Tablet 6,661.65 200,349.50
R2019-0000072191 10-12-2019 201900069273/054026 ELVI MARIA DR. BISMA SP OB00068 BioCal-95 30.00 Tablet 7,128.00 214,340.00
R2019-0000072195 10-12-2019 201900069263/111810 ERNAWATI,NY ADE RAHMAH ON00009 Natrium Diklofenac 50mg 3.00 Tablet 955.84 3,367.52
R2019-0000072195 10-12-2019 201900069263/111810 ERNAWATI,NY ADE RAHMAH OA00085 Antasida Tablet (OGB) 3.00 Tablet 284.30 1,352.90
R2019-0000072195 10-12-2019 201900069263/111810 ERNAWATI,NY ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 3.00 Capsul 1,169.98 4,009.94
R2019-0000072196 10-12-2019 201900069256/077756 ERNA ISYAHLIWANTI, Restu OL00021 Lansoprazole (OGB) 7.00 Capsul 2,230.00 16,110.00
R2019-0000072196 10-12-2019 201900069256/077756 ERNA ISYAHLIWANTI, Restu OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000072196 10-12-2019 201900069256/077756 ERNA ISYAHLIWANTI, Restu OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000072196 10-12-2019 201900069256/077756 ERNA ISYAHLIWANTI, Restu OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072197 10-12-2019 201900069256/077756 ERNA ISYAHLIWANTI, Restu OL00021 Lansoprazole (OGB) 23.00 Capsul 2,230.00 51,790.00
R2019-0000072197 10-12-2019 201900069256/077756 ERNA ISYAHLIWANTI, Restu OA00037 Allopurinol 100mg (OGB) 23.00 Tablet 445.50 10,746.50
R2019-0000072197 10-12-2019 201900069256/077756 ERNA ISYAHLIWANTI, Restu OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
Total 121,354,714.86
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 88 dari 266
ASAL RAWAT JALAN
R2019-0000072197 10-12-2019 201900069256/077756 ERNA ISYAHLIWANTI, Restu OS00160 Seretide Diskus 250 mcg 1.00 Botol 322,681.59 323,181.59
R2019-0000072198 10-12-2019 201900069279/094623 MUHAMMAD BIMA Rianti dr. Sp.A OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000072198 10-12-2019 201900069279/094623 MUHAMMAD BIMA Rianti dr. Sp.A ALD00005 Disposable Syringe 3ml 1.00 Pcs 2,272.05 2,772.05
R2019-0000072198 10-12-2019 201900069279/094623 MUHAMMAD BIMA Rianti dr. Sp.A OM00097 Mucera Drop 1.00 Botol 54,945.00 55,445.00
R2019-0000072198 10-12-2019 201900069279/094623 MUHAMMAD BIMA Rianti dr. Sp.A OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2019-0000072200 10-12-2019 201900069280/096989 RAGIL PRATAMA,AN ADE RAHMAH OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000072200 10-12-2019 201900069280/096989 RAGIL PRATAMA,AN ADE RAHMAH OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000072200 10-12-2019 201900069280/096989 RAGIL PRATAMA,AN ADE RAHMAH OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000072202 10-12-2019 201900069248/071218 FEMMY MASENGI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072202 10-12-2019 201900069248/071218 FEMMY MASENGI,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000072202 10-12-2019 201900069248/071218 FEMMY MASENGI,NY LUSY E. Dr.Sp.PD OA00140 Atorvastatin 20mg (OGB) 7.00 Tablet 6,534.00 46,238.00
R2019-0000072202 10-12-2019 201900069248/071218 FEMMY MASENGI,NY LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000072202 10-12-2019 201900069248/071218 FEMMY MASENGI,NY LUSY E. Dr.Sp.PD OD00047 Diamicron MR 60mg 3.00 Tablet 8,420.00 25,760.00
R2019-0000072202 10-12-2019 201900069248/071218 FEMMY MASENGI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000072201 10-12-2019 201900069248/071218 FEMMY MASENGI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000072201 10-12-2019 201900069248/071218 FEMMY MASENGI,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000072201 10-12-2019 201900069248/071218 FEMMY MASENGI,NY LUSY E. Dr.Sp.PD OA00140 Atorvastatin 20mg (OGB) 23.00 Tablet 6,534.00 150,782.00
R2019-0000072201 10-12-2019 201900069248/071218 FEMMY MASENGI,NY LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000072201 10-12-2019 201900069248/071218 FEMMY MASENGI,NY LUSY E. Dr.Sp.PD OD00047 Diamicron MR 60mg 12.00 Tablet 8,420.00 101,540.00
R2019-0000072201 10-12-2019 201900069248/071218 FEMMY MASENGI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2019-0000072203 10-12-2019 201900069235/021961 AGUS PITRIANI,NY Restu OL00021 Lansoprazole (OGB) 7.00 Capsul 2,230.00 16,110.00
R2019-0000072203 10-12-2019 201900069235/021961 AGUS PITRIANI,NY Restu OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072203 10-12-2019 201900069235/021961 AGUS PITRIANI,NY Restu OB00036 Bis oprolol 5mg (OGB) 7.00 Tablet 5,197.50 36,882.50
R2019-0000072203 10-12-2019 201900069235/021961 AGUS PITRIANI,NY Restu OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000072203 10-12-2019 201900069235/021961 AGUS PITRIANI,NY Restu OA00140 Atorvastatin 20mg (OGB) 7.00 Tablet 6,534.00 46,238.00
R2019-0000072203 10-12-2019 201900069235/021961 AGUS PITRIANI,NY Restu OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000072203 10-12-2019 201900069235/021961 AGUS PITRIANI,NY Restu OG00057 Gabapentin 300mg (OGB) 7.00 Tablet 8,168.00 57,676.00
R2019-0000072203 10-12-2019 201900069235/021961 AGUS PITRIANI,NY Restu OD00065 Domperidon Tablet (OGB) 14.00 Tablet 750.00 11,000.00
R2019-0000072204 10-12-2019 201900069235/021961 AGUS PITRIANI,NY Restu OL00021 Lansoprazole (OGB) 23.00 Capsul 2,230.00 51,790.00
R2019-0000072204 10-12-2019 201900069235/021961 AGUS PITRIANI,NY Restu OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000072204 10-12-2019 201900069235/021961 AGUS PITRIANI,NY Restu OB00036 Bis oprolol 5mg (OGB) 23.00 Tablet 5,197.50 120,042.50
R2019-0000072204 10-12-2019 201900069235/021961 AGUS PITRIANI,NY Restu OC00092 Clopidogrel 75mg (OGB) 23.00 Tablet 14,701.50 338,634.50
R2019-0000072204 10-12-2019 201900069235/021961 AGUS PITRIANI,NY Restu OA00140 Atorvastatin 20mg (OGB) 23.00 Tablet 6,534.00 150,782.00
R2019-0000072204 10-12-2019 201900069235/021961 AGUS PITRIANI,NY Restu OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2019-0000072204 10-12-2019 201900069235/021961 AGUS PITRIANI,NY Restu OG00057 Gabapentin 300mg (OGB) 23.00 Tablet 8,168.00 188,364.00
R2019-0000072205 10-12-2019 201900069075/077128 ALIMAN,TN Restu OD00047 Diamicron MR 60mg 7.00 Tablet 8,420.00 59,440.00
R2019-0000072205 10-12-2019 201900069075/077128 ALIMAN,TN Restu OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000072205 10-12-2019 201900069075/077128 ALIMAN,TN Restu OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
Total 123,916,382.25
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 89 dari 266
ASAL RAWAT JALAN
R2019-0000072205 10-12-2019 201900069075/077128 ALIMAN,TN Restu OF00095 Furosemide 40mg (OGB) 7.00 Tablet 315.26 2,706.82
R2019-0000072206 10-12-2019 201900069075/077128 ALIMAN,TN Restu OD00047 Diamicron MR 60mg 23.00 Tablet 8,420.00 194,160.00
R2019-0000072206 10-12-2019 201900069075/077128 ALIMAN,TN Restu OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2019-0000072206 10-12-2019 201900069075/077128 ALIMAN,TN Restu OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000072206 10-12-2019 201900069075/077128 ALIMAN,TN Restu OF00095 Furosemide 40mg (OGB) 23.00 Tablet 315.26 7,750.98
R2019-0000072207 10-12-2019 201900069203/086275 JONATHAN Restu OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000072207 10-12-2019 201900069203/086275 JONATHAN Restu OA00140 Atorvastatin 20mg (OGB) 3.00 Tablet 6,534.00 20,102.00
R2019-0000072207 10-12-2019 201900069203/086275 JONATHAN Restu OP00200 Pioglitazon 30 Mg 7.00 Tab 7,425.00 52,475.00
R2019-0000072207 10-12-2019 201900069203/086275 JONATHAN Restu ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000072208 10-12-2019 201900069203/086275 JONATHAN Restu OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2019-0000072208 10-12-2019 201900069203/086275 JONATHAN Restu OA00140 Atorvastatin 20mg (OGB) 12.00 Tablet 6,534.00 78,908.00
R2019-0000072208 10-12-2019 201900069203/086275 JONATHAN Restu OP00200 Pioglitazon 30 Mg 23.00 Tab 7,425.00 171,275.00
R2019-0000072208 10-12-2019 201900069203/086275 JONATHAN Restu OL00056 Levemir Insulin 1.00 Flexpen 287,330.88 287,830.88
R2019-0000072209 10-12-2019 201900069285/111813 RACHELIA HALIM,AN ADE RAHMAH OB00058 Bufect Suspensi, 60ml 1.00 Botol 21,681.00 22,181.00
R2019-0000072210 10-12-2019 201900069173/108016 HARRY FUJI R,TN Restu ALN00005 Needle Novo Twist 32G 1.00 Pcs 3,690.23 4,190.23
R2019-0000072210 10-12-2019 201900069173/108016 HARRY FUJI R,TN Restu OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000072210 10-12-2019 201900069173/108016 HARRY FUJI R,TN Restu OD00047 Diamicron MR 60mg 7.00 Tablet 8,420.00 59,440.00
R2019-0000072210 10-12-2019 201900069173/108016 HARRY FUJI R,TN Restu OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000072210 10-12-2019 201900069173/108016 HARRY FUJI R,TN Restu OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072210 10-12-2019 201900069173/108016 HARRY FUJI R,TN Restu OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000072210 10-12-2019 201900069173/108016 HARRY FUJI R,TN Restu OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000072210 10-12-2019 201900069173/108016 HARRY FUJI R,TN Restu OC00039 Cefixime 100mg (OGB) 20.00 Capsul 4,266.70 85,834.00
R2019-0000072210 10-12-2019 201900069173/108016 HARRY FUJI R,TN Restu OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000072211 10-12-2019 201900069173/108016 HARRY FUJI R,TN Restu OL00056 Levemir Insulin 2.00 Flexpen 287,330.88 575,161.76
R2019-0000072211 10-12-2019 201900069173/108016 HARRY FUJI R,TN Restu OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2019-0000072211 10-12-2019 201900069173/108016 HARRY FUJI R,TN Restu OD00047 Diamicron MR 60mg 23.00 Tablet 8,420.00 194,160.00
R2019-0000072211 10-12-2019 201900069173/108016 HARRY FUJI R,TN Restu OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000072211 10-12-2019 201900069173/108016 HARRY FUJI R,TN Restu OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000072211 10-12-2019 201900069173/108016 HARRY FUJI R,TN Restu OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000072211 10-12-2019 201900069173/108016 HARRY FUJI R,TN Restu OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000072212 10-12-2019 201900069204/091573 MERRY JONATHAN,NY Restu OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072212 10-12-2019 201900069204/091573 MERRY JONATHAN,NY Restu OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072212 10-12-2019 201900069204/091573 MERRY JONATHAN,NY Restu OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000072213 10-12-2019 201900069204/091573 MERRY JONATHAN,NY Restu OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000072213 10-12-2019 201900069204/091573 MERRY JONATHAN,NY Restu OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000072213 10-12-2019 201900069204/091573 MERRY JONATHAN,NY Restu OH00025 Hydrochlortiazide (OGB) 23.00 Tablet 240.30 6,026.90
R2019-0000072214 10-12-2019 201900069210/089476 TUMINI,NY LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 7.00 Tablet 206.41 1,944.87
R2019-0000072214 10-12-2019 201900069210/089476 TUMINI,NY LUSY E. Dr.Sp.PD OT00148 Tablet Tambah Darah 7.00 Tablet 742.00 5,694.00
Total 126,849,950.04
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 90 dari 266
ASAL RAWAT JALAN
R2019-0000072214 10-12-2019 201900069210/089476 TUMINI,NY LUSY E. Dr.Sp.PD OG00025 Gliquidone 30mg (OGB) 14.00 Tablet 1,967.44 28,044.16
R2019-0000072214 10-12-2019 201900069210/089476 TUMINI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072214 10-12-2019 201900069210/089476 TUMINI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072215 10-12-2019 201900069193/111488 RUSNADI,TN LUSY E. Dr.Sp.PD OU00028 Ursodeoxycholic Acid 30.00 Tablet 9,147.60 274,928.00
R2019-0000072215 10-12-2019 201900069193/111488 RUSNADI,TN LUSY E. Dr.Sp.PD OB00050 Braxidin 10.00 Tablet 1,648.35 16,983.50
R2019-0000072215 10-12-2019 201900069193/111488 RUSNADI,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072216 10-12-2019 201900069183/092361 ABDUL HALIQ,TN LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 7.00 Tablet 3,164.00 22,648.00
R2019-0000072216 10-12-2019 201900069183/092361 ABDUL HALIQ,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000072216 10-12-2019 201900069183/092361 ABDUL HALIQ,TN LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000072216 10-12-2019 201900069183/092361 ABDUL HALIQ,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000072216 10-12-2019 201900069183/092361 ABDUL HALIQ,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072217 10-12-2019 201900069183/092361 ABDUL HALIQ,TN LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 23.00 Tablet 3,164.00 73,272.00
R2019-0000072217 10-12-2019 201900069183/092361 ABDUL HALIQ,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2019-0000072217 10-12-2019 201900069183/092361 ABDUL HALIQ,TN LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 23.00 Tablet 240.30 6,026.90
R2019-0000072217 10-12-2019 201900069183/092361 ABDUL HALIQ,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000072217 10-12-2019 201900069183/092361 ABDUL HALIQ,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000072218 10-12-2019 201900069179/093772 SETYANING LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072218 10-12-2019 201900069179/093772 SETYANING LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072218 10-12-2019 201900069179/093772 SETYANING LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000072218 10-12-2019 201900069179/093772 SETYANING LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072219 10-12-2019 201900069195/111569 MARDIANSYAH,SDR LUSY E. Dr.Sp.PD OU00022 Urotractin 400mg Tablet 10.00 Tablet 7,189.03 72,390.30
R2019-0000072219 10-12-2019 201900069195/111569 MARDIANSYAH,SDR LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000072220 10-12-2019 201900069165/098190 SUMANI,TN LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 7.00 Capsul 4,266.70 30,366.90
R2019-0000072220 10-12-2019 201900069165/098190 SUMANI,TN LUSY E. Dr.Sp.PD OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000072220 10-12-2019 201900069165/098190 SUMANI,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000072220 10-12-2019 201900069165/098190 SUMANI,TN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072220 10-12-2019 201900069165/098190 SUMANI,TN LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 7.00 Tablet 315.26 2,706.82
R2019-0000072221 10-12-2019 201900069165/098190 SUMANI,TN LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 23.00 Tablet 315.26 7,750.98
R2019-0000072222 10-12-2019 201900069189/111802 JUARSIH KARMITA,NY LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 7.00 Tablet 206.41 1,944.87
R2019-0000072222 10-12-2019 201900069189/111802 JUARSIH KARMITA,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000072223 10-12-2019 201900069146/110554 WA AKI,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000072223 10-12-2019 201900069146/110554 WA AKI,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 3.00 Tablet 315.26 1,445.78
R2019-0000072223 10-12-2019 201900069146/110554 WA AKI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 7.00 Tablet 5,197.50 36,882.50
R2019-0000072223 10-12-2019 201900069146/110554 WA AKI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072223 10-12-2019 201900069146/110554 WA AKI,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000072224 10-12-2019 201900069144/015117 DARMIYATI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072224 10-12-2019 201900069144/015117 DARMIYATI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
Total 128,291,720.10
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 91 dari 266
ASAL RAWAT JALAN
R2019-0000072224 10-12-2019 201900069144/015117 DARMIYATI,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000072224 10-12-2019 201900069144/015117 DARMIYATI,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072225 10-12-2019 201900069191/111548 SUMI,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000072226 10-12-2019 201900069159/064269 NASIYAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072226 10-12-2019 201900069159/064269 NASIYAH,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072226 10-12-2019 201900069159/064269 NASIYAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000072226 10-12-2019 201900069159/064269 NASIYAH,NY LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000072227 10-12-2019 201900069159/064269 NASIYAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000072227 10-12-2019 201900069159/064269 NASIYAH,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000072227 10-12-2019 201900069159/064269 NASIYAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000072227 10-12-2019 201900069159/064269 NASIYAH,NY LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000072228 10-12-2019 201900069134/093550 AGUS YUNARKO,TN LUSY E. Dr.Sp.PD OC00091 Clonidin 0.15mg (OGB) 14.00 Tablet 359.37 5,531.18
R2019-0000072228 10-12-2019 201900069134/093550 AGUS YUNARKO,TN LUSY E. Dr.Sp.PD OG00025 Gliquidone 30mg (OGB) 3.00 Tablet 1,967.44 6,402.32
R2019-0000072228 10-12-2019 201900069134/093550 AGUS YUNARKO,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072228 10-12-2019 201900069134/093550 AGUS YUNARKO,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072228 10-12-2019 201900069134/093550 AGUS YUNARKO,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000072228 10-12-2019 201900069134/093550 AGUS YUNARKO,TN LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000072232 10-12-2019 201900069192/110811 DESY RARA Ismail dr. Msc. OL00080 Loratadin 10mg (OGB) 30.00 Tablet 520.00 16,100.00
R2019-0000072229 10-12-2019 201900069134/093550 AGUS YUNARKO,TN LUSY E. Dr.Sp.PD OC00091 Clonidin 0.15mg (OGB) 46.00 Tablet 359.37 17,031.02
R2019-0000072229 10-12-2019 201900069134/093550 AGUS YUNARKO,TN LUSY E. Dr.Sp.PD OG00025 Gliquidone 30mg (OGB) 12.00 Tablet 1,967.44 24,109.28
R2019-0000072229 10-12-2019 201900069134/093550 AGUS YUNARKO,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000072229 10-12-2019 201900069134/093550 AGUS YUNARKO,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000072229 10-12-2019 201900069134/093550 AGUS YUNARKO,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000072229 10-12-2019 201900069134/093550 AGUS YUNARKO,TN LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 23.00 Tablet 14,701.50 338,634.50
R2019-0000072230 10-12-2019 201900069035/19731 Syahriana, LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072230 10-12-2019 201900069035/19731 Syahriana, LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072230 10-12-2019 201900069035/19731 Syahriana, LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000072230 10-12-2019 201900069035/19731 Syahriana, LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072234 10-12-2019 201900069120/028092 VIKY NUR AINI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000072234 10-12-2019 201900069120/028092 VIKY NUR AINI,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072234 10-12-2019 201900069120/028092 VIKY NUR AINI,NY LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 7.00 Tablet 811.18 6,178.26
R2019-0000072235 10-12-2019 201900069120/028092 VIKY NUR AINI,NY LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 23.00 Tablet 811.18 19,157.14
R2019-0000072236 10-12-2019 201900069066/086416 YOHANIS RAGA,TN LUSY E. Dr.Sp.PD OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000072236 10-12-2019 201900069066/086416 YOHANIS RAGA,TN LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 5.00 Tablet 2,079.00 10,895.00
R2019-0000072236 10-12-2019 201900069066/086416 YOHANIS RAGA,TN LUSY E. Dr.Sp.PD OM00045 Methyl Prednisolon 4mg 6.00 Tablet 792.99 5,257.94
R2019-0000072236 10-12-2019 201900069066/086416 YOHANIS RAGA,TN LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 7.00 Tablet 206.41 1,944.87
R2019-0000072236 10-12-2019 201900069066/086416 YOHANIS RAGA,TN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000072237 10-12-2019 201900069066/086416 YOHANIS RAGA,TN LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 23.00 Tablet 206.41 5,247.43
Total 129,814,745.59
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 92 dari 266
ASAL RAWAT JALAN
R2019-0000072237 10-12-2019 201900069066/086416 YOHANIS RAGA,TN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000072238 10-12-2019 201900069132/081410 URWAH,AN FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000072238 10-12-2019 201900069132/081410 URWAH,AN FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000072238 10-12-2019 201900069132/081410 URWAH,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000072238 10-12-2019 201900069132/081410 URWAH,AN FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
R2019-0000072238 10-12-2019 201900069132/081410 URWAH,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000072238 10-12-2019 201900069132/081410 URWAH,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 20.00 Sachet 207.90 11,658.00
R2019-0000072239 10-12-2019 201900069130/058002 KHAULAH,AN FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000072239 10-12-2019 201900069130/058002 KHAULAH,AN FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000072239 10-12-2019 201900069130/058002 KHAULAH,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 5.00 Tablet 1,173.15 6,365.75
R2019-0000072239 10-12-2019 201900069130/058002 KHAULAH,AN FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000072239 10-12-2019 201900069130/058002 KHAULAH,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 5.00 Granula 297.00 1,985.00
R2019-0000072239 10-12-2019 201900069130/058002 KHAULAH,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 20.00 Sachet 207.90 11,658.00
R2019-0000072240 10-12-2019 201900069131/078273 HAFSHAH,AN FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 5.00 Capsul 4,266.70 21,833.50
R2019-0000072240 10-12-2019 201900069131/078273 HAFSHAH,AN FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000072240 10-12-2019 201900069131/078273 HAFSHAH,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000072240 10-12-2019 201900069131/078273 HAFSHAH,AN FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
R2019-0000072240 10-12-2019 201900069131/078273 HAFSHAH,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000072240 10-12-2019 201900069131/078273 HAFSHAH,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 20.00 Sachet 207.90 11,658.00
R2019-0000072241 10-12-2019 201900069168/098639 NAVISHA ZAHRA Ismail dr. Msc. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000072241 10-12-2019 201900069168/098639 NAVISHA ZAHRA Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000072241 10-12-2019 201900069168/098639 NAVISHA ZAHRA Ismail dr. Msc. OG00066 Genoint Salep Kulit 2.00 Tube 7,350.75 15,201.50
R2019-0000072241 10-12-2019 201900069168/098639 NAVISHA ZAHRA Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000072242 10-12-2019 201900069205/041239 HAPPY MUHAMAD Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 15.00 Tablet 965.25 14,978.75
R2019-0000072242 10-12-2019 201900069205/041239 HAPPY MUHAMAD Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 15.00 Tablet 623.70 9,855.50
R2019-0000072242 10-12-2019 201900069205/041239 HAPPY MUHAMAD Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000072242 10-12-2019 201900069205/041239 HAPPY MUHAMAD Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000072242 10-12-2019 201900069205/041239 HAPPY MUHAMAD Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000072247 10-12-2019 201900069157/086935 LISTIA Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000072247 10-12-2019 201900069157/086935 LISTIA Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000072247 10-12-2019 201900069157/086935 LISTIA Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000072247 10-12-2019 201900069157/086935 LISTIA Ismail dr. Msc. OG00066 Genoint Salep Kulit 2.00 Tube 7,350.75 15,201.50
R2019-0000072247 10-12-2019 201900069157/086935 LISTIA Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000072253 10-12-2019 201900069289/022452 ADIKA AUFA ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000072253 10-12-2019 201900069289/022452 ADIKA AUFA ADE RAHMAH OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000072249 10-12-2019 201900069291/110839 SAFARAZ AZRI ADE RAHMAH OB00058 Bufect Suspensi, 60ml 1.00 Botol 21,681.00 22,181.00
R2019-0000072249 10-12-2019 201900069291/110839 SAFARAZ AZRI ADE RAHMAH OI00117 Imunos Plus Syrup, 60ml 1.00 Botol 136,620.00 137,120.00
R2019-0000072250 10-12-2019 201900069287/111724 MUHAMMAD IHSAN ADE RAHMAH OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
Total 130,379,345.50
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 93 dari 266
ASAL RAWAT JALAN
R2019-0000072250 10-12-2019 201900069287/111724 MUHAMMAD IHSAN ADE RAHMAH OC00132 CTM 4mg 3.00 Tablet 157.41 972.23
R2019-0000072250 10-12-2019 201900069287/111724 MUHAMMAD IHSAN ADE RAHMAH OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000072250 10-12-2019 201900069287/111724 MUHAMMAD IHSAN ADE RAHMAH OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000072250 10-12-2019 201900069287/111724 MUHAMMAD IHSAN ADE RAHMAH OS00010 Salbutamol 4mg (OGB) 2.00 Tablet 249.48 998.96
R2019-0000072250 10-12-2019 201900069287/111724 MUHAMMAD IHSAN ADE RAHMAH OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000072250 10-12-2019 201900069287/111724 MUHAMMAD IHSAN ADE RAHMAH ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000072255 10-12-2019 201900069263/111810 ERNAWATI,NY ADE RAHMAH OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 Botol 22,542.30 23,042.30
R2019-0000072255 10-12-2019 201900069263/111810 ERNAWATI,NY ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000072257 10-12-2019 201900069289/022452 ADIKA AUFA ADE RAHMAH OA00087 Antiza Syrup, 60ml 1.00 Botol 26,730.00 27,230.00
R2019-0000072257 10-12-2019 201900069289/022452 ADIKA AUFA ADE RAHMAH OB00091 Biovitan Syrup, 60ml 1.00 Botol 8,019.00 8,519.00
R2019-0000072257 10-12-2019 201900069289/022452 ADIKA AUFA ADE RAHMAH OC00038 Cefila Dry Syrup 1.00 Botol 123,255.00 123,755.00
R2019-0000072258 10-12-2019 201900069307/111814 MALINDA HIKMAH,NN ADE RAHMAH OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000072258 10-12-2019 201900069307/111814 MALINDA HIKMAH,NN ADE RAHMAH ALB00132 Blood Set 1.00 Pcs 33,976.80 34,476.80
R2019-0000072258 10-12-2019 201900069307/111814 MALINDA HIKMAH,NN ADE RAHMAH ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000072260 10-12-2019 201900069286/063468 MARLIYANTI,NY ADE RAHMAH OE00056 Ecosol Nacl 0,9 % 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000072261 10-12-2019 201900069287/111724 MUHAMMAD IHSAN ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000072261 10-12-2019 201900069287/111724 MUHAMMAD IHSAN ADE RAHMAH OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000072263 10-12-2019 201900069292/054005 CHAVIVA NONI ADE RAHMAH OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000072263 10-12-2019 201900069292/054005 CHAVIVA NONI ADE RAHMAH OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000072263 10-12-2019 201900069292/054005 CHAVIVA NONI ADE RAHMAH OP00184 Neo Protifed Tablet 3.00 Tablet 1,263.73 4,291.19
R2019-0000072262 09-12-2019 201900068822/104756 AGUS DJUMARTI,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000072262 09-12-2019 201900068822/104756 AGUS DJUMARTI,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072264 09-12-2019 201900068803/079481 ERIKA CHAMSIATI ROY , Dr.Sp.OG OF00090 Fucilex Cream, 5gr 1.00 Tube 14,850.00 15,350.00
R2019-0000072265 09-12-2019 201900068832/093386 SHERLY Nafon Zaitun, Dr. OC00085 Clindamycin 150mg 10.00 Tablet 981.59 10,315.90
R2019-0000072265 09-12-2019 201900068832/093386 SHERLY Nafon Zaitun, Dr. OZ00005 Zinc Tablet (OGB) 10.00 Tablet 1,000.00 10,500.00
R2019-0000072266 09-12-2019 201900068801/19616 HENNY,NY TEDDY OC00290 Cendo LFX ED 5ml 1.00 Botol 102,836.25 103,336.25
R2019-0000072266 09-12-2019 201900068801/19616 HENNY,NY TEDDY OC00274 Cendo Noncort Minidose 1.00 Strip 62,741.00 63,241.00
R2019-0000072267 09-12-2019 201900069161/110796 SURIANTO,TN TEDDY OL00115 Cendo LFX Minidose 0,6 1.00 Strip 102,465.00 102,965.00
R2019-0000072267 09-12-2019 201900069161/110796 SURIANTO,TN TEDDY OC00274 Cendo Noncort Minidose 1.00 Strip 62,741.00 63,241.00
R2019-0000072268 09-12-2019 201900068846/111761 SUNARDI,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072269 09-12-2019 201900068738/107410 ELISABETH NOOR,NY LUSY E. Dr.Sp.PD OA00074 Analsik 10.00 Tablet 2,264.63 23,146.30
R2019-0000072269 09-12-2019 201900068738/107410 ELISABETH NOOR,NY LUSY E. Dr.Sp.PD OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000072271 09-12-2019 201900068860/081363 CAESAR FAUDZAN FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000072271 09-12-2019 201900068860/081363 CAESAR FAUDZAN FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000072271 09-12-2019 201900068860/081363 CAESAR FAUDZAN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000072271 09-12-2019 201900068860/081363 CAESAR FAUDZAN FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000072271 09-12-2019 201900068860/081363 CAESAR FAUDZAN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000072271 09-12-2019 201900068860/081363 CAESAR FAUDZAN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
Total 131,318,663.98
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 94 dari 266
ASAL RAWAT JALAN
R2019-0000072270 10-12-2019 201900068861/081997 KESYA DAYANA FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 5.00 Capsul 4,266.70 21,833.50
R2019-0000072270 10-12-2019 201900068861/081997 KESYA DAYANA FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000072270 10-12-2019 201900068861/081997 KESYA DAYANA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000072270 10-12-2019 201900068861/081997 KESYA DAYANA FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
R2019-0000072270 10-12-2019 201900068861/081997 KESYA DAYANA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000072270 10-12-2019 201900068861/081997 KESYA DAYANA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000072272 09-12-2019 201900068850/096753 NGATINI,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000072272 09-12-2019 201900068850/096753 NGATINI,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072273 09-12-2019 201900068876/044330 IQBAL AL FARIZI,AN FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000072273 09-12-2019 201900068876/044330 IQBAL AL FARIZI,AN FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000072273 09-12-2019 201900068876/044330 IQBAL AL FARIZI,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 5.00 Tablet 1,173.15 6,365.75
R2019-0000072273 09-12-2019 201900068876/044330 IQBAL AL FARIZI,AN FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000072273 09-12-2019 201900068876/044330 IQBAL AL FARIZI,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 5.00 Granula 297.00 1,985.00
R2019-0000072273 09-12-2019 201900068876/044330 IQBAL AL FARIZI,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000072274 09-12-2019 201900068826/111758 DAWIYAH,NY LUSY E. Dr.Sp.PD OB001002 Betahistine 15.00 Tab 5,940.00 89,600.00
R2019-0000072275 09-12-2019 201900068759/107268 NI KOMANG LUSY E. Dr.Sp.PD OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000072275 09-12-2019 201900068759/107268 NI KOMANG LUSY E. Dr.Sp.PD OV00080 Vitamin B Compleks 10.00 Tablet 241.79 2,917.90
R2019-0000072276 09-12-2019 201900068890/097594 SITI JUMAIYAH,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 36,140.00 36,640.00
R2019-0000072276 09-12-2019 201900068890/097594 SITI JUMAIYAH,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072278 09-12-2019 201900068848/049474 NINING SUNARSIH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072278 09-12-2019 201900068848/049474 NINING SUNARSIH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072278 09-12-2019 201900068848/049474 NINING SUNARSIH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000072278 09-12-2019 201900068848/049474 NINING SUNARSIH,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072279 09-12-2019 201900068854/111652 DEDY AZWARI,TN LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000072279 09-12-2019 201900068854/111652 DEDY AZWARI,TN LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000072281 09-12-2019 201900068831/040367 LASMARI,TN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 10.00 Tablet 1,555.00 16,050.00
R2019-0000072281 09-12-2019 201900068831/040367 LASMARI,TN LUSY E. Dr.Sp.PD OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000072291 10-12-2019 201900069062/111619 TARMIJI,TN Maulin Nikmah OG00057 Gabapentin 300mg (OGB) 6.00 Tablet 8,168.00 49,508.00
R2019-0000072306 10-12-2019 201900069054/090924 SUMIATI,NY Herika dr. OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000072306 10-12-2019 201900069054/090924 SUMIATI,NY Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000072307 10-12-2019 201900069180/105529 ARKA REYSAN Herika dr. OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000072308 10-12-2019 201900069162/111801 RISKY MELLYIADI,AN Herika dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000072285 10-12-2019 201900069055/111782 DIAN WULANDARI,NN Herika dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000072309 10-12-2019 201900068725/019334 MARIZKA HARDINI,AN ADE RAHMAH OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000072309 10-12-2019 201900068725/019334 MARIZKA HARDINI,AN ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000072309 10-12-2019 201900068725/019334 MARIZKA HARDINI,AN ADE RAHMAH ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000072309 10-12-2019 201900068725/019334 MARIZKA HARDINI,AN ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000072309 10-12-2019 201900068725/019334 MARIZKA HARDINI,AN ADE RAHMAH OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
Total 132,283,469.78
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 95 dari 266
ASAL RAWAT JALAN
R2019-0000072311 10-12-2019 201900069057/071439 WA OPO,NY Herika dr. OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000072311 10-12-2019 201900069057/071439 WA OPO,NY Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000072310 10-12-2019 201900069085/111786 CARO LINE ORLEE Herika dr. OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000072310 10-12-2019 201900069085/111786 CARO LINE ORLEE Herika dr. OB00091 Biovitan Syrup, 60ml 1.00 Botol 8,019.00 8,519.00
R2019-0000072312 10-12-2019 201900069141/090509 MEIVA CHELSEA Herika dr. OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000072312 10-12-2019 201900069141/090509 MEIVA CHELSEA Herika dr. OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000072312 10-12-2019 201900069141/090509 MEIVA CHELSEA Herika dr. OO00040 Oralit 200 8.00 Sachet 706.00 6,148.00
R2019-0000072314 10-12-2019 201900069181/105581 AZKA Herika dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000072314 10-12-2019 201900069181/105581 AZKA Herika dr. OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
R2019-0000072314 10-12-2019 201900069181/105581 AZKA Herika dr. OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000072315 11-12-2019 201900069304/19776 ANDY MULYONO,TN Niki Juniar OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000072315 11-12-2019 201900069304/19776 ANDY MULYONO,TN Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000072317 10-12-2019 201900069162/111801 RISKY MELLYIADI,AN Herika dr. OS00027 Sanmag Tablet 5.00 Tablet 1,321.65 7,108.25
R2019-0000072317 10-12-2019 201900069162/111801 RISKY MELLYIADI,AN Herika dr. OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000072318 10-12-2019 201900069180/105529 ARKA REYSAN Herika dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000072318 10-12-2019 201900069180/105529 ARKA REYSAN Herika dr. OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000072318 10-12-2019 201900069180/105529 ARKA REYSAN Herika dr. OC00132 CTM 4mg 1.00 Tablet 157.41 657.41
R2019-0000072318 10-12-2019 201900069180/105529 ARKA REYSAN Herika dr. OB00091 Biovitan Syrup, 60ml 1.00 Botol 8,019.00 8,519.00
R2019-0000072319 10-12-2019 201900069122/017867 WAHIDA,NY MAGDA ROSSA, OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072319 10-12-2019 201900069122/017867 WAHIDA,NY MAGDA ROSSA, OD00030 Dexamethasone Injeksi 5.00 Ampul 4,502.52 23,012.60
R2019-0000072320 10-12-2019 201900069112/111754 NURDIN B,TN Eviwati OM00154 Mecobalamin 500mg 21.00 Tablet 1,118.00 23,978.00
R2019-0000072321 10-12-2019 201900069164/111656 FADLI ALRDINATA,AN FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000072321 10-12-2019 201900069164/111656 FADLI ALRDINATA,AN FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000072321 10-12-2019 201900069164/111656 FADLI ALRDINATA,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000072321 10-12-2019 201900069164/111656 FADLI ALRDINATA,AN FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
R2019-0000072321 10-12-2019 201900069164/111656 FADLI ALRDINATA,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000072321 10-12-2019 201900069164/111656 FADLI ALRDINATA,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000072321 10-12-2019 201900069164/111656 FADLI ALRDINATA,AN FREDRIK, Dr,Sp.A OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000072323 10-12-2019 201900069151/070466 AHMAD ZAINAL FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000072323 10-12-2019 201900069151/070466 AHMAD ZAINAL FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000072323 10-12-2019 201900069151/070466 AHMAD ZAINAL FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000072323 10-12-2019 201900069151/070466 AHMAD ZAINAL FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000072323 10-12-2019 201900069151/070466 AHMAD ZAINAL FREDRIK, Dr,Sp.A OS00009 Salbutamol 2mg (OGB) 3.00 Tablet 213.30 1,139.90
R2019-0000072323 10-12-2019 201900069151/070466 AHMAD ZAINAL FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000072323 10-12-2019 201900069151/070466 AHMAD ZAINAL FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000072323 10-12-2019 201900069151/070466 AHMAD ZAINAL FREDRIK, Dr,Sp.A OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000072323 10-12-2019 201900069151/070466 AHMAD ZAINAL FREDRIK, Dr,Sp.A OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000072322 10-12-2019 201900069150/110548 MAHIRAQIL TEDDY OC00276 Cendo Eyefresh Minidose 1.00 Strip 34,341.00 34,841.00
Total 132,795,871.16
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 96 dari 266
ASAL RAWAT JALAN
R2019-0000072326 10-12-2019 201900069160/110796 SURIANTO,TN TEDDY OC00274 Cendo Noncort Minidose 1.00 Strip 62,741.00 63,241.00
R2019-0000072326 10-12-2019 201900069160/110796 SURIANTO,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072324 10-12-2019 201900069152/111657 MUHAMMAD NUR FREDRIK, Dr,Sp.A OL00001 L - BIO Sachet 6.00 Sachet 10,395.00 62,870.00
R2019-0000072328 10-12-2019 201900069129/111793 RIO DWIYANTO,SDR TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072327 10-12-2019 201900069073/033580 DEDY MULYADI,SDR Dameria Sri OK00002 Kalium Diklofenac 50mg 20.00 Tablet 1,100.00 22,500.00
R2019-0000072327 10-12-2019 201900069073/033580 DEDY MULYADI,SDR Dameria Sri OE00057 Eperisone Hcl 50mg 20.00 Tablet 2,286.90 46,238.00
R2019-0000072327 10-12-2019 201900069073/033580 DEDY MULYADI,SDR Dameria Sri OA00062 Amitriptyline Tablet, 4.00 Tablet 252.45 1,509.80
R2019-0000072327 10-12-2019 201900069073/033580 DEDY MULYADI,SDR Dameria Sri OF00007 Farbion Tablet 8.00 Tablet 1,782.00 14,756.00
R2019-0000072327 10-12-2019 201900069073/033580 DEDY MULYADI,SDR Dameria Sri ALK00037 Kapsul No.1 8.00 pcs 200.00 9,100.00
R2019-0000072330 09-12-2019 201900068859/50922 MULIANA Z ABIDIN,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000072330 09-12-2019 201900068859/50922 MULIANA Z ABIDIN,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072329 10-12-2019 201900069148/111800 CIKAL NUSANTARA,AN FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000072329 10-12-2019 201900069148/111800 CIKAL NUSANTARA,AN FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000072329 10-12-2019 201900069148/111800 CIKAL NUSANTARA,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000072329 10-12-2019 201900069148/111800 CIKAL NUSANTARA,AN FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000072329 10-12-2019 201900069148/111800 CIKAL NUSANTARA,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000072329 10-12-2019 201900069148/111800 CIKAL NUSANTARA,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000072331 10-12-2019 201900069137/111795 FIONA JOVANI TIAR FREDRIK, Dr,Sp.A OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000072331 10-12-2019 201900069137/111795 FIONA JOVANI TIAR FREDRIK, Dr,Sp.A OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000072332 10-12-2019 201900069124/098722 YASIN ALIKHAN,TN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000072332 10-12-2019 201900069124/098722 YASIN ALIKHAN,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072333 10-12-2019 201900069067/076435 MUHAMMAD AFFAN FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000072333 10-12-2019 201900069067/076435 MUHAMMAD AFFAN FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000072333 10-12-2019 201900069067/076435 MUHAMMAD AFFAN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000072333 10-12-2019 201900069067/076435 MUHAMMAD AFFAN FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
R2019-0000072333 10-12-2019 201900069067/076435 MUHAMMAD AFFAN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000072333 10-12-2019 201900069067/076435 MUHAMMAD AFFAN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000072335 10-12-2019 201900069108/090606 SUKARTI,NY Maulin Nikmah OG00057 Gabapentin 300mg (OGB) 6.00 Tablet 8,168.00 49,508.00
R2019-0000072335 10-12-2019 201900069108/090606 SUKARTI,NY Maulin Nikmah ALK00037 Kapsul No.1 6.00 pcs 200.00 8,700.00
R2019-0000072335 10-12-2019 201900069108/090606 SUKARTI,NY Maulin Nikmah OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000072334 10-12-2019 201900069102/096743 SUWARNI,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000072334 10-12-2019 201900069102/096743 SUWARNI,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072336 10-12-2019 201900069071/061151 SUMARLIANSYAH,TN TEDDY OC00255 Cendo Tobroson Eye Drop 1.00 Botol 68,681.25 69,181.25
R2019-0000072336 10-12-2019 201900069071/061151 SUMARLIANSYAH,TN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000072337 10-12-2019 201900069104/111536 SUKARTI,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072338 10-12-2019 201900069043/101448 DAHLIA RUSNI,NY Dameria Sri OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000072338 10-12-2019 201900069043/101448 DAHLIA RUSNI,NY Dameria Sri OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
Total 133,804,422.02
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 97 dari 266
ASAL RAWAT JALAN
R2019-0000072338 10-12-2019 201900069043/101448 DAHLIA RUSNI,NY Dameria Sri OL00021 Lansoprazole (OGB) 6.00 Capsul 2,230.00 13,880.00
R2019-0000072338 10-12-2019 201900069043/101448 DAHLIA RUSNI,NY Dameria Sri OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000072339 10-12-2019 201900069041/084385 SUDARYANTI,NY Dameria Sri OG00057 Gabapentin 300mg (OGB) 14.00 Tablet 8,168.00 114,852.00
R2019-0000072339 10-12-2019 201900069041/084385 SUDARYANTI,NY Dameria Sri OK00002 Kalium Diklofenac 50mg 14.00 Tablet 1,100.00 15,900.00
R2019-0000072339 10-12-2019 201900069041/084385 SUDARYANTI,NY Dameria Sri OM00154 Mecobalamin 500mg 14.00 Tablet 1,118.00 16,152.00
R2019-0000072340 10-12-2019 201900069033/076373 MUKMINAH,NY Dameria Sri OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000072342 10-12-2019 201900069030/093710 HENDRICK C Dameria Sri OP00199 Pletaal 100mg 7.00 Capsul 19,961.00 140,227.00
R2019-0000072342 10-12-2019 201900069030/093710 HENDRICK C Dameria Sri OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000072342 10-12-2019 201900069030/093710 HENDRICK C Dameria Sri OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000072342 10-12-2019 201900069030/093710 HENDRICK C Dameria Sri OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000072342 10-12-2019 201900069030/093710 HENDRICK C Dameria Sri OA00043 Alprazolam 0,5mg (OGB) 8.00 Tablet 996.50 8,472.00
R2019-0000072342 10-12-2019 201900069030/093710 HENDRICK C Dameria Sri OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000072345 10-12-2019 201900069116/109834 PATMAWATI,NY Nafon Zaitun, Dr. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000072345 10-12-2019 201900069116/109834 PATMAWATI,NY Nafon Zaitun, Dr. OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072345 10-12-2019 201900069116/109834 PATMAWATI,NY Nafon Zaitun, Dr. OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000072347 10-12-2019 201900069089/065394 ISTIHIAL,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000072347 10-12-2019 201900069089/065394 ISTIHIAL,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072349 10-12-2019 201900069065/099830 ARWANA,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000072349 10-12-2019 201900069065/099830 ARWANA,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072350 11-12-2019 201900069304/19776 ANDY MULYONO,TN Niki Juniar OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000072348 10-12-2019 201900069093/088663 ANDRA IRVANI MAGDA ROSSA, OC00034 Cefadroxil 500mg (OGB) 12.00 Capsul 1,633.50 20,102.00
R2019-0000072348 10-12-2019 201900069093/088663 ANDRA IRVANI MAGDA ROSSA, OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072351 10-12-2019 201900069096/066525 RENAWATY Maulin Nikmah OG00057 Gabapentin 300mg (OGB) 7.00 Tablet 8,168.00 57,676.00
R2019-0000072351 10-12-2019 201900069096/066525 RENAWATY Maulin Nikmah ALK00037 Kapsul No.1 8.00 pcs 200.00 9,100.00
R2019-0000072352 10-12-2019 201900069086/083562 FAISAL REZA,TN TEDDY OC00284 Cendo Oculenta ED 1.00 Botol 122,445.00 122,945.00
R2019-0000072353 10-12-2019 201900069047/093151 ASLIANI,NY Dameria Sri OG00057 Gabapentin 300mg (OGB) 8.00 Tablet 8,168.00 65,844.00
R2019-0000072353 10-12-2019 201900069047/093151 ASLIANI,NY Dameria Sri OA00062 Amitriptyline Tablet, 2.00 Tablet 252.45 1,004.90
R2019-0000072353 10-12-2019 201900069047/093151 ASLIANI,NY Dameria Sri OF00007 Farbion Tablet 8.00 Tablet 1,782.00 14,756.00
R2019-0000072353 10-12-2019 201900069047/093151 ASLIANI,NY Dameria Sri ALK00037 Kapsul No.1 8.00 pcs 200.00 9,100.00
Total 135,031,513.15
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 98 dari 266
ASAL RAWAT JALAN
R2019-0000072355 10-12-2019 201900069125/111791 EVI ADRIANY,NY TEDDY OC00279 Cendo As thenof ED 5ml 1.00 Botol 31,185.00 31,685.00
R2019-0000072355 10-12-2019 201900069125/111791 EVI ADRIANY,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072358 10-12-2019 201900069313/107355 RINA ANRIATI,NY ROY , Dr.Sp.OG OF00090 Fucilex Cream, 5gr 1.00 Tube 14,850.00 15,350.00
R2019-0000072368 11-12-2019 201900069349/050261 QALITA ZIHAN SEPTIA NOVITA OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000072368 11-12-2019 201900069349/050261 QALITA ZIHAN SEPTIA NOVITA OE00017 Epexol Syrup 1.00 Botol 25,690.50 26,190.50
R2019-0000072368 11-12-2019 201900069349/050261 QALITA ZIHAN SEPTIA NOVITA OA00016 Acyclovir Cream 5gr 1.00 Tube 4,893.00 5,393.00
R2019-0000072368 11-12-2019 201900069349/050261 QALITA ZIHAN SEPTIA NOVITA OA00135 Acyclovir 200mg (OGB) 20.00 Tablet 955.00 19,600.00
R2019-0000072369 11-12-2019 201900069354/052637 JEFRIYANTO SEPTIA NOVITA OC00144 Cefila Capsul, 100mg 10.00 Capsul 28,957.00 290,070.00
R2019-0000072369 11-12-2019 201900069354/052637 JEFRIYANTO SEPTIA NOVITA OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000072369 11-12-2019 201900069354/052637 JEFRIYANTO SEPTIA NOVITA OI00134 Imunos Plus Tablet 4.00 Tablet 14,107.50 56,930.00
R2019-0000072370 11-12-2019 201900069321/089751 NURALMIAH,NY MAGDA ROSSA, OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072370 11-12-2019 201900069321/089751 NURALMIAH,NY MAGDA ROSSA, OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000072372 11-12-2019 201900069351/098818 NINA FITRASARI,NY Herika dr. OM00154 Mecobalamin 500mg 4.00 Tablet 1,118.00 4,972.00
R2019-0000072372 11-12-2019 201900069351/098818 NINA FITRASARI,NY Herika dr. OT00063 Tramadol 50mg Tablet 6.00 Tablet 1,113.75 7,182.50
R2019-0000072372 11-12-2019 201900069351/098818 NINA FITRASARI,NY Herika dr. OC00172 Candesartan Cilexetil 2.00 Tablet 10,617.75 21,735.50
R2019-0000072371 11-12-2019 201900069327/078704 SUHUFIL ULLA,NY EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000072371 11-12-2019 201900069327/078704 SUHUFIL ULLA,NY EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072371 11-12-2019 201900069327/078704 SUHUFIL ULLA,NY EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000072371 11-12-2019 201900069327/078704 SUHUFIL ULLA,NY EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000072375 11-12-2019 201900069341/111601 AGUNG ANUGRAH,AN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000072375 11-12-2019 201900069341/111601 AGUNG ANUGRAH,AN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072375 11-12-2019 201900069341/111601 AGUNG ANUGRAH,AN EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000072375 11-12-2019 201900069341/111601 AGUNG ANUGRAH,AN EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000072377 11-12-2019 201900069322/111476 JHANIF INDRA EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000072377 11-12-2019 201900069322/111476 JHANIF INDRA EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000072376 11-12-2019 201900069332/088607 MULYONO,TN Herika dr. OB00028 Bioplacenton Cream, 15gr 1.00 Tube 25,245.00 25,745.00
R2019-0000072376 11-12-2019 201900069332/088607 MULYONO,TN Herika dr. OA00106 Asam Mefenamat 500mg 6.00 Tablet 415.80 2,994.80
R2019-0000072376 11-12-2019 201900069332/088607 MULYONO,TN Herika dr. OA00063 Amlodipin 10mg (OGB) 3.00 Tablet 2,743.00 8,729.00
R2019-0000072378 11-12-2019 201900069369/074287 MUHAMMAD LUTFI,TN Herika dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072378 11-12-2019 201900069369/074287 MUHAMMAD LUTFI,TN Herika dr. OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000072378 11-12-2019 201900069369/074287 MUHAMMAD LUTFI,TN Herika dr. OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000072380 11-12-2019 201900069331/39311 IRLIANA ISMAIL,NY Angie Renatha , OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000072382 11-12-2019 201900069345/046305 RUKINI,NY Angie Renatha , OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000072382 11-12-2019 201900069345/046305 RUKINI,NY Angie Renatha , OK00002 Kalium Diklofenac 50mg 10.00 Tablet 1,100.00 11,500.00
R2019-0000072382 11-12-2019 201900069345/046305 RUKINI,NY Angie Renatha , OP00184 Neo Protifed Tablet 15.00 Tablet 1,263.73 19,455.95
R2019-0000072383 11-12-2019 201900069340/101657 SAFANAH RAHADATUL Angie Renatha , OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
Total 135,931,500.26
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 99 dari 266
ASAL RAWAT JALAN
R2019-0000072383 11-12-2019 201900069340/101657 SAFANAH RAHADATUL Angie Renatha , OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000072383 11-12-2019 201900069340/101657 SAFANAH RAHADATUL Angie Renatha , OP00011 Paracetamol 500mg 4.00 Tablet 387.36 2,049.44
R2019-0000072383 11-12-2019 201900069340/101657 SAFANAH RAHADATUL Angie Renatha , ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000072385 11-12-2019 201900069363/100265 SUROTO NARDI,TN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000072385 11-12-2019 201900069363/100265 SUROTO NARDI,TN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072385 11-12-2019 201900069363/100265 SUROTO NARDI,TN EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000072385 11-12-2019 201900069363/100265 SUROTO NARDI,TN EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000072388 11-12-2019 201900069028/074460 INDRAWATI DEWI,NY Dameria Sri OP00199 Pletaal 100mg 30.00 Capsul 19,961.00 599,330.00
R2019-0000072388 11-12-2019 201900069028/074460 INDRAWATI DEWI,NY Dameria Sri OP00011 Paracetamol 500mg 20.00 Tablet 387.36 8,247.20
R2019-0000072388 11-12-2019 201900069028/074460 INDRAWATI DEWI,NY Dameria Sri OV00046 Valis anbe 5mg Tablet 8.00 Tablet 579.15 5,133.20
R2019-0000072388 11-12-2019 201900069028/074460 INDRAWATI DEWI,NY Dameria Sri OC00017 Kapsul No. 00 20.00 Capsul 200.00 11,500.00
R2019-0000072388 11-12-2019 201900069028/074460 INDRAWATI DEWI,NY Dameria Sri OA00043 Alprazolam 0,5mg (OGB) 6.00 Tablet 996.50 6,479.00
R2019-0000072388 11-12-2019 201900069028/074460 INDRAWATI DEWI,NY Dameria Sri OM00158 Mevrabal 500 Mg 10.00 Tablet 2,100.00 21,500.00
R2019-0000072388 11-12-2019 201900069028/074460 INDRAWATI DEWI,NY Dameria Sri OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000072388 11-12-2019 201900069028/074460 INDRAWATI DEWI,NY Dameria Sri OL00021 Lansoprazole (OGB) 6.00 Capsul 2,230.00 13,880.00
R2019-0000072388 11-12-2019 201900069028/074460 INDRAWATI DEWI,NY Dameria Sri OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000072389 11-12-2019 201900069379/111710 RIDWAN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000072389 11-12-2019 201900069379/111710 RIDWAN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072390 11-12-2019 201900069350/073825 DIANAH OKTAFIAH,NY Angie Renatha , OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000072390 11-12-2019 201900069350/073825 DIANAH OKTAFIAH,NY Angie Renatha , OD00031 Dexamethasone Tablet 15.00 Tablet 208.00 3,620.00
R2019-0000072392 11-12-2019 201900069359/111818 ZULFAA BINTANG Angie Renatha , OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000072393 11-12-2019 201900069391/111821 ADIN DWI MAGDA ROSSA, OT00149 Toramine 10 Mg Tablet 10.00 Tablet 8,167.50 82,175.00
R2019-0000072395 11-12-2019 201900069368/087163 MURNIATI,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000072395 11-12-2019 201900069368/087163 MURNIATI,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072397 11-12-2019 201900069401/104328 RAMADHANIA,NY Nafon Zaitun, Dr. OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000072397 11-12-2019 201900069401/104328 RAMADHANIA,NY Nafon Zaitun, Dr. OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000072398 11-12-2019 201900069325/081351 MUHAMMAD HANIF,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072399 11-12-2019 201900069344/111816 SYAHDAN,TN TEDDY OC00255 Cendo Tobroson Eye Drop 1.00 Botol 68,681.25 69,181.25
R2019-0000072401 11-12-2019 201900069371/00013527 INSIAH,NY LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 30.00 Tab 7,150.00 215,000.00
R2019-0000072401 11-12-2019 201900069371/00013527 INSIAH,NY LUSY E. Dr.Sp.PD OA00001 AB - Vask 10mg 30.00 Tablet 14,850.00 446,000.00
R2019-0000072401 11-12-2019 201900069371/00013527 INSIAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 30.00 Tablet 10,617.75 319,032.50
R2019-0000072401 11-12-2019 201900069371/00013527 INSIAH,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 30.00 Tablet 14,701.50 441,545.00
R2019-0000072401 11-12-2019 201900069371/00013527 INSIAH,NY LUSY E. Dr.Sp.PD OA00140 Atorvastatin 20mg (OGB) 15.00 Tablet 6,534.00 98,510.00
R2019-0000072402 11-12-2019 201900069413/111824 NISHA RAZAQ,AN Herika dr. OA00068 Amoxsan Capsul, 500mg 10.00 Capsul 4,752.00 48,020.00
R2019-0000072402 11-12-2019 201900069413/111824 NISHA RAZAQ,AN Herika dr. OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000072403 11-12-2019 201900069413/111824 NISHA RAZAQ,AN Herika dr. OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000072400 11-12-2019 201900069382/111819 ROMI,NY TEDDY OR00029 Retivit Tablet 30.00 Tablet 5,672.70 170,681.00
Total 138,926,595.60
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 100 dari 266
ASAL RAWAT JALAN
R2019-0000072404 11-12-2019 201900069374/00013527 INSIAH,NY TEDDY OC00169 Cendo Lyteers 15ml ED 3.00 Botol 36,140.00 108,920.00
R2019-0000072404 11-12-2019 201900069374/00013527 INSIAH,NY TEDDY OC00283 Cendo Oculenta Eye Oint 3.00 Tube 135,877.50 408,132.50
R2019-0000072396 10-12-2019 201900069023/10274 BECCE,NY Dameria Sri OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000072396 10-12-2019 201900069023/10274 BECCE,NY Dameria Sri OS00173 Simvastatin 20mg (OGB) 23.00 Tablet 1,782.00 41,486.00
R2019-0000072396 10-12-2019 201900069023/10274 BECCE,NY Dameria Sri OT00156 Telmisartan 40 mg 23.00 Tablet 6,534.00 150,782.00
R2019-0000072396 10-12-2019 201900069023/10274 BECCE,NY Dameria Sri OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000072406 10-12-2019 201900069037/057495 NURLINAH,NY Dameria Sri OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000072410 11-12-2019 201900069411/082394 JONAN WERBIN FREDRIK, Dr,Sp.A OI00084 Interhistin Syrup, 60ml 1.00 Botol 54,202.50 54,702.50
R2019-0000072412 11-12-2019 201900069424/091190 KANZIA ARISHA FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 3.00 Capsul 28,957.00 87,371.00
R2019-0000072412 11-12-2019 201900069424/091190 KANZIA ARISHA FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 3.00 Tablet 430.65 1,791.95
R2019-0000072412 11-12-2019 201900069424/091190 KANZIA ARISHA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000072412 11-12-2019 201900069424/091190 KANZIA ARISHA FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 3.00 Tablet 1,232.55 4,197.65
R2019-0000072412 11-12-2019 201900069424/091190 KANZIA ARISHA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000072412 11-12-2019 201900069424/091190 KANZIA ARISHA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 200.20 23,003.00
R2019-0000072412 11-12-2019 201900069424/091190 KANZIA ARISHA FREDRIK, Dr,Sp.A OA00093 Apialys Drop 1.00 Botol 59,400.00 59,900.00
R2019-0000072414 11-12-2019 201900069427/111825 M. ISMAIL FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 9.00 Capsul 28,957.00 261,113.00
R2019-0000072414 11-12-2019 201900069427/111825 M. ISMAIL FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 6.00 Tablet 430.65 3,083.90
R2019-0000072414 11-12-2019 201900069427/111825 M. ISMAIL FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 6.00 Tablet 1,173.15 7,538.90
R2019-0000072414 11-12-2019 201900069427/111825 M. ISMAIL FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 6.00 Tablet 1,232.55 7,895.30
R2019-0000072414 11-12-2019 201900069427/111825 M. ISMAIL FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 5.00 Granula 297.00 1,985.00
R2019-0000072414 11-12-2019 201900069427/111825 M. ISMAIL FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000072414 11-12-2019 201900069427/111825 M. ISMAIL FREDRIK, Dr,Sp.A ON00004 Naprex Syrup, 60ml 1.00 Botol 59,251.50 59,751.50
R2019-0000072415 11-12-2019 201900069419/076939 JUMARTI,NY Herika dr. OP00164 Pumpitor Injeksi 1.00 Vial 222,750.00 223,250.00
R2019-0000072415 11-12-2019 201900069419/076939 JUMARTI,NY Herika dr. OD00058 Dipenhydramine Injeksi 2.00 Ampul 2,517.23 5,534.46
R2019-0000072415 11-12-2019 201900069419/076939 JUMARTI,NY Herika dr. ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000072415 11-12-2019 201900069419/076939 JUMARTI,NY Herika dr. OF00065 Flunarizine 5mg 10.00 Tablet 2,970.00 30,200.00
R2019-0000072415 11-12-2019 201900069419/076939 JUMARTI,NY Herika dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072415 11-12-2019 201900069419/076939 JUMARTI,NY Herika dr. OF00007 Farbion Tablet 10.00 Tablet 1,782.00 18,320.00
R2019-0000072416 11-12-2019 201900069440/098240 MUTTAQI FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 3.00 Capsul 28,957.00 87,371.00
R2019-0000072416 11-12-2019 201900069440/098240 MUTTAQI FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 3.00 Tablet 430.65 1,791.95
R2019-0000072416 11-12-2019 201900069440/098240 MUTTAQI FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000072416 11-12-2019 201900069440/098240 MUTTAQI FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000072416 11-12-2019 201900069440/098240 MUTTAQI FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000072416 11-12-2019 201900069440/098240 MUTTAQI FREDRIK, Dr,Sp.A OO00062 Ottopan Syrup, 60ml 1.00 Botol 29,700.00 30,200.00
R2019-0000072418 11-12-2019 201900069454/069740 FAJAR NAZRIL Herika dr. OD00077 Dumin Rectal 250mg 1.00 Tube 29,254.50 29,754.50
R2019-0000072417 11-12-2019 201900069446/111826 MOHAMMAD AFIEF,TN SEPTIA NOVITA OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000072417 11-12-2019 201900069446/111826 MOHAMMAD AFIEF,TN SEPTIA NOVITA OA00088 Antiza Tablet 8.00 Tablet 1,633.00 13,564.00
R2019-0000072417 11-12-2019 201900069446/111826 MOHAMMAD AFIEF,TN SEPTIA NOVITA OB00007 Becom - C 5.00 Tablet 2,123.55 11,117.75
Total 140,869,185.41
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 101 dari 266
ASAL RAWAT JALAN
R2019-0000072408 10-12-2019 201900069017/065038 USMIATI,NY Dameria Sri OK00002 Kalium Diklofenac 50mg 10.00 Tablet 1,100.00 11,500.00
R2019-0000072408 10-12-2019 201900069017/065038 USMIATI,NY Dameria Sri OG00073 Glucosamine 250 Mg 15.00 Tablet 1,633.50 25,002.50
R2019-0000072408 10-12-2019 201900069017/065038 USMIATI,NY Dameria Sri OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000072408 10-12-2019 201900069017/065038 USMIATI,NY Dameria Sri OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000072421 10-12-2019 201900069037/057495 NURLINAH,NY Dameria Sri OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072421 10-12-2019 201900069037/057495 NURLINAH,NY Dameria Sri OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000072421 10-12-2019 201900069037/057495 NURLINAH,NY Dameria Sri OB00016 Betahistine Mesilat 6mg 10.00 Tablet 1,500.00 15,500.00
R2019-0000072419 11-12-2019 201900069454/069740 FAJAR NAZRIL Herika dr. OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000072419 11-12-2019 201900069454/069740 FAJAR NAZRIL Herika dr. OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
R2019-0000072419 11-12-2019 201900069454/069740 FAJAR NAZRIL Herika dr. ON00082 Nymiko Drop 1.00 Botol 48,856.00 49,356.00
R2019-0000072419 11-12-2019 201900069454/069740 FAJAR NAZRIL Herika dr. OV00106 Vosedon Suspensi 1.00 Botol 43,213.50 43,713.50
R2019-0000072425 11-12-2019 201900069402/111805 H RUSLIH TEDDY OC00054 Cendo Xitrol T etes Mata 1.00 Botol 46,800.00 47,300.00
R2019-0000072430 11-12-2019 201900069466/060089 EKA PUTRIANI,NY SEPTIA NOVITA OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000072432 11-12-2019 201900069457/074784 DIVA SAYLA,AN Niki Juniar OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072432 11-12-2019 201900069457/074784 DIVA SAYLA,AN Niki Juniar OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000072432 11-12-2019 201900069457/074784 DIVA SAYLA,AN Niki Juniar OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000072432 11-12-2019 201900069457/074784 DIVA SAYLA,AN Niki Juniar OI00134 Imunos Plus Tablet 5.00 Tablet 14,107.50 71,037.50
R2019-0000072431 11-12-2019 201900069457/074784 DIVA SAYLA,AN Niki Juniar OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000072431 11-12-2019 201900069457/074784 DIVA SAYLA,AN Niki Juniar OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000072431 11-12-2019 201900069457/074784 DIVA SAYLA,AN Niki Juniar ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000072440 11-12-2019 201900069477/111832 ABDUL JALIL,SDR Niki Juniar OO00014 Omeprazole 20mg (OGB) 3.00 Capsul 1,169.98 4,009.94
R2019-0000072440 11-12-2019 201900069477/111832 ABDUL JALIL,SDR Niki Juniar OB00050 Braxidin 3.00 Tablet 1,648.35 5,445.05
R2019-0000072433 11-12-2019 201900069461/111829 MUHAMMAD RIZKY Niki Juniar OB00007 Becom - C 5.00 Tablet 2,123.55 11,117.75
R2019-0000072433 11-12-2019 201900069461/111829 MUHAMMAD RIZKY Niki Juniar OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000072433 11-12-2019 201900069461/111829 MUHAMMAD RIZKY Niki Juniar OE00022 Eprinoc Tablet 10.00 Tablet 5,093.55 51,435.50
R2019-0000072433 11-12-2019 201900069461/111829 MUHAMMAD RIZKY Niki Juniar ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000072433 11-12-2019 201900069461/111829 MUHAMMAD RIZKY Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000072454 11-12-2019 201900069483/39524 IDAWATI,NY Ismail dr. Msc. OM00045 Methyl Prednisolon 4mg 15.00 Tablet 792.99 12,394.85
R2019-0000072454 11-12-2019 201900069483/39524 IDAWATI,NY Ismail dr. Msc. OL00080 Loratadin 10mg (OGB) 15.00 Tablet 520.00 8,300.00
R2019-0000072454 11-12-2019 201900069483/39524 IDAWATI,NY Ismail dr. Msc. OB00017 Betametason Cream 3.00 Tube 5,049.00 15,647.00
R2019-0000072454 11-12-2019 201900069483/39524 IDAWATI,NY Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000072454 11-12-2019 201900069483/39524 IDAWATI,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 24,000.00
R2019-0000072449 11-12-2019 201900069476/111831 ANDRI PRASETIA Niki Juniar OS00144 Sanmol Infus 1.00 Botol 90,733.50 91,233.50
R2019-0000072449 11-12-2019 201900069476/111831 ANDRI PRASETIA Niki Juniar OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000072449 11-12-2019 201900069476/111831 ANDRI PRASETIA Niki Juniar ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000072449 11-12-2019 201900069476/111831 ANDRI PRASETIA Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000072457 11-12-2019 201900069476/111831 ANDRI PRASETIA Niki Juniar OS00029 Sanmol Tablet, 500mg 8.00 Tablet 430.65 3,945.20
R2019-0000072457 11-12-2019 201900069476/111831 ANDRI PRASETIA Niki Juniar OI00134 Imunos Plus Tablet 5.00 Tablet 14,107.50 71,037.50
Total 141,923,103.74
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 102 dari 266
ASAL RAWAT JALAN
R2019-0000072457 11-12-2019 201900069476/111831 ANDRI PRASETIA Niki Juniar OC00120 Cortidex Tablet 10.00 Tablet 430.65 4,806.50
R2019-0000072457 11-12-2019 201900069476/111831 ANDRI PRASETIA Niki Juniar OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000072457 11-12-2019 201900069476/111831 ANDRI PRASETIA Niki Juniar OS00014 Sanadryl DMP Syrup, 60ml 1.00 Botol 17,820.00 18,320.00
R2019-0000072459 11-12-2019 201900069415/111390 RU KARSINI,NY Windy Krisanti OA00063 Amlodipin 10mg (OGB) 30.00 Tablet 2,743.00 82,790.00
R2019-0000072459 11-12-2019 201900069415/111390 RU KARSINI,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 20.00 Tablet 8,168.00 163,860.00
R2019-0000072459 11-12-2019 201900069415/111390 RU KARSINI,NY Windy Krisanti OL00021 Lansoprazole (OGB) 10.00 Capsul 2,230.00 22,800.00
R2019-0000072459 11-12-2019 201900069415/111390 RU KARSINI,NY Windy Krisanti OM00018 Meloxicam 7.5mg (OGB) 20.00 Tablet 1,287.00 26,240.00
R2019-0000072458 11-12-2019 201900069470/101625 NURDINA,NY Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 15.00 Tablet 965.25 14,978.75
R2019-0000072458 11-12-2019 201900069470/101625 NURDINA,NY Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 15.00 Tablet 623.70 9,855.50
R2019-0000072458 11-12-2019 201900069470/101625 NURDINA,NY Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000072458 11-12-2019 201900069470/101625 NURDINA,NY Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000072458 11-12-2019 201900069470/101625 NURDINA,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000072465 11-12-2019 201900069465/062329 DJUWITO TEGUH Ismail dr. Msc. OM00045 Methyl Prednisolon 4mg 15.00 Tablet 792.99 12,394.85
R2019-0000072465 11-12-2019 201900069465/062329 DJUWITO TEGUH Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 15.00 Tablet 623.70 9,855.50
R2019-0000072465 11-12-2019 201900069465/062329 DJUWITO TEGUH Ismail dr. Msc. GK003 Ketoconazole Cream 10 1.00 Tube 8,019.00 8,519.00
R2019-0000072465 11-12-2019 201900069465/062329 DJUWITO TEGUH Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000072465 11-12-2019 201900069465/062329 DJUWITO TEGUH Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000072468 11-12-2019 201900069441/029841 LI'AH,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 14.00 Tablet 8,168.00 114,852.00
R2019-0000072468 11-12-2019 201900069441/029841 LI'AH,NY Windy Krisanti OV00046 Valis anbe 5mg Tablet 14.00 Tablet 579.15 8,608.10
R2019-0000072468 11-12-2019 201900069441/029841 LI'AH,NY Windy Krisanti OM00154 Mecobalamin 500mg 14.00 Tablet 1,118.00 16,152.00
R2019-0000072468 11-12-2019 201900069441/029841 LI'AH,NY Windy Krisanti OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000072469 11-12-2019 201900069410/103071 ROSITA R,NY TEDDY OC00054 Cendo Xitrol T etes Mata 1.00 Botol 46,800.00 47,300.00
R2019-0000072470 11-12-2019 201900069473/110404 DAVID FADILAH R,BY Ismail dr. Msc. OH00026 Hydrocortis on Cream 2.00 Tube 11,880.00 24,260.00
R2019-0000072470 11-12-2019 201900069473/110404 DAVID FADILAH R,BY Ismail dr. Msc. GK003 Ketoconazole Cream 10 1.00 Tube 8,019.00 8,519.00
R2019-0000072470 11-12-2019 201900069473/110404 DAVID FADILAH R,BY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000072472 11-12-2019 201900069460/111830 ASEP JUHERI,TN Niki Juniar OA00074 Analsik 3.00 Tablet 2,264.63 7,293.89
R2019-0000072472 11-12-2019 201900069460/111830 ASEP JUHERI,TN Niki Juniar OD00065 Domperidon Tablet (OGB) 4.00 Tablet 750.00 3,500.00
R2019-0000072471 11-12-2019 201900069459/111828 HANA Niki Juniar OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2019-0000072471 11-12-2019 201900069459/111828 HANA Niki Juniar OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
R2019-0000072473 11-12-2019 201900069472/110798 NURHAYAT I,NY MAGDA ROSSA, OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000072473 11-12-2019 201900069472/110798 NURHAYAT I,NY MAGDA ROSSA, OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072473 11-12-2019 201900069472/110798 NURHAYAT I,NY MAGDA ROSSA, OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000072475 11-12-2019 201900069432/110108 BINTANG KENCANA Ismail dr. Msc. OM00045 Methyl Prednisolon 4mg 15.00 Tablet 792.99 12,394.85
R2019-0000072475 11-12-2019 201900069432/110108 BINTANG KENCANA Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 15.00 Tablet 623.70 9,855.50
R2019-0000072475 11-12-2019 201900069432/110108 BINTANG KENCANA Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 5,049.00 10,598.00
R2019-0000072475 11-12-2019 201900069432/110108 BINTANG KENCANA Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000072475 11-12-2019 201900069432/110108 BINTANG KENCANA Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
Total 142,769,859.43
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 103 dari 266
ASAL RAWAT JALAN
R2019-0000072477 11-12-2019 201900069507/049979 ROZA Niki Juniar OL00041 Lasgan Capsul 9.00 Capsul 21,000.00 189,500.00
R2019-0000072477 11-12-2019 201900069507/049979 ROZA Niki Juniar OB00007 Becom - C 5.00 Tablet 2,123.55 11,117.75
R2019-0000072477 11-12-2019 201900069507/049979 ROZA Niki Juniar OB001002 Betahistine 10.00 Tab 5,940.00 59,900.00
R2019-0000072477 11-12-2019 201900069507/049979 ROZA Niki Juniar OE00057 Eperisone Hcl 50mg 10.00 Tablet 2,286.90 23,369.00
R2019-0000072474 11-12-2019 201900069355/084049 ARIFIN,TN Windy Krisanti OT00147 Trilac 10mg Injeksi 1.00 Vial 148,500.00 149,000.00
R2019-0000072474 11-12-2019 201900069355/084049 ARIFIN,TN Windy Krisanti OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000072474 11-12-2019 201900069355/084049 ARIFIN,TN Windy Krisanti OG00057 Gabapentin 300mg (OGB) 14.00 Tablet 8,168.00 114,852.00
R2019-0000072474 11-12-2019 201900069355/084049 ARIFIN,TN Windy Krisanti OG00073 Glucosamine 250 Mg 14.00 Tablet 1,633.50 23,369.00
R2019-0000072474 11-12-2019 201900069355/084049 ARIFIN,TN Windy Krisanti OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000072456 11-12-2019 201900069489/110814 ISTIANI,NY Windy Krisanti OM00018 Meloxicam 7.5mg (OGB) 15.00 Tablet 1,287.00 19,805.00
R2019-0000072456 11-12-2019 201900069489/110814 ISTIANI,NY Windy Krisanti OV00046 Valis anbe 5mg Tablet 3.00 Tablet 579.15 2,237.45
R2019-0000072456 11-12-2019 201900069489/110814 ISTIANI,NY Windy Krisanti ALK00037 Kapsul No.1 15.00 pcs 200.00 10,500.00
R2019-0000072456 11-12-2019 201900069489/110814 ISTIANI,NY Windy Krisanti OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000072481 11-12-2019 201900069517/083767 NASYITHA KRASIVA Niki Juniar OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000072481 11-12-2019 201900069517/083767 NASYITHA KRASIVA Niki Juniar OM00099 Mucera Syrup 1.00 Botol 34,155.00 34,655.00
R2019-0000072481 11-12-2019 201900069517/083767 NASYITHA KRASIVA Niki Juniar OC00291 Cerini Syrup 1.00 Botol 59,103.00 59,603.00
R2019-0000072482 11-12-2019 201900069481/41802 ANDI LAWA,TN Windy Krisanti OG00057 Gabapentin 300mg (OGB) 14.00 Tablet 8,168.00 114,852.00
R2019-0000072482 11-12-2019 201900069481/41802 ANDI LAWA,TN Windy Krisanti OG00073 Glucosamine 250 Mg 14.00 Tablet 1,633.50 23,369.00
R2019-0000072482 11-12-2019 201900069481/41802 ANDI LAWA,TN Windy Krisanti OM00154 Mecobalamin 500mg 14.00 Tablet 1,118.00 16,152.00
R2019-0000072482 11-12-2019 201900069481/41802 ANDI LAWA,TN Windy Krisanti OB00016 Betahistine Mesilat 6mg 14.00 Tablet 1,500.00 21,500.00
R2019-0000072482 11-12-2019 201900069481/41802 ANDI LAWA,TN Windy Krisanti OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000072483 11-12-2019 201900069506/063582 NURUL NISFAH,HJ Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000072483 11-12-2019 201900069506/063582 NURUL NISFAH,HJ Niki Juniar OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072483 11-12-2019 201900069506/063582 NURUL NISFAH,HJ Niki Juniar OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000072485 11-12-2019 201900069495/108830 NAUFAL DZUHDI Niki Juniar OA00052 Ambroxol Tablet, 30mg 6.00 Tablet 445.50 3,173.00
R2019-0000072485 11-12-2019 201900069495/108830 NAUFAL DZUHDI Niki Juniar OS00009 Salbutamol 2mg (OGB) 4.00 Tablet 213.30 1,353.20
R2019-0000072485 11-12-2019 201900069495/108830 NAUFAL DZUHDI Niki Juniar OC00060 Cetirizine 10mg (OGB) 4.00 Tablet 623.70 2,994.80
R2019-0000072485 11-12-2019 201900069495/108830 NAUFAL DZUHDI Niki Juniar OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
R2019-0000072486 11-12-2019 201900069474/074516 MUHAMMAD HOFURUL Niki Juniar OB00007 Becom - C 2.00 Tablet 2,123.55 4,747.10
R2019-0000072486 11-12-2019 201900069474/074516 MUHAMMAD HOFURUL Niki Juniar OB00016 Betahistine Mesilat 6mg 4.00 Tablet 1,500.00 6,500.00
R2019-0000072487 11-12-2019 201900069468/060839 NOOR SYELFIANTI,NN Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000072487 11-12-2019 201900069468/060839 NOOR SYELFIANTI,NN Niki Juniar OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000072488 11-12-2019 201900069316/063810 TUTY WAHYUNI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072488 11-12-2019 201900069316/063810 TUTY WAHYUNI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072489 11-12-2019 201900069104/111536 SUKARTI,NY TEDDY OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000072489 11-12-2019 201900069104/111536 SUKARTI,NY TEDDY OC00076 Ciprofloxacin 500mg 30.00 Tablet 1,039.50 31,685.00
R2019-0000072489 11-12-2019 201900069104/111536 SUKARTI,NY TEDDY OA00106 Asam Mefenamat 500mg 5.00 Tablet 415.80 2,579.00
R2019-0000072491 11-12-2019 201900069420/108950 RAYYAN AMMAR FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
Total 143,955,142.42
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 104 dari 266
ASAL RAWAT JALAN
R2019-0000072491 11-12-2019 201900069420/108950 RAYYAN AMMAR FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 2.00 Tablet 208.00 916.00
R2019-0000072491 11-12-2019 201900069420/108950 RAYYAN AMMAR FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 2.00 Tablet 1,173.15 2,846.30
R2019-0000072491 11-12-2019 201900069420/108950 RAYYAN AMMAR FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000072491 11-12-2019 201900069420/108950 RAYYAN AMMAR FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000072491 11-12-2019 201900069420/108950 RAYYAN AMMAR FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000072492 11-12-2019 201900069496/111834 SLAMET ISKABUL,TN Niki Juniar OB00016 Betahistine Mesilat 6mg 4.00 Tablet 1,500.00 6,500.00
R2019-0000072492 11-12-2019 201900069496/111834 SLAMET ISKABUL,TN Niki Juniar OA00074 Analsik 3.00 Tablet 2,264.63 7,293.89
R2019-0000072490 11-12-2019 201900069453/065736 BAGONG,TN Windy Krisanti OE00057 Eperisone Hcl 50mg 20.00 Tablet 2,286.90 46,238.00
R2019-0000072490 11-12-2019 201900069453/065736 BAGONG,TN Windy Krisanti OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000072494 11-12-2019 201900069445/055682 LAINGGA,TN Windy Krisanti OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000072494 11-12-2019 201900069445/055682 LAINGGA,TN Windy Krisanti OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000072494 11-12-2019 201900069445/055682 LAINGGA,TN Windy Krisanti OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000072494 11-12-2019 201900069445/055682 LAINGGA,TN Windy Krisanti OS00173 Simvastatin 20mg (OGB) 23.00 Tablet 1,782.00 41,486.00
R2019-0000072494 11-12-2019 201900069445/055682 LAINGGA,TN Windy Krisanti OV00080 Vitamin B Compleks 23.00 Tablet 241.79 6,061.17
R2019-0000072495 11-12-2019 201900069445/055682 LAINGGA,TN Windy Krisanti OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000072495 11-12-2019 201900069445/055682 LAINGGA,TN Windy Krisanti OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072495 11-12-2019 201900069445/055682 LAINGGA,TN Windy Krisanti OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072495 11-12-2019 201900069445/055682 LAINGGA,TN Windy Krisanti OS00173 Simvastatin 20mg (OGB) 7.00 Tablet 1,782.00 12,974.00
R2019-0000072495 11-12-2019 201900069445/055682 LAINGGA,TN Windy Krisanti OV00080 Vitamin B Compleks 7.00 Tablet 241.79 2,192.53
R2019-0000072497 11-12-2019 201900069508/097661 AIRA HUMAIRA Riyanti Puji dr. OC00291 Cerini Syrup 1.00 Botol 59,103.00 59,603.00
R2019-0000072497 11-12-2019 201900069508/097661 AIRA HUMAIRA Riyanti Puji dr. OA00096 Apolar N Cream, 10gr 1.00 Tube 53,014.50 53,514.50
R2019-0000072498 11-12-2019 201900069442/097330 REICO F D Windy Krisanti OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000072498 11-12-2019 201900069442/097330 REICO F D Windy Krisanti OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000072498 11-12-2019 201900069442/097330 REICO F D Windy Krisanti OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000072496 11-12-2019 201900069442/097330 REICO F D Windy Krisanti OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072496 11-12-2019 201900069442/097330 REICO F D Windy Krisanti OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072496 11-12-2019 201900069442/097330 REICO F D Windy Krisanti OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000072496 11-12-2019 201900069442/097330 REICO F D Windy Krisanti OA00062 Amitriptyline Tablet, 15.00 Tablet 252.45 4,286.75
R2019-0000072496 11-12-2019 201900069442/097330 REICO F D Windy Krisanti OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000072499 11-12-2019 201900069394/102819 RAFAEL YEREMIA Riyanti Puji dr. OF00141 Farizol Suspensi, 60ml 1.00 Botol 18,532.00 19,032.00
R2019-0000072499 11-12-2019 201900069394/102819 RAFAEL YEREMIA Riyanti Puji dr. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000072502 11-12-2019 201900069444/016346 LILI MUSRIATUN,NY Windy Krisanti OT00147 Trilac 10mg Injeksi 1.00 Vial 148,500.00 149,000.00
R2019-0000072502 11-12-2019 201900069444/016346 LILI MUSRIATUN,NY Windy Krisanti OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000072502 11-12-2019 201900069444/016346 LILI MUSRIATUN,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 15.00 Tablet 8,168.00 123,020.00
Total 145,304,747.59
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 105 dari 266
ASAL RAWAT JALAN
R2019-0000072502 11-12-2019 201900069444/016346 LILI MUSRIATUN,NY Windy Krisanti OM00154 Mecobalamin 500mg 15.00 Tablet 1,118.00 17,270.00
R2019-0000072502 11-12-2019 201900069444/016346 LILI MUSRIATUN,NY Windy Krisanti OG00073 Glucosamine 250 Mg 15.00 Tablet 1,633.50 25,002.50
R2019-0000072501 11-12-2019 201900069505/105436 SITI RAMLAH,NY Niki Juniar OA00052 Ambroxol Tablet, 30mg 6.00 Tablet 445.50 3,173.00
R2019-0000072501 11-12-2019 201900069505/105436 SITI RAMLAH,NY Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000072501 11-12-2019 201900069505/105436 SITI RAMLAH,NY Niki Juniar OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
R2019-0000072503 11-12-2019 201900069519/067433 MUHAMMAD RAKA Niki Juniar OO00062 Ottopan Syrup, 60ml 1.00 Botol 29,700.00 30,200.00
R2019-0000072503 11-12-2019 201900069519/067433 MUHAMMAD RAKA Niki Juniar ON00082 Nymiko Drop 1.00 Botol 48,856.00 49,356.00
R2019-0000072505 11-12-2019 201900069501/095258 WANTI,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 15.00 Tablet 8,168.00 123,020.00
R2019-0000072505 11-12-2019 201900069501/095258 WANTI,NY Windy Krisanti OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000072504 11-12-2019 201900069503/109163 NUR FITRI,NY Windy Krisanti OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000072506 11-12-2019 201900069491/22243 Kasman,TN Windy Krisanti OT00157 Telmisartan 80 mg 3.00 Tablet 9,801.00 29,903.00
R2019-0000072506 11-12-2019 201900069491/22243 Kasman,TN Windy Krisanti OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000072506 11-12-2019 201900069491/22243 Kasman,TN Windy Krisanti OS00173 Simvastatin 20mg (OGB) 7.00 Tablet 1,782.00 12,974.00
R2019-0000072506 11-12-2019 201900069491/22243 Kasman,TN Windy Krisanti OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000072506 11-12-2019 201900069491/22243 Kasman,TN Windy Krisanti OA00043 Alprazolam 0,5mg (OGB) 10.00 Tablet 996.50 10,465.00
R2019-0000072506 11-12-2019 201900069491/22243 Kasman,TN Windy Krisanti OG00057 Gabapentin 300mg (OGB) 14.00 Tablet 8,168.00 114,852.00
R2019-0000072508 11-12-2019 201900069491/22243 Kasman,TN Windy Krisanti OT00157 Telmisartan 80 mg 12.00 Tablet 9,801.00 118,112.00
R2019-0000072508 11-12-2019 201900069491/22243 Kasman,TN Windy Krisanti OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000072508 11-12-2019 201900069491/22243 Kasman,TN Windy Krisanti OS00173 Simvastatin 20mg (OGB) 23.00 Tablet 1,782.00 41,486.00
R2019-0000072507 11-12-2019 201900069513/111835 DELON AF ZEDY,AN Maulin Nikmah OP00011 Paracetamol 500mg 4.00 Tablet 387.36 2,049.44
R2019-0000072507 11-12-2019 201900069513/111835 DELON AF ZEDY,AN Maulin Nikmah OB00007 Becom - C 3.00 Tablet 2,123.55 6,870.65
R2019-0000072507 11-12-2019 201900069513/111835 DELON AF ZEDY,AN Maulin Nikmah OA00180 Acetylcyst ein 200mg 6.00 Tablet 1,485.00 9,410.00
R2019-0000072510 11-12-2019 201900069497/090362 TIPAH,NY Windy Krisanti OA00111 Aspilets Chawable 8.00 Tablet 811.35 6,990.80
R2019-0000072510 11-12-2019 201900069497/090362 TIPAH,NY Windy Krisanti OC00172 Candesartan Cilexetil 8.00 Tablet 10,617.75 85,442.00
R2019-0000072510 11-12-2019 201900069497/090362 TIPAH,NY Windy Krisanti OA00064 Amlodipin 5mg (OGB) 8.00 Tablet 1,555.00 12,940.00
R2019-0000072511 11-12-2019 201900069484/16917 SUTIANI,NY Windy Krisanti OE00057 Eperisone Hcl 50mg 15.00 Tablet 2,286.90 34,803.50
R2019-0000072511 11-12-2019 201900069484/16917 SUTIANI,NY Windy Krisanti OM00018 Meloxicam 7.5mg (OGB) 15.00 Tablet 1,287.00 19,805.00
R2019-0000072511 11-12-2019 201900069484/16917 SUTIANI,NY Windy Krisanti OL00021 Lansoprazole (OGB) 10.00 Capsul 2,230.00 22,800.00
R2019-0000072511 11-12-2019 201900069484/16917 SUTIANI,NY Windy Krisanti OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000072513 11-12-2019 201900069523/111838 HASBI RIZKI Niki Juniar OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000072513 11-12-2019 201900069523/111838 HASBI RIZKI Niki Juniar OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000072513 11-12-2019 201900069523/111838 HASBI RIZKI Niki Juniar OD00065 Domperidon Tablet (OGB) 4.00 Tablet 750.00 3,500.00
R2019-0000072512 11-12-2019 201900069516/110197 DESI,NY Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000072512 11-12-2019 201900069516/110197 DESI,NY Niki Juniar OO00074 Ondansetron Tablet, 4mg 6.00 Tablet 4,455.00 27,230.00
R2019-0000072514 11-12-2019 201900069525/111790 FARIDA AMALIA,NY Niki Juniar OO00018 Ondansetron Injeksi 2.00 Ampul 12,000.00 24,500.00
R2019-0000072516 11-12-2019 201900069514/111836 LAENRE, DRS,TN Niki Juniar OK00027 Ketorolac 3% Injeksi 2.00 Ampul 40,500.40 81,500.80
R2019-0000072516 11-12-2019 201900069514/111836 LAENRE, DRS,TN Niki Juniar OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000072516 11-12-2019 201900069514/111836 LAENRE, DRS,TN Niki Juniar ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
Total 146,416,512.46
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 106 dari 266
ASAL RAWAT JALAN
R2019-0000072516 11-12-2019 201900069514/111836 LAENRE, DRS,TN Niki Juniar ALI00006 I.V Catheter No. 24 2.00 Pcs 38,900.00 78,300.00
R2019-0000072515 11-12-2019 201900069524/111839 PUTERI AWALIA,NN Niki Juniar ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000072515 11-12-2019 201900069524/111839 PUTERI AWALIA,NN Niki Juniar OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000072519 11-12-2019 201900069495/108830 NAUFAL DZUHDI Niki Juniar OV00057 Ventolin Nebules 2.5mg 2.00 Ampul 15,365.00 31,230.00
R2019-0000072519 11-12-2019 201900069495/108830 NAUFAL DZUHDI Niki Juniar OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000072520 11-12-2019 201900069524/111839 PUTERI AWALIA,NN Niki Juniar OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000072520 11-12-2019 201900069524/111839 PUTERI AWALIA,NN Niki Juniar OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072520 11-12-2019 201900069524/111839 PUTERI AWALIA,NN Niki Juniar OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000072520 11-12-2019 201900069524/111839 PUTERI AWALIA,NN Niki Juniar OC00120 Cortidex Tablet 10.00 Tablet 430.65 4,806.50
R2019-0000072520 11-12-2019 201900069524/111839 PUTERI AWALIA,NN Niki Juniar OC00057 Cerini 10.00 Tablet 5,093.55 51,435.50
R2019-0000072520 11-12-2019 201900069524/111839 PUTERI AWALIA,NN Niki Juniar OI00134 Imunos Plus Tablet 5.00 Tablet 14,107.50 71,037.50
R2019-0000072517 11-12-2019 201900069506/063582 NURUL NISFAH,HJ Niki Juniar OK00027 Ketorolac 3% Injeksi 2.00 Ampul 40,500.40 81,500.80
R2019-0000072517 11-12-2019 201900069506/063582 NURUL NISFAH,HJ Niki Juniar OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000072522 11-12-2019 201900069536/027572 GENZHIO Niki Juniar OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000072522 11-12-2019 201900069536/027572 GENZHIO Niki Juniar ALI00006 I.V Catheter No. 24 2.00 Pcs 38,900.00 78,300.00
R2019-0000072522 11-12-2019 201900069536/027572 GENZHIO Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000072522 11-12-2019 201900069536/027572 GENZHIO Niki Juniar ALN00003 Nasal Canule Infant/Anak 1.00 Pcs 19,305.00 19,805.00
R2019-0000072524 11-12-2019 201900069468/060839 NOOR SYELFIANTI,NN Niki Juniar OI00050 Infus Otsu-NS (NaCl 1.00 Botol 22,542.30 23,042.30
R2019-0000072524 11-12-2019 201900069468/060839 NOOR SYELFIANTI,NN Niki Juniar OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000072523 11-12-2019 201900069525/111790 FARIDA AMALIA,NY Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000072523 11-12-2019 201900069525/111790 FARIDA AMALIA,NY Niki Juniar OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000072526 11-12-2019 201900069459/111828 HANA Niki Juniar OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000072527 11-12-2019 201900069532/111840 SHANDY LIOW,SDR Niki Juniar OL00021 Lansoprazole (OGB) 10.00 Capsul 2,230.00 22,800.00
R2019-0000072527 11-12-2019 201900069532/111840 SHANDY LIOW,SDR Niki Juniar OB00050 Braxidin 10.00 Tablet 1,648.35 16,983.50
R2019-0000072527 11-12-2019 201900069532/111840 SHANDY LIOW,SDR Niki Juniar OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000072544 12-12-2019 201900069542/111843 MUHAMMAD ARLI ADE RAHMAH OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000072544 12-12-2019 201900069542/111843 MUHAMMAD ARLI ADE RAHMAH OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000072545 12-12-2019 201900069534/111841 WIDHYASIH Niki Juniar OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072545 12-12-2019 201900069534/111841 WIDHYASIH Niki Juniar OA00085 Antasida Tablet (OGB) 6.00 Tablet 284.30 2,205.80
R2019-0000072545 12-12-2019 201900069534/111841 WIDHYASIH Niki Juniar OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000072546 12-12-2019 201900069531/109711 ENDANG SRI Niki Juniar ON00009 Natrium Diklofenac 50mg 5.00 Tablet 955.84 5,279.20
R2019-0000072546 12-12-2019 201900069531/109711 ENDANG SRI Niki Juniar OM00045 Methyl Prednisolon 4mg 4.00 Tablet 792.99 3,671.96
R2019-0000072546 12-12-2019 201900069531/109711 ENDANG SRI Niki Juniar OC00034 Cefadroxil 500mg (OGB) 6.00 Capsul 1,633.50 10,301.00
R2019-0000072547 12-12-2019 201900069549/105719 KASTI,NY ADE RAHMAH OA00074 Analsik 2.00 Tablet 2,264.63 5,029.26
R2019-0000072547 12-12-2019 201900069549/105719 KASTI,NY ADE RAHMAH OI00001 Ibuprofen 400mg (OGB) 5.00 Tablet 682.00 3,910.00
R2019-0000072547 12-12-2019 201900069549/105719 KASTI,NY ADE RAHMAH OB00016 Betahistine Mesilat 6mg 4.00 Tablet 1,500.00 6,500.00
R2019-0000072554 11-12-2019 201900069423/058313 BAMBANG LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072554 11-12-2019 201900069423/058313 BAMBANG LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
Total 147,466,077.81
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 107 dari 266
ASAL RAWAT JALAN
R2019-0000072554 11-12-2019 201900069423/058313 BAMBANG LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072555 11-12-2019 201900069386/111636 YATEMIN,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072555 11-12-2019 201900069386/111636 YATEMIN,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072555 11-12-2019 201900069386/111636 YATEMIN,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072555 11-12-2019 201900069386/111636 YATEMIN,TN LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000072556 11-12-2019 201900069377/093501 SRI HASTUTI SE,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 7.00 Tablet 371.25 3,098.75
R2019-0000072556 11-12-2019 201900069377/093501 SRI HASTUTI SE,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072556 11-12-2019 201900069377/093501 SRI HASTUTI SE,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000072556 11-12-2019 201900069377/093501 SRI HASTUTI SE,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000072556 11-12-2019 201900069377/093501 SRI HASTUTI SE,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072557 11-12-2019 201900069367/088671 ALIBASAH,TN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000072557 11-12-2019 201900069367/088671 ALIBASAH,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000072557 11-12-2019 201900069367/088671 ALIBASAH,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072558 11-12-2019 201900069366/060945 KARJADI,TN LUSY E. Dr.Sp.PD OG00024 Glimepiride 4mg Tablet 7.00 Tablet 3,869.89 27,589.23
R2019-0000072558 11-12-2019 201900069366/060945 KARJADI,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000072558 11-12-2019 201900069366/060945 KARJADI,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072558 11-12-2019 201900069366/060945 KARJADI,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072558 11-12-2019 201900069366/060945 KARJADI,TN LUSY E. Dr.Sp.PD OA00178 Acarbose 100mg (OGB) 21.00 Tablet 2,839.00 60,119.00
R2019-0000072558 11-12-2019 201900069366/060945 KARJADI,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072559 11-12-2019 201900069365/060944 SRI HARTINI,NY LUSY E. Dr.Sp.PD ON00075 Novomix 30 Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000072559 11-12-2019 201900069365/060944 SRI HARTINI,NY LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000072559 11-12-2019 201900069365/060944 SRI HARTINI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000072559 11-12-2019 201900069365/060944 SRI HARTINI,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000072559 11-12-2019 201900069365/060944 SRI HARTINI,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072559 11-12-2019 201900069365/060944 SRI HARTINI,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000072562 11-12-2019 201900069361/018039 MUJIONO,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000072562 11-12-2019 201900069361/018039 MUJIONO,TN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000072562 11-12-2019 201900069361/018039 MUJIONO,TN LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000072562 11-12-2019 201900069361/018039 MUJIONO,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000072562 11-12-2019 201900069361/018039 MUJIONO,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072561 12-12-2019 201900069596/096740 OLOAN SILALAHI,SDR MAGDA ROSSA, OA00068 Amoxsan Capsul, 500mg 12.00 Capsul 4,752.00 57,524.00
R2019-0000072561 12-12-2019 201900069596/096740 OLOAN SILALAHI,SDR MAGDA ROSSA, OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072561 12-12-2019 201900069596/096740 OLOAN SILALAHI,SDR MAGDA ROSSA, OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000072563 11-12-2019 201900069346/032083 NURAENI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000072563 11-12-2019 201900069346/032083 NURAENI,NY LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 7.00 Tablet 2,525.00 18,175.00
R2019-0000072564 11-12-2019 201900069326/069340 MUHAMMAD LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 7.00 Tablet 3,164.00 22,648.00
R2019-0000072564 11-12-2019 201900069326/069340 MUHAMMAD LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000072564 11-12-2019 201900069326/069340 MUHAMMAD LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
Total 148,408,707.29
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 108 dari 266
ASAL RAWAT JALAN
R2019-0000072564 11-12-2019 201900069326/069340 MUHAMMAD LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000072565 11-12-2019 201900069320/070785 MURNI,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000072565 11-12-2019 201900069320/070785 MURNI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000072566 11-12-2019 201900069324/072670 SRI MARYANI,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000072566 11-12-2019 201900069324/072670 SRI MARYANI,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072566 11-12-2019 201900069324/072670 SRI MARYANI,NY LUSY E. Dr.Sp.PD OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000072570 12-12-2019 201900069591/111848 ALISYA ADELINA A,NY IQBAL, dr OL00039 Lasal Expect Syrup, 1.00 Botol 55,687.50 56,187.50
R2019-0000072570 12-12-2019 201900069591/111848 ALISYA ADELINA A,NY IQBAL, dr ON00004 Naprex Syrup, 60ml 1.00 Botol 59,251.50 59,751.50
R2019-0000072570 12-12-2019 201900069591/111848 ALISYA ADELINA A,NY IQBAL, dr OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
R2019-0000072570 12-12-2019 201900069591/111848 ALISYA ADELINA A,NY IQBAL, dr OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000072570 12-12-2019 201900069591/111848 ALISYA ADELINA A,NY IQBAL, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000072570 12-12-2019 201900069591/111848 ALISYA ADELINA A,NY IQBAL, dr ALD00005 Disposable Syringe 3ml 1.00 Pcs 2,272.05 2,772.05
R2019-0000072570 12-12-2019 201900069591/111848 ALISYA ADELINA A,NY IQBAL, dr ALM00003 Masker Nebuliz er 1.00 Pcs 57,767.00 58,267.00
R2019-0000072572 11-12-2019 201900069319/093710 HENDRICK C LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000072572 11-12-2019 201900069319/093710 HENDRICK C LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 7.00 Tablet 3,164.00 22,648.00
R2019-0000072572 11-12-2019 201900069319/093710 HENDRICK C LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 14.00 Capsul 1,169.98 16,879.72
R2019-0000072572 11-12-2019 201900069319/093710 HENDRICK C LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072569 11-12-2019 201900069317/095937 HASAN,TN IQBAL, dr OG00022 Glimepiride 2mg Tablet 7.00 Tablet 2,525.00 18,175.00
R2019-0000072569 11-12-2019 201900069317/095937 HASAN,TN IQBAL, dr OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000072573 11-12-2019 201900069314/107791 SURATI,NY LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000072573 11-12-2019 201900069314/107791 SURATI,NY LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000072574 11-12-2019 201900069330/078097 SULISTYO LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072574 11-12-2019 201900069330/078097 SULISTYO LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000072574 11-12-2019 201900069330/078097 SULISTYO LUSY E. Dr.Sp.PD OG00021 Glimepiride 1mg Tablet 7.00 Tablet 1,245.00 9,215.00
R2019-0000072574 11-12-2019 201900069330/078097 SULISTYO LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000072576 11-12-2019 201900069330/078097 SULISTYO LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000072576 11-12-2019 201900069330/078097 SULISTYO LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000072576 11-12-2019 201900069330/078097 SULISTYO LUSY E. Dr.Sp.PD OG00021 Glimepiride 1mg Tablet 23.00 Tablet 1,245.00 29,135.00
R2019-0000072576 11-12-2019 201900069330/078097 SULISTYO LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 46.00 Tablet 371.25 17,577.50
R2019-0000072575 11-12-2019 201900069387/110610 JULYANA SUSANA LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072575 11-12-2019 201900069387/110610 JULYANA SUSANA LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072575 11-12-2019 201900069387/110610 JULYANA SUSANA LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 3.00 Tablet 240.30 1,220.90
R2019-0000072575 11-12-2019 201900069387/110610 JULYANA SUSANA LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000072575 11-12-2019 201900069387/110610 JULYANA SUSANA LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000072577 11-12-2019 201900069387/110610 JULYANA SUSANA LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000072577 11-12-2019 201900069387/110610 JULYANA SUSANA LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000072577 11-12-2019 201900069387/110610 JULYANA SUSANA LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 12.00 Tablet 240.30 3,383.60
R2019-0000072577 11-12-2019 201900069387/110610 JULYANA SUSANA LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 46.00 Tablet 371.25 17,577.50
Total 149,927,971.71
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 109 dari 266
ASAL RAWAT JALAN
R2019-0000072578 11-12-2019 201900069342/111610 SRIYONO,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000072579 11-12-2019 201900069342/111610 SRIYONO,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000072580 11-12-2019 201900069622/111301 SETIONO,TN LUSY E. Dr.Sp.PD OC00054 Cendo Xitrol T etes Mata 1.00 Botol 46,800.00 47,300.00
R2019-0000072580 11-12-2019 201900069622/111301 SETIONO,TN LUSY E. Dr.Sp.PD OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072584 12-12-2019 201900069640/111417 SUMITHA,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072583 12-12-2019 201900069614/086514 SUKARDI,TN TEDDY OC00274 Cendo Noncort Minidose 1.00 Strip 62,741.00 63,241.00
R2019-0000072583 12-12-2019 201900069614/086514 SUKARDI,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072586 12-12-2019 201900069573/111670 NOOR JANNAH,NY EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000072586 12-12-2019 201900069573/111670 NOOR JANNAH,NY EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072586 12-12-2019 201900069573/111670 NOOR JANNAH,NY EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
R2019-0000072586 12-12-2019 201900069573/111670 NOOR JANNAH,NY EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000072586 12-12-2019 201900069573/111670 NOOR JANNAH,NY EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000072585 12-12-2019 201900069575/090911 JAMIUN,NY Maulin Nikmah OL00063 Lidocain HCl 2% Injeksi 3.00 Ampul 2,376.00 7,628.00
R2019-0000072585 12-12-2019 201900069575/090911 JAMIUN,NY Maulin Nikmah ALJ00002 Jarum Needle No. 24G 5.00 Pcs 2,673.00 13,865.00
R2019-0000072588 12-12-2019 201900069568/097422 BAHARIN Maulin Nikmah OB00016 Betahistine Mesilat 6mg 6.00 Tablet 1,500.00 9,500.00
R2019-0000072589 12-12-2019 201900069578/111846 TITIN SUPRIANTIN,NY Angie Renatha , OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000072591 12-12-2019 201900069586/110153 RIDWAN,TN Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000072591 12-12-2019 201900069586/110153 RIDWAN,TN Dwi Astuti, dr OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000072591 12-12-2019 201900069586/110153 RIDWAN,TN Dwi Astuti, dr OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000072591 12-12-2019 201900069586/110153 RIDWAN,TN Dwi Astuti, dr OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000072591 12-12-2019 201900069586/110153 RIDWAN,TN Dwi Astuti, dr OL00080 Loratadin 10mg (OGB) 3.00 Tablet 520.00 2,060.00
R2019-0000072593 12-12-2019 201900069582/111847 ADELIA NAFTALI TEDDY OO00022 Opicef 500mg Capsul 15.00 Capsul 14,850.00 223,250.00
R2019-0000072593 12-12-2019 201900069582/111847 ADELIA NAFTALI TEDDY OC00053 Cendo Xitrol Salep Mata 1.00 Botol 53,274.37 53,774.37
R2019-0000072594 12-12-2019 201900069595/030583 SITI BACHRAH,HJ EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000072594 12-12-2019 201900069595/030583 SITI BACHRAH,HJ EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072594 12-12-2019 201900069595/030583 SITI BACHRAH,HJ EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000072594 12-12-2019 201900069595/030583 SITI BACHRAH,HJ EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000072597 12-12-2019 201900069636/111805 H RUSLIH TEDDY OC00054 Cendo Xitrol T etes Mata 1.00 Botol 46,800.00 47,300.00
R2019-0000072597 12-12-2019 201900069636/111805 H RUSLIH TEDDY OR00029 Retivit Tablet 10.00 Tablet 5,672.70 57,227.00
R2019-0000072596 12-12-2019 201900069635/089080 IRNA,NY TEDDY OC00054 Cendo Xitrol T etes Mata 1.00 Botol 46,800.00 47,300.00
R2019-0000072596 12-12-2019 201900069635/089080 IRNA,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
Total 151,379,756.43
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 110 dari 266
ASAL RAWAT JALAN
R2019-0000072600 12-12-2019 201900069633/103071 ROSITA R,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072599 12-12-2019 201900069641/106276 NESADELIANA Dwi Astuti, dr OT00148 Tablet Tambah Darah 5.00 Tablet 742.00 4,210.00
R2019-0000072599 12-12-2019 201900069641/106276 NESADELIANA Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000072599 12-12-2019 201900069641/106276 NESADELIANA Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000072599 12-12-2019 201900069641/106276 NESADELIANA Dwi Astuti, dr OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2019-0000072599 12-12-2019 201900069641/106276 NESADELIANA Dwi Astuti, dr OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000072603 12-12-2019 201900069625/111851 RUSLAN,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072604 12-12-2019 201900069600/085164 WENDY JOHANES Alvarez Sp .OT OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000072604 12-12-2019 201900069600/085164 WENDY JOHANES Alvarez Sp .OT OE00057 Eperisone Hcl 50mg 14.00 Tablet 2,286.90 32,516.60
R2019-0000072605 12-12-2019 201900069580/111633 IHSAN MALIK Alvarez Sp .OT OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
R2019-0000072605 12-12-2019 201900069580/111633 IHSAN MALIK Alvarez Sp .OT OE00007 Elkana Syrup 1.00 Botol 34,303.50 34,803.50
R2019-0000072605 12-12-2019 201900069580/111633 IHSAN MALIK Alvarez Sp .OT OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000072609 12-12-2019 201900069839/111672 KASIMAN,TN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000072609 12-12-2019 201900069839/111672 KASIMAN,TN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072609 12-12-2019 201900069839/111672 KASIMAN,TN EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
R2019-0000072609 12-12-2019 201900069839/111672 KASIMAN,TN EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000072609 12-12-2019 201900069839/111672 KASIMAN,TN EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000072608 12-12-2019 201900069613/015391 HAFIZH ANSHARI,TN Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000072608 12-12-2019 201900069613/015391 HAFIZH ANSHARI,TN Dwi Astuti, dr OB00050 Braxidin 5.00 Tablet 1,648.35 8,741.75
R2019-0000072608 12-12-2019 201900069613/015391 HAFIZH ANSHARI,TN Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000072611 12-12-2019 201900069577/111845 LA ADA,TN Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000072611 12-12-2019 201900069577/111845 LA ADA,TN Dwi Astuti, dr OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000072611 12-12-2019 201900069577/111845 LA ADA,TN Dwi Astuti, dr OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2019-0000072612 12-12-2019 201900069598/107795 ENDANG WINARSIH,NY Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 5.00 Tablet 1,113.75 6,068.75
R2019-0000072612 12-12-2019 201900069598/107795 ENDANG WINARSIH,NY Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000072612 12-12-2019 201900069598/107795 ENDANG WINARSIH,NY Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000072612 12-12-2019 201900069598/107795 ENDANG WINARSIH,NY Dwi Astuti, dr OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000072612 12-12-2019 201900069598/107795 ENDANG WINARSIH,NY Dwi Astuti, dr OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000072613 12-12-2019 201900069571/049731 NENDEN SRI Maulin Nikmah OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000072613 12-12-2019 201900069571/049731 NENDEN SRI Maulin Nikmah OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072613 12-12-2019 201900069571/049731 NENDEN SRI Maulin Nikmah OA00085 Antasida Tablet (OGB) 10.00 Tablet 284.30 3,343.00
R2019-0000072614 09-12-2019 201900068743/090417 RABIATUL ULFAH,NY Maulin Nikmah OG00057 Gabapentin 300mg (OGB) 20.00 Tablet 8,168.00 163,860.00
R2019-0000072614 09-12-2019 201900068743/090417 RABIATUL ULFAH,NY Maulin Nikmah OB00016 Betahistine Mesilat 6mg 20.00 Tablet 1,500.00 30,500.00
R2019-0000072614 09-12-2019 201900068743/090417 RABIATUL ULFAH,NY Maulin Nikmah OM00017 Meloxicam 15mg (OGB) 8.00 2,079.00 17,132.00
R2019-0000072617 12-12-2019 201900069650/100870 MADIMAN,TN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000072617 12-12-2019 201900069650/100870 MADIMAN,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072619 12-12-2019 201900069634/064857 PATMIATUN,NY TEDDY OC00264 Cendo Timol 0.5% ED 1.00 Botol 70,908.75 71,408.75
Total 152,128,820.24
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 111 dari 266
ASAL RAWAT JALAN
R2019-0000072619 12-12-2019 201900069634/064857 PATMIATUN,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000072618 12-12-2019 201900069630/104756 AGUS DJUMARTI,NY TEDDY OC00054 Cendo Xitrol T etes Mata 1.00 Botol 46,800.00 47,300.00
R2019-0000072621 12-12-2019 201900069584/109498 ANANDA FACHREL Amer dr. Sp.An OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000072621 12-12-2019 201900069584/109498 ANANDA FACHREL Amer dr. Sp.An OE00057 Eperisone Hcl 50mg 14.00 Tablet 2,286.90 32,516.60
R2019-0000072623 12-12-2019 201900069609/111849 JIE TELLY Alvarez Sp .OT OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000072623 12-12-2019 201900069609/111849 JIE TELLY Alvarez Sp .OT OE00057 Eperisone Hcl 50mg 10.00 Tablet 2,286.90 23,369.00
R2019-0000072622 12-12-2019 201900069624/111852 SAPITRI,TN Alvarez Sp .OT OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000072622 12-12-2019 201900069624/111852 SAPITRI,TN Alvarez Sp .OT OE00057 Eperisone Hcl 50mg 14.00 Tablet 2,286.90 32,516.60
R2019-0000072624 12-12-2019 201900069643/089687 NURIYAH,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000072624 12-12-2019 201900069643/089687 NURIYAH,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072625 12-12-2019 201900069605/088778 MARDIYAH,NY Alvarez Sp .OT OP00196 Pregabalin 75 mg 3.00 tablet 10,617.75 32,353.25
R2019-0000072625 12-12-2019 201900069605/088778 MARDIYAH,NY Alvarez Sp .OT OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000072625 12-12-2019 201900069605/088778 MARDIYAH,NY Alvarez Sp .OT OE00057 Eperisone Hcl 50mg 14.00 Tablet 2,286.90 32,516.60
R2019-0000072626 12-12-2019 201900069668/111859 FITRIANI,NY Dwi Astuti, dr OA00088 Antiza Tablet 5.00 Tablet 1,633.00 8,665.00
R2019-0000072626 12-12-2019 201900069668/111859 FITRIANI,NY Dwi Astuti, dr OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000072626 12-12-2019 201900069668/111859 FITRIANI,NY Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000072626 12-12-2019 201900069668/111859 FITRIANI,NY Dwi Astuti, dr OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2019-0000072628 12-12-2019 201900069682/084370 SAFWAN FAEYZA FREDRIK, Dr,Sp.A OS00183 Sporetik 200mg Capsul 2.00 Capsul 42,396.75 85,293.50
R2019-0000072628 12-12-2019 201900069682/084370 SAFWAN FAEYZA FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 3.00 Tablet 430.65 1,791.95
R2019-0000072628 12-12-2019 201900069682/084370 SAFWAN FAEYZA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000072628 12-12-2019 201900069682/084370 SAFWAN FAEYZA FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 3.00 Tablet 1,232.55 4,197.65
R2019-0000072628 12-12-2019 201900069682/084370 SAFWAN FAEYZA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000072628 12-12-2019 201900069682/084370 SAFWAN FAEYZA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000072629 12-12-2019 201900069678/111763 SUMIATI,NY TEDDY OC00054 Cendo Xitrol T etes Mata 1.00 Botol 46,800.00 47,300.00
R2019-0000072629 12-12-2019 201900069678/111763 SUMIATI,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072631 12-12-2019 201900069680/065660 ENZY CHALIVA FREDRIK, Dr,Sp.A OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000072631 12-12-2019 201900069680/065660 ENZY CHALIVA FREDRIK, Dr,Sp.A OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000072630 12-12-2019 201900069672/097541 AFIQA MAFAZA,AN FREDRIK, Dr,Sp.A OD00106 Domperidon 5mg/ml Drop 1.00 Botol 44,550.00 45,050.00
R2019-0000072630 12-12-2019 201900069672/097541 AFIQA MAFAZA,AN FREDRIK, Dr,Sp.A OC00033 Cefadroxil 125mg Syrup, 1.00 Botol 13,283.32 13,783.32
R2019-0000072630 12-12-2019 201900069672/097541 AFIQA MAFAZA,AN FREDRIK, Dr,Sp.A OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2019-0000072632 12-12-2019 201900069652/111856 ADIK SUJARNO,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072633 12-12-2019 201900069549/105719 KASTI,NY ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000072638 11-12-2019 201900069531/109711 ENDANG SRI Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000072639 12-12-2019 201900069540/074109 CARLO S EVANS ADE RAHMAH OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000072641 12-12-2019 201900069548/111724 MUHAMMAD IHSAN ADE RAHMAH OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000072641 12-12-2019 201900069548/111724 MUHAMMAD IHSAN ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000072642 11-12-2019 201900069534/111841 WIDHYASIH Niki Juniar OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
Total 153,091,933.16
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 112 dari 266
ASAL RAWAT JALAN
R2019-0000072642 11-12-2019 201900069534/111841 WIDHYASIH Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000072642 11-12-2019 201900069534/111841 WIDHYASIH Niki Juniar ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000072643 12-12-2019 201900069841/111864 SAHWA KHORIL Dwi Astuti, dr OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000072643 12-12-2019 201900069841/111864 SAHWA KHORIL Dwi Astuti, dr ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000072643 12-12-2019 201900069841/111864 SAHWA KHORIL Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000072644 12-12-2019 201900069586/110153 RIDWAN,TN Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000072645 12-12-2019 201900069641/106276 NESADELIANA Dwi Astuti, dr OL00063 Lidocain HCl 2% Injeksi 2.00 Ampul 2,376.00 5,252.00
R2019-0000072646 12-12-2019 201900069714/111867 WARIYANTO,TN Dwi Astuti, dr OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000072646 12-12-2019 201900069714/111867 WARIYANTO,TN Dwi Astuti, dr OC00096 Codein 10mg 10.00 Tablet 924.80 9,748.00
R2019-0000072648 12-12-2019 201900069766/111639 MARIA,NY Eviwati OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000072648 12-12-2019 201900069766/111639 MARIA,NY Eviwati OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072647 12-12-2019 201900069722/090321 RITA WAHYUNI,NY Nathalia dr. OP00138 Pumpitor Capsul 6.00 Capsul 20,092.05 121,052.30
R2019-0000072647 12-12-2019 201900069722/090321 RITA WAHYUNI,NY Nathalia dr. ON00047 New Diatabs 10.00 Tablet 767.13 8,171.30
R2019-0000072647 12-12-2019 201900069722/090321 RITA WAHYUNI,NY Nathalia dr. OS00176 Scopma Plus Tablet 10.00 Tablet 2,090.22 21,402.20
R2019-0000072647 12-12-2019 201900069722/090321 RITA WAHYUNI,NY Nathalia dr. OP00164 Pumpitor Injeksi 1.00 Vial 222,750.00 223,250.00
R2019-0000072647 12-12-2019 201900069722/090321 RITA WAHYUNI,NY Nathalia dr. OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000072647 12-12-2019 201900069722/090321 RITA WAHYUNI,NY Nathalia dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000072649 12-12-2019 201900069701/086183 NOVITA SARI,NY Eviwati OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000072650 12-12-2019 201900069718/059214 ANISA OLIVIANTI Angie Renatha , OF00150 Fukricin Eye Drop 1.00 Botol 102,762.00 103,262.00
R2019-0000072651 12-12-2019 201900069706/111866 MEREYKE Angie Renatha , OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000072651 12-12-2019 201900069706/111866 MEREYKE Angie Renatha , OP00184 Neo Protifed Tablet 15.00 Tablet 1,263.73 19,455.95
R2019-0000072651 12-12-2019 201900069706/111866 MEREYKE Angie Renatha , OD00031 Dexamethasone Tablet 15.00 Tablet 208.00 3,620.00
R2019-0000072651 12-12-2019 201900069706/111866 MEREYKE Angie Renatha , OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000072654 11-12-2019 201900069603/064523 HANNA YULISTINE,NY Maulin Nikmah OG00057 Gabapentin 300mg (OGB) 14.00 Tablet 8,168.00 114,852.00
R2019-0000072654 11-12-2019 201900069603/064523 HANNA YULISTINE,NY Maulin Nikmah OG00073 Glucosamine 250 Mg 14.00 Tablet 1,633.50 23,369.00
R2019-0000072654 11-12-2019 201900069603/064523 HANNA YULISTINE,NY Maulin Nikmah OM00154 Mecobalamin 500mg 14.00 Tablet 1,118.00 16,152.00
R2019-0000072654 11-12-2019 201900069603/064523 HANNA YULISTINE,NY Maulin Nikmah OC00010 Calcium Lactat 500mg 10.00 Tablet 302.37 3,523.70
R2019-0000072654 11-12-2019 201900069603/064523 HANNA YULISTINE,NY Maulin Nikmah OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000072655 12-12-2019 201900069660/082991 ARIF EKO Eviwati OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000072657 12-12-2019 201900069730/063676 RAMEYZA AYU Angie Renatha , OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000072657 12-12-2019 201900069730/063676 RAMEYZA AYU Angie Renatha , OD00031 Dexamethasone Tablet 8.00 Tablet 208.00 2,164.00
R2019-0000072657 12-12-2019 201900069730/063676 RAMEYZA AYU Angie Renatha , OP00011 Paracetamol 500mg 8.00 Tablet 387.36 3,598.88
R2019-0000072657 12-12-2019 201900069730/063676 RAMEYZA AYU Angie Renatha , ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000072658 12-12-2019 201900069709/096075 SETYA NINGSIH,NY Ismail dr. Msc. OF00061 Fluconazole Tablet, 1.00 Tablet 31,460.00 31,960.00
R2019-0000072658 12-12-2019 201900069709/096075 SETYA NINGSIH,NY Ismail dr. Msc. OC00057 Cerini 10.00 Tablet 5,093.55 51,435.50
R2019-0000072658 12-12-2019 201900069709/096075 SETYA NINGSIH,NY Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 5,049.00 5,549.00
R2019-0000072658 12-12-2019 201900069709/096075 SETYA NINGSIH,NY Ismail dr. Msc. OK00022 Ketoconazol Cream 2% 2.00 Tube 11,000.00 22,500.00
R2019-0000072658 12-12-2019 201900069709/096075 SETYA NINGSIH,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 19,000.00
Total 154,324,170.64
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 113 dari 266
ASAL RAWAT JALAN
R2019-0000072667 12-12-2019 201900069742/099250 KANAYA QHUMAIRAH Nathalia dr. OC00291 Cerini Syrup 1.00 Botol 59,103.00 59,603.00
R2019-0000072667 12-12-2019 201900069742/099250 KANAYA QHUMAIRAH Nathalia dr. OA00016 Acyclovir Cream 5gr 1.00 Tube 4,893.00 5,393.00
R2019-0000072667 12-12-2019 201900069742/099250 KANAYA QHUMAIRAH Nathalia dr. OA00070 Amoxsan Dry Syrup 1.00 Botol 33,412.50 33,912.50
R2019-0000072669 12-12-2019 201900069688/111648 RIZAL HIDAYAT,TN LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 12.00 Tab 7,425.00 89,600.00
R2019-0000072668 12-12-2019 201900069723/111868 RAHMAWATI,NY LUSY E. Dr.Sp.PD OL00021 Lansoprazole (OGB) 10.00 Capsul 2,230.00 22,800.00
R2019-0000072668 12-12-2019 201900069723/111868 RAHMAWATI,NY LUSY E. Dr.Sp.PD OB00050 Braxidin 10.00 Tablet 1,648.35 16,983.50
R2019-0000072668 12-12-2019 201900069723/111868 RAHMAWATI,NY LUSY E. Dr.Sp.PD OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000072671 12-12-2019 201900069698/094418 SYAMSIAH,NY LUSY E. Dr.Sp.PD OG00025 Gliquidone 30mg (OGB) 23.00 Tablet 1,967.44 45,751.12
R2019-0000072671 12-12-2019 201900069698/094418 SYAMSIAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000072671 12-12-2019 201900069698/094418 SYAMSIAH,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 23.00 Tablet 14,701.50 338,634.50
R2019-0000072671 12-12-2019 201900069698/094418 SYAMSIAH,NY LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 23.00 Tablet 206.41 5,247.43
R2019-0000072671 12-12-2019 201900069698/094418 SYAMSIAH,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000072681 12-12-2019 201900069751/111871 ARI HERYAN Nathalia dr. OA00064 Amlodipin 5mg (OGB) 10.00 Tablet 1,555.00 16,050.00
R2019-0000072681 12-12-2019 201900069751/111871 ARI HERYAN Nathalia dr. OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000072681 12-12-2019 201900069751/111871 ARI HERYAN Nathalia dr. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000072681 12-12-2019 201900069751/111871 ARI HERYAN Nathalia dr. OV00080 Vitamin B Compleks 10.00 Tablet 241.79 2,917.90
R2019-0000072670 12-12-2019 201900069749/111870 WIMALA GENTARI AZ Nathalia dr. OA00067 Amoxicillin Dry Syrup, 2.00 Botol 9,652.50 19,805.00
R2019-0000072682 12-12-2019 201900069745/024818 ENDANG SUSANTI,NY Nathalia dr. OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000072682 12-12-2019 201900069745/024818 ENDANG SUSANTI,NY Nathalia dr. OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000072682 12-12-2019 201900069745/024818 ENDANG SUSANTI,NY Nathalia dr. OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000072682 12-12-2019 201900069745/024818 ENDANG SUSANTI,NY Nathalia dr. OC00060 Cetirizine 10mg (OGB) 4.00 Tablet 623.70 2,994.80
R2019-0000072683 12-12-2019 201900069658/111163 RIDWAN,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000072683 12-12-2019 201900069658/111163 RIDWAN,TN LUSY E. Dr.Sp.PD OD00065 Domperidon Tablet (OGB) 10.00 Tablet 750.00 8,000.00
R2019-0000072683 12-12-2019 201900069658/111163 RIDWAN,TN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072685 12-12-2019 201900069736/036612 SITI PURWANTI,NY LUSY E. Dr.Sp.PD OM00045 Methyl Prednisolon 4mg 5.00 Tablet 792.99 4,464.95
R2019-0000072685 12-12-2019 201900069736/036612 SITI PURWANTI,NY LUSY E. Dr.Sp.PD OA00074 Analsik 6.00 Tablet 2,264.63 14,087.78
R2019-0000072685 12-12-2019 201900069736/036612 SITI PURWANTI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072690 12-12-2019 201900069736/036612 SITI PURWANTI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000072692 12-12-2019 201900069729/108704 SULASTRI LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072692 12-12-2019 201900069729/108704 SULASTRI LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072692 12-12-2019 201900069729/108704 SULASTRI LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000072692 12-12-2019 201900069729/108704 SULASTRI LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072691 12-12-2019 201900069753/059181 YUMNA FARIHA Nathalia dr. OS00098 Sporetik Dry Syrup 1.00 Botol 123,923.25 124,423.25
R2019-0000072691 12-12-2019 201900069753/059181 YUMNA FARIHA Nathalia dr. OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000072694 12-12-2019 201900069737/086475 ISMANIAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000072694 12-12-2019 201900069737/086475 ISMANIAH,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
Total 155,719,623.53
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 114 dari 266
ASAL RAWAT JALAN
R2019-0000072696 12-12-2019 201900069692/086484 ENNY Eviwati OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000072698 12-12-2019 201900069716/037998 TRIY ANI LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000072698 12-12-2019 201900069716/037998 TRIY ANI LUSY E. Dr.Sp.PD OB00016 Betahistine Mesilat 6mg 10.00 Tablet 1,500.00 15,500.00
R2019-0000072697 12-12-2019 201900069698/094418 SYAMSIAH,NY LUSY E. Dr.Sp.PD OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072697 12-12-2019 201900069698/094418 SYAMSIAH,NY LUSY E. Dr.Sp.PD OG00025 Gliquidone 30mg (OGB) 7.00 Tablet 1,967.44 14,272.08
R2019-0000072697 12-12-2019 201900069698/094418 SYAMSIAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072697 12-12-2019 201900069698/094418 SYAMSIAH,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000072697 12-12-2019 201900069698/094418 SYAMSIAH,NY LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 7.00 Tablet 206.41 1,944.87
R2019-0000072697 12-12-2019 201900069698/094418 SYAMSIAH,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072700 12-12-2019 201900069711/095970 ERWI DYAS HARIANTI LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072699 12-12-2019 201900069688/111648 RIZAL HIDAYAT,TN LUSY E. Dr.Sp.PD OP00191 Pioglitazone 15 Mg 7.00 Tablet 4,455.00 31,685.00
R2019-0000072702 12-12-2019 201900069679/058574 FARIKHATUS Eviwati OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000072703 12-12-2019 201900069683/081384 SAPRAH,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000072703 12-12-2019 201900069683/081384 SAPRAH,NY LUSY E. Dr.Sp.PD OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000072704 12-12-2019 201900069731/095142 SYAM XAVIER Ismail dr. Msc. OZ00021 Zinkid Syrup 1.00 Botol 40,837.50 41,337.50
R2019-0000072701 12-12-2019 201900069662/111470 ENI KUSRINI,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000072701 12-12-2019 201900069662/111470 ENI KUSRINI,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072701 12-12-2019 201900069662/111470 ENI KUSRINI,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000072701 12-12-2019 201900069662/111470 ENI KUSRINI,NY LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000072705 12-12-2019 201900069646/068486 BURHANUDIN,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072705 12-12-2019 201900069646/068486 BURHANUDIN,TN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000072707 12-12-2019 201900069657/096048 SULASMI,NY LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 4.00 Flexpen 226,917.80 908,171.20
R2019-0000072707 12-12-2019 201900069657/096048 SULASMI,NY LUSY E. Dr.Sp.PD OL00056 Levemir Insulin 1.00 Flexpen 287,330.88 287,830.88
R2019-0000072707 12-12-2019 201900069657/096048 SULASMI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000072707 12-12-2019 201900069657/096048 SULASMI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000072706 12-12-2019 201900069657/096048 SULASMI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072706 12-12-2019 201900069657/096048 SULASMI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000072708 12-12-2019 201900069762/111873 HERMAWAN,TN Nathalia dr. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000072708 12-12-2019 201900069762/111873 HERMAWAN,TN Nathalia dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072708 12-12-2019 201900069762/111873 HERMAWAN,TN Nathalia dr. OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000072709 12-12-2019 201900069732/111869 NUR QOLBU Ismail dr. Msc. OM00045 Methyl Prednisolon 4mg 15.00 Tablet 792.99 12,394.85
R2019-0000072709 12-12-2019 201900069732/111869 NUR QOLBU Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 15.00 Tablet 623.70 9,855.50
R2019-0000072709 12-12-2019 201900069732/111869 NUR QOLBU Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 5,049.00 5,549.00
R2019-0000072709 12-12-2019 201900069732/111869 NUR QOLBU Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000072709 12-12-2019 201900069732/111869 NUR QOLBU Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000072710 12-12-2019 201900069659/021698 MASTARIAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
Total 157,710,057.73
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 115 dari 266
ASAL RAWAT JALAN
R2019-0000072710 12-12-2019 201900069659/021698 MASTARIAH,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000072711 12-12-2019 201900069669/042615 NUR IBNATUL Eviwati OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000072714 12-12-2019 201900069664/019720 HAMIDAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000072714 12-12-2019 201900069664/019720 HAMIDAH,NY LUSY E. Dr.Sp.PD OA00167 Acarbose 50mg (OGB) 21.00 Tablet 1,695.70 36,109.70
R2019-0000072714 12-12-2019 201900069664/019720 HAMIDAH,NY LUSY E. Dr.Sp.PD OG00025 Gliquidone 30mg (OGB) 14.00 Tablet 1,967.44 28,044.16
R2019-0000072714 12-12-2019 201900069664/019720 HAMIDAH,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072714 12-12-2019 201900069664/019720 HAMIDAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072714 12-12-2019 201900069664/019720 HAMIDAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072714 12-12-2019 201900069664/019720 HAMIDAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000072715 12-12-2019 201900069741/015236 TRI MURTINI,NY Ismail dr. Msc. OD00072 Doxyciclyn 100mg (OGB) 20.00 Tablet 650.00 13,500.00
R2019-0000072715 12-12-2019 201900069741/015236 TRI MURTINI,NY Ismail dr. Msc. OA00106 Asam Mefenamat 500mg 20.00 Tablet 415.80 8,816.00
R2019-0000072719 11-12-2019 201900069384/19616 HENNY,NY TEDDY OC00290 Cendo LFX ED 5ml 1.00 Botol 102,836.25 103,336.25
R2019-0000072720 11-12-2019 201900069390/087305 LIM HENNY,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072722 11-12-2019 201900069395/111684 HALIJA,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 14.00 Capsul 1,169.98 16,879.72
R2019-0000072722 11-12-2019 201900069395/111684 HALIJA,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072722 11-12-2019 201900069395/111684 HALIJA,NY LUSY E. Dr.Sp.PD OC00134 Curcuma Tablet 14.00 Tablet 1,336.50 19,211.00
R2019-0000072722 11-12-2019 201900069395/111684 HALIJA,NY LUSY E. Dr.Sp.PD OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000072721 11-12-2019 201900069378/036086 SUMILAH,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 20.00 Tablet 315.26 6,805.20
R2019-0000072723 11-12-2019 201900069372/109720 SALAMAH,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000072723 11-12-2019 201900069372/109720 SALAMAH,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072726 11-12-2019 201900069396/091659 LIKE MAKI LUSY E. Dr.Sp.PD OA00043 Alprazolam 0,5mg (OGB) 10.00 Tablet 996.50 10,465.00
R2019-0000072726 11-12-2019 201900069396/091659 LIKE MAKI LUSY E. Dr.Sp.PD OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000072728 11-12-2019 201900069416/064546 ERLINA MUGNIATI,NY LUSY E. Dr.Sp.PD OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000072728 11-12-2019 201900069416/064546 ERLINA MUGNIATI,NY LUSY E. Dr.Sp.PD OM00018 Meloxicam 7.5mg (OGB) 5.00 Tablet 1,287.00 6,935.00
R2019-0000072728 11-12-2019 201900069416/064546 ERLINA MUGNIATI,NY LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000072729 11-12-2019 201900069435/109578 MUHAMMAD ZAIN AL FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000072729 11-12-2019 201900069435/109578 MUHAMMAD ZAIN AL FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 2.00 Tablet 208.00 916.00
R2019-0000072729 11-12-2019 201900069435/109578 MUHAMMAD ZAIN AL FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 2.00 Tablet 1,173.15 2,846.30
R2019-0000072729 11-12-2019 201900069435/109578 MUHAMMAD ZAIN AL FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
Total 158,618,579.44
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 116 dari 266
ASAL RAWAT JALAN
R2019-0000072729 11-12-2019 201900069435/109578 MUHAMMAD ZAIN AL FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000072730 11-12-2019 201900069388/061045 DARMAWAN,TN LUSY E. Dr.Sp.PD ON00082 Nymiko Drop 1.00 Botol 48,856.00 49,356.00
R2019-0000072731 11-12-2019 201900069397/111822 ASMARI,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000072731 11-12-2019 201900069397/111822 ASMARI,TN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072731 11-12-2019 201900069397/111822 ASMARI,TN LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000072731 11-12-2019 201900069397/111822 ASMARI,TN LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000072731 11-12-2019 201900069397/111822 ASMARI,TN LUSY E. Dr.Sp.PD OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000072732 11-12-2019 201900069398/111823 SYAHRIADI,TN LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 10.00 Tablet 2,525.00 25,750.00
R2019-0000072732 11-12-2019 201900069398/111823 SYAHRIADI,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 20.00 Tablet 371.25 7,925.00
R2019-0000072732 11-12-2019 201900069398/111823 SYAHRIADI,TN LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 10.00 Tablet 7,425.00 74,750.00
R2019-0000072733 11-12-2019 201900069333/088248 TIORIM TEDDY OC00264 Cendo Timol 0.5% ED 1.00 Botol 70,908.75 71,408.75
R2019-0000072733 11-12-2019 201900069333/088248 TIORIM TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072733 11-12-2019 201900069333/088248 TIORIM TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000072735 11-12-2019 201900069351/098818 NINA FITRASARI,NY Herika dr. OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000072736 11-12-2019 201900069449/111827 GAGAS AUFAR Herika dr. OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000072736 11-12-2019 201900069449/111827 GAGAS AUFAR Herika dr. OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000072737 11-12-2019 201900069417/110803 SUMIATI,NY Herika dr. OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000072737 11-12-2019 201900069417/110803 SUMIATI,NY Herika dr. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000072737 11-12-2019 201900069417/110803 SUMIATI,NY Herika dr. OD00065 Domperidon Tablet (OGB) 10.00 Tablet 750.00 8,000.00
R2019-0000072712 12-12-2019 201900069713/045143 APRILIANA TENOA Rizka OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000072712 12-12-2019 201900069713/045143 APRILIANA TENOA Rizka OC00034 Cefadroxil 500mg (OGB) 15.00 Capsul 1,633.50 25,002.50
R2019-0000072712 12-12-2019 201900069713/045143 APRILIANA TENOA Rizka OM00052 Metronidazole 500mg 15.00 Tablet 525.39 8,380.85
R2019-0000072740 12-12-2019 201900069778/077320 MUHAMMAD ABID Riyanti Puji dr. OF00141 Farizol Suspensi, 60ml 1.00 Botol 18,532.00 19,032.00
R2019-0000072740 12-12-2019 201900069778/077320 MUHAMMAD ABID Riyanti Puji dr. OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000072740 12-12-2019 201900069778/077320 MUHAMMAD ABID Riyanti Puji dr. OT00142 Trilac 4mg 5.00 Tablet 5,200.00 26,500.00
R2019-0000072740 12-12-2019 201900069778/077320 MUHAMMAD ABID Riyanti Puji dr. ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000072740 12-12-2019 201900069778/077320 MUHAMMAD ABID Riyanti Puji dr. OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000072727 12-12-2019 201900069776/111875 SITI AISAH,NY Nathalia dr. OP00164 Pumpitor Injeksi 1.00 Vial 222,750.00 223,250.00
R2019-0000072727 12-12-2019 201900069776/111875 SITI AISAH,NY Nathalia dr. OK00027 Ketorolac 3% Injeksi 2.00 Ampul 40,500.40 81,500.80
R2019-0000072727 12-12-2019 201900069776/111875 SITI AISAH,NY Nathalia dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000072716 12-12-2019 201900069764/111874 IRNANDY REZKI Rizka OF00099 Folda Tablet 30.00 Tablet 6,661.65 200,349.50
R2019-0000072716 12-12-2019 201900069764/111874 IRNANDY REZKI Rizka ON00051 Nifedipin 10mg (OGB) 10.00 Tablet 261.21 3,112.10
R2019-0000072743 12-12-2019 201900069776/111875 SITI AISAH,NY Nathalia dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072743 12-12-2019 201900069776/111875 SITI AISAH,NY Nathalia dr. OP00138 Pumpitor Capsul 6.00 Capsul 20,092.05 121,052.30
Total 160,032,534.36
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 117 dari 266
ASAL RAWAT JALAN
R2019-0000072739 11-12-2019 201900069748/074224 ZAIRA NADIA Riyanti Puji dr. OE00024 Erysanbe 200mg Ceweble 6.00 Tablet 2,272.00 14,132.00
R2019-0000072738 11-12-2019 201900069777/107867 ENDANG TEDDY OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072742 12-12-2019 201900069772/093211 LUVY FERNANDA Nathalia dr. OS00009 Salbutamol 2mg (OGB) 10.00 Tablet 213.30 2,633.00
R2019-0000072742 12-12-2019 201900069772/093211 LUVY FERNANDA Nathalia dr. OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000072742 12-12-2019 201900069772/093211 LUVY FERNANDA Nathalia dr. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000072747 12-12-2019 201900069782/111878 ZAINAL ASIKIN,TN Nathalia dr. OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072747 12-12-2019 201900069782/111878 ZAINAL ASIKIN,TN Nathalia dr. OM00052 Metronidazole 500mg 15.00 Tablet 525.39 8,380.85
R2019-0000072748 12-12-2019 201900069783/110305 EKO DIAN,TN Nathalia dr. OD00065 Domperidon Tablet (OGB) 10.00 Tablet 750.00 8,000.00
R2019-0000072748 12-12-2019 201900069783/110305 EKO DIAN,TN Nathalia dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072748 12-12-2019 201900069783/110305 EKO DIAN,TN Nathalia dr. OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000072745 12-12-2019 201900069785/111879 TARISSA ZAHRINA Nathalia dr. OS00010 Salbutamol 4mg (OGB) 10.00 Tablet 249.48 2,994.80
R2019-0000072745 12-12-2019 201900069785/111879 TARISSA ZAHRINA Nathalia dr. OC00057 Cerini 5.00 Tablet 5,093.55 25,967.75
R2019-0000072745 12-12-2019 201900069785/111879 TARISSA ZAHRINA Nathalia dr. OC00120 Cortidex Tablet 10.00 Tablet 430.65 4,806.50
R2019-0000072748 12-12-2019 201900069783/110305 EKO DIAN,TN Nathalia dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000072748 12-12-2019 201900069783/110305 EKO DIAN,TN Nathalia dr. OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000072748 12-12-2019 201900069783/110305 EKO DIAN,TN Nathalia dr. ALI00006 I.V Catheter No. 24 2.00 Pcs 38,900.00 78,300.00
R2019-0000072748 12-12-2019 201900069783/110305 EKO DIAN,TN Nathalia dr. OK00027 Ketorolac 3% Injeksi 2.00 Ampul 40,500.40 81,500.80
R2019-0000072744 12-12-2019 201900069789/111876 NUR PUTRI Nathalia dr. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000072744 12-12-2019 201900069789/111876 NUR PUTRI Nathalia dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000072744 12-12-2019 201900069789/111876 NUR PUTRI Nathalia dr. ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000072750 12-12-2019 201900069784/039604 RUSTY ANANDA Nathalia dr. OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000072750 12-12-2019 201900069784/039604 RUSTY ANANDA Nathalia dr. OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000072751 12-12-2019 201900069790/111877 IRMAWATI,NY Nathalia dr. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000072751 12-12-2019 201900069790/111877 IRMAWATI,NY Nathalia dr. ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000072751 12-12-2019 201900069790/111877 IRMAWATI,NY Nathalia dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000072751 12-12-2019 201900069790/111877 IRMAWATI,NY Nathalia dr. ALB00132 Blood Set 1.00 Pcs 33,976.80 34,476.80
R2019-0000072749 12-12-2019 201900069770/097989 MARLINA,NY Ismail dr. Msc. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000072749 12-12-2019 201900069770/097989 MARLINA,NY Ismail dr. Msc. ALB00132 Blood Set 1.00 Pcs 33,976.80 34,476.80
R2019-0000072749 12-12-2019 201900069770/097989 MARLINA,NY Ismail dr. Msc. ALI00003 I.V Catheter No. 18 2.00 Pcs 29,744.00 59,988.00
R2019-0000072752 12-12-2019 201900069772/093211 LUVY FERNANDA Nathalia dr. OV00057 Ventolin Nebules 2.5mg 2.00 Ampul 15,365.00 31,230.00
R2019-0000072752 12-12-2019 201900069772/093211 LUVY FERNANDA Nathalia dr. OP00136 Pulmicort Respules 2.00 Ampul 33,802.98 68,105.96
R2019-0000072752 12-12-2019 201900069772/093211 LUVY FERNANDA Nathalia dr. OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000072752 12-12-2019 201900069772/093211 LUVY FERNANDA Nathalia dr. OD00031 Dexamethasone Tablet 1.00 Tablet 208.00 708.00
Total 160,919,277.52
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 118 dari 266
ASAL RAWAT JALAN
R2019-0000072753 12-12-2019 201900069745/024818 ENDANG SUSANTI,NY Nathalia dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000072753 12-12-2019 201900069745/024818 ENDANG SUSANTI,NY Nathalia dr. OI00097 Isosorbide Dinitrate 5mg 1.00 Tablet 311.85 811.85
R2019-0000072754 12-12-2019 201900069782/111878 ZAINAL ASIKIN,TN Nathalia dr. OL00063 Lidocain HCl 2% Injeksi 2.00 Ampul 2,376.00 5,252.00
R2019-0000072755 12-12-2019 201900069765/111374 SARI NURJANNAH,NY Nathalia dr. OM00047 Metoclopramide Injeksi 1.00 Ampul 10,395.00 10,895.00
R2019-0000072757 12-12-2019 201900069786/067829 SHAFIYAH,AN Niki Juniar OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000072757 12-12-2019 201900069786/067829 SHAFIYAH,AN Niki Juniar OI00117 Imunos Plus Syrup, 60ml 1.00 Botol 136,620.00 137,120.00
R2019-0000072758 12-12-2019 201900069787/111880 SITI RAHMAH,NN Niki Juniar OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072758 12-12-2019 201900069787/111880 SITI RAHMAH,NN Niki Juniar OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000072759 12-12-2019 201900069791/42275 SUPRAYITNO AGUS Niki Juniar OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000072759 12-12-2019 201900069791/42275 SUPRAYITNO AGUS Niki Juniar OB00007 Becom - C 3.00 Tablet 2,123.55 6,870.65
R2019-0000072759 12-12-2019 201900069791/42275 SUPRAYITNO AGUS Niki Juniar OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000072759 12-12-2019 201900069791/42275 SUPRAYITNO AGUS Niki Juniar OA00180 Acetylcyst ein 200mg 6.00 Tablet 1,485.00 9,410.00
R2019-0000072761 12-12-2019 201900069793/102135 NAFISAH HANANIA,BY Niki Juniar OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000072761 12-12-2019 201900069793/102135 NAFISAH HANANIA,BY Niki Juniar OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000072760 12-12-2019 201900069797/086474 HERU CAHYONO,TN Niki Juniar OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000072760 12-12-2019 201900069797/086474 HERU CAHYONO,TN Niki Juniar OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072760 12-12-2019 201900069797/086474 HERU CAHYONO,TN Niki Juniar OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000072760 12-12-2019 201900069797/086474 HERU CAHYONO,TN Niki Juniar OB00007 Becom - C 5.00 Tablet 2,123.55 11,117.75
R2019-0000072762 12-12-2019 201900069796/106814 SELMA WATI DEWI,NN Niki Juniar OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000072762 12-12-2019 201900069796/106814 SELMA WATI DEWI,NN Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000072762 12-12-2019 201900069796/106814 SELMA WATI DEWI,NN Niki Juniar OP00011 Paracetamol 500mg 4.00 Tablet 387.36 2,049.44
R2019-0000072771 13-12-2019 201900069795/069925 DANISH EKA Niki Juniar OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000072771 13-12-2019 201900069795/069925 DANISH EKA Niki Juniar OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000072771 13-12-2019 201900069795/069925 DANISH EKA Niki Juniar OD00031 Dexamethasone Tablet 2.00 Tablet 208.00 916.00
R2019-0000072771 13-12-2019 201900069795/069925 DANISH EKA Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000072771 13-12-2019 201900069795/069925 DANISH EKA Niki Juniar ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 12,079.00
R2019-0000072779 12-12-2019 201900069797/086474 HERU CAHYONO,TN Niki Juniar OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000072781 13-12-2019 201900069799/23834 B RADIVA Niki Juniar OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 Botol 22,542.30 23,042.30
R2019-0000072782 12-12-2019 201900069795/069925 DANISH EKA Niki Juniar OD00077 Dumin Rectal 250mg 1.00 Tube 29,254.50 29,754.50
R2019-0000072781 13-12-2019 201900069799/23834 B RADIVA Niki Juniar OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000072781 13-12-2019 201900069799/23834 B RADIVA Niki Juniar OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000072781 13-12-2019 201900069799/23834 B RADIVA Niki Juniar OM00045 Methyl Prednisolon 4mg 6.00 Tablet 792.99 5,257.94
R2019-0000072781 13-12-2019 201900069799/23834 B RADIVA Niki Juniar OA00180 Acetylcyst ein 200mg 6.00 Tablet 1,485.00 9,410.00
R2019-0000072781 13-12-2019 201900069799/23834 B RADIVA Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000072791 13-12-2019 201900069820/047119 ROKHMAD JOKO Niki Juniar OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000072791 13-12-2019 201900069820/047119 ROKHMAD JOKO Niki Juniar OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000072791 13-12-2019 201900069820/047119 ROKHMAD JOKO Niki Juniar OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000072798 13-12-2019 201900069836/106902 SAN ZEFO BET SEAN MAGDA ROSSA, OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
Total 161,488,744.99
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 119 dari 266
ASAL RAWAT JALAN
R2019-0000072799 13-12-2019 201900069814/111883 SUGIARTO,TN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072800 13-12-2019 201900069812/089165 MISRANTO,TN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000072800 13-12-2019 201900069812/089165 MISRANTO,TN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072800 13-12-2019 201900069812/089165 MISRANTO,TN EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000072800 13-12-2019 201900069812/089165 MISRANTO,TN EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000072801 13-12-2019 201900069847/107149 ROHANI Angie Renatha , OK00023 Ketoconazole 200mg 10.00 Tablet 774.24 8,242.40
R2019-0000072801 13-12-2019 201900069847/107149 ROHANI Angie Renatha , OF00150 Fukricin Eye Drop 1.00 Botol 102,762.00 103,262.00
R2019-0000072801 13-12-2019 201900069847/107149 ROHANI Angie Renatha , ALD00003 Disposable Syringe 1ml 1.00 Pcs 3,500.00 4,000.00
R2019-0000072801 13-12-2019 201900069847/107149 ROHANI Angie Renatha , OS00014 Sanadryl DMP Syrup, 60ml 1.00 Botol 17,820.00 18,320.00
R2019-0000072801 13-12-2019 201900069847/107149 ROHANI Angie Renatha , OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000072802 13-12-2019 201900069842/094721 MARTUA DAVID Dwi Astuti, dr OB00050 Braxidin 5.00 Tablet 1,648.35 8,741.75
R2019-0000072802 13-12-2019 201900069842/094721 MARTUA DAVID Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000072802 13-12-2019 201900069842/094721 MARTUA DAVID Dwi Astuti, dr OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072802 13-12-2019 201900069842/094721 MARTUA DAVID Dwi Astuti, dr OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000072803 13-12-2019 201900069807/093710 HENDRICK C TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000072803 13-12-2019 201900069807/093710 HENDRICK C TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072804 13-12-2019 201900069848/019833 FAISAL RAMADHAN,AN TEDDY OC00288 Cendo Conver 2% 15ml 1.00 Botol 37,700.00 38,200.00
R2019-0000072805 13-12-2019 201900069863/111085 FITRIANSYAH NUR,TN Dwi Astuti, dr OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000072805 13-12-2019 201900069863/111085 FITRIANSYAH NUR,TN Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072805 13-12-2019 201900069863/111085 FITRIANSYAH NUR,TN Dwi Astuti, dr OU00022 Urotractin 400mg Tablet 10.00 Tablet 7,189.03 72,390.30
R2019-0000072806 13-12-2019 201900069827/111857 DINDA AULIA LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000072806 13-12-2019 201900069827/111857 DINDA AULIA LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072807 13-12-2019 201900069824/111163 RIDWAN,TN LUSY E. Dr.Sp.PD OU00028 Ursodeoxycholic Acid 20.00 Tablet 9,147.60 183,452.00
R2019-0000072807 13-12-2019 201900069824/111163 RIDWAN,TN LUSY E. Dr.Sp.PD OB00050 Braxidin 10.00 Tablet 1,648.35 16,983.50
R2019-0000072808 13-12-2019 201900069855/080242 RUSMILA SARI,NY Nafon Zaitun, Dr. OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000072808 13-12-2019 201900069855/080242 RUSMILA SARI,NY Nafon Zaitun, Dr. OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000072808 13-12-2019 201900069855/080242 RUSMILA SARI,NY Nafon Zaitun, Dr. OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000072808 13-12-2019 201900069855/080242 RUSMILA SARI,NY Nafon Zaitun, Dr. OE00008 Elkana Tablet 7.00 Tablet 1,247.40 9,231.80
R2019-0000072809 13-12-2019 201900069826/111868 RAHMAWATI,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072809 13-12-2019 201900069826/111868 RAHMAWATI,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000072810 13-12-2019 201900069865/069091 KURNIA,NN LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000072816 13-12-2019 201900069876/111889 AXEL D ZAKWAN,AN Niki Juniar OA00106 Asam Mefenamat 500mg 3.00 Tablet 415.80 1,747.40
R2019-0000072816 13-12-2019 201900069876/111889 AXEL D ZAKWAN,AN Niki Juniar OA00066 Amoxicillin Tablet, 500mg 3.00 Tablet 1,113.75 3,841.25
R2019-0000072816 13-12-2019 201900069876/111889 AXEL D ZAKWAN,AN Niki Juniar OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000072822 13-12-2019 201900069832/022687 SURIANSYAH LUSY E. Dr.Sp.PD OA00038 Allopurinol 300mg (OGB) 23.00 Tablet 580.00 13,840.00
R2019-0000072821 13-12-2019 201900069869/108735 SALMIAH,NY LUSY E. Dr.Sp.PD OM00045 Methyl Prednisolon 4mg 16.00 Tablet 792.99 13,187.84
R2019-0000072821 13-12-2019 201900069869/108735 SALMIAH,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000072821 13-12-2019 201900069869/108735 SALMIAH,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
Total 162,319,692.68
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 120 dari 266
ASAL RAWAT JALAN
R2019-0000072824 13-12-2019 201900069864/107867 ENDANG LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 14.00 Capsul 1,169.98 16,879.72
R2019-0000072824 13-12-2019 201900069864/107867 ENDANG LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072826 13-12-2019 201900069859/075346 ERWIN LINGGI LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072826 13-12-2019 201900069859/075346 ERWIN LINGGI LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072826 13-12-2019 201900069859/075346 ERWIN LINGGI LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000072827 13-12-2019 201900069849/111886 YOHANA BUNGIN,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 20.00 Tablet 371.25 7,925.00
R2019-0000072827 13-12-2019 201900069849/111886 YOHANA BUNGIN,NY LUSY E. Dr.Sp.PD OG00021 Glimepiride 1mg Tablet 10.00 Tablet 1,245.00 12,950.00
R2019-0000072827 13-12-2019 201900069849/111886 YOHANA BUNGIN,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 10.00 Tablet 1,555.00 16,050.00
R2019-0000072827 13-12-2019 201900069849/111886 YOHANA BUNGIN,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 10.00 Tablet 10,617.75 106,677.50
R2019-0000072828 13-12-2019 201900069829/107103 ABDUL WAHAB,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000072828 13-12-2019 201900069829/107103 ABDUL WAHAB,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072828 13-12-2019 201900069829/107103 ABDUL WAHAB,TN LUSY E. Dr.Sp.PD OM00154 Mecobalamin 500mg 21.00 Tablet 1,118.00 23,978.00
R2019-0000072829 13-12-2019 201900069837/088193 I MADE SUYASA,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072829 13-12-2019 201900069837/088193 I MADE SUYASA,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072829 13-12-2019 201900069837/088193 I MADE SUYASA,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000072830 13-12-2019 201900069843/111671 ERNA,NY LUSY E. Dr.Sp.PD OL00107 Lisinopril 10mg (OGB) 3.00 Tablet 786.50 2,859.50
R2019-0000072831 13-12-2019 201900069832/022687 SURIANSYAH LUSY E. Dr.Sp.PD OA00038 Allopurinol 300mg (OGB) 7.00 Tablet 580.00 4,560.00
R2019-0000072831 13-12-2019 201900069832/022687 SURIANSYAH LUSY E. Dr.Sp.PD OG00057 Gabapentin 300mg (OGB) 4.00 Tablet 8,168.00 33,172.00
R2019-0000072831 13-12-2019 201900069832/022687 SURIANSYAH LUSY E. Dr.Sp.PD ALK00037 Kapsul No.1 10.00 pcs 200.00 9,500.00
R2019-0000072832 13-12-2019 201900069878/111891 AL TEDDY OC00255 Cendo Tobroson Eye Drop 1.00 Botol 68,681.25 69,181.25
R2019-0000072832 13-12-2019 201900069878/111891 AL TEDDY OC00300 Cendo Hyalub Minidose 1.00 Strip 84,645.00 85,145.00
R2019-0000072832 13-12-2019 201900069878/111891 AL TEDDY OM00045 Methyl Prednisolon 4mg 20.00 Tablet 792.99 16,359.80
R2019-0000072832 13-12-2019 201900069878/111891 AL TEDDY OS00079 Sirplus Granula 10.00 Granula 297.00 3,470.00
R2019-0000072832 13-12-2019 201900069878/111891 AL TEDDY ATKK031 Kertas Puyer Handbond 20.00 Sachet 207.90 19,158.00
R2019-0000072833 13-12-2019 201900069879/111892 EL DZAKWANSYAH,AN TEDDY OC00255 Cendo Tobroson Eye Drop 1.00 Botol 68,681.25 69,181.25
R2019-0000072833 13-12-2019 201900069879/111892 EL DZAKWANSYAH,AN TEDDY OC00300 Cendo Hyalub Minidose 1.00 Strip 84,645.00 85,145.00
R2019-0000072833 13-12-2019 201900069879/111892 EL DZAKWANSYAH,AN TEDDY OM00045 Methyl Prednisolon 4mg 20.00 Tablet 792.99 16,359.80
R2019-0000072833 13-12-2019 201900069879/111892 EL DZAKWANSYAH,AN TEDDY OS00079 Sirplus Granula 10.00 Granula 297.00 3,470.00
R2019-0000072833 13-12-2019 201900069879/111892 EL DZAKWANSYAH,AN TEDDY ATKK031 Kertas Puyer Handbond 20.00 Sachet 207.90 19,158.00
R2019-0000072835 13-12-2019 201900069877/111890 SUPARIYATI,NY TEDDY OC00255 Cendo Tobroson Eye Drop 1.00 Botol 68,681.25 69,181.25
R2019-0000072835 13-12-2019 201900069877/111890 SUPARIYATI,NY TEDDY OC00300 Cendo Hyalub Minidose 1.00 Strip 84,645.00 85,145.00
R2019-0000072835 13-12-2019 201900069877/111890 SUPARIYATI,NY TEDDY OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000072836 13-12-2019 201900069871/066788 TOHIR,TN TEDDY OC00264 Cendo Timol 0.5% ED 1.00 Botol 70,908.75 71,408.75
R2019-0000072836 13-12-2019 201900069871/066788 TOHIR,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072837 13-12-2019 201900069860/00012898 YANTO. M. SC,TN LUSY E. Dr.Sp.PD OG00025 Gliquidone 30mg (OGB) 14.00 Tablet 1,967.44 28,044.16
R2019-0000072837 13-12-2019 201900069860/00012898 YANTO. M. SC,TN LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
Total 163,634,007.36
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 121 dari 266
ASAL RAWAT JALAN
R2019-0000072837 13-12-2019 201900069860/00012898 YANTO. M. SC,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072837 13-12-2019 201900069860/00012898 YANTO. M. SC,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072838 13-12-2019 201900069862/061368 SUKARNI,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000072838 13-12-2019 201900069862/061368 SUKARNI,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000072839 13-12-2019 201900069963/111893 FITRIANA AJI,NY Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000072839 13-12-2019 201900069963/111893 FITRIANA AJI,NY Niki Juniar ALB00132 Blood Set 1.00 Pcs 33,976.80 34,476.80
R2019-0000072839 13-12-2019 201900069963/111893 FITRIANA AJI,NY Niki Juniar ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000072839 13-12-2019 201900069963/111893 FITRIANA AJI,NY Niki Juniar OI00115 Infus Otsu-MgSO4 40%, 1.00 Botol 10,692.00 11,192.00
R2019-0000072839 13-12-2019 201900069963/111893 FITRIANA AJI,NY Niki Juniar ALF00007 Folley Catheter No. 14 1.00 Pcs 37,125.00 37,625.00
R2019-0000072839 13-12-2019 201900069963/111893 FITRIANA AJI,NY Niki Juniar ALU00007 Urine Bag 1.00 Pcs 19,305.00 19,805.00
R2019-0000072839 13-12-2019 201900069963/111893 FITRIANA AJI,NY Niki Juniar OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000072839 13-12-2019 201900069963/111893 FITRIANA AJI,NY Niki Juniar OD00066 Dopamet 250mg Tablet 2.00 Tablet 2,776.95 6,053.90
R2019-0000072840 13-12-2019 201900069963/111893 FITRIANA AJI,NY Niki Juniar OD00030 Dexamethasone Injeksi 3.00 Ampul 4,502.52 14,007.56
R2019-0000072842 13-12-2019 201900069880/076035 DWI RAHAYU IRMA SARI OS00016 Sanadryl Expectoran 1.00 Botol 14,701.50 15,201.50
R2019-0000072842 13-12-2019 201900069880/076035 DWI RAHAYU IRMA SARI OI00134 Imunos Plus Tablet 10.00 Tablet 14,107.50 141,575.00
R2019-0000072842 13-12-2019 201900069880/076035 DWI RAHAYU IRMA SARI OA00161 Aloclair Spray 1.00 Botol 151,937.00 152,437.00
R2019-0000072846 13-12-2019 201900069884/42280 DJARMAN,TN Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072846 13-12-2019 201900069884/42280 DJARMAN,TN Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000072846 13-12-2019 201900069884/42280 DJARMAN,TN Dwi Astuti, dr OA00063 Amlodipin 10mg (OGB) 5.00 Tablet 2,743.00 14,215.00
R2019-0000072846 13-12-2019 201900069884/42280 DJARMAN,TN Dwi Astuti, dr OL00063 Lidocain HCl 2% Injeksi 2.00 Ampul 2,376.00 5,252.00
R2019-0000072847 13-12-2019 201900069896/111895 MUHAMMAD ILFAN IQBAL, dr OA00015 Acyclovir 400mg (OGB) 50.00 Tablet 1,262.25 63,612.50
R2019-0000072847 13-12-2019 201900069896/111895 MUHAMMAD ILFAN IQBAL, dr OC00057 Cerini 10.00 Tablet 5,093.55 51,435.50
R2019-0000072847 13-12-2019 201900069896/111895 MUHAMMAD ILFAN IQBAL, dr OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000072847 13-12-2019 201900069896/111895 MUHAMMAD ILFAN IQBAL, dr OA00016 Acyclovir Cream 5gr 2.00 Tube 4,893.00 10,286.00
R2019-0000072847 13-12-2019 201900069896/111895 MUHAMMAD ILFAN IQBAL, dr OI00134 Imunos Plus Tablet 10.00 Tablet 14,107.50 141,575.00
R2019-0000072848 13-12-2019 201900069900/109742 DAVID USMAN,TN IQBAL, dr OA00001 AB - Vask 10mg 30.00 Tablet 14,850.00 446,000.00
R2019-0000072848 13-12-2019 201900069900/109742 DAVID USMAN,TN IQBAL, dr OS00173 Simvastatin 20mg (OGB) 30.00 Tablet 1,782.00 53,960.00
R2019-0000072848 13-12-2019 201900069900/109742 DAVID USMAN,TN IQBAL, dr OC00057 Cerini 10.00 Tablet 5,093.55 51,435.50
R2019-0000072849 13-12-2019 201900069894/111451 FARZANA DELISHA Dwi Astuti, dr OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000072851 13-12-2019 201900069962/111882 MUSPITA SARI,NN Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000072851 13-12-2019 201900069962/111882 MUSPITA SARI,NN Niki Juniar ALB00132 Blood Set 1.00 Pcs 33,976.80 34,476.80
R2019-0000072851 13-12-2019 201900069962/111882 MUSPITA SARI,NN Niki Juniar ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000072850 13-12-2019 201900069863/111085 FITRIANSYAH NUR,TN Dwi Astuti, dr OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000072850 13-12-2019 201900069863/111085 FITRIANSYAH NUR,TN Dwi Astuti, dr OI00051 Infus Otsu-NS (NaCl 1.00 Botol 9,388.17 9,888.17
R2019-0000072852 13-12-2019 201900069964/38505 KARTIKA Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000072852 13-12-2019 201900069964/38505 KARTIKA Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 1.00 Tablet 415.80 915.80
R2019-0000072852 13-12-2019 201900069964/38505 KARTIKA Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000072852 13-12-2019 201900069964/38505 KARTIKA Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
Total 165,353,431.44
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 122 dari 266
ASAL RAWAT JALAN
R2019-0000072853 13-12-2019 201900069890/049979 ROZA IQBAL, dr OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000072853 13-12-2019 201900069890/049979 ROZA IQBAL, dr OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000072856 13-12-2019 201900069891/109275 RINI LIA SARI,NY Maulin Nikmah ALK00024 Korset TLSO (Thoraco 1.00 Pcs 455,000.00 455,500.00
R2019-0000072867 13-12-2019 201900069880/076035 DWI RAHAYU IQBAL, dr OR00041 Rhinos SR Capsul 10.00 Capsul 9,581.00 96,310.00
R2019-0000072870 13-12-2019 201900069923/111900 HAGES FAZA ASSA,TN Nathalia dr. OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000072870 13-12-2019 201900069923/111900 HAGES FAZA ASSA,TN Nathalia dr. OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000072870 13-12-2019 201900069923/111900 HAGES FAZA ASSA,TN Nathalia dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000072872 13-12-2019 201900069852/097053 NURUL KAMALIAH Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000072872 13-12-2019 201900069852/097053 NURUL KAMALIAH Ismail dr. Msc. OF00061 Fluconazole Tablet, 2.00 Tablet 32,670.00 65,840.00
R2019-0000072872 13-12-2019 201900069852/097053 NURUL KAMALIAH Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000072872 13-12-2019 201900069852/097053 NURUL KAMALIAH Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000072872 13-12-2019 201900069852/097053 NURUL KAMALIAH Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000072873 13-12-2019 201900069918/110058 FEYSI CLAYDIA Nathalia dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000072874 13-12-2019 201900069909/085254 SRI FITRIAH,NY Nathalia dr. OV00080 Vitamin B Compleks 10.00 Tablet 241.79 2,917.90
R2019-0000072874 13-12-2019 201900069909/085254 SRI FITRIAH,NY Nathalia dr. OC00096 Codein 10mg 10.00 Tablet 924.80 9,748.00
R2019-0000072874 13-12-2019 201900069909/085254 SRI FITRIAH,NY Nathalia dr. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000072874 13-12-2019 201900069909/085254 SRI FITRIAH,NY Nathalia dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072875 13-12-2019 201900069919/107331 M. SYAHRIL,TN Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000072875 13-12-2019 201900069919/107331 M. SYAHRIL,TN Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000072875 13-12-2019 201900069919/107331 M. SYAHRIL,TN Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000072875 13-12-2019 201900069919/107331 M. SYAHRIL,TN Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000072875 13-12-2019 201900069919/107331 M. SYAHRIL,TN Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000072876 13-12-2019 201900069914/111898 ADZKIYA NUR Ismail dr. Msc. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000072876 13-12-2019 201900069914/111898 ADZKIYA NUR Ismail dr. Msc. GK003 Ketoconazole Cream 10 1.00 Tube 8,019.00 8,519.00
R2019-0000072876 13-12-2019 201900069914/111898 ADZKIYA NUR Ismail dr. Msc. OH00026 Hydrocortis on Cream 2.00 Tube 11,880.00 24,260.00
R2019-0000072876 13-12-2019 201900069914/111898 ADZKIYA NUR Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000072877 13-12-2019 201900069901/090606 SUKARTI,NY Maulin Nikmah OL00080 Loratadin 10mg (OGB) 3.00 Tablet 520.00 2,060.00
R2019-0000072878 13-12-2019 201900070071/111896 EKA PUTRI Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000072878 13-12-2019 201900070071/111896 EKA PUTRI Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000072878 13-12-2019 201900070071/111896 EKA PUTRI Dwi Astuti, dr ALB00132 Blood Set 1.00 Pcs 33,976.80 34,476.80
R2019-0000072879 13-12-2019 201900069895/051225 YITNO,TN DYAH, dr Sp. OB00094 Berotec MDI 1.00 Botol 130,000.00 130,500.00
R2019-0000072879 13-12-2019 201900069895/051225 YITNO,TN DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000072879 13-12-2019 201900069895/051225 YITNO,TN DYAH, dr Sp. OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000072880 13-12-2019 201900069935/079256 TITO FAIZAL,TN DYAH, dr Sp. OS00185 Symbicort Turbuhaler 1.00 botol 412,776.54 413,276.54
R2019-0000072880 13-12-2019 201900069935/079256 TITO FAIZAL,TN DYAH, dr Sp. OB00094 Berotec MDI 1.00 Botol 130,000.00 130,500.00
R2019-0000072893 13-12-2019 201900069948/111901 AGUS FIRMANSYAH,TN Nathalia dr. OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000072893 13-12-2019 201900069948/111901 AGUS FIRMANSYAH,TN Nathalia dr. OL00108 Lexatrans 500mg 10.00 Tablet 1,871.00 19,210.00
R2019-0000072894 13-12-2019 201900069951/111903 BURHANUDDIN,TN Nathalia dr. OF00084 Forumen Ear Drop 1.00 Botol 37,941.75 38,441.75
Total 167,399,175.41
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 123 dari 266
ASAL RAWAT JALAN
R2019-0000072895 13-12-2019 201900069950/111902 AYLA SHAKILA DARA Nathalia dr. OS00009 Salbutamol 2mg (OGB) 10.00 Tablet 213.30 2,633.00
R2019-0000072895 13-12-2019 201900069950/111902 AYLA SHAKILA DARA Nathalia dr. OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000072895 13-12-2019 201900069950/111902 AYLA SHAKILA DARA Nathalia dr. OC00132 CTM 4mg 10.00 Tablet 157.41 2,074.10
R2019-0000072895 13-12-2019 201900069950/111902 AYLA SHAKILA DARA Nathalia dr. OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000072895 13-12-2019 201900069950/111902 AYLA SHAKILA DARA Nathalia dr. ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000072896 13-12-2019 201900069949/073625 FARAH AULIA,AN Nathalia dr. OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
R2019-0000072896 13-12-2019 201900069949/073625 FARAH AULIA,AN Nathalia dr. OC00132 CTM 4mg 4.00 Tablet 157.41 1,129.64
R2019-0000072896 13-12-2019 201900069949/073625 FARAH AULIA,AN Nathalia dr. OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000072896 13-12-2019 201900069949/073625 FARAH AULIA,AN Nathalia dr. ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000072896 13-12-2019 201900069949/073625 FARAH AULIA,AN Nathalia dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000072896 13-12-2019 201900069949/073625 FARAH AULIA,AN Nathalia dr. OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000072897 13-12-2019 201900069940/111405 YOHANA MINGGU,NY Hendra Dr, Sp. OE00008 Elkana Tablet 7.00 Tablet 1,247.40 9,231.80
R2019-0000072897 13-12-2019 201900069940/111405 YOHANA MINGGU,NY Hendra Dr, Sp. OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000072898 13-12-2019 201900069945/080658 NELLI PUSPAYANTI Hendra Dr, Sp. OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000072898 13-12-2019 201900069945/080658 NELLI PUSPAYANTI Hendra Dr, Sp. OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000072899 13-12-2019 201900069881/103300 MARDIAH,NY DYAH, dr Sp. OL00021 Lansoprazole (OGB) 7.00 Capsul 2,230.00 16,110.00
R2019-0000072900 13-12-2019 201900069935/079256 TITO FAIZAL,TN DYAH, dr Sp. OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000072900 13-12-2019 201900069935/079256 TITO FAIZAL,TN DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000072901 13-12-2019 201900069916/029158 AJI MA'RIFAT,TN Hendra Dr, Sp. OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000072905 13-12-2019 201900069906/110590 SALBIYAH,NY Hendra Dr, Sp. OE00008 Elkana Tablet 7.00 Tablet 1,247.40 9,231.80
R2019-0000072905 13-12-2019 201900069906/110590 SALBIYAH,NY Hendra Dr, Sp. OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000072906 13-12-2019 201900069946/111870 WIMALA GENTARI AZ Nathalia dr. OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000072906 13-12-2019 201900069946/111870 WIMALA GENTARI AZ Nathalia dr. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000072907 13-12-2019 201900069931/104968 RINJANI RISTA Nathalia dr. OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000072907 13-12-2019 201900069931/104968 RINJANI RISTA Nathalia dr. OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000072907 13-12-2019 201900069931/104968 RINJANI RISTA Nathalia dr. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000072907 13-12-2019 201900069931/104968 RINJANI RISTA Nathalia dr. OV00080 Vitamin B Compleks 10.00 Tablet 241.79 2,917.90
R2019-0000072913 13-12-2019 201900069952/080376 FAJRI ISNAINI Nathalia dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000072913 13-12-2019 201900069952/080376 FAJRI ISNAINI Nathalia dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000072913 13-12-2019 201900069952/080376 FAJRI ISNAINI Nathalia dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000072913 13-12-2019 201900069952/080376 FAJRI ISNAINI Nathalia dr. ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000072914 13-12-2019 201900069954/111905 SITI ASIA,NY Nathalia dr. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000072914 13-12-2019 201900069954/111905 SITI ASIA,NY Nathalia dr. OV00080 Vitamin B Compleks 10.00 Tablet 241.79 2,917.90
R2019-0000072914 13-12-2019 201900069954/111905 SITI ASIA,NY Nathalia dr. OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000072915 13-12-2019 201900069953/111904 AZIZAH NOOR Nathalia dr. OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000072915 13-12-2019 201900069953/111904 AZIZAH NOOR Nathalia dr. OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000072916 13-12-2019 201900069931/104968 RINJANI RISTA Nathalia dr. OP00011 Paracetamol 500mg 1.00 Tablet 387.36 887.36
R2019-0000072917 13-12-2019 201900069918/110058 FEYSI CLAYDIA Nathalia dr. OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
Total 167,812,645.54
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 124 dari 266
ASAL RAWAT JALAN
R2019-0000072918 13-12-2019 201900069948/111901 AGUS FIRMANSYAH,TN Nathalia dr. OA00108 Asam Traneksamat 1.00 Ampul 14,850.00 15,350.00
R2019-0000072918 13-12-2019 201900069948/111901 AGUS FIRMANSYAH,TN Nathalia dr. OV00088 Vitamin K Injeksi 10 1.00 Ampul 7,100.00 7,600.00
R2019-0000072918 13-12-2019 201900069948/111901 AGUS FIRMANSYAH,TN Nathalia dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000072918 13-12-2019 201900069948/111901 AGUS FIRMANSYAH,TN Nathalia dr. OI00097 Isosorbide Dinitrate 5mg 2.00 Tablet 311.85 1,123.70
R2019-0000072918 13-12-2019 201900069948/111901 AGUS FIRMANSYAH,TN Nathalia dr. OE00021 Epinephrine Injeksi 0.1% 1.00 Ampul 9,033.25 9,533.25
R2019-0000072918 13-12-2019 201900069948/111901 AGUS FIRMANSYAH,TN Nathalia dr. OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 Botol 22,542.30 23,042.30
R2019-0000072918 13-12-2019 201900069948/111901 AGUS FIRMANSYAH,TN Nathalia dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000072929 14-12-2019 201900069961/111908 IDA HAMIDAH,NY Niki Juniar OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000072929 14-12-2019 201900069961/111908 IDA HAMIDAH,NY Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000072930 14-12-2019 201900069961/111908 IDA HAMIDAH,NY Niki Juniar OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072930 14-12-2019 201900069961/111908 IDA HAMIDAH,NY Niki Juniar OL00041 Lasgan Capsul 10.00 Capsul 21,000.00 210,500.00
R2019-0000072930 14-12-2019 201900069961/111908 IDA HAMIDAH,NY Niki Juniar OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000072931 14-12-2019 201900069961/111908 IDA HAMIDAH,NY Niki Juniar ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000072931 14-12-2019 201900069961/111908 IDA HAMIDAH,NY Niki Juniar ALI00006 I.V Catheter No. 24 2.00 Pcs 38,900.00 78,300.00
R2019-0000072932 14-12-2019 201900069966/111909 WULAN Niki Juniar OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072932 14-12-2019 201900069966/111909 WULAN Niki Juniar OL00041 Lasgan Capsul 10.00 Capsul 21,000.00 210,500.00
R2019-0000072932 14-12-2019 201900069966/111909 WULAN Niki Juniar OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000072932 14-12-2019 201900069966/111909 WULAN Niki Juniar OT00107 Topazol Injeksi, 40mg 1.00 Vial 218,295.00 218,795.00
R2019-0000072932 14-12-2019 201900069966/111909 WULAN Niki Juniar ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000072934 14-12-2019 201900069960/096207 ALIF SAPUTRA,AN Niki Juniar OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000072927 13-12-2019 201900069956/111906 ALTHAFAREZ Niki Juniar OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000072935 14-12-2019 201900069960/096207 ALIF SAPUTRA,AN Niki Juniar OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000072935 14-12-2019 201900069960/096207 ALIF SAPUTRA,AN Niki Juniar OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000072935 14-12-2019 201900069960/096207 ALIF SAPUTRA,AN Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000072935 14-12-2019 201900069960/096207 ALIF SAPUTRA,AN Niki Juniar ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 12,079.00
R2019-0000072935 14-12-2019 201900069960/096207 ALIF SAPUTRA,AN Niki Juniar OZ00005 Zinc Tablet (OGB) 10.00 Tablet 1,000.00 10,500.00
R2019-0000072936 14-12-2019 201900069959/111907 BAMBANG IRAWAN,TN Niki Juniar OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000072936 14-12-2019 201900069959/111907 BAMBANG IRAWAN,TN Niki Juniar OB00007 Becom - C 3.00 Tablet 2,123.55 6,870.65
R2019-0000072936 14-12-2019 201900069959/111907 BAMBANG IRAWAN,TN Niki Juniar OA00180 Acetylcyst ein 200mg 6.00 Tablet 1,485.00 9,410.00
R2019-0000072936 14-12-2019 201900069959/111907 BAMBANG IRAWAN,TN Niki Juniar OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000072937 14-12-2019 201900069956/111906 ALTHAFAREZ Niki Juniar OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000072937 14-12-2019 201900069956/111906 ALTHAFAREZ Niki Juniar OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000072937 14-12-2019 201900069956/111906 ALTHAFAREZ Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000072937 14-12-2019 201900069956/111906 ALTHAFAREZ Niki Juniar ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 12,079.00
R2019-0000072938 14-12-2019 201900069955/073451 ELDWIN NUGRAHA Niki Juniar OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000072938 14-12-2019 201900069955/073451 ELDWIN NUGRAHA Niki Juniar OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000072938 14-12-2019 201900069955/073451 ELDWIN NUGRAHA Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000072938 14-12-2019 201900069955/073451 ELDWIN NUGRAHA Niki Juniar OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
Total 169,045,633.35
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 125 dari 266
ASAL RAWAT JALAN
R2019-0000072938 14-12-2019 201900069955/073451 ELDWIN NUGRAHA Niki Juniar ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 12,079.00
R2019-0000072944 14-12-2019 201900069985/097092 FELISHA QUEENA Niki Juniar OO00040 Oralit 200 10.00 Sachet 706.00 7,560.00
R2019-0000072944 14-12-2019 201900069985/097092 FELISHA QUEENA Niki Juniar OT00076 Tremenza Syrup 1.00 Botol 30,442.50 30,942.50
R2019-0000072944 14-12-2019 201900069985/097092 FELISHA QUEENA Niki Juniar OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000072944 14-12-2019 201900069985/097092 FELISHA QUEENA Niki Juniar OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000072950 14-12-2019 201900070013/111912 SITI MUSAROFAH,NY IQBAL, dr OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000072950 14-12-2019 201900070013/111912 SITI MUSAROFAH,NY IQBAL, dr OT00030 Teosal 10.00 Tablet 282.15 3,321.50
R2019-0000072950 14-12-2019 201900070013/111912 SITI MUSAROFAH,NY IQBAL, dr OS00016 Sanadryl Expectoran 1.00 Botol 14,701.50 15,201.50
R2019-0000072955 14-12-2019 201900070044/077209 NANDANG LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 23.00 Tablet 811.18 19,157.14
R2019-0000072956 14-12-2019 201900069982/099944 WATINAH,NY LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 3.00 Flexpen 226,917.80 681,253.40
R2019-0000072956 14-12-2019 201900069982/099944 WATINAH,NY LUSY E. Dr.Sp.PD OL00056 Levemir Insulin 2.00 Flexpen 287,330.88 575,161.76
R2019-0000072957 14-12-2019 201900069982/099944 WATINAH,NY LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000072957 14-12-2019 201900069982/099944 WATINAH,NY LUSY E. Dr.Sp.PD ALN00005 Needle Novo Twist 32G 2.00 Pcs 3,690.23 7,880.46
R2019-0000072952 14-12-2019 201900070061/111682 FARIDA,NY Herika dr. OA00052 Ambroxol Tablet, 30mg 6.00 Tablet 445.50 3,173.00
R2019-0000072952 14-12-2019 201900070061/111682 FARIDA,NY Herika dr. OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000072952 14-12-2019 201900070061/111682 FARIDA,NY Herika dr. OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000072952 14-12-2019 201900070061/111682 FARIDA,NY Herika dr. OB00017 Betametason Cream 1.00 Tube 7,276.50 7,776.50
R2019-0000072952 14-12-2019 201900070061/111682 FARIDA,NY Herika dr. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000072952 14-12-2019 201900070061/111682 FARIDA,NY Herika dr. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000072966 14-12-2019 201900069987/086494 PUTRI AHDA LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000072966 14-12-2019 201900069987/086494 PUTRI AHDA LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072966 14-12-2019 201900069987/086494 PUTRI AHDA LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000072966 14-12-2019 201900069987/086494 PUTRI AHDA LUSY E. Dr.Sp.PD OP00184 Neo Protifed Tablet 10.00 Tablet 1,263.73 13,137.30
R2019-0000072965 14-12-2019 201900069975/111910 PUSPARIYANTI,NY LUSY E. Dr.Sp.PD OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000072965 14-12-2019 201900069975/111910 PUSPARIYANTI,NY LUSY E. Dr.Sp.PD OU00022 Urotractin 400mg Tablet 15.00 Tablet 7,189.03 108,335.45
R2019-0000072965 14-12-2019 201900069975/111910 PUSPARIYANTI,NY LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000072967 14-12-2019 201900069983/077209 NANDANG LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 7.00 Tablet 811.18 6,178.26
R2019-0000072968 14-12-2019 201900070037/111043 UTAMI TAMBAH MAGDA ROSSA, OC00034 Cefadroxil 500mg (OGB) 12.00 Capsul 1,633.50 20,102.00
R2019-0000072968 14-12-2019 201900070037/111043 UTAMI TAMBAH MAGDA ROSSA, OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072969 14-12-2019 201900070016/099387 MEISKE OLGA Herika dr. OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000072969 14-12-2019 201900070016/099387 MEISKE OLGA Herika dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072970 14-12-2019 201900070028/020466 WAHYUNI,NY Herika dr. OT00063 Tramadol 50mg Tablet 6.00 Tablet 1,113.75 7,182.50
R2019-0000072970 14-12-2019 201900070028/020466 WAHYUNI,NY Herika dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072972 14-12-2019 201900070054/088935 YENNY BURHAN,NY Herika dr. OB00050 Braxidin 4.00 Tablet 1,648.35 7,093.40
R2019-0000072972 14-12-2019 201900070054/088935 YENNY BURHAN,NY Herika dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000072974 14-12-2019 201900069996/015249 ANISA LUTFIANI,NY Herika dr. OA00085 Antasida Tablet (OGB) 6.00 Tablet 284.30 2,205.80
R2019-0000072974 14-12-2019 201900069996/015249 ANISA LUTFIANI,NY Herika dr. OF00065 Flunarizine 5mg 4.00 Tablet 2,970.00 12,380.00
R2019-0000072974 14-12-2019 201900069996/015249 ANISA LUTFIANI,NY Herika dr. OB00016 Betahistine Mesilat 6mg 6.00 Tablet 1,500.00 9,500.00
Total 171,139,772.10
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 126 dari 266
ASAL RAWAT JALAN
R2019-0000072975 14-12-2019 201900070002/111756 INDRA DWI EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000072975 14-12-2019 201900070002/111756 INDRA DWI EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000072975 14-12-2019 201900070002/111756 INDRA DWI EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000072975 14-12-2019 201900070002/111756 INDRA DWI EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000072976 14-12-2019 201900069997/097986 KASIUNAH,NY Herika dr. OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000072976 14-12-2019 201900069997/097986 KASIUNAH,NY Herika dr. OA00063 Amlodipin 10mg (OGB) 2.00 Tablet 2,743.00 5,986.00
R2019-0000072977 14-12-2019 201900069998/099305 SAYED MUQSITH Herika dr. OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000072977 14-12-2019 201900069998/099305 SAYED MUQSITH Herika dr. OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000072977 14-12-2019 201900069998/099305 SAYED MUQSITH Herika dr. OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
R2019-0000072979 14-12-2019 201900070024/110617 KUSTINI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 60.00 Tablet 371.25 22,775.00
R2019-0000072979 14-12-2019 201900070024/110617 KUSTINI,NY LUSY E. Dr.Sp.PD OT00148 Tablet Tambah Darah 30.00 Tablet 742.00 22,760.00
R2019-0000072979 14-12-2019 201900070024/110617 KUSTINI,NY LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 30.00 Tablet 206.41 6,692.30
R2019-0000072980 14-12-2019 201900070026/097550 LELY,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000072980 14-12-2019 201900070026/097550 LELY,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000072980 14-12-2019 201900070026/097550 LELY,NY LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 23.00 Tablet 2,525.00 58,575.00
R2019-0000072980 14-12-2019 201900070026/097550 LELY,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 46.00 Tablet 371.25 17,577.50
R2019-0000072981 14-12-2019 201900070020/111708 M SYAFI'IE HASAN,TN LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 7.00 Tablet 2,525.00 18,175.00
R2019-0000072981 14-12-2019 201900070020/111708 M SYAFI'IE HASAN,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000072981 14-12-2019 201900070020/111708 M SYAFI'IE HASAN,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072981 14-12-2019 201900070020/111708 M SYAFI'IE HASAN,TN LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000072981 14-12-2019 201900070020/111708 M SYAFI'IE HASAN,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072981 14-12-2019 201900070020/111708 M SYAFI'IE HASAN,TN LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000072983 14-12-2019 201900070015/111913 AGUS HARTONO,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 10.00 Tablet 371.25 4,212.50
R2019-0000072983 14-12-2019 201900070015/111913 AGUS HARTONO,TN LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000072984 14-12-2019 201900070014/105138 IDA SUSANTI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000072984 14-12-2019 201900070014/105138 IDA SUSANTI,NY LUSY E. Dr.Sp.PD OG00021 Glimepiride 1mg Tablet 7.00 Tablet 1,245.00 9,215.00
R2019-0000072984 14-12-2019 201900070014/105138 IDA SUSANTI,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000072984 14-12-2019 201900070014/105138 IDA SUSANTI,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000072984 14-12-2019 201900070014/105138 IDA SUSANTI,NY LUSY E. Dr.Sp.PD OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000072985 14-12-2019 201900069994/062887 SRI RAHMAWATI,NY LUSY E. Dr.Sp.PD OL00107 Lisinopril 10mg (OGB) 5.00 Tablet 786.50 4,432.50
R2019-0000072985 14-12-2019 201900069994/062887 SRI RAHMAWATI,NY LUSY E. Dr.Sp.PD OA00086 Antihemoroid Supositoria 3.00 Suppo 4,975.00 15,425.00
R2019-0000072986 14-12-2019 201900070078/111824 NISHA RAZAQ,AN Herika dr. ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000072986 14-12-2019 201900070078/111824 NISHA RAZAQ,AN Herika dr. ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000072982 14-12-2019 201900070026/097550 LELY,NY Ismail dr. Msc. OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
Total 172,126,946.15
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 127 dari 266
ASAL RAWAT JALAN
R2019-0000072982 14-12-2019 201900070026/097550 LELY,NY Ismail dr. Msc. OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072982 14-12-2019 201900070026/097550 LELY,NY Ismail dr. Msc. OG00022 Glimepiride 2mg Tablet 7.00 Tablet 2,525.00 18,175.00
R2019-0000072982 14-12-2019 201900070026/097550 LELY,NY Ismail dr. Msc. OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000072989 14-12-2019 201900070000/052156 MUNASRI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000072989 14-12-2019 201900070000/052156 MUNASRI,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000072989 14-12-2019 201900070000/052156 MUNASRI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072989 14-12-2019 201900070000/052156 MUNASRI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072988 14-12-2019 201900070062/111781 FELICYA SITORUS,AN FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 3.00 Capsul 28,957.00 87,371.00
R2019-0000072988 14-12-2019 201900070062/111781 FELICYA SITORUS,AN FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 3.00 Tablet 430.65 1,791.95
R2019-0000072988 14-12-2019 201900070062/111781 FELICYA SITORUS,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000072988 14-12-2019 201900070062/111781 FELICYA SITORUS,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000072988 14-12-2019 201900070062/111781 FELICYA SITORUS,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000072990 14-12-2019 201900070053/095218 BADZLINA ALMEER FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 3.00 Capsul 28,957.00 87,371.00
R2019-0000072990 14-12-2019 201900070053/095218 BADZLINA ALMEER FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 3.00 Tablet 430.65 1,791.95
R2019-0000072990 14-12-2019 201900070053/095218 BADZLINA ALMEER FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000072990 14-12-2019 201900070053/095218 BADZLINA ALMEER FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 3.00 Tablet 1,232.55 4,197.65
R2019-0000072990 14-12-2019 201900070053/095218 BADZLINA ALMEER FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000072990 14-12-2019 201900070053/095218 BADZLINA ALMEER FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000072990 14-12-2019 201900070053/095218 BADZLINA ALMEER FREDRIK, Dr,Sp.A OA00093 Apialys Drop 1.00 Botol 59,400.00 59,900.00
R2019-0000072987 14-12-2019 201900070066/090023 JASMINE RATU NOVIANA, Dr. Sp OC00144 Cefila Capsul, 100mg 4.00 Capsul 28,957.00 116,328.00
R2019-0000072987 14-12-2019 201900070066/090023 JASMINE RATU NOVIANA, Dr. Sp OC00120 Cortidex Tablet 4.00 Tablet 430.65 2,222.60
R2019-0000072987 14-12-2019 201900070066/090023 JASMINE RATU NOVIANA, Dr. Sp OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000072987 14-12-2019 201900070066/090023 JASMINE RATU NOVIANA, Dr. Sp OM00100 Mucera Tablet 4.00 Tablet 1,782.00 7,628.00
R2019-0000072987 14-12-2019 201900070066/090023 JASMINE RATU NOVIANA, Dr. Sp OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000072987 14-12-2019 201900070066/090023 JASMINE RATU NOVIANA, Dr. Sp ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000072987 14-12-2019 201900070066/090023 JASMINE RATU NOVIANA, Dr. Sp OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000072987 14-12-2019 201900070066/090023 JASMINE RATU NOVIANA, Dr. Sp OB00002 Baquinor Eye Drop 0.3%, 1.00 Botol 50,267.25 50,767.25
R2019-0000072991 14-12-2019 201900070073/037193 ZAYN NUR KANOWIT FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 6.00 Capsul 28,957.00 174,242.00
R2019-0000072991 14-12-2019 201900070073/037193 ZAYN NUR KANOWIT FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 5.00 Tablet 430.65 2,653.25
R2019-0000072991 14-12-2019 201900070073/037193 ZAYN NUR KANOWIT FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 5.00 Tablet 1,173.15 6,365.75
R2019-0000072991 14-12-2019 201900070073/037193 ZAYN NUR KANOWIT FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 5.00 Tablet 1,232.55 6,662.75
R2019-0000072991 14-12-2019 201900070073/037193 ZAYN NUR KANOWIT FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000072991 14-12-2019 201900070073/037193 ZAYN NUR KANOWIT FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 4.00 Sachet 200.20 20,800.80
R2019-0000072991 14-12-2019 201900070073/037193 ZAYN NUR KANOWIT FREDRIK, Dr,Sp.A OI00117 Imunos Plus Syrup, 60ml 1.00 Botol 136,620.00 137,120.00
R2019-0000072994 14-12-2019 201900070083/101521 ELANO KENZO FREDRIK, Dr,Sp.A OT00053 Tiriz Oral Drops 1.00 Botol 96,525.00 97,025.00
R2019-0000072993 14-12-2019 201900070077/078439 MUHAMMAD DHAVA FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 4.00 Capsul 28,957.00 116,328.00
R2019-0000072993 14-12-2019 201900070077/078439 MUHAMMAD DHAVA FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 3.00 Tablet 430.65 1,791.95
R2019-0000072993 14-12-2019 201900070077/078439 MUHAMMAD DHAVA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
Total 173,517,668.50
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 128 dari 266
ASAL RAWAT JALAN
R2019-0000072993 14-12-2019 201900070077/078439 MUHAMMAD DHAVA FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 3.00 Tablet 1,232.55 4,197.65
R2019-0000072993 14-12-2019 201900070077/078439 MUHAMMAD DHAVA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000072993 14-12-2019 201900070077/078439 MUHAMMAD DHAVA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000072993 14-12-2019 201900070077/078439 MUHAMMAD DHAVA FREDRIK, Dr,Sp.A OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000072995 14-12-2019 201900070070/111916 SYAHNAZWA ALAM,AN FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 3.00 Capsul 28,957.00 87,371.00
R2019-0000072995 14-12-2019 201900070070/111916 SYAHNAZWA ALAM,AN FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 2.00 Tablet 430.65 1,361.30
R2019-0000072995 14-12-2019 201900070070/111916 SYAHNAZWA ALAM,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 2.00 Tablet 1,173.15 2,846.30
R2019-0000072995 14-12-2019 201900070070/111916 SYAHNAZWA ALAM,AN FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 2.00 Tablet 1,232.55 2,965.10
R2019-0000072995 14-12-2019 201900070070/111916 SYAHNAZWA ALAM,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000072995 14-12-2019 201900070070/111916 SYAHNAZWA ALAM,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000072996 14-12-2019 201900070081/050680 RAFFA FAIZ FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 6.00 Capsul 28,957.00 174,242.00
R2019-0000072996 14-12-2019 201900070081/050680 RAFFA FAIZ FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 4.00 Tablet 430.65 2,222.60
R2019-0000072996 14-12-2019 201900070081/050680 RAFFA FAIZ FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000072996 14-12-2019 201900070081/050680 RAFFA FAIZ FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 5.00 Tablet 1,232.55 6,662.75
R2019-0000072996 14-12-2019 201900070081/050680 RAFFA FAIZ FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 5.00 Granula 297.00 1,985.00
R2019-0000072996 14-12-2019 201900070081/050680 RAFFA FAIZ FREDRIK, Dr,Sp.A OO00062 Ottopan Syrup, 60ml 1.00 Botol 29,700.00 30,200.00
R2019-0000072996 14-12-2019 201900070081/050680 RAFFA FAIZ FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 200.20 23,003.00
R2019-0000072996 14-12-2019 201900070081/050680 RAFFA FAIZ FREDRIK, Dr,Sp.A OI00117 Imunos Plus Syrup, 60ml 1.00 Botol 136,620.00 137,120.00
R2019-0000072997 14-12-2019 201900070031/105244 WAODE NUR LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000072997 14-12-2019 201900070031/105244 WAODE NUR LUSY E. Dr.Sp.PD OU00022 Urotractin 400mg Tablet 10.00 Tablet 7,189.03 72,390.30
R2019-0000072999 14-12-2019 201900070069/042381 SARMI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000072999 14-12-2019 201900070069/042381 SARMI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000072999 14-12-2019 201900070069/042381 SARMI,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000072999 14-12-2019 201900070069/042381 SARMI,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000072998 14-12-2019 201900070058/108526 RAMSINAH,NY LUSY E. Dr.Sp.PD OT00148 Tablet Tambah Darah 7.00 Tablet 742.00 5,694.00
R2019-0000072998 14-12-2019 201900070058/108526 RAMSINAH,NY LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 7.00 Tablet 206.41 1,944.87
R2019-0000072998 14-12-2019 201900070058/108526 RAMSINAH,NY LUSY E. Dr.Sp.PD OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000072998 14-12-2019 201900070058/108526 RAMSINAH,NY LUSY E. Dr.Sp.PD OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000073000 14-12-2019 201900070038/028351 NANANG HARIYADI,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000073000 14-12-2019 201900070038/028351 NANANG HARIYADI,TN LUSY E. Dr.Sp.PD OV00080 Vitamin B Compleks 10.00 Tablet 241.79 2,917.90
R2019-0000073001 14-12-2019 201900070074/111917 PARULIAN Herika dr. OA00106 Asam Mefenamat 500mg 6.00 Tablet 415.80 2,994.80
R2019-0000073001 14-12-2019 201900070074/111917 PARULIAN Herika dr. OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000073002 14-12-2019 201900070058/108526 RAMSINAH,NY LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 23.00 Tablet 206.41 5,247.43
R2019-0000073002 14-12-2019 201900070058/108526 RAMSINAH,NY LUSY E. Dr.Sp.PD OT00148 Tablet Tambah Darah 23.00 Tablet 742.00 17,566.00
R2019-0000073005 14-12-2019 201900069996/015249 ANISA LUTFIANI,NY Herika dr. OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000073005 14-12-2019 201900069996/015249 ANISA LUTFIANI,NY Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000073005 14-12-2019 201900069996/015249 ANISA LUTFIANI,NY Herika dr. OD00058 Dipenhydramine Injeksi 2.00 Ampul 2,517.23 5,534.46
R2019-0000073005 14-12-2019 201900069996/015249 ANISA LUTFIANI,NY Herika dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
Total 174,556,205.01
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 129 dari 266
ASAL RAWAT JALAN
R2019-0000073006 14-12-2019 201900070054/088935 YENNY BURHAN,NY Herika dr. OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000073006 14-12-2019 201900070054/088935 YENNY BURHAN,NY Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000073007 14-12-2019 201900070016/099387 MEISKE OLGA Herika dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000073007 14-12-2019 201900070016/099387 MEISKE OLGA Herika dr. ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000073008 14-12-2019 201900070074/111917 PARULIAN Herika dr. OA00125 ATS (Anti Tetanus 1.00 Ampul 222,750.00 223,250.00
R2019-0000073008 14-12-2019 201900070074/111917 PARULIAN Herika dr. OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000073008 14-12-2019 201900070074/111917 PARULIAN Herika dr. OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000073009 14-12-2019 201900070028/020466 WAHYUNI,NY Herika dr. OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000073010 14-12-2019 201900070087/022713 FIRLYANDA AKBAR,AN Herika dr. OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000073010 14-12-2019 201900070087/022713 FIRLYANDA AKBAR,AN Herika dr. OT00076 Tremenza Syrup 1.00 Botol 30,442.50 30,942.50
R2019-0000073010 14-12-2019 201900070087/022713 FIRLYANDA AKBAR,AN Herika dr. OM00099 Mucera Syrup 1.00 Botol 34,155.00 34,655.00
R2019-0000073010 14-12-2019 201900070087/022713 FIRLYANDA AKBAR,AN Herika dr. OA00070 Amoxsan Dry Syrup 1.00 Botol 33,412.50 33,912.50
R2019-0000073013 14-12-2019 201900070086/111919 HERU DWI Herika dr. OC00097 Codein 15mg 10.00 Tablet 1,665.87 17,158.70
R2019-0000073013 14-12-2019 201900070086/111919 HERU DWI Herika dr. OA00068 Amoxsan Capsul, 500mg 10.00 Capsul 4,752.00 48,020.00
R2019-0000073013 14-12-2019 201900070086/111919 HERU DWI Herika dr. OC00057 Cerini 10.00 Tablet 5,093.55 51,435.50
R2019-0000073013 14-12-2019 201900070086/111919 HERU DWI Herika dr. OE00018 Epexol Tablet 10.00 Tablet 1,232.55 12,825.50
R2019-0000073016 14-12-2019 201900070008/111771 ELKI KURNIAWAN,TN Eviwati OC00091 Clonidin 0.15mg (OGB) 1.00 Tablet 359.37 859.37
R2019-0000073017 14-12-2019 201900063099/110972 RICKY RIZAL Eviwati OC00091 Clonidin 0.15mg (OGB) 1.00 Tablet 359.37 859.37
R2019-0000073018 14-12-2019 201900070088/111920 KIKI PARAMITA,NN Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073018 14-12-2019 201900070088/111920 KIKI PARAMITA,NN Dwi Astuti, dr OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000073018 14-12-2019 201900070088/111920 KIKI PARAMITA,NN Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000073023 14-12-2019 201900070091/070918 SUAIBAH,NY Dwi Astuti, dr ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000073023 14-12-2019 201900070091/070918 SUAIBAH,NY Dwi Astuti, dr OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000073023 14-12-2019 201900070091/070918 SUAIBAH,NY Dwi Astuti, dr OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000073023 14-12-2019 201900070091/070918 SUAIBAH,NY Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000073023 14-12-2019 201900070091/070918 SUAIBAH,NY Dwi Astuti, dr OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000073032 14-12-2019 201900070094/106367 SAYEKTI KATARINA Dwi Astuti, dr OB00041 Boraginol - N Supositoria 5.00 Suppo 15,818.22 79,591.10
R2019-0000073032 14-12-2019 201900070094/106367 SAYEKTI KATARINA Dwi Astuti, dr OC00160 Codipront Cum 10.00 Capsul 19,305.00 193,550.00
R2019-0000073032 14-12-2019 201900070094/106367 SAYEKTI KATARINA Dwi Astuti, dr OA00043 Alprazolam 0,5mg (OGB) 5.00 Tablet 996.50 5,482.50
R2019-0000073032 14-12-2019 201900070094/106367 SAYEKTI KATARINA Dwi Astuti, dr OK00030 Ketricin Salep 0.1%, 5gr 1.00 Tube 66,825.00 67,325.00
R2019-0000073037 14-12-2019 201900070100/029061 ZAINAL DAHMAD Dwi Astuti, dr OC00144 Cefila Capsul, 100mg 10.00 Capsul 28,957.00 290,070.00
R2019-0000073037 14-12-2019 201900070100/029061 ZAINAL DAHMAD Dwi Astuti, dr OC00151 Codipront Capsul 10.00 Capsul 13,649.35 136,993.50
R2019-0000073037 14-12-2019 201900070100/029061 ZAINAL DAHMAD Dwi Astuti, dr OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000073037 14-12-2019 201900070100/029061 ZAINAL DAHMAD Dwi Astuti, dr OI00126 Interhistin 50mg, Tablet 5.00 Tablet 1,173.15 6,365.75
R2019-0000073037 14-12-2019 201900070100/029061 ZAINAL DAHMAD Dwi Astuti, dr OB00007 Becom - C 5.00 Tablet 2,123.55 11,117.75
R2019-0000073036 14-12-2019 201900070095/030863 TAUFIQ ZAKLY,AN Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 6.00 Tablet 415.80 2,994.80
R2019-0000073036 14-12-2019 201900070095/030863 TAUFIQ ZAKLY,AN Dwi Astuti, dr OM00045 Methyl Prednisolon 4mg 6.00 Tablet 792.99 5,257.94
R2019-0000073036 14-12-2019 201900070095/030863 TAUFIQ ZAKLY,AN Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
Total 176,342,803.46
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 130 dari 266
ASAL RAWAT JALAN
R2019-0000073040 14-12-2019 201900070105/111924 ELROY GEVARIEL Dwi Astuti, dr OA00030 Alco Drops 15ml 1.00 Botol 106,920.00 107,420.00
R2019-0000073038 14-12-2019 201900070106/12971 KUNTARI DWI N,NY Dwi Astuti, dr ALO00004 Opsite Post-Op 1.00 Pcs 71,500.00 72,000.00
R2019-0000073044 14-12-2019 201900070093/111922 KHALILA NUR Dwi Astuti, dr OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000073044 14-12-2019 201900070093/111922 KHALILA NUR Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000073043 14-12-2019 201900070097/40228 HENDRIYANI,NY Dwi Astuti, dr OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000073046 14-12-2019 201900070096/44585 ROMI YANTI,NY Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000073046 14-12-2019 201900070096/44585 ROMI YANTI,NY Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000073047 14-12-2019 201900070103/081298 NOVITA DEWI,NY Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000073047 14-12-2019 201900070103/081298 NOVITA DEWI,NY Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000073045 14-12-2019 201900070102/086103 WILLEM PALAR Dwi Astuti, dr ALP00056 Perban Elastis 3" 1.00 roll 29,700.00 30,200.00
R2019-0000073048 14-12-2019 201900070102/086103 WILLEM PALAR Dwi Astuti, dr OM00045 Methyl Prednisolon 4mg 6.00 Tablet 792.99 5,257.94
R2019-0000073048 14-12-2019 201900070102/086103 WILLEM PALAR Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 6.00 Tablet 415.80 2,994.80
R2019-0000073048 14-12-2019 201900070102/086103 WILLEM PALAR Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000073049 14-12-2019 201900070101/041973 SHOFI RAMADHANI,AN Dwi Astuti, dr OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000073049 14-12-2019 201900070101/041973 SHOFI RAMADHANI,AN Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000073049 14-12-2019 201900070101/041973 SHOFI RAMADHANI,AN Dwi Astuti, dr OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000073051 14-12-2019 201900070093/111922 KHALILA NUR Dwi Astuti, dr OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000073051 14-12-2019 201900070093/111922 KHALILA NUR Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 3.00 Tablet 1,113.75 3,841.25
R2019-0000073051 14-12-2019 201900070093/111922 KHALILA NUR Dwi Astuti, dr OS00180 Salfenal Forte Syrup 60 1.00 Botol 10,400.00 10,900.00
R2019-0000073050 14-12-2019 201900070092/111921 AMIRA,NY Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 5.00 Tablet 415.80 2,579.00
R2019-0000073050 14-12-2019 201900070092/111921 AMIRA,NY Dwi Astuti, dr OE00057 Eperisone Hcl 50mg 4.00 Tablet 2,286.90 9,647.60
R2019-0000073052 14-12-2019 201900070099/108021 LA ODE GUSFERLY Dwi Astuti, dr ON00009 Natrium Diklofenac 50mg 3.00 Tablet 955.84 3,367.52
R2019-0000073052 14-12-2019 201900070099/108021 LA ODE GUSFERLY Dwi Astuti, dr OE00057 Eperisone Hcl 50mg 4.00 Tablet 2,286.90 9,647.60
R2019-0000073053 14-12-2019 201900070098/111923 ALIA RUBBY Dwi Astuti, dr OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000073053 14-12-2019 201900070098/111923 ALIA RUBBY Dwi Astuti, dr OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000073054 14-12-2019 201900070096/44585 ROMI YANTI,NY Dwi Astuti, dr OS00009 Salbutamol 2mg (OGB) 6.00 Tablet 213.30 1,779.80
R2019-0000073054 14-12-2019 201900070096/44585 ROMI YANTI,NY Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000073054 14-12-2019 201900070096/44585 ROMI YANTI,NY Dwi Astuti, dr OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000073054 14-12-2019 201900070096/44585 ROMI YANTI,NY Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 6.00 Tablet 445.50 3,173.00
R2019-0000073054 14-12-2019 201900070096/44585 ROMI YANTI,NY Dwi Astuti, dr OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000073055 14-12-2019 201900070097/40228 HENDRIYANI,NY Dwi Astuti, dr OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000073055 14-12-2019 201900070097/40228 HENDRIYANI,NY Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073060 14-12-2019 201900070103/081298 NOVITA DEWI,NY Dwi Astuti, dr OM00102 Mucohexin Elixir, 120ml 1.00 Botol 24,354.00 24,854.00
R2019-0000073060 14-12-2019 201900070103/081298 NOVITA DEWI,NY Dwi Astuti, dr OF00039 FG Troches 6.00 Tablet 1,730.02 10,880.12
R2019-0000073061 14-12-2019 201900070109/111925 MARTO KAH,NY Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000073061 14-12-2019 201900070109/111925 MARTO KAH,NY Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000073061 14-12-2019 201900070109/111925 MARTO KAH,NY Dwi Astuti, dr OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000073061 14-12-2019 201900070109/111925 MARTO KAH,NY Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
Total 176,986,048.58
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 131 dari 266
ASAL RAWAT JALAN
R2019-0000073070 15-12-2019 201900070115/111928 RIZKI NURFADILAH,TN Niki Juniar OS00029 Sanmol Tablet, 500mg 8.00 Tablet 430.65 3,945.20
R2019-0000073070 15-12-2019 201900070115/111928 RIZKI NURFADILAH,TN Niki Juniar OI00134 Imunos Plus Tablet 5.00 Tablet 14,107.50 71,037.50
R2019-0000073081 15-12-2019 201900070127/100204 MUHAMMAD ANAR,TN Herika dr. OE00018 Epexol Tablet 10.00 Tablet 1,232.55 12,825.50
R2019-0000073081 15-12-2019 201900070127/100204 MUHAMMAD ANAR,TN Herika dr. OT00077 Tremenza Tablet 10.00 Tablet 2,160.68 22,106.80
R2019-0000073081 15-12-2019 201900070127/100204 MUHAMMAD ANAR,TN Herika dr. OI00133 Imunvit Plus Tablet 10.00 Tablet 13,365.00 134,150.00
R2019-0000073083 15-12-2019 201900070132/102364 NICOLAS DAVIN Herika dr. OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000073083 15-12-2019 201900070132/102364 NICOLAS DAVIN Herika dr. OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000073083 15-12-2019 201900070132/102364 NICOLAS DAVIN Herika dr. OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000073084 15-12-2019 201900070131/111930 WA EVA,NY Herika dr. OA00185 Akilen Ear Drop 1.00 Botol 90,139.50 90,639.50
R2019-0000073084 15-12-2019 201900070131/111930 WA EVA,NY Herika dr. OA00068 Amoxsan Capsul, 500mg 10.00 Capsul 4,752.00 48,020.00
R2019-0000073084 15-12-2019 201900070131/111930 WA EVA,NY Herika dr. OI00001 Ibuprofen 400mg (OGB) 6.00 Tablet 682.00 4,592.00
R2019-0000073085 15-12-2019 201900070130/097712 RIZQA SHOLEHAH,NN Herika dr. OA00068 Amoxsan Capsul, 500mg 4.00 Capsul 4,752.00 19,508.00
R2019-0000073085 15-12-2019 201900070130/097712 RIZQA SHOLEHAH,NN Herika dr. OA00180 Acetylcyst ein 200mg 10.00 Tablet 1,485.00 15,350.00
R2019-0000073085 15-12-2019 201900070130/097712 RIZQA SHOLEHAH,NN Herika dr. OC00039 Cefixime 100mg (OGB) 20.00 Capsul 4,266.70 85,834.00
R2019-0000073086 15-12-2019 201900070126/111929 AMELIA,NY Herika dr. OC00076 Ciprofloxacin 500mg 6.00 Tablet 1,039.50 6,737.00
R2019-0000073086 15-12-2019 201900070126/111929 AMELIA,NY Herika dr. OU00022 Urotractin 400mg Tablet 6.00 Tablet 7,189.03 43,634.18
R2019-0000073086 15-12-2019 201900070126/111929 AMELIA,NY Herika dr. OD00065 Domperidon Tablet (OGB) 10.00 Tablet 750.00 8,000.00
R2019-0000073086 15-12-2019 201900070126/111929 AMELIA,NY Herika dr. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000073087 15-12-2019 201900070125/106511 ESNA SITINJAK,NY Herika dr. OC00060 Cetirizine 10mg (OGB) 4.00 Tablet 623.70 2,994.80
R2019-0000073087 15-12-2019 201900070125/106511 ESNA SITINJAK,NY Herika dr. OA00106 Asam Mefenamat 500mg 6.00 Tablet 415.80 2,994.80
R2019-0000073087 15-12-2019 201900070125/106511 ESNA SITINJAK,NY Herika dr. OM00046 Methyl Prednisolon 8mg 6.00 Tablet 965.25 6,291.50
R2019-0000073088 15-12-2019 201900070137/083791 SHAFA SALSABILA,NN Herika dr. ALF00007 Folley Catheter No. 14 1.00 Pcs 37,125.00 37,625.00
R2019-0000073088 15-12-2019 201900070137/083791 SHAFA SALSABILA,NN Herika dr. ALU00007 Urine Bag 1.00 Pcs 19,305.00 19,805.00
R2019-0000073088 15-12-2019 201900070137/083791 SHAFA SALSABILA,NN Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000073089 15-12-2019 201900070138/111931 KUSNUL KOPIPAH,AN Herika dr. OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000073090 15-12-2019 201900070122/088142 ANNISA LATIFAH Herika dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000073090 15-12-2019 201900070122/088142 ANNISA LATIFAH Herika dr. OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000073090 15-12-2019 201900070122/088142 ANNISA LATIFAH Herika dr. OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000073090 15-12-2019 201900070122/088142 ANNISA LATIFAH Herika dr. OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000073090 15-12-2019 201900070122/088142 ANNISA LATIFAH Herika dr. OC00132 CTM 4mg 3.00 Tablet 157.41 972.23
R2019-0000073091 14-12-2019 201900070111/111926 SULISTIYAWATI,NY Dwi Astuti, dr OB00050 Braxidin 4.00 Tablet 1,648.35 7,093.40
R2019-0000073093 15-12-2019 201900070137/083791 SHAFA SALSABILA,NN Herika dr. OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000073094 15-12-2019 201900070141/111932 MARGARETA AMUR,NY Herika dr. OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000073095 15-12-2019 201900070138/111931 KUSNUL KOPIPAH,AN Herika dr. OM00099 Mucera Syrup 1.00 Botol 34,155.00 34,655.00
R2019-0000073095 15-12-2019 201900070138/111931 KUSNUL KOPIPAH,AN Herika dr. OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000073095 15-12-2019 201900070138/111931 KUSNUL KOPIPAH,AN Herika dr. OB00091 Biovitan Syrup, 60ml 1.00 Botol 8,019.00 8,519.00
R2019-0000073095 15-12-2019 201900070138/111931 KUSNUL KOPIPAH,AN Herika dr. OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000073095 15-12-2019 201900070138/111931 KUSNUL KOPIPAH,AN Herika dr. OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
Total 177,972,749.14
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 132 dari 266
ASAL RAWAT JALAN
R2019-0000073095 15-12-2019 201900070138/111931 KUSNUL KOPIPAH,AN Herika dr. OI00051 Infus Otsu-NS (NaCl 1.00 Botol 9,388.17 9,888.17
R2019-0000073096 15-12-2019 201900070140/110784 JIME DAENG JINTU,NY Herika dr. OF00065 Flunarizine 5mg 4.00 Tablet 2,970.00 12,380.00
R2019-0000073096 15-12-2019 201900070140/110784 JIME DAENG JINTU,NY Herika dr. OB00016 Betahistine Mesilat 6mg 6.00 Tablet 1,500.00 9,500.00
R2019-0000073096 15-12-2019 201900070140/110784 JIME DAENG JINTU,NY Herika dr. OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000073097 15-12-2019 201900070141/111932 MARGARETA AMUR,NY Herika dr. OT00063 Tramadol 50mg Tablet 10.00 Tablet 1,113.75 11,637.50
R2019-0000073097 15-12-2019 201900070141/111932 MARGARETA AMUR,NY Herika dr. OF00007 Farbion Tablet 10.00 Tablet 1,782.00 18,320.00
R2019-0000073097 15-12-2019 201900070141/111932 MARGARETA AMUR,NY Herika dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000073098 15-12-2019 201900070133/110535 SAPINGI,TN Herika dr. OS00173 Simvastatin 20mg (OGB) 2.00 Tablet 1,782.00 4,064.00
R2019-0000073098 15-12-2019 201900070133/110535 SAPINGI,TN Herika dr. OL00021 Lansoprazole (OGB) 4.00 Capsul 2,230.00 9,420.00
R2019-0000073098 15-12-2019 201900070133/110535 SAPINGI,TN Herika dr. OA00111 Aspilets Chawable 2.00 Tablet 811.35 2,122.70
R2019-0000073113 15-12-2019 201900070145/111933 RINI,NN Herika dr. OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000073113 15-12-2019 201900070145/111933 RINI,NN Herika dr. OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000073118 15-12-2019 201900070125/106511 ESNA SITINJAK,NY Herika dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000073119 15-12-2019 201900070140/110784 JIME DAENG JINTU,NY Herika dr. OD00058 Dipenhydramine Injeksi 2.00 Ampul 2,517.23 5,534.46
R2019-0000073119 15-12-2019 201900070140/110784 JIME DAENG JINTU,NY Herika dr. OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000073119 15-12-2019 201900070140/110784 JIME DAENG JINTU,NY Herika dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000073120 15-12-2019 201900070133/110535 SAPINGI,TN Herika dr. OC00019 Captopril 25mg (OGB) 1.00 Tablet 267.35 767.35
R2019-0000073120 15-12-2019 201900070133/110535 SAPINGI,TN Herika dr. OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000073122 15-12-2019 201900070148/099595 SINGGIH HENDRA,SDR Herika dr. OB00017 Betametason Cream 1.00 Tube 7,276.50 7,776.50
R2019-0000073122 15-12-2019 201900070148/099595 SINGGIH HENDRA,SDR Herika dr. OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000073122 15-12-2019 201900070148/099595 SINGGIH HENDRA,SDR Herika dr. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 19,000.00
R2019-0000073122 15-12-2019 201900070148/099595 SINGGIH HENDRA,SDR Herika dr. OO00022 Opicef 500mg Capsul 10.00 Capsul 14,850.00 149,000.00
R2019-0000073122 15-12-2019 201900070148/099595 SINGGIH HENDRA,SDR Herika dr. OI00126 Interhistin 50mg, Tablet 10.00 Tablet 1,173.15 12,231.50
R2019-0000073122 15-12-2019 201900070148/099595 SINGGIH HENDRA,SDR Herika dr. OM00046 Methyl Prednisolon 8mg 10.00 Tablet 965.25 10,152.50
R2019-0000073122 15-12-2019 201900070148/099595 SINGGIH HENDRA,SDR Herika dr. OC00053 Cendo Xitrol Salep Mata 1.00 Botol 53,274.37 53,774.37
R2019-0000073123 15-12-2019 201900070149/077936 SHERRA MAHSA Herika dr. OF00039 FG Troches 3.00 Tablet 1,730.02 5,690.06
R2019-0000073123 15-12-2019 201900070149/077936 SHERRA MAHSA Herika dr. OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000073125 15-12-2019 201900070150/071322 AHMAD FAIZI Herika dr. OA00071 Amoxsan Forte Dry Syrup 1.00 Botol 47,520.00 48,020.00
R2019-0000073125 15-12-2019 201900070150/071322 AHMAD FAIZI Herika dr. OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000073125 15-12-2019 201900070150/071322 AHMAD FAIZI Herika dr. OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000073125 15-12-2019 201900070150/071322 AHMAD FAIZI Herika dr. OM00099 Mucera Syrup 1.00 Botol 34,155.00 34,655.00
R2019-0000073125 15-12-2019 201900070150/071322 AHMAD FAIZI Herika dr. OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
R2019-0000073126 15-12-2019 201900070151/057226 MUHAMMAD RISAL,AN Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 3.00 Tablet 1,113.75 3,841.25
R2019-0000073126 15-12-2019 201900070151/057226 MUHAMMAD RISAL,AN Dwi Astuti, dr OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000073126 15-12-2019 201900070151/057226 MUHAMMAD RISAL,AN Dwi Astuti, dr OA00087 Antiza Syrup, 60ml 1.00 Botol 26,730.00 27,230.00
R2019-0000073128 15-12-2019 201900070152/101158 QUEENCY MINORI Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 3.00 Tablet 1,113.75 3,841.25
R2019-0000073128 15-12-2019 201900070152/101158 QUEENCY MINORI Dwi Astuti, dr OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000073128 15-12-2019 201900070152/101158 QUEENCY MINORI Dwi Astuti, dr OS00180 Salfenal Forte Syrup 60 1.00 Botol 10,400.00 10,900.00
Total 178,780,545.54
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 133 dari 266
ASAL RAWAT JALAN
R2019-0000073132 15-12-2019 201900070155/111934 DARMIATI,NY Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000073132 15-12-2019 201900070155/111934 DARMIATI,NY Dwi Astuti, dr OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000073132 15-12-2019 201900070155/111934 DARMIATI,NY Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000073132 15-12-2019 201900070155/111934 DARMIATI,NY Dwi Astuti, dr ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000073132 15-12-2019 201900070155/111934 DARMIATI,NY Dwi Astuti, dr OG00018 Gitas Injeksi 1ml 1.00 Ampul 38,201.62 38,701.62
R2019-0000073132 15-12-2019 201900070155/111934 DARMIATI,NY Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000073132 15-12-2019 201900070155/111934 DARMIATI,NY Dwi Astuti, dr OL00076 Lodia 2mg 2.00 Tablet 1,485.00 3,470.00
R2019-0000073132 15-12-2019 201900070155/111934 DARMIATI,NY Dwi Astuti, dr ON00047 New Diatabs 4.00 Tablet 767.13 3,568.52
R2019-0000073132 15-12-2019 201900070155/111934 DARMIATI,NY Dwi Astuti, dr OS00176 Scopma Plus Tablet 5.00 Tablet 2,090.22 10,951.10
R2019-0000073132 15-12-2019 201900070155/111934 DARMIATI,NY Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000073132 15-12-2019 201900070155/111934 DARMIATI,NY Dwi Astuti, dr OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000073132 15-12-2019 201900070155/111934 DARMIATI,NY Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 5.00 Tablet 415.80 2,579.00
R2019-0000073135 15-12-2019 201900070162/075582 MUHAMMAD RESKI Dwi Astuti, dr OS00098 Sporetik Dry Syrup 1.00 Botol 123,923.25 124,423.25
R2019-0000073135 15-12-2019 201900070162/075582 MUHAMMAD RESKI Dwi Astuti, dr OP00101 Proceles Syrup, 60ml 1.00 Botol 51,975.00 52,475.00
R2019-0000073135 15-12-2019 201900070162/075582 MUHAMMAD RESKI Dwi Astuti, dr OA00087 Antiza Syrup, 60ml 1.00 Botol 26,730.00 27,230.00
R2019-0000073135 15-12-2019 201900070162/075582 MUHAMMAD RESKI Dwi Astuti, dr OA00157 Apecur Syrup 1.00 Botol 51,975.00 52,475.00
R2019-0000073136 15-12-2019 201900070154/085013 HASTUTI,NY Dwi Astuti, dr OA00088 Antiza Tablet 5.00 Tablet 1,633.00 8,665.00
R2019-0000073136 15-12-2019 201900070154/085013 HASTUTI,NY Dwi Astuti, dr OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000073137 15-12-2019 201900070166/110766 ROY DIKI CANDRA,TN Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000073137 15-12-2019 201900070166/110766 ROY DIKI CANDRA,TN Dwi Astuti, dr OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000073137 15-12-2019 201900070166/110766 ROY DIKI CANDRA,TN Dwi Astuti, dr OL00076 Lodia 2mg 2.00 Tablet 1,485.00 3,470.00
R2019-0000073137 15-12-2019 201900070166/110766 ROY DIKI CANDRA,TN Dwi Astuti, dr ON00047 New Diatabs 4.00 Tablet 767.13 3,568.52
R2019-0000073137 15-12-2019 201900070166/110766 ROY DIKI CANDRA,TN Dwi Astuti, dr OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000073137 15-12-2019 201900070166/110766 ROY DIKI CANDRA,TN Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000073138 15-12-2019 201900070171/100744 SLAMET,TN Dwi Astuti, dr OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000073138 15-12-2019 201900070171/100744 SLAMET,TN Dwi Astuti, dr OE00018 Epexol Tablet 10.00 Tablet 1,232.55 12,825.50
R2019-0000073138 15-12-2019 201900070171/100744 SLAMET,TN Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000073138 15-12-2019 201900070171/100744 SLAMET,TN Dwi Astuti, dr OC00057 Cerini 5.00 Tablet 5,093.55 25,967.75
R2019-0000073138 15-12-2019 201900070171/100744 SLAMET,TN Dwi Astuti, dr OB00007 Becom - C 5.00 Tablet 2,123.55 11,117.75
R2019-0000073139 15-12-2019 201900070167/111937 CARO LINA Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000073139 15-12-2019 201900070167/111937 CARO LINA Dwi Astuti, dr OP00184 Neo Protifed Tablet 5.00 Tablet 1,263.73 6,818.65
R2019-0000073139 15-12-2019 201900070167/111937 CARO LINA Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000073139 15-12-2019 201900070167/111937 CARO LINA Dwi Astuti, dr OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000073141 15-12-2019 201900070168/111938 MAKMUR Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000073141 15-12-2019 201900070168/111938 MAKMUR Dwi Astuti, dr OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000073141 15-12-2019 201900070168/111938 MAKMUR Dwi Astuti, dr OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
R2019-0000073141 15-12-2019 201900070168/111938 MAKMUR Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000073146 15-12-2019 201900070175/088942 HADI HARIYANTO,TN Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
Total 179,497,321.67
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 134 dari 266
ASAL RAWAT JALAN
R2019-0000073146 15-12-2019 201900070175/088942 HADI HARIYANTO,TN Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000073146 15-12-2019 201900070175/088942 HADI HARIYANTO,TN Dwi Astuti, dr OB00050 Braxidin 5.00 Tablet 1,648.35 8,741.75
R2019-0000073148 15-12-2019 201900070192/038873 SELFI KRISNAWATI,NY Dwi Astuti, dr ON00051 Nifedipin 10mg (OGB) 1.00 Tablet 261.21 761.21
R2019-0000073153 15-12-2019 201900070178/102802 FITRAH DAVIDSON Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000073153 15-12-2019 201900070178/102802 FITRAH DAVIDSON Dwi Astuti, dr OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000073153 15-12-2019 201900070178/102802 FITRAH DAVIDSON Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000073153 15-12-2019 201900070178/102802 FITRAH DAVIDSON Dwi Astuti, dr OS00009 Salbutamol 2mg (OGB) 3.00 Tablet 213.30 1,139.90
R2019-0000073153 15-12-2019 201900070178/102802 FITRAH DAVIDSON Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000073153 15-12-2019 201900070178/102802 FITRAH DAVIDSON Dwi Astuti, dr OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000073153 15-12-2019 201900070178/102802 FITRAH DAVIDSON Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000073155 15-12-2019 201900070174/111940 DESI ISMA YUNITA,NY Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000073155 15-12-2019 201900070174/111940 DESI ISMA YUNITA,NY Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000073155 15-12-2019 201900070174/111940 DESI ISMA YUNITA,NY Dwi Astuti, dr OA00088 Antiza Tablet 5.00 Tablet 1,633.00 8,665.00
R2019-0000073155 15-12-2019 201900070174/111940 DESI ISMA YUNITA,NY Dwi Astuti, dr OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000073149 15-12-2019 201900070181/111943 JOHAN HENDARTO,TN Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000073149 15-12-2019 201900070181/111943 JOHAN HENDARTO,TN Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000073149 15-12-2019 201900070181/111943 JOHAN HENDARTO,TN Dwi Astuti, dr OI00051 Infus Otsu-NS (NaCl 1.00 Botol 9,388.17 9,888.17
R2019-0000073156 15-12-2019 201900070180/111942 BUDI SUSANTO,TN Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 5.00 Tablet 415.80 2,579.00
R2019-0000073156 15-12-2019 201900070180/111942 BUDI SUSANTO,TN Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000073158 15-12-2019 201900070161/091856 TITI SANTI,NY Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000073158 15-12-2019 201900070161/091856 TITI SANTI,NY Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 6.00 Tablet 415.80 2,994.80
R2019-0000073158 15-12-2019 201900070161/091856 TITI SANTI,NY Dwi Astuti, dr OA00085 Antasida Tablet (OGB) 5.00 Tablet 284.30 1,921.50
R2019-0000073158 15-12-2019 201900070161/091856 TITI SANTI,NY Dwi Astuti, dr OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000073159 15-12-2019 201900070182/099303 MARIA ULFA,NY Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000073159 15-12-2019 201900070182/099303 MARIA ULFA,NY Dwi Astuti, dr OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000073159 15-12-2019 201900070182/099303 MARIA ULFA,NY Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000073159 15-12-2019 201900070182/099303 MARIA ULFA,NY Dwi Astuti, dr OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2019-0000073160 15-12-2019 201900070184/00013099 RINI,NY Dwi Astuti, dr OM00017 Meloxicam 15mg (OGB) 5.00 Tablet 2,079.00 10,895.00
R2019-0000073160 15-12-2019 201900070184/00013099 RINI,NY Dwi Astuti, dr OM00154 Mecobalamin 500mg 3.00 Tablet 1,118.00 3,854.00
R2019-0000073161 15-12-2019 201900070186/13627 ANISA RIZKY Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000073161 15-12-2019 201900070186/13627 ANISA RIZKY Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073161 15-12-2019 201900070186/13627 ANISA RIZKY Dwi Astuti, dr OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000073164 15-12-2019 201900070185/110849 SALWA PUTRI Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000073164 15-12-2019 201900070185/110849 SALWA PUTRI Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000073164 15-12-2019 201900070185/110849 SALWA PUTRI Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000073164 15-12-2019 201900070185/110849 SALWA PUTRI Dwi Astuti, dr OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000073164 15-12-2019 201900070185/110849 SALWA PUTRI Dwi Astuti, dr OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000073164 15-12-2019 201900070185/110849 SALWA PUTRI Dwi Astuti, dr OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
Total 179,829,328.47
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 135 dari 266
ASAL RAWAT JALAN
R2019-0000073164 15-12-2019 201900070185/110849 SALWA PUTRI Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000073164 15-12-2019 201900070185/110849 SALWA PUTRI Dwi Astuti, dr OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000073166 15-12-2019 201900070190/111946 SABRINA NUR Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000073166 15-12-2019 201900070190/111946 SABRINA NUR Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000073166 15-12-2019 201900070190/111946 SABRINA NUR Dwi Astuti, dr OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000073166 15-12-2019 201900070190/111946 SABRINA NUR Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000073166 15-12-2019 201900070190/111946 SABRINA NUR Dwi Astuti, dr OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000073166 15-12-2019 201900070190/111946 SABRINA NUR Dwi Astuti, dr OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000073166 15-12-2019 201900070190/111946 SABRINA NUR Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000073166 15-12-2019 201900070190/111946 SABRINA NUR Dwi Astuti, dr OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000073167 15-12-2019 201900070189/111945 ADITYA NOFAL THRISIA dr. Sp OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000073167 15-12-2019 201900070189/111945 ADITYA NOFAL THRISIA dr. Sp OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000073167 15-12-2019 201900070189/111945 ADITYA NOFAL THRISIA dr. Sp OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000073167 15-12-2019 201900070189/111945 ADITYA NOFAL THRISIA dr. Sp OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000073167 15-12-2019 201900070189/111945 ADITYA NOFAL THRISIA dr. Sp OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000073167 15-12-2019 201900070189/111945 ADITYA NOFAL THRISIA dr. Sp OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000073167 15-12-2019 201900070189/111945 ADITYA NOFAL THRISIA dr. Sp ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 2,579.00
R2019-0000073167 15-12-2019 201900070189/111945 ADITYA NOFAL THRISIA dr. Sp OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000073169 15-12-2019 201900070161/091856 TITI SANTI,NY Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000073169 15-12-2019 201900070161/091856 TITI SANTI,NY Dwi Astuti, dr OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000073169 15-12-2019 201900070161/091856 TITI SANTI,NY Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000073170 15-12-2019 201900070218/111948 MUHAMMAD Dwi Astuti, dr OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000073170 15-12-2019 201900070218/111948 MUHAMMAD Dwi Astuti, dr ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000073170 15-12-2019 201900070218/111948 MUHAMMAD Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000073170 15-12-2019 201900070218/111948 MUHAMMAD Dwi Astuti, dr OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000073170 15-12-2019 201900070218/111948 MUHAMMAD Dwi Astuti, dr OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000073171 15-12-2019 201900070219/035045 ERAM,NY Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000073171 15-12-2019 201900070219/035045 ERAM,NY Dwi Astuti, dr ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000073171 15-12-2019 201900070219/035045 ERAM,NY Dwi Astuti, dr OI00051 Infus Otsu-NS (NaCl 1.00 Botol 9,388.17 9,888.17
R2019-0000073171 15-12-2019 201900070219/035045 ERAM,NY Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000073171 15-12-2019 201900070219/035045 ERAM,NY Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000073174 15-12-2019 201900070152/101158 QUEENCY MINORI Dwi Astuti, dr OE00056 Ecosol Nacl 0,9 % 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000073174 15-12-2019 201900070152/101158 QUEENCY MINORI Dwi Astuti, dr OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000073175 15-12-2019 201900070174/111940 DESI ISMA YUNITA,NY ROY , Dr.Sp.OG OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000073175 15-12-2019 201900070174/111940 DESI ISMA YUNITA,NY ROY , Dr.Sp.OG OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000073176 15-12-2019 201900070178/102802 FITRAH DAVIDSON Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000073177 15-12-2019 201900070183/054515 JHANIF INDRA Dwi Astuti, dr OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000073177 15-12-2019 201900070183/054515 JHANIF INDRA Dwi Astuti, dr OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
Total 180,514,865.11
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 136 dari 266
ASAL RAWAT JALAN
R2019-0000073178 15-12-2019 201900070187/063391 ADHYASTHA SHINE Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000073178 15-12-2019 201900070187/063391 ADHYASTHA SHINE Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000073178 15-12-2019 201900070187/063391 ADHYASTHA SHINE Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000073178 15-12-2019 201900070187/063391 ADHYASTHA SHINE Dwi Astuti, dr OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000073178 15-12-2019 201900070187/063391 ADHYASTHA SHINE Dwi Astuti, dr OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000073178 15-12-2019 201900070187/063391 ADHYASTHA SHINE Dwi Astuti, dr OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000073178 15-12-2019 201900070187/063391 ADHYASTHA SHINE Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000073178 15-12-2019 201900070187/063391 ADHYASTHA SHINE Dwi Astuti, dr OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000073179 15-12-2019 201900070172/032638 ROHMAN Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000073179 15-12-2019 201900070172/032638 ROHMAN Dwi Astuti, dr ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000073179 15-12-2019 201900070172/032638 ROHMAN Dwi Astuti, dr OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000073180 15-12-2019 201900070217/111947 MUHAMMAD NUR Dwi Astuti, dr OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000073180 15-12-2019 201900070217/111947 MUHAMMAD NUR Dwi Astuti, dr ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000073180 15-12-2019 201900070217/111947 MUHAMMAD NUR Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000073186 15-12-2019 201900070208/111949 SIAUW ING BAN,NY Dwi Astuti, dr OL00063 Lidocain HCl 2% Injeksi 2.00 Ampul 2,376.00 5,252.00
R2019-0000073186 15-12-2019 201900070208/111949 SIAUW ING BAN,NY Dwi Astuti, dr OE00056 Ecosol Nacl 0,9 % 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000073186 15-12-2019 201900070208/111949 SIAUW ING BAN,NY Dwi Astuti, dr OA00125 ATS (Anti Tetanus 1.00 Ampul 222,750.00 223,250.00
R2019-0000073186 15-12-2019 201900070208/111949 SIAUW ING BAN,NY Dwi Astuti, dr OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000073186 15-12-2019 201900070208/111949 SIAUW ING BAN,NY Dwi Astuti, dr OO00022 Opicef 500mg Capsul 10.00 Capsul 14,850.00 149,000.00
R2019-0000073194 15-12-2019 201900070205/095688 RIZAL TISNA Eko Dian Syafitra OS00183 Sporetik 200mg Capsul 2.00 Capsul 42,396.75 85,293.50
R2019-0000073194 15-12-2019 201900070205/095688 RIZAL TISNA Eko Dian Syafitra OA00166 Azithromycin 500mg 2.00 Tablet 14,850.00 30,200.00
R2019-0000073195 15-12-2019 201900070209/42923 RUDI IRIANTO,TN Eko Dian Syafitra OS00009 Salbutamol 2mg (OGB) 10.00 Tablet 213.30 2,633.00
R2019-0000073195 15-12-2019 201900070209/42923 RUDI IRIANTO,TN Eko Dian Syafitra OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000073195 15-12-2019 201900070209/42923 RUDI IRIANTO,TN Eko Dian Syafitra OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000073204 16-12-2019 201900070214/111954 MUHAMMAD FISABIL Eko Dian Syafitra OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000073205 16-12-2019 201900070210/092443 SAVIRA NUR Eko Dian Syafitra OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000073206 16-12-2019 201900070203/111951 IKA KARTIKA,NY Eko Dian Syafitra OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000073206 16-12-2019 201900070203/111951 IKA KARTIKA,NY Eko Dian Syafitra OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000073206 16-12-2019 201900070203/111951 IKA KARTIKA,NY Eko Dian Syafitra OS00176 Scopma Plus Tablet 6.00 Tablet 2,090.22 13,041.32
R2019-0000073207 16-12-2019 201900070222/066639 RIKA OKTAVIA,NY Eko Dian Syafitra ON00051 Nifedipin 10mg (OGB) 10.00 Tablet 261.21 3,112.10
R2019-0000073207 16-12-2019 201900070222/066639 RIKA OKTAVIA,NY Eko Dian Syafitra OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000073208 16-12-2019 201900070224/111956 MOH MASHUDI Eko Dian Syafitra OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000073208 16-12-2019 201900070224/111956 MOH MASHUDI Eko Dian Syafitra OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000073208 16-12-2019 201900070224/111956 MOH MASHUDI Eko Dian Syafitra OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000073208 16-12-2019 201900070224/111956 MOH MASHUDI Eko Dian Syafitra OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000073209 16-12-2019 201900070225/044549 LISEBETH Eko Dian Syafitra OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000073209 16-12-2019 201900070225/044549 LISEBETH Eko Dian Syafitra OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000073209 16-12-2019 201900070225/044549 LISEBETH Eko Dian Syafitra OB00050 Braxidin 10.00 Tablet 1,648.35 16,983.50
Total 181,567,350.76
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 137 dari 266
ASAL RAWAT JALAN
R2019-0000073193 15-12-2019 201900070212/102802 FITRAH DAVIDSON Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000073193 15-12-2019 201900070212/102802 FITRAH DAVIDSON Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000073212 16-12-2019 201900070203/111951 IKA KARTIKA,NY Dwi Astuti, dr ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000073212 16-12-2019 201900070203/111951 IKA KARTIKA,NY Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000073212 16-12-2019 201900070203/111951 IKA KARTIKA,NY Dwi Astuti, dr OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000073212 16-12-2019 201900070203/111951 IKA KARTIKA,NY Dwi Astuti, dr ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000073213 16-12-2019 201900070214/111954 MUHAMMAD FISABIL Eko Dian Syafitra OD00077 Dumin Rectal 250mg 1.00 Tube 29,254.50 29,754.50
R2019-0000073216 16-12-2019 201900070225/044549 LISEBETH Eko Dian Syafitra OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000073216 16-12-2019 201900070225/044549 LISEBETH Eko Dian Syafitra OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000073216 16-12-2019 201900070225/044549 LISEBETH Eko Dian Syafitra ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000073216 16-12-2019 201900070225/044549 LISEBETH Eko Dian Syafitra ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000073222 16-12-2019 201900070250/111957 MAHER AZKA RESTU Niki Juniar OA00135 Acyclovir 200mg (OGB) 50.00 Tablet 955.00 48,250.00
R2019-0000073222 16-12-2019 201900070250/111957 MAHER AZKA RESTU Niki Juniar OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000073222 16-12-2019 201900070250/111957 MAHER AZKA RESTU Niki Juniar OI00117 Imunos Plus Syrup, 60ml 1.00 Botol 136,620.00 137,120.00
R2019-0000073222 16-12-2019 201900070250/111957 MAHER AZKA RESTU Niki Juniar OA00016 Acyclovir Cream 5gr 1.00 Tube 4,893.00 5,393.00
R2019-0000073230 16-12-2019 201900070240/089707 NORHAYATI,NY Niki Juniar OP00011 Paracetamol 500mg 4.00 Tablet 387.36 2,049.44
R2019-0000073230 16-12-2019 201900070240/089707 NORHAYATI,NY Niki Juniar OP00184 Neo Protifed Tablet 4.00 Tablet 1,263.73 5,554.92
R2019-0000073230 16-12-2019 201900070240/089707 NORHAYATI,NY Niki Juniar OB00007 Becom - C 3.00 Tablet 2,123.55 6,870.65
R2019-0000073220 16-12-2019 201900070260/080381 SUPARMI,NY Niki Juniar OE00057 Eperisone Hcl 50mg 4.00 Tablet 2,286.90 9,647.60
R2019-0000073220 16-12-2019 201900070260/080381 SUPARMI,NY Niki Juniar ON00009 Natrium Diklofenac 50mg 4.00 Tablet 955.84 4,323.36
R2019-0000073220 16-12-2019 201900070260/080381 SUPARMI,NY Niki Juniar OM00154 Mecobalamin 500mg 2.00 Tablet 1,118.00 2,736.00
R2019-0000073233 16-12-2019 201900070265/111959 INDRAYANI,NY Niki Juniar ALP00025 Policrepe 4" (10cmx4.5m) 1.00 Roll 96,228.00 96,728.00
R2019-0000073233 16-12-2019 201900070265/111959 INDRAYANI,NY Niki Juniar OE00022 Eprinoc Tablet 10.00 Tablet 5,093.55 51,435.50
R2019-0000073233 16-12-2019 201900070265/111959 INDRAYANI,NY Niki Juniar OT00149 Toramine 10 Mg Tablet 10.00 Tablet 8,167.50 82,175.00
R2019-0000073231 16-12-2019 201900070274/110867 IDA NINGRUM ROY , Dr.Sp.OG OO00022 Opicef 500mg Capsul 14.00 Capsul 14,850.00 208,400.00
R2019-0000073231 16-12-2019 201900070274/110867 IDA NINGRUM ROY , Dr.Sp.OG OM00052 Metronidazole 500mg 15.00 Tablet 525.39 8,380.85
R2019-0000073239 16-12-2019 201900070289/047119 ROKHMAD JOKO Niki Juniar ALB00001 Bactigras (10cmx10cm) 1.00 Pcs 22,720.50 23,220.50
R2019-0000073232 16-12-2019 201900070258/084866 HUKMAH,NY EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000073232 16-12-2019 201900070258/084866 HUKMAH,NY EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073232 16-12-2019 201900070258/084866 HUKMAH,NY EDO, Dr.Sp.B ALK00005 Kasa Hydrofil New DRC 12.00 lembar 816.75 10,301.00
R2019-0000073232 16-12-2019 201900070258/084866 HUKMAH,NY EDO, Dr.Sp.B ALH00020 Hypafix 10cm x 5m 1.00 Cm 400.00 900.00
R2019-0000073238 16-12-2019 201900070256/111539 H .H NASRUN EDO, Dr.Sp.B ALK00005 Kasa Hydrofil New DRC 12.00 lembar 816.75 10,301.00
R2019-0000073238 16-12-2019 201900070256/111539 H .H NASRUN EDO, Dr.Sp.B ALH00020 Hypafix 10cm x 5m 1.00 Cm 400.00 900.00
R2019-0000073242 16-12-2019 201900070269/109037 TUMINAH,NY EDO, Dr.Sp.B ALK00005 Kasa Hydrofil New DRC 12.00 lembar 816.75 10,301.00
R2019-0000073245 16-12-2019 201900070227/8434 AMRIZAL RUSTAM,TN Dameria Sri OP00011 Paracetamol 500mg 20.00 Tablet 387.36 8,247.20
R2019-0000073245 16-12-2019 201900070227/8434 AMRIZAL RUSTAM,TN Dameria Sri OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000073245 16-12-2019 201900070227/8434 AMRIZAL RUSTAM,TN Dameria Sri OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000073245 16-12-2019 201900070227/8434 AMRIZAL RUSTAM,TN Dameria Sri OG00073 Glucosamine 250 Mg 10.00 Tablet 1,633.50 16,835.00
Total 182,872,642.34
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 138 dari 266
ASAL RAWAT JALAN
R2019-0000073244 16-12-2019 201900070262/105085 HAPSARI,NY EDO, Dr.Sp.B OR00007 Reco Salep Mata 1.00 Tube 7,425.00 7,925.00
R2019-0000073248 16-12-2019 201900070286/111377 DEWI SHINTA R,AN Dameria Sri OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000073248 16-12-2019 201900070286/111377 DEWI SHINTA R,AN Dameria Sri OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073248 16-12-2019 201900070286/111377 DEWI SHINTA R,AN Dameria Sri ALK00005 Kasa Hydrofil New DRC 12.00 lembar 816.75 10,301.00
R2019-0000073248 16-12-2019 201900070286/111377 DEWI SHINTA R,AN Dameria Sri ALH00020 Hypafix 10cm x 5m 1.00 Cm 400.00 900.00
R2019-0000073242 16-12-2019 201900070269/109037 TUMINAH,NY EDO, Dr.Sp.B ALH00020 Hypafix 10cm x 5m 1.00 Cm 400.00 900.00
R2019-0000073249 16-12-2019 201900070268/079712 DJAMILIS,TN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000073249 16-12-2019 201900070268/079712 DJAMILIS,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000073250 16-12-2019 201900070296/066862 HATTA GOBEL,TN Angie Renatha , GK003 Ketoconazole Cream 10 1.00 Tube 8,019.00 8,519.00
R2019-0000073253 16-12-2019 201900070247/102686 TEDDY ISKANDAR,TN TEDDY OC00300 Cendo Hyalub Minidose 1.00 Strip 84,645.00 85,145.00
R2019-0000073253 16-12-2019 201900070247/102686 TEDDY ISKANDAR,TN TEDDY OR00060 Retivit Plus Tablet 5.00 Tablet 10,343.02 52,215.10
R2019-0000073254 16-12-2019 201900070295/111323 IKA NUR Angie Renatha , OF00150 Fukricin Eye Drop 1.00 Botol 102,762.00 103,262.00
R2019-0000073251 16-12-2019 201900070239/111846 TITIN SUPRIANTIN,NY TEDDY OC00255 Cendo Tobroson Eye Drop 1.00 Botol 68,681.25 69,181.25
R2019-0000073251 16-12-2019 201900070239/111846 TITIN SUPRIANTIN,NY TEDDY OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000073255 16-12-2019 201900070275/111792 PUTRI HAIRA Angie Renatha , OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073255 16-12-2019 201900070275/111792 PUTRI HAIRA Angie Renatha , OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000073255 16-12-2019 201900070275/111792 PUTRI HAIRA Angie Renatha , OD00031 Dexamethasone Tablet 15.00 Tablet 208.00 3,620.00
R2019-0000073255 16-12-2019 201900070275/111792 PUTRI HAIRA Angie Renatha , OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000073255 16-12-2019 201900070275/111792 PUTRI HAIRA Angie Renatha , OP00184 Neo Protifed Tablet 15.00 Tablet 1,263.73 19,455.95
R2019-0000073257 16-12-2019 201900070284/029181 JAYADI MUSTAFA,SDR Angie Renatha , OP00184 Neo Protifed Tablet 15.00 Tablet 1,263.73 19,455.95
R2019-0000073257 16-12-2019 201900070284/029181 JAYADI MUSTAFA,SDR Angie Renatha , OA00052 Ambroxol Tablet, 30mg 15.00 Tablet 445.50 7,182.50
R2019-0000073257 16-12-2019 201900070284/029181 JAYADI MUSTAFA,SDR Angie Renatha , OD00031 Dexamethasone Tablet 15.00 Tablet 208.00 3,620.00
R2019-0000073256 16-12-2019 201900070288/024084 HARIYAH, HJ,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000073256 16-12-2019 201900070288/024084 HARIYAH, HJ,NY TEDDY OC00264 Cendo Timol 0.5% ED 1.00 Botol 70,908.75 71,408.75
R2019-0000073256 16-12-2019 201900070288/024084 HARIYAH, HJ,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000073265 16-12-2019 201900070235/097422 BAHARIN Dameria Sri ON00009 Natrium Diklofenac 50mg 10.00 Tablet 955.84 10,058.40
R2019-0000073265 16-12-2019 201900070235/097422 BAHARIN Dameria Sri OB00016 Betahistine Mesilat 6mg 15.00 Tablet 1,500.00 23,000.00
R2019-0000073265 16-12-2019 201900070235/097422 BAHARIN Dameria Sri OF00065 Flunarizine 5mg 10.00 Tablet 2,970.00 30,200.00
R2019-0000073265 16-12-2019 201900070235/097422 BAHARIN Dameria Sri OA00043 Alprazolam 0,5mg (OGB) 4.00 Tablet 996.50 4,486.00
R2019-0000073269 16-12-2019 201900070304/110089 NORAENI RASYID,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000073269 16-12-2019 201900070304/110089 NORAENI RASYID,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000073259 16-12-2019 201900070231/103586 SARIP,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000073270 16-12-2019 201900070292/111962 RUSMINI,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000073271 16-12-2019 201900070232/073811 RIANA ANGGRAINI,NY Dameria Sri OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000073271 16-12-2019 201900070232/073811 RIANA ANGGRAINI,NY Dameria Sri OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000073271 16-12-2019 201900070232/073811 RIANA ANGGRAINI,NY Dameria Sri OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
Total 184,043,291.44
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 139 dari 266
ASAL RAWAT JALAN
R2019-0000073271 16-12-2019 201900070232/073811 RIANA ANGGRAINI,NY Dameria Sri OV00045 Valis anbe 2mg Tablet 20.00 Tablet 348.98 7,479.60
R2019-0000073271 16-12-2019 201900070232/073811 RIANA ANGGRAINI,NY Dameria Sri OE00057 Eperisone Hcl 50mg 10.00 Tablet 2,286.90 23,369.00
R2019-0000073272 16-12-2019 201900070232/073811 RIANA ANGGRAINI,NY Dameria Sri OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000073272 16-12-2019 201900070232/073811 RIANA ANGGRAINI,NY Dameria Sri OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000073272 16-12-2019 201900070232/073811 RIANA ANGGRAINI,NY Dameria Sri OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000073274 16-12-2019 201900070334/056442 WIWIN TEDDY OR00029 Retivit Tablet 30.00 Tablet 5,672.70 170,681.00
R2019-0000073277 16-12-2019 201900070357/050680 RAFFA FAIZ FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 6.00 Capsul 28,957.00 174,242.00
R2019-0000073277 16-12-2019 201900070357/050680 RAFFA FAIZ FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 4.00 Tablet 430.65 2,222.60
R2019-0000073277 16-12-2019 201900070357/050680 RAFFA FAIZ FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000073277 16-12-2019 201900070357/050680 RAFFA FAIZ FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 5.00 Tablet 1,232.55 6,662.75
R2019-0000073277 16-12-2019 201900070357/050680 RAFFA FAIZ FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000073277 16-12-2019 201900070357/050680 RAFFA FAIZ FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 200.20 23,003.00
R2019-0000073277 16-12-2019 201900070357/050680 RAFFA FAIZ FREDRIK, Dr,Sp.A OV00217 Velutine Nebules 5.00 Vial 10,395.00 52,475.00
R2019-0000073277 16-12-2019 201900070357/050680 RAFFA FAIZ FREDRIK, Dr,Sp.A OP00136 Pulmicort Respules 5.00 Ampul 33,802.98 169,514.90
R2019-0000073273 16-12-2019 201900070365/111388 JOEL IMMANUEL FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 6.00 Capsul 28,957.00 174,242.00
R2019-0000073273 16-12-2019 201900070365/111388 JOEL IMMANUEL FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 5.00 Tablet 430.65 2,653.25
R2019-0000073273 16-12-2019 201900070365/111388 JOEL IMMANUEL FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 5.00 Tablet 1,173.15 6,365.75
R2019-0000073273 16-12-2019 201900070365/111388 JOEL IMMANUEL FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 5.00 Tablet 1,232.55 6,662.75
R2019-0000073273 16-12-2019 201900070365/111388 JOEL IMMANUEL FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 5.00 Granula 297.00 1,985.00
R2019-0000073273 16-12-2019 201900070365/111388 JOEL IMMANUEL FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000073279 16-12-2019 201900070261/069911 ANISA APRIYANTI,NY NOVIANA, Dr. Sp OF00099 Folda Tablet 15.00 Tablet 6,661.65 100,424.75
R2019-0000073281 16-12-2019 201900070395/034575 NUR HERITA,NY NOVIANA, Dr. Sp OF00099 Folda Tablet 30.00 Tablet 6,661.65 200,349.50
R2019-0000073281 16-12-2019 201900070395/034575 NUR HERITA,NY NOVIANA, Dr. Sp OB00068 BioCal-95 30.00 Tablet 7,128.00 214,340.00
R2019-0000073281 16-12-2019 201900070395/034575 NUR HERITA,NY NOVIANA, Dr. Sp OS00050 Sanvita B Plus Eff 3.00 Tube 57,395.25 172,685.75
R2019-0000073283 16-12-2019 201900070302/111866 MEREYKE Angie Renatha , OA00166 Azithromycin 500mg 3.00 Tablet 14,850.00 45,050.00
R2019-0000073283 16-12-2019 201900070302/111866 MEREYKE Angie Renatha , OP00184 Neo Protifed Tablet 15.00 Tablet 1,263.73 19,455.95
R2019-0000073283 16-12-2019 201900070302/111866 MEREYKE Angie Renatha , OD00031 Dexamethasone Tablet 15.00 Tablet 208.00 3,620.00
R2019-0000073283 16-12-2019 201900070302/111866 MEREYKE Angie Renatha , OA00013 Avamys Nasal Spray 1.00 Botol 237,451.50 237,951.50
R2019-0000073288 16-12-2019 201900070429/111981 RAFIF ALFAREZI Niki Juniar OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000073288 16-12-2019 201900070429/111981 RAFIF ALFAREZI Niki Juniar ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000073288 16-12-2019 201900070429/111981 RAFIF ALFAREZI Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000073282 16-12-2019 201900070433/111982 ALVARO Niki Juniar OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000073282 16-12-2019 201900070433/111982 ALVARO Niki Juniar ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000073282 16-12-2019 201900070433/111982 ALVARO Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000073289 16-12-2019 201900070339/100224 TRI DIAN UTAMI,NY DR. BISMA SP OA00134 Asta Plus 15.00 Tablet 12,623.00 189,845.00
R2019-0000073290 16-12-2019 201900070417/076478 PUTRI AMELIA Angie Renatha , OA00013 Avamys Nasal Spray 1.00 Botol 237,451.50 237,951.50
R2019-0000073290 16-12-2019 201900070417/076478 PUTRI AMELIA Angie Renatha , OP00184 Neo Protifed Tablet 15.00 Tablet 1,263.73 19,455.95
R2019-0000073290 16-12-2019 201900070417/076478 PUTRI AMELIA Angie Renatha , OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
Total 186,720,181.89
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 140 dari 266
ASAL RAWAT JALAN
R2019-0000073293 16-12-2019 201900070431/107794 NARA TALITA Niki Juniar OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000073293 16-12-2019 201900070431/107794 NARA TALITA Niki Juniar ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000073293 16-12-2019 201900070431/107794 NARA TALITA Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000073292 16-12-2019 201900071176/080856 MUNDI AFWAN Eviwati OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073292 16-12-2019 201900071176/080856 MUNDI AFWAN Eviwati OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000073294 16-12-2019 201900070320/057012 AGUS PRAYITNO,TN Eviwati OT00149 Toramine 10 Mg Tablet 10.00 Tablet 8,167.50 82,175.00
R2019-0000073294 16-12-2019 201900070320/057012 AGUS PRAYITNO,TN Eviwati OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000073295 16-12-2019 201900070257/111958 VINA EKA DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000073295 16-12-2019 201900070257/111958 VINA EKA DYAH, dr Sp. OA00052 Ambroxol Tablet, 30mg 15.00 Tablet 445.50 7,182.50
R2019-0000073295 16-12-2019 201900070257/111958 VINA EKA DYAH, dr Sp. OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000073299 16-12-2019 201900070326/111790 FARIDA AMALIA,NY Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000073299 16-12-2019 201900070326/111790 FARIDA AMALIA,NY Niki Juniar OM00045 Methyl Prednisolon 4mg 6.00 Tablet 792.99 5,257.94
R2019-0000073299 16-12-2019 201900070326/111790 FARIDA AMALIA,NY Niki Juniar OC00076 Ciprofloxacin 500mg 6.00 Tablet 1,039.50 6,737.00
R2019-0000073300 16-12-2019 201900070377/064745 NAJMA AMIR Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000073300 16-12-2019 201900070377/064745 NAJMA AMIR Ismail dr. Msc. OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000073301 16-12-2019 201900070393/110912 KINANDA SAPTAWANA Eviwati OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000073302 16-12-2019 201900070410/072991 NORSEMAH,NY DYAH, dr Sp. OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000073302 16-12-2019 201900070410/072991 NORSEMAH,NY DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000073303 16-12-2019 201900070373/111975 RANI MELANI,AN Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 10.00 Tablet 965.25 10,152.50
R2019-0000073303 16-12-2019 201900070373/111975 RANI MELANI,AN Ismail dr. Msc. OC00085 Clindamycin 150mg 10.00 Tablet 981.59 10,315.90
R2019-0000073303 16-12-2019 201900070373/111975 RANI MELANI,AN Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 7,276.50 7,776.50
R2019-0000073303 16-12-2019 201900070373/111975 RANI MELANI,AN Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000073303 16-12-2019 201900070373/111975 RANI MELANI,AN Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073304 16-12-2019 201900070411/111765 TEGUH JUNIARTO,AN DYAH, dr Sp. OB00094 Berotec MDI 1.00 Botol 130,000.00 130,500.00
R2019-0000073305 16-12-2019 201900070391/111980 EKO ALAM Eviwati OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000073305 16-12-2019 201900070391/111980 EKO ALAM Eviwati OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073306 16-12-2019 201900070369/102722 RITASARI,NY Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000073306 16-12-2019 201900070369/102722 RITASARI,NY Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000073306 16-12-2019 201900070369/102722 RITASARI,NY Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000073306 16-12-2019 201900070369/102722 RITASARI,NY Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000073306 16-12-2019 201900070369/102722 RITASARI,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073307 16-12-2019 201900070487/080236 RAFFASYA ADE RAHMAH OD00077 Dumin Rectal 250mg 1.00 Tube 29,254.50 29,754.50
R2019-0000073308 16-12-2019 201900070337/060238 DJARKASI,TN Ismail dr. Msc. OL00080 Loratadin 10mg (OGB) 30.00 Tablet 520.00 16,100.00
R2019-0000073308 16-12-2019 201900070337/060238 DJARKASI,TN Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 7,276.50 7,776.50
R2019-0000073308 16-12-2019 201900070337/060238 DJARKASI,TN Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000073308 16-12-2019 201900070337/060238 DJARKASI,TN Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073309 16-12-2019 201900070385/111978 CENNA FARRA Ismail dr. Msc. OC00173 Cetirizine 10mg/ml Drop, 1.00 Botol 37,125.00 37,625.00
R2019-0000073309 16-12-2019 201900070385/111978 CENNA FARRA Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 7,276.50 7,776.50
Total 187,450,325.53
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 141 dari 266
ASAL RAWAT JALAN
R2019-0000073309 16-12-2019 201900070385/111978 CENNA FARRA Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000073309 16-12-2019 201900070385/111978 CENNA FARRA Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073316 16-12-2019 201900070372/019833 FAISAL RAMADHAN,AN DYAH, dr Sp. OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000073316 16-12-2019 201900070372/019833 FAISAL RAMADHAN,AN DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000073316 16-12-2019 201900070372/019833 FAISAL RAMADHAN,AN DYAH, dr Sp. OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000073315 16-12-2019 201900070372/019833 FAISAL RAMADHAN,AN DYAH, dr Sp. OS00160 Seretide Diskus 250 mcg 1.00 Botol 322,681.59 323,181.59
R2019-0000073317 16-12-2019 201900070411/111765 TEGUH JUNIARTO,AN DYAH, dr Sp. OM00045 Methyl Prednisolon 4mg 15.00 Tablet 792.99 12,394.85
R2019-0000073318 16-12-2019 201900070404/099315 DIANA HERAWATI,NY Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000073318 16-12-2019 201900070404/099315 DIANA HERAWATI,NY Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000073318 16-12-2019 201900070404/099315 DIANA HERAWATI,NY Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 7,276.50 7,776.50
R2019-0000073318 16-12-2019 201900070404/099315 DIANA HERAWATI,NY Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000073318 16-12-2019 201900070404/099315 DIANA HERAWATI,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073321 16-12-2019 201900070423/111983 AMELION Ismail dr. Msc. OC00057 Cerini 10.00 Tablet 5,093.55 51,435.50
R2019-0000073324 16-12-2019 201900070444/086103 WILLEM PALAR Hendra Dr, Sp. OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000073324 16-12-2019 201900070444/086103 WILLEM PALAR Hendra Dr, Sp. OC00010 Calcium Lactat 500mg 10.00 Tablet 302.37 3,523.70
R2019-0000073325 16-12-2019 201900070409/045944 RONNY A.M.YANIS,TN Ismail dr. Msc. OM00044 Methyl Prednisolon 16mg 30.00 Tablet 2,632.50 79,475.00
R2019-0000073325 16-12-2019 201900070409/045944 RONNY A.M.YANIS,TN Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000073325 16-12-2019 201900070409/045944 RONNY A.M.YANIS,TN Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000073325 16-12-2019 201900070409/045944 RONNY A.M.YANIS,TN Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000073325 16-12-2019 201900070409/045944 RONNY A.M.YANIS,TN Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073326 16-12-2019 201900070443/106375 ANGGREANI ADE RAHMAH OA00088 Antiza Tablet 4.00 Tablet 1,633.00 7,032.00
R2019-0000073326 16-12-2019 201900070443/106375 ANGGREANI ADE RAHMAH OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000073328 16-12-2019 201900070442/27635 ENDANG KUSRINI,NY ADE RAHMAH OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000073328 16-12-2019 201900070442/27635 ENDANG KUSRINI,NY ADE RAHMAH OA00180 Acetylcyst ein 200mg 3.00 Tablet 1,485.00 4,955.00
R2019-0000073328 16-12-2019 201900070442/27635 ENDANG KUSRINI,NY ADE RAHMAH OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000073328 16-12-2019 201900070442/27635 ENDANG KUSRINI,NY ADE RAHMAH OA00085 Antasida Tablet (OGB) 3.00 Tablet 284.30 1,352.90
R2019-0000073328 16-12-2019 201900070442/27635 ENDANG KUSRINI,NY ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 3.00 Capsul 1,169.98 4,009.94
R2019-0000073329 16-12-2019 201900070388/055051 SRIYANI,NY Ismail dr. Msc. OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000073329 16-12-2019 201900070388/055051 SRIYANI,NY Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000073329 16-12-2019 201900070388/055051 SRIYANI,NY Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 7,276.50 7,776.50
R2019-0000073329 16-12-2019 201900070388/055051 SRIYANI,NY Ismail dr. Msc. OK00022 Ketoconazol Cream 2% 1.00 Tube 11,000.00 11,500.00
R2019-0000073329 16-12-2019 201900070388/055051 SRIYANI,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073330 16-12-2019 201900070418/064352 CHIKO Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000073330 16-12-2019 201900070418/064352 CHIKO Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000073330 16-12-2019 201900070418/064352 CHIKO Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000073330 16-12-2019 201900070418/064352 CHIKO Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073330 16-12-2019 201900070418/064352 CHIKO Ismail dr. Msc. OS00053 Scabimate Cream, 10gr 1.00 Tube 63,112.50 63,612.50
R2019-0000073331 16-12-2019 201900070454/030419 NAYLA NAFISAH ADE RAHMAH OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
Total 188,344,322.91
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 142 dari 266
ASAL RAWAT JALAN
R2019-0000073331 16-12-2019 201900070454/030419 NAYLA NAFISAH ADE RAHMAH OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000073331 16-12-2019 201900070454/030419 NAYLA NAFISAH ADE RAHMAH ON00009 Natrium Diklofenac 50mg 3.00 Tablet 955.84 3,367.52
R2019-0000073332 16-12-2019 201900070487/080236 RAFFASYA ADE RAHMAH ALN00003 Nasal Canule Infant/Anak 1.00 Pcs 19,305.00 19,805.00
R2019-0000073323 16-12-2019 201900070412/029450 ALIVA DILA, SP,NY Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000073323 16-12-2019 201900070412/029450 ALIVA DILA, SP,NY Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000073323 16-12-2019 201900070412/029450 ALIVA DILA, SP,NY Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000073323 16-12-2019 201900070412/029450 ALIVA DILA, SP,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073335 16-12-2019 201900070445/10555 NAKIR,TN Hendra Dr, Sp. OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000073335 16-12-2019 201900070445/10555 NAKIR,TN Hendra Dr, Sp. OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000073336 16-12-2019 201900070425/085917 EDWARD VIANDY Ismail dr. Msc. OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000073336 16-12-2019 201900070425/085917 EDWARD VIANDY Ismail dr. Msc. OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000073336 16-12-2019 201900070425/085917 EDWARD VIANDY Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000073339 16-12-2019 201900070449/021283 JERRYANDI OLOAN Hendra Dr, Sp. OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000073339 16-12-2019 201900070449/021283 JERRYANDI OLOAN Hendra Dr, Sp. OC00010 Calcium Lactat 500mg 10.00 Tablet 302.37 3,523.70
R2019-0000073339 16-12-2019 201900070449/021283 JERRYANDI OLOAN Hendra Dr, Sp. OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000073343 16-12-2019 201900070455/062371 FEBRIANTY,NY ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000073343 16-12-2019 201900070455/062371 FEBRIANTY,NY ADE RAHMAH OA00085 Antasida Tablet (OGB) 6.00 Tablet 284.30 2,205.80
R2019-0000073343 16-12-2019 201900070455/062371 FEBRIANTY,NY ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000073343 16-12-2019 201900070455/062371 FEBRIANTY,NY ADE RAHMAH OI00001 Ibuprofen 400mg (OGB) 5.00 Tablet 682.00 3,910.00
R2019-0000073338 16-12-2019 201900070236/078939 TINI SUKARTINI,NY Hendra Dr, Sp. OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000073338 16-12-2019 201900070236/078939 TINI SUKARTINI,NY Hendra Dr, Sp. OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000073353 16-12-2019 201900070430/052054 LAUW SIN LAM,TN Hendra Dr, Sp. OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000073353 16-12-2019 201900070430/052054 LAUW SIN LAM,TN Hendra Dr, Sp. OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000073356 16-12-2019 201900070471/085772 ARDIANA,NY Hendra Dr, Sp. OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000073356 16-12-2019 201900070471/085772 ARDIANA,NY Hendra Dr, Sp. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000073354 16-12-2019 201900070464/12971 KUNTARI DWI N,NY Rizka OA00106 Asam Mefenamat 500mg 15.00 Tablet 415.80 6,737.00
R2019-0000073354 16-12-2019 201900070464/12971 KUNTARI DWI N,NY Rizka OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000073360 16-12-2019 201900070475/105157 MUHAMMAD DAVINO ADE RAHMAH OK00030 Ketricin Salep 0.1%, 5gr 1.00 Tube 66,825.00 67,325.00
R2019-0000073363 16-12-2019 201900070474/083023 WULANDARA,NY ADE RAHMAH OS00009 Salbutamol 2mg (OGB) 6.00 Tablet 213.30 1,779.80
R2019-0000073363 16-12-2019 201900070474/083023 WULANDARA,NY ADE RAHMAH OA00180 Acetylcyst ein 200mg 6.00 Tablet 1,485.00 9,410.00
R2019-0000073363 16-12-2019 201900070474/083023 WULANDARA,NY ADE RAHMAH OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
R2019-0000073362 16-12-2019 201900070248/066360 SITI AMINAH,NY Dameria Sri ON00009 Natrium Diklofenac 50mg 14.00 Tablet 955.84 13,881.76
R2019-0000073362 16-12-2019 201900070248/066360 SITI AMINAH,NY Dameria Sri OE00057 Eperisone Hcl 50mg 10.00 Tablet 2,286.90 23,369.00
R2019-0000073362 16-12-2019 201900070248/066360 SITI AMINAH,NY Dameria Sri OG00073 Glucosamine 250 Mg 15.00 Tablet 1,633.50 25,002.50
R2019-0000073362 16-12-2019 201900070248/066360 SITI AMINAH,NY Dameria Sri OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000073362 16-12-2019 201900070248/066360 SITI AMINAH,NY Dameria Sri OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000073364 16-12-2019 201900070248/066360 SITI AMINAH,NY Dameria Sri OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000073365 16-12-2019 201900070468/100910 GHIBRAN ZAVIER NUR ADE RAHMAH OM00097 Mucera Drop 1.00 Botol 54,945.00 55,445.00
Total 189,164,052.37
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 143 dari 266
ASAL RAWAT JALAN
R2019-0000073365 16-12-2019 201900070468/100910 GHIBRAN ZAVIER NUR ADE RAHMAH OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000073365 16-12-2019 201900070468/100910 GHIBRAN ZAVIER NUR ADE RAHMAH OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000073366 16-12-2019 201900070470/111984 DAMAR ADE RAHMAH OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000073366 16-12-2019 201900070470/111984 DAMAR ADE RAHMAH OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000073366 16-12-2019 201900070470/111984 DAMAR ADE RAHMAH OP00011 Paracetamol 500mg 3.00 Tablet 387.36 1,662.08
R2019-0000073366 16-12-2019 201900070470/111984 DAMAR ADE RAHMAH OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000073367 16-12-2019 201900070473/077320 MUHAMMAD ABID Rianti dr. Sp.A OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000073367 16-12-2019 201900070473/077320 MUHAMMAD ABID Rianti dr. Sp.A OF00141 Farizol Suspensi, 60ml 1.00 Botol 18,532.00 19,032.00
R2019-0000073367 16-12-2019 201900070473/077320 MUHAMMAD ABID Rianti dr. Sp.A OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000073368 16-12-2019 201900070370/104796 ALEEM AR RAYYAN,AN Riyanti Puji dr. OS00009 Salbutamol 2mg (OGB) 3.00 Tablet 213.30 1,139.90
R2019-0000073368 16-12-2019 201900070370/104796 ALEEM AR RAYYAN,AN Riyanti Puji dr. OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000073368 16-12-2019 201900070370/104796 ALEEM AR RAYYAN,AN Riyanti Puji dr. OP00184 Neo Protifed Tablet 2.00 Tablet 1,263.73 3,027.46
R2019-0000073368 16-12-2019 201900070370/104796 ALEEM AR RAYYAN,AN Riyanti Puji dr. OC00033 Cefadroxil 125mg Syrup, 1.00 Botol 13,283.32 13,783.32
R2019-0000073368 16-12-2019 201900070370/104796 ALEEM AR RAYYAN,AN Riyanti Puji dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000073371 16-12-2019 201900070478/111985 ANDI AYU LESTARI ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000073372 16-12-2019 201900070478/111985 ANDI AYU LESTARI ADE RAHMAH OE00057 Eperisone Hcl 50mg 10.00 Tablet 10 2,286.90 21,082.10
R2019-0000073372 16-12-2019 201900070478/111985 ANDI AYU LESTARI ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 10 12,399.75 11,659.77
R2019-0000073375 16-12-2019 201900070486/070918 SUAIBAH,NY ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000073375 16-12-2019 201900070486/070918 SUAIBAH,NY ADE RAHMAH ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000073375 16-12-2019 201900070486/070918 SUAIBAH,NY ADE RAHMAH OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000073375 16-12-2019 201900070486/070918 SUAIBAH,NY ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000073374 16-12-2019 201900070468/100910 GHIBRAN ZAVIER NUR ADE RAHMAH OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000073376 16-12-2019 201900070487/080236 RAFFASYA ADE RAHMAH OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000073376 16-12-2019 201900070487/080236 RAFFASYA ADE RAHMAH OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000073376 16-12-2019 201900070487/080236 RAFFASYA ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000073376 16-12-2019 201900070487/080236 RAFFASYA ADE RAHMAH ALI00006 I.V Catheter No. 24 3.00 Pcs 38,900.00 117,200.00
R2019-0000073377 16-12-2019 201900070455/062371 FEBRIANTY,NY ADE RAHMAH ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000073377 16-12-2019 201900070455/062371 FEBRIANTY,NY ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000073377 16-12-2019 201900070455/062371 FEBRIANTY,NY ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000073378 16-12-2019 201900070474/083023 WULANDARA,NY ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000073378 16-12-2019 201900070474/083023 WULANDARA,NY ADE RAHMAH OP00136 Pulmicort Respules 2.00 Ampul 33,802.98 68,105.96
R2019-0000073379 16-12-2019 201900070488/061854 SITI FATIMAH,NY ADE RAHMAH OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000073379 16-12-2019 201900070488/061854 SITI FATIMAH,NY ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000073379 16-12-2019 201900070488/061854 SITI FATIMAH,NY ADE RAHMAH ALB00132 Blood Set 1.00 Pcs 33,976.80 34,476.80
R2019-0000073379 16-12-2019 201900070488/061854 SITI FATIMAH,NY ADE RAHMAH ALI00004 I.V Catheter No. 20 2.00 Pcs 36,808.20 74,116.40
R2019-0000073379 16-12-2019 201900070488/061854 SITI FATIMAH,NY ADE RAHMAH ALI00003 I.V Catheter No. 18 2.00 Pcs 29,744.00 59,988.00
R2019-0000073380 16-12-2019 201900070489/111986 HARIANTI,NY ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000073380 16-12-2019 201900070489/111986 HARIANTI,NY ADE RAHMAH OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
Total 190,079,433.93
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 144 dari 266
ASAL RAWAT JALAN
R2019-0000073380 16-12-2019 201900070489/111986 HARIANTI,NY ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000073380 16-12-2019 201900070489/111986 HARIANTI,NY ADE RAHMAH ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000073381 16-12-2019 201900070470/111984 DAMAR ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000073408 16-12-2019 201900070490/092166 SUBEKTI,NY Nathalia dr. OI00097 Isosorbide Dinitrate 5mg 1.00 Tablet 311.85 811.85
R2019-0000073408 16-12-2019 201900070490/092166 SUBEKTI,NY Nathalia dr. OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000073410 16-12-2019 201900070491/111987 MEILINA Nathalia dr. OM00047 Metoclopramide Injeksi 1.00 Ampul 10,395.00 10,895.00
R2019-0000073410 16-12-2019 201900070491/111987 MEILINA Nathalia dr. OP00011 Paracetamol 500mg 2.00 Tablet 387.36 1,274.72
R2019-0000073409 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000073409 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000073409 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. OI00051 Infus Otsu-NS (NaCl 1.00 Botol 9,388.17 9,888.17
R2019-0000073409 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000073409 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. OI00097 Isosorbide Dinitrate 5mg 1.00 Tablet 311.85 811.85
R2019-0000073409 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000073409 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. ALF00008 Folley Catheter No. 16 1.00 Pcs 29,700.00 30,200.00
R2019-0000073409 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000073409 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. ALU00007 Urine Bag 1.00 Pcs 19,305.00 19,805.00
R2019-0000073409 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000073411 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000073411 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000073411 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. OI00051 Infus Otsu-NS (NaCl 1.00 Botol 9,388.17 9,888.17
R2019-0000073411 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000073411 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. OI00097 Isosorbide Dinitrate 5mg 1.00 Tablet 311.85 811.85
R2019-0000073411 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000073411 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. ALF00008 Folley Catheter No. 16 1.00 Pcs 29,700.00 30,200.00
R2019-0000073411 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000073411 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. ALU00007 Urine Bag 1.00 Pcs 19,305.00 19,805.00
R2019-0000073411 17-12-2019 201900070499/085435 BERNARD C Nathalia dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000073412 17-12-2019 201900070500/083100 JIERGO YONGKI Nathalia dr. OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000073413 16-12-2019 201900070494/071986 USNI MAAY AN,NN Nathalia dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000073413 16-12-2019 201900070494/071986 USNI MAAY AN,NN Nathalia dr. OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000073413 16-12-2019 201900070494/071986 USNI MAAY AN,NN Nathalia dr. ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000073415 17-12-2019 201900070500/083100 JIERGO YONGKI Nathalia dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000073415 17-12-2019 201900070500/083100 JIERGO YONGKI Nathalia dr. OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000073415 17-12-2019 201900070500/083100 JIERGO YONGKI Nathalia dr. OA00052 Ambroxol Tablet, 30mg 6.00 Tablet 445.50 3,173.00
R2019-0000073415 17-12-2019 201900070500/083100 JIERGO YONGKI Nathalia dr. OC00132 CTM 4mg 6.00 Tablet 157.41 1,444.46
R2019-0000073415 17-12-2019 201900070500/083100 JIERGO YONGKI Nathalia dr. ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000073416 16-12-2019 201900070490/092166 SUBEKTI,NY Nathalia dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000073416 16-12-2019 201900070490/092166 SUBEKTI,NY Nathalia dr. OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
Total 190,742,662.47
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 145 dari 266
ASAL RAWAT JALAN
R2019-0000073416 16-12-2019 201900070490/092166 SUBEKTI,NY Nathalia dr. OA00052 Ambroxol Tablet, 30mg 6.00 Tablet 445.50 3,173.00
R2019-0000073417 16-12-2019 201900070494/071986 USNI MAAY AN,NN Nathalia dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000073417 16-12-2019 201900070494/071986 USNI MAAY AN,NN Nathalia dr. OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000073418 16-12-2019 201900070491/111987 MEILINA Nathalia dr. OM00143 Metoclopramide 10mg 6.00 Tablet 211.95 1,771.70
R2019-0000073418 16-12-2019 201900070491/111987 MEILINA Nathalia dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000073418 16-12-2019 201900070491/111987 MEILINA Nathalia dr. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000073441 16-12-2019 201900070512/55677 ANANDA VARRELL Herika dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000073441 16-12-2019 201900070512/55677 ANANDA VARRELL Herika dr. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000073441 16-12-2019 201900070512/55677 ANANDA VARRELL Herika dr. OB00091 Biovitan Syrup, 60ml 1.00 Botol 8,019.00 8,519.00
R2019-0000073421 17-12-2019 201900070526/00013212 CANDRA RACHMAD,AN IRMA SARI OT00077 Tremenza Tablet 8.00 Tablet 2,160.68 17,785.44
R2019-0000073421 17-12-2019 201900070526/00013212 CANDRA RACHMAD,AN IRMA SARI OM00014 Mefinal 500mg 8.00 Tablet 1,982.48 16,359.84
R2019-0000073421 17-12-2019 201900070526/00013212 CANDRA RACHMAD,AN IRMA SARI OC00095 Co-Amoxiclave 625mg 10.00 Tablet 7,840.99 78,909.90
R2019-0000073443 17-12-2019 201900070521/062463 SUGENG,TN Herika dr. OC00097 Codein 15mg 10.00 Tablet 1,665.87 17,158.70
R2019-0000073443 17-12-2019 201900070521/062463 SUGENG,TN Herika dr. OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000073445 17-12-2019 201900070537/066109 FITRIONO,TN IRMA SARI OE00034 Estazor 250mg 10.00 Tablet 13,365.00 134,150.00
R2019-0000073445 17-12-2019 201900070537/066109 FITRIONO,TN IRMA SARI OC00134 Curcuma Tablet 10.00 Tablet 1,336.50 13,865.00
R2019-0000073447 17-12-2019 201900070549/064141 FIRMAN FATTA,TN IRMA SARI OC00144 Cefila Capsul, 100mg 10.00 Capsul 28,957.00 290,070.00
R2019-0000073447 17-12-2019 201900070549/064141 FIRMAN FATTA,TN IRMA SARI OA00088 Antiza Tablet 8.00 Tablet 1,633.00 13,564.00
R2019-0000073447 17-12-2019 201900070549/064141 FIRMAN FATTA,TN IRMA SARI ON00047 New Diatabs 8.00 Tablet 767.13 6,637.04
R2019-0000073447 17-12-2019 201900070549/064141 FIRMAN FATTA,TN IRMA SARI OO00040 Oralit 200 5.00 Sachet 706.00 4,030.00
R2019-0000073447 17-12-2019 201900070549/064141 FIRMAN FATTA,TN IRMA SARI OS00050 Sanvita B Plus Eff 1.00 Tube 57,395.25 57,895.25
R2019-0000073449 17-12-2019 201900070551/060986 SITI MARWATI,NY IRMA SARI OE00017 Epexol Syrup 1.00 Botol 25,690.50 26,190.50
R2019-0000073449 17-12-2019 201900070551/060986 SITI MARWATI,NY IRMA SARI OS00029 Sanmol Tablet, 500mg 8.00 Tablet 430.65 3,945.20
R2019-0000073449 17-12-2019 201900070551/060986 SITI MARWATI,NY IRMA SARI OT00077 Tremenza Tablet 8.00 Tablet 2,160.68 17,785.44
R2019-0000073451 17-12-2019 201900070517/110933 MARWAH,NY TEDDY OC00268 Cendo Eyefresh 5ml ED 1.00 Botol 42,879.37 43,379.37
R2019-0000073456 17-12-2019 201900070583/111996 DINAR WAHYU Herika dr. OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000073456 17-12-2019 201900070583/111996 DINAR WAHYU Herika dr. OE00006 Eflagen 50mg 10.00 Tablet 3,118.50 31,685.00
R2019-0000073458 17-12-2019 201900070567/111992 BUYUNG IFIANI,TN IRMA SARI OA00140 Atorvastatin 20mg (OGB) 5.00 Tablet 6,534.00 33,170.00
R2019-0000073460 17-12-2019 201900070591/086133 NASRAWATI,NY TEDDY OP00065 Polidemisin Eye Drop 1.00 Botol 41,134.50 41,634.50
R2019-0000073460 17-12-2019 201900070591/086133 NASRAWATI,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000073457 17-12-2019 201900070587/089476 TUMINI,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000073457 17-12-2019 201900070587/089476 TUMINI,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000073461 17-12-2019 201900070573/111994 ARBAIN,TN Herika dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000073461 17-12-2019 201900070573/111994 ARBAIN,TN Herika dr. OL00021 Lansoprazole (OGB) 3.00 Capsul 2,230.00 7,190.00
R2019-0000073462 17-12-2019 201900070535/065736 BAGONG,TN Maulin Nikmah OG00057 Gabapentin 300mg (OGB) 4.00 Tablet 8,168.00 33,172.00
R2019-0000073462 17-12-2019 201900070535/065736 BAGONG,TN Maulin Nikmah ALK00037 Kapsul No.1 6.00 pcs 200.00 6,200.00
R2019-0000073465 17-12-2019 201900070565/111991 MELLY YUNIDA,NY Alvarez Sp .OT OE00057 Eperisone Hcl 50mg 14.00 Tablet 2,286.90 32,516.60
R2019-0000073463 17-12-2019 201900070553/085164 WENDY JOHANES TEDDY OE00057 Eperisone Hcl 50mg 14.00 Tablet 2,286.90 32,516.60
Total 191,940,121.57
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 146 dari 266
ASAL RAWAT JALAN
R2019-0000073463 17-12-2019 201900070553/085164 WENDY JOHANES TEDDY ON00009 Natrium Diklofenac 50mg 14.00 Tablet 955.84 13,881.76
R2019-0000073468 17-12-2019 201900070600/111999 MARLISTA Herika dr. OI00134 Imunos Plus Tablet 10.00 Tablet 14,107.50 141,575.00
R2019-0000073468 17-12-2019 201900070600/111999 MARLISTA Herika dr. OS00029 Sanmol Tablet, 500mg 12.00 Tablet 430.65 5,667.80
R2019-0000073469 17-12-2019 201900070598/104580 MUHAMMAD SULTAN Herika dr. OO00062 Ottopan Syrup, 60ml 1.00 Botol 29,700.00 30,200.00
R2019-0000073469 17-12-2019 201900070598/104580 MUHAMMAD SULTAN Herika dr. OA00094 Apialys Syrup 100ml 1.00 Botol 49,005.00 49,505.00
R2019-0000073469 17-12-2019 201900070598/104580 MUHAMMAD SULTAN Herika dr. OA00070 Amoxsan Dry Syrup 1.00 Botol 33,412.50 33,912.50
R2019-0000073467 17-12-2019 201900070589/109140 ANISA LARA Herika dr. OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000073467 17-12-2019 201900070589/109140 ANISA LARA Herika dr. OP00138 Pumpitor Capsul 6.00 Capsul 20,092.05 121,052.30
R2019-0000073467 17-12-2019 201900070589/109140 ANISA LARA Herika dr. OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000073467 17-12-2019 201900070589/109140 ANISA LARA Herika dr. ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000073470 17-12-2019 201900070574/022584 AYU INDAH PERMATA TEDDY OR00029 Retivit Tablet 30.00 Tablet 5,672.70 170,681.00
R2019-0000073470 17-12-2019 201900070574/022584 AYU INDAH PERMATA TEDDY OC00300 Cendo Hyalub Minidose 3.00 Strip 84,645.00 254,435.00
R2019-0000073474 17-12-2019 201900070612/106930 RAMADANIA Herika dr. OS00029 Sanmol Tablet, 500mg 12.00 Tablet 430.65 5,667.80
R2019-0000073474 17-12-2019 201900070612/106930 RAMADANIA Herika dr. OE00018 Epexol Tablet 10.00 Tablet 1,232.55 12,825.50
R2019-0000073474 17-12-2019 201900070612/106930 RAMADANIA Herika dr. OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000073474 17-12-2019 201900070612/106930 RAMADANIA Herika dr. OI00134 Imunos Plus Tablet 10.00 Tablet 14,107.50 141,575.00
R2019-0000073474 17-12-2019 201900070612/106930 RAMADANIA Herika dr. OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000073474 17-12-2019 201900070612/106930 RAMADANIA Herika dr. OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000073472 17-12-2019 201900070617/112001 MUHAMMAD UMAR FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 4.00 Capsul 28,957.00 116,328.00
R2019-0000073472 17-12-2019 201900070617/112001 MUHAMMAD UMAR FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 3.00 Tablet 430.65 1,791.95
R2019-0000073472 17-12-2019 201900070617/112001 MUHAMMAD UMAR FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000073472 17-12-2019 201900070617/112001 MUHAMMAD UMAR FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 3.00 Tablet 1,232.55 4,197.65
R2019-0000073472 17-12-2019 201900070617/112001 MUHAMMAD UMAR FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000073472 17-12-2019 201900070617/112001 MUHAMMAD UMAR FREDRIK, Dr,Sp.A OA00096 Apolar N Cream, 10gr 1.00 Tube 53,014.50 53,514.50
R2019-0000073472 17-12-2019 201900070617/112001 MUHAMMAD UMAR FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 23,118.50
R2019-0000073475 17-12-2019 201900070611/108715 ANDI ABID NAILUN FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000073475 17-12-2019 201900070611/108715 ANDI ABID NAILUN FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000073475 17-12-2019 201900070611/108715 ANDI ABID NAILUN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000073475 17-12-2019 201900070611/108715 ANDI ABID NAILUN FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000073475 17-12-2019 201900070611/108715 ANDI ABID NAILUN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000073475 17-12-2019 201900070611/108715 ANDI ABID NAILUN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000073476 17-12-2019 201900070509/050942 YUSMIRIL RUDYAN IRMA SARI OA00064 Amlodipin 5mg (OGB) 30.00 Tablet 1,555.00 47,150.00
R2019-0000073477 17-12-2019 201900070633/036129 AHZAN ZAHIR FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 6.00 Capsul 28,957.00 174,242.00
R2019-0000073477 17-12-2019 201900070633/036129 AHZAN ZAHIR FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 5.00 Tablet 430.65 2,653.25
R2019-0000073477 17-12-2019 201900070633/036129 AHZAN ZAHIR FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 5.00 Tablet 1,173.15 6,365.75
R2019-0000073477 17-12-2019 201900070633/036129 AHZAN ZAHIR FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 5.00 Tablet 1,232.55 6,662.75
R2019-0000073477 17-12-2019 201900070633/036129 AHZAN ZAHIR FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 5.00 Granula 297.00 1,985.00
R2019-0000073477 17-12-2019 201900070633/036129 AHZAN ZAHIR FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
Total 193,819,677.58
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 147 dari 266
ASAL RAWAT JALAN
R2019-0000073478 17-12-2019 201900070581/082946 CHARLLOT E EUGINA FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 4.00 Capsul 28,957.00 116,328.00
R2019-0000073478 17-12-2019 201900070581/082946 CHARLLOT E EUGINA FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 4.00 Tablet 430.65 2,222.60
R2019-0000073478 17-12-2019 201900070581/082946 CHARLLOT E EUGINA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000073478 17-12-2019 201900070581/082946 CHARLLOT E EUGINA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000073478 17-12-2019 201900070581/082946 CHARLLOT E EUGINA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000073480 17-12-2019 201900070634/056071 MARISSA LETICIA FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 5.00 Capsul 28,957.00 145,285.00
R2019-0000073480 17-12-2019 201900070634/056071 MARISSA LETICIA FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 4.00 Tablet 430.65 2,222.60
R2019-0000073480 17-12-2019 201900070634/056071 MARISSA LETICIA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000073480 17-12-2019 201900070634/056071 MARISSA LETICIA FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 4.00 Tablet 1,232.55 5,430.20
R2019-0000073480 17-12-2019 201900070634/056071 MARISSA LETICIA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000073480 17-12-2019 201900070634/056071 MARISSA LETICIA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 200.20 23,003.00
R2019-0000073482 17-12-2019 201900070645/112007 FRENGKY IRMA SARI OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000073482 17-12-2019 201900070645/112007 FRENGKY IRMA SARI OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000073482 17-12-2019 201900070645/112007 FRENGKY IRMA SARI OL00017 Lameson 4mg 8.00 Tablet 5,049.00 40,892.00
R2019-0000073482 17-12-2019 201900070645/112007 FRENGKY IRMA SARI OB00007 Becom - C 5.00 Tablet 2,123.55 11,117.75
R2019-0000073482 17-12-2019 201900070645/112007 FRENGKY IRMA SARI OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000073484 17-12-2019 201900070630/065146 IKA SARI DEWI NOVIANA, Dr. Sp OT00077 Tremenza Tablet 10.00 Tablet 2,160.68 22,106.80
R2019-0000073484 17-12-2019 201900070630/065146 IKA SARI DEWI NOVIANA, Dr. Sp OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000073487 17-12-2019 201900070629/112004 MARDIYAH,NY NOVIANA, Dr. Sp OA00134 Asta Plus 15.00 Tablet 12,623.00 189,845.00
R2019-0000073489 16-12-2019 201900070319/111758 DAWIYAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000073490 16-12-2019 201900070319/111758 DAWIYAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000073492 16-12-2019 201900070243/111670 NOOR JANNAH,NY LUSY E. Dr.Sp.PD OK00022 Ketoconazol Cream 2% 1.00 Tube 11,000.00 11,500.00
R2019-0000073492 16-12-2019 201900070243/111670 NOOR JANNAH,NY LUSY E. Dr.Sp.PD OH00026 Hydrocortis on Cream 1.00 Tube 11,880.00 12,380.00
R2019-0000073492 16-12-2019 201900070243/111670 NOOR JANNAH,NY LUSY E. Dr.Sp.PD ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073495 16-12-2019 201900070230/101448 DAHLIA RUSNI,NY Dameria Sri OL00021 Lansoprazole (OGB) 8.00 Capsul 2,230.00 18,340.00
R2019-0000073495 16-12-2019 201900070230/101448 DAHLIA RUSNI,NY Dameria Sri OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
Total 195,957,704.73
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 148 dari 266
ASAL RAWAT JALAN
R2019-0000073495 16-12-2019 201900070230/101448 DAHLIA RUSNI,NY Dameria Sri OB001002 Betahistine 14.00 Tab 5,940.00 83,660.00
R2019-0000073497 16-12-2019 201900070228/072483 INSIAH,NY Dameria Sri OP00199 Pletaal 100mg 6.00 Capsul 19,961.00 120,266.00
R2019-0000073497 16-12-2019 201900070228/072483 INSIAH,NY Dameria Sri OO00014 Omeprazole 20mg (OGB) 8.00 Capsul 1,169.98 9,859.84
R2019-0000073499 16-12-2019 201900070324/110583 HARYONO,TN LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000073500 16-12-2019 201900070341/085012 A SUANSI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000073500 16-12-2019 201900070341/085012 A SUANSI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000073500 16-12-2019 201900070341/085012 A SUANSI,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 23.00 Tablet 14,701.50 338,634.50
R2019-0000073500 16-12-2019 201900070341/085012 A SUANSI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000073500 16-12-2019 201900070341/085012 A SUANSI,NY LUSY E. Dr.Sp.PD OL00056 Levemir Insulin 2.00 Flexpen 287,330.88 575,161.76
R2019-0000073500 16-12-2019 201900070341/085012 A SUANSI,NY LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 4.00 Flexpen 226,917.80 908,171.20
R2019-0000073501 16-12-2019 201900070341/085012 A SUANSI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000073501 16-12-2019 201900070341/085012 A SUANSI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000073501 16-12-2019 201900070341/085012 A SUANSI,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000073501 16-12-2019 201900070341/085012 A SUANSI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000073501 16-12-2019 201900070341/085012 A SUANSI,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 14.00 Capsul 1,169.98 16,879.72
R2019-0000073502 16-12-2019 201900070255/111823 SYAHRIADI,TN Dameria Sri OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000073502 16-12-2019 201900070255/111823 SYAHRIADI,TN Dameria Sri OS00173 Simvastatin 20mg (OGB) 23.00 Tablet 1,782.00 41,486.00
R2019-0000073503 16-12-2019 201900070255/111823 SYAHRIADI,TN Dameria Sri OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000073503 16-12-2019 201900070255/111823 SYAHRIADI,TN Dameria Sri OS00173 Simvastatin 20mg (OGB) 7.00 Tablet 1,782.00 12,974.00
R2019-0000073503 16-12-2019 201900070255/111823 SYAHRIADI,TN Dameria Sri OC00182 Citicolin Tablet 500mg 10.00 Tablet 10,098.00 101,480.00
R2019-0000073504 17-12-2019 201900070661/112010 RIDHATUL Eviwati OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000073505 16-12-2019 201900070353/106555 BINTI KHOFIFAH,NY LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 23.00 Tablet 2,525.00 58,575.00
R2019-0000073505 16-12-2019 201900070353/106555 BINTI KHOFIFAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 46.00 Tablet 371.25 17,577.50
R2019-0000073505 16-12-2019 201900070353/106555 BINTI KHOFIFAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000073505 16-12-2019 201900070353/106555 BINTI KHOFIFAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
Total 199,892,224.40
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 149 dari 266
ASAL RAWAT JALAN
R2019-0000073505 16-12-2019 201900070353/106555 BINTI KHOFIFAH,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 23.00 Tablet 240.30 6,026.90
R2019-0000073486 17-12-2019 201900070605/111120 BONIFASIUS BUKO,TN Maulin Nikmah OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073506 16-12-2019 201900070353/106555 BINTI KHOFIFAH,NY LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 7.00 Tablet 2,525.00 18,175.00
R2019-0000073506 16-12-2019 201900070353/106555 BINTI KHOFIFAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000073506 16-12-2019 201900070353/106555 BINTI KHOFIFAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000073506 16-12-2019 201900070353/106555 BINTI KHOFIFAH,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000073506 16-12-2019 201900070353/106555 BINTI KHOFIFAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000073509 17-12-2019 201900070635/111788 RAIYSA NAURA,AN Eviwati OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073508 17-12-2019 201900071177/099099 SITI NUR FAT IMAH,NY Eviwati OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000073508 17-12-2019 201900071177/099099 SITI NUR FAT IMAH,NY Eviwati OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073511 17-12-2019 201900070655/21432 MINEM IRMA SARI OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000073511 17-12-2019 201900070655/21432 MINEM IRMA SARI OL00119 L-cisin Tablet 15.00 Tablet 5,940.00 89,600.00
R2019-0000073511 17-12-2019 201900070655/21432 MINEM IRMA SARI OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000073511 17-12-2019 201900070655/21432 MINEM IRMA SARI OO00066 Oxoril Syrup, 60ml 1.00 Botol 41,580.00 42,080.00
R2019-0000073510 17-12-2019 201900070614/102853 DILLA REIFINA Ismail dr. Msc. ALD00003 Disposable Syringe 1ml 1.00 Pcs 3,500.00 4,000.00
R2019-0000073516 17-12-2019 201900070626/111649 ERNANY PUSPA,NY Ismail dr. Msc. ALD00003 Disposable Syringe 1ml 1.00 Pcs 3,500.00 4,000.00
R2019-0000073517 17-12-2019 201900070664/112012 SITI SUWARTI, ADE RAHMAH ON00013 Nebacetin Powder 1.00 Pot 30,442.50 30,942.50
R2019-0000073527 17-12-2019 201900070668/112014 VINA NUR AFIJA,NN ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000073519 17-12-2019 201900070659/077756 ERNA ISYAHLIWANTI, Ismail dr. Msc. OM00045 Methyl Prednisolon 4mg 15.00 Tablet 792.99 12,394.85
R2019-0000073519 17-12-2019 201900070659/077756 ERNA ISYAHLIWANTI, Ismail dr. Msc. OL00080 Loratadin 10mg (OGB) 30.00 Tablet 520.00 16,100.00
R2019-0000073519 17-12-2019 201900070659/077756 ERNA ISYAHLIWANTI, Ismail dr. Msc. OR00003 Ranitidin 150mg (OGB) 30.00 Tablet 891.00 27,230.00
R2019-0000073519 17-12-2019 201900070659/077756 ERNA ISYAHLIWANTI, Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 7,276.50 7,776.50
R2019-0000073519 17-12-2019 201900070659/077756 ERNA ISYAHLIWANTI, Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000073519 17-12-2019 201900070659/077756 ERNA ISYAHLIWANTI, Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073528 17-12-2019 201900070657/095835 BARDIMAN,TN Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000073528 17-12-2019 201900070657/095835 BARDIMAN,TN Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000073528 17-12-2019 201900070657/095835 BARDIMAN,TN Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000073528 17-12-2019 201900070657/095835 BARDIMAN,TN Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073528 17-12-2019 201900070657/095835 BARDIMAN,TN Ismail dr. Msc. OL00080 Loratadin 10mg (OGB) 20.00 Tablet 520.00 10,900.00
R2019-0000073531 17-12-2019 201900070654/044797 MU'MIN,NY Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000073531 17-12-2019 201900070654/044797 MU'MIN,NY Ismail dr. Msc. OG00057 Gabapentin 300mg (OGB) 30.00 Tablet 8,168.00 245,540.00
R2019-0000073531 17-12-2019 201900070654/044797 MU'MIN,NY Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000073531 17-12-2019 201900070654/044797 MU'MIN,NY Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000073531 17-12-2019 201900070654/044797 MU'MIN,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073532 17-12-2019 201900070597/111998 DARREN Herika dr. OP00138 Pumpitor Capsul 10.00 Capsul 20,092.05 201,420.50
R2019-0000073532 17-12-2019 201900070597/111998 DARREN Herika dr. OI00134 Imunos Plus Tablet 10.00 Tablet 14,107.50 141,575.00
R2019-0000073507 17-12-2019 201900070650/089699 CHAIRUL FITRI,TN Eviwati OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000073507 17-12-2019 201900070650/089699 CHAIRUL FITRI,TN Eviwati OL00080 Loratadin 10mg (OGB) 20.00 520.00 10,900.00
Total 201,114,169.75
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 150 dari 266
ASAL RAWAT JALAN
R2019-0000073507 17-12-2019 201900070650/089699 CHAIRUL FITRI,TN Eviwati GK003 Ketoconazole Cream 10 1.00 Tube 8,019.00 8,519.00
R2019-0000073507 17-12-2019 201900070650/089699 CHAIRUL FITRI,TN Eviwati OH00026 Hydrocortis on Cream 2.00 Tube 11,880.00 24,260.00
R2019-0000073507 17-12-2019 201900070650/089699 CHAIRUL FITRI,TN Eviwati ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073533 17-12-2019 201900070639/076579 EDY RAHMAD,TN Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000073533 17-12-2019 201900070639/076579 EDY RAHMAD,TN Ismail dr. Msc. OC00086 Clindamycin 300mg 20.00 Tablet 2,700.00 54,500.00
R2019-0000073533 17-12-2019 201900070639/076579 EDY RAHMAD,TN Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 7,276.50 7,776.50
R2019-0000073533 17-12-2019 201900070639/076579 EDY RAHMAD,TN Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000073533 17-12-2019 201900070639/076579 EDY RAHMAD,TN Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073536 17-12-2019 201900070620/111595 ANDI MUHAMMAD Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 15.00 Tablet 623.70 9,855.50
R2019-0000073536 17-12-2019 201900070620/111595 ANDI MUHAMMAD Ismail dr. Msc. OK00022 Ketoconazol Cream 2% 1.00 Tube 11,000.00 11,500.00
R2019-0000073536 17-12-2019 201900070620/111595 ANDI MUHAMMAD Ismail dr. Msc. OH00026 Hydrocortis on Cream 2.00 Tube 11,880.00 24,260.00
R2019-0000073536 17-12-2019 201900070620/111595 ANDI MUHAMMAD Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073538 17-12-2019 201900070608/111364 CHRISTINA Eviwati OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073541 17-12-2019 201900070586/048881 FARREL ANDIKA Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000073541 17-12-2019 201900070586/048881 FARREL ANDIKA Ismail dr. Msc. OL00080 Loratadin 10mg (OGB) 30.00 Tablet 520.00 16,100.00
R2019-0000073541 17-12-2019 201900070586/048881 FARREL ANDIKA Ismail dr. Msc. OR00003 Ranitidin 150mg (OGB) 30.00 Tablet 891.00 27,230.00
R2019-0000073541 17-12-2019 201900070586/048881 FARREL ANDIKA Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 7,276.50 7,776.50
R2019-0000073541 17-12-2019 201900070586/048881 FARREL ANDIKA Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000073541 17-12-2019 201900070586/048881 FARREL ANDIKA Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073543 17-12-2019 201900070662/112011 FAKHRUL ROZI,TN ADE RAHMAH OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000073543 17-12-2019 201900070662/112011 FAKHRUL ROZI,TN ADE RAHMAH OB00007 Becom - C 3.00 Tablet 2,123.55 6,870.65
R2019-0000073544 17-12-2019 201900070667/072399 ETTY NURHAYAT I,NY ADE RAHMAH OG00057 Gabapentin 300mg (OGB) 4.00 Tablet 8,168.00 33,172.00
R2019-0000073544 17-12-2019 201900070667/072399 ETTY NURHAYAT I,NY ADE RAHMAH OC00016 Kapsul No. 0 10.00 Capsul 200.00 22,000.00
R2019-0000073544 17-12-2019 201900070667/072399 ETTY NURHAYAT I,NY ADE RAHMAH OE00022 Eprinoc Tablet 10.00 Tablet 5,093.55 51,435.50
R2019-0000073544 17-12-2019 201900070667/072399 ETTY NURHAYAT I,NY ADE RAHMAH OD00102 Dexketoprofen 25mg 10.00 Tablet 4,290.00 43,400.00
R2019-0000073544 17-12-2019 201900070667/072399 ETTY NURHAYAT I,NY ADE RAHMAH OB00007 Becom - C 10.00 Tablet 2,123.55 21,735.50
R2019-0000073544 17-12-2019 201900070667/072399 ETTY NURHAYAT I,NY ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000073547 17-12-2019 201900070676/107516 NATHAN AZFAR ADE RAHMAH OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000073547 17-12-2019 201900070676/107516 NATHAN AZFAR ADE RAHMAH OL00001 L - BIO Sachet 10.00 Sachet 10,395.00 104,450.00
R2019-0000073549 17-12-2019 201900070651/068060 ZAKARIA,TN Restu OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000073549 17-12-2019 201900070651/068060 ZAKARIA,TN Restu OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000073549 17-12-2019 201900070651/068060 ZAKARIA,TN Restu OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000073549 17-12-2019 201900070651/068060 ZAKARIA,TN Restu OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000073549 17-12-2019 201900070651/068060 ZAKARIA,TN Restu OD00047 Diamicron MR 60mg 7.00 Tablet 8,420.00 59,440.00
R2019-0000073545 17-12-2019 201900070627/062329 DJUWITO TEGUH Restu OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000073545 17-12-2019 201900070627/062329 DJUWITO TEGUH Restu OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000073545 17-12-2019 201900070627/062329 DJUWITO TEGUH Restu OD00047 Diamicron MR 60mg 7.00 Tablet 8,420.00 59,440.00
R2019-0000073545 17-12-2019 201900070627/062329 DJUWITO TEGUH Restu OS00173 Simvastatin 20mg (OGB) 7.00 Tablet 1,782.00 12,974.00
Total 202,018,037.87
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 151 dari 266
ASAL RAWAT JALAN
R2019-0000073545 17-12-2019 201900070627/062329 DJUWITO TEGUH Restu OG00057 Gabapentin 300mg (OGB) 7.00 Tablet 8,168.00 57,676.00
R2019-0000073545 17-12-2019 201900070627/062329 DJUWITO TEGUH Restu OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000073551 17-12-2019 201900070627/062329 DJUWITO TEGUH Restu OL00056 Levemir Insulin 2.00 Flexpen 287,330.88 575,161.76
R2019-0000073551 17-12-2019 201900070627/062329 DJUWITO TEGUH Restu OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2019-0000073551 17-12-2019 201900070627/062329 DJUWITO TEGUH Restu OD00047 Diamicron MR 60mg 23.00 Tablet 8,420.00 194,160.00
R2019-0000073551 17-12-2019 201900070627/062329 DJUWITO TEGUH Restu OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000073551 17-12-2019 201900070627/062329 DJUWITO TEGUH Restu OS00173 Simvastatin 20mg (OGB) 23.00 Tablet 1,782.00 41,486.00
R2019-0000073551 17-12-2019 201900070627/062329 DJUWITO TEGUH Restu OG00057 Gabapentin 300mg (OGB) 23.00 Tablet 8,168.00 188,364.00
R2019-0000073551 17-12-2019 201900070627/062329 DJUWITO TEGUH Restu OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000073552 17-12-2019 201900070571/081410 URWAH,AN FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000073552 17-12-2019 201900070571/081410 URWAH,AN FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000073552 17-12-2019 201900070571/081410 URWAH,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000073552 17-12-2019 201900070571/081410 URWAH,AN FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000073552 17-12-2019 201900070571/081410 URWAH,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000073552 17-12-2019 201900070571/081410 URWAH,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000073554 17-12-2019 201900070569/078273 HAFSHAH,AN FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000073554 17-12-2019 201900070569/078273 HAFSHAH,AN FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000073554 17-12-2019 201900070569/078273 HAFSHAH,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000073554 17-12-2019 201900070569/078273 HAFSHAH,AN FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
R2019-0000073554 17-12-2019 201900070569/078273 HAFSHAH,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000073554 17-12-2019 201900070569/078273 HAFSHAH,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000073555 17-12-2019 201900070530/2794 AKHMAD BUSTAMAN Restu OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000073555 17-12-2019 201900070530/2794 AKHMAD BUSTAMAN Restu OF00095 Furosemide 40mg (OGB) 3.00 Tablet 315.26 1,445.78
R2019-0000073555 17-12-2019 201900070530/2794 AKHMAD BUSTAMAN Restu OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000073556 17-12-2019 201900070530/2794 AKHMAD BUSTAMAN Restu OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000073556 17-12-2019 201900070530/2794 AKHMAD BUSTAMAN Restu OF00095 Furosemide 40mg (OGB) 12.00 Tablet 315.26 4,283.12
R2019-0000073556 17-12-2019 201900070530/2794 AKHMAD BUSTAMAN Restu OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000073559 17-12-2019 201900070677/112016 SAPIAH,NY ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000073553 17-12-2019 201900070671/110860 RATNA ADE RAHMAH OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000073553 17-12-2019 201900070671/110860 RATNA ADE RAHMAH OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000073553 17-12-2019 201900070671/110860 RATNA ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000073553 17-12-2019 201900070671/110860 RATNA ADE RAHMAH OD00065 Domperidon Tablet (OGB) 10.00 Tablet 750.00 8,000.00
R2019-0000073553 17-12-2019 201900070671/110860 RATNA ADE RAHMAH OB00007 Becom - C 5.00 Tablet 2,123.55 11,117.75
R2019-0000073560 17-12-2019 201900070542/110953 HARIS,TN Dameria Sri OG00057 Gabapentin 300mg (OGB) 4.00 Tablet 8,168.00 33,172.00
R2019-0000073560 17-12-2019 201900070542/110953 HARIS,TN Dameria Sri OC00016 Kapsul No. 0 8.00 Capsul 200.00 2,100.00
R2019-0000073560 17-12-2019 201900070542/110953 HARIS,TN Dameria Sri OB00016 Betahistine Mesilat 6mg 15.00 Tablet 1,500.00 23,000.00
R2019-0000073560 17-12-2019 201900070542/110953 HARIS,TN Dameria Sri OF00065 Flunarizine 5mg 10.00 Tablet 2,970.00 30,200.00
R2019-0000073560 17-12-2019 201900070542/110953 HARIS,TN Dameria Sri OM00017 Meloxicam 15mg (OGB) 8.00 Tablet 2,079.00 17,132.00
Total 204,042,365.83
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 152 dari 266
ASAL RAWAT JALAN
R2019-0000073562 17-12-2019 201900070599/106950 RAHATIN,NY Restu OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000073562 17-12-2019 201900070599/106950 RAHATIN,NY Restu OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000073562 17-12-2019 201900070599/106950 RAHATIN,NY Restu OH00025 Hydrochlortiazide (OGB) 23.00 Tablet 240.30 6,026.90
R2019-0000073562 17-12-2019 201900070599/106950 RAHATIN,NY Restu OB00036 Bis oprolol 5mg (OGB) 23.00 Tablet 5,197.50 120,042.50
R2019-0000073564 17-12-2019 201900070529/096255 PURNAMA,NY Restu OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000073564 17-12-2019 201900070529/096255 PURNAMA,NY Restu OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000073564 17-12-2019 201900070529/096255 PURNAMA,NY Restu OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000073565 17-12-2019 201900070672/112015 MUH. AL-FAT IH,SDR ADE RAHMAH OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000073565 17-12-2019 201900070672/112015 MUH. AL-FAT IH,SDR ADE RAHMAH OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000073565 17-12-2019 201900070672/112015 MUH. AL-FAT IH,SDR ADE RAHMAH OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000073563 17-12-2019 201900070677/112016 SAPIAH,NY ADE RAHMAH OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000073563 17-12-2019 201900070677/112016 SAPIAH,NY ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000073563 17-12-2019 201900070677/112016 SAPIAH,NY ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000073568 17-12-2019 201900070665/112013 SHAFIYY AH Riyanti Puji dr. OA00015 Acyclovir 400mg (OGB) 7.00 Tablet 1,262.25 9,335.75
R2019-0000073568 17-12-2019 201900070665/112013 SHAFIYY AH Riyanti Puji dr. ATKK031 Kertas Puyer Handbond 20.00 Sachet 207.90 19,158.00
R2019-0000073568 17-12-2019 201900070665/112013 SHAFIYY AH Riyanti Puji dr. OA00016 Acyclovir Cream 5gr 1.00 Tube 4,893.00 5,393.00
R2019-0000073568 17-12-2019 201900070665/112013 SHAFIYY AH Riyanti Puji dr. OC00291 Cerini Syrup 1.00 Botol 59,103.00 59,603.00
R2019-0000073568 17-12-2019 201900070665/112013 SHAFIYY AH Riyanti Puji dr. OI00117 Imunos Plus Syrup, 60ml 1.00 Botol 136,620.00 137,120.00
R2019-0000073567 17-12-2019 201900070679/041973 SHOFI RAMADHANI,AN ADE RAHMAH OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000073567 17-12-2019 201900070679/041973 SHOFI RAMADHANI,AN ADE RAHMAH OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000073570 17-12-2019 201900070683/18955 ADITYA LATHIF,SDR ADE RAHMAH OC00120 Cortidex Tablet 10.00 Tablet 430.65 4,806.50
R2019-0000073570 17-12-2019 201900070683/18955 ADITYA LATHIF,SDR ADE RAHMAH OF00039 FG Troches 10.00 Tablet 1,730.02 17,800.20
R2019-0000073566 17-12-2019 201900070680/112017 YONGKI FIRMAN ADE RAHMAH OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000073571 17-12-2019 201900070678/060925 AGUSTINUS,TN ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 3.00 Capsul 1,169.98 4,009.94
R2019-0000073571 17-12-2019 201900070678/060925 AGUSTINUS,TN ADE RAHMAH OA00085 Antasida Tablet (OGB) 3.00 Tablet 284.30 1,352.90
R2019-0000073571 17-12-2019 201900070678/060925 AGUSTINUS,TN ADE RAHMAH OD00065 Domperidon Tablet (OGB) 3.00 Tablet 750.00 2,750.00
R2019-0000073573 17-12-2019 201900070671/110860 RATNA ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000073573 17-12-2019 201900070671/110860 RATNA ADE RAHMAH ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000073574 17-12-2019 201900070672/112015 MUH. AL-FAT IH,SDR ADE RAHMAH OP00011 Paracetamol 500mg 1.00 Tablet 387.36 887.36
R2019-0000073574 17-12-2019 201900070672/112015 MUH. AL-FAT IH,SDR ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000073574 17-12-2019 201900070672/112015 MUH. AL-FAT IH,SDR ADE RAHMAH OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000073576 17-12-2019 201900070678/060925 AGUSTINUS,TN ADE RAHMAH OP00150 Pantoprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000073576 17-12-2019 201900070678/060925 AGUSTINUS,TN ADE RAHMAH OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000073575 17-12-2019 201900070681/111737 ATIKA AISH Riyanti Puji dr. OL00005 Lactacyd Baby, 60ml 1.00 Botol 34,155.00 34,655.00
R2019-0000073580 17-12-2019 201900070682/086965 RAFFASYA MILANO Rianti dr. Sp.A OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000073580 17-12-2019 201900070682/086965 RAFFASYA MILANO Rianti dr. Sp.A OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000073580 17-12-2019 201900070682/086965 RAFFASYA MILANO Rianti dr. Sp.A OC00132 CTM 4mg 3.00 Tablet 157.41 972.23
R2019-0000073580 17-12-2019 201900070682/086965 RAFFASYA MILANO Rianti dr. Sp.A OT00142 Trilac 4mg 5.00 Tablet 5,200.00 26,500.00
Total 205,184,105.98
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 153 dari 266
ASAL RAWAT JALAN
R2019-0000073580 17-12-2019 201900070682/086965 RAFFASYA MILANO Rianti dr. Sp.A ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000073588 17-12-2019 201900070684/112018 YUSVA HUSNI ADE RAHMAH OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000073588 17-12-2019 201900070684/112018 YUSVA HUSNI ADE RAHMAH OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000073590 17-12-2019 201900071445/111377 DEWI SHINTA R,AN ADE RAHMAH OE00056 Ecosol Nacl 0,9 % 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000073590 17-12-2019 201900071445/111377 DEWI SHINTA R,AN ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000073602 18-12-2019 201900071445/111377 DEWI SHINTA R,AN ADE RAHMAH OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000073602 18-12-2019 201900071445/111377 DEWI SHINTA R,AN ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000073602 18-12-2019 201900071445/111377 DEWI SHINTA R,AN ADE RAHMAH ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000073602 18-12-2019 201900071445/111377 DEWI SHINTA R,AN ADE RAHMAH ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000073603 18-12-2019 201900070691/094867 ABDUL LATIF N,SDR Nathalia dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000073603 18-12-2019 201900070691/094867 ABDUL LATIF N,SDR Nathalia dr. OS00176 Scopma Plus Tablet 1.00 Tablet 2,090.22 2,590.22
R2019-0000073604 18-12-2019 201900070697/054098 SUSAN Nathalia dr. OI00097 Isosorbide Dinitrate 5mg 2.00 Tablet 311.85 1,123.70
R2019-0000073604 18-12-2019 201900070697/054098 SUSAN Nathalia dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000073605 18-12-2019 201900070692/112019 WAHYU PURNOMO Nathalia dr. OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000073606 18-12-2019 201900070686/32191 MARIA GORETY Nathalia dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000073606 18-12-2019 201900070686/32191 MARIA GORETY Nathalia dr. OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000073606 18-12-2019 201900070686/32191 MARIA GORETY Nathalia dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000073606 18-12-2019 201900070686/32191 MARIA GORETY Nathalia dr. OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000073606 18-12-2019 201900070686/32191 MARIA GORETY Nathalia dr. OC00018 Captopril 12.5mg (OGB) 1.00 Tablet 180.00 680.00
R2019-0000073607 18-12-2019 201900070693/059019 MEIKEL Nathalia dr. OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000073607 18-12-2019 201900070693/059019 MEIKEL Nathalia dr. OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000073608 18-12-2019 201900070691/094867 ABDUL LATIF N,SDR Nathalia dr. OS00176 Scopma Plus Tablet 10.00 Tablet 2,090.22 21,402.20
R2019-0000073609 18-12-2019 201900070697/054098 SUSAN Nathalia dr. OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000073609 18-12-2019 201900070697/054098 SUSAN Nathalia dr. OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000073609 18-12-2019 201900070697/054098 SUSAN Nathalia dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000073614 17-12-2019 201900070554/111989 JACKLY N JOEHANA Herika dr. OP00011 Paracetamol 500mg 8.00 Tablet 387.36 3,598.88
R2019-0000073614 17-12-2019 201900070554/111989 JACKLY N JOEHANA Herika dr. OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000073614 17-12-2019 201900070554/111989 JACKLY N JOEHANA Herika dr. OA00052 Ambroxol Tablet, 30mg 6.00 Tablet 445.50 3,173.00
R2019-0000073614 17-12-2019 201900070554/111989 JACKLY N JOEHANA Herika dr. OF00039 FG Troches 4.00 Tablet 1,730.02 7,420.08
R2019-0000073615 17-12-2019 201900070621/080450 CANDIKA REIHAN AL Herika dr. OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000073620 17-12-2019 201900070573/111994 ARBAIN,TN Herika dr. OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000073619 17-12-2019 201900070534/103025 AISYAH AZAHRA,AN Herika dr. OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000073619 17-12-2019 201900070534/103025 AISYAH AZAHRA,AN Herika dr. OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000073622 17-12-2019 201900070572/080614 SABULAN,TN Herika dr. OA00111 Aspilets Chawable 1.00 Tablet 811.35 1,311.35
R2019-0000073622 17-12-2019 201900070572/080614 SABULAN,TN Herika dr. OC00092 Clopidogrel 75mg (OGB) 1.00 Tablet 14,701.50 15,201.50
R2019-0000073622 17-12-2019 201900070572/080614 SABULAN,TN Herika dr. OB00036 Bis oprolol 5mg (OGB) 1.00 Tablet 5,197.50 5,697.50
R2019-0000073622 17-12-2019 201900070572/080614 SABULAN,TN Herika dr. OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000073622 17-12-2019 201900070572/080614 SABULAN,TN Herika dr. ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
Total 205,925,204.97
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 154 dari 266
ASAL RAWAT JALAN
R2019-0000073624 17-12-2019 201900070536/093710 HENDRICK C Herika dr. OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000073624 17-12-2019 201900070536/093710 HENDRICK C Herika dr. OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000073624 17-12-2019 201900070536/093710 HENDRICK C Herika dr. OM00035 Metformin 500mg (OGB) 5.00 Tablet 371.25 2,356.25
R2019-0000073624 17-12-2019 201900070536/093710 HENDRICK C Herika dr. OG00023 Glimepiride 3mg Tablet 5.00 Tablet 3,164.00 16,320.00
R2019-0000073624 17-12-2019 201900070536/093710 HENDRICK C Herika dr. OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2019-0000073625 17-12-2019 201900070547/095258 WANTI,NY Dameria Sri OK00002 Kalium Diklofenac 50mg 14.00 Tablet 1,100.00 15,900.00
R2019-0000073625 17-12-2019 201900070547/095258 WANTI,NY Dameria Sri OA00062 Amitriptyline Tablet, 4.00 Tablet 252.45 1,509.80
R2019-0000073625 17-12-2019 201900070547/095258 WANTI,NY Dameria Sri OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000073623 17-12-2019 201900070622/056918 JEVERA ARSA IQBAL OF00141 Farizol Suspensi, 60ml 1.00 Botol 18,532.00 19,032.00
R2019-0000073626 17-12-2019 201900070628/112003 AMAR GUSTI FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 5.00 Capsul 4,266.70 21,833.50
R2019-0000073626 17-12-2019 201900070628/112003 AMAR GUSTI FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000073626 17-12-2019 201900070628/112003 AMAR GUSTI FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000073626 17-12-2019 201900070628/112003 AMAR GUSTI FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
R2019-0000073626 17-12-2019 201900070628/112003 AMAR GUSTI FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000073626 17-12-2019 201900070628/112003 AMAR GUSTI FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000073626 17-12-2019 201900070628/112003 AMAR GUSTI FREDRIK, Dr,Sp.A OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000073627 17-12-2019 201900070523/24660 SITI FAUZIAH,NY Dameria Sri OK00002 Kalium Diklofenac 50mg 14.00 Tablet 1,100.00 15,900.00
R2019-0000073627 17-12-2019 201900070523/24660 SITI FAUZIAH,NY Dameria Sri OA00062 Amitriptyline Tablet, 4.00 Tablet 252.45 1,509.80
R2019-0000073627 17-12-2019 201900070523/24660 SITI FAUZIAH,NY Dameria Sri OE00057 Eperisone Hcl 50mg 15.00 Tablet 2,286.90 34,803.50
R2019-0000073630 17-12-2019 201900070596/110548 MAHIRAQIL TEDDY OC00053 Cendo Xitrol Salep Mata 1.00 Botol 53,274.37 53,774.37
R2019-0000073629 17-12-2019 201900070624/110803 SUMIATI,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000073635 17-12-2019 201900070524/094061 SAHI MARIATI,NY MAGDA ROSSA, ON00009 Natrium Diklofenac 50mg 10.00 Tablet 955.84 10,058.40
R2019-0000073636 17-12-2019 201900070503/072746 SYARIFUDDIN,TN Dameria Sri OG00057 Gabapentin 300mg (OGB) 20.00 Tablet 8,168.00 163,860.00
R2019-0000073636 17-12-2019 201900070503/072746 SYARIFUDDIN,TN Dameria Sri OA00062 Amitriptyline Tablet, 4.00 Tablet 252.45 1,509.80
R2019-0000073636 17-12-2019 201900070503/072746 SYARIFUDDIN,TN Dameria Sri OG00073 Glucosamine 250 Mg 14.00 Tablet 1,633.50 23,369.00
R2019-0000073639 17-12-2019 201900070541/111821 ADIN DWI MAGDA ROSSA, OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073639 17-12-2019 201900070541/111821 ADIN DWI MAGDA ROSSA, OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000073641 17-12-2019 201900070636/020954 SUNNIATI,NY NOVIANA, Dr. Sp OE00008 Elkana Tablet 7.00 Tablet 1,247.40 9,231.80
R2019-0000073643 12-12-2019 201900069599/100265 SUROTO NARDI,TN Alvarez Sp .OT OM00134 Meiact 200 mg 25.00 Tablet 47,800.00 1,195,500.00
R2019-0000073637 17-12-2019 201900070504/087557 PONIRAH,NY Dameria Sri OP00011 Paracetamol 500mg 20.00 Tablet 387.36 8,247.20
R2019-0000073637 17-12-2019 201900070504/087557 PONIRAH,NY Dameria Sri OE00057 Eperisone Hcl 50mg 20.00 Tablet 2,286.90 46,238.00
R2019-0000073637 17-12-2019 201900070504/087557 PONIRAH,NY Dameria Sri OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000073645 18-12-2019 201900070748/112022 OMSAH NURLIA IQBAL OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000073645 18-12-2019 201900070748/112022 OMSAH NURLIA IQBAL OI00134 Imunos Plus Tablet 5.00 Tablet 14,107.50 71,037.50
R2019-0000073652 18-12-2019 201900070751/112023 BAYU ARIADI,TN Herika dr. OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
Total 207,957,243.05
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 155 dari 266
ASAL RAWAT JALAN
R2019-0000073652 18-12-2019 201900070751/112023 BAYU ARIADI,TN Herika dr. OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000073652 18-12-2019 201900070751/112023 BAYU ARIADI,TN Herika dr. OP00164 Pumpitor Injeksi 1.00 Vial 222,750.00 223,250.00
R2019-0000073652 18-12-2019 201900070751/112023 BAYU ARIADI,TN Herika dr. OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000073652 18-12-2019 201900070751/112023 BAYU ARIADI,TN Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000073652 18-12-2019 201900070751/112023 BAYU ARIADI,TN Herika dr. ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000073653 18-12-2019 201900070774/077492 SIDIK GUNARTO,TN IQBAL OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000073653 18-12-2019 201900070774/077492 SIDIK GUNARTO,TN IQBAL OM00100 Mucera Tablet 10.00 Tablet 1,782.00 18,320.00
R2019-0000073653 18-12-2019 201900070774/077492 SIDIK GUNARTO,TN IQBAL OL00017 Lameson 4mg 6.00 Tablet 5,049.00 30,794.00
R2019-0000073653 18-12-2019 201900070774/077492 SIDIK GUNARTO,TN IQBAL OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000073654 18-12-2019 201900070780/064198 VINCENZO JOAQUIN IQBAL, dr OC00291 Cerini Syrup 1.00 Botol 59,103.00 59,603.00
R2019-0000073654 18-12-2019 201900070780/064198 VINCENZO JOAQUIN IQBAL, dr OM00099 Mucera Syrup 1.00 Botol 34,155.00 34,655.00
R2019-0000073654 18-12-2019 201900070780/064198 VINCENZO JOAQUIN IQBAL, dr OH00026 Hydrocortis on Cream 1.00 Tube 11,880.00 12,380.00
R2019-0000073657 18-12-2019 201900070786/112031 MACDALENA,NY IQBAL, dr OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000073657 18-12-2019 201900070786/112031 MACDALENA,NY IQBAL, dr OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000073657 18-12-2019 201900070786/112031 MACDALENA,NY IQBAL, dr OE00057 Eperisone Hcl 50mg 10.00 Tablet 2,286.90 23,369.00
R2019-0000073658 18-12-2019 201900070784/111837 HERRY WALDO EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000073658 18-12-2019 201900070784/111837 HERRY WALDO EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073658 18-12-2019 201900070784/111837 HERRY WALDO EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000073658 18-12-2019 201900070784/111837 HERRY WALDO EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000073662 18-12-2019 201900070778/070651 SALMIAH,NY Herika dr. OF00065 Flunarizine 5mg 4.00 Tablet 2,970.00 12,380.00
R2019-0000073662 18-12-2019 201900070778/070651 SALMIAH,NY Herika dr. OL00021 Lansoprazole (OGB) 4.00 Capsul 2,230.00 9,420.00
R2019-0000073662 18-12-2019 201900070778/070651 SALMIAH,NY Herika dr. OA00063 Amlodipin 10mg (OGB) 2.00 Tablet 2,743.00 5,986.00
R2019-0000073664 18-12-2019 201900070771/015016 ANTONIUS Herika dr. OA00066 Amoxicillin Tablet, 500mg 10.00 1,113.75 11,637.50
R2019-0000073664 18-12-2019 201900070771/015016 ANTONIUS Herika dr. OA00106 Asam Mefenamat 500mg 6.00 Tablet 415.80 2,994.80
R2019-0000073666 18-12-2019 201900070735/106666 RISNAWATI,NY ROY , Dr.Sp.OG OB00029 Biosanbe Capsul 7.00 Capsul 1,596.37 11,674.59
R2019-0000073668 18-12-2019 201900070731/036183 RATIH FEBRIANI,NY ROY , Dr.Sp.OG OO00074 Ondansetron Tablet, 4mg 6.00 Tablet 4,455.00 27,230.00
R2019-0000073668 18-12-2019 201900070731/036183 RATIH FEBRIANI,NY ROY , Dr.Sp.OG OB00029 Biosanbe Capsul 7.00 Capsul 1,596.37 11,674.59
R2019-0000073667 18-12-2019 201900070713/062188 MIFTAHUL ROY , Dr.Sp.OG OA00106 Asam Mefenamat 500mg 15.00 Tablet 415.80 6,737.00
R2019-0000073667 18-12-2019 201900070713/062188 MIFTAHUL ROY , Dr.Sp.OG OL00108 Lexatrans 500mg 15.00 Tablet 1,871.00 28,565.00
R2019-0000073671 18-12-2019 201900070746/088607 MULYONO,TN Herika dr. OC00034 Cefadroxil 500mg (OGB) 6.00 Capsul 1,633.50 10,301.00
R2019-0000073671 18-12-2019 201900070746/088607 MULYONO,TN Herika dr. OA00106 Asam Mefenamat 500mg 6.00 Tablet 415.80 2,994.80
R2019-0000073671 18-12-2019 201900070746/088607 MULYONO,TN Herika dr. OB00007 Becom - C 2.00 Tablet 2,123.55 4,747.10
R2019-0000073673 18-12-2019 201900070700/079185 RINI CY LVIA,NY Nathalia dr. OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000073675 18-12-2019 201900070700/079185 RINI CY LVIA,NY Nathalia dr. OB00016 Betahistine Mesilat 6mg 10.00 Tablet 1,500.00 15,500.00
R2019-0000073676 18-12-2019 201900070723/111816 SYAHDAN,TN TEDDY OC00255 Cendo Tobroson Eye Drop 1.00 Botol 68,681.25 69,181.25
R2019-0000073678 18-12-2019 201900070766/110174 SUNARTO,TN LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 30.00 Tablet 7,425.00 223,250.00
R2019-0000073678 18-12-2019 201900070766/110174 SUNARTO,TN LUSY E. Dr.Sp.PD OC00057 Cerini 10.00 Tablet 5,093.55 51,435.50
R2019-0000073678 18-12-2019 201900070766/110174 SUNARTO,TN LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 30.00 Tablet 811.18 24,835.40
Total 209,143,574.51
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 156 dari 266
ASAL RAWAT JALAN
R2019-0000073678 18-12-2019 201900070766/110174 SUNARTO,TN LUSY E. Dr.Sp.PD OK00022 Ketoconazol Cream 2% 1.00 Tube 11,000.00 11,500.00
R2019-0000073678 18-12-2019 201900070766/110174 SUNARTO,TN LUSY E. Dr.Sp.PD OH00026 Hydrocortis on Cream 1.00 Tube 11,880.00 12,380.00
R2019-0000073678 18-12-2019 201900070766/110174 SUNARTO,TN LUSY E. Dr.Sp.PD ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 14,000.00
R2019-0000073687 18-12-2019 201900070804/45540 DINIYATIN NUR,AN Nafon Zaitun, Dr. OF00099 Folda Tablet 30.00 Tablet 6,661.65 200,349.50
R2019-0000073692 18-12-2019 201900070808/111809 ANITA LUCIANA,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000073692 18-12-2019 201900070808/111809 ANITA LUCIANA,NY LUSY E. Dr.Sp.PD OB00050 Braxidin 10.00 Tablet 1,648.35 16,983.50
R2019-0000073692 18-12-2019 201900070808/111809 ANITA LUCIANA,NY LUSY E. Dr.Sp.PD OC00134 Curcuma Tablet 10.00 Tablet 1,336.50 13,865.00
R2019-0000073692 18-12-2019 201900070808/111809 ANITA LUCIANA,NY LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000073677 18-12-2019 201900070797/112034 YAZID AHMAD FREDRIK, Dr,Sp.A OA00069 Amoxsan Drop 1.00 Botol 33,264.00 33,764.00
R2019-0000073677 18-12-2019 201900070797/112034 YAZID AHMAD FREDRIK, Dr,Sp.A OM00097 Mucera Drop 1.00 Botol 54,945.00 55,445.00
R2019-0000073693 18-12-2019 201900070825/105885 SHAFA SAFIYYAH,AN FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 2.00 Capsul 28,957.00 58,414.00
R2019-0000073693 18-12-2019 201900070825/105885 SHAFA SAFIYYAH,AN FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 2.00 Tablet 430.65 1,361.30
R2019-0000073693 18-12-2019 201900070825/105885 SHAFA SAFIYYAH,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 2.00 Tablet 1,173.15 2,846.30
R2019-0000073693 18-12-2019 201900070825/105885 SHAFA SAFIYYAH,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000073693 18-12-2019 201900070825/105885 SHAFA SAFIYYAH,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000073694 18-12-2019 201900070776/112026 MUHAMMAD FARIZ,BY FREDRIK, Dr,Sp.A OO00022 Opicef 500mg Capsul 5.00 Capsul 14,850.00 74,750.00
R2019-0000073694 18-12-2019 201900070776/112026 MUHAMMAD FARIZ,BY FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 2.00 Tablet 430.65 1,361.30
R2019-0000073694 18-12-2019 201900070776/112026 MUHAMMAD FARIZ,BY FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 2.00 Tablet 1,173.15 2,846.30
R2019-0000073694 18-12-2019 201900070776/112026 MUHAMMAD FARIZ,BY FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 1.00 Granula 297.00 797.00
R2019-0000073694 18-12-2019 201900070776/112026 MUHAMMAD FARIZ,BY FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 20.00 Sachet 207.90 19,158.00
R2019-0000073694 18-12-2019 201900070776/112026 MUHAMMAD FARIZ,BY FREDRIK, Dr,Sp.A OA00096 Apolar N Cream, 10gr 1.00 Tube 53,014.50 53,514.50
R2019-0000073696 18-12-2019 201900070864/036786 VENTJE J IQBAL OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000073696 18-12-2019 201900070864/036786 VENTJE J IQBAL OI00134 Imunos Plus Tablet 10.00 Tablet 14,107.50 141,575.00
R2019-0000073696 18-12-2019 201900070864/036786 VENTJE J IQBAL OS00016 Sanadryl Expectoran 1.00 Botol 14,701.50 15,201.50
R2019-0000073696 18-12-2019 201900070864/036786 VENTJE J IQBAL OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000073698 18-12-2019 201900070823/030191 SUYANTO,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000073698 18-12-2019 201900070823/030191 SUYANTO,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000073698 18-12-2019 201900070823/030191 SUYANTO,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 23.00 Tablet 5,197.50 120,042.50
R2019-0000073698 18-12-2019 201900070823/030191 SUYANTO,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000073698 18-12-2019 201900070823/030191 SUYANTO,TN LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 12.00 Tablet 240.30 3,383.60
R2019-0000073695 18-12-2019 201900070863/051526 ELLA TRISNAWATI,NY NOVIANA, Dr. Sp OV00107 Vosedon Tablet 90.00 Tablet 3,452.63 311,236.70
R2019-0000073695 18-12-2019 201900070863/051526 ELLA TRISNAWATI,NY NOVIANA, Dr. Sp OF00099 Folda Tablet 30.00 Tablet 6,661.65 200,349.50
R2019-0000073695 18-12-2019 201900070863/051526 ELLA TRISNAWATI,NY NOVIANA, Dr. Sp OF00071 Folavit 400mcg 30.00 Tablet 1,329.07 40,372.10
R2019-0000073703 18-12-2019 201900070889/112043 SHOFI Niki Juniar OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
Total 211,184,246.82
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 157 dari 266
ASAL RAWAT JALAN
R2019-0000073703 18-12-2019 201900070889/112043 SHOFI Niki Juniar OA00180 Acetylcyst ein 200mg 6.00 Tablet 1,485.00 9,410.00
R2019-0000073703 18-12-2019 201900070889/112043 SHOFI Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000073703 18-12-2019 201900070889/112043 SHOFI Niki Juniar OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000073701 18-12-2019 201900070888/098201 ADAM MAGHFIRAH Herika dr. OL00076 Lodia 2mg 6.00 Tablet 1,485.00 9,410.00
R2019-0000073701 18-12-2019 201900070888/098201 ADAM MAGHFIRAH Herika dr. OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000073701 18-12-2019 201900070888/098201 ADAM MAGHFIRAH Herika dr. OS00176 Scopma Plus Tablet 10.00 Tablet 2,090.22 21,402.20
R2019-0000073712 18-12-2019 201900070856/092572 SUKATI,NY Herika dr. OB00016 Betahistine Mesilat 6mg 6.00 Tablet 1,500.00 9,500.00
R2019-0000073712 18-12-2019 201900070856/092572 SUKATI,NY Herika dr. OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000073712 18-12-2019 201900070856/092572 SUKATI,NY Herika dr. OC00171 Candesartan Cilexetil 2.00 Tablet 7,425.00 15,350.00
R2019-0000073718 18-12-2019 201900070866/112042 SANDY Ismail dr. Msc. OS00183 Sporetik 200mg Capsul 10.00 Capsul 42,396.75 424,467.50
R2019-0000073718 18-12-2019 201900070866/112042 SANDY Ismail dr. Msc. OA00166 Azithromycin 500mg 2.00 Tablet 14,850.00 30,200.00
R2019-0000073716 18-12-2019 201900070847/112039 NAINI,NY Ismail dr. Msc. OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000073716 18-12-2019 201900070847/112039 NAINI,NY Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000073716 18-12-2019 201900070847/112039 NAINI,NY Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 7,276.50 7,776.50
R2019-0000073716 18-12-2019 201900070847/112039 NAINI,NY Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000073716 18-12-2019 201900070847/112039 NAINI,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073716 18-12-2019 201900070847/112039 NAINI,NY Ismail dr. Msc. OS00053 Scabimate Cream, 10gr 1.00 Tube 63,112.50 63,612.50
R2019-0000073717 18-12-2019 201900070892/110817 FADHILLAH NUR LUSY E. Dr.Sp.PD OC00173 Cetirizine 10mg/ml Drop, 1.00 Botol 37,125.00 37,625.00
R2019-0000073717 18-12-2019 201900070892/110817 FADHILLAH NUR LUSY E. Dr.Sp.PD OB00017 Betametason Cream 1.00 Tube 7,276.50 7,776.50
R2019-0000073717 18-12-2019 201900070892/110817 FADHILLAH NUR LUSY E. Dr.Sp.PD GK003 Ketoconazole Cream 10 1.00 Tube 8,019.00 8,519.00
R2019-0000073717 18-12-2019 201900070892/110817 FADHILLAH NUR LUSY E. Dr.Sp.PD ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073722 18-12-2019 201900070830/064523 HANNA YULISTINE,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 15.00 Tablet 8,168.00 123,020.00
R2019-0000073722 18-12-2019 201900070830/064523 HANNA YULISTINE,NY Windy Krisanti OG00073 Glucosamine 250 Mg 15.00 Tablet 1,633.50 25,002.50
R2019-0000073722 18-12-2019 201900070830/064523 HANNA YULISTINE,NY Windy Krisanti OM00154 Mecobalamin 500mg 15.00 Tablet 1,118.00 17,270.00
R2019-0000073722 18-12-2019 201900070830/064523 HANNA YULISTINE,NY Windy Krisanti OC00010 Calcium Lactat 500mg 10.00 Tablet 302.37 3,523.70
R2019-0000073722 18-12-2019 201900070830/064523 HANNA YULISTINE,NY Windy Krisanti OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000073725 18-12-2019 201900070822/089191 ANDI DAHLIA,NY Windy Krisanti OM00154 Mecobalamin 500mg 15.00 Tablet 1,118.00 17,270.00
R2019-0000073725 18-12-2019 201900070822/089191 ANDI DAHLIA,NY Windy Krisanti OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000073725 18-12-2019 201900070822/089191 ANDI DAHLIA,NY Windy Krisanti OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000073726 18-12-2019 201900070890/057495 NURLINAH,NY Ismail dr. Msc. OK00023 Ketoconazole 200mg 15.00 Tablet 774.24 12,113.60
R2019-0000073726 18-12-2019 201900070890/057495 NURLINAH,NY Ismail dr. Msc. OH00026 Hydrocortis on Cream 1.00 Tube 11,880.00 12,380.00
R2019-0000073726 18-12-2019 201900070890/057495 NURLINAH,NY Ismail dr. Msc. GK003 Ketoconazole Cream 10 1.00 Tube 8,019.00 8,519.00
R2019-0000073726 18-12-2019 201900070890/057495 NURLINAH,NY Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 7,276.50 7,776.50
R2019-0000073726 18-12-2019 201900070890/057495 NURLINAH,NY Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000073728 18-12-2019 201900070886/078010 ANNA ANDINA,AN Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000073727 18-12-2019 201900070798/108715 ANDI ABID NAILUN FREDRIK, Dr,Sp.A OI00094 Isoniazide 100mg (OGB) 38.00 Tablet 193.00 7,834.00
Total 212,250,270.40
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 158 dari 266
ASAL RAWAT JALAN
R2019-0000073727 18-12-2019 201900070798/108715 ANDI ABID NAILUN FREDRIK, Dr,Sp.A OV00085 Vitamin B6 Tablet (OGB) 3.00 Tablet 199.80 1,099.40
R2019-0000073727 18-12-2019 201900070798/108715 ANDI ABID NAILUN FREDRIK, Dr,Sp.A OR00043 Rifampicin 450mg (OGB) 10.00 Tablet 2,524.50 25,745.00
R2019-0000073731 18-12-2019 201900070850/112040 MUHAMMAD ISMUL Ismail dr. Msc. OS00053 Scabimate Cream, 10gr 1.00 Tube 63,112.50 63,612.50
R2019-0000073731 18-12-2019 201900070850/112040 MUHAMMAD ISMUL Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000073731 18-12-2019 201900070850/112040 MUHAMMAD ISMUL Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 7,276.50 7,776.50
R2019-0000073731 18-12-2019 201900070850/112040 MUHAMMAD ISMUL Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000073731 18-12-2019 201900070850/112040 MUHAMMAD ISMUL Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073731 18-12-2019 201900070850/112040 MUHAMMAD ISMUL Ismail dr. Msc. OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000073730 18-12-2019 201900070851/111326 MUHAMMAD FAUZAN Ismail dr. Msc. OS00053 Scabimate Cream, 10gr 1.00 Tube 63,112.50 63,612.50
R2019-0000073730 18-12-2019 201900070851/111326 MUHAMMAD FAUZAN Ismail dr. Msc. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000073730 18-12-2019 201900070851/111326 MUHAMMAD FAUZAN Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 7,276.50 7,776.50
R2019-0000073730 18-12-2019 201900070851/111326 MUHAMMAD FAUZAN Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000073730 18-12-2019 201900070851/111326 MUHAMMAD FAUZAN Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000073734 18-12-2019 201900070874/101235 SUMIYAT I,NY Windy Krisanti OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000073734 18-12-2019 201900070874/101235 SUMIYAT I,NY Windy Krisanti OL00080 Loratadin 10mg (OGB) 10.00 Tablet 520.00 5,700.00
R2019-0000073734 18-12-2019 201900070874/101235 SUMIYAT I,NY Windy Krisanti OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000073736 18-12-2019 201900070874/101235 SUMIYAT I,NY Windy Krisanti OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000073735 18-12-2019 201900070770/064564 NINA SRIWANI LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000073735 18-12-2019 201900070770/064564 NINA SRIWANI LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000073735 18-12-2019 201900070770/064564 NINA SRIWANI LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 2.00 Flexpen 226,917.80 454,335.60
R2019-0000073735 18-12-2019 201900070770/064564 NINA SRIWANI LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 7.00 Tablet 2,525.00 18,175.00
R2019-0000073735 18-12-2019 201900070770/064564 NINA SRIWANI LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000073735 18-12-2019 201900070770/064564 NINA SRIWANI LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000073735 18-12-2019 201900070770/064564 NINA SRIWANI LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000073735 18-12-2019 201900070770/064564 NINA SRIWANI LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000073735 18-12-2019 201900070770/064564 NINA SRIWANI LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000073740 18-12-2019 201900070817/25808 WINARSIH,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 14.00 Tablet 8,168.00 114,852.00
R2019-0000073740 18-12-2019 201900070817/25808 WINARSIH,NY Windy Krisanti OG00073 Glucosamine 250 Mg 15.00 Tablet 1,633.50 25,002.50
R2019-0000073740 18-12-2019 201900070817/25808 WINARSIH,NY Windy Krisanti OL00021 Lansoprazole (OGB) 6.00 Capsul 2,230.00 13,880.00
R2019-0000073740 18-12-2019 201900070817/25808 WINARSIH,NY Windy Krisanti OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000073738 18-12-2019 201900070821/112035 M ALI,TN Windy Krisanti OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000073738 18-12-2019 201900070821/112035 M ALI,TN Windy Krisanti OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000073738 18-12-2019 201900070821/112035 M ALI,TN Windy Krisanti OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000073737 18-12-2019 201900070829/109316 SRI SETIANINGSIH,NY Windy Krisanti OT00147 Trilac 10mg Injeksi 1.00 Vial 148,500.00 149,000.00
Total 213,811,688.48
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 159 dari 266
ASAL RAWAT JALAN
R2019-0000073737 18-12-2019 201900070829/109316 SRI SETIANINGSIH,NY Windy Krisanti OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000073737 18-12-2019 201900070829/109316 SRI SETIANINGSIH,NY Windy Krisanti OM00046 Methyl Prednisolon 8mg 10.00 Tablet 965.25 10,152.50
R2019-0000073745 18-12-2019 201900070836/066857 ARIANI,NY Windy Krisanti OP00011 Paracetamol 500mg 8.00 Tablet 387.36 3,598.88
R2019-0000073745 18-12-2019 201900070836/066857 ARIANI,NY Windy Krisanti OT00063 Tramadol 50mg Tablet 12.00 Tablet 1,113.75 13,865.00
R2019-0000073745 18-12-2019 201900070836/066857 ARIANI,NY Windy Krisanti ALK00037 Kapsul No.1 16.00 pcs 200.00 10,700.00
R2019-0000073745 18-12-2019 201900070836/066857 ARIANI,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 20.00 Tablet 8,168.00 163,860.00
R2019-0000073745 18-12-2019 201900070836/066857 ARIANI,NY Windy Krisanti OL00021 Lansoprazole (OGB) 6.00 Capsul 2,230.00 13,880.00
R2019-0000073745 18-12-2019 201900070836/066857 ARIANI,NY Windy Krisanti OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000073745 18-12-2019 201900070836/066857 ARIANI,NY Windy Krisanti OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000073745 18-12-2019 201900070836/066857 ARIANI,NY Windy Krisanti OB00016 Betahistine Mesilat 6mg 10.00 Tablet 1,500.00 15,500.00
R2019-0000073746 18-12-2019 201900070899/31907 HADIJAH,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 4.00 Tablet 8,168.00 33,172.00
R2019-0000073746 18-12-2019 201900070899/31907 HADIJAH,NY Windy Krisanti ALK00037 Kapsul No.1 10.00 pcs 200.00 9,500.00
R2019-0000073746 18-12-2019 201900070899/31907 HADIJAH,NY Windy Krisanti OM00154 Mecobalamin 500mg 15.00 Tablet 1,118.00 17,270.00
R2019-0000073746 18-12-2019 201900070899/31907 HADIJAH,NY Windy Krisanti ON00009 Natrium Diklofenac 50mg 5.00 Tablet 955.84 5,279.20
R2019-0000073747 18-12-2019 201900070860/080683 REWUK SRI Windy Krisanti OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000073747 18-12-2019 201900070860/080683 REWUK SRI Windy Krisanti OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000073747 18-12-2019 201900070860/080683 REWUK SRI Windy Krisanti OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000073747 18-12-2019 201900070860/080683 REWUK SRI Windy Krisanti OL00021 Lansoprazole (OGB) 6.00 Capsul 2,230.00 13,880.00
R2019-0000073749 18-12-2019 201900070925/104059 MARIA,NY Windy Krisanti OB00016 Betahistine Mesilat 6mg 30.00 Tablet 1,500.00 45,500.00
R2019-0000073749 18-12-2019 201900070925/104059 MARIA,NY Windy Krisanti OL00021 Lansoprazole (OGB) 6.00 Capsul 2,230.00 13,880.00
R2019-0000073749 18-12-2019 201900070925/104059 MARIA,NY Windy Krisanti OF00007 Farbion Tablet 7.00 Tablet 1,782.00 12,974.00
R2019-0000073742 18-12-2019 201900070912/099237 ANITA RINI Windy Krisanti OG00057 Gabapentin 300mg (OGB) 15.00 Tablet 8,168.00 123,020.00
R2019-0000073742 18-12-2019 201900070912/099237 ANITA RINI Windy Krisanti OM00154 Mecobalamin 500mg 15.00 Tablet 1,118.00 17,270.00
R2019-0000073752 18-12-2019 201900070951/104998 SHINDY BIDURY,NY DR. BISMA SP OB00068 BioCal-95 30.00 Tablet 7,128.00 214,340.00
R2019-0000073754 18-12-2019 201900070939/112048 MARDIYAH,NY Niki Juniar OS00014 Sanadryl DMP Syrup, 60ml 1.00 Botol 17,820.00 18,320.00
R2019-0000073754 18-12-2019 201900070939/112048 MARDIYAH,NY Niki Juniar OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000073754 18-12-2019 201900070939/112048 MARDIYAH,NY Niki Juniar OI00134 Imunos Plus Tablet 5.00 Tablet 14,107.50 71,037.50
R2019-0000073754 18-12-2019 201900070939/112048 MARDIYAH,NY Niki Juniar OT00077 Tremenza Tablet 10.00 Tablet 2,160.68 22,106.80
R2019-0000073754 18-12-2019 201900070939/112048 MARDIYAH,NY Niki Juniar OS00029 Sanmol Tablet, 500mg 8.00 Tablet 430.65 3,945.20
R2019-0000073755 18-12-2019 201900070944/045696 DEVANO FATHAN Riyanti Puji dr. OA00015 Acyclovir 400mg (OGB) 10.00 Tablet 1,262.25 13,122.50
R2019-0000073755 18-12-2019 201900070944/045696 DEVANO FATHAN Riyanti Puji dr. ATKK031 Kertas Puyer Handbond 20.00 Sachet 207.90 19,158.00
R2019-0000073755 18-12-2019 201900070944/045696 DEVANO FATHAN Riyanti Puji dr. OA00016 Acyclovir Cream 5gr 1.00 Tube 4,893.00 5,393.00
R2019-0000073755 18-12-2019 201900070944/045696 DEVANO FATHAN Riyanti Puji dr. ON00004 Naprex Syrup, 60ml 1.00 Botol 59,251.50 59,751.50
R2019-0000073756 18-12-2019 201900070907/015236 TRI MURTINI,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 20.00 Tablet 8,168.00 163,860.00
Total 215,351,372.71
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 160 dari 266
ASAL RAWAT JALAN
R2019-0000073756 18-12-2019 201900070907/015236 TRI MURTINI,NY Windy Krisanti OM00154 Mecobalamin 500mg 20.00 Tablet 1,118.00 22,860.00
R2019-0000073756 18-12-2019 201900070907/015236 TRI MURTINI,NY Windy Krisanti OG00073 Glucosamine 250 Mg 15.00 Tablet 1,633.50 25,002.50
R2019-0000073758 18-12-2019 201900070929/109620 RUKIANI,NY Windy Krisanti OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000073758 18-12-2019 201900070929/109620 RUKIANI,NY Windy Krisanti OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000073758 18-12-2019 201900070929/109620 RUKIANI,NY Windy Krisanti OL00021 Lansoprazole (OGB) 6.00 Capsul 2,230.00 13,880.00
R2019-0000073758 18-12-2019 201900070929/109620 RUKIANI,NY Windy Krisanti OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000073758 18-12-2019 201900070929/109620 RUKIANI,NY Windy Krisanti OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000073757 18-12-2019 201900070929/109620 RUKIANI,NY Windy Krisanti OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000073757 18-12-2019 201900070929/109620 RUKIANI,NY Windy Krisanti OC00092 Clopidogrel 75mg (OGB) 23.00 Tablet 14,701.50 338,634.50
R2019-0000073761 18-12-2019 201900070920/060314 VERA ANGGELINA,NY DR. BISMA SP OF00099 Folda Tablet 15.00 Tablet 6,661.65 100,424.75
R2019-0000073761 18-12-2019 201900070920/060314 VERA ANGGELINA,NY DR. BISMA SP OB00068 BioCal-95 15.00 Tablet 7,128.00 107,420.00
R2019-0000073761 18-12-2019 201900070920/060314 VERA ANGGELINA,NY DR. BISMA SP OH0046 Hb-Vit Tablet 15.00 tablet 5,197.50 78,462.50
R2019-0000073760 18-12-2019 201900070913/112046 RUSDIANSYAH,TN Hendra Dr, Sp. OE00008 Elkana Tablet 7.00 Tablet 1,247.40 9,231.80
R2019-0000073762 18-12-2019 201900070769/069298 NIZAR AMALUN Hendra Dr, Sp. OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000073762 18-12-2019 201900070769/069298 NIZAR AMALUN Hendra Dr, Sp. OE00007 Elkana Syrup 1.00 Botol 34,303.50 34,803.50
R2019-0000073763 18-12-2019 201900070942/047018 NOER AINI,TN Hendra Dr, Sp. OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000073763 18-12-2019 201900070942/047018 NOER AINI,TN Hendra Dr, Sp. OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000073763 18-12-2019 201900070942/047018 NOER AINI,TN Hendra Dr, Sp. OG00057 Gabapentin 300mg (OGB) 10.00 Tablet 8,168.00 82,180.00
R2019-0000073766 18-12-2019 201900070906/095284 NORMA,NY Windy Krisanti OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000073766 18-12-2019 201900070906/095284 NORMA,NY Windy Krisanti OM00046 Methyl Prednisolon 8mg 10.00 Tablet 965.25 10,152.50
R2019-0000073766 18-12-2019 201900070906/095284 NORMA,NY Windy Krisanti OM00018 Meloxicam 7.5mg (OGB) 15.00 Tablet 1,287.00 19,805.00
R2019-0000073766 18-12-2019 201900070906/095284 NORMA,NY Windy Krisanti OL00021 Lansoprazole (OGB) 10.00 Capsul 2,230.00 22,800.00
R2019-0000073765 18-12-2019 201900070902/111758 DAWIYAH,NY Windy Krisanti OA00074 Analsik 10.00 Tablet 2,264.63 23,146.30
R2019-0000073765 18-12-2019 201900070902/111758 DAWIYAH,NY Windy Krisanti OL00021 Lansoprazole (OGB) 6.00 Capsul 2,230.00 13,880.00
R2019-0000073767 18-12-2019 201900070904/111687 NURUL TRI Windy Krisanti OG00057 Gabapentin 300mg (OGB) 4.00 Tablet 8,168.00 33,172.00
R2019-0000073767 18-12-2019 201900070904/111687 NURUL TRI Windy Krisanti ALK00037 Kapsul No.1 10.00 pcs 200.00 9,500.00
R2019-0000073768 18-12-2019 201900070950/070520 RAIHANA HILYAH Niki Juniar OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000073768 18-12-2019 201900070950/070520 RAIHANA HILYAH Niki Juniar OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000073768 18-12-2019 201900070950/070520 RAIHANA HILYAH Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000073768 18-12-2019 201900070950/070520 RAIHANA HILYAH Niki Juniar OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
R2019-0000073768 18-12-2019 201900070950/070520 RAIHANA HILYAH Niki Juniar OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000073768 18-12-2019 201900070950/070520 RAIHANA HILYAH Niki Juniar ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000073769 18-12-2019 201900070945/111915 NATHANIEL LUTHER Riyanti Puji dr. OA00093 Apialys Drop 1.00 Botol 59,400.00 59,900.00
R2019-0000073769 18-12-2019 201900070945/111915 NATHANIEL LUTHER Riyanti Puji dr. OS00007 Sagestam Eye Drop, 5ml 1.00 Botol 42,768.00 43,268.00
R2019-0000073759 18-12-2019 201900070885/074128 NOORSIAH,NY Hendra Dr, Sp. OM00154 Mecobalamin 500mg 20.00 Tablet 1,118.00 22,860.00
R2019-0000073759 18-12-2019 201900070885/074128 NOORSIAH,NY Hendra Dr, Sp. OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000073759 18-12-2019 201900070885/074128 NOORSIAH,NY Hendra Dr, Sp. OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000073759 18-12-2019 201900070885/074128 NOORSIAH,NY Hendra Dr, Sp. OS00173 Simvastatin 20mg (OGB) 7.00 Tablet 1,782.00 12,974.00
Total 216,965,534.26
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 161 dari 266
ASAL RAWAT JALAN
R2019-0000073759 18-12-2019 201900070885/074128 NOORSIAH,NY Hendra Dr, Sp. OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000073759 18-12-2019 201900070885/074128 NOORSIAH,NY Hendra Dr, Sp. OL000131 Leparson Tablet 14.00 Tablet 5,917.35 83,342.90
R2019-0000073771 18-12-2019 201900070959/110803 SUMIATI,NY DR. BISMA SP OH0046 Hb-Vit Tablet 15.00 tablet 5,197.50 78,462.50
R2019-0000073772 18-12-2019 201900070900/109908 RUSITAH,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 15.00 Tablet 8,168.00 123,020.00
R2019-0000073772 18-12-2019 201900070900/109908 RUSITAH,NY Windy Krisanti OP00011 Paracetamol 500mg 8.00 Tablet 387.36 3,598.88
R2019-0000073772 18-12-2019 201900070900/109908 RUSITAH,NY Windy Krisanti OV00046 Valis anbe 5mg Tablet 3.00 Tablet 579.15 2,237.45
R2019-0000073772 18-12-2019 201900070900/109908 RUSITAH,NY Windy Krisanti OA00062 Amitriptyline Tablet, 4.00 Tablet 252.45 1,509.80
R2019-0000073772 18-12-2019 201900070900/109908 RUSITAH,NY Windy Krisanti OC00017 Kapsul No. 00 15.00 Capsul 200.00 10,500.00
R2019-0000073772 18-12-2019 201900070900/109908 RUSITAH,NY Windy Krisanti OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000073777 18-12-2019 201900070888/098201 ADAM MAGHFIRAH Niki Juniar OG00018 Gitas Injeksi 1ml 1.00 Ampul 38,201.62 38,701.62
R2019-0000073779 18-12-2019 201900070960/112050 SUMARNI,NY Niki Juniar OB00016 Betahistine Mesilat 6mg 4.00 Tablet 1,500.00 6,500.00
R2019-0000073779 18-12-2019 201900070960/112050 SUMARNI,NY Niki Juniar OD00065 Domperidon Tablet (OGB) 4.00 Tablet 750.00 3,500.00
R2019-0000073781 18-12-2019 201900070966/017310 ACHMAD FACHRI,AN Niki Juniar OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000073781 18-12-2019 201900070966/017310 ACHMAD FACHRI,AN Niki Juniar OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000073783 18-12-2019 201900070819/111488 RUSNADI,TN LUSY E. Dr.Sp.PD OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000073783 18-12-2019 201900070819/111488 RUSNADI,TN LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000073782 18-12-2019 201900070965/112051 ARIEF RACHMAN,TN Niki Juniar OE00057 Eperisone Hcl 50mg 4.00 Tablet 2,286.90 9,647.60
R2019-0000073782 18-12-2019 201900070965/112051 ARIEF RACHMAN,TN Niki Juniar OA00074 Analsik 4.00 Tablet 2,264.63 9,558.52
R2019-0000073786 18-12-2019 201900070966/017310 ACHMAD FACHRI,AN Niki Juniar OL00039 Lasal Expect Syrup, 1.00 Botol 55,687.50 56,187.50
R2019-0000073786 18-12-2019 201900070966/017310 ACHMAD FACHRI,AN Niki Juniar OC00057 Cerini 5.00 Tablet 5,093.55 25,967.75
R2019-0000073783 18-12-2019 201900070819/111488 RUSNADI,TN LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 5.00 Tablet 2,079.00 10,895.00
R2019-0000073787 18-12-2019 201900070968/112052 SRI DHATIYAH,NY Niki Juniar OA00074 Analsik 4.00 Tablet 2,264.63 9,558.52
R2019-0000073787 18-12-2019 201900070968/112052 SRI DHATIYAH,NY Niki Juniar OB00007 Becom - C 3.00 Tablet 2,123.55 6,870.65
R2019-0000073796 19-12-2019 201900070971/112053 ROUNCING,SDR ADE RAHMAH OB00096 Betaserc 24 mg Tablet 1.00 tablet 9,517.36 10,017.36
R2019-0000073796 19-12-2019 201900070971/112053 ROUNCING,SDR ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000073799 19-12-2019 201900070970/32191 MARIA GORETY ADE RAHMAH OG00018 Gitas Injeksi 1ml 2.00 Ampul 38,201.62 76,903.24
R2019-0000073807 19-12-2019 201900070971/112053 ROUNCING,SDR ADE RAHMAH OB001002 Betahistine 10.00 Tab 5,940.00 59,900.00
R2019-0000073807 19-12-2019 201900070971/112053 ROUNCING,SDR ADE RAHMAH OF00148 Flunarizine 10mg (OGB) 10.00 Tablet 5,940.00 59,900.00
R2019-0000073807 19-12-2019 201900070971/112053 ROUNCING,SDR ADE RAHMAH OD00065 Domperidon Tablet (OGB) 10.00 Tablet 750.00 8,000.00
R2019-0000073807 19-12-2019 201900070971/112053 ROUNCING,SDR ADE RAHMAH OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000073808 19-12-2019 201900070975/099217 WA KAMBA,NY ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000073808 19-12-2019 201900070975/099217 WA KAMBA,NY ADE RAHMAH OP00136 Pulmicort Respules 2.00 Ampul 33,802.98 68,105.96
R2019-0000073808 19-12-2019 201900070975/099217 WA KAMBA,NY ADE RAHMAH OM00043 Methyl Prednisolon 125mg 1.00 Vial 69,795.00 70,295.00
R2019-0000073808 19-12-2019 201900070975/099217 WA KAMBA,NY ADE RAHMAH OA00180 Acetylcyst ein 200mg 6.00 Tablet 1,485.00 9,410.00
R2019-0000073808 19-12-2019 201900070975/099217 WA KAMBA,NY ADE RAHMAH OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000073808 19-12-2019 201900070975/099217 WA KAMBA,NY ADE RAHMAH OP00184 Neo Protifed Tablet 6.00 Tablet 1,263.73 8,082.38
R2019-0000073809 19-12-2019 201900070969/095135 SUNARTO,TN ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000073809 19-12-2019 201900070969/095135 SUNARTO,TN ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
Total 218,027,692.82
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 162 dari 266
ASAL RAWAT JALAN
R2019-0000073809 19-12-2019 201900070969/095135 SUNARTO,TN ADE RAHMAH OP00011 Paracetamol 500mg 1.00 Tablet 387.36 887.36
R2019-0000073809 19-12-2019 201900070969/095135 SUNARTO,TN ADE RAHMAH OA00074 Analsik 2.00 Tablet 2,264.63 5,029.26
R2019-0000073809 19-12-2019 201900070969/095135 SUNARTO,TN ADE RAHMAH OO00074 Ondansetron Tablet, 4mg 3.00 Tablet 4,455.00 13,865.00
R2019-0000073809 19-12-2019 201900070969/095135 SUNARTO,TN ADE RAHMAH OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000073809 19-12-2019 201900070969/095135 SUNARTO,TN ADE RAHMAH ON00009 Natrium Diklofenac 50mg 3.00 Tablet 955.84 3,367.52
R2019-0000073784 18-12-2019 201900070974/079507 BUDIANSYAH,TN ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000073784 18-12-2019 201900070974/079507 BUDIANSYAH,TN ADE RAHMAH OU00022 Urotractin 400mg Tablet 6.00 Tablet 7,189.03 43,634.18
R2019-0000073784 18-12-2019 201900070974/079507 BUDIANSYAH,TN ADE RAHMAH OC00076 Ciprofloxacin 500mg 5.00 Tablet 1,039.50 5,697.50
R2019-0000073784 18-12-2019 201900070974/079507 BUDIANSYAH,TN ADE RAHMAH OS00176 Scopma Plus Tablet 5.00 Tablet 2,090.22 10,951.10
R2019-0000073784 18-12-2019 201900070974/079507 BUDIANSYAH,TN ADE RAHMAH OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000073784 18-12-2019 201900070974/079507 BUDIANSYAH,TN ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000073810 19-12-2019 201900070970/32191 MARIA GORETY ADE RAHMAH OG00018 Gitas Injeksi 1ml 2.00 Ampul 38,201.62 76,903.24
R2019-0000073810 19-12-2019 201900070970/32191 MARIA GORETY ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000073810 19-12-2019 201900070970/32191 MARIA GORETY ADE RAHMAH OS00176 Scopma Plus Tablet 3.00 Tablet 2,090.22 6,770.66
R2019-0000073810 19-12-2019 201900070970/32191 MARIA GORETY ADE RAHMAH OA00085 Antasida Tablet (OGB) 3.00 Tablet 284.30 1,352.90
R2019-0000073810 19-12-2019 201900070970/32191 MARIA GORETY ADE RAHMAH OD00065 Domperidon Tablet (OGB) 3.00 Tablet 750.00 2,750.00
R2019-0000073811 19-12-2019 201900070972/105749 CUNCUN JEHAN ADE RAHMAH OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000073811 19-12-2019 201900070972/105749 CUNCUN JEHAN ADE RAHMAH OB00007 Becom - C 5.00 Tablet 2,123.55 11,117.75
R2019-0000073811 19-12-2019 201900070972/105749 CUNCUN JEHAN ADE RAHMAH ON00009 Natrium Diklofenac 50mg 5.00 Tablet 955.84 5,279.20
R2019-0000073812 19-12-2019 201900070973/112054 RISKA ZAHRATUL ADE RAHMAH OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000073812 19-12-2019 201900070973/112054 RISKA ZAHRATUL ADE RAHMAH OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000073812 19-12-2019 201900070973/112054 RISKA ZAHRATUL ADE RAHMAH OD00031 Dexamethasone Tablet 2.00 Tablet 208.00 916.00
R2019-0000073825 19-12-2019 201900070994/112055 HANDIE MARYANI,NY Herika dr. OG00018 Gitas Injeksi 1ml 1.00 Ampul 38,201.62 38,701.62
R2019-0000073825 19-12-2019 201900070994/112055 HANDIE MARYANI,NY Herika dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000073829 19-12-2019 201900070984/074704 DODO TRIYO IRMA SARI OC00144 Cefila Capsul, 100mg 15.00 Capsul 28,957.00 434,855.00
R2019-0000073829 19-12-2019 201900070984/074704 DODO TRIYO IRMA SARI OS00029 Sanmol Tablet, 500mg 8.00 Tablet 430.65 3,945.20
R2019-0000073829 19-12-2019 201900070984/074704 DODO TRIYO IRMA SARI OL00041 Lasgan Capsul 7.00 Capsul 21,000.00 147,500.00
R2019-0000073829 19-12-2019 201900070984/074704 DODO TRIYO IRMA SARI OF00007 Farbion Tablet 5.00 Tablet 1,782.00 9,410.00
R2019-0000073831 17-12-2019 201900070585/110653 SILVRI,NY Eviwati OC00091 Clonidin 0.15mg (OGB) 1.00 Tablet 359.37 859.37
R2019-0000073830 16-12-2019 201900070271/110107 YANTI ANA Dameria Sri OE00057 Eperisone Hcl 50mg 14.00 Tablet 2,286.90 32,516.60
R2019-0000073830 16-12-2019 201900070271/110107 YANTI ANA Dameria Sri OA00062 Amitriptyline Tablet, 4.00 Tablet 252.45 1,509.80
R2019-0000073834 17-12-2019 201900070520/096649 TARIONO Dameria Sri OP00036 Phenytoin Capsul 21.00 Capsul 816.75 17,651.75
R2019-0000073834 17-12-2019 201900070520/096649 TARIONO Dameria Sri OV00085 Vitamin B6 Tablet (OGB) 10.00 Tablet 199.80 2,498.00
R2019-0000073834 17-12-2019 201900070520/096649 TARIONO Dameria Sri OA00175 Afolat 400mcg 10.00 Tablet 206.41 2,564.10
R2019-0000073836 17-12-2019 201900070575/088260 ALEX SANTOSO,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000073835 19-12-2019 201900070994/112055 HANDIE MARYANI,NY Herika dr. ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000073835 19-12-2019 201900070994/112055 HANDIE MARYANI,NY Herika dr. OS00027 Sanmag Tablet 10.00 Tablet 1,321.65 13,716.50
R2019-0000073835 19-12-2019 201900070994/112055 HANDIE MARYANI,NY Herika dr. OO00040 Oralit 200 10.00 Sachet 706.00 7,560.00
Total 219,104,674.44
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 163 dari 266
ASAL RAWAT JALAN
R2019-0000073835 19-12-2019 201900070994/112055 HANDIE MARYANI,NY Herika dr. ON00047 New Diatabs 12.00 Tablet 767.13 9,705.56
R2019-0000073837 17-12-2019 201900070594/081642 RUGAYAH,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000073839 17-12-2019 201900070527/25808 WINARSIH,NY Maulin Nikmah OG00057 Gabapentin 300mg (OGB) 4.00 Tablet 8,168.00 33,172.00
R2019-0000073840 17-12-2019 201900070544/072574 ASHILLA Alvarez Sp .OT OE00007 Elkana Syrup 1.00 Botol 34,303.50 34,803.50
R2019-0000073838 17-12-2019 201900070546/071340 ERMINA,NY Alvarez Sp .OT OE00057 Eperisone Hcl 50mg 14.00 Tablet 2,286.90 32,516.60
R2019-0000073838 17-12-2019 201900070546/071340 ERMINA,NY Alvarez Sp .OT OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000073838 17-12-2019 201900070546/071340 ERMINA,NY Alvarez Sp .OT OP00196 Pregabalin 75 mg 3.00 tablet 10,617.75 32,353.25
R2019-0000073838 17-12-2019 201900070546/071340 ERMINA,NY Alvarez Sp .OT OF00007 Farbion Tablet 7.00 Tablet 1,782.00 12,974.00
R2019-0000073841 17-12-2019 201900070522/111849 JIE TELLY Alvarez Sp .OT OE00057 Eperisone Hcl 50mg 14.00 Tablet 2,286.90 32,516.60
R2019-0000073841 17-12-2019 201900070522/111849 JIE TELLY Alvarez Sp .OT OF00007 Farbion Tablet 14.00 Tablet 1,782.00 25,448.00
R2019-0000073843 17-12-2019 201900070515/069459 MUHAMMAD Alvarez Sp .OT OP00196 Pregabalin 75 mg 3.00 tablet 10,617.75 32,353.25
R2019-0000073843 17-12-2019 201900070515/069459 MUHAMMAD Alvarez Sp .OT OF00007 Farbion Tablet 7.00 Tablet 1,782.00 12,974.00
R2019-0000073842 17-12-2019 201900070311/109275 RINI LIA SARI,NY Dameria Sri OG00057 Gabapentin 300mg (OGB) 20.00 Tablet 8,168.00 163,860.00
R2019-0000073842 17-12-2019 201900070311/109275 RINI LIA SARI,NY Dameria Sri OA00062 Amitriptyline Tablet, 4.00 Tablet 252.45 1,509.80
R2019-0000073842 17-12-2019 201900070311/109275 RINI LIA SARI,NY Dameria Sri OK00002 Kalium Diklofenac 50mg 14.00 Tablet 1,100.00 15,900.00
R2019-0000073842 17-12-2019 201900070311/109275 RINI LIA SARI,NY Dameria Sri OE00057 Eperisone Hcl 50mg 15.00 Tablet 2,286.90 34,803.50
R2019-0000073844 17-12-2019 201900070548/111476 JHANIF INDRA EDO, Dr.Sp.B OR00003 Ranitidin 150mg (OGB) 10.00 Tablet 891.00 9,410.00
R2019-0000073845 19-12-2019 201900070979/090149 BACO SIDE,TN MAGDA ROSSA, OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000073845 19-12-2019 201900070979/090149 BACO SIDE,TN MAGDA ROSSA, OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073845 19-12-2019 201900070979/090149 BACO SIDE,TN MAGDA ROSSA, OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000073848 17-12-2019 201900070613/088301 LIVNI SHEVA TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000073847 19-12-2019 201900071032/112057 ALOYSIUS YANTO TEDDY OS00183 Sporetik 200mg Capsul 10.00 Capsul 42,396.75 424,467.50
R2019-0000073847 19-12-2019 201900071032/112057 ALOYSIUS YANTO TEDDY OT00149 Toramine 10 Mg Tablet 8.00 Tablet 8,167.50 65,840.00
R2019-0000073850 19-12-2019 201900071025/027712 TRI HANDAYANI,NY Angie Renatha , OA00013 Avamys Nasal Spray 1.00 Botol 237,451.50 237,951.50
R2019-0000073855 18-12-2019 201900070762/091659 LIKE MAKI EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000073855 18-12-2019 201900070762/091659 LIKE MAKI EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073855 18-12-2019 201900070762/091659 LIKE MAKI EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
R2019-0000073855 18-12-2019 201900070762/091659 LIKE MAKI EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000073855 18-12-2019 201900070762/091659 LIKE MAKI EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000073859 19-12-2019 201900070983/111876 NUR PUTRI EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000073859 19-12-2019 201900070983/111876 NUR PUTRI EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073859 19-12-2019 201900070983/111876 NUR PUTRI EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
R2019-0000073859 19-12-2019 201900070983/111876 NUR PUTRI EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000073859 19-12-2019 201900070983/111876 NUR PUTRI EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000073856 19-12-2019 201900071030/030583 SITI BACHRAH,HJ EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000073856 19-12-2019 201900071030/030583 SITI BACHRAH,HJ EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073856 19-12-2019 201900071030/030583 SITI BACHRAH,HJ EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000073856 19-12-2019 201900071030/030583 SITI BACHRAH,HJ EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
Total 220,528,346.70
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 164 dari 266
ASAL RAWAT JALAN
R2019-0000073862 19-12-2019 201900071034/088238 RIMBA MAULANA,TN Herika dr. OC00039 Cefixime 100mg (OGB) 12.00 Capsul 4,266.70 51,700.40
R2019-0000073862 19-12-2019 201900071034/088238 RIMBA MAULANA,TN Herika dr. OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000073862 19-12-2019 201900071034/088238 RIMBA MAULANA,TN Herika dr. OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000073860 19-12-2019 201900070995/093710 HENDRICK C Maulin Nikmah OK00002 Kalium Diklofenac 50mg 10.00 Tablet 1,100.00 11,500.00
R2019-0000073860 19-12-2019 201900070995/093710 HENDRICK C Maulin Nikmah OA00052 Ambroxol Tablet, 30mg 6.00 Tablet 445.50 3,173.00
R2019-0000073865 19-12-2019 201900070990/106511 ESNA SITINJAK,NY Angie Renatha , OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000073865 19-12-2019 201900070990/106511 ESNA SITINJAK,NY Angie Renatha , OP00184 Neo Protifed Tablet 15.00 Tablet 1,263.73 19,455.95
R2019-0000073865 19-12-2019 201900070990/106511 ESNA SITINJAK,NY Angie Renatha , OD00031 Dexamethasone Tablet 15.00 Tablet 208.00 3,620.00
R2019-0000073865 19-12-2019 201900070990/106511 ESNA SITINJAK,NY Angie Renatha , OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073866 19-12-2019 201900071005/022457 MARIYA OLFAH,NY Angie Renatha , OK00023 Ketoconazole 200mg 10.00 Tablet 774.24 8,242.40
R2019-0000073870 19-12-2019 201900071004/104220 NARENDRA MAGDA ROSSA, OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000073867 19-12-2019 201900071001/110107 YANTI ANA Maulin Nikmah OG00057 Gabapentin 300mg (OGB) 4.00 Tablet 8,168.00 33,172.00
R2019-0000073867 19-12-2019 201900071001/110107 YANTI ANA Maulin Nikmah ALK00037 Kapsul No.1 6.00 pcs 200.00 8,700.00
R2019-0000073871 16-12-2019 201900070306/111963 NUR AVIANTO,TN TEDDY OP00065 Polidemisin Eye Drop 1.00 Botol 41,134.50 41,634.50
R2019-0000073871 16-12-2019 201900070306/111963 NUR AVIANTO,TN TEDDY OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000073876 16-12-2019 201900070294/086909 SARTUN,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000073876 16-12-2019 201900070294/086909 SARTUN,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000073877 16-12-2019 201900070291/095409 MUHAMMAD DJAFAR TEDDY OC00280 Cendo Vitrolenta ED 5ml 1.00 Botol 48,633.75 49,133.75
R2019-0000073877 16-12-2019 201900070291/095409 MUHAMMAD DJAFAR TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000073878 16-12-2019 201900070273/087375 ALI KARSANA,TN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000073880 16-12-2019 201900070345/111970 MUSDALIFAH,NN Niki Juniar OB00016 Betahistine Mesilat 6mg 4.00 Tablet 1,500.00 6,500.00
R2019-0000073880 16-12-2019 201900070345/111970 MUSDALIFAH,NN Niki Juniar OO00014 Omeprazole 20mg (OGB) 2.00 Capsul 1,169.98 2,839.96
R2019-0000073880 16-12-2019 201900070345/111970 MUSDALIFAH,NN Niki Juniar OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000073886 19-12-2019 201900071024/066857 ARIANI,NY Maulin Nikmah ALK00024 Korset TLSO (Thoraco 1.00 Pcs 455,000.00 455,500.00
R2019-0000073890 19-12-2019 201900070998/020150 NUR JANNAH,NY Nafon Zaitun, Dr. OD00072 Doxyciclyn 100mg (OGB) 10.00 Tablet 650.00 7,000.00
R2019-0000073890 19-12-2019 201900070998/020150 NUR JANNAH,NY Nafon Zaitun, Dr. OC00086 Clindamycin 300mg 10.00 Tablet 2,700.00 27,500.00
R2019-0000073892 19-12-2019 201900071044/092157 AMANIAH,NY TEDDY OC00263 Cendo Vasacon-A ED 1.00 Botol 33,226.87 33,726.87
R2019-0000073891 19-12-2019 201900071035/096020 VICT OR TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000073894 19-12-2019 201900071068/067167 AQILLA QOIRINA TEDDY OC00255 Cendo Tobroson Eye Drop 1.00 Botol 68,681.25 69,181.25
R2019-0000073894 19-12-2019 201900071068/067167 AQILLA QOIRINA TEDDY OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000073898 19-12-2019 201900071069/111951 IKA KARTIKA,NY Nafon Zaitun, Dr. OZ00005 Zinc Tablet (OGB) 30.00 Tablet 1,000.00 30,500.00
R2019-0000073897 19-12-2019 201900071045/083402 NGAINUL FATAYAH,NY Dwi Astuti, dr OO00074 Ondansetron Tablet, 4mg 6.00 Tablet 4,455.00 27,230.00
R2019-0000073897 19-12-2019 201900071045/083402 NGAINUL FATAYAH,NY Dwi Astuti, dr OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000073899 19-12-2019 201900071060/094867 ABDUL LATIF N,SDR Herika dr. OO00040 Oralit 200 6.00 Sachet 706.00 4,736.00
R2019-0000073899 19-12-2019 201900071060/094867 ABDUL LATIF N,SDR Herika dr. OS00027 Sanmag Tablet 6.00 Tablet 1,321.65 8,429.90
R2019-0000073899 19-12-2019 201900071060/094867 ABDUL LATIF N,SDR Herika dr. OZ00005 Zinc Tablet (OGB) 6.00 Tablet 1,000.00 6,500.00
R2019-0000073899 19-12-2019 201900071060/094867 ABDUL LATIF N,SDR Herika dr. OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
Total 221,789,352.38
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 165 dari 266
ASAL RAWAT JALAN
R2019-0000073900 19-12-2019 201900071054/8031 SYAMSUDIN GS,TN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000073900 19-12-2019 201900071054/8031 SYAMSUDIN GS,TN TEDDY OC00264 Cendo Timol 0.5% ED 1.00 Botol 70,908.75 71,408.75
R2019-0000073900 19-12-2019 201900071054/8031 SYAMSUDIN GS,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000073901 19-12-2019 201900071023/110904 BAIQ MAEMUNAH,NY Nafon Zaitun, Dr. OC00010 Calcium Lactat 500mg 20.00 Tablet 302.37 6,547.40
R2019-0000073902 19-12-2019 201900071053/064857 PATMIATUN,NY TEDDY OC00264 Cendo Timol 0.5% ED 1.00 Botol 70,908.75 71,408.75
R2019-0000073902 19-12-2019 201900071053/064857 PATMIATUN,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000073903 19-12-2019 201900071040/021283 JERRYANDI OLOAN Maulin Nikmah OK00002 Kalium Diklofenac 50mg 6.00 Tablet 1,100.00 7,100.00
R2019-0000073904 19-12-2019 201900071052/111536 SUKARTI,NY TEDDY OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000073905 19-12-2019 201900071049/084524 SUMAIKAH,NY MAGDA ROSSA, OA00066 Amoxicillin Tablet, 500mg 12.00 Tablet 1,113.75 13,865.00
R2019-0000073905 19-12-2019 201900071049/084524 SUMAIKAH,NY MAGDA ROSSA, OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000073906 19-12-2019 201900071037/111963 NUR AVIANTO,TN TEDDY OP00065 Polidemisin Eye Drop 1.00 Botol 41,134.50 41,634.50
R2019-0000073906 19-12-2019 201900071037/111963 NUR AVIANTO,TN TEDDY OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000073907 19-12-2019 201900071051/089080 IRNA,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000073908 18-12-2019 201900070806/020404 SUYADI,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000073908 18-12-2019 201900070806/020404 SUYADI,TN LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000073908 18-12-2019 201900070806/020404 SUYADI,TN LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 23.00 Tablet 811.18 19,157.14
R2019-0000073909 19-12-2019 201900071064/076455 ALZENA ZAYBA FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 5.00 Capsul 28,957.00 145,285.00
R2019-0000073909 19-12-2019 201900071064/076455 ALZENA ZAYBA FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 5.00 Tablet 430.65 2,653.25
R2019-0000073909 19-12-2019 201900071064/076455 ALZENA ZAYBA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000073909 19-12-2019 201900071064/076455 ALZENA ZAYBA FREDRIK, Dr,Sp.A OM00100 Mucera Tablet 5.00 Tablet 1,782.00 9,410.00
R2019-0000073909 19-12-2019 201900071064/076455 ALZENA ZAYBA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 5.00 Granula 297.00 1,985.00
R2019-0000073909 19-12-2019 201900071064/076455 ALZENA ZAYBA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000073912 18-12-2019 201900070806/020404 SUYADI,TN LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000073912 18-12-2019 201900070806/020404 SUYADI,TN LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 7.00 Tablet 811.18 6,178.26
R2019-0000073914 18-12-2019 201900070823/030191 SUYANTO,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000073914 18-12-2019 201900070823/030191 SUYANTO,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 7.00 Tablet 5,197.50 36,882.50
R2019-0000073914 18-12-2019 201900070823/030191 SUYANTO,TN LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 3.00 Tablet 240.30 1,220.90
R2019-0000073914 18-12-2019 201900070823/030191 SUYANTO,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000073913 19-12-2019 201900071090/108918 ESHANATA EL FREDRIK, Dr,Sp.A OM00097 Mucera Drop 1.00 Botol 54,945.00 55,445.00
R2019-0000073913 19-12-2019 201900071090/108918 ESHANATA EL FREDRIK, Dr,Sp.A OT00053 Tiriz Oral Drops 1.00 Botol 96,525.00 97,025.00
R2019-0000073915 19-12-2019 201900071066/112060 SUPARTI,NY Herika dr. OB00050 Braxidin 4.00 Tablet 1,648.35 7,093.40
R2019-0000073915 19-12-2019 201900071066/112060 SUPARTI,NY Herika dr. OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000073915 19-12-2019 201900071066/112060 SUPARTI,NY Herika dr. OA00063 Amlodipin 10mg (OGB) 3.00 Tablet 2,743.00 8,729.00
R2019-0000073916 19-12-2019 201900071094/105885 SHAFA SAFIYYAH,AN FREDRIK, Dr,Sp.A OL00001 L - BIO Sachet 6.00 Sachet 10,395.00 62,870.00
Total 222,967,241.50
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 166 dari 266
ASAL RAWAT JALAN
R2019-0000073917 19-12-2019 201900071079/027849 ASPIANSYAH,TN TEDDY OC00270 Cendo Tobroson Minidose 1.00 Strip 43,065.00 43,565.00
R2019-0000073917 19-12-2019 201900071079/027849 ASPIANSYAH,TN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000073917 19-12-2019 201900071079/027849 ASPIANSYAH,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000073919 19-12-2019 201900071067/102691 MAHDALENA,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000073919 19-12-2019 201900071067/102691 MAHDALENA,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000073922 19-12-2019 201900071109/066918 RIYAN RIZQY FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 4.00 Capsul 28,957.00 116,328.00
R2019-0000073922 19-12-2019 201900071109/066918 RIYAN RIZQY FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 4.00 Tablet 430.65 2,222.60
R2019-0000073922 19-12-2019 201900071109/066918 RIYAN RIZQY FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000073922 19-12-2019 201900071109/066918 RIYAN RIZQY FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 4.00 Tablet 1,232.55 5,430.20
R2019-0000073922 19-12-2019 201900071109/066918 RIYAN RIZQY FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000073922 19-12-2019 201900071109/066918 RIYAN RIZQY FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000073922 19-12-2019 201900071109/066918 RIYAN RIZQY FREDRIK, Dr,Sp.A OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000073918 19-12-2019 201900070793/112032 KUNNAENI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000073924 19-12-2019 201900071110/105037 MUHAMMAD KHOLIL FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 3.00 Capsul 28,957.00 87,371.00
R2019-0000073924 19-12-2019 201900071110/105037 MUHAMMAD KHOLIL FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 2.00 Tablet 430.65 1,361.30
R2019-0000073924 19-12-2019 201900071110/105037 MUHAMMAD KHOLIL FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 2.00 Tablet 1,173.15 2,846.30
R2019-0000073924 19-12-2019 201900071110/105037 MUHAMMAD KHOLIL FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000073924 19-12-2019 201900071110/105037 MUHAMMAD KHOLIL FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000073924 19-12-2019 201900071110/105037 MUHAMMAD KHOLIL FREDRIK, Dr,Sp.A OS00030 Sanmol Drop, 15ml 1.00 Botol 23,314.00 23,814.00
R2019-0000073934 18-12-2019 201900070756/107173 SURATI,NY LUSY E. Dr.Sp.PD OK00040 KSR Tablet 1.00 Tablet 3,883.17 4,383.17
R2019-0000073934 18-12-2019 201900070756/107173 SURATI,NY LUSY E. Dr.Sp.PD OC00134 Curcuma Tablet 10.00 Tablet 1,336.50 13,865.00
R2019-0000073934 18-12-2019 201900070756/107173 SURATI,NY LUSY E. Dr.Sp.PD OK00040 KSR Tablet 3.00 Tablet 3,883.17 12,149.51
R2019-0000073934 18-12-2019 201900070756/107173 SURATI,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 14.00 Capsul 1,169.98 16,879.72
R2019-0000073934 18-12-2019 201900070756/107173 SURATI,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
Total 224,336,624.40
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 167 dari 266
ASAL RAWAT JALAN
R2019-0000073936 01-12-2019 201900070715/111750 HUDANG,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000073936 01-12-2019 201900070715/111750 HUDANG,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000073936 01-12-2019 201900070715/111750 HUDANG,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000073935 18-12-2019 201900070715/111750 HUDANG,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000073935 18-12-2019 201900070715/111750 HUDANG,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000073935 18-12-2019 201900070715/111750 HUDANG,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000073937 18-12-2019 201900070801/069675 RAHAYU LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 23.00 Tablet 445.50 10,746.50
R2019-0000073939 18-12-2019 201900070801/069675 RAHAYU LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000073939 18-12-2019 201900070801/069675 RAHAYU LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000073939 18-12-2019 201900070801/069675 RAHAYU LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000073939 18-12-2019 201900070801/069675 RAHAYU LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 7.00 Tablet 3,164.00 22,648.00
R2019-0000073939 18-12-2019 201900070801/069675 RAHAYU LUSY E. Dr.Sp.PD OS00173 Simvastatin 20mg (OGB) 7.00 Tablet 1,782.00 12,974.00
R2019-0000073939 18-12-2019 201900070801/069675 RAHAYU LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000073928 19-12-2019 201900071130/092296 MIRZA UKAIL,AN Niki Juniar OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000073928 19-12-2019 201900071130/092296 MIRZA UKAIL,AN Niki Juniar OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000073928 19-12-2019 201900071130/092296 MIRZA UKAIL,AN Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000073928 19-12-2019 201900071130/092296 MIRZA UKAIL,AN Niki Juniar OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
R2019-0000073928 19-12-2019 201900071130/092296 MIRZA UKAIL,AN Niki Juniar OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000073928 19-12-2019 201900071130/092296 MIRZA UKAIL,AN Niki Juniar ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000073940 18-12-2019 201900070773/106626 ARI WIBOWO,TN LUSY E. Dr.Sp.PD OG00024 Glimepiride 4mg Tablet 23.00 Tablet 3,869.89 89,507.47
R2019-0000073940 18-12-2019 201900070773/106626 ARI WIBOWO,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2019-0000073940 18-12-2019 201900070773/106626 ARI WIBOWO,TN LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 23.00 Tab 7,425.00 171,275.00
R2019-0000073941 18-12-2019 201900070773/106626 ARI WIBOWO,TN LUSY E. Dr.Sp.PD OG00024 Glimepiride 4mg Tablet 7.00 Tablet 3,869.89 27,589.23
R2019-0000073941 18-12-2019 201900070773/106626 ARI WIBOWO,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000073941 18-12-2019 201900070773/106626 ARI WIBOWO,TN LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 7.00 Tab 7,425.00 52,475.00
R2019-0000073942 18-12-2019 201900070777/098374 EMI LESTARI,NY LUSY E. Dr.Sp.PD OT00135 Thyrozol 5mg 46.00 Tablet 2,188.89 101,188.94
R2019-0000073943 18-12-2019 201900070777/098374 EMI LESTARI,NY LUSY E. Dr.Sp.PD OT00135 Thyrozol 5mg 14.00 Tablet 2,188.89 31,144.46
R2019-0000073946 19-12-2019 201900071088/112064 H M ALIMANSYAH Herika dr. OF00094 Furosemide Injeksi, 1.00 Ampul 5,259.87 5,759.87
R2019-0000073946 19-12-2019 201900071088/112064 H M ALIMANSYAH Herika dr. OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000073946 19-12-2019 201900071088/112064 H M ALIMANSYAH Herika dr. OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000073946 19-12-2019 201900071088/112064 H M ALIMANSYAH Herika dr. OM00043 Methyl Prednisolon 125mg 1.00 Vial 69,795.00 70,295.00
R2019-0000073946 19-12-2019 201900071088/112064 H M ALIMANSYAH Herika dr. ALM00002 Masker Nebuliz er 1.00 Pcs 57,172.50 57,672.50
R2019-0000073938 19-12-2019 201900071132/112067 YULIANA,NY Niki Juniar ON00009 Natrium Diklofenac 50mg 4.00 Tablet 955.84 4,323.36
R2019-0000073938 19-12-2019 201900071132/112067 YULIANA,NY Niki Juniar OE00057 Eperisone Hcl 50mg 4.00 Tablet 2,286.90 9,647.60
R2019-0000073947 19-12-2019 201900071139/112068 HAICRIL AKBAR,SDR Niki Juniar OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000073947 19-12-2019 201900071139/112068 HAICRIL AKBAR,SDR Niki Juniar OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000073949 19-12-2019 201900071072/083042 ZAINAL ABIDIN,TN Ismail dr. Msc. OG00057 Gabapentin 300mg (OGB) 30.00 Tablet 8,168.00 245,540.00
R2019-0000073949 19-12-2019 201900071072/083042 ZAINAL ABIDIN,TN Ismail dr. Msc. OA00106 Asam Mefenamat 500mg 30.00 Tablet 415.80 12,974.00
Total 226,006,010.16
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 168 dari 266
ASAL RAWAT JALAN
R2019-0000073949 19-12-2019 201900071072/083042 ZAINAL ABIDIN,TN Ismail dr. Msc. OV00080 Vitamin B Compleks 10.00 Tablet 241.79 2,917.90
R2019-0000073948 19-12-2019 201900071073/023981 SYAFRAN,TN Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000073948 19-12-2019 201900071073/023981 SYAFRAN,TN Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000073948 19-12-2019 201900071073/023981 SYAFRAN,TN Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000073948 19-12-2019 201900071073/023981 SYAFRAN,TN Ismail dr. Msc. OK00022 Ketoconazol Cream 2% 1.00 Tube 11,000.00 11,500.00
R2019-0000073948 19-12-2019 201900071073/023981 SYAFRAN,TN Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 19,000.00
R2019-0000073953 19-12-2019 201900071125/112066 M KHALIF ASRI,AN Ismail dr. Msc. OI00053 Infus Otsu-NaCl 3%, 1.00 Botol 20,000.00 20,500.00
R2019-0000073953 19-12-2019 201900071125/112066 M KHALIF ASRI,AN Ismail dr. Msc. ALK00005 Kasa Hydrofil New DRC 24.00 lembar 816.75 20,102.00
R2019-0000073953 19-12-2019 201900071125/112066 M KHALIF ASRI,AN Ismail dr. Msc. OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000073953 19-12-2019 201900071125/112066 M KHALIF ASRI,AN Ismail dr. Msc. OB00058 Bufect Suspensi, 60ml 1.00 Botol 21,681.00 22,181.00
R2019-0000073951 19-12-2019 201900070985/057495 NURLINAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 7.00 Tablet 371.25 3,098.75
R2019-0000073957 19-12-2019 201900070985/057495 NURLINAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 23.00 Tablet 371.25 9,038.75
R2019-0000073960 19-12-2019 201900071111/102392 LINA,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 14.00 Capsul 1,169.98 16,879.72
R2019-0000073960 19-12-2019 201900071111/102392 LINA,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000073960 19-12-2019 201900071111/102392 LINA,NY LUSY E. Dr.Sp.PD OB00050 Braxidin 20.00 Tablet 1,648.35 33,467.00
R2019-0000073960 19-12-2019 201900071111/102392 LINA,NY LUSY E. Dr.Sp.PD OA00186 Asam Ursodeoksikolat 30.00 Tablet 6,237.00 187,610.00
R2019-0000073965 19-12-2019 201900071085/111676 NURUL KOMARIAH,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 23.00 Tablet 315.26 7,750.98
R2019-0000073965 19-12-2019 201900071085/111676 NURUL KOMARIAH,NY LUSY E. Dr.Sp.PD OS00093 Spironolacton 100mg 12.00 Tablet 2,200.00 26,900.00
R2019-0000073965 19-12-2019 201900071085/111676 NURUL KOMARIAH,NY LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000073965 19-12-2019 201900071085/111676 NURUL KOMARIAH,NY LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 2.00 Flexpen 226,917.80 454,335.60
R2019-0000073965 19-12-2019 201900071085/111676 NURUL KOMARIAH,NY LUSY E. Dr.Sp.PD OL00056 Levemir Insulin 1.00 Flexpen 287,330.88 287,830.88
R2019-0000073961 19-12-2019 201900071100/077150 MUHAMMAD ISA ALI LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000073961 19-12-2019 201900071100/077150 MUHAMMAD ISA ALI LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000073961 19-12-2019 201900071100/077150 MUHAMMAD ISA ALI LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000073944 19-12-2019 201900071174/109417 JAMIATU ROCHIM,NY LUSY E. Dr.Sp.PD OP00121 Propylthiouracil 100mg 21.00 Tablet 791.50 17,121.50
R2019-0000073944 19-12-2019 201900071174/109417 JAMIATU ROCHIM,NY LUSY E. Dr.Sp.PD OP00117 Propanolol 10mg (OGB) 14.00 Tablet 131.50 2,341.00
R2019-0000073944 19-12-2019 201900071174/109417 JAMIATU ROCHIM,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 14.00 Capsul 1,169.98 16,879.72
R2019-0000073944 19-12-2019 201900071174/109417 JAMIATU ROCHIM,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000073975 19-12-2019 201900071128/111047 MUHAMMAD ALI LUSY E. Dr.Sp.PD OM00143 Metoclopramide 10mg 10.00 Tablet 211.95 2,619.50
R2019-0000073975 19-12-2019 201900071128/111047 MUHAMMAD ALI LUSY E. Dr.Sp.PD OP00151 Propepsa Syrup, 100ml 1.00 Botol 29,403.00 29,903.00
R2019-0000073975 19-12-2019 201900071128/111047 MUHAMMAD ALI LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000073971 19-12-2019 201900071174/109417 JAMIATU ROCHIM,NY LUSY E. Dr.Sp.PD OP00121 Propylthiouracil 100mg 69.00 Tablet 791.50 55,113.50
R2019-0000073971 19-12-2019 201900071174/109417 JAMIATU ROCHIM,NY LUSY E. Dr.Sp.PD OP00117 Propanolol 10mg (OGB) 46.00 Tablet 131.50 6,549.00
R2019-0000073976 19-12-2019 201900071121/083456 AZAN CHAIRULLAH,TN Ismail dr. Msc. OC00172 Candesartan Cilexetil 60.00 Tablet 10,617.75 637,565.00
R2019-0000073976 19-12-2019 201900071121/083456 AZAN CHAIRULLAH,TN Ismail dr. Msc. OA00038 Allopurinol 300mg (OGB) 60.00 Tablet 580.00 35,300.00
R2019-0000073976 19-12-2019 201900071121/083456 AZAN CHAIRULLAH,TN Ismail dr. Msc. OG00009 Gemfibrozil 300mg (OGB) 60.00 Tablet 811.18 49,170.80
R2019-0000073984 19-12-2019 201900071133/021698 MASTARIAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000073984 19-12-2019 201900071133/021698 MASTARIAH,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 23.00 Tablet 240.30 6,026.90
Total 228,310,164.31
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 169 dari 266
ASAL RAWAT JALAN
R2019-0000073984 19-12-2019 201900071133/021698 MASTARIAH,NY LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000073987 19-12-2019 201900071160/099268 ABDURRAHMAN AUF Niki Juniar OB00058 Bufect Suspensi, 60ml 1.00 Botol 21,681.00 22,181.00
R2019-0000073958 19-12-2019 201900071135/098527 SITI JULAEHA,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 5.00 Tablet 315.26 2,076.30
R2019-0000073958 19-12-2019 201900071135/098527 SITI JULAEHA,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 5.00 Tablet 5,197.50 26,487.50
R2019-0000073991 19-12-2019 201900071166/112072 YOYO SUTIONO,TN Niki Juniar OA00015 Acyclovir 400mg (OGB) 10.00 Tablet 1,262.25 13,122.50
R2019-0000073991 19-12-2019 201900071166/112072 YOYO SUTIONO,TN Niki Juniar OC00060 Cetirizine 10mg (OGB) 4.00 Tablet 623.70 2,994.80
R2019-0000073991 19-12-2019 201900071166/112072 YOYO SUTIONO,TN Niki Juniar OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000073991 19-12-2019 201900071166/112072 YOYO SUTIONO,TN Niki Juniar OA00016 Acyclovir Cream 5gr 1.00 Tube 4,893.00 5,393.00
R2019-0000073997 19-12-2019 201900071169/112073 RASMI,NY Niki Juniar ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000073997 19-12-2019 201900071169/112073 RASMI,NY Niki Juniar OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000073997 19-12-2019 201900071169/112073 RASMI,NY Niki Juniar OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000073994 19-12-2019 201900071169/112073 RASMI,NY Niki Juniar OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000073994 19-12-2019 201900071169/112073 RASMI,NY Niki Juniar OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000073994 19-12-2019 201900071169/112073 RASMI,NY Niki Juniar OC00134 Curcuma Tablet 4.00 Tablet 1,336.50 5,846.00
R2019-0000073998 19-12-2019 201900071158/069151 NURYAN RIANTI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000073998 19-12-2019 201900071158/069151 NURYAN RIANTI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000073998 19-12-2019 201900071158/069151 NURYAN RIANTI,NY LUSY E. Dr.Sp.PD OA00074 Analsik 10.00 Tablet 2,264.63 23,146.30
R2019-0000073992 19-12-2019 201900071181/084347 NURCAHYADI Niki Juniar OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000073992 19-12-2019 201900071181/084347 NURCAHYADI Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000073999 19-12-2019 201900071191/112075 AGUS YULIANTO ,TN Niki Juniar OS00029 Sanmol Tablet, 500mg 8.00 Tablet 430.65 3,945.20
R2019-0000073999 19-12-2019 201900071191/112075 AGUS YULIANTO ,TN Niki Juniar OT00077 Tremenza Tablet 10.00 Tablet 2,160.68 22,106.80
R2019-0000073999 19-12-2019 201900071191/112075 AGUS YULIANTO ,TN Niki Juniar OI00011 Imunos Tablet 5.00 Tablet 11,138.00 56,190.00
R2019-0000073999 19-12-2019 201900071191/112075 AGUS YULIANTO ,TN Niki Juniar OC00120 Cortidex Tablet 10.00 Tablet 430.65 4,806.50
R2019-0000074002 19-12-2019 201900071152/068429 MARINI SUSANTI,NY LUSY E. Dr.Sp.PD OT00135 Thyrozol 5mg 14.00 Tablet 2,188.89 31,144.46
R2019-0000074002 19-12-2019 201900071152/068429 MARINI SUSANTI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000074003 19-12-2019 201900071152/068429 MARINI SUSANTI,NY LUSY E. Dr.Sp.PD OT00135 Thyrozol 5mg 46.00 Tablet 2,188.89 101,188.94
R2019-0000074003 19-12-2019 201900071152/068429 MARINI SUSANTI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000074004 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 14.00 Tablet 315.26 4,913.64
R2019-0000074004 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 14.00 Capsul 1,169.98 16,879.72
R2019-0000074004 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074004 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000074004 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000074004 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000074004 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000074004 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000074004 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 7.00 Tablet 811.18 6,178.26
R2019-0000074004 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 7.00 Tablet 206.41 1,944.87
R2019-0000074004 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
Total 229,337,419.03
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 170 dari 266
ASAL RAWAT JALAN
R2019-0000074005 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD ON00075 Novomix 30 Flexpen 2.00 Flexpen 226,917.80 454,335.60
R2019-0000074005 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 46.00 Tablet 315.26 15,001.96
R2019-0000074005 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000074005 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000074005 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 23.00 Tablet 14,701.50 338,634.50
R2019-0000074005 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000074005 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 23.00 Tablet 811.18 19,157.14
R2019-0000074005 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 23.00 Tablet 206.41 5,247.43
R2019-0000074005 19-12-2019 201900071136/099592 NINGSIH,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 23.00 Tablet 445.50 10,746.50
R2019-0000074001 19-12-2019 201900071134/099591 DAUD IGEN,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000074001 19-12-2019 201900071134/099591 DAUD IGEN,TN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000074001 19-12-2019 201900071134/099591 DAUD IGEN,TN LUSY E. Dr.Sp.PD OC00060 Cetirizine 10mg (OGB) 14.00 Tablet 623.70 9,231.80
R2019-0000074001 19-12-2019 201900071134/099591 DAUD IGEN,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 14.00 Capsul 1,169.98 16,879.72
R2019-0000074001 19-12-2019 201900071134/099591 DAUD IGEN,TN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074001 19-12-2019 201900071134/099591 DAUD IGEN,TN LUSY E. Dr.Sp.PD OH00026 Hydrocortis on Cream 1.00 Tube 11,880.00 12,380.00
R2019-0000074001 19-12-2019 201900071134/099591 DAUD IGEN,TN LUSY E. Dr.Sp.PD OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000074001 19-12-2019 201900071134/099591 DAUD IGEN,TN LUSY E. Dr.Sp.PD ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000074006 19-12-2019 201900071134/099591 DAUD IGEN,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 46.00 Tablet 371.25 17,577.50
R2019-0000074006 19-12-2019 201900071134/099591 DAUD IGEN,TN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000074007 19-12-2019 201900071133/021698 MASTARIAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000074007 19-12-2019 201900071133/021698 MASTARIAH,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000074007 19-12-2019 201900071133/021698 MASTARIAH,NY LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000074009 19-12-2019 201900071116/036015 SUPARMI,NY Gulam dr. SP An OG00023 Glimepiride 3mg Tablet 10.00 Tablet 3,164.00 32,140.00
R2019-0000074009 19-12-2019 201900071116/036015 SUPARMI,NY Gulam dr. SP An OM00035 Metformin 500mg (OGB) 20.00 Tablet 371.25 7,925.00
R2019-0000074009 19-12-2019 201900071116/036015 SUPARMI,NY Gulam dr. SP An OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000074009 19-12-2019 201900071116/036015 SUPARMI,NY Gulam dr. SP An OC00172 Candesartan Cilexetil 10.00 Tablet 10,617.75 106,677.50
R2019-0000074008 19-12-2019 201900071096/073836 MARIATY HUSNI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000074008 19-12-2019 201900071096/073836 MARIATY HUSNI,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000074008 19-12-2019 201900071096/073836 MARIATY HUSNI,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074008 19-12-2019 201900071096/073836 MARIATY HUSNI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000074008 19-12-2019 201900071096/073836 MARIATY HUSNI,NY LUSY E. Dr.Sp.PD OS00176 Scopma Plus Tablet 10.00 Tablet 2,090.22 21,402.20
R2019-0000074008 19-12-2019 201900071096/073836 MARIATY HUSNI,NY LUSY E. Dr.Sp.PD OD00065 Domperidon Tablet (OGB) 10.00 Tablet 750.00 8,000.00
R2019-0000074008 19-12-2019 201900071096/073836 MARIATY HUSNI,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000074008 19-12-2019 201900071096/073836 MARIATY HUSNI,NY LUSY E. Dr.Sp.PD OA00043 Alprazolam 0,5mg (OGB) 10.00 Tablet 996.50 10,465.00
R2019-0000074015 19-12-2019 201900071085/111676 NURUL KOMARIAH,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 7.00 Tablet 315.26 2,706.82
R2019-0000074015 19-12-2019 201900071085/111676 NURUL KOMARIAH,NY LUSY E. Dr.Sp.PD OS00093 Spironolacton 100mg 3.00 Tablet 2,200.00 7,100.00
R2019-0000074015 19-12-2019 201900071085/111676 NURUL KOMARIAH,NY LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000074015 19-12-2019 201900071085/111676 NURUL KOMARIAH,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 14.00 Capsul 1,169.98 16,879.72
Total 231,088,466.72
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 171 dari 266
ASAL RAWAT JALAN
R2019-0000074015 19-12-2019 201900071085/111676 NURUL KOMARIAH,NY LUSY E. Dr.Sp.PD OL00056 Levemir Insulin 1.00 Flexpen 287,330.88 287,830.88
R2019-0000074015 19-12-2019 201900071085/111676 NURUL KOMARIAH,NY LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000074015 19-12-2019 201900071085/111676 NURUL KOMARIAH,NY LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 2.00 Pcs 3,690.00 7,880.00
R2019-0000074016 19-12-2019 201900071184/111918 DJIHAD KELANA Riyanti Puji dr. OB00091 Biovitan Syrup, 60ml 1.00 Botol 8,019.00 8,519.00
R2019-0000074019 19-12-2019 201900071092/108263 LA INDO,TN LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000074019 19-12-2019 201900071092/108263 LA INDO,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000074019 19-12-2019 201900071092/108263 LA INDO,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000074019 19-12-2019 201900071092/108263 LA INDO,TN LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 7.00 Tablet 315.26 2,706.82
R2019-0000074019 19-12-2019 201900071092/108263 LA INDO,TN LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000074020 19-12-2019 201900071149/111487 BEVERLY ALEXANDRA Niki Juniar OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000074020 19-12-2019 201900071149/111487 BEVERLY ALEXANDRA Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000074020 19-12-2019 201900071149/111487 BEVERLY ALEXANDRA Niki Juniar OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000074020 19-12-2019 201900071149/111487 BEVERLY ALEXANDRA Niki Juniar ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000074020 19-12-2019 201900071149/111487 BEVERLY ALEXANDRA Niki Juniar OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000074018 19-12-2019 201900071186/112074 TSAMARA HADID,AN Riyanti Puji dr. OA00030 Alco Drops 15ml 1.00 Botol 106,920.00 107,420.00
R2019-0000074018 19-12-2019 201900071186/112074 TSAMARA HADID,AN Riyanti Puji dr. OA00093 Apialys Drop 1.00 Botol 59,400.00 59,900.00
R2019-0000074021 19-12-2019 201900071084/28366 ROSID PURNOMO,TN LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 7.00 Tablet 3,164.00 22,648.00
R2019-0000074021 19-12-2019 201900071084/28366 ROSID PURNOMO,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000074021 19-12-2019 201900071084/28366 ROSID PURNOMO,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000074021 19-12-2019 201900071084/28366 ROSID PURNOMO,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000074021 19-12-2019 201900071084/28366 ROSID PURNOMO,TN LUSY E. Dr.Sp.PD OC00091 Clonidin 0.15mg (OGB) 21.00 Tablet 359.37 8,046.77
R2019-0000074021 19-12-2019 201900071084/28366 ROSID PURNOMO,TN LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000074021 19-12-2019 201900071084/28366 ROSID PURNOMO,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 7.00 Tablet 5,197.50 36,882.50
R2019-0000074021 19-12-2019 201900071084/28366 ROSID PURNOMO,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000074022 19-12-2019 201900071077/107215 BASERIAH,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000074022 19-12-2019 201900071077/107215 BASERIAH,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000074022 19-12-2019 201900071077/107215 BASERIAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000074022 19-12-2019 201900071077/107215 BASERIAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000074022 19-12-2019 201900071077/107215 BASERIAH,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000074022 19-12-2019 201900071077/107215 BASERIAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000074025 19-12-2019 201900071185/105581 AZKA Riyanti Puji dr. OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000074025 19-12-2019 201900071185/105581 AZKA Riyanti Puji dr. OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000074025 19-12-2019 201900071185/105581 AZKA Riyanti Puji dr. OP00184 Neo Protifed Tablet 2.00 Tablet 1,263.73 3,027.46
R2019-0000074025 19-12-2019 201900071185/105581 AZKA Riyanti Puji dr. OT00142 Trilac 4mg 5.00 Tablet 5,200.00 26,500.00
R2019-0000074025 19-12-2019 201900071185/105581 AZKA Riyanti Puji dr. ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000074024 19-12-2019 201900071187/112076 KHUSNUL KHOTIMAH Niki Juniar OE00057 Eperisone Hcl 50mg 4.00 Tablet 2,286.90 9,647.60
R2019-0000074024 19-12-2019 201900071187/112076 KHUSNUL KHOTIMAH Niki Juniar OI00001 Ibuprofen 400mg (OGB) 4.00 Tablet 682.00 3,228.00
R2019-0000074023 19-12-2019 201900071078/111129 RUSMIYAT I,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
Total 232,404,963.10
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 172 dari 266
ASAL RAWAT JALAN
R2019-0000074023 19-12-2019 201900071078/111129 RUSMIYAT I,NY LUSY E. Dr.Sp.PD OG00021 Glimepiride 1mg Tablet 7.00 Tablet 1,245.00 9,215.00
R2019-0000074023 19-12-2019 201900071078/111129 RUSMIYAT I,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000074027 19-12-2019 201900071145/101398 SUHARLENA MM,NY Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000074027 19-12-2019 201900071145/101398 SUHARLENA MM,NY Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000074027 19-12-2019 201900071145/101398 SUHARLENA MM,NY Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000074027 19-12-2019 201900071145/101398 SUHARLENA MM,NY Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000074027 19-12-2019 201900071145/101398 SUHARLENA MM,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000074028 19-12-2019 201900071196/016666 BELLANI PUTRI Niki Juniar OE00057 Eperisone Hcl 50mg 10.00 Tablet 2,286.90 23,369.00
R2019-0000074028 19-12-2019 201900071196/016666 BELLANI PUTRI Niki Juniar OM00154 Mecobalamin 500mg 6.00 Tablet 1,118.00 7,208.00
R2019-0000074028 19-12-2019 201900071196/016666 BELLANI PUTRI Niki Juniar OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000074030 19-12-2019 201900071189/111935 ZHAFRAN NUFAIL Rianti dr. Sp.A OL00005 Lactacyd Baby, 60ml 1.00 Botol 34,155.00 34,655.00
R2019-0000074033 19-12-2019 201900071197/111824 NISHA RAZAQ,AN Niki Juniar OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000074032 19-12-2019 201900071200/112077 ANGGRAENY NOOR Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000074032 19-12-2019 201900071200/112077 ANGGRAENY NOOR Niki Juniar ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074032 19-12-2019 201900071200/112077 ANGGRAENY NOOR Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074032 19-12-2019 201900071200/112077 ANGGRAENY NOOR Niki Juniar OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000074032 19-12-2019 201900071200/112077 ANGGRAENY NOOR Niki Juniar ON00039 Neurosanbe Injeksi 1.00 Ampul 8,122.95 8,622.95
R2019-0000074034 19-12-2019 201900071139/112068 HAICRIL AKBAR,SDR Niki Juniar OL00063 Lidocain HCl 2% Injeksi 2.00 Ampul 2,376.00 5,252.00
R2019-0000074034 19-12-2019 201900071139/112068 HAICRIL AKBAR,SDR Niki Juniar OA00125 ATS (Anti Tetanus 1.00 Ampul 222,750.00 223,250.00
R2019-0000074026 19-12-2019 201900071149/111487 BEVERLY ALEXANDRA Niki Juniar OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074037 19-12-2019 201900071130/092296 MIRZA UKAIL,AN Niki Juniar OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074038 19-12-2019 201900071187/112076 KHUSNUL KHOTIMAH Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000074039 19-12-2019 201900071181/084347 NURCAHYADI Niki Juniar OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000074041 19-12-2019 201900071203/112078 LA DALI,TN Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000074044 19-12-2019 201900071203/112078 LA DALI,TN Niki Juniar OS00176 Scopma Plus Tablet 6.00 Tablet 2,090.22 13,041.32
R2019-0000074047 19-12-2019 201900071200/112077 ANGGRAENY NOOR Niki Juniar OF00099 Folda Tablet 10.00 Tablet 6,661.65 67,116.50
R2019-0000074047 19-12-2019 201900071200/112077 ANGGRAENY NOOR Niki Juniar OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074047 19-12-2019 201900071200/112077 ANGGRAENY NOOR Niki Juniar OO00074 Ondansetron Tablet, 4mg 10.00 Tablet 4,455.00 45,050.00
R2019-0000074048 19-12-2019 201900071207/101523 SILMY AFIFA ADE RAHMAH OG00067 Genoint Tetes Mata 1.00 Botol 13,587.75 14,087.75
R2019-0000074061 20-12-2019 201900071205/7453 ARDIANTO,TN ADE RAHMAH OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 Botol 22,542.30 23,042.30
R2019-0000074061 20-12-2019 201900071205/7453 ARDIANTO,TN ADE RAHMAH ON00039 Neurosanbe Injeksi 1.00 Ampul 8,122.95 8,622.95
R2019-0000074061 20-12-2019 201900071205/7453 ARDIANTO,TN ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000074061 20-12-2019 201900071205/7453 ARDIANTO,TN ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074061 20-12-2019 201900071205/7453 ARDIANTO,TN ADE RAHMAH ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000074062 20-12-2019 201900071206/061362 SUMIYAT I,NY ADE RAHMAH OC00019 Captopril 25mg (OGB) 1.00 Tablet 267.35 767.35
R2019-0000074062 20-12-2019 201900071206/061362 SUMIYAT I,NY ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000074062 20-12-2019 201900071206/061362 SUMIYAT I,NY ADE RAHMAH OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000074062 20-12-2019 201900071206/061362 SUMIYAT I,NY ADE RAHMAH ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
Total 233,388,921.92
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 173 dari 266
ASAL RAWAT JALAN
R2019-0000074062 20-12-2019 201900071206/061362 SUMIYAT I,NY ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074076 20-12-2019 201900071205/7453 ARDIANTO,TN ADE RAHMAH OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000074076 20-12-2019 201900071205/7453 ARDIANTO,TN ADE RAHMAH OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000074076 20-12-2019 201900071205/7453 ARDIANTO,TN ADE RAHMAH OB00016 Betahistine Mesilat 6mg 3.00 Tablet 1,500.00 5,000.00
R2019-0000074076 20-12-2019 201900071205/7453 ARDIANTO,TN ADE RAHMAH OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000074077 20-12-2019 201900071214/00014542 JUMADI,TN ADE RAHMAH OM00058 Microlax Enema Rectal 2.00 Tube 27,843.00 56,186.00
R2019-0000074081 20-12-2019 201900071225/109972 YULIANA,NY SEPTIA NOVITA OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000074081 20-12-2019 201900071225/109972 YULIANA,NY SEPTIA NOVITA OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074078 20-12-2019 201900071226/107841 EFRANDY DWI Niki Juniar OC00144 Cefila Capsul, 100mg 10.00 Capsul 28,957.00 290,070.00
R2019-0000074078 20-12-2019 201900071226/107841 EFRANDY DWI Niki Juniar OL00126 Lactrin Tablet 6.00 Tablet 6,311.25 38,367.50
R2019-0000074078 20-12-2019 201900071226/107841 EFRANDY DWI Niki Juniar OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000074078 20-12-2019 201900071226/107841 EFRANDY DWI Niki Juniar OT00077 Tremenza Tablet 6.00 Tablet 2,160.68 13,464.08
R2019-0000074082 20-12-2019 201900071218/089165 MISRANTO,TN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000074082 20-12-2019 201900071218/089165 MISRANTO,TN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000074082 20-12-2019 201900071218/089165 MISRANTO,TN EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000074082 20-12-2019 201900071218/089165 MISRANTO,TN EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000074084 20-12-2019 201900071227/106511 ESNA SITINJAK,NY Angie Renatha , OA00013 Avamys Nasal Spray 1.00 Botol 237,451.50 237,951.50
R2019-0000074085 20-12-2019 201900071240/112082 DARMAIS,TN ADE RAHMAH OA00066 Amoxicillin Tablet, 500mg 5.00 Tablet 1,113.75 6,068.75
R2019-0000074085 20-12-2019 201900071240/112082 DARMAIS,TN ADE RAHMAH OA00088 Antiza Tablet 5.00 Tablet 1,633.00 8,665.00
R2019-0000074085 20-12-2019 201900071240/112082 DARMAIS,TN ADE RAHMAH OM00045 Methyl Prednisolon 4mg 5.00 Tablet 792.99 4,464.95
R2019-0000074086 20-12-2019 201900071243/050884 YAJIZ OMAR ADAM,TN SEPTIA NOVITA OC00144 Cefila Capsul, 100mg 10.00 Capsul 28,957.00 290,070.00
R2019-0000074086 20-12-2019 201900071243/050884 YAJIZ OMAR ADAM,TN SEPTIA NOVITA OT00077 Tremenza Tablet 6.00 Tablet 2,160.68 13,464.08
R2019-0000074087 20-12-2019 201900071242/112083 CLEMENS RANTETANA MAGDA ROSSA, OT00149 Toramine 10 Mg Tablet 10.00 Tablet 8,167.50 82,175.00
R2019-0000074089 20-12-2019 201900071233/076091 NURHANA,NY LUSY E. Dr.Sp.PD OP00118 Propanolol 40mg (OGB) 34.00 Tablet 404.89 14,266.26
R2019-0000074089 20-12-2019 201900071233/076091 NURHANA,NY LUSY E. Dr.Sp.PD OP00121 Propylthiouracil 100mg 69.00 Tablet 791.50 55,113.50
R2019-0000074089 20-12-2019 201900071233/076091 NURHANA,NY LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 3.00 Flexpen 226,917.80 681,253.40
R2019-0000074089 20-12-2019 201900071233/076091 NURHANA,NY LUSY E. Dr.Sp.PD OL00056 Levemir Insulin 1.00 Flexpen 287,330.88 287,830.88
R2019-0000074091 20-12-2019 201900071239/112081 ASMA BAHRUDIN,NY ROY , Dr.Sp.OG OO00074 Ondansetron Tablet, 4mg 10.00 Tablet 4,455.00 45,050.00
R2019-0000074091 20-12-2019 201900071239/112081 ASMA BAHRUDIN,NY ROY , Dr.Sp.OG OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074091 20-12-2019 201900071239/112081 ASMA BAHRUDIN,NY ROY , Dr.Sp.OG OF00099 Folda Tablet 30.00 Tablet 6,661.65 200,349.50
R2019-0000074091 20-12-2019 201900071239/112081 ASMA BAHRUDIN,NY ROY , Dr.Sp.OG OB00068 BioCal-95 30.00 Tablet 7,128.00 214,340.00
R2019-0000074092 20-12-2019 201900071263/111477 ELIDA ROSLINA SEPTIA NOVITA OA00074 Analsik 4.00 Tablet 2,264.63 9,558.52
R2019-0000074096 20-12-2019 201900071264/112085 KASMIRAN RAIS,TN Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000074096 20-12-2019 201900071264/112085 KASMIRAN RAIS,TN Dwi Astuti, dr OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074096 20-12-2019 201900071264/112085 KASMIRAN RAIS,TN Dwi Astuti, dr OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000074098 20-12-2019 201900071252/035045 ERAM,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
Total 236,173,744.78
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 174 dari 266
ASAL RAWAT JALAN
R2019-0000074099 20-12-2019 201900071252/035045 ERAM,NY LUSY E. Dr.Sp.PD OC00134 Curcuma Tablet 14.00 Tablet 1,336.50 19,211.00
R2019-0000074099 20-12-2019 201900071252/035045 ERAM,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000074099 20-12-2019 201900071252/035045 ERAM,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000074095 20-12-2019 201900071260/031960 NAMIRA,NN Nafon Zaitun, Dr. OM00035 Metformin 500mg (OGB) 20.00 Tablet 371.25 7,925.00
R2019-0000074095 20-12-2019 201900071260/031960 NAMIRA,NN Nafon Zaitun, Dr. OZ00005 Zinc Tablet (OGB) 30.00 Tablet 1,000.00 30,500.00
R2019-0000074102 20-12-2019 201900071259/061368 SUKARNI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000074102 20-12-2019 201900071259/061368 SUKARNI,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000074102 20-12-2019 201900071259/061368 SUKARNI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000074102 20-12-2019 201900071259/061368 SUKARNI,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000074102 20-12-2019 201900071259/061368 SUKARNI,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 23.00 Tablet 445.50 10,746.50
R2019-0000074102 20-12-2019 201900071259/061368 SUKARNI,NY LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 23.00 Tablet 206.41 5,247.43
R2019-0000074100 20-12-2019 201900071259/061368 SUKARNI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000074100 20-12-2019 201900071259/061368 SUKARNI,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000074100 20-12-2019 201900071259/061368 SUKARNI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000074100 20-12-2019 201900071259/061368 SUKARNI,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000074100 20-12-2019 201900071259/061368 SUKARNI,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000074100 20-12-2019 201900071259/061368 SUKARNI,NY LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 7.00 Tablet 206.41 1,944.87
R2019-0000074101 20-12-2019 201900071262/077798 LASOFA,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000074101 20-12-2019 201900071262/077798 LASOFA,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 10.00 Tablet 10,617.75 106,677.50
R2019-0000074101 20-12-2019 201900071262/077798 LASOFA,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 5.00 Tablet 5,197.50 26,487.50
R2019-0000074104 20-12-2019 201900071249/099036 BOYKE SETIAWAN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000074104 20-12-2019 201900071249/099036 BOYKE SETIAWAN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000074104 20-12-2019 201900071249/099036 BOYKE SETIAWAN LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000074105 20-12-2019 201900071256/106258 ASIAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 20.00 Tablet 371.25 7,925.00
R2019-0000074105 20-12-2019 201900071256/106258 ASIAH,NY LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 10.00 Tablet 3,164.00 32,140.00
R2019-0000074105 20-12-2019 201900071256/106258 ASIAH,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 10.00 Tablet 1,555.00 16,050.00
R2019-0000074105 20-12-2019 201900071256/106258 ASIAH,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 10.00 Tablet 7,425.00 74,750.00
R2019-0000074105 20-12-2019 201900071256/106258 ASIAH,NY LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000074106 20-12-2019 201900071233/076091 NURHANA,NY LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 2.00 Pcs 3,690.00 7,880.00
R2019-0000074107 20-12-2019 201900071238/28353 MURSIYAH,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000074107 20-12-2019 201900071238/28353 MURSIYAH,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000074107 20-12-2019 201900071238/28353 MURSIYAH,NY LUSY E. Dr.Sp.PD OV00080 Vitamin B Compleks 20.00 Tablet 241.79 5,335.80
R2019-0000074107 20-12-2019 201900071238/28353 MURSIYAH,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000074108 20-12-2019 201900071253/061561 NURUL HIDAYATI,NY Nafon Zaitun, Dr. OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000074108 20-12-2019 201900071253/061561 NURUL HIDAYATI,NY Nafon Zaitun, Dr. OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000074109 20-12-2019 201900071231/044020 MAIDI,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
Total 237,269,926.52
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 175 dari 266
ASAL RAWAT JALAN
R2019-0000074109 20-12-2019 201900071231/044020 MAIDI,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000074109 20-12-2019 201900071231/044020 MAIDI,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 5,197.50 16,092.50
R2019-0000074109 20-12-2019 201900071231/044020 MAIDI,TN LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000074109 20-12-2019 201900071231/044020 MAIDI,TN LUSY E. Dr.Sp.PD OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000074110 20-12-2019 201900071221/099684 RIANUR SETYANI,NY LUSY E. Dr.Sp.PD OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000074111 20-12-2019 201900071264/112085 KASMIRAN RAIS,TN Dwi Astuti, dr OO00074 Ondansetron Tablet, 4mg 5.00 Tablet 4,455.00 22,775.00
R2019-0000074111 20-12-2019 201900071264/112085 KASMIRAN RAIS,TN Dwi Astuti, dr OL00021 Lansoprazole (OGB) 5.00 Capsul 2,230.00 11,650.00
R2019-0000074113 20-12-2019 201900071269/070948 DWI ASTUTI Dwi Astuti, dr OT00077 Tremenza Tablet 5.00 Tablet 2,160.68 11,303.40
R2019-0000074113 20-12-2019 201900071269/070948 DWI ASTUTI Dwi Astuti, dr OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000074113 20-12-2019 201900071269/070948 DWI ASTUTI Dwi Astuti, dr OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2019-0000074112 20-12-2019 201900071265/078788 NGANTIAH,NY Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000074112 20-12-2019 201900071265/078788 NGANTIAH,NY Dwi Astuti, dr OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000074112 20-12-2019 201900071265/078788 NGANTIAH,NY Dwi Astuti, dr OS00009 Salbutamol 2mg (OGB) 6.00 Tablet 213.30 1,779.80
R2019-0000074112 20-12-2019 201900071265/078788 NGANTIAH,NY Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000074112 20-12-2019 201900071265/078788 NGANTIAH,NY Dwi Astuti, dr OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000074114 20-12-2019 201900071265/078788 NGANTIAH,NY Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074114 20-12-2019 201900071265/078788 NGANTIAH,NY Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074115 20-12-2019 201900071255/19518 APRILIYA RATNA NOVIANA, Dr. Sp OB00029 Biosanbe Capsul 7.00 Capsul 1,596.37 11,674.59
R2019-0000074115 20-12-2019 201900071255/19518 APRILIYA RATNA NOVIANA, Dr. Sp OE00008 Elkana Tablet 7.00 Tablet 1,247.40 9,231.80
R2019-0000074116 20-12-2019 201900071284/057495 NURLINAH,NY NOVIANA, Dr. Sp OB00007 Becom - C 6.00 Tablet 2,123.55 13,241.30
R2019-0000074117 20-12-2019 201900071273/079682 NYOMAN DIVTA,AN FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 4.00 Capsul 28,957.00 116,328.00
R2019-0000074117 20-12-2019 201900071273/079682 NYOMAN DIVTA,AN FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 4.00 Tablet 430.65 2,222.60
R2019-0000074117 20-12-2019 201900071273/079682 NYOMAN DIVTA,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000074117 20-12-2019 201900071273/079682 NYOMAN DIVTA,AN FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 4.00 Tablet 1,232.55 5,430.20
R2019-0000074117 20-12-2019 201900071273/079682 NYOMAN DIVTA,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000074117 20-12-2019 201900071273/079682 NYOMAN DIVTA,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000074117 20-12-2019 201900071273/079682 NYOMAN DIVTA,AN FREDRIK, Dr,Sp.A ON00004 Naprex Syrup, 60ml 1.00 Botol 59,251.50 59,751.50
R2019-0000074118 20-12-2019 201900071286/036535 DIAN NOVIANA, Dr. Sp ON00090 Nutribreast 30.00 Tablet 13,148.19 394,945.70
R2019-0000074124 20-12-2019 201900071268/088519 KIKYE Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000074124 20-12-2019 201900071268/088519 KIKYE Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000074128 20-12-2019 201900071300/111593 HJ HALIMAH,NY Ismail dr. Msc. OZ00005 Zinc Tablet (OGB) 20.00 Tablet 1,000.00 20,500.00
R2019-0000074127 20-12-2019 201900071299/101041 ALIF CAHAYA Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000074127 20-12-2019 201900071299/101041 ALIF CAHAYA Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000074127 20-12-2019 201900071299/101041 ALIF CAHAYA Ismail dr. Msc. OK00022 Ketoconazol Cream 2% 1.00 Tube 11,000.00 11,500.00
R2019-0000074127 20-12-2019 201900071299/101041 ALIF CAHAYA Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000074136 20-12-2019 201900071297/111264 ALUNA DIANDRA Ismail dr. Msc. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000074136 20-12-2019 201900071297/111264 ALUNA DIANDRA Ismail dr. Msc. OH00026 Hydrocortis on Cream 2.00 Tube 11,880.00 24,260.00
R2019-0000074136 20-12-2019 201900071297/111264 ALUNA DIANDRA Ismail dr. Msc. OK00022 Ketoconazol Cream 2% 1.00 Tube 11,000.00 11,500.00
Total 238,325,684.01
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 176 dari 266
ASAL RAWAT JALAN
R2019-0000074136 20-12-2019 201900071297/111264 ALUNA DIANDRA Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000074135 20-12-2019 201900071295/102665 AKHMAD UBAIDILLAH Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000074135 20-12-2019 201900071295/102665 AKHMAD UBAIDILLAH Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000074135 20-12-2019 201900071295/102665 AKHMAD UBAIDILLAH Ismail dr. Msc. OS00053 Scabimate Cream, 10gr 1.00 Tube 63,112.50 63,612.50
R2019-0000074135 20-12-2019 201900071295/102665 AKHMAD UBAIDILLAH Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 7,276.50 7,776.50
R2019-0000074135 20-12-2019 201900071295/102665 AKHMAD UBAIDILLAH Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000074135 20-12-2019 201900071295/102665 AKHMAD UBAIDILLAH Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000074137 20-12-2019 201900071241/111171 ARIMUDIN,TN Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000074137 20-12-2019 201900071241/111171 ARIMUDIN,TN Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000074137 20-12-2019 201900071241/111171 ARIMUDIN,TN Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000074137 20-12-2019 201900071241/111171 ARIMUDIN,TN Ismail dr. Msc. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000074137 20-12-2019 201900071241/111171 ARIMUDIN,TN Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000074138 20-12-2019 201900071306/077735 AREL HERMAWAN,TN Herika dr. OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000074138 20-12-2019 201900071306/077735 AREL HERMAWAN,TN Herika dr. OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000074138 20-12-2019 201900071306/077735 AREL HERMAWAN,TN Herika dr. OF00039 FG Troches 4.00 Tablet 1,730.02 7,420.08
R2019-0000074138 20-12-2019 201900071306/077735 AREL HERMAWAN,TN Herika dr. OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000074140 20-12-2019 201900071241/111171 ARIMUDIN,TN Ismail dr. Msc. OC00039 Cefixime 100mg (OGB) 12.00 Capsul 4,266.70 51,700.40
R2019-0000074140 20-12-2019 201900071241/111171 ARIMUDIN,TN Ismail dr. Msc. OU00022 Urotractin 400mg Tablet 6.00 Tablet 7,189.03 43,634.18
R2019-0000074140 20-12-2019 201900071241/111171 ARIMUDIN,TN Ismail dr. Msc. OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000074141 20-12-2019 201900071296/058101 JOKO WAGE CIPTADI Herika dr. OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000074141 20-12-2019 201900071296/058101 JOKO WAGE CIPTADI Herika dr. ON00009 Natrium Diklofenac 50mg 6.00 Tablet 955.84 6,235.04
R2019-0000074141 20-12-2019 201900071296/058101 JOKO WAGE CIPTADI Herika dr. OA00085 Antasida Tablet (OGB) 6.00 Tablet 284.30 2,205.80
R2019-0000074142 20-12-2019 201900071320/046904 ADJI DEO RESKY,SDR Herika dr. OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000074142 20-12-2019 201900071320/046904 ADJI DEO RESKY,SDR Herika dr. OI00133 Imunvit Plus Tablet 3.00 Tablet 13,365.00 40,595.00
R2019-0000074142 20-12-2019 201900071320/046904 ADJI DEO RESKY,SDR Herika dr. OP00138 Pumpitor Capsul 10.00 Capsul 20,092.05 201,420.50
R2019-0000074143 20-12-2019 201900071276/112086 SURYA SAPUTRA,TN Hendra Dr, Sp. OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000074143 20-12-2019 201900071276/112086 SURYA SAPUTRA,TN Hendra Dr, Sp. OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000074143 20-12-2019 201900071276/112086 SURYA SAPUTRA,TN Hendra Dr, Sp. ALP00056 Perban Elastis 3" 1.00 roll 29,700.00 30,200.00
R2019-0000074103 20-12-2019 201900071281/112087 BAHRIAH,NY Hendra Dr, Sp. OD00102 Dexketoprofen 25mg 10.00 Tablet 10 4,290.00 39,110.00
R2019-0000074103 20-12-2019 201900071281/112087 BAHRIAH,NY Hendra Dr, Sp. OM00154 Mecobalamin 500mg 10.00 Tablet 10 1,118.00 10,562.00
R2019-0000074150 20-12-2019 201900071277/093032 ABDI YASA,AN DYAH, dr Sp. OS00160 Seretide Diskus 250 mcg 1.00 Botol 322,681.59 323,181.59
R2019-0000074150 20-12-2019 201900071277/093032 ABDI YASA,AN DYAH, dr Sp. OB00094 Berotec MDI 1.00 Botol 130,000.00 130,500.00
R2019-0000074153 20-12-2019 201900071338/112096 MOHAMMAD NASIR Herika dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000074153 20-12-2019 201900071338/112096 MOHAMMAD NASIR Herika dr. OC00046 Celebrex 200mg 6.00 Tablet 21,511.21 129,567.26
R2019-0000074153 20-12-2019 201900071338/112096 MOHAMMAD NASIR Herika dr. OF00007 Farbion Tablet 10.00 Tablet 1,782.00 18,320.00
R2019-0000074154 20-12-2019 201900071340/112097 IRKHAM IMAM Herika dr. OC00039 Cefixime 100mg (OGB) 20.00 Capsul 4,266.70 85,834.00
R2019-0000074155 20-12-2019 201900071344/112098 ADINDA PINKY Herika dr. OC00039 Cefixime 100mg (OGB) 20.00 Capsul 4,266.70 85,834.00
R2019-0000074155 20-12-2019 201900071344/112098 ADINDA PINKY Herika dr. OU00022 Urotractin 400mg Tablet 10.00 Tablet 7,189.03 72,390.30
Total 239,985,807.45
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 177 dari 266
ASAL RAWAT JALAN
R2019-0000074155 20-12-2019 201900071344/112098 ADINDA PINKY Herika dr. OE00006 Eflagen 50mg 10.00 Tablet 3,118.50 31,685.00
R2019-0000074161 20-12-2019 201900071343/097462 WA KANANTEA,NY Windy Krisanti OG00073 Glucosamine 250 Mg 15.00 Tablet 1,633.50 25,002.50
R2019-0000074161 20-12-2019 201900071343/097462 WA KANANTEA,NY Windy Krisanti ON00009 Natrium Diklofenac 50mg 10.00 Tablet 955.84 10,058.40
R2019-0000074162 20-12-2019 201900071337/112095 MOCH CHOLICHUN,TN Herika dr. OC00134 Curcuma Tablet 4.00 Tablet 1,336.50 5,846.00
R2019-0000074162 20-12-2019 201900071337/112095 MOCH CHOLICHUN,TN Herika dr. OM00035 Metformin 500mg (OGB) 4.00 Tablet 371.25 1,985.00
R2019-0000074162 20-12-2019 201900071337/112095 MOCH CHOLICHUN,TN Herika dr. OG00022 Glimepiride 2mg Tablet 2.00 Tablet 2,525.00 5,550.00
R2019-0000074162 20-12-2019 201900071337/112095 MOCH CHOLICHUN,TN Herika dr. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000074162 20-12-2019 201900071337/112095 MOCH CHOLICHUN,TN Herika dr. OC00097 Codein 15mg 5.00 Tablet 1,665.87 8,829.35
R2019-0000074163 20-12-2019 201900071317/081200 NASRA,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 15.00 Tablet 8,168.00 123,020.00
R2019-0000074163 20-12-2019 201900071317/081200 NASRA,NY Windy Krisanti OL00021 Lansoprazole (OGB) 6.00 Capsul 2,230.00 13,880.00
R2019-0000074163 20-12-2019 201900071317/081200 NASRA,NY Windy Krisanti OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074164 20-12-2019 201900071313/57229 PONITI,NY Windy Krisanti OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000074164 20-12-2019 201900071313/57229 PONITI,NY Windy Krisanti OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000074164 20-12-2019 201900071313/57229 PONITI,NY Windy Krisanti OB00036 Bis oprolol 5mg (OGB) 23.00 Tablet 5,197.50 120,042.50
R2019-0000074165 20-12-2019 201900071313/57229 PONITI,NY Windy Krisanti OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000074165 20-12-2019 201900071313/57229 PONITI,NY Windy Krisanti OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000074165 20-12-2019 201900071313/57229 PONITI,NY Windy Krisanti OB00036 Bis oprolol 5mg (OGB) 7.00 Tablet 5,197.50 36,882.50
R2019-0000074165 20-12-2019 201900071313/57229 PONITI,NY Windy Krisanti OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000074166 20-12-2019 201900071280/47505 NUR HADIJAH,NN Hendra Dr, Sp. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074166 20-12-2019 201900071280/47505 NUR HADIJAH,NN Hendra Dr, Sp. OA00043 Alprazolam 0,5mg (OGB) 5.00 Tablet 996.50 5,482.50
R2019-0000074169 20-12-2019 201900071333/097027 PAWE,TN Herika dr. OA00180 Acetylcyst ein 200mg 6.00 Tablet 1,485.00 9,410.00
R2019-0000074169 20-12-2019 201900071333/097027 PAWE,TN Herika dr. OA00063 Amlodipin 10mg (OGB) 3.00 Tablet 2,743.00 8,729.00
R2019-0000074169 20-12-2019 201900071333/097027 PAWE,TN Herika dr. OC00172 Candesartan Cilexetil 3.00 Tablet 10,617.75 32,353.25
R2019-0000074169 20-12-2019 201900071333/097027 PAWE,TN Herika dr. OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000074168 20-12-2019 201900071348/079422 AMELYA GUSTIAWAN Herika dr. OL00001 L - BIO Sachet 6.00 Sachet 10,395.00 62,870.00
R2019-0000074168 20-12-2019 201900071348/079422 AMELYA GUSTIAWAN Herika dr. OS00176 Scopma Plus Tablet 10.00 Tablet 2,090.22 21,402.20
R2019-0000074168 20-12-2019 201900071348/079422 AMELYA GUSTIAWAN Herika dr. OO00040 Oralit 200 10.00 Sachet 706.00 7,560.00
R2019-0000074174 20-12-2019 201900071356/112100 ARY PURNAMA,TN Herika dr. OT00077 Tremenza Tablet 10.00 Tablet 2,160.68 22,106.80
R2019-0000074174 20-12-2019 201900071356/112100 ARY PURNAMA,TN Herika dr. OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000074174 20-12-2019 201900071356/112100 ARY PURNAMA,TN Herika dr. OE00018 Epexol Tablet 10.00 Tablet 1,232.55 12,825.50
R2019-0000074177 20-12-2019 201900071308/107160 ASWAD,TN Windy Krisanti OG00057 Gabapentin 300mg (OGB) 20.00 Tablet 8,168.00 163,860.00
R2019-0000074177 20-12-2019 201900071308/107160 ASWAD,TN Windy Krisanti OT00063 Tramadol 50mg Tablet 15.00 Tablet 1,113.75 17,206.25
Total 241,627,199.60
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 178 dari 266
ASAL RAWAT JALAN
R2019-0000074177 20-12-2019 201900071308/107160 ASWAD,TN Windy Krisanti OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000074178 20-12-2019 201900071219/112035 M ALI,TN Windy Krisanti OF00095 Furosemide 40mg (OGB) 12.00 Tablet 315.26 4,283.12
R2019-0000074179 20-12-2019 201900071219/112035 M ALI,TN Windy Krisanti OF00095 Furosemide 40mg (OGB) 3.00 Tablet 315.26 1,445.78
R2019-0000074180 20-12-2019 201900071289/089969 ACHMAD SOFYAN,TN Windy Krisanti OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000074180 20-12-2019 201900071289/089969 ACHMAD SOFYAN,TN Windy Krisanti OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000074180 20-12-2019 201900071289/089969 ACHMAD SOFYAN,TN Windy Krisanti OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000074180 20-12-2019 201900071289/089969 ACHMAD SOFYAN,TN Windy Krisanti OF00007 Farbion Tablet 10.00 Tablet 1,782.00 18,320.00
R2019-0000074180 20-12-2019 201900071289/089969 ACHMAD SOFYAN,TN Windy Krisanti OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000074152 20-12-2019 201900071267/110936 JUNAIYAH,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 14.00 Tablet 8,168.00 114,852.00
R2019-0000074152 20-12-2019 201900071267/110936 JUNAIYAH,NY Windy Krisanti OM00154 Mecobalamin 500mg 14.00 Tablet 1,118.00 16,152.00
R2019-0000074152 20-12-2019 201900071267/110936 JUNAIYAH,NY Windy Krisanti OA00062 Amitriptyline Tablet, 2.00 Tablet 252.45 1,004.90
R2019-0000074182 20-12-2019 201900071285/103256 SINTOYO,TN Windy Krisanti OG00057 Gabapentin 300mg (OGB) 5.00 Tablet 8,168.00 41,340.00
R2019-0000074182 20-12-2019 201900071285/103256 SINTOYO,TN Windy Krisanti ALK00037 Kapsul No.1 15.00 pcs 200.00 10,500.00
R2019-0000074182 20-12-2019 201900071285/103256 SINTOYO,TN Windy Krisanti OV00046 Valis anbe 5mg Tablet 15.00 Tablet 579.15 9,187.25
R2019-0000074182 20-12-2019 201900071285/103256 SINTOYO,TN Windy Krisanti OM00154 Mecobalamin 500mg 15.00 Tablet 1,118.00 17,270.00
R2019-0000074182 20-12-2019 201900071285/103256 SINTOYO,TN Windy Krisanti OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000074186 20-12-2019 201900071275/029841 LI'AH,NY Windy Krisanti OG00057 Gabapentin 300mg (OGB) 15.00 Tablet 8,168.00 123,020.00
R2019-0000074186 20-12-2019 201900071275/029841 LI'AH,NY Windy Krisanti OV00046 Valis anbe 5mg Tablet 15.00 Tablet 579.15 9,187.25
R2019-0000074186 20-12-2019 201900071275/029841 LI'AH,NY Windy Krisanti OM00154 Mecobalamin 500mg 15.00 Tablet 1,118.00 17,270.00
R2019-0000074184 20-12-2019 201900071212/080247 AZWAR Hendra Dr, Sp. OD00102 Dexketoprofen 25mg 10.00 Tablet 4,290.00 43,400.00
R2019-0000074184 20-12-2019 201900071212/080247 AZWAR Hendra Dr, Sp. OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000074187 20-12-2019 201900071307/019419 FARIDHOTUL DYAH, dr Sp. OS00160 Seretide Diskus 250 mcg 1.00 Botol 322,681.59 323,181.59
R2019-0000074181 20-12-2019 201900071283/111405 YOHANA MINGGU,NY Hendra Dr, Sp. OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000074181 20-12-2019 201900071283/111405 YOHANA MINGGU,NY Hendra Dr, Sp. OC00095 Co-Amoxiclave 625mg 15.00 Tablet 7,840.99 118,114.85
R2019-0000074188 20-12-2019 201900071304/060089 EKA PUTRIANI,NY DYAH, dr Sp. OP00184 Neo Protifed Tablet 10.00 Tablet 1,263.73 13,137.30
R2019-0000074190 20-12-2019 201900071350/106939 SHELBY EXZO Herika dr. OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000074190 20-12-2019 201900071350/106939 SHELBY EXZO Herika dr. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000074190 20-12-2019 201900071350/106939 SHELBY EXZO Herika dr. OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000074189 20-12-2019 201900071351/105807 YUNNY EKO Ismail dr. Msc. OK00030 Ketricin Salep 0.1%, 5gr 1.00 Tube 66,825.00 67,325.00
R2019-0000074191 20-12-2019 201900071271/16455 JUNJUNGAN Windy Krisanti OA00140 Atorvastatin 20mg (OGB) 12.00 Tablet 6,534.00 78,908.00
R2019-0000074191 20-12-2019 201900071271/16455 JUNJUNGAN Windy Krisanti OC00092 Clopidogrel 75mg (OGB) 23.00 Tablet 14,701.50 338,634.50
R2019-0000074191 20-12-2019 201900071271/16455 JUNJUNGAN Windy Krisanti OF00095 Furosemide 40mg (OGB) 23.00 Tablet 315.26 7,750.98
Total 243,685,126.84
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 179 dari 266
ASAL RAWAT JALAN
R2019-0000074191 20-12-2019 201900071271/16455 JUNJUNGAN Windy Krisanti OM00035 Metformin 500mg (OGB) 46.00 Tablet 371.25 17,577.50
R2019-0000074191 20-12-2019 201900071271/16455 JUNJUNGAN Windy Krisanti OG00022 Glimepiride 2mg Tablet 23.00 Tablet 2,525.00 58,575.00
R2019-0000074194 20-12-2019 201900071271/16455 JUNJUNGAN Windy Krisanti OA00140 Atorvastatin 20mg (OGB) 3.00 Tablet 6,534.00 20,102.00
R2019-0000074194 20-12-2019 201900071271/16455 JUNJUNGAN Windy Krisanti OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000074194 20-12-2019 201900071271/16455 JUNJUNGAN Windy Krisanti OF00095 Furosemide 40mg (OGB) 7.00 Tablet 315.26 2,706.82
R2019-0000074194 20-12-2019 201900071271/16455 JUNJUNGAN Windy Krisanti OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000074194 20-12-2019 201900071271/16455 JUNJUNGAN Windy Krisanti OG00022 Glimepiride 2mg Tablet 7.00 Tablet 2,525.00 18,175.00
R2019-0000074195 20-12-2019 201900071303/098527 SITI JULAEHA,NY DYAH, dr Sp. OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000074195 20-12-2019 201900071303/098527 SITI JULAEHA,NY DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000074196 20-12-2019 201900071258/106364 JAMUDDIN DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000074196 20-12-2019 201900071258/106364 JAMUDDIN DYAH, dr Sp. OF00095 Furosemide 40mg (OGB) 10.00 Tablet 315.26 3,652.60
R2019-0000074196 20-12-2019 201900071258/106364 JAMUDDIN DYAH, dr Sp. OC00096 Codein 10mg 10.00 Tablet 924.80 9,748.00
R2019-0000074196 20-12-2019 201900071258/106364 JAMUDDIN DYAH, dr Sp. OA00085 Antasida Tablet (OGB) 10.00 Tablet 284.30 3,343.00
R2019-0000074197 20-12-2019 201900071257/112084 SYLVIA CHANDRA,NY Hendra Dr, Sp. OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000074197 20-12-2019 201900071257/112084 SYLVIA CHANDRA,NY Hendra Dr, Sp. OE00008 Elkana Tablet 7.00 Tablet 1,247.40 9,231.80
R2019-0000074197 20-12-2019 201900071257/112084 SYLVIA CHANDRA,NY Hendra Dr, Sp. OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000074198 20-12-2019 201900071358/112102 LAODE SYAID Herika dr. OA00015 Acyclovir 400mg (OGB) 12.00 Tablet 1,262.25 15,647.00
R2019-0000074198 20-12-2019 201900071358/112102 LAODE SYAID Herika dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000074198 20-12-2019 201900071358/112102 LAODE SYAID Herika dr. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000074198 20-12-2019 201900071358/112102 LAODE SYAID Herika dr. OA00016 Acyclovir Cream 5gr 1.00 Tube 4,893.00 5,393.00
R2019-0000074199 20-12-2019 201900071353/112099 ASHAR DEDE,AN Herika dr. OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000074199 20-12-2019 201900071353/112099 ASHAR DEDE,AN Herika dr. OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
R2019-0000074199 20-12-2019 201900071353/112099 ASHAR DEDE,AN Herika dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000074199 20-12-2019 201900071353/112099 ASHAR DEDE,AN Herika dr. OB00091 Biovitan Syrup, 60ml 1.00 Botol 8,019.00 8,519.00
R2019-0000074201 20-12-2019 201900071362/094715 RIKA AMELIA Herika dr. OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000074201 20-12-2019 201900071362/094715 RIKA AMELIA Herika dr. OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000074201 20-12-2019 201900071362/094715 RIKA AMELIA Herika dr. OF00039 FG Troches 3.00 Tablet 1,730.02 5,690.06
R2019-0000074203 20-12-2019 201900071352/106472 WAHERE,NY Herika dr. ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000074203 20-12-2019 201900071352/106472 WAHERE,NY Herika dr. OI00051 Infus Otsu-NS (NaCl 2.00 Botol 9,388.17 19,276.34
R2019-0000074203 20-12-2019 201900071352/106472 WAHERE,NY Herika dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074203 20-12-2019 201900071352/106472 WAHERE,NY Herika dr. OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000074203 20-12-2019 201900071352/106472 WAHERE,NY Herika dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074204 20-12-2019 201900071330/112094 TARWADI,TN Herika dr. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000074204 20-12-2019 201900071330/112094 TARWADI,TN Herika dr. OC00041 Cefotaxim 1.0gr Injeksi 1.00 Vial 60,885.00 61,385.00
R2019-0000074204 20-12-2019 201900071330/112094 TARWADI,TN Herika dr. OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000074204 20-12-2019 201900071330/112094 TARWADI,TN Herika dr. ALI00004 I.V Catheter No. 20 2.00 Pcs 36,808.20 74,116.40
R2019-0000074204 20-12-2019 201900071330/112094 TARWADI,TN Herika dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074204 20-12-2019 201900071330/112094 TARWADI,TN Herika dr. OW00001 Water For Injeksi 25ml 2.00 Botol 9,222.00 18,944.00
Total 244,467,736.84
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 180 dari 266
ASAL RAWAT JALAN
R2019-0000074206 20-12-2019 201900071312/112090 MUHAMMAD ASKAR EDO, Dr.Sp.B OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074206 20-12-2019 201900071312/112090 MUHAMMAD ASKAR EDO, Dr.Sp.B OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074206 20-12-2019 201900071312/112090 MUHAMMAD ASKAR EDO, Dr.Sp.B ALN00003 Nasal Canule Infant/Anak 1.00 Pcs 19,305.00 19,805.00
R2019-0000074208 20-12-2019 201900071287/095590 DARMAKASIAH,NY Herika dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074208 20-12-2019 201900071287/095590 DARMAKASIAH,NY Herika dr. ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000074207 20-12-2019 201900071333/097027 PAWE,TN Herika dr. OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074207 20-12-2019 201900071333/097027 PAWE,TN Herika dr. OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074209 20-12-2019 201900071361/061849 GILANG PURNAMA,SDR Herika dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000074210 20-12-2019 201900071353/112099 ASHAR DEDE,AN Herika dr. OD00077 Dumin Rectal 250mg 1.00 Tube 29,254.50 29,754.50
R2019-0000074212 20-12-2019 201900071359/112103 ANNISA Herika dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000074212 20-12-2019 201900071359/112103 ANNISA Herika dr. OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000074212 20-12-2019 201900071359/112103 ANNISA Herika dr. OC00132 CTM 4mg 1.00 Tablet 157.41 657.41
R2019-0000074212 20-12-2019 201900071359/112103 ANNISA Herika dr. OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000074212 20-12-2019 201900071359/112103 ANNISA Herika dr. OC00132 CTM 4mg 1.00 Tablet 157.41 657.41
R2019-0000074212 20-12-2019 201900071359/112103 ANNISA Herika dr. OB00091 Biovitan Syrup, 60ml 1.00 Botol 8,019.00 8,519.00
R2019-0000074212 20-12-2019 201900071359/112103 ANNISA Herika dr. ON00082 Nymiko Drop 1.00 Botol 48,856.00 49,356.00
R2019-0000074211 20-12-2019 201900071363/079007 ADI WARSITO,TN Herika dr. OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000074214 20-12-2019 201900071361/061849 GILANG PURNAMA,SDR Herika dr. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000074214 20-12-2019 201900071361/061849 GILANG PURNAMA,SDR Herika dr. OP00184 Neo Protifed Tablet 6.00 Tablet 1,263.73 8,082.38
R2019-0000074214 20-12-2019 201900071361/061849 GILANG PURNAMA,SDR Herika dr. OF00039 FG Troches 3.00 Tablet 1,730.02 5,690.06
R2019-0000074214 20-12-2019 201900071361/061849 GILANG PURNAMA,SDR Herika dr. OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000074213 20-12-2019 201900071363/079007 ADI WARSITO,TN Herika dr. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000074213 20-12-2019 201900071363/079007 ADI WARSITO,TN Herika dr. OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000074213 20-12-2019 201900071363/079007 ADI WARSITO,TN Herika dr. OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000074233 21-12-2019 201900071372/107370 ENDAH Niki Juniar OP00184 Neo Protifed Tablet 6.00 Tablet 1,263.73 8,082.38
R2019-0000074233 21-12-2019 201900071372/107370 ENDAH Niki Juniar OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000074233 21-12-2019 201900071372/107370 ENDAH Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000074233 21-12-2019 201900071372/107370 ENDAH Niki Juniar OS00010 Salbutamol 4mg (OGB) 10.00 Tablet 249.48 2,994.80
R2019-0000074236 21-12-2019 201900071377/055712 NURUL AFIFAH,NY Nathalia dr. OB00007 Becom - C 6.00 Tablet 2,123.55 13,241.30
R2019-0000074236 21-12-2019 201900071377/055712 NURUL AFIFAH,NY Nathalia dr. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000074236 21-12-2019 201900071377/055712 NURUL AFIFAH,NY Nathalia dr. OC00039 Cefixime 100mg (OGB) 5.00 Capsul 4,266.70 21,833.50
R2019-0000074236 21-12-2019 201900071377/055712 NURUL AFIFAH,NY Nathalia dr. OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000074237 21-12-2019 201900071373/049187 ERI,NY Nathalia dr. OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000074237 21-12-2019 201900071373/049187 ERI,NY Nathalia dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074241 21-12-2019 201900071389/110623 DEWI DIANA,NY Nathalia dr. OA00185 Akilen Ear Drop 1.00 Botol 90,139.50 90,639.50
R2019-0000074241 21-12-2019 201900071389/110623 DEWI DIANA,NY Nathalia dr. OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000074241 21-12-2019 201900071389/110623 DEWI DIANA,NY Nathalia dr. OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000074242 21-12-2019 201900071373/049187 ERI,NY Nathalia dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
Total 245,056,519.22
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 181 dari 266
ASAL RAWAT JALAN
R2019-0000074242 21-12-2019 201900071373/049187 ERI,NY Nathalia dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000074242 21-12-2019 201900071373/049187 ERI,NY Nathalia dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074240 21-12-2019 201900071372/107370 ENDAH Niki Juniar ALN00002 Nasal Canule 1.00 Pcs 25,245.00 25,745.00
R2019-0000074240 21-12-2019 201900071372/107370 ENDAH Niki Juniar OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000074240 21-12-2019 201900071372/107370 ENDAH Niki Juniar OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074240 21-12-2019 201900071372/107370 ENDAH Niki Juniar OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074240 21-12-2019 201900071372/107370 ENDAH Niki Juniar OC00060 Cetirizine 10mg (OGB) 1.00 Tablet 623.70 1,123.70
R2019-0000074243 21-12-2019 201900071411/112107 CALLIA MAISARA Nathalia dr. OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000074243 21-12-2019 201900071411/112107 CALLIA MAISARA Nathalia dr. ALI00011 Infus Set Makro 2.00 Pcs 12,087.90 24,675.80
R2019-0000074243 21-12-2019 201900071411/112107 CALLIA MAISARA Nathalia dr. ALI00006 I.V Catheter No. 24 2.00 Pcs 38,900.00 78,300.00
R2019-0000074243 21-12-2019 201900071411/112107 CALLIA MAISARA Nathalia dr. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000074245 21-12-2019 201900071368/035512 TESIYA NAFA Nathalia dr. OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074245 21-12-2019 201900071368/035512 TESIYA NAFA Nathalia dr. OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074245 21-12-2019 201900071368/035512 TESIYA NAFA Nathalia dr. OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000074247 21-12-2019 201900071412/111254 MADINATUL Nathalia dr. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000074247 21-12-2019 201900071412/111254 MADINATUL Nathalia dr. ALI00003 I.V Catheter No. 18 2.00 Pcs 29,744.00 59,988.00
R2019-0000074247 21-12-2019 201900071412/111254 MADINATUL Nathalia dr. ALB00132 Blood Set 1.00 Pcs 33,976.80 34,476.80
R2019-0000074247 21-12-2019 201900071412/111254 MADINATUL Nathalia dr. ALF00007 Folley Catheter No. 14 1.00 Pcs 37,125.00 37,625.00
R2019-0000074247 21-12-2019 201900071412/111254 MADINATUL Nathalia dr. ALU00007 Urine Bag 1.00 Pcs 19,305.00 19,805.00
R2019-0000074247 21-12-2019 201900071412/111254 MADINATUL Nathalia dr. OW00001 Water For Injeksi 25ml 3.00 Botol 9,222.00 28,166.00
R2019-0000074247 21-12-2019 201900071412/111254 MADINATUL Nathalia dr. OC00043 Ceft riaxone 1.0gr Injeksi 2.00 Vial 53,460.00 107,420.00
R2019-0000074247 21-12-2019 201900071412/111254 MADINATUL Nathalia dr. OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 Botol 22,542.30 23,042.30
R2019-0000074250 21-12-2019 201900071367/041681 YAYUK PURWATI,NY Nathalia dr. ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000074250 21-12-2019 201900071367/041681 YAYUK PURWATI,NY Nathalia dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074250 21-12-2019 201900071367/041681 YAYUK PURWATI,NY Nathalia dr. OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000074250 21-12-2019 201900071367/041681 YAYUK PURWATI,NY Nathalia dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074251 19-12-2019 201900071102/089512 MIKHAYLA RIZKYA FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000074251 19-12-2019 201900071102/089512 MIKHAYLA RIZKYA FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000074251 19-12-2019 201900071102/089512 MIKHAYLA RIZKYA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000074251 19-12-2019 201900071102/089512 MIKHAYLA RIZKYA FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000074251 19-12-2019 201900071102/089512 MIKHAYLA RIZKYA FREDRIK, Dr,Sp.A OS00010 Salbutamol 4mg (OGB) 1.00 Tablet 249.48 749.48
R2019-0000074251 19-12-2019 201900071102/089512 MIKHAYLA RIZKYA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000074251 19-12-2019 201900071102/089512 MIKHAYLA RIZKYA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000074251 19-12-2019 201900071102/089512 MIKHAYLA RIZKYA FREDRIK, Dr,Sp.A OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074251 19-12-2019 201900071102/089512 MIKHAYLA RIZKYA FREDRIK, Dr,Sp.A OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074252 19-12-2019 201900071076/112061 SURIANSYAH,TN Herika dr. OA00063 Amlodipin 10mg (OGB) 2.00 Tablet 2,743.00 5,986.00
R2019-0000074252 19-12-2019 201900071076/112061 SURIANSYAH,TN Herika dr. OC00172 Candesartan Cilexetil 2.00 Tablet 10,617.75 21,735.50
R2019-0000074253 21-12-2019 201900071076/112061 SURIANSYAH,TN Herika dr. OC00019 Captopril 25mg (OGB) 1.00 Tablet 267.35 767.35
Total 245,945,421.08
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 182 dari 266
ASAL RAWAT JALAN
R2019-0000074244 19-12-2019 201900071060/094867 ABDUL LATIF N,SDR Herika dr. OG00018 Gitas Injeksi 1ml 1.00 Ampul 38,201.62 38,701.62
R2019-0000074244 19-12-2019 201900071060/094867 ABDUL LATIF N,SDR Herika dr. ALI00004 I.V Catheter No. 20 2.00 Pcs 36,808.20 74,116.40
R2019-0000074263 19-12-2019 201900070988/111718 KARNI,NY Herika dr. OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000074263 19-12-2019 201900070988/111718 KARNI,NY Herika dr. OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000074263 19-12-2019 201900070988/111718 KARNI,NY Herika dr. ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000074265 19-12-2019 201900071098/020466 WAHYUNI,NY Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000074269 21-12-2019 201900071416/112111 LUPITA SANJAYA,NY MAGDA ROSSA, OM00065 Minosep Gargle 1.00 Botol 56,430.00 56,930.00
R2019-0000074275 19-12-2019 201900071066/112060 SUPARTI,NY Herika dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074276 21-12-2019 201900071420/111814 MALINDA HIKMAH,NN ROY , Dr.Sp.OG OF00090 Fucilex Cream, 5gr 1.00 Tube 14,850.00 15,350.00
R2019-0000074278 21-12-2019 201900071392/40588 SOEHARTONO,TN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000074278 21-12-2019 201900071392/40588 SOEHARTONO,TN EDO, Dr.Sp.B OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000074277 21-12-2019 201900071406/098301 KURNIA ROY , Dr.Sp.OG OB00029 Biosanbe Capsul 7.00 Capsul 1,596.37 11,674.59
R2019-0000074279 21-12-2019 201900071422/111756 INDRA DWI EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000074279 21-12-2019 201900071422/111756 INDRA DWI EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000074279 21-12-2019 201900071422/111756 INDRA DWI EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 1.00 Cm 150.00 650.00
R2019-0000074280 21-12-2019 201900071418/106902 SAN ZEFO BET SEAN MAGDA ROSSA, OC00033 Cefadroxil 125mg Syrup, 1.00 Botol 13,283.32 13,783.32
R2019-0000074280 21-12-2019 201900071418/106902 SAN ZEFO BET SEAN MAGDA ROSSA, OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000074281 21-12-2019 201900071414/101682 LIDYA SUHARSIH,NY Nathalia dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074281 21-12-2019 201900071414/101682 LIDYA SUHARSIH,NY Nathalia dr. OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000074281 21-12-2019 201900071414/101682 LIDYA SUHARSIH,NY Nathalia dr. OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000074281 21-12-2019 201900071414/101682 LIDYA SUHARSIH,NY Nathalia dr. OM00035 Metformin 500mg (OGB) 6.00 Tablet 371.25 2,727.50
R2019-0000074282 21-12-2019 201900071427/112113 LULU SALSABILA MAGDA ROSSA, OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000074283 20-12-2019 201900071270/098766 SABARIAH,HJ Windy Krisanti OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000074283 20-12-2019 201900071270/098766 SABARIAH,HJ Windy Krisanti OT00156 Telmisartan 40 mg 23.00 Tablet 6,534.00 150,782.00
R2019-0000074287 20-12-2019 201900071270/098766 SABARIAH,HJ Windy Krisanti OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000074287 20-12-2019 201900071270/098766 SABARIAH,HJ Windy Krisanti OT00156 Telmisartan 40 mg 7.00 Tablet 6,534.00 46,238.00
R2019-0000074287 20-12-2019 201900071270/098766 SABARIAH,HJ Windy Krisanti OB00016 Betahistine Mesilat 6mg 10.00 Tablet 1,500.00 15,500.00
R2019-0000074287 20-12-2019 201900071270/098766 SABARIAH,HJ Windy Krisanti OL00021 Lansoprazole (OGB) 6.00 Capsul 2,230.00 13,880.00
R2019-0000074287 20-12-2019 201900071270/098766 SABARIAH,HJ Windy Krisanti OB00050 Braxidin 10.00 Tablet 1,648.35 16,983.50
R2019-0000074286 21-12-2019 201900071431/112114 ARIF SETIYADI,TN MAGDA ROSSA, OF00055 Flamar Tablet, 50mg 10.00 Tablet 2,710.13 27,601.30
R2019-0000074286 21-12-2019 201900071431/112114 ARIF SETIYADI,TN MAGDA ROSSA, OB00087 Betadine Gargle 100ml 1.00 Botol 18,042.75 18,542.75
R2019-0000074248 21-12-2019 201900071467/112112 WAHYU Nathalia dr. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000074248 21-12-2019 201900071467/112112 WAHYU Nathalia dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074248 21-12-2019 201900071467/112112 WAHYU Nathalia dr. ALI00003 I.V Catheter No. 18 2.00 Pcs 29,744.00 59,988.00
R2019-0000074248 21-12-2019 201900071467/112112 WAHYU Nathalia dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074295 21-12-2019 201900071454/112119 EDI SINARMA,TN Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000074295 21-12-2019 201900071454/112119 EDI SINARMA,TN Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
Total 246,955,088.16
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 183 dari 266
ASAL RAWAT JALAN
R2019-0000074295 21-12-2019 201900071454/112119 EDI SINARMA,TN Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074291 21-12-2019 201900071440/106881 FALAH FREDRIK, Dr,Sp.A OT00053 Tiriz Oral Drops 1.00 Botol 10 96,525.00 87,372.50
R2019-0000074291 21-12-2019 201900071440/106881 FALAH FREDRIK, Dr,Sp.A OA00096 Apolar N Cream, 10gr 1.00 Tube 10 53,014.50 48,213.05
R2019-0000074296 21-12-2019 201900071454/112119 EDI SINARMA,TN Dwi Astuti, dr ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000074296 21-12-2019 201900071454/112119 EDI SINARMA,TN Dwi Astuti, dr OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074297 21-12-2019 201900071451/112118 MUHAMMAD RAFI FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 6.00 Capsul 28,957.00 174,242.00
R2019-0000074297 21-12-2019 201900071451/112118 MUHAMMAD RAFI FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 6.00 Tablet 430.65 3,083.90
R2019-0000074297 21-12-2019 201900071451/112118 MUHAMMAD RAFI FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 5.00 Tablet 1,173.15 6,365.75
R2019-0000074297 21-12-2019 201900071451/112118 MUHAMMAD RAFI FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 5.00 Granula 297.00 1,985.00
R2019-0000074297 21-12-2019 201900071451/112118 MUHAMMAD RAFI FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 200.20 23,003.00
R2019-0000074290 21-12-2019 201900071470/101993 DAVIN ABHISEVA,AN FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 4.00 Capsul 28,957.00 116,328.00
R2019-0000074290 21-12-2019 201900071470/101993 DAVIN ABHISEVA,AN FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 3.00 Tablet 430.65 1,791.95
R2019-0000074290 21-12-2019 201900071470/101993 DAVIN ABHISEVA,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000074290 21-12-2019 201900071470/101993 DAVIN ABHISEVA,AN FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 3.00 Tablet 1,232.55 4,197.65
R2019-0000074290 21-12-2019 201900071470/101993 DAVIN ABHISEVA,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000074290 21-12-2019 201900071470/101993 DAVIN ABHISEVA,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 23,118.50
R2019-0000074290 21-12-2019 201900071470/101993 DAVIN ABHISEVA,AN FREDRIK, Dr,Sp.A OA00157 Apecur Syrup 1.00 Botol 51,975.00 52,475.00
R2019-0000074299 21-12-2019 201900071451/112118 MUHAMMAD RAFI FREDRIK, Dr,Sp.A OC00075 Cinolon N Cream 1.00 Tube 29,310.00 29,810.00
R2019-0000074303 21-12-2019 201900071473/100589 MURSALIM,TN Dwi Astuti, dr OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000074303 21-12-2019 201900071473/100589 MURSALIM,TN Dwi Astuti, dr OA00088 Antiza Tablet 5.00 Tablet 1,633.00 8,665.00
R2019-0000074303 21-12-2019 201900071473/100589 MURSALIM,TN Dwi Astuti, dr OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000074303 21-12-2019 201900071473/100589 MURSALIM,TN Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000074304 21-12-2019 201900071471/112120 MUHAMMAD DAFFA Dwi Astuti, dr OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000074304 21-12-2019 201900071471/112120 MUHAMMAD DAFFA Dwi Astuti, dr OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000074304 21-12-2019 201900071471/112120 MUHAMMAD DAFFA Dwi Astuti, dr OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000074306 21-12-2019 201900071454/112119 EDI SINARMA,TN Dwi Astuti, dr OA00068 Amoxsan Capsul, 500mg 10.00 Capsul 4,752.00 48,020.00
R2019-0000074306 21-12-2019 201900071454/112119 EDI SINARMA,TN Dwi Astuti, dr OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000074306 21-12-2019 201900071454/112119 EDI SINARMA,TN Dwi Astuti, dr OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074306 21-12-2019 201900071454/112119 EDI SINARMA,TN Dwi Astuti, dr OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2019-0000074239 21-12-2019 201900071473/100589 MURSALIM,TN Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074239 21-12-2019 201900071473/100589 MURSALIM,TN Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074302 21-12-2019 201900071414/101682 LIDYA SUHARSIH,NY Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000074302 21-12-2019 201900071414/101682 LIDYA SUHARSIH,NY Dwi Astuti, dr OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000074305 21-12-2019 201900071472/112121 ALFATH MAHAREZ FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 2.00 Capsul 4,266.70 9,033.40
R2019-0000074305 21-12-2019 201900071472/112121 ALFATH MAHAREZ FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 2.00 Tablet 208.00 916.00
R2019-0000074305 21-12-2019 201900071472/112121 ALFATH MAHAREZ FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 2.00 Tablet 1,173.15 2,846.30
R2019-0000074305 21-12-2019 201900071472/112121 ALFATH MAHAREZ FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000074305 21-12-2019 201900071472/112121 ALFATH MAHAREZ FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
Total 247,914,782.42
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 184 dari 266
ASAL RAWAT JALAN
R2019-0000074305 21-12-2019 201900071472/112121 ALFATH MAHAREZ FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000074313 21-12-2019 201900071463/083677 MUHAMMAD DAFFA FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000074313 21-12-2019 201900071463/083677 MUHAMMAD DAFFA FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000074313 21-12-2019 201900071463/083677 MUHAMMAD DAFFA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000074313 21-12-2019 201900071463/083677 MUHAMMAD DAFFA FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
R2019-0000074313 21-12-2019 201900071463/083677 MUHAMMAD DAFFA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000074318 21-12-2019 201900071455/112090 MUHAMMAD ASKAR FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 5.00 Capsul 4,266.70 21,833.50
R2019-0000074318 21-12-2019 201900071455/112090 MUHAMMAD ASKAR FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000074318 21-12-2019 201900071455/112090 MUHAMMAD ASKAR FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000074318 21-12-2019 201900071455/112090 MUHAMMAD ASKAR FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
R2019-0000074318 21-12-2019 201900071455/112090 MUHAMMAD ASKAR FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000074318 21-12-2019 201900071455/112090 MUHAMMAD ASKAR FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000074324 19-12-2019 201900071080/064865 DOLY EFRIZA TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000074324 19-12-2019 201900071080/064865 DOLY EFRIZA TEDDY OC00182 Citicolin Tablet 500mg 7.00 Tablet 10,098.00 71,186.00
R2019-0000074326 21-12-2019 201900071458/080236 RAFFASYA FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000074326 21-12-2019 201900071458/080236 RAFFASYA FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000074326 21-12-2019 201900071458/080236 RAFFASYA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000074326 21-12-2019 201900071458/080236 RAFFASYA FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000074326 21-12-2019 201900071458/080236 RAFFASYA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000074326 21-12-2019 201900071458/080236 RAFFASYA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000074327 21-12-2019 201900071457/044330 IQBAL AL FARIZI,AN FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000074327 21-12-2019 201900071457/044330 IQBAL AL FARIZI,AN FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000074327 21-12-2019 201900071457/044330 IQBAL AL FARIZI,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 5.00 Tablet 1,173.15 6,365.75
R2019-0000074327 21-12-2019 201900071457/044330 IQBAL AL FARIZI,AN FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000074327 21-12-2019 201900071457/044330 IQBAL AL FARIZI,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 5.00 Granula 297.00 1,985.00
R2019-0000074327 21-12-2019 201900071457/044330 IQBAL AL FARIZI,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000074329 21-12-2019 201900071476/112123 LA BALI,TN Eko Dian Syafitra OL00080 Loratadin 10mg (OGB) 10.00 Tablet 520.00 5,700.00
R2019-0000074329 21-12-2019 201900071476/112123 LA BALI,TN Eko Dian Syafitra OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000074328 21-12-2019 201900071481/069852 RIFAT NAUFAL FAZLE Eko Dian Syafitra OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000074328 21-12-2019 201900071481/069852 RIFAT NAUFAL FAZLE Eko Dian Syafitra OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000074357 21-12-2019 201900071487/105976 SAYYID ALWI,TN Eko Dian Syafitra OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000074357 21-12-2019 201900071487/105976 SAYYID ALWI,TN Eko Dian Syafitra OS00176 Scopma Plus Tablet 10.00 Tablet 2,090.22 21,402.20
Total 248,296,398.02
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 185 dari 266
ASAL RAWAT JALAN
R2019-0000074364 21-12-2019 201900071488/112126 ARIANTO,SDR Eko Dian Syafitra OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000074364 21-12-2019 201900071488/112126 ARIANTO,SDR Eko Dian Syafitra OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000074364 21-12-2019 201900071488/112126 ARIANTO,SDR Eko Dian Syafitra OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000074364 21-12-2019 201900071488/112126 ARIANTO,SDR Eko Dian Syafitra OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000074364 21-12-2019 201900071488/112126 ARIANTO,SDR Eko Dian Syafitra OV00080 Vitamin B Compleks 6.00 Tablet 241.79 1,950.74
R2019-0000074366 21-12-2019 201900071490/015989 MAHMUD JUMALI,HJ Eko Dian Syafitra OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000074366 21-12-2019 201900071490/015989 MAHMUD JUMALI,HJ Eko Dian Syafitra OL00017 Lameson 4mg 20.00 Tablet 5,049.00 101,480.00
R2019-0000074366 21-12-2019 201900071490/015989 MAHMUD JUMALI,HJ Eko Dian Syafitra OE00065 Erdomex Syrup 1.00 Botol 60,885.00 61,385.00
R2019-0000074367 21-12-2019 201900071492/096667 AZKA NIO PUTRA Eko Dian Syafitra OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000074367 21-12-2019 201900071492/096667 AZKA NIO PUTRA Eko Dian Syafitra OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000074367 21-12-2019 201900071492/096667 AZKA NIO PUTRA Eko Dian Syafitra OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000074367 21-12-2019 201900071492/096667 AZKA NIO PUTRA Eko Dian Syafitra OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000074367 21-12-2019 201900071492/096667 AZKA NIO PUTRA Eko Dian Syafitra ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000074367 21-12-2019 201900071492/096667 AZKA NIO PUTRA Eko Dian Syafitra OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000074367 21-12-2019 201900071492/096667 AZKA NIO PUTRA Eko Dian Syafitra OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000074371 21-12-2019 201900071507/112130 SAHRUL NUR Eko Dian Syafitra OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 Botol 22,542.30 23,042.30
R2019-0000074371 21-12-2019 201900071507/112130 SAHRUL NUR Eko Dian Syafitra ON00039 Neurosanbe Injeksi 1.00 Ampul 8,122.95 8,622.95
R2019-0000074370 21-12-2019 201900071505/112128 RITA MUSLIMAH,NY Eko Dian Syafitra OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000074374 21-12-2019 201900071507/112130 SAHRUL NUR Eko Dian Syafitra ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000074374 21-12-2019 201900071507/112130 SAHRUL NUR Eko Dian Syafitra ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074374 21-12-2019 201900071507/112130 SAHRUL NUR Eko Dian Syafitra OI00134 Imunos Plus Tablet 10.00 Tablet 14,107.50 141,575.00
R2019-0000074374 21-12-2019 201900071507/112130 SAHRUL NUR Eko Dian Syafitra OE00022 Eprinoc Tablet 10.00 Tablet 5,093.55 51,435.50
R2019-0000074373 21-12-2019 201900071504/112127 SYAFRIUDIN,TN Eko Dian Syafitra OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000074373 21-12-2019 201900071504/112127 SYAFRIUDIN,TN Eko Dian Syafitra OS00176 Scopma Plus Tablet 10.00 Tablet 2,090.22 21,402.20
R2019-0000074373 21-12-2019 201900071504/112127 SYAFRIUDIN,TN Eko Dian Syafitra OP00116 Pronalges Supositoria 1.00 Suppo 19,824.75 20,324.75
R2019-0000074376 21-12-2019 201900071502/098040 NORMAH,NY Eko Dian Syafitra OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074376 21-12-2019 201900071502/098040 NORMAH,NY Eko Dian Syafitra OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000074376 21-12-2019 201900071502/098040 NORMAH,NY Eko Dian Syafitra OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000074376 21-12-2019 201900071502/098040 NORMAH,NY Eko Dian Syafitra OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000074377 21-12-2019 201900071477/108015 KHANZA NAZILLA Eko Dian Syafitra ALN00003 Nasal Canule Infant/Anak 1.00 Pcs 19,305.00 19,805.00
R2019-0000074377 21-12-2019 201900071477/108015 KHANZA NAZILLA Eko Dian Syafitra ALM00016 Masker Oxygen Non 1.00 Pcs 100,980.00 101,480.00
R2019-0000074377 21-12-2019 201900071477/108015 KHANZA NAZILLA Eko Dian Syafitra ALI00012 Infus Set Mikro 1.00 Pcs 19,602.00 20,102.00
R2019-0000074377 21-12-2019 201900071477/108015 KHANZA NAZILLA Eko Dian Syafitra ALI00006 I.V Catheter No. 24 2.00 Pcs 38,900.00 78,300.00
R2019-0000074377 21-12-2019 201900071477/108015 KHANZA NAZILLA Eko Dian Syafitra OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074377 21-12-2019 201900071477/108015 KHANZA NAZILLA Eko Dian Syafitra OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000074380 21-12-2019 201900071502/098040 NORMAH,NY Eko Dian Syafitra OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074380 21-12-2019 201900071502/098040 NORMAH,NY Eko Dian Syafitra ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000074380 21-12-2019 201900071502/098040 NORMAH,NY Eko Dian Syafitra ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
Total 249,260,316.81
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 186 dari 266
ASAL RAWAT JALAN
R2019-0000074382 21-12-2019 201900071488/112126 ARIANTO,SDR Eko Dian Syafitra ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000074382 21-12-2019 201900071488/112126 ARIANTO,SDR Eko Dian Syafitra OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000074383 21-12-2019 201900071492/096667 AZKA NIO PUTRA Eko Dian Syafitra OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000074384 21-12-2019 201900071476/112123 LA BALI,TN Eko Dian Syafitra OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000074389 16-12-2019 201900070317/083226 BAMBANG Dameria Sri OK00002 Kalium Diklofenac 50mg 7.00 Tablet 1,100.00 8,200.00
R2019-0000074389 16-12-2019 201900070317/083226 BAMBANG Dameria Sri OG00057 Gabapentin 300mg (OGB) 5.00 Tablet 8,168.00 41,340.00
R2019-0000074389 16-12-2019 201900070317/083226 BAMBANG Dameria Sri OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000074389 16-12-2019 201900070317/083226 BAMBANG Dameria Sri OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000074404 22-12-2019 201900071520/087557 PONIRAH,NY Nathalia dr. OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000074404 22-12-2019 201900071520/087557 PONIRAH,NY Nathalia dr. OV00080 Vitamin B Compleks 10.00 Tablet 241.79 2,917.90
R2019-0000074404 22-12-2019 201900071520/087557 PONIRAH,NY Nathalia dr. OG00057 Gabapentin 300mg (OGB) 5.00 Tablet 8,168.00 41,340.00
R2019-0000074405 22-12-2019 201900071508/078738 ADIBA KHALILA Eko Dian Syafitra OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000074405 22-12-2019 201900071508/078738 ADIBA KHALILA Eko Dian Syafitra OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000074405 22-12-2019 201900071508/078738 ADIBA KHALILA Eko Dian Syafitra OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000074413 22-12-2019 201900071520/087557 PONIRAH,NY Nathalia dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074413 22-12-2019 201900071520/087557 PONIRAH,NY Nathalia dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074413 22-12-2019 201900071520/087557 PONIRAH,NY Nathalia dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000074412 21-12-2019 201900071518/049187 ERI,NY Nathalia dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074412 21-12-2019 201900071518/049187 ERI,NY Nathalia dr. OC00092 Clopidogrel 75mg (OGB) 6.00 Tablet 14,701.50 88,709.00
R2019-0000074412 21-12-2019 201900071518/049187 ERI,NY Nathalia dr. OA00111 Aspilets Chawable 6.00 Tablet 811.35 5,368.10
R2019-0000074412 21-12-2019 201900071518/049187 ERI,NY Nathalia dr. OI00097 Isosorbide Dinitrate 5mg 2.00 Tablet 311.85 1,123.70
R2019-0000074412 21-12-2019 201900071518/049187 ERI,NY Nathalia dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074412 21-12-2019 201900071518/049187 ERI,NY Nathalia dr. OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000074412 21-12-2019 201900071518/049187 ERI,NY Nathalia dr. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000074412 21-12-2019 201900071518/049187 ERI,NY Nathalia dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074414 21-12-2019 201900071508/078738 ADIBA KHALILA Eko Dian Syafitra OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000074416 21-12-2019 201900071523/112131 SITI AMINAH,NY Eko Dian Syafitra OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000074416 21-12-2019 201900071523/112131 SITI AMINAH,NY Eko Dian Syafitra ALB00132 Blood Set 1.00 Pcs 33,976.80 34,476.80
R2019-0000074416 21-12-2019 201900071523/112131 SITI AMINAH,NY Eko Dian Syafitra ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074425 16-12-2019 201900070361/111973 EVANDERS JULIUS Niki Juniar OD00065 Domperidon Tablet (OGB) 4.00 Tablet 750.00 3,500.00
R2019-0000074425 16-12-2019 201900070361/111973 EVANDERS JULIUS Niki Juniar OO00014 Omeprazole 20mg (OGB) 3.00 Capsul 1,169.98 4,009.94
R2019-0000074425 16-12-2019 201900070361/111973 EVANDERS JULIUS Niki Juniar OP00011 Paracetamol 500mg 4.00 Tablet 387.36 2,049.44
R2019-0000074426 16-12-2019 201900070259/106694 LAHAKIM,TN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000074427 16-12-2019 201900070278/083562 FAISAL REZA,TN TEDDY OC00283 Cendo Oculenta Eye Oint 1.00 Tube 135,877.50 136,377.50
R2019-0000074428 16-12-2019 201900070335/060089 EKA PUTRIANI,NY LUSY E. Dr.Sp.PD OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000074429 16-12-2019 201900070362/111974 B SOENARTI,NY Niki Juniar OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000074429 16-12-2019 201900070362/111974 B SOENARTI,NY Niki Juniar ON00009 Natrium Diklofenac 50mg 4.00 Tablet 955.84 4,323.36
Total 250,091,975.47
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 187 dari 266
ASAL RAWAT JALAN
R2019-0000074429 16-12-2019 201900070362/111974 B SOENARTI,NY Niki Juniar OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000074430 16-12-2019 201900070287/060368 NIKAMAH,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000074430 16-12-2019 201900070287/060368 NIKAMAH,TN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074430 16-12-2019 201900070287/060368 NIKAMAH,TN LUSY E. Dr.Sp.PD OS00176 Scopma Plus Tablet 6.00 Tablet 2,090.22 13,041.32
R2019-0000074431 16-12-2019 201900070348/070466 AHMAD ZAINAL FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000074431 16-12-2019 201900070348/070466 AHMAD ZAINAL FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000074431 16-12-2019 201900070348/070466 AHMAD ZAINAL FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000074431 16-12-2019 201900070348/070466 AHMAD ZAINAL FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000074431 16-12-2019 201900070348/070466 AHMAD ZAINAL FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000074431 16-12-2019 201900070348/070466 AHMAD ZAINAL FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000074432 16-12-2019 201900070226/111951 IKA KARTIKA,NY LUSY E. Dr.Sp.PD OD00065 Domperidon Tablet (OGB) Tablet 750.00 500.00
R2019-0000074433 16-12-2019 201900070375/104828 YANTI,NY Niki Juniar OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000074433 16-12-2019 201900070375/104828 YANTI,NY Niki Juniar OB00007 Becom - C 3.00 Tablet 2,123.55 6,870.65
R2019-0000074433 16-12-2019 201900070375/104828 YANTI,NY Niki Juniar OA00180 Acetylcyst ein 200mg 6.00 Tablet 1,485.00 9,410.00
R2019-0000074433 16-12-2019 201900070375/104828 YANTI,NY Niki Juniar OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000074434 16-12-2019 201900070379/064010 SUPRIHATIN,NY NOVIANA, Dr. Sp OB00007 Becom - C 7.00 Tablet 2,123.55 15,364.85
R2019-0000074435 16-12-2019 201900070355/110263 HANOVA MEISIA,AN FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000074435 16-12-2019 201900070355/110263 HANOVA MEISIA,AN FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000074435 16-12-2019 201900070355/110263 HANOVA MEISIA,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000074435 16-12-2019 201900070355/110263 HANOVA MEISIA,AN FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000074435 16-12-2019 201900070355/110263 HANOVA MEISIA,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000074435 16-12-2019 201900070355/110263 HANOVA MEISIA,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000074435 16-12-2019 201900070355/110263 HANOVA MEISIA,AN FREDRIK, Dr,Sp.A OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2019-0000074437 16-12-2019 201900070381/102244 RATNA NOVITASARI NOVIANA, Dr. Sp OB00007 Becom - C 7.00 Tablet 2,123.55 15,364.85
R2019-0000074436 16-12-2019 201900070378/100589 MURSALIM,TN Niki Juniar OA00074 Analsik 4.00 Tablet 2,264.63 9,558.52
R2019-0000074436 16-12-2019 201900070378/100589 MURSALIM,TN Niki Juniar OM00045 Methyl Prednisolon 4mg 4.00 Tablet 792.99 3,671.96
R2019-0000074436 16-12-2019 201900070378/100589 MURSALIM,TN Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000074436 16-12-2019 201900070378/100589 MURSALIM,TN Niki Juniar OA00180 Acetylcyst ein 200mg 4.00 Tablet 1,485.00 6,440.00
R2019-0000074438 16-12-2019 201900070405/111682 FARIDA,NY NOVIANA, Dr. Sp OB00007 Becom - C 6.00 Tablet 2,123.55 13,241.30
R2019-0000074440 16-12-2019 201900070406/020828 SUCI WINARTI,NY NOVIANA, Dr. Sp OE00008 Elkana Tablet 7.00 Tablet 1,247.40 9,231.80
R2019-0000074440 16-12-2019 201900070406/020828 SUCI WINARTI,NY NOVIANA, Dr. Sp OB00029 Biosanbe Capsul 7.00 Capsul 1,596.37 11,674.59
Total 250,475,596.87
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 188 dari 266
ASAL RAWAT JALAN
R2019-0000074441 16-12-2019 201900070312/19616 HENNY,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000074442 16-12-2019 201900070277/111961 TIMANG,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 5.00 Tablet 2,079.00 10,895.00
R2019-0000074443 16-12-2019 201900070241/109676 ALI AFIFI,TN Dameria Sri OC00171 Candesartan Cilexetil 6.00 Tablet 7,425.00 45,050.00
R2019-0000074444 16-12-2019 201900070316/076831 DAMARIS KENDEK,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000074444 16-12-2019 201900070316/076831 DAMARIS KENDEK,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000074445 16-12-2019 201900070308/105699 ELIA AGUSTINUS LUSY E. Dr.Sp.PD OG00057 Gabapentin 300mg (OGB) 7.00 Tablet 8,168.00 57,676.00
R2019-0000074446 16-12-2019 201900070325/067167 AQILLA QOIRINA TEDDY OC00255 Cendo Tobroson Eye Drop 1.00 Botol 68,681.25 69,181.25
R2019-0000074446 16-12-2019 201900070325/067167 AQILLA QOIRINA TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000074446 16-12-2019 201900070325/067167 AQILLA QOIRINA TEDDY OM00045 Methyl Prednisolon 4mg 20.00 Tablet 792.99 16,359.80
R2019-0000074447 16-12-2019 201900070331/065606 KAMARUDDIN,TN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 10.00 Tablet 1,555.00 16,050.00
R2019-0000074447 16-12-2019 201900070331/065606 KAMARUDDIN,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 10.00 Tablet 10,617.75 106,677.50
R2019-0000074447 16-12-2019 201900070331/065606 KAMARUDDIN,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000074447 16-12-2019 201900070331/065606 KAMARUDDIN,TN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074447 16-12-2019 201900070331/065606 KAMARUDDIN,TN LUSY E. Dr.Sp.PD OB00016 Betahistine Mesilat 6mg 10.00 Tablet 1,500.00 15,500.00
R2019-0000074448 16-12-2019 201900070329/075815 JUMAIN,TN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074449 16-12-2019 201900070378/100589 MURSALIM,TN Niki Juniar OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074449 16-12-2019 201900070378/100589 MURSALIM,TN Niki Juniar OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074450 16-12-2019 201900070383/034197 MUHAMMAD JAFAR,TN Niki Juniar OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074450 16-12-2019 201900070383/034197 MUHAMMAD JAFAR,TN Niki Juniar OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074453 16-12-2019 201900070383/034197 MUHAMMAD JAFAR,TN Niki Juniar OM00045 Methyl Prednisolon 4mg 6.00 Tablet 792.99 5,257.94
R2019-0000074453 16-12-2019 201900070383/034197 MUHAMMAD JAFAR,TN Niki Juniar OC00060 Cetirizine 10mg (OGB) 4.00 Tablet 623.70 2,994.80
R2019-0000074453 16-12-2019 201900070383/034197 MUHAMMAD JAFAR,TN Niki Juniar OA00180 Acetylcyst ein 200mg 4.00 Tablet 1,485.00 6,440.00
R2019-0000074453 16-12-2019 201900070383/034197 MUHAMMAD JAFAR,TN Niki Juniar OE00057 Eperisone Hcl 50mg 6.00 Tablet 2,286.90 14,221.40
R2019-0000074417 22-12-2019 201900071528/099707 EMAN SULAEMAN,TN ADE RAHMAH ALN00006 NGT (Feeding Tube) No. 1.00 Pcs 19,575.00 20,075.00
R2019-0000074456 18-12-2019 201900070771/015016 ANTONIUS Herika dr. OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000074459 18-12-2019 201900070778/070651 SALMIAH,NY Herika dr. OD00058 Dipenhydramine Injeksi 2.00 Ampul 2,517.23 5,534.46
R2019-0000074459 18-12-2019 201900070778/070651 SALMIAH,NY Herika dr. OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000074459 18-12-2019 201900070778/070651 SALMIAH,NY Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000074459 18-12-2019 201900070778/070651 SALMIAH,NY Herika dr. ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000074461 18-12-2019 201900070844/073794 SALBIAH,NY Herika dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000074462 18-12-2019 201900070856/092572 SUKATI,NY Herika dr. OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000074462 18-12-2019 201900070856/092572 SUKATI,NY Herika dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074462 18-12-2019 201900070856/092572 SUKATI,NY Herika dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074454 22-12-2019 201900071528/099707 EMAN SULAEMAN,TN ADE RAHMAH ALF00008 Folley Catheter No. 16 1.00 Pcs 29,700.00 30,200.00
R2019-0000074454 22-12-2019 201900071528/099707 EMAN SULAEMAN,TN ADE RAHMAH ALU00007 Urine Bag 1.00 Pcs 19,305.00 19,805.00
R2019-0000074463 18-12-2019 201900070852/112041 FATIMAH AK,NY Herika dr. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
Total 251,664,897.56
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 189 dari 266
ASAL RAWAT JALAN
R2019-0000074463 18-12-2019 201900070852/112041 FATIMAH AK,NY Herika dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074463 18-12-2019 201900070852/112041 FATIMAH AK,NY Herika dr. ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000074463 18-12-2019 201900070852/112041 FATIMAH AK,NY Herika dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074463 18-12-2019 201900070852/112041 FATIMAH AK,NY Herika dr. OC00078 Citicoline Injeksi 2.00 Ampul 33,412.50 67,325.00
R2019-0000074463 18-12-2019 201900070852/112041 FATIMAH AK,NY Herika dr. OC00019 Captopril 25mg (OGB) 1.00 Tablet 267.35 767.35
R2019-0000074463 18-12-2019 201900070852/112041 FATIMAH AK,NY Herika dr. ALF00008 Folley Catheter No. 16 1.00 Pcs 29,700.00 30,200.00
R2019-0000074463 18-12-2019 201900070852/112041 FATIMAH AK,NY Herika dr. ALU00007 Urine Bag 1.00 Pcs 19,305.00 19,805.00
R2019-0000074463 18-12-2019 201900070852/112041 FATIMAH AK,NY Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000074464 18-12-2019 201900070671/110860 RATNA ADE RAHMAH OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000074464 18-12-2019 201900070671/110860 RATNA ADE RAHMAH ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000074464 18-12-2019 201900070671/110860 RATNA ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074464 18-12-2019 201900070671/110860 RATNA ADE RAHMAH OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000074464 18-12-2019 201900070671/110860 RATNA ADE RAHMAH OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000074467 22-12-2019 201900071527/112135 SITI NURZANA,NY ADE RAHMAH OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000074466 22-12-2019 201900071526/112134 SYAHRUDDIN,TN ADE RAHMAH OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000074466 22-12-2019 201900071526/112134 SYAHRUDDIN,TN ADE RAHMAH OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000074466 22-12-2019 201900071526/112134 SYAHRUDDIN,TN ADE RAHMAH OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000074466 22-12-2019 201900071526/112134 SYAHRUDDIN,TN ADE RAHMAH OI00134 Imunos Plus Tablet 10.00 Tablet 14,107.50 141,575.00
R2019-0000074468 18-12-2019 201900070844/073794 SALBIAH,NY Herika dr. OU00022 Urotractin 400mg Tablet 4.00 Tablet 7,189.03 29,256.12
R2019-0000074468 18-12-2019 201900070844/073794 SALBIAH,NY Herika dr. OC00076 Ciprofloxacin 500mg 6.00 Tablet 1,039.50 6,737.00
R2019-0000074468 18-12-2019 201900070844/073794 SALBIAH,NY Herika dr. OI00001 Ibuprofen 400mg (OGB) 6.00 Tablet 682.00 4,592.00
R2019-0000074469 18-12-2019 201900070842/111951 IKA KARTIKA,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000074469 18-12-2019 201900070842/111951 IKA KARTIKA,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074469 18-12-2019 201900070842/111951 IKA KARTIKA,NY LUSY E. Dr.Sp.PD OD00065 Domperidon Tablet (OGB) 10.00 Tablet 750.00 8,000.00
R2019-0000074471 18-12-2019 201900070813/015924 ROSHANNA,NY LUSY E. Dr.Sp.PD OG00021 Glimepiride 1mg Tablet 1.00 Tablet 1,245.00 1,745.00
R2019-0000074471 18-12-2019 201900070813/015924 ROSHANNA,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 20.00 Tablet 371.25 7,925.00
R2019-0000074471 18-12-2019 201900070813/015924 ROSHANNA,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 10.00 Tablet 1,555.00 16,050.00
R2019-0000074471 18-12-2019 201900070813/015924 ROSHANNA,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 10.00 Tablet 1,662.00 17,120.00
R2019-0000074470 18-12-2019 201900070799/111778 KHOIRIL QOMARI,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 14.00 Capsul 1,169.98 16,879.72
R2019-0000074470 18-12-2019 201900070799/111778 KHOIRIL QOMARI,TN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074472 18-12-2019 201900070880/108090 EDY SUPONO,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000074475 18-12-2019 201900070728/082058 SUTIRWI,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000074477 18-12-2019 201900070790/103071 ROSITA R,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000074478 18-12-2019 201900070750/061151 SUMARLIANSYAH,TN TEDDY OC00263 Cendo Vasacon-A ED 1.00 Botol 33,226.87 33,726.87
R2019-0000074478 18-12-2019 201900070750/061151 SUMARLIANSYAH,TN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
Total 252,838,603.52
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 190 dari 266
ASAL RAWAT JALAN
R2019-0000074480 18-12-2019 201900070805/110665 SALEH,TN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000074480 18-12-2019 201900070805/110665 SALEH,TN TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000074482 18-12-2019 201900070800/080507 NASSER DJAMAL,TN TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000074482 18-12-2019 201900070800/080507 NASSER DJAMAL,TN TEDDY OT00150 Tim Opthal 0.5% ED 1.00 Botol 70,834.50 71,334.50
R2019-0000074484 18-12-2019 201900070803/065394 ISTIHIAL,NY TEDDY OC00169 Cendo Lyteers 15ml ED 1.00 Botol 36,140.00 36,640.00
R2019-0000074484 18-12-2019 201900070803/065394 ISTIHIAL,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000074485 18-12-2019 201900070781/112028 NOOR KADARIAH,NY TEDDY OC00264 Cendo Timol 0.5% ED 1.00 Botol 70,908.75 71,408.75
R2019-0000074485 18-12-2019 201900070781/112028 NOOR KADARIAH,NY TEDDY OR00029 Retivit Tablet 5.00 Tablet 5,672.70 28,863.50
R2019-0000074487 18-12-2019 201900070848/111991 MELLY YUNIDA,NY Maulin Nikmah OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000074488 18-12-2019 201900070809/069633 JUBAIDIN,TN LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000074488 18-12-2019 201900070809/069633 JUBAIDIN,TN LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000074488 18-12-2019 201900070809/069633 JUBAIDIN,TN LUSY E. Dr.Sp.PD OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
R2019-0000074488 18-12-2019 201900070809/069633 JUBAIDIN,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000074486 18-12-2019 201900070858/111058 RESNANDA RADIAN,NY NOVIANA, Dr. Sp OC00039 Cefixime 100mg (OGB) 20.00 Capsul 4,266.70 85,834.00
R2019-0000074489 18-12-2019 201900070867/54952 AGUSTINA PARESA,NY NOVIANA, Dr. Sp OB00007 Becom - C 10.00 Tablet 2,123.55 21,735.50
R2019-0000074490 22-12-2019 201900071535/112138 ENI SULISTIANI,NY ADE RAHMAH OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000074499 22-12-2019 201900071534/071504 FICE TANGKE ADE RAHMAH OC00144 Cefila Capsul, 100mg 10.00 Capsul 28,957.00 290,070.00
R2019-0000074499 22-12-2019 201900071534/071504 FICE TANGKE ADE RAHMAH OS00029 Sanmol Tablet, 500mg 20.00 Tablet 430.65 9,113.00
R2019-0000074499 22-12-2019 201900071534/071504 FICE TANGKE ADE RAHMAH OB00007 Becom - C 10.00 Tablet 2,123.55 21,735.50
R2019-0000074500 22-12-2019 201900071537/112139 ASLAM,TN ADE RAHMAH OC00153 Cendo Gentamicin 0.3% 1.00 Tube 54,016.87 54,516.87
R2019-0000074501 22-12-2019 201900071536/064691 SERGIO SAMUEL ADE RAHMAH OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000074501 22-12-2019 201900071536/064691 SERGIO SAMUEL ADE RAHMAH OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000074501 22-12-2019 201900071536/064691 SERGIO SAMUEL ADE RAHMAH OD00065 Domperidon Tablet (OGB) 3.00 Tablet 750.00 2,750.00
R2019-0000074502 22-12-2019 201900071535/112138 ENI SULISTIANI,NY ADE RAHMAH OL00041 Lasgan Capsul 5.00 Capsul 21,000.00 105,500.00
R2019-0000074502 22-12-2019 201900071535/112138 ENI SULISTIANI,NY ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074502 22-12-2019 201900071535/112138 ENI SULISTIANI,NY ADE RAHMAH OA00085 Antasida Tablet (OGB) 10.00 Tablet 284.30 3,343.00
R2019-0000074504 22-12-2019 201900071538/112140 KHALISA ADE RAHMAH OS00030 Sanmol Drop, 15ml 1.00 Botol 23,314.00 23,814.00
R2019-0000074505 22-12-2019 201900071540/098329 MARCELL BERNAD ADE RAHMAH OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000074505 22-12-2019 201900071540/098329 MARCELL BERNAD ADE RAHMAH OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000074491 22-12-2019 201900071539/100632 MUHAMMAD SOHIBUR ADE RAHMAH OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000074491 22-12-2019 201900071539/100632 MUHAMMAD SOHIBUR ADE RAHMAH OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000074491 22-12-2019 201900071539/100632 MUHAMMAD SOHIBUR ADE RAHMAH OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000074508 22-12-2019 201900071541/112141 MUARI,TN ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074508 22-12-2019 201900071541/112141 MUARI,TN ADE RAHMAH OP00136 Pulmicort Respules 2.00 Ampul 33,802.98 68,105.96
R2019-0000074508 22-12-2019 201900071541/112141 MUARI,TN ADE RAHMAH OM00043 Methyl Prednisolon 125mg 1.00 Vial 69,795.00 70,295.00
R2019-0000074507 22-12-2019 201900071542/065436 MUHAMMAD ZAID ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
Total 254,450,080.65
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 191 dari 266
ASAL RAWAT JALAN
R2019-0000074511 22-12-2019 201900071544/091630 TALITHA LEVINA Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000074511 22-12-2019 201900071544/091630 TALITHA LEVINA Dwi Astuti, dr OR00003 Ranitidin 150mg (OGB) 5.00 Tablet 891.00 4,955.00
R2019-0000074511 22-12-2019 201900071544/091630 TALITHA LEVINA Dwi Astuti, dr OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000074511 22-12-2019 201900071544/091630 TALITHA LEVINA Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000074509 22-12-2019 201900071548/078406 SITI KHODIROTUL Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000074509 22-12-2019 201900071548/078406 SITI KHODIROTUL Dwi Astuti, dr OL00017 Lameson 4mg 5.00 Tablet 5,049.00 25,745.00
R2019-0000074509 22-12-2019 201900071548/078406 SITI KHODIROTUL Dwi Astuti, dr OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000074512 22-12-2019 201900071561/52619 ELGHA MARINDA Dwi Astuti, dr OS00016 Sanadryl Expectoran 1.00 Botol 14,701.50 15,201.50
R2019-0000074512 22-12-2019 201900071561/52619 ELGHA MARINDA Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000074512 22-12-2019 201900071561/52619 ELGHA MARINDA Dwi Astuti, dr OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000074523 22-12-2019 201900071557/089767 DRA LINAWATI,NY Dwi Astuti, dr OA00063 Amlodipin 10mg (OGB) 5.00 Tablet 2,743.00 14,215.00
R2019-0000074523 22-12-2019 201900071557/089767 DRA LINAWATI,NY Dwi Astuti, dr OC00172 Candesartan Cilexetil 5.00 Tablet 10,617.75 53,588.75
R2019-0000074523 22-12-2019 201900071557/089767 DRA LINAWATI,NY Dwi Astuti, dr OM00017 Meloxicam 15mg (OGB) 5.00 Tablet 2,079.00 10,895.00
R2019-0000074527 22-12-2019 201900071556/112144 MUHAMMAD Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000074527 22-12-2019 201900071556/112144 MUHAMMAD Dwi Astuti, dr OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2019-0000074527 22-12-2019 201900071556/112144 MUHAMMAD Dwi Astuti, dr OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000074528 22-12-2019 201900071558/083238 ISMAIL,TN Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 5.00 Tablet 415.80 2,579.00
R2019-0000074528 22-12-2019 201900071558/083238 ISMAIL,TN Dwi Astuti, dr OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000074532 22-12-2019 201900071565/106791 VINA PERMATA Dwi Astuti, dr OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000074532 22-12-2019 201900071565/106791 VINA PERMATA Dwi Astuti, dr OT00129 Trovensis 4mg Tablet 5.00 Tablet 18,146.70 91,233.50
R2019-0000074532 22-12-2019 201900071565/106791 VINA PERMATA Dwi Astuti, dr OP00138 Pumpitor Capsul 5.00 Capsul 20,092.05 100,960.25
R2019-0000074533 22-12-2019 201900071562/069787 MUHAMMAD AZKA Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000074533 22-12-2019 201900071562/069787 MUHAMMAD AZKA Dwi Astuti, dr OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000074533 22-12-2019 201900071562/069787 MUHAMMAD AZKA Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000074533 22-12-2019 201900071562/069787 MUHAMMAD AZKA Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000074533 22-12-2019 201900071562/069787 MUHAMMAD AZKA Dwi Astuti, dr OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000074533 22-12-2019 201900071562/069787 MUHAMMAD AZKA Dwi Astuti, dr OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000074533 22-12-2019 201900071562/069787 MUHAMMAD AZKA Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000074533 22-12-2019 201900071562/069787 MUHAMMAD AZKA Dwi Astuti, dr OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000074536 22-12-2019 201900071563/069373 EKO HADI Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000074536 22-12-2019 201900071563/069373 EKO HADI Dwi Astuti, dr OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000074536 22-12-2019 201900071563/069373 EKO HADI Dwi Astuti, dr OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000074536 22-12-2019 201900071563/069373 EKO HADI Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000074537 22-12-2019 201900071549/064761 SHAHIDI RACHMAN,TN Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000074537 22-12-2019 201900071549/064761 SHAHIDI RACHMAN,TN Dwi Astuti, dr OB00050 Braxidin 5.00 Tablet 1,648.35 8,741.75
R2019-0000074537 22-12-2019 201900071549/064761 SHAHIDI RACHMAN,TN Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000074538 22-12-2019 201900071546/103661 RENDRA ETHAN Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 2.00 Capsul 4,266.70 9,033.40
R2019-0000074538 22-12-2019 201900071546/103661 RENDRA ETHAN Dwi Astuti, dr OD00031 Dexamethasone Tablet 2.00 Tablet 208.00 916.00
Total 255,079,312.12
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 192 dari 266
ASAL RAWAT JALAN
R2019-0000074538 22-12-2019 201900071546/103661 RENDRA ETHAN Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 2.00 Tablet 623.70 1,747.40
R2019-0000074538 22-12-2019 201900071546/103661 RENDRA ETHAN Dwi Astuti, dr OV00080 Vitamin B Compleks 2.00 Tablet 241.79 983.58
R2019-0000074538 22-12-2019 201900071546/103661 RENDRA ETHAN Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000074538 22-12-2019 201900071546/103661 RENDRA ETHAN Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000074538 22-12-2019 201900071546/103661 RENDRA ETHAN Dwi Astuti, dr OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000074539 22-12-2019 201900071567/112146 M ATHA,AN Dwi Astuti, dr OB00058 Bufect Suspensi, 60ml 1.00 Botol 21,681.00 22,181.00
R2019-0000074540 22-12-2019 201900071542/065436 MUHAMMAD ZAID Dwi Astuti, dr OS00009 Salbutamol 2mg (OGB) 3.00 Tablet 213.30 1,139.90
R2019-0000074540 22-12-2019 201900071542/065436 MUHAMMAD ZAID Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000074540 22-12-2019 201900071542/065436 MUHAMMAD ZAID Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000074540 22-12-2019 201900071542/065436 MUHAMMAD ZAID Dwi Astuti, dr OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000074540 22-12-2019 201900071542/065436 MUHAMMAD ZAID Dwi Astuti, dr OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000074540 22-12-2019 201900071542/065436 MUHAMMAD ZAID Dwi Astuti, dr OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000074540 22-12-2019 201900071542/065436 MUHAMMAD ZAID Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000074540 22-12-2019 201900071542/065436 MUHAMMAD ZAID Dwi Astuti, dr OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000074541 22-12-2019 201900071541/112141 MUARI,TN ADE RAHMAH OA00180 Acetylcyst ein 200mg 5.00 Tablet 1,485.00 7,925.00
R2019-0000074541 22-12-2019 201900071541/112141 MUARI,TN ADE RAHMAH OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000074541 22-12-2019 201900071541/112141 MUARI,TN ADE RAHMAH OM00045 Methyl Prednisolon 4mg 5.00 Tablet 792.99 4,464.95
R2019-0000074541 22-12-2019 201900071541/112141 MUARI,TN ADE RAHMAH OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000074541 22-12-2019 201900071541/112141 MUARI,TN ADE RAHMAH OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000074542 22-12-2019 201900071569/112147 AQILA ADYA PARNAJA Dwi Astuti, dr OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000074542 22-12-2019 201900071569/112147 AQILA ADYA PARNAJA Dwi Astuti, dr OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000074542 22-12-2019 201900071569/112147 AQILA ADYA PARNAJA Dwi Astuti, dr OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000074550 22-12-2019 201900071577/110793 SAMIAH,NY TEDDY OC00290 Cendo LFX ED 5ml 1.00 Botol 102,836.25 103,336.25
R2019-0000074550 22-12-2019 201900071577/110793 SAMIAH,NY TEDDY OC00274 Cendo Noncort Minidose 1.00 Strip 62,741.00 63,241.00
R2019-0000074549 22-12-2019 201900071557/089767 DRA LINAWATI,NY Dwi Astuti, dr OA00064 Amlodipin 5mg (OGB) 1.00 Tablet 1,555.00 2,055.00
R2019-0000074521 22-12-2019 201900071575/052555 CLARISSA SHANE Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074521 22-12-2019 201900071575/052555 CLARISSA SHANE Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074554 22-12-2019 201900071575/052555 CLARISSA SHANE Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074554 22-12-2019 201900071575/052555 CLARISSA SHANE Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074557 22-12-2019 201900071556/112144 MUHAMMAD Dwi Astuti, dr OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074557 22-12-2019 201900071556/112144 MUHAMMAD Dwi Astuti, dr OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000074557 22-12-2019 201900071556/112144 MUHAMMAD Dwi Astuti, dr ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000074558 22-12-2019 201900071575/052555 CLARISSA SHANE Dwi Astuti, dr OP00101 Proceles Syrup, 60ml 1.00 Botol 51,975.00 52,475.00
R2019-0000074558 22-12-2019 201900071575/052555 CLARISSA SHANE Dwi Astuti, dr ON00004 Naprex Syrup, 60ml 1.00 Botol 59,251.50 59,751.50
R2019-0000074558 22-12-2019 201900071575/052555 CLARISSA SHANE Dwi Astuti, dr OM00099 Mucera Syrup 1.00 Botol 34,155.00 34,655.00
R2019-0000074558 22-12-2019 201900071575/052555 CLARISSA SHANE Dwi Astuti, dr OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000074558 22-12-2019 201900071575/052555 CLARISSA SHANE Dwi Astuti, dr OC00038 Cefila Dry Syrup 1.00 Botol 123,255.00 123,755.00
R2019-0000074575 23-12-2019 201900071583/112148 AZWAR,AN Eko Dian Syafitra ON00047 New Diatabs 15.00 Tablet 767.13 12,006.95
Total 255,910,945.61
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 193 dari 266
ASAL RAWAT JALAN
R2019-0000074575 23-12-2019 201900071583/112148 AZWAR,AN Eko Dian Syafitra OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000074575 23-12-2019 201900071583/112148 AZWAR,AN Eko Dian Syafitra OS00176 Scopma Plus Tablet 10.00 Tablet 2,090.22 21,402.20
R2019-0000074576 23-12-2019 201900071584/112149 ALI ZAIN LAHATI,AN Eko Dian Syafitra OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000074576 23-12-2019 201900071584/112149 ALI ZAIN LAHATI,AN Eko Dian Syafitra OA00070 Amoxsan Dry Syrup 1.00 Botol 33,412.50 33,912.50
R2019-0000074576 23-12-2019 201900071584/112149 ALI ZAIN LAHATI,AN Eko Dian Syafitra OA00153 Alco Plus DMP Syrup 1.00 Botol 62,370.00 62,870.00
R2019-0000074576 23-12-2019 201900071584/112149 ALI ZAIN LAHATI,AN Eko Dian Syafitra OD00077 Dumin Rectal 250mg 1.00 Tube 29,254.50 29,754.50
R2019-0000074577 23-12-2019 201900071586/088530 NADINE ELYSIA Eko Dian Syafitra OA00070 Amoxsan Dry Syrup 1.00 Botol 33,412.50 33,912.50
R2019-0000074577 23-12-2019 201900071586/088530 NADINE ELYSIA Eko Dian Syafitra OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074577 23-12-2019 201900071586/088530 NADINE ELYSIA Eko Dian Syafitra OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074581 23-12-2019 201900071599/043161 ATHAYA TSAQIF Eko Dian Syafitra OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000074581 23-12-2019 201900071599/043161 ATHAYA TSAQIF Eko Dian Syafitra OA00070 Amoxsan Dry Syrup 1.00 Botol 33,412.50 33,912.50
R2019-0000074581 23-12-2019 201900071599/043161 ATHAYA TSAQIF Eko Dian Syafitra OM00045 Methyl Prednisolon 4mg 5.00 Tablet 792.99 4,464.95
R2019-0000074581 23-12-2019 201900071599/043161 ATHAYA TSAQIF Eko Dian Syafitra OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000074581 23-12-2019 201900071599/043161 ATHAYA TSAQIF Eko Dian Syafitra ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 17,079.00
R2019-0000074581 23-12-2019 201900071599/043161 ATHAYA TSAQIF Eko Dian Syafitra OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000074581 23-12-2019 201900071599/043161 ATHAYA TSAQIF Eko Dian Syafitra OE00007 Elkana Syrup 1.00 Botol 34,303.50 34,803.50
R2019-0000074582 23-12-2019 201900071604/112153 ERNI LINDA UNUR,NY Eko Dian Syafitra OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074582 23-12-2019 201900071604/112153 ERNI LINDA UNUR,NY Eko Dian Syafitra OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000074582 23-12-2019 201900071604/112153 ERNI LINDA UNUR,NY Eko Dian Syafitra ALI00003 I.V Catheter No. 18 2.00 Pcs 29,744.00 59,988.00
R2019-0000074582 23-12-2019 201900071604/112153 ERNI LINDA UNUR,NY Eko Dian Syafitra OP00116 Pronalges Supositoria 1.00 Suppo 19,824.75 20,324.75
R2019-0000074583 23-12-2019 201900071582/023554 RATNA,NY Eko Dian Syafitra OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074583 23-12-2019 201900071582/023554 RATNA,NY Eko Dian Syafitra OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074583 23-12-2019 201900071582/023554 RATNA,NY Eko Dian Syafitra OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000074583 23-12-2019 201900071582/023554 RATNA,NY Eko Dian Syafitra OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000074583 23-12-2019 201900071582/023554 RATNA,NY Eko Dian Syafitra OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000074583 23-12-2019 201900071582/023554 RATNA,NY Eko Dian Syafitra ALI00004 I.V Catheter No. 20 2.00 Pcs 36,808.20 74,116.40
R2019-0000074583 23-12-2019 201900071582/023554 RATNA,NY Eko Dian Syafitra OC00019 Captopril 25mg (OGB) 1.00 Tablet 267.35 767.35
R2019-0000074584 23-12-2019 201900071588/112151 SUWARTONO,TN Eko Dian Syafitra OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000074584 23-12-2019 201900071588/112151 SUWARTONO,TN Eko Dian Syafitra OM00046 Methyl Prednisolon 8mg 10.00 Tablet 965.25 10,152.50
R2019-0000074584 23-12-2019 201900071588/112151 SUWARTONO,TN Eko Dian Syafitra OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000074584 23-12-2019 201900071588/112151 SUWARTONO,TN Eko Dian Syafitra OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000074584 23-12-2019 201900071588/112151 SUWARTONO,TN Eko Dian Syafitra OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000074587 23-12-2019 201900071587/106672 ESTER PRATISTA Eko Dian Syafitra OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000074588 23-12-2019 201900071582/023554 RATNA,NY Eko Dian Syafitra OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000074588 23-12-2019 201900071582/023554 RATNA,NY Eko Dian Syafitra OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000074589 23-12-2019 201900071604/112153 ERNI LINDA UNUR,NY Eko Dian Syafitra OS00176 Scopma Plus Tablet 10.00 Tablet 2,090.22 21,402.20
R2019-0000074589 23-12-2019 201900071604/112153 ERNI LINDA UNUR,NY Eko Dian Syafitra OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000074593 23-12-2019 201900071650/054613 RIDUAN,TN ADE RAHMAH OA00180 Acetylcyst ein 200mg 5.00 Tablet 1,485.00 7,925.00
Total 256,819,890.71
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 194 dari 266
ASAL RAWAT JALAN
R2019-0000074593 23-12-2019 201900071650/054613 RIDUAN,TN ADE RAHMAH OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000074593 23-12-2019 201900071650/054613 RIDUAN,TN ADE RAHMAH OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000074593 23-12-2019 201900071650/054613 RIDUAN,TN ADE RAHMAH OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000074597 23-12-2019 201900071664/112159 WENDI URIP IQBAL, dr OB00019 Bevalex Cream 1.00 Tube 15,295.50 15,795.50
R2019-0000074597 23-12-2019 201900071664/112159 WENDI URIP IQBAL, dr OC00057 Cerini 10.00 Tablet 5,093.55 51,435.50
R2019-0000074597 23-12-2019 201900071664/112159 WENDI URIP IQBAL, dr OM00046 Methyl Prednisolon 8mg 10.00 Tablet 965.25 10,152.50
R2019-0000074598 23-12-2019 201900071592/071581 SAMSIAH,NY Dameria Sri OG00057 Gabapentin 300mg (OGB) 10.00 Tablet 8,168.00 82,180.00
R2019-0000074598 23-12-2019 201900071592/071581 SAMSIAH,NY Dameria Sri ALK00037 Kapsul No.1 20.00 pcs 200.00 11,500.00
R2019-0000074598 23-12-2019 201900071592/071581 SAMSIAH,NY Dameria Sri OM00154 Mecobalamin 500mg 20.00 Tablet 1,118.00 22,860.00
R2019-0000074591 23-12-2019 201900071610/40588 SOEHARTONO,TN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000074591 23-12-2019 201900071610/40588 SOEHARTONO,TN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000074591 23-12-2019 201900071610/40588 SOEHARTONO,TN EDO, Dr.Sp.B OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000074601 17-12-2019 201900070518/073817 SARDJONO,TN Dameria Sri OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000074603 23-12-2019 201900071644/111913 AGUS HARTONO,TN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000074603 23-12-2019 201900071644/111913 AGUS HARTONO,TN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000074603 23-12-2019 201900071644/111913 AGUS HARTONO,TN EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
R2019-0000074603 23-12-2019 201900071644/111913 AGUS HARTONO,TN EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000074603 23-12-2019 201900071644/111913 AGUS HARTONO,TN EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000074604 17-12-2019 201900070506/082057 MOHAMMAD LUTFI Dameria Sri OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000074604 17-12-2019 201900070506/082057 MOHAMMAD LUTFI Dameria Sri OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000074604 17-12-2019 201900070506/082057 MOHAMMAD LUTFI Dameria Sri OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000074606 17-12-2019 201900070505/111113 RAJIYEM,NY Alvarez Sp .OT OC00010 Calcium Lactat 500mg 23.00 Tablet 302.37 7,454.51
R2019-0000074600 23-12-2019 201900071676/112160 MASRIE,TN ADE RAHMAH OT00030 Teosal 6.00 Tablet 282.15 2,192.90
R2019-0000074600 23-12-2019 201900071676/112160 MASRIE,TN ADE RAHMAH OA00180 Acetylcyst ein 200mg 10.00 Tablet 1,485.00 15,350.00
R2019-0000074600 23-12-2019 201900071676/112160 MASRIE,TN ADE RAHMAH OT00077 Tremenza Tablet 10.00 Tablet 2,160.68 22,106.80
R2019-0000074600 23-12-2019 201900071676/112160 MASRIE,TN ADE RAHMAH OA00064 Amlodipin 5mg (OGB) 10.00 Tablet 1,555.00 16,050.00
R2019-0000074600 23-12-2019 201900071676/112160 MASRIE,TN ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074600 23-12-2019 201900071676/112160 MASRIE,TN ADE RAHMAH OP00136 Pulmicort Respules 2.00 Ampul 33,802.98 68,105.96
R2019-0000074605 23-12-2019 201900071623/099739 LUSI SIRANTE,NY ROY , Dr.Sp.OG OM00014 Mefinal 500mg 15.00 Tablet 1,982.48 30,237.20
R2019-0000074605 23-12-2019 201900071623/099739 LUSI SIRANTE,NY ROY , Dr.Sp.OG OL00108 Lexatrans 500mg 15.00 Tablet 1,871.00 28,565.00
R2019-0000074608 23-12-2019 201900071642/087861 NOVINDA FRISCA Angie Renatha , OF00150 Fukricin Eye Drop 1.00 Botol 102,762.00 103,262.00
R2019-0000074608 23-12-2019 201900071642/087861 NOVINDA FRISCA Angie Renatha , OK00023 Ketoconazole 200mg 20.00 Tablet 774.24 15,984.80
R2019-0000074608 23-12-2019 201900071642/087861 NOVINDA FRISCA Angie Renatha , ALD00003 Disposable Syringe 1ml 1.00 Pcs 3,500.00 4,000.00
R2019-0000074607 17-12-2019 201900070516/071013 ARDANIAH,NY Dameria Sri OC00092 Clopidogrel 75mg (OGB) 23.00 Tablet 14,701.50 338,634.50
R2019-0000074607 17-12-2019 201900070516/071013 ARDANIAH,NY Dameria Sri OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000074607 17-12-2019 201900070516/071013 ARDANIAH,NY Dameria Sri OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000074607 17-12-2019 201900070516/071013 ARDANIAH,NY Dameria Sri OS00173 Simvastatin 20mg (OGB) 23.00 Tablet 1,782.00 41,486.00
R2019-0000074612 23-12-2019 201900071728/058356 RACHEL AZZA IQBAL, dr OM00099 Mucera Syrup 1.00 Botol 34,155.00 34,655.00
Total 258,630,088.90
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 195 dari 266
ASAL RAWAT JALAN
R2019-0000074612 23-12-2019 201900071728/058356 RACHEL AZZA IQBAL, dr OA00087 Antiza Syrup, 60ml 1.00 Botol 26,730.00 27,230.00
R2019-0000074612 23-12-2019 201900071728/058356 RACHEL AZZA IQBAL, dr OC00038 Cefila Dry Syrup 1.00 Botol 123,255.00 123,755.00
R2019-0000074609 23-12-2019 201900071682/082871 SUKARDJO,TN Angie Renatha , OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000074609 23-12-2019 201900071682/082871 SUKARDJO,TN Angie Renatha , OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000074614 23-12-2019 201900071736/112068 HAICRIL AKBAR,SDR ADE RAHMAH OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000074613 23-12-2019 201900071696/107149 ROHANI Angie Renatha , OF00150 Fukricin Eye Drop 1.00 Botol 102,762.00 103,262.00
R2019-0000074613 23-12-2019 201900071696/107149 ROHANI Angie Renatha , OS00014 Sanadryl DMP Syrup, 60ml 1.00 Botol 17,820.00 18,320.00
R2019-0000074615 23-12-2019 201900071735/095606 NELSYA BERLIANA ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000074615 23-12-2019 201900071735/095606 NELSYA BERLIANA ADE RAHMAH OB001002 Betahistine 1.00 Tab 5,940.00 6,440.00
R2019-0000074617 23-12-2019 201900071701/034630 NURHAYAT I,NY MAGDA ROSSA, OM00052 Metronidazole 500mg 10.00 Tablet 525.39 5,753.90
R2019-0000074617 23-12-2019 201900071701/034630 NURHAYAT I,NY MAGDA ROSSA, OT00149 Toramine 10 Mg Tablet 10.00 Tablet 8,167.50 82,175.00
R2019-0000074616 23-12-2019 201900071617/076929 DJARIAH,NY Dameria Sri OP00011 Paracetamol 500mg 20.00 Tablet 387.36 8,247.20
R2019-0000074618 23-12-2019 201900071709/112030 LASURA,TN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000074618 23-12-2019 201900071709/112030 LASURA,TN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000074618 23-12-2019 201900071709/112030 LASURA,TN EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
R2019-0000074618 23-12-2019 201900071709/112030 LASURA,TN EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000074618 23-12-2019 201900071709/112030 LASURA,TN EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000074619 23-12-2019 201900071720/094036 JURI,TN ADE RAHMAH OA00180 Acetylcyst ein 200mg 5.00 Tablet 1,485.00 7,925.00
R2019-0000074619 23-12-2019 201900071720/094036 JURI,TN ADE RAHMAH OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000074619 23-12-2019 201900071720/094036 JURI,TN ADE RAHMAH OP00184 Neo Protifed Tablet 5.00 Tablet 1,263.73 6,818.65
R2019-0000074619 23-12-2019 201900071720/094036 JURI,TN ADE RAHMAH OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000074619 23-12-2019 201900071720/094036 JURI,TN ADE RAHMAH OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000074619 23-12-2019 201900071720/094036 JURI,TN ADE RAHMAH OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000074620 23-12-2019 201900071614/090417 RABIATUL ULFAH,NY Dameria Sri OG00057 Gabapentin 300mg (OGB) 20.00 Tablet 8,168.00 163,860.00
R2019-0000074620 23-12-2019 201900071614/090417 RABIATUL ULFAH,NY Dameria Sri OB00016 Betahistine Mesilat 6mg 10.00 Tablet 1,500.00 15,500.00
R2019-0000074620 23-12-2019 201900071614/090417 RABIATUL ULFAH,NY Dameria Sri OF00065 Flunarizine 5mg 10.00 Tablet 2,970.00 30,200.00
R2019-0000074620 23-12-2019 201900071614/090417 RABIATUL ULFAH,NY Dameria Sri OM00017 Meloxicam 15mg (OGB) 8.00 Tablet 2,079.00 17,132.00
R2019-0000074621 23-12-2019 201900071613/109676 ALI AFIFI,TN Dameria Sri OT00063 Tramadol 50mg Tablet 6.00 Tablet 1,113.75 7,182.50
R2019-0000074623 23-12-2019 201900071615/041206 WIN AZWIR,TN Dameria Sri OA00100 Aricept Evess 10mg 7.00 Tablet 16,855.00 118,485.00
R2019-0000074624 23-12-2019 201900071615/041206 WIN AZWIR,TN Dameria Sri OA00100 Aricept Evess 10mg 23.00 Tablet 16,855.00 388,165.00
R2019-0000074625 23-12-2019 201900071626/075743 ALVARO GAVRIEL Angie Renatha , OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
R2019-0000074625 23-12-2019 201900071626/075743 ALVARO GAVRIEL Angie Renatha , OD00031 Dexamethasone Tablet 3.00 208.00 1,124.00
R2019-0000074625 23-12-2019 201900071626/075743 ALVARO GAVRIEL Angie Renatha , OP00011 Paracetamol 500mg 3.00 Tablet 387.36 1,662.08
R2019-0000074625 23-12-2019 201900071626/075743 ALVARO GAVRIEL Angie Renatha , OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
Total 260,339,491.63
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 196 dari 266
ASAL RAWAT JALAN
R2019-0000074625 23-12-2019 201900071626/075743 ALVARO GAVRIEL Angie Renatha , ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000074625 23-12-2019 201900071626/075743 ALVARO GAVRIEL Angie Renatha , OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000074626 23-12-2019 201900071607/083226 BAMBANG Dameria Sri OK00002 Kalium Diklofenac 50mg 10.00 Tablet 1,100.00 11,500.00
R2019-0000074626 23-12-2019 201900071607/083226 BAMBANG Dameria Sri OG00057 Gabapentin 300mg (OGB) 7.00 Tablet 8,168.00 57,676.00
R2019-0000074626 23-12-2019 201900071607/083226 BAMBANG Dameria Sri OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000074628 23-12-2019 201900071649/25698 JAM'AN,TN Angie Renatha , OA00013 Avamys Nasal Spray 1.00 Botol 237,451.50 237,951.50
R2019-0000074628 23-12-2019 201900071649/25698 JAM'AN,TN Angie Renatha , OP00184 Neo Protifed Tablet 10.00 Tablet 1,263.73 13,137.30
R2019-0000074629 23-12-2019 201900071703/112162 MAY DIANA TESSA,NN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000074629 23-12-2019 201900071703/112162 MAY DIANA TESSA,NN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000074631 23-12-2019 201900071598/072483 INSIAH,NY Dameria Sri OE00057 Eperisone Hcl 50mg 14.00 Tablet 2,286.90 32,516.60
R2019-0000074631 23-12-2019 201900071598/072483 INSIAH,NY Dameria Sri OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000074631 23-12-2019 201900071598/072483 INSIAH,NY Dameria Sri OA00043 Alprazolam 0,5mg (OGB) 4.00 Tablet 996.50 4,486.00
R2019-0000074630 23-12-2019 201900071693/111043 UTAMI TAMBAH MAGDA ROSSA, OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000074630 23-12-2019 201900071693/111043 UTAMI TAMBAH MAGDA ROSSA, OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000074630 23-12-2019 201900071693/111043 UTAMI TAMBAH MAGDA ROSSA, OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000074630 23-12-2019 201900071693/111043 UTAMI TAMBAH MAGDA ROSSA, OB00087 Betadine Gargle 100ml 1.00 Botol 18,042.75 18,542.75
R2019-0000074632 23-12-2019 201900071652/079563 ANASTASIA ROY , Dr.Sp.OG OB00029 Biosanbe Capsul 5.00 Capsul 1,596.37 8,481.85
R2019-0000074632 23-12-2019 201900071652/079563 ANASTASIA ROY , Dr.Sp.OG OO00074 Ondansetron Tablet, 4mg 5.00 Tablet 4,455.00 22,775.00
R2019-0000074633 23-12-2019 201900071744/079448 FAIQ AHMAD IQBAL OL00001 L - BIO Sachet 5.00 Sachet 10,395.00 52,475.00
R2019-0000074633 23-12-2019 201900071744/079448 FAIQ AHMAD IQBAL OV00057 Ventolin Nebules 2.5mg 3.00 Ampul 15,365.00 46,595.00
R2019-0000074633 23-12-2019 201900071744/079448 FAIQ AHMAD IQBAL OP00136 Pulmicort Respules 3.00 Ampul 33,802.98 101,908.94
R2019-0000074634 23-12-2019 201900071593/087557 PONIRAH,NY Dameria Sri OP00011 Paracetamol 500mg 20.00 Tablet 387.36 8,247.20
R2019-0000074634 23-12-2019 201900071593/087557 PONIRAH,NY Dameria Sri OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000074634 23-12-2019 201900071593/087557 PONIRAH,NY Dameria Sri OC00060 Cetirizine 10mg (OGB) 6.00 Tablet 623.70 4,242.20
R2019-0000074634 23-12-2019 201900071593/087557 PONIRAH,NY Dameria Sri OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074636 23-12-2019 201900071629/111882 MUSPITA SARI,NN ROY , Dr.Sp.OG OF00090 Fucilex Cream, 5gr 1.00 Tube 14,850.00 15,350.00
R2019-0000074635 23-12-2019 201900071622/086513 INDRA PUJIANTI,NY ROY , Dr.Sp.OG OB00029 Biosanbe Capsul 6.00 Capsul 1,596.37 10,078.22
R2019-0000074637 23-12-2019 201900071609/061854 SITI FATIMAH,NY ROY , Dr.Sp.OG OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000074637 23-12-2019 201900071609/061854 SITI FATIMAH,NY ROY , Dr.Sp.OG OB00038 Bledstop Tablet 15.00 Tablet 824.18 12,862.70
R2019-0000074638 23-12-2019 201900071590/097422 BAHARIN Dameria Sri ON00009 Natrium Diklofenac 50mg 14.00 Tablet 955.84 13,881.76
R2019-0000074638 23-12-2019 201900071590/097422 BAHARIN Dameria Sri OE00057 Eperisone Hcl 50mg 20.00 Tablet 2,286.90 46,238.00
R2019-0000074638 23-12-2019 201900071590/097422 BAHARIN Dameria Sri OB00016 Betahistine Mesilat 6mg 10.00 Tablet 1,500.00 15,500.00
R2019-0000074638 23-12-2019 201900071590/097422 BAHARIN Dameria Sri OA00043 Alprazolam 0,5mg (OGB) 4.00 Tablet 996.50 4,486.00
R2019-0000074639 23-12-2019 201900071686/063591 WAFIAH,NY EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
Total 261,641,843.40
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 197 dari 266
ASAL RAWAT JALAN
R2019-0000074639 23-12-2019 201900071686/063591 WAFIAH,NY EDO, Dr.Sp.B OP00051 Pirofel Gel 1.00 Tube 26,284.50 26,784.50
R2019-0000074640 23-12-2019 201900071653/112021 UYUN WAHYUDI,TN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000074640 23-12-2019 201900071653/112021 UYUN WAHYUDI,TN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000074640 23-12-2019 201900071653/112021 UYUN WAHYUDI,TN EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
R2019-0000074640 23-12-2019 201900071653/112021 UYUN WAHYUDI,TN EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000074640 23-12-2019 201900071653/112021 UYUN WAHYUDI,TN EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000074641 23-12-2019 201900071596/092426 INDRA Dameria Sri OP00036 Phenytoin Capsul 21.00 Capsul 816.75 17,651.75
R2019-0000074641 23-12-2019 201900071596/092426 INDRA Dameria Sri OV00085 Vitamin B6 Tablet (OGB) 10.00 Tablet 199.80 2,498.00
R2019-0000074641 23-12-2019 201900071596/092426 INDRA Dameria Sri OA00175 Afolat 400mcg 10.00 Tablet 206.41 2,564.10
R2019-0000074642 23-12-2019 201900071713/090891 FATIMAH,NY MAGDA ROSSA, OT00149 Toramine 10 Mg Tablet 10.00 Tablet 8,167.50 82,175.00
R2019-0000074643 23-12-2019 201900071735/095606 NELSYA BERLIANA ADE RAHMAH OB00016 Betahistine Mesilat 6mg 10.00 Tablet 1,500.00 15,500.00
R2019-0000074643 23-12-2019 201900071735/095606 NELSYA BERLIANA ADE RAHMAH OF00065 Flunarizine 5mg 10.00 Tablet 2,970.00 30,200.00
R2019-0000074643 23-12-2019 201900071735/095606 NELSYA BERLIANA ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074643 23-12-2019 201900071735/095606 NELSYA BERLIANA ADE RAHMAH OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000074644 23-12-2019 201900071621/093151 ASLIANI,NY Dameria Sri OG00057 Gabapentin 300mg (OGB) 8.00 Tablet 8,168.00 65,844.00
R2019-0000074644 23-12-2019 201900071621/093151 ASLIANI,NY Dameria Sri OA00062 Amitriptyline Tablet, 4.00 Tablet 252.45 1,509.80
R2019-0000074644 23-12-2019 201900071621/093151 ASLIANI,NY Dameria Sri OF00007 Farbion Tablet 14.00 Tablet 1,782.00 25,448.00
R2019-0000074644 23-12-2019 201900071621/093151 ASLIANI,NY Dameria Sri ALK00037 Kapsul No.1 14.00 pcs 200.00 10,300.00
R2019-0000074644 23-12-2019 201900071621/093151 ASLIANI,NY Dameria Sri OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000074646 23-12-2019 201900071624/060365 SUDARWATI,NY Dameria Sri OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000074646 23-12-2019 201900071624/060365 SUDARWATI,NY Dameria Sri OS00173 Simvastatin 20mg (OGB) 7.00 Tablet 1,782.00 12,974.00
R2019-0000074646 23-12-2019 201900071624/060365 SUDARWATI,NY Dameria Sri OF00007 Farbion Tablet 10.00 Tablet 1,782.00 18,320.00
R2019-0000074646 23-12-2019 201900071624/060365 SUDARWATI,NY Dameria Sri OA00175 Afolat 400mcg 10.00 Tablet 206.41 2,564.10
R2019-0000074646 23-12-2019 201900071624/060365 SUDARWATI,NY Dameria Sri OC00034 Cefadroxil 500mg (OGB) 14.00 Capsul 1,633.50 23,369.00
R2019-0000074646 23-12-2019 201900071624/060365 SUDARWATI,NY Dameria Sri OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000074646 23-12-2019 201900071624/060365 SUDARWATI,NY Dameria Sri OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000074647 23-12-2019 201900071624/060365 SUDARWATI,NY Dameria Sri OS00173 Simvastatin 20mg (OGB) 23.00 Tablet 1,782.00 41,486.00
R2019-0000074650 23-12-2019 201900071637/094925 SURIANA,NY Dameria Sri OG00057 Gabapentin 300mg (OGB) 7.00 Tablet 8,168.00 57,676.00
R2019-0000074650 23-12-2019 201900071637/094925 SURIANA,NY Dameria Sri OC00017 Kapsul No. 00 14.00 Capsul 200.00 3,300.00
R2019-0000074650 23-12-2019 201900071637/094925 SURIANA,NY Dameria Sri OM00154 Mecobalamin 500mg 20.00 Tablet 1,118.00 22,860.00
R2019-0000074651 23-12-2019 201900071608/090207 WARTINAH,NY Dameria Sri OU00022 Urotractin 400mg Tablet 10.00 Tablet 7,189.03 72,390.30
R2019-0000074651 23-12-2019 201900071608/090207 WARTINAH,NY Dameria Sri OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000074652 23-12-2019 201900071654/080109 SRI WIDJAYANTI,NY Dameria Sri OG00057 Gabapentin 300mg (OGB) 14.00 Tablet 8,168.00 114,852.00
R2019-0000074652 23-12-2019 201900071654/080109 SRI WIDJAYANTI,NY Dameria Sri OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000074655 23-12-2019 201900071602/061992 ORBA LUSY E. Dr.Sp.PD OG00024 Glimepiride 4mg Tablet 7.00 Tablet 3,869.89 27,589.23
R2019-0000074655 23-12-2019 201900071602/061992 ORBA LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000074655 23-12-2019 201900071602/061992 ORBA LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000074655 23-12-2019 201900071602/061992 ORBA LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
Total 262,575,015.11
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 198 dari 266
ASAL RAWAT JALAN
R2019-0000074655 23-12-2019 201900071602/061992 ORBA LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000074656 23-12-2019 201900071656/096649 TARIONO Dameria Sri OV00085 Vitamin B6 Tablet (OGB) 14.00 Tablet 199.80 3,297.20
R2019-0000074656 23-12-2019 201900071656/096649 TARIONO Dameria Sri OA00175 Afolat 400mcg 14.00 Tablet 206.41 3,389.74
R2019-0000074660 23-12-2019 201900071634/112157 MUNAWIR,TN LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 10.00 Tablet 811.18 8,611.80
R2019-0000074660 23-12-2019 201900071634/112157 MUNAWIR,TN LUSY E. Dr.Sp.PD OP00167 Proliver 20.00 Kalpet 7,574.00 151,980.00
R2019-0000074661 23-12-2019 201900071627/28759 JAMILAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000074661 23-12-2019 201900071627/28759 JAMILAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 10.00 Tablet 10,617.75 106,677.50
R2019-0000074661 23-12-2019 201900071627/28759 JAMILAH,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 10.00 Tablet 1,662.00 17,120.00
R2019-0000074661 23-12-2019 201900071627/28759 JAMILAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 5.00 Tablet 5,197.50 26,487.50
R2019-0000074661 23-12-2019 201900071627/28759 JAMILAH,NY LUSY E. Dr.Sp.PD OB00016 Betahistine Mesilat 6mg 10.00 Tablet 1,500.00 15,500.00
R2019-0000074659 23-12-2019 201900071647/111876 NUR PUTRI LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 4.00 Flexpen 226,917.80 908,171.20
R2019-0000074659 23-12-2019 201900071647/111876 NUR PUTRI LUSY E. Dr.Sp.PD OL00056 Levemir Insulin 2.00 Flexpen 287,330.88 575,161.76
R2019-0000074662 23-12-2019 201900071770/071893 FERI SOEGIARTO,TN LUSY E. Dr.Sp.PD OL00056 Levemir Insulin 1.00 Flexpen 10 287,330.88 259,097.79
R2019-0000074663 23-12-2019 201900071660/059016 SUYADI,TN LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 7.00 Tablet 315.26 2,706.82
R2019-0000074663 23-12-2019 201900071660/059016 SUYADI,TN LUSY E. Dr.Sp.PD OI00097 Isosorbide Dinitrate 5mg 21.00 Tablet 311.85 7,048.85
R2019-0000074663 23-12-2019 201900071660/059016 SUYADI,TN LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000074663 23-12-2019 201900071660/059016 SUYADI,TN LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000074657 23-12-2019 201900071660/059016 SUYADI,TN LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 2.00 Flexpen 226,917.80 454,335.60
R2019-0000074657 23-12-2019 201900071660/059016 SUYADI,TN LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 23.00 Tablet 315.26 7,750.98
R2019-0000074657 23-12-2019 201900071660/059016 SUYADI,TN LUSY E. Dr.Sp.PD OI00097 Isosorbide Dinitrate 5mg 69.00 Tablet 311.85 22,017.65
R2019-0000074657 23-12-2019 201900071660/059016 SUYADI,TN LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 23.00 Tablet 14,701.50 338,634.50
R2019-0000074670 23-12-2019 201900071765/015783 MU'MINA,NN IQBAL OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000074670 23-12-2019 201900071765/015783 MU'MINA,NN IQBAL OI00078 Inpepsa Syrup, 100ml 1.00 Botol 115,830.00 116,330.00
R2019-0000074670 23-12-2019 201900071765/015783 MU'MINA,NN IQBAL OL00017 Lameson 4mg 5.00 Tablet 5,049.00 25,745.00
R2019-0000074670 23-12-2019 201900071765/015783 MU'MINA,NN IQBAL OI00134 Imunos Plus Tablet 4.00 Tablet 14,107.50 56,930.00
R2019-0000074671 23-12-2019 201900071752/112166 NUR SANIYAH,NY NOVIANA, Dr. Sp OF00099 Folda Tablet 30.00 Tablet 6,661.65 200,349.50
R2019-0000074671 23-12-2019 201900071752/112166 NUR SANIYAH,NY NOVIANA, Dr. Sp OF00071 Folavit 400mcg 30.00 Tablet 1,329.07 40,372.10
R2019-0000074671 23-12-2019 201900071752/112166 NUR SANIYAH,NY NOVIANA, Dr. Sp OV00107 Vosedon Tablet 30.00 Tablet 3,452.63 104,078.90
R2019-0000074676 23-12-2019 201900071754/094818 ALKHALIFI ZIKRI FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 6.00 Capsul 28,957.00 174,242.00
R2019-0000074676 23-12-2019 201900071754/094818 ALKHALIFI ZIKRI FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 5.00 Tablet 430.65 2,653.25
R2019-0000074676 23-12-2019 201900071754/094818 ALKHALIFI ZIKRI FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 5.00 Tablet 1,173.15 6,365.75
R2019-0000074676 23-12-2019 201900071754/094818 ALKHALIFI ZIKRI FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 5.00 Granula 297.00 1,985.00
R2019-0000074676 23-12-2019 201900071754/094818 ALKHALIFI ZIKRI FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 20.00 Sachet 207.90 19,158.00
R2019-0000074677 23-12-2019 201900071772/104160 KEANU,BY FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 2.00 Capsul 28,957.00 58,414.00
Total 266,598,281.88
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 199 dari 266
ASAL RAWAT JALAN
R2019-0000074677 23-12-2019 201900071772/104160 KEANU,BY FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 2.00 Tablet 430.65 1,361.30
R2019-0000074677 23-12-2019 201900071772/104160 KEANU,BY FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 2.00 Tablet 1,173.15 2,846.30
R2019-0000074677 23-12-2019 201900071772/104160 KEANU,BY FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 2.00 Tablet 1,232.55 2,965.10
R2019-0000074677 23-12-2019 201900071772/104160 KEANU,BY FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000074677 23-12-2019 201900071772/104160 KEANU,BY FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000074677 23-12-2019 201900071772/104160 KEANU,BY FREDRIK, Dr,Sp.A OO00061 Ottopan Drops, 15ml 1.00 Botol 40,837.50 41,337.50
R2019-0000074678 23-12-2019 201900071773/112168 KRISTINE,AN FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 6.00 Capsul 28,957.00 174,242.00
R2019-0000074678 23-12-2019 201900071773/112168 KRISTINE,AN FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000074678 23-12-2019 201900071773/112168 KRISTINE,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 5.00 Tablet 1,173.15 6,365.75
R2019-0000074678 23-12-2019 201900071773/112168 KRISTINE,AN FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 5.00 Tablet 1,232.55 6,662.75
R2019-0000074678 23-12-2019 201900071773/112168 KRISTINE,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 5.00 Granula 297.00 1,985.00
R2019-0000074678 23-12-2019 201900071773/112168 KRISTINE,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000074679 23-12-2019 201900071777/065628 GIBRAN EL CAESAR FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 4.00 Capsul 28,957.00 116,328.00
R2019-0000074679 23-12-2019 201900071777/065628 GIBRAN EL CAESAR FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 4.00 Tablet 430.65 2,222.60
R2019-0000074679 23-12-2019 201900071777/065628 GIBRAN EL CAESAR FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000074679 23-12-2019 201900071777/065628 GIBRAN EL CAESAR FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000074679 23-12-2019 201900071777/065628 GIBRAN EL CAESAR FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000074679 23-12-2019 201900071777/065628 GIBRAN EL CAESAR FREDRIK, Dr,Sp.A OO00062 Ottopan Syrup, 60ml 1.00 Botol 29,700.00 30,200.00
R2019-0000074682 23-12-2019 201900071716/21432 MINEM LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 23.00 Tablet 811.18 19,157.14
R2019-0000074682 23-12-2019 201900071716/21432 MINEM LUSY E. Dr.Sp.PD OA00178 Acarbose 100mg (OGB) 46.00 Tablet 2,839.00 131,094.00
R2019-0000074683 23-12-2019 201900071789/095133 HARI SULISTYONO,TN IQBAL, dr OA00074 Analsik 3.00 Tablet 2,264.63 7,293.89
R2019-0000074683 23-12-2019 201900071789/095133 HARI SULISTYONO,TN IQBAL, dr OL00017 Lameson 4mg 5.00 Tablet 5,049.00 25,745.00
R2019-0000074683 23-12-2019 201900071789/095133 HARI SULISTYONO,TN IQBAL, dr OI00134 Imunos Plus Tablet 4.00 Tablet 14,107.50 56,930.00
R2019-0000074684 23-12-2019 201900071798/095595 ALMIRA ADE RAHMAH OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000074684 23-12-2019 201900071798/095595 ALMIRA ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074684 23-12-2019 201900071798/095595 ALMIRA ADE RAHMAH OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074685 23-12-2019 201900071798/095595 ALMIRA ADE RAHMAH OS00030 Sanmol Drop, 15ml 1.00 Botol 23,314.00 23,814.00
R2019-0000074685 23-12-2019 201900071798/095595 ALMIRA ADE RAHMAH OL00039 Lasal Expect Syrup, 1.00 Botol 55,687.50 56,187.50
R2019-0000074685 23-12-2019 201900071798/095595 ALMIRA ADE RAHMAH OA00094 Apialys Syrup 100ml 1.00 Botol 49,005.00 49,505.00
R2019-0000074687 23-12-2019 201900071738/104219 SURIYANI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000074687 23-12-2019 201900071738/104219 SURIYANI,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000074687 23-12-2019 201900071738/104219 SURIYANI,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000074687 23-12-2019 201900071738/104219 SURIYANI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000074687 23-12-2019 201900071738/104219 SURIYANI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000074687 23-12-2019 201900071738/104219 SURIYANI,NY LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 7.00 Tablet 3,164.00 22,648.00
R2019-0000074687 23-12-2019 201900071738/104219 SURIYANI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000074688 23-12-2019 201900071738/104219 SURIYANI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000074688 23-12-2019 201900071738/104219 SURIYANI,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 23.00 Tablet 240.30 6,026.90
Total 267,800,646.64
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 200 dari 266
ASAL RAWAT JALAN
R2019-0000074688 23-12-2019 201900071738/104219 SURIYANI,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 23.00 Tablet 14,701.50 338,634.50
R2019-0000074688 23-12-2019 201900071738/104219 SURIYANI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000074688 23-12-2019 201900071738/104219 SURIYANI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000074688 23-12-2019 201900071738/104219 SURIYANI,NY LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 23.00 Tablet 3,164.00 73,272.00
R2019-0000074688 23-12-2019 201900071738/104219 SURIYANI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2019-0000074689 23-12-2019 201900071811/057332 RUSMINI, HJ,NY Dwi Astuti, dr OF00055 Flamar Tablet, 50mg 5.00 Tablet 2,710.13 14,050.65
R2019-0000074689 23-12-2019 201900071811/057332 RUSMINI, HJ,NY Dwi Astuti, dr OL00017 Lameson 4mg 5.00 Tablet 5,049.00 25,745.00
R2019-0000074690 23-12-2019 201900071730/091173 LAKIGI,TN LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000074690 23-12-2019 201900071730/091173 LAKIGI,TN LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000074690 23-12-2019 201900071730/091173 LAKIGI,TN LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 7.00 Tablet 2,525.00 18,175.00
R2019-0000074690 23-12-2019 201900071730/091173 LAKIGI,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000074690 23-12-2019 201900071730/091173 LAKIGI,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000074690 23-12-2019 201900071730/091173 LAKIGI,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000074693 23-12-2019 201900071723/100942 WAWAN SUTRISNO,TN LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000074693 23-12-2019 201900071723/100942 WAWAN SUTRISNO,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000074693 23-12-2019 201900071723/100942 WAWAN SUTRISNO,TN LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 7.00 Tablet 315.26 2,706.82
R2019-0000074693 23-12-2019 201900071723/100942 WAWAN SUTRISNO,TN LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 7.00 Tablet 206.41 1,944.87
R2019-0000074693 23-12-2019 201900071723/100942 WAWAN SUTRISNO,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000074693 23-12-2019 201900071723/100942 WAWAN SUTRISNO,TN LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000074694 23-12-2019 201900071723/100942 WAWAN SUTRISNO,TN LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 2.00 Flexpen 226,917.80 454,335.60
R2019-0000074694 23-12-2019 201900071723/100942 WAWAN SUTRISNO,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000074694 23-12-2019 201900071723/100942 WAWAN SUTRISNO,TN LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 23.00 Tablet 315.26 7,750.98
R2019-0000074694 23-12-2019 201900071723/100942 WAWAN SUTRISNO,TN LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 23.00 Tablet 206.41 5,247.43
R2019-0000074694 23-12-2019 201900071723/100942 WAWAN SUTRISNO,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000074694 23-12-2019 201900071723/100942 WAWAN SUTRISNO,TN LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 23.00 Tablet 445.50 10,746.50
R2019-0000074696 23-12-2019 201900071743/065606 KAMARUDDIN,TN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000074696 23-12-2019 201900071743/065606 KAMARUDDIN,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000074696 23-12-2019 201900071743/065606 KAMARUDDIN,TN LUSY E. Dr.Sp.PD OB001002 Betahistine 10.00 Tab 5,940.00 59,900.00
R2019-0000074697 23-12-2019 201900071774/109728 KARTINI,NY Maulin Nikmah OG00057 Gabapentin 300mg (OGB) 4.00 Tablet 8,168.00 33,172.00
R2019-0000074697 23-12-2019 201900071774/109728 KARTINI,NY Maulin Nikmah ALK00037 Kapsul No.1 12.00 pcs 200.00 9,900.00
R2019-0000074698 23-12-2019 201900071724/102270 A SYAHRIL,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000074698 23-12-2019 201900071724/102270 A SYAHRIL,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000074698 23-12-2019 201900071724/102270 A SYAHRIL,TN LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000074699 23-12-2019 201900071724/102270 A SYAHRIL,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000074699 23-12-2019 201900071724/102270 A SYAHRIL,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2019-0000074699 23-12-2019 201900071724/102270 A SYAHRIL,TN LUSY E. Dr.Sp.PD ON00075 Novomix 30 Flexpen 4.00 Flexpen 226,917.80 908,171.20
R2019-0000074700 23-12-2019 201900071715/059102 NURHANA,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000074700 23-12-2019 201900071715/059102 NURHANA,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
Total 271,079,041.24
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 201 dari 266
ASAL RAWAT JALAN
R2019-0000074700 23-12-2019 201900071715/059102 NURHANA,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000074702 23-12-2019 201900071712/110611 LUSI TANDI LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000074701 23-12-2019 201900071700/099155 IKHWAN PRISTIYO LUSY E. Dr.Sp.PD ON00075 Novomix 30 Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000074701 23-12-2019 201900071700/099155 IKHWAN PRISTIYO LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000074701 23-12-2019 201900071700/099155 IKHWAN PRISTIYO LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000074701 23-12-2019 201900071700/099155 IKHWAN PRISTIYO LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 7.00 Tablet 2,525.00 18,175.00
R2019-0000074701 23-12-2019 201900071700/099155 IKHWAN PRISTIYO LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000074701 23-12-2019 201900071700/099155 IKHWAN PRISTIYO LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000074701 23-12-2019 201900071700/099155 IKHWAN PRISTIYO LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000074701 23-12-2019 201900071700/099155 IKHWAN PRISTIYO LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000074703 23-12-2019 201900071716/21432 MINEM LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000074703 23-12-2019 201900071716/21432 MINEM LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 7.00 Tablet 811.18 6,178.26
R2019-0000074703 23-12-2019 201900071716/21432 MINEM LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 7.00 Tablet 3,164.00 22,648.00
R2019-0000074703 23-12-2019 201900071716/21432 MINEM LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000074703 23-12-2019 201900071716/21432 MINEM LUSY E. Dr.Sp.PD OA00178 Acarbose 100mg (OGB) 14.00 Tablet 2,839.00 40,246.00
R2019-0000074703 23-12-2019 201900071716/21432 MINEM LUSY E. Dr.Sp.PD OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000074705 23-12-2019 201900071806/111988 AMRI DYAH, dr Sp. OT00077 Tremenza Tablet 10.00 Tablet 2,160.68 22,106.80
R2019-0000074705 23-12-2019 201900071806/111988 AMRI DYAH, dr Sp. OL00126 Lactrin Tablet 20.00 Tablet 6,311.25 126,725.00
R2019-0000074704 23-12-2019 201900071786/112172 HUSNIA,NY NOVIANA, Dr. Sp OB00029 Biosanbe Capsul 6.00 Capsul 1,596.37 10,078.22
R2019-0000074707 23-12-2019 201900071800/019833 FAISAL RAMADHAN,AN DYAH, dr Sp. OS00160 Seretide Diskus 250 mcg 1.00 Botol 322,681.59 323,181.59
R2019-0000074707 23-12-2019 201900071800/019833 FAISAL RAMADHAN,AN DYAH, dr Sp. OB00094 Berotec MDI 1.00 Botol 130,000.00 130,500.00
R2019-0000074708 23-12-2019 201900071812/051225 YITNO,TN DYAH, dr Sp. OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000074708 23-12-2019 201900071812/051225 YITNO,TN DYAH, dr Sp. OL00126 Lactrin Tablet 10.00 Tablet 6,311.25 63,612.50
R2019-0000074708 23-12-2019 201900071812/051225 YITNO,TN DYAH, dr Sp. OL00017 Lameson 4mg 15.00 Tablet 5,049.00 76,235.00
R2019-0000074709 23-12-2019 201900071780/060089 EKA PUTRIANI,NY DYAH, dr Sp. OS00160 Seretide Diskus 250 mcg 1.00 Botol 322,681.59 323,181.59
R2019-0000074711 23-12-2019 201900071813/092100 SITI AULIA Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 20.00 Tablet 965.25 19,805.00
R2019-0000074711 23-12-2019 201900071813/092100 SITI AULIA Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000074711 23-12-2019 201900071813/092100 SITI AULIA Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000074711 23-12-2019 201900071813/092100 SITI AULIA Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000074711 23-12-2019 201900071813/092100 SITI AULIA Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000074714 23-12-2019 201900071681/080195 ASNI,NY LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000074714 23-12-2019 201900071681/080195 ASNI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000074714 23-12-2019 201900071681/080195 ASNI,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000074714 23-12-2019 201900071681/080195 ASNI,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000074714 23-12-2019 201900071681/080195 ASNI,NY LUSY E. Dr.Sp.PD OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000074712 23-12-2019 201900071803/045944 RONNY A.M.YANIS,TN Ismail dr. Msc. OM00044 Methyl Prednisolon 16mg 20.00 Tablet 2,632.50 53,150.00
R2019-0000074712 23-12-2019 201900071803/045944 RONNY A.M.YANIS,TN Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000074712 23-12-2019 201900071803/045944 RONNY A.M.YANIS,TN Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
Total 273,114,197.15
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 202 dari 266
ASAL RAWAT JALAN
R2019-0000074712 23-12-2019 201900071803/045944 RONNY A.M.YANIS,TN Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000074712 23-12-2019 201900071803/045944 RONNY A.M.YANIS,TN Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000074715 23-12-2019 201900071779/100274 NURWAHIDA,NY DYAH, dr Sp. OA00085 Antasida Tablet (OGB) 10.00 Tablet 284.30 3,343.00
R2019-0000074716 23-12-2019 201900071779/100274 NURWAHIDA,NY DYAH, dr Sp. OS00160 Seretide Diskus 250 mcg 1.00 Botol 322,681.59 323,181.59
R2019-0000074717 23-12-2019 201900071787/112173 RAFISQY ALFAREZI,AN Ismail dr. Msc. OC00173 Cetirizine 10mg/ml Drop, 1.00 Botol 37,125.00 37,625.00
R2019-0000074717 23-12-2019 201900071787/112173 RAFISQY ALFAREZI,AN Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000074717 23-12-2019 201900071787/112173 RAFISQY ALFAREZI,AN Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000074717 23-12-2019 201900071787/112173 RAFISQY ALFAREZI,AN Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000074719 23-12-2019 201900071705/4809 SALIM,TN NONO, Dr.Sp.PD OC00134 Curcuma Tablet 20.00 Tablet 1,336.50 27,230.00
R2019-0000074718 23-12-2019 201900071767/104904 NUR ASSYIFA FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000074718 23-12-2019 201900071767/104904 NUR ASSYIFA FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000074718 23-12-2019 201900071767/104904 NUR ASSYIFA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000074718 23-12-2019 201900071767/104904 NUR ASSYIFA FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000074718 23-12-2019 201900071767/104904 NUR ASSYIFA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000074718 23-12-2019 201900071767/104904 NUR ASSYIFA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 3,618.50
R2019-0000074720 23-12-2019 201900071711/056283 SATUKAR,TN Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 15.00 Tablet 965.25 14,978.75
R2019-0000074720 23-12-2019 201900071711/056283 SATUKAR,TN Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 15.00 Tablet 623.70 9,855.50
R2019-0000074720 23-12-2019 201900071711/056283 SATUKAR,TN Ismail dr. Msc. GK003 Ketoconazole Cream 10 1.00 Tube 8,019.00 8,519.00
R2019-0000074720 23-12-2019 201900071711/056283 SATUKAR,TN Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 7,276.50 7,776.50
R2019-0000074720 23-12-2019 201900071711/056283 SATUKAR,TN Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000074721 23-12-2019 201900071794/053252 SINTOYO,TN Maulin Nikmah OG00057 Gabapentin 300mg (OGB) 6.00 Tablet 8,168.00 49,508.00
R2019-0000074722 23-12-2019 201900071792/104159 FINZA FIKRI,TN DYAH, dr Sp. OP00180 Pro TB 4 Tablet 6.00 Tablet 7,326.45 44,458.70
R2019-0000074723 23-12-2019 201900071783/112171 EVAN ABRAHAM Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 15.00 Tablet 965.25 14,978.75
R2019-0000074723 23-12-2019 201900071783/112171 EVAN ABRAHAM Ismail dr. Msc. OE00056 Ecosol Nacl 0,9 % 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000074723 23-12-2019 201900071783/112171 EVAN ABRAHAM Ismail dr. Msc. ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000074723 23-12-2019 201900071783/112171 EVAN ABRAHAM Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000074723 23-12-2019 201900071783/112171 EVAN ABRAHAM Ismail dr. Msc. OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000074706 23-12-2019 201900071833/112175 D. KASID,TN Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000074706 23-12-2019 201900071833/112175 D. KASID,TN Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000074706 23-12-2019 201900071833/112175 D. KASID,TN Dwi Astuti, dr OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000074706 23-12-2019 201900071833/112175 D. KASID,TN Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000074706 23-12-2019 201900071833/112175 D. KASID,TN Dwi Astuti, dr OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000074727 23-12-2019 201900071842/047484 GUSTI ANDRI Dwi Astuti, dr OE00022 Eprinoc Tablet 4.00 Tablet 5,093.55 20,874.20
R2019-0000074727 23-12-2019 201900071842/047484 GUSTI ANDRI Dwi Astuti, dr OB00050 Braxidin 5.00 Tablet 1,648.35 8,741.75
R2019-0000074727 23-12-2019 201900071842/047484 GUSTI ANDRI Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000074728 23-12-2019 201900071841/079256 TITO FAIZAL,TN Dwi Astuti, dr OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000074728 23-12-2019 201900071841/079256 TITO FAIZAL,TN Dwi Astuti, dr OS00009 Salbutamol 2mg (OGB) 6.00 Tablet 213.30 1,779.80
R2019-0000074728 23-12-2019 201900071841/079256 TITO FAIZAL,TN Dwi Astuti, dr OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
Total 273,985,760.54
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 203 dari 266
ASAL RAWAT JALAN
R2019-0000074728 23-12-2019 201900071841/079256 TITO FAIZAL,TN Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000074730 23-12-2019 201900071725/080683 REWUK SRI LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000074730 23-12-2019 201900071725/080683 REWUK SRI LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000074730 23-12-2019 201900071725/080683 REWUK SRI LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 14.00 Capsul 1,169.98 16,879.72
R2019-0000074730 23-12-2019 201900071725/080683 REWUK SRI LUSY E. Dr.Sp.PD OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000074745 23-12-2019 201900071853/100518 RAHMAT HIDAYAT,TN DODDY DR. OC00144 Cefila Capsul, 100mg 10.00 Capsul 28,957.00 290,070.00
R2019-0000074745 23-12-2019 201900071853/100518 RAHMAT HIDAYAT,TN DODDY DR. OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000074745 23-12-2019 201900071853/100518 RAHMAT HIDAYAT,TN DODDY DR. OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000074745 23-12-2019 201900071853/100518 RAHMAT HIDAYAT,TN DODDY DR. OP00184 Neo Protifed Tablet 10.00 Tablet 1,263.73 13,137.30
R2019-0000074745 23-12-2019 201900071853/100518 RAHMAT HIDAYAT,TN DODDY DR. OE00018 Epexol Tablet 10.00 Tablet 1,232.55 12,825.50
R2019-0000074746 23-12-2019 201900071850/059536 MARI'IE MUHAMMAD Dwi Astuti, dr OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000074746 23-12-2019 201900071850/059536 MARI'IE MUHAMMAD Dwi Astuti, dr OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
R2019-0000074729 23-12-2019 201900071848/42812 SUDJAI,TN Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000074729 23-12-2019 201900071848/42812 SUDJAI,TN Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000074747 23-12-2019 201900071855/112178 RUSLI,TN Dwi Astuti, dr OT00030 Teosal 10.00 Tablet 282.15 3,321.50
R2019-0000074747 23-12-2019 201900071855/112178 RUSLI,TN Dwi Astuti, dr OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000074747 23-12-2019 201900071855/112178 RUSLI,TN Dwi Astuti, dr OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000074749 23-12-2019 201900071704/092872 BACHTIAR,TN LUSY E. Dr.Sp.PD OA00178 Acarbose 100mg (OGB) 14.00 Tablet 2,839.00 40,246.00
R2019-0000074749 23-12-2019 201900071704/092872 BACHTIAR,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000074749 23-12-2019 201900071704/092872 BACHTIAR,TN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000074749 23-12-2019 201900071704/092872 BACHTIAR,TN LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000074749 23-12-2019 201900071704/092872 BACHTIAR,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000074749 23-12-2019 201900071704/092872 BACHTIAR,TN LUSY E. Dr.Sp.PD ON00009 Natrium Diklofenac 50mg 10.00 Tablet 955.84 10,058.40
R2019-0000074750 23-12-2019 201900071860/112182 RINI APRILIWATI,NY Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000074750 23-12-2019 201900071860/112182 RINI APRILIWATI,NY Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000074748 23-12-2019 201900071856/112179 RIMADONA,NY Dwi Astuti, dr OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
R2019-0000074748 23-12-2019 201900071856/112179 RIMADONA,NY Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000074748 23-12-2019 201900071856/112179 RIMADONA,NY Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000074751 23-12-2019 201900071857/112180 ARYA DHIVALDY,AN Dwi Astuti, dr OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074751 23-12-2019 201900071857/112180 ARYA DHIVALDY,AN Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000074751 23-12-2019 201900071857/112180 ARYA DHIVALDY,AN Dwi Astuti, dr OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000074751 23-12-2019 201900071857/112180 ARYA DHIVALDY,AN Dwi Astuti, dr OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000074753 23-12-2019 201900071858/100589 MURSALIM,TN Dwi Astuti, dr OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074753 23-12-2019 201900071858/100589 MURSALIM,TN Dwi Astuti, dr OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000074753 23-12-2019 201900071858/100589 MURSALIM,TN Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000074753 23-12-2019 201900071858/100589 MURSALIM,TN Dwi Astuti, dr OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000074752 23-12-2019 201900071859/112181 MARSIM,TN Dwi Astuti, dr ON00050 Nifedin 10mg 1.00 Tablet 831.60 1,331.60
R2019-0000074752 23-12-2019 201900071859/112181 MARSIM,TN Dwi Astuti, dr OA00063 Amlodipin 10mg (OGB) 5.00 Tablet 2,743.00 14,215.00
Total 274,899,564.21
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 204 dari 266
ASAL RAWAT JALAN
R2019-0000074752 23-12-2019 201900071859/112181 MARSIM,TN Dwi Astuti, dr OF00095 Furosemide 40mg (OGB) 5.00 Tablet 315.26 2,076.30
R2019-0000074752 23-12-2019 201900071859/112181 MARSIM,TN Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000074752 23-12-2019 201900071859/112181 MARSIM,TN Dwi Astuti, dr OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000074752 23-12-2019 201900071859/112181 MARSIM,TN Dwi Astuti, dr OI00097 Isosorbide Dinitrate 5mg 5.00 Tablet 311.85 2,059.25
R2019-0000074754 23-12-2019 201900071866/112184 ACO SYAHRIL Dwi Astuti, dr OM00017 Meloxicam 15mg (OGB) 5.00 Tablet 2,079.00 10,895.00
R2019-0000074754 23-12-2019 201900071866/112184 ACO SYAHRIL Dwi Astuti, dr OM00045 Methyl Prednisolon 4mg 5.00 Tablet 792.99 4,464.95
R2019-0000074754 23-12-2019 201900071866/112184 ACO SYAHRIL Dwi Astuti, dr OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000074755 23-12-2019 201900071865/069223 BUNGARAN P,SDR Dwi Astuti, dr OB00050 Braxidin 5.00 Tablet 1,648.35 8,741.75
R2019-0000074755 23-12-2019 201900071865/069223 BUNGARAN P,SDR Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000074755 23-12-2019 201900071865/069223 BUNGARAN P,SDR Dwi Astuti, dr OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074756 23-12-2019 201900071865/069223 BUNGARAN P,SDR Dwi Astuti, dr OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074756 23-12-2019 201900071865/069223 BUNGARAN P,SDR Dwi Astuti, dr OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000074756 23-12-2019 201900071865/069223 BUNGARAN P,SDR Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000074758 23-12-2019 201900071864/065928 DARMAWATI,NY Dwi Astuti, dr OG00067 Genoint Tetes Mata 1.00 Botol 13,587.75 14,087.75
R2019-0000074758 23-12-2019 201900071864/065928 DARMAWATI,NY Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000074758 23-12-2019 201900071864/065928 DARMAWATI,NY Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000074758 23-12-2019 201900071864/065928 DARMAWATI,NY Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000074758 23-12-2019 201900071864/065928 DARMAWATI,NY Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000074758 23-12-2019 201900071864/065928 DARMAWATI,NY Dwi Astuti, dr OA00063 Amlodipin 10mg (OGB) 5.00 Tablet 2,743.00 14,215.00
R2019-0000074726 23-12-2019 201900071883/112174 PDT. THOMAS Dwi Astuti, dr OE00055 Ecosol RL 500ml 2.00 Botol 19,305.00 39,110.00
R2019-0000074726 23-12-2019 201900071883/112174 PDT. THOMAS Dwi Astuti, dr ALI00011 Infus Set Makro 2.00 Pcs 12,087.90 24,675.80
R2019-0000074726 23-12-2019 201900071883/112174 PDT. THOMAS Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000074726 23-12-2019 201900071883/112174 PDT. THOMAS Dwi Astuti, dr ALF00007 Folley Catheter No. 14 1.00 Pcs 37,125.00 37,625.00
R2019-0000074726 23-12-2019 201900071883/112174 PDT. THOMAS Dwi Astuti, dr ALU00007 Urine Bag 1.00 Pcs 19,305.00 19,805.00
R2019-0000074726 23-12-2019 201900071883/112174 PDT. THOMAS Dwi Astuti, dr OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000074710 23-12-2019 201900071880/112177 NUR AZZAM DYAH, dr Sp. OI00040 Infus Otsu-KA-EN 3B, 2.00 Botol 27,473.00 55,446.00
R2019-0000074710 23-12-2019 201900071880/112177 NUR AZZAM DYAH, dr Sp. OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000074710 23-12-2019 201900071880/112177 NUR AZZAM DYAH, dr Sp. ALI00006 I.V Catheter No. 24 3.00 Pcs 38,900.00 117,200.00
R2019-0000074710 23-12-2019 201900071880/112177 NUR AZZAM DYAH, dr Sp. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074760 23-12-2019 201900071876/112183 TRIANA DEWI WULAN Dwi Astuti, dr OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000074760 23-12-2019 201900071876/112183 TRIANA DEWI WULAN Dwi Astuti, dr ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000074760 23-12-2019 201900071876/112183 TRIANA DEWI WULAN Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074760 23-12-2019 201900071876/112183 TRIANA DEWI WULAN Dwi Astuti, dr ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074762 23-12-2019 201900071858/100589 MURSALIM,TN Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074762 23-12-2019 201900071858/100589 MURSALIM,TN Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074762 23-12-2019 201900071858/100589 MURSALIM,TN Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000074763 23-12-2019 201900071849/090207 WARTINAH,NY Dwi Astuti, dr OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074763 23-12-2019 201900071849/090207 WARTINAH,NY Dwi Astuti, dr OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
Total 275,923,820.06
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 205 dari 266
ASAL RAWAT JALAN
R2019-0000074763 23-12-2019 201900071849/090207 WARTINAH,NY Dwi Astuti, dr ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000074764 23-12-2019 201900071855/112178 RUSLI,TN Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074764 23-12-2019 201900071855/112178 RUSLI,TN Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074761 23-12-2019 201900071848/42812 SUDJAI,TN Dwi Astuti, dr OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000074765 23-12-2019 201900072082/112122 NUR ALAM,NY Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000074765 23-12-2019 201900072082/112122 NUR ALAM,NY Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074765 23-12-2019 201900072082/112122 NUR ALAM,NY Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000074766 23-12-2019 201900071847/014674 SYAMSI,TN Dwi Astuti, dr ALM00015 Masker Oxygen Non 1.00 Pcs 82,863.00 83,363.00
R2019-0000074766 23-12-2019 201900071847/014674 SYAMSI,TN Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074766 23-12-2019 201900071847/014674 SYAMSI,TN Dwi Astuti, dr OE00055 Ecosol RL 500ml 3.00 Botol 19,305.00 58,415.00
R2019-0000074766 23-12-2019 201900071847/014674 SYAMSI,TN Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000074766 23-12-2019 201900071847/014674 SYAMSI,TN Dwi Astuti, dr ALF00008 Folley Catheter No. 16 1.00 Pcs 29,700.00 30,200.00
R2019-0000074766 23-12-2019 201900071847/014674 SYAMSI,TN Dwi Astuti, dr ALU00007 Urine Bag 1.00 Pcs 19,305.00 19,805.00
R2019-0000074766 23-12-2019 201900071847/014674 SYAMSI,TN Dwi Astuti, dr OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000074767 23-12-2019 201900071847/014674 SYAMSI,TN Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074767 23-12-2019 201900071847/014674 SYAMSI,TN Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074767 23-12-2019 201900071847/014674 SYAMSI,TN Dwi Astuti, dr OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000074768 23-12-2019 201900071841/079256 TITO FAIZAL,TN Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074769 23-12-2019 201900071870/110648 SITI AMINAH,NY Eko Dian Syafitra OV00057 Ventolin Nebules 2.5mg 2.00 Ampul 15,365.00 31,230.00
R2019-0000074769 23-12-2019 201900071870/110648 SITI AMINAH,NY Eko Dian Syafitra OP00136 Pulmicort Respules 2.00 Ampul 33,802.98 68,105.96
R2019-0000074773 23-12-2019 201900071869/112185 RESA MAHARANI,NN Eko Dian Syafitra OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000074773 23-12-2019 201900071869/112185 RESA MAHARANI,NN Eko Dian Syafitra OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
R2019-0000074773 23-12-2019 201900071869/112185 RESA MAHARANI,NN Eko Dian Syafitra OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000074786 24-12-2019 201900071878/112176 NASRUN ATU,TN Eko Dian Syafitra ALF00009 Folley Catheter No. 18 1.00 Pcs 33,412.50 33,912.50
R2019-0000074786 24-12-2019 201900071878/112176 NASRUN ATU,TN Eko Dian Syafitra ALU00007 Urine Bag 1.00 Pcs 19,305.00 19,805.00
R2019-0000074786 24-12-2019 201900071878/112176 NASRUN ATU,TN Eko Dian Syafitra OW00001 Water For Injeksi 25ml 2.00 Botol 9,222.00 18,944.00
R2019-0000074775 23-12-2019 201900071856/112179 RIMADONA,NY Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074775 23-12-2019 201900071856/112179 RIMADONA,NY Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074802 24-12-2019 201900071874/112188 YOBER SULOK Eko Dian Syafitra OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000074802 24-12-2019 201900071874/112188 YOBER SULOK Eko Dian Syafitra OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000074802 24-12-2019 201900071874/112188 YOBER SULOK Eko Dian Syafitra OD00065 Domperidon Tablet (OGB) 10.00 Tablet 750.00 8,000.00
R2019-0000074802 24-12-2019 201900071874/112188 YOBER SULOK Eko Dian Syafitra OV00080 Vitamin B Compleks 6.00 Tablet 241.79 1,950.74
R2019-0000074803 24-12-2019 201900071892/112189 RIMA DWI Eko Dian Syafitra OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000074803 24-12-2019 201900071892/112189 RIMA DWI Eko Dian Syafitra OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000074804 24-12-2019 201900071860/112182 RINI APRILIWATI,NY Dwi Astuti, dr OA00125 ATS (Anti Tetanus 1.00 Ampul 222,750.00 223,250.00
R2019-0000074805 24-12-2019 201900071873/112187 IMAM Eko Dian Syafitra OS00009 Salbutamol 2mg (OGB) 6.00 Tablet 213.30 1,779.80
R2019-0000074805 24-12-2019 201900071873/112187 IMAM Eko Dian Syafitra OV00080 Vitamin B Compleks 6.00 Tablet 241.79 1,950.74
R2019-0000074806 24-12-2019 201900071872/111146 MUHAMMAD RIDWAN Eko Dian Syafitra OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
Total 276,989,732.94
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 206 dari 266
ASAL RAWAT JALAN
R2019-0000074806 24-12-2019 201900071872/111146 MUHAMMAD RIDWAN Eko Dian Syafitra OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000074806 24-12-2019 201900071872/111146 MUHAMMAD RIDWAN Eko Dian Syafitra OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000074806 24-12-2019 201900071872/111146 MUHAMMAD RIDWAN Eko Dian Syafitra ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 12,079.00
R2019-0000074807 24-12-2019 201900071870/110648 SITI AMINAH,NY Dwi Astuti, dr OS00009 Salbutamol 2mg (OGB) 2.00 Tablet 213.30 926.60
R2019-0000074807 24-12-2019 201900071870/110648 SITI AMINAH,NY Dwi Astuti, dr OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000074807 24-12-2019 201900071870/110648 SITI AMINAH,NY Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000074807 24-12-2019 201900071870/110648 SITI AMINAH,NY Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000074808 24-12-2019 201900071863/112144 MUHAMMAD Dwi Astuti, dr OC00019 Captopril 25mg (OGB) 1.00 Tablet 267.35 767.35
R2019-0000074808 24-12-2019 201900071863/112144 MUHAMMAD Dwi Astuti, dr OM00158 Mevrabal 500 Mg 5.00 Tablet 2,100.00 11,000.00
R2019-0000074808 24-12-2019 201900071863/112144 MUHAMMAD Dwi Astuti, dr OA00043 Alprazolam 0,5mg (OGB) 2.00 Tablet 996.50 2,493.00
R2019-0000074808 24-12-2019 201900071863/112144 MUHAMMAD Dwi Astuti, dr OA00063 Amlodipin 10mg (OGB) 5.00 Tablet 2,743.00 14,215.00
R2019-0000074812 24-12-2019 201900071901/095861 KAILASH MUHAMMAD Eko Dian Syafitra OE00007 Elkana Syrup 1.00 Botol 34,303.50 34,803.50
R2019-0000074812 24-12-2019 201900071901/095861 KAILASH MUHAMMAD Eko Dian Syafitra OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2019-0000074818 24-12-2019 201900071910/092622 WIWID SEPTIA NOVITA OM00100 Mucera Tablet 10.00 Tablet 1,782.00 18,320.00
R2019-0000074818 24-12-2019 201900071910/092622 WIWID SEPTIA NOVITA OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000074818 24-12-2019 201900071910/092622 WIWID SEPTIA NOVITA OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000074822 24-12-2019 201900071918/112191 JASMINE NUR Herika dr. OI00001 Ibuprofen 400mg (OGB) 5.00 Tablet 682.00 3,910.00
R2019-0000074822 24-12-2019 201900071918/112191 JASMINE NUR Herika dr. OA00066 Amoxicillin Tablet, 500mg 5.00 Tablet 1,113.75 6,068.75
R2019-0000074823 24-12-2019 201900071922/062874 NEO RANGGA SEPTIA NOVITA OA00068 Amoxsan Capsul, 500mg 10.00 Capsul 4,752.00 48,020.00
R2019-0000074823 24-12-2019 201900071922/062874 NEO RANGGA SEPTIA NOVITA OM00100 Mucera Tablet 10.00 Tablet 1,782.00 18,320.00
R2019-0000074823 24-12-2019 201900071922/062874 NEO RANGGA SEPTIA NOVITA OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000074823 24-12-2019 201900071922/062874 NEO RANGGA SEPTIA NOVITA OC00057 Cerini 5.00 Tablet 5,093.55 25,967.75
R2019-0000074827 24-12-2019 201900071933/112196 MUHAMMAD NAUVAL SEPTIA NOVITA OA00070 Amoxsan Dry Syrup 1.00 Botol 33,412.50 33,912.50
R2019-0000074827 24-12-2019 201900071933/112196 MUHAMMAD NAUVAL SEPTIA NOVITA OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000074827 24-12-2019 201900071933/112196 MUHAMMAD NAUVAL SEPTIA NOVITA OA00094 Apialys Syrup 100ml 1.00 Botol 49,005.00 49,505.00
R2019-0000074828 24-12-2019 201900071931/112194 RITNAWATI,NY SEPTIA NOVITA OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000074828 24-12-2019 201900071931/112194 RITNAWATI,NY SEPTIA NOVITA OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000074828 24-12-2019 201900071931/112194 RITNAWATI,NY SEPTIA NOVITA OP00184 Neo Protifed Tablet 10.00 Tablet 1,263.73 13,137.30
R2019-0000074830 24-12-2019 201900071900/097422 BAHARIN Maulin Nikmah ALK00024 Korset TLSO (Thoraco 1.00 Pcs 455,000.00 455,500.00
R2019-0000074832 24-12-2019 201900071937/112197 MUHAMMAD SEPTIA NOVITA OA00070 Amoxsan Dry Syrup 1.00 Botol 33,412.50 33,912.50
R2019-0000074832 24-12-2019 201900071937/112197 MUHAMMAD SEPTIA NOVITA OO00062 Ottopan Syrup, 60ml 1.00 Botol 29,700.00 30,200.00
R2019-0000074832 24-12-2019 201900071937/112197 MUHAMMAD SEPTIA NOVITA OF00036 Ferlin Drops 1.00 Botol 49,005.00 49,505.00
R2019-0000074833 24-12-2019 201900071939/106830 MUHAMMAD INDRA SEPTIA NOVITA OA00002 AB - Vask 5mg 30.00 Tablet 8,539.00 256,670.00
R2019-0000074834 24-12-2019 201900071951/112198 SAROZAH,NY Herika dr. OP00150 Pantoprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000074834 24-12-2019 201900071951/112198 SAROZAH,NY Herika dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074835 24-12-2019 201900071953/112199 UNTUNG PRIBADI,TN MAGDA ROSSA, OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000074835 24-12-2019 201900071953/112199 UNTUNG PRIBADI,TN MAGDA ROSSA, OT00149 Toramine 10 Mg Tablet 10.00 Tablet 8,167.50 82,175.00
R2019-0000074835 24-12-2019 201900071953/112199 UNTUNG PRIBADI,TN MAGDA ROSSA, OM00065 Minosep Gargle 1.00 Botol 56,430.00 56,930.00
Total 278,589,568.29
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 207 dari 266
ASAL RAWAT JALAN
R2019-0000074836 24-12-2019 201900071944/044773 TIMBUL MARINGAN SEPTIA NOVITA OE00018 Epexol Tablet 10.00 Tablet 1,232.55 12,825.50
R2019-0000074836 24-12-2019 201900071944/044773 TIMBUL MARINGAN SEPTIA NOVITA OC00057 Cerini 5.00 Tablet 5,093.55 25,967.75
R2019-0000074838 24-12-2019 201900071956/112201 THALITA VALERI Herika dr. OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000074838 24-12-2019 201900071956/112201 THALITA VALERI Herika dr. OE00017 Epexol Syrup 1.00 Botol 25,690.50 26,190.50
R2019-0000074838 24-12-2019 201900071956/112201 THALITA VALERI Herika dr. OT00076 Tremenza Syrup 1.00 Botol 30,442.50 30,942.50
R2019-0000074838 24-12-2019 201900071956/112201 THALITA VALERI Herika dr. OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000074837 24-12-2019 201900071951/112198 SAROZAH,NY Herika dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074837 24-12-2019 201900071951/112198 SAROZAH,NY Herika dr. OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000074837 24-12-2019 201900071951/112198 SAROZAH,NY Herika dr. OM00035 Metformin 500mg (OGB) 15.00 Tablet 371.25 6,068.75
R2019-0000074837 24-12-2019 201900071951/112198 SAROZAH,NY Herika dr. OG00023 Glimepiride 3mg Tablet 10.00 Tablet 3,164.00 32,140.00
R2019-0000074837 24-12-2019 201900071951/112198 SAROZAH,NY Herika dr. OA00064 Amlodipin 5mg (OGB) 10.00 Tablet 1,555.00 16,050.00
R2019-0000074841 24-12-2019 201900071968/090117 ARI YULIANA,NY Herika dr. OG00018 Gitas Injeksi 1ml 1.00 Ampul 38,201.62 38,701.62
R2019-0000074841 24-12-2019 201900071968/090117 ARI YULIANA,NY Herika dr. ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000074841 24-12-2019 201900071968/090117 ARI YULIANA,NY Herika dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074843 24-12-2019 201900071973/050397 MAHDY,TN Herika dr. OC00039 Cefixime 100mg (OGB) 20.00 Capsul 4,266.70 85,834.00
R2019-0000074843 24-12-2019 201900071973/050397 MAHDY,TN Herika dr. OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000074844 24-12-2019 201900071971/112202 MISHAEL G FREDRIK, Dr,Sp.A OV00204 Vomis top Drop 10 ml 1.00 Botol 59,400.00 59,900.00
R2019-0000074844 24-12-2019 201900071971/112202 MISHAEL G FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 3.00 Capsul 28,957.00 87,371.00
R2019-0000074844 24-12-2019 201900071971/112202 MISHAEL G FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 3.00 Tablet 430.65 1,791.95
R2019-0000074844 24-12-2019 201900071971/112202 MISHAEL G FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000074844 24-12-2019 201900071971/112202 MISHAEL G FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 3.00 Tablet 1,232.55 4,197.65
R2019-0000074844 24-12-2019 201900071971/112202 MISHAEL G FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000074844 24-12-2019 201900071971/112202 MISHAEL G FREDRIK, Dr,Sp.A OS00030 Sanmol Drop, 15ml 1.00 Botol 23,314.00 23,814.00
R2019-0000074844 24-12-2019 201900071971/112202 MISHAEL G FREDRIK, Dr,Sp.A OA00093 Apialys Drop 1.00 Botol 59,400.00 59,900.00
R2019-0000074844 24-12-2019 201900071971/112202 MISHAEL G FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 23,118.50
R2019-0000074845 24-12-2019 201900071968/090117 ARI YULIANA,NY Herika dr. OO00040 Oralit 200 10.00 Sachet 706.00 7,560.00
R2019-0000074845 24-12-2019 201900071968/090117 ARI YULIANA,NY Herika dr. OL00076 Lodia 2mg 10.00 Tablet 1,485.00 15,350.00
R2019-0000074845 24-12-2019 201900071968/090117 ARI YULIANA,NY Herika dr. OS00027 Sanmag Tablet 10.00 Tablet 1,321.65 13,716.50
R2019-0000074847 24-12-2019 201900071978/081070 ROSITA NOVIANTI Herika dr. OS00026 Sanmag Syrup 1.00 Botol 37,125.00 37,625.00
R2019-0000074847 24-12-2019 201900071978/081070 ROSITA NOVIANTI Herika dr. OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000074847 24-12-2019 201900071978/081070 ROSITA NOVIANTI Herika dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074847 24-12-2019 201900071978/081070 ROSITA NOVIANTI Herika dr. OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000074847 24-12-2019 201900071978/081070 ROSITA NOVIANTI Herika dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074848 24-12-2019 201900071980/046129 ZULFIKAR,TN Herika dr. OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000074848 24-12-2019 201900071980/046129 ZULFIKAR,TN Herika dr. OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000074848 24-12-2019 201900071980/046129 ZULFIKAR,TN Herika dr. OA00085 Antasida Tablet (OGB) 5.00 Tablet 284.30 1,921.50
R2019-0000074848 24-12-2019 201900071980/046129 ZULFIKAR,TN Herika dr. OO00040 Oralit 200 6.00 Sachet 706.00 4,736.00
R2019-0000074850 24-12-2019 201900071918/112191 JASMINE NUR Herika dr. OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 22,542.30 23,042.30
Total 279,522,993.13
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 208 dari 266
ASAL RAWAT JALAN
R2019-0000074850 24-12-2019 201900071918/112191 JASMINE NUR Herika dr. OL00063 Lidocain HCl 2% Injeksi 2.00 Ampul 2,376.00 5,252.00
R2019-0000074850 24-12-2019 201900071918/112191 JASMINE NUR Herika dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074852 24-12-2019 201900071980/046129 ZULFIKAR,TN Herika dr. OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000074851 24-12-2019 201900071923/112192 AYUMY ZAHABIYA Herika dr. OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000074853 24-12-2019 201900071943/105655 JOHOSUA Herika dr. OF00094 Furosemide Injeksi, 1.00 Ampul 5,259.87 5,759.87
R2019-0000074853 24-12-2019 201900071943/105655 JOHOSUA Herika dr. ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000074853 24-12-2019 201900071943/105655 JOHOSUA Herika dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074853 24-12-2019 201900071943/105655 JOHOSUA Herika dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000074853 24-12-2019 201900071943/105655 JOHOSUA Herika dr. OC00019 Captopril 25mg (OGB) 1.00 Tablet 267.35 767.35
R2019-0000074855 24-12-2019 201900071989/090814 MOHTAR,TN Herika dr. OI00054 Infus Otsu-RL, 500ml 1.00 Botol 17,820.00 18,320.00
R2019-0000074855 24-12-2019 201900071989/090814 MOHTAR,TN Herika dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074855 24-12-2019 201900071989/090814 MOHTAR,TN Herika dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074855 24-12-2019 201900071989/090814 MOHTAR,TN Herika dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074854 24-12-2019 201900071943/105655 JOHOSUA MAGDA ROSSA, OF00095 Furosemide 40mg (OGB) 3.00 Tablet 315.26 1,445.78
R2019-0000074854 24-12-2019 201900071943/105655 JOHOSUA MAGDA ROSSA, OS00076 Simvastatin 10mg (OGB) 3.00 Tablet 1,662.00 5,486.00
R2019-0000074854 24-12-2019 201900071943/105655 JOHOSUA MAGDA ROSSA, OC00096 Codein 10mg 4.00 Tablet 924.80 4,199.20
R2019-0000074854 24-12-2019 201900071943/105655 JOHOSUA MAGDA ROSSA, OA00063 Amlodipin 10mg (OGB) 3.00 Tablet 2,743.00 8,729.00
R2019-0000074854 24-12-2019 201900071943/105655 JOHOSUA MAGDA ROSSA, OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000074856 24-12-2019 201900071960/054159 TAKDIR Herika dr. OI00001 Ibuprofen 400mg (OGB) 5.00 Tablet 682.00 3,910.00
R2019-0000074856 24-12-2019 201900071960/054159 TAKDIR Herika dr. OC00034 Cefadroxil 500mg (OGB) 6.00 Capsul 1,633.50 10,301.00
R2019-0000074849 24-12-2019 201900071929/112193 WISNU KUNCORO,TN Dameria Sri OK00002 Kalium Diklofenac 50mg 14.00 Tablet 1,100.00 15,900.00
R2019-0000074849 24-12-2019 201900071929/112193 WISNU KUNCORO,TN Dameria Sri OE00057 Eperisone Hcl 50mg 15.00 Tablet 2,286.90 34,803.50
R2019-0000074859 24-12-2019 201900071942/079007 ADI WARSITO,TN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000074859 24-12-2019 201900071942/079007 ADI WARSITO,TN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000074859 24-12-2019 201900071942/079007 ADI WARSITO,TN EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000074859 24-12-2019 201900071942/079007 ADI WARSITO,TN EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000074858 24-12-2019 201900071955/112200 ZIVANA SHAHIA NUR Herika dr. OE00047 Epexol Drop 1.00 Botol 55,836.00 56,336.00
R2019-0000074860 24-12-2019 201900071927/103070 UDIN S,TN Dameria Sri OP00036 Phenytoin Capsul 21.00 Capsul 816.75 17,651.75
R2019-0000074860 24-12-2019 201900071927/103070 UDIN S,TN Dameria Sri OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000074860 24-12-2019 201900071927/103070 UDIN S,TN Dameria Sri OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000074862 24-12-2019 201900071949/052230 ANI,NY MAGDA ROSSA, OC00034 Cefadroxil 500mg (OGB) 12.00 Capsul 1,633.50 20,102.00
R2019-0000074862 24-12-2019 201900071949/052230 ANI,NY MAGDA ROSSA, OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000074862 24-12-2019 201900071949/052230 ANI,NY MAGDA ROSSA, OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000074862 24-12-2019 201900071949/052230 ANI,NY MAGDA ROSSA, OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
Total 280,151,355.85
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 209 dari 266
ASAL RAWAT JALAN
R2019-0000074865 24-12-2019 201900071984/112203 NOPERMAN ADE RAHMAH OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000074865 24-12-2019 201900071984/112203 NOPERMAN ADE RAHMAH OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000074865 24-12-2019 201900071984/112203 NOPERMAN ADE RAHMAH OR00003 Ranitidin 150mg (OGB) 10.00 Tablet 891.00 9,410.00
R2019-0000074863 24-12-2019 201900071985/089406 DIMAS PERDANA,AN ADE RAHMAH OI00084 Interhistin Syrup, 60ml 1.00 Botol 54,202.50 54,702.50
R2019-0000074863 24-12-2019 201900071985/089406 DIMAS PERDANA,AN ADE RAHMAH OC00038 Cefila Dry Syrup 1.00 Botol 123,255.00 123,755.00
R2019-0000074869 24-12-2019 201900071992/110624 OEN GUNAWAN ADE RAHMAH OC00151 Codipront Capsul 10.00 Capsul 14,174.33 142,243.30
R2019-0000074869 24-12-2019 201900071992/110624 OEN GUNAWAN ADE RAHMAH OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000074869 24-12-2019 201900071992/110624 OEN GUNAWAN ADE RAHMAH OI00134 Imunos Plus Tablet 10.00 Tablet 14,107.50 141,575.00
R2019-0000074872 23-12-2019 201900071720/094036 JURI,TN ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074872 23-12-2019 201900071720/094036 JURI,TN ADE RAHMAH OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074872 23-12-2019 201900071720/094036 JURI,TN ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000074874 22-12-2019 201900071761/099217 WA KAMBA,NY Eko Dian Syafitra OA00058 Aminophylin Injeksi, 2.4% 1.00 Ampul 8,354.00 8,854.00
R2019-0000074874 22-12-2019 201900071761/099217 WA KAMBA,NY Eko Dian Syafitra ALN00002 Nasal Canule 1.00 Pcs 25,245.00 25,745.00
R2019-0000074874 22-12-2019 201900071761/099217 WA KAMBA,NY Eko Dian Syafitra OV00057 Ventolin Nebules 2.5mg 2.00 Ampul 15,365.00 31,230.00
R2019-0000074874 22-12-2019 201900071761/099217 WA KAMBA,NY Eko Dian Syafitra OP00136 Pulmicort Respules 2.00 Ampul 33,802.98 68,105.96
R2019-0000074874 22-12-2019 201900071761/099217 WA KAMBA,NY Eko Dian Syafitra ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000074874 22-12-2019 201900071761/099217 WA KAMBA,NY Eko Dian Syafitra OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000074874 22-12-2019 201900071761/099217 WA KAMBA,NY Eko Dian Syafitra OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074874 22-12-2019 201900071761/099217 WA KAMBA,NY Eko Dian Syafitra OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000074875 23-12-2019 201900071619/111778 KHOIRIL QOMARI,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000074875 23-12-2019 201900071619/111778 KHOIRIL QOMARI,TN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074875 23-12-2019 201900071619/111778 KHOIRIL QOMARI,TN LUSY E. Dr.Sp.PD OD00065 Domperidon Tablet (OGB) 10.00 Tablet 750.00 8,000.00
R2019-0000074876 23-12-2019 201900071603/112152 SUTARNO,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000074876 23-12-2019 201900071603/112152 SUTARNO,TN LUSY E. Dr.Sp.PD OA00074 Analsik 10.00 Tablet 2,264.63 23,146.30
R2019-0000074877 23-12-2019 201900071636/112061 SURIANSYAH,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000074877 23-12-2019 201900071636/112061 SURIANSYAH,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 10.00 Tablet 10,617.75 106,677.50
R2019-0000074877 23-12-2019 201900071636/112061 SURIANSYAH,TN LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 10.00 Tablet 811.35 8,613.50
R2019-0000074877 23-12-2019 201900071636/112061 SURIANSYAH,TN LUSY E. Dr.Sp.PD OP00184 Neo Protifed Tablet 10.00 Tablet 1,263.73 13,137.30
R2019-0000074878 23-12-2019 201900071679/069975 SUPINAH NOVIANA, Dr. Sp OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074878 23-12-2019 201900071679/069975 SUPINAH NOVIANA, Dr. Sp OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000074879 23-12-2019 201900071778/107078 ADIBA NAILA FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 2.00 Capsul 4,266.70 9,033.40
R2019-0000074879 23-12-2019 201900071778/107078 ADIBA NAILA FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 2.00 Tablet 208.00 916.00
R2019-0000074879 23-12-2019 201900071778/107078 ADIBA NAILA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 2.00 Tablet 1,173.15 2,846.30
R2019-0000074879 23-12-2019 201900071778/107078 ADIBA NAILA FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000074879 23-12-2019 201900071778/107078 ADIBA NAILA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000074879 23-12-2019 201900071778/107078 ADIBA NAILA FREDRIK, Dr,Sp.A OV00204 Vomis top Drop 10 ml 1.00 Botol 59,400.00 59,900.00
R2019-0000074879 23-12-2019 201900071778/107078 ADIBA NAILA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000074880 23-12-2019 201900071766/064010 SUPRIHATIN,NY NOVIANA, Dr. Sp OB00007 Becom - C 6.00 Tablet 2,123.55 13,241.30
Total 281,391,133.46
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 210 dari 266
ASAL RAWAT JALAN
R2019-0000074866 24-12-2019 201900071988/112204 DZAKY ALFARIZKY,AN ADE RAHMAH OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000074866 24-12-2019 201900071988/112204 DZAKY ALFARIZKY,AN ADE RAHMAH OM00097 Mucera Drop 1.00 Botol 54,945.00 55,445.00
R2019-0000074882 24-12-2019 201900072001/086858 MUHAMMAD AJI ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074882 24-12-2019 201900072001/086858 MUHAMMAD AJI ADE RAHMAH OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074884 24-12-2019 201900072001/086858 MUHAMMAD AJI ADE RAHMAH OA00087 Antiza Syrup, 60ml 1.00 Botol 26,730.00 27,230.00
R2019-0000074884 24-12-2019 201900072001/086858 MUHAMMAD AJI ADE RAHMAH OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000074885 24-12-2019 201900072004/112206 SUSANA SERLI ADE RAHMAH OI00126 Interhistin 50mg, Tablet 10.00 Tablet 1,173.15 12,231.50
R2019-0000074883 24-12-2019 201900071932/112195 RETNO PALUPI INDAH Herika dr. OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000074883 24-12-2019 201900071932/112195 RETNO PALUPI INDAH Herika dr. OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000074887 24-12-2019 201900071923/112192 AYUMY ZAHABIYA Herika dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000074887 24-12-2019 201900071923/112192 AYUMY ZAHABIYA Herika dr. OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000074887 24-12-2019 201900071923/112192 AYUMY ZAHABIYA Herika dr. OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000074887 24-12-2019 201900071923/112192 AYUMY ZAHABIYA Herika dr. OC00132 CTM 4mg 3.00 Tablet 157.41 972.23
R2019-0000074888 24-12-2019 201900071911/094061 SAHI MARIATI,NY MAGDA ROSSA, OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000074889 24-12-2019 201900071921/062169 PATMAYANTI,NY Herika dr. OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000074889 24-12-2019 201900071921/062169 PATMAYANTI,NY Herika dr. OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000074890 24-12-2019 201900071903/065984 INDAH,NY Eko Dian Syafitra OD00065 Domperidon Tablet (OGB) 10.00 Tablet 750.00 8,000.00
R2019-0000074890 24-12-2019 201900071903/065984 INDAH,NY Eko Dian Syafitra OB001002 Betahistine 10.00 Tab 5,940.00 59,900.00
R2019-0000074890 24-12-2019 201900071903/065984 INDAH,NY Eko Dian Syafitra OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000074890 24-12-2019 201900071903/065984 INDAH,NY Eko Dian Syafitra OC00172 Candesartan Cilexetil 10.00 Tablet 10,617.75 106,677.50
R2019-0000074892 24-12-2019 201900071904/112190 ARMIN,TN Herika dr. OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000074892 24-12-2019 201900071904/112190 ARMIN,TN Herika dr. OL00108 Lexatrans 500mg 10.00 Tablet 1,871.00 19,210.00
R2019-0000074892 24-12-2019 201900071904/112190 ARMIN,TN Herika dr. OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000074892 24-12-2019 201900071904/112190 ARMIN,TN Herika dr. OV00080 Vitamin B Compleks 10.00 Tablet 241.79 2,917.90
R2019-0000074893 24-12-2019 201900071903/065984 INDAH,NY Eko Dian Syafitra OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000074893 24-12-2019 201900071903/065984 INDAH,NY Eko Dian Syafitra OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000074893 24-12-2019 201900071903/065984 INDAH,NY Eko Dian Syafitra ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074891 24-12-2019 201900071892/112189 RIMA DWI Eko Dian Syafitra ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000074891 24-12-2019 201900071892/112189 RIMA DWI Eko Dian Syafitra OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000074891 24-12-2019 201900071892/112189 RIMA DWI Eko Dian Syafitra OP00011 Paracetamol 500mg 1.00 Tablet 387.36 887.36
R2019-0000074891 24-12-2019 201900071892/112189 RIMA DWI Eko Dian Syafitra ALI00004 I.V Catheter No. 20 2.00 Pcs 36,808.20 74,116.40
R2019-0000074894 23-12-2019 201900071874/112188 YOBER SULOK Eko Dian Syafitra ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074894 23-12-2019 201900071874/112188 YOBER SULOK Eko Dian Syafitra OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000074894 23-12-2019 201900071874/112188 YOBER SULOK Eko Dian Syafitra ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000074894 23-12-2019 201900071874/112188 YOBER SULOK Eko Dian Syafitra OA00063 Amlodipin 10mg (OGB) 1.00 Tablet 2,743.00 3,243.00
Total 282,315,849.88
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 211 dari 266
ASAL RAWAT JALAN
R2019-0000074898 24-12-2019 201900072005/042168 RUHAINI,NY ADE RAHMAH OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000074898 24-12-2019 201900072005/042168 RUHAINI,NY ADE RAHMAH OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000074898 24-12-2019 201900072005/042168 RUHAINI,NY ADE RAHMAH OP00184 Neo Protifed Tablet 5.00 Tablet 1,263.73 6,818.65
R2019-0000074899 24-12-2019 201900072007/034132 BARI KHAIRUL ADE RAHMAH OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000074899 24-12-2019 201900072007/034132 BARI KHAIRUL ADE RAHMAH OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000074899 24-12-2019 201900072007/034132 BARI KHAIRUL ADE RAHMAH OI00001 Ibuprofen 400mg (OGB) 5.00 Tablet 682.00 3,910.00
R2019-0000074901 23-12-2019 201900072014/112207 ARIQ ADE RAHMAH OS00030 Sanmol Drop, 15ml 1.00 Botol 23,314.00 23,814.00
R2019-0000074901 23-12-2019 201900072014/112207 ARIQ ADE RAHMAH OI00084 Interhistin Syrup, 60ml 1.00 Botol 54,202.50 54,702.50
R2019-0000074901 23-12-2019 201900072014/112207 ARIQ ADE RAHMAH OA00094 Apialys Syrup 100ml 1.00 Botol 49,005.00 49,505.00
R2019-0000074903 23-12-2019 201900072015/42874 BAYER GABRIEL,TN ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074903 23-12-2019 201900072015/42874 BAYER GABRIEL,TN ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000074903 23-12-2019 201900072015/42874 BAYER GABRIEL,TN ADE RAHMAH OS00027 Sanmag Tablet 10.00 Tablet 1,321.65 13,716.50
R2019-0000074903 23-12-2019 201900072015/42874 BAYER GABRIEL,TN ADE RAHMAH OC00134 Curcuma Tablet 10.00 Tablet 1,336.50 13,865.00
R2019-0000074900 24-12-2019 201900072016/064282 JONATHAN AX EL ADE RAHMAH OE00057 Eperisone Hcl 50mg 3.00 Tablet 2,286.90 7,360.70
R2019-0000074900 24-12-2019 201900072016/064282 JONATHAN AX EL ADE RAHMAH OA00106 Asam Mefenamat 500mg 5.00 Tablet 415.80 2,579.00
R2019-0000074900 24-12-2019 201900072016/064282 JONATHAN AX EL ADE RAHMAH OR00003 Ranitidin 150mg (OGB) 5.00 Tablet 891.00 4,955.00
R2019-0000074900 24-12-2019 201900072016/064282 JONATHAN AX EL ADE RAHMAH OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000074920 24-12-2019 201900072018/112209 TUKIMIN,TN ADE RAHMAH OF00095 Furosemide 40mg (OGB) 3.00 Tablet 315.26 1,445.78
R2019-0000074920 24-12-2019 201900072018/112209 TUKIMIN,TN ADE RAHMAH OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000074920 24-12-2019 201900072018/112209 TUKIMIN,TN ADE RAHMAH OA00106 Asam Mefenamat 500mg 5.00 Tablet 415.80 2,579.00
R2019-0000074919 24-12-2019 201900072024/112212 HANDI PRAYITNO,TN ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000074919 24-12-2019 201900072024/112212 HANDI PRAYITNO,TN ADE RAHMAH OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000074919 24-12-2019 201900072024/112212 HANDI PRAYITNO,TN ADE RAHMAH ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000074922 24-12-2019 201900072023/092063 ACHMAD FAIRUUS ADE RAHMAH OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000074922 24-12-2019 201900072023/092063 ACHMAD FAIRUUS ADE RAHMAH OI00001 Ibuprofen 400mg (OGB) 3.00 Tablet 682.00 2,546.00
R2019-0000074923 24-12-2019 201900072026/094036 JURI,TN Herika dr. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000074923 24-12-2019 201900072026/094036 JURI,TN Herika dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074923 24-12-2019 201900072026/094036 JURI,TN Herika dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074923 24-12-2019 201900072026/094036 JURI,TN Herika dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074923 24-12-2019 201900072026/094036 JURI,TN Herika dr. OK00027 Ketorolac 3% Injeksi 2.00 Ampul 40,500.40 81,500.80
R2019-0000074923 24-12-2019 201900072026/094036 JURI,TN Herika dr. OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074923 24-12-2019 201900072026/094036 JURI,TN Herika dr. OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074924 24-12-2019 201900072028/061944 SITI SUNDARI,NY ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074924 24-12-2019 201900072028/061944 SITI SUNDARI,NY ADE RAHMAH OP00136 Pulmicort Respules 2.00 Ampul 33,802.98 68,105.96
R2019-0000074924 24-12-2019 201900072028/061944 SITI SUNDARI,NY ADE RAHMAH OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000074924 24-12-2019 201900072028/061944 SITI SUNDARI,NY ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074924 24-12-2019 201900072028/061944 SITI SUNDARI,NY ADE RAHMAH ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
Total 283,010,284.14
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 212 dari 266
ASAL RAWAT JALAN
R2019-0000074921 24-12-2019 201900072005/042168 RUHAINI,NY ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074921 24-12-2019 201900072005/042168 RUHAINI,NY ADE RAHMAH OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074925 24-12-2019 201900072007/034132 BARI KHAIRUL ADE RAHMAH OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000074925 24-12-2019 201900072007/034132 BARI KHAIRUL ADE RAHMAH OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000074925 24-12-2019 201900072007/034132 BARI KHAIRUL ADE RAHMAH ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000074927 24-12-2019 201900072030/112210 ABD. KARIM,TN ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 2.00 Ampul 15,365.00 31,230.00
R2019-0000074927 24-12-2019 201900072030/112210 ABD. KARIM,TN ADE RAHMAH OP00136 Pulmicort Respules 3.00 Ampul 33,802.98 101,908.94
R2019-0000074927 24-12-2019 201900072030/112210 ABD. KARIM,TN ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000074929 24-12-2019 201900072029/112211 RAFA RADITIYA,AN ADE RAHMAH OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000074929 24-12-2019 201900072029/112211 RAFA RADITIYA,AN ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074929 24-12-2019 201900072029/112211 RAFA RADITIYA,AN ADE RAHMAH ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000074930 23-12-2019 201900072017/112208 SUSIATI,NY ADE RAHMAH OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000074930 23-12-2019 201900072017/112208 SUSIATI,NY ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074930 23-12-2019 201900072017/112208 SUSIATI,NY ADE RAHMAH ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074926 24-12-2019 201900072017/112208 SUSIATI,NY ADE RAHMAH OE00056 Ecosol Nacl 0,9 % 500ml 2.00 Botol 19,305.00 39,110.00
R2019-0000074926 24-12-2019 201900072017/112208 SUSIATI,NY ADE RAHMAH OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000074932 24-12-2019 201900072027/112205 MUNAWAROH,NY ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000074932 24-12-2019 201900072027/112205 MUNAWAROH,NY ADE RAHMAH ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074932 24-12-2019 201900072027/112205 MUNAWAROH,NY ADE RAHMAH OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000074932 24-12-2019 201900072027/112205 MUNAWAROH,NY ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074881 23-12-2019 201900072017/112208 SUSIATI,NY ADE RAHMAH OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000074881 23-12-2019 201900072017/112208 SUSIATI,NY ADE RAHMAH OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000074881 23-12-2019 201900072017/112208 SUSIATI,NY ADE RAHMAH OR00003 Ranitidin 150mg (OGB) 10.00 Tablet 891.00 9,410.00
R2019-0000074935 25-12-2019 201900072034/025218 SETIANI,NY Dwi Astuti, dr OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000074935 25-12-2019 201900072034/025218 SETIANI,NY Dwi Astuti, dr OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000074935 25-12-2019 201900072034/025218 SETIANI,NY Dwi Astuti, dr ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074935 25-12-2019 201900072034/025218 SETIANI,NY Dwi Astuti, dr OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074935 25-12-2019 201900072034/025218 SETIANI,NY Dwi Astuti, dr OV00107 Vosedon Tablet 5.00 Tablet 3,452.63 17,763.15
R2019-0000074935 25-12-2019 201900072034/025218 SETIANI,NY Dwi Astuti, dr ON00047 New Diatabs 6.00 Tablet 767.13 5,102.78
R2019-0000074935 25-12-2019 201900072034/025218 SETIANI,NY Dwi Astuti, dr OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000074940 24-12-2019 201900072038/069678 SARNO DWI Dwi Astuti, dr OI00054 Infus Otsu-RL, 500ml 1.00 Botol 17,820.00 18,320.00
R2019-0000074940 24-12-2019 201900072038/069678 SARNO DWI Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074940 24-12-2019 201900072038/069678 SARNO DWI Dwi Astuti, dr ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074940 24-12-2019 201900072038/069678 SARNO DWI Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000074944 25-12-2019 201900072036/42554 AHMAD RIZQULLAH Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000074944 25-12-2019 201900072036/42554 AHMAD RIZQULLAH Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000074944 25-12-2019 201900072036/42554 AHMAD RIZQULLAH Dwi Astuti, dr OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000074941 24-12-2019 201900072039/112215 KANAYA RAISHA Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 2.00 Capsul 4,266.70 9,033.40
Total 283,996,254.47
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 213 dari 266
ASAL RAWAT JALAN
R2019-0000074941 24-12-2019 201900072039/112215 KANAYA RAISHA Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000074941 24-12-2019 201900072039/112215 KANAYA RAISHA Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 2.00 Tablet 623.70 1,747.40
R2019-0000074941 24-12-2019 201900072039/112215 KANAYA RAISHA Dwi Astuti, dr OV00080 Vitamin B Compleks 2.00 Tablet 241.79 983.58
R2019-0000074941 24-12-2019 201900072039/112215 KANAYA RAISHA Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000074950 25-12-2019 201900072036/42554 AHMAD RIZQULLAH Dwi Astuti, dr OS00009 Salbutamol 2mg (OGB) 6.00 Tablet 213.30 1,779.80
R2019-0000074950 25-12-2019 201900072036/42554 AHMAD RIZQULLAH Dwi Astuti, dr OA00052 Ambroxol Tablet, 30mg 6.00 Tablet 445.50 3,173.00
R2019-0000074950 25-12-2019 201900072036/42554 AHMAD RIZQULLAH Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000074950 25-12-2019 201900072036/42554 AHMAD RIZQULLAH Dwi Astuti, dr OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
R2019-0000074951 24-12-2019 201900072024/112212 HANDI PRAYITNO,TN ADE RAHMAH OB001002 Betahistine 5.00 Tab 5,940.00 30,200.00
R2019-0000074951 24-12-2019 201900072024/112212 HANDI PRAYITNO,TN ADE RAHMAH OF00148 Flunarizine 10mg (OGB) 5.00 Tablet 5,940.00 30,200.00
R2019-0000074951 24-12-2019 201900072024/112212 HANDI PRAYITNO,TN ADE RAHMAH OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000074951 24-12-2019 201900072024/112212 HANDI PRAYITNO,TN ADE RAHMAH OA00085 Antasida Tablet (OGB) 5.00 Tablet 284.30 1,921.50
R2019-0000074962 25-12-2019 201900072048/077342 RITA,NY Niki Juniar OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000074962 25-12-2019 201900072048/077342 RITA,NY Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000074962 25-12-2019 201900072048/077342 RITA,NY Niki Juniar OM00143 Metoclopramide 10mg 4.00 Tablet 211.95 1,347.80
R2019-0000074972 25-12-2019 201900072047/112217 ALIF SAPUTRA,AN Niki Juniar OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000074972 25-12-2019 201900072047/112217 ALIF SAPUTRA,AN Niki Juniar OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000074972 25-12-2019 201900072047/112217 ALIF SAPUTRA,AN Niki Juniar OZ00005 Zinc Tablet (OGB) 10.00 Tablet 1,000.00 10,500.00
R2019-0000074953 25-12-2019 201900072050/112216 MUHAMMAD Ismail dr. Msc. OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000074953 25-12-2019 201900072050/112216 MUHAMMAD Ismail dr. Msc. OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000074973 25-12-2019 201900072045/093975 ANNA DWI Niki Juniar OI00001 Ibuprofen 400mg (OGB) 4.00 Tablet 682.00 3,228.00
R2019-0000074973 25-12-2019 201900072045/093975 ANNA DWI Niki Juniar OM00143 Metoclopramide 10mg 4.00 Tablet 211.95 1,347.80
R2019-0000074978 24-12-2019 201900072021/090207 WARTINAH,NY ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000074978 24-12-2019 201900072021/090207 WARTINAH,NY ADE RAHMAH ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000074978 24-12-2019 201900072021/090207 WARTINAH,NY ADE RAHMAH ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000074978 24-12-2019 201900072021/090207 WARTINAH,NY ADE RAHMAH OI00054 Infus Otsu-RL, 500ml 1.00 Botol 17,820.00 18,320.00
R2019-0000074978 24-12-2019 201900072021/090207 WARTINAH,NY ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074981 25-12-2019 201900072038/069678 SARNO DWI Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000074981 25-12-2019 201900072038/069678 SARNO DWI Dwi Astuti, dr ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000074981 25-12-2019 201900072038/069678 SARNO DWI Dwi Astuti, dr OI00054 Infus Otsu-RL, 500ml 1.00 Botol 17,820.00 18,320.00
R2019-0000074981 25-12-2019 201900072038/069678 SARNO DWI Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000074990 25-12-2019 201900072057/095595 ALMIRA Niki Juniar OE00018 Epexol Tablet 2.00 Tablet 1,232.55 2,965.10
R2019-0000074990 25-12-2019 201900072057/095595 ALMIRA Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000074990 25-12-2019 201900072057/095595 ALMIRA Niki Juniar OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000074990 25-12-2019 201900072057/095595 ALMIRA Niki Juniar ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 17,079.00
R2019-0000074994 25-12-2019 201900072068/020414 SYAIFUL BAHRI,TN Niki Juniar OE00017 Epexol Syrup 1.00 Botol 25,690.50 26,190.50
R2019-0000074994 25-12-2019 201900072068/020414 SYAIFUL BAHRI,TN Niki Juniar OC00057 Cerini 10.00 Tablet 5,093.55 51,435.50
R2019-0000074994 25-12-2019 201900072068/020414 SYAIFUL BAHRI,TN Niki Juniar OI00134 Imunos Plus Tablet 5.00 Tablet 14,107.50 71,037.50
Total 284,720,814.54
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 214 dari 266
ASAL RAWAT JALAN
R2019-0000074994 25-12-2019 201900072068/020414 SYAIFUL BAHRI,TN Niki Juniar OS00029 Sanmol Tablet, 500mg 8.00 Tablet 430.65 3,945.20
R2019-0000075005 25-12-2019 201900072055/083121 WIDYA DEWI Niki Juniar OD00031 Dexamethasone Tablet 1.00 Tablet 208.00 708.00
R2019-0000075020 23-12-2019 201900071692/060652 HENI SISWANTI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075020 23-12-2019 201900071692/060652 HENI SISWANTI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075020 23-12-2019 201900071692/060652 HENI SISWANTI,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000075020 23-12-2019 201900071692/060652 HENI SISWANTI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 7.00 Tablet 5,197.50 36,882.50
R2019-0000075020 23-12-2019 201900071692/060652 HENI SISWANTI,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000075015 25-12-2019 201900072076/056112 LAODE HASUDDIN,TN Niki Juniar OI00054 Infus Otsu-RL, 500ml 1.00 Botol 17,820.00 18,320.00
R2019-0000075015 25-12-2019 201900072076/056112 LAODE HASUDDIN,TN Niki Juniar ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000075015 25-12-2019 201900072076/056112 LAODE HASUDDIN,TN Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000075015 25-12-2019 201900072076/056112 LAODE HASUDDIN,TN Niki Juniar ON00039 Neurosanbe Injeksi 1.00 Ampul 8,122.95 8,622.95
R2019-0000075015 25-12-2019 201900072076/056112 LAODE HASUDDIN,TN Niki Juniar OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000075015 25-12-2019 201900072076/056112 LAODE HASUDDIN,TN Niki Juniar OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000075015 25-12-2019 201900072076/056112 LAODE HASUDDIN,TN Niki Juniar OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000075018 25-12-2019 201900072051/112217 ALIF SAPUTRA,AN Niki Juniar OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000075023 25-12-2019 201900072045/093975 ANNA DWI Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000075019 24-12-2019 201900071898/074460 INDRAWATI DEWI,NY Dameria Sri OP00011 Paracetamol 500mg 20.00 Tablet 387.36 8,247.20
R2019-0000075019 24-12-2019 201900071898/074460 INDRAWATI DEWI,NY Dameria Sri OV00046 Valis anbe 5mg Tablet 4.00 Tablet 579.15 2,816.60
R2019-0000075019 24-12-2019 201900071898/074460 INDRAWATI DEWI,NY Dameria Sri OC00017 Kapsul No. 00 20.00 Capsul 200.00 12,000.00
R2019-0000075019 24-12-2019 201900071898/074460 INDRAWATI DEWI,NY Dameria Sri OA00043 Alprazolam 0,5mg (OGB) 6.00 Tablet 996.50 6,479.00
R2019-0000075019 24-12-2019 201900071898/074460 INDRAWATI DEWI,NY Dameria Sri OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000075019 24-12-2019 201900071898/074460 INDRAWATI DEWI,NY Dameria Sri OL00021 Lansoprazole (OGB) 6.00 Capsul 2,230.00 13,880.00
R2019-0000075019 24-12-2019 201900071898/074460 INDRAWATI DEWI,NY Dameria Sri OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000075019 24-12-2019 201900071898/074460 INDRAWATI DEWI,NY Dameria Sri OF00007 Farbion Tablet 6.00 Tablet 1,782.00 11,192.00
R2019-0000075022 23-12-2019 201900071721/080650 SUPRAYITNO,TN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000075022 23-12-2019 201900071721/080650 SUPRAYITNO,TN LUSY E. Dr.Sp.PD OG00021 Glimepiride 1mg Tablet 7.00 Tablet 1,245.00 9,215.00
R2019-0000075022 23-12-2019 201900071721/080650 SUPRAYITNO,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000075022 23-12-2019 201900071721/080650 SUPRAYITNO,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000075022 23-12-2019 201900071721/080650 SUPRAYITNO,TN LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000075025 25-12-2019 201900072073/112221 LILIK PUJIWATI,NY Niki Juniar OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000075025 25-12-2019 201900072073/112221 LILIK PUJIWATI,NY Niki Juniar OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000075025 25-12-2019 201900072073/112221 LILIK PUJIWATI,NY Niki Juniar ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000075024 25-12-2019 201900072069/077027 ARJUNA KRISNA,AN Niki Juniar OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000075026 23-12-2019 201900071672/095173 SURIPAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000075026 23-12-2019 201900071672/095173 SURIPAH,NY LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 7.00 Tablet 3,164.00 22,648.00
R2019-0000075026 23-12-2019 201900071672/095173 SURIPAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075026 23-12-2019 201900071672/095173 SURIPAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075026 23-12-2019 201900071672/095173 SURIPAH,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 3.00 Tablet 315.26 1,445.78
Total 285,555,304.30
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 215 dari 266
ASAL RAWAT JALAN
R2019-0000075028 23-12-2019 201900071662/103812 SITI SANIAH,NY LUSY E. Dr.Sp.PD OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000075028 23-12-2019 201900071662/103812 SITI SANIAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075028 23-12-2019 201900071662/103812 SITI SANIAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000075028 23-12-2019 201900071662/103812 SITI SANIAH,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000075028 23-12-2019 201900071662/103812 SITI SANIAH,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000075028 23-12-2019 201900071662/103812 SITI SANIAH,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 3.00 Tablet 315.26 1,445.78
R2019-0000075030 23-12-2019 201900071658/079716 MISJEM,NY LUSY E. Dr.Sp.PD ON00075 Novomix 30 Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000075030 23-12-2019 201900071658/079716 MISJEM,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075030 23-12-2019 201900071658/079716 MISJEM,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000075030 23-12-2019 201900071658/079716 MISJEM,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 3.00 Tablet 315.26 1,445.78
R2019-0000075030 23-12-2019 201900071658/079716 MISJEM,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000075030 23-12-2019 201900071658/079716 MISJEM,NY LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000075030 23-12-2019 201900071658/079716 MISJEM,NY LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000075027 25-12-2019 201900072055/083121 WIDYA DEWI Niki Juniar OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000075027 25-12-2019 201900072055/083121 WIDYA DEWI Niki Juniar OC00060 Cetirizine 10mg (OGB) 4.00 Tablet 623.70 2,994.80
R2019-0000075029 25-12-2019 201900072054/073794 SALBIAH,NY Niki Juniar OA00106 Asam Mefenamat 500mg 4.00 Tablet 415.80 2,163.20
R2019-0000075029 25-12-2019 201900072054/073794 SALBIAH,NY Niki Juniar OL00108 Lexatrans 500mg 4.00 Tablet 1,871.00 7,984.00
R2019-0000075033 25-12-2019 201900072077/059516 MAIDA RUSMIYATI,NY Niki Juniar ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000075033 25-12-2019 201900072077/059516 MAIDA RUSMIYATI,NY Niki Juniar OI00054 Infus Otsu-RL, 500ml 1.00 Botol 17,820.00 18,320.00
R2019-0000075033 25-12-2019 201900072077/059516 MAIDA RUSMIYATI,NY Niki Juniar ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000075033 25-12-2019 201900072077/059516 MAIDA RUSMIYATI,NY Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000075033 25-12-2019 201900072077/059516 MAIDA RUSMIYATI,NY Niki Juniar ON00039 Neurosanbe Injeksi 1.00 Ampul 8,122.95 8,622.95
R2019-0000075033 25-12-2019 201900072077/059516 MAIDA RUSMIYATI,NY Niki Juniar OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000075033 25-12-2019 201900072077/059516 MAIDA RUSMIYATI,NY Niki Juniar OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000075031 25-12-2019 201900071628/066402 DWI ERNASTUTI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 7.00 Tablet 371.25 3,098.75
R2019-0000075031 25-12-2019 201900071628/066402 DWI ERNASTUTI,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000075031 25-12-2019 201900071628/066402 DWI ERNASTUTI,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000075031 25-12-2019 201900071628/066402 DWI ERNASTUTI,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000075021 17-12-2019 201900070516/071013 ARDANIAH,NY Dameria Sri OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000075021 17-12-2019 201900070516/071013 ARDANIAH,NY Dameria Sri OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075021 17-12-2019 201900070516/071013 ARDANIAH,NY Dameria Sri OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000075021 17-12-2019 201900070516/071013 ARDANIAH,NY Dameria Sri OS00173 Simvastatin 20mg (OGB) 7.00 Tablet 1,782.00 12,974.00
R2019-0000075021 17-12-2019 201900070516/071013 ARDANIAH,NY Dameria Sri OV00045 Valis anbe 2mg Tablet 20.00 Tablet 348.98 7,479.60
R2019-0000075021 17-12-2019 201900070516/071013 ARDANIAH,NY Dameria Sri OV00080 Vitamin B Compleks 14.00 Tablet 241.79 3,885.06
R2019-0000075036 25-12-2019 201900072073/112221 LILIK PUJIWATI,NY Niki Juniar OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000075036 25-12-2019 201900072073/112221 LILIK PUJIWATI,NY Niki Juniar OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075036 25-12-2019 201900072073/112221 LILIK PUJIWATI,NY Niki Juniar OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000075036 25-12-2019 201900072073/112221 LILIK PUJIWATI,NY Niki Juniar OB00016 Betahistine Mesilat 6mg 6.00 Tablet 1,500.00 9,500.00
Total 286,900,335.27
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 216 dari 266
ASAL RAWAT JALAN
R2019-0000075036 25-12-2019 201900072073/112221 LILIK PUJIWATI,NY Niki Juniar ALI00004 I.V Catheter No. 20 2.00 Pcs 36,808.20 74,116.40
R2019-0000075036 25-12-2019 201900072073/112221 LILIK PUJIWATI,NY Niki Juniar OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000075036 25-12-2019 201900072073/112221 LILIK PUJIWATI,NY Niki Juniar OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000075034 17-12-2019 201900070505/111113 RAJIYEM,NY Alvarez Sp .OT OC00010 Calcium Lactat 500mg 7.00 Tablet 302.37 2,616.59
R2019-0000075034 17-12-2019 201900070505/111113 RAJIYEM,NY Alvarez Sp .OT OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000075034 17-12-2019 201900070505/111113 RAJIYEM,NY Alvarez Sp .OT OE00057 Eperisone Hcl 50mg 14.00 Tablet 2,286.90 32,516.60
R2019-0000075039 17-12-2019 201900070506/082057 MOHAMMAD LUTFI Dameria Sri OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000075039 17-12-2019 201900070506/082057 MOHAMMAD LUTFI Dameria Sri OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075039 17-12-2019 201900070506/082057 MOHAMMAD LUTFI Dameria Sri OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075039 17-12-2019 201900070506/082057 MOHAMMAD LUTFI Dameria Sri OM00017 Meloxicam 15mg (OGB) 8.00 Tablet 2,079.00 17,132.00
R2019-0000075039 17-12-2019 201900070506/082057 MOHAMMAD LUTFI Dameria Sri OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000075038 17-12-2019 201900070518/073817 SARDJONO,TN Dwi Astuti, dr OG00057 Gabapentin 300mg (OGB) 14.00 Tablet 8,168.00 114,852.00
R2019-0000075038 17-12-2019 201900070518/073817 SARDJONO,TN Dwi Astuti, dr OE00057 Eperisone Hcl 50mg 14.00 Tablet 2,286.90 32,516.60
R2019-0000075038 17-12-2019 201900070518/073817 SARDJONO,TN Dwi Astuti, dr OP00011 Paracetamol 500mg 20.00 Tablet 387.36 8,247.20
R2019-0000075038 17-12-2019 201900070518/073817 SARDJONO,TN Dwi Astuti, dr OB00016 Betahistine Mesilat 6mg 15.00 Tablet 1,500.00 23,000.00
R2019-0000075038 17-12-2019 201900070518/073817 SARDJONO,TN Dwi Astuti, dr OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000075043 25-12-2019 201900072074/094860 MALINDA,NY ADE RAHMAH OA00074 Analsik 3.00 Tablet 2,264.63 7,293.89
R2019-0000075043 25-12-2019 201900072074/094860 MALINDA,NY ADE RAHMAH OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000075040 17-12-2019 201900070507/077906 AGUSTINA LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000075040 17-12-2019 201900070507/077906 AGUSTINA LUSY E. Dr.Sp.PD OS00173 Simvastatin 20mg (OGB) 7.00 Tablet 1,782.00 12,974.00
R2019-0000075045 23-12-2019 201900071673/088410 ACHMAD BAKIR,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075045 23-12-2019 201900071673/088410 ACHMAD BAKIR,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075045 23-12-2019 201900071673/088410 ACHMAD BAKIR,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000075045 23-12-2019 201900071673/088410 ACHMAD BAKIR,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000075045 23-12-2019 201900071673/088410 ACHMAD BAKIR,TN LUSY E. Dr.Sp.PD OV00080 Vitamin B Compleks 7.00 Tablet 241.79 2,192.53
R2019-0000075044 25-12-2019 201900072079/112222 IDA FARIDA,NY ADE RAHMAH OT00107 Topazol Injeksi, 40mg 1.00 Vial 218,295.00 218,795.00
R2019-0000075044 25-12-2019 201900072079/112222 IDA FARIDA,NY ADE RAHMAH ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000075044 25-12-2019 201900072079/112222 IDA FARIDA,NY ADE RAHMAH OS00176 Scopma Plus Tablet 1.00 Tablet 2,090.22 2,590.22
R2019-0000075046 25-12-2019 201900072079/112222 IDA FARIDA,NY ADE RAHMAH OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000075046 25-12-2019 201900072079/112222 IDA FARIDA,NY ADE RAHMAH OL00076 Lodia 2mg 10.00 Tablet 1,485.00 15,350.00
R2019-0000075046 25-12-2019 201900072079/112222 IDA FARIDA,NY ADE RAHMAH OS00176 Scopma Plus Tablet 10.00 Tablet 2,090.22 21,402.20
R2019-0000075046 25-12-2019 201900072079/112222 IDA FARIDA,NY ADE RAHMAH OO00074 Ondansetron Tablet, 4mg 10.00 Tablet 4,455.00 45,050.00
R2019-0000075046 25-12-2019 201900072079/112222 IDA FARIDA,NY ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075047 25-12-2019 201900072081/112223 NOVI YULIANI,NY ADE RAHMAH OS00176 Scopma Plus Tablet 10.00 Tablet 2,090.22 21,402.20
R2019-0000075047 25-12-2019 201900072081/112223 NOVI YULIANI,NY ADE RAHMAH OE00022 Eprinoc Tablet 10.00 Tablet 5,093.55 51,435.50
R2019-0000075050 25-12-2019 201900072085/112225 AJIE HOGANTARA ADE RAHMAH OA00088 Antiza Tablet 5.00 Tablet 1,633.00 8,665.00
R2019-0000075050 25-12-2019 201900072085/112225 AJIE HOGANTARA ADE RAHMAH OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
R2019-0000075050 25-12-2019 201900072085/112225 AJIE HOGANTARA ADE RAHMAH OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
Total 288,049,515.33
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 217 dari 266
ASAL RAWAT JALAN
R2019-0000075049 25-12-2019 201900072087/101568 TONY NOOR,TN ADE RAHMAH OS00014 Sanadryl DMP Syrup, 60ml 1.00 Botol 17,820.00 18,320.00
R2019-0000075068 25-12-2019 201900072089/112226 SALAMIYAH,NY ADE RAHMAH OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000075068 25-12-2019 201900072089/112226 SALAMIYAH,NY ADE RAHMAH OI00001 Ibuprofen 400mg (OGB) 5.00 Tablet 682.00 3,910.00
R2019-0000075068 25-12-2019 201900072089/112226 SALAMIYAH,NY ADE RAHMAH OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000075051 25-12-2019 201900072090/112227 KHUSNUL ADE RAHMAH OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000075051 25-12-2019 201900072090/112227 KHUSNUL ADE RAHMAH OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000075051 25-12-2019 201900072090/112227 KHUSNUL ADE RAHMAH ON00009 Natrium Diklofenac 50mg 3.00 Tablet 955.84 3,367.52
R2019-0000075071 25-12-2019 201900070793/112032 KUNNAENI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 10.00 Tablet 10,617.75 106,677.50
R2019-0000075071 25-12-2019 201900070793/112032 KUNNAENI,NY LUSY E. Dr.Sp.PD OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000075074 23-12-2019 201900071706/079113 WIYONO,TN Dameria Sri OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000075074 23-12-2019 201900071706/079113 WIYONO,TN Dameria Sri OS00173 Simvastatin 20mg (OGB) 7.00 Tablet 1,782.00 12,974.00
R2019-0000075074 23-12-2019 201900071706/079113 WIYONO,TN Dameria Sri OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075074 23-12-2019 201900071706/079113 WIYONO,TN Dameria Sri OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000075074 23-12-2019 201900071706/079113 WIYONO,TN Dameria Sri OF00007 Farbion Tablet 10.00 Tablet 1,782.00 18,320.00
R2019-0000075075 23-12-2019 201900071706/079113 WIYONO,TN Dameria Sri OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000075075 23-12-2019 201900071706/079113 WIYONO,TN Dameria Sri OS00173 Simvastatin 20mg (OGB) 23.00 Tablet 1,782.00 41,486.00
R2019-0000075075 23-12-2019 201900071706/079113 WIYONO,TN Dameria Sri OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000075075 23-12-2019 201900071706/079113 WIYONO,TN Dameria Sri OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000075076 23-12-2019 201900071687/110089 NORAENI RASYID,NY LUSY E. Dr.Sp.PD OT00046 Thyrozol 10mg 14.00 Tablet 2,913.41 41,287.74
R2019-0000075076 23-12-2019 201900071687/110089 NORAENI RASYID,NY LUSY E. Dr.Sp.PD OP00118 Propanolol 40mg (OGB) 3.00 Tablet 404.89 1,714.67
R2019-0000075077 23-12-2019 201900071687/110089 NORAENI RASYID,NY LUSY E. Dr.Sp.PD OT00046 Thyrozol 10mg 46.00 Tablet 2,913.41 134,516.86
R2019-0000075077 23-12-2019 201900071687/110089 NORAENI RASYID,NY LUSY E. Dr.Sp.PD OP00118 Propanolol 40mg (OGB) 12.00 Tablet 404.89 5,358.68
R2019-0000075072 25-12-2019 201900072095/035595 RAHMAT MAULANA,TN ADE RAHMAH OA00088 Antiza Tablet 3.00 Tablet 1,633.00 5,399.00
R2019-0000075078 23-12-2019 201900071669/107833 DASWANI,NY LUSY E. Dr.Sp.PD OT00135 Thyrozol 5mg 14.00 Tablet 2,188.89 31,144.46
R2019-0000075078 23-12-2019 201900071669/107833 DASWANI,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075078 23-12-2019 201900071669/107833 DASWANI,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000075079 23-12-2019 201900071669/107833 DASWANI,NY LUSY E. Dr.Sp.PD OT00135 Thyrozol 5mg 46.00 Tablet 2,188.89 101,188.94
R2019-0000075081 23-12-2019 201900071647/111876 NUR PUTRI LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 2.00 Pcs 3,690.00 7,880.00
R2019-0000075082 23-12-2019 201900071643/059164 PARMAN,TN LUSY E. Dr.Sp.PD OP00184 Neo Protifed Tablet 10.00 Tablet 1,263.73 13,137.30
R2019-0000075082 23-12-2019 201900071643/059164 PARMAN,TN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000075082 23-12-2019 201900071643/059164 PARMAN,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000075082 23-12-2019 201900071643/059164 PARMAN,TN LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 7.00 Botol 10,395.00 73,265.00
R2019-0000075082 23-12-2019 201900071643/059164 PARMAN,TN LUSY E. Dr.Sp.PD OE00054 Euthyrox 100mcg 7.00 Tablet 3,256.93 23,298.51
R2019-0000075083 23-12-2019 201900071643/059164 PARMAN,TN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000075083 23-12-2019 201900071643/059164 PARMAN,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000075083 23-12-2019 201900071643/059164 PARMAN,TN LUSY E. Dr.Sp.PD OE00054 Euthyrox 100mcg 23.00 Tablet 3,256.93 75,409.39
R2019-0000075084 23-12-2019 201900071655/088387 SRI YUN CAHYANI,NY LUSY E. Dr.Sp.PD OG00025 Gliquidone 30mg (OGB) 14.00 Tablet 1,967.44 28,044.16
Total 289,370,759.96
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 218 dari 266
ASAL RAWAT JALAN
R2019-0000075084 23-12-2019 201900071655/088387 SRI YUN CAHYANI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000075084 23-12-2019 201900071655/088387 SRI YUN CAHYANI,NY LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000075085 23-12-2019 201900071655/088387 SRI YUN CAHYANI,NY LUSY E. Dr.Sp.PD OG00025 Gliquidone 30mg (OGB) 46.00 Tablet 1,967.44 91,002.24
R2019-0000075085 23-12-2019 201900071655/088387 SRI YUN CAHYANI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 46.00 Tablet 371.25 17,577.50
R2019-0000075085 23-12-2019 201900071655/088387 SRI YUN CAHYANI,NY LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000075073 25-12-2019 201900072096/109068 MUHAMMAD ZIDAN ADE RAHMAH OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000075073 25-12-2019 201900072096/109068 MUHAMMAD ZIDAN ADE RAHMAH OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000075086 23-12-2019 201900071683/108088 SUYONO SALIM,TN Dameria Sri OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000075086 23-12-2019 201900071683/108088 SUYONO SALIM,TN Dameria Sri OS00173 Simvastatin 20mg (OGB) 7.00 Tablet 1,782.00 12,974.00
R2019-0000075086 23-12-2019 201900071683/108088 SUYONO SALIM,TN Dameria Sri OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000075086 23-12-2019 201900071683/108088 SUYONO SALIM,TN Dameria Sri OA00043 Alprazolam 0,5mg (OGB) 7.00 Tablet 996.50 7,475.50
R2019-0000075086 23-12-2019 201900071683/108088 SUYONO SALIM,TN Dameria Sri OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075087 23-12-2019 201900071683/108088 SUYONO SALIM,TN Dameria Sri OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000075087 23-12-2019 201900071683/108088 SUYONO SALIM,TN Dameria Sri OS00173 Simvastatin 20mg (OGB) 23.00 Tablet 1,782.00 41,486.00
R2019-0000075087 23-12-2019 201900071683/108088 SUYONO SALIM,TN Dameria Sri OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2019-0000075087 23-12-2019 201900071683/108088 SUYONO SALIM,TN Dameria Sri OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000075088 25-12-2019 201900072099/112228 P INDRA MURTHI ADE RAHMAH OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000075080 25-12-2019 201900072093/067317 FARIS RIDHWAN ADE RAHMAH OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000075080 25-12-2019 201900072093/067317 FARIS RIDHWAN ADE RAHMAH OI00001 Ibuprofen 400mg (OGB) 5.00 Tablet 682.00 3,910.00
R2019-0000075089 25-12-2019 201900072098/053054 YETI TRIPUJI ADE RAHMAH OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000075092 25-12-2019 201900072094/058694 SALWA DZIKRA ADE RAHMAH OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000075092 25-12-2019 201900072094/058694 SALWA DZIKRA ADE RAHMAH OC00097 Codein 15mg 2.00 Tablet 1,665.87 3,831.74
R2019-0000075092 25-12-2019 201900072094/058694 SALWA DZIKRA ADE RAHMAH OC00132 CTM 4mg 3.00 Tablet 157.41 972.23
R2019-0000075092 25-12-2019 201900072094/058694 SALWA DZIKRA ADE RAHMAH OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000075092 25-12-2019 201900072094/058694 SALWA DZIKRA ADE RAHMAH ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000075092 25-12-2019 201900072094/058694 SALWA DZIKRA ADE RAHMAH OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000075092 25-12-2019 201900072094/058694 SALWA DZIKRA ADE RAHMAH OP00011 Paracetamol 500mg 1.00 Tablet 387.36 887.36
R2019-0000075090 25-12-2019 201900072098/053054 YETI TRIPUJI ADE RAHMAH OL00080 Loratadin 10mg (OGB) 10.00 Tablet 520.00 5,700.00
R2019-0000075090 25-12-2019 201900072098/053054 YETI TRIPUJI ADE RAHMAH OC00120 Cortidex Tablet 10.00 Tablet 430.65 4,806.50
R2019-0000075093 25-12-2019 201900072099/112228 P INDRA MURTHI ADE RAHMAH OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000075093 25-12-2019 201900072099/112228 P INDRA MURTHI ADE RAHMAH OO00022 Opicef 500mg Capsul 10.00 Capsul 14,850.00 149,000.00
R2019-0000075093 25-12-2019 201900072099/112228 P INDRA MURTHI ADE RAHMAH OR00003 Ranitidin 150mg (OGB) 10.00 Tablet 891.00 9,410.00
R2019-0000075091 25-12-2019 201900072092/100589 MURSALIM,TN ADE RAHMAH OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000075091 25-12-2019 201900072092/100589 MURSALIM,TN ADE RAHMAH OA00106 Asam Mefenamat 500mg 5.00 Tablet 415.80 2,579.00
R2019-0000075091 25-12-2019 201900072092/100589 MURSALIM,TN ADE RAHMAH OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000075091 25-12-2019 201900072092/100589 MURSALIM,TN ADE RAHMAH OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000075091 25-12-2019 201900072092/100589 MURSALIM,TN ADE RAHMAH OP00184 Neo Protifed Tablet 3.00 Tablet 1,263.73 4,291.19
R2019-0000075098 25-12-2019 201900072089/112226 SALAMIYAH,NY ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
Total 290,313,770.87
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 219 dari 266
ASAL RAWAT JALAN
R2019-0000075097 25-12-2019 201900072100/109702 NAZIM ARIL ADE RAHMAH OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000075099 25-12-2019 201900072103/082095 HUSNUL ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000075101 25-12-2019 201900072074/094860 MALINDA,NY ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000075100 25-12-2019 201900072092/100589 MURSALIM,TN ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075100 25-12-2019 201900072092/100589 MURSALIM,TN ADE RAHMAH OP00136 Pulmicort Respules 2.00 Ampul 33,802.98 68,105.96
R2019-0000075100 25-12-2019 201900072092/100589 MURSALIM,TN ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000075102 25-12-2019 201900072108/112229 EPI NURYANI,NY ADE RAHMAH OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000075102 25-12-2019 201900072108/112229 EPI NURYANI,NY ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000075102 25-12-2019 201900072108/112229 EPI NURYANI,NY ADE RAHMAH ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000075103 25-12-2019 201900072104/027431 SAHMAL RUHIP, SE,TN ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075103 25-12-2019 201900072104/027431 SAHMAL RUHIP, SE,TN ADE RAHMAH OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000075104 25-12-2019 201900072104/027431 SAHMAL RUHIP, SE,TN ADE RAHMAH OF00039 FG Troches 10.00 Tablet 1,730.02 17,800.20
R2019-0000075104 25-12-2019 201900072104/027431 SAHMAL RUHIP, SE,TN ADE RAHMAH OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000075104 25-12-2019 201900072104/027431 SAHMAL RUHIP, SE,TN ADE RAHMAH OA00180 Acetylcyst ein 200mg 5.00 Tablet 1,485.00 7,925.00
R2019-0000075104 25-12-2019 201900072104/027431 SAHMAL RUHIP, SE,TN ADE RAHMAH OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000075106 25-12-2019 201900072106/085876 SATRIA KEVIN Eko Dian Syafitra OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000075106 25-12-2019 201900072106/085876 SATRIA KEVIN Eko Dian Syafitra OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000075107 25-12-2019 201900072107/105354 A IMAN BANGSAWAN Eko Dian Syafitra OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000075107 25-12-2019 201900072107/105354 A IMAN BANGSAWAN Eko Dian Syafitra OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000075107 25-12-2019 201900072107/105354 A IMAN BANGSAWAN Eko Dian Syafitra OS00009 Salbutamol 2mg (OGB) 10.00 Tablet 213.30 2,633.00
R2019-0000075107 25-12-2019 201900072107/105354 A IMAN BANGSAWAN Eko Dian Syafitra OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000075107 25-12-2019 201900072107/105354 A IMAN BANGSAWAN Eko Dian Syafitra OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000075110 26-12-2019 201900072110/112231 WAGI,TN Eko Dian Syafitra OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000075110 26-12-2019 201900072110/112231 WAGI,TN Eko Dian Syafitra OS00176 Scopma Plus Tablet 10.00 Tablet 2,090.22 21,402.20
R2019-0000075108 25-12-2019 201900072105/112230 AMBO NGANDRO,TN Eko Dian Syafitra OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000075108 25-12-2019 201900072105/112230 AMBO NGANDRO,TN Eko Dian Syafitra ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000075108 25-12-2019 201900072105/112230 AMBO NGANDRO,TN Eko Dian Syafitra ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000075108 25-12-2019 201900072105/112230 AMBO NGANDRO,TN Eko Dian Syafitra ALU00007 Urine Bag 1.00 Pcs 19,305.00 19,805.00
R2019-0000075108 25-12-2019 201900072105/112230 AMBO NGANDRO,TN Eko Dian Syafitra ALF00007 Folley Catheter No. 14 1.00 Pcs 37,125.00 37,625.00
R2019-0000075108 25-12-2019 201900072105/112230 AMBO NGANDRO,TN Eko Dian Syafitra OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000075108 25-12-2019 201900072105/112230 AMBO NGANDRO,TN Eko Dian Syafitra OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000075108 25-12-2019 201900072105/112230 AMBO NGANDRO,TN Eko Dian Syafitra OF00094 Furosemide Injeksi, 1.00 Ampul 5,259.87 5,759.87
R2019-0000075129 25-12-2019 201900072105/112230 AMBO NGANDRO,TN Eko Dian Syafitra ALN00013 NGT (Stomach Tube) No. 1.00 Pcs 44,550.00 45,050.00
R2019-0000075129 25-12-2019 201900072105/112230 AMBO NGANDRO,TN Eko Dian Syafitra ALD00006 Disposable Syringe 50ml 1.00 Pcs 32,670.00 33,170.00
R2019-0000075129 25-12-2019 201900072105/112230 AMBO NGANDRO,TN Eko Dian Syafitra ALM00015 Masker Oxygen Non 1.00 Pcs 82,863.00 83,363.00
R2019-0000075129 25-12-2019 201900072105/112230 AMBO NGANDRO,TN Eko Dian Syafitra OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000075129 25-12-2019 201900072105/112230 AMBO NGANDRO,TN Eko Dian Syafitra OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000075130 25-12-2019 201900072106/085876 SATRIA KEVIN Eko Dian Syafitra OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
Total 291,108,456.13
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 220 dari 266
ASAL RAWAT JALAN
R2019-0000075131 25-12-2019 201900072107/105354 A IMAN BANGSAWAN Eko Dian Syafitra OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075131 25-12-2019 201900072107/105354 A IMAN BANGSAWAN Eko Dian Syafitra OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000075153 26-12-2019 201900072131/086739 NURI,NY Herika dr. OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000075153 26-12-2019 201900072131/086739 NURI,NY Herika dr. OB00050 Braxidin 4.00 Tablet 1,648.35 7,093.40
R2019-0000075154 26-12-2019 201900072143/112234 NUNUNG HODIJAH,NY IRMA SARI OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000075154 26-12-2019 201900072143/112234 NUNUNG HODIJAH,NY IRMA SARI OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000075154 26-12-2019 201900072143/112234 NUNUNG HODIJAH,NY IRMA SARI OM00102 Mucohexin Elixir, 120ml 1.00 Botol 24,354.00 24,854.00
R2019-0000075154 26-12-2019 201900072143/112234 NUNUNG HODIJAH,NY IRMA SARI OL00017 Lameson 4mg 7.00 5,049.00 35,843.00
R2019-0000075154 26-12-2019 201900072143/112234 NUNUNG HODIJAH,NY IRMA SARI OS00010 Salbutamol 4mg (OGB) 10.00 Tablet 249.48 2,994.80
R2019-0000075136 26-12-2019 201900072118/024707 MUHAMMAD IMAM Herika dr. OA00180 Acetylcyst ein 200mg 6.00 Tablet 1,485.00 9,410.00
R2019-0000075136 26-12-2019 201900072118/024707 MUHAMMAD IMAM Herika dr. OS00010 Salbutamol 4mg (OGB) 6.00 Tablet 249.48 1,996.88
R2019-0000075136 26-12-2019 201900072118/024707 MUHAMMAD IMAM Herika dr. OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000075136 26-12-2019 201900072118/024707 MUHAMMAD IMAM Herika dr. OM00045 Methyl Prednisolon 4mg 4.00 Tablet 792.99 3,671.96
R2019-0000075155 26-12-2019 201900072113/081228 ARBAYAH,NY Maulin Nikmah OG00057 Gabapentin 300mg (OGB) 6.00 Tablet 8,168.00 49,508.00
R2019-0000075157 26-12-2019 201900072145/067026 MARLINA MARGA,NY Herika dr. OP00164 Pumpitor Injeksi 1.00 Vial 222,750.00 223,250.00
R2019-0000075157 26-12-2019 201900072145/067026 MARLINA MARGA,NY Herika dr. OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000075157 26-12-2019 201900072145/067026 MARLINA MARGA,NY Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000075157 26-12-2019 201900072145/067026 MARLINA MARGA,NY Herika dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000075156 26-12-2019 201900072138/016346 LILI MUSRIATUN,NY Maulin Nikmah OG00057 Gabapentin 300mg (OGB) 5.00 Tablet 8,168.00 41,340.00
R2019-0000075111 26-12-2019 201900072153/112237 SRI JUBAIDAH,NY Herika dr. OP00164 Pumpitor Injeksi 1.00 Vial 222,750.00 223,250.00
R2019-0000075111 26-12-2019 201900072153/112237 SRI JUBAIDAH,NY Herika dr. OD00058 Dipenhydramine Injeksi 2.00 Ampul 2,517.23 5,534.46
R2019-0000075111 26-12-2019 201900072153/112237 SRI JUBAIDAH,NY Herika dr. ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000075160 26-12-2019 201900072145/067026 MARLINA MARGA,NY Herika dr. OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000075160 26-12-2019 201900072145/067026 MARLINA MARGA,NY Herika dr. OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000075160 26-12-2019 201900072145/067026 MARLINA MARGA,NY Herika dr. OB00050 Braxidin 10.00 Tablet 1,648.35 16,983.50
R2019-0000075161 26-12-2019 201900072147/101008 FITRIANSYAH,TN Herika dr. OC00039 Cefixime 100mg (OGB) 12.00 Capsul 4,266.70 51,700.40
R2019-0000075161 26-12-2019 201900072147/101008 FITRIANSYAH,TN Herika dr. OF00039 FG Troches 3.00 Tablet 1,730.02 5,690.06
R2019-0000075161 26-12-2019 201900072147/101008 FITRIANSYAH,TN Herika dr. OP00011 Paracetamol 500mg 8.00 Tablet 387.36 3,598.88
R2019-0000075158 26-12-2019 201900072153/112237 SRI JUBAIDAH,NY Herika dr. OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000075158 26-12-2019 201900072153/112237 SRI JUBAIDAH,NY Herika dr. OF00065 Flunarizine 5mg 10.00 Tablet 2,970.00 30,200.00
R2019-0000075158 26-12-2019 201900072153/112237 SRI JUBAIDAH,NY Herika dr. OF00007 Farbion Tablet 10.00 Tablet 1,782.00 18,320.00
R2019-0000075158 26-12-2019 201900072153/112237 SRI JUBAIDAH,NY Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000075164 26-12-2019 201900072166/112240 SAID AQIYLA PUTRA IRMA SARI OC00120 Cortidex Tablet 10.00 Tablet 430.65 4,806.50
R2019-0000075164 26-12-2019 201900072166/112240 SAID AQIYLA PUTRA IRMA SARI OM00080 Molakrim 30gr 1.00 Tube 18,859.50 19,359.50
R2019-0000075165 26-12-2019 201900072177/112243 NATHAN,AN Herika dr. OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000075165 26-12-2019 201900072177/112243 NATHAN,AN Herika dr. OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000075165 26-12-2019 201900072177/112243 NATHAN,AN Herika dr. OA00070 Amoxsan Dry Syrup 1.00 Botol 33,412.50 33,912.50
R2019-0000075169 26-12-2019 201900072167/087534 DEVI ALAWIYAH Herika dr. OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
Total 292,414,159.79
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 221 dari 266
ASAL RAWAT JALAN
R2019-0000075169 26-12-2019 201900072167/087534 DEVI ALAWIYAH Herika dr. OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000075168 26-12-2019 201900072169/094623 MUHAMMAD BIMA Herika dr. OM00097 Mucera Drop 1.00 Botol 54,945.00 55,445.00
R2019-0000075168 26-12-2019 201900072169/094623 MUHAMMAD BIMA Herika dr. OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2019-0000075168 26-12-2019 201900072169/094623 MUHAMMAD BIMA Herika dr. OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000075174 26-12-2019 201900072203/112248 ADEEBA SHAKILA Herika dr. OO00040 Oralit 200 6.00 Sachet 706.00 4,736.00
R2019-0000075174 26-12-2019 201900072203/112248 ADEEBA SHAKILA Herika dr. OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000075174 26-12-2019 201900072203/112248 ADEEBA SHAKILA Herika dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075175 26-12-2019 201900072195/112246 DEVI ROVIKA Herika dr. OO00040 Oralit 200 6.00 Sachet 706.00 4,736.00
R2019-0000075175 26-12-2019 201900072195/112246 DEVI ROVIKA Herika dr. OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000075175 26-12-2019 201900072195/112246 DEVI ROVIKA Herika dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075176 26-12-2019 201900072217/112251 IRSAM SABIR,TN Herika dr. OI00023 Inerson Cream 1.00 Tube 101,351.25 101,851.25
R2019-0000075176 26-12-2019 201900072217/112251 IRSAM SABIR,TN Herika dr. OF00090 Fucilex Cream, 5gr 1.00 Tube 14,850.00 15,350.00
R2019-0000075176 26-12-2019 201900072217/112251 IRSAM SABIR,TN Herika dr. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 14,000.00
R2019-0000075176 26-12-2019 201900072217/112251 IRSAM SABIR,TN Herika dr. OI00126 Interhistin 50mg, Tablet 10.00 Tablet 1,173.15 12,231.50
R2019-0000075177 26-12-2019 201900072212/112250 MUSWARANDI,SDR Herika dr. OL00063 Lidocain HCl 2% Injeksi 2.00 Ampul 2,376.00 5,252.00
R2019-0000075177 26-12-2019 201900072212/112250 MUSWARANDI,SDR Herika dr. OE00056 Ecosol Nacl 0,9 % 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000075177 26-12-2019 201900072212/112250 MUSWARANDI,SDR Herika dr. ALU00004 Underpad 1.00 Pcs 11,880.00 12,380.00
R2019-0000075179 26-12-2019 201900072169/094623 MUHAMMAD BIMA Herika dr. OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075179 26-12-2019 201900072169/094623 MUHAMMAD BIMA Herika dr. OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000075179 26-12-2019 201900072169/094623 MUHAMMAD BIMA Herika dr. OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000075178 26-12-2019 201900072118/024707 MUHAMMAD IMAM Herika dr. OV00057 Ventolin Nebules 2.5mg 3.00 Ampul 15,365.00 46,595.00
R2019-0000075178 26-12-2019 201900072118/024707 MUHAMMAD IMAM Herika dr. OP00136 Pulmicort Respules 3.00 Ampul 33,802.98 101,908.94
R2019-0000075178 26-12-2019 201900072118/024707 MUHAMMAD IMAM Herika dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000075178 26-12-2019 201900072118/024707 MUHAMMAD IMAM Herika dr. OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000075178 26-12-2019 201900072118/024707 MUHAMMAD IMAM Herika dr. OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000075182 26-12-2019 201900072131/086739 NURI,NY Herika dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000075183 26-12-2019 201900072195/112246 DEVI ROVIKA Herika dr. OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000075183 26-12-2019 201900072195/112246 DEVI ROVIKA Herika dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000075183 26-12-2019 201900072195/112246 DEVI ROVIKA Herika dr. ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000075184 26-12-2019 201900072203/112248 ADEEBA SHAKILA Herika dr. OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000075184 26-12-2019 201900072203/112248 ADEEBA SHAKILA Herika dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000075184 26-12-2019 201900072203/112248 ADEEBA SHAKILA Herika dr. ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000075185 26-12-2019 201900072212/112250 MUSWARANDI,SDR Herika dr. OA00068 Amoxsan Capsul, 500mg 15.00 Capsul 4,752.00 71,780.00
R2019-0000075185 26-12-2019 201900072212/112250 MUSWARANDI,SDR Herika dr. OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000075187 26-12-2019 201900072237/112253 NORITA SIRAIT,NY Herika dr. OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000075187 26-12-2019 201900072237/112253 NORITA SIRAIT,NY Herika dr. OI00001 Ibuprofen 400mg (OGB) 4.00 Tablet 682.00 3,228.00
R2019-0000075200 26-12-2019 201900072250/112255 RIAN ANDRI Niki Juniar OB00016 Betahistine Mesilat 6mg 10.00 Tablet 1,500.00 15,500.00
R2019-0000075200 26-12-2019 201900072250/112255 RIAN ANDRI Niki Juniar OF00065 Flunarizine 5mg 5.00 Tablet 2,970.00 15,350.00
Total 293,340,993.92
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 222 dari 266
ASAL RAWAT JALAN
R2019-0000075200 26-12-2019 201900072250/112255 RIAN ANDRI Niki Juniar OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000075200 26-12-2019 201900072250/112255 RIAN ANDRI Niki Juniar OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000075190 26-12-2019 201900072158/062756 ADOLINA LUSY E. Dr.Sp.PD OT00046 Thyrozol 10mg 60.00 Tablet 2,913.41 175,304.60
R2019-0000075190 26-12-2019 201900072158/062756 ADOLINA LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 5.00 Tablet 5,197.50 26,487.50
R2019-0000075190 26-12-2019 201900072158/062756 ADOLINA LUSY E. Dr.Sp.PD OM00154 Mecobalamin 500mg 20.00 Tablet 1,118.00 22,860.00
R2019-0000075202 26-12-2019 201900072178/084829 HARUN WAHYUDI,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 10.00 Tablet 5,197.50 52,475.00
R2019-0000075204 26-12-2019 201900072182/095995 MUHAMMAD NASIR,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 10.00 Tablet 371.25 4,212.50
R2019-0000075204 26-12-2019 201900072182/095995 MUHAMMAD NASIR,TN LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 10.00 Tablet 445.50 4,955.00
R2019-0000075215 26-12-2019 201900072246/112254 JUNI HAMDILAH,TN Niki Juniar OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000075215 26-12-2019 201900072246/112254 JUNI HAMDILAH,TN Niki Juniar OD00065 Domperidon Tablet (OGB) 4.00 Tablet 750.00 3,500.00
R2019-0000075215 26-12-2019 201900072246/112254 JUNI HAMDILAH,TN Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000075215 26-12-2019 201900072246/112254 JUNI HAMDILAH,TN Niki Juniar OB00007 Becom - C 3.00 Tablet 2,123.55 6,870.65
R2019-0000075216 26-12-2019 201900072171/111966 SAODAH WATI,NY LUSY E. Dr.Sp.PD OI00097 Isosorbide Dinitrate 5mg 10.00 Tablet 311.85 3,618.50
R2019-0000075216 26-12-2019 201900072171/111966 SAODAH WATI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 3.00 Tablet 10,617.75 32,353.25
R2019-0000075216 26-12-2019 201900072171/111966 SAODAH WATI,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 3.00 Tablet 14,701.50 44,604.50
R2019-0000075216 26-12-2019 201900072171/111966 SAODAH WATI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 2.00 Tablet 5,197.50 10,895.00
R2019-0000075218 26-12-2019 201900072266/112258 IMAM BASRONI,TN Niki Juniar OA00125 ATS (Anti Tetanus 1.00 Ampul 222,750.00 223,250.00
R2019-0000075220 26-12-2019 201900072188/064063 WATINI,NY LUSY E. Dr.Sp.PD OC00182 Citicolin Tablet 500mg 10.00 Tablet 10,098.00 101,480.00
R2019-0000075223 26-12-2019 201900072262/107516 NATHAN AZFAR Niki Juniar OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000075221 26-12-2019 201900072252/065854 NURLIANA,NY Niki Juniar OL00041 Lasgan Capsul 10.00 Capsul 21,000.00 210,500.00
R2019-0000075221 26-12-2019 201900072252/065854 NURLIANA,NY Niki Juniar OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000075221 26-12-2019 201900072252/065854 NURLIANA,NY Niki Juniar OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000075221 26-12-2019 201900072252/065854 NURLIANA,NY Niki Juniar OE00057 Eperisone Hcl 50mg 10.00 Tablet 2,286.90 23,369.00
R2019-0000075221 26-12-2019 201900072252/065854 NURLIANA,NY Niki Juniar OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000075229 26-12-2019 201900072208/070676 PONIEM,NY LUSY E. Dr.Sp.PD OB00016 Betahistine Mesilat 6mg 10.00 Tablet 1,500.00 15,500.00
R2019-0000075229 26-12-2019 201900072208/070676 PONIEM,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075229 26-12-2019 201900072208/070676 PONIEM,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075232 26-12-2019 201900072194/088214 FEBE MASYE LUSY E. Dr.Sp.PD OT00135 Thyrozol 5mg 7.00 Tablet 2,188.89 15,822.23
R2019-0000075234 26-12-2019 201900072194/088214 FEBE MASYE LUSY E. Dr.Sp.PD OT00135 Thyrozol 5mg 23.00 Tablet 2,188.89 50,844.47
R2019-0000075233 26-12-2019 201900072196/055371 KURUSIAH,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000075233 26-12-2019 201900072196/055371 KURUSIAH,NY LUSY E. Dr.Sp.PD OC00134 Curcuma Tablet 10.00 Tablet 1,336.50 13,865.00
R2019-0000075233 26-12-2019 201900072196/055371 KURUSIAH,NY LUSY E. Dr.Sp.PD OS00093 Spironolacton 100mg 3.00 Tablet 2,200.00 7,100.00
R2019-0000075233 26-12-2019 201900072196/055371 KURUSIAH,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 14.00 Tablet 315.26 4,913.64
R2019-0000075235 26-12-2019 201900072210/112249 RACHMAN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000075235 26-12-2019 201900072210/112249 RACHMAN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075235 26-12-2019 201900072210/112249 RACHMAN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000075236 26-12-2019 201900072251/088660 POLSAR SIHOTANG,TN Niki Juniar OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
Total 294,842,490.29
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 223 dari 266
ASAL RAWAT JALAN
R2019-0000075236 26-12-2019 201900072251/088660 POLSAR SIHOTANG,TN Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000075236 26-12-2019 201900072251/088660 POLSAR SIHOTANG,TN Niki Juniar OB00050 Braxidin 4.00 Tablet 1,648.35 7,093.40
R2019-0000075236 26-12-2019 201900072251/088660 POLSAR SIHOTANG,TN Niki Juniar OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000075237 26-12-2019 201900072193/112245 ROSNAWATI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000075237 26-12-2019 201900072193/112245 ROSNAWATI,NY LUSY E. Dr.Sp.PD OL00108 Lexatrans 500mg 10.00 Tablet 1,871.00 19,210.00
R2019-0000075238 26-12-2019 201900072192/036015 SUPARMI,NY LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 7.00 Tablet 3,164.00 22,648.00
R2019-0000075238 26-12-2019 201900072192/036015 SUPARMI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000075238 26-12-2019 201900072192/036015 SUPARMI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075238 26-12-2019 201900072192/036015 SUPARMI,NY LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000075239 26-12-2019 201900072190/108570 ASRANI,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000075239 26-12-2019 201900072190/108570 ASRANI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075239 26-12-2019 201900072190/108570 ASRANI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075239 26-12-2019 201900072190/108570 ASRANI,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000075240 26-12-2019 201900072236/015924 ROSHANNA,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000075240 26-12-2019 201900072236/015924 ROSHANNA,NY LUSY E. Dr.Sp.PD OG00021 Glimepiride 1mg Tablet 7.00 Tablet 1,245.00 9,215.00
R2019-0000075240 26-12-2019 201900072236/015924 ROSHANNA,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000075240 26-12-2019 201900072236/015924 ROSHANNA,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000075240 26-12-2019 201900072236/015924 ROSHANNA,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000075242 26-12-2019 201900072272/097449 ROLAND MARLON Niki Juniar OS00016 Sanadryl Expectoran 1.00 Botol 14,701.50 15,201.50
R2019-0000075242 26-12-2019 201900072272/097449 ROLAND MARLON Niki Juniar OC00057 Cerini 5.00 Tablet 5,093.55 25,967.75
R2019-0000075242 26-12-2019 201900072272/097449 ROLAND MARLON Niki Juniar OI00134 Imunos Plus Tablet 5.00 Tablet 14,107.50 71,037.50
R2019-0000075242 26-12-2019 201900072272/097449 ROLAND MARLON Niki Juniar OC00144 Cefila Capsul, 100mg 6.00 Capsul 28,957.00 174,242.00
R2019-0000075241 26-12-2019 201900072191/102601 ARTINAH,NY LUSY E. Dr.Sp.PD OT00135 Thyrozol 5mg 7.00 Tablet 2,188.89 15,822.23
R2019-0000075241 26-12-2019 201900072191/102601 ARTINAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000075241 26-12-2019 201900072191/102601 ARTINAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075244 26-12-2019 201900072168/112032 KUNNAENI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 15.00 Tablet 371.25 6,068.75
R2019-0000075244 26-12-2019 201900072168/112032 KUNNAENI,NY LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 10.00 Tablet 2,525.00 25,750.00
R2019-0000075244 26-12-2019 201900072168/112032 KUNNAENI,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 10.00 Tablet 1,662.00 17,120.00
R2019-0000075244 26-12-2019 201900072168/112032 KUNNAENI,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 10.00 Tablet 10,617.75 106,677.50
R2019-0000075244 26-12-2019 201900072168/112032 KUNNAENI,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 5.00 Tablet 5,197.50 26,487.50
R2019-0000075243 26-12-2019 201900072170/091280 MAYA SARI,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000075243 26-12-2019 201900072170/091280 MAYA SARI,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075245 26-12-2019 201900072240/098527 SITI JULAEHA,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000075247 26-12-2019 201900072142/029806 NGATIANA,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075247 26-12-2019 201900072142/029806 NGATIANA,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000075247 26-12-2019 201900072142/029806 NGATIANA,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000075247 26-12-2019 201900072142/029806 NGATIANA,NY LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 7.00 Tablet 2,525.00 18,175.00
Total 295,963,948.74
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 224 dari 266
ASAL RAWAT JALAN
R2019-0000075246 26-12-2019 201900072245/036985 RISKY NASYUKHA Niki Juniar OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000075246 26-12-2019 201900072245/036985 RISKY NASYUKHA Niki Juniar OI00001 Ibuprofen 400mg (OGB) 4.00 Tablet 682.00 3,228.00
R2019-0000075248 26-12-2019 201900072129/019754 LINGSIR HARINI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000075248 26-12-2019 201900072129/019754 LINGSIR HARINI,NY LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 7.00 Tablet 2,525.00 18,175.00
R2019-0000075250 26-12-2019 201900072267/112259 DESY ERLIANA,NY Niki Juniar OP00011 Paracetamol 500mg 4.00 Tablet 387.36 2,049.44
R2019-0000075250 26-12-2019 201900072267/112259 DESY ERLIANA,NY Niki Juniar OB00007 Becom - C 3.00 Tablet 2,123.55 6,870.65
R2019-0000075250 26-12-2019 201900072267/112259 DESY ERLIANA,NY Niki Juniar OA00180 Acetylcyst ein 200mg 4.00 Tablet 1,485.00 6,440.00
R2019-0000075249 26-12-2019 201900072238/061362 SUMIYAT I,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000075249 26-12-2019 201900072238/061362 SUMIYAT I,NY LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 4.00 Capsul 4,266.70 17,566.80
R2019-0000075249 26-12-2019 201900072238/061362 SUMIYAT I,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000075249 26-12-2019 201900072238/061362 SUMIYAT I,NY LUSY E. Dr.Sp.PD OI00097 Isosorbide Dinitrate 5mg 21.00 Tablet 311.85 7,048.85
R2019-0000075249 26-12-2019 201900072238/061362 SUMIYAT I,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075249 26-12-2019 201900072238/061362 SUMIYAT I,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000075249 26-12-2019 201900072238/061362 SUMIYAT I,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000075249 26-12-2019 201900072238/061362 SUMIYAT I,NY LUSY E. Dr.Sp.PD ON00009 Natrium Diklofenac 50mg 6.00 Tablet 955.84 6,235.04
R2019-0000075249 26-12-2019 201900072238/061362 SUMIYAT I,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075251 26-12-2019 201900072238/061362 SUMIYAT I,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 46.00 Tablet 371.25 17,577.50
R2019-0000075251 26-12-2019 201900072238/061362 SUMIYAT I,NY LUSY E. Dr.Sp.PD OI00097 Isosorbide Dinitrate 5mg 69.00 Tablet 311.85 22,017.65
R2019-0000075251 26-12-2019 201900072238/061362 SUMIYAT I,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000075251 26-12-2019 201900072238/061362 SUMIYAT I,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000075251 26-12-2019 201900072238/061362 SUMIYAT I,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 23.00 Tablet 240.30 6,026.90
R2019-0000075251 26-12-2019 201900072238/061362 SUMIYAT I,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000075252 26-12-2019 201900072139/070918 SUAIBAH,NY LUSY E. Dr.Sp.PD OU00028 Ursodeoxycholic Acid 20.00 Tablet 9,147.60 183,452.00
R2019-0000075252 26-12-2019 201900072139/070918 SUAIBAH,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000075252 26-12-2019 201900072139/070918 SUAIBAH,NY LUSY E. Dr.Sp.PD OC00134 Curcuma Tablet 20.00 Tablet 1,336.50 27,230.00
R2019-0000075253 26-12-2019 201900072243/083235 BINTI MASROFAH,NY Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000075253 26-12-2019 201900072243/083235 BINTI MASROFAH,NY Niki Juniar OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075253 26-12-2019 201900072243/083235 BINTI MASROFAH,NY Niki Juniar OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000075253 26-12-2019 201900072243/083235 BINTI MASROFAH,NY Niki Juniar OB00016 Betahistine Mesilat 6mg 4.00 Tablet 1,500.00 6,500.00
R2019-0000075254 26-12-2019 201900072123/111085 FITRIANSYAH NUR,TN LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000075254 26-12-2019 201900072123/111085 FITRIANSYAH NUR,TN LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000075254 26-12-2019 201900072123/111085 FITRIANSYAH NUR,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075254 26-12-2019 201900072123/111085 FITRIANSYAH NUR,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075254 26-12-2019 201900072123/111085 FITRIANSYAH NUR,TN LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 7.00 Tablet 206.41 1,944.87
R2019-0000075255 26-12-2019 201900072115/090120 FARID RAMDHANI LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 2.00 Pcs 3,690.00 7,880.00
R2019-0000075255 26-12-2019 201900072115/090120 FARID RAMDHANI LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000075255 26-12-2019 201900072115/090120 FARID RAMDHANI LUSY E. Dr.Sp.PD OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000075255 26-12-2019 201900072115/090120 FARID RAMDHANI LUSY E. Dr.Sp.PD OE00056 Ecosol Nacl 0,9 % 500ml 1.00 Botol 19,305.00 19,805.00
Total 297,296,474.06
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 225 dari 266
ASAL RAWAT JALAN
R2019-0000075255 26-12-2019 201900072115/090120 FARID RAMDHANI LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000075255 26-12-2019 201900072115/090120 FARID RAMDHANI LUSY E. Dr.Sp.PD ALD00007 Disposable Syringe 5ml 1.00 Pcs 3,000.00 3,500.00
R2019-0000075256 26-12-2019 201900072115/090120 FARID RAMDHANI LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 6.00 Flexpen 226,917.80 1,362,006.80
R2019-0000075256 26-12-2019 201900072115/090120 FARID RAMDHANI LUSY E. Dr.Sp.PD OL00056 Levemir Insulin 3.00 Flexpen 287,330.88 862,492.64
R2019-0000075256 26-12-2019 201900072115/090120 FARID RAMDHANI LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000075256 26-12-2019 201900072115/090120 FARID RAMDHANI LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 46.00 Tablet 371.25 17,577.50
R2019-0000075257 26-12-2019 201900072112/112029 H. BARIAH,BY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075257 26-12-2019 201900072112/112029 H. BARIAH,BY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 7.00 Tablet 5,197.50 36,882.50
R2019-0000075257 26-12-2019 201900072112/112029 H. BARIAH,BY LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 2.00 Pcs 3,690.00 7,880.00
R2019-0000075258 26-12-2019 201900072112/112029 H. BARIAH,BY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000075258 26-12-2019 201900072112/112029 H. BARIAH,BY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000075258 26-12-2019 201900072112/112029 H. BARIAH,BY LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 4.00 Flexpen 226,917.80 908,171.20
R2019-0000075258 26-12-2019 201900072112/112029 H. BARIAH,BY LUSY E. Dr.Sp.PD OL00056 Levemir Insulin 2.00 Flexpen 287,330.88 575,161.76
R2019-0000075259 26-12-2019 201900072191/102601 ARTINAH,NY LUSY E. Dr.Sp.PD OT00135 Thyrozol 5mg 23.00 Tablet 2,188.89 50,844.47
R2019-0000075259 26-12-2019 201900072191/102601 ARTINAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000075259 26-12-2019 201900072191/102601 ARTINAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000075262 26-12-2019 201900072280/070526 ADAM PERDANA LUSY E. Dr.Sp.PD OA00140 Atorvastatin 20mg (OGB) 10.00 Tablet 6,534.00 65,840.00
R2019-0000075262 26-12-2019 201900072280/070526 ADAM PERDANA LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 10.00 Tablet 445.50 4,955.00
R2019-0000075262 26-12-2019 201900072280/070526 ADAM PERDANA LUSY E. Dr.Sp.PD OM00154 Mecobalamin 500mg 6.00 Tablet 1,118.00 7,208.00
R2019-0000075262 26-12-2019 201900072280/070526 ADAM PERDANA LUSY E. Dr.Sp.PD OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000075266 26-12-2019 201900072282/091288 MARYA BEAUTY Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000075266 26-12-2019 201900072282/091288 MARYA BEAUTY Niki Juniar OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075266 26-12-2019 201900072282/091288 MARYA BEAUTY Niki Juniar OB00050 Braxidin 4.00 Tablet 1,648.35 7,093.40
R2019-0000075267 26-12-2019 201900072281/104578 MARIANI,NY Niki Juniar OP00011 Paracetamol 500mg 4.00 Tablet 387.36 2,049.44
R2019-0000075267 26-12-2019 201900072281/104578 MARIANI,NY Niki Juniar OB00007 Becom - C 3.00 Tablet 2,123.55 6,870.65
R2019-0000075268 26-12-2019 201900072277/111947 MUHAMMAD NUR Riyanti Puji dr. OB00091 Biovitan Syrup, 60ml 1.00 Botol 8,019.00 8,519.00
R2019-0000075269 26-12-2019 201900072278/111948 MUHAMMAD Riyanti Puji dr. OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
R2019-0000075269 26-12-2019 201900072278/111948 MUHAMMAD Riyanti Puji dr. OB00091 Biovitan Syrup, 60ml 1.00 Botol 8,019.00 8,519.00
R2019-0000075270 26-12-2019 201900072283/111935 ZHAFRAN NUFAIL Riyanti Puji dr. OC00173 Cetirizine 10mg/ml Drop, 1.00 Botol 37,125.00 37,625.00
R2019-0000075273 26-12-2019 201900072284/109924 AISHADARA HAVVA Rianti dr. Sp.A OP00074 Pralax Syrup, 100ml 1.00 Botol 103,950.00 104,450.00
R2019-0000075278 26-12-2019 201900072245/036985 RISKY NASYUKHA Niki Juniar OA00125 ATS (Anti Tetanus 1.00 Ampul 222,750.00 223,250.00
R2019-0000075278 26-12-2019 201900072245/036985 RISKY NASYUKHA Niki Juniar OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000075278 26-12-2019 201900072245/036985 RISKY NASYUKHA Niki Juniar OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 Botol 22,542.30 23,042.30
R2019-0000075277 26-12-2019 201900072296/112252 RAPPE,NY Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000075277 26-12-2019 201900072296/112252 RAPPE,NY Niki Juniar ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000075277 26-12-2019 201900072296/112252 RAPPE,NY Niki Juniar ALI00011 Infus Set Makro 2.00 Pcs 12,087.90 24,675.80
R2019-0000075277 26-12-2019 201900072296/112252 RAPPE,NY Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000075277 26-12-2019 201900072296/112252 RAPPE,NY Niki Juniar OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
Total 302,703,387.34
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 226 dari 266
ASAL RAWAT JALAN
R2019-0000075279 26-12-2019 201900072298/094020 LISNA RULY,NY Niki Juniar OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000075279 26-12-2019 201900072298/094020 LISNA RULY,NY Niki Juniar OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000075279 26-12-2019 201900072298/094020 LISNA RULY,NY Niki Juniar OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000075279 26-12-2019 201900072298/094020 LISNA RULY,NY Niki Juniar OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075280 26-12-2019 201900072243/083235 BINTI MASROFAH,NY Niki Juniar OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000075280 26-12-2019 201900072243/083235 BINTI MASROFAH,NY Niki Juniar OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000075280 26-12-2019 201900072243/083235 BINTI MASROFAH,NY Niki Juniar ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000075281 26-12-2019 201900072300/112257 RUSITAH,NY Niki Juniar OP00011 Paracetamol 500mg 2.00 Tablet 387.36 1,274.72
R2019-0000075281 26-12-2019 201900072300/112257 RUSITAH,NY Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000075281 26-12-2019 201900072300/112257 RUSITAH,NY Niki Juniar ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000075281 26-12-2019 201900072300/112257 RUSITAH,NY Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000075281 26-12-2019 201900072300/112257 RUSITAH,NY Niki Juniar OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000075282 26-12-2019 201900072685/109712 BAMBANG Niki Juniar OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000075283 26-12-2019 201900072299/112256 ZAKARIA NORMAN Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000075283 26-12-2019 201900072299/112256 ZAKARIA NORMAN Niki Juniar ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000075283 26-12-2019 201900072299/112256 ZAKARIA NORMAN Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000075283 26-12-2019 201900072299/112256 ZAKARIA NORMAN Niki Juniar OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000075283 26-12-2019 201900072299/112256 ZAKARIA NORMAN Niki Juniar OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000075283 26-12-2019 201900072299/112256 ZAKARIA NORMAN Niki Juniar OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000075283 26-12-2019 201900072299/112256 ZAKARIA NORMAN Niki Juniar OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000075284 26-12-2019 201900072251/088660 POLSAR SIHOTANG,TN Niki Juniar ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000075284 26-12-2019 201900072251/088660 POLSAR SIHOTANG,TN Niki Juniar OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000075284 26-12-2019 201900072251/088660 POLSAR SIHOTANG,TN Niki Juniar OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000075285 26-12-2019 201900072301/112262 TERESA SUBUN,AN Niki Juniar OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000075285 26-12-2019 201900072301/112262 TERESA SUBUN,AN Niki Juniar ALI00006 I.V Catheter No. 24 2.00 Pcs 38,900.00 78,300.00
R2019-0000075285 26-12-2019 201900072301/112262 TERESA SUBUN,AN Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000075276 26-12-2019 201900072286/112261 TONY JANA Niki Juniar OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075276 26-12-2019 201900072286/112261 TONY JANA Niki Juniar OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000075289 26-12-2019 201900072294/112266 NATAN BILUNG,TN Niki Juniar ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000075289 26-12-2019 201900072294/112266 NATAN BILUNG,TN Niki Juniar OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000075289 26-12-2019 201900072294/112266 NATAN BILUNG,TN Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000075290 26-12-2019 201900072302/024707 MUHAMMAD IMAM Niki Juniar OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075290 26-12-2019 201900072302/024707 MUHAMMAD IMAM Niki Juniar OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000075290 26-12-2019 201900072302/024707 MUHAMMAD IMAM Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000075290 26-12-2019 201900072302/024707 MUHAMMAD IMAM Niki Juniar ALI00004 I.V Catheter No. 20 Pcs 36,808.20 500.00
R2019-0000075290 26-12-2019 201900072302/024707 MUHAMMAD IMAM Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000075291 26-12-2019 201900072685/109712 BAMBANG Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000075291 26-12-2019 201900072685/109712 BAMBANG Niki Juniar ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
Total 303,695,464.38
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 227 dari 266
ASAL RAWAT JALAN
R2019-0000075291 26-12-2019 201900072685/109712 BAMBANG Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000075291 26-12-2019 201900072685/109712 BAMBANG Niki Juniar OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000075314 27-12-2019 201900072305/057208 NORMA,NY ADE RAHMAH OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000075314 27-12-2019 201900072305/057208 NORMA,NY ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000075314 27-12-2019 201900072305/057208 NORMA,NY ADE RAHMAH ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000075314 27-12-2019 201900072305/057208 NORMA,NY ADE RAHMAH OL00041 Lasgan Capsul 10.00 Capsul 21,000.00 210,500.00
R2019-0000075314 27-12-2019 201900072305/057208 NORMA,NY ADE RAHMAH OT00129 Trovensis 4mg Tablet 10.00 Tablet 18,146.70 181,967.00
R2019-0000075314 27-12-2019 201900072305/057208 NORMA,NY ADE RAHMAH OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000075312 26-12-2019 201900072304/089840 MUHAMMAD ATHA ADE RAHMAH OC00132 CTM 4mg 2.00 Tablet 157.41 814.82
R2019-0000075312 26-12-2019 201900072304/089840 MUHAMMAD ATHA ADE RAHMAH OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000075312 26-12-2019 201900072304/089840 MUHAMMAD ATHA ADE RAHMAH OS00009 Salbutamol 2mg (OGB) 3.00 Tablet 213.30 1,139.90
R2019-0000075312 26-12-2019 201900072304/089840 MUHAMMAD ATHA ADE RAHMAH OA00052 Ambroxol Tablet, 30mg 1.00 Tablet 445.50 945.50
R2019-0000075312 26-12-2019 201900072304/089840 MUHAMMAD ATHA ADE RAHMAH ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 10,579.00
R2019-0000075312 26-12-2019 201900072304/089840 MUHAMMAD ATHA ADE RAHMAH OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2019-0000075315 27-12-2019 201900072295/112267 ULFA ROFIANITA,NY ADE RAHMAH OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000075315 27-12-2019 201900072295/112267 ULFA ROFIANITA,NY ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000075315 27-12-2019 201900072295/112267 ULFA ROFIANITA,NY ADE RAHMAH OA00085 Antasida Tablet (OGB) 5.00 Tablet 284.30 1,921.50
R2019-0000075315 27-12-2019 201900072295/112267 ULFA ROFIANITA,NY ADE RAHMAH OP00184 Neo Protifed Tablet 5.00 Tablet 1,263.73 6,818.65
R2019-0000075316 27-12-2019 201900072294/112266 NATAN BILUNG,TN Niki Juniar OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000075316 27-12-2019 201900072294/112266 NATAN BILUNG,TN Niki Juniar OI00001 Ibuprofen 400mg (OGB) 4.00 Tablet 682.00 3,228.00
R2019-0000075316 27-12-2019 201900072294/112266 NATAN BILUNG,TN Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000075316 27-12-2019 201900072294/112266 NATAN BILUNG,TN Niki Juniar OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000075317 27-12-2019 201900072292/112264 FELIX HARLY Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000075317 27-12-2019 201900072292/112264 FELIX HARLY Niki Juniar OB00007 Becom - C 3.00 Tablet 2,123.55 6,870.65
R2019-0000075317 27-12-2019 201900072292/112264 FELIX HARLY Niki Juniar OE00057 Eperisone Hcl 50mg 4.00 Tablet 2,286.90 9,647.60
R2019-0000075318 27-12-2019 201900072307/099249 KIREINA TRISTAN ADE RAHMAH OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000075322 27-12-2019 201900072307/099249 KIREINA TRISTAN ADE RAHMAH OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000075322 27-12-2019 201900072307/099249 KIREINA TRISTAN ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075322 27-12-2019 201900072307/099249 KIREINA TRISTAN ADE RAHMAH OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000075323 27-12-2019 201900072313/36000 DANIK APRILIANA,NY ADE RAHMAH OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000075323 27-12-2019 201900072313/36000 DANIK APRILIANA,NY ADE RAHMAH OB00007 Becom - C 5.00 Tablet 2,123.55 11,117.75
R2019-0000075324 27-12-2019 201900072310/068057 NOVIANTI,NY ADE RAHMAH OT00030 Teosal 5.00 Tablet 282.15 1,910.75
R2019-0000075324 27-12-2019 201900072310/068057 NOVIANTI,NY ADE RAHMAH OA00180 Acetylcyst ein 200mg 5.00 Tablet 1,485.00 7,925.00
R2019-0000075324 27-12-2019 201900072310/068057 NOVIANTI,NY ADE RAHMAH OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000075325 27-12-2019 201900072304/089840 MUHAMMAD ATHA ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075325 27-12-2019 201900072304/089840 MUHAMMAD ATHA ADE RAHMAH OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000075326 27-12-2019 201900072295/112267 ULFA ROFIANITA,NY ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000075327 27-12-2019 201900072307/099249 KIREINA TRISTAN ADE RAHMAH OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
Total 304,664,371.00
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 228 dari 266
ASAL RAWAT JALAN
R2019-0000075327 27-12-2019 201900072307/099249 KIREINA TRISTAN ADE RAHMAH OM00097 Mucera Drop 1.00 Botol 54,945.00 55,445.00
R2019-0000075327 27-12-2019 201900072307/099249 KIREINA TRISTAN ADE RAHMAH OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
R2019-0000075336 27-12-2019 201900072314/082596 YESTI DWI Herika dr. OO00040 Oralit 200 6.00 Sachet 706.00 4,736.00
R2019-0000075336 27-12-2019 201900072314/082596 YESTI DWI Herika dr. OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000075336 27-12-2019 201900072314/082596 YESTI DWI Herika dr. OS00176 Scopma Plus Tablet 6.00 Tablet 2,090.22 13,041.32
R2019-0000075338 27-12-2019 201900072317/097462 WA KANANTEA,NY EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000075338 27-12-2019 201900072317/097462 WA KANANTEA,NY EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000075338 27-12-2019 201900072317/097462 WA KANANTEA,NY EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
R2019-0000075338 27-12-2019 201900072317/097462 WA KANANTEA,NY EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000075338 27-12-2019 201900072317/097462 WA KANANTEA,NY EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000075340 27-12-2019 201900072330/112109 PURWIYONO,TN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000075340 27-12-2019 201900072330/112109 PURWIYONO,TN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000075340 27-12-2019 201900072330/112109 PURWIYONO,TN EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
R2019-0000075340 27-12-2019 201900072330/112109 PURWIYONO,TN EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000075340 27-12-2019 201900072330/112109 PURWIYONO,TN EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000075345 27-12-2019 201900072326/106258 ASIAH,NY EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000075345 27-12-2019 201900072326/106258 ASIAH,NY EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000075345 27-12-2019 201900072326/106258 ASIAH,NY EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
R2019-0000075345 27-12-2019 201900072326/106258 ASIAH,NY EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000075345 27-12-2019 201900072326/106258 ASIAH,NY EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000075346 27-12-2019 201900072336/103932 NORHAYATI,NY LUSY E. Dr.Sp.PD OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000075346 27-12-2019 201900072336/103932 NORHAYATI,NY LUSY E. Dr.Sp.PD OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000075348 27-12-2019 201900072344/111876 NUR PUTRI EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000075348 27-12-2019 201900072344/111876 NUR PUTRI EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000075348 27-12-2019 201900072344/111876 NUR PUTRI EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
R2019-0000075348 27-12-2019 201900072344/111876 NUR PUTRI EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000075348 27-12-2019 201900072344/111876 NUR PUTRI EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000075349 27-12-2019 201900072321/111670 NOOR JANNAH,NY EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000075347 27-12-2019 201900072358/075147 RONY SUROTO,TN IQBAL OS00016 Sanadryl Expectoran 1.00 Botol 14,701.50 15,201.50
R2019-0000075347 27-12-2019 201900072358/075147 RONY SUROTO,TN IQBAL OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000075347 27-12-2019 201900072358/075147 RONY SUROTO,TN IQBAL OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000075347 27-12-2019 201900072358/075147 RONY SUROTO,TN IQBAL OI00134 Imunos Plus Tablet 10.00 Tablet 14,107.50 141,575.00
R2019-0000075350 27-12-2019 201900072352/112080 ALIQAH MEYSISCA EDO, Dr.Sp.B OC00153 Cendo Gentamicin 0.3% 1.00 Tube 54,016.87 54,516.87
R2019-0000075350 27-12-2019 201900072352/112080 ALIQAH MEYSISCA EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000075350 27-12-2019 201900072352/112080 ALIQAH MEYSISCA EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000075351 27-12-2019 201900072332/110828 ISMAIL,TN Herika dr. OU00022 Urotractin 400mg Tablet 10.00 Tablet 7,189.03 72,390.30
R2019-0000075351 27-12-2019 201900072332/110828 ISMAIL,TN Herika dr. OC00076 Ciprofloxacin 500mg 6.00 Tablet 1,039.50 6,737.00
R2019-0000075351 27-12-2019 201900072332/110828 ISMAIL,TN Herika dr. OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
Total 305,307,083.04
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 229 dari 266
ASAL RAWAT JALAN
R2019-0000075351 27-12-2019 201900072332/110828 ISMAIL,TN Herika dr. OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000075351 27-12-2019 201900072332/110828 ISMAIL,TN Herika dr. OA00064 Amlodipin 5mg (OGB) 3.00 Tablet 1,555.00 5,165.00
R2019-0000075349 27-12-2019 201900072321/111670 NOOR JANNAH,NY EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000075349 27-12-2019 201900072321/111670 NOOR JANNAH,NY EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000075349 27-12-2019 201900072321/111670 NOOR JANNAH,NY EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000075353 27-12-2019 201900072360/106436 HENI NUR IQBAL OB00028 Bioplacenton Cream, 15gr 1.00 Tube 25,245.00 25,745.00
R2019-0000075353 27-12-2019 201900072360/106436 HENI NUR IQBAL OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000075353 27-12-2019 201900072360/106436 HENI NUR IQBAL OI00134 Imunos Plus Tablet 10.00 Tablet 14,107.50 141,575.00
R2019-0000075355 27-12-2019 201900072365/112273 IMAM SUWOKO,AN Herika dr. OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000075355 27-12-2019 201900072365/112273 IMAM SUWOKO,AN Herika dr. OA00068 Amoxsan Capsul, 500mg 10.00 Capsul 4,752.00 48,020.00
R2019-0000075355 27-12-2019 201900072365/112273 IMAM SUWOKO,AN Herika dr. OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000075354 27-12-2019 201900072363/057012 AGUS PRAYITNO,TN MAGDA ROSSA, OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000075354 27-12-2019 201900072363/057012 AGUS PRAYITNO,TN MAGDA ROSSA, OC00120 Cortidex Tablet 4.00 Tablet 430.65 2,222.60
R2019-0000075354 27-12-2019 201900072363/057012 AGUS PRAYITNO,TN MAGDA ROSSA, OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000075354 27-12-2019 201900072363/057012 AGUS PRAYITNO,TN MAGDA ROSSA, OM00065 Minosep Gargle 1.00 Botol 56,430.00 56,930.00
R2019-0000075357 27-12-2019 201900072362/112271 MIFTAKHUL HUDA,AN IQBAL ON00004 Naprex Syrup, 60ml 1.00 Botol 59,251.50 59,751.50
R2019-0000075357 27-12-2019 201900072362/112271 MIFTAKHUL HUDA,AN IQBAL OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000075357 27-12-2019 201900072362/112271 MIFTAKHUL HUDA,AN IQBAL OC00120 Cortidex Tablet 2.00 Tablet 430.65 1,361.30
R2019-0000075357 27-12-2019 201900072362/112271 MIFTAKHUL HUDA,AN IQBAL OC00057 Cerini 6.00 Tablet 5,093.55 31,061.30
R2019-0000075357 27-12-2019 201900072362/112271 MIFTAKHUL HUDA,AN IQBAL OE00018 Epexol Tablet 2.00 Tablet 1,232.55 2,965.10
R2019-0000075357 27-12-2019 201900072362/112271 MIFTAKHUL HUDA,AN IQBAL OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000075357 27-12-2019 201900072362/112271 MIFTAKHUL HUDA,AN IQBAL ATKK031 Kertas Puyer Handbond 12.00 Sachet 207.90 17,494.80
R2019-0000075358 27-12-2019 201900072376/072951 AJI IKHWAN IQBAL OT00077 Tremenza Tablet 10.00 Tablet 2,160.68 22,106.80
R2019-0000075358 27-12-2019 201900072376/072951 AJI IKHWAN IQBAL OM00100 Mucera Tablet 10.00 Tablet 1,782.00 18,320.00
R2019-0000075358 27-12-2019 201900072376/072951 AJI IKHWAN IQBAL OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000075359 27-12-2019 201900072329/112269 LULU WIRIATI,NY Herika dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075359 27-12-2019 201900072329/112269 LULU WIRIATI,NY Herika dr. OC00096 Codein 10mg 6.00 Tablet 924.80 6,048.80
R2019-0000075359 27-12-2019 201900072329/112269 LULU WIRIATI,NY Herika dr. OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000075362 27-12-2019 201900072366/065394 ISTIHIAL,NY Herika dr. OG00067 Genoint Tetes Mata 1.00 Botol 13,587.75 14,087.75
R2019-0000075362 27-12-2019 201900072366/065394 ISTIHIAL,NY Herika dr. OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000075361 27-12-2019 201900072382/106948 SITI SA'DIYAH MAGDA ROSSA, OO00023 Opicef Dry Syrup, 60ml 1.00 Botol 66,825.00 67,325.00
R2019-0000075361 27-12-2019 201900072382/106948 SITI SA'DIYAH MAGDA ROSSA, OB00058 Bufect Suspensi, 60ml 1.00 Botol 21,681.00 22,181.00
R2019-0000075364 27-12-2019 201900072323/110576 SARIDAH,NY LUSY E. Dr.Sp.PD OE00054 Euthyrox 100mcg 7.00 Tablet 3,256.93 23,298.51
R2019-0000075384 27-12-2019 201900072315/030456 PADLIANSYAH,TN LUSY E. Dr.Sp.PD OC00134 Curcuma Tablet 20.00 Tablet 1,336.50 27,230.00
R2019-0000075384 27-12-2019 201900072315/030456 PADLIANSYAH,TN LUSY E. Dr.Sp.PD OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000075363 27-12-2019 201900072323/110576 SARIDAH,NY LUSY E. Dr.Sp.PD OE00054 Euthyrox 100mcg 23.00 Tablet 3,256.93 75,409.39
R2019-0000075385 27-12-2019 201900072320/112249 RACHMAN LUSY E. Dr.Sp.PD OC00134 Curcuma Tablet 10.00 Tablet 1,336.50 13,865.00
R2019-0000075385 27-12-2019 201900072320/112249 RACHMAN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
Total 306,286,877.57
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 230 dari 266
ASAL RAWAT JALAN
R2019-0000075385 27-12-2019 201900072320/112249 RACHMAN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075387 27-12-2019 201900072325/059244 SUKRIANTO,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000075387 27-12-2019 201900072325/059244 SUKRIANTO,TN LUSY E. Dr.Sp.PD OD00047 Diamicron MR 60mg 7.00 Tablet 8,420.00 59,440.00
R2019-0000075387 27-12-2019 201900072325/059244 SUKRIANTO,TN LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000075386 27-12-2019 201900072392/54743 WAHYUNI,NY Herika dr. OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000075388 27-12-2019 201900072393/089713 ISTIQOMAH Herika dr. OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000075388 27-12-2019 201900072393/089713 ISTIQOMAH Herika dr. OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000075388 27-12-2019 201900072393/089713 ISTIQOMAH Herika dr. OA00085 Antasida Tablet (OGB) 6.00 Tablet 284.30 2,205.80
R2019-0000075389 27-12-2019 201900072345/103138 DJUNDAH LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075389 27-12-2019 201900072345/103138 DJUNDAH LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075389 27-12-2019 201900072345/103138 DJUNDAH LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000075389 27-12-2019 201900072345/103138 DJUNDAH LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000075391 27-12-2019 201900072341/092400 SITI ASIAH,HJH LUSY E. Dr.Sp.PD OG00024 Glimepiride 4mg Tablet 7.00 Tablet 3,869.89 27,589.23
R2019-0000075391 27-12-2019 201900072341/092400 SITI ASIAH,HJH LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000075391 27-12-2019 201900072341/092400 SITI ASIAH,HJH LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 3.00 Tab 7,425.00 22,775.00
R2019-0000075391 27-12-2019 201900072341/092400 SITI ASIAH,HJH LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000075391 27-12-2019 201900072341/092400 SITI ASIAH,HJH LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075391 27-12-2019 201900072341/092400 SITI ASIAH,HJH LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075392 27-12-2019 201900072341/092400 SITI ASIAH,HJH LUSY E. Dr.Sp.PD OG00024 Glimepiride 4mg Tablet 23.00 Tablet 3,869.89 89,507.47
R2019-0000075392 27-12-2019 201900072341/092400 SITI ASIAH,HJH LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2019-0000075392 27-12-2019 201900072341/092400 SITI ASIAH,HJH LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 12.00 Tab 7,425.00 89,600.00
R2019-0000075392 27-12-2019 201900072341/092400 SITI ASIAH,HJH LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 23.00 Tablet 445.50 10,746.50
R2019-0000075392 27-12-2019 201900072341/092400 SITI ASIAH,HJH LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000075392 27-12-2019 201900072341/092400 SITI ASIAH,HJH LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000075393 27-12-2019 201900072340/107867 ENDANG LUSY E. Dr.Sp.PD OB001002 Betahistine 10.00 Tab 5,940.00 59,900.00
R2019-0000075393 27-12-2019 201900072340/107867 ENDANG LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000075393 27-12-2019 201900072340/107867 ENDANG LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075394 27-12-2019 201900072333/108109 TAHIR,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000075394 27-12-2019 201900072333/108109 TAHIR,TN LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 7.00 Tablet 2,525.00 18,175.00
R2019-0000075390 27-12-2019 201900072335/091951 RUSLI MANSYUR,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075390 27-12-2019 201900072335/091951 RUSLI MANSYUR,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075390 27-12-2019 201900072335/091951 RUSLI MANSYUR,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 7.00 Tablet 5,197.50 36,882.50
R2019-0000075390 27-12-2019 201900072335/091951 RUSLI MANSYUR,TN LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000075395 27-12-2019 201900072334/091952 SALHAH RUSLI,NY LUSY E. Dr.Sp.PD OG00024 Glimepiride 4mg Tablet 7.00 Tablet 3,869.89 27,589.23
R2019-0000075395 27-12-2019 201900072334/091952 SALHAH RUSLI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
Total 307,653,677.53
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 231 dari 266
ASAL RAWAT JALAN
R2019-0000075395 27-12-2019 201900072334/091952 SALHAH RUSLI,NY LUSY E. Dr.Sp.PD OV00080 Vitamin B Compleks 20.00 Tablet 241.79 5,335.80
R2019-0000075396 27-12-2019 201900072343/111127 DARTI,NY LUSY E. Dr.Sp.PD OB00016 Betahistine Mesilat 6mg 10.00 Tablet 1,500.00 15,500.00
R2019-0000075396 27-12-2019 201900072343/111127 DARTI,NY LUSY E. Dr.Sp.PD OG00025 Gliquidone 30mg (OGB) 14.00 Tablet 1,967.44 28,044.16
R2019-0000075396 27-12-2019 201900072343/111127 DARTI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000075396 27-12-2019 201900072343/111127 DARTI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075396 27-12-2019 201900072343/111127 DARTI,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000075396 27-12-2019 201900072343/111127 DARTI,NY LUSY E. Dr.Sp.PD OL00080 Loratadin 10mg (OGB) 10.00 Tablet 520.00 5,700.00
R2019-0000075396 27-12-2019 201900072343/111127 DARTI,NY LUSY E. Dr.Sp.PD OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000075396 27-12-2019 201900072343/111127 DARTI,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000075398 27-12-2019 201900072391/108934 ALISHA MEDINA FREDRIK, Dr,Sp.A OO00022 Opicef 500mg Capsul 3.00 Capsul 14,850.00 45,050.00
R2019-0000075398 27-12-2019 201900072391/108934 ALISHA MEDINA FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 2.00 Tablet 430.65 1,361.30
R2019-0000075398 27-12-2019 201900072391/108934 ALISHA MEDINA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 2.00 Tablet 1,173.15 2,846.30
R2019-0000075398 27-12-2019 201900072391/108934 ALISHA MEDINA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 1.00 Granula 297.00 797.00
R2019-0000075398 27-12-2019 201900072391/108934 ALISHA MEDINA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 13,118.50
R2019-0000075398 27-12-2019 201900072391/108934 ALISHA MEDINA FREDRIK, Dr,Sp.A OB00002 Baquinor Eye Drop 0.3%, 1.00 Botol 50,267.25 50,767.25
R2019-0000075397 27-12-2019 201900072351/071568 DJAENAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000075397 27-12-2019 201900072351/071568 DJAENAH,NY LUSY E. Dr.Sp.PD OG00024 Glimepiride 4mg Tablet 7.00 Tablet 3,869.89 27,589.23
R2019-0000075397 27-12-2019 201900072351/071568 DJAENAH,NY LUSY E. Dr.Sp.PD OA00167 Acarbose 50mg (OGB) 14.00 Tablet 1,695.70 24,239.80
R2019-0000075397 27-12-2019 201900072351/071568 DJAENAH,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000075397 27-12-2019 201900072351/071568 DJAENAH,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 3.00 Tablet 315.26 1,445.78
R2019-0000075397 27-12-2019 201900072351/071568 DJAENAH,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000075400 27-12-2019 201900072351/071568 DJAENAH,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2019-0000075400 27-12-2019 201900072351/071568 DJAENAH,NY LUSY E. Dr.Sp.PD OG00024 Glimepiride 4mg Tablet 23.00 Tablet 3,869.89 89,507.47
R2019-0000075400 27-12-2019 201900072351/071568 DJAENAH,NY LUSY E. Dr.Sp.PD OA00167 Acarbose 50mg (OGB) 46.00 Tablet 1,695.70 78,502.20
R2019-0000075400 27-12-2019 201900072351/071568 DJAENAH,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000075400 27-12-2019 201900072351/071568 DJAENAH,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 12.00 Tablet 315.26 4,283.12
R2019-0000075401 27-12-2019 201900072339/058428 DODY SURYA LUSY E. Dr.Sp.PD ON00075 Novomix 30 Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000075401 27-12-2019 201900072339/058428 DODY SURYA LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000075401 27-12-2019 201900072339/058428 DODY SURYA LUSY E. Dr.Sp.PD ALA00006 Alkohol Swap 2.00 Pcs 752.00 2,004.00
R2019-0000075402 27-12-2019 201900072350/104591 RAHAYU,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000075402 27-12-2019 201900072350/104591 RAHAYU,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075402 27-12-2019 201900072350/104591 RAHAYU,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000075402 27-12-2019 201900072350/104591 RAHAYU,NY LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 7.00 Tablet 206.41 1,944.87
R2019-0000075402 27-12-2019 201900072350/104591 RAHAYU,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 3.00 Tablet 240.30 1,220.90
R2019-0000075403 27-12-2019 201900072353/112270 DIAH LUSY E. Dr.Sp.PD OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000075403 27-12-2019 201900072353/112270 DIAH LUSY E. Dr.Sp.PD OC00096 Codein 10mg 10.00 Tablet 924.80 9,748.00
R2019-0000075403 27-12-2019 201900072353/112270 DIAH LUSY E. Dr.Sp.PD OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000075403 27-12-2019 201900072353/112270 DIAH LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
Total 308,865,339.51
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 232 dari 266
ASAL RAWAT JALAN
R2019-0000075403 27-12-2019 201900072353/112270 DIAH LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075403 27-12-2019 201900072353/112270 DIAH LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 10.00 Tablet 7,425.00 74,750.00
R2019-0000075405 27-12-2019 201900072355/077798 LASOFA,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075405 27-12-2019 201900072355/077798 LASOFA,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075405 27-12-2019 201900072355/077798 LASOFA,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000075406 27-12-2019 201900072371/041219 DAMAI AGUNG LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000075406 27-12-2019 201900072371/041219 DAMAI AGUNG LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000075406 27-12-2019 201900072371/041219 DAMAI AGUNG LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000075406 27-12-2019 201900072371/041219 DAMAI AGUNG LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 23.00 Tablet 811.18 19,157.14
R2019-0000075356 27-12-2019 201900072350/104591 RAHAYU,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000075356 27-12-2019 201900072350/104591 RAHAYU,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000075356 27-12-2019 201900072350/104591 RAHAYU,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000075356 27-12-2019 201900072350/104591 RAHAYU,NY LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 23.00 Tablet 206.41 5,247.43
R2019-0000075356 27-12-2019 201900072350/104591 RAHAYU,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 12.00 Tablet 240.30 3,383.60
R2019-0000075408 27-12-2019 201900072374/099659 SUBANDI,TN LUSY E. Dr.Sp.PD OT00135 Thyrozol 5mg 46.00 Tablet 2,188.89 101,188.94
R2019-0000075408 27-12-2019 201900072374/099659 SUBANDI,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000075407 27-12-2019 201900072329/112269 LULU WIRIATI,NY Herika dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000075407 27-12-2019 201900072329/112269 LULU WIRIATI,NY Herika dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000075407 27-12-2019 201900072329/112269 LULU WIRIATI,NY Herika dr. ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000075407 27-12-2019 201900072329/112269 LULU WIRIATI,NY Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000075399 27-12-2019 201900072406/068954 LA BANTA,TN Herika dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000075399 27-12-2019 201900072406/068954 LA BANTA,TN Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000075409 27-12-2019 201900072438/112276 NURLIA,NY Herika dr. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000075409 27-12-2019 201900072438/112276 NURLIA,NY Herika dr. ALB00132 Blood Set 1.00 Pcs 33,976.80 34,476.80
R2019-0000075409 27-12-2019 201900072438/112276 NURLIA,NY Herika dr. ALI00004 I.V Catheter No. 20 Pcs 36,808.20 500.00
R2019-0000075411 27-12-2019 201900072439/112277 EMY FEBRUARTINI,NY Herika dr. OD00058 Dipenhydramine Injeksi 2.00 Ampul 2,517.23 5,534.46
R2019-0000075411 27-12-2019 201900072439/112277 EMY FEBRUARTINI,NY Herika dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000075411 27-12-2019 201900072439/112277 EMY FEBRUARTINI,NY Herika dr. ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000075411 27-12-2019 201900072439/112277 EMY FEBRUARTINI,NY Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000075411 27-12-2019 201900072439/112277 EMY FEBRUARTINI,NY Herika dr. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000075411 27-12-2019 201900072439/112277 EMY FEBRUARTINI,NY Herika dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000075412 27-12-2019 201900072393/089713 ISTIQOMAH Herika dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000075410 27-12-2019 201900072392/54743 WAHYUNI,NY Herika dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000075410 27-12-2019 201900072392/54743 WAHYUNI,NY Herika dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000075410 27-12-2019 201900072392/54743 WAHYUNI,NY Herika dr. ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000075414 27-12-2019 201900072440/108103 MUHAMMAD RONAN Herika dr. ALI00006 I.V Catheter No. 24 3.00 Pcs 38,900.00 117,200.00
R2019-0000075414 27-12-2019 201900072440/108103 MUHAMMAD RONAN Herika dr. ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
Total 310,625,548.13
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 233 dari 266
ASAL RAWAT JALAN
R2019-0000075414 27-12-2019 201900072440/108103 MUHAMMAD RONAN Herika dr. OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000075414 27-12-2019 201900072440/108103 MUHAMMAD RONAN Herika dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000075413 27-12-2019 201900072310/068057 NOVIANTI,NY ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075413 27-12-2019 201900072310/068057 NOVIANTI,NY ADE RAHMAH OP00136 Pulmicort Respules 2.00 Ampul 33,802.98 68,105.96
R2019-0000075415 27-12-2019 201900072332/110828 ISMAIL,TN Herika dr. OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000075415 27-12-2019 201900072332/110828 ISMAIL,TN Herika dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000075415 27-12-2019 201900072332/110828 ISMAIL,TN Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000075415 27-12-2019 201900072332/110828 ISMAIL,TN Herika dr. ALI00003 I.V Catheter No. 18 2.00 Pcs 29,744.00 59,988.00
R2019-0000075415 27-12-2019 201900072332/110828 ISMAIL,TN Herika dr. OG00018 Gitas Injeksi 1ml 1.00 Ampul 38,201.62 38,701.62
R2019-0000075415 27-12-2019 201900072332/110828 ISMAIL,TN Herika dr. ALI00006 I.V Catheter No. 24 2.00 Pcs 38,900.00 78,300.00
R2019-0000075417 27-12-2019 201900072314/082596 YESTI DWI Herika dr. OG00018 Gitas Injeksi 1ml 1.00 Ampul 38,201.62 38,701.62
R2019-0000075416 27-12-2019 201900072441/112268 AZKA RAFFASYA,AN ADE RAHMAH OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000075416 27-12-2019 201900072441/112268 AZKA RAFFASYA,AN ADE RAHMAH ALI00012 Infus Set Mikro 1.00 Pcs 19,602.00 20,102.00
R2019-0000075416 27-12-2019 201900072441/112268 AZKA RAFFASYA,AN ADE RAHMAH ALI00006 I.V Catheter No. 24 2.00 Pcs 38,900.00 78,300.00
R2019-0000075418 27-12-2019 201900072406/068954 LA BANTA,TN Herika dr. OA00088 Antiza Tablet 4.00 Tablet 1,633.00 7,032.00
R2019-0000075418 27-12-2019 201900072406/068954 LA BANTA,TN Herika dr. OV00080 Vitamin B Compleks 2.00 Tablet 241.79 983.58
R2019-0000075419 27-12-2019 201900072373/074224 ZAIRA NADIA FREDRIK, Dr,Sp.A OS00009 Salbutamol 2mg (OGB) 4.00 Tablet 213.30 1,353.20
R2019-0000075419 27-12-2019 201900072373/074224 ZAIRA NADIA FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 7.00 Capsul 4,266.70 30,366.90
R2019-0000075419 27-12-2019 201900072373/074224 ZAIRA NADIA FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000075419 27-12-2019 201900072373/074224 ZAIRA NADIA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 5.00 Tablet 1,173.15 6,365.75
R2019-0000075419 27-12-2019 201900072373/074224 ZAIRA NADIA FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 6.00 Tablet 445.50 3,173.00
R2019-0000075419 27-12-2019 201900072373/074224 ZAIRA NADIA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 5.00 Granula 297.00 1,985.00
R2019-0000075419 27-12-2019 201900072373/074224 ZAIRA NADIA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000075420 27-12-2019 201900072374/099659 SUBANDI,TN LUSY E. Dr.Sp.PD OT00135 Thyrozol 5mg 14.00 Tablet 2,188.89 31,144.46
R2019-0000075420 27-12-2019 201900072374/099659 SUBANDI,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075422 27-12-2019 201900072379/111163 RIDWAN,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000075422 27-12-2019 201900072379/111163 RIDWAN,TN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075422 27-12-2019 201900072379/111163 RIDWAN,TN LUSY E. Dr.Sp.PD OU00028 Ursodeoxycholic Acid 10.00 Tablet 9,147.60 91,976.00
R2019-0000075423 27-12-2019 201900072372/034434 ASTRI LUSY E. Dr.Sp.PD OP00121 Propylthiouracil 100mg 3.00 Tablet 791.50 2,874.50
R2019-0000075421 27-12-2019 201900072372/034434 ASTRI LUSY E. Dr.Sp.PD OP00121 Propylthiouracil 100mg 12.00 Tablet 791.50 9,998.00
R2019-0000075424 27-12-2019 201900072375/024756 FABIANUS DANNY,TN LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 10.00 Tablet 811.18 8,611.80
R2019-0000075424 27-12-2019 201900072375/024756 FABIANUS DANNY,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 10.00 Tablet 1,662.00 17,120.00
R2019-0000075425 27-12-2019 201900072371/041219 DAMAI AGUNG LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075425 27-12-2019 201900072371/041219 DAMAI AGUNG LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075425 27-12-2019 201900072371/041219 DAMAI AGUNG LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000075425 27-12-2019 201900072371/041219 DAMAI AGUNG LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 7.00 Tablet 811.18 6,178.26
R2019-0000075426 27-12-2019 201900072361/112272 SHARIFAH ULFAH LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000075426 27-12-2019 201900072361/112272 SHARIFAH ULFAH LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 10.00 Tablet 3,164.00 32,140.00
Total 311,665,317.38
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 234 dari 266
ASAL RAWAT JALAN
R2019-0000075426 27-12-2019 201900072361/112272 SHARIFAH ULFAH LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 20.00 Tablet 371.25 7,925.00
R2019-0000075427 27-12-2019 201900072347/060368 NIKAMAH,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000075427 27-12-2019 201900072347/060368 NIKAMAH,TN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075427 27-12-2019 201900072347/060368 NIKAMAH,TN LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 7.00 Tablet 2,525.00 18,175.00
R2019-0000075427 27-12-2019 201900072347/060368 NIKAMAH,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000075427 27-12-2019 201900072347/060368 NIKAMAH,TN LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000075427 27-12-2019 201900072347/060368 NIKAMAH,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075429 27-12-2019 201900072402/103406 MUHAMMAD RABBANI FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000075429 27-12-2019 201900072402/103406 MUHAMMAD RABBANI FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 2.00 Tablet 208.00 916.00
R2019-0000075429 27-12-2019 201900072402/103406 MUHAMMAD RABBANI FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 2.00 Tablet 1,173.15 2,846.30
R2019-0000075429 27-12-2019 201900072402/103406 MUHAMMAD RABBANI FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000075429 27-12-2019 201900072402/103406 MUHAMMAD RABBANI FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000075429 27-12-2019 201900072402/103406 MUHAMMAD RABBANI FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000075429 27-12-2019 201900072402/103406 MUHAMMAD RABBANI FREDRIK, Dr,Sp.A OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2019-0000075428 27-12-2019 201900072369/090606 SUKARTI,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000075428 27-12-2019 201900072369/090606 SUKARTI,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075430 27-12-2019 201900072404/099104 FRISKA AZURA FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000075430 27-12-2019 201900072404/099104 FRISKA AZURA FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000075430 27-12-2019 201900072404/099104 FRISKA AZURA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000075430 27-12-2019 201900072404/099104 FRISKA AZURA FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000075430 27-12-2019 201900072404/099104 FRISKA AZURA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000075430 27-12-2019 201900072404/099104 FRISKA AZURA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000075432 27-12-2019 201900072409/106652 FAUSTIN ELIGIO Herika dr. OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000075432 27-12-2019 201900072409/106652 FAUSTIN ELIGIO Herika dr. OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000075432 27-12-2019 201900072409/106652 FAUSTIN ELIGIO Herika dr. ALI00006 I.V Catheter No. 24 3.00 Pcs 38,900.00 117,200.00
R2019-0000075432 27-12-2019 201900072409/106652 FAUSTIN ELIGIO Herika dr. OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000075431 27-12-2019 201900072398/111709 INRI MONALISA NOVIANA, Dr. Sp OF00099 Folda Tablet 30.00 Tablet 6,661.65 200,349.50
R2019-0000075431 27-12-2019 201900072398/111709 INRI MONALISA NOVIANA, Dr. Sp OB00068 BioCal-95 30.00 Tablet 7,128.00 214,340.00
R2019-0000075436 27-12-2019 201900072403/112279 TRI ASTUTIK,NY NOVIANA, Dr. Sp OB00029 Biosanbe Capsul 7.00 Capsul 1,596.37 11,674.59
R2019-0000075433 27-12-2019 201900072411/026821 MASTIAH,NY NOVIANA, Dr. Sp OB00029 Biosanbe Capsul 5.00 Capsul 1,596.37 8,481.85
R2019-0000075433 27-12-2019 201900072411/026821 MASTIAH,NY NOVIANA, Dr. Sp OE00008 Elkana Tablet 5.00 Tablet 1,247.40 6,737.00
R2019-0000075437 27-12-2019 201900072428/072911 ALARY CE THEODORA Niki Juniar OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000075437 27-12-2019 201900072428/072911 ALARY CE THEODORA Niki Juniar OA00066 Amoxicillin Tablet, 500mg 3.00 Tablet 1,113.75 3,841.25
R2019-0000075437 27-12-2019 201900072428/072911 ALARY CE THEODORA Niki Juniar OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000075442 27-12-2019 201900072414/112280 RIZAL PURWANTO,TN IQBAL OS00173 Simvastatin 20mg (OGB) 20.00 Tablet 1,782.00 36,140.00
R2019-0000075443 27-12-2019 201900072432/060740 BEBY ASTIANA,NY NOVIANA, Dr. Sp OS00029 Sanmol Tablet, 500mg 15.00 Tablet 430.65 6,959.75
R2019-0000075443 27-12-2019 201900072432/060740 BEBY ASTIANA,NY NOVIANA, Dr. Sp OV00107 Vosedon Tablet 60.00 Tablet 3,452.63 207,657.80
R2019-0000075443 27-12-2019 201900072432/060740 BEBY ASTIANA,NY NOVIANA, Dr. Sp ON00090 Nutribreast 30.00 Tablet 13,148.19 394,945.70
Total 313,295,761.37
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 235 dari 266
ASAL RAWAT JALAN
R2019-0000075444 27-12-2019 201900072446/112284 ERINDA ZEBUA,NY IQBAL OF00055 Flamar Tablet, 50mg 10.00 Tablet 2,710.13 27,601.30
R2019-0000075444 27-12-2019 201900072446/112284 ERINDA ZEBUA,NY IQBAL OL00017 Lameson 4mg 6.00 Tablet 5,049.00 30,794.00
R2019-0000075444 27-12-2019 201900072446/112284 ERINDA ZEBUA,NY IQBAL OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000075448 27-12-2019 201900072445/062052 LUVI OKTAVIANI,NY NOVIANA, Dr. Sp OA00134 Asta Plus 30.00 Tablet 12,623.00 379,190.00
R2019-0000075460 27-12-2019 201900072445/062052 LUVI OKTAVIANI,NY NOVIANA, Dr. Sp OP00153 Prodiva Gel 30Gr 1.00 Botol 371,250.00 371,750.00
R2019-0000075461 27-12-2019 201900072453/112287 YUDHI FERDIAN,TN Ismail dr. Msc. OM00044 Methyl Prednisolon 16mg 20.00 Tablet 2,632.50 53,150.00
R2019-0000075461 27-12-2019 201900072453/112287 YUDHI FERDIAN,TN Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000075461 27-12-2019 201900072453/112287 YUDHI FERDIAN,TN Ismail dr. Msc. ON00101 Noroid Lotion 1.00 Box 212,355.00 212,855.00
R2019-0000075464 27-12-2019 201900072457/110655 PUSPITA,NY Ismail dr. Msc. OS00183 Sporetik 200mg Capsul 10.00 Capsul 42,396.75 424,467.50
R2019-0000075464 27-12-2019 201900072457/110655 PUSPITA,NY Ismail dr. Msc. OA00166 Azithromycin 500mg 2.00 Tablet 14,850.00 30,200.00
R2019-0000075465 27-12-2019 201900072460/090216 JUSMAN,TN Ismail dr. Msc. OS00183 Sporetik 200mg Capsul 10.00 Capsul 42,396.75 424,467.50
R2019-0000075465 27-12-2019 201900072460/090216 JUSMAN,TN Ismail dr. Msc. OA00166 Azithromycin 500mg 2.00 Tablet 14,850.00 30,200.00
R2019-0000075472 27-12-2019 201900072447/112285 GUSTIARAYNAVO Niki Juniar OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000075471 27-12-2019 201900072455/062329 DJUWITO TEGUH NOVIANA, Dr. Sp OM00045 Methyl Prednisolon 4mg 20.00 Tablet 792.99 16,359.80
R2019-0000075471 27-12-2019 201900072455/062329 DJUWITO TEGUH NOVIANA, Dr. Sp OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000075471 27-12-2019 201900072455/062329 DJUWITO TEGUH NOVIANA, Dr. Sp OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000075471 27-12-2019 201900072455/062329 DJUWITO TEGUH NOVIANA, Dr. Sp OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000075471 27-12-2019 201900072455/062329 DJUWITO TEGUH NOVIANA, Dr. Sp ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000075470 27-12-2019 201900072452/065468 TUMINAH,NY Ismail dr. Msc. OM00044 Methyl Prednisolon 16mg 20.00 Tablet 2,632.50 53,150.00
R2019-0000075470 27-12-2019 201900072452/065468 TUMINAH,NY Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000075470 27-12-2019 201900072452/065468 TUMINAH,NY Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000075470 27-12-2019 201900072452/065468 TUMINAH,NY Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000075470 27-12-2019 201900072452/065468 TUMINAH,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000075477 27-12-2019 201900072459/073730 SLAMET RIYADI,TN Ismail dr. Msc. OM00044 Methyl Prednisolon 16mg 10.00 Tablet 2,632.50 26,825.00
R2019-0000075477 27-12-2019 201900072459/073730 SLAMET RIYADI,TN Ismail dr. Msc. OD00072 Doxyciclyn 100mg (OGB) 20.00 Tablet 650.00 13,500.00
R2019-0000075477 27-12-2019 201900072459/073730 SLAMET RIYADI,TN Ismail dr. Msc. OE00056 Ecosol Nacl 0,9 % 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000075477 27-12-2019 201900072459/073730 SLAMET RIYADI,TN Ismail dr. Msc. ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000075474 27-12-2019 201900072472/112288 MARSYA AQEELA Niki Juniar OA00015 Acyclovir 400mg (OGB) 10.00 Tablet 1,262.25 13,122.50
R2019-0000075474 27-12-2019 201900072472/112288 MARSYA AQEELA Niki Juniar OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000075474 27-12-2019 201900072472/112288 MARSYA AQEELA Niki Juniar OC00060 Cetirizine 10mg (OGB) 4.00 Tablet 623.70 2,994.80
R2019-0000075474 27-12-2019 201900072472/112288 MARSYA AQEELA Niki Juniar OA00016 Acyclovir Cream 5gr 1.00 Tube 4,893.00 5,393.00
R2019-0000075478 27-12-2019 201900072407/078288 MUHAMMAD FATHAN Ismail dr. Msc. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000075478 27-12-2019 201900072407/078288 MUHAMMAD FATHAN Ismail dr. Msc. OK00022 Ketoconazol Cream 2% 1.00 Tube 11,000.00 11,500.00
R2019-0000075478 27-12-2019 201900072407/078288 MUHAMMAD FATHAN Ismail dr. Msc. OH00026 Hydrocortis on Cream 2.00 Tube 11,880.00 24,260.00
Total 315,668,033.43
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 236 dari 266
ASAL RAWAT JALAN
R2019-0000075478 27-12-2019 201900072407/078288 MUHAMMAD FATHAN Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000075480 27-12-2019 201900072434/110097 ATI MARIANA,NY NOVIANA, Dr. Sp OE00008 Elkana Tablet 7.00 Tablet 1,247.40 9,231.80
R2019-0000075480 27-12-2019 201900072434/110097 ATI MARIANA,NY NOVIANA, Dr. Sp OB00029 Biosanbe Capsul 7.00 Capsul 1,596.37 11,674.59
R2019-0000075481 27-12-2019 201900072426/112133 HAMIDAH,NY NOVIANA, Dr. Sp OB00029 Biosanbe Capsul 7.00 Capsul 1,596.37 11,674.59
R2019-0000075481 27-12-2019 201900072426/112133 HAMIDAH,NY NOVIANA, Dr. Sp OE00008 Elkana Tablet 7.00 Tablet 1,247.40 9,231.80
R2019-0000075483 27-12-2019 201900072421/104505 MAGDALENA,NY DYAH, dr Sp. OS00132 Symbicort Inhaler 160/45 1.00 Botol/6 412,776.54 413,276.54
R2019-0000075493 27-12-2019 201900072485/112289 HERLINA NATALIA,NY Niki Juniar OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000075493 27-12-2019 201900072485/112289 HERLINA NATALIA,NY Niki Juniar OT00149 Toramine 10 Mg Tablet 10.00 Tablet 8,167.50 82,175.00
R2019-0000075490 27-12-2019 201900072418/095173 SURIPAH,NY DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000075498 27-12-2019 201900072418/095173 SURIPAH,NY DYAH, dr Sp. OS00160 Seretide Diskus 250 mcg 1.00 Botol 322,681.59 323,181.59
R2019-0000075499 27-12-2019 201900072435/096956 SAMSUDIN,TN DYAH, dr Sp. OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000075499 27-12-2019 201900072435/096956 SAMSUDIN,TN DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000075500 27-12-2019 201900072415/031880 MURSINAH,NY DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000075502 27-12-2019 201900072415/031880 MURSINAH,NY DYAH, dr Sp. OS00160 Seretide Diskus 250 mcg 1.00 Botol 322,681.59 323,181.59
R2019-0000075501 27-12-2019 201900072454/046833 ARIE WIBISONO,TN DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000075501 27-12-2019 201900072454/046833 ARIE WIBISONO,TN DYAH, dr Sp. OL00021 Lansoprazole (OGB) 7.00 Capsul 2,230.00 16,110.00
R2019-0000075503 27-12-2019 201900072454/046833 ARIE WIBISONO,TN DYAH, dr Sp. OB00094 Berotec MDI 1.00 Botol 130,000.00 130,500.00
R2019-0000075504 27-12-2019 201900072487/088395 JURAIDAH,NY Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000075504 27-12-2019 201900072487/088395 JURAIDAH,NY Niki Juniar OI00001 Ibuprofen 400mg (OGB) 4.00 Tablet 682.00 3,228.00
R2019-0000075504 27-12-2019 201900072487/088395 JURAIDAH,NY Niki Juniar OD00065 Domperidon Tablet (OGB) 4.00 Tablet 750.00 3,500.00
R2019-0000075504 27-12-2019 201900072487/088395 JURAIDAH,NY Niki Juniar OA00180 Acetylcyst ein 200mg 4.00 Tablet 1,485.00 6,440.00
R2019-0000075513 27-12-2019 201900072359/112190 ARMIN,TN DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000075513 27-12-2019 201900072359/112190 ARMIN,TN DYAH, dr Sp. OA00052 Ambroxol Tablet, 30mg 15.00 Tablet 445.50 7,182.50
R2019-0000075521 27-12-2019 201900072481/073268 MOHAMAD FAKUR,TN Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000075521 27-12-2019 201900072481/073268 MOHAMAD FAKUR,TN Niki Juniar OD00065 Domperidon Tablet (OGB) 4.00 Tablet 750.00 3,500.00
R2019-0000075521 27-12-2019 201900072481/073268 MOHAMAD FAKUR,TN Niki Juniar OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075512 27-12-2019 201900072468/34819 RUSTAM JUNAIDI,TN DYAH, dr Sp. OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000075512 27-12-2019 201900072468/34819 RUSTAM JUNAIDI,TN DYAH, dr Sp. OV00085 Vitamin B6 Tablet (OGB) 10.00 Tablet 199.80 2,498.00
R2019-0000075523 27-12-2019 201900072468/34819 RUSTAM JUNAIDI,TN DYAH, dr Sp. OB00094 Berotec MDI 1.00 Botol 130,000.00 130,500.00
R2019-0000075525 27-12-2019 201900072489/046925 SUCIATI,NY Niki Juniar OS00014 Sanadryl DMP Syrup, 60ml 1.00 Botol 17,820.00 18,320.00
R2019-0000075525 27-12-2019 201900072489/046925 SUCIATI,NY Niki Juniar OC00144 Cefila Capsul, 100mg 6.00 Capsul 28,957.00 174,242.00
R2019-0000075525 27-12-2019 201900072489/046925 SUCIATI,NY Niki Juniar OC00057 Cerini 5.00 Tablet 5,093.55 25,967.75
R2019-0000075525 27-12-2019 201900072489/046925 SUCIATI,NY Niki Juniar OI00134 Imunos Plus Tablet 5.00 Tablet 14,107.50 71,037.50
R2019-0000075526 27-12-2019 201900072494/103042 PRADIKA ARBI Niki Juniar OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
R2019-0000075526 27-12-2019 201900072494/103042 PRADIKA ARBI Niki Juniar OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000075527 27-12-2019 201900072492/105534 SAFITRI,NN Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000075527 27-12-2019 201900072492/105534 SAFITRI,NN Niki Juniar OB00050 Braxidin 6.00 Tablet 1,648.35 10,390.10
R2019-0000075527 27-12-2019 201900072492/105534 SAFITRI,NN Niki Juniar OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
Total 317,584,463.79
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 237 dari 266
ASAL RAWAT JALAN
R2019-0000075529 27-12-2019 201900072497/055053 EDI,TN Niki Juniar OE00057 Eperisone Hcl 50mg 10.00 Tablet 2,286.90 23,369.00
R2019-0000075529 27-12-2019 201900072497/055053 EDI,TN Niki Juniar ON00009 Natrium Diklofenac 50mg 10.00 Tablet 955.84 10,058.40
R2019-0000075528 27-12-2019 201900072496/100209 MUHAMMAD DAUD Rianti dr. Sp.A OC00057 Cerini 10.00 Tablet 5,093.55 51,435.50
R2019-0000075528 27-12-2019 201900072496/100209 MUHAMMAD DAUD Rianti dr. Sp.A OC00144 Cefila Capsul, 100mg 10.00 Capsul 28,957.00 290,070.00
R2019-0000075528 27-12-2019 201900072496/100209 MUHAMMAD DAUD Rianti dr. Sp.A OA00096 Apolar N Cream, 10gr 1.00 Tube 53,014.50 53,514.50
R2019-0000075531 27-12-2019 201900072503/050680 RAFFA FAIZ Niki Juniar OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000075531 27-12-2019 201900072503/050680 RAFFA FAIZ Niki Juniar OI00117 Imunos Plus Syrup, 60ml 1.00 Botol 136,620.00 137,120.00
R2019-0000075467 27-12-2019 201900072507/103911 ALENA REMBANG,AN Rianti dr. Sp.A OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000075467 27-12-2019 201900072507/103911 ALENA REMBANG,AN Rianti dr. Sp.A OP00101 Proceles Syrup, 60ml 1.00 Botol 51,975.00 52,475.00
R2019-0000075467 27-12-2019 201900072507/103911 ALENA REMBANG,AN Rianti dr. Sp.A OC00038 Cefila Dry Syrup 1.00 Botol 123,255.00 123,755.00
R2019-0000075467 27-12-2019 201900072507/103911 ALENA REMBANG,AN Rianti dr. Sp.A OI00117 Imunos Plus Syrup, 60ml 1.00 Botol 136,620.00 137,120.00
R2019-0000075468 27-12-2019 201900072508/112294 CATALINA FREDRIK, Dr,Sp.A OE00017 Epexol Syrup 1.00 Botol 25,690.50 26,190.50
R2019-0000075468 27-12-2019 201900072508/112294 CATALINA FREDRIK, Dr,Sp.A OT00076 Tremenza Syrup 1.00 Botol 30,442.50 30,942.50
R2019-0000075534 27-12-2019 201900072504/112292 ACHMAD RIZALDI,SDR Niki Juniar OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000075534 27-12-2019 201900072504/112292 ACHMAD RIZALDI,SDR Niki Juniar OB00007 Becom - C 5.00 Tablet 2,123.55 11,117.75
R2019-0000075535 27-12-2019 201900072505/32932 ENDRU DAFFA Niki Juniar OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000075535 27-12-2019 201900072505/32932 ENDRU DAFFA Niki Juniar OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000075535 27-12-2019 201900072505/32932 ENDRU DAFFA Niki Juniar OB00007 Becom - C 5.00 Tablet 2,123.55 11,117.75
R2019-0000075535 27-12-2019 201900072505/32932 ENDRU DAFFA Niki Juniar ALP00026 Policrepe 6" (15cmx4.5m) 1.00 Roll 122,958.00 123,458.00
R2019-0000075536 27-12-2019 201900072506/112293 SEVHANDI CEURO Niki Juniar OV00107 Vosedon Tablet 10.00 Tablet 3,452.63 35,026.30
R2019-0000075536 27-12-2019 201900072506/112293 SEVHANDI CEURO Niki Juniar OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000075536 27-12-2019 201900072506/112293 SEVHANDI CEURO Niki Juniar OB00007 Becom - C 5.00 Tablet 2,123.55 11,117.75
R2019-0000075537 27-12-2019 201900072512/020642 MUHAMMAD Niki Juniar OU00022 Urotractin 400mg Tablet 6.00 Tablet 7,189.03 43,634.18
R2019-0000075537 27-12-2019 201900072512/020642 MUHAMMAD Niki Juniar OE00057 Eperisone Hcl 50mg 6.00 Tablet 2,286.90 14,221.40
R2019-0000075538 27-12-2019 201900072510/112295 MUHAMMAD Niki Juniar OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000075538 27-12-2019 201900072510/112295 MUHAMMAD Niki Juniar OE00057 Eperisone Hcl 50mg 4.00 Tablet 2,286.90 9,647.60
R2019-0000075540 27-12-2019 201900072492/105534 SAFITRI,NN Niki Juniar OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075540 27-12-2019 201900072492/105534 SAFITRI,NN Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000075541 27-12-2019 201900072429/107277 DAVID ALEXANDER,BY Niki Juniar OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075541 27-12-2019 201900072429/107277 DAVID ALEXANDER,BY Niki Juniar OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000075544 27-12-2019 201900072515/112261 TONY JANA Niki Juniar OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075544 27-12-2019 201900072515/112261 TONY JANA Niki Juniar OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000075545 27-12-2019 201900072517/00012341 GUSNANINGSIH,NY Niki Juniar OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000075550 27-12-2019 201900072521/027435 PUTRI SILA ADE RAHMAH OM00058 Microlax Enema Rectal 1.00 Tube 27,843.00 28,343.00
R2019-0000075550 27-12-2019 201900072521/027435 PUTRI SILA ADE RAHMAH OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000075567 28-12-2019 201900072528/112300 SENTOSA ADE RAHMAH OF00039 FG Troches 10.00 Tablet 1,730.02 17,800.20
R2019-0000075567 28-12-2019 201900072528/112300 SENTOSA ADE RAHMAH OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000075566 28-12-2019 201900072527/112299 FEBI HANY ADE RAHMAH OA00015 Acyclovir 400mg (OGB) 80.00 Tablet 1,262.25 101,480.00
Total 319,215,865.07
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 238 dari 266
ASAL RAWAT JALAN
R2019-0000075566 28-12-2019 201900072527/112299 FEBI HANY ADE RAHMAH OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000075566 28-12-2019 201900072527/112299 FEBI HANY ADE RAHMAH OM00102 Mucohexin Elixir, 120ml 1.00 Botol 24,354.00 24,854.00
R2019-0000075566 28-12-2019 201900072527/112299 FEBI HANY ADE RAHMAH OA00016 Acyclovir Cream 5gr 1.00 Tube 4,893.00 5,393.00
R2019-0000075566 28-12-2019 201900072527/112299 FEBI HANY ADE RAHMAH OC00120 Cortidex Tablet 10.00 Tablet 430.65 4,806.50
R2019-0000075568 28-12-2019 201800041158/038373 NADYA PUTRI SEPTIA NOVITA OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075568 28-12-2019 201800041158/038373 NADYA PUTRI SEPTIA NOVITA OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000075569 27-12-2019 201900072519/111579 HARDI, ST,TN ADE RAHMAH OB001002 Betahistine 1.00 Tab 5,940.00 6,440.00
R2019-0000075569 27-12-2019 201900072519/111579 HARDI, ST,TN ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000075570 28-12-2019 201900072523/112297 CYNTIA OKTAVIA,NY ADE RAHMAH ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000075571 28-12-2019 201900072531/107552 MUHAMMAD RAY YAN ADE RAHMAH OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000075572 28-12-2019 201900072525/076965 AGUSTINA UTARY,NY ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000075575 28-12-2019 201900072531/107552 MUHAMMAD RAY YAN ADE RAHMAH OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2019-0000075575 28-12-2019 201900072531/107552 MUHAMMAD RAY YAN ADE RAHMAH OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
R2019-0000075575 28-12-2019 201900072531/107552 MUHAMMAD RAY YAN ADE RAHMAH OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000075577 28-12-2019 201900072526/076190 AZZAHRA FADLI ADE RAHMAH OB00091 Biovitan Syrup, 60ml 1.00 Botol 8,019.00 8,519.00
R2019-0000075578 28-12-2019 201900072525/076965 AGUSTINA UTARY,NY ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075578 28-12-2019 201900072525/076965 AGUSTINA UTARY,NY ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000075578 28-12-2019 201900072525/076965 AGUSTINA UTARY,NY ADE RAHMAH OA00085 Antasida Tablet (OGB) 6.00 Tablet 284.30 2,205.80
R2019-0000075578 28-12-2019 201900072525/076965 AGUSTINA UTARY,NY ADE RAHMAH OS00057 Scopamin Plus Caplet 3.00 Tablet 3,712.50 11,637.50
R2019-0000075580 28-12-2019 201900072524/112298 RUKMAN,TN ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075580 28-12-2019 201900072524/112298 RUKMAN,TN ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 6.00 Capsul 1,169.98 7,519.88
R2019-0000075579 28-12-2019 201900072523/112297 CYNTIA OKTAVIA,NY ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075579 28-12-2019 201900072523/112297 CYNTIA OKTAVIA,NY ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 3.00 Capsul 1,169.98 4,009.94
R2019-0000075579 28-12-2019 201900072523/112297 CYNTIA OKTAVIA,NY ADE RAHMAH OA00085 Antasida Tablet (OGB) 3.00 Tablet 284.30 1,352.90
R2019-0000075582 27-12-2019 201900072522/103345 HERY SUGIARTO,TN ADE RAHMAH OP00036 Phenytoin Capsul 6.00 Capsul 816.75 5,400.50
R2019-0000075584 27-12-2019 201900072520/112296 MARK KEANY ADE RAHMAH OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000075584 27-12-2019 201900072520/112296 MARK KEANY ADE RAHMAH OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000075583 27-12-2019 201900072519/111579 HARDI, ST,TN ADE RAHMAH OB00016 Betahistine Mesilat 6mg 3.00 Tablet 1,500.00 5,000.00
R2019-0000075583 27-12-2019 201900072519/111579 HARDI, ST,TN ADE RAHMAH OF00148 Flunarizine 10mg (OGB) 3.00 Tablet 5,940.00 18,320.00
R2019-0000075583 27-12-2019 201900072519/111579 HARDI, ST,TN ADE RAHMAH OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000075585 27-12-2019 201900072517/00012341 GUSNANINGSIH,NY Niki Juniar OB00016 Betahistine Mesilat 6mg 4.00 Tablet 1,500.00 6,500.00
R2019-0000075585 27-12-2019 201900072517/00012341 GUSNANINGSIH,NY Niki Juniar OF00065 Flunarizine 5mg 4.00 Tablet 2,970.00 12,380.00
R2019-0000075585 27-12-2019 201900072517/00012341 GUSNANINGSIH,NY Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000075595 28-12-2019 201900072549/112301 ISRI WAHYUNI,NN MAGDA ROSSA, OC00034 Cefadroxil 500mg (OGB) 12.00 Capsul 1,633.50 20,102.00
R2019-0000075595 28-12-2019 201900072549/112301 ISRI WAHYUNI,NN MAGDA ROSSA, OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000075595 28-12-2019 201900072549/112301 ISRI WAHYUNI,NN MAGDA ROSSA, OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000075587 28-12-2019 201900072540/109285 LAMINAH,NY EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000075587 28-12-2019 201900072540/109285 LAMINAH,NY EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
Total 319,738,937.62
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 239 dari 266
ASAL RAWAT JALAN
R2019-0000075587 28-12-2019 201900072540/109285 LAMINAH,NY EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
R2019-0000075587 28-12-2019 201900072540/109285 LAMINAH,NY EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000075587 28-12-2019 201900072540/109285 LAMINAH,NY EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000075598 28-12-2019 201900072562/061362 SUMIYAT I,NY EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 2.00 Botol 9,801.00 20,102.00
R2019-0000075598 28-12-2019 201900072562/061362 SUMIYAT I,NY EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000075598 28-12-2019 201900072562/061362 SUMIYAT I,NY EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000075599 28-12-2019 201900072534/38118 SRI PRIHARTINI,NY EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000075599 28-12-2019 201900072534/38118 SRI PRIHARTINI,NY EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000075599 28-12-2019 201900072534/38118 SRI PRIHARTINI,NY EDO, Dr.Sp.B ALP00031 Povidon Iodin, 60ml 1.00 Botol 9,801.00 10,301.00
R2019-0000075599 28-12-2019 201900072534/38118 SRI PRIHARTINI,NY EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000075599 28-12-2019 201900072534/38118 SRI PRIHARTINI,NY EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000075600 28-12-2019 201900072552/111377 DEWI SHINTA R,AN EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000075600 28-12-2019 201900072552/111377 DEWI SHINTA R,AN EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000075600 28-12-2019 201900072552/111377 DEWI SHINTA R,AN EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000075600 28-12-2019 201900072552/111377 DEWI SHINTA R,AN EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000075601 28-12-2019 201900072553/109037 TUMINAH,NY EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000075601 28-12-2019 201900072553/109037 TUMINAH,NY EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000075601 28-12-2019 201900072553/109037 TUMINAH,NY EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000075601 28-12-2019 201900072553/109037 TUMINAH,NY EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2019-0000075602 28-12-2019 201900072618/068879 MUHAMMAD INDRA EDO, Dr.Sp.B OG00024 Glimepiride 4mg Tablet 23.00 Tablet 3,869.89 89,507.47
R2019-0000075602 28-12-2019 201900072618/068879 MUHAMMAD INDRA EDO, Dr.Sp.B OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2019-0000075602 28-12-2019 201900072618/068879 MUHAMMAD INDRA EDO, Dr.Sp.B OP00200 Pioglitazon 30 Mg 12.00 Tab 7,425.00 89,600.00
R2019-0000075602 28-12-2019 201900072618/068879 MUHAMMAD INDRA EDO, Dr.Sp.B OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000075604 28-12-2019 201900072576/112303 EKA SEPTIAN Dwi Astuti, dr OO00075 Otilon Tetes Telinga 1.00 Botol 57,246.75 57,746.75
R2019-0000075604 28-12-2019 201900072576/112303 EKA SEPTIAN Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 6.00 Tablet 415.80 2,994.80
R2019-0000075608 28-12-2019 201900072595/112305 MUHAMAD FATONI,TN Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000075608 28-12-2019 201900072595/112305 MUHAMAD FATONI,TN Dwi Astuti, dr OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000075608 28-12-2019 201900072595/112305 MUHAMAD FATONI,TN Dwi Astuti, dr OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000075608 28-12-2019 201900072595/112305 MUHAMAD FATONI,TN Dwi Astuti, dr OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2019-0000075610 28-12-2019 201900072596/112306 NASMAH,NY Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000075610 28-12-2019 201900072596/112306 NASMAH,NY Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000075610 28-12-2019 201900072596/112306 NASMAH,NY Dwi Astuti, dr OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000075621 28-12-2019 201900072565/081192 RUKMAYANTI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075621 28-12-2019 201900072565/081192 RUKMAYANTI,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000075621 28-12-2019 201900072565/081192 RUKMAYANTI,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000075622 28-12-2019 201900072536/41246 ARIWIDIATI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075624 28-12-2019 201900072622/077462 HAFIZAH DZAKIAH Riyanti Puji dr. OF00141 Farizol Suspensi, 60ml 1.00 Botol 18,532.00 19,032.00
R2019-0000075625 28-12-2019 201900072585/109420 ELLY DEWI SUSEIN,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
Total 320,639,972.59
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 240 dari 266
ASAL RAWAT JALAN
R2019-0000075625 28-12-2019 201900072585/109420 ELLY DEWI SUSEIN,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075625 28-12-2019 201900072585/109420 ELLY DEWI SUSEIN,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000075625 28-12-2019 201900072585/109420 ELLY DEWI SUSEIN,NY LUSY E. Dr.Sp.PD OG00021 Glimepiride 1mg Tablet 7.00 Tablet 1,245.00 9,215.00
R2019-0000075626 28-12-2019 201900072615/018288 DALA ULENG, HJ,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000075629 28-12-2019 201900072629/076295 ZAKIR FAQIH AL FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 4.00 Capsul 28,957.00 116,328.00
R2019-0000075629 28-12-2019 201900072629/076295 ZAKIR FAQIH AL FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 3.00 Tablet 430.65 1,791.95
R2019-0000075629 28-12-2019 201900072629/076295 ZAKIR FAQIH AL FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000075629 28-12-2019 201900072629/076295 ZAKIR FAQIH AL FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 3.00 Tablet 1,232.55 4,197.65
R2019-0000075629 28-12-2019 201900072629/076295 ZAKIR FAQIH AL FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000075629 28-12-2019 201900072629/076295 ZAKIR FAQIH AL FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000075631 28-12-2019 201900072638/112137 HAMIDAH,BY FREDRIK, Dr,Sp.A OC00173 Cetirizine 10mg/ml Drop, 1.00 Botol 37,125.00 37,625.00
R2019-0000075634 28-12-2019 201900072623/075126 ASMAHRITA,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075634 28-12-2019 201900072623/075126 ASMAHRITA,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075634 28-12-2019 201900072623/075126 ASMAHRITA,NY LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000075634 28-12-2019 201900072623/075126 ASMAHRITA,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000075634 28-12-2019 201900072623/075126 ASMAHRITA,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000075635 28-12-2019 201900072656/112244 SUYANTO,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000075635 28-12-2019 201900072656/112244 SUYANTO,TN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075637 28-12-2019 201900072627/077027 ARJUNA KRISNA,AN FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 5.00 Capsul 4,266.70 21,833.50
R2019-0000075637 28-12-2019 201900072627/077027 ARJUNA KRISNA,AN FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000075637 28-12-2019 201900072627/077027 ARJUNA KRISNA,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000075637 28-12-2019 201900072627/077027 ARJUNA KRISNA,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000075637 28-12-2019 201900072627/077027 ARJUNA KRISNA,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000075639 28-12-2019 201900072615/018288 DALA ULENG, HJ,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075641 28-12-2019 201900072603/112304 SURATMAN,TN LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000075641 28-12-2019 201900072603/112304 SURATMAN,TN LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000075641 28-12-2019 201900072603/112304 SURATMAN,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 10.00 Tablet 371.25 4,212.50
R2019-0000075641 28-12-2019 201900072603/112304 SURATMAN,TN LUSY E. Dr.Sp.PD OL00059 Levofloxacin 500mg 5.00 Tablet 1,793.00 9,465.00
R2019-0000075641 28-12-2019 201900072603/112304 SURATMAN,TN LUSY E. Dr.Sp.PD OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000075641 28-12-2019 201900072603/112304 SURATMAN,TN LUSY E. Dr.Sp.PD ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000075642 28-12-2019 201900072603/112304 SURATMAN,TN LUSY E. Dr.Sp.PD OL00056 Levemir Insulin 1.00 Flexpen 287,330.88 287,830.88
R2019-0000075643 28-12-2019 201900072618/068879 MUHAMMAD INDRA LUSY E. Dr.Sp.PD OG00024 Glimepiride 4mg Tablet 7.00 Tablet 3,869.89 27,589.23
R2019-0000075643 28-12-2019 201900072618/068879 MUHAMMAD INDRA LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000075643 28-12-2019 201900072618/068879 MUHAMMAD INDRA LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 3.00 Tab 7,425.00 22,775.00
R2019-0000075643 28-12-2019 201900072618/068879 MUHAMMAD INDRA LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075643 28-12-2019 201900072618/068879 MUHAMMAD INDRA LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 7.00 Tablet 811.18 6,178.26
Total 322,187,955.66
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 241 dari 266
ASAL RAWAT JALAN
R2019-0000075643 28-12-2019 201900072618/068879 MUHAMMAD INDRA LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000075643 28-12-2019 201900072618/068879 MUHAMMAD INDRA LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075602 28-12-2019 201900072618/068879 MUHAMMAD INDRA EDO, Dr.Sp.B OG00009 Gemfibrozil 300mg (OGB) 23.00 Tablet 811.18 19,157.14
R2019-0000075602 28-12-2019 201900072618/068879 MUHAMMAD INDRA EDO, Dr.Sp.B OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2019-0000075602 28-12-2019 201900072618/068879 MUHAMMAD INDRA EDO, Dr.Sp.B OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000075644 28-12-2019 201900072577/110648 SITI AMINAH,NY LUSY E. Dr.Sp.PD OV00056 Ventolin Inhaler CFC 1.00 Botol 157,599.99 158,099.99
R2019-0000075646 28-12-2019 201900072599/048520 SARDIMAN A BUTAR LUSY E. Dr.Sp.PD OT00135 Thyrozol 5mg 7.00 Tablet 2,188.89 15,822.23
R2019-0000075646 28-12-2019 201900072599/048520 SARDIMAN A BUTAR LUSY E. Dr.Sp.PD OP00118 Propanolol 40mg (OGB) 11.00 Tablet 404.89 4,953.79
R2019-0000075662 28-12-2019 201900072613/058002 KHAULAH,AN FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 5.00 Capsul 4,266.70 21,833.50
R2019-0000075662 28-12-2019 201900072613/058002 KHAULAH,AN FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 4.00 Tablet 208.00 1,332.00
R2019-0000075662 28-12-2019 201900072613/058002 KHAULAH,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000075662 28-12-2019 201900072613/058002 KHAULAH,AN FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
R2019-0000075662 28-12-2019 201900072613/058002 KHAULAH,AN FREDRIK, Dr,Sp.A OS00009 Salbutamol 2mg (OGB) 3.00 Tablet 213.30 1,139.90
R2019-0000075662 28-12-2019 201900072613/058002 KHAULAH,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000075662 28-12-2019 201900072613/058002 KHAULAH,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2019-0000075663 28-12-2019 201900072666/112314 MASNUN SURATIN,NY Nathalia dr. OA00074 Analsik 2.00 Tablet 2,264.63 5,029.26
R2019-0000075663 28-12-2019 201900072666/112314 MASNUN SURATIN,NY Nathalia dr. OA00085 Antasida Tablet (OGB) 10.00 Tablet 284.30 3,343.00
R2019-0000075663 28-12-2019 201900072666/112314 MASNUN SURATIN,NY Nathalia dr. OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000075665 28-12-2019 201900072658/052032 YULIA ERNAWATI,NY Dwi Astuti, dr OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075665 28-12-2019 201900072658/052032 YULIA ERNAWATI,NY Dwi Astuti, dr OL00021 Lansoprazole (OGB) 5.00 Capsul 2,230.00 11,650.00
R2019-0000075665 28-12-2019 201900072658/052032 YULIA ERNAWATI,NY Dwi Astuti, dr OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000075667 28-12-2019 201900072678/112316 PRIYO HARTONO,TN Nathalia dr. OE00018 Epexol Tablet 10.00 Tablet 1,232.55 12,825.50
R2019-0000075676 28-12-2019 201900072680/106873 RIZKY INDRIANI Nathalia dr. OS00176 Scopma Plus Tablet 10.00 Tablet 2,090.22 21,402.20
R2019-0000075676 28-12-2019 201900072680/106873 RIZKY INDRIANI Nathalia dr. OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000075676 28-12-2019 201900072680/106873 RIZKY INDRIANI Nathalia dr. ON00009 Natrium Diklofenac 50mg 6.00 Tablet 955.84 6,235.04
R2019-0000075677 28-12-2019 201900072672/19559 KUSMAWATI,NY Nathalia dr. OB00016 Betahistine Mesilat 6mg 6.00 Tablet 1,500.00 9,500.00
R2019-0000075677 28-12-2019 201900072672/19559 KUSMAWATI,NY Nathalia dr. OV00080 Vitamin B Compleks 10.00 Tablet 241.79 2,917.90
R2019-0000075678 28-12-2019 201900072679/095111 AYSHA AILANI Nathalia dr. OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000075678 28-12-2019 201900072679/095111 AYSHA AILANI Nathalia dr. OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000075679 28-12-2019 201900072681/073765 PONY,NY Nathalia dr. OB00050 Braxidin 10.00 Tablet 1,648.35 16,983.50
R2019-0000075679 28-12-2019 201900072681/073765 PONY,NY Nathalia dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075679 28-12-2019 201900072681/073765 PONY,NY Nathalia dr. OD00065 Domperidon Tablet (OGB) 10.00 Tablet 750.00 8,000.00
R2019-0000075680 28-12-2019 201900072677/112315 TESTYAN Nathalia dr. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000075680 28-12-2019 201900072677/112315 TESTYAN Nathalia dr. OP00011 Paracetamol 500mg 1.00 Tablet 387.36 887.36
R2019-0000075681 28-12-2019 201900072682/094510 ALIF SULTIANA,NN Nathalia dr. OO00022 Opicef 500mg Capsul 10.00 Capsul 14,850.00 149,000.00
R2019-0000075681 28-12-2019 201900072682/094510 ALIF SULTIANA,NN Nathalia dr. OE00018 Epexol Tablet 10.00 Tablet 1,232.55 12,825.50
R2019-0000075681 28-12-2019 201900072682/094510 ALIF SULTIANA,NN Nathalia dr. OT00077 Tremenza Tablet 10.00 Tablet 2,160.68 22,106.80
R2019-0000075687 28-12-2019 201900072684/087768 AGUSTYA RAHMA Niki Juniar OA00068 Amoxsan Capsul, 500mg 10.00 Capsul 4,752.00 48,020.00
Total 323,028,192.77
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 242 dari 266
ASAL RAWAT JALAN
R2019-0000075687 28-12-2019 201900072684/087768 AGUSTYA RAHMA Niki Juniar OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000075687 28-12-2019 201900072684/087768 AGUSTYA RAHMA Niki Juniar OG00066 Genoint Salep Kulit 1.00 Tube 7,350.75 7,850.75
R2019-0000075628 28-12-2019 201900072883/112312 MISRIATI,NY Dwi Astuti, dr OC00041 Cefotaxim 1.0gr Injeksi 2.00 Vial 60,885.00 122,270.00
R2019-0000075628 28-12-2019 201900072883/112312 MISRIATI,NY Dwi Astuti, dr OW00001 Water For Injeksi 25ml 2.00 Botol 9,222.00 18,944.00
R2019-0000075689 28-12-2019 201900072883/112312 MISRIATI,NY Dwi Astuti, dr ALB00132 Blood Set 1.00 Pcs 33,976.80 34,476.80
R2019-0000075689 28-12-2019 201900072883/112312 MISRIATI,NY Dwi Astuti, dr OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000075689 28-12-2019 201900072883/112312 MISRIATI,NY Dwi Astuti, dr ALF00007 Folley Catheter No. 14 1.00 Pcs 37,125.00 37,625.00
R2019-0000075690 28-12-2019 201900072659/110176 REFAT SALMAN,AN Dwi Astuti, dr OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000075690 28-12-2019 201900072659/110176 REFAT SALMAN,AN Dwi Astuti, dr ALI00006 I.V Catheter No. 24 3.00 Pcs 38,900.00 117,200.00
R2019-0000075690 28-12-2019 201900072659/110176 REFAT SALMAN,AN Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000075690 28-12-2019 201900072659/110176 REFAT SALMAN,AN Dwi Astuti, dr OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000075691 28-12-2019 201900072429/107277 DAVID ALEXANDER,BY Niki Juniar OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2019-0000075691 28-12-2019 201900072429/107277 DAVID ALEXANDER,BY Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000075691 28-12-2019 201900072429/107277 DAVID ALEXANDER,BY Niki Juniar ALI00006 I.V Catheter No. 24 3.00 Pcs 38,900.00 117,200.00
R2019-0000075694 28-12-2019 201900072687/054399 ARI NURAINUN,NY Nathalia dr. OV00080 Vitamin B Compleks 10.00 Tablet 241.79 2,917.90
R2019-0000075694 28-12-2019 201900072687/054399 ARI NURAINUN,NY Nathalia dr. OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000075693 28-12-2019 201900072690/025731 KASMAH,NY Nathalia dr. OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000075693 28-12-2019 201900072690/025731 KASMAH,NY Nathalia dr. OS00010 Salbutamol 4mg (OGB) 10.00 Tablet 249.48 2,994.80
R2019-0000075693 28-12-2019 201900072690/025731 KASMAH,NY Nathalia dr. OA00180 Acetylcyst ein 200mg 10.00 Tablet 1,485.00 15,350.00
R2019-0000075695 28-12-2019 201900072686/112317 ROEMAWIN Nathalia dr. OC00039 Cefixime 100mg (OGB) 20.00 Capsul 4,266.70 85,834.00
R2019-0000075695 28-12-2019 201900072686/112317 ROEMAWIN Nathalia dr. OA00064 Amlodipin 5mg (OGB) 10.00 Tablet 1,555.00 16,050.00
R2019-0000075695 28-12-2019 201900072686/112317 ROEMAWIN Nathalia dr. OS00057 Scopamin Plus Caplet 10.00 Tablet 3,712.50 37,625.00
R2019-0000075696 28-12-2019 201900072529/038373 NADYA PUTRI ADE RAHMAH OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000075699 28-12-2019 201900072604/106902 SAN ZEFO BET SEAN MAGDA ROSSA, OC00033 Cefadroxil 125mg Syrup, 1.00 Botol 13,283.32 13,783.32
R2019-0000075700 28-12-2019 201900072614/100624 WA BONSA,NN Dwi Astuti, dr ON00047 New Diatabs 6.00 Tablet 767.13 5,102.78
R2019-0000075700 28-12-2019 201900072614/100624 WA BONSA,NN Dwi Astuti, dr OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000075700 28-12-2019 201900072614/100624 WA BONSA,NN Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000075697 28-12-2019 201900072663/112313 FAIZ AMRU Nathalia dr. ALN00013 NGT (Stomach Tube) No. 1.00 Pcs 44,550.00 45,050.00
R2019-0000075697 28-12-2019 201900072663/112313 FAIZ AMRU Nathalia dr. ALU00007 Urine Bag 1.00 Pcs 19,305.00 19,805.00
R2019-0000075697 28-12-2019 201900072663/112313 FAIZ AMRU Nathalia dr. ALF00007 Folley Catheter No. 14 1.00 Pcs 37,125.00 37,625.00
R2019-0000075697 28-12-2019 201900072663/112313 FAIZ AMRU Nathalia dr. OE00055 Ecosol RL 500ml 2.00 Botol 19,305.00 39,110.00
R2019-0000075697 28-12-2019 201900072663/112313 FAIZ AMRU Nathalia dr. ALK00008 Kasa Perban 10cm 1.00 Pcs 3,267.00 3,767.00
R2019-0000075697 28-12-2019 201900072663/112313 FAIZ AMRU Nathalia dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000075697 28-12-2019 201900072663/112313 FAIZ AMRU Nathalia dr. ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000075697 28-12-2019 201900072663/112313 FAIZ AMRU Nathalia dr. ALU00004 Underpad 4.00 Pcs 11,880.00 48,020.00
R2019-0000075697 28-12-2019 201900072663/112313 FAIZ AMRU Nathalia dr. ALM00015 Masker Oxygen Non 1.00 Pcs 82,863.00 83,363.00
R2019-0000075702 28-12-2019 201900072681/073765 PONY,NY Nathalia dr. OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000075702 28-12-2019 201900072681/073765 PONY,NY Nathalia dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
Total 324,378,906.57
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 243 dari 266
ASAL RAWAT JALAN
R2019-0000075702 28-12-2019 201900072681/073765 PONY,NY Nathalia dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000075703 28-12-2019 201900072690/025731 KASMAH,NY Nathalia dr. OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075703 28-12-2019 201900072690/025731 KASMAH,NY Nathalia dr. OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000075703 28-12-2019 201900072690/025731 KASMAH,NY Nathalia dr. OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000075704 28-12-2019 201900072686/112317 ROEMAWIN Nathalia dr. OC00019 Captopril 25mg (OGB) 1.00 Tablet 267.35 767.35
R2019-0000075705 28-12-2019 201900072672/19559 KUSMAWATI,NY Nathalia dr. OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000075706 28-12-2019 201900072696/097431 GINDO PANJAITAN,TN Nathalia dr. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000075706 28-12-2019 201900072696/097431 GINDO PANJAITAN,TN Nathalia dr. ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000075706 28-12-2019 201900072696/097431 GINDO PANJAITAN,TN Nathalia dr. ALI00004 I.V Catheter No. 20 2.00 Pcs 36,808.20 74,116.40
R2019-0000075707 28-12-2019 201900072692/112318 FADHIL Nathalia dr. OD00077 Dumin Rectal 250mg 1.00 Tube 29,254.50 29,754.50
R2019-0000075710 28-12-2019 201900072695/21586 RUSLAN, Nathalia dr. OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075710 28-12-2019 201900072695/21586 RUSLAN, Nathalia dr. OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000075710 28-12-2019 201900072695/21586 RUSLAN, Nathalia dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000075711 28-12-2019 201900072666/112314 MASNUN SURATIN,NY Nathalia dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000075711 28-12-2019 201900072666/112314 MASNUN SURATIN,NY Nathalia dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000075701 28-12-2019 201800019783/068472 RUFAIDHAH PUTRI ANDINA OD00077 Dumin Rectal 250mg 1.00 Tube 29,254.50 29,754.50
R2019-0000075712 28-12-2019 201900072692/112318 FADHIL Nathalia dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000075712 28-12-2019 201900072692/112318 FADHIL Nathalia dr. OA00066 Amoxicillin Tablet, 500mg 8.00 Tablet 1,113.75 9,410.00
R2019-0000075712 28-12-2019 201900072692/112318 FADHIL Nathalia dr. OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000075712 28-12-2019 201900072692/112318 FADHIL Nathalia dr. ON00047 New Diatabs 10.00 Tablet 767.13 8,171.30
R2019-0000075715 28-12-2019 201900072693/112319 RABUYATUL Eko Dian Syafitra OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000075715 28-12-2019 201900072693/112319 RABUYATUL Eko Dian Syafitra OO00022 Opicef 500mg Capsul 10.00 Capsul 14,850.00 149,000.00
R2019-0000075715 28-12-2019 201900072693/112319 RABUYATUL Eko Dian Syafitra OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000075715 28-12-2019 201900072693/112319 RABUYATUL Eko Dian Syafitra OS00016 Sanadryl Expectoran 1.00 Botol 14,701.50 15,201.50
R2019-0000075715 28-12-2019 201900072693/112319 RABUYATUL Eko Dian Syafitra OP00011 Paracetamol 500mg 1.00 Tablet 387.36 887.36
R2019-0000075714 28-12-2019 201900072694/112320 RUFAIDAH Eko Dian Syafitra OA00069 Amoxsan Drop 1.00 Botol 33,264.00 33,764.00
R2019-0000075714 28-12-2019 201900072694/112320 RUFAIDAH Eko Dian Syafitra OE00007 Elkana Syrup 1.00 Botol 34,303.50 34,803.50
R2019-0000075714 28-12-2019 201900072694/112320 RUFAIDAH Eko Dian Syafitra OS00030 Sanmol Drop, 15ml 1.00 Botol 23,314.00 23,814.00
R2019-0000075729 28-12-2019 201900072697/091157 MONA JULIADE Eko Dian Syafitra OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000075729 28-12-2019 201900072697/091157 MONA JULIADE Eko Dian Syafitra OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000075729 28-12-2019 201900072697/091157 MONA JULIADE Eko Dian Syafitra OS00026 Sanmag Syrup 1.00 Botol 37,125.00 37,625.00
R2019-0000075730 29-12-2019 201900072704/104482 MANSON HUTAPEA,TN Eko Dian Syafitra OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000075731 29-12-2019 201900072698/00012901 HAMIM SOLIHIN,TN Eko Dian Syafitra OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000075731 29-12-2019 201900072698/00012901 HAMIM SOLIHIN,TN Eko Dian Syafitra OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000075732 29-12-2019 201900072703/094641 NADYA SHESILIA,NN Eko Dian Syafitra OM00046 Methyl Prednisolon 8mg 10.00 Tablet 965.25 10,152.50
R2019-0000075732 29-12-2019 201900072703/094641 NADYA SHESILIA,NN Eko Dian Syafitra OA00180 Acetylcyst ein 200mg 10.00 Tablet 1,485.00 15,350.00
R2019-0000075732 29-12-2019 201900072703/094641 NADYA SHESILIA,NN Eko Dian Syafitra OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000075732 29-12-2019 201900072703/094641 NADYA SHESILIA,NN Eko Dian Syafitra OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
Total 325,355,663.06
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 244 dari 266
ASAL RAWAT JALAN
R2019-0000075739 28-12-2019 201900072712/112321 ASTRI YULIANI,NY Eko Dian Syafitra OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000075739 28-12-2019 201900072712/112321 ASTRI YULIANI,NY Eko Dian Syafitra ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000075739 28-12-2019 201900072712/112321 ASTRI YULIANI,NY Eko Dian Syafitra ALI00004 I.V Catheter No. 20 2.00 Pcs 36,808.20 74,116.40
R2019-0000075739 28-12-2019 201900072712/112321 ASTRI YULIANI,NY Eko Dian Syafitra ALI00011 Infus Set Makro 2.00 Pcs 12,087.90 24,675.80
R2019-0000075739 28-12-2019 201900072712/112321 ASTRI YULIANI,NY Eko Dian Syafitra OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000075739 28-12-2019 201900072712/112321 ASTRI YULIANI,NY Eko Dian Syafitra OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000075739 28-12-2019 201900072712/112321 ASTRI YULIANI,NY Eko Dian Syafitra OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 Botol 22,542.30 23,042.30
R2019-0000075740 29-12-2019 201900072711/055371 KURUSIAH,NY Eko Dian Syafitra OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000075740 29-12-2019 201900072711/055371 KURUSIAH,NY Eko Dian Syafitra OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000075740 29-12-2019 201900072711/055371 KURUSIAH,NY Eko Dian Syafitra OD00058 Dipenhydramine Injeksi 1.00 Ampul 2,517.23 3,017.23
R2019-0000075740 29-12-2019 201900072711/055371 KURUSIAH,NY Eko Dian Syafitra ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000075740 29-12-2019 201900072711/055371 KURUSIAH,NY Eko Dian Syafitra OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000075740 29-12-2019 201900072711/055371 KURUSIAH,NY Eko Dian Syafitra ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000075743 29-12-2019 201900072710/112323 DYAH PRISTYANTI,NY Eko Dian Syafitra OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000075743 29-12-2019 201900072710/112323 DYAH PRISTYANTI,NY Eko Dian Syafitra OL00076 Lodia 2mg 10.00 Tablet 1,485.00 15,350.00
R2019-0000075743 29-12-2019 201900072710/112323 DYAH PRISTYANTI,NY Eko Dian Syafitra OS00176 Scopma Plus Tablet 10.00 Tablet 2,090.22 21,402.20
R2019-0000075743 29-12-2019 201900072710/112323 DYAH PRISTYANTI,NY Eko Dian Syafitra OD00065 Domperidon Tablet (OGB) 10.00 Tablet 750.00 8,000.00
R2019-0000075742 28-12-2019 201900072636/8695 NURSIAH,NY LUSY E. Dr.Sp.PD OG00025 Gliquidone 30mg (OGB) 3.00 Tablet 1,967.44 6,402.32
R2019-0000075742 28-12-2019 201900072636/8695 NURSIAH,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000075742 28-12-2019 201900072636/8695 NURSIAH,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000075742 28-12-2019 201900072636/8695 NURSIAH,NY LUSY E. Dr.Sp.PD OG00057 Gabapentin 300mg (OGB) 10.00 Tablet 8,168.00 82,180.00
R2019-0000075751 28-12-2019 201900072630/059320 WAHYU LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000075751 28-12-2019 201900072630/059320 WAHYU LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000075751 28-12-2019 201900072630/059320 WAHYU LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000075751 28-12-2019 201900072630/059320 WAHYU LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 23.00 Tablet 240.30 6,026.90
R2019-0000075752 28-12-2019 201900072630/059320 WAHYU LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075752 28-12-2019 201900072630/059320 WAHYU LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075752 28-12-2019 201900072630/059320 WAHYU LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000075752 28-12-2019 201900072630/059320 WAHYU LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 7.00 Tablet 240.30 2,182.10
R2019-0000075754 28-12-2019 201900072541/061925 SUNAN,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075754 28-12-2019 201900072541/061925 SUNAN,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075754 28-12-2019 201900072541/061925 SUNAN,TN LUSY E. Dr.Sp.PD OH00025 Hydrochlortiazide (OGB) 3.00 Tablet 240.30 1,220.90
R2019-0000075754 28-12-2019 201900072541/061925 SUNAN,TN LUSY E. Dr.Sp.PD OB00016 Betahistine Mesilat 6mg 10.00 Tablet 1,500.00 15,500.00
R2019-0000075753 29-12-2019 201900072563/068954 LA BANTA,TN LUSY E. Dr.Sp.PD OP00184 Neo Protifed Tablet 10.00 Tablet 1,263.73 13,137.30
R2019-0000075753 29-12-2019 201900072563/068954 LA BANTA,TN LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000075753 29-12-2019 201900072563/068954 LA BANTA,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075753 29-12-2019 201900072563/068954 LA BANTA,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075755 28-12-2019 201900072544/104476 KARNI,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
Total 326,806,728.91
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 245 dari 266
ASAL RAWAT JALAN
R2019-0000075755 28-12-2019 201900072544/104476 KARNI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075755 28-12-2019 201900072544/104476 KARNI,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000075759 28-12-2019 201900072570/081806 SAMSIAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075759 28-12-2019 201900072570/081806 SAMSIAH,NY LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000075759 28-12-2019 201900072570/081806 SAMSIAH,NY LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000075758 29-12-2019 201900072718/112250 MUSWARANDI,SDR Dwi Astuti, dr OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000075761 28-12-2019 201900072584/111166 ANDI ROSALINA,NY LUSY E. Dr.Sp.PD OE00054 Euthyrox 100mcg 12.00 Tablet 3,256.93 39,583.16
R2019-0000075761 28-12-2019 201900072584/111166 ANDI ROSALINA,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000075761 28-12-2019 201900072584/111166 ANDI ROSALINA,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000075762 28-12-2019 201900072588/108099 ERNAWATI,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075763 28-12-2019 201900072566/063194 MURNIATY,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000075763 28-12-2019 201900072566/063194 MURNIATY,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2019-0000075763 28-12-2019 201900072566/063194 MURNIATY,NY LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 7.00 Tablet 2,525.00 18,175.00
R2019-0000075763 28-12-2019 201900072566/063194 MURNIATY,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000075763 28-12-2019 201900072566/063194 MURNIATY,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000075763 28-12-2019 201900072566/063194 MURNIATY,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000075765 28-12-2019 201900072598/062887 SRI RAHMAWATI,NY LUSY E. Dr.Sp.PD OL00106 Lisinopril 5mg (OGB) 6.00 Tablet 457.60 3,245.60
R2019-0000075765 28-12-2019 201900072598/062887 SRI RAHMAWATI,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000075765 28-12-2019 201900072598/062887 SRI RAHMAWATI,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000075764 28-12-2019 201900072608/026230 SELVIA IMELDA,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 14.00 Tablet 371.25 5,697.50
R2019-0000075768 28-12-2019 201900072599/048520 SARDIMAN A BUTAR LUSY E. Dr.Sp.PD OT00135 Thyrozol 5mg 23.00 Tablet 2,188.89 50,844.47
R2019-0000075768 28-12-2019 201900072599/048520 SARDIMAN A BUTAR LUSY E. Dr.Sp.PD OP00118 Propanolol 40mg (OGB) 19.00 Tablet 404.89 8,192.91
R2019-0000075745 29-12-2019 201900072715/078238 RATNA JAMILAH,NY Dwi Astuti, dr OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000075745 29-12-2019 201900072715/078238 RATNA JAMILAH,NY Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000075745 29-12-2019 201900072715/078238 RATNA JAMILAH,NY Dwi Astuti, dr OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000075745 29-12-2019 201900072715/078238 RATNA JAMILAH,NY Dwi Astuti, dr OF00065 Flunarizine 5mg 3.00 Tablet 2,970.00 9,410.00
R2019-0000075770 29-12-2019 201900072714/112324 ALHIQNI SHAKIEL Dwi Astuti, dr OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000075770 29-12-2019 201900072714/112324 ALHIQNI SHAKIEL Dwi Astuti, dr OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000075770 29-12-2019 201900072714/112324 ALHIQNI SHAKIEL Dwi Astuti, dr OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000075770 29-12-2019 201900072714/112324 ALHIQNI SHAKIEL Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 3.00 Tablet 1,113.75 3,841.25
R2019-0000075771 29-12-2019 201900072723/102809 JEANNIE YEARIKE Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000075771 29-12-2019 201900072723/102809 JEANNIE YEARIKE Dwi Astuti, dr OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000075771 29-12-2019 201900072723/102809 JEANNIE YEARIKE Dwi Astuti, dr OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2019-0000075787 29-12-2019 201900072725/073576 IRFAN YUSRAN,AN Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000075787 29-12-2019 201900072725/073576 IRFAN YUSRAN,AN Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000075787 29-12-2019 201900072725/073576 IRFAN YUSRAN,AN Dwi Astuti, dr OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000075787 29-12-2019 201900072725/073576 IRFAN YUSRAN,AN Dwi Astuti, dr OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000075787 29-12-2019 201900072725/073576 IRFAN YUSRAN,AN Dwi Astuti, dr OS00009 Salbutamol 2mg (OGB) 3.00 Tablet 213.30 1,139.90
Total 327,677,429.27
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 246 dari 266
ASAL RAWAT JALAN
R2019-0000075787 29-12-2019 201900072725/073576 IRFAN YUSRAN,AN Dwi Astuti, dr OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000075787 29-12-2019 201900072725/073576 IRFAN YUSRAN,AN Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000075787 29-12-2019 201900072725/073576 IRFAN YUSRAN,AN Dwi Astuti, dr OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000075789 29-12-2019 201900072730/015717 MUHAMMAD FAJRI Dwi Astuti, dr OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000075789 29-12-2019 201900072730/015717 MUHAMMAD FAJRI Dwi Astuti, dr OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000075789 29-12-2019 201900072730/015717 MUHAMMAD FAJRI Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000075789 29-12-2019 201900072730/015717 MUHAMMAD FAJRI Dwi Astuti, dr OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000075789 29-12-2019 201900072730/015717 MUHAMMAD FAJRI Dwi Astuti, dr OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000075793 29-12-2019 201900072731/112328 M ROBBYANTO,SDR Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000075793 29-12-2019 201900072731/112328 M ROBBYANTO,SDR Dwi Astuti, dr OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000075793 29-12-2019 201900072731/112328 M ROBBYANTO,SDR Dwi Astuti, dr OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000075793 29-12-2019 201900072731/112328 M ROBBYANTO,SDR Dwi Astuti, dr OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2019-0000075797 29-12-2019 201900072725/073576 IRFAN YUSRAN,AN Dwi Astuti, dr OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075797 29-12-2019 201900072725/073576 IRFAN YUSRAN,AN Dwi Astuti, dr OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000075810 29-12-2019 201900072734/024684 RUSDIANA,NY Herika dr. OG00057 Gabapentin 300mg (OGB) 1.00 Tablet 8,168.00 8,668.00
R2019-0000075810 29-12-2019 201900072734/024684 RUSDIANA,NY Herika dr. ALK00037 Kapsul No.1 2.00 pcs 200.00 5,400.00
R2019-0000075810 29-12-2019 201900072734/024684 RUSDIANA,NY Herika dr. OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000075810 29-12-2019 201900072734/024684 RUSDIANA,NY Herika dr. OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000075810 29-12-2019 201900072734/024684 RUSDIANA,NY Herika dr. OF00039 FG Troches 3.00 Tablet 1,730.02 5,690.06
R2019-0000075818 29-12-2019 201900072735/39341 TJAHYA,NY Herika dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075818 29-12-2019 201900072735/39341 TJAHYA,NY Herika dr. OL00021 Lansoprazole (OGB) 4.00 Capsul 2,230.00 9,420.00
R2019-0000075817 29-12-2019 201900072733/112330 ARY ANDANI,NY Herika dr. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000075817 29-12-2019 201900072733/112330 ARY ANDANI,NY Herika dr. OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000075817 29-12-2019 201900072733/112330 ARY ANDANI,NY Herika dr. OC00039 Cefixime 100mg (OGB) 6.00 Capsul 4,266.70 26,100.20
R2019-0000075817 29-12-2019 201900072733/112330 ARY ANDANI,NY Herika dr. OS00016 Sanadryl Expectoran 1.00 Botol 14,701.50 15,201.50
R2019-0000075819 29-12-2019 201900072732/112329 WANDA A. Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000075819 29-12-2019 201900072732/112329 WANDA A. Dwi Astuti, dr OI00001 Ibuprofen 400mg (OGB) 6.00 Tablet 682.00 4,592.00
R2019-0000075822 29-12-2019 201900072743/106873 RIZKY INDRIANI Herika dr. OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000075822 29-12-2019 201900072743/106873 RIZKY INDRIANI Herika dr. OT00063 Tramadol 50mg Tablet 6.00 Tablet 1,113.75 7,182.50
R2019-0000075824 29-12-2019 201900072745/088094 RAINA SHAFA,AN Herika dr. OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000075824 29-12-2019 201900072745/088094 RAINA SHAFA,AN Herika dr. OA00052 Ambroxol Tablet, 30mg 6.00 Tablet 445.50 3,173.00
R2019-0000075824 29-12-2019 201900072745/088094 RAINA SHAFA,AN Herika dr. OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000075823 29-12-2019 201900072742/079072 FITRI MARYANI,NY Herika dr. OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000075823 29-12-2019 201900072742/079072 FITRI MARYANI,NY Herika dr. OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000075823 29-12-2019 201900072742/079072 FITRI MARYANI,NY Herika dr. OA00085 Antasida Tablet (OGB) 10.00 Tablet 284.30 3,343.00
R2019-0000075826 29-12-2019 201900072739/083042 ZAINAL ABIDIN,TN Herika dr. OB00036 Bis oprolol 5mg (OGB) 2.00 Tablet 5,197.50 10,895.00
R2019-0000075826 29-12-2019 201900072739/083042 ZAINAL ABIDIN,TN Herika dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075826 29-12-2019 201900072739/083042 ZAINAL ABIDIN,TN Herika dr. OV00080 Vitamin B Compleks 2.00 Tablet 241.79 983.58
Total 328,160,961.95
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 247 dari 266
ASAL RAWAT JALAN
R2019-0000075827 29-12-2019 201900072738/112331 HASNA PRADIPTA Herika dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000075827 29-12-2019 201900072738/112331 HASNA PRADIPTA Herika dr. OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000075827 29-12-2019 201900072738/112331 HASNA PRADIPTA Herika dr. OP00198 Protifed Syrup 60 ml 1.00 Botol 11,063.25 11,563.25
R2019-0000075827 29-12-2019 201900072738/112331 HASNA PRADIPTA Herika dr. OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000075828 29-12-2019 201900072746/112332 NUR YAHMAN,TN Herika dr. OS00029 Sanmol Tablet, 500mg 12.00 Tablet 430.65 5,667.80
R2019-0000075828 29-12-2019 201900072746/112332 NUR YAHMAN,TN Herika dr. OS00014 Sanadryl DMP Syrup, 60ml 1.00 Botol 17,820.00 18,320.00
R2019-0000075828 29-12-2019 201900072746/112332 NUR YAHMAN,TN Herika dr. OC00034 Cefadroxil 500mg (OGB) 10.00 Capsul 1,633.50 16,835.00
R2019-0000075831 29-12-2019 201900072747/102802 FITRAH DAVIDSON Herika dr. OS00009 Salbutamol 2mg (OGB) 3.00 Tablet 213.30 1,139.90
R2019-0000075831 29-12-2019 201900072747/102802 FITRAH DAVIDSON Herika dr. OS00079 Sirplus Granula 1.00 Granula 297.00 797.00
R2019-0000075831 29-12-2019 201900072747/102802 FITRAH DAVIDSON Herika dr. ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000075831 29-12-2019 201900072747/102802 FITRAH DAVIDSON Herika dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000075831 29-12-2019 201900072747/102802 FITRAH DAVIDSON Herika dr. OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000075831 29-12-2019 201900072747/102802 FITRAH DAVIDSON Herika dr. OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000075832 29-12-2019 201900072752/112334 SALBIAH,NY Herika dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075832 29-12-2019 201900072752/112334 SALBIAH,NY Herika dr. OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000075832 29-12-2019 201900072752/112334 SALBIAH,NY Herika dr. OC00172 Candesartan Cilexetil 2.00 Tablet 10,617.75 21,735.50
R2019-0000075834 29-12-2019 201900072753/112335 ANGUN,NY Herika dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000075834 29-12-2019 201900072753/112335 ANGUN,NY Herika dr. OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000075834 29-12-2019 201900072753/112335 ANGUN,NY Herika dr. ALI00003 I.V Catheter No. 18 2.00 Pcs 29,744.00 59,988.00
R2019-0000075834 29-12-2019 201900072753/112335 ANGUN,NY Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000075835 29-12-2019 201900072735/39341 TJAHYA,NY Herika dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000075833 29-12-2019 201900072733/112330 ARY ANDANI,NY Herika dr. OW00001 Water For Injeksi 25ml 1.00 Botol 9,222.00 9,722.00
R2019-0000075833 29-12-2019 201900072733/112330 ARY ANDANI,NY Herika dr. ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000075833 29-12-2019 201900072733/112330 ARY ANDANI,NY Herika dr. OR00004 Ranitidin Injeksi (OGB) 2.00 Ampul 9,653.00 19,806.00
R2019-0000075833 29-12-2019 201900072733/112330 ARY ANDANI,NY Herika dr. ALI00005 I.V Catheter No. 22 2.00 Pcs 27,324.00 55,148.00
R2019-0000075836 29-12-2019 201900072738/112331 HASNA PRADIPTA Herika dr. OD00077 Dumin Rectal 250mg 1.00 Tube 29,254.50 29,754.50
R2019-0000075838 29-12-2019 201900072740/104901 MUHAMMAD SULTAN Herika dr. OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000075839 29-12-2019 201900072751/106727 NAOMI SALSABILA Herika dr. OS00014 Sanadryl DMP Syrup, 60ml 1.00 Botol 17,820.00 18,320.00
R2019-0000075840 29-12-2019 201900072742/079072 FITRI MARYANI,NY Herika dr. ALU00004 Underpad 2.00 Pcs 11,880.00 24,260.00
R2019-0000075840 29-12-2019 201900072742/079072 FITRI MARYANI,NY Herika dr. OL00063 Lidocain HCl 2% Injeksi 2.00 Ampul 2,376.00 5,252.00
R2019-0000075840 29-12-2019 201900072742/079072 FITRI MARYANI,NY Herika dr. OE00056 Ecosol Nacl 0,9 % 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000075841 29-12-2019 201900072747/102802 FITRAH DAVIDSON Herika dr. OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075841 29-12-2019 201900072747/102802 FITRAH DAVIDSON Herika dr. OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000075839 29-12-2019 201900072751/106727 NAOMI SALSABILA Herika dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000075842 29-12-2019 201900072749/33795 HARIYADI,TN Herika dr. OC00076 Ciprofloxacin 500mg 6.00 Tablet 1,039.50 6,737.00
R2019-0000075842 29-12-2019 201900072749/33795 HARIYADI,TN Herika dr. OP00011 Paracetamol 500mg 8.00 Tablet 387.36 3,598.88
R2019-0000075842 29-12-2019 201900072749/33795 HARIYADI,TN Herika dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075842 29-12-2019 201900072749/33795 HARIYADI,TN Herika dr. OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
Total 328,788,618.16
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 248 dari 266
ASAL RAWAT JALAN
R2019-0000075843 29-12-2019 201900072754/093734 ALGHONIYYU Herika dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000075843 29-12-2019 201900072754/093734 ALGHONIYYU Herika dr. OS00016 Sanadryl Expectoran 1.00 Botol 14,701.50 15,201.50
R2019-0000075843 29-12-2019 201900072754/093734 ALGHONIYYU Herika dr. OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000075843 29-12-2019 201900072754/093734 ALGHONIYYU Herika dr. OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000075844 29-12-2019 201900072753/112335 ANGUN,NY Herika dr. OO00040 Oralit 200 6.00 Sachet 706.00 4,736.00
R2019-0000075844 29-12-2019 201900072753/112335 ANGUN,NY Herika dr. OD00065 Domperidon Tablet (OGB) 6.00 Tablet 750.00 5,000.00
R2019-0000075844 29-12-2019 201900072753/112335 ANGUN,NY Herika dr. OT00063 Tramadol 50mg Tablet 4.00 Tablet 1,113.75 4,955.00
R2019-0000075844 29-12-2019 201900072753/112335 ANGUN,NY Herika dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075845 29-12-2019 201900072756/112337 ELSA FEBRIANTI,NN Niki Juniar OB00050 Braxidin 3.00 Tablet 1,648.35 5,445.05
R2019-0000075846 29-12-2019 201900072755/112336 GUSTI DINA RIZKI Herika dr. OS00010 Salbutamol 4mg (OGB) 6.00 Tablet 249.48 1,996.88
R2019-0000075846 29-12-2019 201900072755/112336 GUSTI DINA RIZKI Herika dr. OA00052 Ambroxol Tablet, 30mg 6.00 Tablet 445.50 3,173.00
R2019-0000075846 29-12-2019 201900072755/112336 GUSTI DINA RIZKI Herika dr. OM00046 Methyl Prednisolon 8mg 4.00 Tablet 965.25 4,361.00
R2019-0000075846 29-12-2019 201900072755/112336 GUSTI DINA RIZKI Herika dr. OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2019-0000075848 29-12-2019 201900072759/094987 AZRIL RASYA AL Niki Juniar OD00077 Dumin Rectal 250mg 1.00 Tube 29,254.50 29,754.50
R2019-0000075850 29-12-2019 201900072759/094987 AZRIL RASYA AL Niki Juniar OI00117 Imunos Plus Syrup, 60ml 1.00 Botol 136,620.00 137,120.00
R2019-0000075856 30-12-2019 201900072758/059764 RANGGA FAHRESA Niki Juniar OB00050 Braxidin 4.00 Tablet 1,648.35 7,093.40
R2019-0000075856 30-12-2019 201900072758/059764 RANGGA FAHRESA Niki Juniar OO00014 Omeprazole 20mg (OGB) 4.00 Capsul 1,169.98 5,179.92
R2019-0000075857 30-12-2019 201900072757/084677 LAODE ALFIAN Niki Juniar OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000075857 30-12-2019 201900072757/084677 LAODE ALFIAN Niki Juniar OA00066 Amoxicillin Tablet, 500mg 3.00 Tablet 1,113.75 3,841.25
R2019-0000075857 30-12-2019 201900072757/084677 LAODE ALFIAN Niki Juniar OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000075858 30-12-2019 201900072768/111632 AMELIA FUTRIAYU,AN Niki Juniar OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000075858 30-12-2019 201900072768/111632 AMELIA FUTRIAYU,AN Niki Juniar OR00003 Ranitidin 150mg (OGB) 6.00 Tablet 891.00 5,846.00
R2019-0000075859 30-12-2019 201900072771/101449 MAUZA NAIRA Niki Juniar OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000075859 30-12-2019 201900072771/101449 MAUZA NAIRA Niki Juniar OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2019-0000075862 30-12-2019 201900072791/112339 ANNISA AULIA,NY Niki Juniar OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000075862 30-12-2019 201900072791/112339 ANNISA AULIA,NY Niki Juniar ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000075862 30-12-2019 201900072791/112339 ANNISA AULIA,NY Niki Juniar ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000075862 30-12-2019 201900072791/112339 ANNISA AULIA,NY Niki Juniar OO00019 Ondansetron Injeksi 1.00 Ampul 25,000.00 25,500.00
R2019-0000075862 30-12-2019 201900072791/112339 ANNISA AULIA,NY Niki Juniar ON00039 Neurosanbe Injeksi 1.00 Ampul 8,122.95 8,622.95
R2019-0000075863 30-12-2019 201900072771/101449 MAUZA NAIRA Niki Juniar OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000075864 30-12-2019 201900072768/111632 AMELIA FUTRIAYU,AN Niki Juniar OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000075865 30-12-2019 201900072790/112338 HANNA ISMAJANTI Niki Juniar OE00055 Ecosol RL 500ml 2.00 Botol 19,305.00 39,110.00
R2019-0000075865 30-12-2019 201900072790/112338 HANNA ISMAJANTI Niki Juniar ALI00004 I.V Catheter No. 20 2.00 Pcs 36,808.20 74,116.40
R2019-0000075865 30-12-2019 201900072790/112338 HANNA ISMAJANTI Niki Juniar ALB00132 Blood Set 1.00 Pcs 33,976.80 34,476.80
R2019-0000075867 30-12-2019 201900072758/059764 RANGGA FAHRESA Niki Juniar OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000075869 30-12-2019 201900072757/084677 LAODE ALFIAN Niki Juniar OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000075870 30-12-2019 201900072755/112336 GUSTI DINA RIZKI Herika dr. OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075870 30-12-2019 201900072755/112336 GUSTI DINA RIZKI Herika dr. OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
Total 329,521,772.61
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 249 dari 266
ASAL RAWAT JALAN
R2019-0000075873 30-12-2019 201900072780/077773 ELINA PUTRI Niki Juniar OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000075873 30-12-2019 201900072780/077773 ELINA PUTRI Niki Juniar OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000075873 30-12-2019 201900072780/077773 ELINA PUTRI Niki Juniar OD00031 Dexamethasone Tablet 6.00 Tablet 208.00 1,748.00
R2019-0000075873 30-12-2019 201900072780/077773 ELINA PUTRI Niki Juniar OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000075873 30-12-2019 201900072780/077773 ELINA PUTRI Niki Juniar OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2019-0000075873 30-12-2019 201900072780/077773 ELINA PUTRI Niki Juniar ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000075873 30-12-2019 201900072780/077773 ELINA PUTRI Niki Juniar OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2019-0000075872 30-12-2019 201900072786/107704 NIKI JUNIAR ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075872 30-12-2019 201900072786/107704 NIKI JUNIAR ADE RAHMAH OB00007 Becom - C 5.00 Tablet 2,123.55 11,117.75
R2019-0000075874 30-12-2019 201900072786/107704 NIKI JUNIAR ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000075874 30-12-2019 201900072786/107704 NIKI JUNIAR ADE RAHMAH OE00056 Ecosol Nacl 0,9 % 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000075874 30-12-2019 201900072786/107704 NIKI JUNIAR ADE RAHMAH ON00039 Neurosanbe Injeksi 1.00 Ampul 8,122.95 8,622.95
R2019-0000075874 30-12-2019 201900072786/107704 NIKI JUNIAR ADE RAHMAH OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000075874 30-12-2019 201900072786/107704 NIKI JUNIAR ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000075874 30-12-2019 201900072786/107704 NIKI JUNIAR ADE RAHMAH ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2019-0000075874 30-12-2019 201900072786/107704 NIKI JUNIAR ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000075875 29-12-2019 201900072710/112323 DYAH PRISTYANTI,NY Eko Dian Syafitra OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000075875 29-12-2019 201900072710/112323 DYAH PRISTYANTI,NY Eko Dian Syafitra OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000075875 29-12-2019 201900072710/112323 DYAH PRISTYANTI,NY Eko Dian Syafitra ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000075876 30-12-2019 201900072775/112342 RIZKY FEBRIAN,SDR Niki Juniar OP00011 Paracetamol 500mg 6.00 Tablet 387.36 2,824.16
R2019-0000075876 30-12-2019 201900072775/112342 RIZKY FEBRIAN,SDR Niki Juniar OA00180 Acetylcyst ein 200mg 6.00 Tablet 1,485.00 9,410.00
R2019-0000075876 30-12-2019 201900072775/112342 RIZKY FEBRIAN,SDR Niki Juniar OB00007 Becom - C 3.00 Tablet 2,123.55 6,870.65
R2019-0000075876 30-12-2019 201900072775/112342 RIZKY FEBRIAN,SDR Niki Juniar OO00014 Omeprazole 20mg (OGB) 3.00 Capsul 1,169.98 4,009.94
R2019-0000075878 30-12-2019 201900072827/112159 WENDI URIP SEPTIA NOVITA OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000075878 30-12-2019 201900072827/112159 WENDI URIP SEPTIA NOVITA OE00008 Elkana Tablet 5.00 Tablet 1,247.40 6,737.00
R2019-0000075882 30-12-2019 201900072832/103042 PRADIKA ARBI ADE RAHMAH OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000075882 30-12-2019 201900072832/103042 PRADIKA ARBI ADE RAHMAH OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000075884 30-12-2019 201900072842/100589 MURSALIM,TN ADE RAHMAH OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075885 30-12-2019 201900073000/112350 SUPARTI,NY ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000075885 30-12-2019 201900073000/112350 SUPARTI,NY ADE RAHMAH OO00018 Ondansetron Injeksi 1.00 Ampul 12,000.00 12,500.00
R2019-0000075887 30-12-2019 201900072807/112346 DAMIATI,NY SEPTIA NOVITA OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000075887 30-12-2019 201900072807/112346 DAMIATI,NY SEPTIA NOVITA OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000075887 30-12-2019 201900072807/112346 DAMIATI,NY SEPTIA NOVITA OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000075887 30-12-2019 201900072807/112346 DAMIATI,NY SEPTIA NOVITA ALD00005 Disposable Syringe 3ml 1.00 Pcs 2,272.05 2,772.05
R2019-0000075887 30-12-2019 201900072807/112346 DAMIATI,NY SEPTIA NOVITA ALA00006 Alkohol Swap 1.00 Pcs 752.00 1,252.00
R2019-0000075894 30-12-2019 201900072866/058152 RATIH ANJARDINI,NY SEPTIA NOVITA OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000075894 30-12-2019 201900072866/058152 RATIH ANJARDINI,NY SEPTIA NOVITA OL00126 Lactrin Tablet 6.00 Tablet 6,311.25 38,367.50
R2019-0000075894 30-12-2019 201900072866/058152 RATIH ANJARDINI,NY SEPTIA NOVITA OL00017 Lameson 4mg 5.00 Tablet 5,049.00 25,745.00
Total 330,215,239.78
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 250 dari 266
ASAL RAWAT JALAN
R2019-0000075884 30-12-2019 201900072842/100589 MURSALIM,TN ADE RAHMAH ON00009 Natrium Diklofenac 50mg 5.00 Tablet 955.84 5,279.20
R2019-0000075884 30-12-2019 201900072842/100589 MURSALIM,TN ADE RAHMAH OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000075896 30-12-2019 201900073000/112350 SUPARTI,NY ADE RAHMAH ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000075896 30-12-2019 201900073000/112350 SUPARTI,NY ADE RAHMAH OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000075896 30-12-2019 201900073000/112350 SUPARTI,NY ADE RAHMAH OM00047 Metoclopramide Injeksi 1.00 Ampul 10,395.00 10,895.00
R2019-0000075895 30-12-2019 201900072856/071489 DARWIS,TN ADE RAHMAH OP00136 Pulmicort Respules 2.00 Ampul 33,802.98 68,105.96
R2019-0000075895 30-12-2019 201900072856/071489 DARWIS,TN ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075898 30-12-2019 201900072856/071489 DARWIS,TN ADE RAHMAH OC00144 Cefila Capsul, 100mg 10.00 Capsul 28,957.00 290,070.00
R2019-0000075898 30-12-2019 201900072856/071489 DARWIS,TN ADE RAHMAH OM00102 Mucohexin Elixir, 120ml 1.00 Botol 24,354.00 24,854.00
R2019-0000075898 30-12-2019 201900072856/071489 DARWIS,TN ADE RAHMAH OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000075898 30-12-2019 201900072856/071489 DARWIS,TN ADE RAHMAH OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000075901 30-12-2019 201900072868/41802 ANDI LAWA,TN ADE RAHMAH OA00074 Analsik 2.00 Tablet 2,264.63 5,029.26
R2019-0000075901 30-12-2019 201900072868/41802 ANDI LAWA,TN ADE RAHMAH ON00009 Natrium Diklofenac 50mg 5.00 Tablet 955.84 5,279.20
R2019-0000075901 30-12-2019 201900072868/41802 ANDI LAWA,TN ADE RAHMAH OR00003 Ranitidin 150mg (OGB) 5.00 Tablet 891.00 4,955.00
R2019-0000075903 30-12-2019 201900072839/111374 SARI NURJANNAH,NY Nafon Zaitun, Dr. OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000075903 30-12-2019 201900072839/111374 SARI NURJANNAH,NY Nafon Zaitun, Dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075903 30-12-2019 201900072839/111374 SARI NURJANNAH,NY Nafon Zaitun, Dr. OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000075905 30-12-2019 201900072863/077841 MUHAMMAD MAGDA ROSSA, OA00070 Amoxsan Dry Syrup 1.00 Botol 33,412.50 33,912.50
R2019-0000075910 30-12-2019 201900072862/069852 RIFAT NAUFAL FAZLE MAGDA ROSSA, OO00023 Opicef Dry Syrup, 60ml 1.00 Botol 66,825.00 67,325.00
R2019-0000075912 30-12-2019 201900072890/112355 ARGA ADITYA SEPTIA NOVITA OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000075912 30-12-2019 201900072890/112355 ARGA ADITYA SEPTIA NOVITA OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000075912 30-12-2019 201900072890/112355 ARGA ADITYA SEPTIA NOVITA OI00134 Imunos Plus Tablet 4.00 Tablet 14,107.50 56,930.00
R2019-0000075924 30-12-2019 201900072802/106258 ASIAH,NY LUSY E. Dr.Sp.PD OL00056 Levemir Insulin 1.00 Flexpen 287,330.88 287,830.88
R2019-0000075926 30-12-2019 201900072897/088228 MUHAMMAD BAIM FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 4.00 Capsul 28,957.00 116,328.00
R2019-0000075926 30-12-2019 201900072897/088228 MUHAMMAD BAIM FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 3.00 Tablet 430.65 1,791.95
R2019-0000075926 30-12-2019 201900072897/088228 MUHAMMAD BAIM FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000075926 30-12-2019 201900072897/088228 MUHAMMAD BAIM FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000075926 30-12-2019 201900072897/088228 MUHAMMAD BAIM FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 23,118.50
R2019-0000075926 30-12-2019 201900072897/088228 MUHAMMAD BAIM FREDRIK, Dr,Sp.A OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000075928 30-12-2019 201900072874/112354 ABDULLAH UMAR,AN FREDRIK, Dr,Sp.A OF00097 Futaderm Cream, 10gr 1.00 Tube 158,000.00 158,500.00
R2019-0000075925 30-12-2019 201900072874/112354 ABDULLAH UMAR,AN FREDRIK, Dr,Sp.A OO00022 Opicef 500mg Capsul 3.00 Capsul 14,850.00 45,050.00
R2019-0000075925 30-12-2019 201900072874/112354 ABDULLAH UMAR,AN FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 2.00 Tablet 430.65 1,361.30
R2019-0000075925 30-12-2019 201900072874/112354 ABDULLAH UMAR,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 2.00 Tablet 1,173.15 2,846.30
R2019-0000075925 30-12-2019 201900072874/112354 ABDULLAH UMAR,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
Total 331,970,894.28
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 251 dari 266
ASAL RAWAT JALAN
R2019-0000075925 30-12-2019 201900072874/112354 ABDULLAH UMAR,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 200.20 23,003.00
R2019-0000075929 30-12-2019 201900072930/110362 MUHAMMAD ARAFAT FREDRIK, Dr,Sp.A OS00030 Sanmol Drop, 15ml 1.00 Botol 23,314.00 23,814.00
R2019-0000075930 30-12-2019 201900072914/105283 PUSPA RAHAYU SEPTIA NOVITA OL00017 Lameson 4mg 6.00 Tablet 5,049.00 30,794.00
R2019-0000075930 30-12-2019 201900072914/105283 PUSPA RAHAYU SEPTIA NOVITA OI00134 Imunos Plus Tablet 5.00 Tablet 14,107.50 71,037.50
R2019-0000075932 30-12-2019 201900072903/096498 SAPARUDIN,TN ADE RAHMAH OB00029 Biosanbe Capsul 20.00 Capsul 1,596.37 32,427.40
R2019-0000075933 30-12-2019 201900072898/111588 SHAFIYAH NUWAIRA FREDRIK, Dr,Sp.A OL00001 L - BIO Sachet 6.00 Sachet 10,395.00 62,870.00
R2019-0000075936 30-12-2019 201900072942/112362 MUJIATI,NY ADE RAHMAH OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000075936 30-12-2019 201900072942/112362 MUJIATI,NY ADE RAHMAH OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000075935 30-12-2019 201900072921/021777 AMELIA LOUISA,NY NOVIANA, Dr. Sp OF00099 Folda Tablet 30.00 Tablet 6,661.65 200,349.50
R2019-0000075935 30-12-2019 201900072921/021777 AMELIA LOUISA,NY NOVIANA, Dr. Sp OB00068 BioCal-95 30.00 Tablet 7,128.00 214,340.00
R2019-0000075935 30-12-2019 201900072921/021777 AMELIA LOUISA,NY NOVIANA, Dr. Sp OS00050 Sanvita B Plus Eff 3.00 Tube 57,395.25 172,685.75
R2019-0000075937 30-12-2019 201900072908/112357 LINA LUSY E. Dr.Sp.PD OB001002 Betahistine 10.00 Tab 5,940.00 59,900.00
R2019-0000075937 30-12-2019 201900072908/112357 LINA LUSY E. Dr.Sp.PD OF00065 Flunarizine 5mg 10.00 Tablet 2,970.00 30,200.00
R2019-0000075939 30-12-2019 201900072919/110213 SRI WINDARTI,NY ADE RAHMAH OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 Botol 22,542.30 23,042.30
R2019-0000075939 30-12-2019 201900072919/110213 SRI WINDARTI,NY ADE RAHMAH ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000075939 30-12-2019 201900072919/110213 SRI WINDARTI,NY ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000075939 30-12-2019 201900072919/110213 SRI WINDARTI,NY ADE RAHMAH OC00058 Cernevit Injeksi 1.00 Vial 256,905.00 257,405.00
R2019-0000075940 30-12-2019 201900072919/110213 SRI WINDARTI,NY ADE RAHMAH OC00151 Codipront Capsul 10.00 Capsul 13,649.35 136,993.50
R2019-0000075940 30-12-2019 201900072919/110213 SRI WINDARTI,NY ADE RAHMAH OI00134 Imunos Plus Tablet 10.00 Tablet 14,107.50 141,575.00
R2019-0000075940 30-12-2019 201900072919/110213 SRI WINDARTI,NY ADE RAHMAH OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000075955 30-12-2019 201900072918/062052 LUVI OKTAVIANI,NY NOVIANA, Dr. Sp OB00039 Blesifen 5.00 Tablet 18,696.15 93,980.75
R2019-0000075956 30-12-2019 201900072934/096956 SAMSUDIN,TN DYAH, dr Sp. OB00094 Berotec MDI 1.00 Botol 130,000.00 130,500.00
R2019-0000075957 30-12-2019 201900072957/112365 IBRAHIM AL FATIH,AN SEPTIA NOVITA OA00070 Amoxsan Dry Syrup 1.00 Botol 33,412.50 33,912.50
R2019-0000075957 30-12-2019 201900072957/112365 IBRAHIM AL FATIH,AN SEPTIA NOVITA OS00031 Sanmol Syrup 1.00 Botol 17,374.00 17,874.00
R2019-0000075957 30-12-2019 201900072957/112365 IBRAHIM AL FATIH,AN SEPTIA NOVITA OE00017 Epexol Syrup 1.00 Botol 25,690.50 26,190.50
R2019-0000075958 30-12-2019 201900072958/112367 LATIFAH AL SEPTIA NOVITA OE00017 Epexol Syrup 1.00 Botol 25,690.50 26,190.50
R2019-0000075958 30-12-2019 201900072958/112367 LATIFAH AL SEPTIA NOVITA OM00058 Microlax Enema Rectal 1.00 Tube 27,843.00 28,343.00
R2019-0000075959 30-12-2019 201900072848/112316 PRIYO HARTONO,TN DYAH, dr Sp. OP00180 Pro TB 4 Tablet 21.00 Tablet 7,326.45 154,355.45
R2019-0000075959 30-12-2019 201900072848/112316 PRIYO HARTONO,TN DYAH, dr Sp. OL00126 Lactrin Tablet 7.00 Tablet 6,311.25 44,678.75
R2019-0000075961 30-12-2019 201900072952/112363 HARRIS Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 10.00 Tablet 965.25 10,152.50
R2019-0000075961 30-12-2019 201900072952/112363 HARRIS Ismail dr. Msc. GK003 Ketoconazole Cream 10 1.00 Tube 8,019.00 8,519.00
R2019-0000075961 30-12-2019 201900072952/112363 HARRIS Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000075961 30-12-2019 201900072952/112363 HARRIS Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 19,000.00
R2019-0000075961 30-12-2019 201900072952/112363 HARRIS Ismail dr. Msc. OK00023 Ketoconazole 200mg 20.00 Tablet 774.24 15,984.80
R2019-0000075963 30-12-2019 201900072951/087524 ENDINI TETRASARI Ismail dr. Msc. OK00050 Kloderma Ointment, 10gr 2.00 Tube 60,580.00 121,660.00
R2019-0000075962 30-12-2019 201900072951/087524 ENDINI TETRASARI Ismail dr. Msc. OL00017 Lameson 4mg 20.00 Tablet 5,049.00 101,480.00
R2019-0000075962 30-12-2019 201900072951/087524 ENDINI TETRASARI Ismail dr. Msc. OK00022 Ketoconazol Cream 2% 2.00 Tube 11,000.00 22,500.00
R2019-0000075962 30-12-2019 201900072951/087524 ENDINI TETRASARI Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 24,000.00
Total 334,477,811.88
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 252 dari 266
ASAL RAWAT JALAN
R2019-0000075964 30-12-2019 201900072971/112368 YATMI,NY Dwi Astuti, dr OA00063 Amlodipin 10mg (OGB) 5.00 Tablet 2,743.00 14,215.00
R2019-0000075964 30-12-2019 201900072971/112368 YATMI,NY Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2019-0000075964 30-12-2019 201900072971/112368 YATMI,NY Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000075966 30-12-2019 201900072971/112368 YATMI,NY Dwi Astuti, dr OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000075969 30-12-2019 201900072977/109196 SITI ALFIAH Dwi Astuti, dr OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000075969 30-12-2019 201900072977/109196 SITI ALFIAH Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000075969 30-12-2019 201900072977/109196 SITI ALFIAH Dwi Astuti, dr OB00017 Betametason Cream 1.00 Tube 7,276.50 7,776.50
R2019-0000075969 30-12-2019 201900072977/109196 SITI ALFIAH Dwi Astuti, dr OD00107 Desoximetasone 0.25% 1.00 Tube 19,765.00 20,265.00
R2019-0000075969 30-12-2019 201900072977/109196 SITI ALFIAH Dwi Astuti, dr ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000075972 30-12-2019 201900072986/112369 HAFIZH,AN Dwi Astuti, dr OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000075973 30-12-2019 201900072986/112369 HAFIZH,AN Dwi Astuti, dr OA00071 Amoxsan Forte Dry Syrup 1.00 Botol 47,520.00 48,020.00
R2019-0000075973 30-12-2019 201900072986/112369 HAFIZH,AN Dwi Astuti, dr OB00057 Bufect Forte Suspensi, 1.00 Botol 30,442.50 30,942.50
R2019-0000075974 30-12-2019 201900072904/077213 JUMIAH,NY DYAH, dr Sp. OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000075974 30-12-2019 201900072904/077213 JUMIAH,NY DYAH, dr Sp. OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000075976 30-12-2019 201900072904/077213 JUMIAH,NY DYAH, dr Sp. OS00160 Seretide Diskus 250 mcg 1.00 Botol 322,681.59 323,181.59
R2019-0000075978 30-12-2019 201900072941/099015 SYAMSIAH,NY DYAH, dr Sp. OS00132 Symbicort Inhaler 160/45 1.00 Botol/6 412,776.54 413,276.54
R2019-0000075977 30-12-2019 201900072933/112358 TONI PATONI,TN DYAH, dr Sp. OS00160 Seretide Diskus 250 mcg 1.00 Botol 322,681.59 323,181.59
R2019-0000075979 30-12-2019 201900072960/061944 SITI SUNDARI,NY DYAH, dr Sp. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000075980 30-12-2019 201900072960/061944 SITI SUNDARI,NY DYAH, dr Sp. OS00160 Seretide Diskus 250 mcg 1.00 Botol 322,681.59 323,181.59
R2019-0000075980 30-12-2019 201900072960/061944 SITI SUNDARI,NY DYAH, dr Sp. OB00094 Berotec MDI 1.00 Botol 130,000.00 130,500.00
R2019-0000075982 30-12-2019 201900072955/080346 RIDWAN CANIAGO,TN DYAH, dr Sp. OB00094 Berotec MDI 1.00 Botol 130,000.00 130,500.00
R2019-0000075981 30-12-2019 201900072955/080346 RIDWAN CANIAGO,TN DYAH, dr Sp. ON00009 Natrium Diklofenac 50mg 10.00 Tablet 955.84 10,058.40
R2019-0000075934 30-12-2019 201900072922/09/11/39 Puspita Hanum,NY Nathalia dr. OO00073 Ondansentron Tablet, 6.00 Tablet 7,500.00 45,500.00
R2019-0000075934 30-12-2019 201900072922/09/11/39 Puspita Hanum,NY Nathalia dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000075986 30-12-2019 201900072936/090369 BILANG MAULI ADE RAHMAH OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000075986 30-12-2019 201900072936/090369 BILANG MAULI ADE RAHMAH OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000075985 30-12-2019 201900072949/054261 ALARY CE THEODORA Dwi Astuti, dr OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000075985 30-12-2019 201900072949/054261 ALARY CE THEODORA Dwi Astuti, dr OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2019-0000075987 30-12-2019 201900072910/112132 TRI LIDIA NINGSIH,NY NOVIANA, Dr. Sp OB00029 Biosanbe Capsul 6.00 Capsul 1,596.37 10,078.22
R2019-0000075987 30-12-2019 201900072910/112132 TRI LIDIA NINGSIH,NY NOVIANA, Dr. Sp OB00007 Becom - C 6.00 Tablet 2,123.55 13,241.30
R2019-0000075988 30-12-2019 201900072913/102244 RATNA NOVITASARI NOVIANA, Dr. Sp OB00007 Becom - C 6.00 Tablet 2,123.55 13,241.30
R2019-0000075989 30-12-2019 201900072896/056183 FARREL ZAHRAN ADE RAHMAH OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000075989 30-12-2019 201900072896/056183 FARREL ZAHRAN ADE RAHMAH OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000075991 30-12-2019 201900072842/100589 MURSALIM,TN ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000075995 30-12-2019 201900072868/41802 ANDI LAWA,TN ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000075997 30-12-2019 201900072867/112286 SRI REJEKI,NY DYAH, dr Sp. OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000075997 30-12-2019 201900072867/112286 SRI REJEKI,NY DYAH, dr Sp. OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000075997 30-12-2019 201900072867/112286 SRI REJEKI,NY DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
Total 336,684,649.66
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 253 dari 266
ASAL RAWAT JALAN
R2019-0000075997 30-12-2019 201900072867/112286 SRI REJEKI,NY DYAH, dr Sp. OV00085 Vitamin B6 Tablet (OGB) 10.00 Tablet 199.80 2,498.00
R2019-0000075998 30-12-2019 201900072870/112352 SITI MASRU'AH,NY DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000075998 30-12-2019 201900072870/112352 SITI MASRU'AH,NY DYAH, dr Sp. OA00052 Ambroxol Tablet, 30mg 10.00 Tablet 445.50 4,955.00
R2019-0000075998 30-12-2019 201900072870/112352 SITI MASRU'AH,NY DYAH, dr Sp. OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000075999 30-12-2019 201900072885/030456 PADLIANSYAH,TN DYAH, dr Sp. OA00052 Ambroxol Tablet, 30mg 1.00 Tablet 445.50 945.50
R2019-0000075999 30-12-2019 201900072885/030456 PADLIANSYAH,TN DYAH, dr Sp. OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000076000 30-12-2019 201900072853/097053 NURUL KAMALIAH Ismail dr. Msc. OM00046 Methyl Prednisolon 8mg 30.00 Tablet 965.25 29,457.50
R2019-0000076000 30-12-2019 201900072853/097053 NURUL KAMALIAH Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000076000 30-12-2019 201900072853/097053 NURUL KAMALIAH Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000076000 30-12-2019 201900072853/097053 NURUL KAMALIAH Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000076000 30-12-2019 201900072853/097053 NURUL KAMALIAH Ismail dr. Msc. OF00061 Fluconazole Tablet, 2.00 Tablet 32,670.00 65,840.00
R2019-0000076001 30-12-2019 201900072927/102665 AKHMAD UBAIDILLAH Ismail dr. Msc. OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000076001 30-12-2019 201900072927/102665 AKHMAD UBAIDILLAH Ismail dr. Msc. OS00053 Scabimate Cream, 10gr 1.00 Tube 63,112.50 63,612.50
R2019-0000076001 30-12-2019 201900072927/102665 AKHMAD UBAIDILLAH Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000076001 30-12-2019 201900072927/102665 AKHMAD UBAIDILLAH Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000076001 30-12-2019 201900072927/102665 AKHMAD UBAIDILLAH Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000076002 30-12-2019 201900072940/112361 ACHMAD FURQAAN,AN Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000076002 30-12-2019 201900072940/112361 ACHMAD FURQAAN,AN Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000076002 30-12-2019 201900072940/112361 ACHMAD FURQAAN,AN Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000076002 30-12-2019 201900072940/112361 ACHMAD FURQAAN,AN Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 20.00 Tablet 623.70 12,974.00
R2019-0000076004 30-12-2019 201900072806/112345 IIN KURNIASIH DYAH, dr Sp. OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2019-0000076004 30-12-2019 201900072806/112345 IIN KURNIASIH DYAH, dr Sp. OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000076005 30-12-2019 201900072851/111978 CENNA FARRA Ismail dr. Msc. OC00173 Cetirizine 10mg/ml Drop, 1.00 Botol 37,125.00 37,625.00
R2019-0000076005 30-12-2019 201900072851/111978 CENNA FARRA Ismail dr. Msc. OB00017 Betametason Cream 1.00 Tube 7,276.50 7,776.50
R2019-0000076005 30-12-2019 201900072851/111978 CENNA FARRA Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000076005 30-12-2019 201900072851/111978 CENNA FARRA Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000076003 30-12-2019 201900072950/112173 RAFISQY ALFAREZI,AN Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000076003 30-12-2019 201900072950/112173 RAFISQY ALFAREZI,AN Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 2.00 Tube 4,826.00 10,152.00
R2019-0000076003 30-12-2019 201900072950/112173 RAFISQY ALFAREZI,AN Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000076006 30-12-2019 201900072233/029450 ALIVA DILA, SP,NY Ismail dr. Msc. OB00017 Betametason Cream 2.00 Tube 7,276.50 15,053.00
R2019-0000076006 30-12-2019 201900072233/029450 ALIVA DILA, SP,NY Ismail dr. Msc. OG00060 Gentalex Cream 5Gr 1.00 Tube 4,826.00 5,326.00
R2019-0000076006 30-12-2019 201900072233/029450 ALIVA DILA, SP,NY Ismail dr. Msc. ALP00029 Pot Salep, 30gr 1.00 Pcs 4,000.00 11,500.00
R2019-0000076006 30-12-2019 201900072233/029450 ALIVA DILA, SP,NY Ismail dr. Msc. OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000076007 30-12-2019 201900072794/019156 SYARIFAH ELVIRA Nafon Zaitun, Dr. OD00072 Doxyciclyn 100mg (OGB) 10.00 Tablet 650.00 7,000.00
R2019-0000076009 30-12-2019 201900072978/103500 ATHAR RIZKY Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 2.00 Capsul 4,266.70 9,033.40
R2019-0000076009 30-12-2019 201900072978/103500 ATHAR RIZKY Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 2.00 Tablet 623.70 1,747.40
R2019-0000076009 30-12-2019 201900072978/103500 ATHAR RIZKY Dwi Astuti, dr OD00031 Dexamethasone Tablet 2.00 Tablet 208.00 916.00
R2019-0000076009 30-12-2019 201900072978/103500 ATHAR RIZKY Dwi Astuti, dr OV00080 Vitamin B Compleks 2.00 Tablet 241.79 983.58
Total 337,208,739.44
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 254 dari 266
ASAL RAWAT JALAN
R2019-0000076009 30-12-2019 201900072978/103500 ATHAR RIZKY Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000076008 30-12-2019 201900072985/105350 MOHAMMAD BINTANG Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2019-0000076008 30-12-2019 201900072985/105350 MOHAMMAD BINTANG Dwi Astuti, dr OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2019-0000076008 30-12-2019 201900072985/105350 MOHAMMAD BINTANG Dwi Astuti, dr OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000076010 30-12-2019 201900072994/025219 RAHMAT AZMI Dwi Astuti, dr OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000076010 30-12-2019 201900072994/025219 RAHMAT AZMI Dwi Astuti, dr OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000076010 30-12-2019 201900072994/025219 RAHMAT AZMI Dwi Astuti, dr OA00087 Antiza Syrup, 60ml 1.00 Botol 26,730.00 27,230.00
R2019-0000076011 30-12-2019 201900072795/074497 AJI EKA ROSITA,NY Hendra Dr, Sp. OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000076011 30-12-2019 201900072795/074497 AJI EKA ROSITA,NY Hendra Dr, Sp. OG00073 Glucosamine 250 Mg 10.00 Tablet 1,633.50 16,835.00
R2019-0000076013 30-12-2019 201900072974/112094 TARWADI,TN Hendra Dr, Sp. OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000076013 30-12-2019 201900072974/112094 TARWADI,TN Hendra Dr, Sp. OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000076012 30-12-2019 201900072972/110954 RIZKI WAHYU Hendra Dr, Sp. OE00007 Elkana Syrup 1.00 Botol 34,303.50 34,803.50
R2019-0000076016 30-12-2019 201900072993/112371 ADNAN ZAEDAN,AN Rianti dr. Sp.A OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2019-0000076016 30-12-2019 201900072993/112371 ADNAN ZAEDAN,AN Rianti dr. Sp.A OS00010 Salbutamol 4mg (OGB) 2.00 Tablet 249.48 998.96
R2019-0000076016 30-12-2019 201900072993/112371 ADNAN ZAEDAN,AN Rianti dr. Sp.A OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2019-0000076016 30-12-2019 201900072993/112371 ADNAN ZAEDAN,AN Rianti dr. Sp.A OC00132 CTM 4mg 2.00 Tablet 157.41 814.82
R2019-0000076016 30-12-2019 201900072993/112371 ADNAN ZAEDAN,AN Rianti dr. Sp.A OT00142 Trilac 4mg 3.00 Tablet 5,200.00 16,100.00
R2019-0000076016 30-12-2019 201900072993/112371 ADNAN ZAEDAN,AN Rianti dr. Sp.A ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 9,579.00
R2019-0000076017 30-12-2019 201900072899/063291 ADI MUHAMMAD Rianti dr. Sp.A OI00094 Isoniazide 100mg (OGB) 45.00 Tablet 193.00 9,185.00
R2019-0000076017 30-12-2019 201900072899/063291 ADI MUHAMMAD Rianti dr. Sp.A OV00080 Vitamin B Compleks 3.00 Tablet 241.79 1,225.37
R2019-0000076017 30-12-2019 201900072899/063291 ADI MUHAMMAD Rianti dr. Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000076017 30-12-2019 201900072899/063291 ADI MUHAMMAD Rianti dr. Sp.A ATKK031 Kertas Puyer Handbond 30.00 Sachet 207.90 13,737.00
R2019-0000076017 30-12-2019 201900072899/063291 ADI MUHAMMAD Rianti dr. Sp.A OR00043 Rifampicin 450mg (OGB) 14.00 Tablet 2,524.50 35,843.00
R2019-0000076017 30-12-2019 201900072899/063291 ADI MUHAMMAD Rianti dr. Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000076017 30-12-2019 201900072899/063291 ADI MUHAMMAD Rianti dr. Sp.A ATKK031 Kertas Puyer Handbond 30.00 Sachet 207.90 13,737.00
R2019-0000076017 30-12-2019 201900072899/063291 ADI MUHAMMAD Rianti dr. Sp.A OC00184 Cetirizine 5mg/5ml Syrup 1.00 Botol 14,094.13 14,594.13
R2019-0000076015 30-12-2019 201900073010/112375 FRANSISCUS X EKA Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000076015 30-12-2019 201900073010/112375 FRANSISCUS X EKA Dwi Astuti, dr OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2019-0000076015 30-12-2019 201900073010/112375 FRANSISCUS X EKA Dwi Astuti, dr OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2019-0000076019 30-12-2019 201900073006/112017 YONGKI FIRMAN Dwi Astuti, dr OA00166 Azithromycin 500mg 5.00 Tablet 14,850.00 74,750.00
R2019-0000076019 30-12-2019 201900073006/112017 YONGKI FIRMAN Dwi Astuti, dr OC00096 Codein 10mg 10.00 Tablet 924.80 9,748.00
R2019-0000076019 30-12-2019 201900073006/112017 YONGKI FIRMAN Dwi Astuti, dr OM00045 Methyl Prednisolon 4mg 6.00 Tablet 792.99 5,257.94
R2019-0000076019 30-12-2019 201900073006/112017 YONGKI FIRMAN Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000076019 30-12-2019 201900073006/112017 YONGKI FIRMAN Dwi Astuti, dr OI00001 Ibuprofen 400mg (OGB) 10.00 Tablet 682.00 7,320.00
R2019-0000076021 30-12-2019 201900072970/102854 NIMADE SUARNI,NY Hendra Dr, Sp. OD00102 Dexketoprofen 25mg 6.00 Tablet 4,290.00 26,240.00
R2019-0000076021 30-12-2019 201900072970/102854 NIMADE SUARNI,NY Hendra Dr, Sp. OM00154 Mecobalamin 500mg 10.00 Tablet 1,118.00 11,680.00
R2019-0000076022 30-12-2019 201900072964/112089 NGADIONO,TN Hendra Dr, Sp. OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000076022 30-12-2019 201900072964/112089 NGADIONO,TN Hendra Dr, Sp. OC00010 Calcium Lactat 500mg 10.00 Tablet 302.37 3,523.70
Total 337,767,370.51
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 255 dari 266
ASAL RAWAT JALAN
R2019-0000076023 30-12-2019 201900072998/112372 SITI NURHIDAYAH,NY Hendra Dr, Sp. OB00016 Betahistine Mesilat 6mg 10.00 Tablet 1,500.00 15,500.00
R2019-0000076023 30-12-2019 201900072998/112372 SITI NURHIDAYAH,NY Hendra Dr, Sp. OA00074 Analsik 4.00 Tablet 2,264.63 9,558.52
R2019-0000076023 30-12-2019 201900072998/112372 SITI NURHIDAYAH,NY Hendra Dr, Sp. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000076023 30-12-2019 201900072998/112372 SITI NURHIDAYAH,NY Hendra Dr, Sp. OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2019-0000076024 30-12-2019 201900072963/112084 SYLVIA CHANDRA,NY Hendra Dr, Sp. OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000076024 30-12-2019 201900072963/112084 SYLVIA CHANDRA,NY Hendra Dr, Sp. OC00010 Calcium Lactat 500mg 10.00 Tablet 302.37 3,523.70
R2019-0000076025 30-12-2019 201900072871/111852 SAPITRI,TN Hendra Dr, Sp. OM00018 Meloxicam 7.5mg (OGB) 10.00 Tablet 1,287.00 13,370.00
R2019-0000076027 30-12-2019 201900072891/112304 SURATMAN,TN Hendra Dr, Sp. OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2019-0000076027 30-12-2019 201900072891/112304 SURATMAN,TN Hendra Dr, Sp. OM00052 Metronidazole 500mg 15.00 Tablet 525.39 8,380.85
R2019-0000076027 30-12-2019 201900072891/112304 SURATMAN,TN Hendra Dr, Sp. OE00056 Ecosol Nacl 0,9 % 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000076027 30-12-2019 201900072891/112304 SURATMAN,TN Hendra Dr, Sp. ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2019-0000076032 30-12-2019 201900073016/043668 ARIANTO,TN Nathalia dr. OP00011 Paracetamol 500mg 1.00 Tablet 387.36 887.36
R2019-0000076032 30-12-2019 201900073016/043668 ARIANTO,TN Nathalia dr. OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000076032 30-12-2019 201900073016/043668 ARIANTO,TN Nathalia dr. OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000076032 30-12-2019 201900073016/043668 ARIANTO,TN Nathalia dr. OE00018 Epexol Tablet 10.00 Tablet 1,232.55 12,825.50
R2019-0000076032 30-12-2019 201900073016/043668 ARIANTO,TN Nathalia dr. OA00068 Amoxsan Capsul, 500mg 15.00 Capsul 4,752.00 71,780.00
R2019-0000076041 30-12-2019 201900073021/112379 MUHAMMAD RIZAL,TN Nathalia dr. OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000076048 30-12-2019 201900073014/112377 ENDAH MISTIANA,NN Dwi Astuti, dr OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000076050 30-12-2019 201900073014/112377 ENDAH MISTIANA,NN Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000076050 30-12-2019 201900073014/112377 ENDAH MISTIANA,NN Dwi Astuti, dr OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000076050 30-12-2019 201900073014/112377 ENDAH MISTIANA,NN Dwi Astuti, dr OB00009 Bedak Salicyl, 60gr 1.00 Botol 8,108.00 8,608.00
R2019-0000076051 30-12-2019 201900073006/112017 YONGKI FIRMAN Dwi Astuti, dr ON00062 Norages Injeksi 1.00 Ampul 12,399.75 12,899.75
R2019-0000076052 30-12-2019 201900072985/105350 MOHAMMAD BINTANG Dwi Astuti, dr OP00011 Paracetamol 500mg 1.00 Tablet 387.36 887.36
R2019-0000076054 30-12-2019 201900072953/073509 ABRI ADRIJANTO,TN Dwi Astuti, dr OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000076054 30-12-2019 201900072953/073509 ABRI ADRIJANTO,TN Dwi Astuti, dr OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000076054 30-12-2019 201900072953/073509 ABRI ADRIJANTO,TN Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000076054 30-12-2019 201900072953/073509 ABRI ADRIJANTO,TN Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000076056 30-12-2019 201900072990/112370 IBRAHIM,TN Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000076056 30-12-2019 201900072990/112370 IBRAHIM,TN Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000076056 30-12-2019 201900072990/112370 IBRAHIM,TN Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000076056 30-12-2019 201900072990/112370 IBRAHIM,TN Dwi Astuti, dr OO00076 Omeprazole Injeksi 1.00 Vial 126,225.00 126,725.00
R2019-0000076057 30-12-2019 201900072949/054261 ALARY CE THEODORA Dwi Astuti, dr OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000076057 30-12-2019 201900072949/054261 ALARY CE THEODORA Dwi Astuti, dr OE00056 Ecosol Nacl 0,9 % 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000076059 30-12-2019 201900072998/112372 SITI NURHIDAYAH,NY Dwi Astuti, dr OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000076071 31-12-2019 201900073032/033211 SUMARNI,NY Nathalia dr. OA00106 Asam Mefenamat 500mg 6.00 Tablet 415.80 2,994.80
R2019-0000076071 31-12-2019 201900073032/033211 SUMARNI,NY Nathalia dr. OR00003 Ranitidin 150mg (OGB) 5.00 Tablet 891.00 4,955.00
R2019-0000076070 31-12-2019 201900073025/112380 S. IDRUS Nathalia dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000076070 31-12-2019 201900073025/112380 S. IDRUS Nathalia dr. OR00003 Ranitidin 150mg (OGB) 6.00 Tablet 891.00 5,846.00
Total 338,446,325.27
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 256 dari 266
ASAL RAWAT JALAN
R2019-0000076072 31-12-2019 201900073023/086686 ARKHA ALFADIEL,AN Nathalia dr. OA00070 Amoxsan Dry Syrup 1.00 Botol 33,412.50 33,912.50
R2019-0000076072 31-12-2019 201900073023/086686 ARKHA ALFADIEL,AN Nathalia dr. OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2019-0000076072 31-12-2019 201900073023/086686 ARKHA ALFADIEL,AN Nathalia dr. OA00052 Ambroxol Tablet, 30mg 4.00 Tablet 445.50 2,282.00
R2019-0000076072 31-12-2019 201900073023/086686 ARKHA ALFADIEL,AN Nathalia dr. OC00132 CTM 4mg 5.00 Tablet 157.41 1,287.05
R2019-0000076072 31-12-2019 201900073023/086686 ARKHA ALFADIEL,AN Nathalia dr. ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 12,079.00
R2019-0000076073 31-12-2019 201900073020/079006 EDI LASITO,TN Nathalia dr. OL00076 Lodia 2mg 10.00 Tablet 1,485.00 15,350.00
R2019-0000076073 31-12-2019 201900073020/079006 EDI LASITO,TN Nathalia dr. OS00176 Scopma Plus Tablet 10.00 Tablet 2,090.22 21,402.20
R2019-0000076073 31-12-2019 201900073020/079006 EDI LASITO,TN Nathalia dr. OR00003 Ranitidin 150mg (OGB) 10.00 Tablet 891.00 9,410.00
R2019-0000076074 31-12-2019 201900073022/093436 ACHMAD NOOR,TN Nathalia dr. OS00009 Salbutamol 2mg (OGB) 10.00 Tablet 213.30 2,633.00
R2019-0000076074 31-12-2019 201900073022/093436 ACHMAD NOOR,TN Nathalia dr. OC00060 Cetirizine 10mg (OGB) 5.00 Tablet 623.70 3,618.50
R2019-0000076074 31-12-2019 201900073022/093436 ACHMAD NOOR,TN Nathalia dr. OD00031 Dexamethasone Tablet 10.00 Tablet 208.00 2,580.00
R2019-0000076074 31-12-2019 201900073022/093436 ACHMAD NOOR,TN Nathalia dr. OA00064 Amlodipin 5mg (OGB) 10.00 Tablet 1,555.00 16,050.00
R2019-0000076075 31-12-2019 201900073029/099697 SARI RAMADANA Nathalia dr. OR00003 Ranitidin 150mg (OGB) 5.00 Tablet 891.00 4,955.00
R2019-0000076075 31-12-2019 201900073029/099697 SARI RAMADANA Nathalia dr. OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000076076 30-12-2019 201900073016/043668 ARIANTO,TN Nathalia dr. OP00011 Paracetamol 500mg 1.00 Tablet 387.36 887.36
R2019-0000076077 30-12-2019 201900073022/093436 ACHMAD NOOR,TN Nathalia dr. OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2019-0000076077 30-12-2019 201900073022/093436 ACHMAD NOOR,TN Nathalia dr. OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000076077 30-12-2019 201900073022/093436 ACHMAD NOOR,TN Nathalia dr. OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000076079 30-12-2019 201900073020/079006 EDI LASITO,TN Nathalia dr. OL00076 Lodia 2mg 2.00 Tablet 1,485.00 3,470.00
R2019-0000076079 30-12-2019 201900073020/079006 EDI LASITO,TN Nathalia dr. OS00176 Scopma Plus Tablet 1.00 Tablet 2,090.22 2,590.22
R2019-0000076080 31-12-2019 201900073023/086686 ARKHA ALFADIEL,AN Nathalia dr. OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2019-0000076081 31-12-2019 201900073024/112247 ADEEBA SHAKILA Nathalia dr. OV00057 Ventolin Nebules 2.5mg 1.00 Ampul 15,365.00 15,865.00
R2019-0000076081 31-12-2019 201900073024/112247 ADEEBA SHAKILA Nathalia dr. OP00136 Pulmicort Respules 1.00 Ampul 33,802.98 34,302.98
R2019-0000076082 31-12-2019 201900073025/112380 S. IDRUS Nathalia dr. ALI00004 I.V Catheter No. 20 2.00 Pcs 36,808.20 74,116.40
R2019-0000076082 31-12-2019 201900073025/112380 S. IDRUS Nathalia dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000076082 31-12-2019 201900073025/112380 S. IDRUS Nathalia dr. OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000076085 31-12-2019 201900073029/099697 SARI RAMADANA Nathalia dr. OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000076085 31-12-2019 201900073029/099697 SARI RAMADANA Nathalia dr. OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000076085 31-12-2019 201900073029/099697 SARI RAMADANA Nathalia dr. ALI00004 I.V Catheter No. 20 1.00 Pcs 36,808.20 37,308.20
R2019-0000076103 31-12-2019 201900073049/015717 MUHAMMAD FAJRI ADE RAHMAH OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000076103 31-12-2019 201900073049/015717 MUHAMMAD FAJRI ADE RAHMAH OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2019-0000076103 31-12-2019 201900073049/015717 MUHAMMAD FAJRI ADE RAHMAH OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000076103 31-12-2019 201900073049/015717 MUHAMMAD FAJRI ADE RAHMAH OB00007 Becom - C 10.00 Tablet 2,123.55 21,735.50
R2019-0000076110 31-12-2019 201900073076/046345 SAIFUL,TN IQBAL, dr OA00002 AB - Vask 5mg 15.00 Tablet 8,539.00 128,585.00
R2019-0000076110 31-12-2019 201900073076/046345 SAIFUL,TN IQBAL, dr OL00041 Lasgan Capsul 10.00 Capsul 21,000.00 210,500.00
R2019-0000076110 31-12-2019 201900073076/046345 SAIFUL,TN IQBAL, dr OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000076086 31-12-2019 201900073079/080234 DENA PUTRI IQBAL OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000076086 31-12-2019 201900073079/080234 DENA PUTRI IQBAL OS00016 Sanadryl Expectoran 1.00 Botol 14,701.50 15,201.50
Total 339,467,194.70
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 257 dari 266
ASAL RAWAT JALAN
R2019-0000076086 31-12-2019 201900073079/080234 DENA PUTRI IQBAL OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000076086 31-12-2019 201900073079/080234 DENA PUTRI IQBAL OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000076120 31-12-2019 201900073098/028054 SAONAH,NY IQBAL OE00017 Epexol Syrup 1.00 Botol 25,690.50 26,190.50
R2019-0000076120 31-12-2019 201900073098/028054 SAONAH,NY IQBAL OC00172 Candesartan Cilexetil 20.00 Tablet 10,617.75 212,855.00
R2019-0000076120 31-12-2019 201900073098/028054 SAONAH,NY IQBAL OA00063 Amlodipin 10mg (OGB) 20.00 Tablet 2,743.00 55,360.00
R2019-0000076127 31-12-2019 201900073115/112389 HALIMAH,NY ADE RAHMAH OM00014 Mefinal 500mg 10.00 Tablet 1,982.48 20,324.80
R2019-0000076127 31-12-2019 201900073115/112389 HALIMAH,NY ADE RAHMAH OR00003 Ranitidin 150mg (OGB) 10.00 Tablet 891.00 9,410.00
R2019-0000076123 31-12-2019 201900073115/112389 HALIMAH,NY ADE RAHMAH OK00027 Ketorolac 3% Injeksi 1.00 Ampul 40,500.40 41,000.40
R2019-0000076129 31-12-2019 201900073130/112392 MOCHAMMAD IQBAL, dr OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000076129 31-12-2019 201900073130/112392 MOCHAMMAD IQBAL, dr OI00134 Imunos Plus Tablet 10.00 Tablet 14,107.50 141,575.00
R2019-0000076130 31-12-2019 201900073130/112392 MOCHAMMAD IQBAL, dr OR00041 Rhinos SR Capsul 10.00 Capsul 10,722.00 107,720.00
R2019-0000076131 31-12-2019 201900073118/112214 ILYAS ALHANAN,AN FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 3.00 Capsul 4,266.70 13,300.10
R2019-0000076131 31-12-2019 201900073118/112214 ILYAS ALHANAN,AN FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 3.00 Tablet 208.00 1,124.00
R2019-0000076131 31-12-2019 201900073118/112214 ILYAS ALHANAN,AN FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 3.00 Tablet 1,173.15 4,019.45
R2019-0000076131 31-12-2019 201900073118/112214 ILYAS ALHANAN,AN FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 3.00 Tablet 445.50 1,836.50
R2019-0000076131 31-12-2019 201900073118/112214 ILYAS ALHANAN,AN FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 3.00 Granula 297.00 1,391.00
R2019-0000076131 31-12-2019 201900073118/112214 ILYAS ALHANAN,AN FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000076132 31-12-2019 201900073135/090838 NANANG Niki Juniar OA00001 AB - Vask 10mg 20.00 Tablet 14,850.00 297,500.00
R2019-0000076135 31-12-2019 201900073136/112393 RONY S,TN ADE RAHMAH ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2019-0000076135 31-12-2019 201900073136/112393 RONY S,TN ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000076135 31-12-2019 201900073136/112393 RONY S,TN ADE RAHMAH OE00066 Ecosol Nacl 0,9% 100 Ml 1.00 Botol 22,542.30 23,042.30
R2019-0000076136 31-12-2019 201900073138/086946 MUHAMMAD HAIKAL FREDRIK, Dr,Sp.A OC00144 Cefila Capsul, 100mg 4.00 Capsul 28,957.00 116,328.00
R2019-0000076136 31-12-2019 201900073138/086946 MUHAMMAD HAIKAL FREDRIK, Dr,Sp.A OC00120 Cortidex Tablet 4.00 Tablet 430.65 2,222.60
R2019-0000076136 31-12-2019 201900073138/086946 MUHAMMAD HAIKAL FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 4.00 Tablet 1,173.15 5,192.60
R2019-0000076136 31-12-2019 201900073138/086946 MUHAMMAD HAIKAL FREDRIK, Dr,Sp.A OE00018 Epexol Tablet 4.00 Tablet 1,232.55 5,430.20
R2019-0000076136 31-12-2019 201900073138/086946 MUHAMMAD HAIKAL FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 4.00 Granula 297.00 1,688.00
R2019-0000076136 31-12-2019 201900073138/086946 MUHAMMAD HAIKAL FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 18,118.50
R2019-0000076136 31-12-2019 201900073138/086946 MUHAMMAD HAIKAL FREDRIK, Dr,Sp.A OO00062 Ottopan Syrup, 60ml 1.00 Botol 29,700.00 30,200.00
R2019-0000076133 31-12-2019 201900073141/112394 MARRYAM ADE RAHMAH OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000076133 31-12-2019 201900073141/112394 MARRYAM ADE RAHMAH OR00003 Ranitidin 150mg (OGB) 10.00 Tablet 891.00 9,410.00
R2019-0000076133 31-12-2019 201900073141/112394 MARRYAM ADE RAHMAH OB00007 Becom - C 10.00 Tablet 2,123.55 21,735.50
R2019-0000076143 31-12-2019 201900073153/029355 SEPTIAN Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000076143 31-12-2019 201900073153/029355 SEPTIAN Dwi Astuti, dr OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000076143 31-12-2019 201900073153/029355 SEPTIAN Dwi Astuti, dr OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2019-0000076143 31-12-2019 201900073153/029355 SEPTIAN Dwi Astuti, dr OC00097 Codein 15mg 10.00 Tablet 1,665.87 17,158.70
R2019-0000076146 31-12-2019 201900073156/112396 LISMAN,TN Dwi Astuti, dr OA00068 Amoxsan Capsul, 500mg 10.00 Capsul 4,752.00 48,020.00
R2019-0000076146 31-12-2019 201900073156/112396 LISMAN,TN Dwi Astuti, dr OF00055 Flamar Tablet, 50mg 10.00 Tablet 2,710.13 27,601.30
R2019-0000076147 31-12-2019 201900073144/090568 NOVITA SARI,NY NOVIANA, Dr. Sp OA00111 Aspilets Chawable 15.00 Tablet 811.35 12,670.25
Total 341,159,947.75
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 258 dari 266
ASAL RAWAT JALAN
R2019-0000076148 31-12-2019 201900073039/058087 ANITA CHENDRIANI LUSY E. Dr.Sp.PD OA00043 Alprazolam 0,5mg (OGB) 5.00 Tablet 996.50 5,482.50
R2019-0000076152 31-12-2019 201900073095/023566 MAEMUNAH,HJ LUSY E. Dr.Sp.PD OT00148 Tablet Tambah Darah 23.00 Tablet 742.00 17,566.00
R2019-0000076152 31-12-2019 201900073095/023566 MAEMUNAH,HJ LUSY E. Dr.Sp.PD OG00025 Gliquidone 30mg (OGB) 23.00 Tablet 1,967.44 45,751.12
R2019-0000076152 31-12-2019 201900073095/023566 MAEMUNAH,HJ LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 23.00 Tablet 371.25 9,038.75
R2019-0000076152 31-12-2019 201900073095/023566 MAEMUNAH,HJ LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2019-0000076152 31-12-2019 201900073095/023566 MAEMUNAH,HJ LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000076152 31-12-2019 201900073095/023566 MAEMUNAH,HJ LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000076153 31-12-2019 201900073095/023566 MAEMUNAH,HJ LUSY E. Dr.Sp.PD OG00025 Gliquidone 30mg (OGB) 7.00 Tablet 1,967.44 14,272.08
R2019-0000076153 31-12-2019 201900073095/023566 MAEMUNAH,HJ LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 7.00 Tablet 371.25 3,098.75
R2019-0000076153 31-12-2019 201900073095/023566 MAEMUNAH,HJ LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000076153 31-12-2019 201900073095/023566 MAEMUNAH,HJ LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000076153 31-12-2019 201900073095/023566 MAEMUNAH,HJ LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000076153 31-12-2019 201900073095/023566 MAEMUNAH,HJ LUSY E. Dr.Sp.PD OC00096 Codein 10mg 10.00 Tablet 924.80 9,748.00
R2019-0000076153 31-12-2019 201900073095/023566 MAEMUNAH,HJ LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 14.00 Capsul 1,169.98 16,879.72
R2019-0000076155 31-12-2019 201900073133/097578 SUYANTI,NY LUSY E. Dr.Sp.PD OT00135 Thyrozol 5mg 90.00 Tablet 2,188.89 197,500.10
R2019-0000076156 31-12-2019 201900073147/090814 MOHTAR,TN LUSY E. Dr.Sp.PD OC00057 Cerini 10.00 Tablet 5,093.55 51,435.50
R2019-0000076156 31-12-2019 201900073147/090814 MOHTAR,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000076156 31-12-2019 201900073147/090814 MOHTAR,TN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000076156 31-12-2019 201900073147/090814 MOHTAR,TN LUSY E. Dr.Sp.PD OC00134 Curcuma Tablet 20.00 Tablet 1,336.50 27,230.00
R2019-0000076156 31-12-2019 201900073147/090814 MOHTAR,TN LUSY E. Dr.Sp.PD OB00050 Braxidin 10.00 Tablet 1,648.35 16,983.50
R2019-0000076157 31-12-2019 201900073168/112399 REVA RASENDRYA Dwi Astuti, dr OA00071 Amoxsan Forte Dry Syrup 1.00 Botol 47,520.00 48,020.00
R2019-0000076157 31-12-2019 201900073168/112399 REVA RASENDRYA Dwi Astuti, dr OB00057 Bufect Forte Suspensi, 1.00 Botol 30,442.50 30,942.50
R2019-0000076157 31-12-2019 201900073168/112399 REVA RASENDRYA Dwi Astuti, dr OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2019-0000076158 31-12-2019 201900073171/076599 DEVAN KHALISH Dwi Astuti, dr ON00004 Naprex Syrup, 60ml 1.00 Botol 59,251.50 59,751.50
R2019-0000076158 31-12-2019 201900073171/076599 DEVAN KHALISH Dwi Astuti, dr OP00101 Proceles Syrup, 60ml 1.00 Botol 51,975.00 52,475.00
R2019-0000076160 31-12-2019 201900073173/035820 RUDI SUPRIANTO,TN Dwi Astuti, dr OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2019-0000076160 31-12-2019 201900073173/035820 RUDI SUPRIANTO,TN Dwi Astuti, dr OP00104 Paracetamol Infus (OGB) 1.00 Botol 89,100.00 89,600.00
R2019-0000076160 31-12-2019 201900073173/035820 RUDI SUPRIANTO,TN Dwi Astuti, dr OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2019-0000076160 31-12-2019 201900073173/035820 RUDI SUPRIANTO,TN Dwi Astuti, dr ALI00003 I.V Catheter No. 18 1.00 Pcs 29,744.00 30,244.00
R2019-0000076160 31-12-2019 201900073173/035820 RUDI SUPRIANTO,TN Dwi Astuti, dr ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2019-0000076164 31-12-2019 201900073173/035820 RUDI SUPRIANTO,TN Dwi Astuti, dr OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000076164 31-12-2019 201900073173/035820 RUDI SUPRIANTO,TN Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2019-0000076165 31-12-2019 201900073178/071551 ADINA DWI Dwi Astuti, dr OO00074 Ondansetron Tablet, 4mg 5.00 Tablet 4,455.00 22,775.00
R2019-0000076165 31-12-2019 201900073178/071551 ADINA DWI Dwi Astuti, dr OP00151 Propepsa Syrup, 100ml 1.00 Botol 85,387.50 85,887.50
R2019-0000076165 31-12-2019 201900073178/071551 ADINA DWI Dwi Astuti, dr OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000076165 31-12-2019 201900073178/071551 ADINA DWI Dwi Astuti, dr OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000076165 31-12-2019 201900073178/071551 ADINA DWI Dwi Astuti, dr OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000076167 31-12-2019 201900073180/100433 YUDI ISKANDAR,TN Dwi Astuti, dr OC00144 Cefila Capsul, 100mg 10.00 Capsul 28,957.00 290,070.00
Total 342,964,128.87
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 259 dari 266
ASAL RAWAT JALAN
R2019-0000076167 31-12-2019 201900073180/100433 YUDI ISKANDAR,TN Dwi Astuti, dr OS00029 Sanmol Tablet, 500mg 10.00 Tablet 430.65 4,806.50
R2019-0000076167 31-12-2019 201900073180/100433 YUDI ISKANDAR,TN Dwi Astuti, dr OL00017 Lameson 4mg 10.00 Tablet 5,049.00 50,990.00
R2019-0000076167 31-12-2019 201900073180/100433 YUDI ISKANDAR,TN Dwi Astuti, dr OS00016 Sanadryl Expectoran 1.00 Botol 14,701.50 15,201.50
R2019-0000076167 31-12-2019 201900073180/100433 YUDI ISKANDAR,TN Dwi Astuti, dr OT00077 Tremenza Tablet 10.00 Tablet 2,160.68 22,106.80
R2019-0000076169 31-12-2019 201900073182/112403 MUHAMMAD ABDUL Dwi Astuti, dr OF00055 Flamar Tablet, 50mg 10.00 Tablet 2,710.13 27,601.30
R2019-0000076169 31-12-2019 201900073182/112403 MUHAMMAD ABDUL Dwi Astuti, dr ALP00024 Policrepe 3" 1.00 Roll 80,784.00 81,284.00
R2019-0000076172 30-12-2019 201900072896/056183 FARREL ZAHRAN ADE RAHMAH OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2019-0000076172 30-12-2019 201900072896/056183 FARREL ZAHRAN ADE RAHMAH OA00052 Ambroxol Tablet, 30mg 5.00 Tablet 445.50 2,727.50
R2019-0000076172 30-12-2019 201900072896/056183 FARREL ZAHRAN ADE RAHMAH OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2019-0000076173 30-12-2019 201900072906/097712 RIZQA SHOLEHAH,NN ADE RAHMAH OC00053 Cendo Xitrol Salep Mata 1.00 Botol 53,274.37 53,774.37
R2019-0000076173 30-12-2019 201900072906/097712 RIZQA SHOLEHAH,NN ADE RAHMAH OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000076174 30-12-2019 201900072793/112244 SUYANTO,TN LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000076174 30-12-2019 201900072793/112244 SUYANTO,TN LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000076175 30-12-2019 201900072778/094036 JURI,TN LUSY E. Dr.Sp.PD OT00030 Teosal 10.00 Tablet 282.15 3,321.50
R2019-0000076175 30-12-2019 201900072778/094036 JURI,TN LUSY E. Dr.Sp.PD OA00166 Azithromycin 500mg 5.00 Tablet 14,850.00 74,750.00
R2019-0000076175 30-12-2019 201900072778/094036 JURI,TN LUSY E. Dr.Sp.PD OM00045 Methyl Prednisolon 4mg 10.00 Tablet 792.99 8,429.90
R2019-0000076175 30-12-2019 201900072778/094036 JURI,TN LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000076176 30-12-2019 201900072808/112347 SARAH,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 10.00 Tablet 10,617.75 106,677.50
R2019-0000076177 30-12-2019 201900072816/111910 PUSPARIYANTI,NY LUSY E. Dr.Sp.PD ON00009 Natrium Diklofenac 50mg 10.00 Tablet 955.84 10,058.40
R2019-0000076177 30-12-2019 201900072816/111910 PUSPARIYANTI,NY LUSY E. Dr.Sp.PD OL00059 Levofloxacin 500mg 5.00 Tablet 1,793.00 9,465.00
R2019-0000076177 30-12-2019 201900072816/111910 PUSPARIYANTI,NY LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000076178 30-12-2019 201900072888/100948 TATAP HOTMAIDA Nafon Zaitun, Dr. OE00008 Elkana Tablet 7.00 Tablet 1,247.40 9,231.80
R2019-0000076179 30-12-2019 201900072830/112348 SUGIARTI,NY LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 10.00 Tablet 3,164.00 32,140.00
R2019-0000076179 30-12-2019 201900072830/112348 SUGIARTI,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 20.00 Tablet 371.25 7,925.00
R2019-0000076179 30-12-2019 201900072830/112348 SUGIARTI,NY LUSY E. Dr.Sp.PD ON00009 Natrium Diklofenac 50mg 10.00 Tablet 955.84 10,058.40
R2019-0000076180 30-12-2019 201900072837/111913 AGUS HARTONO,TN LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 10.00 Tablet 3,164.00 32,140.00
R2019-0000076180 30-12-2019 201900072837/111913 AGUS HARTONO,TN LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 30.00 371.25 11,637.50
R2019-0000076180 30-12-2019 201900072837/111913 AGUS HARTONO,TN LUSY E. Dr.Sp.PD OL00059 Levofloxacin 500mg 6.00 Tablet 1,793.00 11,258.00
R2019-0000076181 30-12-2019 201900072818/058087 ANITA CHENDRIANI LUSY E. Dr.Sp.PD OL00021 Lansoprazole (OGB) 10.00 Capsul 2,230.00 22,800.00
R2019-0000076181 30-12-2019 201900072818/058087 ANITA CHENDRIANI LUSY E. Dr.Sp.PD OA00186 Asam Ursodeoksikolat 10.00 Tablet 6,237.00 62,870.00
R2019-0000076181 30-12-2019 201900072818/058087 ANITA CHENDRIANI LUSY E. Dr.Sp.PD OM00143 Metoclopramide 10mg 10.00 Tablet 211.95 2,619.50
R2019-0000076181 30-12-2019 201900072818/058087 ANITA CHENDRIANI LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000076182 30-12-2019 201900072937/093006 JOHANIS Dwi Astuti, dr OA00088 Antiza Tablet 6.00 Tablet 1,633.00 10,298.00
R2019-0000076182 30-12-2019 201900072937/093006 JOHANIS Dwi Astuti, dr OM00045 Methyl Prednisolon 4mg 6.00 Tablet 792.99 5,257.94
R2019-0000076182 30-12-2019 201900072937/093006 JOHANIS Dwi Astuti, dr OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2019-0000076183 30-12-2019 201900072884/018072 ZULHAM,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 10.00 Tablet 2,743.00 27,930.00
R2019-0000076184 31-12-2019 201900073188/091051 DIVA SYAFIRA Dwi Astuti, dr OC00144 Cefila Capsul, 100mg 2.00 Capsul 28,957.00 58,414.00
R2019-0000076184 31-12-2019 201900073188/091051 DIVA SYAFIRA Dwi Astuti, dr OL00017 Lameson 4mg 2.00 Tablet 5,049.00 10,598.00
Total 343,873,966.53
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 260 dari 266
ASAL RAWAT JALAN
R2019-0000076184 31-12-2019 201900073188/091051 DIVA SYAFIRA Dwi Astuti, dr OC00057 Cerini 2.00 Tablet 5,093.55 10,687.10
R2019-0000076184 31-12-2019 201900073188/091051 DIVA SYAFIRA Dwi Astuti, dr OV00080 Vitamin B Compleks 2.00 Tablet 241.79 983.58
R2019-0000076184 31-12-2019 201900073188/091051 DIVA SYAFIRA Dwi Astuti, dr ATKK031 Kertas Puyer Handbond 10.00 Sachet 207.90 17,079.00
R2019-0000076185 30-12-2019 201900072892/071783 VERA,NY LUSY E. Dr.Sp.PD ON00075 Novomix 30 Flexpen 2.00 Flexpen 226,917.80 454,335.60
R2019-0000076185 30-12-2019 201900072892/071783 VERA,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000076185 30-12-2019 201900072892/071783 VERA,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000076185 30-12-2019 201900072892/071783 VERA,NY LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 23.00 Tablet 206.41 5,247.43
R2019-0000076185 30-12-2019 201900072892/071783 VERA,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 23.00 Tablet 445.50 10,746.50
R2019-0000076185 30-12-2019 201900072892/071783 VERA,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000076186 30-12-2019 201900072892/071783 VERA,NY LUSY E. Dr.Sp.PD ON00075 Novomix 30 Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000076186 30-12-2019 201900072892/071783 VERA,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000076186 30-12-2019 201900072892/071783 VERA,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000076186 30-12-2019 201900072892/071783 VERA,NY LUSY E. Dr.Sp.PD OA00175 Afolat 400mcg 7.00 Tablet 206.41 1,944.87
R2019-0000076186 30-12-2019 201900072892/071783 VERA,NY LUSY E. Dr.Sp.PD OA00037 Allopurinol 100mg (OGB) 7.00 Tablet 445.50 3,618.50
R2019-0000076186 30-12-2019 201900072892/071783 VERA,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000076186 30-12-2019 201900072892/071783 VERA,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 10.00 Tablet 315.26 3,652.60
R2019-0000076186 30-12-2019 201900072892/071783 VERA,NY LUSY E. Dr.Sp.PD OC00060 Cetirizine 10mg (OGB) 10.00 Tablet 623.70 6,737.00
R2019-0000076186 30-12-2019 201900072892/071783 VERA,NY LUSY E. Dr.Sp.PD OH00026 Hydrocortis on Cream 1.00 Tube 11,880.00 12,380.00
R2019-0000076186 30-12-2019 201900072892/071783 VERA,NY LUSY E. Dr.Sp.PD OA00051 Ambroxol 15mg/5ml 1.00 Botol 10,395.00 10,895.00
R2019-0000076187 30-12-2019 201900072776/38118 SRI PRIHARTINI,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000076187 30-12-2019 201900072776/38118 SRI PRIHARTINI,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000076187 30-12-2019 201900072776/38118 SRI PRIHARTINI,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2019-0000076188 30-12-2019 201900072785/103586 SARIP,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000076188 30-12-2019 201900072785/103586 SARIP,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000076188 30-12-2019 201900072785/103586 SARIP,TN LUSY E. Dr.Sp.PD OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000076189 30-12-2019 201900072799/112152 SUTARNO,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000076192 30-12-2019 201900072796/108534 SITI MARIFAH,NY LUSY E. Dr.Sp.PD OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2019-0000076192 30-12-2019 201900072796/108534 SITI MARIFAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000076192 30-12-2019 201900072796/108534 SITI MARIFAH,NY LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 3.00 Tablet 315.26 1,445.78
R2019-0000076192 30-12-2019 201900072796/108534 SITI MARIFAH,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000076191 31-12-2019 201900072809/106178 DJEMONO,TN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000076191 31-12-2019 201900072809/106178 DJEMONO,TN LUSY E. Dr.Sp.PD ON00077 Novorapid Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2019-0000076194 30-12-2019 201900072802/106258 ASIAH,NY LUSY E. Dr.Sp.PD ALN00021 Needle Novofine 32G 1.00 Pcs 3,690.00 4,190.00
R2019-0000076195 30-12-2019 201900072814/106331 PINGAR LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
Total 345,805,620.59
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 261 dari 266
ASAL RAWAT JALAN
R2019-0000076195 30-12-2019 201900072814/106331 PINGAR LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 23.00 Tablet 10,617.75 244,708.25
R2019-0000076195 30-12-2019 201900072814/106331 PINGAR LUSY E. Dr.Sp.PD OG00025 Gliquidone 30mg (OGB) 69.00 Tablet 1,967.44 136,253.36
R2019-0000076196 30-12-2019 201900072814/106331 PINGAR LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000076196 30-12-2019 201900072814/106331 PINGAR LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000076196 30-12-2019 201900072814/106331 PINGAR LUSY E. Dr.Sp.PD OI00097 Isosorbide Dinitrate 5mg 10.00 Tablet 311.85 3,618.50
R2019-0000076196 30-12-2019 201900072814/106331 PINGAR LUSY E. Dr.Sp.PD OE00040 Ethambutol 500mg 10.00 Tablet 1,188.00 12,380.00
R2019-0000076196 30-12-2019 201900072814/106331 PINGAR LUSY E. Dr.Sp.PD OG00025 Gliquidone 30mg (OGB) 21.00 Tablet 1,967.44 41,816.24
R2019-0000076198 30-12-2019 201900072815/28759 JAMILAH,NY LUSY E. Dr.Sp.PD OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000076198 30-12-2019 201900072815/28759 JAMILAH,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2019-0000076200 30-12-2019 201900072812/052373 DONNA LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000076200 30-12-2019 201900072812/052373 DONNA LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000076200 30-12-2019 201900072812/052373 DONNA LUSY E. Dr.Sp.PD OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000076202 30-12-2019 201900072840/084761 ELISA,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2019-0000076202 30-12-2019 201900072840/084761 ELISA,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2019-0000076202 30-12-2019 201900072840/084761 ELISA,TN LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2019-0000076203 30-12-2019 201900072840/084761 ELISA,TN LUSY E. Dr.Sp.PD OC00134 Curcuma Tablet 20.00 Tablet 1,336.50 27,230.00
R2019-0000076203 30-12-2019 201900072840/084761 ELISA,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000076203 30-12-2019 201900072840/084761 ELISA,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000076203 30-12-2019 201900072840/084761 ELISA,TN LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000076204 30-12-2019 201900072822/084049 ARIFIN,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000076204 30-12-2019 201900072822/084049 ARIFIN,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000076205 30-12-2019 201900072824/087167 LASIYEM,NY LUSY E. Dr.Sp.PD OL00056 Levemir Insulin 1.00 Flexpen 287,330.88 287,830.88
R2019-0000076205 30-12-2019 201900072824/087167 LASIYEM,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2019-0000076205 30-12-2019 201900072824/087167 LASIYEM,NY LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000076205 30-12-2019 201900072824/087167 LASIYEM,NY LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2019-0000076201 30-12-2019 201900072854/017246 SITI HAMIDAH,NY LUSY E. Dr.Sp.PD OG00022 Glimepiride 2mg Tablet 7.00 Tablet 2,525.00 18,175.00
Total 348,297,991.37
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 262 dari 266
ASAL RAWAT JALAN
R2019-0000076201 30-12-2019 201900072854/017246 SITI HAMIDAH,NY LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2019-0000076201 30-12-2019 201900072854/017246 SITI HAMIDAH,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2019-0000076201 30-12-2019 201900072854/017246 SITI HAMIDAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000076206 30-12-2019 201900072872/16859 DAISAH,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2019-0000076206 30-12-2019 201900072872/16859 DAISAH,NY LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2019-0000076206 30-12-2019 201900072872/16859 DAISAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000076206 30-12-2019 201900072872/16859 DAISAH,NY LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000076206 30-12-2019 201900072872/16859 DAISAH,NY LUSY E. Dr.Sp.PD OM00154 Mecobalamin 500mg 20.00 Tablet 1,118.00 22,860.00
R2019-0000076206 30-12-2019 201900072872/16859 DAISAH,NY LUSY E. Dr.Sp.PD OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2019-0000076207 30-12-2019 201900072873/30244 SUNDING, H,TN LUSY E. Dr.Sp.PD OF00095 Furosemide 40mg (OGB) 3.00 Tablet 315.26 1,445.78
R2019-0000076207 30-12-2019 201900072873/30244 SUNDING, H,TN LUSY E. Dr.Sp.PD OC00172 Candesartan Cilexetil 7.00 Tablet 10,617.75 74,824.25
R2019-0000076207 30-12-2019 201900072873/30244 SUNDING, H,TN LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2019-0000076207 30-12-2019 201900072873/30244 SUNDING, H,TN LUSY E. Dr.Sp.PD OM00017 Meloxicam 15mg (OGB) 10.00 Tablet 2,079.00 21,290.00
R2019-0000076207 30-12-2019 201900072873/30244 SUNDING, H,TN LUSY E. Dr.Sp.PD OF00056 Flamar Emulgel, 20gr 1.00 Tube 24,354.00 24,854.00
R2020-0000000003 31-12-2019 201900073196/112404 RUSDI,TN Nathalia dr. OS00176 Scopma Plus Tablet 10.00 Tablet 2,090.22 21,402.20
R2020-0000000027 31-12-2019 201900073052/112384 SUMINI,NY ADE RAHMAH OA00063 Amlodipin 10mg (OGB) 3.00 Tablet 2,743.00 8,729.00
R2020-0000000027 31-12-2019 201900073052/112384 SUMINI,NY ADE RAHMAH OR00003 Ranitidin 150mg (OGB) 5.00 Tablet 891.00 4,955.00
R2020-0000000027 31-12-2019 201900073052/112384 SUMINI,NY ADE RAHMAH OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2020-0000000028 31-12-2019 201900073041/00012743 RICKY E J WELAN,TN EDO, Dr.Sp.B ALK00010 Kasa Steril 16cmX16cm 12.00 Lembar 618.70 7,924.40
R2020-0000000028 31-12-2019 201900073041/00012743 RICKY E J WELAN,TN EDO, Dr.Sp.B ALU00001 Ultrafix Onemed 20.00 Cm 150.00 3,500.00
R2020-0000000029 31-12-2019 201900072813/093710 HENDRICK C EDO, Dr.Sp.B OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2020-0000000029 31-12-2019 201900072813/093710 HENDRICK C EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2020-0000000030 31-12-2019 201900073065/072094 IDA ERIYATI,NY EDO, Dr.Sp.B OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2020-0000000031 31-12-2019 201900073078/112386 BRYAN MOGENS ADE RAHMAH OE00047 Epexol Drop 1.00 Botol 55,836.00 56,336.00
R2020-0000000031 31-12-2019 201900073078/112386 BRYAN MOGENS ADE RAHMAH OG00075 Grafadon Drops 15 Ml 1.00 Botol 17,820.00 18,320.00
R2020-0000000032 31-12-2019 201900073081/112387 KANDA,NY ADE RAHMAH OS00009 Salbutamol 2mg (OGB) 5.00 Tablet 213.30 1,566.50
R2020-0000000032 31-12-2019 201900073081/112387 KANDA,NY ADE RAHMAH OA00180 Acetylcyst ein 200mg 5.00 Tablet 1,485.00 7,925.00
R2020-0000000032 31-12-2019 201900073081/112387 KANDA,NY ADE RAHMAH OL00017 Lameson 4mg 3.00 Tablet 5,049.00 15,647.00
R2020-0000000032 31-12-2019 201900073081/112387 KANDA,NY ADE RAHMAH OB00007 Becom - C 3.00 Tablet 2,123.55 6,870.65
R2020-0000000034 31-12-2019 201900073042/111619 TARMIJI,TN Maulin Nikmah OG00057 Gabapentin 300mg (OGB) 4.00 Tablet 8,168.00 33,172.00
R2020-0000000034 31-12-2019 201900073042/111619 TARMIJI,TN Maulin Nikmah ALK00037 Kapsul No.1 6.00 pcs 200.00 1,700.00
R2020-0000000034 31-12-2019 201900073042/111619 TARMIJI,TN Maulin Nikmah OM00154 Mecobalamin 500mg 6.00 Tablet 1,118.00 7,208.00
R2020-0000000036 31-12-2019 201900073096/112388 USEP SAEPUDIN,TN ADE RAHMAH OA00074 Analsik 2.00 Tablet 2,264.63 5,029.26
R2020-0000000036 31-12-2019 201900073096/112388 USEP SAEPUDIN,TN ADE RAHMAH OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2020-0000000036 31-12-2019 201900073096/112388 USEP SAEPUDIN,TN ADE RAHMAH OA00085 Antasida Tablet (OGB) 5.00 Tablet 284.30 1,921.50
R2020-0000000036 31-12-2019 201900073096/112388 USEP SAEPUDIN,TN ADE RAHMAH OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2020-0000000036 31-12-2019 201900073096/112388 USEP SAEPUDIN,TN ADE RAHMAH ON00009 Natrium Diklofenac 50mg 3.00 Tablet 955.84 3,367.52
R2020-0000000035 31-12-2019 201900073129/112268 AZKA RAFFASYA,AN Nafon Zaitun, Dr. OC00039 Cefixime 100mg (OGB) 2.00 Capsul 4,266.70 9,033.40
Total 348,975,075.73
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 263 dari 266
ASAL RAWAT JALAN
R2020-0000000035 31-12-2019 201900073129/112268 AZKA RAFFASYA,AN Nafon Zaitun, Dr. OD00031 Dexamethasone Tablet 2.00 Tablet 208.00 916.00
R2020-0000000035 31-12-2019 201900073129/112268 AZKA RAFFASYA,AN Nafon Zaitun, Dr. OI00126 Interhistin 50mg, Tablet 2.00 Tablet 1,173.15 2,846.30
R2020-0000000035 31-12-2019 201900073129/112268 AZKA RAFFASYA,AN Nafon Zaitun, Dr. OA00052 Ambroxol Tablet, 30mg 2.00 Tablet 445.50 1,391.00
R2020-0000000035 31-12-2019 201900073129/112268 AZKA RAFFASYA,AN Nafon Zaitun, Dr. OS00079 Sirplus Granula 2.00 Granula 297.00 1,094.00
R2020-0000000035 31-12-2019 201900073129/112268 AZKA RAFFASYA,AN Nafon Zaitun, Dr. ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 10,618.50
R2020-0000000037 31-12-2019 201900073134/080828 RENDRA ABIZARD ADE RAHMAH OD00076 Dumin Rectal 125mg 1.00 Tube 23,032.35 23,532.35
R2020-0000000039 31-12-2019 201900073100/2794 AKHMAD BUSTAMAN Restu OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2020-0000000040 31-12-2019 201900073100/2794 AKHMAD BUSTAMAN Restu OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2020-0000000042 31-12-2019 201900073169/086157 INDRIJANI Restu OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2020-0000000042 31-12-2019 201900073169/086157 INDRIJANI Restu OS00173 Simvastatin 20mg (OGB) 23.00 Tablet 1,782.00 41,486.00
R2020-0000000042 31-12-2019 201900073169/086157 INDRIJANI Restu OM00035 Metformin 500mg (OGB) 69.00 Tablet 371.25 26,116.25
R2020-0000000042 31-12-2019 201900073169/086157 INDRIJANI Restu OD00047 Diamicron MR 60mg 23.00 Tablet 8,420.00 194,160.00
R2020-0000000044 31-12-2019 201900073169/086157 INDRIJANI Restu OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2020-0000000044 31-12-2019 201900073169/086157 INDRIJANI Restu OS00173 Simvastatin 20mg (OGB) 7.00 Tablet 1,782.00 12,974.00
R2020-0000000044 31-12-2019 201900073169/086157 INDRIJANI Restu OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2020-0000000044 31-12-2019 201900073169/086157 INDRIJANI Restu OD00047 Diamicron MR 60mg 7.00 Tablet 8,420.00 59,440.00
R2020-0000000045 31-12-2019 201900073099/47070 ELLYAS NAFIS,TN Restu OT00157 Telmisartan 80 mg 23.00 Tablet 9,801.00 225,923.00
R2020-0000000045 31-12-2019 201900073099/47070 ELLYAS NAFIS,TN Restu OA00140 Atorvastatin 20mg (OGB) 12.00 Tablet 6,534.00 78,908.00
R2020-0000000045 31-12-2019 201900073099/47070 ELLYAS NAFIS,TN Restu OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2020-0000000045 31-12-2019 201900073099/47070 ELLYAS NAFIS,TN Restu OP00200 Pioglitazon 30 Mg 23.00 Tab 7,425.00 171,275.00
R2020-0000000045 31-12-2019 201900073099/47070 ELLYAS NAFIS,TN Restu OD00047 Diamicron MR 60mg 12.00 Tablet 8,420.00 101,540.00
R2020-0000000045 31-12-2019 201900073099/47070 ELLYAS NAFIS,TN Restu OL00021 Lansoprazole (OGB) 23.00 Capsul 2,230.00 51,790.00
R2020-0000000046 31-12-2019 201900073099/47070 ELLYAS NAFIS,TN Restu OT00157 Telmisartan 80 mg 7.00 Tablet 9,801.00 69,107.00
R2020-0000000046 31-12-2019 201900073099/47070 ELLYAS NAFIS,TN Restu OA00140 Atorvastatin 20mg (OGB) 3.00 Tablet 6,534.00 20,102.00
R2020-0000000046 31-12-2019 201900073099/47070 ELLYAS NAFIS,TN Restu OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2020-0000000046 31-12-2019 201900073099/47070 ELLYAS NAFIS,TN Restu OP00200 Pioglitazon 30 Mg 7.00 Tab 7,425.00 52,475.00
R2020-0000000046 31-12-2019 201900073099/47070 ELLYAS NAFIS,TN Restu OD00047 Diamicron MR 60mg 3.00 Tablet 8,420.00 25,760.00
R2020-0000000046 31-12-2019 201900073099/47070 ELLYAS NAFIS,TN Restu OL00021 Lansoprazole (OGB) 7.00 Capsul 2,230.00 16,110.00
R2020-0000000047 31-12-2019 201900073090/109293 NOR HIDAYAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 12.00 Tablet 5,197.50 62,870.00
R2020-0000000047 31-12-2019 201900073090/109293 NOR HIDAYAH,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 23.00 Tablet 7,425.00 171,275.00
R2020-0000000047 31-12-2019 201900073090/109293 NOR HIDAYAH,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 23.00 Tablet 1,555.00 36,265.00
R2020-0000000043 31-12-2019 201900073052/112384 SUMINI,NY ADE RAHMAH OR00004 Ranitidin Injeksi (OGB) 1.00 Ampul 9,653.00 10,153.00
R2020-0000000043 31-12-2019 201900073052/112384 SUMINI,NY ADE RAHMAH OC00018 Captopril 12.5mg (OGB) 1.00 Tablet 180.00 680.00
R2020-0000000048 31-12-2019 201900073090/109293 NOR HIDAYAH,NY LUSY E. Dr.Sp.PD OB00036 Bis oprolol 5mg (OGB) 3.00 Tablet 5,197.50 16,092.50
R2020-0000000048 31-12-2019 201900073090/109293 NOR HIDAYAH,NY LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2020-0000000048 31-12-2019 201900073090/109293 NOR HIDAYAH,NY LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2020-0000000048 31-12-2019 201900073090/109293 NOR HIDAYAH,NY LUSY E. Dr.Sp.PD OA00086 Antihemoroid Supositoria 2.00 Suppo 4,975.00 10,450.00
R2020-0000000048 31-12-2019 201900073090/109293 NOR HIDAYAH,NY LUSY E. Dr.Sp.PD OK00022 Ketoconazol Cream 2% 1.00 Tube 11,000.00 11,500.00
Total 350,719,434.38
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 264 dari 266
ASAL RAWAT JALAN
R2020-0000000050 31-12-2019 201900073152/084339 UDI SURYANDI,TN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2020-0000000050 31-12-2019 201900073152/084339 UDI SURYANDI,TN LUSY E. Dr.Sp.PD OP00184 Neo Protifed Tablet 10.00 Tablet 1,263.73 13,137.30
R2020-0000000053 31-12-2019 201900073121/068612 SUTOPO,TN LUSY E. Dr.Sp.PD OA00064 Amlodipin 5mg (OGB) 7.00 Tablet 1,555.00 11,385.00
R2020-0000000053 31-12-2019 201900073121/068612 SUTOPO,TN LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2020-0000000055 31-12-2019 201900073117/062543 PAULUS ROMBE,TN LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2020-0000000055 31-12-2019 201900073117/062543 PAULUS ROMBE,TN LUSY E. Dr.Sp.PD OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2020-0000000055 31-12-2019 201900073117/062543 PAULUS ROMBE,TN LUSY E. Dr.Sp.PD OC00171 Candesartan Cilexetil 7.00 Tablet 7,425.00 52,475.00
R2020-0000000055 31-12-2019 201900073117/062543 PAULUS ROMBE,TN LUSY E. Dr.Sp.PD OC00092 Clopidogrel 75mg (OGB) 7.00 Tablet 14,701.50 103,410.50
R2020-0000000057 31-12-2019 201900073101/086921 BOBY LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 23.00 Tablet 811.18 19,157.14
R2020-0000000057 31-12-2019 201900073101/086921 BOBY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 23.00 Tablet 1,662.00 38,726.00
R2020-0000000058 31-12-2019 201900073101/086921 BOBY LUSY E. Dr.Sp.PD OG00009 Gemfibrozil 300mg (OGB) 7.00 Tablet 811.18 6,178.26
R2020-0000000058 31-12-2019 201900073101/086921 BOBY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 7.00 Tablet 1,662.00 12,134.00
R2020-0000000058 31-12-2019 201900073101/086921 BOBY LUSY E. Dr.Sp.PD OC00134 Curcuma Tablet 20.00 Tablet 1,336.50 27,230.00
R2020-0000000060 31-12-2019 201900073103/076758 MURDIANA,NY Restu OG00057 Gabapentin 300mg (OGB) 23.00 Tablet 8,168.00 188,364.00
R2020-0000000060 31-12-2019 201900073103/076758 MURDIANA,NY Restu OA00140 Atorvastatin 20mg (OGB) 12.00 Tablet 6,534.00 78,908.00
R2020-0000000060 31-12-2019 201900073103/076758 MURDIANA,NY Restu OA00063 Amlodipin 10mg (OGB) 23.00 Tablet 2,743.00 63,589.00
R2020-0000000060 31-12-2019 201900073103/076758 MURDIANA,NY Restu OA00111 Aspilets Chawable 23.00 Tablet 811.35 19,161.05
R2020-0000000059 31-12-2019 201900073103/076758 MURDIANA,NY Restu OG00057 Gabapentin 300mg (OGB) 7.00 Tablet 8,168.00 57,676.00
R2020-0000000059 31-12-2019 201900073103/076758 MURDIANA,NY Restu OA00140 Atorvastatin 20mg (OGB) 3.00 Tablet 6,534.00 20,102.00
R2020-0000000059 31-12-2019 201900073103/076758 MURDIANA,NY Restu OA00063 Amlodipin 10mg (OGB) 7.00 Tablet 2,743.00 19,701.00
R2020-0000000059 31-12-2019 201900073103/076758 MURDIANA,NY Restu OA00111 Aspilets Chawable 7.00 Tablet 811.35 6,179.45
R2020-0000000059 31-12-2019 201900073103/076758 MURDIANA,NY Restu OC00076 Ciprofloxacin 500mg 10.00 Tablet 1,039.50 10,895.00
R2020-0000000059 31-12-2019 201900073103/076758 MURDIANA,NY Restu ON00047 New Diatabs 10.00 Tablet 767.13 8,171.30
R2020-0000000063 31-12-2019 201900073103/076758 MURDIANA,NY Restu OT00047 Tiaryt Tablet 23.00 Tablet 4,100.00 94,800.00
R2020-0000000063 31-12-2019 201900073103/076758 MURDIANA,NY Restu OT00047 Tiaryt Tablet 7.00 Tablet 4,100.00 29,200.00
R2020-0000000062 31-12-2019 201900073181/112402 KASIATUN,NY Dwi Astuti, dr OL00108 Lexatrans 500mg 10.00 Tablet 1,871.00 19,210.00
R2020-0000000062 31-12-2019 201900073181/112402 KASIATUN,NY Dwi Astuti, dr OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2020-0000000062 31-12-2019 201900073181/112402 KASIATUN,NY Dwi Astuti, dr OT00148 Tablet Tambah Darah 10.00 Tablet 742.00 7,920.00
R2020-0000000062 31-12-2019 201900073181/112402 KASIATUN,NY Dwi Astuti, dr OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2020-0000000064 31-12-2019 201900073170/112400 JOSHUA JEPHTA Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2020-0000000064 31-12-2019 201900073170/112400 JOSHUA JEPHTA Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
R2020-0000000065 31-12-2019 201900073174/105559 ANNISA LUTFIYANDA, Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2020-0000000065 31-12-2019 201900073174/105559 ANNISA LUTFIYANDA, Dwi Astuti, dr OA00088 Antiza Tablet 10.00 Tablet 1,633.00 16,830.00
R2020-0000000066 31-12-2019 201900073175/036276 YOLA FEBRIANTI Dwi Astuti, dr OA00106 Asam Mefenamat 500mg 5.00 Tablet 415.80 2,579.00
Total 351,852,459.33
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 265 dari 266
ASAL RAWAT JALAN
R2020-0000000066 31-12-2019 201900073175/036276 YOLA FEBRIANTI Dwi Astuti, dr OC00060 Cetirizine 10mg (OGB) 3.00 Tablet 623.70 2,371.10
R2020-0000000066 31-12-2019 201900073175/036276 YOLA FEBRIANTI Dwi Astuti, dr OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2020-0000000067 31-12-2019 201900073176/28217 DENI SEPTIANTO,SDR Dwi Astuti, dr OP00011 Paracetamol 500mg 5.00 Tablet 387.36 2,436.80
R2020-0000000067 31-12-2019 201900073176/28217 DENI SEPTIANTO,SDR Dwi Astuti, dr OA00084 Antasida Syrup (OGB) 1.00 Botol 14,100.07 14,600.07
R2020-0000000067 31-12-2019 201900073176/28217 DENI SEPTIANTO,SDR Dwi Astuti, dr OD00065 Domperidon Tablet (OGB) 5.00 Tablet 750.00 4,250.00
R2020-0000000067 31-12-2019 201900073176/28217 DENI SEPTIANTO,SDR Dwi Astuti, dr OO00014 Omeprazole 20mg (OGB) 5.00 Capsul 1,169.98 6,349.90
R2020-0000000067 31-12-2019 201900073176/28217 DENI SEPTIANTO,SDR Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 10.00 Tablet 1,113.75 11,637.50
R2020-0000000068 31-12-2019 201900073177/112401 MUHAMMAD NABIL AL Dwi Astuti, dr OA00067 Amoxicillin Dry Syrup, 1.00 Botol 9,652.50 10,152.50
R2020-0000000068 31-12-2019 201900073177/112401 MUHAMMAD NABIL AL Dwi Astuti, dr OA00066 Amoxicillin Tablet, 500mg 3.00 Tablet 1,113.75 13,341.25
R2020-0000000068 31-12-2019 201900073177/112401 MUHAMMAD NABIL AL Dwi Astuti, dr OS00181 Salfenal Syrup 60 Ml 1.00 Botol 6,000.00 6,500.00
R2020-0000000069 31-12-2019 201900073191/051079 MUHAMMAD FRAZKA Dwi Astuti, dr OC00040 Cefixime 60mg, 30ml 1.00 Botol 50,050.00 50,550.00
R2020-0000000069 31-12-2019 201900073191/051079 MUHAMMAD FRAZKA Dwi Astuti, dr OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2020-0000000069 31-12-2019 201900073191/051079 MUHAMMAD FRAZKA Dwi Astuti, dr OV00080 Vitamin B Compleks 5.00 Tablet 241.79 1,708.95
R2020-0000000069 31-12-2019 201900073191/051079 MUHAMMAD FRAZKA Dwi Astuti, dr OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2020-0000000070 31-12-2019 201900073144/090568 NOVITA SARI,NY NOVIANA, Dr. Sp OA00111 Aspilets Chawable 15.00 Tablet 811.35 12,670.25
R2020-0000000071 30-12-2019 201900072895/112356 DANIEL REYNALDI ADE RAHMAH OI00040 Infus Otsu-KA-EN 3B, 1.00 Botol 27,473.00 27,973.00
R2020-0000000071 30-12-2019 201900072895/112356 DANIEL REYNALDI ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2020-0000000071 30-12-2019 201900072895/112356 DANIEL REYNALDI ADE RAHMAH ALI00006 I.V Catheter No. 24 1.00 Pcs 38,900.00 39,400.00
R2020-0000000072 31-12-2019 201900073181/112402 KASIATUN,NY Dwi Astuti, dr OA00108 Asam Traneksamat 1.00 Ampul 14,850.00 15,350.00
R2020-0000000073 31-12-2019 201900073149/093806 NURBAYA,NY ADE RAHMAH OE00055 Ecosol RL 500ml 1.00 Botol 19,305.00 19,805.00
R2020-0000000073 31-12-2019 201900073149/093806 NURBAYA,NY ADE RAHMAH ALI00005 I.V Catheter No. 22 1.00 Pcs 27,324.00 27,824.00
R2020-0000000073 31-12-2019 201900073149/093806 NURBAYA,NY ADE RAHMAH ALI00011 Infus Set Makro 1.00 Pcs 12,087.90 12,587.90
R2020-0000000075 31-12-2019 201900073175/036276 YOLA FEBRIANTI Dwi Astuti, dr OD00030 Dexamethasone Injeksi 1.00 Ampul 4,502.52 5,002.52
R2020-0000000074 31-12-2019 201900073177/112401 MUHAMMAD NABIL AL Dwi Astuti, dr OL00063 Lidocain HCl 2% Injeksi 1.00 Ampul 2,376.00 2,876.00
R2020-0000000074 31-12-2019 201900073177/112401 MUHAMMAD NABIL AL Dwi Astuti, dr OE00056 Ecosol Nacl 0,9 % 500ml 1.00 Botol 19,305.00 19,805.00
R2020-0000000077 31-12-2019 201900073170/112400 JOSHUA JEPHTA Dwi Astuti, dr OL00063 Lidocain HCl 2% Injeksi 2.00 Ampul 2,376.00 5,252.00
R2020-0000000076 31-12-2019 201900073107/074224 ZAIRA NADIA FREDRIK, Dr,Sp.A OC00039 Cefixime 100mg (OGB) 8.00 Capsul 4,266.70 34,633.60
R2020-0000000076 31-12-2019 201900073107/074224 ZAIRA NADIA FREDRIK, Dr,Sp.A OD00031 Dexamethasone Tablet 5.00 Tablet 208.00 1,540.00
R2020-0000000076 31-12-2019 201900073107/074224 ZAIRA NADIA FREDRIK, Dr,Sp.A OI00126 Interhistin 50mg, Tablet 5.00 Tablet 1,173.15 6,365.75
R2020-0000000076 31-12-2019 201900073107/074224 ZAIRA NADIA FREDRIK, Dr,Sp.A OA00052 Ambroxol Tablet, 30mg 7.00 Tablet 445.50 3,618.50
R2020-0000000076 31-12-2019 201900073107/074224 ZAIRA NADIA FREDRIK, Dr,Sp.A OS00079 Sirplus Granula 5.00 Granula 297.00 1,985.00
R2020-0000000076 31-12-2019 201900073107/074224 ZAIRA NADIA FREDRIK, Dr,Sp.A ATKK031 Kertas Puyer Handbond 15.00 Sachet 207.90 13,118.50
R2020-0000000078 31-12-2019 201900073102/083875 FERIDIANA,NY LUSY E. Dr.Sp.PD ON00075 Novomix 30 Flexpen 1.00 Flexpen 226,917.80 227,417.80
R2020-0000000078 31-12-2019 201900073102/083875 FERIDIANA,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 21.00 Tablet 371.25 8,296.25
R2020-0000000079 31-12-2019 201900073162/112205 MUNAWAROH,NY LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2020-0000000079 31-12-2019 201900073162/112205 MUNAWAROH,NY LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2020-0000000079 31-12-2019 201900073162/112205 MUNAWAROH,NY LUSY E. Dr.Sp.PD OC00134 Curcuma Tablet 20.00 Tablet 1,336.50 27,230.00
R2020-0000000080 31-12-2019 201900073163/100981 MUNIKA,NY LUSY E. Dr.Sp.PD OG00023 Glimepiride 3mg Tablet 10.00 Tablet 3,164.00 32,140.00
Total 352,588,429.17
Tgl ce tak : 10-01-2020

Telp: 0542 877330 Fax : 0542 877331
Hal : 266 dari 266
ASAL RAWAT JALAN
R2020-0000000080 31-12-2019 201900073163/100981 MUNIKA,NY LUSY E. Dr.Sp.PD OM00035 Metformin 500mg (OGB) 20.00 Tablet 371.25 7,925.00
R2020-0000000080 31-12-2019 201900073163/100981 MUNIKA,NY LUSY E. Dr.Sp.PD OS00076 Simvastatin 10mg (OGB) 10.00 Tablet 1,662.00 17,120.00
R2020-0000000080 31-12-2019 201900073163/100981 MUNIKA,NY LUSY E. Dr.Sp.PD OP00200 Pioglitazon 30 Mg 5.00 Tab 7,425.00 37,625.00
R2020-0000000082 31-12-2019 201900073159/112398 WAHID AJI LUSY E. Dr.Sp.PD OC00039 Cefixime 100mg (OGB) 10.00 Capsul 4,266.70 43,167.00
R2020-0000000082 31-12-2019 201900073159/112398 WAHID AJI LUSY E. Dr.Sp.PD OP00011 Paracetamol 500mg 10.00 Tablet 387.36 4,373.60
R2020-0000000082 31-12-2019 201900073159/112398 WAHID AJI LUSY E. Dr.Sp.PD OO00014 Omeprazole 20mg (OGB) 10.00 Capsul 1,169.98 12,199.80
R2020-0000000082 31-12-2019 201900073159/112398 WAHID AJI LUSY E. Dr.Sp.PD OS00169 Sucralf ate Syrup (OGB) 1.00 Botol 29,403.00 29,903.00
R2020-0000000109 31-12-2019 202000000038/079507 BUDIANSYAH,TN Niki Juniar OU00022 Urotractin 400mg Tablet 6.00 Tablet 7,189.03 43,634.18
R2020-0000000109 31-12-2019 202000000038/079507 BUDIANSYAH,TN Niki Juniar OS00057 Scopamin Plus Caplet 4.00 Tablet 3,712.50 15,350.00
R2020-0000000110 31-12-2019 201900073100/2794 AKHMAD BUSTAMAN Restu OP00012 Paracetamol Syrup, 60ml 1.00 Botol 8,910.00 9,410.00
R2020-0000000110 31-12-2019 201900073100/2794 AKHMAD BUSTAMAN Restu OD00064 Domperidon Syrup, 60ml 1.00 Botol 18,089.50 18,589.50
R2020-0000000402 30-12-2019 201900072909/028363 FITRIYAH,NY NOVIANA, Dr. Sp OA00106 Asam Mefenamat 500mg 10.00 Tablet 415.80 4,658.00
Total 352,832,384.25
Total 352,832,384.25
Tgl ce tak : 10-01-2020


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