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DETAIL TAGIHAN 2nd IADI-APRC Study Visit and IDIC International Seminar

WESTIN NUSA DUA, 6-9 NOVEMBER 2022

No Jenis Jasa Harga satuan Satuan Jumlah


1. Ambulance stand by Rp 31.300.000 1 paket Rp 31.300.000
dan Mini ICU 4 hari
2. PCR Sars Cov2 Rp 275.000 orang Rp
3. Antigen Sars Cov2 Rp 75.000 2 orang Rp 150.000
4. Pemakaian Obat-obatan Terlampir Rp
Total Rp
Data Pemeriksaan PCR Sars Cov 2
No PRN Nama Hasil PCR
Tanggal 7 November 2022
1 NEGATIF
Tanggal 8 November 2022
1 NEGATIF
Tanggal 9 November 2022
1 NEGATIF
Data Pemeriksaan Antigen Sars Cov 2
No PRN Nama Hasil Antigen
Tanggal 6 November 2022
1 00504988 Suwandi NEGATIF
Tanggal 9 November 2022
1 00505216 Meyke Ito Florentina POSITIF
Pemakaian Obat-obatan

No Tanggal Nama No Hp Obat-obatan Jumlah Tagihan


Pemeriksaan
1. 06/11/22 Suwandi 08158094938 - Sanexon 4 mg 10 tablet Rp
1 - Sanadryl DMP 1 botol
2. 06/11/22 Yuni Suandari 0881037007883 - Cetirizine 10 mg 10 tablet Rp 81.433
2 - Sanadryl DMP 1 botol
- Sanexon 4 mg 10 tablet
- Sanmol 500 mg 4 tablet
3. 06/11/22 Erina Puspita 087862529868 - Methyl pred 8 mg 10 tablet Rp 44.513
3 - Sanadryl DMP 1 botol
4. 06/11/22 Januar 085779240294 - Becomzet 5 tablet Rp 200.889
4 - Invomit 4 mg 6 tablet
5. 06/11/22 Oka Antara 08175784147 - Sanmol 500 mg 4 tablet Rp 38.775
5 - Sanexon 4 mg 5 tablet
- Becomzet 5 tablet
6. 06/11/22 Juli Antara 081916616816 - Sanadryl DMP 1 botol Rp 58.393
6 - Sanexon 4 mg 5 tablet
- Sanmol 500 mg 4 tablet
7. 06/11/22 Putri Kusuma 081314542205 - Rillus 6 tablet Rp 83.578
7 - Sanmol 500 mg 8 tablet
8. 06/11/22 Caesar Ferino 081282600082 - Sanadryl DMP 1 botol Rp 36.963
8
9. 06/11/22 Radityo Adi Nugroho 082114833337 - Cek GDS Rp 40.000
9
10. 06/11/22 Mercy Kent Yanuar 0817698889 - Sanmol 500 mg 4 tablet Rp 19.985
10 - Becomzet 5 tablet
11. 06/11/22 Rifky Aulia 081229768363 - Intridol 4 mg 10 tablet Rp 86.425
- Becomzet 5 tablet
12. 06/11/22 Prof Iwan Jaya Aziz 08557802005 - Cebex 10 kapsul Rp 88.460
- Mertigo 6 mg 10 tablet
- Sanmol 500 mg 4 tablet
13. 07/11/22 Trisnani Dewi 081280061213 - Cek GD Puasa Rp 76.350
- Inj Pantoprazole 1 vial
- Aqua injeksi 25 mL
- Wing needle 25G 1 pcs
- Spuit 5 cc 1 pcs
- Pantoprazole 40 mg 7 tablet
- Cebex 10 kapsul
- Sanmol 500 mg 10 tablet
14. 08/11/22 Putu Fhanny 089677745477 - Mucera 30 mg 10 tablet Rp 128.760
- Intridol 10 tablet
- Sanmol 500 mg 10 tablet
- Cebex 10 kapsul
15. 08/11/22 Kaankorn +66816452915 - Sanmol 500 mg 4 tablet Rp 2.660
16. 08/11/22 Desak Made Lestari Dewi 085936182867 - Cebex 10 kapsul Rp 139.750
- Rhinos SR 10 kapsul
- Sanmol 500 mg 4 tablet
17. 08/11/22 Oka Antara 08175784147 - Rillus 6 tablet Rp 80.918
- Sanmol 500 mg 4 tablet
18. 08/11/22 Thanut Nusasanov 0817801580 - Sanmol 500 mg 4 tablet Rp 2.660
19. 08/11/22 I Putu Mahendra Artha Mulya 082147704157 - Rhinos SR 10 kapsul Rp 137.090
- Cebex 10 kapsul
20. 08/11/22 Amirah Laras Ulinnuha 081388198901 - Cebex 10 kapsul Rp 29.700
21. 09/11/22 Nanda Laurensia Oematan 082236934230 - Mertigo 6 mg 6 tablet Rp 54.677
- Sanmol 500 mg 4 tablet
- Pantoprazole 40 mg 3 tablet
22. 09/11/22 Feronica 083822450203 - Cebex 10 kapsul Rp 125.220
- Intridol 4 mg 6 tablet
- Intrizin 6 tablet
23. 09/11/22 Meyke Ito Florentina 081212109127 - Cebex 10 kapsul Rp 220.930
- Sanmol 500 mg 4 tablet
- Rhinos SR 10 kapsul
24. 09/11/22 Debbie 089503118338 - Sanmol 500 mg 4 tablet Rp 2.660
25. 09/11/22 Nicholas Edieth 083116121849 - Cebex 4 kapsul Rp
- Intridol 4 tablet
- Sanmol 500 mg 8 tablet
Total Tagihan Rp

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