1-Jan'22 Rekon Breakdown

RS. UMUM DAERAH DR.
SOETOMO
Jl. May jend. Prof. Dr. Moestopo No. 6-8 - Surabaya
Telp. 031- 5501259 / 5501239
Faks. 031 - 5501571
LAPORAN PERSEDIAAN OBAT KOLOM BERTAMBAH
PENYEDIA : PENYEDIA BLUD
PERIODE : 01/01/2022 s.d 31/01/2022
Tgl. Cetak : 02/03/2022
14:10
NO TGL TRANSAKSI NAMA GOLONGAN NAMA PBF NO FAKTUR
1. UNIT : UPPFI
1 03/01/2022 ALKES UPPFS
2 UPPFS
3 UPPFS
SU
4 OBAT UPPFS
5 UPPFS
S
1 14/01/2022 ALKES UPPFS

SU
2 OBAT UPPFS
S
1 24/01/2022 OBAT UPPFS

S
SUB TOTAL Otom

1 01/01/2022 OBAT APOTEK OSCAR 2 UP0101221
2 APOTEK OSCAR 2 UP0101222
S

6 APOTEK KIMIA FARMA 24 UP0201221
S
1 03/01/2022 OBAT APOTEK KIMIA FARMA 24 UP0301221

2 PT.ANUGERAH PHARMINDO LESTARI 1400922315
S

2 KIMIA FARMA 2804909553
S

S
1 06/01/2022 OBAT PT.ANUGRAH ARGON MEDICA 491222003987

S

2 PT.INDOFARMA GLOBAL MEDIKA 1340051325
4 PT.ANUGRAH ARGON MEDICA 491222001553
S
1 08/01/2022 OBAT PT.ENSEVAL PUTERA MEGATRADING TBK 322000188

3 PT.MERAPI UTAMA PHARMA 220031000460
S
1 10/01/2022 OBAT PARIT PADANG 8340586781

3 PARIT PADANG 8340586782
S
1 11/01/2022 ALKES PT.PERMATA BUNDA ARTANO 074/PB/TTB/KONS/01/2022

PT.PERMATA BUNDA ARTANO 074/PB/TTB/KONS/01/2022
2 PT.GALOEH HUSADA FARMA PJ02/22/00261
PT.MILLENIUM PHARMACON
3 750522000005
INTERNASIONAL
5 PT.SURGIKA ALKASINDO IVA02344E
SU
10 OBAT PT.ANUGERAH PHARMINDO LESTARI 1400942424
S
1 12/01/2022 ALKES PT.INTI SUMBER HASIL SEMPURNA NJKMJ220200807

2 PT.INTI SUMBER HASIL SEMPURNA NJKMJ220200807
PT.INTI SUMBER HASIL SEMPURNA NJKMJ220200807
3 PT.TAWADA HEALTHCARE 912058
4 PT.TAWADA HEALTHCARE 912058
SU
8 OBAT PASAR PUCANG UP1201221
9 PASAR PUCANG UP1201221
S
4 PT.ENSEVAL PUTERA MEGATRADING TBK 322000202

1 14/01/2022 OBAT PT.ENSEVAL PUTERA MEGATRADING TBK 322000204
S
1 15/01/2022 ALKES PT.BINA BAKTI MITRA GEMILANG FP-22-01580933

SU
2 OBAT RS. SHEILA MEDIKA UP1501221
7 TOKOPEDIA UP1501222
S

S
1 17/01/2022 ALKES PT.BERKEMBANG SELARAS DAYA BSD0001053

2 PT.BERKEMBANG SELARAS DAYA BSD0001053
3 PT.REKAMILENIUMINDO SELARAS 046850
4 PT.PARIT PADANG 8340592936
5 PT.SURGIKA ALKASINDO TT 170122
SU
6 OBAT PARIT PADANG 8340589517
S
1 18/01/2022 ALKES PT.BERKAH PRIMA ABADI 035/BPA/I/2022

2 PT.BERKEMBANG SELARAS DAYA ST90004782
SU
4 OBAT APOTEK KIMIA FARMA 24 UP1801221
S
1 19/01/2022 ALKES PT.PERMATA BUNDA ARTANO PB/TTB/000345

2 PT.PERMATA BUNDA ARTANO PB/TTB/000345
SU
5 OBAT INDOMARET UP1901221
S
2 20/01/2022 ALKES PT.ANUGERAH PHARMINDO LESTARI 1400950947

3 PT.KHASANAH ALKESINDO KHA/KEU.03A/22/01/00319
SU
9 OBAT PT.SATORIA DISTRIBUSI LESTARI SDL/SI/22/01/0338
18 PT.SATORIA DISTRIBUSI LESTARI SDL/SI/22/01/0339
S
1 21/01/2022 ALKES PT.KARUNIA PHARMINDO S F1/I

2 PT.KARUNIA PHARMINDO S F2/I
3 PT.KARUNIA PHARMINDO S F4A/I
SU
4 MASUK ALKES PT.INTI SUMBER HASIL SEMPURNA NJKMJ220101070
5 OBAT PT.MERAPI UTAMA PHARMA 220031002022
S
1 22/01/2022 ALKES PT.TRANSMEDIC INDONESIA DN2200391

2 PT.TRANSMEDIC INDONESIA DN2200394
SU
6 SUPER INDO UP2201222
3 OBAT PT.MERAPI UTAMA PHARMA 220031002082
S
1 23/01/2022 ALKES 220522000007
INTERNASIONAL
2 220522000007
INTERNASIONAL
SU
1 24/01/2022 ALKES PT.TRANSMEDIC INDONESIA IN2201634

2 750522000007
INTERNASIONAL
3 750522000007
INTERNASIONAL
4 150522000755
INTERNASIONAL
5 PT.NEURO MANDIRI UTAMA 005/FP/NMU/II/22
SU
29 PT. MULTI AKSES JAYA MAJ2201023
33 PT.ANTARMITRA SEMBADA INVSB1220104142
S
1 25/01/2022 ALKES PT.ENSEVAL PUTERA MEGATRADING TBK 322000457

10 PT.SURGIKA ALKASINDO IVA01675
11 PT.SURGIKA ALKASINDO IVA01675
SU
14 OBAT PT.ANUGERAH PHARMINDO LESTARI UP1400935206
18 RSAL UP2501221
19 APOTEK MEDICASTORE UP2501222
21 SUPER INDO UP2501223
S
1 26/01/2022 ALKES PT.BISAWI TUMBUH SELARAS 0792/FKTR/BTS/I/2022

PT.ANUGRAH ARGON MEDICA 491222011379
25 PT.KARUNIA PHARMINDO S F3/I
30 750522000002
INTERNASIONAL
31 PT.ANUGERAH PHARMINDO LESTARI TT260122
32 PT.ANUGERAH PHARMINDO LESTARI TT26012022
SU
64 MENSA BINA SUKSES,PT CD220094507
66 KIMIA FARMA TT 52
39 PT.SATORIA DISTRIBUSI LESTARI SDL/SI/22/01/0429
33 OBAT PARIT PADANG 8340592714
S
1 27/01/2022 ALKES PT.ENSEVAL PUTERA MEGATRADING TBK 322000508

SU
9 OBAT PT.ANUGRAH ARGON MEDICA 491222011783
34 PT.DOS NI ROHA 831241273
S
1 28/01/2022 ALKES PT.SURGIKA ALKASINDO TT 280122

2 PT.MENSA BINASUKSES CD220096044
SU
12 PT.BLESSINDO FARMA 2022-0000641
25 PT.UNITED DICO CITAS 0791797
8 OBAT PT.UNITED DICO CITAS 0791798
S
1 29/01/2022 ALKES PT.ANUGERAH PHARMINDO LESTARI 1400948813

SU
3 MASUK ALKES PARIT PADANG 8340593696
S
1 31/01/2022 ALKES PT.MULYA HUSADA 78/F/II/22

5 PT.BINA BAKTI MITRA GEMILANG FP-22-01580977
7 PT.NEURO MANDIRI UTAMA 007/FP/NMU/II/22
17 PT.BERKEMBANG SELARAS DAYA SBY/SJ/22/0020
19 PT.KARUNIA PHARMINDO S F4 A/ II
PT.MENSA BINASUKSES CD220112715
PT.MENSA BINASUKSES CD220112715
23 PT.KARUNIA PHARMINDO S F5/ I
24 PT.KARUNIA PHARMINDO S F5/ I
25 220522000006
INTERNASIONAL
SU
29 720522000002
INTERNASIONAL
30 720522000001
INTERNASIONAL
34 APOTEK PRAYOGO UP3101222
S
SUB TOTAL Pe
OLOM BERTAMBAH
BLUD
1/01/2022
BERTAMBAH NOMINAL selisih

NAMA BARANG
NILAI FAKTUR =NF - NILAI
MESS 11 750,339.00
MESS 15 1,250,565.00
MESS 20 750,339.00
SUB TOTAL ALKES 03/01/2022 : 2,751,243.00
POVIDON IODIDA 60ML 355,200.00
SKINTACT PAPER RT 34 S 1,016,070.00
SUB TOTAL OBAT 03/01/2022 : 1,371,270.00
SUB TOTAL 03/01/2022 : 4,122,513.00
STARDEC EXAM L 241,560.00
SUB TOTAL ALKES 14/01/2022 : 241,560.00
ALKOHOL 70% 1 LTR 25,000.00
SUB TOTAL OBAT 14/01/2022 : 25,000.00
SUB TOTAL 14/01/2022 : 266,560.00
POVIDON IODIDA 60ML 177,600.00
SUB TOTAL OBAT 24/01/2022 : 177,600.00
SUB TOTAL 24/01/2022 : 177,600.00
SUB TOTAL Otomatis Pinjam Antar Penyedia : 4,566,673.00
DRAMAMINE 32,380.05 32,380.00 -0.05
FELDENE GEL 15GR 96,500.00 96,500.00 0.00
UNALIUM 10 MG TAB 102,120.00 102,120.00 0.00
SUB TOTAL OBAT 01/01/2022 : 231,000.05
SUB TOTAL 01/01/2022 : 231,000.05
BISOLVON DROP 101,507.00 101,507.00 0.00
DEMACOLIN 5,800.00 5,800.00 0.00
NEO KAOLANA 16,500.00 16,500.00 0.00
NEO KAOLANA 16,205.00 16,205.00 0.00
ODR SYR 60ML 120,393.00 120,393.00 0.00
PANTOZOL 20MG 42,492.00 42,492.00 0.00
ZITHROMAX 250MG 300,550.02 300,550.00 -0.02
SUB TOTAL OBAT 02/01/2022 : 603,447.02
SUB TOTAL 02/01/2022 : 603,447.02
BISOLVON DROP 110,396.00 110,396.00 0.00
CYMEVEN 500 MG 2,244,574.05 2,244,574.00 -0.05
SUB TOTAL OBAT 03/01/2022 : 2,354,970.05
SUB TOTAL 03/01/2022 : 2,354,970.05
PANTOZOL 20MG 44,472.00 44,472.00 0.00
PRIMET 2,640,000.00 2,640,000.00 0.00
V-FEND TAB 6,300,000.30 6,300,000.00 -0.30
SUB TOTAL OBAT 04/01/2022 : 8,984,472.30
SUB TOTAL 04/01/2022 : 8,984,472.30
ALINAMIN FORTE 16,500.00 16,500.00 0.00
SUB TOTAL OBAT 05/01/2022 : 16,500.00
SUB TOTAL 05/01/2022 : 16,500.00
FUROSEMIDE INJ 22,152,000.00 22,152,000.00 0.00
SUB TOTAL OBAT 06/01/2022 : 22,152,000.00
SUB TOTAL 06/01/2022 : 22,152,000.00
BISOLVON EXTRA SYR 125ML 89,205.00 89,205.00 0.00
GENISONE 20MG TABLET 6,150,000.00 6,150,000.00 0.00
KABITARIN 1000 MG INJ 9,696,043.50 9,696,043.00 -0.50
KETAMINE 500 MG/ 10 ML INJ 4,093,050.00 4,092,270.00 -780.00
SUB TOTAL OBAT 07/01/2022 : 20,028,298.50
SUB TOTAL 07/01/2022 : 20,028,298.50
BACTESYN 1,5 GR INJ 10,005,000.00 10,005,050.00 50.00
BISOLVON EXTRA SYR 125ML 89,205.00 89,205.00 0.00
KN-2 500ML INFUS 14,220,360.00
RD5 500ML INF 7,663,920.00
MYCAMINE INJ 35,599,960.00 35,599,960.00 0.00
TABLET TAMBAH DARAH 90,400.00 1,468,967.00 -33.00
TABLET TAMBAH DARAH 1,378,600.00
TABLET TAMBAH DARAH 452,000.00 451,990.00 -10.00
SUB TOTAL OBAT 08/01/2022 : 69,499,445.00
SUB TOTAL 08/01/2022 : 69,499,445.00
NIMOTOP 5,818,500.00 5,818,500.00 0.00
PLANTACID SYR 13,063.00 13,063.00 0.00
VORICA 200MG INJ 10,460,000.00 10,460,000.00 0.00
SUB TOTAL OBAT 10/01/2022 : 16,291,563.00
SUB TOTAL 10/01/2022 : 16,291,563.00
AORTIC PUNC 3.5 8,408,400.00 29,394,200.00 0.00
CARDIOVASCULAR PATCH 30MMX60MMX0,4MM 12,320,000.00
STRAIGHT TIP ARTERIAL CAN 14FR 3,946,800.00
VENOUS CANUL NO.18 BENGKOK 4,719,000.00
BREATHING CIRCUIT CORRUGATED PLUS WATER 136,500,000.00 136,500,000.00 0.00
CANOFIX-PU 6*8CM 6,820,040.00 6,820,044.00 4.00
ETT 2.5 NON CUFF 243,000.00 243,000.05 0.05
WECK VISTA OPTICAL PORT 5-10MMX100MM RID 16,200,000.00 30,960,000.13 -0.05
WECK VISTA OPTICAL PORT 5MMX100MM RIDGE 14,760,000.18
SUB TOTAL ALKES 11/01/2022 : 203,917,240.18
BRIDION INJ 100MG/ML 22,000,000.00 33,000,000.00 0.00
BRIDION INJ 100MG/ML 11,000,000.00
CYMEVEN 500 MG 2,244,574.05 2,244,574.00 -0.05
NAVELBIN 10MG INJ 4,768,896.00 8,584,012.00 -0.80
NAVELBIN 10MG INJ 3,815,116.80
SPIRAMYCIN 500 MG 226,600.00 226,600.00 0.00
SUB TOTAL OBAT 11/01/2022 : 44,055,186.85
SUB TOTAL 11/01/2022 : 247,972,427.03
ARM SLING L ONEMED 925,000.00 39,550,000.00 0.00
ARM SLING M ONEMED 925,000.00
KASA STERIL 16X16/OM 8,000,000.00
UNDERPAD 60X90 ONE MED 29,700,000.00
BIPOLAR PACING 6FR RHC SHR 37,500,000.00 85,900,000.00 0.00
HT WHISPER 48,400,000.00
STIKPAN PLASTIK 5,940,000.00 5,940,000.00 0.00
SUB TOTAL ALKES 12/01/2022 : 131,390,000.00
BAHAN ANGGUR 75,000.00 75,000.00 0.00
BAHAN DURIAN 100,000.00 100,000.00 0.00
BRILINTA 90MG 58,828,000.00 58,828,000.00 0.00
D5 1/2 NS/OTSUKA 18,827,820.00 18,827,820.00 0.00
D5 1/2 NS/OTSUKA 2,091,980.00 2,091,980.00 0.00
SUB TOTAL OBAT 12/01/2022 : 79,922,800.00
SUB TOTAL 12/01/2022 : 211,312,800.00
DEFERASIROX 250MG TAB 8,099,400.00 8,099,400.00 0.00
TRIOMIX E 1000 10,439,147.40 11,999,020.00 0.00
TRIOMIX E 1000 1,559,872.60
BACTESYN 1,5 GR INJ 26,233,241.10
BACTESYN 1,5 GR INJ 3,781,908.90 30,015,150.00 0.00
BISOLVON DROP 98,507.00 98,600.00 93.00
ERBITUX 100MG INJ 9,800,001.20 9,800,001.00 -0.20
GLUCODEX 80 MG 4,146.00 4,146.00 0.00
HYDROCORTISONE 100 MG INJEKSI 8,274,750.00 136,935,834.00 0.00
LANSOPRAZOLE 30MG/ML INJ 91,177,884.00
LANSOPRAZOLE 30MG/ML INJ 37,483,200.00
KN-2 500ML INFUS 3,555,090.00 3,555,090.00 0.00
SUB TOTAL OBAT 14/01/2022 : 200,507,148.20
SUB TOTAL 14/01/2022 : 200,507,148.20
CONNECTOR ELBOW DEWASA 03861316 37,200,000.00 37,200,000.00 0.00
SUB TOTAL ALKES 15/01/2022 : 37,200,000.00
aminoPHYLLIN INJ 135,000.00 135,000.00 0.00
HOLOXAN 2G 112,662,000.00 228,854,791.00 -38.90
HOLOXAN 2G 54,077,760.00
MESTINON 60MG TAB 29,437,537.50
MESTINON 60MG TAB 17,662,522.50
UROMITEXAN 400MG 15,015,009.90
MINYAK ZAITUN (VIRGIN OIL) 2LITER 331,800.00 331,800.00 0.00
SUB TOTAL OBAT 15/01/2022 : 229,321,629.90
SUB TOTAL 15/01/2022 : 266,521,629.90
PRORIS SYR 29,400.00 29,400.00 0.00
SUB TOTAL OBAT 16/01/2022 : 29,400.00
SUB TOTAL 16/01/2022 : 29,400.00
ACTI VAC CANISTER WITH GEL 3,140,535.20 6,281,070.00 -0.40
CANISTER WITH GEL 500ML 3,140,535.20
TRANSDUCER KIT PX2X2 12,232,506.00 12,232,506.00 0.00
TRIPLE LUMEN 7F/ARROW 41,250,000.00 41,250,000.00 0.00
WECK VISTA OPTICAL PORT 5/10/12MMX100MM 1,400,000.00 1,400,000.00 0.00
SUB TOTAL ALKES 17/01/2022 : 61,163,576.40
BORTERO 3.5MG INJ 2,004,750.00 3,694,350.00 0.00
ENERCORE 1,689,600.00
BORTERO 3.5MG INJ 2,004,750.00 2,004,750.00 0.00
D5 1/2 NS/OTSUKA 10,459,900.00 10,459,900.00 0.00
HYDROCORTISONE 100 MG INJEKSI 3,894,000.00 3,894,000.00 0.00
PANTOPRAZOL 20MG TAB 97,000.00 97,000.00 0.00
REBOZET 25MG 3,170,580.00 3,170,580.00 0.00
GALVUS 50MG 230,580.00
MYFORTIC 180 MG 53,200,000.00
MYFORTIC 360MG 296,460,000.00
PATIZRA INJ 10MG/ML 115,200,000.00
SANDIMMUN 25MG 63,070,000.00
SANDIMMUN 50MG 47,175,000.00
SANDIMMUN 50MG 82,325,000.00
TASIGNA HGC 150MG 9,800,000.00
TYKERB TAB 250MG 111,650,000.00
TYKERB TAB 250MG 84,700,000.00
ULTIBRO 1,620,000.00 865,430,580.00 0.00
SUB TOTAL OBAT 17/01/2022 : 888,751,160.00
SUB TOTAL 17/01/2022 : 949,914,736.40
DERMACARIER II 1:1.5 4,840,000.00 4,840,000.00 0.00
SENSATRAC MEDIUM GRANUFOAM DRESS 4,186,620.00 4,186,620.00 0.00
SR 75 KONS 12,387,012.00 12,387,012.00 0.00
SUB TOTAL ALKES 18/01/2022 : 21,413,632.00
C.NATACEN MDS 59,524.00 59,524.00 0.00
C.NATACEN MDS 119,048.00 119,048.00 0.00
ERBITUX 100MG INJ 9,800,001.20 9,800,001.00 -0.20
FEBURIC 80MG TABLET 858,000.00 858,000.00 0.00
SUB TOTAL OBAT 18/01/2022 : 10,836,573.20
SUB TOTAL 18/01/2022 : 32,250,205.20
LEFT HEART PAED 13FR 9,249,240.00 23,406,240.00 0.00
VENOUS CANUL NO.20 BENGKOK 4,719,000.00
VENOUS CANULA NO.14 BENGKOK 4,719,000.00
VENOUS CANULA NO.24 BENGKOK 4,719,000.00
SUB TOTAL ALKES 19/01/2022 : 23,406,240.00
BAHAN PISANG 24,300.00 24,300.00 0.00
MST CONT 10MG TAB 46,860,000.00 46,860,000.00 0.00
GAMARAAS 2.5GRAM 50ML 78,294,480.00 78,294,480.00 0.00
LANSOPRAZOLE 30MG/ML INJ 58,754,916.00 58,754,916.00 0.00
MYCAMINE INJ 8,899,990.00 8,899,990.00 0.00
SUB TOTAL OBAT 19/01/2022 : 192,833,686.00
SUB TOTAL 19/01/2022 : 216,239,926.00
ECHELON 60 ECR60B 10,454,400.00 10,454,400.00 0.00
EYE DRAPE PLAIN D700 SURGIWEAR 5,280,000.00 5,280,000.00 0.00
LMA SUPREME NO.4 760,000.00 49,974,020.00 0.00
CANISTER WITH GEL 500ML 3,140,535.00
PDT KIT 7MM SINGLE STAGE 20,001,855.00
PDT KIT 8MM SINGLE STAGE 20,001,855.00
SENSATRAC MEDIUM GRANUFOAM DRESS 4,186,620.00
TRACHEOSTOMY CAN 7.5 1,883,155.00
SUB TOTAL ALKES 20/01/2022 : 65,708,420.00
NAVELBIN 10MG INJ 23,844,480.00 23,844,480.00 0.00
GAMARAAS 2.5GRAM 50ML 78,294,480.00 78,294,480.00 0.00
AQUA 25ML INF SATORIA 13,250,000.00 13,250,000.00 0.00
RL 500ML satoria 2,289,000.00 2,289,000.00 0.00
METRONIDAZOL INFUS 100ML 35,310,000.00 35,310,000.00 0.00
LIDOCAIN HCL 2 1,694,000.00
OMEPRAZOLE INJ 7,130,200.00
OMEPRAZOLE INJ 967,670.00
OMEPRAZOLE INJ 4,889,280.00
OMEPRAZOLE INJ 2,291,850.00 16,973,000.00 0.00
SUB TOTAL OBAT 20/01/2022 : 169,960,960.00
SUB TOTAL 20/01/2022 : 235,669,380.00
PLASTIK TYPE 2 9,405,000.00 9,405,000.00 0.00
PLASTIK TYPE 2 9,405,000.00 9,405,000.00 0.00
PLASTIK TYPE 2 3,135,000.00 3,135,000.00 0.00
SUB TOTAL ALKES 21/01/2022 : 21,945,000.00
ASEPTIC LIQUID 0,2% + ORAL SPONGE 8,316,000.00 8,316,000.00 0.00
REBOZET 25MG 36,461,670.00 36,461,670.00 0.00
cISPLAtin 50MG INJ 4,494,215.00
GEMCIKAL 1000MG INJ 9,220,497.00 13,714,712.00 0.00
BFLUID 500ML 22,584,918.40 52,529,180.00 0.00
BFLUID 500ML 15,565,281.60
NS 100ML PIGGYBACK INF 12,298,000.00
D5 1/4 NS/OTSUKA 2,080,980.00
FURAMIN INJ 8,131,200.00 9,976,200.00 0.00
NA BICARBONAS TABLET PIM 713,400.00
ULTRAVIST 370/100CC 148,000,000.00 185,492,800.00 0.00
ULTRAVIST 370/50ML CAIR 37,492,800.00
SUB TOTAL OBAT 21/01/2022 : 306,490,562.00
SUB TOTAL 21/01/2022 : 328,435,562.00
PERIPHERAL BLOOD STEM CELL DISP SET 2,970,000.00 2,970,000.00 0.00
PERIPHERAL BLOOD STEM CELL DISP SET 2,970,000.00 2,970,000.00 0.00
SUB TOTAL ALKES 22/01/2022 : 5,940,000.00
FENTANYL INJ 8,078,400.00
MST CONT 15MG TAB 26,880,000.00 34,958,392.00 -8.00
METAMIZOLE SODIUM 500MG/ML INJ 27,890,000.00 27,889,950.00 -50.00
GAMARAAS 2.5GRAM 50ML 78,294,480.00 78,294,480.00 0.00
GULAKU 1KG 25,000.00 25,000.00 0.00
NEOSTIGMIN INJ 528,742.50 528,742.00 -0.50
D5 1/4 NS/OTSUKA 4,161,960.00 4,161,960.00 0.00
OMNIPAQUE 300/75ML INJ 5,434,000.00 5,434,000.00 0.00
PROGRAF CAP 1MG 146,155,000.00 146,155,020.00 20.00
PRORIS SYR 29,400.00 29,400.00 0.00
SUB TOTAL OBAT 22/01/2022 : 297,476,982.50
SUB TOTAL 22/01/2022 : 303,416,982.50
T-SILK 2/0 13 X 60 PS30 3,927,000.00 7,854,000.00 0.00
T-SILK 2/0 13 X 60 PS30 3,927,000.00
SUB TOTAL ALKES 23/01/2022 : 7,854,000.00
SUB TOTAL 23/01/2022 : 7,854,000.00
CARTRIDGE CG4+ 67,980,000.00 67,980,000.00 0.00
TRO-VENOCATH 20G 25,834,710.00 34,446,280.00 0.00
TRO-VENOCATH 20G 8,611,570.00
TRO-VENOCATH 26G 12,095,930.00 12,095,930.00 0.00
VP SHUNT MEDIUM METRONIC 5,390,000.00 5,390,000.00 0.00
SUB TOTAL ALKES 24/01/2022 : 119,912,210.00
cISPLAtin 50MG/50MLINJ 17,976,800.00 17,976,800.00 0.00
FONKOPAC 300MG 43,213,500.00 43,213,500.00 0.00
BACTESYN 1,5 GR INJ 20,010,100.00 20,010,100.00 0.00
PROPOFOL INJEKSI 20ML 9,979,200.00 9,979,200.00 0.00
AMINOSTERIL INFANT 10% 100ML INF 1,058,402.40 75,370,075.00 0.00
AMINOSTERIL INFANT 10% 100ML INF 16,581,637.60
GLYCOPHOS INFUS @ 20ML 1,007,603.30
GLYCOPHOS INFUS @ 20ML 3,572,411.70
INTRALIPID 20% 100ML 11,790,075.00
KABIVEN PERIPHERAL 1440ML INF 767,999.10
KABIVEN PERIPHERAL 1440ML INF 12,031,985.90
SMOFLIPID 20% 100ML 2,141,997.00
SMOFLIPID 20% 100ML 26,417,963.00
APIDRA SOLOSTAR 62,649,972.00 98,249,932.00 0.00
LANTUS SOLOSTAR 35,599,960.00
ATRACURIUM BESILATE 25MG INJ 1,795,596.00 12,323,168.00 2.00
OXYTOCIN INJ 563,000.00
ATRACURIUM BESYLATE 50MG INJ 2,064,089.50
ATRACURIUM BESYLATE 50MG INJ 7,900,480.50
atroPIN SULFAS 0.25MG INJ 1,718,000.00 89,780,295.00 -13.00
epiNePhrine INJ 7,575,000.00
KABIMIDINE INJEKSI 69,912,458.00
NEOSTIGMIN INJ 881,237.50
NEOSTIGMIN INJ 9,693,612.50
COLCHICINE TAB 38,940.00 5,227,549.00 -0.60
COMTRO SYR 30ML 111,601.60
FLEET PHOSPOSODA 45ML 3,773,550.00
SOMATOSTATIN LYOMARK INJ 1,013,958.00
VESICARE TAB 5MG 289,500.00
DORNER 20MCG TAB 58,799,760.00 125,080,571.00 80.20
MYCAMINE INJ 64,079,928.00
HARNAL D 0.2 MG 2,200,802.80
LARUTAN NA I - 131 NON INJ (ORAL) 27,500,000.00 27,500,000.00 0.00
NIMODIPINE INFUS 0.2 MG/ML 6,737,500.00 6,737,500.00 0.00
RL 500ML INF 15,259,200.00 15,259,200.00 0.00
SUB TOTAL OBAT 24/01/2022 : 546,707,821.40
SUB TOTAL 24/01/2022 : 666,620,031.40
DIANEAL PD-4 1.5% DEXTWIN 1,840,000.00
DIANEAL PD-4.25% DEXTWIN 12,075,000.00 55,200,005.97 5.97
DIANEAL PD-4 1.5% DEXTWIN 6,900,000.00 6,900,000.00 0.00
GUIDE WIRE COBRA 17,374,360.00 18,488,620.00 0.00
URETER CATHETER 5 FR MARFLOW 1,114,260.00
MASKER ANESTESI NEONATE KOO 893,200.00 1,786,400.00 0.00
MASKER ANESTESI PRENEONATE KOO 893,200.00
PERIFIX 400 18G 30,554,200.00 30,554,200.00 0.00
SUB TOTAL ALKES 25/01/2022 : 154,329,220.00
HERZEMAB 440MG INJEKSI 124,159,992.00 124,159,992.00 0.00
ROCULAX INJ 9,900,000.00 9,900,000.00 0.00
BETMIGA 25MG 643,252.50 643,252.00 -0.50
BORTERO 3.5MG INJ 2,004,750.00 9,396,750.00 0.00
METACOSFAR 320/100ML INJ 7,392,000.00
D5 500ML (W) 6,627,500.00 6,627,500.00 0.00
ERBITUX 100MG INJ 9,800,001.20 9,800,001.00 -0.20
ETOPUL INJ 773,000.00 773,000.00 0.00
ETOPUL INJ 1,823,250.00 1,823,250.00 0.00
GEFITERO 250MG TAB 103,143,150.00 136,863,150.00 0.00
QUETIAPINE 100MG TAB 528,000.00
QUETIAPINE XR 200MG 13,400,000.00
TEMOTERO 100MG CAP 19,792,000.00
GULAKU 1KG 12,500.00 12,500.00 0.00
HOLOXAN 2G 58,584,240.00 84,519,259.00 1.90
UROMITEXAN 400MG 25,935,017.10
MECOBALAMIN 500MCG INJ 4,527,600.00 4,527,600.00 0.00
NAVELBIN 10MG INJ 18,121,804.80 18,121,804.00 -0.80
TABLET TAMBAH DARAH 1,469,000.00 1,468,967.00 -33.00
UROGRAFIN 76%20ML INJ 8,316,000.00 8,316,000.00 0.00
SUB TOTAL OBAT 25/01/2022 : 416,953,057.60
SUB TOTAL 25/01/2022 : 571,282,277.60
BLOOD CARDIOPLEGI SET 9,636,000.00 9,636,000.00 0.00
CARDIOPLEGI SET ADULT 1,606,000.00 1,606,000.00 0.00
DIANEAL PD-4 1.5% DEXTWIN 3,910,000.00 6,900,000.00 0.00
FM CREPE 4 10,510,800.00 70,960,898.13 -1.87
FM CREPE 4 12,539,200.00
FM CREPE 6 28,400,000.00
POLYGIPS 4 972,400.00
POLYGIPS 4 8,972,600.00
POLYGIPS 6 751,400.00
POLYGIPS 6 8,814,500.00
FM CREPE 4 2,305,000.00 10,289,999.00 -1.00
FM CREPE 4 2,305,000.00
FM CREPE 6 227,200.00
FM CREPE 6 5,452,800.00
LAUNCHER GUIDING EBU 3,5 6FR KONS 4,424,211.00 8,848,422.00 0.00
LAUNCHER GUIDING EBU3.0 6FR KONS 4,424,211.00
LAUNCHER GUIDING AL 0.75 6FR KONS 7,373,685.00 103,231,590.00 0.00
LAUNCHER GUIDING EBU 3.5 7FR KONS 22,121,055.00
LAUNCHER GUIDING EBU 4.0 6FR 7,373,685.00
LAUNCHER GUIDING EBU3.0 6FR KONS 14,747,370.00
LAUNCHER GUIDING EBU 3,5 6FR 7,373,685.00
LAUNCHER GUIDING EBU 3,5 6FR KONS 14,747,370.00
LAUNCHER GUIDING JR 3.5 6FR 14,747,370.00
LAUNCHER GUIDING JR 4.0 6FR KONS 14,747,370.00
MASKER ANESTESI NO.3 FORSCH 3,500,000.00 3,500,000.00 0.00
PLASTIK TYPE 2 9,405,000.00 9,405,000.00 0.00
POSTOFIX-PU 6 X 7CM 3,003,114.00 3,003,115.50 1.50
PROLENE 4/0 W8557 956,255.28 956,255.00 -0.28
TFE POLYMER PLEDGET PCP20 5,975,508.24 5,975,508.00 -0.24
SUB TOTAL ALKES 26/01/2022 : 268,812,789.52
AMINOFUSIN HEPAR CAIR 1,737,995.60
AMINOFUSIN PAED 250ML CAIR 569,998.00
AMINOFUSIN PAED 250ML CAIR 1,139,996.00
CLINIMIX N9G15E 1LT 122,499,850.00
COMAFUSIN HEPAR CAIR 15,825,920.00
MANITOL 20% 500 ML CAIR 1,482,794.50
MANITOL 20% 500 ML CAIR 2,453,350.90
MANITOL 20% 500 ML CAIR 6,847,814.60
TRIOMIX 500 20,356,160.00
TUTOSOL INF 37,110,271.00
SUPRANE INF 4,476,000.00
TUTOSOL INF 19,575,479.00 256,037,573.90 -0.10
DEFERASIROX 250MG TAB 4,049,700.00
doxoruBICIN 50MG/KALBE 1,325,214.00
REXTA 100 MG INJ 14,549,997.00
doxoruBICIN 50MG/KALBE 16,344,306.00
BREXEL 80MG INJ 6,790,003.00
EPIRUBICIN 50MG/KALBE 18,551,263.50
METHOTREXATE 50MG INJ 1,775,015.00
cISPLAtin 50MG INJ 8,988,430.00 72,373,928.50 0.00
ENDROLIN INJ 16,043,973.00
HYDROCORTISON 1% 5GR 133,000.00
RITUXIKAL 500MG 33,707,498.00
KAMYFET 500MG KAPLET 12,822,300.00
KAMYFET 500MG KAPLET 26,594,400.00 89,301,146.00 -25.00
ENTECAVIR 0,5MG 9,504,000.00
CEFIXIM 100MG 561,150.00
CEFIXIM 100MG 1,760,850.00
CeFTRIaXoNe 1GR INJ 1,482,300.00
GLIMEPIRID 2MG 492,000.00
CIPROFLOXACIN 500 MG TABLET 620,000.00
OMEPRAZOLE 20MG TAB 3,870,000.00
MEROPENEM 1 GR 16,461,000.00 34,751,301.97 1.97
OCTALBIN 20% 100ML 217,199,928.00
OCTALBIN 5% 250 ML 4,699,997.50
OCTALBIN 5% 250 ML 23,499,987.50 245,399,913.00 0.00
VINORKAL INJ 1,907,558.40
VINORKAL INJ 17,168,025.60 19,075,584.00 0.00
HYDROXYCHLOROQUINE 200 MG TAB 74,250.00
HYDROXYCHLOROQUINE 200 MG TAB 11,063,250.00 11,137,500.00 0.00
GEMCITABINE HCL 1GRAM INJ 5,993,323.00 5,993,323.05 0.05
INOVAD INJ 9,815,520.00 9,815,520.00 0.00
AQUA 25ML INF SATORIA 66,250,000.00 66,250,000.00 0.00
BFLUID 500ML 22,050,815.60 82,791,654.00 0.00
BFLUID 500ML 11,597,660.80
BFLUID 500ML 7,630,040.00
KIDMIN 200CC 5,462,050.00
BFLUID 500ML 35,021,883.60
PAN-AMIN G CAIR 1,029,204.00
ADALAT OROS 30MG TAB 51,778,140.00 96,083,076.00 0.00
NIMOTOP 6,206,400.00
VISANNE 2 MG 5,399,016.00
XARELTO 15MG 19,074,720.00
XARELTO 20MG TAB 13,624,800.00
GABAXA 200MG/ML @100ML INF 7,350,000.30 39,210,000.00 -0.30
ISOTIC ADRETOR 0.5% ED 883,300.00
ISOTIC ADRETOR 0.5% ED 5,166,700.00
OCTREOTIDE ACETATE 0,1MG/1ML INJ 25,810,000.00
GELOFUSIN 500 CC 3,480,531.12 72,075,998.00 -0.61
GELOFUSIN 500 CC 68,595,467.49
MIDAZOLAM 5MG/5ML INJ 7,110,400.00 7,110,400.00 0.00
SURVANTA INJ 75,900,008.80 89,700,010.00 -0.40
SURVANTA INJ 13,800,001.60
SUB TOTAL OBAT 26/01/2022 : 1,197,106,952.81
SUB TOTAL 26/01/2022 : 1,465,919,742.33
FM CREPE 4 5,532,000.00 5,531,999.80 -0.20
GYPSONA 4 3,360,001.20 38,360,000.00 -1.20
GYPSONA 6 2,660,000.00
UNIFLEX 2315 4 18,240,000.00
UNIFLEX 6 14,100,000.00
POLIBAN 6 6,655,000.00 14,905,000.00 0.00
POLIBAN 6 8,250,000.00
STAINLEES STEEL 2 4X50CM 4,065,600.00 4,065,600.00 0.00
SUB TOTAL ALKES 27/01/2022 : 62,862,601.20
ACTRAPID 100 IU INJ 155,000.00
ACTRAPID 100 IU INJ 7,750,000.00
ACTRAPID 100 IU INJ 4,495,000.29
LEVEMIR FLEXPEN 38,270,000.00
NOVOMIX-30 FLEXPEN 11,200,000.00
NOVORAPID FLEXPEN 62,650,000.00 124,520,000.00 -0.29
AROMASIN 25MG 8,064,000.00
AROMASIN 25MG 169,344,000.00
REVATIO TAB 20 MG 252,720,000.00
AROMASIN 25MG 1,344,000.00
CAMPTO 40MIU/1ML INJ 11,497,010.00 442,969,010.00 0.00
SANDIMMUN 25MG 10,710,000.00
SANDIMMUN 25MG 69,020,000.00
TASIGNA HGC 200MG 65,856,000.00
TASIGNA HGC 200MG 169,344,000.00 314,930,000.00 0.00
BICASTRA 50MG TABLET 7,344,000.00
BRACER 1 MG TABLET 984,000.00
BRACER 1 MG TABLET 22,041,600.00
CARBOPLATIN 450 MG INJ 11,235,510.00
CARBOPLATIN 450 MG INJ 23,335,290.00
cISPLAtin 50MG/50MLINJ 1,977,448.00
cISPLAtin 50MG/50MLINJ 4,494,200.00
DOCETAXEL 80 MG INJEKSI 40,740,000.00
EPIRUBICIN HCL 50 MG 18,551,250.00
FONKOGEM 1000MG INJ 9,220,499.40
FONTREXED 500MG INJEKSI 10,798,656.00
FONTREXED 500MG INJEKSI 41,394,848.00
FONYLIN MR 60 MG 9,600,000.00
LATANOPROST ED 5,132,000.00
ZOMETA 4MG/100ML INJ 135,240,000.00
LEBREST 2.5MG 9,306,000.00
LEBREST 2.5MG 9,531,600.00
MOXIFLOXACINE EYE DROP 1,465,860.00
REDDITUX 500MG INJ 101,122,499.40
RYZODEG FLEX TOUCH 6,720,000.00 470,235,262.00 1.20
HERBESSER CD 100MG TAB 11,875,000.00
HERBESSER CD 200MG 1,545,000.00
VENTAVIS INJ 25,200,000.00
HERBESSER CD 200MG 3,605,000.00
TANAPRES 5MG 2,430,000.00 44,655,000.00 0.00
DEFERASIROX 500MG 212,799,944.00
carboPLATIN 450/KALBE 1,440,450.00
carboPLATIN 450/KALBE 12,964,050.00
RHEU-TREX 2.5MG TAB 943,000.00
CALCIUM FOLINAT 50MG INJ 16,732,980.00
VINCRISTINE 2MG INJ 3,836,813.20
VINCRISTINE 2MG INJ 4,883,216.80 253,600,459.80 5.80
ALLOPURINOL 100MG TABLET 1,305,000.00 11,563,462.56 2.56
ALLOPURINOL 300MG 3,000,000.00
ASAM TRANEXAMAT 500MG INJ 1,880,000.00
CeFoTAXime 1GR INJ 1,710,000.00
AMOXICILLIN 500MG 1,206,000.00
IRBESARTAN 150 MG TABLET 979,440.00
IRBESARTAN 300 MG TABLET 1,483,020.00
D10 500ML 719,950.00
D5 500ML/B-BRAUN 5,302,000.00
NS 100ML/B-BRAUN 86,086,000.00
NS 500ML/B-BRAUN 54,401,600.00
RL 500ML/B-BRAUN 11,554,950.00 158,064,500.00 0.00
TACERAL 500 MG TABLET 8,978,400.00
TACERAL 500 MG TABLET 53,122,200.00
OSTEONATE OAW 35MG KAPLET 74,751.60
KALXETIN 10MG TAB 1,911,289.80
V-BLOC TAB 25MG 907,500.00 64,994,131.00 -10.40
AMINOSTERIL INFANT 10% 100ML INF 26,460,060.00 26,460,060.00 0.00
AQUA 1LT CAIR 1,988,316.00 1,988,316.00 0.00
ARICEPT EVESS 10 MG TAB 13,500,480.00 13,500,480.00 0.00
ERLONAT 150MG TAB 1,244,100.00 69,017,430.00 0.00
ERLONAT 150MG TAB 37,323,000.00
PRAMIFROL ER 0,75MG TAB 4,054,500.00
PRAMIFROL ER 0.375 7,320,000.00
SOROQUIN SR 300MG TAB 4,906,080.00
SOROQUIN SR 300MG TAB 5,314,920.00
SOROQUIN XR 400MG TABLET 700,830.00
TOPAMAX 100MG TAB JANSEN 5,670,000.00
TOPAMAX 50MG 2,484,000.00
IMURAN 50 MG TAB 43,442,000.00 139,848,610.00 -18.00
IMURAN 50 MG TAB 91,378,000.00
SERETIDE DISKUS 250MCG INH 5,028,628.00
SUB TOTAL OBAT 27/01/2022 : 2,136,346,740.49
SUB TOTAL 27/01/2022 : 2,199,209,341.69
CLOSE SUCTION 8 12,320,000.00 12,319,999.54 -0.46
EKG 3M 2228 8,029,300.00 8,029,271.25 -28.75
PROLENE 5/0 W8556 7,897,577.28 7,897,577.00 -0.28
PROLENE 5/0 W8556 987,197.16 1,974,394.00 -0.32
PROLENE 5/0 W8556 987,197.16
SPINOCAN 25 6,156,792.00 12,313,684.00 100.00
SPINOCAN 26 6,156,792.00
SUB TOTAL ALKES 28/01/2022 : 42,534,855.60
C.FLOXA MDS 52,965.00
C.MYDRIATIL 1% 5ML ED 1,893,375.00
C.NATACEN MDS 412,087.50
C.NONCORT MONODOSE 1,045,687.50
C.TOBRO MINIDOSE 946,687.50
C.TOBROSON ED 5CC 1,190,475.00
C.TONOR 0.5% 5ML ED 990,000.00
C.TROPIN 0,5% ED 1,113,750.00
C.TROPIN 1% ED 1,237,500.00 8,882,527.50 0.00
CEFOPERAZONE SULBACTAM 1 GRAM INJ 332,520.40
KETOCONAZOLE 200MG 252,000.00
LANSOPRAZOLE 30MG 4,170,000.00
LORATADIN 10MG 163,500.00
METFORMIN 500MG 2,310,000.00
RHEU-TREX 2.5MG TAB 8,487,000.00
SIMVASTATIN 10MG TABLET 272,000.00 15,987,022.70 2.30
HEMAPO INJ 2000IU 1,481,994.80 135,829,881.00 0.00
HEMAPO INJ 2000IU 12,197,957.20
HEMAPO INJ 3000IU 17,599,934.00
LEUCOGEN INJ 25,049,970.00
OCTALBIN 25% 100ML 79,500,025.00
NOREPINEPRINE INJ 9,979,200.00 9,979,200.00 0.00
FENTANYL INJ 99,633,600.00 99,633,600.00 0.00
NTG (NITROGLYCERIN) INJ 1,287,000.00 1,287,000.00 0.00
ENDOXAN 1 GR INJ 10,785,500.00 152,625,000.00 0.00
ENDOXAN 1 GR INJ 31,949,500.00
ENDOXAN 1 GR INJ 109,890,000.00
ESILGAN 1MG TABLET 1,341,429.00 3,394,739.00 -1.00
ESILGAN 2MG TABLET 2,053,311.00
ALINAMIN FORTE 388,080.00 6,010,032.00 -1.19
PANTOZOL 20MG 1,264,120.13
PANTOZOL 40 MG 1,234,200.10
PROSOGAN FD 15MG 899,351.04
PROSOGAN FD 30MG 2,224,281.92
AQUA 1LT CAIR 7,953,264.00 7,953,264.00 0.00
BETAHISTIN HCL 24MG TAB 17,802,000.00 17,802,000.00 0.00
BRILINTA 90MG 66,828,608.00 244,850,551.00 -3.00
PULMICORT 0.5MG/2ML 6,286,800.00
SYMBICORT 160/4.5MCG 60DS 13,557,720.00
SYMBICORT 80/4.5MCG 60DS 4,067,316.00
ZOLADEX 10.8MG INJ 55,284,240.00
ZOLADEX INJ 3,6MG 2,964,776.10
ZOLADEX INJ 3,6MG 95,861,093.90
ETOPUL INJ 1,823,250.00 1,823,250.00 0.00
FUPLATIN 450MG INJ 13,828,320.00 13,828,320.00 0.00
HUMALOG KWIKPEN 192,424,914.00 192,424,914.00 0.00
INOVAD INJ 8,477,040.00 8,477,040.00 0.00
ISDN 5MG 4,300,000.00 4,300,000.00 0.00
KABITARIN 1000 MG INJ 11,407,110.00 11,407,110.00 0.00
NOROID CREAM 80ML 1,188,385.00 1,188,385.00 0.00
URITOS 0,1 MG TAB 114,000.00 114,000.00 0.00
ZYPREXA INJ 5,482,400.00 5,482,400.00 0.00
SUB TOTAL OBAT 28/01/2022 : 943,280,239.09
SUB TOTAL 28/01/2022 : 985,815,094.69
ETHIBOND 5 V-37 MB66G 5,454,801.00 5,454,801.00 0.00
NTLC 75 KONS 8,604,373.80 8,604,373.00 -0.80
SUB TOTAL ALKES 29/01/2022 : 14,059,174.80
CUSTODIOL 500ML PERFUSION SOL 6,732,000.00 6,732,000.00 0.00
ERBITUX 100MG INJ 39,200,004.80 39,200,004.00 -0.80
DOPAMET 250MG 8,865,000.00
LEVETIRACETAM 500MG TAB 2,937,600.00
LEVETIRACETAM 500MG TAB 9,424,800.00 35,793,000.00 0.00
NAROPIN 7.5/20ML INJ 3,987,752.50
NTG (NITROGLYCERIN) INJ 2,574,000.00
PYRAZINAMID 500 MG 483,870.00 7,045,615.00 -7.50
ROCULAX INJ 16,500,000.00
PROPOFOL INJEKSI 20ML 5,544,000.00 22,044,000.00 0.00
SANDIMMUN 100MG TAB 78,625,000.00
SANDIMMUN 100MG TAB 6,375,001.50
STALEVO 42,240,000.00 127,240,000.00 -1.50
THERACIM 50MG INJ 12,941,775.00
THERACIM 50MG INJ 12,941,775.00 25,883,550.00 0.00
SUB TOTAL OBAT 29/01/2022 : 263,938,178.80
SUB TOTAL 29/01/2022 : 277,997,353.60
AMPLATZ SUPER STIFF 0,035 145CM 11,730,004.00 11,730,000.00 -4.00
CERTOFIX TRIO V720 9,988,888.00 9,988,888.00 0.00
CERTOFIX TRIO V720 35,674,600.00 35,674,600.00 0.00
CONNECTOR ELBOW DEWASA 03861316 24,800,000.00 24,800,000.00 0.00
D PULSE DP-P-301 INFLATION DEVICE 28,800,728.40 28,800,728.00 -0.40
EXTERNAL VENTRICULAR DRAINAGE MEDIUM 42,693,750.00 42,693,750.00 0.00
FIXOMULL 5CM X 5CM 103,455,000.00 103,455,000.00 0.00
FM CREPE 6 3,124,000.00 34,079,997.00 -3.00
FM CREPE 6 4,487,200.00
FM CREPE 6 6,134,400.00
FM CREPE 6 17,721,600.00
FM CREPE 6 56,800.00
FM CREPE 6 1,136,000.00
FM CREPE 6 1,420,000.00
PDT KIT 7MM SINGLE STAGE 8,000,742.00 8,000,742.00 0.00
PDT KIT 7MM SINGLE STAGE 28,002,597.00 28,002,597.00 0.00
PLASTIK TYPE 2 25,080,000.00 25,080,000.00 0.00
PROGREAT CATH 2.7FR 130CM 46,142,074.00 124,384,667.86 0.02
RUNTHROUGH HYPER 37,778,983.00
CATH J.R 4.0 6FR 13,960,485.00
FINE CROSS 26,503,125.84
SPUIT 5 CC 17,615,160.00 17,615,875.00 715.00
STERIDRAPE 1040 3,157,000.00 7,639,500.00 0.00
STERIDRAPE 1050 4,482,500.00
T-MONO 5/0 M53 3,281,520.00 3,281,520.00 0.00
SUB TOTAL ALKES 31/01/2022 : 505,227,157.24
ARAVA TABLET 73,872,060.00 76,034,640.00 -20.00
DULCOLAX 10 MG SUPP 2,162,600.00
ETOPUL INJ 1,823,250.00 1,823,250.00 0.00
IOMERON 400/100ML INF 9,355,500.00 9,355,500.00 0.00
IOMERON 400/100ML INF 34,749,000.00 34,749,000.00 0.00
OSTEOCARE TAB 9,900.00 9,900.00 0.00
NOREPINEPHRINE BITARTRATE INJ 4,307,000.00
NOREPINEPHRINE BITARTRATE INJ 4,897,000.00
NOREPINEPHRINE BITARTRATE INJ 8,496,000.00 17,699,998.00 -2.00
PARACETAMOL INFUS 6,216,000.00 6,216,002.00 2.00
SUB TOTAL OBAT 31/01/2022 : 145,888,310.00
SUB TOTAL 31/01/2022 : 651,115,467.24
SUB TOTAL Penerimaan Gudang (Supplier) : 9,958,245,201.70
SUB TOTAL UNIT UPPFI : 9,962,811,874.70
TOTAL : 9,962,811,874.70 9,936,360,912.17 -9.53
KET
21,884,280.00
1,469,000.00
29,394,200.00
30,960,000.18
33,000,000.00
8,584,012.80
39,550,000.00
85,900,000.00
11,999,020.00
30,015,150.00
136,935,834.00
228,854,829.90
6,281,070.40
3,694,350.00
865,430,580.00
23,406,240.00
49,974,020.00
16,973,000.00
13,714,712.00
52,529,180.00
9,976,200.00
185,492,800.00
34,958,400.00
7,854,000.00
34,446,280.00
75,370,075.00
98,249,932.00
12,323,166.00
89,780,308.00
5,227,549.60
125,080,490.80
55,200,000.00
41,400,000.00
18,488,620.00
1,786,400.00
9,396,750.00
136,863,150.00
84,519,257.10
6,900,000.00
34,500,000.00
70,960,900.00
10,290,000.00
8,848,422.00
103,231,590.00
256,037,574.00
72,373,928.50
89,301,171.00
34,751,300.00
245,399,913.00
19,075,584.00
11,137,500.00
82,791,654.00
96,083,076.00
39,210,000.30
72,075,998.61
89,700,010.40
38,360,001.20
14,905,000.00
124,520,000.29
442,969,010.00
314,930,000.00
470,235,260.80
44,655,000.00
253,600,454.00
11,563,460.00
158,064,500.00
64,994,141.40
69,017,430.00
139,848,628.00
1,974,394.32
12,313,584.00
8,882,527.50
15,987,020.40
135,829,881.00
152,625,000.00
3,394,740.00
6,010,033.19
244,850,554.00
35,793,000.00
7,045,622.50
22,044,000.00
127,240,001.50
25,883,550.00
34,080,000.00
124,384,667.84
7,639,500.00
76,034,660.00
17,700,000.00
RS. UMUM DAERAH DR. SOETOMO
Telp. 031- 5501259 / 5501239
Faks. 031 - 5501571
PENYEDIA : PENYEDIA BLU
PERIODE : 01/01/2022 s.d 31/01/2022
Tgl. Cetak : 02/03/2022 14:11
NO TGL TRANSAKSI JENIS BARANG NAMA PBF NO FAKTUR
1. UNIT : UPPFS
1 03/01/2022 ALKES STANDART UPPFI
SUB TOT
2 OBAT DAN BAHAN OBAT UPPFI
3 STANDART UPPFI
SUB TOTAL OBAT DAN BAH

2 UPPFI
SUB TOT
STANDART SUB TOTAL OBAT DAN BAH

2 UPPFI
3 UPPFI
4 UPPFI
SUB TOT
1 07/01/2022 OBAT DAN BAHAN OBAT UPPFI


SUB TOT
3 STANDART UPPFI
4 UPPFI


SUB TOT
3 STANDART UPPFI

2 UPPFI
SUB TOT
4 STANDART UPPFI

STANDART
2 UPPFI

SUB TOT


2 STANDART UPPFI

SUB TOT
SUB TOTAL
1 19/01/2022 DONASI PT. Dexa Medica
SUB T
1 06/01/2022 GAS MEDIS PT.ANEKA GAS INDUSTRI 293196059
2 PT.ANEKA GAS INDUSTRI 293196059
S
1 07/01/2022 ALKES STANDART PT.MILLENIUM PHARMACON 750522000008

2 INTERNASIONAL
PT.MILLENIUM PHARMACON 750522000008
3 INTERNASIONAL
PT.MILLENIUM PHARMACON 750522000008
INTERNASIONAL SUB TOT
1 08/01/2022 X-RAY & MATERI PT.MILITRUS MLT/SS/01/2022/00290

2 RADIODIAGNOSTIK PT.MILITRUS MLT/SS/01/2022/00290
3 PT.MILITRUS MLT/SS/01/2022/00290
SUB TOTAL X-RAY & MATE
1 10/01/2022 ALKES STANDART PT.ABADI MAKMUR BERSAMA 26220

2 PT.PRIMA ALKESINDO NUSANTARA 22990510
SUB TOT
1 13/01/2022 BAHAN LABORATORIUM / PT.SABA INDOMEDIKA E000-2242863720

2 REAGEN PT.SABA INDOMEDIKA E000-2242861300
3 PT.SABA INDOMEDIKA E000-2242861300
SUB TOTAL BAHAN LABO
5 X-RAY & MATERI RAJAWALI NUSINDO FKT/SBA/
6 RADIODIAGNOSTIK RAJAWALI NUSINDO 2022/00000767
FKT/SBA/
2022/00000767
1 14/01/2022 ALKES STANDART PT.INDOFARMA GLOBAL MEDIKA 002/REAGEN/1/2022

6 PT.INDOFARMA GLOBAL MEDIKA 002/REAGEN/1/2022
3 BAHAN LABORATORIUM / PT.INDOFARMA GLOBAL MEDIKA 002/REAGEN/1/2022
2 REAGEN PT.INDOFARMA GLOBAL MEDIKA 1340052951
SUB TOT
1 15/01/2022 OBAT DAN BAHAN OBAT PT.ANUGRAH ARGON MEDICA 491222005286

1 17/01/2022 ALKES STANDART PT.MERAPI UTAMA PHARMA 220031003091

2 PT.PHARMINDORIMPANG KOKOH 011703
SUB TOT
3 BAHAN LABORATORIUM / PT.INDOFARMA GLOBAL MEDIKA 1340052949
4 REAGEN PT.PIONER INDO NUSANTARA PIN/SI-2022/00122
5 PT.MB.CITRA MEDIKA 0022-22.66417357
1 18/01/2022 OBAT DAN BAHAN OBAT PT.AMADEA DEVINA FARMA 003/FP.ADF/I/2022

1 19/01/2022 BAHAN LABORATORIUM / PT.MB.CITRA MEDIKA 0022-22.6647369

REAGEN SUB TOTAL BAHAN LABO
1 20/01/2022 BAHAN LABORATORIUM / PT.INDOFARMA GLOBAL MEDIKA 005/REAGEN/I/2022

4 REAGEN PT.INDOFARMA GLOBAL MEDIKA 005/REAGEN/I/2022
14 PT.INDOFARMA GLOBAL MEDIKA 005/REAGEN/I/2022
2 PT.MAHAKARYA PRATAMA MEDIKA 82233553
3 PT.DIRGANTARA JAYA SAKTI 61040208/I/2022
17 PT.DIRGANTARA JAYA SAKTI 61040213/II/2022
29 X-RAY & MATERI PT.TIRTA PUTRA MEDIKA 03 / F-TPM /I /2022
RADIODIAGNOSTIK SUB TOTAL X-RAY & MATE
1 21/01/2022 ALKES STANDART PT.INDOFARMA GLOBAL MEDIKA 009/REAGEN/I/2022

SUB TOT
2 BAHAN LABORATORIUM / PT.INDOFARMA GLOBAL MEDIKA 007/reagen/i/2022
3 REAGEN PT.INDOFARMA GLOBAL MEDIKA 007/reagen/i/2022
5 PT.INDOFARMA GLOBAL MEDIKA 007/reagen/i/2022
9 PT.TAWADA HEALTHCARE FOC963358
16 PT.SABA INDOMEDIKA DS2000908
20 X-RAY & MATERI PT.INTI SUMBER HASIL SEMPURNA NJKMJ220200321
RADIODIAGNOSTIK SUB TOTAL X-RAY & MATE
1 24/01/2022 BAHAN LABORATORIUM / PT.AMADEA DEVINA FARMA 004/FP.ADF/I/2022

2 REAGEN PT.AMADEA DEVINA FARMA 004/FP.ADF/I/2022
5 OBAT DAN BAHAN OBAT PT.AMADEA DEVINA FARMA 004/FP.ADF/I/2022
3 STANDART PT.TAWADA HEALTHCARE 910272
4 PT.MB.CITRA MEDIKA 002-22.66417383
1 25/01/2022 BAHAN LABORATORIUM / PT.SABA INDOMEDIKA DS2000969

7 REAGEN PT.SABA INDOMEDIKA DS2000969
2 PT.TAMARA OVERSEAS CORPORATION INV2202-0013
9 PT.TAMARA OVERSEAS CORPORATION INV2202-0013
1 26/01/2022 ALKES STANDART RAJAWALI NUSINDO FKT/SBA/

2 PT.INDOFARMA GLOBAL MEDIKA 2022/00000801
011/REAGEN/I/2022
SUB TOT
3 BAHAN LABORATORIUM / PT.INDOFARMA GLOBAL MEDIKA 1340052950
7 REAGEN PT.INDOFARMA GLOBAL MEDIKA 1340052950
4 PT.TRANSMEDIC INDONESIA TT DN2200440
5 PT.TRANSMEDIC INDONESIA TT DN2200440
10 X-RAY & MATERI PT.TIRTA PUTRA MEDIKA 06 / F-TPM /II/2022
11 RADIODIAGNOSTIK PT.TIRTA PUTRA MEDIKA 06 / F-TPM /II/2022
12 PT.TIRTA PUTRA MEDIKA 06 / F-TPM /II/2022
1 27/01/2022 ALKES STANDART PT.KARUNIA PHARMINDO S F4/1

SUB TOT
2 BAHAN LABORATORIUM / PT.DOS NI ROHA 831241808
3 REAGEN PT.DOS NI ROHA 831241808
5 GAS MEDIS PT.ANEKA GAS INDUSTRI 293196045
S
1 28/01/2022 BAHAN LABORATORIUM / PT.MEDIA DIAGNOSTIKA 003-0122-51

2 REAGEN PT.INDOFARMA GLOBAL MEDIKA TANDATERIMA
3 OBAT DAN BAHAN OBAT PT.BRATACHEM IVTDB2200003
4 X-RAY & MATERI PT.MILITRUS MLT / SS
5 RADIODIAGNOSTIK PT.TIRTA PUTRA MEDIKA /2022/01/00300
05 /F-TPM/II/2022
1 29/01/2022 GAS MEDIS PT.ANEKA GAS INDUSTRI 293196044

S
1 31/01/2022 ALKES STANDART PT.MENSA BINASUKSES CD220096049

2 PT.KARUNIA PHARMINDO S F 5 A/ I
SUB TOT
3 BAHAN LABORATORIUM / PT.INTEGASTRA NUSANTARA INT/01-2022/0398
4 REAGEN PT.DIMENSI CITRA SEMESTA ENO11122-00545
5 PT.DIMENSI CITRA SEMESTA ENO11122-00545
6 PT.DIMENSI CITRA SEMESTA ENO11122-00545
SUB TOTA
T KOLOM BERTAMBAH
YEDIA BLU
s.d 31/01/2022
BERTAMBAH NOMINAL
NAMA BARANG SATUAN
QTY NILAI FAKTUR
SPUIT 50 CC LBG TENGAH HD PCS 100.00 467,300.00

SUB TOTAL ALKES STANDART 03/01/2022 : 467,300.00
Otsu NS/RUBB FLES 60.00 384,582.00
WIDA (AQUADEST) 1000ML FLES 40.00 419,980.00
SUB TOTAL OBAT DAN BAHAN OBAT STANDART 03/01/2022 : 804,562.00
SUB TOTAL 03/01/2022 : 1,271,862.00
NEEDLE 25 G BD PCS 1,000.00 265,000.00
Soft Pad 60 x 90 @ 1 PCS 300.00 1,248,720.00
SUB TOTAL ALKES STANDART 04/01/2022 : 1,513,720.00
Aseptic Liquid 0.2 % + Oral Sponge SET 12.00 277,200.00
SUB TOTAL 04/01/2022 : 1,790,920.00
Disp syringe 5 ml ( nipro ) PCS 1,000.00 979,000.00
Disp syringe 50 ml (nipro) PCS 800.00 4,496,800.00
Disp. Syringe 3 cc (Terumo)(B) PCS 500.00 568,995.00
Disp. Syringe 5 cc ( Terumo)(B) PCS 500.00 800,005.00
SUB TOTAL 06/01/2022 : 6,844,800.00
SUB TOTAL 07/01/2022 : 128,194.00
INFUS SET PCS 100.00 544,500.00
AQUADEST @25ML FLES 480.00 1,272,000.00
Emla 5% Cream 5 gr(B) TUBE 4.00 222,714.80
SUB TOTAL OBAT DAN BAHAN OBAT STANDART 10/01/2022 : 2,229,679.80
SUB TOTAL 10/01/2022 : 2,774,179.80
SUB TOTAL 12/01/2022 : 104,995.00
JARUM 18 G ONEMED PCS 500.00 96,800.00
Oleum Ricini(B) LITER 1,000.00 74,990.00
SUB TOTAL 17/01/2022 : 696,765.00
MINYAK ZAITUN BERTOLI BOTOL 2,000.00 332,000.00
NEEDLE 25 G BD PCS 1,000.00 265,000.00
CENDO MYDRIATIL 0.5% 5ML ED FLS 1.00 31,762.50
CHLORAMPENICOL SM 1% 5GR TUB/5GR 10.00 20,075.00
SUB TOTAL 18/01/2022 : 648,837.50
Aseptic Liquid 0.2 % + Oral Sponge SET 24.00 554,400.00
SUB TOTAL 24/01/2022 : 1,195,370.00
JARUM 18 G ONEMED PCS 300.00 58,080.00
SUB TOTAL 25/01/2022 : 58,080.00
GULA PASIR 1000GRAM (GULAKU) GRAM 3,000.00 57,750.00
SUB TOTAL 26/01/2022 : 57,750.00
Cendo Medriatil 1% 5 ml(B) FLES 50.00 2,472,000.00
SUB TOTAL 28/01/2022 : 2,576,995.00
SPUIT 1 TB NIPRO PCS 500.00 511,500.00
SUB TOTAL 31/01/2022 : 511,500.00
SUB TOTAL Otomatis Pinjam Antar Penyedia : 18,660,248.30
BERIATE INJ 250 IU VIAL 52.00 40,560,000.00
SUB TOTAL DONASI 19/01/2022 : 40,560,000.00
SUB TOTAL 19/01/2022 : 40,560,000.00
SUB TOTAL Penerimaan dari Pihak Luar : 40,560,000.00
CO2 @ 25 kg(B) BOTOL 1.00 165,000.00
N2O @20KG BIJI 4.00 8,976,000.00
Oksigen 1 m3 AGI(B) BOTOL 444.00 12,210,000.00
Oksigen 1,5 m3 AGI(B) BOTOL 8.00 264,000.00 21,615,000.00
SUB TOTAL GAS MEDIS 06/01/2022 : 21,615,000.00
SUB TOTAL 06/01/2022 : 21,615,000.00
Septalkan Wipes PACK 167.00 33,399,323.65 39,999,190.00
Septalkan Wipes PACK 31.00 6,199,874.45
Septalkan Wipes PACK 2.00 399,991.90
SUB TOTAL 07/01/2022 : 39,999,190.00
DVE EP 20X25CM (8X10IN ) LBR LBR 2,000.00 26,400,000.00 148,000,000.00
DVE EP 28X35CM (11X14 IN ) LBR LBR 2,000.00 49,600,000.00
DVE EP 35X43CM (14X17IN) LBR LBR 1,875.00 71,999,981.25
SUB TOTAL X-RAY & MATERI RADIODIAGNOSTIK 08/01/2022 : 147,999,981.25
SUB TOTAL 08/01/2022 : 147,999,981.25
ADIPATH FORMALIN BUFER 10% @ GALON 2.00 1,840,000.00 1,840,000.01
10LT
ANIOSYME SINERGY 5 GLN 12.00 14,400,000.00 14,400,000.00
SUB TOTAL 10/01/2022 : 16,240,000.00
CELLPACK DCL 20L(DCL-300A) BOX 2.00 4,202,000.00 4,202,000.00
CT001628
FLUOROCELL WDF CV377552 CARTRID 1.00 8,395,200.00 25,344,000.00
FLUOROCELL WDF CV377552 CARTRID 1.00 8,395,200.00
LYSERCELL WDF ZPPAL337664 PCS 2.00 8,553,600.00
SUB TOTAL BAHAN LABORATORIUM / REAGEN 13/01/2022 : 29,546,000.00
NUPREP TUBE TUB/ 15.00 12,069,750.00 23,197,350.00
TEN 20 POT POT 12.00 11,127,600.00
SUB TOTAL 13/01/2022 : 52,743,350.00
SAMPLIX 3ML K2EDTA BOX 71.00 13,237,950.00 124,337,950.00
GEM PREMIER 3500 IQM PH PCO2 BOX 3.00 89,100,000.00
PO2
D-10 HC
DUAL PROGRAM KIT 1.00 22,000,000.00
REORDERPACK
VAC 2ML FX SODFi / POT x PREM PCS. 3.00 462,000.00 9,757,022.00
GRY
GEM /CVP
13X71 GEM 3K 20X2.5ML BOX/1 1.00 4,647,500.00
GEM CVP 2 GEM 3K 20X2.5ML BOX/1 1.00 4,647,500.00
SYR ABG PRESET 3(1.6)LL 22X1 CE PCS 20.00 0.00
SUB TOTAL 14/01/2022 : 134,094,950.00
Xylocain Spray 50 ml (ASTRA)(B) FLS 30.00 5,673,501.90 5,673,195.00
SUB TOTAL 15/01/2022 : 5,673,501.90
Kasa Lipat X-Ray 10 x 10 PACK 500.00 26,593,875.00 26,593,875.00
SKLAR POLISH (SKLAR POT 6.00 3,408,000.00 3,408,000.00
INSTRUMENTS )
GEM PREMIER 3500 IQM PH PCO2 BOX 3.00 89,100,000.00 89,100,000.00
PO2 HC WAX HISTOLINE @2KG
PARAFIN ZAK 4.00 1,980,000.00 1,980,000.00
RAPID ANTIGEN FLOW FLEX TEST 2,000.00 48,400,000.00 48,400,000.00
ACCON
SUB TOTAL 17/01/2022 : 169,481,875.00
Bleaching @1lt 6%. (LOKAL)(B) FLES 300.00 6,600,000.00 6,600,000.00
SUB TOTAL 18/01/2022 : 6,600,000.00
ACCON
SUB TOTAL 19/01/2022 : 48,400,000.00
AFP KIT 1.00 3,334,674.20 27,589,554.00
CEA KIT 1.00 3,387,880.10
LYPHOCHECK IMMUNOASSAY KIT 1.00 7,447,000.00
PLUS CONTROL
LYPHOCHECK TRIL MARKER
TUMOR KIT 2.00 13,420,000.00
PLUS
Anti D CONTROL
monoclonalLEV
IgG (Rhesus) VIAL 1.00 211,200.00 1,152,800.00
Golongan darah A, B, tulip(B) BOTOL 1.00 149,600.00
Widal Slide Set @ 5ml Remel(B) KIT 1.00 792,000.00
BRILA (BRILLIANT GREEN BILE FLS 2.00 3,850,000.00 9,597,500.00
LACTOSE) BRO
Lactose Broth cat.7661 @ 500 gr
FLS 1.00 1,908,500.00
NUTRIEN AGAR @500GR CAT 5450 FLS 2.00 3,839,000.00
Chlorin test 14670(B) BOTOL 3.00 3,291,750.00 9,292,250.00
SODIUM CHLORIDE (NACL) FLS 5,000.00 6,000,500.00
gram.6404
CMV IgG KIT 2.00 6,265,217.20 61,088,262.00
CMV IgM KIT 2.00 6,265,217.20
HBE AG BOX 1.00 2,642,391.40
MAGLUMI NT-pro BNP (CLIA) BOX 1.00 11,550,000.00
@50TES
PROGESTERON (PRG) KIT 1.00 3,848,804.30
PROGESTERON (PRG) KIT 1.00 3,848,804.30
RUBELLA IgG KIT 4.00 13,333,914.00
TOXO IgG KIT 4.00 13,333,914.00
FORMIC ACID 98-100% FLS 2.00 2,839,100.00 8,471,100.00
(1.00264.1000)
Total Hardness FOR A
/ Aquamerck cat. KIT 2.00 5,632,000.00
8039(B)
Immersion Oil 4699(B) BOTOL 5.00 9,267,500.00 9,267,500.00
Methanol pa @ 2,5 lt 6009(B) BOTOL 2.00 1,635,700.00 5,776,100.00
PAPANICOLUS SOL 2a. 3554 FLS/1000ML 1.00 1,841,950.00
PAPANICOLUS SOL 3b. 3556 FLS/1000ML 1.00 2,105,950.00
SPIRITUS @1LT DIRGANTARA FLES 5.00 192,500.00
Giemsa @ 500 cc 9204(B) BOTOL 50.00 73,040,000.00 73,040,000.00
Kertas USG Type CP 820 DOS 1.00 676,500.00 676,500.00
SUB TOTAL X-RAY & MATERI RADIODIAGNOSTIK 20/01/2022 : 676,500.00
SUB TOTAL 20/01/2022 : 205,951,566.70
ANA SCREEN 50T BOX 6.00 31,636,954.80 112,459,457.00
ANTI-DSDNA IgG BOX 2.00 15,531,522.60
CORTISOL 50T KIT 1.00 3,123,641.40
CORTISOL 50T KIT 1.00 3,123,641.40
RUBELLA IgM KIT 4.00 15,973,914.00
TESTEOSTERON (TEST) KIT 2.00 7,252,825.80
TOXO IgM KIT 4.00 15,859,131.20
TROPONIN I KIT 1.00 6,652,608.60
TROPONIN I KIT 2.00 13,305,217.20
CT001628
PLESTERIN BULAT (FREE) PCS 10,000.00 0.00
URINE CONTAINER STERIL PCS 1,000.00 3,300,000.00 3,300,000.00
XN CHECK BF (L1.12) BY698063 VIAL 1.00 4,042,500.00 12,358,500.00
XN CHECK L1 3.0ML BV 661822 VIAL 3.00 2,772,000.00
XN CHECK L2 3.0ML AK2060533 VIAL 3.00 2,772,000.00
XN CHECK L3 3.0ML BR875289 VIAL 3.00 2,772,000.00
USG GEL @5LT GLN 24.00 3,720,000.00 3,720,000.00
SUB TOTAL 21/01/2022 : 174,012,507.00
EOSIN RAPID (R2) @500ML FLS 2.00 693,000.00 9,966,000.00
(LARUTAN
Eosin RapidEOSIN)
(R3) @ 500 ml FLS/500ML 2.00 693,000.00
(LARUTAN METHY
Acidum Citricum 50%@1 lt (Lokal)(B) GALON 200.00 8,580,000.00
ID NOW TEST COVID 19 ABBOT PCS 816.00 368,016,000.00 368,016,000.00
ACCON
SUB TOTAL 24/01/2022 : 474,782,000.00
CA CLEAN II BT565104 BOX 5.00 4,774,000.00 28,173,200.00
MEDITAPE UC-11A PCS 5.00 4,125,000.00
MEDITAPE UC-11A PCS 15.00 12,375,000.00
UF-CONTROL KIT 2.00 6,899,200.00
CALIBRATOR CARTRIDGE ULTRA KIT 6.00 127,710,000.00 150,876,000.00
CCX
STAT(Stat
STRIPProXPRESS GLUCOSE BOX 54.00 23,166,000.00
TEST STRIPS
CT001628
FLUOROCELL WNR CP066715 CARTRID 2.00 8,632,800.00 8,632,800.00
SUB TOTAL 25/01/2022 : 272,052,000.00
Paper ECG ZOLL 90 x 90 PACK 20.00 3,540,000.00 3,539,999.80
GEM PREMIER 3500 IQM PH PCO2 BOX 3.00 89,100,000.00 89,100,055.00
PO2
SYR HCABG PRESET 3(1.6)LL 22X1 CE PCS 10.00 0.00
SYR ABG PRESET 3(1.6)LL 22X1 CE PCS 40.00 0.00
ISTAT G3+CARTRIDGE BOX 25.00 3,118,500.00 12,474,000.00
(CARTRIDGE G3+)
ISTAT G3+CARTRIDGE BOX 75.00 9,355,500.00
(CARTRIDGE G3+)
REACTION MODULES PCS 45.00 31,556,250.00 31,556,250.00
URINE CONTAINER STERIL PCS 1,500.00 4,950,000.00 4,950,000.00
Aquasonic @ 250 cc (Parker)(B) BOTOL 96.00 10,824,000.00 41,046,500.00
Signa Gel @ 250 gr(B) TUBE 30.00 3,052,500.00
Superior Density BOX 100.00 27,170,000.00
PrintingPaperUp110HG(B)
SUB TOTAL 26/01/2022 : 201,311,750.00
Parafilm(B) ROLL 2.00 1,386,000.00 1,386,000.00
JUSCHEK - AMP1000 TEST - PCS 150.00 3,052,500.00 6,105,000.00
CASSETE
JUSCHEK - MOP300 TEST-CASSETE PCS 150.00 3,052,500.00
PRO 1 MICRO PROTEIN TEST BOX 1.00 1,512,250.00 1,512,250.00
TEST TABUNG BAJA BERTEKANAN TABUNG 4.00 220,000.00 220,000.00
VALVE TABUNG N2O TABUNG 4.00 2,200,000.00 2,200,000.00
SUB TOTAL GAS MEDIS 27/01/2022 : 2,420,000.00
SUB TOTAL 27/01/2022 : 11,423,250.00
ADENOSINE DEAMINASE (ADA) BOX 1.00 9,900,000.00 9,900,000.00
TUBE SST II PLH 13X100 5.0 PLBL PCS 20,000.00 49,742,000.00 49,742,000.00
CE GLD
Formalin Liquid 37% @ 10 lt(B) GALON 5.00 3,300,000.00 3,300,000.00
DVE EP 28X35CM (11X14 IN ) LBR LBR 250.00 6,200,000.00 6,200,000.00
Superior Density BOX 150.00 40,755,000.00 40,755,000.00
PrintingPaperUp110HG(B)
SUB TOTAL 28/01/2022 : 109,897,000.00
N2 CAIR @1LITER TABUNG 30.00 194,700.00 194,700.00
SUB TOTAL GAS MEDIS 29/01/2022 : 194,700.00
SUB TOTAL 29/01/2022 : 194,700.00
Durapore ROL 48.00 901,914.72 901,915.04
Parafilm(B) ROLL 3.00 2,079,000.00
H2O2 450ml Sterilizing Solution T450 FLS 1.00 9,000,000.00 9,000,000.00
(St
MINICAP HEMOGLOBIN (B) KIT 1.00 15,991,937.50 37,473,287.00
MINICAP PROTEIN (e) 6 (B) KIT 1.00 10,106,250.00
STA CLEANER SOLUTION CAT BOX 3.00 11,375,100.00
00973
UF CELLPACK CR (UPR-300A) BTL 1.00 2,323,200.00 12,641,200.00
UF CELLPACK SF (UPF-300A) BTL 1.00 3,058,000.00
UF FLUORECELL CR (UFR-800A) CARTRID 1.00 3,448,500.00
UF FLUORECELL SF (UFF-800A) CARTRID 1.00 3,811,500.00
SUB TOTAL 31/01/2022 : 62,095,402.22
SUB TOTAL Penerimaan Gudang (Supplier) : 2,154,568,024.07
SUB TOTAL UNIT UPPFS : 2,213,788,272.37
TOTAL : 2,213,788,272.37 2,152,488,811.85
selisih
KET
=NF - NILAI
0.00 21,615,000.00
0.00 39,999,190.00
18.75 147,999,981.25
0.01
0.00
0.00
0.00 25,344,000.00
0.00 23,197,350.00
0.00 124,337,950.00
22.00 9,757,000.00
-306.90
0.00
0.00
0.00
0.00
0.00
0.00
0.00
-0.30 27,589,554.30
0.00 1,152,800.00
0.00 9,597,500.00
0.00 9,292,250.00
-0.40 61,088,262.40
0.00 8,471,100.00
0.00
0.00 5,776,100.00
0.00
0.00
0.00
0.00 112,459,457.00
0.00
0.00 25,344,000.00
0.00
0.00 12,358,500.00
0.00
0.00 9,966,000.00
0.00
0.00
0.00 28,173,200.00
0.00 150,876,000.00
0.00
0.00 63,360,000.00
0.00
-0.20
0.00
55.00 89,100,000.00
0.00 12,474,000.00
0.00
0.00
0.00 41,046,500.00
0.00
0.00 6,105,000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.32
0.00
-0.50 37,473,287.50
0.00 12,641,200.00
-212.22
Telp. 031- 5501259 / 5501239
Faks. 031 - 5501571
PERIODE : 01/01/2022 s.d 31/01/2022
Tgl. Cetak : 02/03/2022 14:12
NAMA TGL HIBAH NOMINAL selisih
NO KELOMPOK BARANG NAMA PBF NO FAKTUR KODE BARANG NAMA BARANG SATUAN KET
TRANSAKSI TRANSAKSI QTY NILAI BATCH =NB - NILAI
1. UNIT : UPPFS
Badan
1 Penerimaan 04/01/2022 BANSOS COVID - 19 Badan Penanggulangan Bencana Daerah Penanggulangan 2OSCO40789J RAPID TEST ANTIGEN TEST 2,500.00 212,062,500.00
dari Pihak Luar Bencana Daerah (SUMBANGAN)
SUB TOTAL BANSOS COVID - 19 04/01/2022 : 212,062,500.00
SUB TOTAL 04/01/2022 : 212,062,500.00
1 05/01/2022 DIAGNOSTIC (SUSPECT TB Dinkes Surabaya Dinkes Surabaya 2OSDX002073 PPD 2 TU (PPD RT 23)-Sumbangan VIAL 10.00 6,883,800.00
MDR)
SUB TOTAL DIAGNOSTIC (SUSPECT TB MDR) 05/01/2022 : 6,883,800.00
2 Dinkes Surabaya Dinkes Surabaya 2OSIO033357 COTRIMOXAZOLE 960MG (FORTE) KAPLET 300.00 97,500.00
KAPLET (IO)
SUB TOTAL INFEKSI OPORTUNISTIK-KEMENKES 05/01/2022 : 97,500.00
3 OAT OB-DINKES KOTA SBY Dinkes Surabaya Dinkes Surabaya 2OBOB230001 OAT Kategori Anak(B) PAKET 2.00 496,240.00
SUB TOTAL OAT OB-DINKES KOTA SBY 05/01/2022 : 496,240.00
4 VAKSIN Dinkes Surabaya Dinkes Surabaya 2OSVK018042 VAKSIN COVID 19 ASTRA ZENECA VIAL 2.00 1,723,273.66
SUB TOTAL VAKSIN 05/01/2022 : 1,723,273.66
SUB TOTAL 05/01/2022 : 9,200,813.66
1 07/01/2022 DIAGNOSTIC (SUSPECT TB RSUD Sidoarjo RSUD Sidoarjo 2OSDX025TBR AMESOL 250 MG (B) TABLET 200.00 98,600.00
MDR)
2 RS M Nuir Pamekasan RS M Nuir 2OSDX025TBR AMESOL 250 MG (B) TABLET 300.00 147,900.00
Pamekasan
SUB TOTAL DIAGNOSTIC (SUSPECT TB MDR) 07/01/2022 : 246,500.00
SUB TOTAL 07/01/2022 : 246,500.00
1 11/01/2022 DIAGNOSTIC (SUSPECT TB Dinkes Jatim Dinkes Jatim 2OSDX025TBR AMESOL 250 MG (B) TABLET 2,300.00 966,000.00
MDR)
2 Dinkes Jatim Dinkes Jatim 2OSDX028291 ISONIAZID 300MG (B) TABLET 400.00 60,000.00
5 Dinkes Jatim Dinkes Jatim 2OSDX030891 LEVOFLOXACIN (LFX) 100MG (DT) TABLET 500.00 1,876,000.00
(B)
6 Dinkes Jatim Dinkes Jatim 2OSDX026MDR LINEZOLID 600 MG TAB (B) TABLET 8,000.00 94,624,000.00
7 Dinkes Jatim Dinkes Jatim 2OSDX029HOL PYRAZINAMIDE 500 MG TABLET TABLET 13,100.00 3,013,000.00
(B)
8 Dinkes Jatim Dinkes Jatim 2OSDX024IFI VITAMIN B6 25MG (B) TABLET 44,000.00 9,768,000.00
SUB TOTAL DIAGNOSTIC (SUSPECT TB MDR) 11/01/2022 : 110,472,000.00
9 MALARIA OB-DINKES JATIM Dinkes Jatim Dinkes Jatim 2OBMA009357 DHP-FRIMAL TAB (B) TABLET 36.00 68,400.00
SUB TOTAL MALARIA OB-DINKES JATIM 11/01/2022 : 68,400.00
10 TB LINI KE DUA OB- Dinkes Jatim Dinkes Jatim 2OSOS052885 Cycloserin 250mg (B) TAB 2,500.00 9,850,000.00
KEMENKES RI
11 Dinkes Jatim Dinkes Jatim 2OSOS052885 Cycloserin 250mg (B) TAB 16,500.00 68,343,000.00
12 Dinkes Jatim Dinkes Jatim 2OSOS048885 Ethambutol 400 mg (B) TAB 10,080.00 4,667,040.00
13 Dinkes Jatim Dinkes Jatim 2OSOS048885 Ethambutol 400 mg (B) TAB 7,392.00 3,422,496.00
PERIODE : 01/01/2022 s.d 31/01/2022
Tgl. Cetak : 02/03/2022 14:12
1. UNIT : UPPFS
14 Dinkes Jatim Dinkes Jatim 2OSOS011885 Ethionamid 250 mg MDR (B) TAB 1,600.00 2,286,400.00
15 Dinkes Jatim Dinkes Jatim 2OSOS011885 Ethionamid 250 mg MDR (B) TAB 3,300.00 4,715,700.00
16 TB LINI KE DUA OB- Dinkes Jatim Dinkes Jatim 2OSOA041399 LAMPRENE (Clofazimine) 100 mg TAB 1,700.00 13,547,300.00
KEMENKES RI (B)
17 Dinkes Jatim Dinkes Jatim 2OSOA041399 LAMPRENE (Clofazimine) 100 mg TAB 12,300.00 93,750,600.00
(B)
18 TB LINI KE DUA OB- Dinkes Jatim Dinkes Jatim 2OSOS013885 Levofloxacin 250 mg (B) CAPL 38,700.00 16,254,000.00
KEMENKES RI
19 TB LINI KE DUA OB- Dinkes Jatim Dinkes Jatim 2OSOA042000 SIRTURO (Bedaquiline ) 100 mg TAB 188.00 6,448,400.00
KEMENKES RI (B)
20 Dinkes Jatim Dinkes Jatim 2OSOA042000 SIRTURO (Bedaquiline ) 100 mg TAB 7,708.00 264,384,400.00
(B)
SUB TOTAL TB LINI KE DUA OB-KEMENKES RI 11/01/2022 : 487,669,336.00
21 VAKSIN Dinkes Surabaya Dinkes Surabaya 2OSVK018042 VAKSIN COVID 19 ASTRA ZENECA VIAL 1.00 861,636.83
SUB TOTAL VAKSIN 11/01/2022 : 861,636.83
SUB TOTAL 11/01/2022 : 599,071,372.83
1 12/01/2022 BANSOS COVID - 19 Dinkes Surabaya Dinkes Surabaya 2OSCO343001 ALAT SUNTIK PAKAI 0,5 ML PCS 100.00 105,000.00
(SUMBANGAN)
2 Dinkes Surabaya Dinkes Surabaya 2OSCO346001 ALKOHOL SWAB (SUMBANGAN) PCS 200.00 19,500.00
Badan
3 Badan Penanggulangan Bencana Daerah Penanggulangan 2OSCO40789J RAPID TEST ANTIGEN TEST 1,000.00 84,825,000.00
Bencana Daerah (SUMBANGAN)
4 Dinkes Surabaya Dinkes Surabaya 2OSVK018042 VAKSIN COVID 19 ASTRA ZENECA VIAL 8.00 6,893,094.64
5 Dinkes Surabaya Dinkes Surabaya 2OSVK021001 VAKSIN COVID-19 MODERNA VIAL 1.00 318,304.00
(SUMBANGAN)
SUB TOTAL VAKSIN 12/01/2022 : 7,211,398.64
SUB TOTAL 12/01/2022 : 92,160,898.64
1 13/01/2022 ARV OB-SUBDIT. AID. Dinkes Surabaya Dinkes Surabaya 2OSOA065LDF ACRIPTEGA TABLET (B) TABLET 3,240.00 11,336,760.00
KEMENKES
2 Dinkes Surabaya Dinkes Surabaya 2OSOA065LDF ACRIPTEGA TABLET (B) TABLET 12,960.00 45,347,040.00
3 Dinkes Surabaya Dinkes Surabaya 2OSOA059AR3 DOLUTEGRAVIR 50MG TAB (B) TABLET 300.00 405,159.00
4 Dinkes Surabaya Dinkes Surabaya 2OSOA058AR2 EFAVIRENZ 200 MG TABLETS (B) TABLET 1,800.00 3,166,704.00
5 ARV OB-SUBDIT. AID. Dinkes Surabaya Dinkes Surabaya 2OSOA037291 EFAVIRENZ 600 (B) TAB 2,250.00 14,917,500.00
KEMENKES
6 Dinkes Surabaya Dinkes Surabaya 2OSOA037291 EFAVIRENZ 600 (B) TAB 4,320.00 28,641,600.00
10 ARV OB-SUBDIT. AID. Dinkes Surabaya Dinkes Surabaya 2OSOA062AR3 FORSTAVIR-EM KAPLET (B) KAPLET 1,260.00 5,833,800.00
KEMENKES
11 Dinkes Surabaya Dinkes Surabaya 2OSOA056291 LAMIVUDINE 150 MG + KAPLET 4,500.00 17,316,000.00
ZIDOVUDINE 300 MG KA
PERIODE : 01/01/2022 s.d 31/01/2022
Tgl. Cetak : 02/03/2022 14:12
1. UNIT : UPPFS
16 Dinkes Surabaya Dinkes Surabaya 2OSOA066SRI LOPIVIA 200MG / 50MG (B) TABLET 5,280.00 27,192,000.00
17 Dinkes Surabaya Dinkes Surabaya 2OSOA066SRI LOPIVIA 200MG / 50MG (B) TABLET 33,600.00 173,040,000.00
18 Dinkes Surabaya Dinkes Surabaya 2OSOA039291 Neviraphine 200MG (B) TAB 2,040.00 4,926,600.00
SUB TOTAL ARV OB-SUBDIT. AID. KEMENKES 13/01/2022 : 626,662,683.00
21 Dinkes Surabaya Dinkes Surabaya 2OSIO024001 Benzatinbenzil penisilin 2,4 JT AMPUL 45.00 652,500.00
(IO) (B)
SUB TOTAL INFEKSI OPORTUNISTIK-KEMENKES 13/01/2022 : 652,500.00
22 Dinkes Surabaya Dinkes Surabaya 2OSVK008001 VAKSIN HB+ADS(HEPATITIS B VIAL 100.00 2,583,900.00
IMUNOGLOBULIN
SUB TOTAL VAKSIN 13/01/2022 : 2,583,900.00
SUB TOTAL 13/01/2022 : 629,899,083.00
1 21/01/2022 HEPATITIS C Dinkes Surabaya Dinkes Surabaya 2OSHC010LDF MYHEP 400MG TAB (B) TABLET 1,176.00 13,529,880.00
SUB TOTAL HEPATITIS C 21/01/2022 : 13,529,880.00
2 One Med/Inti Sumber PT. PT. Intisumber Hasil Sempurna PT. Intisumber Hasil 2DNIH003415 Bracket Bed Nylon PCS 100.00 2,926,000.00
Sempurna
SUB TOTAL One Med/Inti Sumber PT. 21/01/2022 : 2,926,000.00
3 REAGEN HIV Dinkes Surabaya Dinkes Surabaya 2OSSR02612P VIROCHECK HIV 1/2 TEST 250.00 2,006,000.00
SUB TOTAL REAGEN HIV 21/01/2022 : 2,006,000.00
SUB TOTAL 21/01/2022 : 18,461,880.00
1 24/01/2022 HEPATITIS C Dinkes Jatim Dinkes Jatim 2OSHC004001 HCV VIRAL LOAD ( CARTRIDGE BIJI 120.00 47,340,000.00
HCV VL)
SUB TOTAL HEPATITIS C 24/01/2022 : 47,340,000.00
SUB TOTAL 24/01/2022 : 47,340,000.00
1 25/01/2022 Kalbe Farma, PT - Donasi Bantuan Sosial Bantuan Sosial 2DNKB002279 HERZEMAB 440MG INJEKSI VIAL 2.00 12,416,000.00
SUB TOTAL Kalbe Farma, PT - Donasi 25/01/2022 : 12,416,000.00
SUB TOTAL 25/01/2022 : 12,416,000.00
1 27/01/2022 ALK. BANTUAN EX DINKES Dinkes Surabaya Dinkes Surabaya 2ASPR08428P ALAT SUNTIK PAKAI 0.3 ML PCS 200.00 251,000.00
JATIM (SUMBANGAN)
SUB TOTAL ALK. BANTUAN EX DINKES JATIM 27/01/2022 : 251,000.00
2 ALKES BANTUAN KEMENKES Dinkes Surabaya Dinkes Surabaya 2OSAK02119P ALAT SUNTIK SEKALI PAKAI 2,5ML PCS 10.00 5,690.00
(SUMBANGA
3 Dinkes Surabaya Dinkes Surabaya 2OSAK022428 NATRIUM KLORIDA 0,9% 10ML BTL 10.00 32,800.00
(SUMBANGAN)
SUB TOTAL ALKES BANTUAN KEMENKES 27/01/2022 : 38,490.00
4 Dinkes Surabaya Dinkes Surabaya 2OSCO346001 ALKOHOL SWAB (SUMBANGAN) PCS 200.00 15,800.00
SUB TOTAL BANSOS COVID - 19 27/01/2022 : 15,800.00
5 Dinkes Surabaya Dinkes Surabaya 2OSVK022439 VAKSIN COVID 19 PFIZER VIAL 10.00 960,000.00
(SUMBANGAN)
6 Dinkes Surabaya Dinkes Surabaya 2OSVK021001 VAKSIN COVID-19 MODERNA VIAL 1.00 318,304.00
(SUMBANGAN)
SUB TOTAL VAKSIN 27/01/2022 : 1,278,304.00
PERIODE : 01/01/2022 s.d 31/01/2022
Tgl. Cetak : 02/03/2022 14:12
1. UNIT : UPPFS
SUB TOTAL 27/01/2022 : 1,583,594.00

1 28/01/2022 NARKOTIKA OB-KEMENKES Kemenkes Kemenkes 2OBOB199291 Methadon HCl 1% @1 lt(B) FLS 10.00 2,860,000.00
RI
2 Kemenkes Kemenkes 2OBOB199291 Methadon HCl 1% @1 lt(B) FLS 25.00 7,150,000.00
SUB TOTAL NARKOTIKA OB-KEMENKES RI 28/01/2022 : 10,010,000.00
SUB TOTAL 28/01/2022 : 10,010,000.00
SUB TOTAL Penerimaan dari Pihak Luar : 1,632,452,642.13
Penerimaan
1 Retur Dari 13/01/2022 BANSOS COVID - 19 IGD LT.1 - UPPFS IGD LT.1 - UPPFS 2OSCO307291 FAVIPIRAVIR 200MG TABLET TABLET 74.00 1,098,900.00
Unit (SUMB)
SUB TOTAL 13/01/2022 : 1,098,900.00
SUB TOTAL Penerimaan Retur Dari Unit : 1,098,900.00
SUB TOTAL UNIT UPPFS : 1,633,551,542.13
TOTAL : 1,633,551,542.13
Telp. 031- 5501259 / 5501239
Faks. 031 - 5501571
PENYEDIA : PENYEDIA BLUD
PERIODE : 01/01/2022 s.d 31/01/2022
Tgl. Cetak :
02/03/2022 14:10
TGL
NO TRANSAK NAMA PBF NO FAKTUR NAMA BARANG
SI
PT.ANUGRAH ARGON
18 362 491222011782 AROMASIN 25MG S
MEDICA
PT.ANUGRAH ARGON
19 363 491222011782 AROMASIN 25MG S
MEDICA
PT.ANUGRAH ARGON
20 365 491222011782 AROMASIN 25MG S
MEDICA
PT.ANUGRAH ARGON
22 371 491222011822 BICASTRA 50MG TABLET S
MEDICA
6 PARIT PADANG 94 8340589517 BORTERO 3.5MG INJ S
PT.ANUGRAH ARGON
23 372 491222011822 BRACER 1 MG TABLET S
MEDICA
PT.ANUGRAH ARGON
24 373 491222011822 BRACER 1 MG TABLET S
MEDICA
PT.ENSEVAL PUTERA
44 301 322000496 BREXEL 80MG INJ S
MEGATRADING TBK
PT.ENSEVAL PUTERA
25 400 322000524 CALCIUM FOLINAT 50MG INJ S
MEGATRADING TBK
PT.ANUGRAH ARGON
26 366 491222011782 CAMPTO 40MIU/1ML INJ S
MEDICA
PT.ANUGRAH ARGON
27 374 491222011822 CARBOPLATIN 450 MG INJ S
MEDICA
PT.ANUGRAH ARGON
28 375 491222011822 CARBOPLATIN 450 MG INJ S
MEDICA
PT.ENSEVAL PUTERA
29 397 322000524 carboPLATIN 450/KALBE S
MEGATRADING TBK
PT.ENSEVAL PUTERA
30 398 322000524 carboPLATIN 450/KALBE S
MEGATRADING TBK
PT.ENSEVAL PUTERA
7 151 322000507 cISPLAtin 50MG INJ S
MEGATRADING TBK
PT.ENSEVAL PUTERA
49 304 322000496 cISPLAtin 50MG INJ S
MEGATRADING TBK
PT.ANUGRAH ARGON
14 183 491222009759 cISPLAtin 50MG/50MLINJ S
MEDICA
PT.ANUGRAH ARGON
MEDICA
PT.ANUGRAH ARGON
MEDICA
PT.ANUGRAH ARGON
37 378 491222011822 DOCETAXEL 80 MG INJEKSI S
MEDICA
PT.ENSEVAL PUTERA
53 298 322000496 doxoruBICIN 50MG/KALBE S
MEGATRADING TBK
PT.ENSEVAL PUTERA
54 300 322000496 doxoruBICIN 50MG/KALBE S
MEGATRADING
PT.ANUGERAH TBK
22 466 1400939528 ENDOXAN 1 GR INJ S
PHARMINDO
PT.ANUGERAHLESTARI
23 467 1400939528 ENDOXAN 1 GR INJ S
PHARMINDO
PT.ANUGERAHLESTARI
24 468 1400939528 ENDOXAN 1 GR INJ S
PHARMINDO
PT.ENSEVAL LESTARI
PUTERA
55 305 322000494 ENDROLIN INJ S
MEGATRADING TBK
PT.ENSEVAL PUTERA
57 302 322000496 EPIRUBICIN 50MG/KALBE S
MEGATRADING TBK
PT.ANUGRAH ARGON
38 379 491222011822 EPIRUBICIN HCL 50 MG S
MEDICA
PT.ANUGERAH
5 74 1400926258 ERBITUX 100MG INJ S
PHARMINDO
PT.ANUGERAHLESTARI
6 117 1400929316 ERBITUX 100MG INJ S
PHARMINDO
PT.ANUGERAHLESTARI
17 237 1400935230 ERBITUX 100MG INJ S
PHARMINDO
PT.ANUGERAHLESTARI
5 497 1400940559 ERBITUX 100MG INJ S
PHARMINDO LESTARI
39 PARIT PADANG 423 8340593160 ERLONAT 150MG TAB S
40 PARIT PADANG 424 8340593160 ERLONAT 150MG TAB S
18 RSAL 238 UP2501221 ETOPUL INJ S
19 APOTEK MEDICASTORE 239 UP2501222 ETOPUL INJ S
PT.ANUGRAH ARGON
41 380 491222011822 FONKOGEM 1000MG INJ S
MEDICA
PT.ANUGRAH ARGON
20 184 491222011213 FONKOPAC 300MG S
MEDICA
PT.ANUGRAH ARGON
42 381 491222011822 FONTREXED 500MG INJEKSI S
MEDICA
PT.ANUGRAH ARGON
43 382 491222011822 FONTREXED 500MG INJEKSI S
MEDICA
TGL
NO TRANSAK NAMA PBF NO FAKTUR NAMA BARANG
SI
PT.ANUGERAH
29 486 1400939496 FUPLATIN 450MG INJ S
PHARMINDO LESTARI
20 PARIT PADANG 240 8340592388 GEFITERO 250MG TAB S
PT.ENSEVAL PUTERA
10 152 322000507 GEMCIKAL 1000MG INJ S
MEGATRADING TBK
61 MENSA BINA SUKSES,PT 325 CD220094508 GEMCITABINE HCL 1GRAM INJ S
PT.ENSEVAL PUTERA
22 231 322000472 HERZEMAB 440MG INJEKSI S
MEGATRADING
PT.ANUGERAH TBK
3 82 1400926746 HOLOXAN 2G S
PHARMINDO
PT.ANUGERAHLESTARI
4 83 1400926746 HOLOXAN 2G S
PHARMINDO
PT.ANUGERAHLESTARI
23 245 1400935235 HOLOXAN 2G S
PHARMINDO
PT.ANUGERAHLESTARI
48 432 1400937654 IMURAN 50 MG TAB S
PHARMINDO
PT.ANUGERAHLESTARI
49 433 1400937654 IMURAN 50 MG TAB S
PHARMINDO
PT.ANUGERAHLESTARI
3 28 1400919744 KABITARIN 1000 MG INJ S
PHARMINDO
PT.ANUGERAHLESTARI
36 490 1400942420 KABITARIN 1000 MG INJ S
PHARMINDO
PT.ANUGRAHLESTARI
ARGON
54 386 491222011822 LEBREST 2.5MG S
MEDICA
PT.ANUGRAH ARGON
55 387 491222011822 LEBREST 2.5MG S
MEDICA
PT.ENSEVAL PUTERA
76 303 322000496 METHOTREXATE 50MG INJ S
MEGATRADING
PT.ANUGERAH TBK
13 53 1400927800 NAVELBIN 10MG INJ S
PHARMINDO
PT.ANUGERAHLESTARI
14 54 1400927800 NAVELBIN 10MG INJ S
PHARMINDO
PT.ANUGERAHLESTARI
13 136 1400937103 NAVELBIN 10MG INJ S
PHARMINDO
PT.ANUGERAHLESTARI
26 248 1400935284 NAVELBIN 10MG INJ S
PHARMINDO
PT.ANUGRAHLESTARI
ARGON
65 389 491222011822 REDDITUX 500MG INJ S
MEDICA
PT.ENSEVAL PUTERA
85 299 322000496 REXTA 100 MG INJ S
MEGATRADING TBK
PT.ENSEVAL PUTERA
86 307 322000494 RITUXIKAL 500MG S
MEGATRADING
PT.ANUGERAH TBK
88 346 1400937535 SURVANTA INJ S
PHARMINDO
PT.ANUGERAHLESTARI
89 347 1400937535 SURVANTA INJ S
PHARMINDO LESTARI
31 PARIT PADANG 243 8340592388 TEMOTERO 100MG CAP S
PT.ENSEVAL PUTERA
18 511 122015565 THERACIM 50MG INJ S
MEGATRADING TBK
PT.ENSEVAL PUTERA
19 512 122015565 THERACIM 50MG INJ S
MEGATRADING TBK
PT.ANUGRAH ARGON
21 109 491222005851 TYKERB TAB 250MG S
MEDICA
PT.ANUGRAH ARGON
22 110 491222005851 TYKERB TAB 250MG S
MEDICA
PT.ANUGERAH
8 86 1400926746 UROMITEXAN 400MG S
PHARMINDO
PT.ANUGERAHLESTARI
33 246 1400935235 UROMITEXAN 400MG S
PHARMINDO
PT.ENSEVAL LESTARI
PUTERA
85 401 322000524 VINCRISTINE 2MG INJ S
MEGATRADING TBK
PT.ENSEVAL PUTERA
86 402 322000524 VINCRISTINE 2MG INJ S
MEGATRADING TBK
PT.ENSEVAL PUTERA
93 321 322000495 VINORKAL INJ S
MEGATRADING TBK
PT.ENSEVAL PUTERA
94 322 322000495 VINORKAL INJ S
MEGATRADING
PT.ANUGERAH TBK
56 482 1400939368 ZOLADEX 10.8MG INJ S
PHARMINDO
PT.ANUGERAHLESTARI
57 483 1400939368 ZOLADEX INJ 3,6MG S
PHARMINDO
PT.ANUGERAHLESTARI
58 484 1400939368 ZOLADEX INJ 3,6MG S
PHARMINDO
PT.ANUGRAHLESTARI
ARGON
87 385 491222011822 ZOMETA 4MG/100ML INJ S
MEDICA
MBAH
SATUAN BERTAMBAH NOMINAL

QTY NILAI SELISIH FAKTUR
TAB 180.00 8,064,000.00 8,064,000.00 0.00
TAB 3,780.00 169,344,000.00 169,344,000.00 0.00
TAB 30.00 1,344,000.00 1,344,000.00 0.00
TABLET 1,020.00 7,344,000.00 7,344,000.00 0.00
VIAL 1.00 2,004,750.00 1,151,400.00 853,350.00 3,694,350.00
VIAL 1.00 2,004,750.00 1,151,400.00 853,350.00 2,004,750.00
VIAL 1.00 2,004,750.00 1,151,400.00 853,350.00 9,396,750.00
TABLET 300.00 984,000.00 984,000.00 0.00
TABLET 6,720.00 22,041,600.00 22,041,600.00 0.00
VIAL 10.00 6,790,003.00 6,790,000.00 3.00
VIAL 600.00 16,732,980.00 16,732,800.00 180.00
VIAL 35.00 11,497,010.00 11,497,010.00 0.00 442,969,010.00
VIAL 39.00 11,235,510.00 11,235,510.00 0.00
VIAL 81.00 23,335,290.00 23,335,290.00 0.00
VIAL 5.00 1,440,450.00 1,440,450.00 0.00
VIAL 45.00 12,964,050.00 12,964,050.00 0.00
VIAL 50.00 4,494,215.00 4,494,200.00 15.00
VIAL 100.00 8,988,430.00 8,988,400.00 30.00 72,373,928.50
VIAL 200.00 17,976,800.00 17,976,800.00 0.00 17,976,800.00
VIAL 22.00 1,977,448.00 1,977,448.00 0.00
VIAL 50.00 4,494,200.00 4,494,200.00 0.00
VIAL 60.00 40,740,000.00 40,740,000.00 0.00
VIAL 6.00 1,325,214.00 1,325,214.00 0.00
VIAL 74.00 16,344,306.00 16,344,306.00 0.00
VIAL 53.00 10,785,500.00 10,785,500.00 0.00 152,625,000.00
VIAL 157.00 31,949,500.00 31,949,500.00 0.00
VIAL 540.00 109,890,000.00 109,890,000.00 0.00
VIAL 30.00 16,043,973.00 16,043,970.00 3.00
VIAL 45.00 18,551,263.50 18,551,250.00 13.50
VIAL 45.00 18,551,250.00 18,551,250.00 0.00
VIAL 4.00 9,800,001.20 9,800,000.00 1.20 9,800,001.00
VIAL 4.00 9,800,001.20 9,800,000.00 1.20 9,800,001.00
VIAL 4.00 9,800,001.20 9,800,000.00 1.20 9,800,001.00
VIAL 16.00 39,200,004.80 39,200,000.00 4.80 39,200,004.00
TAB 30.00 1,244,100.00 1,244,100.00 0.00 69,017,430.00
TAB 900.00 37,323,000.00 37,323,000.00 0.00
AMP 5.00 773,000.00 417,500.00 773,000.00
AMP 15.00 1,823,250.00 0.00 1,823,250.00
AMP 15.00 1,823,250.00 0.00 1,823,250.00
AMP 15.00 1,823,250.00 0.00 1,823,250.00
BOX/1 30.00 9,220,499.40 9,220,500.00 -0.60
VIAL 100.00 43,213,500.00 145,451,500.00 -102,238,000.00 43,213,500.00
VIAL 6.00 10,798,656.00 10,798,656.00 0.00
VIAL 23.00 41,394,848.00 41,394,848.00 0.00
SATUAN BERTAMBAH NOMINAL
QTY NILAI SELISIH FAKTUR
VIAL 48.00 13,828,320.00 13,828,320.00 0.00 13,828,320.00
TAB 2,010.00 103,143,150.00 103,143,150.00 0.00 136,863,150.00
VIAL 30.00 9,220,497.00 9,220,500.00 -3.00 13,714,712.00
VIAL 20.00 5,993,323.00 6,147,000.00 -153,677.00 5,993,323.05
VIAL 20.00 124,159,992.00 124,160,000.00 -8.00 124,159,992.00
VIAL 50.00 112,662,000.00 112,662,000.00 0.00 228,854,791.00
VIAL 24.00 54,077,760.00 54,077,760.00 0.00
VIAL 26.00 58,584,240.00 58,584,240.00 0.00 84,519,259.00
TABLET 5,800.00 43,442,000.00 43,442,000.00 0.00 139,848,610.00
TABLET 12,200.00 91,378,000.00 91,378,000.00 0.00
VIAL 17.00 9,696,043.50 9,695,950.00 93.50 9,696,043.00
VIAL 20.00 11,407,110.00 11,407,000.00 110.00 11,407,110.00
TABLET 4,950.00 9,306,000.00 9,306,000.00 0.00
TABLET 5,070.00 9,531,600.00 9,531,600.00 0.00
AMP 50.00 1,775,015.00 1,775,000.00 15.00
VIAL 10.00 4,768,896.00 4,768,900.00 -4.00 8,584,012.00
VIAL 8.00 3,815,116.80 3,815,120.00 -3.20
VIAL 50.00 23,844,480.00 23,844,500.00 -20.00 23,844,480.00
VIAL 38.00 18,121,804.80 18,121,820.00 -15.20 18,121,804.00
VIAL 15.00 101,122,499.40 101,122,500.00 -0.60
VIAL/1 30.00 14,549,997.00 14,550,000.00 -3.00
VIAL 5.00 33,707,498.00 33,707,500.00 -2.00
VIAL 22.00 75,900,008.80 75,900,000.00 8.80 89,700,010.00
VIAL 4.00 13,800,001.60 13,800,000.00 1.60
CAP 80.00 19,792,000.00 19,792,000.00 0.00
VIAL 4.00 12,941,775.00 0.00 12,941,775.00
VIAL 4.00 12,941,775.00 0.00 12,941,775.00 25,883,550.00
TABLET 2,030.00 111,650,000.00 111,650,000.00 0.00
TABLET 1,540.00 84,700,000.00 84,700,000.00 0.00
AMPUL 165.00 15,015,009.90 15,015,000.00 9.90
AMPUL 285.00 25,935,017.10 25,935,000.00 17.10
VIAL 44.00 3,836,813.20 3,836,800.00 13.20
VIAL 56.00 4,883,216.80 4,883,200.00 16.80 253,600,459.80
VIAL 4.00 1,907,558.40 1,907,560.00 -1.60
VIAL 36.00 17,168,025.60 17,168,040.00 -14.40 19,075,584.00
VIAL 20.00 55,284,240.00 55,284,240.00 0.00
AMPUL 3.00 2,964,776.10 2,964,777.00 -0.90
AMPUL 97.00 95,861,093.90 95,861,123.00 -29.10
BOTOL 84.00 135,240,000.00 135,240,000.00 0.00
selisih beli klaim
=NF - NILAI HARGA EKAT
44,800.00 44,800.00 0.00
44,800.00 44,800.00 0.00
44,800.00 44,800.00 0.00
7,200.00 7,200.00 0.00
-315,150.00 4,009,500.00 2,004,750.00 1,151,400 ###
0.00 2,004,750.00 1,151,400 ###
6,408,000.00 2,988,750.00 2,004,750.00 1,151,400 ###
3,280.00 3,280.00 0.00
3,280.00 3,280.00 0.00
679,000.30 679,000.00 -0.30
27,888.30 27,888.00 -0.30
411,397,770.00 31,571,240.00 328,486.00 328,486.00 0.00
288,090.00 288,090.00 0.00
288,090.00 288,090.00 0.00
288,090.00 288,090.00 0.00
288,090.00 288,090.00 0.00
89,884.30 89,884.00 -0.30
9,082,975.10 63,290,953.40 89,884.30 89,884.00 -0.30
0.00 89,884.00 89,884.00 0.00
89,884.00 89,884.00 0.00
89,884.00 89,884.00 0.00
679,000.00 679,000.00 0.00
220,869.00 220,869.00 0.00
220,869.00 220,869.00 0.00
0.00 152,625,000.00 203,500.00 203,500.00 0.00
203,500.00 203,500.00 0.00
203,500.00 203,500.00 0.00
534,799.10 534,799.00 -0.10
412,250.30 412,250.00 -0.30
412,250.00 412,250.00 0.00
-0.20 2,450,000.30 2,450,000 -0.30
-0.20 2,450,000.30 2,450,000 -0.30
-0.20 2,450,000.30 2,450,000 -0.30
-0.80 2,450,000.30 2,450,000 -0.30
15,358,039.00 53,659,391.00 41,470.00 41,470.00 0.00
41,470.00 41,470.00 0.00
0.00 154,600.00 83,500.00 ###
0.00 121,550.00 ###
0.00 121,550.00 ###
0.00 121,550.00 ###
307,349.98 307,350.00 0.02
0.00 432,135.00 1,454,515.00 ###
1,799,776.00 1,799,776.00 0.00
1,799,776.00 1,799,776.00 0.00
selisih beli klaim
=NF - NILAI HARGA EKAT
0.00 288,090.00 288,090.00 0.00
-47,576,495.61 184,439,645.61 51,315.00 51,315.00 0.00
-64,101,252.49 77,815,964.49 307,349.90 307,350.00 0.10
0.05 299,666.15 307,350.00 ###
0.00 6,207,999.60 6,208,000.00 0.40
-237,294,123.00 466,148,914.00 2,253,240.00 2,253,240.00 0.00
2,253,240.00 2,253,240.00 0.00
-22,464,981.00 106,984,240.00 2,253,240.00 2,253,240.00 0.00
-4,786,910.00 144,635,520.00 7,490.00 7,490.00 0.00
7,490.00 7,490.00 0.00
-0.50 570,355.50 570,350.00 -5.50
0.00 570,355.50 570,350.00 -5.50
1,880.00 1,880.00 0.00
1,880.00 1,880.00 0.00
35,500.30 35,500.00 -0.30
-0.80 8,584,012.80 476,889.60 476,890.00 0.40
476,889.60 476,890.00 0.40
0.00 476,889.60 476,890.00 0.40
-0.80 476,889.60 476,890.00 0.40
6,741,499.96 6,741,500.00 0.04
484,999.90 485,000.00 0.10
6,741,499.60 6,741,500.00 0.40
-0.40 89,700,010.40 3,450,000.40 3,450,000.00 -0.40
3,450,000.40 3,450,000.00 -0.40
247,400.00 247,400.00 0.00
3,235,443.75 ### px umum
0.00 25,883,550.00 3,235,443.75 ### px umum
55,000.00 55,000.00 0.00
55,000.00 55,000.00 0.00
91,000.06 91,000.00 -0.06
91,000.06 91,000.00 -0.06
87,200.30 87,200.00 -0.30
203,652,929.50 49,947,530.30 87,200.30 87,200.00 -0.30
476,889.60 476,890.00 0.40
0.00 19,075,584.00 476,889.60 476,890.00 0.40
2,764,212.00 2,764,212.00 0.00
988,258.70 988,259.00 0.30
988,258.70 988,259.00 0.30
1,610,000.00 1,610,000.00 0.00

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1-Jan&#39;22 Rekon Breakdown

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RS. UMUM DAERAH DR.

NO TGL TRANSAKSI NAMA GOLONGAN NAMA PBF NO FAKTUR

1 14/01/2022 ALKES UPPFS

1 24/01/2022 OBAT UPPFS

SUB TOTAL Otom

1 02/01/2022 OBAT APOTEK OSCAR 2 UP0201223

1 03/01/2022 OBAT APOTEK KIMIA FARMA 24 UP0301221

1 04/01/2022 OBAT APOTEK KIMIA FARMA 24 UP0401221

1 05/01/2022 OBAT APOTEK KIMIA FARMA 24 UP0501221

1 06/01/2022 OBAT PT.ANUGRAH ARGON MEDICA 491222003987

1 07/01/2022 OBAT APOTEK KIMIA FARMA 24 UP0701221

1 08/01/2022 OBAT PT.ENSEVAL PUTERA MEGATRADING TBK 322000188

1 10/01/2022 OBAT PARIT PADANG 8340586781

1 11/01/2022 ALKES PT.PERMATA BUNDA ARTANO 074/PB/TTB/KONS/01/2022

1 12/01/2022 ALKES PT.INTI SUMBER HASIL SEMPURNA NJKMJ220200807

4 PT.ENSEVAL PUTERA MEGATRADING TBK 322000202

1 15/01/2022 ALKES PT.BINA BAKTI MITRA GEMILANG FP-22-01580933

1 16/01/2022 OBAT APOTEK OSCAR 2 UP1601221

1 17/01/2022 ALKES PT.BERKEMBANG SELARAS DAYA BSD0001053

1 18/01/2022 ALKES PT.BERKAH PRIMA ABADI 035/BPA/I/2022

1 19/01/2022 ALKES PT.PERMATA BUNDA ARTANO PB/TTB/000345

2 20/01/2022 ALKES PT.ANUGERAH PHARMINDO LESTARI 1400950947

1 21/01/2022 ALKES PT.KARUNIA PHARMINDO S F1/I

1 22/01/2022 ALKES PT.TRANSMEDIC INDONESIA DN2200391

1 24/01/2022 ALKES PT.TRANSMEDIC INDONESIA IN2201634

1 25/01/2022 ALKES PT.ENSEVAL PUTERA MEGATRADING TBK 322000457

1 26/01/2022 ALKES PT.BISAWI TUMBUH SELARAS 0792/FKTR/BTS/I/2022

1 27/01/2022 ALKES PT.ENSEVAL PUTERA MEGATRADING TBK 322000508

1 28/01/2022 ALKES PT.SURGIKA ALKASINDO TT 280122

1 29/01/2022 ALKES PT.ANUGERAH PHARMINDO LESTARI 1400948813

1 31/01/2022 ALKES PT.MULYA HUSADA 78/F/II/22

BERTAMBAH NOMINAL selisih

NO TGL TRANSAKSI JENIS BARANG NAMA PBF NO FAKTUR

1 04/01/2022 ALKES STANDART UPPFI

1 06/01/2022 ALKES STANDART UPPFI

1 07/01/2022 OBAT DAN BAHAN OBAT UPPFI

1 10/01/2022 ALKES STANDART UPPFI

1 12/01/2022 OBAT DAN BAHAN OBAT UPPFI

1 17/01/2022 ALKES STANDART UPPFI

1 18/01/2022 ALKES STANDART UPPFI

1 24/01/2022 OBAT DAN BAHAN OBAT UPPFI

1 25/01/2022 ALKES STANDART UPPFI

1 26/01/2022 OBAT DAN BAHAN OBAT UPPFI

1 28/01/2022 OBAT DAN BAHAN OBAT UPPFI

1 31/01/2022 ALKES STANDART UPPFI

1 07/01/2022 ALKES STANDART PT.MILLENIUM PHARMACON 750522000008

1 08/01/2022 X-RAY & MATERI PT.MILITRUS MLT/SS/01/2022/00290

1 10/01/2022 ALKES STANDART PT.ABADI MAKMUR BERSAMA 26220

1 13/01/2022 BAHAN LABORATORIUM / PT.SABA INDOMEDIKA E000-2242863720

1 14/01/2022 ALKES STANDART PT.INDOFARMA GLOBAL MEDIKA 002/REAGEN/1/2022

1 15/01/2022 OBAT DAN BAHAN OBAT PT.ANUGRAH ARGON MEDICA 491222005286

1 17/01/2022 ALKES STANDART PT.MERAPI UTAMA PHARMA 220031003091

1 18/01/2022 OBAT DAN BAHAN OBAT PT.AMADEA DEVINA FARMA 003/FP.ADF/I/2022

1 19/01/2022 BAHAN LABORATORIUM / PT.MB.CITRA MEDIKA 0022-22.6647369

1 20/01/2022 BAHAN LABORATORIUM / PT.INDOFARMA GLOBAL MEDIKA 005/REAGEN/I/2022

1 21/01/2022 ALKES STANDART PT.INDOFARMA GLOBAL MEDIKA 009/REAGEN/I/2022

1 24/01/2022 BAHAN LABORATORIUM / PT.AMADEA DEVINA FARMA 004/FP.ADF/I/2022

1 25/01/2022 BAHAN LABORATORIUM / PT.SABA INDOMEDIKA DS2000969

1 26/01/2022 ALKES STANDART RAJAWALI NUSINDO FKT/SBA/

1 27/01/2022 ALKES STANDART PT.KARUNIA PHARMINDO S F4/1

1 28/01/2022 BAHAN LABORATORIUM / PT.MEDIA DIAGNOSTIKA 003-0122-51

1 29/01/2022 GAS MEDIS PT.ANEKA GAS INDUSTRI 293196044

1 31/01/2022 ALKES STANDART PT.MENSA BINASUKSES CD220096049

SPUIT 50 CC LBG TENGAH HD PCS 100.00 467,300.00

1-Jan'22 Rekon Breakdown

1-Jan'22 Rekon Breakdown