Jual Karpet Masjid Di Jakarta

Laporan Penjualan Umum
Periode 29 - 31 Mei 2017

Apotek Telemedika Farma 16 Jl. Percetakan Negara No.17A Jakarta Pusat
2 3 4 5 6 7 8 9 10 11 12 13
Nomor Nama Tanggal Kode Nama Nama Harga Diskon Margin Total Nomor Nomor Total
No Nomor Resep NIKKES Nama Peserta Tanggal Transaksi Kode Dokter Nama Dokter Nama Obat Jumlah Harga HNA Diskon (%) Margin (%) Total Pembayaran No NIKKES Jumlah Pembaya item
Resep Peserta Transaksi Dokter Dokter Obat HNA (%) (%) Resep Resep Pembaya
ran ran
1 SA2905201700058240100022 837003T000 HERYANI 29-05-2017 Molakrim cr 1 12700 0 6 13462 1 SA2905201837003T00HERYANI 29-05-201 0 0 Molakrim c 1 12700 0 6 13462 16 16 13462 1 1SA2905201700058240100022
Minyak Telon TJ 100 ml 1 17476 15 6 15745.88 1 SA2905201837003T00HERYANI 29-05-201 0 0 Minyak Tel 1 17476 15 6 15745.88 16 15745.88 1 1SA2905201700058240100022
Sub Total 29207.88 1 SA2905201837003T00HERYANI 29-05-201 0 0 Minyak Tel 1 17476 15 Sub Total 29207.88 1Sub Total 1Sub Total 29207.88 1 1SA2905201700058240100022
2 SA3005201700096240100022 BELI - FIRMANSYAH 30-05-2017 umum umum Betahistin Mesilat tab. 6 mg 31 1123.26 0 6 36910.32 2 SA3005201837003T00BELI - FI 30-05-201 umum umum Betahistin 31 1123.26 0 6 36910.32 26 26 36910.32 31 2SA3005201700096240100022
Spironolactone tab. 25 mg (Dex) 9 863.1 0 6 8233.97 2 SA3005201837003T00BELI - FI 30-05-201 umum umum Spironolac 9 863.1 0 6 8233.97 26 8233.97 9 2SA3005201700096240100022
Nifedipine kaps. 10 mg (Kim) 22 133.69 0 6 3117.67 2 SA3005201837003T00BELI - FI 30-05-201 umum umum Nifedipine 22 133.69 0 6 3117.67 26 3117.67 22 2SA3005201700096240100022
Artrilox tab. 7,5 mg 7 1609.3 0 6 11941.01 2 SA3005201837003T00BELI - FI 30-05-201 umum umum Artrilox ta 7 1609.3 0 6 11941.01 26 11941.01 7 2SA3005201700096240100022
Diaglime tab. 3 mg 6 4566.67 0 6 29044 2 SA3005201837003T00BELI - FI 30-05-201 umum umum Diaglime ta 6 4566.67 0 6 29044 26 29044 6 2SA3005201700096240100022
Glunor tab. 850 mg 7 1080 0 6 8013.6 2 SA3005201837003T00BELI - FI 30-05-201 umum umum Glunor tab 7 1080 0 6 8013.6 26 8013.6 7 2SA3005201700096240100022
Sub Total 97260.58 2 SA3005201837003T00BELI - FI 30-05-201 umum umum Glunor tab 7 1080 0 Sub Total 97260.58 2Sub Total 2Sub Total 97260.58 7 2SA3005201700096240100022
3 SA3005201700052240100022 beli umum - an. Aqila 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Cefat DS syr. kering 125 mg/5ml, btl. 60 ml 1 39700 0 20 47640 3 SA3005201837003T00beli umum30-05-201
- dr Amar Badr Amar BaCefat DS sy 1 39700 0 20 47640 320 320 47640 1 3SA3005201700052240100022
Otopain tts. telinga, btl. 8 ml 1 45000 0 20 54000 3 SA3005201837003T00beli umum30-05-201
- dr Amar Badr Amar BaOtopain tts. 1 45000 0 20 54000 320 54000 1 3SA3005201700052240100022
Sub Total 101640 3 SA3005201837003T00beli umum30-05-201
- dr Amar Badr Amar BaOtopain tts. 1 45000 0 Sub Total 101640 3Sub Total 3Sub Total 101640 1 3SA3005201700052240100022
4 SA3005201700097240100022 BELI- FERY FERDIAN 30-05-2017 umum umum Folamil Genio Soft Kaps 60 3500 0 6 222600 4 SA3005201837003T00BELI- FERY 30-05-201 umum umum Folamil Gen 60 3500 0 6 222600 46 46 222600 60 4SA3005201700097240100022
Sub Total 222600 4 SA3005201837003T00BELI- FERY 30-05-201 umum umum Folamil Gen 60 3500 0 Sub Total 222600 4Sub Total 4Sub Total 222600 60 4SA3005201700097240100022
5 SA3005201700133240100022 lab - rini 30-05-2017 Gardasil inj. 0,5 ml 24 675000 18 8 14346720 5 SA3005201837003T00lab - rini 30-05-201 umum umum Gardasil inj 24 675000 18 8 14346720 58 58 14346720 24 5SA3005201700133240100022
Sub Total 14346720 5 SA3005201837003T00lab - rini 30-05-201 umum umum Gardasil inj 24 675000 18 Sub Total 14346720 5Sub Total 5Sub Total 14346720 24 5SA3005201700133240100022
6 SA3105201700088240100022 beli umum pak david 31-05-2017 umum umum Emibion kaps. 10 1200 0 20 14400 6 SA3105201837003T00beli umum31-05-201 umum umum Emibion ka 10 1200 0 20 14400 620 620 14400 10 6SA3105201700088240100022
Calcium tab. 500 mg (Kim) 30 47.27 0 20 1701.83 6 SA3105201837003T00beli umum31-05-201 umum umum Calcium ta 30 47.27 0 20 1701.83 620 1701.83 30 6SA3105201700088240100022
Sub Total 16101.83 6 SA3105201837003T00beli umum31-05-201 umum umum Calcium ta 30 47.27 0 Sub Total 16101.83 6Sub Total 6Sub Total 16101.83 30 6SA3105201700088240100022
7 SA3105201700140240100022 beli umum - ibu susilo 31-05-2017 umum umum Hotin Cr Aromatherapy 120 ml 2 15600 0 8 33696 7 SA3105201837003T00beli umum31-05-201
- umum umum Hotin Cr A 2 15600 0 8 33696 78 78 33696 2 7SA3105201700140240100022
Sub Total 33696 7 SA3105201837003T00beli umum31-05-201
- umum umum Hotin Cr A 2 15600 0 Sub Total 33696 7Sub Total 7Sub Total 33696 2 7SA3105201700140240100022
8 SA3105201700193240100022 umum beli 31-05-2017 Magtral Syr. Forte 1 26000 0 25 32500 8 SA3105201837003T00umum beli31-05-201 umum umum Magtral Syr 1 26000 0 25 32500 825 825 32500 1 8SA3105201700193240100022
Sub Total 32500 8 SA3105201837003T00umum beli31-05-201 umum umum Magtral Syr 1 26000 0 Sub Total 32500 8Sub Total 8Sub Total 32500 1 8SA3105201700193240100022
9 SA3105201700196240100022 U11 umum 31-05-2017 Hotin Cr Aromatherapy 120 ml 1 15600 0 15 17940 9 SA3105201U11 umum 31-05-201 umum umum Hotin Cr A 1 15600 0 15 17940 915 915 17940 1 9SA3105201700196240100022
Sub Total 17940 9 SA3105201U11 umum 31-05-201 umum umum Hotin Cr A 1 15600 0 Sub Total 17940 9Sub Total 9Sub Total 17940 1 9SA3105201700196240100022
9 SA3105201U11 umum 31-05-201 umum umum Hotin Cr A 1 15600 0 Sub Total 17940 9Sub Total 17940 1 9SA3105201700196240100022
TOTAL SEBELUM PPN 14897666.29 TOTAL SEB SA3105201U11 umum 31-05-201 umum umum Hotin Cr A 1 15600 0 Sub Total 14897666 TOTAL SEB TOTAL SEB 14897666 1 TOTAL SEBELUM PPNSA3105201700196240100022
TOTAL SETELAH PPN 16387432.919 TOTAL SET SA3105201U11 umum 31-05-201 umum umum Hotin Cr A 1 15600 0 Sub Total 16387433 TOTAL SETETOTAL SETE16387433 1 TOTAL SETELAH PPNSA3105201700196240100022
Yang membuat, Pemeriksa,
Mita Maha Asih Heryani, S.Farm, Apt

AA Telemedika Farma 6 APA Telemedika Farma 6
REKAPITULASI TAGIHAN APOTIK (RJTP) PENJUALAN UMUM
NAMA MITRA : UMUM
PESERTA : TF 6
PERIODE : 29 - 31 Mei 2017
Jumlah Item Obat Biaya Pengobatan

NO Nomor Resep NIK Nama Pegawai Band Posisi Loker NIKES Nama Pasien Tanggal Masuk Tanggal Keluar Nama Dokter ICD X Jenis Peserta Jumlah Total Status
DOT Non DOT Generik 1. Obat / Bahan 2. Jasa Dokter 3. Jasa Dokter 4. Kapitasi
Obat Umum Gigi
Sub Total 1 SA2905201700058240100022 837003T000 HERYANI 29-05-2017 29-05-2017 0 2 29,208 - - - 29,208 1.0.1.
Sub Total 2 SA3005201700096240100022 0 BELI - FIRMANSYAH 30-05-2017 30-05-2017 umum 82 97,261 - - - 97,261 1.0.1.
Sub Total 3 SA3005201700052240100022 0 beli umum - an. Aqila 30-05-2017 30-05-2017 dr Amar Bachtiar 2 101,640 - - - 101,640 1.0.1.
Sub Total 4 SA3005201700097240100022 0 BELI- FERY FERDIAN 30-05-2017 30-05-2017 umum 60 222,600 - - - 222,600 1.0.1.
Sub Total 5 SA3005201700133240100022 0 lab - rini 30-05-2017 30-05-2017 0 24 14,346,720 - - - 14,346,720 1.0.1.
Sub Total 6 SA3105201700088240100022 0 beli umum pak david 31-05-2017 31-05-2017 umum 40 16,102 - - - 16,102 1.0.1.
Sub Total 7 SA3105201700140240100022 0 beli umum - ibu susilo 31-05-2017 31-05-2017 umum 2 33,696 - - - 33,696 1.0.1.
Sub Total 8 SA3105201700193240100022 0 umum beli 31-05-2017 31-05-2017 0 1 32,500 - - - 32,500 1.0.1.
Sub Total 9 SA3105201700196240100022 U11 umum 31-05-2017 31-05-2017 0 1 17,940 - - - 17,940 1.0.1.
214 14,897,666 - - - 14,897,666

Laporan Penjualan YAKES TPBW
Apotek Telemedika Farma 6 Jl. Percetakan Neg
No Nomor Resep Nikes Nama Peserta Tanggal Transaksi Kode Dokter
1 SA2905201700150240100022 829012 - TPBW FARIDA 29-05-2017 dr. Istiyarti Tapilatu
2 SA3105201700187240100022 789023 - TPBW Abdullah Syam 31-05-2017 dr Amar Bachtiar

an Penjualan YAKES TPBW
eriode 29 - 31 Mei 2017
a Farma 6 Jl. Percetakan Negara No.17 A
Total
Nama Dokter Nama Obat Jumlah Harga HNA Diskon Margin (%) Pembayara
(%) n
dr. Istiyarti Tapilatu Ambroxol tab. 30 mg (Indo) 8 124.09 0 18.5 1176.36

Dextafen tab. 8 770 0 18.5 7299.6
Kapsul Kosong No.0 1000 10 31 0 18.5 367.35
Sub Total 8843.31
dr Amar Bachtiar Rydian tab. 10 mg 10 1900 0 18.5 22515
Dextafen tab. 10 770 0 18.5 9124.5
Inerson krim 0,25 %, tube 15 gr 1 25000 0 18.5 29625
Sub Total 61264.5
Total Sebelu 70107.81
Total sesudah 77118.591
Total
Nomor Nama Tanggal Kode Nama Nama Harga
No NIKKES Jumlah Diskon (%) Margin Pembayar
Resep Peserta Transaksi Dokter Dokter Obat HNA (%) an
1 SA2905201 0 829012 - T 29-05-2017dr. Istiyarti dr. Istiyarti Ambroxol ta 8 124.09 0 18.5 1176.36
1 SA2905201 0 829012 - T 29-05-2017dr. Istiyarti dr. Istiyarti Dextafen ta 8 770 0 18.5 7299.6
1 SA2905201 0 829012 - T 29-05-2017dr. Istiyarti dr. Istiyarti Kapsul Koso 10 31 0 18.5 367.35
1 SA2905201 0 829012 - T 29-05-2017dr. Istiyarti dr. Istiyarti Kapsul Koso 10 31 0 Sub Total 8843.31
2 SA3105201 0 789023 - T 31-05-2017dr Amar Bacdr Amar BacRydian tab. 10 1900 0 18.5 22515
2 SA3105201 0 789023 - T 31-05-2017dr Amar Bacdr Amar BacDextafen ta 10 770 0 18.5 9124.5
2 SA3105201 0 789023 - T 31-05-2017dr Amar Bacdr Amar BacInerson kri 1 25000 0 18.5 29625
2 SA3105201 0 789023 - T 31-05-2017dr Amar Bacdr Amar BacInerson kri 1 25000 0 Sub Total 61264.5
2 SA3105201 0 789023 - T 31-05-2017dr Amar Bacdr Amar BacInerson kri 1 25000 0 Total Sebe 70107.81
Total
Nomor Nomor Pembayar item
Resep Resep an
118,5 118,5 1176.36 8 1SA2905201700150240100022

118.5 118.5 7299.6 8 1SA2905201700150240100022
118.5 367.35 10 1SA2905201700150240100022
1Sub Total 1Sub Total 8843.31 10 1SA2905201700150240100022
218.5 218.5 22515 10 2SA3105201700187240100022
218.5 9124.5 10 2SA3105201700187240100022
218.5 29625 1 2SA3105201700187240100022
2Sub Total 2Sub Total 61264.5 1 2SA3105201700187240100022
2Total Seb 2Total Seb 70107.81 1 2SA3105201700187240100022
REKAPITULASI TAGIHAN APOTIK (RJTP) PENJUALAN TPBW
NAMA MITRA : YAKES TPBW
PESERTA : TF 6
PERIODE : 29 -

Nomor Band Jenis Jumlah
NO Resep NIK Nama Pegawai Posisi Loker NIKES Nama Pasien Tanggal Masuk Tanggal Keluar Nama Dokter ICD X Peserta 1. Obat / 2. Jasa 3. Jasa Total Status
DOT Non DOT Generik Bahan Dokter Dokter 4.
Obat Umum Gigi Kapitasi
Sub Total 1 SA29052017 0 829012 - TPBW FARIDA 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu 26 8,843 - - - 8,843 1.1.1.
Sub Total 2 SA31052017 0 789023 - TPBW Abdullah Syam
31-05-2017 31-05-2017 dr Amar Bachtiar 21 61,265 - - - 61,265 1.1.1.
47 - - 70,108 - - - 70,108
Laporan Penjualan Non System PEGAWAI
Tanggal
No Nomor Resep Nikes Nama Peserta Kode Dokter Nama Dokter
Transaksi
1 SA2905201700145240100022 630812.102 DIMAS HARYO WIBISONO 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
2 SA3005201700080240100022 610904.1 SUMARNI 30-05-2017 Bidan Vitha Diana Bidan Vitha Diana
3 SA3005201700083240100022 622888 TUBAGUS BUDIAWAN 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar
4 SA3005201700149240100022 630761.103 NASTITI TRIJAYANTI 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
5 SA3105201700148240100022 690457 DEDI PURWANTO 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar
6 SA3105201700203240100022 690335 WINARKO 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
7 SA2905201700064240100022 632125 PUGUH WAHYU WIDODO, S.E,29-05-2017

M dr Amar Bachtiar dr Amar Bachtiar
System PEGAWAI
Mei 2017
kan Negara No.17A Jakarta Pusat
TOSHIBA:
1 = Kepesertaan Harga Diskon Total
Nama Obat Jumlah Margin (%) Pembayaran Ket. No
2 = Non DOT Nomor Resep NIKKES
HNA (%)
3 = Obat Moll
Rhinos SR kaps. 10 3600 0 18.5 42660 1 SA2905201700145240100022 630812.102

Sub Total 42660 1 SA2905201700145240100022 630812.102
CYCLOFEM INJ 1 6500 0 18.5 7702.5 2 SA3005201700080240100022 610904.1
DISP SYRINGE 2,5CC (TRM) 1 2228 0 18.5 2640.18 2 SA3005201700080240100022 610904.1
Spuit 1 cc 1 3650 0 18.5 4325.25 2 SA3005201700080240100022 610904.1
Sub Total 14667.93 2 SA3005201700080240100022 610904.1
Teofilin tab. 150 mg 30 66.05 0 18.5 2348.08 3 SA3005201700083240100022 622888
Kapsul Kosong No.0 1000 60 31 0 18.5 2204.1 3 SA3005201700083240100022 622888
Asam Mefenamat kapl. 500 mg (Dex) 10 125 0 18.5 1481.25 3 SA3005201700083240100022 622888
Sub Total 6033.43 3 SA3005201700083240100022 622888
Kapsul Kosong No.1 1000 60 31 0 18.5 2204.1 4 SA3005201700149240100022 630761.103
Sub Total 2204.1 4 SA3005201700149240100022 630761.103
Furosemide tab. 40 mg (Kim) 28 93.43 0 18.5 3099.84 5 SA3105201700148240100022 690457
Sub Total 3099.84 5 SA3105201700148240100022 690457
Asam Folat tab. 1 mg 20 82.62 0 18.5 1958.09 6 SA3105201700203240100022 690335
Asam Askorbat (Vitamin C) tab. 50 mg 20 38.88 0 18.5 921.46 6 SA3105201700203240100022 690335
Caco3 500 Mg 60 300 0 18.5 21330 6 SA3105201700203240100022 690335
Natrium Bikarbonat tab. 500 mg 60 17.37 0 18.5 1235.01 6 SA3105201700203240100022 690335
Sub Total 30597.53 6 SA3105201700203240100022 690335
Osfit tab. 500 mg 17 1125 0 18.5 22663.13 7 SA2905201700064240100022 632125
Sub Total 22663.13 7 SA2905201700064240100022 632125
TOTAL SEBELUM PPN 122289.96 ### 7 SA2905201700064240100022 632125
TOTAL SETELAH PPN 134518.956 ### 7 SA2905201700064240100022 632125
Tanggal Harga Diskon
Nama Peserta Kode Dokter Nama Dokter Nama Obat Jumlah
Transaksi HNA (%)
DIMAS HARYO WIBISONO 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Rhinos SR kaps. 10 3600 0
DIMAS HARYO WIBISONO 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Rhinos SR kaps. 10 3600 0
SUMARNI 30-05-2017 Bidan Vitha Diana Bidan Vitha Diana CYCLOFEM INJ 1 6500 0
SUMARNI 30-05-2017 Bidan Vitha Diana Bidan Vitha Diana DISP SYRINGE 2,5CC (TRM) 1 2228 0
SUMARNI 30-05-2017 Bidan Vitha Diana Bidan Vitha Diana Spuit 1 cc 1 3650 0
SUMARNI 30-05-2017 Bidan Vitha Diana Bidan Vitha Diana Spuit 1 cc 1 3650 0
TUBAGUS BUDIAWAN 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Teofilin tab. 150 mg 30 66.05 0
TUBAGUS BUDIAWAN 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Kapsul Kosong No.0 1000 60 31 0
TUBAGUS BUDIAWAN 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Asam Mefenamat kapl. 500 mg (Dex) 10 125 0
TUBAGUS BUDIAWAN 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Asam Mefenamat kapl. 500 mg (Dex) 10 125 0
NASTITI TRIJAYANTI 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.1 1000 60 31 0
NASTITI TRIJAYANTI 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.1 1000 60 31 0
DEDI PURWANTO 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Furosemide tab. 40 mg (Kim) 28 93.43 0
DEDI PURWANTO 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Furosemide tab. 40 mg (Kim) 28 93.43 0
WINARKO 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Asam Folat tab. 1 mg 20 82.62 0
WINARKO 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Asam Askorbat (Vitamin C) tab. 50 mg 20 38.88 0
WINARKO 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.0 1000 80 31 0
WINARKO 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Caco3 500 Mg 60 300 0
WINARKO 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Natrium Bikarbonat tab. 500 mg 60 17.37 0
WINARKO 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Furosemide tab. 40 mg (Kim) 20 93.43 0
WINARKO 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Furosemide tab. 40 mg (Kim) 20 93.43 0
PUGUH WAHYU WIDODO, S.E,29-05-2017
M dr Amar Bachtiar dr Amar Bachtiar Osfit tab. 500 mg 17 1125 0
Total Total
Margin (%) Nomor Resep Nomor Resep
Pembayaran Pembayaran item
18.5 42660 118,5 118,5 42660 10 1SA2905201700145240100022

Sub Total 42660 1Sub Total 1Sub Total 42660 10 1SA2905201700145240100022
18.5 7702.5 218.5 218.5 7702.5 1 2SA3005201700080240100022
18.5 2640.18 218.5 2640.18 1 2SA3005201700080240100022
18.5 4325.25 218.5 4325.25 1 2SA3005201700080240100022
Sub Total 14667.93 2Sub Total 2Sub Total 14667.93 1 2SA3005201700080240100022
18.5 2348.08 318.5 318.5 2348.08 30 3SA3005201700083240100022
18.5 2204.1 318.5 2204.1 60 3SA3005201700083240100022
18.5 1481.25 318.5 1481.25 10 3SA3005201700083240100022
18.5 2204.1 418.5 418.5 2204.1 60 4SA3005201700149240100022
18.5 3099.84 518.5 518.5 3099.84 28 5SA3105201700148240100022
18.5 1958.09 618.5 618.5 1958.09 20 6SA3105201700203240100022
18.5 921.46 618.5 921.46 20 6SA3105201700203240100022
18.5 2938.8 618.5 2938.8 80 6SA3105201700203240100022
18.5 21330 618.5 21330 60 6SA3105201700203240100022
18.5 1235.01 618.5 1235.01 60 6SA3105201700203240100022
18.5 2214.17 618.5 2214.17 20 6SA3105201700203240100022
18.5 22663.13 718.5 718.5 22663.13 17 7SA2905201700064240100022
TOTAL SEBELUM PPN 122289.96 7TOTAL SEBELUM PPN 7TOTAL SEBELUM PPN 122289.96 17 7SA2905201700064240100022
TOTAL SETELAH PPN 134518.956 7TOTAL SETELAH PPN 7TOTAL SETELAH PPN 134518.956 17 7SA2905201700064240100022
REKAPITULASI TAGIHAN APOTIK (RJTP) NON SYSTEM PE
NAMA MITRA : YAKES TELKOM
PESERTA : TF 6
Periode : 29 - 31 Mei 2017
Band
NO Nomor Resep NIK Nama Pegawai Posisi Loker NIKES Nama Pasien Tanggal Masuk
Sub Total 1 SA2905201700145240100022 630812.102 DIMAS HARYO WIBISONO 29-05-2017

Sub Total 2 SA3005201700080240100022 610904.1 SUMARNI 30-05-2017
Sub Total 3 SA3005201700083240100022 622888 TUBAGUS BUDIAWAN 30-05-2017
Sub Total 4 SA3005201700149240100022 630761.103 NASTITI TRIJAYANTI 30-05-2017
Sub Total 5 SA3105201700148240100022 690457 DEDI PURWANTO 31-05-2017
Sub Total 6 SA3105201700203240100022 690335 WINARKO 31-05-2017
Sub Total 7 SA2905201700064240100022 632125 PUGUH WAHYU WIDODO, S.E, M.M29-05-2017
RJTP) NON SYSTEM PEGAWAI

Jenis Jumlah
Tanggal Keluar Nama Dokter ICD X Peserta 2. Jasa 3. Jasa Status
1. Obat / Dokter 4. Total
DOT Non DOT Generik Bahan Obat Umum Dokter Kapitasi
Gigi
29-05-2017 dr. Istiyarti Tapilatu 10 42,660 - - - 42,660 1.2.1.

30-05-2017 Bidan Vitha Diana 3 14,668 - - - 14,668 1.2.1.
30-05-2017 dr Amar Bachtiar 100 6,033 - - - 6,033 1.2.1.
31-05-2017 dr Amar Bachtiar 28 3,100 - - - 3,100 1.2.1.
29-05-2017 dr Amar Bachtiar 17 22,663 - - - 22,663 1.2.1.
478 121,926 - - - 121,926

Laporan Penjualan Non System PENSIUN
Tanggal
Transaksi
1 SA2905201700114240100022 421398.1 K. I. MAHMUD 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
2 SA2905201700118240100022 500126 DJAJA HENDARTO 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
3 SA2905201700124240100022 520872.1 ZURIATI ZUBIR 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar
4 SA2905201700139240100022 511229 MUDJIONO 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
5 SA2905201700141240100022 370472 SURJANA BIN ROJADI 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
6 SA2905201700144240100022 290530.1 SUMIJATI JD SOEBANGIN 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
7 SA2905201700147240100022 460040.1 NADHIROH,NY 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar
8 SA3005201700044240100022 591192.1 DWI ESTI MULYATMI 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
9 SA3005201700063240100022 440847 SUGIMIN BIN SULAIMAN 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
10 SA3005201700065240100022 320126.1 BARIYAH 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
11 SA3005201700067240100022 431114.1 ELIZABETH SUMARTINI 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
12 SA3005201700069240100022 490902.1 JOHANA MARIA DWI PRAPTI P. 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
13 SA3005201700071240100022 640056.1 BUKIT SABAR TAMBUNAN, SH 30-05-2017 drg. Arti R.Nazir drg. Arti R.Nazir
14 SA3005201700074240100022 571138 TADOH 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
15 SA3005201700077240100022 500574 BAHASANNUDIN 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar
16 SA3005201700079240100022 640056.1 BUKIT SABAR TAMBUNAN, SH 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar
17 SA3005201700092240100022 540428 NGAKAN PUTU SANTHA 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar
18 SA3005201700116240100022 511229 MUDJIONO 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar
19 SA3005201700118240100022 511229 MUDJIONO 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar
20 SA3005201700135240100022 551872.1 ESTER LUMBANTOBING 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar
21 SA3005201700139240100022 580123 JOKO TRIYANTO 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
22 SA3005201700140240100022 490934 TEUKU SALADIN, IR. 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar
23 SA3005201700144240100022 532234 ISKANDAR 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
24 SA3005201700145240100022 410437 SUPARDI 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
25 SA3105201700075240100022 410107.2 YANAIDA THAIB 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
26 SA3105201700106240100022 520143 SAEPUDIN 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar
27 SA3105201700107240100022 520143.1 ROIKAH 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar
28 SA3105201700123240100022 460081 DJAUZI 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar
29 SA3105201700144240100022 510051.1 ARYATI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
30 SA3105201700151240100022 532357 BAMBANG SUMBARGO 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
31 SA3105201700161240100022 560442.1 NAZWIR 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar
32 SA3105201700167240100022 460577 ABDUL RACHIM 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
33 SA3105201700168240100022 460577.1 HJ ROCHAINAH 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
34 SA3105201700170240100022 350118.1 SRI MULYANI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
35 SA3105201700171240100022 500287.1 NURIAH 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
36 SA3105201700174240100022 431234 UNUNG MASDUKI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
37 SA3105201700175240100022 450389.1 KASRI 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar
38 SA3105201700178240100022 571011 UNTUNG MUHAEMIN 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
39 SA3105201700179240100022 500069.1 MARIANI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
40 SA3105201700180240100022 500069 JAHJA KELANA 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
41 SA3105201700182240100022 570941.1 ROHATI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
42 SA3105201700183240100022 540286 IGNATIUS BAMBANG BUDISURANTO31-05-2017 dr Amar Bachtiar dr Amar Bachtiar
43 SA3105201700185240100022 591487 ZULHELMA BUSRI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
44 SA3105201700186240100022 360874 SUDIJONO BIN DJEMAKUN 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
45 SA3105201700190240100022 460053 KIMAH ROHIMAH 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
46 SA3105201700192240100022 340553.1 DJUHANA 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar
47 SA3105201700194240100022 510051 SISWO KUNTJORO 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
48 SA3105201700195240100022 400689 SOEHARDI BC.TT 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar
49 SA2905201700021240100022 540961 PURBONO 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar
50 SA2905201700022240100022 591448 AGUNG HARYANTO SUMARGO ADIL29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
51 SA2905201700057240100022 490248 TOTO SULAEMAN 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar
52 SA2905201700061240100022 531849 ASRIZAL 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar
53 SA2905201700063240100022 450742 AGUS SALAM 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
54 SA2905201700066240100022 560309 SUDIRMAN SYARIF 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
55 SA2905201700073240100022 540492 RUSMIJANTO 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu
stem PENSIUN
2017
Negara No.17A Jakarta Pusat
TOSHIBA:
Jum Harga HNA Disk 1 = Kepesertaan
Total Ket No
Nama Obat on Margin (%) 2 = Non DOT Nomor Resep NIKKES
lah Pembayaran .
(%) 3 = Obat Moll
Simarc tab. 2 mg 28 1300 0 18.5 43134 1 SA2905201700114240100022 421398.1

Sub Total 43134 1 SA2905201700114240100022 421398.1
Genta tts. mata 0,3 %, btl 5 ml 1 21750 0 18.5 25773.75 2 SA2905201700118240100022 500126
Sub Total 25773.75 2 SA2905201700118240100022 500126
Hydrochlorothiazide (HCT) tab. 25 mg (Kim) 20 110.55 0 18.5 2619.93 3 SA2905201700124240100022 520872.1
Sub Total 2619.93 3 SA2905201700124240100022 520872.1
Faktu Oint salep 1 70000 0 18.5 82950 4 SA2905201700139240100022 511229
Sub Total 82950 4 SA2905201700139240100022 511229
Casodex FC tab. Sal 50 mg 14 78898.5 0 18.5 1308926.12 5 SA2905201700141240100022 370472
Sub Total 1308926.12 5 SA2905201700141240100022 370472
Mestinon tab. 60 mg 42 6133.33 0 18.5 305255.83 6 SA2905201700144240100022 290530.1
Sub Total 305255.83 6 SA2905201700144240100022 290530.1
Teofilin tab. 150 mg 15 66.05 0 18.5 1174.04 7 SA2905201700147240100022 460040.1
Sub Total 2276.09 7 SA2905201700147240100022 460040.1
Natrium Bikarbonat tab. 500 mg 42 17.37 0 18.5 864.5 8 SA3005201700044240100022 591192.1
Furosemide tab. 40 mg (Kim) 7 93.43 0 18.5 774.96 8 SA3005201700044240100022 591192.1
Sub Total 1639.47 8 SA3005201700044240100022 591192.1
Novo Twist 32G TIP x 5 mm 10 2100 0 18.5 24885 9 SA3005201700063240100022 440847
Sub Total 24885 9 SA3005201700063240100022 440847
C.T.M 4 8 45 0 18.5 426.6 10 SA3005201700065240100022 320126.1
Sub Total 977.63 10 SA3005201700065240100022 320126.1
C.T.M 4 10 45 0 18.5 533.25 11 SA3005201700067240100022 431114.1
Sub Total 1267.95 11 SA3005201700067240100022 431114.1
C.T.M 4 10 45 0 18.5 533.25 12 SA3005201700069240100022 490902.1
Sub Total 1267.95 12 SA3005201700069240100022 490902.1
Minosep lar. 0,2%, btl 60 ml 1 8800 0 18.5 10428 13 SA3005201700071240100022 640056.1
Sub Total 10428 13 SA3005201700071240100022 640056.1
Sub Total 24885 14 SA3005201700074240100022 571138
Simarc tab. 2 mg 20 1300 0 18.5 30810 15 SA3005201700077240100022 500574
Sub Total 30810 15 SA3005201700077240100022 500574
Ricovir tab. 300 mg 30 14895 0 18.5 529517.25 16 SA3005201700079240100022 640056.1
Sub Total 530093.59 16 SA3005201700079240100022 640056.1
Natrium Bikarbonat tab. 500 mg 84 17.37 0 18.5 1729.01 17 SA3005201700092240100022 540428
Caco3 500 Mg 84 300 0 18.5 29862 17 SA3005201700092240100022 540428
Sub Total 34676.75 17 SA3005201700092240100022 540428
KASA STERIL 16/16 1 5350 0 18.5 6339.75 18 SA3005201700116240100022 511229
Sub Total 6339.75 18 SA3005201700116240100022 511229
Faktu Oint salep 1 70000 0 18.5 82950 19 SA3005201700118240100022 511229
Sub Total 82950 19 SA3005201700118240100022 511229
Sub Total 864.5 20 SA3005201700135240100022 551872.1
Hexymer tab. 2 mg 42 297.5 0 18.5 14806.58 21 SA3005201700139240100022 580123
Sub Total 14806.58 21 SA3005201700139240100022 580123
Humalog Mix 50 Kwikpen inj. 100 IU/ml, penfill 3 ml. 3 748828.8 0 18.5 2662086.38 22 SA3005201700140240100022 490934
Sub Total 2662086.38 22 SA3005201700140240100022 490934
Vaselin Albumin 200 25 0 18.5 5925 23 SA3005201700144240100022 532234
POT SALP 20GR 1 250 0 18.5 296.25 23 SA3005201700144240100022 532234
POT SALP 15GR 1 227 0 18.5 269 23 SA3005201700144240100022 532234
Sub Total 6490.25 23 SA3005201700144240100022 532234
C.T.M 4 10 45 0 18.5 533.25 24 SA3005201700145240100022 410437
Sub Total 1815.83 24 SA3005201700145240100022 410437
Caco3 500 Mg 64 300 0 18.5 22752 25 SA3105201700075240100022 410107.2
Sub Total 25103.04 25 SA3105201700075240100022 410107.2
Sub Total 3099.84 26 SA3105201700106240100022 520143
Kapsul Kosong No.0 1000 20 34.09 0 18.5 807.93 27 SA3105201700107240100022 520143.1
Sub Total 807.93 27 SA3105201700107240100022 520143.1
Kapsul Kosong No.00 1000 40 50 0 18.5 2370 28 SA3105201700123240100022 460081
Sub Total 2370 28 SA3105201700123240100022 460081
Caco3 500 Mg 84 300 0 18.5 29862 29 SA3105201700144240100022 510051.1
Sub Total 32947.74 29 SA3105201700144240100022 510051.1
C.T.M 4 8 45 0 18.5 426.6 30 SA3105201700151240100022 532357
Sub Total 977.63 30 SA3105201700151240100022 532357
Simarc tab. 2 mg 28 1300 0 18.5 43134 31 SA3105201700161240100022 560442.1
Sub Total 43134 31 SA3105201700161240100022 560442.1
POT SALP 50GR 1 318 0 18.5 376.83 32 SA3105201700167240100022 460577
Liquor Carbol Detergent (LCD) 1 1440 0 18.5 1706.4 32 SA3105201700167240100022 460577
Sulfur PP 40 70 0 18.5 3318 32 SA3105201700167240100022 460577
Sub Total 5401.23 32 SA3105201700167240100022 460577
POT SALP 15GR 1 227 0 18.5 269 33 SA3105201700168240100022 460577.1
Sub Total 269 33 SA3105201700168240100022 460577.1
Humalog Mix 50 Kwikpen inj. 100 IU/ml, penfill 3 ml. 3 748828.8 0 18.5 2662086.38 34 SA3105201700170240100022 350118.1
Novo Twist 32G TIP x 5 mm 10 2100 0 18.5 24885 34 SA3105201700170240100022 350118.1
Sub Total 2686971.38 34 SA3105201700170240100022 350118.1
Kapsul Kosong No.00 1000 20 50 0 18.5 1185 35 SA3105201700171240100022 500287.1
Sub Total 1185 35 SA3105201700171240100022 500287.1
CLOBAZAM 10 MG 10S 28 960 0 18.5 31852.8 36 SA3105201700174240100022 431234
Sub Total 31852.8 36 SA3105201700174240100022 431234
Sub Total 24885 37 SA3105201700175240100022 450389.1
C.T.M 4 8 45 0 18.5 426.6 38 SA3105201700178240100022 571011
Sub Total 977.63 38 SA3105201700178240100022 571011
Sub Total 24885 39 SA3105201700179240100022 500069.1
Sub Total 24885 40 SA3105201700180240100022 500069
Liquor Carbol Detergent (LCD) 1 1440 0 18.5 1706.4 41 SA3105201700182240100022 570941.1
Sulfur PP 40 70 0 18.5 3318 41 SA3105201700182240100022 570941.1
POT SALP 20GR 1 250 0 18.5 296.25 41 SA3105201700182240100022 570941.1
Sub Total 5320.65 41 SA3105201700182240100022 570941.1
Asam Askorbat (Vitamin C) tab. 50 mg 28 38.88 0 18.5 1290.04 42 SA3105201700183240100022 540286
vitamin B Komplek tab. 28 109.09 0 18.5 3619.64 42 SA3105201700183240100022 540286
Asam Folat tab. 1 mg 28 82.62 0 18.5 2741.33 42 SA3105201700183240100022 540286
Sub Total 8679.59 42 SA3105201700183240100022 540286
Sub Total 3099.84 43 SA3105201700185240100022 591487
C.T.M 4 10 45 0 18.5 533.25 44 SA3105201700186240100022 360874
Sub Total 1267.95 44 SA3105201700186240100022 360874
Plavix tab. 75 mg 28 21806 0 18.5 723523.08 45 SA3105201700190240100022 460053
Sub Total 749296.83 45 SA3105201700190240100022 460053
TRIFLUOPHERAZIN 5 MG 17 576 0 18.5 11603.52 46 SA3105201700192240100022 340553.1
Sub Total 14390.64 46 SA3105201700192240100022 340553.1
C.T.M 4 28 45 0 18.5 1493.1 47 SA3105201700194240100022 510051
Kapsul Kosong No.00 1000 56 50 0 18.5 3318 47 SA3105201700194240100022 510051
Sub Total 6611.29 47 SA3105201700194240100022 510051
Endrolin inj. 3,75 mg 1 1011500 0 18.5 1198627.5 48 SA3105201700195240100022 400689
Sub Total 1198627.5 48 SA3105201700195240100022 400689
PIPET TETES 1 910 0 18.5 1078.35 49 SA2905201700021240100022 540961
BOTOL PLASTIK 100ML 1 1500 0 18.5 1777.5 49 SA2905201700021240100022 540961
Sub Total 2855.85 49 SA2905201700021240100022 540961
Humalog Mix 50 Kwikpen inj. 100 IU/ml, penfill 3 ml. 2 748828.8 0 18.5 1774724.26 50 SA2905201700022240100022 591448
Sub Total 1809563.26 50 SA2905201700022240100022 591448
Sub Total 734.7 51 SA2905201700057240100022 490248
Hydrochlorothiazide (HCT) tab. 25 mg (Kim) 20 110.55 0 18.5 2619.93 52 SA2905201700061240100022 531849
Sub Total 2619.93 52 SA2905201700061240100022 531849
Osfit tab. 500 mg 28 1125 0 18.5 37327.5 53 SA2905201700063240100022 450742
Sub Total 37327.5 53 SA2905201700063240100022 450742
C.T.M 4 8 45 0 18.5 426.6 54 SA2905201700066240100022 560309
Sub Total 977.63 54 SA2905201700066240100022 560309
Sub Total 25773.75 55 SA2905201700073240100022 540492
TOTAL SEBELUM PPN 11984119.4 55 SA2905201700073240100022 540492
TOTAL SETELAH PPN 13182531.4 55 SA2905201700073240100022 540492
Tanggal Jum Harga HNA Disk
Nama Peserta Kode Dokter Nama Dokter Nama Obat on
Transaksi lah (%)
K. I. MAHMUD 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Simarc tab. 2 mg 28 1300 0
K. I. MAHMUD 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Simarc tab. 2 mg 28 1300 0
DJAJA HENDARTO 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Genta tts. mata 0,3 %, btl 5 ml 1 21750 0
DJAJA HENDARTO 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Genta tts. mata 0,3 %, btl 5 ml 1 21750 0
ZURIATI ZUBIR 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar Hydrochlorothiazide (HCT) tab. 25 mg (Kim) 20 110.55 0
ZURIATI ZUBIR 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar Hydrochlorothiazide (HCT) tab. 25 mg (Kim) 20 110.55 0
MUDJIONO 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Faktu Oint salep 1 70000 0
MUDJIONO 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Faktu Oint salep 1 70000 0
SURJANA BIN ROJADI 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Casodex FC tab. Sal 50 mg 14 78898.5 0
SURJANA BIN ROJADI 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Casodex FC tab. Sal 50 mg 14 78898.5 0
SUMIJATI JD SOEBANGIN 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Mestinon tab. 60 mg 42 6133.33 0
SUMIJATI JD SOEBANGIN 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Mestinon tab. 60 mg 42 6133.33 0
NADHIROH,NY 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar Teofilin tab. 150 mg 15 66.05 0
NADHIROH,NY 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar Kapsul Kosong No.0 1000 30 31 0
NADHIROH,NY 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar Kapsul Kosong No.0 1000 30 31 0
DWI ESTI MULYATMI 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Natrium Bikarbonat tab. 500 mg 42 17.37 0
DWI ESTI MULYATMI 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Furosemide tab. 40 mg (Kim) 7 93.43 0
DWI ESTI MULYATMI 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Furosemide tab. 40 mg (Kim) 7 93.43 0
SUGIMIN BIN SULAIMAN 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Novo Twist 32G TIP x 5 mm 10 2100 0
SUGIMIN BIN SULAIMAN 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Novo Twist 32G TIP x 5 mm 10 2100 0
BARIYAH 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu C.T.M 4 8 45 0
BARIYAH 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.1 1000 15 31 0
BARIYAH 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.1 1000 15 31 0
ELIZABETH SUMARTINI 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu C.T.M 4 10 45 0
ELIZABETH SUMARTINI 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.1 1000 20 31 0
ELIZABETH SUMARTINI 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.1 1000 20 31 0
JOHANA MARIA DWI PRAPTI P. 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu C.T.M 4 10 45 0
JOHANA MARIA DWI PRAPTI P. 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.1 1000 20 31 0
JOHANA MARIA DWI PRAPTI P. 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.1 1000 20 31 0
BUKIT SABAR TAMBUNAN, SH 30-05-2017 drg. Arti R.Nazir drg. Arti R.Nazir Minosep lar. 0,2%, btl 60 ml 1 8800 0
BUKIT SABAR TAMBUNAN, SH 30-05-2017 drg. Arti R.Nazir drg. Arti R.Nazir Minosep lar. 0,2%, btl 60 ml 1 8800 0
TADOH 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Novo Twist 32G TIP x 5 mm 10 2100 0
TADOH 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Novo Twist 32G TIP x 5 mm 10 2100 0
BAHASANNUDIN 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Simarc tab. 2 mg 20 1300 0
BAHASANNUDIN 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Simarc tab. 2 mg 20 1300 0
BUKIT SABAR TAMBUNAN, SH 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Natrium Bikarbonat tab. 500 mg 28 17.37 0
BUKIT SABAR TAMBUNAN, SH 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Ricovir tab. 300 mg 30 14895 0
BUKIT SABAR TAMBUNAN, SH 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Ricovir tab. 300 mg 30 14895 0
NGAKAN PUTU SANTHA 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Natrium Bikarbonat tab. 500 mg 84 17.37 0
NGAKAN PUTU SANTHA 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Caco3 500 Mg 84 300 0
NGAKAN PUTU SANTHA 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Kapsul Kosong No.0 1000 84 31 0
NGAKAN PUTU SANTHA 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Kapsul Kosong No.0 1000 84 31 0
MUDJIONO 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar KASA STERIL 16/16 1 5350 0
MUDJIONO 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar KASA STERIL 16/16 1 5350 0
MUDJIONO 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Faktu Oint salep 1 70000 0
MUDJIONO 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Faktu Oint salep 1 70000 0
ESTER LUMBANTOBING 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Natrium Bikarbonat tab. 500 mg 42 17.37 0
ESTER LUMBANTOBING 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Natrium Bikarbonat tab. 500 mg 42 17.37 0
JOKO TRIYANTO 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Hexymer tab. 2 mg 42 297.5 0
JOKO TRIYANTO 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Hexymer tab. 2 mg 42 297.5 0
TEUKU SALADIN, IR. 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Humalog Mix 50 Kwikpen inj. 100 IU/ml, penfill 3 ml. 3 748828.8 0
TEUKU SALADIN, IR. 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar Humalog Mix 50 Kwikpen inj. 100 IU/ml, penfill 3 ml. 3 748828.8 0
ISKANDAR 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Vaselin Albumin 200 25 0
ISKANDAR 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu POT SALP 20GR 1 250 0
SUPARDI 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Teofilin tab. 150 mg 7 66.05 0
SUPARDI 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu C.T.M 4 10 45 0
SUPARDI 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.0 1000 20 31 0
SUPARDI 30-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.0 1000 20 31 0
YANAIDA THAIB 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Caco3 500 Mg 64 300 0
YANAIDA THAIB 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.0 1000 64 31 0
YANAIDA THAIB 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.0 1000 64 31 0
SAEPUDIN 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Furosemide tab. 40 mg (Kim) 28 93.43 0
SAEPUDIN 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Furosemide tab. 40 mg (Kim) 28 93.43 0
ROIKAH 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Kapsul Kosong No.0 1000 20 34.09 0
ROIKAH 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Kapsul Kosong No.0 1000 20 34.09 0
DJAUZI 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Kapsul Kosong No.00 1000 40 50 0
DJAUZI 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Kapsul Kosong No.00 1000 40 50 0
ARYATI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Caco3 500 Mg 84 300 0
ARYATI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.0 1000 84 31 0
ARYATI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.0 1000 84 31 0
BAMBANG SUMBARGO 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu C.T.M 4 8 45 0
BAMBANG SUMBARGO 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.1 1000 15 31 0
BAMBANG SUMBARGO 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.1 1000 15 31 0
NAZWIR 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Simarc tab. 2 mg 28 1300 0
NAZWIR 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Simarc tab. 2 mg 28 1300 0
ABDUL RACHIM 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu POT SALP 50GR 1 318 0
ABDUL RACHIM 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Liquor Carbol Detergent (LCD) 1 1440 0
ABDUL RACHIM 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Sulfur PP 40 70 0
ABDUL RACHIM 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Sulfur PP 40 70 0
HJ ROCHAINAH 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu POT SALP 15GR 1 227 0
HJ ROCHAINAH 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu POT SALP 15GR 1 227 0
SRI MULYANI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Humalog Mix 50 Kwikpen inj. 100 IU/ml, penfill 3 ml. 3 748828.8 0
SRI MULYANI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Novo Twist 32G TIP x 5 mm 10 2100 0
SRI MULYANI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Novo Twist 32G TIP x 5 mm 10 2100 0
NURIAH 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.00 1000 20 50 0
NURIAH 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.00 1000 20 50 0
UNUNG MASDUKI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu CLOBAZAM 10 MG 10S 28 960 0
UNUNG MASDUKI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu CLOBAZAM 10 MG 10S 28 960 0
KASRI 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Novo Twist 32G TIP x 5 mm 10 2100 0
KASRI 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Novo Twist 32G TIP x 5 mm 10 2100 0
UNTUNG MUHAEMIN 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu C.T.M 4 8 45 0
UNTUNG MUHAEMIN 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.0 1000 15 31 0
UNTUNG MUHAEMIN 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.0 1000 15 31 0
MARIANI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Novo Twist 32G TIP x 5 mm 10 2100 0
MARIANI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Novo Twist 32G TIP x 5 mm 10 2100 0
JAHJA KELANA 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Novo Twist 32G TIP x 5 mm 10 2100 0
JAHJA KELANA 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Novo Twist 32G TIP x 5 mm 10 2100 0
ROHATI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Liquor Carbol Detergent (LCD) 1 1440 0
ROHATI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Sulfur PP 40 70 0
ROHATI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu POT SALP 20GR 1 250 0
ROHATI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu POT SALP 20GR 1 250 0
IGNATIUS BAMBANG BUDISURANTO31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Asam Askorbat (Vitamin C) tab. 50 mg 28 38.88 0
IGNATIUS BAMBANG BUDISURANTO31-05-2017 dr Amar Bachtiar dr Amar Bachtiar vitamin B Komplek tab. 28 109.09 0
IGNATIUS BAMBANG BUDISURANTO31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Asam Folat tab. 1 mg 28 82.62 0
IGNATIUS BAMBANG BUDISURANTO31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Kapsul Kosong No.0 1000 28 31 0
IGNATIUS BAMBANG BUDISURANTO31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Kapsul Kosong No.0 1000 28 31 0
ZULHELMA BUSRI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Furosemide tab. 40 mg (Kim) 28 93.43 0
ZULHELMA BUSRI 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Furosemide tab. 40 mg (Kim) 28 93.43 0
SUDIJONO BIN DJEMAKUN 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu C.T.M 4 10 45 0
SUDIJONO BIN DJEMAKUN 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.1 1000 20 31 0
SUDIJONO BIN DJEMAKUN 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.1 1000 20 31 0
KIMAH ROHIMAH 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Genta tts. mata 0,3 %, btl 5 ml 1 21750 0
KIMAH ROHIMAH 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Plavix tab. 75 mg 28 21806 0
KIMAH ROHIMAH 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Plavix tab. 75 mg 28 21806 0
DJUHANA 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar TRIFLUOPHERAZIN 5 MG 17 576 0
DJUHANA 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Kapsul Kosong No.3 1000 84 28 0
DJUHANA 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Kapsul Kosong No.3 1000 84 28 0
SISWO KUNTJORO 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Teofilin tab. 150 mg 23 66.05 0
SISWO KUNTJORO 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu C.T.M 4 28 45 0
SISWO KUNTJORO 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.00 1000 56 50 0
SISWO KUNTJORO 31-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.00 1000 56 50 0
SOEHARDI BC.TT 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Endrolin inj. 3,75 mg 1 1011500 0
SOEHARDI BC.TT 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar Endrolin inj. 3,75 mg 1 1011500 0
PURBONO 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar PIPET TETES 1 910 0
PURBONO 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar BOTOL PLASTIK 100ML 1 1500 0
PURBONO 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar BOTOL PLASTIK 100ML 1 1500 0
AGUNG HARYANTO SUMARGO ADIL29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Humalog Mix 50 Kwikpen inj. 100 IU/ml, penfill 3 ml. 2 748828.8 0
AGUNG HARYANTO SUMARGO ADIL29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Novo Twist 32G TIP x 5 mm 14 2100 0
AGUNG HARYANTO SUMARGO ADIL29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Novo Twist 32G TIP x 5 mm 14 2100 0
TOTO SULAEMAN 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar Kapsul Kosong No.0 1000 20 31 0
TOTO SULAEMAN 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar Kapsul Kosong No.0 1000 20 31 0
ASRIZAL 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar Hydrochlorothiazide (HCT) tab. 25 mg (Kim) 20 110.55 0
ASRIZAL 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar Hydrochlorothiazide (HCT) tab. 25 mg (Kim) 20 110.55 0
AGUS SALAM 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Osfit tab. 500 mg 28 1125 0
AGUS SALAM 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Osfit tab. 500 mg 28 1125 0
SUDIRMAN SYARIF 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu C.T.M 4 8 45 0
SUDIRMAN SYARIF 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.0 1000 15 31 0
SUDIRMAN SYARIF 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Kapsul Kosong No.0 1000 15 31 0
RUSMIJANTO 29-05-2017 dr. Istiyarti Tapilatu dr. Istiyarti Tapilatu Genta tts. mata 0,3 %, btl 5 ml 1 21750 0
Total Total ite
Margin (%) Nomor Resep Nomor Resep
Pembayaran Pembayaran m
18.5 43134 118,5 118,5 43134 28 1SA2905201700114240100022 43134

Sub Total 43134 1Sub Total 1Sub Total 43134 28 1SA2905201700114240100022 43134
18.5 25773.75 218.5 218.5 25773.75 1 2SA2905201700118240100022 25773.75
Sub Total 25773.75 2Sub Total 2Sub Total 25773.75 1 2SA2905201700118240100022 25773.75
18.5 2619.93 318.5 318.5 2619.93 20 3SA2905201700124240100022 2619.93
18.5 82950 418.5 418.5 82950 1 4SA2905201700139240100022 82950
18.5 1308926.12 518.5 518.5 1308926.12 14 5SA2905201700141240100022 1308926.12
18.5 305255.83 618.5 618.5 305255.83 42 6SA2905201700144240100022 305255.83
18.5 1174.04 718.5 718.5 1174.04 15 7SA2905201700147240100022 1174.04
18.5 1102.05 718.5 1102.05 30 7SA2905201700147240100022 1102.05
18.5 864.5 818.5 818.5 864.5 42 8SA3005201700044240100022 864.5
18.5 774.96 818.5 774.96 7 8SA3005201700044240100022 774.96
18.5 24885 918.5 918.5 24885 10 9SA3005201700063240100022 24885
18.5 426.6 1018.5 1018.5 426.6 8 10SA3005201700065240100022 426.6
18.5 551.03 1018.5 551.03 15 10SA3005201700065240100022 551.03
18.5 533.25 1118.5 1118.5 533.25 10 11SA3005201700067240100022 533.25
18.5 734.7 1118.5 734.7 20 11SA3005201700067240100022 734.7
18.5 533.25 1218.5 1218.5 533.25 10 12SA3005201700069240100022 533.25
18.5 734.7 1218.5 734.7 20 12SA3005201700069240100022 734.7
18.5 10428 1318.5 1318.5 10428 1 13SA3005201700071240100022 10428
18.5 24885 1418.5 1418.5 24885 10 14SA3005201700074240100022 24885
18.5 30810 1518.5 1518.5 30810 20 15SA3005201700077240100022 30810
18.5 576.34 1618.5 1618.5 576.34 28 16SA3005201700079240100022 576.34
18.5 529517.25 1618.5 529517.25 30 16SA3005201700079240100022 529517.25
18.5 1729.01 1718.5 1718.5 1729.01 84 17SA3005201700092240100022 1729.01
18.5 29862 1718.5 29862 84 17SA3005201700092240100022 29862
18.5 3085.74 1718.5 3085.74 84 17SA3005201700092240100022 3085.74
18.5 6339.75 1818.5 1818.5 6339.75 1 18SA3005201700116240100022 6339.75
18.5 82950 1918.5 1918.5 82950 1 19SA3005201700118240100022 82950
18.5 864.5 2018.5 2018.5 864.5 42 20SA3005201700135240100022 864.5
18.5 14806.58 2118.5 2118.5 14806.58 42 21SA3005201700139240100022 14806.58
18.5 2662086.38 2218.5 2218.5 2662086.38 3 22SA3005201700140240100022 2662086.38
18.5 5925 2318.5 2318.5 5925 200 23SA3005201700144240100022 5925
18.5 296.25 2318.5 296.25 1 23SA3005201700144240100022 296.25
18.5 269 2318.5 269 1 23SA3005201700144240100022 269
18.5 547.88 2418.5 2418.5 547.88 7 24SA3005201700145240100022 547.88
18.5 533.25 2418.5 533.25 10 24SA3005201700145240100022 533.25
18.5 734.7 2418.5 734.7 20 24SA3005201700145240100022 734.7
18.5 22752 2518.5 2518.5 22752 64 25SA3105201700075240100022 22752
18.5 2351.04 2518.5 2351.04 64 25SA3105201700075240100022 2351.04
18.5 3099.84 2618.5 2618.5 3099.84 28 26SA3105201700106240100022 3099.84
18.5 807.93 2718.5 2718.5 807.93 20 27SA3105201700107240100022 807.93
18.5 2370 2818.5 2818.5 2370 40 28SA3105201700123240100022 2370
18.5 29862 2918.5 2918.5 29862 84 29SA3105201700144240100022 29862
18.5 3085.74 2918.5 3085.74 84 29SA3105201700144240100022 3085.74
18.5 426.6 3018.5 3018.5 426.6 8 30SA3105201700151240100022 426.6
18.5 551.03 3018.5 551.03 15 30SA3105201700151240100022 551.03
18.5 43134 3118.5 3118.5 43134 28 31SA3105201700161240100022 43134
18.5 376.83 3218.5 3218.5 376.83 1 32SA3105201700167240100022 376.83
18.5 1706.4 3218.5 1706.4 1 32SA3105201700167240100022 1706.4
18.5 3318 3218.5 3318 40 32SA3105201700167240100022 3318
18.5 269 3318.5 3318.5 269 1 33SA3105201700168240100022 269
18.5 2662086.38 3418.5 3418.5 2662086.38 3 34SA3105201700170240100022 2662086.38
18.5 24885 3418.5 24885 10 34SA3105201700170240100022 24885
18.5 1185 3518.5 3518.5 1185 20 35SA3105201700171240100022 1185
18.5 31852.8 3618.5 3618.5 31852.8 28 36SA3105201700174240100022 31852.8
18.5 24885 3718.5 3718.5 24885 10 37SA3105201700175240100022 24885
18.5 426.6 3818.5 3818.5 426.6 8 38SA3105201700178240100022 426.6
18.5 551.03 3818.5 551.03 15 38SA3105201700178240100022 551.03
18.5 24885 3918.5 3918.5 24885 10 39SA3105201700179240100022 24885
18.5 24885 4018.5 4018.5 24885 10 40SA3105201700180240100022 24885
18.5 1706.4 4118.5 4118.5 1706.4 1 41SA3105201700182240100022 1706.4
18.5 3318 4118.5 3318 40 41SA3105201700182240100022 3318
18.5 296.25 4118.5 296.25 1 41SA3105201700182240100022 296.25
18.5 1290.04 4218.5 4218.5 1290.04 28 42SA3105201700183240100022 1290.04
18.5 3619.64 4218.5 3619.64 28 42SA3105201700183240100022 3619.64
18.5 2741.33 4218.5 2741.33 28 42SA3105201700183240100022 2741.33
18.5 1028.58 4218.5 1028.58 28 42SA3105201700183240100022 1028.58
18.5 3099.84 4318.5 4318.5 3099.84 28 43SA3105201700185240100022 3099.84
18.5 533.25 4418.5 4418.5 533.25 10 44SA3105201700186240100022 533.25
18.5 734.7 4418.5 734.7 20 44SA3105201700186240100022 734.7
18.5 25773.75 4518.5 4518.5 25773.75 1 45SA3105201700190240100022 25773.75
18.5 723523.08 4518.5 723523.08 28 45SA3105201700190240100022 723523.08
18.5 11603.52 4618.5 4618.5 11603.52 17 46SA3105201700192240100022 11603.52
18.5 2787.12 4618.5 2787.12 84 46SA3105201700192240100022 2787.12
18.5 1800.19 4718.5 4718.5 1800.19 23 47SA3105201700194240100022 1800.19
18.5 1493.1 4718.5 1493.1 28 47SA3105201700194240100022 1493.1
18.5 3318 4718.5 3318 56 47SA3105201700194240100022 3318
18.5 1198627.5 4818.5 4818.5 1198627.5 1 48SA3105201700195240100022 1198627.5
18.5 1078.35 4918.5 4918.5 1078.35 1 49SA2905201700021240100022 1078.35
18.5 1777.5 4918.5 1777.5 1 49SA2905201700021240100022 1777.5
18.5 1774724.26 5018.5 5018.5 1774724.26 2 50SA2905201700022240100022 1774724.26
18.5 34839 5018.5 34839 14 50SA2905201700022240100022 34839
18.5 734.7 5118.5 5118.5 734.7 20 51SA2905201700057240100022 734.7
18.5 2619.93 5218.5 5218.5 2619.93 20 52SA2905201700061240100022 2619.93
18.5 37327.5 5318.5 5318.5 37327.5 28 53SA2905201700063240100022 37327.5
18.5 426.6 5418.5 5418.5 426.6 8 54SA2905201700066240100022 426.6
18.5 551.03 5418.5 551.03 15 54SA2905201700066240100022 551.03
18.5 25773.75 5518.5 5518.5 25773.75 1 55SA2905201700073240100022 25773.75
TOTAL SEBELUM PPN 11984119.4 55TOTAL SEBELUM PPN 55TOTAL SEBELUM PPN 11984119.4 1 55SA2905201700073240100022 11984119.4
TOTAL SETELAH PPN 13182531.4 55TOTAL SETELAH PPN 55TOTAL SETELAH PPN 13182531.4 1 55SA2905201700073240100022 13182531.4
REKAPITULASI TAGIHAN APOTIK (RJTP) NON SYSTEM PENSIUN
NAMA MITRA : Yakes Telkom
PESERTA : TF 6
PERIODE : 29 - 31 Mei 2017
Nama Band Tanggal Tanggal

NO Nomor Resep NIK Posisi Loker NIKES Nama Pasien Nama Dokter
Pegawai Masuk Keluar
1 SA2905201700114240100022 421398.1 K. I. MAHMUD 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu

2 SA2905201700118240100022 500126 DJAJA HENDARTO 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
3 SA2905201700124240100022 520872.1 ZURIATI ZUBIR 29-05-2017 29-05-2017 dr Amar Bachtiar
4 SA2905201700139240100022 511229 MUDJIONO 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
5 SA2905201700141240100022 370472 SURJANA BIN ROJADI 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
6 SA2905201700144240100022 290530.1 SUMIJATI JD SOEBANGIN 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
7 SA2905201700147240100022 460040.1 NADHIROH,NY 29-05-2017 29-05-2017 dr Amar Bachtiar
8 SA3005201700044240100022 591192.1 DWI ESTI MULYATMI 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
9 SA3005201700063240100022 440847 SUGIMIN BIN SULAIMAN 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
10 SA3005201700065240100022 320126.1 BARIYAH 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
11 SA3005201700067240100022 431114.1 ELIZABETH SUMARTINI 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
12 SA3005201700069240100022 490902.1 JOHANA MARIA DWI PRAPTI P. 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
13 SA3005201700071240100022 640056.1 BUKIT SABAR TAMBUNAN, SH 30-05-2017 30-05-2017 drg. Arti R.Nazir
14 SA3005201700074240100022 571138 TADOH 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
15 SA3005201700077240100022 500574 BAHASANNUDIN 30-05-2017 30-05-2017 dr Amar Bachtiar
16 SA3005201700079240100022 640056.1 BUKIT SABAR TAMBUNAN, SH 30-05-2017 30-05-2017 dr Amar Bachtiar
17 SA3005201700092240100022 540428 NGAKAN PUTU SANTHA 30-05-2017 30-05-2017 dr Amar Bachtiar
18 SA3005201700116240100022 511229 MUDJIONO 30-05-2017 30-05-2017 dr Amar Bachtiar

19 SA3005201700118240100022 511229 MUDJIONO 30-05-2017 30-05-2017 dr Amar Bachtiar
20 SA3005201700135240100022 551872.1 ESTER LUMBANTOBING 30-05-2017 30-05-2017 dr Amar Bachtiar
21 SA3005201700139240100022 580123 JOKO TRIYANTO 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
22 SA3005201700140240100022 490934 TEUKU SALADIN, IR. 30-05-2017 30-05-2017 dr Amar Bachtiar
23 SA3005201700144240100022 532234 ISKANDAR 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
24 SA3005201700145240100022 410437 SUPARDI 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
25 SA3105201700075240100022 410107.2 YANAIDA THAIB 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
26 SA3105201700106240100022 520143 SAEPUDIN 31-05-2017 31-05-2017 dr Amar Bachtiar
27 SA3105201700107240100022 520143.1 ROIKAH 31-05-2017 31-05-2017 dr Amar Bachtiar
28 SA3105201700123240100022 460081 DJAUZI 31-05-2017 31-05-2017 dr Amar Bachtiar
29 SA3105201700144240100022 510051.1 ARYATI 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
30 SA3105201700151240100022 532357 BAMBANG SUMBARGO 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
31 SA3105201700161240100022 560442.1 NAZWIR 31-05-2017 31-05-2017 dr Amar Bachtiar
32 SA3105201700167240100022 460577 ABDUL RACHIM 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
33 SA3105201700168240100022 460577.1 HJ ROCHAINAH 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
34 SA3105201700170240100022 350118.1 SRI MULYANI 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
35 SA3105201700171240100022 500287.1 NURIAH 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
36 SA3105201700174240100022 431234 UNUNG MASDUKI 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
37 SA3105201700175240100022 450389.1 KASRI 31-05-2017 31-05-2017 dr Amar Bachtiar
38 SA3105201700178240100022 571011 UNTUNG MUHAEMIN 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
39 SA3105201700179240100022 500069.1 MARIANI 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
40 SA3105201700180240100022 500069 JAHJA KELANA 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
41 SA3105201700182240100022 570941.1 ROHATI 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
42 SA3105201700183240100022 540286 IGNATIUS BAMBANG BUDISURANTO31-05-2017 31-05-2017 dr Amar Bachtiar
43 SA3105201700185240100022 591487 ZULHELMA BUSRI 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
44 SA3105201700186240100022 360874 SUDIJONO BIN DJEMAKUN 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
45 SA3105201700190240100022 460053 KIMAH ROHIMAH 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
46 SA3105201700192240100022 340553.1 DJUHANA 31-05-2017 31-05-2017 dr Amar Bachtiar
47 SA3105201700194240100022 510051 SISWO KUNTJORO 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
48 SA3105201700195240100022 400689 SOEHARDI BC.TT 31-05-2017 31-05-2017 dr Amar Bachtiar
49 SA2905201700021240100022 540961 PURBONO 29-05-2017 29-05-2017 dr Amar Bachtiar
50 SA2905201700022240100022 591448 AGUNG HARYANTO SUMARGO ADIL29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
51 SA2905201700057240100022 490248 TOTO SULAEMAN 29-05-2017 29-05-2017 dr Amar Bachtiar
52 SA2905201700061240100022 531849 ASRIZAL 29-05-2017 29-05-2017 dr Amar Bachtiar
53 SA2905201700063240100022 450742 AGUS SALAM 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
54 SA2905201700066240100022 560309 SUDIRMAN SYARIF 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
55 SA2905201700073240100022 540492 RUSMIJANTO 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
P) NON SYSTEM PENSIUN

ICD Jenis
2. Jasa 3. Jasa Jumlah Total Status
X Peserta Non Gen 1. Obat / Dokter 4.
DOT DOT erik Bahan Obat Umum Dokter
Gigi Kapitasi
28 43,134 - - - 43,134
1 25,774 - - - 25,774
20 2,620 - - - 2,620
1 82,950 - - - 82,950
14 1,308,926 - - - 1,308,926
42 305,256 - - - 305,256
45 2,276 - - - 2,276
49 1,639 - - - 1,639
10 24,885 - - - 24,885
23 978 - - - 978
30 1,268 - - - 1,268
30 1,268 - - - 1,268
1 10,428 - - - 10,428
10 24,885 - - - 24,885
20 30,810 - - - 30,810
58 530,094 - - - 530,094
252 34,677 - - - 34,677
ICD Jenis
DOT Dokter
DOT erik Bahan Obat Umum Gigi Kapitasi
1 6,340 - - - 6,340
1 82,950 - - - 82,950
42 865 - - - 865
42 14,807 - - - 14,807
3 2,662,086 - - - 2,662,086
202 6,490 - - - 6,490
37 1,816 - - - 1,816
128 25,103 - - - 25,103
28 3,100 - - - 3,100
20 808 - - - 808
40 2,370 - - - 2,370
168 32,948 - - - 32,948
23 978 - - - 978
28 43,134 - - - 43,134
42 5,401 - - - 5,401
1 269 - - - 269
13 2,686,971 - - - 2,686,971
20 1,185 - - - 1,185
28 31,853 - - - 31,853
10 24,885 - - - 24,885
23 978 - - - 978
10 24,885 - - - 24,885
10 24,885 - - - 24,885
42 5,321 - - - 5,321
112 8,680 - - - 8,680
28 3,100 - - - 3,100
ICD Jenis
DOT Dokter
DOT erik Bahan Obat Umum Gigi Kapitasi
30 1,268 - - - 1,268
29 749,297 - - - 749,297
101 14,391 - - - 14,391
107 6,611 - - - 6,611
1 1,198,628 - - - 1,198,628
2 2,856 - - - 2,856
16 1,809,563 - - - 1,809,563
20 735 - - - 735
20 2,620 - - - 2,620
28 37,328 - - - 37,328
23 978 - - - 978
1 25,774 - - - 25,774
11,984,119 11,984,119
Laporan Penjualan PEGAWAI TELKOM
29 - 31 Mei 2017
Nomor Tanggal Kode

No Nikes Nama Peserta Nama Dokter
Resep Transaksi Dokter
1 E2102000 690200.1 SRI TUWALIYANTI 29-05-2017 210110013 dr amar bachtiar
2 E2102000 700646 FERRYMANSYAH, ST 29-05-2017 210110013 dr amar bachtiar
3 E2102000 621300 DARMAWAN 29-05-2017 210210001 dr. Istiyarti Tapilatu
4 E2102000 633217.2 SUHARTINI 29-05-2017 210110013 dr amar bachtiar
5 E2102000 633217 WASIMIN 29-05-2017 210110013 dr amar bachtiar
6 E2102000 700208.104 AZHARIANTO 29-05-2017 210210001 dr. Istiyarti Tapilatu
7 E2102000 680413.1 DIAN MARDIANA 29-05-2017 210210001 dr. Istiyarti Tapilatu

8 E2102000 680246 MARTUNUS 29-05-2017 210110013 dr amar bachtiar
9 E2102000 680525.1 ISWAHYUNI BENNY HAN29-05-2017 210210001 dr. Istiyarti Tapilatu
10 E2102000 700372.101 LAYLA JULIA SYAFRIANI 29-05-2017 210110013 dr amar bachtiar
11 E2102000 700112.101 MUHAMMAD DIKIANSY29-05-2017 210110013 dr amar bachtiar
12 E2102000 700112.1 ROSDIANA 29-05-2017 210110013 dr amar bachtiar
13 E2102000 700646.1 META FATIA 29-05-2017 210110013 dr amar bachtiar
14 E2102000 680589.102 NADIYA NURFAIZA 29-05-2017 210210001 dr. Istiyarti Tapilatu

15 E2102000 620453.1 KASRONI 29-05-2017 210210001 dr. Istiyarti Tapilatu
16 E2102000 620453.1 KASRONI 29-05-2017 210210001 dr. Istiyarti Tapilatu
17 E2102000 621815.1 DEBBIE CONNIE RATNIE 29-05-2017 210110013 dr amar bachtiar
18 E21020000 700560.1 RINA YUSNITA 29-05-2017 210320001 drg. Teresa Venir
19 E2102000 680390.1 WIWIT SUMIATI 29-05-2017 210210001 dr. Istiyarti Tapilatu
20 E2102000 690419.1 LILIS TRIYATMI 29-05-2017 210110013 dr amar bachtiar
21 E2102000 670067 MARISI MANULLANG 29-05-2017 210210001 dr. Istiyarti Tapilatu
22 E2102000 690355.101 FITRI RACHMAWATI 29-05-2017 210210001 dr. Istiyarti Tapilatu
23 E2102000 630812 RAHARJO 29-05-2017 210210001 dr. Istiyarti Tapilatu
24 E2102000 660566.1 IIS SURYANI 29-05-2017 210210001 dr. Istiyarti Tapilatu

25 E2102000 700099 NGADI 29-05-2017 210210001 dr. Istiyarti Tapilatu
26 E21020000 810081.1 FITRIA RAHMI 29-05-2017 210220001 drg. Arti R.Nazir
27 E2102000 660443 LASMA LYDIA PINARSIN 29-05-2017 210210001 dr. Istiyarti Tapilatu
28 E2102000 700039.1 DIMYANTI HARTATI 29-05-2017 210110013 dr amar bachtiar
29 E2102000 632462 SYAIFUL BAHRI 29-05-2017 210110013 dr amar bachtiar
30 E2102000 820065.101 MUHAMMAD RASYA PUT

29-05-2017 210210001 dr. Istiyarti Tapilatu
31 E2102000 620492 TETY PUSPITOWATI 29-05-2017 210210001 dr. Istiyarti Tapilatu
32 E2102000 690230.102 FARHAN NAUVAL RAFIF 29-05-2017 210110013 dr amar bachtiar

33 E2102000 690230.101 NANDINI PUTRI DEWITA29-05-2017 210110013 dr amar bachtiar
34 E2102000 690230.1 NURASASIH 29-05-2017 210110013 dr amar bachtiar
35 E2102000 612315 SUPRIYATNO 29-05-2017 210210001 dr. Istiyarti Tapilatu
36 E2102000 680055 KHAIRUL FAHMI 29-05-2017 210110013 dr amar bachtiar
37 E21020000 642305.1 ENDANG SRI WIDANING30-05-2017 210230002 Bidan Vitha Diana
38 E2102000 631899.1 ICE NURDIANI 30-05-2017 210210001 dr. Istiyarti Tapilatu
39 E2102000 631899 LASAM 30-05-2017 210210001 dr. Istiyarti Tapilatu

40 E2102000 690146.1 SARPEN 30-05-2017 210210001 dr. Istiyarti Tapilatu
41 E2102000 690146 TADI 30-05-2017 210210001 dr. Istiyarti Tapilatu
42 E2102000 620577 SYAIFUL BAHRI 30-05-2017 210110013 dr amar bachtiar
43 E2102000 622888 TUBAGUS BUDIAWAN 30-05-2017 210110013 dr amar bachtiar
44 E21020000 810029.1 ANASTASIA MARGARETH30-05-2017 210230002 Bidan Vitha Diana
45 E2102000 632907 SUKATMA 30-05-2017 210210001 dr. Istiyarti Tapilatu
46 E2102000 632113.1 YUNI SUKASNI 30-05-2017 210110013 dr amar bachtiar
47 E2102000 680039.1 FATMAWATY MUIS 30-05-2017 210110013 dr amar bachtiar

48 E21020000 641591 HARYOKO 30-05-2017 210320001 drg. Teresa Venir
49 E2102000 611467 MARGONO 30-05-2017 210110013 dr amar bachtiar
50 E21020000 632113.1 YUNI SUKASNI 30-05-2017 210220001 drg. Arti R.Nazir
51 E2102000 611467.1 MISTIYAH 30-05-2017 210110013 dr amar bachtiar
52 E2102000 710038.103 FARAH DIPTA SALSABIL 30-05-2017 210210001 dr. Istiyarti Tapilatu
53 E2102000 642081.1 NURMAINI 30-05-2017 210210001 dr. Istiyarti Tapilatu
54 E2102000 621220 YUDO IRIANTO 30-05-2017 210110013 dr amar bachtiar

55 E2102000 621220 YUDO IRIANTO 30-05-2017 210110013 dr amar bachtiar
56 E2102000 670563 RAMSES MANURUNG 30-05-2017 210210001 dr. Istiyarti Tapilatu
57 E2102000 630761.103 NASTITI TRIJAYANTI 30-05-2017 210210001 dr. Istiyarti Tapilatu
58 E2102000 642081 ADEK SURYONO 30-05-2017 210210001 dr. Istiyarti Tapilatu
59 E2102000 641095 SUSI SUSWANTI 30-05-2017 210110013 dr amar bachtiar
60 E21020000 633236.1 SRI RETNOWATI 30-05-2017 210220001 drg. Arti R.Nazir
61 E2102000 670363 AHMAD IRIANTO 30-05-2017 210210001 dr. Istiyarti Tapilatu
62 E2102000 640794 PUTU PUTRA RIAWAN 30-05-2017 210110013 dr amar bachtiar
63 E2102000 633236.102 DINDA FAUZIAH OLIMVI30-05-2017 210110013 dr amar bachtiar

64 E2102000 660371 DIDIET HENDRO PRAST 30-05-2017 210210001 dr. Istiyarti Tapilatu
65 E2102000 680525 RACHMAT 30-05-2017 210110013 dr amar bachtiar
66 E2102000 660371.1 RANITA M BAGA 30-05-2017 210210001 dr. Istiyarti Tapilatu
67 E2102000 611460 AKHLANI 31-05-2017 210110013 dr amar bachtiar
68 E2102000 611460.1 SULASTRI 31-05-2017 210110013 dr amar bachtiar
69 E2102000 690496.102 ZHIARA AULIA 31-05-2017 210110013 dr amar bachtiar
70 E2102000 700646.1 META FATIA 31-05-2017 210110013 dr amar bachtiar

71 E2102000 611617 TUKIJA 31-05-2017 210110013 dr amar bachtiar
72 E2102000 611617 TUKIJA 31-05-2017 210110013 dr amar bachtiar
73 E2102000 620955 AFRIZALI 31-05-2017 210210001 dr. Istiyarti Tapilatu
74 E21020000 760042.1 WENI FEBRINA 31-05-2017 210320001 drg. Teresa Venir
75 E2102000 630761.1 JUNAETI WAHYUNINGR 31-05-2017 210210001 dr. Istiyarti Tapilatu
76 E21020000 810081.1 FITRIA RAHMI 31-05-2017 210220001 drg. Arti R.Nazir
77 E21020000 830087 MAYRISA 31-05-2017 210320001 drg. Teresa Venir
78 E2102000 690223 ABDUL RAHMAN 31-05-2017 210110013 dr amar bachtiar
79 E2102000 700355 HARNOLO 31-05-2017 210110013 dr amar bachtiar
80 E2102000 630510 ASEP FACHRUDIN 31-05-2017 210210001 dr. Istiyarti Tapilatu

81 E2102000 621271 SOBAR SISWANTO 31-05-2017 210110013 dr amar bachtiar
82 E2102000 680541 YULI SUNARKA 31-05-2017 210110013 dr amar bachtiar
83 E2102000 710107 ANDY 31-05-2017 210110013 dr amar bachtiar
84 E2102000 622553 RIKA JUNAIDI 31-05-2017 210210001 dr. Istiyarti Tapilatu
85 E2102000 612233 SUSILO KRISMIATI 31-05-2017 210210001 dr. Istiyarti Tapilatu
86 E2102000 622693.1 ENDANG SULISTYOWATI31-05-2017 210210001 dr. Istiyarti Tapilatu
87 E2102000 710025.1 ROHMAWATI 31-05-2017 210210001 dr. Istiyarti Tapilatu
88 E2102000 630316 JOKO MURSITO 31-05-2017 210210001 dr. Istiyarti Tapilatu

89 E2102000 630669 SUMARSONO 31-05-2017 210210001 dr. Istiyarti Tapilatu
90 E2102000 670549 JUNIAR 31-05-2017 210110013 dr amar bachtiar
91 E2102000 700251.101 PUTRI NOVRILIA SUSAN31-05-2017 210110013 dr amar bachtiar
92 E2102000 630669.1 NOERBAETY 31-05-2017 210210001 dr. Istiyarti Tapilatu
93 E2102000 690457 DEDI PURWANTO 31-05-2017 210110013 dr amar bachtiar
94 E2102000 633093 WIDJI TAMTOMO, IR. 31-05-2017 210110013 dr amar bachtiar
95 E2102000 670479 MOCH. DIMYATI 31-05-2017 210210001 dr. Istiyarti Tapilatu

96 E21020000 632125.103 FATTURRAHMAN 31-05-2017 210320001 drg. Teresa Venir
97 E2102000 630853 SUKARJA 31-05-2017 210210001 dr. Istiyarti Tapilatu
98 E2102000 700323 EVAN HUTAJULU 31-05-2017 210110013 dr amar bachtiar
99 E2102000 690335 WINARKO 31-05-2017 210210001 dr. Istiyarti Tapilatu

enjualan PEGAWAI TELKOM
TOSHIBA:
- 31 Mei 2017 1 = Kepesertaan
2 = Non DOT
Percetakan Negara No.17A Jakarta Pusat 3 = Obat Moll
Total
Harga Diskon Margin Pembaya Nomor Nama Tanggal
Nama Obat Jumlah Ket. No NIKKES
HNA (%) (%) Resep Peserta Transaksi
ran
Betaone tab. 5 mg 50 2400 0 18.5 142200 1 E2102000 690200.1 SRI TUWAL29-05-201

Sub Total 142200 1 E2102000 690200.1 SRI TUWAL29-05-201
Anadium kapl. 14 4248 0 18.5 70474.32 2 E2102000 700646 FERRYMANS29-05-201
Sub Total 70474.32 2 E2102000 700646 FERRYMANS29-05-201
Litorcom tab. 20 mg 14 3622.67 0 18.5 60100.04 3 E2102000 621300 DARMAWA29-05-201
Dilavask tab. 5 mg 14 492 0 18.5 8162.28 3 E2102000 621300 DARMAWA29-05-201
Sub Total 68262.32 3 E2102000 621300 DARMAWA29-05-201
Diaformin XR tab. 500 mg 28 900 0 18.5 29862 4 E2102000 633217.2 SUHARTINI29-05-201
Metrix tab. 2 mg 28 1890 0 18.5 62710.2 4 E2102000 633217.2 SUHARTINI29-05-201
Sub Total 92572.2 4 E2102000 633217.2 SUHARTINI29-05-201
Metrix tab. 2 mg 20 1890 0 18.5 44793 5 E2102000 633217 WASIMIN 29-05-201
Thrombo Aspilets tab. 80 mg 20 448 0 18.5 10617.6 5 E2102000 633217 WASIMIN 29-05-201
Tenapril tab. 2,5 mg 20 1575 0 18.5 37327.5 5 E2102000 633217 WASIMIN 29-05-201
Nitrokaf Retard kaps. SR 2,5 mg 40 1818.36 0 18.5 86190.38 5 E2102000 633217 WASIMIN 29-05-201
Simvastatin tab. 10 mg (Kim) 20 221.52 0 18.5 5250.09 5 E2102000 633217 WASIMIN 29-05-201
Sub Total 184178.6 5 E2102000 633217 WASIMIN 29-05-201
Clamixin kapl. 10 5500 0 18.5 65175 6 E2102000 700208.1 AZHARIAN29-05-201
Gentamicin 1% Salep Kulit 5 gram 1 1773 0 8 1914.84 6 E2102000 700208.1 AZHARIAN29-05-201
Cavit D3 kaps. 0,5 mcg 15 1140.7 0 18.5 20275.94 6 E2102000 700208.1 AZHARIAN29-05-201
Rhinofed tab. 10 1155 0 18.5 13686.75 6 E2102000 700208.1 AZHARIAN29-05-201
Sub Total 101052.5 6 E2102000 700208.1 AZHARIAN29-05-201
Opixime tab. 100 mg 8 7560 0 18.5 71668.8 7 E2102000 680413.1 DIAN MAR29-05-201
Urotractin kaps. 400 mg 8 1652 0 18.5 15660.96 7 E2102000 680413.1 DIAN MAR29-05-201
Gitas Plus tab. 6 1750 0 18.5 12442.5 7 E2102000 680413.1 DIAN MAR29-05-201
Sub Total 99772.26 7 E2102000 680413.1 DIAN MAR29-05-201
NovoMix 30 FlexPen inj. 100 IU/ml 1 151278.5 0 18.5 179265.1 8 E2102000 680246 MARTUNU29-05-201
Diaformin XR tab. 500 mg 14 900 0 18.5 14931 8 E2102000 680246 MARTUNU29-05-201
Dilavask tab. 10 mg 14 1050 0 18.5 17419.5 8 E2102000 680246 MARTUNU29-05-201
Canderin tab. 8 mg 14 4800 0 18.5 79632 8 E2102000 680246 MARTUNU29-05-201
Esvat tab. 20 mg 14 866.25 0 18.5 14371.09 8 E2102000 680246 MARTUNU29-05-201
Sub Total 305618.7 8 E2102000 680246 MARTUNU29-05-201
NovoMix 30 FlexPen inj. 100 IU/ml 1 151278.5 0 18.5 179265.1 9 E2102000 680525.1 ISWAHYUN29-05-201
Evothyl kaps. 300 mg 14 4950 0 18.5 82120.5 9 E2102000 680525.1 ISWAHYUN29-05-201
Esvat tab. 20 mg 14 866.25 0 18.5 14371.09 9 E2102000 680525.1 ISWAHYUN29-05-201
Eclid tab. 50 mg 42 1200 0 18.5 59724 9 E2102000 680525.1 ISWAHYUN29-05-201
Diaformin XR tab. 500 mg 28 900 0 18.5 29862 9 E2102000 680525.1 ISWAHYUN29-05-201
Sub Total 365342.7 9 E2102000 680525.1 ISWAHYUN29-05-201
Pyrazinamide tab. 500 mg (Kim) 90 260.7 0 18.5 27803.66 10 E2102000 700372.1 LAYLA JULI29-05-201
Ethambutol tab. 500 mg (Kim) 45 508.42 0 18.5 27111.4 10 E2102000 700372.1 LAYLA JULI29-05-201
Isoniazid tab. 300 mg (Kim) 30 173 0 18.5 6150.15 10 E2102000 700372.1 LAYLA JULI29-05-201
Extropect syr. 30 mg/5 ml, btl. 60 ml 1 14400 0 18.5 17064 10 E2102000 700372.1 LAYLA JULI29-05-201
Fluzep kapl. 10 562.5 0 18.5 6665.63 10 E2102000 700372.1 LAYLA JULI29-05-201
Sub Total 84794.83 10 E2102000 700372.1 LAYLA JULI29-05-201
Gentamicin 1% Salep Kulit 5 gram 2 1773 0 8 3829.68 11 E2102000 700112.1 MUHAMMAD 29-05-201
Fungasol krim 2%, 10 gr 1 14950 0 18.5 17715.75 11 E2102000 700112.1 MUHAMMAD 29-05-201
Sub Total 21545.43 11 E2102000 700112.1 MUHAMMAD 29-05-201
Osfit tab. 500 mg 20 1125 0 18.5 26662.5 12 E2102000 700112.1 ROSDIANA29-05-201
Sub Total 26662.5 12 E2102000 700112.1 ROSDIANA29-05-201
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63 13 E2102000 700646.1 META FATI29-05-201
Rhinos SR kaps. 10 3600 0 18.5 42660 13 E2102000 700646.1 META FATI29-05-201
Sanmol tab. 500 mg 10 250 0 18.5 2962.5 13 E2102000 700646.1 META FATI29-05-201
Sub Total 97081.13 13 E2102000 700646.1 META FATI29-05-201
Eflagen tab. 25 mg 8 672 0 18.5 6370.56 14 E2102000 680589.1 NADIYA NU29-05-201
Flamar emulgel 1% 20 gr 1 11840 0 18.5 14030.4 14 E2102000 680589.1 NADIYA NU29-05-201
Sub Total 20400.96 14 E2102000 680589.1 NADIYA NU29-05-201
Acyclovir cream 5 %, tube 5 gr (indo) 2 2588.32 0 18.5 6134.31 15 E2102000 620453.1 KASRONI 29-05-201
Flamar tab. 50 mg 15 1320 0 18.5 23463 15 E2102000 620453.1 KASRONI 29-05-201
Kalmeco tab. 500 mcg 15 1700 0 18.5 30217.5 15 E2102000 620453.1 KASRONI 29-05-201
Sub Total 59814.81 15 E2102000 620453.1 KASRONI 29-05-201
Damuvit tab. 14 825 0 18.5 13686.75 16 E2102000 620453.1 KASRONI 29-05-201
Sub Total 13686.75 16 E2102000 620453.1 KASRONI 29-05-201
Thombophob gel. 20 gr 1 44887.5 0 18.5 53191.69 17 E2102000 621815.1 DEBBIE CO29-05-201
Anadium kapl. 14 4248 0 18.5 70474.32 17 E2102000 621815.1 DEBBIE CO29-05-201
Diclofenac Potassium tab. 50 mg (Hex) 10 410 0 18.5 4858.5 17 E2102000 621815.1 DEBBIE CO29-05-201
Sub Total 128524.5 17 E2102000 621815.1 DEBBIE CO29-05-201
Cefat kaps. 500 mg 8 4342.5 0 18.5 41166.9 18 E21020000700560.1 RINA YUSN29-05-201
Hexadol Mint sol. 100 ml 1 15000 0 18.5 17775 18 E21020000700560.1 RINA YUSN29-05-201
Diclofenac Potassium tab. 50 mg (Hex) 10 410 0 18.5 4858.5 18 E21020000700560.1 RINA YUSN29-05-201
Sub Total 63800.4 18 E21020000700560.1 RINA YUSN29-05-201
Xytrol ED tts. mata , btl 5 ml 1 23980 0 18.5 28416.3 19 E2102000 680390.1 WIWIT SUM 29-05-201
Sub Total 28416.3 19 E2102000 680390.1 WIWIT SUM 29-05-201
Tequinol tab. 500 mg 10 5040 0 18.5 59724 20 E2102000 690419.1 LILIS TRIY 29-05-201
Extropect syr. 30 mg/5 ml, btl. 60 ml 1 14400 0 18.5 17064 20 E2102000 690419.1 LILIS TRIY 29-05-201
Fluzep kapl. 10 562.5 0 18.5 6665.63 20 E2102000 690419.1 LILIS TRIY 29-05-201
Sub Total 83453.63 20 E2102000 690419.1 LILIS TRIY 29-05-201
Interpec tab. 30 mg 10 550 0 18.5 6517.5 21 E2102000 670067 MARISI M 29-05-201
Dextafen tab. 8 770 0 18.5 7299.6 21 E2102000 670067 MARISI M 29-05-201
Sub Total 13817.1 21 E2102000 670067 MARISI M 29-05-201
Cefat kaps. 500 mg 8 4342.5 0 18.5 41166.9 22 E2102000 690355.1 FITRI RAC 29-05-201
Rhinos SR kaps. 8 3600 0 18.5 34128 22 E2102000 690355.1 FITRI RAC 29-05-201
Ambroxol tab. 30 mg (Indo) 12 124.09 0 18.5 1764.55 22 E2102000 690355.1 FITRI RAC 29-05-201
Sub Total 77059.45 22 E2102000 690355.1 FITRI RAC 29-05-201
Dilavask tab. 5 mg 20 492 0 18.5 11660.4 23 E2102000 630812 RAHARJO 29-05-201
Ursolic kaps. 250 mg 20 4611 0 18.5 109280.7 23 E2102000 630812 RAHARJO 29-05-201
Sub Total 120941.1 23 E2102000 630812 RAHARJO 29-05-201
Neuraxon 5000 tab. 15 1237.5 0 18.5 21996.56 24 E2102000 660566.1 IIS SURYAN29-05-201
Furosemide tab. 40 mg (Kim) 8 93.43 0 18.5 885.67 24 E2102000 660566.1 IIS SURYAN29-05-201
Voltadex emulgel 1%/20 gr 1 17550 0 18.5 20796.75 24 E2102000 660566.1 IIS SURYAN29-05-201
Sub Total 43678.98 24 E2102000 660566.1 IIS SURYAN29-05-201
Diaversa tab. 2 mg 14 992 0 18.5 16457.28 25 E2102000 700099 NGADI 29-05-201
Metformin tab. 500 mg (Dex) 28 156.75 0 18.5 5200.97 25 E2102000 700099 NGADI 29-05-201
Litorcom tab. 20 mg 14 3622.67 0 18.5 60100.04 25 E2102000 700099 NGADI 29-05-201
Ursolic kaps. 250 mg 14 4611 0 18.5 76496.49 25 E2102000 700099 NGADI 29-05-201
Sub Total 158254.8 25 E2102000 700099 NGADI 29-05-201
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63 26 E21020000810081.1 FITRIA RA 29-05-201
Analsik kapl. 10 638 0 18.5 7560.3 26 E21020000810081.1 FITRIA RA 29-05-201
Sub Total 59018.93 26 E21020000810081.1 FITRIA RA 29-05-201
Dilavask tab. 5 mg 10 492 0 18.5 5830.2 27 E2102000 660443 LASMA LYD29-05-201
Clamixin kapl. 10 5500 0 18.5 65175 27 E2102000 660443 LASMA LYD29-05-201
Dextafen tab. 6 770 0 18.5 5474.7 27 E2102000 660443 LASMA LYD29-05-201
Ambroxol tab. 30 mg (Indo) 10 124.09 0 18.5 1470.45 27 E2102000 660443 LASMA LYD29-05-201
Sub Total 77950.35 27 E2102000 660443 LASMA LYD29-05-201
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 28 E2102000 700039.1 DIMYANTI 29-05-201
Irbesartan tab. 150 mg. (Indo) 28 1249.5 0 18.5 41458.41 28 E2102000 700039.1 DIMYANTI 29-05-201
Sub Total 57782.97 28 E2102000 700039.1 DIMYANTI 29-05-201
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63 29 E2102000 632462 SYAIFUL B 29-05-201
Ambroxol tab. 30 mg (Indo) 10 124.09 0 18.5 1470.45 29 E2102000 632462 SYAIFUL B 29-05-201
Rhinos SR kaps. 10 3600 0 18.5 42660 29 E2102000 632462 SYAIFUL B 29-05-201
Sanmol tab. 500 mg 10 250 0 18.5 2962.5 29 E2102000 632462 SYAIFUL B 29-05-201
Sub Total 98551.58 29 E2102000 632462 SYAIFUL B 29-05-201
Dextafen tab. 6 770 0 18.5 5474.7 30 E2102000 820065.1 MUHAMMAD 29-05-201
Bufect Forte syr. 200 mg/5 ml, btl 60 ml 1 12580 0 18.5 14907.3 30 E2102000 820065.1 MUHAMMAD 29-05-201
Clamixin FDS 1 44400 0 18.5 52614 30 E2102000 820065.1 MUHAMMAD 29-05-201
Sub Total 72996 30 E2102000 820065.1 MUHAMMAD 29-05-201
Opixime tab. 100 mg 8 7560 0 18.5 71668.8 31 E2102000 620492 TETY PUSP29-05-201
Sanmol tab. 500 mg 8 250 0 18.5 2370 31 E2102000 620492 TETY PUSP29-05-201
Betason N krim 5 gr 1 9945 0 18.5 11784.83 31 E2102000 620492 TETY PUSP29-05-201
Sub Total 85823.63 31 E2102000 620492 TETY PUSP29-05-201
Tequinol tab. 500 mg 10 5040 0 18.5 59724 32 E2102000 690230.1 FARHAN NA 29-05-201
Codeine tab. 10 mg (Kim) 10 550 0 18.5 6517.5 32 E2102000 690230.1 FARHAN NA29-05-201
Fluzep kapl. 10 562.5 0 18.5 6665.63 32 E2102000 690230.1 FARHAN NA29-05-201
Sub Total 72907.13 32 E2102000 690230.1 FARHAN NA29-05-201
Tequinol tab. 500 mg 10 5040 0 18.5 59724 33 E2102000 690230.1 NANDINI P29-05-201
Codeine tab. 10 mg (Kim) 10 550 0 18.5 6517.5 33 E2102000 690230.1 NANDINI P29-05-201
Fluzep kapl. 10 562.5 0 18.5 6665.63 33 E2102000 690230.1 NANDINI P29-05-201
Sub Total 72907.13 33 E2102000 690230.1 NANDINI P29-05-201
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63 34 E2102000 690230.1 NURASASI 29-05-201
Codeine tab. 10 mg (Kim) 10 550 0 18.5 6517.5 34 E2102000 690230.1 NURASASI 29-05-201
Fluzep kapl. 10 562.5 0 18.5 6665.63 34 E2102000 690230.1 NURASASI 29-05-201
Sub Total 64641.75 34 E2102000 690230.1 NURASASI 29-05-201
Kalmeco tab. 500 mcg 15 1700 0 18.5 30217.5 35 E2102000 612315 SUPRIYATN29-05-201
Voltadex emulgel 1%/20 gr 1 17550 0 18.5 20796.75 35 E2102000 612315 SUPRIYATN29-05-201
Diclofenac Potassium tab. 50 mg (Hex) 15 410 0 18.5 7287.75 35 E2102000 612315 SUPRIYATN29-05-201
Sub Total 58302 35 E2102000 612315 SUPRIYATN29-05-201
Astika tab. 100 mg. 20 374 0 18.5 8863.8 36 E2102000 680055 KHAIRUL F29-05-201
Clopidogrel tab. 75 mg (Hex) 20 3700 0 18.5 87690.01 36 E2102000 680055 KHAIRUL F29-05-201
Angioten tab. 50 mg 20 4080 0 18.5 96696 36 E2102000 680055 KHAIRUL F29-05-201
Betaone tab. 5 mg 20 2400 0 18.5 56880 36 E2102000 680055 KHAIRUL F29-05-201
Dilavask tab. 10 mg 20 1050 0 18.5 24885 36 E2102000 680055 KHAIRUL F29-05-201
Esvat tab. 20 mg 20 866.25 0 18.5 20530.13 36 E2102000 680055 KHAIRUL F29-05-201
Sub Total 295544.9 36 E2102000 680055 KHAIRUL F29-05-201
Emibion kaps. 14 720 0 18.5 11944.8 37 E21020000642305.1 ENDANG SR30-05-201
Sub Total 11944.8 37 E21020000642305.1 ENDANG SR30-05-201
Thrombo Aspilets tab. 80 mg 14 448 0 18.5 7432.32 38 E2102000 631899.1 ICE NURDI30-05-201
Dilavask tab. 5 mg 14 492 0 18.5 8162.28 38 E2102000 631899.1 ICE NURDI30-05-201
Cedocard tab. sublingual 5 mg 42 749.17 0 18.5 37286.03 38 E2102000 631899.1 ICE NURDI30-05-201
Litorcom tab. 20 mg 14 3622.67 0 18.5 60100.04 38 E2102000 631899.1 ICE NURDI30-05-201
Sub Total 112980.7 38 E2102000 631899.1 ICE NURDI30-05-201
Diaformin XR tab. 500 mg 28 900 0 18.5 29862 39 E2102000 631899 LASAM 30-05-201
Angioten tab. 50 mg 14 4080 0 18.5 67687.2 39 E2102000 631899 LASAM 30-05-201
Dilavask tab. 10 mg 14 1050 0 18.5 17419.5 39 E2102000 631899 LASAM 30-05-201
Thrombo Aspilets tab. 80 mg 14 448 0 18.5 7432.32 39 E2102000 631899 LASAM 30-05-201
Allopurinol tab. 100 mg (Kim) 14 144.3 0 18.5 2393.94 39 E2102000 631899 LASAM 30-05-201
Litorcom tab. 20 mg 14 3622.67 0 18.5 60100.04 39 E2102000 631899 LASAM 30-05-201
Diaversa tab. 3 mg 14 1352 0 18.5 22429.68 39 E2102000 631899 LASAM 30-05-201
Sub Total 207324.7 39 E2102000 631899 LASAM 30-05-201
Tramifen kapl 10 4200 0 18.5 49770 40 E2102000 690146.1 SARPEN 30-05-201
Neurosanbe FC tab 10 800 0 18.5 9480 40 E2102000 690146.1 SARPEN 30-05-201
Sub Total 59250 40 E2102000 690146.1 SARPEN 30-05-201
Bactoprim Combi forte tab 800 mg/160 mg . 6 440 0 18.5 3128.4 41 E2102000 690146 TADI 30-05-201
Diagit tab. 10 687.5 0 18.5 8146.88 41 E2102000 690146 TADI 30-05-201
Gitas Plus tab. 6 1750 0 18.5 12442.5 41 E2102000 690146 TADI 30-05-201
Episan susp. 500 mg/5 ml @ 100 ml 1 24310 0 18.5 28807.35 41 E2102000 690146 TADI 30-05-201
Sub Total 52525.13 41 E2102000 690146 TADI 30-05-201
Betaone tab. 5 mg 28 2400 0 18.5 79632 42 E2102000 620577 SYAIFUL B 30-05-201
Atorvastatin tab. 20 mg (Hex) 28 4000 0 8 120960 42 E2102000 620577 SYAIFUL B 30-05-201
Cedocard tab. sublingual 5 mg 5 749.17 0 18.5 4438.81 42 E2102000 620577 SYAIFUL B 30-05-201
Sub Total 205030.8 42 E2102000 620577 SYAIFUL B 30-05-201
Salbutamol sulfate tab. 2 mg (Kim) 60 76.39 0 18.5 5431.39 43 E2102000 622888 TUBAGUS 30-05-201
Rydian tab. 10 mg 18 1900 0 18.5 40527 43 E2102000 622888 TUBAGUS 30-05-201
Ambroxol tab. 30 mg (Indo) 30 124.09 0 18.5 4411.36 43 E2102000 622888 TUBAGUS 30-05-201
Sub Total 50369.76 43 E2102000 622888 TUBAGUS 30-05-201
Biofolat Plus 30 3200 0 18.5 113760 44 E21020000810029.1 ANASTASI 30-05-201
Emibion kaps. 30 720 0 18.5 25596 44 E21020000810029.1 ANASTASI 30-05-201
Cavit D3 kaps. 0,5 mcg 30 1140.7 0 18.5 40551.89 44 E21020000810029.1 ANASTASI 30-05-201
Sub Total 179907.9 44 E21020000810029.1 ANASTASI 30-05-201
Hi-Bone tab. 28 2550 0 18.5 84609 45 E2102000 632907 SUKATMA 30-05-201
Sub Total 84609 45 E2102000 632907 SUKATMA 30-05-201
Acilaz kaps. 30 mg 10 5200 0 18.5 61620 46 E2102000 632113.1 YUNI SUKA30-05-201
Gitas Plus tab. 10 1750 0 18.5 20737.5 46 E2102000 632113.1 YUNI SUKA30-05-201
Magtral Syr. Forte 1 13000 0 18.5 15405 46 E2102000 632113.1 YUNI SUKA30-05-201
Sub Total 97762.5 46 E2102000 632113.1 YUNI SUKA30-05-201
Cameloc tab. 7,5 mg 20 580 0 18.5 13746 47 E2102000 680039.1 FATMAWAT30-05-201
Kalmeco tab. 500 mcg 20 1700 0 18.5 40290 47 E2102000 680039.1 FATMAWAT30-05-201
Hi-Bone tab. 20 2550 0 18.5 60435 47 E2102000 680039.1 FATMAWAT30-05-201
Voltadex emulgel 1%/20 gr 1 17550 0 18.5 20796.75 47 E2102000 680039.1 FATMAWAT30-05-201
Sub Total 135267.8 47 E2102000 680039.1 FATMAWAT30-05-201
Ponstelax kapl. 500 mg 6 350.35 0 18.5 2490.99 48 E21020000 641591 HARYOKO 30-05-201
Sub Total 2490.99 48 E21020000 641591 HARYOKO 30-05-201
Meloxicam tab. 15 mg (Kim) 20 626.12 0 18.5 14839.14 49 E2102000 611467 MARGONO30-05-201
Hi-Bone tab. 15 2550 0 18.5 45326.25 49 E2102000 611467 MARGONO30-05-201
Fungasol krim 2%, 10 gr 1 14950 0 18.5 17715.75 49 E2102000 611467 MARGONO30-05-201
Gentamicin 1% Salep Kulit 5 gram 1 1773 0 8 1914.84 49 E2102000 611467 MARGONO30-05-201
Sub Total 79795.98 49 E2102000 611467 MARGONO30-05-201
Diclofenac Potassium tab. 50 mg (Hex) 10 410 0 18.5 4858.5 50 E21020000632113.1 YUNI SUKA30-05-201
Hexadol Mint sol. 100 ml 1 15000 0 18.5 17775 50 E21020000632113.1 YUNI SUKA30-05-201
Sub Total 22633.5 50 E21020000632113.1 YUNI SUKA30-05-201
Ketricin salep in oral base 5 gr 1 26800 0 18.5 31758 51 E2102000 611467.1 MISTIYAH 30-05-201
Flamar tab. 50 mg 20 1320 0 18.5 31284 51 E2102000 611467.1 MISTIYAH 30-05-201
Voltadex emulgel 1%/20 gr 1 17550 0 18.5 20796.75 51 E2102000 611467.1 MISTIYAH 30-05-201
Sub Total 83838.75 51 E2102000 611467.1 MISTIYAH 30-05-201
Clamixin kapl. 10 5500 0 18.5 65175 52 E2102000 710038.1 FARAH DIP30-05-201
Otopain tts. telinga, btl. 8 ml 1 31500 0 18.5 37327.5 52 E2102000 710038.1 FARAH DIP30-05-201
Ambroxol tab. 30 mg (Indo) 14 124.09 0 18.5 2058.64 52 E2102000 710038.1 FARAH DIP30-05-201
Dextafen tab. 10 770 0 18.5 9124.5 52 E2102000 710038.1 FARAH DIP30-05-201
Eflagen tab. 25 mg 8 672 0 18.5 6370.56 52 E2102000 710038.1 FARAH DIP30-05-201
Sub Total 120056.2 52 E2102000 710038.1 FARAH DIP30-05-201
Tequinol tab. 500 mg 8 5040 0 18.5 47779.2 53 E2102000 642081.1 NURMAINI30-05-201
Urotractin kaps. 400 mg 8 1652 0 18.5 15660.96 53 E2102000 642081.1 NURMAINI30-05-201
Eflagen tab. 25 mg 12 672 0 18.5 9555.84 53 E2102000 642081.1 NURMAINI30-05-201
Plantacid Forte tab. 10 663.64 0 18.5 7864.09 53 E2102000 642081.1 NURMAINI30-05-201
Sub Total 80860.09 53 E2102000 642081.1 NURMAINI30-05-201
Dilavask tab. 5 mg 20 492 0 18.5 11660.4 54 E2102000 621220 YUDO IRIA30-05-201
Febogrel tab. 75 mg 20 5280 0 18.5 125136 54 E2102000 621220 YUDO IRIA30-05-201
Atorvastatin tab. 20 mg (Hex) 20 4000 0 8 86400 54 E2102000 621220 YUDO IRIA30-05-201
Sub Total 223196.4 54 E2102000 621220 YUDO IRIA30-05-201
Primadex kapl. 10 279 0 18.5 3306.15 55 E2102000 621220 YUDO IRIA30-05-201
Diagit tab. 10 687.5 0 18.5 8146.88 55 E2102000 621220 YUDO IRIA30-05-201
Gitas Plus tab. 10 1750 0 18.5 20737.5 55 E2102000 621220 YUDO IRIA30-05-201
Acilaz kaps. 30 mg 10 5200 0 18.5 61620 55 E2102000 621220 YUDO IRIA30-05-201
Sub Total 93810.53 55 E2102000 621220 YUDO IRIA30-05-201
Dilavask tab. 5 mg 14 492 0 18.5 8162.28 56 E2102000 670563 RAMSES M30-05-201
Esvat tab. 10 mg 14 472.5 0 18.5 7838.78 56 E2102000 670563 RAMSES M30-05-201
Alluric tab. 300 mg. 28 1755.45 0 18.5 58245.98 56 E2102000 670563 RAMSES M30-05-201
Sub Total 74247.04 56 E2102000 670563 RAMSES M30-05-201
Stesolid lar. rectal 10 mg/2,5 ml 2 32076 0 18.5 76020.12 57 E2102000 630761.1 NASTITI TR30-05-201
Lepsio syr. 250 mg/5 ml, btl. 120 ml 3 63750 0 18.5 226631.3 57 E2102000 630761.1 NASTITI TR30-05-201
Phenobarbital tab. 30 mg (Kim) 150 120 0 18.5 21330 57 E2102000 630761.1 NASTITI TR30-05-201
Sub Total 323981.4 57 E2102000 630761.1 NASTITI TR30-05-201
Letonal tab. 100 mg 11 2730 0 18.5 35585.55 58 E2102000 642081 ADEK SUR 30-05-201
Valdix tab. 160 mg 23 4400 0 18.5 119922 58 E2102000 642081 ADEK SUR 30-05-201
Bisoprolol tab. 5 mg (Hex) 23 660 0 18.5 17988.3 58 E2102000 642081 ADEK SUR 30-05-201
Sub Total 173495.9 58 E2102000 642081 ADEK SUR 30-05-201
Flamar tab. 50 mg 8 1320 0 18.5 12513.6 59 E2102000 641095 SUSI SUSW30-05-201
Xytrol ED tts. mata , btl 5 ml 1 23980 0 18.5 28416.3 59 E2102000 641095 SUSI SUSW30-05-201
Tequinol tab. 500 mg 8 5040 0 18.5 47779.2 59 E2102000 641095 SUSI SUSW30-05-201
Sub Total 88709.1 59 E2102000 641095 SUSI SUSW30-05-201
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63 60 E21020000633236.1 SRI RETNO30-05-201
Ponstelax kapl. 500 mg 10 350.35 0 18.5 4151.65 60 E21020000633236.1 SRI RETNO30-05-201
Sub Total 55610.27 60 E21020000633236.1 SRI RETNO30-05-201
Metrix tab. 1 mg 20 1094.85 0 18.5 25947.95 61 E2102000 670363 AHMAD IR30-05-201
Diaformin XR tab. 500 mg 20 900 0 18.5 21330 61 E2102000 670363 AHMAD IR30-05-201
Sub Total 47277.95 61 E2102000 670363 AHMAD IR30-05-201
Glucovance 500/2,5 tab 20 2705.43 0 18.5 64118.71 62 E2102000 640794 PUTU PUT 30-05-201
Pionix tab. 15 mg 20 4875.45 0 18.5 115548.3 62 E2102000 640794 PUTU PUT 30-05-201
Sub Total 179667 62 E2102000 640794 PUTU PUT 30-05-201
Gitas Plus tab. 10 1750 0 18.5 20737.5 63 E2102000 633236.1 DINDA FAU30-05-201
Ursolic kaps. 250 mg 10 4611 0 18.5 54640.35 63 E2102000 633236.1 DINDA FAU30-05-201
Kloderma krim 5 gr 1 13875 0 18.5 16441.88 63 E2102000 633236.1 DINDA FAU30-05-201
Sub Total 91819.73 63 E2102000 633236.1 DINDA FAU30-05-201
Canderin tab. 8 mg 20 4800 0 18.5 113760 64 E2102000 660371 DIDIET HE 30-05-201
Cefat kaps. 500 mg 8 4342.5 0 18.5 41166.9 64 E2102000 660371 DIDIET HE 30-05-201
Codeine tab. 10 mg (Kim) 8 550 0 18.5 5214 64 E2102000 660371 DIDIET HE 30-05-201
Ambroxol tab. 30 mg (Indo) 10 124.09 0 18.5 1470.45 64 E2102000 660371 DIDIET HE 30-05-201
Methyl prednisolone tab. 16 mg (Dex) 1 799.85 0 18.5 947.82 64 E2102000 660371 DIDIET HE 30-05-201
Sub Total 162559.2 64 E2102000 660371 DIDIET HE 30-05-201
Tequinol tab. 500 mg 8 5040 0 18.5 47779.2 65 E2102000 680525 RACHMAT 30-05-201
Flamar tab. 50 mg 8 1320 0 18.5 12513.6 65 E2102000 680525 RACHMAT 30-05-201
Xytrol ED tts. mata , btl 5 ml 1 23980 0 18.5 28416.3 65 E2102000 680525 RACHMAT 30-05-201
Sub Total 88709.1 65 E2102000 680525 RACHMAT 30-05-201
Dilavask tab. 5 mg 20 492 0 18.5 11660.4 66 E2102000 660371.1 RANITA M 30-05-201
Cefat kaps. 500 mg 8 4342.5 0 18.5 41166.9 66 E2102000 660371.1 RANITA M 30-05-201
Codeine tab. 10 mg (Kim) 10 550 0 18.5 6517.5 66 E2102000 660371.1 RANITA M 30-05-201
Ambroxol tab. 30 mg (Indo) 14 124.09 0 18.5 2058.64 66 E2102000 660371.1 RANITA M 30-05-201
Methyl prednisolone tab. 16 mg (Dex) 2 799.85 0 18.5 1895.64 66 E2102000 660371.1 RANITA M 30-05-201
Sub Total 63299.08 66 E2102000 660371.1 RANITA M 30-05-201
Kloderma salep 0,1 %, tube 5 g 2 20625 0 18.5 48881.25 67 E2102000 611460 AKHLANI 31-05-201
Gentamicin 1% Salep Kulit 5 gram 1 1773 0 8 1914.84 67 E2102000 611460 AKHLANI 31-05-201
Sub Total 50796.09 67 E2102000 611460 AKHLANI 31-05-201
Diaformin XR tab. 500 mg 28 900 0 18.5 29862 68 E2102000 611460.1 SULASTRI 31-05-201
Metrix tab. 2 mg 28 1890 0 18.5 62710.2 68 E2102000 611460.1 SULASTRI 31-05-201
Sub Total 92572.2 68 E2102000 611460.1 SULASTRI 31-05-201
Depakote tab. 250 mg 14 8011.5 0 18.5 132910.8 69 E2102000 690496.1 ZHIARA AU31-05-201
Sub Total 132910.8 69 E2102000 690496.1 ZHIARA AU31-05-201
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63 70 E2102000 700646.1 META FATI31-05-201
Ambroxol tab. 30 mg (Indo) 10 124.09 0 18.5 1470.45 70 E2102000 700646.1 META FATI31-05-201
Fluzep kapl. 10 562.5 0 18.5 6665.63 70 E2102000 700646.1 META FATI31-05-201
Gerdilium FC tab. 10 mg 10 1400 0 18.5 16590 70 E2102000 700646.1 META FATI31-05-201
Sub Total 76184.7 70 E2102000 700646.1 META FATI31-05-201
Voltadex emulgel 1%/20 gr 1 17550 0 18.5 20796.75 71 E2102000 611617 TUKIJA 31-05-201
Graphalac sir 10mg/15ml (sir 3,335 g/5 mL) 1 25500 0 18.5 30217.5 71 E2102000 611617 TUKIJA 31-05-201
Sub Total 51014.25 71 E2102000 611617 TUKIJA 31-05-201
Thrombo Aspilets tab. 80 mg 28 448 0 18.5 14864.64 72 E2102000 611617 TUKIJA 31-05-201
Clopidogrel tab. 75 mg (Hex) 28 3700 0 18.5 122766 72 E2102000 611617 TUKIJA 31-05-201
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 72 E2102000 611617 TUKIJA 31-05-201
Irbesartan tab. 150 mg. (Indo) 28 1249.5 0 18.5 41458.41 72 E2102000 611617 TUKIJA 31-05-201
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18 72 E2102000 611617 TUKIJA 31-05-201
Sub Total 224155.8 72 E2102000 611617 TUKIJA 31-05-201
Thrombo Aspilets tab. 80 mg 28 448 0 18.5 14864.64 73 E2102000 620955 AFRIZALI 31-05-201
Febogrel tab. 75 mg 28 5280 0 18.5 175190.4 73 E2102000 620955 AFRIZALI 31-05-201
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18 73 E2102000 620955 AFRIZALI 31-05-201
Sub Total 218797.2 73 E2102000 620955 AFRIZALI 31-05-201
Ponstelax kapl. 500 mg 10 350.35 0 18.5 4151.65 74 E21020000760042.1 WENI FEBR31-05-201
Sub Total 4151.65 74 E21020000760042.1 WENI FEBR31-05-201
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 75 E2102000 630761.1 JUNAETI 31-05-201
Glucovance 500/2,5 tab 28 2705.43 0 18.5 89766.2 75 E2102000 630761.1 JUNAETI 31-05-201
Sub Total 106090.8 75 E2102000 630761.1 JUNAETI 31-05-201
Hexadol Mint sol. 100 ml 1 15000 0 18.5 17775 76 E21020000810081.1 FITRIA RA 31-05-201
Sub Total 17775 76 E21020000810081.1 FITRIA RA 31-05-201
Ponstelax kapl. 500 mg 10 350.35 0 18.5 4151.65 77 E21020000 830087 MAYRISA 31-05-201
Sub Total 4151.65 77 E21020000 830087 MAYRISA 31-05-201
NovoMix 30 FlexPen inj. 100 IU/ml 2 151278.5 0 18.5 358530.1 78 E2102000 690223 ABDUL RA 31-05-201
Pyrazinamide tab. 500 mg (Kim) 90 260.7 0 18.5 27803.66 78 E2102000 690223 ABDUL RA 31-05-201
Sub Total 386333.8 78 E2102000 690223 ABDUL RA 31-05-201
Flamar tab. 50 mg 10 1320 0 18.5 15642 79 E2102000 700355 HARNOLO 31-05-201
Tranec tab. 500 mg 10 1540 0 18.5 18249 79 E2102000 700355 HARNOLO 31-05-201
Xytrol ED tts. mata , btl 5 ml 1 23980 0 18.5 28416.3 79 E2102000 700355 HARNOLO 31-05-201
Sub Total 62307.3 79 E2102000 700355 HARNOLO 31-05-201
Atorvastatin tab. 20 mg (Hex) 28 4000 0 8 120960 80 E2102000 630510 ASEP FACH31-05-201
V-Bloc tab. 6,25 mg 14 1750 0 18.5 29032.5 80 E2102000 630510 ASEP FACH31-05-201
Lansoprazole kaps. 30 mg (Indo) 28 736.35 0 18.5 24432.22 80 E2102000 630510 ASEP FACH31-05-201
Aspar K tab. 300 mg 28 1532.7 0 18.5 50854.99 80 E2102000 630510 ASEP FACH31-05-201
Sub Total 225279.7 80 E2102000 630510 ASEP FACH31-05-201
Diaformin XR tab. 500 mg 56 900 0 18.5 59724 81 E2102000 621271 SOBAR SI 31-05-201
Metrix tab. 3 mg 28 2534.85 0 18.5 84106.32 81 E2102000 621271 SOBAR SI 31-05-201
Sub Total 143830.3 81 E2102000 621271 SOBAR SI 31-05-201
Rydian tab. 10 mg 10 1900 0 18.5 22515 82 E2102000 680541 YULI SUNA31-05-201
Dextafen tab. 10 770 0 18.5 9124.5 82 E2102000 680541 YULI SUNA31-05-201
Benoson M Cr 1 38500 0 18.5 45622.5 82 E2102000 680541 YULI SUNA31-05-201
Sub Total 77262 82 E2102000 680541 YULI SUNA31-05-201
Dilavask tab. 10 mg 28 1050 0 18.5 34839 83 E2102000 710107 ANDY 31-05-201
Cameloc tab. 7,5 mg 14 580 0 18.5 9622.2 83 E2102000 710107 ANDY 31-05-201
Sub Total 44461.2 83 E2102000 710107 ANDY 31-05-201
Clonidine HCl tab. 0,15 mg (Indo) 28 186.18 0 18.5 6177.36 84 E2102000 622553 RIKA JUNAI31-05-201
Dilavask tab. 10 mg 28 1050 0 18.5 34839 84 E2102000 622553 RIKA JUNAI31-05-201
Evothyl kaps. 300 mg 28 4950 0 18.5 164241 84 E2102000 622553 RIKA JUNAI31-05-201
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18 84 E2102000 622553 RIKA JUNAI31-05-201
Sub Total 233999.5 84 E2102000 622553 RIKA JUNAI31-05-201
Esvat tab. 10 mg 28 472.5 0 18.5 15677.55 85 E2102000 612233 SUSILO KRI31-05-201
Cameloc tab. 7,5 mg 15 580 0 18.5 10309.5 85 E2102000 612233 SUSILO KRI31-05-201
OA Forte kapl. 10 3311 0 18.5 39235.35 85 E2102000 612233 SUSILO KRI31-05-201
Magtral Syr. Forte 1 13000 0 18.5 15405 85 E2102000 612233 SUSILO KRI31-05-201
Methyl prednisolone tab. 4 mg (Dex) 10 300.75 0 18.5 3563.89 85 E2102000 612233 SUSILO KRI31-05-201
Sub Total 84191.29 85 E2102000 612233 SUSILO KRI31-05-201
Kalmeco tab. 500 mcg 10 1700 0 18.5 20145 86 E2102000 622693.1 ENDANG SU 31-05-201
Sub Total 20145 86 E2102000 622693.1 ENDANG SU 31-05-201
Epsonal tab. 50 mg 5 2172.5 0 18.5 12872.06 87 E2102000 710025.1 ROHMAWA31-05-201
Alpentin kaps. 100 mg 20 2380 0 18.5 56406 87 E2102000 710025.1 ROHMAWA31-05-201
Hi-Bone tab. 14 2550 0 18.5 42304.5 87 E2102000 710025.1 ROHMAWA31-05-201
Sub Total 111582.6 87 E2102000 710025.1 ROHMAWA31-05-201
Atorvastatin tab. 20 mg (Hex) 28 4000 0 8 120960 88 E2102000 630316 JOKO MUR31-05-201
Evothyl kaps. 300 mg 28 4950 0 18.5 164241 88 E2102000 630316 JOKO MUR31-05-201
Sub Total 285201 88 E2102000 630316 JOKO MUR31-05-201
Atorvastatin tab. 20 mg (Hex) 14 4000 0 8 60480 89 E2102000 630669 SUMARSO31-05-201
Epsonal tab. 50 mg 8 2172.5 0 18.5 20595.3 89 E2102000 630669 SUMARSO31-05-201
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 89 E2102000 630669 SUMARSO31-05-201
Diaversa tab. 2 mg 28 992 0 18.5 32914.56 89 E2102000 630669 SUMARSO31-05-201
Glucophage XR tab. 500 mg 28 1620.5 0 18.5 53768.32 89 E2102000 630669 SUMARSO31-05-201
Allopurinol tab. 100 mg (Kim) 28 144.3 0 18.5 4787.87 89 E2102000 630669 SUMARSO31-05-201
Sub Total 188870.6 89 E2102000 630669 SUMARSO31-05-201
Clamixin kapl. 10 5500 0 18.5 65175 90 E2102000 670549 JUNIAR 31-05-201
Rhinos SR kaps. 10 3600 0 18.5 42660 90 E2102000 670549 JUNIAR 31-05-201
Fluzep kapl. 10 562.5 0 18.5 6665.63 90 E2102000 670549 JUNIAR 31-05-201
Sub Total 114500.6 90 E2102000 670549 JUNIAR 31-05-201
Acilaz kaps. 30 mg 14 5200 0 18.5 86268 91 E2102000 700251.1 PUTRI NOV31-05-201
Gerdilium FC tab. 10 mg 20 1400 0 18.5 33180 91 E2102000 700251.1 PUTRI NOV31-05-201
Emibion kaps. 10 720 0 18.5 8532 91 E2102000 700251.1 PUTRI NOV31-05-201
Sub Total 127980 91 E2102000 700251.1 PUTRI NOV31-05-201
Opixime tab. 100 mg 10 7560 0 18.5 89586 92 E2102000 630669.1 NOERBAET31-05-201
Neurosanbe FC tab 15 800 0 18.5 14220 92 E2102000 630669.1 NOERBAET31-05-201
Valisanbe tab. 2 mg 10 128 0 18.5 1516.8 92 E2102000 630669.1 NOERBAET31-05-201
Sub Total 105322.8 92 E2102000 630669.1 NOERBAET31-05-201
Canderin tab. 8 mg 28 4800 0 18.5 159264 93 E2102000 690457 DEDI PUR 31-05-201
Thrombo Aspilets tab. 80 mg 28 448 0 18.5 14864.64 93 E2102000 690457 DEDI PUR 31-05-201
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18 93 E2102000 690457 DEDI PUR 31-05-201
Sub Total 202870.8 93 E2102000 690457 DEDI PUR 31-05-201
Opixime tab. 100 mg 20 7560 0 18.5 179172 94 E2102000 633093 WIDJI TAM31-05-201
Sanmol tab. 500 mg 12 250 0 18.5 3555 94 E2102000 633093 WIDJI TAM31-05-201
Codeine tab. 10 mg (Kim) 20 550 0 18.5 13035 94 E2102000 633093 WIDJI TAM31-05-201
Ambroxol tab. 30 mg (Indo) 10 124.09 0 18.5 1470.45 94 E2102000 633093 WIDJI TAM31-05-201
Prednicort tab. 4 mg 20 1500 0 18.5 35550 94 E2102000 633093 WIDJI TAM31-05-201
Rydian tab. 10 mg 6 1900 0 18.5 13509 94 E2102000 633093 WIDJI TAM31-05-201
Sub Total 246291.5 94 E2102000 633093 WIDJI TAM31-05-201
NovoMix 30 FlexPen inj. 100 IU/ml 2 151278.5 0 18.5 358530.1 95 E2102000 670479 MOCH. DIM31-05-201
Sub Total 358530.1 95 E2102000 670479 MOCH. DIM31-05-201
Ponstelax kapl. 500 mg 10 350.35 0 18.5 4151.65 96 E21020000632125.1 FATTURRA31-05-201
Sub Total 4151.65 96 E21020000632125.1 FATTURRA31-05-201
Santesar tab. 50 mg 28 3773 0 18.5 125188.1 97 E2102000 630853 SUKARJA 31-05-201
Atorvastatin tab. 20 mg (Hex) 28 4000 0 8 120960 97 E2102000 630853 SUKARJA 31-05-201
Thrombo Aspilets tab. 80 mg 28 448 0 18.5 14864.64 97 E2102000 630853 SUKARJA 31-05-201
Sub Total 261012.8 97 E2102000 630853 SUKARJA 31-05-201
Trizedon MR tab. 35 mg 40 2610.39 0 18.5 123732.4 98 E2102000 700323 EVAN HUT31-05-201
Thrombo Aspilets tab. 80 mg 20 448 0 18.5 10617.6 98 E2102000 700323 EVAN HUT31-05-201
Febogrel tab. 75 mg 20 5280 0 18.5 125136 98 E2102000 700323 EVAN HUT31-05-201
Esvat tab. 20 mg 20 866.25 0 18.5 20530.13 98 E2102000 700323 EVAN HUT31-05-201
Sub Total 280016.1 98 E2102000 700323 EVAN HUT31-05-201
Atorvastatin tab. 20 mg (Hex) 20 4000 0 8 86400 99 E2102000 690335 WINARKO 31-05-201
Allopurinol tab. 100 mg (Kim) 20 144.3 0 18.5 3419.91 99 E2102000 690335 WINARKO 31-05-201
Canderin tab. 16 mg 20 6800 0 18.5 161160 99 E2102000 690335 WINARKO 31-05-201
Febogrel tab. 75 mg 20 5280 0 18.5 125136 99 E2102000 690335 WINARKO 31-05-201
Betaone tab. 2,5 mg 10 1404 0 18.5 16637.4 99 E2102000 690335 WINARKO 31-05-201
vitamin B Komplek tab. 20 109.09 0 18.5 2585.45 99 E2102000 690335 WINARKO 31-05-201
Sub Total 395338.8 99 E2102000 690335 WINARKO 31-05-201
TOTAL SEB 11678943 99 E2102000 690335 WINARKO 31-05-201
TOTAL SET 12846837 99 E2102000 690335 WINARKO 31-05-201
Total Total
Kode Nama Nama Harga Diskon Margin Pembaya Nomor Nomor Pembaya
Jumlah
Dokter Dokter Obat HNA (%) (%) Resep Resep
ran ran
2.1E+08 dr amar baBetaone ta 50 2400 0 18.5 142200 118,5 118,5 142200

2.1E+08 dr amar baBetaone ta 50 2400 0 Sub Total 142200 1Sub Total1Sub Total 142200
2.1E+08 dr amar baAnadium ka 14 4248 0 18.5 70474.32 218.5 218.5 70474.32
2.1E+08 dr amar baAnadium ka 14 4248 0 Sub Total 70474.32 2Sub Total2Sub Total 70474.32
2.1E+08 dr. Istiyart Litorcom t 14 3622.67 0 18.5 60100.04 318.5 318.5 60100.04
2.1E+08 dr. Istiyart Dilavask ta 14 492 0 18.5 8162.28 318.5 8162.28
2.1E+08 dr. Istiyart Dilavask ta 14 492 0 Sub Total 68262.32 3Sub Total3Sub Total 68262.32
2.1E+08 dr amar baDiaformin 28 900 0 18.5 29862 418.5 418.5 29862
2.1E+08 dr amar baMetrix tab 28 1890 0 18.5 62710.2 418.5 62710.2
2.1E+08 dr amar baMetrix tab 28 1890 0 Sub Total 92572.2 4Sub Total4Sub Total 92572.2
2.1E+08 dr amar baMetrix tab 20 1890 0 18.5 44793 518.5 518.5 44793
2.1E+08 dr amar baThrombo As 20 448 0 18.5 10617.6 518.5 10617.6
2.1E+08 dr amar baTenapril ta 20 1575 0 18.5 37327.5 518.5 37327.5
2.1E+08 dr amar baNitrokaf Re 40 1818.36 0 18.5 86190.38 518.5 86190.38
2.1E+08 dr amar baSimvastati 20 221.52 0 18.5 5250.09 518.5 5250.09
2.1E+08 dr amar baSimvastati 20 221.52 0 Sub Total 184178.6 5Sub Total5Sub Total 184178.6
2.1E+08 dr. Istiyart Clamixin ka 10 5500 0 18.5 65175 618.5 618.5 65175
2.1E+08 dr. Istiyart Gentamicin 1 1773 0 8 1914.84 68 68 1914.84
2.1E+08 dr. Istiyart Cavit D3 k 15 1140.7 0 18.5 20275.94 618.5 618.5 20275.94
2.1E+08 dr. Istiyart Rhinofed t 10 1155 0 18.5 13686.75 618.5 13686.75
2.1E+08 dr. Istiyart Rhinofed t 10 1155 0 Sub Total 101052.5 6Sub Total6Sub Total 101052.5
2.1E+08 dr. Istiyart Opixime ta 8 7560 0 18.5 71668.8 718.5 718.5 71668.8
2.1E+08 dr. Istiyart Urotractin 8 1652 0 18.5 15660.96 718.5 15660.96
2.1E+08 dr. Istiyart Gitas Plus 6 1750 0 18.5 12442.5 718.5 12442.5
2.1E+08 dr. Istiyart Gitas Plus 6 1750 0 Sub Total 99772.26 7Sub Total7Sub Total 99772.26
2.1E+08 dr amar baNovoMix 30 1 151278.5 0 18.5 179265.1 818.5 818.5 179265.1
2.1E+08 dr amar baDiaformin 14 900 0 18.5 14931 818.5 14931
2.1E+08 dr amar baDilavask t 14 1050 0 18.5 17419.5 818.5 17419.5
2.1E+08 dr amar baCanderin t 14 4800 0 18.5 79632 818.5 79632
2.1E+08 dr amar baEsvat tab. 14 866.25 0 18.5 14371.09 818.5 14371.09
2.1E+08 dr amar baEsvat tab. 14 866.25 0 Sub Total 305618.7 8Sub Total8Sub Total 305618.7
2.1E+08 dr. Istiyart NovoMix 30 1 151278.5 0 18.5 179265.1 918.5 918.5 179265.1
2.1E+08 dr. Istiyart Evothyl ka 14 4950 0 18.5 82120.5 918.5 82120.5
2.1E+08 dr. Istiyart Esvat tab. 14 866.25 0 18.5 14371.09 918.5 14371.09
2.1E+08 dr. Istiyart Eclid tab. 42 1200 0 18.5 59724 918.5 59724
2.1E+08 dr. Istiyart Diaformin 28 900 0 18.5 29862 918.5 29862
2.1E+08 dr. Istiyart Diaformin 28 900 0 Sub Total 365342.7 9Sub Total9Sub Total 365342.7
2.1E+08 dr amar baPyrazinami 90 260.7 0 18.5 27803.66 1018.5 1018.5 27803.66
2.1E+08 dr amar baEthambutol 45 508.42 0 18.5 27111.4 1018.5 27111.4
2.1E+08 dr amar baIsoniazid t 30 173 0 18.5 6150.15 1018.5 6150.15
2.1E+08 dr amar baExtropect s 1 14400 0 18.5 17064 1018.5 17064
2.1E+08 dr amar baFluzep kapl 10 562.5 0 18.5 6665.63 1018.5 6665.63
2.1E+08 dr amar baFluzep kapl 10 562.5 0 Sub Total 84794.83 10Sub Tota10Sub Tota 84794.83
2.1E+08 dr amar baGentamicin 2 1773 0 8 3829.68 118 118 3829.68
2.1E+08 dr amar baFungasol k 1 14950 0 18.5 17715.75 1118.5 1118.5 17715.75
2.1E+08 dr amar baFungasol k 1 14950 0 Sub Total 21545.43 11Sub Tota11Sub Tota 21545.43
2.1E+08 dr amar baOsfit tab. 20 1125 0 18.5 26662.5 1218.5 1218.5 26662.5
2.1E+08 dr amar baOsfit tab. 20 1125 0 Sub Total 26662.5 12Sub Tota12Sub Tota 26662.5
2.1E+08 dr amar baCefat kaps 10 4342.5 0 18.5 51458.63 1318.5 1318.5 51458.63
2.1E+08 dr amar baRhinos SR 10 3600 0 18.5 42660 1318.5 42660
2.1E+08 dr amar baSanmol tab 10 250 0 18.5 2962.5 1318.5 2962.5
2.1E+08 dr amar baSanmol tab 10 250 0 Sub Total 97081.13 13Sub Tota13Sub Tota 97081.13
2.1E+08 dr. Istiyart Eflagen ta 8 672 0 18.5 6370.56 1418.5 1418.5 6370.56
2.1E+08 dr. Istiyart Flamar emu 1 11840 0 18.5 14030.4 1418.5 14030.4
2.1E+08 dr. Istiyart Flamar emu 1 11840 0 Sub Total 20400.96 14Sub Tota14Sub Tota 20400.96
2.1E+08 dr. Istiyart Acyclovir c 2 2588.32 0 18.5 6134.31 1518.5 1518.5 6134.31
2.1E+08 dr. Istiyart Flamar tab 15 1320 0 18.5 23463 1518.5 23463
2.1E+08 dr. Istiyart Kalmeco ta 15 1700 0 18.5 30217.5 1518.5 30217.5
2.1E+08 dr. Istiyart Kalmeco ta 15 1700 0 Sub Total 59814.81 15Sub Tota15Sub Tota 59814.81
2.1E+08 dr. Istiyart Damuvit ta 14 825 0 18.5 13686.75 1618.5 1618.5 13686.75
2.1E+08 dr. Istiyart Damuvit ta 14 825 0 Sub Total 13686.75 16Sub Tota16Sub Tota 13686.75
2.1E+08 dr amar baThombophob 1 44887.5 0 18.5 53191.69 1718.5 1718.5 53191.69
2.1E+08 dr amar baAnadium ka 14 4248 0 18.5 70474.32 1718.5 70474.32
2.1E+08 dr amar baDiclofenac 10 410 0 18.5 4858.5 1718.5 4858.5
2.1E+08 dr amar baDiclofenac 10 410 0 Sub Total 128524.5 17Sub Tota17Sub Tota 128524.5
2.1E+08 drg. TeresaCefat kaps 8 4342.5 0 18.5 41166.9 1818.5 1818.5 41166.9
2.1E+08 drg. TeresaHexadol Mi 1 15000 0 18.5 17775 1818.5 17775
2.1E+08 drg. TeresaDiclofenac 10 410 0 18.5 4858.5 1818.5 4858.5
2.1E+08 drg. TeresaDiclofenac 10 410 0 Sub Total 63800.4 18Sub Tota18Sub Tota 63800.4
2.1E+08 dr. Istiyart Xytrol ED t 1 23980 0 18.5 28416.3 1918.5 1918.5 28416.3
2.1E+08 dr. Istiyart Xytrol ED t 1 23980 0 Sub Total 28416.3 19Sub Tota19Sub Tota 28416.3
2.1E+08 dr amar baTequinol t 10 5040 0 18.5 59724 2018.5 2018.5 59724
2.1E+08 dr amar baExtropect s 1 14400 0 18.5 17064 2018.5 17064
2.1E+08 dr. Istiyart Interpec t 10 550 0 18.5 6517.5 2118.5 2118.5 6517.5
2.1E+08 dr. Istiyart Dextafen t 8 770 0 18.5 7299.6 2118.5 7299.6
2.1E+08 dr. Istiyart Dextafen t 8 770 0 Sub Total 13817.1 21Sub Tota21Sub Tota 13817.1
2.1E+08 dr. Istiyart Cefat kaps 8 4342.5 0 18.5 41166.9 2218.5 2218.5 41166.9
2.1E+08 dr. Istiyart Rhinos SR 8 3600 0 18.5 34128 2218.5 34128
2.1E+08 dr. Istiyart Ambroxol t 12 124.09 0 18.5 1764.55 2218.5 1764.55
2.1E+08 dr. Istiyart Ambroxol t 12 124.09 0 Sub Total 77059.45 22Sub Tota22Sub Tota 77059.45
2.1E+08 dr. Istiyart Dilavask ta 20 492 0 18.5 11660.4 2318.5 2318.5 11660.4
2.1E+08 dr. Istiyart Ursolic ka 20 4611 0 18.5 109280.7 2318.5 109280.7
2.1E+08 dr. Istiyart Ursolic ka 20 4611 0 Sub Total 120941.1 23Sub Tota23Sub Tota 120941.1
2.1E+08 dr. Istiyart Neuraxon 5 15 1237.5 0 18.5 21996.56 2418.5 2418.5 21996.56
2.1E+08 dr. Istiyart Furosemide 8 93.43 0 18.5 885.67 2418.5 885.67
2.1E+08 dr. Istiyart Voltadex e 1 17550 0 18.5 20796.75 2418.5 20796.75
2.1E+08 dr. Istiyart Voltadex e 1 17550 0 Sub Total 43678.98 24Sub Tota24Sub Tota 43678.98
2.1E+08 dr. Istiyart Diaversa t 14 992 0 18.5 16457.28 2518.5 2518.5 16457.28
2.1E+08 dr. Istiyart Metformin 28 156.75 0 18.5 5200.97 2518.5 5200.97
2.1E+08 dr. Istiyart Litorcom t 14 3622.67 0 18.5 60100.04 2518.5 60100.04
2.1E+08 dr. Istiyart Ursolic ka 14 4611 0 18.5 76496.49 2518.5 76496.49
2.1E+08 dr. Istiyart Ursolic ka 14 4611 0 Sub Total 158254.8 25Sub Tota25Sub Tota 158254.8
2.1E+08 drg. Arti RCefat kaps 10 4342.5 0 18.5 51458.63 2618.5 2618.5 51458.63
2.1E+08 drg. Arti RAnalsik kap 10 638 0 18.5 7560.3 2618.5 7560.3
2.1E+08 drg. Arti RAnalsik kap 10 638 0 Sub Total 59018.93 26Sub Tota26Sub Tota 59018.93
2.1E+08 dr. Istiyart Clamixin ka 10 5500 0 18.5 65175 2718.5 65175
2.1E+08 dr. Istiyart Ambroxol t 10 124.09 0 Sub Total 77950.35 27Sub Tota27Sub Tota 77950.35
2.1E+08 dr amar baDilavask ta 28 492 0 18.5 16324.56 2818.5 2818.5 16324.56
2.1E+08 dr amar baIrbesartan 28 1249.5 0 18.5 41458.41 2818.5 41458.41
2.1E+08 dr amar baIrbesartan 28 1249.5 0 Sub Total 57782.97 28Sub Tota28Sub Tota 57782.97
2.1E+08 dr amar baAmbroxol t 10 124.09 0 18.5 1470.45 2918.5 1470.45
2.1E+08 dr amar baSanmol tab 10 250 0 18.5 2962.5 2918.5 2962.5
2.1E+08 dr amar baSanmol tab 10 250 0 Sub Total 98551.58 29Sub Tota29Sub Tota 98551.58
2.1E+08 dr. Istiyart Dextafen t 6 770 0 18.5 5474.7 3018.5 3018.5 5474.7
2.1E+08 dr. Istiyart Bufect Fort 1 12580 0 18.5 14907.3 3018.5 14907.3
2.1E+08 dr. Istiyart Clamixin F 1 44400 0 18.5 52614 3018.5 52614
2.1E+08 dr. Istiyart Clamixin F 1 44400 0 Sub Total 72996 30Sub Tota30Sub Tota 72996
2.1E+08 dr. Istiyart Opixime ta 8 7560 0 18.5 71668.8 3118.5 3118.5 71668.8
2.1E+08 dr. Istiyart Sanmol tab 8 250 0 18.5 2370 3118.5 2370
2.1E+08 dr. Istiyart Betason N 1 9945 0 18.5 11784.83 3118.5 11784.83
2.1E+08 dr. Istiyart Betason N 1 9945 0 Sub Total 85823.63 31Sub Tota31Sub Tota 85823.63
2.1E+08 dr amar baCodeine ta 10 550 0 18.5 6517.5 3218.5 6517.5
2.1E+08 dr. Istiyart Kalmeco ta 15 1700 0 18.5 30217.5 3518.5 3518.5 30217.5
2.1E+08 dr. Istiyart Voltadex e 1 17550 0 18.5 20796.75 3518.5 20796.75
2.1E+08 dr. Istiyart Diclofenac 15 410 0 18.5 7287.75 3518.5 7287.75
2.1E+08 dr. Istiyart Diclofenac 15 410 0 Sub Total 58302 35Sub Tota35Sub Tota 58302
2.1E+08 dr amar baAstika tab. 20 374 0 18.5 8863.8 3618.5 3618.5 8863.8
2.1E+08 dr amar baClopidogre 20 3700 0 18.5 87690.01 3618.5 87690.01
2.1E+08 dr amar baAngioten t 20 4080 0 18.5 96696 3618.5 96696
2.1E+08 dr amar baBetaone ta 20 2400 0 18.5 56880 3618.5 56880
2.1E+08 dr amar baDilavask t 20 1050 0 18.5 24885 3618.5 24885
2.1E+08 dr amar baEsvat tab. 20 866.25 0 Sub Total 295544.9 36Sub Tota36Sub Tota 295544.9
2.1E+08 Bidan Vith Emibion ka 14 720 0 18.5 11944.8 3718.5 3718.5 11944.8
2.1E+08 Bidan Vith Emibion ka 14 720 0 Sub Total 11944.8 37Sub Tota37Sub Tota 11944.8
2.1E+08 dr. Istiyart Thrombo As 14 448 0 18.5 7432.32 3818.5 3818.5 7432.32
2.1E+08 dr. Istiyart Cedocard t 42 749.17 0 18.5 37286.03 3818.5 37286.03
2.1E+08 dr. Istiyart Litorcom t 14 3622.67 0 Sub Total 112980.7 38Sub Tota38Sub Tota 112980.7
2.1E+08 dr. Istiyart Diaformin 28 900 0 18.5 29862 3918.5 3918.5 29862
2.1E+08 dr. Istiyart Angioten t 14 4080 0 18.5 67687.2 3918.5 67687.2
2.1E+08 dr. Istiyart Dilavask t 14 1050 0 18.5 17419.5 3918.5 17419.5
2.1E+08 dr. Istiyart Thrombo As 14 448 0 18.5 7432.32 3918.5 7432.32
2.1E+08 dr. Istiyart Allopurinol 14 144.3 0 18.5 2393.94 3918.5 2393.94
2.1E+08 dr. Istiyart Diaversa t 14 1352 0 18.5 22429.68 3918.5 22429.68
2.1E+08 dr. Istiyart Diaversa t 14 1352 0 Sub Total 207324.7 39Sub Tota39Sub Tota 207324.7
2.1E+08 dr. Istiyart Tramifen k 10 4200 0 18.5 49770 4018.5 4018.5 49770
2.1E+08 dr. Istiyart Neurosanbe 10 800 0 18.5 9480 4018.5 9480
2.1E+08 dr. Istiyart Neurosanbe 10 800 0 Sub Total 59250 40Sub Tota40Sub Tota 59250
2.1E+08 dr. Istiyart Bactoprim 6 440 0 18.5 3128.4 4118.5 4118.5 3128.4
2.1E+08 dr. Istiyart Diagit tab. 10 687.5 0 18.5 8146.88 4118.5 8146.88
2.1E+08 dr. Istiyart Gitas Plus 6 1750 0 18.5 12442.5 4118.5 12442.5
2.1E+08 dr. Istiyart Episan sus 1 24310 0 18.5 28807.35 4118.5 28807.35
2.1E+08 dr. Istiyart Episan sus 1 24310 0 Sub Total 52525.13 41Sub Tota41Sub Tota 52525.13
2.1E+08 dr amar baBetaone ta 28 2400 0 18.5 79632 4218.5 4218.5 79632
2.1E+08 dr amar baAtorvastati 28 4000 0 8 120960 428 428 120960
2.1E+08 dr amar baCedocard t 5 749.17 0 18.5 4438.81 4218.5 4218.5 4438.81
2.1E+08 dr amar baCedocard t 5 749.17 0 Sub Total 205030.8 42Sub Tota42Sub Tota 205030.8
2.1E+08 dr amar baSalbutamol 60 76.39 0 18.5 5431.39 4318.5 4318.5 5431.39
2.1E+08 dr amar baRydian tab 18 1900 0 18.5 40527 4318.5 40527
2.1E+08 dr amar baAmbroxol t 30 124.09 0 Sub Total 50369.76 43Sub Tota43Sub Tota 50369.76
2.1E+08 Bidan Vith Biofolat Pl 30 3200 0 18.5 113760 4418.5 4418.5 113760
2.1E+08 Bidan Vith Emibion ka 30 720 0 18.5 25596 4418.5 25596
2.1E+08 Bidan Vith Cavit D3 k 30 1140.7 0 18.5 40551.89 4418.5 40551.89
2.1E+08 Bidan Vith Cavit D3 k 30 1140.7 0 Sub Total 179907.9 44Sub Tota44Sub Tota 179907.9
2.1E+08 dr. Istiyart Hi-Bone ta 28 2550 0 18.5 84609 4518.5 4518.5 84609
2.1E+08 dr. Istiyart Hi-Bone ta 28 2550 0 Sub Total 84609 45Sub Tota45Sub Tota 84609
2.1E+08 dr amar baAcilaz kaps 10 5200 0 18.5 61620 4618.5 4618.5 61620
2.1E+08 dr amar baGitas Plus 10 1750 0 18.5 20737.5 4618.5 20737.5
2.1E+08 dr amar baMagtral Syr 1 13000 0 18.5 15405 4618.5 15405
2.1E+08 dr amar baMagtral Syr 1 13000 0 Sub Total 97762.5 46Sub Tota46Sub Tota 97762.5
2.1E+08 dr amar baCameloc ta 20 580 0 18.5 13746 4718.5 4718.5 13746
2.1E+08 dr amar baKalmeco ta 20 1700 0 18.5 40290 4718.5 40290
2.1E+08 dr amar baHi-Bone ta 20 2550 0 18.5 60435 4718.5 60435
2.1E+08 dr amar baVoltadex e 1 17550 0 18.5 20796.75 4718.5 20796.75
2.1E+08 dr amar baVoltadex e 1 17550 0 Sub Total 135267.8 47Sub Tota47Sub Tota 135267.8
2.1E+08 drg. TeresaPonstelax 6 350.35 0 18.5 2490.99 4818.5 4818.5 2490.99
2.1E+08 drg. TeresaPonstelax 6 350.35 0 Sub Total 2490.99 48Sub Tota48Sub Tota 2490.99
2.1E+08 dr amar baMeloxicam 20 626.12 0 18.5 14839.14 4918.5 4918.5 14839.14
2.1E+08 dr amar baHi-Bone ta 15 2550 0 18.5 45326.25 4918.5 45326.25
2.1E+08 dr amar baFungasol k 1 14950 0 18.5 17715.75 4918.5 17715.75
2.1E+08 dr amar baGentamicin 1 1773 0 Sub Total 79795.98 49Sub Tota49Sub Tota 79795.98
2.1E+08 drg. Arti RDiclofenac 10 410 0 18.5 4858.5 5018.5 5018.5 4858.5
2.1E+08 drg. Arti RHexadol Mi 1 15000 0 18.5 17775 5018.5 17775
2.1E+08 drg. Arti RHexadol Mi 1 15000 0 Sub Total 22633.5 50Sub Tota50Sub Tota 22633.5
2.1E+08 dr amar baKetricin sa 1 26800 0 18.5 31758 5118.5 5118.5 31758
2.1E+08 dr amar baFlamar tab 20 1320 0 18.5 31284 5118.5 31284
2.1E+08 dr amar baVoltadex e 1 17550 0 18.5 20796.75 5118.5 20796.75
2.1E+08 dr amar baVoltadex e 1 17550 0 Sub Total 83838.75 51Sub Tota51Sub Tota 83838.75
2.1E+08 dr. Istiyart Clamixin ka 10 5500 0 18.5 65175 5218.5 5218.5 65175
2.1E+08 dr. Istiyart Otopain tts. 1 31500 0 18.5 37327.5 5218.5 37327.5
2.1E+08 dr. Istiyart Eflagen ta 8 672 0 18.5 6370.56 5218.5 6370.56
2.1E+08 dr. Istiyart Eflagen ta 8 672 0 Sub Total 120056.2 52Sub Tota52Sub Tota 120056.2
2.1E+08 dr. Istiyart Tequinol t 8 5040 0 18.5 47779.2 5318.5 5318.5 47779.2
2.1E+08 dr. Istiyart Urotractin 8 1652 0 18.5 15660.96 5318.5 15660.96
2.1E+08 dr. Istiyart Eflagen ta 12 672 0 18.5 9555.84 5318.5 9555.84
2.1E+08 dr. Istiyart Plantacid F 10 663.64 0 18.5 7864.09 5318.5 7864.09
2.1E+08 dr. Istiyart Plantacid F 10 663.64 0 Sub Total 80860.09 53Sub Tota53Sub Tota 80860.09
2.1E+08 dr amar baDilavask ta 20 492 0 18.5 11660.4 5418.5 5418.5 11660.4
2.1E+08 dr amar baFebogrel t 20 5280 0 18.5 125136 5418.5 125136
2.1E+08 dr amar baAtorvastati 20 4000 0 8 86400 548 548 86400
2.1E+08 dr amar baAtorvastati 20 4000 0 Sub Total 223196.4 54Sub Tota54Sub Tota 223196.4
2.1E+08 dr amar baPrimadex k 10 279 0 18.5 3306.15 5518.5 5518.5 3306.15
2.1E+08 dr amar baDiagit tab. 10 687.5 0 18.5 8146.88 5518.5 8146.88
2.1E+08 dr amar baGitas Plus 10 1750 0 18.5 20737.5 5518.5 20737.5
2.1E+08 dr amar baAcilaz kaps 10 5200 0 18.5 61620 5518.5 61620
2.1E+08 dr amar baAcilaz kaps 10 5200 0 Sub Total 93810.53 55Sub Tota55Sub Tota 93810.53
2.1E+08 dr. Istiyart Alluric tab 28 1755.45 0 18.5 58245.98 5618.5 58245.98
2.1E+08 dr. Istiyart Alluric tab 28 1755.45 0 Sub Total 74247.04 56Sub Tota56Sub Tota 74247.04
2.1E+08 dr. Istiyart Stesolid la 2 32076 0 18.5 76020.12 5718.5 5718.5 76020.12
2.1E+08 dr. Istiyart Lepsio syr. 3 63750 0 18.5 226631.3 5718.5 226631.3
2.1E+08 dr. Istiyart Phenobarbi 150 120 0 18.5 21330 5718.5 21330
2.1E+08 dr. Istiyart Phenobarbi 150 120 0 Sub Total 323981.4 57Sub Tota57Sub Tota 323981.4
2.1E+08 dr. Istiyart Letonal ta 11 2730 0 18.5 35585.55 5818.5 5818.5 35585.55
2.1E+08 dr. Istiyart Valdix tab 23 4400 0 18.5 119922 5818.5 119922
2.1E+08 dr. Istiyart Bisoprolol 23 660 0 18.5 17988.3 5818.5 17988.3
2.1E+08 dr. Istiyart Bisoprolol 23 660 0 Sub Total 173495.9 58Sub Tota58Sub Tota 173495.9
2.1E+08 dr amar baFlamar tab 8 1320 0 18.5 12513.6 5918.5 5918.5 12513.6
2.1E+08 dr amar baXytrol ED t 1 23980 0 18.5 28416.3 5918.5 28416.3
2.1E+08 dr amar baTequinol t 8 5040 0 18.5 47779.2 5918.5 47779.2
2.1E+08 dr amar baTequinol t 8 5040 0 Sub Total 88709.1 59Sub Tota59Sub Tota 88709.1
2.1E+08 drg. Arti RCefat kaps 10 4342.5 0 18.5 51458.63 6018.5 6018.5 51458.63
2.1E+08 drg. Arti RPonstelax 10 350.35 0 18.5 4151.65 6018.5 4151.65
2.1E+08 drg. Arti RPonstelax 10 350.35 0 Sub Total 55610.27 60Sub Tota60Sub Tota 55610.27
2.1E+08 dr. Istiyart Metrix tab 20 1094.85 0 18.5 25947.95 6118.5 6118.5 25947.95
2.1E+08 dr. Istiyart Diaformin 20 900 0 18.5 21330 6118.5 21330
2.1E+08 dr. Istiyart Diaformin 20 900 0 Sub Total 47277.95 61Sub Tota61Sub Tota 47277.95
2.1E+08 dr amar baGlucovance 20 2705.43 0 18.5 64118.71 6218.5 6218.5 64118.71
2.1E+08 dr amar baPionix tab 20 4875.45 0 18.5 115548.3 6218.5 115548.3
2.1E+08 dr amar baPionix tab 20 4875.45 0 Sub Total 179667 62Sub Tota62Sub Tota 179667
2.1E+08 dr amar baGitas Plus 10 1750 0 18.5 20737.5 6318.5 6318.5 20737.5
2.1E+08 dr amar baUrsolic ka 10 4611 0 18.5 54640.35 6318.5 54640.35
2.1E+08 dr amar baKloderma k 1 13875 0 18.5 16441.88 6318.5 16441.88
2.1E+08 dr amar baKloderma k 1 13875 0 Sub Total 91819.73 63Sub Tota63Sub Tota 91819.73
2.1E+08 dr. Istiyart Canderin t 20 4800 0 18.5 113760 6418.5 6418.5 113760
2.1E+08 dr. Istiyart Cefat kaps 8 4342.5 0 18.5 41166.9 6418.5 41166.9
2.1E+08 dr. Istiyart Codeine ta 8 550 0 18.5 5214 6418.5 5214
2.1E+08 dr. Istiyart Methyl prednisolone
1 tab.799.85
16 mg (Dex) 0 18.5 947.82 6418.5 947.82
1 tab.799.85
16 mg (Dex) 0 Sub Total 162559.2 64Sub Tota64Sub Tota 162559.2
2.1E+08 dr amar baTequinol t 8 5040 0 18.5 47779.2 6518.5 6518.5 47779.2
2.1E+08 dr amar baFlamar tab 8 1320 0 18.5 12513.6 6518.5 12513.6
2.1E+08 dr amar baXytrol ED t 1 23980 0 Sub Total 88709.1 65Sub Tota65Sub Tota 88709.1
2.1E+08 dr. Istiyart Cefat kaps 8 4342.5 0 18.5 41166.9 6618.5 41166.9
2.1E+08 dr. Istiyart Codeine ta 10 550 0 18.5 6517.5 6618.5 6517.5
2 tab.799.85
16 mg (Dex) 0 18.5 1895.64 6618.5 1895.64
2 tab.799.85
2.1E+08 dr amar baKloderma s 2 20625 0 18.5 48881.25 6718.5 6718.5 48881.25
2.1E+08 dr amar baGentamicin 1 1773 0 Sub Total 50796.09 67Sub Tota67Sub Tota 50796.09
2.1E+08 dr amar baMetrix tab 28 1890 0 18.5 62710.2 6818.5 62710.2
2.1E+08 dr amar baMetrix tab 28 1890 0 Sub Total 92572.2 68Sub Tota68Sub Tota 92572.2
2.1E+08 dr amar baDepakote t 14 8011.5 0 18.5 132910.8 6918.5 6918.5 132910.8
2.1E+08 dr amar baDepakote t 14 8011.5 0 Sub Total 132910.8 69Sub Tota69Sub Tota 132910.8
2.1E+08 dr amar baGerdilium 10 1400 0 18.5 16590 7018.5 16590
2.1E+08 dr amar baGerdilium 10 1400 0 Sub Total 76184.7 70Sub Tota70Sub Tota 76184.7
2.1E+08 dr amar baVoltadex e 1 17550 0 18.5 20796.75 7118.5 7118.5 20796.75
2.1E+08 dr amar baGraphalac 1 25500 0 18.5 30217.5 7118.5 30217.5
2.1E+08 dr amar baGraphalac 1 25500 0 Sub Total 51014.25 71Sub Tota71Sub Tota 51014.25
2.1E+08 dr amar baThrombo As 28 448 0 18.5 14864.64 7218.5 7218.5 14864.64
2.1E+08 dr amar baClopidogre 28 3700 0 18.5 122766 7218.5 122766
2.1E+08 dr amar baDilavask ta 28 492 0 18.5 16324.56 7218.5 16324.56
2.1E+08 dr amar baIrbesartan 28 1249.5 0 18.5 41458.41 7218.5 41458.41
2.1E+08 dr. Istiyart Febogrel t 28 5280 0 18.5 175190.4 7318.5 175190.4
2.1E+08 dr. Istiyart Esvat tab. 28 866.25 0 Sub Total 218797.2 73Sub Tota73Sub Tota 218797.2
2.1E+08 dr. Istiyart Glucovance 28 2705.43 0 18.5 89766.2 7518.5 89766.2
2.1E+08 dr. Istiyart Glucovance 28 2705.43 0 Sub Total 106090.8 75Sub Tota75Sub Tota 106090.8
2.1E+08 drg. Arti RHexadol Mi 1 15000 0 18.5 17775 7618.5 7618.5 17775
2.1E+08 drg. Arti RHexadol Mi 1 15000 0 Sub Total 17775 76Sub Tota76Sub Tota 17775
2.1E+08 dr amar baNovoMix 30 2 151278.5 0 18.5 358530.1 7818.5 7818.5 358530.1
2.1E+08 dr amar baPyrazinami 90 260.7 0 18.5 27803.66 7818.5 27803.66
2.1E+08 dr amar baPyrazinami 90 260.7 0 Sub Total 386333.8 78Sub Tota78Sub Tota 386333.8
2.1E+08 dr amar baFlamar tab 10 1320 0 18.5 15642 7918.5 7918.5 15642
2.1E+08 dr amar baTranec tab 10 1540 0 18.5 18249 7918.5 18249
2.1E+08 dr amar baXytrol ED t 1 23980 0 Sub Total 62307.3 79Sub Tota79Sub Tota 62307.3
2.1E+08 dr. Istiyart Atorvastati 28 4000 0 8 120960 808 808 120960
2.1E+08 dr. Istiyart V-Bloc tab 14 1750 0 18.5 29032.5 8018.5 8018.5 29032.5
2.1E+08 dr. Istiyart Lansoprazo 28 736.35 0 18.5 24432.22 8018.5 24432.22
2.1E+08 dr. Istiyart Aspar K ta 28 1532.7 0 18.5 50854.99 8018.5 50854.99
2.1E+08 dr. Istiyart Aspar K ta 28 1532.7 0 Sub Total 225279.7 80Sub Tota80Sub Tota 225279.7
2.1E+08 dr amar baMetrix tab 28 2534.85 0 18.5 84106.32 8118.5 84106.32
2.1E+08 dr amar baMetrix tab 28 2534.85 0 Sub Total 143830.3 81Sub Tota81Sub Tota 143830.3
2.1E+08 dr amar baRydian tab 10 1900 0 18.5 22515 8218.5 8218.5 22515
2.1E+08 dr amar baDextafen t 10 770 0 18.5 9124.5 8218.5 9124.5
2.1E+08 dr amar baBenoson M 1 38500 0 18.5 45622.5 8218.5 45622.5
2.1E+08 dr amar baBenoson M 1 38500 0 Sub Total 77262 82Sub Tota82Sub Tota 77262
2.1E+08 dr amar baDilavask t 28 1050 0 18.5 34839 8318.5 8318.5 34839
2.1E+08 dr amar baCameloc ta 14 580 0 18.5 9622.2 8318.5 9622.2
2.1E+08 dr amar baCameloc ta 14 580 0 Sub Total 44461.2 83Sub Tota83Sub Tota 44461.2
2.1E+08 dr. Istiyart Clonidine H 28 186.18 0 18.5 6177.36 8418.5 8418.5 6177.36
2.1E+08 dr. Istiyart Dilavask t 28 1050 0 18.5 34839 8418.5 34839
2.1E+08 dr. Istiyart Evothyl ka 28 4950 0 18.5 164241 8418.5 164241
2.1E+08 dr. Istiyart Esvat tab. 28 866.25 0 Sub Total 233999.5 84Sub Tota84Sub Tota 233999.5
2.1E+08 dr. Istiyart Esvat tab. 28 472.5 0 18.5 15677.55 8518.5 8518.5 15677.55
2.1E+08 dr. Istiyart Cameloc ta 15 580 0 18.5 10309.5 8518.5 10309.5
2.1E+08 dr. Istiyart OA Forte ka 10 3311 0 18.5 39235.35 8518.5 39235.35
2.1E+08 dr. Istiyart Magtral Syr 1 13000 0 18.5 15405 8518.5 15405
10 tab.300.75
4 mg (Dex) 0 18.5 3563.89 8518.5 3563.89
10 tab.300.75
2.1E+08 dr. Istiyart Kalmeco ta 10 1700 0 18.5 20145 8618.5 8618.5 20145
2.1E+08 dr. Istiyart Kalmeco ta 10 1700 0 Sub Total 20145 86Sub Tota86Sub Tota 20145
2.1E+08 dr. Istiyart Epsonal ta 5 2172.5 0 18.5 12872.06 8718.5 8718.5 12872.06
2.1E+08 dr. Istiyart Alpentin k 20 2380 0 18.5 56406 8718.5 56406
2.1E+08 dr. Istiyart Hi-Bone ta 14 2550 0 18.5 42304.5 8718.5 42304.5
2.1E+08 dr. Istiyart Hi-Bone ta 14 2550 0 Sub Total 111582.6 87Sub Tota87Sub Tota 111582.6
2.1E+08 dr. Istiyart Evothyl ka 28 4950 0 18.5 164241 8818.5 8818.5 164241
2.1E+08 dr. Istiyart Evothyl ka 28 4950 0 Sub Total 285201 88Sub Tota88Sub Tota 285201
2.1E+08 dr. Istiyart Epsonal ta 8 2172.5 0 18.5 20595.3 8918.5 8918.5 20595.3
2.1E+08 dr. Istiyart Diaversa t 28 992 0 18.5 32914.56 8918.5 32914.56
2.1E+08 dr. Istiyart Glucophage 28 1620.5 0 18.5 53768.32 8918.5 53768.32
2.1E+08 dr. Istiyart Allopurinol 28 144.3 0 18.5 4787.87 8918.5 4787.87
2.1E+08 dr. Istiyart Allopurinol 28 144.3 0 Sub Total 188870.6 89Sub Tota89Sub Tota 188870.6
2.1E+08 dr amar baClamixin ka 10 5500 0 18.5 65175 9018.5 9018.5 65175
2.1E+08 dr amar baAcilaz kaps 14 5200 0 18.5 86268 9118.5 9118.5 86268
2.1E+08 dr amar baGerdilium 20 1400 0 18.5 33180 9118.5 33180
2.1E+08 dr amar baEmibion ka 10 720 0 18.5 8532 9118.5 8532
2.1E+08 dr amar baEmibion ka 10 720 0 Sub Total 127980 91Sub Tota91Sub Tota 127980
2.1E+08 dr. Istiyart Opixime ta 10 7560 0 18.5 89586 9218.5 9218.5 89586
2.1E+08 dr. Istiyart Neurosanbe 15 800 0 18.5 14220 9218.5 14220
2.1E+08 dr. Istiyart Valisanbe 10 128 0 18.5 1516.8 9218.5 1516.8
2.1E+08 dr. Istiyart Valisanbe 10 128 0 Sub Total 105322.8 92Sub Tota92Sub Tota 105322.8
2.1E+08 dr amar baCanderin t 28 4800 0 18.5 159264 9318.5 9318.5 159264
2.1E+08 dr amar baOpixime ta 20 7560 0 18.5 179172 9418.5 9418.5 179172
2.1E+08 dr amar baSanmol tab 12 250 0 18.5 3555 9418.5 3555
2.1E+08 dr amar baCodeine ta 20 550 0 18.5 13035 9418.5 13035
2.1E+08 dr amar baPrednicort 20 1500 0 18.5 35550 9418.5 35550
2.1E+08 dr amar baRydian tab 6 1900 0 18.5 13509 9418.5 13509
2.1E+08 dr amar baRydian tab 6 1900 0 Sub Total 246291.5 94Sub Tota94Sub Tota 246291.5
2.1E+08 dr. Istiyart NovoMix 30 2 151278.5 0 18.5 358530.1 9518.5 9518.5 358530.1
2.1E+08 dr. Istiyart NovoMix 30 2 151278.5 0 Sub Total 358530.1 95Sub Tota95Sub Tota 358530.1
2.1E+08 dr. Istiyart Santesar t 28 3773 0 18.5 125188.1 9718.5 9718.5 125188.1
2.1E+08 dr. Istiyart Thrombo As 28 448 0 Sub Total 261012.8 97Sub Tota97Sub Tota 261012.8
2.1E+08 dr amar baTrizedon M 40 2610.39 0 18.5 123732.4 9818.5 9818.5 123732.4
2.1E+08 dr amar baFebogrel t 20 5280 0 18.5 125136 9818.5 125136
2.1E+08 dr. Istiyart Allopurinol 20 144.3 0 18.5 3419.91 9918.5 9918.5 3419.91
2.1E+08 dr. Istiyart Canderin t 20 6800 0 18.5 161160 9918.5 161160
2.1E+08 dr. Istiyart Febogrel t 20 5280 0 18.5 125136 9918.5 125136
2.1E+08 dr. Istiyart Betaone ta 10 1404 0 18.5 16637.4 9918.5 16637.4
2.1E+08 dr. Istiyart vitamin B 20 109.09 0 18.5 2585.45 9918.5 2585.45
2.1E+08 dr. Istiyart vitamin B 20 109.09 0 Sub Total 395338.8 99Sub Tota99Sub Tota 395338.8
2.1E+08 dr. Istiyart vitamin B 20 109.09 0 TOTAL SEB 11678943 99TOTAL S99TOTAL S 11678943
2.1E+08 dr. Istiyart vitamin B 20 109.09 0 TOTAL SET 12846837 99TOTAL S99TOTAL S 12846837
item
50 1E210200000KU17101538
50 1E210200000KU17101538
14 2E210200000KU17101544
14 2E210200000KU17101544
14 3E210200000KU17101546
14 3E210200000KU17101546
14 3E210200000KU17101546
28 4E210200000KU17101548
28 4E210200000KU17101548
28 4E210200000KU17101548
20 5E210200000KU17101550
20 5E210200000KU17101550
20 5E210200000KU17101550
40 5E210200000KU17101550
20 5E210200000KU17101550
20 5E210200000KU17101550
10 6E210200000KU17101556
1 6E210200000KU17101556
15 6E210200000KU17101556
10 6E210200000KU17101556
10 6E210200000KU17101556
8 7E210200000KU17101561
8 7E210200000KU17101561
6 7E210200000KU17101561
6 7E210200000KU17101561
1 8E210200000KU17101563
14 8E210200000KU17101563
14 8E210200000KU17101563
14 8E210200000KU17101563
14 8E210200000KU17101563
14 8E210200000KU17101563
1 9E210200000KU17101551
14 9E210200000KU17101551
14 9E210200000KU17101551
42 9E210200000KU17101551
28 9E210200000KU17101551
28 9E210200000KU17101551
90 10E210200000KU17101565
45 10E210200000KU17101565
30 10E210200000KU17101565
1 10E210200000KU17101565
10 10E210200000KU17101565
10 10E210200000KU17101565
2 11E210200000KU17101566
1 11E210200000KU17101566
1 11E210200000KU17101566
20 12E210200000KU17101567
20 12E210200000KU17101567
10 13E210200000KU17101568
10 13E210200000KU17101568
10 13E210200000KU17101568
10 13E210200000KU17101568
8 14E210200000KU17101575
1 14E210200000KU17101575
1 14E210200000KU17101575
2 15E210200000KU17101579
15 15E210200000KU17101579
15 15E210200000KU17101579
15 15E210200000KU17101579
14 16E210200000KU17101581
14 16E210200000KU17101581
1 17E210200000KU17101564
14 17E210200000KU17101564
10 17E210200000KU17101564
10 17E210200000KU17101564
8 18E210200000GI17091077
1 18E210200000GI17091077
10 18E210200000GI17091077
10 18E210200000GI17091077
1 19E210200000KU17101590
1 19E210200000KU17101590
10 20E210200000KU17101591
1 20E210200000KU17101591
10 20E210200000KU17101591
10 20E210200000KU17101591
10 21E210200000KU17101592
8 21E210200000KU17101592
8 21E210200000KU17101592
8 22E210200000KU17101597
8 22E210200000KU17101597
12 22E210200000KU17101597
12 22E210200000KU17101597
20 23E210200000KU17101599
20 23E210200000KU17101599
20 23E210200000KU17101599
15 24E210200000KU17101601
8 24E210200000KU17101601
1 24E210200000KU17101601
1 24E210200000KU17101601
14 25E210200000KU17101603
28 25E210200000KU17101603
14 25E210200000KU17101603
14 25E210200000KU17101603
14 25E210200000KU17101603
10 26E210200000GI17091080
10 26E210200000GI17091080
10 26E210200000GI17091080
10 27E210200000KU17101598
10 27E210200000KU17101598
6 27E210200000KU17101598
10 27E210200000KU17101598
10 27E210200000KU17101598
28 28E210200000KU17101593
28 28E210200000KU17101593
28 28E210200000KU17101593
10 29E210200000KU17101609
10 29E210200000KU17101609
10 29E210200000KU17101609
10 29E210200000KU17101609
10 29E210200000KU17101609
6 30E210200000KU17101588
1 30E210200000KU17101588
1 30E210200000KU17101588
1 30E210200000KU17101588
8 31E210200000KU17101569
8 31E210200000KU17101569
1 31E210200000KU17101569
1 31E210200000KU17101569
10 32E210200000KU17101611
10 32E210200000KU17101611
10 32E210200000KU17101611
10 32E210200000KU17101611
10 33E210200000KU17101613
10 33E210200000KU17101613
10 33E210200000KU17101613
10 33E210200000KU17101613
10 34E210200000KU17101614
10 34E210200000KU17101614
10 34E210200000KU17101614
10 34E210200000KU17101614
15 35E210200000KU17101615
1 35E210200000KU17101615
15 35E210200000KU17101615
15 35E210200000KU17101615
20 36E210200000KU17101610
20 36E210200000KU17101610
20 36E210200000KU17101610
20 36E210200000KU17101610
20 36E210200000KU17101610
20 36E210200000KU17101610
20 36E210200000KU17101610
14 37E210200000KB17090054
14 37E210200000KB17090054
14 38E210200000KU17101630
14 38E210200000KU17101630
42 38E210200000KU17101630
14 38E210200000KU17101630
14 38E210200000KU17101630
28 39E210200000KU17101627
14 39E210200000KU17101627
14 39E210200000KU17101627
14 39E210200000KU17101627
14 39E210200000KU17101627
14 39E210200000KU17101627
14 39E210200000KU17101627
14 39E210200000KU17101627
10 40E210200000KU17101634
10 40E210200000KU17101634
10 40E210200000KU17101634
6 41E210200000KU17101635
10 41E210200000KU17101635
6 41E210200000KU17101635
1 41E210200000KU17101635
1 41E210200000KU17101635
28 42E210200000KU17101638
28 42E210200000KU17101638
5 42E210200000KU17101638
5 42E210200000KU17101638
60 43E210200000KU17101641
18 43E210200000KU17101641
30 43E210200000KU17101641
30 43E210200000KU17101641
30 44E210200000KB17090055
30 44E210200000KB17090055
30 44E210200000KB17090055
30 44E210200000KB17090055
28 45E210200000KU17101625
28 45E210200000KU17101625
10 46E210200000KU17101645
10 46E210200000KU17101645
1 46E210200000KU17101645
1 46E210200000KU17101645
20 47E210200000KU17101653
20 47E210200000KU17101653
20 47E210200000KU17101653
1 47E210200000KU17101653
1 47E210200000KU17101653
6 48E210200000GI17091083
6 48E210200000GI17091083
20 49E210200000KU17101655
15 49E210200000KU17101655
1 49E210200000KU17101655
1 49E210200000KU17101655
1 49E210200000KU17101655
10 50E210200000GI17091084
1 50E210200000GI17091084
1 50E210200000GI17091084
1 51E210200000KU17101656
20 51E210200000KU17101656
1 51E210200000KU17101656
1 51E210200000KU17101656
10 52E210200000KU17101660
1 52E210200000KU17101660
14 52E210200000KU17101660
10 52E210200000KU17101660
8 52E210200000KU17101660
8 52E210200000KU17101660
8 53E210200000KU17101664
8 53E210200000KU17101664
12 53E210200000KU17101664
10 53E210200000KU17101664
10 53E210200000KU17101664
20 54E210200000KU17101665
20 54E210200000KU17101665
20 54E210200000KU17101665
20 54E210200000KU17101665
10 55E210200000KU17101666
10 55E210200000KU17101666
10 55E210200000KU17101666
10 55E210200000KU17101666
10 55E210200000KU17101666
14 56E210200000KU17101669
14 56E210200000KU17101669
28 56E210200000KU17101669
28 56E210200000KU17101669
2 57E210200000KU17101668
3 57E210200000KU17101668
150 57E210200000KU17101668
150 57E210200000KU17101668
11 58E210200000KU17101672
23 58E210200000KU17101672
23 58E210200000KU17101672
23 58E210200000KU17101672
8 59E210200000KU17101678
1 59E210200000KU17101678
8 59E210200000KU17101678
8 59E210200000KU17101678
10 60E210200000GI17091085
10 60E210200000GI17091085
10 60E210200000GI17091085
20 61E210200000KU17101681
20 61E210200000KU17101681
20 61E210200000KU17101681
20 62E210200000KU17101684
20 62E210200000KU17101684
20 62E210200000KU17101684
10 63E210200000KU17101671
10 63E210200000KU17101671
1 63E210200000KU17101671
1 63E210200000KU17101671
20 64E210200000KU17101696
8 64E210200000KU17101696
8 64E210200000KU17101696
10 64E210200000KU17101696
1 64E210200000KU17101696
1 64E210200000KU17101696
8 65E210200000KU17101700
8 65E210200000KU17101700
1 65E210200000KU17101700
1 65E210200000KU17101700
20 66E210200000KU17101697
8 66E210200000KU17101697
10 66E210200000KU17101697
14 66E210200000KU17101697
2 66E210200000KU17101697
2 66E210200000KU17101697
2 67E210200000KU17101702
1 67E210200000KU17101702
1 67E210200000KU17101702
28 68E210200000KU17101703
28 68E210200000KU17101703
28 68E210200000KU17101703
14 69E210200000KU17101704
14 69E210200000KU17101704
10 70E210200000KU17101737
10 70E210200000KU17101737
10 70E210200000KU17101737
10 70E210200000KU17101737
10 70E210200000KU17101737
1 71E210200000KU17101742
1 71E210200000KU17101742
1 71E210200000KU17101742
28 72E210200000KU17101743
28 72E210200000KU17101743
28 72E210200000KU17101743
28 72E210200000KU17101743
28 72E210200000KU17101743
28 72E210200000KU17101743
28 73E210200000KU17101745
28 73E210200000KU17101745
28 73E210200000KU17101745
28 73E210200000KU17101745
10 74E210200000GI17091087
10 74E210200000GI17091087
28 75E210200000KU17101753
28 75E210200000KU17101753
28 75E210200000KU17101753
1 76E210200000GI17091088
1 76E210200000GI17091088
10 77E210200000GI17091089
10 77E210200000GI17091089
2 78E210200000KU17101733
90 78E210200000KU17101733
90 78E210200000KU17101733
10 79E210200000KU17101781
10 79E210200000KU17101781
1 79E210200000KU17101781
1 79E210200000KU17101781
28 80E210200000KU17101787
14 80E210200000KU17101787
28 80E210200000KU17101787
28 80E210200000KU17101787
28 80E210200000KU17101787
56 81E210200000KU17101786
28 81E210200000KU17101786
28 81E210200000KU17101786
10 82E210200000KU17101782
10 82E210200000KU17101782
1 82E210200000KU17101782
1 82E210200000KU17101782
28 83E210200000KU17101780
14 83E210200000KU17101780
14 83E210200000KU17101780
28 84E210200000KU17101793
28 84E210200000KU17101793
28 84E210200000KU17101793
28 84E210200000KU17101793
28 84E210200000KU17101793
28 85E210200000KU17101791
15 85E210200000KU17101791
10 85E210200000KU17101791
1 85E210200000KU17101791
10 85E210200000KU17101791
10 85E210200000KU17101791
10 86E210200000KU17101747
10 86E210200000KU17101747
5 87E210200000KU17101809
20 87E210200000KU17101809
14 87E210200000KU17101809
14 87E210200000KU17101809
28 88E210200000KU17101812
28 88E210200000KU17101812
28 88E210200000KU17101812
14 89E210200000KU17101769
8 89E210200000KU17101769
28 89E210200000KU17101769
28 89E210200000KU17101769
28 89E210200000KU17101769
28 89E210200000KU17101769
28 89E210200000KU17101769
10 90E210200000KU17101816
10 90E210200000KU17101816
10 90E210200000KU17101816
10 90E210200000KU17101816
14 91E210200000KU17101817
20 91E210200000KU17101817
10 91E210200000KU17101817
10 91E210200000KU17101817
10 92E210200000KU17101818
15 92E210200000KU17101818
10 92E210200000KU17101818
10 92E210200000KU17101818
28 93E210200000KU17101789
28 93E210200000KU17101789
28 93E210200000KU17101789
28 93E210200000KU17101789
20 94E210200000KU17101821
12 94E210200000KU17101821
20 94E210200000KU17101821
10 94E210200000KU17101821
20 94E210200000KU17101821
6 94E210200000KU17101821
6 94E210200000KU17101821
2 95E210200000KU17101822
2 95E210200000KU17101822
10 96E210200000GI17091090
10 96E210200000GI17091090
28 97E210200000KU17101825
28 97E210200000KU17101825
28 97E210200000KU17101825
28 97E210200000KU17101825
40 98E210200000KU17101811
20 98E210200000KU17101811
20 98E210200000KU17101811
20 98E210200000KU17101811
20 98E210200000KU17101811
20 99E210200000KU17101807
20 99E210200000KU17101807
20 99E210200000KU17101807
20 99E210200000KU17101807
10 99E210200000KU17101807
20 99E210200000KU17101807
20 99E210200000KU17101807
20 99E210200000KU17101807
20 99E210200000KU17101807
REKAPITULASI TAGIHAN APOTIK (RJTP) PEGAWAI TELKOM
NAMA MITRA : TELKOM
PESERTA : TF 6
PERIODE : 29-31 Mei 2
Nomor Nama Band

NO Resep NIK Pegawai Posisi Loker NIKES Nama Pasien Tanggal Masuk Tanggal Keluar Nama Dokter ICD X
Sub Total 1 E210200000 690200.1 SRI TUWALIYANTI 29-05-2017 29-05-2017 dr amar bachtiar
Sub Total 2 E210200000 700646 FERRYMANSYAH, ST 29-05-2017 29-05-2017 dr amar bachtiar
Sub Total 3 E210200000 621300 DARMAWAN 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
Sub Total 4 E210200000 633217.2 SUHARTINI 29-05-2017 29-05-2017 dr amar bachtiar
Sub Total 5 E210200000 633217 WASIMIN 29-05-2017 29-05-2017 dr amar bachtiar
Sub Total 6 E210200000 700208.104 AZHARIANTO 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
Sub Total 7 E210200000 680413.1 DIAN MARDIANA 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
Sub Total 8 E210200000 680246 MARTUNUS 29-05-2017 29-05-2017 dr amar bachtiar
Sub Total 9 E210200000 680525.1 ISWAHYUNI BENNY HANDAYANI29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
Sub Total 10 E210200000 700372.101 LAYLA JULIA SYAFRIANI 29-05-2017 29-05-2017 dr amar bachtiar
Sub Total 11 E210200000 700112.101 MUHAMMAD DIKIANSYAH ALWAN 29-05-2017 29-05-2017 dr amar bachtiar
Sub Total 12 E210200000 700112.1 ROSDIANA 29-05-2017 29-05-2017 dr amar bachtiar
Sub Total 13 E210200000 700646.1 META FATIA 29-05-2017 29-05-2017 dr amar bachtiar
Sub Total 14 E210200000 680589.102 NADIYA NURFAIZA 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
Sub Total 15 E210200000 620453.1 KASRONI 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
Sub Total 16 E210200000 620453.1 KASRONI 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
Sub Total 17 E210200000 621815.1 DEBBIE CONNIE RATNIE SONDAKH
29-05-2017 29-05-2017 dr amar bachtiar
Sub Total 18 E210200000 700560.1 RINA YUSNITA 29-05-2017 29-05-2017 drg. Teresa Venir
Sub Total 19 E210200000 680390.1 WIWIT SUMIATI 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
Sub Total 20 E210200000 690419.1 LILIS TRIYATMI 29-05-2017 29-05-2017 dr amar bachtiar
Sub Total 21 E210200000 670067 MARISI MANULLANG 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
Sub Total 22 E210200000 690355.101 FITRI RACHMAWATI 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
Sub Total 23 E210200000 630812 RAHARJO 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
Sub Total 24 E210200000 660566.1 IIS SURYANI 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
Sub Total 25 E210200000 700099 NGADI 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
Sub Total 26 E210200000 810081.1 FITRIA RAHMI 29-05-2017 29-05-2017 drg. Arti R.Nazir
Sub Total 27 E210200000 660443 LASMA LYDIA PINARSINTA 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
Sub Total 28 E210200000 700039.1 DIMYANTI HARTATI 29-05-2017 29-05-2017 dr amar bachtiar
Sub Total 29 E210200000 632462 SYAIFUL BAHRI 29-05-2017 29-05-2017 dr amar bachtiar
Sub Total 30 E210200000 820065.101 MUHAMMAD RASYA PUTRA RENALDI
29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
Sub Total 31 E210200000 620492 TETY PUSPITOWATI 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
Sub Total 32 E210200000 690230.102 FARHAN NAUVAL RAFIF 29-05-2017 29-05-2017 dr amar bachtiar
Sub Total 33 E210200000 690230.101 NANDINI PUTRI DEWITA 29-05-2017 29-05-2017 dr amar bachtiar
Sub Total 34 E210200000 690230.1 NURASASIH 29-05-2017 29-05-2017 dr amar bachtiar
Sub Total 35 E210200000 612315 SUPRIYATNO 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu
Sub Total 36 E210200000 680055 KHAIRUL FAHMI 29-05-2017 29-05-2017 dr amar bachtiar
Sub Total 37 E210200000 642305.1 ENDANG SRI WIDANINGSIH 30-05-2017 30-05-2017 Bidan Vitha Diana
Sub Total 38 E210200000 631899.1 ICE NURDIANI 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
Sub Total 39 E210200000 631899 LASAM 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
Sub Total 40 E210200000 690146.1 SARPEN 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
Sub Total 41 E210200000 690146 TADI 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
Sub Total 42 E210200000 620577 SYAIFUL BAHRI 30-05-2017 30-05-2017 dr amar bachtiar
Sub Total 43 E210200000 622888 TUBAGUS BUDIAWAN 30-05-2017 30-05-2017 dr amar bachtiar
Sub Total 44 E210200000 810029.1 ANASTASIA MARGARETHA SIREGAR
30-05-2017 30-05-2017 Bidan Vitha Diana
Sub Total 45 E210200000 632907 SUKATMA 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
Sub Total 46 E210200000 632113.1 YUNI SUKASNI 30-05-2017 30-05-2017 dr amar bachtiar
Sub Total 47 E210200000 680039.1 FATMAWATY MUIS 30-05-2017 30-05-2017 dr amar bachtiar
Sub Total 48 E210200000 641591 HARYOKO 30-05-2017 30-05-2017 drg. Teresa Venir
Sub Total 49 E210200000 611467 MARGONO 30-05-2017 30-05-2017 dr amar bachtiar
Sub Total 50 E210200000 632113.1 YUNI SUKASNI 30-05-2017 30-05-2017 drg. Arti R.Nazir
Sub Total 51 E210200000 611467.1 MISTIYAH 30-05-2017 30-05-2017 dr amar bachtiar
Sub Total 52 E210200000 710038.103 FARAH DIPTA SALSABILLA DEWANTI
Sub Total 53 E210200000 642081.1 NURMAINI 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
Sub Total 54 E210200000 621220 YUDO IRIANTO 30-05-2017 30-05-2017 dr amar bachtiar
Sub Total 55 E210200000 621220 YUDO IRIANTO 30-05-2017 30-05-2017 dr amar bachtiar
Sub Total 56 E210200000 670563 RAMSES MANURUNG 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
Sub Total 57 E210200000 630761.103 NASTITI TRIJAYANTI 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
Sub Total 58 E210200000 642081 ADEK SURYONO 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
Sub Total 59 E210200000 641095 SUSI SUSWANTI 30-05-2017 30-05-2017 dr amar bachtiar
Sub Total 60 E210200000 633236.1 SRI RETNOWATI 30-05-2017 30-05-2017 drg. Arti R.Nazir
Sub Total 61 E210200000 670363 AHMAD IRIANTO 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
Sub Total 62 E210200000 640794 PUTU PUTRA RIAWAN 30-05-2017 30-05-2017 dr amar bachtiar
Sub Total 63 E210200000 633236.102 DINDA FAUZIAH OLIMVIA 30-05-2017 30-05-2017 dr amar bachtiar
Sub Total 64 E210200000 660371 DIDIET HENDRO PRASTOWO, S.KOMP
Sub Total 65 E210200000 680525 RACHMAT 30-05-2017 30-05-2017 dr amar bachtiar
Sub Total 66 E210200000 660371.1 RANITA M BAGA 30-05-2017 30-05-2017 dr. Istiyarti Tapilatu
Sub Total 67 E210200000 611460 AKHLANI 31-05-2017 31-05-2017 dr amar bachtiar
Sub Total 68 E210200000 611460.1 SULASTRI 31-05-2017 31-05-2017 dr amar bachtiar
Sub Total 69 E210200000 690496.102 ZHIARA AULIA 31-05-2017 31-05-2017 dr amar bachtiar
Sub Total 70 E210200000 700646.1 META FATIA 31-05-2017 31-05-2017 dr amar bachtiar
Sub Total 71 E210200000 611617 TUKIJA 31-05-2017 31-05-2017 dr amar bachtiar
Sub Total 72 E210200000 611617 TUKIJA 31-05-2017 31-05-2017 dr amar bachtiar
Sub Total 73 E210200000 620955 AFRIZALI 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
Sub Total 74 E210200000 760042.1 WENI FEBRINA 31-05-2017 31-05-2017 drg. Teresa Venir
Sub Total 75 E210200000 630761.1 JUNAETI WAHYUNINGRUM 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
Sub Total 76 E210200000 810081.1 FITRIA RAHMI 31-05-2017 31-05-2017 drg. Arti R.Nazir
Sub Total 77 E210200000 830087 MAYRISA 31-05-2017 31-05-2017 drg. Teresa Venir
Sub Total 78 E210200000 690223 ABDUL RAHMAN 31-05-2017 31-05-2017 dr amar bachtiar
Sub Total 79 E210200000 700355 HARNOLO 31-05-2017 31-05-2017 dr amar bachtiar
Sub Total 80 E210200000 630510 ASEP FACHRUDIN 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
Sub Total 81 E210200000 621271 SOBAR SISWANTO 31-05-2017 31-05-2017 dr amar bachtiar
Sub Total 82 E210200000 680541 YULI SUNARKA 31-05-2017 31-05-2017 dr amar bachtiar
Sub Total 83 E210200000 710107 ANDY 31-05-2017 31-05-2017 dr amar bachtiar
Sub Total 84 E210200000 622553 RIKA JUNAIDI 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
Sub Total 85 E210200000 612233 SUSILO KRISMIATI 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
Sub Total 86 E210200000 622693.1 ENDANG SULISTYOWATI 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
Sub Total 87 E210200000 710025.1 ROHMAWATI 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
Sub Total 88 E210200000 630316 JOKO MURSITO 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
Sub Total 89 E210200000 630669 SUMARSONO 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
Sub Total 90 E210200000 670549 JUNIAR 31-05-2017 31-05-2017 dr amar bachtiar
Sub Total 91 E210200000 700251.101 PUTRI NOVRILIA SUSANTO 31-05-2017 31-05-2017 dr amar bachtiar
Sub Total 92 E210200000 630669.1 NOERBAETY 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
Sub Total 93 E210200000 690457 DEDI PURWANTO 31-05-2017 31-05-2017 dr amar bachtiar
Sub Total 94 E210200000 633093 WIDJI TAMTOMO, IR. 31-05-2017 31-05-2017 dr amar bachtiar
Sub Total 95 E210200000 670479 MOCH. DIMYATI 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
Sub Total 96 E210200000 632125.103 FATTURRAHMAN 31-05-2017 31-05-2017 drg. Teresa Venir
Sub Total 97 E210200000 630853 SUKARJA 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
Sub Total 98 E210200000 700323 EVAN HUTAJULU 31-05-2017 31-05-2017 dr amar bachtiar
Sub Total 99 E210200000 690335 WINARKO 31-05-2017 31-05-2017 dr. Istiyarti Tapilatu
JTP) PEGAWAI TELKOM
Jenis
Pese 2. Jasa 3. Jasa Jumlah Total Status
rta DOT Non Generi 1. Obat / Dokter 4.
DOT k Bahan Obat Umum Dokter Kapitasi
Gigi
50 142,200 - - - 142,200 1.4.1.

14 70,474 - - - 70,474 1.4.1.
28 68,262 - - - 68,262 1.4.1.
56 92,572 - - - 92,572 1.4.1.
120 184,179 - - - 184,179 1.4.1.
36 101,053 - - - 101,053 1.4.1.
22 99,772 - - - 99,772 1.4.1.
57 305,619 - - - 305,619 1.4.1.
99 365,343 - - - 365,343 1.4.1.
176 84,795 - - - 84,795 1.4.1.
3 21,545 - - - 21,545 1.4.1.
20 26,663 - - - 26,663 1.4.1.
30 97,081 - - - 97,081 1.4.1.
9 20,401 - - - 20,401 1.4.1.
32 59,815 - - - 59,815 1.4.1.
14 13,687 - - - 13,687 1.4.1.
25 128,525 - - - 128,525 1.4.1.
19 63,800 - - - 63,800 1.4.1.
1 28,416 - - - 28,416 1.4.1.
21 83,454 - - - 83,454 1.4.1.
18 13,817 - - - 13,817 1.4.1.
28 77,059 - - - 77,059 1.4.1.
40 120,941 - - - 120,941 1.4.1.
24 43,679 - - - 43,679 1.4.1.
70 158,255 - - - 158,255 1.4.1.
20 59,019 - - - 59,019 1.4.1.
36 77,950 - - - 77,950 1.4.1.
56 57,783 - - - 57,783 1.4.1.
40 98,552 - - - 98,552 1.4.1.
8 72,996 - - - 72,996 1.4.1.
17 85,824 - - - 85,824 1.4.1.
30 72,907 - - - 72,907 1.4.1.
30 72,907 - - - 72,907 1.4.1.
30 64,642 - - - 64,642 1.4.1.
31 58,302 - - - 58,302 1.4.1.
120 295,545 - - - 295,545 1.4.1.
14 11,945 - - - 11,945 1.4.1.
84 112,981 - - - 112,981 1.4.1.
112 207,325 - - - 207,325 1.4.1.
20 59,250 - - - 59,250 1.4.1.
23 52,525 - - - 52,525 1.4.1.
61 205,031 - - - 205,031 1.4.1.
108 50,370 - - - 50,370 1.4.1.
90 179,908 - - - 179,908 1.4.1.
28 84,609 - - - 84,609 1.4.1.
21 97,763 - - - 97,763 1.4.1.
61 135,268 - - - 135,268 1.4.1.
6 2,491 - - - 2,491 1.4.1.
37 79,796 - - - 79,796 1.4.1.
11 22,634 - - - 22,634 1.4.1.
22 83,839 - - - 83,839 1.4.1.
43 120,056 - - - 120,056 1.4.1.
38 80,860 - - - 80,860 1.4.1.
60 223,196 - - - 223,196 1.4.1.
40 93,811 - - - 93,811 1.4.1.
56 74,247 - - - 74,247 1.4.1.
155 323,981 - - - 323,981 1.4.1.
57 173,496 - - - 173,496 1.4.1.
17 88,709 - - - 88,709 1.4.1.
20 55,610 - - - 55,610 1.4.1.
40 47,278 - - - 47,278 1.4.1.
40 179,667 - - - 179,667 1.4.1.
21 91,820 - - - 91,820 1.4.1.
47 162,559 - - - 162,559 1.4.1.
17 88,709 - - - 88,709 1.4.1.
54 63,299 - - - 63,299 1.4.1.
3 50,796 - - - 50,796 1.4.1.
56 92,572 - - - 92,572 1.4.1.
14 132,911 - - - 132,911 1.4.1.
40 76,185 - - - 76,185 1.4.1.
2 51,014 - - - 51,014 1.4.1.
140 224,156 - - - 224,156 1.4.1.
84 218,797 - - - 218,797 1.4.1.
10 4,152 - - - 4,152 1.4.1.
56 106,091 - - - 106,091 1.4.1.
1 17,775 - - - 17,775 1.4.1.
10 4,152 - - - 4,152 1.4.1.
92 386,334 - - - 386,334 1.4.1.
21 62,307 - - - 62,307 1.4.1.
98 225,280 - - - 225,280 1.4.1.
84 143,830 - - - 143,830 1.4.1.
21 77,262 - - - 77,262 1.4.1.
42 44,461 - - - 44,461 1.4.1.
112 234,000 - - - 234,000 1.4.1.
64 84,191 - - - 84,191 1.4.1.
10 20,145 - - - 20,145 1.4.1.
39 111,583 - - - 111,583 1.4.1.
56 285,201 - - - 285,201 1.4.1.
134 188,871 - - - 188,871 1.4.1.
30 114,501 - - - 114,501 1.4.1.
44 127,980 - - - 127,980 1.4.1.
35 105,323 - - - 105,323 1.4.1.
84 202,871 - - - 202,871 1.4.1.
88 246,291 - - - 246,291 1.4.1.
2 358,530 - - - 358,530 1.4.1.
10 4,152 - - - 4,152 1.4.1.
84 261,013 - - - 261,013 1.4.1.
100 280,016 - - - 280,016 1.4.1.
110 395,339 - - - 395,339 1.4.1.
### - - 11,678,943 - - - 11,678,943 -

Laporan Penjualan PENSIUN TELKOM
Apotek Telemedika Farma 16 Jl. Percetakan Negara No.17A Jak
Tanggal
Transaksi
1 E210200000KU17101530 400689 SOEHARDI BC.TT 29-05-2017 210110013 dr amar bachtiar
2 E210200000KU17101531 400689 SOEHARDI BC.TT 29-05-2017 210110013 dr amar bachtiar
3 E210200000KU17101532 590396 MUHAMMAD YAHYA 29-05-2017 210110013 dr amar bachtiar
4 E210200000KU17101533 550238 ASRO SUGIHARTO 29-05-2017 210210001 dr. Istiyarti Tapilatu
5 E210200000KU17101534 550238.1 SULASIH 29-05-2017 210210001 dr. Istiyarti Tapilatu
6 E210200000KU17101535 540961 PURBONO 29-05-2017 210110013 dr amar bachtiar
7 E210200000KU17101536 620063.1 LILIK SURIYAH 29-05-2017 210210001 dr. Istiyarti Tapilatu
8 E210200000KU17101528 591448 AGUNG HARYANTO SUMARGO

29-05-2017 210210001 dr. Istiyarti Tapilatu
Tanggal
Transaksi
9 E210200000KU17101539 340553 DJUNAEDI BIN DIDI 29-05-2017 210110013 dr amar bachtiar
10 E210200000KU17101529 591494 ENDANG PURWATI 29-05-2017 210210001 dr. Istiyarti Tapilatu
11 E210200000KU17101541 551531.1 YULI ARTINI 29-05-2017 210210001 dr. Istiyarti Tapilatu
12 E210200000KU17101542 610943.1 SRI SULASTIKA SARI 29-05-2017 210210001 dr. Istiyarti Tapilatu
13 E210200000KU17101543 610943.1 SRI SULASTIKA SARI 29-05-2017 210210001 dr. Istiyarti Tapilatu
14 E210200000KU17101545 610943.104 RICKY HARDIAN 29-05-2017 210210001 dr. Istiyarti Tapilatu
15 E210200000KU17101537 540961 PURBONO 29-05-2017 210110013 dr amar bachtiar
16 E210200000KU17101547 421398 DIAH ESTHININGRUM 29-05-2017 210210001 dr. Istiyarti Tapilatu

Tanggal
Transaksi
17 E210200000KU17101549 421398.1 K. I. MAHMUD 29-05-2017 210210001 dr. Istiyarti Tapilatu
18 E210200000KU17101553 560309 SUDIRMAN SYARIF 29-05-2017 210210001 dr. Istiyarti Tapilatu
19 E210200000KU17101554 490248.1 TOTO SULAEMAN 29-05-2017 210110013 dr amar bachtiar
20 E210200000KU17101555 490248 SUMINI 29-05-2017 210110013 dr amar bachtiar
21 E210200000KU17101557 470748 NURMAN BURHAN, BCTT. 29-05-2017 210110013 dr amar bachtiar
22 E210200000KU17101558 470748.1 LIA NURLAELA 29-05-2017 210110013 dr amar bachtiar

Tanggal
Transaksi
23 E210200000KU17101560 510745 ENTANG MUCHTAR 29-05-2017 210210001 dr. Istiyarti Tapilatu
24 E210200000KU17101552 520382 YOZEF THEEDENS 29-05-2017 210210001 dr. Istiyarti Tapilatu
25 E210200000KU17101570 540264 NINIEK RUSMINIWATI 29-05-2017 210110013 dr amar bachtiar
26 E210200000KU17101571 540264.1 BUDIONO RUSSALI 29-05-2017 210110013 dr amar bachtiar
27 E210200000KU17101572 540492 RUSMIJANTO 29-05-2017 210210001 dr. Istiyarti Tapilatu
28 E210200000KU17101573 540364 SLAMET BUDI RISJANTO 29-05-2017 210210001 dr. Istiyarti Tapilatu
29 E210200000KU17101574 570124 HERRY SUARDI 29-05-2017 210110013 dr amar bachtiar
30 E210200000GI17091078 580763 DULIL AMIN 29-05-2017 210220001 drg. Arti R.Nazir

Tanggal
Transaksi
31 E210200000KU17101577 600223 SUMARTONO 29-05-2017 210110013 dr amar bachtiar
32 E210200000KU17101578 541714.1 HARTATI 29-05-2017 210210001 dr. Istiyarti Tapilatu
33 E210200000KU17101576 551611.1 DARMINI 29-05-2017 210110013 dr amar bachtiar
34 E210200000KU17101582 570107 MARSINTA LUMBAN GAOL 29-05-2017 210110013 dr amar bachtiar
35 E210200000KU17101583 530314 GERTRUDO TRI HERWANTI 29-05-2017 210210001 dr. Istiyarti Tapilatu
36 E210200000KU17101584 530314.1 ALOYSIUS HERTANTO 29-05-2017 210210001 dr. Istiyarti Tapilatu
37 E210200000KU17101585 540364.1 SEMIM 29-05-2017 210210001 dr. Istiyarti Tapilatu
38 E210200000KU17101586 531204 NENNY SRI SUPARMI 29-05-2017 210110013 dr amar bachtiar

Tanggal
Transaksi
39 E210200000KU17101589 500351 MISWAN GUNAWAN 29-05-2017 210110013 dr amar bachtiar
40 E210200000GI17091079 470479.1 SUMIYATI 29-05-2017 210220001 drg. Arti R.Nazir
41 E210200000KU17101594 500126 DJAJA HENDARTO 29-05-2017 210210001 dr. Istiyarti Tapilatu
42 E210200000KU17101595 500126.1 VERA LANIJANTI 29-05-2017 210210001 dr. Istiyarti Tapilatu
43 E210200000KU17101596 500126.1 VERA LANIJANTI 29-05-2017 210210001 dr. Istiyarti Tapilatu
44 E210200000KU17101600 580102 I GDE NYOMAN SUMADIA 29-05-2017 210110013 dr amar bachtiar
45 E210200000KU17101602 560069.1 SRI MULYATUN 29-05-2017 210110013 dr amar bachtiar
46 E210200000KU17101605 520872.1 ZURIATI ZUBIR 29-05-2017 210110013 dr amar bachtiar
47 E210200000KU17101606 190236.1 MUHIJA JD ANANG NOERDIN29-05-2017 210210001 dr. Istiyarti Tapilatu

Tanggal
Transaksi
48 E210200000KU17101607 530934.1 NURMIATI, S.AG 29-05-2017 210110013 dr amar bachtiar
49 E210200000KU17101608 540429.1 SRI DEWI EKOWATI 29-05-2017 210210001 dr. Istiyarti Tapilatu
50 E210200000KU17101612 370472 SURJANA BIN ROJADI 29-05-2017 210210001 dr. Istiyarti Tapilatu
51 E210200000KU17101587 630305.103 MARLUTFIANTO TRIPUTRA 29-05-2017 210110013 dr amar bachtiar
52 E210200000KU17101617 511229 MUDJIONO 29-05-2017 210210001 dr. Istiyarti Tapilatu
53 E210200000KU17101604 460040.1 NADHIROH,NY 29-05-2017 210110013 dr amar bachtiar

Tanggal
Transaksi
54 E210200000KU17101618 640056.1 BUKIT SABAR TAMBUNAN, SH30-05-2017 210110013 dr amar bachtiar
55 E210200000KU17101619 500574 BAHASANNUDIN 30-05-2017 210110013 dr amar bachtiar
56 E210200000KU17101620 490902 BAMBANG SEKTIJOSO, IR. 30-05-2017 210210001 dr. Istiyarti Tapilatu
57 E210200000KU17101621 490902.1 JOHANA MARIA DWI PRAPTI P30-05-2017 210210001 dr. Istiyarti Tapilatu
58 E210200000KU17101623 571138 TADOH 30-05-2017 210210001 dr. Istiyarti Tapilatu
59 E210200000KU17101624 571138 TADOH 30-05-2017 210210001 dr. Istiyarti Tapilatu

Tanggal
Transaksi
60 E210200000KU17101626 571138.1 SITI SADIYAH 30-05-2017 210210001 dr. Istiyarti Tapilatu
61 E210200000KU17101628 460544.1 DIAH ARYU PARLAWATY 30-05-2017 210110013 dr amar bachtiar
62 E210200000GI17091081 640056.1 BUKIT SABAR TAMBUNAN, SH30-05-2017 210220001 drg. Arti R.Nazir
63 E210200000KU17101629 320126.1 BARIYAH 30-05-2017 210210001 dr. Istiyarti Tapilatu
64 E210200000KU17101631 560067 SANIM SUKANDAR 30-05-2017 210210001 dr. Istiyarti Tapilatu
65 E210200000KU17101636 560067 SANIM SUKANDAR 30-05-2017 210210001 dr. Istiyarti Tapilatu
66 E210200000GI17091082 520874.1 TITIN SUTINAH 30-05-2017 210220001 drg. Arti R.Nazir

Tanggal
Transaksi
67 E210200000KU17101640 370764.2 HAFIDAH 30-05-2017 210210001 dr. Istiyarti Tapilatu
68 E210200000KU17101642 370764.2 HAFIDAH 30-05-2017 210210001 dr. Istiyarti Tapilatu
69 E210200000KU17101643 490333 KARTONO 30-05-2017 210210001 dr. Istiyarti Tapilatu
70 E210200000KU17101633 560165 DJOHNI LIANSEN 30-05-2017 210210001 dr. Istiyarti Tapilatu
71 E210200000KU17101646 581293 SYAFRUDDIN. B 30-05-2017 210110013 dr amar bachtiar
72 E210200000KU17101647 360683.1 RATU TIEN L. 30-05-2017 210210001 dr. Istiyarti Tapilatu
73 E210200000KU17101648 590275.1 SITI FATIMAH 30-05-2017 210110013 dr amar bachtiar
74 E210200000KU17101639 591192.1 DWI ESTI MULYATMI 30-05-2017 210210001 dr. Istiyarti Tapilatu
Tanggal
Transaksi
75 E210200000KU17101649 551034 TRI AGUS JOKO PURNOMO 30-05-2017 210210001 dr. Istiyarti Tapilatu
76 E210200000KU17101650 580889 MARYANI 30-05-2017 210210001 dr. Istiyarti Tapilatu
77 E210200000KU17101651 310137 SOEWARSO BCAT 30-05-2017 210210001 dr. Istiyarti Tapilatu
78 E210200000KU17101652 310137 SOEWARSO BCAT 30-05-2017 210210001 dr. Istiyarti Tapilatu
79 E210200000KU17101654 580889.101 IKA RACHMALIKA 30-05-2017 210210001 dr. Istiyarti Tapilatu
80 E210200000KU17101658 591139 ETTY ROHAYATI 30-05-2017 210110013 dr amar bachtiar
81 E210200000KU17101644 440847 SUGIMIN BIN SULAIMAN 30-05-2017 210210001 dr. Istiyarti Tapilatu
82 E210200000KU17101659 601639 MULYANA 30-05-2017 210210001 dr. Istiyarti Tapilatu

Tanggal
Transaksi
83 E210200000KU17101637 560067.1 TITIN SUKAESIH 30-05-2017 210210001 dr. Istiyarti Tapilatu
84 E210200000KU17101622 431114.1 ELIZABETH SUMARTINI 30-05-2017 210210001 dr. Istiyarti Tapilatu
85 E210200000KU17101661 570948 SRI SUHARTI 30-05-2017 210210001 dr. Istiyarti Tapilatu
86 E210200000KU17101662 570948.1 DJONO WIDJOSENO 30-05-2017 210210001 dr. Istiyarti Tapilatu
87 E210200000KU17101663 350079.1 SITI SAODAH 30-05-2017 210210001 dr. Istiyarti Tapilatu
88 E210200000KU17101667 550158.1 RINNY SULISTYOWATI 30-05-2017 210110013 dr amar bachtiar
89 E210200000KU17101657 540428 NGAKAN PUTU SANTHA 30-05-2017 210110013 dr amar bachtiar
90 E210200000KU17101670 561565.102 MUHAMMAD EMIR FADILLAH30-05-2017 210110013 dr amar bachtiar

Tanggal
Transaksi
91 E210200000KU17101673 601278 SITI AQILAH 30-05-2017 210210001 dr. Istiyarti Tapilatu
92 E210200000KU17101674 551487.104 IRA TRISNAWATI 30-05-2017 210110013 dr amar bachtiar
93 E210200000KU17101675 601096.102 DWIKY NURDAYA ANDYARTO 30-05-2017 210110013 dr amar bachtiar
94 E210200000KU17101676 601096.1 TITIN DWI ANDI ANGGRAENI 30-05-2017 210110013 dr amar bachtiar
95 E210200000KU17101677 470366.1 SABARIAH 30-05-2017 210110013 dr amar bachtiar
96 E210200000KU17101680 511229 MUDJIONO 30-05-2017 210110013 dr amar bachtiar
97 E210200000KU17101682 511229.1 SUDARWATI 30-05-2017 210110013 dr amar bachtiar

Tanggal
Transaksi
98 E210200000KU17101683 640230 ISDI HANDAYANI 30-05-2017 210110013 dr amar bachtiar
99 E210200000KU17101685 640230.1 SYAFEI 30-05-2017 210110013 dr amar bachtiar
100 E210200000KU17101686 612321.1 WAHYUNING 30-05-2017 210210001 dr. Istiyarti Tapilatu
101 E210200000KU17101679 511229 MUDJIONO 30-05-2017 210110013 dr amar bachtiar
102 E210200000KU17101688 490934.1 TJUT KESUMA BHAKTY 30-05-2017 210110013 dr amar bachtiar
103 E210200000KU17101687 410437 SUPARDI 30-05-2017 210210001 dr. Istiyarti Tapilatu

Tanggal
Transaksi
104 E210200000KU17101694 560848 JONAR PANJAITAN 30-05-2017 210110013 dr amar bachtiar
105 E210200000KU17101695 460631 REMEDI PERANGINANGIN IR.30-05-2017 210210001 dr. Istiyarti Tapilatu
106 E210200000KU17101693 551872.1 ESTER LUMBANTOBING 30-05-2017 210110013 dr amar bachtiar
107 E210200000KU17101698 530092 MUHAMMAD MUNIF 30-05-2017 210210001 dr. Istiyarti Tapilatu
108 E210200000KU17101701 360800.1 HINDUN 30-05-2017 210210001 dr. Istiyarti Tapilatu
109 E210200000KU17101691 580123 JOKO TRIYANTO 30-05-2017 210210001 dr. Istiyarti Tapilatu
110 E210200000KU17101690 532234 ISKANDAR 30-05-2017 210210001 dr. Istiyarti Tapilatu

Tanggal
Transaksi
111 E210200000KU17101692 460631.1 SETIANA SINULINGGA 30-05-2017 210210001 dr. Istiyarti Tapilatu
112 E210200000KU17101699 561086 SUPRAPTO SURYANI 30-05-2017 210210001 dr. Istiyarti Tapilatu
113 E210200000KU17101705 360161 SANOESI BIN ALIAS 31-05-2017 210110013 dr amar bachtiar
114 E210200000KU17101706 460053 KIMAH ROHIMAH 31-05-2017 210210001 dr. Istiyarti Tapilatu
115 E210200000KU17101707 441131 UDJANG BIN PIUL 31-05-2017 210210001 dr. Istiyarti Tapilatu
116 E210200000KU17101708 441131.1 NINAH 31-05-2017 210210001 dr. Istiyarti Tapilatu
117 E210200000KU17101709 540286 IGNATIUS BAMBANG BUDISU31-05-2017 210110013 dr amar bachtiar

Tanggal
Transaksi
118 E210200000KU17101710 441131.1 NINAH 31-05-2017 210210001 dr. Istiyarti Tapilatu
119 E210200000KU17101711 540286.1 MARIA MARGARETA KUSUMA31-05-2017 210110013 dr amar bachtiar
120 E210200000KU17101712 470015.1 HARTINI NY 31-05-2017 210210001 dr. Istiyarti Tapilatu
121 E210200000KU17101713 470015.1 HARTINI NY 31-05-2017 210210001 dr. Istiyarti Tapilatu
122 E210200000KU17101716 470015 SOEBARNO 31-05-2017 210210001 dr. Istiyarti Tapilatu
123 E210200000KU17101717 470015 SOEBARNO 31-05-2017 210210001 dr. Istiyarti Tapilatu
124 E210200000KU17101718 581143 ATANG RACHMAT 31-05-2017 210110013 dr amar bachtiar

Tanggal
Transaksi
125 E210200000KU17101720 591487.1 M YUSUF NS 31-05-2017 210210001 dr. Istiyarti Tapilatu
126 E210200000KU17101721 591487.1 M YUSUF NS 31-05-2017 210210001 dr. Istiyarti Tapilatu
127 E210200000KU17101722 410770.1 SARMI 31-05-2017 210110013 dr amar bachtiar
128 E210200000KU17101723 550461 SUBANDI 31-05-2017 210210001 dr. Istiyarti Tapilatu
129 E210200000KU17101724 510167.1 SRI WINARNI 31-05-2017 210110013 dr amar bachtiar
130 E210200000KU17101725 550461 SUBANDI 31-05-2017 210210001 dr. Istiyarti Tapilatu
131 E210200000KU17101726 431249 SURIPTO 31-05-2017 210210001 dr. Istiyarti Tapilatu

Tanggal
Transaksi
132 E210200000KU17101727 410222.1 NANI SUPIATI 31-05-2017 210110013 dr amar bachtiar
133 E210200000KU17101729 470652 MUHAMAD ADENAN 31-05-2017 210110013 dr amar bachtiar
134 E210200000KU17101730 360874 SUDIJONO BIN DJEMAKUN 31-05-2017 210210001 dr. Istiyarti Tapilatu
135 E210200000KU17101732 431249 SURIPTO 31-05-2017 210210001 dr. Istiyarti Tapilatu
136 E210200000KU17101728 431249.1 SUPARTI 31-05-2017 210210001 dr. Istiyarti Tapilatu
137 E210200000KU17101734 431249.1 SUPARTI 31-05-2017 210210001 dr. Istiyarti Tapilatu
138 E210200000KU17101735 500069 JAHJA KELANA 31-05-2017 210210001 dr. Istiyarti Tapilatu
Tanggal
Transaksi
139 E210200000KU17101736 500069 JAHJA KELANA 31-05-2017 210210001 dr. Istiyarti Tapilatu
140 E210200000KU17101738 500069.1 MARIANI 31-05-2017 210210001 dr. Istiyarti Tapilatu
141 E210200000KU17101731 510051 SISWO KUNTJORO 31-05-2017 210210001 dr. Istiyarti Tapilatu
142 E210200000KU17101739 500069.1 MARIANI 31-05-2017 210210001 dr. Istiyarti Tapilatu
143 E210200000KU17101740 532286 HATTA YUSUF,DRS 31-05-2017 210110013 dr amar bachtiar
144 E210200000KU17101744 441224 ATER ROBERT MARPAUNG 31-05-2017 210110013 dr amar bachtiar
145 E210200000KU17101746 480670.1 JOSEPHINE SIMANJUTAK 31-05-2017 210110013 dr amar bachtiar
146 E210200000KU17101748 500287 MISNAN 31-05-2017 210210001 dr. Istiyarti Tapilatu

Tanggal
Transaksi
147 E210200000KU17101749 591515 WIYANTO 31-05-2017 210210001 dr. Istiyarti Tapilatu
148 E210200000KU17101751 500287.1 NURIAH 31-05-2017 210210001 dr. Istiyarti Tapilatu
149 E210200000KU17101752 500287.1 NURIAH 31-05-2017 210210001 dr. Istiyarti Tapilatu
150 E210200000KU17101754 520143.1 ROIKAH 31-05-2017 210110013 dr amar bachtiar
151 E210200000KU17101758 570595 AZWIR 31-05-2017 210110013 dr amar bachtiar

Tanggal
Transaksi
152 E210200000KU17101759 460577.1 HJ ROCHAINAH 31-05-2017 210210001 dr. Istiyarti Tapilatu
153 E210200000KU17101760 530117 SURYADI 31-05-2017 210210001 dr. Istiyarti Tapilatu
154 E210200000KU17101761 570595.1 SUWARNI 31-05-2017 210110013 dr amar bachtiar
155 E210200000KU17101763 570595.1 SUWARNI 31-05-2017 210110013 dr amar bachtiar
156 E210200000KU17101767 560442.1 NAZWIR 31-05-2017 210110013 dr amar bachtiar

Tanggal
Transaksi
157 E210200000KU17101768 610876 DARMANTO 31-05-2017 210210001 dr. Istiyarti Tapilatu
158 E210200000KU17101750 610876 DARMANTO 31-05-2017 210210001 dr. Istiyarti Tapilatu
159 E210200000KU17101770 560442 KUSNILAWATI 31-05-2017 210110013 dr amar bachtiar
160 E210200000KU17101772 591233 MOCHAMAD ZUHRI, BA 31-05-2017 210210001 dr. Istiyarti Tapilatu
161 E210200000KU17101773 591233.102 MUHAMMAD DARIS MULKIY 31-05-2017 210210001 dr. Istiyarti Tapilatu
162 E210200000KU17101774 570124 HERRY SUARDI 31-05-2017 210110013 dr amar bachtiar
163 E210200000KU17101775 600846 BERNAD PASARIBU 31-05-2017 210210001 dr. Istiyarti Tapilatu
Tanggal
Transaksi
164 E210200000KU17101765 431234 UNUNG MASDUKI 31-05-2017 210210001 dr. Istiyarti Tapilatu
165 E210200000KU17101776 530417 PETRUS SISWANTO 31-05-2017 210210001 dr. Istiyarti Tapilatu
166 E210200000KU17101766 431234.1 ONOH NONOH 31-05-2017 210210001 dr. Istiyarti Tapilatu
167 E210200000KU17101778 450389.1 KASRI 31-05-2017 210110013 dr amar bachtiar
168 E210200000KU17101771 390027.1 REDJO 31-05-2017 210210001 dr. Istiyarti Tapilatu
169 E210200000KU17101783 510165 RACHMAD 31-05-2017 210110013 dr amar bachtiar

Tanggal
Transaksi
170 E210200000KU17101755 520143 SAEPUDIN 31-05-2017 210110013 dr amar bachtiar
171 E210200000KU17101788 520098 ALI CECILIA 31-05-2017 210210001 dr. Istiyarti Tapilatu
172 E210200000KU17101785 510165.1 WAGINEM 31-05-2017 210110013 dr amar bachtiar
173 E210200000KU17101790 520671.1 SUPIAH 31-05-2017 210210001 dr. Istiyarti Tapilatu
174 E210200000KU17101792 570124.1 SRI RIYATI 31-05-2017 210210001 dr. Istiyarti Tapilatu
175 E210200000KU17101794 460081 DJAUZI 31-05-2017 210110013 dr amar bachtiar
176 E210200000KU17101795 532357 BAMBANG SUMBARGO 31-05-2017 210210001 dr. Istiyarti Tapilatu
Tanggal
Transaksi
177 E210200000KU17101796 460081 DJAUZI 31-05-2017 210110013 dr amar bachtiar
178 E210200000KU17101797 532357 BAMBANG SUMBARGO 31-05-2017 210210001 dr. Istiyarti Tapilatu
179 E210200000KU17101799 532357.1 SUWARTI 31-05-2017 210210001 dr. Istiyarti Tapilatu
180 E210200000KU17101800 470397 RIZAL SAAT 31-05-2017 210210001 dr. Istiyarti Tapilatu
181 E210200000KU17101801 470397 RIZAL SAAT 31-05-2017 210210001 dr. Istiyarti Tapilatu
182 E210200000KU17101805 580761 AWALUDIN NOOR 31-05-2017 210210001 dr. Istiyarti Tapilatu
Tanggal
Transaksi
183 E210200000KU17101806 500228.1 NANI WINANINGSIH 31-05-2017 210110013 dr amar bachtiar
184 E210200000KU17101784 520098.1 SITI ASIYAH 31-05-2017 210210001 dr. Istiyarti Tapilatu
185 E210200000KU17101798 521490 TRI KURNIANTO 31-05-2017 210210001 dr. Istiyarti Tapilatu
186 E210200000KU17101779 530417.1 ELISABETH CICILIA SAYAN 31-05-2017 210210001 dr. Istiyarti Tapilatu
187 E210200000KU17101808 570970.1 SASMITO 31-05-2017 210110013 dr amar bachtiar
188 E210200000KU17101803 470397.1 SRI MARTINI 31-05-2017 210210001 dr. Istiyarti Tapilatu
Tanggal
Transaksi
189 E210200000KU17101810 601279.1 ICHFA SYAFAWI 31-05-2017 210110013 dr amar bachtiar
190 E210200000KU17101741 510051.1 ARYATI 31-05-2017 210210001 dr. Istiyarti Tapilatu
191 E210200000KU17101813 551530.102 AMALIA HERINAWATI 31-05-2017 210110013 dr amar bachtiar
192 E210200000KU17101777 510051.1 ARYATI 31-05-2017 210210001 dr. Istiyarti Tapilatu
193 E210200000KU17101815 490730 DARYONO KANDARDWIATMA31-05-2017 210110013 dr amar bachtiar
194 E210200000KU17101819 602339.1 PONIYATI 31-05-2017 210210001 dr. Istiyarti Tapilatu
195 E210200000KU17101820 602339.1 PONIYATI 31-05-2017 210210001 dr. Istiyarti Tapilatu

Tanggal
Transaksi
196 E210200000KU17101804 571011 UNTUNG MUHAEMIN 31-05-2017 210210001 dr. Istiyarti Tapilatu
197 E210200000KU17101823 611953 EDDY PAHALA SIHOMBING 31-05-2017 210210001 dr. Istiyarti Tapilatu
198 E210200000KU17101824 480069.1 WARTINI 31-05-2017 210210001 dr. Istiyarti Tapilatu
199 E210200000KU17101814 551530.1 BARO,AH HERYSUSTIKA 31-05-2017 210110013 dr amar bachtiar
200 E210200000KU17101829 530930 TRUMAN S TAMBUNAN 31-05-2017 210110013 dr amar bachtiar

Tanggal
Transaksi
201 E210200000KU17101830 500814 DJAJADI 31-05-2017 210110013 dr amar bachtiar
202 E210200000KU17101831 500814.1 TUTI ELLYANA 31-05-2017 210110013 dr amar bachtiar
203 E210200000KU17101762 460577.1 HJ ROCHAINAH 31-05-2017 210210001 dr. Istiyarti Tapilatu
204 E210200000KU17101757 460577 ABDUL RACHIM 31-05-2017 210210001 dr. Istiyarti Tapilatu
205 E210200000KU17101756 570941.1 ROHATI 31-05-2017 210210001 dr. Istiyarti Tapilatu

Tanggal
Transaksi
206 E210200000KU17101719 591487 ZULHELMA BUSRI 31-05-2017 210210001 dr. Istiyarti Tapilatu
207 E210200000KU17101715 531547 BARYONO 31-05-2017 210110013 dr amar bachtiar
208 E210200000KU17101832 340553.1 DJUHANA 31-05-2017 210110013 dr amar bachtiar
209 E210200000KU17101828 320145.1 RAMIANTA BORU HALOHO 31-05-2017 210210001 dr. Istiyarti Tapilatu
210 E210200000KU17101826 611953 EDDY PAHALA SIHOMBING 31-05-2017 210210001 dr. Istiyarti Tapilatu
Penjualan PENSIUN TELKOM
de 29 - 31 Mei 2017
Jl. Percetakan Negara No.17A Jakarta Pusat
TOSHIBA:
Jumlah Harga HNA Diskon Total 1 = Kepesertaan
Nama Obat Margin (%)
(%) Pembayaran Ket. No 2 = Non DOT
3 = Obat Moll
NovoMix 30 FlexPen inj. 100 IU/ml 3 151278.53 0 18.5 537795.19 1
Sub Total 537795.19 1
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63 2
Codeine tab. 10 mg (Kim) 20 550 0 18.5 13035 2
Sub Total 64493.63 2
Diaformin XR tab. 500 mg 56 900 0 18.5 59724 3
Pionix tab. 15 mg 28 4875.45 0 18.5 161767.58 3
Sub Total 221491.58 3
Cameloc tab. 15 mg 15 920 0 18.5 16353 4
Osteomax kaps. 10 6400 0 18.5 75840 4
Sub Total 92193 4
Opineuron kapl. 15 550 0 18.5 9776.25 5
Acilaz kaps. 30 mg 10 5200 0 18.5 61620 5
Neurosanbe FC tab 15 800 0 18.5 14220 5
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 6
Clopidogrel tab. 75 mg (Hex) 28 3700 0 18.5 122766.01 6
Sub Total 139090.57 6
Cameloc tab. 7,5 mg 15 580 0 18.5 10309.5 7
Epsonal tab. 50 mg 8 2172.5 0 18.5 20595.3 7
Kalmeco tab. 500 mcg 15 1700 0 18.5 30217.5 7
Sub Total 61122.3 7
Litorcom tab. 20 mg 14 3622.67 0 18.5 60100.04 8
Kalmeco tab. 500 mcg 28 1700 0 18.5 56406 8
Sub Total 116506.04 8
TOSHIBA:
3 = Obat Moll
Kalmeco tab. 500 mcg 20 1700 0 18.5 40290 9
Meloxicam tab. 7,5 mg (Kim) 20 361.31 0 18.5 8562.93 9
Emibion kaps. 20 720 0 18.5 17064 9
Diaversa tab. 2 mg 28 992 0 18.5 32914.56 10
Glucophage tab. 500 mg 56 811.69 0 18.5 53863.88 10
Sub Total 86778.44 10
Cameloc tab. 15 mg 10 920 0 18.5 10902 11
OA Forte kapl. 10 3311 0 18.5 39235.35 11
Neuraxon 5000 tab. 10 1237.5 0 18.5 14664.38 11
Sub Total 64801.73 11
Kalnex tab. 500 mg 10 2400 0 18.5 28440 12
Emibion kaps. 15 720 0 18.5 12798 12
Sub Total 41238 12
Lifezar tab. 50 mg 20 4192.5 0 18.5 99362.25 13
Dilavask tab. 5 mg 20 492 0 18.5 11660.4 13
Sub Total 111022.65 13
Plantacid Forte tab. 15 663.64 0 18.5 11796.14 14
Acilaz kaps. 30 mg 10 5200 0 18.5 61620 14
Domperidone tab. 10 mg (Indo) 10 256.59 0 18.5 3040.63 14
Sub Total 76456.77 14
Carboglycerine tetes telinga 10% botol 5 ml 6 1500 0 8 9720 15
Sub Total 9720 15
Herbesser CD kaps. 200 mg 56 9330.75 0 18.5 619188.57 16
Clonidine HCl tab. 0,15 mg (Indo) 42 186.18 0 18.5 9266.04 16
Betaone tab. 2,5 mg 28 1404 0 18.5 46584.72 16
Alganax tab. 0,25 mg 28 848 0 18.5 28136.64 16
Lansoprazole kaps. 30 mg (Indo) 56 736.35 0 18.5 48864.44 16
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18 16
Sub Total 780782.59 16
TOSHIBA:
3 = Obat Moll
Canderin tab. 8 mg 28 4800 0 18.5 159264 17
Concor tab. 2,5 mg 28 2916.54 0 18.5 96770.8 17
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18 17
Alganax tab. 0,25 mg 28 848 0 18.5 28136.64 17
Tramifen kapl 56 4200 0 18.5 278712 17
Sub Total 640490.05 17
Cefat kaps. 500 mg 8 4342.5 0 18.5 41166.9 18
Ambroxol tab. 30 mg (Indo) 10 124.09 0 18.5 1470.45 18
Methyl prednisolone tab. 4 mg (Dex) 4 300.75 0 18.5 1425.56 18
Sub Total 49276.91 18
Prednisone tab. 5 mg (Kim) 20 135 0 8 2916 19
Rydian tab. 10 mg 6 1900 0 18.5 13509 19
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63 19
Sub Total 82389.08 19
Prednicort tab. 4 mg 10 1500 0 18.5 17775 20
Rhinos SR kaps. 10 3600 0 18.5 42660 20
Sub Total 60435 20
Betaone tab. 2,5 mg 20 1404 0 18.5 33274.8 21
Canderin tab. 8 mg 10 4800 0 18.5 56880 21
Astika tab. 100 mg. 20 374 0 18.5 8863.8 21
Esvat tab. 20 mg 20 866.25 0 18.5 20530.13 21
Sub Total 207238.73 21
Lodem tab. 30 mg 20 1282.5 0 18.5 30395.25 22
Dilavask tab. 5 mg 20 492 0 18.5 11660.4 22
Meloxicam tab. 15 mg (Kim) 20 626.12 0 18.5 14839.14 22
TOSHIBA:
3 = Obat Moll
Nucral susp. 500 mg/5 ml @ 200 ml 1 41687.5 0 18.5 49399.69 22
Sub Total 106294.48 22
Hemapo prefilled syringe 3000 IU 4 185250 0 18.5 878085 23
Sub Total 878085 23
Chlorpromazine tab. sal 100 mg (Kim) 28 208.93 0 18.5 6932.23 24
Risperidone tab. 2 mg (Dex) 28 2055.3 0 18.5 68194.85 24
Sub Total 75127.09 24
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63 25
Sanmol tab. 500 mg 10 250 0 18.5 2962.5 25
Codeine tab. 10 mg (Kim) 15 550 0 18.5 9776.25 25
Rydian tab. 10 mg 5 1900 0 18.5 11257.5 25
Sub Total 78818.24 25
Tequinol tab. 500 mg 10 5040 0 18.5 59724 26
Rhinos SR kaps. 10 3600 0 18.5 42660 26
Sanmol tab. 500 mg 10 250 0 18.5 2962.5 26
Sub Total 105346.5 26
Urotractin kaps. 400 mg 15 1652 0 18.5 29364.3 27
Flamar tab. 50 mg 10 1320 0 18.5 15642 27
Simvastatin tab. 10 mg (Kim) 14 221.52 0 18.5 3675.06 28
Febogrel tab. 75 mg 14 5280 0 18.5 87595.2 28
Astika tab. 100 mg. 14 374 0 18.5 6204.66 28
Sub Total 97474.92 28
Dilavask tab. 5 mg 14 492 0 18.5 8162.28 29
Sub Total 21197.28 29
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63 30
Ponstelax kapl. 500 mg 10 350.35 0 18.5 4151.65 30
TOSHIBA:
3 = Obat Moll
Sub Total 55610.27 30
Tequinol tab. 500 mg 10 5040 0 18.5 59724 31
Extropect syr. 30 mg/5 ml, btl. 60 ml 1 14400 0 18.5 17064 31
Fluzep kapl. 10 562.5 0 18.5 6665.63 31
Sub Total 83453.63 31
Omeprazole kaps. 20 mg (Indo) 40 333.77 0 18.5 15820.55 32
Sub Total 15820.55 32
Clamixin kapl. 10 5500 0 18.5 65175 33
Rhinofed tab. 10 1155 0 18.5 13686.75 33
Sanmol tab. 500 mg 10 250 0 18.5 2962.5 33
Sub Total 81824.25 33
Depakote tab. 250 mg 28 8011.5 0 18.5 265821.57 34
Sub Total 340476.58 34
Dilavask tab. 5 mg 20 492 0 18.5 11660.4 35
Diaversa tab. 3 mg 20 1352 0 18.5 32042.4 35
Glucophage XR tab. 500 mg 40 1620.5 0 18.5 76811.89 35
Esvat tab. 10 mg 20 472.5 0 18.5 11198.25 35
Sub Total 131712.94 35
Dilavask tab. 5 mg 20 492 0 18.5 11660.4 36
Glucovance 500/2,5 tab 40 2705.43 0 18.5 128237.43 36
Sub Total 139897.83 36
Primadex kapl. 6 279 0 18.5 1983.69 37
Diagit tab. 10 687.5 0 18.5 8146.88 37
Gitas Plus tab. 6 1750 0 18.5 12442.5 37
Sub Total 22573.07 37
Opineuron kapl. 20 550 0 18.5 13035 38
Voltadex emulgel 1%/20 gr 1 17550 0 18.5 20796.75 38
TOSHIBA:
3 = Obat Moll
Sub Total 51283.34 38
Primadex kapl. 10 279 0 18.5 3306.15 39
Gitas Plus tab. 10 1750 0 18.5 20737.5 39
Acilaz kaps. 30 mg 10 5200 0 18.5 61620 39
Diagit tab. 10 687.5 0 18.5 8146.88 39
Sub Total 93810.53 39
Opimox kaps. 500 mg 15 1200 0 18.5 21330 40
Sanmol tab. 500 mg 10 250 0 18.5 2962.5 40
Metrix tab. 3 mg 28 2534.85 0 18.5 84106.32 41
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 41
Interhistin tab. 50 mg 15 429 0 18.5 7625.48 41
Sub Total 188852.18 41
Valdix tab. 80 mg 28 3025 0 18.5 100369.5 42
Dilavask tab. 10 mg 28 1050 0 18.5 34839 42
Litorcom tab. 20 mg 28 3622.67 0 18.5 120200.08 42
Sub Total 255408.58 42
OA Forte kapl. 14 3311 0 18.5 54929.49 43
Sub Total 54929.49 43
Flutias i.h 25/125 mcg/puff, 120 semprot 1 82500 0 18.5 97762.5 44
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 45
Opineuron kapl. 10 550 0 18.5 6517.5 45
Sub Total 43638.81 45
Canderin tab. 8 mg 20 4800 0 18.5 113760 46
Gerdilium FC tab. 10 mg 20 1400 0 18.5 33180 46
Sub Total 146940 46
Irbesartan tab. 300 mg. (Indo) 20 2418.5 0 18.5 57318.45 47
TOSHIBA:
3 = Obat Moll
Dilavask tab. 10 mg 20 1050 0 18.5 24885 47
Evothyl kaps. 300 mg 20 4950 0 18.5 117315 47
Alluric tab. 300 mg. 20 1755.45 0 18.5 41604.27 47
Neurosanbe Plus kapl. 15 760 0 18.5 13509 47
Sub Total 254631.72 47
Eyefresh ED lar. 2% btl 5 ml 1 25410 0 18.5 30110.85 48
Sub Total 30110.85 48
Albiotin kaps. 300 mg 10 1300 0 18.5 15405 49
Dextafen tab. 10 770 0 18.5 9124.5 49
Betason N krim 5 gr 1 9945 0 18.5 11784.83 49
Acid Salicyl 2 90 0 8 194.4 49
Kloderma krim 5 gr 1 13875 0 18.5 16441.88 49
Canderin tab. 8 mg 10 4800 0 18.5 56880 49
Sub Total 109830.6 49
Febogrel tab. 75 mg 14 5280 0 18.5 87595.2 50
Digoxin tab. 0,25 mg 14 168.83 0 18.5 2800.89 50
Canderin tab. 8 mg 14 4800 0 18.5 79632 50
Reucid tab. 100 mg 14 600 0 18.5 9954 50
Evothyl kaps. 300 mg 14 4950 0 18.5 82120.5 50
Sub Total 262102.59 50
Salbutamol sulfate tab. 2 mg (Kim) 20 76.39 0 18.5 1810.46 51
Suprasma i.h 100 mcg/puff, 200 semprot 1 63000 0 18.5 74655 51
Sub Total 76465.46 51
Canderin tab. 8 mg 14 4800 0 18.5 79632 52
Sub Total 79632 52
Reucid tab. 300 mg 28 1000 0 18.5 33180 53
TOSHIBA:
3 = Obat Moll
Rydian tab. 10 mg 15 1900 0 18.5 33772.5 53
Flutias i.h 25/125 mcg/puff, 120 semprot 1 82500 0 18.5 97762.5 53
Sub Total 261111.59 53
Canderin tab. 8 mg 28 4800 0 18.5 159264 54
Metformin tab. 500 mg (Dex) 84 156.75 0 18.5 15602.9 54
Sub Total 174866.9 54
Canderin tab. 8 mg 20 4800 0 18.5 113760 55
Betaone tab. 5 mg 20 2400 0 18.5 56880 55
Nitrokaf Retard kaps. SR 5 mg 40 2645.31 0 18.5 125387.72 55
Allopurinol tab. 100 mg (Kim) 20 144.3 0 18.5 3419.91 55
Sub Total 306877.58 55
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 56
Tenapril tab. 2,5 mg 28 1575 0 18.5 52258.5 56
Neuraxon 5000 tab. 14 1237.5 0 18.5 20530.13 56
Sub Total 89113.19 56
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 57
Tenapril tab. 5 mg 28 2250 0 18.5 74655 57
Cefat kaps. 500 mg 8 4342.5 0 18.5 41166.9 57
Sub Total 146651.91 57
Thrombo Aspilets tab. 80 mg 20 448 0 18.5 10617.6 58
Kalmeco tab. 500 mcg 20 1700 0 18.5 40290 58
Sub Total 477525.08 58
TOSHIBA:
3 = Obat Moll
Acilaz kaps. 30 mg 15 5200 0 18.5 92430 60
Domperidone tab. 10 mg (Indo) 15 256.59 0 18.5 4560.95 60
Opineuron kapl. 10 550 0 18.5 6517.5 60
Sub Total 103508.45 60
Lodem tab. 30 mg 28 1282.5 0 18.5 42553.35 61
Metrix tab. 2 mg 14 1890 0 18.5 31355.1 61
Atorvastatin tab. 20 mg (Hex) 14 4000 0 8 60480 61
Sub Total 164250.45 61
Clindamycin kaps. 300 mg (Dex) 10 1155.42 0 18.5 13691.73 62
Ponstelax kapl. 500 mg 10 350.35 0 18.5 4151.65 62
Sub Total 17843.37 62
Opimox kaps. 500 mg 12 1200 0 18.5 17064 63
Vastigo tab. 6 mg 10 495 0 18.5 5865.75 63
Sub Total 58331.31 63
Dilavask tab. 5 mg 20 492 0 18.5 11660.4 64
Febogrel tab. 75 mg 20 5280 0 18.5 125136 64
Esvat tab. 10 mg 20 472.5 0 18.5 11198.25 64
Sub Total 147994.65 64
Osteomax kaps. 10 6400 0 18.5 75840 65
Sub Total 96636.75 65
Albiotin kaps. 300 mg 15 1300 0 18.5 23107.5 66
Sanmol tab. 500 mg 10 250 0 18.5 2962.5 66
Hexadol Mint sol. 100 ml 1 15000 0 18.5 17775 66
Sub Total 43845 66
TOSHIBA:
3 = Obat Moll
Letonal tab. 25 mg 14 900 0 18.5 14931 67
Dilavask tab. 5 mg 14 492 0 18.5 8162.28 67
Metrix tab. 1 mg 14 1094.85 0 18.5 18163.56 67
Sub Total 125003.17 67
Evothyl kaps. 300 mg 14 4950 0 18.5 82120.5 68
Sub Total 85795.56 68
Fluimucil kaps. 200 mg 10 4095 0 18.5 48525.75 69
Sub Total 48525.75 69
Anadium kapl. 10 4248 0 18.5 50338.8 70
Cameloc tab. 7,5 mg 15 580 0 18.5 10309.5 70
Valisanbe tab. 5 mg 10 200 0 18.5 2370 70
Sub Total 65412.24 70
Sub Total 30110.85 71
Sanmol tab. 500 mg 10 250 0 18.5 2962.5 72
Sub Total 2962.5 72
Tequinol tab. 500 mg 6 5040 0 18.5 35834.4 73
Urinter kaps. 400 mg 10 2400 0 18.5 28440 73
Gitas Plus tab. 10 1750 0 18.5 20737.5 73
Sub Total 93737.69 73
Canderin tab. 8 mg 14 4800 0 18.5 79632 74
Cedocard tab. sublingual 5 mg 42 749.17 0 18.5 37286.03 74
TOSHIBA:
3 = Obat Moll
Cefixime tab. 100 mg (Kim) 20 1306.15 0 18.5 30955.65 74
Sub Total 257782.43 74
Flamar tab. 50 mg 15 1320 0 18.5 23463 75
OA Forte kapl. 10 3311 0 18.5 39235.35 75
Metrix tab. 3 mg 14 2534.85 0 18.5 42053.16 76
Eclid tab. 50 mg 14 1200 0 18.5 19908 76
Sub Total 70837.19 76
Lifezar tab. 50 mg 20 4192.5 0 18.5 99362.25 77
Betaserc tab. 24 mg 30 7476.88 0 18.5 265802.91 77
Sub Total 367790.2 77
Rydian tab. 10 mg 10 1900 0 18.5 22515 78
Sanbe Tears lar. 2 % btl 5 ml 1 13895 0 18.5 16465.58 78
Sub Total 46400.15 78
Sub Total 48525.75 79
Evothyl kaps. 300 mg 20 4950 0 18.5 117315 80
Reucid tab. 300 mg 20 1000 0 18.5 23700 80
Sub Total 141015 80
Dilavask tab. 5 mg 14 492 0 18.5 8162.28 81
Sub Total 372967.95 81
Hemapo prefilled syringe 3000 IU 2 185250 0 18.5 439042.5 82
TOSHIBA:
3 = Obat Moll
Flamar tab. 50 mg 10 1320 0 18.5 15642 82
Sub Total 454684.5 82
Cameloc tab. 7,5 mg 20 580 0 18.5 13746 83
Sub Total 34542.75 83
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63 84
Cameloc tab. 7,5 mg 20 580 0 18.5 13746 84
Sub Total 79710.08 84
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 85
Magtral Syr. Forte 1 13000 0 18.5 15405 85
Sub Total 31729.56 85
Metrix tab. 1 mg 28 1094.85 0 18.5 36327.12 86
Sub Total 36327.12 86
Levemir Flexpen inj 100 IU/ml, flexpen 3 ml 1 170186.54 0 18.5 201671.05 87
Sub Total 560201.18 87
Primadex kapl. 10 279 0 18.5 3306.15 88
Gitas Plus tab. 8 1750 0 18.5 16590 88
Diagit tab. 8 687.5 0 18.5 6517.5 88
Acilaz kaps. 30 mg 10 5200 0 18.5 61620 88
Sub Total 88033.65 88
Opineuron kapl. 20 550 0 18.5 13035 89
Sub Total 33831.75 89
Rydian tab. 10 mg 5 1900 0 18.5 11257.5 90
TOSHIBA:
3 = Obat Moll
Tequinol tab. 500 mg 10 5040 0 18.5 59724 90
Sub Total 83668.94 90
Sub Total 17775 91
Lodem tab. 30 mg 40 1282.5 0 18.5 60790.5 92
Metrix tab. 2 mg 20 1890 0 18.5 44793 92
Evothyl kaps. 300 mg 20 4950 0 18.5 117315 92
Ciprofloxacin tab. 500 mg (Hex) 8 330 0 8 2851.2 92
Gentamicin 1% Salep Kulit 5 gram 1 1773 0 8 1914.84 92
Fungasol krim 2%, 10 gr 1 14950 0 18.5 17715.75 92
Sub Total 288040.29 92
Clamixin kapl. 10 5500 0 18.5 65175 93
Rhinofed tab. 10 1155 0 18.5 13686.75 93
Sanmol tab. 500 mg 10 250 0 18.5 2962.5 93
Sub Total 81824.25 93
Euthyrox tab. 100 mcg 56 1524.6 0 18.5 101172.46 94
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18 94
Reucid tab. 300 mg 28 1000 0 18.5 33180 94
Sub Total 163094.63 94
Gitas Plus tab. 10 1750 0 18.5 20737.5 95
Sub Total 103317.19 95
Anadium kapl. 10 4248 0 18.5 50338.8 96
Dilavask tab. 10 mg 14 1050 0 18.5 17419.5 97
Canderin tab. 8 mg 14 4800 0 18.5 79632 97
TOSHIBA:
3 = Obat Moll
Fungasol krim 2%, 10 gr 1 14950 0 18.5 17715.75 97
Sub Total 144629.25 97
Metrix tab. 2 mg 14 1890 0 18.5 31355.1 98
Pionix tab. 15 mg 14 4875.45 0 18.5 80883.79 98
Dilavask tab. 5 mg 14 492 0 18.5 8162.28 98
Ciprofloxacin tab. 500 mg (Hex) 6 330 0 8 2138.4 98
Urinter kaps. 400 mg 6 2400 0 18.5 17064 98
Gitas Plus tab. 6 1750 0 18.5 12442.5 98
Sub Total 152046.07 98
V-Bloc tab. 6,25 mg 14 1750 0 18.5 29032.5 99
Tenapril tab. 5 mg 14 2250 0 18.5 37327.5 99
Letonal tab. 25 mg 14 900 0 18.5 14931 99
Esvat tab. 20 mg 14 866.25 0 18.5 14371.09 99
Reucid tab. 100 mg 14 600 0 18.5 9954 99
Sub Total 113048.41 99
Esvat tab. 10 mg 14 472.5 0 18.5 7838.78 100
Sub Total 7838.78 100
Tramifen kapl 10 4200 0 18.5 49770 101
Thombophob gel. 20 gr 2 44887.5 0 18.5 106383.38 101
Sub Total 156153.38 101
Canderin tab. 8 mg 20 4800 0 18.5 113760 102
Esvat tab. 20 mg 20 866.25 0 18.5 20530.13 102
Sub Total 514150.25 102
Neuraxon 5000 tab. 10 1237.5 0 18.5 14664.38 103
TOSHIBA:
3 = Obat Moll
Levofloxacin tab. 500 mg (Dex) 5 1048.8 0 8 5663.52 103
Sub Total 66558.52 103
Tequinol tab. 500 mg 10 5040 0 18.5 59724 104
Fluzep kapl. 10 562.5 0 18.5 6665.63 104
Sub Total 67860.08 104
Betaone tab. 2,5 mg 28 1404 0 18.5 46584.72 105
Natrium Bikarbonat tab. 500 mg 84 17.37 0 8 1575.81 105
Litorcom tab. 10 mg 28 3622.67 0 18.5 120200.08 105
Sub Total 209819.02 105
Dilavask tab. 10 mg 14 1050 0 18.5 17419.5 106
Phenytoin kaps. 100 mg 14 550 0 8 8316 106
Sub Total 67261.46 106
Dilavask tab. 10 mg 20 1050 0 18.5 24885 107
Fluzep kapl. 10 562.5 0 18.5 6665.63 107
Sub Total 147563.78 107
Lodem tab. 30 mg 60 1282.5 0 18.5 91185.75 108
Esvat tab. 10 mg 20 472.5 0 18.5 11198.25 108
Sub Total 102384 108
Sifrol tab. 0,125 mg 42 5471.62 0 18.5 272322.53 109
Leparson kaps. 42 2466.75 0 18.5 122770.15 109
Sub Total 395092.67 109
Rydian tab. 10 mg 8 1900 0 18.5 18012 110
Epexol syr. 15 mg/5 ml, btl. 120 ml 1 10506 0 18.5 12449.61 110
TOSHIBA:
3 = Obat Moll
Dextafen tab. 10 770 0 18.5 9124.5 110
Neurosanbe Plus kapl. 10 760 0 18.5 9006 110
Acid Salicyl 30 90 0 8 2916 110
Inerson krim 0,25 %, tube 15 gr 1 25000 0 18.5 29625 110
Sub Total 81133.11 110
Esvat tab. 20 mg 14 866.25 0 18.5 14371.09 111
Betaone tab. 2,5 mg 28 1404 0 18.5 46584.72 111
Dilavask tab. 10 mg 28 1050 0 18.5 34839 111
Sub Total 95794.81 111
Cefat kaps. 500 mg 8 4342.5 0 18.5 41166.9 112
Sanmol tab. 500 mg 8 250 0 18.5 2370 112
Sub Total 45451.74 112
Dilavask tab. 10 mg 20 1050 0 18.5 24885 113
Zypraz tab. 0,5 mg 20 1375.45 0 18.5 32598.27 113
Vastigo tab. 6 mg 20 495 0 18.5 11731.5 113
Sub Total 115053.8 113
Sub Total 16465.58 114
Rydian tab. 10 mg 15 1900 0 18.5 33772.5 115
Osfit tab. 500 mg 15 1125 0 18.5 19996.88 115
Sub Total 53769.38 115
Opineuron kapl. 15 550 0 18.5 9776.25 116
Sub Total 9776.25 116
Dilavask tab. 10 mg 28 1050 0 18.5 34839 117
Clonidine HCl tab. 0,15 mg (Indo) 28 186.18 0 18.5 6177.36 117
Reucid tab. 300 mg 28 1000 0 18.5 33180 117
TOSHIBA:
3 = Obat Moll
Metrix tab. 2 mg 28 1890 0 18.5 62710.2 117
Aminefron tab. 630 mg 28 4550 0 18.5 150969 117
Sub Total 302740.2 117
Lifezar tab. 50 mg 28 4192.5 0 18.5 139107.15 118
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 118
Reucid tab. 100 mg 28 600 0 18.5 19908 118
Sub Total 190204.35 118
Diltiazem tab. 30 mg (Kim) 14 139.7 0 18.5 2317.62 119
Captopril tab. 25 mg (Hex) 14 106.36 0 18.5 1764.57 119
Symbicort i.h 160/4,5 mcg/puff 60 semprot 1 238255.2 0 18.5 282332.41 119
Sub Total 286414.61 119
Amlodipine tab. 5 mg (Kim) 28 392.73 0 18.5 13030.78 120
Alpentin kaps. 100 mg 20 2380 0 18.5 56406 120
Sub Total 69436.78 120
Episan susp. 500 mg/5 ml @ 100 ml 1 24310 0 18.5 28807.35 121
Gitas Plus tab. 10 1750 0 18.5 20737.5 121
Sub Total 49544.85 121
Cameloc tab. 15 mg 15 920 0 18.5 16353 122
Sub Total 16353 122
Nitrokaf Retard kaps. SR 2,5 mg 28 1818.36 0 18.5 60333.27 123
Betaone tab. 5 mg 28 2400 0 18.5 79632 123
Diaversa tab. 1 mg 28 585 0 18.5 19410.3 123
Santesar tab. 50 mg 28 3773 0 18.5 125188.14 123
Esvat tab. 10 mg 28 472.5 0 18.5 15677.55 123
Sub Total 315105.9 123
Letonal tab. 25 mg 20 900 0 18.5 21330 124
TOSHIBA:
3 = Obat Moll
Betaone tab. 2,5 mg 20 1404 0 18.5 33274.8 124
Sub Total 239312.41 124
Diaversa tab. 1 mg 28 585 0 18.5 19410.3 125
Sub Total 19410.3 125
Febogrel tab. 75 mg 28 5280 0 18.5 175190.4 126
Nitrokaf Retard kaps. SR 2,5 mg 28 1818.36 0 18.5 60333.27 126
Angioten tab. 50 mg 28 4080 0 18.5 135374.4 126
Sub Total 385762.71 126
Dilavask tab. 10 mg 28 1050 0 18.5 34839 127
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18 127
Metrix tab. 2 mg 28 1890 0 18.5 62710.2 127
Sub Total 181010.73 127
Ursolic kaps. 250 mg 28 4611 0 18.5 152992.98 128
Harnal D tab. 0,2 mg 14 10874.05 0 18.5 180400.49 128
Sub Total 333393.47 128
Metrix tab. 2 mg 28 1890 0 18.5 62710.2 129
Clamixin kapl. 10 5500 0 18.5 65175 129
Rhinofed tab. 10 1155 0 18.5 13686.75 129
Sanmol tab. 500 mg 10 250 0 18.5 2962.5 129
Sub Total 204258.45 129
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 130
Esvat tab. 10 mg 28 472.5 0 18.5 15677.55 130
Xytrol ED tts. mata , btl 5 ml 1 23980 0 18.5 28416.3 130
Sub Total 60418.41 130
Canderin tab. 8 mg 28 4800 0 18.5 159264 131
TOSHIBA:
3 = Obat Moll
Dilavask tab. 10 mg 28 1050 0 18.5 34839 131
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18 131
Sub Total 222845.18 131
Metrix tab. 2 mg 28 1890 0 18.5 62710.2 132
Canderin tab. 8 mg 28 4800 0 18.5 159264 132
Sub Total 251836.2 132
Dilavask tab. 10 mg 28 1050 0 18.5 34839 133
Canderin tab. 16 mg 28 6800 0 18.5 225624 133
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18 133
Sub Total 289205.18 133
Angioten tab. 50 mg 28 4080 0 18.5 135374.4 134
Dilavask tab. 10 mg 28 1050 0 18.5 34839 134
Mertigo SR tab. 24 mg 14 3461.25 0 18.5 57422.14 134
Sub Total 257008.42 134
Tramifen kapl 10 4200 0 18.5 49770 135
Kalmeco tab. 500 mcg 10 1700 0 18.5 20145 135
Neuraxon 5000 tab. 10 1237.5 0 18.5 14664.38 135
Sub Total 84579.38 135
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 136
Diaversa tab. 1 mg 28 585 0 18.5 19410.3 136
Concor tab. 5 mg 14 4223.34 0 18.5 70065.21 136
Sub Total 105800.07 136
Alganax tab. 0,25 mg 10 848 0 18.5 10048.8 137
Sub Total 10048.8 137
Imdur tab. 60 mg 28 5902 0 8 178476.48 138
TOSHIBA:
3 = Obat Moll
Sub Total 716271.67 138
Rydian tab. 10 mg 10 1900 0 18.5 22515 139
Sub Total 22515 139
Opineuron kapl. 10 550 0 18.5 6517.5 140
Diclofenac Potassium tab. 50 mg (Hex) 15 410 0 18.5 7287.75 141
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 141
Litorcom tab. 20 mg 14 3622.67 0 18.5 60100.04 141
Sub Total 154205.55 141
Sub Total 537795.19 142
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 143
Betaone tab. 2,5 mg 28 1404 0 18.5 46584.72 143
Esvat tab. 10 mg 28 472.5 0 18.5 15677.55 143
Sub Total 120045.24 143
Evothyl kaps. 300 mg 28 4950 0 18.5 164241 144
Reucid tab. 300 mg 28 1000 0 18.5 33180 144
Inerson krim 0,25 %, tube 15 gr 1 25000 0 18.5 29625 144
Episan susp. 500 mg/5 ml @ 100 ml 1 24310 0 18.5 28807.35 144
Sub Total 255853.35 144
Betaone tab. 5 mg 20 2400 0 18.5 56880 145
Canderin tab. 16 mg 10 6800 0 18.5 80580 145
Febogrel tab. 75 mg 20 5280 0 18.5 125136 145
Sub Total 292706.85 145
Tramifen kapl 10 4200 0 18.5 49770 146
TOSHIBA:
3 = Obat Moll
Neuraxon 5000 tab. 10 1237.5 0 18.5 14664.38 146
Sub Total 103254.98 146
Betaone tab. 2,5 mg 14 1404 0 18.5 23292.36 147
Dilavask tab. 5 mg 14 492 0 18.5 8162.28 147
Trizedon MR tab. 35 mg 14 2610.39 0 18.5 43306.34 147
Imdur tab. 60 mg 14 5902 0 8 89238.24 147
Sub Total 343264.28 147
Betaserc tab. 24 mg 15 7476.88 0 18.5 132901.45 148
Paracetamol tab. 500 mg (Kim) 14 88.3 0 18.5 1464.82 148
Ergotamine Coffeine tab. (Kim) 7 175.75 0 18.5 1457.85 148
Alganax tab. 0,25 mg 7 848 0 18.5 7034.16 148
Sub Total 142858.28 148
Ketricin salep in oral base 5 gr 1 26800 0 18.5 31758 149
Sub Total 31758 149
Tequinol tab. 500 mg 10 5040 0 18.5 59724 150
Sanmol tab. 500 mg 10 250 0 18.5 2962.5 150
Rydian tab. 10 mg 6 1900 0 18.5 13509 150
Suprasma i.h 100 mcg/puff, 200 semprot 1 63000 0 18.5 74655 150
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 151
Betaone tab. 5 mg 28 2400 0 18.5 79632 151
Lodem tab. 30 mg 28 1282.5 0 18.5 42553.35 151
Metrix tab. 3 mg 28 2534.85 0 18.5 84106.32 151
TOSHIBA:
3 = Obat Moll
Sub Total 248178.9 151
Vastigo tab. 6 mg 56 495 0 18.5 32848.2 152
Lodem tab. 30 mg 84 1282.5 0 18.5 127660.05 152
Sub Total 303617.02 152
Dilavask tab. 10 mg 14 1050 0 18.5 17419.5 153
Lodem tab. 30 mg 42 1282.5 0 18.5 63830.03 153
Reucid tab. 100 mg 28 600 0 18.5 19908 153
Evothyl kaps. 300 mg 28 4950 0 18.5 164241 153
Sub Total 314207.06 153
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 154
Betaone tab. 5 mg 28 2400 0 18.5 79632 154
Metrix tab. 4 mg 28 2939.85 0 18.5 97544.22 154
Sub Total 253224.78 154
Sanmol tab. 500 mg 10 250 0 18.5 2962.5 155
Rydian tab. 10 mg 5 1900 0 18.5 11257.5 155
Tequinol tab. 500 mg 10 5040 0 18.5 59724 155
Sub Total 85620.8 155
Digoxin tab. 0,25 mg 28 168.83 0 18.5 5601.78 156
Betaone tab. 5 mg 28 2400 0 18.5 79632 156
Tenapril tab. 10 mg 28 3000 0 18.5 99540 156
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18 156
TOSHIBA:
3 = Obat Moll
Zypraz tab. 0,5 mg 28 1375.45 0 18.5 45637.58 156
Mertigo SR tab. 24 mg 20 3461.25 0 18.5 82031.63 156
Sub Total 365617.38 156
Sub Total 30110.85 157
Evothyl kaps. 300 mg 28 4950 0 18.5 164241 158
Kalmeco tab. 500 mcg 20 1700 0 18.5 40290 158
Canderin tab. 8 mg 28 4800 0 18.5 159264 159
Hi-Bone tab. 20 2550 0 18.5 60435 159
Esvat tab. 20 mg 10 866.25 0 18.5 10265.06 159
Reucid tab. 300 mg 10 1000 0 18.5 11850 159
Sub Total 241814.06 159
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 160
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63 160
Sub Total 75448.04 160
Clamixin kapl. 12 5500 0 18.5 78210 161
Fluzep kapl. 10 562.5 0 18.5 6665.63 161
Sub Total 86640.17 161
Primadex kapl. 10 279 0 18.5 3306.15 162
Gitas Plus tab. 10 1750 0 18.5 20737.5 162
Acilaz kaps. 30 mg 10 5200 0 18.5 61620 162
Sub Total 93527.74 162
Ursolic kaps. 250 mg 28 4611 0 18.5 152992.98 163
TOSHIBA:
3 = Obat Moll
Cholestat tab. 20 mg 28 3850 0 18.5 127743 163
Sub Total 285523.85 163
Haloperidol tab. 5 mg (Indo) 28 122.17 0 18.5 4053.6 164
Hexymer tab. 2 mg 28 297.5 0 18.5 9871.05 164
Sub Total 13924.65 164
Glucovance 250/1,25 tab. 28 1686.43 0 18.5 55955.88 165
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 165
Sub Total 179817.09 165
Valdix tab. 80 mg 28 3025 0 18.5 100369.5 166
Esvat tab. 10 mg 28 472.5 0 18.5 15677.55 166
Meloxicam tab. 7,5 mg (Kim) 15 361.31 0 18.5 6422.2 166
Sub Total 138934.82 166
Euthyrox tab. 100 mcg 14 1524.6 0 18.5 25293.11 167
Dilavask tab. 5 mg 14 492 0 18.5 8162.28 167
Cardismo tab. 20 mg 14 1973.4 0 18.5 32738.71 167
Sub Total 441032.57 167
Metrix tab. 1 mg 28 1094.85 0 18.5 36327.12 168
Angioten tab. 50 mg 28 4080 0 18.5 135374.4 168
Dilavask tab. 10 mg 28 1050 0 18.5 34839 168
Opineuron kapl. 15 550 0 18.5 9776.25 168
Sub Total 216316.77 168
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18 169
Reucid tab. 300 mg 28 1000 0 18.5 33180 169
TOSHIBA:
3 = Obat Moll
Angioten tab. 50 mg 28 4080 0 18.5 135374.4 169
Sub Total 197296.58 169
Anadium kapl. 14 4248 0 18.5 70474.32 170
Sub Total 111932.73 170
Kalmeco tab. 500 mcg 14 1700 0 18.5 28203 171
Sub Total 34272 171
Esvat tab. 10 mg 28 472.5 0 18.5 15677.55 172
Reucid tab. 300 mg 28 1000 0 18.5 33180 172
Dilavask tab. 10 mg 28 1050 0 18.5 34839 172
Canderin tab. 8 mg 28 4800 0 18.5 159264 172
Sub Total 242960.55 172
Metrix tab. 1 mg 28 1094.85 0 18.5 36327.12 173
Neuraxon 5000 tab. 14 1237.5 0 18.5 20530.13 173
Sub Total 90394.31 173
Cholestat tab. 20 mg 28 3850 0 18.5 127743 174
Amitriptyline tab. salut 25 mg (Indo) 28 155.85 0 18.5 5171.1 175
Vastigo tab. 6 mg 28 495 0 18.5 16424.1 175
Opineuron kapl. 20 550 0 18.5 13035 175
Ranitidine tab. 150 mg (Dex) 40 150 0 18.5 7110 175
Sub Total 82784.29 175
Diaversa tab. 3 mg 28 1352 0 18.5 44859.36 176
TOSHIBA:
3 = Obat Moll
Eclid tab. 50 mg 56 1200 0 18.5 79632 176
Cholestat tab. 10 mg 28 2200 0 18.5 72996 176
Sub Total 227349.36 176
Diltiazem tab. 30 mg (Kim) 28 139.7 0 18.5 4635.25 177
Sub Total 11985.37 177
Levofloxacin tab. 500 mg (Dex) 5 1048.8 0 8 5663.52 178
Opineuron kapl. 10 550 0 18.5 6517.5 178
Sub Total 14386.7 178
Diaversa tab. 2 mg 28 992 0 18.5 32914.56 179
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18 179
Opimox kaps. 500 mg 12 1200 0 18.5 17064 179
Opineuron kapl. 10 550 0 18.5 6517.5 179
Sub Total 151646.69 179
Neuraxon 5000 tab. 10 1237.5 0 18.5 14664.38 180
Sub Total 14664.38 180
Amlodipine tab. 5 mg (Kim) 28 392.73 0 18.5 13030.78 181
Angioten tab. 50 mg 28 4080 0 18.5 135374.4 181
Litorcom tab. 20 mg 28 3622.67 0 18.5 120200.08 181
Kalmeco tab. 500 mcg 56 1700 0 18.5 112812 181
Betaone tab. 2,5 mg 28 1404 0 18.5 46584.72 181
OA Forte kapl. 14 3311 0 18.5 54929.49 181
Sub Total 482931.47 181
Angioten tab. 50 mg 28 4080 0 18.5 135374.4 182
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 182
Dextafen tab. 10 770 0 18.5 9124.5 182
TOSHIBA:
3 = Obat Moll
Sub Total 160823.46 182
Hi-Bone tab. 20 2550 0 18.5 60435 183
Tequinol tab. 500 mg 10 5040 0 18.5 59724 183
Fluzep kapl. 10 562.5 0 18.5 6665.63 183
Sub Total 148181.27 183
Diamicron MR tab. 60 mg 28 4960.12 0 18.5 164576.65 184
Eclid tab. 50 mg 28 1200 0 18.5 39816 184
Pionix tab. 15 mg 28 4875.45 0 18.5 161767.58 184
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18 184
Sub Total 394902.41 184
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 185
Febogrel tab. 75 mg 28 5280 0 18.5 175190.4 185
Esvat tab. 10 mg 28 472.5 0 18.5 15677.55 185
Metrix tab. 2 mg 28 1890 0 18.5 62710.2 185
Sub Total 284767.35 185
Santesar tab. 50 mg 28 3773 0 18.5 125188.14 186
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 186
Thyrozol tab. 10 mg 14 1326.6 0 18.5 22008.29 186
Sub Total 217289.32 186
Harnal Ocas tab. 0,4 mg 14 9927.75 0 18.5 164701.37 187
Sub Total 164701.37 187
OA Forte kapl. 14 3311 0 18.5 54929.49 188
Valdix tab. 160 mg 28 4400 0 18.5 145992 188
Kalmeco tab. 500 mcg 56 1700 0 18.5 112812 188
TOSHIBA:
3 = Obat Moll
Litorcom tab. 10 mg 12 3622.67 0 18.5 51514.32 188
Dilavask tab. 10 mg 28 1050 0 18.5 34839 188
Sub Total 522488.1 188
Primadex kapl. 10 279 0 18.5 3306.15 189
Tequinol tab. 500 mg 10 5040 0 18.5 59724 189
Diagit tab. 10 687.5 0 18.5 8146.88 189
Gitas Plus tab. 10 1750 0 18.5 20737.5 189
Sub Total 107319.53 189
Acilaz kaps. 30 mg 10 5200 0 18.5 61620 190
Flamar tab. 50 mg 10 1320 0 18.5 15642 190
Sub Total 113463.75 190
Acilaz kaps. 30 mg 10 5200 0 18.5 61620 191
Gitas Plus tab. 10 1750 0 18.5 20737.5 191
Sub Total 90221.59 191
Metrix tab. 1 mg 28 1094.85 0 18.5 36327.12 192
Evothyl kaps. 300 mg 28 4950 0 18.5 164241 192
Tenapril tab. 5 mg 28 2250 0 18.5 74655 192
Sub Total 319949.76 192
Dilavask tab. 10 mg 28 1050 0 18.5 34839 193
Diaversa tab. 1 mg 28 585 0 18.5 19410.3 193
Sub Total 54249.3 193
Kalmeco tab. 500 mcg 20 1700 0 18.5 40290 194
Sub Total 40290 194
TOSHIBA:
3 = Obat Moll
Sub Total 10401.93 195
Opixime tab. 100 mg 8 7560 0 18.5 71668.8 196
Flamar emulgel 1% 20 gr 1 11840 0 18.5 14030.4 196
Sub Total 88629.07 196
Esvat tab. 20 mg 14 866.25 0 18.5 14371.09 197
Ursolic kaps. 250 mg 14 4611 0 18.5 76496.49 197
Dilavask tab. 10 mg 14 1050 0 18.5 17419.5 197
Sub Total 118113.33 197
Hemapo prefilled syringe 3000 IU 1 185250 0 18.5 219521.25 198
Valdix tab. 160 mg 7 4400 0 18.5 36498 198
Dilavask tab. 10 mg 7 1050 0 18.5 8709.75 198
Natrium Bikarbonat tab. 500 mg 21 17.37 0 8 393.95 198
Osfit tab. 500 mg 21 1125 0 18.5 27995.63 198
Sub Total 294315.55 198
Glucovance 500/5 tab 20 3285.11 0 18.5 77857.2 199
Sub Total 206616.34 199
Letonal tab. 25 mg 14 900 0 18.5 14931 200
Canderin tab. 16 mg 14 6800 0 18.5 112812 200
TOSHIBA:
3 = Obat Moll
Betaone tab. 2,5 mg 8 1404 0 18.5 13309.92 200
Furosemide tab. 40 mg (Kim) 14 93.43 0 18.5 1549.92 200
Lodem tab. 30 mg 14 1282.5 0 18.5 21276.68 200
Sub Total 254458.59 200
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 201
Fluzep kapl. 10 562.5 0 18.5 6665.63 201
Fungasol krim 2%, 10 gr 1 14950 0 18.5 17715.75 201
Gitas Plus tab. 10 1750 0 18.5 20737.5 201
Sub Total 62913.89 201
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 202
Rhinos SR kaps. 10 3600 0 18.5 42660 202
Prednicort tab. 4 mg 10 1500 0 18.5 17775 202
Sub Total 76759.56 202
Acid Salicyl 30 90 0 8 2916 203
Betamethasone krim 0,1 %, tube 10 gram (Kim) 1 1842 0 8 1989.36 203
Rydian tab. 10 mg 10 1900 0 18.5 22515 203
Sub Total 29335.2 203
Metonate krim 0,05 %, tube 10 gr 1 12750 0 18.5 15108.75 204
Interhistin tab. 50 mg 15 429 0 18.5 7625.48 204
Acid Salicyl 40 90 0 8 3888 204
Fungasol krim 2%, 10 gr 1 14950 0 18.5 17715.75 204
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63 204
Sub Total 95796.6 204
Diaversa tab. 3 mg 28 1352 0 18.5 44859.36 205
Esvat tab. 10 mg 28 472.5 0 18.5 15677.55 205
TOSHIBA:
3 = Obat Moll
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 205
Acid Salicyl 40 90 0 8 3888 205
Fungasol krim 2%, 10 gr 1 14950 0 18.5 17715.75 205
Betamethasone krim 0,1 %, tube 10 gram (Kim) 1 1842 0 8 1989.36 205
Sub Total 127386.52 205
Canderin tab. 8 mg 28 4800 0 18.5 159264 206
Letonal tab. 25 mg 14 900 0 18.5 14931 206
Dilavask tab. 5 mg 28 492 0 18.5 16324.56 207
Angioten tab. 50 mg 28 4080 0 18.5 135374.4 207
Ciprofloxacin tab. 500 mg (Hex) 10 330 0 8 3564 207
Rydian tab. 10 mg 5 1900 0 18.5 11257.5 207
Sub Total 178197.26 207
Risperidone tab. 2 mg (Dex) 28 2055.3 0 18.5 68194.85 208
Valisanbe tab. 2 mg 28 128 0 18.5 4247.04 208
Sub Total 72441.89 208
Tramifen kapl 15 4200 0 18.5 74655 209
Neuraxon 5000 tab. 15 1237.5 0 18.5 21996.56 209
Valisanbe tab. 2 mg 15 128 0 18.5 2275.2 209
Sub Total 98926.76 209
Sub Total 28416.3 210
TOTAL SEBELUM PPN 32939402.77 210
TOTAL SETELAH PPN 36233343.05 210
TOSHIBA:
1 = Kepesertaan Tanggal Kode
Nomor Resep NIKKES Nama Peserta Nama Dokter
2 = Non DOT Transaksi Dokter
3 = Obat Moll
E210200000KU17101530 400689 SOEHARDI BC.TT 29-05-2017 210110013 dr amar bachtiar
E210200000KU17101532 590396 MUHAMMAD YAHYA 29-05-2017 210110013 dr amar bachtiar
E210200000KU17101533 550238 ASRO SUGIHARTO 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101534 550238.1 SULASIH 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101535 540961 PURBONO 29-05-2017 210110013 dr amar bachtiar
E210200000KU17101536 620063.1 LILIK SURIYAH 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101528 591448 AGUNG HARYANTO SUMARGO ADIL 29-05-2017 210210001 dr. Istiyarti Tapilatu
TOSHIBA:
3 = Obat Moll
E210200000KU17101539 340553 DJUNAEDI BIN DIDI 29-05-2017 210110013 dr amar bachtiar
E210200000KU17101529 591494 ENDANG PURWATI 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101541 551531.1 YULI ARTINI 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101542 610943.1 SRI SULASTIKA SARI 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101545 610943.104 RICKY HARDIAN 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101547 421398 DIAH ESTHININGRUM 29-05-2017 210210001 dr. Istiyarti Tapilatu
TOSHIBA:
3 = Obat Moll
E210200000KU17101549 421398.1 K. I. MAHMUD 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101553 560309 SUDIRMAN SYARIF 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101554 490248.1 TOTO SULAEMAN 29-05-2017 210110013 dr amar bachtiar
E210200000KU17101555 490248 SUMINI 29-05-2017 210110013 dr amar bachtiar
E210200000KU17101557 470748 NURMAN BURHAN, BCTT. 29-05-2017 210110013 dr amar bachtiar
E210200000KU17101558 470748.1 LIA NURLAELA 29-05-2017 210110013 dr amar bachtiar
TOSHIBA:
3 = Obat Moll
E210200000KU17101560 510745 ENTANG MUCHTAR 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101560 510745 ENTANG MUCHTAR 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101552 520382 YOZEF THEEDENS 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101570 540264 NINIEK RUSMINIWATI 29-05-2017 210110013 dr amar bachtiar
E210200000KU17101571 540264.1 BUDIONO RUSSALI 29-05-2017 210110013 dr amar bachtiar
E210200000KU17101572 540492 RUSMIJANTO 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101573 540364 SLAMET BUDI RISJANTO 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101574 570124 HERRY SUARDI 29-05-2017 210110013 dr amar bachtiar
E210200000GI17091078 580763 DULIL AMIN 29-05-2017 210220001 drg. Arti R.Nazir
TOSHIBA:
3 = Obat Moll
E210200000KU17101577 600223 SUMARTONO 29-05-2017 210110013 dr amar bachtiar
E210200000KU17101578 541714.1 HARTATI 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101578 541714.1 HARTATI 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101576 551611.1 DARMINI 29-05-2017 210110013 dr amar bachtiar
E210200000KU17101582 570107 MARSINTA LUMBAN GAOL 29-05-2017 210110013 dr amar bachtiar
E210200000KU17101583 530314 GERTRUDO TRI HERWANTI 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101584 530314.1 ALOYSIUS HERTANTO 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101585 540364.1 SEMIM 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101586 531204 NENNY SRI SUPARMI 29-05-2017 210110013 dr amar bachtiar
TOSHIBA:
3 = Obat Moll
E210200000KU17101589 500351 MISWAN GUNAWAN 29-05-2017 210110013 dr amar bachtiar
E210200000GI17091079 470479.1 SUMIYATI 29-05-2017 210220001 drg. Arti R.Nazir
E210200000KU17101594 500126 DJAJA HENDARTO 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101595 500126.1 VERA LANIJANTI 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101600 580102 I GDE NYOMAN SUMADIA 29-05-2017 210110013 dr amar bachtiar
E210200000KU17101600 580102 I GDE NYOMAN SUMADIA 29-05-2017 210110013 dr amar bachtiar
E210200000KU17101602 560069.1 SRI MULYATUN 29-05-2017 210110013 dr amar bachtiar
E210200000KU17101605 520872.1 ZURIATI ZUBIR 29-05-2017 210110013 dr amar bachtiar
E210200000KU17101606 190236.1 MUHIJA JD ANANG NOERDIN 29-05-2017 210210001 dr. Istiyarti Tapilatu
TOSHIBA:
3 = Obat Moll
E210200000KU17101607 530934.1 NURMIATI, S.AG 29-05-2017 210110013 dr amar bachtiar
E210200000KU17101607 530934.1 NURMIATI, S.AG 29-05-2017 210110013 dr amar bachtiar
E210200000KU17101608 540429.1 SRI DEWI EKOWATI 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101612 370472 SURJANA BIN ROJADI 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101587 630305.103 MARLUTFIANTO TRIPUTRA 29-05-2017 210110013 dr amar bachtiar
E210200000KU17101617 511229 MUDJIONO 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101617 511229 MUDJIONO 29-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101604 460040.1 NADHIROH,NY 29-05-2017 210110013 dr amar bachtiar
TOSHIBA:
3 = Obat Moll
E210200000KU17101618 640056.1 BUKIT SABAR TAMBUNAN, SH 30-05-2017 210110013 dr amar bachtiar
E210200000KU17101619 500574 BAHASANNUDIN 30-05-2017 210110013 dr amar bachtiar
E210200000KU17101620 490902 BAMBANG SEKTIJOSO, IR. 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101621 490902.1 JOHANA MARIA DWI PRAPTI P. 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101623 571138 TADOH 30-05-2017 210210001 dr. Istiyarti Tapilatu
TOSHIBA:
3 = Obat Moll
E210200000KU17101626 571138.1 SITI SADIYAH 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101628 460544.1 DIAH ARYU PARLAWATY 30-05-2017 210110013 dr amar bachtiar
E210200000GI17091081 640056.1 BUKIT SABAR TAMBUNAN, SH 30-05-2017 210220001 drg. Arti R.Nazir
E210200000KU17101629 320126.1 BARIYAH 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101631 560067 SANIM SUKANDAR 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000GI17091082 520874.1 TITIN SUTINAH 30-05-2017 210220001 drg. Arti R.Nazir
TOSHIBA:
3 = Obat Moll
E210200000KU17101640 370764.2 HAFIDAH 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101643 490333 KARTONO 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101643 490333 KARTONO 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101633 560165 DJOHNI LIANSEN 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101646 581293 SYAFRUDDIN. B 30-05-2017 210110013 dr amar bachtiar
E210200000KU17101646 581293 SYAFRUDDIN. B 30-05-2017 210110013 dr amar bachtiar
E210200000KU17101647 360683.1 RATU TIEN L. 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101647 360683.1 RATU TIEN L. 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101648 590275.1 SITI FATIMAH 30-05-2017 210110013 dr amar bachtiar
E210200000KU17101639 591192.1 DWI ESTI MULYATMI 30-05-2017 210210001 dr. Istiyarti Tapilatu
TOSHIBA:
3 = Obat Moll
E210200000KU17101649 551034 TRI AGUS JOKO PURNOMO 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101650 580889 MARYANI 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101651 310137 SOEWARSO BCAT 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101654 580889.101 IKA RACHMALIKA 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101654 580889.101 IKA RACHMALIKA 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101658 591139 ETTY ROHAYATI 30-05-2017 210110013 dr amar bachtiar
E210200000KU17101644 440847 SUGIMIN BIN SULAIMAN 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101659 601639 MULYANA 30-05-2017 210210001 dr. Istiyarti Tapilatu
TOSHIBA:
3 = Obat Moll
E210200000KU17101637 560067.1 TITIN SUKAESIH 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101622 431114.1 ELIZABETH SUMARTINI 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101661 570948 SRI SUHARTI 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101662 570948.1 DJONO WIDJOSENO 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101662 570948.1 DJONO WIDJOSENO 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101663 350079.1 SITI SAODAH 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101667 550158.1 RINNY SULISTYOWATI 30-05-2017 210110013 dr amar bachtiar
E210200000KU17101657 540428 NGAKAN PUTU SANTHA 30-05-2017 210110013 dr amar bachtiar
E210200000KU17101670 561565.102 MUHAMMAD EMIR FADILLAH 30-05-2017 210110013 dr amar bachtiar
TOSHIBA:
3 = Obat Moll
E210200000KU17101673 601278 SITI AQILAH 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101673 601278 SITI AQILAH 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101674 551487.104 IRA TRISNAWATI 30-05-2017 210110013 dr amar bachtiar
E210200000KU17101675 601096.102 DWIKY NURDAYA ANDYARTO 30-05-2017 210110013 dr amar bachtiar
E210200000KU17101676 601096.1 TITIN DWI ANDI ANGGRAENI 30-05-2017 210110013 dr amar bachtiar
E210200000KU17101677 470366.1 SABARIAH 30-05-2017 210110013 dr amar bachtiar
E210200000KU17101680 511229 MUDJIONO 30-05-2017 210110013 dr amar bachtiar
E210200000KU17101682 511229.1 SUDARWATI 30-05-2017 210110013 dr amar bachtiar
TOSHIBA:
3 = Obat Moll
E210200000KU17101683 640230 ISDI HANDAYANI 30-05-2017 210110013 dr amar bachtiar
E210200000KU17101685 640230.1 SYAFEI 30-05-2017 210110013 dr amar bachtiar
E210200000KU17101686 612321.1 WAHYUNING 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101686 612321.1 WAHYUNING 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101688 490934.1 TJUT KESUMA BHAKTY 30-05-2017 210110013 dr amar bachtiar
E210200000KU17101687 410437 SUPARDI 30-05-2017 210210001 dr. Istiyarti Tapilatu
TOSHIBA:
3 = Obat Moll
E210200000KU17101694 560848 JONAR PANJAITAN 30-05-2017 210110013 dr amar bachtiar
E210200000KU17101695 460631 REMEDI PERANGINANGIN IR. 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101693 551872.1 ESTER LUMBANTOBING 30-05-2017 210110013 dr amar bachtiar
E210200000KU17101698 530092 MUHAMMAD MUNIF 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101701 360800.1 HINDUN 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101691 580123 JOKO TRIYANTO 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101690 532234 ISKANDAR 30-05-2017 210210001 dr. Istiyarti Tapilatu
TOSHIBA:
3 = Obat Moll
E210200000KU17101692 460631.1 SETIANA SINULINGGA 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101699 561086 SUPRAPTO SURYANI 30-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101705 360161 SANOESI BIN ALIAS 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101706 460053 KIMAH ROHIMAH 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101706 460053 KIMAH ROHIMAH 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101707 441131 UDJANG BIN PIUL 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101708 441131.1 NINAH 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101709 540286 IGNATIUS BAMBANG BUDISURANTO 31-05-2017 210110013 dr amar bachtiar
TOSHIBA:
3 = Obat Moll
E210200000KU17101711 540286.1 MARIA MARGARETA KUSUMA INDRIATI31-05-2017 210110013 dr amar bachtiar
E210200000KU17101712 470015.1 HARTINI NY 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101716 470015 SOEBARNO 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101718 581143 ATANG RACHMAT 31-05-2017 210110013 dr amar bachtiar
TOSHIBA:
3 = Obat Moll
E210200000KU17101720 591487.1 M YUSUF NS 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101722 410770.1 SARMI 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101723 550461 SUBANDI 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101724 510167.1 SRI WINARNI 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101726 431249 SURIPTO 31-05-2017 210210001 dr. Istiyarti Tapilatu
TOSHIBA:
3 = Obat Moll
E210200000KU17101727 410222.1 NANI SUPIATI 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101729 470652 MUHAMAD ADENAN 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101730 360874 SUDIJONO BIN DJEMAKUN 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101728 431249.1 SUPARTI 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101735 500069 JAHJA KELANA 31-05-2017 210210001 dr. Istiyarti Tapilatu
TOSHIBA:
3 = Obat Moll
E210200000KU17101738 500069.1 MARIANI 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101731 510051 SISWO KUNTJORO 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101740 532286 HATTA YUSUF,DRS 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101744 441224 ATER ROBERT MARPAUNG 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101746 480670.1 JOSEPHINE SIMANJUTAK 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101748 500287 MISNAN 31-05-2017 210210001 dr. Istiyarti Tapilatu
TOSHIBA:
3 = Obat Moll
E210200000KU17101749 591515 WIYANTO 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101751 500287.1 NURIAH 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101754 520143.1 ROIKAH 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101758 570595 AZWIR 31-05-2017 210110013 dr amar bachtiar
TOSHIBA:
3 = Obat Moll
E210200000KU17101759 460577.1 HJ ROCHAINAH 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101760 530117 SURYADI 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101761 570595.1 SUWARNI 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101767 560442.1 NAZWIR 31-05-2017 210110013 dr amar bachtiar
TOSHIBA:
3 = Obat Moll
E210200000KU17101768 610876 DARMANTO 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101770 560442 KUSNILAWATI 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101772 591233 MOCHAMAD ZUHRI, BA 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101773 591233.102 MUHAMMAD DARIS MULKIYAH 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101775 600846 BERNAD PASARIBU 31-05-2017 210210001 dr. Istiyarti Tapilatu
TOSHIBA:
3 = Obat Moll
E210200000KU17101765 431234 UNUNG MASDUKI 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101776 530417 PETRUS SISWANTO 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101766 431234.1 ONOH NONOH 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101778 450389.1 KASRI 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101771 390027.1 REDJO 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101783 510165 RACHMAD 31-05-2017 210110013 dr amar bachtiar
TOSHIBA:
3 = Obat Moll
E210200000KU17101755 520143 SAEPUDIN 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101788 520098 ALI CECILIA 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101785 510165.1 WAGINEM 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101790 520671.1 SUPIAH 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101792 570124.1 SRI RIYATI 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101792 570124.1 SRI RIYATI 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101794 460081 DJAUZI 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101795 532357 BAMBANG SUMBARGO 31-05-2017 210210001 dr. Istiyarti Tapilatu
TOSHIBA:
3 = Obat Moll
E210200000KU17101799 532357.1 SUWARTI 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101800 470397 RIZAL SAAT 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101805 580761 AWALUDIN NOOR 31-05-2017 210210001 dr. Istiyarti Tapilatu
TOSHIBA:
3 = Obat Moll
E210200000KU17101806 500228.1 NANI WINANINGSIH 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101784 520098.1 SITI ASIYAH 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101798 521490 TRI KURNIANTO 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101779 530417.1 ELISABETH CICILIA SAYAN 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101808 570970.1 SASMITO 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101808 570970.1 SASMITO 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101803 470397.1 SRI MARTINI 31-05-2017 210210001 dr. Istiyarti Tapilatu
TOSHIBA:
3 = Obat Moll
E210200000KU17101810 601279.1 ICHFA SYAFAWI 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101741 510051.1 ARYATI 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101813 551530.102 AMALIA HERINAWATI 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101815 490730 DARYONO KANDARDWIATMADJA 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101819 602339.1 PONIYATI 31-05-2017 210210001 dr. Istiyarti Tapilatu
TOSHIBA:
3 = Obat Moll
E210200000KU17101804 571011 UNTUNG MUHAEMIN 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101823 611953 EDDY PAHALA SIHOMBING 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101824 480069.1 WARTINI 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101814 551530.1 BARO,AH HERYSUSTIKA 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101829 530930 TRUMAN S TAMBUNAN 31-05-2017 210110013 dr amar bachtiar
TOSHIBA:
3 = Obat Moll
E210200000KU17101830 500814 DJAJADI 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101831 500814.1 TUTI ELLYANA 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101757 460577 ABDUL RACHIM 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101756 570941.1 ROHATI 31-05-2017 210210001 dr. Istiyarti Tapilatu
TOSHIBA:
3 = Obat Moll
E210200000KU17101719 591487 ZULHELMA BUSRI 31-05-2017 210210001 dr. Istiyarti Tapilatu
E210200000KU17101715 531547 BARYONO 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101832 340553.1 DJUHANA 31-05-2017 210110013 dr amar bachtiar
E210200000KU17101828 320145.1 RAMIANTA BORU HALOHO 31-05-2017 210210001 dr. Istiyarti Tapilatu
Jumlah Harga HNA Diskon Total
(%) Pembayaran
NovoMix 30 FlexPen inj. 100 IU/ml 3 151278.53 0 18.5 537795.19

NovoMix 30 FlexPen inj. 100 IU/ml 3 151278.53 0 Sub Total 537795.19
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63
Codeine tab. 10 mg (Kim) 20 550 0 18.5 13035
Codeine tab. 10 mg (Kim) 20 550 0 Sub Total 64493.63
Diaformin XR tab. 500 mg 56 900 0 18.5 59724
Pionix tab. 15 mg 28 4875.45 0 18.5 161767.58
Pionix tab. 15 mg 28 4875.45 0 Sub Total 221491.58
Cameloc tab. 15 mg 15 920 0 18.5 16353
Osteomax kaps. 10 6400 0 18.5 75840
Osteomax kaps. 10 6400 0 Sub Total 92193
Opineuron kapl. 15 550 0 18.5 9776.25
Acilaz kaps. 30 mg 10 5200 0 18.5 61620
Neurosanbe FC tab 15 800 0 18.5 14220
Neurosanbe FC tab 15 800 0 Sub Total 85616.25
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Clopidogrel tab. 75 mg (Hex) 28 3700 0 18.5 122766.01
Clopidogrel tab. 75 mg (Hex) 28 3700 0 Sub Total 139090.57
Cameloc tab. 7,5 mg 15 580 0 18.5 10309.5
Epsonal tab. 50 mg 8 2172.5 0 18.5 20595.3
Kalmeco tab. 500 mcg 15 1700 0 18.5 30217.5
Kalmeco tab. 500 mcg 15 1700 0 Sub Total 61122.3
Litorcom tab. 20 mg 14 3622.67 0 18.5 60100.04
Kalmeco tab. 500 mcg 28 1700 0 18.5 56406
(%) Pembayaran
Kalmeco tab. 500 mcg 20 1700 0 18.5 40290
Meloxicam tab. 7,5 mg (Kim) 20 361.31 0 18.5 8562.93
Emibion kaps. 20 720 0 18.5 17064
Emibion kaps. 20 720 0 Sub Total 65916.93
Diaversa tab. 2 mg 28 992 0 18.5 32914.56
Glucophage tab. 500 mg 56 811.69 0 18.5 53863.88
Glucophage tab. 500 mg 56 811.69 0 Sub Total 86778.44
Cameloc tab. 15 mg 10 920 0 18.5 10902
OA Forte kapl. 10 3311 0 18.5 39235.35
Neuraxon 5000 tab. 10 1237.5 0 18.5 14664.38
Neuraxon 5000 tab. 10 1237.5 0 Sub Total 64801.73
Kalnex tab. 500 mg 10 2400 0 18.5 28440
Emibion kaps. 15 720 0 18.5 12798
Emibion kaps. 15 720 0 Sub Total 41238
Lifezar tab. 50 mg 20 4192.5 0 18.5 99362.25
Dilavask tab. 5 mg 20 492 0 18.5 11660.4
Dilavask tab. 5 mg 20 492 0 Sub Total 111022.65
Plantacid Forte tab. 15 663.64 0 18.5 11796.14
Acilaz kaps. 30 mg 10 5200 0 18.5 61620
Domperidone tab. 10 mg (Indo) 10 256.59 0 18.5 3040.63
Domperidone tab. 10 mg (Indo) 10 256.59 0 Sub Total 76456.77
Carboglycerine tetes telinga 10% botol 5 ml 6 1500 0 8 9720
Carboglycerine tetes telinga 10% botol 5 ml 6 1500 0 Sub Total 9720
Herbesser CD kaps. 200 mg 56 9330.75 0 18.5 619188.57
Clonidine HCl tab. 0,15 mg (Indo) 42 186.18 0 18.5 9266.04
Betaone tab. 2,5 mg 28 1404 0 18.5 46584.72
Alganax tab. 0,25 mg 28 848 0 18.5 28136.64
Lansoprazole kaps. 30 mg (Indo) 56 736.35 0 18.5 48864.44
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18
Esvat tab. 20 mg 28 866.25 0 Sub Total 780782.59
(%) Pembayaran
Canderin tab. 8 mg 28 4800 0 18.5 159264
Concor tab. 2,5 mg 28 2916.54 0 18.5 96770.8
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18
Alganax tab. 0,25 mg 28 848 0 18.5 28136.64
Tramifen kapl 56 4200 0 18.5 278712
Tramifen kapl 56 4200 0 Sub Total 640490.05
Cefat kaps. 500 mg 8 4342.5 0 18.5 41166.9
Ambroxol tab. 30 mg (Indo) 10 124.09 0 18.5 1470.45
Methyl prednisolone tab. 4 mg (Dex) 4 300.75 0 18.5 1425.56
Methyl prednisolone tab. 4 mg (Dex) 4 300.75 0 Sub Total 49276.91
Prednisone tab. 5 mg (Kim) 20 135 0 8 2916
Rydian tab. 10 mg 6 1900 0 18.5 13509
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63
Cefat kaps. 500 mg 10 4342.5 0 Sub Total 82389.08
Prednicort tab. 4 mg 10 1500 0 18.5 17775
Rhinos SR kaps. 10 3600 0 18.5 42660
Rhinos SR kaps. 10 3600 0 Sub Total 60435
Betaone tab. 2,5 mg 20 1404 0 18.5 33274.8
Canderin tab. 8 mg 10 4800 0 18.5 56880
Astika tab. 100 mg. 20 374 0 18.5 8863.8
Esvat tab. 20 mg 20 866.25 0 18.5 20530.13
Lodem tab. 30 mg 20 1282.5 0 18.5 30395.25
Dilavask tab. 5 mg 20 492 0 18.5 11660.4
Meloxicam tab. 15 mg (Kim) 20 626.12 0 18.5 14839.14
(%) Pembayaran
Nucral susp. 500 mg/5 ml @ 200 ml 1 41687.5 0 18.5 49399.69
Nucral susp. 500 mg/5 ml @ 200 ml 1 41687.5 0 Sub Total 106294.48
Hemapo prefilled syringe 3000 IU 4 185250 0 18.5 878085
Hemapo prefilled syringe 3000 IU 4 185250 0 Sub Total 878085
Chlorpromazine tab. sal 100 mg (Kim) 28 208.93 0 18.5 6932.23
Risperidone tab. 2 mg (Dex) 28 2055.3 0 18.5 68194.85
Risperidone tab. 2 mg (Dex) 28 2055.3 0 Sub Total 75127.09
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63
Sanmol tab. 500 mg 10 250 0 18.5 2962.5
Codeine tab. 10 mg (Kim) 15 550 0 18.5 9776.25
Rydian tab. 10 mg 5 1900 0 18.5 11257.5
Rydian tab. 10 mg 5 1900 0 Sub Total 78818.24
Tequinol tab. 500 mg 10 5040 0 18.5 59724
Rhinos SR kaps. 10 3600 0 18.5 42660
Sanmol tab. 500 mg 10 250 0 18.5 2962.5
Sanmol tab. 500 mg 10 250 0 Sub Total 105346.5
Urotractin kaps. 400 mg 15 1652 0 18.5 29364.3
Flamar tab. 50 mg 10 1320 0 18.5 15642
Flamar tab. 50 mg 10 1320 0 Sub Total 45006.3
Simvastatin tab. 10 mg (Kim) 14 221.52 0 18.5 3675.06
Febogrel tab. 75 mg 14 5280 0 18.5 87595.2
Astika tab. 100 mg. 14 374 0 18.5 6204.66
Astika tab. 100 mg. 14 374 0 Sub Total 97474.92
Dilavask tab. 5 mg 14 492 0 18.5 8162.28
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63
Ponstelax kapl. 500 mg 10 350.35 0 18.5 4151.65
(%) Pembayaran
Ponstelax kapl. 500 mg 10 350.35 0 Sub Total 55610.27
Tequinol tab. 500 mg 10 5040 0 18.5 59724
Extropect syr. 30 mg/5 ml, btl. 60 ml 1 14400 0 18.5 17064
Fluzep kapl. 10 562.5 0 18.5 6665.63
Fluzep kapl. 10 562.5 0 Sub Total 83453.63
Omeprazole kaps. 20 mg (Indo) 40 333.77 0 18.5 15820.55
Omeprazole kaps. 20 mg (Indo) 40 333.77 0 Sub Total 15820.55
Clamixin kapl. 10 5500 0 18.5 65175
Rhinofed tab. 10 1155 0 18.5 13686.75
Sanmol tab. 500 mg 10 250 0 18.5 2962.5
Depakote tab. 250 mg 28 8011.5 0 18.5 265821.57
Dilavask tab. 5 mg 20 492 0 18.5 11660.4
Diaversa tab. 3 mg 20 1352 0 18.5 32042.4
Glucophage XR tab. 500 mg 40 1620.5 0 18.5 76811.89
Esvat tab. 10 mg 20 472.5 0 18.5 11198.25
Dilavask tab. 5 mg 20 492 0 18.5 11660.4
Glucovance 500/2,5 tab 40 2705.43 0 18.5 128237.43
Glucovance 500/2,5 tab 40 2705.43 0 Sub Total 139897.83
Primadex kapl. 6 279 0 18.5 1983.69
Diagit tab. 10 687.5 0 18.5 8146.88
Gitas Plus tab. 6 1750 0 18.5 12442.5
Gitas Plus tab. 6 1750 0 Sub Total 22573.07
Opineuron kapl. 20 550 0 18.5 13035
Voltadex emulgel 1%/20 gr 1 17550 0 18.5 20796.75
(%) Pembayaran
Voltadex emulgel 1%/20 gr 1 17550 0 Sub Total 51283.34
Primadex kapl. 10 279 0 18.5 3306.15
Gitas Plus tab. 10 1750 0 18.5 20737.5
Acilaz kaps. 30 mg 10 5200 0 18.5 61620
Diagit tab. 10 687.5 0 18.5 8146.88
Diagit tab. 10 687.5 0 Sub Total 93810.53
Opimox kaps. 500 mg 15 1200 0 18.5 21330
Sanmol tab. 500 mg 10 250 0 18.5 2962.5
Metrix tab. 3 mg 28 2534.85 0 18.5 84106.32
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Interhistin tab. 50 mg 15 429 0 18.5 7625.48
Interhistin tab. 50 mg 15 429 0 Sub Total 188852.18
Valdix tab. 80 mg 28 3025 0 18.5 100369.5
Dilavask tab. 10 mg 28 1050 0 18.5 34839
Litorcom tab. 20 mg 28 3622.67 0 18.5 120200.08
Litorcom tab. 20 mg 28 3622.67 0 Sub Total 255408.58
OA Forte kapl. 14 3311 0 18.5 54929.49
OA Forte kapl. 14 3311 0 Sub Total 54929.49
Flutias i.h 25/125 mcg/puff, 120 semprot 1 82500 0 18.5 97762.5
Flutias i.h 25/125 mcg/puff, 120 semprot 1 82500 0 Sub Total 97762.5
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Opineuron kapl. 10 550 0 18.5 6517.5
Canderin tab. 8 mg 20 4800 0 18.5 113760
Gerdilium FC tab. 10 mg 20 1400 0 18.5 33180
Gerdilium FC tab. 10 mg 20 1400 0 Sub Total 146940
Irbesartan tab. 300 mg. (Indo) 20 2418.5 0 18.5 57318.45
(%) Pembayaran
Dilavask tab. 10 mg 20 1050 0 18.5 24885
Evothyl kaps. 300 mg 20 4950 0 18.5 117315
Alluric tab. 300 mg. 20 1755.45 0 18.5 41604.27
Neurosanbe Plus kapl. 15 760 0 18.5 13509
Neurosanbe Plus kapl. 15 760 0 Sub Total 254631.72
Eyefresh ED lar. 2% btl 5 ml 1 25410 0 18.5 30110.85
Eyefresh ED lar. 2% btl 5 ml 1 25410 0 Sub Total 30110.85
Albiotin kaps. 300 mg 10 1300 0 18.5 15405
Dextafen tab. 10 770 0 18.5 9124.5
Betason N krim 5 gr 1 9945 0 18.5 11784.83
Acid Salicyl 2 90 0 8 194.4
Kloderma krim 5 gr 1 13875 0 18.5 16441.88
Canderin tab. 8 mg 10 4800 0 18.5 56880
Canderin tab. 8 mg 10 4800 0 Sub Total 109830.6
Febogrel tab. 75 mg 14 5280 0 18.5 87595.2
Digoxin tab. 0,25 mg 14 168.83 0 18.5 2800.89
Canderin tab. 8 mg 14 4800 0 18.5 79632
Reucid tab. 100 mg 14 600 0 18.5 9954
Evothyl kaps. 300 mg 14 4950 0 18.5 82120.5
Evothyl kaps. 300 mg 14 4950 0 Sub Total 262102.59
Salbutamol sulfate tab. 2 mg (Kim) 20 76.39 0 18.5 1810.46
Suprasma i.h 100 mcg/puff, 200 semprot 1 63000 0 18.5 74655
Suprasma i.h 100 mcg/puff, 200 semprot 1 63000 0 Sub Total 76465.46
Canderin tab. 8 mg 14 4800 0 18.5 79632
Canderin tab. 8 mg 14 4800 0 Sub Total 79632
Reucid tab. 300 mg 28 1000 0 18.5 33180
(%) Pembayaran
Rydian tab. 10 mg 15 1900 0 18.5 33772.5
Flutias i.h 25/125 mcg/puff, 120 semprot 1 82500 0 18.5 97762.5
Flutias i.h 25/125 mcg/puff, 120 semprot 1 82500 0 Sub Total 261111.59
Canderin tab. 8 mg 28 4800 0 18.5 159264
Metformin tab. 500 mg (Dex) 84 156.75 0 18.5 15602.9
Metformin tab. 500 mg (Dex) 84 156.75 0 Sub Total 174866.9
Canderin tab. 8 mg 20 4800 0 18.5 113760
Betaone tab. 5 mg 20 2400 0 18.5 56880
Nitrokaf Retard kaps. SR 5 mg 40 2645.31 0 18.5 125387.72
Allopurinol tab. 100 mg (Kim) 20 144.3 0 18.5 3419.91
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Tenapril tab. 2,5 mg 28 1575 0 18.5 52258.5
Neuraxon 5000 tab. 14 1237.5 0 18.5 20530.13
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Tenapril tab. 5 mg 28 2250 0 18.5 74655
Cefat kaps. 500 mg 8 4342.5 0 18.5 41166.9
Ambroxol tab. 30 mg (Indo) 10 124.09 0 Sub Total 146651.91
Thrombo Aspilets tab. 80 mg 20 448 0 18.5 10617.6
Kalmeco tab. 500 mcg 20 1700 0 18.5 40290
Omeprazole kaps. 20 mg (Indo) 20 333.77 0 Sub Total 7910.28
(%) Pembayaran
Acilaz kaps. 30 mg 15 5200 0 18.5 92430
Domperidone tab. 10 mg (Indo) 15 256.59 0 18.5 4560.95
Opineuron kapl. 10 550 0 18.5 6517.5
Opineuron kapl. 10 550 0 Sub Total 103508.45
Lodem tab. 30 mg 28 1282.5 0 18.5 42553.35
Metrix tab. 2 mg 14 1890 0 18.5 31355.1
Atorvastatin tab. 20 mg (Hex) 14 4000 0 8 60480
Atorvastatin tab. 20 mg (Hex) 14 4000 0 Sub Total 164250.45
Clindamycin kaps. 300 mg (Dex) 10 1155.42 0 18.5 13691.73
Ponstelax kapl. 500 mg 10 350.35 0 18.5 4151.65
Ponstelax kapl. 500 mg 10 350.35 0 Sub Total 17843.37
Opimox kaps. 500 mg 12 1200 0 18.5 17064
Vastigo tab. 6 mg 10 495 0 18.5 5865.75
Dilavask tab. 5 mg 20 492 0 18.5 11660.4
Febogrel tab. 75 mg 20 5280 0 18.5 125136
Esvat tab. 10 mg 20 472.5 0 18.5 11198.25
Osteomax kaps. 10 6400 0 18.5 75840
Albiotin kaps. 300 mg 15 1300 0 18.5 23107.5
Sanmol tab. 500 mg 10 250 0 18.5 2962.5
Hexadol Mint sol. 100 ml 1 15000 0 18.5 17775
Hexadol Mint sol. 100 ml 1 15000 0 Sub Total 43845
(%) Pembayaran
Letonal tab. 25 mg 14 900 0 18.5 14931
Dilavask tab. 5 mg 14 492 0 18.5 8162.28
Metrix tab. 1 mg 14 1094.85 0 18.5 18163.56
Metrix tab. 1 mg 14 1094.85 0 Sub Total 125003.17
Evothyl kaps. 300 mg 14 4950 0 18.5 82120.5
Simvastatin tab. 10 mg (Kim) 14 221.52 0 Sub Total 85795.56
Fluimucil kaps. 200 mg 10 4095 0 18.5 48525.75
Fluimucil kaps. 200 mg 10 4095 0 Sub Total 48525.75
Anadium kapl. 10 4248 0 18.5 50338.8
Cameloc tab. 7,5 mg 15 580 0 18.5 10309.5
Valisanbe tab. 5 mg 10 200 0 18.5 2370
Valisanbe tab. 5 mg 10 200 0 Sub Total 65412.24
Sanmol tab. 500 mg 10 250 0 18.5 2962.5
Tequinol tab. 500 mg 6 5040 0 18.5 35834.4
Urinter kaps. 400 mg 10 2400 0 18.5 28440
Gitas Plus tab. 10 1750 0 18.5 20737.5
Lansoprazole kaps. 30 mg (Indo) 10 736.35 0 Sub Total 93737.69
Canderin tab. 8 mg 14 4800 0 18.5 79632
Cedocard tab. sublingual 5 mg 42 749.17 0 18.5 37286.03
(%) Pembayaran
Cefixime tab. 100 mg (Kim) 20 1306.15 0 18.5 30955.65
Cefixime tab. 100 mg (Kim) 20 1306.15 0 Sub Total 257782.43
Flamar tab. 50 mg 15 1320 0 18.5 23463
OA Forte kapl. 10 3311 0 18.5 39235.35
Metrix tab. 3 mg 14 2534.85 0 18.5 42053.16
Eclid tab. 50 mg 14 1200 0 18.5 19908
Eclid tab. 50 mg 14 1200 0 Sub Total 70837.19
Lifezar tab. 50 mg 20 4192.5 0 18.5 99362.25
Betaserc tab. 24 mg 30 7476.88 0 18.5 265802.91
Betaserc tab. 24 mg 30 7476.88 0 Sub Total 367790.2
Rydian tab. 10 mg 10 1900 0 18.5 22515
Sanbe Tears lar. 2 % btl 5 ml 1 13895 0 18.5 16465.58
Sanbe Tears lar. 2 % btl 5 ml 1 13895 0 Sub Total 46400.15
Evothyl kaps. 300 mg 20 4950 0 18.5 117315
Reucid tab. 300 mg 20 1000 0 18.5 23700
Reucid tab. 300 mg 20 1000 0 Sub Total 141015
Dilavask tab. 5 mg 14 492 0 18.5 8162.28
Hemapo prefilled syringe 3000 IU 2 185250 0 18.5 439042.5
(%) Pembayaran
Flamar tab. 50 mg 10 1320 0 18.5 15642
Flamar tab. 50 mg 10 1320 0 Sub Total 454684.5
Cameloc tab. 7,5 mg 20 580 0 18.5 13746
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63
Cameloc tab. 7,5 mg 20 580 0 18.5 13746
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Magtral Syr. Forte 1 13000 0 18.5 15405
Magtral Syr. Forte 1 13000 0 Sub Total 31729.56
Metrix tab. 1 mg 28 1094.85 0 18.5 36327.12
Levemir Flexpen inj 100 IU/ml, flexpen 3 ml 1 170186.54 0 18.5 201671.05
Primadex kapl. 10 279 0 18.5 3306.15
Gitas Plus tab. 8 1750 0 18.5 16590
Diagit tab. 8 687.5 0 18.5 6517.5
Acilaz kaps. 30 mg 10 5200 0 18.5 61620
Acilaz kaps. 30 mg 10 5200 0 Sub Total 88033.65
Opineuron kapl. 20 550 0 18.5 13035
Rydian tab. 10 mg 5 1900 0 18.5 11257.5
(%) Pembayaran
Tequinol tab. 500 mg 10 5040 0 18.5 59724
Tequinol tab. 500 mg 10 5040 0 Sub Total 83668.94
Hexadol Mint sol. 100 ml 1 15000 0 Sub Total 17775
Lodem tab. 30 mg 40 1282.5 0 18.5 60790.5
Metrix tab. 2 mg 20 1890 0 18.5 44793
Evothyl kaps. 300 mg 20 4950 0 18.5 117315
Ciprofloxacin tab. 500 mg (Hex) 8 330 0 8 2851.2
Gentamicin 1% Salep Kulit 5 gram 1 1773 0 8 1914.84
Fungasol krim 2%, 10 gr 1 14950 0 18.5 17715.75
Fungasol krim 2%, 10 gr 1 14950 0 Sub Total 288040.29
Clamixin kapl. 10 5500 0 18.5 65175
Rhinofed tab. 10 1155 0 18.5 13686.75
Sanmol tab. 500 mg 10 250 0 18.5 2962.5
Euthyrox tab. 100 mcg 56 1524.6 0 18.5 101172.46
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18
Reucid tab. 300 mg 28 1000 0 18.5 33180
Reucid tab. 300 mg 28 1000 0 Sub Total 163094.63
Gitas Plus tab. 10 1750 0 18.5 20737.5
Hexadol Mint sol. 100 ml 1 15000 0 Sub Total 103317.19
Anadium kapl. 10 4248 0 18.5 50338.8
Anadium kapl. 10 4248 0 Sub Total 50338.8
Dilavask tab. 10 mg 14 1050 0 18.5 17419.5
Canderin tab. 8 mg 14 4800 0 18.5 79632
(%) Pembayaran
Fungasol krim 2%, 10 gr 1 14950 0 18.5 17715.75
Fungasol krim 2%, 10 gr 1 14950 0 Sub Total 144629.25
Metrix tab. 2 mg 14 1890 0 18.5 31355.1
Pionix tab. 15 mg 14 4875.45 0 18.5 80883.79
Dilavask tab. 5 mg 14 492 0 18.5 8162.28
Ciprofloxacin tab. 500 mg (Hex) 6 330 0 8 2138.4
Urinter kaps. 400 mg 6 2400 0 18.5 17064
Gitas Plus tab. 6 1750 0 18.5 12442.5
V-Bloc tab. 6,25 mg 14 1750 0 18.5 29032.5
Tenapril tab. 5 mg 14 2250 0 18.5 37327.5
Letonal tab. 25 mg 14 900 0 18.5 14931
Esvat tab. 20 mg 14 866.25 0 18.5 14371.09
Reucid tab. 100 mg 14 600 0 18.5 9954
Esvat tab. 10 mg 14 472.5 0 18.5 7838.78
Tramifen kapl 10 4200 0 18.5 49770
Thombophob gel. 20 gr 2 44887.5 0 18.5 106383.38
Thombophob gel. 20 gr 2 44887.5 0 Sub Total 156153.38
Canderin tab. 8 mg 20 4800 0 18.5 113760
Esvat tab. 20 mg 20 866.25 0 18.5 20530.13
Neuraxon 5000 tab. 10 1237.5 0 18.5 14664.38
(%) Pembayaran
Levofloxacin tab. 500 mg (Dex) 5 1048.8 0 8 5663.52
Levofloxacin tab. 500 mg (Dex) 5 1048.8 0 Sub Total 66558.52
Tequinol tab. 500 mg 10 5040 0 18.5 59724
Fluzep kapl. 10 562.5 0 18.5 6665.63
Betaone tab. 2,5 mg 28 1404 0 18.5 46584.72
Natrium Bikarbonat tab. 500 mg 84 17.37 0 8 1575.81
Litorcom tab. 10 mg 28 3622.67 0 18.5 120200.08
Litorcom tab. 10 mg 28 3622.67 0 Sub Total 209819.02
Dilavask tab. 10 mg 14 1050 0 18.5 17419.5
Phenytoin kaps. 100 mg 14 550 0 8 8316
Dilavask tab. 10 mg 20 1050 0 18.5 24885
Fluzep kapl. 10 562.5 0 18.5 6665.63
Lodem tab. 30 mg 60 1282.5 0 18.5 91185.75
Esvat tab. 10 mg 20 472.5 0 18.5 11198.25
Esvat tab. 10 mg 20 472.5 0 Sub Total 102384
Sifrol tab. 0,125 mg 42 5471.62 0 18.5 272322.53
Leparson kaps. 42 2466.75 0 18.5 122770.15
Leparson kaps. 42 2466.75 0 Sub Total 395092.67
Rydian tab. 10 mg 8 1900 0 18.5 18012
Epexol syr. 15 mg/5 ml, btl. 120 ml 1 10506 0 18.5 12449.61
(%) Pembayaran
Dextafen tab. 10 770 0 18.5 9124.5
Neurosanbe Plus kapl. 10 760 0 18.5 9006
Acid Salicyl 30 90 0 8 2916
Inerson krim 0,25 %, tube 15 gr 1 25000 0 Sub Total 81133.11
Esvat tab. 20 mg 14 866.25 0 18.5 14371.09
Betaone tab. 2,5 mg 28 1404 0 18.5 46584.72
Dilavask tab. 10 mg 28 1050 0 18.5 34839
Cefat kaps. 500 mg 8 4342.5 0 18.5 41166.9
Sanmol tab. 500 mg 8 250 0 18.5 2370
Dilavask tab. 10 mg 20 1050 0 18.5 24885
Zypraz tab. 0,5 mg 20 1375.45 0 18.5 32598.27
Vastigo tab. 6 mg 20 495 0 18.5 11731.5
Rydian tab. 10 mg 15 1900 0 18.5 33772.5
Osfit tab. 500 mg 15 1125 0 18.5 19996.88
Osfit tab. 500 mg 15 1125 0 Sub Total 53769.38
Opineuron kapl. 15 550 0 18.5 9776.25
Dilavask tab. 10 mg 28 1050 0 18.5 34839
Clonidine HCl tab. 0,15 mg (Indo) 28 186.18 0 18.5 6177.36
Reucid tab. 300 mg 28 1000 0 18.5 33180
(%) Pembayaran
Metrix tab. 2 mg 28 1890 0 18.5 62710.2
Aminefron tab. 630 mg 28 4550 0 18.5 150969
Aminefron tab. 630 mg 28 4550 0 Sub Total 302740.2
Lifezar tab. 50 mg 28 4192.5 0 18.5 139107.15
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Reucid tab. 100 mg 28 600 0 18.5 19908
Diltiazem tab. 30 mg (Kim) 14 139.7 0 18.5 2317.62
Captopril tab. 25 mg (Hex) 14 106.36 0 18.5 1764.57
Symbicort i.h 160/4,5 mcg/puff 60 semprot 1 238255.2 0 18.5 282332.41
Symbicort i.h 160/4,5 mcg/puff 60 semprot 1 238255.2 0 Sub Total 286414.61
Amlodipine tab. 5 mg (Kim) 28 392.73 0 18.5 13030.78
Alpentin kaps. 100 mg 20 2380 0 18.5 56406
Alpentin kaps. 100 mg 20 2380 0 Sub Total 69436.78
Episan susp. 500 mg/5 ml @ 100 ml 1 24310 0 18.5 28807.35
Gitas Plus tab. 10 1750 0 18.5 20737.5
Cameloc tab. 15 mg 15 920 0 18.5 16353
Cameloc tab. 15 mg 15 920 0 Sub Total 16353
Nitrokaf Retard kaps. SR 2,5 mg 28 1818.36 0 18.5 60333.27
Betaone tab. 5 mg 28 2400 0 18.5 79632
Diaversa tab. 1 mg 28 585 0 18.5 19410.3
Santesar tab. 50 mg 28 3773 0 18.5 125188.14
Esvat tab. 10 mg 28 472.5 0 18.5 15677.55
Letonal tab. 25 mg 20 900 0 18.5 21330
(%) Pembayaran
Betaone tab. 2,5 mg 20 1404 0 18.5 33274.8
Diaversa tab. 1 mg 28 585 0 18.5 19410.3
Diaversa tab. 1 mg 28 585 0 Sub Total 19410.3
Febogrel tab. 75 mg 28 5280 0 18.5 175190.4
Nitrokaf Retard kaps. SR 2,5 mg 28 1818.36 0 18.5 60333.27
Angioten tab. 50 mg 28 4080 0 18.5 135374.4
Angioten tab. 50 mg 28 4080 0 Sub Total 385762.71
Dilavask tab. 10 mg 28 1050 0 18.5 34839
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18
Metrix tab. 2 mg 28 1890 0 18.5 62710.2
Metrix tab. 2 mg 28 1890 0 Sub Total 181010.73
Ursolic kaps. 250 mg 28 4611 0 18.5 152992.98
Harnal D tab. 0,2 mg 14 10874.05 0 18.5 180400.49
Harnal D tab. 0,2 mg 14 10874.05 0 Sub Total 333393.47
Metrix tab. 2 mg 28 1890 0 18.5 62710.2
Clamixin kapl. 10 5500 0 18.5 65175
Rhinofed tab. 10 1155 0 18.5 13686.75
Sanmol tab. 500 mg 10 250 0 18.5 2962.5
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Esvat tab. 10 mg 28 472.5 0 18.5 15677.55
Xytrol ED tts. mata , btl 5 ml 1 23980 0 18.5 28416.3
Xytrol ED tts. mata , btl 5 ml 1 23980 0 Sub Total 60418.41
Canderin tab. 8 mg 28 4800 0 18.5 159264
(%) Pembayaran
Dilavask tab. 10 mg 28 1050 0 18.5 34839
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18
Metrix tab. 2 mg 28 1890 0 18.5 62710.2
Canderin tab. 8 mg 28 4800 0 18.5 159264
Dilavask tab. 10 mg 28 1050 0 18.5 34839
Canderin tab. 16 mg 28 6800 0 18.5 225624
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18
Angioten tab. 50 mg 28 4080 0 18.5 135374.4
Dilavask tab. 10 mg 28 1050 0 18.5 34839
Mertigo SR tab. 24 mg 14 3461.25 0 18.5 57422.14
Tramifen kapl 10 4200 0 18.5 49770
Kalmeco tab. 500 mcg 10 1700 0 18.5 20145
Neuraxon 5000 tab. 10 1237.5 0 18.5 14664.38
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Diaversa tab. 1 mg 28 585 0 18.5 19410.3
Concor tab. 5 mg 14 4223.34 0 18.5 70065.21
Concor tab. 5 mg 14 4223.34 0 Sub Total 105800.07
Alganax tab. 0,25 mg 10 848 0 18.5 10048.8
Alganax tab. 0,25 mg 10 848 0 Sub Total 10048.8
Imdur tab. 60 mg 28 5902 0 8 178476.48
(%) Pembayaran
Imdur tab. 60 mg 28 5902 0 Sub Total 716271.67
Rydian tab. 10 mg 10 1900 0 18.5 22515
Rydian tab. 10 mg 10 1900 0 Sub Total 22515
Opineuron kapl. 10 550 0 18.5 6517.5
Diclofenac Potassium tab. 50 mg (Hex) 15 410 0 18.5 7287.75
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Litorcom tab. 20 mg 14 3622.67 0 18.5 60100.04
Salbutamol sulfate tab. 2 mg (Kim) 28 76.39 0 Sub Total 154205.55
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Betaone tab. 2,5 mg 28 1404 0 18.5 46584.72
Esvat tab. 10 mg 28 472.5 0 18.5 15677.55
Evothyl kaps. 300 mg 28 4950 0 18.5 164241
Reucid tab. 300 mg 28 1000 0 18.5 33180
Episan susp. 500 mg/5 ml @ 100 ml 1 24310 0 18.5 28807.35
Episan susp. 500 mg/5 ml @ 100 ml 1 24310 0 Sub Total 255853.35
Betaone tab. 5 mg 20 2400 0 18.5 56880
Canderin tab. 16 mg 10 6800 0 18.5 80580
Febogrel tab. 75 mg 20 5280 0 18.5 125136
Tramifen kapl 10 4200 0 18.5 49770
(%) Pembayaran
Neuraxon 5000 tab. 10 1237.5 0 18.5 14664.38
Betaone tab. 2,5 mg 14 1404 0 18.5 23292.36
Dilavask tab. 5 mg 14 492 0 18.5 8162.28
Trizedon MR tab. 35 mg 14 2610.39 0 18.5 43306.34
Imdur tab. 60 mg 14 5902 0 8 89238.24
Imdur tab. 60 mg 14 5902 0 Sub Total 343264.28
Betaserc tab. 24 mg 15 7476.88 0 18.5 132901.45
Paracetamol tab. 500 mg (Kim) 14 88.3 0 18.5 1464.82
Ergotamine Coffeine tab. (Kim) 7 175.75 0 18.5 1457.85
Alganax tab. 0,25 mg 7 848 0 18.5 7034.16
Alganax tab. 0,25 mg 7 848 0 Sub Total 142858.28
Ketricin salep in oral base 5 gr 1 26800 0 18.5 31758
Ketricin salep in oral base 5 gr 1 26800 0 Sub Total 31758
Tequinol tab. 500 mg 10 5040 0 18.5 59724
Sanmol tab. 500 mg 10 250 0 18.5 2962.5
Rydian tab. 10 mg 6 1900 0 18.5 13509
Suprasma i.h 100 mcg/puff, 200 semprot 1 63000 0 18.5 74655
Lansoprazole kaps. 30 mg (Indo) 20 736.35 0 Sub Total 184618
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Betaone tab. 5 mg 28 2400 0 18.5 79632
Lodem tab. 30 mg 28 1282.5 0 18.5 42553.35
Metrix tab. 3 mg 28 2534.85 0 18.5 84106.32
(%) Pembayaran
Meloxicam tab. 15 mg (Kim) 28 626.12 0 Sub Total 248178.9
Vastigo tab. 6 mg 56 495 0 18.5 32848.2
Lodem tab. 30 mg 84 1282.5 0 18.5 127660.05
Dilavask tab. 10 mg 14 1050 0 18.5 17419.5
Lodem tab. 30 mg 42 1282.5 0 18.5 63830.03
Reucid tab. 100 mg 28 600 0 18.5 19908
Evothyl kaps. 300 mg 28 4950 0 18.5 164241
Evothyl kaps. 300 mg 28 4950 0 Sub Total 314207.06
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Betaone tab. 5 mg 28 2400 0 18.5 79632
Metrix tab. 4 mg 28 2939.85 0 18.5 97544.22
Sanmol tab. 500 mg 10 250 0 18.5 2962.5
Rydian tab. 10 mg 5 1900 0 18.5 11257.5
Tequinol tab. 500 mg 10 5040 0 18.5 59724
Tequinol tab. 500 mg 10 5040 0 Sub Total 85620.8
Digoxin tab. 0,25 mg 28 168.83 0 18.5 5601.78
Betaone tab. 5 mg 28 2400 0 18.5 79632
Tenapril tab. 10 mg 28 3000 0 18.5 99540
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18
(%) Pembayaran
Zypraz tab. 0,5 mg 28 1375.45 0 18.5 45637.58
Mertigo SR tab. 24 mg 20 3461.25 0 18.5 82031.63
Mertigo SR tab. 24 mg 20 3461.25 0 Sub Total 365617.38
Evothyl kaps. 300 mg 28 4950 0 18.5 164241
Kalmeco tab. 500 mcg 20 1700 0 18.5 40290
Kalmeco tab. 500 mcg 20 1700 0 Sub Total 204531
Canderin tab. 8 mg 28 4800 0 18.5 159264
Hi-Bone tab. 20 2550 0 18.5 60435
Esvat tab. 20 mg 10 866.25 0 18.5 10265.06
Reucid tab. 300 mg 10 1000 0 18.5 11850
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63
Methyl prednisolone tab. 16 mg (Dex) 2 799.85 0 Sub Total 75448.04
Clamixin kapl. 12 5500 0 18.5 78210
Fluzep kapl. 10 562.5 0 18.5 6665.63
Primadex kapl. 10 279 0 18.5 3306.15
Gitas Plus tab. 10 1750 0 18.5 20737.5
Acilaz kaps. 30 mg 10 5200 0 18.5 61620
Plantacid Forte tab. 10 663.64 0 Sub Total 93527.74
Ursolic kaps. 250 mg 28 4611 0 18.5 152992.98
(%) Pembayaran
Cholestat tab. 20 mg 28 3850 0 18.5 127743
Cholestat tab. 20 mg 28 3850 0 Sub Total 285523.85
Haloperidol tab. 5 mg (Indo) 28 122.17 0 18.5 4053.6
Hexymer tab. 2 mg 28 297.5 0 18.5 9871.05
Hexymer tab. 2 mg 28 297.5 0 Sub Total 13924.65
Glucovance 250/1,25 tab. 28 1686.43 0 18.5 55955.88
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Valdix tab. 80 mg 28 3025 0 18.5 100369.5
Esvat tab. 10 mg 28 472.5 0 18.5 15677.55
Meloxicam tab. 7,5 mg (Kim) 15 361.31 0 18.5 6422.2
Euthyrox tab. 100 mcg 14 1524.6 0 18.5 25293.11
Dilavask tab. 5 mg 14 492 0 18.5 8162.28
Cardismo tab. 20 mg 14 1973.4 0 18.5 32738.71
Thrombo Aspilets tab. 80 mg 14 448 0 Sub Total 441032.57
Metrix tab. 1 mg 28 1094.85 0 18.5 36327.12
Angioten tab. 50 mg 28 4080 0 18.5 135374.4
Dilavask tab. 10 mg 28 1050 0 18.5 34839
Opineuron kapl. 15 550 0 18.5 9776.25
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18
Reucid tab. 300 mg 28 1000 0 18.5 33180
(%) Pembayaran
Angioten tab. 50 mg 28 4080 0 18.5 135374.4
Angioten tab. 50 mg 28 4080 0 Sub Total 197296.58
Anadium kapl. 14 4248 0 18.5 70474.32
Anadium kapl. 14 4248 0 Sub Total 111932.73
Kalmeco tab. 500 mcg 14 1700 0 18.5 28203
Simvastatin tab. 10 mg (Kim) 14 221.52 0 Sub Total 34272
Esvat tab. 10 mg 28 472.5 0 18.5 15677.55
Reucid tab. 300 mg 28 1000 0 18.5 33180
Dilavask tab. 10 mg 28 1050 0 18.5 34839
Canderin tab. 8 mg 28 4800 0 18.5 159264
Metrix tab. 1 mg 28 1094.85 0 18.5 36327.12
Neuraxon 5000 tab. 14 1237.5 0 18.5 20530.13
Cholestat tab. 20 mg 28 3850 0 18.5 127743
Cholestat tab. 20 mg 28 3850 0 Sub Total 127743
Amitriptyline tab. salut 25 mg (Indo) 28 155.85 0 18.5 5171.1
Vastigo tab. 6 mg 28 495 0 18.5 16424.1
Opineuron kapl. 20 550 0 18.5 13035
Ranitidine tab. 150 mg (Dex) 40 150 0 18.5 7110
Diaversa tab. 3 mg 28 1352 0 18.5 44859.36
(%) Pembayaran
Eclid tab. 50 mg 56 1200 0 18.5 79632
Cholestat tab. 10 mg 28 2200 0 18.5 72996
Cholestat tab. 10 mg 28 2200 0 Sub Total 227349.36
Diltiazem tab. 30 mg (Kim) 28 139.7 0 18.5 4635.25
Simvastatin tab. 10 mg (Kim) 28 221.52 0 Sub Total 11985.37
Levofloxacin tab. 500 mg (Dex) 5 1048.8 0 8 5663.52
Opineuron kapl. 10 550 0 18.5 6517.5
Diaversa tab. 2 mg 28 992 0 18.5 32914.56
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18
Opimox kaps. 500 mg 12 1200 0 18.5 17064
Opineuron kapl. 10 550 0 18.5 6517.5
Neuraxon 5000 tab. 10 1237.5 0 18.5 14664.38
Amlodipine tab. 5 mg (Kim) 28 392.73 0 18.5 13030.78
Angioten tab. 50 mg 28 4080 0 18.5 135374.4
Litorcom tab. 20 mg 28 3622.67 0 18.5 120200.08
Kalmeco tab. 500 mcg 56 1700 0 18.5 112812
Betaone tab. 2,5 mg 28 1404 0 18.5 46584.72
OA Forte kapl. 14 3311 0 18.5 54929.49
OA Forte kapl. 14 3311 0 Sub Total 482931.47
Angioten tab. 50 mg 28 4080 0 18.5 135374.4
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Dextafen tab. 10 770 0 18.5 9124.5
(%) Pembayaran
Dextafen tab. 10 770 0 Sub Total 160823.46
Hi-Bone tab. 20 2550 0 18.5 60435
Tequinol tab. 500 mg 10 5040 0 18.5 59724
Fluzep kapl. 10 562.5 0 18.5 6665.63
Diamicron MR tab. 60 mg 28 4960.12 0 18.5 164576.65
Eclid tab. 50 mg 28 1200 0 18.5 39816
Pionix tab. 15 mg 28 4875.45 0 18.5 161767.58
Esvat tab. 20 mg 28 866.25 0 18.5 28742.18
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Febogrel tab. 75 mg 28 5280 0 18.5 175190.4
Esvat tab. 10 mg 28 472.5 0 18.5 15677.55
Metrix tab. 2 mg 28 1890 0 18.5 62710.2
Metrix tab. 2 mg 28 1890 0 Sub Total 284767.35
Santesar tab. 50 mg 28 3773 0 18.5 125188.14
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Thyrozol tab. 10 mg 14 1326.6 0 18.5 22008.29
Glucophage XR tab. 500 mg 28 1620.5 0 Sub Total 217289.32
Harnal Ocas tab. 0,4 mg 14 9927.75 0 18.5 164701.37
Harnal Ocas tab. 0,4 mg 14 9927.75 0 Sub Total 164701.37
OA Forte kapl. 14 3311 0 18.5 54929.49
Valdix tab. 160 mg 28 4400 0 18.5 145992
Kalmeco tab. 500 mcg 56 1700 0 18.5 112812
(%) Pembayaran
Litorcom tab. 10 mg 12 3622.67 0 18.5 51514.32
Dilavask tab. 10 mg 28 1050 0 18.5 34839
Primadex kapl. 10 279 0 18.5 3306.15
Tequinol tab. 500 mg 10 5040 0 18.5 59724
Diagit tab. 10 687.5 0 18.5 8146.88
Gitas Plus tab. 10 1750 0 18.5 20737.5
Acilaz kaps. 30 mg 10 5200 0 18.5 61620
Flamar tab. 50 mg 10 1320 0 18.5 15642
Acilaz kaps. 30 mg 10 5200 0 18.5 61620
Gitas Plus tab. 10 1750 0 18.5 20737.5
Metrix tab. 1 mg 28 1094.85 0 18.5 36327.12
Evothyl kaps. 300 mg 28 4950 0 18.5 164241
Tenapril tab. 5 mg 28 2250 0 18.5 74655
Tenapril tab. 5 mg 28 2250 0 Sub Total 319949.76
Dilavask tab. 10 mg 28 1050 0 18.5 34839
Diaversa tab. 1 mg 28 585 0 18.5 19410.3
Diaversa tab. 1 mg 28 585 0 Sub Total 54249.3
Kalmeco tab. 500 mcg 20 1700 0 18.5 40290
Kalmeco tab. 500 mcg 20 1700 0 Sub Total 40290
(%) Pembayaran
Opixime tab. 100 mg 8 7560 0 18.5 71668.8
Flamar emulgel 1% 20 gr 1 11840 0 18.5 14030.4
Flamar emulgel 1% 20 gr 1 11840 0 Sub Total 88629.07
Esvat tab. 20 mg 14 866.25 0 18.5 14371.09
Ursolic kaps. 250 mg 14 4611 0 18.5 76496.49
Dilavask tab. 10 mg 14 1050 0 18.5 17419.5
Hemapo prefilled syringe 3000 IU 1 185250 0 18.5 219521.25
Valdix tab. 160 mg 7 4400 0 18.5 36498
Dilavask tab. 10 mg 7 1050 0 18.5 8709.75
Natrium Bikarbonat tab. 500 mg 21 17.37 0 8 393.95
Osfit tab. 500 mg 21 1125 0 18.5 27995.63
Osfit tab. 500 mg 21 1125 0 Sub Total 294315.55
Glucovance 500/5 tab 20 3285.11 0 18.5 77857.2
Nucral susp. 500 mg/5 ml @ 200 ml 1 41687.5 0 Sub Total 206616.34
Letonal tab. 25 mg 14 900 0 18.5 14931
Canderin tab. 16 mg 14 6800 0 18.5 112812
(%) Pembayaran
Betaone tab. 2,5 mg 8 1404 0 18.5 13309.92
Furosemide tab. 40 mg (Kim) 14 93.43 0 18.5 1549.92
Lodem tab. 30 mg 14 1282.5 0 18.5 21276.68
Diaformin XR tab. 500 mg 14 900 0 Sub Total 254458.59
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Fluzep kapl. 10 562.5 0 18.5 6665.63
Fungasol krim 2%, 10 gr 1 14950 0 18.5 17715.75
Gitas Plus tab. 10 1750 0 18.5 20737.5
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Rhinos SR kaps. 10 3600 0 18.5 42660
Prednicort tab. 4 mg 10 1500 0 18.5 17775
Prednicort tab. 4 mg 10 1500 0 Sub Total 76759.56
Betamethasone krim 0,1 %, tube 10 gram (Kim) 1 1842 0 8 1989.36
Rydian tab. 10 mg 10 1900 0 18.5 22515
Rydian tab. 10 mg 10 1900 0 Sub Total 29335.2
Metonate krim 0,05 %, tube 10 gr 1 12750 0 18.5 15108.75
Interhistin tab. 50 mg 15 429 0 18.5 7625.48
Fungasol krim 2%, 10 gr 1 14950 0 18.5 17715.75
Cefat kaps. 500 mg 10 4342.5 0 18.5 51458.63
Cefat kaps. 500 mg 10 4342.5 0 Sub Total 95796.6
Diaversa tab. 3 mg 28 1352 0 18.5 44859.36
Esvat tab. 10 mg 28 472.5 0 18.5 15677.55
(%) Pembayaran
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Fungasol krim 2%, 10 gr 1 14950 0 18.5 17715.75
Betamethasone krim 0,1 %, tube 10 gram (Kim) 1 1842 0 8 1989.36
Betamethasone krim 0,1 %, tube 10 gram (Kim) 1 1842 0 Sub Total 127386.52
Canderin tab. 8 mg 28 4800 0 18.5 159264
Letonal tab. 25 mg 14 900 0 18.5 14931
Letonal tab. 25 mg 14 900 0 Sub Total 174195
Dilavask tab. 5 mg 28 492 0 18.5 16324.56
Angioten tab. 50 mg 28 4080 0 18.5 135374.4
Ciprofloxacin tab. 500 mg (Hex) 10 330 0 8 3564
Rydian tab. 10 mg 5 1900 0 18.5 11257.5
Salbutamol sulfate tab. 2 mg (Kim) 8 76.39 0 Sub Total 178197.26
Risperidone tab. 2 mg (Dex) 28 2055.3 0 18.5 68194.85
Valisanbe tab. 2 mg 28 128 0 18.5 4247.04
Tramifen kapl 15 4200 0 18.5 74655
Neuraxon 5000 tab. 15 1237.5 0 18.5 21996.56
Valisanbe tab. 2 mg 15 128 0 18.5 2275.2
Xytrol ED tts. mata , btl 5 ml 1 23980 0 Sub Total 28416.3
Xytrol ED tts. mata , btl 5 ml 1 23980 0 TOTAL SEBELUM PPN 32939402.77
Xytrol ED tts. mata , btl 5 ml 1 23980 0 TOTAL SETELAH PPN 36233343.05
Total
Nomor Resep Nomor Resep Pembayaran item
118,5 118,5 537795.19 3 1E210200000KU17101530

1Sub Total 1Sub Total 537795.19 3 1E210200000KU17101530
218.5 218.5 51458.63 10 2E210200000KU17101531
218.5 13035 20 2E210200000KU17101531
318.5 318.5 59724 56 3E210200000KU17101532
318.5 161767.58 28 3E210200000KU17101532
418.5 418.5 16353 15 4E210200000KU17101533
418.5 75840 10 4E210200000KU17101533
4Sub Total 4Sub Total 92193 10 4E210200000KU17101533
518.5 518.5 9776.25 15 5E210200000KU17101534
518.5 61620 10 5E210200000KU17101534
518.5 14220 15 5E210200000KU17101534
618.5 618.5 16324.56 28 6E210200000KU17101535
618.5 122766.01 28 6E210200000KU17101535
718.5 718.5 10309.5 15 7E210200000KU17101536
718.5 20595.3 8 7E210200000KU17101536
718.5 30217.5 15 7E210200000KU17101536
818.5 818.5 60100.04 14 8E210200000KU17101528
818.5 56406 28 8E210200000KU17101528
Total
918.5 918.5 40290 20 9E210200000KU17101539
918.5 8562.93 20 9E210200000KU17101539
918.5 17064 20 9E210200000KU17101539
1018.5 1018.5 32914.56 28 10E210200000KU17101529
1018.5 53863.88 56 10E210200000KU17101529
1118.5 1118.5 10902 10 11E210200000KU17101541
1118.5 39235.35 10 11E210200000KU17101541
1118.5 14664.38 10 11E210200000KU17101541
1218.5 1218.5 28440 10 12E210200000KU17101542
1218.5 12798 15 12E210200000KU17101542
1318.5 1318.5 99362.25 20 13E210200000KU17101543
1318.5 11660.4 20 13E210200000KU17101543
1418.5 1418.5 11796.14 15 14E210200000KU17101545
1418.5 61620 10 14E210200000KU17101545
1418.5 3040.63 10 14E210200000KU17101545
158 158 9720 6 15E210200000KU17101537
1618.5 1618.5 619188.57 56 16E210200000KU17101547
1618.5 9266.04 42 16E210200000KU17101547
1618.5 46584.72 28 16E210200000KU17101547
1618.5 28136.64 28 16E210200000KU17101547
1618.5 48864.44 56 16E210200000KU17101547
1618.5 28742.18 28 16E210200000KU17101547
Total
1718.5 1718.5 159264 28 17E210200000KU17101549
1718.5 96770.8 28 17E210200000KU17101549
1718.5 28742.18 28 17E210200000KU17101549
1718.5 28136.64 28 17E210200000KU17101549
1718.5 48864.44 56 17E210200000KU17101549
1718.5 278712 56 17E210200000KU17101549
1818.5 1818.5 41166.9 8 18E210200000KU17101553
1818.5 1470.45 10 18E210200000KU17101553
1818.5 5214 8 18E210200000KU17101553
1818.5 1425.56 4 18E210200000KU17101553
1918.5 1918.5 13035 20 19E210200000KU17101554
1918.5 1470.45 10 19E210200000KU17101554
198 198 2916 20 19E210200000KU17101554
1918.5 1918.5 13509 6 19E210200000KU17101554
1918.5 51458.63 10 19E210200000KU17101554
2018.5 2018.5 17775 10 20E210200000KU17101555
2018.5 42660 10 20E210200000KU17101555
2118.5 2118.5 33274.8 20 21E210200000KU17101557
2118.5 56880 10 21E210200000KU17101557
2118.5 87690.01 20 21E210200000KU17101557
2118.5 8863.8 20 21E210200000KU17101557
2118.5 20530.13 20 21E210200000KU17101557
2218.5 2218.5 30395.25 20 22E210200000KU17101558
2218.5 11660.4 20 22E210200000KU17101558
2218.5 14839.14 20 22E210200000KU17101558
Total
2218.5 49399.69 1 22E210200000KU17101558
2318.5 2318.5 878085 4 23E210200000KU17101560
2418.5 2418.5 6932.23 28 24E210200000KU17101552
2418.5 68194.85 28 24E210200000KU17101552
2518.5 2518.5 51458.63 10 25E210200000KU17101570
2518.5 2962.5 10 25E210200000KU17101570
2518.5 9776.25 15 25E210200000KU17101570
2518.5 1176.36 8 25E210200000KU17101570
258 258 2187 15 25E210200000KU17101570
2518.5 2518.5 11257.5 5 25E210200000KU17101570
2618.5 2618.5 59724 10 26E210200000KU17101571
2618.5 42660 10 26E210200000KU17101571
2618.5 2962.5 10 26E210200000KU17101571
2718.5 2718.5 29364.3 15 27E210200000KU17101572
2718.5 15642 10 27E210200000KU17101572
2818.5 2818.5 3675.06 14 28E210200000KU17101573
2818.5 87595.2 14 28E210200000KU17101573
2818.5 6204.66 14 28E210200000KU17101573
2918.5 2918.5 8162.28 14 29E210200000KU17101574
2918.5 13035 20 29E210200000KU17101574
3018.5 3018.5 51458.63 10 30E210200000GI17091078
3018.5 4151.65 10 30E210200000GI17091078
Total
30Sub Total 30Sub Total 55610.27 10 30E210200000GI17091078
3118.5 3118.5 59724 10 31E210200000KU17101577
3118.5 17064 1 31E210200000KU17101577
3118.5 6665.63 10 31E210200000KU17101577
3218.5 3218.5 15820.55 40 32E210200000KU17101578
3318.5 3318.5 65175 10 33E210200000KU17101576
3318.5 13686.75 10 33E210200000KU17101576
3318.5 2962.5 10 33E210200000KU17101576
3418.5 3418.5 265821.57 28 34E210200000KU17101582
3418.5 61383.01 14 34E210200000KU17101582
3418.5 13272 14 34E210200000KU17101582
3518.5 3518.5 11660.4 20 35E210200000KU17101583
3518.5 32042.4 20 35E210200000KU17101583
3518.5 76811.89 40 35E210200000KU17101583
3518.5 11198.25 20 35E210200000KU17101583
3618.5 3618.5 11660.4 20 36E210200000KU17101584
3618.5 128237.43 40 36E210200000KU17101584
3718.5 3718.5 1983.69 6 37E210200000KU17101585
3718.5 8146.88 10 37E210200000KU17101585
3718.5 12442.5 6 37E210200000KU17101585
3818.5 3818.5 13035 20 38E210200000KU17101586
3818.5 17451.59 20 38E210200000KU17101586
3818.5 20796.75 1 38E210200000KU17101586
Total
3918.5 3918.5 3306.15 10 39E210200000KU17101589
3918.5 20737.5 10 39E210200000KU17101589
3918.5 61620 10 39E210200000KU17101589
3918.5 8146.88 10 39E210200000KU17101589
4018.5 4018.5 21330 15 40E210200000GI17091079
4018.5 2962.5 10 40E210200000GI17091079
4118.5 4118.5 84106.32 28 41E210200000KU17101594
4118.5 80795.82 84 41E210200000KU17101594
4118.5 16324.56 28 41E210200000KU17101594
4118.5 7625.48 15 41E210200000KU17101594
4218.5 4218.5 100369.5 28 42E210200000KU17101595
4218.5 34839 28 42E210200000KU17101595
4218.5 120200.08 28 42E210200000KU17101595
4318.5 4318.5 54929.49 14 43E210200000KU17101596
4418.5 4418.5 97762.5 1 44E210200000KU17101600
4518.5 4518.5 16324.56 28 45E210200000KU17101602
4518.5 6517.5 10 45E210200000KU17101602
4518.5 20796.75 1 45E210200000KU17101602
4618.5 4618.5 113760 20 46E210200000KU17101605
4618.5 33180 20 46E210200000KU17101605
4718.5 4718.5 57318.45 20 47E210200000KU17101606
Total
4718.5 24885 20 47E210200000KU17101606
4718.5 117315 20 47E210200000KU17101606
4718.5 41604.27 20 47E210200000KU17101606
4718.5 13509 15 47E210200000KU17101606
4818.5 4818.5 30110.85 1 48E210200000KU17101607
4918.5 4918.5 15405 10 49E210200000KU17101608
4918.5 9124.5 10 49E210200000KU17101608
4918.5 11784.83 1 49E210200000KU17101608
498 498 194.4 2 49E210200000KU17101608
4918.5 4918.5 16441.88 1 49E210200000KU17101608
4918.5 56880 10 49E210200000KU17101608
5018.5 5018.5 87595.2 14 50E210200000KU17101612
5018.5 2800.89 14 50E210200000KU17101612
5018.5 79632 14 50E210200000KU17101612
5018.5 9954 14 50E210200000KU17101612
5018.5 82120.5 14 50E210200000KU17101612
5118.5 5118.5 1810.46 20 51E210200000KU17101587
5118.5 74655 1 51E210200000KU17101587
5218.5 5218.5 79632 14 52E210200000KU17101617
5318.5 5318.5 41458.41 28 53E210200000KU17101604
5318.5 33180 20 53E210200000KU17101604
5318.5 33180 28 53E210200000KU17101604
5318.5 19552.5 30 53E210200000KU17101604
5318.5 2205.68 15 53E210200000KU17101604
Total
5318.5 33772.5 15 53E210200000KU17101604
5318.5 97762.5 1 53E210200000KU17101604
5418.5 5418.5 159264 28 54E210200000KU17101618
5418.5 15602.9 84 54E210200000KU17101618
5518.5 5518.5 113760 20 55E210200000KU17101619
5518.5 56880 20 55E210200000KU17101619
5518.5 125387.72 40 55E210200000KU17101619
5518.5 3419.91 20 55E210200000KU17101619
5518.5 7429.95 40 55E210200000KU17101619
5618.5 5618.5 16324.56 28 56E210200000KU17101620
5618.5 52258.5 28 56E210200000KU17101620
5618.5 20530.13 14 56E210200000KU17101620
5718.5 5718.5 16324.56 28 57E210200000KU17101621
5718.5 74655 28 57E210200000KU17101621
5718.5 41166.9 8 57E210200000KU17101621
5718.5 13035 20 57E210200000KU17101621
5718.5 1470.45 10 57E210200000KU17101621
5818.5 5818.5 358530.13 2 58E210200000KU17101623
5818.5 29613.15 20 58E210200000KU17101623
5818.5 38474.2 40 58E210200000KU17101623
5818.5 10617.6 20 58E210200000KU17101623
5818.5 40290 20 58E210200000KU17101623
5918.5 5918.5 7910.28 20 59E210200000KU17101624
Total
6018.5 6018.5 92430 15 60E210200000KU17101626
6018.5 4560.95 15 60E210200000KU17101626
6018.5 6517.5 10 60E210200000KU17101626
6118.5 6118.5 42553.35 28 61E210200000KU17101628
6118.5 29862 28 61E210200000KU17101628
6118.5 31355.1 14 61E210200000KU17101628
618 618 60480 14 61E210200000KU17101628
6218.5 6218.5 13691.73 10 62E210200000GI17091081
6218.5 4151.65 10 62E210200000GI17091081
6318.5 6318.5 19237.1 20 63E210200000KU17101629
6318.5 17064 12 63E210200000KU17101629
6318.5 1470.45 10 63E210200000KU17101629
6318.5 5214 8 63E210200000KU17101629
6318.5 5865.75 10 63E210200000KU17101629
6318.5 9480 10 63E210200000KU17101629
6418.5 6418.5 11660.4 20 64E210200000KU17101631
6418.5 125136 20 64E210200000KU17101631
6418.5 11198.25 20 64E210200000KU17101631
6518.5 6518.5 75840 10 65E210200000KU17101636
6518.5 20796.75 1 65E210200000KU17101636
6618.5 6618.5 23107.5 15 66E210200000GI17091082
6618.5 2962.5 10 66E210200000GI17091082
6618.5 17775 1 66E210200000GI17091082
66Sub Total 66Sub Total 43845 1 66E210200000GI17091082
Total
6718.5 6718.5 7432.32 14 67E210200000KU17101640
6718.5 61383.01 14 67E210200000KU17101640
6718.5 14931 14 67E210200000KU17101640
6718.5 8162.28 14 67E210200000KU17101640
6718.5 14931 14 67E210200000KU17101640
6718.5 18163.56 14 67E210200000KU17101640
6818.5 6818.5 82120.5 14 68E210200000KU17101642
6818.5 3675.06 14 68E210200000KU17101642
6918.5 6918.5 48525.75 10 69E210200000KU17101643
7018.5 7018.5 50338.8 10 70E210200000KU17101633
7018.5 10309.5 15 70E210200000KU17101633
7018.5 2393.94 14 70E210200000KU17101633
7018.5 2370 10 70E210200000KU17101633
7118.5 7118.5 30110.85 1 71E210200000KU17101646
7218.5 7218.5 2962.5 10 72E210200000KU17101647
7318.5 7318.5 35834.4 6 73E210200000KU17101648
7318.5 28440 10 73E210200000KU17101648
7318.5 20737.5 10 73E210200000KU17101648
7318.5 8725.79 10 73E210200000KU17101648
7418.5 7418.5 61383.01 14 74E210200000KU17101639
7418.5 79632 14 74E210200000KU17101639
7418.5 37286.03 42 74E210200000KU17101639
7418.5 48525.75 10 74E210200000KU17101639
Total
7418.5 30955.65 20 74E210200000KU17101639
7518.5 7518.5 23463 15 75E210200000KU17101649
7518.5 39235.35 10 75E210200000KU17101649
7518.5 20796.75 1 75E210200000KU17101649
7618.5 7618.5 42053.16 14 76E210200000KU17101650
7618.5 5200.97 28 76E210200000KU17101650
7618.5 3675.06 14 76E210200000KU17101650
7618.5 19908 14 76E210200000KU17101650
7718.5 7718.5 99362.25 20 77E210200000KU17101651
7718.5 2625.04 10 77E210200000KU17101651
7718.5 265802.91 30 77E210200000KU17101651
7818.5 7818.5 7419.57 10 78E210200000KU17101652
7818.5 22515 10 78E210200000KU17101652
7818.5 16465.58 1 78E210200000KU17101652
7918.5 7918.5 48525.75 10 79E210200000KU17101654
8018.5 8018.5 117315 20 80E210200000KU17101658
8018.5 23700 20 80E210200000KU17101658
8118.5 8118.5 358530.13 2 81E210200000KU17101644
8118.5 3675.06 14 81E210200000KU17101644
8118.5 8162.28 14 81E210200000KU17101644
8118.5 2600.48 14 81E210200000KU17101644
8218.5 8218.5 439042.5 2 82E210200000KU17101659
Total
8218.5 15642 10 82E210200000KU17101659
8318.5 8318.5 13746 20 83E210200000KU17101637
8318.5 20796.75 1 83E210200000KU17101637
8418.5 8418.5 51458.63 10 84E210200000KU17101622
8418.5 13746 20 84E210200000KU17101622
8418.5 13035 20 84E210200000KU17101622
8418.5 1470.45 10 84E210200000KU17101622
8518.5 8518.5 16324.56 28 85E210200000KU17101661
8518.5 15405 1 85E210200000KU17101661
8618.5 8618.5 36327.12 28 86E210200000KU17101662
8718.5 8718.5 201671.05 1 87E210200000KU17101663
8718.5 358530.13 2 87E210200000KU17101663
8818.5 8818.5 3306.15 10 88E210200000KU17101667
8818.5 16590 8 88E210200000KU17101667
8818.5 6517.5 8 88E210200000KU17101667
8818.5 61620 10 88E210200000KU17101667
8918.5 8918.5 13035 20 89E210200000KU17101657
8918.5 20796.75 1 89E210200000KU17101657
9018.5 9018.5 9776.25 15 90E210200000KU17101670
9018.5 724.19 8 90E210200000KU17101670
908 908 2187 15 90E210200000KU17101670
9018.5 9018.5 11257.5 5 90E210200000KU17101670
Total
9018.5 59724 10 90E210200000KU17101670
9118.5 9118.5 17775 1 91E210200000KU17101673
9218.5 9218.5 42660 40 92E210200000KU17101674
9218.5 60790.5 40 92E210200000KU17101674
9218.5 44793 20 92E210200000KU17101674
9218.5 117315 20 92E210200000KU17101674
928 928 2851.2 8 92E210200000KU17101674
928 1914.84 1 92E210200000KU17101674
9218.5 9218.5 17715.75 1 92E210200000KU17101674
9318.5 9318.5 65175 10 93E210200000KU17101675
9318.5 13686.75 10 93E210200000KU17101675
9318.5 2962.5 10 93E210200000KU17101675
9418.5 9418.5 101172.46 56 94E210200000KU17101676
9418.5 28742.18 28 94E210200000KU17101676
9418.5 33180 28 94E210200000KU17101676
9518.5 9518.5 49399.69 1 95E210200000KU17101677
9518.5 20737.5 10 95E210200000KU17101677
9518.5 15405 1 95E210200000KU17101677
9518.5 17775 1 95E210200000KU17101677
9618.5 9618.5 50338.8 10 96E210200000KU17101680
9718.5 9718.5 17419.5 14 97E210200000KU17101682
9718.5 79632 14 97E210200000KU17101682
9718.5 29862 28 97E210200000KU17101682
Total
9718.5 17715.75 1 97E210200000KU17101682
9818.5 9818.5 31355.1 14 98E210200000KU17101683
9818.5 80883.79 14 98E210200000KU17101683
9818.5 8162.28 14 98E210200000KU17101683
988 988 2138.4 6 98E210200000KU17101683
9818.5 9818.5 17064 6 98E210200000KU17101683
9818.5 12442.5 6 98E210200000KU17101683
9918.5 9918.5 7432.32 14 99E210200000KU17101685
9918.5 29032.5 14 99E210200000KU17101685
9918.5 37327.5 14 99E210200000KU17101685
9918.5 14931 14 99E210200000KU17101685
9918.5 14371.09 14 99E210200000KU17101685
9918.5 9954 14 99E210200000KU17101685
10018.5 10018.5 7838.78 14 100E210200000KU17101686
10118.5 10118.5 49770 10 101E210200000KU17101679
10118.5 106383.38 2 101E210200000KU17101679
10218.5 10218.5 358530.13 2 102E210200000KU17101688
10218.5 21330 20 102E210200000KU17101688
10218.5 113760 20 102E210200000KU17101688
10218.5 20530.13 20 102E210200000KU17101688
10318.5 10318.5 14664.38 10 103E210200000KU17101687
10318.5 2940.91 20 103E210200000KU17101687
10318.5 3563.89 10 103E210200000KU17101687
10318.5 905.23 10 103E210200000KU17101687
Total
10318.5 38820.6 8 103E210200000KU17101687
1038 1038 5663.52 5 103E210200000KU17101687
10418.5 10418.5 59724 10 104E210200000KU17101694
10418.5 1470.45 10 104E210200000KU17101694
10418.5 6665.63 10 104E210200000KU17101694
10518.5 10518.5 41458.41 28 105E210200000KU17101695
10518.5 46584.72 28 105E210200000KU17101695
1058 1058 1575.81 84 105E210200000KU17101695
10518.5 10518.5 120200.08 28 105E210200000KU17101695
10618.5 10618.5 17419.5 14 106E210200000KU17101693
10618.5 20729.21 14 106E210200000KU17101693
1068 1068 8316 14 106E210200000KU17101693
10618.5 10618.5 20796.75 1 106E210200000KU17101693
10718.5 10718.5 24885 20 107E210200000KU17101698
10718.5 29613.15 20 107E210200000KU17101698
1078 1078 86400 20 107E210200000KU17101698
10718.5 10718.5 6665.63 10 107E210200000KU17101698
10818.5 10818.5 91185.75 60 108E210200000KU17101701
10818.5 11198.25 20 108E210200000KU17101701
10918.5 10918.5 272322.53 42 109E210200000KU17101691
10918.5 122770.15 42 109E210200000KU17101691
11018.5 11018.5 18012 8 110E210200000KU17101690
11018.5 12449.61 1 110E210200000KU17101690
Total
11018.5 9124.5 10 110E210200000KU17101690
11018.5 9006 10 110E210200000KU17101690
1108 1108 2916 30 110E210200000KU17101690
11018.5 11018.5 29625 1 110E210200000KU17101690
11118.5 11118.5 14371.09 14 111E210200000KU17101692
11118.5 46584.72 28 111E210200000KU17101692
11118.5 34839 28 111E210200000KU17101692
11218.5 11218.5 41166.9 8 112E210200000KU17101699
1128 1128 1914.84 1 112E210200000KU17101699
11218.5 11218.5 2370 8 112E210200000KU17101699
11318.5 11318.5 24885 20 113E210200000KU17101705
11318.5 32598.27 20 113E210200000KU17101705
11318.5 11731.5 20 113E210200000KU17101705
11318.5 15728.18 20 113E210200000KU17101705
11318.5 30110.85 1 113E210200000KU17101705
11418.5 11418.5 16465.58 1 114E210200000KU17101706
11518.5 11518.5 33772.5 15 115E210200000KU17101707
11518.5 19996.88 15 115E210200000KU17101707
11618.5 11618.5 9776.25 15 116E210200000KU17101708
11718.5 11718.5 34839 28 117E210200000KU17101709
11718.5 6177.36 28 117E210200000KU17101709
11718.5 33180 28 117E210200000KU17101709
11718.5 14864.64 28 117E210200000KU17101709
Total
11718.5 62710.2 28 117E210200000KU17101709
11718.5 150969 28 117E210200000KU17101709
11818.5 11818.5 14864.64 28 118E210200000KU17101710
11818.5 139107.15 28 118E210200000KU17101710
11818.5 16324.56 28 118E210200000KU17101710
11818.5 19908 28 118E210200000KU17101710
11918.5 11918.5 2317.62 14 119E210200000KU17101711
11918.5 1764.57 14 119E210200000KU17101711
11918.5 282332.41 1 119E210200000KU17101711
12018.5 12018.5 13030.78 28 120E210200000KU17101712
12018.5 56406 20 120E210200000KU17101712
12118.5 12118.5 28807.35 1 121E210200000KU17101713
12118.5 20737.5 10 121E210200000KU17101713
12218.5 12218.5 16353 15 122E210200000KU17101716
12318.5 12318.5 60333.27 28 123E210200000KU17101717
12318.5 79632 28 123E210200000KU17101717
12318.5 19410.3 28 123E210200000KU17101717
12318.5 14864.64 28 123E210200000KU17101717
12318.5 125188.14 28 123E210200000KU17101717
12318.5 15677.55 28 123E210200000KU17101717
12418.5 12418.5 10617.6 20 124E210200000KU17101718
12418.5 87690.01 20 124E210200000KU17101718
12418.5 21330 20 124E210200000KU17101718
Total
12418.5 33274.8 20 124E210200000KU17101718
1248 1248 86400 20 124E210200000KU17101718
12518.5 12518.5 19410.3 28 125E210200000KU17101720
12618.5 12618.5 175190.4 28 126E210200000KU17101721
12618.5 14864.64 28 126E210200000KU17101721
12618.5 60333.27 28 126E210200000KU17101721
12618.5 135374.4 28 126E210200000KU17101721
12718.5 12718.5 34839 28 127E210200000KU17101722
12718.5 24857.35 28 127E210200000KU17101722
12718.5 29862 28 127E210200000KU17101722
12718.5 28742.18 28 127E210200000KU17101722
12718.5 62710.2 28 127E210200000KU17101722
12818.5 12818.5 152992.98 28 128E210200000KU17101723
12818.5 180400.49 14 128E210200000KU17101723
12918.5 12918.5 59724 56 129E210200000KU17101724
12918.5 62710.2 28 129E210200000KU17101724
12918.5 65175 10 129E210200000KU17101724
12918.5 13686.75 10 129E210200000KU17101724
12918.5 2962.5 10 129E210200000KU17101724
13018.5 13018.5 16324.56 28 130E210200000KU17101725
13018.5 15677.55 28 130E210200000KU17101725
13018.5 28416.3 1 130E210200000KU17101725
13118.5 13118.5 159264 28 131E210200000KU17101726
Total
13118.5 34839 28 131E210200000KU17101726
13118.5 28742.18 28 131E210200000KU17101726
13218.5 13218.5 29862 28 132E210200000KU17101727
13218.5 62710.2 28 132E210200000KU17101727
13218.5 159264 28 132E210200000KU17101727
13318.5 13318.5 34839 28 133E210200000KU17101729
13318.5 225624 28 133E210200000KU17101729
13318.5 28742.18 28 133E210200000KU17101729
13418.5 13418.5 135374.4 28 134E210200000KU17101730
13418.5 34839 28 134E210200000KU17101730
13418.5 57422.14 14 134E210200000KU17101730
13418.5 20796.75 1 134E210200000KU17101730
13418.5 6517.5 10 134E210200000KU17101730
13418.5 2058.64 14 134E210200000KU17101730
13518.5 13518.5 49770 10 135E210200000KU17101732
13518.5 20145 10 135E210200000KU17101732
13518.5 14664.38 10 135E210200000KU17101732
13618.5 13618.5 16324.56 28 136E210200000KU17101728
13618.5 19410.3 28 136E210200000KU17101728
13618.5 70065.21 14 136E210200000KU17101728
13718.5 13718.5 10048.8 10 137E210200000KU17101734
13818.5 13818.5 537795.19 3 138E210200000KU17101735
1388 1388 178476.48 28 138E210200000KU17101735
Total
13918.5 13918.5 22515 10 139E210200000KU17101736
14018.5 14018.5 6517.5 10 140E210200000KU17101738
14118.5 14118.5 7287.75 15 141E210200000KU17101731
14118.5 16324.56 28 141E210200000KU17101731
14118.5 60100.04 14 141E210200000KU17101731
14118.5 59724 56 141E210200000KU17101731
14118.5 8234.55 56 141E210200000KU17101731
14118.5 2534.65 28 141E210200000KU17101731
14218.5 14218.5 537795.19 3 142E210200000KU17101739
14318.5 14318.5 41458.41 28 143E210200000KU17101740
14318.5 16324.56 28 143E210200000KU17101740
14318.5 46584.72 28 143E210200000KU17101740
14318.5 15677.55 28 143E210200000KU17101740
14418.5 14418.5 164241 28 144E210200000KU17101744
14418.5 33180 28 144E210200000KU17101744
14418.5 29625 1 144E210200000KU17101744
14418.5 28807.35 1 144E210200000KU17101744
14518.5 14518.5 56880 20 145E210200000KU17101746
14518.5 80580 10 145E210200000KU17101746
14518.5 125136 20 145E210200000KU17101746
14518.5 30110.85 1 145E210200000KU17101746
14618.5 14618.5 49770 10 146E210200000KU17101748
Total
14618.5 14664.38 10 146E210200000KU17101748
14618.5 38820.6 8 146E210200000KU17101748
14718.5 14718.5 179265.06 1 147E210200000KU17101749
14718.5 23292.36 14 147E210200000KU17101749
14718.5 8162.28 14 147E210200000KU17101749
14718.5 43306.34 14 147E210200000KU17101749
1478 1478 89238.24 14 147E210200000KU17101749
14818.5 14818.5 132901.45 15 148E210200000KU17101751
14818.5 1464.82 14 148E210200000KU17101751
14818.5 1457.85 7 148E210200000KU17101751
14818.5 7034.16 7 148E210200000KU17101751
14918.5 14918.5 31758 1 149E210200000KU17101752
15018.5 15018.5 59724 10 150E210200000KU17101754
15018.5 2962.5 10 150E210200000KU17101754
15018.5 13035 20 150E210200000KU17101754
15018.5 1470.45 10 150E210200000KU17101754
15018.5 13509 6 150E210200000KU17101754
15018.5 1810.46 20 150E210200000KU17101754
15018.5 74655 1 150E210200000KU17101754
15018.5 17451.59 20 150E210200000KU17101754
15118.5 15118.5 16324.56 28 151E210200000KU17101758
15118.5 79632 28 151E210200000KU17101758
15118.5 42553.35 28 151E210200000KU17101758
15118.5 84106.32 28 151E210200000KU17101758
15118.5 4787.87 28 151E210200000KU17101758
Total
15118.5 20774.8 28 151E210200000KU17101758
15218.5 15218.5 22148.77 56 152E210200000KU17101759
15218.5 32848.2 56 152E210200000KU17101759
15218.5 127660.05 84 152E210200000KU17101759
1528 1528 120960 28 152E210200000KU17101759
15318.5 15318.5 17419.5 14 153E210200000KU17101760
15318.5 41458.41 28 153E210200000KU17101760
15318.5 63830.03 42 153E210200000KU17101760
15318.5 19908 28 153E210200000KU17101760
15318.5 7350.12 28 153E210200000KU17101760
15318.5 164241 28 153E210200000KU17101760
15418.5 15418.5 16324.56 28 154E210200000KU17101761
15418.5 79632 28 154E210200000KU17101761
15418.5 59724 56 154E210200000KU17101761
15418.5 97544.22 28 154E210200000KU17101761
15518.5 15518.5 2962.5 10 155E210200000KU17101763
15518.5 9776.25 15 155E210200000KU17101763
15518.5 1176.36 8 155E210200000KU17101763
15518.5 11257.5 5 155E210200000KU17101763
15518.5 724.19 8 155E210200000KU17101763
15518.5 59724 10 155E210200000KU17101763
15618.5 15618.5 5601.78 28 156E210200000KU17101767
15618.5 79632 28 156E210200000KU17101767
15618.5 99540 28 156E210200000KU17101767
15618.5 28742.18 28 156E210200000KU17101767
Total
15618.5 24432.22 28 156E210200000KU17101767
15618.5 45637.58 28 156E210200000KU17101767
15618.5 82031.63 20 156E210200000KU17101767
15718.5 15718.5 30110.85 1 157E210200000KU17101768
15818.5 15818.5 164241 28 158E210200000KU17101750
15818.5 40290 20 158E210200000KU17101750
15918.5 15918.5 159264 28 159E210200000KU17101770
15918.5 60435 20 159E210200000KU17101770
15918.5 10265.06 10 159E210200000KU17101770
15918.5 11850 10 159E210200000KU17101770
16018.5 16018.5 16324.56 28 160E210200000KU17101772
16018.5 51458.63 10 160E210200000KU17101772
16018.5 4411.36 30 160E210200000KU17101772
16018.5 1357.85 15 160E210200000KU17101772
16018.5 1895.64 2 160E210200000KU17101772
16118.5 16118.5 78210 12 161E210200000KU17101773
16118.5 6665.63 10 161E210200000KU17101773
16118.5 1764.55 12 161E210200000KU17101773
16218.5 16218.5 3306.15 10 162E210200000KU17101774
16218.5 20737.5 10 162E210200000KU17101774
16218.5 61620 10 162E210200000KU17101774
16218.5 7864.09 10 162E210200000KU17101774
16318.5 16318.5 152992.98 28 163E210200000KU17101775
Total
16318.5 4787.87 28 163E210200000KU17101775
16318.5 127743 28 163E210200000KU17101775
16418.5 16418.5 4053.6 28 164E210200000KU17101765
16418.5 9871.05 28 164E210200000KU17101765
16518.5 16518.5 55955.88 28 165E210200000KU17101776
16518.5 107536.65 56 165E210200000KU17101776
16518.5 16324.56 28 165E210200000KU17101776
16618.5 16618.5 100369.5 28 166E210200000KU17101766
16618.5 15677.55 28 166E210200000KU17101766
16618.5 6422.2 15 166E210200000KU17101766
16618.5 16465.58 1 166E210200000KU17101766
16718.5 16718.5 3675.06 14 167E210200000KU17101778
16718.5 25293.11 14 167E210200000KU17101778
16718.5 358530.13 2 167E210200000KU17101778
16718.5 5200.97 28 167E210200000KU17101778
16718.5 8162.28 14 167E210200000KU17101778
16718.5 32738.71 14 167E210200000KU17101778
16718.5 7432.32 14 167E210200000KU17101778
16818.5 16818.5 36327.12 28 168E210200000KU17101771
16818.5 135374.4 28 168E210200000KU17101771
16818.5 34839 28 168E210200000KU17101771
16818.5 9776.25 15 168E210200000KU17101771
16918.5 16918.5 28742.18 28 169E210200000KU17101783
16918.5 33180 28 169E210200000KU17101783
Total
16918.5 135374.4 28 169E210200000KU17101783
17018.5 17018.5 41458.41 28 170E210200000KU17101755
17018.5 70474.32 14 170E210200000KU17101755
17118.5 17118.5 28203 14 171E210200000KU17101788
17118.5 2393.94 14 171E210200000KU17101788
17118.5 3675.06 14 171E210200000KU17101788
17218.5 17218.5 15677.55 28 172E210200000KU17101785
17218.5 33180 28 172E210200000KU17101785
17218.5 34839 28 172E210200000KU17101785
17218.5 159264 28 172E210200000KU17101785
17318.5 17318.5 36327.12 28 173E210200000KU17101790
17318.5 29862 28 173E210200000KU17101790
17318.5 3675.06 14 173E210200000KU17101790
17318.5 20530.13 14 173E210200000KU17101790
17418.5 17418.5 127743 28 174E210200000KU17101792
17518.5 17518.5 5171.1 28 175E210200000KU17101794
17518.5 16424.1 28 175E210200000KU17101794
17518.5 13035 20 175E210200000KU17101794
17518.5 33180 20 175E210200000KU17101794
17518.5 7110 40 175E210200000KU17101794
17518.5 7864.09 10 175E210200000KU17101794
17618.5 17618.5 44859.36 28 176E210200000KU17101795
17618.5 29862 28 176E210200000KU17101795
Total
17618.5 79632 56 176E210200000KU17101795
17618.5 72996 28 176E210200000KU17101795
17718.5 17718.5 4635.25 28 177E210200000KU17101796
17718.5 7350.12 28 177E210200000KU17101796
1788 1788 5663.52 5 178E210200000KU17101797
17818.5 17818.5 2205.68 15 178E210200000KU17101797
17818.5 6517.5 10 178E210200000KU17101797
17918.5 17918.5 32914.56 28 179E210200000KU17101799
17918.5 59724 56 179E210200000KU17101799
17918.5 28742.18 28 179E210200000KU17101799
17918.5 17064 12 179E210200000KU17101799
17918.5 6517.5 10 179E210200000KU17101799
17918.5 1470.45 10 179E210200000KU17101799
17918.5 5214 8 179E210200000KU17101799
18018.5 18018.5 14664.38 10 180E210200000KU17101800
18118.5 18118.5 13030.78 28 181E210200000KU17101801
18118.5 135374.4 28 181E210200000KU17101801
18118.5 120200.08 28 181E210200000KU17101801
18118.5 112812 56 181E210200000KU17101801
18118.5 46584.72 28 181E210200000KU17101801
18118.5 54929.49 14 181E210200000KU17101801
18218.5 18218.5 135374.4 28 182E210200000KU17101805
18218.5 16324.56 28 182E210200000KU17101805
18218.5 9124.5 10 182E210200000KU17101805
Total
18318.5 18318.5 14839.14 20 183E210200000KU17101806
18318.5 60435 20 183E210200000KU17101806
18318.5 59724 10 183E210200000KU17101806
18318.5 6517.5 10 183E210200000KU17101806
18318.5 6665.63 10 183E210200000KU17101806
18418.5 18418.5 164576.65 28 184E210200000KU17101784
18418.5 39816 28 184E210200000KU17101784
18418.5 161767.58 28 184E210200000KU17101784
18418.5 28742.18 28 184E210200000KU17101784
18518.5 18518.5 16324.56 28 185E210200000KU17101798
18518.5 14864.64 28 185E210200000KU17101798
18518.5 175190.4 28 185E210200000KU17101798
18518.5 15677.55 28 185E210200000KU17101798
18518.5 62710.2 28 185E210200000KU17101798
18618.5 18618.5 125188.14 28 186E210200000KU17101779
18618.5 16324.56 28 186E210200000KU17101779
18618.5 22008.29 14 186E210200000KU17101779
18618.5 53768.32 28 186E210200000KU17101779
18718.5 18718.5 164701.37 14 187E210200000KU17101808
18818.5 18818.5 107536.65 56 188E210200000KU17101803
18818.5 54929.49 14 188E210200000KU17101803
18818.5 145992 28 188E210200000KU17101803
18818.5 14864.64 28 188E210200000KU17101803
18818.5 112812 56 188E210200000KU17101803
Total
18818.5 51514.32 12 188E210200000KU17101803
18818.5 34839 28 188E210200000KU17101803
18918.5 18918.5 3306.15 10 189E210200000KU17101810
18918.5 59724 10 189E210200000KU17101810
18918.5 15405 1 189E210200000KU17101810
18918.5 8146.88 10 189E210200000KU17101810
18918.5 20737.5 10 189E210200000KU17101810
19018.5 19018.5 15405 1 190E210200000KU17101741
19018.5 61620 10 190E210200000KU17101741
19018.5 15642 10 190E210200000KU17101741
19018.5 20796.75 1 190E210200000KU17101741
19118.5 19118.5 61620 10 191E210200000KU17101813
19118.5 20737.5 10 191E210200000KU17101813
19118.5 7864.09 10 191E210200000KU17101813
19218.5 19218.5 36327.12 28 192E210200000KU17101777
19218.5 29862 28 192E210200000KU17101777
19218.5 164241 28 192E210200000KU17101777
19218.5 14864.64 28 192E210200000KU17101777
19218.5 74655 28 192E210200000KU17101777
19318.5 19318.5 34839 28 193E210200000KU17101815
19318.5 19410.3 28 193E210200000KU17101815
19418.5 19418.5 40290 20 194E210200000KU17101819
19518.5 19518.5 10401.93 56 195E210200000KU17101820
Total
19618.5 19618.5 71668.8 8 196E210200000KU17101804
19618.5 2205.68 15 196E210200000KU17101804
19618.5 724.19 8 196E210200000KU17101804
19618.5 14030.4 1 196E210200000KU17101804
19718.5 19718.5 7432.32 14 197E210200000KU17101823
19718.5 14371.09 14 197E210200000KU17101823
19718.5 76496.49 14 197E210200000KU17101823
19718.5 2393.94 14 197E210200000KU17101823
19718.5 17419.5 14 197E210200000KU17101823
19818.5 19818.5 219521.25 1 198E210200000KU17101824
19818.5 36498 7 198E210200000KU17101824
19818.5 8709.75 7 198E210200000KU17101824
19818.5 1196.97 7 198E210200000KU17101824
1988 1988 393.95 21 198E210200000KU17101824
19818.5 19818.5 27995.63 21 198E210200000KU17101824
19918.5 19918.5 21330 20 199E210200000KU17101814
19918.5 77857.2 20 199E210200000KU17101814
19918.5 29613.15 20 199E210200000KU17101814
19918.5 28416.3 1 199E210200000KU17101814
19918.5 49399.69 1 199E210200000KU17101814
20018.5 20018.5 7432.32 14 200E210200000KU17101829
20018.5 61383.01 14 200E210200000KU17101829
20018.5 14931 14 200E210200000KU17101829
20018.5 112812 14 200E210200000KU17101829
20018.5 4438.81 5 200E210200000KU17101829
Total
20018.5 13309.92 8 200E210200000KU17101829
20018.5 1549.92 14 200E210200000KU17101829
20018.5 2393.94 14 200E210200000KU17101829
20018.5 21276.68 14 200E210200000KU17101829
20018.5 14931 14 200E210200000KU17101829
20118.5 20118.5 16324.56 28 201E210200000KU17101830
20118.5 1470.45 10 201E210200000KU17101830
20118.5 6665.63 10 201E210200000KU17101830
20118.5 17715.75 1 201E210200000KU17101830
20118.5 20737.5 10 201E210200000KU17101830
20218.5 20218.5 16324.56 28 202E210200000KU17101831
20218.5 42660 10 202E210200000KU17101831
20218.5 17775 10 202E210200000KU17101831
2038 2038 2916 30 203E210200000KU17101762
2038 1914.84 1 203E210200000KU17101762
2038 1989.36 1 203E210200000KU17101762
20318.5 20318.5 22515 10 203E210200000KU17101762
20418.5 20418.5 15108.75 1 204E210200000KU17101757
20418.5 7625.48 15 204E210200000KU17101757
2048 2048 3888 40 204E210200000KU17101757
20418.5 20418.5 17715.75 1 204E210200000KU17101757
20418.5 51458.63 10 204E210200000KU17101757
20518.5 20518.5 44859.36 28 205E210200000KU17101756
20518.5 15677.55 28 205E210200000KU17101756
20518.5 26931.94 28 205E210200000KU17101756
Total
20518.5 16324.56 28 205E210200000KU17101756
2058 2058 3888 40 205E210200000KU17101756
20518.5 20518.5 17715.75 1 205E210200000KU17101756
2058 2058 1989.36 1 205E210200000KU17101756
20618.5 20618.5 159264 28 206E210200000KU17101719
20618.5 14931 14 206E210200000KU17101719
20718.5 20718.5 16324.56 28 207E210200000KU17101715
20718.5 135374.4 28 207E210200000KU17101715
2078 2078 3564 10 207E210200000KU17101715
20718.5 20718.5 9776.25 15 207E210200000KU17101715
20718.5 1176.36 8 207E210200000KU17101715
20718.5 11257.5 5 207E210200000KU17101715
20718.5 724.19 8 207E210200000KU17101715
20818.5 20818.5 68194.85 28 208E210200000KU17101832
20818.5 4247.04 28 208E210200000KU17101832
20918.5 20918.5 74655 15 209E210200000KU17101828
20918.5 21996.56 15 209E210200000KU17101828
20918.5 2275.2 15 209E210200000KU17101828
21018.5 21018.5 28416.3 1 210E210200000KU17101826
210TOTAL SEBELUM PPN 210TOTAL SEBELUM PPN 32939402.77 1 210E210200000KU17101826
210TOTAL SETELAH PPN 210TOTAL SETELAH PPN 36233343.05 1 210E210200000KU17101826
REKAPITULASI TAGIHAN APOTIK (RJTP) PENSIUN TELKOM
NAMA MITRA : TELKOM
PESERTA : TF 6
PERIODE : 29 - 31 Mei 2017
Nama Band
NO Nomor Resep NIK Loker NIKES Nama Pasien Tanggal Masuk Tanggal Keluar
Pegawai Posisi
1 E210200000KU17101530 400689 SOEHARDI BC.TT 29-05-2017 29-05-2017

2 E210200000KU17101531 400689 SOEHARDI BC.TT 29-05-2017 29-05-2017
3 E210200000KU17101532 590396 MUHAMMAD YAHYA 29-05-2017 29-05-2017
4 E210200000KU17101533 550238 ASRO SUGIHARTO 29-05-2017 29-05-2017
5 E210200000KU17101534 550238.1 SULASIH 29-05-2017 29-05-2017
6 E210200000KU17101535 540961 PURBONO 29-05-2017 29-05-2017
7 E210200000KU17101536 620063.1 LILIK SURIYAH 29-05-2017 29-05-2017
8 E210200000KU17101528 591448 AGUNG HARYANTO SUMARGO ADIL
29-05-2017 29-05-2017
9 E210200000KU17101539 340553 DJUNAEDI BIN DIDI 29-05-2017 29-05-2017
10 E210200000KU17101529 591494 ENDANG PURWATI 29-05-2017 29-05-2017
11 E210200000KU17101541 551531.1 YULI ARTINI 29-05-2017 29-05-2017
12 E210200000KU17101542 610943.1 SRI SULASTIKA SARI 29-05-2017 29-05-2017
13 E210200000KU17101543 610943.1 SRI SULASTIKA SARI 29-05-2017 29-05-2017
14 E210200000KU17101545 610943.104 RICKY HARDIAN 29-05-2017 29-05-2017
15 E210200000KU17101537 540961 PURBONO 29-05-2017 29-05-2017
16 E210200000KU17101547 421398 DIAH ESTHININGRUM 29-05-2017 29-05-2017
17 E210200000KU17101549 421398.1 K. I. MAHMUD 29-05-2017 29-05-2017
18 E210200000KU17101553 560309 SUDIRMAN SYARIF 29-05-2017 29-05-2017
19 E210200000KU17101554 490248.1 TOTO SULAEMAN 29-05-2017 29-05-2017
Nama Band
Pegawai Posisi
20 E210200000KU17101555 490248 SUMINI 29-05-2017 29-05-2017

21 E210200000KU17101557 470748 NURMAN BURHAN, BCTT. 29-05-2017 29-05-2017
22 E210200000KU17101558 470748.1 LIA NURLAELA 29-05-2017 29-05-2017
23 E210200000KU17101560 510745 ENTANG MUCHTAR 29-05-2017 29-05-2017
24 E210200000KU17101552 520382 YOZEF THEEDENS 29-05-2017 29-05-2017
25 E210200000KU17101570 540264 NINIEK RUSMINIWATI 29-05-2017 29-05-2017
26 E210200000KU17101571 540264.1 BUDIONO RUSSALI 29-05-2017 29-05-2017
27 E210200000KU17101572 540492 RUSMIJANTO 29-05-2017 29-05-2017
28 E210200000KU17101573 540364 SLAMET BUDI RISJANTO 29-05-2017 29-05-2017
29 E210200000KU17101574 570124 HERRY SUARDI 29-05-2017 29-05-2017
30 E210200000GI17091078 580763 DULIL AMIN 29-05-2017 29-05-2017
31 E210200000KU17101577 600223 SUMARTONO 29-05-2017 29-05-2017
32 E210200000KU17101578 541714.1 HARTATI 29-05-2017 29-05-2017
33 E210200000KU17101576 551611.1 DARMINI 29-05-2017 29-05-2017
34 E210200000KU17101582 570107 MARSINTA LUMBAN GAOL 29-05-2017 29-05-2017
35 E210200000KU17101583 530314 GERTRUDO TRI HERWANTI 29-05-2017 29-05-2017
36 E210200000KU17101584 530314.1 ALOYSIUS HERTANTO 29-05-2017 29-05-2017
37 E210200000KU17101585 540364.1 SEMIM 29-05-2017 29-05-2017
38 E210200000KU17101586 531204 NENNY SRI SUPARMI 29-05-2017 29-05-2017
39 E210200000KU17101589 500351 MISWAN GUNAWAN 29-05-2017 29-05-2017
40 E210200000GI17091079 470479.1 SUMIYATI 29-05-2017 29-05-2017
41 E210200000KU17101594 500126 DJAJA HENDARTO 29-05-2017 29-05-2017
42 E210200000KU17101595 500126.1 VERA LANIJANTI 29-05-2017 29-05-2017
43 E210200000KU17101596 500126.1 VERA LANIJANTI 29-05-2017 29-05-2017
44 E210200000KU17101600 580102 I GDE NYOMAN SUMADIA 29-05-2017 29-05-2017
45 E210200000KU17101602 560069.1 SRI MULYATUN 29-05-2017 29-05-2017
46 E210200000KU17101605 520872.1 ZURIATI ZUBIR 29-05-2017 29-05-2017
47 E210200000KU17101606 190236.1 MUHIJA JD ANANG NOERDIN 29-05-2017 29-05-2017
Nama Band
Pegawai Posisi
48 E210200000KU17101607 530934.1 NURMIATI, S.AG 29-05-2017 29-05-2017

49 E210200000KU17101608 540429.1 SRI DEWI EKOWATI 29-05-2017 29-05-2017
50 E210200000KU17101612 370472 SURJANA BIN ROJADI 29-05-2017 29-05-2017
51 E210200000KU17101587 630305.103 MARLUTFIANTO TRIPUTRA 29-05-2017 29-05-2017
52 E210200000KU17101617 511229 MUDJIONO 29-05-2017 29-05-2017
53 E210200000KU17101604 460040.1 NADHIROH,NY 29-05-2017 29-05-2017
54 E210200000KU17101618 640056.1 BUKIT SABAR TAMBUNAN, SH 30-05-2017 30-05-2017
55 E210200000KU17101619 500574 BAHASANNUDIN 30-05-2017 30-05-2017
56 E210200000KU17101620 490902 BAMBANG SEKTIJOSO, IR. 30-05-2017 30-05-2017
57 E210200000KU17101621 490902.1 JOHANA MARIA DWI PRAPTI P. 30-05-2017 30-05-2017
58 E210200000KU17101623 571138 TADOH 30-05-2017 30-05-2017
59 E210200000KU17101624 571138 TADOH 30-05-2017 30-05-2017
60 E210200000KU17101626 571138.1 SITI SADIYAH 30-05-2017 30-05-2017
61 E210200000KU17101628 460544.1 DIAH ARYU PARLAWATY 30-05-2017 30-05-2017
62 E210200000GI17091081 640056.1 BUKIT SABAR TAMBUNAN, SH 30-05-2017 30-05-2017
63 E210200000KU17101629 320126.1 BARIYAH 30-05-2017 30-05-2017
64 E210200000KU17101631 560067 SANIM SUKANDAR 30-05-2017 30-05-2017
65 E210200000KU17101636 560067 SANIM SUKANDAR 30-05-2017 30-05-2017
66 E210200000GI17091082 520874.1 TITIN SUTINAH 30-05-2017 30-05-2017
67 E210200000KU17101640 370764.2 HAFIDAH 30-05-2017 30-05-2017
68 E210200000KU17101642 370764.2 HAFIDAH 30-05-2017 30-05-2017
69 E210200000KU17101643 490333 KARTONO 30-05-2017 30-05-2017
70 E210200000KU17101633 560165 DJOHNI LIANSEN 30-05-2017 30-05-2017
71 E210200000KU17101646 581293 SYAFRUDDIN. B 30-05-2017 30-05-2017
72 E210200000KU17101647 360683.1 RATU TIEN L. 30-05-2017 30-05-2017
73 E210200000KU17101648 590275.1 SITI FATIMAH 30-05-2017 30-05-2017
74 E210200000KU17101639 591192.1 DWI ESTI MULYATMI 30-05-2017 30-05-2017
75 E210200000KU17101649 551034 TRI AGUS JOKO PURNOMO 30-05-2017 30-05-2017
Nama Band
Pegawai Posisi
76 E210200000KU17101650 580889 MARYANI 30-05-2017 30-05-2017

77 E210200000KU17101651 310137 SOEWARSO BCAT 30-05-2017 30-05-2017
78 E210200000KU17101652 310137 SOEWARSO BCAT 30-05-2017 30-05-2017
79 E210200000KU17101654 580889.101 IKA RACHMALIKA 30-05-2017 30-05-2017
80 E210200000KU17101658 591139 ETTY ROHAYATI 30-05-2017 30-05-2017
81 E210200000KU17101644 440847 SUGIMIN BIN SULAIMAN 30-05-2017 30-05-2017
82 E210200000KU17101659 601639 MULYANA 30-05-2017 30-05-2017
83 E210200000KU17101637 560067.1 TITIN SUKAESIH 30-05-2017 30-05-2017
84 E210200000KU17101622 431114.1 ELIZABETH SUMARTINI 30-05-2017 30-05-2017
85 E210200000KU17101661 570948 SRI SUHARTI 30-05-2017 30-05-2017
86 E210200000KU17101662 570948.1 DJONO WIDJOSENO 30-05-2017 30-05-2017
87 E210200000KU17101663 350079.1 SITI SAODAH 30-05-2017 30-05-2017
88 E210200000KU17101667 550158.1 RINNY SULISTYOWATI 30-05-2017 30-05-2017
89 E210200000KU17101657 540428 NGAKAN PUTU SANTHA 30-05-2017 30-05-2017
90 E210200000KU17101670 561565.102 MUHAMMAD EMIR FADILLAH 30-05-2017 30-05-2017
91 E210200000KU17101673 601278 SITI AQILAH 30-05-2017 30-05-2017
92 E210200000KU17101674 551487.104 IRA TRISNAWATI 30-05-2017 30-05-2017
93 E210200000KU17101675 601096.102 DWIKY NURDAYA ANDYARTO 30-05-2017 30-05-2017
94 E210200000KU17101676 601096.1 TITIN DWI ANDI ANGGRAENI 30-05-2017 30-05-2017
95 E210200000KU17101677 470366.1 SABARIAH 30-05-2017 30-05-2017
96 E210200000KU17101680 511229 MUDJIONO 30-05-2017 30-05-2017
97 E210200000KU17101682 511229.1 SUDARWATI 30-05-2017 30-05-2017
98 E210200000KU17101683 640230 ISDI HANDAYANI 30-05-2017 30-05-2017
99 E210200000KU17101685 640230.1 SYAFEI 30-05-2017 30-05-2017
100 E210200000KU17101686 612321.1 WAHYUNING 30-05-2017 30-05-2017
101 E210200000KU17101679 511229 MUDJIONO 30-05-2017 30-05-2017
102 E210200000KU17101688 490934.1 TJUT KESUMA BHAKTY 30-05-2017 30-05-2017
103 E210200000KU17101687 410437 SUPARDI 30-05-2017 30-05-2017
Nama Band
Pegawai Posisi
104 E210200000KU17101694 560848 JONAR PANJAITAN 30-05-2017 30-05-2017

105 E210200000KU17101695 460631 REMEDI PERANGINANGIN IR. 30-05-2017 30-05-2017
106 E210200000KU17101693 551872.1 ESTER LUMBANTOBING 30-05-2017 30-05-2017
107 E210200000KU17101698 530092 MUHAMMAD MUNIF 30-05-2017 30-05-2017
108 E210200000KU17101701 360800.1 HINDUN 30-05-2017 30-05-2017
109 E210200000KU17101691 580123 JOKO TRIYANTO 30-05-2017 30-05-2017
110 E210200000KU17101690 532234 ISKANDAR 30-05-2017 30-05-2017
111 E210200000KU17101692 460631.1 SETIANA SINULINGGA 30-05-2017 30-05-2017
112 E210200000KU17101699 561086 SUPRAPTO SURYANI 30-05-2017 30-05-2017
113 E210200000KU17101705 360161 SANOESI BIN ALIAS 31-05-2017 31-05-2017
114 E210200000KU17101706 460053 KIMAH ROHIMAH 31-05-2017 31-05-2017
115 E210200000KU17101707 441131 UDJANG BIN PIUL 31-05-2017 31-05-2017
116 E210200000KU17101708 441131.1 NINAH 31-05-2017 31-05-2017
117 E210200000KU17101709 540286 IGNATIUS BAMBANG BUDISURANTO31-05-2017 31-05-2017
118 E210200000KU17101710 441131.1 NINAH 31-05-2017 31-05-2017
119 E210200000KU17101711 540286.1 MARIA MARGARETA KUSUMA INDRIATI
31-05-2017 31-05-2017
120 E210200000KU17101712 470015.1 HARTINI NY 31-05-2017 31-05-2017
121 E210200000KU17101713 470015.1 HARTINI NY 31-05-2017 31-05-2017
122 E210200000KU17101716 470015 SOEBARNO 31-05-2017 31-05-2017
123 E210200000KU17101717 470015 SOEBARNO 31-05-2017 31-05-2017
124 E210200000KU17101718 581143 ATANG RACHMAT 31-05-2017 31-05-2017
125 E210200000KU17101720 591487.1 M YUSUF NS 31-05-2017 31-05-2017
126 E210200000KU17101721 591487.1 M YUSUF NS 31-05-2017 31-05-2017
127 E210200000KU17101722 410770.1 SARMI 31-05-2017 31-05-2017
128 E210200000KU17101723 550461 SUBANDI 31-05-2017 31-05-2017
129 E210200000KU17101724 510167.1 SRI WINARNI 31-05-2017 31-05-2017
130 E210200000KU17101725 550461 SUBANDI 31-05-2017 31-05-2017
131 E210200000KU17101726 431249 SURIPTO 31-05-2017 31-05-2017
Nama Band
Pegawai Posisi
132 E210200000KU17101727 410222.1 NANI SUPIATI 31-05-2017 31-05-2017

133 E210200000KU17101729 470652 MUHAMAD ADENAN 31-05-2017 31-05-2017
134 E210200000KU17101730 360874 SUDIJONO BIN DJEMAKUN 31-05-2017 31-05-2017
135 E210200000KU17101732 431249 SURIPTO 31-05-2017 31-05-2017
136 E210200000KU17101728 431249.1 SUPARTI 31-05-2017 31-05-2017
137 E210200000KU17101734 431249.1 SUPARTI 31-05-2017 31-05-2017
138 E210200000KU17101735 500069 JAHJA KELANA 31-05-2017 31-05-2017
139 E210200000KU17101736 500069 JAHJA KELANA 31-05-2017 31-05-2017
140 E210200000KU17101738 500069.1 MARIANI 31-05-2017 31-05-2017
141 E210200000KU17101731 510051 SISWO KUNTJORO 31-05-2017 31-05-2017
142 E210200000KU17101739 500069.1 MARIANI 31-05-2017 31-05-2017
143 E210200000KU17101740 532286 HATTA YUSUF,DRS 31-05-2017 31-05-2017
144 E210200000KU17101744 441224 ATER ROBERT MARPAUNG 31-05-2017 31-05-2017
145 E210200000KU17101746 480670.1 JOSEPHINE SIMANJUTAK 31-05-2017 31-05-2017
146 E210200000KU17101748 500287 MISNAN 31-05-2017 31-05-2017
147 E210200000KU17101749 591515 WIYANTO 31-05-2017 31-05-2017
148 E210200000KU17101751 500287.1 NURIAH 31-05-2017 31-05-2017
149 E210200000KU17101752 500287.1 NURIAH 31-05-2017 31-05-2017
150 E210200000KU17101754 520143.1 ROIKAH 31-05-2017 31-05-2017
151 E210200000KU17101758 570595 AZWIR 31-05-2017 31-05-2017
152 E210200000KU17101759 460577.1 HJ ROCHAINAH 31-05-2017 31-05-2017
153 E210200000KU17101760 530117 SURYADI 31-05-2017 31-05-2017
154 E210200000KU17101761 570595.1 SUWARNI 31-05-2017 31-05-2017
155 E210200000KU17101763 570595.1 SUWARNI 31-05-2017 31-05-2017
156 E210200000KU17101767 560442.1 NAZWIR 31-05-2017 31-05-2017
157 E210200000KU17101768 610876 DARMANTO 31-05-2017 31-05-2017
158 E210200000KU17101750 610876 DARMANTO 31-05-2017 31-05-2017
159 E210200000KU17101770 560442 KUSNILAWATI 31-05-2017 31-05-2017
Nama Band
Pegawai Posisi
160 E210200000KU17101772 591233 MOCHAMAD ZUHRI, BA 31-05-2017 31-05-2017

161 E210200000KU17101773 591233.102 MUHAMMAD DARIS MULKIYAH 31-05-2017 31-05-2017
162 E210200000KU17101774 570124 HERRY SUARDI 31-05-2017 31-05-2017
163 E210200000KU17101775 600846 BERNAD PASARIBU 31-05-2017 31-05-2017
164 E210200000KU17101765 431234 UNUNG MASDUKI 31-05-2017 31-05-2017
165 E210200000KU17101776 530417 PETRUS SISWANTO 31-05-2017 31-05-2017
166 E210200000KU17101766 431234.1 ONOH NONOH 31-05-2017 31-05-2017
167 E210200000KU17101778 450389.1 KASRI 31-05-2017 31-05-2017
168 E210200000KU17101771 390027.1 REDJO 31-05-2017 31-05-2017
169 E210200000KU17101783 510165 RACHMAD 31-05-2017 31-05-2017
170 E210200000KU17101755 520143 SAEPUDIN 31-05-2017 31-05-2017
171 E210200000KU17101788 520098 ALI CECILIA 31-05-2017 31-05-2017
172 E210200000KU17101785 510165.1 WAGINEM 31-05-2017 31-05-2017
173 E210200000KU17101790 520671.1 SUPIAH 31-05-2017 31-05-2017
174 E210200000KU17101792 570124.1 SRI RIYATI 31-05-2017 31-05-2017
175 E210200000KU17101794 460081 DJAUZI 31-05-2017 31-05-2017
176 E210200000KU17101795 532357 BAMBANG SUMBARGO 31-05-2017 31-05-2017
177 E210200000KU17101796 460081 DJAUZI 31-05-2017 31-05-2017
178 E210200000KU17101797 532357 BAMBANG SUMBARGO 31-05-2017 31-05-2017
179 E210200000KU17101799 532357.1 SUWARTI 31-05-2017 31-05-2017
180 E210200000KU17101800 470397 RIZAL SAAT 31-05-2017 31-05-2017
181 E210200000KU17101801 470397 RIZAL SAAT 31-05-2017 31-05-2017
182 E210200000KU17101805 580761 AWALUDIN NOOR 31-05-2017 31-05-2017
183 E210200000KU17101806 500228.1 NANI WINANINGSIH 31-05-2017 31-05-2017
184 E210200000KU17101784 520098.1 SITI ASIYAH 31-05-2017 31-05-2017
185 E210200000KU17101798 521490 TRI KURNIANTO 31-05-2017 31-05-2017
186 E210200000KU17101779 530417.1 ELISABETH CICILIA SAYAN 31-05-2017 31-05-2017
187 E210200000KU17101808 570970.1 SASMITO 31-05-2017 31-05-2017
Nama Band
Pegawai Posisi
188 E210200000KU17101803 470397.1 SRI MARTINI 31-05-2017 31-05-2017

189 E210200000KU17101810 601279.1 ICHFA SYAFAWI 31-05-2017 31-05-2017
190 E210200000KU17101741 510051.1 ARYATI 31-05-2017 31-05-2017
191 E210200000KU17101813 551530.102 AMALIA HERINAWATI 31-05-2017 31-05-2017
192 E210200000KU17101777 510051.1 ARYATI 31-05-2017 31-05-2017
193 E210200000KU17101815 490730 DARYONO KANDARDWIATMADJA31-05-2017 31-05-2017
194 E210200000KU17101819 602339.1 PONIYATI 31-05-2017 31-05-2017
195 E210200000KU17101820 602339.1 PONIYATI 31-05-2017 31-05-2017
196 E210200000KU17101804 571011 UNTUNG MUHAEMIN 31-05-2017 31-05-2017
197 E210200000KU17101823 611953 EDDY PAHALA SIHOMBING 31-05-2017 31-05-2017
198 E210200000KU17101824 480069.1 WARTINI 31-05-2017 31-05-2017
199 E210200000KU17101814 551530.1 BARO,AH HERYSUSTIKA 31-05-2017 31-05-2017
200 E210200000KU17101829 530930 TRUMAN S TAMBUNAN 31-05-2017 31-05-2017
201 E210200000KU17101830 500814 DJAJADI 31-05-2017 31-05-2017
202 E210200000KU17101831 500814.1 TUTI ELLYANA 31-05-2017 31-05-2017
203 E210200000KU17101762 460577.1 HJ ROCHAINAH 31-05-2017 31-05-2017
204 E210200000KU17101757 460577 ABDUL RACHIM 31-05-2017 31-05-2017
205 E210200000KU17101756 570941.1 ROHATI 31-05-2017 31-05-2017
206 E210200000KU17101719 591487 ZULHELMA BUSRI 31-05-2017 31-05-2017
207 E210200000KU17101715 531547 BARYONO 31-05-2017 31-05-2017
208 E210200000KU17101832 340553.1 DJUHANA 31-05-2017 31-05-2017
209 E210200000KU17101828 320145.1 RAMIANTA BORU HALOHO 31-05-2017 31-05-2017
210 E210200000KU17101826 611953 EDDY PAHALA SIHOMBING 31-05-2017 31-05-2017
NSIUN TELKOM
Jenis
Nama Dokter ICD X Peserta 2. Jasa 3. Jasa Jumlah Total Status
Non Gene 1. Obat / Dokter 4.
DOT Dokter
DOT rik Bahan Obat Umum Gigi Kapitasi
dr amar bachtiar 3 537,795 - - - 537,795

dr amar bachtiar 30 64,494 - - - 64,494
dr amar bachtiar 84 221,492 - - - 221,492
dr. Istiyarti Tapilatu 25 92,193 - - - 92,193
dr amar bachtiar 56 139,091 - - - 139,091
dr amar bachtiar 60 65,917 - - - 65,917
dr amar bachtiar 6 9,720 - - - 9,720
dr amar bachtiar 66 82,389 - - - 82,389
Jenis
DOT DOT rik Bahan Obat Umum Dokter
Gigi Kapitasi
dr amar bachtiar 20 60,435 - - - 60,435

dr amar bachtiar 90 207,239 - - - 207,239
dr amar bachtiar 61 106,294 - - - 106,294
dr amar bachtiar 63 78,818 - - - 78,818
dr amar bachtiar 30 105,347 - - - 105,347
dr amar bachtiar 34 21,197 - - - 21,197
drg. Arti R.Nazir 20 55,610 - - - 55,610
dr amar bachtiar 21 83,454 - - - 83,454
dr amar bachtiar 30 81,824 - - - 81,824
dr amar bachtiar 56 340,477 - - - 340,477
dr amar bachtiar 41 51,283 - - - 51,283
dr amar bachtiar 40 93,811 - - - 93,811
drg. Arti R.Nazir 25 24,293 - - - 24,293
dr amar bachtiar 1 97,763 - - - 97,763
dr amar bachtiar 39 43,639 - - - 43,639
dr amar bachtiar 40 146,940 - - - 146,940
Jenis
Gigi Kapitasi
dr amar bachtiar 1 30,111 - - - 30,111

dr amar bachtiar 21 76,465 - - - 76,465
dr amar bachtiar 137 261,112 - - - 261,112
dr amar bachtiar 112 174,867 - - - 174,867
dr amar bachtiar 140 306,878 - - - 306,878
dr amar bachtiar 84 164,250 - - - 164,250
drg. Arti R.Nazir 20 17,843 - - - 17,843
drg. Arti R.Nazir 26 43,845 - - - 43,845
dr amar bachtiar 1 30,111 - - - 30,111
dr amar bachtiar 36 93,738 - - - 93,738
Jenis
Gigi Kapitasi

dr amar bachtiar 40 141,015 - - - 141,015
dr amar bachtiar 36 88,034 - - - 88,034
dr amar bachtiar 21 33,832 - - - 33,832
dr amar bachtiar 53 83,669 - - - 83,669
dr amar bachtiar 130 288,040 - - - 288,040
dr amar bachtiar 30 81,824 - - - 81,824
dr amar bachtiar 112 163,095 - - - 163,095
dr amar bachtiar 13 103,317 - - - 103,317
dr amar bachtiar 10 50,339 - - - 50,339
dr amar bachtiar 57 144,629 - - - 144,629
dr amar bachtiar 60 152,046 - - - 152,046
dr amar bachtiar 84 113,048 - - - 113,048
dr amar bachtiar 12 156,153 - - - 156,153
dr amar bachtiar 62 514,150 - - - 514,150
Jenis
Gigi Kapitasi
dr amar bachtiar 30 67,860 - - - 67,860

dr amar bachtiar 43 67,261 - - - 67,261
dr amar bachtiar 81 115,054 - - - 115,054
dr amar bachtiar 168 302,740 - - - 302,740
dr amar bachtiar 29 286,415 - - - 286,415
dr amar bachtiar 100 239,312 - - - 239,312
dr amar bachtiar 140 181,011 - - - 181,011
dr amar bachtiar 114 204,258 - - - 204,258
Jenis
Gigi Kapitasi
dr amar bachtiar 84 251,836 - - - 251,836

dr amar bachtiar 84 289,205 - - - 289,205
dr amar bachtiar 112 120,045 - - - 120,045
dr amar bachtiar 58 255,853 - - - 255,853
dr amar bachtiar 51 292,707 - - - 292,707
dr amar bachtiar 97 184,618 - - - 184,618
dr amar bachtiar 168 248,179 - - - 248,179
dr amar bachtiar 140 253,225 - - - 253,225
dr amar bachtiar 56 85,621 - - - 85,621
dr amar bachtiar 188 365,617 - - - 365,617
dr amar bachtiar 68 241,814 - - - 241,814
Jenis
Gigi Kapitasi

dr amar bachtiar 40 93,528 - - - 93,528
dr amar bachtiar 100 441,033 - - - 441,033
dr amar bachtiar 84 197,297 - - - 197,297
dr amar bachtiar 42 111,933 - - - 111,933
dr amar bachtiar 112 242,961 - - - 242,961
dr amar bachtiar 146 82,784 - - - 82,784
dr amar bachtiar 56 11,985 - - - 11,985
dr amar bachtiar 70 148,181 - - - 148,181
dr amar bachtiar 14 164,701 - - - 164,701
Jenis
Gigi Kapitasi

dr amar bachtiar 41 107,320 - - - 107,320
dr amar bachtiar 30 90,222 - - - 90,222
dr amar bachtiar 56 54,249 - - - 54,249
dr amar bachtiar 62 206,616 - - - 206,616
dr amar bachtiar 125 254,459 - - - 254,459
dr amar bachtiar 59 62,914 - - - 62,914
dr amar bachtiar 48 76,760 - - - 76,760
dr amar bachtiar 102 178,197 - - - 178,197
dr amar bachtiar 56 72,442 - - - 72,442
13,045 - - 32,939,403 - - - 32,939,403

Laporan Penjualan BPJS
Apotek Telemedika Farma 6 Jl. Percetakan Negara No.17 A Jakarta Pusa
Tanggal
Transaksi
1.15.
1.15.
1.15.
1.15.
1.15.
1.15.
1.15.
1.15.
1.15.
1.15.
1.15.
1.15.
1.15.
1.15.
1.15.
1.15.
1.15.
1.15.
1.15.
Yang membuat,
Mita Maha Asih

AA Telemedika Farma 6
BPJS
2017
Negara No.17 A Jakarta Pusat
Nomor Nama
No NIKKES
Resep Peserta

Nama Obat Margin (%) Pembayaran
(%)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Pemeriksa,
Heryani, S.Farm, Apt

APA Telemedika Farma 6
Total Total
Tanggal Kode Nama Nama Harga Diskon (%) Margin Nomor Nomor
Jumlah Pembayar Pembayar
Transaksi Dokter Dokter Obat HNA (%) Resep Resep
an an
### 0 0 0 0 0 0 0 0 00 00 0
### 0 0 0 0 0 0 0 0 00 0
### 0 0 0 0 0 0 0 0 00 0
### 0 0 0 0 0 0 0 0 00 0
### 0 0 0 0 0 0 0 0 00 0
### 0 0 0 0 0 0 0 0 00 0
### 0 0 0 0 0 0 0 0 00 0
### 0 0 0 0 0 0 0 0 00 0
### 0 0 0 0 0 0 0 0 00 0
### 0 0 0 0 0 0 0 0 00 0
### 0 0 0 0 0 0 0 0 00 0
### 0 0 0 0 0 0 0 0 00 0
### 0 0 0 0 0 0 0 0 00 0
### 0 0 0 0 0 0 0 0 00 0
### 0 0 0 0 0 0 0 0 00 0
### 0 0 0 0 0 0 0 0 00 0
### 0 0 0 0 0 0 0 0 00 0
### 0 0 0 0 0 0 0 0 00 0
### 0 0 0 0 0 0 0 0 00 0
### 0 0 0 0 0 0 0 0 00 0
### 0 0 0 0 0 0 0 0 00 0
item
0 00
0 00
0 00
0 00
0 00
0 00
0 00
0 00
0 00
0 00
0 00
0 00
0 00
0 00
0 00
0 00
0 00
0 00
0 00
0 00
0 00
REKAPITULASI TAGIHAN APOTIK (RJTP) PENSIUN TELKOM
NAMA MITRA : TELKOM
PESERTA : TF 6
Periode : 29 - 31 Mei 2017
Jumlah
Nama Band Tanggal Tanggal Jenis
NO Nomor Resep NIK Loker NIKES Nama Pasien Nama Dokter ICD X Peserta
Pegawai Posisi Masuk Keluar
DOT
-

Non Generik 1. Obat / Dokter 4.
DOT Bahan Obat Umum Dokter
Gigi Kapitasi
- - - - - - -
REKAPITULASI LAPORAN AKTIVITAS
APOTEK TELEMEDIKA FARMA 6
JL. Percetakan negara 17 a
Periode 31 Mei 2017
JML
URAIAN JML ITEM
RESEP
1. PENJUALAN
1.0.1. Rekp Penjualan Umum 214 9
1.1.1. Rekap Penjualan TPBW 47 2
1.2.1. Rekap Non System Pegawai 478 7
1.3.1. Rekap Non System Pensiun 2,114 55
1.4.1. Rekap Tagihan System Pegawai 4,609 99
1.5.1. Rekap Tagihan System Pensiun 13,045 210
1.6.1. Rekap Tagihan Peseta TelkoMedika 138 6
1.51. rekap tagihan BPJS -
JUMLA PENJUALAN 20,645 388
2. MATERAIAL KESEHATAN
1.7. Rincian Tagihan Matkes Gigi -
1.8. Rincian Tagihan Matkes Umum -
1.9. Rincian Tagihan Matkes KB/KIA -
3. MUTASI
1.10. Mutasi Masuk 321
1.11. Mutasi Keluar 26,221
4. PEMBELIAN
1.12. Pembelian PBF
5. STOCK OPNAME
1.13. Stock Opname
6. EXPIRED DATE
1.14. Rekap Expired Date Obat
Mengetahui,
Yeni Handayani
Head Of Regional Jakarta
RATA2
JML BIAYA
RESEP
14,897,666 1,655,296
70,108 35,054
121,926 17,418
11,984,119 217,893
11,678,943 117,969
32,939,403 156,854
1,038,553 173,092
- #DIV/0!
72,730,718 187,450
-
-
-
569,859
122,948,401
Dibuat Oleh;
Heryani, S. Farm, Apt

Apoteker
Laporan Penjualan Obat PESERTA TELKOMEDIKA
PERIODE 29 - 31 Mei 2017
Tanggal
Transaksi
1 SA2905201700097240100022 U63107 Ratna Dewi Putri Hutajulu 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar
2 SA2905201700098240100022 U84368 khalid hisyam 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar
3 SA3005201700046240100022 750063C000 - ARI ROWANT 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar
4 SA3005201700060240100022 S201701039 - RIRISNAWATI 30-05-2017 Bidan Vitha Diana Bidan Vitha Diana
ESERTA TELKOMEDIKA
1 Mei 2017
kan Negara No.17A Jakarta Pusat
TOSHIBA:
Total 1 = Kepesertaan
Nama Obat Jumlah Harga HNA Diskon (%) Margin (%) Pembayaran Ket. No
2 = Non DOT
3 = Obat Moll
Prednicort tab. 4 mg 20 1500 0 6 31800 1

Fluimucil kaps. 200 mg 10 4095 0 6 43407 1
Sub Total 75207 1
Sangobion Baby drop 15mg/ml, btl @15 1 28960 0 6 30697.6 2
RHINOS NEO DROP 10ML 1 32000 0 6 33920 2
Sub Total 64617.6 2
Tequinol tab. 500 mg 10 12000 0 20 144000 3
Flamar tab. 50 mg 10 1650 0 20 19800 3
Xytrol ED tts. mata , btl 5 ml 1 27250 0 20 32700 3
Sub Total 196500 3
Biofolat Plus 14 4000 0 20 67200 4
Sub Total 67200 4
REKAPITULASI TAGIHAN APOTIK (RJTP) PESERTA RASAPALA
NAMA MITRA : CORPORATE :
PESERTA : TF 6
PERIODE : 6 - 12 Mei 2017
NO Nomor Resep NIK Nama Band Loker NIKES Nama Pasien Tanggal Tanggal Nama Dokter ICD X Jenis
Pegawai Posisi Masuk Keluar Peserta 2. Jasa 3. Jasa 4. Jumlah Total Status
DOT Non Gener 1. Obat / Dokter Dokter Kapit
DOT ik Bahan Obat
Umum Gigi asi
Sub Total 1 SA2905201700097240100022 U63107 Ratna Dewi Putri Hutajulu 29-05-2017 29-05-2017 dr Amar Bachtiar 30 75,207 - - - 75,207 1.6.1.
Sub Total 2 SA2905201700098240100022 U84368 khalid hisyam 29-05-2017 29-05-2017 dr Amar Bachtiar 2 64,618 - - - 64,618 1.6.1.
Sub Total 3 SA3005201700046240100022 0 750063C000 - ARI ROWANTO 30-05-2017 30-05-2017 dr Amar Bachtiar 21 196,500 - - - 196,500 1.6.1.
Sub Total 4 SA3005201700060240100022 0 S201701039 - RIRISNAWATI MAULIDITHA30-05-2017 30-05-2017 Bidan Vitha Diana 14 67,200 - - - 67,200 1.6.1.
Sub Total 5 SA3105201700036240100022 623099C100 NURYENI 31-05-2017 31-05-2017 dr Amar Bachtiar 61 628,560 - - - 628,560 1.6.1.
Sub Total 6 SA3105201700042240100022 0 000150K100 - RUTHY CHRISTINA S. 31-05-2017 31-05-2017 drg. Teresa Venir 10 6,468 - - - 6,468 1.6.1.
138 - - 1,038,553 - - - 1,038,553

NAMA PROVIDER : APOTEK TELEMEDIKA FARMA 6 JAKARTA
TANGGAL :
TAGIHAN PERIODE : 29 - 31 Mei 2017
NO KWITANSI/INVOICE :
NO. REKENING :
NAMA BANK :
NAMA PENERIMA DI BANK :
TGL BEROBAT
NO NAMA CORPORATE NAMA KARYAWAN

Masuk Keluar
1 SIGMA 29/05/2017 5/29/2017 R. ARYANDITO TJAHJO T.

2 TM 29/05/2017 5/29/2017 RATNA DEWI PUTRI HUTAJULU
3 TM 29/05/2017 5/29/2017 HERYANI
4 MITRATEL 30/05/2017 5/30/2017 ARI ROWANTO
5 SIGMA 30/05/2017 5/30/2017 RIRINASWARI MAULIDITHA
6 MITRATEL 31/05/2017 5/31/2017 FRIS YANRIZAL
7 MITRATEL 31/05/2017 5/31/2017 FRIS YANRIZAL
8 GSD PUSAT 31/05/2017 5/31/2017 WINDU MURTYONO
TOTAL
Verifikator
(.................................)
HardCopy dikirimkan:
PT TelkoMedika (Rasapala)
Jl. Percetakan Negara No 17
Jakarta Pusat
Softcopy Dikirimkan:
hsjkt.telkomedika@gmail.com
ddrswd83@gmail.com
APOTEK TELEMEDIKA FARMA 6 JAK
BERITA ACARA PENAGIHAN RESEP KARYAWAN PESERTA TELK
TelkoMedika:
Di Isi Nomer Kartu Peserta
Jika, Nomer Kartu tidak ada harap
KODE STATUS RELATIONSH
menghubungi ibu Asih (021) 424 1746
NUMBER CARD PASIEN NAMA PASIEN Keluarga
ICD-X IP Administrasi Imunisasi Berencana
8000329200505150 NISSA MUKHAROMAH B01 Y SPOUSE 10,000

8000329200845481 RATNA DEWI PUTRI HUTAJULU R05 N PRINCIPA 10,000
8000329200871024 KHALID HISYAM J06 N CHILD 10,000
8000329200819122 ARI ROWANTO H10 Y PRINCIPA 10,000
8000329200869838 RIRINASWARI MAULIDITHA J00 Y PRINCIPA 10,000
8000329200841605 FRIS YANRIZAL K04 Y PRINCIPA 7,000
8000329200841571 NURYENI R05 Y SPOUSE 10,000
8000329200062350 RUTHY CHRISTINA S. K04 Y SPOUSE 12,000
79,000
A 6 JAKARTA
A TELKOMEDIKA REGIONAL JAKARTA
TelkoMedika:
RAWAT JALAN Di Isi sesuai Field
Konsulta Konsulta Konsultasi SUB TOTAL RAWAT

Laboratori Fisioterap si dan si NAMA DOKTER
Obat-obatan Dokter Tindakan Medis JALAN
um i Obat- Dokter
obatan Spesialis Umum/Gigi
55,000 65,000 dr. Amar Bachtiar
82,728 55,000 147,728 dr. Amar Bachtiar
71,079 55,000 136,079 dr. Amar Bachtiar
216,150 55,000 281,150 dr. Amar Bachtiar
73,920 55,000 138,920 Bidan Vitha Diana
70,000 77,000 drg. Teressa Venir
691,416 55,000 756,416 dr. Amar Bachtiar
7,115 40,000 215,000 274,115 drg. Teressa Venir
1,142,408 440,000 215,000 1,876,408
Jakarta, 31 Mei 2017
MITA MAHA ASIH

KETERANGAN
prednicort 4mg. 20, fluimucil kaps. 10

sangobion drops. 1, rhinos neo drops. 1
tequinol 500mg. 10, flamar 50mg. 10. cendo xitrol ED. 1
biofolat tab. 14
opixime 100mg. 20, extropec syr. 1, sanmol tab. 10, rhinos SR. 10, mertigo SR. 20
ponstelax 500mg. 10
REKAP PENERIMAAN EXCESS NOT PAID
TPK : PERCETAKAN NEGARA
PERIODE : MEI 2017
ID ENTRY TANGGAL NOMER KARTU PASIEN NAMA PASIEN PLAN ID NAMA PEGAWAI KOORPORASI
JENIS LAYANAN JUMLAH TPK
PN
PN
PN
JUMLAH Rp 18,000.00
RINCIAN TAGIHAN PENJUALAN KE YAKES TELKOM
PERMINTAAN MATKES GIGI TELEMEDIKA FARMA 6
BULAN MEI 2017
MARGIN PPN
NO NAMA BARANG SATUAN QTY DISTRIBUTOR HARGA SATUAN (HNA) HARGA JUAL TOTAL KETERANGAN
8% 10%
1 2 3 4 5 6 7=(6x8%) 8=(6+7)x10% 9=6+7+8 10=4x9 11
1.7.
1.7.
1.7.
1.7. TOTAL
1.7.
Mengetahui, Yang membuat,
Heryani, S.Farm,Apt Yeni Handayani Marliatin Nurhayati

Apoteker TF 6 Head Of Regional AA TF 6
PERMINTAAN MATKES UMUM TF 6
BULAN MEI 2017
HARGA SATUAN MARGIN PPN
NO NAMA BARANG SATUAN JUMLAH DISTRIBUTOR HARGA JUAL TOTAL KETERANGAN
(HNA) 7% 10%
1 2 3 4 5 6 7=(6x7%) 8=(6+7)x10% 9=6+7+8 10=4x9 11
1.8.
1.8.
1.8.
1.8.
1.8.
1.8.
1.8.
TOTAL Rp -


PERMINTAAN MATKES KIA/KB TELEMEDIKA FARMA 6
BULAN MEI 2017
HARGA SATUAN MARGIN PPN
NO NAMA BARANG SATUAN JUMLAH DISTRIBUTOR HARGA JUAL TOTAL KETERANGAN
(HNA) 8% 10%
1 2 3 4 5 6 7=(6x8%) 8=(6+7)x10% 9=6+7+8 10=4x9 11
1.9. 1
1.9. 2
1.9. 3
1.9. 4
1.9. 5
TOTAL


MUTASI MASUK APOTEK TELEMEDIKA
PERIODE 26 - 31 Mei 2017
NO KODE OBAT NAMA OBAT SUMBER SATUAN BESAR ISI
1 100190001 Faktu Oint salep Apotek Telemedika Farma 13

2 900002954 TRIFLUOPHERAZIN 5 MG Apotek Telemedika Farma 13
3 900001208 Pyrazinamide tab. 500 mg (Kim) Apotek Telemedika Farma 13
3
TOTAL
Menyetujui;
Yeni Handayani
Page 300 of 438

DE 26 - 31 Mei 2017
TANGGAL
SATUAN KECILHNA SATUAN KECILDISC HNA - DISKON QTY MUTASI VALUE MUTASI
MUTASI
93480 5 467400 31-05-2017

505.55 82 41454.94 31-05-2017
260.7 234 61003.8 31-05-2017
569858.74

YANG MENGAJUKAN

Apoteker Telemedika Farma 6
Page 301 of 438

MUTASI KELUAR APOTEK TELEMEDIKA FARMA 6
Periode 26-31 Mei 2017
SATUAN SATUAN HNA SATUAN

NO KODE OBAT NAMA OBAT TUJUAN ISI DISC
BESAR KECIL KECIL
1 900005629 Concor tab. 5 mg Apotek Telemedika Farma 04

2 900002593 Ponstelax kapl. 500 mg Apotek Telemedika Farma 07
3 900004543 Metrix tab. 3 mg Apotek Telemedika Farma 07
4 150340004 Amlodipine tab. 5 mg (Kim) Apotek Telemedika Farma 07
5 100070001 Epexol syr. 15 mg/5 ml, btl. 120 ml Apotek Telemedika Farma 08
6 103040002 Adalat Oros tab. 30 mg Apotek Telemedika Farma 08
7 900005668 Glucophage tab. 500 mg Apotek Telemedika Farma 08
8 150100032 NovoMix 30 FlexPen inj. 100 IU/ml Apotek Telemedika Farma 08
9 900005670 Glucophage XR tab. 500 mg Apotek Telemedika Farma 08
10 900008036 Clopidogrel tab. 75 mg (Hex) Apotek Telemedika Farma 08
11 110127001 Genta salep mata 0,3 %, tube 3,5 gr Apotek Telemedika Farma 08
12 900008040 Cpg 75 Mg Apotek Telemedika Farma 11
13 900004444 Frego tab. 5 mg Apotek Telemedika Farma 11
14 900004611 RANTIN 150MG Apotek Telemedika Farma 11
15 169090001 Irvask tab. 150 mg Apotek Telemedika Farma 11
16 169090053 Irvask tab. 300 mg Apotek Telemedika Farma 11
17 900005629 Concor tab. 5 mg Apotek Telemedika Farma 11
Jakarta, 3
Menyetujui; YANG MEN
Page 302 of 438

SATUAN SATUAN HNA SATUAN
NO KODE OBAT NAMA OBAT TUJUAN ISI DISC
BESAR KECIL KECIL
Yeni Handayani Heryani, S

Head Of Regional Jakarta Apoteker Telem
Page 303 of 438

POTEK TELEMEDIKA FARMA 6
e 26-31 Mei 2017
TANGGAL
QTY
HNA -
MUTAS VALUE MUTASI
DISKON MUTASI
I
4223.34 6000 25,340,040 31-05-2017

350.35 100 35,035 30-05-2017
1140.69 60 68,441 30-05-2017
392.73 150 58,909 31-05-2017
10505.38 5 52,527 30-05-2017
5977.5 30 179,325 30-05-2017
811.64 100 81,164 30-05-2017
137525.94 5 687,630 31-05-2017
1620.5 120 194,460 31-05-2017
3454.2 150 518,130 31-05-2017
24250 1 24,250 31-05-2017
9130 3000 27,390,000 30-05-2017
1215.38 2500 3,038,450 30-05-2017
3440 5000 17,200,000 30-05-2017
6530 1500 9,795,000 30-05-2017
8630 1500 12,945,000 30-05-2017
4223.34 6000 25,340,040 30-05-2017
Rp 122,948,401.46

YANG MENGAJUKAN
Page 304 of 438

TANGGAL
QTY
HNA -
MUTAS VALUE MUTASI
DISKON MUTASI
I

Page 305 of 438

MONITORING OBAT
JL PERCETAKAN NEGARA 17 A
PERIODE: 19 - 25 Februari 2017
NO KODE OBAT NAMA OBAT STATUS OBAT HARGA SATUAN
1 2 3 4 5
1 900006142 Abilify tab. 10 mg

2 159000004 Abilify tab. 5 mg
3 169110051 Err:504
4 169110050 Err:504
5 900002154 Acid Salicyl
6 130086001 Acilaz kaps. 30 mg
7 100300001 Acyclovir cream 5 %, tube 5 gr (indo)
8 100300002 Acyclovir tab. 200 mg (Kim)
9 151000003 Acyclovir tab. 400 mg (Hex)
10 103040002 Adalat Oros tab. 30 mg
11 900004321 Albiotin kaps. 150 mg
12 900004322 Albiotin kaps. 300 mg
13 169100054 Albothyl Concentrate 5 ml
14 900000328 ALDACTONE 100 TAB
15 900003694 Alganax tab. 0,25 mg
16 900003695 Alganax tab. 0,5 mg
17 152300001 Allopurinol tab. 100 mg (Kim)
18 110006002 Alluric tab. 300 mg.
19 130038001 Alpentin kaps. 100 mg
20 110122001 Alpentin kaps. 300 mg
21 169120017 Amaryl M tab. 1/250 mg
22 900000350 Ambroxol syr. paed 15 mg/5 ml, btl 60 ml (Indo)
23 900000351 Ambroxol tab. 30 mg (Indo)
24 130006002 Amcor tab. 10 mg
25 130537001 Aminefron tab. 630 mg
26 100100002 Aminofilin tab. 200 mg
27 100120001 Amitriptyline tab. salut 25 mg (Indo)
28 900008017 Amlodipin Besilat tab. 10 mg (Hex)
29 900008018 Amlodipin Besilat tab. 5 mg (Hex)
30 900006598 Amoxicillin kaps. 500 mg (Kim)
31 900004033 Anadex tab.
32 130067001 Anadium kapl.
33 102200001 Analsik kapl.
34 900004328 Angioten tab. 50 mg
35 900000371 Antasida DOEN II suspensi. kombinasi: Aluminium Hidroksida 200 mg/5ml Magnesium H
36 150100055 Apidra Solostar inj 100 IU/ml, solostar pen @ 3 ml
37 900002471 Artrilox tab. 7,5 mg
38 900004246 Asam Askorbat (Vitamin C) tab. 50 mg
39 120000011 Asam Folat tab. 1 mg
40 900000379 Asam Mefenamat kapl. 500 mg (Dex)
41 900007718 Aspar K tab. 300 mg
42 100220004 Astika tab. 100 mg.
43 155200001 Atorvastatin tab. 10 mg (Hex)
44 130723002 Atorvastatin tab. 20 mg (Hex)
45 130723003 Azithromycin tab. 500 mg (Kim)
46 110495001 Bactoderm Krim 2%, 5 gr
47 900002473 Bactoprim Combi forte tab 800 mg/160 mg .
48 900008022 Baraclude tab. 0,5 mg
49 100960001 Baraclude tab. 1 mg
50 900008023 Bd Microfine Pen Needle 31X5 (31G5Mm)
51 900001851 Benoson M Cr
52 900003767 Betablok tab. 50 mg
53 103300001 Betadine Gargle lar. 1 %. btl 100 ml
54 120000021 Betahistin Mesilat tab. 6 mg
55 169060011 Betametason 0,1% tube 5 gr
56 100460001 Betaone tab. 2,5 mg
57 100460002 Betaone tab. 5 mg
58 900000421 Betaserc tab. 24 mg
59 102040001 Err:504
60 170100110 Biofolat Plus
61 102110001 Biosanbe kaps.
62 900002081 Bisolvon syr. elixir 4 mg/5 ml, btl 125 ml
63 900002089 Bisolvon tab. 8 mg
64 900004002 Bisoprolol tab. 5 mg (Hex)
65 900000124 BOTOL PLASTIK 100ML
66 900000127 BOTOL PLASTIK 30ML
67 130045007 Bufect Forte syr. 200 mg/5 ml, btl 60 ml
68 101520001 Bufect syr. 100 mg/5 ml, btl 60 ml
69 900002893 Burnazin krim 1 %, 35 gr
70 900002092 BUSCOPAN INJ
71 900000452 C.T.M 4
72 900008028 Caco3 500 Mg
73 900000459 Calcium tab. 500 mg (Kim)
74 101690001 Calos Chewable tab. 500 mg.
75 110489002 Cameloc tab. 15 mg
76 110489001 Cameloc tab. 7,5 mg
77 130016001 Canderin tab. 16 mg
78 130016002 Canderin tab. 8 mg
79 900000463 Captopril tab. 12,5 mg (Hex)
80 900000464 Captopril tab. 25 mg (Hex)
81 159400003 Err:504
82 101740001 Carboglycerine tetes telinga 10% botol 5 ml
83 900001772 Cardio Aspirin tab. 100 mg
84 900006610 Cardismo tab. 20 mg
85 900001630 Casodex FC tab. Sal 50 mg
86 900005897 CATAFLAM 50MG
87 101950001 Catarlent tts. Mata, btl 5 ml
88 900005623 Cavit D3 kaps. 0,5 mcg
89 101630001 Cedocard tab. sublingual 10 mg
90 101630002 Cedocard tab. sublingual 5 mg
91 120000148 Cefadroxil kaps. 500 mg (Hex)
92 900007074 Cefat DS syr. kering 125 mg/5ml, btl. 60 ml
93 103480001 Cefat Forte syr. kering 250 mg/5ml, btl. 60 ml
94 103480002 Cefat kaps. 250 mg
95 900007073 Cefat kaps. 500 mg
96 900008032 Cefixime 100 Mg Caps
97 151100005 Cefixime syr 100 mg/5 ml (Indo)
98 151100003 Cefixime tab. 100 mg (Kim)
99 102950001 Cellcept tab. 500 mg
100 900002361 Cendo lyteers ED, btl 15 ml
101 900000492 Cetirizine tab. 10 mg (Kim)
102 900004799 CHLORAMFECORT CR 10GR
103 130000048 Err:504
104 101850002 Chlorpheniramine Maleat 4 mg
105 900000500 Chlorpromazine tab. sal 100 mg (Kim)
106 900004365 Cholestat tab. 10 mg
107 900004366 Cholestat tab. 20 mg
108 152780001 Cinolonn Cr 0,025% 10 gr
109 900000510 Ciprofloxacin tab. 500 mg (Hex)
110 900004371 Citaz tab. 50 mg
111 140000008 Citicoline tab 500 mg
112 900004049 CLABAT 500MG TAB
113 900004048 Err:504
114 130061002 Clamixin DS
115 130062002 Clamixin FDS
116 130069001 Clamixin kapl.
117 120000068 Clindamycin kaps. 150 mg (Dex)
118 120000069 Clindamycin kaps. 300 mg (Dex)
119 900002984 CLOBAZAM 10 MG 10S
120 900000514 Clonidine HCl tab. 0,15 mg (Indo)
121 900008036 Clopidogrel tab. 75 mg (Hex)
122 170100056 Cloxer tab. 25 mg
123 151610001 Clozer tab. 25 mg
124 101890001 Codeine tab. 10 mg (Kim)
125 102180001 Combivent solution 0,025%
126 900005628 Concor tab. 2,5 mg
127 900005629 Concor tab. 5 mg
128 900007283 Cordarone tab. 200 mg
129 900000523 CoTrimoxazole syr. btl 60 ml (Indo)
130 900008040 Cpg 75 Mg
131 900001631 CRESTOR 20 MG
132 130000004 Cripsa tab. 2,5 mg
133 103520003 Cyanocobalamin (vitaminB12) tab. 50 mcg (Kim)
134 900007872 CYCLOFEM INJ
135 102090001 Cycloprogynova tab.
136 130042001 Cytodrox kaps. 500 mg
137 170100026 Damuvit tab.
138 170100008 Debostin tab. 10 mg
139 169100093 Debostin tab. 20 mg
140 103810018 Depakene syr. 250 mg/5 ml. btl. 120 ml
141 103810019 Depakote ER tab. 500 mg
142 103810020 Depakote tab. 250 mg
143 900008043 Depo Progestin 1 Cc
144 900003001 Dexacap tab. 25 mg
145 151900002 Dexamethasone tab. 0,5 mg (Kim)
146 102070001 Dextafen tab.
147 170100058 Err:504
148 201508241 Diaformin XR tab. 500 mg
149 100370002 Diagit tab.
150 900008047 Diaglime tab. 3 mg
151 991501010 Diamicron MR tab. 60 mg
152 101300009 Diaversa tab. 1 mg
155 170100054 Diclofenac Potassium tab. 50 mg (Hex)
156 110496004 Diclofenac Sodium tab. 25 mg (Kim)
157 900004014 Diclofenac sodium tab. 50 mg (Indo)
158 100830003 Diflam tab. 50 mg
159 100820001 Digoxin tab. 0,25 mg
160 150340002 Dilavask tab. 10 mg
161 150340005 Dilavask tab. 5 mg
162 900000593 Diltiazem tab. 30 mg (Kim)
163 900000601 DISP SYRINGE 2,5CC (TRM)
164 110092001 Domperidone syr. 5 mg/5 ml, btl 60 ml (Hex)
165 900008051 Domperidone tab. 10 mg (Indo)
166 110001002 Eclid tab. 50 mg
167 100830004 Eflagen tab. 25 mg
168 900003704 Elox krim 10 gr
169 900003706 Emibion kaps.
170 900003611 ENGERIK-B INJ ADULT 20MCG
171 900003612 ENGERIK-B INJ PAED 10MCG
172 100070001 Epexol syr. 15 mg/5 ml, btl. 120 ml
173 130130001 Episan susp. 500 mg/5 ml @ 100 ml
174 900004276 Err:504
175 900006924 Epsonal tab. 50 mg
176 100530001 Ergotamine Coffeine tab. (Kim)
177 103550001 Esvat tab. 10 mg
178 103550002 Esvat tab. 20 mg
179 101010002 Ethambutol tab. 500 mg (Kim)
180 103760001 Euthyrox tab. 100 mcg
181 900003708 Evothyl kaps. 100 mg
182 900003709 Evothyl kaps. 300 mg
183 170100047 Extropect syr. 30 mg/5 ml, btl. 60 ml
184 110457001 Eyefresh ED lar. 2% btl 5 ml
185 100190001 Faktu Oint salep
186 100190002 Faktu Supp
187 100820002 Fargoxin tab. 0,25 mg
188 110183002 Febogrel tab. 75 mg
189 900002385 Fenicol ED tts mata 0,5%, btl 5 ml
190 101130001 Finpro tab. 5 mg
191 900000163 FITTY DENT
192 103060003 Fladystin ovula 500 mg
193 101340002 Err:504
194 101340001 Err:504
195 900007980 Fluimucil kaps. 200 mg
196 150100040 Flutias i.h 25/125 mcg/puff, 120 semprot
197 102240003 Err:504
198 110426001 Forcanox kaps. 100 mg
199 900004444 Frego tab. 5 mg
200 169100035 Fresh Care 10 ml
201 900003717 Fuladic salep 20 mg/gr, tube 5 gr
202 900003722 Fungasol krim 2%, 10 gr
203 130050002 Fungasol SS scalp sol 2%
204 900000714 Furosemide tab. 40 mg (Kim)
205 169060034 Galvusmet 50/500 FCT
206 101220002 Ganin kaps. 300 mg
207 900005254 Gastran tab.
208 110127002 Genta tts. mata 0,3 %, btl 5 ml
209 900002391 Err:504
210 900007877 Gentamicin sulfate krim 0.1%, tube @ 5 gr (Kim)
211 900006263 Gerdilium FC tab. 10 mg
212 100920005 Gerdilium syr. 5 mg/5 ml, btl 60 ml
213 900004090 Gitas Plus tab.
214 900000731 Glibenclamide tab. 5 mg (Indo)
215 900008062 Glimepiride tab. 2 mg (Kim)
216 900008063 Glimepiride tab. 3 mg (Kim)
217 900000737 Gliseril guaiakolat tab. 100 mg
218 900005668 Glucophage tab. 500 mg
219 900005669 Glucophage tab. 850 mg
220 900005670 Glucophage XR tab. 500 mg
221 102130001 Glucovance 250/1,25 tab.
222 102140001 Glucovance 500/2,5 tab
223 102150001 Glucovance 500/5 tab
224 110285001 Glunor tab. 850 mg
225 130078001 Goralgin kapl.
226 153730001 Graphalac sir 10mg/15ml (sir 3,335 g/5 mL)
227 101460001 H.C.T. tab. 25 mg (Kim)
228 130010013 H2O2 3%
229 900000747 Haloperidol tab. 0,5 mg (Indo)
230 900000748 Haloperidol tab. 1,5 mg (Indo)
231 900000749 Haloperidol tab. 5 mg (Indo)
232 900002535 Harnal D tab. 0,2 mg
233 150100058 Harnal Ocas tab. 0,4 mg
234 900004450 Hemapo prefilled syringe 3000 IU
235 900004451 HEPAMAX
236 110389001 Err:504
237 100840002 Herbesser CD kaps. 100 mg
238 100840004 Herbesser CD kaps. 200 mg
239 101440001 Hexadol Mint sol. 100 ml
240 103810001 Hexymer tab. 2 mg
241 140000007 Hi-Bone tab.
242 170300009 Hotin Cr 120 gr
243 170300058 Hotin Cr Aromatherapy 120 ml
244 170100173 Humalog Mix 50 Kwikpen inj. 100 IU/ml, penfill 3 ml.
245 900000779 ICHTYOL OINT 15GR
246 900001634 Imdur tab. 60 mg
247 100380001 Imuran tab. 50 mg
248 900003736 Indanox kaps. 300 mg
249 170100018 Inerson krim 0,25 %, tube 15 gr
250 900003047 Inoxin tab. 400 mg
251 102740002 Interhistin tab. 50 mg
252 100480002 Interpec syr. paed 15 mg/5 ml, btl 100 ml
253 100070002 Interpec tab. 30 mg
254 101770001 Interzol krim 2 %, 5 gr
255 900004135 INTRIZIN DROP 15ML
256 169060018 Irbesartan tab. 150 mg. (Indo)
257 169060041 Irbesartan tab. 300 mg. (Indo)
258 900000818 Isoniazid tab. 300 mg (Kim)
259 900004142 Isoric tab. 300 mg.
260 900000832 Err:504
261 900004485 Kalmeco tab. 500 mcg
262 900004492 Kalmoxilin kaps. 500 mg
263 900004496 Kalnex tab. 500 mg
264 900004508 Err:504
265 900004511 Kaltrofen tab. 100 mg (Kal)
266 900004507 Err:504
267 900008077 Kapsul Kosong No.0 1000
268 900008078 Kapsul Kosong No.00 1000
269 900008079 Kapsul Kosong No.1 1000
270 900008080 Kapsul Kosong No.2 1000
271 900008081 Kapsul Kosong No.3 1000
272 900000850 KASA STERIL 16/16
273 900002921 Kendaron tab. 200 mg
274 140000000 Keppra Tab
275 900000856 KERTAS PERKAMEN
276 130050001 Ketoconazole krim 2 %, 5 gr (Dex)
277 900008083 Ketoconazole tab. 200 mg (Kim)
278 103790003 Ketricin salep in oral base 5 gr
279 900007658 KLODERMA CREAM 0.05% 10GR
280 900007659 Kloderma krim 5 gr
281 169110010 Kloderma Oint 10 gr
282 900007660 Kloderma salep 0,1 %, tube 5 g
283 900006539 Kolkatriol tab. 0,25 mg
284 900000370 Kombinasi : aluminium hydroxide 200 mg, magnesium hydroxide 200
285 170100175 Err:504
286 900005683 KSR tab. siap larut 600 mg
287 900003995 LACTULAX 200ML
288 900000899 LAMICTAL 100MG
289 900000903 LANOLIN
290 153740002 Lansoprazole kaps. 30 mg (Indo)
291 158110002 Lantus inj. 100 IU/ml, solostar pen @ 3 ml
292 900001701 Lasix tab. 40 mg
293 900003057 Leparson kaps.
294 170100147 Err:504
295 103580001 Letonal tab. 100 mg
296 103580002 Letonal tab. 25 mg
297 158110001 Levemir Flexpen inj 100 IU/ml, flexpen 3 ml
298 900000917 Err:504
299 153870003 Levofloxacin tab. 500 mg (Kim)
300 110268001 Lifezar tab. 50 mg
301 130010006 Liquor Carbol Detergent (LCD)
302 110033001 Litorcom tab. 10 mg
303 110033002 Litorcom tab. 20 mg
304 101290002 Lodem tab. 30 mg
305 900007114 Lodia FC tab. 2 mg
306 900000938 Loratadine tab. 10 mg (Hex)
307 900004143 Lotasbat krim 10 gr
308 900007002 Madopar Disp kaps.
309 170300008 Madu TJ Murni 500 gr
310 101980002 Magtral Syr. Forte
311 170400054 Err:504
312 900003509 Medixon tab. 4 mg
313 100250003 Mefinal kaps. 250 mg
314 900000971 Meloxicam tab. 15 mg (Kim)
315 900000972 Meloxicam tab. 7,5 mg (Kim)
316 900002174 Menthol
317 156500004 Mertigo SR tab. 24 mg
318 103390001 Mestinon tab. 60 mg
319 900000979 Metformin tab. 500 mg (Dex)
320 102870004 Methyl prednisolone tab. 16 mg (Dex)
321 102870005 Methyl prednisolone tab. 4 mg (Dex)
322 900006277 Err:504
323 900004541 Metrix tab. 1 mg
324 900004542 Metrix tab. 2 mg
325 900004543 Metrix tab. 3 mg
326 900004544 Metrix tab. 4 mg
327 900000986 Metronidazole tab. 500 mg (Kim)
328 110492002 Miconazole krim 2 %, 10 gr (Kim)
329 900000003 MICROPORE 1 X 10
330 100600001 Minosep lar. 0,2%, btl 60 ml
331 170300007 Minyak Telon Herbal Plus Citronella 100 ml
332 169120001 Err:504
333 110319003 Moretic tts. 60 mg/0,6 ml
334 169110110 Mucera Drops
335 103620002 Musin susp. 500 mg/5 ml @ 100 ml
336 900005949 MYFORTIC 180 MG
337 900001034 Natrium Bikarbonat tab. 500 mg
338 900008089 Needle 24
339 900005841 Neo Mercazole tab. 5 mg
340 900004574 Neuralgin RX kapl.
341 170100036 Neuraxon 5000 tab.
342 900007124 Neurosanbe FC tab
343 900007123 Neurosanbe Plus kapl.
344 900008091 Nexavar
345 900001074 Nifedipine kaps. 10 mg (Kim)
346 101330002 Nitrokaf Retard kaps. SR 2,5 mg
347 101330001 Nitrokaf Retard kaps. SR 5 mg
348 170100116 Nolipo tab. 500 mg
349 900003070 Noperten tab. 10 mg
350 103080001 Norelut tab. 5 mg
351 900007389 Nova set/buah
352 169080001 Novo Twist 32G TIP x 5 mm
353 150100032 NovoMix 30 FlexPen inj. 100 IU/ml
354 900008094 Novorapid flexpen inj. 100 IU/ml
355 130130004 Nucral susp. 500 mg/5 ml @ 200 ml
356 150100043 Nutricholin tab.
357 103060006 Nymiko susp. 100.000 IU/ml, btl. 12 ml
358 130000021 Nyndia susp. 100.000 IU/ml, btl. 12 ml
359 103100001 O.B.H cairan, btl 100 ml
360 900004172 OA Forte kapl.
361 154980001 Omeprazole kaps. 20 mg (Indo)
362 900001118 ONE STEP TEST
363 154950004 Err:504
364 900006289 Opilax syr 10 mg/ 5 ml. Btl 120 ml
365 900006293 Opimox Forte syr. kering 250 mg/ 5 ml, btl 60 ml
366 900006292 Opimox kaps. 500 mg
367 102200003 Opineuron kapl.
368 900006303 Opixime tab. 100 mg
369 158900001 Oscal tab. 0,25 mcg
370 169090072 Osfit tab. 500 mg
371 900003077 Ossoral 800 tab.
372 169110112 Ossovit kapl.
373 150100027 Osteomax kaps.
374 102260001 Otopain tts. telinga, btl. 8 ml
375 103180001 Ottopan Drops tts. 100 mg/ml
376 900004178 Pamol syr. 120 mg/5 ml, btl 60 ml
377 900001169 Paracetamol syr. 120 mg/5 ml, btl 60 ml (Kim)
378 103180004 Paracetamol tab. 500 mg (Kim)
379 101080002 Phenobarbital tab. 30 mg (Kim)
380 101070004 Phenytoin kaps. 100 mg
381 130115001 Pionix tab. 15 mg
382 900000218 PIPET TETES
383 900003079 Piracetam tab. 1200 mg
384 900003081 Piracetam tab. 800 mg
385 170100226 Pirotop krim 2%, 5 gr
386 900001209 Piroxicam kaps. 10 mg (Kim)
387 900002184 PK CRYSTAL
388 101980004 Plantacid Forte tab.
389 101830002 Plavix tab. 75 mg
390 900007131 Polidemisin ED tts. mata , btl 5 ml
391 900002412 Polydex ED tts. mata , btl 5 ml
392 900002593 Ponstelax kapl. 500 mg
393 900000225 POT SALP 15GR
394 900000226 POT SALP 20GR
395 900000227 POT SALP 50GR
396 130000117 Pradaxa kaps. 110 mg
397 130117001 Pravinat tab. 10 mg
398 900006319 Prednicort tab. 4 mg
399 103320001 Prednisone tab. 5 mg (Kim)
400 900003089 Primadex kapl.
401 103340001 Probenid tab. 500 mg
402 900001715 Err:504
403 900001249 Propanolol tab. 10 mg ( HCl )
404 103370004 Propanolol tab. 40 mg (Kim)
405 103360001 Propylthiouracil tab. 100 mg (Indo)
406 101130002 Prostacom tab. 5 mg
407 900001208 Pyrazinamide tab. 500 mg (Kim)
408 900007537 Pyridoxine HCl. (vitamin B6) tab. 10 mg (Kim)
409 900001267 Ranitidin tab. 150 mg. (Hex)
410 155900001 Err:504
411 169110100 Err:504
412 169110042 Recansa tab. 10 mg
413 100060002 Reucid tab. 100 mg
414 100060003 Reucid tab. 300 mg
415 102270001 Rhinofed susp. tiap 5 ml, btl 60 ml
416 102270002 Rhinofed tab.
417 900003111 Err:504
418 900003112 Err:504
419 102450002 Rhinos SR kaps.
420 159000005 Ricovir tab. 300 mg
421 900002733 Rif kaps. 300 mg
422 900002734 Rif tab. 450 mg
423 900001290 Rifampicin kapl. 600 mg (Kim)
424 900001289 Rifampicin tab. 450 mg (Kim)
425 102660007 Rihest syr. 5 mg/5 ml, btl 60 ml
426 120000145 Risperidone tab. 2 mg (Dex)
427 101000001 Rivanol lar. 0,1%, btl 300 ml
428 900000232 RIVANOL SOL 100ML IKA
429 110058001 Rydian tab. 10 mg
430 153050001 Sagestam ED tts. mata 0,3 %, btl 5 ml
431 101270004 Sagestam EO salep mata 0,3 %, tube 3,5 gr
432 900001317 Salbutamol sulfate tab. 2 mg (Kim)
433 900003997 SALICYL TALK (IKA)
434 900003173 Salofalk tab. 250 mg
435 101920001 Sanbe Tears lar. 2 % btl 5 ml
436 154830001 Sanfuro syr. 250 mg/5 ml
437 900005713 Sangobion Baby drop 15mg/ml, btl @15ml
438 900005714 Sangobion Kids sir. 15mg/5ml, btl @100ml
439 130000025 Sanmol Forte kapl. 650 mg
440 103180008 Sanmol tab. 500 mg
441 154060001 Santesar tab. 50 mg
442 103210001 Scabimite krim 5 %. 10 gr
443 101490002 Scopamin tab. 10 mg
444 103670001 Sebivo tab. 600 mg
130030018 Seretide Discus disc. 50/250 mcg
102310001 Seretide Inhaler i.h 25/125 mcg/puff, 120 semprot
103310001 Sifrol tab. 0,125 mg
103810031 Simarc tab. 2 mg
103550004 Simvastatin tab. 10 mg (Kim)
900001415 Simvastatin tab. 20 mg (Kim)
900001721 Sofratulle kasa steril 1%
900002022 SPASMINAL
900002737 Spectrem Forte kapl.
900002736 Spectrem kapl.
900002145 Spiriva Refill kap 18 mcg refill
900008105 Spironolactone tab. 25 mg (Dex)
900001433 Spuit 1 cc
900001434 SPUIT 3CC
900003245 Stesolid lar. rectal 10 mg/2,5 ml
100440004 Stolax supp. 10 mg
103640001 Sulcolon kaps. Sal enterik 500 mg
900002189 Sulfur PP
156110001 Suprasma i.h 100 mcg/puff, 200 semprot
900001465 Symbicort i.h 160/4,5 mcg/puff 60 semprot
102050001 Symbicort i.h 80/4,5 mcg/puff 60 semprot
900000605 SYRINGE TERUMO SPUIT 5 CC
900004637 Err:504
101550001 Tanapress tab. 10 mg
101550002 Tanapress tab. 5 mg
900004638 Tarivid tab. 200 mg
103110006 Tarivid tab. 400 mg
101720004 Tegretol tab. 200 mg
900005982 Tegretol tab. CR 200 mg
900003140 Tenapril tab. 10 mg
103400012 Tenapril tab. 2,5 mg
103400013 Tenapril tab. 5 mg
110265002 Tensiphar tab. 5 mg
153560001 Tensira tab. 150 mg
153560002 Tensira tab. 300 mg
900002192 Teofilin tab. 150 mg
900003142 Teosal tab.
103560003 Tequinol tab. 500 mg
103700002 Termisil krim 5 gr
110013002 Theravask tab. 5 mg
103730004 Thiamycin Forte syr. kering 250 mg, btl 60 ml
900004204 Thiamycin kaps. 500 mg
110374002 Thiamycin syr. 125mg, btl 60 ml
101420001 Thombophob gel. 20 gr
100220006 Thrombo Aspilets tab. 80 mg
101420002 Err:504
900005729 Thyrozol tab. 10 mg
103750002 Tim Opthal tts. mata 0,5 %, btl. 5 ml
900002423 Timol ED tts. mata 0,5 %, btl. 5 ml
900001507 Tramadol kaps. 50 mg (Indo)
130080001 Tramifen kapl
100270003 Tranec tab. 500 mg
100070007 Transbroncho syr. paed 15 mg/5 ml, btl 100 ml
900001734 TRENTAL 400
103800001 Trifluoperazine tab. 5 mg
900002954 TRIFLUOPHERAZIN 5 MG
900008106 Trilac inj. 10 mg/ml @ 5 ml
900004885 Trimate E kapl.
103810005 Trizedon MR tab. 35 mg
102220002 Tuzalos tab.
900003759 Unalium tab. 5 mg
900004225 Urinter kaps. 400 mg
900007191 Urotractin kaps. 400 mg
110407001 Ursolic kaps. 250 mg
170300064 Vaksin Flubio
169020002 Valdix tab. 160 mg
169020003 Valdix tab. 80 mg
100770006 Valisanbe tab. 2 mg
100770007 Valisanbe tab. 5 mg
157080001 Err:504
157080002 Varten tab. 80 mg
900002195 Vaselin Albumin
100430001 Vastigo tab. 6 mg
100570003 V-Bloc tab. 25 mg
900008107 V-Bloc tab. 6,25 mg
103470003 Ventolin i.h 100 mcg/puff, 200 semprot
103810025 Verapamil tab. 80 mg (Kim)
900001549 Verban (Kecil)
101340006 Viopor kapl.
900004242 VIT B1 50
900007590 vitamin B Komplek tab.
110341002 Vivace tab. 2,5 mg
900003163 Voltadex emulgel 1%/20 gr
900005811 Xepaneuron tab.
900002436 Xitrol salep mata 3,5 mg
900002435 Xytrol ED tts. mata , btl 5 ml
900002199 ZINCI OXYD
900006897 Zumafib kaps. 300 mg
900004690 Err:504
JUMLAH
Menyetujui;
Yeni Handayani
STOCK AWAL PEMBELIAN MUTASI MASUK
QTY JUMLAH RUPIAH QTY JUMLAH RUPIAH QTY JUMLAH RUPIAH
6 7 8 9 10 11
ida 200 mg/5ml Magnesium Hidroksida 200 mg/5 ml. btl 60 ml
droxide 200
227,791 632,924,068 70,398 37,603,182
Jakarta, 29 April 2017

Dibuat Oleh;

PENJUALAN MUTASI KELUAR STOCK AKHIR
QTY JUMLAH RUPIAH QTY JUMLAH RUPIAH QTY
16=(6+8+10)-
12 13 14 15 (12+14)
191,748 484,895,282 54,374 302,151,499 -
STOCK AKHIR
JUMLAH RUPIAH
17 = (7+9+11)-(13+15)
-
LAPORAN PEMBELIAN KE PBF
PERIODE 29-31 Mei 2017
Per : 12 May 2017

NO KODE NAMA KODE TANGGAL TANGGAL TERIMA NO NO TANGGAL KREDIT HARGA DISC
PBF PBF TF FAKTUR BARANG FAKTUR FAKTUR PAJAK FAKTUR PAJAK (HARI)
1 AAM PT. ANUGRAH ARGON MEDICA TF6 29 May 17 30 May 17 27170015430 30 23,463,000 10,792,980
2 AAM PT. ANUGRAH ARGON MEDICA TF6 29 May 17 30 May 17 27170015429 30 4,862,665 882,500
7 APL PT. ANUGERAH PHARMINDO LESTARI TF6 29 May 17 29 May 17 1115930434 30 840,436
8 APL PT. ANUGERAH PHARMINDO LESTARI TF6 29 May 17 30 May 17 1115931845 30 16,200,000 2,916,000
9 BSP PT. BINA SAN PRIMA TF6 29 May 17 29 May 17 FKJK2/201705/17153 30 1,706,600 828,343
10 BSP PT. BINA SAN PRIMA TF6 29 May 17 30 May 17 FKJK2/201705/17188 30 646,000
11 EVL PT. ENSEVAL PUTERA MEGATRADING TF6 26 May 17 26 May 17 317002982 30 6,463,650
14 EVL PT. ENSEVAL PUTERA MEGATRADING TF6 30 May 17 31 May 17 317003097 30 500,100
15 KALL PT. KALLISTA PRIMA TF6 29 May 17 30 May 17 33436 30 3,588,000 1,771,175
16 KALL PT. KALLISTA PRIMA TF6 31 May 17 31 May 17 33995 30 677,000 272,621
17 kby PT. KEBAYORAN PHARMA TF6 29 May 17 29 May 17 07ASB17023011 21 5,289,000 2,736,000
18 MBS PT. MENSA BINASUKSES TF6 29 May 17 29 May 17 CD192045097 30 510,000 153,000
19 MBS PT. MENSA BINASUKSES TF6 29 May 17 30 May 17 CD192045102 30 11,137,000 5,930,057
20 MBS PT. MENSA BINASUKSES TF6 30 May 17 30 May 17 CD192051642 30 150,000 25,005
21 MBS PT. MENSA BINASUKSES TF6 31 May 17 31 May 17 cd192061591 30 1,100,000 550,000
22 mrp PT. MERAPI UTAMA PHARMA TF6 29 May 17 30 May 17 00021800 21 425,440
22 Total Pembelian (Rp) 211,097,291 51,813,166

Menyetujui; YANG MENGAJUKAN
Yeni Handayani Heryani, S. Farm, Apt

Head Of Regional Jakarta Apoteker Telemedika Farma 6
6
user:
HARGA PPN 10% HARGA user: JATUH
Nilai Retur RETUR/ POTONGAN NILAI TANGGAL nilai harus dibayar SISA
Jika terdapat retur
SDH DISC + PPN WAJIB di NO.FAKTUR
TEMPO isi RETUR/PAJAK RETUR KONTRA BON HARI
Pada Faktur tertentu
sesuai dengan
isi dikolom ini.
Nilai Retur yang
12,670,020 1,267,002 JANGAN
13,937,022 di Kolom
29 Jun 17 13,937,022 29
Tertera
3,980,165 398,016 PEMBELIAN
4,378,181 29 Jun 17 4,378,181 29
5,873,475 587,347 6,460,822 29 Jun 17 6,460,822 29
1,800,000 180,000 1,980,000 29 Jun 17 1,980,000 29
2,700,000 270,000 2,970,000 30 Jun 17 2,970,000 30
25,340,040 2,534,004 27,874,044 30 Jun 17 27,874,044 30
840,436 84,044 924,480 28 Jun 17 924,480 28
13,284,000 1,328,400 14,612,400 29 Jun 17 14,612,400 29
878,257 87,826 966,083 28 Jun 17 966,083 28
646,000 64,600 710,600 29 Jun 17 710,600 29
6,463,650 646,365 7,110,015 25 Jun 17 7,110,015 25
67,330,000 6,733,000 74,063,000 25 Jun 17 74,063,000 25
5,539,400 553,940 6,093,340 29 Jun 17 6,093,340 29
500,100 50,010 550,110 30 Jun 17 550,110 30
1,816,825 181,683 1,998,508 29 Jun 17 1,998,508 29
404,379 40,437 444,816 30 Jun 17 444,816 30
2,553,000 255,300 2,808,300 19 Jun 17 2,808,300 19
357,000 35,700 392,700 28 Jun 17 392,700 28
5,206,943 520,694 5,727,637 29 Jun 17 174,240 5,553,397 29
124,995 12,500 137,495 29 Jun 17 137,495 29
550,000 55,000 605,000 30 Jun 17 605,000 30
425,440 42,544 467,984 20 Jun 17 467,984 20
159,284,125 15,928,411 175,212,536 174,240 175,038,296
STOCK OPNAME
Periode: Mei 2017
STOCK OPNAME
No ID OBAT Obat HNA Total
S. BESAR S. KECIL JML STOCK
STOCK OPNAME
STOCK OPNAME
STOCK OPNAME
STOCK OPNAME
STOCK OPNAME
STOCK OPNAME
STOCK OPNAME
STOCK OPNAME
STOCK OPNAME
STOCK OPNAME
STOCK OPNAME
STOCK OPNAME
STOCK OPNAME
STOCK OPNAME
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
STOCK OPNAME
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
0
Jakarta, 29 April 2017

Mengetahui
Head Of Regional Jakarta Apoteker

REKAPITULASI EXPIRED DATE OBAT JANGKA WAKTU 9 BULAN
BULAN APRIL 2017
No Kode Obat Nama Obat Nama Principal Nomor Batch Tanggal Transaksi Tanggal Kadaluarsa Jumlah Obat
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
Menyetujui; Yang m
Yeni Handayani Heryani, S
Head Of Regional Jakarta Apoteker Tele
DATE OBAT JANGKA WAKTU 9 BULAN
TELEMEDIKA FARMA 6
LAN APRIL 2017
HNA KP Total (Rp)
0.00
Yang membuat
REKAPITULASI PENGGUNAAN IMPREST FUND APOTEK
PER 31 Mei 2017
JL. Percetakan Negara No.17 A
NO URAIAN TANGGAL NILAI

26-May-17 Saldo awal 26-May-17
27-May-17 Biaya Makan Lembur RM. Sinar Family 27-May-17 150,000
27-May-17 Biaya Service Motor Dinas D 4796 HC Toko Surya Cahaya Motor 27-May-17 320,000
26-May-17 Biaya Jilid Laporan Aktivitas Toko Java Sukses 26-May-17 60,000
30-May-17 Biaya Kirim barang ke TF11 PT. Tiki 030067680196 30-May-17 91,200
31-May-17 Biaya Kirirm barang ke TF4 PT. Tiki 030067680312 31-May-17 76,950
SALDO AKHIR
Jakarta, 31-5-201
MENGETAHUI Yang membuat
Yeni Handayani Estu Dwi Kartika

Head Of Regional Telkomedika Jakarta AA Telemedika Farm
TEK
SALDO KAS
2,241,308
2,134,190
1,857,072
1,839,953
1,791,638
1,757,574
Rp 1,757,574.00
Jakarta, 31-5-2017
Yang membuat
Estu Dwi Kartika

AA Telemedika Farma 6
BERITA ACARA PEMERIKSAAN KAS
BULAN MEI 2017
APOTIK TELEMEDIKA FARMA 6
Pada hari ini tanggal 31 bulan Mei tahun 2017, pukul 17.00 WIB bertempat di ruangan
Apotik Telemedika Farma 6 Jalan Percetakan Negara 17 A telah di lakukan pemeriksaan kas
Bendahara Apotek Telemedika Farma 6 dengan hasil sebagai berikut :
UANG TUNAI
Uang Kertas Rp 100,000 10Rp 1,000,000

2 Uang Kertas Rp 50,000 13Rp 650,000
3 Uang Kertas Rp 20,000 1Rp 20,000
8 Uang Logam Rp 1,000 2Rp 2,000
9 Uang Logam Rp 500 5Rp 2,500
10 Uang Logam Rp 200 Rp -
11 Uang Logam Rp 100 1 Rp 100
12 Uang Logam Rp 50 Rp -
JUMLAH Rp 1,757,600
Jumlah menurut buku kas Rp 1,757,574
Selisih Rp (26)
Jakarta 31 Mei 2017
Yang Membuat PEMERIKSA
Estu Dwi Kartika Heryani, S Farm, apt

AA TF 6 Apoteker
Mengetahui,
Yeni Handayani
c
ds
REKAP TAGIHAN PENJUALAN KE YAKES TELKOM
( SISFO, TPBW, NON SISFO & NON DOT )
Periode 21 FEBRUARI - 24 MARET 2016
SISFO e-Apotek TPBW NON SISFO NON DOT TAGIHAN SELISIH TOTAL
NO TANGGAL
RESEP TAGIHAN RESEP TAGIHAN RESEP TAGIHAN RESEP TAGIHAN SISFO e-APOTEK RESEP TAGIHAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
JUMLAH 0 Rp - 0 Rp - 0 Rp - 0 Rp - Rp - 0 Rp -
Bandung, 24 Maret 2016

Mengetahui, Yang membuat
Agus Gumelar S.Si, Apt Nur Asiyah

APOTEKER TF2 AA TF 2
TELEMEDIKA FARMA 6
BUKU KAS MASUK - PENJUALAN UMUM
PERIODE 8 - 12 MEI 2017
,
NO TGL. NO. BUKTI URAIAN DEBET KREDIT SALDO
Saldo ( 5 Mei 2017) Rp 2,222,766.32
1 29-05-2017 SA2905201700058240100022 HERYANI 29,208 Rp 2,251,974.20
2 30-05-2017 SA3005201700096240100022 BELI - FIRMANSYAH 97,261 Rp 2,349,234.78
3 30-05-2017 SA3005201700052240100022 beli umum - an. Aqila 101,640 Rp 2,450,874.78
4 30-05-2017 SA3005201700097240100022 BELI- FERY FERDIAN 222,600 Rp 2,673,474.78
5 30-05-2017 SA3005201700133240100022 lab - rini (konfirmasi pusat untuk vaksin gardasil lab) 14,346,720 Rp 17,020,194.78
6 31-05-2017 SA3105201700088240100022 beli umum pak david 16,102 Rp 17,036,296.61
7 31-05-2017 SA3105201700140240100022 beli umum - ibu susilo 33,696 Rp 17,069,992.61
8 31-05-2017 SA3105201700193240100022 umum beli 32,500 Rp 17,102,492.61
9 31-05-2017 SA3105201700196240100022 umum 17,940 Rp 17,120,432.61
10 5/29/2017 SETOR PENJUALAN UMUM 837,157 Rp 16,283,275.31
JUMLAH SEBELUM PPN Rp 14,897,666.29 Rp 837,157.30 Rp 16,283,275.31
JUMLAH SETELAH PPN Rp 17,911,602.84
tanggal 29-5-2017 transfer sisa ppn belum dijumlahkan periode 25 april nilai yang dibayarkan tanpa ppn, hingga saat pembayaran 19-05-2017, ditambahkan selisih kekurangan pembayaran senilai 23678,1
Yang Membuat, Pemeriksa, Mengetahui,
Marliatin Nurhayati Heryani, S.Farm, Apt Yeni Handayani

AA Telemedika Farma 6 Apoteker Telemedika Farma 6 Head Of Regional Telkomedika Jakarta
LAPORAN PEMBELIAN RINCI
PERIODE : 6 - 12 Mei 2017
SISTEM
NO NO. PO TG. PO TG. INPUT FAKTUR PBF / SUPPLIER ITM KD OBAT NAMA OBAT DOT PO DO HNA
1 2 3 4 5 6 7 8 9 11 12 13 14
1 1.0052E+21
2 1.0052E+21
3 1.0052E+21
4 1.0052E+21
5 1.0052E+21
6
7
8
9
10
11
Jakart
Menyetujui; Yan
Yeni Handayani Heryan

Head Of Regional Jakarta Apoteker T
PEMBELIAN RINCI
E : 6 - 12 Mei 2017
SISTEM FAKTUR
% PKS HNA % BELI JUMLAH

15 16 17 18
TOTAL (Rp) : 0

Yang membuat

LAPORAN SELISIH HARGA PEMBELI
# Apotek Nomor PO Tanggal PO Entry Date Tanggal BarangTanggal FaktuNomor Faktur Nomor Fakt
1 Apotek Telemedika Farma 06 2.905202E+21 29-05-2017 30-05-2017 30-05-2017 29-05-2017 FKJK2/201705/17188

2 Apotek Telemedika Farma 06 2.905202E+21 29-05-2017 30-05-2017 30-05-2017 29-05-2017 21800
8 Apotek Telemedika Farma 06 2.905202E+21 29-05-2017 30-05-2017 30-05-2017 9-52-2017 CD192045102
9 Apotek Telemedika Farma 06 2.905202E+21 29-05-2017 30-05-2017 30-05-2017 9-52-2017 CD192045102
12 Apotek Telemedika Farma 06 2.905202E+21 29-05-2017 29-05-2017 29-05-2017 29-05-2017 FKJK2/201705/17153
Mengetahui/ menyetujui,
Yeni Handayani
Head Of Regional
LAPORAN SELISIH HARGA PEMBELIAN APOTEK TELEMEDIKA FARMA 6
Nama PBF Kode Obat Nama Obat DOT PKS PO DO Sistem Faktur Total Harga
HNA KP % PKS HNA KP % PKS
BINA SAN PRIMA PT. / BSP 169090062 Retivit Plus Kapl. Tidak Tidak 100 100 630 0 6460 0 646000
MERAPI UTAMA PHARMA PT./MRP 900006142 Abilify tab. 10 mg Tidak Tidak 10 10 36750 0 42544 0 425440
ANUGRAH ARGON MEDICA PT. / AAM 159000002 Folamil Genio Soft Kaps Tidak Tidak 60 60 3100 0 3500 0 210000
ANUGRAH ARGON MEDICA PT. / AAM 900005629 Concor tab. 5 mg Ya Ya 6000 6000 4223 46 4223.34 46 46926000
ENSEVAL PUTERA MEGATRADING Tbk. PT. / 900004444 Frego tab. 5 mg Ya Ya 2500 2500 2585 52.99 2585.46 0 6463650
ANUGRAH ARGON MEDICA PT. / AAM 900005629 Concor tab. 5 mg Ya Ya 3000 3000 4223 46 4223.34 46 23463000
ANUGRAH ARGON MEDICA PT. / AAM 150340005 Dilavask tab. 5 mg Ya Ya 1000 1000 492 70 492.03 53.8 1065000
MENSA BINA SUKSES PT. / MBS 900004172 OA Forte kapl. Ya Ya 100 100 3311 57 3311.28 60.58 840000
MENSA BINA SUKSES PT. / MBS 140000007 Hi-Bone tab. Ya Ya 150 150 2550 15 2550.1 27.14 525000
ANUGRAH ARGON MEDICA PT. / AAM 110489001 Cameloc tab. 7,5 mg Ya Ya 300 300 580 60 580.04 38.62 283500
ANUGRAH ARGON MEDICA PT. / AAM 110489002 Cameloc tab. 15 mg Ya Ya 200 200 920 60 920.02 38.46 299000
BINA SAN PRIMA PT. / BSP 154060001 Santesar tab. 50 mg Ya Ya 180 180 3773 51 3773.02 52.21 1421100
Yang mengajukan,

Total Diskon Total Pembelian SELISIH HNA
PER UNITTOTAL
0 646000 -5830 -583000
0 425440 -5794 -57940
0 210000 -400 -24000
21585960 25340040 -0.34 -2040
0 6463650 -0.46 -1150
10792980 12670020 -0.34 -1020
572970 492030 -0.03 -30
508872 331128 -0.28 -28
142485 382515 -0.1 -15
109487.7 174012.3 -0.04 -12
114995.4 184004.6 -0.02 -4
741956.31 679143.69 -0.02 -3.6
LAPORAN PEMBELIAN OBAT TF 6
Per : 31 May 2017 Jatuh Tempo Kurang dari :

NO KODE NAMA KODE TANGGAL NO FAKTUR PAJAK KREDIT HARGA
PBF PBF TF/LAB FAKTUR FAKTUR KODE & NOMOR SERI TANGGAL (HARI)
1 AAM PT. ANUGRAH ARGON MEDICA TF6 22 May 17 27170014609 30 5,723,245

4 AAM PT. ANUGRAH ARGON MEDICA TF6 24 May 17 27170014892 30 982,500
11 APL PT. ANUGERAH PHARMINDO LESTARI TF6 24 May 17 1115923008 30 718,200
12 APL PT. ANUGERAH PHARMINDO LESTARI TF6 24 May 17 1115923176 30 34,618,450
17 BSP PT. BINA SAN PRIMA TF6 29 May 17 FKJK2/201705/17153 30 1,706,600
18 BSP PT. BINA SAN PRIMA TF6 29 May 17 FKJK2/201705/17188 30 646,000
19 DBM PT. DISTRIVERSA BUANAMAS TF6 23 May 17 BDA/SPJ/1727966 14 234,000
20 EVL PT. ENSEVAL PUTERA MEGATRADING TF6 23 May 17 317002896 30 2,569,627
24 EVL PT. ENSEVAL PUTERA MEGATRADING TF6 30 May 17 317003097 30 500,100
25 KALL PT. KALLISTA PRIMA TF6 15 May 17 30243 30 3,242,000
26 KALL PT. KALLISTA PRIMA TF6 17 May 17 30901 30 367,500
33 KBY PT. KEBAYORAN PHARMA TF6 04 May 17 07ASB17019235 21 1,646,000
34 kby PT. KEBAYORAN PHARMA TF6 24 May 17 07asb17022339 21 7,552,500
35 kby PT. KEBAYORAN PHARMA TF6 29 May 17 07ASB17023011 21 5,289,000
36 MBS PT. MENSA BINASUKSES TF6 29 May 17 CD192045097 30 510,000
37 MBS PT. MENSA BINASUKSES TF6 29 May 17 CD192045102 30 11,137,000

38 MBS PT. MENSA BINASUKSES TF6 30 May 17 CD192051642 30 150,000
39 MBS PT. MENSA BINASUKSES TF6 31 May 17 cd192061591 30 1,100,000
40 MPI PT. MILLENNIUM PHARMACON INTERNATIONAL TF6 23 May 17 131517011856 21 195,532
41 mrp PT. MERAPI UTAMA PHARMA TF6 29 May 17 00021800 21 425,440
42 SAPTA pt. sapta sari tama TF6 22 May 17 1044904 21 1,275,000
43 TMP PT. TEMPO TF6 10 May 17 1702055895 21 5,107,847
44 TMP PT. TEMPO TF6 18 May 17 1702057633 21 1,302,469
196 TOTAL PEMBELIAN 308,155,586

1 AAM PT. ANUGRAH ARGON MEDICA TF6 03 May 17 271217011705 010.018-17.42359604 3/May/17 30 9,795,915
8 AAM PT. ANUGRAH ARGON MEDICA TF6 10 May 17 271217012348 010.018-17.42389818 10/May/17 30 160,000
11 AAM PT. ANUGRAH ARGON MEDICA TF6 17 May 17 271217013007 010.018-17.42418979 17/May/17 30 462,000
15 AMS PT. ANTARMITRA SEMBADA TF6 14 Mar 17 F5IV067 010.000-17.71520271 14/Mar/17 29 869,000
16 AMS PT. ANTARMITRA SEMBADA TF6 16 May 17 F5JL626 010.017-17.97927173 16/May/17 29 1,833,800
17 APL PT. ANUGERAH PHARMINDO LESTARI TF6 12 May 17 1115902565 010.017-17.96592430 12/May/17 30 1,683,130
18 APL PT. ANUGERAH PHARMINDO LESTARI TF6 17 May 17 1115911854 010.017-17.96635382 17/May/17 30 17,542,583
19 BSP PT. BINA SAN PRIMA TF6 03 May 17 FKJK2/201705/00741 010.000-17.85251829 3/May/17 30 545,400
20 BSP PT. BINA SAN PRIMA TF6 27 Apr 17 FKJK2/201704/14240 010.000-17.85304838 27/Apr/17 30 490,000
21 BSP PT. BINA SAN PRIMA TF6 28 Apr 17 FKJK2/201704/15599 010.000-17.85306026 28/Apr/17 30 305,000
22 BSP PT. BINA SAN PRIMA TF6 28 Apr 17 FKJK2/201704/15749 010.000-17.85306039 28/Apr/17 30 5,863,000
24 BSP PT. BINA SAN PRIMA TF6 08 May 17 FKJK2/201705/04082 010.000-17.87255034 8/May/17 30 8,153,500
26 BSP PT. BINA SAN PRIMA TF6 08 May 17 FJK2/201705/04164 010.000-17.87255094 8/May/17 30 124,000
39 DSN PT. DOS NI ROHA TF6 27 Apr 17 825806813 010.017-17.93202338 27/Apr/17 30 375,450
40 DSN PT. DOS NI ROHA TF6 04 May 17 825838350 010.017-17.93214130 4/May/17 30 125,150
41 ESP Eva Surya Pratama TF6 02 May 17 HO/17/05/02/P00413 010.009-17.05622574 2/May/17 30 1,935,000
42 ESP Eva Surya Pratama TF6 18 May 17 HO/17/05/18/P00169 010.009-17.05627137 18/May/17 30 1,860,000
43 EVL PT. ENSEVAL PUTERA MEGATRADING TF6 25 Apr 17 317002257 010.018-17.06822780 25/Apr/17 30 8,562,196
45 EVL PT. ENSEVAL PUTERA MEGATRADING TF6 27 Apr 17 117065665 010.018-17.06857129 27/Apr/17 30 365,052
47 EVL PT. ENSEVAL PUTERA MEGATRADING TF6 03 May 17 117069022 010.018-17.06924434 3/May/17 30 960,000
48 EVL PT. ENSEVAL PUTERA MEGATRADING TF6 03 May 17 317002450 010.018-17.06924944 3/May/17 30 2,002,460
63 IGM PT. INDOFARMA GLOBAL MEDIKA TF6 18 Apr 17 10INV.04.2017.3820 010.001-17.21043492 18/Apr/17 30 362,640
64 IGM PT. INDOFARMA GLOBAL MEDIKA TF6 25 Apr 17 10INV.04.2017.3972 010.001-17.21043654 25/Apr/17 30 376,028
65 IGM PT. INDOFARMA GLOBAL MEDIKA TF6 04 May 17 10INV.05.2017.4345 010.001-17.21043938 4/May/17 30 391,860
69 KALL PT. KALLISTA PRIMA TF6 10 Apr 17 22748 010.000-17.80341706 10/Apr/17 30 930,000
70 KALL PT. KALLISTA PRIMA TF6 11 Apr 17 22997 010.000-17.80344247 11/Apr/17 30 204,000
71 KALL PT. KALLISTA PRIMA TF6 29 Apr 17 27192 010.017-17.70566573 29/Apr/17 30 6,622,000
77 KALL PT. KALLISTA PRIMA TF6 04 May 17 28072 010.017-17.79576243 4/May/17 30 1,004,000
78 KALL PT. KALLISTA PRIMA TF6 10 May 17 29539 010.017-17.79588509 10/May/17 30 1,946,000
79 KBY PT. KEBAYORAN PHARMA TF6 20 Apr 17 07ASB17017079 010.018-17.13760736 20/Apr/17 21 5,116,000
80 KBY PT. KEBAYORAN PHARMA TF6 25 Apr 17 07ASB17017624 010.018-17.13761323 25/Apr/17 21 1,336,500
81 KBY PT. KEBAYORAN PHARMA TF6 10 May 17 07ASB17018896 010.018-17.13762565 10/May/17 21 -
82 KBY PT. KEBAYORAN PHARMA TF6 02 May 17 07ASB17018896 010.018-17.13762652 2/May/17 21 7,167,000
84 KBY PT. KEBAYORAN PHARMA TF6 10 May 17 07asb17020350 010.018-17.13764172 10/May/17 21 4,050,000
85 KBY PT. KEBAYORAN PHARMA TF6 10 May 17 07ASB17020388/FAKTUR PENGGANTI 07ASB17018896 010.018-17.13764216 10/May/17 21 7,167,000
87 kf PT. KIMIA FARMA TF6 23 Feb 17 2800211486 010.001-17.45881781 23/Feb/17 21 279,901
88 KF PT. KIMIA FARMA TF6 18 Apr 17 2800302131 010.001-17.45969218 18/Apr/17 21 1,199,236
89 KF PT. KIMIA FARMA TF6 18 Apr 17 2800303073 010.001-17.45969231 18/Apr/17 21 1,238,124
90 KF PT. KIMIA FARMA TF6 25 Apr 17 2800316095 010.001-17.45981040 25/Apr/17 21 162,585
91 KF PT. KIMIA FARMA TF6 29 Apr 17 2800327345 010.001-17.45995059 29/Apr/17 21 909,180
92 KF PT. KIMIA FARMA TF6 05 May 17 2800339952 010.001-17.46004399 5/May/17 21 628,762
94 KF PT. KIMIA FARMA TF6 06 May 17 2800341548 010.001-17.46005428 6/May/17 21 2,681,100
99 MBS PT. MENSA BINASUKSES TF6 25 Apr 17 CD191872361 010.018-17.22686408 25/Apr/17 30 7,293,500
100 MBS PT. MENSA BINASUKSES TF6 26 Apr 17 CD191878799 010.018-17.22692789 26/Apr/17 30 110,050
101 MBS PT. MENSA BINASUKSES TF6 26 Apr 17 CD191882005 010.018-17.22695963 26/Apr/17 30 430,075
6
Jatuh Tempo Kurang dari : 30 Hari

DISC HARGA PPN 10% HARGA JATUH RETUR/ POTONGAN NILAI TANGGAL nilai harus dibayar
SDH DISC + PPN TEMPO NO.FAKTUR RETUR/PAJAK RETUR KONTRA BON
2,305,325 3,417,920 341,792 3,759,712 21 Jun 17 0 - 30-Dec-99 3,759,712

545,610 1,175,936 117,592 1,293,527 22 Jun 17 0 - 30-Dec-99 1,293,527
2,722,568 9,489,183 948,918 10,438,101 22 Jun 17 0 - 30-Dec-99 10,438,101
520,485 462,015 46,201 508,216 23 Jun 17 0 - 30-Dec-99 508,216
10,792,980 12,670,020 1,267,002 13,937,022 29 Jun 17 0 - 30-Dec-99 13,937,022
882,500 3,980,165 398,016 4,378,181 29 Jun 17 0 - 30-Dec-99 4,378,181
2,244,525 5,873,475 587,347 6,460,822 29 Jun 17 0 - 30-Dec-99 6,460,822
450,000 1,800,000 180,000 1,980,000 29 Jun 17 0 - 30-Dec-99 1,980,000
675,000 2,700,000 270,000 2,970,000 30 Jun 17 0 - 30-Dec-99 2,970,000
21,585,960 25,340,040 2,534,004 27,874,044 30 Jun 17 0 - 30-Dec-99 27,874,044
197,730 520,470 52,047 572,517 23 Jun 17 0 - 30-Dec-99 572,517
14,836,450 19,782,000 1,978,200 21,760,200 23 Jun 17 0 - 30-Dec-99 21,760,200
30,232 793,116 79,311 872,427 23 Jun 17 0 - 30-Dec-99 872,427
5,934,580 7,912,800 791,280 8,704,080 25 Jun 17 0 - 30-Dec-99 8,704,080
- 840,436 84,044 924,480 28 Jun 17 0 - 30-Dec-99 924,480
2,916,000 13,284,000 1,328,400 14,612,400 29 Jun 17 0 - 30-Dec-99 14,612,400
828,343 878,257 87,826 966,083 28 Jun 17 0 - 30-Dec-99 966,083
- 646,000 64,600 710,600 29 Jun 17 0 - 30-Dec-99 710,600
24,480 209,520 20,952 230,472 07 Jun 17 0 - 30-Dec-99 230,472
- 2,569,627 256,963 2,826,590 22 Jun 17 0 - 30-Dec-99 2,826,590
- 6,463,650 646,365 7,110,015 25 Jun 17 0 - 30-Dec-99 7,110,015
- 67,330,000 6,733,000 74,063,000 25 Jun 17 0 - 30-Dec-99 74,063,000
- 5,539,400 553,940 6,093,340 29 Jun 17 0 - 30-Dec-99 6,093,340
- 500,100 50,010 550,110 30 Jun 17 0 - 30-Dec-99 550,110
1,472,915 1,769,085 176,908 1,945,993 15 Jun 17 0 - 30-Dec-99 1,945,993
143,252 224,248 22,424 246,672 17 Jun 17 0 - 30-Dec-99 246,672
333,150 416,850 41,685 458,535 18 Jun 17 0 - 30-Dec-99 458,535
191,002 298,998 29,900 328,898 18 Jun 17 0 - 30-Dec-99 328,898
245,700 245,700 24,570 270,270 21 Jun 17 0 - 30-Dec-99 270,270
582,109 605,891 60,589 666,480 22 Jun 17 0 - 30-Dec-99 666,480
1,771,175 1,816,825 181,683 1,998,508 29 Jun 17 0 - 30-Dec-99 1,998,508
272,621 404,379 40,437 444,816 30 Jun 17 0 - 30-Dec-99 444,816
159,600 1,486,400 148,640 1,635,040 26 May 17 0 1,580,040 30-Dec-99 55,000
3,456,000 4,096,500 409,650 4,506,150 14 Jun 17 0 - 30-Dec-99 4,506,150
2,736,000 2,553,000 255,300 2,808,300 19 Jun 17 0 - 30-Dec-99 2,808,300
153,000 357,000 35,700 392,700 28 Jun 17 0 - 30-Dec-99 392,700
5,930,057 5,206,943 520,694 5,727,637 29 Jun 17 0 174,240 30-Dec-99 5,553,397

25,005 124,995 12,500 137,495 29 Jun 17 0 - 30-Dec-99 137,495
550,000 550,000 55,000 605,000 30 Jun 17 0 - 30-Dec-99 605,000
50,310 145,222 14,522 159,744 13 Jun 17 0 - 30-Dec-99 159,744
- 425,440 42,544 467,984 20 Jun 17 0 - 30-Dec-99 467,984
314,924 960,076 96,007 1,056,083 13 Jun 17 0 - 30-Dec-99 1,056,083
362,233 4,745,615 474,561 5,220,176 02 Jun 17 0 294,642 30-Dec-99 4,925,534
144,855 1,157,614 115,761 1,273,375 09 Jun 17 0 - 30-Dec-99 1,273,375
86,386,677 221,768,910 22,176,882 243,945,792 2,048,922 241,896,870
2,328,208 7,467,707 746,771 8,214,477 02 Jun 17 0 - 9-May-17 8,214,477

596,107 1,242,051 124,205 1,366,256 03 Jun 17 0 - 9-May-17 1,366,256
1,322,914 1,697,306 169,730 1,867,036 07 Jun 17 0 - 16-May-17 1,867,036
1,597,463 4,687,538 468,754 5,156,291 08 Jun 17 0 - 16-May-17 5,156,291
534,823 4,813,408 481,341 5,294,749 09 Jun 17 0 - 16-May-17 5,294,749
410,662 3,145,965 314,596 3,460,561 09 Jun 17 0 - 16-May-17 3,460,561
1,713,641 5,647,440 564,744 6,212,184 09 Jun 17 0 - 16-May-17 6,212,184
- 160,000 16,000 176,000 09 Jun 17 0 - 16-May-17 176,000
1,931,800 2,134,950 213,495 2,348,445 14 Jun 17 0 - 23-May-17 2,348,445
1,203,633 3,446,367 344,637 3,791,004 15 Jun 17 0 - 23-May-17 3,791,004
115,500 346,500 34,650 381,150 16 Jun 17 0 - 23-May-17 381,150
1,636,979 5,704,146 570,415 6,274,561 16 Jun 17 0 - 23-May-17 6,274,561
212,686 853,925 85,390 939,315 17 Jun 17 0 - 23-May-17 939,315
1,856,158 3,225,092 322,509 3,547,601 18 Jun 17 0 - 23-May-17 3,547,601
207,570 661,430 66,143 727,573 12 Apr 17 RC83151 680,625 12-May-17 46,948
395,450 1,438,350 143,835 1,582,185 14 Jun 17 0 - 23-May-17 1,582,185
528,031 1,155,099 115,509 1,270,608 14 Jun 17 0 - 23-May-17 1,270,608
7,381,976 10,160,607 1,016,060 11,176,667 17 Jun 17 0 - 30-May-17 11,176,667
145,677 399,723 39,972 439,695 02 Jun 17 0 - 5-May-17 439,695
176,400 313,600 31,360 344,960 28 May 17 0 - 2-May-17 344,960
67,009 237,991 23,799 261,790 01 Jun 17 0 - 4-May-17 261,790
2,853,314 3,009,686 300,969 3,310,655 01 Jun 17 0 - 4-May-17 3,310,655
33,979 224,021 22,402 246,423 04 Jun 17 0 - 8-May-17 246,423
4,086,904 4,066,596 406,660 4,473,256 07 Jun 17 0 - 15-May-17 4,473,256
75,000 175,000 17,500 192,500 07 Jun 17 0 - 10-May-17 192,500

38,800 85,200 8,520 93,720 07 Jun 17 0 - 10-May-17 93,720
119,100 277,900 27,790 305,690 11 Jun 17 0 - 15-May-17 305,690
460,598 1,084,402 108,440 1,192,842 11 Jun 17 0 - 15-May-17 1,192,842
314,880 649,020 64,902 713,922 14 Jun 17 0 - 17-May-17 713,922
20,534,996 17,267,504 1,726,750 18,994,254 16 Jun 17 0 - 19-May-17 18,994,254
562,469 2,000,031 200,003 2,200,034 16 Jun 17 0 - 19-May-17 2,200,034
149,488 456,462 45,646 502,108 16 Jun 17 0 - 19-May-17 502,108
100,822 355,178 35,518 390,696 17 Jun 17 0 - 22-May-17 390,696
10,613,070 8,686,930 868,693 9,555,623 18 Jun 17 0 - 23-May-17 9,555,623
61,264,955 51,667,045 5,166,705 56,833,750 21 Jun 17 0 - 23-May-17 56,833,750
1,591,961 1,303,039 130,304 1,433,343 22 Jun 17 0 - 29-May-17 1,433,343
1,098,817 1,387,183 138,718 1,525,901 23 Jun 17 0 - 29-May-17 1,525,901
141,203 500,797 50,080 550,877 23 Jun 17 0 - 29-May-17 550,877
56,318 319,132 31,913 351,045 02 Jun 17 0 - 9-May-17 351,045
6,258 118,892 11,889 130,781 04 Jun 17 0 - 19-May-17 130,781
870,750 1,064,250 106,425 1,170,675 03 Jun 17 0 - 17-May-17 1,170,675
837,000 1,023,000 102,300 1,125,300 18 Jun 17 0 - 31-May-17 1,125,300
- 8,562,196 856,220 9,418,416 25 May 17 0 - 4-May-17 9,418,416
- 3,198,792 319,879 3,518,671 25 May 17 0 - 4-May-17 3,518,671
- 365,052 36,505 401,557 27 May 17 0401/NT/JK1/1701699910 212,408 4-May-18 189,149
- 4,179,800 417,980 4,597,780 01 Jun 17 0 - 8-May-17 4,597,780
288,000 672,000 67,200 739,200 02 Jun 17 0 - 12-May-17 739,200
- 2,002,460 200,246 2,202,706 02 Jun 17 0 - 12-May-17 2,202,706
- 7,307,052 730,704 8,037,757 02 Jun 17 0 - 12-May-17 8,037,757
- 270,677 27,067 297,744 04 Jun 17 0 - 12-May-17 297,744
- 3,543,280 354,328 3,897,608 04 Jun 17 0 - 12-May-17 3,897,608
- 9,786,000 978,600 10,764,600 07 Jun 17 0 - 16-May-17 10,764,600
720,000 1,680,000 168,000 1,848,000 08 Jun 17 0 - 16-May-17 1,848,000
- 1,253,150 125,315 1,378,465 08 Jun 17 0 - 16-May-17 1,378,465
- 1,700,000 170,000 1,870,000 08 Jun 17 0 - 16-May-17 1,870,000
- 675,000 67,500 742,500 09 Jun 17 0 - 18-May-17 742,500
- 5,995,576 599,557 6,595,133 09 Jun 17 0 - 18-May-17 6,595,133
- 41,085,000 4,108,500 45,193,500 16 Jun 17 0 - 22-May-17 45,193,500
360,000 840,000 84,000 924,000 16 Jun 17 0 - 22-May-17 924,000
- 3,556,417 355,641 3,912,058 16 Jun 17 0 - 22-May-17 3,912,058
- 343,865 34,386 378,251 16 Jun 17 0 - 22-May-17 378,251
- 3,562,980 356,298 3,919,278 21 Jun 17 0 - 29-May-17 3,919,278
- 362,640 36,264 398,904 20 May 17 0 - 4-May-17 398,904
7,281 368,747 36,876 405,622 25 May 17 0 - 4-May-17 405,622
19,593 372,267 37,227 409,494 04 Jun 17 0 - 16-May-17 409,494

11,757 431,781 43,178 474,959 04 Jun 17 0 - 16-May-17 474,959
- 266,433 26,643 293,076 09 Jun 17 0 - 16-May-17 293,076
12,561 577,272 57,727 634,999 21 Jun 17 0 - 30-May-17 634,999
409,921 520,079 52,007 572,086 11 May 17 0 - 2-May-17 572,086
61,200 142,800 14,280 157,080 12 May 17 0 - 8-May-17 157,080
3,244,382 3,377,618 337,761 3,715,379 01 Jun 17 0 - 22-May-17 3,715,379
4,974,887 4,330,113 433,011 4,763,124 01 Jun 17 0 - 22-May-17 4,763,124
4,866,486 4,373,514 437,351 4,810,865 20 May 17 0 - 8-May-17 4,810,865
707,511 1,085,489 108,548 1,194,037 20 May 17 0 - 8-May-17 1,194,037
605,678 722,322 72,232 794,554 21 May 17 0 - 8-May-17 794,554
1,438,025 1,399,975 139,998 1,539,973 26 May 17 0 - 15-May-17 1,539,973
476,496 527,504 52,750 580,254 04 Jun 17 0 - 29-May-17 580,254
821,390 1,124,610 112,461 1,237,071 11 Jun 17 0 - 29-May-17 1,237,071
2,736,000 2,380,000 238,000 2,618,000 11 May 17 0 - 2-May-17 2,618,000
360,000 976,500 97,650 1,074,150 16 May 17 0 - 4-May-17 1,074,150
- - - - 31 May 17 07ASG17001231 4,865,520 16-May-17 (4,865,520)
2,743,800 4,423,200 442,320 4,865,520 24 May 17 0 - 9-May-17 4,865,520
2,738,600 2,712,900 271,290 2,984,190 30 May 17 0 - 15-May-17 2,984,190
1,170,000 2,880,000 288,000 3,168,000 31 May 17 0 - 15-May-17 3,168,000
3,283,800 3,883,200 388,320 4,271,520 31 May 17 0 - 16-May-17 4,271,520
2,736,000 2,280,000 228,000 2,508,000 07 Jun 17 0 - 22-May-17 2,508,000
- 279,901 27,990 307,891 16 Mar 17 0 - 12-May-17 307,891
- 1,199,236 119,924 1,319,160 09 May 17 0 - 30-May-17 1,319,160
- 1,238,124 123,812 1,361,936 16 May 17 0 - 2-May-17 1,361,936
- 162,585 16,259 178,844 17 May 17 0 - 30-May-17 178,844
- 909,180 90,918 1,000,098 23 May 17 0 - 9-May-17 1,000,098
- 628,762 62,876 691,638 29 May 17 0 - 23-May-17 691,638
2,303 133,234 13,323 146,557 29 May 17 0 - 23-May-17 146,557
- 2,681,100 268,110 2,949,210 29 May 17 0 - 23-May-17 2,949,210
- 485,550 48,555 534,105 30 May 17 0 - 23-May-17 534,105
3,454 134,696 13,470 148,166 05 Jun 17 0 - 23-May-17 148,166
- 493,245 49,325 542,570 05 Jun 17 0 - 23-May-17 542,570
- 545,508 54,551 600,059 07 Jun 17 0 - 30-May-17 600,059
3,880,183 3,413,317 341,332 3,754,649 25 May 17 0 - 3-May-17 3,754,649
16,350 93,700 9,370 103,070 26 May 17 0 - 3-May-17 103,070
182,475 247,600 24,760 272,360 27 May 17 0 - 3-May-17 272,360
647,528 862,472 86,247 948,719 27 May 17 0 - 3-May-17 948,719
4,764,782 3,997,218 399,722 4,396,940 27 May 17 CR100921098 174,240 3-May-17 4,222,700
REKAP PEMBAYARAN APT. TELEMEDIKA FARMA 6
Per : 30 May 2017

KODE KODE TANGGAL NO NO HARGA
NO HARGA DISC
PBF TF FAKTUR FAKTUR FAKTUR PAJAK SDH DISC
1 AAM TF6 17 Apr 17 271217010144 010.000-17.70248572 2,795,000 962,959 1,832,041

2 AAM TF6 17 Apr 17 271217010136 010.000-17.70248456 17,572,168 1,652,217 15,919,951
3 AAM TF6 17 Apr 17 271217010202 010.000-17.70251215 3,553,033 1,424,042 2,128,991
4 AAM TF6 18 Apr 17 271217010354 010.000-17.70258680 375,000 56,250 318,750
5 AAM TF6 18 Apr 17 271217010373 010.000-17.70259243 2,439,000 265,650 2,173,350
6 AAM TF6 18 Apr 17 271217010365 010.000-17.70259067 10,124,720 3,023,565 7,101,155
7 AAM TF6 20 Apr 17 271217010498 010.000-17.70270494 1,025,000 147,498 877,503
8 AAM TF6 20 Apr 17 271217010501 010.000-17.70270690 6,503,365 1,448,502 5,054,864
9 AAM TF6 25 Apr 17 271217010873 010.000-17.70286759 3,840,000 799,200 3,040,800
10 AAM TF6 27 Apr 17 271217011124 010.000-17.70299619 3,855,655 828,116 3,027,539
11 AAM TF6 27 Apr 17 271217011240 010.018-17.42338355 4,930,000 1,007,500 3,922,500
12 AAM TF6 28 Apr 17 271217011425 010.018-17.42346711 14,558,905 3,451,565 11,107,337
13 AAM TF6 28 Apr 17 271217011394 010.018-17.42345820 1,538,280 384,814 1,153,466
13 TOTAL PEMBELIAN 73,110,126 15,451,878 57,658,247
Mengetahui/ menyetujui,
Yeni Handayani
HARUS BAYAR JATUH
PPN 10%
HARGA + PPN TEMPO Tanggal
Pembayaran
183,204 2,015,245 17 May 17 31 May 17

1,591,995 17,511,946 17 May 17 31 May 17
212,899 2,341,890 17 May 17 31 May 17
31,875 350,625 18 May 17 31 May 17
217,335 2,390,685 18 May 17 31 May 17
710,116 7,811,271 18 May 17 31 May 17
87,750 965,253 20 May 17 31 May 17
505,486 5,560,350 20 May 17 31 May 17
304,080 3,344,880 25 May 17 31 May 17
302,754 3,330,293 27 May 17 31 May 17
392,250 4,314,750 27 May 17 31 May 17
1,110,734 12,218,071 28 May 17 31 May 17
115,347 1,268,813 28 May 17 31 May 17
5,765,825 63,424,072

Dibuat Oleh;

1450000 1022250
562500 168750
7433330 1904209
1445000 864225
9946160 2628345
8931300 3325164
11226976 3478347
2964339 296434
1487320 312337
135000 27000
130000 0
52018938 26306441 -1
5297400 0
3010500 306770
6060140 3204994
327000 124186
119910 38035 -1
3627000 1971259
1960575 792229
385780 122351
14071500 7957751
384000 165581
336000 112358
84030 21663
85650 27168
294587 58917
975075 206276.25
517590 12940
772200 78687
445000 67000
861000 430500
24097000 12445245
22804524 10062855
1440000 720000
5515000 2412850
1140000 309726
1271000 480125
1061000 0
530000 318000
825900 123885
1352229 198301
21609960 6566438
2481616 341722
914250 357746
533175 0
240000 84000
1839500 931150 -1
2010000 1030200
131250 52500
65625 26250
1594000 119550
801000 239199
LAPORAN INVENTARIS KANTOR
TELEMEDIKA FARMA 6 PERCETAKAN NEGARA - JAKARTA
NO NAMA BARANG/AKTIVA MERK TYPE UNIT KODE AKUN AUDIT KONDISI LOKASI KETERANGAN
TGL PEMBELIAN
TETAP
UMUM
1 Kulkas Sharp 1 TF 6 1231001 - 001 11 Maret '15 BAIK APOTEK

2 Monitor Komputer 1 TF 6 1231001 - 002 11 Maret '15 BAIK APOTEK
3 CPU Komputer 1 TF 6 1231001 - 003 11 Maret '15 BAIK APOTEK
4 Monitor Komputer 1 TF 6 1231001 - 004 11 Maret '15 BAIK APOTEK
5 CPU Komputer 1 TF 6 1231001 - 005 11 Maret '15 BAIK APOTEK
6 Printer HP P 1005 1 TF 6 1231001 - 006 11 Maret '15 BAIK APOTEK
7 Dispenser 1 TF 6 1231001 - 008 11 Maret '15 BAIK APOTEK
8 Telephone Panasonic 1 TF 6 1231001 - 009 11 Maret '15 BAIK APOTEK
9 Timbangan mg 1 TF 6 1231001 - 011 11 Maret '15 BAIK APOTEK
10 Timbangan gram 1 TF 6 1231001 - 012 11 Maret '15 BAIK APOTEK
11 printer hp p1002 1 TF 6 1231001 - 013 baik APOTEK
12 scanner canon LIDE 120 1 TF 6 1231001 - 014 BAIK APOTEK
14 ac split panasonic 1/2 pk TF 6 1231001 - 015 BAIK APOTEK
15 Kulkas aqua TF 6 1231001 - 016 BAIK APOTEK
MEUBELAIR
1 Lemari OKT + Narkotika 1 TF 6 1231002 - 001 11 Maret '15 BAIK APOTEK

2 Meja Racik 1 TF 6 1231002 - 003
3 Kursi kerja Jet Star Black - grey 1 19-Mar-17 TF 6 1231002 - 002 BAIK APOTEK
4 Kitchen Set 1 TF 6 1231002 - 005 11 Maret '15 BAIK APOTEK
5 Kursi kerja black 3 19-Mar-17 TF 6 1231002 - 004 BAIK APOTEK
6 loker 4 pintu D54-WHITE YELLOW 2 19-Mar-17 TF 6 1231002 - 006 BAIK APOTEK
Kendaraan Bermotor ( KBM )
1 Motor Honda 1 TF 6 1231003 - 006 11 Maret '15 BAIK APOTEK
Catatan : 1. Apabila dalam pelabelan barang terdapat kesulitan dikarenakan barangnya lebih kecil dari label, maka kertas label bisa di gunting dan yang ada hanyalah pencantuman kode akun saja.
2. Kami menyediakan 5 s/d 10 lembar label yang kosong untuk dapat dipergunakan apabila ada barang yang belum tercatat dan apabila ada ba ada barang yang patut di labe dalam
laporan tidak di label.
3. Apabila ada penambahan label , mohon untuk dapat mencantumkan kode akun disesuaikan dengan no urut yang terakhir.
Jakarta, 12 May 2017
Mengetahui/
menyetujui, Yang mengajukan,
Head Of Regional Apoteker Telemedika Farma 6

Catatan : Khusus untuk penulisan nomor serie dari KODE AKUN dan AUDIT, dicatat oleh Kantor Pusat.
Kursi 4 Rasapala
Kursi 1 Rasapala Hitam
Kursi 1 Rasapala Merah
Kursi 2 Rasapala Kursi baso 304
Kursi 3 Rasapala Kursi baso 304
Lemar 1
Lemar 1
Meja 2
Meja 1
Kursi 1
Conta 1 40545
Tikar 1 39958
Monit 1 Telkomedika
Merk AOC DFHBAHA006651
CPU 1 Telkomedika Merk LG DE Series

Mengetahui, Yang Membuat,
Agus Gumelar S.Si, Apt Nur Asiyah

Apoteker TF 2 AA TF 2
DATA TAGIHAN SELISIH HARGA E-APOTEK DOT 2015 NON PKS Berdasarkan Harga Pembelian ( Sesuai Faktur ) TELEM
Periode 21 FEBRUARI - 24 MARET 2016
No Tanggal Kode Obat Nama Obat Nomor Resep Jumlah NIK Nama Pegawai
Yang Membuat,
Nur Asiyah
Asisten Apoteker TF 2
ai Faktur ) TELEMEDIKA FARMA 2
Harga Harga
Faktur Total Obat
Harga ( E-
NIKKES Nama Pasien Nama Dokter Diskon (%) Margin (%) Total ( HNA Non Total
Apotek) Pembaya per Harga HNA
Margins
ran HNA tablet ) (M*F) belum PPN
belum ( Plus
PPN ( E- Margins 8
Apotek ) %)
- -
PPN 10 %

Pemeriksa,
Agus Gumelar S.Si, Apt

Apoteker TF 2
Selisih HNA
belum PPN
(O-L)
-
-
-
-
# Apotek Nomor PO Tanggal PO Entry Date Tanggal Barang Tiba
1 Apotek Telemedika Farma 06 2.6052E+21 26-05-2017 29-05-2017 29-05-2017

Tanggal Faktur Nomor Faktur Nomor Faktur Pajak
26-05-2017 317002982
26-05-2017 317002978
26-05-2017 317002978
26-05-2017 317002978
26-05-2017 317002978
29-05-2017 FKJK2/201705/17153
29-05-2017 FKJK2/201705/17153
29-05-2017 FKJK2/201705/17153
29-05-2017 1115930434
29-05-2017 CD192045097
29-05-2017 07ASB17023011
29-05-2017 07ASB17023011
29-05-2017 27170015430
29-05-2017 27170015429
29-05-2017 27170015429
29-05-2017 27170015429
29-05-2017 27170015429
29-05-2017 27170015427
29-05-2017 27170015427
29-05-2017 27170015427
29-05-2017 27170015427
29-05-2017 27170015427
29-05-2017 27170015427
29-05-2017 27170015427
29-05-2017 21800
29-05-2017 1115931845
29-05-2017 33436
29-05-2017 33436
29-05-2017 33436
29-05-2017 FKJK2/201705/17188
9-52-2017 CD192045102
9-52-2017 CD192045102
9-52-2017 CD192045102
9-52-2017 CD192045102
9-52-2017 CD192045102
9-52-2017 CD192045102
9-52-2017 CD192045102
9-52-2017 CD192045102
9-52-2017 CD192045102
30-05-2017 CD192051642
30-05-2017 27170015590
29-05-2017 317003037
29-05-2017 317003037
29-05-2017 317003037
29-05-2017 317003037
29-05-2017 317003037
29-05-2017 317003037
29-05-2017 317003037
29-05-2017 317003037
29-05-2017 317003037
31-05-2017 27170015785
31-05-2017 CD192061591
30-05-2017 27170015646
30-05-2017 317003097
30-05-2017 317003097
31-05-2017 33995
31-05-2017 33995
Nama PBF Kode Obat
ENSEVAL PUTERA MEGATRADING Tbk. PT. / EVL 900004444

BINA SAN PRIMA PT. / BSP 154060001
ANUGERAH PHARMINDO LESTARI PT. / APL 170100173
MENSA BINA SUKSES PT. / MBS 169060018
KEBAYORAN PHARMA PT. / KBY 103810031
KEBAYORAN PHARMA PT. / KBY 900008036
ANUGRAH ARGON MEDICA PT. / AAM 900005629
MERAPI UTAMA PHARMA PT./MRP 900006142
ANUGERAH PHARMINDO LESTARI PT. / APL 170200007
KALLISTA PRIMA PT. / KALL 110407001
Nama Obat DOT PKS PO DO Sistem
HNA KP % PKS
Frego tab. 5 mg Ya Ya 2500 2500 2585 52.99
Cpg 75 Mg Tidak Tidak 3000 3000 14267 0
Irvask tab. 150 mg Tidak Tidak 1500 1500 6533 0
Irvask tab. 300 mg Tidak Tidak 1500 1500 12333 0
RANTIN 150MG Tidak Tidak 5000 5000 4300 0
Santesar tab. 50 mg Ya Ya 180 180 3773 51
Sanmol tab. 500 mg Ya Ya 400 400 250 0
Urotractin kaps. 400 mg Ya Ya 60 60 1652 44
Humalog Mix 50 Kwikpen inj. 100 IU/ml, penfill 3 ml. Ya Ya 5 5 748829 10
Irbesartan tab. 150 mg. (Indo) Ya Ya 300 300 1250 30
Simarc tab. 2 mg Tidak Tidak 200 200 1365 0
Clopidogrel tab. 75 mg (Hex) Ya Ya 660 660 3700 26.49
Concor tab. 5 mg Ya Ya 3000 3000 4223 46
Cameloc tab. 7,5 mg Ya Ya 300 300 580 60
Cameloc tab. 15 mg Ya Ya 200 200 920 60
NovoMix 30 FlexPen inj. 100 IU/ml Ya Ya 25 25 151279 10
Medixon tab. 4 mg Ya Ya 200 200 920 60
Folamil Genio Soft Kaps Tidak Tidak 60 60 3100 0
Esvat tab. 10 mg Ya Ya 360 360 473 55
Canderin tab. 8 mg Ya Ya 600 600 4800 20
Canderin tab. 16 mg Ya Ya 180 180 6800 20
Dilavask tab. 5 mg Ya Ya 1000 1000 492 70
Tenapril tab. 5 mg Ya Ya 150 150 2250 55
Herbesser CD kaps. 200 mg Ya Ya 60 60 9331 17.5
Abilify tab. 10 mg Tidak Tidak 10 10 36750 0
Gardasil inj. 0,5 ml Tidak Tidak 24 24 675000 0
Ursolic kaps. 250 mg Ya Ya 180 180 4611 47
Rydian tab. 10 mg Ya Ya 300 300 1900 50
Nucral susp. 500 mg/5 ml @ 200 ml Ya Ya 10 10 41688 42.5
Retivit Plus Kapl. Tidak Tidak 100 100 630 0
Letonal tab. 100 mg Ya Ya 100 100 2730 35
Acilaz kaps. 30 mg Ya Ya 200 200 5200 60
Gitas Plus tab. Ya Ya 250 250 1750 30
Diaformin XR tab. 500 mg Ya Ya 2000 2000 900 40
Dextafen tab. Ya Ya 200 200 770 30
Hi-Bone tab. Ya Ya 150 150 2550 15
Debostin tab. 20 mg Ya Ya 90 90 5600 60
Febogrel tab. 75 mg Ya Ya 60 60 5280 60
OA Forte kapl. Ya Ya 100 100 3311 57
Allopurinol tab. 100 mg (Kim) Ya Ya 1000 1000 144 7.5
Rhinos SR kaps. Ya Ya 500 500 3600 20
Angioten tab. 50 mg Ya Ya 180 180 4080 60
Betaone tab. 2,5 mg Ya Ya 200 200 1404 35
Betaone tab. 5 mg Ya Ya 120 120 2400 40
Endrolin inj. 3,75 mg Ya Ya 1 1 1011500 15
Hemapo prefilled syringe 3000 IU Ya Ya 10 10 185250 5
Metformin tab. 500 mg (Dex) Ya Ya 600 600 157 5
Metrix tab. 2 mg Ya Ya 450 450 1890 55
Osfit tab. 500 mg Ya Ya 300 300 1125 25
V-Bloc tab. 6,25 mg Ya Ya 60 60 1750 30
Rhinos SR kaps. Ya Ya 750 750 3600 20
Opineuron kapl. Ya Ya 1000 1000 550 45
Concor tab. 5 mg Ya Ya 6000 6000 4223 46
Flutias i.h 25/125 mcg/puff, 120 semprot Ya Ya 4 4 82500 25
Metrix tab. 2 mg Ya Ya 90 90 1890 55
Anadium kapl. Ya Ya 60 60 4248 41
Fungasol krim 2%, 10 gr Ya Ya 10 10 14950 35
Faktur Total Harga Total Diskon Total Pembelian
HNA KP % PKS
2585.46 0 6463650 0 6463650
9130 0 27390000 0 27390000
6530 0 9795000 0 9795000
8630 0 12945000 0 12945000
3440 0 17200000 0 17200000
3773.02 52.21 1421100 741956.31 679143.69
249.99 3.85 104000 4004 99996
1651.95 45.39 181500 82382.85 99117.15
168087.2 0 840436 0 840436
1190 30 510000 153000 357000
1365 0 273000 0 273000
3454.2 54.55 5016000 2736228 2279772
4223.34 46 23463000 10792980 12670020
580.04 38.62 283500 109487.7 174012.3
920.02 38.46 299000 114995.4 184004.6
137525.94 10 3820165 382016.5 3438148.5
920 60 460000 276000 184000
3500 0 210000 0 210000
472.5 40.19 284400 114300.36 170099.64
4800 20 3600000 720000 2880000
6800 20 1530000 306000 1224000
492.03 53.8 1065000 572970 492030
2250 55 750000 412500 337500
9330.75 17.5 678600 118755 559845
42544 0 425440 0 425440
553500 18 16200000 2916000 13284000
4610.97 49.33 1638000 808025.4 829974.6
1900 52.5 1200000 630000 570000
41685 44.42 750000 333150 416850
6460 0 646000 0 646000
2730 35 420000 147000 273000
5200 60 2600000 1560000 1040000
1750 65 1250000 812500 437500
884 44.75 3200000 1432000 1768000
770 38.4 250000 96000 154000
2550.1 27.14 525000 142485 382515
5600 60 1260000 756000 504000
5280 60 792000 475200 316800
3311.28 60.58 840000 508872 331128
125 16.67 150000 25005 124995
3600 20 2250000 450000 1800000
4080 0 734400 0 734400
1404 0 280800 0 280800
2400 0 288000 0 288000
1011500 0 1011500 0 1011500
185250 0 1852500 0 1852500
132 0 79200 0 79200
1890 0 850500 0 850500
1125 0 337500 0 337500
1750 0 105000 0 105000
3600 20 3375000 675000 2700000
550 50 1100000 550000 550000
4223.34 46 46926000 21585960 25340040
82500 0 330000 0 330000
1890 0 170100 0 170100
4248 41 432000 177120 254880
14949.9 38.98 245000 95501 149499
TOTAL SEBELUM PPN 211097291 51813394.52 159283896.48
TOTAL SETELAH PPN 232207020.1 56994733.97 175212286.13

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Laporan Penjualan Umum

Periode 29 - 31 Mei 2017

Yang membuat, Pemeriksa,

Mita Maha Asih Heryani, S.Farm, Apt

Jumlah Item Obat Biaya Pengobatan

214 14,897,666 - - - 14,897,666

No Nomor Resep Nikes Nama Peserta Tanggal Transaksi Kode Dokter

1 SA2905201700150240100022 829012 - TPBW FARIDA 29-05-2017 dr. Istiyarti Tapilatu

2 SA3105201700187240100022 789023 - TPBW Abdullah Syam 31-05-2017 dr Amar Bachtiar

dr. Istiyarti Tapilatu Ambroxol tab. 30 mg (Indo) 8 124.09 0 18.5 1176.36

118,5 118,5 1176.36 8 1SA2905201700150240100022

Jumlah Item Obat Biaya Pengobatan

3 SA3005201700083240100022 622888 TUBAGUS BUDIAWAN 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar

5 SA3105201700148240100022 690457 DEDI PURWANTO 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar

7 SA2905201700064240100022 632125 PUGUH WAHYU WIDODO, S.E,29-05-2017

Rhinos SR kaps. 10 3600 0 18.5 42660 1 SA2905201700145240100022 630812.102

18.5 42660 118,5 118,5 42660 10 1SA2905201700145240100022

Sub Total 1 SA2905201700145240100022 630812.102 DIMAS HARYO WIBISONO 29-05-2017

Jumlah Item Obat Biaya Pengobatan

29-05-2017 dr. Istiyarti Tapilatu 10 42,660 - - - 42,660 1.2.1.

478 121,926 - - - 121,926

3 SA2905201700124240100022 520872.1 ZURIATI ZUBIR 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar

7 SA2905201700147240100022 460040.1 NADHIROH,NY 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar

15 SA3005201700077240100022 500574 BAHASANNUDIN 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar

18 SA3005201700116240100022 511229 MUDJIONO 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar

19 SA3005201700118240100022 511229 MUDJIONO 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar

20 SA3005201700135240100022 551872.1 ESTER LUMBANTOBING 30-05-2017 dr Amar Bachtiar dr Amar Bachtiar

26 SA3105201700106240100022 520143 SAEPUDIN 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar

27 SA3105201700107240100022 520143.1 ROIKAH 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar

28 SA3105201700123240100022 460081 DJAUZI 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar

31 SA3105201700161240100022 560442.1 NAZWIR 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar

37 SA3105201700175240100022 450389.1 KASRI 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar

42 SA3105201700183240100022 540286 IGNATIUS BAMBANG BUDISURANTO31-05-2017 dr Amar Bachtiar dr Amar Bachtiar

48 SA3105201700195240100022 400689 SOEHARDI BC.TT 31-05-2017 dr Amar Bachtiar dr Amar Bachtiar

49 SA2905201700021240100022 540961 PURBONO 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar

51 SA2905201700057240100022 490248 TOTO SULAEMAN 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar

52 SA2905201700061240100022 531849 ASRIZAL 29-05-2017 dr Amar Bachtiar dr Amar Bachtiar

Simarc tab. 2 mg 28 1300 0 18.5 43134 1 SA2905201700114240100022 421398.1

18.5 43134 118,5 118,5 43134 28 1SA2905201700114240100022 43134

Nama Band Tanggal Tanggal

1 SA2905201700114240100022 421398.1 K. I. MAHMUD 29-05-2017 29-05-2017 dr. Istiyarti Tapilatu

18 SA3005201700116240100022 511229 MUDJIONO 30-05-2017 30-05-2017 dr Amar Bachtiar

Jumlah Item Obat Biaya Pengobatan

Nomor Tanggal Kode

1 E2102000 690200.1 SRI TUWALIYANTI 29-05-2017 210110013 dr amar bachtiar

2 E2102000 700646 FERRYMANSYAH, ST 29-05-2017 210110013 dr amar bachtiar

3 E2102000 621300 DARMAWAN 29-05-2017 210210001 dr. Istiyarti Tapilatu

4 E2102000 633217.2 SUHARTINI 29-05-2017 210110013 dr amar bachtiar

5 E2102000 633217 WASIMIN 29-05-2017 210110013 dr amar bachtiar

6 E2102000 700208.104 AZHARIANTO 29-05-2017 210210001 dr. Istiyarti Tapilatu

7 E2102000 680413.1 DIAN MARDIANA 29-05-2017 210210001 dr. Istiyarti Tapilatu

9 E2102000 680525.1 ISWAHYUNI BENNY HAN29-05-2017 210210001 dr. Istiyarti Tapilatu

10 E2102000 700372.101 LAYLA JULIA SYAFRIANI 29-05-2017 210110013 dr amar bachtiar

11 E2102000 700112.101 MUHAMMAD DIKIANSY29-05-2017 210110013 dr amar bachtiar

12 E2102000 700112.1 ROSDIANA 29-05-2017 210110013 dr amar bachtiar

13 E2102000 700646.1 META FATIA 29-05-2017 210110013 dr amar bachtiar

14 E2102000 680589.102 NADIYA NURFAIZA 29-05-2017 210210001 dr. Istiyarti Tapilatu