Apotek KF - PPO KF Kejayaan
depok, Kota Depok, Jawa Barat, 16432
21
Laporan Pembayaran dengan Jaminan
Tanggal Pembuatan Laporan
Total Pendapatan dari periode 20-09-2021 s/d 25-09-2021:
TIRTA INVESTAMA PT-CITEUREUP
Harga/Obat Total Harga Total Ditanggung
No. Tgl LIPH Nama Pasien Nama Obat Qty Diagnosa
(Rp.) (Rp.) (Rp.)
1 25-09-2021 Ahmad Sofyan / 01596 SYNBIO CAP@30 9 Rp 6,188 Rp 55,692 Rp 55,692 Diare
2 25-09-2021 Suherman / 13048 LORATADINE 10 MG (NOVELL) 10 Rp 383 Rp 3,830 Rp 3,830 Alergi
TENSIVASK 5MG TAB@50 30 Rp 7,838 Rp 235,140
3 25-09-2021 Isnainatun / 01513 Rp 263,871 Hipertensi
DAKTARIN CR 5GR 1 Rp 28,731 Rp 28,731
MOVIX 15MG TAB@20 6 Rp 12,100 Rp 72,600
4 25-09-2021 Hindayani / 01248 NEUROBION FORTE TAB@250 10 Rp 4,454 Rp 44,540 Rp 120,680 Myalgia
AMBROXOL 30MG TAB@100 INAF 10 Rp 354 Rp 3,540
5 25-09-2021 Sisri Supatmi / 03109 RILLUS TAB@30 6 Rp 9,855 Rp 59,130 Rp 59,130 Gastritis
TENSIVASK 5MG TAB@50 30 Rp 7,838 Rp 235,140
6 25-09-2021 Subarno / 10120 Rp 257,828 Hipertensi
POLYCROL GEL 100ML 1 Rp 22,688 Rp 22,688
LANSOPRAZOLE KAPS @ 20 ( GNV ) 10 Rp 1,555 Rp 15,550
7 24-09-2021 Ilyas / 05100 Rp 77,430 Gastritis
SYNBIO CAP@30 10 Rp 6,188 Rp 61,880
TENSIVASK 10MG TAB@50 30 Rp 13,750 Rp 412,500
8 24-09-2021 Endang Uminarsih / 01830 NEURALGIN RX KPL@100 10 Rp 1,031 Rp 10,310 Rp 451,541 Hipertensi
DAKTARIN CR 5GR 1 Rp 28,731 Rp 28,731
OSKOM STR@30 1 Rp 53,625 Rp 53,625
9 24-09-2021 Sugianto / 03800 Rp 288,765 Hipertensi
TENSIVASK 5MG TAB@50 30 Rp 7,838 Rp 235,140
10 24-09-2021 Yana Sutisna / 03116 VOLTAREN 50MG TAB@50 6 Rp 8,844 Rp 53,064 Rp 53,064 Myalgia
11 24-09-2021 Samsul / 02882 SANGOBION KAPSUL @ 250 30 Rp 1,863 Rp 55,890 Rp 55,890 Vitamin
PANADOL CAPL 100'S 10 Rp 1,166 Rp 11,660
12 24-09-2021 Dicky / 20276 ERSYLAN EXPECTORANT 60ML - BJN 1 Rp 33,000 Rp 33,000 Rp 46,040 Faringitis
KALMETHASONE 0.5MG TAB@200 10 Rp 138 Rp 1,380
COUNTERPAIN CR 60GR 1 Rp 86,075 Rp 86,075
13 24-09-2021 Rusmei / 03610 Rp 104,603 Myalgia
BETASON N CREAM (TUBE 5 GRAM) 1 Rp 18,528 Rp 18,528
14 24-09-2021 Agus Haryanto / 03001 GALVUSMET 50/500MG TAB@30 20 Rp 10,418 Rp 208,360 Rp 208,360 Diabetes
15 24-09-2021 Kristiani Catur / 08651 CHLORAMFECORT H CREAM (TUBE 10 GRAM) 1 Rp 15,813 Rp 15,813 Rp 15,813 Dermatitis
BIOPLACENTON JELLY 1 Rp 30,250 Rp 30,250
TOPGESIC 500 MG TABLET SALUT SELAPUT 10 Rp 2,475 Rp 24,750
16 23-09-2021 Aris Firmansyah / 20634 Rp 64,990 Combustio
AMOXICILLIN 500 MG @100 CAP (PEHA) 10 Rp 405 Rp 4,050
ZINK DISPERSIBEL (DUS 100 TAB) 10 Rp 594 Rp 5,940
TENSIVASK 5MG TAB@50 30 Rp 7,838 Rp 235,140
17 23-09-2021 Tatang Mulyana / 01428 Rp 288,765 Hipertensi
OSKOM STR@30 1 Rp 53,625 Rp 53,625
18 23-09-2021 Joko Prihartono / 18349 DIANE 35 TAB@21 1 Rp 177,844 Rp 177,844 Rp 177,844 KB
19 23-09-2021 Jono Wahyudi / 02901 DIANE 35 TAB@21 1 Rp 177,844 Rp 177,844 Rp 177,844 KB
FG TROCHES @ 300 TAB 10 Rp 1,602 Rp 16,020
20 23-09-2021 Fanfan / 23894 CORTIDEX 0.5MG TAB@100 10 Rp 399 Rp 3,990 Rp 36,830 Faringitis
PARATUSIN TAB @ 200 10 Rp 1,682 Rp 16,820
COUNTERPAIN CR 60GR 1 Rp 86,075 Rp 86,075
21 23-09-2021 Ali Wahyudi / 04650 Rp 125,675 Myalgia
MYONEP 50MG TAB@100 6 Rp 6,600 Rp 39,600
CEFIXIME 100MG CAP@50 GHX 10 Rp 1,645 Rp 16,450
22 23-09-2021 Wahyudi / 04598 DEXTAMINE 30X10'S 10 Rp 2,230 Rp 22,300 Rp 159,750 Dermatitis
DIGENTA CR 10GR 1 Rp 121,000 Rp 121,000
METHYCOBAL 500MCG CAP@100 10 Rp 5,070 Rp 50,700
23 23-09-2021 Yakub / 01659 MOVIX 15MG TAB@20 6 Rp 12,100 Rp 72,600 Rp 162,900 Myalgia
MYONEP 50MG TAB@100 6 Rp 6,600 Rp 39,600
24 23-09-2021 Sisri Supatmi / 03109 VOMCERAN 4MG TAB@10 6 Rp 22,000 Rp 132,000 Rp 132,000 Gastritis
CIPROFLOXACIN 500 MG @50 TAB (PEHA) 6 Rp 750 Rp 4,500
KALMETHASONE 0.5MG TAB@200 10 Rp 138 Rp 1,380
25 23-09-2021 Dadang Indra / 16528 Rp 108,775 Faringitis
PARATUSIN TAB @ 200 10 Rp 1,682 Rp 16,820
COUNTERPAIN CR 60GR 1 Rp 86,075 Rp 86,075
AMBEVEN KAPSULS 14 Rp 2,206 Rp 30,884
26 22-09-2021 Subagyo / 02569 Rp 42,544 Hemoroid
PANADOL CAPL 100'S 10 Rp 1,166 Rp 11,660
IMODIUM 2MG TAB@100 8 Rp 10,332 Rp 82,656
LANSOPRAZOLE KAPS @ 20 ( GNV ) 10 Rp 1,555 Rp 15,550
27 22-09-2021 Ahmad Sofyan / 01596 Rp 157,566 Gastritis
VOMETA FLASH TAB@50 10 Rp 5,500 Rp 55,000
BIOGESIC BLISTER 100 S (UN) 8 Rp 545 Rp 4,360
MICROGYNON LIBI@ 10 1 Rp 21,051 Rp 21,051
28 22-09-2021 Siti Ngaisah / 03916 Rp 107,126 KB
COUNTERPAIN CR 60GR 1 Rp 86,075 Rp 86,075
29 22-09-2021 Nunung Siti / 03629 COUNTERPAIN CR 60GR 1 Rp 86,075 Rp 86,075 Rp 86,075 Myalgia
ENKASARI HERBAL (BTL@120 ML) 1 Rp 23,442 Rp 23,442
30 22-09-2021 Ratnawati / 00901 Rp 68,542 Vitamin
CALDECE TAB EFF@10 1 Rp 45,100 Rp 45,100
31 22-09-2021 Kristiani Catur / 08651 DIVASK 10 MG TAB 20 Rp 15,125 Rp 302,500 Rp 302,500 Hipertensi
32 22-09-2021 Siti Chusnul / 04410 KALTROFEN GEL 30GR 1 Rp 75,625 Rp 75,625 Rp 75,625 Myalgia
HYDROXYUREA MEDAC 500 MG@50 30 Rp 12,584 Rp 377,520
33 21-09-2021 Amirudin Gaja / 00995 Rp 412,590 Hipertensi
ASCARDIA 80MG TAB@100 30 Rp 1,169 Rp 35,070
MICROGYNON LIBI@ 10 1 Rp 21,051 Rp 21,051
34 21-09-2021 Siti Komariah / 04632 NEURALGIN RX KPL@100 10 Rp 1,031 Rp 10,310 Rp 97,361 KB
MYONEP 50MG TAB@100 10 Rp 6,600 Rp 66,000
TENSIVASK 10MG TAB@50 30 Rp 13,750 Rp 412,500
35 21-09-2021 Suharto / 03519 Rp 498,575 Hipertensi
COUNTERPAIN CR 60GR 1 Rp 86,075 Rp 86,075
COUNTERPAIN CR 60GR 1 Rp 86,075 Rp 86,075
36 21-09-2021 Surdi Sanusi / 18959 Rp 87,990 Myalgia
LORATADINE 10 MG (NOVELL) 5 Rp 383 Rp 1,915
OSKOM STR@30 1 Rp 53,625 Rp 53,625
37 21-09-2021 Suharni / 04160 Rp 106,689 Myalgia
VOLTAREN 50MG TAB@50 6 Rp 8,844 Rp 53,064
38 21-09-2021 Kustanto / 02092 TENSIVASK 10MG TAB@50 30 Rp 13,750 Rp 412,500 Rp 412,500 Hipertensi
COTRIMOXAZOLE ADULT (DUS 100 TAB) 20 Rp 458 Rp 9,160
IMODIUM 2MG TAB@100 10 Rp 10,332 Rp 103,320
39 21-09-2021 Ahmad Sofyan / 01596 Rp 158,515 Gastritis
PANADOL CAPL 100'S 10 Rp 1,166 Rp 11,660
POLYCROL FORTE GEL 100ML 1 Rp 34,375 Rp 34,375
NEURALGIN RX KPL@100 10 Rp 1,031 Rp 10,310
40 21-09-2021 Enriani / 03100 CENDO FENICOL 0,5% EYE DROPS 5 ML 1 Rp 42,109 Rp 42,109 Rp 74,719 Konjungtivitis
DEXTAMINE 30X10'S 10 Rp 2,230 Rp 22,300
41 20-09-2021 Santi Chirsmawati / 04348 YAZ TAB@28 1 Rp 349,983 Rp 349,983 Rp 349,983 KB
DEXTAMINE 30X10'S 10 Rp 2,230 Rp 22,300
42 20-09-2021 Maryani / 02386 Rp 40,615 Alergi
ROHTO COOL 1 Rp 18,315 Rp 18,315
TENSIVASK 5MG TAB@50 30 Rp 7,838 Rp 235,140
43 20-09-2021 Mulyana / 02559 Rp 257,440 Hipertensi
DEXTAMINE 30X10'S 10 Rp 2,230 Rp 22,300
44 20-09-2021 Satinah / 04785 VOLTAREN EMULGEL 1 % 20 GRAM 1 Rp 105,931 Rp 105,931 Rp 105,931 Myalgia
DECOLSIN KAPSUL @ 100 (UN) 8 Rp 766 Rp 6,128
45 20-09-2021 Eriati Gaja / 01414 Rp 22,578 Faringitis
CEFIXIME 100MG CAP@50 GHX 10 Rp 1,645 Rp 16,450
46 20-09-2021 Muhamad Syahdi / 01891 KALMETHASONE 0.5MG TAB@200 10 Rp 138 Rp 1,380 Rp 1,380 Faringitis
47 20-09-2021 Syafi'i Bin Casma / 07773 DEXTAMINE 30X10'S 10 Rp 2,230 Rp 22,300 Rp 22,300 Alergi
BETADINE OBAT KUMUR 190 ML 1 Rp 37,125 Rp 37,125
48 20-09-2021 Dadi / 01860 Rp 116,188 Faringitis
KENALOG IN ORABASE 5GR 1 Rp 79,063 Rp 79,063
49 20-09-2021 Herni / 04571 TENSIVASK 10MG TAB@50 30 Rp 13,750 Rp 412,500 Rp 412,500 Hipertensi
KALMETHASONE 0.5MG TAB@200 10 Rp 138 Rp 1,380
WOODS COUGH SIRUP ATT 60 ML 1 Rp 22,312 Rp 22,312
50 20-09-2021 Epung Toyib / 06494 Rp 43,385 Faringitis
PANADOL CAPL 100'S 10 Rp 1,166 Rp 11,660
BEDAK SALICYL 2% 60 gr 1 Rp 8,033 Rp 8,033
TOTAL Rp 7,559,127