Implan Dan BMHP Nonekatalog

PENERIMAAN TAHUN 2018 ALKES dan BMHP NON EKATALOG
NAMA_KEL TOTAL_TA
NM_SUPPL NO_SUPPLI TGL_TRAN KODE_JENI NAMA_BA HARGA_DA DISCOUNT NONEKATAL NONEKATALOG
NO SATUAN OMPOK_B JUMLAH PPN_ITEM GIHAN_ITE
IER ER SAKSI S_BARANG RANG SAR _RUPIAH OG (NO_SP) (NO_KONTRAK)
ARANG M
PETAN 14/09/201 5.0MM
1138/PDM BN.01.01/PP
DAYA 8 FTM
1 /FP/IX/20 ALKES Pcs IMPLANT 3 8075000 0 2422500 26647500 K.BLU.FAR/9
MEDICA, 17:30:06.3 SUPER
18 816/2018
PT 33 REVO
Disp
Concent
CAHAYA BN.01.01/PP
EMG
DUA 0052/CDD 22/05/201 1958725.9 21545985. K-
2 BMHP Needle Pcs BMHP 150 130581.73 0
DELAPAN. /V/2018 8 10:19:00 5 45 BLU.FAR/618
Elect
PT 8/2018
Green
37mm
CAHAYA BN.01.01/PP
DUA 0052/CDD 22/05/201 PASTA EEG 349999.99 3849999.9 K-
3 BMHP Pcs BMHP 6 583333.33 0
DELAPAN. /V/2018 8 10:19:00 TEN 20 8 78 BLU.FAR/618
PT 8/2018
ANUGERA
H 08/02/201 Bibag
PHARMIN 22124441 8 Sodium HK.06,01/IV,2,1/
4 BMHP Bag BMHP 200 66150 0 1323000 14553000
DO 66 15:16:23.9 Bicarbonat 759/2014
LESTARI, 33 650g
PT
ANUGERA
H 08/02/201
Bloodline
PHARMIN 22124441 8 HK.06,01/IV,2,1/
5 BMHP Tubing Set BMHP 200 79920 0 1598400 17582400
DO 66 15:16:23.9 759/2014
System
LESTARI, 33
PT
6 ANUGERA 22124441 08/02/201 BMHP Dialyser Pcs BMHP 200 159750 0 3195000 35145000 HK.06,01/IV,2,1/
H 66 8 FX10 759/2014
PHARMIN 15:16:23.9
DO 33
LESTARI,
PT
ANUGERA
H 08/02/201
Fistula
PHARMIN 22124441 8 HK.06,01/IV,2,1/
7 BMHP Needle Set BMHP 200 9270 0 185400 2039400
DO 66 15:16:23.9 759/2014
16GV F25
LESTARI, 33
PT
ANUGERA
H 08/02/201 Fistula
PHARMIN 22124441 8 Needle 16 HK.06,01/IV,2,1/
8 BMHP Set BMHP 200 9270 0 185400 2039400
DO 66 15:16:23.9 Gar32 759/2014
LESTARI, 33 Rotary
PT
ANUGERA
H 08/02/201
HD
PHARMIN 22124441 8 HK.06,01/IV,2,1/
9 BMHP Solution Galon BMHP 200 75600 0 1512000 16632000
DO 66 15:16:23.9 759/2014
Part A
LESTARI, 33
PT
DIMAS 16/10/201 FILM DI-
ANDALAS D1810- 8 HL 20.3 X 14266.666 2140000.0 23540000. BN.01.01/PPK-
10 BMHP Lembar BMHP 1500 0
MAKMUR. 00836 11:50:58.8 25.4CM 7 05 05 III/4028/2018
PT 13 FUJI
DIMAS 16/10/201
FILM DI-
ANDALAS D1810- 8 BN.01.01/PPK-
11 BMHP HL 26 X Lembar BMHP 1500 21200 0 3180000 34980000
MAKMUR. 00836 11:50:58.8 III/4028/2018
36CM FUJI
PT 13
Medifix
BN.01.01/PPK.01
DOS NI 82754387 31/08/201 Line 90cm
12 BMHP Pcs BMHP 100 103500 0 1035000 11385000 .01/PPK-
ROHA, PT 3 8 09:48:00 With
III/8839/2018
Intrafix
Medifix BN.01.01/PPK.01
DOS NI 82754387 31/08/201
13 BMHP monomete P c s BMHP 50 193500 0 967500 10642500 .01/PPK-
ROHA, PT 3 8 09:48:00
r III/8839/2018
Medifix
DOS NI 82784924 10/12/201 Line 90cm BN.01.01/PPK-
14 BMHP Pcs BMHP 145 103500 0 1500750 16508250
ROHA, PT 8 8 17:09:00 With III/8839/2018
Intrafix
Medifix
DOS NI 82784924 10/12/201 BN.01.01/PPK-
15 BMHP monomete P c s BMHP 150 193500 0 2902500 31927500
ROHA, PT 8 8 17:09:00 III/8839/2018
r
FRISMED 23/07/201 ID-Liss
HOSLAB 000037/F 8 Coombs 50094000 BN.01.01/PPK.III
16 BMHP Pcs BMHP LAB 5760 79062.5 0 45540000
INDONESI HI/VII/18 12:54:27.1 Card 0 /1250/2018
A.PT 4 24x12
27/12/201 Art +
MENDJAN 18120560 8 Venous 11736978 HK.05,01/IV,2,1/
17 BMHP Pcs BMHP 1091 97800 0 10669980
GAN, PT 17 13:19:25.3 Blood Line 0 757/2014
43 W/Filt
27/12/201
DIALYZER
MENDJAN 18120560 8 20641720 HK.05,01/IV,2,1/
18 BMHP POLYPURE P c s BMHP 1091 172000 0 18765200
GAN, PT 17 13:19:25.3 0 757/2014
16S
43
27/12/201
MENDJAN 18120560 8 Biasol Acid HK.05,01/IV,2,1/
19 BMHP Galon BMHP 1091 81000 0 8837100 97208100
GAN, PT 17 13:19:25.3 Conc 6 ltr 757/2014
43
27/12/201
MENDJAN 18120560 8 Bicarbonat HK.05,01/IV,2,1/
20 BMHP Galon BMHP 1091 82200 0 8968020 98648220
GAN, PT 17 13:19:25.3 Solution 757/2014
43
27/12/201
AV. Fistula
MENDJAN 18120560 8 HK.05,01/IV,2,1/
21 BMHP Needle Pcs BMHP 2182 9750 0 2127450 23401950
GAN, PT 17 13:19:25.3 757/2014
16G x 1
43
MERAPI 21/09/201
Harum
UTAMA 8 45674.545 164428.36 1808712.0 BN.01.01/PPK-
22 00027796 BMHP Skin Pcs BMHP 36 0
PHARMA, 14:57:33.4 5 38 02 III/8847/2018
Marker
PT 86
MILLENNI
UM PerClot
13/09/201
PHARMAC Polysaccari
23061800 8 BN.01.01/PPK-
23 ON BMHP de Sacchet BMHP 5 3334500 0 1667250 18339750
0321 16:31:16.4 III/8857/2018
INTERNAT Haemost
03
IONAL Syst 3Gr
TBK, PT
24 OPAL 1247/OPS 25/07/201 BMHP Syringe Pcs BMHP 30 488000 0 1464000 16104000 BN.01.01/PPK.III
StellaDual
PERKASA 8
200ml
SEJAHTER /VII/18 16:23:15.8 /7610/2018
Cat.SDS.CT
A. PT 86
P.QFT
OPAL 25/10/201 Film
BMHP
PERKASA 1387/OPS 8 Drystar BN.01.01/PPK.III
25 BMHP Lembar RADIOLOG 1000 14280 0 1428000 15708000
SEJAHTER /X/2018 14:53:44.6 DT28 Uk 8 /7610
I
A. PT 06 x 10
Film UPT
OPAL 25/10/201
517 14x17 BMHP
PERKASA 1387/OPS 8 BN.01.01/PPK.III
26 BMHP Blue Lembar RADIOLOG 625 30712 0 1919500 21114500
SEJAHTER /X/2018 14:53:44.6 /7610
Thermal I
A. PT 06
(35x43)
OPAL 25/10/201
Syringe
27 BMHP Salient Pcs BMHP 29 460000 0 1334000 14674000
SEJAHTER /X/2018 14:53:44.6 /7610
190ml
A. PT 06
Syringe
OPAL 25/10/201
150ml
28 BMHP disp, with P c s BMHP 30 256000 0 768000 8448000
SEJAHTER /X/2018 14:53:44.6 /7610
quick fill
A. PT 06
tube
Syringe
OPAL 25/10/201
StellaDual
29 BMHP 200ml Pcs BMHP 30 488000 0 1464000 16104000
SEJAHTER /X/2018 14:53:44.6 /7610
Cat.SDS.CT
A. PT 06
P.QFT
MENSA 14/08/201
Blood Bag
BINA CD194431 8 BN.01.01/PPK-
30 BMHP Singel 350 P c s BMHP 400 32270 0 1290800 14198800
SUKSES, 084 13:28:05.7 III/8853/2018
ml
PT 8
MENSA 14/08/201
Blood Bag
BINA CD194431 8 BN.01.01/PPK-
31 BMHP Triple 350 Buah BMHP 500 62180 0 3109000 34199000
SUKSES, 084 13:28:05.7 III/8853/2018
ml
PT 8
32 TRANSME IN180130416/03/201 BMHP Therapeuti P c s BMHP 32 2700000 0 8640000 95040000 BN.01.01/PPK.III
DIC 8 c Plasma /1852/2018
INDONESI 17:04:27.9 Exchance
A. PT 6 Set MCS-
980E
MCS+LDP
TRANSME 16/03/201
W/Filter W
DIC 8 BN.01.01/PPK.III
33 IN1801304 BMHP New Saf Set BMHP LAB 32 2299865 0 7359568 80955248
INDONESI 17:04:27.9 /1852/2018
F+ACD-
A. PT 6
A500ml
INTERGRA
22/10/201
STA Parafilm BN.01.01/PP-
JP 8
34 ARTHA BMHP 2in x Roll BMHP 12 635000 0 762000 8382000 BLU.FAR/110
18003018 10:57:15.4
NUSANTA 250FT 14/2018
8
RA.PT
INTERGRA
22/10/201 RACKED
STA BN.01.01/PP-
JP 8 FILTERED
35 ARTHA BMHP Box BMHP 10 2550000 0 2550000 28050000 BLU.FAR/110
18003018 10:57:15.4 TIPS
NUSANTA 14/2018
8 1000UL
RA.PT
INTERGRA
22/10/201 Lowenstei
STA BN.01.01/PP-
JP 8 n Jensen Pack/500g
36 ARTHA BMHP BMHP LAB 1 1500000 0 150000 1650000 BLU.FAR/110
18003018 10:57:15.4 Medium r
NUSANTA 14/2018
8 Base 500gr
RA.PT
MILLENNI
UM Bioglue
28/03/201
PHARMAC Pre-Filled BN.01.01/PP-
13061801 8
37 ON BMHP Syr 5ml Syringe BMHP 5 7653750 0 3826875 42095625 BLU.FAR/319
3397 08:44:17.4
INTERNAT SURG.ADH 9/2018
26
IONAL ESIVE
TBK, PT
02/05/201 ELECTROD
TOTAL BN.01.01/PP
TMP/18/0 8 E ADULT 10600000.
38 MEDIKA BMHP Pcs BMHP 10000 963.6364 0 963636.4 K - BLU.Far/
4/3157 15:23:11.2 MSGLT- 4
PERSADA 4123 /2018
8 01G
02/05/201
TOTAL ELECTROD BN.01.01/PP
TMP/18/0 8 121727.26 1338999.9
39 MEDIKA BMHP E PED Pcs BMHP 1300 936.3636 0 K - BLU.Far/
4/3157 15:23:11.2 8 48
PERSADA MSGST-37 4123 /2018
8
40 TOTAL TMP/18/0 02/05/201 BMHP ELECTROD P c s BMHP 90 26250 0 236250 2598750 BN.01.01/PP
MEDIKA 4/3157 8 E K - BLU.Far/
PERSADA 15:23:11.2 NEONATE 4123 /2018
8 MPRYB-78
EVERCROS
SINERGI 14/02/201
IN/18/02/ S 035- BN.01.01/PP
TRIDAYA 8
41 20/00011 ALKES 5MM X Pcs STENT 1 3600000 0 360000 3960000 K - BLU.FAR/
MEDICAL, 16:40:44.9
0 60MM X 1026 /2018
PT 33
135CM
SINERGI 14/02/201 Evercross
IN/18/02/ BN.01.01/PP
TRIDAYA 8 035- 6mm
42 20/00011 ALKES Pcs STENT 1 3600000 0 360000 3960000 K - BLU.FAR/
MEDICAL, 16:40:44.9 x 60mm x
0 1026 /2018
PT 33 135cm
PETAN 15/02/201
205/PDM/ GRAFTMA BN.01.01/PP
DAYA 8
43 FP/ II ALKES X BUTTON P c s ALKES 1 10450000 0 1045000 11495000 K - BLU.FAR/
MEDICA, 15:19:58.0
/2018 ALB 1187 /2018
PT 4
PETAN 15/02/201 Bio Screw
205/PDM/ BN.01.01/PP
DAYA 8 for ACL
44 FP/ II ALKES Pcs IMPLANT 1 7600000 0 760000 8360000 K - BLU.FAR/
MEDICA, 15:19:58.0 Recon 8 x
/2018 1187 /2018
PT 4 25mm
30/11/201
Cystofix BN.01.01/PP
DOS NI 82782560 8 348181.81 104454.54
45 BMHP CH10 Pcs BMHP 3 0 1149000 K - BLU.Far/
ROHA, PT 0 15:12:07.6 82 55
120mm 11965 /2018
13
30/11/201
BN.01.01/PP
DOS NI 82782560 8 LYOSTIPT 4968000.1
46 BMHP Sacchet BMHP 60 75272.73 0 451636.38 K - BLU.Far/
ROHA, PT 0 15:12:07.6 5 x 8cm 8
11965 /2018
13
VP SHUNT
SINERGI 07/02/201
IN/18/02/ BURR BN.01.01/PP
TRIDAYA 8
47 09/00003 ALKES HOLE LOW P c s IMPLANT 1 3936000 0 393600 4329600 K - BLU.FAR/
MEDICAL, 13:25:48.5
3 PRESS 952 /2018
PT 56
12mm
SINERGI 07/02/201 VP Shunt
IN/18/02/ BN.01.01/PP
TRIDAYA 8 Burr Hole
48 09/00003 ALKES Pcs ALKES 1 3936000 0 393600 4329600 K - BLU.FAR/
MEDICAL, 13:25:48.5 Low
3 952 /2018
PT 56 Pressure
49 SINERGI IN/18/02/ 07/02/201 ALKES VP SHUNT P c s ALKES 6 3936000 0 2361600 25977600 BN.01.01/PP
TRIDAYA 09/00003 8 BURR K - BLU.FAR/
MEDICAL, 3 13:25:48.5 HOLE 952 /2018
PT 56 MEDIUM
16mmPRE
SS
VP SHUNT
SINERGI 07/02/201 BURR
IN/18/02/ BN.01.01/PP
TRIDAYA 8 HOLE
50 09/00003 ALKES Pcs IMPLANT 3 3936000 0 1180800 12988800 K - BLU.FAR/
MEDICAL, 13:25:48.5 MEDIUM
3 952 /2018
PT 56 PRESS
12mm
SUKSES 25/09/201 BN.01.01/PP
JAYA INV/SJA/1 8 VENTISOR K-
51 BMHP Galon BMHP 5 617000 0 308500 3393500
ALKESIND 8/IX/0513 16:13:27.4 B 4,5KG BLU.Far/100
O. PT 43 98/2018
SUKSES 25/09/201 BN.01.01/PP
JAYA INV/SJA/1 8 PASTA EEG 583333.33 174999.99 1924999.9 K -
52 BMHP Pcs BMHP 3 0
ALKESIND 8/IX/0513 16:13:27.4 TEN 20 3 99 99 BLU.Far/100
O. PT 43 98/2018
Guide Wire
REKAMILE 20/03/201 BN.01.01/PP
0.038
NIUMINDO 0207/RS/F 8 K-
53 BMHP 150cm Pcs BMHP 37 165000 0 610500 6715500
SELARAS, /3/2018 12:05:08.4 BLU.Far/278
IQ38F150J
PT 63 6/2018
3
SteerEase
NIUMINDO 0207/RS/F 8 4336734.5 9540816.0 K -
54 BMHP Occuleder P c s BMHP 2 0 867346.91
SELARAS, /3/2018 12:05:08.4 5 1 BLU.Far/278
14Fr
PT 63 6/2018
Steerease
NIUMINDO 0207/RS/F 8 4336734.5 433673.45 4770408.0 K -
55 BMHP Occuleder P c s BMHP 1 0
SELARAS, /3/2018 12:05:08.4 5 5 05 BLU.Far/278
6F
PT 63 6/2018
Cera ASD
NIUMINDO 0207/RS/F 8 24454545. 2445454.5 K-
56 BMHP Occuleder P c s BMHP 1 0 26900000
SELARAS, /3/2018 12:05:08.4 45 45 BLU.Far/278
No.32
PT 63 6/2018
17/04/201 SEcretion BN.01.01/PP
ANDRA
APJ/INV/1 8 Canister + K-
57 PRIMA BMHP Set BMHP 30 1400000 0 4200000 46200000
8/IV/674 10:57:21.5 Tubing BLU.Far/423
JAYA. PT
86 System 4/2018
58 HEXALAB HS.0918- 29/11/201 ALKES TKR PS Pcs IMPLANT 2 26814090. 0 5362818.1 58991000 BN.01.01/PP
SUMATER 00300 8 RIGHT 91 82 K-
12:41:09.4 BLU.Far/958
A.PT
26 9/2018
29/11/201 BN.01.01/PP
HEXALAB
HS.0918- 8 TKR PS 26814090. 2681409.0 K-
59 SUMATER ALKES Pcs IMPLANT 1 0 29495500
00300 12:41:09.4 LEFT 91 91 BLU.Far/958
A.PT
26 9/2018
IDS Nasal Mask
BN.01.01/PP
MEDICAL Size L
EG800000 14/09/201 K-
60 SYSTEM BMHP nCPAP Pcs BMHP 10 522500 0 522500 5747500
32 8 15:26:00 BLU.FAR/966
INDONESI GeneratorS
4/2018
A PT LE1000
IDS Nasal Mask
BN.01.01/PP
MEDICAL Size M
EG800000 14/09/201 K-
32 8 15:26:00 BLU.FAR/966
INDONESI GeneratorS
4/2018
A PT LE1000
IDS Nasal Mask
BN.01.01/PP
MEDICAL Size S
EG800000 14/09/201 K-
32 8 15:26:00 BLU.FAR/966
INDONESI GeneratorS
4/2018
A PT LE1000
WEGO 13/02/201 BN.01.01/PP
SIC- DC
MEDIKA 8 K
63 MDN/II/1 BMHP INFINITY Buah BMHP 20 323680 0 647360 7120960
INDONESI 11:22:12.0 \-BLU.FAR/1
8/0055 JL 3,5 - 6F
A 06 179/2018
WEGO 13/02/201 BN.01.01/PP
SIC-
MEDIKA 8 DC Infinity K
64 MDN/II/1 BMHP Pcs BMHP 20 323680 0 647360 7120960
INDONESI 11:22:12.0 JR 3,5 - 6F \-BLU.FAR/1
8/0055
A 06 179/2018
INTERGRA Labell Blue
22/02/201 BN.01.01/PP
STA Ind For
JP 8 1156600.0 12722600. K-
65 ARTHA BMHP Steam- Roll BMHP 24 481916.67 0
18000566 11:20:44.7 08 09 BLU.FAR/150
NUSANTA 240-
4 8/2018
RA.PT 872ENS
Acrilic
AKARIM BN.01.01/PP
18/AJF/X/ 03/10/201 ( Vertex +
66 JAYA ALKES Set IMPLANT 30 390000 0 1170000 12870000 K.BLU.FAR/1
1134 8 14:35:00 Meliodent
FARMA.PT 0357/2018
)
67 ENSEVAL 31800685 31/10/201 ALKES Durolane P c s IMPLANT 15 2040909.0 0 3061363.6 33674999. BN.01.01/PP
PUTERA
8
MEGATRA K.BLU.FAR/1
1 11:42:18.7 9 35 98
DING TBK, 1333/2018
13
PT
PETAN Bio Screw
BN.01.01/PP
DAYA 1533/PDM 18/12/201 for ACL
68 ALKES Pcs IMPLANT 1 7600000 0 760000 8360000 K.BLU.FAR/1
MEDICA, /FP/XI/18 8 10:05:00 Recon 8 x
2608/2018
PT 25mm
BN.01.01/PP
BRATACO. IVMDG180 06/09/201 Kertas
69 BMHP Lembar BMHP 22000 14.545 0 31999 351989 K.BLU.FAR/9
PT 1054 8 11:28:00 Perkamen
523/2018
BN.01.01/PP
BRATACO. IVMDG180 06/09/201 Acid Citric
70 BMHP Kg BMHP 100 40909.09 0 409090.9 4499999.9 K.BLU.FAR/9
PT 1054 8 11:28:00 1Kg
523/2018
BN.01.01/PP
BRATACO. IVMDG180 06/09/201 390909.09 781818.19 8600000.1
71 BMHP Alkohol 96 Gln/20ltr BMHP 20 0 K.BLU.FAR/9
PT 1054 8 11:28:00 8 6 56
523/2018
BN.01.01/PP
BRATACO. IVMDG180 06/09/201 1500012.2
72 BMHP Glyserin Btl/ltr BMHP LAB 25 54545.9 0 136364.75 K.BLU.FAR/9
PT 1054 8 11:28:00 5
523/2018
AKARIM Archbar / BN.01.01/PP
18/AJF/IX 04/09/201
73 JAYA ALKES Splint With P c s IMPLANT 3 650000 0 195000 2145000 K.BLU.FAR/9
/1005 8 10:00:00
FARMA.PT Hook 551/2018
05/10/201 Mantoux
RAJAWALI FKT/MDN BN.01.01/PP
8 Test/
74 NUSINDO, /2018000 BMHP Vial/1,5ml BMHP 15 702250 0 1053375 11587125 K/BLU.Far/1
09:45:54.5 Tuberculin
PT 00736 0202/2018
1 PPD
MILLENNI
UM
30/01/201
PHARMAC Septalkan BN.01.01/PP
13061800 8
75 ON BMHP Pack 100 Pack BMHP 50 220500 0 1102500 12127500 K/BLU/FAR/
3473 15:58:32.5
INTERNAT Wipes 570/2018
6
IONAL
TBK, PT
SEcretion BN.01.01/PP
ANDRA
APJ/INV/1 22/03/201 Canister + K-
8/III/652 8 14:55:00 Tubing BLU,FAR/295
JAYA. PT
System 3/2018
77 MITRA 1902/ 08/02/201 ALKES BONE Pcs IMPLANT 6 1100000 0 660000 7260000 BN.01.01/PP
FAJAR CEMENT +
K-BLU.FAR/
SELARAS, II/2018 8 16:55:00 ANTIBIOTI
1056 /2018
PT K
12/10/201
HEXALAB BN.01.01/PP
HS.1018- 8 Laminaria
78 SUMATER BMHP Pcs BMHP 3 125000 0 37500 412500 K-BLU.FAR/
00197 11:22:05.7 L
A.PT 10628 /2018
96
12/10/201
HEXALAB BN.01.01/PP
HS.1018- 8 Laminaria
79 SUMATER BMHP Pcs BMHP 3 125000 0 37500 412500 K-BLU.FAR/
00197 11:22:05.7 M.
A.PT 10628 /2018
96
PETAN 13/02/201
DAYA 8
80 FP/ II ALKES X BUTTON P c s ALKES 1 10450000 0 1045000 11495000 K-BLU.FAR/
MEDICA, 16:36:52.1
/2018 ALB 1146 /2018
PT 76
204/PDM/ BN.01.01/PP
DAYA 8 For ACL
81 FP/ II ALKES Pcs IMPLANT 1 7600000 0 760000 8360000 K-BLU.FAR/
/2018 1146 /2018
PT 76 25mm
DIMAS 21/02/201 Axilla
BN.01.01/PP
ANDALAS D1802- 8 Crutch/To 3700000.0
82 ALKES Pasang ALKES 20 168181.82 0 336363.64 K-BLU.FAR/
MAKMUR. 01061 11:01:33.2 ngkat 4
1369 /2018
PT 4 Ketiak M
BN.01.01/PP
ANDALAS D1802- 8 Crutch/To
83 ALKES Pasang ALKES 5 168181.82 0 84090.91 925000.01 K-BLU.FAR/
MAKMUR. 01061 11:01:33.2 ngkat
1369 /2018
PT 4 Ketiak L
BN.01.01/PP
ANDALAS D1802- 8 Crutch/To
84 ALKES Pasang ALKES 5 168181.82 0 84090.91 925000.01 K-BLU.FAR/
MAKMUR. 01061 11:01:33.2 ngkat
1369 /2018
PT 4 Ketiak S
PETAN 22/02/201
DAYA 8
85 FP/ II ALKES X BUTTON P c s ALKES 1 10450000 0 1045000 11495000 K-BLU.FAR/
MEDICA, 14:22:57.9
/2018 ALB 1433 /2018
PT 73
206/PDM/ BN.01.01/PP
DAYA 8 For ACL
86 FP/ II ALKES Pcs IMPLANT 1 7600000 0 760000 8360000 K-BLU.FAR/
/2018 1433 /2018
PT 73 25mm
VP SHUNT
IN/18/02/ BN.01.01/PP
TRIDAYA 8 HOLE
87 28/00019 ALKES Pcs ALKES 11 3936000 0 4329600 47625600 K-BLU.FAR/
4 1434 /2018
PT 73 16mmPRE
SS
PPM
26/02/201
NUGRA SENSIA BN.01.01/PP
8 PACU
88 KARSERA. 0001097 ALKES SES01 Set 2 16000000 0 3200000 35200000 K-BLU.FAR/
15:23:45.6 JANTUNG
PT Single 1511 /2018
03
Chamber
PPM
27/02/201
8 PACU
09:57:12.6 JANTUNG
13
Chamber
PETAN 06/03/201
DAYA 8
90 FP/III/201 ALKES X BUTTON P c s ALKES 1 10450000 0 1045000 11495000 K-BLU.FAR/
MEDICA, 14:07:10.3
8 ALB 2020 /2018
PT 96
273/PDM/ BN.01.01/PP
DAYA 8 For ACL
91 FP/III/201 ALKES Pcs IMPLANT 1 7600000 0 760000 8360000 K-BLU.FAR/
8 2020 /2018
PT 96 25mm
PPM
07/03/201
8 PACU
16:42:37.9 JANTUNG
5
Chamber
PPM
08/03/201
8 PACU
10:00:04.1 JANTUNG
86
Chamber
MITRA Cervical
BN.01.01/PP
FAJAR 8674/ III / 12/03/201 Fusion
94 ALKES Pcs IMPLANT 1 5500000 0 550000 6050000 K-BLU.FAR/
SELARAS, 2018 8 12:28:00 Cage No.5
2371 /2018
PT L12MM
95 MITRA 8675/ III / 21/03/201 ALKES ORTHOCE Pcs IMPLANT 5 1100000 0 550000 6050000 BN.01.01/PP
M 3G
FAJAR
(boncemen K-BLU.FAR/
SELARAS, 2018 8 09:37:00
t+genta)40 2752 /2018
PT
Gr
VP SHUNT
BN.01.01/PP
TRIDAYA STM- 8 HOLE
MEDICAL, 180214 16:12:13.2 MEDIUM
293 /2018
PT 06 PRESS
12mm
VP SHUNT
BN.01.01/PP
TRIDAYA STM- 8 HOLE
97 ALKES Pcs ALKES 6 3936000 0 2361600 25977600 K-BLU.FAR/
MEDICAL, 180214 16:12:13.2 MEDIUM
293 /2018
PT 06 16mmPRE
SS
VP SHUNT
IN/18/04/ BN.01.01/PP
TRIDAYA 8 HOLE
98 03/00068 ALKES Pcs IMPLANT 2 3936000 0 787200 8659200 K-BLU.FAR/
8 2959 /2018
PT 96 PRESS
12mm
VP SHUNT
IN/18/04/ BN.01.01/PP
TRIDAYA 8 HOLE
8 2959 /2018
PT 96 16mmPRE
SS
VP SHUNT
SINERGI 23/03/201
IN/18/04/ BURR BN.01.01/PP
TRIDAYA 8
100 03/00068 ALKES HOLE LOW P c s IMPLANT 1 3936000 0 393600 4329600 K-BLU.FAR/
MEDICAL, 15:08:42.1
8 PRESS 2959 /2018
PT 96
12mm
VP Shunt
SINERGI 23/03/201
IN/18/04/ FlatBottom BN.01.01/PP
TRIDAYA 8
101 03/00068 ALKES Medium P c s IMPLANT 5 3936000 0 1968000 21648000 K-BLU.FAR/
MEDICAL, 15:08:42.1
8 16mmPres 2959 /2018
PT 96
s
102 DIMAS D1804- 05/04/201 ALKES Axilla Pasang ALKES 5 168181.82 0 84090.91 925000.01 BN.01.01/PP
ANDALAS 8 Crutch/To
K-BLU.FAR/
MAKMUR. 00219 11:24:19.5 ngkat
3675 /2018
PT 3 Ketiak L
BN.01.01/PP
MAKMUR. 00219 11:24:19.5 ngkat 4
3675 /2018
PT 3 Ketiak M
09/04/201 PPM
NUGRA BN.01.01/PP
8 Sensia DR PACU
104 KARSERA. 0002079 ALKES Set 1 34100000 0 3410000 37510000 K-BLU.FAR/
14:22:51.5 dual JANTUNG
PT 3984 /2018
83 chamber
VP SHUNT
SINERGI
IN/18/04/ BURR BN.01.01/PP
TRIDAYA 06/04/201
105 16/00087 ALKES HOLE LOW P c s IMPLANT 1 3936000 0 393600 4329600 K-BLU.FAR/
MEDICAL, 8 15:03:00
0 PRESS 3985 /2018
PT
12mm
VP SHUNT
SINERGI BURR
IN/18/04/ BN.01.01/PP
TRIDAYA 06/04/201 HOLE
106 16/00087 ALKES Pcs IMPLANT 10 3936000 0 3936000 43296000 K-BLU.FAR/
MEDICAL, 8 15:03:00 MEDIUM
0 3985 /2018
PT PRESS
12mm
Locking
TRANSME
Screw BN.01.01/PP
DIC 13/04/201
107 IN1801892 ALKES 2.4mm, Pcs IMPLANT 3 637500 0 191250 2103750 K-BLU.FAR/
INDONESI 8 14:36:00
L14mm 3986 /2018
A. PT
Titanium
Locking
TRANSME
Screw BN.01.01/PP
DIC 13/04/201
108 IN1801892 ALKES 2.4mm, Pcs IMPLANT 1 637500 0 63750 701250 K-BLU.FAR/
INDONESI 8 14:36:00
L16mm 3986 /2018
A. PT
Titanium
LCP
MITRA PROXIMAL
BN.01.01/PP
FAJAR 1038 /I 23/01/201 FEMUR
SELARAS, /2018 8 14:30:00 PLATE 4
412 /2018
PT HOLE
RIGHT
110 MITRA 1038 /I 23/01/201 ALKES LOCKING P c s IMPLANT 1 500000 0 50000 550000 BN.01.01/PP
FAJAR SCREW
K-BLU.FAR/
SELARAS, /2018 8 14:30:00 5,0MM L
412 /2018
PT 30MM
MITRA LOCKING
BN.01.01/PP
FAJAR 1038 /I 23/01/201 SCREW
SELARAS, /2018 8 14:30:00 5,0MM L
412 /2018
PT 34MM
MITRA LOCKING
BN.01.01/PP
FAJAR 1038 /I 23/01/201 SCREW
SELARAS, /2018 8 14:30:00 5,0MM L
412 /2018
PT 38MM
LOCKING
MITRA
LAG BN.01.01/PP
FAJAR 1038 /I 23/01/201
113 ALKES SCREW Pcs IMPLANT 1 1170000 0 117000 1287000 K-BLU.FAR/
SELARAS, /2018 8 14:30:00
7,0MM L 412 /2018
PT
80MM
LOCKING
MITRA
LAG BN.01.01/PP
FAJAR 1038 /I 23/01/201
SELARAS, /2018 8 14:30:00
7,0MM L 412 /2018
PT
85MM
LOCKING
MITRA
LAG BN.01.01/PP
FAJAR 1038 /I 23/01/201
SELARAS, /2018 8 14:30:00
7,0MM L 412 /2018
PT
90MM
LOCKING
MITRA
LAG BN.01.01/PP
FAJAR 1038 /I 23/01/201
SELARAS, /2018 8 14:30:00
7,0MM L 412 /2018
PT
95MM
External
SINERGI
Drainage BN.01.01/PP
TRIDAYA STM- 25/01/201
117 ALKES Set Pcs IMPLANT 13 3350000 0 4355000 47905000 K-BLU.FAR/
MEDICAL, 180298 8 16:19:00
(VP.Shunt 413 /2018
PT
KID)
118 AKARIM 18/AJF/IV 13/04/201 ALKES Archbar / P c s IMPLANT 3 650000 0 195000 2145000 BN.01.01/PP
JAYA /376 8 Splint With K-BLU.FAR/
FARMA.PT 14:50:34.7 Hook 4134 /2018
8
PPM
13/04/201
8 PACU
09:20:42.8 JANTUNG
53
Chamber
LCP
MITRA 13/04/201 PROXIMAL
BN.01.01/PP
FAJAR 8231IV/20 8 FEMORAL
SELARAS, 18 17:08:30.0 PLT 6
4232 /2018
PT 63 HOLE
RIGHT
MITRA 13/04/201 LOCKING
BN.01.01/PP
FAJAR 8231IV/20 8 SCREW
SELARAS, 18 17:08:30.0 5,0MM L
4232 /2018
PT 63 30MM
BN.01.01/PP
SELARAS, 18 17:08:30.0 5,0MM L
4232 /2018
PT 63 34MM
BN.01.01/PP
SELARAS, 18 17:08:30.0 5,0MM L
4232 /2018
PT 63 32MM
BN.01.01/PP
SELARAS, 18 17:08:30.0 5,0MM L
4232 /2018
PT 63 38MM
LOCKING
MITRA 13/04/201
LAG BN.01.01/PP
FAJAR 8231IV/20 8
SELARAS, 18 17:08:30.0
7,0MM L 4232 /2018
PT 63
70MM
LOCKING
MITRA 13/04/201
LAG BN.01.01/PP
FAJAR 8231IV/20 8
SELARAS, 18 17:08:30.0
7,0MM L 4232 /2018
PT 63
75MM
127 MITRA 8231IV/20 13/04/201 ALKES LOCKING P c s IMPLANT 1 1170000 0 117000 1287000 BN.01.01/PP
LAG
FAJAR 8
SCREW K-BLU.FAR/
SELARAS, 18 17:08:30.0
7,0MM L 4232 /2018
PT 63
80MM
LOCKING
MITRA 13/04/201
LAG BN.01.01/PP
FAJAR 8231IV/20 8
SELARAS, 18 17:08:30.0
7,0MM L 4232 /2018
PT 63
85MM
VP SHUNT
IN/18/04/ BN.01.01/PP
TRIDAYA 8 HOLE
2 4335 /2018
PT 13 16mmPRE
SS
MERAPI
FIREHAW BN.01.01/PP
UTAMA 20/04/201
130 00010434 ALKES K 3.0 X Pcs IMPLANT 1 5409600 0 540960 5950560 K-BLU.FAR/
PHARMA, 8 10:23:00
29MM 4336 /2018
PT
MERAPI
FIREHAW BN.01.01/PP
UTAMA 20/04/201
PHARMA, 8 10:23:00
33MM 4336 /2018
PT
MERAPI
FIREHAW BN.01.01/PP
UTAMA 20/04/201
132 00010434 ALKES K DES 3.0 P c s IMPLANT 1 5409600 0 540960 5950560 K-BLU.FAR/
PHARMA, 8 10:23:00
X 38MM 4336 /2018
PT
MERAPI
FIREHAW BN.01.01/PP
UTAMA 20/04/201
133 00010434 ALKES K DES 3.5 P c s IMPLANT 1 5409600 0 540960 5950560 K-BLU.FAR/
PHARMA, 8 10:23:00
X 29MM 4336 /2018
PT
MERAPI
FIREHAW BN.01.01/PP
UTAMA 20/04/201
PHARMA, 8 10:23:00
33MM 4336 /2018
PT
MERAPI
FIREHAW BN.01.01/PP
UTAMA 20/04/201
PHARMA, 8 10:23:00
38MM 4336 /2018
PT
PPM
23/04/201
8 PACU
12:35:35.2 JANTUNG
63
Chamber
PPM
25/04/201
8 PACU
14:37:17.8 JANTUNG
13
Chamber
External
SINERGI 27/04/201
IN/18/05/ Drainage BN.01.01/PP
TRIDAYA 8
138 03/00110 ALKES Set Pcs IMPLANT 13 3350000 0 4355000 47905000 K-BLU.FAR/
MEDICAL, 12:29:15.7
3 (VP.Shunt 5040 /2018
PT 63
KID)
MITRA Cervical
BN.01.01/PP
FAJAR 1039/ I 24/01/201 Fusion
SELARAS, /2018 8 16:48:00 Cage no. 6
523 /2018
PT L12mm
MITRA Cervical
BN.01.01/PP
FAJAR 1039/ I 24/01/201 Fusion
SELARAS, /2018 8 16:48:00 Cage no.7
523 /2018
PT L12mm
ORTHOCE
MITRA 04/05/201
M 3G BN.01.01/PP
FAJAR 6360/V/2 8
141 ALKES (boncemen P c s IMPLANT 4 1100000 0 440000 4840000 K-BLU.FAR/
SELARAS, 018 13:25:08.0
t+genta)40 5351 /2018
PT 26
Gr
BN.01.01/PP
MAKMUR. 00201 10:27:49.4 ngkat 5
5447 /2018
PT 4 Ketiak M
BN.01.01/PP
MAKMUR. 00201 10:27:49.4 ngkat 2
5447 /2018
PT 4 Ketiak L
ANDALAS 00201 8 Crutch/To 2 K-BLU.FAR/
MAKMUR. 10:27:49.4 ngkat 5447 /2018
PT 4 Ketiak S
VP SHUNT
AGUNGWIJ 16/05/201 BURR
021/AWE/ BN.01.01/PP
AYA 8 HOLE
145 FP/IV/201 ALKES Pcs ALKES 5 4200000 0 2100000 23100000 K-BLU.FAR/
EKASENTO 10:13:49.7 MEDIUM
8 5742 /2018
SA, PT 93 16mmPRE
SS
AGUNGWIJ 16/05/201 VP SHUNT
021/AWE/ BN.01.01/PP
AYA 8 FLAT
146 FP/IV/201 ALKES Pcs IMPLANT 5 4200000 0 2100000 23100000 K-BLU.FAR/
EKASENTO 10:13:49.7 BOTTOM -
8 5742 /2018
SA, PT 93 M
External
SINERGI 17/05/201
TRIDAYA 8
MEDICAL, 12:57:14.4
1 (VP.Shunt 5853 /2018
PT 6
KID)
IN/18/06/ BN.01.01/PP
TRIDAYA 8 Burr Hole
1 5853 /2018
PT 6 Pressure
TITANIUM
MITRA
ROD FOR BN.01.01/PP
FAJAR 9603/V/2 21/05/201
149 ALKES PEDICLE Pcs IMPLANT 2 2657000 0 531400 5845400 K-BLU.FAR/
SELARAS, 018 8 11:59:00
SCREW 5991 /2018
PT
400MM
24/05/201
AKARIM BN.01.01/PP
18/AJF/V/ 8 DRILL BIT 136363.63 1499999.9
150 JAYA ALKES Pcs IMPLANT 5 272727.27 0 K-BLU.FAR/
569 13:34:31.3 3,2 MM 5 85
FARMA.PT 6119 /2018
86
24/05/201 Acrilic
AKARIM BN.01.01/PP
18/AJF/V/ 8 ( Vertex +
151 JAYA ALKES Set IMPLANT 20 342000 0 684000 7524000 K-BLU.FAR/
569 13:34:31.3 Meliodent
FARMA.PT 6119 /2018
86 )
External
SINERGI 06/06/201
TRIDAYA 8
MEDICAL, 10:06:32.8
0 (VP.Shunt 6608 /2018
PT 63
KID)
153 SINERGI IN/18/06/ 06/06/201 ALKES VP SHUNT P c s IMPLANT 3 3936000 0 1180800 12988800 BN.01.01/PP
BURR
TRIDAYA 8 HOLE
28/00185 K-BLU.FAR/
1 6646 /2018
PT 96 PRESS
12mm
VP SHUNT
IN/18/06/ BN.01.01/PP
TRIDAYA 8 HOLE
1 6646 /2018
PT 96 16mmPRE
SS
IN/18/06/ BN.01.01/PP
TRIDAYA 8 Burr Hole
1 6646 /2018
PT 96 Pressure
IN/18/06/ BN.01.01/PP
TRIDAYA 8 Burr Hole
MEDICAL, 10:08:20.6 High16mm
1 6646 /2018
PT 96 Pressure
ORTHOCE
MITRA 22/06/201
M 3G BN.01.01/PP
FAJAR 0068/VI/2 8
157 ALKES (boncemen P c s IMPLANT 10 1100000 0 1100000 12100000 K-BLU.FAR/
SELARAS, 018 11:47:39.8
t+genta)40 6851 /2018
PT 66
Gr
BN.01.01/PP
MAKMUR. 00878 15:47:56.2 ngkat 4
7010 /2018
PT 23 Ketiak M
26/06/201
AKARIM Archbar / BN.01.01/PP
18/AJF/VI 8
159 JAYA ALKES Splint With P c s IMPLANT 2 650000 0 130000 1430000 K-BLU.FAR/
/701 15:16:07.6
FARMA.PT Hook 7072 /2018
36
BN.01.01/PP
MAKMUR. 01436 10:40:01.8 ngkat 3
731 /2018
PT 53 Ketiak M
ANDALAS 01436 8 Crutch/To K-BLU.FAR/
MAKMUR. 10:40:01.8 ngkat 731 /2018
PT 53 Ketiak S
VP SHUNT
IN/18/07/ BN.01.01/PP
TRIDAYA 8 HOLE
7 7847 /2018
PT 16 16mmPRE
SS
IN/18/07/ BN.01.01/PP
TRIDAYA 8 Burr Hole
MEDICAL, 14:29:36.5 High16mm
7 7847 /2018
PT 16 Pressure
Multi
REKAMILE BN.01.01/PP
Function
NIUMINDO 0007/RS/F 02/01/201 16590909. 1659090.9 K-
SELARAS, /1/2018 8 10:35:00 09 09 BLU.FAR/1/2
/ MFO
PT 018
No.9-7
VSD
NIUMINDO 0007/RS/F 02/01/201 16590909. 1659090.9 K-
165 BMHP Occluder / P c s BMHP 1 0 18250000
SELARAS, /1/2018 8 10:35:00 09 09 BLU.FAR/1/2
MFO 8-6
PT 018
Canula
PERMATA 25/09/201 BN.01.01/PP
127/PB/F Venous
BUNDA 8 K-
166 AK/09/20 BMHP Bengkok Buah BMHP 5 882000 0 441000 4851000
ARTANO, 17:05:25.1 BLU.FAR/100
18 No.31
PT 7 15/2018
66331
25/09/201 BN.01.01/PP
STA Ind For
JP 8 1156599.9 12722599. K-
18002737 08:39:35.3 84 82 BLU.FAR/100
NUSANTA 240-
73 94/2018
RA.PT 872ENS
INTERGRA
25/09/201 Laparatom BN.01.01/PP
STA
JP 8 y Sponges K-
168 ARTHA BMHP Buah BMHP 500 19160 0 958000 10538000
18002737 08:39:35.3 X Ray 35 X BLU.FAR/100
NUSANTA
73 35CM 94/2018
RA.PT
169 INTERGRA JP 25/09/201 BMHP Mini Bio Ampul BMHP 5 1587600 0 793800 8731800 BN.01.01/PP
STA 18002737 8 Plus- K-
ARTHA 08:39:35.3 Sterotherm BLU.FAR/100
NUSANTA 73 ophilus 94/2018
RA.PT 327-601
Cauter /
DIMAS 25/09/201 BN.01.01/PP
Dispo
ANDALAS D1809- 8 K-
170 BMHP Hanswith P c s BMHP 50 160656 0 803280 8836080
MAKMUR. 01225 14:19:51.8 BLU.FAR/100
Pencil (E-
PT 33 95/2018
2515)
DIMAS 25/09/201 BN.01.01/PP
ANDALAS D1809- 8 Kaca Mata K-
171 BMHP Buah BMHP 100 34850 0 348500 3833500
MAKMUR. 01227 15:03:41.5 Clear BLU.FAR/100
PT 26 95/2018
BISAWI 24/09/201 BN.01.01/PP
4836/FKT Thoracic
TUMBUH 8 K-
172 R/BTS/IX/ BMHP Draig Cath Buah BMHP 10 120000 0 120000 1320000
SELARAS. 13:41:16.0 BLU.FAR/100
18 No.28
PT 56 97/2018
BISAWI 24/09/201 BN.01.01/PP
4836/FKT Thoracic
TUMBUH 8 K-
173 R/BTS/IX/ BMHP Draig Cath P c s BMHP 10 120000 0 120000 1320000
18 No.32
PT 56 97/2018
TIRTA 25/09/201 BN.01.01/PP
MEDICAL 1916/FP/1 8 Compolab K-
174 BMHP Test BMHP LAB 1500 8150.4 0 1222560 13448160
INDONESI 8 11:10:03.6 Cuvette BLU.FAR/101
A,PT 8 33/2018
PERMATA 26/09/201 BN.01.01/PP
174/PB/F Hemoconc
BUNDA 8 K-
175 AK/09/20 BMHP entrator S e t BMHP 10 1800000 0 1800000 19800000
18 for Adult
PT 3 99/2018
Anaerobic
DIPA 28/09/201 BN.01.01/PP
Gas
PUSPA 0718.FP- 8 K-
176 BMHP Generat/ Box/10kit BMHP LAB 10 799000 0 799000 8789000
LABSAINS. 10215 11:48:03.9 BLU.FAR/102
ANAEROG
PT 86 29/2018
EN
DIPA 28/09/201 BN.01.01/PP
PUSPA 0718.FP- 8 Anaerobic K-
177 BMHP Set BMHP LAB 3 1027650 0 308295 3391245
LABSAINS. 10215 11:48:03.9 Indicator BLU.FAR/102
PT 86 29/2018
DIPA 28/09/201 BN.01.01/PP
PUSPA 0718.FP- 8 Kit/5X50di K-
178 BMHP Cefotaxime BMHP LAB 1 371450 0 37145 408595
LABSAINS. 10215 11:48:03.9 sc BLU.FAR/102
PT 86 29/2018
DIPA 28/09/201 BN.01.01/PP
PUSPA 0718.FP- 8 CEFTAZIDI K-
179 BMHP Disc 5x50 BMHP LAB 1 371450 0 37145 408595
LABSAINS. 10215 11:48:03.9 ME Disc BLU.FAR/102
PT 86 29/2018
DIPA 28/09/201 BN.01.01/PP
Cefoperazo
180 BMHP ne BMHP LAB 1 371450 0 37145 408595
Sulbactam
PT 86 29/2018
DIPA 28/09/201 BN.01.01/PP
PUSPA 0718.FP- 8 Amies Agar K-
181 BMHP Kit/50s BMHP LAB 5 1115200 0 557600 6133600
LABSAINS. 10215 11:48:03.9 Gel BLU.FAR/102
PT 86 29/2018
BN.01.01/PP
ALEXA Extention
FM/18/21 10/10/201 K-
182 MEDIKA, BMHP Tube Buah BMHP 3000 12000 0 3600000 39600000
86 8 13:50:00 BLU.FAR/102
PT 150cm
30/2018
WEGO 02/10/201 BN.01.01/PP
SJ/CRD-
MEDIKA 8 DC Infinity K-
183 HAM/IX/1 BMHP Pcs BMHP 10 253000 0 253000 2783000
INDONESI 11:52:27.9 MPA2 - 6F BLU.FAR/102
8/005
A 76 31/2018
HD
PARIT 07/02/201 BN.01.01/PP
DoubLum
PADANG 81600518 8 K-
184 BMHP Farc 115- Set BMHP 30 504000 0 1512000 16632000
GLOBAL, 09- 16:18:36.3 BLU.FAR/102
15(preCur
PT 13 7/2018
ved)
27/09/201 Surgical BN.01.01/PP
DOS NI 82763115 8 Loop Red K-
185 BMHP Buah BMHP 48 120150 0 576720 6343920
ROHA, PT 2 16:48:56.7 1,5 mm BLU.FAR/102
06 75cm 70/2018
Premicron BN.01.01/PP
DOS NI 82763814 01/10/201 e 3/0 2 717885.14 7896736.5 K-
186 BMHP Sacchet BMHP 72 99706.27 0
ROHA, PT 9 8 09:57:00 xHR26 90 4 84 BLU.FAR/102
cm 70/2018
187 MILLENNI 23061800 28/09/201 BMHP Septalkan Botol BMHP 50 256950 0 1284750 14132250 BN.01.01/PP
UM 0366 8 Spray K-
PHARMAC 16:16:00.0 750ml BLU.FAR/102
ON 06 75/2018
INTERNAT
IONAL
TBK, PT
MILLENNI
UM
08/10/201 BN.01.01/PP
PHARMAC Septalkan
23061800 8 K-
188 ON BMHP Spray Botol BMHP 50 256950 0 1284750 14132250
0409 11:57:36.9 BLU.FAR/102
INTERNAT 750ml
26 75/2018
IONAL
TBK, PT
Cotton-
CAHAYA 07/02/201 Leung BN.01.01/PP
DUA 0009/CDD 8 Billiary K-
189 BMHP Pcs BMHP 6 1583650 0 950190 10452090
DELAPAN. /II/2018 14:04:27.0 Stent BLU.FAR/102
PT 5 Only,10Fr, 8/2018
9c
CAHAYA 07/02/201 BN.01.01/PP
Karet
DUA 0009/CDD 8 K-
190 BMHP Ligasi Bks BMHP 2 842625 0 168525 1853775
DELAPAN. /II/2018 14:04:27.0 BLU.FAR/102
Aescu
PT 5 8/2018
07/02/201 BN.01.01/PP
FAJAR MAS 8 Unicassett K-
191 LBI-06028 BMHP Pcs BMHP 1000 3000 0 300000 3300000
MURNI. PT 12:59:22.5 e BLU.FAR/102
93 9/2018
MENSA 07/02/201 BN.01.01/PP
OXYGENAT
BINA CD193414 8 43391894. K-
192 BMHP OR ADULT S e t BMHP 7 5635311 0 3944717.7
SUKSES, 267 16:16:17.1 7 BLU.FAR/103
FX25RW40
PT 63 0/2018
MENSA 07/02/201 Oxygenato BN.01.01/PP
BINA CD193414 8 r With 6951536.3 695153.63 7646689.9 K-
193 BMHP Set BMHP 1 0
SUKSES, 264 16:12:36.0 Reservoir 6 6 96 BLU.FAR/103
PT 23 (Baby RX) 1/2018
02/10/201 BN.01.01/PP
TIGA Gigli Wire
8 K-
194 BERKENA 48413226 BMHP Saw Fine-6 Buah BMHP 50 314820 0 1574100 17315100
09:49:03.1 BLU.FAR/103
N JAYA Wire 500
5 17/2018
Dispos
02/10/201 BN.01.01/PP
TIGA Singel
8 K-
195 BERKENA 48413226 BMHP Filter Pcs BMHP 1000 4239 0 423900 4662900
09:49:03.1 BLU.FAR/103
N JAYA 100%/PK
5 17/2018
08800
02/10/201 BN.01.01/PP
BRATACO. IVMDG180 8 390909.09 1172727.2 K-
196 BMHP Alkohol 96 Gln/20ltr BMHP 30 0 12900000
PT 1189 10:03:39.5 1 73 BLU.FAR/103
1 19/2018
ENSEVAL
03/10/201 BN.01.01/PP
PUTERA Extended
31800613 8 139707.27 1536780.0 K-
197 MEGATRA BMHP Life Pd Buah BMHP 7 199581.82 0
8 12:25:49.6 4 14 BLU.FAR/103
DING TBK, Transfer
86 20/2018
PT
ENSEVAL
03/10/201 BN.01.01/PP
PUTERA
31800613 8 Titanium K-
198 MEGATRA BMHP Pcs BMHP 2 720000 0 144000 1584000
8 12:25:49.6 Adaptor BLU.FAR/103
DING TBK,
86 20/2018
PT
ENSEVAL
03/10/201 BN.01.01/PP
PUTERA
31800613 8 Ultraclamp 120400.01 K-
199 MEGATRA BMHP Buah BMHP 4 27363.64 0 10945.456
8 12:25:49.6 (Red) 6 BLU.FAR/103
DING TBK,
86 20/2018
PT
ENSEVAL
03/10/201 BN.01.01/PP
PUTERA
31800613 8 K-
200 MEGATRA BMHP Tenckoff Pcs BMHP 2 755000 0 151000 1661000
8 12:25:49.6 BLU.FAR/103
DING TBK,
86 20/2018
PT
10/10/201 NEUTRAL BN.01.01/PP
BIOGEN
SI18/0189 8 BUFFER K-
201 SCIENTIFI BMHP Galon BMHP 10 523000 0 523000 5753000
4 14:45:58.1 FORMALIN BLU.Far/103
C. PT
76 10% - 3,8L 54/2018
Guide Wire
0.038
NIUMINDO 0626/RS/F 02/10/201 K-
202 BMHP 150cm Pcs BMHP 50 165000 0 825000 9075000
SELARAS, /11/2018 8 10:10:00 BLU.FAR/103
IQ38F150J
PT 55/2018
3
REVASS 05/10/201 BN.01.01/PP
UTAMA RMU18- 8 Manifold 8999999.9 K-
203 BMHP Pcs BMHP 100 81818.181 0 818181.81
MEDIKA 05187 16:51:35.8 Angioway 1 BLU.FAR/103
.PT 13 95/2018
204 CAHAYA 0106/CDD 04/10/201 BMHP DISPOSAB P c s BMHP 40 35000 0 140000 1540000 BN.01.01/PP
DUA /IX/2018 8 LE SHORT K-
DELAPAN. 12:18:28.9 BLU.FAR/104
PT 6 26/2018
Neutral
05/10/201 Buffer BN.01.01/PP
SINGA
SMP18100 8 Formalin K-
205 MUDA BMHP Galon BMHP LAB 3 1900000 0 570000 6270000
002 17:22:12.8 10 BLU.FAR/104
PERKASA
9 (1ken=19lt 27/2018
r)
BN.01.01/PP
HEXALAB Skin
HS.0918- 09/10/201 731670.99 K-
206 SUMATER BMHP Traction Roll BMHP 5 133031.09 0 66515.545
00420 8 11:31:00 5 BLU.FAR/104
A.PT Adult BSN
29/2018
BN.01.01/PP
HEXALAB Skin
HS.0918- 09/10/201 K-
207 SUMATER BMHP Traction Roll BMHP 5 99000 0 49500 544500
00420 8 11:31:00 BLU.FAR/104
A.PT Paed
29/2018
05/10/201 BN.01.01/PP
DIMAS
DAM 8 Petri Dish K-
208 ANDALAS BMHP Buah BMHP 2000 1693.12 0 338624 3724864
1810030 16:59:30.8 3Vent BLU.FAR/104
MEDIKA
8 74/2018
09/10/201 BN.01.01/PP
DIMAS Inoculation
DAM 8 K-
209 ANDALAS BMHP Loop 1Ul P c s BMHP 1000 1218.3 0 121830 1340130
1810048 13:14:10.7 BLU.FAR/104
MEDIKA & 10Ul
53 74/2018
MBL
CAHAYA 08/10/201 BN.01.01/PP
SPEEDBAN
DUA 0107/CDD 8 K-
210 BMHP D Pcs BMHP 1 3300000 0 330000 3630000
DELAPAN. /X/2018 10:27:05.9 BLU.FAR/104
SUPERVIE
PT 33 75/2018
W SUPER 7
CAHAYA 08/10/201 Transbron BN.01.01/PP
DUA 0107/CDD 8 chiale K-
211 BMHP Buah BMHP 2 2327975 0 465595 5121545
DELAPAN. /X/2018 10:27:05.9 Nadel / BLU.FAR/104
PT 33 TBN I 75/2018
DUA 0108/CDD 8 chiale 2327975.0 4423152.5 48654678. K-
212 BMHP Buah BMHP 19 0
DELAPAN. /X/2018 11:08:34.1 Nadel / 3 57 13 BLU.FAR/105
PT 43 TBN I 12/2018
213 SUKSES INV/SJA/1 11/10/201 BMHP VENTISOR Galon BMHP 10 617000 0 617000 6787000 BN.01.01/PP
JAYA 8/X/0539 8 B 4,5KG K-
ALKESIND 12:02:24.9 BLU.FAR/105
O. PT 93 49/2018
Kertas ECG
SUKSES 11/10/201 BN.01.01/PP
Bionet,
JAYA INV/SJA/1 8 K-
214 BMHP Cardiocare Roll BMHP 60 88182 0 529092 5820012
ALKESIND 8/X/0539 12:02:24.9 BLU.FAR/105
215mmx2
O. PT 93 49/2018
5m
KERTAS
SUKSES 11/10/201 TREADMIL BN.01.01/PP
JAYA INV/SJA/1 8 MARQUET K-
215 BMHP Pcs BMHP 30 412000 0 1236000 13596000
ALKESIND 8/X/0539 12:02:24.9 TE BLU.FAR/105
O. PT 93 215X280X 49/2018
300SH
DAVINDO 09/10/201 Film DVB BN.01.01/PP
VISI 004/PT.DV 8 35 x 43 K-
216 BMHP Lembar BMHP 375 45144 0 1692900 18621900
LESTARI. L/X/2018 08:52:37.0 Carestrea BLU.FAR/105
PT 7 m @125 50/2018
DAVINDO 09/10/201 BN.01.01/PP
Film DVB
VISI 004/PT.DV 8 K-
217 BMHP 20 x 25 Lembar BMHP 500 16632 0 831600 9147600
LESTARI. L/X/2018 08:52:37.0 BLU.FAR/105
@125
PT 7 50/2018
IDS F&P RT124
09/10/201 BN.01.01/PP
MEDICAL CIRC.W/
EG800001 8 K-
218 SYSTEM BMHP nCAP Set BMHP 10 2090000 0 2090000 22990000
75 10:32:46.8 BLU.FAR/105
INDONESI GENERAT
86 51/2018
A PT OSLE1000
Singel Use
IDS
09/10/201 Flow BN.01.01/PP
MEDICAL
EG800001 8 Sensor for K-
219 SYSTEM BMHP Pcs BMHP 10 1149500 0 1149500 12644500
75 10:32:46.8 SLE BLU.FAR/105
INDONESI
86 4000/500 51/2018
A PT
0
Tracheosto BN.01.01/PP
SURGIKA
07/11/201 my Tube K-
220 ALKESIND IRJ02277 BMHP Set BMHP 2 494250 0 98850 1087350
8 15:09:00 with Cuff + BLU.FAR/105
O, PT
Set,Size 5 88/2018
221 AKARIM 18/AJF/X/ 10/10/201 BMHP HD Double P c s BMHP 20 616500 0 1233000 13563000 BN.01.01/PP
JAYA 1164 8 Lumen K-
FARMA.PT 14:48:49.9 12Fr,16cm BLU.Far/105
13 FR-2265G 89/2018
Bioglue
PARIT 08/02/201 BN.01.01/PP
Pre-Filled
PADANG 81600520 8 K-
222 BMHP Syr 5ml Syringe BMHP 5 7653750 0 3826875 42095625
GLOBAL, 48- 15:08:48.8 BLU.FAR/105
SURG.ADH
PT 33 9/2018
ESIVE
Oxygenato
PERMATA 08/02/201 BN.01.01/PP
043/PB/F r Affnity
BUNDA 8 K-
223 AK/02/20 BMHP Fusion Set BMHP 2 6750000 0 1350000 14850000
18 Complete
PT 26 1/2018
Adult
PERMATA 08/02/201 BN.01.01/PP
043/PB/F CARDIOPL
BUNDA 8 K-
224 AK/02/20 BMHP EGIA SET S e t BMHP 5 1800000 0 900000 9900000
18 PED
PT 26 1/2018
PERMATA 08/02/201 BN.01.01/PP
043/PB/F Hemoconc
BUNDA 8 K-
18 for Adult
PT 26 1/2018
HOSPI 10/10/201 Cauter / BN.01.01/PP
1518/HMI
MEDIK 8 Goldline 116507.54 116507.54 1281582.9 K-
226 /KWI/X/2 BMHP Buah BMHP 10 0
INDONESI 15:40:44.2 Pencil + tip 5 5 95 BLU.FAR/106
018
A. PT 1 cleaner 25/2018
ANUGERA BN.01.01/PP
0636- Test Tube
H REZEKI 12/10/201 K-
227 18/10/AR BMHP Plastik Tube BMHP 7000 510 0 357000 3927000
BERSAMA 8 11:09:00 BLU.FAR/106
BI/129 12x75
I. PT 29/2018
Canula
PERMATA 12/10/201 BN.01.01/PP
114/PB/F Venous
BUNDA 8 K-
18 No.20
PT 66 30/2018
67320
PERMATA 12/10/201 Off Pump BN.01.01/PP
114/PB/F
BUNDA 8 System K-
229 AK/10/20 BMHP Set BMHP 1 30420000 0 3042000 33462000
ARTANO, 12:07:58.7 (Octopus+ BLU.FAR/106
18
PT 66 Starfish) 30/2018
230 PERMATA 114/PB/F 12/10/201 BMHP Canula Buah BMHP 2 882000 0 176400 1940400 BN.01.01/PP
BUNDA AK/10/20 8 Venous K-
ARTANO, 18 12:07:58.7 Bengkok BLU.FAR/106
PT 66 No.28 CVB. 30/2018
Sterilizatio
PETAN 12/10/201 BN.01.01/PP
1233/PDM n Agent
DAYA 8 2053636.3 22590000. K-
231 /FP/X/201 BMHP (H2O2) Pcs BMHP 45 456363.64 0
MEDICA, 13:46:36.3 8 18 BLU.FAR/106
8 SA10/
PT 13 31/2018
15units
IDS
BN.01.01/PP
MEDICAL Thoracic
19/10/201 K-
232 SYSTEM 0165281 BMHP Catheter Pcs BMHP 5 112500 0 56250 618750
8 14:43:00 BLU.FAR/106
INDONESI No. 20
32/2018
A PT
IDS
Double BN.01.01/PP
MEDICAL
19/10/201 Lumen K-
233 SYSTEM 0165495 BMHP Pcs BMHP 10 980000 0 980000 10780000
8 15:30:00 Multicath BLU.FAR/106
INDONESI
3Fr, 10cm 32/2018
A PT
Oxygenato
PERMATA 12/10/201 BN.01.01/PP
113/PB/F r Affnity
BUNDA 8 K-
18 Complete
PT 86 58/2018
Adult
PERMATA 12/10/201 BN.01.01/PP
113/PB/F Hemoconc
BUNDA 8 K-
18 For Ped
PT 86 58/2018
Canula
PERMATA 12/10/201 BN.01.01/PP
113/PB/F Venous
BUNDA 8 K-
18 No.31
PT 86 58/2018
66331
Canula
PERMATA 12/10/201 BN.01.01/PP
113/PB/F Venouse
BUNDA 8 K-
237 AK/10/20 BMHP VC2 Pcs BMHP 5 810000 0 405000 4455000
18 34/48FR
PT 86 58/2018
Two Stage
238 ANUGERA 15100042 15/10/201 BMHP Nylon Tape Sacchet BMHP 12 35325 0 42390 466290 BN.01.01/PP
H 69 8 W275 K-
PHARMIN 08:21:38.1 BLU.FAR/106
DO 2 59/2018
LESTARI,
PT
SUKSES 12/10/201 Breathing BN.01.01/PP
JAYA INV/SJA/1 8 Circuit Ped K-
239 BMHP Set BMHP 20 168182 0 336364 3700004
ALKESIND 8/X/0555 14:38:53.9 Set BLU.FAR/106
O. PT 43 Complete 61/2018
Film UPT
OPAL 09/02/201 BN.01.01/PP
517 14x17 BMHP
PERKASA 987/OPS/I 8 K-
SEJAHTER I/18 10:18:24.0 BLU.FAR/108
Thermal I
A. PT 23 8/2018
(35x43)
TRANSME 16/10/201 BN.01.01/PP
Katub
DIC 8 K-
241 IN1806498 BMHP Mitral Pcs BMHP 1 15100000 0 1510000 16610000
INDONESI 14:19:42.6 BLU.FAR/108
No.33mm
A. PT 66 95/2018
DIMAS 16/10/201 Polyhesive BN.01.01/PP
ANDALAS D1810- 8 II Ret Elect K-
242 BMHP Buah BMHP 55 109536 0 602448 6626928
MAKMUR. 00784 08:46:08.9 E7507 BLU.FAR/108
PT 2 adult cabl 97/2018
DIMAS 16/10/201 BN.01.01/PP
243 BMHP Buah BMHP 100 34850 0 348500 3833500
PT 1 97/2018
REKAMILE 17/10/201 Hearttr TM BN.01.01/PP
NIUMINDO 0341/RS/F 8 PDA K-
244 BMHP Pcs BMHP 1 12000000 0 1200000 13200000
SELARAS, /10/2018 09:15:29.2 Occuleder BLU.FAR/108
PT 6 XJD0608 98/2018
245 BMHP Pcs BMHP 1 12000000 0 1200000 13200000
PT 6 XJF 0406 98/2018
Guide Wire
0.038
246 BMHP 150cm Pcs BMHP 50 165000 0 825000 9075000
SELARAS, /10/2018 09:15:29.2 BLU.FAR/108
IQ38F150J
PT 6 98/2018
3
247 BIOGEN BN.01.01/ 15/10/201 BMHP NEUTRAL Galon BMHP 32 392250 0 1255200 13807200 BN.01.01/PP
SCIENTIFI BLU/1091 8 BUFFER K-
C. PT 0 14:08:15.1 FORMALIN BLU.FAR/109
73 10% - 3,8L 10/2018
15/10/201 BN.01.01/PP
BIOGEN BN.01.01/ Parafin -
8 K-
248 SCIENTIFI BLU/1091 BMHP Paraplast P c s BMHP 3 120000 0 36000 396000
14:08:15.1 BLU.FAR/109
C. PT 0 1kg
73 10/2018
BINA CD193428 8 r With 6951536.3 695153.63 7646689.9 K-
PT 06 (Baby RX) 2/2018
MENSA 09/02/201 BN.01.01/PP
Blood Bag
BINA CD193428 8 K-
SUKSES, 751 17:17:53.5 BLU.FAR/109
ml
PT 26 3/2018
MBL
CAHAYA 18/10/201 BN.01.01/PP
SPEEDBAN
DUA 117/CDD/ 8 K-
251 BMHP D Pcs BMHP 3 3000000 0 900000 9900000
DELAPAN. X/2018 10:01:06.3 BLU.FAR/109
SUPERVIE
PT 23 84/2018
W SUPER 7
26/10/201 BN.01.01/PP
THOMASO TOXAVIT
X/TN/18/ 8 K-
252 NG BMHP DENTAL Botol BMHP 1 1350000 0 135000 1485000
1891 12:00:05.7 BLU.FAR/109
NIRMALA PASTE 2 G
53 85/2018
26/10/201 Fuji 1 BN.01.01/PP
THOMASO
X/TN/18/ 8 POWDER 1227272.7 245454.54 2700000.0 K-
253 NG BMHP Set BMHP GIGI 2 0
1891 12:00:05.7 35G+LIQ 3 6 06 BLU.FAR/109
NIRMALA
53 25G 85/2018
26/10/201 BN.01.01/PP
THOMASO Fuji IX
X/TN/18/ 8 1136363.6 227272.72 2500000.0 K-
254 NG BMHP (Glaciono S e t BMHP GIGI 2 0
1891 12:00:05.7 4 8 08 BLU.FAR/109
NIRMALA mere)
53 85/2018
26/10/201 BN.01.01/PP
THOMASO Mata Bor
X/TN/18/ 8 1174999.9 K-
255 NG BMHP Tulang 0,8 Buah BMHP 5 213636.36 0 106818.18
1891 12:00:05.7 8 BLU.FAR/109
NIRMALA - 28mm
53 85/2018
26/10/201 BN.01.01/PP
THOMASO
X/TN/18/ 8 K-
256 NG BMHP CITODUR Botol BMHP 2 180000 0 36000 396000
1891 12:00:05.7 BLU.FAR/109
NIRMALA
53 85/2018
257 THOMASO X/TN/18/ 26/10/201 BMHP PULVERIL- Botol BMHP 2 477272.73 0 95454.546 1050000.0 BN.01.01/PP
8 K-
NG CRESOTIN
1891 12:00:05.7 06 BLU.FAR/109
NIRMALA LIQ NO.1
53 85/2018
JARUM
26/10/201 LENTULO BN.01.01/PP
THOMASO
X/TN/18/ 8 ROOT 113636.36 1250000.0 K-
258 NG BMHP Strip BMHP 5 227272.73 0
1891 12:00:05.7 FILLER L 5 15 BLU.FAR/109
NIRMALA
53 21MM(4PC 85/2018
S)
26/10/201 BN.01.01/PP
THOMASO MATA BUR
X/TN/18/ 8 K-
259 NG BMHP DIAMOND S e t BMHP GIGI 5 315000 0 157500 1732500
1891 12:00:05.7 BLU.FAR/109
NIRMALA High Speed
53 85/2018
Cauter /
DIMAS 17/10/201 BN.01.01/PP
Dispo
ANDALAS D1810- 8 K-
MAKMUR. 00994 15:16:05.3 BLU.FAR/109
Pencil (E-
PT 46 99/2018
2515)
DIMAS 17/10/201 BN.01.01/PP
Colostomy
ANDALAS D1810- 8 K-
261 BMHP Bag No.2 P c s BMHP 230 2635 0 60605 666655
MAKMUR. 00997 15:32:00.7 BLU.FAR/109
OM
PT 76 99/2018
DIMAS 17/10/201 BN.01.01/PP
Colostomy
ANDALAS D1810- 8 K-
MAKMUR. 00997 15:32:00.7 BLU.FAR/109
OM
PT 76 99/2018
ENSEVAL
18/10/201 BN.01.01/PP
PUTERA
11809164 8 Vitek AST K-
263 MEGATRA BMHP Kit BMHP LAB 6 2734200 0 1640520 18045720
7 13:11:25.5 GN93 BLU.FAR/110
DING TBK,
3 08/2018
PT
ENSEVAL
18/10/201 BN.01.01/PP
PUTERA GN Tet
11809164 8 K-
264 MEGATRA BMHP Vtk2 20 Kit BMHP LAB 7 2734200 0 1913940 21053340
7 13:11:25.5 BLU.FAR/110
DING TBK, Cards
3 08/2018
PT
265 ENSEVAL 11809164 18/10/201 BMHP Bactalert Buah BMHP LAB 1 7761600 0 776160 8537760 BN.01.01/PP
PUTERA 7 8 FN Plus K-
MEGATRA 13:11:25.5 BLU.FAR/110
DING TBK,
3 08/2018
PT
ENSEVAL
18/10/201 BN.01.01/PP
PUTERA
11809154 8 K-
266 MEGATRA BMHP Cytofunnel B o x BMHP LAB 8 1600000 0 1280000 14080000
5 10:54:12.2 BLU.FAR/110
DING TBK,
4 11/2018
PT
ENSEVAL
18/10/201 BN.01.01/PP
PUTERA Pisau
11809154 8 K-
267 MEGATRA BMHP Microtome P c s BMHP LAB 300 43200 0 1296000 14256000
5 10:54:12.2 BLU.FAR/110
DING TBK, TS
4 11/2018
PT
ENSEVAL
18/10/201 BN.01.01/PP
PUTERA Histoplast
11809154 8 K-
268 MEGATRA BMHP parafin Pack BMHP LAB 1 360000 0 36000 396000
5 10:54:12.2 BLU.FAR/110
DING TBK, 6774006
4 11/2018
PT
22/10/201 HD Double BN.01.01/PP
AKARIM
18/AJF/X/ 8 Lumen K-
269 JAYA BMHP Pcs BMHP 30 616500 0 1849500 20344500
1220 08:09:50.4 12Fr,16cm BLU.FAR/110
FARMA.PT
6 FR-2265G 82/2018
CAHAYA 22/10/201 BN.01.01/PP
DUA 119/CDD/ 8 DISPOSAB K-
270 BMHP Pcs BMHP 60 35000 0 210000 2310000
DELAPAN. X/2018 13:10:56.1 LE SHORT BLU.FAR/110
PT 86 83/2018
REKAMILE Hearttr TM BN.01.01/PP
NIUMINDO 0647/RS/F 24/10/201 PDA K-
271 BMHP Pcs BMHP 1 12000000 0 1200000 13200000
SELARAS, /10/2018 8 15:09:00 Occuleder BLU.FAR/110
PT XJD0608 84/2018
PERMATA Katub BN.01.01/PP
293/PB/F
BUNDA 18/10/201 Mitral Size K-
272 AK/10/20 BMHP Buah BMHP 1 15750000 0 1575000 17325000
ARTANO, 8 17:05:00 31mm - BLU.FAR/110
18
PT 753661 85/2018
PERMATA BN.01.01/PP
293/PB/F Hemoconc
BUNDA 18/10/201 K-
ARTANO, 8 17:05:00 BLU.FAR/110
18 for Adult
PT 85/2018
274 PERMATA 293/PB/F 18/10/201 BMHP Blower / P c s BMHP 5 1350000 0 675000 7425000 BN.01.01/PP
BUNDA AK/10/20 8 17:05:00 Mister Kit K-
ARTANO, BLU.FAR/110
18
PT 85/2018
ENSEVAL
23/10/201 BN.01.01/PP
PUTERA
31800670 8 Iodosorb 8224999.7 K-
275 MEGATRA BMHP Sacchet BMHP 125 59818.18 0 747727.25
3 11:04:19.6 3Gr 5 BLU.FAR/111
DING TBK,
63 43/2018
PT
ENSEVAL
23/10/201 BN.01.01/PP
PUTERA
31800670 8 MELOLIN K-
276 MEGATRA BMHP Lembar BMHP 125 7600 0 95000 1045000
3 11:04:19.6 10X10CM BLU.FAR/111
DING TBK,
63 43/2018
PT
24/10/201 BN.01.01/PP
FAJAR MAS LBI- 8 Unicassett K-
277 BMHP Pcs BMHP 3000 3000 0 900000 9900000
MURNI. PT 04540-00 08:42:21.5 e BLU.FAR/111
76 59/2018
29/10/201 Kasa Lipat BN.01.01/PP
RAJAWALI FKT/MDN
8 40X25/ K-
278 NUSINDO, /2018/000 BMHP Pcs BMHP 30000 1500 0 4500000 49500000
15:37:41.6 7.5X7.5x16 BLU.FAR/111
PT 1632
76 PL 61/2018
ENSEVAL
26/10/201 BN.01.01/PP
PUTERA
11809415 8 Vitek AST K-
4 11:52:49.7 GN93 BLU.FAR/112
DING TBK,
46 75/2018
PT
ENSEVAL
26/10/201 BN.01.01/PP
PUTERA Vitek 2,Ast
11809415 8 K-
280 MEGATRA BMHP Gp67 Buah BMHP LAB 1 2734200 0 273420 3007620
4 11:52:49.7 BLU.FAR/112
DING TBK, Cards
46 75/2018
PT
ENSEVAL
26/10/201 BN.01.01/PP
PUTERA
11809415 8 Crystal K-
281 MEGATRA BMHP Kit BMHP 1 1059380 0 105938 1165318
4 11:52:49.7 Violet C BLU.FAR/112
DING TBK,
46 75/2018
PT
282 ENSEVAL 11809415 26/10/201 BMHP Aceton Kit BMHP LAB 1 2060940 0 206094 2267034 BN.01.01/PP
PUTERA 4 8 Safranin A K-
DING TBK, 46 75/2018
PT
ENSEVAL
26/10/201 BN.01.01/PP
PUTERA
11809415 8 K-
283 MEGATRA BMHP Iodine B Btl/500ml BMHP LAB 1 1246560 0 124656 1371216
4 11:52:49.7 BLU.FAR/112
DING TBK,
46 75/2018
PT
ENSEVAL
26/10/201 BN.01.01/PP
PUTERA
11809415 8 Bactalert K-
284 MEGATRA BMHP Buah BMHP LAB 1 7761600 0 776160 8537760
4 11:52:49.7 FN Plus BLU.FAR/112
DING TBK,
46 75/2018
PT
ENSEVAL
26/10/201 BN.01.01/PP
PUTERA GP TET
11809415 8 K-
285 MEGATRA BMHP VTK2 20 Kit BMHP LAB 3 2734200 0 820260 9022860
4 11:52:49.7 BLU.FAR/112
DING TBK, Cards
46 75/2018
PT
ENSEVAL
26/10/201 BN.01.01/PP
PUTERA GN Tet
11809415 8 K-
4 11:52:49.7 BLU.FAR/112
DING TBK, Cards
46 75/2018
PT
PETAN 26/10/201 Chemical BN.01.01/PP
1274/PDM
DAYA 8 Indicator K-
287 /FP/X/201 BMHP Pcs BMHP 500 15181.82 0 759091 8350001
MEDICA. 08:13:31.0 Strip BLU.FAR/112
8
PT 23 250ea 78/2018
Sterilizatio
PETAN 26/10/201 BN.01.01/PP
1274/PDM n Agent
DAYA 8 2053636.3 22590000. K-
288 /FP/X/201 BMHP (H2O2) Pcs BMHP 45 456363.64 0
MEDICA. 08:13:31.0 8 18 BLU.FAR/112
8 SA10/
PT 23 78/2018
15units
Skin BN.01.01/PP
HEXALAB
HS.1018- 08/11/201 Marker K-
289 SUMATER BMHP Buah BMHP 20 33000 0 66000 726000
00485 8 07:53:00 -Regular BLU.FAR/112
A.PT
Tip 86/2018
BISAWI 29/10/201 Needle BN.01.01/PP
5548/FKT
TUMBUH 8 18G x 7.0 K-
290 R/BTS/X/ BMHP Pcs BMHP 100 37272.8 0 372728 4100008
SELARAS. 16:13:30.6 cm/ BLU.FAR/113
2018
PT 16 Pungture 13/2018
291 REVASS RUM18- 29/10/201 BMHP ASD Pcs BMHP 1 14175000 0 1417500 15592500 BN.01.01/PP
8 K-
MEDICAL.P OCCLUDER
05346 16:17:15.1 BLU.FAR/113
T 36F
6 15/2018
29/10/201 DELIVERY BN.01.01/PP
REVASS
RUM18- 8 SYSTEM K-
292 MEDICAL.P BMHP Pcs BMHP 1 3500000 0 350000 3850000
05346 16:17:15.1 OCCLUDER BLU.FAR/113
T
6 14F 15/2018
293 BMHP Flotrac Set BMHP 10 3150000 0 3150000 34650000
SELARAS, /11/2018 16:11:46.4 BLU.FAR/113
PT 7 17/2018
31/10/201 TIP BN.01.01/PP
RAJAWALI FKT/MDN
8 CLEANER/ K-
294 NUSINDO, /2018/000 BMHP Pcs BMHP 200 20065.5 0 401310 4414410
09:02:07.8 HARUM BLU.FAR/113
PT 1855
66 CLEAN 34/2018
02/11/201 COVERALL BN.01.01/PP
RAJAWALI FKT/MDN
8 L/BAJU K-
16:15:00.0 FLU BLU.FAR/113
PT 3154
36 BURUNG 34/2018
ENSEVAL
30/10/201 BN.01.01/PP
PUTERA Intrasite
31800683 8 K-
296 MEGATRA BMHP Gel Tube BMHP 50 89000 0 445000 4895000
0 08:15:49.5 BLU.Far/113
DING TBK, 15g/1X10
66 36/2018
PT
ENSEVAL
30/10/201 BN.01.01/PP
PUTERA Histoplast
11809535 8 K-
3 09:20:25.7 BLU.Far/113
DING TBK, 6774006
73 36/2018
PT
ENSEVAL
30/10/201 Coverglses BN.01.01/PP
PUTERA
11809535 8 24x60 mm K-
298 MEGATRA BMHP Buah BMHP 600 1260 0 75600 831600
3 09:20:25.7 6776325 BLU.Far/113
DING TBK,
73 (100) 36/2018
PT
Rapid
MULTI 31/10/201 BN.01.01/PP
Staining of
MEDIKA MML0069 8 K-
299 BMHP Blood/He Kit BMHP LAB 2 2310000 0 462000 5082000
LABORAT 59/1018 14:10:43.7 BLU.FAR/113
macolor-
ORY.PT 36 36/2018
3x500
1641/HMI
MEDIK 8 Goldline K-
300 /KWI/X/2 BMHP Buah BMHP 100 116507.5 0 1165075 12815825
INDONESI 16:16:23.4 Pencil + tip BLU.FAR/113
018
SUKSES Film DVB BN.01.01/PP
31/10/201
JAYA INV/SJA/1 35 x 43 2670454.5 29375000. K-
301 8 BMHP Lembar BMHP 625 42727.273 0
ALKESIND 8/X/0591 Carestrea 63 19 BLU.FAR/113
14:24:12.5
O. PT m @125 65/2018
ANUGERA
H 02/11/201 BN.01.01/PP
PHARMIN 51001249 8 Nylon Tape K-
302 BMHP Sacchet BMHP 12 35325 0 42390 466290
DO 8 10:37:31.7 W275 BLU.FAR/113
LESTARI, 63 66/2018
PT
ANUGERA
H 02/11/201 BN.01.01/PP
PHARMIN 51001249 8 Surgicel W K-
DO 8 10:37:31.7 1913T BLU.FAR/113
LESTARI, 63 66/2018
PT
ANUGERA
H 06/11/201 BN.01.01/PP
DO 81 08:15:34.3 W275 BLU.FAR/113
LESTARI, 2 66/2018
PT
ANUGERA
H 06/11/201 BN.01.01/PP
Mersilk
PHARMIN 15100135 8 K-
305 BMHP No.1 W215 Sacchet BMHP 60 60450 0 362700 3989700
DO 81 08:15:34.3 BLU.FAR/113
(13x60cm)
LESTARI, 2 66/2018
PT
Cellebrity
CAHAYA 01/11/201 BN.01.01/PP
Cytology
DUA 124/CDD/ 8 K-
306 BMHP Brush Pcs BMHP 10 800000 0 800000 8800000
DELAPAN. X/2018 12:27:15.9 BLU.FAR/113
1,5x140
PT 5 67/2018
BX/10
307 CAHAYA 125/CDD/ 01/11/201 BMHP PASTA EEG P c s BMHP 4 583332.95 0 233333.18 2566665.0 BN.01.01/PP
DUA X/2018 8 TEN 20 5 2 02 K-
DELAPAN. 12:36:58.0 BLU.FAR/113
PT 96 67/2018
308 BMHP Buah BMHP 100 109536 0 1095360 12048960
MAKMUR. 01902 14:01:30.4 E7507 BLU.FAR/113
POLYHESI
DIMAS 01/11/201 BN.01.01/PP
VE INFANT
ANDALAS D1810- 8 K-
309 BMHP RETURN P c s BMHP 5 197088 0 98544 1083984
MAKMUR. 01902 14:01:30.4 BLU.FAR/113
ELEC
PT 03 68/2018
E7510-25
DIMAS 01/11/201 Neonatal BN.01.01/PP
ANDALAS D1810- 8 Rem K-
310 BMHP Buah BMHP 15 401600 0 602400 6626400
MAKMUR. 01902 14:01:30.4 Polyhesive BLU.FAR/113
PT 03 II E7512 68/2018
01/11/201 BN.01.01/PP
BRATACO. IVMDN/18 8 Pot Plastik K-
311 BMHP Buah BMHP 1100 1590.91 0 175000.1 1925001.1
PT 06352 15:40:47.4 100 cc BLU.FAR/113
9 69/2018
01/11/201 BN.01.01/PP
BRATACO. IVMDN/18 8 Pot Plastik K-
312 BMHP Pcs BMHP 400 1000 0 40000 440000
PT 06352 15:40:47.4 40 cc BLU.FAR/113
9 69/2018
01/11/201 BN.01.01/PP
BRATACO. IVMDN/18 8 1200000.5 K-
313 BMHP Glyserin Btl/ltr BMHP LAB 20 54545.48 0 109090.96
PT 06352 15:40:47.4 6 BLU.FAR/113
9 69/2018
01/11/201 BN.01.01/PP
BRATACO. IVMDN/18 8 Kertas K-
314 BMHP Lembar BMHP 33000 14.545 0 47998.5 527983.5
PT 06352 15:40:47.4 Perkamen BLU.FAR/113
9 69/2018
01/11/201 BN.01.01/PP
BRATACO. IVMDN/18 8 Brand K-
315 BMHP Liter BMHP LAB 10 22728.4 0 22728.4 250012.4
PT 06352 15:40:47.4 Spiritus BLU.FAR/113
9 69/2018
01/11/201 BN.01.01/PP
Botol
BRATACO. IVMDN/18 8 K-
316 BMHP Plastik 100 Buah BMHP 800 1272.73 0 101818.4 1120002.4
PT 06352 15:40:47.4 BLU.FAR/113
cc
9 69/2018
01/11/201 BN.01.01/PP
BRATACO. IVMDG180 8 1068181.8 11750000. K-
317 BMHP Alkohol 96 Gln/20ltr BMHP 25 427272.73 0
PT 1347 15:45:00.2 25 07 BLU.FAR/113
9 69/2018
MENSA 01/11/201 BN.01.01/PP
Oxygenato
BINA CD194899 8 K-
318 BMHP r 10 Ped. P c s BMHP 3 5080480 0 1524144 16765584
SUKSES, 161 14:48:47.1 BLU.FAR/113
FX15RW30
PT 56 70/2018
Blood Line
MENSA 01/11/201 BN.01.01/PP
Ped/
BINA CD194899 8 K-
319 BMHP Custom Pcs BMHP 3 1 0 0.3 3.3
SUKSES, 161 14:48:47.1 BLU.FAR/113
Pack CX
PT 56 70/2018
910
DIMAS Cervical BN.01.01/PP
ANDALAS D1810- 01/11/201 Collar Fix 450000.01 K-
320 BMHP Pcs BMHP 3 136363.64 0 40909.092
MAKMUR. 01874 8 15:40:00 model CC 2 BLU.FAR/113
PT 01(keras) 75/2018
09/02/201 BN.01.01/PP
ALEXA Extention
FM/18/02 8 K-
58 15:28:58.2 BLU.FAR/113
PT 150cm
63 8/2018
DIMAS 01/11/201 BN.01.01/PP
322 BMHP Buah BMHP 150 34850 0 522750 5750250
PT 03 89/2018
DIMAS 01/11/201 BN.01.01/PP
TOUNG
ANDALAS D1810- 8 K-
323 BMHP SPATEL Pcs BMHP 1000 290 0 29000 319000
MAKMUR. 01879 11:13:44.4 BLU.FAR/113
KAYU
PT 03 89/2018
DIMAS 01/11/201 BN.01.01/PP
HEARING
ANDALAS D1810- 8 454545.45 772727.27 8500000.0 K-
324 BMHP AMPLIFIE Unit BMHP 17 0
MAKMUR. 01885 13:03:31.2 5 35 09 BLU.FAR/113
R HA 20
PT 86 89/2018
DIMAS 01/11/201 BN.01.01/PP
Colostomy
ANDALAS D1810- 8 K-
MAKMUR. 01900 13:56:33.5 BLU.FAR/113
OM
PT 3 89/2018
326 DIMAS D1810- 01/11/201 BMHP Colostomy P c s BMHP 960 2635 0 252960 2782560 BN.01.01/PP
ANDALAS 01900 8 Bag No.3 K-
MAKMUR. 13:56:33.5 BLU.FAR/113
OM
PT 3 89/2018
DIMAS 01/11/201 COTTON BN.01.01/PP
ANDALAS D1810- 8 SWAB K-
327 BMHP Pcs BMHP 400 1100 0 44000 484000
MAKMUR. 01900 13:56:33.5 STERIL M BLU.FAR/113
PT 3 (1/BKS) 89/2018
ANUGERA
H 12/02/201 BN.01.01/PP
DO 79 14:18:44.9 W275 BLU.FAR/113
LESTARI, 16 9/2018
PT
ANUGERA
H 12/02/201 BN.01.01/PP
DO 79 14:18:44.9 1913T BLU.FAR/113
LESTARI, 16 9/2018
PT
ANUGERA
H 13/02/201 BN.01.01/PP
Physiomes
PHARMIN 22124459 8 K-
330 BMHP h Open 15 P c s BMHP 1 12730500 0 1273050 14003550
DO 93 12:13:32.5 BLU.FAR/113
x 20cm
LESTARI, 8 9/2018
PT
INTERGRA
09/02/201 BN.01.01/PP
STA Test Tube
JP 8 K-
331 ARTHA BMHP Plastik Tube BMHP 5000 500 0 250000 2750000
18000441 16:35:53.4 BLU.FAR/114
NUSANTA 12x75
5 0/2018
RA.PT
INTERGRA
09/02/201 BN.01.01/PP
STA Tabung
JP 8 K-
332 ARTHA BMHP EDTA 3ml Box/100 BMHP 5000 1275 0 637500 7012500
18000441 16:35:53.4 BLU.FAR/114
NUSANTA K3
5 0/2018
RA.PT
09/02/201 Skin BN.01.01/PP
HEXALAB
HS.0218- 8 Marker K-
00110 16:34:45.3 -Regular BLU.FAR/114
A.PT
63 Tip 1/2018
BUNDA Venous K-
AK/02/20
ARTANO, 8 12:52:00 Bengkok BLU.FAR/114
18
PT No.24 CVB 4/2018
Canula
PERMATA BN.01.01/PP
048/PB/F Venous
BUNDA 13/02/201 K-
18 No.18
PT 4/2018
67318
Canula
PERMATA BN.01.01/PP
048/PB/F Venous
BUNDA 13/02/201 K-
18 No.20
PT 4/2018
67320
Canula
PERMATA BN.01.01/PP
048/PB/F Venous
BUNDA 13/02/201 K-
337 AK/02/20 BMHP Bengkok Pcs BMHP 2 882000 0 176400 1940400
18 No.16
PT 4/2018
67316
Canula
PERMATA BN.01.01/PP
048/PB/F Venous
BUNDA 13/02/201 K-
338 AK/02/20 BMHP Bengkok Pcs BMHP 2 882000 0 176400 1940400
18 NO.12
PT 4/2018
63712
PERMATA 02/11/201 BN.01.01/PP
031/PB/F Hemoconc
BUNDA 8 K-
339 AK/II/201 BMHP entrator S e t BMHP 10 1800000 0 1800000 19800000
8 for Adult
PT 53 58/2018
ECG
PAPER
BERKEMB 02/11/201 BN.01.01/PP
RECORDIN
ANG 8 K-
340 B0000287 BMHP G Roll BMHP 105 38000 0 399000 4389000
SELARAS 13:24:48.7 BLU.FAR/114
50MMX20
DAYA 03 59/2018
M (DC-
SHOCK)
341 BERKEMB B0000884 18/12/201 BMHP ECG Roll BMHP 15 38000 0 57000 627000 BN.01.01/PP
ANG 8 PAPER K-
SELARAS 14:07:35.0 RECORDIN BLU.FAR/114
DAYA 33 G 59/2018
50MMX20
M (DC-
SHOCK)
02/11/201 Bola BN.01.01/PP
AKARIM
18/AJF/XI 8 Lampu K-
342 JAYA BMHP Buah BMHP 20 141500 0 283000 3113000
/1280 11:55:44.2 Laringosco BLU.FAR/114
FARMA
93 pe Anak 60/2018
02/11/201 Nelaton BN.01.01/PP
AKARIM
18/AJF/XI 8 Catheter K-
/1280 11:55:44.2 No.10 BLU.FAR/114
FARMA
93 Rusch 60/2018
02/11/201 BN.01.01/PP
AKARIM Nelaton
18/AJF/XI 8 K-
344 JAYA BMHP Catheter Buah BMHP 20 12500 0 25000 275000
/1280 11:55:44.2 BLU.FAR/114
FARMA No. 8
93 60/2018
REVASS BN.01.01/PP
UTAMA RUM18- 08/11/201 Manifold K-
345 BMHP Pcs BMHP 100 81818.18 0 818181.8 8999999.8
MEDIKA 05400 8 10:57:00 Angioway BLU.FAR/114
.PT 93/2018
REKAMILE 05/11/201 Introducer BN.01.01/PP
NIUMINDO 0643/RS/F 8 Sheat 7F- K-
346 BMHP Pcs BMHP 10 200000 0 200000 2200000
SELARAS, /11/2018 12:06:46.3 11cm PSI- BLU.FAR/114
PT 43 7F-11-038 97/2018
347 BMHP Pcs BMHP 10 200000 0 200000 2200000
PT 53 7F-11-038 97/2018
348 BMHP Pcs BMHP 40 200000 0 800000 8800000
PT 56 7F-11-038 97/2018
REKAMILE Introducer BN.01.01/PP
NIUMINDO 1434/RS/F 09/11/201 Sheat 7F- K-
349 BMHP Pcs BMHP 40 200000 0 800000 8800000
SELARAS, /11/2018 8 13:36:00 11cm PSI- BLU.FAR/114
PT 7F-11-038 97/2018
07/11/201 BN.01.01/PP
STA Ind For
JP 8 481916.66 1156600.0 12722600. K-
350 ARTHA BMHP Steam- Roll BMHP 24 0
18003231 15:46:24.4 7 01 01 BLU.FAR/115
NUSANTA 240-
93 28/2018
RA.PT 872ENS
INTERGRA
07/11/201 BN.01.01/PP
STA Tabung
JP 8 K-
351 ARTHA BMHP Centrifuge Buah BMHP 300 3560 0 106800 1174800
18003265 15:57:26.2 BLU.FAR/115
NUSANTA Tube 50ml
93 28/2018
RA.PT
ENSEVAL
08/11/201 BN.01.01/PP
PUTERA
2 12:31:41.5 FN Plus BLU.FAR/115
DING TBK,
6 54/2018
PT
ENSEVAL
08/11/201 BN.01.01/PP
PUTERA GN Tet
11809856 8 K-
2 12:31:41.5 BLU.FAR/115
DING TBK, Cards
6 54/2018
PT
ENSEVAL
08/11/201 BN.01.01/PP
PUTERA
11809856 8 Vitek AST K-
2 12:31:41.5 GN93 BLU.FAR/115
DING TBK,
6 54/2018
PT
ENSEVAL
08/11/201 BN.01.01/PP
PUTERA GP TET
11809856 8 K-
2 12:31:41.5 BLU.FAR/115
DING TBK, Cards
6 54/2018
PT
ENSEVAL
08/11/201 BN.01.01/PP
PUTERA Vitek 2,Ast
11809856 8 K-
2 12:31:41.5 BLU.FAR/115
DING TBK, Cards
6 54/2018
PT
ENSEVAL
08/11/201 BN.01.01/PP
PUTERA
11809856 8 Vitek AST K-
2 12:31:41.5 ST01 BLU.FAR/115
DING TBK,
6 54/2018
PT
PERMATA 06/11/201 BN.01.01/PP
058/PB/F CARDIOPL
BUNDA 8 K-
358 AK/II/201 BMHP EGIA SET S e t BMHP 15 1600000 0 2400000 26400000
8 ADULT
PT 86 55/2018
IDS
07/11/201 Double BN.01.01/PP
MEDICAL
8 Lumen K-
13:56:12.4 Multicath BLU.FAR/115
INDONESI
63 3Fr, 10cm 56/2018
A PT
ENSEVAL
08/11/201 BN.01.01/PP
PUTERA Extended
31800703 8 139707.27 1536780.0 K-
2 13:48:40.9 4 14 BLU.FAR/115
DING TBK, Transfer
03 57/2018
PT
ENSEVAL
08/11/201 BN.01.01/PP
PUTERA
31800703 8 K-
361 MEGATRA BMHP Tenckoff Pcs BMHP 2 755000 0 151000 1661000
2 13:48:40.9 BLU.FAR/115
DING TBK,
03 57/2018
PT
ENSEVAL
08/11/201 BN.01.01/PP
PUTERA
DING TBK,
03 57/2018
PT
ENSEVAL
08/11/201 BN.01.01/PP
PUTERA
31800703 8 Ultraclamp 120400.01 K-
363 MEGATRA BMHP Buah BMHP 4 27363.64 0 10945.456
2 13:48:40.9 (Red) 6 BLU.FAR/115
DING TBK,
03 57/2018
PT
ANUGERA
H BN.01.01/PP
Disp.Syring
PHARMIN 15100157 09/11/201 K-
364 BMHP e / Spuit P c s BMHP 4000 1115.45 0 446180 4907980
DO 30 8 08:33:00 BLU.FAR/115
10ml T-sy
LESTARI, 66/2018
PT
08/11/201 BN.01.01/PP
DIMAS
DAM 8 Petri Dish 3650366.7 K-
365 ANDALAS BMHP Buah BMHP 1960 1693.12 0 331851.52
1811035 15:01:45.2 3Vent 2 BLU.FAR/115
MEDIKA
36 70/2018
08/11/201 LACTOSE BN.01.01/PP
DIMAS
DAM 8 BROTH 1066494.5 106649.45 1173144.0 K-
366 ANDALAS BMHP Botol BMHP 1 0
1811035 15:01:45.2 EUR 5 5 05 BLU.FAR/115
MEDIKA
36 PHARMA 70/2018
BRILLIANT
08/11/201 BN.01.01/PP
DIMAS GREEN
DAM 8 1789334.5 178933.45 1968268.0 K-
367 ANDALAS BMHP BILE Botol BMHP 1 0
1811035 15:01:45.2 5 5 05 BLU.FAR/115
MEDIKA BROTH 2%
36 70/2018
PR
BISAWI 16/11/201 Inflasion BN.01.01/PP
5792/FKT
TUMBUH 8 Device 854545.45 2563636.3 28200000. K-
368 R/BTS/XI/ BMHP Set BMHP 30 0
SELARAS. 15:33:55.2 Comp.With 5 65 02 BLU.FAR/115
18
PT 03 Acces 73/2018
08/11/201 NEUTRAL BN.01.01/PP
BIOGEN
8SPB 10:11:19.0 FORMALIN BLU.FAR/115
C. PT
93 10% - 3,8L 98/2018
23/11/201 Kasa Lipat BN.01.01/PP
RAJAWALI FKT/MDN
8 40X25/ K-
14:00:57.9 7.5X7.5x16 BLU.FAR/116
PT 521
66 PL 44/2018
INTERGRA
13/11/201 BOTOL BN.01.01/PP
STA
JP 8 HANDSOA K-
371 ARTHA BMHP Botol BMHP 1000 8500 0 850000 9350000
18003336 15:45:44.8 P/HANDR BLU.FAR/116
NUSANTA
5 UB 500ml 85/2018
RA.PT
JAYA INV/SJA/1 8 Circuit Ped K-
372 BMHP Set BMHP 50 168182 0 840910 9250010
ALKESIND 8/XI/0622 15:28:13.9 Set BLU.FAR/116
0624,0625 SIZING
NIUMINDO 8 4545455.4 454545.54 5000000.9 K-
373 /RS/F/11/ BMHP BALLON Buah BMHP 1 0
SELARAS, 13:27:28.9 5 5 95 BLU.FAR/116
20 24
PT 73 87/2018
0624,0625 SIZING
NIUMINDO 8 4545454.5 10000000. K-
374 /RS/F/11/ BMHP BALLON Buah BMHP 2 0 909090.91
SELARAS, 13:27:28.9 5 01 BLU.FAR/116
20 34
PT 73 87/2018
TEST
ANUGERA 14/11/201 BN.01.01/PP
1025- TUBE
H REZEKI 8 K-
375 18/11/AR BMHP PLASTIK P c s BMHP 7000 510 0 357000 3927000
BERSAMA 14:59:55.3 BLU.FAR/117
BI/153 12X75
I. PT 76 16/2018
(250/BOX)
Steerease
NIUMINDO 0078/RS/F 13/02/201 4336734.5 433673.45 4770408.0 K-
SELARAS, /2/2018 8 09:04:00 5 5 05 BLU.FAR/117
5F
PT 4/2018
SteerEase
NIUMINDO 0078/RS/F 13/02/201 4336734.5 433673.45 4770408.0 K-
SELARAS, /2/2018 8 09:04:00 5 5 05 BLU.FAR/117
7F
PT 4/2018
Steerease
NIUMINDO 0078/RS/F 13/02/201 4336734.5 9540816.0 K-
SELARAS, /2/2018 8 09:04:00 5 1 BLU.FAR/117
8Fr
PT 4/2018
REKAMILE DC BN.01.01/PP
NIUMINDO 0078/RS/F 13/02/201 PIGTAIL K-
379 BMHP Buah BMHP 20 350000 0 700000 7700000
SELARAS, /2/2018 8 09:04:00 cath 5Fr BLU.FAR/117
PT 7529-11 4/2018
REKAMILE DC. JR 4.0 - BN.01.01/PP
NIUMINDO 0079/RS/F 13/02/201 6F/Angiog K-
380 BMHP Pcs BMHP 14 265000 0 371000 4081000
SELARAS, /5/2018 8 09:51:00 raphic BLU.FAR/117
PT 7503-21 4/2018
DC. JL 3.5 -
NIUMINDO 0079/RS/F 13/02/201 K-
381 BMHP 6F MM Pcs BMHP 2 265000 0 53000 583000
SELARAS, /5/2018 8 09:51:00 BLU.FAR/117
7501-13
PT 4/2018
ENSEVAL
16/11/201 BN.01.01/PP
PUTERA
11810137 8 Vitek AST K-
2 10:01:14.6 GN93 BLU.FAR/117
DING TBK,
63 66/2018
PT
ENSEVAL
16/11/201 BN.01.01/PP
PUTERA
2 10:01:14.6 FA Plus BLU.FAR/117
DING TBK,
63 66/2018
PT
ENSEVAL
16/11/201 BN.01.01/PP
PUTERA GN Tet
11810137 8 K-
2 10:01:14.6 BLU.FAR/117
DING TBK, Cards
63 66/2018
PT
ENSEVAL
16/11/201 BN.01.01/PP
PUTERA GP TET
11810137 8 K-
2 10:01:14.6 BLU.FAR/117
DING TBK, Cards
63 66/2018
PT
ENSEVAL
16/11/201 BN.01.01/PP
PUTERA Vitek 2,Ast
11810137 8 K-
2 10:01:14.6 BLU.FAR/117
DING TBK, Cards
63 66/2018
PT
ENSEVAL
16/11/201 BN.01.01/PP
PUTERA YST Tet
11810137 8 K-
2 10:01:14.6 BLU.FAR/117
DING TBK, Cards
63 66/2018
PT
TIRTA 16/11/201 BN.01.01/PP
A,PT 46 69/2018
DIMAS 13/02/201 Cauter / BN.01.01/PP
ANDALAS D1802- 8 Pencil with 1563636.3 17200000. K-
389 BMHP Buah BMHP 172 90909.091 0
MAKMUR. 00696 11:08:12.3 Holster 65 02 BLU.FAR/118
PT 73 VL2610 0/2018
19/11/201 BN.01.01/PP
Botol
BRATACO. IVMDN180 8 K-
390 BMHP Plastik 100 Buah BMHP 1200 1272.73 0 152727.6 1680003.6
PT 6734 12:27:32.9 BLU.FAR/118
cc
46 10/2018
19/11/201 BN.01.01/PP
BRATACO. IVMDN180 8 Methyl 499999.99 K-
391 BMHP Kg BMHP LAB 1 454545.45 0 45454.545
PT 6734 12:27:32.9 Paraben 5 BLU.FAR/118
46 10/2018
19/11/201 BN.01.01/PP
BRATACO. IVMDN180 8 Acid Citric K-
392 BMHP Kg BMHP 100 40909.09 0 409090.9 4499999.9
PT 6734 12:27:32.9 1Kg BLU.FAR/118
46 10/2018
19/11/201 BN.01.01/PP
393 BMHP Glyserin Btl/ltr BMHP LAB 20 54545.3 0 109090.6 1199996.6
PT 6734 12:27:32.9 BLU.FAR/118
46 10/2018
BISAWI 14/02/201 BN.01.01/PP
0667/FKT Thoracic
TUMBUH 8 K-
394 R/BTS/II/ BMHP Draig Cath Buah BMHP 50 80000 0 400000 4400000
18 No.28
PT 6 4/2018
BISAWI 14/02/201 BN.01.01/PP
0667/FKT Thoracic
TUMBUH 8 K-
395 R/BTS/II/ BMHP Draig Cath P c s BMHP 40 80000 0 320000 3520000
18 No.32
PT 6 4/2018
BISAWI 14/02/201 Thoracic BN.01.01/PP
0667/FKT
TUMBUH 8 Drainage K-
396 R/BTS/II/ BMHP Pcs BMHP 5 80000 0 40000 440000
SELARAS. 09:57:03.0 Straight BLU.FAR/118
18
PT 6 No.16 4/2018
21/11/201 BN.01.01/PP
BRATACO. IVMDG180 8 1281818.1 14100000. K-
PT 1432 16:08:10.4 9 09 BLU.FAR/118
36 45/2018
DIMAS 28/11/201 BN.01.01/PP
EMERGEN
ANDALAS D1811- 8 19000000. K-
398 BMHP CY KEY Pcs BMHP 2000 8636.364 0 1727272.8
MAKMUR. 01363 17:02:22.2 8 BLU.FAR/118
disposable
PT 93 49/2018
21/11/201 HD Double BN.01.01/PP
AKARIM
18/AJF/X/ 8 Lumen K-
1347 11:19:39.0 12Fr,16cm BLU.FAR/118
FARMA, PT
13 FR-2265G 78/2018
PERMATA 23/11/201 BN.01.01/PP
193/PB/F Hemoconc
BUNDA 8 K-
400 AK/II/201 BMHP entrator S e t BMHP 15 1800000 0 2700000 29700000
8 for Adult
PT 5 79/2018
PERMATA 23/11/201 BN.01.01/PP
193/PB/F Cardiopleg
BUNDA 8 K-
401 AK/II/201 BMHP ia Kallife S e t BMHP 10 1600000 0 1600000 17600000
8 Adult
PT 5 79/2018
IDS ECG Z-
BN.01.01/PP
MEDICAL FOLD
27/11/201 K-
402 SYSTEM 0169940 BMHP PAPER Roll BMHP 25 56250 0 140625 1546875
8 13:28:25 BLU.FAR/118
INDONESI 90X90X36
82/2018
A PT 0sheet
403 DOS NI 82779894 23/11/201 BMHP Premicron Sacchet BMHP 36 150800 0 542880 5971680 BN.01.01/PP
ROHA, PT 8 8 e 4/0 K-
13:43:01.1 2xHRT17 BLU.FAR/118
86 90cm 85/2018
CAHAYA 11/01/201 Quick Core BN.01.01/PP
DUA 0001/CDD 8 Biopsy K-
404 BMHP Pcs BMHP 10 868182 0 868182 9550002
DELAPAN. /I/2018 14:00:29.5 Needle, BLU.FAR/119
PT 6 18G/20cm /2018
Cotton-
405 BMHP Pcs BMHP 4 1583650 0 633460 6968060
DELAPAN. /I/2018 14:00:29.5 Stent BLU.FAR/119
PT 6 Only,10Fr, /2018
9c
Cotton-
406 BMHP Buah BMHP 2 1583650 0 316730 3484030
DELAPAN. /I/2018 14:00:29.5 Stent BLU.FAR/119
PT 6 Only,10Fr1 /2018
2
CAHAYA 11/01/201 BN.01.01/PP
Blood Bag
DUA 0001/CDD 8 K-
407 BMHP Singel Pcs BMHP 500 31150 0 1557500 17132500
DELAPAN. /I/2018 14:00:29.5 BLU.FAR/119
350ml
PT 6 /2018
Kertas ECG
SUKSES 23/11/201 BN.01.01/PP
Bionet,
JAYA INV/SJA/1 8 K-
408 BMHP Cardiocare Roll BMHP 50 88181.82 0 440909.1 4850000.1
ALKESIND 8/XI/0641 17:03:58.3 BLU.FAR/119
215mmx2
O. PT 23 37/2018
5m
PERMATA 26/11/201 BN.01.01/PP
213/PB/F
BUNDA 8 Blower / K-
409 AK/II/201 BMHP Pcs BMHP 10 1350000 0 1350000 14850000
ARTANO, 08:12:31.6 Mister Kit BLU.FAR/119
8
PT 03 38/2018
ENSEVAL
26/11/201 BN.01.01/PP
PUTERA
3 13:54:14.4 FA Plus BLU.FAR/119
DING TBK,
93 39/2018
PT
411 ENSEVAL 11810388 26/11/201 BMHP Kit Kit BMHP LAB 1 4606000 0 460600 5066600 BN.01.01/PP
PUTERA 3 8 Densichek K-
MEGATRA 13:54:14.4 Plus STD BLU.FAR/119
DING TBK,
93 39/2018
PT
ENSEVAL
26/11/201 Pipette BN.01.01/PP
PUTERA
11810388 8 Tips 100- K-
412 MEGATRA BMHP Buah BMHP LAB 192 3093.125 0 59388 653268
3 13:54:14.4 1000ul BLU.FAR/119
DING TBK,
93 (96pcs) 39/2018
PT
ENSEVAL
26/11/201 BN.01.01/PP
PUTERA
11810388 8 Vitek AST K-
3 13:54:14.4 YS07 BLU.FAR/119
DING TBK,
93 39/2018
PT
ENSEVAL
26/11/201 BN.01.01/PP
PUTERA GN Tet
11810388 8 K-
3 13:54:14.4 BLU.FAR/119
DING TBK, Cards
93 39/2018
PT
ENSEVAL
26/11/201 BN.01.01/PP
PUTERA GP TET
11810388 8 K-
3 13:54:14.4 BLU.FAR/119
DING TBK, Cards
93 39/2018
PT
ENSEVAL
26/11/201 BN.01.01/PP
PUTERA Vitek 2,Ast
11810388 8 K-
3 13:54:14.4 BLU.FAR/119
DING TBK, Cards
93 39/2018
PT
ENSEVAL
26/11/201 BN.01.01/PP
PUTERA
11810388 8 Vitek AST K-
3 13:54:14.4 GN93 BLU.FAR/119
DING TBK,
93 39/2018
PT
Sterilizatio
PETAN 29/11/201 BN.01.01/PP
1423/PDM n Agent
DAYA 8 2738181.8 30120000. K-
418 /FP/XI/20 BMHP (H2O2) Pcs BMHP 60 456363.64 0
MEDICA, 09:53:58.4 4 24 BLU.FAR/119
18 SA10/
PT 16 70/2018
15units
419 PETAN 1423/PDM 29/11/201 BMHP Chemical P c s BMHP 1000 15181.82 0 1518182 16700002 BN.01.01/PP
DAYA /FP/XI/20 8 Indicator K-
MEDICA, 09:53:58.4 Strip BLU.FAR/119
18
PT 16 250ea 70/2018
05/12/201 BN.01.01/PP
ANDRA Tubing
APJ/INV/1 8 K-
420 PRIMA BMHP System for Buah BMHP 10 600000 0 600000 6600000
8/XI/1079 13:09:31.6 BLU.FAR/119
JAYA. PT E/S201
9 73/2018
MENSA BN.01.01/PP
04/12/201 Oxygenato
BINA CD195040 K-
421 8 BMHP r 10 Ped. P c s BMHP 5 5080480 0 2540240 27942640
SUKSES, 369 BLU.FAR/119
11:29:33.2 FX15RW30
PT 98/2018
Blood Line
MENSA BN.01.01/PP
04/12/201 Ped/
BINA CD195040 K-
422 8 BMHP Custom Pcs BMHP 3 1 0 0.3 3.3
11:29:33.2 Pack CX
PT 98/2018
910
Blood Line
MENSA BN.01.01/PP
04/12/201 Infant/
BINA CD195040 K-
423 8 BMHP Custom Pcs BMHP 2 1 0 0.2 2.2
11:29:33.2 Pack
PT 98/2018
CX921
DIPA 29/11/201 BN.01.01/PP
PUSPA 0718.FP- 8 Petri Dish K-
424 BMHP Buah BMHP 1000 2020.2 0 202020 2222220
LABSAINS. 101483 16:55:11.3 3Vent BLU.FAR/119
PT 06 99/2018
DIPA 29/11/201 BN.01.01/PP
Sulfametox
425 BMHP azole/Trim BMHP LAB 1 371450 0 37145 408595
etropin
PT 06 99/2018
DIPA 29/11/201 BN.01.01/PP
PUSPA 0718.FP- 8 Vancomysi Kit/5X50di K-
426 BMHP BMHP LAB 1 371450 0 37145 408595
LABSAINS. 101483 16:55:11.3 n sc BLU.FAR/119
PT 06 99/2018
DIPA 29/11/201 BN.01.01/PP
PUSPA 0718.FP- 8 Clindamyci K-
427 BMHP Disc 5x50 BMHP LAB 1 371450 0 37145 408595
LABSAINS. 101483 16:55:11.3 n BLU.FAR/119
PT 06 99/2018
428 DIPA 0718.FP- 29/11/201 BMHP Cefuroxim Kit/5X50di BMHP LAB 1 371450 0 37145 408595 BN.01.01/PP
PUSPA 101483 8 a sc K-
LABSAINS. 16:55:11.3 BLU.FAR/119
PT 06 99/2018
DIPA 29/11/201 BN.01.01/PP
PUSPA 0718.FP- 8 Meropene Kit/5X50di K-
429 BMHP BMHP LAB 1 371450 0 37145 408595
LABSAINS. 101483 16:55:11.3 m sc BLU.FAR/119
PT 06 99/2018
DIPA 29/11/201 BN.01.01/PP
PT 06 99/2018
DIPA 29/11/201 BN.01.01/PP
PT 1 99/2018
DIPA 29/11/201 BN.01.01/PP
Xylene,BA
PUSPA 0718.FP- 8 K-
432 BMHP R, ACS Botol BMHP LAB 2 1165500 0 233100 2564100
LABSAINS. 101484 17:02:05.7 BLU.FAR/119
Reagent
PT 1 99/2018
06/12/201 BN.01.01/PP
DEMKA ARI/18/11 8 Hemocron 1672469.8 18397168. K-
433 BMHP Tube BMHP 380 44012.364 0
SAKTI. PT /1001800 15:17:30.2 e 32 15 BLU.FAR/120
16 01/2018
ANUGERA 29/11/201 BN.01.01/PP
1221- Tabung
H REZEKI 8 K-
434 18/11/AR BMHP EDTA 3ml P c s BMHP 4000 1200 0 480000 5280000
BI/349 K3 glass
I. PT 26 41/2018
PETAN 29/11/201 Bio Screw BN.01.01/PP
1435/PDM
DAYA 8 For ACL K-
435 /FP/XI/20 ALKES Pcs IMPLANT 1 7600000 0 760000 8360000
MEDICA, 13:32:26.6 Recon 9 x BLU.FAR/120
18
PT 5 25mm 42/2018
PETAN 29/11/201 BN.01.01/PP
1436/PDM 4.2 MM
DAYA 8 K-
436 /FP/XI/20 BMHP GREAT Pcs BMHP 1 3800000 0 380000 4180000
MEDICA, 11:18:26.5 BLU.FAR/120
18 WHITE
PT 2 43/2018
1791/HMI
MEDIK 8 Goldline K-
437 /KWI/XI/2 BMHP Buah BMHP 100 116507.5 0 1165075 12815825
INDONESI 14:54:57.6 Pencil + tip BLU.FAR/120
018
438 TIGA 45632439 30/11/201 BMHP DERMATO P c s BMHP 20 269190 0 538380 5922180 BN.01.01/PP
BERKENA 8 ME K-
BLADES
10:25:08.9 STERIL(GB BLU.FAR/120
N JAYA
86 228R) 45/2018
electric
ENSEVAL
10/12/201 BN.01.01/PP
PUTERA
31800762 8 Pico 15 x K-
439 MEGATRA BMHP Set BMHP 1 4727250 0 472725 5199975
7 09:31:35.3 20cm BLU.FAR/120
DING TBK,
36 46/2018
PT
ANUGERA
H 30/11/201 LIGA CLIP BN.01.01/PP
PHARMIN 15100234 8 APPLIER K-
440 BMHP Pcs BMHP 2 6864000 0 1372800 15100800
DO 16 09:38:25.8 7,5 INCHI BLU.FAR/120
LESTARI, 33 MEDIUM 61/2018
PT
HD
DOUBLE BN.01.01/PP
EUREKA
INV1118E 07/12/201 LUMEN K-
441 SUKSES BMHP Set BMHP 50 495000 0 2475000 27225000
SA0222 8 14:13:00 11,5-16CM BLU.FAR/120
ABADI
(PRECURV 62/2018
ED)
30/11/201 BN.01.01/PP
AKARIM
18/AJF/XI 8 Gigli Saw K-
/1386 11:12:32.8 Wire 40cm BLU.FAR/120
FARMA.PT
7 65/2018
ENSEVAL
30/11/201 BN.01.01/PP
PUTERA
11810555 8 Vitek AST K-
7 15:37:41.7 GN93 BLU.FAR/120
DING TBK,
9 66/2018
PT
ENSEVAL
30/11/201 BN.01.01/PP
PUTERA
7 15:37:41.7 FN Plus BLU.FAR/120
DING TBK,
9 66/2018
PT
445 ENSEVAL 11810555 30/11/201 BMHP GN Tet Kit BMHP LAB 3 2734200 0 820260 9022860 BN.01.01/PP
PUTERA 7 8 Vtk2 20 K-
MEGATRA 15:37:41.7 Cards BLU.FAR/120
DING TBK, 9 66/2018
PT
ENSEVAL
30/11/201 BN.01.01/PP
PUTERA GP TET
11810555 8 K-
7 15:37:41.7 BLU.FAR/120
DING TBK, Cards
9 66/2018
PT
ENSEVAL
30/11/201 Pipette BN.01.01/PP
PUTERA
11810555 8 Tips 100- K-
7 15:37:41.7 1000ul BLU.FAR/120
DING TBK,
9 (96pcs) 66/2018
PT
ENSEVAL
30/11/201 BN.01.01/PP
PUTERA Vitek 2,Ast
11810555 8 K-
7 15:37:41.7 BLU.FAR/120
DING TBK, Cards
9 66/2018
PT
ENSEVAL
30/11/201 BN.01.01/PP
PUTERA
11810555 8 Vitek2 K-
7 15:37:41.7 BCL, Cards BLU.FAR/120
DING TBK,
9 66/2018
PT
Cauter /
DIMAS 30/11/201 BN.01.01/PP
Dispo
ANDALAS D1811- 8 K-
MAKMUR. 01712 16:11:55.4 BLU.FAR/120
Pencil (E-
PT 16 67/2018
2515)
ANUGERA
H BN.01.01/PP
12/01/201
PHARMIN 22124327 Surgicel W K-
451 8 BMHP Sacchet BMHP 48 79050 0 379440 4173840
DO 21 1913T BLU.FAR/121
13:46:25.3
LESTARI, /2018
PT
6125/FKT
TUMBUH 8 18G x 7.0 2050000.0 K-
452 R/BTS/XI/ BMHP Pcs BMHP 50 37272.728 0 186363.64
SELARAS. 08:22:15.0 cm/ 4 BLU.FAR/121
18
453 MEGA INTI 014 04/12/201 BMHP Electroda P c s BMHP 7000 2690.91 0 1883637 20720007 BN.01.01/PP
MAKMUR 8 Adult Red K-
MEDIKA. 09:35:59.8 dot 2228 BLU.FAR/121
PT 96 33/2018
ENSEVAL
05/12/201 BN.01.01/PP
PUTERA
DING TBK,
66 34/2018
PT
ENSEVAL
05/12/201 BN.01.01/PP
PUTERA Extended
31800773 8 179623.63 1975860.0 K-
3 14:29:21.0 8 18 BLU.FAR/121
DING TBK, Transfer
66 34/2018
PT
ENSEVAL
05/12/201 BN.01.01/PP
PUTERA
31800773 8 Ultraclamp K-
456 MEGATRA BMHP Buah BMHP 2 27363.64 0 5472.728 60200.008
3 14:29:21.0 (Red) BLU.FAR/121
DING TBK,
66 34/2018
PT
DIMAS BN.01.01/PP
ANDALAS D1802- 14/02/201 Kaca Mata K-
457 BMHP Buah BMHP 200 34850 0 697000 7667000
MAKMUR. 00755 8 09:09:00 Clear BLU.FAR/121
PT 4/2018
14/02/201 BN.01.01/PP
BRATACO. IVMDN180 8 Formalin K-
458 BMHP Gln/10ltr BMHP LAB 5 500000 0 250000 2750000
PT 0931 10:02:16.8 37 BLU.FAR/121
7 6/2018
14/02/201 BN.01.01/PP
BRATACO. IVMDN180 8 Acid Citric K-
459 BMHP Kg BMHP 100 40909.1 0 409091 4500001
PT 0931 10:02:16.8 1Kg BLU.FAR/121
7 6/2018
OPAL 15/02/201 BN.01.01/PP
Film UPP-
460 BMHP 84HG Roll BMHP 20 240000 0 480000 5280000
SEJAHTER I/18 16:49:57.2 BLU.FAR/122
Paper B/W
A. PT 26 0/2018
Radial
REVASS 15/02/201 Artery BN.01.01/PP
UTAMA RUM18- 8 Compressi K-
461 BMHP Pcs BMHP 15 330000 0 495000 5445000
MEDIKA 00300 09:07:20.0 on BLU.FAR/122
.PT 03 Tourniquet 1/2018
e
462 ALEXA FM/18/26 06/12/201 BMHP Extention Buah BMHP 3000 12000 0 3600000 39600000 BN.01.01/PP
8 K-
MEDIKA, Tube
97 10:17:45.6 BLU.FAR/122
PT 150cm
06 10/2018
ENSEVAL
15/02/201 BN.01.01/PP
PUTERA
11801366 8 K-
463 MEGATRA BMHP BLUING Botol/L BMHP LAB 2 303750 0 60750 668250
0 09:57:21.9 BLU.FAR/122
DING TBK,
1 2/2018
PT
ENSEVAL
PUTERA
11801366 8 24x60 mm K-
0 09:57:21.9 6776325 BLU.FAR/122
DING TBK,
1 (100) 2/2018
PT
ENSEVAL
15/02/201 BN.01.01/PP
PUTERA Pisau
11801366 8 K-
0 09:57:21.9 BLU.FAR/122
DING TBK, TS
1 2/2018
PT
ENSEVAL
15/02/201 BN.01.01/PP
PUTERA Histoplast
11801366 8 K-
0 09:57:21.9 BLU.FAR/122
DING TBK, 6774006
1 2/2018
PT
MILLENNI
UM PerClot
BN.01.01/PP
PHARMAC Polysaccari
13061800 20/02/201 K-
467 ON BMHP de Pcs BMHP 5 1365000 0 682500 7507500
6773 8 13:49:00 BLU.FAR/122
INTERNAT Haemost
3/2018
IONAL Syst 1Gr
TBK, PT
07/12/201 Urether BN.01.01/PP
ALEXA
FM/18/27 8 Stent Via K-
468 MEDIKA, BMHP Pcs BMHP 2 785200 0 157040 1727440
55 17:40:31.7 Cystos / BLU.FAR/122
PT
33 Open 4.7Fr 82/2018
10/12/201 Urether BN.01.01/PP
ALEXA
FM/18/28 8 Stent Via K-
07 12:39:27.6 Cystos / BLU.FAR/122
PT
83 Open 4.7Fr 82/2018
470 BISAWI 6283/FKT 11/12/201 BMHP Inflasion S e t BMHP 50 854545.45 0 4272727.2 46999999. BN.01.01/PP
TUMBUH 8 Device K-
R/BTS/XII
SELARAS. 15:09:28.9 Comp.With 5 75 BLU.FAR/122
/18
PT 03 Acces 84/2018
SUKSES 07/12/201 BN.01.01/PP
INV/SJA/1 Oxygen
JAYA 8 K-
471 8/XII/066 BMHP Conecting P c s BMHP 100 3272.73 0 32727.3 360000.3
ALKESIND 13:19:32.9 BLU.FAR/122
8 180cm O2
O. PT 9 98/2018
ENSEVAL
07/12/201 BN.01.01/PP
PUTERA
11810792 8 Vitek AST K-
3 14:21:03.3 GN93 BLU.FAR/122
DING TBK,
63 99/2018
PT
ENSEVAL
07/12/201 BN.01.01/PP
PUTERA
3 14:21:03.3 FN Plus BLU.FAR/122
DING TBK,
63 99/2018
PT
ENSEVAL
07/12/201 BN.01.01/PP
PUTERA GN Tet
11810792 8 K-
3 14:21:03.3 BLU.FAR/122
DING TBK, Cards
63 99/2018
PT
ENSEVAL
07/12/201 BN.01.01/PP
PUTERA GP TET
11810792 8 K-
3 14:21:03.3 BLU.FAR/122
DING TBK, Cards
63 99/2018
PT
ENSEVAL
07/12/201 BN.01.01/PP
PUTERA Vitek 2,Ast
11810792 8 K-
3 14:21:03.3 BLU.FAR/122
DING TBK, Cards
63 99/2018
PT
ENSEVAL
07/12/201 BN.01.01/PP
PUTERA
11810792 8 vitek ast K-
3 14:21:03.3 YS08 BLU.FAR/122
DING TBK,
63 99/2018
PT
478 REKAMILE 0626/RS/F 11/12/201 BMHP Introducer P c s BMHP 100 200000 0 2000000 22000000 BN.01.01/PP
NIUMINDO /12/2018 8 Sheat 7F- K-
SELARAS, 10:37:32.7 11cm PSI- BLU.FAR/123
PT 53 7F-11-038 02/2018
10/12/201 BN.01.01/PP
Botol
BRATACO. IVMDN180 8 192681.86 2119500.4 K-
479 BMHP Plastik 1 Buah BMHP 471 4090.91 0
PT 7188 11:33:08.5 1 71 BLU.FAR/123
Liter
13 18/2018
10/12/201 BN.01.01/PP
Botol
480 BMHP Plastik Pcs BMHP 200 909.09 0 18181.8 199999.8
PT 7188 11:33:08.5 BLU.FAR/123
Uk.30cc
13 18/2018
10/12/201 BN.01.01/PP
Botol
BRATACO. IVMDN180 8 244236.88 2686605.7 K-
481 BMHP Plastik 100 Buah BMHP 1919 1272.73 0
PT 7188 11:33:08.5 7 57 BLU.FAR/123
cc
13 18/2018
21/12/201 BN.01.01/PP
ANDRA APJ/INV/1
8 Secretion K-
482 PRIMA 8/XII/109 BMHP Buah BMHP 30 800000 0 2400000 26400000
17:39:51.6 Jar 2Lt BLU.FAR/123
JAYA. PT 3
56 33/2018
21/12/201 BN.01.01/PP
ANDRA APJ/INV/1 Tubing
8 K-
483 PRIMA 8/XII/109 BMHP System for Buah BMHP 30 600000 0 1800000 19800000
17:39:51.6 BLU.FAR/123
JAYA. PT 3 E/S201
56 33/2018
INV/SJA/1
JAYA 8 Circuit Ped K-
484 8/XII/067 BMHP Set BMHP 55 168182 0 925001 10175011
ALKESIND 11:55:23.3 Set BLU.FAR/123
5
SUKSES 12/12/201 BN.01.01/PP
INV/SJA/1
JAYA 8 PASTA EEG 583333.33 174999.99 1924999.9 K-
485 8/XII/067 BMHP Pcs BMHP 3 0
ALKESIND 11:55:23.3 TEN 20 2 96 96 BLU.FAR/123
5
O. PT 76 48/2018
PETAN 18/12/201 BN.01.01/PP
1530/PDM Biological
DAYA 8 K-
486 /FP/XII/2 BMHP Indicator P c s BMHP 60 260000 0 1560000 17160000
MEDICA. 08:12:29.3 BLU.FAR/123
018 30ea
PT 56 49/2018
Sterilizatio
PETAN 18/12/201 BN.01.01/PP
1530/PDM n Agent
DAYA 8 2738181.8 30120000. K-
487 /FP/XII/2 BMHP (H2O2) Pcs BMHP 60 456363.64 0
MEDICA. 08:12:29.3 4 24 BLU.FAR/123
018 SA10/
PT 56 49/2018
15units
MILLENNI
UM
19/12/201 BN.01.01/PP
PHARMAC Septalkan
23061800 8 K-
0560 13:41:20.7 BLU.FAR/123
INTERNAT 750ml
13 62/2018
IONAL
TBK, PT
MILLENNI
UM
19/12/201 BN.01.01/PP
PHARMAC Septalkan
23061800 8 K-
0559 14:53:48.1 BLU.FAR/123
INTERNAT 750ml
7 62/2018
IONAL
TBK, PT
1531/PDM
DAYA 8 Indicator K-
490 /FP/XII/2 BMHP Pcs BMHP 2500 15181.82 0 3795455 41750005
MEDICA, 08:41:12.5 Strip BLU.FAR/124
018
PT 23 250ea 20/2018
MCS+LDP
TRANSME 17/12/201 BN.01.01/PP
W/Filter W
DIC DN180491 8 2299865.4 5059703.9 K-
491 BMHP New Saf Set BMHP LAB 2 0 459973.09
INDONESI 0 17:12:05.0 5 9 BLU.FAR/124
F+ACD-
A. PT 53 60/2018
A500ml
13/12/201 NEUTRAL BN.01.01/PP
BIOGEN
9 12:28:40.2 FORMALIN BLU.FAR/124
C. PT
46 10% - 3,8L 63/2018
ENSEVAL
17/12/201 BN.01.01/PP
PUTERA
31800803 8 Iodosorb K-
493 MEGATRA BMHP Sacchet BMHP 150 59818.18 0 897272.7 9869999.7
5 12:23:14.7 3Gr BLU.FAR/124
DING TBK,
03 63/2018
PT
ENSEVAL
17/12/201 BN.01.01/PP
PUTERA Intrasite
31800803 8 K-
494 MEGATRA BMHP Gel Tube BMHP 50 89000 0 445000 4895000
5 12:23:14.7 BLU.FAR/124
DING TBK, 15g/1X10
03 63/2018
PT
495 ENSEVAL 11810976 13/12/201 BMHP Vitek AST Kit BMHP LAB 6 2734200 0 1640520 18045720 BN.01.01/PP
PUTERA 4 8 GN93 K-
MEGATRA
14:14:11.7 BLU.FAR/124
DING TBK,
5 65/2018
PT
ENSEVAL
13/12/201 BN.01.01/PP
PUTERA GN Tet
11810976 8 K-
4 14:14:11.7 BLU.FAR/124
DING TBK, Cards
5 65/2018
PT
ENSEVAL
13/12/201 BN.01.01/PP
PUTERA GP TET
11810976 8 K-
4 14:14:11.7 BLU.FAR/124
DING TBK, Cards
5 65/2018
PT
ENSEVAL
13/12/201 Pipette BN.01.01/PP
PUTERA
11810976 8 Tips 100- K-
4 14:14:11.7 1000ul BLU.FAR/124
DING TBK,
5 (96pcs) 65/2018
PT
ENSEVAL
13/12/201 BN.01.01/PP
PUTERA Vitek 2,Ast
11810976 8 K-
4 14:14:11.7 BLU.FAR/124
DING TBK, Cards
5 65/2018
PT
ENSEVAL
13/12/201 BN.01.01/PP
PUTERA
11810976 8 vitek ast K-
4 14:14:11.7 YS08 BLU.FAR/124
DING TBK,
5 65/2018
PT
ENSEVAL
13/12/201 BN.01.01/PP
PUTERA YST Tet
11810976 8 K-
4 14:14:11.7 BLU.FAR/124
DING TBK, Cards
5 65/2018
PT
502 BMHP Buah BMHP 24 120150 0 288360 3171960
ROHA, PT 9 15:05:48.9 1,5 mm BLU.FAR/124
13 75cm 73/2018
503 DIPA 0718.FP- 17/12/201 BMHP Petri Dish Buah BMHP 3500 2020.2 0 707070 7777770 BN.01.01/PP
PUSPA 101571 8 3Vent K-
PT 76 33/2018
DIPA 17/12/201 BN.01.01/PP
Mac
PUSPA 0718.FP- 8 K-
504 BMHP Conkey Kit BMHP LAB 6 970700 0 582420 6406620
LABSAINS. 101571 15:18:27.4 BLU.FAR/125
Agar No,3
PT 76 33/2018
DIPA 17/12/201 BN.01.01/PP
PUSPA 0718.FP- 8 Chloramfe Kit/5X50di K-
505 BMHP BMHP LAB 1 371450 0 37145 408595
LABSAINS. 101571 15:18:27.4 nicol sc BLU.FAR/125
PT 76 33/2018
DIPA 17/12/201 BN.01.01/PP
PUSPA 0718.FP- 8 TRIMETHO K-
506 BMHP Kit BMHP LAB 1 371450 0 37145 408595
LABSAINS. 101571 15:18:27.4 PRIM W5 BLU.FAR/125
PT 76 33/2018
IDS SU Circuit
22/02/201 BN.01.01/PP
MEDICAL w/ Twin
8 1092500.0 12017500. K-
507 SYSTEM 0134958 BMHP Spiral Pcs BMHP 15 728333.34 0
15:30:07.4 1 11 BLU.FAR/125
INDONESI Heated
23 6/2018
A PT Circ
6386/FKT
508 R/BTS/XII BMHP Pcs BMHP 100 37272.73 0 372727.3 4100000.3
/18
27/12/201 BN.01.01/PP
ALEXA
FM/18/33 8 INFUS SET K-
81 17:20:41.6 PED HOS BLU.FAR/126
PT
63 18/2018
PERMATA 26/12/201 BN.01.01/PP
215/PB/F Hemoconc
BUNDA 8 K-
18 for Adult
PT 7 19/2018
21/12/201 BN.01.01/PP
INDOSOPH LEVEL
INV18120 8 19500000. K-
511 A SAKTI. BMHP SENSOR Pcs BMHP 100 177272.73 0 1772727.3
57 16:46:57.2 3 BLU.FAR/126
PT PAD
46 64/2018
PERMATA 19/12/201 BN.01.01/PP
162/PB/F
BUNDA 8 Blower / K-
512 AK/12/20 BMHP Pcs BMHP 9 1350000 0 1215000 13365000
ARTANO, 08:26:26.7 Mister Kit BLU.FAR/126
18
PT 5 71/2018
PERMATA 19/12/201 BN.01.01/PP
162/PB/F Hemoconc
BUNDA 8 K-
18 for Adult
PT 5 71/2018
PERMATA 19/12/201 BN.01.01/PP
162/PB/F CARDIOPL
BUNDA 8 K-
18 ADULT
PT 5 71/2018
1891/HMI
MEDIK 8 Goldline 2097130.8 23068439. K-
515 /KWI/XII/ BMHP Buah BMHP 180 116507.27 0
INDONESI 09:13:24.5 Pencil + tip 6 46 BLU.FAR/127
18
ENSEVAL
20/12/201 BN.01.01/PP
PUTERA
11811217 8 Aceton K-
8 12:10:21.2 Safranin A BLU.FAR/127
DING TBK,
66 47/2018
PT
ENSEVAL
20/12/201 BN.01.01/PP
PUTERA
11811217 8 Vitek AST K-
8 12:10:21.2 GN93 BLU.FAR/127
DING TBK,
66 47/2018
PT
ENSEVAL
20/12/201 BN.01.01/PP
PUTERA
8 12:10:21.2 FN Plus BLU.FAR/127
DING TBK,
66 47/2018
PT
ENSEVAL
20/12/201 BN.01.01/PP
PUTERA
8 12:10:21.2 PF Plus BLU.FAR/127
DING TBK,
66 47/2018
PT
ENSEVAL
20/12/201 BN.01.01/PP
PUTERA
11811217 8 Crystal K-
8 12:10:21.2 Violet C BLU.FAR/127
DING TBK,
66 47/2018
PT
521 ENSEVAL 11811217 20/12/201 BMHP GN Tet Kit BMHP LAB 2 2734200 0 546840 6015240 BN.01.01/PP
PUTERA 8 8 Vtk2 20 K-
MEGATRA
12:10:21.2 BLU.FAR/127
DING TBK, Cards
66 47/2018
PT
ENSEVAL
20/12/201 BN.01.01/PP
PUTERA GP TET
11811217 8 K-
8 12:10:21.2 BLU.FAR/127
DING TBK, Cards
66 47/2018
PT
ENSEVAL
20/12/201 BN.01.01/PP
PUTERA
11811217 8 K-
523 MEGATRA BMHP Iodine B Btl/500ml BMHP LAB 1 1246560 0 124656 1371216
8 12:10:21.2 BLU.FAR/127
DING TBK,
66 47/2018
PT
ENSEVAL
20/12/201 Pipette BN.01.01/PP
PUTERA
11811217 8 Tips 0,5 49784.006 547624.07 K-
524 MEGATRA BMHP Buah BMHP LAB 192 2592.917 0
8 12:10:21.2 250ul 4 04 BLU.FAR/127
DING TBK,
66 (96pcs) 47/2018
PT
ENSEVAL
20/12/201 BN.01.01/PP
PUTERA Vitek 2,Ast
11811217 8 K-
8 12:10:21.2 BLU.FAR/127
DING TBK, Cards
66 47/2018
PT
ENSEVAL
20/12/201 BN.01.01/PP
PUTERA
11811217 8 vitek ast K-
8 12:10:21.2 YS08 BLU.FAR/127
DING TBK,
66 47/2018
PT
ENSEVAL
20/12/201 BN.01.01/PP
PUTERA YST Tet
11811217 8 K-
8 12:10:21.2 BLU.FAR/127
DING TBK, Cards
66 47/2018
PT
20/12/201 BN.01.01/PP
AKARIM
18/AJF/XII 8 Gigli Saw K-
/1479 12:20:46.2 Wire 40cm BLU.FAR/127
FARMA.PT
16 48/2018
529 AKARIM 18/AJF/XII 20/12/201 BMHP HD Double P c s BMHP 5 810000 0 405000 4455000 BN.01.01/PP
JAYA /1479 8 Lumen K-
12:20:46.2 8,5Fr 16cm BLU.FAR/127
FARMA.PT
16 FR2965 48/2018
20/12/201 BN.01.01/PP
AKARIM Nelaton
18/AJF/XII 8 K-
/1479 12:20:46.2 BLU.FAR/127
FARMA.PT No. 8
16 48/2018
BINA CD193461 8 r 10 Ped. 4999012.4 999802.49 10997827. K-
SUKSES, 736 09:20:40.3 RX15RW3 8 6 46 BLU.FAR/129
PT 5 0 3/2018
Blood Line
MENSA 19/02/201 BN.01.01/PP
Infant/
BINA CD193461 8 K-
SUKSES, 736 09:20:40.3 BLU.FAR/129
Pack
PT 5 3/2018
CX921
MENSA 19/02/201 BN.01.01/PP
Arterial
BINA CD193461 8 127398.65 1401385.2 K-
533 BMHP Filter 02 Pcs BMHP 2 636993.28 0
SUKSES, 736 09:20:40.3 6 16 BLU.FAR/129
Ped
PT 5 3/2018
0728/FKT
534 R/BTS/II/ BMHP Pcs BMHP 100 37272.73 0 372727.3 4100000.3
18
PERMATA 20/02/201 Canula BN.01.01/PP
080/PB/F
BUNDA 8 Venous K-
535 AK/02/20 BMHP Buah BMHP 10 882000 0 882000 9702000
ARTANO, 16:10:21.3 Bengkok BLU.FAR/129
18
PT 03 No.28 CVB. 7/2018
PERMATA 20/02/201 BN.01.01/PP
080/PB/F CARDIOPL
BUNDA 8 K-
18 ADULT
PT 03 7/2018
HOSPI 26/12/201 BN.01.01/PP
1911/HMI
MEDIK 8 Surefit K-
537 /KWI/XII/ BMHP Pcs BMHP 100 80150.91 0 801509.1 8816600.1
INDONESI 12:57:14.7 Cable BLU.FAR/130
18
A. PT 96 14/2018
PUTERA 1 8 GN93 K-
DING TBK, 56 58/2018
PT
ENSEVAL
28/12/201 BN.01.01/PP
PUTERA
1 08:17:51.5 FA Plus BLU.FAR/130
DING TBK,
56 58/2018
PT
ENSEVAL
28/12/201 BN.01.01/PP
PUTERA GN Tet
11811443 8 K-
1 08:17:51.5 BLU.FAR/130
DING TBK, Cards
56 58/2018
PT
ENSEVAL
28/12/201 BN.01.01/PP
PUTERA GP TET
11811443 8 K-
1 08:17:51.5 BLU.FAR/130
DING TBK, Cards
56 58/2018
PT
ENSEVAL
28/12/201 Pipette BN.01.01/PP
PUTERA
11811443 8 Tips 100- K-
1 08:17:51.5 1000ul BLU.FAR/130
DING TBK,
56 (96pcs) 58/2018
PT
ENSEVAL
28/12/201 Pipette BN.01.01/PP
PUTERA
11811443 8 Tips 0,5 124460.01 1369060.1 K-
543 MEGATRA BMHP Buah BMHP LAB 480 2592.917 0
1 08:17:51.5 250ul 6 76 BLU.FAR/130
DING TBK,
56 (96pcs) 58/2018
PT
ENSEVAL
28/12/201 BN.01.01/PP
PUTERA Vitek 2,Ast
11811443 8 K-
1 08:17:51.5 BLU.FAR/130
DING TBK, Cards
56 58/2018
PT
ENSEVAL
28/12/201 BN.01.01/PP
PUTERA
11811443 8 vitek ast K-
1 08:17:51.5 YS08 BLU.FAR/130
DING TBK,
56 58/2018
PT
PUTERA 1 8 ST01 K-
DING TBK,
56 58/2018
PT
ENSEVAL
28/12/201 BN.01.01/PP
PUTERA YST Tet
11811443 8 K-
1 08:17:51.5 BLU.FAR/130
DING TBK, Cards
56 58/2018
PT
IDS
31/12/201 Double BN.01.01/PP
MEDICAL
8 Lumen K-
11:21:12.3 Multicath BLU.FAR/131
INDONESI
8 3Fr, 10cm 36/2018
A PT
DC. MPA 2
549 BMHP - 5F 100cm Buah BMHP 2 265000 0 53000 583000
SELARAS, /2/2018 13:15:04.0 BLU.FAR/136
7533-23
PT 23 4/2018
DC. MPA 2
550 BMHP - 6F 7513- P c s BMHP 2 265000 0 53000 583000
SELARAS, /2/2018 13:15:04.0 BLU.FAR/136
23
PT 23 4/2018
Guide Wire
0.038
551 BMHP 150cm Pcs BMHP 25 165000 0 412500 4537500
SELARAS, /2/2018 13:15:04.0 BLU.FAR/136
IQ38F150J
PT 23 4/2018
3
19/02/201 BN.01.01/PP
MULTI Sputum
MPM18 8 K-
552 PLUS BMHP Pot Plastik P c s BMHP 1000 1819 0 181900 2000900
020175 15:35:22.5 BLU.FAR/136
MEDILAB Steril
1 5/2018
CANULA
PERMATA 20/02/201 BN.01.01/PP
081/PB/F ORTIC
BUNDA 8 K-
553 AK/02/20 BMHP STRAIGHT Buah BMHP 10 684000 0 684000 7524000
18 NO.24
PT 73 6/2018
cat.70424
Cardiovasc
PERMATA 20/02/201 BN.01.01/PP
081/PB/F ular Patch
BUNDA 8 K-
554 AK/02/20 BMHP 30mm x P c s BMHP 1 5950000 0 595000 6545000
18 60mm x
PT 73 6/2018
0.4mm
Cannula
PERMATA 20/02/201 BN.01.01/PP
081/PB/F Aortic
BUNDA 8 K-
555 AK/02/20 BMHP StraightNo. P c s BMHP 3 684000 0 205200 2257200
18 16FR
PT 73 6/2018
CAT70016
IDS
21/02/201 BN.01.01/PP
MEDICAL Paper
8 K-
556 SYSTEM 0134837 BMHP Mouthpiec P c s BMHP 400 5727.27 0 229090.8 2519998.8
17:01:08.1 BLU.FAR/137
INDONESI e
9 0/2018
A PT
IDS F&P RT124
20/02/201 BN.01.01/PP
MEDICAL CIRC.W/
8 K-
557 SYSTEM 0134557 BMHP nCAP Set BMHP 10 2090000 0 2090000 22990000
17:00:25.9 BLU.FAR/143
INDONESI GENERAT
76 1/2018
A PT OSLE1000
23/02/201 BN.01.01/PP
KASIH Plastik
02/KTJ/II/ 8 K-
558 THREEBER BMHP Assoy Kg BMHP 10 32500 0 32500 357500
2018 12:43:30.2 BLU.FAR/143
S JAYA. PT Putih 2 Kg
23 2/2018
23/02/201 BN.01.01/PP
KASIH Plastik
02/KTJ/II/ 8 K-
2018 12:43:30.2 BLU.FAR/143
23 2/2018
23/02/201 BN.01.01/PP
KASIH Plastik
02/KTJ/II/ 8 K-
2018 12:43:30.2 BLU.FAR/143
23 2/2018
23/02/201 BN.01.01/PP
KASIH Plastik
02/KTJ/II/ 8 K-
561 THREEBER BMHP Obat Uk 8 Kg BMHP 10 32500 0 32500 357500
2018 12:43:30.2 BLU.FAR/143
S JAYA. PT x 13
23 2/2018
23/02/201 BN.01.01/PP
KASIH Plastik
02/KTJ/II/ 8 K-
562 THREEBER BMHP Obat Uk 10 Kg BMHP 10 32500 0 32500 357500
2018 12:43:30.2 BLU.FAR/143
S JAYA. PT x 15
23 2/2018
23/02/201 BN.01.01/PP
KASIH
02/KTJ/II/ 8 Plastik Klip K-
563 THREEBER BMHP Buah BMHP 500 975 0 48750 536250
2018 12:43:30.2 35 x 25cm BLU.FAR/143
S JAYA. PT
23 2/2018
23/02/201 BN.01.01/PP
KASIH
564 THREEBER BMHP Lembar BMHP 5000 130 0 65000 715000
2018 12:43:30.2 10 x 15cm BLU.FAR/143
S JAYA. PT
23 2/2018
23/02/201 BN.01.01/PP
KASIH
565 THREEBER BMHP Buah BMHP 5000 70 0 35000 385000
2018 12:43:30.2 10 x 6cm BLU.FAR/143
S JAYA. PT
23 2/2018
DIMAS 12/01/201 FILM DI- BN.01.01/PP
ANDALAS D1801- 8 HL 20.3 X K-
566 BMHP Lembar BMHP 750 18000 0 1350000 14850000
MAKMUR. 00494 11:02:04.1 25.4CM BLU.FAR/146
PT 53 FUJI /2018
DIMAS 12/01/201 BN.01.01/PP
FILM DI-
ANDALAS D1801- 8 2300000.0 25300000. K-
567 BMHP HL 26 X Lembar BMHP 750 30666.667 0
MAKMUR. 00494 11:02:04.1 25 27 BLU.FAR/146
36CM FUJI
PT 53 /2018
Steerease
NIUMINDO 0128/RS/F 8 4336734.5 433673.45 4770408.0 K-
SELARAS, /1/2018 17:03:21.1 5 5 05 BLU.FAR/147
6F
PT 16 /2018
SteerEase
NIUMINDO 0128/RS/F 8 4336734.5 9540816.0 K-
SELARAS, /1/2018 17:03:21.1 5 1 BLU.FAR/147
7F
PT 16 /2018
570 BMHP Pcs BMHP 1 12000000 0 1200000 13200000
PT 16 XJD0608 /2018
IDS
BN.01.01/PP
MEDICAL Paper
12/01/201 K-
8 15:53:00 BLU.FAR/149
INDONESI e
/2018
A PT
IDS
18/01/201 BN.01.01/PP
MEDICAL Paper
8 K-
15:56:52.7 BLU.FAR/149
INDONESI e
5 /2018
A PT
573 THOMASO II/TN/18/ 02/03/201 BMHP Mata Bor Buah BMHP 50 185000 0 925000 10175000 BN.01.01/PP
K-
NG Tulang 0,8
0370 8 11:47:00 BLU.FAR/150
NIRMALA - 28mm
9/2018
BN.01.01/PP
THOMASO
II/TN/18/ 02/03/201 BONDING K-
574 NG BMHP Botol BMHP 2 900000 0 180000 1980000
0370 8 11:47:00 TECO DMG BLU.FAR/150
NIRMALA
9/2018
23/02/201 BN.01.01/PP
BRATACO. IVMDG180 8 390909.09 1172727.2 K-
575 BMHP Alkohol 96 Gln/20ltr BMHP 30 0 12900000
PT 0210 13:12:25.5 1 73 BLU.Far/157
5 0/2018
23/02/201 BN.01.01/PP
Botol
BRATACO. IVMDG180 8 K-
576 BMHP Plastik 100 Buah BMHP 1700 1000 0 170000 1870000
PT 0210 13:12:25.5 BLU.Far/157
cc
5 0/2018
DC. MPA 2
SELARAS, /2/2018 11:43:45.3 BLU.FAR/164
7533-23
PT 66 3/2018
DC. MPA 2
578 BMHP - 6F 7513- P c s BMHP 13 265000 0 344500 3789500
SELARAS, /2/2018 11:43:45.3 BLU.FAR/164
23
PT 66 3/2018
PERMATA BN.01.01/PP
110/PB/F Hemoconc
BUNDA 07/03/201 K-
18 for Adult
PT 4/2018
PERMATA BN.01.01/PP
110/PB/F Hemoconc
BUNDA 07/03/201 K-
18 For Ped
PT 4/2018
DOS NI 82694788 26/02/201 e 2/0 2x K-
581 BMHP Sacchet BMHP 36 88627.5 0 319059 3509649
ROHA, PT 0 8 15:04:00 HRT26 BLU.FAR/164
90Cm 7/2018
BN.01.01/PP
Premilene
DOS NI 82694788 26/02/201 K-
582 BMHP 4/0 2 x Sacchet BMHP 36 112387.5 0 404595 4450545
ROHA, PT 0 8 15:04:00 BLU.FAR/164
HR17
7/2018
BN.01.01/PP
Medifix
DOS NI 82694802 26/02/201 K-
583 BMHP Line Buah BMHP 64 117300 0 750720 8257920
ROHA, PT 1 8 15:22:00 BLU.FAR/164
100cm
7/2018
27/02/201 Premicron BN.01.01/PP
DOS NI 82695301 8 e 4/0 K-
ROHA, PT 3 16:09:21.3 2xHRT17 BLU.FAR/164
3 90cm 7/2018
585 BMHP Buah BMHP 48 87547.5 0 420228 4622508
ROHA, PT 5 13:10:59.9 1,5 mm BLU.FAR/164
9 75cm 7/2018
28/02/201 BN.01.01/PP
STEEL 3/0
DOS NI 82695758 8 K-
586 BMHP HRT26-GS P c s BMHP 36 237465 0 854874 9403614
ROHA, PT 5 13:10:59.9 BLU.FAR/164
65V
9 7/2018
MITRAPRI 01/03/201 Renodrain BN.01.01/PP
MA 8 Yell Nephr K-
587 15074 BMHP Pcs BMHP 20 2098800 0 4197600 46173600
LESTARI 13:36:15.9 Punct Set BLU.FAR/165
.PT 33 No.7/34cm 3/2018
02/03/201 BN.01.01/PP
INDOSOPH LEVEL
INV18020 8 5850000.0 K-
588 A SAKTI. BMHP SENSOR Pcs BMHP 30 177272.73 0 531818.19
25 15:49:22.0 9 BLU.FAR/170
PT PAD
9 8/2018
589 BMHP Lembar BMHP 750 18000 0 1350000 14850000
MAKMUR. 01466 14:48:19.9 25.4CM BLU.FAR/171
PT 46 FUJI 5/2018
DIMAS 27/02/201 BN.01.01/PP
FILM DI-
ANDALAS D1802- 8 2300000.0 25300000. K-
MAKMUR. 01466 14:48:19.9 25 27 BLU.FAR/171
36CM FUJI
PT 46 5/2018
DIPA 28/02/201 BN.01.01/PP
PUSPA 0718.FP- 8 Petri Dish K-
591 BMHP Buah BMHP 5000 1820 0 910000 10010000
LABSAINS. 100216 11:59:15.3 3Vent BLU.FAR/171
PT 06 9/2018
592 DIPA 0718.FP- 28/02/201 BMHP Xylene,BA Botol BMHP LAB 5 1050266.2 0 525133.12 5776464.3 BN.01.01/PP
PUSPA 100216 8 R, ACS 5 5 75 K-
LABSAINS. 11:59:15.3 Reagent BLU.FAR/171
PT 06 9/2018
DIPA 28/02/201 BN.01.01/PP
10Ul
PUSPA 0718.FP- 8 K-
593 BMHP Inoculating P c s BMHP 1000 942.5 0 94250 1036750
LABSAINS. 100216 11:59:15.3 BLU.FAR/171
Loop Blue
PT 06 9/2018
ANDRA
APJ/INV/1 8 Canister + K-
8/II/630 14:52:18.3 Tubing BLU.FAR/172
JAYA. PT
93 System 3/2018
SENSATRA
IDS
02/03/201 C MEDIUM BN.01.01/PP
MEDICAL
8 GRANUFO K-
15:45:10.0 AM BLU.FAR/172
INDONESI
1 DRESSING 7/2018
A PT
10PC
IDS
02/03/201 BN.01.01/PP
MEDICAL CANISTER
8 K-
596 SYSTEM 0136344 BMHP WITH GEL P c s BMHP 2 484500 0 96900 1065900
15:45:10.0 BLU.FAR/172
INDONESI 500ML
1 7/2018
A PT
IDS
02/03/201 BN.01.01/PP
MEDICAL BTR 3-
8 K-
597 SYSTEM 0135918 BMHP 4812, Pcs BMHP 1 750000 0 75000 825000
15:46:35.5 BLU.FAR/172
INDONESI Triple Line
3 7/2018
A PT
IDS
02/03/201 Bipolar Pac BN.01.01/PP
MEDICAL
8 Catheter K-
15:46:35.5 W/O BLU.FAR/172
INDONESI
3 Balloon 7/2018
A PT
IDS Paper for
02/03/201 BN.01.01/PP
MEDICAL Hi-801/HI-
8 K-
599 SYSTEM 0136371 BMHP 105/ Roll BMHP 10 272727 0 272727 2999997
15:47:49.6 BLU.FAR/172
INDONESI Thermal
7 7/2018
A PT 112mm
600 MILLENNI 7846 28/02/201 BMHP Wrap PPR Lembar BMHP 2000 10524.8 0 2104960 23154560 BN.01.01/PP
UM 8 SMS K-
PHARMAC 16:40:51.7 120X120c BLU.FAR/179
ON 53 m (125) 3/2018
INTERNAT
IONAL
TBK, PT
01/03/201 BN.01.01/PP
Botol
601 BMHP Plastik 1 Buah BMHP 500 3181.82 0 159091 1750001
PT 1239 15:32:30.6 BLU.FAR/179
Liter
76 4/2018
01/03/201 BN.01.01/PP
Botol
PT 1239 15:32:30.6 BLU.FAR/179
cc
76 4/2018
MILLENNI
UM Bioglue
01/03/201 BN.01.01/PP
PHARMAC Pre-Filled
13061800 8 K-
603 ON BMHP Syr 5ml Syringe BMHP 5 7653750 0 3826875 42095625
8899 16:01:38.6 BLU.Far/179
INTERNAT SURG.ADH
4 6/2018
IONAL ESIVE
TBK, PT
0267/HMI
MEDIK 8 Goldline 4485529.8 49340828. K-
604 /KWI/II/2 BMHP Buah BMHP 385 116507.27 0
INDONESI 14:20:26.3 Pencil + tip 95 84 BLU.FAR/179
018
MILLENNI
UM
09/03/201 BN.01.01/PP
PHARMAC Septalkan
8 K-
605 ON 7845 BMHP Pack 100 Pack BMHP 77 220500 0 1697850 18676350
14:55:13.0 BLU.FAR/179
INTERNAT Wipes
2 9/2018
IONAL
TBK, PT
02/03/201 BN.01.01/PP
Medifix
DOS NI 82697080 8 K-
606 BMHP Line Buah BMHP 36 117300 0 422280 4645080
ROHA, PT 6 15:34:41.9 BLU.FAR/187
100cm
93 4/2018
PARIT 08/03/201 Wrap PPR BN.01.01/PP
PADANG 81600555 8 SMS K-
607 BMHP Lembar BMHP 3750 10524.8 0 3946800 43414800
GLOBAL, 84- 11:33:09.3 120X120c BLU.FAR/187
PT 8 m (125) 9/2018
608 ANUGERA 1216- 06/03/201 BMHP Anti-A Vial BMHP LAB 10 53600 0 53600 589600 BN.01.01/PP
H REZEKI 18/02/AR 8 Mono K-
BI/284
I. PT 46 0/2018
ANUGERA 06/03/201 BN.01.01/PP
1216-
H REZEKI 8 Anti-B K-
609 18/02/AR BMHP Vial BMHP LAB 10 53600 0 53600 589600
BERSAMA 13:04:30.9 Mono BLU.FAR/188
BI/284
I. PT 46 0/2018
BN.01.01/PP
SURGIKA
08/03/201 Horizon K-
610 ALKESIND IRB02190 BMHP Pcs BMHP 55 87000 0 478500 5263500
8 12:14:00 Clip S BLU.FAR/188
O, PT
1/2018
BN.01.01/PP
SURGIKA
08/03/201 Tracheos K-
611 ALKESIND IRB02190 BMHP Pcs BMHP 150 31875 0 478125 5259375
8 12:14:00 Filter BLU.FAR/188
O, PT
1/2018
ANUGERA
H 16/03/201 BN.01.01/PP
DO 79 13:32:25.9 W275 BLU.FAR/188
LESTARI, 43 2/2018
PT
ANUGERA
H 16/03/201 BN.01.01/PP
Mersilk
PHARMIN 22124594 8 K-
DO 88 13:37:26.2 BLU.FAR/188
(13x60cm)
LESTARI, 4 2/2018
PT
Reusable
IDS
16/03/201 Flow BN.01.01/PP
MEDICAL
8 Sensor for K-
614 SYSTEM 0138180 BMHP Buah BMHP 4 6840000 0 2736000 30096000
13:56:30.5 SLE BLU.FAR/188
INDONESI
93 4000/500 3/2018
A PT
0
IDS SU Circuit
16/03/201 BN.01.01/PP
MEDICAL w/ Twin
8 1092500.0 12017500. K-
615 SYSTEM 0138196 BMHP Spiral Pcs BMHP 15 728333.35 0
13:44:47.0 25 28 BLU.FAR/188
INDONESI Heated
7 4/2018
A PT Circ
616 IDS 0138196 16/03/201 BMHP Paper Pcs BMHP 400 5727.27 0 229090.8 2519998.8 BN.01.01/PP
MEDICAL 8 Mouthpiec K-
SYSTEM
13:44:47.0 BLU.FAR/188
INDONESI e
7 4/2018
A PT
IDS SLE 1000
16/03/201 BN.01.01/PP
MEDICAL nCPAP
8 K-
617 SYSTEM 0138196 BMHP Generator P c s BMHP 10 1503850 0 1503850 16542350
13:44:47.0 BLU.FAR/188
INDONESI Only(Inc3P
7 4/2018
A PT rong)
17/01/201 HD Double BN.01.01/PP
AKARIM
18/AJF/I/ 8 Lumen K-
031 08:41:27.9 8,5Fr 16cm BLU.FAR/193
FARMA.PT
96 FR2925 /2018
17/01/201 BN.01.01/PP
AKARIM
18/AJF/I/ 8 Kondom K-
619 JAYA BMHP Buah BMHP 24 1125.45 0 2701.08 29711.88
031 08:41:27.9 Sutera BLU.FAR/193
FARMA.PT
96 /2018
17/01/201 BN.01.01/PP
AKARIM Nelaton
18/AJF/I/ 8 K-
620 JAYA BMHP No.16 Pcs BMHP 10 11500 0 11500 126500
031 08:41:27.9 BLU.FAR/193
FARMA.PT Rusch
96 /2018
17/01/201 Nelaton BN.01.01/PP
AKARIM
18/AJF/I/ 8 Catheter K-
031 08:41:27.9 No.10 BLU.FAR/193
FARMA.PT
96 Rusch /2018
17/01/201 BN.01.01/PP
AKARIM Nelaton
18/AJF/I/ 8 K-
031 08:41:27.9 BLU.FAR/193
FARMA.PT No. 12
96 /2018
17/01/201 BN.01.01/PP
AKARIM
18/AJF/I/ 8 Nelaton K-
031 08:41:27.9 No.18 BLU.FAR/193
FARMA.PT
96 /2018
CAHAYA 02/03/201 BN.01.01/PP
Blood Bag
DUA 0020/CDD 8 K-
624 BMHP Singel Pcs BMHP 500 31150 0 1557500 17132500
DELAPAN. /III/2018 11:30:11.0 BLU.FAR/193
350ml
PT 56 6/2018
625 SUKSES INV/SJA/1 05/03/201 BMHP Breathing S e t BMHP 32 159090.91 0 509090.91 5600000.0 BN.01.01/PP
JAYA 8/III/0100 8 14:37:04 Circuit 2 32 K-
ALKESIND Adult Set BLU.FAR/193
O. PT Complete 7/2018
626 BMHP Pcs BMHP 3 12000000 0 3600000 39600000
PT 13 XJD0608 8/2018
MEGA INTI 17/01/201 Stylet BN.01.01/PP
MAKMUR 8 No.2,0mm( K-
627 024C BMHP Buah BMHP 20 70000 0 140000 1540000
MEDIKA. 11:19:32.8 for ETT 2,5 BLU.FAR/194
PT 43 - 4,5 ) /2018
Kertas
MEGA INTI 17/01/201 BN.01.01/PP
Tredmil /
MAKMUR 8 K-
628 024C BMHP Premium Pack BMHP 3 1300000 0 390000 4290000
MEDIKA. 11:19:32.8 BLU.FAR/194
Termal
PT 43 /2018
Paper
MEGA INTI 17/01/201 BN.01.01/PP
Pigtail
MAKMUR 8 K-
629 024C BMHP Drain Cath. P c s BMHP 10 1330000 0 1330000 14630000
MEDIKA. 11:19:32.8 BLU.FAR/194
12Fr-30cm
PT 43 /2018
MENSA 08/03/201 BN.01.01/PP
OXYGENAT
BINA CD193547 8 43391894. K-
SUKSES, 110 15:22:23.9 7 BLU.FAR/194
FX25RW40
PT 96 0/2018
REKAMILE Hearttr TM BN.01.01/PP
NIUMINDO 0008/RS/F 02/01/201 PDA K-
631 BMHP Pcs BMHP 1 12000000 0 1200000 13200000
SELARAS, /1/2018 8 10:29:00 Occuleder BLU.FAR/2/2
PT XJD0608 018
Multi
Function
NIUMINDO 0008/RS/F 02/01/201 16590909. 1659090.9 K-
SELARAS, /1/2018 8 10:29:00 09 09 BLU.FAR/2/2
/MFO
PT 018
No.12-14
SUKSES Breathing BN.01.01/PP
JAYA INV/SJA/1 22/03/201 Circuit 1193181.8 13125000. K-
633 BMHP Set BMHP 75 159090.91 0
ALKESIND 8/III/0156 8 16:05:00 Adult Set 25 07 BLU.FAR/201
O. PT Complete 8/2018
PERMATA 06/03/201 Katub BN.01.01/PP
019/PB/F
BUNDA 8 Mitral Size K-
634 AK/03/20 BMHP Buah BMHP 1 15750000 0 1575000 17325000
ARTANO, 11:21:01.4 31mm - BLU.FAR/201
18
PT 13 753661 9/2018
019/PB/F
635 AK/03/20 BMHP Buah BMHP 1 15750000 0 1575000 17325000
ARTANO, 11:21:01.4 33mm - BLU.FAR/201
18
PT 13 758270 9/2018
Steerease
NIUMINDO 0800/RS/F 8 4336734.5 433673.45 4770408.0 K-
SELARAS, /3/2018 12:44:02.0 5 5 05 BLU.FAR/202
5F
PT 93 1/2018
Steerease
NIUMINDO 0800/RS/F 8 4336734.5 1301020.3 14311224. K-
SELARAS, /3/2018 12:44:02.0 5 65 02 BLU.FAR/202
6F
PT 93 1/2018
SteerEase
NIUMINDO 0800/RS/F 8 4336734.5 433673.45 4770408.0 K-
SELARAS, /3/2018 12:44:02.0 5 5 05 BLU.FAR/202
7F
PT 93 1/2018
Cardiovasc
PERMATA 16/01/201 BN.01.01/PP
069/PB/F ular Patch
BUNDA 8 K-
639 AK/01/20 BMHP 30mm x P c s BMHP 1 6000000 0 600000 6600000
18 60mm x
PT 03 /2018
0,4mm
Canula
PERMATA 16/01/201 BN.01.01/PP
069/PB/F Venous
BUNDA 8 K-
18 No.20
PT 03 /2018
67320
069/PB/F
BUNDA 8 Venous K-
641 AK/01/20 BMHP Buah BMHP 5 882000 0 441000 4851000
18
PT 03 No.28 CVB. /2018
PERMATA 16/01/201 BN.01.01/PP
069/PB/F CARDIOPL
BUNDA 8 K-
18 PED
PT 03 /2018
PERMATA 16/01/201 BN.01.01/PP
069/PB/F Hemoconc
BUNDA 8 K-
18 for Adult
PT 03 /2018
644 PERMATA 020/PB/F 06/03/201 BMHP Oxygenato S e t BMHP 4 6750000 0 2700000 29700000 BN.01.01/PP
r Affnity
BUNDA 8 K-
AK/03/20 Fusion
18 Complete
PT 3 9/2018
Adult
IDS
09/03/201 BN.01.01/PP
MEDICAL BTR 3-
8 K-
14:37:50.5 BLU.FAR/209
56 8/2018
A PT
ANUGERA 09/03/201 BOTOL BN.01.01/PP
H MANORI 10116/AM 8 HANDSOA K-
646 BMHP Botol BMHP 1000 8500 0 850000 9350000
INTERASIA I-III/2018 16:47:47.8 P/HANDR BLU.FAR/209
.PT 06 UB 500ml 9/2018
TIRTA 08/03/201 BN.01.01/PP
MEDICAL 3740/FP/1 8 Anti-A K-
647 BMHP Vial BMHP LAB 20 53600 0 107200 1179200
INDONESI 8 16:11:29.2 Mono BLU.FAR/223
A,PT 53 4/2018
TIRTA 08/03/201 BN.01.01/PP
MEDICAL 3740/FP/1 8 Anti-B K-
A,PT 53 4/2018
ANUGERA
12/03/201 BN.01.01/PP
H Plastik
68/AMN/II 8 K-
649 MANDIRI BMHP Assoy Kg BMHP 10 31050 0 31050 341550
I/2018 15:11:32.4 BLU.FAR/236
INTERASIA Putih 2 Kg
83 9/2018
, PT
ANUGERA
12/03/201 BN.01.01/PP
H Plastik
68/AMN/II 8 K-
I/2018 15:11:32.4 BLU.FAR/236
83 9/2018
, PT
ANUGERA
12/03/201 BN.01.01/PP
H Plastik
68/AMN/II 8 K-
I/2018 15:11:32.4 BLU.FAR/236
83 9/2018
, PT
652 ANUGERA 68/AMN/II 12/03/201 BMHP Plastik Kg BMHP 10 35000 0 35000 385000 BN.01.01/PP
H I/2018 8 Obat Uk 8 K-
MANDIRI 15:11:32.4 x 13 BLU.FAR/236
INTERASIA
83 9/2018
, PT
ANUGERA
12/03/201 BN.01.01/PP
H Plastik
68/AMN/II 8 K-
653 MANDIRI BMHP Obat Uk 10 Kg BMHP 10 35000 0 35000 385000
I/2018 15:11:32.4 BLU.FAR/236
INTERASIA x 17
83 9/2018
, PT
ANUGERA
12/03/201 BN.01.01/PP
H
68/AMN/II 8 Plastik Klip K-
654 MANDIRI BMHP Buah BMHP 500 975 0 48750 536250
I/2018 15:11:32.4 35 x 25cm BLU.FAR/236
INTERASIA
83 9/2018
, PT
ANUGERA
12/03/201 BN.01.01/PP
H
655 MANDIRI BMHP Lembar BMHP 5000 130 0 65000 715000
I/2018 15:11:32.4 10 x 15cm BLU.FAR/236
INTERASIA
83 9/2018
, PT
ANUGERA
12/03/201 BN.01.01/PP
H
I/2018 15:11:32.4 10 x 6cm BLU.FAR/236
INTERASIA
83 9/2018
, PT
ANUGERA
12/03/201 BOTOL BN.01.01/PP
H
68/AMN/II 8 HANDSOA K-
657 MANDIRI BMHP Botol BMHP 1008 9000 0 907200 9979200
I/2018 15:11:32.4 P/HANDR BLU.FAR/236
INTERASIA
83 UB 500ml 9/2018
, PT
PerClot
PARIT 29/03/201 BN.01.01/PP
Polysaccari
PADANG 81600581 8 K-
658 BMHP de Sacchet BMHP 5 3334500 0 1667250 18339750
GLOBAL, 46 - 15:11:21.1 BLU.FAR/240
Haemost
PT 86 5/2018
Syst 3Gr
ANUGERA
H 29/03/201 Prolene BN.01.01/PP
PHARMIN 22124659 8 No.8/0 K-
DO 95 17:00:34.0 EVPt JEP BLU.FAR/240
LESTARI, 56 8741H 6/2018
PT
660 ANUGERA 22124659 29/03/201 BMHP Nylon TapeSacchet BMHP 24 35325 0 84780 932580 BN.01.01/PP
H
PHARMIN 8 K-
DO 95 17:00:34.0 W275 BLU.FAR/240
LESTARI, 56 6/2018
PT
ANUGERA
H 29/03/201 BN.01.01/PP
DO 95 17:00:34.0 1913T BLU.FAR/240
LESTARI, 56 6/2018
PT
BINA CD193762 8 r With 6951536.3 695153.63 7646689.9 K-
PT 6 (Baby RX) 3/2018
13/03/201 HD Double BN.01.01/PP
AKARIM
18/AJF/III 8 Lumen K-
/254 12:36:27.8 8,5Fr 16cm BLU.FAR/244
FARMA.PT
46 FR2925 0/2018
13/03/201 BN.01.01/PP
BRATACO. IVMDG180 8 390909.09 1563636.3 17200000. K-
664 BMHP Alkohol 96 Gln/20ltr BMHP 40 0
PT 0288 12:47:31.2 5 8 18 BLU.FAR/244
6 1/2018
13/03/201 BN.01.01/PP
BRATACO. IVMDG180 8 Acid Citric K-
665 BMHP Kg BMHP 100 40909.09 0 409090.9 4499999.9
PT 0288 12:47:31.2 1Kg BLU.FAR/244
6 1/2018
PERMATA 16/03/201 Antegrade BN.01.01/PP
061/PB/F
BUNDA 8 Aortic Root K-
666 AK/03/20 BMHP Pcs BMHP 25 630000 0 1575000 17325000
ARTANO, 13:25:39.3 Cannula BLU.FAR/244
18
PT 46 WVL 9Fr 4/2018
PERMATA 16/03/201 Micro BN.01.01/PP
061/PB/F
BUNDA 8 Sucker K-
667 AK/03/20 BMHP Pcs BMHP 5 720000 0 360000 3960000
ARTANO, 13:25:39.3 Suction BLU.FAR/244
18
PT 46 Tube 9Fr 4/2018
668 PERMATA 061/PB/F 16/03/201 BMHP VASCUTEK P c s BMHP 1 12750000 0 1275000 14025000 BN.01.01/PP
BUNDA AK/03/20 8 GELSEAL K-
ARTANO, 18 13:25:39.3 BIFURCAT BLU.FAR/244
PT 46 E 4/2018
20X10MM-
45CM
DANVI THERMO BN.01.01/PP
DMP
MEDILAB 14/03/201 HIGRO K-
669 201803/2 BMHP Pcs BMHP 10 185000 0 185000 2035000
PERKASA. 8 12:02:00 IN/OUT BLU.FAR/244
09
PT DOOR 5/2018
External
SINERGI 16/03/201 BN.01.01/PP
IN/18/03/ Drainage
TRIDAYA 8 K-
670 27/00059 ALKES Set Pcs IMPLANT 13 3350000 0 4355000 47905000
MEDICAL, 14:35:04.3 BLU.FAR/244
5 (VP.Shunt
PT 16 9/2018
KID)
WEGO 27/03/201 BN.01.01/PP
SIC-
MEDIKA 8 GC. AR1- K-
671 MDN/III/1 BMHP Pcs BMHP 1 1742650 0 174265 1916915
INDONESI 10:24:00.2 6F BLU.FAR/245
8/0149
A 46 0/2018
WEGO 27/03/201 BN.01.01/PP
SIC-
MEDIKA 8 GC. AR2 - K-
672 MDN/III/1 BMHP Pcs BMHP 1 1742650 0 174265 1916915
INDONESI 10:24:00.2 6F BLU.FAR/245
8/0149
A 46 0/2018
DIMAS 13/03/201 BN.01.01/PP
LUmpang +
ANDALAS D1803- 8 K-
673 ALKES Stamfer Set ALKES 5 36364 0 18182 200002
MAKMUR. 00731 18:49:55.2 BLU.FAR/253
13cm
PT 73 1/2018
DIMAS 13/03/201 BN.01.01/PP
ANDALAS D1803- 8 Spatula K-
674 BMHP Buah BMHP 500 290 0 14500 159500
MAKMUR. 00731 18:49:55.2 Kayu BLU.FAR/253
PT 73 1/2018
Cauter /
DIMAS 13/03/201 BN.01.01/PP
Dispo
ANDALAS D1803- 8 K-
MAKMUR. 00741 18:56:23.1 BLU.FAR/253
Pencil (E-
PT 33 1/2018
2515)
KERTAS
ECG
SUKSES 20/03/201 BN.01.01/PP
210MMX2
JAYA INV/SJA/1 8 K-
676 BMHP 95MMX15 P c s BMHP 2 250000 0 50000 550000
ALKESIND 8/III/0125 15:40:12.6 BLU.FAR/253
05H
O. PT 36 6/2018
MARQUET
TE
KERTAS
SUKSES 20/03/201 BN.01.01/PP
ECG
JAYA INV/SJA/1 8 K-
677 BMHP 58MMX25 P c s BMHP 20 28000 0 56000 616000
MX16MM
O. PT 36 6/2018
CSO RED
CAHAYA 16/03/201 Disp.Triple BN.01.01/PP
DUA 0027/CDD 8 Lumen K-
678 ALKES Pcs ALKES 1 6730900 0 673090 7403990
DELAPAN. /III/2018 16:48:38.6 Sphinctero BLU.FAR/260
PT 56 tome 7/2018
Cotton-
679 BMHP Pcs BMHP 5 1583650 0 791825 8710075
DELAPAN. /III/2018 16:44:34.3 Stent BLU.FAR/260
PT 53 Only,10Fr, 7/2018
9c
Tracer
CAHAYA 16/03/201 BN.01.01/PP
Metro
DUA 0025/CDD 8 K-
680 BMHP Dir.W.G.,St Buah BMHP 2 4246000 0 849200 9341200
DELAPAN. /III/2018 16:44:34.3 BLU.FAR/260
raight
PT 53 7/2018
0,035/480
CAHAYA 16/03/201 Cytology BN.01.01/PP
DUA 0025/CDD 8 Brush, K-
681 BMHP Pcs BMHP 10 650000 0 650000 7150000
DELAPAN. /III/2018 16:44:34.3 G22178 / BLU.FAR/260
PT 53 5Fr-120cm 7/2018
16/03/201 BN.01.01/PP
AKARIM Rectal
18/AJF/III 8 K-
682 JAYA BMHP Tube No. Buah BMHP 20 12500 0 25000 275000
/265 15:59:34.0 BLU.FAR/260
FARMA.PT 30
13 8/2018
16/03/201 BN.01.01/PP
AKARIM Rectal
18/AJF/III 8 K-
683 JAYA BMHP Tube No. Buah BMHP 20 12500 0 25000 275000
/265 15:59:34.0 BLU.FAR/260
FARMA.PT 32
13 8/2018
16/03/201 Rectal BN.01.01/PP
AKARIM
18/AJF/III 8 Tube K-
/265 15:59:34.0 No.28 - BLU.FAR/260
FARMA.PT
13 40cm 8/2018
685 AKARIM 18/AJF/III 16/03/201 BMHP Bola Buah BMHP 6 141500 0 84900 933900 BN.01.01/PP
JAYA /265 8 Lampu K-
FARMA.PT 15:59:34.0 Laringosco BLU.FAR/260
13 pe Anak 8/2018
Oxygenato
PERMATA 15/03/201 BN.01.01/PP
067/PB/F r Affnity
BUNDA 8 K-
18 Complete
PT 3 9/2018
Adult
16/03/201 BN.01.01/PP
SURGIKA Mouth
8 K-
687 ALKESIND IRC00963 BMHP Piece,180c P c s BMHP 50 19875 0 99375 1093125
16:53:36.4 BLU.FAR/267
O, PT m Tubing
3 0/2018
Breathing
16/03/201 BN.01.01/PP
SURGIKA Circuit
8 K-
688 ALKESIND IRC00963 BMHP Adult Set BMHP 12 131950 0 158340 1741740
16:53:36.4 BLU.FAR/267
O, PT 22mm
3 0/2018
Corrugated
JAYA INV/SJA/1 8 Circuit 1877272.7 20650000. K-
689 BMHP Set BMHP 118 159090.91 0
ALKESIND 8/III/0137 16:50:33.1 Adult Set 38 12 BLU.FAR/267
DIMAS 16/03/201 BN.01.01/PP
HEARING
ANDALAS D1803- 8 454545.45 454545.45 5000000.0 K-
690 BMHP AMPLIFIE Unit BMHP 10 0
MAKMUR. 00940 16:41:25.7 5 5 05 BLU.FAR/267
R HA 20
PT 9 2/2018
DIMAS 16/03/201 BN.01.01/PP
ANDALAS D1803- 8 Senter / K-
691 BMHP Buah BMHP 5 28000 0 14000 154000
MAKMUR. 00940 16:41:25.7 Pen Light BLU.FAR/267
PT 9 2/2018
MENSA 16/03/201 BN.01.01/PP
Blood Bag
BINA CD193628 8 K-
SUKSES, 011 16:52:23.1 BLU.FAR/267
ml
PT 1 3/2018
Syringe
OPAL 26/03/201 BN.01.01/PP
150ml
PERKASA 1042/OPS 8 K-
SEJAHTER /III/18 13:48:38.5 BLU.FAR/267
quick fill
A. PT 46 7/2018
tube
694 OPAL 1042/OPS 26/03/201 BMHP Syringe Pcs BMHP 20 460000 0 920000 10120000 BN.01.01/PP
PERKASA /III/18 8 Salient K-
SEJAHTER 13:48:38.5 190ml BLU.FAR/267
A. PT 46 7/2018
Syringe
OPAL 26/03/201 BN.01.01/PP
StellaDual
695 BMHP 200ml Pcs BMHP 20 488000 0 976000 10736000
Cat.SDS.CT
A. PT 46 7/2018
P.QFT
Connec
OPAL 26/03/201 Salient BN.01.01/PP
PERKASA 1042/OPS 8 150cm K-
696 BMHP Pcs BMHP 50 112000 0 560000 6160000
SEJAHTER /III/18 13:48:38.5 /Exten BLU.FAR/267
A. PT 46 Tubi ZY- 7/2018
5151
28/03/201 Tyshak II BN.01.01/PP
NUGRA
8 14.0mm x 9090909.0 909090.90 9999999.9 K-
697 KARSERA. 0001646 BMHP Pcs BMHP 1 0
09:53:46.7 3.0cm x 9 9 99 BLU.FAR/267
PT
8 100cm 8/2018
28/03/201 Tyshak II BN.01.01/PP
NUGRA
8 16.0mm x 9090909.0 909090.90 9999999.9 K-
698 KARSERA. 0001646 BMHP Pcs BMHP 1 0
09:53:46.7 3.0cm x 9 9 99 BLU.FAR/267
PT
8 100cm 8/2018
Bioglue
PARIT BN.01.01/PP
Pre-Filled
PADANG 81600568 20/03/201 K-
699 BMHP Syr 5ml Syringe BMHP 5 7653750 0 3826875 42095625
GLOBAL, 40 8 13:25:38 BLU.FAR/274
SURG.ADH
PT 5/2018
ESIVE
Cera ASD
NIUMINDO 0201/RS/F 8 24454545. 2445454.5 K-
SELARAS, /3/2018 16:54:34.1 45 45 BLU.FAR/274
No.34
PT 2 6/2018
SIZING
NIUMINDO 0201/RS/F 8 4545455.4 454545.54 5000000.9 K-
701 BMHP BALLON Buah BMHP 1 0
SELARAS, /3/2018 16:54:34.1 5 5 95 BLU.FAR/274
24
PT 2 6/2018
REKAMILE 19/03/201 STEEREAS BN.01.01/PP
NIUMINDO 0201/RS/F 8 E 4336734.5 9540816.0 K-
702 BMHP Buah BMHP 2 0 867346.91
SELARAS, /3/2018 16:54:34.1 OCCULEDE 5 1 BLU.FAR/274
PT 2 R 12F 6/2018
703 REKAMILE 0201/RS/F 19/03/201 BMHP SIZING Buah BMHP 1 4545454.5 0 454545.45 5000000.0 BN.01.01/PP
NIUMINDO /3/2018 8 BALLON 5 5 05 K-
SELARAS, 16:54:34.1 BLU.FAR/274
34
PT 2 6/2018
Cera ASD
NIUMINDO 0206/RS/F 8 24454545. 2445454.5 K-
SELARAS, /3/2018 17:24:19.7 45 45 BLU.FAR/274
No.18
PT 26 7/2018
Steerease
NIUMINDO 0206/RS/F 8 4336734.5 9540816.0 K-
SELARAS, /3/2018 17:24:19.7 5 1 BLU.FAR/274
6F
PT 26 7/2018
DC. MPA 2
706 BMHP - 6F 7513- P c s BMHP 7 265000 0 185500 2040500
SELARAS, /3/2018 17:24:19.7 BLU.FAR/274
23
PT 26 7/2018
DC. MPA 2
SELARAS, /3/2018 17:24:19.7 BLU.FAR/274
7533-23
PT 26 7/2018
Hemococe
708 BMHP ntrator for S e t BMHP 5 1450000 0 725000 7975000
SELARAS, /3/2018 17:24:19.7 BLU.FAR/274
Adult
PT 26 7/2018
709 BMHP Lembar BMHP 750 18000 0 1350000 14850000
MAKMUR. 01014 13:28:51.6 25.4CM BLU.FAR/278
PT 9 FUJI 7/2018
DIMAS 20/03/201 BN.01.01/PP
FILM DI-
ANDALAS D1803- 8 2300000.1 25300001. K-
MAKMUR. 01014 13:28:51.6 75 93 BLU.FAR/278
36CM FUJI
PT 9 7/2018
Cera ASD
NIUMINDO 0200/RS/F 8 24454545. 2445454.5 K-
SELARAS, /3/2018 11:50:16.5 45 45 BLU.FAR/278
No.36
PT 6 8/2018
SteerEase
NIUMINDO 0200/RS/F 8 4336734.5 1301020.3 14311224. K-
SELARAS, /3/2018 11:50:16.5 5 65 02 BLU.FAR/278
7F
PT 6 8/2018
713 INTERGRA JP 20/03/201 BMHP Test Tube Tube BMHP 10000 500 0 500000 5500000 BN.01.01/PP
STA
8 K-
ARTHA Plastik
18000846 13:30:20.5 BLU.FAR/278
NUSANTA 12x75
03 9/2018
RA.PT
INTERGRA Mini Bio
20/03/201 BN.01.01/PP
STA Plus-
JP 8 K-
714 ARTHA BMHP Sterotherm Ampul BMHP 5 1587600 0 793800 8731800
18000846 13:30:20.5 BLU.FAR/278
NUSANTA ophilus
03 9/2018
RA.PT 327-601
ANUGERA
20/03/201 BIBIT BN.01.01/PP
H
72/AMN/II 8 PARFUM K-
715 MANDIRI BMHP Btl/1ltr BMHP LAB 3 770000 0 231000 2541000
I/2018 15:44:42.7 STRAWBE BLU.FAR/279
INTERASIA
8 RRY 1Ltr 0/2018
, PT
ANUGERA
21/03/201 BN.01.01/PP
H
73/AMN/II 8 Kapas K-
I/2018 10:30:11.3 Cebok BLU.FAR/279
INTERASIA
7 0/2018
, PT
Film UPT
OPAL 18/01/201 BN.01.01/PP
517 14x17 BMHP
SEJAHTER /18 09:35:30.8 BLU.FAR/283
Thermal I
A. PT 1 /2018
(35x43)
MENSA 18/01/201 BN.01.01/PP
OXYGENAT
BINA CD193297 8 K-
718 BMHP OR ADULT S e t BMHP 8 5635310 0 4508248 49590728
SUKSES, 407 15:39:56.5 BLU.FAR/285
FX25RW40
PT 53 /2018
MENSA 18/01/201 Custom BN.01.01/PP
BINA CD193297 8 Pack / K-
719 BMHP Pcs BMHP 8 1 0 0.8 8.8
SUKSES, 407 15:39:56.5 Blood Line BLU.FAR/285
PT 53 Adult /2018
OPAL Film BN.01.01/PP
BMHP
PERKASA 1051/OPS 21/03/201 Drystar K-
SEJAHTER /III/18 8 11:20:00 DT28 Uk 8 BLU.FAR/286
I
A. PT x 10 5/2018
721 PERMATA 082PB/FA 22/03/201 BMHP VASCUTEK P c s BMHP 1 12750000 0 1275000 14025000 BN.01.01/PP
BUNDA K/03/201 8 GELSEAL K-
ARTANO, 8 15:01:41.8 BIFURCAT BLU.FAR/286
ED
PT 2 18X9MM,4 6/2018
5CM
082PB/FA
BUNDA 8 Aortic Size K-
722 K/03/201 BMHP Buah BMHP 1 15750000 0 1575000 17325000
ARTANO, 15:01:41.8 18mm - BLU.FAR/286
8
PT 2 727227 6/2018
Skin BN.01.01/PP
HEXALAB
HS.0318- 22/03/201 Marker K-
00325 8 15:15:00 -Regular BLU.FAR/286
A.PT
Tip 7/2018
ANUGERA
H 23/03/201 BN.01.01/PP
Mersilk
PHARMIN 22124627 8 K-
DO 80 15:16:48.6 BLU.Far/294
(13x60cm)
LESTARI, 13 4/2018
PT
ANUGERA
H 23/03/201 BN.01.01/PP
DO 80 15:16:48.6 W275 BLU.Far/294
LESTARI, 13 4/2018
PT
ANUGERA
H 23/03/201 Physiomes BN.01.01/PP
PHARMIN 22124627 8 h Open K-
726 BMHP Pcs BMHP 1 10275000 0 1027500 11302500
DO 80 15:16:48.6 12x15cm BLU.Far/294
LESTARI, 13 Flex Comp 4/2018
PT
SENSATRA
IDS
C MEDIUM BN.01.01/PP
MEDICAL
27/03/201 GRANUFO K-
8 10:02:00 AM BLU.FAR/294
INDONESI
DRESSING 9/2018
A PT
10PC
728 IDS 0139627 27/03/201 BMHP CANISTER P c s BMHP 9 484500 0 436050 4796550 BN.01.01/PP
MEDICAL 8 10:02:00 WITH GEL K-
SYSTEM 500ML BLU.FAR/294
INDONESI 9/2018
A PT
SENSATRA
IDS
C MEDIUM BN.01.01/PP
MEDICAL
27/03/201 GRANUFO K-
8 10:10:00 AM BLU.FAR/294
INDONESI
DRESSING 9/2018
A PT
10PC
IDS
BN.01.01/PP
MEDICAL CANISTER
27/03/201 K-
730 SYSTEM 0138897 BMHP WITH GEL P c s BMHP 1 484500 0 48450 532950
8 10:10:00 BLU.FAR/294
INDONESI 500ML
9/2018
A PT
TRANSME 28/03/201 BN.01.01/PP
Katub
DIC 8 K-
731 IN1801417 BMHP Mitral Buah BMHP 1 15100000 0 1510000 16610000
No.31mm
A. PT 76 0/2018
TRANSME 28/03/201 Katub BN.01.01/PP
DIC 8 Aortic K-
732 IN1801417 BMHP Pcs BMHP 1 15100000 0 1510000 16610000
INDONESI 11:15:53.2 No.19mm BLU.FAR/296
A. PT 76 Mechanical 0/2018
DIAN HD
26/03/201 BN.01.01/PP
LANGGEN DoubLum
FK180329 8 K-
733 G BMHP Farc 115- S e t BMHP 30 504000 0 1512000 16632000
2 15:29:19.7 BLU.FAR/309
PRATAMA. 15(preCur
4 9/2018
PT ved)
ANDALAS D1803- 8 Pencil with 1818181.8 20000000. K-
734 BMHP Buah BMHP 200 90909.091 0
MAKMUR. 01311 11:41:11.3 Holster 2 02 BLU.FAR/310
PT 26 VL2610 9/2018
ANUGERA BN.01.01/PP
1460-
H REZEKI 26/03/201 Anti-B K-
BERSAMA 8 11:17:00 Mono BLU.FAR/311
BI/227
I. PT 0/2018
ANUGERA BN.01.01/PP
1460-
H REZEKI 26/03/201 Anti-A K-
BERSAMA 8 11:17:00 Mono BLU.FAR/311
BI/227
I. PT 0/2018
737 TRANSME IN1801476 28/03/201 BMHP Katub Buah BMHP 2 15100000 0 3020000 33220000 BN.01.01/PP
DIC /IN180163 8 Mitral K-
7 No.31mm
A. PT 23 2/2018
TRANSME 28/03/201 BN.01.01/PP
IN1801476 Katub
DIC 8 K-
738 /IN180163 BMHP Mitral Pcs BMHP 1 15100000 0 1510000 16610000
7 No.33mm
A. PT 23 2/2018
26/03/201 Medifix BN.01.01/PP
DOS NI 82704793 8 Line 90cm K-
739 BMHP Pcs BMHP 95 117300 0 1114350 12257850
ROHA, PT 0 16:09:42.6 With BLU.FAR/311
76 Intrafix 4/2018
26/03/201 BN.01.01/PP
Medifix
DOS NI 82704793 8 K-
ROHA, PT 0 16:09:42.6 BLU.FAR/311
r
76 4/2018
BUNDA 117/PB/Fa 8 Mitral Size K-
741 BMHP Buah BMHP 1 15750000 0 1575000 17325000
ARTANO, k/03/2018 09:11:43.1 33mm - BLU.FAR/311
PT 4 758270 6/2018
PERMATA 27/03/201 BN.01.01/PP
Hemoconc
BUNDA 117/PB/Fa 8 K-
742 BMHP entrator S e t BMHP 15 1800000 0 2700000 29700000
ARTANO, k/03/2018 09:11:43.1 BLU.FAR/311
for Adult
PT 4 6/2018
743 BMHP Buah BMHP 1 15750000 0 1575000 17325000
PT 93 460706 7/2018
744 BMHP Buah BMHP 1 15750000 0 1575000 17325000
PT 93 753661 7/2018
Oxygenato
PERMATA 27/03/201 BN.01.01/PP
r Affnity
BUNDA 121/PB/Fa 8 K-
745 BMHP Fusion Set BMHP 4 6750000 0 2700000 29700000
ARTANO, k/03/2018 09:08:36.3 BLU.FAR/311
Complete
PT 13 8/2018
Adult
MENSA 27/03/201 BN.01.01/PP
OXYGENAT
BINA CD193672 8 30994210. K-
SUKSES, 364 09:37:57.7 5 BLU.FAR/311
FX25RW40
PT 03 9/2018
747 BMHP Pcs BMHP 5 1 0 0.5 5.5
PT 03 Adult 9/2018
Recording
MEGA INTI 02/04/201 paper BN.01.01/PP
MAKMUR 8 1000/200 K-
748 087 BMHP Pack BMHP 10 297000 0 297000 3267000
MEDIKA. 10:50:46.2 0MAC BLU.FAR/312
PT 63 215x280x1 4/2018
50
MEGA INTI 02/04/201 Corong BN.01.01/PP
MAKMUR 8 Spirometri K-
749 087 BMHP Buah BMHP 100 6000 0 60000 660000
MEDIKA. 10:50:46.2 /mouthpie BLU.FAR/312
PT 63 ce 4/2018
KERTAS
ECG
SUKSES 28/03/201 BN.01.01/PP
210MMX2
JAYA INV/SJA/1 8 K-
750 BMHP 95MMX15 P c s BMHP 20 250000 0 500000 5500000
05H
O. PT 36 1/2018
MARQUET
TE
ANUGERA 28/03/201 BN.01.01/PP
Leukofix
H ARGON 12180018 8 K-
751 BMHP 2137 (1 x Roll BMHP 10 24669 0 24669 271359
MEDICA, 489 15:50:36.3 BLU.FAR/318
10)
PT 06 5/2018
ANUGERA 28/03/201 BN.01.01/PP
Skin
H ARGON 12180018 8 K-
752 BMHP Traction Roll BMHP 40 133031.25 0 532125 5853375
MEDICA, 463 16:21:22.6 BLU.FAR/318
Adult BSN
PT 26 5/2018
ANUGERA 28/03/201 BN.01.01/PP
Skin
H ARGON 12180018 8 K-
753 BMHP Traction Roll BMHP 8 99000 0 79200 871200
MEDICA, 463 16:21:22.6 BLU.FAR/318
Paed
PT 26 5/2018
PLEDGET
ANUGERA 28/03/201 BN.01.01/PP
3x7x1,5M
H ARGON 12180018 8 K-
754 BMHP M/ PTFE P c s BMHP 36 289600 0 1042560 11468160
MEDICA, 463 16:21:22.6 BLU.FAR/318
POLYMER
PT 26 5/2018
PLEDGETS
755 RAJAWALI FKT80020 06/04/201 BMHP COVERALL Buah BMHP 50 18578.4 0 92892 1021812 BN.01.01/PP
XL/BAJU K-
NUSINDO,
92 8 14:42:00 FLUBURU BLU.FAR/318
PT
NG 8/2018
MENSA 27/03/201 BN.01.01/PP
OXYGENAT
BINA CD193677 8 30994210. K-
SUKSES, 883 16:57:23.4 5 BLU.FAR/319
FX25RW40
PT 86 8/2018
757 BMHP Pcs BMHP 5 1 0 0.5 5.5
PT 86 Adult 8/2018
DIMAS 29/03/201 Tip BN.01.01/PP
ANDALAS D1803- 8 Cleaner K-
758 BMHP Pcs BMHP 75 52000 0 390000 4290000
MAKMUR. 01621 16:45:24.3 For BLU.FAR/326
PT 9 Elec,Disp 7/2018
Detergent
DIMAS 02/04/201 BN.01.01/PP
Liq
ANDALAS D1803- 8 K-
759 BMHP Neodisher Galon BMHP 4 3194700 0 1277880 14056680
MAKMUR. 01496 15:43:49.1 BLU.FAR/326
(Atos
PT 2 7/2018
Clear)
DIMAS 02/04/201 Torniquet BN.01.01/PP
ANDALAS D1803- 8 / Pengikat K-
760 BMHP Pcs BMHP 52 10837.5 0 56355 619905
MAKMUR. 01496 15:43:49.1 Lengan BLU.FAR/326
PT 2 Blue OM 7/2018
Neutral
09/04/201 Buffer BN.01.01/PP
BIOZATIX
BZ 8 Formalin K-
761 INDONESI BMHP Galon BMHP LAB 3 1710000 0 513000 5643000
18030153 16:34:59.6 10 BLU.FAR/326
A. PT
6 (1ken=19lt 8/2018
r)
DIMAS 08/03/201 BN.01.01/PP
HEARING
ANDALAS D1803- 8 2500000.0 K-
762 BMHP AMPLIFIE Unit BMHP 5 454545.46 0 227272.73
MAKMUR. 00458 14:14:16.7 3 BLU.FAR/330
R HA 20
PT 76 0/2018
29/03/201 BN.01.01/PP
TARAFIS
INV/TAM/ 8 Microscop K-
763 ANUGERA BMHP Pcs BMHP 2 315000 0 63000 693000
18/III/044 13:00:36.2 es Drapes BLU.FAR/340
H MEDIKA
83 3/2018
764 OPAL 1062/OPS 03/04/201 BMHP Film UPT Lembar BMHP 1375 30712 0 4222900 46451900 BN.01.01/PP
517 14x17
PERKASA 8 K-
Blue RADIOLOG
Thermal I
A. PT 23 4/2018
(35x43)
TIRTA BN.01.01/PP
MEDICAL 2541/FP/1 19/01/201 Syphilis K-
765 BMHP Kit BMHP LAB 100 15000 0 150000 1650000
INDONESI 8 8 09:41:00 Device BLU.FAR/345
A,PT /2018
19/01/201 BN.01.01/PP
BRATACO. IVMDG180 8 1172727.2 12899999. K-
PT 0044 09:04:26.3 7 97 BLU.FAR/348
5 /2018
19/01/201 BN.01.01/PP
767 BMHP Kg BMHP 100 40909.09 0 409090.9 4499999.9
PT 0044 09:04:26.3 1Kg BLU.FAR/348
5 /2018
19/01/201 BN.01.01/PP
Botol
PT 0044 09:04:26.3 BLU.FAR/348
cc
5 /2018
19/01/201 BN.01.01/PP
Botol
769 BMHP Plastik Pcs BMHP 300 727.27 0 21818.1 239999.1
PT 0044 09:04:26.3 BLU.FAR/348
Uk.30cc
5 /2018
19/01/201 BN.01.01/PP
BRATACO. IVMDG180 8 1799999.5 K-
PT 0044 09:04:26.3 2 BLU.FAR/348
5 /2018
19/01/201 BN.01.01/PP
BRATACO. IVMDG180 8 Pot Plastik K-
771 BMHP Buah BMHP 400 1363.68 0 54547.2 600019.2
PT 0044 09:04:26.3 100 cc BLU.FAR/348
5 /2018
19/01/201 BN.01.01/PP
772 BMHP Pcs BMHP 400 909.09 0 36363.6 399999.6
PT 0044 09:04:26.3 40 cc BLU.FAR/348
5 /2018
773 BRATACO. IVMDG180 19/01/201 BMHP Kertas Lembar BMHP 32000 14.545 0 46544 511984 BN.01.01/PP
PT 0044 8 Perkamen K-
09:04:26.3 BLU.FAR/348
5 /2018
02/04/201 BN.01.01/PP
Silkam 3/0
DOS NI 82707192 8 K-
774 BMHP NNS 13x60 Sacchet BMHP 144 44347.5 0 638604 7024644
ROHA, PT 5 11:35:29.1 BLU.FAR/351
cm
13 8/2018
02/04/201 BN.01.01/PP
Premilene
DOS NI 82707192 8 K-
775 BMHP 5/0 DS16 Sacchet BMHP 36 86872.5 0 312741 3440151
ROHA, PT 5 11:35:29.1 BLU.FAR/351
Cut
13 8/2018
02/04/201 BN.01.01/PP
BRATACO. IVMDG180 8 1563636.3 17199999. K-
PT 0365 14:37:07.6 2 52 BLU.FAR/351
16 9/2018
02/04/201 BN.01.01/PP
Botol
PT 0365 14:37:07.6 BLU.FAR/351
cc
16 9/2018
02/04/201 BN.01.01/PP
Botol
778 BMHP Plastik 1 Buah BMHP 1000 3181.82 0 318182 3500002
PT 0365 14:37:07.6 BLU.FAR/351
Liter
16 9/2018
02/04/201 BN.01.01/PP
BRATACO. IVMDG180 8 4199998.8 K-
PT 0365 14:37:07.6 8 BLU.FAR/351
16 9/2018
MENSA 02/04/201 BN.01.01/PP
Steri Drape
BINA CD193703 8 K-
780 BMHP / U Drape P c s BMHP 20 208785 0 417570 4593270
SUKSES, 330 16:27:06.7 BLU.FAR/352
1015
PT 43 3/2018
Docare
MENSA 03/04/201 BN.01.01/PP
Wash
BINA CD193724 8 K-
781 BMHP Gloves 4 Pcs BMHP 700 4215.75 0 295102.5 3246127.5
SUKSES, 717 15:40:25.4 BLU.FAR/352
Sheet
PT 4 3/2018
Parfume
MENSA 03/04/201 BN.01.01/PP
BINA CD193724 8 DoCare K-
782 BMHP Pcs BMHP 50 40880 0 204400 2248400
SUKSES, 717 15:40:25.4 Hair Clean BLU.FAR/352
PT 4 3/2018
783 MENSA CD193718 03/04/201 BMHP Clipper Set BMHP 150 61600 0 924000 10164000 BN.01.01/PP
BINA 8 K-
SUKSES, 255 16:10:33.3 Blade 9660 BLU.FAR/352
PT 43 3/2018
MEGA INTI 04/04/201 IOL BN.01.01/PP
MAKMUR 8 FOLDABLE 681818.19 136363.63 1500000.0 K-
784 015 BMHP Pcs BMHP 2 0
MEDIKA. 13:20:21.4 YELLOW 5 9 29 BLU.FAR/367
PT 73 23 3/2018
HPMC 2%
MEGA INTI 04/04/201 (HYDROXY BN.01.01/PP
MAKMUR 8 PROPYL K-
785 015 BMHP Pcs BMHP 2 150000 0 30000 330000
MEDIKA. 13:20:21.4 METHYLC BLU.FAR/367
PT 73 ELLULOSE 3/2018
)
SODIUM
MEGA INTI 04/04/201 BN.01.01/PP
HYALURO
MAKMUR 8 8499999.9 K-
786 015 BMHP NATE Pcs BMHP 10 772727.27 0 772727.27
MEDIKA. 13:20:21.4 7 BLU.FAR/367
OPHTALMI
PT 73 3/2018
ICAL SOL
787 BMHP Pcs BMHP 2 12000000 0 2400000 26400000
PT 9 XJD0608 4/2018
Guide Wire
0.038
788 BMHP 150cm Pcs BMHP 20 165000 0 330000 3630000
SELARAS, /4/2018 16:39:17.2 BLU.FAR/367
IQ38F150J
PT 9 4/2018
3
HOSPI 16/04/201 BN.01.01/PP
0548/HMI
MEDIK 8 Surefit K-
789 /KWI/IV/2 BMHP Pcs BMHP 100 84075.45 0 840754.5 9248299.5
INDONESI 10:38:17.0 Cable BLU.FAR/376
018
A. PT 5 4/2018
0548/HMI
MEDIK 8 Goldline 38447399. K-
790 /KWI/IV/2 BMHP Buah BMHP 300 116507.27 0 3495218.1
INDONESI 10:38:17.0 Pencil + tip 1 BLU.FAR/376
018
05/04/201 BN.01.01/PP
TIGA Gigli Wire
8 K-
791 BERKENA 48413224 BMHP Saw Fine-6 Buah BMHP 75 260400 0 1953000 21483000
15:35:34.8 BLU.FAR/378
N JAYA Wire 500
4 4/2018
IDS F&P RT124
05/04/201 BN.01.01/PP
MEDICAL CIRC.W/
8 K-
16:30:00.5 BLU.FAR/378
INDONESI GENERAT
53 8/2018
A PT OSLE1000
Singel Use
IDS
05/04/201 Flow BN.01.01/PP
MEDICAL
8 Sensor for K-
16:30:00.5 SLE BLU.FAR/378
INDONESI
53 4000/500 8/2018
A PT
0
TRANSME 09/04/201 BN.01.01/PP
Katub
DIC 8 K-
794 IN1801889 BMHP Aortic Buah BMHP 1 15100000 0 1510000 16610000
No.21mm
A. PT 8 8/2018
TRANSME 09/04/201 BN.01.01/PP
Katub
DIC 8 K-
795 IN1801889 BMHP Mitral Pcs BMHP 1 15100000 0 1510000 16610000
No.29mm
A. PT 8 8/2018
796 BMHP Lembar BMHP 750 18000 0 1350000 14850000
MAKMUR. 00143 15:39:34.2 25.4CM BLU.FAR/38/
PT 46 FUJI 2018
DIMAS 05/01/201 BN.01.01/PP
FILM DI-
ANDALAS D1801- 8 2300000.0 25300000. K-
MAKMUR. 00143 15:39:34.2 25 27 BLU.FAR/38/
36CM FUJI
PT 46 2018
MENSA 09/04/201 BN.01.01/PP
Blood Bag
BINA CD193756 8 K-
SUKSES, 880 13:38:23.9 BLU.Far/387
ml
PT 66 9/2018
TIRTA 09/04/201 BN.01.01/PP
A,PT 2 0/2018
800 ENSEVAL 11803004 09/04/201 BMHP BLUING Botol/L BMHP LAB 2 303750 0 60750 668250 BN.01.01/PP
PUTERA 1 8 K-
DING TBK, 5 5/2018
PT
ENSEVAL
PUTERA
11803004 8 24x60 mm K-
1 16:13:58.9 6776325 BLU.FAR/388
DING TBK,
5 (100) 5/2018
PT
ENSEVAL
09/04/201 BN.01.01/PP
PUTERA
11803004 8 K-
802 MEGATRA BMHP Cytofunnel B o x BMHP LAB 40 40000 0 160000 1760000
1 16:13:58.9 BLU.FAR/388
DING TBK,
5 5/2018
PT
ENSEVAL
09/04/201 BN.01.01/PP
PUTERA Pisau
11803004 8 K-
8 16:17:50.2 BLU.FAR/388
DING TBK, TS
36 5/2018
PT
ENSEVAL
09/04/201 BN.01.01/PP
PUTERA Histoplast
11803004 8 K-
8 16:17:50.2 BLU.FAR/388
DING TBK, 6774006
36 5/2018
PT
MILLENNI
UM Bioglue
09/04/201 BN.01.01/PP
PHARMAC Pre-Filled
8 K-
805 ON 13137 BMHP Syr 5ml Syringe BMHP 5 7653750 0 3826875 42095625
15:34:03.4 BLU.FAR/388
INTERNAT SURG.ADH
3 6/2018
IONAL ESIVE
TBK, PT
Recording
SUKSES 09/04/201 BN.01.01/PP
Chart
JAYA INV/SJA/1 8 K-
806 BMHP Papers Box BMHP 30 75000 0 225000 2475000
ALKESIND 8/IV/0185 16:38:19.6 BLU.FAR/389
90mmx90x
O. PT 93 3/2018
360Sheets
BN.01.01/PP
THOMASO BLUE
I/TN/18/0 08/01/201 K-
807 NG BMHP ETCHING B o x BMHP 1 645000 0 64500 709500
115 8 10:39:00 BLU.FAR/39/
NIRMALA GEL
2018
808 THOMASO I/TN/18/0 08/01/201 BMHP TOXAVIT Botol BMHP 1 1350000 0 135000 1485000 BN.01.01/PP
NG 115 8 10:39:00 DENTAL K-
BLU.FAR/39/
NIRMALA PASTE 2 G
2018
BN.01.01/PP
THOMASO MATA BUR
I/TN/18/0 08/01/201 K-
809 NG BMHP DIAMOND S e t BMHP GIGI 2 315000 0 63000 693000
115 8 10:39:00 BLU.FAR/39/
NIRMALA High Speed
2018
BN.01.01/PP
THOMASO
I/TN/18/0 08/01/201 Jarum K-
810 NG BMHP Strip BMHP 2 145000 0 29000 319000
115 8 10:39:00 Exterpasi BLU.FAR/39/
NIRMALA
2018
BN.01.01/PP
THOMASO Jarum File
I/TN/18/0 08/01/201 K-
811 NG BMHP Densplay Box/6s BMHP 2 210000 0 42000 462000
115 8 10:39:00 BLU.FAR/39/
NIRMALA UK.15-40
2018
KALZINOL BN.01.01/PP
THOMASO
I/TN/18/0 08/01/201 POWDER K-
812 NG BMHP Set BMHP 2 750000 0 150000 1650000
115 8 10:39:00 40 G + BLU.FAR/39/
NIRMALA
LIQUID 2018
Dental
BN.01.01/PP
THOMASO Needle
I/TN/18/0 08/01/201 K-
813 NG BMHP Short 30 g Box/100s BMHP 5 155000 0 77500 852500
115 8 10:39:00 BLU.FAR/39/
NIRMALA (0.3X16M
2018
M)
CANULA
PERMATA 10/04/201 BN.01.01/PP
036/PB/F ORTIC
BUNDA 8 K-
814 AK/04/20 BMHP STRAIGHT Buah BMHP 25 684000 0 1710000 18810000
18 NO.24
PT 96 1/2018
cat.70424
PERMATA 10/04/201 Macro BN.01.01/PP
036/PB/F
BUNDA 8 Sucker K-
815 AK/04/20 BMHP Pcs BMHP 5 765000 0 382500 4207500
18
PT 96 Tube 20Fr 1/2018
PERMATA 10/04/201 Connector BN.01.01/PP
036/PB/F
BUNDA 8 Straight K-
816 AK/04/20 BMHP Pcs BMHP 5 64000 0 32000 352000
ARTANO, 10:56:36.0 1/4 x 1/4 BLU.FAR/397
18
PT 96 CLL 1/2018
817 PERMATA 036/PB/F 10/04/201 BMHP Connector Pcs BMHP 10 64000 0 64000 704000 BN.01.01/PP
BUNDA AK/04/20 8 Y 3/8 x K-
ARTANO, 18 10:56:36.0 3/8 x 1/4 BLU.FAR/397
PT 96 CLL 1/2018
PERMATA 10/04/201 BN.01.01/PP
036/PB/F Connector
BUNDA 8 K-
818 AK/04/20 BMHP Straight Pcs BMHP 10 64000 0 64000 704000
18 3/8 x 3/8
PT 96 1/2018
PERMATA 10/04/201 Aortic BN.01.01/PP
036/PB/F
BUNDA 8 Punch K-
819 AK/04/20 BMHP Pcs BMHP 17 882000 0 1499400 16493400
ARTANO, 10:56:36.0 4,0mm BLU.FAR/397
18
PT 96 Med 1/2018
Cardiovasc
PERMATA 10/04/201 BN.01.01/PP
036/PB/F ular Patch
BUNDA 8 K-
820 AK/04/20 BMHP IMPRA Pcs BMHP 1 6460000 0 646000 7106000
18 3,5mm
PT 96 1/2018
x10CM
Oxygenato
PERMATA 10/04/201 BN.01.01/PP
037/PB/F r Affnity
BUNDA 8 K-
18 Complete
PT 86 2/2018
Adult
OPAL 10/04/201 BN.01.01/PP
Film UPP-
822 BMHP 84HG Roll BMHP 20 240000 0 480000 5280000
SEJAHTER /IV/18 13:36:48.4 BLU.FAR/404
Paper B/W
A. PT 03 3/2018
JAYA INV/SJA/1 8 Circuit 3977272.7 43750000. K-
823 BMHP Set BMHP 250 159090.91 0
ALKESIND 8/IV/0189 13:29:44.8 Adult Set 5 25 BLU.FAR/404
GabarithP
HOSPI BN.01.01/PP
0590/HMI M Set-3DT-
MEDIK 13/04/201 K-
824 /KWI/IV/2 BMHP XX- Set BMHP 20 742400 0 1484800 16332800
INDONESI 8 14:41:00 BLU.FAR/404
018 150cm/Re
A. PT 5/2018
d Blue&Yel
SteerEase
NIUMINDO 0086/RS/F 8 4336734.5 1734693.8 19081632. K-
SELARAS, /4/2018 15:30:12.6 5 2 02 BLU.FAR/404
7F
PT 46 9/2018
826 REKAMILE 0086/RS/F 10/04/201 BMHP Hearttr Tm P c s BMHP 1 12000000 0 1200000 13200000 BN.01.01/PP
NIUMINDO /4/2018 8 PDA K-
SELARAS, 15:30:12.6 Occuleder BLU.FAR/404
PT 46 XJD1820 9/2018
Guide Wire
0.038
827 BMHP 150cm Pcs BMHP 33 165000 0 544500 5989500
SELARAS, /4/2018 15:30:12.6 BLU.FAR/404
IQ38F150J
PT 46 9/2018
3
REKAMILE 10/04/201 DC BN.01.01/PP
NIUMINDO 0085/RS/F 8 PIGTAIL K-
828 BMHP Buah BMHP 2 350000 0 70000 770000
SELARAS, /4/2018 13:48:13.5 cath 5Fr BLU.FAR/405
PT 73 7529-11 0/2018
DC
REKAMILE 10/04/201 PIGTAIL BN.01.01/PP
NIUMINDO 0085/RS/F 8 6Fr/ K-
829 BMHP Buah BMHP 2 350000 0 70000 770000
SELARAS, /4/2018 13:48:13.5 Angiograpi BLU.FAR/405
PT 73 c cath 0/2018
7509-11
DC. MPA 2
SELARAS, /4/2018 13:48:13.5 BLU.FAR/405
7533-23
PT 73 0/2018
DC. MPA 2
831 BMHP - 6F 7513- P c s BMHP 3 265000 0 79500 874500
SELARAS, /4/2018 13:48:13.5 BLU.FAR/405
23
PT 73 0/2018
MA 8 Yell Nephr K-
832 15275 BMHP Pcs BMHP 20 2098800 0 4197600 46173600
.PT 26 No.7/34cm 1/2018
13/04/201 BN.01.01/PP
KASIH
03/KTJ/III 8 Aqua Non K-
833 THREEBER BMHP Galon BMHP 150 8500 0 127500 1402500
/2018 16:05:19.1 Steril BLU.FAR/405
S JAYA. PT
46 3/2018
ANUGERA
BOTOL BN.01.01/PP
H
75/AMN/I 09/04/201 HANDSOA K-
V/2018 8 16:10:00 P/HANDR BLU.FAR/405
INTERASIA
UB 500ml 4/2018
, PT
835 ANUGERA 76/AMN/I 12/04/201 BMHP BOTOL Botol BMHP 504 9000 0 453600 4989600 BN.01.01/PP
H V/2018 8 16:13:00 HANDSOA K-
MANDIRI
P/HANDR BLU.FAR/405
INTERASIA
UB 500ml 4/2018
, PT
ANUGERA
H 23/10/201 BN.01.01/PP
DO 74 08:28:26.0 W275 BLU.FAR/408
LESTARI, 56 375/2018
PT
ANUGERA
H 26/10/201 Prolene BN.01.01/PP
PHARMIN 15100094 8 No.8/0 K-
DO 28 11:55:12.4 EVPt JEP BLU.Far/408
LESTARI, 83 8741H 375/2018
PT
DOS NI 82711337 8 e 4/0 K-
5 90cm 8/2018
PERMATA 12/04/201 BN.01.01/PP
070/PB/F Vascular
BUNDA 8 K-
839 AK/04/20 BMHP Touniquet Buah BMHP 10 270000 0 270000 2970000
18 Set- 79006
PT 33 9/2018
PERMATA 12/04/201 BN.01.01/PP
070/PB/F CARDIOPL
BUNDA 8 K-
18 ADULT
PT 33 9/2018
PERMATA 12/04/201 BN.01.01/PP
070/PB/F CARDIOPL
BUNDA 8 K-
18 PED
PT 33 9/2018
069/PB/F
842 AK/04/20 BMHP Buah BMHP 2 15750000 0 3150000 34650000
ARTANO, 14:50:45.7 33mm - BLU.FAR/422
18
PT 5 758270 3/2018
DIPA 12/04/201 BN.01.01/PP
Mac
PUSPA 0718.FP- 8 K-
843 BMHP Conkey Kit BMHP LAB 1 874225 0 87422.5 961647.5
LABSAINS. 100427 13:08:46.5 BLU.FAR/422
Agar No,3
PT 03 4/2018
DIPA 12/04/201 BN.01.01/PP
Columbia
PUSPA 0718.FP- 8 K-
844 BMHP Blood Agar Pack BMHP LAB 1 1403903 0 140390.3 1544293.3
LABSAINS. 100427 13:08:46.5 BLU.FAR/422
Base 500gr
PT 03 4/2018
DIPA 12/04/201 BN.01.01/PP
845 BMHP Tetracyclin BMHP LAB 5 334263 0 167131.5 1838446.5
PT 03 4/2018
DIPA 12/04/201 BN.01.01/PP
PUSPA 0718.FP- 8 Netilimicin K-
846 BMHP Pack BMHP LAB 5 334263 0 167131.5 1838446.5
LABSAINS. 100427 13:08:46.5 Net30 Disc BLU.FAR/422
PT 03 4/2018
DIPA 12/04/201 BN.01.01/PP
PUSPA 0718.FP- 8 Ciprofloxac Kit/5X50di 1838443.7 K-
847 BMHP BMHP LAB 5 334262.5 0 167131.25
LABSAINS. 100427 13:08:46.5 in. sc 5 BLU.FAR/422
PT 03 4/2018
DIPA 12/04/201 BN.01.01/PP
848 BMHP Ofloxacin BMHP LAB 4 334262.5 0 133705 1470755
PT 03 4/2018
PYROGEN
DIPA 12/04/201 BN.01.01/PP
FREE
PUSPA 0718.FP- 8 K-
849 BMHP DILUTION Kit BMHP 2 1022516 0 204503.2 2249535.2
LABSAINS. 100427 13:08:46.5 BLU.FAR/422
13X100M
PT 03 4/2018
M
DIMAS 12/04/201 BN.01.01/PP
850 BMHP Buah BMHP 250 34850 0 871250 9583750
PT 76 5/2018
Neutral
12/04/201 Buffer BN.01.01/PP
BIOZATIX
IQM18040 8 Formalin K-
851 INDONESI BMHP Galon BMHP LAB 2 1710000 0 342000 3762000
12 16:06:33.3 10 BLU.FAR/422
A. PT
16 (1ken=19lt 6/2018
r)
852 REKAMILE 0074/RS/F 11/04/201 BMHP MUlti Pcs BMHP 1 16590909. 0 1659090.9 18250000 BN.01.01/PP
NIUMINDO /4/2018 8 Function 09 09 K-
SELARAS, 16:09:12.9 Occuleder BLU.FAR/430
PT 43 / MFO 4/2018
No.7-5
Multi
Function
NIUMINDO 0074/RS/F 8 16590909. 1659090.9 K-
SELARAS, /4/2018 16:09:12.9 09 09 BLU.FAR/430
/ MFO
PT 43 4/2018
No.9-7
TIRTA 12/04/201 BN.01.01/PP
MEDICAL 4545/FP/1 8 Anti-A K-
A,PT 66 1/2018
TIRTA 12/04/201 BN.01.01/PP
MEDICAL 4545/FP/1 8 Anti-B K-
A,PT 66 1/2018
Canula
PERMATA 12/04/201 BN.01.01/PP
071/PB/F Venous
BUNDA 8 K-
856 AK/04/20 BMHP Bengkok P c s BMHP 5 882000 0 441000 4851000
18 No.16
PT 1 8/2018
67316
071/PB/F
BUNDA 8 Venous K-
857 AK/04/20 BMHP Buah BMHP 5 882000 0 441000 4851000
18
PT 1 No.28 CVB. 8/2018
Canula
PERMATA 12/04/201 BN.01.01/PP
071/PB/F Venous
BUNDA 8 K-
18 No.31
PT 1 8/2018
66331
Canula
PERMATA 12/04/201 BN.01.01/PP
071/PB/F Venouse
BUNDA 8 K-
859 AK/04/20 BMHP VC2 Pcs BMHP 5 810000 0 405000 4455000
18 34/48FR
PT 1 8/2018
Two Stage
13/04/201 BN.01.01/PP
STA Ind For
JP 8 1156599.9 12722599. K-
18001096 10:45:06.9 84 82 BLU.FAR/433
NUSANTA 240-
96 1/2018
RA.PT 872ENS
861 INTERGRA JP 13/04/201 BMHP Label Pcs BMHP 12 481916.66 0 578299.99 6361299.9 BN.01.01/PP
Green
STA
8 Proses For K-
ARTHA
18001096 10:45:06.9 Plasma- 2 12 BLU.FAR/433
NUSANTA
96 244- 1/2018
RA.PT
871ENS
MILLENNI
UM
13/04/201 BloodStoo BN.01.01/PP
PHARMAC
13061801 8 p/ K-
862 ON BMHP Pcs BMHP 6 514250 0 308550 3394050
5071 15:22:17.1 Hemostatic BLU.FAR/433
INTERNAT
56 Gauze IX 2/2018
IONAL
TBK, PT
BISAWI 20/04/201 BN.01.01/PP
1892/FKT Thoracic
TUMBUH 8 K-
863 R/BTS/IV/ BMHP Catheter Pcs BMHP 20 80000 0 160000 1760000
18 No. 24
PT 63 7/2018
1892/FKT
TUMBUH 8 Drainage K-
864 R/BTS/IV/ BMHP Pcs BMHP 10 80000 0 80000 880000
SELARAS. 15:16:27.9 Straight BLU.FAR/433
18
PT 63 No.20 7/2018
BISAWI 20/04/201 BN.01.01/PP
1895/FKT
TUMBUH 8 DC MPA 2 K-
SELARAS. 15:25:29.0 4Fr BLU.FAR/433
18
PT 96 7/2018
BISAWI 20/04/201 BN.01.01/PP
1895/FKT
18
PT 96 7/2018
BISAWI 20/04/201 BN.01.01/PP
1895/FKT
18
PT 96 7/2018
BISAWI 20/04/201 BN.01.01/PP
1895/FKT
TUMBUH 8 DC Pigtail K-
SELARAS. 15:25:29.0 STR 4Fr BLU.FAR/433
18
PT 96 7/2018
869 INDOSOPH INV18040 11/05/201 BMHP LEVEL Pcs BMHP 50 177272.73 0 886363.65 9750000.1 BN.01.01/PP
A SAKTI. 44 8 SENSOR 5 K-
PT 14:38:21.4 PAD BLU.FAR/440
46 1/2018
ANDALAS D1804- 8 Rem K-
870 BMHP Buah BMHP 10 401600 0 401600 4417600
MAKMUR. 00831 16:16:51.2 Polyhesive BLU.FAR/448
PT 6 II E7512 7/2018
871 BMHP Buah BMHP 75 109536 0 821520 9036720
MAKMUR. 00831 16:16:51.2 E7507 BLU.FAR/448
ANDALAS D1804- 8 Pencil with 19999999. K-
872 BMHP Buah BMHP 200 90909.09 0 1818181.8
MAKMUR. 00831 16:16:51.2 Holster 8 BLU.FAR/448
PT 6 VL2610 7/2018
POLYHESI
DIMAS 17/04/201 BN.01.01/PP
VE INFANT
ANDALAS D1804- 8 K-
873 BMHP RETURN P c s BMHP 10 197088 0 197088 2167968
MAKMUR. 00831 16:16:51.2 BLU.FAR/448
ELEC
PT 6 7/2018
E7510-25
Cauter /
DIMAS 17/04/201 BN.01.01/PP
Dispo
ANDALAS D1804- 8 K-
MAKMUR. 00831 16:16:51.2 BLU.FAR/448
Pencil (E-
PT 6 7/2018
2515)
IDS
19/04/201 BN.01.01/PP
MEDICAL SION
8 1272727.2 127272.72 1399999.9 K-
875 SYSTEM 0142473 BMHP GUIDE Pcs BMHP 1 0
16:22:45.8 7 7 97 BLU.FAR/449
INDONESI WIRE
93 0/2018
A PT
IDS
19/04/201 Sion Blue BN.01.01/PP
MEDICAL
8 Striaght 1272727.2 381818.18 4199999.9 K-
876 SYSTEM 0142473 BMHP Pcs BMHP 3 0
16:22:45.8 Wire 7 1 91 BLU.FAR/449
INDONESI
93 180cm 0/2018
A PT
IDS
19/04/201 BN.01.01/PP
MEDICAL Asahi
8 1272727.2 254545.45 2799999.9 K-
877 SYSTEM 0142473 BMHP Rinato Pcs BMHP 2 0
16:22:45.8 7 4 94 BLU.FAR/449
INDONESI Wire
93 0/2018
A PT
878 DIMAS D1804- 17/04/201 BMHP HEARING Unit BMHP 15 454545.45 0 681818.17 7499999.9 BN.01.01/PP
ANDALAS 8 K-
AMPLIFIE
MAKMUR. 00898 13:20:08.8 5 25 BLU.FAR/449
R HA 20
PT 9 1/2018
Cotton-
879 BMHP Pcs BMHP 3 1583650 0 475095 5226045
DELAPAN. /IV/2018 10:45:39.5 Stent BLU.FAR/457
PT 1 Only,10Fr, 8/2018
9c
Tracer
CAHAYA 18/04/201 BN.01.01/PP
Metro
DUA 0037/CDD 8 K-
880 BMHP Dir.W.G.,St Buah BMHP 1 4246000 0 424600 4670600
DELAPAN. /IV/2018 10:45:39.5 BLU.FAR/457
raight
PT 1 8/2018
0,035/480
DIMAS 19/04/201 BN.01.01/PP
Kapas Lidi
ANDALAS D1804- 8 K-
881 BMHP Steril Pcs BMHP 1300 432 0 56160 617760
MAKMUR. 01031 10:06:15.0 BLU.FAR/457
Swabs
PT 8 9/2018
ACTIMO
DIMAS 19/04/201 BN.01.01/PP
CERVICAL
ANDALAS D1804- 8 899999.99 K-
882 BMHP COLLAR - P c s BMHP 3 272727.27 0 81818.181
MAKMUR. 01031 10:06:15.0 1 BLU.FAR/457
M (LEHER)
PT 8 9/2018
4090
ACTIMO
DIMAS 19/04/201 BN.01.01/PP
CERVICAL
ANDALAS D1804- 8 109090.90 1199999.9 K-
883 BMHP COLLAR - P c s BMHP 4 272727.27 0
MAKMUR. 01031 10:06:15.0 8 88 BLU.FAR/457
L(LEHER)
PT 8 9/2018
4090
ACTIMO
DIMAS 19/04/201 BN.01.01/PP
CERVICAL
ANDALAS D1804- 8 599999.99 K-
884 BMHP COLLAR - S P c s BMHP 2 272727.27 0 54545.454
MAKMUR. 01031 10:06:15.0 4 BLU.FAR/457
(LEHER)
PT 8 9/2018
4090
Steerease
NIUMINDO 0237/RS/F 8 4336734.5 9540816.0 K-
SELARAS, /4/2018 15:06:06.8 5 1 BLU.FAR/458
5F
PT 13 5/2018
886 REKAMILE 0237/RS/F 20/04/201 BMHP Fenale Set BMHP 18 190000 0 342000 3762000 BN.01.01/PP
NIUMINDO /4/2018 8 K-
SELARAS, 15:06:06.8 BLU.FAR/458
PT 13 5/2018
MILLENNI
UM Bioglue
19/04/201 BN.01.01/PP
PHARMAC Pre-Filled
13061801 8 K-
887 ON BMHP Syr 5ml Syringe BMHP 5 7653750 0 3826875 42095625
5801 13:52:08.6 BLU.FAR/465
INTERNAT SURG.ADH
43 9/2018
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TBK, PT
410/PDM/
DAYA 8 Indicator 20875002. K-
888 FP/IV/201 BMHP Pcs BMHP 1250 15181.82 0 1897727.5
MEDICA. 10:18:00.0 Strip 5 BLU.FAR/466
8
PT 83 250ea 1/2018
OPAL 20/04/201 Film BN.01.01/PP
BMHP
PERKASA 1117/OPS 8 Drystar K-
SEJAHTER /IV/18 15:34:29.7 DT28 Uk 8 BLU.FAR/466
I
A. PT 43 x 10 4/2018
IDS
20/04/201 BN.01.01/PP
MEDICAL Paper
8 K-
15:29:35.0 BLU.FAR/466
INDONESI e
26 5/2018
A PT
IDS
20/04/201 BN.01.01/PP
MEDICAL BTR 3-
8 K-
15:31:14.4 BLU.FAR/466
5 5/2018
A PT
IDS
20/04/201 BN.01.01/PP
MEDICAL BTR 2-
8 K-
892 SYSTEM 0142547 BMHP 4812.Dual P c s BMHP 5 600000 0 300000 3300000
15:31:14.4 BLU.FAR/466
INDONESI Line
5 5/2018
A PT
IDS
23/04/201 EMBOLEC BN.01.01/PP
MEDICAL
8 TOMY K-
893 SYSTEM 0142482 BMHP Pcs BMHP 3 785197 0 235559.1 2591150.1
16:22:51.8 CATHETER BLU.FAR/467
INDONESI
2 4FR 7/2018
A PT
894 IDS 0142482 23/04/201 BMHP EMBOLEC P c s BMHP 3 785197 0 235559.1 2591150.1 BN.01.01/PP
MEDICAL 8 TOMY K-
SYSTEM CATHETER
16:22:51.8 BLU.FAR/467
INDONESI 5FR
2 7/2018
A PT EL1580
IDS EMBOLEC
23/04/201 BN.01.01/PP
MEDICAL TOMY
8 K-
895 SYSTEM 0142482 BMHP CATHETER P c s BMHP 2 785197 0 157039.4 1727433.4
16:22:51.8 BLU.FAR/467
INDONESI 6FR
2 7/2018
A PT EL1680
20/04/201 BN.01.01/PP
SURGIKA
8 Tracheos K-
896 ALKESIND IRD01726 BMHP Pcs BMHP 200 31875 0 637500 7012500
15:15:06.1 Filter BLU.FAR/475
O, PT
66 6/2018
Steerease
NIUMINDO 0238/RS/F 8 4336734.5 2168367.2 23852040. K-
SELARAS, /4/2018 15:13:46.2 5 75 02 BLU.FAR/475
6F
PT 43 7/2018
SteerEase
NIUMINDO 0238/RS/F 8 4336734.5 2168367.2 23852040. K-
SELARAS, /4/2018 15:13:46.2 5 75 02 BLU.FAR/475
7F
PT 43 7/2018
ANUGERA
H 23/01/201 Prolene BN.01.01/PP
PHARMIN 22124371 8 No.8/0 K-
DO 97 11:01:57.5 EVPt JEP BLU.FAR/483
LESTARI, 1 8741H /2018
PT
ANUGERA
H 23/01/201 BN.01.01/PP
DO 97 11:01:57.5 1913T BLU.FAR/483
LESTARI, 1 /2018
PT
ANUGERA
H 23/01/201 BN.01.01/PP
Ethibond
PHARMIN 22124371 8 K-
901 BMHP No.2 Sacchet BMHP 24 192900 0 462960 5092560
DO 97 11:01:57.5 BLU.FAR/483
W4843
LESTARI, 1 /2018
PT
902 DIMAS D1804- 20/04/201 BMHP HEARING Unit BMHP 21 454545.45 0 954545.45 10500000. BN.01.01/PP
ANDALAS 8 K-
AMPLIFIE
MAKMUR. 01167 13:12:51.1 5 55 01 BLU.FAR/483
R HA 20
PT 96 8/2018
PERMATA 23/04/201 BN.01.01/PP
111/PB/F Hemoconc
BUNDA 8 K-
18 for Adult
PT 06 7/2018
113/PB/F
BUNDA 8 System K-
904 AK/04/20 BMHP Set BMHP 1 30420000 0 3042000 33462000
ARTANO, 14:18:23.2 (Octopus+ BLU.FAR/484
18
PERMATA 23/04/201 BN.01.01/PP
113/PB/F Hemoconc
BUNDA 8 K-
18 For Ped
PT 03 8/2018
112/PB/F
BUNDA 8 Sucker K-
906 AK/04/20 BMHP Pcs BMHP 10 765000 0 765000 8415000
18
PT 93 Tube 20Fr 9/2018
112/PB/F
BUNDA 8 Sucker K-
907 AK/04/20 BMHP Pcs BMHP 10 720000 0 720000 7920000
18
PT 93 Tube 9Fr 9/2018
112/PB/F
BUNDA 8 Y 3/8 x K-
908 AK/04/20 BMHP Pcs BMHP 13 64000 0 83200 915200
ARTANO, 10:53:45.8 3/8 x 1/4 BLU.FAR/484
18
PT 93 CLL 9/2018
PERMATA 27/04/201 BN.01.01/PP
112/PB/F Connector
BUNDA 8 K-
909 AK/04/20 BMHP Straight Pcs BMHP 13 64000 0 83200 915200
18 3/8 x 3/8
PT 93 9/2018
112/PB/F
BUNDA 8 Y 1/4 x K-
910 AK/04/20 BMHP Pcs BMHP 10 64000 0 64000 704000
ARTANO, 10:53:45.8 1/4 x 1/4 BLU.FAR/484
18
PT 93 CLL 9/2018
911 DIAN FK180425 26/04/201 BMHP HD Set BMHP 50 504000 0 2520000 27720000 BN.01.01/PP
LANGGEN 9 8 DoubLum K-
G 14:49:32.6 Farc 115- BLU.FAR/485
PRATAMA. 66 15(preCur 3/2018
PT ved)
Yel Star
MITRAPRI 25/04/201 BN.01.01/PP
Doub J
MA 8 K-
912 15444 BMHP Uret Sten Buah BMHP 4 1339200 0 535680 5892480
LESTARI 11:48:29.9 BLU.Far/485
Fr4,7 Close
.PT 7 5/2018
Ti
MITRAPRI 25/04/201 White Star BN.01.01/PP
MA 8 Doub J K-
913 15444 BMHP Pcs BMHP 3 998100 0 299430 3293730
LESTARI 11:48:29.9 Uret Stent BLU.Far/485
.PT 7 4,7Fr 5/2018
26/04/201 BN.01.01/PP
VERSACON INV/18/03
8 Urether 2749772.7 824931.81 9074250.0 K-
914 MEDICAL.P 37/VM/RE BMHP Pcs BMHP 3 0
16:03:56.2 Stent NO.3 3 9 09 BLU.FAR/485
T V
43 9/2018
26/04/201 Quick Core BN.01.01/PP
VERSACON INV/18/03
8 Biopsy K-
915 MEDICAL.P 37/VM/RE BMHP Pcs BMHP 20 1131818 0 2263636 24899996
16:03:56.2 Needle, BLU.FAR/485
T V
43 18G/20cm 9/2018
IDS SLE 1000
27/04/201 BN.01.01/PP
MEDICAL nCPAP
8 K-
916 SYSTEM 0142976 BMHP Generator P c s BMHP 10 1503850 0 1503850 16542350
15:18:21.3 BLU.FAR/491
INDONESI Only(Inc3P
4 8/2018
A PT rong)
Singel Use
IDS
27/04/201 Flow BN.01.01/PP
MEDICAL
8 Sensor for K-
15:18:21.3 SLE BLU.FAR/491
INDONESI
4 4000/500 8/2018
A PT
0
IDS F&P RT124
27/04/201 BN.01.01/PP
MEDICAL CIRC.W/
8 K-
15:18:21.3 BLU.FAR/491
INDONESI GENERAT
4 8/2018
A PT OSLE1000
919 CAHAYA 0042/CDD 25/04/201 BMHP Cotton- Pcs BMHP 10 1143500 0 1143500 12578500 BN.01.01/PP
DUA /IV/2018 8 Leung K-
DELAPAN. 14:54:33.3 Billiary BLU.FAR/492
PT 9 Stent 1/2018
Only,10Fr,
9c
MILLENNI
UM PerClot
26/04/201 BN.01.01/PP
PHARMAC Polysaccari
8 K-
920 ON 15543 BMHP de Sacchet BMHP 5 3332106 0 1666053 18326583
12:51:32.1 BLU.FAR/492
INTERNAT Haemost
66 2/2018
IONAL Syst 3Gr
TBK, PT
Multi
Function
NIUMINDO 0239/RS/F 8 16590909. 3318181.8 K-
SELARAS, /4/2018 16:24:33.9 09 18 BLU.FAR/492
/ MFO
PT 06 3/2018
No.5-3
IDS SU Circuit
27/04/201 BN.01.01/PP
MEDICAL w/ Twin
8 K-
922 SYSTEM 0142979 BMHP Spiral Pcs BMHP 15 1030750 0 1546125 17007375
12:27:18.8 BLU.FAR/498
INDONESI Heated
53 9/2018
A PT Circ
OPAL 26/04/201 Film BN.01.01/PP
BMHP
PERKASA 1122/OPS 8 Drystar K-
SEJAHTER /IV/18 16:15:26.5 DT28 Uk 8 BLU.FAR/499
I
A. PT 46 x 10 2/2018
HOSPI 25/04/201 BN.01.01/PP
0695A/HM SUREFIT
MEDIK 8 K-
924 I/KWI/IV/ BMHP NON Pcs BMHP 100 59400 0 594000 6534000
INDONESI 11:50:41.3 BLU.Far/499
18 CABLE
A. PT 36 3/2018
HOSPI 25/04/201 BN.01.01/PP
0695A/HM
MEDIK 8 Surefit K-
925 I/KWI/IV/ BMHP Pcs BMHP 200 84075.45 0 1681509 18496599
INDONESI 11:50:41.3 Cable BLU.Far/499
18
A. PT 36 3/2018
MILLENNI
UM Bioglue
26/04/201 BN.01.01/PP
PHARMAC Pre-Filled
8 K-
926 ON 15556 BMHP Syr 5ml Syringe BMHP 5 7653750 0 3826875 42095625
14:38:03.0 BLU.FAR/499
INTERNAT SURG.ADH
23 4/2018
IONAL ESIVE
TBK, PT
BUNDA AK/01/20 8 r Affnity K-
Fusion
ARTANO, 15:24:54.7 BLU.FAR/5/2
18 Complete
PT 6 018
Adult
Needle One
Wall /
928 BMHP Fungture P c s BMHP 100 50000 0 500000 5500000
SELARAS, /4/2018 16:01:33.0 BLU.FAR/503
AD18T71
PT 86 8/2018
W
DC. MPA 2
SELARAS, /4/2018 16:01:33.0 BLU.FAR/503
7533-23
PT 86 8/2018
DC. MPA 2
930 BMHP - 6F 7513- P c s BMHP 5 265000 0 132500 1457500
SELARAS, /4/2018 16:01:33.0 BLU.FAR/503
23
PT 86 8/2018
REKAMILE 26/04/201 DC BN.01.01/PP
NIUMINDO 0498/RS/F 8 PIGTAIL K-
931 BMHP Buah BMHP 20 350000 0 700000 7700000
SELARAS, /4/2018 16:01:33.0 cath 5Fr BLU.FAR/503
PT 86 7529-11 8/2018
DC
REKAMILE 26/04/201 PIGTAIL BN.01.01/PP
NIUMINDO 0498/RS/F 8 6Fr/ K-
932 BMHP Buah BMHP 20 350000 0 700000 7700000
SELARAS, /4/2018 16:01:33.0 Angiograpi BLU.FAR/503
PT 86 c cath 8/2018
7509-11
REKAMILE 26/04/201 DC. JR 4.0 - BN.01.01/PP
NIUMINDO 0498/RS/F 8 6F/Angiog K-
933 BMHP Pcs BMHP 10 265000 0 265000 2915000
SELARAS, /4/2018 16:01:33.0 raphic BLU.FAR/503
PT 86 7503-21 8/2018
REKAMILE 26/04/201 DC JR 3.5 - BN.01.01/PP
NIUMINDO 0498/RS/F 8 6F/Angiog K-
934 BMHP Pcs BMHP 11 265000 0 291500 3206500
SELARAS, /4/2018 16:01:33.0 raphic cath BLU.FAR/503
PT 86 7503-13 8/2018
Guide Wire
0.038
935 BMHP 150cm Pcs BMHP 50 165000 0 825000 9075000
SELARAS, /4/2018 16:01:33.0 BLU.FAR/503
IQ38F150J
PT 86 8/2018
3
26/04/201 BN.01.01/PP
ALEXA Extention
FM/18/08 8 K-
37 15:04:38.3 BLU.FAR/503
PT 150cm
23 9/2018
DIMAS 23/01/201 BN.01.01/PP
Colostomy
ANDALAS D1801- 8 K-
MAKMUR. 01039 14:38:42.5 BLU.FAR/508
OM
PT 2 /2018
DIMAS 23/01/201 BN.01.01/PP
Colostomy
ANDALAS D1801- 8 K-
MAKMUR. 01039 14:38:42.5 BLU.FAR/508
OM
PT 2 /2018
Cauter /
DIMAS 23/01/201 BN.01.01/PP
Dispo
ANDALAS D1801- 8 K-
MAKMUR. 01036 14:36:24.3 BLU.FAR/509
Pencil (E-
PT 83 /2018
2515)
940 BMHP Buah BMHP 50 109536 0 547680 6024480
MAKMUR. 01036 14:36:24.3 E7507 BLU.FAR/509
PT 83 adult cabl /2018
DIMAS FILM DI- BN.01.01/PP
23/01/201
ANDALAS D1801- HL 20.3 X K-
941 8 BMHP Lembar BMHP 750 18000 0 1350000 14850000
MAKMUR. 01057 25.4CM BLU.FAR/510
14:40:22.2
PT FUJI /2018
DIMAS BN.01.01/PP
23/01/201 FILM DI-
ANDALAS D1801- 2300000.0 25300000. K-
942 8 BMHP HL 26 X Lembar BMHP 750 30666.667 0
MAKMUR. 01057 25 27 BLU.FAR/510
14:40:22.2 36CM FUJI
PT /2018
27/04/201 Medifix BN.01.01/PP
943 BMHP Pcs BMHP 99 117300 0 1161270 12773970
33 Intrafix 6/2018
27/04/201 BN.01.01/PP
Medifix
DOS NI 82716946 8 K-
ROHA, PT 1 14:27:20.9 BLU.FAR/510
r
33 6/2018
945 DOS NI 82718443 02/05/201 BMHP Medifix Pcs BMHP 20 219300 0 438600 4824600 BN.01.01/PP
ROHA, PT 2 8 monomete K-
15:10:55.8 BLU.FAR/510
r
26 6/2018
DOS NI 82718443 8 e 4/0 K-
26 90cm 6/2018
22/06/201 Medifix BN.01.01/PP
947 BMHP Pcs BMHP 10 117300 0 117300 1290300
8 Intrafix 6/2018
Medifix BN.01.01/PP
DOS NI 82728463 22/06/201 Line 90cm K-
948 BMHP Pcs BMHP 91 117300 0 1067430 11741730
ROHA, PT 9 8 14:21:00 With BLU.FAR/510
Intrafix 6/2018
DOS NI 82728463 22/06/201 e 3/0 2 K-
ROHA, PT 9 8 14:21:00 xHR26 90 BLU.FAR/510
cm 6/2018
Docare
MENSA BN.01.01/PP
Wash
BINA CD193872 02/05/201 K-
950 BMHP Gloves 4 Pcs BMHP 1000 4215.75 0 421575 4637325
SUKSES, 747 8 08:57:00 BLU.FAR/510
Sheet
PT 9/2018
Parfume
MENSA BN.01.01/PP
BINA CD193872 02/05/201 Docare Pre K-
951 BMHP Pack BMHP 50 8760 0 43800 481800
SUKSES, 747 8 08:57:00 Ops BLU.FAR/510
PT 9/2018
MENSA BN.01.01/PP
BINA CD193872 02/05/201 DoCare K-
952 BMHP Pcs BMHP 100 40880 0 408800 4496800
SUKSES, 747 8 08:57:00 Hair Clean BLU.FAR/510
PT 9/2018
MENSA BN.01.01/PP
Steri Drape
BINA CD193872 02/05/201 K-
953 BMHP / U Drape P c s BMHP 30 208785 0 626355 6889905
SUKSES, 743 8 09:05:00 BLU.FAR/510
1015
PT 9/2018
MENSA 30/04/201 BN.01.01/PP
Blood Bag
BINA CD193873 8 K-
SUKSES, 008 14:10:26.6 BLU.FAR/511
ml
PT 16 0/2018
MENSA 30/04/201 BN.01.01/PP
Blood Bag
BINA CD193873 8 2549454.6 28044000. K-
955 BMHP Triple 350 Buah BMHP 410 62181.82 0
SUKSES, 008 14:10:26.6 2 82 BLU.FAR/511
ml
PT 16 0/2018
Blood Line
MENSA 04/05/201 BN.01.01/PP
Infant/
BINA CD193872 8 K-
SUKSES, 740 15:29:19.1 BLU.FAR/516
Pack
PT 43 3/2018
CX921
BINA CD193872 8 r 10 Ped. 4999012.4 1499703.7 16496741. K-
SUKSES, 740 15:29:19.1 RX15RW3 8 44 18 BLU.FAR/516
PT 43 0 3/2018
MENSA 04/05/201 BN.01.01/PP
Arterial
BINA CD193872 8 191097.98 2102077.8 K-
958 BMHP Filter 02 Pcs BMHP 3 636993.28 0
SUKSES, 740 15:29:19.1 4 24 BLU.FAR/516
Ped
PT 43 3/2018
MENSA 04/05/201 BN.01.01/PP
Oxygenato
BINA CD193872 8 K-
959 BMHP r 10 Ped. P c s BMHP 2 5080480 0 1016096 11177056
SUKSES, 753 15:56:45.7 BLU.FAR/516
FX15RW30
PT 2 3/2018
Blood Line
MENSA 04/05/201 BN.01.01/PP
Ped/
BINA CD193872 8 K-
SUKSES, 753 15:56:45.7 BLU.FAR/516
Pack CX
PT 2 3/2018
910
RAJAWALI
FKT80026 8 XL/BAJU K-
961 NUSINDO, BMHP Buah BMHP 50 18578.4 0 92892 1021812
80 09:10:51.3 FLUBURU BLU.FAR/516
PT
06 NG 5/2018
RAJAWALI
FKT80026 8 L/BAJU K-
962 NUSINDO, BMHP Pcs BMHP 75 18578.4 0 139338 1532718
80 09:10:51.3 FLU BLU.FAR/516
PT
06 BURUNG 5/2018
MA 8 Yell Nephr K-
963 15504 BMHP Pcs BMHP 20 2098800 0 4197600 46173600
.PT 63 No.7/34cm 6/2018
964 MENSA CD193872 04/05/201 BMHP Oxygenato S e t BMHP 3 6817200 0 2045160 22496760 BN.01.01/PP
r
BINA 8 K-
NEONATE
SUKSES, 750 13:51:46.0 BLU.FAR/516
FX05RW
PT 6 7/2018
(Baby RX)
Blood Line
MENSA 04/05/201 BN.01.01/PP
Neonat /
BINA CD193872 8 K-
SUKSES, 750 13:51:46.0 BLU.FAR/516
Pack
PT 6 7/2018
Neonat
Cera ASD
NIUMINDO 0044/RS/F 8 24454545. 2445454.5 K-
SELARAS, /5/2018 13:18:17.0 45 45 BLU.FAR/522
No.36
PT 03 2/2018
SteerEase
NIUMINDO 0044/RS/F 8 4336734.5 9540816.0 K-
SELARAS, /5/2018 13:18:17.0 5 1 BLU.FAR/522
14Fr
PT 03 2/2018
NIUMINDO 0044/RS/F 8 E 4336734.5 433673.45 4770408.0 K-
968 BMHP Buah BMHP 1 0
SELARAS, /5/2018 13:18:17.0 OCCULEDE 5 5 05 BLU.FAR/522
PT 03 R 10F 2/2018
CAHAYA Guide Wire BN.01.01/PP
04/05/201
DUA 0045/cdd/ S.0,035/45 K-
969 8 ALKES Pcs ALKES 2 4023250 0 804650 8851150
DELAPAN. iv/2018 0cm BLU.FAR/523
12:46:57.4
PT straight tip 2/2018
Truetome
CAHAYA BN.01.01/PP
04/05/201 4,4F
DUA 0045/cdd/ K-
970 8 BMHP (1,5mmx2 P c s BMHP 4 2873750 0 1149500 12644500
DELAPAN. iv/2018 BLU.FAR/523
12:46:57.4 0mm)
PT 2/2018
0,035in
CAHAYA Guide Wire BN.01.01/PP
04/05/201
DUA 0045/cdd/ S.0,025/45 K-
971 8 BMHP Pcs BMHP 2 4425600 0 885120 9736320
DELAPAN. iv/2018 0cm BLU.FAR/523
12:46:57.4
PT straight tip 2/2018
IDS
02/05/201 Bipolar Pac BN.01.01/PP
MEDICAL
8 Catheter K-
15:19:55.6 W/O BLU.FAR/523
INDONESI
16 Balloon 3/2018
A PT
IDS Double
02/05/201 BN.01.01/PP
MEDICAL Lumen
8 K-
973 SYSTEM 0144201 BMHP Multicath P c s BMHP 4 891440 0 356576 3922336
15:19:55.6 BLU.FAR/523
INDONESI 4,5Fr.12,5c
16 3/2018
A PT m
Neonatal
SUKSES 02/05/201 BN.01.01/PP
Adhesive
JAYA INV/SJA/1 8 K-
974 BMHP Sensor Set BMHP 20 560000 0 1120000 12320000
ALKESIND 8/V/0225 15:31:01.6 BLU.FAR/523
18inci M-
O. PT 26 4/2018
LNCS
BISAWI 07/05/201 Inflasion BN.01.01/PP
2218/FKT
TUMBUH 8 Device 4272727.2 46999999. K-
975 R/BTS/IV/ BMHP Set BMHP 50 854545.45 0
SELARAS. 08:40:36.2 Comp.With 5 75 BLU.FAR/523
18
PT 43 Acces 7/2018
2426/FKT
976 R/BTS/IV/ BMHP Pcs BMHP 100 37272.73 0 372727.3 4100000.3
18
ANUGERA
02/05/201 BOTOL BN.01.01/PP
H
80/AMN/V 8 HANDSOA K-
/2018 11:24:08.3 P/HANDR BLU.FAR/528
INTERASIA
1 UB 500ml 0/2018
, PT
TIRTA 04/05/201 BN.01.01/PP
Blood Bag
MEDICAL 5080/FP/1 8 K-
978 BMHP Singel Pcs BMHP 400 35454.55 0 1418182 15600002
INDONESI 8 13:34:11.9 BLU.FAR/528
350ml
A,PT 96 6/2018
DERMATO
04/05/201 ME BN.01.01/PP
TIGA
8 BLADES K-
979 BERKENA 48413225 BMHP Pcs BMHP 20 267000 0 534000 5874000
12:52:12.0 STERIL(GB BLU.FAR/528
N JAYA
9 228R) 7/2018
electric
Oxygenato
PERMATA BN.01.01/PP
005/PB/F 04/05/201 r Affnity
BUNDA K-
980 AK/05/20 8 BMHP Fusion Set BMHP 4 6750000 0 2700000 29700000
ARTANO, BLU.FAR/534
18 16:10:27.8 Complete
PT 8/2018
Adult
981 PERMATA 005/PB/F 04/05/201 BMHP Vascular Buah BMHP 10 585000 0 585000 6435000 BN.01.01/PP
BUNDA Tourniquet K-
AK/05/20 8
ARTANO, Set /Sure- BLU.FAR/534
18 16:10:27.8
PT Snare 8/2018
PERMATA Octobase BN.01.01/PP
005/PB/F 04/05/201
BUNDA Suture K-
982 AK/05/20 8 BMHP Pcs BMHP 4 1620000 0 648000 7128000
ARTANO, Holding BLU.FAR/534
18 16:10:27.8
PT Insert 8/2018
OPAL 04/05/201 BN.01.01/PP
BMHP
PERKASA 1133/OPS 8 Film Upp 171818.18 859090.92 9450000.1 K-
983 BMHP Roll RADIOLOG 50 0
SEJAHTER /V/18 10:10:58.9 110 HG 5 5 75 BLU.FAR/534
I
A. PT 7 9/2018
Film UPT
OPAL 04/05/201 BN.01.01/PP
517 14x17 BMHP
SEJAHTER /V/18 10:56:03.4 BLU.FAR/535
Thermal I
A. PT 26 0/2018
(35x43)
INTERGRA
07/05/201 BN.01.01/PP
STA Parafilm
JP 8 K-
985 ARTHA BMHP 2in x Roll BMHP 16 550000 0 880000 9680000
18001322 12:09:27.5 BLU.FAR/544
NUSANTA 250FT
63 8/2018
RA.PT
INTERGRA
07/05/201 BN.01.01/PP
STA Cryovial
JP 8 K-
986 ARTHA BMHP PP 1,8ML Buah BMHP 1000 13600 0 1360000 14960000
18001322 12:09:27.5 BLU.FAR/544
NUSANTA SPL
63 8/2018
RA.PT
INTERGRA
07/05/201 RACKED BN.01.01/PP
STA
JP 8 FILTERED K-
987 ARTHA BMHP Box BMHP 5 2550000 0 1275000 14025000
18001322 12:09:27.5 TIPS BLU.FAR/544
NUSANTA
63 1000UL 8/2018
RA.PT
INTERGRA
07/05/201 BN.01.01/PP
STA Test Tube
JP 8 K-
988 ARTHA BMHP Plastik Tube BMHP 2500 500 0 125000 1375000
18001322 12:09:27.5 BLU.FAR/544
NUSANTA 12x75
63 8/2018
RA.PT
989 BRATACO. IVMDN180 07/05/201 BMHP Formalin Gln/10ltr BMHP LAB 5 500000 0 250000 2750000 BN.01.01/PP
PT 2775 8 37 K-
12:45:04.4 BLU.FAR/545
23 0/2018
07/05/201 BN.01.01/PP
BRATACO. IVMDG180 8 Kertas K-
990 BMHP Lembar BMHP 35000 17.273 0 60455.5 665010.5
PT 0480 14:46:19.4 Perkamen BLU.FAR/545
4 0/2018
07/05/201 BN.01.01/PP
BRATACO. IVMDG180 8 Brand K-
991 BMHP Liter BMHP LAB 10 24545.45 0 24545.45 269999.95
PT 0480 14:46:19.4 Spiritus BLU.FAR/545
4 0/2018
07/05/201 BN.01.01/PP
BRATACO. IVMDG180 8 1172727.2 12899999. K-
PT 0480 14:46:19.4 7 97 BLU.FAR/545
4 0/2018
07/05/201 BN.01.01/PP
993 BMHP Kg BMHP 100 45454.55 0 454545.5 5000000.5
PT 0480 14:46:19.4 1Kg BLU.FAR/545
4 0/2018
07/05/201 BN.01.01/PP
994 BMHP Buah BMHP 1800 1363.64 0 245455.2 2700007.2
PT 0480 14:46:19.4 100 cc BLU.FAR/545
4 0/2018
MENSA 11/05/201 BN.01.01/PP
Blood Bag
BINA CD193932 8 20520000. K-
995 BMHP Triple 350 Buah BMHP 300 62181.82 0 1865454.6
SUKSES, 840 15:30:04.4 6 BLU.FAR/545
ml
PT 83 4/2018
MENSA 11/05/201 BN.01.01/PP
Blood Bag
BINA CD193914 8 K-
SUKSES, 076 16:16:32.5 BLU.FAR/545
ml
PT 53 4/2018
Syringe
OPAL 07/05/201 BN.01.01/PP
StellaDual
997 BMHP 200ml Pcs BMHP 20 488000 0 976000 10736000
Cat.SDS.CT
A. PT 46 7/2018
P.QFT
Syringe
OPAL 14/05/201 BN.01.01/PP
150ml
quick fill
A. PT 06 7/2018
tube
OPAL 14/05/201 BN.01.01/PP
Syringe
999 BMHP Salient Pcs BMHP 30 460000 0 1380000 15180000
190ml
A. PT 06 7/2018
IDS
08/05/201 BN.01.01/PP
MEDICAL BTR 4812-
100 8 K-
SYSTEM 0144901 BMHP 3 Singel Pcs BMHP 20 260000 0 520000 5720000
0 16:38:07.1 BLU.FAR/547
INDONESI Lumen
26 8/2018
A PT
IDS
08/05/201 BN.01.01/PP
MEDICAL BTR 3-
100 8 K-
SYSTEM 0144901 BMHP 4812, Pcs BMHP 5 750000 0 375000 4125000
1 16:38:07.1 BLU.FAR/547
26 8/2018
A PT
IDS
08/05/201 BN.01.01/PP
MEDICAL BTR 2-
100 8 K-
SYSTEM 0144901 BMHP 4812.Dual P c s BMHP 5 600000 0 300000 3300000
2 16:38:07.1 BLU.FAR/547
INDONESI Line
26 8/2018
A PT
IDS Double
08/05/201 BN.01.01/PP
MEDICAL Lumen
100 8 K-
SYSTEM 0144767 BMHP Multicath P c s BMHP 1 891440 0 89144 980584
3 16:41:00.3 BLU.FAR/547
43 8/2018
A PT m
IDS
08/05/201 BN.01.01/PP
MEDICAL Tracheosto
100 8 K-
SYSTEM 0144767 BMHP my Tube P c s BMHP 2 307458 0 61491.6 676407.6
4 16:41:00.3 BLU.FAR/547
INDONESI Size 3,5
43 8/2018
A PT
IDS Paper for
09/05/201 BN.01.01/PP
MEDICAL Hi-801/HI-
100 8 K-
SYSTEM 0145057 BMHP 105/ Roll BMHP 20 272727 0 545454 5999994
5 13:19:13.8 BLU.FAR/547
INDONESI Thermal
9 8/2018
A PT 112mm
IDS
17/05/201 BN.01.01/PP
MEDICAL Paper
100 8 K-
SYSTEM 0146052 BMHP Mouthpiec P c s BMHP 100 5727.27 0 57272.7 629999.7
6 14:54:40.2 BLU.FAR/547
INDONESI e
53 8/2018
A PT
IDS
18/05/201 BN.01.01/PP
MEDICAL Paper
100 8 K-
7 14:53:02.0 BLU.FAR/547
INDONESI e
63 8/2018
A PT
IDS
BN.01.01/PP
MEDICAL Paper
100 25/05/201 K-
8 8 13:41:00 BLU.FAR/547
INDONESI e
8/2018
A PT
IDS
08/06/201 BN.01.01/PP
MEDICAL Paper
100 8 K-
9 13:24:53.7 BLU.FAR/547
INDONESI e
16 8/2018
A PT
026/PB/F
101 BUNDA 8 Aortic Root K-
AK/05/20 BMHP Pcs BMHP 7 630000 0 441000 4851000
0 ARTANO, 13:43:21.1 Cannula BLU.FAR/548
18
PT 4 WVL 9Fr 5/2018
CANULA
PERMATA 08/05/201 BN.01.01/PP
026/PB/F ORTIC
101 BUNDA 8 K-
AK/05/20 BMHP STRAIGHT Buah BMHP 3 684000 0 205200 2257200
1 ARTANO, 13:43:21.1 BLU.FAR/548
18 NO.24
PT 4 5/2018
cat.70424
026/PB/F
101 BUNDA 8 Sucker K-
AK/05/20 BMHP Pcs BMHP 10 765000 0 765000 8415000
2 ARTANO, 13:43:21.1 Suction BLU.FAR/548
18
PT 4 Tube 20Fr 5/2018
026/PB/F
AK/05/20 BMHP Pcs BMHP 10 720000 0 720000 7920000
18
PT 4 Tube 9Fr 5/2018
Canula
PERMATA 08/05/201 BN.01.01/PP
026/PB/F Venouse
101 BUNDA 8 K-
AK/05/20 BMHP VC2 Pcs BMHP 10 810000 0 810000 8910000
4 ARTANO, 13:43:21.1 BLU.FAR/548
18 34/48FR
PT 4 5/2018
Two Stage
5 BUNDA AK/05/20 8 Venous K-
Bengkok
18 No.22
PT 4 5/2018
67322
026/PB/F
101 BUNDA 8 Venous K-
AK/05/20 BMHP Buah BMHP 8 882000 0 705600 7761600
6 ARTANO, 13:43:21.1 Bengkok BLU.FAR/548
18
PT 4 No.28 CVB. 5/2018
Canula
PERMATA 08/05/201 BN.01.01/PP
026/PB/F Aortic
101 BUNDA 8 K-
AK/05/20 BMHP NO.22Fr Buah BMHP 4 684000 0 273600 3009600
7 ARTANO, 13:43:21.1 BLU.FAR/548
18 Flexi
PT 4 5/2018
Cat.70422
Canula
PERMATA 08/05/201 BN.01.01/PP
027/PB/F Venous
101 BUNDA 8 K-
AK/05/20 BMHP Bengkok Buah BMHP 8 882000 0 705600 7761600
8 ARTANO, 11:15:33.3 BLU.FAR/548
18 No.31
PT 3 6/2018
66331
Cardiovasc
PERMATA 08/05/201 BN.01.01/PP
027/PB/F ular Patch
101 BUNDA 8 K-
AK/05/20 BMHP 50mm x Buah BMHP 1 6630000 0 663000 7293000
9 ARTANO, 11:15:33.3 BLU.FAR/548
18 75mm x
PT 3 6/2018
0,6mm
027/PB/F
102 BUNDA 8 Punch K-
AK/05/20 BMHP Pcs BMHP 8 882000 0 705600 7761600
0 ARTANO, 11:15:33.3 4,0mm BLU.FAR/548
18
PT 3 Med 6/2018
PERMATA 08/05/201 BN.01.01/PP
027/PB/F
102 BUNDA 8 Blower / K-
AK/05/20 BMHP Pcs BMHP 7 1350000 0 945000 10395000
1 ARTANO, 11:15:33.3 Mister Kit BLU.FAR/548
18
PT 3 6/2018
102 JAYA INV/SJA/1 8 Circuit 3738636.3 41125000. K-
BMHP Set BMHP 235 159090.91 0
2 ALKESIND 8/V/0233 16:31:51.5 Adult Set 85 23 BLU.FAR/548
102 SUKSES INV/SJA/1 09/05/201 BMHP KERTAS P c s BMHP 20 250000 0 500000 5500000 BN.01.01/PP
3 JAYA 8/V/0239 8 ECG K-
ALKESIND 11:52:22.6 210MMX2 BLU.FAR/548
O. PT 9 95MMX15 8/2018
05H
MARQUET
TE
TIRTA 08/05/201 BN.01.01/PP
Blood Bag
102 MEDICAL 5169/FP/1 8 19500002. K-
BMHP Singel Pcs BMHP 500 35454.55 0 1772727.5
4 INDONESI 8 14:43:59.4 5 BLU.FAR/549
350ml
A,PT 76 0/2018
TIRTA 14/05/201 BN.01.01/PP
102 MEDICAL 5244/FP/1 8 Compolab K-
BMHP Test BMHP LAB 1500 8150.4 0 1222560 13448160
5 INDONESI 8 09:34:50.2 Cuvette BLU.Far/549
A,PT 7 0/2018
BN.01.01/PP
SURGIKA ETT
102 23/05/201 K-
ALKESIND IRE00312 BMHP UNCUFFED P c s BMHP 5 14250 0 7125 78375
6 8 11:00:00 BLU.FAR/549
O, PT NO.2
2/2018
JACKSON BN.01.01/PP
SURGIKA
102 23/05/201 REEVES K-
ALKESIND IRE00312 BMHP Pcs BMHP 2 225000 0 45000 495000
7 8 11:00:00 MODIFIED BLU.FAR/549
O, PT
PED 2/2018
CORRUGA
TED BN.01.01/PP
SURGIKA
102 23/05/201 TUBING Y K-
8 8 11:00:00 CON.PED BLU.FAR/549
O, PT
U/JACKSO 2/2018
N
Guide Wire
0.038
102 NIUMINDO 0075/RS/F 8 K-
BMHP 150cm Pcs BMHP 100 165000 0 1650000 18150000
9 SELARAS, /1/2018 13:44:42.1 BLU.FAR/55/
IQ38F150J
PT 66 2018
3
MUlti
Function
103 NIUMINDO 0075/RS/F 8 16590909. 1659090.9 K-
BMHP Occuleder P c s BMHP 1 0 18250000
0 SELARAS, /1/2018 13:44:42.1 09 09 BLU.FAR/55/
/ MFO
PT 66 2018
No.7-5
0745/HMI
103 MEDIK 8 Goldline 38447399. K-
/KWI/V/1 BMHP Buah BMHP 300 116507.27 0 3495218.1
1 INDONESI 10:30:05.8 Pencil + tip 1 BLU.FAR/554
8
103 HOSPI 0745/HMI 18/05/201 BMHP Surefit Pcs BMHP 100 84075.45 0 840754.5 9248299.5 BN.01.01/PP
MEDIK 8 K-
/KWI/V/1
2 INDONESI 10:30:05.8 Cable BLU.FAR/554
8
A. PT 06 1/2018
DIMAS 09/05/201 BN.01.01/PP
HEARING
103 ANDALAS D1805- 8 6999999.9 K-
BMHP AMPLIFIE Unit BMHP 14 454545.45 0 636363.63
3 MAKMUR. 00376 11:55:31.8 3 BLU.FAR/555
R HA 20
PT 13 8/2018
DIMAS 09/05/201 BN.01.01/PP
103 ANDALAS D1805- 8 Kaca Mata K-
BMHP Buah BMHP 200 34850 0 697000 7667000
4 MAKMUR. 00376 11:55:31.8 Clear BLU.FAR/555
PT 13 8/2018
Cauter /
DIMAS 09/05/201 BN.01.01/PP
Dispo
103 ANDALAS D1805- 8 K-
BMHP Hanswith P c s BMHP 50 160656 0 803280 8836080
5 MAKMUR. 00377 12:01:12.4 BLU.FAR/555
Pencil (E-
PT 73 8/2018
2515)
103 ANDALAS D1805- 8 Pencil with 19999999. K-
BMHP Buah BMHP 200 90909.09 0 1818181.8
6 MAKMUR. 00377 12:01:12.4 Holster 8 BLU.FAR/555
PT 73 VL2610 8/2018
DIMAS 09/05/201 Tip BN.01.01/PP
103 ANDALAS D1805- 8 Cleaner K-
BMHP Pcs BMHP 50 52000 0 260000 2860000
7 MAKMUR. 00377 12:01:12.4 For BLU.FAR/555
PT 73 Elec,Disp 8/2018
09/05/201 BN.01.01/PP
SURGIKA Mouth
103 8 K-
ALKESIND IRE00317 BMHP Piece,180c P c s BMHP 100 19875 0 198750 2186250
8 12:02:18.2 BLU.FAR/555
O, PT m Tubing
76 9/2018
09/05/201 BN.01.01/PP
SURGIKA
103 8 Tracheos K-
9 12:02:18.2 Filter BLU.FAR/555
O, PT
76 9/2018
09/05/201 Thoracic BN.01.01/PP
ALEXA
104 FM/18/09 8 Trocar & K-
MEDIKA, BMHP Pcs BMHP 10 118463 0 118463 1303093
0 37 15:34:54.7 Cannula BLU.FAR/556
PT
06 CH 16 0/2018
104 ALEXA FM/18/09 09/05/201 BMHP THORACIC P c s BMHP 10 118463 0 118463 1303093 BN.01.01/PP
1 MEDIKA, 37 8 TROCAR & K-
PT 15:34:54.7 CANNULA BLU.FAR/556
06 CH 20 0/2018
09/05/201 THORACIC BN.01.01/PP
ALEXA
104 FM/18/09 8 TROCAR & K-
2 37 15:34:54.7 CANNULA BLU.FAR/556
PT
06 CH 28 0/2018
IDS F&P RT124
09/01/201 BN.01.01/PP
MEDICAL CIRC.W/
104 8 K-
SYSTEM 0129288 BMHP nCAP Set BMHP 10 2090000 0 2090000 22990000
3 13:20:04.4 BLU.FAR/56/
INDONESI GENERAT
73 2018
A PT OSLE1000
ANUGERA
H 14/05/201 BN.01.01/PP
104 PHARMIN 22124849 8 Nylon Tape K-
BMHP Sacchet BMHP 48 35325 0 169560 1865160
4 DO 47 13:38:33.7 W275 BLU.FAR/568
LESTARI, 93 6/2018
PT
ANUGERA
H 14/05/201 BN.01.01/PP
Mersilk
104 PHARMIN 22124849 8 K-
BMHP No.1 W215 Sacchet BMHP 36 60450 0 217620 2393820
5 DO 66 13:44:59.5 BLU.FAR/568
(13x60cm)
LESTARI, 7 6/2018
PT
ANUGERA
H 21/05/201 BN.01.01/PP
104 PHARMIN 22124884 8 Nylon Tape K-
6 DO 90 12:12:26.1 W275 BLU.Far/568
LESTARI, 76 6/2018
PT
11/05/201 BN.01.01/PP
Botol
104 BRATACO. IVMDN180 8 K-
BMHP Plastik 1 Buah BMHP 1000 3181.82 0 318182 3500002
7 PT 2848 10:54:13.4 BLU.Far/568
Liter
73 7/2018
11/05/201 BN.01.01/PP
Botol
104 BRATACO. IVMDN180 8 K-
BMHP Plastik 100 Buah BMHP 3000 1000 0 300000 3300000
8 PT 2848 10:54:13.4 BLU.Far/568
cc
73 7/2018
104 BRATACO. IVMDN180 11/05/201 BMHP Botol Pcs BMHP 200 727.27 0 14545.4 159999.4 BN.01.01/PP
9 PT 2848 8 Plastik K-
10:54:13.4 Uk.30cc BLU.Far/568
73 7/2018
INTERGRA
STA
105 JP 8 y Sponges K-
ARTHA BMHP Buah BMHP 250 19160 0 479000 5269000
0 18001369 15:04:42.2 X Ray 35 X BLU.FAR/569
NUSANTA
96 35CM 1/2018
RA.PT
16/05/201 BN.01.01/PP
STA Ind For
105 JP 8 1156599.9 12722599. K-
ARTHA BMHP Steam- Roll BMHP 24 481916.66 0
1 18001369 15:04:42.2 84 82 BLU.FAR/569
NUSANTA 240-
96 1/2018
RA.PT 872ENS
Label
INTERGRA
16/05/201 Green BN.01.01/PP
STA
105 JP 8 Proses For 578299.99 6361299.9 K-
ARTHA BMHP Pcs BMHP 12 481916.66 0
2 18001417 15:50:09.7 Plasma- 2 12 BLU.FAR/569
NUSANTA
2 244- 1/2018
RA.PT
871ENS
INTERGRA Mini Bio
16/05/201 BN.01.01/PP
STA Plus-
105 JP 8 K-
ARTHA BMHP Sterotherm Ampul BMHP 5 1587600 0 793800 8731800
3 18001417 15:50:09.7 BLU.FAR/569
NUSANTA ophilus
2 1/2018
RA.PT 327-601
INTERGRA
16/05/201 BN.01.01/PP
STA Test Tube
105 JP 8 K-
ARTHA BMHP Plastik Tube BMHP 500 500 0 25000 275000
4 18001417 15:50:09.7 BLU.FAR/569
NUSANTA 12x75
2 1/2018
RA.PT
Singel Use
IDS
11/05/201 Flow BN.01.01/PP
MEDICAL
105 8 Sensor for K-
SYSTEM 0145367 BMHP Pcs BMHP 10 1149500 0 1149500 12644500
5 16:57:23.6 SLE BLU.FAR/569
INDONESI
9 4000/500 2/2018
A PT
0
IDS Nasal Mask
11/05/201 BN.01.01/PP
MEDICAL Size S
105 8 K-
SYSTEM 0145367 BMHP nCPAP Pcs BMHP 10 522500 0 522500 5747500
6 16:57:23.6 BLU.FAR/569
INDONESI GeneratorS
9 2/2018
A PT LE1000
105 IDS 0145367 11/05/201 BMHP Nasal Mask P c s BMHP 10 522500 0 522500 5747500 BN.01.01/PP
MEDICAL Size M
8 K-
SYSTEM nCPAP
7 16:57:23.6 BLU.FAR/569
INDONESI GeneratorS
9 2/2018
A PT LE1000
IDS Nasal Mask
11/05/201 BN.01.01/PP
MEDICAL Size L
105 8 K-
SYSTEM 0145367 BMHP nCPAP Pcs BMHP 10 522500 0 522500 5747500
8 16:57:23.6 BLU.FAR/569
INDONESI GeneratorS
9 2/2018
A PT LE1000
Kertas ECG
SUKSES 14/05/201 BN.01.01/PP
Bionet,
105 JAYA INV/SJA/1 8 K-
BMHP Cardiocare Roll BMHP 50 88182 0 440910 4850010
9 ALKESIND 8/V/0246 09:17:45.7 BLU.FAR/569
215mmx2
O. PT 5 3/2018
5m
SUKSES 14/05/201 Kertas EKG BN.01.01/PP
106 JAYA INV/SJA/1 8 3 Channel K-
BMHP Roll BMHP 30 56000 0 168000 1848000
0 ALKESIND 8/V/0246 09:17:45.7 63 mm x BLU.FAR/569
O. PT 5 30 m 3/2018
ANUGERA
09/01/201 BOTOL BN.01.01/PP
H
106 60/AMN/I 8 HANDSOA K-
MANDIRI BMHP Botol BMHP 1512 9000 0 1360800 14968800
1 /2018 09:05:14.9 P/HANDR BLU.FAR/57/
INTERASIA
2 UB 500ml 2018
, PT
ANUGERA Tutup
09/01/201 BN.01.01/PP
H Botol
106 60/AMN/I 8 K-
MANDIRI BMHP Pump Buah BMHP 200 3750 0 75000 825000
2 /2018 09:05:14.9 BLU.FAR/57/
INTERASIA Handscrub
2 2018
, PT 500ml
ANUGERA
09/01/201 BN.01.01/PP
H Plastik
106 60/AMN/I 8 K-
MANDIRI BMHP Assoy Kg BMHP 10 31050 0 31050 341550
3 /2018 09:05:14.9 BLU.FAR/57/
2 2018
, PT
ANUGERA
09/01/201 BN.01.01/PP
H Plastik
106 60/AMN/I 8 K-
4 /2018 09:05:14.9 BLU.FAR/57/
2 2018
, PT
106 ANUGERA 60/AMN/I 09/01/201 BMHP Plastik Kg BMHP 11 31050 0 34155 375705 BN.01.01/PP
H
8 K-
MANDIRI Assoy
5 /2018 09:05:14.9 BLU.FAR/57/
2 2018
, PT
ANUGERA
09/01/201 BN.01.01/PP
H Plastik
106 60/AMN/I 8 K-
MANDIRI BMHP Obat Uk 8 Kg BMHP 12 35000 0 42000 462000
6 /2018 09:05:14.9 BLU.FAR/57/
INTERASIA x 13
2 2018
, PT
ANUGERA
09/01/201 BN.01.01/PP
H Plastik
106 60/AMN/I 8 K-
7 /2018 09:05:14.9 BLU.FAR/57/
INTERASIA x 17
2 2018
, PT
ANUGERA
09/01/201 BN.01.01/PP
H Plastik
106 60/AMN/I 8 K-
8 /2018 09:05:14.9 BLU.FAR/57/
INTERASIA x7
2 2018
, PT
CE
Bioprothes
BMHP is Valve Pcs BMHP 1 37000000 0 3700000 40700000
9 SELARAS, /5/2018 11:38:21.2 BLU.FAR/570
Mitral
PT 33 3/2018
33mm
Cera ASD
107 NIUMINDO 0080/RS/F 8 24454545. 2445454.5 K-
0 SELARAS, /5/2018 16:45:39.5 45 45 BLU.FAR/574
No.30
PT 9 4/2018
SIZING
107 NIUMINDO 0080/RS/F 8 4545455.4 454545.54 5000000.9 K-
BMHP BALLON Buah BMHP 1 0
1 SELARAS, /5/2018 16:45:39.5 5 5 95 BLU.FAR/574
24
PT 9 4/2018
SIZING
107 NIUMINDO 0080/RS/F 8 4545454.5 454545.45 5000000.0 K-
BMHP BALLON Buah BMHP 1 0
2 SELARAS, /5/2018 16:45:39.5 5 5 05 BLU.FAR/574
34
PT 9 4/2018
107 REKAMILE 0080/RS/F 15/05/201 BMHP Sequare P c s BMHP 1 5102040.9 0 510204.09 5612245.0 BN.01.01/PP
3 NIUMINDO /5/2018 8 TM Snare 1 1 01 K-
SELARAS, 16:45:39.5 Set 6Fr- BLU.FAR/574
PT 9 25mm 4/2018
IDS PT. 84
16/05/201 BN.01.01/PP
MEDICAL (Bulk Pack
107 8 163090.92 1794000.2 K-
SYSTEM 0145733 BMHP w/ Pcs BMHP 52 31363.64 0
4 15:52:51.1 8 08 BLU.FAR/574
INDONESI Box&Label
06 5/2018
A PT )
CITRA IOL BN.01.01/PP
107 MEDICA 54/CMI/V/ 25/05/201 FORDABEL K-
BMHP Buku BMHP 1 770000 0 77000 847000
5 INDONESI 2018 8 13:27:00 NASPRO BLU.FAR/574
A, CV 19 8/2018
CITRA Iol BN.01.01/PP
107 MEDICA 54/CMI/V/ 25/05/201 Fordabel K-
BMHP Pcs BMHP 1 770000 0 77000 847000
6 INDONESI 2018 8 13:27:00 Naspro BLU.FAR/574
A, CV 20,0 8/2018
BMHP Buah BMHP 1 770000 0 77000 847000
A, CV 21,0 8/2018
BMHP Buah BMHP 1 770000 0 77000 847000
A, CV 21,5 8/2018
BMHP Pcs BMHP 1 770000 0 77000 847000
9 INDONESI 2018 8 13:27:00 Naspro 22 BLU.FAR/574
A, CV D 8/2018
108 MEDICA 54/CMI/V/ 25/05/201 FORDABEL K-
BMHP Buah BMHP 1 770000 0 77000 847000
0 INDONESI 2018 8 13:27:00 NASPRO BLU.FAR/574
A, CV 22,5 8/2018
BMHP Pcs BMHP 3 770000 0 231000 2541000
A, CV 23,0 8/2018
CITRA IOl BN.01.01/PP
BMHP Buah BMHP 1 770000 0 77000 847000
A, CV 23,5 8/2018
108 CITRA 54/CMI/V/25/05/201 BMHP Iol Pcs BMHP 1 770000 0 77000 847000 BN.01.01/PP
MEDICA K-
Fordabel
3 INDONESI 2018 8 13:27:00 BLU.FAR/574
Naspro 25
A, CV 8/2018
CITRA BN.01.01/PP
Appavisc
108 MEDICA 54/CMI/V/ 25/05/201 K-
BMHP HV PFS Pcs BMHP 10 130000 0 130000 1430000
4 INDONESI 2018 8 13:27:00 BLU.FAR/574
2ml
A, CV 8/2018
CITRA BN.01.01/PP
108 MEDICA 54/CMI/V/ 25/05/201 Appavisc K-
BMHP Pcs BMHP 10 105000 0 105000 1155000
5 INDONESI 2018 8 13:27:00 PFS 3 ml BLU.FAR/574
A, CV 8/2018
Cohevisc
CITRA BN.01.01/PP
1.4ml
108 MEDICA 54/CMI/V/ 25/05/201 K-
BMHP (Sodium P c s BMHP 10 306000 0 306000 3366000
6 INDONESI 2018 8 13:27:00 BLU.FAR/574
Hyaluronat
A, CV 8/2018
e)
CITRA BN.01.01/PP
Couter Pen
108 MEDICA 54/CMI/V/ 25/05/201 K-
BMHP Bovie Pcs BMHP 5 409000 0 204500 2249500
7 INDONESI 2018 8 13:27:00 BLU.FAR/574
Aaron
A, CV 8/2018
CITRA Cressent BN.01.01/PP
108 MEDICA 54/CMI/V/ 25/05/201 Knives App K-
BMHP Pcs BMHP 10 115000 0 115000 1265000
8 INDONESI 2018 8 13:27:00 2,1mm BLU.FAR/574
A, CV 561021 8/2018
Stab
CITRA BN.01.01/PP
Knives
108 MEDICA 54/CMI/V/ 25/05/201 K-
BMHP Sharpoint P c s BMHP 12 115000 0 138000 1518000
9 INDONESI 2018 8 13:27:00 BLU.FAR/574
15- 72-
A, CV 8/2018
1501
CITRA BN.01.01/PP
109 MEDICA 54/CMI/V/ 25/05/201 Slit Knife K-
BMHP Pcs BMHP 12 115000 0 138000 1518000
0 INDONESI 2018 8 13:27:00 2,75 BLU.FAR/574
A, CV 8/2018
KERTAS
109 JAYA INV/SJA/1 8 MARQUET K-
BMHP Pcs BMHP 5 412000 0 206000 2266000
1 ALKESIND 8/V/0253 10:43:30.3 TE BLU.FAR/581
O. PT 1 215X280X 0/2018
300SH
16/05/201 BN.01.01/PP
109 FAJAR MAS 8 Unicassett K-
LBI-06116 BMHP Pcs BMHP 3000 3000 0 900000 9900000
2 MURNI. PT 11:06:40.9 e BLU.FAR/581
66 1/2018
16/05/201 BN.01.01/PP
KASIH
109 04/KTJ/V/ 8 Aqua Non K-
THREEBER BMHP Galon BMHP 150 8500 0 127500 1402500
3 2018 12:21:42.6 Steril BLU.FAR/581
S JAYA. PT
93 2/2018
MILLENNI
UM Bioglue
16/05/201 BN.01.01/PP
PHARMAC 23061800 Pre-Filled
109 8 K-
ON 120 / BMHP Syr 5ml Syringe BMHP 5 7653750 0 3826875 42095625
4 13:41:29.5 BLU.FAR/581
INTERNAT 18477 SURG.ADH
03 3/2018
IONAL ESIVE
TBK, PT
CAHAYA 17/05/201 Guide Wire BN.01.01/PP
109 DUA 0049/CDD 8 S.0,035/45 K-
ALKES Pcs ALKES 2 2011625 0 402325 4425575
5 DELAPAN. /V/2018 15:22:31.4 0cm BLU.FAR/585
PT 33 straight tip 2/2018
Tri-Tome
CAHAYA 17/05/201 BN.01.01/PP
Protector
109 DUA 0049/CDD 8 K-
BMHP Lumen Buah BMHP 1 2873750 0 287375 3161125
6 DELAPAN. /V/2018 15:22:31.4 BLU.FAR/585
Sphinctero
PT 33 2/2018
tome
Cotton-
109 DUA 0049/CDD 8 Billiary K-
BMHP Pcs BMHP 10 1143500 0 1143500 12578500
7 DELAPAN. /V/2018 15:22:31.4 Stent BLU.FAR/585
PT 33 Only,10Fr, 2/2018
9c
Pusher-
CAHAYA 17/05/201 Naviflex BN.01.01/PP
109 DUA 0049/CDD 8 RX K-
BMHP Pcs BMHP 2 1980000 0 396000 4356000
8 DELAPAN. /V/2018 15:22:31.4 Delivery BLU.FAR/585
PT 33 system 2/2018
10Fr
109 AKARIM 18/AJF/V/ 22/05/201 BMHP Bola Buah BMHP 10 141500 0 141500 1556500 BN.01.01/PP
9 JAYA 537 8 Lampu K-
FARMA.PT 13:13:59.7 Laringosco BLU.FAR/585
36 pe Anak 4/2018
22/05/201 Bola BN.01.01/PP
AKARIM
110 18/AJF/V/ 8 Lampu K-
JAYA BMHP Buah BMHP 8 141500 0 113200 1245200
0 537 13:13:59.7 Laryngosc BLU.FAR/585
FARMA.PT
36 ope Adult 4/2018
22/05/201 BN.01.01/PP
AKARIM
110 18/AJF/V/ 8 Nelaton K-
1 537 13:13:59.7 No.24 Rusc BLU.FAR/585
FARMA.PT
36 4/2018
22/05/201 BN.01.01/PP
AKARIM
110 18/AJF/V/ 8 KEER T. K-
JAYA BMHP Pcs BMHP 3 347000 0 104100 1145100
2 537 13:13:59.7 Tube No.4 BLU.FAR/585
FARMA.PT
36 4/2018
22/05/201 BN.01.01/PP
AKARIM
110 18/AJF/V/ 8 Keer T. K-
3 537 13:13:59.7 Tube No. 5 BLU.FAR/585
FARMA.PT
36 4/2018
22/05/201 BN.01.01/PP
AKARIM
110 18/AJF/V/ 8 Kerr T. K-
4 537 13:13:59.7 Tube No. 6 BLU.FAR/585
FARMA.PT
36 4/2018
22/05/201 HD Double BN.01.01/PP
AKARIM
110 18/AJF/V/ 8 Lumen K-
5 537 13:13:59.7 8,5Fr 16cm BLU.FAR/585
FARMA.PT
36 FR2965 4/2018
Dispos
22/05/201 BN.01.01/PP
AKARIM Singel
110 18/AJF/V/ 8 K-
JAYA BMHP Filter Pcs BMHP 1000 5950 0 595000 6545000
6 537 13:13:59.7 BLU.FAR/585
FARMA.PT 100%/PK
36 4/2018
08800
DIPA 17/05/201 BN.01.01/PP
110 PUSPA 0718.FP- 8 Petri Dish K-
BMHP Buah BMHP 3000 1820 0 546000 6006000
7 LABSAINS. 100585 15:26:07.0 3Vent BLU.FAR/585
PT 6 5/2018
DIPA 17/05/201 BN.01.01/PP
Xylene,BA
110 PUSPA 0718.FP- 8 1050266.2 525133.12 5776464.3 K-
BMHP R, ACS Botol BMHP LAB 5 0
8 LABSAINS. 100585 15:26:07.0 5 5 75 BLU.FAR/585
Reagent
PT 6 5/2018
110 DIPA 0718.FP- 17/05/201 BMHP Mac Kit BMHP LAB 10 874225 0 874225 9616475 BN.01.01/PP
PUSPA 8 K-
Conkey
9 LABSAINS. 100585 15:26:07.0 BLU.FAR/585
Agar No,3
PT 6 5/2018
DIPA 17/05/201 BN.01.01/PP
Columbia
111 PUSPA 0718.FP- 8 K-
BMHP Blood Agar Pack BMHP LAB 10 1403903 0 1403903 15442933
0 LABSAINS. 100585 15:26:07.0 BLU.FAR/585
Base 500gr
PT 6 5/2018
MEGA INTI 17/05/201 BN.01.01/PP
Pigtail
111 MAKMUR 8 K-
064 BMHP Drain Cath. P c s BMHP 20 1330000 0 2660000 29260000
1 MEDIKA. 15:04:17.6 BLU.FAR/585
12Fr-30cm
PT 4 6/2018
067/PB/F
111 BUNDA 8 Mitral Size K-
AK/05/20 BMHP Buah BMHP 1 15750000 0 1575000 17325000
2 ARTANO, 13:38:46.7 31mm - BLU.FAR/588
18
PT 9 753661 9/2018
Slide
BN.01.01/PP
BIOGEN Microscop
111 S118/0097 24/05/201 5790383.2 K-
SCIENTIFI BMHP e Pcs BMHP 720 7311.09 0 526398.48
3 1 8 13:32:00 8 BLU.FAR/598
C. PT Superfrost
6/2018
72s
Pisau BN.01.01/PP
BIOGEN
111 S118/0097 24/05/201 Microtome K-
SCIENTIFI BMHP Pcs BMHP 300 32064 0 961920 10581120
4 1 8 13:32:00 disp.blades BLU.FAR/598
C. PT
819 6/2018
BN.01.01/PP
BIOGEN Parafin -
111 S118/0097 24/05/201 K-
SCIENTIFI BMHP Paraplast P c s BMHP 5 120000 0 60000 660000
5 1 8 13:32:00 BLU.FAR/598
C. PT 1kg
6/2018
Papanicolo BN.01.01/PP
BIOGEN
111 S118/0097 24/05/201 us K-
SCIENTIFI BMHP Btl/500 BMHP 1 329600 0 32960 362560
6 1 8 13:32:00 Hematoxyl BLU.FAR/598
C. PT
in 500ml 6/2018
BN.01.01/PP
BIOGEN Papanicolo
111 S118/0097 24/05/201 K-
SCIENTIFI BMHP us EA-50 Btl/500ml BMHP 1 231200 0 23120 254320
7 1 8 13:32:00 BLU.FAR/598
C. PT 500ml
6/2018
111 BIOGEN S118/0097 24/05/201 BMHP Papanicolo Btl/500ml BMHP 1 264000 0 26400 290400 BN.01.01/PP
8 SCIENTIFI 1 8 13:32:00 us Orange K-
C. PT G-6 500ml BLU.FAR/598
6/2018
PERMATA 21/05/201 BN.01.01/PP
068/PB/F
AK/05/20 BMHP Pcs BMHP 3 1350000 0 405000 4455000
18
PT 4 8/2018
CANULA
PERMATA 21/05/201 BN.01.01/PP
068/PB/F ORTIC
112 BUNDA 8 K-
0 ARTANO, 14:06:30.5 BLU.FAR/598
18 NO.24
PT 4 8/2018
cat.70424
CANULA
PERMATA 21/05/201 BN.01.01/PP
068/PB/F AORTIC
112 BUNDA 8 K-
AK/05/20 BMHP PERF Pcs BMHP 2 684000 0 136800 1504800
1 ARTANO, 14:06:30.5 BLU.FAR/598
18 NO.22FR
PT 4 8/2018
70422
068/PB/F
AK/05/20 BMHP Buah BMHP 2 882000 0 176400 1940400
18
PT 4 No.28 CVB. 8/2018
068/PB/F
AK/05/20 BMHP Pcs BMHP 8 630000 0 504000 5544000
18
PT 4 WVL 9Fr 8/2018
BN.01.01/PP
112 BRATACO. IVMDG180 23/05/201 1172727.2 12899999. K-
BMHP Alkohol 96 Gln/20ltr BMHP 30 390909.09 0
4 PT 0557 8 14:19:00 7 97 BLU.FAR/611
7/2018
MILLENNI
UM
30/05/201 BN.01.01/PP
PHARMAC Septalkan
112 23061800 8 K-
ON BMHP Pack 100 Pack BMHP 50 220500 0 1102500 12127500
5 0125 14:58:02.4 BLU.FAR/612
INTERNAT Wipes
66 2/2018
IONAL
TBK, PT
112 MILLENNI 23061800 30/05/201 BMHP Septalkan Botol BMHP 100 256950 0 2569500 28264500 BN.01.01/PP
6 UM 0125 8 Spray K-
PHARMAC 14:58:02.4 750ml BLU.FAR/612
ON 66 2/2018
INTERNAT
IONAL
TBK, PT
MENSA 28/05/201 BN.01.01/PP
Blood Bag
112 BINA CD194004 8 K-
BMHP Triple 350 Buah BMHP 300 62181.9 0 1865457 20520027
7 SUKSES, 953 16:21:41.7 BLU.FAR/612
ml
PT 23 3/2018
MENSA 28/05/201 BN.01.01/PP
Blood Bag
112 BINA CD194004 8 K-
BMHP Singel 350 P c s BMHP 500 32270 0 1613500 17748500
8 SUKSES, 953 16:21:41.7 BLU.FAR/612
ml
PT 23 3/2018
TRANSME BN.01.01/PP
28/05/201 Katub
112 DIC K-
IN1803036 8 BMHP Mitral Pcs BMHP 1 15100000 0 1510000 16610000
9 INDONESI BLU.FAR/613
15:45:29.2 No.33mm
A. PT 2/2018
TRANSME BN.01.01/PP
31/05/201 Katub
113 DIC K-
IN1803165 8 BMHP Mitral Buah BMHP 1 15100000 0 1510000 16610000
16:46:57.8 No.31mm
A. PT 2/2018
TRANSME BN.01.01/PP
31/05/201 Katub
113 DIC K-
16:46:57.8 No.33mm
A. PT 2/2018
PLEDGET
ANUGERA 31/05/201 BN.01.01/PP
3x3x1,85M
113 H ARGON 12180032 8 K-
BMHP M/PTFE P c s BMHP 36 233600 0 840960 9250560
2 MEDICA, 059 12:43:13.3 BLU.FAR/613
POLYMER
PT 33 3/2018
PLEDGETS
MILLENNI
UM PerClot
28/05/201 BN.01.01/PP
PHARMAC Polysaccari
113 23061800 8 K-
ON BMHP de Sacchet BMHP 5 3334500 0 1667250 18339750
3 0124 13:52:48.3 BLU.FAR/613
INTERNAT Haemost
43 5/2018
IONAL Syst 3Gr
TBK, PT
113 MILLENNI 13061802 28/05/201 BMHP Wrap PPR Lembar BMHP 1875 10524.8 0 1973400 21707400 BN.01.01/PP
4 UM 0891 8 SMS K-
PHARMAC 15:35:51.5 120X120c BLU.FAR/613
ON 06 m (125) 5/2018
INTERNAT
IONAL
TBK, PT
ANDRA
113 APJ/INV/1 8 Canister + K-
PRIMA BMHP Set BMHP 30 1400000 0 4200000 46200000
5 8/V/734 13:31:49.3 Tubing BLU.FAR/613
JAYA. PT
56 System 8/2018
INTERGRA
30/05/201 BN.01.01/PP
STA Test Tube
113 JP 8 K-
6 18001489 11:42:26.6 BLU.FAR/620
NUSANTA 12x75
1 9/2018
RA.PT
Singel Use
IDS
31/05/201 Flow BN.01.01/PP
MEDICAL
113 8 Sensor for K-
7 12:28:46.4 SLE BLU.FAR/621
INDONESI
86 4000/500 2/2018
A PT
0
Reusable
IDS
31/05/201 Flow BN.01.01/PP
MEDICAL
113 8 Sensor for K-
SYSTEM 0147229 BMHP Buah BMHP 2 6840000 0 1368000 15048000
8 12:28:46.4 SLE BLU.FAR/621
INDONESI
86 4000/500 2/2018
A PT
0
MILLENNI
UM Bioglue
30/05/201 BN.01.01/PP
PHARMAC Pre-Filled
113 23061800 8 K-
ON BMHP Syr 5ml Syringe BMHP 5 7653750 0 3826875 42095625
9 0140 11:39:40.5 BLU.FAR/632
INTERNAT SURG.ADH
9 4/2018
IONAL ESIVE
TBK, PT
PERMATA 30/05/201 BN.01.01/PP
119/PB/F CARDIOPL
114 BUNDA 8 K-
AK/05/20 BMHP EGIA SET S e t BMHP 15 1600000 0 2400000 26400000
0 ARTANO, 13:40:05.0 BLU.FAR/632
18 ADULT
PT 16 5/2018
PERMATA 30/05/201 BN.01.01/PP
119/PB/F Hemoconc
114 BUNDA 8 K-
AK/05/20 BMHP entrator S e t BMHP 7 1800000 0 1260000 13860000
1 ARTANO, 13:40:05.0 BLU.FAR/632
18 for Adult
PT 16 5/2018
r Affnity
BUNDA 8 K-
AK/05/20 Fusion
2 ARTANO, 13:32:33.8 BLU.FAR/632
18 Complete
PT 26 6/2018
Adult
118/PB/F
AK/05/20 BMHP Pcs BMHP 10 765000 0 765000 8415000
18
PT 26 Tube 20Fr 6/2018
118/PB/F
AK/05/20 BMHP Pcs BMHP 10 720000 0 720000 7920000
18
PT 26 Tube 9Fr 6/2018
ENSEVAL
05/06/201 BN.01.01/PP
PUTERA Extended
114 31800334 8 159665.45 1756320.0 K-
MEGATRA BMHP Life Pd Buah BMHP 8 199581.82 0
5 4 11:40:27.4 6 16 BLU.FAR/632
DING TBK, Transfer
63 8/2018
PT
ENSEVAL
05/06/201 BN.01.01/PP
PUTERA
114 31800334 8 K-
MEGATRA BMHP Tenckoff Pcs BMHP 2 755000 0 151000 1661000
6 4 11:40:27.4 BLU.FAR/632
DING TBK,
63 8/2018
PT
ENSEVAL
05/06/201 BN.01.01/PP
PUTERA
114 31800334 8 Titanium K-
MEGATRA BMHP Pcs BMHP 2 720000 0 144000 1584000
7 4 11:40:27.4 Adaptor BLU.FAR/632
DING TBK,
63 8/2018
PT
ENSEVAL
05/06/201 BN.01.01/PP
PUTERA
114 31800334 8 Ultraclamp 120400.01 K-
MEGATRA BMHP Buah BMHP 4 27363.64 0 10945.456
8 4 11:40:27.4 (Red) 6 BLU.FAR/632
DING TBK,
63 8/2018
PT
04/06/201 BN.01.01/PP
Medifix
114 DOS NI 82728782 8 K-
BMHP monomete P c s BMHP 20 219300 0 438600 4824600
9 ROHA, PT 2 10:38:49.3 BLU.FAR/643
r
36 5/2018
115 BISAWI 2865/FKT 04/06/201 BMHP Thoracic Buah BMHP 30 80000 0 240000 2640000 BN.01.01/PP
0 TUMBUH R/BTS/V/ 8 Draig Cath K-
SELARAS. 18 10:09:25.6 No.28 BLU.FAR/648
PT 53 2/2018
BISAWI 04/06/201 BN.01.01/PP
2865/FKT Thoracic
115 TUMBUH 8 K-
R/BTS/V/ BMHP Draig Cath P c s BMHP 15 80000 0 120000 1320000
1 SELARAS. 10:09:25.6 BLU.FAR/648
18 No.32
PT 53 2/2018
2865/FKT
115 TUMBUH 8 Drainage K-
R/BTS/V/ BMHP Pcs BMHP 5 80000 0 40000 440000
2 SELARAS. 10:09:25.6 Straight BLU.FAR/648
18
PT 53 No.16 2/2018
05/06/201 BN.01.01/PP
ALEXA Extention
115 FM/18/11 8 K-
MEDIKA, BMHP Tube Buah BMHP 650 12000 0 780000 8580000
3 74 10:26:54.7 BLU.FAR/648
PT 150cm
1 3/2018
MENSA 04/06/201 BN.01.01/PP
OXYGENAT
115 BINA CD194075 8 49590736. K-
BMHP OR ADULT S e t BMHP 8 5635311 0 4508248.8
4 SUKSES, 329 14:44:10.9 8 BLU.FAR/648
FX25RW40
PT 76 7/2018
115 BINA CD194075 8 Pack / K-
BMHP Pcs BMHP 8 1 0 0.8 8.8
5 SUKSES, 329 14:44:10.9 Blood Line BLU.FAR/648
PT 76 Adult 7/2018
DIAN HD
BN.01.01/PP
LANGGEN DoubLum
115 FK180603 08/06/201 K-
G BMHP Farc 115- S e t BMHP 50 504000 0 2520000 27720000
6 3 8 08:26:00 BLU.FAR/660
PRATAMA. 15(preCur
0/2018
PT ved)
003/PB/F
115 BUNDA 8 System K-
AK/06/20 BMHP Set BMHP 1 30420000 0 3042000 33462000
7 ARTANO, 10:59:23.4 (Octopus+ BLU.FAR/660
18
PERMATA 05/06/201 BN.01.01/PP
003/PB/F
AK/06/20 BMHP Pcs BMHP 5 1350000 0 675000 7425000
18
PT 06 2/2018
003/PB/F
AK/06/20 BMHP Pcs BMHP 10 630000 0 630000 6930000
18
PT 06 WVL 9Fr 2/2018
116 OPAL 1181/OPS 06/06/201 BMHP Film Upp Roll BMHP 50 171818.18 0 859090.9 9449999.9 BN.01.01/PP
PERKASA 8 K-
RADIOLOG
0 SEJAHTER /VI/18 10:35:33.8 110 HG BLU.FAR/660
I
A. PT 23 5/2018
OPAL 06/06/201 BN.01.01/PP
Film UPP-
116 PERKASA 1181/OPS 8 K-
BMHP 84HG Roll BMHP 20 240000 0 480000 5280000
1 SEJAHTER /VI/18 10:35:33.8 BLU.FAR/660
Paper B/W
A. PT 23 5/2018
OPAL 06/06/201 Film BN.01.01/PP
BMHP
116 PERKASA 1181/OPS 8 Drystar K-
BMHP Lembar RADIOLOG 1000 14280 0 1428000 15708000
2 SEJAHTER /VI/18 10:35:33.8 DT28 Uk 8 BLU.FAR/660
I
A. PT 23 x 10 5/2018
Syringe
OPAL 06/06/201 BN.01.01/PP
StellaDual
BMHP 200ml Pcs BMHP 25 488000 0 1220000 13420000
Cat.SDS.CT
A. PT 73 6/2018
P.QFT
Film UPT
OPAL 06/06/201 BN.01.01/PP
517 14x17 BMHP
BMHP Blue Lembar RADIOLOG 625 30712 0 1919500 21114500
Thermal I
A. PT 73 6/2018
(35x43)
TRANSME 06/06/201 BN.01.01/PP
Katub
116 DIC INI180320 8 K-
BMHP Mitral Pcs BMHP 1 15100000 0 1510000 16610000
5 INDONESI 5 13:22:03.9 BLU.FAR/661
No.27mm
A. PT 36 1/2018
TRANSME 06/06/201 BN.01.01/PP
Katub
116 DIC INI180320 8 K-
BMHP Aortic Pcs BMHP 1 15100000 0 1510000 16610000
NO.17mm
A. PT 36 1/2018
116 MA 8 Yell Nephr K-
15781 BMHP Pcs BMHP 20 2098800 0 4197600 46173600
7 LESTARI 13:11:23.4 Punct Set BLU.FAR/664
.PT 93 No.7/34cm 8/2018
06/06/201 Skin BN.01.01/PP
HEXALAB
116 HS.0618- 8 Marker K-
SUMATER BMHP Buah BMHP 15 33000 0 49500 544500
8 00090 14:22:20.4 -Regular BLU.FAR/669
A.PT
7 Tip 1/2018
116 MULTI MML0035 07/06/201 BMHP Rapid Kit BMHP LAB 1 2310000 0 231000 2541000 BN.01.01/PP
9 MEDIKA 35/0618 8 Staining of K-
Blood/He
LABORAT 12:39:25.5 BLU.FAR/669
macolor-
ORY.PT 86 5/2018
3x500
Sterilizatio
PETAN 21/06/201 BN.01.01/PP
682/PDM/ n Agent
117 DAYA 8 2738181.8 30120000. K-
FP/VI/201 BMHP (H2O2) Pcs BMHP 60 456363.64 0
0 MEDICA, 08:45:02.4 4 24 BLU.FAR/669
8 SA10/
PT 6 8/2018
15units
682/PDM/
117 DAYA 8 Indicator K-
FP/VI/201 BMHP Pcs BMHP 500 15181.82 0 759091 8350001
1 MEDICA, 08:45:02.4 Strip BLU.FAR/669
8
PT 6 250ea 8/2018
INTERGRA
STA
2 18001636 15:57:49.3 X Ray 35 X BLU.FAR/675
NUSANTA
06 35CM 8/2018
RA.PT
ANUGERA
H 22/06/201 BN.01.01/PP
117 PHARMIN 22125008 8 Surgicel W K-
3 DO 16 10:52:17.7 1913T BLU.FAR/680
LESTARI, 9 0/2018
PT
IDS Paper for
08/06/201 BN.01.01/PP
MEDICAL Hi-801/HI-
117 8 K-
SYSTEM 0148949 BMHP 105/ Roll BMHP 20 272727 0 545454 5999994
4 15:38:01.5 BLU.FAR/680
INDONESI Thermal
6 0/2018
A PT 112mm
IDS SU Circuit
08/06/201 BN.01.01/PP
MEDICAL w/ Twin
117 8 K-
SYSTEM 0148949 BMHP Spiral Pcs BMHP 15 1030750 0 1546125 17007375
5 15:38:01.5 BLU.FAR/680
INDONESI Heated
6 0/2018
A PT Circ
Singel Use
IDS
08/06/201 Flow BN.01.01/PP
MEDICAL
117 8 Sensor for K-
6 15:38:01.5 SLE BLU.FAR/680
INDONESI
6 4000/500 0/2018
A PT
0
IDS
08/06/201 BN.01.01/PP
MEDICAL BTR 3-
117 8 K-
7 16:13:49.9 BLU.FAR/680
53 0/2018
A PT
PERCUTAN
IDS
08/06/201 EOUS BN.01.01/PP
MEDICAL
117 8 DILATION K-
SYSTEM 0149016 BMHP Kit BMHP 1 4800000 0 480000 5280000
8 16:13:49.9 TRACHEOS BLU.FAR/680
INDONESI
53 TOMY 0/2018
A PT
7.0mm
IDS
HD KIT 2 BN.01.01/PP
MEDICAL
117 08/06/201 LUMEN K-
9 8 16:15:00 8FR X BLU.FAR/680
INDONESI
11CM 0/2018
A PT
ENSEVAL
26/06/201 BN.01.01/PP
PUTERA LABGEO
118 11805307 8 K-
MEGATRA BMHP REAGENT Liter BMHP 1 2200000 0 220000 2420000
0 2 11:32:48.5 BLU.FAR/681
DING TBK, CLEANER
46 1/2018
PT
ENSEVAL
26/06/201 BN.01.01/PP
PUTERA LABGEO
118 11805307 8 K-
MEGATRA BMHP REAGENT Liter BMHP 1 3300000 0 330000 3630000
1 2 11:32:48.5 BLU.FAR/681
DING TBK, LYSE
46 1/2018
PT
ENSEVAL
26/06/201 BN.01.01/PP
PUTERA LABGEO
118 11805307 8 K-
MEGATRA BMHP Reagent Kit BMHP LAB 1 2750000 0 275000 3025000
2 2 11:32:48.5 BLU.FAR/681
DING TBK, Diluent
46 1/2018
PT
IDS F&P RT124
21/06/201 BN.01.01/PP
MEDICAL CIRC.W/
118 8 K-
3 09:51:10.0 BLU.FAR/681
INDONESI GENERAT
33 2/2018
A PT OSLE1000
118 OPAL 1190/OPS 21/06/201 BMHP Film Lembar BMHP 1000 14280 0 1428000 15708000 BN.01.01/PP
4 PERKASA /VI/18 8 Drystar RADIOLOG K-
SEJAHTER 09:49:20.3 DT28 Uk 8 I BLU.FAR/681
A. PT 06 x 10 3/2018
POLYHESI
DIMAS 22/06/201 BN.01.01/PP
VE INFANT
118 ANDALAS D1806- 8 K-
BMHP RETURN P c s BMHP 5 197088 0 98544 1083984
5 MAKMUR. 00441 08:45:37.0 BLU.FAR/681
ELEC
PT 4 4/2018
E7510-25
118 ANDALAS D1806- 8 Pencil with K-
BMHP Buah BMHP 100 90909.09 0 909090.9 9999999.9
6 MAKMUR. 00441 08:45:37.0 Holster BLU.FAR/681
PT 4 VL2610 4/2018
Cauter /
DIMAS 22/06/201 BN.01.01/PP
Dispo
118 ANDALAS D1806- 8 K-
7 MAKMUR. 00441 08:45:37.0 BLU.FAR/681
Pencil (E-
PT 4 4/2018
2515)
DIMAS 22/06/201 Broncocat BN.01.01/PP
118 ANDALAS D1806- 8 h Cath ET K-
BMHP Set BMHP 1 704728 0 70472.8 775200.8
8 MAKMUR. 00441 08:45:37.0 No.39 BLU.FAR/681
PT 4 Right 4/2018
118 ANDALAS D1806- 8 Rem K-
BMHP Buah BMHP 30 401600 0 1204800 13252800
9 MAKMUR. 00441 08:45:37.0 Polyhesive BLU.FAR/681
PT 4 II E7512 4/2018
21/06/201 BN.01.01/PP
Medifix
119 DOS NI 82731073 8 K-
BMHP Line Buah BMHP 275 117300 0 3225750 35483250
0 ROHA, PT 3 14:13:08.0 BLU.FAR/681
100cm
26 5/2018
21/06/201 BN.01.01/PP
Medifix
119 DOS NI 82731073 8 K-
1 ROHA, PT 5 14:17:43.5 BLU.FAR/681
r
33 5/2018
PERMATA 21/06/201 BN.01.01/PP
042/PB/F Hemoconc
119 BUNDA 8 K-
2 ARTANO, 13:40:54.2 BLU.FAR/684
18 for Adult
PT 5 4/2018
3 BUNDA AK/06/20 8 Venous K-
ARTANO, 18 13:40:54.2 Bengkok BLU.FAR/684
PT 5 No.31 4/2018
66331
PERMATA 21/06/201 BN.01.01/PP
041/PB/F CARDIOPL
119 BUNDA 8 K-
4 ARTANO, 13:44:39.4 BLU.FAR/684
18 ADULT
PT 93 5/2018
041/PB/F
AK/06/20 BMHP Set BMHP 1 30420000 0 3042000 33462000
18
Cellebrity
CAHAYA 22/06/201 BN.01.01/PP
Cytology
119 DUA 0061/CDD 8 K-
BMHP Brush Pcs BMHP 20 800000 0 1600000 17600000
6 DELAPAN. /VI/2018 13:14:05.3 BLU.FAR/685
1,5x140
PT 4 0/2018
BX/10
CAHAYA 22/06/201 BN.01.01/PP
Karet
119 DUA 0061/CDD 8 K-
BMHP Ligasi Bks BMHP 2 842625 0 168525 1853775
7 DELAPAN. /VI/2018 13:14:05.3 BLU.FAR/685
Aescu
PT 4 0/2018
0963/HMI
119 MEDIK 8 Goldline 38447399. K-
/KWI/VI/2 BMHP Buah BMHP 300 116507.27 0 3495218.1
8 INDONESI 13:26:16.3 Pencil + tip 1 BLU.FAR/700
018
THORACIC BN.01.01/PP
ALEXA 25/06/201
119 FM/18/12 TROCAR & K-
MEDIKA, 8 BMHP Pcs BMHP 24 118463 0 284311.2 3127423.2
9 71 CANNULA BLU.FAR/706
PT 16:33:38.3
CH 28 2/2018
BN.01.01/PP
ALEXA 25/06/201 Extention
120 FM/18/12 K-
MEDIKA, 8 BMHP Tube Buah BMHP 1050 12000 0 1260000 13860000
0 71 BLU.FAR/706
PT 16:33:38.3 150cm
2/2018
02/07/201 THORACIC BN.01.01/PP
ALEXA
120 FM/18/13 8 TROCAR & K-
MEDIKA, BMHP Pcs BMHP 6 118463 0 71077.8 781855.8
1 17 11:31:50.4 CANNULA BLU.FAR/706
PT
83 CH 28 2/2018
02/07/201 BN.01.01/PP
ALEXA Extention
120 FM/18/13 8 K-
2 17 11:31:50.4 BLU.FAR/706
PT 150cm
83 2/2018
8 K-
MEDIKA, Tube
3 09 13:29:51.5 BLU.FAR/706
PT 150cm
93 2/2018
25/06/201 BN.01.01/PP
120 BRATACO. IVMDG180 8 1172727.2 12899999. K-
4 PT 0680 16:38:07.3 7 97 BLU.FAR/706
26 8/2018
25/06/201 BN.01.01/PP
120 BRATACO. IVMDG180 8 Acid Citric K-
BMHP Kg BMHP 100 40909.09 0 409090.9 4499999.9
5 PT 0680 16:38:07.3 1Kg BLU.FAR/706
26 8/2018
120 JAYA INV/SJA/1 8 Circuit 35000000. K-
BMHP Set BMHP 200 159090.91 0 3181818.2
6 ALKESIND 8/VI/0330 14:28:09.6 Adult Set 2 BLU.FAR/706
04/07/201 BN.01.01/PP
DAYA OCTENIC
120 8 2988358.5 K-
MUDA 009906 BMHP BODYWAS P c s BMHP 996 2727.6 0 271668.96
7 14:54:09.6 6 BLU.FAR/712
AGUNG. PT H GLOVE
93 0/2018
04/07/201 BN.01.01/PP
DAYA OCTENIC
120 8 K-
MUDA 009906 BMHP HAIRWAS P c s BMHP 400 4000 0 160000 1760000
8 14:54:09.6 BLU.FAR/712
AGUNG. PT H GLOVE
93 0/2018
04/07/201 BN.01.01/PP
DAYA OCTENIC
120 8 6012721.4 K-
MUDA 010034 BMHP BODYWAS P c s BMHP 2004 2727.6 0 546611.04
9 15:10:11.3 4 BLU.FAR/712
AGUNG. PT H GLOVE
76 0/2018
TRANSME 02/07/201 BN.01.01/PP
Katub
121 DIC 8 K-
IN1803669 BMHP Mitral Pcs BMHP 1 15100000 0 1510000 16610000
0 INDONESI 09:01:48.3 BLU.FAR/713
No.27mm
A. PT 4 6/2018
TRANSME 02/07/201 Katub BN.01.01/PP
121 DIC 8 Aortic K-
IN1803669 BMHP Pcs BMHP 1 15100000 0 1510000 16610000
1 INDONESI 09:01:48.3 No.19mm BLU.FAR/713
A. PT 4 Mechanical 6/2018
121 ENSEVAL 31800391 04/07/201 BMHP Extended Buah BMHP 8 199581.82 0 159665.45 1756320.0 BN.01.01/PP
2 PUTERA 6 8 Life Pd 6 16 K-
MEGATRA 16:35:20.8 Transfer BLU.FAR/714
DING TBK, 33 0/2018
PT
ENSEVAL
04/07/201 BN.01.01/PP
PUTERA
121 31800391 8 K-
3 6 16:35:20.8 BLU.FAR/714
DING TBK,
33 0/2018
PT
ENSEVAL
04/07/201 BN.01.01/PP
PUTERA
121 31800391 8 Titanium K-
4 6 16:35:20.8 Adaptor BLU.FAR/714
DING TBK,
33 0/2018
PT
ENSEVAL
04/07/201 BN.01.01/PP
PUTERA
121 31800391 8 Ultraclamp 120400.01 K-
5 6 16:35:20.8 (Red) 6 BLU.FAR/714
DING TBK,
33 0/2018
PT
MENSA 11/07/201 BN.01.01/PP
Blood Bag
121 BINA CD194222 8 47880001. K-
BMHP Triple 350 Buah BMHP 700 62181.82 0 4352727.4
6 SUKSES, 672 10:26:56.6 4 BLU.FAR/718
ml
PT 63 2/2018
Neonatal
SUKSES 02/07/201 BN.01.01/PP
INV/SJA/1 Adhesive
121 JAYA 8 K-
8/VII/034 BMHP Sensor Set BMHP 80 560000 0 4480000 49280000
7 ALKESIND 10:17:33.1 BLU.FAR/719
4 18inci M-
O. PT 16 7/2018
LNCS
121 DOS NI 82735636 8 Loop Red K-
BMHP Buah BMHP 36 120150 0 432540 4757940
8 ROHA, PT 3 15:03:04.3 1,5 mm BLU.FAR/719
4 75cm 8/2018
Premicron
02/07/201 e 2/0 BN.01.01/PP
121 DOS NI 82735636 8 HRT17 K-
9 ROHA, PT 3 15:03:04.3 Firm3x3x1 BLU.FAR/719
4 ,5mm(8x7 8/2018
5)
BN.01.01/PP
MULTI 02/07/201 Sputum
122 MPM18 K-
PLUS 8 BMHP Pot Plastik P c s BMHP 1500 1819 0 272850 3001350
0 060232 BLU.FAR/719
MEDILAB 15:05:34.5 Steril
9/2018
MILLENNI
UM Bioglue
06/07/201 BN.01.01/PP
PHARMAC Pre-Filled
122 23061800 8 K-
1 0210 10:32:01.8 BLU.FAR/728
INTERNAT SURG.ADH
56 8/2018
IONAL ESIVE
TBK, PT
HOSPI 03/07/201 BN.01.01/PP
1005/HMI
122 MEDIK 8 Surefit K-
/KWI/VII/ BMHP Pcs BMHP 100 84075.45 0 840754.5 9248299.5
18
A. PT 13 6/2018
Cardiovasc
PERMATA 11/01/201 BN.01.01/PP
024/PB/F ular Patch
122 BUNDA 8 K-
3 ARTANO, 13:11:13.2 BLU.FAR/74/
18 75mm x
PT 33 2018
0,6mm
Oxygenato
PERMATA 11/01/201 BN.01.01/PP
024/PB/F r Affnity
122 BUNDA 8 K-
AK/01/20 BMHP Fusion Set BMHP 4 6750000 0 2700000 29700000
4 ARTANO, 13:11:13.2 BLU.FAR/74/
18 Complete
PT 33 2018
Adult
DIMAS 04/07/201 BN.01.01/PP
HEARING
122 ANDALAS D1807- 8 2999999.9 K-
BMHP AMPLIFIE Unit BMHP 6 454545.45 0 272727.27
5 MAKMUR. 00042 14:49:14.6 7 BLU.FAR/741
R HA 20
PT 96 6/2018
DIMAS 04/07/201 BN.01.01/PP
TOUNG
122 ANDALAS D1807- 8 K-
BMHP SPATEL Pcs BMHP 500 290 0 14500 159500
6 MAKMUR. 00042 14:49:14.6 BLU.FAR/741
KAYU
PT 96 6/2018
Oxygenato
PERMATA 05/07/201 BN.01.01/PP
016/PB/F r Affnity
122 BUNDA 8 K-
7 ARTANO, 09:25:19.7 BLU.FAR/741
18 Complete
PT 3 7/2018
Adult
Cardiovasc
PERMATA 05/07/201 BN.01.01/PP
016/PB/F ular Patch
122 BUNDA 8 K-
8 ARTANO, 09:25:19.7 BLU.FAR/741
18 75mm x
PT 3 7/2018
0,6mm
IDS F&P RT124
BN.01.01/PP
MEDICAL 05/07/201 CIRC.W/
122 K-
SYSTEM 0151523 8 BMHP nCAP Set BMHP 10 2090000 0 2090000 22990000
9 BLU.FAR/741
INDONESI 09:48:27.9 GENERAT
8/2018
A PT OSLE1000
Singel Use
IDS
Flow BN.01.01/PP
MEDICAL 05/07/201
123 Sensor for K-
SYSTEM 0151523 8 BMHP Pcs BMHP 5 1149500 0 574750 6322250
0 SLE BLU.FAR/741
INDONESI 09:48:27.9
4000/500 8/2018
A PT
0
IDS
06/07/201 BN.01.01/PP
MEDICAL Paper
123 8 K-
1 12:12:03.7 BLU.FAR/741
INDONESI e
96 8/2018
A PT
BISAWI 16/07/201 Medical BN.01.01/PP
3442/FKT
123 TUMBUH 8 Tubing 1/4 K-
R/BTS/VII BMHP Pcs BMHP 10 126000 0 126000 1386000
2 SELARAS. 09:27:13.4 x 1/16 x 12 BLU.FAR/754
/18
PT 03 Feet 5/2018
06/07/201 Quick Core BN.01.01/PP
VERSACON
123 INV/18/05 8 Biopsy 11204998. K-
MEDICAL.P BMHP Pcs BMHP 9 1131818 0 1018636.2
3 22/VM 13:58:16.7 Needle, 2 BLU.FAR/759
T
43 18G/20cm 6/2018
DIPA 10/07/201 BN.01.01/PP
123 PUSPA 0718.FP- 8 Petri Dish K-
BMHP Buah BMHP 3000 1820 0 546000 6006000
4 LABSAINS. 100812 16:05:00.5 3Vent BLU.FAR/766
PT 36 2/2018
DIPA 10/07/201 BN.01.01/PP
10Ul
123 PUSPA 0718.FP- 8 K-
BMHP Inoculating P c s BMHP 1000 942.5 0 94250 1036750
5 LABSAINS. 100812 16:05:00.5 BLU.FAR/766
Loop Blue
PT 36 2/2018
DIPA 10/07/201 BN.01.01/PP
Sulfametox
123 PUSPA 0718.FP- 8 Kit/5X50di K-
BMHP azole/Trim BMHP LAB 1 334262.5 0 33426.25 367688.75
6 LABSAINS. 100812 16:05:00.5 sc BLU.FAR/766
etropin
PT 36 2/2018
123 DIPA 0718.FP- 10/07/201 BMHP Meropene Kit/5X50di BMHP LAB 1 334262.5 0 33426.25 367688.75 BN.01.01/PP
7 PUSPA 100812 8 m sc K-
PT 36 2/2018
ENSEVAL
10/07/201 BN.01.01/PP
PUTERA
123 11805798 8 K-
MEGATRA BMHP BLUING Botol/L BMHP LAB 4 303750 0 121500 1336500
8 3 16:24:59.4 BLU.FAR/766
DING TBK,
33 3/2018
PT
ENSEVAL
10/07/201 BN.01.01/PP
PUTERA
123 11805798 8 K-
MEGATRA BMHP Cytofunnel B o x BMHP LAB 120 40000 0 480000 5280000
9 3 16:24:59.4 BLU.FAR/766
DING TBK,
33 3/2018
PT
ENSEVAL
10/07/201 BN.01.01/PP
PUTERA Pisau
124 11805798 8 K-
MEGATRA BMHP Microtome P c s BMHP LAB 200 43200 0 864000 9504000
0 3 16:24:59.4 BLU.FAR/766
DING TBK, TS
33 3/2018
PT
ENSEVAL RAPID
10/07/201 BN.01.01/PP
PUTERA CROMETM
124 11805798 8 K-
MEGATRA BMHP h&e frozen S e t BMHP LAB 2 2660000 0 532000 5852000
1 3 16:24:59.4 BLU.FAR/766
DING TBK, section
33 3/2018
PT stains
ENSEVAL
10/07/201 BN.01.01/PP
PUTERA Histoplast
124 11805798 8 K-
MEGATRA BMHP parafin Pack BMHP LAB 2 360000 0 72000 792000
2 3 16:24:59.4 BLU.FAR/766
DING TBK, 6774006
33 3/2018
PT
SENSATRA
IDS
10/07/201 C MEDIUM BN.01.01/PP
MEDICAL
124 8 GRANUFO K-
3 15:52:37.9 AM BLU.FAR/766
INDONESI
23 DRESSING 4/2018
A PT
10PC
IDS
10/07/201 BN.01.01/PP
MEDICAL CANISTER
124 8 K-
SYSTEM 0152150 BMHP WITH GEL P c s BMHP 5 484500 0 242250 2664750
4 15:52:37.9 BLU.FAR/766
INDONESI 500ML
23 4/2018
A PT
124 IDS 0152992 18/07/201 BMHP SENSATRA P c s BMHP 4 816000 0 326400 3590400 BN.01.01/PP
5 MEDICAL 8 C MEDIUM K-
GRANUFO
SYSTEM
15:31:40.7 AM BLU.FAR/766
INDONESI
83 DRESSING 4/2018
A PT
10PC
IDS
18/07/201 BN.01.01/PP
MEDICAL CANISTER
124 8 K-
6 15:31:40.7 BLU.FAR/766
INDONESI 500ML
83 4/2018
A PT
SENSATRA
IDS
20/07/201 C MEDIUM BN.01.01/PP
MEDICAL
124 8 GRANUFO K-
7 15:48:57.2 AM BLU.FAR/766
INDONESI
1 DRESSING 4/2018
A PT
10PC
IDS
20/07/201 BN.01.01/PP
MEDICAL CANISTER
124 8 K-
8 15:48:57.2 BLU.FAR/766
INDONESI 500ML
1 4/2018
A PT
12/07/201 BN.01.01/PP
124 BRATACO. IVMDG180 8 1172727.2 12899999. K-
9 PT 0763 12:27:24.7 7 97 BLU.FAR/771
86 5/2018
ENDO 10/08/201 BN.01.01/PP
Inv- STERILE
125 MEDICA 8 K-
0718/014 BMHP NEEDLE P c s BMHP 100 91000 0 910000 10010000
0 NUSANTA 11:13:26.3 BLU.FAR/778
76 COUNTER
RA.PT 96 0/2018
MENSA 16/07/201 BN.01.01/PP
OXYGENAT
125 BINA CD194249 8 24795368. K-
1 SUKSES, 185 13:03:04.7 4 BLU.FAR/778
FX25RW40
PT 13 1/2018
125 BINA CD194249 8 Pack / K-
PT 13 Adult 1/2018
125 MENSA CD194249 16/07/201 BMHP Oxygenato P c s BMHP 5 5080480 0 2540240 27942640 BN.01.01/PP
3 BINA 129 8 r 10 Ped. K-
SUKSES, 12:34:47.6 FX15RW30 BLU.FAR/778
PT 46 2/2018
Blood Line
MENSA 16/07/201 BN.01.01/PP
Ped/
125 BINA CD194249 8 K-
BMHP Custom Pcs BMHP 5 1 0 0.5 5.5
4 SUKSES, 129 12:34:47.6 BLU.FAR/778
Pack CX
PT 46 2/2018
910
DANVI 12/07/201 BN.01.01/PP
DMP Blood Bag
125 MEDILAB 8 K-
201807/1 BMHP Triple Pcs BMHP 420 61818 0 2596356 28559916
5 PERKASA. 14:35:04.6 BLU.FAR/778
59 350Ml
PT 56 9/2018
DANVI 12/07/201 Disp. BN.01.01/PP
DMP
125 MEDILAB 8 Syringe / 13999999. K-
201807/1 BMHP Pcs BMHP 400 31818.18 0 1272727.2
6 PERKASA. 15:07:28.6 Spuit 2 BLU.FAR/778
66
PT 56 100cc UT 9/2018
MENSA 14/08/201 BN.01.01/PP
125 BINA CD193813 8 TR BAND K-
BMHP Pcs BMHP 20 245000 0 490000 5390000
7 SUKSES, 090 14:50:40.6 (XX RF06) BLU.FAR/779
PT 66 1/2018
25/07/201 BN.01.01/PP
SURGIKA Mouth
125 8 K-
ALKESIND IRG01869 BMHP Piece,180c P c s BMHP 37 19875 0 73537.5 808912.5
8 10:35:28.9 BLU.FAR/784
O, PT m Tubing
86 7/2018
25/07/201 BN.01.01/PP
SURGIKA
125 8 Tracheos K-
ALKESIND IRG01869 BMHP Pcs BMHP 200 31875 0 637500 7012500
9 10:35:28.9 Filter BLU.FAR/784
O, PT
86 7/2018
25/07/201 BN.01.01/PP
SURGIKA Broncocat
126 8 K-
ALKESIND IRG01869 BMHP h Cath ET S e t BMHP 1 911250 0 91125 1002375
0 10:35:28.9 BLU.FAR/784
O, PT No.37 Left
86 7/2018
MBL
CAHAYA 16/07/201 BN.01.01/PP
SPEEDBAN
126 DUA 0067/CDD 8 K-
BMHP D Pcs BMHP 6 3000000 0 1800000 19800000
1 DELAPAN. /VII/2018 16:37:13.6 BLU.FAR/784
SUPERVIE
PT 06 9/2018
W SUPER 7
TIRTA 16/07/201 BN.01.01/PP
126 MEDICAL 6467FP/1 8 Compolab K-
2 INDONESI 8 15:42:35.0 Cuvette BLU.FAR/785
A,PT 6 0/2018
126 DUA 0068/CDD 8 chiale 2327975.4 4423153.3 48654686. K-
BMHP Buah BMHP 19 0
3 DELAPAN. /VII/2018 08:56:43.3 Nadel / 5 55 91 BLU.FAR/790
PT 13 TBN I 5/2018
BN.01.01/PP
VERSACON
126 INV/18/05 24/07/201 Urether 2749772.7 274977.27 3024750.0 K-
MEDICAL.P BMHP Pcs BMHP 1 0
4 79/VM 8 15:20:00 Stent NO.3 3 3 03 BLU.FAR/790
T
7/2018
DIMAS 17/07/201 BN.01.01/PP
Lumpang +
126 ANDALAS D1807- 8 K-
ALKES Stamfer Set ALKES 3 66000 0 19800 217800
5 MAKMUR. 00903 10:51:45.3 BLU.FAR/796
16cm
PT 03 5/2018
Cauter /
DIMAS 17/07/201 BN.01.01/PP
Dispo
126 ANDALAS D1807- 8 K-
6 MAKMUR. 00905 11:30:47.8 BLU.FAR/796
Pencil (E-
PT 73 5/2018
2515)
Sterilizatio
PETAN 27/07/201 BN.01.01/PP
n Agent
126 DAYA 841/PDM/ 8 2738181.8 30120000. K-
BMHP (H2O2) Pcs BMHP 60 456363.64 0
7 MEDICA, FP/VII/18 10:45:20.6 4 24 BLU.FAR/796
SA10/
PT 86 6/2018
15units
126 DAYA 841/PDM/ 8 Indicator K-
BMHP Pcs BMHP 1000 15181.82 0 1518182 16700002
8 MEDICA, FP/VII/18 10:45:20.6 Strip BLU.FAR/796
PT 86 250ea 6/2018
INTERGRA
17/07/201 BN.01.01/PP
STA Test Tube
126 JP 8 K-
9 18001965 09:40:00.7 BLU.FAR/796
NUSANTA 12x75
86 7/2018
RA.PT
INTERGRA
STA
0 18001965 09:40:00.7 X Ray 35 X BLU.FAR/796
NUSANTA
86 35CM 7/2018
RA.PT
127 INTERGRA JP 17/07/201 BMHP Laparatom Buah BMHP 300 9010 0 270300 2973300 BN.01.01/PP
1 STA 18001965 8 y Spongos K-
ARTHA 09:40:00.7 Hosp X BLU.FAR/796
NUSANTA RAY
86 7/2018
RA.PT 23x23cm
INTERGRA
17/07/201 BN.01.01/PP
STA Tabung
127 JP 8 K-
ARTHA BMHP EDTA 3ml Box/100 BMHP 5000 1275 0 637500 7012500
2 18001965 09:40:00.7 BLU.FAR/796
NUSANTA K3
86 7/2018
RA.PT
MERAPI 18/07/201 TIP BN.01.01/PP
127 UTAMA 8 CLEANER/ 50163.637 551800.01 K-
00018892 BMHP Pcs BMHP 25 20065.455 0
3 PHARMA, 11:58:07.0 HARUM 5 25 BLU.FAR/796
PT 4 CLEAN 8/2018
BMHP Flotrac Set BMHP 5 3150000 0 1575000 17325000
4 SELARAS, /7/2018 15:42:58.7 BLU.FAR/803
PT 8 5/2018
Steerease
127 NIUMINDO 0561/RS/F 8 4336734.5 9540816.0 K-
BMHP Occuleder P c s BMHP 2 0 867346.91
5 SELARAS, /7/2018 15:42:58.7 5 1 BLU.FAR/803
8Fr
PT 8 5/2018
Steerease
127 NIUMINDO 0561/RS/F 8 4336734.5 9540816.0 K-
6 SELARAS, /7/2018 15:42:58.7 5 1 BLU.FAR/803
5F
PT 8 5/2018
Steerease
127 NIUMINDO 0561/RS/F 8 4336734.5 9540816.0 K-
7 SELARAS, /7/2018 15:42:58.7 5 1 BLU.FAR/803
6F
PT 8 5/2018
064/PB/F
AK/07/20 BMHP Buah BMHP 1 15750000 0 1575000 17325000
8 ARTANO, 15:48:27.7 33mm - BLU.FAR/804
18
PT 26 758270 2/2018
064/PB/F
AK/07/20 BMHP Buah BMHP 1 15750000 0 1575000 17325000
9 ARTANO, 15:48:27.7 29mm - BLU.FAR/804
18
PT 26 460706 2/2018
062/PB/F
AK/07/20 BMHP Buah BMHP 2 15750000 0 3150000 34650000
0 ARTANO, 15:26:19.5 31mm - BLU.FAR/804
18
PT 4 753661 3/2018
Kertas ECG
SUKSES 18/07/201 BN.01.01/PP
INV/SJA/1 Bionet,
128 JAYA 8 K-
8/VII/037 BMHP Cardiocare Roll BMHP 50 88181.82 0 440909.1 4850000.1
1 ALKESIND 16:51:38.7 BLU.Far/804
5 215mmx2
O. PT 16 4/2018
5m
KERTAS
ECG
SUKSES 18/07/201 BN.01.01/PP
INV/SJA/1 210MMX2
128 JAYA 8 K-
8/VII/037 BMHP 95MMX15 P c s BMHP 20 250000 0 500000 5500000
2 ALKESIND 16:51:38.7 BLU.Far/804
5 05H
O. PT 16 4/2018
MARQUET
TE
KERTAS
INV/SJA/1
128 JAYA 8 MARQUET K-
8/VII/037 BMHP Pcs BMHP 3 412000 0 123600 1359600
3 ALKESIND 16:51:38.7 TE BLU.Far/804
5
O. PT 16 215X280X 4/2018
300SH
063/PB/F
128 BUNDA 8 Aortic Size K-
AK/07/20 BMHP Buah BMHP 1 15750000 0 1575000 17325000
4 ARTANO, 15:35:58.2 20mm - BLU.FAR/809
18
PT 4 736784 4/2018
Cardiovasc
PERMATA 18/07/201 BN.01.01/PP
063/PB/F ular Patch
128 BUNDA 8 K-
AK/07/20 BMHP 30mm x P c s BMHP 1 5950000 0 595000 6545000
5 ARTANO, 15:35:58.2 BLU.FAR/809
18 60mm x
PT 4 4/2018
0.4mm
INTERGRA Mini Bio
19/07/201 BN.01.01/PP
STA Plus-
128 JP 8 K-
ARTHA BMHP Sterotherm Box/50 BMHP 1 2812500 0 281250 3093750
6 18002001 15:11:11.9 BLU.FAR/809
NUSANTA ophilus
13 9/2018
RA.PT forsteam
YellStar
Doub J
128 MA 8 K-
16027 BMHP Uret Stent P c s BMHP 1 1339200 0 133920 1473120
7 LESTARI 10:45:13.1 BLU.FAR/810
Fr6/22-
.PT 36 4/2018
30clos
128 MENSA CD194301 25/07/201 BMHP Blood Bag P c s BMHP 230 32270 0 742210 8164310 BN.01.01/PP
8 BINA 247 8 Singel 350 K-
SUKSES, 11:54:37.4 BLU.FAR/815
ml
PT 5 2/2018
MENSA 25/07/201 BN.01.01/PP
Blood Bag
128 BINA CD194301 8 K-
BMHP Triple 350 Buah BMHP 20 62181.9 0 124363.8 1368001.8
9 SUKSES, 247 11:54:37.4 BLU.FAR/815
ml
PT 5 2/2018
082/PB/F
AK/07/20 BMHP Pcs BMHP 20 765000 0 1530000 16830000
18
PT 5 Tube 20Fr 4/2018
PERMATA 24/07/201 BN.01.01/PP
082/PB/F Hemoconc
129 BUNDA 8 K-
1 ARTANO, 11:21:03.2 BLU.FAR/815
18 For Ped
PT 5 4/2018
082/PB/F
AK/07/20 BMHP Pcs BMHP 10 630000 0 630000 6930000
18
PT 5 WVL 9Fr 4/2018
PERMATA 24/07/201 BN.01.01/PP
082/PB/F
AK/07/20 BMHP Pcs BMHP 10 1350000 0 1350000 14850000
18
PT 5 4/2018
IDS
24/07/201 BN.01.01/PP
MEDICAL BTR 3-
129 8 K-
4 15:16:54.4 BLU.FAR/818
96 3/2018
A PT
IDS
24/07/201 BN.01.01/PP
MEDICAL BTR 4812-
129 8 K-
5 15:16:54.4 BLU.FAR/818
INDONESI Lumen
96 3/2018
A PT
IDS
27/07/201 BN.01.01/PP
MEDICAL BTR 3-
129 8 K-
6 10:19:08.4 BLU.FAR/818
26 3/2018
A PT
129 IDS 0154454 27/07/201 BMHP EMBOLEC P c s BMHP 2 785197 0 157039.4 1727433.4 BN.01.01/PP
7 MEDICAL 8 TOMY K-
SYSTEM
10:19:08.4 CATHETER BLU.FAR/818
INDONESI
26 4FR 3/2018
A PT
IDS EMBOLEC
27/07/201 BN.01.01/PP
MEDICAL TOMY
129 8 K-
SYSTEM 0154454 BMHP CATHETER P c s BMHP 2 785197 0 157039.4 1727433.4
8 10:19:08.4 BLU.FAR/818
INDONESI 6FR
26 3/2018
A PT EL1680
Oxygenato
PERMATA 24/07/201 BN.01.01/PP
083/PB/F r Affnity
129 BUNDA 8 K-
9 ARTANO, 11:35:24.5 BLU.FAR/818
18 Complete
PT 43 7/2018
Adult
Canula
PERMATA 24/07/201 BN.01.01/PP
083/PB/F Venous
130 BUNDA 8 K-
0 ARTANO, 11:35:24.5 BLU.FAR/818
18 No.20
PT 43 7/2018
67320
083/PB/F
AK/07/20 BMHP Pcs BMHP 6 882000 0 529200 5821200
1 ARTANO, 11:35:24.5 4,0mm BLU.FAR/818
18
PT 43 Med 7/2018
HOSPI 23/07/201 BN.01.01/PP
TANDATE
130 MEDIK 8 Surefit K-
RIMA BMHP Pcs BMHP 100 84075.45 0 840754.5 9248299.5
1119/HMI
A. PT 4 8/2018
Steerease
130 NIUMINDO 0560/RS/F 8 4336734.5 433673.45 4770408.0 K-
BMHP Occuleder P c s BMHP 1 0
3 SELARAS, /7/18 15:45:14.2 5 5 05 BLU.FAR/818
9Fr
PT 3 9/2018
130 NIUMINDO 0560/RS/F 8 E 4336734.5 433673.45 4770408.0 K-
BMHP Buah BMHP 1 0
4 SELARAS, /7/18 15:45:14.2 OCCULEDE 5 5 05 BLU.FAR/818
PT 3 R 10F 9/2018
Guide Wire
0.038
BMHP 150cm Pcs BMHP 33 165000 0 544500 5989500
5 SELARAS, /7/18 15:45:14.2 BLU.FAR/818
IQ38F150J
PT 3 9/2018
3
23/07/201 Skin BN.01.01/PP
HEXALAB
130 HS.0718- 8 Marker K-
SUMATER BMHP Buah BMHP 50 33000 0 165000 1815000
6 00353 16:13:01.1 -Regular BLU.FAR/823
A.PT
96 Tip 1/2018
MILLENNI
UM Bioglue
30/07/201 BN.01.01/PP
PHARMAC Pre-Filled
130 23061800 8 K-
7 0213 14:02:38.4 BLU.FAR/823
INTERNAT SURG.ADH
2 4/2018
IONAL ESIVE
TBK, PT
MILLENNI
UM
30/07/201 BN.01.01/PP
PHARMAC Septalkan
130 23061800 8 K-
8 0251 15:44:21.0 BLU.FAR/823
INTERNAT Wipes
26 4/2018
IONAL
TBK, PT
IDS SU Circuit
BN.01.01/PP
MEDICAL w/ Twin
130 27/07/201 K-
SYSTEM 0154171 BMHP Spiral Pcs BMHP 15 1059250 0 1588875 17477625
9 8 12:17:00 BLU.FAR/823
INDONESI Heated
6/2018
A PT Circ
MILLENNI
UM
25/07/201 Wrap PPR BN.01.01/PP
PHARMAC
131 23061800 8 SMS K-
ON BMHP Lembar BMHP 2500 10524.8 0 2631200 28943200
0 0158 12:30:54.5 120X120c BLU.FAR/823
INTERNAT
9 m (125) 7/2018
IONAL
TBK, PT
MERAPI 25/07/201 TIP BN.01.01/PP
131 UTAMA 8 CLEANER/ 551799.87 K-
00019835 BMHP Pcs BMHP 25 20065.45 0 50163.625
1 PHARMA, 12:25:51.0 HARUM 5 BLU.FAR/828
PT 96 CLEAN 6/2018
ENSEVAL
PUTERA
131 11806287 8 24x60 mm K-
MEGATRA BMHP Buah BMHP 2000 1260 0 252000 2772000
2 0 14:06:52.8 6776325 BLU.FAR/829
DING TBK,
83 (100) 0/2018
PT
DIPA 27/07/201 BN.01.01/PP
Xylene,BA
131 PUSPA 0718.FP- 8 1050266.2 K-
BMHP R, ACS Botol BMHP LAB 8 0 840213 9242343
3 LABSAINS. 100908 14:03:20.6 5 BLU.FAR/838
Reagent
PT 2 3/2018
DIPA 27/07/201 BN.01.01/PP
131 PUSPA 0718.FP- 8 Norfloxaci K-
BMHP Box BMHP LAB 2 334262.5 0 66852.5 735377.5
4 LABSAINS. 100908 14:03:20.6 n 10 BLU.FAR/838
PT 2 3/2018
WEGO 31/07/201 BN.01.01/PP
SIC-
131 MEDIKA 8 DC Infinity K-
MDN/VII/ BMHP Pcs BMHP 20 265000 0 530000 5830000
5 INDONESI 13:01:13.6 MPA2 - 5F BLU.FAR/845
18/0629
A 56 3/2018
WEGO 31/07/201 BN.01.01/PP
SIC-
MDN/VII/ BMHP Pcs BMHP 20 265000 0 530000 5830000
18/0629
A 56 3/2018
30/07/201 BN.01.01/PP
131 BRATACO. IVMDG180 8 1172727.2 12899999. K-
7 PT 0829 09:19:41.2 7 97 BLU.FAR/845
16 7/2018
30/07/201 BN.01.01/PP
131 BRATACO. IVMDG180 8 899999.92 K-
BMHP Glyserin Btl/ltr BMHP LAB 15 54545.45 0 81818.175
8 PT 0829 09:19:41.2 5 BLU.FAR/845
16 7/2018
ANDRA
9 8 /827 15:14:53.6 Tubing BLU.FAR/845
JAYA. PT
13 System 8/2018
Guide Wire
0.038
BMHP 150cm Pcs BMHP 67 165000 0 1105500 12160500
0 SELARAS, /8/2018 11:43:53.8 BLU.FAR/845
IQ38F150J
PT 6 9/2018
3
DC. MPA 2
BMHP - 6F 7513- P c s BMHP 12 265000 0 318000 3498000
1 SELARAS, /8/2018 11:43:53.8 BLU.FAR/845
23
PT 6 9/2018
132 MENSA CD194373 09/08/201 BMHP Blood Bag P c s BMHP 300 32270 0 968100 10649100 BN.01.01/PP
2 BINA 835 8 Singel 350 K-
SUKSES, 15:01:06.1 BLU.FAR/846
ml
PT 2 2/2018
INTERGRA Mini Bio
BN.01.01/PP
STA Plus-
132 JP 30/07/201 K-
3 18002124 8 09:59:00 BLU.FAR/851
NUSANTA ophilus
8/2018
RA.PT forsteam
ENSEVAL
01/08/201 BN.01.01/PP
PUTERA
132 31800473 8 K-
4 0 16:04:27.8 BLU.FAR/852
DING TBK,
86 0/2018
PT
ENSEVAL
01/08/201 BN.01.01/PP
PUTERA Extended
132 31800473 8 219540.00 2414940.0 K-
MEGATRA BMHP Life Pd Buah BMHP 11 199581.82 0
5 0 16:04:27.8 2 22 BLU.FAR/852
DING TBK, Transfer
86 0/2018
PT
ENSEVAL
01/08/201 BN.01.01/PP
PUTERA
132 31800473 8 Titanium K-
6 0 16:04:27.8 Adaptor BLU.FAR/852
DING TBK,
86 0/2018
PT
ENSEVAL
01/08/201 BN.01.01/PP
PUTERA
132 31800473 8 Ultraclamp 120400.01 K-
7 0 16:04:27.8 (Red) 6 BLU.FAR/852
DING TBK,
86 0/2018
PT
INV/SJA/1
132 JAYA 8 Circuit Ped K-
8/VII/039 BMHP Set BMHP 30 168182 0 504546 5550006
8 ALKESIND 11:04:02.7 Set BLU.FAR/852
4
MENSA 07/08/201 BN.01.01/PP
132 BINA CD194376 8 TR BAND K-
BMHP Pcs BMHP 10 245000 0 245000 2695000
9 SUKSES, 150 14:32:27.8 (XX RF06) BLU.FAR/852
PT 13 2/2018
TIRTA 07/08/201 BN.01.01/PP
133 MEDICAL 6925/FP/1 8 Syphilis K-
BMHP Kit BMHP LAB 100 15000 0 150000 1650000
0 INDONESI 8 11:30:17.7 Device BLU.FAR/852
A,PT 06 3/2018
TIRTA 07/08/201 BN.01.01/PP
Blood Bag
133 MEDICAL 7005/FP/1 8 K-
BMHP Triple Pcs BMHP 500 72727.28 0 3636364 40000004
350Ml
A,PT 1 3/2018
MILLENNI
UM PerClot
15/08/201 BN.01.01/PP
PHARMAC Polysaccari
133 23061800 8 K-
2 0265 12:24:27.0 BLU.FAR/852
INTERNAT Haemost
06 5/2018
IONAL Syst 3Gr
TBK, PT
Neutral
01/08/201 Buffer BN.01.01/PP
SINGA
133 SMP18080 8 Formalin K-
MUDA BMHP Galon BMHP LAB 1 1710000 0 171000 1881000
3 001 16:12:56.9 10 BLU.FAR/855
PERKASA
4 (1ken=19lt 5/2018
r)
Neutral
09/08/201 Buffer BN.01.01/PP
SINGA
133 SMP18080 8 Formalin K-
MUDA BMHP Galon BMHP LAB 1 1710000 0 171000 1881000
4 002 15:06:30.0 10 BLU.FAR/855
PERKASA
2 (1ken=19lt 5/2018
r)
Vascutek
PERMATA BN.01.01/PP
020/PB/F 07/08/201 Seal PTFE
133 BUNDA K-
AK/08/20 8 BMHP 5mm x Buah BMHP 1 12325000 0 1232500 13557500
5 ARTANO, BLU.FAR/855
18 13:54:02.1 40cm
PT 6/2018
cat.54005S
PERMATA BN.01.01/PP
020/PB/F 07/08/201
133 BUNDA Shunt Flow K-
AK/08/20 8 BMHP Pcs BMHP 5 1350000 0 675000 7425000
6 ARTANO, 1,75 mm BLU.FAR/855
18 13:54:02.1
PT 6/2018
PERMATA BN.01.01/PP
020/PB/F 07/08/201
133 BUNDA Shunt Flow K-
AK/08/20 8 BMHP Buah BMHP 5 1350000 0 675000 7425000
7 ARTANO, 2,0mm BLU.FAR/855
18 13:54:02.1
PT 6/2018
133 BISAWI 3977/FKT 06/08/201 BMHP Thoracic Buah BMHP 20 120000 0 240000 2640000 BN.01.01/PP
8 TUMBUH R/BTS/VII 8 Draig Cath K-
SELARAS. /20 11:44:36.4 No.28 BLU.FAR/855
PT 03 7/2018
BISAWI 06/08/201 BN.01.01/PP
3977/FKT Thoracic
133 TUMBUH 8 K-
R/BTS/VII BMHP Draig Cath P c s BMHP 20 120000 0 240000 2640000
9 SELARAS. 11:44:36.4 BLU.FAR/855
/20 No.32
PT 03 7/2018
MENSA 07/08/201 BN.01.01/PP
OXYGENAT
134 BINA CD194373 8 49590736. K-
0 SUKSES, 846 14:22:53.4 8 BLU.FAR/855
FX25RW40
PT 93 8/2018
134 BINA CD194373 8 Pack / K-
PT 93 Adult 8/2018
MILLENNI
UM Bioglue
15/08/201 BN.01.01/PP
PHARMAC Pre-Filled
134 23061800 8 K-
2 0264 13:18:31.7 BLU.FAR/855
INTERNAT SURG.ADH
46 9/2018
IONAL ESIVE
TBK, PT
ENSEVAL
04/09/201 BN.01.01/PP
PUTERA Extended
134 31800549 8 1097700.0 K-
MEGATRA BMHP Life Pd Buah BMHP 5 199581.82 0 99790.91
3 6 17:01:20.8 1 BLU.FAR/856
DING TBK, Transfer
3 0/2018
PT
INV/SJA/1
134 JAYA 8 Circuit 17500000. K-
8/VIII/040 BMHP Set BMHP 100 159090.91 0 1590909.1
4 ALKESIND 10:36:40.5 Adult Set 1 BLU.FAR/860
0
DIMAS 02/08/201 BN.01.01/PP
BMHP Buah BMHP 100 34850 0 348500 3833500
PT 4 8/2018
DIMAS 02/08/201 BN.01.01/PP
HEARING
134 ANDALAS D1808- 8 681818.17 7499999.9 K-
BMHP AMPLIFIE Unit BMHP 15 454545.45 0
6 MAKMUR. 00066 11:28:07.5 5 25 BLU.FAR/860
R HA 20
PT 4 8/2018
134 INTERGRA JP 06/08/201 BMHP Mini Bio Ampul BMHP 15 1587600 0 2381400 26195400 BN.01.01/PP
7 STA 18002188 8 Plus- K-
ARTHA Sterotherm
11:47:07.8 BLU.FAR/868
NUSANTA ophilus
83 5/2018
RA.PT 327-601
INTERGRA Mini Bio
06/08/201 BN.01.01/PP
STA Plus-
134 JP 8 K-
8 18002188 11:47:07.8 BLU.FAR/868
NUSANTA ophilus
83 5/2018
RA.PT forsteam
CAHAYA 07/08/201 BN.01.01/PP
134 DUA 0074/CDD 8 DISPOSAB K-
BMHP Pcs BMHP 30 35000 0 105000 1155000
9 DELAPAN. /VIII/2018 14:02:07.5 LE SHORT BLU.FAR/868
PT 86 7/2018
CAHAYA 07/08/201 BN.01.01/PP
135 DUA 0074/CDD 8 PASTA EEG 349999.99 3849999.9 K-
BMHP Pcs BMHP 6 583333.33 0
0 DELAPAN. /VIII/2018 14:02:07.5 TEN 20 8 78 BLU.FAR/868
PT 86 7/2018
CAHAYA 16/08/201 BN.01.01/PP
Blood Bag
135 DUA 0076/CDD 8 K-
BMHP Triple Pcs BMHP 600 64700 0 3882000 42702000
1 DELAPAN. /VIII/2018 10:19:32.0 BLU.FAR/868
350Ml
PT 2 7/2018
REVASS 07/08/201 BN.01.01/PP
135 UTAMA RUM18- 8 Manifold 9000000.0 K-
BMHP Pcs BMHP 100 81818.182 0 818181.82
2 MEDIKA 03474 14:10:52.3 Angioway 2 BLU.FAR/868
.PT 16 8/2018
IDS
BN.01.01/PP
MEDICAL 07/08/201 Paper
135 K-
SYSTEM 0156069 8 BMHP Mouthpiec P c s BMHP 1000 5727.28 0 572728 6300008
3 BLU.FAR/872
INDONESI 13:59:01.1 e
0/2018
A PT
IDS Paper for
BN.01.01/PP
MEDICAL 07/08/201 Hi-801/HI-
135 K-
SYSTEM 0156069 8 BMHP 105/ Roll BMHP 30 272727.1 0 818181.3 8999994.3
4 BLU.FAR/872
INDONESI 13:59:01.1 Thermal
0/2018
A PT 112mm
ANDRA
5 8/II/605 14:30:00.1 Tubing BLU.FAR/875
JAYA. PT
63 System /2018
135 IDS 0156464 09/08/201 BMHP PT. 84 Pcs BMHP 83 31363.64 0 260318.21 2863500.3 BN.01.01/PP
MEDICAL (Bulk Pack
8 K-
SYSTEM w/
6 16:20:32.7 2 32 BLU.FAR/877
INDONESI Box&Label
03 0/2018
A PT )
IDS PT. 84
BN.01.01/PP
MEDICAL (Bulk Pack
135 09/08/201 147409.10 1621500.1 K-
SYSTEM 0156070 BMHP w/ Pcs BMHP 47 31363.64 0
7 8 16:23:00 8 88 BLU.FAR/877
INDONESI Box&Label
0/2018
A PT )
IDS
BN.01.01/PP
MEDICAL BTR 2-
135 09/08/201 K-
8 8 16:23:00 BLU.FAR/877
INDONESI Line
0/2018
A PT
ANUGERA
H 08/08/201 BN.01.01/PP
135 PHARMIN 22125217 8 CIDEX OPA K-
BMHP Gln/5ltr BMHP 11 638880 0 702768 7730448
9 DO 76 13:15:49.9 SOL 5L BLU.FAR/878
LESTARI, 7 7/2018
PT
ANUGERA
H 10/08/201 BN.01.01/PP
CIDEX OPA
136 PHARMIN 22125234 8 K-
BMHP TEST Strip BMHP 60 12800 0 76800 844800
0 DO 51 11:58:53.0 BLU.FAR/878
STRIPS
LESTARI, 3 7/2018
PT
ANUGERA
H 10/08/201 BN.01.01/PP
136 PHARMIN 22125234 8 Surgicel W K-
1 DO 51 11:58:53.0 1913T BLU.FAR/878
LESTARI, 3 7/2018
PT
ANUGERA
H 16/08/201 BN.01.01/PP
CIDEX OPA
136 PHARMIN 22125249 8 K-
BMHP TEST Strip BMHP 60 12800 0 76800 844800
2 DO 72 15:56:38.2 BLU.FAR/878
STRIPS
LESTARI, 56 7/2018
PT
136 MENSA CD194421 10/08/201 BMHP Steri Drape P c s BMHP 30 208785 0 626355 6889905 BN.01.01/PP
BINA 8 K-
/ U Drape
3 SUKSES, 359 16:33:20.8 BLU.FAR/879
1015
PT 1 9/2018
MENSA 10/08/201 BN.01.01/PP
136 BINA CD194421 8 Clipper K-
BMHP Set BMHP 100 61600 0 616000 6776000
4 SUKSES, 359 16:33:20.8 Blade 9660 BLU.FAR/879
PT 1 9/2018
ANUGERA
09/08/201 BN.01.01/PP
H
136 92/AMN/V 8 Kapas K-
MANDIRI BMHP Buah BMHP 1200 500 0 60000 660000
5 III/2018 15:03:45.1 Cebok BLU.FAR/883
INTERASIA
93 5/2018
, PT
INTERGRA Mini Bio
10/08/201 BN.01.01/PP
STA Plus-
136 JP 8 K-
6 18002252 11:23:19.2 BLU.FAR/886
NUSANTA ophilus
46 1/2018
RA.PT 327-601
VP SHUNT
SINERGI 10/08/201 BURR BN.01.01/PP
IN/18/08/
136 TRIDAYA 8 HOLE K-
20/00267 ALKES Pcs ALKES 5 3936000 0 1968000 21648000
7 MEDICAL, 16:53:14.3 MEDIUM BLU.FAR/886
0
PT 7 16mmPRE 2/2018
SS
SINERGI 10/08/201 VP Shunt BN.01.01/PP
IN/18/08/
136 TRIDAYA 8 Burr Hole K-
20/00267 ALKES Pcs ALKES 1 3936000 0 393600 4329600
8 MEDICAL, 16:53:14.3 High16mm BLU.FAR/886
0
PT 7 Pressure 2/2018
KERTAS
SUKSES 10/08/201 BN.01.01/PP
INV/SJA/1 ECG
136 JAYA 8 K-
8/VIII/042 BMHP 58MMX25 P c s BMHP 10 28000 0 28000 308000
1 MX16MM
O. PT 66 3/2018
CSO RED
PAPER
SUKSES 10/08/201 DEFIBRILL BN.01.01/PP
INV/SJA/1
137 JAYA 8 ATOR K-
8/VIII/042 BMHP Roll BMHP 10 33500 0 33500 368500
0 ALKESIND 17:07:32.3 57MM X BLU.FAR/886
1
O. PT 66 30M 3/2018
BR5730
137 SUKSES INV/SJA/1 10/08/201 BMHP KERTAS P c s BMHP 10 412000 0 412000 4532000 BN.01.01/PP
TREADMIL
JAYA 8 MARQUET K-
8/VIII/042
1 ALKESIND 17:07:32.3 TE BLU.FAR/886
1
O. PT 66 215X280X 3/2018
300SH
Recording
SUKSES BN.01.01/PP
INV/SJA/1 Chart
137 JAYA 10/08/201 K-
8/VIII/042 BMHP Papers Box BMHP 20 75000 0 150000 1650000
2 ALKESIND 8 17:10:00 BLU.FAR/886
3 90mmx90x
O. PT 3/2018
360Sheets
Multi
Function
137 NIUMINDO 0079/RS/F 8 16590909. 1659090.9 K-
3 SELARAS, /1/2018 15:55:48.7 09 09 BLU.FAR/89/
/ MFO
PT 93 2018
No.9-7
Multi
Function
137 NIUMINDO 0079/RS/F 8 16590909. 1659090.9 K-
4 SELARAS, /1/2018 15:55:48.7 09 09 BLU.FAR/89/
/ MFO
PT 93 2018
No.10-8
054/PB/F
AK/08/20 BMHP Pcs BMHP 10 630000 0 630000 6930000
18
PT 9 WVL 9Fr 3/2018
PERMATA 14/08/201 BN.01.01/PP
054/PB/F
AK/08/20 BMHP Pcs BMHP 10 1350000 0 1350000 14850000
18
PT 9 3/2018
TIRTA 15/08/201 BN.01.01/PP
137 MEDICAL 7084/FP/1 8 Compolab K-
7 INDONESI 8 13:16:59.2 Cuvette BLU.FAR/892
A,PT 83 7/2018
Sterilizatio
PETAN 15/08/201 BN.01.01/PP
n Agent
137 DAYA 926/PDM/ 8 2738181.8 30120000. K-
BMHP (H2O2) Pcs BMHP 60 456363.64 0
8 MEDICA. FP/VIII/18 15:01:26.0 4 24 BLU.FAR/896
SA10/
PT 16 3/2018
15units
137 ENSEVAL 11807010 14/08/201 BMHP BLUING Botol/L BMHP LAB 2 303750 0 60750 668250 BN.01.01/PP
9 PUTERA 2 8 K-
MEGATRA
15:54:14.4 BLU.FAR/896
DING TBK,
43 4/2018
PT
ENSEVAL
PUTERA
138 11807010 8 24x60 mm K-
MEGATRA BMHP Buah BMHP 1000 1260 0 126000 1386000
0 2 15:54:14.4 6776325 BLU.FAR/896
DING TBK,
43 (100) 4/2018
PT
ENSEVAL
14/08/201 BN.01.01/PP
PUTERA Pisau
138 11807010 8 K-
MEGATRA BMHP Microtome P c s BMHP LAB 150 43200 0 648000 7128000
1 2 15:54:14.4 BLU.FAR/896
DING TBK, TS
43 4/2018
PT
ENSEVAL
14/08/201 BN.01.01/PP
PUTERA Histoplast
138 11807010 8 K-
MEGATRA BMHP parafin Pack BMHP LAB 3 360000 0 108000 1188000
2 2 15:54:14.4 BLU.FAR/896
DING TBK, 6774006
43 4/2018
PT
ANUGERA 14/08/201 BN.01.01/PP
7642- Test Tube
138 H REZEKI 8 K-
18/08/AR BMHP Plastik Tube BMHP 10000 510 0 510000 5610000
3 BERSAMA 13:43:30.2 BLU.FAR/896
BI/132 12x75
I. PT 16 5/2018
TRANSME 14/08/201 BN.01.01/PP
Katub
138 DIC 8 K-
IN1804785 BMHP Aortic Buah BMHP 1 15100000 0 1510000 16610000
No.21mm
A. PT 03 5/2018
TRANSME 14/08/201 BN.01.01/PP
Katub
138 DIC 8 K-
IN1804785 BMHP Aortic Galon BMHP 1 15100000 0 1510000 16610000
No.23mm
A. PT 03 5/2018
04/09/201 BN.01.01/PP
TARAFIS IINV/TAM
138 8 Microscop K-
ANUGERA /18/VIII/0 BMHP Pcs BMHP 5 315000 0 157500 1732500
6 16:25:32.0 es Drapes BLU.FAR/896
H MEDIKA 11
66 7/2018
15/08/201 BN.01.01/PP
SURGIKA Oxygen
138 8 K-
ALKESIND IRH01092 BMHP Conecting P c s BMHP 75 7500 0 56250 618750
7 13:14:03.6 BLU.FAR/896
O, PT 180cm O2
5 8/2018
138 REKAMILE 0077/RS/F 10/01/201 BMHP Multi Pcs BMHP 2 16590909. 0 3318181.8 36500000 BN.01.01/PP
Function
NIUMINDO 8 K-
Occuleder
8 SELARAS, /1/2018 15:51:55.9 09 18 BLU.FAR/90/
/MFO
PT 76 2018
No.6-4
16/08/201 BN.01.01/PP
AKARIM Rectal
138 18/AJF/VII 8 K-
JAYA BMHP Tube No. Pcs BMHP 20 12500 0 25000 275000
9 I/926 15:44:48.5 BLU.FAR/901
FARMA.PT 24
96 6/2018
16/08/201 Rectal BN.01.01/PP
AKARIM
139 18/AJF/VII 8 Tube K-
0 I/926 15:44:48.5 No.28 - BLU.FAR/901
FARMA.PT
96 40cm 6/2018
Dispos
16/08/201 BN.01.01/PP
AKARIM Singel
139 18/AJF/VII 8 K-
JAYA BMHP Filter Pcs BMHP 1000 5950 0 595000 6545000
1 I/926 15:44:48.5 BLU.FAR/901
FARMA.PT 100%/PK
96 6/2018
08800
25/09/201 BN.01.01/PP
139 DEMKA ARI/18/08 8 Hemocron 1677248.0 18449728. K-
BMHP Tube BMHP 380 44138.106 0
2 SAKTI. PT /1001284 16:40:50.1 e 28 31 BLU.Far/905
96 3/2018
071/PB/F
AK/08/20 BMHP Buah BMHP 10 882000 0 882000 9702000
18
PT 76 No.28 CVB. 4/2018
Canula
PERMATA 20/08/201 BN.01.01/PP
071/PB/F Venouse
139 BUNDA 8 K-
4 ARTANO, 12:14:50.2 BLU.FAR/905
18 34/48FR
PT 76 4/2018
Two Stage
PERMATA 20/08/201 BN.01.01/PP
071/PB/F CARDIOPL
139 BUNDA 8 K-
5 ARTANO, 12:14:50.2 BLU.FAR/905
18 ADULT
PT 76 4/2018
071/PB/F
AK/08/20 BMHP Pcs BMHP 8 720000 0 576000 6336000
18
PT 76 Tube 9Fr 4/2018
139 MITRA 0250/v111 16/08/201 ALKES ORTHOCE P c s IMPLANT 6 1100000 0 660000 7260000 BN.01.01/PP
M 3G
FAJAR K-
(boncemen
7 SELARAS, /2018 8 16:02:00 BLU.FAR/905
t+genta)40
PT 8/2018
Gr
Multi
Function
139 NIUMINDO 0076/RS/F 8 16590909. 3318181.8 K-
8 SELARAS, /1/2018 15:53:32.1 09 18 BLU.FAR/91/
/ MFO
PT 03 2018
No.5-3
072/PB/F
AK/08/20 BMHP Pcs BMHP 10 765000 0 765000 8415000
18
PT 56 Tube 20Fr 5/2018
PERMATA 20/08/201 BN.01.01/PP
072/PB/F Hemoconc
140 BUNDA 8 K-
0 ARTANO, 13:04:39.5 BLU.FAR/910
18 for Adult
PT 56 5/2018
Oxygenato
PERMATA 20/08/201 BN.01.01/PP
072/PB/F r Affnity
140 BUNDA 8 K-
1 ARTANO, 13:04:39.5 BLU.FAR/910
18 Complete
PT 56 5/2018
Adult
Singel Use
IDS
20/08/201 Flow BN.01.01/PP
MEDICAL
140 8 Sensor for K-
2 15:31:08.0 SLE BLU.FAR/910
INDONESI
1 4000/500 9/2018
A PT
0
IDS F&P RT124
20/08/201 BN.01.01/PP
MEDICAL CIRC.W/
140 8 K-
3 15:31:08.0 BLU.FAR/910
INDONESI GENERAT
1 9/2018
A PT OSLE1000
PAPER
SUKSES 21/08/201 DEFIBRILL BN.01.01/PP
INV/SJA/1
140 JAYA 8 ATOR K-
8/VIII/043 BMHP Roll BMHP 20 33500 0 67000 737000
4 ALKESIND 15:48:03.7 57MM X BLU.FAR/911
1
O. PT 9 30M 1/2018
BR5730
KERTAS
SUKSES 21/08/201 BN.01.01/PP
INV/SJA/1 ECG
140 JAYA 8 K-
1 MX16MM
O. PT 9 1/2018
CSO RED
KERTAS
SUKSES 21/08/201 BN.01.01/PP
INV/SJA/1 ECG
140 JAYA 8 K-
1 MMX16M
O. PT 9 1/2018
M CST RED
IDS
21/08/201 BN.01.01/PP
MEDICAL BTR 3-
140 8 K-
7 15:45:07.6 BLU.FAR/911
13 3/2018
A PT
DIMAS 24/08/201 BN.01.01/PP
BMHP Buah BMHP 200 34850 0 697000 7667000
PT 13 8/2018
DIMAS 24/08/201 BN.01.01/PP
140 ANDALAS D1808- 8 Spatula K-
BMHP Buah BMHP 500 290 0 14500 159500
9 MAKMUR. 01188 09:01:59.0 Kayu BLU.FAR/911
PT 13 8/2018
DIMAS 24/08/201 BN.01.01/PP
BMHP Buah BMHP 100 34850 0 348500 3833500
PT 53 8/2018
BN.01.01/PP
24/08/201
141 BRATACO. IVMDG180 390909.09 781818.18 8600000.0 K-
8 BMHP Alkohol 96 Gln/20ltr BMHP 20 0
1 PT 0963 1 2 02 BLU.FAR/919
13:57:40.8
4/2018
INTERGRA Mini Bio
28/08/201 BN.01.01/PP
STA Plus-
141 JP 8 K-
2 18002412 13:05:00.7 BLU.FAR/919
NUSANTA ophilus
2 7/2018
RA.PT 327-601
141 REKAMILE 0078/RS/F 10/01/201 BMHP Multi Pcs BMHP 2 16590909. 0 3318181.8 36500000 BN.01.01/PP
3 NIUMINDO /1/2018 8 Function 09 18 K-
SELARAS, 15:17:55.2 Occuleder BLU.FAR/92/
/MFO
PT 76 2018
No.12-14
TRANSME BN.01.01/PP
27/08/201 Katub
141 DIC K-
14:48:38.4 No.29mm
A. PT 2/2018
TRANSME BN.01.01/PP
27/08/201 Katub
141 DIC K-
14:48:38.4 No.33mm
A. PT 2/2018
TRANSME BN.01.01/PP
27/08/201 Katub
141 DIC K-
IN1805047 8 BMHP Mitral Buah BMHP 1 15100000 0 1510000 16610000
14:48:38.4 No.31mm
A. PT 2/2018
ANUGERA 28/08/201 BN.01.01/PP
7770- Tabung
141 H REZEKI 8 K-
18/08/AR BMHP EDTA 3ml P c s BMHP 3000 1200 0 360000 3960000
7 BERSAMA 14:35:54.1 BLU.FAR/923
BI/260 K3 glass
I. PT 93 1/2018
MBL
CAHAYA 28/08/201 BN.01.01/PP
SPEEDBAN
141 DUA 0083/CDD 8 K-
BMHP D Pcs BMHP 6 3000000 0 1800000 19800000
SUPERVIE
PT 36 3/2018
W SUPER 7
Cellebrity
CAHAYA 28/08/201 BN.01.01/PP
Cytology
141 DUA 0083/CDD 8 K-
1,5x140
PT 36 3/2018
BX/10
MENSA BN.01.01/PP
OXYGENAT
142 BINA CD194495 27/08/201 K-
BMHP OR ADULT S e t BMHP 5 5635310 0 2817655 30994205
0 SUKSES, 486 8 13:16:00 BLU.FAR/923
FX25RW40
PT 6/2018
MENSA Custom BN.01.01/PP
142 BINA CD194495 27/08/201 Pack / K-
1 SUKSES, 486 8 13:16:00 Blood Line BLU.FAR/923
PT Adult 6/2018
142 MENSA CD194495 27/08/201 BMHP Blood Line P c s BMHP 3 1 0 0.3 3.3 BN.01.01/PP
2 BINA 486 8 13:16:00 Infant/ K-
SUKSES, Custom BLU.FAR/923
Pack
PT 6/2018
CX921
142 DAYA 983/PDM/ 8 Indicator K-
BMHP Pcs BMHP 1000 15181.82 0 1518182 16700002
3 MEDICA, FP/VIII/18 11:24:02.9 Strip BLU.FAR/923
PT 13 250ea 7/2018
Sterilizatio
PETAN 28/08/201 BN.01.01/PP
n Agent
142 DAYA 983/PDM/ 8 7530000.0 K-
BMHP (H2O2) Pcs BMHP 15 456363.64 0 684545.46
4 MEDICA, FP/VIII/18 11:24:02.9 6 BLU.FAR/923
SA10/
PT 13 7/2018
15units
142 ANDALAS D1808- 8 II Ret Elect K-
BMHP Buah BMHP 75 109536 0 821520 9036720
5 MAKMUR. 01372 16:42:34.5 E7507 BLU.FAR/923
142 ANDALAS D1808- 8 Pencil with K-
BMHP Buah BMHP 100 90909.09 0 909090.9 9999999.9
6 MAKMUR. 01372 16:42:34.5 Holster BLU.FAR/923
PT 96 VL2610 8/2018
Kertas ECG
SUKSES 27/08/201 BN.01.01/PP
INV/SJA/1 Bionet,
142 JAYA 8 K-
8/VIII/045 BMHP Cardiocare Roll BMHP 50 88181.82 0 440909.1 4850000.1
6 215mmx2
O. PT 8 1/2018
5m
28/08/201 BN.01.01/PP
ALEXA Extention
142 FM/18/18 8 K-
8 38 14:33:09.3 BLU.FAR/926
PT 150cm
8 2/2018
BN.01.01/PP
ALEXA Extention
142 FM/18/18 03/09/201 K-
9 84 8 09:46:00 BLU.FAR/926
PT 150cm
2/2018
28/08/201 Bola BN.01.01/PP
AKARIM
143 18/AJF/VII 8 Lampu K-
0 I/974 15:17:23.8 Laryngosc BLU.FAR/926
FARMA.PT
36 ope Adult 9/2018
143 DAVINDO 003/PT.DV 24/09/201 BMHP Film DVB Lembar BMHP 500 16632 0 831600 9147600 BN.01.01/PP
1 VISI L/VII/201 8 20 x 25 K-
LESTARI. 7 16:29:50.1 @125 BLU.FAR/927
PT 13 4/2018
DAVINDO 24/09/201 Film DVB BN.01.01/PP
003/PT.DV
143 VISI 8 35 x 43 K-
L/VII/201 BMHP Lembar BMHP 500 45144 0 2257200 24829200
2 LESTARI. 16:29:50.1 Carestrea BLU.FAR/927
7
PT 13 m @125 4/2018
Syringe
EVIZA 10/01/201 BN.01.01/PP
SFP/001/E StellaDual
143 JAYA 8 K-
JM/01201 BMHP 200ml Pcs BMHP 20 428000 0 856000 9416000
3 MEDICA. 15:38:10.7 BLU.FAR/93/
8 Cat.SDS.CT
PT 1 2018
P.QFT
INTERGRA
Laparatom BN.01.01/PP
STA
143 JP 31/08/201 y Sponges K-
4 18002480 8 10:26:00 X Ray 35 X BLU.FAR/938
NUSANTA
35CM 7/2018
RA.PT
BN.01.01/PP
AKARIM
143 18/AJF/VII 31/08/201 Gigli Saw K-
5 I/994 8 16:02:00 Wire 40cm BLU.FAR/939
FARMA.PT
0/2018
DIMAS 11/01/201 BN.01.01/PP
Thermome
143 ANDALAS D1801- 8 34090.909 375000.00 K-
BMHP ter Digital P c s BMHP 15 22727.273 0
6 MAKMUR. 00405 12:49:07.9 5 45 BLU.FAR/94/
Alpha 3
PT 56 2018
DIMAS 11/01/201 BN.01.01/PP
143 ANDALAS D1801- 8 Spatula K-
BMHP Buah BMHP 50 290 0 1450 15950
7 MAKMUR. 00405 12:49:07.9 Kayu BLU.FAR/94/
PT 56 2018
MENSA 05/01/201 BN.01.01/PP
143 BINA CD193216 8 Arterial 127398.65 1401385.2 K-
BMHP Pcs BMHP 2 636993.28 0
8 SUKSES, 296 15:40:48.3 Filter Adult 6 16 BLU.FAR/940
PT 86 4/2017
DIMAS 04/09/201 Torniquet BN.01.01/PP
143 ANDALAS D1808- 8 / Pengikat K-
BMHP Pcs BMHP 20 12750 0 25500 280500
9 MAKMUR. 01753 10:48:13.8 Lengan BLU.FAR/945
PT 2 Blue OM 4/2018
144 DIMAS D1808- 04/09/201 BMHP Cauter / P c s BMHP 100 160656 0 1606560 17672160 BN.01.01/PP
0 ANDALAS 01753 8 Dispo K-
MAKMUR. 10:48:13.8 Hanswith BLU.FAR/945
PT 2 Pencil (E- 4/2018
2515)
144 ANDALAS D1808- 8 II Ret Elect K-
BMHP Buah BMHP 50 109536 0 547680 6024480
1 MAKMUR. 01753 10:48:13.8 E7507 BLU.FAR/945
DIMAS 04/09/201 BN.01.01/PP
HEARING
144 ANDALAS D1808- 8 681818.17 7499999.9 K-
BMHP AMPLIFIE Unit BMHP 15 454545.45 0
2 MAKMUR. 01753 10:48:13.8 5 25 BLU.FAR/945
R HA 20
PT 2 4/2018
MENSA 06/02/201 BN.01.01/PP
Steri Drape
144 BINA CD193404 8 K-
BMHP / U Drape P c s BMHP 30 202050 0 606150 6667650
3 SUKSES, 211 13:05:13.2 BLU.FAR/947
1015
PT 73 /2018
DIAN HD
06/09/201 BN.01.01/PP
LANGGEN DoubLum
144 FK180903 8 K-
G BMHP Farc 115- S e t BMHP 30 504000 0 1512000 16632000
4 3 12:23:48.3 BLU.FAR/951
PRATAMA. 15(preCur
26 6/2018
PT ved)
Cardiovasc
PERMATA 05/09/201 BN.01.01/PP
018/PB/F ular Patch
144 BUNDA 8 K-
5 ARTANO, 11:27:11.7 BLU.FAR/955
18 60mm x
PT 46 2/2018
0.4mm
CANULA
PERMATA 05/09/201 BN.01.01/PP
018/PB/F ORTIC
144 BUNDA 8 K-
6 ARTANO, 11:27:11.7 BLU.FAR/955
18 NO.24
PT 46 2/2018
cat.70424
CANULA
PERMATA 05/09/201 BN.01.01/PP
018/PB/F ORTIC
144 BUNDA 8 K-
7 ARTANO, 11:27:11.7 BLU.FAR/955
18 NO.18
PT 46 2/2018
CAT.75318
018/PB/F
AK/09/20 BMHP Buah BMHP 3 882000 0 264600 2910600
18
PT 46 No.24 CVB 2/2018
144 PERMATA 018/PB/F 05/09/201 BMHP CARDIOPL S e t BMHP 9 1600000 0 1440000 15840000 BN.01.01/PP
9 BUNDA AK/09/20 8 EGIA SET K-
18 ADULT
PT 46 2/2018
017/PB/F
AK/09/20 BMHP Set BMHP 1 30420000 0 3042000 33462000
18
017/PB/F
AK/09/20 BMHP Pcs BMHP 10 882000 0 882000 9702000
1 ARTANO, 12:41:48.5 4,0mm BLU.FAR/958
18
PT 1 Med 7/2018
MENSA 12/09/201 BN.01.01/PP
Oxygenato
145 BINA CD194576 8 K-
BMHP r 10 Ped. P c s BMHP 3 5080480 0 1524144 16765584
2 SUKSES, 678 11:27:07.2 BLU.FAR/963
FX15RW30
PT 4 2/2018
Blood Line
MENSA 12/09/201 BN.01.01/PP
Ped/
145 BINA CD194576 8 K-
3 SUKSES, 678 11:27:07.2 BLU.FAR/963
Pack CX
PT 4 2/2018
910
Blood Line
MENSA 12/09/201 BN.01.01/PP
Infant/
145 BINA CD194576 8 K-
4 SUKSES, 678 11:27:07.2 BLU.FAR/963
Pack
PT 4 2/2018
CX921
MENSA 12/09/201 BN.01.01/PP
OXYGENAT
145 BINA CD194576 8 K-
BMHP OR ADULT S e t BMHP 3 5635310 0 1690593 18596523
5 SUKSES, 678 11:27:07.2 BLU.FAR/963
FX25RW40
PT 4 2/2018
145 BINA CD194576 8 Pack / K-
PT 4 Adult 2/2018
PERMATA 12/09/201 BN.01.01/PP
060/PB/F Hemoconc
145 BUNDA 8 K-
7 ARTANO, 11:23:23.0 BLU.FAR/966
18 for Adult
PT 93 2/2018
145 PERMATA 060/PB/F 12/09/201 BMHP Katub Buah BMHP 1 15750000 0 1575000 17325000 BN.01.01/PP
8 BUNDA AK/09/20 8 Aortic Size K-
ARTANO, 18 11:23:23.0 18mm - BLU.FAR/966
PT 93 727227 2/2018
145 ANDALAS D1809- 8 II K-
BMHP Pcs BMHP 50 62064 0 310320 3413520
9 MAKMUR. 00565 16:00:33.9 Cordlesse BLU.FAR/966
PT 8 7509 3/2018
ANUGERA 26/09/201 BN.01.01/PP
Skin
146 H ARGON 12180053 8 120936.32 544213.48 5986348.3 K-
BMHP Traction Roll BMHP 45 0
0 MEDICA, 630 16:36:52.2 99 46 3 BLU.FAR/967
Adult BSN
PT 2 2/2018
ANUGERA 26/09/201 BN.01.01/PP
Skin
146 H ARGON 12180053 8 K-
BMHP Traction Roll BMHP 10 90013.11 0 90013.11 990144.21
1 MEDICA, 630 16:36:52.2 BLU.FAR/967
Paed
PT 2 2/2018
ANUGERA 26/09/201 BN.01.01/PP
Leukofix
146 H ARGON 12180053 8 K-
BMHP 2137 (1 x Roll BMHP 5 24669 0 12334.5 135679.5
2 MEDICA, 630 16:36:52.2 BLU.FAR/967
10)
PT 2 2/2018
ANUGERA
H 24/09/201 BN.01.01/PP
Mersilk
146 PHARMIN 22125428 8 K-
3 DO 29 13:33:14.8 BLU.FAR/967
(13x60cm)
LESTARI, 86 3/2018
PT
146 DAYA 1043/PDM 8 Indicator K-
BMHP Pcs BMHP 1000 15181.82 0 1518182 16700002
4 MEDICA. /FP/IX/18 09:39:48.7 Strip BLU.FAR/977
PT 43 250ea 7/2018
Sterilizatio
PETAN 13/09/201 BN.01.01/PP
n Agent
146 DAYA 1043/PDM 8 2738181.8 30120000. K-
BMHP (H2O2) Pcs BMHP 60 456363.64 0
5 MEDICA. /FP/IX/18 09:39:48.7 4 24 BLU.FAR/977
SA10/
PT 43 7/2018
15units
Cellebrity
CAHAYA 13/09/201 BN.01.01/PP
Cytology
146 DUA 0094/CDD 8 K-
6 DELAPAN. /IX/2018 10:59:57.2 BLU.FAR/977
1,5x140
PT 46 8/2018
BX/10
146 BIOGEN SI 09/02/201 BMHP APEX Box/72 BMHP 5 592200 0 296100 3257100 BN.01.01/PP
7 SCIENTIFI 18/00210 8 09:45:00 SUPERIOR K-
ADHESIVE BLU.FAR/979
C. PT
SLIDES /2018
TRANSME BN.01.01/PP
Katub
146 DIC 01/10/201 K-
8 INDONESI 8 15:42:00 BLU.FAR/979
No.33mm
A. PT 8/2018
Film UPT
OPAL 09/02/201 BN.01.01/PP
517 14x17 BMHP
146 PERKASA 983/OPS/I 8 K-
9 SEJAHTER I/18 09:50:57.6 BLU.FAR/982
Thermal I
A. PT 76 /2018
(35x43)
GabarithP
HOSPI 17/09/201 BN.01.01/PP
TT M Set-3DT-
147 MEDIK 8 K-
1393/HMI- BMHP XX- Set BMHP 10 742400 0 742400 8166400
MDN/IX/ 150cm/Re
A. PT 4 1/2018
d Blue&Yel
IDS F&P RT124
20/09/201 BN.01.01/PP
MEDICAL CIRC.W/
147 EG800000 8 K-
SYSTEM BMHP nCAP Set BMHP 10 2090000 0 2090000 22990000
1 37 16:25:04.9 BLU.FAR/985
INDONESI GENERAT
3 4/2018
A PT OSLE1000
Singel Use
IDS
20/09/201 Flow BN.01.01/PP
MEDICAL
147 EG800000 8 Sensor for K-
SYSTEM BMHP Pcs BMHP 5 1149500 0 574750 6322250
2 055 16:31:13.9 SLE BLU.FAR/985
INDONESI
13 4000/500 4/2018
A PT
0
IDS SU Circuit
20/09/201 BN.01.01/PP
MEDICAL w/ Twin
147 EG800000 8 K-
SYSTEM BMHP Spiral Pcs BMHP 15 1059250 0 1588875 17477625
3 055 16:31:13.9 BLU.FAR/985
INDONESI Heated
13 4/2018
A PT Circ
18/09/201 BN.01.01/PP
147 BRATACO. IVMDG180 8 390909.09 1172727.2 K-
BMHP Alkohol 96 Gln/20ltr BMHP 30 0 12900000
4 PT 1121 11:54:12.6 1 73 BLU.FAR/991
06 1/2018
147 TRANSME IN180570826/09/201 BMHP Katub Pcs BMHP 1 15100000 0 1510000 16610000 BN.01.01/PP
5 DIC 8 13:14:00 Aortic K-
INDONESI No.19mm BLU.FAR/991
A. PT Mechanical 3/2018
Oxygenato
PERMATA 18/09/201 BN.01.01/PP
124/PB/F r Affnity
147 BUNDA 8 K-
6 ARTANO, 15:22:31.0 BLU.FAR/991
18 Complete
PT 33 4/2018
Adult
124/PB/F
AK/09/20 BMHP Buah BMHP 1 15750000 0 1575000 17325000
7 ARTANO, 15:22:31.0 31mm - BLU.FAR/991
18
PT 33 753661 4/2018
ENSEVAL
BN.01.01/PP
PUTERA
147 11808140 19/09/201 K-
MEGATRA BMHP Cytofunnel B o x BMHP LAB 2 1600000 0 320000 3520000
8 8 8 10:43:00 BLU.FAR/991
DING TBK,
6/2018
PT
WEGO 19/09/201 BN.01.01/PP
SIC-
MDN/IX/1 BMHP Pcs BMHP 5 253000 0 126500 1391500
8/0846
A 1 7/2018
WEGO 19/09/201 BN.01.01/PP
SIC-
148 MEDIKA 8 DC Pigtail K-
MDN/IX/1 BMHP Pcs BMHP 5 253000 0 126500 1391500
0 INDONESI 13:18:31.7 STR 4Fr BLU.FAR/991
8/0846
A 1 7/2018
ANUGERA
H 20/09/201 BN.01.01/PP
148 PHARMIN 22125407 8 Nald K-
BMHP Buah BMHP 900 300 0 27000 297000
1 DO 28 16:05:45.0 No.18G BLU.FAR/995
LESTARI, 16 7/2018
PT
ANUGERA
H 12/10/201 BN.01.01/PP
148 PHARMIN 15100038 8 Nald K-
BMHP Buah BMHP 2100 300 0 63000 693000
2 DO 00 10:35:14.2 No.18G BLU.FAR/995
LESTARI, 83 7/2018
PT
148 IDS 0161774 19/09/201 BMHP Bipolar Pac P c s BMHP 10 1812500 0 1812500 19937500 BN.01.01/PP
3 MEDICAL 8 Catheter K-
SYSTEM 13:22:55.9 W/O BLU.FAR/998
INDONESI 7 Balloon 1/2018
A PT
IDS
19/09/201 BN.01.01/PP
MEDICAL BTR 4812-
148 8 K-
4 13:22:55.9 BLU.FAR/998
INDONESI Lumen
7 1/2018
A PT
IDS
19/09/201 BN.01.01/PP
MEDICAL BTR 3-
148 8 K-
5 13:22:55.9 BLU.FAR/998
7 1/2018
A PT
IDS PAPER
19/09/201 BN.01.01/PP
MEDICAL ECG Z-
148 8 K-
SYSTEM 0161774 BMHP FOLD Pcs BMHP 5 146250 0 73125 804375
6 13:22:55.9 BLU.FAR/998
INDONESI 210X295X
7 1/2018
A PT 150SHEET
IDS
24/09/201 BN.01.01/PP
MEDICAL BTR 3-
148 8 K-
7 15:30:49.1 BLU.FAR/998
1 1/2018
A PT
IDS PAPER
24/09/201 BN.01.01/PP
MEDICAL ECG Z-
148 8 K-
SYSTEM 0162298 BMHP FOLD Pcs BMHP 15 146250 0 219375 2413125
8 15:30:49.1 BLU.FAR/998
INDONESI 210X295X
1 1/2018
A PT 150SHEET
TRANSME 28/09/201 BN.01.01/PP
Katub
148 DIC IN1806044 8 K-
BMHP Aortic Pcs BMHP 1 15100000 0 1510000 16610000
9 INDONESI WA 08:51:25.2 BLU.FAR1027
NO.17mm
A. PT 2 3/2018
008/PB/F
AK/02/20 BMHP Buah BMHP 1 15750000 0 1575000 17325000
0 ARTANO, 11:23:19.8 31mm - BLU/FAK/88
18
PT 03 753661 9/2018
008/PB/F
AK/02/20 BMHP Buah BMHP 1 15750000 0 1575000 17325000
1 ARTANO, 11:23:19.8 33mm - BLU/FAK/88
18
PT 03 758270 9/2018
K-
MEDIKA, Tube
2 23 8 11:23:00 BLU/FAR/27
PT 150cm
91/2018
Urether BN.01.01/PP
ALEXA
149 FM/18/05 21/03/201 Stent Via K-
3 23 8 11:23:00 Cystos / BLU/FAR/27
PT
Open 4.7Fr 91/2018
ALEXA
149 FM/18/05 21/03/201 TROCAR & K-
4 23 8 11:23:00 CANNULA BLU/FAR/27
PT
CH 28 91/2018
ALEXA
149 FM/18/05 21/03/201 TROCAR & K-
MEDIKA, BMHP Pcs BMHP 5 118463 0 59231.5 651546.5
5 23 8 11:23:00 CANNULA BLU/FAR/27
PT
CH 20 91/2018
DC. JL 3.5 -
149 NIUMINDO 0272/RS/F 19/01/201 K-
BMHP 6F MM Pcs BMHP 15 265000 0 397500 4372500
6 SELARAS, /1/2018 8 16:47:00 BLU/FAR/29
7501-13
PT 2/2018
REKAMILE DC JR 3.5 - BN.01.01/PP
149 NIUMINDO 0272/RS/F 19/01/201 6F/Angiog K-
BMHP Pcs BMHP 15 265000 0 397500 4372500
7 SELARAS, /1/2018 8 16:47:00 raphic cath BLU/FAR/29
PT 7503-13 2/2018
REKAMILE Bipolar BN.01.01/PP
149 NIUMINDO 0272/RS/F 19/01/201 Pacel K-
BMHP Pcs BMHP 4 1900000 0 760000 8360000
8 SELARAS, /1/2018 8 16:47:00 Pacing BLU/FAR/29
PT Cath 6F 2/2018
Cera ASD
149 NIUMINDO 0272/RS/F 19/01/201 24454545. 2445454.5 K-
9 SELARAS, /1/2018 8 16:47:00 45 45 BLU/FAR/29
No.34
PT 2/2018
Cera ASD
150 NIUMINDO 0334/RS/F 19/01/201 24454545. 2445454.5 K-
0 SELARAS, /1/2018 8 15:32:00 45 45 BLU/FAR/34
No.18
PT 7/2018
Steerease
150 NIUMINDO 0334/RS/F 19/01/201 4336734.5 433673.45 4770408.0 K-
BMHP Occuleder P c s BMHP 1 0
1 SELARAS, /1/2018 8 15:32:00 5 5 05 BLU/FAR/34
6F
PT 7/2018
MUlti
Function
150 NIUMINDO 0373/RS/F 22/01/201 16590909. 1659090.9 K-
2 SELARAS, /1/2018 8 10:36:00 09 09 BLU/FAR/35
/ MFO
PT 5/2018
No.7-5
VSD
150 NIUMINDO 0373/RS/F 22/01/201 16590909. 1659090.9 K-
BMHP Occluder / P c s BMHP 1 0 18250000
3 SELARAS, /1/2018 8 10:36:00 09 09 BLU/FAR/35
MFO 8-6
PT 5/2018
150 BINA CD193315 8 r 10 Ped. 4999012.4 2499506.2 27494568. K-
BMHP Pcs BMHP 5 0
4 SUKSES, 699 13:15:23.6 RX15RW3 8 4 64 BLU/FAR/41
PT 3 0 1/2018
MENSA 22/01/201 BN.01.01/PP
150 BINA CD193315 8 Arterial 3503463.0 K-
BMHP Pcs BMHP 5 636993.28 0 318496.64
5 SUKSES, 699 13:15:23.6 Filter Adult 4 BLU/FAR/41
PT 3 1/2018
Blood Line
MENSA 22/01/201 BN.01.01/PP
Infant/
150 BINA CD193315 8 K-
6 SUKSES, 699 13:15:23.6 BLU/FAR/41
Pack
PT 3 1/2018
CX921
Blood Line
MENSA 22/01/201 BN.01.01/PP
Ped/
150 BINA CD193315 8 K-
7 SUKSES, 699 13:15:23.6 BLU/FAR/41
Pack CX
PT 3 1/2018
910
ANUGERA
H 24/01/201 BN.01.01/PP
Mersilk
150 PHARMIN 22124375 8 K-
8 DO 31 11:58:01.8 BLU/FAR/48
(13x60cm)
LESTARI, 9 3/2018
PT
OPAL 25/01/201 SYRINGE BN.01.01/PP
150 PERKASA 966/OPS/I 8 150ml K-
BMHP Buah BMHP 50 217600 0 1088000 11968000
9 SEJAHTER /18 08:50:34.5 FTQ/ BLU/FAR/51
A. PT 76 MEDRAD 8/2018
151 ANUGERA 63/AMN/I 25/01/201 BMHP Plastik Kg BMHP 10 31050 0 31050 341550 BN.01.01/PP
0 H /2018 8 Assoy K-
MANDIRI
11:35:06.3 BLU/FAR/51
7 9/2018
, PT
ANUGERA
25/01/201 BN.01.01/PP
H Plastik
151 63/AMN/I 8 K-
1 /2018 11:35:06.3 BLU/FAR/51
7 9/2018
, PT
ANUGERA
25/01/201 BN.01.01/PP
H Plastik
151 63/AMN/I 8 K-
2 /2018 11:35:06.3 BLU/FAR/51
7 9/2018
, PT
ANUGERA
25/01/201 BN.01.01/PP
H Plastik
151 63/AMN/I 8 K-
3 /2018 11:35:06.3 BLU/FAR/51
INTERASIA x 13
7 9/2018
, PT
ANUGERA
25/01/201 BN.01.01/PP
H Plastik
151 63/AMN/I 8 K-
4 /2018 11:35:06.3 BLU/FAR/51
INTERASIA x 17
7 9/2018
, PT
ANUGERA
25/01/201 BN.01.01/PP
H
151 63/AMN/I 8 Plastik Klip K-
5 /2018 11:35:06.3 35 x 25cm BLU/FAR/51
INTERASIA
7 9/2018
, PT
ANUGERA
25/01/201 BN.01.01/PP
H
6 /2018 11:35:06.3 10 x 6cm BLU/FAR/51
INTERASIA
7 9/2018
, PT
ANUGERA
25/01/201 BN.01.01/PP
H
151 63/AMN/I 8 Kapas K-
7 /2018 11:35:06.3 Cebok BLU/FAR/51
INTERASIA
7 9/2018
, PT
151 ANUGERA 63/AMN/I 25/01/201 BMHP BOTOL Botol BMHP 1008 9000 0 907200 9979200 BN.01.01/PP
H
8 HANDSOA K-
MANDIRI
8 /2018 11:35:06.3 P/HANDR BLU/FAR/51
INTERASIA
7 UB 500ml 9/2018
, PT
ANUGERA
25/01/201 BN.01.01/PP
H
MANDIRI BMHP Lembar BMHP 5000 130 0 65000 715000
9 /2018 11:35:06.3 10 x 15cm BLU/FAR/51
INTERASIA
7 9/2018
, PT
152 MA 8 Yell Nephr K-
14870 BMHP Pcs BMHP 20 2098800 0 4197600 46173600
0 LESTARI 16:45:33.7 Punct Set BLU/FAR/52
.PT 16 No.7/34cm 1/2018
MITRAPRI 25/01/201 White Star BN.01.01/PP
152 MA 8 Doub J K-
14871 BMHP Pcs BMHP 2 998100 0 199620 2195820
1 LESTARI 16:43:44.6 Uret Stent BLU/FAR/52
.PT 96 4,7Fr 2/2018
Yel Star
Doub J
152 MA 8 K-
14871 BMHP Uret Sten Buah BMHP 2 1339200 0 267840 2946240
2 LESTARI 16:43:44.6 BLU/FAR/52
Fr4,7 Close
.PT 96 2/2018
Ti
IDS
24/01/201 BN.01.01/PP
MEDICAL Tracheosto
152 8 K-
SYSTEM 0131408 BMHP my Tube P c s BMHP 3 307458 0 92237.4 1014611.4
3 15:45:09.2 BLU/FAR/56
INDONESI Size 5
56 3/2018
A PT
IDS
24/01/201 HD KIT 2 BN.01.01/PP
MEDICAL
152 8 LUMEN K-
4 15:45:09.2 8FR X BLU/FAR/56
INDONESI
56 11CM 3/2018
A PT
IDS
24/01/201 BN.01.01/PP
MEDICAL Thoracic
152 8 K-
SYSTEM 0131408 BMHP Catheter Pcs BMHP 20 262500 0 525000 5775000
5 15:45:09.2 BLU/FAR/56
INDONESI No.28
56 3/2018
A PT
152 IDS 0131408 24/01/201 BMHP LMA Pcs BMHP 3 434520 0 130356 1433916 BN.01.01/PP
6 MEDICAL 8 Supreme K-
SYSTEM
15:45:09.2 BLU/FAR/56
INDONESI SU Size 2
56 3/2018
A PT
Radial
REVASS Artery BN.01.01/PP
152 UTAMA RUM18- 25/01/201 Compressi K-
BMHP Pcs BMHP 10 330000 0 330000 3630000
7 MEDIKA 00066 8 09:03:00 on BLU/FAR/56
.PT Tourniquet 4/2018
e
MILLENNI
UM Bioglue
BN.01.01/PP
PHARMAC Pre-Filled
152 13061800 25/01/201 K-
8 3470 8 09:01:00 BLU/FAR/56
INTERNAT SURG.ADH
9/2018
IONAL ESIVE
TBK, PT
PYROGEN
DIPA 25/01/201 BN.01.01/PP
FREE
152 PUSPA 0718.FP- 8 K-
BMHP DILUTION Kit BMHP 1 1022516 0 102251.6 1124767.6
9 LABSAINS. 100099 12:20:23.4 BLU/FAR/62
13X100M
PT 46 4/2018
M
PYROGENT
DIPA 25/01/201 BN.01.01/PP
PLUS 200
153 PUSPA 0718.FP- 8 K-
BMHP TEST Kit BMHP 1 11050000 0 1105000 12155000
0 LABSAINS. 100099 12:20:23.4 BLU/FAR/62
0.25EU/M
PT 46 4/2018
L
DIPA 25/01/201 LAL BN.01.01/PP
153 PUSPA 0718.FP- 8 Reagent K-
BMHP Botol BMHP LAB 1 300883 0 30088.3 330971.3
1 LABSAINS. 100099 12:20:23.4 Water BLU/FAR/62
PT 46 100ml 4/2018
130/PB/F
153 BUNDA 8 Aortic Size K-
AK/01/20 BMHP Buah BMHP 1 14950000 0 1495000 16445000
2 ARTANO, 17:03:45.4 20mm - BLU/FAR/62
18
PT 7 736784 5/2018
130/PB/F
153 BUNDA 8 Mitral Size 14945454. 1494545.4 16440000. K-
AK/01/20 BMHP Buah BMHP 1 0
3 ARTANO, 17:03:45.4 31mm - 55 55 01 BLU/FAR/62
18
PT 7 753661 5/2018
153 PERMATA 133/PB/F 29/01/201 BMHP Antegrade P c s BMHP 10 630000 0 630000 6930000 BN.01.01/PP
BUNDA 8 Aortic Root K-
AK/01/20
4 ARTANO, 09:53:10.9 Cannula BLU/FAR/73
18
PT 4 WVL 9Fr 0/2018
133/PB/F
AK/01/20 BMHP Buah BMHP 1 15750000 0 1575000 17325000
5 ARTANO, 09:53:10.9 31mm - BLU/FAR/73
18
PT 4 753661 0/2018
PERMATA 29/01/201 BN.01.01/PP
133/PB/F Cardiopleg
153 BUNDA 8 K-
AK/01/20 BMHP ia Kallife S e t BMHP 10 1600000 0 1600000 17600000
6 ARTANO, 09:53:10.9 BLU/FAR/73
18 Adult
PT 4 0/2018
Cannula
PERMATA 29/01/201 BN.01.01/PP
133/PB/F Aortic
153 BUNDA 8 K-
AK/01/20 BMHP StraightNo. P c s BMHP 3 684000 0 205200 2257200
7 ARTANO, 09:53:10.9 BLU/FAR/73
18 16FR
PT 4 0/2018
CAT70016
IDS
30/01/201 BN.01.01/PP
MEDICAL Paper
153 8 K-
8 15:10:56.0 BLU/FAR/73
INDONESI e
46 4/2018
A PT
DIMAS BN.01.01/PP
HEARING
153 ANDALAS D1801- 30/01/201 454545.45 363636.36 4000000.0 K-
BMHP AMPLIFIE Unit BMHP 8 0
9 MAKMUR. 01517 8 13:40:00 5 4 04 BLU/FAR/78
R HA 20
PT 2/2018
DIMAS 31/01/201 BN.01.01/PP
154 ANDALAS D1801- 8 387672.72 4264400.0 K-
BMHP Sodalime Galon BMHP 8 484590.91 0
0 MAKMUR. 01561 14:40:36.4 8 08 BLU/FAR/78
PT 23 2/2018
BN.01.01/PP
KASIH
154 01/KTJ/I/ 30/01/201 Aqua Non K-
THREEBER BMHP Galon BMHP 150 8500 0 127500 1402500
1 2018 8 13:33:00 Steril BLU/FAR/78
S JAYA. PT
4/2018
Oxygenato
PERMATA 31/01/201 BN.01.01/PP
150/PB/F r Affnity
154 BUNDA 8 K-
2 ARTANO, 09:40:00.7 BLU/FAR/80
18 Complete
PT 4 3/2018
Adult
154 MEGA INTI 069 01/02/201 BMHP Kertas ECG Roll BMHP 98 97325.455 0 953789.45 10491684. BN.01.01/PP
Bionet,
MAKMUR 8 K-
Cardiocare
3 MEDIKA. 14:52:48.0 9 05 BLU/FAR/86
215mmx2
PT 96 6/2018
5m
SENSATRA
IDS
05/02/201 C MEDIUM BN.01.01/PP
MEDICAL
154 8 GRANUFO K-
4 13:53:42.5 AM BLU/FAR/87
INDONESI
4 DRESSING 2/2018
A PT
10PC
IDS
05/02/201 BN.01.01/PP
MEDICAL CANISTER
154 8 K-
5 13:53:42.5 BLU/FAR/87
INDONESI 500ML
4 2/2018
A PT
MENSA 05/02/201 BN.01.01/PP
154 BINA CD193386 8 Clipper K-
BMHP Set BMHP 200 60200 0 1204000 13244000
6 SUKSES, 166 17:26:23.3 Blade 9660 BLU/FAR/87
PT 06 3/2018
MENSA 05/02/201 BN.01.01/PP
154 BINA CD193387 8 DoCare K-
BMHP Pcs BMHP 50 40880 0 204400 2248400
7 SUKSES, 154 17:27:58.8 Hair Clean BLU/FAR/87
PT 9 4/2018
Docare
MENSA 05/02/201 BN.01.01/PP
Wash
154 BINA CD193387 8 K-
BMHP Gloves 4 P c s BMHP 764 4215.75 0 322083.3 3542916.3
8 SUKSES, 154 17:27:58.8 BLU/FAR/87
Sheet
PT 9 4/2018
Parfume
Rapid
MULTI 01/02/201 BN.01.01/PP
Staining of
154 MEDIKA MML0007 8 K-
BMHP Blood/He Kit BMHP LAB 1 2310000 0 231000 2541000
9 LABORAT 13/0218 15:22:48.2 BLU/FAR/88
macolor-
ORY.PT 66 4/2018
3x500
06/02/201 BN.01.01/PP
155 BRATACO. IVMDG180 8 390909.09 1172727.2 K-
BMHP Alkohol 96 Gln/20ltr BMHP 30 0 12900000
0 PT 0134 12:25:24.9 1 73 BLU/FAR/97
3 8/2018
155 INDOSOPH INV18080 29/08/201 BMHP LEVEL Pcs BMHP 100 177272.73 0 1772727.3 19500000. BN.01.01/PP
1 A SAKTI. 40 8 10:12:00 SENSOR 3 K-
FAR/9110/20
PT PAD
18
LCP
BONANDO
PROXIMAL
LOK
155 05/12/201 FEMORAL 4454545.4 445454.54 4899999.9 BN.01.01/PPK-
PANDE 00075 ALKES Pcs IMPLANT 1 0
2 8 08:52:00 PLT 5 5 5 95 III/9146/2018
MANDIRI
HOLE
PT
RIGHT
LCP
BONANDO
PROXIMAL
LOK
155 05/12/201 FEMORAL 4454545.4 445454.54 4899999.9 BN.01.01/PPK-
3 8 08:52:00 PLT 7 5 5 95 III/9146/2018
MANDIRI
HOLE
PT
LEFT
LCP
BONANDO
PROXIMAL
LOK
155 05/12/201 FEMORAL 4454545.4 445454.54 4899999.9 BN.01.01/PPK-
4 8 08:52:00 PLT 7 5 5 95 III/9146/2018
MANDIRI
HOLE
PT
RIGHT
LCP
BONANDO
PROXIMAL
LOK
155 05/12/201 FEMORAL 4454545.4 445454.54 4899999.9 BN.01.01/PPK-
5 8 08:52:00 PLT 9 5 5 95 III/9146/2018
MANDIRI
HOLE
PT
LEFT
LCP
BONANDO
PROXIMAL
LOK
155 05/12/201 FEMORAL 4454545.4 445454.54 4899999.9 BN.01.01/PPK-
6 8 08:52:00 PLT 9 5 5 95 III/9146/2018
MANDIRI
HOLE
PT
RIGHT
BONANDO
LOCKING
LOK
155 05/12/201 SCREW 118636.36 1305000.0 BN.01.01/PPK-
PANDE 00075 ALKES Pcs IMPLANT 3 395454.55 0
7 8 08:52:00 5.0MM 5 15 III/9146/2018
MANDIRI
L18MM
PT
155 BONANDO 00075 05/12/201 ALKES LOCKING P c s IMPLANT 3 395454.55 0 118636.36 1305000.0 BN.01.01/PPK-
8 LOK 8 08:52:00 SCREW 5 15 III/9146/2018
PANDE
5.0MM L
MANDIRI
20MM
PT
BONANDO
LOCKING
LOK
155 05/12/201 SCREW 118636.36 1305000.0 BN.01.01/PPK-
9 8 08:52:00 5.0MM 5 15 III/9146/2018
MANDIRI
L22MM
PT
BONANDO
LOCKING
LOK
156 05/12/201 SCREW 118636.36 1305000.0 BN.01.01/PPK-
0 8 08:52:00 5.0MM 5 15 III/9146/2018
MANDIRI
L24MM
PT
BONANDO
LOCKING
LOK
156 05/12/201 SCREW 118636.36 1305000.0 BN.01.01/PPK-
1 8 08:52:00 5.0MM 5 15 III/9146/2018
MANDIRI
L26MM
PT
BONANDO
LOCKING
LOK
156 05/12/201 SCREW 118636.36 1305000.0 BN.01.01/PPK-
2 8 08:52:00 5.0MM 5 15 III/9146/2018
MANDIRI
L28MM
PT
BONANDO
LOCKING
LOK
156 05/12/201 SCREW 118636.36 1305000.0 BN.01.01/PPK-
3 8 08:52:00 5.0MM 5 15 III/9146/2018
MANDIRI
L30MM
PT
BONANDO
LOCKING
LOK
156 05/12/201 SCREW 118636.36 1305000.0 BN.01.01/PPK-
4 8 08:52:00 5.0MM 5 15 III/9146/2018
MANDIRI
L32MM
PT
BONANDO
LOCKING
LOK
156 05/12/201 SCREW 118636.36 1305000.0 BN.01.01/PPK-
5 8 08:52:00 5.0MM 5 15 III/9146/2018
MANDIRI
L34MM
PT
LOK
SCREW
PANDE
6 8 08:52:00 5.0MM 5 15 III/9146/2018
MANDIRI
L36MM
PT
BONANDO
LOCKING
LOK
156 05/12/201 SCREW BN.01.01/PPK-
PANDE 00075 ALKES Pcs IMPLANT 2 395454.55 0 79090.91 870000.01
7 8 08:52:00 5.0MM III/9146/2018
MANDIRI
L38MM
PT
BONANDO
LOCKING
LOK
156 05/12/201 SCREW BN.01.01/PPK-
8 8 08:52:00 5.0MM III/9146/2018
MANDIRI
L40MM
PT
BONANDO
LOCKING
LOK
156 05/12/201 SCREW BN.01.01/PPK-
9 8 08:52:00 5.0MM III/9146/2018
MANDIRI
L42MM
PT
BONANDO
LOCKING
LOK
157 05/12/201 SCREW BN.01.01/PPK-
0 8 08:52:00 5.0MM III/9146/2018
MANDIRI
L44MM
PT
BONANDO
LOCKING
LOK
157 05/12/201 SCREW BN.01.01/PPK-
1 8 08:52:00 5.0MM III/9146/2018
MANDIRI
L46MM
PT
BONANDO
LOCKING
LOK
157 05/12/201 SCREW BN.01.01/PPK-
2 8 08:52:00 5.0MM III/9146/2018
MANDIRI
L48MM
PT
BONANDO
LOCKING
LOK
157 05/12/201 SCREW BN.01.01/PPK-
3 8 08:52:00 5.0MM III/9146/2018
MANDIRI
L50MM
PT
BONANDO
LOCKING
LOK
157 05/12/201 SCREW BN.01.01/PPK-
4 8 08:52:00 5.0MM III/9146/2018
MANDIRI
L55MM
PT
BONANDO
LOCKING
LOK
157 05/12/201 SCREW BN.01.01/PPK-
5 8 08:52:00 5.0MM III/9146/2018
MANDIRI
L60MM
PT
BONANDO
LOCKING
LOK
157 05/12/201 SCREW BN.01.01/PPK-
6 8 08:52:00 5.0MM III/9146/2018
MANDIRI
L65MM
PT
BONANDO
LOCKING
LOK
157 05/12/201 SCREW BN.01.01/PPK-
7 8 08:52:00 5.0MM III/9146/2018
MANDIRI
L70MM
PT
BONANDO
LOCKING
LOK
157 05/12/201 SCREW BN.01.01/PPK-
8 8 08:52:00 5.0MM III/9146/2018
MANDIRI
L75MM
PT
BONANDO
LOCKING
LOK
157 05/12/201 SCREW BN.01.01/PPK-
9 8 08:52:00 5.0MM III/9146/2018
MANDIRI
L80MM
PT
BONANDO
LOCKING
LOK
158 05/12/201 SCREW BN.01.01/PPK-
0 8 08:52:00 5.0MM III/9146/2018
MANDIRI
L85MM
PT
1 LOK 8 08:52:00 SCREW III/9146/2018
PANDE 5.0MM
MANDIRI L90MM
PT
BONANDO
LOCKING
LOK
158 05/12/201 SCREW 820000.00 BN.01.01/PPK-
PANDE 00075 ALKES Pcs IMPLANT 1 745454.55 0 74545.455
2 8 08:52:00 6.5MM 5 III/9146/2018
MANDIRI
L100MM
PT
BONANDO
LOCKING
LOK
158 05/12/201 SCREW 820000.00 BN.01.01/PPK-
3 8 08:52:00 6.5MM 5 III/9146/2018
MANDIRI
L105MM
PT
BONANDO
LOCKING
LOK
158 05/12/201 SCREW 820000.00 BN.01.01/PPK-
4 8 08:52:00 6.5MM 5 III/9146/2018
MANDIRI
L110MM
PT
BONANDO
LOCKING
LOK
158 05/12/201 SCREW 820000.00 BN.01.01/PPK-
5 8 08:52:00 6.5MM 5 III/9146/2018
MANDIRI
L115MM
PT
BONANDO
LOCKING
LOK
158 05/12/201 SCREW 1640000.0 BN.01.01/PPK-
6 8 08:52:00 6.5MM 1 III/9146/2018
MANDIRI
L35MM
PT
BONANDO
LOCKING
LOK
158 05/12/201 SCREW 1640000.0 BN.01.01/PPK-
7 8 08:52:00 6.5MM 1 III/9146/2018
MANDIRI
L40MM
PT
BONANDO
LOCKING
LOK
158 05/12/201 SCREW 1640000.0 BN.01.01/PPK-
8 8 08:52:00 6.5MM 1 III/9146/2018
MANDIRI
L45MM
PT
9 LOK 8 08:52:00 SCREW 5 III/9146/2018
PANDE 6.5MM
MANDIRI
L50MM
PT
BONANDO
LOCKING
LOK
159 05/12/201 SCREW 820000.00 BN.01.01/PPK-
0 8 08:52:00 6.5MM 5 III/9146/2018
MANDIRI
L55MM
PT
BONANDO
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LOK
159 05/12/201 SCREW 820000.00 BN.01.01/PPK-
1 8 08:52:00 6.5MML80 5 III/9146/2018
MANDIRI
MM
PT
BONANDO
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LOK
159 05/12/201 SCREW 820000.00 BN.01.01/PPK-
2 8 08:52:00 6.5MM 5 III/9146/2018
MANDIRI
L60MM
PT
BONANDO
LOCKING
LOK
159 05/12/201 SCREW 820000.00 BN.01.01/PPK-
3 8 08:52:00 6.5MM 5 III/9146/2018
MANDIRI
L65MM
PT
BONANDO
LOCKING
LOK
159 05/12/201 SCREW 820000.00 BN.01.01/PPK-
4 8 08:52:00 6.5MM 5 III/9146/2018
MANDIRI
L70MM
PT
BONANDO
LOCKING
LOK
159 05/12/201 SCREW 820000.00 BN.01.01/PPK-
5 8 08:52:00 6.5MM 5 III/9146/2018
MANDIRI
L75MM
PT
BONANDO
LOCKING
LOK
159 05/12/201 SCREW 820000.00 BN.01.01/PPK-
6 8 08:52:00 6.5MM 5 III/9146/2018
MANDIRI
L85MM
PT
7 LOK 8 08:52:00 SCREW 5 III/9146/2018
PANDE
6.5MM
MANDIRI
L90MM
PT
BONANDO
LOCKING
LOK
159 05/12/201 SCREW 820000.00 BN.01.01/PPK-
8 8 08:52:00 6.5MM 5 III/9146/2018
MANDIRI
L95MM
PT
159 ANDALAS D1809- 8 Crutch/To 1850000.0 BN.01.01/PPK-
ALKES Pasang ALKES 10 168181.82 0 168181.82
9 MAKMUR. 00922 13:54:37.4 ngkat 2 III/9156/2018
PT 43 Ketiak L
160 ANDALAS D1809- 8 Crutch/To 353181.82 3885000.0 BN.01.01/PPK-
ALKES Pasang ALKES 21 168181.82 0
0 MAKMUR. 00922 13:54:37.4 ngkat 2 42 III/9156/2018
PT 43 Ketiak M
DIMAS Axilla
160 ANDALAS D1809- 24/09/201 Crutch/To 740000.00 BN.01.01/PPK-
1 MAKMUR. 01264 8 11:13:00 ngkat 8 III/9156/2018
PT Ketiak M
2 MAKMUR. 00460 13:53:47.7 ngkat 8 III/9156/2018
PT 9 Ketiak M
3 MAKMUR. 00460 13:53:47.7 ngkat 2 III/9156/2018
PT 9 Ketiak L
4 MAKMUR. 00460 13:53:47.7 ngkat 2 III/9156/2018
PT 9 Ketiak S
IDS
BIOMATRI
MEDICAL BN.01.01/PPK
160 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
SYSTEM B0000140 ALKES Pcs STENT 1 0 -BLUFar/9514/2
5 8 10:00:00 2.5 X 3 3 03
INDONESI 018
11MM
A PT
160 IDS B0000140 21/09/201 ALKES BIOMATRI P c s STENT 1 7727272.7 0 772727.27 8500000.0 BN.01.01/PPK
6 MEDICAL 8 10:00:00 X Flex DES 3 3 03 -BLUFar/9514/2
SYSTEM
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INDONESI 018
14MM
A PT
IDS
BIOMATRI
160 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
7 8 10:00:00 2.5 X 3 3 03
INDONESI 018
18MM
A PT
IDS
BIOMATRI
160 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
8 8 10:00:00 2.5 X 3 3 03
INDONESI 018
24MM
A PT
IDS
BIOMATRI
160 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
9 8 10:00:00 2.5 x 3 3 03
INDONESI 018
28MM
A PT
IDS
MEDICAL BIOMATRI BN.01.01/PPK
161 21/09/201 7727272.7 772727.27 8500000.0
SYSTEM B0000140 ALKES X Flex DES P c s STENT 1 0 -BLUFar/9514/2
0 8 10:00:00 3 3 03
INDONESI 2.5 X 8MM 018
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IDS
BIOMATRI
161 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
1 8 10:00:00 2.5 X 3 3 03
INDONESI 018
33MM
A PT
IDS
BIOMATRI
161 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
2 8 10:00:00 2.5 X 3 3 03
INDONESI 018
36MM
A PT
IDS
BIOMATRI
161 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
3 8 10:00:00 2.75 X 3 3 03
INDONESI 018
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A PT
161 IDS B0000140 21/09/201 ALKES BIOMATRI P c s STENT 1 7727272.7 0 772727.27 8500000.0 BN.01.01/PPK
MEDICAL
X Flex DES
SYSTEM -BLUFar/9514/2
4 8 10:00:00 2.75 X 3 3 03
INDONESI 018
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A PT
IDS
BIOMATRI
161 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
5 8 10:00:00 2.75 X 3 3 03
INDONESI 018
33MM
A PT
IDS
BIOMATRI
161 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
6 8 10:00:00 2.75 X 3 3 03
INDONESI 018
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A PT
IDS
BIOMATRI
161 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
7 8 10:00:00 3.0 X 3 3 03
INDONESI 018
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A PT
IDS
BIOMATRI
161 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
8 8 10:00:00 3.0 X 3 3 03
INDONESI 018
14MM
A PT
IDS
BIOMATRI
161 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
9 8 10:00:00 3.0 X 3 3 03
INDONESI 018
18MM
A PT
IDS
BIOMATRI
162 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
0 8 10:00:00 3.0 X 3 3 03
INDONESI 018
28MM
A PT
IDS
162 21/09/201 7727272.7 772727.27 8500000.0
1 8 10:00:00 3 3 03
A PT
IDS
BIOMATRI
162 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
2 8 10:00:00 3.0 X 3 3 03
INDONESI 018
36MM
A PT
IDS
BIOMATRI
162 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
3 8 10:00:00 3.5 X 3 3 03
INDONESI 018
14MM
A PT
IDS
BIOMATRI
162 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
4 8 10:00:00 3.5 X 3 3 03
INDONESI 018
18MM
A PT
IDS
BIOMATRI
162 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
5 8 10:00:00 3.5 X 3 3 03
INDONESI 018
33MM
A PT
IDS
BIOMATRI
162 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
6 8 10:00:00 3.5 X 3 3 03
INDONESI 018
36MM
A PT
IDS
BIOMATRI
162 21/09/201 X FLex DES 7727272.7 772727.27 8500000.0
7 8 10:00:00 3.5 X 3 3 03
INDONESI 018
11MM
A PT
IDS
162 21/09/201 7727272.7 772727.27 8500000.0
8 8 10:00:00 3 3 03
A PT
162 IDS B0000140 21/09/201 ALKES BIOMATRX P c s STENT 1 7727272.7 0 772727.27 8500000.0 BN.01.01/PPK
9 MEDICAL 8 10:00:00 Flex DES 3 3 03 -BLUFar/9514/2
SYSTEM 3.0 X 018
INDONESI 33MM
A PT
IDS
BIOMATRI
163 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
0 8 10:00:00 4.0 X 3 3 03
INDONESI 018
11MM
A PT
IDS
BIOMATRI
163 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
1 8 10:00:00 4.0 X 3 3 03
INDONESI 018
14MM
A PT
IDS
BIOMATRI
163 21/09/201 X Flex DES 7727272.7 772727.27 8500000.0
2 8 10:00:00 4.0 X 3 3 03
INDONESI 018
18MM
A PT
IDS
163 21/09/201 7727272.7 772727.27 8500000.0
3 8 10:00:00 3 3 03
A PT
IDS
BIOMATRI
163 21/09/201 X FLex DES 7727272.7 772727.27 8500000.0
4 8 10:00:00 4.0 X 3 3 03
INDONESI 018
28MM
A PT
ORTHOCE
MITRA
M 3G
163 FAJAR 0227/XI/2 29/11/201 BN.01.01./PPK-
ALKES (boncemen P c s IMPLANT 60 1072500 0 6435000 70785000
5 SELARAS, 018 8 11:00:00 III/9144/2018
t+genta)40
PT
Gr
MITRA
Cervical
163 FAJAR 0227/XI/2 29/11/201 BN.01.01./PPK-
ALKES Mesh Plate P c s IMPLANT 5 4387500 0 2193750 24131250
6 SELARAS, 018 8 11:00:00 III/9144/2018
10cm
PT
163 NUGRA NK- 08/11/201 ALKES PPM Set PACU 6 16000000 0 9600000 10560000 BN.01.01/PPK-
7 KARSERA. 2018.0006 8 12:10:00 SENSIA JANTUNG 0 III/9154/2018
PT 106 SES01
Single
Chamber
PPM
NUGRA NK- SENSIA
163 10/12/201 PACU BN.01.01/PPK-
KARSERA. 2018.0006 ALKES SES01 Set 5 16000000 0 8000000 88000000
8 8 12:00:00 JANTUNG III/9154/2018
PT 810 Single
Chamber
PPM
NUGRA NK-
163 10/12/201 Sensia DR PACU BN.01.01/PPK-
KARSERA. 2018.0006 ALKES Set 1 34100000 0 3410000 37510000
9 8 12:00:00 dual JANTUNG III/9154/2018
PT 810
chamber
ORIONTA
164 16/10/201 CERVICAL 4863636.3 486363.63 5349999.9 bn.01.01/PPK-
MA JAYA, 18/1488 ALKES Pcs IMPLANT 1 0
0 8 14:10:00 CAGE 5L 6 6 96 III/9148/2018
PT
ORIONTA
164 16/10/201 CERVICAL 4863636.3 486363.63 5349999.9 bn.01.01/PPK-
1 8 14:10:00 CAGE 5M 6 6 96 III/9148/2018
PT
ORIONTA
164 16/10/201 CERVICAL 4863636.3 486363.63 5349999.9 bn.01.01/PPK-
2 8 14:10:00 CAGE 5S 6 6 96 III/9148/2018
PT
ORIONTA
164 16/10/201 CERVICAL 4863636.3 486363.63 5349999.9 bn.01.01/PPK-
3 8 14:10:00 CAGE 6M 6 6 96 III/9148/2018
PT
ORIONTA
164 16/10/201 CERVICAL 4863636.3 486363.63 5349999.9 bn.01.01/PPK-
4 8 14:10:00 CAGE 6S 6 6 96 III/9148/2018
PT
ORIONTA CERVICAL
164 16/10/201 5256363.6 1051272.7 11564000. bn.01.01/PPK-
MA JAYA, 18/1488 ALKES PLATE L Pcs IMPLANT 2 0
5 8 14:10:00 4 28 01 III/9148/2018
PT 29MM
ORIONTA CERVICAL
164 16/10/201 5256363.6 1051272.7 11564000. bn.01.01/PPK-
6 8 14:10:00 4 28 01 III/9148/2018
PT 34MM
ORIONTA CERVICAL
164 16/10/201 5256363.6 1051272.7 11564000. bn.01.01/PPK-
7 8 14:10:00 4 28 01 III/9148/2018
PT 38MM
ORIONTA CERVICAL
164 16/10/201 5256363.6 1051272.7 11564000. bn.01.01/PPK-
8 8 14:10:00 4 28 01 III/9148/2018
PT 41MM
164 ORIONTA 18/1488 16/10/201 ALKES Cervical Pcs IMPLANT 2 5256363.6 0 1051272.7 11564000. bn.01.01/PPK-
MA JAYA, Plate L
9 8 14:10:00 4 28 01 III/9148/2018
PT 46mm
CERVICAL
ORIONTA
165 16/10/201 SCREW 613836.36 6752200.0 bn.01.01/PPK-
MA JAYA, 18/1488 ALKES Pcs IMPLANT 13 472181.82 0
0 8 14:10:00 4.0mm 6 26 III/9148/2018
PT
L12mm
CERVICAL
ORIONTA
165 16/10/201 SCREW 5194000.0 bn.01.01/PPK-
MA JAYA, 18/1488 ALKES Pcs IMPLANT 10 472181.82 0 472181.82
1 8 14:10:00 4.0mm 2 III/9148/2018
PT
L14mm
CERVICAL
ORIONTA
165 16/10/201 SCREW 330527.27 3635800.0 bn.01.01/PPK-
MA JAYA, 18/1488 ALKES Pcs IMPLANT 7 472181.82 0
2 8 14:10:00 4.0mm 4 14 III/9148/2018
PT
L16mm
PARIT 1,3 MM
BN.01.01./PPK
165 PADANG 81600836 28/09/201 PILOT 1280795.4 28177499.
ALKES Pcs IMPLANT 20 0 2561590.9 -BLU.Far/ 9961
3 GLOBAL, 71 8 10:00:00 DRILL 5 9
2018
PT 320-1413
PARIT
1,6mm BN.01.01./PPK
165 PADANG 81600836 28/09/201 1280795.4 28177499.
ALKES Drill J-latch P c s IMPLANT 20 0 2561590.9 -BLU.Far/ 9961
4 GLOBAL, 71 8 10:00:00 5 9
320-1416 2018
PT
PARIT 1,6 X 4MM
BN.01.01./PPK
165 PADANG 81600836 28/09/201 AUTO-DRV 70105620.
ALKES Pcs IMPLANT 200 318661.91 0 6373238.2 -BLU.Far/ 9961
5 GLOBAL, 71 8 10:00:00 SCRW 211- 2
2018
PT 1604.
PARIT 1,6 X 5MM
BN.01.01./PPK
165 PADANG 81600836 28/09/201 AUTO-DRV 35052810.
6 GLOBAL, 71 8 10:00:00 SCRW 211- 1
2018
PT 1605
PARIT 1.6mm x
BN.01.01./PPK
165 PADANG 81600836 28/09/201 14mm Non 7889699.9
7 GLOBAL, 71 8 10:00:00 Lock Scre 5
2018
PT 331-1614
PARIT 1,6 X 6MM
BN.01.01./PPK
165 PADANG 81600836 28/09/201 AUTO-DRV 35052810.
8 GLOBAL, 71 8 10:00:00 SCRW 211- 1
2018
PT 1606
165 PARIT 81600836 28/09/201 ALKES 2,0 X 8MM P c s IMPLANT 50 318661.91 0 1593309.5 17526405. BN.01.01./PPK
PADANG AUTO-DRV
-BLU.Far/ 9961
9 GLOBAL, 71 8 10:00:00 SCRW 211- 5 05
2018
PT 2008
PARIT 1.6mm x
BN.01.01./PPK
166 PADANG 81600836 28/09/201 10mm Non 7889699.9
0 GLOBAL, 71 8 10:00:00 Lock Screw 5
2018
PT 331-1610
PARIT 2,0 X 6MM
BN.01.01./PPK
166 PADANG 81600836 28/09/201 AUTO-DRV 1593309.5 17526405.
ALKES Pcs IMPLANT 50 318661.91 0 -BLU.Far/ 9961
1 GLOBAL, 71 8 10:00:00 SCRW 211- 5 05
2018
PT 2006
PARIT
1.6mm 3 x BN.01.01./PPK
166 PADANG 81600836 28/09/201 2561590.9 1536954.5 16906500.
ALKES 8 T-Plate P c s IMPLANT 6 0 -BLU.Far/ 9961
2 GLOBAL, 71 8 10:00:00 1 46 01
333-1606 2018
PT
PARIT 1,6 X 8MM
BN.01.01./PPK
166 PADANG 81600836 28/09/201 AUTO-DRV 1593309.5 17526405.
3 GLOBAL, 71 8 10:00:00 SCRW 211- 5 05
2018
PT 1608
PARIT 2,0MM X
BN.01.01./PPK
166 PADANG 81600836 28/09/201 10MM 1499384.5 16493230.
4 GLOBAL, 71 8 10:00:00 SCREW 5 05
2018
PT 202-2010
PARIT 2,0 X 5MM
BN.01.01./PPK
166 PADANG 81600836 28/09/201 AUTO-DRV 35052810.
5 GLOBAL, 71 8 10:00:00 SCRW 211- 1
2018
PT 2005
PARIT 2,0MM X
BN.01.01./PPK
166 PADANG 81600836 28/09/201 12MM 32986460.
6 GLOBAL, 71 8 10:00:00 SCREW 1
2018
PT 202-2012
2,0MM X
PARIT
12MM BN.01.01./PPK
166 PADANG 81600836 28/09/201 486702.27 5353725.0
ALKES LOCKING P c s IMPLANT 5 973404.55 0 -BLU.Far/ 9961
7 GLOBAL, 71 8 10:00:00 5 25
SCRE 330- 2018
PT
2012
166 PARIT 81600836 28/09/201 ALKES 1.6mm x P c s IMPLANT 10 973404.55 0 973404.55 10707450. BN.01.01./PPK
8 PADANG 71 8 10:00:00 10mm 05 -BLU.Far/ 9961
GLOBAL, Locking 2018
Screw 330-
PT
1610
1.6mm x
PARIT
8mm BN.01.01./PPK
166 PADANG 81600836 28/09/201 8565960.0
ALKES Locking Pcs IMPLANT 8 973404.55 0 778723.64 -BLU.Far/ 9961
9 GLOBAL, 71 8 10:00:00 4
Screw 330- 2018
PT
1608
2,0MM X
PARIT
10MM BN.01.01./PPK
167 PADANG 81600836 28/09/201 486702.27 5353725.0
0 GLOBAL, 71 8 10:00:00 5 25
SCRE 330- 2018
PT
2010
1,6MM X
PARIT
14MM BN.01.01./PPK
167 PADANG 81600836 28/09/201 486702.27 5353725.0
1 GLOBAL, 71 8 10:00:00 5 25
SCREW 2018
PT
330-1614
PARIT MINI
BN.01.01./PPK
167 PADANG 81600836 28/09/201 PLATE 40 4801104.4 14403313. 15843644
ALKES Pcs IMPLANT 30 0 -BLU.Far/ 9961
2 GLOBAL, 71 8 10:00:00 HOLE 210- 5 35 6.8
2018
PT 0050
1.6mm x
PARIT
12mm BN.01.01./PPK
167 PADANG 81600836 28/09/201 10707450.
ALKES Locking Pcs IMPLANT 10 973404.55 0 973404.55 -BLU.Far/ 9961
3 GLOBAL, 71 8 10:00:00 05
Screw 330- 2018
PT
1612
1,6MM
PARIT
RIGID BN.01.01./PPK
167 PADANG 81600836 28/09/201 1228880.5 81106116.
ALKES STRAIGHT P c s IMPLANT 60 0 7373283.3 -BLU.Far/ 9961
4 GLOBAL, 71 8 10:00:00 5 3
PLT 213- 2018
PT
0019
Endo
RAJAWALI PKT/MDN
167 02/11/201 Button for BN.01.01/PPK-
NUSINDO, 2018/000 ALKES Pcs IMPLANT 5 10450000 0 5225000 57475000
5 8 12:00:00 ACL Recon III/9150/2018
PT 02055
15mm
Endo
RAJAWALI PKT/MDN
167 02/11/201 Button For BN.01.01/PPK-
NUSINDO, 2018/000 ALKES Pcs IMPLANT 5 10450000 0 5225000 57475000
6 8 12:00:00 ACL Recon III/9150/2018
PT 02055
20mm
VP Shunt
SINERGI
IN/18/10/ Flatbottom
167 TRIDAYA 27/09/201 BN.01.01/PPK-
02/00345 ALKES High Pcs IMPLANT 4 3778560 0 1511424 16625664
7 MEDICAL, 8 10:00:00 III/9912/2018
5 16mmPres
PT
s
VP Shunt
SINERGI
IN/18/10/ FlatBottom
167 TRIDAYA 27/09/201 BN.01.01/PPK-
02/00345 ALKES Medium P c s IMPLANT 2 3778560 0 755712 8312832
8 MEDICAL, 8 10:00:00 III/9912/2018
5 16mmPres
PT
s
VP SHUNT
SINERGI BURR
IN/18/10/
167 TRIDAYA 27/09/201 HOLE BN.01.01/PPK-
02/00345 ALKES Pcs ALKES 5 3857280 0 1928640 21215040
9 MEDICAL, 8 10:00:00 MEDIUM III/9912/2018
5
PT 16mmPRE
SS
VP SHUNT
SINERGI BURR
IN/18/10/
02/00345 ALKES Pcs IMPLANT 7 3857280 0 2700096 29701056
5
PT PRESS
12mm
External
SINERGI
IN/18/10/ Drainage
168 TRIDAYA 27/09/201 BN.01.01/PPK-
02/00345 ALKES Set Pcs IMPLANT 5 3350000 0 1675000 18425000
1 MEDICAL, 8 10:00:00 III/9912/2018
5 (VP.Shunt
PT
KID)
VP SHUNT
SINERGI BURR
IN/18/10/
168 TRIDAYA 26/10/201 HOLE BN.01.01/PPK-/9
29/00392 ALKES Pcs ALKES 15 3857280 0 5785920 63645120
2 MEDICAL, 8 13:15:00 MEDIUM 152/2018
3
PT 16mmPRE
SS
VP SHUNT
SINERGI BURR
IN/18/10/
168 TRIDAYA 26/10/201 HOLE BN.01.01/PPK-/9
3 MEDICAL, 8 13:15:00 MEDIUM 152/2018
3
PT PRESS
12mm
SINERGI VP Shunt
IN/18/10/
168 TRIDAYA 26/10/201 Ultra Small BN.01.01/PPK-/9
4 MEDICAL, 8 13:15:00 Medium 152/2018
3
PT Press
External
SINERGI
IN/18/10/ Drainage
168 TRIDAYA 26/10/201 BN.01.01/PPK-/9
5 MEDICAL, 8 13:15:00 152/2018
3 (VP.Shunt
PT
KID)
SINERGI VP Shunt
IN/18/10/
168 TRIDAYA 26/10/201 Burr Hole BN.01.01/PPK-/9
29/00392 ALKES Pcs ALKES 1 3857280 0 385728 4243008
6 MEDICAL, 8 13:15:00 High16mm 152/2018
3
PT Pressure
SINERGI
IN/18/10/ VP Shunt
168 TRIDAYA 26/10/201 BN.01.01/PPK-/9
29/00392 ALKES Flatbottom P c s IMPLANT 2 3778560 0 755712 8312832
7 MEDICAL, 8 13:15:00 152/2018
3 Low Press
PT
VP Shunt
SINERGI
168 TRIDAYA 26/10/201 BN.01.01/PPK-/9
8 MEDICAL, 8 13:15:00 152/2018
3 16mmPres
PT
s
VP SHUNT
SINERGI BURR
IN/18/11/
22/00440 ALKES Pcs ALKES 10 3857280 0 3857280 42430080
6
PT 16mmPRE
SS
External
SINERGI
IN/18/11/ Drainage
169 TRIDAYA 22/11/201 BN.01.01/PPK-
0 MEDICAL, 8 11:25:00 III/9152/2018
6 (VP.Shunt
PT
KID)
SINERGI
IN/18/11/ VP Shunt
169 TRIDAYA 22/11/201 BN.01.01/PPK-
22/00440 ALKES Flatbottom P c s IMPLANT 3 3778560 0 1133568 12469248
1 MEDICAL, 8 11:25:00 III/9152/2018
6 Low Press
PT
169 SINERGI IN/18/11/ 22/11/201 ALKES VP Shunt P c s IMPLANT 10 3778560 0 3778560 41564160 BN.01.01/PPK-
2 TRIDAYA 22/00440 8 11:25:00 FlatBottom III/9152/2018
Medium
MEDICAL,
6 16mmPres
PT
s
VP SHUNT
SINERGI BURR
IN/18/12/
19/00496 ALKES Pcs ALKES 15 3857280 0 5785920 63645120
0
PT 16mmPRE
SS
VP SHUNT
SINERGI BURR
IN/18/12/
0
PT PRESS
12mm
SINERGI VP Shunt
IN/18/12/
169 TRIDAYA 10/12/201 Ultra Small BN.01.01/PPK-
5 MEDICAL, 8 14:56:00 Medium III/9152/2018
0
PT Press
External
SINERGI
IN/18/12/ Drainage
169 TRIDAYA 10/12/201 BN.01.01/PPK-
6 MEDICAL, 8 14:56:00 III/9152/2018
0 (VP.Shunt
PT
KID)
SINERGI VP Shunt
IN/18/12/
169 TRIDAYA 10/12/201 Burr Hole BN.01.01/PPK-
19/00496 ALKES Pcs ALKES 2 3857280 0 771456 8486016
7 MEDICAL, 8 14:56:00 High16mm III/9152/2018
0
PT Pressure
VP Shunt
SINERGI
IN/18/12/ Flatbottom
169 TRIDAYA 10/12/201 BN.01.01/PPK-
19/00496 ALKES High Pcs IMPLANT 6 3778560 0 2267136 24938496
8 MEDICAL, 8 14:56:00 III/9152/2018
0 16mmPres
PT
s
VP Shunt
SINERGI
169 TRIDAYA 10/12/201 BN.01.01/PPK-
9 MEDICAL, 8 14:56:00 III/9152/2018
0 16mmPres
PT
s
170 SINERGI IN/18/12/ 10/12/201 ALKES VP Shunt P c s ALKES 1 3857280 0 385728 4243008 BN.01.01/PPK-
TRIDAYA Burr Hole
19/00496
0 MEDICAL, 8 14:56:00 Low III/9152/2018
0
PT Pressure
ANUGERA 04/04/201
Bactec
170 H ARGON 12180018 8 BN.01.01/PPK-
BMHP MGIT 960 Kit BMHP LAB 25 1796900 0 4492250 49414750
1 MEDICA, 875 16:13:40.0 III/2296/2017
Sire
PT 36
ANUGERA 04/04/201 Bactec
170 H ARGON 12180018 8 MGIT 960 BN.01.01/PPK-
BMHP Test BMHP LAB 30 1196860 0 3590580 39496380
2 MEDICA, 875 16:13:40.0 Supplemen III/2296/2017
PT 36 t 100test
ANUGERA 04/04/201
Bactec
170 H ARGON 12180018 8 27832761 BN.01.01/PPK-
BMHP MGIT 7ml Tube BMHP LAB 9000 28113.9 0 25302510
3 MEDICA, 875 16:13:40.0 0 III/2296/2017
245122
PT 36
ANUGERA 04/04/201
AST
170 H ARGON 12180018 8 BN.01.01/PPK-
BMHP Carrier 5 Set BMHP 40 986680 0 3946720 43413920
4 MEDICA, 875 16:13:40.0 III/2296/2017
Tube
PT 36
ANUGERA 04/04/201
170 H ARGON 12180018 8 Mycoprep 10661805 BN.01.01/PPK-
BMHP Kit BMHP LAB 90 1076950 0 9692550
5 MEDICA, 875 16:13:40.0 75ml 0 III/2296/2017
PT 36
ANUGERA 04/04/201
TB Ag
170 H ARGON 12180018 8 BN.01.01/PPK-
BMHP MPT64 Box BMHP LAB 48 1170000 0 5616000 61776000
6 MEDICA, 875 16:13:40.0 III/2296/2017
(25test)
PT 36
ANUGERA 17/04/201
AST
170 H ARGON 12180021 8 BN.01.01/PPK-
BMHP Carrier 5 Set BMHP 10 986680 0 986680 10853480
7 MEDICA, 966 16:13:56.3 III/2296/2017
Tube
PT 3
ANUGERA 17/04/201
TB Ag
170 H ARGON 12180021 8 BN.01.01/PPK-
BMHP MPT64 Box BMHP LAB 12 1170000 0 1404000 15444000
8 MEDICA, 966 16:13:56.3 III/2296/2017
(25test)
PT 3
ANUGERA 01/11/201 MGIT
170 H ARGON 12180060 8 OADC BN.01.01/PPK-
BMHP Box/6 BMHP 25 856180 0 2140450 23544950
9 MEDICA, 969 16:52:41.3 ENRICHME III/7605/2018
PT 73 NT 245116
ANUGERA 01/11/201 Bactec
171 H ARGON 12180060 8 MGIT 960 BN.01.01/PPK-
BMHP Test BMHP LAB 30 1196860 0 3590580 39496380
0 MEDICA, 969 16:52:41.3 Supplemen III/7605/2018
PT 73 t 100test
ANUGERA 01/11/201
Bactec
171 H ARGON 12180060 8 28113.899 25302509. 27832760 BN.01.01/PPK-
BMHP MGIT 7ml Tube BMHP LAB 9000 0
1 MEDICA, 969 16:52:41.3 9 91 9 III/7605/2018
245122
PT 73
ANUGERA 01/11/201 Tube
171 H ARGON 12180060 8 Phoenix ID BN.01.01/PPK-
BMHP Box BMHP LAB 1 1823250 0 182325 2005575
2 MEDICA, 969 16:52:41.3 Broth III/7605/2018
PT 73 SP100
ANUGERA 01/11/201
171 H ARGON 12180060 8 Mycoprep 10661805 BN.01.01/PPK-
BMHP Kit BMHP LAB 90 1076950 0 9692550
3 MEDICA, 969 16:52:41.3 75ml 0 III/7605/2018
PT 73
ANUGERA 01/11/201
TB Ag
171 H ARGON 12180060 8 10193040 BN.01.01/PPK-
BMHP MPT64 Box BMHP LAB 72 1287000 0 9266400
4 MEDICA, 969 16:52:41.3 0 III/7605/2018
(25test)
PT 73
ANUGERA 01/11/201 Tube
171 H ARGON 12180060 8 Phoenix BN.01.01/PPK-
BMHP Box BMHP LAB 1 2076550 0 207655 2284205
5 MEDICA, 969 16:52:41.3 AST Broth III/7605/2018
PT 73 SP100
ANUGERA 01/11/201 PHOENIX
171 H ARGON 12180060 8 AST BN.01.01/PPK-
BMHP Box BMHP 1 1587800 0 158780 1746580
6 MEDICA, 969 16:52:41.3 INDICATO III/7605/2018
PT 73 R
ANUGERA 01/11/201
PANEL
171 H ARGON 12180060 8 13738177. BN.01.01/PPK-
BMHP PHOENIX B o x BMHP 4 3122313 0 1248925.2
7 MEDICA, 969 16:52:41.3 2 III/7605/2018
NMIC/ID 4
PT 73
ANUGERA 01/11/201 PANEL
171 H ARGON 12180060 8 PHOENIX 13665863. BN.01.01/PPK-
BMHP Box BMHP 4 3105878 0 1242351.2
8 MEDICA, 969 16:52:41.3 PMIC/ID 2 III/7605/2018
PT 73 14
171 ANUGERA 22124320 12/01/201 BMHP Bibag Bag BMHP 152 66150 0 1005480 11060280 HK.06,01/IV,2,1/
9 H 27 8 Sodium 759/2014
PHARMIN 10:56:30.1 Bicarbonat
DO
LESTARI, 8 650g
PT
ANUGERA
H 12/01/201
Bloodline
172 PHARMIN 22124320 8 HK.06,01/IV,2,1/
BMHP Tubing Set BMHP 152 79920 0 1214784 13362624
0 DO 27 10:56:30.1 759/2014
System
LESTARI, 8
PT
ANUGERA
H 12/01/201
172 PHARMIN 22124320 8 Dialyser HK.06,01/IV,2,1/
BMHP Pcs BMHP 152 159750 0 2428200 26710200
1 DO 27 10:56:30.1 FX10 759/2014
LESTARI, 8
PT
ANUGERA
H 12/01/201
Fistula
172 PHARMIN 22124320 8 HK.06,01/IV,2,1/
BMHP Needle Set BMHP 152 9270 0 140904 1549944
2 DO 27 10:56:30.1 759/2014
16GV F25
LESTARI, 8
PT
ANUGERA
H 12/01/201 Fistula
172 PHARMIN 22124320 8 Needle 16 HK.06,01/IV,2,1/
BMHP Set BMHP 152 9270 0 140904 1549944
3 DO 27 10:56:30.1 Gar32 759/2014
LESTARI, 8 Rotary
PT
ANUGERA
H 12/01/201
172 PHARMIN 22124320 8 Hemosol HK.06,01/IV,2,1/
BMHP Galon BMHP 152 75600 0 1149120 12640320
4 DO 27 10:56:30.1 Part A 759/2014
LESTARI, 8
PT
ANUGERA
H 15/03/201 Bibag
172 PHARMIN 22124589 8 Sodium HK.06.01/IV,2,1/
BMHP Bag BMHP 200 66150 0 1323000 14553000
5 DO 25 12:29:33.7 Bicarbonat 759/2014
LESTARI, 2 650g
PT
ANUGERA
H 15/03/201
Bloodline
172 PHARMIN 22124589 8 HK.06.01/IV,2,1/
6 DO 25 12:29:33.7 759/2014
System
LESTARI, 2
PT
ANUGERA
H 15/03/201
172 PHARMIN 22124589 8 Dialyser HK.06.01/IV,2,1/
BMHP Pcs BMHP 200 159750 0 3195000 35145000
7 DO 25 12:29:33.7 FX10 759/2014
LESTARI, 2
PT
ANUGERA
H 15/03/201
Fistula
172 PHARMIN 22124589 8 HK.06.01/IV,2,1/
8 DO 25 12:29:33.7 759/2014
16GV F25
LESTARI, 2
PT
ANUGERA
H 15/03/201 Fistula
172 PHARMIN 22124589 8 Needle 16 HK.06.01/IV,2,1/
BMHP Set BMHP 200 9270 0 185400 2039400
9 DO 25 12:29:33.7 Gar32 759/2014
LESTARI, 2 Rotary
PT
ANUGERA
H 15/03/201
HD
173 PHARMIN 22124589 8 HK.06.01/IV,2,1/
BMHP Solution Galon BMHP 200 75600 0 1512000 16632000
0 DO 25 12:29:33.7 759/2014
Part A
LESTARI, 2
PT
ANUGERA
H 13/04/201 Bibag
173 PHARMIN 22124716 8 Sodium HK.06,01/IV,2,1/
BMHP Bag BMHP 200 66150 0 1323000 14553000
1 DO 71 09:50:53.6 Bicarbonat 759/2014
LESTARI, 66 650g
PT
173 ANUGERA 22124716 13/04/201 BMHP Bloodline S e t BMHP 200 79920 0 1598400 17582400 HK.06,01/IV,2,1/
2 H 71 8 Tubing 759/2014
PHARMIN 09:50:53.6 System
DO
LESTARI, 66
PT
ANUGERA
H 13/04/201
BMHP Pcs BMHP 200 159750 0 3195000 35145000
3 DO 71 09:50:53.6 FX10 759/2014
LESTARI, 66
PT
ANUGERA
H 13/04/201
Fistula
173 PHARMIN 22124716 8 HK.06,01/IV,2,1/
4 DO 71 09:50:53.6 759/2014
16GV F25
LESTARI, 66
PT
ANUGERA
H 13/04/201 Fistula
BMHP Set BMHP 200 9270 0 185400 2039400
5 DO 71 09:50:53.6 Gar32 759/2014
LESTARI, 66 Rotary
PT
ANUGERA
H 13/04/201
HD
173 PHARMIN 22124716 8 HK.06,01/IV,2,1/
6 DO 71 09:50:53.6 759/2014
Part A
LESTARI, 66
PT
ANUGERA
H Bibag
BN.01.01/PPK-
173 PHARMIN 22124908 25/05/201 Sodium
BMHP Bag BMHP 150 66150 0 992250 10914750 BLU.Far/5474/2
7 DO 02 8 10:04:00 Bicarbonat
018
LESTARI, 650g
PT
ANUGERA
H
Bloodline BN.01.01/PPK-
173 PHARMIN 22124908 25/05/201
BMHP Tubing Set BMHP 150 79920 0 1198800 13186800 BLU.Far/5474/2
8 DO 02 8 10:04:00
System 018
LESTARI,
PT
ANUGERA
H
BN.01.01/PPK-
173 PHARMIN 22124908 25/05/201 Dialyser
BMHP Pcs BMHP 150 159750 0 2396250 26358750 BLU.Far/5474/2
9 DO 02 8 10:04:00 FX10
018
LESTARI,
PT
ANUGERA
H
Fistula BN.01.01/PPK-
174 PHARMIN 22124908 25/05/201
BMHP Needle Set BMHP 150 9270 0 139050 1529550 BLU.Far/5474/2
0 DO 02 8 10:04:00
16GV F25 018
LESTARI,
PT
ANUGERA
H Fistula
BN.01.01/PPK-
174 PHARMIN 22124908 25/05/201 Needle 16
BMHP Set BMHP 150 9270 0 139050 1529550 BLU.Far/5474/2
1 DO 02 8 10:04:00 Gar32
018
LESTARI, Rotary
PT
ANUGERA
H
HD BN.01.01/PPK-
174 PHARMIN 22124908 25/05/201
BMHP Solution Galon BMHP 150 75600 0 1134000 12474000 BLU.Far/5474/2
2 DO 02 8 10:04:00
Part A 018
LESTARI,
PT
ANUGERA
H 07/06/201 Bibag
BMHP Bag BMHP 200 66150 0 1323000 14553000
3 DO 00 09:26:55.7 Bicarbonat 759/2014
LESTARI, 36 650g
PT
ANUGERA
H 07/06/201
Bloodline
174 PHARMIN 22124962 8 HK.06,01/IV,2,1/
4 DO 00 09:26:55.7 759/2014
System
LESTARI, 36
PT
174 ANUGERA 22124962 07/06/201 BMHP Dialyser Pcs BMHP 200 159750 0 3195000 35145000 HK.06,01/IV,2,1/
5 H 00 8 FX10 759/2014
PHARMIN 09:26:55.7
DO
LESTARI, 36
PT
ANUGERA
H 07/06/201
Fistula
174 PHARMIN 22124962 8 HK.06,01/IV,2,1/
6 DO 00 09:26:55.7 759/2014
16GV F25
LESTARI, 36
PT
ANUGERA
H 07/06/201 Fistula
BMHP Set BMHP 200 9270 0 185400 2039400
7 DO 00 09:26:55.7 Gar32 759/2014
LESTARI, 36 Rotary
PT
ANUGERA
H 07/06/201
HD
174 PHARMIN 22124962 8 HK.06,01/IV,2,1/
8 DO 00 09:26:55.7 759/2014
Part A
LESTARI, 36
PT
ANUGERA
H 12/07/201 Bibag
BMHP Bag BMHP 200 66150 0 1323000 14553000
9 DO 99 09:17:58.8 Bicarbonat 759/2014
LESTARI, 53 650g
PT
ANUGERA
H 12/07/201
Bloodline
175 PHARMIN 22125092 8 HK.06,01/IV,2,1/
0 DO 99 09:17:58.8 759/2014
System
LESTARI, 53
PT
ANUGERA
H 12/07/201
BMHP Pcs BMHP 200 159750 0 3195000 35145000
1 DO 99 09:17:58.8 FX10 759/2014
LESTARI, 53
PT
ANUGERA
H 12/07/201
Fistula
175 PHARMIN 22125092 8 HK.06,01/IV,2,1/
2 DO 99 09:17:58.8 759/2014
16GV F25
LESTARI, 53
PT
ANUGERA
H 12/07/201
HD
175 PHARMIN 22125092 8 HK.06,01/IV,2,1/
3 DO 99 09:17:58.8 759/2014
Part A
LESTARI, 53
PT
ANUGERA
H 23/07/201 Fistula
BMHP Set BMHP 200 9270 0 185400 2039400
4 DO 86 14:55:32.4 Gar32 759/2014
LESTARI, 43 Rotary
PT
ANUGERA
H 21/08/201 Bibag
BMHP Bag BMHP 200 66150 0 1323000 14553000
5 DO 20 08:34:00.8 Bicarbonat 759/2014
LESTARI, 2 650g
PT
ANUGERA
H 21/08/201
Bloodline
175 PHARMIN 22125263 8 HK.06,01/IV,2,1/
6 DO 20 08:34:00.8 759/2014
System
LESTARI, 2
PT
ANUGERA
H 21/08/201
BMHP Pcs BMHP 200 159750 0 3195000 35145000
7 DO 20 08:34:00.8 FX10 759/2014
LESTARI, 2
PT
175 ANUGERA 22125263 21/08/201 BMHP Fistula Set BMHP 200 9270 0 185400 2039400 HK.06,01/IV,2,1/
8 H 20 8 Needle 759/2014
PHARMIN 08:34:00.8 16GV F25
DO
LESTARI, 2
PT
ANUGERA
H 21/08/201 Fistula
BMHP Set BMHP 200 9270 0 185400 2039400
9 DO 20 08:34:00.8 Gar32 759/2014
LESTARI, 2 Rotary
PT
ANUGERA
H 21/08/201
HD
176 PHARMIN 22125263 8 HK.06,01/IV,2,1/
0 DO 20 08:34:00.8 759/2014
Part A
LESTARI, 2
PT
ANUGERA
H 27/09/201 Bibag
BMHP Bag BMHP 200 68130 0 1362600 14988600
1 DO 91 08:57:02.8 Bicarbonat 759/2014
LESTARI, 56 650g
PT
ANUGERA
H 27/09/201
Bloodline
176 PHARMIN 22125455 8 HK.06,01/IV,2,1/
2 DO 91 08:57:02.8 759/2014
System
LESTARI, 56
PT
ANUGERA
H 27/09/201
BMHP Pcs BMHP 200 164700 0 3294000 36234000
3 DO 91 08:57:02.8 FX10 759/2014
LESTARI, 56
PT
ANUGERA
H 27/09/201
Fistula
176 PHARMIN 22125455 8 HK.06,01/IV,2,1/
4 DO 91 08:57:02.8 759/2014
16GV F25
LESTARI, 56
PT
ANUGERA
H 27/09/201 Fistula
BMHP Set BMHP 200 9540 0 190800 2098800
5 DO 91 08:57:02.8 Gar32 759/2014
LESTARI, 56 Rotary
PT
ANUGERA
H 27/09/201
HD
176 PHARMIN 22125455 8 HK.06,01/IV,2,1/
6 DO 91 08:57:02.8 759/2014
Part A
LESTARI, 56
PT
ANUGERA
H 12/10/201 Bibag
BMHP Bag BMHP 200 68130 0 1362600 14988600
7 DO 95 10:39:34.8 Bicarbonat 759/2014
LESTARI, 83 650g
PT
ANUGERA
H 12/10/201
Bloodline
176 PHARMIN 15100037 8 HK.06,01/IV,2,1/
8 DO 95 10:39:34.8 759/2014
System
LESTARI, 83
PT
ANUGERA
H 12/10/201
BMHP Pcs BMHP 200 164700 0 3294000 36234000
9 DO 95 10:39:34.8 FX10 759/2014
LESTARI, 83
PT
ANUGERA
H 12/10/201
Fistula
177 PHARMIN 15100037 8 HK.06,01/IV,2,1/
0 DO 95 10:39:34.8 759/2014
16GV F25
LESTARI, 83
PT
177 ANUGERA 15100037 12/10/201 BMHP Fistula Set BMHP 200 9540 0 190800 2098800 HK.06,01/IV,2,1/
1 H 95 8 Needle 16 759/2014
PHARMIN 10:39:34.8 Gar32
DO
LESTARI, 83 Rotary
PT
ANUGERA
H 12/10/201
HD
177 PHARMIN 15100037 8 HK.06,01/IV,2,1/
2 DO 95 10:39:34.8 759/2014
Part A
LESTARI, 83
PT
ANUGERA
H 14/11/201 Bibag
BMHP Bag BMHP 200 68130 0 1362600 14988600
3 DO 52 08:51:52.1 Bicarbonat 759/2014
LESTARI, 56 650g
PT
ANUGERA
H 14/11/201
Bloodline
177 PHARMIN 15100167 8 HK.06,01/IV,2,1/
4 DO 52 08:51:52.1 759/2014
System
LESTARI, 56
PT
ANUGERA
H 14/11/201
BMHP Pcs BMHP 200 164700 0 3294000 36234000
5 DO 52 08:51:52.1 FX10 759/2014
LESTARI, 56
PT
ANUGERA
H 14/11/201
Fistula
177 PHARMIN 15100167 8 HK.06,01/IV,2,1/
6 DO 52 08:51:52.1 759/2014
16GV F25
LESTARI, 56
PT
ANUGERA
H 14/11/201 Fistula
BMHP Set BMHP 200 9540 0 190800 2098800
7 DO 52 08:51:52.1 Gar32 759/2014
LESTARI, 56 Rotary
PT
ANUGERA
H 14/11/201
HD
177 PHARMIN 15100167 8 HK.06,01/IV,2,1/
8 DO 52 08:51:52.1 759/2014
Part A
LESTARI, 56
PT
ANUGERA
H 06/12/201 Bibag
BMHP Bag BMHP 250 68130 0 1703250 18735750
9 DO 29 08:25:21.5 Bicarbonat 759/2014
LESTARI, 46 650g
PT
ANUGERA
H 06/12/201
Bloodline
178 PHARMIN 15100251 8 HK.06,01/IV,2,1/
0 DO 29 08:25:21.5 759/2014
System
LESTARI, 46
PT
ANUGERA
H 06/12/201
BMHP Pcs BMHP 250 164700 0 4117500 45292500
1 DO 29 08:25:21.5 FX10 759/2014
LESTARI, 46
PT
ANUGERA
H 06/12/201
Fistula
178 PHARMIN 15100251 8 HK.06,01/IV,2,1/
2 DO 29 08:25:21.5 759/2014
16GV F25
LESTARI, 46
PT
ANUGERA
H 06/12/201 Fistula
BMHP Set BMHP 250 9540 0 238500 2623500
3 DO 29 08:25:21.5 Gar32 759/2014
LESTARI, 46 Rotary
PT
178 ANUGERA 15100251 06/12/201 BMHP HD Galon BMHP 250 77850 0 1946250 21408750 HK.06,01/IV,2,1/
4 H 29 8 Solution 759/2014
PHARMIN 08:25:21.5 Part A
DO
LESTARI, 46
PT
POLYPECT
OMY
CAHAYA 21/08/201
SNARE
178 DUA 0081/CDD 8
BMHP CAPTIVAT P c s BMHP 10 450000 0 450000 4950000
5 DELAPAN. /VIII/2018 12:06:31.4
OR
PT 76
L30MM-
240CM
CAHAYA
JAG WIRE
178 DUA 164/CDD/ 21/12/201 BN.01.01/PPK-
BMHP 0.035/450 P c s BMHP 4 1750000 0 700000 7700000
6 DELAPAN. XII/2018 8 13:19:00 III/11670/2018
(BX2)
PT
CAHAYA TBAN
178 DUA 164/CDD/ 21/12/201 21GA/15M BN.01.01/PPK-
BMHP Pcs BMHP 20 4092000 0 8184000 90024000
7 DELAPAN. XII/2018 8 13:19:00 M/130CM III/11670/2018
PT (BX/5)
Cellebrity
CAHAYA
Cytology
178 DUA 164/CDD/ 21/12/201 BN.01.01/PPK-
8 DELAPAN. XII/2018 8 13:19:00 III/11670/2018
1,5x140
PT
BX/10
MBL
CAHAYA
SPEEDBAN
178 DUA 164/CDD/ 21/12/201 BN.01.01/PPK-
BMHP D Pcs BMHP 5 3300000 0 1650000 18150000
9 DELAPAN. XII/2018 8 13:19:00 III/11670/2018
SUPERVIE
PT
W SUPER 7
CAHAYA ADVANIX
179 DUA 164/CDD/ 21/12/201 PANKREA BN.01.01/PPK-
BMHP Pcs BMHP 2 2200000 0 440000 4840000
0 DELAPAN. XII/2018 8 13:19:00 TIC 5FR III/11670/2018
PT 5CM
CAHAYA ADVANIX
179 DUA 164/CDD/ 21/12/201 PANKREA BN.01.01/PPK-
BMHP Pcs BMHP 2 2200000 0 440000 4840000
1 DELAPAN. XII/2018 8 13:19:00 TIC 5FR III/11670/2018
PT 7CM
179 CAHAYA 164/CDD/ 21/12/201 BMHP CRE Pcs BMHP 1 8000000 0 800000 8800000 BN.01.01/PPK-
2 DUA XII/2018 8 13:19:00 BILIARY III/11670/2018
DELAPAN. 10-11-12
PT MM
CAHAYA CRE
179 DUA 164/CDD/ 21/12/201 BILIARY BN.01.01/PPK-
BMHP Pcs BMHP 5 8000000 0 4000000 44000000
3 DELAPAN. XII/2018 8 13:19:00 12-13, 5- III/11670/2018
PT 15 MM
CAHAYA CRE
179 DUA 164/CDD/ 21/12/201 BILIARY BN.01.01/PPK-
BMHP Pcs BMHP 2 8000000 0 1600000 17600000
4 DELAPAN. XII/2018 8 13:19:00 15-16- 5- III/11670/2018
PT 18 MM
CAHAYA EXTRACTO
179 DUA 164/CDD/ 21/12/201 R PRO XL BN.01.01/PPK-
BMHP Pcs BMHP 2 4800000 0 960000 10560000
5 DELAPAN. XII/2018 8 13:19:00 9-12 MM III/11670/2018
PT ABOVE
CAHAYA ALLINCE II
179 DUA 164/CDD/ 21/12/201 INFLATIO BN.01.01/PPK-
BMHP Pcs BMHP 1 2000000 0 200000 2200000
6 DELAPAN. XII/2018 8 13:19:00 N/LITHO III/11670/2018
PT DEVICE
ALLINCE II
CAHAYA
INFLATIO
179 DUA 164/CDD/ 21/12/201 BN.01.01/PPK-
BMHP N/ Pcs BMHP 5 800000 0 400000 4400000
7 DELAPAN. XII/2018 8 13:19:00 III/11670/2018
SYRINGE
PT
(BX/5)
Truetome
CAHAYA
3,9F
179 DUA 164/CDD/ 21/12/201 BN.01.01/PPK-
BMHP (1,3mmx2 P c s BMHP 2 2500000 0 500000 5500000
8 DELAPAN. XII/2018 8 13:19:00 III/11670/2018
0mm)
PT
0,025in
DIMAS FILM DI-
179 ANDALAS D1805- 31/05/201 HL 20.3 X 14266.666 3210000.0 35310000. BN.01.01/PPK-
BMHP Lembar BMHP 2250 0
9 MAKMUR. 01739 8 16:01:00 25.4CM 7 07 08 III/4028/2018
PT FUJI
DIMAS
FILM DI-
180 ANDALAS D1805- 31/05/201 BN.01.01/PPK-
BMHP HL 26 X Lembar BMHP 2250 21200 0 4770000 52470000
0 MAKMUR. 01739 8 16:01:00 III/4028/2018
36CM FUJI
PT
180 ANDALAS D1806- 8 HL 20.3 X 14266.666 2140000.0 23540000. BN.01.01/PPK-
1 MAKMUR. 01092 13:00:56.3 25.4CM 7 05 05 III/4028/2018
PT 66 FUJI
DIMAS 05/07/201
FILM DI-
180 ANDALAS D1806- 8 BN.01.01/PPK-
2 MAKMUR. 01092 13:00:56.3 III/4028/2018
36CM FUJI
PT 66
3 MAKMUR. 01051 15:51:45.0 25.4CM 7 05 05 III/4028/2018
PT 7 FUJI
DIMAS 24/08/201
FILM DI-
180 ANDALAS D1808- 8 BN.01.01/PPK-
4 MAKMUR. 01051 15:51:45.0 III/4028/2018
36CM FUJI
PT 7
5 MAKMUR. 01044 09:07:26.3 25.4CM 7 05 05 III/4028/2018
PT 83 FUJI
DIMAS 20/09/201
FILM DI-
180 ANDALAS D1809- 8 BN.01.01/PPK-
6 MAKMUR. 01044 09:07:26.3 III/4028/2018
36CM FUJI
PT 83
7 MAKMUR. 00783 14:32:41.3 25.4CM 7 05 05 III/4028/2018
PT 4 FUJI
DIMAS 14/11/201
FILM DI-
180 ANDALAS D1811- 8 BN.01.01/PPK-
8 MAKMUR. 00783 14:32:41.3 III/4028/2018
36CM FUJI
PT 4
DIPA 17/04/201
Cooked
180 PUSPA 0718.FP- 8 BN.01.01/PPK.III
BMHP Meat Btl/500gr BMHP 1 3702600 0 370260 4072860
9 LABSAINS. 100457 14:52:14.7 /4030/2018
Medium
PT 46
DIPA 17/04/201
181 PUSPA 0718.FP- 8 Cephazolin BN.01.01/PPK.III
BMHP Disc 5x50 BMHP LAB 1 334263 0 33426.3 367689.3
0 LABSAINS. 100457 14:52:14.7 Kz30 /4030/2018
PT 46
181 DIPA 0718.FP- 17/04/201 BMHP Penicilin G Kit/5X50di BMHP LAB 1 334263 0 33426.3 367689.3 BN.01.01/PPK.III
1 PUSPA 100457 8 sc /4030/2018
LABSAINS. 14:52:14.7
PT 46
DIPA 17/04/201
181 PUSPA 0718.FP- 8 Tigecycline BN.01.01/PPK.III
BMHP Disc 5x50 BMHP LAB 2 334263 0 66852.6 735378.6
2 LABSAINS. 100457 14:52:14.7 TGC15 /4030/2018
PT 46
DIPA 17/04/201
BMHP
181 PUSPA 0718.FP- 8 STAPHAUR BN.01.01/PPK.III
BMHP Kit RADIOLOG 2 1653102 0 330620.4 3636824.4
3 LABSAINS. 100457 14:52:14.7 EX /4030/2018
I
PT 46
DIPA 17/04/201
Vitox
181 PUSPA 0718.FP- 8 BN.01.01/PPK.III
BMHP Growth Vial BMHP LAB 1 1388475 0 138847.5 1527322.5
4 LABSAINS. 100457 14:52:14.7 /4030/2018
Supplemen
PT 46
DIPA 17/04/201
181 PUSPA 0718.FP- 8 Amies Agar BN.01.01/PPK.III
BMHP Kit/50s BMHP LAB 10 1004947 0 1004947 11054417
5 LABSAINS. 100457 14:52:14.7 Gel /4030/2018
PT 46
Medifix
BN.01.01/PPK.01
181 DOS NI 82754352 31/08/201 Line 90cm
BMHP Pcs BMHP 50 103500 0 517500 5692500 .01/PPK-
6 ROHA, PT 8 8 10:12:00 With
III/8839/2018
Intrafix
27/09/201 Medifix
181 DOS NI 82763117 8 Line 90cm BN.01.01/PPK-
BMHP Pcs BMHP 230 103500 0 2380500 26185500
7 ROHA, PT 4 16:31:46.7 With III/8839/2018
6 Intrafix
27/09/201
Medifix
181 DOS NI 82763117 8 BN.01.01/PPK-
8 ROHA, PT 4 16:31:46.7 III/8839/2018
r
6
02/11/201 Medifix
181 DOS NI 82773883 8 Line 90cm BN.01.01/PPK-
BMHP Pcs BMHP 200 103500 0 2070000 22770000
9 ROHA, PT 7 11:02:21.6 With III/8839/2018
56 Intrafix
02/11/201
Medifix
182 DOS NI 82773883 8 BN.01.01/PPK-
0 ROHA, PT 7 11:02:21.6 III/8839/2018
r
56
182 ENSEVAL 11800752 30/01/201 BMHP Vitek AST Kit BMHP LAB 5 2734200 0 1367100 15038100 HK.05,01/IV,2,1/
1 PUTERA 2 8 YS07 5425/2017
MEGATRA
15:37:06.0
DING TBK,
9
PT
ENSEVAL
30/01/201
PUTERA
182 11800752 8 Vitek AST HK.05,01/IV,2,1/
MEGATRA BMHP Kit BMHP LAB 12 2734200 0 3281040 36091440
2 2 15:37:06.0 -N317 5425/2017
DING TBK,
9
PT
ENSEVAL
30/01/201
PUTERA GN Tet
182 11800752 8 HK.05,01/IV,2,1/
MEGATRA BMHP Vtk2 20 Kit BMHP LAB 12 2734200 0 3281040 36091440
3 2 15:37:06.0 5425/2017
DING TBK, Cards
9
PT
ENSEVAL
30/01/201
PUTERA GP TET
182 11800752 8 HK.05,01/IV,2,1/
MEGATRA BMHP VTK2 20 Kit BMHP LAB 5 2734200 0 1367100 15038100
4 2 15:37:06.0 5425/2017
DING TBK, Cards
9
PT
ENSEVAL
30/01/201
PUTERA Vitek 2,Ast
182 11800752 8 HK.05,01/IV,2,1/
MEGATRA BMHP Gp67 Buah BMHP LAB 10 2734200 0 2734200 30076200
5 2 15:37:06.0 5425/2017
DING TBK, Cards
9
PT
ENSEVAL
30/01/201
PUTERA YST Tet
182 11800752 8 HK.05,01/IV,2,1/
6 2 15:37:06.0 5425/2017
DING TBK, Cards
9
PT
ENSEVAL
30/01/201
PUTERA
182 11800752 8 Aceton HK.05,01/IV,2,1/
7 1 15:48:55.7 Safranin A 5425/2017
DING TBK,
5
PT
ENSEVAL
30/01/201
PUTERA
182 11800752 8 Bactalert HK.05,01/IV,2,1/
8 1 15:48:55.7 FA Plus 5425/2017
DING TBK,
5
PT
182 ENSEVAL 11800752 30/01/201 BMHP Bactalert Buah BMHP LAB 4 7761600 0 3104640 34151040 HK.05,01/IV,2,1/
PUTERA
8
MEGATRA
9 1 15:48:55.7 FN Plus 5425/2017
DING TBK,
5
PT
ENSEVAL
30/01/201
PUTERA
183 11800752 8 Bactalert HK.05,01/IV,2,1/
0 1 15:48:55.7 PF Plus 5425/2017
DING TBK,
5
PT
ENSEVAL
30/01/201
PUTERA
183 11800752 8 Crystal HK.05,01/IV,2,1/
MEGATRA BMHP Kit BMHP 1 1059380 0 105938 1165318
1 1 15:48:55.7 Violet C 5425/2017
DING TBK,
5
PT
ENSEVAL
30/01/201 Pipette
PUTERA
183 11800752 8 Tips 0,5 124460.00 1369060.0 HK.05,01/IV,2,1/
MEGATRA BMHP Buah BMHP LAB 480 2592.9167 0
2 1 15:48:55.7 250ul 16 18 5425/2017
DING TBK,
5 (96pcs)
PT
ENSEVAL
30/01/201 Pipette
PUTERA
183 11800752 8 Tips 100- HK.05,01/IV,2,1/
MEGATRA BMHP Buah BMHP LAB 960 3093.125 0 296940 3266340
3 1 15:48:55.7 1000ul 5425/2017
DING TBK,
5 (96pcs)
PT
ENSEVAL
31/01/201
PUTERA Dianeal BN.01.01/PPK-
183 31800059 8 10487070
MEGATRA BMHP pd-4 1,5 Fls BMHP 1980 48150 0 9533700 BLU.Far/414/20
4 5 14:41:57.8 0
DING TBK, Dexwin 18
16
PT
ENSEVAL
31/01/201
PUTERA Dianeal BN.01.01/PPK-
183 31800059 8 13347180
MEGATRA BMHP Pd-4 2,5% P c s BMHP 2520 48150 0 12133800 BLU.Far/414/20
5 5 14:41:57.8 0
DING TBK, Dextwin 18
16
PT
ENSEVAL
31/01/201 Dianeal
PUTERA BN.01.01/PPK-
183 31800059 8 PD-4
MEGATRA BMHP Pcs BMHP 60 48150 0 288900 3177900 BLU.Far/414/20
6 5 14:41:57.8 4,25%
DING TBK, 18
16 DEXTWIN.
PT
ENSEVAL
31/01/201
183 31800058 8
MEGATRA BMHP Tenckoff Pcs BMHP 1 755000 0 75500 830500 BLU.Far/414/20
7 8 14:45:43.4
DING TBK, 18
13
PT
ENSEVAL
31/01/201
PUTERA Extended BN.01.01/PPK-
183 31800058 8 159665.45 1756320.0
MEGATRA BMHP Life Pd Buah BMHP 8 199581.82 0 BLU.Far/414/20
8 8 14:45:43.4 6 16
DING TBK, Transfer 18
13
PT
ENSEVAL
31/01/201
PUTERA Minicap BN.01.01/PPK-
183 31800058 8
MEGATRA BMHP Disonnect P c s BMHP 4560 4500 0 2052000 22572000 BLU.Far/414/20
9 8 14:45:43.4
DING TBK, Cap. 18
13
PT
ENSEVAL
31/01/201
184 31800058 8 Titanium
MEGATRA BMHP Pcs BMHP 1 720000 0 72000 792000 BLU.Far/414/20
0 8 14:45:43.4 Adaptor
DING TBK, 18
13
PT
ENSEVAL
31/01/201
184 31800058 8 Ultraclamp
MEGATRA BMHP Buah BMHP 2 27363.64 0 5472.728 60200.008 BLU.Far/414/20
1 8 14:45:43.4 (Red)
DING TBK, 18
13
PT
ENSEVAL
28/02/201
PUTERA
184 31800115 8 BN.01.01/PPK.III
2 4 15:05:32.1 /414/2018
DING TBK,
3
PT
ENSEVAL
28/02/201
PUTERA Extended
184 31800115 8 BN.01.01/PPK.III
MEGATRA BMHP Life Pd Buah BMHP 4 199581.8 0 79832.72 878159.92
3 4 15:05:32.1 /414/2018
DING TBK, Transfer
3
PT
184 ENSEVAL 31800115 28/02/201 BMHP Minicap Pcs BMHP 4800 4500 0 2160000 23760000 BN.01.01/PPK.III
4 PUTERA 4 8 Disonnect /414/2018
MEGATRA 15:05:32.1 Cap.
DING TBK, 3
PT
ENSEVAL
28/02/201
PUTERA
184 31800115 8 Titanium BN.01.01/PPK.III
5 4 15:05:32.1 Adaptor /414/2018
DING TBK,
3
PT
ENSEVAL
28/02/201
PUTERA
184 31800115 8 Ultraclamp BN.01.01/PPK.III
MEGATRA BMHP Buah BMHP 4 27364 0 10945.6 120401.6
6 4 15:05:32.1 (Red) /414/2018
DING TBK,
3
PT
ENSEVAL
28/02/201
PUTERA Dianeal
184 31800116 8 11122650 BN.01.01/PPK.III
MEGATRA BMHP pd-4 1,5 Fls BMHP 2100 48150 0 10111500
7 0 15:19:17.3 0 /414/2018
DING TBK, Dexwin
93
PT
ENSEVAL
28/02/201
PUTERA Dianeal
184 31800116 8 13982760 BN.01.01/PPK.III
MEGATRA BMHP Pd-4 2,5% P c s BMHP 2640 48150 0 12711600
8 0 15:19:17.3 0 /414/2018
DING TBK, Dextwin
93
PT
ENSEVAL
28/02/201 Dianeal
PUTERA
184 31800116 8 PD-4 BN.01.01/PPK.III
9 0 15:19:17.3 4,25% /414/2018
DING TBK,
93 DEXTWIN.
PT
ENSEVAL
28/02/201
PUTERA
185 11801738 8 Bactalert HK.05,01/IV,2,1/
0 0 15:22:14.3 FA Plus 5425/2017
DING TBK,
33
PT
ENSEVAL
28/02/201 Pipette
PUTERA
185 11801738 8 Tips 0,5 124460.00 1369060.0 HK.05,01/IV,2,1/
1 0 15:22:14.3 250ul 16 18 5425/2017
DING TBK,
33 (96pcs)
PT
185 ENSEVAL 11801738 28/02/201 BMHP Pipette Buah BMHP LAB 480 3093.125 0 148470 1633170 HK.05,01/IV,2,1/
2 PUTERA 0 8 Tips 100- 5425/2017
MEGATRA 15:22:14.3 1000ul
DING TBK,
33 (96pcs)
PT
ENSEVAL
28/02/201
PUTERA VITEK2
185 11801738 8 HK.05,01/IV,2,1/
MEGATRA BMHP ANC Pcs BMHP LAB 1 2734200 0 273420 3007620
3 0 15:22:14.3 5425/2017
DING TBK, CARDS.
33
PT
ENSEVAL
28/02/201 Vitek2 Test
PUTERA
185 11801738 8 Tube HK.05,01/IV,2,1/
MEGATRA BMHP Pcs BMHP LAB 2000 4846.1 0 969220 10661420
4 0 15:22:14.3 12x75mm 5425/2017
DING TBK,
33 (2000)
PT
ENSEVAL
28/02/201
PUTERA
185 11801734 8 Vitek AST HK.05,01/IV,2,1/
5 1 15:33:33.2 GN93 5425/2017
DING TBK,
63
PT
ENSEVAL
28/02/201
PUTERA
185 11801734 8 Vitek AST HK.05,01/IV,2,1/
6 1 15:33:33.2 YS07 5425/2017
DING TBK,
63
PT
ENSEVAL
28/02/201
PUTERA GN Tet
185 11801734 8 HK.05,01/IV,2,1/
7 1 15:33:33.2 5425/2017
DING TBK, Cards
63
PT
ENSEVAL
28/02/201
PUTERA GP TET
185 11801734 8 HK.05,01/IV,2,1/
8 1 15:33:33.2 5425/2017
DING TBK, Cards
63
PT
ENSEVAL
28/02/201
PUTERA YST Tet
185 11801734 8 HK.05,01/IV,2,1/
9 1 15:33:33.2 5425/2017
DING TBK, Cards
63
PT
186 ENSEVAL 31800179 29/03/201 BMHP Dianeal Fls BMHP 1920 48150 0 9244800 10169280 BN.01.01/PPK.III
0 PUTERA 4 8 pd-4 1,5 0 /414/2018
MEGATRA
13:34:57.9
DING TBK, Dexwin
83
PT
ENSEVAL
29/03/201
PUTERA Dianeal
186 31800179 8 13664970 BN.01.01/PPK.III
MEGATRA BMHP Pd-4 2,5% P c s BMHP 2580 48150 0 12422700
1 4 13:34:57.9 0 /414/2018
DING TBK, Dextwin
83
PT
ENSEVAL
29/03/201 Dianeal
PUTERA
186 31800179 8 PD-4 BN.01.01/PPK.III
2 4 13:34:57.9 4,25% /414/2018
DING TBK,
83 DEXTWIN.
PT
ENSEVAL
29/03/201
PUTERA
186 31800178 8 BN.01.01/PPK.III
3 9 13:41:14.0 /414/2018K
DING TBK,
86
PT
ENSEVAL
29/03/201
PUTERA Extended
186 31800178 8 439080.00 BN.01.01/PPK.III
4 9 13:41:14.0 4 /414/2018K
DING TBK, Transfer
86
PT
ENSEVAL
29/03/201
PUTERA Minicap
186 31800178 8 BN.01.01/PPK.III
MEGATRA BMHP Disonnect P c s BMHP 4560 4500 0 2052000 22572000
5 9 13:41:14.0 /414/2018K
DING TBK, Cap.
86
PT
ENSEVAL
29/03/201
PUTERA
6 9 13:41:14.0 Adaptor /414/2018K
DING TBK,
86
PT
ENSEVAL
29/03/201
PUTERA
186 31800178 8 Ultraclamp 120400.01 BN.01.01/PPK.III
7 9 13:41:14.0 (Red) 6 /414/2018K
DING TBK,
86
PT
186 ENSEVAL 11803335 17/04/201 BMHP Bactalert Kit BMHP LAB 5 7761600 0 3880800 42688800 HK.05,01/IV,2,1/
PUTERA
8
MEGATRA
8 4 16:25:02.9 FA Plus 5425/2017
DING TBK,
63
PT
ENSEVAL
17/04/201
PUTERA
186 11803335 8 Bactalert HK.05,01/IV,2,1/
MEGATRA BMHP Buah BMHP LAB 3 7761600 0 2328480 25613280
9 4 16:25:02.9 FN Plus 5425/2017
DING TBK,
63
PT
ENSEVAL
17/04/201
PUTERA
187 11803335 8 Bactalert HK.05,01/IV,2,1/
0 4 16:25:02.9 PF Plus 5425/2017
DING TBK,
63
PT
ENSEVAL
17/04/201
PUTERA
187 11803335 8 Crystal HK.05,01/IV,2,1/
MEGATRA BMHP Kit BMHP 1 1059380 0 105938 1165318
1 4 16:25:02.9 Violet C 5425/2017
DING TBK,
63
PT
ENSEVAL
17/04/201
PUTERA
187 11803335 8 HK.05,01/IV,2,1/
MEGATRA BMHP Iodine B Btl/500ml BMHP LAB 1 1246560 0 124656 1371216
2 4 16:25:02.9 5425/2017
DING TBK,
63
PT
ENSEVAL
17/04/201 Pipette
PUTERA
187 11803335 8 Tips 0,5 248920.00 2738120.0 HK.05,01/IV,2,1/
3 4 16:25:02.9 250ul 32 35 5425/2017
DING TBK,
63 (96pcs)
PT
ENSEVAL
17/04/201 Pipette
PUTERA
187 11803335 8 Tips 100- HK.05,01/IV,2,1/
4 4 16:25:02.9 1000ul 5425/2017
DING TBK,
63 (96pcs)
PT
ENSEVAL
17/04/201
PUTERA VITEK2
187 11803335 8 HK.05,01/IV,2,1/
5 4 16:25:02.9 5425/2017
DING TBK, CARDS.
63
PT
ENSEVAL
PUTERA
187 11803335 8 Tube HK.05,01/IV,2,1/
6 4 16:25:02.9 12x75mm 5425/2017
DING TBK,
63 (2000)
PT
ENSEVAL
17/04/201
PUTERA
187 11803335 8 Vitek AST HK.05,01/IV,2,1/
7 7 16:37:19.7 GN93 5425/2017
DING TBK,
66
PT
ENSEVAL
17/04/201
PUTERA
187 11803335 8 Vitek AST HK.05,01/IV,2,1/
8 7 16:37:19.7 YS07 5425/2017
DING TBK,
66
PT
ENSEVAL
17/04/201
PUTERA GN Tet
187 11803335 8 HK.05,01/IV,2,1/
9 7 16:37:19.7 5425/2017
DING TBK, Cards
66
PT
ENSEVAL
17/04/201
PUTERA GP TET
188 11803335 8 HK.05,01/IV,2,1/
0 7 16:37:19.7 5425/2017
DING TBK, Cards
66
PT
ENSEVAL
17/04/201
PUTERA Vitek 2,Ast
188 11803335 8 HK.05,01/IV,2,1/
1 7 16:37:19.7 5425/2017
DING TBK, Cards
66
PT
ENSEVAL
17/04/201
PUTERA YST Tet
188 11803335 8 HK.05,01/IV,2,1/
2 7 16:37:19.7 5425/2017
DING TBK, Cards
66
PT
188 ENSEVAL 31800251 30/04/201 BMHP Dianeal Fls BMHP 2520 52272.727 0 13172727. 14489999 BN.01.01/PPK.III
3 PUTERA 7 8 pd-4 1,5 2 9.2 /5041/2018
MEGATRA 16:12:31.5 Dexwin
DING TBK, 16
PT
ENSEVAL
30/04/201
PUTERA Dianeal
188 31800251 8 12545454. 13799999 BN.01.01/PPK.III
MEGATRA BMHP Pd-4 2,5% P c s BMHP 2400 52272.727 0
4 7 16:12:31.5 48 9.3 /5041/2018
DING TBK, Dextwin
16
PT
ENSEVAL
30/04/201
PUTERA
188 31800251 8 BN.01.01/PPK.III
5 6 16:17:06.3 /5401/2018
DING TBK,
86
PT
ENSEVAL
30/04/201
PUTERA Extended
188 31800251 8 2195400.0 BN.01.01/PPK.III
6 6 16:17:06.3 2 /5401/2018
DING TBK, Transfer
86
PT
ENSEVAL
30/04/201
PUTERA
7 6 16:17:06.3 Adaptor /5401/2018
DING TBK,
86
PT
ENSEVAL
30/04/201
PUTERA
188 31800251 8 Ultraclamp 180600.02 BN.01.01/PPK.III
8 6 16:17:06.3 (Red) 4 /5401/2018
DING TBK,
86
PT
ENSEVAL
188 11804556 25/05/201 Vitek AST
MEGATRA BMHP Kit BMHP LAB 20 2734200 0 5468400 60152400 BLU.Far/6207/2
9 6 8 15:15:00 GN93
DING TBK, 018
PT
ENSEVAL
189 11804556 25/05/201 Vitek AST
0 6 8 15:15:00 YS07
DING TBK, 018
PT
189 ENSEVAL 11804556 25/05/201 BMHP GN Tet Kit BMHP LAB 28 2734200 0 7655760 84213360 BN.01.01/PPK-
1 PUTERA 6 8 15:15:00 Vtk2 20 BLU.Far/6207/2
MEGATRA Cards 018
DING TBK,
PT
ENSEVAL
189 11804556 25/05/201
MEGATRA BMHP Vitek2 NH Kit BMHP LAB 1 2734200 0 273420 3007620 BLU.Far/6207/2
2 6 8 15:15:00
DING TBK, 018
PT
ENSEVAL
PUTERA Vitek 2,Ast BN.01.01/PPK-
189 11804556 25/05/201
MEGATRA BMHP Gp67 Buah BMHP LAB 5 2734200 0 1367100 15038100 BLU.Far/6207/2
3 6 8 15:15:00
DING TBK, Cards 018
PT
ENSEVAL
PUTERA YST Tet BN.01.01/PPK-
189 11804556 25/05/201
MEGATRA BMHP Vtk2 20 Kit BMHP LAB 3 2734200 0 820260 9022860 BLU.Far/6207/2
4 6 8 15:15:00
DING TBK, Cards 018
PT
ENSEVAL
189 11804568 25/05/201 Aceton
5 1 8 15:23:00 Safranin A
DING TBK, 018
PT
ENSEVAL
189 11804568 25/05/201 Bactalert
6 1 8 15:23:00 FA Plus
DING TBK, 018
PT
ENSEVAL
189 11804568 25/05/201 Bactalert
MEGATRA BMHP Buah BMHP LAB 4 7761600 0 3104640 34151040 BLU.Far/6207/2
7 1 8 15:23:00 FN Plus
DING TBK, 018
PT
ENSEVAL
189 11804568 25/05/201 Bactalert
8 1 8 15:23:00 PF Plus
DING TBK, 018
PT
189 ENSEVAL 11804568 25/05/201 BMHP Crystal Kit BMHP 1 1059380 0 105938 1165318 BN.01.01/PPK-
9 PUTERA 1 8 15:23:00 Violet C BLU.Far/6207/2
MEGATRA
DING TBK, 018
PT
ENSEVAL
190 11804568 25/05/201
MEGATRA BMHP Iodine B Btl/500ml BMHP LAB 1 1246560 0 124656 1371216 BLU.Far/6207/2
0 1 8 15:23:00
DING TBK, 018
PT
ENSEVAL
Pipette
190 11804568 25/05/201 Tips 0,5 2738112.9
MEGATRA BMHP Buah BMHP LAB 960 2592.91 0 248919.36 BLU.Far/6207/2
1 1 8 15:23:00 250ul 6
DING TBK, 018
(96pcs)
PT
ENSEVAL
Pipette
190 11804568 25/05/201 Tips 100- 3266345.2
MEGATRA BMHP Buah BMHP LAB 960 3093.13 0 296940.48 BLU.Far/6207/2
2 1 8 15:23:00 1000ul 8
DING TBK, 018
(96pcs)
PT
ENSEVAL
190 11804568 25/05/201 Vitek2
3 1 8 15:23:00 BCL, Cards
DING TBK, 018
PT
ENSEVAL
04/07/201
PUTERA
190 11805597 8 Bactalert HK.05,01/IV,2,1/
4 8 16:53:35.6 FA Plus 5425/2017
DING TBK,
7
PT
ENSEVAL
04/07/201
PUTERA
190 11805597 8 Bactalert HK.05,01/IV,2,1/
5 8 16:53:35.6 FN Plus 5425/2017
DING TBK,
7
PT
ENSEVAL
04/07/201
PUTERA
190 11805597 8 Bactalert HK.05,01/IV,2,1/
6 8 16:53:35.6 PF Plus 5425/2017
DING TBK,
7
PT
190 ENSEVAL 11805597 04/07/201 BMHP Vitek AST Kit BMHP LAB 3 2734200 0 820260 9022860 HK.05,01/IV,2,1/
PUTERA
8
MEGATRA
7 8 16:53:35.6 ST01 5425/2017
DING TBK,
7
PT
ENSEVAL
04/07/201
PUTERA
190 11805597 8 Vitek HK.05,01/IV,2,1/
8 8 16:53:35.6 Salina 0,45 5425/2017
DING TBK,
7
PT
ENSEVAL
04/07/201
PUTERA VITEK2
190 11805597 8 HK.05,01/IV,2,1/
9 8 16:53:35.6 5425/2017
DING TBK, CARDS.
7
PT
ENSEVAL
PUTERA
191 11805597 8 Tube HK.05,01/IV,2,1/
0 8 16:53:35.6 12x75mm 5425/2017
DING TBK,
7 (2000)
PT
ENSEVAL
04/07/201
PUTERA
191 11805541 8 Vitek AST HK.05,01/IV,2,1/
1 1 17:09:16.2 GN93 5425/2017
DING TBK,
66
PT
ENSEVAL
04/07/201
PUTERA
191 11805541 8 Vitek AST HK.05,01/IV,2,1/
2 1 17:09:16.2 YS07 5425/2017
DING TBK,
66
PT
ENSEVAL
04/07/201
PUTERA GN Tet
191 11805541 8 HK.05,01/IV,2,1/
3 1 17:09:16.2 5425/2017
DING TBK, Cards
66
PT
ENSEVAL
04/07/201
PUTERA GP TET
191 11805541 8 HK.05,01/IV,2,1/
4 1 17:09:16.2 5425/2017
DING TBK, Cards
66
PT
ENSEVAL
04/07/201
PUTERA Vitek 2,Ast
191 11805541 8 HK.05,01/IV,2,1/
5 1 17:09:16.2 5425/2017
DING TBK, Cards
66
PT
ENSEVAL
04/07/201
PUTERA YST Tet
191 11805541 8 HK.05,01/IV,2,1/
6 1 17:09:16.2 5425/2017
DING TBK, Cards
66
PT
ENSEVAL
26/07/201
PUTERA
191 11806378 8 Bactalert HK.05,01/IV,2,1/
7 7 14:39:42.4 FA Plus 5425/2017
DING TBK,
9
PT
ENSEVAL
26/07/201
PUTERA
191 11806378 8 Bactalert HK.05,01/IV,2,1/
8 7 14:39:42.4 FN Plus 5425/2017
DING TBK,
9
PT
ENSEVAL
26/07/201
PUTERA
191 11806378 8 Bactalert HK.05,01/IV,2,1/
9 7 14:39:42.4 PF Plus 5425/2017
DING TBK,
9
PT
ENSEVAL
26/07/201
PUTERA
192 11806378 8 Vitek HK.05,01/IV,2,1/
0 7 14:39:42.4 Salina 0,45 5425/2017
DING TBK,
9
PT
ENSEVAL
26/07/201
PUTERA VITEK2
192 11806378 8 HK.05,01/IV,2,1/
1 7 14:39:42.4 5425/2017
DING TBK, CARDS.
9
PT
192 ENSEVAL 11806378 26/07/201 BMHP Vitek2 Test P c s BMHP LAB 4000 4846.1 0 1938440 21322840 HK.05,01/IV,2,1/
2 PUTERA 7 8 Tube 5425/2017
MEGATRA 14:39:42.4 12x75mm
DING TBK, 9 (2000)
PT
ENSEVAL
26/07/201
PUTERA
192 11806380 8 Vitek AST HK.05,01/IV,2,1/
3 1 15:07:27.9 GN93 5425/2017
DING TBK,
06
PT
ENSEVAL
26/07/201
PUTERA
192 11806380 8 Vitek AST HK.05,01/IV,2,1/
4 1 15:07:27.9 YS07 5425/2017
DING TBK,
06
PT
ENSEVAL
26/07/201
PUTERA GN Tet
192 11806380 8 HK.05,01/IV,2,1/
5 1 15:07:27.9 5425/2017
DING TBK, Cards
06
PT
ENSEVAL
26/07/201
PUTERA GP TET
192 11806380 8 HK.05,01/IV,2,1/
6 1 15:07:27.9 5425/2017
DING TBK, Cards
06
PT
ENSEVAL
26/07/201
PUTERA
192 11806380 8 Vitek AST HK.05,01/IV,2,1/
7 1 15:07:27.9 ST01 5425/2017
DING TBK,
06
PT
ENSEVAL
26/07/201
PUTERA Vitek 2,Ast
192 11806380 8 HK.05,01/IV,2,1/
8 1 15:07:27.9 5425/2017
DING TBK, Cards
06
PT
ENSEVAL
26/07/201
PUTERA YST Tet
192 11806380 8 HK.05,01/IV,2,1/
9 1 15:07:27.9 5425/2017
DING TBK, Cards
06
PT
193 ENSEVAL 11807172 21/08/201 BMHP Bactalert Buah BMHP LAB 1 7761600 0 776160 8537760 HK.05,01/IV,2,1/
0 PUTERA 4 8 FN Plus 5425/2017
MEGATRA 14:03:40.8
DING TBK,
66
PT
ENSEVAL
21/08/201 Pipette
PUTERA
193 11807172 8 Tips 100- HK.05,01/IV,2,1/
1 4 14:03:40.8 1000ul 5425/2017
DING TBK,
66 (96pcs)
PT
ENSEVAL
21/08/201
PUTERA
193 11807173 8 Vitek AST HK.05,01/IV,2,1/
2 7 14:21:54.9 GN93 5425/2017
DING TBK,
4
PT
ENSEVAL
21/08/201
PUTERA
193 11807173 8 Vitek AST HK.05,01/IV,2,1/
3 7 14:21:54.9 YS07 5425/2017
DING TBK,
4
PT
ENSEVAL
21/08/201
PUTERA GN Tet
193 11807173 8 HK.05,01/IV,2,1/
4 7 14:21:54.9 5425/2017
DING TBK, Cards
4
PT
ENSEVAL
21/08/201
PUTERA GP TET
193 11807173 8 HK.05,01/IV,2,1/
5 7 14:21:54.9 5425/2017
DING TBK, Cards
4
PT
ENSEVAL
21/08/201
PUTERA
193 11807173 8 HK.05,01/IV,2,1/
MEGATRA BMHP Vitek2 NH Kit BMHP LAB 1 2734200 0 273420 3007620
6 7 14:21:54.9 5425/2017
DING TBK,
4
PT
ENSEVAL
21/08/201
PUTERA Vitek 2,Ast
193 11807173 8 HK.05,01/IV,2,1/
7 7 14:21:54.9 5425/2017
DING TBK, Cards
4
PT
193 ENSEVAL 11807173 21/08/201 BMHP YST Tet Kit BMHP LAB 7 2734200 0 1913940 21053340 HK.05,01/IV,2,1/
8 PUTERA 7 8 Vtk2 20 5425/2017
MEGATRA
14:21:54.9
DING TBK, Cards
4
PT
HD
27/12/201 DOUBLE
EUREKA
193 INV1218E 8 LUMEN BN.01.01/PPK-
SUKSES BMHP Set BMHP 150 495000 0 7425000 81675000
9 SA0260 16:43:22.8 11,5-16CM III/12688/2018
ABADI
2 (PRECURV
ED)
194 HOSLAB 000252/F 8 Coombs 10018800 BN.01.01/PPK.III
BMHP Pcs BMHP LAB 1152 79062.5 0 9108000
0 INDONESI HI/XI/18 14:10:31.0 Card 0 /1250/2018
A.PT 96 24x12
FRISMED 08/08/201
194 HOSLAB 000252/F 8 ID-Diluent BN.01.01/PPK.III
BMHP Btl/500ml BMHP LAB 5 2079000 0 1039500 11434500
1 INDONESI HI/XI/18 14:10:31.0 2 500ml /1250/2018
A.PT 96
BMHP Pcs BMHP LAB 1152 79062.5 0 9108000
A.PT 36 24x12
FRISMED 28/08/201
3 INDONESI HI/XI/18 14:24:28.6 2 500ml /1250/2018
A.PT 36
BMHP Pcs BMHP LAB 5760 79062.5 0 45540000
A.PT 93 24x12
FRISMED 10/09/201
5 INDONESI HI/XI/18 10:38:30.7 2 500ml /1250/2018
A.PT 93
FRISMED 19/11/201 ID DIACEL
194 HOSLAB 000202/F 8 ASIA (3 BN.01.01/PPK.III
BMHP Box BMHP 1 1386000 0 138600 1524600
6 INDONESI HI/XI/18 15:39:19.8 botol @ /1250/2018
A.PT 33 10ml)
194 FRISMED 000202/F 19/11/201 BMHP ID Kit BMHP LAB 1 2970000 0 297000 3267000 BN.01.01/PPK.III
7 HOSLAB HI/XI/18 8 Diapanel /1250/2018
INDONESI 15:39:19.8 (11 botol
A.PT 33 @4ml)
BMHP Pcs BMHP LAB 1440 79062.5 0 11385000
A.PT 53 24x12
FRISMED 28/11/201
9 INDONESI HI/XI/18 10:29:36.1 2 500ml /1250/2018
A.PT 53
FRISMED ID-Liss
195 HOSLAB 000249/F 28/11/201 Coombs 25047000 BN.01.01/PPK.III
BMHP Pcs BMHP LAB 2880 79062.5 0 22770000
0 INDONESI HI/XI/18 8 11:11:09 Card 0 /1250/2018
A.PT 24x12
HOSPI
195 MEDIK 1253/HMI 27/08/201 Surefit 10579920. BN.01.01/PPK-
BMHP Pcs BMHP 120 80150.91 0 961810.92
1 INDONESI /KWI/SPB 8 14:48:00 Cable 12 III/8849/2018
A. PT
HOSPI 30/10/201
1640/HMI SUREFIT
195 MEDIK 8 56627.272 509645.45 5606099.9 BN.01.01/PPK-
/KWI/X/2 BMHP NON Pcs BMHP 90 0
2 INDONESI 16:19:51.0 7 43 97 III/8849/2018
018 CABLE
A. PT 2
IDS
21/08/201 EMBOLEC
MEDICAL
195 8 TOMY BN.01.01/PPK-
SYSTEM 0157816 BMHP Pcs BMHP 3 785197 0 235559.1 2591150.1
3 15:53:55.6 CATHETER III/8859/2018
INDONESI
73 4FR
A PT
IDS EMBOLEC
21/08/201
MEDICAL TOMY
195 8 BN.01.01/PPK-
4 15:53:55.6 III/8859/2018
INDONESI 5FR
73
A PT EL1580
IDS EMBOLEC
21/08/201
MEDICAL TOMY
195 8 BN.01.01/PPK-
5 15:53:55.6 III/8859/2018
INDONESI 6FR
73
A PT EL1680
195 IDS 0157816 21/08/201 BMHP Double Pcs BMHP 5 980000 0 490000 5390000 BN.01.01/PPK-
6 MEDICAL 8 Lumen III/8859/2018
SYSTEM
15:53:55.6 Multicath
INDONESI
73 3Fr, 10cm
A PT
IDS THORACIC
21/08/201
MEDICAL TROCAR &
195 8 BN.01.01/PPK-
SYSTEM 0157816 BMHP CANNULA P c s BMHP 5 115181 0 57590.5 633495.5
7 15:53:55.6 III/8859/2018
INDONESI CH-28
73
A PT redax
IDS THORACIC
21/08/201
MEDICAL TROCAR &
195 8 BN.01.01/PPK-
SYSTEM 0157816 BMHP CANNULA P c s BMHP 5 115181 0 57590.5 633495.5
8 15:53:55.6 III/8859/2018
INDONESI CH-24
73
A PT REDAX
IDS Breathing
MEDICAL Set
195 12/09/201 16933951. 20320742. 22352816 BN.01.01/PPK-
SYSTEM 0158429 BMHP Adul,Single S e t BMHP 12 0
9 8 08:34:00 82 18 4 III/7300/2018
INDONESI water,reus
A PT able
SU
IDS
Proximal
MEDICAL
196 12/09/201 Flow 9534437.2 9534437.2 10487881 BN.01.01/PPK-
SYSTEM 0158429 BMHP Box/10 BMHP 10 0
0 8 08:34:00 Sensor 7 7 0 III/7300/2018
INDONESI
pedstoadul
A PT
t
IDS
17/09/201 Double
MEDICAL
196 8 Lumen BN.01.01/PPK-
1 16:19:02.0 Multicath III/8859/2018
INDONESI
16 3Fr, 10cm
A PT
IDS THORACIC
17/09/201
MEDICAL TROCAR &
196 8 1266990.0 BN.01.01/PPK-
SYSTEM 0161386 BMHP CANNULA P c s BMHP 10 115180.91 0 115180.91
2 16:19:02.0 1 III/8859/2018
INDONESI CH-16
16
A PT REDAX
IDS
17/09/201 THORACIC
MEDICAL
196 8 TROCAR & 1266990.0 BN.01.01/PPK-
SYSTEM 0161386 BMHP Pcs BMHP 10 115180.91 0 115180.91
3 16:19:02.0 CANNULA 1 III/8859/2018
INDONESI
16 CH-20 red
A PT
IDS
17/09/201 THORACIC
MEDICAL
196 8 TROCAR & 1266990.0 BN.01.01/PPK-
SYSTEM 0161386 BMHP Pcs BMHP 10 115180.91 0 115180.91
4 16:19:02.0 CANNULA 1 III/8859/2018
INDONESI
16 CH-32 reda
A PT
IDS THORACIC
17/09/201
MEDICAL TROCAR &
196 8 1266990.0 BN.01.01/PPK-
5 16:19:02.0 1 III/8859/2018
INDONESI CH-24
16
A PT REDAX
IDS THORACIC
17/09/201
MEDICAL TROCAR &
196 8 3800970.0 BN.01.01/PPK-
6 16:19:02.0 3 III/8859/2018
INDONESI CH-28
16
A PT redax
IDS
18/09/201
MEDICAL Paper
196 8 BN.01.01/PPK-
SYSTEM 0161145 BMHP Mouthpiec P c s BMHP 1000 5727.27 0 572727 6299997
7 09:55:04.1 III/8859/2018
INDONESI e
13
A PT
IDS Breathing
24/09/201
MEDICAL Set
196 8 22866832. 11433416. 12576758 BN.01.01/PPK-
SYSTEM 0162266 BMHP Ped,Single S e t BMHP 5 0
8 16:17:23.3 73 36 0 III/7300/2018
INDONESI water,reus
76
A PT able
IDS THORACIC
08/10/201
MEDICAL TROCAR &
196 8 115180.90 46072.363 BN.01.01/PPK-
SYSTEM 0164252 BMHP CANNULA P c s BMHP 4 0 506796
9 15:41:49.2 91 6 III/8859/2018
INDONESI CH-28
83
A PT redax
IDS
08/10/201 Double
MEDICAL
0 15:41:49.2 Multicath III/8859/2018
INDONESI
83 3Fr, 10cm
A PT
197 IDS 0164252 08/10/201 BMHP THORACIC P c s BMHP 10 115180.90 0 115180.90 1266990 BN.01.01/PPK-
1 MEDICAL 8 TROCAR & 91 91 III/8859/2018
SYSTEM 15:41:49.2 CANNULA
INDONESI 83 CH-16
A PT REDAX
IDS
08/10/201 THORACIC
MEDICAL
197 8 TROCAR & 115180.90 115180.90 BN.01.01/PPK-
SYSTEM 0164252 BMHP Pcs BMHP 10 0 1266990
2 15:41:49.2 CANNULA 91 91 III/8859/2018
INDONESI
83 CH-20 red
A PT
IDS THORACIC
08/10/201
MEDICAL TROCAR &
197 8 115180.90 115180.90 BN.01.01/PPK-
3 15:41:49.2 91 91 III/8859/2018
INDONESI CH-24
83
A PT REDAX
IDS
10/10/201
MEDICAL Paper
197 8 BN.01.01/PPK-
4 14:57:26.3 III/8859/2018
INDONESI e
9
A PT
IDS THORACIC
19/10/201
MEDICAL TROCAR &
197 8 115180.90 598940.72 6588348.0 BN01.01/PPK-
SYSTEM 0165799 BMHP CANNULA P c s BMHP 52 0
5 11:17:21.9 91 73 01 III/8859/2018
INDONESI CH-28
4
A PT redax
IDS
19/10/201 THORACIC
MEDICAL
197 8 TROCAR & 115180.90 345542.72 BN01.01/PPK-
SYSTEM 0165799 BMHP Pcs BMHP 30 0 3800970
6 11:17:21.9 CANNULA 91 73 III/8859/2018
INDONESI
4 CH-32 reda
A PT
IDS THORACIC
19/10/201
MEDICAL TROCAR &
197 8 115180.90 46072.363 BN01.01/PPK-
7 16:35:18.9 91 6 III/8859/2018
INDONESI CH-28
36
A PT redax
IDS PT. 84
25/10/201
MEDICAL (Bulk Pack
197 8 BN.01.01/PPK-
SYSTEM 0166606 BMHP w/ Pcs BMHP 140 40150 0 562100 6183100
8 15:17:10.5 III/11094/2018
INDONESI Box&Label
33
A PT )
197 IDS 0166356 25/10/201 BMHP BTR 2- Pcs BMHP 10 456000 0 456000 5016000 BN.01.01/PPK-
9 MEDICAL 8 4812.Dual III/11094/2018
SYSTEM 16:21:23.9 Line
INDONESI
06
A PT
IDS
25/10/201
MEDICAL BTR 3-
198 8 BN.01.01/PPK-
0 16:21:23.9 III/11094/2018
06
A PT
IDS
25/10/201
MEDICAL BTR 4812-
198 8 BN.01.01/PPK-
1 16:21:23.9 III/11094/2018
INDONESI Lumen
06
A PT
IDS PT. 84
25/10/201
MEDICAL (Bulk Pack
198 8 BN.01.01/PPK-
2 16:21:23.9 III/11094/2018
INDONESI Box&Label
06
A PT )
IDS
25/10/201
MEDICAL Thoracic
198 8 104545.45 52272.727 574999.99 BN.01.01/PPK-
SYSTEM 0166356 BMHP Catheter Pcs BMHP 5 0
3 16:21:23.9 45 3 98 III/11094/2018
INDONESI No. 20
06
A PT
IDS
25/10/201
MEDICAL Thoracic
198 8 104545.45 209090.90 2299999.9 BN.01.01/PPK-
4 16:21:23.9 45 9 99 III/11094/2018
INDONESI No.28
06
A PT
IDS
25/10/201
MEDICAL Thoracic
198 8 104545.45 209090.90 2299999.9 BN.01.01/PPK-
5 16:21:23.9 45 9 99 III/11094/2018
INDONESI No.32
06
A PT
IDS F&P RT124
31/10/201
MEDICAL CIRC.W/
198 EG800003 8 BN.01.01/PPK-
6 65 14:38:18.9 III/10939/2018
INDONESI GENERAT
2
A PT OSLE1000
198 IDS EG800003 31/10/201 BMHP SU Circuit P c s BMHP 15 905600 0 1358400 14942400 BN.01.01/PPK-
7 MEDICAL 65 8 w/ Twin III/10939/2018
SYSTEM Spiral
14:38:18.9
INDONESI Heated
2
A PT Circ
Singel Use
IDS
13/11/201 Flow
MEDICAL
198 EG800004 8 Sensor for BN.01.01/PPK.III
8 75 15:39:48.5 SLE /10939/2018
INDONESI
33 4000/500
A PT
0
IDS F&P RT124
13/11/201
MEDICAL CIRC.W/
198 EG800004 8 BN.01.01/PPK.III
9 75 15:39:48.5 /10939/2018
INDONESI GENERAT
33
A PT OSLE1000
IDS SU Circuit
13/11/201
MEDICAL w/ Twin
199 EG800004 8 BN.01.01/PPK.III
SYSTEM BMHP Spiral Pcs BMHP 30 905600 0 2716800 29884800
0 75 15:39:48.5 /10939/2018
INDONESI Heated
33
A PT Circ
IDS
15/11/201
MEDICAL BTR 2-
199 8 BN.01.01/PPK-
1 15:55:08.8 III/11094/2018
INDONESI Line
56
A PT
IDS
15/11/201
MEDICAL BTR 3-
199 8 BN.01.01/PPK-
2 15:55:08.8 III/11094/2018
56
A PT
IDS
15/11/201
MEDICAL BTR 4812-
199 8 BN.01.01/PPK-
3 15:55:08.8 III/11094/2018
INDONESI Lumen
56
A PT
IDS PT. 84
15/11/201
MEDICAL (Bulk Pack
199 8 BN.01.01/PPK-
4 15:55:08.8 III/11094/2018
INDONESI Box&Label
56
A PT )
IDS
15/11/201
MEDICAL Thoracic
199 8 104545.45 522727.27 5749999.9 BN.01.01/PPK-
5 15:55:08.8 45 25 97 III/11094/2018
INDONESI No.28
56
A PT
IDS
15/11/201
MEDICAL Thoracic
199 8 104545.45 418181.81 4599999.9 BN.01.01/PPK-
6 15:55:08.8 45 8 98 III/11094/2018
INDONESI No.32
56
A PT
IDS
15/11/201
MEDICAL Thoracic
199 8 104545.45 104545.45 1149999.9 BN.01.01/PPK-
7 15:55:08.8 45 45 99 III/11094/2018
INDONESI No. 24
56
A PT
IDS Double
21/11/201
MEDICAL Lumen
199 8 BN.01.01/PPK-
SYSTEM 0169682 BMHP Multicath P c s BMHP 5 891440 0 445720 4902920
8 09:45:43.6 III/8859/2018
86
A PT m
IDS
21/11/201 THORACIC
MEDICAL
199 8 TROCAR & BN.01.01/PPK-
9 09:45:43.6 CANNULA III/8859/2018
INDONESI
86 CH-20 red
A PT
IDS
21/11/201
MEDICAL Tracheosto
200 8 BN.01.01/PPK-
SYSTEM 0169682 BMHP my Tube P c s BMHP 5 307272 0 153636 1689996
0 09:45:43.6 III/8859/2018
INDONESI Size 5
86
A PT
IDS
21/11/201 EMBOLEC
MEDICAL
200 8 TOMY BN.01.01/PPK-
1 09:45:43.6 CATHETER III/8859/2018
INDONESI
86 4FR
A PT
200 IDS 0169682 21/11/201 BMHP THORACIC P c s BMHP 45 115181 0 518314.5 5701459.5 BN.01.01/PPK-
2 MEDICAL 8 TROCAR & III/8859/2018
SYSTEM 09:45:43.6 CANNULA
INDONESI 86 CH-28
A PT redax
IDS EMBOLEC
21/11/201
MEDICAL TOMY
200 8 BN.01.01/PPK-
3 09:45:43.6 III/8859/2018
INDONESI 5FR
86
A PT EL1580
IDS EMBOLEC
21/11/201
MEDICAL TOMY
200 8 BN.01.01/PPK-
4 09:45:43.6 III/8859/2018
INDONESI 6FR
86
A PT EL1680
IDS
21/11/201 THORACIC
MEDICAL
200 8 TROCAR & BN.01.01/PPK-
5 09:45:43.6 CANNULA III/8859/2018
INDONESI
86 CH-32 reda
A PT
IDS Nasal Mask
07/12/201
MEDICAL Size L
200 EG800006 8 BN.01.01/PPK-
SYSTEM BMHP nCPAP Pcs BMHP 10 446700 0 446700 4913700
6 80 17:27:51.4 III/10939/2018
INDONESI GeneratorS
53
A PT LE1000
IDS Nasal Mask
07/12/201
MEDICAL Size M
200 EG800006 8 BN.01.01/PPK-
7 80 17:27:51.4 III/10939/2018
INDONESI GeneratorS
53
A PT LE1000
IDS Nasal Mask
07/12/201
MEDICAL Size S
200 EG800006 8 BN.01.01/PPK-
8 80 17:27:51.4 III/10939/2018
INDONESI GeneratorS
53
A PT LE1000
IDS F&P RT124
07/12/201
MEDICAL CIRC.W/
200 EG800006 8 BN.01.01/PPK-
9 80 17:27:51.4 III/10939/2018
INDONESI GENERAT
53
A PT OSLE1000
201 IDS EG800006 07/12/201 BMHP SU Circuit P c s BMHP 15 905600 0 1358400 14942400 BN.01.01/PPK-
0 MEDICAL 80 8 w/ Twin III/10939/2018
SYSTEM 17:27:51.4 Spiral
INDONESI Heated
53
A PT Circ
Singel Use
IDS
07/12/201 Flow
MEDICAL
201 EG800006 8 Sensor for BN.01.01/PPK-
1 80 17:27:51.4 SLE III/10939/2018
INDONESI
53 4000/500
A PT
0
IDS
10/12/201 THORACIC
MEDICAL
201 8 TROCAR & 172771.36 1900485.0 BN.01.01/PPK-
SYSTEM 0172359 BMHP Pcs BMHP 15 115180.91 0
2 17:03:51.5 CANNULA 5 15 III/8859/2018
INDONESI
4 CH-32 reda
A PT
IDS
10/12/201
MEDICAL Paper
201 8 BN.01.01/PPK-
3 17:13:51.8 III/8859/2018
INDONESI e
4
A PT
IDS
10/12/201
MEDICAL BTR 2-
201 8 BN.01.01/PPK-
4 17:35:26.4 III/11094/2018
INDONESI Line
53
A PT
IDS
10/12/201
MEDICAL BTR 3-
201 8 BN.01.01/PPK-
5 17:35:26.4 III/11094/2018
53
A PT
IDS
10/12/201
MEDICAL BTR 4812-
201 8 BN.01.01/PPK-
6 17:35:26.4 III/11094/2018
INDONESI Lumen
53
A PT
IDS PT. 84
10/12/201
MEDICAL (Bulk Pack
201 8 BN.01.01/PPK-
7 17:35:26.4 III/11094/2018
INDONESI Box&Label
53
A PT )
201 IDS 0172362 10/12/201 BMHP Thoracic P c s BMHP 5 104545.45 0 52272.727 574999.99 BN.01.01/PPK-
MEDICAL
8
SYSTEM Catheter
8 17:35:26.4 45 3 98 III/11094/2018
INDONESI No. 20
53
A PT
IDS
10/12/201
MEDICAL Thoracic
201 8 104545.45 104545.45 1149999.9 BN.01.01/PPK-
9 17:35:26.4 45 45 99 III/11094/2018
INDONESI No. 24
53
A PT
IDS
10/12/201
MEDICAL Thoracic
202 8 104545.45 209090.90 2299999.9 BN.01.01/PPK-
0 17:35:26.4 45 9 99 III/11094/2018
INDONESI No.28
53
A PT
IDS
10/12/201
MEDICAL Thoracic
202 8 104545.45 209090.90 2299999.9 BN.01.01/PPK-
1 17:35:26.4 45 9 99 III/11094/2018
INDONESI No.32
53
A PT
Art +
202 MENDJAN 18010560 12/01/201 Venous HK.05,01/IV,2,1/
BMHP Pcs BMHP 900 97800 0 8802000 96822000
2 GAN, PT 09 8 09:35:00 Blood Line 757/2014
W/Filt
DIALYZER
202 MENDJAN 18010560 12/01/201 17028000 HK.05,01/IV,2,1/
BMHP POLYPURE P c s BMHP 900 172000 0 15480000
3 GAN, PT 09 8 09:35:00 0 757/2014
16S
202 MENDJAN 18010560 12/01/201 Biasol Acid HK.05,01/IV,2,1/
BMHP Galon BMHP 450 162000 0 7290000 80190000
4 GAN, PT 09 8 09:35:00 Conc 6 ltr 757/2014
202 MENDJAN 18010560 12/01/201 Bicarbonat HK.05,01/IV,2,1/
BMHP Galon BMHP 900 82200 0 7398000 81378000
5 GAN, PT 09 8 09:35:00 Solution 757/2014
AV. Fistula
202 MENDJAN 18010560 12/01/201 HK.05,01/IV,2,1/
BMHP Needle Pcs BMHP 1800 9750 0 1755000 19305000
6 GAN, PT 09 8 09:35:00 757/2014
16G x 1
27/02/201 Art +
202 MENDJAN 18020560 8 Venous HK.05,01/IV,2,1/
BMHP Pcs BMHP 848 97800 0 8293440 91227840
7 GAN, PT 21 16:17:30.7 Blood Line 757/2014
6 W/Filt
202 MENDJAN 18020560 27/02/201 BMHP DIALYZER P c s BMHP 848 172000 0 14585600 16044160 HK.05,01/IV,2,1/
8 GAN, PT 21 8 POLYPURE 0 757/2014
16:17:30.7
16S
6
27/02/201
202 MENDJAN 18020560 8 Biasol Acid HK.05,01/IV,2,1/
BMHP Galon BMHP 424 162000 0 6868800 75556800
9 GAN, PT 21 16:17:30.7 Conc 6 ltr 757/2014
6
27/02/201
203 MENDJAN 18020560 8 Bicarbonat HK.05,01/IV,2,1/
BMHP Galon BMHP 848 82200 0 6970560 76676160
0 GAN, PT 21 16:17:30.7 Solution 757/2014
6
27/02/201
AV. Fistula
203 MENDJAN 18020560 8 HK.05,01/IV,2,1/
1 GAN, PT 21 16:17:30.7 757/2014
16G x 1
6
Art +
BN.01.01/PPK-
203 MENDJAN 18030560 20/03/201 Venous 10758000
BMHP Pcs BMHP 1000 97800 0 9780000 BLU.Far/2155/2
2 GAN, PT 18 8 08:32:00 Blood Line 0
018
W/Filt
DIALYZER BN.01.01/PPK-
203 MENDJAN 18030560 20/03/201 18920000
BMHP POLYPURE P c s BMHP 1000 172000 0 17200000 BLU.Far/2155/2
3 GAN, PT 18 8 08:32:00 0
16S 018
BN.01.01/PPK-
203 MENDJAN 18030560 20/03/201 Biasol Acid
BMHP Galon BMHP 500 162000 0 8100000 89100000 BLU.Far/2155/2
4 GAN, PT 18 8 08:32:00 Conc 6 ltr
018
BN.01.01/PPK-
203 MENDJAN 18030560 20/03/201 Bicarbonat
BMHP Galon BMHP 1000 82200 0 8220000 90420000 BLU.Far/2155/2
5 GAN, PT 18 8 08:32:00 Solution
018
AV. Fistula BN.01.01/PPK-
203 MENDJAN 18030560 20/03/201
BMHP Needle Pcs BMHP 2000 9750 0 1950000 21450000 BLU.Far/2155/2
6 GAN, PT 18 8 08:32:00
16G x 1 018
26/04/201 Art +
BMHP Pcs BMHP 922 97800 0 9017160 99188760
7 GAN, PT 25 16:25:09.1 Blood Line 757/2014
96 W/Filt
26/04/201
DIALYZER
203 MENDJAN 18040560 8 17444240 HK.05,01/IV,2,1/
8 GAN, PT 25 16:25:09.1 0 757/2014
16S
96
203 MENDJAN 18040560 26/04/201 BMHP Biasol Acid Galon BMHP 461 162000 0 7468200 82150200 HK.05,01/IV,2,1/
8
9 GAN, PT 25 16:25:09.1 Conc 6 ltr 757/2014
96
26/04/201
BMHP Galon BMHP 922 82200 0 7578840 83367240
0 GAN, PT 25 16:25:09.1 Solution 757/2014
96
26/04/201
AV. Fistula
204 MENDJAN 18040560 8 HK.05,01/IV,2,1/
1 GAN, PT 25 16:25:09.1 757/2014
16G x 1
96
30/05/201 Art +
BMHP Pcs BMHP 858 97800 0 8391240 92303640
2 GAN, PT 23 15:40:29.9 Blood Line 757/2014
33 W/Filt
30/05/201
DIALYZER
204 MENDJAN 18050560 8 16233360 HK.05,01/IV,2,1/
3 GAN, PT 23 15:40:29.9 0 757/2014
16S
33
30/05/201
BMHP Galon BMHP 858 81000 0 6949800 76447800
4 GAN, PT 23 15:40:29.9 Conc 6 ltr 757/2014
33
30/05/201
BMHP Galon BMHP 858 82200 0 7052760 77580360
5 GAN, PT 23 15:40:29.9 Solution 757/2014
33
30/05/201
AV. Fistula
204 MENDJAN 18050560 8 HK.05,01/IV,2,1/
6 GAN, PT 23 15:40:29.9 757/2014
16G x 1
33
Art +
204 MENDJAN 18060560 29/06/201 Venous 10198584 HK.05,01/IV,2,1/
BMHP Pcs BMHP 948 97800 0 9271440
7 GAN, PT 26 8 08:11:00 Blood Line 0 757/2014
W/Filt
DIALYZER
204 MENDJAN 18060560 29/06/201 17936160 HK.05,01/IV,2,1/
8 GAN, PT 26 8 08:11:00 0 757/2014
16S
204 MENDJAN 18060560 29/06/201 BMHP Biasol Acid Galon BMHP 948 81000 0 7678800 84466800 HK.05,01/IV,2,1/
9 GAN, PT 26 8 08:11:00 Conc 6 ltr 757/2014
205 MENDJAN 18060560 29/06/201 Bicarbonat HK.05,01/IV,2,1/
BMHP Galon BMHP 948 82200 0 7792560 85718160
0 GAN, PT 26 8 08:11:00 Solution 757/2014
AV. Fistula
205 MENDJAN 18060560 29/06/201 HK.05,01/IV,2,1/
1 GAN, PT 26 8 08:11:00 757/2014
16G x 1
26/07/201 Art +
BMHP Pcs BMHP 864 97800 0 8449920 92949120
2 GAN, PT 19 15:23:59.0 Blood Line 757/2014
53 W/Filt
26/07/201
DIALYZER
205 MENDJAN 18070560 8 16346880 HK.05,01/IV,2,1/
3 GAN, PT 19 15:23:59.0 0 757/2014
16S
53
26/07/201
BMHP Galon BMHP 864 81000 0 6998400 76982400
4 GAN, PT 19 15:23:59.0 Conc 6 ltr 757/2014
53
26/07/201
BMHP Galon BMHP 864 82200 0 7102080 78122880
5 GAN, PT 19 15:23:59.0 Solution 757/2014
53
26/07/201
AV. Fistula
205 MENDJAN 18070560 8 HK.05,01/IV,2,1/
6 GAN, PT 19 15:23:59.0 757/2014
16G x 1
53
06/09/201 Art +
205 MENDJAN 18090560 8 Venous 10091004 HK.05,01/IV,2,1/
BMHP Pcs BMHP 938 97800 0 9173640
7 GAN, PT 03 15:10:59.9 Blood Line 0 757/2014
46 W/Filt
06/09/201
DIALYZER
205 MENDJAN 18090560 8 17746960 HK.05,01/IV,2,1/
8 GAN, PT 03 15:10:59.9 0 757/2014
16S
46
06/09/201
BMHP Galon BMHP 938 81000 0 7597800 83575800
9 GAN, PT 03 15:10:59.9 Conc 6 ltr 757/2014
46
206 MENDJAN 18090560 06/09/201 BMHP Bicarbonat Galon BMHP 938 82200 0 7710360 84813960 HK.05,01/IV,2,1/
8
0 GAN, PT 03 15:10:59.9 Solution 757/2014
46
06/09/201
AV. Fistula
206 MENDJAN 18090560 8 HK.05,01/IV,2,1/
1 GAN, PT 03 15:10:59.9 757/2014
16G x 1
46
21/09/201 Art +
BMHP Pcs BMHP 946 97800 0 9251880
2 GAN, PT 22 15:22:41.0 Blood Line 0 757/2014
26 W/Filt
21/09/201
DIALYZER
206 MENDJAN 18090560 8 17898320 HK.05,01/IV,2,1/
3 GAN, PT 22 15:22:41.0 0 757/2014
16S
26
21/09/201
BMHP Galon BMHP 946 81000 0 7662600 84288600
4 GAN, PT 22 15:22:41.0 Conc 6 ltr 757/2014
26
21/09/201
BMHP Galon BMHP 946 82200 0 7776120 85537320
5 GAN, PT 22 15:22:41.0 Solution 757/2014
26
21/09/201
AV. Fistula
206 MENDJAN 18090560 8 HK.05,01/IV,2,1/
6 GAN, PT 22 15:22:41.0 757/2014
16G x 1
26
29/10/201 Art +
BMHP Pcs BMHP 946 97800 0 9251880
7 GAN, PT 15 10:00:08.3 Blood Line 0 757/2014
53 W/Filt
29/10/201
DIALYZER
206 MENDJAN 18100560 8 17898320 HK.05,01/IV,2,1/
8 GAN, PT 15 10:00:08.3 0 757/2014
16S
53
29/10/201
BMHP Galon BMHP 946 81000 0 7662600 84288600
9 GAN, PT 15 10:00:08.3 Conc 6 ltr 757/2014
53
29/10/201
BMHP Galon BMHP 946 82200 0 7776120 85537320
0 GAN, PT 15 10:00:08.3 Solution 757/2014
53
29/10/201
AV. Fistula
207 MENDJAN 18100560 8 HK.05,01/IV,2,1/
1 GAN, PT 15 10:00:08.3 757/2014
16G x 1
53
28/11/201 Art +
207 MENDJAN 18110560 8 Venous 11973654 HK.05,01/IV,2,/7
BMHP Pcs BMHP 1113 97800 0 10885140
2 GAN, PT 20 09:18:53.9 Blood Line 0 57/2014
03 W/Filt
28/11/201
207 MENDJAN 18110560 8 Dialyzer 21057960 HK.05,01/IV,2,/7
BMHP Pcs BMHP 1113 172000 0 19143600
3 GAN, PT 20 09:18:53.9 (LF) 1,6M2 0 57/2014
03
28/11/201
207 MENDJAN 18110560 8 Biasol Acid HK.05,01/IV,2,/7
BMHP Galon BMHP 1113 81000 0 9015300 99168300
4 GAN, PT 20 09:18:53.9 Conc 6 ltr 57/2014
03
28/11/201
207 MENDJAN 18110560 8 Bicarbonat 10063746 HK.05,01/IV,2,/7
BMHP Galon BMHP 1113 82200 0 9148860
5 GAN, PT 20 09:18:53.9 Solution 0 57/2014
03
28/11/201
AV. Fistula
207 MENDJAN 18110560 8 HK.05,01/IV,2,/7
6 GAN, PT 20 09:18:53.9 57/2014
16G x 1
03
MENSA
Blood Bag
207 BINA CD194534 31/08/201 BN.01.01/PPK-
7 SUKSES, 674 8 15:22:00 III/8853/2018
ml
PT
MENSA
Blood Bag
207 BINA CD194495 25/08/201 BN.01.01/PPK-
BMHP Triple 350 Buah BMHP 900 62100 0 5589000 61479000
8 SUKSES, 489 8 15:31:00 III/8853/2018
ml
PT
207 MENSA CD194573 17/09/201 BMHP Blood Bag Buah BMHP 640 62100 0 3974400 43718400 BN.01.01/PPK-
9 BINA 282 8 Triple 350 III/8853/2018
SUKSES, 14:34:50.9 ml
PT 6
MENSA
Blood Bag
208 BINA CD194673 28/09/201 BN.01.01/PPK-
BMHP Triple 350 Buah BMHP 360 62100 0 2235600 24591600
0 SUKSES, 721 8 10:08:00 III/8853/2018
ml
PT
MENSA 01/11/201
Blood Bag
208 BINA CD194899 8 BN.01.01/PPK-
1 SUKSES, 164 16:07:49.3 III/8853/2018
ml
PT 06
MENSA 01/11/201
Blood Bag
208 BINA CD194899 8 BN.01.01/PPK-
2 SUKSES, 156 16:21:23.2 III/8853/2018
ml
PT 06
MENSA 01/11/201
Blood Bag
208 BINA CD194899 8 10929600 BN.01.01/PPK-
BMHP Triple 350 Buah BMHP 1600 62100 0 9936000
3 SUKSES, 156 16:21:23.2 0 III/8853/2018
ml
PT 06
MENSA 22/11/201
Blood Bag
208 BINA CD194989 8 BN.01.01/PPK-
4 SUKSES, 782 09:24:38.1 III/8853/2018
ml
PT 43
MENSA 27/11/201
Steri Drape
208 BINA CD194953 8 BN.01.01/PPK-
5 SUKSES, 877 08:30:12.9 III/11089/2018
1015
PT 5
MENSA 27/11/201
OXYGENAT
208 BINA CD194953 8 5636363.6 2254545.4 BN.01.01/PPK-
BMHP OR ADULT S e t BMHP 4 0 24800000
6 SUKSES, 749 12:42:43.8 36 55 III/11089/2018
FX25RW40
PT 4
MENSA 27/11/201 Custom
208 BINA CD194953 8 Pack / BN.01.01/PPK-
7 SUKSES, 749 12:42:43.8 Blood Line III/11089/2018
PT 4 Adult
MENSA 27/11/201
OXYGENAT
208 BINA CD195014 8 5636363.6 3945454.5 BN.01.01/PPK-
8 SUKSES, 855 13:11:48.0 36 46 III/11089/2018
FX25RW40
PT 96
208 MENSA CD195014 27/11/201 BMHP Custom Pcs BMHP 6 1 0 0.6 6.6 BN.01.01/PPK-
9 BINA 855 8 Pack / III/11089/2018
SUKSES, 13:11:48.0 Blood Line
PT 96 Adult
MENSA 28/11/201
OXYGENAT
209 BINA CD195041 8 5636363.6 16345454. 17980000 BN.01.01/PPK-
BMHP OR ADULT S e t BMHP 29 0
0 SUKSES, 435 15:14:07.2 36 55 0 III/11089/2018
FX25RW40
PT 7
BMHP Pcs BMHP 30 1 0 3 33
PT 7 Adult
MENSA 10/12/201
Steri Drape
209 BINA CD195105 8 BN.01.01/PPK-
2 SUKSES, 902 10:47:17.8 III/11089/2018
1015
PT 83
MENSA 10/12/201
Blood Bag
209 BINA CD195110 8 BN.01.01/PPK-
3 SUKSES, 130 16:23:14.6 III/8853/2018
ml
PT 76
MENSA 10/12/201
209 BINA CD195111 8 Docare Pre BN.01.01/PPK-
BMHP Pack BMHP 100 8760 0 87600 963600
4 SUKSES, 655 16:42:19.9 Ops III/8853/2018
PT 36
MENSA
OXYGENAT
209 BINA CD195104 08/12/201 5636363.6 7890909.0 BN.01.01/PPK-
5 SUKSES, 570 8 18:57:00 36 91 III/11089/2018
FX25RW40
PT
MENSA Custom
209 BINA CD195104 08/12/201 Pack / BN.01.01/PPK-
BMHP Pcs BMHP 14 1 0 1.4 15.4
6 SUKSES, 570 8 18:57:00 Blood Line III/11089/2018
PT Adult
MENSA 10/12/201
OXYGENAT
209 BINA CD195110 8 5636363.6 3381818.1 BN.01.01/PPK-
7 SUKSES, 955 19:03:21.5 36 82 III/11089/2018
FX25RW40
PT 1
PT 1 Adult
209 MERAPI 00022249 30/08/201 BMHP TIP Pcs BMHP 15 20065.454 0 30098.181 331079.99 BN.01.01/PPK-
UTAMA CLEANER/
9 PHARMA, 8 15:23:00 HARUM 5 8 93 III/8847/2018
PT CLEAN
MERAPI
Harum
210 UTAMA 30/08/201 45674.545 452178.00 BN.01.01/PPK-
00025403 BMHP Skin Pcs BMHP 9 0 41107.091
0 PHARMA, 8 15:55:00 5 05 III/8847/2018
Marker
PT
MERAPI 12/09/201 TIP
210 UTAMA 8 CLEANER/ 210687.22 2317559.4 BN.01.01/PPK-
00026836 BMHP Pcs BMHP 105 20065.45 0
1 PHARMA, 14:57:35.5 HARUM 5 75 III/8847/2018
PT 16 CLEAN
MERAPI 20/09/201
OCTENIC
210 UTAMA 8 BN.01.01/PPK-
00027573 BMHP BODYWAS P c s BMHP 312 2727.6 0 85101.12 936112.32
2 PHARMA, 13:41:19.6 III/8847/2018
H GLOVE
PT 53
MERAPI 20/09/201
OCTENIC
00027573 BMHP HAIRWAS P c s BMHP 200 4000 0 80000 880000
3 PHARMA, 13:41:19.6 III/8847/2018
H GLOVE
PT 53
MERAPI 12/10/201
OCTENIC
4 PHARMA, 11:36:48.7 III/8847/2018
H GLOVE
PT 66
MERAPI 12/10/201
OCTENIC
210 UTAMA 8 312727.27 3439999.9 BN.01.01/PPK-
00029824 BMHP HAIRWAS P c s BMHP 800 3909.0909 0
5 PHARMA, 11:36:48.7 2 92 III/8847/2018
H GLOVE
PT 66
MERAPI 04/12/201
OCTENIC
6 PHARMA, 13:27:45.2 III/8847/2018
H GLOVE
PT 8
MERAPI 04/12/201
OCTENIC
210 UTAMA 8 212654.54 2339199.9 BN.01.01/PPK-
00035331 BMHP HAIRWAS P c s BMHP 544 3909.0909 0
7 PHARMA, 13:27:45.2 5 95 III/8847/2018
H GLOVE
PT 8
210 MILLENNI 23061800 14/09/201 BMHP Wrap PPR Lembar BMHP 1250 10524.55 0 1315568.7 14471256. BN.01.01/PPKIII
8 UM 0322 8 SMS 5 25 /8857/2018
PHARMAC 08:25:04.8 120X120c
ON 23 m (125)
INTERNAT
IONAL
TBK, PT
MILLENNI
UM
14/09/201
PHARMAC Septalkan
210 23061800 8 BN.01.01/PPKIII
9 0322 08:25:04.8 /8857/2018
INTERNAT Wipes
23
IONAL
TBK, PT
MILLENNI
UM PerClot
28/09/201
PHARMAC Polysaccari
211 23061800 8 BN.01.01/PPK-
0 0359 16:37:04.0 III/8857/2018
INTERNAT Haemost
86
IONAL Syst 3Gr
TBK, PT
MILLENNI
UM
28/09/201 Wrap PPR
PHARMAC
211 23061800 8 SMS 10524.545 1315568.1 14471250. BN.01.01/PPK-
ON BMHP Lembar BMHP 1250 0
1 0370 16:48:35.3 120X120c 5 88 06 III/8857/2018
INTERNAT
06 m (125)
IONAL
TBK, PT
MILLENNI
UM
04/10/201 Wrap PPR
PHARMAC
211 23061800 8 SMS BN.01.01/PPK-
ON BMHP Lembar BMHP 1000 4469.091 0 446909.1 4916000.1
2 0367 09:32:57.3 75X75cm III/8857/2018
INTERNAT
16 Blue (250)
IONAL
TBK, PT
MILLENNI
UM Bioglue
08/10/201
PHARMAC Pre-Filled
211 23061800 8 BN.01.01/PPK-
3 0385 14:52:41.9 III/8857/2018
INTERNAT SURG.ADH
23
IONAL ESIVE
TBK, PT
211 MILLENNI 23061800 08/10/201 BMHP PerClot Sacchet BMHP 5 3334500 0 1667250 18339750 BN.01.01/PPK-
UM
PHARMAC Polysaccari
8
ON de
4 0386 15:22:42.8 III/8857/2018
INTERNAT Haemost
93
IONAL Syst 3Gr
TBK, PT
MILLENNI
UM Bioglue
08/10/201
PHARMAC Pre-Filled
211 23061800 8 BN.01.01/PPK-
5 0259 15:27:33.8 III/8857/2018
INTERNAT SURG.ADH
93
IONAL ESIVE
TBK, PT
MILLENNI
UM
08/10/201
PHARMAC Septalkan
211 23061800 8 BN.01.01/PPK-
6 0407 15:35:43.3 III/8857/2018
INTERNAT Wipes
06
IONAL
TBK, PT
MILLENNI
UM
30/10/201 Wrap PPR
PHARMAC
211 23061800 8 SMS 10524.545 3288920.4 36178125. BN.01.01/PPK-
7 0410 16:05:11.6 120X120c 5 69 16 III/8857/2018
INTERNAT
16 m (125)
IONAL
TBK, PT
MILLENNI
UM Bioglue
31/10/201
PHARMAC Pre-Filled
211 23061800 8 BN.01.01/PPK-
8 0405 10:11:03.3 III/8857/2018
INTERNAT SURG.ADH
86
IONAL ESIVE
TBK, PT
211 MILLENNI 23061800 31/10/201 BMHP Bioglue Syringe BMHP 9 7653750 0 6888375 75772125 BN.01.01/PPK-
9 UM 0473 8 Pre-Filled III/8857/2018
PHARMAC 11:15:11.8 Syr 5ml
ON 46 SURG.ADH
INTERNAT ESIVE
IONAL
TBK, PT
MILLENNI
UM
31/10/201 Wrap PPR
PHARMAC
212 23061800 8 SMS 9831999.9 BN.01.01/PPK-
ON BMHP Lembar BMHP 2000 4469.0909 0 893818.18
0 0475 11:29:48.5 75X75cm 8 III/8857/2018
INTERNAT
36 Blue (250)
IONAL
TBK, PT
MILLENNI
UM
31/10/201
PHARMAC Septalkan
212 23061800 8 BN.01.01/PPK-
1 0476 11:37:48.3 III/8857/2018
INTERNAT Wipes
7
IONAL
TBK, PT
MILLENNI
UM PerClot
31/10/201
PHARMAC Polysaccari
212 23061800 8 BN.01.01/PPK-
2 0474 11:45:41.0 III/8857/2018
INTERNAT Haemost
56
IONAL Syst 3Gr
TBK, PT
MILLENNI
UM Bioglue
10/12/201
PHARMAC Pre-Filled
212 23061800 8 BN.01.01/PPK-
3 0562 18:04:12.8 III/8857/2018
INTERNAT SURG.ADH
53
IONAL ESIVE
TBK, PT
MILLENNI
UM PerClot
10/12/201
PHARMAC Polysaccari
212 23061800 8 BN.01.01/PPK-
4 0562 18:04:12.8 III/8857/2018
INTERNAT Haemost
53
IONAL Syst 3Gr
TBK, PT
212 MILLENNI 23061800 10/12/201 BMHP Bioglue Syringe BMHP 8 7653750 0 6123000 67353000 BN.01.01/PPK-
5 UM 0561 8 Pre-Filled III/8857/2018
PHARMAC
ON Syr 5ml
18:12:57.0
INTERNAT SURG.ADH
4
IONAL ESIVE
TBK, PT
MILLENNI
UM PerClot
10/12/201
PHARMAC Polysaccari
212 23061800 8 BN.01.01/PPK-
6 0561 18:12:57.0 III/8857/2018
INTERNAT Haemost
4
IONAL Syst 3Gr
TBK, PT
MILLENNI
UM Bioglue
10/12/201
PHARMAC Pre-Filled
212 23061800 8 BN.01.01/PPK-
7 0479 18:43:58.5 III/8857/2018
INTERNAT SURG.ADH
1
IONAL ESIVE
TBK, PT
MILLENNI
UM
Wrap PPR
PHARMAC
212 23061800 10/12/201 SMS 4916160.0 BN.01.01/PPK-
8 0411 8 13:33:00 75X75cm 4 III/8857/2018
INTERNAT
Blue (250)
IONAL
TBK, PT
MILLENNI
UM
PHARMAC Septalkan
212 23061800 10/12/201 BN.01.01/PPK-
9 0558A 8 14:47:00 III/8857/2018
INTERNAT Wipes
IONAL
TBK, PT
213 MILLENNI 23061800 10/12/201 BMHP Wrap PPR Lembar BMHP 3125 10524.55 0 3288921.8 36178140. BN.01.01/PPK-
0 UM 0563 8 16:06:00 SMS 75 63 III/8857/2018
PHARMAC 120X120c
ON m (125)
INTERNAT
IONAL
TBK, PT
MILLENNI
UM
Wrap PPR
PHARMAC
213 23061800 10/12/201 SMS 10524.545 3946704.5 43413750. BN.01.01/PPK-
1 0566 8 16:05:00 120X120c 5 63 19 III/8857/2018
INTERNAT
m (125)
IONAL
TBK, PT
MILLENNI
UM
Wrap PPR
PHARMAC
213 23061800 10/12/201 SMS 6145200.0 BN.01.01/PPK-
2 0566 8 16:05:00 75X75cm 5 III/8857/2018
INTERNAT
Blue (250)
IONAL
TBK, PT
MILLENNI
UM
Wrap PPR
PHARMAC
213 23061800 10/12/201 SMS 3288921.8 36178140. BN.01.01/PPK-
ON BMHP Lembar BMHP 3125 10524.55 0
3 0565 8 16:29:00 120X120c 75 63 III/8857/2018
INTERNAT
m (125)
IONAL
TBK, PT
MILLENNI
UM
Wrap PPR
PHARMAC
213 23061800 10/12/201 SMS 10524.545 3946704.5 43413750. BN.01.01/PPK-
4 0567 8 16:38:00 120X120c 5 63 19 III/8857/2018
INTERNAT
m (125)
IONAL
TBK, PT
MILLENNI
UM
Wrap PPR
PHARMAC
213 23061800 10/12/201 SMS 4916160.0 BN.01.01/PPK-
5 0567 8 16:38:00 75X75cm 4 III/8857/2018
INTERNAT
Blue (250)
IONAL
TBK, PT
213 MILLENNI 23061800 10/12/201 BMHP Wrap PPR Lembar BMHP 3750 10524.545 0 3946704.5 43413750. BN.01.01/PPK-
6 UM 0568 8 17:01:00 SMS 5 63 19 III/8857/2018
PHARMAC 120X120c
ON
INTERNAT
m (125)
IONAL
TBK, PT
MILLENNI
UM PerClot
PHARMAC Polysaccari
213 23061800 10/12/201 BN.01.01/PPK-
7 0564 8 17:24:00 III/8857/2018
INTERNAT Haemost
IONAL Syst 3Gr
TBK, PT
MITRAPRI 14/09/201 Renodrain
213 MA 8 Yell Nephr 1907272.7 5721818.1 62940000. BN.01.01/PPK-
8 LESTARI 10:21:25.4 Punct Set 3 9 09 III/8851/2018
.PT 63 No.7/34cm
MITRAPRI 14/09/201 White Star
213 MA 8 Doub J 181472.72 1996200.0 BN.01.01/PPK-
16247 BMHP Pcs BMHP 2 907363.64 0
9 LESTARI 10:21:25.4 Uret Stent 8 08 III/8851/2018
.PT 63 4,7Fr
Yell Star
MITRAPRI 14/09/201
Doub J Ure
214 MA 8 1217454.5 243490.90 BN.01.01/PPK-
16247 BMHP Stent Pcs BMHP 2 0 2678400
0 LESTARI 10:21:25.4 46 91 III/8851/2018
Fr4,7/22
.PT 63
open
MITRAPRI 02/11/201 Renodrain
214 MA 8 Yell Nephr 1907272.7 5721818.1 62940000. BN.01.01/PPK-
1 LESTARI 10:50:28.1 Punct Set 3 9 09 III/8851/2018
.PT 2 No.7/34cm
Yel Star
MITRAPRI 02/11/201
Doub J
214 MA 8 1217454.5 2678400.0 BN.01.01/PPK-
16742 BMHP Uret Sten Buah BMHP 2 0 243490.91
2 LESTARI 10:50:28.1 5 1 III/8851/2018
Fr4,7 Close
.PT 2
Ti
MITRAPRI Renodrain
214 MA 10/12/201 Yell Nephr 1907272.7 17165454. 18882000 BN.01.01/PPK-
3 LESTARI 8 13:37:00 Punct Set 3 57 0.3 III/8851/2018
.PT No.7/34cm
214 MITRAPRI 17094 10/12/201 BMHP Yel Star Buah BMHP 4 1217454.5 0 486981.82 5356800.0 BN.01.01/PPK-
4 MA 8 13:37:00 Doub J 5 2 III/8851/2018
Uret Sten
LESTARI
Fr4,7 Close
.PT
Ti
MITRAPRI White Star
214 MA 10/12/201 Doub J 362945.45 3992400.0 BN.01.01/PPK-
17094 BMHP Pcs BMHP 4 907363.64 0
5 LESTARI 8 13:37:00 Uret Stent 6 16 III/8851/2018
.PT 4,7Fr
BIPOLAR
PAC
13/11/201
NUGRA NK- CATHETER
214 8 BN.01.01/PPK-
KARSERA. 2018.0054 BMHP / TPM Pcs BMHP 35 1620000 0 5670000 62370000
6 14:31:08.0 III/11096/2018
PT 95 LEAD
76
W/BALLO
N
Film UPT
OPAL 19/07/201
517 14x17 BMHP
214 PERKASA 1223/OPS 8 BN.01.01/PPK.III
7 SEJAHTER /VII/18 15:16:39.6 /7610/2018
Thermal I
A. PT 1
(35x43)
OPAL 19/07/201 Film
BMHP
214 PERKASA 1224/OPS 8 Drystar BN.01.01/PPK.III
8 SEJAHTER /VII/18 15:21:35.1 DT28 Uk 8 /7610/2018
I
A. PT 7 x 10
Film UPT
OPAL 25/07/201
517 14x17 BMHP
9 SEJAHTER /VII/18 16:00:47.3 /7610/2018
Thermal I
A. PT 23
(35x43)
OPAL 25/07/201 Film
BMHP
0 SEJAHTER /VII/18 16:00:47.3 DT28 Uk 8 /7610/2018
I
A. PT 23 x 10
OPAL 15/08/201 Film
BMHP
1 SEJAHTER /VIII/18 15:25:17.4 DT28 Uk 8 /7610/2018
I
A. PT 4 x 10
215 OPAL 1281/OPS 15/08/201 BMHP Film UPT Lembar BMHP 875 30712 0 2687300 29560300 BN.01.01/PPK.III
2 PERKASA /VIII/18 8 517 14x17 RADIOLOG /7610/2018
SEJAHTER 15:33:43.2 Blue I
Thermal
A. PT 9
(35x43)
Film UPT
OPAL 15/08/201
517 14x17 BMHP
3 SEJAHTER /VIII/18 15:37:36.5 /7610/2018
Thermal I
A. PT 76
(35x43)
Syringe
OPAL 17/09/201
StellaDual
BMHP 200ml Pcs BMHP 35 488000 0 1708000 18788000
4 SEJAHTER /IX/18 16:44:34.3 /7610/2018
Cat.SDS.CT
A. PT 73
P.QFT
OPAL 17/09/201
Syringe
BMHP Salient Pcs BMHP 30 460000 0 1380000 15180000
5 SEJAHTER /IX/18 16:44:34.3 /7610/2018
190ml
A. PT 73
OPAL 17/09/201 Film
BMHP
6 SEJAHTER /IX/18 16:44:34.3 DT28 Uk 8 /7610/2018
I
A. PT 73 x 10
OPAL 28/09/201 Film
BMHP
7 SEJAHTER /IX/18 14:06:28.7 DT28 Uk 8 /7610/2018
I
A. PT 8 x 10
Film UPT
OPAL 28/09/201
517 14x17 BMHP
8 SEJAHTER /IX/18 14:48:27.8 /7610/2018
Thermal I
A. PT 06
(35x43)
Film UPT
OPAL 31/10/201
517 14x17 BMHP
215 PERKASA 1389/OPS 8 BN.01.01/PPK-
9 SEJAHTER /X/18 14:32:14.0 III/7610/2018
Thermal I
A. PT 4
(35x43)
Syringe
OPAL
26/11/201 StellaDual
216 PERKASA 1447/OPS BN.01.01/PPK.III
8 BMHP 200ml Pcs BMHP 40 488000 0 1952000 21472000
0 SEJAHTER /XI/18 /7610/2018
09:18:18.1 Cat.SDS.CT
A. PT
P.QFT
Film UPT
OPAL
26/11/201 517 14x17 BMHP
1 SEJAHTER /XI/18 /7610/2018
09:18:18.1 Thermal I
A. PT
(35x43)
Connec
OPAL Salient
26/11/201
216 PERKASA 1447/OPS 150cm BN.01.01/PPK.III
8 BMHP Pcs BMHP 50 112000 0 560000 6160000
2 SEJAHTER /XI/18 /Exten /7610/2018
09:18:18.1
A. PT Tubi ZY-
5151
Syringe
OPAL
26/11/201 150ml
8 BMHP disp, with Pcs BMHP 20 256000 0 512000 5632000
3 SEJAHTER /XI/18 /7610/2018
09:18:18.1 quick fill
A. PT
tube
Syringe
OPAL 12/12/201
StellaDual
BMHP 200ml Pcs BMHP 25 488000 0 1220000 13420000
4 SEJAHTER /XII/18 09:39:03.9 /7610/2018
Cat.SDS.CT
A. PT 76
P.QFT
OPAL 12/12/201 Film
BMHP
5 SEJAHTER /XII/18 09:39:03.9 DT28 Uk 8 /7610/2018
I
A. PT 76 x 10
OPAL 12/12/201
Syringe
BMHP Salient Pcs BMHP 121 460000 0 5566000 61226000
6 SEJAHTER /XII/18 09:39:03.9 /7610/2018
190ml
A. PT 76
Connec
OPAL 12/12/201 Salient
216 PERKASA 1460/OPS 8 150cm BN.01.01/PPK.III
BMHP Pcs BMHP 50 112000 0 560000 6160000
7 SEJAHTER /XII/18 09:39:03.9 /Exten /7610/2018
A. PT 76 Tubi ZY-
5151
216 OPAL 1460/OPS 12/12/201 BMHP Syringe Pcs BMHP 225 256000 0 5760000 63360000 BN.01.01/PPK.III
8 PERKASA /XII/18 8 150ml /7610/2018
SEJAHTER 09:39:03.9 disp, with
A. PT 76 quick fill
tube
21/08/201 HD Double
ORIONTA
MA JAYA, 18/1230 BMHP Pcs BMHP 10 801900 0 801900 8820900
9 15:37:33.7 8,5Fr 16cm III/8837/2017
PT
66 FR2965
Cardiovasc
PERMATA 26/10/201
298/PB/F ular Patch
217 BUNDA 8 BN.01.01/PPK-
0 ARTANO, 13:44:31.3 III/11090/2018
18 60mm x
PT 23
0.4mm
Cardiovasc
PERMATA 26/10/201
298/PB/F ular Patch
1 ARTANO, 13:44:31.3 III/11090/2018
18 75mm x
PT 23
0,6mm
PERMATA 26/10/201 Katub
298/PB/F
217 BUNDA 8 Aortic Size BN.01.01/PPK-
AK/10/20 BMHP Buah BMHP 1 15750000 0 1575000 17325000
2 ARTANO, 13:44:31.3 16mm - III/11090/2018
18
PT 23 608356
298/PB/F
AK/10/20 BMHP Buah BMHP 1 15750000 0 1575000 17325000
3 ARTANO, 13:44:31.3 18mm - III/11090/2018
18
PT 23 727227
298/PB/F
AK/10/20 BMHP Buah BMHP 2 15750000 0 3150000 34650000
4 ARTANO, 13:44:31.3 20mm - III/11090/2018
18
PT 23 736784
298/PB/F
AK/10/20 BMHP Buah BMHP 1 15750000 0 1575000 17325000
5 ARTANO, 13:44:31.3 22mm - III/11090/2018
18
PT 23 592045
PERMATA 26/10/201 Aortic
298/PB/F
217 BUNDA 8 Punch BN.01.01/PPK-
AK/10/20 BMHP Pcs BMHP 14 882000 0 1234800 13582800
6 ARTANO, 13:44:31.3 4,0mm III/11090/2018
18
PT 23 Med
PERMATA 26/10/201 Canula
298/PB/F
217 BUNDA 8 Aorta BN.01.01/PPK-
AK/10/20 BMHP Pcs BMHP 7 684000 0 478800 5266800
7 ARTANO, 13:44:31.3 Curved III/11090/2018
18
PT 23 No.24 Med
Canula
PERMATA 26/10/201
298/PB/F Aortic
AK/10/20 BMHP NO.22Fr Buah BMHP 6 684000 0 410400 4514400
8 ARTANO, 13:44:31.3 III/11090/2018
18 Flexi
PT 23
Cat.70422
CANULA
PERMATA 26/10/201
298/PB/F ORTIC
9 ARTANO, 13:44:31.3 III/11090/2018
18 NO.18
PT 23
CAT.75318
PERMATA 26/10/201 Micro
298/PB/F
218 BUNDA 8 Sucker BN.01.01/PPK-
AK/10/20 BMHP Pcs BMHP 20 720000 0 1440000 15840000
0 ARTANO, 13:44:31.3 Suction III/11090/2018
18
PT 23 Tube 9Fr
Canula
PERMATA 26/10/201
298/PB/F Venous
AK/10/20 BMHP Bengkok P c s BMHP 5 882000 0 441000 4851000
1 ARTANO, 13:44:31.3 III/11090/2018
18 No.16
PT 23
67316
Canula
PERMATA 26/10/201
298/PB/F Venous
2 ARTANO, 13:44:31.3 III/11090/2018
18 No.20
PT 23
67320
298/PB/F
218 BUNDA 8 Venous BN.01.01/PPK-
AK/10/20 BMHP Buah BMHP 5 882000 0 441000 4851000
3 ARTANO, 13:44:31.3 Bengkok III/11090/2018
18
PT 23 No.24 CVB
PERMATA 26/10/201
298/PB/F
218 BUNDA 8 Shunt Flow BN.01.01/PPK-
AK/10/20 BMHP Pcs BMHP 3 1350000 0 405000 4455000
4 ARTANO, 13:44:31.3 1,75 mm III/11090/2018
18
PT 23
PERMATA 26/10/201 Macro
298/PB/F
AK/10/20 BMHP Pcs BMHP 17 765000 0 1300500 14305500
18
PT 23 Tube 20Fr
218 PERMATA 298/PB/F 26/10/201 BMHP Oxygenato S e t BMHP 4 6750000 0 2700000 29700000 BN.01.01/PPK-
6 BUNDA AK/10/20 8 r Affnity III/11090/2018
ARTANO, 18 13:44:31.3 Fusion
Complete
PT 23
Adult
PERMATA 26/10/201
298/PB/F CARDIOPL
7 ARTANO, 13:44:31.3 III/11090/2018
18 PED
PT 23
PERMATA 26/10/201 Antegrade
298/PB/F
218 BUNDA 8 Aortic Root BN.01.01/PPK-
AK/10/20 BMHP Pcs BMHP 15 630000 0 945000 10395000
8 ARTANO, 13:44:31.3 Cannula III/11090/2018
18
PT 23 WVL 9Fr
PERMATA 26/10/201 Octobase
298/PB/F
218 BUNDA 8 Suture BN.01.01/PPK-
AK/10/20 BMHP Pcs BMHP 2 1620000 0 324000 3564000
9 ARTANO, 13:44:31.3 Holding III/11090/2018
18
PT 23 Insert
Canula
PERMATA 26/10/201
298/PB/F Venouse
0 ARTANO, 13:44:31.3 III/11090/2018
18 34/48FR
PT 23
Two Stage
Canula
PERMATA 26/10/201
298/PB/F Venous
1 ARTANO, 13:44:31.3 III/11090/2018
18 No.31
PT 23
66331
298/PB/F
219 BUNDA 8 Venous BN.01.01/PPK-
AK/10/20 BMHP Buah BMHP 20 882000 0 1764000 19404000
2 ARTANO, 13:44:31.3 Bengkok III/11090/2018
18
PT 23 No.28 CVB.
Oxygenato
PERMATA 01/11/201
029/PB/F r Affnity
AK/II/201 BMHP Fusion Set BMHP 11 6750000 0 7425000 81675000
3 ARTANO, 15:23:28.1 III/11090/2018
8 Complete
PT 3
Adult
Canula
PERMATA 01/11/201
029/PB/F Venouse
AK/II/201 BMHP VC2 Pcs BMHP 4 810000 0 324000 3564000
4 ARTANO, 15:23:28.1 III/11090/2018
8 34/48FR
PT 3
Two Stage
219 PERMATA 029/PB/F 01/11/201 BMHP Antegrade P c s BMHP 15 630000 0 945000 10395000 BN.01.01/PPK-
BUNDA 8 Aortic Root
AK/II/201
8
PT 3 WVL 9Fr
PERMATA 01/11/201 CANULA
029/PB/F
219 BUNDA 8 ORTIC BN.01.01/PPK-
AK/II/201 BMHP Buah BMHP 5 684000 0 342000 3762000
6 ARTANO, 15:23:28.1 STRAIGHT III/11090/2018
8
PT 3 NO.10
029/PB/F
219 BUNDA 8 Ortic BN.01.01/PPK-
7 ARTANO, 15:23:28.1 Straight III/11090/2018
8
PT 3 No.12
PERMATA 01/11/201 CANULA
029/PB/F
219 BUNDA 8 ORTIC BN.01.01/PPK-
8 ARTANO, 15:23:28.1 STRAIGHT III/11090/2018
8
PT 3 NO.14
029/PB/F
9 ARTANO, 15:23:28.1 16mm - III/11090/2018
8
PT 3 608356
029/PB/F
0 ARTANO, 15:23:28.1 18mm - III/11090/2018
8
PT 3 727227
029/PB/F
1 ARTANO, 15:23:28.1 20mm - III/11090/2018
8
PT 3 736784
029/PB/F
2 ARTANO, 15:23:28.1 22mm - III/11090/2018
8
PT 3 592045
PERMATA 01/11/201
029/PB/F
AK/II/201 BMHP Pcs BMHP 2 1350000 0 270000 2970000
3 ARTANO, 15:23:28.1 1,75 mm III/11090/2018
8
PT 3
029/PB/F
AK/II/201 BMHP Pcs BMHP 2 882000 0 176400 1940400
4 ARTANO, 15:23:28.1 4,0mm III/11090/2018
8
PT 3 Med
PERMATA 01/11/201 Off Pump
029/PB/F
220 BUNDA 8 System BN.01.01/PPK-
AK/II/201 BMHP Set BMHP 2 30420000 0 6084000 66924000
5 ARTANO, 15:23:28.1 (Octopus+ III/11090/2018
8
PT 3 Starfish)
CANULA
PERMATA 05/11/201
ORTIC
220 BUNDA 051/pb/fa 8 BN.01.01/PPK-
BMHP STRAIGHT Buah BMHP 23 684000 0 1573200 17305200
6 ARTANO, k/11/2018 08:04:39.7 III/11090/2018
NO.24
PT 53
cat.70424
220 BUNDA 051/pb/fa 8 Sucker BN.01.01/PPK-
BMHP Pcs BMHP 3 765000 0 229500 2524500
7 ARTANO, k/11/2018 08:04:39.7 Suction III/11090/2018
PT 53 Tube 20Fr
PERMATA 10/12/201 Antegrade
092/PB/F
220 BUNDA 8 Aortic Root BN.01.01/PPK-
AK/12/20 BMHP Pcs BMHP 40 630000 0 2520000 27720000
18
PT 83 WVL 9Fr
PERMATA 10/12/201
092/PB/F CARDIOPL
9 ARTANO, 16:58:26.8 III/11090/2018
18 PED
PT 83
PERMATA 10/12/201 Octobase
092/PB/F
221 BUNDA 8 Suture BN.01.01/PPK-
AK/12/20 BMHP Pcs BMHP 2 1620000 0 324000 3564000
0 ARTANO, 16:58:26.8 Holding III/11090/2018
18
PT 83 Insert
PERMATA 10/12/201
092/PB/F
AK/12/20 BMHP Pcs BMHP 5 1350000 0 675000 7425000
1 ARTANO, 16:58:26.8 1,75 mm III/11090/2018
18
PT 83
PERMATA 10/12/201 Micro
092/PB/F
AK/12/20 BMHP Pcs BMHP 20 720000 0 1440000 15840000
18
PT 83 Tube 9Fr
092/PB/F
AK/12/20 BMHP Pcs BMHP 17 765000 0 1300500 14305500
18
PT 83 Tube 20Fr
221 PERMATA 092/PB/F 10/12/201 BMHP Cardiovasc Buah BMHP 2 6630000 0 1326000 14586000 BN.01.01/PPK-
4 BUNDA AK/12/20 8 ular Patch III/11090/2018
50mm x
ARTANO, 16:58:26.8
18 75mm x
PT 83
0,6mm
092/PB/F
AK/12/20 BMHP Pcs BMHP 34 882000 0 2998800 32986800
5 ARTANO, 16:58:26.8 4,0mm III/11090/2018
18
PT 83 Med
092/PB/F
AK/12/20 BMHP Buah BMHP 2 15750000 0 3150000 34650000
6 ARTANO, 16:58:26.8 18mm - III/11090/2018
18
PT 83 727227
092/PB/F
AK/12/20 BMHP Buah BMHP 2 15750000 0 3150000 34650000
7 ARTANO, 16:58:26.8 20mm - III/11090/2018
18
PT 83 736784
Canula
PERMATA 10/12/201
092/PB/F Venouse
8 ARTANO, 16:58:26.8 III/11090/2018
18 34/48FR
PT 83
Two Stage
Cannula
PERMATA 10/12/201
092/PB/F Aortic
AK/12/20 BMHP StraightNo. P c s BMHP 8 684000 0 547200 6019200
9 ARTANO, 16:58:26.8 III/11090/2018
18 16FR
PT 83
CAT70016
CANULA
PERMATA 10/12/201
092/PB/F ORTIC
0 ARTANO, 16:58:26.8 III/11090/2018
18 NO.18
PT 83
CAT.75318
CANULA
PERMATA 10/12/201
092/PB/F AORTIC
AK/12/20 BMHP PERF Pcs BMHP 15 684000 0 1026000 11286000
1 ARTANO, 16:58:26.8 III/11090/2018
18 NO.22FR
PT 83
70422
222 PERMATA 092/PB/F 10/12/201 BMHP CANULA Buah BMHP 20 684000 0 1368000 15048000 BN.01.01/PPK-
2 BUNDA AK/12/20 8 ORTIC III/11090/2018
ARTANO, 18 16:58:26.8 STRAIGHT
PT 83 NO.24
cat.70424
Oxygenato
PERMATA 10/12/201
092/PB/F r Affnity
222 BUNDA 8 14850000 BN.01.01/PPK-
AK/12/20 BMHP Fusion Set BMHP 20 6750000 0 13500000
3 ARTANO, 16:58:26.8 0 III/11090/2018
18 Complete
PT 83
Adult
Canula
PERMATA 10/12/201
092/PB/F Venous
4 ARTANO, 16:58:26.8 III/11090/2018
18 No.31
PT 83
66331
PERMATA 10/12/201 Off Pump
092/PB/F
222 BUNDA 8 System BN.01.01/PPK-
AK/12/20 BMHP Set BMHP 2 30420000 0 6084000 66924000
5 ARTANO, 16:58:26.8 (Octopus+ III/11090/2018
18
PT 83 Starfish)
Cardiovasc
PERMATA 10/12/201
092/PB/F ular Patch
6 ARTANO, 16:58:26.8 III/11090/2018
18 60mm x
PT 83
0.4mm
Kasa
29/11/201
RAJAWALI FKT/MDN Depper
222 8 BN.01.01/PPK-
NUSINDO, /2018/000 BMHP Kecil Pcs BMHP 3600 320 0 115200 1267200
7 16:27:08.1 III/8841/2018
PT 2509 (15cmx15c
7
m)
Kasa
18/12/201
RAJAWALI FKT/MDN Lipat/Kasa
222 8 259090.90 2849999.9 BN.01.01/PPK-
NUSINDO, /2018/003 BMHP Hydrofil P c s BMHP 1500 1727.2727 0
8 14:45:53.5 5 55 III/12053/2018
PT 592A 40X40cm
9
(10X10)
18/12/201 Kasa Lipat
RAJAWALI FKT/MDN
222 8 40X25/ BN.01.01/PPK-
NUSINDO, /2018/003 BMHP Pcs BMHP 40000 1519.8 0 6079200 66871200
9 14:45:53.5 7.5X7.5x16 III/12053/2018
PT 592A
9 PL
Kasa
RAJAWALI FKT/MDN 18/12/201 Lipat/Kasa
223 17013636. 18714999 BN.01.01/PPK-
NUSINDO, /2018/000 8 BMHP Hydrofil P c s BMHP 98500 1727.2727 0
0 09 7 III/12053/2018
PT 3616 15:36:13.2 40X40cm
(10X10)
Kasa Lipat
RAJAWALI FKT/MDN 18/12/201
223 40X25/ 26748480 BN.01.01/PPK-
NUSINDO, /2018/000 8 BMHP Pcs BMHP 160000 1519.8 0 24316800
1 7.5X7.5x16 0 III/12053/2018
PT 3616 15:36:13.2
PL
REKAMILE 30/10/201
Steerease
223 NIUMINDO 8 BN.01.01/PPK-
030756 BMHP Occuleder P c s BMHP 2 4000000 0 800000 8800000
2 SELARAS, 16:22:49.9 III/11092/2018
5F
PT 56
REKAMILE 30/10/201
Steerease
3 SELARAS, 16:22:49.9 III/11092/2018
6F
PT 56
REKAMILE 30/10/201
SteerEase
4 SELARAS, 16:22:49.9 III/11092/2018
7F
PT 56
REKAMILE 30/10/201
Steerease
5 SELARAS, 16:22:49.9 III/11092/2018
8Fr
PT 56
REKAMILE 30/10/201
Steerease
6 SELARAS, 16:22:49.9 III/11092/2018
9Fr
PT 56
REKAMILE 30/10/201 STEEREAS
223 NIUMINDO 8 E BN.01.01/PPK-
030756 BMHP Buah BMHP 2 4000000 0 800000 8800000
7 SELARAS, 16:22:49.9 OCCULEDE III/11092/2018
PT 56 R 12F
REKAMILE
Cera ASD
223 NIUMINDO 0033/RS/F 03/12/201 BN.01.01/PPK-
BMHP Occuleder P c s BMHP 1 23500000 0 2350000 25850000
8 SELARAS, /12/2018 8 16:05:00 III/11092/2018
No.36
PT
REKAMILE
Cera ASD
9 SELARAS, /12/2018 8 16:05:00 III/11092/2018
No.32
PT
224 REKAMILE 0033/RS/F 03/12/201 BMHP Hearttr TM P c s BMHP 4 11500000 0 4600000 50600000 BN.01.01/PPK-
0 NIUMINDO /12/2018 8 16:05:00 PDA III/11092/2018
SELARAS, Occuleder
PT XJD0608
REKAMILE Hearttr TM
224 NIUMINDO 0033/RS/F 03/12/201 PDA BN.01.01/PPK-
BMHP Pcs BMHP 2 11500000 0 2300000 25300000
1 SELARAS, /12/2018 8 16:05:00 Occuleder III/11092/2018
PT XJF 0406
REKAMILE
Cera ASD
2 SELARAS, /12/2018 8 16:05:00 III/11092/2018
No.34
PT
Guide Wire
REKAMILE
0.038
BMHP 150cm Pcs BMHP 100 149000 0 1490000 16390000
3 SELARAS, /12/2018 8 16:05:00 III/11092/2018
IQ38F150J
PT
3
REKAMILE
Cera ASD
BMHP Occuleder Buah BMHP 1 23500000 0 2350000 25850000
4 SELARAS, /12/2018 8 16:05:00 III/11092/2018
No.10
PT
REKAMILE
Cera ASD
5 SELARAS, /12/2018 8 16:05:00 III/11092/2018
No.20
PT
REKAMILE SEQURE
224 NIUMINDO 0033/RS/F 03/12/201 TM SNARE BN.01.01/PPK-
BMHP Set BMHP 1 4375000 0 437500 4812500
6 SELARAS, /12/2018 8 16:05:00 SYSTEM III/11092/2018
PT 6Fr-20mm
REKAMILE Sequare
224 NIUMINDO 0033/RS/F 03/12/201 TM Snare BN.01.01/PPK-
BMHP Pcs BMHP 1 5000000 0 500000 5500000
7 SELARAS, /12/2018 8 16:05:00 Set 6Fr- III/11092/2018
PT 25mm
REKAMILE
SteerEase
8 SELARAS, /12/2018 8 16:05:00 III/11092/2018
7F
PT
REKAMILE
Steerease
9 SELARAS, /12/2018 8 16:05:00 III/11092/2018
6F
PT
225 REKAMILE 0033/RS/F 03/12/201 BMHP Steerease P c s BMHP 1 4000000 0 400000 4400000 BN.01.01/PPK-
NIUMINDO
Occuleder
0 SELARAS, /12/2018 8 16:05:00 III/11092/2018
5F
PT
REKAMILE Hearttr Tm
225 NIUMINDO 0033/RS/F 03/12/201 PDA BN.01.01/PPK-
BMHP Pcs BMHP 1 11500000 0 1150000 12650000
1 SELARAS, /12/2018 8 16:05:00 Occuleder III/11092/2018
PT XJD1820
REKAMILE
225 NIUMINDO 0033/RS/F 03/12/201 DC Pigtail BN.01.01/PPK-
BMHP Buah BMHP 4 305000 0 122000 1342000
2 SELARAS, /12/2018 8 16:05:00 4FR III/11092/2018
PT
REKAMILE
Steerease
3 SELARAS, /12/2018 8 16:05:00 III/11092/2018
8Fr
PT
REKAMILE 07/12/201 Hearttr TM
225 NIUMINDO 0165/RS/F 8 PDA 12650000 BN.01.01/PPK-
BMHP Pcs BMHP 10 11500000 0 11500000
4 SELARAS, /12/2018 18:03:00.7 Occuleder 0 III/11092/2018
PT 76 XJD0608
REKAMILE 07/12/201
Steerease
225 NIUMINDO 0165/RS/F 8 BN.01.01/PPK-
5 SELARAS, /12/2018 18:03:00.7 III/11092/2018
6F
PT 76
REKAMILE 07/12/201
225 NIUMINDO 0165/RS/F 8 DC Pigtail BN.01.01/PPK-
BMHP Buah BMHP 10 305000 0 305000 3355000
6 SELARAS, /12/2018 18:03:00.7 4FR III/11092/2018
PT 76
REKAMILE 07/12/201
Cera ASD
7 SELARAS, /12/2018 18:03:00.7 III/11092/2018
No.10
PT 76
REKAMILE 07/12/201
Cera ASD
8 SELARAS, /12/2018 18:03:00.7 III/11092/2018
No.12
PT 76
REKAMILE 07/12/201
Cera ASD
9 SELARAS, /12/2018 18:03:00.7 III/11092/2018
No.20
PT 76
REKAMILE 07/12/201
Cera ASD
0 SELARAS, /12/2018 18:03:00.7 III/11092/2018
No.22
PT 76
REKAMILE 07/12/201
Cera ASD
1 SELARAS, /12/2018 18:03:00.7 III/11092/2018
No.24
PT 76
REKAMILE 07/12/201
Cera ASD
2 SELARAS, /12/2018 18:03:00.7 III/11092/2018
No.26
PT 76
REKAMILE 07/12/201
Cera ASD
3 SELARAS, /12/2018 18:03:00.7 III/11092/2018
No.28
PT 76
REKAMILE 07/12/201
Cera ASD
4 SELARAS, /12/2018 18:03:00.7 III/11092/2018
No.30
PT 76
REKAMILE 07/12/201
Cera ASD
5 SELARAS, /12/2018 18:03:00.7 III/11092/2018
No.36
PT 76
Guide Wire
REKAMILE 07/12/201
0.038
BMHP 150cm Pcs BMHP 200 149000 0 2980000 32780000
6 SELARAS, /12/2018 18:03:00.7 III/11092/2018
IQ38F150J
PT 76
3
226 NIUMINDO 0165/RS/F 8 PDA BN.01.01/PPK-
BMHP Pcs BMHP 2 11500000 0 2300000 25300000
7 SELARAS, /12/2018 18:03:00.7 Occuleder III/11092/2018
PT 76 XJD1416
REKAMILE 07/12/201 Hearttr Tm
BMHP Pcs BMHP 1 11500000 0 1150000 12650000
8 SELARAS, /12/2018 18:03:00.7 Occuleder III/11092/2018
PT 76 XJD1820
226 REKAMILE 0165/RS/F 07/12/201 BMHP Steerease P c s BMHP 9 4000000 0 3600000 39600000 BN.01.01/PPK-
9 NIUMINDO /12/2018 8 Occuleder III/11092/2018
SELARAS, 18:03:00.7
6F
PT 76
REKAMILE 07/12/201
Steerease
0 SELARAS, /12/2018 18:03:00.7 III/11092/2018
8Fr
PT 76
REKAMILE 07/12/201
SteerEase
1 SELARAS, /12/2018 18:03:00.7 III/11092/2018
7F
PT 76
227 NIUMINDO 0165/RS/F 8 E BN.01.01/PPK-
BMHP Buah BMHP 4 4000000 0 1600000 17600000
2 SELARAS, /12/2018 18:03:00.7 OCCULEDE III/11092/2018
PT 76 R 12F
REKAMILE 07/12/201
Steerease
3 SELARAS, /12/2018 18:03:00.7 III/11092/2018
5F
PT 76
REKAMILE 07/12/201
Cera ASD
4 SELARAS, /12/2018 18:03:00.7 III/11092/2018
No.34
PT 76
REKAMILE 10/12/201
Steerease
5 SELARAS, // 17:40:00.2 III/11092/2018
5F
PT 66
REKAMILE 10/12/201
SteerEase
6 SELARAS, // 17:40:00.2 III/11092/2018
7F
PT 66
227 NIUMINDO 0166/RS/F 8 E BN.01.01/PPK-
BMHP Buah BMHP 1 4000000 0 400000 4400000
7 SELARAS, // 17:40:00.2 OCCULEDE III/11092/2018
PT 66 R 10F
REKAMILE 10/12/201 HearttR
227 NIUMINDO 0166/RS/F 8 TM PDA BN.01.01/PPK-
BMHP Pcs BMHP 6 11500000 0 6900000 75900000
8 SELARAS, // 17:40:00.2 Occuluder III/11092/2018
PT 66 XJD0810
227 REKAMILE 0166/RS/F 10/12/201 BMHP Hearttr TM P c s BMHP 3 11500000 0 3450000 37950000 BN.01.01/PPK-
NIUMINDO 8 PDA
9 SELARAS, // 17:40:00.2 Occuleder III/11092/2018
PT 66 XJD1012
REKAMILE 10/12/201
228 NIUMINDO 0166/RS/F 8 DC Pigtail BN.01.01/PPK-
BMHP Buah BMHP 1 305000 0 30500 335500
0 SELARAS, // 17:40:00.2 4FR III/11092/2018
PT 66
Guide Wire
REKAMILE 10/12/201
0.038
BMHP 150cm Pcs BMHP 220 149000 0 3278000 36058000
1 SELARAS, // 17:40:00.2 III/11092/2018
IQ38F150J
PT 66
3
BMHP Pcs BMHP 1 11500000 0 1150000 12650000
2 SELARAS, // 17:40:00.2 Occuleder III/11092/2018
PT 66 XJF 0406
REKAMILE 10/12/201
Steerease
3 SELARAS, // 17:40:00.2 III/11092/2018
6F
PT 66
REKAMILE 10/12/201
Steerease
4 SELARAS, // 17:40:00.2 III/11092/2018
9Fr
PT 66
CE
REKAMILE 10/12/201
Bioprothes
228 NIUMINDO 0166/RS/F 8 11880000 BN.01.01/PPK-
BMHP is Valve Pcs BMHP 3 36000000 0 10800000
5 SELARAS, // 17:40:00.2 0 III/11092/2018
Mitral
PT 66
33mm
REVASS 05/12/201
228 UTAMA RUM18- 8 BN.01.01/PPK-
BMHP Fenale Set BMHP 30 150000 0 450000 4950000
6 MEDIKA 05943 08:18:08.2 III/11095/2018
.PT 46
REVASS 11/12/201
228 UTAMA RUM18- 8 Manifold BN.01.01/PPK-
BMHP Pcs BMHP 400 80450 0 3218000 35398000
7 MEDIKA 06049 15:39:11.8 Angioway III/11095/2018
.PT 13
228 Roda Inti INV003/XI 15/11/201 BMHP Disp. Pcs BMHP 2100 24500 0 0 51450000 BN.01.01/PPK-
8 Nusantara /2018 8 Syringe / III/8843/2018
Spuit
08:20:02.1
PT 100cc UT
3
OM
15/11/201
Roda Inti BMHP
228 INV003/XI 8 Film Upp BN.01.01/PPK-
Nusantara BMHP Roll RADIOLOG 100 219900 0 0 21990000
9 /2018 08:20:02.1 110 HG III/8843/2018
PT I
3
15/11/201
Roda Inti BMHP
229 INV003/XI 8 Film UPP BN.01.01/PPK-
Nusantara BMHP Roll RADIOLOG 20 219900 0 0 4398000
0 /2018 08:20:02.1 110HD III/8843/2018
PT I
3
Paper for
07/12/201
Roda Inti Hi-801/HI-
229 INV004/XI 8 127272.72 381818.18 4200000.0 BN.01.01/PPK-
Nusantara BMHP 105/ Roll BMHP 30 0
1 /2018 16:15:09.5 73 19 01 III/8843/2018
PT Thermal
36
112mm
Disp.
07/12/201
Roda Inti Syringe /
229 INV005/XI 8 22272.727 1534590.9 16880500. BN.01.01/PPK-
Nusantara BMHP Spuit Pcs BMHP 689 0
2 I/2018 16:57:24.5 3 11 02 III/8843/2018
PT 100cc UT
9
OM
07/12/201
Roda Inti BMHP
229 INV005/XI 8 Film Upp 199909.09 999545.45 BN.01.01/PPK-
Nusantara BMHP Roll RADIOLOG 50 0 10995000
3 I/2018 16:57:24.5 110 HG 09 45 III/8843/2018
PT I
9
Paper for
07/12/201
Roda Inti Hi-801/HI-
229 INV005/XI 8 127272.72 381818.18 4200000.0 BN.01.01/PPK-
Nusantara BMHP 105/ Roll BMHP 30 0
4 I/2018 16:57:24.5 73 19 01 III/8843/2018
PT Thermal
9
112mm
09/01/201
SINAR ARI- ELISIO
229 8 11022000 HK.05,01/IV,2,1/
RODA MDN/18/0 BMHP HOLLOW Buah BMHP 600 167000 0 10020000
5 09:00:01.8 0 24/2016
UTAMA, PT 1/100009 FIBER 15H
7
09/01/201 Blood
SINAR ARI-
229 8 Tubing Set HK.05,01/IV,2,1/
RODA MDN/18/0 BMHP Set BMHP 600 103000 0 6180000 67980000
6 09:00:01.8 Ad16+V60 24/2016
UTAMA, PT 1/100009
7 4
229 SINAR ARI- 09/01/201 BMHP AV. Fistula Buah BMHP 1200 6500 0 780000 8580000 HK.05,01/IV,2,1/
8
RODA MDN/18/0 16G x 1
7 09:00:01.8 24/2016
UTAMA, PT 1/100009 HC-N
7
09/01/201
SINAR ARI- Concentrat
229 8 HK.05,01/IV,2,1/
RODA MDN/18/0 BMHP e Type AK Gln/10ltr BMHP 300 158000 0 4740000 52140000
8 09:00:01.8 24/2016
UTAMA, PT 1/100009 @10Ltr
7
09/01/201 CONCENT
SINAR ARI-
229 8 RATE HK.05,01/IV,2,1/
RODA MDN/18/0 BMHP Gln/5ltr BMHP 600 77000 0 4620000 50820000
9 09:00:01.8 TYPE 24/2016
UTAMA, PT 1/100009
7 AT@10Ltr
23/02/201
SINAR ARI- ELISIO
230 8 12859000 HK.05,01/IV,2,1/
0 13:29:14.9 0 24/2016
9
23/02/201 Blood
SINAR ARI-
230 8 Tubing Set HK.05,01/IV,2,1/
1 13:29:14.9 Ad16+V60 24/2016
UTAMA, PT 2/100076
9 4
23/02/201
SINAR ARI- AV. Fistula
230 8 HK.05,01/IV,2,1/
RODA MDN/18/0 BMHP 16G x 1 Buah BMHP 1400 6500 0 910000 10010000
2 13:29:14.9 24/2016
9
23/02/201
230 8 HK.05,01/IV,2,1/
3 13:29:14.9 24/2016
9
23/02/201 CONCENT
SINAR ARI-
230 8 RATE HK.05,01/IV,2,1/
4 13:29:14.9 TYPE 24/2016
UTAMA, PT 2/100076
9 AT@10Ltr
14/03/201
SINAR ARI- ELISIO
230 8 11095480 HK.05,01/IV,2,1/
5 12:27:45.8 0 24/2016
96
14/03/201 Blood
SINAR ARI-
230 8 Tubing Set HK.05,01/IV,2,1/
6 12:27:45.8 Ad16+V60 24/2016
UTAMA, PT 3/100103
96 4
14/03/201
230 8 HK.05,01/IV,2,1/
7 12:27:45.8 24/2016
96
14/03/201
230 8 HK.05,01/IV,2,1/
8 12:27:45.8 24/2016
96
14/03/201 CONCENT
SINAR ARI-
230 8 RATE HK.05,01/IV,2,1/
9 12:27:45.8 TYPE 24/2016
UTAMA, PT 3/100103
96 AT@10Ltr
27/04/201
SINAR ARI- ELISIO
231 8 11022000 HK.05,01/IV,2,1/
0 10:42:22.0 0 24/2016
43
27/04/201 Blood
SINAR ARI-
231 8 Tubing Set HK.05,01/IV,2,1/
1 10:42:22.0 Ad16+V60 24/2016
UTAMA, PT 4/100167
43 4
27/04/201
231 8 HK.05,01/IV,2,1/
2 10:42:22.0 24/2016
43
27/04/201
231 8 HK.05,01/IV,2,1/
3 10:42:22.0 24/2016
43
27/04/201 CONCENT
SINAR ARI-
231 8 RATE HK.05,01/IV,2,1/
4 10:42:22.0 TYPE 24/2016
UTAMA, PT 4/100167
43 AT@10Ltr
16/05/201
SINAR ARI- ELISIO
231 8 HK.05,01/IV,2,1/
RODA MDN/18/0 BMHP HOLLOW Buah BMHP 538 167000 0 8984600 98830600
5 11:21:16.3 24/2016
7
231 SINAR ARI- 16/05/201 BMHP Blood Set BMHP 538 103000 0 5541400 60955400 HK.05,01/IV,2,1/
6 RODA MDN/18/0 8 Tubing Set 24/2016
UTAMA, PT 5/100194 11:21:16.3 Ad16+V60
7 4
16/05/201
231 8 HK.05,01/IV,2,1/
7 11:21:16.3 24/2016
7
16/05/201
231 8 HK.05,01/IV,2,1/
8 11:21:16.3 24/2016
7
16/05/201 CONCENT
SINAR ARI-
231 8 RATE HK.05,01/IV,2,1/
9 11:21:16.3 TYPE 24/2016
UTAMA, PT 5/100194
7 AT@10Ltr
08/06/201
SINAR ARI- ELISIO
232 8 11022000 HK.05,01/IV,2,1/
0 14:12:31.4 0 24/2016
2
08/06/201 Blood
SINAR ARI-
232 8 Tubing Set HK.05,01/IV,2,1/
1 14:12:31.4 Ad16+V60 24/2016
UTAMA, PT 6/100239
2 4
08/06/201
232 8 HK.05,01/IV,2,1/
2 14:12:31.4 24/2016
2
08/06/201
232 8 HK.05,01/IV,2,1/
3 14:12:31.4 24/2016
2
08/06/201 CONCENT
SINAR ARI-
232 8 RATE HK.05,01/IV,2,1/
4 14:12:31.4 TYPE 24/2016
UTAMA, PT 6/100239
2 AT@10Ltr
30/07/201
SINAR ARI- ELISIO
232 8 10103500 HK.05,01/IV,2,1/
5 12:14:12.8 0 24/2016
83
232 SINAR ARI- 30/07/201 BMHP Blood Set BMHP 550 103000 0 5665000 62315000 HK.05,01/IV,2,1/
6 RODA MDN/18/0 8 Tubing Set 24/2016
12:14:12.8 Ad16+V60
UTAMA, PT7/100307
83 4
30/07/201
232 8 HK.05,01/IV,2,1/
7 12:14:12.8 24/2016
83
30/07/201
232 8 HK.05,01/IV,2,1/
8 12:14:12.8 24/2016
83
30/07/201 CONCENT
SINAR ARI-
232 8 RATE HK.05,01/IV,2,1/
9 12:14:12.8 TYPE 24/2016
UTAMA, PT 7/100307
83 AT@10Ltr
SINAR ARI- ELISIO BN.01.01/PPK-
233 31/08/201 11022000
RODA MDN18/08 BMHP HOLLOW Buah BMHP 600 167000 0 10020000 BLU.FAR/8876/2
0 8 14:16:00 0
UTAMA, PT /1000345 FIBER 15H 018
Blood
SINAR ARI- BN.01.01/PPK-
233 31/08/201 Tubing Set
RODA MDN18/08 BMHP Set BMHP 600 103000 0 6180000 67980000 BLU.FAR/8876/2
1 8 14:16:00 Ad16+V60
UTAMA, PT /1000345 018
4
SINAR ARI- AV. Fistula BN.01.01/PPK-
233 31/08/201
RODA MDN18/08 BMHP 16G x 1 Buah BMHP 1200 6500 0 780000 8580000 BLU.FAR/8876/2
2 8 14:16:00
UTAMA, PT /1000345 HC-N 018
SINAR ARI- Concentrat BN.01.01/PPK-
233 31/08/201
RODA MDN18/08 BMHP e Type AK Gln/10ltr BMHP 300 158000 0 4740000 52140000 BLU.FAR/8876/2
3 8 14:16:00
UTAMA, PT /1000345 @10Ltr 018
CONCENT
SINAR ARI- BN.01.01/PPK-
233 31/08/201 RATE
RODA MDN18/08 BMHP Gln/5ltr BMHP 600 77000 0 4620000 50820000 BLU.FAR/8876/2
4 8 14:16:00 TYPE
UTAMA, PT /1000345 018
AT@10Ltr
29/11/201
SINAR ARI- ELISIO
233 8 11022000 HK.05,01/IV,2,1/
5 10:29:49.8 0 24/2016
5
29/11/201 Blood
SINAR ARI-
233 8 Tubing Set HK.05,01/IV,2,1/
6 10:29:49.8 Ad16+V60 24/2016
UTAMA, PT 1/100510
5 4
29/11/201
233 8 HK.05,01/IV,2,1/
7 10:29:49.8 24/2016
5
29/11/201
233 8 HK.05,01/IV,2,1/
8 10:29:49.8 24/2016
5
29/11/201 CONCENT
SINAR ARI-
233 8 RATE HK.05,01/IV,2,1/
9 10:29:49.8 TYPE 24/2016
UTAMA, PT 1/100510
5 AT@10Ltr
SUKSES 24/08/201 Breathing
INV/SJA/1
234 JAYA 8 Circuit 154545.45 2318181.8 25500000. BN.01.01/PPK-
8/VIII/044 BMHP Set BMHP 150 0
0 ALKESIND 14:26:26.6 Adult Set 46 19 01 III/8855/2018
3
O. PT 3 Complete
234 JAYA INV/SJA/1 8 Circuit 154545.45 154545.45 1699999.9 BN.01.01/PPK-
BMHP Set BMHP 10 0
1 ALKESIND 8/IX/0498 15:56:57.9 Adult Set 45 45 99 III/8855/2018
O. PT 86 Complete
234 JAYA INV/SJA/1 8 Circuit 154545.45 927272.72 BN.01.01/PPK-
BMHP Set BMHP 60 0 10200000
2 ALKESIND 8/IX/0517 16:07:17.4 Adult Set 45 7 III/8855/2018
O. PT 6 Complete
234 JAYA INV/SJA/1 8 Circuit Ped BN.01.01/PPK-
BMHP Set BMHP 25 168182 0 420455 4625005
3 ALKESIND 8/IX/0521 14:13:50.1 Set III/8855/2018
O. PT 23 Complete
BMHP Set BMHP 40 0
4 ALKESIND 8/X/0572 10:34:01.8 Adult Set 45 8 98 III/8855/2018
O. PT 63 Complete
BMHP Set BMHP 15 0
O. PT 13 Complete
234 SUKSES INV/SJA/1 31/10/201 BMHP Breathing S e t BMHP 129 154545.45 0 1993636.3 21929999. BN.01.01/PPK-
6 JAYA 8/X/0536 8 Circuit 45 63 99 III/8855/2018
ALKESIND 13:16:24.8 Adult Set
O. PT 1 Complete
BMHP Set BMHP 10 0
O. PT 66 Complete
BMHP Set BMHP 10 0
8 ALKESIND 8/XI/0599 10:33:49.4 Adult Set 45 45 99 III/8855/2018
O. PT 56 Complete
BMHP Set BMHP 10 0
O. PT 56 Complete
BMHP Set BMHP 30 0
O. PT 2 Complete
235 JAYA INV/SJA/1 8 Circuit BN.01.01/PPK-
BMHP Set BMHP 20 154545.45 0 309090.9 3399999.9
1 ALKESIND 8/XI/0616 15:19:30.4 Adult Set III/8855/2018
O. PT 13 Complete
BMHP Set BMHP 10 0
O. PT 03 Complete
BMHP Set BMHP 26 0
O. PT 3 Complete
235 JAYA INV/SJA/1 8 Circuit 154545.45 4636363.6 51000000. BN.01.01/PPK-
BMHP Set BMHP 300 0
O. PT 93 Complete
235 JAYA INV/SJA/1 8 Circuit 154545.45 4636363.6 51000000. BN.01.01/PPK-
BMHP Set BMHP 300 0
O. PT 26 Complete
235 SURGIKA IRI01482 28/09/201 BMHP Tracheos Pcs BMHP 200 27625.454 0 552509.09 6077600.0 BN.01.01/PPK-
6 ALKESIND 8 08:37:00 Filter 6 2 12 III/8845/2018
O, PT
SURGIKA Mouth
235 28/09/201 BN.01.01/PPK-
ALKESIND IRI01482 BMHP Piece,180c P c s BMHP 100 18500 0 185000 2035000
7 8 08:37:00 III/8845/2018
O, PT m Tubing
23/11/201
SURGIKA
235 8 Tracheos 27625.454 966890.90 10635799. BN.01.01/PPK-
ALKESIND IRK00848 BMHP Pcs BMHP 350 0
8 13:54:42.5 Filter 5 75 98 III/8845/2018
O, PT
33
23/11/201
SURGIKA Mouth
235 IRK01778 8 BN.01.01/PPK-
ALKESIND BMHP Piece,180c P c s BMHP 50 18500 0 92500 1017500
9 1 13:59:14.3 III/8845/2018
O, PT m Tubing
63
18/12/201
SURGIKA Mouth
236 8 BN.01.01/PPK-
ALKESIND IRL01322 BMHP Piece,180c P c s BMHP 200 18500 0 370000 4070000
0 16:32:02.9 III/8845/2018
O, PT m Tubing
96
18/12/201
SURGIKA
236 8 Tracheos 27625.454 1243145.4 13674600. BN.01.01/PPK-
ALKESIND IRL01322 BMHP Pcs BMHP 450 0
1 16:32:02.9 Filter 6 57 03 III/8845/2018
O, PT
96
HANDPIEC
E FOR
31/10/201
THOMASO HIGH
236 X/TN/18/ 8 BN.01.01/PPK-
NG BMHP SPEED Pcs BMHP 2 3140000 0 628000 6908000
2 1888 15:49:40.3 III/11097/2018
NIRMALA TYPE
5
PUSH
BUTTO
HANDPIEC
31/10/201 E FOR
THOMASO
236 X/TN/18/ 8 HIGH BN.01.01/PPK-
NG BMHP Set BMHP 2 10500000 0 2100000 23100000
3 1888 15:49:40.3 SPEED III/11097/2018
NIRMALA
5 WITH
OPTIC LED
ARCHITEC
TIRTA 31/05/201
T ANTI-
236 MEDICAL 5657/FP/1 8 10679460 11747406 BN.01.01/PPK.III
BMHP HCV Kit BMHP 1 0 10679460
4 INDONESI 8 12:54:51.6 0 0 /1654/2018
REAGENT
A,PT 93
2000T
236 TIRTA 5657/FP/1 31/05/201 BMHP ARCHITEC Kit BMHP 1 31118900 0 3111890 34230790 BN.01.01/PPK.III
MEDICAL 8 T HBSAG
5 INDONESI 8 12:54:51.6 REAGENT /1654/2018
A,PT 93 2000T
TIRTA 31/05/201 ARCHITEC
236 MEDICAL 5657/FP/1 8 T SYPHILIS BN.01.01/PPK.III
BMHP Kit BMHP 4 7778600 0 3111440 34225840
A,PT 93 500T
236 MEDICAL 5657/FP/1 8 T HIV BN.01.01/PPK.III
BMHP Pcs BMHP 1 56704000 0 5670400 62374400
A,PT 93 2000T
ARCHITEC
TIRTA 09/07/201
T ANTI-
236 MEDICAL 8 10679460 11747406 BN.01.01/PPK.III
5657 BMHP HCV Kit BMHP 1 0 10679460
8 INDONESI 10:12:29.8 0 0 /1654/2018
REAGENT
A,PT 1
2000T
236 MEDICAL 8 T HBSAG BN.01.01/PPK.III
5657 BMHP Kit BMHP 1 31118900 0 3111890 34230790
9 INDONESI 10:12:29.8 REAGENT /1654/2018
A,PT 1 2000T
237 MEDICAL 8 T SYPHILIS BN.01.01/PPK.III
5657 BMHP Kit BMHP 4 7778600 0 3111440 34225840
A,PT 1 500T
237 MEDICAL 8 T HIV BN.01.01/PPK.III
5657 BMHP Pcs BMHP 1 56704000 0 5670400 62374400
A,PT 1 2000T
ARCHITEC
TIRTA 24/08/201
T ANTI-
2 INDONESI 8 14:01:13.1 0 0 /1654/2018
REAGENT
A,PT 86
2000T
237 MEDICAL 7269/FP/1 8 T HBSAG BN.01.01/PPK.III
BMHP Kit BMHP 1 31118900 0 3111890 34230790
A,PT 86 2000T
237 TIRTA 7269/FP/1 24/08/201 BMHP ARCHITEC Kit BMHP 4 7778600 0 3111440 34225840 BN.01.01/PPK.III
4 MEDICAL 8 8 T SYPHILIS /1654/2018
INDONESI 14:01:13.1 REAGENT
A,PT 86 500T
BMHP Pcs BMHP 1 56704000 0 5670400 62374400
A,PT 86 2000T
ARCHITEC
TIRTA 28/09/201
T ANTI-
6 INDONESI 8 15:09:44.3 0 0 /1654/2018
REAGENT
A,PT 9
2000T
BMHP Kit BMHP 1 31118900 0 3111890 34230790
A,PT 9 2000T
BMHP Kit BMHP 4 7778600 0 3111440 34225840
A,PT 9 500T
BMHP Pcs BMHP 1 56704000 0 5670400 62374400
A,PT 9 2000T
ARCHITEC
TIRTA 22/11/201
T ANTI-
0 INDONESI 8 12:05:47.6 0 0 /1654/2018
REAGENT
A,PT 86
2000T
BMHP Kit BMHP 1 31118900 0 3111890 34230790
A,PT 86 2000T
BMHP Kit BMHP 4 7778600 0 3111440 34225840
A,PT 86 500T
238 TIRTA 3214/FP/1 22/11/201 BMHP ARCHITEC P c s BMHP 1 56704000 0 5670400 62374400 BN.01.01/PPK.III
3 MEDICAL 8 8 T HIV /1654/2018
INDONESI 12:05:47.6 REAGENT
A,PT 86 2000T
MCS+LDP
TRANSME 07/05/201
W/Filter W
238 DIC 8 BN.01.01/PPK.III
IN1802509 BMHP New Saf Set BMHP LAB 8 2299865 0 1839892 20238812
4 INDONESI 14:58:35.3 /1852/2018
F+ACD-
A. PT 9
A500ml
MCS+LDP
TRANSME 11/05/201
W/Filter W
5 INDONESI 15:27:47.2 /1852/2018
F+ACD-
A. PT 36
A500ml
Therapeuti
TRANSME 11/05/201
c Plasma
IN1802652 BMHP Exchance P c s BMHP 32 2700000 0 8640000 95040000
6 INDONESI 15:27:47.2 /1852/2018
Set MCS-
A. PT 36
980E
MCS+LDP
TRANSME 08/06/201
W/Filter W
7 INDONESI 14:27:06.7 /1852/2018
F+ACD-
A. PT 1
A500ml
Therapeuti
TRANSME 08/06/201
c Plasma
IN1803248 BMHP Exchance P c s BMHP 32 2700000 0 8640000 95040000
8 INDONESI 14:27:06.7 /1852/2018
Set MCS-
A. PT 1
980E
MCS+LDP
TRANSME 21/09/201
W/Filter W
9 INDONESI 09:05:11.2 /1852/2018
F+ACD-
A. PT 8
A500ml
MCS+LDP
TRANSME 25/10/201
W/Filter W
239 DIC 8 BN.01.01/PPK-
0 INDONESI 09:41:15.7 III/1852/2018
F+ACD-
A. PT 36
A500ml
239 TRANSME IN180715612/11/201 BMHP Katub Pcs BMHP 4 15100000 0 6040000 66440000 BN.01.01/PPK-
1 DIC 8 Mitral III/11091/2018
INDONESI 13:23:36.4 No.29mm
A. PT 86
TRANSME 12/11/201
Katub
239 DIC 8 BN.01.01/PPK-
IN1807156 BMHP Mitral Buah BMHP 4 15100000 0 6040000 66440000
2 INDONESI 13:23:36.4 III/11091/2018
No.31mm
A. PT 86
TRANSME 12/11/201
Katub
239 DIC 8 BN.01.01/PPK-
3 INDONESI 13:23:36.4 III/11091/2018
No.33mm
A. PT 86
TRANSME 12/11/201
Katub
239 DIC 8 BN.01.01/PPK-
4 INDONESI 13:23:36.4 III/11091/2018
No.27mm
A. PT 86
MCS+LDP
TRANSME
W/Filter W
239 DIC 01/11/201 16191049 BN.01.01/PPK-
IN1905059 BMHP New Saf Set BMHP LAB 64 2299865 0 14719136
5 INDONESI 8 15:43:00 6 III/1852/2018
F+ACD-
A. PT
A500ml
MCS+LDP
TRANSME 19/11/201
W/Filter W
239 DIC 8 43007475. BN.01.01/PPK.III
IN1807358 BMHP New Saf Set BMHP LAB 17 2299865 0 3909770.5
6 INDONESI 16:06:31.7 5 /1852/2018
F+ACD-
A. PT 46
A500ml
TRANSME 10/12/201
Katub
239 DIC IM182298 8 BN.01.01/PPK-
7 INDONESI 2 12:13:35.6 III/11091/2018
No.27mm
A. PT 96
TRANSME 10/12/201
Katub
239 DIC IM182298 8 BN.01.01/PPK-
8 INDONESI 2 12:13:35.6 III/11091/2018
No.29mm
A. PT 96
TRANSME 10/12/201
Katub
239 DIC IM182298 8 BN.01.01/PPK-
BMHP Mitral Buah BMHP 3 15100000 0 4530000 49830000
9 INDONESI 2 12:13:35.6 III/11091/2018
No.31mm
A. PT 96
TRANSME 10/12/201
Katub
240 DIC IM182298 8 BN.01.01/PPK-
0 INDONESI 2 12:13:35.6 III/11091/2018
No.33mm
A. PT 96
WEGO 26/10/201
240 MEDIKA SURAT 8 DC Infinity BN.01.01/PPK-
BMHP Pcs BMHP 10 242760 0 242760 2670360
1 INDONESI JALAN 14:03:09.6 MPA2 - 4F III/11093/2018
A 8
WEGO 26/10/201
BMHP Pcs BMHP 40 242760 0 971040 10681440
A 8
WEGO 26/10/201
BMHP Pcs BMHP 40 242760 0 971040 10681440
A 8
WEGO 27/11/201
SIC-
240 MEDIKA 8 DC Infinity BN.01.01/PPK-
MDN/XI/1 BMHP Pcs BMHP 15 242760 0 364140 4005540
4 INDONESI 15:52:21.7 MPA2 - 5F III/11093/2018
8/1139
A 6
WEGO 27/11/201
SIC-
240 MEDIKA 8 DC Infinity BN.01.01/PPK-
MDN/XI/1 BMHP Pcs BMHP 40 242760 0 971040 10681440
5 INDONESI 15:52:21.7 MPA2 - 6F III/11093/2018
8/1139
A 6
4
2,625,877,
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Implan Dan BMHP Nonekatalog

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PENERIMAAN TAHUN 2018 ALKES dan BMHP NON EKATALOG

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