Sensus Harian Rawat Inap - Jul 2017 (2) D

DAFTAR PASIEN RAWAT INAP
HP = Hari Perawatan Per Tanggal : 03 Jul 2017
No. Tgl. Masuk HP Nama Pasien Cara Bayar Kamar Kelas Dokter No. MR Total Biaya Diagnosa Kode ICD INACBG
Perawatan
1 20-06-17 13 Tn. JALUDIN MANALU BPJS TOP UP Flamboyan (I- B) Kelas II A Indra, dr. Sp.BU 207094 35,907,500
PTPN
2 01-07-17 2 Ny. NURAINI BPJS ASKES Flamboyan (I-A) Kelas I A Faisal, Dr. Sp.Pd 149720 2,091,280
3 02-07-17 1 Ny. DARMILAWATI BPJS IN PROSES Flamboyan (II-A) Kelas II A Befimiroza Adam, 207740 2,829,380
dr. Sp.OG
4 30-06-17 3 Ny. YUSMARNI BPJS Kesehatan Flamboyan (II-A) Kelas II A Indra, dr. Sp.BU 099720 13,682,500
Mandiri
5 01-07-17 2 Ny. ERNI BINTI MAJI BPJS TOP UP HCU HCU-A HCU Faisal, Dr. Sp.Pd 207706 4,473,300
PTPN
6 21-06-17 12 Ny. RITA ASMARA BPJS NO Badan HCU HCU-C HCU Dafnil,dr.Sp.OG 103089 32,506,490
Usaha
7 30-06-17 3 Ny. ROSMIDA PANJAITAN BPJS IN PROSES Mawar (I-A) Kelas II A Befimiroza Adam, 207653 2,668,700
dr. Sp.OG
8 02-07-17 1 Ny. NORULITA SITOMPUL BPJS Kesehatan Mawar (II-A) Kelas II A Indra, dr. Sp.BU 186480 10,096,300
Mandiri
9 02-07-17 1 Ny. UMI MARHAMAH BPJS IN PROSES Mawar (II-A) Kelas II A Befimiroza Adam, 207745 5,946,000
dr. Sp.OG
10 01-07-17 2 Ny. SURYANI BPJS NO Mawar (II-A) Kelas II A Sari Rahmawati, 207721 7,748,470
SIMANJUNTAK Kesehatan Mandiri dr. SpOG
11 02-07-17 1 Tn. DARWINSYAH BPJS Badan Mawar (II-A) Kelas II A Indra, dr. Sp.BU 206537 4,869,800
SIPAYUNG Usaha
12 02-07-17 1 Ny. KHAIRUNNISA BPJS NKO Mawar (VIP) VIP Khairul Nasir, dr. 207506 438,750
Sp.OG
13 27-06-17 6 Ny. ARNIA BINTI KASNO BPJS TOP UP Lavender (I-A) Kelas II A Ismar, dr. Sp.BA 207479 16,694,900
PTPN
14 28-06-17 5 Ny. RITA DEWI BPJS TOP UP Lavender (I-A) Kelas II A Faisal, Dr. Sp.Pd 186583 8,964,870
PTPN
15 02-07-17 1 An. FARID RIZKY ATALLAH BPJS NO Gardenia (III) Kelas III Irawati, dr.SpA 188176 241,620
Kesehatan Mandiri
16 02-07-17 1 Ny. TINA SIREGAR BPJS Kesehatan Gardenia (III) Kelas III Khairul Nasir, dr. 119314 2,103,200
Mandiri Sp.OG
17 01-07-17 2 Ny. YANTI HARIADI BPJS NO Gardenia (III) Kls III Dafnil,dr.Sp.OG 207725 6,478,510
PBI/JAMKESMAS
/KIS
18 02-07-17 1 Ny. DEWI SUSANTI BPJS IN PROSES Gardenia (III) Kelas III Befimiroza Adam, 207757 5,279,200
dr. Sp.OG
19 30-06-17 3 Ny. ANOM ROMIAH BPJS NO Gardenia (III) Kelas III Befimiroza Adam, 193980 7,737,970
Kesehatan Mandiri dr. Sp.OG
20 01-07-17 2 Ny. MEGAWATI BPJS Kesehatan Gardenia (III) Kelas III Befimiroza Adam, 206744 5,965,760
Mandiri dr. Sp.OG
No. Tgl. Masuk HP Nama Pasien Cara Bayar Kamar Kelas Dokter No. MR Total Biaya Diagnosa Kode ICD INACBG
Perawatan
21 02-07-17 1 Ny. MAILAN ROSALIN BPJS Kesehatan Gardenia (III) Kelas III Khairul Nasir, dr. 207744 5,242,900
Mandiri Sp.OG
22 18-06-17 15 Tn. ANGGA PERDANA BPJS NO Melati (I-A) Kelas I A Rinelia 206896 26,592,910
PUTRA Kesehatan Mandiri Minaswary,dr.
Sp.JP
23 01-07-17 2 Tn. TOGAR SIMANULLANG BPJS TOP UP Melati (I-A) Kelas II A Faisal, Dr. Sp.Pd 207696 3,533,500
PTPN
24 01-07-17 2 Ny. ELDAWATI BPJS ASKES Melati (I-A) Kelas I A Befimiroza Adam, 059241 8,094,000
dr. Sp.OG
25 02-07-17 1 Ny. WIDYA SETIAHATI BPJS TNI NO Melati (II-A) Kelas II A Faisal, Dr. Sp.Pd 176095 3,456,330
26 01-07-17 2 Ny. MEGI PUSPITA BPJS Badan Melati (VIP) Kelas II A Memmi, dr. Sp.OG 042904 3,349,200
Usaha
27 01-07-17 2 Ny. ZULFIA NAIDI BPJS NO Badan ICU ICU-5 ICU Befimiroza Adam, 196681 7,772,330
Usaha dr. Sp.OG
28 24-06-17 9 By. NY. JULYANI BPJS NKO NICU ICU Nazardi Oyong, dr. 207362 24,386,140
Sp.A
29 21-06-17 12 By. NY. RITA ASMARA II BPJS NO Badan SCN I ICU Nazardi Oyong, dr. 207207 18,124,560
Usaha Sp.A
30 21-06-17 12 By. NY. RITA ASMARA I BPJS NO Badan SCN I ICU Nazardi Oyong, dr. 207205 18,800,280
Usaha Sp.A
31 27-06-17 6 By. Ny. CICI ANGGRAINI BPJS MITRA BU SCN II ICU Irawati, dr.SpA 207511 13,912,500
PT. ASTRA AGRO
LESTARI
32 20-06-17 13 By. NY. ROSLAINI BPJS
(PT.TPP) SCN II ICU Nazardi Oyong, dr. 207090 22,256,000
PBI/JAMKESMAS Sp.A
/KIS
33 30-06-17 3 An. NAGITA ELISABETH BPJS Badan Asoka (II-A) Kelas II A Irawati, dr.SpA 103758 2,073,400
SINAGA Usaha
34 02-07-17 1 Tn. ARI SUYATNA BPJS IN PROSES Asoka (VIP) VIP Syafrudin, dr. 207772 1,192,970
Sp.OT
35 02-07-17 1 Ny. ZAITUN MUNAWARAH BPJS IN PROSES Asoka (VIP) VIP Donel, dr. Sp.OG 207732 11,127,250
(KFM)
36 02-07-17 1 Ny. AMY VERSARI BPJS IN PROSES Asoka (VIP) Kelas I A Khairul Nasir, dr. 170397 757,010
SIREGAR Sp.OG
37 02-07-17 1 Ny. RATNA SUSANTI BPJS NO POLRI Asoka (VIP) Kelas II A Khairul Nasir, dr. 006125 7,022,540
Sp.OG
38 01-07-17 2 Ny. MARIA SUSANTI BPJS NKO Sakura (VIP) VIP Befimiroza Adam, 054147 13,179,110
dr. Sp.OG
39 30-06-17 3 Ny. FUJIATUL ISNAINI BPJS Badan Sakura (VIP) Kelas II A Befimiroza Adam, 125254 6,743,700 6,023,900
Usaha dr. Sp.OG
40 30-06-17 3 Ny. RIA HESTI BPJS Badan Sakura (VIP) Kelas II A Befimiroza Adam, 044712 7,029,400 6,023,900
Usaha dr. Sp.OG
No. Tgl. HP Nama Pasien No. MR Cara Bayar Kamar Kelas Dokter Total Biaya Diagnosa Kode ICD INACBG
Masuk Perawatan
1 20-06-17 14 Tn. JALUDIN MANALU 207094 BPJS TOP UP PTPN Flamboyan (I- B) Kelas II A Indra, dr. Sp.BU 37,208,400 post nefrectomy+debridement plg
2 01-07-17 3 Ny. NURAINI 149720 BPJS ASKES Flamboyan (I-A) Kelas I A Faisal, Dr. Sp.Pd 2,779,780 plg
3 04-07-17 0 Ny. NURHAYATI 205317 BPJS PBI/JAMKESMAS/K

Flamboyan (II-A) Kelas III Romy Deviandri, dr. 0 cyst et tumor pedis dextra
4 21-06-17 13 Ny. RITA ASMARA 103089 BPJS NO Badan UsahaFlamboyan (II-A) Kelas II A Dafnil,dr.Sp.OG 33,057,430 post sc, gemeli, aki, susp encephalopathy, retinopathy, post
HD
5 03-07-17 1 Ny. SUPRIANI 144144 BPJS Badan Usaha Flamboyan (II-A) Kelas II A Khairul Nasir, dr. Sp 367,400 abortus imminens O20.0 1,539,300
6 30-06-17 4 Ny. YUSMARNI 099720 BPJS Kesehatan MandirFlamboyan (II-A) Kelas II A Indra, dr. Sp.BU 14,223,700 post uretronectomy
7 03-07-17 1 Ny. WAN ROBIATUN 082651 BPJS ASKES Flamboyan (II-A) Kelas II A Taufik Hidayat. dr, S 1,761,000 tumor mammae, post eksisi 6,052,700
8 03-07-17 1 Ny. VEBRIA NELA 207284 BPJS IN PROSES HCU HCU-A Donel, dr. Sp.OG (K 2,079,200 post sc, PEB
9 03-07-17 1 Tn. EDI AGUS PITOYO 198816 BPJS MITRA MARGIE HCU HCU-E Kelas II A Faisal, Dr. Sp.Pd 1,493,750 CKD, anemia, transfusi darah N18.5, D64.9, 99.04 3,711,900
10 30-06-17 4 Ny. ROSMIDA PANJAITAN 207653 BPJS Badan Usaha Mawar (I-A) Kelas II A Befimiroza Adam, dr. 3,265,000 abortus imminens O20.0 1,539,300
11 02-07-17 2 Ny. UMI MARHAMAH 207745 BPJS PBI/JAMKESMASMawar (II-A) Kelas II A Befimiroza Adam, dr. 6,489,700 post sc, bsk O82.0, Z37.0, 74.0 6,023,900
12 01-07-17 3 Ny. SURYANI SIMANJUNTAK 207721 BPJS NO Kesehatan MaMawar (II-A) Kelas II A Sari Rahmawati, dr. 8,095,050 post sc, PRM O82.9, Z37.0, 74.0 6,023,900
13 01-07-17 3 Ny. ZULFIA NAIDI 196681 BPJS NO Badan UsahaMawar (II-A) Kelas II A Befimiroza Adam, dr. 10,525,900 ALO, PEB, VE, J81, O14.1, O81.4, Z37.0, 73.4 5,346,100
14 03-07-17 1 Tn. TENGKU HENDRI YASIN 207885 BPJS MITRA MARGIE Mawar (II-A) Kelas I A Boekit P, dr. Sp.PD 805,800 Colic abdomen R104
15 03-07-17 1 Tn. SYAHRUL 159990 BPJS NO Kesehatan MaMawar (II-A) Kelas I A Rohani, dr. Sp.P 1,488,800 PPOK exacerbasi akut J44.1 3,985,500
16 03-07-17 1 Nn. NANDA ALIFAH NAFSANI 207857 BPJS ASKES Mawar (II-A) Kelas I A Ismar, dr. Sp.BA 804,300 tumor inguinal, post eksisi D48.7, 86.3 5,379,000
17 03-07-17 1 Ny. KAMSIAH BINTI MATSAJARI 207889 BPJS TOP UP PTPN Mawar (II-A) Kelas II A Asrizal, dr. Sp.PD 1,664,400 ulkus pedis, dm E14.5 5,315,300
18 02-07-17 2 Ny. KHAIRUNNISA 207506 BPJS NKO Mawar (VIP) Khairul Nasir, dr. Sp 2,200,870 abortus imminens O20.0
19 27-06-17 7 Ny. ARNIA BINTI KASNO 207479 BPJS TOP UP PTPN Lavender (I-A) Kelas II A Ismar, dr. Sp.BA 17,633,200 peritonitis akut ec pankreatitis, anemia, post LE, TF K65.9, K85, D64.9, 54.11, 99.04 7,956,500
20 03-07-17 1 Ny. IRDATI BINTI JULIUS SARUJI 202962 BPJS TNI NO Lavender (I-A) Kelas I A Ismar, dr. Sp.BA 1,263,100 hemoroid, hemoroidectomy I84.2, 49.46 6,433,200
21 02-07-17 2 An. FARID RIZKY ATALLAH 188176 BPJS NO Kesehatan MaGardenia (III) Kelas III Irawati, dr.SpA 1,358,020 GE A09 1,461,500
22 03-07-17 1 Tn. SUARLIS 207782 BPJS Kesehatan MandirGardenia (III) Kelas III Taufik Hidayat. dr, S 2,043,500 hernia inguinalis, hernioraphy+mesh K40.9, 53.05 4,706,700
23 03-07-17 1 Tn. KADAI BIN SYAMSUDIN 207807 BPJS Kesehatan MandirGardenia (III) Kelas III Taufik Hidayat. dr, S 1,991,500 hernia inguinalis, hernioraphy+mesh K40.9, 53.05 4,706,700
24 03-07-17 1 Tn. SELAMAT SUTRISNO 174232 BPJS Kesehatan MandirGardenia (III) Kelas III Rinelia Minaswary,dr. 939,160 CHF + DM I50.0, E14.9
Masuk Perawatan
25 04-07-17 0 Tn. NOTABELI TELAUNBANUA 201811 BPJS MITRA MARGIE Gardenia (III) Kelas II A Yasri, dr. Sp.M 0
26 03-07-17 1 Ny. SUMIATI BINTI NGADI 202282 BPJS Kesehatan MandirGardenia (III) Kelas III Indra, dr. Sp.BU 172,300
27 02-07-17 2 Ny. TINA SIREGAR 119314 BPJS Kesehatan MandirGardenia (III) Kelas III Khairul Nasir, dr. Sp 2,906,600 ILO T81.4 2,880,200
28 01-07-17 3 Ny. YANTI HARIADI 207725 BPJS NO PBI/JAMKES Gardenia (III) Kls III Dafnil,dr.Sp.OG 6,759,130 sc, PRM 5,019,900
29 02-07-17 2 Ny. DEWI SUSANTI 207757 BPJS PBI/JAMKESMASGardenia (III) Kelas III Befimiroza Adam, dr. 5,625,000 post SC, galin 5,019,901
30 03-07-17 1 Ny. ASNIMAR 207855 BPJS IN PROSES Gardenia (III) Kelas III Ismar, dr. Sp.BA 1,415,300
31 01-07-17 3 Ny. MEGAWATI 206744 BPJS Kesehatan MandirGardenia (III) Kelas III Befimiroza Adam, dr. 6,096,960
32 02-07-17 2 Ny. MAILAN ROSALIN 207744 BPJS Kesehatan MandirGardenia (III) Kelas III Khairul Nasir, dr. Sp 5,652,900 sc, PRM
33 18-06-17 16 Tn. ANGGA PERDANA PUTRA 206896 BPJS NO Kesehatan MaMelati (I-A) Kelas I A Rinelia Minaswary,dr. 27,727,290
34 01-07-17 3 Tn. TOGAR SIMANULLANG 207696 BPJS TOP UP PTPN Melati (I-A) Kelas II A Faisal, Dr. Sp.Pd 4,431,400
35 01-07-17 3 Ny. ERNI BINTI MAJI 207706 BPJS TOP UP PTPN Melati (I-A) Kelas II A Faisal, Dr. Sp.Pd 6,720,900 dm tipe 2, low intake,
36 03-07-17 1 An. RAIHAN AHMAD DWI AULIA 207846 BPJS ASKES NO Melati (II-A) Kelas I A Romy Deviandri, dr. 505,320
37 02-07-17 2 Ny. WIDYA SETIAHATI 176095 BPJS TNI NO Melati (II-A) Kelas II A Faisal, Dr. Sp.Pd 4,975,200
38 03-07-17 1 Ny. SANTA NORA TAMPUBOLON 190283 BPJS Badan Usaha Melati (II-A) Kelas II A Rudolf, dr. Sp.M 361,500
39 03-07-17 1 Ny. RATINI BINTI SUWARJO 205879 BPJS TOP UP PTPN Melati (II-A) Kelas II A Yasri, dr. Sp.M 653,200
40 24-06-17 10 By. NY. JULYANI 207362 BPJS NKO NICU NICU-3 ICU Nazardi Oyong, dr. S 27,678,050 bb:3.5 kg, HIE, ventilator >4hr, aspiksia, SGN P91.6, P21.0, P22.0, 96.72, 93.93, 17,539,700
93.90
41 30-06-17 4 An. NAGITA ELISABETH SINAGA 103758 BPJS Badan Usaha PICU PICU-2 ICU Irawati, dr.SpA 3,642,200
42 27-06-17 7 By. Ny. CICI ANGGRAINI 207511 BPJS MITRA BU PT. A SCN II SCN II-1 ICU Irawati, dr.SpA 15,029,400
43 21-06-17 13 By. NY. RITA ASMARA I 207205 BPJS NO Badan UsahaSCN II SCN II-10 ICU Nazardi Oyong, dr. S 19,375,280
44 21-06-17 13 By. NY. RITA ASMARA II 207207 BPJS NO Badan UsahaSCN II SCN II-2 ICU Nazardi Oyong, dr. S 18,524,560
45 01-07-17 3 Ny. MARIA SUSANTI 054147 BPJS NKO Sakura (VIP) 503 VIP Befimiroza Adam, dr. 13,929,110
46 03-07-17 1 Ny. SITI DESMAWATI 207862 BPJS NKO Sakura (VIP) 505 VIP Donel, dr. Sp.OG (K 344,990
47 30-06-17 4 Ny. RIA HESTI 044712 BPJS Badan Usaha Sakura (VIP) 507 Kelas II A Befimiroza Adam, dr. 7,258,800
48 04-07-17 0 An. AKBAR SHABRI ATHAYA 105465 BPJS Badan Usaha(EksiAsoka (II-A) Kelas II A Ismar, dr. Sp.BA 0
49 03-07-17 1 An. MIRZA RAFIF DANADIPTA 128208 BPJS Kesehatan MandirAsoka (II-A) Kelas II A Evi Kamelia, dr. Sp.A 302,200
50 03-07-17 1 An. MARCELL HALIM 148177 BPJS Badan Usaha Asoka (II-A) Kelas II A Ismar, dr. Sp.BA 1,245,200
Masuk Perawatan
51 03-07-17 1 Tn. BUDI PERDANAS PERANGIN 190720 BPJS NKO Asoka (PS) VIP Faisal, Dr. Sp.Pd 992,830
ANGIN
52 02-07-17 2 Tn. ARI SUYATNA 207772 BPJS IN PROSES Asoka (VIP) VIP Syafrudin, dr. Sp.OT 5,866,720
53 02-07-17 2 Ny. ZAITUN MUNAWARAH 207732 BPJS IN PROSES Asoka (VIP) VIP Donel, dr. Sp.OG (K 11,603,810
54 03-07-17 1 Ny. HASNATUL MUNAWARAH 125481 BPJS NO Kesehatan MaAsoka (VIP) Kelas I A Khairul Nasir, dr. Sp 2,481,520
55 02-07-17 2 Ny. RATNA SUSANTI 006125 BPJS NO POLRI Ruang Bayi RB-34 Kelas II A Khairul Nasir, dr. Sp 7,739,220
56 04-07-17 0 Ny. HENNY DWI SETIANTI 117010 BPJS NO Badan UsahaRuang Bayi RB-47 Kelas I A Khairul Nasir, dr. Sp.OG
57 03-07-17 1 Tn. DEFRI EDASA SIP 207480 BPJS ASKES Ruang Bayi RB-50 Kelas I A Afdhal, dr. Sp.BU 2,280,800
58 03-07-17 1 Tn. AGUS NUR YUSUF 176574 BPJS ASKES Ruang Bayi RB-52 Kelas I A Ismar, dr. Sp.BA 1,286,800
No. Tgl. Masuk HP Nama Pasien No. MR Cara Bayar Kamar Kelas Dokter Sendiri Penanggung Total Diagnosa Kode ICD INACBG
1 20-06-17 15 Tn. JALUDIN MANALU 207094 TOP UP Flamboyan (I- B) Kelas II A Indra, dr. 0 38,005,200 38,005,200 fournier ganggren, abses scrotum, hipoalbumin post N49.2, R77.0, 3,491,900
PTPN nekrotomy+debridement 86.28
2 04-07-17 1 Ny. RISNAWATI 208022 ASKES Flamboyan (I-A) Kelas II A Boekit P, d 0 603,600 603,600
3 04-07-17 1 Ny. NURHAYATI 205317 PBI/JAMKE Flamboyan (II-A) Kelas III Romy Devia 0 4,640,400 4,640,400 cyst et tumor pedis dextra
SMAS/KIS(
4 04-07-17 1 Ny. LENNY LENA 203161 Eksisi)
Badan Flamboyan (II-A) Kelas II A Memmi, dr. 0 5,822,300 5,822,300
Usaha
5 04-07-17 1 Ny. LASTINA 133739 NO Badan Flamboyan (II-A) Kelas II A Memmi, dr. 2,151,260 5,686,650 7,837,910
Usaha
6 03-07-17 2 Tn. SELAMAT SUTRISNO 174232 Kesehatan Flamboyan (II-A) Kelas III Rinelia Min 0 1,962,260 1,962,260 CHF + DM I50.0, E14.9 2,676,800
Mandiri
7 05-07-17 0 An. ADITYA PUTRA PRATAMA 207933 PBI/JAMKE Flamboyan (II-A) Kelas III Ismar, dr. 0 0 0
SMAS/KIS
8 03-07-17 2 Ny. SUPRIANI 144144 Badan Flamboyan (II-A) Kelas II A Khairul Nas 0 1,500,400 1,500,400 abortus imminens O20.0 1,539,300
Usaha
9 04-07-17 1 Ny. SITI SAFA'AH 174411 NO Flamboyan (II-A) Kelas II A Rinelia Min 40,370 675,720 716,090
Kesehatan
10 04-07-17 1 Tn. MUAMMAD MUHAJIR 186131 Mandiri
Badan HCU HCU-A Kelas II Faisal, Dr. 0 738,490 738,490 DHF, GEA, hiponatremi, hipokalemi A91, A09, 2,835,300
Usaha E87.1, E87.6
11 04-07-17 1 Ny. SUSI SUCI YANTI 188890 IN PROSES HCU HCU-C Isolasi B Faisal, Dr. 0 1,774,400 1,774,400 TB paru, ikterik, chf ec. ASD 5,959,400
TOP UP
12 03-07-17 2 Ny. SITI DESMAWATI 207862 PTPN
NKO HCU HCU-D Kelas I Donel, dr. 3,250,000 9,618,240 12,868,240 post sc, peb, IUGR O36.5, O14.1, 7,423,300
O82.9, Z37.0
13 03-07-17 2 Tn. EDI AGUS PITOYO 198816 MITRA HCU HCU-E HCU Faisal, Dr. 0 5,701,250 5,701,250 CKD, anemia, transfusi darah N18.5, D64.9, 3,711,900
MARGIE 99.04
14 04-07-17 1 Ny. SRI MAHDALENA 010485 ASKES Mawar (I-A) Kelas I A Khairul Nas 200,000 455,000 655,000 mola hodatidosa O01.9 2,909,700
15 02-07-17 3 Ny. UMI MARHAMAH 207745 PBI/JAMKE Mawar (II-A) Kelas II A Befimiroza 0 6,782,500 6,782,500 post sc, bsk O82.0, Z37.0, 6,023,900
SMAS/KIS 74.0
16 04-07-17 1 Ny. SUCI HARDIANTI 207806 NO Mawar (II-A) Kelas III Memmi, dr. 46,200 261,120 307,320
Kesehatan
17 01-07-17 4 Ny. ZULFIA NAIDI 196681 Mandiri
NO Badan Mawar (II-A) Kelas II A Befimiroza 3,829,900 7,662,940 11,492,840 ALO, PEB, VE, J81, O14.1, 5,346,100
Usaha O81.4, Z37.0,
73.4
18 04-07-17 1 Tn. RIZAL NATALEO NAPITUPULU 206558 MITRA Mawar (II-A) Kelas II A Boekit P, d 0 831,800 831,800 colic abdomen R10.4 1,753,800
MARGIE
19 04-07-17 1 Tn. SABAR NARIMO 207918 Kesehatan Mawar (II-A) Kelas III Ismar, dr. 0 4,739,300 4,739,300 hidrokel N43.3 2,850,000
Mandiri
20 03-07-17 2 Tn. SYAHRUL 159990 NO Mawar (II-A) Kelas I A Rohani, dr. 1,800,330 2,621,170 4,421,500 PPOK exacerbasi akut J44.1 3,985,500
Kesehatan
21 04-07-17 1 Ny. KASMUNAH BINTI NAAM 186809 Mandiri
TOP UP Mawar (II-A) Kelas II A Boekit P, d 0 1,105,300 1,105,300 anemia, diare, dm E14.9, D64.9 5,804,000
PTPN
22 03-07-17 2 Ny. KAMSIAH BINTI MATSAJARI 207889 TOP UP Mawar (II-A) Kelas II A Asrizal, dr 0 2,974,800 2,974,800 ulkus pedis, dm, infark cerebri, hemiplegi E14.5, I63.9, 7,231,100
PTPN G81.9
23 04-07-17 1 Ny. SITI AISYAH BR. SAMOSIR 190969 TOP UP Mawar (II-A) Kelas II A Boekit P, d 0 1,005,600 1,005,600 diare KUT, ckd on hd, HD N18.5, A09, 3,068,900
PTPN 39.95
24 02-07-17 3 Ny. KHAIRUNNISA 207506 NKO Mawar (VIP) VIP Khairul Nas 0 3,984,320 3,984,320 abortus imminens O20.0
25 27-06-17 8 Ny. ARNIA BINTI KASNO 207479 TOP UP Lavender (I-A) Kelas II A Ismar, dr. 0 18,239,200 18,239,200 peritonitis akut ec pankreatitis, anemia, post LE, TF K65.9, K85, 7,956,500
PTPN D64.9, 54.11,
26 03-07-17 2 Ny. IRDATI BINTI JULIUS SARUJI 202962 TNI NO Lavender (I-A) Kelas I A Ismar, dr. 1,748,770 6,333,560 8,082,330 hemoroid, hemoroidectomy 99.04
I84.2, 49.46 6,433,200
27 04-07-17 1 An. FARID RIZKY ATALLAH 188176 IN PROSES Gardenia (III) Kelas III Dedy S, dr. 761,800 140,140 901,940 GE A09 1,461,500
28 05-07-17 0 An. SYAFIRA ZAHARANIS SYAFLI 207987 POLRI Gardenia (III) Kelas II A Ismar, dr. 0 0 0
29 03-07-17 2 Tn. SUARLIS 207782 Kesehatan Gardenia (III) Kelas III Taufik Hida 0 6,614,600 6,614,600 hernia inguinalis, hernioraphy+mesh K40.9, 53.05 4,706,700
Mandiri
30 03-07-17 2 Tn. KADAI BIN SYAMSUDIN 207807 Kesehatan Gardenia (III) Kelas III Taufik Hida 0 6,555,400 6,555,400 hernia inguinalis, hernioraphy+mesh K40.9, 53.05 4,706,700
Mandiri
31 04-07-17 1 Tn. YOSRIZAL BIN BUYUNG OTO 193888 Kesehatan Gardenia (III) Kelas III Faisal, Dr. 0 3,151,300 3,151,300 stemi, dm tp 2, cad, hiponatremi, efusi pleura, melena
Mandiri
32 04-07-17 1 Tn. BENSON MANALU 122275 PBI/JAMKE Gardenia (III) Kelas III Ismar, dr. 0 5,026,900 5,026,900
SMAS/KIS
33 04-07-17 1 Tn. NOTABELI TELAUNBANUA 201811 MITRA Gardenia (III) Kelas II A Yasri, dr. 0 5,143,300 5,143,300
MARGIE
34 05-07-17 0 Ny. LASDEWATA 124789 IN PROSES Gardenia (III) Kelas III Ismar, dr. 0 98,200 98,200
35 04-07-17 1 Ny. HURTINI 208021 PBI/JAMKE Gardenia (III) Kelas III Afdhal, dr. 0 1,537,290 1,537,290
SMAS/KIS
36 04-07-17 1 Ny. YUSNIDA FITRI 207878 Kesehatan Gardenia (III) Kelas III Memmi, dr. 0 291,400 291,400
Mandiri
37 04-07-17 1 Nn. ITA ROSDELIMA BR TAMBUNAN 208033 IN PROSES Gardenia (III) Kelas III Boekit P, d 0 711,100 711,100
38 04-07-17 1 Ny. LATRI NURAENI IPDAYATI 078723 NO Gardenia (III) Kelas III Khairul Nas 1,410,970 5,286,080 6,697,050
Kesehatan
39 05-07-17 0 Ny. RINI OKTAVIA 206792 Mandiri
IN PROSES Gardenia (III) Kelas III Sari Rahma 0 644,000 644,000
40 05-07-17 0 Ny. TIASINA BR SIMORANGKIR 208036 IN PROSES Gardenia (Isolasi) Kelas II A Faisal, Dr. 0 1,117,500 1,117,500
TOP UP
41 18-06-17 17 Tn. ANGGA PERDANA PUTRA 206896 PTPN
NO Melati (I-A) Kelas I A Rinelia Min 8,865,510 19,896,890 28,762,400 hipoalbumin, hipokalemi, hiponatremi, MS, CHF
Kesehatan
42 03-07-17 2 Tn. TENGKU HENDRI YASIN 207885 Mandiri
MITRA Melati (I-A) Kelas I A Boekit P, d 0 2,555,300 2,555,300 Colic abdomen R104 2,046,000
MARGIE
43 01-07-17 4 Ny. ERNI BINTI MAJI 207706 TOP UP Melati (I-A) Kelas II A Faisal, Dr. 0 8,939,900 8,939,900 dm tipe 2, low intake,
PTPN
44 03-07-17 2 An. RAIHAN AHMAD DWI AULIA 207846 ASKES NO Melati (II-A) Kelas I A Romy Devia 2,038,080 2,010,830 4,048,910 Arthritis HIP M13.95 3,011,500
45 03-07-17 2 Ny. RATINI BINTI SUWARJO 205879 TOP UP Melati (II-A) Kelas II A Yasri, dr. 0 8,295,300 8,295,300 endopthamisis H44.1, 16.39 5,272,600
PTPN
46 04-07-17 1 Ny. KODARIYAH 196395 TOP UP ICU ICU-3 ICU Faisal, Dr. 0 3,721,200 3,721,200 pneumoni, ascites, dm tp 2, hiponatremi, hipoalbumin 7,203,900
PTPN
47 24-06-17 11 By. NY. JULYANI 207362 NKO NICU NICU-3 ICU Nazardi Oyo 0 29,573,530 29,573,530 bb:3.5 kg, HIE, ventilator >4hr, aspiksia, SGN P91.6, P21.0, 17,539,700
P22.0, 96.72,
93.93, 93.90
48 05-07-17 0 By. NY. SITI DESMAWATI 208035 IN PROSES NICU NICU-4 ICU Dedy S, dr. 0 969,200 969,200 BBLRS 1350 gr, SGN, CPAP P07.1, P22.0, 9,719,300
93.90
49 30-06-17 5 An. NAGITA ELISABETH SINAGA 103758 Badan PICU PICU-2 ICU Irawati, dr 0 5,364,900 5,364,900 meningoencephalopathy dd SOL, prolong fever
Usaha
50 27-06-17 8 By. Ny. CICI ANGGRAINI 207511 MITRA BU SCN II ICU Irawati, dr 0 15,824,400 15,824,400 BBLR: 1.2 kg, SGN, prematur, CPAP P07.1, P22.0, 8,330,980
PT. ASTRA 93.90
AGRO
51 21-06-17 14 By. NY. RITA ASMARA I 207205 NO Badan SCN II
LESTARI KLS II Nazardi Oyo 3,990,450 16,002,450 19,992,900 BBLR: 1.6 kg, SGN, prematur, CPAP P07.1, P22.0, 11,657,800
Usaha
(PT.TPP) 93.90
52 21-06-17 14 By. NY. RITA ASMARA II 207207 NO Badan SCN II KLS II Nazardi Oyo 3,023,930 15,950,630 18,974,560 BBLR: 1.6 kg, SGN, prematur, CPAP P07.1, P22.0, 11,657,801
Usaha 93.90
53 04-07-17 1 Ny. YANTI BINTI SUHERMAN 188088 NKO Sakura (VIP) VIP Khairul Nas 3,300,000 7,992,160 11,292,160
54 04-07-17 1 Ny. HENNY DWI SETIANTI 117010 NKO Sakura (VIP) VIP Khairul Nas 4,550,000 7,379,160 11,929,160
55 05-07-17 0 An. ADLI AHZA DANISH 207917 Badan Asoka (II-A) Kelas II A Ismar, dr. 0 0 0 tumor et maxila D48.0 2,734,300
Usaha
56 03-07-17 2 An. MIRZA RAFIF DANADIPTA 128208 Kesehatan Asoka (II-A) Kelas II A Evi Kamelia 0 1,368,400 1,368,400 -
Mandiri
57 04-07-17 1 An. MARIO GILBERT LUMBAN BATU 175113 Badan Asoka (II-A) Kelas II A Dedy S, dr. 360,000 618,700 978,700 susp pneumoni, susp isk 6,003,400
Usaha
58 04-07-17 1 Ny. IRIANI BINTI MUKHLIS 194473 NKO Asoka (PS) VIP Ismar, dr. 0 1,292,360 1,292,360 cholelithiasis
59 04-07-17 1 Ny. AYU DEWITA 043642 NK Badan Asoka (VIP) VIP Faisal, Dr. 0 261,000 261,000 DHF
Usaha
60 03-07-17 2 Ny. HASNATUL MUNAWARAH 125481 NO Asoka (VIP) Kelas I A Khairul Nas 1,652,750 6,937,770 8,590,520 post sc, kpd, bekas sc
Kesehatan
61 Kesehatan
Mandiri
03-07-17 2 Ny. VEBRIA NELA 207284 Mandiri Ruang Bayi RB-3 Kelas II A Donel, dr. 200,000 7,252,200 7,452,200 post sc, PEB 6,362,800
No. Tgl. Masuk HP Nama Pasien No. MR Cara Bayar Kamar Kelas Dokter Total Diagnosa Kode ICD INACBG SELISIH
1 20-06-17 18 Tn. JALUDIN MANALU 207094 TOP UP PTP Flamboyan Kelas II A Indra, dr. Sp.BU 54,007,200 fournier ganggren, abses scrotum, hipoalbumin post nekrotomy+debridement N49.2, 3,491,900 ###
(I- B) 314-A R77.0,
86.28
2 06-07-17 2 Ny. OTRI YANIS 208067 ASKES Flamboyan Kelas I A Donel, dr. 6,997,500
(I-A) 313-A Sp.OG (KFM)
3 05-07-17 3 Ny. SUMA SEMBIRING 208121 TOP UP PTP Flamboyan Kelas II A Faisal, Dr. 7,699,500
(I-A) 313-B Sp.Pd
4 05-07-17 3 Ny. LILIS SUSIANI 049587 Kesehatan MaFlamboyan Kelas III Donel, dr. 6,782,900
(II-A) 310-B Sp.OG (KFM)
5 07-07-17 1 Tn. JOHNY 096003 Kesehatan MaFlamboyan Kelas I A Afdhal, dr. 1,084,600
(II-A) 311-C Sp.BU
6 05-07-17 3 Ny. IRMA SYAHFITRI 141810 Badan Usah Flamboyan Kelas II A Memmi, dr. 6,716,900
(II-A) 312-C Sp.OG
7 04-07-17 4 Ny. SITI SAFA'AH 174411 NO Kesehata Flamboyan Kelas II A Rinelia 5,048,100
(II-A) 312-D Minaswary,dr.
Sp.JP
8 05-07-17 3 Tn. HENDRI BIN BURHAN 182182 NO KesehataHCU HCU-C HCU Rinelia 6,055,620
Minaswary,dr.
Sp.JP
9 06-07-17 2 Ny. ASTRIA HELNI 208227 PBI/JAMKES HCU HCU-D Kelas III Dafnil,dr.Sp.OG 8,602,300
10 03-07-17 5 Tn. EDI AGUS PITOYO 198816 MITRA MARGHCU HCU-E Kelas II B Faisal, Dr. 16,220,550 CKD, anemia, transfusi darah N18.5, 3,711,900 ###
Sp.Pd D64.9,
99.04
11 04-07-17 4 Tn. YOSRIZAL BIN BUYUNG OTO 193888 Kesehatan MaHCU HCU-F HCU Faisal, Dr. 9,626,400 stemi, dm tp 2, cad, hiponatremi, efusi pleura, melena
Sp.Pd
12 05-07-17 3 Tn. HERMANTO BIN SAIPUL 208120 TOP UP PTP HCU HCU-G Kelas II A Rohani, dr. 3,500,700
Sp.P
13 07-07-17 1 Ny. RESDARIAH 112560 Kesehatan MaMawar (I-A) Kelas I A Donel, dr. 7,053,100
407-B Sp.OG (KFM)
14 07-07-17 1 Ny. TRI NURHAYATI 164598 IN PROSES Mawar (II-A) Kelas II A Donel, dr. 5,895,080
402-A Sp.OG (KFM)
15 06-07-17 2 Ny. RIFKA HELEN BR SIMATUPANG 208153 Badan Usah Mawar (II-A) Kelas II A Erik, dr. Sp.OG 6,512,900
402-B
16 07-07-17 1 Ny. DASIKEM BINTI PAIMAN 190026 NO Kesehata Mawar (II-A) Kelas III Rohani, dr. 2,866,350
402-C Sp.P
17 04-07-17 4 Ny. KASMUNAH BINTI NAAM 186809 TOP UP PTP Mawar (II-A) Kelas II A Boekit P, dr. 8,094,100 anemia, diare, dm E14.9, 5,804,000 ###
402-D Sp.PD D64.9
18 04-07-17 4 Tn. RIZAL NATALEO NAPITUPULU 206558 MITRA MARGMawar (II-A) Kelas II A Boekit P, dr. 9,369,400 colic abdomen R10.4 1,753,800 ###
408-B Sp.PD
19 06-07-17 2 Tn. JON RICO H.S 208175 NO Badan U Mawar (II-A) Kelas II A Ismar, dr. 7,135,540
408-C Sp.BA
20 05-07-17 3 Tn. AMSTRONG 207892 NO Badan U Mawar (II-A) Kelas II A Rohani, dr. 7,441,490
408-D Sp.P
21 03-07-17 5 Ny. KAMSIAH BINTI MATSAJARI 207889 TOP UP PTP Mawar (II-A.) Kelas II A Asrizal, dr. 12,359,000 ulkus pedis, dm, infark cerebri, hemiplegi E14.5, 7,231,100 ###
409-B Sp.PD I63.9,
G81.9
22 04-07-17 4 Ny. SITI AISYAH BR. SAMOSIR 190969 TOP UP PTP Mawar (II-A.) Kelas II A Boekit P, dr. 6,625,270 diare KUT, ckd on hd, HD N18.5, 3,068,900 ###
409-C Sp.PD A09, 39.95
23 06-07-17 2 Tn. MUHAMMAD BIN DAUD 208254 NKO Mawar (VIP) VIP Dasril, dr. 8,092,270
405 Sp.PD (KGEH)
24 27-06-17 11 Ny. ARNIA BINTI KASNO 207479 TOP UP PTP Lavender (I- Kelas II A Ismar, dr. 20,132,100 peritonitis akut ec pankreatitis, anemia, post LE, TF K65.9, 7,956,500 ###
A) 413-A Sp.BA K85,
D64.9,
25 07-07-17 1 Tn. MULYONO SAIDI 153706 NKO Lavender VIP Dasril, dr. 2,261,170
(VIP) 411 Sp.PD (KGEH)
26 07-07-17 1 An. ALVIN MORALES SITORUS 208302 Kesehatan MaGardenia (III) Kelas III Ismar, dr. 4,636,400
Gardenia (III) Sp.BA
317-A
27 04-07-17 4 An. FARID RIZKY ATALLAH 188176 NO Kesehata Gardenia (III) Kelas III Dedy S, dr. 4,411,820 GE A09 1,461,500 ###
Gardenia (III) Sp.A
317-B
28 05-07-17 3 An. JIHAN SAUQIA DZAHIN 189254 POLRI Gardenia (III) Kelas II A Dedy S, dr. 1,828,100
Gardenia (III) Sp.A
317-C
29 06-07-17 2 Ny. SEDIANA BR SINAGA 208209 Kesehatan MaGardenia (III) Kelas III Indra, dr. Sp.BU 13,268,800
Gardenia (III)
318-A
30 07-07-17 1 Ny. YESI AMELIA 131858 Kesehatan MaGardenia (III) Kelas III Erik, dr. Sp.OG 5,317,950
Gardenia (III)
318-F
31 07-07-17 1 Ny. ZULMIYENTI 206983 Badan Usah Gardenia (III) Kelas I A Ismar, dr. 1,805,500
Gardenia (III) Sp.BA
318-J
32 04-07-17 4 Ny. HURTINI 208021 PBI/JAMKES Gardenia (III) Kelas III Afdhal, dr. 12,647,390
Gardenia (III) Sp.BU
319-C
33 07-07-17 1 Ny. SITI MESRAWATI MUSLIMAH 208264 Kesehatan MaGardenia (III) Kelas III Erik, dr. Sp.OG 5,151,720
Gardenia (III)
319-G
34 07-07-17 1 Ny. RACHMAWATI WULANDARI 208271 PBI/JAMKES Gardenia (III) Kelas III Donel, dr. 5,179,200
Gardenia (III) Sp.OG (KFM)
319-I
35 07-07-17 1 Tn. SUTRISNO SLAMET 051013 Kesehatan MaMelati (I-A) Kelas I A Taufik Hidayat. 4,941,600
306-A dr, SpB
36 03-07-17 5 Ny. RATINI BINTI SUWARJO 205879 TOP UP PTP Melati (I-A) Kelas II A Yasri, dr. Sp.M 10,549,900 endopthamisis H44.1, 5,272,600 ###
307-A 16.39
37 05-07-17 3 Ny. TIASINA BR SIMORANGKIR 208036 TOP UP PTP Melati (I-A) Kelas II A Faisal, Dr. 11,313,500
307-B Sp.Pd
38 05-07-17 3 An. IMANUEL NAINGGOLAN 208143 TOP UP PTP Melati (II-A) Kelas II A Fahrul H, dr. 14,305,700
302-B Sp.BP
39 07-07-17 1 Tn. FEBRY SYAHPUTRA LUBIS 208369 IN PROSES Melati (II-A) Kelas II A Faisal, Dr. 1,750,200
308-A Sp.Pd
40 06-07-17 2 Tn. JONI BIN RAMLI 191175 Badan Usah Melati (II-A) Kelas II A Asrizal, dr. 3,124,800
308-B Sp.PD
41 07-07-17 1 Tn. BAHARUDIN 208353 IN PROSES Melati (II-A) Kelas I A Indra, dr. Sp.BU 734,600
308-C
42 06-07-17 2 Ny. MARDIANA SIMBOLON 208149 IN PROSES Melati (II-A.) Kelas II A Dafnil,dr.Sp.OG 6,662,900
309-A
43 07-07-17 1 Ny. WITRI HANDAYANI 208345 Badan Usah Melati (II-A.) Kelas II A Khairul Nasir, 7,074,200
309-B dr. Sp.OG
44 07-07-17 1 Ny. ELFA SUSANTI 113579 Badan Usah Melati (II-A.) Kelas II A Donel, dr. 6,429,490
309-C Sp.OG (KFM)
45 05-07-17 3 Ny. SITI KHADIJAH 193950 NKO Melati (VIP) VIP Elvina, dr. Sp.S 6,233,300
305
46 04-07-17 4 Ny. KODARIYAH 196395 TOP UP PTP ICU ICU-3 Kelas II A Faisal, Dr. 14,061,800 pneumoni, ascites, dm tp 2, hiponatremi, hipoalbumin 7,203,900 ###
Sp.Pd
47 05-07-17 3 Ny. EVA NOVRITA 156693 PBI/JAMKES ICU ICU-6 ICU Faisal, Dr. 15,202,180
Sp.Pd
48 24-06-17 14 By. NY. JULYANI 207362 NKO NICU NICU-3 ICU Nazardi Oyong, 39,704,680 bb:3.5 kg, HIE, ventilator >4hr, aspiksia, SGN P91.6, 17,539,700 ###
dr. Sp.A P21.0,
P22.0,
49 08-07-17 0 Ny. SYAMSIMAR BINTI NURBIT 208382 ASKES NO PICU PICU-1 ICU Riky, dr. Sp.S 928,130 96.72,
93.93,
93.90
50 30-06-17 8 An. NAGITA ELISABETH SINAGA 103758 Badan Usah PICU PICU-2 Kelas II A Irawati, dr.SpA 8,245,200 meningoencephalopathy dd SOL, prolong fever
51 27-06-17 11 By. Ny. CICI ANGGRAINI 207511 MITRA BU PTSCN II SCN ICU Irawati, dr.SpA 18,696,900 BBLR: 1.2 kg, SGN, prematur, CPAP P07.1, 8,330,980 ###
II-1 P22.0,
93.90
52 21-06-17 17 By. NY. RITA ASMARA I 207205 NO Badan U SCN II SCN ICU Nazardi Oyong, 21,670,260 BBLR: 1.6 kg, SGN, prematur, CPAP P07.1, 11,657,800 ###
II-10 dr. Sp.A P22.0,
93.90
53 21-06-17 17 By. NY. RITA ASMARA II 207207 NO Badan U SCN II SCN ICU Nazardi Oyong, 20,785,650 BBLR: 1.6 kg, SGN, prematur, CPAP P07.1, 11,657,801 ###
II-2 dr. Sp.A P22.0,
93.90
54 07-07-17 1 Ny. RITA ASMARA 103089 NO Badan U SCN II SCN ICU Boekit P, dr. 3,624,590
II-7 Sp.PD
55 07-07-17 1 An. MOEKHAMAD YUNUS 208276 Badan Usah Asoka (II-A) Kelas II A Taufik Hidayat. 4,469,600
602-B dr, SpB
56 06-07-17 2 An. ZAKI AMIRUDIN 011266 Kesehatan MaAsoka (II-A) Kelas III Evi Kamelia, dr. 1,383,300
602-D Sp.A
57 04-07-17 4 Ny. IRIANI BINTI MUKHLIS 194473 NKO Asoka (PS) VIP Ismar, dr. 27,284,430 cholelithiasis
601 Sp.BA
58 05-07-17 3 Ny. ELMIATI 040545 NKO Asoka (VIP) VIP Memmi, dr. 13,848,720
605 Sp.OG
59 07-07-17 1 An. RASYIF IQBAL ALQAIS 208307 NKO Asoka (VIP) VIP Evi Kamelia, dr. 1,123,540
606 Sp.A
60 04-07-17 4 Ny. AYU DEWITA 043642 NK Badan U Asoka (VIP) VIP Faisal, Dr. 5,325,970 DHF
608 Sp.Pd
61 07-07-17 1 An. ZAYAN KAMIL IBRAHIM 208268 IN PROSES Asoka (VIP) VIP Ismar, dr. 10,469,640
609 Sp.BA
62 06-07-17 2 Ny. MANISTA SEMBIRING 208195 TOP UP PTP Asoka (VIP) Kelas I A Faisal, Dr. 2,757,700
610 Sp.Pd
63 07-07-17 1 Ny. REHKA AYUDIA WATI 206974 NO Badan U Asoka (VIP) Kelas I A Khairul Nasir, 8,786,500
611 dr. Sp.OG
64 05-07-17 3 Ny. EMI WIDAYU 171823 NKO Sakura (PS) President Suite Khairul Nasir, 16,723,080
502 dr. Sp.OG
65 05-07-17 3 Ny. YANE MARGARET 059490 NKO Sakura (VIP) VIP Khairul Nasir, 12,959,740
503 dr. Sp.OG
66 07-07-17 1 Ny. MIRTA YOLANDA 034389 NKO Sakura (VIP) VIP Donel, dr. 12,131,750
504 Sp.OG (KFM)
67 06-07-17 2 Ny. RIKA NELVIA 116580 NKO Sakura (VIP) VIP Khairul Nasir, 5,665,980
505 dr. Sp.OG
68 07-07-17 1 Ny. MARTI LAILI 208261 ASKES NO Ruang Bayi Kelas I A Donel, dr. 4,268,960
RB-46 Sp.OG (KFM)
69 07-07-17 1 Ny. RIZA AGHNIYA'A ILMA 197757 IN PROSES Ruang Bayi VIP Memmi, dr. 818,300
RB-46 Sp.OG
70 07-07-17 1 Ny. LINA PLIA 189354 IN PROSES Ruang Bayi Kelas II A Erik, dr. Sp.OG 5,878,600
RB-49
71 07-07-17 1 Ny. DIAN SANDRA 208090 Badan Usah Ruang Bayi Kelas II A Erik, dr. Sp.OG 5,851,800
RB-51
72 02-07-17 6 Ny. KHAIRUNNISA 207506 NKO Ruang Bayi VIP Khairul Nasir, 7,186,680 abortus imminens O20.0 ###
RB-56 dr. Sp.OG
73 07-07-17 1 Ny. HETI ASTUTI 178119 NO Kesehata Ruang Bayi Kelas I A Khairul Nasir, 7,429,520
RB-57 dr. Sp.OG
74 04-07-17 4 Tn. MUAMMAD MUHAJIR 186131 Badan Usah Ruang Bayi Kelas II A Faisal, Dr. 6,607,990 DHF, GEA, hiponatremi, hipokalemi A91, A09, 2,835,300 ###
RB-60 Sp.Pd E87.1,
E87.6
No. Tgl. Masuk HP Nama Pasien No. MR Cara Bayar Kamar Kelas Dokter Sendiri Penanggung Total Diagnosa Kode ICD INACBG SELISIH
1 20-06-17 20 Tn. JALUDIN MANALU 207094 TOP UP P Flamboy Kelas II A Indra, dr. 0 54,692,100 54,692,100 fournier ganggren, abses scrotum, hipoalbumin post nekrotomy+debridement N49.2, R77.0, 86.28 3,491,900 ###
Sp.BU
2 05-07-17 5 Tn. HERMANTO BIN SAIPUL 208120 TOP UP P Flamboy Kelas II A Rohani, dr. 0 6,996,300 6,996,300
Sp.P
3 08-07-17 2 Ny. HERLINA 208450 IN PROSE Flamboy Kelas I A Khairul Nasir, 0 7,082,500 7,082,500
dr. Sp.OG
4 09-07-17 1 Ny. RAHMANIYAH 068514 IN PROSE Flamboy Kelas II A Khairul Nasir, 1,593,790 5,882,080 7,475,870
dr. Sp.OG
5 04-07-17 6 Ny. SITI SAFA'AH 174411 NO KesehaFlamboy Kelas II A Rinelia 2,133,350 4,552,620 6,685,970
Minaswary,dr.
Sp.JP
6 09-07-17 1 Tn. M. ADI PRIYANTO 208483 IN PROSE HCU Taufik Hidayat. 0 15,314,500 15,314,500
dr, SpB
7 05-07-17 5 Tn. HENDRI BIN BURHAN 182182 NO KesehaHCU Rinelia 2,120,520 5,730,150 7,850,670
Minaswary,dr.
Sp.JP
8 04-07-17 6 Ny. KASMUNAH BINTI NAAM 186809 TOP UP P Mawar Kelas II A Boekit P, dr. 0 10,665,900 10,665,900 anemia, diare, dm E14.9, D64.9 5,804,000 ###
Sp.PD
9 10-07-17 0 Tn. ARFAN 208521 ASKES N Mawar Kelas I A Afdhal, dr. 345,740 1,254,170 1,599,910
Sp.BU
10 06-07-17 4 Tn. JON RICO H.S 208175 NO Badan Mawar Kelas II A Ismar, dr. 3,377,110 6,629,110 10,006,220
Sp.BA
11 03-07-17 7 Ny. KAMSIAH BINTI MATSAJARI 207889 TOP UP P Mawar Kelas II A Asrizal, dr. 0 13,967,100 13,967,100 ulkus pedis, dm, infark cerebri, hemiplegi E14.5, I63.9, G81.9 7,231,100 ###
Sp.PD
12 04-07-17 6 Ny. SITI AISYAH BR. SAMOSIR 190969 TOP UP P Mawar Kelas II A Boekit P, dr. 70,000 8,576,970 8,646,970 diare KUT, ckd on hd, HD N18.5, A09, 39.95 3,068,900 ###
Sp.PD
13 06-07-17 4 Tn. MUHAMMAD BIN DAUD 208254 NKO Mawar Dasril, dr. 0 16,298,940 16,298,940
Sp.PD (KGEH)
14 09-07-17 1 Tn. MUHAMMAD KHAIRIANDI 207518 IN PROSE Mawar Asrizal, dr. 0 1,366,000 1,366,000
Sp.PD
15 10-Jul-17 Ny. ELIMPA HUNJI EMI ASKES Mawar 0 0 - -
16 27-06-17 13 Ny. ARNIA BINTI KASNO 207479 TOP UP P Lavender Kelas II A Ismar, dr. 0 21,288,200 21,288,200 peritonitis akut ec pankreatitis, anemia, post LE, TF K65.9, K85, D64.9, 7,956,500 ###
Sp.BA 54.11, 99.04
17 09-07-17 1 Ny. SUMARNI 195503 IN PROSE Lavender Kelas II A Dasril, dr. 0 6,637,100 6,637,100
Sp.PD (KGEH)
18 08-07-17 2 Tn. SULTAN SALADIN 208465 IN PROSE Lavender Kelas II A Taufik Hidayat. 0 3,001,500 3,001,500
dr, SpB
19 07-07-17 3 Tn. FEBRY SYAHPUTRA LUBIS 208369 IN PROSE Lavender Kelas II A Faisal, Dr. 0 2,645,900 2,645,900
Sp.Pd
20 07-07-17 3 Tn. MULYONO SAIDI 153706 NKO Lavender Dasril, dr. 0 7,509,810 7,509,810
Sp.PD (KGEH)
21 09-07-17 1 An. FATHIR ALFANUR 069900 NO KesehaGardenia Kelas III Evi Kamelia, 698,170 349,190 1,047,360
dr. Sp.A
22 06-07-17 4 Ny. SEDIANA BR SINAGA 208209 NO KesehaGardenia Kelas III Indra, dr. 827,970 14,550,260 15,378,230
Sp.BU
23 05-07-17 5 Ny. EVA NOVRITA 156693 PBI/JAMK Gardenia Kelas III Faisal, Dr. 7,934,350 11,263,130 19,197,480
Sp.Pd
24 06-07-17 4 Ny. ASTRIA HELNI 208227 IN PROSE Gardenia Kelas III Dafnil,dr.Sp.O 760,000 9,574,500 10,334,500
G
25 09-07-17 1 Ny. BERLIANA 021047 IN PROSE Gardenia Kelas III Khairul Nasir, 126,640 457,020 583,660
dr. Sp.OG
26 07-07-17 3 Tn. SUTRISNO SLAMET 051013 Kesehatan Melati Kelas I A Taufik Hidayat. 0 7,607,100 7,607,100
dr, SpB
27 09-07-17 1 Ny. SITI PATIMAH 208510 MITRA BU Melati Kelas I A Ismar, dr. 0 839,000 839,000
Sp.BA
28 07-07-17 3 Tn. BAHARUDIN 208353 ASKES Melati Kelas I A Indra, dr. 0 13,223,500 13,223,500
Sp.BU
29 09-07-17 1 Tn. ALADIN 208506 NO KesehaMelati Kelas II A Boekit P, dr. 1,326,380 580,210 1,906,590
Sp.PD
30 04-07-17 6 Ny. KODARIYAH 196395 TOP UP P Melati Kelas II A Faisal, Dr. 0 20,129,500 20,129,500 pneumoni, ascites, dm tp 2, hiponatremi, hipoalbumin 7,203,900 ###
Sp.Pd
31 05-07-17 5 Ny. SITI KHADIJAH 193950 NKO Melati Elvina, dr. Sp.S 0 9,984,720 9,984,720
32 08-07-17 2 Ny. DARYUNITA 208467 NKO ICU Rinelia 0 12,644,790 12,644,790

Minaswary,dr.
Sp.JP
33 24-06-17 16 By. NY. JULYANI 207362 NKO NICU Nazardi 0 42,707,890 42,707,890 bb:3.5 kg, HIE, ventilator >4hr, aspiksia, SGN P91.6, P21.0, P22.0, 17,539,700 ###
Oyong, dr. 96.72, 93.93, 93.90
Sp.A
34 08-07-17 2 Ny. SYAMSIMAR BINTI NURBIT 208382 ASKES N PICU Riky, dr. Sp.S 8,674,690 5,563,990 14,238,680
35 30-06-17 10 An. NAGITA ELISABETH SINAGA 103758 Badan Us PICU Irawati, dr.SpA 0 9,822,200 9,822,200 meningoencephalopathy dd SOL, prolong fever
36 27-06-17 13 By. Ny. CICI ANGGRAINI 207511 MITRA BU SCN Irawati, dr.SpA 0 20,054,400 20,054,400 BBLR: 1.2 kg, SGN, prematur, CPAP P07.1, P22.0, 93.90 8,330,980 ###
37 09-07-17 1 Tn. DAHLIL DALIMI 208476 NKO SCN Taufik Hidayat. 0 2,138,110 2,138,110
dr, SpB
38 07-07-17 3 Ny. RITA ASMARA 103089 NO Badan SCN Boekit P, dr. 7,211,000 12,312,490 19,523,490
Sp.PD
39 07-07-17 3 Ny. MIRTA YOLANDA 034389 NKO Sakura Donel, dr. 5,250,000 8,950,860 14,200,860
Sp.OG (KFM)
40 09-07-17 1 Ny. KHAIRUNNISA 207506 IN PROSE Sakura Khairul Nasir, 0 699,450 699,450 abortus imminens O20.0
dr. Sp.OG
41 07-07-17 3 Ny. RIZA AGHNIYA'A ILMA 197757 IN PROSE Sakura Memmi, dr. 0 8,632,250 8,632,250
Sp.OG
42 07-07-17 3 An. MOEKHAMAD YUNUS 208276 Badan Us Asoka Kelas II A Taufik Hidayat. 0 6,289,900 6,289,900
dr, SpB
43 09-07-17 1 An. MUQAFFI BIRRU 193542 Badan Us Asoka Kelas II A Evi Kamelia, 0 1,274,800 1,274,800
dr. Sp.A
44 04-07-17 6 Ny. IRIANI BINTI MUKHLIS 194473 NKO Asoka Ismar, dr. 0 30,931,500 30,931,500 cholelithiasis
Sp.BA
45 09-07-17 1 An. SARAH NUR RAUDA 172729 NKO Asoka Evi Kamelia, 0 586,500 586,500
dr. Sp.A
46 08-07-17 2 An. SARAH HAFIZAH 178792 BU MITRA Asoka Kelas I A Dedy S, dr. 0 3,868,200 3,868,200
Sp.A
47 07-07-17 3 An. ZAYAN KAMIL IBRAHIM 208268 IN PROSE Asoka Ismar, dr. 0 14,984,730 14,984,730
Sp.BA
48 06-07-17 4 Ny. MANISTA SEMBIRING 208195 TOP UP P Asoka Kelas I A Faisal, Dr. 0 4,278,500 4,278,500
Sp.Pd
49 08-07-17 2 By. NY. CHINDY CLAUDIA ANDERSEN 207661 Badan Us Ruang BaKelas II A Evi Kamelia, 0 577,000 577,000
dr. Sp.A
50 09-07-17 1 By. NY. CICI PONILAWA 208484 NKO Ruang BaKelas III Nazardi 0 268,490 268,490
Oyong, dr.
Sp.A
51 07-07-17 3 By. NY. MIRTA YOLANDA 208272 NKO Ruang Bayi Dedy S, dr. 0 403,560 403,560
Sp.A
52 10-07-17 0 An. GWEN SYAREEFA APRILIA 208522 Badan Us Ruang BaKelas II A Dedy S, dr. 0 330,400 330,400
Sp.A
53 08-07-17 2 Ny. CICI PONILAWA 009369 IN PROSE Ruang Bayi Khairul Nasir, 0 5,564,350 5,564,350
dr. Sp.OG
54 08-07-17 2 An. SYAFIRA ULI L TOBING 063531 Badan Us Ruang BaKelas II A Evi Kamelia, 0 1,928,300 1,928,300
dr. Sp.A
55 10-07-17 0 Ny. INDAH MULIA SRI REZKI 169583 IN PROSE Ruang BaKelas II A Memmi, dr. 0 0 -
Sp.OG
No. Tgl. Masuk HP Nama Pasien No. MR Kam Kelas Dokter Total Diagnosa Kode ICD INACBG
ar
1 20-06-17 21 Tn. JALUDIN MANALU 207094 TOP UP Flam Kelas II Indra, dr. 55,159,400 fournier ganggren, abses scrotum, hipoalbumin post nekrotomy+debridement, anemia, TIL, hipoalbumin, medial thigh N49.2, R77.0,D64.9 86.28, 14,116,800
PTPN boya A Sp.BU vescularized flap+dkin graf 86.70, 99.04
n
4 10-07-17 1 Ny. ZULHEFA MARYAM 208572 Kesehatan Flam Kelas III Khairul 5,210,500 post sc, ptm, kpd O42.9, O82.9, Z37.0, 74.0 5,019,900
Mandiri boya Nasir, dr.
5 10-07-17 1 Tn. TITAPRI 187138 Kesehatan nFlam Kelas II Sp.OG
Indra, dr. 12,317,400 post ureteral meaotomy, turp, bph N40, 56.1, 60.29 8,788,600
Mandiri boya A Sp.BU
6 09-07-17 2 Ny. RAHMANIYAH 068514 IN PROSES n
Flam Kelas II Khairul 8,181,590 post sc, bsk, pprom O34.2, O82.0, Z37.0, 74.0 6,023,900
boya A Nasir, dr.
7 10-07-17 1 Ny. ROZA ELFITA,S.PT 189411 IN PROSES nFlam Kelas I Sp.OG
Befimiroza 2,219,870 psp O80.9, 73.59 2,247,800
boya A Adam, dr.
8 10-07-17 1 Ny. SHALLY FEBRINDAH 204853 ASKES NO Flamn Sp.OGP, dr.
Kelas I Boekit 1,696,710 chf I50.0 3,747,500
boya A Sp.PD
9 10-07-17 1 An. BELLA SEPHIA 208562 n
Badan Usaha Flam Kelas II Romy 11,879,100 post orif
ANGGRAINI boya A Deviandri,
10 11-07-17 0 Tn. FAHRIZAL AHMAD 197456 IN PROSES nHCU Kelas II dr.Sp.OT
Asrizal, dr. 1,239,000 ckd on hd, anemia, ALO, hiperkalemi, asidosis metabolik N18.9, D64.9, J81, E87.5, 5,459,700
TOP UP Sp.PD E87.2
PTPN
11 10-07-17 Ny. ELIMPA HUNJI EMI 208400 ASKES Maw 5,045,800 tumor mammae, eksisi D48.6, 85.21
ar
12 11-07-17 0 Ny. LEVI AGUSTINA 078534 Kesehatan Maw Kelas I Ariman 96,000 sinusitis maksilaris J32.0 2,657,300
Mandiri ar A Syukri, dr.
13 10-07-17 1 Tn. ROMDONI 208539 Badan Usaha Maw Kelas II Sp THT
Taufik 4,271,100 tumor scapula, eksisi D48.5, 86.3 4,610,500
ar A Hidayat. dr,
14 10-07-17 1 Tn. SUARDI MS 208557 TOP UP Maw Kelas II SpB dr.
Asrizal, 1,298,300 febris, dd/ selulitis cruris L02 1,574,500
PTPN ar A Sp.PD
15 03-07-17 8 Ny. KAMSIAH BINTI 207889 TOP UP Maw Kelas II Asrizal, dr. 17,777,700 ulkus pedis, dm, infark cerebri, hemiplegi E14.5, I63.9, G81.9 7,231,100
MATSAJARI PTPN ar A Sp.PD
16 04-07-17 7 Ny. SITI AISYAH BR. 190969 TOP UP Maw Kelas II Boekit P, dr. 9,760,570 diare KUT, ckd on hd, HD N18.5, A09, 39.95 3,068,900
SAMOSIR PTPN ar A Sp.PD
17 09-07-17 2 Tn. MUHAMMAD 207518 NKO Maw Asrizal, dr. 3,929,790 ikterik, ruptur hepar R17, S36.1
KHAIRIANDI ar Sp.PD
18 27-06-17 14 Ny. ARNIA BINTI KASNO 207479 TOP UP Lave Kelas II Ismar, dr. 21,805,100 peritonitis akut ec pankreatitis, anemia, post LE, TF K65.9, K85, D64.9, 54.11, 7,956,500
PTPN nder A Sp.BA 99.04
19 04-07-17 7 Ny. KASMUNAH BINTI 186809 TOP UP Lave Kelas II Asrizal, dr. 13,813,200 anemia, diare, dm E14.9, D64.9 5,804,000
NAAM PTPN nder A Sp.PD
20 10-07-17 1 Tn. SUKIRMAN 165447 IN PROSES Lave Kelas II Syafrudin, 1,084,300 paraparese ec. Syrongomyelia level c-7, mri columna G95.0, G82.2 4,106,700
nder A dr. Sp.OT
21 09-07-17 2 Tn. M. ADI PRIYANTO 208483 MITRA BU Lave Kelas II Taufik 17,852,700
PT. ASTRA nder A Hidayat. dr,
22 09-07-17 2 Ny. SUMARNI 195503 AGRO
TOP UP Lave SpB dr.
Dasril, 11,303,100 ascites, anemia, hipoalbumin, sirosi hepatis 4,535,900
LESTARI
PTPN NK nder Sp.PD
23 09-07-17 2 An. FATHIR ALFANUR 069900 (PT.EDI)
NO Gard Kelas III (KGEH)
Evi Kamelia, 2,136,090 BP J18.0 3,463,500
Kesehatan enia dr. Sp.A
24 10-07-17 1 An. GWEN SYAREEFA 208522 Mandiri
Badan Usaha Gard Kelas II Dedy S, dr. 1,182,000 gea A09 1,753,800
APRILIA enia A Sp.A
26 05-07-17 6 Ny. EVA NOVRITA 156693 PBI/JAMKES Gard Kelas III Faisal, Dr. 22,217,080 ca. paru, efusi pleura, hiponatremi C34.9, J90, E87.1 6,559,200
MAS/KIS enia Sp.Pd
27 10-07-17 1 Ny. MIRAWATI BINTI 208621 Kesehatan Gard Kelas III Befimiroza 312,600 prematur kontraksi O47.0 1,562,100
MASNI Mandiri enia Adam, dr.
28 06-07-17 5 Ny. ASTRIA HELNI 208227 IN PROSES Gard Kelas III Sp.OG
Dafnil,dr.Sp. 10,907,100
enia OG
29 09-07-17 2 Ny. BERLIANA 021047 Kesehatan Gard Kelas III Khairul 3,413,660 partus normal, gemeli 73.59 1,900,300
Mandiri enia Nasir, dr.
30 10-07-17 1 Ny. AJIRNA 208574 Kesehatan Gard Kelas III Sp.OG
Befimiroza 5,144,700
Mandiri enia Adam, dr.
31 10-07-17 1 Tn. ZAINUDDIN 208468 COB PT. Gard Kelas I Sp.OG
Elvina, dr. 2,030,500
POS enia A Sp.S
INDONESIA
ar
32 08-07-17 3 Ny. DARYUNITA 208467 NKO ICU Rinelia 13,910,930
Minaswary,d
33 24-06-17 17 By. NY. JULYANI 207362 NKO r. Sp.JP
NICU Kelas II Nazardi 48,837,190 bb:3.5 kg, HIE, ventilator >4hr, aspiksia, SGN umur 0 hr P91.6, P21.0, P22.0, 96.72, 17,539,700
A Oyong, dr. 93.93, 93.90
Sp.A
34 08-07-17 3 Ny. SYAMSIMAR BINTI 208382 ASKES NO PICU Riky, dr. 20,030,450 spontaneus ICH, SAB ec aneurysm ruptur, IVH
NURBIT Sp.S
35 30-06-17 11 An. NAGITA ELISABETH 103758 Badan Usaha PICU Irawati, 10,864,000 meningoencephalopathy dd SOL, prolong fever
SINAGA dr.SpA
36 27-06-17 14 By. Ny. CICI ANGGRAINI 207511 MITRA BU SCN Irawati, 20,783,100 BBLR: 1.2 kg, SGN, prematur, CPAP P07.1, P22.0, 93.90 8,330,980
PT. ASTRA dr.SpA
37 07-07-17 4 Ny. RITA ASMARA 103089 AGRO
NO Badan SCN Boekit P, dr. 23,834,930
LESTARI
Usaha Sp.PD
38 10-07-17 1 Tn. AROFATI MENDROFA 208556 (PT.TPP)
IN PROSES Melat Kelas II Afdhal, dr. 1,362,900
TOP UP i A Sp.BU
39 09-07-17 2 Ny. SITI PATIMAH 208510 PTPN
MITRA BU Melat Kelas I Ismar, dr. 10,236,300 appendicitis akut, app-tomy K35.8, 47.09 4,060,500
PT. ASTRA i A Sp.BA
40 10-07-17 1 An. MUHAMMAD ILHAM 202348 AGRO
TOP UP Melat Kelas II Romy 5,744,900
LESTARI
PTPN i A Deviandri,
41 10-07-17 1 An. SITI NURAISYAH 208579 (PT.KTU)
Badan Melat Kelas II dr.Sp.OT
Ismar, dr. 5,608,800
Usaha(Eksisi i A Sp.BA
42 07-07-17 4 Tn. BAHARUDIN 208353 )ASKES Melat Kelas I Indra, dr. 13,735,200
i A Sp.BU
43 10-07-17 1 Tn. AMINULLAH BIN ZUHDI 195600 TOP UP Melat Kelas II Asrizal, dr. 981,000 dyspepsia 1,808,000
PTPN i A Sp.PD
44 09-07-17 2 Tn. ALADIN 208506 NO Melat Kelas II Boekit P, dr. 5,451,960 gastritis erosif 2,668,200
Kesehatan i A Sp.PD
45 04-07-17 7 Ny. KODARIYAH 196395 Mandiri
TOP UP Melat Kelas II Faisal, Dr. 23,709,600 pneumoni, ascites, dm tp 2, hiponatremi, hipoalbumin E11.9, R18, J18.9, E87.1, 7,203,900
PTPN i A Sp.Pd R77.0,
46 10-07-17 1 Ny. NURJANAH 208635 IN PROSES Melat Kelas III Memmi, dr. 191,500
i Sp.OG
47 10-07-17 1 Tn. ZAINAL ARIFIN 208634 IN PROSES Melat Kelas I Ramzi, dr. 6,416,080 gangren dm, amputasu bwh lutut) E11.5, 8415 9,965,600
i A Sp.B (K)
48 09-07-17 2 Tn. DAHLIL DALIMI 208476 NKO Melat Ismar, dr. 6,340,270
i Sp.BA
49 08-07-17 3 Ny. CICI PONILAWA 009369 NKO Sakur Khairul 5,688,660
a Nasir, dr.
50 09-07-17 2 Ny. KHAIRUNNISA 207506 IN PROSES Sakur Sp.OG
Khairul 3,540,440 abortus imminens O20.0
a Nasir, dr.
51 09-07-17 2 An. MUQAFFI BIRRU 193542 Badan Usaha Asok Kelas II Sp.OG
Evi Kamelia, 1,622,400
a A dr. Sp.A
52 04-07-17 7 Ny. IRIANI BINTI MUKHLIS 194473 NKO Asok Ismar, dr. 33,139,460 cholelithiasis
a Sp.BA
53 09-07-17 2 An. SARAH NUR RAUDA 172729 NKO Asok Evi Kamelia, 2,963,150
a dr. Sp.A
54 08-07-17 3 An. SARAH HAFIZAH 178792 BU MITRA Asok Kelas I Dedy S, dr. 5,335,700
WILMAR a A Sp.A
55 07-07-17 4 An. ZAYAN KAMIL IBRAHIM 208268 (PT.MSS)
IN PROSES Asok Ismar, dr. 17,043,060
a Sp.BA
56 10-07-17 1 An. MUHAMMAD FALKEN 161215 Badan Usaha Asok Kelas II Ismar, dr. 5,287,300
PRANAJA a A Sp.BA
57 11-07-17 0 An. NADIRA ARSYIFA 170321 Kesehatan Kelas II Evi Kamelia, 222,700
YULHENDRI Mandiri A dr. Sp.A
58 10-07-17 1 Tn. SUKARDI II 208575 Badan Usaha Kelas II Indra, dr. 697,300
A Sp.BU
59 10-07-17 1 Ny. SITI NURHEMA AYU 121130 NO Badan Kelas II Asrizal, dr. 961,660
Usaha A Sp.PD
60 08-07-17 3 An. SYAFIRA ULI L TOBING 063531 Badan Usaha Kelas II Evi Kamelia, 2,514,200
A dr. Sp.A
ar
61 10-07-17 1 Tn. DENDY FRI YANTO 204243 Badan Usaha Kelas II Indra, dr. 2,524,600
A Sp.BU
1 20-06-17 22 Tn. JALUDIN MANALU 207094 TOP UP P Flambo Kelas II A Indra, dr. 24,800 55,804,700 55,829,500 fournier ganggren, abses scrotum, hipoalbumin post nekrotomy+debridement, anemia, TIL, N49.2, R77.0,D64.9 14,116,800 ###
hipoalbumin, medial thigh vescularized flap+dkin graf 86.28, 86.70, 99.04
2 11-07-17 1 Ny. NENI PUTRI WARTI 075940 Badan Usa Flambo Kelas I A Memmi, dr 0 271,900 271,900 partus normal O80.9, Z37.0, 73.59 2,247,800 1,975,900
3 10-07-17 2 Ny. ZULHEFA MARYAM 208572 Kesehatan Flambo Kelas III Khairul Nas 0 5,497,100 5,497,100 post sc, ptm, kpd O42.9, O82.9, Z37.0, 5,019,900 (477,200)
74.0
4 11-07-17 1 Ny. NURSIAH 044070 Badan Usa Flambo Kelas II A Ismar, dr. 0 5,218,400 5,218,400 tumor mammae, eksisi D48.6, 85.21 6,052,700 834,300
5 11-07-17 1 Ny. RENI LUKMAN 208410 NO KesehatFlambo Kelas I A Dasril, dr 1,114,520 572,840 1,687,360 dyspepsia, pneumonia K30, J18.9 3,083,000 1,395,640
6 11-07-17 1 Ny. KELEMENTINA BR TAMPUBO 208739 IN PROSE Flambo Kelas II A Khairul Nas 0 384,850 384,850 Ruptur vagina, laserasi vagina grade III post delivery, repair vagina O71.4, 75.69 1,840,300 1,455,450
7 11-07-17 1 Ny. LAMRIA BR SIMAMORA 206001 IN PROSE Flambo Kelas II A Afdhal, dr. 0 2,513,200 2,513,200 Batu ureter, ESWL N20.1, 98.51 8,788,600 6,275,400
8 10-07-17 2 An. BELLA SEPHIA ANGGRAINI 208562 Badan Usa Flambo Kelas II A Romy Devia 200,000 13,130,700 13,330,700 # femur, transfusi darah, post orif S72.9, 99.04, 11,444,800 ###
9 11-07-17 1 Ny. SRI PURWANTI 208714 NO KesehatHCU Donel, dr. 182,050 439,550 621,600 (621,600)
Sp.OG
10 12-07-17 0 Ny. HARMIALIS BINTI SYAFRUDDI 206703 Badan Usa HCU Kelas II A (KFM)
Ariman Syu 0 116,100 116,100 sinusitis maksilaris , plan: AWO J32.0 2,277,700 2,161,600
11 12-07-17 0 An. INTAN NURAINI 206056 IN PROSE HCU Kelas II A Ariman Syu 0 0 0 tonsilitis kronis, tonsilektomy J35.0, 28.2 4,426,400 4,426,400
12 11-07-17 1 Ny. ELISA FANNI HUTAGALUNG 108914 NO Badan Mawar Kelas II A Donel, dr. 1,181,000 5,547,930 6,728,930 post SC, bekas sc O82.0 6,023,900 (705,030)
13 11-07-17 1 Ny. RITA DEWI 186583 IN PROSESMawar Kelas II A Asrizal, dr 0 618,200 618,200 CKD stage V on hd, vomitus N18.5, R11 3,068,900 2,450,700
14 11-07-17 1 Ny. LEVI AGUSTINA 078534 Kesehatan Mawar Kelas I A Ariman Syu 0 3,918,900 3,918,900 sinusitis maksilaris J32.0 2,657,300 ###
15 11-07-17 1 Tn. FRIM EDUWART 076068 NO Badan Mawar Kelas II A Boekit P, d 639,650 696,010 1,335,660 gastritis + konstipasi K29.7, K59.0 2,668,200 1,332,540
16 10-07-17 2 Tn. SUARDI MS 208557 TOP UP P Mawar Kelas II A Asrizal, dr 0 2,513,100 2,513,100 gout arthritis, obs febris M1096, 2,581,400 68,300
17 03-07-17 9 Ny. KAMSIAH BINTI MATSAJARI 207889 TOP UP P Mawar Kelas II A Asrizal, dr 0 21,330,100 21,330,100 ulkus pedis, dm, infark cerebri, hemiplegi E14.5, I63.9, G81.9 7,231,100 ###
18 04-07-17 8 Ny. SITI AISYAH BR. SAMOSIR 190969 TOP UP P Mawar Kelas II A Boekit P, d 70,000 11,386,370 11,456,370 diare akut, ckd on hd, HD N18.5, A09, 39.95 3,068,900 ###
19 10-07-17 2 Tn. ZAINUDDIN 208468 COB PT. P Mawar Kelas I A Elvina, dr. 0 4,409,900 4,409,900 ICH I61.9 3,192,900 ###
20 09-07-17 3 Tn. MUHAMMAD KHAIRIANDI 207518 NKO Mawar Asrizal, dr 523,490 5,121,130 5,644,620 ikterik, ruptur hepar R17, S36.1 4,542,500 ###
67 10-07-17 2 Ny. SHALLY FEBRINDAH 204853 ASKES NO Mawar Kelas I A Boekit P, d 2,195,890 2,173,040 4,368,930 chf, tb, hiponatremi, hipoalbumin I50.0, A16.2, E87.1, 4,343,800 (25,130)
E88.0
63 10-07-17 2 Ny. SITI NURHEMA AYU 121130 NO Badan Mawar Kelas II A Asrizal, dr 1,846,960 1,499,130 3,346,090 sepsis, dermatitis eksploratif, hiponatremi A41.9, L26, E871 4,010,300 664,210
21 27-06-17 15 Ny. ARNIA BINTI KASNO 207479 TOP UP P Lavend Kelas II A Ismar, dr. 0 22,162,200 22,162,200 peritonitis akut ec pankreatitis, anemia, post LE, TF K65.9, K85, D64.9, 7,956,500 ###
54.11, 99.04
22 04-07-17 8 Ny. KASMUNAH BINTI NAAM 186809 TOP UP P Lavend Kelas II A Asrizal, dr 0 15,855,900 15,855,900 CKD on HD, CDL, anemia,hiponatremi, N18.9, D64.9, E87.1, 8,002,800 ###
38.95
23 10-07-17 2 Tn. SUKIRMAN 165447 IN PROSE Lavend Kelas II A Syafrudin, 0 2,517,400 2,517,400 paraparese ec. Syrongomyelia level c-7, mri columna G95.0, G82.2 4,106,700 1,589,300
24 09-07-17 3 Tn. M. ADI PRIYANTO 208483 MITRA BU Lavend Kelas II A Taufik Hida 0 20,537,400 20,537,400 post LE, adhesiolisis ###
25 11-07-17 1 Ny. DIAWATI BINTI BUSTAMI 190696 IN PROSE Lavend Khairul Nas 0 763,980 763,980 PSP induksi O80.9 (763,980)
26 09-07-17 3 Ny. SUMARNI 195503 TOP UP PT Lavend Kelas II A Dasril, dr 0 14,164,200 14,164,200 ascites, anemia, hipoalbumin, sirosi hepatis K74.6, D64.9, E88.0 4,535,900 ###
27 10-07-17 2 An. GWEN SYAREEFA APRILIA 208522 Badan Usa Garden Kelas II A Dedy S, dr 0 1,688,000 1,688,000 gea A09 1,753,800 65,800
28 11-07-17 1 Tn. SYAFRI BIN ABU DINA 208661 PBI/JAMKEGarden Kelas III Afdhal, dr. 0 142,800 142,800 Batu ginjal N20.0 3377300 3,234,500
29 11-07-17 1 Tn. SLAMET 208528 PBI/JAMKEGarden Kelas III Indra, dr. 0 10,624,500 10,624,500 post ureterolithotomy ###
30 11-07-17 1 Tn. SEPRIANTO SIREGAR 208728 Badan Usa Garden Kelas II A Elvina, dr. 0 677,210 677,210 paraplegia (L) G82.2 3,922,900 3,245,690
31 10-07-17 2 Ny. MIRAWATI BINTI MASNI 208621 Kesehatan Garden Kelas III Befimiroza 0 1,418,200 1,418,200 prematur kontraksi O47.0 1,562,100 143,900
32 10-07-17 2 Ny. NURJANAH 208635 Kesehatan Garden Kelas III Memmi, dr 0 5,614,800 5,614,800 post SC, PEB O82.9, O14.1 5,302,400 (312,400)
33 10-07-17 2 Ny. AJIRNA 208574 Kesehatan Garden Kelas III Befimiroza 0 5,481,400 5,481,400 PRM, post SC 5,302,401 (178,999)
34 11-07-17 1 Tn. RADIKUN BIN DARWI 203722 MITRA BU Garden Isolasi A Boekit P, d 0 1,805,600 1,805,600 sirosis hepatis, hipoalbumin, anemia K74.6, D64.9, E88.0 ###
35 10-07-17 2 Tn. AROFATI MENDROFA 208556 IN PROSESMelati Kelas II A Afdhal, dr. 0 2,639,900 2,639,900 batu ginjal (D), hidronephrosis (D) N13.2 4,052,700 1,412,800
36 09-07-17 3 Ny. SITI PATIMAH 208510 MITRA BU Melati Kelas II A Ismar, dr. 0 10,694,300 10,694,300 appendicitis akut, app-tomy K35.8, 47.09 3,480,400 ###
37 11-07-17 1 Ny. RIA NATI 162241 BU MITRA Melati Kelas II A Ismar, dr. 0 2,395,000 2,395,000 peritonitis ec appendicitis K35.8 3,414,600 1,019,600
38 11-07-17 1 An. DELVINA AYU 191360 IN PROSE Melati Kelas III Dedy S, dr 1,019,480 438,920 1,458,400 GEA A099 1,461,500 3,100
39 07-07-17 5 Tn. BAHARUDIN 208353 ASKES Melati Kelas I A Indra, dr. 0 14,135,200 14,135,200 retensi urin, TURP, BPH N40, 60.29 9,548,800 ###
40 10-07-17 2 Tn. SUKARDI II 208575 Badan Usa Melati Kelas II A Indra, dr. 0 11,361,700 11,361,700 batu ureter, post uretero meatotomy N20.1, 56.1 8,788,600 ###
41 10-07-17 2 Tn. AMINULLAH BIN ZUHDI 195600 IN PROSESMelati Kelas II A Asrizal, dr 0 2,484,800 2,484,800 dyspepsia K30, J18.9 1,808,000 (676,800)
42 10-07-17 2 Tn. TITAPRI 187138 Kesehatan Melati Kelas II A Indra, dr. 0 13,170,200 13,170,200 post ureteral meaotomy, turp, bph N40, 56.1, 60.29 8,788,600 ###
43 04-07-17 8 Ny. KODARIYAH 196395 TOP UP P Melati Kelas II A Faisal, Dr. 0 27,284,300 27,284,300 pneumoni, ascites, dm tp 2, hiponatremi, hipoalbumin E11.9, R18, J18.9, 7,203,900 ###
E87.1, R77.0,
44 11-07-17 1 Ny. IKA NURMALA SARI 208715 NO Badan Melati Kelas II A Khairul Nas 823,240 514,260 1,337,500 HEG O21.9 2494100 1,156,600
45 10-07-17 2 Tn. ZAINAL ARIFIN 208634 IN PROSE Melati Kelas I A Ramzi, dr. 0 9,120,080 9,120,080 gangren dm, amputasu bwh lutut) E11.5, 8415 9,965,600 845,520
46 09-07-17 3 Tn. DAHLIL DALIMI 208476 IN PROSE Melati Kelas II A Ismar, dr. 0 9,350,740 9,350,740 Ileus paralitik, dm tipe II K56.0 2,416,600 ###
66 30-06-17 12 An. NAGITA ELISABETH SINAGA 103758 Badan Usa Melati Kelas II A Dedy S, dr 0 11,514,400 11,514,400 meningoencephalopathy dd SOL, prolong fever, TB A17.8, G05.0 6,135,300 ###
47 08-07-17 4 Ny. DARYUNITA 208467 NKO ICU Kelas I A Rinelia Min 0 16,485,800 16,485,800 stemi inferior, streptokinase I21.0 7,263,800 ###
48 08-07-17 4 Ny. SYAMSIMAR BINTI NURBIT 208382 ASKES NO ICU Kelas II A Riky, dr. S 16,184,700 8,577,510 24,762,210 SAB ec aneurysm ruptur, spontaneus ICH, , IVH I72.9, I61.9, I61.5, 23,260,600 ###
I60.9, 96.71
49 24-06-17 18 By. NY. JULYANI 207362 NKO NICU Kelas II A Nazardi Oy 0 51,574,460 51,574,460 bb:3.5 kg, HIE, ventilator >4hr, aspiksia, SGN umur 0 hr P91.6, P21.0, P22.0, 17,539,700 ###
96.72, 93.93, 93.90
50 27-06-17 15 By. Ny. CICI ANGGRAINI 207511 MITRA BU SCN Irawati, dr 0 22,221,200 22,221,200 BBLR: 1.2 kg, SGN, prematur, CPAP P07.1, P22.0, 93.90 8,330,980 ###
51 11-07-17 1 Tn. FAHRIZAL AHMAD 197456 TOP UP P SCN Kelas II A Asrizal, dr 0 4,047,400 4,047,400 ckd on hd, anemia, ALO, hiperkalemi, asidosis metabolik N18.9, D64.9, J81, 5,459,700 1,412,300
E87.5, E87.2
52 07-07-17 5 Ny. RITA ASMARA 103089 NO Badan SCN Boekit P, d 14,077,560 14,541,030 28,618,590 ckd on hd, syndrome uricemia ###
53 11-07-17 1 An. FATHIR AHMAD AZZAMY 149290 NO KesehatAsoka Kelas I B Evi Kamelia 352,320 442,950 795,270 (795,270)
54 11-07-17 1 An. NADIRA ARSYIFA YULHENDRI 170321 Kesehatan Asoka Kelas II A Evi Kamelia 0 352,500 352,500 (352,500)
55 11-07-17 1 An. REYHAN SAPUTRA 199920 ASKES Asoka Kelas II A Ikhsan, dr 0 3,655,100 3,655,100 ###
56 11-07-17 1 Tn. dr.WILSON, Sp. A, M.Biomed 208417 ASKES Asoka Kelas I A Indra, dr. 0 10,227,400 10,227,400 ###
57 08-07-17 4 An. SARAH HAFIZAH 178792 BU MITRA Asoka Kelas I A Dedy S, dr 931,700 5,483,000 6,414,700 ###
58 07-07-17 5 An. ZAYAN KAMIL IBRAHIM 208268 NKO Asoka Ismar, dr. 0 18,542,180 18,542,180 ###
59 09-07-17 3 Ny. KHAIRUNNISA 207506 IN PROSE Sakura Khairul Nas 817,830 4,617,310 5,435,140 abortus imminens O20.0 ###
60 10-07-17 2 Ny. INDAH MULIA SRI REZKI 169583 IN PROSE Sakura Kelas II A Memmi, dr 100,000 6,597,700 6,697,700 ###
61 12-07-17 0 Ny. LENI DERITA 106651 NKO Sakura Khairul Nas 0 2,005,590 2,005,590 ###
62 11-07-17 1 Ny. TENGKU SYARIFAH ZAINUN 199132 ASKES Kelas III Ade, dr. 0 1,136,700 1,136,700 ###
64 08-07-17 4 An. SYAFIRA ULI L TOBING 063531 Badan Usa Kelas II A Evi Kamelia 0 8,758,000 8,758,000 ###
65 12-07-17 0 Ny. WAHYUNI BINTI IRMAN 198294 NO Badan Kelas II A Donel, dr. 7,040 75,000 82,040 (82,040)
68 12-07-17 0 Ny. MASRAWATI 207066 PBI/JAMKE Kelas III Memmi, dr 0 90,200 90,200 (90,200)
69 12-07-17 Ny. MISDALENA BINTI AMIRUDIN 206777 NO Kesehat 669,680 812,910 1,482,590 ###
No. Tgl. Masuk HP Nama Pasien Med Rec Kamar Kelas Dokter Sendiri Penanggung Total Diagnosa Kode ICD INACBG SELISIH
1 20-06-17 23 Tn. JALUDIN MANALU 207094 TOP UP PT Flamboy Kelas II A Indra, dr 24,800 56,272,400.00 56,297,200 fournier ganggren, abses scrotum, hipoalbumin post N49.2, 14,116,800 ###
nekrotomy+debridement, anemia, hipoalbumin, medial thigh R77.0,D64.9
vescularized flap+skin graf, rencana repair penis 86.28, 86.70,
99.04
2 11-07-17 2 Ny. NENI PUTRI WARTI 075940 Badan Usah Flamboy Kelas I A Memmi, d - 3,751,900.00 3,751,900 partus normal O80.9, Z37.0, 2,247,800 ###
73.59
3 12-07-17 1 Ny. YUSNIAR 191469 NO KesehataFlamboy Kelas II A Taufik Hi 1,772,650 3,830,490.00 5,603,140 Celulitis pedis (s), post debridement+wide insisi 1,574,500 ###
4 12-07-17 1 Ny. TUTY FEBRIANTY 189616 Kesehatan MFlamboy Kelas II A Memmi, d - 5,858,700.00 5,858,700 sc a/i: PP 6,023,899 165,199
5 12-07-17 1 Ny. DEFA NANDA 105852 Badan Usah Flamboy Kelas II A Khairul N - 5,689,600.00 5,689,600 sc a/i: oblique 6,023,900 334,300
6 12-07-17 1 Ny. DEWI KUSUMA 105286 NO Badan UFlamboy Kelas II A Khairul N 574,200 137,450.00 711,650 abortus imminens O20.0 1,539,300 827,650
7 11-07-17 2 Ny. RENI LUKMAN 208410 NO KesehataFlamboy Kelas I A Dasril, 2,870,010 2,180,470.00 5,050,480 dyspepsia, pneumonia K30, J18.9 3,083,000 ###
8 11-07-17 2 Ny. KELEMENTINA BR T 208739 IN PROSES Flamboy Kelas II A Khairul N 456,270 2,939,310.00 3,395,580 Ruptur vagina, laserasi vagina grade III post delivery, repair O71.4, 75.69 1,840,300 ###
vagina
9 11-07-17 2 Ny. LAMRIA BR SIMAMOR 206001 IN PROSES Flamboy Kelas II A Afdhal, d - 3,413,200.00 3,413,200 Batu ureter, ESWL N20.1, 98.51 8,788,600 5,375,400
10 10-07-17 3 An. BELLA SEPHIA ANGGR 208562 Badan Usah Flamboy Kelas II A Romy Dev 200,000 14,099,100.00 14,299,100 # femur, transfusi darah, post orif S72.9, 99.04, 11,444,800 ###
11 12-07-17 1 An. ANGEL SYAKIRA PUTR 156389 Kesehatan MGardeni Kelas II A Evi Kamel - 240,280.05 240,280 DHF A91 1,882,100 1,641,820
12 10-07-17 3 An. GWEN SYAREEFA APRI 208522 Badan Usah Gardeni Kelas II A Dedy S, - 2,002,900.00 2,002,900 gea A09 1,753,800 (249,100)
13 11-07-17 2 Tn. SYAFRI BIN ABU DINA 208661 PBI/JAMKE Gardeni Kelas III Afdhal, d - 10,918,200.00 10,918,200 Batu ginjal N20.0 3,377,300 ###
14 12-07-17 1 Tn. ARIADI BIN RAMLI 208766 Badan Usah Gardeni Kelas II A Taufik Hi - 5,353,800.00 5,353,800 eksisi
15 12-07-17 1 Tn. AHLAN NASIR 208761 Badan Usah Gardeni Kelas II A Taufik Hi - 5,424,400.00 5,424,400 eksisi
16 12-07-17 1 Tn. RIO ANJAR GUSTIAW 208752 IN PROSES Gardeni Kelas II A Taufik Hi - 5,299,900.00 5,299,900 eksisi
17 11-07-17 2 Tn. SEPRIANTO SIREGAR 208728 Badan Usah Gardeni Kelas II A Elvina, d - 1,753,110.00 1,753,110 paraplegia (L) G82.2 3,922,900 2,169,790
18 12-07-17 1 Ny. NELDA PURNAMA SAR 135447 Kesehatan MGardeni Kelas II A Khairul N 1,854,280 5,507,810.00 7,362,090 SC 6,023,900 ###
19 12-07-17 1 Ny. MISDALENA BINTI AM 206777 NO KesehataGardeni Kelas III Khairul N 1,477,180 5,828,760.00 7,305,940 mioma uteri, LE, histerektomi 4,320,500 ###
20 10-07-17 3 Ny. NURJANAH 208635 Kesehatan MGardeni Kelas III Memmi, d - 5,908,400.00 5,908,400 post SC, PEB O82.9, O14.1 5,302,400 (606,000)
21 12-07-17 1 Ny. SUMIATI 208807 PBI/JAMKE Gardeni Kelas III Donel, d 200,000 410,000.00 610,000
22 12-07-17 1 Ny. ZUBAIDA BINTI M DIN 203047 Kesehatan MGardeni Kelas III Ismar, dr - 5,085,600.00 5,085,600 eksisi
23 11-07-17 2 Tn. RADIKUN BIN DARWI 203722 MITRA BU PGardeni Isolasi A Boekit P, - 10,886,900.00 10,886,900 sirosis hepatis, hipoalbumin, anemia K74.6, D64.9, ###
E88.0
24 12-07-17 1 An. KENZHI KIMORA MUL 171004 Badan Usah HCU Kelas II A Dedy S, - 388,700.00 388,700 obs. Vomitus, PRS
25 11-07-17 2 Ny. SRI PURWANTI 208714 NO KesehataHCU Kelas III Donel, d 508,760 1,744,810.00 2,253,570 PEB, G3P O14.1 2,779,300 525,730
26 12-07-17 1 Ny. HARMIALIS BINTI SY 206703 Badan Usah HCU Kelas II A Ariman S - 4,018,700.00 4,018,700 sinusitis maksilaris , plan: AWO J32.0 2,277,700 ###
27 12-07-17 1 An. ASHRHOD HIDAYAH 208796 PBI/JAMKE HCU Kelas III Dedy S, - 373,300.00 373,300 multiple abses dikepala dan leher L02.1, L02.8 1,735,400 1,362,100
28 12-07-17 1 Nn. GUSATRIA DEWI 089147 KetenagakerHCU Kelas II A Ikhsan, - 9,459,500.00 9,459,500 -
29 10-07-17 3 Ny. SHALLY FEBRINDAH 204853 ASKES NO Lavende Isolasi B Boekit P, 3,604,700 5,452,760.00 9,057,460 chf, tb, hiponatremi, hipoalbumin I50.0, A16.2, 4,343,800 ###
E87.1, E88.0
30 10-07-17 3 Tn. SUKIRMAN 165447 IN PROSES Lavende Kelas II A Syafrudin - 3,402,100.00 3,402,100 paraparese ec. Syrongomyelia level c-7, mri columna G95.0, G82.2 4,106,700 704,600
31 09-07-17 4 Tn. M. ADI PRIYANTO 208483 MITRA BU PLavende Kelas II A Taufik Hi - 22,367,300.00 22,367,300 post LE, adhesiolisis ###
32 11-07-17 2 Ny. DIAWATI BINTI BUSTA 190696 IN PROSES Lavende Khairul N - 6,438,000.00 6,438,000 PSP induksi O80.9 ###
33 04-07-17 9 Ny. KASMUNAH BINTI NA 186809 TOP UP PT Mawar Kelas II A Asrizal, - 16,165,600.00 16,165,600 CKD on HD, CDL, anemia,hiponatremi, N18.9, D64.9, 8,002,800 ###
E87.1, 38.95
34 11-07-17 2 Ny. ELISA FANNI HUTAG 108914 NO Badan UMawar Kelas II A Donel, d 1,243,480 6,012,930.00 7,256,410 post SC, bekas sc O82.0 6,023,900 ###
35 11-07-17 2 Ny. RITA DEWI 186583 IN PROSES Mawar Kelas II A Asrizal, - 1,985,100.00 1,985,100 CKD stage V on hd, vomitus N18.5, R11 3,068,900 1,083,800
36 12-07-17 1 Ny. EVI SEFTIANINGSIH 158803 Badan Usah Mawar Kelas II A Khairul N - 5,806,600.00 5,806,600 post sc, bsc
37 11-07-17 2 Tn. FRIM EDUWART 076068 NO Badan UMawar Kelas II A Boekit P, 1,211,830 1,869,360.00 3,081,190 gastritis + konstipasi K29.7, K59.0 2,668,200 (412,990)
38 10-07-17 3 Tn. SUARDI MS 208557 TOP UP PT Mawar Kelas II A Asrizal, - 3,476,800.00 3,476,800 gout arthritis, obs febris, ulcus pedis M10.96,L97, 3,890,300 413,500
86.22
39 03-07-17 10 Ny. KAMSIAH BINTI MATS 207889 TOP UP PT Mawar Kelas II A Asrizal, - 25,381,500.00 25,381,500 ulkus pedis, dm, infark cerebri, hemiplegi E14.5, I63.9, 7,231,100 ###
G81.9
40 04-07-17 9 Ny. SITI AISYAH BR. SAM 190969 TOP UP PT Mawar Kelas II A Boekit P, 70,000 19,523,270.00 19,593,270 diare akut, ckd on hd, HD N18.5, A09, 3,068,900 ###
39.95
41 10-07-17 3 Tn. ZAINUDDIN 208468 COB PT. P Mawar Kelas I A Elvina, d - 5,705,200.00 5,705,200 ICH I61.9 3,192,900 ###
42 09-07-17 4 Tn. MUHAMMAD KHAIRIA 207518 NKO Mawar Asrizal, 523,490 8,833,480.00 9,356,970 ikterik, ruptur hepar R17, S36.1 4,542,500 ###
43 10-07-17 3 Ny. SITI NURHEMA AYU 121130 NO Badan UMawar Kelas II A Asrizal, 2,618,400 2,422,770.00 5,041,170 sepsis, dermatitis eksploratif, hiponatremi A41.9, L26, 4,010,300 ###
E871
44 10-07-17 3 Tn. AROFATI MENDROFA 208556 TOP UP PT Melati Kelas II A Afdhal, d - 3,309,100.00 3,309,100 batu ginjal (D), hidronephrosis (D) N13.2 4,052,700 743,600
45 12-07-17 1 Tn. ZAMRI 098765 MITRA MARMelati Kelas I A Taufik Hi - 5,496,500.00 5,496,500 tumor oksipital, eksisi D48.5, 86.3 5,379,000 (117,500)
46 11-07-17 2 Ny. RIA NATI 162241 BU MITRA Melati Kelas II A Ismar, dr - 4,480,500.00 4,480,500 peritonitis ec appendicitis K35.8 3,414,600 ###
47 12-07-17 1 An. GIBRANSYAH RIDHO A 145825 NO KesehataMelati Kelas II A Irawati, 242,440 279,141.20 521,581 ge, febris 1,753,800 1,232,219
48 08-07-17 5 An. SYAFIRA ULI L TOBING 063531 Badan Usah Melati Kelas II A Evi Kamel - 9,652,399.96 9,652,400 app perforasi, post LE 7,216,500 ###
49 11-07-17 2 An. DELVINA AYU 191360 IN PROSES Melati Kelas III Dedy S, 2,108,500 1,391,760.00 3,500,260 GEA A099 1,461,500 ###
50 12-07-17 1 Tn. MARTOGAR SAMOSIR 196206 TOP UP PT Melati Kelas II A Anwar Be - 2,075,050.00 2,075,050 anemia, transfusi 2,766,200 691,150
51 10-07-17 3 Tn. SUKARDI II 208575 Badan Usah Melati Kelas II A Indra, dr - 12,194,800.00 12,194,800 batu ureter, post uretero meatotomy N20.1, 56.1 8,788,600 ###
52 10-07-17 3 Tn. AMINULLAH BIN ZUHD 195600 TOP UP PT Melati Kelas II A Asrizal, - 3,020,200.00 3,020,200 dyspepsia K30, J18.9 1,808,000 ###
54 04-07-17 9 Ny. KODARIYAH 196395 TOP UP PT Melati Kelas II A Faisal, D - 29,061,800.00 29,061,800 pneumoni, ascites, dm tp 2, hiponatremi, hipoalbumin E11.9, R18, 7,203,900 ###
J18.9, E87.1,
55 11-07-17 2 Ny. IKA NURMALA SARI 208715 NO Badan UMelati Kelas II A Khairul N 1,898,430 1,414,760.00 3,313,190 HEG R77.0,
O21.9 2494100 (819,090)
56 10-07-17 3 Tn. ZAINAL ARIFIN 208634 NKO Melati Kelas I A Ramzi, dr - 17,762,750.00 17,762,750 gangren dm, amputasu bwh lutut) E11.5, 8415 9,965,600 ###
57 09-07-17 4 Tn. DAHLIL DALIMI 208476 IN PROSES Melati Kelas II A Ismar, dr - 12,109,690.00 12,109,690 Ileus paralitik, dm tipe II K56.0 2,416,600 ###
58 12-07-17 Ny. EVINASARI 196049 MITRA BU PMelati 307-A - 743,200.00 743,200 colic abdomen ec dyspepsia K30 1,579,700 836,500
59 30-06-17 13 An. NAGITA ELISABETH S 103758 Badan Usah Melati Kelas II A Dedy S, - 12,175,500.00 12,175,500 meningoencephalopathy dd SOL, prolong fever, TB A17.8, G05.0 6,135,300 ###
60 24-06-17 19 By. NY. JULYANI 207362 NKO NICU Kelas II A Nazardi - 51,996,860.00 51,996,860 bb:3.5 kg, HIE, ventilator >4hr, aspiksia, SGN umur 0 hr P91.6, P21.0, 17,539,700 ###
P22.0, 96.72,
61 08-07-17 5 Ny. SYAMSIMAR BINTI NU 208382 ASKES NO PICU Kelas II A Riky, dr. 19,904,750 12,202,900.00 32,107,650 SAB ec aneurysm ruptur, spontaneus ICH, , IVH 93.93, 93.90
I72.9, I61.9, 23,260,600 ###
I61.5, I60.9,
62 27-06-17 16 By. Ny. CICI ANGGRAINI 207511 MITRA BU PSCN Irawati, - 23,334,200.00 23,334,200 BBLR: 1.2 kg, SGN, prematur, CPAP 96.71
P07.1, P22.0, 8,330,980 ###
93.90
63 07-07-17 6 Ny. RITA ASMARA 103089 NO Badan USCN Boekit P, 14,293,560 15,610,730.00 29,904,290 ckd on hd, syndrome uricemia
64 11-07-17 2 An. FATHIR AHMAD AZZA 149290 NO KesehataAsoka Kelas I B Evi Kamel 678,920 1,583,710.00 2,262,630 gea
65 11-07-17 2 An. NADIRA ARSYIFA YU 170321 Kesehatan MAsoka Kelas II A Evi Kamel - 1,458,500.05 1,458,500 gea
66 12-07-17 1 An. INTAN NURAINI 206056 Kesehatan MAsoka Kelas II A Ariman S - 2,809,000.00 2,809,000 tonsilitis kronis, tonsilektomy J35.0, 28.2 4,426,400 1,617,400
67 08-07-17 5 An. SARAH HAFIZAH 178792 BU MITRA Asoka Kelas I A Dedy S, 931,700 6,877,200.00 7,808,900 bacterial infection
68 07-07-17 6 An. ZAYAN KAMIL IBRAHIM 208268 NKO Asoka Ismar, dr - 19,913,920.00 19,913,920 app perforasi, post LE
69 12-07-17 1 Ny. RAJA DIAH SITI ARRU 158880 NKO Sakura President SDonel, d - 753,500.00 753,500 psp
70 10-07-17 3 Ny. INDAH MULIA SRI REZ 169583 Badan Usah Sakura Kelas II A Memmi, d 100,000 6,870,000.00 6,970,000 sc
71 12-07-17 1 Ny. LENI DERITA 106651 NKO Sakura Khairul N 3,000,000 7,816,850.00 10,816,850 sc
72 12-07-17 1 Ny. DEVI FITRIZAF 208858 NO Badan Usaha Kelas II A Donel, d 1,079,210 5,791,780.00 6,870,990
73 12-07-17 1 Nn. FERINA QONITHA 208818 NKO Ismar, dr - 11,065,660.00 11,065,660
74 12-07-17 1 Ny. INTAN FARAH DIZA 198839 POLRI Kelas I A Ismar, dr - 5,194,900.00 5,194,900
75 12-07-17 1 Tn. AGUS BUDIONO 208805 Badan Usah Kelas II A Ismar, dr - 4,989,300.00 4,989,300
76 12-07-17 1 Ny. RAHMA DONA 208754 Badan Usah Kelas II A Ismar, dr - 4,240,200.00 4,240,200
77 12-07-17 1 Ny. WAHYU TRININGSIH 208757 ASKES Kelas II A Taufik Hi - 4,082,200.00 4,082,200
78 13-07-17 0 Ny. ERMAYUNITA BINTI ZU 208863 IN PROSES Kelas II A Donel, d 1,133,110 744,360.00 1,877,470
79 12-07-17 1 An. RAFLI RAHMADANI 208801 PBI/JAMKE Kelas III Ismar, dr - 4,993,450.00 4,993,450
80 13-07-17 0 Tn. AL-AMIN BIN MANSY 178838 PBI/JAMKE Kelas III Syafrudin - 0 -
81 12-07-17 1 An. ANDIKA PRATAMA 205872 Badan Usah Kelas II A Syafrudin - 1,865,400.00 1,865,400
82 12-07-17 1 Ny. WAHYUNI BINTI IRMA 198294 NO Badan U Kelas II A Donel, d 7,040 195,670.00 202,710 (202,710)
83 12-07-17 1 Ny. MASRAWATI 207066 PBI/JAMKE Kelas III Memmi, d - 5,171,200.00 5,171,200
No. Tgl. Masuk HP Nama Pasien Cara BayarKamar Kelas Dokter
1 16-07-17 1 An. MEGUMI RAMADHANI FIYERA NKO Asoka VIP Evi Kamelia, dr. Sp.A
2 13-07-17 4 Tn. IDRUSMAN ASKES Asoka Kelas I A Indra, dr. Sp.BU
3 20-06-17 27 Tn. JALUDIN MANALU TOP UP Flamboyan Kelas II A Indra, dr. Sp.BU
4 11-07-17 6 Tn. RADIKUN BIN DARWI MITRA BUFlamboyan Kelas II A Boekit P, dr. Sp.PD
5 13-07-17 4 Ny. JULIANTI BINTI NGATIJO MITRA BUFlamboyan Kelas II A Memmi, dr. Sp.OG
6 15-07-17 2 Ny. DEVI KURNIAWATI KesehatanFlamboyan Kelas II A Sari Rahmawati, dr. SpOG
7 16-07-17 1 Ny. DIAN NOVITA NO KesehaFlamboyan Kelas II A Khairul Nasir, dr. Sp.OG
8 17-07-17 0 Ny. ROHANI BR SIDBUTAR KesehatanGardenia Kelas III Donel, dr. Sp.OG (KFM)
9 17-07-17 0 Ny. DEWI TANJUNG NO KesehaGardenia Kelas III Khairul Nasir, dr. Sp.OG
10 15-07-17 2 Ny. YUNI SELVIA KesehatanGardenia Kelas III Sari Rahmawati, dr. SpOG
11 14-07-17 3 Ny. RIZKA MEILANI FAIZAL NO KesehaGardenia Kelas III Befimiroza Adam, dr. Sp.OG
12 14-07-17 3 Tn. ELIZAN CHAN TOP UP Gardenia Isolasi B Rohani, dr. Sp.P
13 13-07-17 4 Ny. MARITO BR MANALU TOP UP Lavender Kelas II A Asrizal, dr. Sp.PD
14 17-07-17 0 Ny. DESI SISWANTY IN PROS Lavender Kelas I A Donel, dr. Sp.OG (KFM)
15 15-07-17 2 Tn. FITRA NURHAKIM KesehatanLavender Kelas I A Asrizal, dr. Sp.PD
16 16-07-17 1 Ny. VINA FEBRYSA NKO Lavender President Suit Khairul Nasir, dr. Sp.OG
17 16-Jul-17 Tn. TALIWANOLO LASE MITRA BULavender
18 04-07-17 13 Ny. KASMUNAH BINTI NAAM TOP UP Mawar Kelas II A Asrizal, dr. Sp.PD
19 16-07-17 1 Ny. NOFRITA IN PROS Mawar Kelas II A Memmi, dr. Sp.OG
20 17-07-17 0 Ny. FEBRINA HOTMATIUR SIREGAR NO POLR Mawar Kelas II A Sari Rahmawati, dr. SpOG
21 17-07-17 0 Ny. VIVI SINTA DEWI ASKES Mawar Kelas II A Khairul Nasir, dr. Sp.OG
22 03-07-17 14 Ny. KAMSIAH BINTI MATSAJARI TOP UP Mawar Kelas II A Asrizal, dr. Sp.PD
23 10-07-17 7 Ny. SITI NURHEMA AYU NO BadanMawar Kelas II A Asrizal, dr. Sp.PD
24 14-07-17 3 Ny. MINAULI TURNIP NKO Mawar VIP Elvina, dr. Sp.S
25 17-07-17 0 Ny. SRI NOVALINDA COB PT. Mawar Kelas I A Memmi, dr. Sp.OG
26 17-07-17 0 An. IRVANSAPUTRA Badan Us Melati Kelas II A Effa triani, dr. Sp.A
27 17-07-17 0 Tn. HENGKI KURNIAWAN IN PROS Melati Kelas II A Dasril, dr. Sp.PD (KGEH)
28 10-07-17 7 Tn. AMINULLAH BIN ZUHDI TOP UP Melati Kelas II A Asrizal, dr. Sp.PD
29 10-07-17 7 Tn. ZAINAL ARIFIN NKO Melati VIP Ramzi, dr. Sp.B (K)
30 10-Jul-17 Tn. SUKIRMAN MITRA BUMelati Kelas II A
31 24-06-17 23 By. NY. JULYANI NKO NICU Kelas II A Nazardi Oyong, dr. Sp.A
32 16-07-17 1 Tn. SADI BIN TISNO NKO PICU ICU Elvina, dr. Sp.S
33 15-07-17 2 By. NY. YUNI SELVIA NO KesehaRuang Bayi Kelas III Evi Kamelia, dr. Sp.A
34 17-07-17 0 By. Ny. DEWI TANJUNG IN PROS Ruang Bayi Kelas III Effa triani, dr. Sp.A
35 17-07-17 0 By. NY. FAUZIAH AR. AMDKEB NKO Ruang Bayi President Suit Effa triani, dr. Sp.A
36 17-07-17 0 By. NY. VINA FEBRYSA NKO Ruang Bayi President Suit Effa triani, dr. Sp.A
37 17-07-17 0 By. Ny. NILAM MAULANI NKO Ruang Bayi VIP Effa triani, dr. Sp.A
38 17-07-17 0 By. Ny. VIVI SINTA DEWI IN PROS Ruang Bayi Kelas II A Effa triani, dr. Sp.A
39 17-07-17 0 Ny. SUSI ARBIA NO KesehaRuang Bayi Kelas III Erik, dr. Sp.OG
40 17-07-17 0 Tn. R MOCHTAR NKO Ruang Bayi VIP Dasril, dr. Sp.PD (KGEH)
41 15-07-17 2 Ny. DAHLIA IN PROS Ruang Bayi Kelas II A Befimiroza Adam, dr. Sp.OG
42 17-07-17 0 Ny. JUMIARTI MITRA M Ruang Bayi Kelas I A Asrizal, dr. Sp.PD
43 17-07-17 0 Ny. MUTIARA REZAWITA KesehatanRuang Bayi Kelas III Befimiroza Adam, dr. Sp.OG
44 17-07-17 0 Ny. DEWI SARTIKA IN PROS Ruang Bayi Kelas III Khairul Nasir, dr. Sp.OG
45 17-07-17 0 Ny. NURLINA BR MANURUNG Badan Us Ruang Bayi Kelas II A Befimiroza Adam, dr. Sp.OG
46 17-07-17 0 Ny. YULIA NINGSIH Badan Us Ruang Bayi Kelas II A Memmi, dr. Sp.OG
47 17-07-17 0 Ny. NILAM MAULANI NKO Sakura VIP Khairul Nasir, dr. Sp.OG
48 17-07-17 0 Ny. FAUZIAH AR.AMKEB NKO Sakura President Suit Khairul Nasir, dr. Sp.OG
49 17-07-17 0 Ny. dr. LHARA RAFFANY IN PROS Sakura VIP Befimiroza Adam, dr. Sp.OG
50 17-07-17 0 Ny DEWI RAHMADANI NKO Sakura VIP Donel, dr. Sp.OG (KFM)
51 27-06-17 20 By. Ny. CICI ANGGRAINI MITRA BUSCN Irawati, dr.SpA
Sendiri Penanggung Total Med Rec Diagnosa Kode ICD INACBG SELISIH
0 2,114,940.00 2,114,940 105478
0 14,641,600.00 14,641,600 208914
24,800.00 64,136,600.00 64,161,400 207094 fournier ganggren, abses scrotum, hipoalbumin N49.2, 14,116,800 ###
post nekrotomy+debridement, anemia, R77.0,D64.9
0 20,180,100.00 20,180,100 203722 sirosis hepatis,
hipoalbumin, hipoalbumin,
medial anemia
thigh vescularized K74.6, D64.9,
86.28, 86.70, ###
flap+skin graf, rencana repair penis E88.0
99.04
0 3,989,700.00 3,989,700 208899
0 1,709,100.00 1,709,100 206476
4,730.00 50,000.00 54,730 070198
0 1,518,800.00 1,518,800 209167
1,239,590.00 1,273,110.00 2,512,700 205838
1,422,410.00 5,534,870.00 6,957,280 026001
0 1,655,700.00 1,655,700 209059
0 4,850,200.00 4,850,200 208933
0 3,602,400.00 3,602,400 173478
0 689,800.00 689,800 135903
0 2,521,600.00 2,521,600 172956
0 3,429,090.00 3,429,090 189378
0 4,492,000.00 4,492,000 209130
0 22,070,700.00 22,070,700 186809 CKD on HD, CDL, anemia,hiponatremi, N18.9, D64.9, 8,002,800 ###
E87.1, 38.95
140,640.00 3,875,390.00 4,016,030 209148
980,120.00 685,440.00 1,665,560 196051
0 1,557,800.00 1,557,800 012796
0 29,602,100.00 29,602,100 207889 ulkus pedis, dm, infark cerebri, hemiplegi E14.5, I63.9, 7,231,100 ###
G81.9
5,751,730.00 4,971,130.00 10,722,860 121130 sepsis, dermatitis eksploratif, hiponatremi A41.9, L26, 4,010,300 ###
E871
0 6,624,330.00 6,624,330 208926
0 65,200.00 65,200 208876
0 1,087,160.00 1,087,160 209105
0 344,230.00 344,230 209213
0 6,232,800.00 6,232,800 195600 dyspepsia K30, J18.9 1,808,000 ###
8,005,820.00 48,951,620.00 56,957,440 208634 gangren dm, amputasu bwh lutut) E11.5, 8415 9,965,600 ###
0 14,993,700.00 14,993,700 165447 paraparese ec. Syrongomyelia level c-7, mri G95.0, G82.2 4,106,700 ###
columna
0 64,858,170.00 64,858,170 207362 bb:3.5 kg, HIE, ventilator >4hr, aspiksia, SGN P91.6, P21.0, 17,539,700 ###
umur 0 hr P22.0, 96.72,
0 10,796,640.00 10,796,640 209129 93.93, 93.90
0 2,000,000.00 2,000,000 209095
0 225,000.00 225,000 209201
0 332,500.00 332,500 209208
0 0 0 209237
0 0 0 209193
0 113,200.00 113,200 209204
1,013,870.00 641,550.00 1,655,420 209179
0 738,230.00 738,230 164322
2,166,410.00 6,833,170.00 8,999,580 024864
0 546,100.00 546,100 204909
0 285,100.00 285,100 209219
253,440.00 190,570.00 444,010 065034
0 50,000.00 50,000 194180
0 0 0 208535
0 3,447,240.00 3,447,240 009752
0 3,393,290.00 3,393,290 012671
0 0 0 189628
0 160,540.00 160,540 119757
0 27,039,800.00 27,039,800 207511 BBLR: 1.2 kg, SGN, prematur, CPAP P07.1, P22.0, 8,330,980 ###
93.90
No. Tgl. Masuk HP Nama Pasien Med Rec Cara Bayar Kamar Kelas Dokter Sendiri Penanggung Total Diagnosa Kode ICD INACBG SELISIH
1 17-07-17 1 An. MUHAMM 209266 IN PROSES AsokaKelas II ADedy S, d - 357,000 357,000 diare akut A09 1,753,800 1,396,800
2 18-07-17 0 Ny. HASIHOL 209300 IN PROSES AsokaKelas II ADonel, dr 2,200,000 8,038,710 ### kala II lama, sc O63.1, O82.9, Z37.0, 74.0 6,023,900 (4,214,810)
3 18-07-17 0 Ny. PEBRI YE 198133 Badan Usah FlambKelas II AMemmi, d - 275,900 275,900 psp O80.9, Z37.0, 73.59 1,926,700 1,650,800
4 17-07-17 1 Ny. YULIA N 208535 Badan Usah FlambKelas II AMemmi, d - 262,600 262,600 post kuret, abortus incomplet, gravid 8-9 O06.4, 69.02 2,066,600 1,804,000
mgg
5 17-07-17 1 Ny. MULDAYA 209286 IN PROSES GardeKelas III Khairul Na - 389,000 389,000 abortus incomplete, curetage O06.4, 69.09 1,722,200 1,333,200
6 17-07-17 1 Ny. ROHANI 209167 Kesehatan MGardeKelas III Donel, dr - 5,274,000 5,274,000 sc 5,019,900 (254,100)
7 17-07-17 1 Ny. DESI SI 135903 IN PROSES LavenKelas I A Donel, dr - 6,381,100 6,381,100 post sc, cpd 7,423,300 1,042,200
8 15-07-17 3 Tn. FITRA N 172956 Kesehatan MLavenKelas I A Asrizal, d - 2,761,300 2,761,300 febris ec. Parotitis K11.2 3,199,800 438,500
9 17-07-17 1 Ny. VIVI SIN 012796 ASKES Mawa Kelas II AKhairul Na - 5,984,300 5,984,300 sc, letak obliq O32.2, O82.9, 74.0 6,023,900 39,600
10 16-07-17 2 Ny. NOFRITA 209148 IN PROSES Mawa Kelas II AMemmi, d 180,350 3,890,450 4,070,800 psp O80.9, Z37.0, 73.59 1,926,700 (2,144,100)
11 17-07-17 1 Ny. IRMA AD 090426 IN PROSES Mawa Kelas III Khairul Na - - - kuret, abortus incomplete O06.4, 69.09 1,722,200 1,722,200
12 17-07-17 1 An. SYARIIF 209294 ASKES Melati Kelas II AEvi Kameli - 320,700 320,700 febris 3,129,800 2,809,100
13 17-07-17 1 An. IRVANSA 209105 Badan Usah Melati Kelas II AEffa triani - 1,137,160 1,137,160 dhf A91 1,882,100 744,940
14 17-07-17 1 Tn. HENGKI 209213 IN PROSES Melati Kelas II ADasril, d - 1,160,730 1,160,730
15 17-07-17 1 Tn. ZAINUDD 209184 IN PROSES Melati Kelas II AAfdhal, dr - 1,667,800 1,667,800 stenosis urethral N13.1 4,052,700 2,384,900
16 17-07-17 1 By. NY. FAUZ 209208 IN PROSES SCN Nazardi O - 760,840 760,840 anemia, susp. Umbilical bleeding, bb jatah kelas blm tahu
3.590gr

No. Tgl. Masuk HP Nama Pasien Med Rec Cara B Kamar Kelas Dokter Sendiri Penanggung Total Diagnosa Kode ICD INACBG SELISIH
1 20-06-17 29 Tn. JALUDIN MANA 207094 TOP UPFlamboyan Kelas II A Indra, dr. 24,800 64,800,800 64,825,600 fournier ganggren, abses scrotum, hipoalbumin post nekrotomy+debN49.2, R77.0,D64 14,116,800 ###
2 19-07-17 0 Tn. FIRDAUS 029355 Badan Flamboyan Kelas II A Asrizal, d - 50,000 50,000 colic abdomen R10.4 1,753,800 1,703,800
3 18-07-17 1 Ny. SRIKAYATI 191991 ASKES Flamboyan Kelas I A Riky, dr. 645,810 1,338,580 1,984,390 stroke non hemoragic I64 4,425,700 2,441,310
4 18-07-17 1 Ny. SITI ROSITA 200963 IN PR Flamboyan Kelas II A Khairul Na 1,874,630 6,241,910 8,116,540 sc ai: oblique 6,023,900 ###
5 17-07-17 2 Ny. TRI DANIARTI 180405 MITRA Flamboyan Kelas II A Ismar, dr. - 6,211,000 6,211,000 app akut, app-tomi K35.9, 47.09 3,480,400 ###
6 18-07-17 1 Ny. PEBRI YENTI 198133 Badan Flamboyan Kelas II A Memmi, d - 2,563,700 2,563,700 psp O80.9, Z37.0, 1,926,700 ###
7 18-07-17 1 Ny. DWI LESTARI N 199586 Badan Flamboyan Kelas II A Memmi, d 360,000 889,300 1,249,300 multiple myoma+myoma gambut+anemia D25.9, D64.9 4,573,800 3,324,500
8 16-07-17 3 Ny. DIAN NOVITA 070198 NO Kes Flamboyan Kelas II A Khairul Na 154,330 3,581,980 3,736,310 psp O80.9, Z37.0, 73 1,926,700 ###
9 19-07-17 0 Ny. FITRI AMINA 056228 Badan Flamboyan Kelas II A Khairul Na 760,000 410,000 1,170,000
10 18-Jul-17 Ny. SURYATI BINTI 209327 BU MI Flamboyan 1,000,000 5,916,000 6,916,000
11 18-Jul-17 Ny. SARI AMIJAR 209337 BU MI Flamboyan - 327,900 327,900
12 11-07-17 8 Tn. RADIKUN BIN 203722 MITRA HCU Kelas II A Boekit P, - 26,917,000 26,917,000 sirosis hepatis, hipoalbumin, anemia, muntah darah, melena K74.6, D64.9, E8 4,535,900 ###
13 18-07-17 1 Tn. ABDUL RAHMAN 209159 ASKES HCU Rinelia M 162,140 1,144,300 1,306,440 CHF ec. CAD ###
14 17-07-17 2 Ny. FEBRINA HOT 196051 NO POLMawar Kelas II A Sari Rahm 1,985,540 6,501,280 8,486,820 sc, bsc O34.2, O82.0, 74 6,023,900 ###
15 17-07-17 2 Ny. VIVI SINTA DEW 012796 ASKES Mawar Kelas II A Khairul Na - 6,566,500 6,566,500 sc, letak obliq O32.2, O82.9 6,023,900 ###
16 18-07-17 1 Tn. PERNANDO SI 208584 Badan Mawar Kelas II A Ismar, dr. - 4,437,100 4,437,100 hidrocele+ligasi letak tinggi ###
17 18-07-17 1 Tn. M.ZEN 188002 Badan Mawar Kelas II A Ismar, dr. - 5,643,500 5,643,500 HIL, hernioraphy K40.9, 53.00 5,648,100 4,600
18 18-07-17 1 Tn. PAIMO BIN JULI 209315 KesehatMawar Kelas II A Indra, dr. - 650,800 650,800 BPH, Batu ginjal N40, N20.0 4,588,700 3,937,900
19 10-07-17 9 Ny. SITI NURHEMA 121130 NO BadMawar Kelas II A Asrizal, d 6,794,700 5,575,700 12,370,400 dermatitis eksploratif, hiponatremi L26, E871 4,095,200 ###
20 13-07-17 6 Ny. MARITO BR M 173478 TOP UPLavender Kelas II A Asrizal, d - 4,495,300 4,495,300 akut abdomen, TTH, fatty liver K76.0, R10.0, G4 3,893,600 ###
21 17-07-17 2 Ny. DESI SISWANT 135903 ASKES Lavender Kelas I A Donel, dr - 7,239,900 7,239,900 post sc, cpd 7,423,300 183,400
22 15-07-17 4 Tn. FITRA NURHAK 172956 KesehatLavender Kelas I A Asrizal, d - 3,378,800 3,378,800 febris ec. Parotitis K11.2 3,199,800 ###
23 16-07-17 3 Ny. VINA FEBRYSA 189378 NKO Lavender Khairul Na 7,580,000 5,836,580 13,416,580 sc
24 18-07-17 1 An. AURA PUTRI 209235 PBI/JA Gardenia Kelas III Evi Kameli - 505,300 505,300 vomitus R11 1,461,500 956,200
25 19-07-17 0 Tn. SYOFIAN HADI 203554 IN PR Gardenia Kelas II A Indra, dr. - 155,800 155,800
26 18-07-17 1 Tn. MARSUDI 192827 PBI/JA Gardenia Kelas III Ramzi, dr. - 4,132,800 4,132,800 CKD 2,557,400 ###
27 17-07-17 2 Ny. ROSWEN 187436 NO Kes Gardenia Kelas III Ismar, dr. 2,827,880 1,598,350 4,426,230 ulkus dm E11.5 4,429,400 3,170
28 17-07-17 2 Ny. ROHANI BR SI 209167 KesehatGardenia Kelas III Donel, dr - 5,430,400 5,430,400 sc 5,019,900 ###
29 17-07-17 2 Ny. DEWI TANJUNG 205838 NO Kes Gardenia Kelas III Khairul Na 1,486,540 5,338,110 6,824,650 heg 2,078,400 ###
30 18-07-17 1 Ny. NUR AINI 209311 KesehatGardenia Kelas III Sari Rahm - 5,192,600 5,192,600 sc 5,019,900 ###
31 17-07-17 2 Ny. SUSI ARBIAH 209179 NO Kes Gardenia Kelas III Erik, dr. 1,511,510 5,288,910 6,800,420 sc 5,019,901 ###
32 18-07-17 1 Ny. RIANA PANGAR 209006 NO Kes Gardenia Kelas III Memmi, d 51,810 3,867,350 3,919,160 post kuret
33 14-07-17 5 Ny. RIZKA MEILANI 209059 NO Kes Gardenia Kelas III Befimiroz 1,896,080 7,091,330 8,987,410 sc 5,019,900 ###
34 17-07-17 2 Ny. DEWI SARTIKA 065034 IN PR Gardenia Kelas III Khairul Na 2,054,710 1,122,150 3,176,860 heg 2,078,400 ###
35 18-07-17 1 Tn. SURIP 209387 IN PRO Melati Kelas II A Elvina, dr - 2,312,700 2,312,700 infark cerebri, hemiparese, dm 6,206,800 3,894,100
36 17-07-17 2 An. IRVANSAPUTR 209105 Badan Melati Kelas II A Effa triani - 1,626,160 1,626,160 dhf A91 1,882,100 255,940
37 17-07-17 2 An. SYARIIF ASROF 209294 ASKES Melati Kelas II A Evi Kameli - 1,405,600 1,405,600 febris 3,129,800 1,724,200
38 18-07-17 1 An. NAFIZAH AWLI 177761 BU (PT Melati Kelas II A Ismar, dr. - 644,400 644,400
39 17-07-17 2 Tn. HENGKI KURN 209213 KesehatMelati Kelas II A Dasril, d - 2,858,930 2,858,930
40 18-07-17 1 Tn. JULIS RAMADH 209358 Badan Melati Kelas II A Indra, dr. - 1,452,100 1,452,100
41 18-07-17 1 Ny. EDAENG KIET 209239 Badan Melati Kelas II A Ismar, dr. - 5,085,500 5,085,500
No. Tgl. Masuk HP Nama Pasien Med Rec Cara B Kamar Kelas Dokter Sendiri Penanggung Total Diagnosa Kode ICD INACBG SELISIH
42 17-07-17 2 Tn. R MOCHTAR 164322 NKO Melati Dasril, d - 3,715,730 3,715,730 vertigo, hiperkalemi, dm, ht E11.9, E87, R42, 5,804,000 2,088,270
43 10-07-17 9 Tn. ZAINAL ARIFIN 208634 NKO Melati Kelas I A Ramzi, dr. 10,405,470 52,714,850 63,120,320 gangren dm, amputasu bwh lutut) E11.5, 8415 9,965,600 ###
44 18-07-17 1 Ny. RINI ZARMAN 075049 NKO Melati Befimiroz - 673,980 673,980
45 10-Jul-17 Tn. SUKIRMAN 165447 MITRA Melati Kelas II A - 16,392,600 16,392,600 paraparese ec. Syrongomyelia level c-7, mri columna G95.0, G82.2 4,106,700 ###
46 18-Jul-17 Tn. SENENG SUGE 209231 ASKES Melati - 4,330,300 4,330,300
47 17-07-17 2 By. NY. FAUZIAH A 209208 NKO NICU Nazardi O - 4,044,810 4,044,810 anemia, susp. Umbilical bleeding, bb 3.590gr jatah kelas blm tahu
48 16-07-17 3 Tn. SADI BIN TISN 209129 NKO PICU Kelas III Elvina, dr - 20,805,640 20,805,640 infark cerebri, BP, VES, SR, RBBB I63.9, J18.9, I49. 7,790,300 ###
49 27-06-17 22 By. Ny. CICI ANGGR 207511 MITRA SCN Nazardi O - 27,930,800 27,930,800 BBLR: 1.2 kg, SGN, prematur, CPAP P07.1, P22.0, 93 8,330,980 ###
50 24-06-17 25 By. NY. JULYANI 207362 NKO SCN Kelas II A Nazardi O - 66,806,610 66,806,610 bb:3.5 kg, HIE, ventilator >4hr, aspiksia, SGN umur 0 hr P91.6, P21.0, P2 17,539,700 ###
51 17-07-17 2 An. YASMIN AL AD 127718 NO Kes Asoka Kelas I A Evi Kameli 982,530 1,721,960 2,704,490 susp BP J18.0 4,848,800 2,144,310
52 18-07-17 1 An. ARUMI ZALEA 184157 Badan Asoka Kelas II A Dedy S, d - 352,460 352,460
53 17-07-17 2 An. MUHAMMAD A 209266 IN PR Asoka Kelas II A Dedy S, d - 1,635,200 1,635,200 diare akut A09 1,753,800 118,600
54 18-07-17 1 Ny. ELLEN YOLAND 204611 IN PR Asoka Khairul Na - 165,000 165,000
55 18-07-17 1 Ny. HASIHOLAN S 209300 NKO Asoka Kelas II A Donel, dr 2,500,000 8,318,690 10,818,690 kala II lama, sc O63.1, O82.9, 6,023,900 ###
56 17-07-17 2 Tn. SAMIDI 159187 MITRA Asoka Kelas II A Ismar, dr. - 10,691,700 10,691,700 hernioraphy+mesh, HIL 5,648,100 ###
57 17-07-17 2 Ny. IRMA HAYATI 209233 MITRA Asoka Kelas I A Boekit P, - 2,137,700 2,137,700 febris 3,651,400 1,513,700
58 17-07-17 2 Ny. FAUZIAH AR.A 012671 NKO Sakura Khairul Na 5,400,000 8,167,710 13,567,710 ###
59 17-07-17 2 Ny. dr. LHARA RAF 189628 NKO Sakura Befimiroz 2,590,000 10,776,480 13,366,480 ###
60 17-07-17 2 Ny. NILAM MAULAN 009752 NKO Sakura Khairul Na 3,140,000 9,291,940 12,431,940 ###
61 17-07-17 2 Ny DEWI RAHMADA 119757 NKO Sakura Donel, dr 4,140,000 9,126,370 13,266,370 ###
62 19-07-17 0 Ny. SRI LILIS ARB 209328 IN PR Kelas III Memmi, d 200,000 868,400 1,068,400 ###
63 18-07-17 1 Ny. HENNY IDAYAN 209363 Badan Kelas I A Befimiroz - 759,200 759,200 ###
64 18-07-17 1 Tn. ARMAN METRO 135600 IN PR Riky, dr. - 1,250,540 1,250,540 ###
65 17-07-17 2 Ny. NURLINA MA 194180 Badan Kelas II A Befimiroz - 6,443,100 6,443,100 ###
66 18-07-17 1 An. M. FATIH EL F 196220 NO Bad Kelas II A Dedy S, d 305,140 369,510 674,650 ###
HP = H Per Tanggal : 20 Jul 2017
No. Tgl. Masuk HP Nama Pasien Med Rec Cara BayarKamar Kelas Dokter Sendiri Penanggung Total Diagnosa Kode ICD INACBG SELISIH
1 19-07-17 1 FIRDAUS 029355 Badan Us FlambKelas II A Asrizal, dr - 1,489,400 1,489,400 colic abdomen R10.4 1,753,800 264,400
2 18-07-17 2 SRIKAYATI 191991 ASKES N FlambKelas I A Riky, dr. Sp 1,476,990 2,780,930 4,257,920 stroke non hemoragic I64 4,425,700 167,780
3 18-07-17 2 SITI ROSITA 200963 NO BadanFlambKelas II A Khairul Nas 2,043,260 6,721,910 8,765,170 sc ai: oblique 6,023,900 ###
4 17-07-17 3 TRI DANIARTI 180405 MITRA M FlambKelas II A Ismar, dr. - 6,635,500 6,635,500 app akut, app-tomi K35.9, 47.09 3,480,400 ###
5 19-07-17 1 DESI NOVITA SARI 208097 Badan Us FlambKelas II A Ismar, dr. - 4,628,300 4,628,300 app akut, app-tomi K35.9, 47.09 3,480,400 ###
6 18-07-17 2 DWI LESTARI NINGSIH 199586 Badan Us FlambKelas II A Memmi, dr. 720,000 2,561,000 3,281,000 multiple myoma+myoma gambut+anemia D25.9, D64.9 4,573,800 1,292,800
7 19-07-17 1 YULIA FITRI 209436 NO BadanFlamb Erik, dr. S 1,114,630 5,693,540 6,808,170 post sc, kpd+cpd
8 19-07-17 1 FITRI AMINA HARAHAP 056228 Badan Us FlambKelas II A Khairul Nas 760,000 6,134,600 6,894,600 post sc, bsc 6,023,900 (870,700)
9 18-Jul-17 SURYATI BINTI AMIR 209327 BU MINA Flamb 1,000,000 6,592,000 7,592,000 post sc, letak obliq, mow
10 11-07-17 9 RADIKUN BIN DARWI 203722 MITRA BUHCU Kelas II A Boekit P, d - 30,958,300 30,958,300 sirosis hepatis, hipoalbumin, anemia, muntah K74.6, D64.9, 4,535,900 ###
darah, melena E88.0
11 18-07-17 2 ABDUL RAHMAN BIN M. 209159 ASKES N HCU Rinelia Min 936,840 3,315,640 4,252,480 CHF ec. CAD I50.0, I25.1 3,212,100 ###
12 19-07-17 1 SARPANI 173578 ASKES Mawa Kelas I A Rudolf, dr. - 211,000 211,000 pterygium, post eksisi H11.0, 11.39 6,151,400 5,940,400
13 19-07-17 1 MARNI YASTUTI 019610 KesehatanMawa Kelas II A Taufik Hida - 5,033,800 5,033,800 tumor axilla, eksisi D48.7, 86.3 4,610,500 (423,300)
14 18-07-17 2 PERNANDO SIREGAR 208584 Badan Us Mawa Kelas II A Ismar, dr. - 5,555,700 5,555,700 hidrocele+ligasi letak tinggi N43.3, 63.1 8,001,600 2,445,900
15 18-07-17 2 M.ZEN 188002 Badan Us Mawa Kelas II A Ismar, dr. - 6,986,100 6,986,100 HIL, hernioraphy K40.9, 53.00 5,648,100 ###
16 18-07-17 2 PAIMO BIN JULI 209315 KesehatanMawa Kelas II A Indra, dr. - 11,105,300 11,105,300 sc 5,019,900 ###
17 10-07-17 10 SITI NURHEMA AYU 121130 NO BadanMawa Kelas II A Asrizal, dr 6,874,230 6,106,800 12,981,030 dermatitis eksploratif, hiponatremi L26, E871 4,095,200 ###
18 19-07-17 1 AISYAH 197598 NKO Mawa Asrizal, dr 760,000 494,700 1,254,700 dm, anemia E14.9, D64.9
19 16-07-17 4 VINA FEBRYSA 189378 NKO Laven Khairul Nas 6,706,000 8,944,990 15,650,990 sc
20 18-07-17 2 AURA PUTRI 209235 PBI/JAM Garde Kelas III Evi Kamelia - 1,486,600 1,486,600
21 19-07-17 1 SUSANDI 209473 Badan Us Garde Kelas II A Boekit P, d - 905,700 905,700
22 19-07-17 1 DEDI SAPUTRA 209502 Badan Us Garde Kelas II A Asrizal, dr - 853,100 853,100
23 19-07-17 1 RAYMOND SAPUTRA 209313 KesehatanGarde Kelas II A Asrizal, dr - 441,500 441,500
24 17-07-17 3 SANONGONI ZEBUA 175094 KetenagakGarde Kelas II A Asrizal, dr - 4,401,830 4,401,830
25 17-07-17 3 ROSWEN 187436 NO KesehaGarde Kelas III Ismar, dr. 3,852,090 2,140,650 5,992,740 ulkus dm E11.5 4,429,400 ###
26 18-07-17 2 NUR AINI 209311 KesehatanGarde Kelas III Sari Rahma - 5,574,600 5,574,600
27 19-07-17 1 HENI NURHAENI 209483 NO KesehaGarde Kelas III Dasril, dr. 600,760 408,530 1,009,290
28 19-07-17 1 YULIAR BINTI SAID 209416 PBI/JAM Melati Kelas III Ismar, dr. - 4,781,600 4,781,600
29 18-07-17 2 SURIP 209387 TOP UP Melati Kelas II A Elvina, dr. - 3,471,500 3,471,500
30 19-07-17 1 GITA MESYA KANIA 209438 IN PROS Melati Kelas II A Ismar, dr. - 4,831,600 4,831,600
31 18-07-17 2 NAFIZAH AWLIYAH AZZA 177761 BU (PT. Melati Kelas II A Ismar, dr. - 3,654,300 3,654,300
32 19-07-17 1 ABDUL QODIR ZAILANI 209470 Badan Us Melati Kelas II A Ismar, dr. - 4,814,800 4,814,800
33 19-07-17 1 ALIFA WAHDINI 058116 NO KesehaMelati Kelas II A Dedy S, dr. 186,230 323,710 509,940
34 19-07-17 1 SYOFIAN HADI 203554 Badan Us Melati Kelas II A Indra, dr. - 10,041,200 10,041,200
35 18-07-17 2 JULIS RAMADHAN 209358 Badan Us Melati Kelas II A Indra, dr. - 2,678,200 2,678,200
36 19-07-17 1 USMAN BIN JAMALUDIN 205363 Badan Us Melati Kelas II A Afdhal, dr. - 43,000 43,000
37 17-07-17 3 R MOCHTAR 164322 NKO Melati Dasril, dr. - 4,976,310 4,976,310 vertigo, hiperkalemi, dm, ht E11.9, E87, 5,804,000 827,690
R42, I10
38 18-07-17 2 RINI ZARMAN 075049 NKO Melati Befimiroza - 5,748,600 5,748,600
39 18-Jul-17 SENENG SUGENG 209231 ASKES Melati Kelas II A - 5,400,300 5,400,300 infark cerebri, hemiparese, dm 6,206,800 806,500
40 16-07-17 4 SADI BIN TISNO 209129 NKO PICU Kelas III Elvina, dr. - 26,408,240 26,408,240 infark cerebri, BP, VES, SR, RBBB I63.9, J18.9, 7,790,300 ###
I49.4, I45.1
41 27-06-17 23 Ny. CICI ANGGRAINI 207511 MITRA BUSCN Nazardi Oyo - 28,091,600 28,091,600 BBLR: 1.2 kg, SGN, prematur, CPAP P07.1, P22.0, 8,330,980 ###
93.90
42 24-06-17 26 NY. JULYANI 207362 NKO SCN Kelas II A Nazardi Oyo - 67,913,350 67,913,350 bb:3.5 kg, HIE, ventilator >4hr, aspiksia, SGN P91.6, P21.0, 17,539,700 ###
umur 0 hr P22.0, 96.72,
93.93, 93.90
43 17-07-17 3 YASMIN AL ADTRA 127718 NO KesehaAsokaKelas I A Evi Kamelia 1,268,260 2,674,710 3,942,970 susp BP, susp TB J18.0, A16.2 5,819,500 1,876,530
44 19-07-17 1 DWI AULIA ZAHRA 209508 IN PROS AsokaKelas II A Evi Kamelia - 392,200 392,200 febris, bacterial infektion, dermatitis seboroid A49.8, L21.9 2,609,600 2,217,400
45 18-07-17 2 M. FATIH EL FAHREZI 196220 NO BadanAsokaKelas II A Dedy S, dr. 554,300 1,678,020 2,232,320 diare akut A09 1,753,800 (478,520)
46 18-07-17 2 ELLEN YOLANDA SINAGA 204611 NKO Asoka Khairul Nas - 1,792,940 1,792,940 PSP VE O81.9
47 18-07-17 2 HASIHOLAN SITUMORAN 209300 NKO Asoka Donel, dr. 3,950,000 8,412,600 12,362,600
48 17-07-17 3 SAMIDI 159187 MITRA BUAsokaKelas II A Ismar, dr. - 11,390,900 11,390,900 hernioraphy+mesh, HIL 5,648,100 ###
49 19-07-17 1 SITI NUR'AINI 190599 NKO Sakur Khairul Nas - 165,000 165,000
50 17-07-17 3 dr. LHARA RAFFANY 189628 NKO Sakur Befimiroza 4,040,000 10,357,420 14,397,420
51 17-07-17 3 NILAM MAULANI 009752 NKO Sakur Khairul Nas 4,440,000 9,001,300 13,441,300
52 17-07-17 3 DEWI RAHMADANI 119757 NKO Sakur Donel, dr. 5,540,000 8,773,340 14,313,340
53 19-07-17 1 SRI LILIS ARBAATUN 209328 IN PROS Kelas III Memmi, dr. 200,000 6,519,900 6,719,900 BPH, Batu ginjal N40, N20.0 4,588,700 ###
54 18-07-17 2 HENNY IDAYANTI SINAG 209363 Badan Us Kelas I A Befimiroza - 6,335,400 6,335,400
55 20-07-17 0 INTAN SUMIATI 205313 NKO Khairul Nas - 2,171,250 2,171,250

No. Tgl. Masuk HP Nama Pasien Cara Bayar Kamar Sendiri Penanggung Total INACBG SELISIH
39 07-07-17 5 Tn. BAHARUDIN ASKES Melati 0 14,135,200 14,135,200 (14,135,200)
55 11-07-17 1 An. REYHAN SAPUTRA ASKES Asoka 0 3,655,100 3,655,100
56 11-07-17 1 Tn. dr.WILSON, Sp. A, M.Biomed ASKES Asoka 0 10,227,400 10,227,400
62 11-07-17 1 Ny. TENGKU SYARIFAH ZAINUN ASKES 0 1,136,700 1,136,700
67 10-07-17 2 Ny. SHALLY FEBRINDAH ASKES NO Mawar 2,195,890 2,173,040 4,368,930 4,343,800 (25,130)
48 08-07-17 4 Ny. SYAMSIMAR BINTI NURBIT ASKES NO ICU 16,184,700 8,577,510 24,762,210 23,260,600 (1,501,610)
10 12-07-17 0 Ny. HARMIALIS BINTI SYAFRUDDI Badan Usa HCU 0 116,100 116,100 2,277,700 2,161,600
2 11-07-17 1 Ny. NENI PUTRI WARTI Badan Usa Flambo 0 271,900 271,900 2,247,800 1,975,900
4 11-07-17 1 Ny. NURSIAH Badan Usa Flambo 0 5,218,400 5,218,400 6,052,700 834,300
27 10-07-17 2 An. GWEN SYAREEFA APRILIA Badan Usa Garden 0 1,688,000 1,688,000 1,753,800 65,800
8 10-07-17 2 An. BELLA SEPHIA ANGGRAINI Badan Usa Flambo 200,000 13,130,700 13,330,700 11,444,800 (1,885,900)
66 30-06-17 12 An. NAGITA ELISABETH SINAGA Badan Usa Melati 0 11,514,400 11,514,400 6,135,300 (5,379,100)
40 10-07-17 2 Tn. SUKARDI II Badan Usa Melati 0 11,361,700 11,361,700 (11,361,700)
30 11-07-17 1 Tn. SEPRIANTO SIREGAR Badan Usa Garden 0 677,210 677,210
64 08-07-17 4 An. SYAFIRA ULI L TOBING Badan Usa 0 8,758,000 8,758,000
57 08-07-17 4 An. SARAH HAFIZAH BU MITRA Asoka 931,700 5,483,000 6,414,700
37 11-07-17 1 Ny. RIA NATI BU MITRA Melati 0 2,395,000 2,395,000 3,414,600 1,019,600
19 10-07-17 2 Tn. ZAINUDDIN COB PT. P Mawar 0 4,409,900 4,409,900 3,192,900 (1,217,000)
11 12-07-17 0 An. INTAN NURAINI IN PROSE HCU 0 0 0 4,426,400 4,426,400
23 10-07-17 2 Tn. SUKIRMAN IN PROSE Lavend 0 2,517,400 2,517,400 4,106,700 1,589,300
6 11-07-17 1 Ny. KELEMENTINA BR TAMPUBO IN PROSE Flambo 0 384,850 384,850 1,840,300 1,455,450
45 10-07-17 2 Tn. ZAINAL ARIFIN IN PROSE Melati 0 9,120,080 9,120,080 9,965,600 845,520
38 11-07-17 1 An. DELVINA AYU IN PROSE Melati 1,019,480 438,920 1,458,400 (1,458,400)
25 11-07-17 1 Ny. DIAWATI BINTI BUSTAMI IN PROSE Lavend 0 763,980 763,980
46 09-07-17 3 Tn. DAHLIL DALIMI IN PROSE Melati 0 9,350,740 9,350,740
59 09-07-17 3 Ny. KHAIRUNNISA IN PROSE Sakura 817,830 4,617,310 5,435,140
60 10-07-17 2 Ny. INDAH MULIA SRI REZKI IN PROSE Sakura 100,000 6,597,700 6,697,700
70 10-07-17 2 By. NY. INDAH MULIA SRI REZEKI IN PROSE Ruang 0 329,200 329,200
71 11-07-17 1 By. NY. NURJANNAH IN PROSE Ruang 0 0 0
75 11-07-17 By. NY. ELISA FANNI HUTAGALUN IN PROSE Ruang 252,000 109,300 361,300
7 11-07-17 1 Ny. LAMRIA BR SIMAMORA IN PROSE Flambo 0 2,513,200 2,513,200 8,788,600 6,275,400
13 11-07-17 1 Ny. RITA DEWI IN PROSESMawar 0 618,200 618,200 3,068,900 2,450,700
35 10-07-17 2 Tn. AROFATI MENDROFA IN PROSESMelati 0 2,639,900 2,639,900 4,052,700 1,412,800
41 10-07-17 2 Tn. AMINULLAH BIN ZUHDI IN PROSESMelati 0 2,484,800 2,484,800 1,808,000 (676,800)
31 10-07-17 2 Ny. MIRAWATI BINTI MASNI Kesehatan Garden 0 1,418,200 1,418,200 1,562,100 143,900
33 10-07-17 2 Ny. AJIRNA Kesehatan Garden 0 5,481,400 5,481,400 5,302,401 (178,999)
32 10-07-17 2 Ny. NURJANAH Kesehatan Garden 0 5,614,800 5,614,800 5,302,400 (312,400)
3 10-07-17 2 Ny. ZULHEFA MARYAM Kesehatan Flambo 0 5,497,100 5,497,100 5,019,900 (477,200)
14 11-07-17 1 Ny. LEVI AGUSTINA Kesehatan Mawar 0 3,918,900 3,918,900 2,657,300 (1,261,600)
42 10-07-17 2 Tn. TITAPRI Kesehatan Melati 0 13,170,200 13,170,200 8,788,600 (4,381,600)
54 11-07-17 1 An. NADIRA ARSYIFA YULHENDRI Kesehatan Asoka 0 352,500 352,500
72 10-07-17 2 By. Ny. AJIRNA Kesehatan Ruang 0 221,100 221,100
74 10-07-17 By. Ny. ZULHEFA MARYAM Kesehatan Ruang 240,000 2,000,000 2,240,000
24 09-07-17 3 Tn. M. ADI PRIYANTO MITRA BU Lavend 0 20,537,400 20,537,400
36 09-07-17 3 Ny. SITI PATIMAH MITRA BU Melati 0 10,694,300 10,694,300 3,480,400 (7,213,900)
34 11-07-17 1 Tn. RADIKUN BIN DARWI MITRA BU Garden 0 1,805,600 1,805,600 (1,805,600)
50 27-06-17 15 By. Ny. CICI ANGGRAINI MITRA BU SCN 0 22,221,200 22,221,200 8,330,980 (13,890,220)
20 09-07-17 3 Tn. MUHAMMAD KHAIRIANDI NKO Mawar 523,490 5,121,130 5,644,620 4,542,500 (1,102,120)
47 08-07-17 4 Ny. DARYUNITA NKO ICU 0 16,485,800 16,485,800 7,263,800 (9,222,000)
49 24-06-17 18 By. NY. JULYANI NKO NICU 0 51,574,460 51,574,460 17,539,700 (34,034,760)
15 11-07-17 1 Tn. FRIM EDUWART NO Badan Mawar 639,650 696,010 1,335,660 2,668,200 1,332,540
No. Tgl. Masuk HP Nama Pasien Cara Bayar Kamar Sendiri Penanggung Total INACBG SELISIH
12 11-07-17 1 Ny. ELISA FANNI HUTAGALUNG NO Badan Mawar 1,181,000 5,547,930 6,728,930 6,023,900 (705,030)
63 10-07-17 2 Ny. SITI NURHEMA AYU NO Badan 1,846,960 1,499,130 3,346,090 4,010,300 664,210
5 11-07-17 1 Ny. RENI LUKMAN NO KesehatFlambo 1,114,520 572,840 1,687,360 3,083,000 1,395,640
28 11-07-17 1 Tn. SYAFRI BIN ABU DINA PBI/JAMKEGarden 0 142,800 142,800 3,377,300 3,234,500
51 11-07-17 1 Tn. FAHRIZAL AHMAD TOP UP P SCN 0 4,047,400 4,047,400 5,459,700 1,412,300
16 10-07-17 2 Tn. SUARDI MS TOP UP P Mawar 0 2,513,100 2,513,100 2,581,400 68,300
22 04-07-17 8 Ny. KASMUNAH BINTI NAAM TOP UP P Lavend 0 15,855,900 15,855,900 8,002,800 (7,853,100)
18 04-07-17 8 Ny. SITI AISYAH BR. SAMOSIR TOP UP P Mawar 70,000 11,386,370 11,456,370 3,068,900 (8,387,470)
17 03-07-17 9 Ny. KAMSIAH BINTI MATSAJARI TOP UP P Mawar 0 21,330,100 21,330,100 7,231,100 (14,099,000)
21 27-06-17 15 Ny. ARNIA BINTI KASNO TOP UP P Lavend 0 22,162,200 22,162,200 7,956,500 (14,205,700)
43 04-07-17 8 Ny. KODARIYAH TOP UP P Melati 0 27,284,300 27,284,300 7,203,900 (20,080,400)
1 20-06-17 22 Tn. JALUDIN MANALU TOP UP P Flambo 24,800 55,804,700 55,829,500 14,116,800 (41,712,700)
26 09-07-17 3 Ny. SUMARNI TOP UP PT Lavend 0 14,164,200 14,164,200 4,535,900 (9,628,300)
58 07-07-17 5 An. ZAYAN KAMIL IBRAHIM NKO Asoka 0 18,542,180 18,542,180
61 12-07-17 0 Ny. LENI DERITA NKO Sakura 0 2,005,590 2,005,590
73 11-07-17 1 By. NY. DIAWATI NKO Ruang 0 248,490 248,490
44 11-07-17 1 Ny. IKA NURMALA SARI NO Badan Melati 823,240 514,260 1,337,500
52 07-07-17 5 Ny. RITA ASMARA NO Badan SCN 14,077,560 14,541,030 28,618,590
65 12-07-17 0 Ny. WAHYUNI BINTI IRMAN NO Badan 7,040 75,000 82,040
53 11-07-17 1 An. FATHIR AHMAD AZZAMY NO KesehatAsoka 352,320 442,950 795,270
69 12-07-17 Ny. MISDALENA BINTI AMIRUDIN NO Kesehat 669,680 812,910 1,482,590
9 11-07-17 1 Ny. SRI PURWANTI NO KesehatHCU 182,050 439,550 621,600
29 11-07-17 1 Tn. SLAMET PBI/JAMKEGarden 0 10,624,500 10,624,500 (10,624,500)
68 12-07-17 0 Ny. MASRAWATI PBI/JAMKE 0 90,200 90,200 (90,200)
No. Tgl. Masuk HP Nama Pasien Cara BayarKamar Total INACBG SELISIH
1 11-07-17 1 Ny. LAMRIA BR SIMAMORA IN PROSE Flamboyan 2,513,200 8,788,600 6,275,400
2 11-07-17 1 Ny. NURSIAH Badan Usa Flamboyan 5,218,400 6,052,700 834,300
3 10-07-17 2 An. BELLA SEPHIA ANGGRAINI Badan Usa Flamboyan 13,330,700 11,444,800 (1,885,900)
4 11-07-17 1 Tn. SYAFRI BIN ABU DINA PBI/JAMK Gardenia 142,800 3,377,300 3,234,500
5 10-07-17 2 Ny. MIRAWATI BINTI MASNI Kesehatan Gardenia 1,418,200 1,562,100 143,900
6 10-07-17 2 Ny. AJIRNA Kesehatan Gardenia 5,481,400 5,302,401 (178,999)
7 10-07-17 2 An. GWEN SYAREEFA APRILIA Badan Usa Gardenia 1,688,000 1,753,800 65,800
8 12-07-17 0 Ny. HARMIALIS BINTI SYAFRUDDIN Badan Usa HCU 116,100 2,277,700 2,161,600
9 12-07-17 0 An. INTAN NURAINI IN PROSE HCU 0 4,426,400 4,426,400
10 08-07-17 4 Ny. SYAMSIMAR BINTI NURBIT ASKES NOICU 24,762,210 23,260,600 (1,501,610)
11 10-07-17 2 Tn. SUKIRMAN IN PROSE Lavender 2,517,400 4,106,700 1,589,300
12 11-07-17 1 Ny. LEVI AGUSTINA Kesehatan Mawar 3,918,900 2,657,300 (1,261,600)
13 11-07-17 1 Ny. RITA DEWI IN PROSE Mawar 618,200 3,068,900 2,450,700
14 10-07-17 2 Ny. SHALLY FEBRINDAH ASKES NOMawar 4,368,930 4,343,800 (25,130)
15 10-07-17 2 Tn. ZAINUDDIN COB PT. P Mawar 4,409,900 3,192,900 (1,217,000)
16 10-07-17 2 Tn. AROFATI MENDROFA IN PROSE Melati 2,639,900 4,052,700 1,412,800
17 10-07-17 2 Tn. AMINULLAH BIN ZUHDI IN PROSE Melati 2,484,800 1,808,000 (676,800)
18 30-06-17 12 An. NAGITA ELISABETH SINAGA Badan Usa Melati 11,514,400 6,135,300 (5,379,100)
19 11-07-17 1 An. DELVINA AYU IN PROSE Melati 1,458,400 1,461,500 3,100
20 07-07-17 5 Tn. BAHARUDIN ASKES Melati 14,135,200 9,548,800 (4,586,400)
21 10-07-17 2 Tn. SUKARDI II Badan Usa Melati 11,361,700 8,788,600 (2,573,100)
22 10-07-17 2 Tn. TITAPRI Kesehatan Melati 13,170,200 8,788,600 (4,381,600)
23 11-07-17 1 Ny. RIA NATI BU MITRA Melati 2,395,000 3,414,600 1,019,600
24 09-07-17 3 Ny. SITI PATIMAH MITRA BU Melati 10,694,300 3,480,400 (7,213,900)
25 10-07-17 2 Tn. ZAINAL ARIFIN IN PROSE Melati 9,120,080 9,965,600 845,520
26 27-06-17 15 By. Ny. CICI ANGGRAINI MITRA BU SCN 22,221,200 8,330,980 (13,890,220)
No. Tgl. Masuk HP Nama Pasien Cara Bayar
Kamar Total INACBG SELISIH
1 09-07-17 3 Tn. MUHAMMAD KHAIRIANDI NKO Mawar 5,644,620 4,542,500 (1,102,120)
2 08-07-17 4 Ny. DARYUNITA NKO ICU 16,485,800 7,263,800 (9,222,000)
3 24-06-17 18 By. NY. JULYANI NKO NICU 51,574,460 17,539,700 (34,034,760)
4 11-07-17 1 Tn. FRIM EDUWART NO BadMawar 1,335,660 2,668,200 1,332,540

5 11-07-17 1 Ny. ELISA FANNI HUTAGALUNG NO BadMawar 6,728,930 6,023,900 (705,030)
6 10-07-17 2 Ny. SITI NURHEMA AYU NO BadMawar 3,346,090 4,010,300 664,210
7 11-07-17 1 Ny. IKA NURMALA SARI NO BadMelati 1,337,500 2,494,100 1,156,600
8 11-07-17 1 Ny. RENI LUKMAN NO KeseFlamboyan 1,687,360 3,083,000 1,395,640
9 11-07-17 1 Tn. SYAFRI BIN ABU DINA PBI/JA Gardenia 142,800 3,377,300 3,234,500
10 11-07-17 1 Tn. FAHRIZAL AHMAD TOP UPSCN 4,047,400 5,459,700 1,412,300
11 10-07-17 2 Tn. SUARDI MS TOP UPMawar 2,513,100 2,581,400 68,300

12 04-07-17 8 Ny. KASMUNAH BINTI NAAM TOP UPLavender 15,855,900 8,002,800 (7,853,100)
13 04-07-17 8 Ny. SITI AISYAH BR. SAMOSIR TOP UPMawar 11,456,370 3,068,900 (8,387,470)
14 03-07-17 9 Ny. KAMSIAH BINTI MATSAJARI TOP UPMawar 21,330,100 7,231,100 (14,099,000)
15 27-06-17 15 Ny. ARNIA BINTI KASNO TOP UPLavender 22,162,200 7,956,500 (14,205,700)
16 04-07-17 8 Ny. KODARIYAH TOP UPMelati 27,284,300 7,203,900 (20,080,400)
17 20-06-17 22 Tn. JALUDIN MANALU TOP UPFlamboyan 55,829,500 14,116,800 (41,712,700)
18 09-07-17 3 Ny. SUMARNI TOP UPLavender 14,164,200 4,535,900 (9,628,300)

No. Tgl. HP Nama Pasien No. MR Cara Bayar Ka Kelas Dokter Total Biaya DP NKO CODING SISA TAGIHAN ATENSI
Masuk Perawatan
1 20-06-17 14 Tn. JALUDIN MANALU 207094 BPJS TOP UP PTPN Fl Kelas II A Indra, dr. Sp.BU 37,208,400
2 01-07-17 3 Ny. NURAINI 149720 BPJS ASKES Fl Kelas I A Faisal, Dr. Sp.Pd 2,779,780 3,000,000 -220,220 PULANGKAN PASIEN
3 04-07-17 0 Ny. NURHAYATI 205317 BPJS PBI/JAMKESMAS/Fl Kelas III Romy Deviandri, dr. 0 MINIMALIS THERAPY
4 21-06-17 13 Ny. RITA ASMARA 103089 BPJS NO Badan Usaha Fl Kelas II A Dafnil,dr.Sp.OG 33,057,430
5 03-07-17 1 Ny. SUPRIANI 144144 BPJS Badan Usaha Fl Kelas II A Khairul Nasir, dr. Sp 367,400
6 30-06-17 4 Ny. YUSMARNI 099720 BPJS Kesehatan MandirFl Kelas II A Indra, dr. Sp.BU 14,223,700
7 03-07-17 1 Ny. WAN ROBIATUN 082651 BPJS ASKES Fl Kelas II A Taufik Hidayat. dr, Sp 1,761,000
8 03-07-17 1 Ny. VEBRIA NELA 207284 BPJS IN PROSES HCU HCU-A Donel, dr. Sp.OG (K 2,079,200
9 03-07-17 1 Tn. EDI AGUS PITOYO 198816 BPJS MITRA MARGIE HCU HCU-E Faisal, Dr. Sp.Pd 1,493,750
10 30-06-17 4 Ny. ROSMIDA PANJAITAN 207653 BPJS Badan Usaha MaKelas II A Befimiroza Adam, dr. 3,265,000
11 02-07-17 2 Ny. UMI MARHAMAH 207745 BPJS PBI/JAMKESMASMaKelas II A Befimiroza Adam, dr. 6,489,700
12 01-07-17 3 Ny. SURYANI SIMANJUNTAK 207721 BPJS NO Kesehatan Man

MaKelas II A Sari Rahmawati, dr. 8,095,050
13 01-07-17 3 Ny. ZULFIA NAIDI 196681 BPJS NO Badan Usaha MaKelas II A Befimiroza Adam, dr. 10,525,900
14 03-07-17 1 Tn. TENGKU HENDRI YASIN 207885 BPJS MITRA MARGIE MaKelas I A Boekit P, dr. Sp.PD 805,800
15 03-07-17 1 Tn. SYAHRUL 159990 BPJS NO Kesehatan Man

MaKelas I A Rohani, dr. Sp.P 1,488,800
16 03-07-17 1 Nn. NANDA ALIFAH NAFSANI 207857 BPJS ASKES MaKelas I A Ismar, dr. Sp.BA 804,300
17 03-07-17 1 Ny. KAMSIAH BINTI MATSAJARI 207889 BPJS TOP UP PTPN MaKelas II A Asrizal, dr. Sp.PD 1,664,400
18 02-07-17 2 Ny. KHAIRUNNISA 207506 BPJS NKO Mawar (VIP) Khairul Nasir, dr. Sp 2,200,870
19 27-06-17 7 Ny. ARNIA BINTI KASNO 207479 BPJS TOP UP PTPN La Kelas II A Ismar, dr. Sp.BA 17,633,200
20 03-07-17 1 Ny. IRDATI BINTI JULIUS SARUJI 202962 BPJS TNI NO La Kelas I A Ismar, dr. Sp.BA 1,263,100
21 02-07-17 2 An. FARID RIZKY ATALLAH 188176 BPJS NO Kesehatan Man

GarKelas III Irawati, dr.SpA 1,358,020
22 03-07-17 1 Tn. SUARLIS 207782 BPJS Kesehatan MandirGarKelas III Taufik Hidayat. dr, Sp 2,043,500
23 03-07-17 1 Tn. KADAI BIN SYAMSUDIN 207807 BPJS Kesehatan MandirGarKelas III Taufik Hidayat. dr, Sp 1,991,500
24 03-07-17 1 Tn. SELAMAT SUTRISNO 174232 BPJS Kesehatan MandirGarKelas III Rinelia Minaswary,dr. 939,160
25 04-07-17 0 Tn. NOTABELI TELAUNBANUA 201811 BPJS MITRA MARGIE GarKelas II A Yasri, dr. Sp.M 0
26 03-07-17 1 Ny. SUMIATI BINTI NGADI 202282 BPJS Kesehatan MandirGarKelas III Indra, dr. Sp.BU 172,300
27 02-07-17 2 Ny. TINA SIREGAR 119314 BPJS Kesehatan MandirGarKelas III Khairul Nasir, dr. Sp 2,906,600
28 01-07-17 3 Ny. YANTI HARIADI 207725 BPJS NO PBI/JAMKES GarKls III Dafnil,dr.Sp.OG 6,759,130
No. Tgl. HP Nama Pasien No. MR Cara Bayar Ka Kelas Dokter Total Biaya DP NKO CODING SISA TAGIHAN ATENSI
Masuk Perawatan
29 02-07-17 2 Ny. DEWI SUSANTI 207757 BPJS PBI/JAMKESMASGarKelas III Befimiroza Adam, dr. 5,625,000
30 03-07-17 1 Ny. ASNIMAR 207855 BPJS IN PROSES GarKelas III Ismar, dr. Sp.BA 1,415,300
31 01-07-17 3 Ny. MEGAWATI 206744 BPJS Kesehatan MandirGarKelas III Befimiroza Adam, dr. 6,096,960
32 02-07-17 2 Ny. MAILAN ROSALIN 207744 BPJS Kesehatan MandirGarKelas III Khairul Nasir, dr. Sp 5,652,900
33 18-06-17 16 Tn. ANGGA PERDANA PUTRA 206896 BPJS NO Kesehatan Man

MelKelas I A Rinelia Minaswary,dr. 27,727,290
34 01-07-17 3 Tn. TOGAR SIMANULLANG 207696 BPJS TOP UP PTPN MelKelas II A Faisal, Dr. Sp.Pd 4,431,400
35 01-07-17 3 Ny. ERNI BINTI MAJI 207706 BPJS TOP UP PTPN MelKelas II A Faisal, Dr. Sp.Pd 6,720,900
36 03-07-17 1 An. RAIHAN AHMAD DWI AULIA 207846 BPJS ASKES NO MelKelas I A Romy Deviandri, dr. 505,320
37 02-07-17 2 Ny. WIDYA SETIAHATI 176095 BPJS TNI NO MelKelas II A Faisal, Dr. Sp.Pd 4,975,200
38 03-07-17 1 Ny. SANTA NORA TAMPUBOLON 190283 BPJS Badan Usaha MelKelas II A Rudolf, dr. Sp.M 361,500
39 03-07-17 1 Ny. RATINI BINTI SUWARJO 205879 BPJS TOP UP PTPN MelKelas II A Yasri, dr. Sp.M 653,200
40 24-06-17 10 By. NY. JULYANI 207362 BPJS NKO NI ICU Nazardi Oyong, dr. S 27,678,050
41 30-06-17 4 An. NAGITA ELISABETH SINAGA 103758 BPJS Badan Usaha PI ICU Irawati, dr.SpA 3,642,200
42 27-06-17 7 By. Ny. CICI ANGGRAINI 207511 BPJS MITRA BU PT. A SCICU Irawati, dr.SpA 15,029,400
43 21-06-17 13 By. NY. RITA ASMARA I 207205 BPJS NO Badan Usaha SCICU Nazardi Oyong, dr. S 19,375,280
44 21-06-17 13 By. NY. RITA ASMARA II 207207 BPJS NO Badan Usaha SCICU Nazardi Oyong, dr. S 18,524,560
45 01-07-17 3 Ny. MARIA SUSANTI 054147 BPJS NKO Sa VIP Befimiroza Adam, dr. 13,929,110
46 03-07-17 1 Ny. SITI DESMAWATI 207862 BPJS NKO Sa VIP Donel, dr. Sp.OG (K 344,990
47 30-06-17 4 Ny. RIA HESTI 044712 BPJS Badan Usaha Sa Kelas II A Befimiroza Adam, dr. 7,258,800
48 04-07-17 0 An. AKBAR SHABRI ATHAYA 105465 BPJS Badan Usaha(EksiAs Kelas II A Ismar, dr. Sp.BA 0
49 03-07-17 1 An. MIRZA RAFIF DANADIPTA 128208 BPJS Kesehatan MandirAs Kelas II A Evi Kamelia, dr. Sp.A 302,200
50 03-07-17 1 An. MARCELL HALIM 148177 BPJS Badan Usaha As Kelas II A Ismar, dr. Sp.BA 1,245,200
51 03-07-17 1 Tn. BUDI PERDANAS PERANGIN 190720 BPJS NKO As VIP Faisal, Dr. Sp.Pd 992,830
ANGIN
52 02-07-17 2 Tn. ARI SUYATNA 207772 BPJS IN PROSES As VIP Syafrudin, dr. Sp.OT 5,866,720
53 02-07-17 2 Ny. ZAITUN MUNAWARAH 207732 BPJS IN PROSES As VIP Donel, dr. Sp.OG (K 11,603,810
54 03-07-17 1 Ny. HASNATUL MUNAWARAH 125481 BPJS NO Kesehatan Man

As Kelas I A Khairul Nasir, dr. Sp 2,481,520
55 02-07-17 2 Ny. RATNA SUSANTI 006125 BPJS NO POLRI Ru Kelas II A Khairul Nasir, dr. Sp 7,739,220
56 04-07-17 0 Ny. HENNY DWI SETIANTI 117010 BPJS NO Badan Usaha Ru Kelas I A Khairul Nasir, dr. Sp.OG
57 03-07-17 1 Tn. DEFRI EDASA SIP 207480 BPJS ASKES Ru Kelas I A Afdhal, dr. Sp.BU 2,280,800
58 03-07-17 1 Tn. AGUS NUR YUSUF 176574 BPJS ASKES Ru Kelas I A Ismar, dr. Sp.BA 1,286,800
Diagnosa Kode ICD INACBG
Diagnosa Kode ICD INACBG
HP = Hari PerawatanPer Tanggal : 11 Jul 2017
No. Tgl. Masuk HP Nama Pasien No. MR Cara Ka Total INACBG SELISIH
Bayar mar
1 20-06-17 21 Tn. JALUDIN 207094 TOP UP Fla 55,159,400 14,116,800 (41,042,600)
MANALU PTPN mb
oya
n
4 10-07-17 1 Ny. ZULHEFA 208572 Kesehata Fla 5,210,500 5,019,900 (190,600)

MARYAM n Mandiri mb
5 10-07-17 1 Tn. TITAPRI 187138 Kesehata Fla 12,317,400 8,788,600 (3,528,800)
oya
n Mandiri mb
nFla
6 09-07-17 2 Ny. RAHMANIYAH 068514 IN 8,181,590 6,023,900 (2,157,690)
oya
PROSES mb
nFla
7 10-07-17 1 Ny. ROZA 189411 IN oya 2,219,870 2,247,800 27,930
ELFITA,S.PT PROSES mb
nFla
8 10-07-17 1 Ny. SHALLY 204853 ASKES oya 1,696,710 3,747,500 2,050,790
FEBRINDAH NO mb
nHC
10 11-07-17 0 Tn. FAHRIZAL 197456 IN oya 1,239,000 3,711,900 2,472,900
AHMAD PROSES U
nMa
12 11-07-17 0 Ny. LEVI AGUSTINA 078534 Kesehata
TOP UP 96,000 2,657,300 2,561,300
n Mandiri war
13 10-07-17 1 Tn. ROMDONI 208539 PTPN
Badan Ma 4,271,100 4,610,500 339,400
Usaha war
14 10-07-17 1 Tn. SUARDI MS 208557 TOP UP Ma 1,298,300 1,574,500 276,200
PTPN war
15 03-07-17 8 Ny. KAMSIAH BINTI 207889 TOP UP Ma 17,777,700 7,231,100 (10,546,600)
MATSAJARI PTPN war
16 04-07-17 7 Ny. SITI AISYAH 190969 TOP UP Ma 9,760,570 3,068,900 (6,691,670)
BR. SAMOSIR PTPN war
18 27-06-17 14 Ny. ARNIA BINTI 207479 TOP UP Lav 21,805,100 7,956,500 (13,848,600)
KASNO PTPN end
19 04-07-17 7 Ny. KASMUNAH 186809 TOP UP Lav 13,813,200 5,804,000 (8,009,200)
er
BINTI NAAM PTPN end
20 10-07-17 1 Tn. SUKIRMAN 165447 IN Lav
er 1,084,300 4,106,700 3,022,400
PROSES end
22 09-07-17 2 Ny. SUMARNI 195503 TOP UP Lav 11,303,100 4,535,900 (6,767,200)
er
PTPN NK end
23 09-07-17 2 An. FATHIR 069900 NO Gar
er 2,136,090 3,463,500 1,327,410
ALFANUR Kesehata deni
24 10-07-17 1 An. GWEN 208522 Badan
n Mandiri Gar
a 1,182,000 1,753,800 571,800
SYAREEFA APRILIA Usaha deni
26 05-07-17 6 Ny. EVA NOVRITA 156693 PBI/JAM Gar 22,217,080 6,559,200 (15,657,880)
a
KESMAS deni
27 10-07-17 1 Ny. MIRAWATI 208621 Kesehata
/KIS Gar
a 312,600 1,562,100 1,249,500
BINTI MASNI n Mandiri deni
29 09-07-17 2 Ny. BERLIANA 021047 Kesehata Gar 3,413,660 1,900,300 (1,513,360)
a
n Mandiri deni
33 24-06-17 17 By. NY. JULYANI 207362 NKO NIC 48,837,190 17,539,700 (31,297,490)
a
U
36 27-06-17 14 By. Ny. CICI 207511 MITRA SC 20,783,100 8,330,980 (12,452,120)

ANGGRAINI BU PT. N
39 09-07-17 2 Ny. SITI PATIMAH 208510 MITRA Mel 10,236,300 4,060,500 (6,175,800)
ASTRA
BU PT. ati
43 10-07-17 1 Tn. AMINULLAH 195600 AGRO
TOP
ASTRA UP Mel 981,000 1,808,000 827,000
BIN ZUHDI LESTARI
PTPN ati
44 09-07-17 2 Tn. ALADIN 208506 AGRO
NO
(PT.TPP) Mel 5,451,960 2,668,200 (2,783,760)
LESTARI
Kesehata ati
45 04-07-17 7 Ny. KODARIYAH 196395 TOP UP Mel 23,709,600 7,203,900 (16,505,700)
n(PT.KTU)
Mandiri
PTPN ati
47 10-07-17 1 Tn. ZAINAL ARIFIN 208634 IN Mel 6,416,080 9,965,600 3,549,520

PROSES ati

Sensus Harian Rawat Inap - Jul 2017 (2) D

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DAFTAR PASIEN RAWAT INAP

HP = Hari Perawatan Per Tanggal : 03 Jul 2017

HP = Hari Perawatan Per Tanggal : 03 Jul 2017

HP = Hari Perawatan Per Tanggal : 04 Jul 2017

3 04-07-17 0 Ny. NURHAYATI 205317 BPJS PBI/JAMKESMAS/K

HP = Hari Perawatan Per Tanggal : 05 Jul 2017

32 08-07-17 2 Ny. DARYUNITA 208467 NKO ICU Rinelia 0 12,644,790 12,644,790

HP = Hari Perawatan Per Tanggal : 13 Jul 2017

73 12-07-17 1 Nn. FERINA QONITHA 208818 NKO Ismar, dr - 11,065,660.00 11,065,660

HP = Hari Perawatan Per Tanggal : 19 Jul 2017

HP = H Per Tanggal : 20 Jul 2017

21 19-07-17 1 SUSANDI 209473 Badan Us Garde Kelas II A Boekit P, d - 905,700 905,700

23 19-07-17 1 RAYMOND SAPUTRA 209313 KesehatanGarde Kelas II A Asrizal, dr - 441,500 441,500

24 17-07-17 3 SANONGONI ZEBUA 175094 KetenagakGarde Kelas II A Asrizal, dr - 4,401,830 4,401,830

38 18-07-17 2 RINI ZARMAN 075049 NKO Melati Befimiroza - 5,748,600 5,748,600

55 20-07-17 0 INTAN SUMIATI 205313 NKO Khairul Nas - 2,171,250 2,171,250

4 11-07-17 1 Tn. FRIM EDUWART NO BadMawar 1,335,660 2,668,200 1,332,540

11 10-07-17 2 Tn. SUARDI MS TOP UPMawar 2,513,100 2,581,400 68,300

16 04-07-17 8 Ny. KODARIYAH TOP UPMelati 27,284,300 7,203,900 (20,080,400)

17 20-06-17 22 Tn. JALUDIN MANALU TOP UPFlamboyan 55,829,500 14,116,800 (41,712,700)

18 09-07-17 3 Ny. SUMARNI TOP UPLavender 14,164,200 4,535,900 (9,628,300)

HP = Hari Perawatan Per Tanggal : 04 Jul 2017

12 01-07-17 3 Ny. SURYANI SIMANJUNTAK 207721 BPJS NO Kesehatan Man

15 03-07-17 1 Tn. SYAHRUL 159990 BPJS NO Kesehatan Man

21 02-07-17 2 An. FARID RIZKY ATALLAH 188176 BPJS NO Kesehatan Man

33 18-06-17 16 Tn. ANGGA PERDANA PUTRA 206896 BPJS NO Kesehatan Man

54 03-07-17 1 Ny. HASNATUL MUNAWARAH 125481 BPJS NO Kesehatan Man

4 10-07-17 1 Ny. ZULHEFA 208572 Kesehata Fla 5,210,500 5,019,900 (190,600)

36 27-06-17 14 By. Ny. CICI 207511 MITRA SC 20,783,100 8,330,980 (12,452,120)

47 10-07-17 1 Tn. ZAINAL ARIFIN 208634 IN Mel 6,416,080 9,965,600 3,549,520

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