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LAPORAN REKAP
Pasien KLAIM
Rawat - RUMAH
Inap SAKIT
dan Rawat IBUPeriode
Jalan, DAN ANAK MAWAR
Tanggal Pulang: 1 Jan 2019 s/d 31 Jan 2019
Filter: Metode Pembayaran = Semua / Kelas Rawat = Semua / Severity = Semua / Cara Pulang = Semua / Jenis Tarif = T

No. Tgl. Masuk Tgl. Pulang No. RM Nama Pasien

1 31 Des 2018 1 Jan 2019 945101 SITI TUKINAH
2 31 Des 2018 2 Jan 2019 704101 RATNA SARI
3 1 Jan 2019 2 Jan 2019 005201 SUPATMI
4 31 Des 2018 3 Jan 2019 975101 SURYATI
5 3 Jan 2019 5 Jan 2019 055201 NURMALA SARI
6 3 Jan 2019 6 Jan 2019 095201 SRI WIDARTI
7 7 Jan 2019 9 Jan 2019 375101 WIWIK YUNINGSIH
8 6 Jan 2019 10 Jan 2019 145201 TUGINEM
9 8 Jan 2019 10 Jan 2019 195201 ENDANG
10 9 Jan 2019 11 Jan 2019 255201 NOVIANA
11 10 Jan 2019 11 Jan 2019 285201 LILIK ENDANG SUPARMIASIH
12 11 Jan 2019 13 Jan 2019 335201 SURANTINAH
13 12 Jan 2019 13 Jan 2019 425201 UMISA DIYAH
14 12 Jan 2019 14 Jan 2019 804401 NGATIRAH
15 13 Jan 2019 15 Jan 2019 455201 ETIK NURMALA SARI
16 12 Jan 2019 16 Jan 2019 353601 RENI INDRAS WATI
17 14 Jan 2019 16 Jan 2019 505201 LATHIFATUR ROHMAH
18 15 Jan 2019 17 Jan 2019 515201 PARTIMAH
19 16 Jan 2019 18 Jan 2019 555201 NINGSIH ASPUTRI
20 17 Jan 2019 19 Jan 2019 135101 BINTI SUKMA SYAM
21 16 Jan 2019 19 Jan 2019 575201 DESI AFRIANI
22 17 Jan 2019 19 Jan 2019 645201 TRI YUNI WIDIANTI
23 17 Jan 2019 19 Jan 2019 703501 SULASTRI
24 17 Jan 2019 19 Jan 2019 665201 SRI RAHAYU
25 18 Jan 2019 19 Jan 2019 325201 SUMILAH
26 18 Jan 2019 20 Jan 2019 255201 NOVIANA
27 18 Jan 2019 20 Jan 2019 755201 SUMINI
28 20 Jan 2019 21 Jan 2019 815201 UMI KHOLIFAH
29 22 Jan 2019 24 Jan 2019 774901 JUARIYAH
30 23 Jan 2019 25 Jan 2019 555001 MUNASIAH
31 24 Jan 2019 26 Jan 2019 955201 SYAIFATUL MAHMUDAH
32 25 Jan 2019 26 Jan 2019 975201 YUYUN WIJAYANTI
33 26 Jan 2019 27 Jan 2019 985201 SUMARTIK
34 26 Jan 2019 28 Jan 2019 995201 ENDANG LESTARI
35 28 Jan 2019 29 Jan 2019 085301 SAWIYAH
36 27 Jan 2019 29 Jan 2019 025301 RUDIAWATI
Total
Kode RS: 1804013

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ang = Semua / Jenis Tarif = TARIF RS KELAS C SWASTA

No. SEP INACBG Top Up Total Tarif Tarif RS Jenis

0101R0111218V000102 W-1-11-I 1,722,200 3,700,000 RI
0101R0111218V000096 O-6-10-I 5,019,900 8,200,000 RI
0101R0110119V000001 O-6-12-I 1,878,400 5,000,000 RI
0101R0111218V000101 O-6-10-I 5,019,900 8,200,000 RI
0101R0110119V000007 O-6-10-I 5,019,900 8,200,000 RI
0101R0110119V000009 O-6-10-II 5,302,400 8,400,000 RI
0101R0110119V000011 O-6-10-II 6,362,800 8,000,000 RI
0101R0110119V000010 O-6-10-I 5,019,900 9,275,000 RI
0101R0110119V000014 O-6-10-II 5,302,400 8,445,000 RI
0101R0110119V000016 W-4-15-I 1,562,100 2,200,000 RI
0101R0110119V000018 O-6-13-I 1,605,500 5,000,000 RI
0101R0110119V000022 O-6-10-I 5,019,900 8,200,000 RI
0101R0110119V000019 W-1-11-I 1,722,200 3,160,000 RI
0101R0110119V000021 O-6-10-I 5,019,900 8,000,000 RI
0101R0110119V000020 O-6-10-I 5,019,900 8,700,000 RI
0101R0110119V000023 O-6-10-I 5,019,900 9,910,000 RI
0101R0110119V000027 W-1-11-I 1,722,200 3,360,000 RI
0101R0110119V000031 O-6-10-I 5,019,900 8,200,000 RI
0101R0110119V000033 O-6-10-I 5,019,900 8,000,000 RI
0101R0110119V000042 W-4-16-I 2,078,400 2,000,000 RI
0101R0110119V000032 O-6-10-I 5,019,900 8,200,000 RI
0101R0110119V000036 O-6-10-I 5,019,900 8,000,000 RI
0101R0110119V000043 O-6-10-I 5,019,900 8,700,000 RI
0101R0110119V000035 O-6-10-I 6,023,900 8,000,000 RI
0101R0110119V000041 W-1-10-I 2,306,800 5,235,000 RI
0101R0110119V000039 O-6-10-I 5,019,900 8,200,000 RI
0101R0110119V000040 O-6-10-I 5,019,900 8,200,000 RI
0101R0110119V000045 W-4-16-I 2,078,400 2,000,000 RI
0101R0110119V000054 O-6-10-I 5,019,900 8,000,000 RI
0101R0110119V000055 O-6-10-I 5,019,900 8,000,000 RI
0101R0110119V000056 O-6-10-I 5,019,900 8,500,000 RI
0101R0110119V000057 W-1-11-I 1,722,200 3,360,000 RI
0101R0110119V000058 W-4-17-II 2,769,000 3,000,000 RI
0101R0110119V000059 O-6-10-I 5,019,900 8,700,000 RI
0101R0110119V000062 W-1-11-I 1,722,200 3,360,000 RI
0101R0110119V000060 O-6-10-I 5,019,900 8,200,000 RI
146,279,100 241,805,000

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