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LAPORAN REKAP KLAIM - RS CHARIS MEDIKA

Pasien Rawat Inap dan Rawat Jalan, Periode Tanggal Pulang: 1 Apr 2018 s/d 30 Apr 2018

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

1 31 Mar 2018 2 Apr 2018 096436 NISMA SINAMBELA
2 31 Mar 2018 3 Apr 2018 096443 NURMA YANTI SIMATUPANG
3 2 Apr 2018 4 Apr 2018 096467 SITI AMINAH
4 6 Apr 2018 8 Apr 2018 096531 MIRA KARMILA
5 10 Apr 2018 12 Apr 2018 095900 JAMIATUN
6 10 Apr 2018 12 Apr 2018 096471 DENNY ELRIDA PANJAITAN
7 11 Apr 2018 13 Apr 2018 096585 RAMLAH
8 11 Apr 2018 13 Apr 2018 096584 BAYI NY MAHYUNI RAMBE II
9 12 Apr 2018 14 Apr 2018 096595 NURHALIMAH
10 13 Apr 2018 15 Apr 2018 096610 NORMAH
11 17 Apr 2018 18 Apr 2018 096656 NURJANNAH NASUTION
12 16 Apr 2018 19 Apr 2018 096647 HERAWATI
13 19 Apr 2018 21 Apr 2018 096678 BRAYEN MOWGLY HARAINJA
14 23 Apr 2018 25 Apr 2018 096727 BY NYONYA MARIETTA KRISTINA SIMATUPAN
15 25 Apr 2018 28 Apr 2018 096747 ELFIANTI
16 26 Apr 2018 29 Apr 2018 096755 DELI WANTI SIMATUPANG
17 28 Apr 2018 29 Apr 2018 096774 DERNI
18 28 Apr 2018 30 Apr 2018 096764 DELIMA VERAWATI SIMAMORA
Total
Kode RS: 2071037

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No. SEP INACBG Top Up Total Tarif Tarif RS Jenis

0070R0180318V000478 O-6-10-I 6,041,800 9,905,400 RI
0070R0180318V000482 O-6-10-I 6,041,800 10,328,900 RI
0070R0180418V000017 O-6-10-I 5,034,900 9,460,400 RI
0070R0180418V000094 O-6-10-I 5,034,900 9,717,900 RI
0070R0180418V000131 O-6-10-I 6,041,800 9,858,900 RI
0070R0180418V000140 O-6-10-I 5,034,900 9,692,400 RI
0070R0180418V000137 O-6-10-I 5,034,900 10,871,900 RI
0070R0180418V000168 P-8-13-I 6,241,200 1,719,500 RI
0070R0180418V000152 W-4-16-I 2,084,600 1,274,500 RI
0070R0180418V000171 N-4-16-I 2,860,800 1,998,675 RI
0070R0180418V000245 W-4-16-I 2,501,500 4,143,050 RI
0070R0180418V000220 O-6-10-I 6,041,800 10,347,400 RI
0070R0180418V000288 P-8-17-I 4,160,800 1,650,000 RI
0070R0180418V000329 P-8-17-I 4,160,800 1,150,000 RI
0070R0180418V000351 O-6-10-I 5,034,900 11,727,650 RI
0070R0180418V000376 O-6-10-I 6,041,800 10,195,900 RI
0070R0180418V000378 O-6-13-I 1,610,300 3,513,575 RI
0070R0180418V000370 O-6-10-I 5,034,900 9,786,900 RI
84,038,400 127,342,950

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