You are on page 1of 1

RESYA REZKI RAMADHAN

RS KARTIKA DOCTA RINCIAN PEMBAYARAN


Jl. Gajah Mada No. 14 Gunung Pangilun, Padang, Sumatra Barat.
Telp: (0751) 4481278 for patient
Website: www.kartikadocta.com, Email: info@kartikadocta.com

Nama : Tn .X Ruangan : Al-Wakil (Kls III)


No. MR : 101 Tgl Masuk : 12-Sep-19
Alamat : Bengkulu Status : JASA RAHARJA

No Keterangan Freq Jumlah


1 Kamar Rawatan
* Kamar rawatan 4 Rp 960,000

2 Visite
* Visite dokter spesialis ( dr. Noverial, Sp. OT) 3 Rp 450,000

* Visite dokter umum ( dr. Yellaw Suwidariland) 5 Rp 300,000

3 Rawat Jalan
4 Biaya Operasi : Paket Operasi
* Operator (dr. Noverial, Sp.OT) 1 Rp 400,000

* Anastesi ( dr. Edy Widodo, Sp.An) 1 Rp 1,400,000

* Jasa perawat ok 1 Rp 160,000


* Jasa Asisten Anestesi 1 Rp 560,000
5 Sewa Kamar OK 1 Rp 710,000 2 90000 180000 5 15000 75000
6 BHP OK 1 Rp 1,396,757 2 50000 100000 3 35000 105000
7 Labor 7 Rp 654,000 1 42000 42000 4 50000 200000
9 Pemakaian Alat Implant 2 Rp 6,000,000 1 42000 42000 1 35000 35000
10 Tindakan Perasat (Rajal/ IGD/ Ranap/ OK) 14 Rp 445,000 1 290000 290000 1 30000 30000
11 Obat (Rawat Inap) 1 Rp 967,352 7 654000 14 445000
12 Radiologi 2 Rp 300,000

13 Obat ( Pulang ) 1 Rp 75,000 3500000


14 Administrasi 2500000
Padang, 17 September 2019 Rp 14,778,109
Total 6000000
Jasa Raharja Rp 20,000,000

Sisa Jasa Raharja Rp 5,221,891

You might also like