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  • Rajal Maret 2018 Rev 2

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    ZohanSantosoII
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    This document provides a report summarizing patient claims and reimbursement details for a public hospital in Surakarta, Central Java, Indonesia for the period of March 1-31, 2018. It includes 18 patient entries with details on admission and discharge dates, patient IDs, names, diagnosis codes, total tariffs, hospital tariffs, and claim types. The total tariff claimed for all patients was 30,527,700 with 15,198,084 being reimbursed by the hospital's insurance program for class C government rates.

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    This document provides a report summarizing patient claims and reimbursement details for a public hospital in Surakarta, Central Java, Indonesia for the period of March 1-31, 2018. It includes 18 patient entries with details on admission and discharge dates, patient IDs, names, diagnosis codes, total tariffs, hospital tariffs, and claim types. The total tariff claimed for all patients was 30,527,700 with 15,198,084 being reimbursed by the hospital's insurance program for class C government rates.

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    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
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    9 views2 pages

    Rajal Maret 2018 Rev 2

    Uploaded by

    ZohanSantosoII
    This document provides a report summarizing patient claims and reimbursement details for a public hospital in Surakarta, Central Java, Indonesia for the period of March 1-31, 2018. It includes 18 patient entries with details on admission and discharge dates, patient IDs, names, diagnosis codes, total tariffs, hospital tariffs, and claim types. The total tariff claimed for all patients was 30,527,700 with 15,198,084 being reimbursed by the hospital's insurance program for class C government rates.

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    © All Rights Reserved
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    of 2

    sheet1 -1

    LAPORAN REKAP
    Pasien KLAIM
    Rawat - RSUD
    Inap KOTAJalan,
    dan Rawat SURAKARTA
    Periode Tanggal Pulang: 1 Mar 2018 s/d 31 Mar 2018
    Filter: / Kelas Rawat = Semua / Severity = Semua / Cara Pulang = Semua / Jenis Tarif = TARIF RS KELAS C PEMERIN

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


    1 5 Mar 2018 5 Mar 2018 109836 WIDODO
    2 7 Mar 2018 7 Mar 2018 109962 ARYANI DEFI UNTARI
    3 7 Mar 2018 7 Mar 2018 036229 NURUL MUSLIMAH
    4 7 Mar 2018 7 Mar 2018 093079 AHMAD MUHARIYANTO TAMBUNAN
    5 5 Mar 2018 5 Mar 2018 109492 ANSHORI
    6 5 Mar 2018 5 Mar 2018 083162 SUWITO
    7 5 Mar 2018 5 Mar 2018 108371 AMINI
    8 5 Mar 2018 5 Mar 2018 094055 ARSIH WENDA WIGIYANTI
    9 5 Mar 2018 5 Mar 2018 092482 SRI WIDATI
    10 5 Mar 2018 5 Mar 2018 047043 WIYATI
    11 5 Mar 2018 5 Mar 2018 102452 SITI WARSIYAH
    12 5 Mar 2018 5 Mar 2018 024088 ROKAYAH
    13 5 Mar 2018 5 Mar 2018 109616 SHOLIHIN
    14 12 Mar 2018 12 Mar 2018 109892 JUMINEM
    15 12 Mar 2018 12 Mar 2018 078407 NGADIMAN
    16 26 Mar 2018 26 Mar 2018 099346 MURMINAH
    17 28 Mar 2018 28 Mar 2018 027770 CH. TRI CAHYANI
    18 27 Mar 2018 27 Mar 2018 077519 SISKA AYU FEBRYANI
    Total
    Kode RS: 3372234

    Page 1
    sheet1 -1

    IF RS KELAS C PEMERINTAH

    No. SEP INACBG Top Up Total Tarif Tarif RS Jenis


    1124R0030318V000976 Z-3-23-0 549,400 334,996 RJ
    1124R0030318V001581 Q-5-23-0 127,200 424,149 RJ
    1124R0030318V001627 Q-5-44-0 181,400 188,500 RJ
    1124R0030318V001732 Q-5-44-0 181,400 163,500 RJ
    1124R0030318V001805 Q-5-44-0 181,400 68,600 RJ
    1124R0030318V001808 Q-5-44-0 181,400 77,240 RJ
    1124R0030318V001810 Q-5-44-0 181,400 77,240 RJ
    1124R0030318V001826 Q-5-44-0 181,400 33,500 RJ
    1124R0030318V001829 Q-5-44-0 181,400 323,800 RJ
    1124R0030318V001831 Q-5-44-0 181,400 144,830 RJ
    1124R0030318V001834 Q-5-44-0 181,400 107,065 RJ
    1124R0030318V001835 Q-5-44-0 181,400 442,899 RJ
    1124R0030318V001841 H-2-36-0 YY-10-III,YY-10-III 6,930,000 3,050,837 RJ
    1124R0030318V002734 H-2-36-0 YY-10-III,YY-10-III 6,930,000 3,120,000 RJ
    1124R0030318V002737 H-2-36-0 YY-10-III,YY-10-III 6,930,000 3,105,000 RJ
    1124R0030318V006443 H-2-36-0 YY-10-III,YY-10-III 6,930,000 3,282,426 RJ
    1124R0030318V008158 Q-5-44-0 181,400 117,988 RJ
    1124R0030318V008159 Q-5-25-0 135,700 135,514 RJ
    30,527,700 15,198,084

    Page 2

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