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  • Lampiran Bast Nov

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    asep sumarwan
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    LAMPIRAN BAST NOV

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    7 views1 page

    Lampiran Bast Nov

    Uploaded by

    asep sumarwan

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    LAMPIRAN BERITA ACARA SERAH TERIMA KLAIM - RAWAT INAP

    NO NOFPK NOREGISTER NOEKLAIM NOSURAT NOPENGAJUAN TGLSEP TGLPULANG LOS JNSPEL NOIDENTITAS NMPESERTA TGLLAHIRPASIEN UMUR KDINACBG TARIPINACBG TOTALGRUPER BYPENGAJUAN
    1 10171220CV0008 0132R0461220CV00001 3216385R47011205 6582/BA/IV-13/1220 3216385ICC20110002 2020-10-30 21:43:30 2020-11-12 21:43:30 14 INAP 3216090408690002 ANIMAN AKHYAR 1969-08-04 51 A-4-13-I 2069600.00 2069600 103169000.00
    2 10171220CV0008 0132R0461220CV00001 3216385R47011205 6582/BA/IV-13/1220 3216385ICC20110003 2020-11-06 21:48:05 2020-11-19 21:48:05 14 INAP 3212234502020008 PUTRI ISTIQOMAH 2002-02-05 18 A-4-13-I 2069600.00 2069600 103169000.00
    3 10171220CV0008 0132R0461220CV00001 3216385R47011205 6582/BA/IV-13/1220 3216385ICC20110008 2020-11-10 22:12:29 2020-11-24 22:12:29 15 INAP 3208163007860002 TAUPIK 1986-07-30 34 A-4-13-I 2069600.00 2069600 110669000.00
    4 10171220CV0008 0132R0461220CV00001 3216385R47011205 6582/BA/IV-13/1220 3216385ICC20120001 2020-11-10 17:01:02 2020-11-28 17:01:02 19 INAP 3210216208960001 ANNISSA RATNA MILANDA 1996-08-22 24 A-4-13-I 2069600.00 2069600 140669000.00
    5 10171220CV0008 0132R0461220CV00001 3216385R47011205 6582/BA/IV-13/1220 3216385ICC20110009 2020-11-11 22:16:37 2020-11-24 22:16:37 14 INAP 3216212101820004 MUHAMAD TOSIN 1982-01-21 38 A-4-13-I 2069600.00 2069600 103169000.00
    6 10171220CV0008 0132R0461220CV00001 3216385R47011205 6582/BA/IV-13/1220 3216385ICC20110004 2020-11-11 21:52:03 2020-11-21 21:52:03 11 INAP 3216211708710003 FREDERICK F.BATLAJERY 1971-08-17 49 A-4-13-I 2069600.00 2069600 102669000.00
    7 10171220CV0008 0132R0461220CV00001 3216385R47011205 6582/BA/IV-13/1220 3216385ICC20110005 2020-11-11 22:02:40 2020-11-24 22:02:40 14 INAP 3216164505970001 MELIYAH TUZZAKIYAH 1997-05-05 23 A-4-13-I 2069600.00 2069600 103169000.00
    8 10171220CV0008 0132R0461220CV00001 3216385R47011205 6582/BA/IV-13/1220 3216385ICC20110007 2020-11-12 22:09:19 2020-11-24 22:09:19 13 INAP 3216095010730018 HANDRIYANI NASUTION.SE 1973-10-10 47 A-4-13-I 2069600.00 2069600 95669000.00
    9 10171220CV0008 0132R0461220CV00001 3216385R47011205 6582/BA/IV-13/1220 3216385ICC20120002 2020-11-14 11:47:51 2020-12-01 11:47:51 18 INAP 1702182305810001 EROPRIA NESTA 1981-05-23 39 A-4-13-II 3657500.00 3657500 134364000.00
    10 10171220CV0008 0132R0461220CV00001 3216385R47011205 6582/BA/IV-13/1220 3216385ICC20110006 2020-11-15 22:05:16 2020-11-24 22:05:16 10 INAP 3216085905760001 SITI MUSLIKAH 1976-05-19 44 A-4-13-I 2069600.00 2069600 73169000.00
    11 10171220CV0008 0132R0461220CV00001 3216385R47011205 6582/BA/IV-13/1220 3216385ICC2011000B 2020-11-20 22:21:52 2020-11-26 22:21:52 7 INAP 3216204110820002 SUSI WINDI SATRIANI 1982-10-01 38 A-4-13-I 2069600.00 2069600 50669000.00
    12 10171220CV0008 0132R0461220CV00001 3216385R47011205 6582/BA/IV-13/1220 3216385ICC20120003 2020-11-21 12:08:27 2020-12-02 12:08:27 12 INAP 3216205802780005 SRI AMINATUN 1978-02-18 42 A-4-13-I 2069600.00 2069600 88169000.00

    Cikarang, 10 Desember 2020


    Direktur Rumah Sakit Harapan Keluarga

    dr.Virgia Widyawati, MM
    100.59.20

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