PENDAPATAN IGD 2 DESEMBER 2019

NO No. RM Nama Pasien Harga JP JS

1 'OTC YULIDA 1,390 0 0
2 '23-32-80 TINA 34,019 8500 13000
3 '23-32-37 SHINTA ANGGRAENI 58,432 3000 3000
4 '23-33-80 SUPIYATUN 26,085 8000 3000
5 '23-33-53 Bayi Ny. FANNY APRIANI 208,871 18500 13000
6 '23-32-76 ISTIQOMAH 21,743 8500 13000
7 '23-33-61 Bayi Ny. AFRI INDRAWATI 205,702 16500 13000
8 '23-32-91 ASNAH 72,502 4000 3000
9 'OTC UNTUNG WIDIARTO 11,656 1000 3000
10 '23-33-79 SUMAIYAH 105,988 12000 10500
11 'OTC ROFIAH 42,056 2000 3000
12 'OTC NURHASANAH 14,519 2000 3000
13 'OTC MUFIDA 21,142 0 0
14 'OTC ACHMAD ROMADHONI 1,390 0 0
15 'OTC ICTRIS PREFANTI, A.Md.Kep 19,740 0 0
16 '23-33-75 RAJA MAULANA ISHAQ 51,892 12000 13500
17 '23-29-40 JUMATI 153,580 9500 13000
18 '23-32-76 ISTIQOMAH 32,261 11500 13000
19 '23-32-61 NY VIRTA DWI ASMITA 28,062 10500 16000
20 '23-33-71 NISA 50,312 12000 10500
21 '23-33-73 ABDUL HADI 225,580 18000 10500
22 '19-59-88 MISARI 32,205 10000 10500
23 '15-88-98 DALDIRI 34,700 9000 10500
24 'OTC BUSAIRI 60,584 2000 3000
25 'OTC LIFIA 45,832 2000 3000
26 '23-33-68 ODI IVANDRIONO 54,536 11000 13500
27 'OTC SOEPARTI 67,760 3000 3000
28 '04-65-21 SOEBANDI 130,410 3000 3000
29 '04-65-21 SOEBANDI 77,750 7000 10500
30 '14-27-49 EKO WAHYU MULYANTO, SE 300,971 16000 10500
31 '23-33-33 WIDYA SURYAKA 117,352 17000 10500
32 '23-33-49 ALI MUKHTAR 65,330 3000 3000
33 '23-33-64 NURMAN HIDAYATULLOH 306,574 16000 10500
34 '22-61-02 APRILIA ISMANI 17,480 6000 3000
35 '23-33-26 MUHAMMAD HASAN TURABI 23,570 6000 3000
36 '17-25-71 FARIDA 58,280 5000 3000
37 '23-33-27 MOCH FARHAN AFIFUDDIN 75,904 4000 3000
38 '23-30-20 SALSABILA AZZAHRA 36,327 5000 3000
39 '23-31-59 HERMAN 17,800 5000 3000
40 'OTC B SUJENES 42,056 2000 3000
41 '23-31-76 AINUN HAKIM KUSUMA DEHAR19,000 5000 3000
42 '23-26-94 HARTATIK 274,585 6000 3000
43 'OTC SANATI 67,760 3000 3000
44 '23-13-46 ALMA NOVIA MAHARANI 16,000 2000 3000
45 'OTC SATUNI 43,056 3000 3000
46 'OTC FIRMAN ADI SANJAYA, dr, Sp.B37,520 4000 0
47 '23-31-39 FAHYARUL WAROH 79,360 12000 10500
48 '23-26-98 HENRY SUPRIADI 35,075 5000 3000
49 'OTC BAYU 4,534 0 0
50 '09-14-28 HARSIKIN 56,149 7000 3000
51 '22-57-91 ROHMAT ASRI 47,228 5000 3000
52 'OTC ISMAIL HADI 43,380 2000 10500
53 '20-24-63 SUMAWI 17,285 2000 10500
54 'OTC DERI 13,430 2000 0
55 'OTC FATHUR 3,637 0 0
56 'OTC ADELIA NURMAYULITA 60,951 5000 3000
57 '23-33-00 MARSANI 49,006 9000 3000
58 '22-09-65 AFRI INDRAWATI 175,214 17500 13000
59 '22-09-65 AFRI INDRAWATI 83,321 7000 3000
60 '22-09-65 AFRI INDRAWATI 91,350 17500 13000
61 '23-32-80 TINA 67,191 12500 13000
62 '23-32-97 AHMAD HERU 515,293 19500 13000
63 '23-32-99 RIDA WAHYUNI 59,781 9000 3000
64 '23-32-98 ISMAIL 20,380 4000 3000
65 '21-28-74 DIYAN SULIYANA 37,274 9000 10500
4,870,103 457500 402500
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 RESEP JAMINAN RAWAT INAP 2 DESEMBER 2019
Departe Ruanga
NO No. RM Nama Pasien Harga JP JS
men n
1 '23-22-68 SLAMET HARIYANTO IGD - 110,032 23500.00 13000.00
2 '20-80-18 LIFIA MAYDIFAIQAH PUTRI IGD - 142,590 20000.00 3000.00
3 '17-63-58 ARDHYA GARINI ICCU ICCU- ICCU 84,400 15000.00 13000.00
4 '23-33-69 MUHAMMAD IRSYA AL MUWAFIQ KELAS III MAS ALIT- 76,300 16500.00 13000.00
5 '23-33-35 NISWATIN ICCU ICCU- ICCU 10,175 2000.00 3000.00
6 '16-85-09 MIARSO KELAS UTAM SRI TANJUN 128,591 14500.00 13000.00
7 '16-85-09 MIARSO IGD - 222,166 22500.00 13000.00
8 '20-25-01 HJ. SITI RAHMANI BERSALIN SAYUWIWIT 87,176 15500.00 13000.00
9 '20-25-01 HJ. SITI RAHMANI IGD - 123,271 17500.00 13000.00
10 '15-50-86 HAKESHA FARRAS GIANT OKTAVIGD - 129,947 17500.00 13000.00
11 '22-98-70 SURIYATI KELAS III AGUNG WILIS 196,621 13500.00 13000.00
12 '23-33-70 ROFIAH BERSALIN SAYUWIWIT 58,247 13500.00 13000.00
13 '17-43-57 GAYATRI MAYANG HANDAYANI KELAS I SAYUWIWIT- 99,039 17500.00 10500.00
14 '23-32-83 PRISKA AGUSTINA KELAS II SAYUWIWIT- 243,059 24500.00 13000.00
15 '17-54-48 BERLIANTA IFO GRADINI AS BERSALIN SAYUWIWIT 386,391 32500.00 13000.00
16 '23-33-72 MARSANI KELAS III TAWANG ALU 70,650 12500.00 13000.00
17 '23-33-72 MARSANI IGD - 110,008 3000.00 3000.00
18 '23-33-72 MARSANI IGD - 96,730 13000.00 3000.00
19 '23-33-70 ROFIAH BERSALIN SAYUWIWIT 309,189 25000.00 10500.00
20 '23-29-22 HIKMAH KELAS III TAWANG ALU 49,209 9500.00 13000.00
21 '11-53-27 YUNIATI BERSALIN SAYUWIWIT 51,357 15500.00 13000.00
22 '11-81-39 NUR AZIZAH KURNIAWATI KELAS I SAYUWIWIT- 22,994 8500.00 13000.00
23 '23-05-12 SALATI KELAS III TAWANG AL 105,854 11500.00 13000.00
24 '11-53-27 YUNIATI BERSALIN SAYUWIWIT 11,380 2000.00 3000.00
25 '23-32-82 BAYI NY. NUR AZIZAH KURNIAWANICU SEKARDADU 310,684 23500.00 13000.00
26 '23-33-69 MUHAMMAD IRSYA AL MUWAFIQ IGD - 120,164 19500.00 13000.00
27 '23-33-70 ROFIAH BERSALIN SAYUWIWIT 42,922 10500.00 13000.00
28 '20-80-18 LIFIA MAYDIFAIQAH PUTRI IGD - 27,692 10000.00 10500.00
29 '23-33-18 NUR IRMA GUSTIANA SARI IGD - 72,158 10000.00 10500.00
30 '22-77-00 SUPRIYADI IGD - 220,444 14000.00 10500.00
31 '11-53-27 YUNIATI IGD - 75,936 11000.00 10500.00
32 '11-84-56 EDDY BINTORO KELAS II AGUNG WILI 422,126 2700.00 10500.00
33 '12-51-74 FAIRUZ AL ALIFI KURNIAWAN IGD - 103,184 17000.00 10500.00
34 '18-79-49 ABDAD AHMAD ABQARI IGD - 122,843 16000.00 10500.00
35 '07-52-47 IDA YULI ASTUTIK IGD - 117,181 19000.00 10500.00
36 '17-63-58 ARDHYA GARINI IGD - 290,427 31000.00 10500.00
37 '16-99-28 FAYZA KHANSA LAHA AFAF IGD - 89,737 16500.00 13000.00
38 '22-98-70 SURIYATI KELAS III AGUNG WILIS 62,910 11500.00 13000.00
39 '18-79-49 ABDAD AHMAD ABQARI IGD - 68,732 6500.00 5100.00
40 '23-30-17 ARBAKIYAK KELAS I SRITANJUNG 115,499 10500.00 13000.00
41 'OTC SUNALIS OTC - 66,908 7000.00 10500.00
42 'OTC FAIZ FADHOLI OTC - 9,996 0.00 0.00
R 2019
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 RESEP JAMINAN RAWAT JALAN 2 DESEMBER 2019
Nama Ruanga
NO No. RM Departemen Harga JP JS Status
Pasien n
1 '19-58-89 ABDUL HADI IGD - 285,615 16500.00 13000.00 Belum Lunas

2 '00-64-03 SUWARNI IGD - 63,811 16500.00 13000.00 Belum Lunas

3 '15-48-01 FEBISHAFIRAIGD - 37,887 9000.00 13500.00 Belum Lunas

4 '14-82-64 TUGIYONO IGD - 41,479 13000.00 10500.00 Belum Lunas

5 '00-52-46 MISWAN IGD - 74,284 15500.00 10500.00 Belum Lunas

6 '12-17-06 MOCH. IKSA IGD - 46,212 9000.00 10500.00 Belum Lunas

7 '22-11-64 IMAM PURW IGD - 36,290 9000.00 10500.00 Belum Lunas

8 '23-33-67 MUHAMMAD IRGD - 25,446 8000.00 10500.00 Belum Lunas

9 '23-33-63 SUHANNAN IGD - 36,553 11000.00 10500.00 Belum Lunas

10 '23-33-65 HENDRI ARYIGD - 31,732 11000.00 10500.00 Belum Lunas

11 '20-30-67 FITRI WIDIY OBGYN KLINIK - 19,840 7000.00 10500.00 Belum Lunas

12 '21-77-97 JUWANI BEDAH UMUM KLINIK - 113,360 8000.00 10500.00 Belum Lunas

13 '23-07-67 SUNIYEM BEDAH UMUM KLINIK - 32,319 9000.00 10500.00 Belum Lunas

14 '23-33-47 USWATUN H OBGYN KLINIK - 19,840 7000.00 10500.00 Belum Lunas

15 '23-33-17 MISKANAH BEDAH UMUM KLINIK - 26,810 5000.00 3000.00 Belum Lunas

16 '23-27-49 MOHAMMAD B
NEDAH UMUM KLINIK - 31,694 8000.00 10500.00 Belum Lunas

17 '23-33-31 SAIDAH OBGYN KLINIK - 24,680 8000.00 10500.00 Belum Lunas

18 '23-12-85 ALIANDRA PABEDAH UMUM KLINIK - 20,930 7000.00 10500.00 Belum Lunas

19 '21-22-50 USNIATI BEDAH UMUM KLINIK - 26,770 10000.00 10500.00 Belum Lunas

20 '15-92-85 MAR AH BEDAH UMUM KLINIK - 32,386 8000.00 10500.00 Belum Lunas

21 '23-33-05 MUTIMMAH OBGYN KLINIK - 75,786 9000.00 10500.00 Belum Lunas

22 '23-01-94 ANUWAR MUS

UROLOGY KLINIK - 27,512 9000.00 10500.00 Belum Lunas

23 '23-23-01 VITA PUJI LE OBGYN KLINIK - 26,191 9000.00 10500.00 Belum Lunas

24 '09-70-91 DITA KUSUMTHT KLINIK - 36,469 10000.00 10500.00 Belum Lunas

25 '14-40-34 DEWI YUL OBGYN KLINIK - 22,851 8000.00 10500.00 Belum Lunas

26 '23-22-32 MOHAMMAD B
REDAH UMUM KLINIK - 28,570 8000.00 10500.00 Belum Lunas

27 '14-08-72 RUNI ARDI BEDAH UMUM KLINIK - 69,842 12000.00 10500.00 Belum Lunas

28 '23-25-16 HARIS MUARBEDAH UMUM KLINIK - 38,840 8000.00 10500.00 Belum Lunas

29 '23-01-29 YULIS NUR DOBGYN KLINIK - 29,819 9000.00 10500.00 Belum Lunas

30 '22-47-14 SUJENES BEDAH UMUM KLINIK - 38,148 10000.00 10500.00 Belum Lunas

31 '23-15-45 SOEPARTI BEDAH UMUM KLINIK - 38,840 8000.00 10500.00 Belum Lunas

32 '18-83-75 BUHANI OBGYN KLINIK - 41,586 8000.00 10500.00 Belum Lunas

33 '23-23-63 NUR LAILY A OBGYN KLINIK - 20,371 7000.00 10500.00 Belum Lunas

34 '23-24-54 SANATI BEDAH UMUM KLINIK - 38,840 8000.00 10500.00 Belum Lunas

35 '12-86-16 H YASIN SU IGD - 27,892 8000.00 10500.00 Belum Lunas

36 '14-61-27 CANTIKA DE BEDAH UMUM KLINIK - 30,030 7000.00 10500.00 Belum Lunas

37 '17-54-17 NANIK SULASOBGYN KLINIK - 20,690 7000.00 10500.00 Belum Lunas

38 '22-04-58 BUHADIN BEDAH UMUM KLINIK - 22,285 7000.00 10500.00 Belum Lunas

39 '22-04-59 ZAMRONI ALIIGD - 20,690 7000.00 10500.00 Belum Lunas

40 '21-56-68 SATUNI BEDAH UMUM KLINIK - 37,148 9000.00 10500.00 Belum Lunas
41 '23-22-51 HENDRA KURBEDAH UMUM KLINIK - 41,920 10000.00 10500.00 Belum Lunas

42 '10-54-57 BAMBANG SEUROLOGY KLINIK - 195,490 7000.00 10500.00 Belum Lunas

43 '22-95-03 ZURKONI UROLOGY KLINIK - 61,893 8000.00 10500.00 Belum Lunas

44 '23-21-11 NURMALAH OBGYN KLINIK - 22,285 7000.00 10500.00 Belum Lunas

45 '02-00-20 SEMAUN UROLOGY KLINIK - 461,270 8000.00 10500.00 Belum Lunas

46 '23-14-69 SUHARTINI BEDAH UMUM KLINIK - 128,053 9000.00 10500.00 Belum Lunas

47 '09-91-59 NAIMATUS S OBGYN KLINIK - 22,691 8000.00 10500.00 Belum Lunas

48 '23-07-49 RINA RISNAWOBGYN KLINIK - 24,575 9000.00 10500.00 Belum Lunas

49 '23-33-23 ERMA HARI TIGD - 81,650 13000.00 10500.00 Belum Lunas

50 '23-08-08 INDAH HAYUOBGYN KLINIK - 24,575 9000.00 10500.00 Belum Lunas

51 '07-80-03 AGUS IRAWAUROLOGY KLINIK - 97,902 10000.00 10500.00 Belum Lunas

52 '07-60-78 LASINEM OBGYN KLINIK - 18,011 7000.00 10500.00 Belum Lunas

53 '01-45-21 SOEKARJO BEDAH UMUM KLINIK - 127,918 9000.00 10500.00 Belum Lunas

54 '23-21-73 SITI HAMIDA OBGYN KLINIK - 20,257 8000.00 10500.00 Belum Lunas

55 '22-94-97 SUNALIS BEDAH UMUM KLINIK - 36,660 9000.00 10500.00 Belum Lunas

56 '22-82-36 ISMAIL HADI BEDAH UMUM KLINIK - 34,976 9000.00 10500.00 Belum Lunas

57 '23-27-13 MAKIYATUL OBGYN KLINIK - 21,818 9000.00 10500.00 Belum Lunas

58 '00-10-18 JAENAH BEDAH UMUM KLINIK - 48,020 2000.00 10500.00 Belum Lunas

59 '17-76-64 TULUS SETYOBGYN KLINIK - 42,840 9000.00 10500.00 Belum Lunas

60 '23-29-26 RUSMINI OBGYN KLINIK - 38,399 9000.00 10500.00 Belum Lunas

61 '22-78-38 MALEAH IGD - 76,672 14000.00 10500.00 Belum Lunas

62 '06-39-12 AHMAD DJUNSYARAF KLINIK - 106,077 10000.00 10500.00 Belum Lunas

63 '23-33-03 NUR HAYATI IGD - 70,504 14000.00 10500.00 Belum Lunas