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  • RUJUKAN KE SARI ASIH SANGIANG Jli

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    IRAYANA
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    The document is a report from PT. RSIA Bunda Sejahtera detailing 37 medical referrals to RS Sari Asih Sangiang in June 2019. It shows the patient names, dates of referral, procedures performed, billing costs from each hospital, and that there was no difference between the costs. The total billing from both hospitals was Rp. 8,570,000. The report was prepared on August 1, 2019 in Tangerang.

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    The document is a report from PT. RSIA Bunda Sejahtera detailing 37 medical referrals to RS Sari Asih Sangiang in June 2019. It shows the patient names, dates of referral, procedures performed, billing costs from each hospital, and that there was no difference between the costs. The total billing from both hospitals was Rp. 8,570,000. The report was prepared on August 1, 2019 in Tangerang.

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    12 views2 pages

    RUJUKAN KE SARI ASIH SANGIANG Jli

    Uploaded by

    IRAYANA
    The document is a report from PT. RSIA Bunda Sejahtera detailing 37 medical referrals to RS Sari Asih Sangiang in June 2019. It shows the patient names, dates of referral, procedures performed, billing costs from each hospital, and that there was no difference between the costs. The total billing from both hospitals was Rp. 8,570,000. The report was prepared on August 1, 2019 in Tangerang.

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    © All Rights Reserved
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    of 2

    PT.

    RSIA BUNDA SEJAHTERA


    DATA RUJUKAN KE SARI ASIH SANGIANG
    BULAN JUNI 2019

    NO TANGGAL RUJUK NO REGISTRASI NAMA PASIEN PEMERIKSAAN HARGA BILINGAN RS (Rp) HARGA RS Sari Asih (Rp) SELISIH HARGA
    1 7/9/2019 RI20190707-0007 BY NY KOMALA Baby Gram Rp 260,000.00 Rp 260,000.00 Rp -
    2 7/9/2019 RI20190707-0012 BY NY DESI IRMAWATI Baby Gram Rp 260,000.00 Rp 260,000.00 Rp -
    3 7/9/2019 RI20190709-0006 BY NY RIBKA MARYANI Baby Gram Rp 260,000.00 Rp 260,000.00 Rp -
    4 7/10/2019 RI20190707-0016 MUHAMAD RIDWAN Thorax AP Rp 140,000.00 Rp 140,000.00 Rp -
    5 7/11/2019 RI20190711-0019 BY NY MUSLIKAH Baby Gram Rp 260,000.00 Rp 260,000.00 Rp -
    6 7/11/2019 RI20190711-0022 BY NY EEN JUHAENI Baby Gram Rp 260,000.00 Rp 260,000.00 Rp -
    7 7/11/2019 RI20190711-0021 BY NY LIA PUJI ASTUTI Baby Gram Rp 260,000.00 Rp 260,000.00 Rp -
    8 7/13/2019 RI20190713-0001 BY NY FITRIYAH Baby Gram Rp 260,000.00 Rp 260,000.00 Rp -
    9 7/13/2019 RI20190712-0023 BY NY SUMARSIH Baby Gram Rp 260,000.00 Rp 260,000.00 Rp -
    10 7/13/2019 RI20190712-0026 BY NY SITI NURASIYAH Baby Gram Rp 260,000.00 Rp 260,000.00 Rp -
    11 7/13/2019 RI20190710-0014 LAILA KUSUMA USG Abdomen Rp 450,000.00 Rp 450,000.00 Rp -
    12 7/13/2019 RI20190710-0015 APRILIA WINDIA SARI USG Abdomen Rp 450,000.00 Rp 450,000.00 Rp -
    13 7/15/2019 RI20190713-0011 BY NY IDA SUSANTI Baby Gram Rp 190,000.00 Rp 190,000.00 Rp -
    14 7/15/2019 RI20190713-0012 BY NY ELISAH WULANDARI Baby Gram Rp 190,000.00 Rp 190,000.00 Rp -
    15 7/15/2019 RI20190714-0019 BY NY NASIAH Baby Gram Rp 190,000.00 Rp 190,000.00 Rp -
    16 7/16/2019 RI20190715-0021 BY NY LARASATI WISNU P.L Baby Gram Rp 190,000.00 Rp 190,000.00 Rp -
    17 7/16/2019 RI20190716-0004 BY NY HARDIYANTI Baby Gram Rp 190,000.00 Rp 190,000.00 Rp -
    18 7/16/2019 RI20190715-0028 BY NY LESWIRA SITUMORANG Baby Gram Rp 190,000.00 Rp 190,000.00 Rp -
    19 7/16/2019 RI20190715-0025 BY NY PATIMAH Baby Gram Rp 190,000.00 Rp 190,000.00 Rp -
    20 7/17/2019 RI20190716-0016 BY NY EVI YULIANAH Baby Gram Rp 190,000.00 Rp 190,000.00 Rp -
    21 7/17/2019 RI20190716-0014 STIVEN VALENTINO USG Abdomen Rp 450,000.00 Rp 450,000.00 Rp -
    22 7/17/2019  1907170038 By Ny. SITI NASIROH Baby Gram Rp 190,000.00 Rp 190,000.00 Rp -
    23 7/17/2019  1907170025 AULIA OCTAVIYANI Thorax AP Rp 140,000.00 Rp 140,000.00 Rp -
    24 7/18/2019  1907180063 NINING PRATIWI Thorax AP Rp 140,000.00 Rp 140,000.00 Rp -
    25 7/19/2019  1907180055 By Ny. SITI MUNAWAROH Baby Gram Rp 190,000.00 Rp 190,000.00 Rp -
    26 7/20/2019  1907190021 TJUI LAN USG Abdomen Rp 450,000.00 Rp 450,000.00 Rp -
    27 7/21/2019  1907200044 BAYI NY. EKA NOVIANTI Baby Gram Rp 260,000.00 Rp 260,000.00 Rp -
    28 7/22/2019  1907210049 AMORA SIMANJUNTAK Thorax AP Rp 140,000.00 Rp 140,000.00 Rp -
    29 7/23/2019  1907230047 By Ny. FITA SARI ASTUTI Baby Gram Rp 190,000.00 Rp 190,000.00 Rp -
    30 7/25/2019  1907240077 By Ny. IDA ROYANI Baby Gram Rp 190,000.00 Rp 190,000.00 Rp -
    31 7/25/2019  1907240030 By Ny. JULIANA Baby Gram Rp 190,000.00 Rp 190,000.00 Rp -
    32 7/27/2019  1907270029 By Ny.
    By Ny. MEGA
    SENI YULIA Baby Gram Rp 190,000.00 Rp 190,000.00 Rp -
    33 7/27/2019  1907260050 POERWANTO Baby Gram Rp 190,000.00 Rp 190,000.00 Rp -
    34 7/28/2019  1907270048 By Ny. SHINTA SUSANTI Baby Gram Rp 190,000.00 Rp 190,000.00 Rp -
    35 7/30/2019  1907290036 By Ny. SITI MAESURI Baby Gram Rp 190,000.00 Rp 190,000.00 Rp -
    36 7/31/2019  1907300073 BY NY EIGHTY
    SRI RAHMAWATI Baby Gram Rp 190,000.00 Rp 190,000.00 Rp -
    By Ny. WINDA
    37 7/31/2019  1907280055 ARIESVIA Baby Gram Rp 190,000.00 Rp 190,000.00 Rp -
    Rp 8,570,000.00 Rp 8,570,000.00 Rp -

    Tangerang, 01 Agustus 2019


    Diketahui Oleh Dibuat Oleh,

    dr. Bondan Rahmawati Rian Sandi Nugraha


    Ka. Bid Medis & Penunjang Medis Radiografer

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