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LAPORAN REKAP KLAIM - RS AR-RASYID PA

Pasien Rawat Inap dan Rawat Jalan, Periode Tanggal Pulang: 1 O
Filter: / Kelas Rawat = Semua / Severity = Semua / Cara Pulang = Se
No. Tgl. Masuk Tgl. Pulang No. RM Nama Pasien
1 28 Sep 2021 1 Okt 2021 029151 NURVIANA
2 28 Sep 2021 1 Okt 2021 067163 SARTIKA
3 28 Sep 2021 1 Okt 2021 067175 EKA ANGGRAINI
4 28 Sep 2021 1 Okt 2021 067194 MERY PEBRIYANTI
5 28 Sep 2021 1 Okt 2021 067182 YAMSANA
6 28 Sep 2021 1 Okt 2021 067218 BY. NY. NURVIANA BIN PANGKI SUWITO
7 28 Sep 2021 1 Okt 2021 067215 BY. NY. EKA ANGGRAINI BIN JUNI ALEXSIN
8 28 Sep 2021 1 Okt 2021 067219 BY. NY. MERY PEBRIYANTI BIN ALPIAN SYAH
9 29 Sep 2021 1 Okt 2021 067251 BY. NY. RIFKA NENGGOLAN BIN MARIHAT
10 29 Sep 2021 1 Okt 2021 067258 BY. NY. SURYATI BIN AGUS HARYANTO
11 29 Sep 2021 1 Okt 2021 067246 BY. NY. WINDAH SANTRI BIN DIMAS SAPUTR
12 29 Sep 2021 1 Okt 2021 037162 ANDI BUDIMAN
13 29 Sep 2021 1 Okt 2021 066132 RULI DEVIANSYAN
14 29 Sep 2021 1 Okt 2021 028194 ISMAIL
15 29 Sep 2021 1 Okt 2021 067228 M IRGI ZAFRAN KHADAFI
16 29 Sep 2021 1 Okt 2021 067183 SITI ASIYAH
17 29 Sep 2021 1 Okt 2021 067207 MIRA SARTIKA
18 29 Sep 2021 1 Okt 2021 067078 M SYAFRI
19 25 Sep 2021 1 Okt 2021 042685 GEMI ASTUTI
20 28 Sep 2021 1 Okt 2021 067169 HOMSIA
21 30 Sep 2021 2 Okt 2021 067283 BY. NY. SITI UMAIRAH BINTI M ASEP ANDER
22 29 Sep 2021 2 Okt 2021 067205 SRI LESTARI
23 30 Sep 2021 2 Okt 2021 009789 RENI ANDAYANI
24 29 Sep 2021 2 Okt 2021 067227 VERA PRATIWI
25 30 Sep 2021 2 Okt 2021 067231 META SUSILAWATI
26 24 Sep 2021 2 Okt 2021 067079 RATINI
27 29 Sep 2021 2 Okt 2021 023024 WINDAH SANTRI
28 29 Sep 2021 2 Okt 2021 018709 RIFKA NENGGOLAN
29 29 Sep 2021 2 Okt 2021 066846 SURYATI
30 29 Sep 2021 2 Okt 2021 033492 SITI UMAIRAH
31 30 Sep 2021 2 Okt 2021 067254 BY. NY. META SUSILAWATI BINTI M JON KEN
32 30 Sep 2021 2 Okt 2021 067249 BY. NY. VERA PRATIWI BIN ADI SUYONO
33 30 Sep 2021 2 Okt 2021 067280 BY. NY. YULIANA BIN WAHYUDI IRAWAN
34 30 Sep 2021 2 Okt 2021 067285 BY. NY. ASIA OKTAVIANA BINTI RAHMAT KA
35 30 Sep 2021 2 Okt 2021 067250 BY. NY. RENI ANDAYANI BIN AHMAD RASID
36 26 Sep 2021 2 Okt 2021 067112 PARYAH
37 27 Sep 2021 2 Okt 2021 067073 IDA
38 26 Sep 2021 2 Okt 2021 033959 YUNIAR
39 28 Sep 2021 2 Okt 2021 067116 ARIFAH RISANTI

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40 25 Sep 2021 2 Okt 2021 067102 ANDIKA LORENGO

41 28 Sep 2021 2 Okt 2021 067192 ANISYA ANGELITA
42 30 Sep 2021 3 Okt 2021 067179 YULIANA
43 30 Sep 2021 3 Okt 2021 008502 MINARNI
44 30 Sep 2021 3 Okt 2021 060069 ASIA OKTAVIANA
45 30 Sep 2021 3 Okt 2021 067252 SITI RUSMINAH
46 29 Sep 2021 3 Okt 2021 065257 SITI FATIMA
47 1 Okt 2021 3 Okt 2021 067281 BY. NY. MINARNI BINTI FIRMAN SYAFIKRI
48 28 Sep 2021 3 Okt 2021 067209 BY. NY. RADA BINTI RUDI HARTONO
49 1 Okt 2021 3 Okt 2021 067286 BY. NY. JUMRIA BINTI ALPIAN
50 26 Sep 2021 3 Okt 2021 067149 BY. NY. NIRMALA DEWI BIN RAMO RAFIKA
51 29 Sep 2021 3 Okt 2021 067198 NYOMAN NURATI
52 1 Okt 2021 3 Okt 2021 067278 MARLINA
53 29 Sep 2021 3 Okt 2021 064873 SURITA
54 30 Sep 2021 3 Okt 2021 067257 RATNA
55 1 Okt 2021 4 Okt 2021 067272 JUMRIA
56 2 Okt 2021 4 Okt 2021 067315 CAHYATI RAMADONA
57 2 Okt 2021 4 Okt 2021 021255 JUNAEDAH
58 3 Okt 2021 4 Okt 2021 067328 UKAESIH
59 1 Okt 2021 4 Okt 2021 067284 AKHMAR NIZAM ATHALLAH
60 1 Okt 2021 4 Okt 2021 061604 ADZKIYA ALTHAFUNNISA
61 29 Sep 2021 4 Okt 2021 005429 YUSLAINI
62 2 Okt 2021 4 Okt 2021 067301 LISVANELY
63 3 Okt 2021 5 Okt 2021 067365 BY. NY. SUPRIYANTI BIN IDHAM KHOLIK
64 2 Okt 2021 5 Okt 2021 067358 BY. NY. SRI HARTANTY BIN SAIPUL ASNAWI
65 3 Okt 2021 5 Okt 2021 067376 BY. NY. DESTI YESIKA BINTI ARIFIN
66 3 Okt 2021 5 Okt 2021 067321 NURHAYATI
67 2 Okt 2021 5 Okt 2021 003360 SRI HARTANTY
68 2 Okt 2021 5 Okt 2021 030962 ERISA MURYATI
69 4 Okt 2021 5 Okt 2021 067338 DWI OKTAVIOLA
70 3 Okt 2021 5 Okt 2021 067319 KARTIKA IKA MAYUH
71 3 Okt 2021 5 Okt 2021 067320 DIANA
72 29 Sep 2021 5 Okt 2021 067221 SANGKUT WALUYO
73 2 Okt 2021 5 Okt 2021 066900 HAFIZA NUR HAYYUNA
74 1 Okt 2021 5 Okt 2021 066952 RISTIONO
75 4 Okt 2021 6 Okt 2021 067340 NGAJIYO
76 3 Okt 2021 6 Okt 2021 056162 ROHMAH
77 3 Okt 2021 6 Okt 2021 066220 FARIDA ARYANI
78 3 Okt 2021 6 Okt 2021 022628 SOFIYAH
79 2 Okt 2021 6 Okt 2021 067189 PARINEM
80 2 Okt 2021 6 Okt 2021 018770 SUKAPTI
81 4 Okt 2021 6 Okt 2021 034935 AL-AYYUBI ADRIANSYAH
82 5 Okt 2021 6 Okt 2021 067374 NURMAIDA

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83 4 Okt 2021 6 Okt 2021 067342 NANDA PUTRI FRANSISKA

84 4 Okt 2021 6 Okt 2021 067341 ERNAWATI
85 3 Okt 2021 6 Okt 2021 067334 DESTI YESIKA
86 3 Okt 2021 6 Okt 2021 067331 RAHMA DONA
87 3 Okt 2021 6 Okt 2021 042822 SUPRIYANTI
88 3 Okt 2021 6 Okt 2021 008555 ALIFAH WIDAYANTI
89 3 Okt 2021 6 Okt 2021 067396 BY. NY. ALIFAH WIDAYANTI BINTI HOSTIN EF
90 5 Okt 2021 7 Okt 2021 018241 TAZILIH
91 5 Okt 2021 7 Okt 2021 067425 BY. NY. APRILIA ANGGRAINI BIN DIMAS AN
92 5 Okt 2021 7 Okt 2021 067375 SRI TINA
93 4 Okt 2021 7 Okt 2021 067337 SUSI SUSANTI
94 4 Okt 2021 7 Okt 2021 052296 SUHARNI
95 1 Okt 2021 7 Okt 2021 067268 INTAN SUNTANI
96 6 Okt 2021 7 Okt 2021 067461 BY. NY. ROSITA BINTI HENDRO NOVIANTO
97 6 Okt 2021 7 Okt 2021 067464 BY. NY. EKA PUJI LESTARI BINTI RENDI SET
98 5 Okt 2021 7 Okt 2021 067428 BY. NY. SANTI BIN M HARIRI
99 5 Okt 2021 7 Okt 2021 067431 BY. NY. ARMIDESI BIN M GENLEKER

Kode RS: 1671343

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M - RS AR-RASYID PALEMBANG
riode Tanggal Pulang: 1 Okt 2021 s/d 11 Okt 2021
Semua / Cara Pulang = Semua / Jenis Tarif = Semua
No. Klaim / SEP INACBG Top Up Total Tarif Tarif RS Jenis
0090R0390921V003202 O-6-10-II 5,302,400 12,207,072 RI
0090R0390921V002951 W-4-17-II 2,769,000 2,578,926 RI
0090R0390921V003051 O-6-10-II 5,302,400 11,012,376 RI
0090R0390921V003086 O-6-10-I 5,019,900 11,053,298 RI
0090R0390921V003062 O-6-10-I 6,023,900 12,241,266 RI
0090R0390921V003208 P-8-16-I 1,857,000 1,067,142 RI
0090R0390921V003201 P-8-17-I 3,457,000 848,000 RI
0090R0390921V003209 P-8-17-I 3,457,000 848,000 RI
0090R0390921V003356 P-8-17-I 3,457,000 827,642 RI
0090R0390921V003373 P-8-17-I 3,457,000 608,500 RI
0090R0390921V003342 P-8-17-I 3,457,000 608,500 RI
0090R0390921V003226 L-1-40-I 3,842,100 10,341,436 RI
0090R0390921V003224 U-1-20-I 5,560,300 11,003,096 RI
0090R0390921V003218 K-1-14-I 5,648,100 11,908,485 RI
0090R0390921V003239 A-4-13-I 1,882,100 1,430,560 RI
0090R0390921V003212 L-1-50-I 5,043,900 10,169,410 RI
0090R0390921V003223 L-1-40-I 3,842,100 10,559,957 RI
0090R0390921V003227 K-1-14-I 4,706,700 10,831,830 RI
0090R0390921V002722 I-4-15-I 4,429,400 12,412,570 RI
0090R0390921V003076 K-1-14-I 4,706,700 10,684,989 RI
0090R0390921V003394 P-8-13-I 5,185,500 757,000 RI
0090R0390921V003197 O-6-13-I 1,605,500 7,199,571 RI
0090R0390921V003313 O-6-10-I 6,023,900 11,380,708 RI
0090R0390921V003235 O-6-10-I 5,019,900 10,653,521 RI
0090R0390921V003318 O-6-10-I 5,019,900 10,110,175 RI
0090R0390921V002753 W-4-16-III 3,766,900 4,919,984 RI
0090R0390921V003156 O-6-10-I 5,019,900 10,457,480 RI
0090R0390921V003207 O-6-10-I 5,019,900 10,674,596 RI
0090R0390921V003198 O-6-10-I 5,019,900 10,514,101 RI
0090R0390921V003234 O-6-10-I 5,019,900 10,607,473 RI
0090R0390921V003365 P-8-17-I 3,457,000 608,500 RI
0090R0390921V003351 P-8-17-I 3,457,000 827,642 RI
0090R0390921V003393 P-8-17-I 3,457,000 608,500 RI
0090R0390921V003395 P-8-17-I 3,457,000 608,500 RI
0090R0390921V003357 P-8-17-I 3,457,000 608,500 RI
0090R0390921V002763 D-4-13-I 2,766,200 6,184,141 RI
0090R0390921V002916 B-1-12-I 5,269,600 17,421,791 RI
0090R0390921V002765 I-4-17-II 2,978,800 7,425,300 RI
0090R0390921V003093 A-4-13-I 1,882,100 3,983,422 RI

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0090R0390921V002741 J-4-16-I 3,463,500 4,473,123 RI

0090R0390921V003081 A-4-13-I 1,568,400 2,089,958 RI
0090R0390921V003266 O-6-10-I 5,019,900 10,480,376 RI
0090R0390921V003389 O-6-10-I 5,019,900 10,541,420 RI
0090R0390921V003390 O-6-10-I 5,019,900 10,624,940 RI
0090R0390921V003366 O-6-10-II 5,302,400 10,516,646 RI
0090R0390921V003238 O-6-10-I 6,023,900 13,159,192 RI
0090R0391021V000063 P-8-17-I 3,457,000 608,500 RI
0090R0390921V003191 P-8-08-I 3,992,400 2,323,267 RI
0090R0391021V000083 P-8-17-I 3,457,000 827,642 RI
0090R0390921V002922 P-8-17-I 3,457,000 2,887,954 RI
0090R0390921V003215 V-1-13-I 3,478,100 12,654,928 RI
0090R0391021V000069 L-4-14-I 2,272,000 10,528,299 RI
0090R0390921V003348 W-1-20-I 7,653,400 14,104,076 RI
0090R0390921V003385 M-1-60-I 6,164,000 31,709,348 RI
0090R0391021V000049 O-6-10-I 5,019,900 10,632,859 RI
0090R0391021V000156 O-6-13-I 2,247,800 7,571,190 RI
0090R0391021V000299 O-6-10-I 5,019,900 10,259,799 RI
0090R0391021V000178 O-6-13-I 1,605,500 4,666,502 RI
0090R0391021V000081 K-4-17-I 1,753,800 2,190,871 RI
0090R0391021V000082 K-4-17-I 1,753,800 2,183,662 RI
0090R0390921V003222 I-4-10-I 3,026,600 4,929,307 RI
0090R0391021V000143 W-1-11-I 2,066,600 8,605,082 RI
0090R0391021V000323 P-8-17-I 3,457,000 608,500 RI
0090R0391021V000300 P-8-17-I 3,457,000 848,000 RI
0090R0391021V000422 P-8-17-I 3,457,000 827,642 RI
0090R0391021V000169 O-6-10-I 5,019,900 9,789,059 RI
0090R0391021V000150 O-6-10-I 5,019,900 11,646,451 RI
0090R0391021V000142 W-1-20-I 7,653,400 12,109,139 RI
0090R0391021V000293 W-1-11-I 1,722,200 6,595,351 RI
0090R0391021V000162 O-6-10-I 6,023,900 11,462,220 RI
0090R0391021V000171 L-4-13-I 2,826,800 11,433,659 RI
0090R0391021V000298 H-1-20-I 5,272,600 13,188,536 RI
0090R0391021V000141 N-4-12-I 2,240,000 1,913,754 RI
0090R0391021V000092 G-4-26-I 3,076,100 4,550,488 RI
0090R0391021V000331 K-1-14-I 4,706,700 10,425,906 RI
0090R0391021V000195 G-4-26-II 3,578,400 4,181,550 RI
0090R0391021V000176 E-4-11-I 2,736,500 3,619,268 RI
0090R0391021V000170 B-4-14-I 3,889,400 4,602,396 RI
0090R0391021V000114 B-4-13-I 3,893,600 5,493,848 RI
0090R0391021V000112 I-4-16-I 1,948,200 4,786,844 RI
0090R0391021V000337 J-4-16-I 3,463,500 1,687,147 RI
0090R0391021V000347 O-6-13-I 1,605,500 4,584,420 RI

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0090R0391021V000428 O-6-10-I 5,019,900 9,961,554 RI

0090R0391021V000284 O-6-10-I 5,019,900 9,778,895 RI
0090R0391021V000193 O-6-10-I 5,019,900 10,747,175 RI
0090R0391021V000182 O-6-10-I 5,019,900 10,723,052 RI
0090R0391021V000183 O-6-10-I 5,019,900 10,422,505 RI
0090R0391021V000476 O-6-10-II 5,302,400 10,966,631 RI
0090R0391021V000488 P-8-17-I 3,457,000 848,000 RI
0090R0391021V000427 L-1-40-I 5,379,000 12,854,459 RI
0090R0391021V000603 P-8-13-I 6,222,600 2,365,625 RI
0090R0391021V000419 O-6-10-I 5,019,900 9,911,524 RI
0090R0391021V000197 O-6-10-I 5,019,900 10,772,009 RI
0090R0391021V000484 O-6-10-I 7,027,900 14,400,698 RI
0090R0391021V000072 W-1-20-II 7,969,200 14,558,878 RI
0090R0391021V000727 P-8-17-I 3,457,000 369,000 RI
0090R0391021V000731 P-8-13-I 5,185,500 369,000 RI
0090R0391021V000613 P-8-17-I 3,457,000 608,500 RI
0090R0391021V000623 P-8-17-I 3,457,000 608,500 RI
Total 409,048,100 711,983,084

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