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LAPORAN REKAP KLAIM

Pasien Rawat Inap dan Rawat Jalan, Peri
Filter: / Kelas Rawat = Semua / Severity = S
No. Tgl. Masuk Tgl. Pulang No. RM
1 14 Jan 2022 22 Jan 2022 519794
2 14 Jan 2022 22 Jan 2022 541788
3 15 Jan 2022 22 Jan 2022 397872
4 15 Jan 2022 22 Jan 2022 433437
5 15 Jan 2022 22 Jan 2022 541898
6 16 Jan 2022 22 Jan 2022 465504
7 16 Jan 2022 22 Jan 2022 532946
8 16 Jan 2022 22 Jan 2022 216013
9 16 Jan 2022 22 Jan 2022 541819
10 16 Jan 2022 22 Jan 2022 437091
11 16 Jan 2022 22 Jan 2022 367194
12 16 Jan 2022 22 Jan 2022 541986
13 17 Jan 2022 22 Jan 2022 541988
14 16 Jan 2022 22 Jan 2022 541551
15 17 Jan 2022 22 Jan 2022 245778
16 18 Jan 2022 22 Jan 2022 000345
17 18 Jan 2022 22 Jan 2022 542085
18 18 Jan 2022 22 Jan 2022 204576
19 19 Jan 2022 22 Jan 2022 542166
20 19 Jan 2022 22 Jan 2022 542179
21 19 Jan 2022 22 Jan 2022 542172
22 19 Jan 2022 22 Jan 2022 397973
23 19 Jan 2022 22 Jan 2022 542189
24 19 Jan 2022 22 Jan 2022 542181
25 19 Jan 2022 22 Jan 2022 536657
26 19 Jan 2022 22 Jan 2022 542214
27 19 Jan 2022 22 Jan 2022 526636
28 19 Jan 2022 22 Jan 2022 542231
29 20 Jan 2022 22 Jan 2022 354462
30 18 Jan 2022 22 Jan 2022 542116
31 20 Jan 2022 22 Jan 2022 424953
32 20 Jan 2022 22 Jan 2022 509644
33 19 Jan 2022 22 Jan 2022 222265
34 20 Jan 2022 22 Jan 2022 520520
35 20 Jan 2022 22 Jan 2022 273066
36 21 Jan 2022 22 Jan 2022 411142
37 19 Jan 2022 22 Jan 2022 000773
38 20 Jan 2022 22 Jan 2022 542303
39 21 Jan 2022 22 Jan 2022 542337

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40 20 Jan 2022 22 Jan 2022 535061

41 20 Jan 2022 22 Jan 2022 542301

Kode RS: 3515106

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LAPORAN REKAP KLAIM - RS ISLAM SITI HAJAR

Pasien Rawat Inap dan Rawat Jalan, Periode Tanggal Pulang: 22 Jan 2022 s/d 22 Jan 2022
Filter: / Kelas Rawat = Semua / Severity = Semua / Cara Pulang = Semua / Jenis Tarif = Semua
Nama Pasien No. Klaim / SEP INACBG
ALI GHUFRON. TN 0195R0290122V006341 N-4-16-III
MISTI, NY. 0195R0290122V006372 J-4-16-III
SURADJI, DRS TN 0195R0290122V006590 J-4-15-II
ABDUL MUNIF 0195R0290122V006872 G-4-14-I
SARMANI. NY 0195R0290122V006933 J-4-20-I
DICKY SISWANTO, TN 0195R0290122V007095 I-4-10-III
SUGIYANTO. TN 0195R0290122V007106 G-4-14-II
WARNI TN 0195R0290122V007119 N-4-10-II
MUHAMMAD DAZTAN ADHIYASTA AN 0195R0290122V007123 A-4-14-I
FAIZ NUR WICAKSONO,AN 0195R0290122V007135 A-4-13-I
FENI ROSITA NY 0195R0290122V007184 U-4-13-I
ANNIRA ALHAQQU IRAWAN.AN 0195R0290122V007487 J-4-16-I
SOEMARNO. TN 0195R0290122V007525 J-4-15-I
MOH. SUFA'AT.TN 0195R0290122V007596 I-4-10-III
MARDIYAH NY 0195R0290122V007633 N-4-10-II
RIZA DWI PRAHARANI NY 0195R0290122V007851 E-4-11-III
DHIAFAKHRI AZFAR RACHMAN AN 0195R0290122V007856 G-4-22-I
SAMSUL ARIFIN 0195R0290122V008313 K-4-18-I
SITI JUARIA,NY 0195R0290122V008439 O-6-10-I
PRAMITHA LAURENTIA WIPA PUTRI .AN 0195R0290122V008553 A-4-13-I
HANIM INWAN .NY 0195R0290122V008589 G-4-17-I
ARMAIRA AYA MARITSA 0195R0290122V008624 A-4-13-III
ENANG PADUKA ,TN 0195R0290122V008653 A-4-13-I
MUFIDATUL HIKMAH. NN 0195R0290122V008683 W-1-20-I
KUSNAN. TN 0195R0290122V008709 N-1-20-I
NURUL AMUDI. TN 0195R0290122V008768 B-4-14-II
KHAIRAH ALMAHYRA AN 0195R0290122V008784 J-4-16-I
HIJAYUD FURIYANTI. NY 0195R0290122V008788 O-6-10-I
BAYU RETNO WATI 0195R0290122V008937 O-6-10-I
IKA MAGHFIROTUN NIKMAH , NY 0195R0290122V009034 A-4-15-II
EVA RUSDIANA, NY 0195R0290122V009045 O-6-10-I
DWI DEHANA WULAN SARI, NY 0195R0290122V009143 K-4-17-I
SITI AMINAH .NY 0195R0290122V009247 N-4-16-I
BILQIS KHUMAIRA RAMADHANI, AN 0195R0290122V009279 K-1-14-I
WUJUD TN 0195R0290122V009332 K-4-17-I
MIKAYLA MISA SAFANA RAMADHANI.AN 0195R0290122V009393 J-4-16-I
WILDAN HIDAYATULLOH. SDR 0195R0290122V009616 A-4-12-I
ANNES PRILLA KUSUMA, BY NY 0195R0290122V009665 P-8-13-I
DWI NUR ISROTIN .NY 0195R0290122V009671 W-4-16-I

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ANNES PRILLA KUSUMA, NY 0195R0290122V009961 O-6-10-I

BAYU RETNO WATI, BY NY 0195R0290122V010034 P-8-15-I
T

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an 2022
f = Semua
Top Up Total Tarif Tarif RS Jenis
10,134,400 19,724,400 RI
6,419,700 17,131,900 RI
7,253,300 24,121,200 RI
7,018,400 12,554,200 RI
4,640,500 15,899,000 RI
14,562,700 16,490,200 RI
6,909,500 9,219,400 RI
4,958,500 9,927,600 RI
2,722,500 5,794,900 RI
2,925,900 7,545,500 RI
2,772,200 8,767,300 RI
4,335,900 6,123,400 RI
6,071,100 26,439,600 RI
12,482,300 18,218,800 RI
5,784,900 11,098,000 RI
8,810,600 5,599,000 RI
3,718,200 5,624,900 RI
2,033,900 6,299,112 RI
6,981,500 12,663,660 RI
2,925,900 5,079,170 RI
6,296,600 10,269,500 RI
4,481,300 3,175,400 RI
2,090,000 2,844,000 RI
8,264,200 9,453,422 RI
13,696,900 17,924,700 RI
5,879,600 6,163,400 RI
5,058,500 3,636,900 RI
6,981,500 9,087,941 RI
6,981,500 8,281,758 RI
18,017,100 7,432,900 RI
6,981,500 9,149,657 RI
2,405,100 3,546,000 RI
3,695,900 4,622,900 RI
5,489,000 6,061,888 RI
1,718,000 2,480,100 RI
5,058,500 3,223,500 RI
3,695,000 4,350,200 RI
5,483,600 1,650,600 RI
2,168,300 1,669,100 RI

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6,981,500 9,028,741 RI
2,741,100 1,634,000 RI
Total 247,626,600 370,007,849

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