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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 12 Jan 2022 19 Jan 2022 008901
2 12 Jan 2022 19 Jan 2022 541002
3 13 Jan 2022 19 Jan 2022 476971
4 13 Jan 2022 19 Jan 2022 541651
5 13 Jan 2022 19 Jan 2022 541668
6 13 Jan 2022 19 Jan 2022 541666
7 13 Jan 2022 19 Jan 2022 537066
8 13 Jan 2022 19 Jan 2022 527472
9 14 Jan 2022 19 Jan 2022 320769
10 14 Jan 2022 19 Jan 2022 490417
11 14 Jan 2022 19 Jan 2022 541737
12 14 Jan 2022 19 Jan 2022 355542
13 15 Jan 2022 19 Jan 2022 273566
14 15 Jan 2022 19 Jan 2022 367129
15 15 Jan 2022 19 Jan 2022 541903
16 15 Jan 2022 19 Jan 2022 204667
17 16 Jan 2022 19 Jan 2022 541910
18 16 Jan 2022 19 Jan 2022 529961
19 16 Jan 2022 19 Jan 2022 513804
20 16 Jan 2022 19 Jan 2022 491066
21 16 Jan 2022 19 Jan 2022 425058
22 16 Jan 2022 19 Jan 2022 534621
23 16 Jan 2022 19 Jan 2022 537956
24 16 Jan 2022 19 Jan 2022 212554
25 16 Jan 2022 19 Jan 2022 302655
26 16 Jan 2022 19 Jan 2022 541748
27 16 Jan 2022 19 Jan 2022 531628
28 16 Jan 2022 19 Jan 2022 509062
29 16 Jan 2022 19 Jan 2022 523570
30 17 Jan 2022 19 Jan 2022 523583
31 17 Jan 2022 19 Jan 2022 408897
32 17 Jan 2022 19 Jan 2022 200650
33 16 Jan 2022 19 Jan 2022 540209
34 17 Jan 2022 19 Jan 2022 495229
35 17 Jan 2022 19 Jan 2022 467146
36 17 Jan 2022 19 Jan 2022 542043
37 18 Jan 2022 19 Jan 2022 469197
38 18 Jan 2022 19 Jan 2022 222830
39 17 Jan 2022 19 Jan 2022 542063

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40 17 Jan 2022 19 Jan 2022 541994

Kode RS: 3515106

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LAPORAN REKAP KLAIM - RS ISLAM SITI HAJAR

Pasien Rawat Inap dan Rawat Jalan, Periode Tanggal Pulang: 19 Jan 2022 s/d 19 Jan 2022
Filter: / Kelas Rawat = Semua / Severity = Semua / Cara Pulang = Semua / Jenis Tarif = Semua
Nama Pasien No. Klaim / SEP INACBG
KUSMAN TN 0195R0290122V004995 G-4-13-II
KHURROTUL AINI, NY 0195R0290122V005413 Z-4-12-II
MAIDA RINDYA RAMADHANI, AN 0195R0290122V005532 K-4-17-I
DAFFA CHOIR ALFATIH SUMARTA, AN 0195R0290122V005615 G-4-22-I
CHILLA SAFAATUS LAKUM HUSNA.AN 0195R0290122V005787 A-4-14-I
MIRZA ATHALLAH WIJAYA .AN 0195R0290122V005795 A-4-13-I
ANDY PRIHARJANTO, TN 0195R0290122V005816 E-4-11-II
MOULAY SALIM AR-RAEES RUPAWAN .AN 0195R0290122V005920 J-4-16-I
SITI NURWATI. NY 0195R0290122V006032 J-4-16-II
PRAKOSO WIBOWO .AN 0195R0290122V006138 D-4-11-I
YETTI ERNANINGSIH, NY 0195R0290122V006161 N-4-10-II
SULASMI. NY 0195R0290122V006451 N-4-10-II
CATUR SATRIYO UTOMO , TN 0195R0290122V006835 K-4-18-I
AZRYAN ARSYA RAVINDRA ATMOKO AN. 0195R0290122V006923 J-4-16-I
AULIAN RAFKA HAUFANHAZZA .AN 0195R0290122V006936 J-4-16-I
APRILLIA KUSUMANINGRUM. NN 0195R0290122V006943 N-4-10-II
MUHAMMAD ARSYAD ARIFIN .AN 0195R0290122V006970 J-4-16-I
MOCHAMMAD FAIZ FIRMANSYAH .SDR 0195R0290122V007048 A-4-13-I
SHERLY AGUSTIN SUTRISNO , NY 0195R0290122V007093 E-4-11-II
KIMORA ATTHIYA AZZAHRA AN 0195R0290122V007107 A-4-12-I
SUHARSIYAH,NY 0195R0290122V007109 J-4-16-III
MUHAMMAD GHAVI REZKY DERMAWAN, AN 0195R0290122V007116 K-4-17-I
ELLYA SANDI SULISTYA , NY 0195R0290122V007124 L-1-30-I
IKA DEWI SETYA SARI. NY 0195R0290122V007131 B-1-14-I
ARIF RUDIYANTO 0195R0290122V007139 M-1-80-I
SITI MASLUCHAH, NY 0195R0290122V007168 W-1-20-I
YUSRIN AULIA, NY 0195R0290122V007169 O-6-13-I
NURIL ISTIQOMAH.NY 0195R0290122V007171 W-4-14-I
DESI WAHYU RINANINGSIH, NY 0195R0290122V007178 O-6-10-I
AHMAD AYDAN AL-MIRZA. AN 0195R0290122V007259 K-4-17-I
MUHAMMAD FAQIH MAULANA AL-HAMDI, AN 0195R0290122V007262 U-4-13-I
CHUSNUL CHOTIMAH,NY 0195R0290122V007286 U-4-11-I
BAGOES ERIC RAMADHAN SDR 0195R0290122V007518 V-1-12-I
SHEMA ALEA MARZEA. AN 0195R0290122V007564 G-4-22-I
SUPRI EDI.TN 0195R0290122V007661 H-1-20-I
KASIDI. TN 0195R0290122V007670 J-4-18-II
NALIFA NY 0195R0290122V008304 E-4-11-II
FAIZI NUR ALFISYAHRI .AN 0195R0290122V008306 M-1-60-I
YUSRIN AULIA, BY NY 0195R0290122V008629 P-8-16-I

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HASNA AUFA' AFIFAH .BY .NY 0195R0290122V008740 P-8-16-I

T

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an 2022
f = Semua
Top Up Total Tarif Tarif RS Jenis
6,183,900 10,022,550 RI
3,938,000 11,036,600 RI
2,405,100 8,140,100 RI
3,718,200 6,163,800 RI
2,722,500 5,412,900 RI
2,925,900 8,643,200 RI
6,306,900 10,696,100 RI
5,058,500 7,441,300 RI
7,108,500 15,004,400 RI
4,042,800 4,320,300 RI
4,132,100 8,588,600 RI
4,132,100 9,371,700 RI
2,033,900 7,325,400 RI
5,058,500 4,687,000 RI
5,058,500 4,750,100 RI
4,132,100 5,161,400 RI
5,058,500 4,513,700 RI
2,925,900 4,923,400 RI
6,306,900 4,844,400 RI
3,695,000 3,652,700 RI
6,419,700 5,028,100 RI
2,405,100 3,310,900 RI
12,436,800 12,498,700 RI
7,704,100 12,746,188 RI
10,406,400 14,958,000 RI
8,264,200 8,700,959 RI
2,344,900 5,832,800 RI
1,662,200 2,594,700 RI
6,981,500 9,907,757 RI
2,405,100 2,477,300 RI
2,772,200 3,530,600 RI
1,517,500 2,950,400 RI
8,640,200 7,803,525 RI
3,718,200 2,708,100 RI
14,255,100 11,724,713 RI
2,969,700 10,636,100 RI
4,504,900 3,098,500 RI
7,987,100 7,144,200 RI
2,480,700 1,913,800 RI

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2,976,900 2,129,000 RI
Total 199,796,300 276,393,992

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