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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 5 Jan 2022 14 Jan 2022 395103
2 5 Jan 2022 14 Jan 2022 540934
3 7 Jan 2022 14 Jan 2022 541102
4 7 Jan 2022 14 Jan 2022 528856
5 8 Jan 2022 14 Jan 2022 541144
6 8 Jan 2022 14 Jan 2022 489114
7 8 Jan 2022 14 Jan 2022 442993
8 8 Jan 2022 14 Jan 2022 495160
9 9 Jan 2022 14 Jan 2022 541284
10 10 Jan 2022 14 Jan 2022 541388
11 10 Jan 2022 14 Jan 2022 458543
12 9 Jan 2022 14 Jan 2022 393767
13 10 Jan 2022 14 Jan 2022 541405
14 10 Jan 2022 14 Jan 2022 541408
15 10 Jan 2022 14 Jan 2022 541412
16 10 Jan 2022 14 Jan 2022 402264
17 10 Jan 2022 14 Jan 2022 389422
18 10 Jan 2022 14 Jan 2022 383047
19 11 Jan 2022 14 Jan 2022 530666
20 7 Jan 2022 14 Jan 2022 541171
21 11 Jan 2022 14 Jan 2022 314889
22 11 Jan 2022 14 Jan 2022 201852
23 11 Jan 2022 14 Jan 2022 539752
24 12 Jan 2022 14 Jan 2022 456932
25 12 Jan 2022 14 Jan 2022 541572
26 11 Jan 2022 14 Jan 2022 248696
27 12 Jan 2022 14 Jan 2022 274934
28 12 Jan 2022 14 Jan 2022 508957
29 12 Jan 2022 14 Jan 2022 275391
30 12 Jan 2022 14 Jan 2022 541483
31 12 Jan 2022 14 Jan 2022 541482
32 12 Jan 2022 14 Jan 2022 449114
33 12 Jan 2022 14 Jan 2022 408275
34 12 Jan 2022 14 Jan 2022 213569
35 13 Jan 2022 14 Jan 2022 309099
36 10 Jan 2022 14 Jan 2022 541435
37 11 Jan 2022 14 Jan 2022 538711
38 12 Jan 2022 14 Jan 2022 541574
39 13 Jan 2022 14 Jan 2022 312880

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40 11 Jan 2022 14 Jan 2022 524574

Kode RS: 3515106

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LAPORAN REKAP KLAIM - RS ISLAM SITI HAJAR

Pasien Rawat Inap dan Rawat Jalan, Periode Tanggal Pulang: 14 Jan 2022 s/d 14 Jan 2022
Filter: / Kelas Rawat = Semua / Severity = Semua / Cara Pulang = Semua / Jenis Tarif = Semua
Nama Pasien No. Klaim / SEP INACBG
SUKANI, NY 0195R0290122V002190 E-4-12-II
LILIK NOER LAILI. BY NY 0195R0290122V002658 P-8-13-III
AKIO SETIA PERMANA, AN 0195R0290122V003058 J-4-16-I
MOCH KHOLIQ, TN 0195R0290122V003215 I-4-15-III
MITRI INDARYATI .NY 0195R0290122V003607 I-4-16-II
WATIMAH .NY 0195R0290122V003639 G-4-14-I
PRAWOTO ,TN 0195R0290122V003664 E-4-10-I
ERLIE DWI ARIESTA, AN 0195R0290122V003673 J-4-16-I
MUHAMMAD ROZAKUL RIZKY HARIYADI, AN 0195R0290122V003696 J-4-16-I
ALMAYRA SAYYIDINA ERWANSYAH, AN 0195R0290122V004213 K-4-17-I
NERRILITA DARWIN, NY 0195R0290122V004255 D-4-13-III
KASIANAH,NY 0195R0290122V004271 E-4-11-III
SITI UTAMI ENDANG BY NY 0195R0290122V004319 J-4-21-I
SUJITNO ,TN 0195R0290122V004341 J-4-19-I
ANDRI RIZKY PRAYOGO. TN 0195R0290122V004353 J-4-18-I
SUWATI NY 0195R0290122V004355 I-4-19-II
SRIANI. NY 0195R0290122V004369 K-4-18-I
MARFU'AH. NY 0195R0290122V004388 E-4-11-I
EVI AGUSNIA, NY 0195R0290122V004683 W-1-20-III
HERLINA YUDHAWATI BY NY 0195R0290122V004711 P-8-13-I
ERNI RINAWATI. NY 0195R0290122V004818 M-1-80-I
MIA RENTA MAHARANINGTYAS NY 0195R0290122V004918 O-6-10-I
SARIYANTO , TN 0195R0290122V004936 J-4-16-I
NADYA ARZETY JUNIYASARI, NY 0195R0290122V005054 O-6-10-I
MUHAMMAD ARIS TN. 0195R0290122V005255 J-4-15-I
NURUL MUSLIKAH NY 0195R0290122V005265 I-4-20-I
AISYAH INTAN GHIFRINA, NY 0195R0290122V005331 A-4-14-I
WINDA PURWANTI NY 0195R0290122V005347 W-4-14-I
UJANG ISWAHYUDI .TN 0195R0290122V005363 M-1-40-I
MUHADI. TN 0195R0290122V005400 M-1-50-I
MOCH. DJAZULI. TN 0195R0290122V005406 K-1-40-I
NIZAM ADRIAN.AN 0195R0290122V005409 U-4-13-I
M. AJI SASMITO, TN 0195R0290122V005426 E-1-20-I
AFRIAN DWI HENDRAWIJAYA. AN 0195R0290122V005434 N-4-16-I
CHUSNUL AMRI TN 0195R0290122V005528 J-4-17-I
IMROATUS SHOLICHAH, AN 0195R0290122V005671 J-4-16-I
NITA AMELIA, NY 0195R0290122V005791 O-6-10-I
MIA RENTA MAHARANINGTYAS, BY NY 0195R0290122V005843 P-8-15-I
RATNA HARTATI, NY 0195R0290122V005875 M-1-40-I

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SITI CHUSNAH. NY 0195R0290122V006141 J-4-16-II

T

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an 2022
f = Semua
Top Up Total Tarif Tarif RS Jenis
8,231,300 29,359,970 RI
13,289,500 18,682,300 RI
3,613,200 9,116,570 RI
7,317,500 22,719,600 RI
4,178,900 7,521,800 RI
5,013,100 17,760,100 RI
4,903,800 13,256,500 RI
5,058,500 8,618,370 RI
4,335,900 5,331,100 RI
2,405,100 5,343,800 RI
7,570,100 8,433,100 RI
7,552,000 6,253,700 RI
3,917,900 5,710,100 RI
7,274,100 9,169,000 RI
3,116,300 7,647,014 RI
6,111,300 7,409,500 RI
2,033,900 6,109,600 RI
2,954,900 8,004,700 RI
11,970,800 16,356,179 RI
5,483,600 7,312,013 RI
8,672,000 12,566,650 RI
5,984,100 7,202,925 RI
3,613,200 9,097,400 RI
5,984,100 9,493,025 RI
6,071,100 10,171,100 RI
4,202,600 4,266,600 RI
3,176,200 4,586,000 RI
1,662,200 2,403,200 RI
6,041,900 8,594,550 RI
7,464,200 8,091,600 RI
7,792,500 7,834,647 RI
1,980,100 2,562,600 RI
10,523,000 9,372,901 RI
5,174,200 6,230,188 RI
3,688,800 3,894,900 RI
3,613,200 2,863,100 RI
5,984,100 8,469,100 RI
2,741,100 1,571,000 RI
6,041,900 7,622,259 RI

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5,077,500 9,982,400 RI
Total 221,819,700 356,991,161

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