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No. Tgl. Masuk Tgl. Pulang No.

RM Nama Pasien
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2 2-Dec-21 3-Dec-21 0019513 AKROM DHIYA UMRI
3 1-Dec-21 3-Dec-21 0019640 RENI SAFITRI
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No. Klaim / SEP Tambahan Biaya Total Tarif Tarif RS Jenis
RI
0129R0081221V000073 761,600 4,569,400 3,720,509 RI
0129R0081221V000006 995,000 5,970,200 6,183,939 RI
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