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    This document is an invoice for inpatient medical care from a hospital. It lists charges for administration fees, nursing care, medical equipment usage, medications, lab tests, hospital room, and doctor visits for a patient from March 30th to April 1st. The total charge for all items is 3,120,427 Indonesian Rupiah.

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    This document is an invoice for inpatient medical care from a hospital. It lists charges for administration fees, nursing care, medical equipment usage, medications, lab tests, hospital room, and doctor visits for a patient from March 30th to April 1st. The total charge for all items is 3,120,427 Indonesian Rupiah.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    5 views2 pages

    Billing Contoh

    Uploaded by

    novita
    This document is an invoice for inpatient medical care from a hospital. It lists charges for administration fees, nursing care, medical equipment usage, medications, lab tests, hospital room, and doctor visits for a patient from March 30th to April 1st. The total charge for all items is 3,120,427 Indonesian Rupiah.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    INV NUMBER 220017342

    Invoice Rawat Inap


    ( ASLI

    Tanggal Registrasi Nama Pasien


    Tanggal Keluar No. RM/No. Registrasi
    Penjamin Dokter Penanggung Jawab
    Kelas Dokter Perujuk

    KETERANGAN JML HARGA SUBTOTAL

    Administrasi
       30-03-2022    Biaya Administrasi Rawat Jalan(IGD) [Disc.Rs] 1 17,500 17,500
       30-03-2022    Biaya Administrasi Rawat Jalan(IGD) [Disc.Rs] 1 17,500 50,000
    Subtotal 67,500
    Biaya Tindakan Medis
       30-03-2022    Asuhan Keperawatan 1 34,500 34,500
       30-03-2022    Asuhan Keperawatan 1 34,500 34,500
       30-03-2022    Asuhan Keperawatan 1 34,500 34,500
       30-03-2022    Asuhan Keperawatan 1 34,500 34,500
       30-03-2022    Asuhan Keperawatan 1 34,500 34,500
       30-03-2022    Asuhan Keperawatan 1 34,500 34,500
       30-03-2022    Asuhan Keperawatan 1 34,500 34,500
       30-03-2022    Asuhan Keperawatan 1 34,500 34,500
       30-03-2022    Asuhan Keperawatan 1 34,500 34,500
       30-03-2022    Asuhan Keperawatan 1 34,500 34,500
       30-03-2022    Asuhan Keperawatan 1 23,000 34,500
    Subtotal
    Biaya Penggunaan Alat
    1 12,825 12,825
    Subtotal 12,825
    Biaya Farmasi
       30-03-2022    Ident Alert Yellow Snap (fall Risk) [Disc.Rs] 1 3,919 49,851
       30-03-2022    Ident Alert Yellow Snap (fall Risk) [Disc.Rs] 1 3,919 49,851
       30-03-2022    Ident Alert Yellow Snap (fall Risk) [Disc.Rs] 1 3,919 49,851
       30-03-2022    Ident Alert Yellow Snap (fall Risk) [Disc.Rs] 2 3,919 49,851
       30-03-2022    Ident Alert Yellow Snap (fall Risk) [Disc.Rs] 1 3,919 49,851
       30-03-2022    Ident Alert Yellow Snap (fall Risk) [Disc.Rs] 1 3,919 49,851
       30-03-2022    Ident Alert Yellow Snap (fall Risk) [Disc.Rs] 1 3,919 49,851
       30-03-2022    Ident Alert Yellow Snap (fall Risk) [Disc.Rs] 1 3,919 49,851
       30-03-2022    Ident Alert Yellow Snap (fall Risk) [Disc.Rs] 6 3,919 49,851
       30-03-2022    Ident Alert Yellow Snap (fall Risk) [Disc.Rs] 2 3,919 49,851
       30-03-2022    Ident Alert Yellow Snap (fall Risk) [Disc.Rs] 1 3,919 49,851
       30-03-2022    Ident Alert Yellow Snap (fall Risk) [Disc.Rs] 1 3,919 49,851
       30-03-2022    Sarung Tangan Non Steril T-glove S [Disc.Rs] 6 3,919 49,851
       30-03-2022    Sarung Tangan Non Steril T-glove S [Disc.Rs] 2 3,919 49,851
       30-03-2022    Sarung Tangan Non Steril T-glove S [Disc.Rs] 1 3,919 49,851
       30-03-2022    Sarung Tangan Non Steril T-glove S [Disc.Rs] 2 3,919 49,851
       30-03-2022    Sarung Tangan Non Steril T-glove S [Disc.Rs] 1 3,919 49,851
       30-03-2022    Sarung Tangan Non Steril T-glove S [Disc.Rs] 5 3,919 49,851
       30-03-2022    Sarung Tangan Non Steril T-glove S [Disc.Rs] 2 3,919 49,851
       30-03-2022    Sarung Tangan Non Steril T-glove S [Disc.Rs] 1 3,919 49,851
       30-03-2022    Sarung Tangan Non Steril T-glove S [Disc.Rs] 2 3,919 49,851
       30-03-2022    Sarung Tangan Non Steril T-glove S [Disc.Rs] 2 3,919 49,851
       30-03-2022    Sarung Tangan Non Steril T-glove S [Disc.Rs] 2 3,919 49,851
       30-03-2022    Sarung Tangan Non Steril T-glove S [Disc.Rs] 5 3,919 49,851
       30-03-2022    Sarung Tangan Non Steril T-glove S [Disc.Rs] 4 3,919 49,851
       30-03-2022    Sarung Tangan Non Steril T-glove S [Disc.Rs] 2 3,919 49,851
       30-03-2022    Sarung Tangan Non Steril T-glove S [Disc.Rs] 1 3,919 49,851
       30-03-2022    Sarung Tangan Non Steril T-glove S [Disc.Rs] 1 3,919 49,851
       30-03-2022    Sarung Tangan Non Steril T-glove S [Disc.Rs] -2 3,919 49,851
       30-03-2022    Sarung Tangan Non Steril T-glove S [Disc.Rs] -1 3,919 49,851
       01-04-2022    Taxegram 1gr Injek [Disc.Rs] -1 3,919 49,851
       01-04-2022    Taxegram 1gr Injek [Disc.Rs] 1 3,919 49,851
       01-04-2022    Taxegram 1gr Injek [Disc.Rs] 1 3,919 49,851
       01-04-2022    Taxegram 1gr Injek [Disc.Rs] 1 49,851 49,851
    Subtotal 1,135,952
    Biaya Laboratorium
       30-03-2022    Rapid Test Antigen Covid 19 (ugd)(IGD) [Disc.Rs] 1 94,050 94,050
       30-03-2022    Rapid Test Antigen Covid 19 (ugd)(IGD) [Disc.Rs] 1 94,050 94,050
       30-03-2022    Rapid Test Antigen Covid 19 (ugd)(IGD) [Disc.Rs] 1 94,050 94,050
       30-03-2022    Rapid Test Antigen Covid 19 (ugd)(IGD) [Disc.Rs] 1 94,050 94,050
       30-03-2022    Rapid Test Antigen Covid 19 (ugd)(IGD) [Disc.Rs] 1 94,050 94,050
       30-03-2022    Rapid Test Antigen Covid 19 (ugd)(IGD) [Disc.Rs] 1 94,050 94,050
       30-03-2022    Rapid Test Antigen Covid 19 (ugd)(IGD) [Disc.Rs] 1 94,050 99,750
    Subtotal 800,850
    Biaya Kamar
       30-03-2022    Kelas 3 [Disc.Rs] 1 175,000 175,000
       31-03-2022    Kelas 3 [Disc.Rs] 1 175,000 175,000
    Subtotal 350,000
    Biaya Visite
    1 120,000 120,000
    1 120,000 120,000
    1 120,000 120,000
    Subtotal 360,000

    Total Tagihan : 3,120,427

    Dicetak Oleh : Novita Candra Buana Lestari, 16 Jun 2022 11:46


    Cirebon, 16 Jun 2022 Cirebon, 16 Jun 2022

    (Ratu Shafira Alfaretta


    (Novita Candra Buana Lestari) Azarine)
    PETUGAS PASIEN

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