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    RSIA Graha Kurnia
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    This 3 sentence summary provides the key details from the medical document: The document is a medical record from RSIA Graha Kurnia provider for Puji Lestari, who has health insurance through Admedika-Brilife, showing that she received a pregnancy test that was 90% covered by insurance, including HIV, TORCH, and 4D ultrasound screening, and insured prenatal visits until the birth of her third living child. The patient was required to pay the remaining balance on site.

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    This 3 sentence summary provides the key details from the medical document: The document is a medical record from RSIA Graha Kurnia provider for Puji Lestari, who has health insurance through Admedika-Brilife, showing that she received a pregnancy test that was 90% covered by insurance, including HIV, TORCH, and 4D ultrasound screening, and insured prenatal visits until the birth of her third living child. The patient was required to pay the remaining balance on site.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    6 views1 page

    Img 006

    Uploaded by

    RSIA Graha Kurnia
    This 3 sentence summary provides the key details from the medical document: The document is a medical record from RSIA Graha Kurnia provider for Puji Lestari, who has health insurance through Admedika-Brilife, showing that she received a pregnancy test that was 90% covered by insurance, including HIV, TORCH, and 4D ultrasound screening, and insured prenatal visits until the birth of her third living child. The patient was required to pay the remaining balance on site.

    Copyright:

    © All Rights Reserved
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    of 1

    2/4/23, 7:27 PM Provider EDC (Web Version) of Rsia.

    Graha Kumia [12405164]

    RSIAGRAHAKURNIA
    Tel No: 0735-3740538|
    TID: 12405164 [RSIA GRAHA KURNIA]
    JL. SYEKH A.KALIYUDDIN (KEMILING) RT.11/Ftw.04 DESA TANJUNG BARU, BATURAJA TIMUR AdMATka
    OGAN KOMERING ULU -~_,Qt

    Patient: PUJI LESTARI


    Principal Name: RAHDIALTA TOMHART
    Card No.: 8001001000460411
    Date of Birth: Feb-19-1987
    Policy No: 30000005
    Member lD: 001350270
    Policy Date: Apr-01-2022 To Mar-31-2023
    PlaLn: 30000005GHOP005
    *ELIGIBILITY (PENDAFTARAN PASIEN)

    Reference lD : 120392851

    PENDAFTARAN PASIEN
    PAYOR: ADMEDIKA -BRILIFE (BANK BRl)
    PT. BANK RAKYAT INDONESIA (Persero), Tbk
    BENEFIT:CEK HAMIL
    ****************************************
    CEK HAMIL SESUAI TAGIHAN
    ****************************************
    90% DIJAMIN ASURANSI
    SCRENING KEHAMILAN TERMASUK
    PEMERIKSAAN HIV,TORCH & USG 4 DIMENSI
    MENJAMIN KONTROL HAMIL SAMPAI DENGAN -
    KELAHIRAN ANAK KE 3 HIDUP
    SELISIH BIAYA BAYAR DI TEMPAT

    Siiiffiiffi|ii|fiiff|iiffii|i||iiiii|'D

    By: RSIA GRAHA KURNIA (PK9425)

    https://mobile.admedika.com/edc/ mi!

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