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  • Provider EDC (Web Version) of Klinik Yadika Cibubur (12380549)

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    KLINIK YADIKA CIBUBUR
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    This document is a letter of confirmation from Klinik Yadika Cibubur for patient Buddy Basharuddin with reference ID 119919503. It details medical expenses of IDR 75,000 for a general doctor visit, IDR 100,500 for medications, and a total cost of IDR 175,500 covered by the patient's insurance provider. It instructs the patient to scan their reference ID and was reprinted on January 20, 2023.

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    Provider EDC (Web Version) of Klinik Yadika Cibubur [12380549]

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    This document is a letter of confirmation from Klinik Yadika Cibubur for patient Buddy Basharuddin with reference ID 119919503. It details medical expenses of IDR 75,000 for a general doctor visit, IDR 100,500 for medications, and a total cost of IDR 175,500 covered by the patient's insurance provider. It instructs the patient to scan their reference ID and was reprinted on January 20, 2023.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    11 views1 page

    Provider EDC (Web Version) of Klinik Yadika Cibubur (12380549)

    Uploaded by

    KLINIK YADIKA CIBUBUR
    This document is a letter of confirmation from Klinik Yadika Cibubur for patient Buddy Basharuddin with reference ID 119919503. It details medical expenses of IDR 75,000 for a general doctor visit, IDR 100,500 for medications, and a total cost of IDR 175,500 covered by the patient's insurance provider. It instructs the patient to scan their reference ID and was reprinted on January 20, 2023.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    20/01/23 07.

    59 Provider EDC (Web Version) of Klinik Yadika Cibubur [12380549]

    Re-Print Letter of Confirmation


    Provider : KLINIK YADIKA CIBUBUR
    Terminal ID : 12380549
    Date and Time : Jan-19-2023 08:53:03pm
    Patient Name : BUDDY BASHARUDDIN
    Reference ID : 119919503

    PENGESAHAN & TAGIHAN


    EQUITY LIFE
    TOKYU PROPERTY MANAGEMENT INDONESIA, PT
    2022013666-0
    DIAG:M79.19 IZIN SAKIT:0
    B.DR.SPEC    
    B.DR.UMUM    75,000.00
    B.TEST DIAG  
    B.OBAT       100,500.00
    FISIOTHERAPI 
    ----------------------------------------
    JUM.BIAYA :175,500.00
    JUM.DIBYR ASS:175,500.00
    DIBYR PASIEN:0.00
    ----------------------------------------
    EKSES BAYAR DI TEMPAT

    Scan your Reference ID

    By PK1096
    Re Print on January 20, 2023, 7:48 am

    https://mobile.admedika.co.id/edc/# 1/1

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