Rumah Sakit Mitra Medika

RINCIAN BIAYA LABORATORIUM RAWAT JALAN

No Reg / No. RM : OP20231006-0149 / 00-17-93-75 Dokter Utama : dr. Edy Chandera, Sp. JP
Tanggal Masuk : 06-Oct-2023 Penjamin Bayar : INSTANSI
Nama Pasien : ARSYAD Instansi : NAYAKA ERA HUSADA CABANG BEKASI, PT
Tanggal Lahir : 10-Jul-1961

No. No. Lab Nama Test Selisih Harga Diskon Jumlah

Tanggal : 06-October-2023
2023100600006
1 Urine Lengkap 0.00 68,000.00 6,800.00 61,200.00
2 Darah Rutin 0.00 78,000.00 7,800.00 70,200.00
3 Gula Darah Sewaktu 0.00 47,000.00 4,700.00 42,300.00
4 Cholesterol Total 0.00 47,000.00 4,700.00 42,300.00
5 HDL Cholesterol 0.00 102,000.00 10,200.00 91,800.00
6 LDL Cholesterol 0.00 137,000.00 13,700.00 123,300.00
7 Trigliserida 0.00 50,000.00 5,000.00 45,000.00
8 SGOT 0.00 68,000.00 6,800.00 61,200.00
9 SGPT 0.00 68,000.00 6,800.00 61,200.00
10 Urea N / BUN 0.00 53,000.00 5,300.00 47,700.00
11 Creatinin 0.00 48,000.00 4,800.00 43,200.00

Subtotal 766,000.00
Total Diskon Nomor Lab 2023100600006 -76,600.00
Total Nomor Lab 2023100600006 689,400.00
Total Tanggal 06-October-2023 689,400.00
TOTAL
689,400.00