Laporan detail tindakan dan biaya pasien rawat jalan & inap
| No | No.Rawat | No.R.M. | Nama Pasien | Poli | Cara Bayar | Dokter Poli | Tgl.Reg | Jam Reg | Status | Status Bayar | No SEP | Tarif INA-CBG | Tarif RS | Dokter | Paramedis | Dokter+Paramedis | Radiologi | Laboratorium | Operasi | Farmasi | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 2026/04/03/000045 | 223109 | IMAM MAULANA | Unit IGD | UMUM | dr. Johannes Lie | 2026-04-03 | 23:58:27 | Sudah | Sudah Bayar | - | Rp 0 | Rp 176.404 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 117.000 | Rp 0 | Rp 7.404 | ||
| 2 | 2026/04/03/000040 | 223106 | NAIMATUL LIYATNA SARI | Unit IGD | UMUM | dr. Muhammad Akip Aprianto | 2026-04-03 | 23:35:02 | Sudah | Belum Bayar | - | Rp 0 | Rp 768.297 | Rp 0 | Rp 0 | Rp 305.500 | Rp 0 | Rp 377.000 | Rp 0 | Rp 85.797 | ||
| 3 | 2026/04/03/000037 | 223104 | AZRIEL REYHAN DIKA ALFARIQ | Unit IGD | BPJS | dr. Muhammad Akip Aprianto | 2026-04-03 | 23:18:35 | Sudah | Belum Bayar | - | Rp 0 | Rp 357.500 | Rp 0 | Rp 0 | Rp 195.000 | Rp 0 | Rp 162.500 | Rp 0 | Rp 0 | ||
| 4 | 2026/04/03/000038 | 093449 | ADE BAKAR | Unit IGD | BPJS | dr. Johannes Lie | 2026-04-03 | 22:41:20 | Sudah | Belum Bayar |
0603R0010426V000351 INACBG: 0 |
Rp 0 | Rp 786.099 | Rp 0 | Rp 0 | Rp 500.500 | Rp 0 | Rp 0 | Rp 0 | Rp 285.599 | ||
| 5 | 2026/04/03/000030 | 223100 | CHALISTA INAYA | Unit IGD | BPJS | dr. Restiko Maleo Fibullah | 2026-04-03 | 22:27:56 | Sudah | Belum Bayar |
0603R0010426V000349 INACBG: 0 |
Rp 0 | Rp 876.500 | Rp 0 | Rp 0 | Rp 571.000 | Rp 0 | Rp 305.500 | Rp 0 | Rp 0 | ||
| 6 | 2026/04/03/000033 | 065304 | DIMAH | Unit IGD | UMUM | dr. Muhammad Akip Aprianto | 2026-04-03 | 21:57:16 | Sudah | Sudah Bayar | - | Rp 0 | Rp 187.518 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 117.000 | Rp 0 | Rp 18.518 | ||
| 7 | 2026/04/03/000034 | 223102 | SHELSI OLIVIA | Unit IGD | UMUM | dr. Johannes Lie | 2026-04-03 | 21:48:18 | Sudah | Sudah Bayar | - | Rp 0 | Rp 341.078 | Rp 0 | Rp 0 | Rp 143.000 | Rp 0 | Rp 162.500 | Rp 0 | Rp 35.578 | ||
| 8 | 2026/04/03/000031 | 108094 | WINSI BINTI HERMAN | Unit IGD | UMUM | dr. Muhammad Akip Aprianto | 2026-04-03 | 21:32:00 | Sudah | Sudah Bayar | - | Rp 0 | Rp 254.739 | Rp 0 | Rp 0 | Rp 253.500 | Rp 0 | Rp 0 | Rp 0 | Rp 1.239 | ||
| 9 | 2026/04/03/000035 | 130358 | MAS ROIL | Unit IGD | UMUM | dr. Muhammad Akip Aprianto | 2026-04-03 | 21:04:38 | Meninggal | Sudah Bayar | - | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 10 | 2026/04/03/000029 | 223099 | KRISTIAWAN | Unit IGD | UMUM | dr. Restiko Maleo Fibullah | 2026-04-03 | 20:13:10 | Belum | Sudah Bayar | - | Rp 0 | Rp 546.500 | Rp 0 | Rp 0 | Rp 137.000 | Rp 0 | Rp 409.500 | Rp 0 | Rp 0 | ||
| 11 | 2026/04/03/000027 | 103819 | SALEHA | Unit IGD | UMUM | dr. Tommy Dwi purnama | 2026-04-03 | 18:59:09 | Sudah | Sudah Bayar | - | Rp 0 | Rp 73.479 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 21.479 | ||
| 12 | 2026/04/03/000025 | 123908 | FITRIA UTAMA WASIL | Unit IGD | UMUM | dr. Anggun Nurul Fitria | 2026-04-03 | 16:39:33 | Sudah | Sudah Bayar | - | Rp 0 | Rp 286.000 | Rp 0 | Rp 0 | Rp 91.000 | Rp 0 | Rp 195.000 | Rp 0 | Rp 0 | ||
| 13 | 2026/04/03/000024 | 223097 | MADE RAKA ARSENIO PUTRA | Unit IGD | UMUM | dr. Anggun Nurul Fitria | 2026-04-03 | 13:21:25 | Belum | Sudah Bayar | - | Rp 0 | Rp 182.500 | Rp 0 | Rp 0 | Rp 20.000 | Rp 162.500 | Rp 0 | Rp 0 | Rp 0 | ||
| 14 | 2026/04/03/000021 | 223094 | DANNISHA ZALFA Q | Unit IGD | UMUM | dr. Anggun Nurul Fitria | 2026-04-03 | 11:59:49 | Sudah | Belum Bayar | - | Rp 0 | Rp 97.500 | Rp 0 | Rp 0 | Rp 97.500 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 15 | 2026/04/03/000020 | 223093 | KHOIRUNNISA BINTI HENDRYYAN | Unit IGD | UMUM | dr. Anggun Nurul Fitria | 2026-04-03 | 11:45:07 | Sudah | Sudah Bayar | - | Rp 0 | Rp 513.500 | Rp 0 | Rp 0 | Rp 188.500 | Rp 325.000 | Rp 0 | Rp 0 | Rp 0 | ||
| 16 | 2026/04/03/000019 | 223092 | DAMHAZI BIN WAHIDIN | Unit IGD | UMUM | dr. Anggun Nurul Fitria | 2026-04-03 | 11:19:38 | Sudah | Sudah Bayar | - | Rp 0 | Rp 599.500 | Rp 0 | Rp 0 | Rp 112.000 | Rp 487.500 | Rp 0 | Rp 0 | Rp 0 | ||
| 17 | 2026/04/03/000014 | 222633 | RIPALEDI | Unit IGD | UMUM | dr. Anggun Nurul Fitria | 2026-04-03 | 11:10:03 | Sudah | Sudah Bayar | - | Rp 0 | Rp 819.000 | Rp 0 | Rp 0 | Rp 52.000 | Rp 650.000 | Rp 117.000 | Rp 0 | Rp 0 | ||
| 18 | 2026/04/03/000017 | 223091 | MARSDEWITA | Unit IGD | UMUM | dr. Anggun Nurul Fitria | 2026-04-03 | 11:08:43 | Sudah | Sudah Bayar | - | Rp 0 | Rp 123.500 | Rp 0 | Rp 0 | Rp 123.500 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 19 | 2026/04/03/000013 | 098833 | TRISNA MAYA CANTI | Unit IGD | UMUM | dr. Anggun Nurul Fitria | 2026-04-03 | 11:06:20 | Sudah | Sudah Bayar | - | Rp 0 | Rp 221.106 | Rp 0 | Rp 0 | Rp 62.000 | Rp 0 | Rp 143.000 | Rp 0 | Rp 16.106 | ||
| 20 | 2026/04/03/000009 | 210719 | WISNU ERLANGGA | Poli Hemodialisa | BPJS | dr. Deddy Primadona Mulia, Sp. PD - K.GH, FINASIM | 2026-04-03 | 09:52:54 | Sudah | Sudah Bayar |
0603R0010426V000341 INACBG: 0 |
Rp 0 | Rp 996.356 | Rp 0 | Rp 0 | Rp 850.000 | Rp 0 | Rp 29.900 | Rp 0 | Rp 116.456 | ||
| 21 | 2026/04/03/000008 | 130754 | BUSRONI bin SANSON | Poli Hemodialisa | BPJS | dr. Deddy Primadona Mulia, Sp. PD - K.GH, FINASIM | 2026-04-03 | 09:50:29 | Sudah | Sudah Bayar |
0603R0010426V000340 INACBG: 0 |
Rp 0 | Rp 996.356 | Rp 0 | Rp 0 | Rp 850.000 | Rp 0 | Rp 29.900 | Rp 0 | Rp 116.456 | ||
| 22 | 2026/04/03/000006 | 136052 | KASINTEN BINTI MUKAYAT | Poli Hemodialisa | BPJS | dr. Deddy Primadona Mulia, Sp. PD - K.GH, FINASIM | 2026-04-03 | 09:46:35 | Sudah | Sudah Bayar |
0603R0010426V000339 INACBG: 0 |
Rp 0 | Rp 996.356 | Rp 0 | Rp 0 | Rp 850.000 | Rp 0 | Rp 29.900 | Rp 0 | Rp 116.456 | ||
| 23 | 2026/04/03/000012 | 223089 | SOMAR | Unit IGD | UMUM | dr. Anggun Nurul Fitria | 2026-04-03 | 09:05:19 | Sudah | Sudah Bayar | - | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 24 | 2026/04/03/000007 | 198285 | SOFIAH BINTI M ALI | Poli Hemodialisa | BPJS | dr. Deddy Primadona Mulia, Sp. PD - K.GH, FINASIM | 2026-04-03 | 07:27:55 | Sudah | Sudah Bayar |
0603R0010426V000338 INACBG: 0 |
Rp 0 | Rp 996.356 | Rp 0 | Rp 0 | Rp 850.000 | Rp 0 | Rp 29.900 | Rp 0 | Rp 116.456 | ||
| 25 | 2026/04/03/000010 | 223086 | AMALIYAH | Unit IGD | UMUM | dr. Husti Noprianrest | 2026-04-03 | 07:18:46 | Sudah | Sudah Bayar | - | Rp 0 | Rp 369.700 | Rp 0 | Rp 0 | Rp 20.000 | Rp 0 | Rp 349.700 | Rp 0 | Rp 0 | ||
| 26 | 2026/04/03/000001 | 223083 | HUMAIRA PUTRI SALSABILA | Unit IGD | UMUM | dr. Husti Noprianrest | 2026-04-03 | 07:04:33 | Berkas Diterima | Sudah Bayar | - | Rp 0 | Rp 75.447 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 23.447 | ||
| 27 | 2026/04/03/000005 | 202069 | CIK ALI | Unit IGD | UMUM | dr. Husti Noprianrest | 2026-04-03 | 05:47:25 | Sudah | Sudah Bayar | - | Rp 0 | Rp 58.530 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 6.530 | ||
| 28 | 2026/04/03/000004 | 223085 | JHOSUA MARBUN | Unit IGD | UMUM | dr. Husti Noprianrest | 2026-04-03 | 02:47:54 | Berkas Diterima | Sudah Bayar | - | Rp 0 | Rp 62.369 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 10.369 | ||
| TOTAL | Rp 0 | Rp 11.866.190 | Rp 0 | Rp 0 | Rp 6.688.000 | Rp 1.625.000 | Rp 2.575.300 | Rp 0 | Rp 977.890 | |||||||||||||