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 | 2026/05/31/000028 | 214713 | KARTINI BINTI YABANI | Unit IGD | UMUM | dr. Tommy Dwi purnama | 2026-05-31 | 20:21:21 | Berkas Diterima | Sudah Bayar | - | Rp 0 | Rp 141.787 | Rp 0 | Rp 0 | Rp 137.000 | Rp 0 | Rp 0 | Rp 0 | Rp 4.787 | ||
| 2 | 2026/05/31/000036 | 225903 | MUHAMMAD HARIZ GIBRAN | Unit IGD | UMUM | dr. Anggun Nurul Fitria | 2026-05-31 | 20:17:47 | Belum | Sudah Bayar | - | Rp 0 | Rp 181.200 | Rp 0 | Rp 0 | Rp 20.000 | Rp 0 | Rp 161.200 | Rp 0 | Rp 0 | ||
| 3 | 2026/05/31/000035 | 058260 | ROBY SUSANTO | Unit IGD | BPJS | dr. Dini Mudira Sari | 2026-05-31 | 20:10:00 | Berkas Diterima | Belum Bayar |
0603R0010526V003238 INACBG: 0 |
Rp 0 | Rp 150.860 | Rp 0 | Rp 0 | Rp 91.000 | Rp 0 | Rp 0 | Rp 0 | Rp 59.860 | ||
| 4 | 2026/05/31/000033 | 090364 | AZWARSYAH | Unit IGD | BPJS | dr. Anggun Nurul Fitria | 2026-05-31 | 20:03:33 | Sudah | Belum Bayar | - | Rp 0 | Rp 91.000 | Rp 0 | Rp 0 | Rp 91.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 5 | 2026/05/31/000031 | 225902 | NUR DIANA | Unit IGD | UMUM | dr. Muhammad Akip Aprianto | 2026-05-31 | 19:57:01 | Berkas Diterima | Sudah Bayar | - | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 6 | 2026/05/31/000032 | 223067 | CAYATI | Unit IGD | BPJS | dr. Muhammad Akip Aprianto | 2026-05-31 | 19:37:41 | Belum | Belum Bayar | - | Rp 0 | Rp 162.500 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 162.500 | Rp 0 | Rp 0 | ||
| 7 | 2026/05/31/000025 | 009319 | AHMAD BIN YASIN | Unit IGD | UMUM | dr. Muhammad Akip Aprianto | 2026-05-31 | 19:19:27 | Sudah | Sudah Bayar | - | Rp 0 | Rp 114.595 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 10.595 | ||
| 8 | 2026/05/31/000030 | 225901 | LINDA | Unit IGD | UMUM | dr. Tommy Dwi purnama | 2026-05-31 | 19:06:04 | Berkas Diterima | Sudah Bayar | - | Rp 0 | Rp 57.909 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 5.909 | ||
| 9 | 2026/05/31/000026 | 225900 | HAIRUL SANI | Unit IGD | UMUM | dr. Tommy Dwi purnama | 2026-05-31 | 17:24:30 | Berkas Diterima | Sudah Bayar | - | Rp 0 | Rp 105.516 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 53.516 | ||
| 10 | 2026/05/31/000024 | 031213 | YUSUF ZAIN MUHAMMAD | Unit IGD | BPJS | dr. Tommy Dwi purnama | 2026-05-31 | 17:09:13 | Sudah | Sudah Bayar |
0603R0010526V003235 INACBG: 0 |
Rp 0 | Rp 353.646 | Rp 0 | Rp 0 | Rp 227.500 | Rp 0 | Rp 0 | Rp 0 | Rp 126.146 | ||
| 11 | 2026/05/31/000023 | 225899 | ENDE MURNI | Unit IGD | BPJS | dr. Muhammad Akip Aprianto | 2026-05-31 | 16:40:51 | Sudah | Belum Bayar | - | Rp 0 | Rp 468.951 | Rp 0 | Rp 0 | Rp 195.000 | Rp 0 | Rp 162.500 | Rp 0 | Rp 111.451 | ||
| 12 | 2026/05/31/000022 | 225898 | NUR AIDA AMELIA | Unit IGD | UMUM | dr. Tommy Dwi purnama | 2026-05-31 | 16:00:00 | Sudah | Sudah Bayar | - | Rp 0 | Rp 109.700 | Rp 0 | Rp 0 | Rp 20.000 | Rp 0 | Rp 89.700 | Rp 0 | Rp 0 | ||
| 13 | 2026/05/31/000019 | 121510 | RIFAI | Unit IGD | UMUM | dr. Tommy Dwi purnama | 2026-05-31 | 15:02:26 | Sudah | Sudah Bayar | - | Rp 0 | Rp 225.629 | Rp 0 | Rp 0 | Rp 195.000 | Rp 0 | Rp 0 | Rp 0 | Rp 30.629 | ||
| 14 | 2026/05/31/000018 | 224523 | MAT ROPI | Unit IGD | UMUM | dr. Tommy Dwi purnama | 2026-05-31 | 14:46:12 | Sudah | Sudah Bayar | - | Rp 0 | Rp 214.800 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 117.000 | Rp 0 | Rp 45.800 | ||
| 15 | 2026/05/31/000012 | 200721 | YULIANA | Unit IGD | UMUM | dr. Restiko Maleo Fibullah | 2026-05-31 | 14:34:48 | Sudah | Sudah Bayar | - | Rp 0 | Rp 266.357 | Rp 0 | Rp 0 | Rp 143.000 | Rp 0 | Rp 58.500 | Rp 0 | Rp 64.857 | ||
| 16 | 2026/05/31/000017 | 036355 | SITI HARDIYANTI | Unit IGD | UMUM | dr. Restiko Maleo Fibullah | 2026-05-31 | 13:32:06 | Sudah | Sudah Bayar | - | Rp 0 | Rp 307.969 | Rp 0 | Rp 0 | Rp 136.500 | Rp 0 | Rp 0 | Rp 0 | Rp 171.469 | ||
| 17 | 2026/05/31/000009 | 225892 | SUKADI bin BASRI | Unit IGD | UMUM | dr. Restiko Maleo Fibullah | 2026-05-31 | 13:10:17 | Sudah | Sudah Bayar | - | Rp 0 | Rp 175.500 | Rp 0 | Rp 0 | Rp 143.000 | Rp 0 | Rp 32.500 | Rp 0 | Rp 0 | ||
| 18 | 2026/05/31/000011 | 125376 | FERRY SYAHPUTRA RGG | Unit IGD | UMUM | dr. Restiko Maleo Fibullah | 2026-05-31 | 13:01:03 | Sudah | Sudah Bayar | - | Rp 0 | Rp 139.690 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 87.690 | ||
| 19 | 2026/05/31/000016 | 225896 | ZELINE NAUREEN AZQILA FAYOLA | Unit IGD | UMUM | dr. Restiko Maleo Fibullah | 2026-05-31 | 12:40:45 | Sudah | Sudah Bayar | - | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 20 | 2026/05/31/000014 | 225894 | SITI NINGSIH | Unit IGD | UMUM | dr. Restiko Maleo Fibullah | 2026-05-31 | 11:55:55 | Sudah | Sudah Bayar | - | Rp 0 | Rp 204.670 | Rp 0 | Rp 0 | Rp 141.000 | Rp 0 | Rp 0 | Rp 0 | Rp 63.670 | ||
| 21 | 2026/05/31/000008 | 216279 | CRISTINE SIHOMBING | Unit IGD | UMUM | dr. Rini Utami | 2026-05-31 | 11:34:15 | Sudah | Sudah Bayar | - | Rp 0 | Rp 52.708 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 708 | ||
| 22 | 2026/05/31/000010 | 225861 | JENNAIRA KHALISAH | Unit IGD | UMUM | dr. Rini Utami | 2026-05-31 | 11:04:06 | Sudah | Sudah Bayar | - | Rp 0 | Rp 112.300 | Rp 0 | Rp 0 | Rp 20.000 | Rp 0 | Rp 92.300 | Rp 0 | Rp 0 | ||
| 23 | 2026/05/31/000007 | 223759 | ALAN SETIAWAN | Unit IGD | UMUM | dr. Rini Utami | 2026-05-31 | 10:07:31 | Sudah | Sudah Bayar | - | Rp 0 | Rp 230.442 | Rp 0 | Rp 0 | Rp 52.000 | Rp 162.500 | Rp 0 | Rp 0 | Rp 15.942 | ||
| 24 | 2026/05/31/000006 | 217625 | ARIA | Unit IGD | UMUM | dr. Rini Utami | 2026-05-31 | 09:21:56 | Sudah | Belum Bayar | - | Rp 0 | Rp 20.000 | Rp 0 | Rp 0 | Rp 20.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 25 | 2026/05/31/000002 | 225889 | ABDUL HARIS | Unit IGD | UMUM | dr. Tommy Dwi purnama | 2026-05-31 | 08:35:39 | Berkas Diterima | Sudah Bayar | - | Rp 0 | Rp 84.473 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 32.473 | ||
| 26 | 2026/05/31/000005 | 206669 | HOLIFAH FATONA | Unit IGD | UMUM | dr. Rini Utami | 2026-05-31 | 08:27:21 | Sudah | Sudah Bayar | - | Rp 0 | Rp 49.900 | Rp 0 | Rp 0 | Rp 20.000 | Rp 0 | Rp 29.900 | Rp 0 | Rp 0 | ||
| 27 | 2026/05/31/000004 | 225891 | SYAMSIAH | Unit IGD | BPJS | dr. Rini Utami | 2026-05-31 | 07:59:32 | Sudah | Belum Bayar | - | Rp 0 | Rp 836.500 | Rp 0 | Rp 0 | Rp 154.000 | Rp 0 | Rp 682.500 | Rp 0 | Rp 0 | ||
| 28 | 2026/05/31/000003 | 225890 | YENI MEILITA | Unit IGD | UMUM | dr. Tommy Dwi purnama | 2026-05-31 | 07:25:37 | Sudah | Sudah Bayar | - | Rp 0 | Rp 567.690 | Rp 0 | Rp 0 | Rp 237.500 | Rp 325.000 | Rp 0 | Rp 0 | Rp 5.190 | ||
| 29 | 2026/05/31/000001 | 029431 | MARUYAH | Unit IGD | UMUM | dr. Tommy Dwi purnama | 2026-05-31 | 06:36:20 | Belum | Sudah Bayar | - | Rp 0 | Rp 19.789 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 19.789 | ||
| TOTAL | Rp 0 | Rp 5.550.081 | Rp 0 | Rp 0 | Rp 2.511.500 | Rp 487.500 | Rp 1.588.600 | Rp 0 | Rp 910.481 | |||||||||||||