TGL NAMA PASIEN NO.

MR SHIFT PELAKSANA

16/02/2016 ELAN TN 131769 P ARIA SUTJAHJO. DR

16/02/2016 NADA FAUZIAH NN P ARIA SUTJAHJO. DR
16/02/2016 KHANSA HANIFAH AN P SUSWARDANA, M.Kes, SpKK
16/02/2016 YULISA P DEBI NUGGIH NURMASARI
16/02/2016 NADA FAUZIAH NN P ARIA SUTJAHJO. DR
16/02/2016 NADA FAUZIAH NN P KEPERAWATAN
16/02/2016 JUWITA WULAN NIRMALA NY 131738 P
16/02/2016 JUWITA WULAN NIRMALA NY 131738 P
16/02/2016 JUWITA WULAN NIRMALA NY 131738 P
16/02/2016 JUWITA WULAN NIRMALA NY 131738 P
16/02/2016 JUWITA WULAN NIRMALA NY 131738 P
16/02/2016 JUWITA WULAN NIRMALA NY 131738 P
16/02/2016 JUWITA WULAN NIRMALA NY 131738 P KEBIDANAN
16/02/2016 DITA TANTRI S BONA VENTURA, SpOG DR
16/02/2016 NURHAYATIH S BONA VENTURA, SpOG DR
16/02/2016 FAJAR S DEBI NUGGIH NURMASARI
16/02/2016 WIWI S BONA VENTURA, SpOG DR
16/02/2016 HAINULLAH S BAMBANG
16/02/2016 FATHAN R S SUSWARDANA, M.Kes, SpKK
16/02/2016 ASMARA NY 45232 S ARIA SUTJAHJO. DR
16/02/2016 KOESMARANDI TN 10920 S BAMBANG RENALDI, Sp.M DR
16/02/2016 ERNESDI NY S BAMBANG RENALDI, Sp.M DR
16/02/2016 TATI R NY S BAMBANG RENALDI, Sp.M DR
16/02/2016 SUGIARTI NY S BAMBANG RENALDI, Sp.M DR
16/02/2016 SUHARTATI NY S BAMBANG RENALDI, Sp.M DR
16/02/2016 RINA HUTAGALUNG NY S BAMBANG RENALDI, Sp.M DR
16/02/2016 TOTO P TN S SUSWARDANA, M.Kes, SpKK
16/02/2016 TIHAMAH NY S BONA VENTURA, SpOG DR
16/02/2016 HALIMAH NY S SOLIKHIN, SpKFR
16/02/2016 HALIMAH NY S SUTOYO
16/02/2016 SURYA SAPUTRA AN S JUMIYETI, SpA
16/02/2016 M FAISAL AN S ETRA ARIADNO, SpPD
16/02/2016 WARSINI NY S ETRA ARIADNO, SpPD
16/02/2016 DJADIATE NY S ETRA ARIADNO, SpPD
16/02/2016 YAMIRI NY S ETRA ARIADNO, SpPD
16/02/2016 BAMBANG NY S ETRA ARIADNO, SpPD
16/02/2016 SURANTI NY S ETRA ARIADNO, SpPD
16/02/2016 ENCIH NY S ETRA ARIADNO, SpPD
16/02/2016 RIZKI D.W.A AN S RONY PRASETYO, SpB
16/02/2016 SAMAJI TN S BAMBANG RENALDI, Sp.M DR
16/02/2016 MIMIN LAKSMINI NY S BAMBANG RENALDI, Sp.M DR
16/02/2016 JABERLIN TN S ETRA ARIADNO, SpPD
16/02/2016 DIAH WIDOWATI NY S ETRA ARIADNO, SpPD
16/02/2016 SITI NUR ARIF NY S MASAGUS TADJUDIN, SpOG
16/02/2016 RAMADAN TJ AN S ENI ARTA DAMANIK
16/02/2016 M. FAHRI AN S ENI ARTA DAMANIK
16/02/2016 KRISTIJAH NY S ETRA ARIADNO, SpPD
16/02/2016 YUMENAH MAMAN NY 131745 S OKIIIPKT*
16/02/2016 YUMENAH MAMAN NY 131745 S OKIIIPKT*
16/02/2016 YUMENAH MAMAN NY 131745 S OKIIIPKT*
16/02/2016 YUMENAH MAMAN NY 131745 S OKIIIPKT*
16/02/2016 YUMENAH MAMAN NY 131745 S OKIIIPKT*
16/02/2016 YUMENAH MAMAN NY 131745 S OKIIIPKT*
16/02/2016 YUMENAH MAMAN NY 131745 S OKIIIPKT*
16/02/2016 ASMANA NY S KEPERAWATAN
16/02/2016 M ZAIDAN TN M DESY FIDYAWATI
16/02/2016 ADITYA RIZKY AN M ENI ARTA DAMANIK
16/02/2016 ABRIYA F AN M ENI ARTA DAMANIK
16/02/2016 NURHAYATI NY M ENI ARTA DAMANIK
16/02/2016 ALEHA AN M ENI ARTA DAMANIK
16/02/2016 CARISSA M ENI ARTA DAMANIK
16/02/2016 JATI TN M ENI ARTA DAMANIK
17/02/2016 M RIZIQ AN P AZIS MASDUKI, SpA
17/02/2016 SAHABAT TENJO TN P ARIA SUTJAHJO. DR
17/02/2016 MALIQ IBRAHIM AN P JUMIYETI, SpA
17/02/2016 DWI ARJUNA AN P JUMIYETI, SpA
17/02/2016 SRI SUPINI NY P ARIA SUTJAHJO. DR
17/02/2016 NURHAYATI NY 131787 P
17/02/2016 NURHAYATI NY 131787 P
17/02/2016 NURHAYATI NY 131787 P KEPERAWATAN
17/02/2016 RENI WAHDINI NY S JULIUS EDY
17/02/2016 ERLANGGA DIPO SURYA S JULIUS EDY
17/02/2016 HENDRI SAPUTRA S JULIUS EDY
17/02/2016 LIA AGUSTINA S PUTRA AGUNG WISNU M, SpOG
17/02/2016 SAIF S S JULIUS EDY
17/02/2016 DWI RANTIL S JULIUS EDY
17/02/2016 LIANA ARIANI S JULIUS EDY
17/02/2016 LASMA BR S RONY PRASETYO, SpB
17/02/2016 HELMY AFRIZAH S RONY PRASETYO, SpB
17/02/2016 RENNI S ETRA ARIADNO, SpPD
17/02/2016 INDRAWATI S ETRA ARIADNO, SpPD
17/02/2016 M. SYAFIQ SETIAWAN AN 131758 S
17/02/2016 M. SYAFIQ SETIAWAN AN 131758 S
17/02/2016 M. SYAFIQ SETIAWAN AN 131758 S KEPERAWATAN
17/02/2016 EVA ROSANNA M JULIUS EDY
17/02/2016 ALTHAF ASWANGGA M JULIUS EDY
17/02/2016 SUHATI SULAEMA NY M BAMBANG SISWANTO, SpS
17/02/2016 JALIAH SUPARTI NY M BAMBANG SISWANTO, SpS
17/02/2016 NURJANAH ALI NY M BAMBANG SISWANTO, SpS
17/02/2016 ACHJADI FANANG TN M BAMBANG SISWANTO, SpS
17/02/2016 ELLEN NY M BAMBANG SISWANTO, SpS
17/02/2016 PALAL TN M BAMBANG SISWANTO, SpS
17/02/2016 HAERIYA NY M BAMBANG SISWANTO, SpS
17/02/2016 KARDI TN M BAMBANG SISWANTO, SpS
17/02/2016 RULINA S NY M BAMBANG SISWANTO, SpS
17/02/2016 ERNA NN M KRISNADI SETIAWAN, Sp.Pros
17/02/2016 SUDARMIN TJONG TN M KRISNADI SETIAWAN, Sp.Pros
17/02/2016 NADIA SALMA NY M KRISNADI SETIAWAN, Sp.Pros
17/02/2016 JULIA NN M KRISNADI SETIAWAN, Sp.Pros
17/02/2016 IDAYANTI NY M KRISNADI SETIAWAN, Sp.Pros
18/02/2016 PRASETYO TN P JULIUS EDY
18/02/2016 AKMAL MAULANA AN P JULIUS EDY
18/02/2016 TRALITSATUL AZHARA NN P DEBI NUGGIH NURMASARI
18/02/2016 MUCHAEL HANIF AN P SUSWARDANA, M.Kes, SpKK
18/02/2016 IKA LESTARI NY P DOUNALD MARPAUNG, Sp. THT
18/02/2016 EPI MULYANA TN P DOUNALD MARPAUNG, Sp. THT
18/02/2016 EPI MULYANA TN P DOUNALD MARPAUNG, Sp. THT
18/02/2016 SAFIA AN P KRISNADI SETIAWAN, Sp.Pros
18/02/2016 SOFRI BAHAR TN P KRISNADI SETIAWAN, Sp.Pros
18/02/2016 KURNIA INTAN AN P ARIA SUTJAHJO. DR
18/02/2016 JENY TONY NY P DEBI NUGGIH NURMASARI
18/02/2016 MEGA R NY P ARIA SUTJAHJO. DR
18/02/2016 INDAH WIDIASTUTI NY 131820 P PUTRA AGUNG WISNU M, SpOG
18/02/2016 INDAH WIDIASTUTI NY 131820 P KEBIDANAN
18/02/2016 DEVI ANGGRAINI NN 131718 P
18/02/2016 DEVI ANGGRAINI NN 131718 P
18/02/2016 DEVI ANGGRAINI NN 131718 P KEPERAWATAN
18/02/2016 SYARIFUDIN TN 131707 P
18/02/2016 SYARIFUDIN TN 131707 P
18/02/2016 SYARIFUDIN TN 131707 P
18/02/2016 SYARIFUDIN TN 131707 P KEPERAWATAN
18/02/2016 MEGA R NY P KEPERAWATAN
18/02/2016 RATNA NY S SUHARTOYO
18/02/2016 M SALMAN A AN S SUHARTOYO
18/02/2016 DIDIN SOLEHUDIN TN S ARIA SUTJAHJO. DR
18/02/2016 FATHIRA AZZAHRA AN S JUMIYETI, SpA
18/02/2016 KOMARUDIN TN S ETRA ARIADNO, SpPD
18/02/2016 SITI ROBIAH NY S ETRA ARIADNO, SpPD
18/02/2016 NAROH NY S ETRA ARIADNO, SpPD
18/02/2016 KASWAN TN S ETRA ARIADNO, SpPD
18/02/2016 TD DESYFIRYANTI NY S ETRA ARIADNO, SpPD
18/02/2016 HALIMAH NY S ETRA ARIADNO, SpPD
18/02/2016 ROSYITA INDAH P NY S ETRA ARIADNO, SpPD
18/02/2016 SRI SUPRAPTI NY S ETRA ARIADNO, SpPD
18/02/2016 WIM R TN S DONALD
18/02/2016 SAFIRA ALIQHA AN S ARIA SUTJAHJO. DR
18/02/2016 SAHABAT LERJO S TN S ARIA SUTJAHJO. DR
18/02/2016 ANDIKA AN S SITI AINUN
18/02/2016 DALFA AN S SITI AINUN
18/02/2016 SUGIYANTO TN S SITI AINUN
18/02/2016 RATNAWATI NY S PUTRA AGUNG WISNU M, SpOG
18/02/2016 NABILLA AN S SITI AINUN
18/02/2016 SUPARJONO M SUHARTONO, SpPD
18/02/2016 RATNAWATI NY M PUTRA AGUNG WISNU M, SpOG
18/02/2016 CAHYA PUTRI M DESY FIDYAWATI
18/02/2016 VIHA NUR AINI M SITI AINUN
18/02/2016 ARSYA ALFIANSYAH M SITI AINUN
18/02/2016 NURAGEL M SITI AINUN
18/02/2016 DEDEN M SITI AINUN
18/02/2016 NURMALA SARI M SITI AINUN
18/02/2016 ENDAH WIDIHASTUTI R M SITI AINUN
18/02/2016 MALADI PRASETYA M SITI AINUN
18/02/2016 CASDIH M SITI AINUN
18/02/2016 CASDIK M SITI AINUN
18/02/2016 CASDIK M KEPERAWATAN
18/02/2016
18/02/2016
18/02/2016
RUANG URAIAN PEMBAYARAN TINDAKAN % HONOR KET.

POLI BIAYA PERIKSA 48,000 35% 16,800

POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 99,000 80% 79,200
GIGI EXO 500,000 40% 200,000
POLI PEN. REHIDRASI 48,000 40% 19,200
POLI PEN. REHIDRASI+infus 29,800 100% 29,800
OKPKT3 SC STERIL PAKET 2 HARI KLA 1,100,000 100% 1,100,000
OKPKT3 ASISTEN (STERIL) 100% -
OKPKT3 INSTRUMENTATOR (STERIL) 100% -
OKPKT3 DOKTER ANESTESI (STERIL) 400,000 100% 400,000
OKPKT3 DOKTER ANAK (STERIL) 125,000 100% 125,000
OKPKT3 PENATA ANESTESI (STERIL) 75,000 100% 75,000
OKPKT3 BIDAN (STERIL) 30,500 100% 30,500
POLI BIAYA PERIKSA 169,000 0% - BPJS
POLI BIAYA PERIKSA 169,000 0% - BPJS
POLI SCALING+TUMPAT KOMPO 600,000 0% - ASURANSI
POLI BIAYA PERIKSA 169,000 0% - ASURANSI
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 48,000 0% 10,000
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 169,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI FISIOTERAFI 185,000 25% 46,250
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
 POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 199,000 80% 159,200 BPJS
POLI BIAYA PERIKSA 48,000 35% 16,800 BPJS
POLI BIAYA PERIKSA 48,000 35% 16,800 BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
OKIIIPKT* SC PAKET 2 HARI KLAS 3 750,000 100% 750,000
OKIIIPKT* ASISTEN 100% -
OKIIIPKT* INSTRUMENTATOR 100% -
OKIIIPKT* DOKTER ANESTESI 275,000 100% 275,000
OKIIIPKT* DOKTER ANAK 125,000 100% 125,000
OKIIIPKT* PENATA ANESTESI 65,000 100% 65,000
OKIIIPKT* BIDAN 30,500 100% 30,500
POLI LUKA BESAR 28,000 100% 28,000
GIGI KONTROL BRACES 1,300,000 80% 1,040,000
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 99,000 80% 79,200
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 48,000 35% 16,800
PU3 PEN.REHIDRASI 72,000 40% 28,800
PU3 VISITE 106,000 80% 84,800
PU3 PEN.REHIDRASI+VISITE+T 42,800 100% 42,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 199,000 80% 159,200
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 0% 10,000
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
PU3 PEN.REHIDRASI 48,000 40% 19,200
PU3 VISITE 318,000 80% 254,400
PU3 PEN.REHIDRASI+VISITE+T 66,600 100% 66,600
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 0% 10,000
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
GIGI KONSUL 114,000 0% - BPJS
GIGI KONSUL 114,000 0% - BPJS
GIGI KONSUL 114,000 0% - BPJS
GIGI KONSUL 99,000 80% 79,200
GIGI KONSUL + TINDAKAN 199,000 80% 159,200
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
GIGI SCALING RA+RB+TAMBAL 900,000 40% 360,000
POLI BIAYA PERIKSA 99,000 80% 79,200
POLI BIAYA PERIKSA 99,000 80% 79,200
POLI BIAYA PERIKSA 99,000 80% 79,200
POLI SERUMEN DI TELINGA 150,000 80% 120,000
GIGI KONSUL+PSA 279,000 0% - BPJS
GIGI KONSUL+PSA 279,000 0% - BPJS
POLI BIAYA PERIKSA 48,000 35% 16,800
GIGI PSA 240,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 80% 79,200
VK KURETAGE 2,400,000 -
VK KURETAGE 2,400,000 10% 240,000
PU3 PENREHIDRASI 48,000 40% 19,200
PU3 VISITE 530,000 80% 424,000
PU3 PEN.REHIDRASI+VISITE+T 107,800 100% 107,800
PU2 PEN.REHIDRASI 72,000 40% 28,800
PU2 VISITE 552,000 80% 441,600
PU2 VISITE 276,000 80% 220,800
PU2 PEN.REHIDRASI+VISITE+T 140,000 100% 140,000
POLI INHALASI 11,000 100% 11,000
POLI FISIOTERAFI 185,000 25% 46,250
POLI FISIOTERAFI 140,000 25% 35,000
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 99,000 80% 79,200
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 99,000 0% - BPJS
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 99,000 80% 79,200
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 99,000 80% 79,200
POLI USG 70,000 80% 56,000
GIGI CAVIT 450,000 60% 270,000
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI BIAYA PERIKSA 48,000 35% 16,800
POLI HECTING 350,000 40% 140,000
POLI HECTING 100,000 100% 100,000
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