DR Samuel Mei 2020

dr.
Samuel Christopel Kapitan

Tanggal No Registration MR Nama Pasien
BPJS KESEHATAN RAWAT JALAN

4/26/2020 REG/OP/200426-0005 015147 DODDY BUDI YANTO
4/27/2020 REG/OP/200427-0030 018993 ABDUL AJIS
4/28/2020 REG/OP/200428-0001 018982 FITRIA SARASWATI
4/29/2020 REG/OP/200429-0052 012363 HJ. CICIH
5/15/2020 REG/OP/200515-0036 019162 MURNI YAYANG KOMALASARI
5/15/2020 REG/OP/200515-0040 014104 SIMI BIN H NASIM
5/16/2020 REG/OP/200516-0001 015137 KANARI
5/16/2020 REG/OP/200516-0002 019159 ASIH MAESAROH
5/16/2020 REG/OP/200516-0003 019163 YUSUF
5/22/2020 REG/OP/200522-0052 019243 KARSIDAH
TOTAL BPJS
TOTAL BPJS KESEHATA
Tanggal No Registration MR Nama Pasien
ASURANSI & JAMINAN RAWAT INAP

5/3/2020 REG/IP/200429-0001 019004 QIANA AZZAHRA HUMAIRAH
5/3/2020 REG/IP/200429-0001 019004 QIANA AZZAHRA HUMAIRAH
5/3/2020 REG/IP/200429-0004 019014 DWINANTO
5/3/2020 REG/IP/200429-0004 019014 DWINANTO
5/13/2020 REG/IP/200511-0005 015532 DISKI BILADINA
5/13/2020 REG/IP/200511-0006 019105 ANDRIAN DWI HANDOKO
5/13/2020 REG/IP/200511-0006 019105 ANDRIAN DWI HANDOKO
5/13/2020 REG/IP/200512-0001 019109 RATU JUNITA NURAZIZAH PRATIWI HAMZAH
5/13/2020 REG/IP/200512-0001 019109 RATU JUNITA NURAZIZAH PRATIWI HAMZAH
5/13/2020 REG/IP/200512-0002 017519 DIDI WALUYO
5/13/2020 REG/IP/200512-0002 017519 DIDI WALUYO
5/13/2020 REG/IP/200512-0003 019110 MARTIN
5/13/2020 REG/IP/200512-0003 019110 MARTIN
5/13/2020 REG/IP/200512-0003 019110 MARTIN
5/13/2020 REG/IP/200513-0001 011590 BUDIONO
5/13/2020 REG/IP/200513-0001 011590 BUDIONO
5/18/2020 REG/IP/200515-0003 016946 MOH. RANGGA NURJATI
5/18/2020 REG/IP/200515-0003 016946 MOH. RANGGA NURJATI
5/18/2020 REG/IP/200515-0004 016058 RIAN TAUFIK AMRULLOH
5/18/2020 REG/IP/200515-0004 016058 RIAN TAUFIK AMRULLOH
5/18/2020 REG/IP/200516-0004 019167 RUDI HERMAWAN
5/18/2020 REG/IP/200516-0004 019167 RUDI HERMAWAN
5/18/2020 REG/IP/200516-0006 019170 YUSUF TRIHANDOKO
5/18/2020 REG/IP/200517-0001 011594 MUHAMAD ABIZAR AL GHIFARI
5/18/2020 REG/IP/200517-0001 011594 MUHAMAD ABIZAR AL GHIFARI
TOTAL ASURAN
ASURANSI & JAMINAN RAWAT JALAN
4/26/2020 REG/OP/200426-0002 018966 IMAM RUSLI
4/26/2020 REG/OP/200426-0002 018966 IMAM RUSLI
4/26/2020 REG/OP/200426-0003 018976 ROFIATI
4/26/2020 REG/OP/200426-0006 018980 DODI RISTIYANTO
4/26/2020 REG/OP/200426-0006 018980 DODI RISTIYANTO
4/26/2020 REG/OP/200426-0007 018981 MOH KHUNAIFI
4/27/2020 REG/OP/200427-0001 018913 SUNANDAR
4/27/2020 REG/OP/200427-0024 018988 RAFSAN AKBAR ISBILLY
4/27/2020 REG/OP/200427-0027 018990 DONNY IRAWAN
4/27/2020 REG/OP/200427-0027 018990 DONNY IRAWAN
4/27/2020 REG/OP/200427-0031 018994 KERIN APRILIA
4/27/2020 REG/OP/200427-0032 018995 NURSIDIK
4/28/2020 REG/OP/200428-0003 018996 RINA RUSNIAWATI
4/29/2020 REG/OP/200429-0048 019018 GUNAWAN
4/29/2020 REG/OP/200429-0048 019018 GUNAWAN
5/6/2020 REG/OP/200506-0061 012878 WAHYU TRIAJI SASONGKO
5/12/2020 REG/OP/200512-0001 019109 RATU JUNITA NURAZIZAH PRATIWI HAMZAH
5/12/2020 REG/OP/200512-0002 007831 DENNY ARDIYANSYAH
5/22/2020 REG/OP/200522-0051 019204 SITI MARIAH
5/22/2020 REG/OP/200522-0051 019204 SITI MARIAH
TOTAL ASURAN
PRIBADI RAWAT INAP
5/13/2020 REG/IP/200513-0002 019090 DANIS DE RAMADHAN
5/18/2020 REG/IP/200516-0003 019145 OKTAVIANA LOSYITA PUTRI
TOTAL
PRIBADI RAWAT JALAN
4/26/2020 REG/OP/200426-0004 018979 TRI PRASTYO TEGUH CAHYADI
4/26/2020 REG/OP/200426-0004 018979 TRI PRASTYO TEGUH CAHYADI
4/27/2020 REG/OP/200427-0028 018991 VINA YULIANI
4/27/2020 REG/OP/200427-0029 018992 KHOPIYAH
4/29/2020 REG/OP/200429-0049 017307 JUNAEDY
4/30/2020 REG/OP/200430-0001 019019 REZA MALINDA
4/30/2020 REG/OP/200430-0051 019029 RISKIA FARASSYA
5/9/2020 REG/OP/200509-0017 019094 KRISNA SEPRI NUGRAHA
5/9/2020 REG/OP/200509-0023 019095 FEBRI DERIANA
5/9/2020 REG/OP/200509-0024 019096 AIDAN SYAHM HERMANTO
5/9/2020 REG/OP/200509-0032 018658 HENDRY SATRIA
5/11/2020 REG/OP/200511-0039 019108 RESTU WIDODO
5/22/2020 REG/OP/200522-0054 000971 BUDIYANTO
5/22/2020 REG/OP/200522-0054 000971 BUDIYANTO
TOTAL P
TOTAL RAWA
Dinas Malam 26 April - 25 Mei 2020
BPJS Kesehatan
Penjamin
KEMENTRIAN KESEHATAN RI
BPJS KESEHATAN
BPJS KESEHATAN
BPJS KESEHATAN
BPJS KESEHATAN
BPJS KESEHATAN
BPJS KESEHATAN
BPJS KESEHATAN
BPJS KESEHATAN
BPJS KESEHATAN
TOTAL BPJS KESEHATAN RAWAT JALAN
TOTAL BPJS KESEHATAN RAWAT INAP DAN RAWAT JALAN
Penjamin
ADMEDIKA - TOKIO MARINE

ADMEDIKA - TOKIO MARINE
BPJS KETENAGAKERJAAN
DENSO INDONESIA, PT
DENSO INDONESIA, PT
ASURANSI ASTRA BUANA
ADMEDIKA - AJ CENTRAL ASIA RAYA
ADMEDIKA - AJ CENTRAL ASIA RAYA
INDOFOOD SUKSES MAKMUR,Tbk. PT (div. Noodle)
TOTAL ASURANSI & JAMINAN RAWAT INAP
DENSO INDONESIA, PT
ADMEDIKA - ASURANSI ASTRA BUANA
TOYO SEAL INDONESIA, PT
CAR-PREVENSIA
CAR-PREVENSIA
MIKUNI INDONESIA, PT
ADMEDIKA - AVRIST ASSURANCE
ADMEDIKA-PACIFIC CROSS
ADMEDIKA-PACIFIC CROSS
ADMEDIKA - SOMPO INSURANCE
ADMEDIKA - DAYIN MITRA
TOTAL ASURANSI & JAMINAN RAWAT JALAN
PRIBADI
PRIBADI
TOTAL PRIBADI RAWAT INAP
PRIBADI
PRIBADI
PRIBADI
PRIBADI
PRIBADI
PRIBADI
PRIBADI
PRIBADI
PRIBADI
PRIBADI
PRIBADI
PRIBADI
PRIBADI
PRIBADI
PRIBADI
PRIBADI
TOTAL PRIBADI RAWAT JALAN
TOTAL RAWAT INAP DAN RAWAT JALAN
Nama Tindakan Harga
KONSULTASI DOKTER UMUM / IGD / GIGI 120,000.00

1,200,000.00
1,200,000.00
Nama Tindakan Harga
VISIT DOKTER UMUM 100,000.00

GANTI VERBAN (Um) 27,500.00
GANTI VERBAN RINGAN 110,000.00
1,907,500.00

WOUND TOILET (BERSIHKAN LUKA) 125,000.00
INJEKSI ( DILUAR OBAT ) ( D ) 50,000.00
JASA TINDAKAN JAHIT LUKA 1 – 5 JAHITAN (Um) 120,000.00
INSISI SILANG (Um) 120,000.00
INSISI SILANG (Um) 120,000.00
ANGKAT JAHITAN 1-10 JAHITAN (Um) 40,000.00
2,520,000.00

150,000.00

EKG (Um) 80,000.00
WOUND TOILET (BERSIHKAN LUKA) 125,000.00
EKG (Um) 80,000.00
ANGKAT JAHITAN 1-10 JAHITAN (Um) 40,000.00
1,765,000.00
6,342,500.00
Biasa = 10 hari @250.000, Libur = 4 hari @500.000 4,500,000.00
Periode Mei 2020 1,000,000.00
Fee 10,451,900.00
GF 7,000,000.00
DPP 50% 5,996,250.00
PPh 21 299,812.00
NETTO 10,152,088.00
POTONGAN 500,000.00
DITRANSFER 9,652,088.00
INACBG'S Fee
15,000.00
15,000.00
15,000.00
15,000.00
15,000.00
15,000.00
15,000.00
15,000.00
15,000.00
15,000.00
- 150,000.00
- 150,000.00
Discount Fee
- 80,000.00
- 80,000.00
7,800.00 44,200.00
3,300.00 18,700.00
7,800.00 44,200.00
3,300.00 18,700.00
7,800.00 44,200.00
- 60,000.00
- 60,000.00
- 60,000.00
- 60,000.00
7,800.00 44,200.00
7,800.00 44,200.00
7,800.00 44,200.00
7,800.00 44,200.00
3,300.00 18,700.00
7,800.00 44,200.00
7,800.00 44,200.00
- 40,000.00
- 40,000.00
- 60,000.00
- 60,000.00
- 40,000.00
- 40,000.00
7,800.00 44,200.00
13,200.00 74,800.00
7,800.00 44,200.00
- 60,000.00
- 60,000.00
108,900.00 1,417,100.00
14,400.00 81,600.00
15,000.00 85,000.00
- 96,000.00
- 96,000.00
- 50,000.00
- 96,000.00
14,400.00 81,600.00
14,400.00 81,600.00
14,400.00 81,600.00
- 96,000.00
- 96,000.00
- 96,000.00
- 96,000.00
- 96,000.00
- 96,000.00
- 96,000.00
14,400.00 81,600.00
4,800.00 27,200.00
- 96,000.00
- 96,000.00
- 96,000.00
14,400.00 81,600.00
3,000.00 17,000.00
109,200.00 1,916,800.00
- 80,000.00
- 40,000.00
- 120,000.00
- 96,000.00
- 32,000.00
- 96,000.00
- 96,000.00
- 96,000.00
- 96,000.00
- 96,000.00
- 96,000.00
- 96,000.00
- 100,000.00
- 32,000.00
- 96,000.00
- 96,000.00
- 96,000.00
- 96,000.00
- 32,000.00
- 1,348,000.00
218,100.00 4,801,900.00
- 4,500,000.00
- 1,000,000.00
Biaya Rekom SIP IDI Kab Bekasi

DR Samuel Mei 2020

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DR Samuel Mei 2020

Hochgeladen von

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dr.

Samuel Christopel Kapitan

BPJS KESEHATAN RAWAT JALAN

Tanggal No Registration MR Nama Pasien

ASURANSI & JAMINAN RAWAT INAP

Dinas Malam 26 April - 25 Mei 2020

ADMEDIKA - TOKIO MARINE

KONSULTASI DOKTER UMUM / IGD / GIGI 120,000.00

Nama Tindakan Harga

VISIT DOKTER UMUM 100,000.00

KONSULTASI DOKTER UMUM / IGD / GIGI 120,000.00

VISIT DOKTER UMUM 100,000.00

KONSULTASI DOKTER UMUM / IGD / GIGI 120,000.00

Biasa = 10 hari @250.000, Libur = 4 hari @500.000 4,500,000.00

Periode Mei 2020 1,000,000.00

Biaya Rekom SIP IDI Kab Bekasi

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