Laporan Kleim PLN RWJ

RS. TELAGA BUNDA BIERUN

No No. Invoice NAMA PASIEN Biaya Kleim tgl berobat
1 1070/RSTB/U/III/2023 Nurhayati M. Ali Rp 667,900 2/13/2023
2 1070/RSTB/U/III/2023 vebbi justina Rp 417,900 2/15/2023
3 1070/RSTB/U/III/2023 vebbi justina Rp 65,000 2/15/2023
4 1070/RSTB/U/III/2023 basri Rp 616,100 2/20/2023
5 1070/RSTB/U/III/2023 Husaini, ST Rp 264,000 2/20/2023
6 1070/RSTB/U/III/2023 M. Johni Insya Rp 298,800 2/23/2023
7 1070/RSTB/U/III/2023 M. Nurdin Rp 619,100 2/24/2023
Rp 2,948,800

8 2004/RSTB/U/III/2023 Rizki Amla Rp 169,400 3/1/2023

9 2004/RSTB/U/III/2023 Nazariah Rp 438,500 3/3/2023
10 2004/RSTB/U/III/2023 siti herlina Rp 481,100 3/6/2023
11 2004/RSTB/U/III/2023 siti herlina Rp 55,000 3/6/2023
12 2004/RSTB/U/III/2023 Basri Rp 523,200 3/6/2023
13 2004/RSTB/U/III/2023 M. rayhan aracelli Rp 65,000 3/14/2023
14 2004/RSTB/U/III/2023 M. rayhan aracelli Rp 174,196 3/14/2023
15 2004/RSTB/U/III/2023 Muttaqin Rp 248,300 3/14/2023
16 2004/RSTB/U/III/2023 M. Nurdin Rp 700,600 3/17/2023
17 2004/RSTB/U/III/2023 basri Rp 502,200 3/21/2023
Rp 3,357,496

18 2927/RSTB/U/VI/2023 Maryam Rp 461,500 5/15/2023

19 2927/RSTB/U/VI/2023 Siti Aminah Rp 229,000 5/16/2023
20 2927/RSTB/U/VI/2023 Siti Aminah Rp 299,900 6/16/2023
21 2927/RSTB/U/VI/2023 Anwar benseh Rp 293,400 5/20/2023
22 2927/RSTB/U/VI/2023 Nurhayati Rp 762,700 5/26/2023
23 2927/RSTB/U/VI/2023 M. nurdin Rp 513,500 5/29/2023
24 2927/RSTB/U/VI/2023 siti herlina Rp 370,000 5/29/2023
25 2927/RSTB/U/VI/2023 basri Rp 624,300 5/29/2023
26 2927/RSTB/U/VI/2023 nazariah Rp 498,800 5/31/2023
Rp 4,053,100

27 3208/RSTB/U/VI/2023 Basri Rp 441,364 6/13/2023

28 3208/RSTB/U/VI/2023 Nazariah Rp 752,900 6/19/2023
29 3208/RSTB/U/VI/2023 M.Nurdin Rp 630,900 6/19/2023
30 3208/RSTB/U/VI/2023 Vebbi Justina Rp 288,300 6/21/2023
31 3208/RSTB/U/VI/2023 basri Rp 650,700 6/26/2023
32 3208/RSTB/U/VI/2023 Maryam Rp 326,200 6/26/2023
Rp 3,090,364

33 3612/RSTB/U/VIII/2023 Zulkarnaini Rp 294,600 7/26/2023

34 3612/RSTB/U/VIII/2023 Basri Rp 530,600 7/29/2023
35 3612/RSTB/U/VIII/2023 Nazariah Rp 348,700 7/31/2023
36 3612/RSTB/U/VIII/2023 Siti Herlina Rp 327,900 7/31/2023
Rp 1,501,800

37 4156/RSTB/U/IX/2023 Faris A. Rahman Rp 109,200 8/25/2023

38 4156/RSTB/U/IX/2023 Basri Rp 542,200 8/28/2023
39 4156/RSTB/U/IX/2023 Muzakkir AR Rp 55,000 8/28/2023
40 4156/RSTB/U/IX/2023 Muzakkir AR Rp 582,500 8/28/2023
41 4156/RSTB/U/IX/2023 Zulkarnaen Norman Rp 238,100 8/30/2023
42 4156/RSTB/U/IX/2023 Zulkarnaen Norman Rp 55,000 8/30/2023
43 4156/RSTB/U/IX/2023 M. Husni Rp 65,000 8/31/2023
44 4156/RSTB/U/IX/2023 M. Husni Rp 269,800 8/31/2023
Rp 1,916,800

45 3986/RSTB/U/VIII/2023 Zulkarnain Rp 394,000 8/2/2023

46 3986/RSTB/U/VIII/2023 Siti Herlina Rp 301,900 8/7/2023
47 3986/RSTB/U/VIII/2023 Zulkarnain Rp 284,300 8/9/2023
48 3986/RSTB/U/VIII/2023 Iqlima Rp 161,700 8/10/2023
49 3986/RSTB/U/VIII/2023 Siti Herlina Rp 301,900 8/14/2023
50 3986/RSTB/U/VIII/2023 Basri Rp 640,600 8/14/2023
51 3986/RSTB/U/VIII/2023 Chairi Amalia Rp 435,700 8/14/2023
52 3986/RSTB/U/VIII/2023 Zulkarnain Rp 285,400 8/16/2023
53 3986/RSTB/U/VIII/2023 M. Nurdin Rp 398,700 8/21/2023
54 3986/RSTB/U/VIII/2023 Nazariah Rp 536,500 8/21/2023
Rp 3,740,700

56 4397/RSTB/U/IX/2023 Nazariah Rp 561,700 9/4/2023

57 4397/RSTB/U/IX/2023 Nazariah Rp 55,000 9/4/2023
58 4397/RSTB/U/IX/2023 Siti Herlina Rp 606,800 9/4/2023
59 4397/RSTB/U/IX/2023 Siti Herlina Rp 55,000 9/4/2023
60 4397/RSTB/U/IX/2023 M. Nurdin Rp 547,600 9/4/2023
61 4397/RSTB/U/IX/2023 M. Nurdin Rp 55,000 9/4/2023
62 4397/RSTB/U/IX/2023 Siti Aminah Rp 454,600 9/5/2023
63 4397/RSTB/U/IX/2023 Siti Aminah Rp 55,000 9/5/2023
64 4397/RSTB/U/IX/2023 Siti Aminah Rp 289,200 9/7/2023
65 4397/RSTB/U/IX/2023 m. Husni Rp 55,000 9/7/2023
66 4397/RSTB/U/IX/2023 m. Husni Rp 167,100 9/7/2023
67 4397/RSTB/U/IX/2023 Agus Rianda Rp 405,100 9/10/2023
68 4397/RSTB/U/IX/2023 Siti Aminah Rp 347,100 9/12/2023
69 4397/RSTB/U/IX/2023 Siti Aminah Rp 55,000 9/12/2023
70 4397/RSTB/U/IX/2023 Basri Rp 599,800 9/12/2023
Rp 4,309,000

71 4611/RSTB/U/X/2023 M. Nurdin Rp 55,000 9/19/2023

72 4611/RSTB/U/X/2023 M. Nurdin Rp 592,000 9/19/2023
73 4611/RSTB/U/X/2023 Siti Aminah Rp 55,000 9/21/2023
74 4611/RSTB/U/X/2023 Siti Aminah Rp 577,900 9/21/2023
75 4611/RSTB/U/X/2023 Azzumar Rp 299,100 9/22/2023
76 4611/RSTB/U/X/2023 M. Husni Rp 55,000 9/22/2023
77 4611/RSTB/U/X/2023 M. Husni Rp 540,700 9/22/2023
78 4611/RSTB/U/X/2023 Nurhayati M. Ali Rp 688,700 9/25/2023
79 4611/RSTB/U/X/2023 Nazariah Rp 55,000 9/25/2023
79 4611/RSTB/U/X/2023 Nazariah Rp 326,900 9/25/2023
Rp 3,245,300
 Laporan Kleim PLN RWI
No No. Invoice NAMA PASIEN Biaya Kleim tgl berobat
1 5366/RSTB/U/XI/2023 Jusnawati Rp 3,103,400 11/30/2023
Rp 3,103,400

2 5365/RSTB/U/XI/2023 Usman yusuf Rp 5,093,776 11/30/2023

Rp 5,093,776

3 5004/RSTB/U/X/2023 Zulkarnain Norman Rp 2,605,900 11/2/2023

Rp 2,605,900

4 5632/RSTB/U/XII/2023 Jusnawati Rp 3,517,000 12/19/2023

Rp 3,517,000