PHILHEALTH ACCREDITATION NO.

MM DD
HERMOGENES CORACHEA SR. MD 1 1 0 0 - 9809998-0 01 01
DIOGENES CORACHEA MD. 1 1 0 0 - 1430115-4 02 02
DENNIS CORACHEA MD. 1 5 0 1 - 0817844-3 03 03
LUZVIMINDA CORACHEA MD. 1 5 0 1 - 1327810- 2 04 04
MAJOREE SORIANO MD. 1 5 0 1 - 1327637 -1 05 05
ROSSANA LUMBAN LARON MD. 1 2 0 3 - 0300822-8 06 06
SUSAN ROSA CANTOR MD. 1 1 0 0 - 0 7 0 0 5 4 6 -1 07 07
ABELLA SIM LIRIO MD. 1 6 0 1 - 9802765-7 08 08
ANNABELE TULLAS GUMAPAC MD. 1 5 0 1 - 0701222-8 09 09
ALDWIN O. TULLAS MD. 1 5 0 1 - 0918905-1 10 10
ALBERT BENJAMIN PAGTAKHAN MD. 1 5 0 1 - 1121408-8 11 11
MA. LYRA GUEVARRA 1 5 0 1 - 1326119-2
ENRIQUITO CONTRERAS MD. 0 1 0 0 - 5829 12 12
EDUARDO CHUA MD. 1 1 0 0 - 9810226-2 13
DELIA TAGLE MD. 1 5 0 1 - 9808678-3 14
NOEL TOREJA MD. 1 5 0 1 - 0400854-2 15
TERESITA HERNANDEZ MD. 1 5 0 1 - 9812311-6 16
PERLA DEREZ MD. 1 5 0 1 - 9816492-2 17
RAUL DY MD. 1 5 0 1 - 9817013-9 18
ROMMEL GUARIN M.D. 1 5 0 1 - 1432187-2
SYLVIA RAMILO MD. 1 5 0 1 - 9809509-1 19
SHIELA MARIE GONZALES MD. 0 3 0 0 - 0210860-3 20
ABIGAIL JOY CUAYONG MD. 1 5 0 1 - 1327324-4 21
CAROLITA LAT MD. 1 3 0 2 - 9813374-5 22
ERLINDA MASANGKAY III MD. 1 4 0 0 - 0500266-4 23
SHIELA STA. ANA M.D. 1 5 0 1 - 0700461-7 24
TIRAA 1 4 0 0 - 9811906-2 25
MALIJAN 1 6 0 1 - 9812281-7 26
27
28
29
30
31
A. COLLANTES ST., TANAUAN CITY, BATANGAS
ALTURA BATA, TANAUAN CITY, BATANGAS
ALTURA MATANDA, TANAUAN CITY, BATANGAS
ALTURA SOUTH, TANAUAN CITY, BATANGAS
AMBULONG, TANAUAN CITY, BATANGAS
AYA, TALISAY, BATANGAS
BAGBAG, TANAUAN CITY, BATANGAS
BAGUMBAYAN, TANAUAN CITY, BATANGAS
BALAKILONG, LAUREL, BATANGAS
BALAS, TALISAY, BATANGAS
BALAYAN, BATANGAS
BALELE, TANAUAN CITY, BATANGAS
BALETE, TANAUAN CITY, BATANGAS
BANADERO, TANAUAN CITY, BATANGAS
BANJO WEST, TANAUAN CITY, BATANGAS
BARCENAGA, NAUJAN, ORIENTAL MINDORO
BERINAYAN, LAUREL, BATANGAS
BILOG-BILOG, TANAUAN CITY, BATANGAS
BILUCAO, MALVAR, BATANGAS
BITIN BAY, LAGUNA
BUGTONG NA PULO, LIPA CITY
BOOT, TANAUAN CITY, BATANGAS
BRGY. PAGASPAS, TANAUAN CITY, BATANGAS
BRGY.1, TANAUAN CITY, BATANGAS
BRGY.2, STO.TOMAS, BATANGAS
BRGY.2, TANAUAN CITY, BATANGAS
BRGY.3, TANAUAN CITY, BATANGAS
BRGY.4, TANAUAN CITY, BATANGAS
BRGY.5, TANAUAN CITY, BATANGAS
BRGY.6, TANAUAN CITY, BATANGAS
BRGY.7, TANAUAN CITY, BATANGAS
BRGY.3, LAS PALMAS, STO.TOMAS, BATANGAS
BULA, CAMARINES SUR
BULA, CAMARINES SUR
BULACNIN, LIPA CITY, BATANGAS
BULIHAN, MALVAR, BATANGAS
BUNGGO, CALAMBA CITY
BUROL, CALAMBA CITY
CALE, TANAUAN CITY, BATANGAS
CALOOCAN, TALISAY, BATANGAS
DARASA, TANAUAN CITY, BATANGAS
GONZALES, TANAUAN CITY, BATANGAS
GULOD, LAUREL, BATANGAS
HIDALGO, TANAUAN CITY, BATANGAS
HORNALAN, CALAMBA, LAGUNA
ILAYANG PANAHON, UNISAN, QUEZON
INOSLUBAN, LIPA CITY, BATANGAS
IPIL, SILANG, CAVITE
JANOPOL OCC., TANAUAN CITY, BATANGAS
JANOPOL OR., TANAUAN CITY, BATANGAS
KAPITAN MARIA, MALVAR, BATANGAS
LAUREL, TANAUAN CITY, BATANGAS
LAUREL, BATANGAS
LEYNES, TALISAY BATANGAS
LOOC, BALETE, BATANGAS
LUMINA HOMES, STO.TOMAS, BATANGAS
LUTA DEL SUR, MALVAR, BATANGAS
LUTA NORTE, MALVAR, BATANGAS
LUYOS, TANAUAN CITY, BATANGAS
MA. PAZ, TANAUAN CITY, BATANGAS
MAASIN, CANDELARIA, QUEZON
MABAYABAS, TAYSAN, BATANGAS
MABINI, TANAUAN CITY, BATANGAS
MAKILING, CALAMBA CITY, LAGUNA
MALAKING PULO, TANAUAN CITY, BATANGAS
MALAYA, PILILLA, RIZAL
MALVAR, BATANGAS
MALIGAYA CMPD, TANAUAN CITY, BATANGAS
MARAUOY, LIPA CITY
MARIKINA HEIGHTS, MARIKINA CITY
MATULA-TULA, POLA, ORIENTAL MINDORO
MAUGAT, TANAUAN CITY, BATANGAS
MAUNONG, CALAMBA CITY, LAGUNA
MILAGROS, CALAMBA CITY, LAGUNA
MONTANA, TANAUAN CITY, BATANGAS
NATATAS, TANAUAN CITY, BATANGAS
PAGASPAS, TANAUAN CITY, BATANGAS
PALINDAN, IBAAN, BATANGAS
PANTAY BATA, TANAUAN CITY, BTGS
PANTAY MATANDA, TANAUAN CITY, BTGS
POBLACION 1, TANAUAN CITY, BATANGAS
POBLACION 2 , TANUAN CITY, BATANGAS
POBLACION 2, STO.TOMAS, BATANGAS
POBLACION 3, STO.TOMAS, BATANGAS
POBLACION 4, TANAUAN CITY, BATANGAS
POBLACION 4, STO.TOMAS, BATANGAS
POBLACION 6, TANAUAN CITY, BATANGAS
POBLACION 7, TANAUAN CITY, BATANGAS
POBLACION, MALVAR, BATANGAS
PULO, TALISAY BATANGAS
PUTTING LUPA, CALAMBA CITY, LAGUNA
QUILING, TALISAY, BATANGAS
SABANG, LIPA CITY, BATANGAS
SAIMSIM, CALAMBA CITY, LAGUNA
SALA, TANAUAN CITY, BATANGAS
SALES, BALETE, BATANGAS
SAMBAT, TANAUAN CITY, BATANGAS
SAMBONG, TAGAYTAY, CAVITE
SAMPALOC, TALISAY, BATANGAS
SAMPALOCAN, BALETE, BATANGAS
SAN ANTONIO, STO. TOMAS, BATANGAS
SAN ANDRES, ALAMINOS, LAGUNA
SAN BARTOLOME, STO. TOMAS, BATANGAS
SAN FELIX, STO.TOMAS, BATANGAS
SAN FERNANDO, MALVAR, BATANGAS
SAN FERNANDO, STO.TOMAS, BATANGAS
SAN FRANCISCO, STO.TOMAS, BATANGAS
SAN GABRIEL, LAUREL, BATANGAS
SAN GUILLERMO, TALISAY, BATANGAS
SAN GREGORIO, MALAVAR, BATANGAS
SAN ISIDRO, CUENCA, BATANGAS
SAN ISIDRO, STO. TOMAS, BATANGAS
SAN ISIDRO, MALVAR, BATANGAS
SAN ISIDRO, TALISAY, BATANGAS
SAN JOAQUIN, STO.TOMAS, BATANGAS
SAN JOSE, LIPA CITY, BATANGAS
SAN JOSE, TANAUAN CITY, BATANGAS
SAN JOSE, STO.TOMAS, BATANGAS
SAN JUAN, MALVAR, BATANGAS
SAN JUAN, STO.TOMAS, BATANGAS
SAN LUCAS, SAN PABLO, LAGUNA
SAN LUIS, STO.TOMAS, BATANGAS
SAN MIGUEL, STO. TOMAS, BATANGAS
SAN PABLO, STO.TOMAS, BATANGAS
SAN PEDRO, MALVAR, BATANGAS
SAN PEDRO, STO.TOMAS, BATANGAS
SAN PIOQUINTO, MALVAR, BATANGAS
SAN RAFAEL, STO.TOMAS, BATANGAS
SAN ROQUE, STO.TOMAS, BATANGAS
SAN SEBASTIAN, BALETE, BATANGAS
SAN VICENTE, STO,TOMAS, BATANGAS
SANTIAGO, MALVAR, BATANGAS
SANTIAGO, STO.TOMAS, BATANGAS
SANTOR, TANAUAN CITY, BATANGAS
SINISIAN, CALACA, BATANGAS
SOLIS, BALETE, BATANGAS
STA. ANA, STO.TOMAS, BATANGAS
STA. ANASTACIA, STO.TOMAS, BATANGAS
STA. CLARA, STO.TOMAS, BATANGAS
STA. MARIA, STO.TOMAS, BATANGAS
STA. ROSA, LAGUNA
SULPOC, TANAUAN CITY, BATANGAS
SUPLANG, TANAUAN CITY, BATANGAS
TALAGA, TANAUAN CITY, BATANGAS
TALISAY, BATANGAS
TANGWAY, LIPA CITY, BATANGAS
TAPIA SUBD., TANAUAN CITY, BATANGAS
TAYTAY, NAGCARLAN, LAGUNA
TINURIK, TANAUAN CITY, BATANGAS
TRANCA BAY, LAGUNA
TRANCA, TALISAY, BATANGAS
TRAPICHE 1, TANAUAN CITY, BATANGAS
TRAPICHE 3, TANAUAN CITY, BATANGAS
TRAPICHE 4, TANAUAN CITY, BATANGAS
TURBINA, CALAMBA CITY, LAGUNA
ULANGO, TANAUAN CITY, BATANGAS
WAWA, TANAUAN CITY, BATANGAS
UNISAN, CALAMBA CITY
 YR
2014
2015
2016
2017
 1100-1430115-4
DIOGENES CORACHEA MD.

02 13 2017

1501-1432187-2
ROMMEL GUARIN M.D.

02 13 2017

- 0.00

- 2,200.00
`
 SUMMARY OF STATEMENT OF ACCOUNT

PATIENT'S NAME: MALABANAN, MAURO

ADDRESS: BOOT, TANAUAN CITY, BATANGAS
DATE ADMITTED: 2/11/2017 TIME ADMITTED: 11:20AM
DATE DISCHARGED: 2/13/2017 TIME DISCHARGED: 2:20PM

ACTUAL PHILHEALTH DISCOUNTS

HOSPITAL CHARGES
E.R./ADM Fee 1,050.00 100.00
OR/DR Fee
Room/Misc 1,600.00 200.00
Medicine/Suppl. 3,985.00 490.00
Laboratory/Xray 3,815.00 700.00
SUB TOTAL 10,450.00 - 1,490.00

PROFESSIONAL FEE
DIOGENES CORACHEA MD. 7,840.00 - 1,800.00

SUB TOTAL 7,840.00 - 1,800.00

TOTAL CHARGES 18,290.00 - 3,290.00

JANE I. LITCHER
Billing Clerk

MERCY JANE LUMBRES

Cashier
2,200.00

12,800.00 PACKAGE - -
-

0.00 TOTAL EXCESS

2,200.00 TOTAL PYMT
2,200.00 DISCOUNT

DIOGENES L. CORACHEA, M.D.

 .

EXCESS

ER 187.50

RM 285.71
MED 711.61
LAB 681.25
8,960.00 PF 1,400.00
3,266.07

6,040.00
- 1,866.07
6,040.00 1,400.00
pymt 3,266.07

15,000.00 2,200.00 12,800.00

PH PACKAGE: 12,800.00
 PF 500
2,000
2,250

4,750

3250

- validation j33 + j36

2,200.00 input pymt
(2,200.00) discount

D.
HOSP
PF
TOTAL SR (23.93) DIFF-Other Discount

11,733.93 SHOULD BE EXCESS

3,266.07
MEI
JI
H.M. CORACHEA GENERAL HOSPITAL
A. Collantes St., Brgy.7, Tanauan City, Batangas

MR. ROLANDO M. LATAYAN

President
Golden Eye Security Agency Co. Inc.
Minamichi Bldg., Unit 4, A. Bonifacio St.,
Sto, Tomas, Batangas
13 1
14 2
15 3
16 4
17 5
18 6
19 7
20 8
21 9
22 10
23 11
 30%
30% HOLIDAY HOLIDAY
14 430.00 129.00 559.00
15 430.00 430.00
16 430.00 430.00
17 430.00 430.00
18 430.00 430.00
19 430.00 430.00
20 OFF -
21 SUN 430.00 129.00 167.70 726.70
22 430.00 430.00
23 430.00 430.00
24 430.00 430.00
25 430.00 430.00
26 430.00 430.00
27 OFF -
28 SUN 430.00 129.00 559.00
29 430.00 ### 860.00
6,020.00 387.00 167.70 430.00 7,004.70
-