Scribd Logo
Upload

Welcome to Scribd!

  • 33 views

    Rincian Biaya Pemeriksaan Rawat Jalan: Rsud Sekayu

    Uploaded by

    Ari Anggara
    This document is a billing statement from RSUD SEKAYU hospital detailing the costs for an outpatient visit. It lists the medications prescribed to AZHARI SALIM BIN ARNI SOHAR including Abilify, Diazepam, and Trihexyphenidyl. It also includes fees for reviewing old medical records and a doctor's examination. The total cost is Rp 286,813 to be paid by the patient as the insurance does not cover any of the expenses.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content

    You might also like

    Rincian Biaya Pemeriksaan Rawat Jalan: Rsud Sekayu

    Uploaded by

    Ari Anggara
    33 views1 page
    This document is a billing statement from RSUD SEKAYU hospital detailing the costs for an outpatient visit. It lists the medications prescribed to AZHARI SALIM BIN ARNI SOHAR including Abilify, Diazepam, and Trihexyphenidyl. It also includes fees for reviewing old medical records and a doctor's examination. The total cost is Rp 286,813 to be paid by the patient as the insurance does not cover any of the expenses.

    Original Description:

    DAFTAR

    Original Title

    BillingStatementDetail(25)

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This document is a billing statement from RSUD SEKAYU hospital detailing the costs for an outpatient visit. It lists the medications prescribed to AZHARI SALIM BIN ARNI SOHAR including Abilify, Diazepam, and Trihexyphenidyl. It also includes fees for reviewing old medical records and a doctor's examination. The total cost is Rp 286,813 to be paid by the patient as the insurance does not cover any of the expenses.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    33 views1 page

    Rincian Biaya Pemeriksaan Rawat Jalan: Rsud Sekayu

    Uploaded by

    Ari Anggara
    This document is a billing statement from RSUD SEKAYU hospital detailing the costs for an outpatient visit. It lists the medications prescribed to AZHARI SALIM BIN ARNI SOHAR including Abilify, Diazepam, and Trihexyphenidyl. It also includes fees for reviewing old medical records and a doctor's examination. The total cost is Rp 286,813 to be paid by the patient as the insurance does not cover any of the expenses.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 1

    RSUD SEKAYU

    Jl. Kol. Wahid Udin Lingkungan I Kel. Kayuara


    Kec. Sekayu
    Sekayu
    Telp. 0714-321855 Fax

    RINCIAN BIAYA PEMERIKSAAN RAWAT JALAN


    No.Reg / No.RM : REG/OP/190328-0170 / 292259 Ruang Pemeriksaan : R.Poli Jiwa
    Nama Pasien : AZHARI SALIM BIN ARNI SOHAR Poliklinik : POLI JIWA
    Tanggal Lahir : 03-Mar-1998 Penjamin Bayar : PERUSAHAAN / ASURANSI
    Dokter Utama : dr. Latifah, SpKJ Instansi : BPJS (KESEHATAN)
    Tanggal Periksa : 28-Mar-2019

    Uraian / Transaksi Tanggal Qty Diskon Instansi Pasien

    FARMASI RAWAT JALAN


    R/ ABILIFY DISCMELT TAB 15 MG (A) 28/03/2019 7.00 0.00 0.00 227,936.00
    R/ DIAZEPAM TAB 5 MG 28/03/2019 7.00 0.00 0.00 1,266.00
    R/ TRIHEXYPHENIDYL TAB 2 MG (A) 28/03/2019 7.00 0.00 0.00 1,111.00
    TOTAL FARMASI 0.00 0.00 230,313.00
    POLI JIWA
    Berkas RM Lama 28/03/2019 1.00 0.00 0.00 1,500.00
    Periksa Dokter Spesialis dr. Latifah, SpKJ 28/03/2019 1.00 0.00 0.00 55,000.00
    TOTAL BIAYA ADMINISTRASI 0.00 0.00 56,500.00
    SUB TOTAL 0.00 0.00 286,813.00
    TOTAL 0.00 0.00 286,813.00

    Instansi Pasien
    Jumlah Tagihan : 0.00 Jumlah Tagihan : 286,813.00
    Adm & Pelayanan : 0.00 Adm & Pelayanan : 0.00
    0.00 286,813.00
    Uang Angsuran : 0.00 Uang Angsuran : 0.00
    Piutang : 0.00 Piutang : 0.00
    Pelunasan : 0.00 Pelunasan : 0.00
    Diskon : 0.00 Diskon : 0.00
    Diskon Administrasi : 0.00 Diskon Administrasi : 0.00

    Sisa Tagihan : 0.00 Sisa Tagihan : 286,813.00

    Sekayu 28-05-2019 08:38

    ( )

    28.05.2019 08:38:00 1 of 1

    You might also like