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    TGL 18

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    Qonita Nabilatuz dahnia
    The document is a report listing 37 patient claims from a hospital in Indonesia from January 13th to 18th 2022. It includes each patient's name, medical record number, admission and discharge dates, claim/SEP number, and diagnosis. It also provides a total for top up costs, total tariffs, hospital tariffs, and type of tariffs for each patient, as well as grand totals for top up costs and total tariffs for all patients.

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    TGL 18

    Uploaded by

    Qonita Nabilatuz dahnia
    3 views3 pages
    The document is a report listing 37 patient claims from a hospital in Indonesia from January 13th to 18th 2022. It includes each patient's name, medical record number, admission and discharge dates, claim/SEP number, and diagnosis. It also provides a total for top up costs, total tariffs, hospital tariffs, and type of tariffs for each patient, as well as grand totals for top up costs and total tariffs for all patients.

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    The document is a report listing 37 patient claims from a hospital in Indonesia from January 13th to 18th 2022. It includes each patient's name, medical record number, admission and discharge dates, claim/SEP number, and diagnosis. It also provides a total for top up costs, total tariffs, hospital tariffs, and type of tariffs for each patient, as well as grand totals for top up costs and total tariffs for all patients.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xlsx, pdf, or txt
    3 views3 pages

    TGL 18

    Uploaded by

    Qonita Nabilatuz dahnia
    The document is a report listing 37 patient claims from a hospital in Indonesia from January 13th to 18th 2022. It includes each patient's name, medical record number, admission and discharge dates, claim/SEP number, and diagnosis. It also provides a total for top up costs, total tariffs, hospital tariffs, and type of tariffs for each patient, as well as grand totals for top up costs and total tariffs for all patients.

    Copyright:

    © All Rights Reserved
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    of 3

    sheet1 -1

    LAPORAN REKAP KLAIM


    Pasien Rawat Inap dan Rawat Jalan, Peri
    Filter: / Kelas Rawat = Semua / Severity = S
    No. Tgl. Masuk Tgl. Pulang No. RM
    1 12 Jan 2022 18 Jan 2022 476734
    2 12 Jan 2022 18 Jan 2022 301001
    3 13 Jan 2022 18 Jan 2022 541661
    4 13 Jan 2022 18 Jan 2022 226432
    5 13 Jan 2022 18 Jan 2022 521828
    6 13 Jan 2022 18 Jan 2022 278776
    7 13 Jan 2022 18 Jan 2022 195140
    8 14 Jan 2022 18 Jan 2022 541740
    9 14 Jan 2022 18 Jan 2022 540941
    10 14 Jan 2022 18 Jan 2022 244250
    11 14 Jan 2022 18 Jan 2022 278982
    12 13 Jan 2022 18 Jan 2022 541696
    13 14 Jan 2022 18 Jan 2022 541774
    14 14 Jan 2022 18 Jan 2022 432480
    15 14 Jan 2022 18 Jan 2022 468625
    16 14 Jan 2022 18 Jan 2022 541123
    17 14 Jan 2022 18 Jan 2022 541619
    18 15 Jan 2022 18 Jan 2022 537702
    19 15 Jan 2022 18 Jan 2022 404438
    20 15 Jan 2022 18 Jan 2022 363042
    21 15 Jan 2022 18 Jan 2022 541816
    22 16 Jan 2022 18 Jan 2022 541912
    23 16 Jan 2022 18 Jan 2022 071101
    24 16 Jan 2022 18 Jan 2022 531120
    25 16 Jan 2022 18 Jan 2022 540993
    26 16 Jan 2022 18 Jan 2022 437771
    27 16 Jan 2022 18 Jan 2022 306300
    28 16 Jan 2022 18 Jan 2022 538449
    29 16 Jan 2022 18 Jan 2022 538389
    30 16 Jan 2022 18 Jan 2022 269401
    31 16 Jan 2022 18 Jan 2022 541657
    32 17 Jan 2022 18 Jan 2022 541057
    33 17 Jan 2022 18 Jan 2022 531337
    34 17 Jan 2022 18 Jan 2022 323684
    35 17 Jan 2022 18 Jan 2022 542026
    36 17 Jan 2022 18 Jan 2022 541935
    37 18 Jan 2022 18 Jan 2022 494483

    Kode RS: 3515106

    Page 1
    sheet1 -1

    LAPORAN REKAP KLAIM - RS ISLAM SITI HAJAR


    Pasien Rawat Inap dan Rawat Jalan, Periode Tanggal Pulang: 18 Jan 2022 s/d 18 Jan 2022
    Filter: / Kelas Rawat = Semua / Severity = Semua / Cara Pulang = Semua / Jenis Tarif = Semua
    Nama Pasien No. Klaim / SEP INACBG
    ULIL IFFAH, NY 0195R0290122V005446 B-1-14-I
    IMAM BUKHORI, AN 0195R0290122V005451 J-4-16-I
    ROBET ABDUL QONI .SDR 0195R0290122V005777 A-4-13-I
    M. RAFI ALKHANANI .SDR 0195R0290122V005913 A-4-13-I
    HAIKAL FATHAN GHAZAWAN .AN 0195R0290122V005919 J-4-16-I
    CHUSNUL FADILAH NY 0195R0290122V005924 J-4-18-II
    SAID ISKANDAR. TN 0195R0290122V006013 J-4-16-I
    M. ROFIUL ARIF HAMDANI.SDR 0195R0290122V006211 A-4-13-I
    ICHA VERANIA PRAVITA, BY NY 0195R0290122V006287 B-4-13-II
    REYHAN RADITHYA RAFI .AN 0195R0290122V006305 A-4-13-I
    ASYRAF AL ZIDAN PUTRA RUDIANTO .AN 0195R0290122V006316 J-4-16-I
    ENDANG SUWARDININGSIH .NY 0195R0290122V006330 N-4-16-II
    RAJENDRA EZRA WILLIAM .AN 0195R0290122V006387 A-4-13-III
    AISYAH RAHMAN AN 0195R0290122V006420 J-4-16-I
    SITI NUR CHALIMAH ,AN 0195R0290122V006422 J-4-16-I
    FATIMAH AURISTELA DANIYAH, AN 0195R0290122V006433 A-4-12-I
    MUHAMMAD ZIDAN AL-FARIZI. AN 0195R0290122V006450 K-4-17-I
    ASLICHATUN, NY 0195R0290122V006508 E-4-10-II
    ADJIS, TN 0195R0290122V006768 I-4-19-II
    SUJIATI .NY 0195R0290122V006866 J-4-19-II
    M. KHOIR MUZAQI,TN 0195R0290122V006889 N-4-10-II
    MUHAMMAD ABHIZAR ALVERO, AN 0195R0290122V006973 J-4-16-I
    DWI NUR ROHMAT, SDR 0195R0290122V007032 U-4-13-I
    WAFA ZEA AS SALWA,AN 0195R0290122V007036 U-4-13-I
    ADI WALUYO. TN 0195R0290122V007132 N-1-40-I
    ENI SOLIKHAH ,NY 0195R0290122V007141 L-1-30-I
    ASIYAM, NY 0195R0290122V007144 U-1-30-I
    RAGIL SUPARMAN. TN 0195R0290122V007145 U-4-14-I
    LINTANG RIZKY ATTALAH AN 0195R0290122V007150 M-1-40-I
    NUR MOCHAMMAD DERMAWAN. TN 0195R0290122V007156 G-4-14-I
    ABDUL QODIM , TN 0195R0290122V007172 K-1-14-I
    HASNA AUFA' AFIFAH, NY 0195R0290122V007198 O-6-13-I
    KUMAIYAH. NY 0195R0290122V007257 N-4-10-II
    SUKARTI. NY 0195R0290122V007432 N-4-10-II
    GHAISAN ABRAR ARDEFA , AN 0195R0290122V007707 V-1-11-I
    SITI ERNAWATI, NY 0195R0290122V007779 W-1-11-I
    MUSLIKHA 0195R0290122V008003 K-4-17-I
    T

    Page 2
    sheet1 -1

    an 2022
    f = Semua
    Top Up Total Tarif Tarif RS Jenis
    10,785,700 20,819,800 RI
    3,613,200 4,777,400 RI
    2,090,000 3,323,600 RI
    2,090,000 4,183,900 RI
    4,335,900 4,466,400 RI
    4,157,500 11,411,200 RI
    5,058,500 14,529,600 RI
    2,090,000 4,538,800 RI
    4,897,800 4,889,888 RI
    2,925,900 6,232,400 RI
    5,058,500 6,270,100 RI
    5,275,200 8,210,600 RI
    4,481,300 6,307,600 RI
    3,613,200 3,621,900 RI
    5,058,500 4,577,900 RI
    3,695,000 5,114,600 RI
    2,405,100 4,548,700 RI
    4,894,400 6,178,100 RI
    6,111,300 3,926,400 RI
    8,249,300 6,047,700 RI
    4,958,500 3,883,900 RI
    3,613,200 2,207,900 RI
    2,772,200 3,590,700 RI
    2,772,200 3,222,100 RI
    11,257,400 11,408,950 RI
    12,436,800 10,932,788 RI
    7,431,700 7,471,188 RI
    5,163,500 7,504,988 RI
    4,315,600 5,533,288 RI
    6,015,800 6,553,900 RI
    5,489,000 6,726,125 RI
    2,009,900 3,813,500 RI
    4,132,100 10,335,300 RI
    5,784,900 12,450,120 RI
    11,027,800 9,266,588 RI
    2,300,600 3,708,638 RI
    1,718,000 1,055,400 RI
    Total 184,085,500 243,641,961

    Page 3

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