DAFTAR PASIEN YANG MENDAPAT OBAT KRONIS IFRS CITRA HUSADA MELAWI

BULAN JANUARI 2020

NO NO RESEP NO APOTIK NO SEP/KUNJUNGAN NO KARTU NAMA TGL ENTRY TGL RESEP TGL PLYN RESEP BY TAGIHAN
1 00001 0446A00701200000003 0446R0010120V000027 0002748095133 RAMA YANTI 1/6/2020 1/3/2020 1/10/2020 11,540
2 00002 0446A00701200000004 0446R0010120V000075 0000882322738 TEMAI 1/14/2020 1/8/2020 1/15/2020 6,359
3 00005 0446A00701200000007 0446R0010120V000107 0001594449808 MERI EVAYANTI 1/14/2020 1/10/2020 1/17/2020 12,335
4 00003 0446A00701200000005 0446R0010120V000108 0002619462429 ELISABET ROMA 1/14/2020 1/10/2020 1/17/2020 13,012
5 00004 0446A00701200000006 0446R0010120V000109 0001483097624 JOHAN FREDERIK ASUMBAK 1/14/2020 1/10/2020 1/17/2020 3,091
6 00006 0446A00701200000008 0446R0010120V000111 0000052339994 RUDOLFUS GLEKO 1/14/2020 1/10/2020 1/17/2020 225,742
7 00008 0446A00701200000010 0446R0010120V000136 0000881587811 SUMARNI 1/14/2020 1/13/2020 1/20/2020 12,394
8 00007 0446A00701200000009 0446R0010120V000143 0002450431978 MUSLIMIN 1/14/2020 1/13/2020 1/20/2020 12,276
9 00009 0446A00701200000011 0446R0010120V000164 0002316730768 A. WAHID 1/14/2020 1/14/2020 1/21/2020 211,554
10 00010 0446A00701200000012 0446R0010120V000241 0000052099244 TEGUH YUWONO 1/17/2020 1/16/2020 1/23/2020 31,500
11 00011 0446A00701200000013 0446R0010120V000248 0001123524281 SUWANDI 1/17/2020 1/17/2020 1/24/2020 225,742
12 00012 0446A00701200000014 0446R0010120V000263 0002903787235 MELISA ASARI 1/21/2020 1/17/2020 1/24/2020 68,310
13 00013 0446A00701200000015 0446R0010120V000275 0002265237281 KABRAN 1/21/2020 1/18/2020 1/25/2020 225,742
14 00015 0446A00701200000017 0446R0010120V000351 0000052333839 THERESIA TONON 1/24/2020 1/21/2020 1/28/2020 217,648
15 00018 0446A00701200000020 0446R0010120V000359 0002742225941 INDRA LAKSAMANA PUTRA 1/24/2020 1/21/2020 1/28/2020 25,642
16 00014 0446A00701200000016 0446R0010120V000360 0002197431246 MESI VINIA SARI 1/24/2020 1/21/2020 1/28/2020 325,017
17 00016 0446A00701200000018 0446R0010120V000407 0000166792353 MARSIANA AKUK 1/24/2020 1/22/2020 1/29/2020 225,742
18 00017 0446A00701200000019 0446R0010120V000420 0000052363023 HASANUDIN M 1/24/2020 1/23/2020 1/30/2020 338,612
19 00020 0446A00701200000023 0446R0010120V000472 0002227678907 TRI PUJI ASTUTI 1/28/2020 1/24/2020 1/31/2020 231,718
20 00026 0446A00712190000028 0446R0011219V000511 0001885821298 DJAN DJAN 12/29/2019 12/27/2019 1/3/2020 27,555
21 00024 0446A00712190000026 0446R0011219V000512 0001885820141 KU BUN SYANG 12/29/2019 12/27/2019 1/3/2020 5,858
22 00025 0446A00712190000027 0446R0011219V000513 0000052146562 SITI ASIAH 12/29/2019 12/27/2019 1/3/2020 12,512
23 00027 0446A00712190000029 0446R0011219V000514 0002483956967 MARIANA 12/29/2019 12/27/2019 1/3/2020 2,355
24 00028 0446A00712190000030 0446R0011219V000526 0001830713152 JAN JOHAN 12/29/2019 12/28/2019 1/4/2020 3,209
25 00029 0446A00701200000001 0446R0011219V000540 0001592730437 GOMPUS 1/6/2020 12/30/2019 1/6/2020 9,715
26 00030 0446A00701200000002 0446R0011219V000548 0001064096368 JUNAH 1/6/2020 12/30/2019 1/6/2020 9,833
 DAFTAR PASIEN YANG TIDAK TERCLAIM OBAT KRONIS IFRS CITRA HUSADA MELAWI
BULAN FEBRUARI 2023

NO SEP NO RESEP NO KARTU NAMA TGL RESEP KD JENIS OBAT NAMA JENIS OBAT BIAYA TAG
Obat Kronis Blm
0446R0010223V000059 00001 0003122641405 SALWA AL ZAHARA 6/2/2023 2 Rp 173,998
Stabil
Obat Kronis Blm
0446R0010223V000354 00002 0003505785748 FUON 28/02/2023 2 Rp 6,959
Stabil
Obat Kronis Blm
0446R0010223V000347 00003 0000052390563 SALIM 28/02/2023 2 Rp 8,351
TOTAL Stabil Rp 189,308
 DAFTAR PASIEN YANG MENDAPAT OBAT KRONIS IFRS CITRA HUSADA
BULAN JUNI 2020

NO SEP NO RESEP NO KARTU NAMA TGL RESEP

0446R0010720V000132 00001 2909244341 RIZKIA RUMAIZA LATIFAH 7/16/2020
0446R0010720V000158 00002 2903787235 MELISA ASARI 7/20/2020

TOTAL

DAFTAR PASIEN YANG MENDAPAT OBAT KRONIS IFRS CITRA HUSADA

BULAN JULI 2020

NO SEP NO RESEP NO KARTU NAMA TGL RESEP

0446R0010720V000132 00001 2909244341 RIZKIA RUMAIZA LATIFAH 7/16/2020
0446R0010720V000158 00002 2903787235 MELISA ASARI 7/20/2020

TOTAL

DAFTAR PASIEN YANG MENDAPAT OBAT KRONIS IFRS CITRA HUSADA

BULAN JULI 2021

NO SEP NO RESEP NO KARTU NAMA TGL RESEP

0446R0010721V00000
00001 TEMAI
7 882322738 01/07/2021
0446R0010721V00000
00002 1132052207 LAJAN 7/1/2021
2
0446R0010721V00003
00003 2428533009 ACEL 07/07/2021
9
0446R0010721V00008
00004 2292907511 WELLY SAPUTRA 12/07/2021
9
TOTAL

DAFTAR PASIEN YANG TIDAK TERCLAIM OBAT KRONIS IFRS CITRA HUS
BULAN MEI 2021

NO SEP NO RESEP NO KARTU NAMA TGL RESEP

0446R0010721V00013
00001 881324605 MIDAH 19/072021
5
0446R0010821V00015
00002 2230842069 ANISAH 8/18/2021
8
0446R0010921V00000
00003 1594599772 SUGENG HARIADI 02/09/2021
9
0446R0010821V00027
00004 878949718 MAHMUD 8/26/2021
7
0446R0010821V00030
00005 881324605 MIDAH 8/30/2021
7
0446R0010921V00003
00006 2612546087 SENOT 9/7/2021
2
0446R0010921V00001
00007 882322738 TEMAI 9/2/2021
0
TOTAL
RONIS IFRS CITRA HUSADA MELAWI
2020

KD JENIS OBAT NAMA JENIS OBAT BIAYA TAG BPJS HARGA OBAT APOTEK
2 Obat Kronis Blm Stabil Rp 45,540 Rp 72,672
2 Obat Kronis Blm Stabil Rp 91,080 Rp 301,870

Rp 136,620 Rp 374,542

RONIS IFRS CITRA HUSADA MELAWI

2020

KD JENIS OBAT NAMA JENIS OBAT BIAYA TAG BPJS HARGA OBAT APOTEK
2 Obat Kronis Blm Stabil Rp 45,540 Rp 145,345
2 Obat Kronis Blm Stabil Rp 91,080 Rp 290,690

Rp 136,620 Rp 436,035

RONIS IFRS CITRA HUSADA MELAWI

I 2021

KD JENIS OBAT NAMA JENIS OBAT BIAYA TAG

2 Obat Kronis Blm Stabil Rp 32,442

2 Obat Kronis Blm Stabil Rp 17,694

2 Obat Kronis Blm Stabil Rp 27,555

2 Obat Kronis Blm Stabil Rp 563,220

Rp 640,911

T KRONIS IFRS CITRA HUSADA MELAWI

I 2021

KD JENIS OBAT NAMA JENIS OBAT BIAYA TAG

4 Obat Kronis Blm Stabil Rp 72,122

3 Obat Kronis Blm Stabil Rp 58,435

3 Obat Kronis Blm Stabil Rp 91,734

4 Obat Kronis Blm Stabil Rp 74,368

4 Obat Kronis Blm Stabil Rp 78,994

3 Obat Kronis Blm Stabil Rp 69,128

3 Obat Kronis Blm Stabil Rp 77,378

Rp 522,159
 SELISIH
Rp 27,132
RP 210.790

Rp 237,922

SELISIH
Rp 99,805
RP 199.610

Rp 299,415