Rekap Pasien Spesialis Bln. Februari 2024

dr.
Lisbeth Meilina, SpS

Rekapitulasi Pasien
Bulan Desember 2023
1. Rawat Inap Pasien Umum,Inhealth dan Perusahaan

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Visite HD/Visite Sub Total Total Tagihan
1 Fitriani Tanjung 116766 Umum HDU 2/5/2024 2/5/2024 1 50,000 50,000
2 Khairul Azhar Nasution 116824 Umum KLS III 2/6/2024 2/11/2024 5 40,000 200,000
3 Patar Silitonga 117038 JR Kelas I 2/15/2024 2/16/2024 2 60,000 120,000
4 Sumarno 116860 Umum KLS III 2/8/2024 2/11/2024 2 60,000 120,000
5 Sadurlina Nainggolan 106879 Umum HDU 2/12/2024 2/14/2024 2 50,000 100,000
6 Berliana Tp Bolon 117177 Umum KLS III 2/20/2024 2/20/2024 1 40,000 40,000
4 Indartono 117105 JR KLS III 17/02/2024 2/21/2024 3 40,000 120,000
5 Songli Bosma Siregar 117103 JR KLS III 17/02/2024 2/21/2024 3 40,000 120,000
6 Redo Irawan 117270 JR KLS III 2/24/2024 2/28/2024 3 40,000 120,000
7
Total 22 990,000 -
2. Rawat Inap BPJS

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Total Klaim Jasa Dokter Diagnosa DPJP
1 Karni 068791 BPJS KLS III 2/8/2024 2/11/2024 2,119,000 105,950 HT+Vertigo dr. Ridho,Sp.PD
2 Imdhani 104392 BPJS Klas II 25/02/2024 29/02/2024 3,151,200 105,040 DM+TB+Vertigo 'dr. Ridho,Sp.PD+dr. Desmon,Sp.PD
3 Julia 116488 BPJS KLS III 1/28/2024 2/2/2024 4,910,800 163,693 Celebral Infarktion 'dr. Ridho,Sp.PD+dr. Marolop,SpJ
4 Rosmaini Gultom 040135 BPJS KLS III 1/31/2024 2/1/2024 3,000,100 150,005 LBP dr. Maharani,Sp.KFR
5 Novi Yanti Elihartini 066728 BPJS Klas II 1/29/2024 2/2/2024 3,495,100 174,755 LBP dr. Maharani,Sp.KFR
6 Aisyah 116589 BPJS KLS III 1/31/2024 2/2/2024 1,499,200 149,920 Hemiplegia
7 Salmiati 116594 BPJS Klas II 1/31/2024 03/02/2024 3,200,300 320,030 Hi
8 Rizky Zuni Aldy Harahap 116565 BPJS Klas II 1/30/2024 03/02/2024 3,223,100 322,310 Susp Epilepsi
9 Rusmayanti Halaho 62490 BPJS Kelas I 2/1/2024 03/02/2024 1,911,000 95,550 Vertigo dr. Yanika,Sp.PD
10 Suriyadi 104964 BPJS KLS III 2/1/2024 03/02/2024 2,292,400 114,620 Thypoid dr. Yanika,Sp.PD
11 Sukarmin 116616 BPJS Klas II 2/1/2024 2/4/2024 2,641,500 132,075 OA dr. Desmon,SpP
12 Estherina Gultom 072950 BPJS KLS III 2/4/2024 2/5/2024 2,119,000 211,900 Infartium
13 M Joli 106135 BPJS Klas II 2/1/2024 06/02/2024 4,250,700 141,690 DM+TB 'dr. Yanika,Sp.PD+dr. Dian,SpP
14 Firnawati 075387 BPJS KLS III 2/4/2024 06/02/2024 2,155,900 71,863 TTH 'dr. Rika,Sp.THT+dr. Desmon,SpP
15 Sarnia Purba 081260 BPJS KLS III 2/3/2024 07/02/2024 2,155,900 107,795 Vertigo dr. Dian,SpP
16 Lasmaria 106317 BPJS Klas II 2/5/2024 08/02/2024 2,511,600 251,160 HT
17 Siti Marlina 116787 BPJS KLS III 2/6/2024 08/02/2024 2,155,900 215,590 HT
18 S Kristina Lumban Toruan 116773 BPJS Kelas I 2/5/2024 08/02/2024 3,466,800 173,340 Hi dr. Heri,SpB
19 Masyitah Saragih 118821 BPJS KLS III 2/6/2024 09/02/2024 2,155,900 215,590 HT
20 Syahrul 096301 BPJS Klas II 2/7/2024 10/02/2024 3,777,600 377,760 Cereberal Infarktion
21 Supario 116940 BPJS KLS III 2/11/2024 2/12/2024 2,451,400 81,713 Stroke+Af 'dr. Wirandi,Sp.PD+dr. Marolop,SpJ
22 Jamakita Saragih 116895 BPJS KLS III 09/02/2024 2/13/2024 4,077,800 407,780 Cereberal Infarktion
23 Nursana Siregar 116941 BPJS KLS III 2/11/2024 2/13/2024 2,747,000 137,350 Penurunan Kesadaran dr. Wirandi,Sp.PD
24 Dahlia 91670 BPJS KLS III 2/13/2024 2/13/2024 1,499,200 49,973 DM+LBP 'dr. Yanika,Sp.PD+dr. Marolop,SpJ
25 Merry Sitanggang 5702 BPJS KLS III 2/11/2024 2/14/2024 2,155,900 107,795 Dyspepsia dr. Wirandi,Sp.PD
26 Bresman Siagian 58374 BPJS Kelas I 2/12/2024 2/14/2024 3,990,100 399,010 LBP
27 Afridanis 101281 BPJS KLS III 2/12/2024 15/02/2024 3,000,100 100,003 LBP+Colic Abd 'dr. Wirandi,Sp.PD+dr. Dian,SpP
28 Rezaiwansyah 116946 BPJS Klas II 2/12/2024 15/02/2024 4,262,100 213,105 HT dr. Maharani,Sp.KFR
29 Sukarni 117043 BPJS KLS III 2/15/2024 2/17/2024 4,077,800 407,780 Coma
30 Misdi K,S 102469 BPJS Klas II 2/15/2024 2/17/2024 4,750,600 475,060 Cereberal Infarktion
31 Asna Situneang 063404 BPJS KLS III 2/14/2024 2/17/2024 2,155,900 215,590 Vertigo
32 Suriyanti 117056 BPJS Klas II 2/16/2024 2/19/2024 2,511,600 125,580 Vertigo dr. Desmon,SpP
33 Rasni Br Purba 117046 BPJS KLS III 2/15/2024 2/19/2024 4,077,800 203,890 Stroke dr. Wirandi,Sp.PD
34 Paiman 102211 BPJS Klas II 17/02/2024 2/20/2024 3,495,100 174,755 LBP dr. Maharani,Sp.KFR
35 Paidi 117113 BPJS KLS III 18/02/2024 2/21/2024 3,537,500 176,875 LBP+Anemia dr. Yanika,Sp.PD
36 Marni 102797 BPJS KLS III 18/02/2024 2/22/2024 1,436,900 71,845 Vertigo dr. Cut,Sp.THT
37 Tuti Susanti 117109 BPJS Klas II 18/02/2024 2/22/2024 3,777,600 377,760 SOL
38 Suri Erdawati 117174 BPJS KLS III 2/20/2024 2/23/2024 3,000,100 300,010 LBP
39 Habdiyah 66867 BPJS Kelas I 2/22/2024 24/2/2024 3,990,100 199,505 HNP dr. Yanika,Sp.PD
40 Andrianti 053170 BPJS Klas II 2/21/2024 25/02/2024 4,202,300 420,230 Vertigo
41 Hosneli Asma 117291 BPJS KLS III 26/02/2024 29/02/2024 4,196,000 139,867 DM+LBP+TB 'dr. Ridho,SpB+dr. Dian,SpP
42 Aliman 114841 BPJS KLS III 25/02/2024 29/02/2024 2,119,000 105,950 HT dr. Soraya,SpM
43
44
45
3. Rawat Jalan
No Nama Pasien MR Status Tgl Berobat Total Klaim Honor BPJS Honor Umum Total Honor Diagnosa
1 Masliana Daulay jkn 11/1/2022 25,000 25,000 lbp ec hnp
2 Sukatuh jkn 11/1/2022 25,000 25,000 cts + lbp
3 Sukartik jkn 11/1/2022 25,000 25,000 post stroke iskemik
4 Emmyria Guru Singa jkn 11/1/2022 25,000 25,000 sequele of ci
5 Zahara jkn 11/1/2022 25,000 25,000 lbp
6 Harianto jkn 11/1/2022 25,000 25,000 lbp
7 Kristina Sinaga jkn 11/1/2022 25,000 25,000 post stroke iskemik
8 Musti Ambarita jkn 11/1/2022 25,000 25,000 parkinson disease + oa
9 H Mhd Sobri Nasution jkn 11/1/2022 25,000 25,000 sequele of ci
10 Janur Barus ST jkn 11/1/2022 25,000 25,000 sequele of ci
11 Musa Togi Marpaung Dr jkn 11/1/2022 25,000 25,000 lbp
12 Henny Riska Sulastri jkn 11/1/2022 25,000 25,000 lbp ec hnp
13 Sapri jkn 11/1/2022 25,000 25,000 ischelsia ec hnp
14 Satiman jkn 11/1/2022 25,000 25,000 lbp ec parkinson disease
15 Bayu Andika jkn 11/1/2022 25,000 25,000 migren tanpa aura
16 Eliana Ginting jkn 11/1/2022 25,000 25,000 stroke iskemik + ht
17 Syamsinar Pasaribu jkn 11/1/2022 25,000 25,000 cervical pain
18 Sri Rahayu Eka Putri jkn 11/1/2022 25,000 25,000 lbp ec hnp
19 Della Aulia jkn 11/1/2022 25,000 25,000 epilepsi
20 Betti Br Hutabalian jkn 11/1/2022 25,000 25,000 lbp ec hnp
21 Jumanto jkn 11/1/2022 25,000 25,000 post stroke iskemik
22 Richan Siburian jkn 11/1/2022 25,000 25,000 bells palsy
23 Sunarsih jkn 11/3/2022 25,000 25,000 lbp ec hnp
24 Erlinda lubis jkn 11/3/2022 25,000 25,000 lbp ec hnp
25 Novi yanti jkn 11/3/2022 25,000 25,000 lbp ec hnp
26 Susterlina Saragih jkn 11/3/2022 25,000 25,000 hnp cervical
27 Marjansah Saragih jkn 11/3/2022 25,000 25,000 lbp
28 Novita Adriana jkn 11/3/2022 25,000 25,000 oa genu
29 Marice Raja GukGuk jkn 11/3/2022 25,000 25,000 neuropati
30 Hasfina Simarmata jkn 11/3/2022 25,000 25,000 sequele of ci
31 Nizaruddin jkn 11/3/2022 25,000 25,000 lbp ec
32 It hoa jkn 11/3/2022 25,000 25,000 post tia
33 Norma jkn 11/3/2022 25,000 25,000 lbp
34 Passius Manurung jkn 11/3/2022 25,000 25,000 post stroke
35 Karmidin Panjaitan jkn 11/3/2022 25,000 25,000 brachelsia + neoropaty
36 M Handi Pratama jkn 11/3/2022 25,000 25,000 epilepsi
37 Masdiani Harahap jkn 11/3/2022 25,000 25,000 epilepsi
38 Delfi Siahaan jkn 11/3/2022 25,000 25,000 parkinson disease
39 Tan Lang Moi jkn 11/3/2022 25,000 25,000 sequele of ci
40 Jawilson Damanik jkn 11/3/2022 25,000 25,000 post stroke iskemik
41 Dermawan s jkn 11/3/2022 25,000 25,000 parkinson disease
42 Syamsuddin jkn 11/3/2022 25,000 25,000 parkinson disease
43 Rehgegehna Ginting jkn 11/3/2022 25,000 25,000 post stroke iskemik + dm
44 Nurli sibarani jkn 11/3/2022 25,000 25,000 stroke iskemik + ht
45 Legiyem jkn 11/3/2022 25,000 25,000 lbp
46 Rosinda Lumban Tobing jkn 11/3/2022 25,000 25,000 lbp ec scoliosis lumbalis
47 Aprida Manalu jkn 11/3/2022 25,000 25,000 lbp ec hnp
48 Ani Roida br Silalahi jkn 11/3/2022 25,000 25,000 hnp cervical
49 Novita A Lumban Gaol jkn 11/3/2022 25,000 25,000 oa genu sin
50 Rahno handoko jkn 11/3/2022 25,000 25,000 sequele of ci
51 Selamat jkn 11/3/2022 25,000 25,000 stroke iskemik
52 Hawai mahana umum 11/3/2022 40,000 40,000 epilepsi
53 Semi jkn 11/4/2022 25,000 25,000 lbp ec oa
54 Mariatik jkn 11/4/2022 25,000 25,000 sequele of ci
55 Nurmala jkn 11/4/2022 25,000 25,000 post stroke
56 Rapiun Manalu jkn 11/4/2022 25,000 25,000 ht + pn vi
57 Natanael Rajagukguk jkn 11/4/2022 25,000 25,000 sequele of ci
58 Sardiaman Silalahi jkn 11/4/2022 25,000 25,000 lbp ec hnp
59 Adianson Purba jkn 11/4/2022 25,000 25,000 lbp
60 Wati jkn 11/4/2022 25,000 25,000 cervical pain
61 Hariono jkn 11/4/2022 25,000 25,000 sequele of ci
62 Royani Agustina jkn 11/4/2022 25,000 25,000 neuropati
63 Suharyati jkn 11/4/2022 25,000 25,000 post stroke iskemik
64 Tan lie Gioh jkn 11/4/2022 25,000 25,000 lbp
65 Lim Lai Hing jkn 11/4/2022 25,000 25,000 post stroke iskemik
66 Legiman Saru jkn 11/4/2022 25,000 25,000 post stroke iskemik
67 Rosnani jkn 11/4/2022 25,000 25,000 lbp ec hnp
68 Darmansyah Sagala jkn 11/4/2022 25,000 25,000 post stroke iskemik
69 Hj Rosmawati jkn 11/4/2022 25,000 25,000 lbp
70 Ellianis jkn 11/4/2022 25,000 25,000 post stroke iskemik
71 Jumini jkn 11/4/2022 25,000 25,000 lbp ec hnp
72 Maniur Manurung jkn 11/4/2022 25,000 25,000 parkinson disease
73 Darwin Damanik jkn 11/4/2022 25,000 25,000 parkinson disease
74 Maslyani jkn 11/4/2022 25,000 25,000 oa genu
75 Dekson jkn 11/4/2022 25,000 25,000 radiculopaty
76 Santi Hutapea jkn 11/4/2022 25,000 25,000 lbp ec hnp
77 Pande Sihombing jkn 11/4/2022 25,000 25,000 vertigo
78 Rosida Simatupang jkn 11/4/2022 25,000 25,000 oa + lbp
79 Abdul Rahim Harahap jkn 11/4/2022 25,000 25,000 neoralgia trygeminal
80 Tiurlah Hasiholan jkn 11/4/2022 25,000 25,000 oa genu
81 Sumisti jkn 11/4/2022 25,000 25,000 lbp ec hnp
82 Sri Yani jkn 11/4/2022 25,000 25,000 lbp ec hnp
83 Uning Muriati jkn 11/4/2022 25,000 25,000 oa genu
84 Naisal Sembiring jkn 11/4/2022 25,000 25,000 vertigo + lbp
85 Bahagia br Tarigan jkn 11/4/2022 25,000 25,000 lbp ec susp hnp
86 Zulfadly jkn 11/4/2022 25,000 25,000 sequele of ci
87 Tigor Turnip jkn 11/4/2022 25,000 25,000 post stroke iskemik
88 Rosenni Nurmawati jkn 11/4/2022 25,000 25,000 lbp + susp oa genu
89 Mariden Pangaribuan jkn 11/4/2022 25,000 25,000 lbp ec hnp
90 Siti Aisah jkn 11/4/2022 25,000 25,000 cervical pain
91 Zainab jkn 11/4/2022 25,000 25,000 secondary headache
92 Farida Silalahi jkn 11/4/2022 25,000 25,000 oa genu
93 Bresman Siagian jkn 11/4/2022 25,000 25,000 sequele of ci
94 Hafsah Fitri jkn 11/4/2022 25,000 25,000 frozen sholder
95 Abdul Anwar jkn 11/4/2022 25,000 25,000 parkinson disease
96 Monika Simangunsong jkn 11/4/2022 25,000 25,000 post stroke iskemik
97 Sofian Pane jkn 11/4/2022 25,000 25,000 sequele of ci
98 Manihar Sirait jkn 11/4/2022 25,000 25,000 sequele of ci
99 Erni Rosdiana Ritonga jkn 11/4/2022 25,000 25,000 cervical pain
100 Tiara Pardede jkn 11/7/2022 25,000 25,000 sequele of ci
101 Romde Sitanggang jkn 11/7/2022 25,000 25,000 frozen sholder
102 Dewi Susanti Simanjuntak jkn 11/7/2022 25,000 25,000 icelgia
103 Henny jkn 11/7/2022 25,000 25,000 sequele of ci
104 Pasu manurung jkn 11/7/2022 25,000 25,000 post stroke
105 Syahanum purba jkn 11/7/2022 25,000 25,000 lbp ec hnp
106 Renti butar butar jkn 11/7/2022 25,000 25,000 neoralgia trygeminal
107 Heldi simbolon jkn 11/7/2022 25,000 25,000 parkinson disease
108 Suarno jkn 11/7/2022 25,000 25,000 lbp hnp
109 Asniar jkn 11/7/2022 25,000 25,000 thygertamey lbp
110 Salimatuz zulfian br lubis jkn 11/7/2022 25,000 25,000 sequele of ci
111 Nurdin jkn 11/7/2022 25,000 25,000 stroke iskemik
112 Lismirian Saragih jkn 11/7/2022 25,000 25,000 vertigo
113 Muhammad al amin jkn 11/7/2022 25,000 25,000 epilepsi
114 Marsintauili Siahaan jkn 11/7/2022 25,000 25,000 lbp ec hnp
115 Masdalena Dachi jkn 11/7/2022 25,000 25,000 epilepsi
116 Masdelina jkn 11/7/2022 25,000 25,000 secondary headache
117 Siti Saodah jkn 11/7/2022 25,000 25,000 movemen disolder
118 Dahlia Yohana Agustian jkn 11/7/2022 25,000 25,000 plantar tas p hyaf
119 Mami jkn 11/7/2022 25,000 25,000 ibpee hp
120 Canada Purba jkn 11/7/2022 25,000 25,000 epilepsi
121 Junaidi jkn 11/7/2022 25,000 25,000 oa + lbp
122 Suksenin pratty jkn 11/7/2022 25,000 25,000 oa genu
123 Jones Purba jkn 11/7/2022 25,000 25,000 lbp + susp drop foot sinistra
124 Fatimah jkn 11/7/2022 25,000 25,000 susp oa
125 Ruai jkn 11/7/2022 25,000 25,000 stroke iskemik
126 Pirka Barus jkn 11/7/2022 25,000 25,000 lbp
127 Purnomo jkn 11/7/2022 25,000 25,000 epilepsi
128 Erika Aruan jkn 11/7/2022 25,000 25,000 lbp
129 Supiyan jkn 11/7/2022 25,000 25,000 parkinson disease
130 Atik Nurhayati jkn 11/7/2022 25,000 25,000 stroke iskemik
131 Syafrida jkn 11/7/2022 25,000 25,000 sequele of ci
132 Ramunan Perangin angin jkn 11/7/2022 25,000 25,000 post stroke + ht
133 Mardiani jkn 11/7/2022 25,000 25,000 lbp ec hnp
134 Markiya jkn 11/7/2022 25,000 25,000 sequele of ci
135 Helen sri Wahyuni jkn 11/7/2022 25,000 25,000 lbp
136 Johanes Sinaga jkn 11/7/2022 25,000 25,000 lbp
137 Marnala Manurung jkn 11/8/2022 25,000 25,000 lbp
138 Buang jkn 11/8/2022 25,000 25,000 lbp
139 Rosmiaty Panut jkn 11/8/2022 25,000 25,000 post stroke iskemik
140 Sumiani jkn 11/8/2022 25,000 25,000 stroke iskemik
141 Susanti jkn 11/8/2022 25,000 25,000 lbp
142 Joni jkn 11/8/2022 25,000 25,000 stroke iskemik
143 Hj Sulasih jkn 11/8/2022 25,000 25,000 sequele of ci
144 Sumiyem jkn 11/8/2022 25,000 25,000 sequele of ci
145 Marahika Manalu jkn 11/8/2022 25,000 25,000 lbp
146 Petrus Barus jkn 11/8/2022 25,000 25,000 lbp ec hnp
147 Ertina Barus jkn 11/8/2022 25,000 25,000 frozen sholder
148 Suparmin K jkn 11/8/2022 25,000 25,000 post stroke iskemik
149 Najamuddin jkn 11/8/2022 25,000 25,000 parkinson disease
150 Sri Rahayu jkn 11/8/2022 25,000 25,000 vertigo
151 Syahzila jkn 11/8/2022 25,000 25,000 lbp
152 Edi Sutarto jkn 11/8/2022 25,000 25,000 post stroke iskemik
153 Tinus Gultom jkn 11/8/2022 25,000 25,000 vertigo feriver
154 Novianita jkn 11/8/2022 25,000 25,000 epilepsi
155 Daesta Manurung jkn 11/8/2022 25,000 25,000 post stroke iskemik
156 Agian Saragih jkn 11/8/2022 25,000 25,000 parkinson disease
157 Sri Yani jkn 11/8/2022 25,000 25,000 epilepsi
158 Luminar Sihombing jkn 11/8/2022 25,000 25,000 lbp ec hnp
159 Abd fatah lbs jkn 11/8/2022 25,000 25,000 lbp ec hnp
160 Ponirah jkn 11/8/2022 25,000 25,000 sequele of ci
161 Suhadi jkn 11/8/2022 25,000 25,000 epilepsi
162 Aswandi jkn 11/8/2022 25,000 25,000 stroke iskemik
163 Maulim tambunan jkn 11/8/2022 25,000 25,000 parkinson disease
164 Junita Silalahi jkn 11/8/2022 25,000 25,000 lbp ec hnp
165 Sannaria Sinaga jkn 11/8/2022 25,000 25,000 lbp ec hnp
166 Misriati jkn 11/8/2022 25,000 25,000 lbp ec hnp
167 Sangki Purba jkn 11/8/2022 25,000 25,000 sequele of ci
168 Nurman jkn 11/8/2022 25,000 25,000 pelvic pain
169 Jul Triwita Silalahi jkn 11/8/2022 25,000 25,000 plantar facsh
170 Rahmad Hidayah jkn 11/8/2022 25,000 25,000 cervical pain
171 Juliana Saragih jkn 11/8/2022 25,000 25,000 neuropati
172 Riana Simanjuntak jkn 11/8/2022 25,000 25,000 lbp
173 Kie Bun Tiong jkn 11/8/2022 25,000 25,000 post stroke
174 Nurmasari jkn 11/8/2022 25,000 25,000 lbp
175 Jumiatik jkn 11/8/2022 25,000 25,000 hnp
176 Saida br Hasibuan jkn 11/8/2022 25,000 25,000 lbp ec hnp
177 Elprida br Purba jkn 11/8/2022 25,000 25,000 stroke iskemik
178 Avelina Ginting jkn 11/8/2022 25,000 25,000 bell's palsy
179 Dasiyem jkn 11/10/2022 25,000 25,000 cervical pain
180 Dame Sianturi jkn 11/10/2022 25,000 25,000 vertigo + ht
181 Sarida jkn 11/10/2022 25,000 25,000 post stroke iskemik
182 Sri marheni jkn 11/10/2022 25,000 25,000 polineoropaty
183 Rina mariati sipayung jkn 11/10/2022 25,000 25,000 migren tanpa aura
184 Bismar Sitorus jkn 11/10/2022 25,000 25,000 lbp
185 Purnama Sinaga jkn 11/10/2022 25,000 25,000 brachelsia + neoropaty
186 Jesrin Sihombing jkn 11/10/2022 25,000 25,000 epilepsi
187 Iskandar lubis jkn 11/10/2022 25,000 25,000 sequele of ci
188 Tunggal jkn 11/10/2022 25,000 25,000 stroke iskemik
189 Elisa tripusparini jkn 11/10/2022 25,000 25,000 epilepsi
190 Nurhayati barus jkn 11/10/2022 25,000 25,000 lbp ec hnp
191 Andi winanta jkn 11/10/2022 25,000 25,000 epilepsi
192 Rouli siagian jkn 11/10/2022 25,000 25,000 lbp ec hnp
193 Erni puspita sari jkn 11/10/2022 25,000 25,000 oa genu
194 Parida hanum jkn 11/10/2022 25,000 25,000 susp oa sin
195 Taruli sinaga jkn 11/10/2022 25,000 25,000 lbp ec hnp
196 Hendro jkn 11/10/2022 25,000 25,000 parkinson disease
197 Muliani jkn 11/10/2022 25,000 25,000 bppv
198 Syamsur s jkn 11/10/2022 25,000 25,000 stroke iskemik
199 Masanta ginting jkn 11/10/2022 25,000 25,000 epilepsi
200 Rumida sinaga jkn 11/10/2022 25,000 25,000 vertigo feriver
201 Ponikem jkn 11/10/2022 25,000 25,000 stroke iskemik
202 Ernawati jkn 11/10/2022 25,000 25,000 tic
203 Ronly sipayung jkn 11/10/2022 25,000 25,000 sequele of ci
204 Nova dewi hutapea jkn 11/10/2022 25,000 25,000 lbp ec hnp
205 Sarnik jkn 11/10/2022 25,000 25,000 lbp
206 Eli sumanti trg jkn 11/10/2022 25,000 25,000 bell's palsy
207 Anner sitorus jkn 11/10/2022 25,000 25,000 epilepsi
208 Rumlani jkn 11/10/2022 25,000 25,000 lbp
209 Supina jkn 11/11/2022 25,000 25,000 epilepsi
210 Zulaiha jkn 11/11/2022 25,000 25,000 parkinson disease
211 Adi asrono jkn 11/11/2022 25,000 25,000 parkinson disease
212 Siti aminah jkn 11/11/2022 25,000 25,000 frozen sholder
213 Jumini jkn 11/11/2022 25,000 25,000 sequele of ci
214 Herawaty tanjung jkn 11/11/2022 25,000 25,000 lbp
215 Loiren simatupang jkn 11/11/2022 25,000 25,000 vertigo feriver
216 Murkis cietra jkn 11/11/2022 25,000 25,000 post stroke iskemik
217 Mauluddin putra jkn 11/11/2022 25,000 25,000 post stroke iskemik
218 Hafizah nasution jkn 11/11/2022 25,000 25,000 lbp ec hnp
219 Rosalina jkn 11/11/2022 25,000 25,000 lbp ec hnp
220 Agus setiawan jkn 11/11/2022 25,000 25,000 parkinson disease
221 Marlina jkn 11/11/2022 25,000 25,000 stroke iskemik
222 Selamat susanto jkn 11/11/2022 25,000 25,000 lbp
223 Sadarih munthe jkn 11/11/2022 25,000 25,000 post stroke iskemik
224 Pintauli pasaribu jkn 11/11/2022 25,000 25,000 frozen sholder
225 M adelin yahya jkn 11/11/2022 25,000 25,000 epilepsi + lbp
226 Jusmawati jkn 11/11/2022 25,000 25,000 lbp ec hnp
227 Bismark jkn 11/11/2022 25,000 25,000 vertigo + ht
228 Humairah jkn 11/11/2022 25,000 25,000 epilepsi
229 Suriati jkn 11/11/2022 25,000 25,000 lbp ec hnp
230 Dfd dermawan jkn 11/11/2022 25,000 25,000 lbp + oa genu
231 Yuliarti nainggolan jkn 11/11/2022 25,000 25,000 lbp ec spondylosis
232 Robinson sinaga jkn 11/11/2022 25,000 25,000 epilepsi
233 Elfrida mida jkn 11/11/2022 25,000 25,000 lbp ec hnp
234 Sampe pasaribu jkn 11/11/2022 25,000 25,000 lbp
235 Sartiem jkn 11/11/2022 25,000 25,000 post stroke iskemik
236 Sabar ambarita jkn 11/11/2022 25,000 25,000 sequele of ci
237 Joni jkn 11/11/2022 25,000 25,000 parkinson disease
238 Sri astuti jkn 11/11/2022 25,000 25,000 lbp ec hnp
239 Rina sri wahyuni jkn 11/11/2022 25,000 25,000 epilepsi
240 Warianti jkn 11/11/2022 25,000 25,000 migren tanpa aura
241 Daulat sitompul jkn 11/11/2022 25,000 25,000 post stroke iskemik
242 Sukarela sembiring jkn 11/11/2022 25,000 25,000 susp oa
243 Hawai mahana umum 11/11/2022 40,000 40,000 epilepsi
244 Siti mutiah br hasibuan jkn 11/14/2022 25,000 25,000 epilepsi
245 Roskami purba jkn 11/14/2022 25,000 25,000 frozen sholder
246 Yustina br ginting jkn 11/14/2022 25,000 25,000 sequele of ci
247 Ngapul barus jkn 11/14/2022 25,000 25,000 parkinson disease
248 Marinem jkn 11/14/2022 25,000 25,000 lbp
249 Ringgas toman lumban tobing jkn 11/14/2022 25,000 25,000 sequele of ci
250 Susi juliana jkn 11/14/2022 25,000 25,000 lbp
251 Kartika naibaho jkn 11/14/2022 25,000 25,000 lbp
252 Lismaria jkn 11/14/2022 25,000 25,000 vertigo feriver
253 Roden tarigan jkn 11/14/2022 25,000 25,000 ht + oa
254 M syahputra jkn 11/14/2022 25,000 25,000 epilepsi
255 Rickie kristian siburian jkn 11/14/2022 25,000 25,000 bell's palsy
256 Sariyah saragih jkn 11/14/2022 25,000 25,000 stroke iskemik
257 Arita sari jkn 11/14/2022 25,000 25,000 bell's palsy
258 Muthiaah mawadah r jkn 11/14/2022 25,000 25,000 migren kronik
259 Nasruddin jkn 11/14/2022 25,000 25,000 sequele of ci
260 Idarisna jkn 11/14/2022 25,000 25,000 oa genu
261 Emanuel sitepu jkn 11/14/2022 25,000 25,000 ischelsia
262 Bahar silalahi jkn 11/14/2022 25,000 25,000 post stroke
263 Nurli br sirait jkn 11/14/2022 25,000 25,000 sequele of ci
264 Samsiah jkn 11/14/2022 25,000 25,000 stroke iskemik
265 Rudi sucitra jkn 11/14/2022 25,000 25,000 epilepsi
266 Alfanus sidauruk jkn 11/14/2022 25,000 25,000 post stroke iskemik
267 Md jasa alif negara jkn 11/14/2022 25,000 25,000 epilepsi
268 Dinar hutabarat jkn 11/14/2022 25,000 25,000 parkinson disease
269 Marojahan simarmata jkn 11/15/2022 25,000 25,000 post stroke + ht
270 Sukatun jkn 11/15/2022 25,000 25,000 lbp
271 Doma roslina sitorus jkn 11/15/2022 25,000 25,000 lbp
272 Zainuar jkn 11/15/2022 25,000 25,000 parkinson disease
273 Kristina Sinaga jkn 11/15/2022 25,000 25,000 post stroke iskemik
274 Nuryati jkn 11/15/2022 25,000 25,000 lbp ec hnp
275 Emmyria br guru singa jkn 11/15/2022 25,000 25,000 sequele of ci
276 Hariyanto jkn 11/15/2022 25,000 25,000 lbp
277 Satiman jkn 11/15/2022 25,000 25,000 lbp
278 Greni sweta karina br ginting jkn 11/15/2022 25,000 25,000 secondary headache
279 Janur Barus ST jkn 11/15/2022 25,000 25,000 sequele of ci
280 Raudatu saniah jkn 11/15/2022 25,000 25,000 sequele of ci
281 Reza lukmanul hakim jkn 11/15/2022 25,000 25,000 epilepsi
283 Nusti ambarita jkn 11/15/2022 25,000 25,000 parkinson disease
284 Sukarti jkn 11/15/2022 25,000 25,000 post stroke
285 Nelita barus jkn 11/15/2022 25,000 25,000 post stroke
286 H Mhd Sobri Nasution jkn 11/15/2022 25,000 25,000 sequele of ci
287 Betti Br Hutabalian jkn 11/15/2022 25,000 25,000 lbp ec hnp
288 Eliana Ginting jkn 11/15/2022 25,000 25,000 stroke iskemik
289 Tuti mariana harahap jkn 11/15/2022 25,000 25,000 neoralsia + post herpes
291 Sapri jkn 11/15/2022 25,000 25,000 ischelsia ec hnp
292 Della aulia jkn 11/15/2022 25,000 25,000 epilepsi
294 Rustam jkn 11/15/2022 25,000 25,000 hemi facial spasm
296 Romaida pangaribuan jkn 11/15/2022 25,000 25,000 parkinson disease
297 Krizova hastuti jkn 11/15/2022 25,000 25,000 cervical pain
298 Kostina simanjuntak jkn 11/15/2022 25,000 25,000 hnp cervical
299 Rista br manalu jkn 11/15/2022 25,000 25,000 dizzenis
300 Mardiana jkn 11/15/2022 25,000 25,000 lbp ec hnp
301 Netty panjaitan jkn 11/15/2022 25,000 25,000 sequele of ci
302 Iwan nugroho jkn 11/15/2022 25,000 25,000 secondary headache
303 Rehgegehna Ginting jkn 11/17/2022 25,000 25,000 post stroke
304 Norma sembiring jkn 11/17/2022 25,000 25,000 lbp ec hnp
305 Karmidin Panjaitan jkn 11/17/2022 25,000 25,000 brachelsia
306 Juita fransisca dewi t jkn 11/17/2022 25,000 25,000 epilepsi
307 Erlinda lubis jkn 11/17/2022 25,000 25,000 lbp ec hnp
308 Ani Roida br Silalahi jkn 11/17/2022 25,000 25,000 frozen sholder
309 Aprilda manalu jkn 11/17/2022 25,000 25,000 lbp
310 Hermady jkn 11/17/2022 25,000 25,000 post stroke iskemik
311 Eleonora simanjuntak jkn 11/17/2022 25,000 25,000 sequele of ci
312 Marjansah Saragih SP jkn 11/17/2022 25,000 25,000 lbp
313 Mariana siregar jkn 11/17/2022 25,000 25,000 lbp
314 Zepin aripsa jkn 11/17/2022 25,000 25,000 epilepsi
315 Nurlela br ginting jkn 11/17/2022 25,000 25,000 hnp
316 Eko prabowo jkn 11/17/2022 25,000 25,000 epilepsi
317 Jamaluddin siregar jkn 11/17/2022 25,000 25,000 epilepsi
318 Renta br sihombing jkn 11/17/2022 25,000 25,000 lbp ec hnp
319 Susterlina Saragih jkn 11/17/2022 25,000 25,000 cervical pain
320 Musa togi marpaung jkn 11/17/2022 25,000 25,000 lbp
321 It hoa jkn 11/17/2022 25,000 25,000 post tia
322 Rosinda Lumban Tobing jkn 11/17/2022 25,000 25,000 lbp + ht
323 Marzuki galimin jkn 11/17/2022 25,000 25,000 oa + parkinson disease
324 Ilyasak jkn 11/17/2022 25,000 25,000 sequele of ci
325 Jannes edison nababan jkn 11/17/2022 25,000 25,000 lbp ec scoliosis
326 Tan lang moi jkn 11/17/2022 25,000 25,000 sequele of ci
327 Tanggan tarigan jkn 11/17/2022 25,000 25,000 lbp + oa
328 Adi syahputra simamora jkn 11/17/2022 25,000 25,000 post kraniatomi
329 Muhammad handi p jkn 11/17/2022 25,000 25,000 epilepsi
330 Hespina simarmata jkn 11/17/2022 25,000 25,000 sequele of ci
331 Hermady jkn 11/17/2022 25,000 25,000 post stroke
332 Marliany jkn 11/17/2022 25,000 25,000 lbp ec hnp
333 Abdul muis jkn 11/18/2022 25,000 25,000 epilepsi
334 Rapiun manalu jkn 11/18/2022 25,000 25,000 paraparase c vii
335 Hariono jkn 11/18/2022 25,000 25,000 sequele of ci
336 Sardiaman Silalahi jkn 11/18/2022 25,000 25,000 lbp ec hnp
337 Royani Agustina jkn 11/18/2022 25,000 25,000 lbp
338 Manihar Sirait jkn 11/18/2022 25,000 25,000 sequele of ci
339 Ellianis jkn 11/18/2022 25,000 25,000 post stroke
340 Suharyati jkn 11/18/2022 25,000 25,000 sequele of ci
341 Jumini jkn 11/18/2022 25,000 25,000 lbp
342 Rosnani jkn 11/18/2022 25,000 25,000 lbp
343 Legiman Saru jkn 11/18/2022 25,000 25,000 post stroke iskemik
344 Nurmala jkn 11/18/2022 25,000 25,000 post stroke
345 Natanael Rajagukguk jkn 11/18/2022 25,000 25,000 sequele of ci
346 Aniati jkn 11/18/2022 25,000 25,000 post stroke + ht
347 Susi handayani jkn 11/18/2022 25,000 25,000 oa + post stroke
348 Wati jkn 11/18/2022 25,000 25,000 neoralsia
349 Pariyem jkn 11/18/2022 25,000 25,000 lbp
350 Adianson Purba jkn 11/18/2022 25,000 25,000 post stroke iskemik
351 Mariatik jkn 11/18/2022 25,000 25,000 sequele of ci
352 Semi jkn 11/18/2022 25,000 25,000 lbp + oa
353 Supriono jkn 11/18/2022 25,000 25,000 sequele of ci
354 Pande Sihombing jkn 11/18/2022 25,000 25,000 vertigo + oa
355 Sumisti jkn 11/18/2022 25,000 25,000 lbp ec hnp
356 Sri yani jkn 11/18/2022 25,000 25,000 lbp ec hnp
357 Santi br hutapea jkn 11/18/2022 25,000 25,000 lbp ec hnp
358 Hj Rosmawati jkn 11/18/2022 25,000 25,000 lbp
359 Maslyani jkn 11/18/2022 25,000 25,000 cts + lbp
360 Adi herman jkn 11/18/2022 25,000 25,000 susp stroke iskemik
361 Zainab jkn 11/18/2022 25,000 25,000 secondary headache
362 Uning Muriati jkn 11/18/2022 25,000 25,000 oa genu
363 Salam damanik jkn 11/18/2022 25,000 25,000 sequele of ci
364 Sania jkn 11/18/2022 25,000 25,000 lbp ec hnp
365 Farida Silalahi jkn 11/18/2022 25,000 25,000 lbp + oa
366 Bresman Siagian jkn 11/18/2022 25,000 25,000 post stroke iskemik
367 Tan lie lian jkn 11/18/2022 25,000 25,000 lbp ec oa
368 Lim lai hing jkn 11/18/2022 25,000 25,000 sequele of ci
369 Masdiani Harahap jkn 11/18/2022 25,000 25,000 epilepsi
370 Bahagia br Tarigan jkn 11/18/2022 25,000 25,000 lbp ec hnp
371 Tiurlan hasiholan s jkn 11/18/2022 25,000 25,000 oa genu
372 Dekson jkn 11/18/2022 25,000 25,000 lbp
373 Erni Rosdiana Ritonga jkn 11/18/2022 25,000 25,000 cervical pain
374 Rosida Simatupang jkn 11/18/2022 25,000 25,000 oa ec lbp
375 Ngena br ginting jkn 11/18/2022 25,000 25,000 post stroke
376 R nat tammo jkn 11/18/2022 25,000 25,000 sequele of ci
377 Superta jkn 11/18/2022 25,000 25,000 lbp ec hnp
378 Juliana jkn 11/18/2022 25,000 25,000 pph
379 Mariana br tarigan jkn 11/18/2022 25,000 25,000 lbp ec susp hnp
380 Maniur Manurung jkn 11/21/2022 25,000 25,000 parkinson disease
381 Reinhard erwin meinus jkn 11/21/2022 25,000 25,000 post stroke iskemik
382 Julianti tanjung jkn 11/21/2022 25,000 25,000 epilepsi
383 Drs hatta b jkn 11/21/2022 25,000 25,000 lbp ec hnp
384 Pansius manurung jkn 11/21/2022 25,000 25,000 post stroke iskemik
385 Salimatuz zulfian br lubis jkn 11/21/2022 25,000 25,000 sequele of ci
386 Sinar lestari saragih jkn 11/21/2022 25,000 25,000 epilepsi
387 Sumaji jkn 11/21/2022 25,000 25,000 sequele of ci
388 Helen sri Wahyuni jkn 11/21/2022 25,000 25,000 lbp ec hnp
389 Pirak boru barus jkn 11/21/2022 25,000 25,000 lbp + oa
390 Eni suarni jkn 11/21/2022 25,000 25,000 lbp ec hnp
391 Suharto drs jkn 11/21/2022 25,000 25,000 hnp lumbal
392 Supiyah jkn 11/21/2022 25,000 25,000 parkinson disease + oa
393 Mardiani jkn 11/21/2022 25,000 25,000 lbp
394 Renti butar butar jkn 11/21/2022 25,000 25,000 neoralsia trygemind
395 Syafrida jkn 11/21/2022 25,000 25,000 sequele of ci
396 Pasu manurung jkn 11/21/2022 25,000 25,000 post stroke iskemik
397 Heldi simbolon jkn 11/21/2022 25,000 25,000 parkinson disease
398 Jawilson Damanik jkn 11/21/2022 25,000 25,000 post stroke join
399 Romida sitanggang jkn 11/21/2022 25,000 25,000 frozen sholder
400 Junaidi jkn 11/21/2022 25,000 25,000 oa
401 Markiya jkn 11/21/2022 25,000 25,000 sequele of ci
402 Fatimah pane jkn 11/21/2022 25,000 25,000 cervical pain
403 Syahnum purba jkn 11/21/2022 25,000 25,000 lbp ec scoliosis
404 Jones Purba jkn 11/21/2022 25,000 25,000 lbp ec hnp
405 Ramunah peranginangin jkn 11/21/2022 25,000 25,000 post stroke iskemik
406 Atik Nurhayati jkn 11/21/2022 25,000 25,000 stroke iskemik
407 Sofian pane jkn 11/21/2022 25,000 25,000 sequele of ci
408 Hayati jkn 11/21/2022 25,000 25,000 neoralsia
409 Maria julfidar jkn 11/21/2022 25,000 25,000 parkinson disease
410 Suarno jkn 11/21/2022 25,000 25,000 lbp
411 Syahrifuddin jkn 11/21/2022 25,000 25,000 stroke haemorage
412 Sutan muda lubis jkn 11/21/2022 25,000 25,000 post stroke
413 Tigor Turnip jkn 11/21/2022 25,000 25,000 sequele of ci
414 Sulestriana jkn 11/21/2022 25,000 25,000 oa
415 Syamsuddin jkn 11/21/2022 25,000 25,000 parkinson disease
416 Erika Aruan jkn 11/21/2022 25,000 25,000 lbp ec hnp
417 Hitler naibaho jkn 11/21/2022 25,000 25,000 post stroke
418 Rahno handoko jkn 11/21/2022 25,000 25,000 sequele of ci
419 Dewi Susanti Simanjuntak jkn 11/21/2022 25,000 25,000 ischelsia ec hnp
420 Masdelina jkn 11/21/2022 25,000 25,000 vertigo
421 Kamel saragih jkn 11/21/2022 25,000 25,000 post stroke iskemik
422 Susanti jkn 11/22/2022 25,000 25,000 sequele of ci
423 Suhadi jkn 11/22/2022 25,000 25,000 lbp + epilepsi
424 Marahika Manalu jkn 11/22/2022 25,000 25,000 lbp ec hnp
425 Marnala Manurung jkn 11/22/2022 25,000 25,000 lbp ec hnp
426 Joni jkn 11/22/2022 25,000 25,000 lbp ec hnp
427 Kie Bun Tiong jkn 11/22/2022 25,000 25,000 post stroke iskemik
428 Sangkot pardede jkn 11/22/2022 25,000 25,000 dd epilepsi
429 Siti aisyah jkn 11/22/2022 25,000 25,000 cervical pain
430 Ratna jkn 11/22/2022 25,000 25,000 post stroke + ht
431 Gudo jkn 11/22/2022 25,000 25,000 lbp
432 Tinus Gultom jkn 11/22/2022 25,000 25,000 vertigo feriver
433 Misriati jkn 11/22/2022 25,000 25,000 lbp ec hnp
434 Syahzily jkn 11/22/2022 25,000 25,000 lbp
435 Muslim tambunan jkn 11/22/2022 25,000 25,000 parkinson disease
436 Sri Rahayu jkn 11/22/2022 25,000 25,000 vertigo feriver
437 Suparmin k jkn 11/22/2022 25,000 25,000 sequele of ci
438 Juliana Saragih jkn 11/22/2022 25,000 25,000 neoralsia
439 Siti Saodah jkn 11/22/2022 25,000 25,000 movement disordi
440 Petrus Barus jkn 11/22/2022 25,000 25,000 lbp ec hnp
441 Aswandi jkn 11/22/2022 25,000 25,000 post stroke iskemik
442 Abdul fatah lubis jkn 11/22/2022 25,000 25,000 lbp ec hnp
443 Ertina br barus jkn 11/22/2022 25,000 25,000 frozen sholder
444 Daesta Manurung jkn 11/22/2022 25,000 25,000 sequele of ci
445 Edi susanto jkn 11/22/2022 25,000 25,000 sequele of ci
446 Rahmad Hidayah jkn 11/22/2022 25,000 25,000 scoliosis cervical
447 Najamuddin jkn 11/22/2022 25,000 25,000 parkinson disease
448 Jumiatik jkn 11/22/2022 25,000 25,000 lbp ec hnp
449 Novianita jkn 11/22/2022 25,000 25,000 epilepsi
450 Poniran jkn 11/22/2022 25,000 25,000 sequele of ci
451 Israel lumbantoruan jkn 11/22/2022 25,000 25,000 cervical pain
452 Nurman jkn 11/22/2022 25,000 25,000 susp bsk
453 Hj sulasih jkn 11/22/2022 25,000 25,000 sequele of ci
454 Buang jkn 11/22/2022 25,000 25,000 lbp
455 Rusmiaty panut jkn 11/22/2022 25,000 25,000 sequele of ci
456 Dalimah lubis jkn 11/22/2022 25,000 25,000 secondary headache
457 Saida br Hasibuan jkn 11/22/2022 25,000 25,000 lbp ec frozen sholder
458 Sinar deliana saragih jkn 11/22/2022 25,000 25,000 epilepsi
459 Elsaria samosir jkn 11/22/2022 25,000 25,000 lbp ec hnp
460 Elfrida purba jkn 11/22/2022 25,000 25,000 post stroke iskemik
461 Sri yani jkn 11/22/2022 25,000 25,000 epilepsi
462 Sarnik jkn 11/24/2022 25,000 25,000 lbp
463 Parida hanum jkn 11/24/2022 25,000 25,000 oa genu
464 Ernida jkn 11/24/2022 25,000 25,000 monoparase
465 Eli sumanti jkn 11/24/2022 25,000 25,000 tic
466 Nurhayati barus jkn 11/24/2022 25,000 25,000 lbp + hnp
467 Dame Sianturi jkn 11/24/2022 25,000 25,000 vertigo + ht
468 Dasiyem jkn 11/24/2022 25,000 25,000 cervical pain
469 Sarida jkn 11/24/2022 25,000 25,000 lbp ec hnp
470 Sri marheni jkn 11/24/2022 25,000 25,000 polioneoropaty diabetik
471 Ronly sipayung jkn 11/24/2022 25,000 25,000 sequele of ci
472 Irdiansyah chah jkn 11/24/2022 25,000 25,000 epilepsi
473 Leonardo sinaga jkn 11/24/2022 25,000 25,000 post stroke iskemik + ht
474 Muliani jkn 11/24/2022 25,000 25,000 bppv + hemifasial spasme
475 Ruslan keliwon jkn 11/24/2022 25,000 25,000 epilepsi
476 Syamsuar jkn 11/24/2022 25,000 25,000 post stroke
477 Tetty heriatuh jkn 11/24/2022 25,000 25,000 post stroke iskemik
478 Taruli sinaga jkn 11/24/2022 25,000 25,000 lbp ec hnp
479 Sumiati jkn 11/24/2022 25,000 25,000 epilepsi
480 Purnama Sinaga jkn 11/24/2022 25,000 25,000 brachelsia
481 Bismar Sitorus jkn 11/24/2022 25,000 25,000 lbp
482 Hendro jkn 11/24/2022 25,000 25,000 parkinson disease
483 Wilda ajeng jkn 11/24/2022 25,000 25,000 epilepsi
484 Darwin Damanik jkn 11/24/2022 25,000 25,000 post stroke iskemik
485 Parasian situmorang jkn 11/24/2022 25,000 25,000 lbp
486 Nurli sibarani jkn 11/24/2022 25,000 25,000 post stroke iskemik
487 Suratmin jkn 11/24/2022 25,000 25,000 post stroke iskemik
488 Adi astono jkn 11/25/2022 25,000 25,000 parkinson disease
489 Zulaiha jkn 11/25/2022 25,000 25,000 parkinson disease
490 Hafizah nasution jkn 11/25/2022 25,000 25,000 lbp ec hnp
491 Rosalina sembiring jkn 11/25/2022 25,000 25,000 lbp ec hnp + oa
492 Sri astuti jkn 11/25/2022 25,000 25,000 lbp ec hnp lumbal
493 Mauluddin putra jkn 11/25/2022 25,000 25,000 post stroke
494 Sartiem jkn 11/25/2022 25,000 25,000 post stroke
495 Sujarwo jkn 11/25/2022 25,000 25,000 sequele of ci
496 Agus setiawan jkn 11/25/2022 25,000 25,000 parkinson disease
497 Sariani sipayung jkn 11/25/2022 25,000 25,000 lbp
498 Dodi sukiando jkn 11/25/2022 25,000 25,000 lbp ec hnp
499 Loiren simatupang jkn 11/25/2022 25,000 25,000 vertigo feriver
500 Sampe pasaribu jkn 11/25/2022 25,000 25,000 lbp
501 Sangki Purba jkn 11/25/2022 25,000 25,000 post stroke
502 Sannaria Sinaga jkn 11/25/2022 25,000 25,000 lbp ec hnp
503 Rumiani jkn 11/25/2022 25,000 25,000 lbp
504 Sukardi jkn 11/25/2022 25,000 25,000 epilepsi
505 Sabar ambarita jkn 11/25/2022 25,000 25,000 post stroke
506 Siti aminah jkn 11/25/2022 25,000 25,000 frozen sholder join
507 Robinson sinaga jkn 11/25/2022 25,000 25,000 sequele of ci
508 Bismark simarmata jkn 11/25/2022 25,000 25,000 vertigo + ht
509 Sri maini jkn 11/25/2022 25,000 25,000 neoralsia trygeminal
510 Suriati jkn 11/25/2022 25,000 25,000 lbp ec hnp
511 Heriana jkn 11/25/2022 25,000 25,000 susp osbosarcom
512 Pilem sembiring jkn 11/25/2022 25,000 25,000 lbp ec hnp
513 Daulat sitompul jkn 11/25/2022 25,000 25,000 post stroke iskemik
514 Sadarih munthe jkn 11/25/2022 25,000 25,000 post stroke
515 Joni jkn 11/25/2022 25,000 25,000 parkinson disease
516 Martini jkn 11/25/2022 25,000 25,000 stroke iskemik
517 Anner sitorus jkn 11/25/2022 25,000 25,000 epilepsi
518 Chaidir munthe jkn 11/25/2022 25,000 25,000 post stroke iskemik
519 Bonur hutabarat jkn 11/25/2022 25,000 25,000 parapase n vii cc hnp
520 Iskandar lubis jkn 11/25/2022 25,000 25,000 sequele of ci
521 Badia silalahi jkn 11/28/2022 25,000 25,000 post stroke
522 Neni sumarni jkn 11/28/2022 25,000 25,000 ischelsia
523 Rickie kristian siburian jkn 11/28/2022 25,000 25,000 bell's palsy
524 Nursani jkn 11/28/2022 25,000 25,000 lbp ec hnp
525 Ringgas toman lumban tobing jkn 11/28/2022 25,000 25,000 sequele of ci
526 Lismaria jkn 11/28/2022 25,000 25,000 vertigo feriver + ht
527 Rosna situmorang jkn 11/28/2022 25,000 25,000 secondary headache
528 Roskemi purba jkn 11/28/2022 25,000 25,000 frozen sholder
529 Sariyah saragih jkn 11/28/2022 25,000 25,000 lbp ec hnp
530 Ernawati jkn 11/28/2022 25,000 25,000 tic
531 Ida risna jkn 11/28/2022 25,000 25,000 oa
532 Nasruddin jkn 11/28/2022 25,000 25,000 sequele of ci
533 Saniah jkn 11/28/2022 25,000 25,000 epilepsi
534 Mutiara br tarigan jkn 11/28/2022 25,000 25,000 stroke haemorage
535 Sopar siregar jkn 11/28/2022 25,000 25,000 lbp
536 Kartika naibaho jkn 11/28/2022 25,000 25,000 lbp hnp lumbal
537 Rudi jkn 11/28/2022 25,000 25,000 post stroke iskemik + ht
538 Senty br sihaloho jkn 11/28/2022 25,000 25,000 lbp
539 Agian Saragih jkn 11/28/2022 25,000 25,000 parkinson disease
540 Yustina br ginting jkn 11/28/2022 25,000 25,000 sequele of ci
541 Anita sari jkn 11/28/2022 25,000 25,000 bell's palsy
542 Emmanuel sitepu jkn 11/28/2022 25,000 25,000 ischelsia ec hnp
543 Juhariah jkn 11/28/2022 25,000 25,000 sequele of ci
544 M adelin yahya jkn 11/28/2022 25,000 25,000 oa
545 Sri muliani jkn 11/28/2022 25,000 25,000 post stroke
546 Supini jkn 11/28/2022 25,000 25,000 oa
547 M amin amir jkn 11/28/2022 25,000 25,000 oa
548 Lamhot marurat sinaga jkn 11/28/2022 25,000 25,000 oa
549 Krizova hastuti jkn 11/29/2022 25,000 25,000 scoliosis cervical
550 Jumadin jkn 11/29/2022 25,000 25,000 stroke iskemik
551 Darmansyah Sagala jkn 11/29/2022 25,000 25,000 sequele of ci
552 Amos sigalingging jkn 11/29/2022 25,000 25,000 stroke iskemik
553 Julfranto saragih jkn 11/29/2022 25,000 25,000 epilepsi
554 Mhd sobri nst jkn 11/29/2022 25,000 25,000 sequele of ci
555 Nusti ambarita jkn 11/29/2022 25,000 25,000 parkinson disease
556 Nurdin jkn 11/29/2022 25,000 25,000 post stroke iskemik
557 Erna barus jkn 11/29/2022 25,000 25,000 lbp ec hnp
559 Tan lang moi jkn 11/29/2022 25,000 25,000 tia + ht
560 Rista manalu jkn 11/29/2022 25,000 25,000 diztenes
561 Kostina simanjuntak jkn 11/29/2022 25,000 25,000 hnp cervical
562 Della aulia jkn 11/29/2022 25,000 25,000 epilepsi
563 Betti Br Hutabalian jkn 11/29/2022 25,000 25,000 lbp
564 Emmyria girsang jkn 11/29/2022 25,000 25,000 sequele of ci
566 Nuryati jkn 11/29/2022 25,000 25,000 lbp ec hnp
567 Kristina Sinaga jkn 11/29/2022 25,000 25,000 post stroke + ht
568 Murli sirait jkn 11/29/2022 25,000 25,000 sequele of ci
569 Sukatun jkn 11/29/2022 25,000 25,000 lbp ec hnp
570 Marujahan simarmata jkn 11/29/2022 25,000 25,000 stroke iskemik
571 Sari melati jkn 11/29/2022 25,000 25,000 stroke iskemik + lbp
572 Eliana Ginting jkn 11/29/2022 25,000 25,000 stroke iskemik + ht
575 Safri jkn 11/29/2022 25,000 25,000 ischelsia ec hnp
576 Selamet susanto jkn 11/29/2022 25,000 25,000 lbp
577 Panca ratna gultom jkn 11/29/2022 25,000 25,000 lbp
578 Mhd efendi jkn 11/29/2022 25,000 25,000 epilepsi
579 Netti panjaitan jkn 11/29/2022 25,000 25,000 sequele of ci
Total 14,425,000 80,000 14,505,000

Kalkulasi Penggajian / Honor:
Lubuk Pakam, November 2022 Rawat Inap:
Penerima; Ka. Keuangan Umum 990,000
Rawat Jalan:
Umum 80,000 +
Total 1,070,000
dr. Lisbeth Meilani, Sp.S Melki Tampubolon, SE Potongan ke RS 10 % 107,000 -
Total Honor Umum Bersih 963,000
Rawat Inap BPJS -
Diketahui Oleh: Rawat Jalan BPJS 14,425,000 +
Direktur RS Pendaptan Honor 15,388,000
Pajak (TAX) 5 % 769,400 -
Honor Bruto 14,618,600
Transportasi - +
dr. Arifin P Sitompul Total Honor Diterima 14,618,600
Diagnosa Total Bill
Injury 4,284,750
Hi 4,259,750
KLL 2,737,250
Hi 2,543,500
Hi 5,092,250
LBP 890,000
Hi 3,587,250
Hi 3,472,250
Hi 3,472,250
30,339,250
DPJP
idho,Sp.PD
Ridho,Sp.PD+dr. Desmon,Sp.PD
Ridho,Sp.PD+dr. Marolop,SpJ
Maharani,Sp.KFR
Maharani,Sp.KFR
anika,Sp.PD
anika,Sp.PD
esmon,SpP
anika,Sp.PD+dr. Dian,SpP
Rika,Sp.THT+dr. Desmon,SpP
ian,SpP
eri,SpB
Wirandi,Sp.PD+dr. Marolop,SpJ
Wirandi,Sp.PD
anika,Sp.PD+dr. Marolop,SpJ
Wirandi,Sp.PD
Wirandi,Sp.PD+dr. Dian,SpP
Maharani,Sp.KFR
esmon,SpP
Wirandi,Sp.PD
Maharani,Sp.KFR
anika,Sp.PD
ut,Sp.THT
anika,Sp.PD
Ridho,SpB+dr. Dian,SpP
oraya,SpM
dr. Amarwati, SpN
Rekapitulasi Pasien
Bulan Desember 2023

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Visite HD/Visite Sub Total Total Tagihan
1
2
Total - - -
2. Rawat Inap BPJS

1 Waslan 76842 BPJS Klas II 09/02/2024 2/14/2024 6,454,900 161,373 Cerebral Infarktion 'dr. Desmon,SpP+dr. Ridho,Sp.PD+dr. Marolop,SpJ
1 Salim 050194 BPJS Klas II 2/7/2024 09/02/2024 3,340,100 167,005 UAP dr. Marolop,SpJ
2
3
4
5
6
7
8
-
-
-
Total - 328,378
3. Rawat Jalan
1 Sugiartik Jkn 11/2/2022 25,000 25,000 LBP
2 Sulistiani Jkn 11/2/2022 25,000 25,000 Squele
3 isnani Jkn 11/2/2022 25,000 25,000 LBP
4 Elisabet Barus Jkn 11/2/2022 25,000 25,000 HT
5 Nurlela Jkn 11/2/2022 25,000 25,000 LBP
6 Horas Morgan Jkn 11/2/2022 25,000 25,000 Cervical Syndrom
7 Jhon Lumban Tobing Jkn 11/2/2022 25,000 25,000 LBP
8 Jekson Tampubolon Jkn 11/2/2022 25,000 25,000 Eplepsi
9 Reni Jkn 11/2/2022 25,000 25,000 Low Back Pain
10 Patar Sihotang Jkn 11/2/2022 25,000 25,000 OA Bilateral
11 Sumiati Jkn 11/2/2022 25,000 25,000 Vertigo
12 Sumardi Jkn 11/2/2022 25,000 25,000 Squele
13 Hotman Siahaan Jkn 11/2/2022 25,000 25,000 Squele
14 Suratmi Jkn 11/2/2022 25,000 25,000 LBP
15 Ahmad Suhaini Jkn 11/2/2022 25,000 25,000 LBP
16 Nurgini Jkn 11/2/2022 25,000 25,000 Secondary Headache
17 Mahmuddin Jkn 11/2/2022 25,000 25,000 Squele
18 Budi Siburian Jkn 11/2/2022 25,000 25,000 LBP
19 Suriono Jkn 11/2/2022 25,000 25,000 Squele
20 Wahyudi Jkn 11/2/2022 25,000 25,000 LBP
21 Sunarni Jkn 11/2/2022 25,000 25,000 Squele
22 Ale Ambarita Jkn 11/2/2022 25,000 25,000 LBP
23 Feri Juanda Jkn 11/4/2022 25,000 25,000 Bell's Palsy
24 Edy Suprapto Jkn 11/4/2022 25,000 25,000 LBP
25 Nuah Sinaga Jkn 11/4/2022 25,000 25,000 HNP Lumbal
26 Sumiati Jkn 11/4/2022 25,000 25,000 LBP
27 Mariati Sinaga Jkn 11/4/2022 25,000 25,000 Post Stroke
28 Ratnawati Saragih Jkn 11/4/2022 25,000 25,000 LBP
29 Sumiarni Jemidi Jkn 11/4/2022 25,000 25,000 LBP
30 Hapsah Jkn 11/4/2022 25,000 25,000 Spondylosis
31 Siswadi Jkn 11/4/2022 25,000 25,000 Cervical Syndrom
32 Rumiati Jkn 11/4/2022 25,000 25,000 LBP
33 Masriyani Jkn 11/5/2022 25,000 25,000 Post Head Injury
34 Nurhayati Jkn 11/5/2022 25,000 25,000 CTTH
35 Nizar Syahfitri Jkn 11/9/2022 25,000 25,000 Eplepsi
36 Andrian Maulia Pratama Jkn 11/9/2022 25,000 25,000 LBP
37 Corry Desima Tampubolon Jkn 11/9/2022 25,000 25,000 Eplepsi
38 Sumiati Jkn 11/9/2022 25,000 25,000 Vertigo
39 Pani Jkn 11/9/2022 25,000 25,000 Eplepsi
40 Tiany Siregar Jkn 11/9/2022 25,000 25,000 LBP
41 Ale Ambarita Jkn 11/9/2022 25,000 25,000 LBP
42 Gintar Ginting Jkn 11/9/2022 25,000 25,000 Squele
43 Erni Anto Lubis Jkn 11/9/2022 25,000 25,000 Stroke Iskemik
44 Jekson Tampubolon Jkn 11/9/2022 25,000 25,000 Eplepsi
45 Sofyan Hendry Jkn 11/9/2022 25,000 25,000 Squele
46 Rolia Jkn 11/11/2022 25,000 25,000 Squele
47 Nurlela Jkn 11/12/2022 25,000 25,000 HNP Lumbal
48 Norma Sari Jkn 11/12/2022 25,000 25,000 LBP
49 Asari Purba Jkn 11/12/2022 25,000 25,000 Transient Ischemic
51 Norma Sari Jkn 11/12/2022 25,000 25,000 Squele
52 Mariono Jkn 11/12/2022 25,000 25,000 Squele
53 Syamsudin Lubis Jkn 11/12/2022 25,000 25,000 Squele
54 Elisabet Barus Jkn 11/16/2022 25,000 25,000 LBP
56 Sunarni Jkn 11/16/2022 25,000 25,000 Squele
58 Jhon Lumban Tobing Jkn 11/16/2022 25,000 25,000 LBP
60 Putri Yolanda Sari Jkn 11/16/2022 25,000 25,000 LBP
61 Suratmi Jkn 11/16/2022 25,000 25,000 LBP
63 Nurlela Jkn 11/16/2022 25,000 25,000 LBP
64 Suyitno Jkn 11/16/2022 25,000 25,000 LBP
65 isnani Jkn 11/16/2022 25,000 25,000 LBP
66 Reni Jkn 11/16/2022 25,000 25,000 LBP
68 Irwan Jkn 11/18/2022 25,000 25,000 Squele
69 Erni Anto Lubis Jkn 11/18/2022 25,000 25,000 Squele
70 Eka Putra Lethy Jkn 11/18/2022 25,000 25,000 Post Head Injury
71 Ali Sitepu Jkn 11/18/2022 25,000 25,000 Squele
72 Rumiati Jkn 11/18/2022 25,000 25,000 LBP
73 Mariati Sinaga Jkn 11/18/2022 25,000 25,000 Squele
74 Wahyudi Jkn 11/18/2022 25,000 25,000 LBP
75 Edy Suprapto Jkn 11/18/2022 25,000 25,000 LBP
76 Sumiarni Jemidi Jkn 11/18/2022 25,000 25,000 LBP
78 Rusmani Silaban Jkn 11/19/2022 40,000 40,000 Secondary Headache
79 Masnilam Hutapea Jkn 11/19/2022 25,000 25,000 Cervical Syndrom
80 Indra Parta Gurning Jkn 11/19/2022 25,000 25,000 LBP
81 Nurhayati Jkn 11/19/2022 25,000 25,000 CTTH
82 Ros Samsidar Jkn 11/19/2022 40,000 40,000 Bell's Palsy
83 Nizar Syahfitri Jkn 11/23/2022 25,000 25,000 Eplepsi
84 Halimah Tusadiah Jkn 11/23/2022 25,000 25,000 Squele
85 Andrian Maulia Pratama Jkn 11/23/2022 25,000 25,000 LBP
86 Suyitno Jkn 11/23/2022 25,000 25,000 Low Back Pain
87 Tiany Siregar Jkn 11/23/2022 25,000 25,000 LBP
88 Lasma Manalu Jkn 11/23/2022 25,000 25,000 LBP
89 Corry Desima Tampubolon Jkn 11/23/2022 25,000 25,000 Eplepsi
90 Jekson Tampubolon Jkn 11/23/2022 25,000 25,000 Epilepsi
92 Patar Sihotang Jkn 11/23/2022 25,000 25,000 OA Bilateral
93 Pani Jkn 11/23/2022 25,000 25,000 Epilepsi
94 Abdul Kholiq Jkn 11/23/2022 25,000 25,000 Post Head Injury
95 Hanisah Jkn 11/23/2022 25,000 25,000 OA Bilateral
96 Ros Samsidar Jkn 11/23/2022 25,000 25,000 Bell's Palsy
97 Ale Ambarita Jkn 11/23/2022 25,000 25,000 Low Back Pain
98 Putri Yolanda Sari Jkn 11/23/2022 25,000 25,000 LBP
99 Adwar Sihombing Jkn 11/23/2022 25,000 25,000 Susp OA
100 Siti Zaenap Jkn 11/23/2022 25,000 25,000 LBP
101 Erni Anto Lubis Jkn 11/23/2022 25,000 25,000 LBP
102 Rosmaini Jkn 11/23/2022 25,000 25,000 LBP
103 Jerni Damanik Jkn 11/25/2022 25,000 25,000 Sholder Join
104 Gintar Ginting Jkn 11/25/2022 25,000 25,000 Squele
105 Sofyan Hendry Jkn 11/25/2022 25,000 25,000 Squele
106 Rolia Jkn 11/25/2022 25,000 25,000 Squele
109 Indra Parta Gurning Jkn 11/26/2022 25,000 25,000 LBP
110 Erni Anto Lubis Jkn 11/26/2022 25,000 25,000 Squele
111 Tiomas Silitonga Jkn 11/26/2022 25,000 25,000 Hem Dextra
112 Syamsudin Lubis Jkn 11/26/2022 25,000 25,000 Squele
113 Norma Sari Jkn 11/26/2022 25,000 25,000 LBP
115 Sumarni Jkn 11/30/2022 25,000 25,000 Squele
117 isnani Jkn 11/30/2022 25,000 25,000 OA Bilateral
118 Reni Jkn 11/30/2022 25,000 25,000 LBP
121 Masim Ginting Jkn 11/30/2022 25,000 25,000 LBP
123 Juniar Sibarani Jkn 11/30/2022 25,000 25,000 LBP
126 Syamsudin Lubis Jkn 11/30/2022 25,000 25,000 Sefagia
127 Nurlela Jkn 11/30/2022 25,000 25,000 LBP
128 Poltak Sibuea Jkn 11/30/2022 25,000 25,000 Stroke Iskemik
129 Sri Wulandari Jkn 11/30/2022 25,000 25,000 Konvulsi
130 Adwar Sihombing Jkn 11/30/2022 25,000 25,000 OA Genu
Total 3,200,000 80,000 3,280,000

Lubuk Pakam, November 2022 Rawat Inap:
Penerima; Ka. Keuangan Umum -
Rawat Jalan:
Umum 80,000 +
Total 80,000
dr. Dira wahyuni, SpN Melki Tampubolon, SE Potongan ke RS 10 % 8,000 -
Rawat Inap BPJS 328,378
Diketahui Oleh: Rawat Jalan BPJS 3,200,000 +
Direktur RS Pendaptan Honor 3,600,378
Pajak (TAX) 5 % 180,019 -
Transportasi - +
dr. Arifin P Sitompul Total Honor Diterima 3,420,359
Ket : selisih Grantivity dengan Honor Pasien Bulan November 2022 sudah kami kirim ke rekening dokter tersebut.
Honor Pasien November 2022 3,420,359
Grantivity Bln. November 2022 7,000,000 -
(3,579,641)
Diagnosa
on,SpP+dr. Ridho,Sp.PD+dr. Marolop,SpJ

dr. Yanika Sitanggang,Sp.PD
Rekapitulasi Pasien
Bulan Desember 2023

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Visite HD/Visite sub total Keterangan Diagnosa
1 Dikin 116987 Umum KLS III 2/13/2024 2/16/2024 2 40,000 80,000 CHF
2 Suhartono 106091 Umum KLS III 2/6/2024 07/02/2024 2 40,000 80,000 Intoxikasi
3 Robi Gunara 117110 Umum KLS III 18/02/2024 2/20/2024 3 40,000 120,000 Dyspepsia
4 Wiston Vebio Nainggolan 117229 Umum KLS III 2/22/2024 2/23/2024 2 40,000 80,000 Dyspepsia
Total 9 360,000
2. Rawat Inap BPJS

1 Ngatinem 090772 BPJS KLS III 1/29/2024 2/1/2024 2,119,000 211,900 CHF
2 Yosua Yoan Dinata S Aruan 113924 BPJS KLS III 1/30/2024 2/2/2024 2,292,400 114,620 Thypoid dr. Heri,SpB
3 Rahmawati Br Bukit 82658 BPJS KLS III 1/30/2024 2/2/2024 3,658,500 365,850 DM
4 Purwandi 116535 BPJS KLS III 1/29/2024 2/2/2024 3,648,700 364,870 Abd
5 Wagianti 116554 BPJS KLS III 1/30/2024 2/2/2024 1,959,100 195,910 DHF
6 Rusmayanti Halaho 62490 BPJS Kelas I 2/1/2024 03/02/2024 1,911,000 95,550 Vertigo dr. Lisbeth,SpS
7 Suriyadi 104964 BPJS KLS III 2/1/2024 03/02/2024 2,292,400 114,620 Thypoid dr. Lisbeth,SpS
8 Rustina Purba 104545 BPJS KLS III 2/1/2024 03/02/2024 3,648,700 364,870 Thypoid
9 Dahliani 51185 BPJS Kelas I 1/31/2024 03/02/2024 3,048,900 304,890 Thypoid
10 Rohani 116575 BPJS KLS III 1/30/2024 03/02/2024 3,300,600 165,030 PPOK dr. Dian,SpP
11 Nurmala Simamora 054946 BPJS Kelas I 1/31/2024 03/02/2024 4,855,700 242,785 Cholelithiasis dr. Dian,SpP
12 Pursida Elita Sianturi 98895 BPJS Kelas I 2/2/2024 2/4/2024 2,818,300 281,830 Dyspepsia
13 M Sanjaya 058821 BPJS KLS III 2/1/2024 2/5/2024 4,381,700 146,057 Hepatomy+TB 'dr. Cut,Sp.THT+dr. Dian,SpP
14 Leni Purnama Wati Marpa 116635 BPJS Klas II 2/1/2024 2/5/2024 5,104,700 255,235 'Bronchitis+Dyspepsia dr. Desmon,SpP
15 Rabulan Saragih 116731 BPJS KLS III 2/4/2024 06/02/2024 5,130,400 256,520 DBD+TB Paru dr. Desmon,SpP
16 M Joli 106135 BPJS Klas II 2/1/2024 06/02/2024 4,250,700 141,690 DM+TB 'dr. Lisbeth,SpS+dr. Dian,SpP
17 Waginten 116638 BPJS KLS III 2/1/2024 06/02/2024 1,959,100 195,910 DHF
18 Tumiran 085923 BPJS KLS III 2/4/2024 07/02/2024 2,855,900 285,590 DHF
19 Sumardi 116735 BPJS KLS III 2/4/2024 07/02/2024 2,119,000 211,900 Colic Abd
20 Janawi Saragi 108915 BPJS KLS III 2/4/2024 07/02/2024 3,650,900 121,697 COPD 'dr. Desmon,SpP+dr. Marolop,SpJ
21 Poniyem 101699 BPJS KLS III 2/5/2024 08/02/2024 6,351,400 127,028 Ganggren dr. Robert,SpB
22 Monang Hutabarat 116736 BPJS Kelas I 2/4/2024 08/02/2024 4,389,800 219,490 Pneumonia dr. Desmon,SpP
23 Martha Br Silaban 116720 BPJS KLS III 2/4/2024 09/02/2024 4,381,700 219,085 TB dr. Desmon,SpP
24 Hasna Hanum 16.09.19 BPJS KLS III 2/5/2024 09/02/2024 2,218,900 221,890 Thypoid
25 Wagimin 116786 BPJS KLS III 2/6/2024 09/02/2024 3,648,700 364,870 Hypoglicaemia
26 Sulasmi 116805 BPJS KLS III 2/6/2024 09/02/2024 2,855,900 285,590 Thypoid
27 Anhar 114499 BPJS KLS III 2/5/2024 09/02/2024 4,961,400 99,228 Hernia dr. Robert,SpB
28 Murni Waruwu 111350 BPJS KLS III 2/3/2024 09/02/2024 4,381,700 219,085 TB dr. Desmon,SpP
29 Nur Asari 116758 BPJS KLS III 2/6/2024 09/02/2024 1,361,300 136,130 Cholelithiasis
30 Muslianto 116782 BPJS Klas II 2/5/2024 10/02/2024 3,327,200 332,720 DHF
31 Supiah 116809 BPJS KLS III 2/6/2024 10/02/2024 1,959,100 195,910 DHF
32 O RiaNapitupulu 072336 BPJS KLS III 2/8/2024 10/02/2024 1,652,000 165,200 GEA
33 Kristina Fenesya Siahaan 116602 BPJS KLS III 2/8/2024 10/02/2024 1,361,300 136,130 Colic Abd
34 Devi Kurnia Sari 105163 BPJS Klas II 2/6/2024 10/02/2024 4,250,700 425,070 DHF
35 Gina Sherina Munthe 076493 BPJS KLS III 2/8/2024 10/02/2024 2,292,400 229,240 Thypoid
36 Syamsul Bahri 065706 BPJS KLS III 2/8/2024 2/11/2024 3,633,300 181,665 UAP+DM dr. Marolop,SpJ
37 Dina Marisa Luis Anggreni 116862 BPJS Klas II 2/8/2024 2/11/2024 2,670,600 267,060 Thypoid
38 Jainal Cristover Siburian 116869 BPJS KLS III 2/8/2024 2/11/2024 2,292,400 229,240 Thypoid
39 Astuti 116867 BPJS KLS III 2/8/2024 2/11/2024 5,098,400 509,840 Hypoglicaemia
40 Nur Putri Isnani 116874 BPJS KLS III 09/02/2024 2/11/2024 3,668,500 73,370 App dr. Heri,SpB
41 Sarman 116865 BPJS Klas II 2/8/2024 2/12/2024 2,641,500 264,150 Gout Astritis
42 Nurhayatun 66359 BPJS KLS III 09/02/2024 2/12/2024 3,300,600 165,030 Asma Bronchial dr. Dian,SpP
43 Dahlia 91670 BPJS KLS III 2/13/2024 2/13/2024 1,499,200 49,973 DM+LBP 'dr. Lisbeth,SpS+dr. Marolop,SpJ
44 Suramin 116925 BPJS KLS III 10/02/2024 2/14/2024 4,381,700 219,085 TB+Dyspepsia dr. Desmon,SpP
45 Anggi Sahpitri 079854 BPJS KLS III 2/13/2024 15/02/2024 3,668,500 73,370 App dr. Heri,SpB
46 Jeffry Ramadhan 117001 BPJS Klas II 2/13/2024 15/02/2024 3,484,700 348,470 Eruption
47 Rubianti 107255 BPJS KLS III 2/13/2024 2/16/2024 2,429,700 242,970 HT
48 Rut Simamora 116989 BPJS KLS III 2/13/2024 2/16/2024 4,668,700 93,374 DM dr. Heri,SpB
49 Margaretta Sinaga 099098 BPJS KLS III 2/15/2024 2/17/2024 1,361,300 136,130 Dyspepsia
50 Bagus Santoso 104191 BPJS KLS III 2/15/2024 2/17/2024 2,292,400 229,240 Thypoid
51 Legianto 117048 BPJS KLS III 2/15/2024 2/18/2024 1,361,300 136,130 Colic Abd
52 Parida Hanum 117049 BPJS KLS III 2/15/2024 2/18/2024 3648700 364,870 DM
53 Jumiyem 117051 BPJS KLS III 2/16/2024 2/18/2024 3648700 364,870 Hypoglicaemia
54 Masyita Purba 081574 BPJS KLS III 2/15/2024 2/19/2024 1,959,100 195,910 DHF
55 Anju Arjuna Nainggolan 101360 BPJS Klas II 2/14/2024 2/19/2024 3,327,200 332,720 Thypoid
56 Nampat Tarigan (Exit) 117176 BPJS Klas II 2/20/2024 2/21/2024 1,746,500 58,217 Sepsis 'dr. Dian,SpP+dr. Marolop,SpJ
57 Paidi 117113 BPJS KLS III 18/02/2024 2/21/2024 3,537,500 176,875 LBP+Anemia dr. Lisbeth,SpS
58 Juliya 115968 BPJS Klas II 2/19/2024 2/21/2024 1,585,900 158,590 Jaundice
59 Pella Marrie Warda 88063 BPJS KLS III 17/02/2024 2/21/2024 3,650,900 182,545 'Thypoid+Pneumonia dr. Desmon,SpP
60 Fitri Khairani 90663 BPJS Klas II 2/19/2024 2/22/2024 4,006,100 200,305 'Thypoid+Pneumonia dr. Dian,SpP
61 Ronny Antoni 80378 BPJS Klas II 2/19/2024 2/22/2024 2,670,600 267,060 Thypoid
62 Trisnawati Br Purba 117173 BPJS KLS III 2/20/2024 2/22/2024 1,652,000 165,200 GEA
63 Ratna 117181 BPJS KLS III 2/21/2024 2/23/2024 3,648,700 182,435 DM dr. Marolop,SpJ
64 Nur'Asiah Ar 116756 BPJS KLS III 2/20/2024 2/23/2024 2,867,100 143,355 Dyspepsia dr. Marolop,SpJ
65 Siti Aminah 117139 BPJS KLS III 2/20/2024 2/23/2024 3,537,500 353,750 Anemia
66 M Tsunani Pradana 117157 BPJS Klas II 2/20/2024 24/2/2024 3,777,600 377,760 Gastritis
67 Nopita 114831 BPJS KLS III 2/20/2024 24/2/2024 2,429,700 242,970 Anemia
68 Sentosa Parapat 112222 BPJS Kelas I 2/20/2024 24/2/2024 4,832,300 241,615 Dyspepsia dr. Marolop,SpJ
69 Nurhayati 91926 BPJS Kelas I 2/21/2024 24/2/2024 3,048,900 304,890 Thypoid
70 Kardian Turnip 101590 BPJS KLS III 2/22/2024 25/02/2024 4,226,800 211,340 TB dr. Dian,SpP
71 Sutarni 83479 BPJS KLS III 2/22/2024 2/26/2024 3,648,700 364,870 DM
72 Widensi 109402 BPJS KLS III 2/24/2024 2/26/2024 3,648,700 364,870 Colic Abd
73 Risma Sihombing 117227 BPJS KLS III 2/22/2024 2/26/2024 1,959,100 195,910 DHF
74 Saripuddin 112114 BPJS Kelas I 2/22/2024 4/26/2024 3,048,900 304,890 Thypoid
75 Fazira Ramadhani 117230 BPJS Klas II 2/23/2024 4/26/2024 1,924,500 192,450 GEA
76 Sri Marlia 110635 BPJS Klas II 2/22/2024 2/27/2024 3,946,500 197,325 CHF+CKD dr. Marolop,SpJ
77 Sulasmi 116805 BPJS KLS III 27/02/2024 2/27/2024 1,499,200 149,920 Anemia
78 Ariadi 117293 BPJS KLS III 26/02/2024 2/28/2024 2,119,000 211,900 CKD
79 Wandiyem 98849 BPJS KLS III 2/22/2024 2/28/2024 4,668,700 233,435 DM Type 2 dr. Marolop,SpJ
80 Rapael Sinaga 079901 BPJS Kelas I 2/27/2024 29/02/2024 3,048,900 304,890 Thypoid
81 Sri Asni Lubis 94260 BPJS KLS III 2/23/2024 29/02/2024 3,658,500 365,850 DM
82 Susun Dermina 78721 BPJS KLS III 2/27/2024 29/02/2024 1,361,300 136,130 Dyspepsia
Habdiyah 66867 BPJS Kelas I 2/22/2024 24/2/2024 3,990,100 199,505 HNP dr. Lisbeth,SpS
Mendra 109236 BPJS KLS III 1/30/2024 02/02/2024 3,300,600 110,020 CHF 'dr. Dian,SpP+dr. Marolop,SpJ
Gunawan Sembiring 101324 BPJS KLS III 2/24/2024 29/02/2024 3,650,900 182,545 Septicaemia dr. Desmon,SpP
Total 268,127,400 19,072,873
3. Rawat Jalan
1 Marsita br hombing jkn 11/1/2022 25,000 25,000 ht . St iii
2 Suyatno jkn 11/1/2022 25,000 25,000 dm . Ht
3 Maruhum sihombing jkn 11/1/2022 25,000 25,000 hepatoma . Ppok . Ht
4 Muliatik jkn 11/1/2022 25,000 25,000 ht st iii. Dislipidemia
5 Siti walhidayah jambak jkn 11/1/2022 25,000 25,000 dm . Ht . Neuropati
6 Mennaria purba jkn 11/1/2022 25,000 25,000 dm . Ht . Dislipidemia
7 Nurdini jkn 11/1/2022 25,000 25,000 dm . Ht
8 Rosita br damanik jkn 11/1/2022 25,000 25,000 hidronefrosis . Gout artritis
9 Ruslina jkn 11/1/2022 25,000 25,000 dm . Ht . Neuropati
10 Leni armaya jkn 11/1/2022 25,000 25,000 grave's disease
11 Muller lbn gaol jkn 11/1/2022 25,000 25,000 dm . Chf ec hhd .ppok
12 Yunidar jkn 11/1/2022 25,000 25,000 ckd . St iv . Ht
13 Nursedi jkn 11/1/2022 25,000 25,000 chd ec hhd . Dislipidemia . Oa genu
14 Mhd hidayat jkn 11/1/2022 25,000 25,000 dm . Ht
15 Bangun siregar jkn 11/1/2022 25,000 25,000 dm . Ht . Pad
16 Yuda bakti ginting jkn 11/1/2022 25,000 25,000 chf ec hhd / ihd . Dm . Gout
17 Mahdalena endamuli jkn 11/1/2022 25,000 25,000 dm . Ht
18 Ade irma jkn 11/1/2022 25,000 25,000 dm . Neuropati
19 Husin parinduri jkn 11/1/2022 25,000 25,000 dm . Ht
20 Nurlina mandora jkn 11/1/2022 25,000 25,000 dm . Ht . Pad . Gout artritis . Dislipidemia
21 Poloria siagian jkn 11/1/2022 25,000 25,000 grave's disease
22 Siti karuniati jkn 11/1/2022 25,000 25,000 grave's disease
23 Fresly talopa jkn 11/1/2022 25,000 25,000 grave's disease
24 Joneldi sinaga jkn 11/1/2022 25,000 25,000 ht . Gout artritis . Dislipidemia
25 Hamsen togatorop jkn 11/1/2022 25,000 25,000 dm . Ht . Ckd
26 Wisri yasteti jkn 11/1/2022 25,000 25,000 ht et hhd . Dm . Dislipidemia
27 Darwin lubis jkn 11/1/2022 25,000 25,000 dm . Hhd . Gout artritis
28 Serta tambunan jkn 11/1/2022 25,000 25,000 ckd st v . Ht
29 Mardiana jkn 11/1/2022 25,000 25,000 dm . Ht
30 Rosmawati jkn 11/1/2022 25,000 25,000 m . Ht et hhd . Gout artritis
31 Nasda tarigan jkn 11/1/2022 25,000 25,000 ht . Gout artritis
32 Fauzana m nur jkn 11/1/2022 25,000 25,000 grave's disease . Ht
33 Katarina barus jkn 11/1/2022 25,000 25,000 dm . Ht et hhd
34 Sukirman jkn 11/1/2022 25,000 25,000 m . Ht . Bph
35 Victaulina sitorus jkn 11/1/2022 25,000 25,000 grave' disease . Dislipidemia
36 Bambang hariadi jkn 11/1/2022 25,000 25,000 grave's disease
37 Saurma br sagala jkn 11/1/2022 25,000 25,000 grave's disease
38 Nuraini jkn 11/1/2022 25,000 25,000 dm . Ht
39 Rendy br batubara jkn 11/1/2022 25,000 25,000 ht . Hn
40 Nasril jkn 11/1/2022 25,000 25,000 dm . Ht . Gout artritis
41 Nuraini jkn 11/1/2022 25,000 25,000 dm . Ht . Aps
42 Roida br hutajulu jkn 11/1/2022 25,000 25,000 ht st iv . Dislipidemia
43 Julham nst jkn 11/1/2022 25,000 25,000 ckd st v . Anemia renal
44 Fatimah jkn 11/2/2022 25,000 25,000 dm . Ht
45 Masnilam l hutapea jkn 11/2/2022 25,000 25,000 dislipidemia
46 Sekar wahyuning jkn 11/2/2022 25,000 25,000 dm . Ht
47 Harapan sijabat jkn 11/2/2022 25,000 25,000 sirosis hepatis
48 Rosmawani purba jkn 11/2/2022 25,000 25,000 ht
49 Yayuk sartika jkn 11/2/2022 25,000 25,000 dm . Ht
50 Rasma girsang jkn 11/2/2022 25,000 25,000 dm . Surve anemia
51 Elpina sianturi jkn 11/2/2022 25,000 25,000 pneumonia
52 Subandi jkn 11/2/2022 25,000 25,000 chf . Ppok . Dislipidemia
53 Mara sulaiman jkn 11/2/2022 25,000 25,000 dm . Ht
54 Romianna sinambela jkn 11/2/2022 25,000 25,000 dm . Pad
55 Neng eni jkn 11/2/2022 25,000 25,000 dm . Ht
56 M hanafiah jkn 11/2/2022 25,000 25,000 gout artritis . Dyspepsia
57 Neng jasimah jkn 11/2/2022 25,000 25,000 ht
58 Murni naibaho jkn 11/2/2022 25,000 25,000 chf ec hhd
59 Lasma uli simanjuntak jkn 11/2/2022 25,000 25,000 thypoid fever
60 Asmawati jkn 11/2/2022 25,000 25,000 dm . Ht
61 Rotua tampubolon jkn 11/2/2022 25,000 25,000 dm . Ht . Neuropati
62 Efendi nadeak jkn 11/2/2022 25,000 25,000 dm . Cad
63 Nurhappin jkn 11/2/2022 25,000 25,000 chf . Dm
64 Dedi asmana jkn 11/2/2022 25,000 25,000 ht . Urgency . Lbp
65 Elpina sembiring jkn 11/2/2022 25,000 25,000 ht . Cholelithiasis
66 Redingse simanjuntak jkn 11/2/2022 25,000 25,000 ht
67 Desi hidayah jkn 11/2/2022 25,000 25,000 autoimun . Anemia
68 Sumiati jkn 11/2/2022 25,000 25,000 vertigo
69 Budiman jkn 11/2/2022 25,000 25,000 ckf st iv + dm
70 Arba anum jkn 11/2/2022 25,000 25,000 dm . Ht et hhd
71 Mariantina saragih jkn 11/3/2022 25,000 25,000 dm . Ht
72 Syahrial jkn 11/3/2022 25,000 25,000 dm . Ht
73 Suriyono jkn 11/3/2022 25,000 25,000 dm . Ht
74 Orianidar hulu jkn 11/3/2022 25,000 25,000 dm . Ht . Pjk
75 Binsar marulak jkn 11/3/2022 25,000 25,000 dm . Ht
76 Mariduk sibagariang jkn 11/3/2022 25,000 25,000 dm . Pad
77 Leka ika situmorang jkn 11/3/2022 25,000 25,000 gerd
78 Minah jkn 11/3/2022 25,000 25,000 grave's disease
79 Edi sucipto jkn 11/3/2022 25,000 25,000 dm . Ht . Neuropati
80 Indra sakti jkn 11/3/2022 25,000 25,000 grave's disease
81 Nurlina etapani jkn 11/3/2022 25,000 25,000 dm . Ht . Gout artritis
82 Sarihar juni jkn 11/3/2022 25,000 25,000 ht st iii . Gout artritis
83 Nilawati hsb jkn 11/3/2022 25,000 25,000 dm . Ht . Pad
84 Tioria jkn 11/3/2022 25,000 25,000 dm . Ht . Gout artritis
85 Dewi agustini jkn 11/3/2022 25,000 25,000 grave's disease
86 Sunar jkn 11/3/2022 25,000 25,000 gerd
87 Suhendra jkn 11/3/2022 25,000 25,000 gerd
88 Rita j ompungsunggu jkn 11/3/2022 25,000 25,000 dyspepsia
89 Eliani jkn 11/3/2022 25,000 25,000 dm
90 Tapiara purba jkn 11/3/2022 25,000 25,000 dyspepsia
91 Ucok saragih jkn 11/3/2022 25,000 25,000 ht . Bsk et hidronefrosis
92 Ngatini jkn 11/3/2022 25,000 25,000 ht st iii . Gout artritis
93 Juniar jkn 11/3/2022 25,000 25,000 asma bronchiale . Snnt
94 Rahasiyah jkn 11/3/2022 25,000 25,000 dm . Ht
95 Normansyah nst jkn 11/3/2022 25,000 25,000 ht . Cholelithiasis
96 Legini jkn 11/3/2022 25,000 25,000 ht . Dislipidemia
97 Aboe samah jkn 11/3/2022 25,000 25,000 dm . Ht
98 Mariani tarigan jkn 11/3/2022 25,000 25,000 dm . Ht . Neuropati
99 Yus juliani jkn 11/3/2022 25,000 25,000 dm . Post stroke
100 Sri erlindawati jkn 11/3/2022 25,000 25,000 closed faktur
101 Sariah purba jkn 11/4/2022 25,000 25,000 bsk et hn . Gout artritis
102 Imdhani jkn 11/4/2022 25,000 25,000 dm . Neuropati . Bronchitis kronis
103 M adelin yahya jkn 11/4/2022 25,000 25,000 dm . Ht . Pad
104 Oscar hasibuan jkn 11/4/2022 25,000 25,000 dm . Ht
105 Ribut jkn 11/4/2022 25,000 25,000 ht . Hipertiroidisme
106 Fatimah jkn 11/4/2022 25,000 25,000 dm . Ht . Dislipidemia
107 Rika risma jkn 11/4/2022 25,000 25,000 dm . Bronchitis kronis
108 Arixan simbolon jkn 11/4/2022 25,000 25,000 gout artritis . Dyspepsia
109 Debora grace jkn 11/4/2022 25,000 25,000 bronchitis kronis . App kronis
110 Rolia jkn 11/4/2022 25,000 25,000 dm . Ht
111 Lumianna siregar jkn 11/4/2022 25,000 25,000 dm . Ht
112 Suratmi jkn 11/4/2022 25,000 25,000 ht . Dislipidemia
113 Bismar sitorus jkn 11/4/2022 25,000 25,000 chf ec hhd / ihd
114 Ely rahayu jkn 11/4/2022 25,000 25,000 grave's disease
115 Hasnah tarigan jkn 11/4/2022 25,000 25,000 ht . Gout artritis
116 Risman jkn 11/4/2022 25,000 25,000 dm . Ht
117 Watinah jkn 11/4/2022 25,000 25,000 ht . Dm . Dyspepsia
118 Zuraida jkn 11/8/2022 25,000 25,000 dm . Tb . Neuropati
119 Joko mulyanto jkn 11/8/2022 25,000 25,000 psmbb + hemoroid
120 Arba anum jkn 11/8/2022 25,000 25,000 dm + ht
121 Mhd rahmat silangit jkn 11/8/2022 25,000 25,000 abdominal pain
122 Luminar sihombing jkn 11/8/2022 25,000 25,000 dm + lbp
123 Jumini jkn 11/8/2022 25,000 25,000 post dhf
124 Renaty bakara jkn 11/8/2022 25,000 25,000 ckd st v
125 Amir girsang jkn 11/9/2022 25,000 25,000 dm . Ht . Pad
126 Subambang sutrisno jkn 11/9/2022 25,000 25,000 chf ec hhd
127 Dahliana jkn 11/9/2022 25,000 25,000 hematesis
128 Ahmad solihin jkn 11/9/2022 25,000 25,000
129 Budi ketaren jkn 11/9/2022 25,000 25,000 dm . Ht et hhd . Dislipidemia
130 Chairil anwar jkn 11/9/2022 25,000 25,000 dm . Ht . Dislipidemia
131 T rafika jkn 11/9/2022 25,000 25,000 dm
132 Demu meliala jkn 11/9/2022 25,000 25,000 dm . Ht
133 Romauli simarmata jkn 11/9/2022 25,000 25,000 dm . Ht . Pad
134 Renti diana boang jkn 11/9/2022 25,000 25,000 dm . Ht . Dyspepsia
135 Ingansip purba jkn 11/9/2022 25,000 25,000 dm . Ht . Neuropati
136 Rusmin purba jkn 11/9/2022 25,000 25,000 ht . Ppok . Bph
137 Marto diharjo jkn 11/9/2022 25,000 25,000 dm
138 Sustini jkn 11/9/2022 25,000 25,000 dm . Ht . Ckd st iv
139 Ambo jkn 11/9/2022 25,000 25,000 ppok
140 Nita salina jkn 11/9/2022 25,000 25,000 dm . Ht . Dislipidemia
141 Mulyani jkn 11/9/2022 25,000 25,000 dm . Ht . Gout artritis
142 Rasmiani jkn 11/9/2022 25,000 25,000 dm . Ht
143 Nermita simbolon jkn 11/9/2022 25,000 25,000 ht . Oa genu
144 Nurhayati jkn 11/9/2022 25,000 25,000 dm . Ht et hhd
145 Nurli br sirait jkn 11/9/2022 25,000 25,000 dm
146 Tioranta br saragih jkn 11/9/2022 25,000 25,000 dm . Ht . Post stroke
147 Suriyanti jkn 11/9/2022 25,000 25,000 ht et hhd
148 Mainar suryati jkn 11/9/2022 25,000 25,000 dm . Lbp . Oa genu
149 Mulasi turnip jkn 11/10/2022 25,000 25,000 dm . Ht . Neuropati
150 Dedy jkn 11/10/2022 25,000 25,000 dm . Ht
151 Linda siringoringo jkn 11/10/2022 25,000 25,000 ht . Gout artritis . Dislipidemia
152 Fransiska jkn 11/10/2022 25,000 25,000 hipertiroidisme
153 Sulaiman jkn 11/10/2022 25,000 25,000 chf ec hhd / ihd
154 Ertan pasaribu jkn 11/10/2022 25,000 25,000 dm . Pad
155 Suwira yansyah jkn 11/10/2022 25,000 25,000 dm
156 Junaden sinaga jkn 11/10/2022 25,000 25,000 cholelithiasis
157 Saginarti jkn 11/10/2022 25,000 25,000 dm . Neuropati . Ht
158 Muzakir h jkn 11/10/2022 25,000 25,000 dm . Neuropati
159 Dinasti rumapea jkn 11/10/2022 25,000 25,000 grave's disease
160 Robert mazmur jkn 11/10/2022 25,000 25,000 dm . Gout artritis
161 Ponimah jkn 11/10/2022 25,000 25,000 dm . Ht . Neuropati
162 Sunario jkn 11/10/2022 25,000 25,000 pneumonia . Bsk
163 Paenah jkn 11/10/2022 25,000 25,000 dm . Ht . Neuropati
164 Ramena br simanjuntak jkn 11/10/2022 25,000 25,000 dm . Ht . Dislipidemia
165 Mika palentina jkn 11/10/2022 25,000 25,000 thypoid fever
166 Tiara situmorang jkn 11/10/2022 25,000 25,000 dm
167 Minsen tarigan jkn 11/10/2022 25,000 25,000 ht . Oa genu . Gout artritis
168 Rugun aritonang jkn 11/10/2022 25,000 25,000 ht . Oa genu
169 Zurniati jkn 11/10/2022 25,000 25,000 dm . Ht
170 Susi indrayani jkn 11/10/2022 25,000 25,000 dm . Ht . Neuropati
171 Manna dame jkn 11/10/2022 25,000 25,000 dm . Ht
172 Suwandi jkn 11/10/2022 25,000 25,000 ht . St iii
173 Novi karmila jkn 11/10/2022 25,000 25,000 ht st iii . Oa genu
174 Kompak siahaan jkn 11/10/2022 25,000 25,000 muscle spain
175 Sri mulyati jkn 11/10/2022 25,000 25,000 dm . Ht
176 Nurgini jkn 11/10/2022 25,000 25,000 dm . Ht . Neuropati
177 Jamilah jkn 11/10/2022 25,000 25,000 ht . Dislipidemia
178 Denny dharmawan jkn 11/10/2022 25,000 25,000 thypoid fever
179 Edi maret sitepu jkn 11/10/2022 25,000 25,000 ht . Bsk . Gout artritis
180 Ratna malenti jkn 11/10/2022 25,000 25,000 dm. Ht
181 Rostina gultom jkn 11/10/2022 25,000 25,000 ht . Dyspepsia
182 Christina jkn 11/10/2022 25,000 25,000 ht . Gerd
183 Rusfadillah jkn 11/10/2022 25,000 25,000 dm . Chf ec hhd / ihd
184 Suriyatik jkn 11/10/2022 25,000 25,000 dm
185 Rosmawati jkn 11/10/2022 25,000 25,000 dm . Ht . Neuropati
186 Jumingati jkn 11/10/2022 25,000 25,000 dm . Ht
187 Kasmini jkn 11/10/2022 25,000 25,000 dm . Ht et hhd
188 Sorta mannauli jkn 11/11/2022 25,000 25,000 dm . Ht
189 Saniati jkn 11/11/2022 25,000 25,000 dm . Ht . Neuropati
190 Laginem jkn 11/11/2022 25,000 25,000 hipertiroidisme
191 Safi'i jkn 11/11/2022 25,000 25,000 dm . Ht
192 Fitri muryani jkn 11/11/2022 25,000 25,000 bsk
193 Harlon silitonga jkn 11/11/2022 25,000 25,000 ht st iii . Chf
194 Watinah jkn 11/11/2022 25,000 25,000 ht . Dm . Dyspepsia
195 Mhd hadi jkn 11/11/2022 25,000 25,000 dm . Neuropati . Tb paru
196 Riahman rupinus jkn 11/11/2022 25,000 25,000 dm . Ht
197 Turah jkn 11/11/2022 25,000 25,000 dm . Chf
198 Ruminta sianturi jkn 11/11/2022 25,000 25,000 dm . Ppok
199 Dahlia jkn 11/11/2022 25,000 25,000 dm
200 Zulkarnain lubis jkn 11/11/2022 25,000 25,000 ht st iii . Bph
201 Ely rahayu jkn 11/11/2022 25,000 25,000 grave's disease . Ht
202 Eliani jkn 11/11/2022 25,000 25,000 dm
203 Juminem jkn 11/11/2022 25,000 25,000 ihd . Nefrolithiasis
204 Masdariyah nst jkn 11/11/2022 25,000 25,000 chf ec hhd / ihd
205 Rehgegehna ginting jkn 11/11/2022 25,000 25,000
206 Ngateni jkn 11/11/2022 25,000 25,000 dm . Ht
207 Fiktoria sitorus jkn 11/11/2022 25,000 25,000 cholelithiasis
208 Tugiyem jkn 11/11/2022 25,000 25,000 ht . Gout artritis
209 Mhd gazali hasan jkn 11/11/2022 25,000 25,000 dm . Sinusitis
210 Supriyatik jkn 11/11/2022 25,000 25,000 dm . ht
211 Herawati jkn 11/11/2022 25,000 25,000 dm . Pad . Ht
212 Sismawadi jkn 11/11/2022 25,000 25,000 gout artritis
213 Serta tambunan jkn 11/11/2022 25,000 25,000 ckd st v . Ht . Dm
214 Elisabet br purba jkn 11/11/2022 25,000 25,000 ht . Pjk . Neuropati
215 Marjiem jkn 11/11/2022 25,000 25,000 gout artritis . Ht . Sekulitis
216 Sri wahyuni jkn 11/14/2022 25,000 25,000 ht . Dislipidemia . Grave's disease
217 Esterlina harianja jkn 11/14/2022 25,000 25,000 cholelithiasis
218 Rakhmat nst jkn 11/14/2022 25,000 25,000 dm . Ht . Bph
219 Tianur sitorus jkn 11/14/2022 25,000 25,000 dm . Ht . Gout artritis
220 R p erawati siahaan jkn 11/14/2022 25,000 25,000 ht . Hipertiroid
221 Abd majid jkn 11/14/2022 25,000 25,000 dm
222 Karisman jkn 11/14/2022 25,000 25,000 dm . Ht . Neuropati
223 Imadhani jkn 11/14/2022 25,000 25,000 dm
224 Farida hanum jkn 11/14/2022 25,000 25,000 dm . Ht
225 Eka karya barus jkn 11/14/2022 25,000 25,000 dm . Gout artritis . Cad
226 Safsadar jkn 11/14/2022 25,000 25,000 dm . Ht . bph
227 Wagimin jkn 11/14/2022 25,000 25,000 dm . Ht
228 Muliani jkn 11/14/2022 25,000 25,000 dm . Pad . Ckd
229 Erpi sitompul jkn 11/14/2022 25,000 25,000 ht . Gout artritis
230 Martina sitohang jkn 11/14/2022 25,000 25,000 dm . Ht . Dislipidemia
231 Samaria agatha turnip jkn 11/14/2022 25,000 25,000 dm . Ht . Pad
232 Lamasi sigalingging jkn 11/14/2022 25,000 25,000 dm . Dislipidemia
233 Marlik jkn 11/14/2022 25,000 25,000 dm . Neuropati
234 Pujianto jkn 11/14/2022 25,000 25,000 dm . Ht . Dislipidemia
235 Kamini jkn 11/14/2022 25,000 25,000 chf ec hhd / ihd
236 Jono fredy jkn 11/14/2022 25,000 25,000 dm
237 Asmawardi jkn 11/14/2022 25,000 25,000 dm . Ht . Hhd
238 Tukijan jkn 11/14/2022 25,000 25,000 dm . Ht et hhd
239 Ellinamarat jkn 11/14/2022 25,000 25,000 dm . Ht
240 Lasti periati jkn 11/14/2022 25,000 25,000 post app
241 Selaniar purba jkn 11/14/2022 25,000 25,000 limfadenopati colli
242 Supriono jkn 11/14/2022 25,000 25,000 cml
243 Netty irawati jkn 11/14/2022 25,000 25,000 ht . Et hhd . Lendinitis
244 Regyna eka putri jkn 11/14/2022 25,000 25,000 grave's disease
245 Sugianto jkn 11/14/2022 25,000 25,000 dm . Pad
246 Umar sitorus jkn 11/14/2022 25,000 25,000 dm . Chf .bph
247 Sumiasih jkn 11/14/2022 25,000 25,000 ht . Dyspepsia
248 Renti butar butar jkn 11/14/2022 25,000 25,000 ht et ihd . Pneumonia
249 Maysaroh jkn 11/14/2022 25,000 25,000 hipertiroidisme
250 Rondang manurung jkn 11/14/2022 25,000 25,000 dm . Neuropati
251 Sari melda jkn 11/14/2022 25,000 25,000 dm
252 M syahril jkn 11/14/2022 25,000 25,000 tirotoksikosis
253 Henny purba jkn 11/14/2022 25,000 25,000 oa genu . Gout artritis
254 Legiatik jkn 11/14/2022 25,000 25,000 ht urgen . Dm
255 Rosmawati jkn 11/15/2022 25,000 25,000 dm . Ht et hhd . Gout artritis
256 Ade irma jkn 11/15/2022 25,000 25,000 dm . Ht
257 Siti walhidayah jambuk jkn 11/15/2022 25,000 25,000 dm . Ht .neuropati
258 Monika br sembiring jkn 11/15/2022 25,000 25,000 chf ec hhd
259 Sri rayani jkn 11/15/2022 25,000 25,000 dm .ht
260 Muller lumban gaol jkn 11/15/2022 25,000 25,000 dm . Chf ec hhd . Ppok
261 Amet jasin jkn 11/15/2022 25,000 25,000 ht . Susp . Bsk
262 Sriono jkn 11/15/2022 25,000 25,000 chf ec hhd
263 Muhibatulal jkn 11/15/2022 25,000 25,000 snnt
264 Awaluddin jkn 11/15/2022 25,000 25,000 ht . Gout artritis
265 Heri suryanto jkn 11/15/2022 25,000 25,000 dm . Cad . Post pci
266 Joko mulyanto jkn 11/15/2022 25,000 25,000 myalgia . Ht
267 Mhd hidayat jkn 11/15/2022 25,000 25,000 dm . Ht
268 Amos sembiring meliala jkn 11/15/2022 25,000 25,000 dm . Ht . Dislipidemia
269 Khairuddin hasibuan jkn 11/15/2022 25,000 25,000 ht .dm . Ckd
270 Esrom sipayung jkn 11/15/2022 25,000 25,000 ht et hhd . Pneumonia
272 Sukirman jkn 11/15/2022 25,000 25,000 dm . Ht .bph
273 Marsita br hombing jkn 11/15/2022 25,000 25,000 ht st iii
274 Yang julik jkn 11/15/2022 25,000 25,000 grave's disease
275 Sunariyo jkn 11/15/2022 25,000 25,000 dm . Hipertensi .dislipidemia
276 Bambang hariadi jkn 11/15/2022 25,000 25,000 grave's disease
277 Nur ainun jkn 11/15/2022 25,000 25,000 cholelithiasis . Nefrolithiasis
278 Saridah sipayung jkn 11/15/2022 25,000 25,000 ht . Gout artritis
279 Asmarania jkn 11/15/2022 25,000 25,000 dm
280 Mariani br sebayang jkn 11/15/2022 25,000 25,000 grave's disease
281 Redinase simanjuntak jkn 11/16/2022 25,000 25,000 ht
282 Awaluddin jkn 11/16/2022 25,000 25,000 dyspepsia
283 Romianna sinambela jkn 11/16/2022 25,000 25,000 dm . Pad
284 Muliatik jkn 11/16/2022 25,000 25,000 ht st iii . Dislipidemia
285 J luhut m manik jkn 11/16/2022 25,000 25,000 dm . Neuropati
286 Mhd hanafiah jkn 11/16/2022 25,000 25,000 ht
287 Efendi nadeak jkn 11/16/2022 25,000 25,000 dm . Cad
288 Nelly nurmawaty jkn 11/16/2022 25,000 25,000 grave's disease
289 Asmawati jkn 11/16/2022 25,000 25,000 dm . Ht
290 Indra sakti jkn 11/16/2022 25,000 25,000 grave's disease
291 Elpina sembiring jkn 11/16/2022 25,000 25,000 ht . Gad . Cholelithiasis
292 Leni armaya jkn 11/16/2022 25,000 25,000 grave's disease
293 Fatimah jkn 11/16/2022 25,000 25,000 dm . Ht
294 Rendy br batubara jkn 11/16/2022 25,000 25,000 ht . Sn . St iii
295 Jonggi pangaribuan jkn 11/16/2022 25,000 25,000 ht gout artritis
296 Rasma girsang jkn 11/16/2022 25,000 25,000 dm
297 Sumiati jkn 11/16/2022 25,000 25,000 asma bronchiale
298 Ambo jkn 11/16/2022 25,000 25,000 ht . Ppok
299 Sari hayati peranginangin jkn 11/16/2022 25,000 25,000 snnt
300 Mangihut sagala jkn 11/16/2022 25,000 25,000 dm . Dyspepsia
301 Pangihutan hasibuan jkn 11/16/2022 25,000 25,000 ht . Post stroke
302 Ridwan jkn 11/16/2022 25,000 25,000 dm . Ht . Neuropati
303 Renita bangun jkn 11/16/2022 25,000 25,000 grave's disease + ht
304 Siti saodah jkn 11/16/2022 25,000 25,000 grave's disease
305 Siti zainal jkn 11/16/2022 25,000 25,000 lbp ec hnp
306 Yuda bakti jkn 11/16/2022 25,000 25,000 dm
307 Rosma br sinaga jkn 11/17/2022 25,000 25,000 dislipidemia . Ht . Gout artritis
308 Raulina sitanggang jkn 11/17/2022 25,000 25,000 ht et tth . Dislipidemia
309 Indra sakti jkn 11/17/2022 25,000 25,000 dm . Ht et hhd . Myoma uteri
310 Nonna br nababan jkn 11/17/2022 25,000 25,000 dm . Neuropati
311 Sulaiman rangkuti jkn 11/17/2022 25,000 25,000 chf ec cpc / ihd . Ppok
312 Rona rumonda jkn 11/17/2022 25,000 25,000 ht . Dislipidemia
313 Rosmawati purba jkn 11/17/2022 25,000 25,000 ht . Bronchitis kronis
314 Endang wulandari jkn 11/17/2022 25,000 25,000 grave's disease
315 Idawati jkn 11/17/2022 25,000 25,000 dm . Ht . Dislipidemia
316 Seng liong jkn 11/17/2022 25,000 25,000 chf . Gout artritis
317 Rotua tampubolon jkn 11/17/2022 25,000 25,000 dm . Ht . Neuropati
318 Hj nilawati jkn 11/17/2022 25,000 25,000 dm . Ht . Neuropati
319 Sarihar juni jkn 11/17/2022 25,000 25,000 ht . Ckd st iv
320 Tapiara purba jkn 11/17/2022 25,000 25,000 ht . Dyspepsia
321 Dodi asmana jkn 11/17/2022 25,000 25,000 ht . Lbp
322 Ingantaras peranginangin jkn 11/17/2022 25,000 25,000 dm . Ht . Neuropati
323 Husni thamrin jkn 11/17/2022 25,000 25,000 dm . Ht et hhd
324 Liza evayanti jkn 11/17/2022 25,000 25,000 ht . Gout artritis . Post stroke
325 Seri tarigan jkn 11/17/2022 25,000 25,000 ht . Cholelithiasis . Dislipidemia
326 Franky sianturi jkn 11/17/2022 25,000 25,000 dyspepsia . Isk
327 Patar sihotang jkn 11/17/2022 25,000 25,000 gerd . Bph
328 Klara m sianturi jkn 11/17/2022 25,000 25,000 dm . Ht
329 Supar jkn 11/17/2022 25,000 25,000 gerd
330 Sudariati jkn 11/17/2022 25,000 25,000 dm . Hiperglikemia
331 Yus juliani jkn 11/17/2022 25,000 25,000 dm . Post stroke
332 Besli purba jkn 11/17/2022 25,000 25,000 dm . Ht
333 Bismark simarmata jkn 11/17/2022 25,000 25,000 ht et hhd
334 Hj roslaini jkn 11/17/2022 25,000 25,000 lbp ec hnp
335 Evita mariani jkn 11/17/2022 25,000 25,000 ppok . Dyspepsia
336 Aslimah jkn 11/17/2022 25,000 25,000 ht et hhd
337 Ruminta sianturi jkn 11/18/2022 25,000 25,000 dm . Ppok
338 Deliana pohan jkn 11/18/2022 25,000 25,000 dm . Ht
339 Renny lasma jkn 11/18/2022 25,000 25,000 dm . Ht
340 Ngatemi jkn 11/18/2022 25,000 25,000 dm . Ht . Cholelithiasis
341 Heriyanto jkn 11/18/2022 25,000 25,000 dm . Chf ec hhd
342 Ali sitepu jkn 11/18/2022 25,000 25,000 dm . Ht st iii
343 Supatmo jkn 11/18/2022 25,000 25,000 chf ec hhd / ihd
344 Fatimah jkn 11/18/2022 25,000 25,000 dm . Ht . Dislipidemia
345 Rika risma jkn 11/18/2022 25,000 25,000 dm . Bronchitis kronis
346 Suri purwanti jkn 11/18/2022 25,000 25,000 dm . Ht . Dislipidemia
347 Rustiyana sembiring jkn 11/18/2022 25,000 25,000 gastritis . Hipokalemi
348 Dinasti rumapea jkn 11/18/2022 25,000 25,000 grave's disease
349 Arixan simbolon jkn 11/18/2022 25,000 25,000 gout artritis . Dyspepsia
350 Sariah purba jkn 11/18/2022 25,000 25,000 bsk et hn . Gout atritis
351 Heni sulistiani jkn 11/18/2022 25,000 25,000 dm . Ht
352 Zainuddin siregar jkn 11/18/2022 25,000 25,000 dyspepsia
353 Ngaliyah jkn 11/21/2022 25,000 25,000 cholelithiasis . Ht
354 Marmini jkn 11/21/2022 25,000 25,000 dm . Ht
355 Makmur sipayung jkn 11/21/2022 25,000 25,000 ht . Gout artritis
356 Ani nuriati br purba jkn 11/21/2022 25,000 25,000 dm . Ht
357 Renata sibarani jkn 11/21/2022 25,000 25,000 dm
358 Dono jkn 11/21/2022 25,000 25,000 dm . Ckd . St
359 Misiani jkn 11/21/2022 25,000 25,000 dislipidemia
360 Sariaman sinambela jkn 11/21/2022 25,000 25,000 dm . Ht . Neuropati
361 Ponikem jkn 11/21/2022 25,000 25,000 dm . Ht
362 dr ok yulizal jkn 11/21/2022 25,000 25,000 dm . Ht
363 Khairani khudriah jkn 11/21/2022 25,000 25,000 ht . Dislipidemia
364 Mhd nur sugianto jkn 11/21/2022 25,000 25,000 dm . Pad . Ht
365 Saut halomoan jkn 11/21/2022 25,000 25,000 ht et ihd
366 Cintami wijaya jkn 11/21/2022 25,000 25,000 ht . Grave's disease
367 Sumarni jkn 11/21/2022 25,000 25,000 ht
368 Syamsiah jkn 11/21/2022 25,000 25,000 chf ec hhd / ihd . Dislipidemia
369 Edy susanto jkn 11/21/2022 25,000 25,000 dyspepsia tipe uxed
370 Asrul muis hsb jkn 11/21/2022 25,000 25,000 dm
371 Fitriyani jkn 11/21/2022 25,000 25,000 syndrom nefrotik
372 Zainuddin nst jkn 11/21/2022 25,000 25,000 ckd st v . Anemia
373 Selaniar purba jkn 11/21/2022 25,000 25,000 limfadenitis tb
374 Maysaroh jkn 11/21/2022 25,000 25,000 hipotiroidisme
375 Mhd syaiful jkn 11/21/2022 25,000 25,000 dm .ht
376 Ira bertua jkn 11/21/2022 25,000 25,000 dm
377 Loiren simatupang jkn 11/21/2022 25,000 25,000 dm
378 Restuti hasibuan jkn 11/21/2022 25,000 25,000 ht st iii
379 Hazatulo ziliwu jkn 11/21/2022 25,000 25,000 ht . Snnt
380 Pasto jkn 11/21/2022 25,000 25,000 ht . Ur gency ckd
381 Fresly talopa jkn 11/21/2022 25,000 25,000 hashimoto tiroidisme
382 Sumiyem jkn 11/21/2022 25,000 25,000 ckd st iv
383 Mena jkn 11/21/2022 25,000 25,000 dm . Pad
384 Sumariani jkn 11/21/2022 25,000 25,000 dm . Ht
385 Easti romaulida jkn 11/21/2022 25,000 25,000 grave's disease
386 Sarmina jkn 11/21/2022 25,000 25,000 ht . Hipotiroidisme
387 Siti nuriyah jkn 11/21/2022 25,000 25,000 dm . Ht . Gout artritis
388 Nurdin sembiring jkn 11/21/2022 25,000 25,000 dm . Ht
389 Drs bumi sagala jkn 11/21/2022 25,000 25,000 ht et hhd . Dislipidemia
390 Safruddin jkn 11/21/2022 25,000 25,000 dm . Ht . Neuropati
391 Regyna eka putri jkn 11/21/2022 25,000 25,000 grave's disease
392 Saut sigalingging jkn 11/21/2022 25,000 25,000 chf ec hhd
393 Sumiasih jkn 11/21/2022 25,000 25,000 ht . Gerd
394 Dewi maya embun jkn 11/22/2022 25,000 25,000 grave's disease
395 Amos sembiring jkn 11/22/2022 25,000 25,000 dm . Ht . Pneumonia
396 Mariani purba jkn 11/22/2022 25,000 25,000 chf . gout artritis . Hnp
397 Suriyawati jkn 11/22/2022 25,000 25,000 ht . snnt
398 Iswati jkn 11/22/2022 25,000 25,000 dm . Ht
399 Syamsuddin jkn 11/22/2022 25,000 25,000 ht . Nefrolithiasis
400 Joko mulyanto jkn 11/22/2022 25,000 25,000 ht . Oa genu . Gout artritis
401 Siti aminah jkn 11/22/2022 25,000 25,000 dm
402 Armet jasin jkn 11/22/2022 25,000 25,000 ht
403 Asnani jkn 11/22/2022 25,000 25,000 grave's disease . Ht
404 Purnama jkn 11/22/2022 25,000 25,000 dm . Ht . Oa genu
405 Ngadisem jkn 11/22/2022 25,000 25,000 ht . snnt
406 Marlina simarmata jkn 11/22/2022 25,000 25,000 grave's disease . Ht
407 Arni jkn 11/22/2022 25,000 25,000 chf ec hhd . Gout artritis
408 Jumini jkn 11/22/2022 25,000 25,000 ht et tth
409 Rustam butar butar jkn 11/22/2022 25,000 25,000 dm . Ht
410 Maria araventa jkn 11/22/2022 25,000 25,000 dm . Hipertiroidisme
411 Nelson sinurat jkn 11/22/2022 25,000 25,000 dm
412 Amir girsang jkn 11/23/2022 25,000 25,000 dm . Ht . pad
413 Pastina rumapea jkn 11/23/2022 25,000 25,000 thypoid fever . Ht . Dislipidemia
414 Hetty helena jkn 11/23/2022 25,000 25,000 dm . Ht
415 Marto diharjo jkn 11/23/2022 25,000 25,000 dm
416 Tioranta br saragih jkn 11/23/2022 25,000 25,000 dm . Ht . Post stroke
417 Mainar suryati jkn 11/23/2022 25,000 25,000 dm . Chf . Oa genu
418 Ingansip purba jkn 11/23/2022 25,000 25,000 dm . Ht . Neuropati
419 Siti saidah jkn 11/23/2022 25,000 25,000 hashimoto tiroidisme
420 Rasmaini jkn 11/23/2022 25,000 25,000 dm . Ht
421 Juniar sibarani jkn 11/23/2022 25,000 25,000 asma bronchiale . Snnt
422 Suryanti jkn 11/23/2022 25,000 25,000 ht et hhd
423 Sustini jkn 11/23/2022 25,000 25,000 dm . Ht . Ckd
424 Ampar tumanggor jkn 11/23/2022 25,000 25,000 bph . Ht
425 Wijayanti jkn 11/23/2022 25,000 25,000 sle
426 Nurmike sitorus jkn 11/23/2022 25,000 25,000 grave's disease
427 Pilem sembiring jkn 11/23/2022 25,000 25,000 ht
428 Sahbudi jkn 11/23/2022 25,000 25,000 ckd st iv + hipertiroid
429 Mhd gazali hasan jkn 11/23/2022 25,000 25,000 dm . Neuropati
430 Awaluddin jkn 11/23/2022 25,000 25,000 dyspepsia
431 T rafika jkn 11/23/2022 25,000 25,000 dm
432 Agian saragih jkn 11/23/2022 25,000 25,000 ht . Dipokalemia
433 Nurli br sirait jkn 11/23/2022 25,000 25,000 dm
434 Demu meliala jkn 11/23/2022 25,000 25,000 dm . Ht
435 Nita salina sianturi jkn 11/23/2022 25,000 25,000 dm . Ht . Dislipidemia
436 Suminah jkn 11/23/2022 25,000 25,000 anemia ocd + lbp dd hnp
437 Mulyani jkn 11/23/2022 25,000 25,000 dm . Ht
438 Siti zainal jkn 11/23/2022 25,000 25,000 hnp
439 Mulasi turnip jkn 11/24/2022 25,000 25,000 dm . Ht .neuropati
440 Chairullah harahap jkn 11/24/2022 25,000 25,000 dm . Ht . Dislipidemia
441 Risma magdalena jkn 11/24/2022 25,000 25,000 dm . Dislipidemia
442 Rugun aritonang jkn 11/24/2022 25,000 25,000 ht . Cholelithiasis . Gout
443 Dedy jkn 11/24/2022 25,000 25,000 dm . Ht
444 Minsen tarigan jkn 11/24/2022 25,000 25,000 ht .cholelithiasis
445 Ok isnainul, SH jkn 11/24/2022 25,000 25,000 dm . Ht
446 jumingati, s.pd jkn 11/24/2022 25,000 25,000 dm . Ht . Neuropati
447 yusmanidar jkn 11/24/2022 25,000 25,000 chf ec hhd . Oa genu
448 Samson jkn 11/24/2022 25,000 25,000 dm . Neuropati
449 Sumarni jkn 11/24/2022 25,000 25,000 ht . Dislipidemia
450 Saginarti jkn 11/24/2022 25,000 25,000 dm . Ht
451 Tulus marula rajagukguk jkn 11/24/2022 25,000 25,000 ht . Dislipidemia
452 Sutini jkn 11/24/2022 25,000 25,000 dm . ppok
453 Junaden sinaga jkn 11/24/2022 25,000 25,000 cholelithiasis
454 Suruhen sembiring jkn 11/24/2022 25,000 25,000 dm . Chf ec hhd
455 Hotmaida putri jkn 11/24/2022 25,000 25,000 snnt
456 Lena ika situmorang jkn 11/24/2022 25,000 25,000 gerd
457 Ertan pasaribu jkn 11/24/2022 25,000 25,000 dm . Ht . pad
458 Boinem br simarmata jkn 11/24/2022 25,000 25,000 dm . Ht . Gout artritis
459 Robert mazmur jkn 11/24/2022 25,000 25,000 dm . gout artritis
460 Sugeng ariadi jkn 11/24/2022 25,000 25,000 dm . Ht . pad
461 Baniyah jkn 11/24/2022 25,000 25,000 dm . Ht . Neuropati
462 H suparman jkn 11/24/2022 25,000 25,000 dm . Ht . Neuropati
463 Sakiyo jkn 11/24/2022 25,000 25,000 ht et hhd . Gout artritis
464 Monica intan jkn 11/24/2022 25,000 25,000 dm tipe i
465 Suriyani jkn 11/24/2022 25,000 25,000 grave's disease
466 Suroto jkn 11/24/2022 25,000 25,000 ht et hhd
467 Roket ginting jkn 11/24/2022 25,000 25,000 dm
468 Suriyatik jkn 11/24/2022 25,000 25,000 dm . Dyspepsia
469 Mhd jaya jkn 11/24/2022 25,000 25,000 poliuria
470 Mey wanna purba jkn 11/24/2022 25,000 25,000 post thypoid fever
471 Magihut sagala jkn 11/24/2022 25,000 25,000 dm . Dyspepsia
472 Sugito jkn 11/24/2022 25,000 25,000 ht et hhd . Gout artritis
473 Pansamotan marpaung jkn 11/24/2022 25,000 25,000 dyspepsia . Instalance elektrolit
474 Zurniati jkn 11/24/2022 25,000 25,000 dm . Ht . Neuropati
475 Ramena br simanjuntak jkn 11/24/2022 25,000 25,000 dm . Ht
476 Hj nilawati jkn 11/24/2022 25,000 25,000 dm . Ht . Neuropati
477 Kalimantan girsang jkn 11/24/2022 25,000 25,000 dm . Ht
478 Suratman jkn 11/24/2022 25,000 25,000 ht . St iii
479 Ahmad suhaimi jkn 11/24/2022 25,000 25,000 chf ec hhd / cpc . Ppok
480 Misriani jkn 11/24/2022 25,000 25,000 dm
481 Mhd hadi jkn 11/25/2022 25,000 25,000 dm . Neuropati . Tb paru
482 Saniati jkn 11/25/2022 25,000 25,000 dm . Ht . Neuropati
483 Nursyah iriandi sinaga jkn 11/25/2022 25,000 25,000 dm . Ht . Bph
484 Safii jkn 11/25/2022 25,000 25,000 dm . Ht
485 Muslim jkn 11/25/2022 25,000 25,000 dm . Ht
486 Eliani jkn 11/25/2022 25,000 25,000 dm
487 Suroso jkn 11/25/2022 25,000 25,000 bph . Bsk
488 Zuraida jkn 11/25/2022 25,000 25,000 dm . Ht
489 Riltadi jkn 11/25/2022 25,000 25,000 dm . Ht
490 Serta tambunan jkn 11/25/2022 25,000 25,000 ckd st v . Ht . Dm
491 Abd rahman jkn 11/25/2022 25,000 25,000 dm . Ht
492 Herawati jkn 11/25/2022 25,000 25,000 dm . Pad . Ht . Gout
493 Masdariyah nst jkn 11/25/2022 25,000 25,000 chf ec hhd . Ihd
494 Sismawadi jkn 11/25/2022 25,000 25,000 gout artritis
495 Ati yuniarti jkn 11/25/2022 25,000 25,000 chf ec ihd . Grave's disease
496 Ali sitepu jkn 11/25/2022 25,000 25,000 dm . Ht
497 Tugiyem jkn 11/25/2022 25,000 25,000 ht . Gout artritis
498 Marjiyem jkn 11/25/2022 25,000 25,000 gout artritis . Ht
499 Trisnawati jkn 11/25/2022 25,000 25,000 pneumonia . Ht
500 Yeni afriza jkn 11/25/2022 25,000 25,000 grave's disease . Chf
501 Sahara jkn 11/25/2022 25,000 25,000 dm . Ht
502 Elim purba jkn 11/25/2022 25,000 25,000 thypoid fever
503 Katryna tarihoran jkn 11/25/2022 25,000 25,000 grave's disease
504 Daimaini nst jkn 11/25/2022 25,000 25,000 ht
505 Heriati jkn 11/28/2022 25,000 25,000 ht . Dislipidemia . Hemoroid
506 Suwarni jkn 11/28/2022 25,000 25,000 dm . Ht . Dislipidemia
507 Abd majid jkn 11/28/2022 25,000 25,000 dm
508 Imdhani jkn 11/28/2022 25,000 25,000 dm
509 Mahyulina lubis jkn 11/28/2022 25,000 25,000 grave's disease
510 Wartini jkn 11/28/2022 25,000 25,000 dm . Ht . Dislipidemia
511 Silvana maggano jkn 11/28/2022 25,000 25,000 demu . Neuropati
512 Nursamin lbn toruan jkn 11/28/2022 25,000 25,000 dm . Dislipidemia
513 Kamini jkn 11/28/2022 25,000 25,000 chf ec hhd / ihd . Susp dut
514 Djemu kartolo jkn 11/28/2022 25,000 25,000 dm . Ht
515 Masud izhar jkn 11/28/2022 25,000 25,000 ht . Ckd st iv ec . Gout artritis
516 Legiatik jkn 11/28/2022 25,000 25,000 ht . Urgency . Dm
517 Rondang situmorang jkn 11/28/2022 25,000 25,000 dm . Neuropati
518 Marlik jkn 11/28/2022 25,000 25,000 dm . Neuropati
519 Rosita br damanik jkn 11/28/2022 25,000 25,000 hidronefrosis . Bsk
520 Panca teman tarigan jkn 11/28/2022 25,000 25,000 dm
521 Ramli jkn 11/28/2022 25,000 25,000 chf . Dyspepsia
522 Masnaria br sipayung jkn 11/28/2022 25,000 25,000 dyspepsia . Rhinitis
523 Romi andhika jkn 11/28/2022 25,000 25,000 bsk
524 Agustina gultom jkn 11/28/2022 25,000 25,000 dm . Ht
525 Tambah idayana jkn 11/28/2022 25,000 25,000 dyspepsia
526 Saidah br hasibuan jkn 11/28/2022 25,000 25,000 bsk
527 Vivi diana jkn 11/28/2022 25,000 25,000 dm
528 Arba anum jkn 11/28/2022 25,000 25,000 dm . Ht et hhd
529 Tukijan jkn 11/28/2022 25,000 25,000 dm . Ht et hhd
530 Renti butar butar jkn 11/28/2022 25,000 25,000 ht et hhd
531 Rini papana siregar jkn 11/28/2022 25,000 25,000 ht . Grave's disease
532 M syahril jkn 11/28/2022 25,000 25,000 tirotoksikosis
533 Lidia br malau jkn 11/28/2022 25,000 25,000 dm . Ht . Dislipidemia
534 Marliya jkn 11/28/2022 25,000 25,000 grave's disease . ht
535 Lenny maryon jkn 11/28/2022 25,000 25,000 dm
536 Sarwatik jkn 11/28/2022 25,000 25,000 ht . snnt
537 Erwin purnawiran jkn 11/28/2022 25,000 25,000 susp . Limfadenitis tb
538 Mhd nur sugianto jkn 11/28/2022 25,000 25,000 dm . Ht . pad
539 Onaria siringoringo jkn 11/28/2022 25,000 25,000 chf ec hhd
540 Agusap damanik jkn 11/28/2022 25,000 25,000 dm . Neuropati
541 Henny purba jkn 11/28/2022 25,000 25,000 oa genu . Gout artritis
542 Heriani jkn 11/29/2022 25,000 25,000 chf ec hhd . Dislipidemia
543 Siti walhidayah jambuk jkn 11/29/2022 25,000 25,000 dm . Ht
544 Suriyawati jkn 11/29/2022 25,000 25,000 ht . snnt
545 Ade irma jkn 11/29/2022 25,000 25,000 dm . Neuropati
546 Marsita br hombing jkn 11/29/2022 25,000 25,000 ht st iii
547 Sukirman jkn 11/29/2022 25,000 25,000 dm
548 Muller lumban gaol jkn 11/29/2022 25,000 25,000 dm . Chf ec hhd . Ppok
549 Syafruddin jkn 11/29/2022 25,000 25,000 dm . Insbalance elektrolit
550 Syamsuddin jkn 11/29/2022 25,000 25,000 nefrolithiasis . Ht
551 Sarman sitepu jkn 11/29/2022 25,000 25,000 ht . Gout artritis
552 Saut halomoan jkn 11/29/2022 25,000 25,000 ht st iii . Ihd
553 Irmayani jkn 11/29/2022 25,000 25,000 bsl . Ht
554 Herawaty jkn 11/29/2022 25,000 25,000 ht . Ispa
555 Esrom sipayung jkn 11/29/2022 25,000 25,000 ht et hhd
557 Mhd hidayat jkn 11/29/2022 25,000 25,000 dm . Ht .neuropati
558 Rahmawati jkn 11/29/2022 25,000 25,000 bzo
559 Asnani jkn 11/29/2022 25,000 25,000 grave's disease . ht
560 Candra lesmana jkn 11/29/2022 25,000 25,000 hipertiroidisme
561 Nurlela jkn 11/29/2022 25,000 25,000 dm . Ht
562 Rela guru singa jkn 11/29/2022 25,000 25,000 dm . Ht . Bph
563 Yunita sagala jkn 11/29/2022 25,000 25,000 ht . Post dhf
564 Saridah sipayung jkn 11/29/2022 25,000 25,000 ht . Gout artritis
565 Ngadisem jkn 11/29/2022 25,000 25,000 ht . snnt
566 Nurman jkn 11/29/2022 25,000 25,000 dm . Ht
567 Boniyem jkn 11/29/2022 25,000 25,000 dm . Ht . Dyspepsia
568 Nurmalina jkn 11/29/2022 25,000 25,000 grave's disease
569 Sari melati jkn 11/29/2022 25,000 25,000
570 Jariah jkn 11/29/2022 25,000 25,000 ht
571 Muliatik jkn 11/30/2022 25,000 25,000 ht st iii . Dislipidemia
572 Redingse simanjuntak jkn 11/30/2022 25,000 25,000 ht
573 Rasma girsang jkn 11/30/2022 25,000 25,000 dm . Gout artritis
574 Fatimah jkn 11/30/2022 25,000 25,000 dm . Ht
575 Rasida sitohang jkn 11/30/2022 25,000 25,000 grave's disease . Ht . Dyspepsia
576 Khairuddin hasibuan jkn 11/30/2022 25,000 25,000 dm . Ht . Ckd st iv . Gout
577 Jansen siagian jkn 11/30/2022 25,000 25,000 dm . Ht . Ppok
578 Nurhani tampubolon jkn 11/30/2022 25,000 25,000 post thypoid fever . Lbp
579 M yusup tami uma jkn 11/30/2022 25,000 25,000 ibd
580 Yuda bakti jkn 11/30/2022 25,000 25,000 dm . Gout artritis
581 Salmira yunsin jkn 11/30/2022 25,000 25,000 grave's disease
582 Sri ulandari jkn 11/30/2022 25,000 25,000 dm . Ht . Hipotensi
583 Rismaida nainggolan jkn 11/30/2022 25,000 25,000 dm . Ht . Myalgia
584 Iswahyuni jkn 11/30/2022 25,000 25,000 ht . Aps ccs ii . Dislipidemia
585 Kurniawan nst jkn 11/30/2022 25,000 25,000 dm . Neuropati
586 Suminah jkn 11/30/2022 25,000 25,000 anemia . Lbp
587 Subandi jkn 11/30/2022 25,000 25,000 chf . Ppok . Dislipidemia
588 Rosmawati jkn 11/30/2022 25,000 25,000 dm . Ht . Et hhd . Gout
589 Rosid, s.ag jkn 11/30/2022 25,000 25,000 dm . Pad
590 Rina febriani jkn 11/30/2022 25,000 25,000 gerd gad
591 Tionar simarmata umum 11/30/2022 40,000 40,000 myalgia . Dislipidemia
592 Elpina sembiring jkn 11/30/2022 25,000 25,000 cholelithiasis . ht
Total - 9,400,000 40,000 9,440,000
Lubuk Pakam, November 2022 Diketahui Oleh: Kalkulasi Penggajian / Honor:

Ka. Keuangan Direktur RS Rawat Inap:
Umum 360,000
Rawat Jalan:
Melki Tampubolon, SE dr. Arifin P Sitompul Umum 40,000 +

Total 400,000
Potongan ke RS 10 % 40,000 -
Penerima; Rawat Inap BPJS 19,072,873
Rawat Jalan BPJS 9,400,000 +
Pendaptan Honor 28,832,873
Pajak (TAX) 5 % 1,441,644 -
dr. Yanika Sitanggang,Sp.PD Honor Bruto 27,391,230
Transportasi - +
Total Honor Diterima 27,391,230
Total Bill
2,288,750
1,596,250
2,061,250
881,250
6,827,500
dr. Wirandi Dalimunthe, Sp.PD
Rekapitulasi Pasien
Bulan Desember 2023

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Visite HD/Visite Sub total Diagnosa
1 Febri Winata 117016 Umum KLS III 2/15/2024 2/17/2024 3 40,000 120,000 Sepsis
2
3
4
5
6
-
Total 0 120,000
2. Rawat Inap BPJS

1 Jem Mulianta Saragih (Paps 116598 BPJS KLS III 2/1/2024 2/1/2024 1,499,200 149,920 Abd
2 Rusman Asal Gorat Sinaga 116596 BPJS KLS III 1/31/2024 2/1/2024 2,915,200 145,760 TB Paru dr. Dian,SpP
3 RonCharly Tambunan 116585 BPJS KLS III 1/31/2024 2/2/2024 2,292,400 229,240 Thypoid
4 Sri Hayana 116597 BPJS KLS III 1/31/2024 2/2/2024 2,119,000 211,900 HT
5 Putri Febrianti 112905 BPJS Klas II 1/29/2024 2/2/2024 2,670,600 267,060 Thypoid
6 Daud 116592 BPJS KLS III 1/31/2024 2/2/2024 1,652,000 165,200 Abd
7 Ingan Malem Br Sembiring 116578 BPJS Klas II 1/31/2024 2/2/2024 1,924,500 192,450 Abd
8 Annisa Putri 116540 BPJS KLS III 1/30/2024 2/2/2024 2,855,900 285,590 Dengue Haemoroid
9 Novia Wulan Sari 116591 BPJS KLS III 1/31/2024 03/02/2024 3,650,900 182,545 Pneumonia dr. Dian,SpP
10 Suwarni 116312 BPJS KLS III 1/22/2024 03/02/2024 32,673,700 1,089,123 CHF+PSMBA+TB 'dr. Dian,SpP+dr. Marolop,SpJ
11 Maniyah 055029 BPJS KLS III 1/31/2024 03/02/2024 2,429,700 242,970 Anemia
12 Lian Nasution 048503 BPJS KLS III 1/31/2024 03/02/2024 2,292,400 229,240 DM
13 Supardi 080751 BPJS KLS III 1/31/2024 03/02/2024 3,648,700 364,870 Thypoid
14 Yusraini Hasibuan 116784 BPJS Kelas I 2/5/2024 08/02/2024 3,048,900 304,890 Thypoid
15 Donna Harianja 58265 BPJS Klas II 2/5/2024 08/02/2024 4,250,700 212,535 Thypoid dr. Jekson,Sp.OG
16 Bertha Fransiska Manurun 053033 BPJS KLS III 2/5/2024 08/02/2024 2,292,400 229,240 Thypoid
17 Julianto 116855 BPJS KLS III 2/7/2024 09/02/2024 2,292,400 229,240 Thypoid
18 Syaputra 116783 BPJS KLS III 2/5/2024 09/02/2024 2,855,900 285,590 DHF
19 Yudha Safira Tanjung 116844 BPJS Klas II 2/7/2024 09/02/2024 3,327,200 332,720 Thypoid
20 Milan Sitepu 116836 BPJS KLS III 2/7/2024 09/02/2024 3,598,700 179,935 Pneumonia dr. Dian,SpP
21 Supario 116940 BPJS KLS III 2/11/2024 2/12/2024 2,451,400 81,713 Stroke+Af 'dr. Lisbeth,SpS+dr. Marolop,SpJ
22 Jenda Ingan Pulung Barus 116937 BPJS Klas II 2/11/2024 2/13/2024 2,468,600 246,860 Colic Abd
23 Nursana Siregar 116941 BPJS KLS III 2/11/2024 2/13/2024 2,747,000 137,350 Penurunan Kesadaran dr. Lisbeth,SpS
24 Rita Wati 116942 BPJS Kelas I 2/11/2024 2/13/2024 3048900 304,890 Thypoid
25 Regi Armansyah 116935 BPJS KLS III 2/11/2024 2/13/2024 2,855,900 285,590 Thypoid
26 Sakinah 116837 BPJS KLS III 2/7/2024 2/13/2024 3,416,300 341,630 Thypoid
27 Merry Sitanggang 5702 BPJS KLS III 2/11/2024 2/14/2024 2,155,900 107,795 Dyspepsia dr. Lisbeth,SpS
28 Afridanis 101281 BPJS KLS III 2/12/2024 15/02/2024 3,000,100 100,003 LBP+Colic Abd 'dr. Lisbeth,SpS+dr. Dian,SpP
29 Budi Harianto 116512 BPJS KLS III 2/12/2024 15/02/2024 2,292,400 229,240 Thypoid
30 Nurmeilisa 116948 BPJS KLS III 2/12/2024 15/02/2024 5,811,400 193,713 CHF+Efusi Pleura 'dr. Desmon,SpP+dr. Marolop,SpJ
31 Sutiah 115413 BPJS KLS III 2/14/2024 15/02/2024 2,429,700 242,970 Anemia
32 Suyati 113829 BPJS KLS III 2/11/2024 2/16/2024 2,119,000 211,900 Dyspepsia
33 Rizki Nur Ajrina 101171 BPJS KLS III 2/12/2024 2/16/2024 1,652,000 165,200 Colic Abd
34 Tri Sarana Andriani 117015 BPJS Kelas I 2/14/2024 2/16/2024 2,197,100 219,710 Colic Abd
35 Rima Afni 117014 BPJS KLS III 2/14/2024 2/16/2024 4,381,700 219,085 TB Paru dr. Dian,SpP
36 Ismi Syahara 115139 BPJS KLS III 2/14/2024 2/17/2024 2,292,400 229,240 Thypoid
37 Rasni Br Purba 117046 BPJS KLS III 2/15/2024 2/19/2024 4,077,800 203,890 Stroke dr. Lisbeth,SpS
38 Anggi Natasya 116977 BPJS KLS III 2/12/2024 2/19/2024 2,855,900 285,590 Thypoid
39 Suarni 62585 BPJS KLS III 18/02/2024 2/21/2024 1,652,000 165,200 Dyspepsia
40 Ponirin 117112 BPJS KLS III 18/02/2024 2/21/2024 1,652,000 165,200 Dyspepsia
41 Ridwan Lubis 65788 BPJS KLS III 2/19/2024 2/21/2024 2,292,400 114,620 Thypoid dr. Dian,SpP
42 Redamen 72375 BPJS Klas II 2/19/2024 2/22/2024 2468600 246,860 Colic Abd
43 Della Puspita 100753 BPJS Klas II 2/19/2024 2/22/2024 1652000 165,200 Colic Abd
44 Sabarudin 098853 BPJS KLS III 2/19/2024 2/23/2024 5,130,400 256,520 Pneumonia dr. Desmon,SpP
45 Arihta Br Purba 117156 BPJS KLS III 2/20/2024 2/23/2024 1,652,000 165,200 Colic Abd
46 Ernestin Gurning 111874 BPJS Klas II 2/21/2024 24/2/2024 2,670,600 267,060 Thypoid
47 Supinah 117183 BPJS KLS III 2/21/2024 24/2/2024 2,292,400 229,240 Thypoid
48 Samiun 117111 BPJS KLS III 2/18/2024 24/2/2024 6,486,700 324,335 Pneumonia dr. Desmon,SpP
49 Eka Kurnia Wati 46450 BPJS Klas II 2/21/2024 25/02/2024 5,439,000 543,900 Thypoid
50 Rasdayani 99302 BPJS Klas II 26/02/2024 2/27/2024 1,746,500 174,650 Nephrolithiasis
51 Riandi Damanik 117197 BPJS Klas II 2/21/2024 2/27/2024 4,006,100 400,610 Thypoid
52 Ratna Citra Dewi 117330 BPJS KLS III 26/02/2024 2/28/2024 2,991,100 299,110 Allergic
53 Murniati Hutabarat 117303 BPJS KLS III 26/02/2024 2/28/2024 2,292,400 229,240 Thypoid
54 Sareng 117343 BPJS KLS III 26/02/2024 2/29/2024 3,650,900 121,697 Pneumonia 'dr.Heri,SpB+dr. Dian,SpP
55 Anijah 112679 BPJS KLS III 26/02/2024 29/02/2024 2,429,700 242,970 Colic Abd
56
57
58
-
Total 187,048,700 13,448,000
1. Rawat Inap Pasien Covid

1 120 150,000 18,000,000
2 -
3 -
-
Total 120 18,000,000

3. Rawat Jalan
1 Mulainim turnip jkn 11/1/2022 25,000 25,000 ht . Cholelithiasis
2 Jayam sembiring jkn 11/1/2022 25,000 25,000 ht . Oa genu
3 Lerpianna saragih jkn 11/1/2022 25,000 25,000 ht . Vertigo
4 Lie siu seng jkn 11/1/2022 25,000 25,000 ht . Cholelithiasis
5 Rasmiani jkn 11/1/2022 25,000 25,000 dm
6 Drs tagor jkn 11/1/2022 25,000 25,000 ht . Dyspepsia
7 Gusti andriani jkn 11/1/2022 25,000 25,000 ht + dyspepsia
8 Ricard fernando bangun jkn 11/1/2022 25,000 25,000 colic abdomen
9 Tiorli sigiro jkn 11/1/2022 25,000 25,000 gout artritis . Ht
10 Rianto saragih jkn 11/1/2022 25,000 25,000 dm
11 Morhen turnip jkn 11/1/2022 25,000 25,000 dm . Ht
12 Sunarsih jkn 11/1/2022 25,000 25,000 oa genu dextra
13 Hemat tarigan jkn 11/1/2022 25,000 25,000 gout artritis + ge
14 M helianto jkn 11/1/2022 25,000 25,000 chf ec hhd
15 Ely syafrida jkn 11/1/2022 25,000 25,000 dm . Ht
16 Saminah jkn 11/1/2022 25,000 25,000 nefrolithiasis
17 Misiani jkn 11/3/2022 25,000 25,000 ht + dyspepsia + pad
18 Marlin barus jkn 11/3/2022 25,000 25,000 psmba
19 Eko ferdinan sitohang jkn 11/3/2022 25,000 25,000 sirosis hepatis
20 Supartik jkn 11/3/2022 25,000 25,000 hiperglikemia + dm type 2 + ht + snt
21 Mardiah jkn 11/3/2022 25,000 25,000 dm + ht
22 Netty jkn 11/3/2022 25,000 25,000 chf
23 Sya harsalan pohan jkn 11/3/2022 25,000 25,000 ht + lbp
24 Santia ria napitupulu jkn 11/3/2022 25,000 25,000 ht + neoralsia
25 Pella marrie warda jkn 11/3/2022 25,000 25,000 dm type 2 + ht + psk
26 Eva muchayani jkn 11/3/2022 25,000 25,000 grave's disease
27 Juniaty jkn 11/3/2022 25,000 25,000 grave's disease
28 Nevi yanti jkn 11/3/2022 25,000 25,000 dm
29 Warsini jkn 11/4/2022 25,000 25,000 ht
30 Patia panjaitan jkn 11/4/2022 25,000 25,000 gout artritis
31 Luminta butar butar jkn 11/4/2022 25,000 25,000 dm
32 Nurjanah saragih jkn 11/4/2022 25,000 25,000 cholelithiasis
33 Arlina tanjung jkn 11/4/2022 25,000 25,000 dm . Anemia . Tb paru
34 Kasiadi jkn 11/7/2022 25,000 25,000 hep . B kronik
35 Yulisnawati jkn 11/7/2022 25,000 25,000 ht . Dyspepsia
36 Eriady st jkn 11/7/2022 25,000 25,000 dm . ht
37 Hermanto gultom jkn 11/7/2022 25,000 25,000 dm . Ht . Neuropati
38 Fidri ananda jkn 11/7/2022 25,000 25,000 tumor mediastinum
39 Mena jkn 11/7/2022 25,000 25,000 dm . Pad
40 Usman jkn 11/7/2022 25,000 25,000 chf ec hhd . Ppok
41 Suriyatik jkn 11/7/2022 25,000 25,000 dm
42 Lisnawati jkn 11/7/2022 25,000 25,000 chf gt iii ec hhd
44 Ratma rata sianipar jkn 11/7/2022 25,000 25,000 isk + lbp
45 Kamini jkn 11/7/2022 25,000 25,000 pneumonia . Chf
46 Sangapan alfred jkn 11/7/2022 25,000 25,000 dyspepsia
47 Yustino jkn 11/7/2022 25,000 25,000 dm . Ht . Neuropati
48 Jumiati jkn 11/7/2022 25,000 25,000 dm . Neuropati
49 Zulaicha jkn 11/7/2022 25,000 25,000 dm . Ht
50 Yunita armani jkn 11/7/2022 25,000 25,000 myoma uteri
51 Michael steven jkn 11/7/2022 25,000 25,000 pneumonia
52 Sugriwa suwandhi jkn 11/8/2022 25,000 25,000 chf
53 Tiurlam br sitorus jkn 11/8/2022 25,000 25,000 haemoroid interna + dyspepsia
54 Siti sibuea jkn 11/8/2022 25,000 25,000 ht . Dislipidemia
55 Betty napitupulu jkn 11/8/2022 25,000 25,000 grave's disease
56 Marsini jkn 11/8/2022 25,000 25,000 chf + dm
57 Wagiyem jkn 11/8/2022 25,000 25,000 ht . Dyspepsia
58 Ratnauli situmeang jkn 11/8/2022 25,000 25,000 dm + pad
59 Zuraida jkn 11/8/2022 25,000 25,000 grave's disease
60 Rospita r tarigan jkn 11/8/2022 25,000 25,000 dm . Ht . Dyspepsia
61 Gusti andriani jkn 11/8/2022 25,000 25,000 ht . Dyspepsia
62 Barmen parulian jkn 11/8/2022 25,000 25,000 diperglikemia + dm type 2
63 Junaedi jkn 11/8/2022 25,000 25,000 thypoid fever + colic abdomen
64 Astri parhusip jkn 11/8/2022 25,000 25,000 dm . Ht . Pad
65 Joni jkn 11/8/2022 25,000 25,000 dm
66 Nurhapsah lubis jkn 11/10/2022 25,000 25,000 ht
67 Bona br saragih jkn 11/10/2022 25,000 25,000 dm . Ht
68 Ria rosmida panggabean jkn 11/10/2022 25,000 25,000 ht + neuropati
69 Haruddin batubara jkn 11/10/2022 25,000 25,000 gastritis
70 Hotman siahaan jkn 11/10/2022 25,000 25,000 dm . Pad . Stroke
71 Ira kristini sihotang jkn 11/10/2022 25,000 25,000 thypoid
72 Edwin jkn 11/10/2022 25,000 25,000 thypoid
73 Hartiningsih jkn 11/10/2022 25,000 25,000 dm type 2 + chf
74 Susilawati jkn 11/11/2022 25,000 25,000 dm . Neuropati
75 Sabariah cik jkn 11/11/2022 25,000 25,000 dm
76 Abdul hasbi jkn 11/11/2022 25,000 25,000 grave's disease
77 Nurlaila purba jkn 11/11/2022 25,000 25,000 asma + dyspepsia
78 Sulastri jkn 11/11/2022 25,000 25,000 rhemautoid . Arthritis
79 Lusiana sinaga jkn 11/11/2022 25,000 25,000 colic abdomen . Pjk
80 Sumihar sibarani jkn 11/11/2022 25,000 25,000 cholelithiasis
81 Magian jkn 11/11/2022 25,000 25,000 cholelithiasis . Ht . Dm
82 Rejekina sianipar jkn 11/11/2022 25,000 25,000 grave's disease
83 Iwan nugroho jkn 11/15/2022 25,000 25,000 dm type 2 + dyslipidemia
84 Ruliah jkn 11/15/2022 25,000 25,000 hepatomegaly + sludge gd + ht
85 Irawati jkn 11/15/2022 25,000 25,000 hepatomegaly + ht + psmb
86 Marhen turnip jkn 11/15/2022 25,000 25,000 dm type 2 + ht
87 Boniyem jkn 11/15/2022 25,000 25,000 hyperglikemia + dm . Ht
88 Suwartika miranti jkn 11/15/2022 25,000 25,000 cholelithiasis . Multiple
89 Pariaman siregar jkn 11/15/2022 25,000 25,000 ht + ppok
90 Kristina nova jkn 11/15/2022 25,000 25,000 grave's disease
91 Joni jkn 11/15/2022 25,000 25,000 dm
92 Jayam sembiring jkn 11/15/2022 25,000 25,000 ht + oa
93 Lerpianna saragih jkn 11/15/2022 25,000 25,000 ht + vertigo
94 Pertanda sembiring jkn 11/15/2022 25,000 25,000 thypoid fever
96 Hiramawati nst jkn 11/15/2022 25,000 25,000 gerd
97 Luhut sigalingging jkn 11/15/2022 25,000 25,000 ht . Dyspepsia
98 Tandean tarigan jkn 11/15/2022 25,000 25,000 ckd st iv . Ht
99 Nurinsan jkn 11/15/2022 25,000 25,000 thypoid fever
101 Ely syafrida jkn 11/15/2022 25,000 25,000 dm . Ht + dyspepsia
102 Abd mahan bangun jkn 11/17/2022 25,000 25,000 dm type 2 + neuropati
103 Astina panjaitan jkn 11/17/2022 25,000 25,000 colic abdomen + ht
104 Masem jkn 11/17/2022 25,000 25,000 chf ec cad
106 Mardiah jkn 11/17/2022 25,000 25,000 dm . Ht
107 Supartik jkn 11/17/2022 25,000 25,000 dm . Ht
108 Marlina tuti jkn 11/17/2022 25,000 25,000 thypoid fever + pneumonia
109 Sontiria napitupulu jkn 11/17/2022 25,000 25,000 dyspepsia
110 Netty jkn 11/17/2022 25,000 25,000 chf ec hhd
112 Pella marrie warda jkn 11/17/2022 25,000 25,000 dm . Ht . Pjk
113 Sarmaini jkn 11/17/2022 25,000 25,000 dm . Ht . pad
115 Rika herdaria jkn 11/17/2022 25,000 25,000 dyspepsia
116 Siti aminah jkn 11/18/2022 25,000 25,000 oa genu sinistra
117 Ramot br sinaga jkn 11/18/2022 25,000 25,000 cholelithiasis
119 Siti rumini jkn 11/18/2022 25,000 25,000 dm + ht
120 Maslina dharmawati jkn 11/18/2022 25,000 25,000 dm . Ht . pad
121 Saniyah jkn 11/18/2022 25,000 25,000 dm . Ht . Neuropati
122 Mutiara simbolon jkn 11/18/2022 25,000 25,000 dm . Pjk . Ht
123 Nuraini siregar jkn 11/18/2022 25,000 25,000 dm type 2 . Dyspepsia
124 Dumekta br ginting jkn 11/18/2022 25,000 25,000 ht . Pjk
125 Puji rahdita jkn 11/18/2022 25,000 25,000 bronchitis
126 Sugiwa suwandhi jkn 11/22/2022 25,000 25,000 chf ec cad
127 Kadem tarigan jkn 11/22/2022 25,000 25,000 post hypoglikemia . Dm . Ht
128 Liliani jkn 11/22/2022 25,000 25,000 dhf . Dyspepsia
129 Gusti andriani jkn 11/22/2022 25,000 25,000 ht . Dyspepsia . Neuropati
130 Diana sari muliani jkn 11/22/2022 25,000 25,000 post ge akut
131 Rospitalawati jkn 11/22/2022 25,000 25,000 dm type 2
132 Sri awan jkn 11/22/2022 25,000 25,000 cholelithiasis + netroliasis
133 Masriana jkn 11/22/2022 25,000 25,000 dm . Ht . Anemia
135 Jariah jkn 11/22/2022 25,000 25,000 colic abd + ht
136 Jimsoni sinaga jkn 11/22/2022 25,000 25,000 susp appendictis acute
137 Barmen parulian jkn 11/22/2022 25,000 25,000 hiperglikemia + dm
138 Astri parhusip jkn 11/22/2022 25,000 25,000 dm . Ht
139 Ratnauli situmeang jkn 11/22/2022 25,000 25,000 dm . Pad
140 Hartiningsih jkn 11/24/2022 25,000 25,000 dm . Chf ec hhd
141 Mangaraja enda jkn 11/24/2022 25,000 25,000 chf hhd
142 Elpina sianturi jkn 11/24/2022 25,000 25,000 post ge akut
143 Muliono pardede jkn 11/24/2022 25,000 25,000 dm type 2
144 Hotman siahaan jkn 11/24/2022 25,000 25,000 dm + pad
145 Sarnik jkn 11/24/2022 25,000 25,000 ht + chf
147 Bona br saragih jkn 11/24/2022 25,000 25,000 dm . Ht . Lbp
148 Kalep nadapdap jkn 11/25/2022 25,000 25,000 ht et hhd . Dislipidemia
151 Siti rumini jkn 11/25/2022 25,000 25,000 dm . Ht . Tb paru
152 Warsini jkn 11/25/2022 25,000 25,000 ht
153 Tapianai br sinaga jkn 11/25/2022 25,000 25,000 dm . Ht
154 Muriana jkn 11/25/2022 25,000 25,000 anemia + ht
155 Lusiana sinaga jkn 11/25/2022 25,000 25,000 colic abdomen
156 Wagiyem jkn 11/25/2022 25,000 25,000 cholelithiasis . Ht . Dm
157 Lely anita m br sibarani jkn 11/25/2022 25,000 25,000 grave's disease . Dyspepsia
158 Harrudin hrp jkn 11/25/2022 25,000 25,000 dm
159 Arlina tanjung jkn 11/25/2022 25,000 25,000 dm type 2 . Anemia
160 M helianto jkn 11/29/2022 25,000 25,000 chf ec hhd . Cad . Gout artritis
161 Jayam sembiring jkn 11/29/2022 25,000 25,000 ht . Oa
162 Hjaruddin batubara jkn 11/29/2022 25,000 25,000 gastritis
163 Rina herdaria jkn 11/29/2022 25,000 25,000 psmbb . Ht . Anemia
164 Risman sipayung jkn 11/29/2022 25,000 25,000 thypoid fever
165 Morhen turnip jkn 11/29/2022 25,000 25,000 dm . Ht . pad
166 Lie siu seng jkn 11/29/2022 25,000 25,000 ht + cholelithiasis
168 Joni jkn 11/29/2022 25,000 25,000 dm . Dislipidemia
169 Pertanda sembiring jkn 11/29/2022 25,000 25,000 gerd . Chalgia
170 Jumadin jkn 11/29/2022 25,000 25,000 anemia
Total - 4,250,000 - 4,250,000

Umum 120,000
Rawat Jalan:
Umum - +
Melki Tampubolon, SE dr. Arifin P Sitompul Total 120,000
Pasien Covid-2022 18,000,000
Penerima; Rawat Inap BPJS 267,060
Pajak (TAX) 5 % 1,131,253 -
dr. Wirandi Dalimunte,Sp.PD Transportasi - +
Total Bill
1,583,750
1,583,750
pP+dr. Marolop,SpJ
h,SpS+dr. Marolop,SpJ
h,SpS+dr. Dian,SpP
on,SpP+dr. Marolop,SpJ
pB+dr. Dian,SpP
dr. Tengku Muhammad Ridho, Sp.PD
Rekapitulasi Pasien
Bulan Desember 2023

1 Ariyanto 115076 JKK Kelas I 2/1/2024 02/03/2024 3 60,000 180,000 Debridement
2 Rizky Sugandi 118226 Umum KLS III 3/23/2024 26/03/2024 3 40,000 120,000 Thypoid
3 Febby Kurnia Sari 118406 Umum KLS III 30/03/2024 3/30/2024 2 40,000 80,000 Thypoid
4
-
-
-
Total 8 380,000
2. Rawat Inap BPJS

1 Hosneli Asma 117291 BPJS KLS III 26/02/2024 29/02/2024 4,196,000 139,867 DM+LBP+TB 'dr. Lisbeth,SpS+dr. Dian,SpP
2 Rusli Effendi 097732 BPJS Kelas I 2/5/2024 07/02/2024 2,818,300 140,915 Union dr. Alan,Sp.OT
3 Fatimah 117328 BPJS KLS III 26/02/2024 01/03/2024 2,918,600 97,287 CKD+TB 'dr. Dian,SpP+dr. Marolop,SpJ
4 Fadlan 117374 BPJS KLS III 2/27/2024 01/03/2024 1,499,200 49,973 Gouty Arthitis 'dr. Soraya,SpM+dr. Amarwati,SpN
5 Anggi Sahpitri 079854 BPJS KLS III 3/1/2024 03/03/2024 1,499,200 149,920 Colic Abd
6 Ade Puspita Nasution 73158 BPJS Klas II 3/2/2024 03/03/2024 1,585,900 158,590 Dyspepsia
7 Rukiatik 083313 BPJS KLS III 3/1/2024 3/4/2024 3,658,500 365,850 Acute Abd
8 Lia Fitriani 117459 BPJS KLS III 3/1/2024 3/4/2024 4,448,200 444,820 Abd
9 Jamik Siburian 114020 BPJS Klas II 3/1/2024 3/4/2024 2,670,600 267,060 Thypoid
10 Romayani 069950 BPJS KLS III 3/1/2024 3/4/2024 2,292,400 229,240 Thypoid
11 Novia Elisabeth Br Sinaga 117487 BPJS Kelas I 3/2/2024 3/5/2024 3,048,900 304,890 Thypoid
12 Waslim 117455 BPJS Kelas I 3/1/2024 3/5/2024 3,048,900 304,890 Thypoid
13 Theresia Timeria Telaumb 117498 BPJS Kelas I 3/3/2024 3/5/2024 4,852,700 485,270 Hypoglicaemia
14 Nurlayani Gea 117489 BPJS KLS III 3/2/2024 3/5/2024 1,361,300 136,130 Dyspepsia
15 Andri Faisal Lubis 080983 BPJS KLS III 3/1/2024 3/5/2024 3,648,700 182,435 Syndrome dr. Lisbeth,SpS
16 Moan Sitorus 101786 BPJS KLS III 3/3/2024 3/6/2024 2,292,400 229,240 Thypoid
17 Rici Rikardo 117499 BPJS Klas II 3/3/2024 3/6/2024 2,511,600 251,160 Colic Abd
18 Diah Hadiati 117495 BPJS KLS III 3/2/2024 3/6/2024 2,490,400 249,040 Dyspepsia
19 Siti Aminah 110993 BPJS KLS III 3/1/2024 3/8/2024 5,540,700 184,690 Anemia 'dr. Lisbeth,SpS+dr. Desmon,SpP
20 Rosna Sitorus 103857 BPJS KLS III 3/3/2024 3/9/2024 4,668,700 93,374 Debridement dr. Robert,SpB
21 Rosmaita Lumban Tobing 117667 BPJS KLS III 3/8/2024 11/03/2024 2,292,400 229,240 Thypoid
22 Ryan Yehezkiel Simanjunta 117705 BPJS Klas II 3/9/2024 11/03/2024 1,924,500 192,450 GEA
23 Marinus Simanjutak 117685 BPJS Klas II 3/8/2024 3/12/2024 3,327,200 332,720 Thypoid
24 Sukanti 117714 BPJS KLS III 3/9/2024 3/12/2024 1,361,300 136,130 Dyspepsia
25 Jaenab Harahap 98749 BPJS KLS III 3/8/2024 3/12/2024 2,920,600 292,060 DM
26 Lasma Uli Simanjuntak 105083 BPJS KLS III 3/9/2024 3/13/2024 2,292,400 114,620 Thypoid dr. Amarwati,SpN
27 Sari Wulandari 91421 BPJS Kelas I 3/9/2024 3/13/2024 1,810,500 181,050 Dyspepsia
28 Deliana Saragih 117432 BPJS KLS III 3/10/2024 3/13/2024 2,292,400 229,240 Thypoid
29 Aji Setiawan 098951 BPJS Klas II 3/9/2024 3/14/2024 2,670,600 133,530 Thypoid dr. Heri,SpB
30 Sarmi 110017 BPJS KLS III 3/11/2024 3/15/2024 2,119,000 211,900 Anemia
31 Retia Tampubolon 112113 BPJS KLS III 3/8/2024 3/15/2024 2,867,100 143,355 Colic Abd dr. Marolop,SpJ
32 Rosdina Situmorang 117287 BPJS KLS III 3/11/2024 3/15/2024 5,130,400 171,013 DM+HT+Sepsis 'dr. Dian,SpP+dr. Marolop,SpJ
33 Putri Sion Gultom 117941 BPJS KLS III 3/15/2024 18/03/2024 2,855,900 285,590 DHF
34 Indra 117940 BPJS KLS III 3/15/2024 18/03/2024 2,292,400 229,240 Thypoid
35 Putri Maria Kristina Sitoha 64592 BPJS Klas II 3/15/2024 18/03/2024 2,670,600 267,060 Thypoid
36 Supriyaten 109414 BPJS KLS III 3/8/2024 3/19/2024 5,098,400 169,947 Stroke 'dr. Lisbeth,SpS+dr. Marolop,SpJ
37 Surtiyem 117768 BPJS KLS III 3/11/2024 3/19/2024 5,540,700 184,690 Hypoglicaemia 'dr. Lisbeth,SpS+dr. Marolop,SpJ
38 Sudarsih 117912 BPJS KLS III 3/15/2024 3/19/2024 3,146,200 314,620 Colic Abd
39 Mutiara Napitupulu 104576 BPJS KLS III 3/15/2024 3/19/2024 3,000,100 300,010 Anemia
40 Bagus Mulia 117973 BPJS Klas II 3/16/2024 3/19/2024 2,670,600 267,060 Thypoid
41 Horajin Purba 117661 BPJS Klas II 3/16/2024 3/19/2024 3,327,200 332,720 Thypoid
42 Agustina Sianipar 117978 BPJS Kelas I 3/17/2024 3/19/2024 4,852,700 485,270 Thypoid
43 Masmur Repiati Hutahaea 117955 BPJS Kelas I 3/16/2024 3/19/2024 5,827,700 291,385 DM+TB dr. Desmon,SpP
44 Aliman 114841 BPJS KLS III 3/15/2024 3/19/2024 2,292,400 114,620 HT dr. Lisbeth,SpS
45 Maryana 117962 BPJS KLS III 3/16/2024 3/20/2024 1,499,200 149,920 Thypoid
46 Trisnawati 48720 BPJS Kelas I 3/23/2024 25/03/2024 3,048,900 304,890 Thypoid
47 Samuel Hutapea 118197 BPJS KLS III 3/22/2024 25/03/2024 2,292,400 229,240 Thypoid
48 Waskin Situmorang 118165 BPJS KLS III 3/22/2024 25/03/2024 3,650,900 182,545 CAP dr. Desmon,SpP
49 Mutia Septiani 118214 BPJS KLS III 3/23/2024 25/03/2024 2,855,900 142,795 Thypoid dr. Robert,Sp.OG
50 Saud Saragih 118173 BPJS Klas II 3/22/2024 25/03/2024 4,262,100 426,210 DM
51 Ponisah 69290 BPJS KLS III 3/22/2024 25/03/2024 2,267,400 226,740 OA Genu
52 Ernestin Gurning 111874 BPJS Klas II 3/22/2024 25/03/2024 2,670,600 267,060 Thypoid
53 Bungani Br Manalu 118192 BPJS KLS III 3/22/2024 25/03/2024 1,361,300 136,130 Dyspepsia
54 Lilik 118001 BPJS Klas II 3/23/2024 25/03/2024 6,098,600 304,930 TB dr. Desmon,SpP
55 Hernani Kaban 103685 BPJS KLS III 3/22/2024 26/03/2024 3,658,500 365,850 Thypoid
56 Surti Silitonga 118224 BPJS KLS III 3/23/2024 26/03/2024 3,450,100 172,505 Hi dr. Heri,SpB
57 Saur Br Tambunan 091516 BPJS Klas II 3/24/2024 26/03/2024 1,924,500 192,450 GEA
58 Putri Wulandari 118196 BPJS Klas II 3/22/2024 26/03/2024 1,585,900 158,590 Dyspepsia
59 Syamsul Bahri Lubis 108251 BPJS Kelas I 3/16/2024 3/27/2024 9,581,100 319,370 HT+Stroke Infark 'dr. Lisbeth,SpS+dr. Marolop,SpJ
60 Nuriah Silitonga 117537 BPJS KLS III 3/23/2024 3/27/2024 2,292,400 229,240 Thypoid
61 Nursiti Silalahi 063799 BPJS Kelas I 3/24/2024 3/27/2024 3,231,500 323,150 Anemia
62 I Made Arnawa 59749 BPJS Kelas I 3/23/2024 3/28/2024 4,850,600 161,687 TIC 'dr. Lisbeth,SpS+dr. Marolop,SpJ
63 Rotua Sinaga 89180 BPJS KLS III 3/22/2024 3/30/2024 3,878,500 129,283 Dorsalgia 'dr. Lisbeth,SpS+dr. Marolop,SpJ
64
65
66
67
Total 195,898,900 14,356,879
Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Visite HD/Visite Sub total Diagnosa
-
-
-
Total - -
3. Rawat Jalan
1 Mulainim turnip jkn 11/1/2022 25,000 25,000 ht . Cholelithiasis
2 Jayam sembiring jkn 11/1/2022 25,000 25,000 ht . Oa genu
3 Lerpianna saragih jkn 11/1/2022 25,000 25,000 ht . Vertigo
5 Rasmiani jkn 11/1/2022 25,000 25,000 dm
7 Gusti andriani jkn 11/1/2022 25,000 25,000 ht + dyspepsia
8 Ricard fernando bangun jkn 11/1/2022 25,000 25,000 colic abdomen
9 Tiorli sigiro jkn 11/1/2022 25,000 25,000 gout artritis . Ht
10 Rianto saragih jkn 11/1/2022 25,000 25,000 dm
11 Morhen turnip jkn 11/1/2022 25,000 25,000 dm . Ht
12 Sunarsih jkn 11/1/2022 25,000 25,000 oa genu dextra
13 Hemat tarigan jkn 11/1/2022 25,000 25,000 gout artritis + ge
15 Ely syafrida jkn 11/1/2022 25,000 25,000 dm . Ht
16 Saminah jkn 11/1/2022 25,000 25,000 nefrolithiasis
17 Misiani jkn 11/3/2022 25,000 25,000 ht + dyspepsia + pad
18 Marlin barus jkn 11/3/2022 25,000 25,000 psmba
20 Supartik jkn 11/3/2022 25,000 25,000 hiperglikemia + dm type 2 + ht + snt
21 Mardiah jkn 11/3/2022 25,000 25,000 dm + ht
22 Netty jkn 11/3/2022 25,000 25,000 chf
23 Sya harsalan pohan jkn 11/3/2022 25,000 25,000 ht + lbp
24 Santia ria napitupulu jkn 11/3/2022 25,000 25,000 ht + neoralsia
25 Pella marrie warda jkn 11/3/2022 25,000 25,000 dm type 2 + ht + psk
28 Nevi yanti jkn 11/3/2022 25,000 25,000 dm
29 Warsini jkn 11/4/2022 25,000 25,000 ht
30 Patia panjaitan jkn 11/4/2022 25,000 25,000 gout artritis
31 Luminta butar butar jkn 11/4/2022 25,000 25,000 dm
32 Nurjanah saragih jkn 11/4/2022 25,000 25,000 cholelithiasis
33 Arlina tanjung jkn 11/4/2022 25,000 25,000 dm . Anemia . Tb paru
34 Kasiadi jkn 11/7/2022 25,000 25,000 hep . B kronik
35 Yulisnawati jkn 11/7/2022 25,000 25,000 ht . Dyspepsia
36 Eriady st jkn 11/7/2022 25,000 25,000 dm . ht
37 Hermanto gultom jkn 11/7/2022 25,000 25,000 dm . Ht . Neuropati
38 Fidri ananda jkn 11/7/2022 25,000 25,000 tumor mediastinum
39 Mena jkn 11/7/2022 25,000 25,000 dm . Pad
40 Usman jkn 11/7/2022 25,000 25,000 chf ec hhd . Ppok
41 Suriyatik jkn 11/7/2022 25,000 25,000 dm
42 Lisnawati jkn 11/7/2022 25,000 25,000 chf gt iii ec hhd
44 Ratma rata sianipar jkn 11/7/2022 25,000 25,000 isk + lbp
45 Kamini jkn 11/7/2022 25,000 25,000 pneumonia . Chf
46 Sangapan alfred jkn 11/7/2022 25,000 25,000 dyspepsia
47 Yustino jkn 11/7/2022 25,000 25,000 dm . Ht . Neuropati
48 Jumiati jkn 11/7/2022 25,000 25,000 dm . Neuropati
49 Zulaicha jkn 11/7/2022 25,000 25,000 dm . Ht
50 Yunita armani jkn 11/7/2022 25,000 25,000 myoma uteri
51 Michael steven jkn 11/7/2022 25,000 25,000 pneumonia
52 Sugriwa suwandhi jkn 11/8/2022 25,000 25,000 chf
53 Tiurlam br sitorus jkn 11/8/2022 25,000 25,000 haemoroid interna + dyspepsia
55 Betty napitupulu jkn 11/8/2022 25,000 25,000 grave's disease
56 Marsini jkn 11/8/2022 25,000 25,000 chf + dm
57 Wagiyem jkn 11/8/2022 25,000 25,000 ht . Dyspepsia
58 Ratnauli situmeang jkn 11/8/2022 25,000 25,000 dm + pad
59 Zuraida jkn 11/8/2022 25,000 25,000 grave's disease
60 Rospita r tarigan jkn 11/8/2022 25,000 25,000 dm . Ht . Dyspepsia
61 Gusti andriani jkn 11/8/2022 25,000 25,000 ht . Dyspepsia
62 Barmen parulian jkn 11/8/2022 25,000 25,000 diperglikemia + dm type 2
63 Junaedi jkn 11/8/2022 25,000 25,000 thypoid fever + colic abdomen
64 Astri parhusip jkn 11/8/2022 25,000 25,000 dm . Ht . Pad
65 Joni jkn 11/8/2022 25,000 25,000 dm
67 Bona br saragih jkn 11/10/2022 25,000 25,000 dm . Ht
68 Ria rosmida panggabean jkn 11/10/2022 25,000 25,000 ht + neuropati
69 Haruddin batubara jkn 11/10/2022 25,000 25,000 gastritis
70 Hotman siahaan jkn 11/10/2022 25,000 25,000 dm . Pad . Stroke
71 Ira kristini sihotang jkn 11/10/2022 25,000 25,000 thypoid
72 Edwin jkn 11/10/2022 25,000 25,000 thypoid
73 Hartiningsih jkn 11/10/2022 25,000 25,000 dm type 2 + chf
74 Susilawati jkn 11/11/2022 25,000 25,000 dm . Neuropati
75 Sabariah cik jkn 11/11/2022 25,000 25,000 dm
77 Nurlaila purba jkn 11/11/2022 25,000 25,000 asma + dyspepsia
78 Sulastri jkn 11/11/2022 25,000 25,000 rhemautoid . Arthritis
79 Lusiana sinaga jkn 11/11/2022 25,000 25,000 colic abdomen . Pjk
80 Sumihar sibarani jkn 11/11/2022 25,000 25,000 cholelithiasis
81 Magian jkn 11/11/2022 25,000 25,000 cholelithiasis . Ht . Dm
83 Iwan nugroho jkn 11/15/2022 25,000 25,000 dm type 2 + dyslipidemia
84 Ruliah jkn 11/15/2022 25,000 25,000 hepatomegaly + sludge gd + ht
85 Irawati jkn 11/15/2022 25,000 25,000 hepatomegaly + ht + psmb
86 Marhen turnip jkn 11/15/2022 25,000 25,000 dm type 2 + ht
87 Boniyem jkn 11/15/2022 25,000 25,000 hyperglikemia + dm . Ht
88 Suwartika miranti jkn 11/15/2022 25,000 25,000 cholelithiasis . Multiple
89 Pariaman siregar jkn 11/15/2022 25,000 25,000 ht + ppok
90 Kristina nova jkn 11/15/2022 25,000 25,000 grave's disease
91 Joni jkn 11/15/2022 25,000 25,000 dm
92 Jayam sembiring jkn 11/15/2022 25,000 25,000 ht + oa
94 Pertanda sembiring jkn 11/15/2022 25,000 25,000 thypoid fever
96 Hiramawati nst jkn 11/15/2022 25,000 25,000 gerd
97 Luhut sigalingging jkn 11/15/2022 25,000 25,000 ht . Dyspepsia
98 Tandean tarigan jkn 11/15/2022 25,000 25,000 ckd st iv . Ht
99 Nurinsan jkn 11/15/2022 25,000 25,000 thypoid fever
101 Ely syafrida jkn 11/15/2022 25,000 25,000 dm . Ht + dyspepsia
102 Abd mahan bangun jkn 11/17/2022 25,000 25,000 dm type 2 + neuropati
103 Astina panjaitan jkn 11/17/2022 25,000 25,000 colic abdomen + ht
104 Masem jkn 11/17/2022 25,000 25,000 chf ec cad
106 Mardiah jkn 11/17/2022 25,000 25,000 dm . Ht
107 Supartik jkn 11/17/2022 25,000 25,000 dm . Ht
108 Marlina tuti jkn 11/17/2022 25,000 25,000 thypoid fever + pneumonia
109 Sontiria napitupulu jkn 11/17/2022 25,000 25,000 dyspepsia
110 Netty jkn 11/17/2022 25,000 25,000 chf ec hhd
112 Pella marrie warda jkn 11/17/2022 25,000 25,000 dm . Ht . Pjk
113 Sarmaini jkn 11/17/2022 25,000 25,000 dm . Ht . pad
115 Rika herdaria jkn 11/17/2022 25,000 25,000 dyspepsia
116 Siti aminah jkn 11/18/2022 25,000 25,000 oa genu sinistra
117 Ramot br sinaga jkn 11/18/2022 25,000 25,000 cholelithiasis
119 Siti rumini jkn 11/18/2022 25,000 25,000 dm + ht
120 Maslina dharmawati jkn 11/18/2022 25,000 25,000 dm . Ht . pad
121 Saniyah jkn 11/18/2022 25,000 25,000 dm . Ht . Neuropati
122 Mutiara simbolon jkn 11/18/2022 25,000 25,000 dm . Pjk . Ht
123 Nuraini siregar jkn 11/18/2022 25,000 25,000 dm type 2 . Dyspepsia
124 Dumekta br ginting jkn 11/18/2022 25,000 25,000 ht . Pjk
125 Puji rahdita jkn 11/18/2022 25,000 25,000 bronchitis
126 Sugiwa suwandhi jkn 11/22/2022 25,000 25,000 chf ec cad
127 Kadem tarigan jkn 11/22/2022 25,000 25,000 post hypoglikemia . Dm . Ht
128 Liliani jkn 11/22/2022 25,000 25,000 dhf . Dyspepsia
129 Gusti andriani jkn 11/22/2022 25,000 25,000 ht . Dyspepsia . Neuropati
130 Diana sari muliani jkn 11/22/2022 25,000 25,000 post ge akut
131 Rospitalawati jkn 11/22/2022 25,000 25,000 dm type 2
132 Sri awan jkn 11/22/2022 25,000 25,000 cholelithiasis + netroliasis
133 Masriana jkn 11/22/2022 25,000 25,000 dm . Ht . Anemia
135 Jariah jkn 11/22/2022 25,000 25,000 colic abd + ht
136 Jimsoni sinaga jkn 11/22/2022 25,000 25,000 susp appendictis acute
137 Barmen parulian jkn 11/22/2022 25,000 25,000 hiperglikemia + dm
138 Astri parhusip jkn 11/22/2022 25,000 25,000 dm . Ht
139 Ratnauli situmeang jkn 11/22/2022 25,000 25,000 dm . Pad
140 Hartiningsih jkn 11/24/2022 25,000 25,000 dm . Chf ec hhd
141 Mangaraja enda jkn 11/24/2022 25,000 25,000 chf hhd
142 Elpina sianturi jkn 11/24/2022 25,000 25,000 post ge akut
143 Muliono pardede jkn 11/24/2022 25,000 25,000 dm type 2
144 Hotman siahaan jkn 11/24/2022 25,000 25,000 dm + pad
145 Sarnik jkn 11/24/2022 25,000 25,000 ht + chf
147 Bona br saragih jkn 11/24/2022 25,000 25,000 dm . Ht . Lbp
148 Kalep nadapdap jkn 11/25/2022 25,000 25,000 ht et hhd . Dislipidemia
151 Siti rumini jkn 11/25/2022 25,000 25,000 dm . Ht . Tb paru
152 Warsini jkn 11/25/2022 25,000 25,000 ht
153 Tapianai br sinaga jkn 11/25/2022 25,000 25,000 dm . Ht
154 Muriana jkn 11/25/2022 25,000 25,000 anemia + ht
155 Lusiana sinaga jkn 11/25/2022 25,000 25,000 colic abdomen
156 Wagiyem jkn 11/25/2022 25,000 25,000 cholelithiasis . Ht . Dm
157 Lely anita m br sibarani jkn 11/25/2022 25,000 25,000 grave's disease . Dyspepsia
158 Harrudin hrp jkn 11/25/2022 25,000 25,000 dm
159 Arlina tanjung jkn 11/25/2022 25,000 25,000 dm type 2 . Anemia
160 M helianto jkn 11/29/2022 25,000 25,000 chf ec hhd . Cad . Gout artritis
161 Jayam sembiring jkn 11/29/2022 25,000 25,000 ht . Oa
162 Hjaruddin batubara jkn 11/29/2022 25,000 25,000 gastritis
163 Rina herdaria jkn 11/29/2022 25,000 25,000 psmbb . Ht . Anemia
164 Risman sipayung jkn 11/29/2022 25,000 25,000 thypoid fever
165 Morhen turnip jkn 11/29/2022 25,000 25,000 dm . Ht . pad
166 Lie siu seng jkn 11/29/2022 25,000 25,000 ht + cholelithiasis
168 Joni jkn 11/29/2022 25,000 25,000 dm . Dislipidemia
169 Pertanda sembiring jkn 11/29/2022 25,000 25,000 gerd . Chalgia
170 Jumadin jkn 11/29/2022 25,000 25,000 anemia
Total - 4,250,000 - 4,250,000

Umum 380,000
Rawat Jalan:
Umum - +
Melki Tampubolon, SE dr. Arifin P Sitompul Total 380,000
Pasien Covid-2022 -
Penerima; Rawat Inap BPJS 14,356,879
Pajak (TAX) 5 % 947,444 -
dr. Wirandi Dalimunte,Sp.PD Transportasi - +
Total Bill
1,880,000
878,750
2,758,750
h,SpS+dr. Dian,SpP
pP+dr. Marolop,SpJ
,SpM+dr. Amarwati,SpN
h,SpS+dr. Desmon,SpP
pP+dr. Marolop,SpJ
dr. Nova Arianti,SpM
Rekapitulasi Pasien
Bulan Desember 2023
1. Rawat Jalan
No Nama Pasien MR Status Tgl Berobat Jasa Tindakan Jasa Umum Total Klaim Jasa Honor DR Total Honor DR Diagnosa
1 Nursiyah jkn 11/4/2022 35,000 35,000 psf ods + gl absolut + ost astigmat
2 Kardimin jkn 11/4/2022 35,000 35,000 psf os
3 Juliyawati jkn 11/4/2022 35,000 35,000 pt ods
4 Sumardi jkn 11/4/2022 35,000 35,000 psf os
5 Legiran jkn 11/4/2022 35,000 35,000 psf ods + post pp pt os
6 S budi hulu jkn 11/4/2022 35,000 35,000 psf ods + astigmat presbiop
7 Kaswidi umum 11/4/2022 40,000 40,000 kevatitis os
8 Fiktoria sitorus jkn 11/4/2022 35,000 35,000 psf os + ksm od
9 Roida br hutajulu jkn 11/4/2022 35,000 35,000 ksl od + konj's os
10 Minar sitorus jkn 11/4/2022 35,000 35,000 ksm od + ksl os
11 Temu jkn 11/4/2022 35,000 35,000 ksm os + psf od
12 Hormaya purba jkn 11/4/2022 35,000 35,000 ksl ods + dke
13 Ermita tarigan jkn 11/4/2022 35,000 35,000 psf od + post uveitis od
14 Supriono jkn 11/4/2022 35,000 35,000 psf os
15 Waginik jkn 11/4/2022 35,000 35,000 psf ods
16 Sugianto jkn 11/4/2022 35,000 35,000 psf ods + ablatio retina od
17 Ismiati jkn 11/4/2022 35,000 35,000 psf ods + pco es + des
18 Rumini jkn 11/4/2022 35,000 35,000 psf od + ksl os + dr
19 Ruslina hutapea jkn 11/4/2022 35,000 35,000 psf ods
20 Kasiman hutagaol jkn 11/4/2022 35,000 35,000 ksl ods
21 Ponisah jkn 11/4/2022 35,000 35,000 psf ods + hr
22 Hasanuddin jkn 11/4/2022 35,000 35,000 makula kornea os
23 Hotma dame sihombing jkn 11/7/2022 35,000 35,000 pt ods + hiperopia + presbiop
24 Rusli alibasyah jkn 11/7/2022 35,000 35,000 ca conjungtiva + pt + susp calinoma
25 Wardiansyah siregar jkn 11/7/2022 35,000 35,000 ulkus cornea od
26 Paimah jkn 11/7/2022 35,000 35,000 ksl ods + des
27 Nurhayati jkn 11/7/2022 35,000 35,000 glaucoma od + psf ods
28 Agus ad haruti i.m jkn 11/7/2022 35,000 35,000 pt os
29 Jemain jkn 11/7/2022 35,000 35,000 psf ods
30 Sumaryanto jkn 11/7/2022 35,000 35,000 psf od + pr
31 Sabar riyantiba s jkn 11/7/2022 35,000 35,000 tumor palpebra os + chalazion palp os + ksl ods
32 Guntur lumban tobing jkn 11/7/2022 35,000 35,000 hipermetropia + presbiopia pt od
33 H mahadun silaban jkn 11/7/2022 35,000 35,000 psf ods + des + pt od
34 Ponimin jkn 11/7/2022 35,000 35,000 ksl ods + makula cornea od
35 Supriatin jkn 11/7/2022 35,000 35,000 glaucoma od + post + eibek os
36 Semangat juang purba jkn 11/7/2022 35,000 35,000 psf os
37 Rudi supriadi s jkn 11/7/2022 35,000 35,000 konj's od + uveitis sarata od
38 Marsini jkn 11/7/2022 35,000 35,000 ksl ods + floaters os + des
39 Legimin jkn 11/7/2022 35,000 35,000 psf os + des cematocole od
40 Mulai sinaga jkn 11/7/2022 35,000 35,000 psf od + ksl os
41 Law kim yong jkn 11/7/2022 35,000 35,000 ksm os + post reposisi ins puslap os
42 Pariyem jkn 11/11/2022 35,000 35,000 ksl ods
43 Asnani jkn 11/11/2022 35,000 35,000 psf ods + h oculi ods
44 Kardimin jkn 11/11/2022 35,000 35,000 psf os + pco os
45 Ermita tarigan jkn 11/11/2022 35,000 35,000 psf od + post uveitis od
46 Legian jkn 11/11/2022 35,000 35,000 pos + op pt os + psf ods
48 Supriono jkn 11/11/2022 35,000 35,000 psf os + ksl od
49 Rinator br manurung jkn 11/11/2022 35,000 35,000 ksl ods
50 Syamsinar jkn 11/11/2022 35,000 35,000 ksl ods + pt ods
51 Sumaryanto jkn 11/11/2022 35,000 35,000 psf od
52 S budi hulu jkn 11/11/2022 35,000 35,000 psf ods
53 Temu jkn 11/11/2022 35,000 35,000 psf od + ksm os
54 Minar sitorus jkn 11/11/2022 35,000 35,000 ksm od + ksl os
55 Nusti ambarita jkn 11/11/2022 35,000 35,000 psf ods
56 Maryam jkn 11/11/2022 35,000 35,000 psf os + ksl od
57 Rumini jkn 11/11/2022 35,000 35,000 psf od + ksl os
58 Kaswidi jkn 11/11/2022 35,000 35,000 kevatitis os
59 Rantini jkn 11/11/2022 35,000 35,000 psf ods
60 Rusmian br gultom jkn 11/11/2022 35,000 35,000 psf od + ksl os
61 Rusliana hutapea jkn 11/11/2022 35,000 35,000 psf ods + miopia os + presbiopia
62 Roida tua sihombing jkn 11/11/2022 35,000 35,000 pingeulitis ods
63 Lumiana siregar jkn 11/11/2022 35,000 35,000 ksl ods + d r
64 Mardiansyah siregar jkn 11/14/2022 35,000 35,000 ulkus cornea od
65 M adlani nasution st jkn 11/14/2022 35,000 35,000 psf od + vitreous opacity od
66 H mahadun silaban jkn 11/14/2022 35,000 35,000 psf ods
67 Agus salim siregar jkn 11/14/2022 35,000 35,000 post pt os + ksl os
68 Hermaya purba jkn 11/14/2022 35,000 35,000 ksl ods + dks
69 Abdul azis jkn 11/14/2022 35,000 35,000 kevatitis os
70 Sutrisman jkn 11/14/2022 35,000 35,000 ksl ods
71 Tionar br regar jkn 11/14/2022 35,000 35,000 konj's os + ksl ods
72 Asnani jkn 11/18/2022 35,000 35,000 psf ods + hipertensi oculi
73 Syamsinar jkn 11/18/2022 35,000 35,000 ksl ods + pt ods
74 Delima sihombing jkn 11/18/2022 35,000 35,000 psf od + ksl os
76 Supriono jkn 11/18/2022 35,000 35,000 psf os + ksl od
77 Legiran jkn 11/18/2022 35,000 35,000 psf ods + post op mastupasi
78 Kardiman jkn 11/18/2022 35,000 35,000 psf os
79 Syafruddin jkn 11/18/2022 35,000 35,000 psf ods
80 Rumini jkn 11/18/2022 35,000 35,000 psf od + ksl os
81 Kasmidi jkn 11/18/2022 35,000 35,000 kevatitis os
82 Minar sitorus jkn 11/18/2022 35,000 35,000 ksl ods
83 Fiktoria sitorus jkn 11/18/2022 35,000 35,000 ksm os + psf od
84 Kasiman hutagaol jkn 11/18/2022 35,000 35,000 ksl od
85 Waginik jkn 11/18/2022 35,000 35,000 psf ods
86 Aghniya nurul huda jkn 11/18/2022 35,000 35,000 pingeulitis os
87 Mulai sinaga jkn 11/18/2022 35,000 35,000 psf ods
88 Ali syahbana jkn 11/18/2022 35,000 35,000 ca od
89 Law kim yong jkn 11/18/2022 35,000 35,000 psf os + post reposisi iris
90 Nasiem jkn 11/18/2022 35,000 35,000 psf ods + konj's od
91 Sugianto jkn 11/18/2022 35,000 35,000 psf ods + astatic retina od + des
92 Mulianty jkn 11/18/2022 35,000 35,000 konj's ods
93 Erbaini br purba jkn 11/21/2022 35,000 35,000 hipertensi retinopaty + ksl os
94 Sugiartik jkn 11/21/2022 35,000 35,000 ksl ods
96 Tionar br regar jkn 11/21/2022 35,000 35,000 konj's os + ksl ods
97 H mahadun silaban jkn 11/21/2022 35,000 35,000 psf ods
98 Poniman jkn 11/21/2022 35,000 35,000 ksl ods + makula cornea od
99 Nusti ambarita jkn 11/21/2022 35,000 35,000 psf ods
100 Sutrisman jkn 11/21/2022 35,000 35,000 ksl ods
101 Mavieta juliana surbakti jkn 11/21/2022 35,000 35,000 pt os
102 Semangat juang purba jkn 11/21/2022 35,000 35,000 psf os + pt os
103 Legiman jkn 11/21/2022 35,000 35,000 psf os + des cematocole od
104 Agustina jkn 11/21/2022 35,000 35,000 kevatitis os
105 T nur haimah jkn 11/21/2022 35,000 35,000 ksl ods
106 Rusiyem jkn 11/21/2022 35,000 35,000 psf ods
107 Hugo alfaro sitorus jkn 11/21/2022 35,000 35,000 konj's od
108 Firnawati jkn 11/21/2022 35,000 35,000 psf os + gl os
109 Hormaya purba jkn 11/21/2022 35,000 35,000 ksl ods + des
110 Supriatin jkn 11/21/2022 35,000 35,000 glaucoma ods
111 Rosniwati p jkn 11/21/2022 35,000 35,000 diabetic retinopaty
112 Asiani jkn 11/25/2011 35,000 35,000 psf ods + hipertensi oculi
113 Sugiarto jkn 11/25/2011 35,000 35,000 psf od + aphania os
114 Denty sitanggang spd jkn 11/25/2011 35,000 35,000 pt od + ksl ods
115 Sumaryanto jkn 11/25/2011 35,000 35,000 psf od + pt os
116 Sumardi jkn 11/25/2011 35,000 35,000 psf ods
117 Legiran jkn 11/25/2011 35,000 35,000 psf ods + post elisbalitis
118 Supriono jkn 11/25/2011 35,000 35,000 psf os + myiopia od + presbiop
119 Delima sihombing jkn 11/25/2011 35,000 35,000 psf od + ksm os
120 S budi hulu jkn 11/25/2011 35,000 35,000 psf ods
121 Syafruddin jkn 11/25/2011 35,000 35,000 psf ods + hipertensi retinopaty
122 Mulai sinaga jkn 11/25/2011 35,000 35,000 psf ods
123 Law kim yong jkn 11/25/2011 35,000 35,000 psf os
124 Mulianty jkn 11/25/2011 35,000 35,000 konj's ods
126 Mariani jkn 11/28/2022 35,000 35,000 psf os + ksm od
127 Masriana saragih jkn 11/28/2022 35,000 35,000 psf od + ksm os
128 H mahadun silaban jkn 11/28/2022 35,000 35,000 psf ods + des
129 Nurhayati jkn 11/28/2022 35,000 35,000 glaucoma neovaslulasi od
130 Aliyawati jkn 11/28/2022 35,000 35,000 post ekstirpasi pt . Od
131 Paimah jkn 11/28/2022 35,000 35,000 ksl ods + des
132 Roida br hutajulu jkn 11/28/2022 35,000 35,000 ksl od + pingeulitis os
133 Suriadi jkn 11/28/2022 35,000 35,000 anophtaluma os + des
134 Marsini jkn 11/28/2022 35,000 35,000 ksl ods
135 Samson hasugian jkn 11/28/2022 35,000 35,000 ksl ods
136 Abdi jkn 11/28/2022 35,000 35,000 ksl ods
137 Gintar ginting jkn 11/28/2022 35,000 35,000 ksm od + ksl os
138 Agustina jkn 11/28/2022 35,000 35,000 kevatitis os
139 Kamel saragih jkn 11/28/2022 35,000 35,000 hipertensi retinopaty
140 Pangarepan sembiring dr jkn 11/28/2022 35,000 35,000 ksl ods + diabetic retinopaty
Total - 40,000 - 4,865,000 4,905,000
2. Rawat Inap BPJS

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Alat Dokter Total Klaim Jasa Dokter Diagnosa DPJP
1
2
3
4
Total - - -
3. Rawat Inap Pasien Umum, JKK, A+ dan Perusahaan

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Visite HD/Visite Sub Total HD Operasi Total Jasa Dokter Diagnosa
1
2
- -
Total 0 - - -
Lubuk Pakam, November 2022 Diketahui Oleh: Kalkulasi Penggajian / Honor :

Umum - - -
Rawat Jalan: Umum 40,000 +
Total 40,000
Melki Tampubolon, SE dr. Arifin P Sitompul Potongan ke RS 10 % 4,000 -
Total Honor Umum Bersih Dokter 36,000
Rawat Inap BPJS -
Penerima; Jasa Tindakan -
Alat Dokter -
Honor Bruto (Sebelum Pajak) 4,901,000
dr. Nova Arianti, Sp.M Pajak (TAX) 5 % 245,050 -
Total Honor 4,655,950
Transportasi - +
Honor Bersih (Diterima) 4,655,950
dr. Soraya Fasya, Sp.M
Rekapitulasi Pasien
Bulan Desember 2023
1. Rawat Jalan
No Nama Pasien MR Status Tgl Berobat Jasa Tindakan Jasa Umum Total Klaim Jasa Dr Total Honor DR Diagnosa
1 Simson sianipar s.sos jkn 11/1/2022 35,000 35,000 presbiopia
2 Wartini jkn 11/1/2022 35,000 35,000 presbiopia
3 Winah jkn 11/1/2022 35,000 35,000 psf ods
4 Buang sunardi jkn 11/1/2022 35,000 35,000 psf ods
5 Malem ukur br sipayung jkn 11/1/2022 35,000 35,000 psf ods
6 Barisman saragih jkn 11/1/2022 35,000 35,000 ksl ods
7 Suherlina jkn 11/1/2022 35,000 35,000 ulkus kornea od
8 Melyani fauziah jkn 11/1/2022 35,000 35,000 psf ods
9 Sofyan aruan jkn 11/1/2022 35,000 35,000 psf ods + myiopia ods + astigmat ods
10 Muliana jkn 11/1/2022 35,000 35,000 psf od
11 Sadariah jkn 11/1/2022 35,000 35,000 psf ods
12 Misran siswanto jkn 11/1/2022 35,000 35,000 psf os
13 Tumaini jkn 11/1/2022 35,000 35,000 ksl ods
14 Sadid sas jkn 11/1/2022 35,000 35,000 ksl ods
15 Sempa malem br tarigan jkn 11/1/2022 35,000 35,000 aphania od + ksl os
16 Sartika dewi mulia jkn 11/1/2022 35,000 35,000 papil atrofi os
17 Sumiyem jkn 11/1/2022 35,000 35,000 ksl ods
18 Herlina jkn 11/1/2022 35,000 35,000 psf ods
19 Subiati jkn 11/1/2022 35,000 35,000 psf od + pt od
20 Siswanto jkn 11/1/2022 35,000 35,000 psf os + ksl od
21 Harun maulana jkn 11/3/2022 35,000 35,000 hordeslum od
22 Dedi jkn 11/3/2022 35,000 35,000 ksm os + psf od + retinal detachement os
23 Boinem br simamora jkn 11/3/2022 35,000 35,000 dks + ksl ods + pt
24 Rahmawati jkn 11/3/2022 35,000 35,000 ksl od
25 Lister simanullang jkn 11/3/2022 35,000 35,000 psf ods
26 Rahel m barus jkn 11/3/2022 35,000 35,000 psf od + ksl os
27 Nursiti br tumanggor jkn 11/3/2022 35,000 35,000 psf od
28 Sefan sipayung jkn 11/3/2022 35,000 35,000 psf ods
29 Sugiono jkn 11/3/2022 35,000 35,000 psf od
30 Masiyem jkn 11/3/2022 35,000 35,000 dry eye
31 Sontia hasibuan jkn 11/3/2022 35,000 35,000 floaters +hipermatrop + presbiop
32 M abid aqil ramadhan jkn 11/3/2022 35,000 35,000 neuropati optic
33 Trimurti jkn 11/3/2022 35,000 35,000 psf os
34 Sumarno jkn 11/3/2022 35,000 35,000 floaters + presbiop
35 Ngena sipayung jkn 11/3/2022 35,000 35,000 corpus os
36 Nelson damanik jkn 11/3/2022 35,000 35,000 hipermetop
37 Ramunah peranginangin jkn 11/3/2022 35,000 35,000 ulkus kornea
38 Lilik hardianto jkn 11/3/2022 35,000 35,000 corpus od
39 Darliana jkn 11/3/2022 35,000 35,000 astigmat ods + presbiop
40 Walman samosir jkn 11/3/2022 35,000 35,000 ksm od + ksl os
41 Rosidah jkn 11/3/2022 35,000 35,000 ksm os
42 Eca dwi aritonang jkn 11/3/2022 35,000 35,000 sub conjungtiva sled ods
43 Suyatno jkn 11/8/2022 35,000 35,000 ksl ods
44 Ruslan efendi jkn 11/8/2022 35,000 35,000 diabetic retinopaty
45 Winah jkn 11/8/2022 35,000 35,000 psf ods
46 Seng liong jkn 11/8/2022 35,000 35,000 ksl od + pt od
47 Idawati jkn 11/8/2022 35,000 35,000 ksl os + pt ods
48 Ahd nasir hia jkn 11/8/2022 35,000 35,000 diabetic retinopaty
49 Lajasi br ginting jkn 11/8/2022 35,000 35,000 ksm os + sus delatio retina
51 Nimpan br tarigan jkn 11/8/2022 35,000 35,000 psf ods
52 Sucipto jkn 11/8/2022 35,000 35,000 kevatitis os
53 Sayem jkn 11/8/2022 35,000 35,000 diabetic retinopaty ods
54 Misran siswanto jkn 11/8/2022 35,000 35,000 psf ods
55 Legiem jkn 11/8/2022 35,000 35,000 sub conjungtiva sled os
56 Lesman bangun jkn 11/8/2022 35,000 35,000 diabetic retinopaty + ksl ods + myiopia ods
57 Bhi a seng als kidam ali jkn 11/8/2022 35,000 35,000 ksm od
58 Sartika dewi jkn 11/8/2022 35,000 35,000 papil piciase ods
59 Sahara lumban gaol jkn 11/10/2022 35,000 35,000 gxatlix kornea + hipertensi r
60 Rosmawati sianturi jkn 11/10/2022 35,000 35,000 psf ods + dks
61 Sugiono jkn 11/10/2022 35,000 35,000 psf ods
62 Rahmawati jkn 11/10/2022 35,000 35,000 ksl ods
63 Sorta hasibuan jkn 11/10/2022 35,000 35,000 floaters ods + hipermetrofi
64 Gino jkn 11/10/2022 35,000 35,000 ksm ods
65 Bambang irawan jkn 11/10/2022 35,000 35,000 hipermetopia os + astigma os
66 Resnah sitorus jkn 11/10/2022 35,000 35,000 psf os + conj's
68 Bunnaria manik jkn 11/10/2022 35,000 35,000 psf od + in drop od + ksm
70 Mariya jkn 11/10/2022 35,000 35,000 ksl ods
71 Nasran jkn 11/10/2022 35,000 35,000 ksl ods
72 Sehar sipayung jkn 11/10/2022 35,000 35,000 psf od
73 Ramunah peranginangin jkn 11/10/2022 35,000 35,000 erosi cornea os +conj os
74 Suryani br purba jkn 11/10/2022 35,000 35,000 psf ods + uveitis os
75 Ridho april saril jkn 11/10/2022 35,000 35,000 kematon palpebra
76 Rustam jkn 11/10/2022 35,000 35,000 psf ods + dks
77 Nova damaiyanti jkn 11/10/2022 35,000 35,000 papil atrofi
78 Saniah jkn 11/13/2022 35,000 35,000 ksl ods
79 Karel banjarnahor jkn 11/15/2022 35,000 35,000 ksl od + ksm os
80 Sumiani jkn 11/15/2022 35,000 35,000 ksf os
81 Betty napitupulu jkn 11/15/2022 35,000 35,000 ksm od
82 Bhi a seng als kidam ali jkn 11/15/2022 35,000 35,000 ksm od + psf os + keropati
83 Winah jkn 11/15/2022 35,000 35,000 psf ods
84 Erguna br meliala jkn 11/15/2022 35,000 35,000 ksm os
86 Muhammad amin nasution jkn 11/15/2022 35,000 35,000 pds ods
87 Mahpul saputra jkn 11/15/2022 35,000 35,000 psf od + aphania os
88 Sabariana tarigan jkn 11/15/2022 35,000 35,000 pingeucula od
89 Tumaini jkn 11/15/2022 35,000 35,000 ksl os + psf os
90 Sukartini jkn 11/15/2022 35,000 35,000 psf ods
91 Sadin sas jkn 11/15/2022 35,000 35,000 psf od
93 Sempa malem br tarigan jkn 11/15/2022 35,000 35,000 afania os
94 Pisir munthe jkn 11/15/2022 35,000 35,000 ksl od + psf os
95 Subiati jkn 11/15/2022 35,000 35,000 psf os
96 Muhammad ridho abisandi jkn 11/15/2022 35,000 35,000 kornea od
97 Lesman bangun jkn 11/15/2022 35,000 35,000 ksl ods
98 Tengkuh syahwali jkn 11/15/2022 35,000 35,000 dry eye
99 Ridwan jkn 11/15/2022 35,000 35,000 psf os
100 Muhammad fauzan yazid jkn 11/15/2022 35,000 35,000 psf ods
101 Banem br simamora jkn 11/17/2022 35,000 35,000 ksl ods
102 Gembira tarigan jkn 11/17/2022 35,000 35,000 retinopati
103 Sri wahyuni jkn 11/17/2022 35,000 35,000 tumor retubolbor
104 Rosmawati sianturi jkn 11/17/2022 35,000 35,000 psf ods
105 Sugiono jkn 11/17/2022 35,000 35,000 psf os
106 Esnawaty saragih jkn 11/17/2022 35,000 35,000 psf os
109 Sehar sipayung jkn 11/17/2022 35,000 35,000 psf ods
110 Sontia hasibuan jkn 11/17/2022 35,000 35,000 ksl ods + floaters
111 Warimin jkn 11/17/2022 35,000 35,000 psf od
112 Nurmawati jkn 11/17/2022 35,000 35,000 ksl ods + floaters
113 Ponijah jkn 11/17/2022 35,000 35,000 psf ods
114 Mustiarti jkn 11/17/2022 35,000 35,000 diabetic retinopaty
115 Marta jkn 11/17/2022 35,000 35,000 ksl
116 Hamdani ali jkn 11/17/2022 35,000 35,000 ksl os
117 Tazkia zahra jkn 11/17/2022 35,000 35,000 erosi kornea
118 Nasran jkn 11/17/2022 35,000 35,000 lixatux kornea
119 Ramunah peranginangin jkn 11/17/2022 35,000 35,000 dry eye
120 Renaty bakara jkn 11/17/2022 35,000 35,000 psf od
121 Bungairun br ginting jkn 11/22/2022 35,000 35,000 psf od
122 Reza parlaungan jkn 11/22/2022 35,000 35,000 bleparo konjungtivitis od
123 Bhi a seng als kidam ali jkn 11/22/2022 35,000 35,000 ksm od + psf os
124 Winah jkn 11/22/2022 35,000 35,000 psf ods
126 Muhammad amin nasution jkn 11/22/2022 35,000 35,000 psf ods
127 Nursianna manurung jkn 11/22/2022 35,000 35,000 psf od
128 Sabarudin jkn 11/22/2022 35,000 35,000 psf os
129 Sadin sas jkn 11/22/2022 35,000 35,000 psf od
130 Mahpul saputra jkn 11/22/2022 35,000 35,000 psf ods
131 Sempa malem br tarigan jkn 11/22/2022 35,000 35,000 afania os
133 Subiati jkn 11/22/2022 35,000 35,000 psf od
134 Dul bakri jkn 11/22/2022 35,000 35,000 corpus alineum
135 Nimpan br tarigan jkn 11/22/2022 35,000 35,000 psf ods
136 Jojor sianturi jkn 11/22/2022 35,000 35,000 psf ods
137 Reselina br sitorus jkn 11/22/2022 35,000 35,000 pregium od
138 Djoko prayitno jkn 11/22/2022 35,000 35,000 dry eye
139 Muhammad ridho abisandi jkn 11/22/2022 35,000 35,000 ulkus cornea os
140 Siswanto jkn 11/22/2022 35,000 35,000 psf ods
141 Agus fernando fransisco purba jkn 11/22/2022 35,000 35,000 katarak uvenil
142 Misnadrah nasution jkn 11/22/2022 35,000 35,000 psf od + ksl os
143 Darmilah jkn 11/22/2022 35,000 35,000 psf ods
144 Ratauli saragih jkn 11/22/2022 35,000 35,000 dry eye
145 Marsita br hombing jkn 11/22/2022 35,000 35,000 psf ods
146 Sartika dewi jkn 11/22/2022 35,000 35,000 papil atrofi
147 Tumpak sinaga jkn 11/24/2022 35,000 35,000 ksm os + ksl od
148 Nurmawati jkn 11/24/2022 35,000 35,000 ksl ods + floaters od
149 Sugiono jkn 11/24/2022 35,000 35,000 psf od + ksl os
150 Ernawaty saragih jkn 11/24/2022 35,000 35,000 psf os + ksm od
151 Sumiyem jkn 11/24/2022 35,000 35,000 ksl ods
152 Gembira tarigan jkn 11/24/2022 35,000 35,000 retinopati + ksl od
153 Rahmawati jkn 11/24/2022 35,000 35,000 ksl ods
154 Nursiti br tumanggor jkn 11/24/2022 35,000 35,000 psf od + ksl os
155 Sehar sipayung jkn 11/24/2022 35,000 35,000 psf ods
156 Jayari jkn 11/24/2022 35,000 35,000 ksm ods
157 Paian lumban gaol jkn 11/24/2022 35,000 35,000 psf os
158 Tazkia zahra jkn 11/24/2022 35,000 35,000 erosi kornea od + kevatitis
159 Rosyidah jkn 11/24/2022 35,000 35,000 psf os
160 Sumiyem jkn 11/24/2022 35,000 35,000 psf od
161 Sonta panjaitan jkn 11/24/2022 35,000 35,000 diabetic retinopaty ods + ksl ods
162 Jumangin jkn 11/24/2022 35,000 35,000 papil gedem
163 Naisal br sembiring jkn 11/24/2022 35,000 35,000 dry eye
164 Nuriah jkn 11/24/2022 35,000 35,000 astigmatisma + hipertensi retinopaty
165 Paeran jkn 11/24/2022 35,000 35,000 psf ods
166 Suriyani br purba jkn 11/24/2022 35,000 35,000 psf ods
167 Ramunah peranginangin jkn 11/24/2022 35,000 35,000 konjungtivitis os
168 Lena ika situmorang jkn 11/24/2022 35,000 35,000 thypoid eye
169 Suyatno jkn 11/29/2022 35,000 35,000 psf os + ksl od
170 Betty napitupulu jkn 11/29/2022 35,000 35,000 psf os
171 Sabarudin jkn 11/29/2022 35,000 35,000 psf os
172 M amin nst jkn 11/29/2022 35,000 35,000 psf ods
173 Mahpul saputra jkn 11/29/2022 35,000 35,000 psf ods
175 Winah jkn 11/29/2022 35,000 35,000 psf ods
176 Walman samosir jkn 11/29/2022 35,000 35,000 ksm od + ksl os + dks
177 Suratno jkn 11/29/2022 35,000 35,000 conjungtivitis ods
178 Bungairun br ginting jkn 11/29/2022 35,000 35,000 psf od
179 Eliza mulchaini spp jkn 11/29/2022 35,000 35,000 glaucoma
180 Bansman saragih jkn 11/29/2022 35,000 35,000 psf od
181 Sempa malem br tarigan jkn 11/29/2022 35,000 35,000 aphania os
182 Melki verawati jkn 11/29/2022 35,000 35,000 pt ods
183 Bhi a seng als kidam ali jkn 11/29/2022 35,000 35,000 psf os + ksm od
184 Gino jkn 11/29/2022 35,000 35,000 psf od + ksl os
185 Misran siswanto jkn 11/29/2022 35,000 35,000 psf ods
186 Sadin sas jkn 11/29/2022 35,000 35,000 psf os + ksl od
187 Muliana jkn 11/29/2022 35,000 35,000 psf od
188 Siswanto jkn 11/29/2022 35,000 35,000 psf ods
189 Subiati jkn 11/29/2022 35,000 35,000 psf od + pt od
190 Tumarni jkn 11/29/2022 35,000 35,000 psf os + ksl od
191 Suanto jkn 11/29/2022 35,000 35,000 erosi kornea od
192 M ridho abisandy jkn 11/29/2022 35,000 35,000 ulkus cornea od
193 Ronauli lumbangaol jkn 11/29/2022 35,000 35,000 neutis optic
194 Edi sumianto jkn 11/29/2022 35,000 35,000 ksl os
195 Reselina br sitorus jkn 11/29/2022 35,000 35,000 pt ods
Total - - - 6,825,000 6,825,000
2. Rawat Inap BPJS

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Alat Dokter Total Klaim Jasa Dokter Diagnosa DPJP
1 Juan Fernandus 116950 BPJS KLS III 2/19/2024 2/22/2024 2,000,700 66,690 Cepalgia+Sinusitis 'dr. Mahyarani,SpA+dr. Rika,Sp.THT
2 Aliman 114841 BPJS KLS III 25/02/2024 29/02/2024 2,119,000 105,950 HT dr. Lisbeth,SpS
3
4
5
Total - 4,119,700 172,640
3. Rawat Inap Pasien Umum, JKK, A+ dan Perusahaan

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Visite HD/Visite sub total HD Operasi Diagnosa
Total #REF! #REF! #REF!
Lubuk Pakam, November 2022 Diketahui Oleh: Kalkulasi Penggajian / Honor :

Umum - - #REF!
Rawat Jalan: Umum - +
Total #REF!
Melki Tampubolon, SE dr. Arifin P Sitompul Potongan ke RS 10 % #REF! -
Total Honor Umum Bersih Dokter #REF!
Penerima; Jasa Tindakan -
Alat Dokter -
Honor Bruto (Sebelum Pajak) #REF!
dr. Soraya Fasya, Sp.M Pajak (TAX) 5 % #REF! -
Total Honor #REF!
Transportasi - +
Honor Bersih (Diterima) #REF!
ka,Sp.THT
dr. Marolop Hutapea,Sp.JP
Rekapitulasi Pasien
Bulan Desember 2023

No Nama Pasien MR Tgl Masuk Tgl Keluar Visite HD/Visite Honor Visite Treadmill EKG Echo Total Honor Diagnosa
1 Siti Rohani 102330 17/02/2024 2/22/2024 3 50,000 150,000 - 150,000 Cerebral Infarktion
2 Sumardi 95300 25/02/2024 29/02/2024 4 50,000 200,000 100,000 300,000 CAP+Pneumonia
3 Lidia Jojor Tina Simbolon 70157 25/02/2024 29/02/2024 3 50,000 150,000 100,000 250,000 CHF+PPOK
4 Dinda Rahayu 116664 2/2/2024 10/02/2024 6 50,000 300,000 - 300,000 Congestive
5 Janawi Saragi 108915 2/4/2024 07/02/2024 2 50,000 100,000 - 100,000 COPD
6 Sri Handoko 116803 2/6/2024 09/02/2024 3 50,000 150,000 100,000 250,000 UAP
7 Asril Barus 116822 2/6/2024 09/02/2024 3 50,000 150,000 100,000 250,000 CHF
8 Salim 050194 2/7/2024 09/02/2024 2 50,000 100,000 100,000 200,000 UAP
9 Syamsul Bahri 065706 2/8/2024 2/11/2024 2 50,000 100,000 100,000 200,000 UAP+DM
10 Dahlia 91670 2/13/2024 2/13/2024 1 50,000 50,000 - 50,000 DM+LBP
11 Nurmeilisa 116948 2/12/2024 15/02/2024 3 50,000 150,000 100,000 250,000 CHF+Efusi Pleura
12 Nampat Tarigan (Exit) 117176 2/20/2024 2/21/2024 1 50,000 50,000 - 50,000 Sepsis
13 Surya Bakti Purba 094617 2/20/2024 2/23/2024 3 50,000 150,000 100,000 250,000 UAP
14 Juliani 111150 26/02/2024 2/27/2024 1 50,000 50,000 100,000 150,000 CHF
15 Sri Marlia 110635 2/22/2024 2/27/2024 4 50,000 200,000 - 200,000 CHF+CKD
16 Wandiyem 98849 2/22/2024 2/28/2024 3 50,000 150,000 - 150,000 DM Type 2
17 Nur'Asiah Ar 116756 2/20/2024 2/23/2024 3 50,000 150,000 100,000 250,000 Dyspepsia
18 Sentosa Parapat 112222 2/20/2024 24/2/2024 3 50,000 150,000 100,000 250,000 Dyspepsia
19 Ratna 117181 2/21/2024 2/23/2024 2 50,000 100,000 100,000 200,000 DM
20 Fatimah 117328 2/26/2024 3/1/2024 3 50,000 150,000 100,000 250,000
21 Nia Rahma Dhita 117207 2/24/2024 3/2/2024 1 50,000 50,000 100,000 150,000
22 Susilawati 117384 2/27/2024 3/3/2024 3 50,000 150,000 - 150,000
23 Sutarman 100581 2/29/2024 3/2/2024 3 50,000 150,000 100,000 250,000
24 - -
Total 62 3,100,000 - - 1,500,000 4,600,000
EKG
No Nama Pasien MR Tanggal
1 Norma 01/02/2024
2 Rajali 01/02/2024
3 Tengku 02/02/2024
4 Parida 02/02/2024
5 Marusul 02/02/2024
6 Esterina 06/02/2024
7 Lasmaria 06/02/2024
8 Sumanti 12/02/2024
9 Nementina 12/02/2024
10 Sukarmin 09/02/2024
11 Rizki 09/02/2024
12 Salmiati 09/02/2024
13 Cateria 06/02/2024
14 Herbinsar 06/02/2024
15 Herni 06/02/2024
16 Munir 06/02/2024
17 Sahpriyani 07/02/2024
18 Mariana 16/02/2024
19 Sudamaji 20/02/2024
20 Indarsono 20/02/2024
21 Songli B 20/02/2024
22 M Amin 22/02/2024
23 Boimin 22/02/2024
24 Sri Syahmaini 22/02/2024
25 Karulina 22/02/2024
26 Bresman 15/02/2024
27 Novi Yanti 15/02/2024
28 Firnawati 15/02/2024
29 Diman Tampu 15/02/2024
30 Khairul Azhar 15/02/2024
31 Indrawati 15/02/2024
32 Patar 16/02/2024
33 Misdi 16/02/2024
34 Asna Situmorang 16/02/2024
35 Rasni 16/02/2024
36 Kasmuji 16/02/2024
37 Masyirah 19/02/2024
38 Syahri 20/02/2024
39 Tuti Susanti 20/02/2024
40 N Simbolon 20/02/2024
41 Rusli 23/02/2024
42 Suri 23/02/2024
43 Awaludin 29/02/2024
44 Sunarwan 29/02/2024
45 Aliman 29/02/2024
46 Nurhayati 29/02/2024
47 Jeidi 29/02/2024
48 Ervina 29/02/2024
49 Parman 28/02/2024
50 Marni 28/02/2024
51 Jainuddin 28/02/2024
52 Paiman 29/02/2024
53 Aliman 29/02/2024
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
2. Rawat Jalan
No Nama Pasien MR Honor DR Honor BPJS Total KlaimTotal Honor DR Diagnosa
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
Total - - - -
Lubuk Pakam, November

Diketahui
2022 Oleh; Kalkulasi Penggajian / Honor:
Ka. Keuangan Direktur RS
Rawat Jalan
Honor Rawat Jalan Umum -
Melki Tampubolon,
dr. SE
Arifin P Sitompul Honor Rawat Jalan BPJS -
Honor Pasien Rawat Inap 4,600,000 +
Total Honor Bruto 4,600,000
Pajak (Tax) 5 % 230,000 -
Jumlah Honor 4,370,000
Transportasi - +
Total Honor diterima 4,370,000
DPJP
dr. Dian,SpP
dr. Amarwati,SpN
dr. Yanika
dr. Million,Sp.A
Rekapitulasi Pasien
Bulan Desember 2023
1. Rawat Inap Umum, A+ dan Perusahaan

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Visite HD/Visite Sub Total Diagnosa / Ket Total Bill
1 Ridwan Purba 117263 Umum KLS III 2/24/2024 2/28/2024 4 40,000 160,000 Thypoid 2,418,750
2 Axcel Sitorus 116873 Umum KLS III 09/02/2024 09/02/2024 1 40,000 40,000 Febris 639,250
3 M Syahdan 117087 Umum KLS III 2/16/2024 2/19/2024 3 40,000 120,000 BP 1,507,500
4
-
-
Total 320,000 4,565,500
2. Rawat Inap BPJS

No Nama Pasien MR Status Ruang Tgl masuk Tgl keluar Total Klaim Jasa Dokter Ket. Diagnosa DPJP
1 Liora Anandi Hitamauli 110332 BPJS Kelas I 2/1/2024 03/02/2024 3,048,900 304,890 Thypoid
2 Luckiyana Intani Sinurat 116603 BPJS Kelas I 2/1/2024 03/02/2024 1,810,500 181,050 Dyspepsia
3 Dali Tri Anggara 116489 BPJS KLS III 1/28/2024 03/02/2024 2,855,900 285,590 Thypoid
4 Alvan Wijoyo 116700 BPJS Klas II 2/2/2024 2/5/2024 2,670,600 267,060 Thypoid
5 Firda Azhara Butar-Butar 116682 BPJS Klas II 2/2/2024 2/5/2024 2,670,600 267,060 Thypoid
6 Frans Luhud Rajaguk-Guk 116657 BPJS KLS III 2/1/2024 09/02/2024 2,855,900 285,590 Thypoid
7 Yevan Ashish Bonasardo Tamb 116871 BPJS Klas II 2/8/2024 2/11/2024 4,006,100 400,610 Thypoid
8 Bayi Rahma Sari Ginting 116882 BPJS Klas II 09/02/2024 2/11/2024 4,245,000 424,500 Microsuasis
9 Syakila Al Fairuz 114313 BPJS Klas II 09/02/2024 2/12/2024 1,924,500 192,450 GEA
10 Nabil Abimanyu 104157 BPJS Klas II 2/15/2024 2/18/2024 2,670,600 267,060 Tonsilofaringitis
11 Habil Hazari Nasution 117076 BPJS KLS III 16/02/0204 2/19/2024 2,292,400 229,240 Thypoid
12 M Gajali Hasan 077763 BPJS KLS III 2/15/2024 2/19/2024 2,479,100 247,910 ISK
13 M Juaranda 117077 BPJS KLS III 2/16/2024 2/19/2024 1,361,300 136,130 Febris
14 Dwi Cantika 108176 BPJS KLS III 17/02/2024 2/19/2024 2,703,400 270,340 ISPA
15 By Adelia Pratiwi 117072 BPJS KLS III 2/16/2024 2/19/2024 4,363,200 436,320 Asfiksia
16 Bayi Rizky Ananda Siregar 117097 BPJS KLS III 17/02/2024 2/19/2024 4,363,200 436,320 Aspiration
17 Rindu Pratama Sembiring 117033 BPJS Kelas I 2/15/2024 2/19/2024 5,827,700 291,385 TB dr. Dian,SpP
18 Yallsy Basyaasyah 112543 BPJS Klas II 18/02/2024 2/20/2024 1,746,500 87,325 Abdominal Pain dr. Jekson,Sp.OG
19 Imanuael Tamba 117228 BPJS KLS III 2/22/2024 24/2/2024 2,292,400 229,240 Thypoid
20 Bayi Renti Munthe 117201 BPJS KLS III 2/22/2024 24/2/2024 4,363,200 436,320 Asfiksia
21 Iqlima Almira Imran 117226 BPJS Kelas I 2/22/2024 25/02/2024 3,048,900 304,890 Thypoid
22 Syifa Malaika Utari 112520 BPJS KLS III 2/23/2024 2/26/2024 2,249,100 224,910 Asma
23 Hagai Desta Artha Saragih 80943 BPJS KLS III 2/24/2024 2/28/2024 2,292,400 229,240 Sepsis
24 Agnes Teresia Simanjuntak 77039 BPJS KLS III 2/24/2024 2/28/2024 1,652,000 165,200 Colic Abd'
25 -
26 -
27 -
-
Total 66,744,500 6,295,740
No Nama Pasien MR Tanggal Visite Honor Visite Diagnosa

1 Bayi Anne Safrika 1-Feb Visite GE
2 Bayi Rahmasari 9-Feb Non-Visite Hypoglicaemia
3 Bayi Lenny Nurhayati 9-Feb Non-Visite BBLR
4 Bayi Serly M Putri 8-Feb Visite BBLR
5 Bayi Adelia Pratiwi 16-Feb Non-Visite Asfiksia
6 Bayi Rizky Ananda 17-Feb Non-Visite Asfiksia
7 Bayi Renti Munthe 22-Feb Non-Visite Asfiksia
8 Bayi Karolina 29-Feb Non-Visite Asfiksia
9
10
11
12
13
14
15
16
17
2. Rawat Jalan
No Nama Pasien MR Status Tanggal Berobat Honor DR Jasa Honor BPJS Total Tagihan Total Honor DR Diagnosa
1 Ripaldo silaban jkn 11/3/2022 11/06/1968 25,000 limfadenopati tb
2 Osmar hasan jkn 11/3/2022 11/06/1968 25,000 ispa
3 Martha ulina jkn 11/3/2022 11/06/1968 25,000 tb paru
4 Tegar maulana jkn 11/3/2022 11/06/1968 25,000 limfadenitis tb
5 Maysarah jkn 11/3/2022 11/06/1968 25,000 dyspepsia
6 Nathasya margareth jkn 11/3/2022 11/06/1968 25,000 asma bronkial
7 Radhiya tama jkn 11/3/2022 11/06/1968 25,000 faringits kronis
8 Noel wilbert jkn 11/4/2022 11/06/1968 25,000 demam tipoid
9 Rifka jkn 11/4/2022 11/06/1968 25,000 faringits akut
10 Yuni permata jkn 11/4/2022 11/06/1968 25,000 tb paru
11 Fanissyah m jkn 11/4/2022 11/06/1968 25,000 paresthesia
12 Revan ananda jkn 11/5/2022 11/06/1968 25,000 tb paru
13 Icha olyria jkn 11/5/2022 11/06/1968 25,000 dhf
14 Haydar izanuddin jkn 11/5/2022 11/06/1968 25,000 epilepsi
15 Nizam zaky jkn 11/5/2022 11/06/1968 25,000 demam tipoid
16 Akhdan rizky jkn 11/5/2022 11/06/1968 25,000 epilepsi
17 Dean alkana m jkn 11/5/2022 11/06/1968 25,000 faringits
18 Arumi nasha jkn 11/10/2022 11/06/1968 25,000 faringits akut
19 Chintia jkn 11/10/2022 11/06/1968 25,000 dyspepsia
20 Ripaldo silaban jkn 11/10/2022 11/06/1968 25,000 limfadenitis tb
21 Aquila qantrunnadha jkn 11/10/2022 11/06/1968 25,000 afiesia
22 Bayi ny siti annisa jkn 11/10/2022 11/06/1968 25,000 ispa
23 Nur rahayu jkn 11/10/2022 11/06/1968 25,000 tb paru
24 Rizky adriansyah jkn 11/10/2022 11/06/1968 25,000 epilepsi
25 Raffi al faridzhi jkn 11/10/2022 11/06/1968 25,000 demam tipoid + faringits
26 Indah debora jkn 11/10/2022 11/06/1968 25,000 bronkitis kronis
27 Alfi ramadhan sugar jkn 11/10/2022 11/06/1968 25,000 abses tb paru
28 Elyana angelita jkn 11/10/2022 11/06/1968 25,000 ispa
29 Tegar maulana jkn 11/10/2022 11/06/1968 25,000 limfadenitis tb
30 Johan marati jkn 11/11/2022 11/06/1968 25,000 tonsilofaringits akut
31 Noel wilbert jkn 11/11/2022 11/06/1968 25,000 ispa
32 Alisyia nabilla jkn 11/11/2022 11/06/1968 25,000 susp tb paru
33 Jean al fariel jkn 11/11/2022 11/06/1968 25,000 atthralgia
34 Rifka br barus jkn 11/11/2022 11/06/1968 25,000 ispa
35 Alex saputra jkn 11/11/2022 11/06/1968 25,000 epilepsi
36 Osmar hasan jkn 11/11/2022 11/06/1968 25,000 ispa
37 Cantika zahra jkn 11/11/2022 11/06/1968 25,000 sange hema cervical
38 Tiara kasih umum 11/12/2022 06/07/2009 40,000 ispa
39 Khanza a jkn 11/12/2022 11/06/1968 25,000 dhf
40 Orevanel jkn 11/12/2022 11/06/1968 25,000 post covid 19
41 Damar adriansyah jkn 11/12/2022 11/06/1968 25,000 bronkitis
42 Dean alkana m jkn 11/17/2022 11/06/1968 25,000 tb paru
43 Martha ulina jkn 11/17/2022 11/06/1968 25,000 tb paru
44 Elwa timothy jkn 11/17/2022 11/06/1968 25,000 gea
45 Hamizah a jkn 11/17/2022 11/06/1968 25,000 ispa
46 Anggun ariana jkn 11/17/2022 11/06/1968 25,000 tonsilofaringits akut
47 Ady rajasa jkn 11/17/2022 11/06/1968 25,000 ispa
48 Al givahri s jkn 11/17/2022 11/06/1968 25,000 tb paru
49 Zaldan ahmad jkn 11/18/2022 11/06/1968 25,000 broncopneumonia
50 Nur salsabila jkn 11/18/2022 11/06/1968 25,000 colic abdomen
51 Yuni permata jkn 11/18/2022 11/06/1968 25,000 tb paru
52 Alisyia nabilla jkn 11/18/2022 11/06/1968 25,000 sange tb paru
53 Ok mhd dio fahrozi jkn 11/18/2022 11/06/1968 25,000 epilepsi
54 Gabriel elisa jkn 11/18/2022 11/06/1968 25,000 faringits akut
55 Arkan wira jkn 11/18/2022 11/06/1968 25,000 faringits akut
56 Jonathan imanuel jkn 11/19/2022 11/06/1968 25,000 ge akut
57 Gracia eliana br turnip jkn 11/19/2022 11/06/1968 25,000 gea
58 Ajeng putri siregar jkn 11/19/2022 11/06/1968 25,000 epilepsi
59 Dean alkana m jkn 11/24/2022 11/06/1968 25,000 bronkitis
60 Al givahri s jkn 11/24/2022 11/06/1968 25,000 tb paru
61 Fajar jkn 11/24/2022 11/06/1968 25,000 demam tipoid
62 Ady rajasa jkn 11/24/2022 11/06/1968 25,000 eandidiasis + conjunativity
63 Chintia jkn 11/24/2022 11/06/1968 25,000 isk
64 Tantri pramudita jkn 11/24/2022 11/06/1968 25,000 omsk
65 Cantika zahra jkn 11/24/2022 11/06/1968 25,000 hernia lumbalis
66 Nur salsabila jkn 11/25/2022 11/06/1968 25,000 anemia + dispepsia
67 Nur rahayu jkn 11/25/2022 11/06/1968 25,000 tb paru
68 Alisyia nabilla jkn 11/25/2022 11/06/1968 25,000 pneumonia
69 Jesica grasia jkn 11/25/2022 11/06/1968 25,000 demam tipoid
70 Fiqih surya jkn 11/28/2022 11/06/1968 25,000 asma bronkitis
71 Fatimah jkn 11/28/2022 11/06/1968 25,000 ispa
72 Tantri pramudita jkn 11/17/2022 11/06/1968 25,000 ispa
Total 06/07/2009 13/10/6759 - 1,815,000
Diketahui Oleh: Lubuk Pakam, November 2022 Kalkulasi Penggajian / Honor:

Direktur RS Ka.Keuangan
Rawat Inap:
Umum + Inhealth + PRSH 320,000
Rawat Jalan: Umum + Prshn + Inhealth 40,000 +
Total 360,000
dr. Arifin P Sitompul Melki Tampubolon, SE Potongan ke RS 10 % 36,000 -
Jumlah 324,000
Rawat Inap BPJS 6,295,740
Penerima: Rawat Jalan BPJS 1,775,000 +
Pajak (Tax) 5 % 419,737 -
Total Honor Setelah Pajak 7,975,003
Transportasi - +
dr. Siti Aisyah Dalimunthe,Sp.A Total Honor Diterima 7,975,003
Grantivity Bln. November 2022 5,000,000
2,975,003
dr. Mahyarani Dalimunthe,Sp.A
Rekapitulasi Pasien
Bulan Desember 2023
1. Rawat Inap Pasien Umum, A+ dan Perusahaan

No Nama Pasien MR Status Ruang Tgl masuk Tgl keluar Visite HD/Visite Total Honor DR Diagnosa Total Bill
1 Alvaro Gultom 116543 Umum KLS III 1/30/2024 2/1/2024 3 40,000 120,000 Thypoid 1,546,250
2 Winda Deefina Tambunan 116859 Umum KLS III 2/7/2024 08/02/2024 1 40,000 40,000 Thypoid 982,500
3 Ananda Nayla Aurel 116943 Umum Kelas I 2/12/2024 2/13/2024 2 60,000 120,000 Thypoid 1,853,750
4 Senandung Naomi 117115 Umum KLS III 2/19/2024 2/21/2024 3 40,000 120,000 Thypoid 1,588,750
5 Adea Cantika 117178 Umum Klas II 2/20/2024 2/23/2024 4 50,000 200,000 Vomitus 2,088,750
6
7
8
-
-
Total 13 600,000 8,060,000
2. Rawat Inap BPJS

No Nama Pasien MR Status Ruang Tgl masuk Tgl keluar Total Klaim Jasa Dokter Ket. Diagnosa DPJP
1 Syakila Hanawi 109745 BPJS KLS III 1/30/2024 2/1/2024 2,292,400 229,240 Thypoid
2 Bayi Putri Rahayu 116574 BPJS KLS III 1/30/2024 2/1/2024 4,363,200 436,320 Asfiksia
3 Natsya Nainggolan 116576 BPJS Kelas I 1/30/2024 2/1/2024 2,660,900 266,090 Dyspepsia
4 Bastian Tirta Birawa 116569 BPJS KLS III 1/30/2024 03/02/2024 2,855,900 285,590 Thypoid
5 Boi Erwin Romel 113754 BPJS Klas II 2/4/2024 06/02/2024 3,396,200 339,620 Bronchitis
6 Bonaventure Salvator 116732 BPJS KLS III 2/4/2024 06/02/2024 1,652,000 165,200 GEA
7 Yohana Magdalena 116734 BPJS KLS III 2/4/2024 07/02/2024 2,915,200 291,520 Thypoid
8 Bayi Angelina Gultom 116764 BPJS KLS III 2/5/2024 07/02/2024 4,363,200 436,320 Asfiksia
9 Benito Lumban Toruan 114117 BPJS KLS III 2/4/2024 08/02/2024 2,855,900 285,590 Thypoid
10 Elang Hagogoan Situmoran 116771 BPJS KLS III 2/5/2024 08/02/2024 1,652,000 165,200 GEA
11 By Dita Septiana 116840 BPJS KLS III 2/7/2024 09/02/2024 4,363,200 436,320 Asfiksia
12 Yohana Siagian 116856 BPJS KLS III 2/7/2024 09/02/2024 2,292,400 229,240 Thypoid
13 Trisna Chriswanda 091955 BPJS KLS III 2/7/2024 09/02/2024 2,292,400 229,240 Thypoid
14 Viola Zoana Matondang 116797 BPJS KLS III 2/6/2024 09/02/2024 2,855,900 285,590 Epilepsi
15 Rayhan Maulana 107259 BPJS Klas II 2/6/2024 09/02/2024 2,670,600 267,060 Thypoid
16 Imam Eka Putra 072083 BPJS Kelas I 2/6/2024 09/02/2024 3,048,900 304,890 Thypoid
17 Eloise Sihaga Gulo 116806 BPJS Kelas I 2/6/2024 09/02/2024 3,679,500 367,950 Febris
18 By Sahpriyani 116843 BPJS KLS III 2/7/2024 10/02/2024 4,363,200 436,320 Asfiksia
19 Bayi Susi Susanti Damanik 116808 BPJS KLS III 2/6/2024 10/02/2024 4,363,200 436,320 Asfiksia
20 Joanna Bella Br Hombing 116846 BPJS KLS III 2/7/2024 2/12/2024 1,652,000 165,200 GEA
21 Nino Davinza Alfarizqi 116908 BPJS Kelas I 10/02/2024 2/13/2024 3,877,200 387,720 BP
22 Bayi Vicky Amalia 116921 BPJS KLS III 10/02/2024 2/14/2024 4,363,200 436,320 Asfiksia
23 Naura Aprilia 116957 BPJS Klas II 2/12/2024 2/14/2024 3,327,200 332,720 DHF
24 Tan Jeslin 107972 BPJS KLS III 2/11/2024 2/14/2024 1,361,300 136,130 Dyspepsia
25 Dean Alkana Malachi Tamp 093846 BPJS Kelas I 2/13/2024 15/02/2024 3,048,900 304,890 Thypoid
26 M Rayyanza 116936 BPJS Klas II 2/11/2024 2/16/2024 2,585,000 258,500 GEA
27 Hafiz Alfatan 117006 BPJS Klas II 2/13/2024 2/16/2024 2,670,600 267,060 Thypoid
28 Ahmad Farhan Abdurraf 117008 BPJS Klas II 2/13/2024 2/16/2024 2,670,600 267,060 Thypoid
29 Irwan Evando Faeyza 116975 BPJS KLS III 2/12/2024 2/16/2024 2,292,400 114,620 Thypoid dr. Cut,Sp.THT
30 Nikita Anastasya Sinaga 116974 BPJS KLS III 2/12/2024 2/17/2024 2,292,400 229,240 Thypoid
31 M Dzikri Abdillah 086681 BPJS Klas II 2/12/2024 2/17/2024 2,282,400 228,240 DHF
32 Juan Fernandus 116950 BPJS KLS III 2/19/2024 2/22/2024 2,000,700 666,900 Cepalgia+Sinusitis 'dr. Soraya,SpM+dr. Rika,Sp.THT
33 Bayi Rohdearna 117137 BPJS KLS III 2/19/2024 2/22/2024 4,363,200 436,320 Asfiksia
34 Bayi Yusminah 117196 BPJS KLS III 2/21/2024 2/22/2024 4,363,200 436,320 Asfiksia
35 M Indrawan Syah Barus 117175 BPJS KLS III 2/20/2024 2/23/2024 3,582,800 358,280 Hemiplegia
36 Dira Agustina 117189 BPJS KLS III 2/21/2024 2/23/2024 2,292,400 229,240 Thypoid
37 Aliaza Malik Firzatullah 057147 BPJS KLS III 2/21/2024 2/23/2024 1,652,000 165,200 Cholecystistis
38 Umar 115933 BPJS Klas II 2/21/2024 24/2/2024 2,670,600 267,060 Thypoid
39 Eloi Marcelino Sitindaon 117347 BPJS Klas II 2/27/2024 29/02/2024 2,330,800 233,080 DBD
40 Bayi Sari Mutiara 17381 BPJS KLS III 2/27/2024 29/02/2024 4,363,200 436,320 Asfiksia
41 Tomy Josephin Marbun 73472 BPJS KLS III 26/02/2024 29/02/2024 2,292,400 229,240 Thypoid
42 Aprilio N Aginta 74713 BPJS Klas II 2/21/2024 27-Feb 1,585,900 158,590 Acute Abd
43 -
44 -
45 -
-
-
-
Total 122,856,600 12,637,870
No Nama Pasien MR Tanggal Visite Honor Visite Diagnosa

1 Bayi Susi Susanti 6-Feb Non-Visite Asfiksia
2 Bayi Sahpriani 5-Feb Non-Visite Asfiksia
3 Bayi Angelina G 5-Feb Non-Visite Asfiksia
4 Bayi Sri Yuwana 5-Feb Visite BBLR
5 Bayi Dita Septiana 7-Feb Non-Visite Asfiksia
6 Bayi Yusminah 21-Feb Non-Visite Asfiksia
7 Bayi Roh Dearni 19-Feb Non-Visite Asfiksia
8 Bayi Santi Yovi 21-Feb Visite BBLR
9 Bayi Erin Karlina 24-Feb Visite BBLR
10 Bayi Sari Mutiara 27-Feb Non-Visite Asfiksia
11 Tomy Josephi 26-Feb Non-Visite Thypoid
12 Bayi Sarma Widawati 27-Feb Non-Visite Asfiksia
13
14
15
16
17
18
19
20
21
22
Pasien Covid-19
No Nama Pasien MR Status Ruang Tgl masuk Tgl keluar Visite HD/Visite Total Honor DR Diagnosa
1 40 150,000 6,000,000
2 -
3 -
4 -
5 -
6 -
7 -
8 -
9 -
10 -
Total 40 6,000,000
2. Rawat Jalan
No Nama Pasien MR Status Tanggal Berobat Honor DR Jasa Honor BPJS Total Tagihan Total Honor DR Diagnosa
1 Muh alfarizi jkn 11/1/2022 25,000 25,000 epilepsi
2 Attirmidzi jkn 11/1/2022 25,000 25,000 hernia
3 Syafiq jkn 11/1/2022 25,000 25,000 bp
4 Mikhayla jkn 11/1/2022 25,000 25,000 hymen impeforata
5 Muh azzam jkn 11/1/2022 25,000 25,000 epitaksis
6 Zara syauqi jkn 11/1/2022 25,000 25,000 bp
7 Bintang jkn 11/1/2022 25,000 25,000 epilepsi
8 Valentino jkn 11/1/2022 25,000 25,000 bp
9 Tria amorioa jkn 11/1/2022 25,000 25,000 epilepsi
10 Muh aufar jkn 11/1/2022 25,000 25,000 tonsilitis akut
11 Mhd citra alamsyah jkn 11/1/2022 25,000 25,000 gdd
12 Hilya jkn 11/1/2022 25,000 25,000 ge
13 Muhammad arsya jkn 11/2/2022 25,000 25,000 thypoid fever
14 Errismawati jkn 11/2/2022 25,000 25,000 ge
15 Gibran jkn 11/2/2022 25,000 25,000 limfadenitis tb
16 Syu ara jkn 11/2/2022 25,000 25,000 epilepsi
17 Siti azahra jkn 11/2/2022 25,000 25,000 demam thypoid
18 Glory evenes jkn 11/2/2022 25,000 25,000 rhinitis alergi
19 Tia ananda jkn 11/2/2022 25,000 25,000 tb paru + anemia
20 Nayra jkn 11/2/2022 25,000 25,000 Iskemik
21 Aznar jkn 11/2/2022 25,000 25,000 bp
22 Putra zulaika jkn 11/2/2022 25,000 25,000 epilepsi
23 Bayi nyonya lema jkn 11/2/2022 25,000 25,000 asfiksa neonaturum
24 Christopel jkn 11/7/2022 25,000 25,000 astma
25 Raffasa jkn 11/7/2022 25,000 25,000 kds
26 Adinda jkn 11/7/2022 25,000 25,000 epilepsi
27 Jennairati jkn 11/7/2022 25,000 25,000 kds
28 Nadiera jkn 11/7/2022 25,000 25,000 demam thypoid
29 Fiqih jkn 11/7/2022 25,000 25,000 asma
30 Al naufal jkn 11/7/2022 25,000 25,000 nephotic
31 Fiftahu l jkn 11/7/2022 25,000 25,000 limfadenitis tb
32 Carissa yuse jkn 11/7/2022 25,000 25,000 anemia
33 Naila jkn 11/7/2022 25,000 25,000 isk
34 Fauzi jkn 11/7/2022 25,000 25,000 viral infeksi
35 Hasna jkn 11/8/2022 25,000 25,000 hemangioma
36 Muh azzam jkn 11/8/2022 25,000 25,000 epitaksis
37 Andicky jkn 11/8/2022 25,000 25,000 chf
38 Hamka jkn 11/8/2022 25,000 25,000 dhf
39 Muh rafasya jkn 11/8/2022 25,000 25,000 rhinitis alergi
40 Syafiq jkn 11/8/2022 25,000 25,000 fleus
41 Jeremy alvaro jkn 11/8/2022 25,000 25,000 epilepsi
42 Eudia jkn 11/8/2022 25,000 25,000 asd
43 Apprillia jkn 11/8/2022 25,000 25,000 tb paru
44 Daniel jkn 11/8/2022 25,000 25,000 limfadenitis tb
45 Salsabila jkn 11/8/2022 25,000 25,000 hipertiroid
46 Azelca amora jkn 11/8/2022 25,000 25,000 tonsilitis akut
47 Ahmad zaky jkn 11/8/2022 25,000 25,000 isk
48 Kai haverst jkn 11/9/2022 25,000 25,000 tb paru
49 Rindu jkn 11/9/2022 25,000 25,000 kds
50 Jhon andreas jkn 11/9/2022 25,000 25,000 dyspepsia
51 Anggi syah dewi jkn 11/9/2022 25,000 25,000 tb paru
52 Milano rich jkn 11/9/2022 25,000 25,000 epilepsi
53 Muh arsya jkn 11/9/2022 25,000 25,000 broncopeumonia
54 Zara syauqi jkn 11/9/2022 25,000 25,000 broncopeumonia
55 Agnes tesalonika jkn 11/9/2022 25,000 25,000 ga
56 Erisnawati jkn 11/9/2022 25,000 25,000 rhinitis alergi
57 Aski jkn 11/14/2022 25,000 25,000 bp
58 Costan jkn 11/14/2022 25,000 25,000 tb paru
59 Ronald jkn 11/14/2022 25,000 25,000 tonsilitis akut
60 Bayi nyonya sri jkn 11/14/2022 25,000 25,000 neonata seizune
61 Dika setiawan jkn 11/14/2022 25,000 25,000 post tb paru
62 Nabila jkn 11/14/2022 25,000 25,000 epilepsi
63 Fihar odila jkn 11/14/2022 25,000 25,000 haemoroid
64 Kayla nur jkn 11/14/2022 25,000 25,000 isk
65 Maria juan jkn 11/14/2022 25,000 25,000 kds
66 Michael jkn 11/14/2022 25,000 25,000 bp
67 Jihan humaira jkn 11/14/2022 25,000 25,000 dm tipe 2
68 Salsabila jkn 11/15/2022 25,000 25,000 gangguan cemas
69 Muh ibatullail jkn 11/15/2022 25,000 25,000 limfadenitis tb
70 Muh adam luffi jkn 11/15/2022 25,000 25,000 bd
71 Habibi jkn 11/15/2022 25,000 25,000 rhinitis
72 Attahallah jkn 11/15/2022 25,000 25,000 rhinitis
73 Bagas jkn 11/16/2022 25,000 25,000 dka
74 Alif jkn 11/16/2022 25,000 25,000 tb pd anak
75 Nadra jkn 11/16/2022 25,000 25,000 demam thypoid
76 Francius jkn 11/16/2022 25,000 25,000 tb pd anak
77 Ferdiansyah jkn 11/16/2022 25,000 25,000 epilepsi
78 Fauzi jkn 11/16/2022 25,000 25,000 poripheral
79 Azatira jkn 11/16/2022 25,000 25,000 epilepsi
80 Zain jkn 11/16/2022 25,000 25,000 bp
81 Raffasa jkn 11/16/2022 25,000 25,000 bp
82 Gibran jkn 11/16/2022 25,000 25,000 limfadenitis tb
83 Rafqi fazrin jkn 11/16/2022 25,000 25,000 gizi kurang
84 Tristan jkn 11/16/2022 25,000 25,000 thypoid fever
85 Muh arsya jkn 11/16/2022 25,000 25,000 bronkitis
86 Anggi syah jkn 11/16/2022 25,000 25,000 isk
87 Tia amanda jkn 11/16/2022 25,000 25,000 tb
88 Fahrul jkn 11/16/2022 25,000 25,000 tb
89 Farasya jkn 11/16/2022 25,000 25,000 anemia
90 Jiva imanuel jkn 11/21/2022 25,000 25,000 pneumonia
91 Andreas jkn 11/21/2022 25,000 25,000 dyspepsia
92 Musabith jkn 11/21/2022 25,000 25,000 epilepsi
93 Gwjapriol jkn 11/21/2022 25,000 25,000 tonsilitis akut
94 Aska jkn 11/21/2022 25,000 25,000 bp
95 Maria jkn 11/21/2022 25,000 25,000 dermatitis alergi
96 Dika setiawan jkn 11/21/2022 25,000 25,000 bp
97 Raysa jkn 11/21/2022 25,000 25,000 tonsilitis akut
98 Graciela jkn 11/21/2022 25,000 25,000 epilepsi
99 Armiro jkn 11/21/2022 25,000 25,000 kds
100 Fiftahu l jkn 11/21/2022 25,000 25,000 limfadenitis tb
101 Muh faiz jkn 11/21/2022 25,000 25,000 tonsilitis akut
102 Raja jkn 11/21/2022 25,000 25,000 tonsilitis akut
103 Syifa jkn 11/21/2022 25,000 25,000 bronkitis akut
104 Syauqie jkn 11/22/2022 25,000 25,000 demam thypoid
105 Nayra putri jkn 11/22/2022 25,000 25,000 demam thypoid
106 Jevariel jkn 11/22/2022 25,000 25,000 demam thypoid
107 M nur ikhsan jkn 11/22/2022 25,000 25,000 epilepsi
108 Al ayyubi jkn 11/22/2022 25,000 25,000 demam thypoid
109 Arshaka alhaqqi jkn 11/22/2022 25,000 25,000 dka
110 Riska al jkn 11/22/2022 25,000 25,000 demam thypoid
111 Jeremy alvaro jkn 11/22/2022 25,000 25,000 epilepsi
112 Salman jkn 11/22/2022 25,000 25,000 epilepsi
113 Muh adam jkn 11/22/2022 25,000 25,000 oma + gizi kurang
114 Bayi nyonya sri jkn 11/23/2022 25,000 25,000 ncb + a neoma
115 Kai haverst jkn 11/23/2022 25,000 25,000 tb paru
116 Rido ginting jkn 11/23/2022 25,000 25,000 syndrom neplotasis
117 Alif arga jkn 11/23/2022 25,000 25,000 bp
118 Muhibatuilail jkn 11/23/2022 25,000 25,000 limfadenitis tb
119 Juwita khumairah jkn 11/23/2022 25,000 25,000 app
120 Etiyana jkn 11/23/2022 25,000 25,000 dhf
121 Francius jkn 11/23/2022 25,000 25,000 tb kelenjar
122 Arnnisa putri jkn 11/23/2022 25,000 25,000 tonsilitis akut
123 Azahra radya jkn 11/23/2022 25,000 25,000 bp
124 Fadya naura jkn 11/23/2022 25,000 25,000 tonsilitis akut
125 Agra pradifta jkn 11/23/2022 25,000 25,000 dhf
126 Anggi syah jkn 11/23/2022 25,000 25,000 isk
127 Justine jkn 11/23/2022 25,000 25,000 gdd
128 Dean yehuda jkn 11/28/2022 25,000 25,000 tonsilitis akut
129 Syifa jkn 11/28/2022 25,000 25,000 gea
130 Costan alfandi jkn 11/28/2022 25,000 25,000 tb pd anak
131 Reja zal jkn 11/28/2022 25,000 25,000 tonsilitis akut
132 Sahat pranata jkn 11/28/2022 25,000 25,000 tonsilitis akut
133 Nabila saputri jkn 11/28/2022 25,000 25,000 epilepsi
134 Bayi nyonya kristin jkn 11/28/2022 25,000 25,000 asfiksa neonaturum
135 Tristan jkn 11/28/2022 25,000 25,000 epilepsi
136 Raja arga rosizky jkn 11/28/2022 25,000 25,000 tb paru
137 Muh adam luffi jkn 11/29/2022 25,000 25,000 konstipasi
138 Nayra jkn 11/29/2022 25,000 25,000 konstipasi
139 Bayi nyonya rizka jkn 11/29/2022 25,000 25,000 hiv
140 Arsyah jkn 11/29/2022 25,000 25,000 ispa
141 Muh gibran jkn 11/29/2022 25,000 25,000 thypoid fever
142 Justinus limbong jkn 11/30/2022 25,000 25,000 epitaksis
143 Alif arga jkn 11/30/2022 25,000 25,000 pneumonia
144 Francius jkn 11/30/2022 25,000 25,000 lymfadenitis bartonitis
145 Aysar jkn 11/30/2022 25,000 25,000 bradkites
146 Tia amanda jkn 11/30/2022 25,000 25,000 tb pd anak
147 Vino saputra jkn 11/30/2022 25,000 25,000 ge
148 Tesalonika sitorus jkn 11/30/2022 25,000 25,000 bp
149 Arshaka alhaqqi jkn 11/30/2022 25,000 25,000 scabies
150 Azahra radya jkn 11/30/2022 25,000 25,000 bp
151 Osmar haran jkn 11/30/2022 25,000 25,000 rhinitis alergi
152 Diego rapael jkn 11/30/2022 25,000 25,000 p thypoid
153 Abizar jkn 11/30/2022 25,000 25,000 bp
-
Total - 3,825,000 - 3,825,000
Diketahui Oleh: Lubuk Pakam, November 2022 Kalkulasi Penggajian / Honor:
Direktur RS Ka.Keuangan
Rawat Inap:
Rawat Jalan: Umum + Prshn + Inhealth - +
Total 600,000
dr. Arifin P Sitompul Melki Tampubolon, SE Potongan ke RS 10 % 60,000 -
Jumlah 540,000
Pasien Covid-2022 6,000,000
Penerima: Rawat Inap BPJS 12,637,870
Pajak (Tax) 5 % 1,150,144 -
dr. Mahyarani Dalimunthe, SpA Transportasi - +
Honor Pasien November 2022 21,852,727 -
Grantivity Bln. November 2022 5,000,000
16,852,727
dr. Dian Maulisa Fitriani,SpP
Rekapitulasi Pasien
Bulan Desember 2023
1. Rawat Inap Pasien Umum, Inhealth dan Perusahaan

No Nama Pasien MR Status Ruangan/Kelas Tgl Masuk Tgl Keluar Visite Honor/vst sub total Diagnosa Total Bill
1 Karolina Br Barus 117195 Umum KLS III 2/21/2024 25/02/2024 4 40,000 160,000 App+TB 8,267,500
2
.
Total 160,000 8,267,500
2. Rawat Inap BPJS

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Total Klaim Jasa Dokter Ket. Diagnosa DPJP
1 Susiyem 100445 BPJS KLS III 25/02/2024 2/28/2024 3,300,600 165,030 Pneumonia dr. Ridho,Sp.PD
2 Maria Fransiska Nainggolan 113681 BPJS KLS III 1/28/2024 2/1/2024 2,191,800 73,060 PSMBA 'dr. Ridho,Sp.PD+dr. Jekson,Sp.OG
3 Rusman Asal Gorat Sinaga 116596 BPJS KLS III 1/31/2024 2/1/2024 2,915,200 145,760 TB Paru dr. Wirandi,Sp.PD
4 Rianti Pasaribu 115006 BPJS KLS III 1/30/2024 2/2/2024 5,234,900 523,490 Pneumonia dr. Marolop,SpJ
5 Rohani 116575 BPJS KLS III 1/30/2024 03/02/2024 3,300,600 165,030 PPOK dr. Yanika,Sp.PD
6 Nurmala Simamora 054946 BPJS Kelas I 1/31/2024 03/02/2024 4,855,700 242,785 Cholelithiasis dr. Yanika,Sp.PD
7 Novia Wulan Sari 116591 BPJS KLS III 1/31/2024 03/02/2024 3,650,900 182,545 Pneumonia dr. Wirandi,Sp.PD
8 Suwarni 116312 BPJS KLS III 1/22/2024 03/02/2024 32,673,700 1,089,123 CHF+PSMBA+TB 'dr. Marolop,SpJ+dr. Wirandi,Sp.PD
9 Julius Cipto Padang 116660 BPJS KLS III 2/1/2024 03/02/2024 3,300,600 330,060 PPOK
10 M Sanjaya 058821 BPJS KLS III 2/1/2024 2/5/2024 4,381,700 146,057 Hepatomy+TB 'dr. Cut,Sp.THT+dr. Yanika,Sp.PD
11 Munir 067160 BPJS KLS III 2/2/2024 2/5/2024 4,381,700 438,170 TB Paru
12 M Joli 106135 BPJS Klas II 2/1/2024 06/02/2024 4,250,700 141,690 DM+TB 'dr. Lisbeth,SpS+dr. Yanika,Sp.PD
13 Sarnia Purba 081260 BPJS KLS III 2/3/2024 07/02/2024 2,155,900 107,795 Vertigo dr. Lisbeth,SpS
14 Asril Barus 116822 BPJS KLS III 2/6/2024 09/02/2024 2,451,400 122,570 CHF dr. Marolop,SpJ
15 Kasmuji 113371 BPJS KLS III 2/7/2024 09/02/2024 4,226,800 422,680 TB Paru
16 Milan Sitepu 116836 BPJS KLS III 2/7/2024 09/02/2024 3,598,700 179,935 Pneumonia dr. Wirandi,Sp.PD
17 Nurhayatun 66359 BPJS KLS III 09/02/2024 2/12/2024 3,300,600 165,030 Asma Bronchial dr. Yanika,Sp.PD
18 Afridanis 101281 BPJS KLS III 2/12/2024 15/02/2024 3,000,100 100,003 LBP+Colic Abd 'dr. Lisbeth,SpS+dr. Wirandi,Sp.PD
19 Rima Afni 117014 BPJS KLS III 2/14/2024 2/16/2024 4,381,700 219,085 TB Paru dr. Wirandi,Sp.PD
20 Vivian Angreswita Sihombin 098245 BPJS KLS III 2/13/2024 2/17/2024 4,381,700 438,170 TB Paru
21 Rindu Pratama Sembiring 117033 BPJS Kelas I 2/15/2024 2/19/2024 5,827,700 291,385 TB dr. Million,SpA
22 Nampat Tarigan (Exit) 117176 BPJS Klas II 2/20/2024 2/21/2024 1,746,500 58,217 Sepsis 'dr. Yanika,Sp.PD+dr. Marolop,SpJ
23 Ridwan Lubis 65788 BPJS KLS III 2/19/2024 2/21/2024 2,292,400 114,620 Thypoid dr. Wirandi,Sp.PD
24 Jainuddin Tambunan 117159 BPJS KLS III 2/20/2024 2/22/2024 4,381,700 438,170 TB Paru
25 Fitri Khairani 90663 BPJS Klas II 2/19/2024 2/22/2024 4,006,100 200,305 'Thypoid+Pneumonia dr. Yanika,Sp.PD
26 Rusli 103556 BPJS KLS III 2/20/2024 2/23/2024 3,300,600 330,060 Tuberculosis
27 Kornel Erikson Nababan 94746 BPJS KLS III 2/21/2024 24/2/2024 2,915,200 291,520 Bronchitis
28 Kardian Turnip 101590 BPJS KLS III 2/22/2024 25/02/2024 4,226,800 211,340 TB dr. Yanika,Sp.PD
29 Sareng 117343 BPJS KLS III 26/02/2024 2/29/2024 3,650,900 121,697 Pneumonia 'dr.Heri,SpB+dr. Wirandi,Sp.PD
30 Hosneli Asma 117291 BPJS KLS III 26/02/2024 29/02/2024 4,196,000 139,867 DM+LBP+TB 'dr. Lisbeth,SpS+dr. Ridho,Sp.PD
31 Julianus 117422 BPJS Kelas I 2/29/2024 2/29/2024 1,993,900 199,390 Anemia
32 Mendra 109236 BPJS KLS III 1/30/2024 02/02/2024 3,300,600 110,020 CHF 'dr. Yanika,Sp.PD+dr. Marolop,SpJ
33
34
35
36
37
38
39
40
41
42
43
Total 143,773,400 7,904,658
Pasien Covid-19
No Nama Pasien MR Status Ruangan/Kelas Tgl Masuk Tgl Keluar Visite Honor/vst sub total Diagnosa
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Total -
3. Rawat Jalan
No Nama Pasien MR Status Tanggal Berobat Jasa Baca EKG Honor Umum Honor BPJS Total Honor Diagnosa
1 Kliwon jkn 11/1/2022 25,000 25,000 tb paru
2 Farizzon effendi jkn 11/1/2022 25,000 25,000 tb paru
3 Law kim yong jkn 11/1/2022 25,000 25,000 sequele of tb
4 Putri dewita sari jkn 11/1/2022 25,000 25,000 tb paru
5 Rohmaulina jkn 11/1/2022 25,000 25,000 copd + susp tb
6 Norma jkn 11/1/2022 25,000 25,000 sequele of tb
7 Serta tambunan jkn 11/1/2022 25,000 25,000 pneumonia
8 Darwan ferdinan jkn 11/1/2022 25,000 25,000 tb paru + bronchitis
9 Yitro rinardi jkn 11/1/2022 25,000 25,000 bronchitis + asma
10 Firnawati jkn 11/1/2022 25,000 25,000 pneumonia
11 Gongga pangaribuan jkn 11/2/2022 25,000 25,000 copd
12 Supiati jkn 11/2/2022 25,000 25,000 tb paru
13 M yusup jkn 11/3/2022 25,000 25,000 bronchitis kronis
14 Jumanti gultom jkn 11/3/2022 25,000 25,000 limphadenitis tb
15 Eliani jkn 11/3/2022 25,000 25,000 sequele tb
16 Carles tarigan jkn 11/3/2022 25,000 25,000 tb paru + efusi fleura
17 Derita hutasoit jkn 11/3/2022 25,000 25,000 susp tb paru
18 Syah rafli jkn 11/3/2022 25,000 25,000 susp tb
19 Yitro rionaldy purba jkn 11/8/2022 25,000 25,000 bronchitis kronis
20 Rohmaulina jkn 11/8/2022 25,000 25,000 copd
21 Sri winarti jkn 11/8/2022 25,000 25,000 asma bronchiale
22 Lince hotmaida sinaga jkn 11/8/2022 25,000 25,000 cap
23 Zuraida jkn 11/8/2022 25,000 25,000 cap
24 Sondang manalu drs jkn 11/8/2022 25,000 25,000 tb paru
25 Mawang sari jkn 11/8/2022 25,000 25,000 asma bronchiale
26 Mardiana jkn 11/8/2022 25,000 25,000 tb paru
27 Suyitno jkn 11/8/2022 25,000 25,000 copd
28 Muhammad hidayat jkn 11/8/2022 25,000 25,000 tb paru
29 Ronal mangar tua sinaga jkn 11/8/2022 25,000 25,000 asma bronchiale
30 Mangintua sibuea jkn 11/8/2022 25,000 25,000 tb paru
31 Khairul jkn 11/8/2022 25,000 25,000 copd
32 Raja naksir jkn 11/9/2022 25,000 25,000 ppok . Copd
33 Klara m sianturi jkn 11/9/2022 25,000 25,000 tb . Dm
34 Syamtinah jkn 11/9/2022 25,000 25,000 limphadenitis tb
35 Novia andreani jkn 11/9/2022 25,000 25,000 limphadenitis tb
36 Mhd kili jkn 11/9/2022 25,000 25,000 tb paru
37 Krimson simbolon jkn 11/9/2022 25,000 25,000 bronchitis kronis
38 Supriadi jkn 11/9/2022 25,000 25,000 copd
39 Lilik suryadi jkn 11/9/2022 25,000 25,000 tb paru
40 Bitar sihotang jkn 11/9/2022 25,000 25,000 copd
41 Tupon jkn 11/9/2022 25,000 25,000 sequele tb
42 Surya darma jkn 11/10/2022 25,000 25,000 tb paru
43 Syah rafli jkn 11/10/2022 25,000 25,000 bp
44 Siti maryam jkn 11/10/2022 25,000 25,000 tb ekstra paru
45 Derta hutasoit jkn 11/10/2022 25,000 25,000 tb paru
46 Ferdinan umum 11/10/2022 40,000 40,000 ppok
47 Umar simbolon jkn 11/10/2022 25,000 25,000 pneumonia
48 Ely sabet lindawaty jkn 11/10/2022 25,000 25,000
49 Sulaiman jkn 11/10/2022 25,000 25,000 bp
50 Hambiri harahap jkn 11/15/2022 25,000 25,000 copd
51 Zuraida jkn 11/15/2022 25,000 25,000 asma
52 Nawang sari jkn 11/15/2022 25,000 25,000 copd
53 Darmauli simanjuntak jkn 11/15/2022 25,000 25,000 copd
54 Kencana sembiring jkn 11/15/2022 25,000 25,000 copd
55 Tombang nababan jkn 11/15/2022 25,000 25,000 copd
56 Kalimantan girsang jkn 11/15/2022 25,000 25,000 copd
57 Darwan ferdinan jkn 11/15/2022 25,000 25,000 tb paru
58 Elisabet purba jkn 11/15/2022 25,000 25,000 copd
59 Keliwon jkn 11/15/2022 25,000 25,000 tb paru + bronchitis
60 Farizon effendy jkn 11/15/2022 25,000 25,000 tb paru
61 Suryadi jkn 11/15/2022 25,000 25,000 asma
62 Restuti nababan jkn 11/15/2022 25,000 25,000 copd
63 Iwan nugroho jkn 11/15/2022 25,000 25,000 pneumonia
64 Hari setiawan jkn 11/16/2022 25,000 25,000 pneumonia
65 Supiari jkn 11/16/2022 25,000 25,000 tb paru
66 Sucipto jkn 11/16/2022 25,000 25,000 copd
67 Desi pramira jkn 11/16/2022 25,000 25,000 limphadenitis tb
68 Rustel tarigan jkn 11/16/2022 25,000 25,000 copd
69 Ambo jkn 11/16/2022 25,000 25,000 copd
70 Awaludin jkn 11/16/2022 25,000 25,000 pneumonia
71 Sumiati jkn 11/16/2022 25,000 25,000 asma bronchiale
72 Umar simbolon jkn 11/17/2022 25,000 25,000 copd
73 Jumanti gultom jkn 11/17/2022 25,000 25,000 copd
74 Suatik jkn 11/17/2022 25,000 25,000 limphadenitis tb
75 Ely sabet lindawaty jkn 11/17/2022 25,000 25,000 cap
76 Derita hutasoit jkn 11/17/2022 25,000 25,000 tb paru
77 Bation manik jkn 11/17/2022 25,000 25,000 tb paru
78 Ramadhani jkn 11/17/2022 25,000 25,000 haemaptoe ec tb paru
79 Mhd hidayat jkn 11/22/2022 25,000 25,000 tb paru + dm
80 Siti aminah jkn 11/22/2022 25,000 25,000 tb paru + dm
81 Irwan jkn 11/22/2022 25,000 25,000 copd
82 Mardiana jkn 11/22/2022 25,000 25,000 tb paru + dm
83 Nangin peranginangin jkn 11/22/2022 25,000 25,000 tb kelenjar
84 Mahrita saragih jkn 11/22/2022 25,000 25,000 asma
85 Sundung manalu jkn 11/22/2022 25,000 25,000 tb paru
86 Marolop nainggolan jkn 11/22/2022 25,000 25,000 tb paru + hiv
87 Mangintua sibuea jkn 11/22/2022 25,000 25,000 tb paru
88 Pantus sigalingging jkn 11/22/2022 25,000 25,000 cap
89 Evi nurhafni lbs jkn 11/22/2022 25,000 25,000 pneumonia
90 Selaniar jkn 11/22/2022 25,000 25,000 limphadenitis
91 Gunawan sembiring jkn 11/23/2022 25,000 25,000 copd
92 Tupon jkn 11/23/2022 25,000 25,000 haemaptoe ec sequele of tb
93 Ijon pardamen purba jkn 11/23/2022 25,000 25,000 sequele tb
94 Sistem supartik jkn 11/23/2022 25,000 25,000 copd
96 Syamtinah jkn 11/23/2022 25,000 25,000 limphadenitis tb
97 Nurmala wiji saputri jkn 11/23/2022 25,000 25,000 limphadenitis tb
98 Rahmat barus jkn 11/24/2022 25,000 25,000 copd
99 Parasian situmorang jkn 11/24/2022 25,000 25,000 copd
100 Muliono pardede jkn 11/24/2022 25,000 25,000 copd
101 Lilik suryadi jkn 11/24/2022 25,000 25,000 tb paru + dm
102 Sri antini jkn 11/24/2022 25,000 25,000 copd
103 Sulaiman rangkuti jkn 11/24/2022 25,000 25,000 copd
104 Derita hutasoit jkn 11/24/2022 25,000 25,000 tb paru
105 Jessi kristin jkn 11/24/2022 25,000 25,000 tb paru
106 Bation manik jkn 11/24/2022 25,000 25,000 ca paru
107 Irwan jkn 11/29/2022 25,000 25,000 copd
108 Tegar maulana jkn 11/29/2022 25,000 25,000 limphadenitis tb
109 Farizon effendy jkn 11/29/2022 25,000 25,000 tb paru + dm
110 Darwan ferdinan jkn 11/29/2022 25,000 25,000 tb paru + copd
111 Sofiyatuh jkn 11/29/2022 25,000 25,000 sequele tb
112 Dedi irawan jkn 11/29/2022 25,000 25,000 haemaptoe
113 Marlisman jkn 11/29/2022 25,000 25,000 copd
114 Pantus sigalingging jkn 11/29/2022 25,000 25,000 cap
115 Tanda barus jkn 11/29/2022 25,000 25,000 copd
116 Evi nurhafni lbs jkn 11/29/2022 25,000 25,000 cap
118 Rahmat barus jkn 11/30/2022 25,000 25,000 copd
119 Jumanti gultom jkn 11/30/2022 25,000 25,000 limphadenitis tb
120 Ijon pardamen purba jkn 11/30/2022 25,000 25,000 sequelle tb
121 Supiati jkn 11/30/2022 25,000 25,000 tb paru + copd
122 Raja naksir jkn 11/30/2022 25,000 25,000 copd
123 Novia andreani jkn 11/30/2022 25,000 25,000 limphadenitis tb
Total - 40,000 3,050,000 3,090,000

Rawat Jalan:
Umum + Prshan + Inhealth 40,000 +
Total 200,000
Pasien Covid-2022 -
Penerima; Rawat Jalan BPJS 3,050,000
Rawat Inap BPJS 7,904,658 +
Pajak (TAX) 5 % 556,733 -
dr. Rizka Helmi, SpP Total Honor 10,577,925
Transportasi - +
Grantivity Bln. November 2022 5,000,000 -
5,577,925
dr. Desmonia Damanik. Sp.P
Rekapitulasi Pasien
Bulan Desember 2023
1. Rawat Inap Pasien Umum, Inhealth dan Perusahaan

No Nama Pasien MR Status Ruangan/Kelas Tgl Masuk Tgl Keluar Visite Honor/vst sub total
1 Sudarman 061645 Umum Klas II 2/16/2024 2/17/2024 2 50,000 100,000
2 Kamarudin Daely 117254 Umum KLS III 2/23/2024 24/2/2024 2 40,000 80,000
3
4
5
Total 4 180,000
2. Rawat Inap BPJS

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Total Klaim Jasa Dokter Ket. Diagnosa
1 Waslan 76842 BPJS Klas II 09/02/2024 2/14/2024 6,454,900 161,373 Cerebral Infarktion
2 Gustaf Sibarani 116785 BPJS Kelas I 2/5/2024 08/02/2024 5,827,700 291,385 DM+TB
3 Siti Rohani 102330 BPJS KLS III 17/02/2024 2/22/2024 5,098,400 169,947 CAP+Pneumonia
4 Sumardi 95300 BPJS KLS III 25/02/2024 29/02/2024 4,934,700 164,490 CHF+PPOK
5 Lidia Jojor Tina Simbolon 70157 BPJS Klas II 25/02/2024 29/02/2024 5,471,100 182,370 BP
6 Imdhani 104392 BPJS Klas II 25/02/2024 29/02/2024 3,151,200 105,040 DM+TB+Vertigo
7 Sukarmin 116616 BPJS Klas II 2/1/2024 2/4/2024 2,641,500 132,075 OA
8 Leni Purnama Wati Marpa 116635 BPJS Klas II 2/1/2024 2/5/2024 5,104,700 255,235 'Bronchitis+Dyspepsia
9 Ceteria Br Simbolon 057806 BPJS KLS III 2/3/2024 06/02/2024 3,650,900 365,090 CAP
10 Rabulan Saragih 116731 BPJS KLS III 2/4/2024 06/02/2024 5,130,400 256,520 DBD+TB Paru
11 Firnawati 075387 BPJS KLS III 2/4/2024 06/02/2024 2,155,900 71,863 TTH
12 Janawi Saragi 108915 BPJS KLS III 2/4/2024 07/02/2024 3,650,900 121,697 COPD
13 Pitriwan Sianipar 103648 BPJS KLS III 2/5/2024 08/02/2024 4,381,700 438,170 TB
14 Naman Purba 116719 BPJS Klas II 2/4/2024 08/02/2024 4,253,300 425,330 TB
15 Monang Hutabarat 116736 BPJS Kelas I 2/4/2024 08/02/2024 4,389,800 219,490 Pneumonia
16 Martha Br Silaban 116720 BPJS KLS III 2/4/2024 09/02/2024 4,381,700 219,085 TB
17 Murni Waruwu 111350 BPJS KLS III 2/3/2024 09/02/2024 4,381,700 219,085 TB
18 Ricky Adidya 71806 BPJS Kelas I 10/02/2024 2/13/2024 4,855,700 485,570 Pneumonia
19 Suramin 116925 BPJS KLS III 10/02/2024 2/14/2024 4,381,700 219,085 TB+Dyspepsia
20 Nurmeilisa 116948 BPJS KLS III 2/12/2024 15/02/2024 5,811,400 193,713 CHF+Efusi Pleura
21 Boimin 117090 BPJS KLS III 2/16/2024 2/19/2024 3,300,600 330,060 Asma
22 Suriyanti 117056 BPJS Klas II 2/16/2024 2/19/2024 2,511,600 125,580 Vertigo
23 Pella Marrie Warda 88063 BPJS KLS III 17/02/2024 2/21/2024 3,650,900 182,545 'Thypoid+Pneumonia
24 Bebasman Sipayung 117133 BPJS KLS III 2/19/2024 2/22/2024 4,381,700 438,170 TB
25 Merna Simbolon 110524 BPJS KLS III 2/19/2024 2/22/2024 2,915,200 291,520 TB
26 Sabarudin 098853 BPJS KLS III 2/19/2024 2/23/2024 5,130,400 256,520 Pneumonia
27 Samiun 117111 BPJS KLS III 2/18/2024 24/2/2024 6,486,700 324,335 Pneumonia
28 Jamenson Purba 89200 BPJS KLS III 2/23/2024 2/26/2024 3,300,600 330,060 COPD
29 Trisni 112874 BPJS KLS III 2/24/2024 4/26/2024 3,650,900 365,090 Pneumonia
30 Emmalina Br Damanik 117265 BPJS KLS III 2/24/2024 2/28/2024 4,381,700 438,170 Pneumonia
31 Suyetno 117277 BPJS KLS III 25/02/2024 29/02/2024 3,300,600 330,060 Pneumonia
32 Gunawan Sembiring 101324 BPJS KLS III 2/24/2024 29/02/2024 3,650,900 182,545 Septicaemia
33
34
35
36
37
38
39
40
41
42
43
44
45
Total 136,771,100 8,291,268
Pasien Covid-19
No Nama Pasien MR Status Ruangan/Kelas Tgl Masuk Tgl Keluar Visite Honor/vst sub total
1 40 150,000 6,000,000
2 -
3 -
4 -
5 -
Total 40 6,000,000
3. Rawat Jalan
No Nama Pasien MR Status Tanggal Berobat Jasa Baca EKG Honor Umum Honor BPJS Total Honor Diagnosa
1 Yogi satya jkn 11/5/2022 25,000 25,000 copd
2 Susi handayani jkn 11/5/2022 25,000 25,000 copd
3 Rellus butar butar jkn 11/5/2022 25,000 25,000 copd
4 Muhammad rahmad jkn 11/5/2022 25,000 25,000 pneumonia
5 Ponimah jkn 11/5/2022 25,000 25,000 copd
6 Syarifuddin pulungan jkn 11/5/2022 25,000 25,000 haemapto + susp tb ag
7 Poni jkn 11/5/2022 25,000 25,000 copd
8 Surono jkn 11/5/2022 25,000 25,000 copd
9 Jonter pangaribuan jkn 11/5/2022 25,000 25,000 copd
10 Farlin lbn raja jkn 11/5/2022 25,000 25,000 copd
11 Renta pakpahan jkn 11/5/2022 25,000 25,000 cap
12 Syafrizal jkn 11/5/2022 25,000 25,000 copd
13 Megawati jkn 11/5/2022 25,000 25,000 copd
14 Kadar ginting jkn 11/5/2022 25,000 25,000 copd
15 Irma susanti jkn 11/5/2022 25,000 25,000 asma bronchiale
16 Rondang manurung jkn 11/7/2022 25,000 25,000 tb paru
17 Mubin sihombing jkn 11/7/2022 25,000 25,000 post tb
18 Binsar sihombing jkn 11/7/2022 25,000 25,000 sequele of tb
19 Tianur sitorus jkn 11/7/2022 25,000 25,000 copd
20 Mingan jkn 11/7/2022 25,000 25,000 cap
21 Modal sinaga jkn 11/7/2022 25,000 25,000 copd
22 Kiyai harjo tumanggung jkn 11/7/2022 25,000 25,000 tb paru
23 Joko laksono jkn 11/7/2022 25,000 25,000 copd
24 Winardi jkn 11/7/2022 25,000 25,000 tb paru
25 Nurlela jkn 11/7/2022 25,000 25,000 tb paru
26 Dekayana jkn 11/7/2022 25,000 25,000 copd
27 Nurnani barus jkn 11/7/2022 25,000 25,000 copd
28 ok darvis jkn 11/7/2022 25,000 25,000 copd
29 Sahara jkn 11/7/2022 25,000 25,000 ekest pain ec tb paru
30 Sorta simanjuntak jkn 11/7/2022 25,000 25,000 haemaptoe + post tb
31 Anisa zahra jkn 11/7/2022 25,000 25,000 efusi fleura
32 Jonson trg jkn 11/7/2022 25,000 25,000 haemaptoe
33 Hadi gabriel parhusip jkn 11/12/2022 25,000 25,000 tb paru
34 Masita lubis jkn 11/12/2022 25,000 25,000 copd
35 Biner sitohang jkn 11/12/2022 25,000 25,000 copd
36 Jawasi simanjorang jkn 11/12/2022 25,000 25,000 copd
37 Ahmad rizal lubis jkn 11/12/2022 25,000 25,000 tb paru
38 Suwarni jkn 11/12/2022 25,000 25,000 copd
39 Ngatimah jkn 11/12/2022 25,000 25,000 tb paru
40 Tiur kristina jkn 11/12/2022 25,000 25,000 copd
41 Armiati laili jkn 11/12/2022 25,000 25,000 tb paru
42 Syarifuddin jkn 11/12/2022 25,000 25,000 susp tb paru keleps
43 Santi hutapea jkn 11/12/2022 25,000 25,000 copd
44 Carles tarigan jkn 11/12/2022 25,000 25,000 effusi
45 Immanuel nainggolan jkn 11/12/2022 25,000 25,000
46 Asdi wirawan jkn 11/12/2022 25,000 25,000
47 Safaruddin sitorus jkn 11/14/2022 25,000 25,000 copd
48 Imdhani jkn 11/14/2022 25,000 25,000 copd
49 Jonson trg jkn 11/14/2022 25,000 25,000 copd
50 Ibrahim jkn 11/14/2022 25,000 25,000 susp tb
51 Manatap rajagukguk jkn 11/14/2022 25,000 25,000 copd
52 Dedi irawan jkn 11/14/2022 25,000 25,000 haemaptoe + tb paru
53 Boinem jkn 11/14/2022 25,000 25,000 cap
54 Andi syahputra jkn 11/14/2022 25,000 25,000 copd
55 Edi susanto jkn 11/14/2022 25,000 25,000 copd
56 Toni sagala jkn 11/14/2022 25,000 25,000 copd
57 Ngtek liong als zaki aswadi jkn 11/14/2022 25,000 25,000 tb paru
58 Indah wahyu syafitri jkn 11/14/2022 25,000 25,000 tb paru
59 Yusriana jkn 11/14/2022 25,000 25,000 haemaptoe
60 Marice batubara jkn 11/14/2022 25,000 25,000 copd
61 Sutarsih jkn 11/14/2022 25,000 25,000 copd
62 Suprihatin jkn 11/14/2022 25,000 25,000 cap + tb paru
63 Slamet jkn 11/14/2022 25,000 25,000 chest pain + tb paru
64 Sri wahyuningsih jkn 11/14/2022 25,000 25,000 copd
65 Jardim purba jkn 11/14/2022 25,000 25,000 cap
66 Hendriyanto jkn 11/19/2022 25,000 25,000 copd
67 Hetty helena sinaga jkn 11/19/2022 25,000 25,000 copd
68 Horas tambun jkn 11/19/2022 25,000 25,000 copd
69 M yulia fitri jkn 11/19/2022 25,000 25,000 copd
70 Hendrik ponimah jkn 11/19/2022 25,000 25,000 copd
71 Anggi m jkn 11/19/2022 25,000 25,000 copd
72 Dea mahfudzah jkn 11/19/2022 25,000 25,000 asma
73 Ramadhani jkn 11/19/2022 25,000 25,000 tb paru
74 Linting santoso jkn 11/19/2022 25,000 25,000 copd
75 Suriyono jkn 11/19/2022 25,000 25,000 cap
76 Eva yunita jkn 11/19/2022 25,000 25,000 copd
77 Irvan dadi trg jkn 11/19/2022 25,000 25,000 copd
78 Komma rianna jkn 11/19/2022 25,000 25,000 cap
79 Krisman lbn gaol jkn 11/19/2022 25,000 25,000 copd
80 Jonter pangaribuan jkn 11/19/2022 25,000 25,000 tb paru
81 Burhanuddin jkn 11/19/2022 25,000 25,000 copd
82 M yogi subroto jkn 11/19/2022 25,000 25,000 copd
83 Heri yanti jkn 11/19/2022 25,000 25,000 asma
84 Tukarini jkn 11/19/2022 25,000 25,000 copd
85 Renta pakpahan jkn 11/19/2022 25,000 25,000 copd
86 Saut sigalingging jkn 11/21/2022 25,000 25,000 cap
87 Syifa aprilia jkn 11/21/2022 25,000 25,000 susp tb
88 Mhd faiz hilmi jkn 11/21/2022 25,000 25,000 copd
89 Edi susanto jkn 11/21/2022 25,000 25,000 susp tb
90 Rusiana jkn 11/21/2022 25,000 25,000 copd
91 Sorta simanjuntak jkn 11/21/2022 25,000 25,000 dm + ht + neuropati
92 Sahara jkn 11/21/2022 25,000 25,000 copd
93 Bornem jkn 11/21/2022 25,000 25,000 tb paru + ppok + chf
94 Nurlela jkn 11/21/2022 25,000 25,000 cap
95 Indah wahyu syafitri jkn 11/21/2022 25,000 25,000 copd
96 Imdani jkn 11/21/2022 25,000 25,000 copd
97 Marice batubara jkn 11/21/2022 25,000 25,000 copd
98 Tiodar napitupulu jkn 11/21/2022 25,000 25,000 tb paru
99 Winardi jkn 11/21/2022 25,000 25,000 tb paru
100 Mingan jkn 11/21/2022 25,000 25,000 copd
101 Kiyai harjo tumanggung jkn 11/21/2022 25,000 25,000 copd
102 Dorma loli simanjuntak jkn 11/21/2022 25,000 25,000
103 Rondang manurung jkn 11/21/2022 25,000 25,000 tb paru
104 Asmita sari turnip jkn 11/21/2022 25,000 25,000 copd
105 Netti herawati jkn 11/21/2022 25,000 25,000 copd
106 Suriyono jkn 11/26/2022 25,000 25,000 copd
107 Ismail silitonga jkn 11/26/2022 25,000 25,000 cap
108 Semi jkn 11/26/2022 25,000 25,000 asma
109 Ely sabet lindawati jkn 11/26/2022 25,000 25,000 haemaptoe + tb
110 Nurdiansyah jkn 11/26/2022 25,000 25,000 copd
111 Ahmad rizal lubis jkn 11/26/2022 25,000 25,000 cap + tb paru
112 Luhut manik jkn 11/26/2022 25,000 25,000 copd
113 Sumisti jkn 11/26/2022 25,000 25,000 copd
114 Armiati laili jkn 11/26/2022 25,000 25,000 tb paru
115 Jaiman samosir jkn 11/26/2022 25,000 25,000 copd
116 Ngatimah jkn 11/26/2022 25,000 25,000 tb paru
117 Ahmad jkn 11/26/2022 25,000 25,000 copd
118 Hendri yanto jkn 11/26/2022 25,000 25,000 copd
119 Jonter pangaribuan jkn 11/26/2022 25,000 25,000 tb paru
120 Hadi gabriel parhusip jkn 11/26/2022 25,000 25,000 chest pain + tb paru
121 Normansyah nst jkn 11/26/2022 25,000 25,000 copd
122 Patar sijabat jkn 11/26/2022 25,000 25,000 copd
123 Ahmad muklis jkn 11/26/2022 25,000 25,000 copd
124 Firdha stefany jkn 11/26/2022 25,000 25,000 limphanitis tb
125 Ogi fianturi jkn 11/26/2022 25,000 25,000 copd
126 Jadim purba jkn 11/28/2022 25,000 25,000 cap
127 Panca teman trg jkn 11/28/2022 25,000 25,000 tb + dm
128 Bevit sri wahyuni jkn 11/28/2022 25,000 25,000 bronchitis kronis
129 Ngatinem jkn 11/28/2022 25,000 25,000 copd
130 Slamet jkn 11/28/2022 25,000 25,000 dispnoe + tb paru
131 Sri wahyuningsih jkn 11/28/2022 25,000 25,000 sequele of tb + dm
132 Tukijah jkn 11/28/2022 25,000 25,000 cap
133 Kanimariaha jkn 11/28/2022 25,000 25,000 copd
134 Suprihatin jkn 11/28/2022 25,000 25,000 tb paru + dm
Total - - 3,350,000 3,350,000

Rawat Jalan: Umum + Prshan + Inhealth -
Total 180,000
Melki Tampubolon, SE dr. Arifin P Sitompul Potongan ke RS 10 % 18,000
Pasien Covid-2022 6,000,000
Penerima; Rawat Jalan BPJS 3,350,000
Pajak (TAX) 5 % 890,163
dr. Desmonia Damanik, SpP Total Honor 16,913,104
Transportasi -
Diagnosa Total Bill
Pneumonia 1,949,250
Pneumonia 1,781,250
3,730,500
DPJP
'dr. Amarwati,SpN+dr. Ridho,Sp.PD+dr. Marolop,SpJ
dr. Ridho,Sp.PD
'dr. Ridho,Sp.PD+dr. Marolop,SpJ
'dr. Ridho,Sp.PD+dr. Lisbeth,SpS
dr. Lisbeth,SpS
dr. Yanika,Sp.PD
dr. Yanika,Sp.PD
'dr. Lisbeth,SpS+dr. Rika,Sp.THT
'dr. Yanika,Sp.PD+dr. Marolop,SpJ
dr. Yanika,Sp.PD
dr. Yanika,Sp.PD
dr. Yanika,Sp.PD
dr. Yanika,Sp.PD
'dr. Wirandi,Sp.PD+dr. Marolop,SpJ
dr. Lisbeth,SpS
dr. Yanika,Sp.PD
dr. Wirandi,Sp.PD
dr. Wirandi,Sp.PD
dr. Yanika,Sp.PD
Diagnosa
+
+
-
+
dr. Hery, Sp.B
Rekapitulasi Pasien
Bulan Desember 2023
1. Rawat Inap / Operasi Umum, A+, Perusahaan

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Visite HD/Visite sub total Operasi Total Honor DR
1 Widtya Murni 116896 Umum Klas II 2/9/2024 10/02/2024 1 50,000 50,000 50,000
2 Susi Susanti 116553 Umum KLS III 1/30/2024 2/2/2024 - 1,200,000 1,200,000
3 Wahyu Saputra Siahaan 116906 Umum KLS III 09/02/2024 10/02/2024 1 40,000 40,000 40,000
4 M Khairul Abdi 117266 JR KLS III 2/24/2024 4/26/2024 1 40,000 40,000 40,000
5 Joko Purnawan 116559 JKK KLS III 1/30/2024 2/1/2024 - 1,000,000 1,000,000
6 Nopi Ade Bayu Saputra 116889 JKK Kelas I 09/02/2024 2/12/2024 - 1,000,000 1,000,000
7 Kasmin Sibarani 107252 JR KLS III 2/13/2024 2/16/2024 - 1,000,000 1,000,000
8 Ariyanto 83058 JKK Kelas I 2/1/2024 3/2/2024 - 3,000,000 3,000,000
6 Agus Prayogi 116167 JR IGD 1/17/2024 1/17/2024 - 750,000 750,000
7 - -
8 - -
9 - -
Total 1 130,000 7,950,000 8,080,000
1. Rawat Inap BPJS

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Total Klaim Jasa Dokter Ket. Diagnosa DPJP Keterangan
1 Parida 116718 BPJS KLS III 2/3/2024 07/02/2024 6,918,600 1,245,348 Debridement dr. Ridho,Sp.PD
2 Juliadi 107841 BPJS KLS III 2/19/2024 2/22/2024 4,668,700 840,366 Debridement dr. Ridho,Sp.PD
3 Susanto S 117276 BPJS KLS III 25/02/2024 29/02/2024 4,668,700 840,366 Celulitis dr. Ridho,Sp.PD
4 Erni Suryati 116545 BPJS KLS III 1/30/2024 2/1/2024 4,668,700 933,740 'SM
5 Nurdiana Barasa 110353 BPJS KLS III 1/29/2024 2/1/2024 4,668,700 933,740 Ganggren
6 Adelia Paramita Harahap 116567 BPJS KLS III 1/30/2024 2/2/2024 1,361,300 136,130 Haemoroid
7 Yosua Yoan Dinata S Aruan 113924 BPJS KLS III 1/30/2024 2/2/2024 2,292,400 114,620 Thypoid dr. Yanika,Sp.PD
8 Rajali Akup Siregar 83058 BPJS KLS III 2/1/2024 03/02/2024 4,049,700 809,940 Benign Neoplasm
9 Asnah Meryana Br Sinaga 116658 BPJS KLS III 2/1/2024 03/02/2024 2,207,100 220,710 Injury
10 Suruhen Sembiring Depari 94178 BPJS Kelas I 2/1/2024 03/02/2024 5,386,100 1,077,220 STT
11 Norma 104940 BPJS Kelas I 2/1/2024 03/02/2024 5,386,100 1,077,220 STT
12 Rindy Aulia Putri 116550 BPJS KLS III 2/1/2024 03/02/2024 5,316,900 1,063,380 STT
13 Tengku Andansyah Putra 116634 BPJS KLS III 2/1/2024 03/02/2024 2,429,700 242,970 Injury
14 S Kristina Lumban Toruan 116773 BPJS Kelas I 2/5/2024 08/02/2024 3,466,800 173,340 Hi dr. Lisbeth,SpS
15 Tua Haposan Kennedy Marpa 114671 BPJS KLS III 2/6/2024 08/02/2024 4,049,700 809,940 STT
16 Natalia Sipayung 116795 BPJS KLS III 2/6/2024 08/02/2024 3,668,500 733,700 App
17 Bunga Mahrani Nasution 116801 BPJS Klas II 2/6/2024 08/02/2024 4,273,700 854,740 STT
18 Hasmar 116790 BPJS Klas II 2/6/2024 08/02/2024 5780000 1,156,000 Hernia
19 Meliadi 116400 BPJS Klas II 2/6/2024 09/02/2024 3,690,700 369,070 ILO
20 Nur Putri Isnani 116874 BPJS KLS III 09/02/2024 2/11/2024 3,668,500 660,330 App dr. Yanika,Sp.PD
21 Aliman Parman Tampubolon 116927 BPJS KLS III 10/02/2024 2/12/2024 4,867,400 973,480 Combotio
22 Indrawati 116321 BPJS KLS III 2/8/2024 2/12/2024 2,606,000 260,600 Tumor
23 Sugiem 65468 BPJS Kelas I 2/12/2024 2/14/2024 5386100 1,077,220 Exici
24 Anggi Sahpitri 079854 BPJS KLS III 2/13/2024 15/02/2024 3,668,500 660,330 App dr. Yanika,Sp.PD
25 Rut Simamora 116989 BPJS KLS III 2/13/2024 2/16/2024 4,668,700 840,366 DM dr. Yanika,Sp.PD
26 Rizaldi 116978 BPJS KLS III 2/13/2024 2/16/2024 12,123,600 2,424,720 VL
27 Suci Firdayanti 116992 BPJS KLS III 2/13/2024 2/16/2024 5,812,000 1,162,400 Haemoroid
28 Saripah 115805 BPJS Klas II 2/15/2024 2/17/2024 4,894,200 978,840 STT
29 Zul Zidan 117040 BPJS KLS III 2/15/2024 2/17/2024 7,028,900 1,405,780 STT
30 Alvin Pratama 117108 BPJS KLS III 17/02/2024 2/19/2024 2,482,900 248,290 Open Wound
31 Yusnita Zahara Brutu 117037 BPJS KLS III 2/19/2024 2/21/2024 5,316,900 1,063,380 Fanka
32 Tjiong Lai 117027 BPJS Klas II 2/19/2024 2/22/2024 3,946,300 789,260 Benign Neoplasm
33 Janari Khairullah 117118 BPJS Klas II 2/19/2024 2/22/2024 4,273,700 854,740 App
34 M Amin Handoko 99654 BPJS Klas II 2/22/2024 24/2/2024 5,780,000 1,156,000 Haemoroid
35 Ade Hardiansyah 117212 BPJS Klas II 2/22/2024 24/2/2024 14,024,100 2,804,820 STT
36 Reni Amelia 94086 BPJS KLS III 2/22/2024 24/2/2024 3,668,500 733,700 App
37 Paulina Gultom 94078 BPJS KLS III 2/22/2024 24/2/2024 5,316,900 1,063,380 STT
38 Risna Mentari D.Siagian 117162 BPJS KLS III 2/22/2024 24/2/2024 4,049,700 809,940 STT
39 Firdaus Rafael S 117119 BPJS KLS III 2/22/2024 24/2/2024 4,049,700 809,940 STT
40 Misran 117117 BPJS KLS III 2/22/2024 24/2/2024 4,961,400 992,280 Hill
41 Rani Hamelia Putri 117224 BPJS Klas II 2/23/2024 25/02/2024 4,273,700 854,740 App
42 Kennedy Manurung 117222 BPJS Kelas I 26/02/2024 2/28/2024 5,386,100 1,077,220 STT
43 Manuarang Conary Sirait 117187 BPJS Kelas I 26/02/2024 2/28/2024 5,386,100 1,077,220 Exici
44 Suranta 43378 BPJS Klas II 25/02/2024 2/28/2024 4,273,700 854,740 App
45 Dian Satria 117275 BPJS KLS III 25/02/2024 2/28/2024 4,867,400 973,480 Debridement
46 Sarino 117370 BPJS KLS III 2/27/2024 29/02/2024 4,049,700 809,940 STT
47 Bakti Wahyudi 117357 BPJS KLS III 2/27/2024 29/02/2024 4,961,400 992,280 Hill
48 Dewi Rahayu Listia Ningsih 117288 BPJS KLS III 26/02/2024 29/02/2024 3,668,500 733,700 App
49 Calvin Sianturi 117361 BPJS KLS III 2/27/2024 29/02/2024 3,668,500 733,700 App
50 Sareng 117343 BPJS KLS III 26/02/2024 2/29/2024 3,650,900 121,697 Pneumonia 'dr. Dian,SpP+dr. Wirandi,Sp.PD
51 Robinson Purba 37161 BPJS Kelas I 1/11/2024 1/13/2024 6,209,300 807,209 Debridement dr. Ridho,Sp.PD
52 Siti Hadijah 110083 BPJS KLS III 06/01/2024 10/01/2024 4,668,700 606,931 Debridement dr. Ridho,Sp.PD
53 Legini 115712 BPJS KLS III 1/4/2024 07/01/2024 2,482,900 322,777 Ganggren dr. Ridho,Sp.PD
54 Haelani 115283 BPJS KLS III 21/12/2023 27/12/2023 4,194,600 489,370 pasang wsd 'dr. Yanika,Sp.PD+dr. Dian,SpP
55 Kezia Eireney Marbun 114648 BPJS Klas II 04/12/2023 07/12/2023 1,585,900 158,590 Haemoroid
56 Prilia Utari Parinduri 113940 BPJS KLS III 30/11/2023 12/9/2023 4,320,800 86,416 ILO 'dr. Marolop,SpJ+dr. Robert,Sp.OG+dr. Yanika,Sp.PD
Total 242,938,300 43,176,266
2. Rawat Jalan
No Nama Pasien MR Status Tanggal Berobat Honor DR Honor BPJS Total Klaim Total Honor DR Diagnosa
1 Warsono jkn 11/1/2022 25,000 25,000 post op hernia
2 Azira dwi jkn 11/1/2022 25,000 25,000 post op app
3 Ngatiman jkn 11/1/2022 25,000 25,000 bsk
4 Jenny a hutasoit jkn 11/1/2022 25,000 25,000 post op etici
5 Salman jkn 11/1/2022 25,000 25,000 post op etici
6 Manisah jkn 11/1/2022 25,000 25,000 post op fam
7 Intan utari jkn 11/1/2022 25,000 25,000 fatar kamis
8 Rudi hartono jkn 11/1/2022 25,000 25,000 post op debridement
9 Rika aulia jkn 11/1/2022 25,000 25,000 trauma cavitis
10 Nursiati jkn 11/1/2022 25,000 25,000 post op struma
11 Nasrudin jkn 11/1/2022 25,000 25,000 post op hernia
12 Mozza ardra jkn 11/1/2022 25,000 25,000 post op app
13 Eli sabet jkn 11/1/2022 25,000 25,000 post op etici
14 Sudarmanto jkn 11/1/2022 25,000 25,000 post op hernia
15 Sartika jkn 11/1/2022 25,000 25,000 post op fam
16 Rosmiani jkn 11/1/2022 25,000 25,000 stt
17 Sunarseh jkn 11/1/2022 25,000 25,000 post op saparatomy
18 junima jkn 11/3/2022 25,000 25,000 post op etici
19 Ansari dachi jkn 11/3/2022 25,000 25,000 post op etici
20 Ayu agustina jkn 11/3/2022 25,000 25,000 fam
21 Saniah jkn 11/3/2022 25,000 25,000 post op etici
22 Sujatmiko jkn 11/3/2022 25,000 25,000 post op debridement
23 Oki jkn 11/3/2022 25,000 25,000 post op debridement
24 Rito okamen jkn 11/3/2022 25,000 25,000 scc
25 Sutrisno jkn 11/3/2022 25,000 25,000 stt
26 Roni rajagukguk jkn 11/3/2022 25,000 25,000 post op debridement
27 Syarifuddin jkn 11/3/2022 25,000 25,000 post herniatomy
28 Juthpi alvino jkn 11/3/2022 25,000 25,000 post op hernia
29 Sunarseh jkn 11/3/2022 25,000 25,000 post op etici
30 Aripin jkn 11/3/2022 25,000 25,000 post op debridement
31 Rundiani jkn 11/3/2022 25,000 25,000 post op app
32 Pinta rehulina jkn 11/3/2022 25,000 25,000 post op fam
33 Asmarani jkn 11/3/2022 25,000 25,000 post op debridement
34 Rika herdalia jkn 11/3/2022 25,000 25,000 post op haemoroid
35 Ester jkn 11/3/2022 25,000 25,000 post op debridement
36 Widya septia jkn 11/3/2022 25,000 25,000 operasi
37 Intan utari jkn 11/3/2022 25,000 25,000 operasi
38 Ondho shinta jkn 11/3/2022 25,000 25,000 post op app
39 Misriani jkn 11/7/2022 25,000 25,000 post op debridement
40 Lasti deriati jkn 11/7/2022 25,000 25,000 post op app
41 Hartati jkn 11/7/2022 25,000 25,000 post op debridement
42 Resianna jkn 11/7/2022 25,000 25,000 stt
43 Arifin jkn 11/7/2022 25,000 25,000 post op head injury
44 Tito okamen jkn 11/7/2022 25,000 25,000 operasi stt
45 Ayu agustina jkn 11/7/2022 25,000 25,000 operasi fam
46 Sutrisno jkn 11/7/2022 25,000 25,000 operasi stt
47 Elisabet jkn 11/7/2022 25,000 25,000 post op stt
48 Debora jkn 11/8/2022 25,000 25,000 stt kuping
49 Mahyudi asmaro jkn 11/8/2022 25,000 25,000 stt mata kaki
50 Daniel jkn 11/8/2022 25,000 25,000 limpadenitis
51 Ngatiman jkn 11/8/2022 25,000 25,000 neprolithiasi
52 Suhendra jkn 11/8/2022 25,000 25,000 post op etici
53 Nazwa khairuna jkn 11/10/2022 25,000 25,000 limpadenitis
54 Raanel natalip jkn 11/10/2022 25,000 25,000 pam
55 Roni rajagukguk jkn 11/10/2022 25,000 25,000 post debridement
56 Nanda saputra jkn 11/10/2022 25,000 25,000 stt
57 Ansari dachi jkn 11/10/2022 25,000 25,000 post eksisi
58 Oki jkn 11/10/2022 25,000 25,000 post debridement
59 Syarifuddin jkn 11/10/2022 25,000 25,000 post haemoroid
60 Misnawati jkn 11/10/2022 25,000 25,000 stt
61 Rika herdalia jkn 11/10/2022 25,000 25,000 post haemoroid
62 Sinta utari jkn 11/10/2022 25,000 25,000 post eksisi
63 Sartika br munthe jkn 11/10/2022 25,000 25,000 post eksisi
64 Widya septia jkn 11/10/2022 25,000 25,000 post fistular
65 Luthfi hurna jkn 11/10/2022 25,000 25,000 post high hidrocel
66 Sajak miko jkn 11/10/2022 25,000 25,000 kombutio
67 Ondho shinta jkn 11/10/2022 25,000 25,000 post apendic
68 Mandra purba jkn 11/10/2022 25,000 25,000 stt
69 Mozza ardra jkn 11/10/2022 25,000 25,000 post apendic
70 Asmarani jkn 11/10/2022 25,000 25,000 post debridement
71 Arifin sinuhaji jkn 11/10/2022 25,000 25,000 kombutio
72 Misriani jkn 11/14/2022 25,000 25,000 post op etici
73 Sutrisno jkn 11/14/2022 25,000 25,000 post etici
74 Iki jkn 11/14/2022 25,000 25,000 cambutio
75 Sujatmiko jkn 11/14/2022 25,000 25,000 cambutio
76 Ayu agustina jkn 11/14/2022 25,000 25,000 post app
77 Mandra jkn 11/14/2022 25,000 25,000 operasi
78 Misnawati jkn 11/14/2022 25,000 25,000 operasi
79 Arifin jkn 11/14/2022 25,000 25,000 post op etici
80 Nanda saputra jkn 11/15/2022 25,000 25,000 stt
81 Rito okamen jkn 11/15/2022 25,000 25,000 post op etici
82 Rini jkn 11/15/2022 25,000 25,000 post op vc
83 Daniel jkn 11/15/2022 25,000 25,000 stt
84 Ester ferawati jkn 11/15/2022 25,000 25,000 post op debridement
85 Martua jkn 11/15/2022 25,000 25,000 post op debridement
86 Resianna jkn 11/17/2022 25,000 25,000 post etici
87 Mahyudi asmaro jkn 11/17/2022 25,000 25,000 post op etici
88 Oki jkn 11/17/2022 25,000 25,000 cambutio
90 Luthfi hurna jkn 11/17/2022 25,000 25,000 post op hernia
91 Rika hudaria jkn 11/17/2022 25,000 25,000 post op haemoroid
92 Widya septia jkn 11/17/2022 25,000 25,000 post etici
93 Mara manusun sibuea jkn 11/17/2022 25,000 25,000 stt leher
94 Debora jkn 11/17/2022 25,000 25,000 post etici
95 Raguel marito jkn 11/17/2022 25,000 25,000 fam
96 Aripin jkn 11/17/2022 25,000 25,000 post debridement
97 Rita sugiarti jkn 11/17/2022 25,000 25,000 stt
98 Sartika jkn 11/17/2022 25,000 25,000 post fam
99 Misnawati jkn 11/21/2022 25,000 25,000 post etici
100 Oki jkn 11/21/2022 25,000 25,000 cambutio
101 Marlinda jkn 11/21/2022 25,000 25,000 struma
103 Sutrisno jkn 11/21/2022 25,000 25,000 post op etici
104 Ester ferawati jkn 11/21/2022 25,000 25,000 cambutio
105 Ayu agustina jkn 11/21/2022 25,000 25,000 post op etici
106 Asrul anuis jkn 11/21/2022 25,000 25,000 fistula
107 Mandra jkn 11/21/2022 25,000 25,000 post etici
108 Tegar maulana jkn 11/21/2022 25,000 25,000 post etici
109 Rini jkn 11/21/2022 25,000 25,000 post head injuri
110 Misriani jkn 11/21/2022 25,000 25,000 post op debridement
111 Rospita jkn 11/21/2022 25,000 25,000 stt
112 Mara manusun sibuea jkn 11/21/2022 25,000 25,000 operasi
113 Rita sugiarti jkn 11/21/2022 25,000 25,000 operasi
114 Intan utari jkn 11/21/2022 25,000 25,000 post op fam
115 Ika dewi jkn 11/22/2022 25,000 25,000 fam
117 Fauzia jkn 11/22/2022 25,000 25,000 post op app
119 Tengku jkn 11/22/2022 25,000 25,000 post op etici
120 Ondho jkn 11/22/2022 25,000 25,000 post op app
121 Rini jkn 11/24/2022 25,000 25,000 post op debridement
122 Jumita jkn 11/24/2022 25,000 25,000 app
123 Syarifuddin jkn 11/24/2022 25,000 25,000 post haemoroid
124 Resianna jkn 11/24/2022 25,000 25,000 post etici
125 Pahotan jkn 11/24/2022 25,000 25,000 post debridement
126 Ester ferawati jkn 11/24/2022 25,000 25,000 post debridement
127 Risky sandy jkn 11/24/2022 25,000 25,000 stt
128 Yuriska jkn 11/24/2022 25,000 25,000 stt
129 Oki jkn 11/24/2022 25,000 25,000 post op debridement
130 Sujatmiko jkn 11/24/2022 25,000 25,000 post op debridement
131 Melia jkn 11/28/2022 25,000 25,000 fam
132 Tegar jkn 11/28/2022 25,000 25,000 post op etici
133 Ester jkn 11/28/2022 25,000 25,000 post op etici
134 Mandra jkn 11/28/2022 25,000 25,000 post op etici
135 Mara manusun sibuea jkn 11/28/2022 25,000 25,000 post op etici
136 Jumita jkn 11/28/2022 25,000 25,000 app
137 Riky sandy jkn 11/28/2022 25,000 25,000 stt
138 Vivia diana jkn 11/28/2022 25,000 25,000 post op fam
139 Rita sugiarti jkn 11/28/2022 25,000 25,000 post etici
140 Ayu agustina jkn 11/28/2022 25,000 25,000 post op etici
141 Misnawati jkn 11/28/2022 25,000 25,000 post etici
144 Yeni puryanti jkn 11/29/2022 25,000 25,000 colic abdomen
145 Herianto jkn 11/29/2022 25,000 25,000 haemoroid
146 Fauzia jkn 11/29/2022 25,000 25,000 post apendictomy
147 Sonia bella jkn 11/29/2022 25,000 25,000 stt
148 Asmalina jkn 11/29/2022 25,000 25,000 post op fam
149 Imelda jkn 11/29/2022 25,000 25,000 stt
Total - 3,725,000 - 3,725,000
Lubuk Pakam, November 2022 Diketahui Oleh; Kalkulasi Penggajian / Honor:

Umum 8,080,000
Rawat Jalan
Umum - +
Melki Tampubolon, SE dr. Arifin P Sitompul Total Pendapatan Honor Umum 8,080,000
Potongan ke RS 10% 808,000 -
Total Honor Umum 7,272,000
Penerima; Honor BPJS Rawat Inap 43,176,266
Honor BPJS Rawat Jalan 3,725,000 +
Pajak (Tax) 5 % 2,708,663 -
dr. Hery, Sp.B Jumlah Honor 51,464,602
Transportasi - +
Diagnosa Total Bill
Hypoglicaemia 1,886,250
Acute App 7,540,000
KLL 1,886,750
Upper Arm 4,671,750
Debridement
Debridement
KLL
Debridement (3x Op)
Pneumathorax
15,984,750
dr. Robert Siregar, Sp.B
Rekapitulasi Pasien
Bulan Desember 2023

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Visite HD/Visite sub total Operasi Total Honor DR Diagnosa
1 M Dafa 117085 Umum KLS III 16/02/0204 2/17/2024 1 40,000 40,000 40,000 KLL
2 Karolina Br Barus 117195 Umum KLS III 2/21/2024 25/02/2024 1,200,000 1,200,000 App+TB
3 Awaluddin Nasution 117236 Umum KLS III 2/23/2024 25/02/2024 1,200,000 1,200,000 App
4 Bester Sontoba 117392 Umum KLS III 2/28/2024 29/02/2024 1 40,000 40,000 40,000 Rupture tendon
5 Indartono 117105 JR KLS III 17/02/2024 2/21/2024 3 40,000 120,000 120,000 Hi
- -
- -
Total 5 200,000 2,400,000 2,600,000
1. Rawat Inap BPJS

1 Herni 111731 BPJS KLS III 2/16/2024 2/17/2024 3,648,700 182,435 ''Sepsis dr. Ridho,Sp.DP
2 Rodiah 116964 BPJS Klas II 2/19/2024 2/21/2024 4,717,900 849,222 Exici dr. Ridho,Sp.DP
3 Khairunisyah Salsabila 114339 BPJS Klas II 1/30/2024 2/2/2024 4,273,700 854,740 App
4 Tiara Senja 116590 BPJS KLS III 2/2/2024 2/4/2024 3,668,500 733,700 App
5 Shafira Nazwa Aqila Tarigan 116699 BPJS KLS III 2/2/2024 2/5/2024 4,627,400 925,480 Rupture tendon
6 Herni 111731 BPJS KLS III 2/2/2024 2/5/2024 6,896,800 1,379,360 Amputasi Diabetic
7 Abil Alfiqih 116752 BPJS KLS III 2/5/2024 07/02/2024 2,703,400 540,680 STT
8 Poniyem 101699 BPJS KLS III 2/5/2024 08/02/2024 6,351,400 1,143,252 Ganggren dr. Yanika,Sp.PD
9 Anhar 114499 BPJS KLS III 2/5/2024 09/02/2024 4,961,400 893,052 Hernia dr. Yanika,Sp.PD
10 Sartika Br Simamora 116759 BPJS Klas II 2/7/2024 09/02/2024 4,717,900 943,580 STT
11 Wira Dana 116831 BPJS Klas II 2/7/2024 09/02/2024 4,717,900 943,580 STT
12 Yana Safitri 116751 BPJS Klas II 2/7/2024 09/02/2024 6,194,200 1,238,840 STT
13 Klementina Silaen 116828 BPJS KLS III 2/7/2024 10/02/2024 2,482,900 248,290 Injury\
14 Hendry Syahputra 116870 BPJS Klas II 2/8/2024 2/11/2024 8,241,800 1,648,360 Rupture tendon
15 Jsse Karel Barus 116872 BPJS KLS III 2/8/2024 2/11/2024 3,668,500 733,700 App
16 Wagini 78545 BPJS KLS III 2/12/2024 2/14/2024 4,961,400 992,280 Hill
17 Ramlan 116962 BPJS KLS III 2/12/2024 2/14/2024 4,961,400 992,280 Hill
18 Lambok Zhuan 117004 KLS III 2/13/2024 2/16/2024 2,482,900 248,290 Rupture tendon
19 Leni Winda Lestari 117009 BPJS Klas II 2/14/2024 2/17/2024 4,273,700 854,740 App
20 Abu Bakar Sidik 117052 BPJS KLS III 2/16/2024 2/18/2024 2,482,900 248,290 Corpus Alinamen
21 Edo Setiawan 117055 BPJS KLS III 2/16/2024 2/18/2024 4,961,400 992,280 Hernia
22 Mariana 113573 BPJS KLS III 2/16/2024 2/18/2024 4,961,400 992,280 Hernia
23 Sudarmaji 113023 BPJS Klas II 2/16/2024 2/18/2024 5,390,900 1,078,180 Amputasi
24 Arif Pranoto 77155 BPJS KLS III 2/16/2024 2/19/2024 7,074,500 1,414,900 Amputasi
25 Sri Syahmaini 52122 BPJS KLS III 2/19/2024 2/21/2024 4,668,700 933,740 Debridement
26 Fajar Abdullah 117255 BPJS Kelas I 2/23/2024 25/02/2024 4,588,600 917,720 Debridement
27 Rani Angelia Sitorus 117239 BPJS KLS III 2/23/2024 25/02/2024 4,049,700 809,940 STT
28 Tri Muna 117310 BPJS KLS III 26/02/2024 2/28/2024 4,049,700 809,940 Exici
29 Serina Hutabarat 117234 BPJS KLS III 26/02/2024 2/28/2024 4,049,700 809,940 Exici
30 Herman 92276 BPJS Klas II 2/26/2024 2/28/2024 4,717,900 943,580 App
31
32
33
34
Total 139,547,200 26,296,651
2. Rawat Jalan
1 Zainal jkn 11/1/2022 25,000 25,000 hernia operasi
2 Resa febri jkn 11/1/2022 25,000 25,000 apendictis
3 Yudha jkn 11/1/2022 25,000 25,000 hernia
4 Sumarni jkn 11/1/2022 25,000 25,000 struma
5 Amerudin jkn 11/1/2022 25,000 25,000 post op etici
6 Putra ramadhan jkn 11/1/2022 25,000 25,000 post op etici
7 Awaludin jkn 11/1/2022 25,000 25,000 post op apendictomy
8 Siti maryam jkn 11/1/2022 25,000 25,000 fam
9 Sumarni jkn 11/2/2022 25,000 25,000 cystitis
10 Putra jkn 11/2/2022 25,000 25,000 post op debridement
11 Abdul amin jkn 11/2/2022 25,000 25,000 stt jenin
12 Yudha jkn 11/7/2022 25,000 25,000 stt anus rabu
13 Rince ria jkn 11/7/2022 25,000 25,000 post op debridement
14 Anggi jkn 11/7/2022 25,000 25,000 post op app
15 Ayu lestari jkn 11/7/2022 25,000 25,000 fam febri
16 Erpina jkn 11/7/2022 25,000 25,000 post op etici
17 Satini jkn 11/7/2022 25,000 25,000 operasi debridement
18 Abdul amin jkn 11/7/2022 25,000 25,000 operasi stt
19 Mulyani jkn 11/9/2022 25,000 25,000 post op etici
20 Awaludin jkn 11/9/2022 25,000 25,000 post op app
21 Putra jkn 11/9/2022 25,000 25,000 post op debridement
22 Siti maryam jkn 11/9/2022 25,000 25,000 limpadenitis
23 Hesekiel jkn 11/9/2022 25,000 25,000 post op debridement
24 Zainal jkn 11/9/2022 25,000 25,000 post op hernia
26 Jumpa jkn 11/9/2022 25,000 25,000 post op haemoraid
27 Sudarno jkn 11/9/2022 25,000 25,000 stt
28 Uci melinda jkn 11/9/2022 25,000 25,000 fam
29 Ayu lestari jkn 11/9/2022 25,000 25,000 operasi
30 Rajuli eppendi jkn 11/14/2022 25,000 25,000 umlerus seventur
31 Satini jkn 11/14/2022 25,000 25,000 post op debridement
32 Hesekiel jkn 11/14/2022 25,000 25,000 uc
33 Margin jkn 11/14/2022 25,000 25,000 fam
34 Rimel jkn 11/14/2022 25,000 25,000 post op debridement
35 Abdul amin jkn 11/14/2022 25,000 25,000 post op etici
36 Anggi puspita jkn 11/14/2022 25,000 25,000 post op app
37 Fihay adilo jkn 11/14/2022 25,000 25,000 haemoroid
38 Agus lestari jkn 11/16/2022 25,000 25,000 post etici
39 Mulyani jkn 11/16/2022 25,000 25,000 post etici fam
40 Putra ramadhan jkn 11/16/2022 25,000 25,000 post op etici
41 Romeytha uliarta jkn 11/18/2022 25,000 25,000 stt
42 Hesekiel jkn 11/18/2022 25,000 25,000 post op etici
43 Sunarmin jkn 11/18/2022 25,000 25,000 oystitis
44 Sumarno jkn 11/18/2022 25,000 25,000 post op etici
46 Satini jkn 11/21/2022 25,000 25,000 post op debridement
47 Margin jkn 11/21/2022 25,000 25,000 limpadenitis
48 Rince jkn 11/21/2022 25,000 25,000 post op debridement
49 Romeytha jkn 11/21/2022 25,000 25,000 operasi
50 Ayu lestari jkn 11/23/2022 25,000 25,000 post op fam
51 Mhd araf jkn 11/23/2022 25,000 25,000 stt
52 Herlina sinaga jkn 11/23/2022 25,000 25,000 fam
53 Erni jkn 11/25/2022 25,000 25,000 post op fam
54 Putra ramadhan jkn 11/28/2022 25,000 25,000 post debridement
55 Melati napitupulu jkn 11/28/2022 25,000 25,000 fam
56 Romeythar jkn 11/28/2022 25,000 25,000 post etici
57 Rince jkn 11/28/2022 25,000 25,000 post op etici
58 Satini jkn 11/28/2022 25,000 25,000 post op etici
59 Iserlina jkn 11/30/2022 25,000 25,000 ca mamae
Total - 1,475,000 - 1,475,000

Umum 2,600,000
Rawat Jalan
Umum - +
Honor BPJS Rawat Jalan 1,475,000 +
Pajak (Tax) 5 % 1,505,583 -
dr. Robert Siregar, Sp.B Jumlah Honor 28,606,068
Transportasi - +
dr. Henri H.Sitanggang, Sp.B
Rekapitulasi Pasien
Bulan Desember 2023

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Visite HD/Visite sub total Operasi Total Honor DR
1 Sunarwan Nasution 117264 Umum KLS III 2/24/2024 2/26/2024 1200000 1,200,000
2 Firmansyah Nasution 112874 JKK 2/24/2024 4/26/2024 - -
Total 0 - 1,200,000 1,200,000
1. Rawat Inap BPJS

1 Siswidaya 116709 BPJS Klas II 2/3/2024 06/02/2024 4,273,700 769,266 Laparatomy dr. Ridho,Sp.PD
2 Alvino Baser Simatupang 103735 BPJS KLS III 17/2/2024 2/19/2024 4,961,400 992,280 Hernia
3
4
5
6
7
8
9 -
10 -
-
Total 9,235,100 1,761,546
2. Rawat Jalan
1 Rehulina jkn 11/1/2022 25,000 25,000 post op etici
2 Misiem jkn 11/1/2022 25,000 25,000 ca recti
3 Zakiah jkn 11/5/2022 25,000 25,000 post op etici
4 Boini jkn 11/5/2022 25,000 25,000 fam
5 Arap jkn 11/9/2022 25,000 25,000 stt
6 Rimlan jkn 11/9/2022 25,000 25,000 hernia
7 Sustini jkn 11/9/2022 25,000 25,000 post op debridement
8 Arap jkn 11/12/2022 25,000 25,000 stt operasi
9 Sauzan jkn 11/12/2022 25,000 25,000 haemoroid
10 Rimlan jkn 11/16/2022 25,000 25,000 haemoroid
11 Ariadi jkn 11/16/2022 25,000 25,000 cambutio
12 Zainal rahmad jkn 11/19/2022 25,000 25,000 stt
13 Ngatemi jkn 11/19/2022 25,000 25,000 stt
14 Ngatemi jkn 11/23/2022 25,000 25,000 operasi
15 Arap jkn 11/23/2022 25,000 25,000 post etici
16 M yusjungi jkn 11/26/2022 25,000 25,000 npc
17 Hazatulo jkn 11/26/2022 25,000 25,000 stt
18 Ahmad jkn 11/26/2022 25,000 25,000 trauma thorax
19 Ngatemi jkn 11/30/2022 25,000 25,000 post etici
20 Arap jkn 11/30/2022 25,000 25,000 post op etici
Total - 500,000 - 500,000

Umum 1,200,000
Rawat Jalan
Umum - +
Honor BPJS Rawat Jalan 500,000 +
Pajak (Tax) 5 % 167,077 -
dr. Henri H.Sitanggang, Sp.B Jumlah Honor 3,174,469
Transportasi - +
Diagnosa Total Bill
Open Wound 9,101,250
Open Wound
9,101,250
dr. Cut Elvira Novita, SpTHT
Rekapitulasi Pasien
Bulan Desember 2023
1. Rawat Inap Umum

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Visite HD/Visite Operasi Tindakan Total HD Diagnosa Total Tagihan
1
2 -
Total - - - - -
2. Pasien Rawat Inap BPJS

1 M Sanjaya 058821 BPJS KLS III 2/1/2024 2/5/2024 4,381,700 146,057 Hepatomy+TB 'dr. Yanika,Sp.PD+dr. Dian,SpP
2 Herbinsar Pasaribu 53295 BPJS KLS III 2/5/2024 08/02/2024 2,000,700 200,070 Sinusitis
3 Irwan Evando Faeyza 116975 BPJS KLS III 2/12/2024 2/16/2024 2,292,400 114,620 Thypoid dr. Mahyarani,Sp.THT
Marni 102797 BPJS KLS III 18/02/2024 2/22/2024 1,436,900 71,845 Vertigo dr. Lisbeth,SpS
Total 6,382,400 346,127
3. Rawat Jalan
No Nama Pasien MR Status Tanggal Berobat Tindakan Honor Umum Honor BPJS Total Jasa DR Total Tagihan Diagnosa
1 Mhd rivaldo jkn 11/1/2022 35,000 35,000 rhinitis kronis
2 Dinda aqza jkn 11/1/2022 35,000 35,000 corpus alineum ditelinga
3 Rizka aqza jkn 11/1/2022 35,000 35,000 impaded serumen
4 Sayati jkn 11/1/2022 35,000 35,000 tumor nasofaring
5 Anggi fadila jkn 11/1/2022 35,000 35,000 mastord kronis
6 Juliana dewi jkn 11/1/2022 35,000 35,000 rhinitis alergi
7 Rohana purba jkn 11/1/2022 35,000 35,000 snhl
8 Nur dewi pujiati jkn 11/1/2022 35,000 35,000 laringits kronis
9 Mhd rafiqi jkn 11/1/2022 35,000 35,000 omsk
10 Mhd rejli jkn 11/1/2022 35,000 35,000 rhinitis kronis
11 Marlen saragih jkn 11/1/2022 35,000 35,000 npc
12 Elizra sihombing jkn 11/1/2022 35,000 35,000 omsk + serumel
13 Elisabet br barus jkn 11/3/2022 35,000 35,000 heary loss + impaded
14 Djoko prayitno jkn 11/3/2022 35,000 35,000 rhinositis kronis
15 Ahmad solihin jkn 11/3/2022 35,000 35,000 tinitus
16 Sereppinna br banuka jkn 11/3/2022 35,000 35,000 oma + oe
17 Doan saragih jkn 11/3/2022 35,000 35,000 omsk tipe berulang
18 Rinda jkn 11/3/2022 35,000 35,000 omsk
19 Wilson np siahaan jkn 11/3/2022 35,000 35,000 impaded serumen
20 Alman nainggolan jkn 11/3/2022 35,000 35,000 impaded serumen
21 Vika adinda jkn 11/3/2022 35,000 35,000 otomikosis + omsk
22 Michael h jkn 11/3/2022 35,000 35,000 oe difusa
23 Lesita berutu jkn 11/3/2022 35,000 35,000 rhinositis kronis
24 Manjit kaur jkn 11/3/2022 35,000 35,000 impaded serumen
25 Siti suriani jkn 11/3/2022 35,000 35,000 omsk tipe berulang
26 Suyati jkn 11/8/2022 35,000 35,000 ome + susp npe
27 Nuraini jkn 11/8/2022 35,000 35,000 tinitus
28 Juliana dewi jkn 11/8/2022 35,000 35,000 rhinitis alergi
29 Mhd rafasya jkn 11/8/2022 35,000 35,000 impaded serumen
30 Elizra sihombing jkn 11/8/2022 35,000 35,000 oma
31 Nur dewi jkn 11/8/2022 35,000 35,000 susp laringits + rhinitis
32 Rahmayanti jkn 11/8/2022 35,000 35,000 rhinositis kronis
33 Ridho alfi jkn 11/8/2022 35,000 35,000 rhinitis alergi
34 Mhd rejli jkn 11/8/2022 35,000 35,000 rhinositis kronis
35 Mhd rafiqi aktar jkn 11/8/2022 35,000 35,000 oma
36 Siti suriani jkn 11/10/2022 35,000 35,000 omsk suetra
37 Desina br sipayung jkn 11/10/2022 35,000 35,000 rhinositis kronis
38 Michael h jkn 11/10/2022 35,000 35,000 trauma telinga
39 Sereppinna br banuka jkn 11/10/2022 35,000 35,000 omsk
40 Doan saragih jkn 11/10/2022 35,000 35,000 omsk
41 Lister simanullang jkn 11/10/2022 35,000 35,000 omsk
43 Asnah jkn 11/10/2022 35,000 35,000 rhinositis kronis
44 Vika adinda jkn 11/10/2022 35,000 35,000 otomikosis
45 Nur dewi jkn 11/15/2022 35,000 35,000 laringits kronis
46 Mhd abbydzar jkn 11/15/2022 35,000 35,000 impaded serumen
47 Rika hasan jkn 11/15/2022 35,000 35,000 tinitus
48 Ernawati jkn 11/15/2022 35,000 35,000 rhinitis alergi
49 Mhd gozali jkn 11/15/2022 35,000 35,000 rhinositis kronis
50 Julius elbert yohanes jkn 11/15/2022 35,000 35,000 oe difusa
51 Dedek anugrah jkn 11/15/2022 35,000 35,000 omsk
52 Dwi amelia jkn 11/15/2022 35,000 35,000 susp faringits tb
53 Aisyah silmi afiqa jkn 11/17/2022 35,000 35,000 hearing loss
54 Hayatun sakinah jkn 11/17/2022 35,000 35,000 rhinositis kronis
55 Sahat kranatha jkn 11/17/2022 35,000 35,000 oma
56 Serepina jkn 11/17/2022 35,000 35,000 omsk
57 Desma sipayung jkn 11/17/2022 35,000 35,000 rhinitis kronis
58 Ukasya muflih jkn 11/17/2022 35,000 35,000 corpus alineum ditelinga
59 Lely juniati jkn 11/17/2022 35,000 35,000 corpus alineum ditelinga
60 Doan saragih jkn 11/17/2022 35,000 35,000 omsk
61 Siti suriani jkn 11/17/2022 35,000 35,000 omsk
62 Tantri pramudita jkn 11/17/2022 35,000 35,000 ispa + omsk
63 Sereppinna jkn 11/17/2022 35,000 35,000 omsk
64 Sahat jkn 11/17/2022 35,000 35,000 oma
65 Hayatun sakinah jkn 11/17/2022 35,000 35,000
66 Aisyah silmi afiqa jkn 11/17/2022 35,000 35,000 hearing loss
67 Vika adinda jkn 11/17/2022 35,000 35,000 otomikosis
68 Sartiem jkn 11/17/2022 35,000 35,000 omsk
69 Mhd abbidzar jkn 11/22/2022 35,000 35,000 impaded serumen
70 Siti aminah jkn 11/22/2022 35,000 35,000 oma
71 Kenal sembiring jkn 11/22/2022 35,000 35,000 omsk + serumen
73 Dedek anugrah jkn 11/22/2022 35,000 35,000 impaded serumen
74 Olivia zahra jkn 11/22/2022 35,000 35,000 oe + impaded serumen
75 Lister simanullang jkn 11/22/2022 35,000 35,000 omsk tipe berulang
76 Dwi amelia jkn 11/22/2022 35,000 35,000 faringits
77 Mhd rejli jkn 11/22/2022 35,000 35,000 rhinositis kronis
78 Siti karuniyati jkn 11/24/2022 35,000 35,000 rhinositis kronis
79 Herman harahap jkn 11/24/2022 35,000 35,000 impaded serumen
80 Lely juniati jkn 11/24/2022 35,000 35,000 otomikosis
81 Siti suriani jkn 11/24/2022 35,000 35,000 omsk
82 Sutarno jkn 11/24/2022 35,000 35,000 omsk
83 Asnah jkn 11/24/2022 35,000 35,000 rhinitis alergi
84 Risma pakpahan jkn 11/24/2022 35,000 35,000 omsk
85 Nur dewi pujiati jkn 11/24/2022 35,000 35,000 lpr
86 Hj esti aminah jkn 11/29/2022 35,000 35,000 efotis
87 Eko efan jkn 11/29/2022 35,000 35,000 post fess
88 Kenal sembiring jkn 11/29/2022 35,000 35,000 omsk
89 Ezra kristiano jkn 11/29/2022 35,000 35,000 rhinositis kronis
90 Sethya bella jkn 11/29/2022 35,000 35,000 oe difusa + impaded serumen
91 Sanidah jkn 11/29/2022 35,000 35,000 omsk + impaded serumen
92 Suci rahmayanti jkn 11/29/2022 35,000 35,000 impaded serumen + oe
93 Dwi amelia jkn 11/29/2022 35,000 35,000 faringits kronis
95 Lister simanullang jkn 11/29/2022 35,000 35,000 omsk
96 Rolia bariang jkn 11/29/2022 35,000 35,000 corpus alineum
97 Tindakan bln. November 2022 Sebanyak 52 Psn @ 20.000,- 1,040,000 1,040,000 Tindakan
Total 1,040,000 - 3,360,000 4,400,000 -
Lubuk Pakam, November 2022 Kalkulasi Penggajian / Honor:

Penerima; Ka. Keuangan Rawat Inap:
Umum -
Rawat Jalan: Umum + A+ + Prshn - +
Total -
dr. Cut Elvira Novita, SpTHT-KL Melki Tampubolon, SE Potongan ke RS 10 % - -
Jumlah -
Diketahui Oleh: Total Honor 3,706,127
Direktur RS Honor Tindakan 1,040,000
Total Honor Bruto 4,746,127 +
Pajak (Tax) 5 % 237,306 -
dr. Arifin P Sitompul Transportasi - +
Honor Bersih Diterima 4,508,820
dr. Rika Caesaria Hidayat, SpTHT-KL
Rekapitulasi Pasien
Bulan Desember 2023
1. Rawat Inap Umum

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Visite HD/Visite Operasi Tindakan Total HD Diagnosa Total Tagihan
1 0
2 -
Total - - - - -
2. Pasien Rawat Inap BPJS

1 Dian Kerta Yuga 116515 BPJS KLS III 1/29/2024 2/1/2024 2,000,700 200,070 Peritonsilar
2 Lince Herlin Gea 94514 BPJS KLS III 1/29/2024 2/2/2024 2,000,700 200,070 Abcess Toncil
3 Firnawati 075387 BPJS KLS III 2/4/2024 06/02/2024 2,155,900 71,863 TTH 'dr. Lisbeth,SpS+dr. Desmon,SpP
4 Juan Fernandus 116950 BPJS KLS III 2/19/2024 2/22/2024 2,000,700 666,900 Cepalgia+Sinusitis 'dr. Soraya,SpM+dr. Mahyarani,SpA
5 Arya Rizki P.Tarigan 116755 BPJS KLS III 2/22/2024 2/26/2024 6,158,200 1,231,640 Sinusitis
6
Total 14,316,200 2,370,543
3. Rawat Jalan
No Nama Pasien MR Status Tanggal Berobat Tindakan Honor Umum Honor BPJS Total Jasa DR Total Tagihan Diagnosa
1 Zulaika susanti jkn 11/2/2022 35,000 35,000 rinitis alergi
2 Bacri jkn 11/2/2022 35,000 35,000 oma + serumen
3 Haposan simbolon jkn 11/2/2022 35,000 35,000 omsk + serumen
4 Ibrahim jkn 11/2/2022 35,000 35,000 oma + oe
5 Keysa azura jkn 11/2/2022 35,000 35,000 limfadenitis
6 Liza ashati jkn 11/2/2022 35,000 35,000 omsk
7 Zaka khairul jkn 11/2/2022 35,000 35,000 serumen prop
8 Dika syahputra jkn 11/7/2022 35,000 35,000 omsk
9 Fiftahul jkn 11/7/2022 35,000 35,000 serumen prop
10 Dafi arjuna jkn 11/7/2022 35,000 35,000 corpus alineum dihidung
11 Asyla izza tunrisa jkn 11/7/2022 35,000 35,000 omsk
12 Khiarta al hafiz jkn 11/7/2022 35,000 35,000 granulasi + omsk
13 Dhini nur fadhillah jkn 11/7/2022 35,000 35,000 sinusitis
14 Gabriel s jkn 11/7/2022 35,000 35,000 sinusitis
15 Frans antonius jkn 11/7/2022 35,000 35,000 serumen prop
16 Dhiva ajeng jkn 11/9/2022 35,000 35,000 serumen
17 Braeld filemon jkn 11/9/2022 35,000 35,000 serumen prop
18 Maringan l batu jkn 11/9/2022 35,000 35,000 sinusitis
19 Bejo prayitno jkn 11/9/2022 35,000 35,000 omsk
20 Mhd azzar jkn 11/9/2022 35,000 35,000 rinitis alergi
21 Bacri jkn 11/9/2022 35,000 35,000 snnl
22 Polmer nababan jkn 11/9/2022 35,000 35,000 sinusitis
23 Syamsudin sihombing jkn 11/9/2022 35,000 35,000 serumen
24 Joko sutejo jkn 11/9/2022 35,000 35,000 post + raceostomy
25 Adil wanur jkn 11/9/2022 35,000 35,000 sinusitis
26 Mhd dzaki husein jkn 11/14/2022 35,000 35,000 omsk
27 Dika syahputra jkn 11/14/2022 35,000 35,000 omsk
28 Gabriel s jkn 11/14/2022 35,000 35,000 sinusitis
29 Nanda tobina risa jkn 11/14/2022 35,000 35,000 sinusitis
30 Khiarta al hafiz jkn 11/14/2022 35,000 35,000 granulasi + oma
31 H muhammad rusli jkn 11/14/2022 35,000 35,000 kista liang telinga
32 Rosminah nasution jkn 11/14/2022 35,000 35,000 tuba catur
33 Mian sirait jkn 11/14/2022 35,000 35,000 omsk
34 Septy ariskayani jkn 11/14/2022 35,000 35,000 rinitis alergi
35 Daffa al hafids jkn 11/14/2022 35,000 35,000 oma
36 Sutiyanti jkn 11/14/2022 35,000 35,000 corpus + omsk
37 Dhiar nurfadillah jkn 11/14/2022 35,000 35,000 sinusitis
38 Maringan jkn 11/16/2022 35,000 35,000 sinusitis
39 Polmer nababan jkn 11/16/2022 35,000 35,000 post turbinectomy
40 Azka syauqia jkn 11/16/2022 35,000 35,000 serumen prop
41 Bachri jkn 11/16/2022 35,000 35,000 tinitus
42 Adelva virginta jkn 11/16/2022 35,000 35,000 sinusitis
43 Nurhayati jkn 11/16/2022 35,000 35,000 omsk
44 Ilham syahputra jkn 11/16/2022 35,000 35,000 sinusitis
46 Ramadani jkn 11/21/2022 35,000 35,000 rinitis alergi
47 Mutiara nur wahyu jkn 11/21/2022 35,000 35,000 otitis eksterna
48 Makmur jkn 11/21/2022 35,000 35,000 omsk + corpus alineum
49 Swanto jkn 11/21/2022 35,000 35,000 npc
50 Mhd alby jkn 11/21/2022 35,000 35,000 omsk
51 Erick gunawan jkn 11/21/2022 35,000 35,000 rinitis alergi
52 Khiarta al hafiz jkn 11/21/2022 35,000 35,000 oma + granulasi
53 H muhammad rusli jkn 11/21/2022 35,000 35,000 oma
54 Rosminah nasution jkn 11/21/2022 35,000 35,000 tuba catar
55 Muhibatullah lubis jkn 11/23/2022 35,000 35,000 serumen prop
56 Nurhayati jkn 11/23/2022 35,000 35,000 otomikosis + ht
58 Mhd adaun luffi jkn 11/23/2022 35,000 35,000 omsk
59 Fildan jekson jkn 11/23/2022 35,000 35,000 serumen prop
61 Hermansyah jkn 11/23/2022 35,000 35,000 sinusitis
62 Zuwita cahya ningsih jkn 11/23/2022 35,000 35,000 rinitis corpus
63 Maringan lumban batu jkn 11/23/2022 35,000 35,000 sinusitis
64 Sartiem jkn 11/28/2022 35,000 35,000 omsk
65 Marlini jkn 11/28/2022 35,000 35,000 snhl
66 Nurhasanah jkn 11/28/2022 35,000 35,000 oe ads
67 Sereppina jkn 11/28/2022 35,000 35,000 omsk
68 Emy jkn 11/28/2022 35,000 35,000 tinitus
70 Zibran jkn 11/28/2022 35,000 35,000 frontal sinusitis
71 Azka syauqia jkn 11/28/2022 35,000 35,000 serumen prop
72 Dhea mikhaela jkn 11/28/2022 35,000 35,000 serumen prop
73 Sahat franatha jkn 11/28/2022 35,000 35,000 oma
74 Hermansyah jkn 11/30/2022 35,000 35,000 sinusitis
76 Serta malem jkn 11/30/2022 35,000 35,000 limfona maligra + impaded serumen
77 Nasywah f jkn 11/30/2022 35,000 35,000 corpus alineum ditelinga
78 Suriyana jkn 11/30/2022 35,000 35,000 serumen prop + oma
79 Fiklan jekson jkn 11/30/2022 35,000 35,000 serumen prop
81 Aysar khalif jkn 11/30/2022 35,000 35,000 impaded serumen
82 Justinus limbong umum 11/30/2022 40,000 40,000 epistakis
83 Tindakan bln. November 2022 Sebanyak 32 Psn @ 20.000,- 640,000 640,000 Tindakan
Total 640,000 40,000 2,835,000 3,515,000 -

Penerima; Ka. Keuangan Rawat Inap:
Umum -
Rawat Jalan: Umum + A+ + Prshn 40,000 +
Total 40,000
dr. Rika Caesaria Hidayat, SpTHT-KL Melki Tampubolon, SE Potongan ke RS 10 % 4,000 -
Jumlah 36,000
Diketahui Oleh: Total Honor 5,241,543
Direktur RS Honor Tindakan 640,000
Total Honor Bruto 5,881,543 +
Pajak (Tax) 5 % 294,077 -
dr. Arifin P Sitompul Transportasi - +
Honor Bersih Diterima 5,587,466
dr. Jekson Lubis,SpOG
Rekapitulasi Pasien
Bulan Desember 2023
1. Rawat Inap / Operasi Umum, inhealth, dan Perusahaan

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Visite HD/Visite Sub Total Operasi Curret / Manual USG Total Honor DRTotal Tagihan Diagnosa
1
2
- - -
Total - - - - - -
2. Rawat Inap BPJS

1 Maria Fransiska Nainggolan 113681 BPJS KLS III 1/28/2024 2/1/2024 2,191,800 73,060 PSMBA 'dr. Ridho,Sp.PD+dr. Dian,SpP
2 Hotmeinar Simanungkait 116337 BPJS Klas II 1/29/2024 2/1/2024 6,166,000 1,200,000 SC
3 Putri Rahayu 116558 BPJS KLS III 1/30/2024 2/1/2024 5,292,800 1,200,000 SC
4 Siti Juliana 41838 BPJS KLS III 2/1/2024 03/02/2024 1,499,200 149,920 Lyoma
5 Anne Saffika Hutauruk 116599 BPJS KLS III 2/1/2024 2/4/2024 5,292,800 1,200,000 SC
6 Sri Yuwana 061976 BPJS Kelas I 2/5/2024 07/02/2024 7,039,300 1,200,000 SC
7 Hadijah Handayani Sibuea 115689 BPJS Klas II 2/6/2024 07/02/2024 3,030,300 400,000 Curettage
8 Donna Harianja 58265 BPJS Klas II 2/5/2024 08/02/2024 4,250,700 212,535 Thypoid dr. Wirandi,Sp.PD
9 Sumi Hartati 075932 BPJS Klas II 2/6/2024 08/02/2024 3,409,300 340,930 PUA
10 Susi Susanti Damanik 115979 BPJS KLS III 2/6/2024 09/02/2024 5,292,800 1,200,000 SC
11 Sahpriyani 116404 BPJS KLS III 2/7/2024 10/02/2024 5,292,800 1,200,000 SC
12 Serli Mahesa Putri 116802 BPJS KLS III 2/8/2024 2/11/2024 5,590,500 1,200,000 SC
13 Sri Eka Syahputri 117050 BPJS Klas II 2/15/2024 2/17/2024 2,553,500 255,350 Hyperemesis
14 Nurul Hidayah Sembiring 114334 BPJS KLS III 2/16/2024 2/18/2024 2,191,800 219,180 Hyperemesis
15 Adelia Pratiwi 117030 BPJS KLS III 2/16/2024 2/19/2024 5,292,800 1,200,000 SC
16 Yallsy Basyaasyah 112543 BPJS Klas II 18/02/2024 2/20/2024 1,746,500 87,325 Abdominal Pain dr. Million,SpA
17 Santi Yovi Niana Sinaga 116131 BPJS Klas II 2/21/2024 24/2/2024 6,166,000 1,200,000 SC
Sari Mutiara 117379 BPJS KLS III 2/27/2024 29/02/2024 2,196,300 400,000 PSP
Total 74,495,200 12,938,300
3. Rawat Jalan
No Nama Pasien MR Status Tgl Berobat Tindakan Honor Dokter USG Total Klaim Honor Dokter Total Honor Dr Diagnosa
1 Rosita br damanik jkn 11/1/2022 25,000 25,000 kista bartolia
2 Solis ariani jkn 11/1/2022 25,000 25,000 kista bartolia
3 Ita purnama jkn 11/1/2022 25,000 25,000 gravida 36 mggu
4 Rubinem jkn 11/3/2022 25,000 25,000 prolapsus uteri
5 Widia astuti jkn 11/3/2022 25,000 25,000 pua
6 Sri dian jkn 11/3/2022 25,000 25,000 psc
7 Roro istiningsih jkn 11/3/2022 25,000 25,000 post eksisi barto
8 Rinda antika jkn 11/3/2022 25,000 25,000 gravida 36 mggu
9 Parida jkn 11/3/2022 25,000 25,000 gravida 35 - 40 mggu
10 Salpina jkn 11/3/2022 25,000 25,000 pua
11 Rosma dame jkn 11/7/2022 25,000 25,000 kista ovarium
12 Meisyaroh jkn 11/7/2022 25,000 25,000 gravida 35 - 36 mggu
13 Tri ayu jkn 11/7/2022 25,000 25,000 psc
14 Lestarina jkn 11/7/2022 25,000 25,000 ca cervix
15 Novy jkn 11/7/2022 25,000 25,000 gravida 36 mggu
16 Peralina jkn 11/7/2022 25,000 25,000 gravida 35 mggu
17 Elisa jkn 11/7/2022 25,000 25,000 mioma uteri
18 Nurmaningsih jkn 11/7/2022 25,000 25,000 pua
19 Nuryasni jkn 11/8/2022 25,000 25,000 gravida 35 - 36 mggu
20 Sulis ariani jkn 11/10/2022 25,000 25,000 abses
21 Anita jkn 11/10/2022 25,000 25,000 gravida 32 mggu
22 Widia astuti jkn 11/10/2022 25,000 25,000 pua
23 Cyntia putri jkn 11/10/2022 25,000 25,000 post curetage
24 Mahyuni jkn 11/11/2022 25,000 25,000 gravida 7 - 8 mggu
25 Rosita br damanik jkn 11/14/2022 25,000 25,000 kista bartolinitis
26 Ajeng pratiwi jkn 11/14/2022 25,000 25,000 kista folikel
27 Sabaria jkn 11/14/2022 25,000 25,000 gravida 38 mggu
28 Ema asmaini jkn 11/14/2022 25,000 25,000 pua
29 Ida marlina jkn 11/15/2022 25,000 25,000 amenoihoe secunder
30 Susi herawati jkn 11/15/2022 25,000 25,000 pua
31 Yulia jkn 11/15/2022 25,000 25,000 post partum
32 Lela sari jkn 11/17/2022 25,000 25,000 bartolinitis
33 Maria jkn 11/18/2022 25,000 25,000 gravida 19 mggu
34 Riris jkn 11/18/2022 25,000 25,000 gravida 16 mggu
35 Herlina jkn 11/21/2022 25,000 25,000 gravida 33 mggu
36 Nur asnah jkn 11/21/2022 25,000 25,000 gravida 7 - 8 mggu
37 Berliyan jkn 11/21/2022 25,000 25,000 gravida 39 mggu
38 Sri rahayu jkn 11/21/2022 25,000 25,000 gravida 33 mggu
39 Riska anggraini jkn 11/21/2022 25,000 25,000 flour albus
40 Ita purnama jkn 11/21/2022 25,000 25,000 psc
41 Hernita jkn 11/21/2022 25,000 25,000 ab inmineus
42 Dila saskia jkn 11/21/2022 25,000 25,000 pud
43 Devi aprilly jkn 11/22/2022 25,000 25,000 gravida 19 mggu
44 Yemima jkn 11/22/2022 25,000 25,000 gravida 29 mggu
45 Suriana jkn 11/22/2022 25,000 25,000 gravida 17 mggu
46 Nuryasni jkn 11/22/2022 25,000 25,000 gravida 37 mggu
47 Supriani jkn 11/24/2022 25,000 25,000 psc
48 Mariska jkn 11/24/2022 25,000 25,000 reurotage
49 Sri novita jkn 11/24/2022 25,000 25,000 gravida 29 mggu
50 Bujer situmorang jkn 11/24/2022 25,000 25,000 gravida 13 mggu
51 Raulina jkn 11/24/2022 25,000 25,000 ca endometrium
52 Mastiur b nahor jkn 11/24/2022 25,000 25,000 post kista bartolim
53 Susi herawati jkn 11/25/2022 25,000 25,000 pua
54 Sabaria siburian jkn 11/28/2022 25,000 25,000 psc
55 Suci armadana jkn 11/28/2022 25,000 25,000 gravida
56 Sri rahayu jkn 11/28/2022 25,000 25,000 ca vagina
57 Masyaroh jkn 11/28/2022 25,000 25,000 gravida 32 mggu
58 Santa margareta jkn 11/28/2022 25,000 25,000 gyntak
59 Pinta uli jkn 11/28/2022 25,000 25,000 gravida 39 mggu
60 Jariah jkn 11/29/2022 25,000 25,000 pua
61 Dewi susanti umum 11/29/2022 40,000 40,000 post ab complitus
62 Lisna ukur jkn 11/29/2022 25,000 25,000 pua
63 Tindakan USG Bln. November 2022 sebanyak 25 psn @ 20.000,- 500,000 500,000
Total - 40,000 500,000 - 1,525,000 2,065,000

Ka. Keuangan Direktur RS Rawat Inap;
Umum -
Rawat Jalan: Umum + Prshn + A+ 40,000 +
Total 40,000
Jumlah 36,000
Penerima: Rawat Jalan BPJS 1,525,000
USG 500,000 +
Pajak (Tax) 5 % 749,965 -
Total 14,249,335
dr. Jekson Lubis, Sp.OG Transportasi -
Honor Bersih 14,249,335
dr. Robet Simamora, Sp.OG
Rekapitulasi Pasien
Bulan Desember 2023

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Visite HD/Visite Sub Total USG HD Operasi Total Honor DR Diagnosa / Ket
1
2
3
Total - - - -
2. Rawat Inap BPJS

1 Ristiatun Khasanah 116733 BPJS Klas II 2/4/2024 2/5/2024 2,791,500 400,000 Curettage
2 Angelin Gultom 101616 BPJS KLS III 2/5/2024 07/02/2024 5,292,800 1,200,000 SC
3 Dita Septiana Br Purba 101408 BPJS KLS III 2/7/2024 09/02/2024 2,196,300 400,000 PSP
4 Siti Rawiyah 116829 BPJS KLS III 2/7/2024 09/02/2024 2,196,300 219,630 HEG
5 Rahmasari Ginting 111299 BPJS Klas II 2/8/2024 2/11/2024 6,166,000 1,200,000 SC
6 Vicky Amalia Sulmi 116904 BPJS KLS III 09/02/2024 2/14/2024 5,292,800 1,200,000 SC
7 N Br Simbolon 2288 BPJS Kelas I 2/14/2024 2/16/2024 3,892,200 389,220 PUA
8 Rizky Ananda Siregar 117091 BPJS KLS III 17/02/2024 2/19/2024 5,590,500 1,200,000 SC
9 Rohdearna Br Saragih 117114 BPJS KLS III 2/19/2024 2/22/2024 5,292,800 1,200,000 SC
10 Yusminah 117180 BPJS KLS III 2/20/2024 2/23/2024 5,292,800 1,200,000 SC
11 Renti Munthe 117200 BPJS KLS III 2/21/2024 24/2/2024 5,292,800 1,200,000 SC
12 Erin Karlina 89110 BPJS Kelas I 2/24/2024 2/26/2024 7,039,300 1,200,000 SC
13 Irmawati Siagian 117285 BPJS Kelas I 25/02/2024 4/26/2024 3,186,800 400,000 Curettage
14 Sinna Br Simorangkir 113427 BPJS KLS III 2/28/2024 29/02/2024 2,396,100 400,000 Curettage
15
16
17
18
19
20
21
22
23
24
Total 61,919,000 11,808,850
3. Rawat Jalan
No Nama Pasien MR Status Tgl Berobat Total Klaim HD Umum USG Honor BPJS Total Honor DR Diagnosa
1 Lena panjaitan jkn 11/2/2022 25,000 25,000 psc
2 Sri wiyunda jkn 11/5/2022 25,000 25,000 gravida 38 - 39 mggu
3 Winda silviana jkn 11/5/2022 25,000 25,000 p curetage
4 Nurmawan jkn 11/5/2022 25,000 25,000 p curetage
5 Ade marisa jkn 11/9/2022 25,000 25,000 abortus
6 Siti nur jkn 11/9/2022 25,000 25,000 p curetage
7 Indah haryanti jkn 11/9/2022 25,000 25,000 p curetage
8 Sri boyaningsih jkn 11/9/2022 25,000 25,000 psc
9 Sunarta jkn 11/9/2022 25,000 25,000 gravida 30 mggu
10 Sida santi jkn 11/9/2022 25,000 25,000 gravida 30 mggu
11 Herbina umum 11/9/2022 40,000 40,000 psc
12 Cindy jkn 11/12/2022 25,000 25,000 gravida 23 mggu
13 Arbaiyah jkn 11/12/2022 25,000 25,000 prolapsus uteri
14 Supriani jkn 11/16/2022 25,000 25,000 psc
15 Sri wiyunda jkn 11/19/2022 25,000 25,000 gravida 38 mggu
17 Kristina jkn 11/19/2022 25,000 25,000 psc
18 Ritania jkn 11/19/2022 25,000 25,000 gravida 6 mggu
19 Dwi sampras umum 11/19/2022 40,000 40,000 gravida 2 - 3 mggu
20 Noviana jkn 11/23/2022 25,000 25,000 gravida 19 mggu
21 Arlinda jkn 11/23/2022 25,000 25,000 adenomyosis
22 Kristin natalia jkn 11/23/2022 25,000 25,000 psc
23 Marisa br tarigan jkn 11/23/2022 25,000 25,000 psc
24 Maria ningsih umum 11/26/2022 25,000 25,000 psc
25 Yulandari jkn 11/26/2022 25,000 25,000 psc
Total 80,000 120,000 575,000 775,000 -

Lubuk Pakam, November 2022 Rawat Inap;
Penerima; Diketahui Oleh: Ka. Keuangan Umum -
Direktur RS Rawat Jalan: Umum + Prshn + A+ 80,000 +
Total 80,000
Jumlah 72,000
dr. Robet Simamora,Sp.OG dr. Arifin P Sitompul Melki Tampubolon, SE Rawat Inap BPJS 11,808,850
Rawat Jalan BPJS 575,000
USG 120,000 +
Pajak (Tax) 5 % 628,793 -
11,947,058
Transportasi -
dr. Muhammad Gamal, Sp.OG
Rekapitulasi Pasien
Bulan Desember 2023

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Visite HD/Visite Sub Total USG HD Operasi Total Honor DR Diagnosa / Ket
Icha Agatha Ginting 118343 BPJS 3/27/2024 3/30/2024 400,000 PSP
Total - - 400,000 -
2. Rawat Inap BPJS

1 Fatimah 117397 BPJS KLS III 2/29/2024 01/03/2024 2,918,600 291,860 Post Partum
2 Lusyanty Elisabeth Hasibua 117594 BPJS KLS III 3/7/2024 10/03/2024 5,292,800 1,200,000 SC
3 Rika Frida Br Mendrofa 118073 BPJS Klas II 3/23/2024 26/03/2024 6,166,000 1,200,000 SC
4
5
6
7
8
9
10
11
12
Total 14,377,400 2,691,860
3. Rawat Jalan
No Nama Pasien MR Status Tgl Berobat Total Klaim HD Umum USG Honor BPJS Total Honor DR Diagnosa
1 Lena panjaitan jkn 11/2/2022 25,000 25,000 psc
2 Sri wiyunda jkn 11/5/2022 25,000 25,000 gravida 38 - 39 mggu
3 Winda silviana jkn 11/5/2022 25,000 25,000 p curetage
4 Nurmawan jkn 11/5/2022 25,000 25,000 p curetage
5 Ade marisa jkn 11/9/2022 25,000 25,000 abortus
6 Siti nur jkn 11/9/2022 25,000 25,000 p curetage
7 Indah haryanti jkn 11/9/2022 25,000 25,000 p curetage
8 Sri boyaningsih jkn 11/9/2022 25,000 25,000 psc
9 Sunarta jkn 11/9/2022 25,000 25,000 gravida 30 mggu
10 Sida santi jkn 11/9/2022 25,000 25,000 gravida 30 mggu
11 Herbina umum 11/9/2022 40,000 40,000 psc
12 Cindy jkn 11/12/2022 25,000 25,000 gravida 23 mggu
14 Supriani jkn 11/16/2022 25,000 25,000 psc
15 Sri wiyunda jkn 11/19/2022 25,000 25,000 gravida 38 mggu
17 Kristina jkn 11/19/2022 25,000 25,000 psc
18 Ritania jkn 11/19/2022 25,000 25,000 gravida 6 mggu
19 Dwi sampras umum 11/19/2022 40,000 40,000 gravida 2 - 3 mggu
20 Noviana jkn 11/23/2022 25,000 25,000 gravida 19 mggu
21 Arlinda jkn 11/23/2022 25,000 25,000 adenomyosis
22 Kristin natalia jkn 11/23/2022 25,000 25,000 psc
23 Marisa br tarigan jkn 11/23/2022 25,000 25,000 psc
24 Maria ningsih umum 11/26/2022 25,000 25,000 psc
25 Yulandari jkn 11/26/2022 25,000 25,000 psc
Total 80,000 120,000 575,000 775,000 -

Lubuk Pakam, November 2022 Rawat Inap;
Penerima; Diketahui Oleh: Ka. Keuangan Umum -
Direktur RS Rawat Jalan: Umum + Prshn + A+ 80,000 +
Total 80,000
Jumlah 72,000
dr. Robet Simamora,Sp.OG dr. Arifin P Sitompul Melki Tampubolon, SE Rawat Inap BPJS 2,691,860
Rawat Jalan BPJS 575,000
USG 120,000 +
Pajak (Tax) 5 % 172,943 -
3,285,917
Transportasi -
Total Bill
3,042,000
3,042,000
dr. ALAN PHILIPS KUSTIANTO PUTRA RESUBUN, Sp.OT
Rekapitulasi Pasien
Bulan Desember 2023

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Visite HD/Visite Sub Total HD Operasi Total Honor DR Diagnosa / Ket Total Bill
1 Lili Oktaviani Bangun 117010 Umum VIP 2/14/2024 2/14/2024 1 70,000 70,000 70,000 Injury 1,521,250
M Khairul Abdi 117266 JR Klas III 2/24/2024 4/26/2024 2 40,000 80,000 80,000 Upper Arm
Aci Zuliansyah 117198 JKK Klas III 2/21/2024 2/27/2024 1000000 1,000,000 Mfx of Toe
- -
Total 150,000 1,000,000 1,150,000 1,521,250
2. Rawat Inap BPJS

No Nama Pasien MR Status Ruang Tgl Masuk Tgl Keluar Total Klaim Jasa Dokter Alat Dokter Subtotal Ket. Diagnosa DPJP Keterangan
1 Rusli Efendi 97732 BPJS Kelas I 2/27/2024 29/02/2024 5,445,200 980,136 - 980,136 Roi dr. Ridho,Sp.PD
2 Abdillah Al Anshary 116410 BPJS Kelas I 1/30/2024 03/02/2024 9,172,800 1,834,560 - 1,834,560 Fracture
3 Kayra Erfani 116438 BPJS KLS III 1/30/2024 03/02/2024 9,054,000 1,810,800 2,263,500 4,074,300 Fracture
4 Rusli Effendi 097732 BPJS Kelas I 2/5/2024 07/02/2024 2,818,300 140,915 - 140,915 Union dr. Ridho,Sp.PD
5 Sapta Betauli Sugiarti Sim 116827 BPJS KLS III 2/7/2024 08/02/2024 1,499,200 149,920 - 149,920 Injury
6 Bayu Pratama 93742 BPJS KLS III 2/27/2024 29/02/2024 4,094,100 818,820 - 818,820 Fracture
7
8
9
10
-
Total 32,083,600 5,735,151 2,263,500 7,998,651
3. Rawat Jalan
No Nama Pasien MR Status Tgl Berobat Total Klaim HD Umum Honor BPJS Total Honor DR Diagnosa
1 Alfizal jkn 11/1/2022 35,000 35,000 lbp
2 Misno jkn 11/1/2022 35,000 35,000 post op orif
3 Laomani jkn 11/1/2022 35,000 35,000 oa
4 Siti sibuea jkn 11/1/2022 35,000 35,000 oa
5 Yusri jkn 11/1/2022 35,000 35,000 post op orif
6 Riski ayu jkn 11/1/2022 35,000 35,000 post op orif
7 Intan jkn 11/1/2022 35,000 35,000 post op orif
8 M alfaiz jkn 11/1/2022 35,000 35,000 operasi
9 Mastatoh jkn 11/7/2022 35,000 35,000 arteritis tendor
10 Jebrian jkn 11/7/2022 35,000 35,000 post op orif
11 Ernawati jkn 11/7/2022 35,000 35,000 oa
12 Saut jkn 11/7/2022 35,000 35,000 head injuri
13 Yusriadi jkn 11/7/2022 35,000 35,000 post op orif
14 Sri erlindawati jkn 11/7/2022 35,000 35,000 fr radius
15 Febrian jkn 11/14/2022 35,000 35,000 post op orif
16 Saut halomoan jkn 11/14/2022 35,000 35,000 joint injuri
17 Linda jkn 11/14/2022 35,000 35,000 lbp
18 Mhd al faiz jkn 11/14/2022 35,000 35,000 post orif
19 Lydia jkn 11/14/2022 35,000 35,000 oa
20 Kompak siahaan jkn 11/14/2022 35,000 35,000 trauma thorax
21 Syamsidar jkn 11/14/2022 35,000 35,000 oa
22 Medalika jkn 11/17/2022 35,000 35,000 trauma thorax
23 Rizki ayu jkn 11/17/2022 35,000 35,000 post op orif
24 Intan gemilang jkn 11/17/2022 35,000 35,000 post op orif
25 Laomani jkn 11/17/2022 35,000 35,000 oa
26 Siti sibuea jkn 11/17/2022 35,000 35,000 oa
27 Torsina pangaribuan jkn 11/17/2022 35,000 35,000 lbp
28 Misno jkn 11/17/2022 35,000 35,000 post op orif
29 Ernawati jkn 11/21/2022 35,000 35,000 spondalasis
30 Torsina pangaribuan jkn 11/21/2022 35,000 35,000 spondalasis lumbal
31 Kompak siahaan jkn 11/21/2022 35,000 35,000 trauma thorax
32 Lydia jkn 11/21/2022 35,000 35,000 post op orif
33 Citra amanda jkn 11/21/2022 35,000 35,000 post op orif
34 Syamsidar jkn 11/21/2022 35,000 35,000 lbp
35 Milly jkn 11/21/2022 35,000 35,000 post op orif
36 Saut halomoan jkn 11/21/2022 35,000 35,000 fr clavicula
37 Medalika jkn 11/24/2022 35,000 35,000 post op orif
38 Linda tambun jkn 11/24/2022 35,000 35,000 lbp
39 Dewi frini jkn 11/24/2022 35,000 35,000 post op orif
40 M alfaiz jkn 11/28/2022 35,000 35,000 post op orif
41 Saut silaban jkn 11/28/2022 35,000 35,000 fr clavicula
42 Citra amanda jkn 11/28/2022 35,000 35,000 post op orif
43 Lydia jkn 11/28/2022 35,000 35,000 oa
44 Milly jkn 11/28/2022 35,000 35,000 post op orif
Total - 1,540,000 1,540,000 -

Penerima; Diketahui Oleh: Ka. Keuangan Rawat Inap;
Direktur RS Umum 1,150,000
Rawat Jalan: Umum + Prshn + - +
Total 1,150,000
dr. Randy Susanto,Sp.OT dr. Arifin P Sitompul Melki Tampubolon, SE Jumlah 1,035,000
Rawat Jalan BPJS 1,540,000
Pajak (Tax) 5 % 415,508 -
7,894,643
Transportasi -
Ki-Ware 9.1jt
dr. Tuahman Fr Purba, SpAn, M.Kes
Rekapitulasi Pasien
Bulan Desember 2023
1. Kalkulasi Daftar Nama Pasien

No Nama Pasien Status Tanggal Konsul Diagnosa Jumlah/Rp Keterangan
PASIEN IPI/ICU
1 Warni jkn 11/3/2022 tb paru + dm tipe 2 100,000 IPI
2 Amir jkn 11/3/2022 malaria berat 100,000 IPI
3 Bima prastiyo jkn 11/4/2022 intoxikasi insektisida 100,000 IPI
4 Mangipan manalu jkn 11/3/2022 tb paru + ht + dm tipe 2 100,000 IPI
5 Ferdinan saragih jkn 11/5/2022 syok sepsis ec sepsis pneumonia 100,000 IPI
6 Nabila saputri jkn 11/6/2022 epileptikus + sangkaan autoimu 100,000 IPI
7 By ny sri boyaningsih jkn 11/8/2022 neonatal seizure 100,000 IPI
8 Susilawati jkn 11/10/2022 pneumonia 100,000 IPI
9 Romanti br nababan jkn 11/11/2022 tb paru + ckd 100,000 IPI
10 Bayi kristinah jkn 11/12/2022 aspixisa neonatorium 100,000 IPI
11 Bantu barus jkn 11/17/2022 cpc + chf 100,000 IPI
12 Asmidar tarigan jkn 11/1/2022 post op sc 100,000 IPI
13 Sariyati jkn 11/1/2022 post op sc 100,000 IPI
14 Dimas adi putra jkn 11/1/2022 post op appendixtomy 100,000 IPI
15 Khairani jkn 11/1/2022 post op sc 100,000 IPI
16 Dini fera sri ulina jkn 11/2/2022 post op sc 100,000 IPI
17 Maryani jkn 11/3/2022 post op sc 100,000 IPI
18 Junita sari jkn 11/3/2022 post op sc 100,000 IPI
19 jumpa saragih jkn 11/3/2022 post op abces perianal 100,000 IPI
20 Asminah jkn 11/3/2022 post op sc 100,000 IPI
21 Murtika sari tanjung jkn 11/3/2022 post op sc 100,000 IPI
22 Sugiatik jkn 10/4/2022 post op sc 100,000 IPI
23 Tri agustina jkn 11/4/2022 post op sc 100,000 IPI
24 Rumilah jkn 11/4/2022 post op appendixtomy 100,000 IPI
25 Saat wagio jkn 11/4/2022 post op debridement 100,000 IPI
26 Muslim jkn 11/4/2022 post op debridement 100,000 IPI
27 Sukarto jkn 11/5/2022 post op ortoped union tibia 100,000 IPI
28 Novalina saragih jkn 11/5/2022 post op appendixtomy 100,000 IPI
29 Saniah jkn 11/6/2022 post op fam 100,000 IPI
30 Junita jkn 11/6/2022 post op sc 100,000 IPI
31 Adrianus sitorus jkn 11/6/2022 post debridement 100,000 IPI
32 Athar nur ramadan jkn 11/6/2022 post app circumsison 100,000 IPI
33 Nurul janah jkn 11/6/2022 post op sc 100,000 IPI
34 Widi astriani jkn 11/7/2022 post op sc 100,000 IPI
35 Ayu azhari jkn 11/7/2022 post op sc 100,000 IPI
36 Siti aisyah jkn 11/7/2022 post op sc 100,000 IPI
37 Fauziah jkn 11/13/2022 post op laparatomy 100,000 IPI
38 Erifa sianturi jkn 11/14/2022 snh + hipertensi 100,000 IPI
39 Kamsia hotang jkn 11/17/2022 anemia + penurunan kesadaran . 100,000 IPI
40 Suhendra purba jkn 11/1/2022 amputasi jari ii manus 100,000 IPI
41 Erpina jkn 11/1/2022 debridemen + exisi 100,000 IPI
42 Anggita puspita sari jkn 11/1/2022 appendixtomy 100,000 IPI
43 Sri boganingsih jkn 11/1/2022 post op sc 100,000 IPI
44 Muspah jkn 11/1/2022 debridement + corpus allineum 100,000 IPI
45 Heline putri jkn 11/2/2022 post op sc 100,000 IPI
46 Herbina sinaga jkn 11/2/2022 post op sc 100,000 IPI
47 Mulyani jkn 11/2/2022 post op stt 100,000 IPI
48 Zainal arifin lubis jkn 11/2/2022 post op herniatomy dextra 100,000 IPI
49 Siti imamiah jkn 11/2/2022 post op sc 100,000 IPI
50 Dwi novita kestani jkn 11/2/2022 post op appendixilis 100,000 IPI
51 Martua aritonang jkn 11/2/2022 post op debridement + amputasi 100,000 IPI
52 M alfin mandapi jkn 11/3/2022 cloud radius ulna 100,000 IPI
53 Nurlaila wati jkn 11/3/2022 post op sc 100,000 IPI
54 Widya septia ningrum jkn 11/3/2022 post op fistelani 100,000 IPI
55 Intan utari jkn 11/3/2022 post op fam 100,000 IPI
56 Sinta kholijah jkn 11/5/2022 post op sc 100,000 IPI
57 Ariadi umum 11/5/2022 post op debridement 100,000 IPI
58 Ayu agustina jkn 11/7/2022 post op fam 100,000 IPI
59 Tito okamea jkn 11/7/2022 basalioma ec nose basal ca 100,000 IPI
60 Suci antika jkn 11/7/2022 post op sc 100,000 IPI
61 Sutrino jkn 11/7/2022 exisi 100,000 IPI
62 Abd muin jkn 11/7/2022 wide exici 100,000 IPI
63 Saliki jkn 11/7/2022 debridement + amputasi digiti i 100,000 IPI
64 Rini br purba jkn 11/7/2022 debridement dikepala 100,000 IPI
65 Ngatimin jkn 11/7/2022 debridement pd kaki kiri 100,000 IPI
66 Ester perawati jkn 11/8/2022 post flane born 100,000 IPI
67 Durmaya jkn 11/9/2022 post op implant 100,000 IPI
68 Rapael jkn 11/9/2022 post op implant 100,000 IPI
69 Ayu lestari jkn 11/9/2022 post wide exici 100,000 IPI
70 Sabrina jkn 11/9/2022 post op aff 100,000 IPI
71 Resiana manurung jkn 11/10/2022 post op stt bilateral pedis 100,000 IPI
72 Juli br ginting jkn 11/10/2022 skin darfing d/h florte fione ham 100,000 IPI
73 Wahyudi jkn 11/10/2022 post op stt/eksisi 100,000 IPI
74 Debora oppusunggu jkn 11/10/2022 post op stt pd telinga 100,000 IPI
75 Selvina jkn 11/10/2022 post op debridement 100,000 IPI
76 Tegar maulana akbar jkn 11/10/2022 post op exisi stt shoulder 100,000 IPI
77 Mhd arifin lubis jkn 11/10/2022 post op open fx tibia fibula 100,000 IPI
78 Uci melinda jkn 11/11/2022 post op fam kanan 100,000 IPI
79 Sudarno jkn 11/11/2022 post op stt 100,000 IPI
80 Lamsihar butar butar jkn 11/11/2022 post op sc 100,000 IPI
81 Arap p situmorang jkn 11/12/2022 post op occipisal suft tiser tumo 100,000 IPI
82 Kristina delinawati jkn 11/12/2022 post op sc 100,000 IPI
83 Mandra purba jkn 11/14/2022 post op stt 100,000 IPI
84 Misnawati jkn 11/14/2022 post op stt 100,000 IPI
85 Marisa tarigan jkn 11/15/2022 post op sc 100,000 IPI
86 Leli yuslina jkn 11/15/2022 post op sc 100,000 IPI
87 Lutfi alviano banursa jkn 11/24/2022 hidrakal 100,000 IPI
88 Sartika jkn 11/24/2022 exisi 100,000 IPI
89 Rumiah jkn 11/24/2022 post op debridement + amputer 100,000 IPI
90 Selamat riyadi jkn 11/24/2022 post op stt 100,000 IPI
91 Sudarmanto jkn 11/24/2022 post op hil 100,000 IPI
92 Rosa aria jkn 11/24/2022 post op stt 100,000 IPI
93 Mozza jkn 11/24/2022 post op apundex 100,000 IPI
94 Rika syahputry jkn 11/26/2022 post op sc 100,000 IPI
95 Abi napitupulu jkn 11/25/2022 debridenum 100,000 IPI
96 Rudi hartono jkn 11/25/2022 exisi 100,000 IPI
97 Leni panjaitan jkn 11/26/2022 p sc 100,000 IPI
98 Nani kumiati jkn 11/26/2022 post op sc 100,000 IPI
99 Siti khodijah jkn 11/26/2022 post op sc 100,000 IPI
100 Awaludin jkn 11/26/2022 post op apinaucilis 100,000 IPI
101 Khairunisa jkn 11/26/2022 post op sc 100,000 IPI
102 Pitra ramadan jkn 11/26/2022 post op amputasi 100,000 IPI
103 Maharani jkn 11/26/2022 post op sc 100,000 IPI
104 Syarifudin saragih jkn 11/27/2022 post op haemoroid internal grade 100,000 IPI
105 Rika herdarin jkn 11/27/2022 post op haemoroid grade iii 100,000 IPI
106 Yusriadi jkn 11/27/2022 closed lateral crarikul 100,000 IPI
107 Rundiani tarigan jkn 11/27/2022 post op herring femorceis 100,000 IPI
108 Sugito jkn 11/27/2022 post op debridenum 100,000 IPI
109 Marolop hutapea jkn 11/27/2022 post orif 100,000 IPI
110 Farida jkn 11/27/2022 post op debridenum 100,000 IPI
111 Supandi jkn 11/28/2022 post op debridement 100,000 IPI
112 Lasti periati siregar jkn 11/29/2022 post op app 100,000 IPI
113 Nanda saputra jkn 11/15/2022 post op stt 100,000 IPI
114 Yurtika sinaga jkn 11/15/2022 post op sc 100,000 IPI
115 Ita purnama sari jkn 11/15/2022 post op sc 100,000 IPI
116 Tengku samsidar jkn 11/15/2022 post op debridement 100,000 IPI
117 Bonar tua jkn 11/16/2022 post op inplant 100,000 IPI
118 Maria ningsih jkn 11/16/2022 post op sc 100,000 IPI
119 Reva mutia sari jkn 11/16/2022 post op saparatomy 100,000 IPI
120 Mhd regli jkn 11/16/2022 rhinusitis kronis 100,000 IPI
121 Luki danuarta jkn 11/16/2022 post op resposisi nasal 100,000 IPI
122 Kristin natalia lbn gaol jkn 11/17/2022 post op sc 100,000 IPI
123 Supardi jkn 11/17/2022 stroke haemoragie + ht + hipogl 100,000 IPI
124 Bayi ny kristin jkn 11/22/2022 aspixia neonatorium 100,000 IPI
125 Syarfudin jkn 11/21/2022 hiperglikemia + electrolit inbala 100,000 IPI
126 Sri wulandari jkn 11/18/2022 susp honk 100,000 IPI
127 Wagimin jkn 11/22/2022 sepsis + anemia + electrolit inba 100,000 IPI
128 Efri syahputra jkn 11/30/2022 head injury + ve 100,000 IPI
129 Temu umum 11/30/2022 chf ef + dm + tb paru 100,000 IPI
130 Nila suciwahyuni jkn 11/30/2022 sepsis pneumonia + hiperglikem 100,000 IPI
131 Abdillah jkn 11/28/2022 post op debridement 100,000 IPI
132 Juwita hurnaria jkn 11/28/2022 post op appendixitis 100,000 IPI
133 Riski sandi jkn 11/28/2022 post op exici 100,000 IPI
135 Suheni jkn 11/29/2022 post op sc 100,000 IPI
136 Jawalen purba jkn 11/30/2022 chf + pneumonia 100,000 IPI
137 Yuliana sari jkn 11/17/2022 abdominal abses 100,000 IPI
138 Paingot alman silitonga jkn 11/17/2022 explorasi luka kaki 100,000 IPI
139 Dewi frini purba jkn 11/17/2022 post op orif (l) multiple 100,000 IPI
140 Ayu lestari jkn 11/17/2022 post op sc 100,000 IPI
141 Vivi diana jkn 11/18/2022 mastectomy + dm 100,000 IPI
142 Leni arsita jkn 11/20/2022 post op app 100,000 IPI
143 Mara manusun sibuea jkn 11/21/2022 post op eksisi biopsi 100,000 IPI
144 Rita sugiarti jkn 11/21/2022 post op eksisi 100,000 IPI
145 Romiyiha uliasta purba jkn 11/21/2022 post op eksisi 100,000 IPI
146 Sabariana jkn 11/21/2022 post op sc 100,000 IPI
147 Sri uriyunda sari jkn 11/22/2022 post op sc 100,000 IPI
148 Yulandari jkn 11/22/2022 post op sc 100,000 IPI
149 Dewi astuti jkn 11/23/2022 post op sc 100,000 IPI
150 Sucipto jkn 11/23/2022 post op aff implant 100,000 IPI
151 Ngatemi jkn 11/23/2022 post op stt abdoment 100,000 IPI
152 Joe ronaldo jkn 11/23/2022 post eksisi 100,000 IPI
153 Sinta renta marina jkn 11/23/2022 post op sc 100,000 IPI
154 Fitria jkn 11/27/2022 post op sc 100,000 IPI
155 Susi susanti jkn 11/30/2022 post op sc 100,000 IPI
156 Rapina jkn 11/30/2022 post op sc 100,000 IPI
157 Muara simanjuntak jkn 11/30/2022 post op debridement 100,000 IPI
158 Ester mentari jkn 11/30/2022 post op reposisi natal 100,000 IPI
159 Rusmina dewi jkn 11/30/2022 post op debridement 100,000 IPI
160 Nila sri wahyuni jkn 11/30/2022 sepsis pneumonia 100,000 IPI
PASIEN IBS / OK
1 Ade Dea Sri JKN 9/1/2022 Excici 500,000 Op besar
2 Siska JKN 9/1/2022 SC 500,000 Op besar
3 Mersi JKN 9/3/2022 SC 500,000 Op besar
4 Nurul JKN 9/3/2022 SC 500,000 Op besar
5 Mhd Bagis JKN 9/5/2022 Lympadectomy 500,000 Op besar
6 Rina Ramadani JKN 9/5/2022 SC +Kontap 500,000 Op besar
7 Dewi Maya Sari JKN 9/5/2022 Exp laparatomi 500,000 Op besar
8 Nurhayati JKN 9/5/2022 Excici topus 500,000 Op besar
9 Doly Yoan Tamara JKN 9/7/2022 Aff implan 500,000 Op besar
10 Suci Wiranta U 9/7/2022 SC 500,000 Op besar
11 Nurnida JKN 9/7/2022 Debridemnt 500,000 Op besar
12 Meysia Aura P JKN 9/8/2022 Appendictomy 300,000 Op sedang
13 Alimad Farisi JKN 9/8/2022 Lympadectomy 500,000 Op besar
14 Intan Arini JKN 9/8/2022 SC +Kontap 500,000 Op besar
15 Wulandari JKN 9/8/2022 SC 500,000 Op besar
16 Mayam Purba JKN 9/8/2022 Closed reduction 500,000 Op besar
17 Yusri Ananda JKK 9/8/2022 Debridment +ORIF 500,000 Op besar
18 Ade Irawan Kita bisa 9/8/2022 Laparatomy 500,000 Op besar
19 Arshaka JKN 9/8/2022 Herniorapy 500,000 Op besar
20 Bonar Tua T JKK 9/10/2022 Debridment +ORIF 500,000 Op besar
21 Rindu Martalena JKN 9/10/2022 SC+kontap 500,000 Op besar
22 Hasan Basri JKN 9/10/2022 Wide excici 500,000 Op besar
23 Robert Mazmur JKN 9/10/2022 Debridement 500,000 Op besar
24 Diani Manuella JKN 9/11/2022 SC 500,000 Op besar
25 Rudianto Silitong JKN 9/14/2022 Herniolaparatomy 500,000 Op besar
26 Ega Sri Wahyuni JKN 9/14/2022 Curetage 200,000 Tindakan
27 Danu Safriza JKN 9/14/2022 Aff implan 500,000 Op besar
28 Chairuddin JKN 9/14/2022 Debridment 500,000 Op besar
29 Syarif JKN 9/14/2022 Debridment 500,000 Op besar
30 M.Haziz JKN 9/14/2022 Wide excici 500,000 Op besar
31 Sakia JKN 9/14/2022 Exp laparatomy 500,000 Op besar
32 Aprilra Darori JKN 9/14/2022 Excici 500,000 Op besar
33 Rini JKN 9/14/2022 SC 500,000 Op besar
34 Yeska JR 9/15/2022 Wide excici 500,000 Op besar
35 Wito Dermawan JKN 9/15/2022 Debridement 500,000 Op besar
36 Ayu Lesatari JKN 9/15/2022 Debridement 500,000 Op besar
37 Ramadana JKN 9/15/2022 Excici varisee 500,000 Op besar
38 Vera Sonya JKN 9/15/2022 SC 500,000 Op besar
39 Lisa Herawati JKN 9/15/2022 SC 500,000 Op besar
40 Wiwit JKN 9/15/2022 Curetage 200,000 Tindakan
41 Asmiati JKN 9/17/2022 Debridement 500,000 Op besar
42 Ali Altong JKN 9/21/2022 Hemoroidectomy 500,000 Op besar
43 Ramadania JKN 9/21/2022 Sinusectomy 500,000 Op besar
44 Ferrerius JKN 9/21/2022 Sinusectomy 500,000 Op besar
45 Dinda Mayang JKN 9/21/2022 Wide excici 500,000 Op besar
46 Sumiyem JKN 9/21/2022 Wide excici 500,000 Op besar
47 Bahni Rahman JKN 9/21/2022 Debridement 500,000 Op besar
48 Riski Ayu JKN 9/22/2022 ORIF ulna 500,000 Op besar
49 Rusni JKN 9/22/2022 Hemoroidectomy 500,000 Op besar
50 Jamuka Tp Bolon JKN 9/22/2022 Herniorapy 500,000 Op besar
51 Purwani JKN 9/22/2022 SC 500,000 Op besar
52 Sri Hardila JKN 9/24/2022 SC 500,000 Op besar
53 Tuti Desmawati JKN 9/24/2022 SC 500,000 Op besar
54 Naomi Purba JKN 9/25/2022 SC 500,000 Op besar
55 Arap Situmorang JKN 9/28/2022 500,000
56 Arga Karunia JKN 9/28/2022 Appendictomy 300,000 Op sedang
57 Misno JKN 9/29/2022 Debridment 500,000 Op besar
58 Eni Rahmawati JKN 9/29/2022 SC 500,000 Op besar
59 lusiana JKN 9/29/2022 SC 500,000 Op besar
60 Rawainda JKN 9/29/2022 SC 500,000 Op besar
61 Desi Apriana JKN 9/29/2022 Fistelectomy 500,000 Op besar
62 Janwari JKN 11/1/2022 Debridemen 500,000 Op besar
63 Junus Turnip JKN 11/9/2022 Debridemen 500,000 Op besar
64 Rustam JKN 11/21/2022 Debridemen 500,000 Op besar
65 Suriono JKN 11/7/2022 500,000 Op besar
66 Enri Anto Lubis JKN 11/12/2022 500,000 Op besar
67 Boiman JKN 11/16/2022 Debridemen 500,000 Op besar
68 Rusianna Saragih JKN 11/29/2022 Sepsis + Insisi 500,000 Op besar
69 Zubaidal JKN 11/2/2022 500,000 Op besar
70 Kasmini JKN 11/3/2022 500,000 Op besar
71 Muhammad Hadi JKN 11/4/2022 500,000 Op besar
72 Ruminta Sianturi JKN 11/6/2022 500,000 Op besar
73 Nur Ainun JKN 11/9/2022 Abdominal + Debridement 500,000 Op besar
74 Imdhani JKN 11/10/2022 FAM 500,000 Op besar
75 Muhammad Nur Sugianto JKN 11/16/2022 500,000 Op besar
76 Suminah JKN 11/18/2022 Sepsis + Insisi 500,000 Op besar
77 Trisnawati JKN 11/19/2022 500,000 Op besar
78 Sri Ulandari JKN 11/21/2022 500,000 Op besar
79 Rahma Wati JKN 11/23/2022 500,000 Op besar
80 Kamsia Br Hotang JKN 11/21/2022 500,000 Op besar
81 Suhariana JKN 11/22/2022 500,000 Op besar
Total 55,500,000
Total Pendapatan Honor: 55,500,000

Pajak (Tax) 5 % 887,500 -
54,612,500
2. Honor Penanggung Jawab + Transportasi - +
Total Honor: 54,612,500
-
Diketahui Oleh: Lubuk Pakam, November 2022

Direktur RS Ka. Keuangan
dr. Arifin P Sitompul Melki Tampubolon, SE

Penerima;
dr. Tuahman Purba, Sp.An
dr. Tuahman Fr Purba, SpAn, M.Kes
Rekapitulasi Pasien
Bulan Desember 2023
1. Kalkulasi Daftar Nama Pasien

No Nama Pasien Status Tanggal Konsul Diagnosa Jumlah/Rp Keterangan
PASIEN IPI/ICU
1 Warni jkn 11/3/2022 tb paru + dm tipe 2 100,000 IPI
2 Amir jkn 11/3/2022 malaria berat 100,000 IPI
3 Bima prastiyo jkn 11/4/2022 intoxikasi insektisida 100,000 IPI
4 Mangipan manalu jkn 11/3/2022 tb paru + ht + dm tipe 2 100,000 IPI
5 Ferdinan saragih jkn 11/5/2022 syok sepsis ec sepsis pneumonia 100,000 IPI
6 Nabila saputri jkn 11/6/2022 epileptikus + sangkaan autoimu 100,000 IPI
7 By ny sri boyaningsih jkn 11/8/2022 neonatal seizure 100,000 IPI
8 Susilawati jkn 11/10/2022 pneumonia 100,000 IPI
9 Romanti br nababan jkn 11/11/2022 tb paru + ckd 100,000 IPI
10 Bayi kristinah jkn 11/12/2022 aspixisa neonatorium 100,000 IPI
11 Bantu barus jkn 11/17/2022 cpc + chf 100,000 IPI
12 Asmidar tarigan jkn 11/1/2022 post op sc 100,000 IPI
13 Sariyati jkn 11/1/2022 post op sc 100,000 IPI
14 Dimas adi putra jkn 11/1/2022 post op appendixtomy 100,000 IPI
15 Khairani jkn 11/1/2022 post op sc 100,000 IPI
16 Dini fera sri ulina jkn 11/2/2022 post op sc 100,000 IPI
17 Maryani jkn 11/3/2022 post op sc 100,000 IPI
18 Junita sari jkn 11/3/2022 post op sc 100,000 IPI
19 jumpa saragih jkn 11/3/2022 post op abces perianal 100,000 IPI
20 Asminah jkn 11/3/2022 post op sc 100,000 IPI
21 Murtika sari tanjung jkn 11/3/2022 post op sc 100,000 IPI
22 Sugiatik jkn 10/4/2022 post op sc 100,000 IPI
23 Tri agustina jkn 11/4/2022 post op sc 100,000 IPI
24 Rumilah jkn 11/4/2022 post op appendixtomy 100,000 IPI
26 Muslim jkn 11/4/2022 post op debridement 100,000 IPI
27 Sukarto jkn 11/5/2022 post op ortoped union tibia 100,000 IPI
28 Novalina saragih jkn 11/5/2022 post op appendixtomy 100,000 IPI
29 Saniah jkn 11/6/2022 post op fam 100,000 IPI
30 Junita jkn 11/6/2022 post op sc 100,000 IPI
31 Adrianus sitorus jkn 11/6/2022 post debridement 100,000 IPI
32 Athar nur ramadan jkn 11/6/2022 post app circumsison 100,000 IPI
33 Nurul janah jkn 11/6/2022 post op sc 100,000 IPI
34 Widi astriani jkn 11/7/2022 post op sc 100,000 IPI
35 Ayu azhari jkn 11/7/2022 post op sc 100,000 IPI
36 Siti aisyah jkn 11/7/2022 post op sc 100,000 IPI
37 Fauziah jkn 11/13/2022 post op laparatomy 100,000 IPI
38 Erifa sianturi jkn 11/14/2022 snh + hipertensi 100,000 IPI
39 Kamsia hotang jkn 11/17/2022 anemia + penurunan kesadaran . 100,000 IPI
40 Suhendra purba jkn 11/1/2022 amputasi jari ii manus 100,000 IPI
41 Erpina jkn 11/1/2022 debridemen + exisi 100,000 IPI
42 Anggita puspita sari jkn 11/1/2022 appendixtomy 100,000 IPI
43 Sri boganingsih jkn 11/1/2022 post op sc 100,000 IPI
44 Muspah jkn 11/1/2022 debridement + corpus allineum 100,000 IPI
45 Heline putri jkn 11/2/2022 post op sc 100,000 IPI
46 Herbina sinaga jkn 11/2/2022 post op sc 100,000 IPI
47 Mulyani jkn 11/2/2022 post op stt 100,000 IPI
48 Zainal arifin lubis jkn 11/2/2022 post op herniatomy dextra 100,000 IPI
49 Siti imamiah jkn 11/2/2022 post op sc 100,000 IPI
50 Dwi novita kestani jkn 11/2/2022 post op appendixilis 100,000 IPI
51 Martua aritonang jkn 11/2/2022 post op debridement + amputasi 100,000 IPI
52 M alfin mandapi jkn 11/3/2022 cloud radius ulna 100,000 IPI
53 Nurlaila wati jkn 11/3/2022 post op sc 100,000 IPI
54 Widya septia ningrum jkn 11/3/2022 post op fistelani 100,000 IPI
55 Intan utari jkn 11/3/2022 post op fam 100,000 IPI
56 Sinta kholijah jkn 11/5/2022 post op sc 100,000 IPI
57 Ariadi umum 11/5/2022 post op debridement 100,000 IPI
58 Ayu agustina jkn 11/7/2022 post op fam 100,000 IPI
59 Tito okamea jkn 11/7/2022 basalioma ec nose basal ca 100,000 IPI
60 Suci antika jkn 11/7/2022 post op sc 100,000 IPI
61 Sutrino jkn 11/7/2022 exisi 100,000 IPI
62 Abd muin jkn 11/7/2022 wide exici 100,000 IPI
63 Saliki jkn 11/7/2022 debridement + amputasi digiti i 100,000 IPI
64 Rini br purba jkn 11/7/2022 debridement dikepala 100,000 IPI
65 Ngatimin jkn 11/7/2022 debridement pd kaki kiri 100,000 IPI
66 Ester perawati jkn 11/8/2022 post flane born 100,000 IPI
67 Durmaya jkn 11/9/2022 post op implant 100,000 IPI
68 Rapael jkn 11/9/2022 post op implant 100,000 IPI
69 Ayu lestari jkn 11/9/2022 post wide exici 100,000 IPI
70 Sabrina jkn 11/9/2022 post op aff 100,000 IPI
71 Resiana manurung jkn 11/10/2022 post op stt bilateral pedis 100,000 IPI
72 Juli br ginting jkn 11/10/2022 skin darfing d/h florte fione ham 100,000 IPI
73 Wahyudi jkn 11/10/2022 post op stt/eksisi 100,000 IPI
74 Debora oppusunggu jkn 11/10/2022 post op stt pd telinga 100,000 IPI
75 Selvina jkn 11/10/2022 post op debridement 100,000 IPI
76 Tegar maulana akbar jkn 11/10/2022 post op exisi stt shoulder 100,000 IPI
77 Mhd arifin lubis jkn 11/10/2022 post op open fx tibia fibula 100,000 IPI
78 Uci melinda jkn 11/11/2022 post op fam kanan 100,000 IPI
79 Sudarno jkn 11/11/2022 post op stt 100,000 IPI
80 Lamsihar butar butar jkn 11/11/2022 post op sc 100,000 IPI
81 Arap p situmorang jkn 11/12/2022 post op occipisal suft tiser tumo 100,000 IPI
82 Kristina delinawati jkn 11/12/2022 post op sc 100,000 IPI
83 Mandra purba jkn 11/14/2022 post op stt 100,000 IPI
84 Misnawati jkn 11/14/2022 post op stt 100,000 IPI
85 Marisa tarigan jkn 11/15/2022 post op sc 100,000 IPI
86 Leli yuslina jkn 11/15/2022 post op sc 100,000 IPI
87 Lutfi alviano banursa jkn 11/24/2022 hidrakal 100,000 IPI
88 Sartika jkn 11/24/2022 exisi 100,000 IPI
89 Rumiah jkn 11/24/2022 post op debridement + amputer 100,000 IPI
90 Selamat riyadi jkn 11/24/2022 post op stt 100,000 IPI
91 Sudarmanto jkn 11/24/2022 post op hil 100,000 IPI
92 Rosa aria jkn 11/24/2022 post op stt 100,000 IPI
93 Mozza jkn 11/24/2022 post op apundex 100,000 IPI
94 Rika syahputry jkn 11/26/2022 post op sc 100,000 IPI
95 Abi napitupulu jkn 11/25/2022 debridenum 100,000 IPI
96 Rudi hartono jkn 11/25/2022 exisi 100,000 IPI
97 Leni panjaitan jkn 11/26/2022 p sc 100,000 IPI
98 Nani kumiati jkn 11/26/2022 post op sc 100,000 IPI
99 Siti khodijah jkn 11/26/2022 post op sc 100,000 IPI
100 Awaludin jkn 11/26/2022 post op apinaucilis 100,000 IPI
101 Khairunisa jkn 11/26/2022 post op sc 100,000 IPI
102 Pitra ramadan jkn 11/26/2022 post op amputasi 100,000 IPI
103 Maharani jkn 11/26/2022 post op sc 100,000 IPI
104 Syarifudin saragih jkn 11/27/2022 post op haemoroid internal grade 100,000 IPI
105 Rika herdarin jkn 11/27/2022 post op haemoroid grade iii 100,000 IPI
106 Yusriadi jkn 11/27/2022 closed lateral crarikul 100,000 IPI
107 Rundiani tarigan jkn 11/27/2022 post op herring femorceis 100,000 IPI
108 Sugito jkn 11/27/2022 post op debridenum 100,000 IPI
109 Marolop hutapea jkn 11/27/2022 post orif 100,000 IPI
110 Farida jkn 11/27/2022 post op debridenum 100,000 IPI
111 Supandi jkn 11/28/2022 post op debridement 100,000 IPI
112 Lasti periati siregar jkn 11/29/2022 post op app 100,000 IPI
113 Nanda saputra jkn 11/15/2022 post op stt 100,000 IPI
114 Yurtika sinaga jkn 11/15/2022 post op sc 100,000 IPI
115 Ita purnama sari jkn 11/15/2022 post op sc 100,000 IPI
116 Tengku samsidar jkn 11/15/2022 post op debridement 100,000 IPI
117 Bonar tua jkn 11/16/2022 post op inplant 100,000 IPI
118 Maria ningsih jkn 11/16/2022 post op sc 100,000 IPI
119 Reva mutia sari jkn 11/16/2022 post op saparatomy 100,000 IPI
120 Mhd regli jkn 11/16/2022 rhinusitis kronis 100,000 IPI
121 Luki danuarta jkn 11/16/2022 post op resposisi nasal 100,000 IPI
122 Kristin natalia lbn gaol jkn 11/17/2022 post op sc 100,000 IPI
123 Supardi jkn 11/17/2022 stroke haemoragie + ht + hipogl 100,000 IPI
124 Bayi ny kristin jkn 11/22/2022 aspixia neonatorium 100,000 IPI
125 Syarfudin jkn 11/21/2022 hiperglikemia + electrolit inbala 100,000 IPI
126 Sri wulandari jkn 11/18/2022 susp honk 100,000 IPI
127 Wagimin jkn 11/22/2022 sepsis + anemia + electrolit inba 100,000 IPI
128 Efri syahputra jkn 11/30/2022 head injury + ve 100,000 IPI
129 Temu umum 11/30/2022 chf ef + dm + tb paru 100,000 IPI
130 Nila suciwahyuni jkn 11/30/2022 sepsis pneumonia + hiperglikem 100,000 IPI
131 Abdillah jkn 11/28/2022 post op debridement 100,000 IPI
132 Juwita hurnaria jkn 11/28/2022 post op appendixitis 100,000 IPI
133 Riski sandi jkn 11/28/2022 post op exici 100,000 IPI
135 Suheni jkn 11/29/2022 post op sc 100,000 IPI
136 Jawalen purba jkn 11/30/2022 chf + pneumonia 100,000 IPI
137 Yuliana sari jkn 11/17/2022 abdominal abses 100,000 IPI
138 Paingot alman silitonga jkn 11/17/2022 explorasi luka kaki 100,000 IPI
139 Dewi frini purba jkn 11/17/2022 post op orif (l) multiple 100,000 IPI
140 Ayu lestari jkn 11/17/2022 post op sc 100,000 IPI
141 Vivi diana jkn 11/18/2022 mastectomy + dm 100,000 IPI
142 Leni arsita jkn 11/20/2022 post op app 100,000 IPI
143 Mara manusun sibuea jkn 11/21/2022 post op eksisi biopsi 100,000 IPI
144 Rita sugiarti jkn 11/21/2022 post op eksisi 100,000 IPI
145 Romiyiha uliasta purba jkn 11/21/2022 post op eksisi 100,000 IPI
146 Sabariana jkn 11/21/2022 post op sc 100,000 IPI
147 Sri uriyunda sari jkn 11/22/2022 post op sc 100,000 IPI
148 Yulandari jkn 11/22/2022 post op sc 100,000 IPI
149 Dewi astuti jkn 11/23/2022 post op sc 100,000 IPI
150 Sucipto jkn 11/23/2022 post op aff implant 100,000 IPI
151 Ngatemi jkn 11/23/2022 post op stt abdoment 100,000 IPI
152 Joe ronaldo jkn 11/23/2022 post eksisi 100,000 IPI
153 Sinta renta marina jkn 11/23/2022 post op sc 100,000 IPI
154 Fitria jkn 11/27/2022 post op sc 100,000 IPI
155 Susi susanti jkn 11/30/2022 post op sc 100,000 IPI
156 Rapina jkn 11/30/2022 post op sc 100,000 IPI
157 Muara simanjuntak jkn 11/30/2022 post op debridement 100,000 IPI
158 Ester mentari jkn 11/30/2022 post op reposisi natal 100,000 IPI
159 Rusmina dewi jkn 11/30/2022 post op debridement 100,000 IPI
160 Nila sri wahyuni jkn 11/30/2022 sepsis pneumonia 100,000 IPI
PASIEN IBS / OK
1 Ade Dea Sri JKN 9/1/2022 Excici 500,000 Op besar
2 Siska JKN 9/1/2022 SC 500,000 Op besar
3 Mersi JKN 9/3/2022 SC 500,000 Op besar
4 Nurul JKN 9/3/2022 SC 500,000 Op besar
5 Mhd Bagis JKN 9/5/2022 Lympadectomy 500,000 Op besar
6 Rina Ramadani JKN 9/5/2022 SC +Kontap 500,000 Op besar
7 Dewi Maya Sari JKN 9/5/2022 Exp laparatomi 500,000 Op besar
8 Nurhayati JKN 9/5/2022 Excici topus 500,000 Op besar
9 Doly Yoan Tamara JKN 9/7/2022 Aff implan 500,000 Op besar
10 Suci Wiranta U 9/7/2022 SC 500,000 Op besar
11 Nurnida JKN 9/7/2022 Debridemnt 500,000 Op besar
12 Meysia Aura P JKN 9/8/2022 Appendictomy 300,000 Op sedang
13 Alimad Farisi JKN 9/8/2022 Lympadectomy 500,000 Op besar
14 Intan Arini JKN 9/8/2022 SC +Kontap 500,000 Op besar
15 Wulandari JKN 9/8/2022 SC 500,000 Op besar
16 Mayam Purba JKN 9/8/2022 Closed reduction 500,000 Op besar
17 Yusri Ananda JKK 9/8/2022 Debridment +ORIF 500,000 Op besar
18 Ade Irawan Kita bisa 9/8/2022 Laparatomy 500,000 Op besar
19 Arshaka JKN 9/8/2022 Herniorapy 500,000 Op besar
20 Bonar Tua T JKK 9/10/2022 Debridment +ORIF 500,000 Op besar
21 Rindu Martalena JKN 9/10/2022 SC+kontap 500,000 Op besar
22 Hasan Basri JKN 9/10/2022 Wide excici 500,000 Op besar
23 Robert Mazmur JKN 9/10/2022 Debridement 500,000 Op besar
24 Diani Manuella JKN 9/11/2022 SC 500,000 Op besar
25 Rudianto Silitong JKN 9/14/2022 Herniolaparatomy 500,000 Op besar
26 Ega Sri Wahyuni JKN 9/14/2022 Curetage 200,000 Tindakan
27 Danu Safriza JKN 9/14/2022 Aff implan 500,000 Op besar
28 Chairuddin JKN 9/14/2022 Debridment 500,000 Op besar
29 Syarif JKN 9/14/2022 Debridment 500,000 Op besar
30 M.Haziz JKN 9/14/2022 Wide excici 500,000 Op besar
31 Sakia JKN 9/14/2022 Exp laparatomy 500,000 Op besar
32 Aprilra Darori JKN 9/14/2022 Excici 500,000 Op besar
33 Rini JKN 9/14/2022 SC 500,000 Op besar
34 Yeska JR 9/15/2022 Wide excici 500,000 Op besar
35 Wito Dermawan JKN 9/15/2022 Debridement 500,000 Op besar
36 Ayu Lesatari JKN 9/15/2022 Debridement 500,000 Op besar
37 Ramadana JKN 9/15/2022 Excici varisee 500,000 Op besar
38 Vera Sonya JKN 9/15/2022 SC 500,000 Op besar
39 Lisa Herawati JKN 9/15/2022 SC 500,000 Op besar
40 Wiwit JKN 9/15/2022 Curetage 200,000 Tindakan
41 Asmiati JKN 9/17/2022 Debridement 500,000 Op besar
42 Ali Altong JKN 9/21/2022 Hemoroidectomy 500,000 Op besar
43 Ramadania JKN 9/21/2022 Sinusectomy 500,000 Op besar
44 Ferrerius JKN 9/21/2022 Sinusectomy 500,000 Op besar
45 Dinda Mayang JKN 9/21/2022 Wide excici 500,000 Op besar
46 Sumiyem JKN 9/21/2022 Wide excici 500,000 Op besar
47 Bahni Rahman JKN 9/21/2022 Debridement 500,000 Op besar
48 Riski Ayu JKN 9/22/2022 ORIF ulna 500,000 Op besar
49 Rusni JKN 9/22/2022 Hemoroidectomy 500,000 Op besar
50 Jamuka Tp Bolon JKN 9/22/2022 Herniorapy 500,000 Op besar
51 Purwani JKN 9/22/2022 SC 500,000 Op besar
52 Sri Hardila JKN 9/24/2022 SC 500,000 Op besar
53 Tuti Desmawati JKN 9/24/2022 SC 500,000 Op besar
54 Naomi Purba JKN 9/25/2022 SC 500,000 Op besar
55 Arap Situmorang JKN 9/28/2022 500,000
56 Arga Karunia JKN 9/28/2022 Appendictomy 300,000 Op sedang
57 Misno JKN 9/29/2022 Debridment 500,000 Op besar
58 Eni Rahmawati JKN 9/29/2022 SC 500,000 Op besar
59 lusiana JKN 9/29/2022 SC 500,000 Op besar
60 Rawainda JKN 9/29/2022 SC 500,000 Op besar
61 Desi Apriana JKN 9/29/2022 Fistelectomy 500,000 Op besar
Total 45,500,000

Pajak (Tax) 5 % 887,500 -
44,612,500
2. Honor Penanggung Jawab + Transportasi - +
Total Honor: 44,612,500
-
Diketahui Oleh: Lubuk Pakam, November 2022

dr. Arifin P Sitompul Melki Tampubolon, SE

Penerima;
dr. Tuahman Purba, Sp.An

dr. Gloria Situmeang, Sp.An
Rekapitulasi Pasien
Bulan Desember 2023
1. Rawat Inap
No Nama Pasien Status Tanggal Operasi Total Honor DR Ket. Diagnosa Jenis Operasi
1 Sri Boya BPJS 11/1/2022 500,000 SC Op besar
2 Suhendra BPJS 11/1/2022 500,000 Amputasi jari Op besar
3 Erpina BPJS 11/1/2022 500,000 Debridement Op besar
4 Anggi BPJS 11/1/2022 300,000 Cito app Op sedang
5 Muspan JKK 11/1/2022 500,000 Debridement Op besar
6 Tito Okamen BPJS 11/7/2022 500,000 Radical incici Op besar
7 Ayu Agustina BPJS 11/7/2022 500,000 Excici biopsi Op besar
8 Sutrisno BPJS 11/7/2022 500,000 Excici Op besar
9 Abdul Mui BPJS 11/7/2022 500,000 Wide excici Op besar
10 Satini BPJS 11/7/2022 500,000 Debridement Op besar
11 Suci Antika BPJS 11/7/2022 500,000 SC Op besar
12 Rini Purba UMUM 11/7/2022 500,000 Debridement Op besar
13 Ngadimin BPJS 11/7/2022 500,000 Debridement Op besar
14 Ester JKK 11/8/2022 500,000 Debridement Op besar
15 Uci Melida BPJS 11/11/2022 500,000 Wide excici Op besar
16 Sudarno BPJS 11/11/2022 500,000 Wide excici Op besar
17 Lamsihar BPJS 11/11/2022 500,000 SC Op besar
18 Krstina BPJS 11/12/2022 500,000 SC Op besar
19 Arap BPJS 11/12/2022 500,000 Wide excici Op besar
20 Mahdra Purba BPJS 11/14/2022 500,000 Excici Op besar
21 Misnawati BPJS 11/14/2022 500,000 Excici Op besar
22 Marisa T BPJS 11/15/2022 500,000 SC Op besar
23 Lely Yuslina BPJS 11/15/2022 500,000 SC Op besar
24 Ita Purnama BPJS 11/15/2022 500,000 SC Op besar
25 Yuktika BPJS 11/15/2022 500,000 SC Op besar
26 Nanda Saputra BPJS 11/15/2022 500,000 Excici Op besar
27 Tengku Samsidar BPJS 11/15/2022 500,000 Debridement Op besar
28 Vivi Diana BPJS 11/18/2022 500,000 Mastotomy Op besar
29 Leni Arsita BPJS 11/20/2022 300,000 Appendictomy Op sedang
30 Mora Manusun BPJS 11/21/2022 500,000 Excici Op besar
31 Rita Sugiarti BPJS 11/21/2022 500,000 Excici Op besar
32 Romeytha BPJS 11/21/2022 500,000 Wide excici Op besar
33 Sabaria BPJS 11/21/2022 500,000 SC + kontap Op besar
34 Sri Wiyunda BPJS 11/22/2022 500,000 SC + MOW Op besar
35 Yulandari BPJS 11/22/2022 500,000 SC Op besar
36 Roderni BPJS 11/25/2022 500,000 SC Op besar
37 Sri Watini UMUM 11/25/2022 500,000 Debridement Op besar
38 Keistina S BPJS 11/25/2022 200,000 Curetage Tindakan
39 Abdillah JR 11/28/2022 500,000 Debridement Op besar
40 Juwita BPJS 11/28/2022 500,000 Appendictomy Op besar
41 Riky Sandy BPJS 11/28/2022 500,000 Excici Op besar
42 Saat Wagio BPJS 11/28/2022 500,000 Debridement Op besar
43 Suheri BPJS 11/29/2022 500,000 SC Op besar
Total 20,800,000 -

Potongan ke RS 10 % 2,080,000 -
Pajak (Tax) 5 % 936,000 -
Penerima; Diketahui Oleh: Lubuk Pakam, November 2022
dr. Gloria Situmeang, Sp.An dr. Arifin P Sitompul Melki Tampubolon, SE

Rekap Honor Dokter Spesialis
dr. Sanggam Hutagalung, Sp.PA
Bulan Februari 2023
TGL
NO NAMA PASIEN NO. RM NAMA PEMERIKSAAN HONOR PENERIMAAN KETERANGAN
PEMERIKSAAN
1 Risna Mentari 11.71.62 Jaringan PA 2/23/2024 150,000 192,400 R. Jalan
2 Paulina Gultom 09.04.78 Jaringan PA 2/23/2024 150,000 192,400 R. Jalan
3 Nurmahningsih 11.69.44 Biopsi Thyroid 2/26/2024 150,000 192,400 R. Jalan
4 Leni Biopsi Payudara Kiri 2/26/2024 150,000 192,400 R. Jalan
5 Nayra Dwi Kirana 05.87.91 Biopsi Leher Kanan 2/26/2024 150,000 192,400 R. Jalan
6 Alpando 11.71.64 Biopsi Ketiak Kiri 2/27/2024 150,000 192,400 R. Jalan
7 Rukini 09.74.57 Biopsi Leher Kiri 2/28/2024 150,000 192,400 R. Jalan
8 Mertaria 11.72.03 Biopsi Thyroid 2/29/2024 150,000 192,400 R. Jalan
9 Nawla 08.70.81 Biopsi Leher Kanan 3/4/2024 150,000 192,400 R. Jalan
10 Salamiah 11.75.29 Biopsi Payudara Kanan 3/4/2024 150,000 192,400 R. Jalan
11 Sri Rahayu Dewi 11.71.82 FNAB 3/5/2024 150,000 192,400 R. Jalan
12 Nirwandiyani 11.75.19 Jaringan PA 3/5/2024 150,000 192,400 R. Jalan
13 Tumin Haryanto 11.76.42 Jaringan PA 3/8/2024 150,000 192,400 R. Jalan
14 Nurnaningsih 11.69.49 Jaringan PA 3/8/2024 150,000 192,400 R. Jalan
15 Selawati 11.76.29 Biopsi Thyroid 3/14/2024 150,000 192,400 R. Jalan
16 Paulus Sitepu 08.12.61 Biopsi Thyroid 3/14/2024 150,000 192,400 R. Jalan
17 Nuriati 11.09.20 3/14/2024 150,000 192,400 R. Jalan
18 Okki Helentia Jaringan PA 3/14/2024 150,000 192,400 R. Jalan
19 Johannes 07.55.22 Biopsi Leher Kiri 3/19/2024 150,000 192,400 R. Jalan
20 Rezfan 11.73.52 3/19/2024 150,000 192,400 R. Jalan
21 Aman Damanik 08.88.41 Biopsi Leher Kanan 3/19/2024 150,000 192,400 R. Jalan
22 150,000 192,400 R. Jalan
23 150,000 192,400 R. Jalan
24 150,000 192,400 R. Jalan
25 150,000 192,400 R. Jalan
26 150,000 192,400 R. Jalan
27 150,000 192,400 R. Jalan
28 150,000 192,400 R. Jalan
29 150,000 192,400 R. Jalan
30 150,000 192,400 R. Jalan
31 150,000 192,400 R. Jalan
TOTAL 4,650,000 5,964,400
L. Pakam, Maret 2023

Diketahui Oleh: Dibuat Oleh:
dr. Arifin P Sitompul, MHA Melki Tampubolon, SE
Penerima
dr. Sanggam Hutagalung, Sp.PA

HONOR DOKTER SPESIALIS RADIOLOGI
BULAN OKTOBER 2022
RSU SARI MUTIARA L.PAKAM
TANGGAL NAMA PASIEN PEMERIKSAAN STATUS TARIF 25.00%

10/1/2022 SAPARUDIN DAMANIK THORAX JKN 105,000 26,250
ALMA KHUMAIRAH THORAX JKN 105,000 26,250
ATHAN THORAX JKN 105,000 26,250
BNO POLOS JKN 120,000 30,000
DEAN GIOVANO SIMANJUNTAK THORAX UMUM 105,000 26,250
DHIMAS ADI PUTRA THORAX JKN 105,000 26,250
MAIMUNAH THORAX UMUM 105,000 26,250
NAUFAL ANINDRA THORAX UMUM 105,000 26,250
SAAT WAGIO PEDIS JKN 105,000 26,250
THORAX JKN 105,000 26,250
SARING THORAX JKN 105,000 26,250
SULTAN ARFAN AZHAR THORAX JKN 105,000 26,250
SUMAN SIHALOHO THORAX JKN 105,000 26,250
-
10/2/2022 BAYI NYONYA ARI KUSUMA DEWI THORAX UMUM 105,000 26,250
HERAWATI MANURUNG THORAX JKN 105,000 26,250
FERO GRACELLA BR PURBA THORAX JKN 105,000 26,250
GLEN DEFRAN HASIBUAN THORAX JKN 105,000 26,250
HALIMAH TUSAKDIYAH THORAX JKN 105,000 26,250
MUHAMMAD OZIL AL BUKHORI THORAX JKN 105,000 26,250
RAEHAN NUGRAHA THORAX JKN 105,000 26,250
SUHERMAN THORAX JKN 105,000 26,250
TUKIJAH THORAX JKN 105,000 26,250
-
10/3/2022 ADAM AL-MUTAQIN SIMATUPANG THORAX JKN 105,000 26,250
ADRY RIAHMANDO SITUMORANG THORAX JKN 105,000 26,250
AHMAD FERDIANSYAH THORAX UMUM 105,000 26,250
AHZAREEL DOREN ANDRIAN THORAX JKN 105,000 26,250
AISYAH FITRI NASUTION THORAX JKN 105,000 26,250
ALMAN THORAX JKN 105,000 26,250
ASNI THORAX JKN 105,000 26,250
DANIEL DAVU HYMAN TAMPUBOL THORAX JKN 105,000 26,250
ERLINDA LUMBAL JKN 300,000 75,000
JOSIAMAN SARAGIH THORAX JKN 105,000 26,250
Julius Bangun SPN JKN 165,000 41,250
JUMPA SARAGIH THORAX JKN 105,000 26,250
M.ILHAM THORAX UMUM 105,000 26,250
MELIANA BR SIPAYUNG THORAX UMUM 105,000 26,250
MELISA PUTRI SITORUS THORAX JKN 105,000 26,250
MUSLIM THORAX JKN 105,000 26,250
NABILA THORAX JKN 105,000 26,250
NAINA AZKIYARA THORAX UMUM 105,000 26,250
OGI FIANTORI THORAX JKN 105,000 26,250
RAJALI CHANIAGO THORAX JKN 105,000 26,250
RORO ISTININGDIAH THORAX JKN 105,000 26,250
RUMILAH THORAX JKN 105,000 26,250
SAFRI LUMBAL JKN 300,000 75,000
SAINI THORAX JKN 105,000 26,250
SAMSIAH ANKLE JKN 120,000 30,000
SUTRISNI THORAX UMUM 105,000 26,250
-
10/4/2022 ABIL SHIDQI ARSALAN THORAX UMUM 105,000 26,250
AFIFA GHANIA RAMADHANI THORAX JKN 105,000 26,250
ARJUNA SAKHI PRAYOGO THORAX UMUM 105,000 26,250
ATHAR NUR RAMADHAN THORAX JKN 105,000 26,250
CHRISTIAN RAJA GUK GUK THORAX JKN 105,000 26,250
ELISABET SAMOSIR THORAX UMUM 105,000 26,250
HARIYANI THORAX UMUM 105,000 26,250
JUARI LUMBAL JKN 300,000 75,000
JUMSI THORAX JKN 105,000 26,250
LANDUNG PRAYUDA THORAX JKN 105,000 26,250
LEGIYEM THORAX JKN 105,000 26,250
LENNY A HUTASOIT THORAX JKN 105,000 26,250
Linawaty Tampubolon LUMBAL JKN 300,000 75,000
MASRIANA SARAGIH THORAX JKN 105,000 26,250
NURSIATI NASUTION THORAX JKN 105,000 26,250
PRILYLA KINANTI ASYURA THORAX UMUM 105,000 26,250
RASMI BR GINTING THORAX JKN 105,000 26,250
RENTI BUTAR BUTAR THORAX JKN 105,000 26,250
RIZKI DARMAWAN THORAX UMUM 105,000 26,250
RIZKI DARMAWAN THORAX JKN 105,000 26,250
Sabariah Siregar THORACAL JKN 300,000 75,000
SAMINEM THORAX JKN 105,000 26,250
SERTA TAMBUNAN THORAX JKN 105,000 26,250
SISMAWADI THORAX JKN 105,000 26,250
SLAMAT THORAX JKN 105,000 26,250
SOFIYATUN THORAX JKN 105,000 26,250
SULASIH THORAX JKN 105,000 26,250
SYAHDRINA NAMIRA THORAX JKN 105,000 26,250
VERA TIUR MAULI NAINGGOLAN THORAX JKN 105,000 26,250
-
10/5/2022 Adek Zaskia Irawan SCHEDEL JKN 175,000 43,750
AHMAD SUHAIMI LUMBAL JKN 300,000 75,000
Alman Aritonang THORAX JKN 105,000 26,250
CELSI MARTAWATI SIANIPAR CRURIS JKN 105,000 26,250
DEWI AMALIYAH SARI THORAX JKN 105,000 26,250
MANUS JKN 105,000 26,250
EDYANTO THORAX JKN 105,000 26,250
ENDANG DAPIRIN PURBA THORAX UMUM 105,000 26,250
ERSA LUQIA DIDA HARAHAP CLAVICULA JKN 105,000 26,250
FAJAR PANGIHUTAN THORAX JKN 105,000 26,250
IRWAN HARIANTO THORAX JKN 105,000 26,250
LATIFA VIOLLA THORAX UMUM 105,000 26,250
LILIK HARDIANTO THORAX JKN 105,000 26,250
LINDA SIHITE LUMBAL UMUM 300,000 75,000
THORAX UMUM 105,000 26,250
M IBRAHIM AL HAFIZH THORAX UMUM 105,000 26,250
MUHAMMAD RAHMAD EFFENDI SPN JKN 165,000 41,250
MUTIARA NAPITUPULU THORAX JKN 105,000 26,250
NOVALINA SARAGIH THORAX JKN 105,000 26,250
NUR ASRI BR SITORUS THORAX JKN 105,000 26,250
NURLELA THORAX JKN 105,000 26,250
NURUL FADIAH THORAX JKN 105,000 26,250
RIA SYAHFITRI SPN JKN 165,000 41,250
RITAWANI GIRSANG THORAX JKN 105,000 26,250
RUSNI TORA BR PURBA THORAX JKN 105,000 26,250
SAMINEM BNO 3 POSISI JKN 360,000 90,000
SELAMAT DARIANTO THORAX UMUM 105,000 26,250
SLAMAT BNO 3 POSISI JKN 360,000 90,000
SUKARTO CRURIS JKK 105,000 26,250
THORAX JKN 105,000 26,250
SURTINAH THORAX JKN 105,000 26,250
ULAM SAMOSIR LUMBAL JKN 300,000 75,000
-
10/6/2022 ABDUL JAYA SINAGA THORAX JKN 105,000 26,250
Adek Zaskia Irawan THORAX JKN 105,000 26,250
ADTA FAISAL BAGOHWI SIREGAR THORAX UMUM 105,000 26,250
CESYA ANGELICA PANJAITAN THORAX JKN 105,000 26,250
DANI EKO SETIAWAN GENU DEXTRA JKN 120,000 30,000
GENU SINISTRA JKN 120,000 30,000
ELZIO SIMAMORA THORAX JKN 105,000 26,250
FALBO AKBAR RANU BNO 3 POSISI JKN 360,000 90,000
THORAX JKN 105,000 26,250
FATIMAH BR PURBA THORAX JKN 105,000 26,250
FIKRI AULIA RAMADHAN THORAX UMUM 105,000 26,250
HIZRAH AMALIAH RIZKY THORAX JKN 105,000 26,250
HJ. SAHARA PURBA THORAX JKN 105,000 26,250
HUWAIDA KAYYISA MENDROFA THORAX JKN 105,000 26,250
IRWANTO SEMBIRING THORAX JKN 105,000 26,250
JUPITA SAMOSIR THORAX JKN 105,000 26,250
MANIUR PANGIHUTAN TINAMBUN THORAX UMUM 105,000 26,250
MUHAMMAD ABYZAR RAYHAN THORAX JKN 105,000 26,250
NETTY THORAX JKN 105,000 26,250
NURLINDA THORAX JKN 105,000 26,250
OGI FIANTORI THORAX JKN 105,000 26,250
RAHMAT SALEH THORAX JKN 105,000 26,250
RENTA R BR SIHOMBING ANKLE JKN 120,000 30,000
SANTI SIMATUPANG THORAX JKN 105,000 26,250
SEVINA NIKA TELAUMBANUA THORAX UMUM 105,000 26,250
SRI NINGSIH KRISTIANI L TOBING THORAX JKN 105,000 26,250
SRI RAHAYU FEMUR JKN 105,000 26,250
TIMBANGAN BARUS THORAX JKN 105,000 26,250
LUMBAL JKN 300,000 75,000
YAYANG DINDA NASAFRI THORAX JKN 105,000 26,250
-
10/7/2022 AGUSTINA THORAX JKN 105,000 26,250
BAIM ATTHAYA RAFIF THORAX JKN 105,000 26,250
DEVIANA SIANIPAR THORAX JKN 105,000 26,250
ELY AGUS THORAX JKN 105,000 26,250
ERIKSON FERDINAND SINAGA THORAX JKN 105,000 26,250
HARIS RINALDI THORAX JKN 105,000 26,250
HERWIN THORAX JKN 105,000 26,250
HJ ALJANNAH THORAX JKN 105,000 26,250
JUMBRIK THORAX JKN 105,000 26,250
JUNDI AFIF HARIRI THORAX JKN 105,000 26,250
MHD AMRI AZMI THORAX JKN 105,000 26,250
OK AIDIL FITRI THORAX JKN 105,000 26,250
SUKARMAN THORAX JKN 105,000 26,250
SUPRIATI THORAX JKN 105,000 26,250
WASLAN THORAX JKN 105,000 26,250
-
10/8/2022 BAHRUMSYAH THORAX JKN 105,000 26,250
BNO 3 POSISI JKN 360,000 90,000
DELON RAMOS SIBARANI THORAX JKN 105,000 26,250
EDWARD BUTAR-BUTAR THORAX JKN 105,000 26,250
IRMANTO THORAX JKN 105,000 26,250
ISMAYAWATI THORAX JKN 105,000 26,250
JEREMIA TOBING THORAX JKN 105,000 26,250
MUHAMMAD SUPIYAN THORAX JKN 105,000 26,250
M.YOPI DWI SEPTIYAN THORAX JKN 105,000 26,250
MUKRI THORAX JKN 105,000 26,250
MAULIA FATRA THORAX JKN 105,000 26,250
NURLELA THORAX JKN 105,000 26,250
SAIFUL WATHAN CLAVICULA UMUM 105,000 26,250
SARIYEM THORAX UMUM 105,000 26,250
SHANUM DIYA SYAKIRA THORAX JKN 105,000 26,250
SHOFIA BILQIS UFAIRAH THORAX JKN 105,000 26,250
-
10/9/2022 ANSORI DACHI THORAX JKN 105,000 26,250
ASTON ARITONANG THORAX JKN 105,000 26,250
CHINTIA THORAX UMUM 105,000 26,250
Hardi Malau THORAX JKN 105,000 26,250
HELNI ARIANI THORAX UMUM 105,000 26,250
JEMIRAN SARAGIH THORAX JKN 105,000 26,250
JONNI HAIDER LUMBANTOBING THORAX JKN 105,000 26,250
JUMINAH THORAX JKN 105,000 26,250
RINDU HAFIZA THORAX JKN 105,000 26,250
SLAMAT BNO 3 POSISI JKN 360,000 90,000
Syamsuar S THORAX JKN 105,000 26,250
-
10/10/2022 ELSA EMELINA BR SINAGA SHOULDER JKN 120,000 30,000
EPI ASTRIA THORAX JKN 105,000 26,250
FLORA BR SIREGAR THORAX JKN 105,000 26,250
HADI KUSWAIDI THORAX JKN 105,000 26,250
DRS.HATTA. B LUMBAL JKN 300,000 75,000
Havi Hariyono CERVICAL JKN 300,000 75,000
HELNI ARIANI THORAX UMUM 105,000 26,250
HERU SIMANJUNTAK THORAX JKN 105,000 26,250
IRWAN HARIANTO THORAX JKN 105,000 26,250
JAMANSEN SARAGIH THORAX JKN 105,000 26,250
Julius Bangun THORAX JKN 105,000 26,250
LAMBOK HABEAHAN THORAX JKN 105,000 26,250
LENI ARMAYA THORAX JKN 105,000 26,250
ILHAM THORAX JKK 105,000 26,250
MANIGOR SIREGAR THORAX JKN 105,000 26,250
MARA SULAIMAN SILABAN PELVIS JKN 120,000 30,000
LUMBAL JKN 300,000 75,000
THORAX JKN 105,000 26,250
MARYAM THORAX JKN 105,000 26,250
MUSRIADI THORAX JKN 105,000 26,250
NGATMAN THORAX JKN 105,000 26,250
OKI SUGIARTO THORAX JKK 105,000 26,250
OSKAR GULTOM THORAX JKN 120,000 30,000
AHMAD EFFENDI THORAX JKN 105,000 26,250
PERARIHENNA BARUS THORAX JKN 105,000 26,250
RASYA ALFAREZY SIREGAR THORAX UMUM 105,000 26,250
RIZKY MADYO RAMADHAN THORAX JKN 105,000 26,250
ROBINSON SIHOMBING THORAX JKN 105,000 26,250
SARIYEM BNO POLOS UMUM 120,000 30,000
AHMAD SOLIHIN LUMBAL JKK 300,000 75,000
THORAX JKK 105,000 26,250
SIHAR THORAX JKN 105,000 26,250
SITI RUMINI THORAX JKN 105,000 26,250
SRI JULIATIK THORAX JKN 105,000 26,250
SRI WAHYUNI SPD THORAX UMUM 105,000 26,250
SUJADMIKO THORAX JKK 105,000 26,250
SURATMIN THORAX JKN 105,000 26,250
TIARA NADYA TIFANY THORAX UMUM 105,000 26,250
WAGIEM THORAX JKN 105,000 26,250
YUSMAWATI THORAX JKN 105,000 26,250
ZULHAM EFENDI MANUS UMUM 105,000 26,250
ANTEBRACHI UMUM 105,000 26,250
THORAX UMUM 105,000 26,250
-
10/11/2022 AINA AQILAH SIGALINGGING THORAX JKN 105,000 26,250
ANDREANA THORAX JKN 105,000 26,250
DANIEL YOSUA GIAWA THORAX UMUM 105,000 26,250
DESMA BANJARNAHOR THORAX UMUM 105,000 26,250
DEWI AGUS TINI THORAX UMUM 105,000 26,250
HAWA MAHIRA THORAX UMUM 105,000 26,250
HERMADY THORAX JKN 105,000 26,250
IMAM ARMAWAN THORAX UMUM 105,000 26,250
JOHAN DAMANIK THORAX JKK 105,000 26,250
ANKLE JKK 120,000 30,000
LESITA BARUTU SPN JKN 175,000 43,750
LELY ERIYANI MANALU THORAX JKN 105,000 26,250
LERPIANNA SARAGIH THORAX JKN 105,000 26,250
MARSINEM THORAX JKN 105,000 26,250
MASDARIYAH NASUTION THORAX JKN 105,000 26,250
MULIYADI THORAX UMUM 105,000 26,250
BNO POLOS UMUM 120,000 30,000
NINDYA AMELIYA THORAX UMUM 105,000 26,250
NUR DEWI PUJIATI THORAX JKN 105,000 26,250
NURMALA SIMAMORA THORAX JKN 105,000 26,250
NURSALIM THORAX JKN 105,000 26,250
PENDI SITEPU BNO POLOS JKN 120,000 30,000
THORAX JKN 105,000 26,250
PINTA REHULINA PERANGIN THORAX JKN 105,000 26,250
RASMA GIRSANG THORAX JKN 105,000 26,250
RIKA RISMA YULAN DARI THORAX JKN 105,000 26,250
RIKO SUHENDRA SIMANULLANG THORAX UMUM 105,000 26,250
RODY HAPOSAN MARNAE THORAX JKN 105,000 26,250
SALMAN AL FARIZY THORAX JKN 105,000 26,250
SARMAH THORAX JKN 105,000 26,250
SERTA SIPAYUNG THORAX UMUM 105,000 26,250
SRI WAHYUNI THORAX JKN 105,000 26,250
SUWUH THORAX JKN 105,000 26,250
TIARA KAIREEN FAKHIRA THORAX UMUM 105,000 26,250
WARSONO THORAX JKN 105,000 26,250
-
10/12/2022 ABDIEL FODELA TELAUM BANUA THORAX UMUM 105,000 26,250
AGUS ANDANI THORAX JKN 105,000 26,250
AHMAD SUHAIMI LUMBAL JKN 300,000 75,000
AMERUDIN SIPAYUNG THORAX JKN 105,000 26,250
AZHAR LATHIF NASUTION THORAX JKN 105,000 26,250
AZKA RAFIANDRA THORAX UMUM 105,000 26,250
CITRA NURHATIMAH THORAX JKN 105,000 26,250
GADIEL EDGAR WINNER PANDIANG SHOULDER JKN 120,000 30,000
HARIANTO THORAX JKN 105,000 26,250
HOTMARINGAN SIPAHUTAR FEMUR JKN 105,000 26,250
KELIWON THORAX JKN 105,000 26,250
NIKO FAUJI MANUS UMUM 105,000 26,250
PANDU AL FARIS THORAX UMUM 105,000 26,250
PATIA PANJAITAN THORAX JKN 105,000 26,250
RIA SYAHFITRI THORAX JKN 105,000 26,250
SABARIA AGUSTIA GINTING THORAX JKN 105,000 26,250
SUHARTO THORAX JKN 105,000 26,250
SUSILAWATI THORAX UMUM 105,000 26,250
TURIANI THORAX JKN 105,000 26,250
UJIR ALI THORAX JKN 105,000 26,250
WINDA THORAX JKN 105,000 26,250
-
10/13/2022 ABDILAH PRATAMA THORAX JKN 105,000 26,250
AHMAD PARYANTO THORAX UMUM 105,000 26,250
ONDHO SHINTA ULINA BR SIJABAT THORAX JKN 105,000 26,250
APRILIANA PERMATASARI SINAGA THORAX JKN 105,000 26,250
ASMARANI THORAX JKN 105,000 26,250
BAHRIUN THORAX JKN 105,000 26,250
BENI WATI THORAX JKN 105,000 26,250
ELISABET ESMERALDA SIBARANI THORAX JKN 105,000 26,250
HAMSEN TOGATOROP THORAX JKN 105,000 26,250
HERMANSYAH THORAX JKN 105,000 26,250
HOTLON SIBARANI THORAX JKN 105,000 26,250
JUNADEN SINAGA THORAX JKN 105,000 26,250
M YUSUP THORAX JKN 105,000 26,250
MANISAH THORAX JKN 105,000 26,250
MARGIATI NINGSIH THORAX JKN 105,000 26,250
MARIA THORAX UMUM 105,000 26,250
MANSEN PURBA THORAX JKN 105,000 26,250
MUHAMMAD ARSHAKA THORAX JKN 105,000 26,250
NAMAN PURBA THORAX JKN 105,000 26,250
NIZARUDDIN LUMBAL JKN 300,000 75,000
NUR AINI THORAX JKN 105,000 26,250
REDINGSE SIMANJUNTAK THORAX JKN 105,000 26,250
RAFKA ABDILLAH THORAX JKN 105,000 26,250
RATUTRI ANANDAH THORAX JKN 105,000 26,250
REDINGSE SIMANJUNTAK THORAX JKN 105,000 26,250
NUR AINI THORAX JKN 105,000 26,250
NIZARUDDIN LUMBAL JKN 300,000 75,000
MUHAMMAD ARSHAKA THORAX JKN 105,000 26,250
MANSEN PURBA THORAX JKN 105,000 26,250
MARIA THORAX UMUM 105,000 26,250
MARGIATI NINGSIH THORAX JKN 105,000 26,250
MANISAH THORAX JKN 105,000 26,250
M YUSUP THORAX JKN 105,000 26,250
JUNADEN SINAGA THORAX JKN 105,000 26,250
HOTLON SIBARANI THORAX JKN 105,000 26,250
HERMANSYAH THORAX JKN 105,000 26,250
HAMSEN TOGATOROP THORAX JKN 105,000 26,250
ELISABET ESMERALDA SIBARANI THORAX JKN 105,000 26,250
BENI WATI THORAX JKN 105,000 26,250
BAHRIUN THORAX JKN 105,000 26,250
ASMARANI THORAX JKN 105,000 26,250
APRILIANA PERMATASARI SINAGA THORAX JKN 105,000 26,250
ONDHO SHINTA ULINA BR SIJABAT THORAX JKN 105,000 26,250
AHMAD PARYANTO THORAX UMUM 105,000 26,250
ABDILAH PRATAMA THORAX JKN 105,000 26,250
-
10/14/2022 SURATMIN THORAX UMUM 105,000 26,250
SUMINAH THORAX JKN 105,000 26,250
SUMIATI GENU JKN 120,000 30,000
SUDARSIH THORAX JKN 105,000 26,250
SRI ASNI LUBIS THORAX JKN 105,000 26,250
SAGINAH THORAX JKN 105,000 26,250
RIA SYAHFITRI SPN JKN 175,000 43,750
REHMALEMNA SARAGIH THORAX JKN 105,000 26,250
PURIDA THORAX JKN 105,000 26,250
NOVIANI THORAX JKN 105,000 26,250
MULYANI THORAX JKN 105,000 26,250
MUHAMMAD ADITYA RIFQI HAMIZ THORAX JKN 105,000 26,250
KHALIFA NATASYA THORAX JKN 105,000 26,250
ERIKA BR TAMPUBOLON THORAX JKN 105,000 26,250
ENDANG SRI WAHYUNI THORAX UMUM 105,000 26,250
CHELSI SEPTIA MASTOID UMUM 175,000 43,750
THORAX UMUM 105,000 26,250
ALFRIDA APNI LUMBAL JKN 300,000 75,000
-
10/15/2022 WIDIYANTI THORAX JKN 105,000 26,250
SUMARNI THORAX JKN 105,000 26,250
SUARMI THORAX JKN 105,000 26,250
ROBERT MAZMUR MANURUNG PEDIS JKN 105,000 26,250
RISKI PUTRI ANUGRAH THORAX JKN 105,000 26,250
RAZIQ HANAN UZAIRON THORAX JKN 105,000 26,250
PURWANTI CRURIS UMUM 105,000 26,250
PURWANTI THORAX UMUM 105,000 26,250
NURMALIA THORAX JKN 105,000 26,250
NURDIANSYAH THORAX JKN 105,000 26,250
NASRI THORAX JKN 105,000 26,250
M YOGI SUBROTO THORAX JKN 105,000 26,250
KHAIRUNNISA NUWIRA HADIYA THORAX JKN 105,000 26,250
KAILA MUTIA HUSIN BNO 3 POSISI JKN 360,000 90,000
THORAX JKN 105,000 26,250
JONI MANURUNG THORAX JKN 105,000 26,250
IMMANUEL HATIGORAN THORAX JKN 105,000 26,250
Habib Fauzianur Affiyanti CERVICAL JKN 300,000 75,000
BOKKOT DAMANIK THORAX JKN 105,000 26,250
BANTU BARUS THORAX JKN 105,000 26,250
BACHTIAR SIAHAAN THORAX JKN 105,000 26,250
-
10/16/2022 SANDRO MARBUN THORAX JKN 105,000 26,250
NORMA BR PURBA THORAX JKN 105,000 26,250
Meisyah Arinda THORAX JKN 105,000 26,250
MARSELINA PUTRI SARINA GULO THORAX JKN 105,000 26,250
LINA SARI MANALU THORAX JKN 105,000 26,250
JETNIKO SITORUS THORAX JKN 105,000 26,250
GIANTO SHOULDER UMUM 120,000 30,000
THORAX UMUM 105,000 26,250
BUKKIT SIMAMORA THORAX JKN 105,000 26,250
ALFIN SITORUS THORAX JKN 105,000 26,250
-
10/17/2022 YULISTINA THORAX JKN 105,000 26,250
VALENTINO HESEKIEL SIPAYUNG THORAX JKN 105,000 26,250
ULYESTER THORAX JKN 105,000 26,250
SYAMSIDI ANKLE JKN 120,000 30,000
ADAM FAIZ ARKANNA THORAX JKN 105,000 26,250
AGUS SALIM HALAWA THORAX JKN 105,000 26,250
ARTALINA PURBA THORAX JKN 105,000 26,250
BAKHTIAR LUMBAL JKN 300,000 75,000
DIKA SETIAWAN THORAX JKN 105,000 26,250
FITRI KHAIRANI THORAX JKN 105,000 26,250
GRACE TOGATOROP THORAX UMUM 105,000 26,250
HENNY ANDAM DEWI THORAX JKN 105,000 26,250
IZADIN NARAIN THORAX JKN 105,000 26,250
JAWASI SIMANJORANG THORAX JKN 105,000 26,250
KAI HAVERTS ZEIN THORAX JKN 105,000 26,250
KUSRIANTI THORAX JKN 105,000 26,250
MUHAMMAD RAHMAD EFFENDI THORAX JKN 105,000 26,250
NURDIANA SARI NST THORAX JKN 105,000 26,250
PERIYUS THORAX JKN 105,000 26,250
PUTRI SARI TIARA THORAX UMUM 105,000 26,250
RADAR RISQULLAH ABADI THORAX JKN 105,000 26,250
RONDANG MANURUNG THORAX JKN 105,000 26,250
SAHRIZAL THORAX JKN 105,000 26,250
SARING PURWADI THORAX UMUM 175,000 43,750
SUPRIONO THORAX JKN 105,000 26,250
SUPRIHATIN THORAX JKN 105,000 26,250
SUWARDI THORAX JKN 105,000 26,250
SUYITNO THORAX JKN 105,000 26,250
SYAFIQ AL BUKHARI THORAX JKN 105,000 26,250
SYAHRIAL THORAX JKN 105,000 26,250
-
10/18/2022 ABD MAJID ER THORAX JKN 105,000 26,250
ABDILLAH TRI SUCIPTO,ST THORAX JKN 105,000 26,250
AQILAH THORAX UMUM 105,000 26,250
DOLLI FERDINAND ARUAN THORAX JKN 105,000 26,250
DORMAYA SARAGIH THORAX JKN 105,000 26,250
ELIANI THORAX JKN 105,000 26,250
GINI RANEM THORAX JKN 105,000 26,250
HISAR SITUMEANG ANKLE JKK 120,000 30,000
THORAX JKK 105,000 26,250
HORMA BR PURBA GENU JKN 120,000 30,000
THORAX JKN 105,000 26,250
IBNU HERI THORAX UMUM 105,000 26,250
JHONSON SILALAHI MANUS JKN 105,000 26,250
JOHAN MARASI SITORUS THORAX JKN 105,000 26,250
KIKI FIRMANSYAH THORAX UMUM 105,000 26,250
MELISA BR SAMOSIR THORAX JKN 105,000 26,250
MESLIN SAGALA THORAX JKN 105,000 26,250
MISRIANI THORAX JKN 105,000 26,250
MUTIA AGUSTINA THORAX UMUM 105,000 26,250
NORMA THORAX JKN 105,000 26,250
PARTOMUAN LUMBAN TORUAN THORAX JKN 105,000 26,250
PRIATI THORAX JKN 105,000 26,250
RAHMAYANTI SPN JKN 175,000 43,750
RINA PRIHATINI PURBA LUMBAL JKN 300,000 75,000
SURIYADI THORAX JKN 105,000 26,250
SURIYONO THORAX JKN 105,000 26,250
SUTINI THORAX JKN 105,000 26,250
SYAFIQ AL BUKHARI BNO POLOS JKN 120,000 30,000
TUGINA THORAX JKN 105,000 26,250
UCOK DAMANIK THORAX UMUM 105,000 26,250
WAN WIRA MADA YANTI THORAX JKN 105,000 26,250
YUSLI THORAX UMUM 105,000 26,250
-
10/19/2022 ANDRIAN MULIA PRATAMA LUMBAL JKN 300,000 75,000
AFIKA DEARNA BR SIHALOHO THORAX JKN 105,000 26,250
DANI THORAX JKN 105,000 26,250
DITA AYU NOFIANTI THORAX JKN 105,000 26,250
ELIANA THORAX JKN 105,000 26,250
HORAS YUN MORGAN PURBA CERVICAL JKN 300,000 75,000
KAMAL HASIBUAN THORAX UMUM 105,000 26,250
LINDA SITANGGANG CERVICAL JKN 300,000 75,000
MARJIEM THORAX JKN 105,000 26,250
MUHAMMAD YUSUF HARAHAP THORAX JKN 105,000 26,250
PRANCIS SIHOMBING THORAX JKN 105,000 26,250
RAFA ADITYA THORAX JKN 105,000 26,250
RAFAEL SIMANJUNTAK THORAX JKN 105,000 26,250
ROMI AHMAD ROHADI THORAX UMUM 105,000 26,250
Sindy Kartika THORAX JKN 105,000 26,250
SUPARMIN K THORAX JKN 105,000 26,250
SURATMI THORAX JKN 105,000 26,250
SUYATNO ANKLE UMUM 120,000 30,000
THORAX UMUM 105,000 26,250
TURIANI SPN JKN 175,000 43,750
-
10/20/2022 DWI MELATI HUSNAH THORAX JKN 105,000 26,250
DEDI THORAX JKN 105,000 26,250
DJOKO PRAYITNO SPN JKN 175,000 43,750
GIBRAN AL HABSYI RITONGA JKN 105,000 26,250
JUNIMA ZEBUA BNO POLOS UMUM 120,000 30,000
THORAX UMUM 105,000 26,250
LIAN SENG SURIANTO THORAX UMUM 105,000 26,250
LUTHFI ALVINO BANUREA THORAX JKN 105,000 26,250
Mami LUMBAL JKN 300,000 75,000
MISRIATI THORAX JKN 105,000 26,250
LUMBAL JKN 300,000 75,000
Dra Novita Adriana Lbn Gaol THORAX JKN 105,000 26,250
RANDIAR THORAX JKN 105,000 26,250
REPINA SINAGA THORAX JKN 105,000 26,250
SANTIKA MUNTHE THORAX JKN 105,000 26,250
SELANIAR PURBA THORAX JKN 105,000 26,250
SITI SAHPIAH THORAX JKN 105,000 26,250
SUSTERLINA SARAGIH CERVICAL JKN 300,000 75,000
SYAFIQ AL BUKHARI THORAX JKN 105,000 26,250
YAYUK SUYANTI THORAX UMUM 105,000 26,250
-
10/21/2022 -
10/22/2022 -
10/23/2022 ALIRA ZIQRA THORAX JKN 105,000 26,250
ANDY SYAHPUTRA THORAX UMUM 105,000 26,250
ANTEBRACHI UMUM 105,000 26,250
ARBA ANUM THORAX JKN 105,000 26,250
ASTINA PANJAITAN THORAX JKN 105,000 26,250
AYU LESTARI LUMBAL JKN 300,000 75,000
THORAX JKN 105,000 26,250
AZARYA GERAL TAMA SEMBIRING THORAX JKN 105,000 26,250
DARMAULI SIMANJUNTAK THORAX JKN 105,000 26,250
EMMI MINDA ULINA BR SINAGA THORAX JKN 105,000 26,250
BNO POLOS JKN 120,000 30,000
ESTER FERAWATI BR SIRAIT MANUS JKN 105,000 26,250
EXAUDI ROGATA TAMBUNAN ANKLE UMUM 120,000 30,000
PEBRIANTI PANE THORAX JKN 105,000 26,250
GUSTI ANDRIANI THORAX JKN 105,000 26,250
LASMA ULI SIMANJUNTAK THORAX UMUM 105,000 26,250
MAYSARAH THORAX JKN 105,000 26,250
MISBAN THORAX JKN 105,000 26,250
LUMBAL JKN 300,000 75,000
MOZZA AUDRA PUTRI SHALSHABILL THORAX JKN 105,000 26,250
MUHIDIN THORAX UMUM 105,000 26,250
NAIFA KANIA NASUTION THORAX JKN 105,000 26,250
NETTI HERAWATI THORAX JKN 105,000 26,250
NURLI SIBARANI THORAX JKN 105,000 26,250
RAIHAN BAYU PRADANA THORAX JKN 105,000 26,250
RITA J. OMPUSUNGGU THORAX JKN 105,000 26,250
SAIMAH THORAX JKN 105,000 26,250
SARIAMAT DAMANIK SHOULDER UMUM 120,000 30,000
SITI AMINAH THORAX JKN 105,000 26,250
SULISTIANI THORAX JKN 105,000 26,250
SUPRIADI THORAX JKN 105,000 26,250
WIRDA PUTRI TELAUMBANUA THORAX JKN 105,000 26,250
ZEHAN THORAX UMUM 105,000 26,250
Zentra Thianda Al - Varlen THORAX JKN 105,000 26,250
-
10/24/2022 ABDUL JAYA SINAGA THORAX JKN 105,000 26,250
ADIL NAPITUPULU THORAX JKN 105,000 26,250
AFIFAH FITRI THORAX UMUM 105,000 26,250
AGNES TESALONIKA TAMBA THORAX JKN 105,000 26,250
BINSAR SIHOMBING THORAX JKN 105,000 26,250
CHAIRUL MARDIUS THORAX JKN 105,000 26,250
ERNAWATI TARIGAN GENU JKN 120,000 30,000
FARIDAH ANKEL JKN 120,000 30,000
THORAX JKN 105,000 26,250
HABIBI HAFIZ PREVIA DAMAN THORAX JKN 105,000 26,250
JUMAN THORAX JKN 105,000 26,250
JUMINEM THORAX JKN 105,000 26,250
JUNAIDI ANKEL JKN 120,000 30,000
LINCE HUTASOIT THORAX JKN 105,000 26,250
MUHAMMAD HANAFIAH THORAX JKN 105,000 26,250
MAHFUZZAH HERIDA FITRI THORAX UMUM 105,000 26,250
MARLIN BARUS THORAX JKN 105,000 26,250
NATHANIA SIREGAR THORAX UMUM 105,000 26,250
NAUVAL THORAX UMUM 105,000 26,250
NURLINA SINAGA THORAX JKN 105,000 26,250
PETERSON SIMAMORA THORAX JKN 105,000 26,250
RICKY SANJAYA SIMANJUNTAK THORAX JKN 105,000 26,250
RUDI HARTONO THORAX JKN 105,000 26,250
SAMINAH THORAX JKN 105,000 26,250
SELAMET RIYADI THORAX JKN 105,000 26,250
SUDARMANTO THORAX JKN 105,000 26,250
SUKINEM THORAX JKN 105,000 26,250
ANKLE JKN 120,000 30,000
SUKSESMIN PRETTY GENU JKN 120,000 30,000
Sulestriana PEDIS JKN 105,000 26,250
SUSANNAH THORAX JKN 105,000 26,250
TREGANA LUBIS THORAX JKN 105,000 26,250
YENNI JAMAIDAWATI THORAX UMUM 105,000 26,250
YUSRIADI THORAX UMUM 105,000 26,250
SHOULDER UMUM 120,000 30,000
YULISTINA THORAX JKN 105,000 26,250
-
10/25/2022 AL APIS RAMADAN THORAX JKN 105,000 26,250
ALIF ZIYAD KOTO THORAX UMUM 105,000 26,250
ARIXAN SIMBOLON THORAX JKN 105,000 26,250
BASRI THORAX UMUM 105,000 26,250
DANIEL HUTABARAT THORAX JKN 105,000 26,250
DIANA THORAX JKN 105,000 26,250
EKA HARDIANA PUTRA THORAX JKN 105,000 26,250
ELPINA SIANTURI THORAX JKN 105,000 26,250
Ertina Barus SHOULDER JKN 120,000 30,000
FATMAWATI THORAX JKN 105,000 26,250
FELIVEL ELMARGIO LASE THORAX JKN 105,000 26,250
JASON LAURENCIUS SIHITE THORAX JKN 105,000 26,250
JULI SAPRI THORAX UMUM 105,000 26,250
KARISMAN PANUSUNAN SIMBOLO THORAX JKN 105,000 26,250
LISMIARNI THORAX JKN 105,000 26,250
MARICE RAJA GUKGUK THORAX JKN 105,000 26,250
NAPSIN THORAX UMUM 105,000 26,250
NASIB THORAX UMUM 105,000 26,250
Novi Yanti Elhartini THORAX JKN 105,000 26,250
NURMASARI THORAX JKN 105,000 26,250
Ferdinan Sembiring THORAX UMUM 105,000 26,250
PONIMAN THORAX UMUM 105,000 26,250
RAHMAD HIDAYAH CERVICAL JKN 300,000 75,000
RIKA HERDARIA SIAHAAN THORAX JKN 105,000 26,250
RIKA AULIA SCHEDEL JKN 175,000 43,750
SUGITO THORAX JKN 105,000 26,250
SUMIATI THORAX UMUM 105,000 26,250
SYAHZILY LUMBAL JKN 300,000 75,000
SYARIFUDDIN SARAGIH THORAX JKN 105,000 26,250
TUKIJAN THORAX JKN 105,000 26,250
YUSRIADI THORAX UMUM 105,000 26,250
-
10/26/2022 AWALUDDIN THORAX JKN 105,000 26,250
AYUN WIDIASTI THORAX JKN 105,000 26,250
AZRIL ALAMGRI AMSYAR BERUTU THORAX UMUM 105,000 26,250
BUDI SIMBOLON LUMBAL JKN 300,000 75,000
DANI THORAX JKN 105,000 26,250
ERISNAWATI TABITA NADAPDAP THORAX JKN 105,000 26,250
GONGGA PANGARIBUAN THORAX JKN 105,000 26,250
HAURA ALAIKA BR PURBA THORAX JKN 105,000 26,250
JUNIAR SIBARANI THORAX JKN 105,000 26,250
LAMTIAR SIMAMORA THORAX JKN 105,000 26,250
LISNAWATI THORAX JKN 105,000 26,250
MAROLOP HUTAPEA THORAX JKN 105,000 26,250
MANUS JKN 105,000 26,250
MUHAMMAD AZRIEL AL FATTIH THORAX UMUM 105,000 26,250
NADIERA SYAHPUTRI THORAX JKN 105,000 26,250
NURHAPIPIN THORAX JKN 105,000 26,250
POLTAK MANURUNG PELVIS JKN 105,000 26,250
PUTRA RAMADHAN PANE THORAX JR 105,000 26,250
MANUS JR 105,000 26,250
ROLIANNA LUMBAN BATU THORAX JKN 105,000 26,250
RUNDIANI BR TARIGAN THORAX JKN 105,000 26,250
SINUR BR BAGARIANG THORAX UMUM 105,000 26,250
SITI AZAHRA KHALIFA THORAX JKN 105,000 26,250
SUPADI THORAX JKN 105,000 26,250
SUPARTIK THORAX JKN 105,000 26,250
SUSUN DERMINA BR SIANIPAR THORAX UMUM 105,000 26,250
TUGIYEM THORAX JKN 105,000 26,250
WAHYUDI LUMBAL JKN 300,000 75,000
105,000 26,250
10/27/2022 ZURAIDA THORAX JKN -
YUSRIADI SHOULDER JKN 120,000 30,000
SYAH HARSALAN POHAN LUMBAL JKN 300,000 75,000
ROSMERY BR DAMANIK THORAX JKN 105,000 26,250
RISKI AYU ANGGIANI ANTEBRACHI JKN 105,000 26,250
RACHEL PRISILIA BR PURBA THORAX JKN 105,000 26,250
PETRUS DEDI PUTRA MARBUN THORAX JKN 105,000 26,250
PANGIHUTAN SIHOMBING THORAX JKN 105,000 26,250
NIZAM ZAKI MUBARAK SIHOMBING THORAX JKN 105,000 26,250
NATHASYA MARGARETH MARBUN THORAX JKN 105,000 26,250
NADINE FITRIA RAMBE THORAX JKN 105,000 26,250
MAYSARA TIARA PUTRI THORAX UMUM 105,000 26,250
MAROLOP HUTAPEA MANUS JKN 105,000 26,250
Lince Hotmida Sinaga THORAX JKN 105,000 26,250
JUMINI THORAX JKN 105,000 26,250
HUSAINI SINAGA THORAX JKN 105,000 26,250
HARTATI THORAX JKN 105,000 26,250
EDWIN LUMBAL JKN 300,000 75,000
DAMAR ADRIANSYAH SUSANTO THORAX JKN 105,000 26,250
DAHLIANA THORAX JKN 105,000 26,250
Berliana Siburian SHOULDER UMUM 120,000 30,000
THORAX UMUM 105,000 26,250
ARIFIN SINUHAJI THORAX UMUM 105,000 26,250
-
10/28/2022 TRIHANI PARHUSIP THORAX JKN 105,000 26,250
SONY ALEKSANDER SIHOTANG THORAX JKN 105,000 26,250
SEMIN THORAX JKN 105,000 26,250
SAKMAD THORAX UMUM 105,000 26,250
SAFRIL SWANDI SIHOMBING THORAX UMUM 105,000 26,250
LAW KIM YONG THORAX JKN 105,000 26,250
LASTI PERIATI SIREGAR THORAX JKN 105,000 26,250
KAMINI THORAX JKN 105,000 26,250
JUNAEDI THORAX JKN 105,000 26,250
ICHA OLYVIA THORAX JKN 105,000 26,250
HAPSAH THORAX JKN 105,000 26,250
ASARI PURBA THORAX JKN 105,000 26,250
ADE FAKHRI AL-WANSYAH THORAX UMUM 105,000 26,250
-
10/29/2022 ZUBAIDAH THORAX JKN 105,000 26,250
SULENI THORAX UMUM 105,000 26,250
SITI RUMINI THORAX JKN 105,000 26,250
REVAN ANANDA THORAX JKN 105,000 26,250
NUR RAHAYU THORAX JKN 105,000 26,250
NGATEMI THORAX JKN 105,000 26,250
MISWADI THORAX UMUM 105,000 26,250
MISNO THORAX JKN 105,000 26,250
MASRIYANI ANTEBRACHI JKN 120,000 30,000
LUMINAR SIHOMBING THORAX JKN 105,000 26,250
LUMBAL JKN 300,000 75,000
KRIS HANDDOKO THORAX JKN 105,000 26,250
Kasmini THORAX JKN 105,000 26,250
JEKSON ALBERTUS TURNIP THORAX JKN 105,000 26,250
IRMAN THORAX JKN 105,000 26,250
IRPANSYAH DALIMUNTHE THORAX UMUM 105,000 26,250
IRAWATI THORAX JKN 105,000 26,250
SUARNI THORAX JKN 105,000 26,250
HERI LESTARI THORAX JKN 105,000 26,250
H SAJURI THORAX JKN 105,000 26,250
CHINTIA BNO 3 POSISI JKN 360,000 90,000
THORAX JKN 105,000 26,250
ARJUNA ALEXANDER MARBUN THORAX JKN 105,000 26,250
AMIR RAJAB LUBIS THORAX JKN 105,000 26,250
ADELINA THORAX UMUM 105,000 26,250
-
10/30/2022 NURNANI BARUS AMD THORAX JKN 105,000 26,250
LISMARIA SARAGIH THORAX JKN 105,000 26,250
JUMINEM THORAX JKN 105,000 26,250
JASWARI THORAX JKN 105,000 26,250
EMIL ZEIN THORAX JKN 105,000 26,250
DENNY DHARMAWAN THORAX JKN 105,000 26,250
CARISSA YOSE PAULINA MANIK THORAX JKN 105,000 26,250
BAINAH THORAX JKN 105,000 26,250
-
10/31/2022 ZAINUL ARIFIN SIREGAR,SAG THORAX UMUM 105,000 26,250
WIDYA SEPTIA NINGRUM THORAX JKN 105,000 26,250
WARNI THORAX JKN 105,000 26,250
WAGIYEM THORAX JKN 105,000 26,250
SUSI JULIANA LUMBAL JKN 300,000 75,000
SULAIMAN RANGKUTI THORAX JKN 105,000 26,250
SANDRO MARBUN THORAX JKN 105,000 26,250
SABRINA BR PURBA THORAX JKN 105,000 26,250
SABARUDIN THORAX JKN 105,000 26,250
RISKI PALAGUTAN SIMANJUNTAK THORAX JKN 105,000 26,250
RAFFASA ALFARIZEE THORAX JKN 105,000 26,250
PIARA GINTING MUNTHE THORAX UMUM 105,000 26,250
NURMALA MANJUNTAK THORAX JKN 105,000 26,250
NGADINI THORAX JKN 105,000 26,250
M ALFAIZ MAHDAFI PANE ANTEBRACHI JKN 105,000 26,250
MUSPAN GENU JR 120,000 30,000
THORAX JR 105,000 26,250
MARTUA ARITONANG THORAX JKN 105,000 26,250
PEDIS JKN 105,000 26,250
MARIA JOAN SIRINGORINGO THORAX UMUM 105,000 26,250
JOKO LAKSONO THORAX JKN 105,000 26,250
JOHANNES SINAGA LUMBAL JKN 300,000 75,000
ISRAEL LUMBANTORUAN CERVICAL JKN 300,000 75,000
HESEKIEL PANDAPOTAN NABABAN CRURIS UMUM 105,000 26,250
THORAX UMUM 105,000 26,250
GISELA OKTAVIA SILABAN THORAX JKN 105,000 26,250
GABRIEL SEBASTIAN SIHOTANG SPN JKN 175,000 43,750
FERDINAND SARAGIH THORAX JKN 105,000 26,250
ATMAINI THORAX JKN 105,000 26,250
ANGGI VUSPITA SARI THORAX JKN 105,000 26,250
AMIR THORAX JKN 105,000 26,250
-
03/10/20022 ELPINA USG ABDOMEN JKN 325,000 81,250
SARIAH USG ABDOMEN JKN 325,000 81,250
RAMOT BR.SINAGA USG ABDOMEN JKN 325,000 81,250
ADRI USG ABDOMEN JKN 325,000 81,250
ALMA USG ABDOMEN JKN 325,000 81,250
SAPUTRA USG ABDOMEN JKN 325,000 81,250
ABDUL YAHMAN USG ABDOMEN JKN 325,000 81,250
-
10/6/2022 MASNARIA BR.PAYUNG USG ABDOMEN JKN 325,000 81,250
ANDRI SAPUTRA USG ABDOMEN JKN 325,000 81,250
ENDANG USG ABDOMEN JKN 325,000 81,250
SAMINEM USG ABDOMEN JKN 325,000 81,250
HARI YANI USG ABDOMEN JKN 325,000 81,250
-
10/10/2022 LIHARDO TONDANG USG APPENDIX UMUM 325,000 81,250
JONI USG ABDOMEN JKN 325,000 81,250
RENTI USG ABDOMEN JKN 325,000 81,250
FALBO USG ABDOMEN JKN 325,000 81,250
RUSNI USG ABDOMEN JKN 325,000 81,250
RASMI USG ABDOMEN JKN 325,000 81,250
SUKAIMAN USG ABDOMEN JKN 325,000 81,250
M.YOPI USG ABDOMEN JKN 325,000 81,250
DELON USG ABDOMEN JKN 325,000 81,250
JAMANSEN SARAGIH USG ABDOMEN JKN 325,000 81,250
SITI USG PAYUDARAH UMUM 600,000 150,000
-
10/13/2022 AWALUDIN USG ABDOMEN JKN 325,000 81,250
SITI ASRI NST USG ABDOMEN JKN 325,000 81,250
JUNADEN SINAGA USG ABDOMEN JKN 325,000 81,250
ERIKSON USG ABDOMEN JKN 325,000 81,250
NURTASYA USG ABDOMEN JKN 325,000 81,250
SRIJULIATIK USG ABDOMEN JKN 325,000 81,250
SUWUH USG ABDOMEN JKN 325,000 81,250
HARIONO USG ABDOMEN JKN 325,000 81,250
PENDI USG ABDOMEN JKN 325,000 81,250
WAGIEM USG ABDOMEN JKN 325,000 81,250
PERURI HANNA USG ABDOMEN JKN 325,000 81,250
TAUFIK USG LEHER UMUM 600,000 150,000
FRIKA USG PAYUDARAH UMUM 600,000 150,000
-
10/17/2022 HENDRI USG ABDOMEN JKN 325,000 81,250
MARCELLA USG ABDOMEN JKN 325,000 81,250
-
10/20/2022 TESA USG ABDOMEN JKN 325,000 81,250
JUNIAR HALOHO USG ABDOMEN UMUM 325,000 81,250
RAMAYANA USG ABDOMEN UMUM 325,000 81,250
JUMIAH USG ABDOMEN UMUM 325,000 81,250
MILDA USG ABDOMEN UMUM 325,000 81,250
ABDILAH TRI USG ABDOMEN JKN 325,000 81,250
ELIANI USG ABDOMEN JKN 325,000 81,250
WANWIRA USG ABDOMEN JKN 325,000 81,250
GINI RANEM USG ABDOMEN JKN 325,000 81,250
HORMA USG ABDOMEN JKN 325,000 81,250
-
10/24/2022 TAPIARA PURBA USG ABDOMEN JKN 325,000 81,250
RENDY USG ABDOMEN JKN 325,000 81,250
SUGIRAN USG ABDOMEN JKN 325,000 81,250
JUMIAH USG ABDOMEN JKN 325,000 81,250
FITRI USG ABDOMEN JKN 325,000 81,250
RUKIAH HARAHAP USG ABDOMEN JKN 325,000 81,250
EMMI USG ABDOMEN JKN 325,000 81,250
SITI AMINAH USG ABDOMEN JKN 325,000 81,250
M.HANA FIAH USG ABDOMEN JKN 325,000 81,250
ASTINA USG ABDOMEN JKN 325,000 81,250
RITA USG ABDOMEN JKN 325,000 81,250
LASMA ULI USG ABDOMEN JKN 325,000 81,250
WIRDA USG ABDOMEN JKN 325,000 81,250
-
10/27/2022 MASIYA USG ABDOMEN JKN 325,000 81,250
JULIATI USG ABDOMEN JKN 325,000 81,250
SUHENDRA USG ABDOMEN JKN 325,000 81,250
EKO USG ABDOMEN JKN 325,000 81,250
ROY GINTING USG ABDOMEN UMUM 325,000 81,250
SUSUN USG ABDOMEN JKN 325,000 81,250
NURLINA USG ABDOMEN JKN 325,000 81,250
LISNIARNI USG ABDOMEN JKN 325,000 81,250
ARIXAN USG ABDOMEN JKN 325,000 81,250
MARLIN USG ABDOMEN JKN 325,000 81,250
HUSAINI USG ABDOMEN JKN 325,000 81,250
FERDINAN USG ABDOMEN JKN 325,000 81,250
RICKY USG ABDOMEN JKN 325,000 81,250
LISNAWATI USG ABDOMEN JKN 325,000 81,250
FATMAWATI USG ABDOMEN JKN 325,000 81,250
SAMINAH USG ABDOMEN JKN 325,000 81,250
-
10/31/2022 NGATEMI USG ABDOMEN JKN 325,000 81,250
ZUBAIDAH USG ABDOMEN JKN 325,000 81,250
MISNO USG ABDOMEN JKN 325,000 81,250
IRAWATI USG ABDOMEN JKN 325,000 81,250
JUNAEDI USG ABDOMEN JKN 325,000 81,250
SANGAPAN USG ABDOMEN JKN 325,000 81,250
JUMINEM USG ABDOMEN JKN 325,000 81,250
112,750,000 28,187,500
PAJAK 5 % 1,409,375
26,778,125
HONOR P.JAWAB/TRANSPORT -
HONOR BERSIH 26,778,125
L.PAKAM, NOVEMBER 2022
RSU SARI MUTIARA L.PAKAM
DIKETAHUI DIKETAHUI
(Dr.HARIS S A H,SpRad) (MELKI R TAMPUBOLON SE)

Radiolog Keuangan
DIKETAHUI
(dr ARIFIN SITOMPUL)

Direktur
RUMAH SAKIT UMUM SARI MUTIARA
Jalan : Medan No. 17 Tel (061) 7951339 Fax (061)7951334 Lubuk Pakam
Email : rsu_sarimutiara@yahoo.com
Kepada Yth :
Pimpinan Bank Syahriah Indonesia Lubuk Pakam
Cab. Lubuk Pakam
Dengan hormat,
Berikut kami susun rekapitulasi Gaji Dokter Spesialis Bulan November 2022
agar mentransfer ke nomor rekening masing-masing, atas kerja samanya kami ucapkan terima kasih.
HONOR PPH HONOR

NO NAMA DOKTER No. REKENING KET HONOR
BRUTO PASAL 21 BERSIH
1 dr. Lisbeth Meilina, Sp.S 15,388,000 769,400 14,618,600 7137.2611.67 BSI
2 dr. Dira Wahyuni Siregar,Sp.N (3,891,600) 7191.6236.67 BSI
3 dr. Yanika Sitanggang,Sp.PD 28,832,873 1,441,644 27,391,230 7167.7591.86 BSI
4 dr. Wirandi Dalimunthe,Sp.PD 22,625,060 1,131,253 21,493,807 7033.6082.11 BSI
5 dr. Nova Arianti, Sp.M 4,901,000 245,050 4,655,950 7167.6942.78 BSI
6 dr. Soraya Fasya, Sp.M #REF! #REF! #REF! 7210.6060.62 BSI
7 dr. Marolop Hutapea,Sp.JP 4,600,000 230,000 4,370,000 12087915.56 BNI
8 dr. Mahyarani Dalimunthe,Sp.A 16,852,727 1135.6562.13 BSI
9 dr.Siti Aisyah Dalimunthe,Sp.A (3,279,550) 7201.7592.98 BSI
10 dr. Rizka Helmi,Sp.P (2,068,300) 7186.1177.64 BSI
11 dr. Desmonia Trisius Damanik,Sp.P 17,803,268 890,163 16,913,104 7167.6940.33 BSI
12 dr. Robert F Siregar, Sp.B 28,671,170 590,118 28,081,053 900.00.3956231.0 Mandiri
13 dr. Heri Gunanti Surbakti,Sp.B 54,173,266 2,708,663 51,464,602 7201.4620.23 BSI
14 dr. Henry H. Sitanggang,Sp.B 3,341,546 167,077 3,174,469 106.00.9809970.1 Mandiri
15 dr. Cut Elvira Novita, Sp.THT-KL 4,746,127 237,306 4,508,820 2310.8410.48 BSI
16 dr. Imanda Jasmine Siregar,Sp.KK 3,958,000 197,900 3,760,100 7033.3415.17 BSI
17 dr. Jeckson Lubis, SpOG 14,999,300 749,965 14,249,335 2207.1962.93 BSI
18 dr. Robet Rahyuan Simamora,Sp.OG 12,575,850 628,793 11,947,058 105.00.1412140.8 Mandiri
19 dr. Nova Violin Wijaya,Sp.OG 1,371,290 6,856 1,364,434 7188.8840.29 BSI
20 dr. Yudha Eka Kusuma Y ,Sp.OT 2,030,000 101,500 1,928,500 141.001273066.9 Mandiri
21 dr. Tuahman Purba, SpAn, M.Kes 55,500,000 887,500 54,612,500 106.00.0010126.4 MANDIRI
22 dr. Gloria G Situmeang, Sp.An 18,720,000 936,000 17,784,000 105.00.2912027.0 MANDIRI
23 dr. Sanggam Hutagalung,Sp.PK 4,650,000 900.00.3956231.0 MANDIRI
24 dr. Haris S.A Hutagaol, Sp.Rad-Okt 22 28,187,500 1,409,375 26,778,125 7167.6949.28 BSI
TOTAL #REF! #REF! #REF!
Diketahui Oleh : L.Pakam, Maret 2023

Direktur, Ka. Keuangan
( dr. Arifin P Sitompul, MHA ) (Melki Tampubolon, SE )

#REF!
87,343,553
#REF!
RUMAH SAKIT UMUM SARI MUTIARA
Jalan : Medan No. 17 Tel (061) 7951339 Fax (061)7951334 Lubuk Pakam
Email : rsu_sarimutiara@yahoo.com
Kepada Yth :
Pimpinan Bank Syahriah Indonesia Lubuk Pakam
Cab. Lubuk Pakam
Dengan hormat,
Berikut kami susun rekapitulasi Gaji Dokter Spesialis Bulan November 2022
agar mentransfer ke nomor rekening masing-masing, atas kerja samanya kami ucapkan terima kasih.
HONOR PPH HONOR

NO NAMA DOKTER No. REKENING KET HONOR
BRUTO PASAL 21 BERSIH
1 dr. Robert F Siregar, Sp.B 28,671,170 590,118 28,081,053 900.00.3956231.0 Mandiri
2 dr. Tuahman Purba, SpAn, M.Kes 55,500,000 887,500 54,612,500 106.00.0010126.4 MANDIRI
3 dr. Sanggam Hutagalung,Sp.PK 4,650,000 900.00.3956231.0 MANDIRI
TOTAL 84,171,170 1,477,618 87,343,553
Diketahui Oleh : L.Pakam, Maret 2023

Direktur, Ka. Keuangan
( dr. Arifin P Sitompul, MHA ) (Melki Tampubolon, SE )

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dr.

Lisbeth Meilina, SpS

1. Rawat Inap Pasien Umum,Inhealth dan Perusahaan

2. Rawat Inap BPJS

Total 14,425,000 80,000 14,505,000

1. Rawat Inap Pasien Umum,Inhealth dan Perusahaan

2. Rawat Inap BPJS

Total 3,200,000 80,000 3,280,000

on,SpP+dr. Ridho,Sp.PD+dr. Marolop,SpJ

1. Rawat Inap Pasien Umum,Inhealth dan Perusahaan

2. Rawat Inap BPJS

Total - 9,400,000 40,000 9,440,000

Lubuk Pakam, November 2022 Diketahui Oleh: Kalkulasi Penggajian / Honor:

Melki Tampubolon, SE dr. Arifin P Sitompul Umum 40,000 +

1. Rawat Inap Pasien Umum,Inhealth dan Perusahaan

2. Rawat Inap BPJS

1. Rawat Inap Pasien Covid

Total 120 18,000,000

Total - 4,250,000 - 4,250,000

Lubuk Pakam, November 2022 Diketahui Oleh: Kalkulasi Penggajian / Honor:

1. Rawat Inap Pasien Umum,Inhealth dan Perusahaan

2. Rawat Inap BPJS

Total - 4,250,000 - 4,250,000

Lubuk Pakam, November 2022 Diketahui Oleh: Kalkulasi Penggajian / Honor:

2. Rawat Inap BPJS

3. Rawat Inap Pasien Umum, JKK, A+ dan Perusahaan

Lubuk Pakam, November 2022 Diketahui Oleh: Kalkulasi Penggajian / Honor :

Total - - - 6,825,000 6,825,000

2. Rawat Inap BPJS

Total - 4,119,700 172,640

3. Rawat Inap Pasien Umum, JKK, A+ dan Perusahaan

Total #REF! #REF! #REF!

Lubuk Pakam, November 2022 Diketahui Oleh: Kalkulasi Penggajian / Honor :

1. Rawat Inap Pasien Umum,Inhealth dan Perusahaan

Lubuk Pakam, November

1. Rawat Inap Umum, A+ dan Perusahaan

2. Rawat Inap BPJS

No Nama Pasien MR Tanggal Visite Honor Visite Diagnosa

Total 06/07/2009 13/10/6759 - 1,815,000

Diketahui Oleh: Lubuk Pakam, November 2022 Kalkulasi Penggajian / Honor:

1. Rawat Inap Pasien Umum, A+ dan Perusahaan

2. Rawat Inap BPJS

No Nama Pasien MR Tanggal Visite Honor Visite Diagnosa

1. Rawat Inap Pasien Umum, Inhealth dan Perusahaan

2. Rawat Inap BPJS

Total 143,773,400 7,904,658

Total - 40,000 3,050,000 3,090,000

Lubuk Pakam, November 2022 Diketahui Oleh: Kalkulasi Penggajian / Honor:

1. Rawat Inap Pasien Umum, Inhealth dan Perusahaan

2. Rawat Inap BPJS

Total 136,771,100 8,291,268

Total - - 3,350,000 3,350,000

Lubuk Pakam, November 2022 Diketahui Oleh: Kalkulasi Penggajian / Honor:

1. Rawat Inap / Operasi Umum, A+, Perusahaan

1. Rawat Inap BPJS

Total 242,938,300 43,176,266

Total - 3,725,000 - 3,725,000

Lubuk Pakam, November 2022 Diketahui Oleh; Kalkulasi Penggajian / Honor: