Tgl. Masuk Tgl. Pulang No. RM Nama Pasien No.

asien No. Klaim / SEP INACBG Total Tarif Tarif RS Jenis LOS
10 Jan 2023 10 Jan 2023 816109 ADRIANA JULIANA SOPHIA NELWAN 2103R0040123V001581 E-4-10-I 4,860,300 1,536,000 RI 1
26 Jan 2023 27 Jan 2023 768158 IMELDA RASU 2103R0040123V005072 L-4-12-I 1,741,200 2,962,924 RI 2
28 Jan 2023 30 Jan 2023 189025 UNGGU TUWO /210271 2103R0040123V005358 E-4-11-I 4,390,300 1,879,130 RI 3
28 Jan 2023 29 Jan 2023 818350 ARIFKI RASYID RAHMAN 2103R0040123V005470 G-4-22-I 2,902,700 526,000 RI 2
29 Jan 2023 31 Jan 2023 818354 VONNY TUJU 2103R0040123V005481 E-4-11-II 4,740,700 2,147,991 RI 3
11 Jan 2024 11 Jan 2024 835007 OKTIRIANI 2103R0040124V002784 A-4-13-I 2,055,500 712,186 RI 1
25 Jan 2024 26 Jan 2024 213512 ROYANI YOSEFIN TOMBOKAN 2103R0040124V006922 U-4-11-I 1,756,300 1,274,330 RI 2
26 Jan 2024 27 Jan 2024 233985 MEISKE TOMBUKU 2103R0040124V006934 B-4-14-I 3,584,300 875,355 RI 2
28 Jan 2024 30 Jan 2024 835946 CLARA BETZY LUMUNON 2103R0040124V007479 U-4-13-II 2,474,600 979,721 RI 3
28 Jan 2024 30 Jan 2024 836005 RIBKA SIGAR 2103R0040124V007516 W-1-11-I 2,928,800 3,841,141 RI 3
7 Feb 2023 9 Feb 2023 818716 EDWIN KANTER 2103R0040223V001387 N-4-12-I 3,459,300 1,562,542 RI 3
7 Feb 2023 9 Feb 2023 746634 MARTHA ONA MERENTEK 2103R0040223V001398 I-4-20-I 4,441,000 1,693,073 RI 3
27 Feb 2023 28 Feb 2023 802274 PIETER OTNIEL KALELE 2103R0040223V005071 K-4-17-I 1,733,200 547,720 RI 2
27 Feb 2023 28 Feb 2023 819412 SUKARNO Y. KOWEL 2103R0040223V005072 G-4-16-I 2,882,100 1,805,648 RI 2
27 Feb 2023 28 Feb 2023 7965170 NOVA V KUMOWAL 2103R0040223V005273 G-4-23-I 3,008,400 754,509 RI 2
7 Feb 2024 7 Feb 2024 810317 MIRACLE JONATHAN RUAUW 2103R0040224V001904 K-4-18-I 1,663,900 2,654,956 RI 1
23 Feb 2024 23 Feb 2024 118814 VIDYA ELIZABETH LUMANGKUN 2103R0040224V006129 U-4-11-I 2,005,100 2,416,941 RI 1
26 Feb 2024 28 Feb 2024 837749 WULAN CHARINA PIJOH 2103R0040224V006902 N-4-12-I 2,601,000 951,890 RI 3
27 Feb 2024 28 Feb 2024 723416 MAXWELL JERICHO REMBERT SUPIT 2103R0040224V007127 A-4-13-I 2,733,800 880,125 RI 2
28 Feb 2024 29 Feb 2024 828665 RALVI TALUMEWO 2103R0040224V007492 N-4-10-I 3,192,700 1,649,548 RI 2
3 Mar 2023 3 Mar 2023 819573 RAHMAWATI KALUKU 2103R0040323V000446 A-4-13-I 2,055,500 356,000 RI 1
8 Mar 2023 9 Mar 2023 722380 NELLY ALBERTINA PALENDENG 2103R0040323V001687 L-4-13-I 2,605,000 873,488 RI 2
20 Mar 2023 20 Mar 2023 780436 BELLA ALDONA PRICILIA TAMBUWUN 2103R0040323V004120 N-4-12-I 2,601,000 765,000 RI 1
24 Mar 2023 25 Mar 2023 814410 ONESIMUS MANTIRI 2103R0040323V005133 G-4-25-I 2,263,400 2,148,329 RI 2
29 Mar 2023 30 Mar 2023 00255096 IDA AYU NYOMAN PUJA WARASTUTI 2103R0040323V006077 Z-4-12-I 2,092,000 3,923,543 RI 2
1 Apr 2023 1 Apr 2023 733237 RIKE MARITJE MANDANG 2103R0040423V000004 K-4-18-I 1,428,200 1,755,849 RI 1
26 Apr 2023 27 Apr 2023 202541 INDRIA GLEDY SANGIAN 2103R0040423V004820 N-4-12-I 3,030,200 1,670,596 RI 2
27 Apr 2023 29 Apr 2023 821765 DEMSI SAYOW 2103R0040423V005104 J-4-21-I 3,058,600 1,279,598 RI 3
27 Apr 2023 28 Apr 2023 220412 FREDDIE M.M. PAAT 2103R0040423V005318 K-4-18-I 1,899,600 1,423,750 RI 2
28 Apr 2023 29 Apr 2023 815425 TOAR WOLA 2103R0040423V005326 I-4-17-I 2,590,100 682,920 RI 2
26 Apr 2023 28 Apr 2023 763744 KAZUO MCKENZIE RISAGELN MENGKO 2103R0040423V005506 U-4-13-I 2,099,100 902,039 RI 3
6 Mei 2023 7 Mei 2023 822326 FEMMY N WATUNG 2103R0040523V001208 L-1-50-I 5,578,400 2,333,423 RI 2
12 Mei 2023 12 Mei 2023 789688 WENDELINA WOWOR 2103R0040523V002557 N-4-10-I 3,192,700 1,542,042 RI 1
16 Mei 2023 16 Mei 2023 822812 GRATCHIA KEZIA DHEA PANAMBUNAN 2103R0040523V003503 K-4-17-I 2,019,200 772,160 RI 1
17 Mei 2023 18 Mei 2023 738262 FERRY SIWI 2103R0040523V003953 S-4-11-I 2,386,200 1,757,165 RI 2
26 Mei 2023 27 Mei 2023 770042 JEMMY PANGKONG 2103R0040523V005912 J-4-21-I 3,058,600 1,415,480 RI 2
25 Mei 2023 26 Mei 2023 00243254 FERDINAND ORRENTJE MUKUAN 2103R0040523V007024 M-4-20-I 2,502,800 650,702 RI 2
5 Jun 2023 5 Jun 2023 235656 MEIVI PINONTOAN 2103R0040623V001401 U-4-11-I 1,507,600 1,721,832 RI 1
22 Jun 2023 24 Jun 2023 132539 JULIEN PAAT 2103R0040623V004936 M-4-17-I 3,147,700 1,219,605 RI 3
22 Jun 2023 24 Jun 2023 824621 RIKA PUTRI MAHMUD 2103R0040623V004998 W-4-14-I 2,356,700 1,246,500 RI 3
29 Jun 2023 30 Jun 2023 014741 FRANKO JECKY MAMUAJA 2103R0040623V006663 I-4-20-I 4,441,000 2,650,447 RI 2
29 Jun 2023 30 Jun 2023 186345 DJISIANI ERING 2103R0040623V006676 U-4-13-I 2,099,100 739,664 RI 2
5 Jul 2023 5 Jul 2023 825333 CHEZY STEFELI MAUKAR 2103R0040723V001201 I-4-20-I 3,812,000 679,380 RI 1
6 Jul 2023 7 Jul 2023 732117 FRANSISCUS ROTINSULU 2103R0040723V001521 L-4-12-I 2,028,500 3,216,891 RI 2
11 Jul 2023 12 Jul 2023 825134 DEWINNERGIO KAENG 2103R0040723V002673 G-4-25-I 2,263,400 646,766 RI 2
23 Jul 2023 24 Jul 2023 751227 RICHARDO DANIEL KALANGI 2103R0040723V005674 A-4-14-I 2,405,100 697,372 RI 2
30 Jul 2023 31 Jul 2023 802180 JULTJE MONTOLALU 2103R0040723V007400 K-4-17-I 1,733,200 809,822 RI 2
3 Agu 2023 4 Agu 2023 781530 NOVRI ALEXANDER KAENG 2103R0040823V000538 G-4-17-I 5,105,100 1,509,436 RI 2
22 Agu 2023 22 Agu 2023 737811 RONNY PETRUS TUMEWU 2103R0040823V004635 K-4-18-I 1,663,900 910,017 RI 1
27 Agu 2023 28 Agu 2023 720312 MARHO SINDIM, AMAPD 2103R0040823V005920 G-4-23-I 3,008,400 1,387,671 RI 2
28 Agu 2023 30 Agu 2023 185050 KEVIN TIMOTHY SAMBOH 2103R0040823V006227 M-1-80-I 8,647,200 5,028,395 RI 3
28 Agu 2023 30 Agu 2023 7110410 DEITJE PANGEMANAN 2103R0040823V006234 A-4-13-I 2,055,500 1,375,405 RI 3
29 Agu 2023 30 Agu 2023 722281 NICOLAS RORING 2103R0040823V006244 N-4-10-I 3,719,500 2,128,061 RI 2
1 Sep 2023 2 Sep 2023 827936 HERIANTO LIN 2103R0040923V000181 I-1-17-I 11,284,900 1,514,321 RI 2
10 Sep 2023 13 Sep 2023 828588 PATRICIA ANGGRIANI TALUMEPA 2103R0040923V002189 O-6-10-I 5,553,100 7,366,025 RI 1
20 Sep 2023 20 Sep 2023 791118 CIKITA GABRIELA EMAN 2103R0040923V004756 O-6-10-I 5,553,100 6,441,770 RI 1
21 Sep 2023 21 Sep 2023 789733 ALTJE PELEALU 2103R0040923V004851 K-4-17-I 1,733,200 1,212,679 RI 1
25 Sep 2023 26 Sep 2023 722619 JOHANNA GRACE KAINDE 2103R0040923V006003 W-1-10-I 3,629,700 3,731,317 RI 2
26 Sep 2023 27 Sep 2023 803141 LINDA KARUNDENG 2103R0040923V006048 W-4-12-I 3,577,000 3,455,863 RI 2
10 Okt 2023 10 Okt 2023 818810 FARRY UMBOKAHU 2103R0041023V003083 J-4-15-II 5,492,400 6,661,625 RI 1
21 Okt 2023 21 Okt 2023 776521 KRISTI SITORUS 2103R0041023V005427 A-4-13-I 2,055,500 1,468,627 RI 1
21 Okt 2023 21 Okt 2023 830582 STENY TATONTOS 2103R0041023V005482 L-4-13-I 2,605,000 713,750 RI 1
27 Okt 2023 28 Okt 2023 806280 CHLAUDIA TUNAS 2103R0041023V007236 K-4-18-I 1,899,600 2,040,056 RI 2
28 Okt 2023 30 Okt 2023 774967 LISBET RAU 2103R0041023V007431 G-4-26-I 3,402,100 2,688,790 RI 3
29 Okt 2023 31 Okt 2023 831022 EMELY PRICILA SILVANIA LOING 2103R0041023V007522 K-4-17-I 1,733,200 1,094,092 RI 3
30 Okt 2023 31 Okt 2023 776373 ANITJE PANGALILA 2103R0041023V007612 G-4-23-I 2,262,000 1,507,147 RI 2
13 Nov 2023 13 Nov 2023 814484 JOHANIS WENSEN 2103R0041123V004056 J-4-19-I 4,434,700 2,488,421 RI 1
15 Nov 2023 15 Nov 2023 831919 EDWARD DELION ZEIN ANIS 2103R0041123V004168 V-4-11-I 3,672,100 2,661,719 RI 1
18 Nov 2023 19 Nov 2023 831598 SYALOMITA AMANDA PONTOH 2103R0041123V004911 L-4-12-I 2,028,500 4,273,560 RI 2
19 Nov 2023 19 Nov 2023 00253240 REVIVE CLAY PONEKE 2103R0041123V005112 M-4-21-I 3,554,000 3,020,259 RI 1
22 Nov 2023 23 Nov 2023 832274 MARSYA MIRACLE TOREH 2103R0041123V005818 K-4-17-I 1,733,200 683,542 RI 1
23 Nov 2023 24 Nov 2023 226684 FRANS JOSEP PIJOH 2103R0041123V006239 M-4-18-I 2,378,900 1,892,674 RI 2
27 Nov 2023 29 Nov 2023 216096 NORCE H. AROR 2103R0041123V007230 I-4-16-I 1,974,900 2,395,328 RI 3
28 Nov 2023 30 Nov 2023 100097 DJON KOROMPIS 2103R0041123V007436 I-4-19-I 3,341,100 2,491,239 RI 3
11 Des 2023 11 Des 2023 832584 STEVANIE SHERLYN MONGDONG 2103R0041223V002706 N-4-10-II 3,711,500 5,004,047 RI 1
23 Des 2023 23 Des 2023 833815 CHRISTIE DINO WOWOR 2103R0041223V005581 K-4-17-I 2,305,200 847,500 RI 1
29 Des 2023 31 Des 2023 042572 NOVI NONJTE TAMBOTO 2103R0041223V007007 K-4-18-I 1,428,200 1,444,322 RI 3
30 Des 2023 31 Des 2023 834183 BELLVANIA CALYA LANDENG 2103R0041223V007062 K-4-18-I 1,899,600 731,498 RI 2
30 Des 2023 31 Des 2023 798890 JELLY TAROREH 2103R0041223V007130 G-4-10-I 3,615,500 1,356,689 RI 2
31 Des 2023 1 Jan 2024 825005 IMMANUEL HARUN NOVESTAR HERU RAPAR 2103R0041223V007256 K-4-18-I 1,428,200 837,324 RI 2