Laporan detail tindakan dan biaya pasien rawat jalan & inap
| No | No.Rawat | No.R.M. | Nama Pasien | Poli | Cara Bayar | Dokter Poli | Tgl.Reg | Jam Reg | Status | Status Bayar | No SEP | Tarif INA-CBG | Tarif RS | Dokter | Paramedis | Dokter+Paramedis | Radiologi | Laboratorium | Operasi | Farmasi | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 2026/04/17/000158 | 068056 | MEITRI DWI PANGESTIKA | Unit IGD | BPJS | dr. Muhammad Akip Aprianto | 2026-04-17 | 17:06:54 | Belum | Belum Bayar | - | Rp 0 | Rp 117.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 117.000 | Rp 0 | Rp 0 | ||
| 2 | 2026/04/17/000157 | 223837 | ROMI ARDIANSYAH | Unit IGD | BPJS | dr. Restiko Maleo Fibullah | 2026-04-17 | 17:00:29 | Sudah | Belum Bayar | - | Rp 0 | Rp 62.955 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 10.955 | ||
| 3 | 2026/04/17/000156 | 223836 | NURSIAH | Unit IGD | BPJS | dr. Restiko Maleo Fibullah | 2026-04-17 | 16:37:46 | Sudah | Belum Bayar | - | Rp 0 | Rp 162.500 | Rp 0 | Rp 0 | Rp 0 | Rp 162.500 | Rp 0 | Rp 0 | Rp 0 | ||
| 4 | 2026/04/17/000047 | 130754 | BUSRONI bin SANSON | Poli Hemodialisa | BPJS | dr. Deddy Primadona Mulia, Sp. PD - K.GH, FINASIM | 2026-04-17 | 16:36:48 | Berkas Diterima | Belum Bayar |
0603R0010426V002111 INACBG: 0 |
Rp 0 | Rp 876.856 | Rp 0 | Rp 0 | Rp 850.000 | Rp 0 | Rp 0 | Rp 0 | Rp 26.856 | ||
| 5 | 2026/04/17/000155 | 223835 | DWI FATMA SARI | Unit IGD | BPJS | dr. Restiko Maleo Fibullah | 2026-04-17 | 16:14:16 | Sudah | Belum Bayar | - | Rp 0 | Rp 1.304.500 | Rp 0 | Rp 0 | Rp 628.500 | Rp 0 | Rp 676.000 | Rp 0 | Rp 0 | ||
| 6 | 2026/04/17/000154 | 223834 | NENG IBAH | Unit IGD | UMUM | dr. Muhammad Akip Aprianto | 2026-04-17 | 15:27:06 | Sudah | Belum Bayar | - | Rp 0 | Rp 438.352 | Rp 0 | Rp 0 | Rp 97.500 | Rp 325.000 | Rp 0 | Rp 0 | Rp 15.852 | ||
| 7 | 2026/04/17/000153 | 223833 | FIRA MASNAH | Unit IGD | UMUM | dr. Muhammad Akip Aprianto | 2026-04-17 | 15:25:23 | Belum | Belum Bayar | - | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 8 | 2026/04/17/000152 | 223832 | BIANTARA LINTANG PUTRA LAWI | Unit IGD | UMUM | dr. Muhammad Akip Aprianto | 2026-04-17 | 15:23:33 | Sudah | Sudah Bayar | - | Rp 0 | Rp 181.200 | Rp 0 | Rp 0 | Rp 20.000 | Rp 0 | Rp 161.200 | Rp 0 | Rp 0 | ||
| 9 | 2026/04/17/000151 | 223831 | MUSTOPA | Unit IGD | BPJS | dr. Muhammad Akip Aprianto | 2026-04-17 | 15:16:36 | Sudah | Belum Bayar | - | Rp 0 | Rp 351.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 351.000 | Rp 0 | Rp 0 | ||
| 10 | 2026/04/17/000150 | 127068 | JURID | Unit IGD | BPJS | dr. Muhammad Akip Aprianto | 2026-04-17 | 15:13:05 | Sudah | Belum Bayar | - | Rp 0 | Rp 162.500 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 162.500 | Rp 0 | Rp 0 | ||
| 11 | 2026/04/17/000142 | 223827 | WISNAWATI | Unit IGD | UMUM | dr. Mayasari Rizki Utami | 2026-04-17 | 15:00:10 | Sudah | Sudah Bayar | - | Rp 0 | Rp 402.784 | Rp 0 | Rp 0 | Rp 227.500 | Rp 0 | Rp 0 | Rp 0 | Rp 175.284 | ||
| 12 | 2026/04/17/000149 | 063019 | SRIMADI BINTI ALIPIAH | Unit IGD | BPJS | dr. Muhammad Akip Aprianto | 2026-04-17 | 14:55:10 | Sudah | Belum Bayar | - | Rp 0 | Rp 162.500 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 162.500 | Rp 0 | Rp 0 | ||
| 13 | 2026/04/17/000147 | 126783 | AISYAH NURAYU FERDIANSYAH | Unit IGD | BPJS | dr. Muhammad Akip Aprianto | 2026-04-17 | 14:27:32 | Berkas Diterima | Belum Bayar |
0603R0010426V002185 INACBG: 0 |
Rp 0 | Rp 116.536 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 116.536 | ||
| 14 | 2026/04/17/000146 | 223829 | NAPSIAH | Unit IGD | BPJS | dr. Mayasari Rizki Utami | 2026-04-17 | 13:42:57 | Sudah | Belum Bayar | - | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 15 | 2026/04/17/000144 | 223828 | NASILVA AINA MAHARANI | Unit IGD | UMUM | dr. Mayasari Rizki Utami | 2026-04-17 | 13:27:04 | Sudah | Sudah Bayar | - | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 16 | 2026/04/17/000128 | 222639 | NIRWANA | Unit IGD | UMUM | dr. Mayasari Rizki Utami | 2026-04-17 | 13:21:39 | Sudah | Sudah Bayar | - | Rp 0 | Rp 64.218 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 12.218 | ||
| 17 | 2026/04/17/000143 | 043559 | RUPIAH BINTI AMIRIN | Poli Penyakit Dalam | BPJS | dr. Made Suwarno, Sp.PD.,M.Biomed | 2026-04-17 | 13:04:58 | Sudah | Belum Bayar |
0603R0010426V002176 INACBG: 0 |
Rp 0 | Rp 85.105 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 7.105 | ||
| 18 | 2026/04/17/000140 | 223372 | KURNIA SARI | Unit IGD | UMUM | dr. Mayasari Rizki Utami | 2026-04-17 | 12:35:57 | Sudah | Sudah Bayar | - | Rp 0 | Rp 301.126 | Rp 0 | Rp 0 | Rp 211.250 | Rp 0 | Rp 0 | Rp 0 | Rp 89.876 | ||
| 19 | 2026/04/17/000136 | 217153 | RINI SUPRIHATIN | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 12:12:11 | Sudah | Belum Bayar |
0603R0010426V002171 INACBG: 0 |
Rp 0 | Rp 859.810 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 781.810 | ||
| 20 | 2026/04/17/000139 | 109680 | GABRIEL PRASAJA | Poli Anak | BPJS | dr. T. Mirda Zulaicha, M.Ked (Ped), Sp.A | 2026-04-17 | 12:07:30 | Sudah | Belum Bayar |
0603R0010426V002167 INACBG: 0 |
Rp 0 | Rp 276.233 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 198.233 | ||
| 21 | 2026/04/17/000138 | 208283 | WILISTRI BINTI SUHARI | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 12:05:23 | Sudah | Belum Bayar |
0603R0010426V002165 INACBG: 0 |
Rp 0 | Rp 299.587 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 221.587 | ||
| 22 | 2026/04/17/000137 | 210605 | MULYANA BINTI SEKANA | Poli Mata | BPJS | dr. H. Ismi Wildani, Sp.M | 2026-04-17 | 12:04:14 | Sudah | Belum Bayar |
0603R0010426V002164 INACBG: 0 |
Rp 0 | Rp 144.722 | Rp 0 | Rp 0 | Rp 109.850 | Rp 0 | Rp 0 | Rp 0 | Rp 34.872 | ||
| 23 | 2026/04/17/000009 | 128271 | M. FAHLI | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 12:03:37 | Sudah | Belum Bayar |
0603R0010426V002163 INACBG: 0 |
Rp 0 | Rp 350.400 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 272.400 | ||
| 24 | 2026/04/17/000055 | 136775 | FIRMAN BIN ADAM | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 12:03:07 | Sudah | Belum Bayar |
0603R0010426V002162 INACBG: 0 |
Rp 0 | Rp 138.345 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 60.345 | ||
| 25 | 2026/04/17/000126 | 124971 | IMAM SAFII | Poli Bedah | BPJS | dr. Faisal Muttaqien, Sp. B | 2026-04-17 | 12:01:29 | Berkas Diterima | Belum Bayar |
0603R0010426V002127 INACBG: 0 |
Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 26 | 2026/04/17/000133 | 223825 | MELISA BINTI HAMIRI | Poli Penyakit Dalam | BPJS | dr. Made Suwarno, Sp.PD.,M.Biomed | 2026-04-17 | 12:01:19 | Sudah | Belum Bayar |
0603R0010426V002149 INACBG: 0 |
Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 27 | 2026/04/17/000058 | 223805 | SRI HARTATIEK | Poli Mata | BPJS | dr. H. Ismi Wildani, Sp.M | 2026-04-17 | 12:01:13 | Sudah | Belum Bayar |
0603R0010426V002156 INACBG: 0 |
Rp 0 | Rp 125.291 | Rp 0 | Rp 0 | Rp 109.850 | Rp 0 | Rp 0 | Rp 0 | Rp 15.441 | ||
| 28 | 2026/04/17/000059 | 210294 | ABU YAMIN | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 12:00:58 | Sudah | Belum Bayar |
0603R0010426V002160 INACBG: 0 |
Rp 0 | Rp 147.452 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 69.452 | ||
| 29 | 2026/04/17/000135 | 220928 | NELIANI | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 12:00:06 | Sudah | Belum Bayar |
0603R0010426V002159 INACBG: 0 |
Rp 0 | Rp 190.120 | Rp 0 | Rp 0 | Rp 163.000 | Rp 0 | Rp 0 | Rp 0 | Rp 27.120 | ||
| 30 | 2026/04/17/000118 | 053021 | NURHAYATI BINTI TARJO | Poli Saraf | BPJS | dr. Tri Susanti, Sp.N. | 2026-04-17 | 11:59:15 | Berkas Diterima | Belum Bayar |
0603R0010426V002118 INACBG: 0 |
Rp 0 | Rp 98.330 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 20.330 | ||
| 31 | 2026/04/17/000023 | 120956 | SUHAIMI | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 11:57:19 | Sudah | Belum Bayar |
0603R0010426V002153 INACBG: 0 |
Rp 0 | Rp 125.222 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 47.222 | ||
| 32 | 2026/04/17/000049 | 219229 | ZAINAL ABIDIN | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 11:55:14 | Sudah | Belum Bayar |
0603R0010426V002151 INACBG: 0 |
Rp 0 | Rp 350.400 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 272.400 | ||
| 33 | 2026/04/17/000134 | 085020 | NURMALIA BINTI MUCHTAR ABDULLAH | Poli Saraf | BPJS | dr. Tri Susanti, Sp.N. | 2026-04-17 | 11:54:20 | Sudah | Belum Bayar |
0603R0010426V002150 INACBG: 0 |
Rp 0 | Rp 264.914 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 186.914 | ||
| 34 | 2026/04/17/000132 | 133202 | RISCO FABIANSKY | Poli Kulit Kelamin | BPJS | dr. Reti Anggraeni, Sp.D.V | 2026-04-17 | 11:52:25 | Berkas Diterima | Belum Bayar |
0603R0010426V002142 INACBG: 0 |
Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 35 | 2026/04/17/000056 | 217823 | LISWANI BINTI SUPARDI | Poli Penyakit Dalam | BPJS | dr. Made Suwarno, Sp.PD.,M.Biomed | 2026-04-17 | 11:51:47 | Sudah | Belum Bayar |
0603R0010426V002146 INACBG: 0 |
Rp 0 | Rp 142.750 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 64.750 | ||
| 36 | 2026/04/17/000064 | 135928 | MUHAMMAD YUSUF | Poli Saraf | BPJS | dr. Tri Susanti, Sp.N. | 2026-04-17 | 11:49:37 | Sudah | Belum Bayar |
0603R0010426V002145 INACBG: 0 |
Rp 0 | Rp 136.584 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 58.584 | ||
| 37 | 2026/04/17/000113 | 003504 | HANAFI BIN BASRAH | Poli Bedah | BPJS | dr. Faisal Muttaqien, Sp. B | 2026-04-17 | 11:42:11 | Sudah | Belum Bayar |
0603R0010426V002114 INACBG: 0 |
Rp 0 | Rp 363.690 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 285.690 | ||
| 38 | 2026/04/17/000123 | 223823 | ZURIAH | Unit IGD | UMUM | dr. Mayasari Rizki Utami | 2026-04-17 | 11:41:53 | Sudah | Sudah Bayar | - | Rp 0 | Rp 66.199 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 14.199 | ||
| 39 | 2026/04/17/000121 | 222896 | DELI NILAWATI | Poli Penyakit Dalam | UMUM | dr. Made Suwarno, Sp.PD.,M.Biomed | 2026-04-17 | 11:41:12 | Sudah | Belum Bayar | - | Rp 0 | Rp 7.695 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 7.695 | ||
| 40 | 2026/04/17/000131 | 220434 | ZULKIPLI BIN ZAWAWI | Poli Saraf | BPJS | dr. Tri Susanti, Sp.N. | 2026-04-17 | 11:40:40 | Sudah | Belum Bayar |
0603R0010426V002143 INACBG: 0 |
Rp 0 | Rp 126.403 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 48.403 | ||
| 41 | 2026/04/17/000125 | 223824 | TEDDY WIJAYA | Unit IGD | UMUM | dr. Mayasari Rizki Utami | 2026-04-17 | 11:35:26 | Sudah | Sudah Bayar | - | Rp 0 | Rp 106.545 | Rp 0 | Rp 0 | Rp 97.500 | Rp 0 | Rp 0 | Rp 0 | Rp 9.045 | ||
| 42 | 2026/04/17/000130 | 138775 | RATNA NINGSIH | Poli Penyakit Dalam | BPJS | dr. Made Suwarno, Sp.PD.,M.Biomed | 2026-04-17 | 11:35:14 | Sudah | Belum Bayar |
0603R0010426V002139 INACBG: 0 |
Rp 0 | Rp 149.770 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 71.770 | ||
| 43 | 2026/04/17/000129 | 202351 | DAHLIMAH BINTI SIRAN | Poli Kulit Kelamin | BPJS | dr. Reti Anggraeni, Sp.D.V | 2026-04-17 | 11:27:10 | Sudah | Belum Bayar |
0603R0010426V002137 INACBG: 0 |
Rp 0 | Rp 126.975 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 48.975 | ||
| 44 | 2026/04/17/000110 | 223820 | ICHA APRYLIA | Poli Anak | BPJS | dr. T. Mirda Zulaicha, M.Ked (Ped), Sp.A | 2026-04-17 | 11:16:42 | Sudah | Belum Bayar |
0603R0010426V002129 INACBG: 0 |
Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 45 | 2026/04/17/000127 | 222702 | NOVITA AYU RAMADHANI | Poli Saraf | BPJS | dr. Tri Susanti, Sp.N. | 2026-04-17 | 11:09:33 | Sudah | Belum Bayar |
0603R0010426V002126 INACBG: 0 |
Rp 0 | Rp 113.550 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 35.550 | ||
| 46 | 2026/04/17/000107 | 223819 | MALIAN | Unit IGD | UMUM | dr. Mayasari Rizki Utami | 2026-04-17 | 11:09:26 | Sudah | Sudah Bayar | - | Rp 0 | Rp 66.037 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 14.037 | ||
| 47 | 2026/04/17/000124 | 136516 | MURSINA | Poli Penyakit Dalam | BPJS | dr. Made Suwarno, Sp.PD.,M.Biomed | 2026-04-17 | 11:06:28 | Sudah | Belum Bayar |
0603R0010426V002124 INACBG: 0 |
Rp 0 | Rp 193.057 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 115.057 | ||
| 48 | 2026/04/17/000003 | 223242 | ZAIRONI ABDULLAH | Poli Bedah | BPJS | dr. Faisal Muttaqien, Sp. B | 2026-04-17 | 11:04:46 | Sudah | Belum Bayar |
0603R0010426V002125 INACBG: 0 |
Rp 0 | Rp 135.330 | Rp 0 | Rp 0 | Rp 135.330 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 49 | 2026/04/17/000102 | 207998 | DULHASAN bin HASAN BASRI | Unit IGD | UMUM | dr. Mayasari Rizki Utami | 2026-04-17 | 11:03:48 | Sudah | Sudah Bayar | - | Rp 0 | Rp 67.616 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 15.616 | ||
| 50 | 2026/04/17/000122 | 008443 | BURHANUDDIN BIN NUSPIH | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 11:02:29 | Sudah | Belum Bayar |
0603R0010426V002123 INACBG: 0 |
Rp 0 | Rp 467.198 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 351.000 | Rp 0 | Rp 38.198 | ||
| 51 | 2026/04/17/000101 | 223818 | ARBAAH | Poli Saraf | BPJS | dr. Tri Susanti, Sp.N. | 2026-04-17 | 11:00:56 | Berkas Diterima | Belum Bayar |
0603R0010426V002102 INACBG: 0 |
Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 52 | 2026/04/17/000116 | 095417 | ALYA | Poli Prostodonti | BPJS | drg. Budi, Sp.Pros | 2026-04-17 | 11:00:52 | Berkas Diterima | Belum Bayar | - | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 53 | 2026/04/17/000120 | 223372 | KURNIA SARI | Poli Obgyn | BPJS | dr. Rivai Baharudin Yudha Putra, Sp.OG | 2026-04-17 | 10:52:40 | Sudah | Belum Bayar |
0603R0010426V002120 INACBG: 0 |
Rp 0 | Rp 110.577 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 32.577 | ||
| 54 | 2026/04/17/000119 | 217966 | MARYANI FAULINA | Poli THT-KL | BPJS | dr. Ita Wahyuni, Sp. THT-KL | 2026-04-17 | 10:51:19 | Sudah | Belum Bayar |
0603R0010426V002119 INACBG: 0 |
Rp 0 | Rp 79.240 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 1.240 | ||
| 55 | 2026/04/17/000115 | 223821 | MUHAMMAD AGUNG MAHAPUTRA | Poli Umum | UMUM | dr. Anggun Nurul Fitria | 2026-04-17 | 10:38:17 | Berkas Diterima | Belum Bayar | - | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 56 | 2026/04/17/000114 | 097055 | RUSMAN BIN ASIM | Poli Kulit Kelamin | BPJS | dr. Reti Anggraeni, Sp.D.V | 2026-04-17 | 10:38:12 | Sudah | Belum Bayar |
0603R0010426V002115 INACBG: 0 |
Rp 0 | Rp 103.723 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 25.723 | ||
| 57 | 2026/04/17/000108 | 223478 | MASNUN | Poli Saraf | BPJS | dr. Tri Susanti, Sp.N. | 2026-04-17 | 10:36:42 | Sudah | Belum Bayar |
0603R0010426V002107 INACBG: 0 |
Rp 0 | Rp 118.048 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 40.048 | ||
| 58 | 2026/04/17/000112 | 214193 | MUHAMMAD NASBIH AL BARRA | Poli THT-KL | BPJS | dr. Ita Wahyuni, Sp. THT-KL | 2026-04-17 | 10:34:44 | Sudah | Belum Bayar |
0603R0010426V002113 INACBG: 0 |
Rp 0 | Rp 422.197 | Rp 0 | Rp 0 | Rp 372.285 | Rp 0 | Rp 0 | Rp 0 | Rp 49.912 | ||
| 59 | 2026/04/17/000111 | 223779 | AHMAD AZZAM AL HAFIZH | Poli THT-KL | BPJS | dr. Ita Wahyuni, Sp. THT-KL | 2026-04-17 | 10:34:24 | Sudah | Belum Bayar |
0603R0010426V002158 INACBG: 0 |
Rp 0 | Rp 130.072 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 52.072 | ||
| 60 | 2026/04/17/000037 | 136052 | KASINTEN BINTI MUKAYAT | Poli Hemodialisa | BPJS | dr. Deddy Primadona Mulia, Sp. PD - K.GH, FINASIM | 2026-04-17 | 10:33:38 | Sudah | Sudah Bayar |
0603R0010426V002112 INACBG: 0 |
Rp 0 | Rp 903.712 | Rp 0 | Rp 0 | Rp 850.000 | Rp 0 | Rp 0 | Rp 0 | Rp 53.712 | ||
| 61 | 2026/04/17/000048 | 210719 | WISNU ERLANGGA | Poli Hemodialisa | BPJS | dr. Deddy Primadona Mulia, Sp. PD - K.GH, FINASIM | 2026-04-17 | 10:32:06 | Sudah | Sudah Bayar |
0603R0010426V002110 INACBG: 0 |
Rp 0 | Rp 929.070 | Rp 0 | Rp 0 | Rp 850.000 | Rp 0 | Rp 0 | Rp 0 | Rp 79.070 | ||
| 62 | 2026/04/17/000068 | 034809 | SUDARSIH BINTI SUGIHARSONO | Poli Hemodialisa | BPJS | dr. Deddy Primadona Mulia, Sp. PD - K.GH, FINASIM | 2026-04-17 | 10:31:33 | Sudah | Sudah Bayar |
0603R0010426V002108 INACBG: 0 |
Rp 0 | Rp 1.018.670 | Rp 0 | Rp 0 | Rp 850.000 | Rp 0 | Rp 0 | Rp 0 | Rp 168.670 | ||
| 63 | 2026/04/17/000109 | 209538 | KASBIRAN BIN AHMAD | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 10:31:08 | Sudah | Belum Bayar |
0603R0010426V002109 INACBG: 0 |
Rp 0 | Rp 395.400 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 317.400 | ||
| 64 | 2026/04/17/000027 | 079076 | SUHARDI BIN YUSUF | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 10:30:00 | Sudah | Belum Bayar |
0603R0010426V002106 INACBG: 0 |
Rp 0 | Rp 118.038 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 40.038 | ||
| 65 | 2026/04/17/000106 | 209290 | NUR ASMARAN BIN MAHRI | Poli Penyakit Dalam | BPJS | dr. Made Suwarno, Sp.PD.,M.Biomed | 2026-04-17 | 10:23:10 | Berkas Diterima | Belum Bayar | - | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 66 | 2026/04/17/000105 | 020270 | NURBAITI BINTI MAHFI HASAN | Poli Penyakit Dalam | BPJS | dr. Made Suwarno, Sp.PD.,M.Biomed | 2026-04-17 | 10:20:43 | Berkas Diterima | Belum Bayar | - | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 67 | 2026/04/17/000104 | 056472 | OKTARINI BINTI AGONI | Poli Penyakit Dalam | BPJS | dr. Made Suwarno, Sp.PD.,M.Biomed | 2026-04-17 | 10:18:02 | Sudah | Belum Bayar |
0603R0010426V002105 INACBG: 0 |
Rp 0 | Rp 133.752 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 55.752 | ||
| 68 | 2026/04/17/000097 | 212248 | DESI | Poli Penyakit Dalam | BPJS | dr. Made Suwarno, Sp.PD.,M.Biomed | 2026-04-17 | 10:17:47 | Sudah | Belum Bayar |
0603R0010426V002098 INACBG: 0 |
Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 69 | 2026/04/17/000100 | 106401 | ARUMI NASHA RAZITA | Poli THT-KL | UMUM | dr. Ita Wahyuni, Sp. THT-KL | 2026-04-17 | 10:17:26 | Sudah | Sudah Bayar | - | Rp 0 | Rp 229.743 | Rp 0 | Rp 0 | Rp 229.743 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 70 | 2026/04/17/000060 | 223806 | DAVID | Unit IGD | UMUM | dr. Mayasari Rizki Utami | 2026-04-17 | 10:17:12 | Sudah | Sudah Bayar | - | Rp 0 | Rp 446.098 | Rp 0 | Rp 0 | Rp 97.500 | Rp 325.000 | Rp 0 | Rp 0 | Rp 23.598 | ||
| 71 | 2026/04/17/000011 | 223773 | BENI | Poli Penyakit Dalam | BPJS | dr. Made Suwarno, Sp.PD.,M.Biomed | 2026-04-17 | 10:15:22 | Sudah | Belum Bayar |
0603R0010426V002104 INACBG: 0 |
Rp 0 | Rp 84.860 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 6.860 | ||
| 72 | 2026/04/17/000103 | 041397 | PATMAWATI BINTI M ZAHRI | Poli Bedah | BPJS | dr. Faisal Muttaqien, Sp. B | 2026-04-17 | 10:13:15 | Sudah | Belum Bayar |
0603R0010426V002103 INACBG: 0 |
Rp 0 | Rp 135.330 | Rp 0 | Rp 0 | Rp 135.330 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 73 | 2026/04/17/000002 | 133121 | HERTINI BINTI ZAWAWI | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 10:09:56 | Sudah | Belum Bayar |
0603R0010426V002101 INACBG: 0 |
Rp 0 | Rp 139.393 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 61.393 | ||
| 74 | 2026/04/17/000067 | 223270 | AYIB IBRAHIM | Poli Penyakit Dalam | BPJS | dr. Made Suwarno, Sp.PD.,M.Biomed | 2026-04-17 | 10:07:21 | Sudah | Belum Bayar |
0603R0010426V002076 INACBG: 0 |
Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 75 | 2026/04/17/000033 | 197187 | SYAMSUDIN | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 10:06:40 | Sudah | Belum Bayar |
0603R0010426V002100 INACBG: 0 |
Rp 0 | Rp 284.412 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 149.500 | Rp 0 | Rp 56.912 | ||
| 76 | 2026/04/17/000099 | 223252 | ELEN JUWITA SARI | Poli Obgyn | BPJS | dr. Rivai Baharudin Yudha Putra, Sp.OG | 2026-04-17 | 10:06:29 | Sudah | Belum Bayar |
0603R0010426V002099 INACBG: 0 |
Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 77 | 2026/04/17/000094 | 223817 | EDY IRAWANSYAH | Poli Kulit Kelamin | UMUM | dr. Reti Anggraeni, Sp.D.V | 2026-04-17 | 10:06:02 | Sudah | Sudah Bayar | - | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 78 | 2026/04/17/000098 | 220857 | ALEN BINTI ALEX | Poli THT-KL | BPJS | dr. Ita Wahyuni, Sp. THT-KL | 2026-04-17 | 10:05:37 | Sudah | Belum Bayar |
0603R0010426V002169 INACBG: 0 |
Rp 0 | Rp 418.280 | Rp 0 | Rp 0 | Rp 372.285 | Rp 0 | Rp 0 | Rp 0 | Rp 45.995 | ||
| 79 | 2026/04/17/000096 | 197695 | LINDAWATI | Poli Bedah | UMUM | dr. Faisal Muttaqien, Sp. B | 2026-04-17 | 10:03:02 | Sudah | Sudah Bayar | - | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 80 | 2026/04/17/000029 | 111401 | SUHARDIMAN MATTAHAN | Poli Saraf | BPJS | dr. Tri Susanti, Sp.N. | 2026-04-17 | 10:00:23 | Sudah | Belum Bayar |
0603R0010426V002095 INACBG: 0 |
Rp 0 | Rp 118.638 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 40.638 | ||
| 81 | 2026/04/17/000093 | 223812 | MUHAMMAD HUSIN PASHA | Unit IGD | BPJS | dr. Mayasari Rizki Utami | 2026-04-17 | 09:58:33 | Sudah | Belum Bayar | - | Rp 0 | Rp 351.626 | Rp 0 | Rp 0 | Rp 227.500 | Rp 0 | Rp 0 | Rp 0 | Rp 124.126 | ||
| 82 | 2026/04/17/000090 | 223816 | CINAN | Poli Saraf | UMUM | dr. Tri Susanti, Sp.N. | 2026-04-17 | 09:58:11 | Sudah | Sudah Bayar | - | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 83 | 2026/04/17/000092 | 223504 | HERI IRAMA | Poli Saraf | BPJS | dr. Tri Susanti, Sp.N. | 2026-04-17 | 09:58:01 | Sudah | Belum Bayar |
0603R0010426V002094 INACBG: 0 |
Rp 0 | Rp 112.761 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 34.761 | ||
| 84 | 2026/04/17/000091 | 010055 | SAKDIYAH BINTI TANDOK | Poli Mata | BPJS | dr. H. Ismi Wildani, Sp.M | 2026-04-17 | 09:56:15 | Sudah | Belum Bayar |
0603R0010426V002092 INACBG: 0 |
Rp 0 | Rp 151.896 | Rp 0 | Rp 0 | Rp 109.850 | Rp 0 | Rp 0 | Rp 0 | Rp 42.046 | ||
| 85 | 2026/04/17/000085 | 010055 | SAKDIYAH BINTI TANDOK | Poli Mata | BPJS | dr. H. Ismi Wildani, Sp.M | 2026-04-17 | 09:53:25 | Sudah | Belum Bayar | - | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 86 | 2026/04/17/000006 | 127075 | FARIDA ARIANI | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 09:52:27 | Sudah | Belum Bayar |
0603R0010426V002090 INACBG: 0 |
Rp 0 | Rp 873.033 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 795.033 | ||
| 87 | 2026/04/17/000001 | 138101 | M. AKIP BIN M TEGUH | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 09:51:12 | Sudah | Belum Bayar |
0603R0010426V002089 INACBG: 0 |
Rp 0 | Rp 596.646 | Rp 0 | Rp 0 | Rp 528.000 | Rp 0 | Rp 0 | Rp 0 | Rp 68.646 | ||
| 88 | 2026/04/17/000089 | 223815 | ABDUL BAKI | Unit IGD | UMUM | dr. Mayasari Rizki Utami | 2026-04-17 | 09:51:03 | Sudah | Sudah Bayar | - | Rp 0 | Rp 123.500 | Rp 0 | Rp 0 | Rp 123.500 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 89 | 2026/04/17/000087 | 133172 | FANI EFFENDY | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 09:50:20 | Belum | Belum Bayar | - | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 90 | 2026/04/17/000088 | 223814 | ANDI MAISYAROH | Unit IGD | UMUM | dr. Mayasari Rizki Utami | 2026-04-17 | 09:50:08 | Sudah | Sudah Bayar | - | Rp 0 | Rp 123.500 | Rp 0 | Rp 0 | Rp 123.500 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 91 | 2026/04/17/000041 | 223800 | KARBELA BELA | Poli Mata | BPJS | dr. H. Ismi Wildani, Sp.M | 2026-04-17 | 09:49:28 | Sudah | Belum Bayar |
0603R0010426V002088 INACBG: 0 |
Rp 0 | Rp 419.783 | Rp 0 | Rp 0 | Rp 109.850 | Rp 0 | Rp 287.300 | Rp 0 | Rp 22.633 | ||
| 92 | 2026/04/17/000086 | 223813 | RISTIA RIZKY YANI | Poli Umum | UMUM | dr. Nining Sariwati | 2026-04-17 | 09:49:23 | Sudah | Sudah Bayar | - | Rp 0 | Rp 39.000 | Rp 0 | Rp 0 | Rp 39.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 93 | 2026/04/17/000013 | 004240 | ISRO"I | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 09:46:47 | Sudah | Belum Bayar |
0603R0010426V002161 INACBG: 0 |
Rp 0 | Rp 97.058 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 19.058 | ||
| 94 | 2026/04/17/000026 | 045234 | M.DENHAR | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 09:46:37 | Sudah | Belum Bayar |
0603R0010426V002087 INACBG: 0 |
Rp 0 | Rp 384.046 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 306.046 | ||
| 95 | 2026/04/17/000004 | 204700 | ZULKIPLI BIN HAKI | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 09:45:00 | Sudah | Belum Bayar |
0603R0010426V002086 INACBG: 0 |
Rp 0 | Rp 108.450 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 30.450 | ||
| 96 | 2026/04/17/000081 | 028322 | NIA NATALIA | Poli Penyakit Dalam | BPJS | dr. Made Suwarno, Sp.PD.,M.Biomed | 2026-04-17 | 09:44:06 | Sudah | Belum Bayar |
0603R0010426V002085 INACBG: 0 |
Rp 0 | Rp 88.248 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 10.248 | ||
| 97 | 2026/04/17/000046 | 015376 | MUHAMMAD ZAHRI | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 09:42:25 | Sudah | Belum Bayar |
0603R0010426V002084 INACBG: 0 |
Rp 0 | Rp 583.389 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 505.389 | ||
| 98 | 2026/04/17/000080 | 223810 | WILDAN JATI ATRIYA | Poli Umum | UMUM | dr. Anggun Nurul Fitria | 2026-04-17 | 09:42:16 | Sudah | Sudah Bayar | - | Rp 0 | Rp 215.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 195.000 | Rp 0 | Rp 0 | ||
| 99 | 2026/04/17/000079 | 136324 | TOHIR YULIAWAN | Poli Bedah | BPJS | dr. Faisal Muttaqien, Sp. B | 2026-04-17 | 09:41:23 | Sudah | Belum Bayar |
0603R0010426V002083 INACBG: 0 |
Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 100 | 2026/04/17/000073 | 222180 | JAINAB | Poli Bedah | BPJS | dr. Faisal Muttaqien, Sp. B | 2026-04-17 | 09:38:23 | Sudah | Belum Bayar |
0603R0010426V002080 INACBG: 0 |
Rp 0 | Rp 142.478 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 64.478 | ||
| 101 | 2026/04/17/000076 | 123020 | ANUGRAH AKBAR | Unit IGD | UMUM | dr. Mayasari Rizki Utami | 2026-04-17 | 09:38:04 | Sudah | Sudah Bayar | - | Rp 0 | Rp 599.600 | Rp 0 | Rp 0 | Rp 97.500 | Rp 487.500 | Rp 0 | Rp 0 | Rp 14.600 | ||
| 102 | 2026/04/17/000075 | 115155 | FATIMAH BINTI ABU BAKAR | Poli Kulit Kelamin | BPJS | dr. Reti Anggraeni, Sp.D.V | 2026-04-17 | 09:37:45 | Sudah | Belum Bayar |
0603R0010426V002133 INACBG: 0 |
Rp 0 | Rp 91.602 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 13.602 | ||
| 103 | 2026/04/17/000034 | 064151 | NABILA RACHNA SAHIRA | Poli Anak | BPJS | dr. T. Mirda Zulaicha, M.Ked (Ped), Sp.A | 2026-04-17 | 09:37:28 | Sudah | Belum Bayar |
0603R0010426V002079 INACBG: 0 |
Rp 0 | Rp 317.102 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 221.000 | Rp 0 | Rp 18.102 | ||
| 104 | 2026/04/17/000074 | 223809 | MUHAMAD CERAH | Poli Umum | UMUM | dr. Nining Sariwati | 2026-04-17 | 09:36:47 | Sudah | Sudah Bayar | - | Rp 0 | Rp 39.000 | Rp 0 | Rp 0 | Rp 39.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 105 | 2026/04/17/000062 | 223807 | MUHAMMAD RASYIQUL HABIB | Unit IGD | UMUM | dr. Mayasari Rizki Utami | 2026-04-17 | 09:34:25 | Sudah | Sudah Bayar | - | Rp 0 | Rp 174.700 | Rp 0 | Rp 0 | Rp 20.000 | Rp 0 | Rp 154.700 | Rp 0 | Rp 0 | ||
| 106 | 2026/04/17/000072 | 223439 | EL ARDIAN AZHARI | Poli Penyakit Dalam | BPJS | dr. Made Suwarno, Sp.PD.,M.Biomed | 2026-04-17 | 09:34:16 | Belum | Belum Bayar | - | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 107 | 2026/04/17/000071 | 109371 | KAUSAR | Poli THT-KL | BPJS | dr. Widya Adiarti Minwal, Sp. THT-KL | 2026-04-17 | 09:32:21 | Sudah | Belum Bayar |
0603R0010426V002078 INACBG: 0 |
Rp 0 | Rp 597.698 | Rp 0 | Rp 0 | Rp 539.035 | Rp 0 | Rp 0 | Rp 0 | Rp 58.663 | ||
| 108 | 2026/04/17/000070 | 220474 | LINA | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 09:32:14 | Sudah | Belum Bayar |
0603R0010426V002168 INACBG: 0 |
Rp 0 | Rp 364.620 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 286.620 | ||
| 109 | 2026/04/17/000025 | 222896 | DELI NILAWATI | Poli Penyakit Dalam | BPJS | dr. Made Suwarno, Sp.PD.,M.Biomed | 2026-04-17 | 09:31:03 | Sudah | Belum Bayar |
0603R0010426V002147 INACBG: 0 |
Rp 0 | Rp 103.740 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 25.740 | ||
| 110 | 2026/04/17/000069 | 223709 | ABDURRAHMAN | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 09:29:10 | Sudah | Belum Bayar |
0603R0010426V002077 INACBG: 0 |
Rp 0 | Rp 464.973 | Rp 0 | Rp 0 | Rp 450.000 | Rp 0 | Rp 0 | Rp 0 | Rp 14.973 | ||
| 111 | 2026/04/17/000066 | 223808 | RICKY | Poli Umum | UMUM | dr. Nining Sariwati | 2026-04-17 | 09:28:03 | Sudah | Belum Bayar | - | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 112 | 2026/04/17/000065 | 214873 | DAMSI | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 09:25:04 | Sudah | Belum Bayar |
0603R0010426V002075 INACBG: 0 |
Rp 0 | Rp 739.772 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 661.772 | ||
| 113 | 2026/04/17/000022 | 115184 | JUNAIDI bin HAMBALI | Poli Penyakit Dalam | BPJS | dr. Made Suwarno, Sp.PD.,M.Biomed | 2026-04-17 | 09:21:04 | Sudah | Belum Bayar |
0603R0010426V002074 INACBG: 0 |
Rp 0 | Rp 611.478 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 533.478 | ||
| 114 | 2026/04/17/000063 | 033109 | HOLIDI | Unit IGD | BPJS | dr. Mayasari Rizki Utami | 2026-04-17 | 09:18:41 | Berkas Diterima | Belum Bayar |
0603R0010426V002172 INACBG: 0 |
Rp 0 | Rp 195.000 | Rp 0 | Rp 0 | Rp 195.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 115 | 2026/04/17/000054 | 223254 | RISKI ADITIA | Poli Bedah | BPJS | dr. Faisal Muttaqien, Sp. B | 2026-04-17 | 08:56:47 | Berkas Diterima | Belum Bayar |
0603R0010426V002155 INACBG: 0 |
Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 116 | 2026/04/17/000053 | 059026 | M. MUCHTAR | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 08:53:12 | Sudah | Belum Bayar |
0603R0010426V002152 INACBG: 0 |
Rp 0 | Rp 366.918 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 288.918 | ||
| 117 | 2026/04/17/000052 | 223804 | BAIYATI BINTI M SOLEH | Poli Saraf | UMUM | dr. Tri Susanti, Sp.N. | 2026-04-17 | 08:52:33 | Sudah | Sudah Bayar | - | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 118 | 2026/04/17/000050 | 223490 | MECY KARTIKA | Poli Obgyn | UMUM | dr. Rivai Baharudin Yudha Putra, Sp.OG | 2026-04-17 | 08:45:26 | Sudah | Sudah Bayar | - | Rp 0 | Rp 188.500 | Rp 0 | Rp 0 | Rp 188.500 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 119 | 2026/04/17/000045 | 223802 | OKTARINA BINTI SARNUBI | Poli Jantung dan Pembuluh Darah | UMUM | dr. Imran, Sp.PD- KKV | 2026-04-17 | 08:41:01 | Sudah | Sudah Bayar | - | Rp 0 | Rp 613.000 | Rp 0 | Rp 0 | Rp 613.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 120 | 2026/04/17/000044 | 221017 | MARIO SEPTIAWAN | Poli Umum | UMUM | dr. Anggun Nurul Fitria | 2026-04-17 | 08:35:35 | Sudah | Sudah Bayar | - | Rp 0 | Rp 39.000 | Rp 0 | Rp 0 | Rp 39.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 121 | 2026/04/17/000030 | 223797 | UWAIS DIVIINO | Unit IGD | UMUM | dr. Mayasari Rizki Utami | 2026-04-17 | 08:33:19 | Sudah | Sudah Bayar | - | Rp 0 | Rp 409.085 | Rp 0 | Rp 0 | Rp 114.000 | Rp 0 | Rp 195.000 | Rp 0 | Rp 100.085 | ||
| 122 | 2026/04/17/000061 | 223504 | HERI IRAMA | Poli Saraf | BPJS | dr. Tri Susanti, Sp.N. | 2026-04-17 | 08:30:00 | Batal | Belum Bayar | - | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 123 | 2026/04/17/000005 | 223292 | HOLIJAH BINTI ABDULRAHMAN | Poli Bedah | BPJS | dr. Faisal Muttaqien, Sp. B | 2026-04-17 | 08:26:06 | Sudah | Belum Bayar |
0603R0010426V002140 INACBG: 0 |
Rp 0 | Rp 135.330 | Rp 0 | Rp 0 | Rp 135.330 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 124 | 2026/04/17/000043 | 220692 | M.RASYID ANDRIAN | Poli Prostodonti | BPJS | drg. Budi, Sp.Pros | 2026-04-17 | 08:26:03 | Sudah | Belum Bayar |
0603R0010426V002141 INACBG: 0 |
Rp 0 | Rp 241.800 | Rp 0 | Rp 0 | Rp 241.800 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 125 | 2026/04/17/000042 | 223801 | MEI SYANA | Poli Umum | UMUM | dr. Nining Sariwati | 2026-04-17 | 08:24:51 | Sudah | Sudah Bayar | - | Rp 0 | Rp 39.000 | Rp 0 | Rp 0 | Rp 39.000 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 126 | 2026/04/17/000007 | 114276 | HUSIN SULAIMAN | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 08:20:27 | Sudah | Belum Bayar |
0603R0010426V002138 INACBG: 0 |
Rp 0 | Rp 394.900 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 316.900 | ||
| 127 | 2026/04/17/000040 | 223799 | RITA FEBIANA | Poli Umum | UMUM | dr. Nining Sariwati | 2026-04-17 | 08:13:25 | Berkas Diterima | Belum Bayar | - | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 128 | 2026/04/17/000036 | 201254 | RINA ANISA | Poli Umum | UMUM | dr. Nining Sariwati | 2026-04-17 | 08:08:39 | Berkas Diterima | Belum Bayar | - | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 129 | 2026/04/17/000038 | 012007 | EVI BINTI MUSTOFA | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 08:08:24 | Sudah | Belum Bayar |
0603R0010426V002131 INACBG: 0 |
Rp 0 | Rp 130.285 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 52.285 | ||
| 130 | 2026/04/17/000039 | 041397 | PATMAWATI BINTI M ZAHRI | Poli Bedah | BPJS | dr. Faisal Muttaqien, Sp. B | 2026-04-17 | 08:00:00 | Belum | Belum Bayar | - | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 131 | 2026/04/17/000031 | 015860 | RISTA AMALIA | Poli Penyakit Dalam | BPJS | dr. Tri Nisdian Wardiah, Sp.PD | 2026-04-17 | 08:00:00 | Belum | Belum Bayar | - | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | Rp 0 | ||
| 132 | 2026/04/17/000035 | 223798 | WENDI | Poli Bedah | BPJS | dr. Faisal Muttaqien, Sp. B | 2026-04-17 | 07:59:00 | Sudah | Belum Bayar |
0603R0010426V002116 INACBG: 0 |
Rp 0 | Rp 651.300 | Rp 0 | Rp 0 | Rp 78.000 | Rp 162.500 | Rp 410.800 | Rp 0 | Rp 0 | ||
| 133 | 2026/04/17/000010 | 006705 | SUHARDI HERMI | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 07:54:53 | Sudah | Belum Bayar |
0603R0010426V002091 INACBG: 0 |
Rp 0 | Rp 154.860 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 76.860 | ||
| 134 | 2026/04/17/000008 | 132526 | ABU HANIFAH | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 07:50:57 | Sudah | Belum Bayar |
0603R0010426V002096 INACBG: 0 |
Rp 0 | Rp 93.195 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 15.195 | ||
| 135 | 2026/04/17/000014 | 216419 | A MINAH | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 07:49:55 | Sudah | Belum Bayar |
0603R0010426V002134 INACBG: 0 |
Rp 0 | Rp 131.385 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 53.385 | ||
| 136 | 2026/04/17/000032 | 113129 | MULYADI BIN MUSIRAN | Poli Jantung dan Pembuluh Darah | BPJS | dr. Imran, Sp.PD- KKV | 2026-04-17 | 07:43:10 | Berkas Diterima | Belum Bayar |
0603R0010426V002128 INACBG: 0 |
Rp 0 | Rp 92.040 | Rp 0 | Rp 0 | Rp 78.000 | Rp 0 | Rp 0 | Rp 0 | Rp 14.040 | ||
| 137 | 2026/04/17/000020 | 223508 | SITI TIARA KIRANA MENTARI | Unit IGD | UMUM | dr. Desy Manda Sari | 2026-04-17 | 07:13:02 | Sudah | Sudah Bayar | - | Rp 0 | Rp 65.175 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 13.175 | ||
| 138 | 2026/04/17/000018 | 223795 | SYAHDIAH ANAKA NISAGULU | Unit IGD | UMUM | dr. Desy Manda Sari | 2026-04-17 | 07:09:28 | Belum | Sudah Bayar | - | Rp 0 | Rp 124.152 | Rp 0 | Rp 0 | Rp 91.000 | Rp 0 | Rp 0 | Rp 0 | Rp 33.152 | ||
| 139 | 2026/04/17/000016 | 138042 | YOGI ARDIANSYAH PUTRA | Unit IGD | UMUM | dr. Anggun Nurul Fitria | 2026-04-17 | 06:50:42 | Sudah | Sudah Bayar | - | Rp 0 | Rp 802.246 | Rp 0 | Rp 0 | Rp 367.500 | Rp 325.000 | Rp 0 | Rp 0 | Rp 109.746 | ||
| 140 | 2026/04/17/000017 | 034810 | RIZKA AMELIA PRATIWI | Unit IGD | UMUM | dr. Desy Manda Sari | 2026-04-17 | 04:32:35 | Sudah | Sudah Bayar | - | Rp 0 | Rp 99.391 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 47.391 | ||
| 141 | 2026/04/17/000015 | 206546 | TRIA FIKI ULANDARI | Unit IGD | UMUM | dr. Desy Manda Sari | 2026-04-17 | 00:11:34 | Sudah | Sudah Bayar | - | Rp 0 | Rp 54.390 | Rp 0 | Rp 0 | Rp 52.000 | Rp 0 | Rp 0 | Rp 0 | Rp 2.390 | ||
| TOTAL | Rp 0 | Rp 31.350.261 | Rp 0 | Rp 0 | Rp 16.532.288 | Rp 1.787.500 | Rp 3.594.500 | Rp 0 | Rp 9.415.973 | |||||||||||||