|
1101 |
42512180008 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
123 |
42512180008 |
F000001 |
|
Paracetamol |
IDR |
|
0.000000000000 |
100.000000000000 |
1500.000000000000 |
0.000000000000 |
0.000000000000 |
150000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
42512180008 |
|
42512180008 |
|
|
1900-01-01 00:00:00.000000 |
150000.000000000000 |
0.000000000000 |
ren |
1 |
5639004188 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1102 |
22512200002 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
390 |
22512200002 |
A000003 |
|
Rawat Inap |
IDR |
|
0.000000000000 |
1.000000000000 |
500000.000000000000 |
0.000000000000 |
0.000000000000 |
500000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22512200002 |
|
22512200002 |
|
|
1900-01-01 00:00:00.000000 |
500000.000000000000 |
0.000000000000 |
ren |
1 |
5639004444 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1103 |
22601120001 |
2026-04-04 14:00:51.000000 |
3.000000000000 |
671 |
22601120001 |
D000001 |
|
Biaya dr. Umum |
IDR |
|
0.000000000000 |
1.000000000000 |
50000.000000000000 |
0.000000000000 |
0.000000000000 |
50000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22601120001 |
|
22601120001 |
|
|
1900-01-01 00:00:00.000000 |
50000.000000000000 |
0.000000000000 |
ren |
1 |
5639004700 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1104 |
42601150018 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
928 |
42601150018 |
F000001 |
|
Paracetamol |
IDR |
|
0.000000000000 |
1.000000000000 |
1500.000000000000 |
0.000000000000 |
0.000000000000 |
1500.000000000000 |
|
|
|
0.000000000000 |
0 |
|
42601150018 |
|
42601150018 |
|
|
1900-01-01 00:00:00.000000 |
1500.000000000000 |
0.000000000000 |
ren |
1 |
5639004956 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1105 |
42601230011 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1189 |
42601230011 |
F000003 |
|
Alerfed |
IDR |
|
0.000000000000 |
1.000000000000 |
3000.000000000000 |
0.000000000000 |
0.000000000000 |
3000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
42601230011 |
|
42601230011 |
|
|
1900-01-01 00:00:00.000000 |
3000.000000000000 |
0.000000000000 |
ren |
1 |
5639005212 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1106 |
22601230047 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1445 |
22601230047 |
D000003 |
|
Dokter Spesialis 50k (50.000) |
IDR |
|
0.000000000000 |
1.000000000000 |
50000.000000000000 |
0.000000000000 |
0.000000000000 |
50000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22601230047 |
|
22601230047 |
|
|
1900-01-01 00:00:00.000000 |
50000.000000000000 |
0.000000000000 |
ren |
1 |
5639005468 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1107 |
22601240019 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1701 |
22601240019 |
A000001 |
|
Biaya Kartu Pasien |
IDR |
|
0.000000000000 |
1.000000000000 |
50000.000000000000 |
0.000000000000 |
0.000000000000 |
50000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22601240019 |
|
22601240019 |
|
|
1900-01-01 00:00:00.000000 |
50000.000000000000 |
0.000000000000 |
ren |
1 |
5639005724 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1108 |
22603030002 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
2006 |
22603030002 |
A000002 |
|
Rawat Jalan |
IDR |
|
0.000000000000 |
1.000000000000 |
150000.000000000000 |
0.000000000000 |
0.000000000000 |
150000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22603030002 |
|
22603030002 |
|
|
1900-01-01 00:00:00.000000 |
150000.000000000000 |
0.000000000000 |
ren |
1 |
5639005980 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1109 |
42512180010 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
125 |
42512180010 |
F000017 |
|
Panadol |
IDR |
|
0.000000000000 |
10.000000000000 |
12800.000000000000 |
0.000000000000 |
0.000000000000 |
128000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
42512180010 |
|
42512180010 |
|
|
1900-01-01 00:00:00.000000 |
128000.000000000000 |
0.000000000000 |
ren |
1 |
5639004189 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1110 |
22512200002 |
2026-04-04 14:00:51.000000 |
2.000000000000 |
391 |
22512200002 |
D000002 |
|
Biaya Konsultasi dr. Spesialis THT |
IDR |
|
0.000000000000 |
1.000000000000 |
75000.000000000000 |
0.000000000000 |
0.000000000000 |
75000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22512200002 |
|
22512200002 |
|
|
1900-01-01 00:00:00.000000 |
75000.000000000000 |
0.000000000000 |
ren |
1 |
5639004445 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |