|
1211 |
22603040001 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
2019 |
22603040001 |
A000001 |
|
Biaya Kartu Pasien |
IDR |
|
0.000000000000 |
1.000000000000 |
50000.000000000000 |
0.000000000000 |
0.000000000000 |
50000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22603040001 |
|
22603040001 |
|
|
1900-01-01 00:00:00.000000 |
50000.000000000000 |
0.000000000000 |
ren |
1 |
5639005993 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1212 |
42512180018 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
138 |
42512180018 |
F000001 |
|
Paracetamol |
IDR |
|
0.000000000000 |
20.000000000000 |
1500.000000000000 |
0.000000000000 |
0.000000000000 |
30000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
42512180018 |
|
42512180018 |
|
|
1900-01-01 00:00:00.000000 |
30000.000000000000 |
0.000000000000 |
ren |
1 |
5639004202 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1213 |
22512220003 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
404 |
22512220003 |
A000003 |
|
Rawat Inap |
IDR |
|
0.000000000000 |
1.000000000000 |
500000.000000000000 |
0.000000000000 |
0.000000000000 |
500000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22512220003 |
|
22512220003 |
|
|
1900-01-01 00:00:00.000000 |
500000.000000000000 |
0.000000000000 |
ren |
1 |
5639004458 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1214 |
112601120001 |
2026-01-12 14:47:56.000000 |
1.000000000000 |
685 |
112601120001 |
R000002 |
|
CT Scan |
IDR |
|
0.000000000000 |
1.000000000000 |
3500000.000000000000 |
0.000000000000 |
0.000000000000 |
3500000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
112601120001 |
|
112601120001 |
|
|
1900-01-01 00:00:00.000000 |
3500000.000000000000 |
0.000000000000 |
ren |
1 |
5639004714 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1215 |
22601150026 |
2026-04-04 14:00:51.000000 |
2.000000000000 |
942 |
22601150026 |
D000004 |
|
Dokter Spesialis 100k |
IDR |
|
0.000000000000 |
1.000000000000 |
100000.000000000000 |
0.000000000000 |
0.000000000000 |
100000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22601150026 |
|
22601150026 |
|
|
1900-01-01 00:00:00.000000 |
100000.000000000000 |
0.000000000000 |
ren |
1 |
5639004970 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1216 |
42601230013 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1203 |
42601230013 |
F000009 |
|
Amoxicillin |
IDR |
|
0.000000000000 |
1.000000000000 |
96500.000000000000 |
0.000000000000 |
0.000000000000 |
96500.000000000000 |
|
|
|
0.000000000000 |
0 |
|
42601230013 |
|
42601230013 |
|
|
1900-01-01 00:00:00.000000 |
96500.000000000000 |
0.000000000000 |
ren |
1 |
5639005226 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1217 |
22601230050 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1459 |
22601230050 |
D000001 |
|
Biaya dr. Umum (50.000) |
IDR |
|
0.000000000000 |
1.000000000000 |
50000.000000000000 |
0.000000000000 |
0.000000000000 |
50000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22601230050 |
|
22601230050 |
|
|
1900-01-01 00:00:00.000000 |
50000.000000000000 |
0.000000000000 |
ren |
1 |
5639005482 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1218 |
42601240020 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1715 |
42601240020 |
F000003 |
|
Alerfed |
IDR |
|
0.000000000000 |
1.000000000000 |
3000.000000000000 |
0.000000000000 |
0.000000000000 |
3000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
42601240020 |
|
42601240020 |
|
|
1900-01-01 00:00:00.000000 |
3000.000000000000 |
0.000000000000 |
ren |
1 |
5639005738 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1219 |
22603040001 |
2026-04-04 14:00:51.000000 |
2.000000000000 |
2020 |
22603040001 |
D000007 |
|
Konsultasi Dokter SPOG |
IDR |
|
0.000000000000 |
1.000000000000 |
120000.000000000000 |
0.000000000000 |
0.000000000000 |
120000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22603040001 |
|
22603040001 |
|
|
1900-01-01 00:00:00.000000 |
120000.000000000000 |
0.000000000000 |
ren |
1 |
5639005994 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1220 |
42512180019 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
139 |
42512180019 |
F000002 |
|
Paramex |
IDR |
|
0.000000000000 |
10.000000000000 |
2500.000000000000 |
0.000000000000 |
0.000000000000 |
25000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
42512180019 |
|
42512180019 |
|
|
1900-01-01 00:00:00.000000 |
25000.000000000000 |
0.000000000000 |
ren |
1 |
5639004203 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |