|
1401 |
42601230054 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1482 |
42601230054 |
F000006 |
|
Amlodipine |
IDR |
|
0.000000000000 |
1.000000000000 |
25500.000000000000 |
0.000000000000 |
0.000000000000 |
25500.000000000000 |
|
|
|
0.000000000000 |
0 |
|
42601230054 |
|
42601230054 |
|
|
1900-01-01 00:00:00.000000 |
25500.000000000000 |
0.000000000000 |
ren |
1 |
5639005505 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1402 |
22601240025 |
2026-04-04 14:00:51.000000 |
2.000000000000 |
1738 |
22601240025 |
A000002 |
|
Rawat Jalan |
IDR |
|
0.000000000000 |
1.000000000000 |
150000.000000000000 |
0.000000000000 |
0.000000000000 |
150000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22601240025 |
|
22601240025 |
|
|
1900-01-01 00:00:00.000000 |
150000.000000000000 |
0.000000000000 |
ren |
1 |
5639005761 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1403 |
132603100001 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
2044 |
132603100001 |
L000022 |
|
Albumin |
IDR |
|
0.000000000000 |
1.000000000000 |
45000.000000000000 |
0.000000000000 |
0.000000000000 |
45000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
132603100001 |
|
132603100001 |
|
|
1900-01-01 00:00:00.000000 |
45000.000000000000 |
0.000000000000 |
ren |
1 |
5639006017 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1404 |
32512180004 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
164 |
32512180004 |
T000001 |
|
T000001 |
IDR |
|
0.000000000000 |
2.000000000000 |
50000.000000000000 |
0.000000000000 |
0.000000000000 |
100000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
32512180004 |
|
32512180004 |
|
|
1900-01-01 00:00:00.000000 |
100000.000000000000 |
0.000000000000 |
ren |
1 |
5639004226 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1405 |
32512250001 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
429 |
32512250001 |
T000001 |
|
T000001 |
IDR |
|
0.000000000000 |
1.000000000000 |
50000.000000000000 |
0.000000000000 |
0.000000000000 |
50000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
32512250001 |
|
32512250001 |
|
|
1900-01-01 00:00:00.000000 |
50000.000000000000 |
0.000000000000 |
ren |
1 |
5639004482 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1406 |
42601130001 |
2026-04-04 14:00:51.000000 |
3.000000000000 |
710 |
42601130001 |
F000002 |
|
Paramex |
IDR |
|
0.000000000000 |
1.000000000000 |
2500.000000000000 |
0.000000000000 |
0.000000000000 |
2500.000000000000 |
|
|
|
0.000000000000 |
0 |
|
42601130001 |
|
42601130001 |
|
|
1900-01-01 00:00:00.000000 |
2500.000000000000 |
0.000000000000 |
ren |
1 |
5639004738 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1407 |
32601150029 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
967 |
32601150029 |
T000004 |
|
Pemasangan Infus |
IDR |
|
0.000000000000 |
8.000000000000 |
75000.000000000000 |
0.000000000000 |
0.000000000000 |
600000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
32601150029 |
|
32601150029 |
|
|
1900-01-01 00:00:00.000000 |
600000.000000000000 |
0.000000000000 |
ren |
1 |
5639004994 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1408 |
22601230016 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1227 |
22601230016 |
D000007 |
|
Konsultasi Dokter SPOG |
IDR |
|
0.000000000000 |
1.000000000000 |
120000.000000000000 |
0.000000000000 |
0.000000000000 |
120000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22601230016 |
|
22601230016 |
|
|
1900-01-01 00:00:00.000000 |
120000.000000000000 |
0.000000000000 |
ren |
1 |
5639005250 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1409 |
32601230055 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1483 |
32601230055 |
D000002 |
|
Biaya Konsultasi dr. Spesialis THT |
IDR |
|
0.000000000000 |
1.000000000000 |
75000.000000000000 |
0.000000000000 |
0.000000000000 |
75000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
32601230055 |
|
32601230055 |
|
|
1900-01-01 00:00:00.000000 |
75000.000000000000 |
0.000000000000 |
ren |
1 |
5639005506 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1410 |
22601240025 |
2026-04-04 14:00:51.000000 |
3.000000000000 |
1739 |
22601240025 |
D000001 |
|
Biaya dr. Umum |
IDR |
|
0.000000000000 |
1.000000000000 |
50000.000000000000 |
0.000000000000 |
0.000000000000 |
50000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22601240025 |
|
22601240025 |
|
|
1900-01-01 00:00:00.000000 |
50000.000000000000 |
0.000000000000 |
ren |
1 |
5639005762 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |