|
1501 |
132512270001 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
441 |
132512270001 |
L000015 |
|
Tes Golongan Darah |
IDR |
|
0.000000000000 |
1.000000000000 |
10000000.000000000000 |
0.000000000000 |
0.000000000000 |
10000000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
132512270001 |
|
132512270001 |
|
|
1900-01-01 00:00:00.000000 |
10000000.000000000000 |
0.000000000000 |
ren |
1 |
5639004494 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1502 |
32601140001 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
722 |
32601140001 |
T000007 |
|
Perawatan Luka |
IDR |
|
0.000000000000 |
1.000000000000 |
100000.000000000000 |
0.000000000000 |
0.000000000000 |
100000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
32601140001 |
|
32601140001 |
|
|
1900-01-01 00:00:00.000000 |
100000.000000000000 |
0.000000000000 |
ren |
1 |
5639004750 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1503 |
42601150023 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
979 |
42601150023 |
F000003 |
|
Alerfed |
IDR |
|
0.000000000000 |
2.000000000000 |
3000.000000000000 |
0.000000000000 |
0.000000000000 |
6000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
42601150023 |
|
42601150023 |
|
|
1900-01-01 00:00:00.000000 |
6000.000000000000 |
0.000000000000 |
ren |
1 |
5639005006 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1504 |
22601230019 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1239 |
22601230019 |
D000004 |
|
Dokter Spesialis 100k (100.000) |
IDR |
|
0.000000000000 |
1.000000000000 |
100000.000000000000 |
0.000000000000 |
0.000000000000 |
100000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22601230019 |
|
22601230019 |
|
|
1900-01-01 00:00:00.000000 |
100000.000000000000 |
0.000000000000 |
ren |
1 |
5639005262 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1505 |
22601230055 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1495 |
22601230055 |
A000002 |
|
Rawat Jalan |
IDR |
|
0.000000000000 |
1.000000000000 |
150000.000000000000 |
0.000000000000 |
0.000000000000 |
150000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22601230055 |
|
22601230055 |
|
|
1900-01-01 00:00:00.000000 |
150000.000000000000 |
0.000000000000 |
ren |
1 |
5639005518 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1506 |
52601240018 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1751 |
52601240018 |
P000001 |
|
Jarum Suntik |
IDR |
|
0.000000000000 |
3.000000000000 |
2500.000000000000 |
0.000000000000 |
0.000000000000 |
7500.000000000000 |
|
|
|
0.000000000000 |
0 |
|
52601240018 |
|
52601240018 |
|
|
1900-01-01 00:00:00.000000 |
7500.000000000000 |
0.000000000000 |
ren |
1 |
5639005774 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1507 |
22603040001 |
2026-03-12 13:17:16.000000 |
4.000000000000 |
2057 |
22603040001 |
D000001 |
|
Biaya dr. Umum |
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 |
5639006030 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1508 |
32512180013 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
178 |
32512180013 |
T000002 |
|
Konsultasi Dokter Spesialis |
IDR |
|
0.000000000000 |
1.000000000000 |
150000.000000000000 |
0.000000000000 |
0.000000000000 |
150000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
32512180013 |
|
32512180013 |
|
|
1900-01-01 00:00:00.000000 |
150000.000000000000 |
0.000000000000 |
ren |
1 |
5639004239 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1509 |
32512270001 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
442 |
32512270001 |
T000005 |
|
Injeksi Intramuskular |
IDR |
|
0.000000000000 |
1.000000000000 |
40000.000000000000 |
0.000000000000 |
0.000000000000 |
40000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
32512270001 |
|
32512270001 |
|
|
1900-01-01 00:00:00.000000 |
40000.000000000000 |
0.000000000000 |
ren |
1 |
5639004495 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1510 |
32601140001 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
723 |
32601140001 |
T000004 |
|
Pemasangan Infus |
IDR |
|
0.000000000000 |
1.000000000000 |
75000.000000000000 |
0.000000000000 |
0.000000000000 |
75000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
32601140001 |
|
32601140001 |
|
|
1900-01-01 00:00:00.000000 |
75000.000000000000 |
0.000000000000 |
ren |
1 |
5639004751 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |