|
1921 |
22601240003 |
2026-04-04 14:00:51.000000 |
2.000000000000 |
1547 |
22601240003 |
A000002 |
|
Rawat Jalan |
IDR |
|
0.000000000000 |
1.000000000000 |
150000.000000000000 |
0.000000000000 |
0.000000000000 |
150000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22601240003 |
|
22601240003 |
|
|
1900-01-01 00:00:00.000000 |
150000.000000000000 |
0.000000000000 |
ren |
1 |
5639005570 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1922 |
4202601260014 |
2026-01-26 21:02:05.000000 |
1.000000000000 |
1808 |
4202601260014 |
F000002 |
|
Paramex |
IDR |
|
0.000000000000 |
5.000000000000 |
2500.000000000000 |
0.000000000000 |
0.000000000000 |
12500.000000000000 |
|
|
|
0.000000000000 |
0 |
|
4202601260014 |
|
4202601260014 |
|
|
1900-01-01 00:00:00.000000 |
12500.000000000000 |
0.000000000000 |
ren |
1 |
5639005826 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1923 |
132603290002 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
2109 |
132603290002 |
L000006 |
|
Hit. Juml Trombosit |
IDR |
|
0.000000000000 |
1.000000000000 |
11111.000000000000 |
0.000000000000 |
0.000000000000 |
11111.000000000000 |
|
|
|
0.000000000000 |
0 |
|
132603290002 |
|
132603290002 |
|
|
1900-01-01 00:00:00.000000 |
11111.000000000000 |
0.000000000000 |
ren |
1 |
5639006082 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1924 |
2251218000043 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
232 |
2251218000043 |
D000002 |
|
Biaya Konsultasi dr. Spesialis THT |
IDR |
|
0.000000000000 |
0.000000000000 |
75000.000000000000 |
0.000000000000 |
0.000000000000 |
75000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
2251218000043 |
|
2251218000043 |
|
|
1900-01-01 00:00:00.000000 |
75000.000000000000 |
0.000000000000 |
ren |
1 |
5639004291 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1925 |
22601070004 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
494 |
22601070004 |
A000002 |
|
Rawat Jalan |
IDR |
|
0.000000000000 |
1.000000000000 |
150000.000000000000 |
0.000000000000 |
0.000000000000 |
150000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22601070004 |
|
22601070004 |
|
|
1900-01-01 00:00:00.000000 |
150000.000000000000 |
0.000000000000 |
ren |
1 |
5639004547 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1926 |
32601150001 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
775 |
32601150001 |
L000008 |
|
Hematokrit |
IDR |
|
0.000000000000 |
10.000000000000 |
10000000.000000000000 |
0.000000000000 |
0.000000000000 |
100000000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
32601150001 |
|
32601150001 |
|
|
1900-01-01 00:00:00.000000 |
100000000.000000000000 |
0.000000000000 |
ren |
1 |
5639004803 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1927 |
52601150002 |
2026-04-04 14:00:51.000000 |
5.000000000000 |
1033 |
52601150002 |
P000003 |
|
Masker Medis |
IDR |
|
0.000000000000 |
12.000000000000 |
8000.000000000000 |
0.000000000000 |
0.000000000000 |
96000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
52601150002 |
|
52601150002 |
|
|
1900-01-01 00:00:00.000000 |
96000.000000000000 |
0.000000000000 |
ren |
1 |
5639005059 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1928 |
32601230025 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1292 |
32601230025 |
T000004 |
|
Pemasangan Infus |
IDR |
|
0.000000000000 |
1.000000000000 |
75000.000000000000 |
0.000000000000 |
0.000000000000 |
75000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
32601230025 |
|
32601230025 |
|
|
1900-01-01 00:00:00.000000 |
75000.000000000000 |
0.000000000000 |
ren |
1 |
5639005315 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1929 |
22601240003 |
2026-04-04 14:00:51.000000 |
3.000000000000 |
1548 |
22601240003 |
D000001 |
|
Biaya dr. Umum |
IDR |
|
0.000000000000 |
1.000000000000 |
50000.000000000000 |
0.000000000000 |
0.000000000000 |
50000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22601240003 |
|
22601240003 |
|
|
1900-01-01 00:00:00.000000 |
50000.000000000000 |
0.000000000000 |
ren |
1 |
5639005571 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
1930 |
112601270001 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1810 |
112601270001 |
R000004 |
|
USG (Ultrasonography) |
IDR |
|
0.000000000000 |
2.000000000000 |
300000.000000000000 |
0.000000000000 |
0.000000000000 |
600000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
112601270001 |
|
112601270001 |
|
|
1900-01-01 00:00:00.000000 |
600000.000000000000 |
0.000000000000 |
ren |
1 |
5639005827 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |