|
2021 |
42601080001 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
506 |
42601080001 |
F000014 |
|
Ranitidine |
IDR |
|
0.000000000000 |
10.000000000000 |
23000.000000000000 |
0.000000000000 |
0.000000000000 |
230000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
42601080001 |
|
42601080001 |
|
|
1900-01-01 00:00:00.000000 |
230000.000000000000 |
0.000000000000 |
ren |
1 |
5639004559 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
2022 |
42601150002 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
787 |
42601150002 |
F000001 |
|
Paracetamol |
IDR |
|
0.000000000000 |
7.000000000000 |
1500.000000000000 |
0.000000000000 |
0.000000000000 |
10500.000000000000 |
|
|
|
0.000000000000 |
0 |
|
42601150002 |
|
42601150002 |
|
|
1900-01-01 00:00:00.000000 |
10500.000000000000 |
0.000000000000 |
ren |
1 |
5639004815 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
2023 |
226011500035 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1045 |
226011500035 |
D000002 |
|
Biaya Konsultasi dr. Spesialis THT |
IDR |
|
0.000000000000 |
1.000000000000 |
75000.000000000000 |
0.000000000000 |
0.000000000000 |
75000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
226011500035 |
|
226011500035 |
|
|
1900-01-01 00:00:00.000000 |
75000.000000000000 |
0.000000000000 |
ren |
1 |
5639005071 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
2024 |
22601230026 |
2026-04-04 14:00:51.000000 |
2.000000000000 |
1304 |
22601230026 |
D000006 |
|
Dokter Spesialis 200k |
IDR |
|
0.000000000000 |
1.000000000000 |
200000.000000000000 |
0.000000000000 |
0.000000000000 |
200000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22601230026 |
|
22601230026 |
|
|
1900-01-01 00:00:00.000000 |
200000.000000000000 |
0.000000000000 |
ren |
1 |
5639005327 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
2025 |
32601240003 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1560 |
32601240003 |
T000005 |
|
Injeksi Intramuskular |
IDR |
|
0.000000000000 |
1.000000000000 |
40000.000000000000 |
0.000000000000 |
0.000000000000 |
40000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
32601240003 |
|
32601240003 |
|
|
1900-01-01 00:00:00.000000 |
40000.000000000000 |
0.000000000000 |
ren |
1 |
5639005583 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
2026 |
32601290001 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1823 |
32601290001 |
T000003 |
|
Pemeriksaan Tanda Vital |
IDR |
|
0.000000000000 |
1.000000000000 |
25000.000000000000 |
0.000000000000 |
0.000000000000 |
25000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
32601290001 |
|
32601290001 |
|
|
1900-01-01 00:00:00.000000 |
25000.000000000000 |
0.000000000000 |
ren |
1 |
5639005839 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
2027 |
22603300001 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
2122 |
22603300001 |
A000002 |
|
Jalan Rawat |
IDR |
|
0.000000000000 |
1.000000000000 |
150000.000000000000 |
0.000000000000 |
0.000000000000 |
150000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22603300001 |
|
22603300001 |
|
|
1900-01-01 00:00:00.000000 |
150000.000000000000 |
0.000000000000 |
ren |
1 |
5639006095 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
2028 |
2251218000047 |
2026-04-04 14:00:51.000000 |
2.000000000000 |
245 |
2251218000047 |
A000001 |
|
Biaya Kartu Pasien |
IDR |
|
0.000000000000 |
1.000000000000 |
50000.000000000000 |
0.000000000000 |
0.000000000000 |
50000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
2251218000047 |
|
2251218000047 |
|
|
1900-01-01 00:00:00.000000 |
50000.000000000000 |
0.000000000000 |
ren |
1 |
5639004304 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
2029 |
42601080002 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
507 |
42601080002 |
F000006 |
|
Amlodipine |
IDR |
|
0.000000000000 |
1.000000000000 |
25500.000000000000 |
0.000000000000 |
0.000000000000 |
25500.000000000000 |
|
|
|
0.000000000000 |
0 |
|
42601080002 |
|
42601080002 |
|
|
1900-01-01 00:00:00.000000 |
25500.000000000000 |
0.000000000000 |
ren |
1 |
5639004560 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
2030 |
42601150002 |
2026-04-04 14:00:51.000000 |
2.000000000000 |
788 |
42601150002 |
F000003 |
|
Alerfed |
IDR |
|
0.000000000000 |
7.000000000000 |
3000.000000000000 |
0.000000000000 |
0.000000000000 |
21000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
42601150002 |
|
42601150002 |
|
|
1900-01-01 00:00:00.000000 |
21000.000000000000 |
0.000000000000 |
ren |
1 |
5639004816 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |