|
2831 |
42512180060 |
2026-04-04 14:00:51.000000 |
5.000000000000 |
341 |
42512180060 |
F000001 |
|
Paracetamol |
IDR |
|
0.000000000000 |
10.000000000000 |
1500.000000000000 |
0.000000000000 |
0.000000000000 |
15000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
42512180060 |
|
42512180060 |
|
|
1900-01-01 00:00:00.000000 |
15000.000000000000 |
0.000000000000 |
ren |
1 |
5639004400 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
2832 |
22601110002 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
608 |
22601110002 |
A000002 |
|
Rawat Jalan |
IDR |
|
0.000000000000 |
1.000000000000 |
150000.000000000000 |
0.000000000000 |
0.000000000000 |
150000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22601110002 |
|
22601110002 |
|
|
1900-01-01 00:00:00.000000 |
150000.000000000000 |
0.000000000000 |
ren |
1 |
5639004656 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
2833 |
32601150012 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
884 |
32601150012 |
T000006 |
|
Injeksi Intravena |
IDR |
|
0.000000000000 |
1.000000000000 |
50000.000000000000 |
0.000000000000 |
0.000000000000 |
50000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
32601150012 |
|
32601150012 |
|
|
1900-01-01 00:00:00.000000 |
50000.000000000000 |
0.000000000000 |
ren |
1 |
5639004912 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
2834 |
2260123000007 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1145 |
2260123000007 |
D000004 |
|
Dokter Spesialis 100k |
IDR |
|
0.000000000000 |
0.000000000000 |
100000.000000000000 |
0.000000000000 |
0.000000000000 |
100000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
2260123000007 |
|
2260123000007 |
|
|
1900-01-01 00:00:00.000000 |
100000.000000000000 |
0.000000000000 |
ren |
1 |
5639005168 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
2835 |
42601230044 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1401 |
42601230044 |
F000003 |
|
Alerfed |
IDR |
|
0.000000000000 |
1.000000000000 |
3000.000000000000 |
0.000000000000 |
0.000000000000 |
3000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
42601230044 |
|
42601230044 |
|
|
1900-01-01 00:00:00.000000 |
3000.000000000000 |
0.000000000000 |
ren |
1 |
5639005424 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
2836 |
42601240013 |
2026-04-04 14:00:51.000000 |
5.000000000000 |
1657 |
42601240013 |
F000006 |
|
Amlodipine |
IDR |
|
0.000000000000 |
1.000000000000 |
25500.000000000000 |
0.000000000000 |
0.000000000000 |
25500.000000000000 |
|
|
|
0.000000000000 |
0 |
|
42601240013 |
|
42601240013 |
|
|
1900-01-01 00:00:00.000000 |
25500.000000000000 |
0.000000000000 |
ren |
1 |
5639005680 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
2837 |
132602060001 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
1962 |
132602060001 |
L000012 |
|
HBsAg |
IDR |
|
0.000000000000 |
1.000000000000 |
40000.000000000000 |
0.000000000000 |
0.000000000000 |
40000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
132602060001 |
|
132602060001 |
|
|
1900-01-01 00:00:00.000000 |
40000.000000000000 |
0.000000000000 |
ren |
1 |
5639005936 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
2838 |
22512180021 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
80 |
22512180021 |
A000001 |
|
Biaya Kartu Pasien |
IDR |
|
0.000000000000 |
1.000000000000 |
20000.000000000000 |
0.000000000000 |
0.000000000000 |
20000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22512180021 |
|
22512180021 |
|
|
1900-01-01 00:00:00.000000 |
20000.000000000000 |
0.000000000000 |
ren |
1 |
5639004145 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
2839 |
42512180061 |
2026-04-04 14:00:51.000000 |
5.000000000000 |
342 |
42512180061 |
F000006 |
|
Amlodipine |
IDR |
|
0.000000000000 |
5.000000000000 |
25500.000000000000 |
0.000000000000 |
0.000000000000 |
127500.000000000000 |
|
|
|
0.000000000000 |
0 |
|
42512180061 |
|
42512180061 |
|
|
1900-01-01 00:00:00.000000 |
127500.000000000000 |
0.000000000000 |
ren |
1 |
5639004401 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |
|
2840 |
22601110003 |
2026-04-04 14:00:51.000000 |
1.000000000000 |
609 |
22601110003 |
D000002 |
|
Biaya Konsultasi dr. Spesialis THT (75.000) |
IDR |
|
0.000000000000 |
1.000000000000 |
75000.000000000000 |
0.000000000000 |
0.000000000000 |
75000.000000000000 |
|
|
|
0.000000000000 |
0 |
|
22601110003 |
|
22601110003 |
|
|
1900-01-01 00:00:00.000000 |
75000.000000000000 |
0.000000000000 |
ren |
1 |
5639004657 |
2026-04-04 14:00:51.000000 |
system |
2026-04-04 14:00:51.000000 |
system |
0 |
1900-01-01 00:00:00.000000 |