| 1 |
1001788497 |
330591 |
|
KURNADI kurang bayar rawat inap |
51 th |
Zuhri Dirgantoro, Sp.PD, FINASIM |
2022-10-24 |
UAP |
KLS III |
|
|
JAMINAN PRIBADI |
|
5 |
|
Rp 7.605.087 |
- |
|
PULANG KRG BYR |
| 2 |
1001816818 |
333951 |
DENDA PELAYANAN |
PORMAN JUPRIADI. S pasien blm bayar rawat inap |
36 th |
Wibowo Mustoko Negoro, Sp.PD |
2022-12-13 |
CEPHALGIA |
KLS III |
|
|
JAMINAN PRIBADI |
|
4 |
|
Rp 3.682.150 |
- |
|
DENDA PELAYANAN |
| 3 |
1001839374 |
336340 |
|
RAJA WIJAYA pasien blm bayar rawat inap |
9 th |
Dini Zuriana, Sp.A |
2023-01-22 |
OF+MORBILI+ISPA |
KLS III |
|
|
JAMINAN PRIBADI |
|
1180 |
|
Rp 4.763.150 |
- |
|
R/BPJS R/JAMKESDA |
| 4 |
1001888303 |
298177 |
|
HERU APRIANSYAH, TN |
38 th |
Firdaus Amansyah, Sp.B |
2023-04-17 |
COMBUSTIO GR II REGIO MANUS D/EKSISI BESAR |
KLS II |
|
|
BPJS KETENAGAKERJAAN TRAUMA CENTRE |
|
3 |
|
Rp 10.464.184 |
- |
|
|
| 5 |
1002148873 |
377074 |
|
LISA RIYANI , BY NY |
1 th |
Anasry Zakaria, dr, Sp.A |
2024-11-23 |
NCB SMK |
KLS I |
|
|
JAMINAN PRIBADI |
|
509 |
|
Rp 13.026.500 |
- |
|
R/ BPJS/1002148998 ambulance |
| 6 |
1002182293 |
386856 |
|
ANGGI CANDRA WINATA |
26 th |
M.Ibnu Joko, Dr, Sp.B |
2025-02-27 |
abses submandibula, Cellulitis and abscess of mouth - K12.2(Diagnosa Utama) |
KLS III |
|
|
JAMINAN PRIBADI |
|
413 |
|
Rp 10.739.810 |
- |
|
R/UHC/pro insisi gol sedang. diamond 11 |
| 7 |
1002182303 |
386861 |
|
SUSMIATI |
52 th |
M.Ibnu Joko, Dr, Sp.B |
2025-02-28 |
Nipple Mass Sinistra ec susp Fibrocystic mamae dd kanker payudara, Benign neoplasm of breast - D24(Diagnosa Utama) |
KLS III |
|
|
JAMINAN PRIBADI |
|
412 |
|
Rp 11.795.950 |
- |
|
R/UHC |
| 8 |
1002187705 |
388151 |
|
AHMAD SYAHRUL NASRULLAH |
2 th |
Damayani Farastuti, Sp.A |
2025-03-17 |
KDK, Other and unspecified convulsions - R56.8(Diagnosa Masuk) |
KLS III |
|
|
JAMINAN PRIBADI |
|
395 |
|
Rp 2.232.460 |
- |
|
R/UHC |
| 9 |
1002196368 |
390221 |
|
CALISTA PUTRI ,BY , NY |
0 th |
Damayani Farastuti, Sp.A |
2025-04-23 |
ASPEKSIA |
KLS I |
|
|
JAMINAN PRIBADI |
|
358 |
|
Rp 6.986.280 |
- |
|
25/04/2025 pindah perina |
| 10 |
1002201052 |
391565 |
|
AMELIA AGUSTIANI PUTRI , BY NY |
0 th |
Anasry Zakaria, dr, Sp.A |
2025-05-10 |
|
KLS III |
|
|
JAMINAN PRIBADI |
|
341 |
|
Rp 0 |
- |
|
|
| 11 |
1002201390 |
391641 |
|
RANTI PURNAMA SARI, BY, NY |
0 th |
Lony Novita ,Dr, Sp.A.,M.Kes |
2025-05-11 |
|
KLS III |
|
|
JAMINAN PRIBADI |
|
340 |
|
Rp 0 |
- |
|
|
| 12 |
1002208452 |
393289 |
|
UTI SUSILAWATI BY ,NY |
0 th |
|
2025-06-04 |
|
KLS III |
|
|
JAMINAN PRIBADI |
|
316 |
|
Rp 0 |
- |
|
|
| 13 |
1002210963 |
393862 |
|
ADRIAN VALENTINO |
46 th |
Vitri Iriani, Sp.P |
2025-06-13 |
obs dyspnoea EC susp CAP dd Bronkhitis, Dyspnoea - R06.0(Diagnosa Utama) |
KLS III |
|
|
JAMINAN PRIBADI |
|
307 |
|
Rp 6.785.860 |
- |
|
R/ UHC |
| 14 |
1002228592 |
398376 |
|
ESTI NUR FATIMAH, BY NY |
0 th |
|
2025-08-15 |
|
KLS I |
|
|
JAMINAN PRIBADI |
|
244 |
|
Rp 0 |
- |
|
|
| 15 |
1002230932 |
398902 |
|
IROS ROSITA, BY, NY |
0 th |
Damayani Farastuti, Sp.A |
2025-08-24 |
Single live birth |
KLS III |
|
|
JAMINAN PRIBADI |
|
235 |
|
Rp 0 |
- |
|
|
| 16 |
1002235195 |
377882 |
|
Tes BY IT IHU dua |
28 th |
Firdaus Artoni, Dr, Sp.OG |
2025-09-09 |
Z09.8 # Follow-up exam after other treatment for other conditions |
KLS I |
|
|
JAMINAN PRIBADI |
|
219 |
|
Rp 0 |
- |
|
test perina |
| 17 |
1002255341 |
405016 |
|
REGITA PUTRINA SUKMA, BY NY |
0 th |
Anasry Zakaria, dr, Sp.A |
2025-11-20 |
|
KLS III |
|
|
JAMINAN PRIBADI |
|
147 |
|
Rp 0 |
- |
|
|
| 18 |
1002263780 |
407051 |
|
WANDA AYU LESTARI, BY NY |
0 th |
Anasry Zakaria, dr, Sp.A |
2025-12-19 |
|
KLS III |
|
|
JAMINAN PRIBADI |
|
118 |
|
Rp 100.000 |
- |
|
|
| 19 |
1002275330 |
999999 |
|
test by it, Nya |
10 th |
Ronald Vinantius M., Sp.OT (K) Sport Injury |
2026-01-30 |
test, - (Diagnosa Masuk) |
KLS I |
|
|
JAMINAN PRIBADI |
|
76 |
|
Rp 0 |
- |
|
|
| 20 |
1002284179 |
412306 |
|
IIS SUMIYATI |
54 th |
Dewi Yusmeliasari, Dr, Sp.AN |
2026-03-05 |
Abdominal pain ec susp Appendisitis dd cholecystitis dd pancreatitis , - (Diagnosa Utama) |
KLS III |
|
|
JAMINAN PRIBADI |
|
5 |
|
Rp 16.667.573 |
- |
|
R/ UHC |
| 21 |
1002285389 |
352300 |
|
PUTRA PRATAMA, AN |
2 th |
Anasry Zakaria, dr, Sp.A |
2026-03-10 |
Fever, unspecified, - (Diagnosa Masuk) |
KLS III |
|
|
JAMINAN PRIBADI |
|
37 |
|
Rp 3.454.070 |
- |
|
R/UHC |
| 22 |
1002286610 |
412797 |
|
TYO ARIF NURROHMAN |
23 th |
M.Ibnu Joko, Dr, Sp.B |
2026-03-14 |
Suspek Fingertip injury digiti 2 manus sinistra, - (Diagnosa Utama)skin loss, - (Diagnosa Sekunder) |
KLS II |
|
|
JAMINAN PRIBADI |
|
3 |
|
Rp 13.140.550 |
- |
|
|
| 23 |
1002292190 |
331256 |
0117R0810426V002715 |
SURYAH |
42 th |
Bambang Triono, Sp.U |
2026-04-12 |
retensi urin, - (Diagnosa Utama)susp BSK, - (Diagnosa Sekunder) |
KLS III |
3 |
|
BPJS KESEHATAN |
|
4 |
|
Rp 2.030.800 |
- |
|
|
| 24 |
1002292229 |
414226 |
0117R0810426V002779 |
RIZAL AKBAR, TN |
22 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-13 |
Obs. Febris H3 ec Bacterial Infection, - (Diagnosa Masuk) |
KLS III |
3 |
|
BPJS KESEHATAN |
|
3 |
|
Rp 1.484.157 |
- |
|
|
| 25 |
1002292333 |
310716 |
0117R0810426V002853 |
SITI NUROHMAH, NY |
56 th |
Firdaus Amansyah, Sp.B |
2026-04-13 |
CA MAMAE SIN / MODIFIED RADICAL MASTECTOMY SIN ( MRM ) SIN |
KLS III |
|
|
BPJS KESEHATAN |
|
3 |
|
Rp 6.840.420 |
- |
|
|
| 26 |
1002292452 |
414244 |
0117R0810426V002990 |
FITRIYA , NY |
39 th |
Imelda Yunitra, Sp.OG |
2026-04-13 |
G4P3A0 H.40 MG DGN BABY BESAR +KPD / SC |
KLS III |
|
|
BPJS KESEHATAN |
|
3 |
|
Rp 6.324.522 |
- |
|
R/ UHC |
| 27 |
1002292561 |
414310 |
0117R0810426V002990 |
FITRIYA , BY, NY |
0 th |
|
2026-04-13 |
Single live birth |
KLS III |
|
|
BPJS KESEHATAN |
|
3 |
|
Rp 0 |
- |
|
|
| 28 |
1002292624 |
414232 |
0117R0810426V003144 |
NIMAH SALEMAN, NY |
81 th |
Firdaus Amansyah, Sp.B |
2026-04-14 |
TUMOR REGIO FRONTAL UKURAN 5 CM / EKSISI +PA |
KLS III |
|
|
BPJS KESEHATAN |
|
2 |
|
Rp 4.760.242 |
- |
|
|
| 29 |
1002292645 |
326344 |
0117R0810426V003156 |
TJATUR WINARTI |
54 th |
Firdaus Amansyah, Sp.B |
2026-04-14 |
TUMOR MAMAE DX / EKSISI +PA |
KLS II |
|
|
BPJS KESEHATAN |
|
2 |
|
Rp 6.503.265 |
- |
|
|
| 30 |
1002292659 |
404289 |
0117R0810426V003178 |
AMALIA |
40 th |
Firdaus Amansyah, Sp.B |
2026-04-14 |
TUMOR MAMAE DX / EKSISI +PA |
KLS III |
|
|
BPJS KESEHATAN |
|
2 |
|
Rp 4.814.527 |
- |
|
|
| 31 |
1002292682 |
369952 |
0117R0810426V003201 |
MERINDA FARADIANTI |
30 th |
Firdaus Amansyah, Sp.B |
2026-04-14 |
TUMOR MAMAE DX / EKSISI +PA |
KLS III |
|
|
BPJS KESEHATAN |
|
2 |
|
Rp 5.183.602 |
- |
|
|
| 32 |
1002292693 |
412916 |
0117R0810426V003209 |
DAMOR IRAWATI N, NY |
48 th |
Firdaus Amansyah, Sp.B |
2026-04-14 |
TUMOR COLLI UKURAN 4 CM / EKSISI +PA |
KLS II |
|
|
BPJS KESEHATAN |
|
2 |
|
Rp 5.237.227 |
- |
|
|
| 33 |
1002292767 |
414342 |
0117R0810426V003091 |
FITRIANI BY,NY |
0 th |
Damayani Farastuti, Sp.A |
2026-04-14 |
Single live birth |
KLS III |
|
|
BPJS KESEHATAN |
|
2 |
|
Rp 0 |
- |
|
|
| 34 |
1002292776 |
414339 |
0117R0810426V003339 |
EVA RIANA BY, NY |
0 th |
Damayani Farastuti, Sp.A |
2026-04-14 |
Birth asphyxia, unspecified |
KLS I |
|
|
BPJS KESEHATAN |
|
2 |
|
Rp 4.116.835 |
- |
|
|
| 35 |
1002292791 |
414340 |
0117R0810426V002926 |
ATIKAH YULIANTI POHAN BY,NY |
0 th |
Damayani Farastuti, Sp.A |
2026-04-14 |
Single live birth |
KLS III |
|
|
BPJS KESEHATAN |
|
2 |
|
Rp 0 |
- |
|
|
| 36 |
1002292854 |
414369 |
|
NOVITA HARYANI |
19 th |
Imelda Yunitra, Sp.OG |
2026-04-14 |
G1 P0 A0 H 41MG DGN POSTERM + OLIGO// INDUKSI |
KLS III |
|
|
JAMINAN PRIBADI |
|
2 |
|
Rp 1.926.770 |
- |
|
R/ UHC |
| 37 |
1002292960 |
099847 |
0117R0810426V003478 |
KARSONO, TN |
56 th |
Bambang Triono, Sp.U |
2026-04-15 |
HIDRONEPROSIS DX / URS DX |
KLS I |
|
|
BPJS KESEHATAN |
|
1 |
|
Rp 2.165.900 |
- |
|
|
| 38 |
1002292976 |
406448 |
0117R0810426V003495 |
SULASMI ,NY |
50 th |
Bambang Triono, Sp.U |
2026-04-15 |
BATU URETER SINISTRA / OPEN UROLITHIASIS SINISTRA |
KLS I |
|
|
BPJS KESEHATAN |
|
1 |
|
Rp 2.168.350 |
- |
|
|
| 39 |
1002292989 |
414391 |
0117R0810426V003505 |
IIN NURFADILLAH ,NY |
22 th |
Imelda Yunitra, Sp.OG |
2026-04-15 |
G1P0A0 H.39 MG DGN KPD + LTP / SC |
KLS I |
|
|
BPJS KESEHATAN |
|
1 |
|
Rp 6.336.985 |
- |
|
|
| 40 |
1002293031 |
414403 |
|
LILIS SURYANI BY,NY |
0 th |
Damayani Farastuti, Sp.A |
2026-04-15 |
Single live birth |
KLS III |
|
|
JAMINAN PRIBADI |
|
1 |
|
Rp 0 |
- |
|
|
| 41 |
1002293078 |
414411 |
|
IIN NURFADILLAH BY,NY |
0 th |
|
2026-04-15 |
Single live birth |
KLS III |
|
|
JAMINAN PRIBADI |
|
1 |
|
Rp 0 |
- |
|
|
| 42 |
1002293089 |
414418 |
0117R0810426V003609 |
REGINA PUTRI ,NY |
22 th |
Firdaus Artoni, Dr, Sp.OG |
2026-04-15 |
G2P1A0 H.39 MG DGN KPD +PTM / PARTUS SPONTAN |
KLS I |
|
|
BPJS KESEHATAN |
|
1 |
|
Rp 1.711.000 |
- |
|
|
| 43 |
1002293093 |
414426 |
0117R0810426V003609 |
REGINA PUTRI , BY NY |
0 th |
|
2026-04-15 |
Single live birth |
KLS III |
|
|
JAMINAN PRIBADI |
|
1 |
|
Rp 0 |
- |
|
|
| 44 |
1002293153 |
414440 |
|
NOVITA HARYANI, BY NY |
0 th |
|
2026-04-15 |
Single live birth |
KLS III |
|
|
JAMINAN PRIBADI |
|
1 |
|
Rp 0 |
- |
|
IBUNY RENCANA UHC |
| 45 |
1002291219 |
384459 |
0117R0810426V001732 |
MULYANAH |
53 th |
Suvianto Hendri Lesmana, Sp.PD, FINASIM |
2026-04-08 |
GEA dehidrasi sedang berat, - (Diagnosa Utama) |
KLS II |
2 |
DIAMOND |
BPJS KESEHATAN |
|
8 |
|
Rp 9.099.312 |
- |
|
DIMON 20.1/ZR DWI |
| 46 |
1002292182 |
414166 |
0117R0810426V002700 |
MUHAMMAD FAIZ ISMAIL |
13 th |
Lony Novita ,Dr, Sp.A.,M.Kes |
2026-04-12 |
Fever, unspecified, - (Diagnosa Utama) |
VVIP |
1 |
DIAMOND |
BPJS KESEHATAN |
|
4 |
|
Rp 15.092.232 |
- |
|
SP NAIK KLS + |
| 47 |
1002292193 |
222031 |
0117R0810426V002716 |
ENIH BT. BOHI |
59 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-12 |
obs febris h2 + kolik abdomen, - (Diagnosa Utama)hiperglikemi DM, hipertensi, - (Diagnosa Sekunder) |
KLS III |
3 |
DIAMOND |
BPJS KESEHATAN |
|
4 |
|
Rp 3.178.214 |
- |
|
|
| 48 |
1002292201 |
414194 |
0117R0810426V002734 |
AMAS |
63 th |
JD Dian Aryani , Dr, Sp.P |
2026-04-12 |
dyspneu, - (Diagnosa Utama)efusi pleura sinistra, - (Diagnosa Sekunder)dispepsia, - (Diagnosa Sekunder) |
KLS III |
|
DIAMOND |
BPJS KESEHATAN |
|
4 |
|
Rp 3.056.429 |
- |
|
|
| 49 |
1002292209 |
414200 |
0117R0810426V002752 |
SURATI |
58 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-12 |
Obs. febris, - (Diagnosa Utama)Cephalgia, - (Diagnosa Sekunder)DM Tipe 2, - (Diagnosa Sekunder) |
KLS III |
3 |
DIAMOND |
BPJS KESEHATAN |
|
4 |
|
Rp 2.577.553 |
- |
|
|
| 50 |
1002292225 |
414224 |
0117R0810426V002756 |
ACIH KURNIAWATI, NY |
29 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-13 |
Febris H3 ec DHF, - (Diagnosa Utama) |
KLS III |
3 |
DIAMOND |
BPJS KESEHATAN |
|
3 |
|
Rp 1.476.672 |
- |
|
|
| 51 |
1002292366 |
258715 |
0117R0810426V002915 |
M.NADIA HERMANSYAH |
47 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-13 |
GEA dengan dehidrasi sedang, - (Diagnosa Utama) |
KLS III |
3 |
DIAMOND |
BPJS KESEHATAN |
|
3 |
|
Rp 2.003.600 |
- |
|
|
| 52 |
1002292374 |
413277 |
0117R0810426V002918 |
EVA RIANA, NY |
31 th |
Firdaus Artoni, Dr, Sp.OG |
2026-04-13 |
G2P1 HAMIL 38 MG , - (Diagnosa Utama) |
KLS I |
1 |
DIAMOND |
BPJS KESEHATAN |
|
3 |
|
Rp 7.745.900 |
- |
|
|
| 53 |
1002292403 |
359392 |
0117R0810426V003017 |
JASIH |
51 th |
Oki Lestari Irsan, Dr, Sp.S |
2026-04-13 |
ischialgia ec susp HNP L5-S1, - (Diagnosa Utama) |
KLS III |
3 |
DIAMOND |
BPJS KESEHATAN |
|
3 |
|
Rp 1.798.606 |
- |
|
KRONOLOGI+ |
| 54 |
1002292495 |
263377 |
0117R0810426V003080 |
ASMANIJAR, NY |
60 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-13 |
OF EC VIRAL + DM, - (Diagnosa Utama) |
KLS III |
3 |
DIAMOND |
BPJS KESEHATAN |
|
3 |
|
Rp 1.736.958 |
- |
|
|
| 55 |
1002292550 |
246375 |
0117R0810426V003372 |
YUSNIAR, NY |
88 th |
Suvianto Hendri Lesmana, Sp.PD, FINASIM |
2026-04-13 |
dispepsia, - (Diagnosa Utama)ckd, - (Diagnosa Sekunder) |
KLS II |
|
DIAMOND |
BPJS KESEHATAN |
|
3 |
|
Rp 2.294.800 |
- |
|
|
| 56 |
1002292554 |
219876 |
0117R0810426V003100 |
DEWI PURNAMA SARI, NY |
54 th |
dr. Nanik Sulistyowati, Sp.N |
2026-04-13 |
hiperpireksia, - (Diagnosa Sekunder)DM T2, - (Diagnosa Sekunder)cephalgia berat, - (Diagnosa Utama)susp snh?, - (Diagnosa Sekunder) |
KLS III |
3 |
DIAMOND |
BPJS KESEHATAN |
|
3 |
|
Rp 3.589.953 |
- |
|
|
| 57 |
1002292555 |
384904 |
0117R0810426V003094 |
ABYAN ATHAR DHIYAULHAQ |
5 th |
Damayani Farastuti, Sp.A |
2026-04-13 |
Nausea and vomiting |
VIP |
|
DIAMOND |
BPJS KESEHATAN |
|
3 |
|
Rp 6.005.460 |
- |
|
KLS 1 NAIK KELAS |
| 58 |
1002292725 |
286701 |
0117R0810426V003329 |
LILIS SURYANI |
21 th |
Firdaus Artoni, Dr, Sp.OG |
2026-04-14 |
G2P1 HAMIL 38 MG, , - (Diagnosa Utama) |
KLS III |
|
DIAMOND |
BPJS KESEHATAN |
|
2 |
|
Rp 5.022.795 |
- |
|
|
| 59 |
1002292813 |
397359 |
0117R0810426V003373 |
SYAIKAH KANSA ZIVANA |
16 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-14 |
obs febris, - (Diagnosa Utama) |
KLS III |
|
DIAMOND |
BPJS KESEHATAN |
|
2 |
|
Rp 1.548.800 |
- |
|
|
| 60 |
1002292818 |
414358 |
|
RUMSITI |
49 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-14 |
obs dispnea, CHF, HHD, HT emergency, - (Diagnosa Utama) |
KLS III |
|
DIAMOND |
JAMINAN PRIBADI |
|
2 |
|
Rp 6.332.371 |
- |
|
sp pribadi + sp titip + (kebijakan rmh skt titip ksl 2 ) |
| 61 |
1002292992 |
414394 |
0117R0810426V003556 |
LILAH WATI |
63 th |
Vitri Iriani, Sp.P |
2026-04-15 |
dysnoe ec pneumonia, - (Diagnosa Utama)ht urgensi, - (Diagnosa Sekunder)hiperglikemia, - (Diagnosa Sekunder) |
KLS III |
3 |
DIAMOND |
BPJS KESEHATAN |
|
1 |
|
Rp 1.780.600 |
- |
|
|
| 62 |
1002293054 |
326243 |
0117R0810426V003633 |
CARSIM |
61 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-15 |
isk dd bsk, - (Diagnosa Utama)ht, - (Diagnosa Sekunder) |
KLS I |
1 |
DIAMOND |
BPJS KESEHATAN |
|
1 |
|
Rp 2.468.513 |
- |
|
|
| 63 |
1002293126 |
414430 |
|
RIKI WAHYUDI |
28 th |
Ronald Vinantius M., Sp.OT (K) Sport Injury |
2026-04-15 |
Susp ruptur tendon, - (Diagnosa Utama) |
KLS II |
|
DIAMOND |
BPJS KETENAGAKERJAAN TRAUMA CENTRE |
|
1 |
|
Rp 1.822.360 |
- |
|
|
| 64 |
1002292186 |
403087 |
0117R0810426V002706 |
HARDI SISWANTO, TN |
48 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-12 |
Chest pain on breathing, - (Diagnosa Utama)Dyspnoea, - (Diagnosa Sekunder) |
KLS I |
1 |
EMERALD |
BPJS KESEHATAN |
|
4 |
|
Rp 5.824.534 |
- |
|
|
| 65 |
1002292212 |
329776 |
0117R0810426V002742 |
KHUTMAN |
56 th |
Oki Lestari Irsan, Dr, Sp.S |
2026-04-12 |
Vertigo, - (Diagnosa Utama)Dispepsia, - (Diagnosa Sekunder) |
KLS I |
1 |
EMERALD |
BPJS KESEHATAN |
|
4 |
|
Rp 3.549.470 |
- |
|
|
| 66 |
1002292221 |
414223 |
0117R0810426V002753 |
DEDI BIN. KENENG, TN |
56 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-12 |
GEA DRS, - (Diagnosa Utama)Dispepsia, - (Diagnosa Sekunder)Vomitus, - (Diagnosa Sekunder) |
KLS I |
1 |
EMERALD |
BPJS KESEHATAN |
|
4 |
|
Rp 8.538.911 |
- |
|
zr veni/emo 16.2 |
| 67 |
1002292709 |
325870 |
0117R0810426V003310 |
MAMUN MUROD, TN |
48 th |
Firdaus Amansyah, Sp.B |
2026-04-14 |
ORCHITIS SINISTRA |
KLS I |
1 |
EMERALD |
BPJS KESEHATAN |
|
2 |
|
Rp 2.800.860 |
- |
|
|
| 68 |
1002292843 |
393208 |
0117R0810426V003378 |
AHMAD RIFAI |
30 th |
Irman Firmansyah, Sp.PD, FINASIM, SH, MH |
2026-04-14 |
Febris, - (Diagnosa Utama) |
KLS I |
1 |
EMERALD |
BPJS KESEHATAN |
|
2 |
|
Rp 1.784.800 |
- |
|
|
| 69 |
1002292971 |
414390 |
0117R0810426V003541 |
KARMILA, NY |
28 th |
Vitri Iriani, Sp.P |
2026-04-15 |
Bronkitis?, - (Diagnosa Utama) |
KLS I |
1 |
EMERALD |
BPJS KESEHATAN |
|
1 |
|
Rp 2.084.600 |
- |
|
|
| 70 |
1002290787 |
413338 |
0117R0810426V001331 |
SUPARYA, TN |
77 th |
Oki Lestari Irsan, Dr, Sp.S |
2026-04-06 |
penkes ec susp meningitis dd SNH berulang , - (Diagnosa Utama) |
KLS I |
2 |
ICU |
BPJS KESEHATAN |
|
10 |
|
Rp 31.373.336 |
- |
|
|
| 71 |
1002291693 |
414076 |
0117R0810426V002429 |
SARTA HIDAYAT TULOH |
65 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-10 |
Dyspnoea, - (Diagnosa Masuk) susp peritonitis, - (Diagnosa Sekunder) |
KLS I |
|
ICU |
BPJS KESEHATAN |
|
6 |
|
Rp 57.603.300 |
- |
|
R/ UHC |
| 72 |
1002293040 |
080513 |
0117R0810426V003612 |
HETI TRISNIAWATI,NY |
45 th |
JD Dian Aryani , Dr, Sp.P |
2026-04-15 |
asma akut derajat berat, - (Diagnosa Masuk)Asma akut derajat berat, - (Diagnosa Utama) |
KLS I |
|
ICU |
BPJS KESEHATAN |
|
1 |
|
Rp 1.939.400 |
- |
|
|
| 73 |
1002291079 |
407868 |
0117R0810426V001587 |
GATOT SIREGAR |
50 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-07 |
kolik abdomen, - (Diagnosa Utama) + tb paru |
KLS I |
|
RUBBY |
BPJS KESEHATAN |
|
9 |
|
Rp 7.827.201 |
- |
|
|
| 74 |
1002292168 |
405665 |
0117R0810426V002690 |
ROSIDAH |
41 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-11 |
R10.4, - (Diagnosa Utama)Dyspnoea, - (Diagnosa Sekunder) |
KLS III |
3 |
RUBBY |
BPJS KESEHATAN |
|
5 |
|
Rp 3.725.408 |
- |
|
|
| 75 |
1002292232 |
413028 |
0117R0810426V002831 |
KANIH |
74 th |
Suvianto Hendri Lesmana, Sp.PD, FINASIM |
2026-04-13 |
Colic abdomen, - (Diagnosa Utama) |
KLS III |
3 |
RUBBY |
BPJS KESEHATAN |
|
3 |
|
Rp 2.609.312 |
- |
|
|
| 76 |
1002292400 |
414246 |
0117R0810426V003030 |
SANIN |
61 th |
Vitri Iriani, Sp.P |
2026-04-13 |
dyspnoea ec susp TB relapse dd pneumonia, - (Diagnosa Utama) |
KLS II |
2 |
RUBBY |
BPJS KESEHATAN |
|
3 |
|
Rp 3.649.020 |
- |
|
|
| 77 |
1002292437 |
350098 |
0117R0810426V003038 |
RATNI SUKENTI ,NY |
63 th |
Oki Lestari Irsan, Dr, Sp.S |
2026-04-13 |
LBP , - (Diagnosa Utama) |
KLS III |
|
RUBBY |
BPJS KESEHATAN |
|
3 |
|
Rp 1.287.333 |
- |
|
|
| 78 |
1002292504 |
414293 |
0117R0810426V003081 |
RIRIN DESWITA PUTRI |
18 th |
Suvianto Hendri Lesmana, Sp.PD, FINASIM |
2026-04-13 |
prolong febris, - (Diagnosa Utama) |
KLS III |
3 |
RUBBY |
BPJS KESEHATAN |
|
3 |
|
Rp 2.222.468 |
- |
|
|
| 79 |
1002292515 |
410830 |
0117R0810426V003088 |
JENAB |
50 th |
M.Ibnu Joko, Dr, Sp.B |
2026-04-13 |
ulkus dm pedis sin, - (Diagnosa Utama)hiperglikemi, - (Diagnosa Sekunder)anemia gravis, - (Diagnosa Sekunder) |
KLS II |
3 |
RUBBY |
BPJS KESEHATAN |
|
3 |
|
Rp 4.935.000 |
- |
|
|
| 80 |
1002292552 |
389620 |
0117R0810426V003099 |
RACHMAT HIDAYATULLAH, TN |
56 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-13 |
kolik abdomen, - (Diagnosa Utama)tb on oat 1 bulan, - (Diagnosa Sekunder) |
KLS I |
1 |
RUBBY |
BPJS KESEHATAN |
|
3 |
|
Rp 3.807.112 |
- |
|
|
| 81 |
1002292660 |
414331 |
0117R0810426V003241 |
IMAS BT. ISMAT |
58 th |
Oki Lestari Irsan, Dr, Sp.S |
2026-04-14 |
Benign paroxysmal vertigo, - (Diagnosa Utama)vertigo, HT, BI , - (Diagnosa Sekunder) |
KLS III |
3 |
RUBBY |
BPJS KESEHATAN |
|
2 |
|
Rp 2.139.300 |
- |
|
|
| 82 |
1002292849 |
414367 |
|
YADIN SUHERMAN |
53 th |
JD Dian Aryani , Dr, Sp.P |
2026-04-14 |
Febris, - (Diagnosa Sekunder)Dyspnoe ec PPOK eksaserbasi akut dd CAP dd TB paru, - (Diagnosa Sekunder) |
KLS III |
|
RUBBY |
JAMINAN PRIBADI |
|
2 |
|
Rp 4.411.510 |
- |
|
R/ UHC |
| 83 |
1002292851 |
253612 |
0117R0810426V003374 |
MUNAHIR, TN |
58 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-14 |
Dyspnoe ec CHF, - (Diagnosa Utama) |
KLS III |
|
RUBBY |
BPJS KESEHATAN |
|
2 |
|
Rp 1.714.784 |
- |
|
R5.3 |
| 84 |
1002293035 |
414405 |
|
SAHRIPAL, TN |
53 th |
Suvianto Hendri Lesmana, Sp.PD, FINASIM |
2026-04-15 |
GE Kronis, - (Diagnosa Utama)hipoNA, hipoK, hipoCl, - (Diagnosa Sekunder) |
KLS III |
|
RUBBY |
JAMINAN PRIBADI |
|
1 |
|
Rp 3.242.040 |
- |
|
R/UHC |
| 85 |
1002293037 |
414406 |
0117R0810426V003598 |
TOYIB |
59 th |
Suvianto Hendri Lesmana, Sp.PD, FINASIM |
2026-04-15 |
isk dd bsk, - (Diagnosa Masuk) |
KLS III |
3 |
RUBBY |
BPJS KESEHATAN |
|
1 |
|
Rp 1.232.200 |
- |
|
|
| 86 |
1002291853 |
414105 |
0117R0810426V002405 |
UMI NUR PARIKHA |
36 th |
Suvianto Hendri Lesmana, Sp.PD, FINASIM |
2026-04-10 |
OBS. COLIC ABDOMEN , - (Diagnosa Masuk)ANEMIA, - (Diagnosa Sekunder)hiponatremia, - (Diagnosa Sekunder) |
KLS III |
3 |
SAPHIRE |
BPJS KESEHATAN |
|
6 |
|
Rp 3.434.205 |
- |
|
|
| 87 |
1002292161 |
414161 |
0117R0810426V002681 |
ARTHUR FATAHILLAH KAHFI |
16 th |
Suvianto Hendri Lesmana, Sp.PD, FINASIM |
2026-04-11 |
colic abdomen, - (Diagnosa Utama)Nausea and vomiting, - (Diagnosa Sekunder) |
KLS II |
2 |
SAPHIRE |
BPJS KESEHATAN |
|
5 |
|
Rp 7.946.790 |
- |
|
|
| 88 |
1002292162 |
414162 |
0117R0810426V002682 |
AYNA ZAHSY FAHREZI |
3 th |
Lony Novita ,Dr, Sp.A.,M.Kes |
2026-04-11 |
Kejang Demam, - (Diagnosa Utama) |
KLS I |
1 |
SAPHIRE |
BPJS KESEHATAN |
|
5 |
|
Rp 5.669.235 |
- |
|
|
| 89 |
1002292207 |
409644 |
0117R0810426V002739 |
HAYATI |
45 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-12 |
dyspneu, - (Diagnosa Utama)dyspneu, - (Diagnosa Sekunder) |
KLS III |
3 |
SAPHIRE |
BPJS KESEHATAN |
|
4 |
|
Rp 3.707.583 |
- |
|
|
| 90 |
1002292213 |
402799 |
0117R0810426V002741 |
DANIYAL HAFIDZ ALFARIZQI |
5 th |
Lony Novita ,Dr, Sp.A.,M.Kes |
2026-04-12 |
GEA DRS, - (Diagnosa Utama)bacterial infection, - (Diagnosa Sekunder) |
KLS II |
2 |
SAPHIRE |
BPJS KESEHATAN |
|
4 |
|
Rp 3.336.005 |
- |
|
|
| 91 |
1002292214 |
414202 |
0117R0810426V003012 |
MISI |
59 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-12 |
Colic abdomen, - (Diagnosa Utama)Susp ISK, - (Diagnosa Sekunder) |
KLS III |
|
SAPHIRE |
BPJS KESEHATAN |
|
4 |
|
Rp 3.371.207 |
- |
|
R/UHC |
| 92 |
1002292224 |
386481 |
0117R0810426V002754 |
RAYYAN ALVARENDRA |
2 th |
Damayani Farastuti, Sp.A |
2026-04-13 |
GEA DRS, - (Diagnosa Utama)Vomitus, - (Diagnosa Sekunder)Obs Febris H2, - (Diagnosa Sekunder) |
KLS I |
1 |
SAPHIRE |
BPJS KESEHATAN |
|
3 |
|
Rp 3.358.676 |
- |
|
|
| 93 |
1002292365 |
252304 |
0117R0810426V002922 |
MADJANUN SIAGIAN |
66 th |
Vitri Iriani, Sp.P |
2026-04-13 |
dyspnoea ec asma eksaserbasi akut + RIW ppok & Tumor paru (S), - (Diagnosa Utama) |
KLS III |
3 |
SAPHIRE |
BPJS KESEHATAN |
|
3 |
|
Rp 2.380.309 |
- |
|
|
| 94 |
1002292372 |
414237 |
0117R0810426V002923 |
EKO SISWANDI |
57 th |
Oki Lestari Irsan, Dr, Sp.S |
2026-04-13 |
SNH, - (Diagnosa Utama) |
KLS III |
3 |
SAPHIRE |
BPJS KESEHATAN |
|
3 |
|
Rp 2.409.000 |
- |
|
|
| 95 |
1002292385 |
414241 |
0117R0810426V003355 |
OCA , TN |
71 th |
JD Dian Aryani , Dr, Sp.P |
2026-04-13 |
DYSPNOEA EC SUSP PPOK DD PNEUMONIA, - (Diagnosa Masuk) |
KLS III |
|
SAPHIRE |
BPJS KESEHATAN |
|
3 |
|
Rp 3.729.900 |
- |
|
R/ UHC |
| 96 |
1002292431 |
414266 |
0117R0810426V003035 |
AHUM |
83 th |
Firdaus Amansyah, Sp.B |
2026-04-13 |
hernia inguinalis dextra, - (Diagnosa Utama) |
KLS III |
3 |
SAPHIRE |
BPJS KESEHATAN |
|
3 |
|
Rp 5.113.695 |
- |
|
|
| 97 |
1002292517 |
379956 |
0117R0810426V003096 |
SUTINAH |
52 th |
Suvianto Hendri Lesmana, Sp.PD, FINASIM |
2026-04-13 |
gea dehidrasi ringan sedang, - (Diagnosa Utama) |
KLS II |
2 |
SAPHIRE |
BPJS KESEHATAN |
|
3 |
|
Rp 2.411.463 |
- |
|
saphire 5/2 |
| 98 |
1002292528 |
414298 |
0117R0810426V003087 |
KIRANA GAYATRI PILUTAS |
16 th |
Irman Firmansyah, Sp.PD, FINASIM, SH, MH |
2026-04-13 |
prolong febris, - (Diagnosa Utama)tifoid fever, - (Diagnosa Sekunder) |
KLS I |
1 |
SAPHIRE |
BPJS KESEHATAN |
|
3 |
|
Rp 3.610.895 |
- |
|
|
| 99 |
1002292541 |
324970 |
0117R0810426V003097 |
GILANG SYAHILA PUTRA |
27 th |
Irman Firmansyah, Sp.PD, FINASIM, SH, MH |
2026-04-13 |
febris h3 + dispepsia, - (Diagnosa Utama) |
KLS III |
3 |
SAPHIRE |
BPJS KESEHATAN |
|
3 |
|
Rp 1.515.019 |
- |
|
|
| 100 |
1002292559 |
414308 |
0117R0810426V003101 |
NENDI RAMADANI |
19 th |
Irman Firmansyah, Sp.PD, FINASIM, SH, MH |
2026-04-13 |
obs febris h3, - (Diagnosa Utama) |
KLS III |
|
SAPHIRE |
BPJS KESEHATAN |
|
3 |
|
Rp 1.538.600 |
- |
|
TITIP KLAS 2 |
| 101 |
1002292570 |
346845 |
0117R0810426V003172 |
DICKY MAHARDIKA , TN |
26 th |
Irman Firmansyah, Sp.PD, FINASIM, SH, MH |
2026-04-14 |
gea + vertigo, - (Diagnosa Utama) |
KLS I |
1 |
SAPHIRE |
BPJS KESEHATAN |
|
2 |
|
Rp 2.484.705 |
- |
|
|
| 102 |
1002292728 |
414337 |
0117R0810426V003291 |
PONIJA |
48 th |
Oki Lestari Irsan, Dr, Sp.S |
2026-04-14 |
vertigo dengan vomitus, HT emergency, - (Diagnosa Utama) |
KLS I |
1 |
SAPHIRE |
BPJS KESEHATAN |
|
2 |
|
Rp 2.700.100 |
- |
|
|
| 103 |
1002292790 |
374530 |
0117R0810426V003327 |
ALYSSA ARUMI |
1 th |
Lony Novita ,Dr, Sp.A.,M.Kes |
2026-04-14 |
obs febris, - (Diagnosa Utama)Bacterial infection of unspecified site, - (Diagnosa Sekunder) |
KLS III |
3 |
SAPHIRE |
BPJS KESEHATAN |
|
2 |
|
Rp 1.307.500 |
- |
|
|
| 104 |
1002292792 |
363125 |
0117R0810426V003318 |
ADITYA PRAMANA A, AN |
12 th |
Anasry Zakaria, dr, Sp.A |
2026-04-14 |
obs Edema Nefrotic sindrom, - (Diagnosa Utama) |
KLS I |
1 |
SAPHIRE |
BPJS KESEHATAN |
|
2 |
|
Rp 2.774.295 |
- |
|
|
| 105 |
1002292796 |
400525 |
0117R0810426V003340 |
VIONA CALLISTA DEVATHA, AN |
0 th |
Lony Novita ,Dr, Sp.A.,M.Kes |
2026-04-14 |
obs febris, - (Diagnosa Utama)bacterial infection , - (Diagnosa Sekunder) |
KLS I |
1 |
SAPHIRE |
BPJS KESEHATAN |
|
2 |
|
Rp 2.603.250 |
- |
|
|
| 106 |
1002292816 |
414357 |
0117R0810426V003349 |
ANNEUVA HAWA HUMAIRA |
9 th |
Damayani Farastuti, Sp.A |
2026-04-14 |
obs febris, - (Diagnosa Utama)dyspepsia , - (Diagnosa Sekunder) |
KLS I |
1 |
SAPHIRE |
BPJS KESEHATAN |
|
2 |
|
Rp 2.884.440 |
- |
|
|
| 107 |
1002292820 |
343189 |
0117R0810426V003523 |
NENENG NURHASANAH |
48 th |
Oki Lestari Irsan, Dr, Sp.S |
2026-04-14 |
vertigo, HT , - (Diagnosa Utama) |
KLS III |
|
SAPHIRE |
BPJS KESEHATAN |
|
2 |
|
Rp 1.453.400 |
- |
|
BUKTI BAYAR - |
| 108 |
1002292821 |
414359 |
0117R0810426V003675 |
GUNIH |
52 th |
Suvianto Hendri Lesmana, Sp.PD, FINASIM |
2026-04-14 |
obs febris, - (Diagnosa Utama)DM tipe II, - (Diagnosa Sekunder) |
KLS III |
|
SAPHIRE |
BPJS KESEHATAN |
|
2 |
|
Rp 4.475.893 |
- |
|
R/ UHC |
| 109 |
1002292839 |
414365 |
0117R0810426V003375 |
DWI AYU LESTARI |
30 th |
Irman Firmansyah, Sp.PD, FINASIM, SH, MH |
2026-04-14 |
GEA DRS, - (Diagnosa Utama)Abdominal pain ec Dyspepsia, - (Diagnosa Sekunder) |
KLS I |
1 |
SAPHIRE |
BPJS KESEHATAN |
|
2 |
|
Rp 1.796.000 |
- |
|
|
| 110 |
1002292852 |
414368 |
0117R0810426V003382 |
MOH NAUFAL I SHAM FIKRI |
20 th |
Irman Firmansyah, Sp.PD, FINASIM, SH, MH |
2026-04-14 |
Febris ec susp Typhoi fever, - (Diagnosa Utama)Bacterial infection, - (Diagnosa Sekunder) |
KLS I |
1 |
SAPHIRE |
BPJS KESEHATAN |
|
2 |
|
Rp 2.436.090 |
- |
|
|
| 111 |
1002292855 |
414370 |
0117R0810426V003650 |
SAFANA AULIA AZZAHRA |
1 th |
Lony Novita ,Dr, Sp.A.,M.Kes |
2026-04-14 |
KDS, - (Diagnosa Utama)Susp BP, - (Diagnosa Sekunder) |
KLS III |
|
SAPHIRE |
BPJS KESEHATAN |
|
2 |
|
Rp 2.496.050 |
- |
|
R/UHC |
| 112 |
1002292984 |
414392 |
0117R0810426V003525 |
MUHAMMAD IZZAR AL HANAN, AN |
4 th |
Damayani Farastuti, Sp.A |
2026-04-15 |
OF h3, - (Diagnosa Utama)riw epistaksis, - (Diagnosa Sekunder) |
KLS I |
1 |
SAPHIRE |
BPJS KESEHATAN |
|
1 |
|
Rp 1.742.800 |
- |
|
|
| 113 |
1002293028 |
414401 |
0117R0810426V003560 |
RADEN NOVILIA, NY |
50 th |
Irman Firmansyah, Sp.PD, FINASIM, SH, MH |
2026-04-15 |
OF H4 dgn gastritis, - (Diagnosa Utama)Susp TF, - (Diagnosa Sekunder) |
KLS I |
1 |
SAPHIRE |
BPJS KESEHATAN |
|
1 |
|
Rp 1.998.900 |
- |
|
zr lulu/sapir 09.1 |
| 114 |
1002293030 |
414402 |
0117R0810426V003562 |
AHMAD SAGUNA ANDARU, AN |
7 th |
Anasry Zakaria, dr, Sp.A |
2026-04-15 |
OF H3 viral infection, - (Diagnosa Utama)ispa, - (Diagnosa Sekunder) |
KLS I |
1 |
SAPHIRE |
BPJS KESEHATAN |
|
1 |
|
Rp 1.877.300 |
- |
|
zr lulu/sapir 09.2 |
| 115 |
1002293041 |
411231 |
0117R0810426V003567 |
IZELDA AULIA PUTRI ZANETI , AN |
1 th |
Anasry Zakaria, dr, Sp.A |
2026-04-15 |
Varisela inf sekunder, - (Diagnosa Utama) |
KLS I |
1 |
SAPHIRE |
BPJS KESEHATAN |
|
1 |
|
Rp 1.712.500 |
- |
|
|
| 116 |
1002293043 |
356652 |
0117R0810426V003602 |
RAYYAN ALVARENDRA TRIANTORO |
4 th |
Damayani Farastuti, Sp.A |
2026-04-15 |
brpn, - (Diagnosa Utama)viral infection, - (Diagnosa Sekunder) |
KLS I |
1 |
SAPHIRE |
BPJS KESEHATAN |
|
1 |
|
Rp 2.086.700 |
- |
|
|
| 117 |
1002293045 |
329591 |
0117R0810426V003614 |
YANAH |
42 th |
M.Ibnu Joko, Dr, Sp.B |
2026-04-15 |
Susp app, - (Diagnosa Utama) |
KLS I |
1 |
SAPHIRE |
BPJS KESEHATAN |
|
1 |
|
Rp 2.188.600 |
- |
|
|
| 118 |
1002293090 |
414422 |
0117R0810426V003640 |
NAILA NURSABILA |
22 th |
Irman Firmansyah, Sp.PD, FINASIM, SH, MH |
2026-04-15 |
GEA dehidrasi sedang, - (Diagnosa Utama)hipokalemia, - (Diagnosa Sekunder) |
KLS I |
1 |
SAPHIRE |
BPJS KESEHATAN |
|
1 |
|
Rp 1.906.200 |
- |
|
|
| 119 |
1002293103 |
414428 |
0117R0810426V003669 |
FATHORRAHMAN |
41 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-15 |
HT urgensi, - (Diagnosa Utama)sinus takikardi, - (Diagnosa Sekunder) |
KLS II |
2 |
SAPHIRE |
BPJS KESEHATAN |
|
1 |
|
Rp 1.489.500 |
- |
|
|
| 120 |
1002292115 |
366094 |
0117R0810426V002652 |
NAILAH MAU`LLIMAH |
6 th |
Lony Novita ,Dr, Sp.A.,M.Kes |
2026-04-11 |
Fever, unspecified, - (Diagnosa Utama) |
KLS III |
|
TOPAZ |
BPJS KESEHATAN |
|
5 |
|
Rp 3.651.165 |
- |
|
iso topaz 7.3 |
| 121 |
1002292181 |
414178 |
0117R0810426V003311 |
ALLEA SHANUM ALMAHYRA, AN |
1 th |
Anasry Zakaria, dr, Sp.A |
2026-04-12 |
Fever, unspecified, - (Diagnosa Utama)+morbili |
KLS III |
|
TOPAZ |
BPJS KESEHATAN |
|
4 |
|
Rp 3.873.538 |
- |
|
R/UHC |
| 122 |
1002292359 |
414234 |
0117R0810426V002925 |
MINAH BINTI KUSNADI |
47 th |
SUVIANTO HENDRI LESMANA, Sp.PD, FINASIM |
2026-04-13 |
anemia + edema pretibia bilateral ec susp cardiorenal syndrome, - (Diagnosa Utama) |
KLS III |
3 |
TOPAZ |
BPJS KESEHATAN |
|
3 |
|
Rp 2.369.120 |
- |
|
T3.4 |
| 123 |
1002292361 |
414235 |
0117R0810426V002913 |
MUHAMAD ALFARIZI |
6 th |
Damayani Farastuti, Sp.A |
2026-04-13 |
* OF ec viral infection, - (Diagnosa Utama) +morbili |
KLS III |
|
TOPAZ |
BPJS KESEHATAN |
|
3 |
|
Rp 2.559.356 |
- |
|
|
| 124 |
1002292412 |
402224 |
0117R0810426V002958 |
AL BARRAQ MAULANA, AN |
0 th |
Lony Novita ,Dr, Sp.A.,M.Kes |
2026-04-13 |
morbilli+susp bronkhiolitis dd pneumonia, - (Diagnosa Utama) |
KLS III |
3 |
TOPAZ |
BPJS KESEHATAN |
|
3 |
|
Rp 2.482.889 |
- |
|
|
| 125 |
1002292471 |
244005 |
0117R0810426V003067 |
MOHAMMAD GIBRAN EVANO, AN |
7 th |
Lony Novita ,Dr, Sp.A.,M.Kes |
2026-04-13 |
hiprepireksia + viral infeksi + intake sulit, - (Diagnosa Utama) |
KLS III |
|
TOPAZ |
BPJS KESEHATAN |
|
3 |
|
Rp 1.417.000 |
- |
|
|
| 126 |
1002292489 |
364791 |
|
ENCIH BT. UTO |
50 th |
SUVIANTO HENDRI LESMANA, Sp.PD, FINASIM |
2026-04-13 |
OF + ISPA, - (Diagnosa Utama) |
KLS III |
|
TOPAZ |
JAMINAN PRIBADI |
|
3 |
|
Rp 4.630.210 |
- |
|
R/UHC |
| 127 |
1002292560 |
414309 |
0117R0810426V003103 |
MUHAMMAD FATIH ALFARIZKY |
0 th |
Damayani Farastuti, Sp.A |
2026-04-13 |
prolong febris + vomitus, - (Diagnosa Utama)post morbili, - (Diagnosa Sekunder) |
KLS III |
3 |
TOPAZ |
BPJS KESEHATAN |
|
3 |
|
Rp 2.225.310 |
- |
|
|
| 128 |
1002292563 |
414311 |
0117R0810426V003104 |
JULIAN KAELAN NARENDRA |
0 th |
Damayani Farastuti, Sp.A |
2026-04-14 |
susp morbili, - (Diagnosa Utama) |
KLS III |
3 |
TOPAZ |
BPJS KESEHATAN |
|
2 |
|
Rp 1.698.144 |
- |
|
|
| 129 |
1002292794 |
401172 |
0117R0810426V003338 |
MUHAMMAD BAYU HAIDAR ALI |
19 th |
Suvianto Hendri Lesmana, Sp.PD, FINASIM |
2026-04-14 |
obs dispnea, sindrom neftrotik, - (Diagnosa Utama) |
KLS III |
3 |
TOPAZ |
BPJS KESEHATAN |
|
2 |
|
Rp 1.320.000 |
- |
|
|
| 130 |
1002292815 |
414356 |
0117R0810426V003342 |
WALIM |
33 th |
Suvianto Hendri Lesmana, Sp.PD, FINASIM |
2026-04-14 |
obs febris ec susp demam dengue, - (Diagnosa Utama) |
KLS III |
3 |
TOPAZ |
BPJS KESEHATAN |
|
2 |
|
Rp 1.848.512 |
- |
|
|
| 131 |
1002292819 |
413170 |
0117R0810426V003344 |
AZKIA DINARA |
1 th |
Lony Novita ,Dr, Sp.A.,M.Kes |
2026-04-14 |
susp morbili, ISPA, - (Diagnosa Utama) |
KLS III |
|
TOPAZ |
BPJS KESEHATAN |
|
2 |
|
Rp 1.184.300 |
- |
|
|
| 132 |
1002292831 |
374583 |
0117R0810426V003370 |
ALZENA DZAKIYAH ABIDAH BANAFSHA |
2 th |
Lony Novita ,Dr, Sp.A.,M.Kes |
2026-04-14 |
Morbili, - (Diagnosa Sekunder)Demam Tifoid, - (Diagnosa Utama) |
KLS I |
|
TOPAZ |
BPJS KESEHATAN |
|
2 |
|
Rp 2.576.290 |
- |
|
shap 20.2 tunggu ps plng |
| 133 |
1002292837 |
414364 |
0117R0810426V003381 |
IRMA SAYYIDINA |
26 th |
Firdaus Amansyah, Sp.B |
2026-04-14 |
VL ar Genu + Skin loss, - (Diagnosa Utama) |
KLS III |
|
TOPAZ |
BPJS KESEHATAN |
|
2 |
|
Rp 4.446.835 |
- |
|
POST KLL /LP + |
| 134 |
1002292848 |
348384 |
0117R0810426V003402 |
DEVITRI SHANYEHA LUMBANTOBING , NY |
38 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-14 |
Diare akut DRS, - (Diagnosa Utama)Abdominal pain ec Dyspepsia, - (Diagnosa Sekunder) |
KLS III |
|
TOPAZ |
BPJS KESEHATAN |
|
2 |
|
Rp 1.211.300 |
- |
|
|
| 135 |
1002292853 |
390181 |
0117R0810426V003386 |
ENAH |
59 th |
SUVIANTO HENDRI LESMANA, Sp.PD, FINASIM |
2026-04-14 |
Dyspepsia, - (Diagnosa Utama)Hiperglikemia ec DMT2, - (Diagnosa Sekunder)Hipertensi grade II, - (Diagnosa Sekunder) |
KLS III |
3 |
TOPAZ |
BPJS KESEHATAN |
|
2 |
|
Rp 1.247.300 |
- |
|
t5.3 |
| 136 |
1002292856 |
414371 |
0117R0810426V003387 |
SARTINAH |
57 th |
Irman Firmansyah, Sp.PD, FINASIM, SH, MH |
2026-04-14 |
Febris ec Bacterial infection, - (Diagnosa Sekunder)Hiperglikemia ec DMT2, - (Diagnosa Utama)Dyspnoe ec susp BP, - (Diagnosa Sekunder) |
KLS III |
|
TOPAZ |
BPJS KESEHATAN |
|
2 |
|
Rp 1.380.759 |
- |
|
|
| 137 |
1002292857 |
324629 |
0117R0810426V003388 |
NURUSSAADAH |
21 th |
Oki Lestari Irsan, Dr, Sp.S |
2026-04-14 |
Vertigo perifer, - (Diagnosa Utama)Dyspepsia, - (Diagnosa Sekunder) |
KLS III |
3 |
TOPAZ |
BPJS KESEHATAN |
|
2 |
|
Rp 1.001.100 |
- |
|
T1.4 |
| 138 |
1002292987 |
414393 |
|
AI HAYATI, NY |
40 th |
Florentina Carolin Puspita Hapsari, Sp.PD |
2026-04-15 |
back pain, - (Diagnosa Utama) |
KLS III |
|
TOPAZ |
JAMINAN PRIBADI |
|
1 |
|
Rp 2.776.300 |
- |
|
R/UHC/ZR MEILIA TOPAZ 5.1 |
| 139 |
1002292995 |
270838 |
0117R0810426V003537 |
RENDI MAULANA |
23 th |
Irman Firmansyah, Sp.PD, FINASIM, SH, MH |
2026-04-15 |
Abdominal paim, - (Diagnosa Utama) |
KLS III |
3 |
TOPAZ |
BPJS KESEHATAN |
|
1 |
|
Rp 989.100 |
- |
|
|
| 140 |
1002293040 |
080513 |
0117R0810426V003612 |
HETI TRISNIAWATI,NY |
45 th |
JD Dian Aryani , Dr, Sp.P |
2026-04-15 |
asma akut derajat berat, - (Diagnosa Masuk)Asma akut derajat berat, - (Diagnosa Utama) |
KLS I |
|
TOPAZ |
BPJS KESEHATAN |
|
1 |
|
Rp 1.939.400 |
- |
|
|
| 141 |
1002293117 |
306957 |
0117R0810426V003665 |
AHMAD DAHLAN |
20 th |
Suvianto Hendri Lesmana, Sp.PD, FINASIM |
2026-04-15 |
Typhoid fever, - (Diagnosa Utama)Bronchitis, not specified as acute or chronic, - (Diagnosa Sekunder)Dyspepsia, - (Diagnosa Sekunder) |
KLS III |
|
TOPAZ |
BPJS KESEHATAN |
|
1 |
|
Rp 1.470.800 |
- |
|
|
