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REKAPITULASI PASIEN RAWAT JALAN RSKMM PERHARI 2015

TINDAKAN
Tanggal Nama Pasien Alamat dr.Tugas Medical Record ket
Spesialis Repraksi Auto Rep Spuling/Kju USG Tono non Kontak Istihara Laboratorium Obat Jumlah
8/4/2015 Lasmi Lr.Ariodillah 06.66.82 Rp 7,500 Rp 131,000 Rp 138,500
8/4/2015 Dimaz AR Jln.Malaka IV Kenten dr.Farida 09.86.74 Rp 7,500 Rp 82,000 Rp 89,500
8/4/2015 Danila Dsn.II RT.004 Indralaya dr.Anang 09.93.61 Rp 7,500 Rp 5,000 Rp 5,000 Rp 17,500
8/4/2015 Eti Sumiati Jln.Swadaya no 0195 dr.Farida 09.88.15 Rp 7,500 Rp 159,000 Rp 166,500
8/4/2015 Naswirtati Jln.Kancil putih I 09.70.34 Rp 7,500 Rp 7,500
8/4/2015 Idayanti Jln.PLG-PKL.Balai dr.Farida 09.88.11 Rp 7,500 Rp 50,000 Rp 20,000 Rp 189,000 Rp 266,500
8/4/2015 Firdaus Putra Jln.Swadaya no 2921 dr.Farida 09.93.65 Rp 50,000 Rp 56,000 Rp 106,000
8/4/2015 Jaleha Jln.Perindustrian 2.no.1296 dr.Farida 03.61.60 Rp 7,500 Rp 57,000 Rp 64,500
8/4/2015 Rien oktarina Jln.Sukabangun dr.Farida 09.86.77 Rp 47,500 Rp 47,500 Kel.Dora
8/4/2015 Agung Misriyanto Jln.Nias IV.no.637 09.93.85 Rp 5,000 Rp 38,500 Rp 43,500
8/4/2015 Tolip Karang Agung dr.Farida 09.93.75 Rp 7,500 Rp 55,000 Rp 62,500
8/4/2015 Farhan Suandi Jln.Sambireja Mariana dr.Sri 09.71.71 Rp 7,500 Rp 47,000 Rp 54,500
8/4/2015 Cik Rafini Jln.Nusa Pemda II dr.Anang 09.93.90 Rp 7,500 Rp 5,000 Rp 5,000 Rp 19,000 Rp 36,500
8/4/2015 Rahmad Fadli Jln.Padang Selasa dr.Dian 09.93.96 Rp 5,000 Rp 5,000 Rp 10,000
8/4/2015 Alisa Dsn.II RT.001 dr.Anang 09.93.78 Rp 7,500 Rp 5,000 Rp 12,500
8/4/2015 Kalsiah Jln.Ki merogan dr.Farida 09.93.87 Rp 7,500 Rp 131,000 Rp 138,500
8/4/2015 Ardan Suka bangun dr.Sri 09.93.99 Rp 5,000 Rp 5,000 Rp 10,000
8/4/2015 Salna Kertapati dr.Yulida 06.37.25 Rp 7,500 Rp 19,000 Rp 26,500
8/4/2015 Diah Widiastuti Pakjo dr.Dian 09.93.95 Rp 7,500 Rp 5,000 Rp 5,000 Rp 17,500
8/4/2015 Nurhalima Tanjung batu Ogan ilir dr.Yulida 03.41.93 Rp 5,000 Rp 5,000 Rp 10,000
8/4/2015 Rosma Pangaribuan Jln.Betawi Raya dr.Farida 09.93.93 Rp 5,000 Rp 5,000 Rp 10,000
8/4/2015 Ade Putra Maulana Jln.Swadaya no.2409 dr.Tiara 09.94.12 Rp 25,000 Rp 25,000
8/4/2015 Ardiansyah Arriodilah dr.Tiara 09.88.50 Rp 5,000 Rp 5,000 Rp 155,000 Rp 165,000
8/4/2015 Agustinus sitanggung Padat karya talang jambe dr.Yulida 09.94.05 Rp 7,500 Rp 7,500
8/4/2015 Regen Ds.III jejawi dr.Yulida 09.94.05 Rp 5,000 Rp 25,000 Rp 66,500 Rp 96,500
8/4/2015 Jhoni Afriko Jl.Kol.H.Burlian dr.Yulida 09.93.97 Rp 7,500 Rp 166,000 Rp 173,500
8/4/2015 Ema wati Ds.Babat penukal dr.Dian 09.94.22 Rp 5,000 Rp 5,000 Rp 153,500 Rp 163,500
8/4/2015 Rohman hakim Karang agung dr.Dian 09.94.23 Rp 5,000 Rp 5,000 Rp 109,500 Rp 119,500
8/4/2015 Salma Kenten laut dr.Yulida 09.83.80 Rp 7,500 Rp 40,000 Rp 47,500
8/4/2015 Munah Pampangan dr.Farida Rp 125,000 Rp 125,000
8/4/2015 Asriwijaya Kertapati Pasien rawat Rp 58,000 Rp 58,000
8/4/2015 Duaji Talang Kelapa Tanpa nomor Rp 447,000
Jumlah Tindakan 17 13 10 2 1 1 1 1 20
Err:522
Jumlah Biaya Tindakan Rp 127,500 Rp 65,000 Rp 50,000 Rp 100,000 Rp 125,000 Rp 25,000 Rp 25,000 Rp 20,000 Rp 1,779,500

Palembang, 08 April 2015


Mengetahui
Rekam medic KASIR

(UTTAMI A. SUCA S.KM) (UJANG)


REKAPITULASI PASIEN RAWAT JALAN RSKMM PERHARI 2015
TINDAKAN
Tanggal Nama Pasien Alamat dr.Tugas Medical Record ket
Spesialis Repraksi Auto Rep Spuling/Kju Corpus Cornea Laboratorium Obat Jumlah
9/4/2015 Asriwijaya Kertapati Rp 33,500 Rp 33,500
9/4/2015 Muryani Jln.May mahdin dr.yulida 04.84.82 Rp 7,500 Rp 220,000 Rp 227,500
9/4/2015 Khodijah (VIP) Jln.balayudha dr.Karyusi 09.88.51 Rp 81,000 Rp 81,000
9/4/2015 suaji Talang kelapa dr.yulida 06.61.37 Rp 7,500 Rp 140,000 Rp 147,500
9/4/2015 Dika irwansyah Perum Interbis dr.Sri 09.94.54 Rp 7,500 Rp 86,000 Rp 93,500
9/4/2015 Sutejo(VIP) Griya asri talang betutu dr.Dian 09.94.53 Rp 94,000 Rp 94,000
9/4/2015 M.Muhriyadi Sumber mukti Rt 03 dr.yulida 09.94.49 Rp 7,500 Rp 5,000 Rp 5,000 Rp 50,000 Rp 20,000 Rp 196,000 Rp 283,500
9/4/2015 Herman TL.Pematang Oku dr.Siska 09.94.73 Rp 7,500 Rp 60,000 Rp 108,000 Rp 175,500
9/4/2015 Nurhasanah Tl.Banten dr.yulida 09.94.72 Rp 7,500 Rp 50,000 Rp 20,000 Rp 224,000 Rp 301,500
9/4/2015 Marsudi Jln.Mandi Api 2 dr.yulida 09.94.57 Rp 65,000 Rp 281,000 Rp 346,000
9/4/2015 fatimah Tj.batu dr.Siska 09.94.75 Rp 7,500 Rp 60,000 Rp 201,000 Rp 268,500
9/4/2015 Daniel Maskarebet dr.yulida Rp 428,000 Rp 428,000
9/4/2015 Made sukri (VIP) Mataram jaya Rt.001 dr.anang 09.89.61 Rp 92,000 Rp 92,000
9/4/2015 Siti Nurhaliza Jln.dwikora II 09.94.94 Rp 5,000 Rp 5,000 Rp 10,000
9/4/2015 Kartini Oku Timur dr.Dian Rp 347,000 Rp 347,000
9/4/2015 Rusmiati Lr.Sei aur RT.28 09.92.21 Rp 7,500 Rp 178,000 Rp 185,500
9/4/2015 Suminah Ds.Saleh Agung dr.yulida 09.94.90 Rp 7,500 Rp 192,000 Rp 199,500
9/4/2015 Teri wardiansyah Tj.batu dr.sri 09.94.97 Rp 7,500 Rp 75,000 Rp 82,500
9/4/2015 Andika Oki Rp 16,000 Rp 16,000
9/4/2015 Suwani permata biru dr.Tiara 06.86.28 Rp 7,500 Rp 7,500
9/4/2015 Terusiwani Tegal mulyo dr.Siska 09.71.95 Rp 7,500 Rp 108,000 Rp 115,500
9/4/2015 Rati dr.Siska Rp 116,000 Rp 116,000
9/4/2015 Yani Jln.Angkatan 66 dr.Tiara 09.95.00 Rp 7,500 Rp 5,000 Rp 12,500
9/4/2015 Diana sari juwita Jln.Ismail marzuki 09.95.05 Rp 5,000 Rp 5,000 Rp 10,000
9/4/2015 Yulia Deviani Jln SMB II km-12 09.95.08 Rp 5,000 Rp 5,000 Rp 10,000
9/4/2015 Yarlis (VIP) Jln.lematang III no 15 dr.Diana 09.95.10 Rp 74,000 Rp 74,000
9/4/2015 Djie Chai fung Lr.Kepadean dr.yulida 09.95.09 Rp 7,500 Rp 85,000 Rp 92,500
9/4/2015 Honisa Jln.naskah Km-7 dr.Tiara 09.95.02 Rp 7,500 Rp 5,000 Rp 5,000 Rp 19,000 Rp 36,500
9/4/2015 bobi septia Tj batu oi dr.yulida 09.95.38 Rp 7,500 Rp 38,000 Rp 45,500
9/4/2015 Asmah Jl.Lubuk kawah dr.Tiara 09.95.16 Rp 7,500 Rp 5,000 Rp 5,000 Rp 41,000 Rp 58,500
9/4/2015 Sumirah Sukomoro 09.88.39 Rp 7,500 Rp 138,500 Rp 146,000
9/4/2015 Indriani tanjung batu dr.Sri 09.95.39 Rp 5,000 Rp 5,000 Rp 10,000
9/4/2015 Angga Sekayu dr.yulida 09.53.25 Rp 7,500 Rp 153,000 Rp 160,500
9/4/2015 Robi Swadaya 09.95.42 Rp 5,000 Rp 5,000 Rp 75,000 Rp 85,000
9/4/2015 Rohani Jln.Demang no 1143 dr.Dian 09.95.17 Rp 7,500 Rp 5,000 Rp 5,000 Rp 40,000 Rp 57,500
9/4/2015 Yana Senun barat Tj.Batu 09.66.07 Rp 5,000 Rp 5,000 Rp 10,000
9/4/2015 Saiful Kertapati 08.66.07 Rp 35,000 Rp 35,000
Jumlah Tindakan 20 11 10 2 1 4 30
Err:522
Jumlah Biaya Tindakan Rp150,000 Rp55,000 Rp 50,000 Rp 100,000 Rp 65,000 Rp 160,000 Rp 3,915,000

Palembang, 09 April 2015


Mengetahui
Rekam medic KASIR

(UTTAMI A. SUCA S.KM) (UJANG)


REKAPITULASI PASIEN RAWAT JALAN RSKMM PERHARI 2015
TINDAKAN
Tanggal Nama Pasien Alamat dr.Tugas Medical Record ket
Spesialis Repraksi Auto Rep Spuling/Kju USG Tono non Kontak Istihara Laboratorium Obat Jumlah
10/4/2015 Asriwijaya Kertapati P.rawat inap Rp 216,000 Rp 216,000
10/4/2015 Marsudi Jln.Mandi api 2 dr.Yulida 09.94.57 Rp 7,500 Rp 7,500
10/4/2015 Machludin Tanjung lago - Rp 7,500 Rp 157,000 Rp 164,500
10/4/2015 Law ho Tjun GG.Masjid raya dr.Yulida 09.95.52 Rp 7,500 Rp 284,000 Rp 291,500
10/4/2015 Madalok handayani Jln.H.sanusi dr.Yulida 08.31.20 Rp 7,500 Rp 50,000 Rp 84,000 Rp 141,500
10/4/2015 Saidi Sumbawa - P.rawat inap Rp 10,000 Rp 10,000
10/4/2015 Naila Jln.Dr.M.Isa dr.Yulida 09.91.43 Rp 7,500 Rp 107,000 Rp 114,500
10/4/2015 Allia Jln.Puncak sekuning dr.Hamidin 09.95.63 Rp 5,000 Rp 5,000 Rp25,000 Rp 35,000
10/4/2015 Mas nona KH.dahlan dr.Yulida 09.95.49 Rp 60,000 Rp 60,000
10/4/2015 Salma Kenten laut dr.Yulida 09.83.80 Rp 7,500 Rp 35,000 Rp 92,500 Rp 135,000
10/4/2015 Giri sudrjah Talang jambe dr.Yulida 09.95.70 Rp 7,500 Rp 206,800 Rp 214,300
10/4/2015 Rina Utari saputri Rusun blok 31 dr.Hamidin 09.95.62 Rp 5,000 Rp 5,000 Rp 10,000
10/4/2015 Nurbaiti Jln.Tanah merah no.42 09.95.65 Rp 5,000 Rp 5,000 Rp 10,000
10/4/2015 Rabatiah Jln.jend.sudirman dr.Hamidin 09.95.71 Rp 5,000 Rp 5,000 Rp 10,000
10/4/2015 Pedri Setiawan Jln.Tanah merah no.42 09.95.67 Rp 7,500 Rp 5,000 Rp 5,000 Rp 122,000 Rp 134,500
10/4/2015 Hodijah Jln.Let.Simanjuntak dr.Hamidin 09.95.60 Rp 7,500 Rp 75,000 Rp 82,500
10/4/2015 Kasmiati Kenten sako P.luar Rp 13,000 Rp 13,000
10/4/2015 Janes Lebong siarang dr.Hamidin 09.89.42 Rp 7,500 Rp 19,000 Rp 26,500
10/4/2015 Nurmila Pasar lama kaur dr.Dian 09.83.24 Rp 7,500 Rp 47,000 Rp 54,500
10/4/2015 Dea Jln.KH.Wahid hasyim dr.Yulida 09.28.04 Rp 7,500 Rp 7,500
10/4/2015 Septi masna dewi Komp.PPRU indralaya dr.Dian 09.95.75 Rp 5,000 Rp 5,000 Rp 10,000
10/4/2015 Anggi Jln.Tanjung Raya Km-11 dr.Sri 09.95.74 Rp 5,000 Rp 104,500 Rp 109,500
10/4/2015 Kristian Simpang Timbangan dr.Yulida 06.66.19 Rp 7,500 Rp 5,000 Rp 12,500
10/4/2015 Holy safitri Jln.Swadaya pinang raya I dr.Yulida 09.94.59 Rp 5,000 Rp 5,000 Rp 10,000
10/4/2015 Harianto Lr.Temabus RT.35 dr.Yulida 09.95.78 Rp 50,000 Rp 50,000
10/4/2015 Agustina Dwi Astuti Sungai lilin Jaya dr.Dian 09.95.88 Rp 7,500 Rp 5,000 Rp 5,000 Rp 64,000 Rp 81,500
10/4/2015 Syafril imron Jl.manggis komplek pusri dr.Dian
10/4/2015 Endang Jln.Gersik no.30A dr.Hamidin Rp 7,500 Rp 50,000 Rp 25,000 Rp 19,000 Rp 101,500
10/4/2015 Suryadi Jln.Macan Lindungan dr.Yulida 09.95.90 Rp 7,500 Rp 50,000 Rp 47,500 Rp 105,000
10/4/2015 Yanto belitag dr.Yulida 09.95.87 Rp 7,500 Rp 7,500
10/4/2015 Lukman Jln.Merdeka.Tj.batu dr.anang 09.71.98 Rp 5,000 Rp 25,000 Rp 40,500 Rp 70,500
10/4/2015 Iin citra lestari Mega asri I dr.Yulida 09.96.03 Rp 5,000 Rp 25,000 Rp 30,000
10/4/2015 Kamil Banyu Asin dr.Yulida 09.96.02 Rp 5,000 Rp 113,000 Rp 118,000
10/4/2015 Ikral sawabi dr.Hamidin Rp 5,000 Rp 5,000 Rp 10,000
10/4/2015 Sayuning 1 Ulu Kertapati dr.Yulida 09.96.08 Rp 194,000 Rp 194,000
10/4/2015 Djamilah Jln.Beliti no.850 dr.Yulida 09.95.99 Rp 7,500 Rp 5,000 Rp 5,000 Rp 19,000 Rp 36,500
10/4/2015 Syintia Jln.karya baru Km-7 dr.Dian Rp 7,500 Rp 5,000 Rp 5,000 Rp25,000 Rp 42,500
10/4/2015 Atik Jln.Setunggal no.56 09.95.84 Rp 7,500 Rp125,000 Rp 61,500 Rp 194,000
10/4/2015 Junaidi Lempuing jaya Oki 09.95.93 Rp 7,500 Rp 5,000 Rp 5,000 Rp 15,000 Rp 46,000 Rp 78,500
Jumlah Tindakan 21 16 15 4 1 3 2 3 23
Rp 2,999,800
Jumlah biaya Tindakan Rp 157,500 Rp 80,000 Rp 65,000 Rp 200,000 Rp125,000 Rp 75,000 Rp50,000 Rp 110,000 Rp 2,142,300

Palembang, 10 April 2015


Mengetahui
Rekam medic KASIR

(UTTAMI A. SUCA S.KM) (UJANG)


REKAPITULASI DATA PASIEN VIP RUMAH SAKIT KHUSUS MATA MASYARAKAT PERHARI 2015
TINDAKAN
Tanggal Nama Alamat dr.Tugas Medical record
Karcis Fondus copi Auto Rep Konsul Tono non kontak Jumlah Ket
8/4/2015 Daniel Lr.garuda II kec.jambi Timur dr.Farida 09.92.53 Rp 15,000 Rp 40,000 Rp 25,000 Rp 100,000 Rp 180,000
8/4/2015 Yohana teresia Jln.Yudha maka II 16 ulu dr.Anang 09.93.80 Rp 15,000 Rp 40,000 Rp 100,000 Rp 70,000 Rp 225,000
Jumlah Tindakan 2 2 1 2 1
Rp 405,000
Jumlah Biaya Tindakan Rp 30,000 Rp 80,000 Rp 25,000 Rp 200,000 Rp 70,000

Palembang, 08 April 2015


Mengetahui
Rekam medic KASIR

(UTTAMI A. SUCA S.KM) (UJANG)


REKAPITULASI DATA PASIEN VIP RUMAH SAKIT KHUSUS MATA MASYARAKAT PERHARI 2015
TINDAKAN
Tanggal Nama Alamat dr.Tugas Medical record Ket
Fondus copi Auto Rep Konsul Aj Compi metri Tono metri Konsul dr.tgs Karcis Jumlah
9/4/2015 Khodijah (VIP) Jln.balayudha dr.Karyusi 09.88.51 Rp 40,000 Rp 100,000 Rp 15,000 Rp 155,000
9/4/2015 Sutejo(VIP) Griya asri talang betutu dr.Dian 09.94.53 Rp 40,000 Rp 100,000 Rp 15,000 Rp 155,000
9/4/2015 Made sukri (VIP) Mataram jaya Rt.001 dr.Anang 09.89.61 Rp 40,000 Rp 25,000 Rp 100,000 Rp300,000 Rp 15,000 Rp 180,000 Diambil dr.Anang
9/4/2015 Yarlis (VIP) Jln.lematang III no 15 dr.Diana 09.95.10 Rp 40,000 Rp 25,000 Rp 100,000 Rp 15,000 Rp 180,000
9/4/2015 Fika duri safei Jln. A.Yani no 106 dr.Siska 09.94.81 Rp 100,000 Rp260,000 Rp 100,000 Rp 100,000 Rp 15,000 Rp 575,000 Konsul dr.farida
9/4/2015 Zulfirza Ds.Penyandingan muara enim dr.Anang 09.94.46 Rp 40,000 Rp 100,000 Rp 15,000 Rp 155,000
Jumlah tindakan 5 2 6 1 1 1 1 6
Rp 1,400,000
Jumlah Biaya Tindakan Rp 200,000 Rp 50,000 Rp 600,000 Rp300,000 Rp260,000 Rp 100,000 Rp 100,000 Rp 90,000

Palembang, 09 April 2015


Mengetahui
Rekam medic KASIR

(UTTAMI A. SUCA S.KM) (UJANG)


REKAPITULASI DATA PASIEN VIP RUMAH SAKIT KHUSUS MATA MASYARAKAT PERHARI 2015
TINDAKAN
Tanggal Nama Alamat dr.Tugas Medical record Ket
Karcis Fondus copi Kerato metri Bio metri Konsul Tono metri labor Suntikan dexa Jumlah
10/4/2015 Rustam effendy Hz Batu raja dr.Anang 09.95.96 Rp 15,000 Rp 40,000 Rp 25,000 Rp 50,000 Rp 100,000 Rp 50,000 Rp 121,000 Rp 1,400,000 Rp 1,801,000
10/4/2015 Miyem Jalur 8 Telang dr.Anang 09.89.93 Rp 15,000 Rp 40,000 Rp 100,000 Rp 155,000
Jumlah Tindakan 2 2 1 1 2 1 1 1
Rp 1,956,000
Jumlah Biaya Tindakan Rp 30,000 Rp 80,000 Rp 25,000 Rp 50,000 Rp 200,000 Rp 50,000 Rp 121,000 Rp 1,400,000

Palembang, 10 April 2015


Mengetahui
Rekam medic KASIR

(UTTAMI A. SUCA S.KM) (UJANG)