Sheet1

RS. PERMATA CIREBON

JL. TUPAREV NO. 117 CIREBON 45153
SELISIH BIAYA RAWAT INAP (PASIEN NAIK KELAS

Nama Pasien :VRETI WAHYUNI

No. RM : 077-087
UNIT Sapphire-VIP
Rawat Inap lt.2 Tarif Jumlah Total
Kamar Perawatan Setelah Diskon 750,000.00 3 2,250,000.00
Jasa Keperawatan 45,000.00 3 135,000.00
Case Manager / dr. Umum per hari 45,000.00 3 135,000.00
Visite Dokter 140,000.00 2 280,000.00
Injeksi IV 13,824.00 2 27,648.00
Lepas Infus Dewasa 31,104.00 1 31,104.00
BHP RANAP 26,288.40 1 26,288.40
Jumlah Rawat Inap vip
Instalasi Gawat Darurat
Instalasi Farmasi
Laboratorium
Instalasi Farmasi
Laboratorium
Sub Total
Biaya Administrasi 5% dari Sub Total
Materai
Total Rincian Biaya

Total Rincian Biaya Kamar VIP 4,430,718.22

Total Rincian Biaya Kamar Kelas I 3,559,415.62
SELISIH BIAYA RAWAT INAP 871,302.60

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 Sheet1

RS. PERMATA CIREBON

JL. TUPAREV NO. 117 CIREBON 45153
SELISIH BIAYA RAWAT INAP (PASIEN NAIK KELAS)

phire-VIP Ruby – Kelas I

Tarif Jumlah Total
500,000.00 3 1,500,000.00
40,000.00 3 120,000.00
40,000.00 3 120,000.00
120,000.00 2 240,000.00
11,520.00 2 23,040.00
25,900.00 1 25,900.00
26,288.40 1 26,288.40
2,885,040.40 Jumlah Rawat Inap kelas I
133,599.00
335,944.95
301,247.00
470,900.00
87,286.00
4,214,017.35
210,700.87
6,000.00
4,430,718.22

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as I

2,055,228.40
133,599.00
335,944.95
301,247.00
470,900.00
87,286.00
3,384,205.35
169,210.27
6,000.00
3,559,415.62

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