LAPORAN LAYANAN GIGI (PERIODE 1-31 OKTOBER) - PRAKTEK DRG.

DIANA KUSRIYANTI, M
DISCOVERY ALUVIA 7 F/23 BINTARO, TANGERANG SELATAN

No Tanggal Nama Pasien Tindakan

1 1/10/2021 Ayudya Amelia Insersi Retainer U + Aktivasi
Scalling UL
2 2/1/2021 Diyan Rahmayanti
Kontrol Ortho
3 3/10/2021 Putri Megasari Kontrol Ortho
4 3/10/2021 Aditya Purwadana Scalling UL
Kontrol Ortho
5 3/10/2021 Sri Sulistiowati
Tambal Komposit
6 4/10/2021 Tjhia Bie Hiong Perawatan Saluran Akar
Kontrol Ortho
7 5/10/2021 Vicaris Ariel Yofadin
Exo GR 6
8 5/10/2021 Aprian Ridholloh Kontrol Ortho
9 8/10/2021 Tjhia Bie Hiong Perawatan Saluran Akar
Perawatan Saluran Akar
10 9/10/2021 Erwita Yunus
6 Tambal GIC
Gigi 5 Tambal Komposit
11 11/10/2021 Yusni Gigi 6 7 Tambal Komposit
Valplast Gigi 6 5 6 7
12 11/10/2021 Vicaris Ariel Yofadin Kontrol Ortho
13 11/10/2021 Tjhia Bie Hiong Tambal Komposit
14 12/10/2021 Suci Arianti Kontrol Ortho
15 13/10/2021 M. Zakaria Alrazi Tambal Flow
16 13/10/2021 M. Reza Pahlevi Konsultasi
17 14/10/2021 Tjhia Bie Hiong Pengisian + Cetak Crown
Kontrol Ortho
18 15/10/2021 Iis Waryanti
Scalling UL
Replace 3 bracket
Insersi 6 Bracket
19 15/10/2021 M. Reza Pahlevi
Niti 0,14 UL
Lepas ekspansi + Scalling UL
20 21/10/2021 Heri Supandi Tambal Komposit
21 21/10/2021 Titin Widyawati Kontrol Ortho
22 21/10/2021 Tjhia Bie Hiong Insersi PFM

23 22/10/2021 Taka Agustinus S Kontrol Ortho

24 23/10/2021 Hasymi Naseem Kontrol Ortho
25 23/10/2021 Yusni Insersi GTSL
26 24/10/2021 Margareta Limawan Scalling UL
27 24/10/2021 Ice Meriah Hertanti Kontrol Ortho
28 25/10/2021 Revalia Febrianti Kontrol Ortho
29 25/10/2021 Riris Barasa Kontrol Ortho
30 28/10/2021 Wulan Kontrol Ortho
31 28/10/2021 Tjhia Bie Hiong Cetak PFM gigi 4
32 28/10/2021 Triyas Sakdiah Kontrol Ortho
33 30/10/2021 Sulhan Amirudin Scalling UL
Insersi ceramic bracket Dp I
34 30/10/2021 Ghiyats Ramadhan
Scalling UL
35 30/10/2021 Syifa Khoerunnisa Kontrol Ortho
36 30/10/2021 Priscilla C Kontrol Ortho
Tambal Komposit
37 31/10/2021 Santi Rizki A
Exo GR 6
38 31/10/2021 Erwita Yunus Tambal Komposit
BRUTO

NETTO
TEK DRG. DIANA KUSRIYANTI, MARS.
NGERANG SELATAN

Tarif Lab/Bahan Pembayaran

300,000 Transfer BCA
250,000
Transfer BCA
225,000
250,000 Tunai
- Free
- Free
- Free
300,000 Tunai
350,000
Transfer BCA
200,000
285,000 Tunai
300,000 Tunai
50,000
Transfer BCA
200,000
300,000
300,000 Transfer BCA
2,100,000 430,000
200,000 Transfer BCA
350,000 Tunai
150,000 Transfer BCA
200,000 Tf Mandiri
100,000 Tf Mandiri
450,000 Tunai
200,000
Tunai
250,000
150,000
700,000
Tf Mandiri
200,000
250,000
200,000 Tf Mandiri
250,000 Tunai
1,500,000 Transfer BCA
250,000 300,000 Tunai
475,000 Transfer BCA
285,000 Tunai
200,000 Tunai
- Free
150,000 Transfer BCA
325,000 Tunai
250,000 Tunai
200,000 Tunai
- Free
285,000 Tunai
 250,000 Transfer BCA
3,375,000 1,500,000
Transfer BCA
250,000
385,000 Tunai
200,000 Transfer BCA
200,000
Tunai
250,000
100,000 Tunai
17,990,000 2,230,000

15,760,000
TAGIHAN/PEMBELIAN BARANG/BAHAN GIGI BULAN SEPTEMBER 2021

TGL JATUH
NO TGL BELI NAMA SUPLYER/LAB BARANG/BAHAN
TEMPO
Bracket ceramic silvertech
1 8/9/2021 8/9/2021 Alfa Dental
Bucaltube roth 0.22 2pak
2 24/09/2021 24/10/2021 Pasifik Dental T-Fill MAARC
Dental bib
3 9/25/2021 10/25/2021 PT. Perdana Jaya Rahma Power O + Power Chain KMC
4 27/9/2021 27/9/2021 Sunardi Dental Lab Hawley retainer Os Cayu Ra

TOTAL

TAGIHAN/PEBELIAN BARANG/BAHAN GIGI BULAN OKTOBER 2021

TGL JATUH
NO TGL BELI NAMA SUPLYER/LAB BARANG/BAHAN
TEMPO
1 13/10/2021 11/13/2021 Shopee (icha) Safety box
Indomart Aqua 1 dus
Indomart Refill Glade 2 x
Aqua gelas 1
Crown Porcelain Os Tjhia Bie
2 19/10/2021 19/11/2021 Sunardi Lab
Valplast
3 12/10/2021 11/11/2021 Alfa Dental Scandonest 1 strip
4 20/10/2021 20/11/2021 Fiore Komposit Kerr

TOTAL
 TEMBER 2021

HARGA KETERANGAN

275,000
106,000
80,000
85,000
255,200
180,000 Sudah di Transfer

801,200

OBER 2021

HARGA KETERANGAN

45,000
22,000
70,000
7,000
300,000
430,000
200,000
364,000

1,438,000