Periksalab

RSIA PURI BUNDA
Jl. Simpang Sulfat Utara No. 60 A, Malang, Jawa Timur

(0341) 480047
E-mail : puribunda.malang@yahoo.com
Detail Pemeriksaan Laborat
No. No.Rawat No.R.M. Nama Pasien Kd.Prk Pemeriksaan Kode Dokter Dokter P.J.Lab NIP Petugas Lab Kd Perujuk Dokter Perujuk Tanggal Jam Cara Bayar Ruangan Jasa Sarana Paket BHP JM PJ Lab JM Petugas JM Perujuk KSO Menejemen Total
1 2022/04/30/000191 068839 LAILA PUTRI EKA RAMADHANI, KYN.RJ0000 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 01/07/2022 14:11:53 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
Nn 27 karyawan
2 2022/06/27/000218 097881 Almira Rakhmalia Firdaus, An. UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 10:39:03 UMUM KS IGD 2 50,431 26,569 0 3,000 0 0 0 75,000
0001 Sp.A.
3 2022/06/28/000065 043337 MUHAMMAD HASBI ZAFRAN UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 01/07/2022 06:28:50 UMUM KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
NAIM, AN 0001 AMd.AK. Sp.A.
4 2022/06/28/000143 021959 MUHAMMAD FIKRI, AN BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 10:57:10 BPJS Amarta 6A 40,431 26,569 0 3,000 0 0 0 70,000
0001 Sp.A. KESEHATAN
5 2022/06/28/000167 106238 Baroroh Ayu Purnamasari, Ny BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4150215 dr. DEWI INDIASTARI, 01/07/2022 06:36:05 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK. Sp.PD. KESEHATAN
6 2022/06/28/000167 106238 Baroroh Ayu Purnamasari, Ny BPJS.K2B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4150215 dr. DEWI INDIASTARI, 01/07/2022 06:33:08 BPJS KS IGD 1 30,390 6,610 0 3,000 0 0 0 40,000
7 2022/06/28/000167 106238 Baroroh Ayu Purnamasari, Ny BPJS.K2B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4150215 dr. DEWI INDIASTARI, 01/07/2022 06:36:05 BPJS KS IGD 1 31,931 10,069 0 3,000 0 0 0 45,000
8 2022/06/28/000179 070268 HARIYANTI, NY UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4150215 dr. DEWI INDIASTARI, 01/07/2022 19:07:44 UMUM KS IGD 1 50,431 26,569 0 3,000 0 0 0 75,000
0001 AMd.AK. Sp.PD.
9 2022/06/29/000063 060110 MUHAMMAD KAHFI ALVARO, UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 01/07/2022 16:35:40 UMUM KS IGD 1 50,431 26,569 0 3,000 0 0 0 75,000
AN 0001 AMd.AK. Sp.A.
10 2022/06/29/000074 035426 Didik Setiyawanto, Tn KYN.RJ0000 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 01/07/2022 05:33:47 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
27
11 2022/06/29/000188 071669 LAILATUL KAMILAH, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 06:27:34 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK. Sp.A. KESEHATAN
12 2022/06/29/000200 071882 PUTRA DEFRANDS BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 10:58:52 BPJS KS IGD 8 40,431 26,569 0 3,000 0 0 0 70,000
PRATAMA,AN 0001 Sp.A. KESEHATAN
13 2022/06/29/000211 071679 SAKINAH AZZALEA BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 06:25:09 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
RAHMADANI, AN 001 AMd.AK. Sp.A. KESEHATAN
14 2022/06/29/000225 056948 IMROATUL MAHMUDAH, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 01/07/2022 13:40:37 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
001 KARTIKARINI, Sp.OG KESEHATAN 5
15 2022/06/29/000228 071687 DINAR IFTITAH RAHMA, NN UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4150215 dr. DEWI INDIASTARI, 01/07/2022 06:30:16 UMUM KS IGD 2 50,431 26,569 0 3,000 0 0 0 80,000
0001 AMd.AK. Sp.PD.
16 2022/06/29/000231 071260 MUHAMMAD GIBRAN AL BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 16:39:00 BPJS KS IGD 5 33,931 13,069 0 3,000 0 0 0 50,000
HABSYI, AN 00020 AMd.AK. Sp.A. KESEHATAN
17 2022/06/29/000231 071260 MUHAMMAD GIBRAN AL BPJS.KINS0 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 16:39:00 BPJS KS IGD 5 31,936 6,064 0 2,000 0 0 0 40,000
18 2022/06/29/000231 071260 MUHAMMAD GIBRAN AL BPJS.KINS0 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 16:39:00 BPJS KS IGD 5 31,436 6,564 0 2,000 0 0 0 40,000
19 2022/06/29/000232 071263 BENAZIR HAURA SYAH BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 16:41:53 BPJS KS IGD 1 33,931 13,069 0 3,000 0 0 0 50,000
RAMADHAN, AN 00020 AMd.AK. Sp.A. KESEHATAN
20 2022/06/29/000232 071263 BENAZIR HAURA SYAH BPJS.KINS0 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 16:41:53 BPJS KS IGD 1 31,936 6,064 0 2,000 0 0 0 40,000
21 2022/06/29/000232 071263 BENAZIR HAURA SYAH BPJS.KINS0 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 16:41:53 BPJS KS IGD 1 31,436 6,564 0 2,000 0 0 0 40,000
22 2022/06/30/000054 006466 TSAQIF AHMAD MUQAFFA, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 01/07/2022 16:24:24 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
23 2022/06/30/000116 061086 ILA SUSILOWATI, Ny BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 01/07/2022 10:52:17 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
001 SUSILO,Sp.OG. KESEHATAN
24 2022/06/30/000116 061086 ILA SUSILOWATI, Ny BPJS.K2B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 01/07/2022 03:49:24 BPJS KS IGD 2 30,390 6,610 0 3,000 0 0 0 40,000
25 2022/06/30/000148 005027 ZAINAB, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 01/07/2022 12:49:40 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
001 KARTIKARINI, Sp.OG KESEHATAN
26 2022/07/01/000053 071383 CHRISTOPHER HARVEY BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 18:32:55 BPJS KS IGD 1 33,931 13,069 0 3,000 0 0 0 50,000
LIMANTO, An 00020 AMd.AK. Sp.A. KESEHATAN
27 2022/07/01/000060 071745 DINA PRADIANA, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 01/07/2022 10:54:25 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
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28 2022/07/01/000060 071745 DINA PRADIANA, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 01/07/2022 00:59:15 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
29 2022/07/01/000060 071745 DINA PRADIANA, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 01/07/2022 00:59:15 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
30 2022/07/01/000072 071746 DINA PRADIANA, BY NY BPJS.KINS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 03:53:03 BPJS KS NICU 9 40,431 26,569 0 3,000 0 0 0 70,000
31 2022/07/01/000072 071746 DINA PRADIANA, BY NY BPJS.KINS0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 03:53:03 BPJS KS NICU 9 32,431 9,569 0 3,000 0 0 0 45,000
32 2022/07/01/000073 087917 DELLA PUTRI VERNIKASARI, BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 01/07/2022 10:45:17 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
NY 001 DWIJAYASA, Sp.OG (K) KESEHATAN
33 2022/07/01/000074 056715 SHAQILLA ANANNDA NUR BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 01/07/2022 23:38:56 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
SYAHIBA, An 01 AMd.AnKes. KESEHATAN
34 2022/07/01/000074 056715 SHAQILLA ANANNDA NUR BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 01/07/2022 23:38:56 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
35 2022/07/01/000074 056715 SHAQILLA ANANNDA NUR BPJS.RJ000 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 01/07/2022 23:38:56 BPJS IGD 31,931 10,069 0 3,000 0 0 0 45,000
36 2022/07/01/000085 071749 MELVIANO ARSYA GHAISAN W, BPJS.KFIS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 01/07/2022 16:22:25 BPJS KS Fisol 21 40,431 26,569 0 3,000 0 0 0 70,000
AN 0001 AMd.AK. Sp.A. KESEHATAN
37 2022/07/01/000085 071749 MELVIANO ARSYA GHAISAN W, BPJS.KFIS0 Gula Darah 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 01/07/2022 16:22:25 BPJS KS Fisol 21 32,431 9,569 0 3,000 0 0 0 45,000
38 2022/07/01/000092 092732 Widya Kusuma Wardhani, Ny. BPJS.RJ000 Gula Darah Puasa 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4150215 dr. DEWI INDIASTARI, 01/07/2022 10:17:55 BPJS Poli Penyakit 32,431 9,569 0 3,000 0 0 0 45,000
0210 AMd.AK. Sp.PD. KESEHATAN Dalam
39 2022/07/01/000092 092732 Widya Kusuma Wardhani, Ny. BPJS.RJ000 Gula Darah 2 Jam PP 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4150215 dr. DEWI INDIASTARI, 01/07/2022 10:17:55 BPJS Poli Penyakit 32,431 9,569 0 3,000 0 0 0 45,000
40 2022/07/01/000101 071752 RENITA, NY UMUM.RJ00 Plano Test 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 01/07/2022 07:40:47 UMUM IGD 33,140 4,860 0 2,000 0 0 0 40,000
0022 AMd.AK.
41 2022/07/01/000106 071446 ALKAF RAZQA MAHENDRA, AN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 09:51:23 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
0020 AMd.AK. Sp.A.
42 2022/07/01/000106 071446 ALKAF RAZQA MAHENDRA, AN UMUM.RJ00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 09:51:23 UMUM Poli Anak 31,936 6,064 0 2,000 0 0 0 40,000
007 AMd.AK. Sp.A.
43 2022/07/01/000106 071446 ALKAF RAZQA MAHENDRA, AN UMUM.RJ00 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 09:51:23 UMUM Poli Anak 31,436 6,564 0 2,000 0 0 0 40,000
008 AMd.AK. Sp.A.
44 2022/07/01/000110 071755 ZAINAB, BY NY BPJS.K3000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 01/07/2022 10:48:02 BPJS KS Fisol 23 32,431 9,569 0 3,000 0 0 0 45,000
0110 M.Biomed. KESEHATAN
45 2022/07/01/000110 071755 ZAINAB, BY NY BPJS.KFIS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 01/07/2022 10:48:02 BPJS KS Fisol 23 40,431 26,569 0 3,000 0 0 0 70,000
46 2022/07/01/000110 071755 ZAINAB, BY NY BPJS.KFIS0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 01/07/2022 18:10:51 BPJS KS Fisol 23 44,800 35,200 0 5,000 5,000 0 0 90,000
00050 AMd.AK. M.Biomed. KESEHATAN
47 2022/07/01/000113 060274 Ratih Prabowo Putri, Ny BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 01/07/2022 10:29:07 BPJS Hastina 8 40,431 26,569 0 3,000 0 0 0 70,000
48 2022/07/01/000113 060274 Ratih Prabowo Putri, Ny BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 01/07/2022 10:29:07 BPJS Hastina 8 32,431 9,569 0 3,000 0 0 0 45,000
49 2022/07/01/000113 060274 Ratih Prabowo Putri, Ny BPJS.K1B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 01/07/2022 10:29:07 BPJS Hastina 8 32,436 564 0 2,000 0 0 0 35,000
50 2022/07/01/000113 060274 Ratih Prabowo Putri, Ny BPJS.K1B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 01/07/2022 10:29:07 BPJS Hastina 8 32,436 564 0 2,000 0 0 0 35,000
51 2022/07/01/000113 060274 Ratih Prabowo Putri, Ny BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 01/07/2022 10:25:39 BPJS Hastina 8 44,800 35,200 0 5,000 5,000 0 0 90,000
52 2022/07/01/000126 070322 LUSYANA DEWI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 01/07/2022 09:58:06 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
0047
53 2022/07/01/000130 071763 SULISTYOWATI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 01/07/2022 10:24:40 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.PD. KESEHATAN
54 2022/07/01/000130 071763 SULISTYOWATI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 01/07/2022 10:24:40 BPJS KS IGD 10 32,431 9,569 0 3,000 0 0 0 45,000
55 2022/07/01/000130 071763 SULISTYOWATI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 01/07/2022 10:23:47 BPJS KS IGD 10 44,800 35,200 0 5,000 5,000 0 0 90,000
56 2022/07/01/000149 016824 Arka Naufal Rajendra, An UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 11:37:08 UMUM KS IGD 5 50,431 26,569 0 3,000 0 0 0 75,000
0001 Sp.A.
57 2022/07/01/000149 016824 Arka Naufal Rajendra, An UMUM.K2B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 11:37:08 UMUM KS IGD 5 37,431 9,569 0 3,000 0 0 0 50,000
000110 Sp.A.
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58 2022/07/01/000152 071765 AFRINA MAULIA, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 01/07/2022 12:53:23 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
59 2022/07/01/000152 071765 AFRINA MAULIA, AN BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 01/07/2022 12:53:23 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
60 2022/07/01/000152 071765 AFRINA MAULIA, AN BPJS.K2B00 IgG Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 01/07/2022 12:53:23 BPJS KS IGD 1 41,951 46,549 0 1,500 0 0 0 90,000
61 2022/07/01/000152 071765 AFRINA MAULIA, AN BPJS.K2B00 IgM Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 01/07/2022 12:53:23 BPJS KS IGD 1 41,951 46,549 0 1,500 0 0 0 90,000
62 2022/07/01/000152 071765 AFRINA MAULIA, AN BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 01/07/2022 12:52:22 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
63 2022/07/01/000158 068734 RULLY TRIASSANDIKI, NY KYN.RJ0000 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 01/07/2022 14:15:43 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
27 karyawan
64 2022/07/01/000162 068620 SODIQIN, Sdr KYN.RJ0000 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 01/07/2022 14:11:15 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
27 karyawan
65 2022/07/01/000167 071769 HARISMA QURROTUÀINI, NY BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 01/07/2022 14:58:52 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
66 2022/07/01/000167 071769 HARISMA QURROTUÀINI, NY BPJS.K3T20 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 01/07/2022 14:58:52 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
67 2022/07/01/000167 071769 HARISMA QURROTUÀINI, NY BPJS.K3T20 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 01/07/2022 14:58:52 BPJS KS IGD 1 30,390 6,610 0 3,000 0 0 0 40,000
68 2022/07/01/000167 071769 HARISMA QURROTUÀINI, NY BPJS.K3T20 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 01/07/2022 14:58:52 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
69 2022/07/01/000167 071769 HARISMA QURROTUÀINI, NY BPJS.K3T20 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 01/07/2022 14:58:52 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
70 2022/07/01/000167 071769 HARISMA QURROTUÀINI, NY BPJS.K3T20 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 01/07/2022 14:51:46 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
71 2022/07/01/000175 011281 MUHAMMAD ARSYAD UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 01/07/2022 15:41:40 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
ALFARIZQI, AN 001 AMd.AK. KESEHATAN
72 2022/07/01/000177 068831 NUANZHA WULAN KYN.RJ0000 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 01/07/2022 16:37:44 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
PURNAMASARI, NY 27 AMd.AK. karyawan
73 2022/07/01/000187 071785 MUHAMMAD UWAIS AL-QARNI, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 01/07/2022 19:00:04 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
74 2022/07/01/000191 071781 M ABRIZAM REYNAND, AN UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 18:06:30 UMUM ICU 3 40,431 26,569 0 3,000 0 0 0 70,000
0001 AMd.AK. Sp.A.
75 2022/07/01/000191 071781 M ABRIZAM REYNAND, AN UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 18:06:30 UMUM ICU 3 32,431 9,569 0 3,000 0 0 0 45,000
000110 AMd.AK. Sp.A.
76 2022/07/01/000192 071788 KEINARA AISYAH ADREENA G, BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8150214 drg. WIEDIANTO 01/07/2022 21:03:26 BPJS Poliklinik Gigi 40,431 26,569 0 3,000 0 0 0 70,000
AN 01 AMd.AK. SUWARSONO, Sp.KG. KESEHATAN
77 2022/07/01/000192 071788 KEINARA AISYAH ADREENA G, BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8150214 drg. WIEDIANTO 01/07/2022 21:03:26 BPJS Poliklinik Gigi 32,431 9,569 0 3,000 0 0 0 45,000
AN 0110 AMd.AK. SUWARSONO, Sp.KG. KESEHATAN
78 2022/07/01/000194 071789 NENI MASLUHA, Ny UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 01/07/2022 18:31:16 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK.
79 2022/07/01/000194 071789 NENI MASLUHA, Ny UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 01/07/2022 18:31:16 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
00110 AMd.AK.
80 2022/07/01/000194 071789 NENI MASLUHA, Ny UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 01/07/2022 20:37:20 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
0047 AMd.AK. INDRAWAN, Sp. OG (K)
81 2022/07/01/000194 071789 NENI MASLUHA, Ny UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 01/07/2022 18:31:16 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
005 AMd.AK.
82 2022/07/01/000194 071789 NENI MASLUHA, Ny UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 01/07/2022 18:31:16 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
006 AMd.AK.
83 2022/07/01/000197 105202 Arsenio Abqori Purwa Keswara,An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 19:58:30 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK. Sp.A.
84 2022/07/01/000197 105202 Arsenio Abqori Purwa Keswara,An UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 01/07/2022 19:58:30 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 AMd.AK. Sp.A.
85 2022/07/01/000207 055915 KARL ELLENIO YOFA BPJS.K1T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 01/07/2022 21:14:45 BPJS Hastina 9 40,431 26,569 0 3,000 0 0 0 70,000
ANGGORO, An 0001 AMd.AK. Sp.A. KESEHATAN
86 2022/07/01/000207 055915 KARL ELLENIO YOFA BPJS.K1T20 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 01/07/2022 21:14:45 BPJS Hastina 9 32,431 9,569 0 3,000 0 0 0 45,000
87 2022/07/01/000207 055915 KARL ELLENIO YOFA BPJS.K1T20 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 01/07/2022 21:16:53 BPJS Hastina 9 44,800 35,200 0 5,000 5,000 0 0 90,000
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88 2022/07/01/000211 071794 NADILA RAHARDIANI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 01/07/2022 21:09:30 BPJS KS RR 3 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK. INDRAWAN, Sp. OG (K) KESEHATAN
89 2022/07/01/000211 071794 NADILA RAHARDIANI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 01/07/2022 21:36:48 BPJS KS RR 3 40,431 26,569 0 3,000 0 0 0 70,000
90 2022/07/01/000211 071794 NADILA RAHARDIANI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 01/07/2022 21:09:30 BPJS KS RR 3 32,431 9,569 0 3,000 0 0 0 45,000
91 2022/07/01/000211 071794 NADILA RAHARDIANI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 01/07/2022 21:36:48 BPJS KS RR 3 32,431 9,569 0 3,000 0 0 0 45,000
92 2022/07/01/000211 071794 NADILA RAHARDIANI, NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 01/07/2022 21:09:30 BPJS KS RR 3 30,390 6,610 0 3,000 0 0 0 40,000
93 2022/07/01/000211 071794 NADILA RAHARDIANI, NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 01/07/2022 21:43:40 BPJS KS RR 3 30,390 6,610 0 3,000 0 0 0 40,000
94 2022/07/01/000211 071794 NADILA RAHARDIANI, NY BPJS.K3B00 Anti HIV 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 01/07/2022 21:09:30 BPJS KS RR 3 38,951 34,049 0 2,000 0 0 0 75,000
95 2022/07/01/000211 071794 NADILA RAHARDIANI, NY BPJS.K3B00 Anti HIV 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 01/07/2022 21:36:48 BPJS KS RR 3 38,951 34,049 0 2,000 0 0 0 75,000
96 2022/07/01/000211 071794 NADILA RAHARDIANI, NY BPJS.K3B00 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 01/07/2022 21:09:30 BPJS KS RR 3 38,951 34,049 0 2,000 0 0 0 75,000
97 2022/07/01/000211 071794 NADILA RAHARDIANI, NY BPJS.K3B00 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 01/07/2022 21:36:48 BPJS KS RR 3 38,951 34,049 0 2,000 0 0 0 75,000
98 2022/07/01/000211 071794 NADILA RAHARDIANI, NY BPJS.K3B00 TPHA/Sipilis 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 01/07/2022 21:09:30 BPJS KS RR 3 37,951 34,049 0 3,000 0 0 0 75,000
99 2022/07/01/000211 071794 NADILA RAHARDIANI, NY BPJS.K3B00 TPHA/Sipilis 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 01/07/2022 21:36:48 BPJS KS RR 3 37,951 34,049 0 3,000 0 0 0 75,000
100 2022/07/01/000211 071794 NADILA RAHARDIANI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 01/07/2022 21:09:30 BPJS KS RR 3 32,436 564 0 2,000 0 0 0 35,000
101 2022/07/01/000211 071794 NADILA RAHARDIANI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 01/07/2022 21:36:48 BPJS KS RR 3 32,436 564 0 2,000 0 0 0 35,000
102 2022/07/01/000211 071794 NADILA RAHARDIANI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 01/07/2022 21:09:30 BPJS KS RR 3 32,436 564 0 2,000 0 0 0 35,000
103 2022/07/01/000211 071794 NADILA RAHARDIANI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 01/07/2022 21:36:48 BPJS KS RR 3 32,436 564 0 2,000 0 0 0 35,000
104 2022/07/01/000211 071794 NADILA RAHARDIANI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 01/07/2022 21:13:47 BPJS KS RR 3 44,800 35,200 0 5,000 5,000 0 0 90,000
105 2022/07/01/000214 068736 FEDRI DWI SETYAWAN, SDR KYN.RJ0000 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 01/07/2022 21:18:24 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
27 AMd.AK. karyawan
106 2022/07/01/000216 068727 FIANE SWANA CERIA HATI, NN KYN.RJ0000 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 01/07/2022 21:53:32 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
27 AMd.AnKes. karyawan
107 2022/07/01/000220 071796 LULUK IRAWATI,NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 01/07/2022 23:19:49 BPJS Amarta 6A 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AnKes. SUSILO,Sp.OG. KESEHATAN
108 2022/07/01/000220 071796 LULUK IRAWATI,NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 01/07/2022 23:19:49 BPJS Amarta 6A 32,431 9,569 0 3,000 0 0 0 45,000
109 2022/07/01/000220 071796 LULUK IRAWATI,NY BPJS.K3B00 SGOT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 01/07/2022 23:19:49 BPJS Amarta 6A 34,451 12,549 0 3,000 0 0 0 50,000
110 2022/07/01/000220 071796 LULUK IRAWATI,NY BPJS.K3B00 SGPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 01/07/2022 23:19:49 BPJS Amarta 6A 34,451 12,549 0 3,000 0 0 0 50,000
111 2022/07/01/000220 071796 LULUK IRAWATI,NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 01/07/2022 23:21:49 BPJS Amarta 6A 30,390 6,610 0 3,000 0 0 0 40,000
112 2022/07/01/000220 071796 LULUK IRAWATI,NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 01/07/2022 23:19:49 BPJS Amarta 6A 32,436 564 0 2,000 0 0 0 35,000
113 2022/07/01/000220 071796 LULUK IRAWATI,NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 01/07/2022 23:19:49 BPJS Amarta 6A 32,436 564 0 2,000 0 0 0 35,000
114 2022/07/01/000220 071796 LULUK IRAWATI,NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 01/07/2022 23:18:10 BPJS Amarta 6A 44,800 35,200 0 5,000 5,000 0 0 90,000
115 2022/07/01/000224 063095 ANIK FIDIYANTI, Ny BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 01/07/2022 23:56:33 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AnKes. MENUR, Sp.OG KESEHATAN 5
116 2022/07/01/000224 063095 ANIK FIDIYANTI, Ny BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 01/07/2022 23:56:33 BPJS KS Kamar Bersalin 32,431 9,569 0 3,000 0 0 0 45,000
117 2022/07/01/000224 063095 ANIK FIDIYANTI, Ny BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 01/07/2022 23:56:33 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
118 2022/07/01/000224 063095 ANIK FIDIYANTI, Ny BPJS. CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, AMd. 1150219 dr. FATMASARI PERDANA 01/07/2022 23:56:33 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
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K3B00004 AnKes. MENUR, Sp.OG 5
119 2022/07/01/000224 063095 ANIK FIDIYANTI, Ny BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 01/07/2022 23:55:04 BPJS KS Kamar Bersalin 44,800 35,200 0 5,000 5,000 0 0 90,000
120 2022/06/29/000188 071669 LAILATUL KAMILAH, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 02/07/2022 17:19:50 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A. KESEHATAN
121 2022/06/29/000225 056948 IMROATUL MAHMUDAH, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 02/07/2022 06:36:26 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AnKes. KARTIKARINI, Sp.OG KESEHATAN 5
122 2022/06/29/000228 071687 DINAR IFTITAH RAHMA, NN UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4150215 dr. DEWI INDIASTARI, 02/07/2022 06:38:27 UMUM KS IGD 2 50,431 26,569 0 3,000 0 0 0 80,000
0001 AMd.AnKes. Sp.PD.
123 2022/06/30/000065 031310 QANITA NUR AQILAH, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 02/07/2022 11:13:39 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
001 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN
124 2022/06/30/000137 023596 MUHAMMAD BAIHAQI ALFARIZI, BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 02/07/2022 17:18:37 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
AN. 001 Sp.A. KESEHATAN
125 2022/06/30/000202 071414 ABIYAN RISKY MAULANA, AN BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 02/07/2022 16:56:22 BPJS KS IGD 1 33,931 13,069 0 3,000 0 0 0 50,000
126 2022/06/30/000202 071414 ABIYAN RISKY MAULANA, AN BPJS.KINS0 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 02/07/2022 16:56:22 BPJS KS IGD 1 31,936 6,064 0 2,000 0 0 0 40,000
127 2022/06/30/000202 071414 ABIYAN RISKY MAULANA, AN BPJS.KINS0 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 02/07/2022 16:56:22 BPJS KS IGD 1 31,436 6,564 0 2,000 0 0 0 40,000
128 2022/06/30/000205 096277 RAFFASYA ALFARIZKY UDJIR, BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 02/07/2022 16:53:47 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 Sp.A. KESEHATAN
129 2022/06/30/000210 071737 M. FAIDUROHMAN, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 02/07/2022 07:05:59 BPJS ICU 1 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AnKes. Sp.A. KESEHATAN
130 2022/06/30/000214 071738 AINAYA CALISTA ARDHANIA, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 02/07/2022 16:51:30 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN 12/Ayodya 6
131 2022/07/01/000072 071746 DINA PRADIANA, BY NY BPJS.KINS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 02/07/2022 11:11:33 BPJS KS NICU 9 40,431 26,569 0 3,000 0 0 0 70,000
132 2022/07/01/000130 071763 SULISTYOWATI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4150215 dr. DEWI INDIASTARI, 02/07/2022 11:15:41 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
001 ARDHIANSYAH, AMd.Ankes Sp.PD. KESEHATAN
133 2022/07/01/000152 071765 AFRINA MAULIA, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 12:18:29 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
001 ARDHIANSYAH, AMd.Ankes M.Biomed. KESEHATAN
134 2022/07/01/000167 071769 HARISMA QURROTUÀINI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 02/07/2022 17:27:30 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
135 2022/07/01/000211 071794 NADILA RAHARDIANI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 02/07/2022 17:21:50 BPJS KS RR 3 40,431 26,569 0 3,000 0 0 0 70,000
001 INDRAWAN, Sp. OG (K) KESEHATAN
136 2022/07/01/000220 071796 LULUK IRAWATI,NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 02/07/2022 06:40:29 BPJS Amarta 6A 40,431 26,569 0 3,000 0 0 0 70,000
137 2022/07/01/000224 063095 ANIK FIDIYANTI, Ny BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 02/07/2022 17:25:35 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
001 MENUR, Sp.OG KESEHATAN 5
138 2022/07/02/000068 071508 RR KHANZA SIDHARTA A, AN BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 18:40:21 BPJS Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
139 2022/07/02/000068 071508 RR KHANZA SIDHARTA A, AN BPJS.RJ000 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 18:40:21 BPJS Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
140 2022/07/02/000081 014373 Trin Normasari Irianti, Ny. UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 02/07/2022 10:41:11 UMUM Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
001 ARDHIANSYAH, AMd.Ankes MENUR, Sp.OG
141 2022/07/02/000081 014373 Trin Normasari Irianti, Ny. UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 02/07/2022 10:41:11 UMUM Poli Kandungan 30,390 6,610 0 3,000 0 0 0 40,000
142 2022/07/02/000081 014373 Trin Normasari Irianti, Ny. UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 02/07/2022 10:43:16 UMUM Poli Kandungan 31,931 10,069 0 3,000 0 0 0 45,000
143 2022/07/02/000084 071805 WIDYAWATI, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 02/07/2022 01:21:08 UMUM IGD 30,390 6,610 0 3,000 0 0 0 40,000
0021 AMd.AnKes.
144 2022/07/02/000085 071116 NURI VINA MAWADDAH, NY BPJS.K3000 SGOT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150220 dr. IMELDA, Sp.OG. 02/07/2022 01:28:42 BPJS KS IGD 2 34,451 12,549 0 3,000 0 0 0 50,000
016 AMd.AnKes. KESEHATAN
145 2022/07/02/000085 071116 NURI VINA MAWADDAH, NY BPJS.K3000 SGPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150220 dr. IMELDA, Sp.OG. 02/07/2022 01:28:42 BPJS KS IGD 2 34,451 12,549 0 3,000 0 0 0 50,000
146 2022/07/02/000085 071116 NURI VINA MAWADDAH, NY BPJS.K3000 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150220 dr. IMELDA, Sp.OG. 02/07/2022 01:28:42 BPJS KS IGD 2 31,451 10,549 0 3,000 0 0 0 45,000
147 2022/07/02/000085 071116 NURI VINA MAWADDAH, NY BPJS.K3000 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150220 dr. IMELDA, Sp.OG. 02/07/2022 01:28:42 BPJS KS IGD 2 33,951 13,049 0 3,000 0 0 0 50,000
148 2022/07/02/000085 071116 NURI VINA MAWADDAH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150220 dr. IMELDA, Sp.OG. 02/07/2022 01:28:42 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
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149 2022/07/02/000085 071116 NURI VINA MAWADDAH, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150220 dr. IMELDA, Sp.OG. 02/07/2022 01:28:42 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
150 2022/07/02/000085 071116 NURI VINA MAWADDAH, NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150220 dr. IMELDA, Sp.OG. 02/07/2022 01:25:24 BPJS KS IGD 2 30,390 6,610 0 3,000 0 0 0 40,000
151 2022/07/02/000085 071116 NURI VINA MAWADDAH, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150220 dr. IMELDA, Sp.OG. 02/07/2022 01:28:42 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
152 2022/07/02/000085 071116 NURI VINA MAWADDAH, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150220 dr. IMELDA, Sp.OG. 02/07/2022 01:28:42 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
153 2022/07/02/000085 071116 NURI VINA MAWADDAH, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150220 dr. IMELDA, Sp.OG. 02/07/2022 01:22:04 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
154 2022/07/02/000086 017010 Kasih Astuti, Ny BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 02/07/2022 11:21:39 BPJS KS IGD 7 40,431 26,569 0 3,000 0 0 0 70,000
001 ARDHIANSYAH, AMd.Ankes KARTIKARINI, Sp.OG KESEHATAN
155 2022/07/02/000086 017010 Kasih Astuti, Ny BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 02/07/2022 02:04:44 BPJS KS IGD 7 40,431 26,569 0 3,000 0 0 0 70,000
00001 AMd.AnKes. KARTIKARINI, Sp.OG KESEHATAN
156 2022/07/02/000086 017010 Kasih Astuti, Ny BPJS.K2UP1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 02/07/2022 02:04:44 BPJS KS IGD 7 32,431 9,569 0 3,000 0 0 0 45,000
157 2022/07/02/000086 017010 Kasih Astuti, Ny BPJS.K2UP1 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 02/07/2022 02:04:44 BPJS KS IGD 7 32,436 564 0 2,000 0 0 0 35,000
158 2022/07/02/000086 017010 Kasih Astuti, Ny BPJS.K2UP1 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 02/07/2022 02:04:44 BPJS KS IGD 7 32,436 564 0 2,000 0 0 0 35,000
159 2022/07/02/000086 017010 Kasih Astuti, Ny BPJS.K2UP1 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 02/07/2022 02:03:28 BPJS KS IGD 7 44,800 35,200 0 5,000 5,000 0 0 90,000
160 2022/07/02/000090 068722 PUPUT APRILIANA, NN KYN.RJ0000 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 02/07/2022 07:04:51 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
161 2022/07/02/000093 068301 PATRICIA MEYANA DIKPASARI, BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 02/07/2022 06:44:08 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
NY 00001 AMd.AnKes. WISANA, Sp.OG. KESEHATAN
162 2022/07/02/000093 068301 PATRICIA MEYANA DIKPASARI, BPJS.K2UP1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 02/07/2022 06:44:08 BPJS KS IGD 10 32,431 9,569 0 3,000 0 0 0 45,000
163 2022/07/02/000093 068301 PATRICIA MEYANA DIKPASARI, BPJS.K2UP1 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 02/07/2022 06:44:08 BPJS KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
164 2022/07/02/000093 068301 PATRICIA MEYANA DIKPASARI, BPJS.K2UP1 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 02/07/2022 06:44:08 BPJS KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
165 2022/07/02/000093 068301 PATRICIA MEYANA DIKPASARI, BPJS.K2UP1 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 02/07/2022 06:42:50 BPJS KS IGD 10 44,800 35,200 0 5,000 5,000 0 0 90,000
166 2022/07/02/000123 071805 WIDYAWATI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 02/07/2022 09:01:02 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
001 ARDHIANSYAH, AMd.Ankes INDRAWAN, Sp. OG (K) KESEHATAN
167 2022/07/02/000123 071805 WIDYAWATI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 02/07/2022 20:04:14 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
168 2022/07/02/000123 071805 WIDYAWATI, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 02/07/2022 09:01:02 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
169 2022/07/02/000123 071805 WIDYAWATI, NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 02/07/2022 09:01:02 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
170 2022/07/02/000123 071805 WIDYAWATI, NY BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 02/07/2022 09:01:02 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
171 2022/07/02/000123 071805 WIDYAWATI, NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 02/07/2022 09:01:36 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
172 2022/07/02/000127 020180 MEI HIDIANAWATI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 02/07/2022 10:57:09 BPJS Amarta 6C 40,431 26,569 0 3,000 0 0 0 70,000
173 2022/07/02/000127 020180 MEI HIDIANAWATI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 02/07/2022 20:06:06 BPJS Amarta 6C 40,431 26,569 0 3,000 0 0 0 70,000
174 2022/07/02/000127 020180 MEI HIDIANAWATI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 02/07/2022 10:57:09 BPJS Amarta 6C 32,431 9,569 0 3,000 0 0 0 45,000
175 2022/07/02/000127 020180 MEI HIDIANAWATI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 02/07/2022 12:52:59 BPJS Amarta 6C 32,431 9,569 0 3,000 0 0 0 45,000
176 2022/07/02/000127 020180 MEI HIDIANAWATI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 02/07/2022 10:57:09 BPJS Amarta 6C 32,436 564 0 2,000 0 0 0 35,000
177 2022/07/02/000127 020180 MEI HIDIANAWATI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 02/07/2022 10:57:09 BPJS Amarta 6C 32,436 564 0 2,000 0 0 0 35,000
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178 2022/07/02/000127 020180 MEI HIDIANAWATI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 02/07/2022 10:56:24 BPJS Amarta 6C 44,800 35,200 0 5,000 5,000 0 0 90,000
179 2022/07/02/000133 028167 YOLA ALFIANI PUTRI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 02/07/2022 11:03:37 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
001 ARDHIANSYAH, AMd.Ankes
180 2022/07/02/000133 028167 YOLA ALFIANI PUTRI, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 02/07/2022 11:03:37 UMUM Laboratorium 30,390 6,610 0 3,000 0 0 0 40,000
181 2022/07/02/000149 067467 ATHAYA QAWIM ZAAHIRULHAQ BPJS.K2UP1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 02/07/2022 13:56:52 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
P G., AN 0000110 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN
182 2022/07/02/000149 067467 ATHAYA QAWIM ZAAHIRULHAQ UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 02/07/2022 13:03:54 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
P G., AN 001 ARDHIANSYAH, AMd.Ankes KESEHATAN
183 2022/07/02/000154 071825 ARSYANENDRA ATHAYA BPJS.KFIS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 17:24:00 BPJS KS Fisol 1 40,431 26,569 0 3,000 0 0 0 70,000
MANGUN WIBOWO, AN 0001 M.Biomed. KESEHATAN
184 2022/07/02/000164 069704 DWI SAPTO DARMO P, TN UMUM.RJ00 Preparasi Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8170324 dr. EDWIN PRADANA, 02/07/2022 18:03:09 UMUM Poli Andrologi 161,771 738,229 350,000 0 0 50,000 0 1,300,000
0030 Sp.And.
185 2022/07/02/000170 067930 ATHAYA RAMADHANI PUTRI BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 18:53:03 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
ADIZA, An 0001 M.Biomed. KESEHATAN
186 2022/07/02/000170 067930 ATHAYA RAMADHANI PUTRI BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 18:53:03 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
187 2022/07/02/000170 067930 ATHAYA RAMADHANI PUTRI BPJS.K2T10 Faeces Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 20:56:32 BPJS KS IGD 1 31,940 5,060 0 3,000 0 0 0 40,000
188 2022/07/02/000170 067930 ATHAYA RAMADHANI PUTRI BPJS.K2T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 18:52:00 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
189 2022/07/02/000170 067930 ATHAYA RAMADHANI PUTRI BPJS.K2T10 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 18:53:03 BPJS KS IGD 1 31,931 10,069 0 3,000 0 0 0 45,000
190 2022/07/02/000171 029984 AZZAMIR BASIRA GHAYDA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 19:29:16 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 M.Biomed.
191 2022/07/02/000171 029984 AZZAMIR BASIRA GHAYDA, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 19:29:16 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 M.Biomed.
192 2022/07/02/000172 063405 ANAYA NENG LAYLA SOFYAN, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 19:34:06 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 M.Biomed.
193 2022/07/02/000174 084624 DELIA KANIA AZZAHRA PUTRI, BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 17:29:24 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 M.Biomed. KESEHATAN
194 2022/07/02/000174 084624 DELIA KANIA AZZAHRA PUTRI, BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 17:28:21 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
195 2022/07/02/000175 063287 ACHMAD SAMUDERA HAZA, AN UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 02/07/2022 19:02:38 UMUM KS IGD 1 50,431 26,569 0 3,000 0 0 0 75,000
0001 Sp.A.
196 2022/07/02/000175 063287 ACHMAD SAMUDERA HAZA, AN UMUM.K2B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 02/07/2022 19:02:38 UMUM KS IGD 1 37,431 9,569 0 3,000 0 0 0 50,000
000110 Sp.A.
197 2022/07/02/000176 032395 ASSYIFA MIKAYLA PUTRI, AN. UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 19:35:17 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 M.Biomed.
198 2022/07/02/000176 032395 ASSYIFA MIKAYLA PUTRI, AN. UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 19:35:17 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 M.Biomed.
199 2022/07/02/000185 071841 MUHAMMAD HAFIDZ BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 02/07/2022 18:37:34 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
ARDIANSYAH, AN 01 KESEHATAN
200 2022/07/02/000186 41575 LAILATUL BADRIAH, NY KYN.RJ0000 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 02/07/2022 19:28:21 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
27
201 2022/07/02/000190 001523 MUH. ABRISSAM QUTBY BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 20:13:49 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
NAWASENA P., AN 00001 M.Biomed. KESEHATAN
202 2022/07/02/000190 001523 MUH. ABRISSAM QUTBY BPJS.K2UP1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 20:13:49 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
203 2022/07/02/000190 001523 MUH. ABRISSAM QUTBY BPJS.K2UP1 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 20:12:39 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
204 2022/07/02/000190 001523 MUH. ABRISSAM QUTBY BPJS.K2UP1 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 20:13:49 BPJS KS IGD 1 31,931 10,069 0 3,000 0 0 0 45,000
205 2022/07/02/000207 071849 ALEXANDER JULIO NATANAEL, BPJS.KFIS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 02/07/2022 20:38:42 BPJS KS Fisol 30 40,431 26,569 0 3,000 0 0 0 70,000
206 2022/07/02/000212 067862 ELIN INDAH SARI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 02/07/2022 21:01:40 BPJS KS RR 3 40,431 26,569 0 3,000 0 0 0 70,000
001 DWIJAYASA, Sp.OG (K) KESEHATAN
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207 2022/07/02/000212 067862 ELIN INDAH SARI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 02/07/2022 21:01:40 BPJS KS RR 3 32,431 9,569 0 3,000 0 0 0 45,000
208 2022/07/02/000212 067862 ELIN INDAH SARI, NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 02/07/2022 21:01:40 BPJS KS RR 3 30,390 6,610 0 3,000 0 0 0 40,000
209 2022/07/02/000212 067862 ELIN INDAH SARI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 02/07/2022 21:01:40 BPJS KS RR 3 32,436 564 0 2,000 0 0 0 35,000
210 2022/07/02/000212 067862 ELIN INDAH SARI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 02/07/2022 21:01:40 BPJS KS RR 3 32,436 564 0 2,000 0 0 0 35,000
211 2022/07/02/000212 067862 ELIN INDAH SARI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 02/07/2022 20:59:39 BPJS KS RR 3 44,800 35,200 0 5,000 5,000 0 0 90,000
212 2022/06/29/000200 071882 PUTRA DEFRANDS BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 11:40:36 BPJS KS IGD 8 40,431 26,569 0 3,000 0 0 0 70,000
PRATAMA,AN 001 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN
213 2022/06/29/000211 071679 SAKINAH AZZALEA BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 05:50:57 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
RAHMADANI, AN 001 AMd.AK. Sp.A. KESEHATAN
214 2022/06/29/000228 071687 DINAR IFTITAH RAHMA, NN UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4150215 dr. DEWI INDIASTARI, 03/07/2022 05:54:21 UMUM KS IGD 2 50,431 26,569 0 3,000 0 0 0 80,000
0001 AMd.AK. Sp.PD.
215 2022/06/30/000047 071660 VIKO WIJAYA, AN UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 05:52:41 UMUM KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
0001 AMd.AK. Sp.A.
216 2022/06/30/000124 067198 RIZKI WIRA PARAMITA, Ny UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 03/07/2022 23:01:11 UMUM Hastina 3 50,431 26,569 0 3,000 0 0 0 80,000
0001 KARTIKARINI, Sp.OG
217 2022/06/30/000210 071737 M. FAIDUROHMAN, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 08:16:10 BPJS ICU 1 40,431 26,569 0 3,000 0 0 0 70,000
218 2022/07/01/000053 071383 CHRISTOPHER HARVEY BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 15:54:04 BPJS KS IGD 1 33,931 13,069 0 3,000 0 0 0 50,000
LIMANTO, An 00020 AMd.AnKes. Sp.A. KESEHATAN
219 2022/07/01/000053 071383 CHRISTOPHER HARVEY BPJS.KINS0 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 15:54:04 BPJS KS IGD 1 31,936 6,064 0 2,000 0 0 0 40,000
220 2022/07/01/000053 071383 CHRISTOPHER HARVEY BPJS.KINS0 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 15:54:04 BPJS KS IGD 1 31,436 6,564 0 2,000 0 0 0 40,000
221 2022/07/01/000113 060274 Ratih Prabowo Putri, Ny BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 03/07/2022 11:42:15 BPJS Hastina 8 40,431 26,569 0 3,000 0 0 0 70,000
222 2022/07/01/000130 071763 SULISTYOWATI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4150215 dr. DEWI INDIASTARI, 03/07/2022 11:46:24 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
223 2022/07/01/000152 071765 AFRINA MAULIA, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 11:44:18 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
224 2022/07/01/000152 071765 AFRINA MAULIA, AN BPJS.K2B00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 15:22:48 BPJS KS IGD 1 31,936 6,064 0 2,000 0 0 0 40,000
007 AMd.AnKes. M.Biomed. KESEHATAN
225 2022/07/01/000152 071765 AFRINA MAULIA, AN BPJS.K2B00 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 15:22:48 BPJS KS IGD 1 31,436 6,564 0 2,000 0 0 0 40,000
226 2022/07/01/000210 071788 KEINARA AISYAH ADREENA G, BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 11:38:43 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN
227 2022/07/02/000085 071116 NURI VINA MAWADDAH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 03/07/2022 08:18:14 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
228 2022/07/02/000093 068301 PATRICIA MEYANA DIKPASARI, BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 03/07/2022 01:16:50 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
NY 001 AMd.AK. WISANA, Sp.OG. KESEHATAN
229 2022/07/02/000212 067862 ELIN INDAH SARI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 03/07/2022 15:50:49 BPJS KS RR 3 40,431 26,569 0 3,000 0 0 0 70,000
230 2022/07/03/000011 071394 NADYA ZHAFIRA, AN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 19:46:51 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
0020 AMd.AnKes. Sp.A.
231 2022/07/03/000027 071855 ANI PRISTIWI YANTI, Ny BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 03/07/2022 01:23:14 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
0001 AMd.AK. SUSILO,Sp.OG. KESEHATAN
232 2022/07/03/000027 071855 ANI PRISTIWI YANTI, Ny BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 03/07/2022 11:55:28 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
0001 ARDHIANSYAH, AMd.Ankes SUSILO,Sp.OG. KESEHATAN
233 2022/07/03/000027 071855 ANI PRISTIWI YANTI, Ny BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 03/07/2022 01:23:14 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
234 2022/07/03/000027 071855 ANI PRISTIWI YANTI, Ny BPJS.K2T10 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 03/07/2022 01:23:14 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
235 2022/07/03/000027 071855 ANI PRISTIWI YANTI, Ny BPJS.K2T10 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 03/07/2022 01:23:14 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
236 2022/07/03/000027 071855 ANI PRISTIWI YANTI, Ny BPJS.K2T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 03/07/2022 01:22:36 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
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237 2022/07/03/000029 011855 Siti Juariyah Arda, Ny UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 03/07/2022 02:35:56 UMUM KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
0001 AMd.AK. DWIJAYASA, Sp.OG (K)
238 2022/07/03/000029 011855 Siti Juariyah Arda, Ny UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 03/07/2022 11:48:22 UMUM KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
0001 ARDHIANSYAH, AMd.Ankes DWIJAYASA, Sp.OG (K)
239 2022/07/03/000029 011855 Siti Juariyah Arda, Ny UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 03/07/2022 02:35:56 UMUM KS IGD 6 32,431 9,569 0 3,000 0 0 0 45,000
240 2022/07/03/000029 011855 Siti Juariyah Arda, Ny UMUM.K3B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 03/07/2022 02:35:56 UMUM KS IGD 6 32,436 564 0 2,000 0 0 0 35,000
241 2022/07/03/000029 011855 Siti Juariyah Arda, Ny UMUM.K3B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 03/07/2022 02:35:56 UMUM KS IGD 6 32,436 564 0 2,000 0 0 0 35,000
242 2022/07/03/000029 011855 Siti Juariyah Arda, Ny UMUM.K3B0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 03/07/2022 02:35:09 UMUM KS IGD 6 47,300 35,200 0 7,500 5,000 0 0 95,000
243 2022/07/03/000032 059836 ZERINA SHEEVA SALSABILA, BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 10:53:10 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
244 2022/07/03/000032 059836 ZERINA SHEEVA SALSABILA, BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 10:53:10 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
245 2022/07/03/000034 071858 HADRIANA AMIRA KANA RAYA, BPJS.KINS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 06:21:33 BPJS KS NICU 11 40,431 26,569 0 3,000 0 0 0 70,000
246 2022/07/03/000034 071858 HADRIANA AMIRA KANA RAYA, BPJS.KINS0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 06:21:33 BPJS KS NICU 11 32,431 9,569 0 3,000 0 0 0 45,000
247 2022/07/03/000034 071858 HADRIANA AMIRA KANA RAYA, BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 06:21:33 BPJS KS NICU 11 33,931 13,069 0 3,000 0 0 0 50,000
248 2022/07/03/000040 071698 CHESSY SHAQUEENA VANCIA, UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 08:27:53 UMUM KS IGD 2 50,431 26,569 0 3,000 0 0 0 80,000
AN 0001 ARDHIANSYAH, AMd.Ankes Sp.A.
249 2022/07/03/000040 071698 CHESSY SHAQUEENA VANCIA, UMUM.K1B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 08:27:53 UMUM KS IGD 2 42,431 9,569 0 3,000 0 0 0 55,000
250 2022/07/03/000042 090457 Muhammad Nathan Nur Risqi, An. UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 11:14:46 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 ARDHIANSYAH, AMd.Ankes M.Biomed.
251 2022/07/03/000042 090457 Muhammad Nathan Nur Risqi, An. UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 11:14:46 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
252 2022/07/03/000045 031677 Yosafat Benaya Wirasena, An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 10:46:11 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
253 2022/07/03/000045 031677 Yosafat Benaya Wirasena, An UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 10:46:11 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
254 2022/07/03/000046 071862 ALMIRA FELIA SHANUM, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 08:26:08 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
255 2022/07/03/000046 071862 ALMIRA FELIA SHANUM, AN BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 08:26:08 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
256 2022/07/03/000048 071865 INDAH PERMATASARI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 03/07/2022 11:18:40 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 ARDHIANSYAH, AMd.Ankes KESEHATAN
257 2022/07/03/000048 071865 INDAH PERMATASARI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 03/07/2022 11:18:40 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
258 2022/07/03/000048 071865 INDAH PERMATASARI, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 03/07/2022 08:20:20 BPJS IGD 30,390 6,610 0 3,000 0 0 0 40,000
259 2022/07/03/000048 071865 INDAH PERMATASARI, NY UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 03/07/2022 11:18:40 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
260 2022/07/03/000048 071865 INDAH PERMATASARI, NY UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 03/07/2022 11:18:40 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
261 2022/07/03/000048 071865 INDAH PERMATASARI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 03/07/2022 11:17:50 BPJS IGD 47,300 35,200 0 7,500 5,000 0 0 95,000
262 2022/07/03/000050 001253 Ahmad Nurdiansyah,An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 10:43:29 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
263 2022/07/03/000050 001253 Ahmad Nurdiansyah,An UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 10:43:29 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
264 2022/07/03/000051 070676 WINDA PERMATASARI, Ny BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 03/07/2022 11:00:47 BPJS KS RR 3 30,390 6,610 0 3,000 0 0 0 40,000
265 2022/07/03/000051 070676 WINDA PERMATASARI, Ny BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 03/07/2022 08:23:17 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
266 2022/07/03/000051 070676 WINDA PERMATASARI, Ny BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 03/07/2022 08:23:17 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
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267 2022/07/03/000051 070676 WINDA PERMATASARI, Ny BPJS.RJ000 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 03/07/2022 08:23:17 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
268 2022/07/03/000051 070676 WINDA PERMATASARI, Ny BPJS.RJ000 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 03/07/2022 08:23:17 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
269 2022/07/03/000051 070676 WINDA PERMATASARI, Ny BPJS.RJ000 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 03/07/2022 08:22:31 BPJS IGD 44,800 35,200 0 5,000 5,000 0 0 90,000
270 2022/07/03/000055 071868 ELEANORA ORISHA SADEWA, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 10:48:23 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 ARDHIANSYAH, AMd.Ankes M.Biomed.
271 2022/07/03/000055 071868 ELEANORA ORISHA SADEWA, UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 10:48:23 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
AN 009 ARDHIANSYAH, AMd.Ankes M.Biomed.
272 2022/07/03/000058 056388 ALSHAMIRA KHAILEENA BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 10:55:45 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
ANANDARA, An 001 ARDHIANSYAH, AMd.Ankes M.Biomed. KESEHATAN
273 2022/07/03/000058 056388 ALSHAMIRA KHAILEENA BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 10:55:45 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
274 2022/07/03/000058 056388 ALSHAMIRA KHAILEENA BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 10:54:58 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
275 2022/07/03/000058 056388 ALSHAMIRA KHAILEENA BPJS.K1B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 10:55:45 BPJS KS IGD 1 31,931 10,069 0 3,000 0 0 0 45,000
276 2022/07/03/000061 071871 ARKANA IBRAHIM HARIYANTO, BPJS.KFIS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 12:41:12 BPJS KS Fisol 10 40,431 26,569 0 3,000 0 0 0 70,000
AN 0001 ARDHIANSYAH, AMd.Ankes M.Biomed. KESEHATAN
277 2022/07/03/000062 071870 FILZA ALIYA HILYA, AN UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 13:40:45 UMUM KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
278 2022/07/03/000062 071870 FILZA ALIYA HILYA, AN UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 13:40:45 UMUM KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
279 2022/07/03/000062 071870 FILZA ALIYA HILYA, AN UMUM.K3B0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 12:45:14 UMUM KS IGD 1 47,300 35,200 0 7,500 5,000 0 0 95,000
280 2022/07/03/000062 071870 FILZA ALIYA HILYA, AN UMUM.K3B0 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 13:40:45 UMUM KS IGD 1 31,931 10,069 0 3,000 0 0 0 45,000
281 2022/07/03/000063 011281 MUHAMMAD ARSYAD BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 15:24:49 BPJS Pandawa 7 40,431 26,569 0 3,000 0 0 0 70,000
ALFARIZQI, AN 001 AMd.AnKes. M.Biomed. KESEHATAN
282 2022/07/03/000063 011281 MUHAMMAD ARSYAD BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 15:24:49 BPJS Pandawa 7 32,431 9,569 0 3,000 0 0 0 45,000
283 2022/07/03/000063 011281 MUHAMMAD ARSYAD BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 12:45:46 BPJS Pandawa 7 44,800 35,200 0 5,000 5,000 0 0 90,000
ALFARIZQI, AN 0050 ARDHIANSYAH, AMd.Ankes M.Biomed. KESEHATAN
284 2022/07/03/000063 011281 MUHAMMAD ARSYAD BPJS.K1B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 03/07/2022 15:24:49 BPJS Pandawa 7 31,931 10,069 0 3,000 0 0 0 45,000
285 2022/07/03/000067 071490 TARISA NURMALA, NY UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 03/07/2022 13:33:43 UMUM KS IGD 2 50,431 26,569 0 3,000 0 0 0 80,000
286 2022/07/03/000067 071490 TARISA NURMALA, NY UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 03/07/2022 23:02:55 UMUM KS IGD 2 50,431 26,569 0 3,000 0 0 0 80,000
0001 DWIJAYASA, Sp.OG (K)
287 2022/07/03/000067 071490 TARISA NURMALA, NY UMUM.K1B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 03/07/2022 13:33:43 UMUM KS IGD 2 42,431 9,569 0 3,000 0 0 0 55,000
288 2022/07/03/000067 071490 TARISA NURMALA, NY UMUM.K1B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 03/07/2022 13:33:43 UMUM KS IGD 2 42,436 564 0 2,000 0 0 0 45,000
289 2022/07/03/000067 071490 TARISA NURMALA, NY UMUM.K1B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 03/07/2022 13:33:43 UMUM KS IGD 2 42,436 564 0 2,000 0 0 0 45,000
290 2022/07/03/000067 071490 TARISA NURMALA, NY UMUM.K1B0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 03/07/2022 13:33:01 UMUM KS IGD 2 47,300 35,200 0 7,500 5,000 0 0 95,000
291 2022/07/03/000106 013529 AIRA RHENATA VILIANT PUTRI, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 15:30:17 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 AMd.AnKes. Sp.A. KESEHATAN
292 2022/07/03/000106 013529 AIRA RHENATA VILIANT PUTRI, BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 15:30:17 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
293 2022/07/03/000112 062775 JORDANINGTYAS BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 03/07/2022 14:57:34 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
AGUSTININGRUM, NY 001 AMd.AnKes. DWIJAYASA, Sp.OG (K) KESEHATAN
294 2022/07/03/000112 062775 JORDANINGTYAS BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 03/07/2022 14:57:34 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
295 2022/07/03/000112 062775 JORDANINGTYAS BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 03/07/2022 14:57:34 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
296 2022/07/03/000112 062775 JORDANINGTYAS BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 03/07/2022 14:57:34 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
297 2022/07/03/000112 062775 JORDANINGTYAS BPJS. SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, AMd. 10050002 dr. PANDE MADE 03/07/2022 14:56:00 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
DWIJAYASA,
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AGUSTININGRUM, NY K2B000050 AnKes. Sp.OG (K)
298 2022/07/03/000118 033322 BYAN ABIYYA YAHYA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 18:47:41 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
299 2022/07/03/000118 033322 BYAN ABIYYA YAHYA, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 18:47:41 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
300 2022/07/03/000135 091163 Muhammad Azhar Trishakti, An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 03/07/2022 18:29:13 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AnKes.
301 2022/07/03/000138 104751 M. AFIF SARFARAZ AKHDAN, BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 20:57:24 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 AMd.AnKes. Sp.A. KESEHATAN 6/Ayodya 3
302 2022/07/03/000138 104751 M. AFIF SARFARAZ AKHDAN, BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 20:57:24 BPJS Dwarawati 32,431 9,569 0 3,000 0 0 0 45,000
303 2022/07/03/000138 104751 M. AFIF SARFARAZ AKHDAN, BPJS.K2B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 20:57:24 BPJS Dwarawati 31,931 10,069 0 3,000 0 0 0 45,000
304 2022/07/03/000140 078282 GANES RHEVA AQILLA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 03/07/2022 19:45:03 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AnKes.
305 2022/07/03/000140 078282 GANES RHEVA AQILLA, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 03/07/2022 19:45:03 UMUM IGD 31,931 10,069 0 3,000 0 0 0 45,000
009 AMd.AnKes.
306 2022/07/03/000144 071396 AFIZA HAURA ALFARIZQIA BPJS.K3B00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 21:39:34 BPJS KS IGD 2 33,931 13,069 0 3,000 0 0 0 50,000
AFRIGA, AN 0020 Sp.A. KESEHATAN
307 2022/07/03/000145 071261 LAYYINA ALMAHYRA AHSYAR, BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 21:02:52 BPJS KS IGD 5 33,931 13,069 0 3,000 0 0 0 50,000
An 00020 AMd.AnKes. Sp.A. KESEHATAN
308 2022/07/03/000146 060721 MUHAMMAD ZAYN HAZMI, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 22:58:40 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A. KESEHATAN
309 2022/07/03/000146 060721 MUHAMMAD ZAYN HAZMI, AN BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 22:58:40 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
310 2022/07/03/000147 033533 AHMAD ALI ARSHAVIN, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 22:57:38 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A. KESEHATAN
311 2022/07/03/000147 033533 AHMAD ALI ARSHAVIN, AN BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 03/07/2022 22:57:38 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
312 2022/07/03/000151 060643 YANIK IKA RETNO PUTRIANA, UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 03/07/2022 23:41:55 UMUM IGD 30,390 6,610 0 3,000 0 0 0 40,000
NY 0021
313 2022/06/30/000065 031310 QANITA NUR AQILAH, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 04/07/2022 10:19:22 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
314 2022/06/30/000137 023596 MUHAMMAD BAIHAQI ALFARIZI, BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 04/07/2022 06:26:44 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
AN. 001 Sp.A. KESEHATAN
315 2022/06/30/000210 071737 M. FAIDUROHMAN, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 04/07/2022 06:56:48 BPJS ICU 1 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A. KESEHATAN
316 2022/06/30/000214 071738 AINAYA CALISTA ARDHANIA, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 04/07/2022 13:48:17 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
317 2022/07/01/000152 071765 AFRINA MAULIA, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 04/07/2022 06:28:09 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
318 2022/07/02/000085 071116 NURI VINA MAWADDAH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 04/07/2022 08:24:30 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
319 2022/07/02/000149 067467 ATHAYA QAWIM ZAAHIRULHAQ BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 04/07/2022 06:25:01 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
P G., AN 00001 Sp.A. KESEHATAN
320 2022/07/02/000190 001523 MUH. ABRISSAM QUTBY BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 04/07/2022 10:46:52 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
NAWASENA P., AN 00001 AMd.AnKes. M.Biomed. KESEHATAN
321 2022/07/03/000048 071865 INDAH PERMATASARI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 04/07/2022 16:53:58 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
322 2022/07/03/000051 070676 WINDA PERMATASARI, Ny BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 04/07/2022 10:50:35 BPJS KS RR 3 40,431 26,569 0 3,000 0 0 0 70,000
323 2022/07/03/000112 062775 JORDANINGTYAS BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 04/07/2022 06:22:44 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
AGUSTININGRUM, NY 001 DWIJAYASA, Sp.OG (K) KESEHATAN
324 2022/07/04/000028 070396 YOHANES MEDDY, TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8170324 dr. EDWIN PRADANA, 04/07/2022 10:25:48 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
0031 AMd.AnKes. Sp.And.
325 2022/07/04/000037 071502 ACHMAD RAYYANZA IHSAN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 04/07/2022 12:41:52 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
ANNAFIS, AN 0020 AMd.AnKes. M.Biomed.
326 2022/07/04/000037 071502 ACHMAD RAYYANZA IHSAN UMUM.RJ00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 04/07/2022 12:41:52 UMUM Poli Anak 31,936 6,064 0 2,000 0 0 0 40,000
327 2022/07/04/000037 071502 ACHMAD RAYYANZA IHSAN UMUM.RJ00 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 04/07/2022 12:41:52 UMUM Poli Anak 31,436 6,564 0 2,000 0 0 0 40,000
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328 2022/07/04/000043 066275 Riski Kusmayanti, Ny UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 04/07/2022 13:07:09 UMUM Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
00110 AMd.AnKes. WISANA, Sp.OG.
329 2022/07/04/000089 034415 MUHAMMAD AZRI AL FATIH, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 04/07/2022 00:52:19 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A. KESEHATAN
330 2022/07/04/000089 034415 MUHAMMAD AZRI AL FATIH, AN BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 04/07/2022 00:52:19 BPJS KS IGD 10 32,431 9,569 0 3,000 0 0 0 45,000
331 2022/07/04/000090 043815 FARHAN HAIDAS GHASANI, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 04/07/2022 02:26:56 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 KESEHATAN
332 2022/07/04/000090 043815 FARHAN HAIDAS GHASANI, AN UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 04/07/2022 02:26:56 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
00110 KESEHATAN
333 2022/07/04/000091 097521 EARLYTA FAYYOLA PUTRI BPJS.K2T30 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 04/07/2022 04:37:49 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
TUNGGAL, AN 0001 Sp.A. KESEHATAN
334 2022/07/04/000091 097521 EARLYTA FAYYOLA PUTRI BPJS.K2T30 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 04/07/2022 04:37:49 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
TUNGGAL, AN 000110 Sp.A. KESEHATAN
335 2022/07/04/000092 071895 IDA MAIMUNAH, NY BPJS.K2T30 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 04/07/2022 05:29:27 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
336 2022/07/04/000092 071895 IDA MAIMUNAH, NY BPJS.K2T30 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 04/07/2022 05:29:27 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
337 2022/07/04/000092 071895 IDA MAIMUNAH, NY BPJS.K2T30 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 04/07/2022 05:29:27 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
338 2022/07/04/000092 071895 IDA MAIMUNAH, NY BPJS.K2T30 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 04/07/2022 05:29:27 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
339 2022/07/04/000092 071895 IDA MAIMUNAH, NY BPJS.K2T30 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 04/07/2022 05:28:18 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
340 2022/07/04/000096 036194 ZUHROTUS SOLICHAH, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 04/07/2022 09:45:57 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
341 2022/07/04/000096 036194 ZUHROTUS SOLICHAH, NY BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 04/07/2022 09:45:57 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
342 2022/07/04/000096 036194 ZUHROTUS SOLICHAH, NY BPJS.RJ000 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 04/07/2022 09:49:19 BPJS IGD 37,400 47,600 0 5,000 5,000 0 0 95,000
343 2022/07/04/000110 071897 HENDI JAYA PERMANA, TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8170324 dr. EDWIN PRADANA, 04/07/2022 10:25:16 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
344 2022/07/04/000111 096796 Eko Winarmono, Tn UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8170324 dr. EDWIN PRADANA, 04/07/2022 10:24:45 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
345 2022/07/04/000124 071901 NOVITASARI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 04/07/2022 08:28:30 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
346 2022/07/04/000124 071901 NOVITASARI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 04/07/2022 08:28:30 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
347 2022/07/04/000124 071901 NOVITASARI, NY UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 04/07/2022 08:28:30 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
348 2022/07/04/000124 071901 NOVITASARI, NY UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 04/07/2022 08:28:30 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
349 2022/07/04/000152 057893 ACHALENDRA FAAZ ALBIRRU, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 04/07/2022 10:55:09 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
350 2022/07/04/000152 057893 ACHALENDRA FAAZ ALBIRRU, BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 04/07/2022 10:55:09 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
351 2022/07/04/000161 009828 KAYONNA NAOMI ELEANORA, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 04/07/2022 12:39:28 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 AMd.AnKes. M.Biomed.
352 2022/07/04/000161 009828 KAYONNA NAOMI ELEANORA, UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 04/07/2022 12:39:28 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
353 2022/07/04/000163 071511 LUHUR ADHINATA, AN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 04/07/2022 11:54:47 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
0020 AMd.AnKes. M.Biomed.
354 2022/07/04/000163 071511 LUHUR ADHINATA, AN UMUM.RJ00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 04/07/2022 11:54:47 UMUM Poli Anak 31,936 6,064 0 2,000 0 0 0 40,000
355 2022/07/04/000163 071511 LUHUR ADHINATA, AN UMUM.RJ00 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 04/07/2022 11:54:47 UMUM Poli Anak 31,436 6,564 0 2,000 0 0 0 40,000
356 2022/07/04/000165 060643 YANIK IKA RETNO PUTRIANA, BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 04/07/2022 13:05:25 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
NY 001 AMd.AnKes. DWIJAYASA, Sp.OG (K) KESEHATAN 9/Ayodya 5
357 2022/07/04/000165 060643 YANIK IKA RETNO PUTRIANA, BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 04/07/2022 13:05:25 BPJS Dwarawati 32,431 9,569 0 3,000 0 0 0 45,000
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358 2022/07/04/000165 060643 YANIK IKA RETNO PUTRIANA, BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 04/07/2022 13:05:25 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
359 2022/07/04/000165 060643 YANIK IKA RETNO PUTRIANA, BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 04/07/2022 13:05:25 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
360 2022/07/04/000165 060643 YANIK IKA RETNO PUTRIANA, BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 04/07/2022 13:04:19 BPJS Dwarawati 44,800 35,200 0 5,000 5,000 0 0 90,000
361 2022/07/04/000169 008730 KHALIILA QIANA AZKADINA, AN ASKES.K2B Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 9070009 dr. MOHAMMAD MUCHLIS, 04/07/2022 13:09:33 UMUM KS IGD 10 50,431 26,569 0 3,000 0 0 0 75,000
362 2022/07/04/000169 008730 KHALIILA QIANA AZKADINA, AN ASKES.K2B Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 9070009 dr. MOHAMMAD MUCHLIS, 04/07/2022 13:09:33 UMUM KS IGD 10 37,431 9,569 0 3,000 0 0 0 50,000
363 2022/07/04/000171 027580 ALMEERA ALYSSA AZZAHRA, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 04/07/2022 12:16:49 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
AN. 001 AMd.AnKes.
364 2022/07/04/000174 071924 HANIFAH KHANZA AL MAHIRA, UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 9070009 dr. MOHAMMAD MUCHLIS, 04/07/2022 13:13:13 UMUM KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
AN . 0001 AMd.AnKes. Sp.A.
365 2022/07/04/000174 071924 HANIFAH KHANZA AL MAHIRA, UMUM.K3B0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 9070009 dr. MOHAMMAD MUCHLIS, 04/07/2022 13:11:39 UMUM KS IGD 2 47,300 35,200 0 7,500 5,000 0 0 95,000
AN . 00050 AMd.AnKes. Sp.A.
366 2022/07/04/000179 071568 EKA IRVATUL LAILIYA, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 04/07/2022 13:59:48 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AnKes. MENUR, Sp.OG
367 2022/07/04/000179 071568 EKA IRVATUL LAILIYA, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 04/07/2022 13:59:48 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
368 2022/07/04/000179 071568 EKA IRVATUL LAILIYA, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 04/07/2022 13:57:51 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
369 2022/07/04/000179 071568 EKA IRVATUL LAILIYA, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 04/07/2022 13:59:48 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
370 2022/07/04/000179 071568 EKA IRVATUL LAILIYA, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 04/07/2022 13:59:48 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
371 2022/07/04/000188 009828 KAYONNA NAOMI ELEANORA, BPJS.K2T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 04/07/2022 14:48:38 BPJS KS IGD 6 44,800 35,200 0 5,000 5,000 0 0 90,000
AN 00050 AMd.AK. M.Biomed. KESEHATAN
372 2022/07/04/000211 073786 NUR VITAKHUROHMAH, NY BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 04/07/2022 17:59:50 BPJS KS RR 3 40,431 26,569 0 3,000 0 0 0 70,000
373 2022/07/04/000211 073786 NUR VITAKHUROHMAH, NY BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 04/07/2022 17:59:50 BPJS KS RR 3 32,431 9,569 0 3,000 0 0 0 45,000
374 2022/07/04/000211 073786 NUR VITAKHUROHMAH, NY BPJS.K2T10 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 04/07/2022 17:59:50 BPJS KS RR 3 32,436 564 0 2,000 0 0 0 35,000
375 2022/07/04/000211 073786 NUR VITAKHUROHMAH, NY BPJS.K2T10 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 04/07/2022 17:59:50 BPJS KS RR 3 32,436 564 0 2,000 0 0 0 35,000
376 2022/07/04/000211 073786 NUR VITAKHUROHMAH, NY BPJS.K2T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 04/07/2022 18:00:28 BPJS KS RR 3 44,800 35,200 0 5,000 5,000 0 0 90,000
377 2022/07/04/000216 071937 NADIA AZZAHRA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 04/07/2022 18:37:22 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
RAMADHANI,AN 001 Sp.A.
378 2022/07/04/000216 071937 NADIA AZZAHRA UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 04/07/2022 18:37:22 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
RAMADHANI,AN 009 Sp.A.
379 2022/07/04/000224 106238 Baroroh Ayu Purnamasari, Ny UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 04/07/2022 20:44:57 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.PD.
380 2022/07/04/000225 060107 MUHAMMAD ZIDAN ALFARISKY, BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 04/07/2022 20:49:13 BPJS Amarta 7A 40,431 26,569 0 3,000 0 0 0 70,000
381 2022/07/04/000225 060107 MUHAMMAD ZIDAN ALFARISKY, BPJS.K3T20 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 04/07/2022 20:49:13 BPJS Amarta 7A 32,431 9,569 0 3,000 0 0 0 45,000
382 2022/07/04/000226 061151 ROSAHIKA WAHYU BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 04/07/2022 20:56:57 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
PRANITASARI, NY 0001 MENUR, Sp.OG KESEHATAN 8/Ayodya 4
383 2022/07/04/000226 061151 ROSAHIKA WAHYU BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 04/07/2022 20:56:57 BPJS Dwarawati 32,431 9,569 0 3,000 0 0 0 45,000
384 2022/07/04/000226 061151 ROSAHIKA WAHYU BPJS.K2T10 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 04/07/2022 20:56:57 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
385 2022/07/04/000226 061151 ROSAHIKA WAHYU BPJS.K2T10 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 04/07/2022 20:56:57 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
386 2022/07/04/000226 061151 ROSAHIKA WAHYU BPJS.K2T10 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 04/07/2022 20:54:47 BPJS Dwarawati 37,400 47,600 0 5,000 5,000 0 0 95,000
387 2022/07/04/000228 071942 MUHAMMAD ABIZARD REYNDIA UMUM. Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, AMd. 3150145 dr. ZAINUDDIN HAMIDI, 04/07/2022 23:32:21 UMUM Pandawa 1 40,431 26,569 0 3,000 0 0 0 70,000
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WAHYUDI, AN K3T100001 AK.
388 2022/07/04/000228 071942 MUHAMMAD ABIZARD REYNDIA UMUM.K3T1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 04/07/2022 23:32:21 UMUM Pandawa 1 32,431 9,569 0 3,000 0 0 0 45,000
WAHYUDI, AN 0000110 AMd.AK. Sp.A.
389 2022/07/04/000229 061035 HILMI MAULUK DIAH UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 04/07/2022 22:01:18 BPJS IGD 30,390 6,610 0 3,000 0 0 0 40,000
MUSYARROFAH, NY 0021 AMd.AK. KESEHATAN
390 2022/06/30/000047 071660 VIKO WIJAYA, AN UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 13:07:21 UMUM KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
391 2022/07/01/000152 071765 AFRINA MAULIA, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 05/07/2022 09:26:33 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
392 2022/07/02/000085 071116 NURI VINA MAWADDAH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 05/07/2022 10:46:58 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
393 2022/07/02/000170 067930 ATHAYA RAMADHANI PUTRI BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 05/07/2022 07:05:44 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
ADIZA, An 001 AMd.AK. M.Biomed. KESEHATAN
394 2022/07/02/000190 001523 MUH. ABRISSAM QUTBY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 05/07/2022 19:00:54 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
395 2022/07/03/000063 011281 MUHAMMAD ARSYAD BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 05/07/2022 17:15:05 BPJS Pandawa 7 40,431 26,569 0 3,000 0 0 0 70,000
396 2022/07/03/000063 011281 MUHAMMAD ARSYAD BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 05/07/2022 17:15:05 BPJS Pandawa 7 32,431 9,569 0 3,000 0 0 0 45,000
397 2022/07/03/000137 071394 NADYA ZHAFIRA, AN BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 15:34:16 BPJS KS IGD 1 33,931 13,069 0 3,000 0 0 0 50,000
398 2022/07/03/000137 071394 NADYA ZHAFIRA, AN BPJS.KINS0 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 15:34:16 BPJS KS IGD 1 31,936 6,064 0 2,000 0 0 0 40,000
399 2022/07/03/000137 071394 NADYA ZHAFIRA, AN BPJS.KINS0 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 15:34:16 BPJS KS IGD 1 31,436 6,564 0 2,000 0 0 0 40,000
400 2022/07/03/000138 104751 M. AFIF SARFARAZ AKHDAN, BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 09:24:18 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
401 2022/07/03/000144 071396 AFIZA HAURA ALFARIZQIA BPJS.K3B00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 15:36:06 BPJS KS IGD 2 33,931 13,069 0 3,000 0 0 0 50,000
AFRIGA, AN 0020 AMd.AK. Sp.A. KESEHATAN
402 2022/07/03/000144 071396 AFIZA HAURA ALFARIZQIA BPJS.K3B00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 15:36:06 BPJS KS IGD 2 31,936 6,064 0 2,000 0 0 0 40,000
403 2022/07/03/000144 071396 AFIZA HAURA ALFARIZQIA BPJS.K3B00 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 15:36:06 BPJS KS IGD 2 31,436 6,564 0 2,000 0 0 0 40,000
404 2022/07/03/000145 071261 LAYYINA ALMAHYRA AHSYAR, BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 15:37:26 BPJS KS IGD 5 33,931 13,069 0 3,000 0 0 0 50,000
An 00020 AMd.AK. Sp.A. KESEHATAN
405 2022/07/03/000145 071261 LAYYINA ALMAHYRA AHSYAR, BPJS.KINS0 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 15:37:26 BPJS KS IGD 5 31,936 6,064 0 2,000 0 0 0 40,000
406 2022/07/03/000145 071261 LAYYINA ALMAHYRA AHSYAR, BPJS.KINS0 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 15:37:26 BPJS KS IGD 5 31,436 6,564 0 2,000 0 0 0 40,000
407 2022/07/04/000096 036194 ZUHROTUS SOLICHAH, NY BPJS.K2T10 Cholesterol 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4150215 dr. DEWI INDIASTARI, 05/07/2022 09:30:41 BPJS KS IGD 2 29,951 12,049 0 3,000 0 0 0 45,000
00011 AMd.AnKes. Sp.PD. KESEHATAN
408 2022/07/04/000096 036194 ZUHROTUS SOLICHAH, NY BPJS.K2T10 HDL 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4150215 dr. DEWI INDIASTARI, 05/07/2022 09:30:41 BPJS KS IGD 2 34,951 22,049 0 3,000 0 0 0 60,000
409 2022/07/04/000096 036194 ZUHROTUS SOLICHAH, NY BPJS.K2T10 LDL 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4150215 dr. DEWI INDIASTARI, 05/07/2022 09:30:41 BPJS KS IGD 2 34,951 22,049 0 3,000 0 0 0 60,000
410 2022/07/04/000096 036194 ZUHROTUS SOLICHAH, NY BPJS.K2T10 Trigliserida 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4150215 dr. DEWI INDIASTARI, 05/07/2022 09:30:41 BPJS KS IGD 2 34,951 17,049 0 3,000 0 0 0 55,000
411 2022/07/04/000096 036194 ZUHROTUS SOLICHAH, NY BPJS.K2T10 Gula Darah Puasa 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4150215 dr. DEWI INDIASTARI, 05/07/2022 09:28:39 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
412 2022/07/04/000096 036194 ZUHROTUS SOLICHAH, NY BPJS.K2T10 Gula Darah 2 Jam PP 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4150215 dr. DEWI INDIASTARI, 05/07/2022 09:28:39 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
413 2022/07/04/000152 057893 ACHALENDRA FAAZ ALBIRRU, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 13:09:26 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
414 2022/07/04/000165 060643 YANIK IKA RETNO PUTRIANA, BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 05/07/2022 06:21:07 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
NY 001 AMd.AK. DWIJAYASA, Sp.OG (K) KESEHATAN 9/Ayodya 5
415 2022/07/04/000176 071511 LUHUR ADHINATA, AN BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 05/07/2022 13:18:10 BPJS KS IGD 2 33,931 13,069 0 3,000 0 0 0 50,000
416 2022/07/04/000178 071502 ACHMAD RAYYANZA IHSAN BPJS.K1B00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 05/07/2022 13:15:35 BPJS KS IGD 5 33,931 13,069 0 3,000 0 0 0 50,000
ANNAFIS, AN 0020 AMd.AnKes. M.Biomed. KESEHATAN
8/1/22, 8:34 AM Page 14 of 107

417 2022/07/04/000224 106238 Baroroh Ayu Purnamasari, Ny UMUM.RJ00 Hapusan Darah 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 05/07/2022 19:30:15 UMUM Laboratorium 65,431 10,569 50,000 4,000 0 0 0 130,000
002 Sp.PD.
418 2022/07/04/000226 061151 ROSAHIKA WAHYU BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1150219 dr. FATMASARI PERDANA 05/07/2022 06:18:45 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
PRANITASARI, NY 0001 AMd.AK. MENUR, Sp.OG KESEHATAN 8/Ayodya 4
419 2022/07/04/000231 060657 HAN OMAR DEMIRAL, AN BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 02:18:58 BPJS Pandawa 3 40,431 26,569 0 3,000 0 0 0 70,000
420 2022/07/04/000231 060657 HAN OMAR DEMIRAL, AN BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 02:18:58 BPJS Pandawa 3 32,431 9,569 0 3,000 0 0 0 45,000
421 2022/07/05/000004 071558 BINAR LAKESWARA, AN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 20:33:12 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
0020 Sp.A.
422 2022/07/05/000004 071558 BINAR LAKESWARA, AN UMUM.RJ00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 20:33:12 UMUM Poli Anak 31,936 6,064 0 2,000 0 0 0 40,000
007 Sp.A.
423 2022/07/05/000004 071558 BINAR LAKESWARA, AN UMUM.RJ00 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 20:33:12 UMUM Poli Anak 31,436 6,564 0 2,000 0 0 0 40,000
008 Sp.A.
424 2022/07/05/000006 081415 NAOMI IKA HERAWATI, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 05/07/2022 11:33:25 UMUM Poli Kandungan 30,390 6,610 0 3,000 0 0 0 40,000
425 2022/07/05/000011 071586 SHAKILA MAHARANI, AN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 09:17:46 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
426 2022/07/05/000040 071559 CHEISYA AGNIA ALFARIZQIA, UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 09:16:36 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
AN 0020 AMd.AnKes. Sp.A.
427 2022/07/05/000065 071947 SITI FATIMAH, Ny BPJS.K3B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 05/07/2022 00:19:36 BPJS KS IGD 2 37,400 47,600 0 5,000 5,000 0 0 95,000
0047 AMd.AK. KARTIKARINI, Sp.OG KESEHATAN
428 2022/07/05/000065 071947 SITI FATIMAH, Ny BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 05/07/2022 00:18:03 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
429 2022/07/05/000065 071947 SITI FATIMAH, Ny BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 05/07/2022 00:18:03 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
430 2022/07/05/000065 071947 SITI FATIMAH, Ny BPJS.RJ000 SGOT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 05/07/2022 00:18:03 BPJS IGD 34,451 12,549 0 3,000 0 0 0 50,000
431 2022/07/05/000065 071947 SITI FATIMAH, Ny BPJS.RJ000 SGPT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 05/07/2022 00:18:03 BPJS IGD 34,451 12,549 0 3,000 0 0 0 50,000
432 2022/07/05/000065 071947 SITI FATIMAH, Ny BPJS.RJ000 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 05/07/2022 00:18:03 BPJS IGD 31,451 10,549 0 3,000 0 0 0 45,000
433 2022/07/05/000065 071947 SITI FATIMAH, Ny BPJS.RJ000 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 05/07/2022 00:18:03 BPJS IGD 33,951 13,049 0 3,000 0 0 0 50,000
434 2022/07/05/000065 071947 SITI FATIMAH, Ny BPJS.RJ000 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 05/07/2022 00:18:03 BPJS IGD 30,390 6,610 0 3,000 0 0 0 40,000
435 2022/07/05/000065 071947 SITI FATIMAH, Ny BPJS.RJ000 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 05/07/2022 00:18:03 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
436 2022/07/05/000065 071947 SITI FATIMAH, Ny BPJS.RJ000 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 05/07/2022 00:18:03 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
437 2022/07/05/000066 060078 INDAH AYU SAFITRI, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 05/07/2022 19:02:15 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
001 MENUR, Sp.OG KESEHATAN
438 2022/07/05/000066 060078 INDAH AYU SAFITRI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 05/07/2022 06:23:35 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK. KESEHATAN
439 2022/07/05/000066 060078 INDAH AYU SAFITRI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 05/07/2022 06:23:35 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
440 2022/07/05/000066 060078 INDAH AYU SAFITRI, NY UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 05/07/2022 06:23:35 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
441 2022/07/05/000066 060078 INDAH AYU SAFITRI, NY UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 05/07/2022 06:23:35 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
442 2022/07/05/000066 060078 INDAH AYU SAFITRI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 05/07/2022 06:24:11 BPJS IGD 47,300 35,200 0 7,500 5,000 0 0 95,000
443 2022/07/05/000068 071948 FASYA AHMAD MELVIANO BPJS.KFIS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 07:10:44 BPJS KS Fisol 16 40,431 26,569 0 3,000 0 0 0 70,000
SOFYAN, AN 0001 AMd.AK. Sp.A. KESEHATAN
444 2022/07/05/000068 071948 FASYA AHMAD MELVIANO BPJS.KFIS0 Gula Darah 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 07:10:44 BPJS KS Fisol 16 32,431 9,569 0 3,000 0 0 0 45,000
SOFYAN, AN 00010 AMd.AK. Sp.A. KESEHATAN
445 2022/07/05/000078 039899 WAHYU MUHAMMAD UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 05/07/2022 07:40:05 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
MAULADANA, AN 001 AMd.AnKes. KESEHATAN
446 2022/07/05/000078 039899 WAHYU MUHAMMAD UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 05/07/2022 07:40:05 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
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447 2022/07/05/000078 039899 WAHYU MUHAMMAD UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 05/07/2022 09:14:00 BPJS IGD 47,300 35,200 0 7,500 5,000 0 0 95,000
448 2022/07/05/000089 071960 ARLINA WULANDARI SAPUTRI, UMUM.K3T2 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 11:06:10 UMUM KS IGD 9 40,431 26,569 0 3,000 0 0 0 70,000
449 2022/07/05/000089 071960 ARLINA WULANDARI SAPUTRI, UMUM.K3T2 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 11:06:10 UMUM KS IGD 9 32,431 9,569 0 3,000 0 0 0 45,000
450 2022/07/05/000103 042117 Oktavia Arno Yoeanita, Ny. UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 05/07/2022 11:23:27 UMUM Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AnKes. DWIJAYASA, Sp.OG (K)
451 2022/07/05/000103 042117 Oktavia Arno Yoeanita, Ny. UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 05/07/2022 11:23:27 UMUM Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
452 2022/07/05/000103 042117 Oktavia Arno Yoeanita, Ny. UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 05/07/2022 11:21:37 UMUM Poli Kandungan 37,900 47,600 0 7,500 5,000 0 0 98,000
453 2022/07/05/000103 042117 Oktavia Arno Yoeanita, Ny. UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 05/07/2022 11:23:27 UMUM Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
454 2022/07/05/000103 042117 Oktavia Arno Yoeanita, Ny. UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 05/07/2022 11:23:27 UMUM Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
455 2022/07/05/000104 003080 Shesha Viana Khalisa,An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 05/07/2022 08:27:57 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AnKes.
456 2022/07/05/000104 003080 Shesha Viana Khalisa,An UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 05/07/2022 08:27:57 UMUM IGD 31,931 10,069 0 3,000 0 0 0 45,000
009 AMd.AnKes.
457 2022/07/05/000105 049389 PANDE PUTU ADIVYA KYN.RJ0000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 05/07/2022 08:33:09 KARYAWAN Poli Anak 33,431 26,569 0 3,000 0 0 0 63,000
SAVRINADEYA, AN 1 AMd.AnKes. M.Biomed.
458 2022/07/05/000105 049389 PANDE PUTU ADIVYA KYN.RJ0000 IgG Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 05/07/2022 08:33:09 KARYAWAN Poli Anak 32,951 46,549 0 1,500 0 0 0 81,000
459 2022/07/05/000105 049389 PANDE PUTU ADIVYA KYN.RJ0000 IgM Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 05/07/2022 08:33:09 KARYAWAN Poli Anak 32,951 46,549 0 1,500 0 0 0 81,000
460 2022/07/05/000105 049389 PANDE PUTU ADIVYA KYN.RJ0000 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 05/07/2022 08:33:09 KARYAWAN Poli Anak 26,931 10,069 0 3,000 0 0 0 40,000
461 2022/07/05/000109 072936 NARA SATRIA ZILQIAH, An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 10:06:55 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
462 2022/07/05/000109 072936 NARA SATRIA ZILQIAH, An UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 10:06:55 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
463 2022/07/05/000111 069218 EKO WIGATININGSIH, Ny BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 05/07/2022 10:52:30 BPJS Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
01 AMd.AnKes. DWIJAYASA, Sp.OG (K) KESEHATAN
464 2022/07/05/000111 069218 EKO WIGATININGSIH, Ny BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 05/07/2022 10:52:30 BPJS Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
465 2022/07/05/000111 069218 EKO WIGATININGSIH, Ny BPJS.RJ000 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 05/07/2022 10:52:30 BPJS Poli Kandungan 30,390 6,610 0 3,000 0 0 0 40,000
466 2022/07/05/000111 069218 EKO WIGATININGSIH, Ny BPJS.RJ000 Anti HIV 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 05/07/2022 10:52:30 BPJS Poli Kandungan 38,951 34,049 0 2,000 0 0 0 75,000
467 2022/07/05/000111 069218 EKO WIGATININGSIH, Ny BPJS.RJ000 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 05/07/2022 10:52:30 BPJS Poli Kandungan 38,951 34,049 0 2,000 0 0 0 75,000
468 2022/07/05/000111 069218 EKO WIGATININGSIH, Ny BPJS.RJ000 TPHA/Sipilis 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 05/07/2022 10:52:30 BPJS Poli Kandungan 37,951 34,049 0 3,000 0 0 0 75,000
469 2022/07/05/000117 007609 DEVI NOVITA SARI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 05/07/2022 09:57:10 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
470 2022/07/05/000117 007609 DEVI NOVITA SARI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 05/07/2022 09:57:10 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
471 2022/07/05/000117 007609 DEVI NOVITA SARI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 05/07/2022 11:19:14 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
472 2022/07/05/000117 007609 DEVI NOVITA SARI, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 05/07/2022 09:57:10 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
473 2022/07/05/000117 007609 DEVI NOVITA SARI, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 05/07/2022 09:57:10 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
474 2022/07/05/000122 071968 SUBAIDAH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 05/07/2022 09:39:14 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AnKes. INDRAWAN, Sp. OG (K) KESEHATAN
475 2022/07/05/000122 071968 SUBAIDAH, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 05/07/2022 09:39:14 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
476 2022/07/05/000122 071968 SUBAIDAH, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 05/07/2022 09:39:14 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
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477 2022/07/05/000122 071968 SUBAIDAH, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 05/07/2022 09:39:14 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
478 2022/07/05/000122 071968 SUBAIDAH, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 05/07/2022 09:36:37 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
479 2022/07/05/000126 071568 EKA IRVATUL LAILIYA, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 05/07/2022 18:58:18 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
480 2022/07/05/000128 098790 WILDAN SATRIA ABIMANYU, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 9070009 dr. MOHAMMAD MUCHLIS, 05/07/2022 10:10:27 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
481 2022/07/05/000135 071610 ACHMAD REYHAN BPJS.K3B00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 11:28:31 BPJS KS IGD 10 33,931 13,069 0 3,000 0 0 0 50,000
ALFARIZQI,AN 0020 AMd.AnKes. Sp.A. KESEHATAN
482 2022/07/05/000135 071610 ACHMAD REYHAN BPJS.K3B00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 11:28:31 BPJS KS IGD 10 31,936 6,064 0 2,000 0 0 0 40,000
483 2022/07/05/000135 071610 ACHMAD REYHAN BPJS.K3B00 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 11:28:31 BPJS KS IGD 10 31,436 6,564 0 2,000 0 0 0 40,000
484 2022/07/05/000139 070268 HARIYANTI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4150215 dr. DEWI INDIASTARI, 05/07/2022 11:30:45 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
485 2022/07/05/000147 071973 EKA IRVATUL L., BY NY BPJS.KINS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 13:03:03 BPJS KS NICU 10 40,431 26,569 0 3,000 0 0 0 70,000
486 2022/07/05/000147 071973 EKA IRVATUL L., BY NY BPJS.KINS0 Gula Darah 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 13:03:03 BPJS KS NICU 10 32,431 9,569 0 3,000 0 0 0 45,000
487 2022/07/05/000150 071976 DEWI HANDAYANI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 05/07/2022 13:40:42 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
488 2022/07/05/000150 071976 DEWI HANDAYANI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 05/07/2022 13:40:42 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
489 2022/07/05/000150 071976 DEWI HANDAYANI, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 05/07/2022 13:46:14 UMUM Laboratorium 30,390 6,610 0 3,000 0 0 0 40,000
490 2022/07/05/000150 071976 DEWI HANDAYANI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 05/07/2022 13:39:04 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
491 2022/07/05/000150 071976 DEWI HANDAYANI, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 05/07/2022 13:40:42 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
492 2022/07/05/000150 071976 DEWI HANDAYANI, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 05/07/2022 13:40:42 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
493 2022/07/05/000160 053747 Diana Purbo Siwi, Ny BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 05/07/2022 16:04:06 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
01 AMd.AK.
494 2022/07/05/000160 053747 Diana Purbo Siwi, Ny BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 05/07/2022 16:04:06 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
0110 AMd.AK.
495 2022/07/05/000160 053747 Diana Purbo Siwi, Ny BPJS.RJ000 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 05/07/2022 16:04:06 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
05 AMd.AK.
496 2022/07/05/000160 053747 Diana Purbo Siwi, Ny BPJS.RJ000 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 05/07/2022 16:04:06 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
06 AMd.AK.
497 2022/07/05/000160 053747 Diana Purbo Siwi, Ny UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 05/07/2022 16:27:53 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
0047 AMd.AK.
498 2022/07/05/000163 091553 SILVIATAS SHOFFI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 05/07/2022 15:59:28 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
499 2022/07/05/000163 091553 SILVIATAS SHOFFI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 05/07/2022 15:59:28 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
500 2022/07/05/000163 091553 SILVIATAS SHOFFI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 05/07/2022 16:28:24 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
501 2022/07/05/000163 091553 SILVIATAS SHOFFI, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 05/07/2022 15:59:28 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
502 2022/07/05/000163 091553 SILVIATAS SHOFFI, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 05/07/2022 15:59:28 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
503 2022/07/05/000173 071978 SENJA AMALIA YUNITA, AN BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 17:17:20 BPJS Amarta 4B 40,431 26,569 0 3,000 0 0 0 70,000
504 2022/07/05/000173 071978 SENJA AMALIA YUNITA, AN BPJS.K3T20 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 17:17:20 BPJS Amarta 4B 32,431 9,569 0 3,000 0 0 0 45,000
505 2022/07/05/000175 070838 PUJI RAHAYU, NY BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 05/07/2022 17:08:47 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
0001 ARDHIANSYAH, AMd.Ankes DWIJAYASA, Sp.OG (K) KESEHATAN 9/Ayodya 5
506 2022/07/05/000175 070838 PUJI RAHAYU, NY BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 05/07/2022 17:08:47 BPJS Dwarawati 32,431 9,569 0 3,000 0 0 0 45,000
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507 2022/07/05/000175 070838 PUJI RAHAYU, NY BPJS.K2T10 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 05/07/2022 17:08:47 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
508 2022/07/05/000175 070838 PUJI RAHAYU, NY BPJS.K2T10 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 05/07/2022 17:08:47 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
509 2022/07/05/000175 070838 PUJI RAHAYU, NY BPJS.K2T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 05/07/2022 17:08:05 BPJS Dwarawati 44,800 35,200 0 5,000 5,000 0 0 90,000
510 2022/07/05/000177 040977 IRAWATI, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 05/07/2022 16:39:08 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
511 2022/07/05/000177 040977 IRAWATI, NY BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 05/07/2022 16:39:08 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
512 2022/07/05/000177 040977 IRAWATI, NY BPJS.RJ000 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 05/07/2022 16:39:08 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
513 2022/07/05/000177 040977 IRAWATI, NY BPJS.RJ000 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 05/07/2022 16:39:08 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
514 2022/07/05/000177 040977 IRAWATI, NY BPJS.RJ000 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 05/07/2022 16:37:26 BPJS IGD 44,800 35,200 0 5,000 5,000 0 0 90,000
515 2022/07/05/000187 093779 Hana Leony Luvitasari, Ny BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 05/07/2022 17:11:59 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
516 2022/07/05/000187 093779 Hana Leony Luvitasari, Ny BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 05/07/2022 17:11:59 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
517 2022/07/05/000187 093779 Hana Leony Luvitasari, Ny BPJS.RJ000 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 05/07/2022 17:11:59 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
518 2022/07/05/000187 093779 Hana Leony Luvitasari, Ny BPJS.RJ000 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 05/07/2022 17:11:59 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
519 2022/07/05/000187 093779 Hana Leony Luvitasari, Ny BPJS.RJ000 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 05/07/2022 17:11:19 BPJS IGD 44,800 35,200 0 5,000 5,000 0 0 90,000
520 2022/07/05/000191 090298 Ramdhan Satriyo Wicaksono, An UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 18:12:40 UMUM Pandawa 1 50,431 26,569 0 3,000 0 0 0 75,000
0001 ARDHIANSYAH, AMd.Ankes Sp.A.
521 2022/07/05/000191 090298 Ramdhan Satriyo Wicaksono, An UMUM.K2B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 18:12:40 UMUM Pandawa 1 37,431 9,569 0 3,000 0 0 0 50,000
522 2022/07/05/000206 071992 POMPI KARINA, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 05/07/2022 20:28:18 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
001
523 2022/07/05/000206 071992 POMPI KARINA, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 05/07/2022 20:28:18 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
00110
524 2022/07/05/000206 071992 POMPI KARINA, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 05/07/2022 20:27:10 UMUM Laboratorium 30,390 6,610 0 3,000 0 0 0 40,000
0021
525 2022/07/05/000206 071992 POMPI KARINA, NY UMUM.RJ00 Anti HIV 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 05/07/2022 20:28:18 UMUM Laboratorium 38,951 34,049 0 2,000 0 0 0 75,000
0026
526 2022/07/05/000206 071992 POMPI KARINA, NY UMUM.RJ00 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 05/07/2022 20:28:18 UMUM Laboratorium 38,951 34,049 0 2,000 0 0 0 75,000
0027
527 2022/07/05/000206 071992 POMPI KARINA, NY UMUM.RJ00 TPHA/Sipilis 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 05/07/2022 20:28:18 UMUM Laboratorium 37,951 34,049 0 3,000 0 0 0 75,000
0028
528 2022/07/05/000206 071992 POMPI KARINA, NY UMUM.RJ00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 05/07/2022 20:28:18 UMUM Laboratorium 31,936 6,064 0 2,000 0 0 0 40,000
007
529 2022/07/05/000207 071991 ABID AL-SHAKA SAPUTRA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 05/07/2022 19:47:57 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
530 2022/07/05/000211 071856 AYESHA PUTRI JULIAVIRA, AN BPJS.KINS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 21:09:56 BPJS ICU 1 40,431 26,569 0 3,000 0 0 0 70,000
531 2022/07/05/000211 071856 AYESHA PUTRI JULIAVIRA, AN BPJS.KINS0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 05/07/2022 21:09:56 BPJS ICU 1 32,431 9,569 0 3,000 0 0 0 45,000
532 2022/07/05/000213 062463 ROSALIA TRISNAWATI, NY BPJS.K2T30 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 05/07/2022 21:06:06 BPJS Amarta 5B 40,431 26,569 0 3,000 0 0 0 70,000
0001 WISANA, Sp.OG. KESEHATAN
533 2022/07/05/000213 062463 ROSALIA TRISNAWATI, NY BPJS.K2T30 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 05/07/2022 21:06:06 BPJS Amarta 5B 32,431 9,569 0 3,000 0 0 0 45,000
534 2022/07/05/000213 062463 ROSALIA TRISNAWATI, NY BPJS.K2T30 Anti HIV 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 05/07/2022 21:06:06 BPJS Amarta 5B 38,951 34,049 0 2,000 0 0 0 75,000
535 2022/07/05/000213 062463 ROSALIA TRISNAWATI, NY BPJS.K2T30 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 05/07/2022 21:06:06 BPJS Amarta 5B 38,951 34,049 0 2,000 0 0 0 75,000
536 2022/07/05/000213 062463 ROSALIA TRISNAWATI, NY BPJS.K2T30 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 05/07/2022 21:06:06 BPJS Amarta 5B 32,436 564 0 2,000 0 0 0 35,000
8/1/22, 8:34 AM Page 18 of 107

537 2022/07/05/000213 062463 ROSALIA TRISNAWATI, NY BPJS.K2T30 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 05/07/2022 21:06:06 BPJS Amarta 5B 32,436 564 0 2,000 0 0 0 35,000
538 2022/07/05/000213 062463 ROSALIA TRISNAWATI, NY BPJS.K2T30 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 05/07/2022 21:05:08 BPJS Amarta 5B 44,800 35,200 0 5,000 5,000 0 0 90,000
539 2022/07/05/000214 071994 SITI FATIMAH, By Ny BPJS.K3000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 10210442 FIANE SWANA CERIA 1160202 dr. DEWI NURINDAH, Sp.A, 05/07/2022 20:44:21 BPJS KS Fisol 18 40,431 26,569 0 3,000 0 0 0 70,000
01 HATI, AMd.Kep. M.Biomed. KESEHATAN
540 2022/07/05/000214 071994 SITI FATIMAH, By Ny BPJS.KFIS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 05/07/2022 21:09:16 BPJS KS Fisol 18 40,431 26,569 0 3,000 0 0 0 70,000
541 2022/07/05/000217 104299 MARYAM KAMILA MUMTAZA, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 05/07/2022 22:01:59 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 AMd.AK.
542 2022/07/05/000218 049019 FATHIMAH LUTHFA LABIBA, AN BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 05/07/2022 22:03:08 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
01 AMd.AK.
543 2022/06/30/000214 071738 AINAYA CALISTA ARDHANIA, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 09:31:01 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 AMd.AK. Sp.A. KESEHATAN 12/Ayodya 6
544 2022/07/01/000152 071765 AFRINA MAULIA, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 06/07/2022 09:26:45 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
545 2022/07/03/000058 056388 ALSHAMIRA KHAILEENA BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 06/07/2022 06:33:50 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
ANANDARA, An 001 AMd.AK. M.Biomed. KESEHATAN
546 2022/07/04/000090 043815 FARHAN HAIDAS GHASANI, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 06:23:59 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
547 2022/07/04/000152 057893 ACHALENDRA FAAZ ALBIRRU, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 07:04:55 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
548 2022/07/04/000188 009828 KAYONNA NAOMI ELEANORA, BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 06/07/2022 09:29:33 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
549 2022/07/04/000211 073786 NUR VITAKHUROHMAH, NY BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 18:07:05 BPJS KS RR 3 40,431 26,569 0 3,000 0 0 0 70,000
550 2022/07/04/000225 060107 MUHAMMAD ZIDAN ALFARISKY, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 18:14:22 BPJS Amarta 7A 40,431 26,569 0 3,000 0 0 0 70,000
551 2022/07/04/000225 060107 MUHAMMAD ZIDAN ALFARISKY, BPJS.K3B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 18:14:22 BPJS Amarta 7A 31,931 10,069 0 3,000 0 0 0 45,000
552 2022/07/05/000065 071947 SITI FATIMAH, Ny BPJS.K3000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8150167 AYUK FITRYAWATI, AMd. 1110218 dr. NOVINA PURWITA 06/07/2022 16:29:27 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
01 Keb KARTIKARINI, Sp.OG KESEHATAN
553 2022/07/05/000065 071947 SITI FATIMAH, Ny BPJS.K3000 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 8150167 AYUK FITRYAWATI, AMd. 1110218 dr. NOVINA PURWITA 06/07/2022 16:29:27 BPJS KS IGD 2 31,931 10,069 0 3,000 0 0 0 45,000
09 Keb KARTIKARINI, Sp.OG KESEHATAN
554 2022/07/05/000065 071947 SITI FATIMAH, Ny BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 06/07/2022 01:17:58 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
555 2022/07/05/000175 070838 PUJI RAHAYU, NY BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 06/07/2022 12:42:27 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
0001 AMd.AK. DWIJAYASA, Sp.OG (K) KESEHATAN 9/Ayodya 5
556 2022/07/05/000187 093779 Hana Leony Luvitasari, Ny BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 18:16:29 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
557 2022/07/05/000213 062463 ROSALIA TRISNAWATI, NY BPJS.K2T30 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 06/07/2022 09:35:36 BPJS Amarta 5B 40,431 26,569 0 3,000 0 0 0 70,000
0001 AMd.AK. WISANA, Sp.OG. KESEHATAN
558 2022/07/05/000214 071994 SITI FATIMAH, By Ny BPJS.KFIS0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 06/07/2022 08:09:49 BPJS KS Fisol 18 44,800 35,200 0 5,000 5,000 0 0 90,000
559 2022/07/05/000221 035308 SOFIATUL FARDANIYAH, NY UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 06/07/2022 00:23:22 UMUM KS Kamar Bersalin 50,431 26,569 0 3,000 0 0 0 80,000
0001 AMd.AK. KARTIKARINI, Sp.OG 3
560 2022/07/05/000221 035308 SOFIATUL FARDANIYAH, NY UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 18:18:20 UMUM KS Kamar Bersalin 50,431 26,569 0 3,000 0 0 0 80,000
0001 KARTIKARINI, Sp.OG 3
561 2022/07/05/000221 035308 SOFIATUL FARDANIYAH, NY UMUM.K1B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 06/07/2022 00:23:22 UMUM KS Kamar Bersalin 42,431 9,569 0 3,000 0 0 0 55,000
562 2022/07/05/000221 035308 SOFIATUL FARDANIYAH, NY UMUM.K1B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 06/07/2022 00:23:22 UMUM KS Kamar Bersalin 42,436 564 0 2,000 0 0 0 45,000
563 2022/07/05/000221 035308 SOFIATUL FARDANIYAH, NY UMUM.K1B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 06/07/2022 00:23:22 UMUM KS Kamar Bersalin 42,436 564 0 2,000 0 0 0 45,000
564 2022/07/05/000221 035308 SOFIATUL FARDANIYAH, NY UMUM.K1B0 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 06/07/2022 00:23:59 UMUM KS Kamar Bersalin 37,900 47,600 0 7,500 5,000 0 0 98,000
565 2022/07/06/000013 071699 ZUNAIRA PUTRI AFSHEENA, AN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 19:10:08 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
566 2022/07/06/000024 022101 NI MADE AYU WULANSARI, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 16:02:35 BPJS Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
567 2022/07/06/000024 022101 NI MADE AYU WULANSARI, NY BPJS. Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 16:02:35 BPJS Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
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RJ0000110 KARTIKARINI, Sp.OG
568 2022/07/06/000024 022101 NI MADE AYU WULANSARI, NY BPJS.RJ000 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 16:02:35 BPJS Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
569 2022/07/06/000024 022101 NI MADE AYU WULANSARI, NY BPJS.RJ000 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 16:14:39 BPJS Poli Kandungan 44,800 35,200 0 5,000 5,000 0 0 90,000
570 2022/07/06/000024 022101 NI MADE AYU WULANSARI, NY BPJS.RJ000 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 16:02:35 BPJS Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
571 2022/07/06/000025 061831 CHANDRA NUR AFIFAH, NY BPJS.RJ000 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 06/07/2022 12:57:08 BPJS Poli Kandungan 30,390 6,610 0 3,000 0 0 0 40,000
572 2022/07/06/000056 063695 INDRIANI RESPATI PUTRI, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 15:44:32 BPJS Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
573 2022/07/06/000056 063695 INDRIANI RESPATI PUTRI, NY BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 15:44:32 BPJS Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
574 2022/07/06/000056 063695 INDRIANI RESPATI PUTRI, NY BPJS.RJ000 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 15:44:32 BPJS Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
575 2022/07/06/000056 063695 INDRIANI RESPATI PUTRI, NY BPJS.RJ000 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 15:43:26 BPJS Poli Kandungan 44,800 35,200 0 5,000 5,000 0 0 90,000
576 2022/07/06/000056 063695 INDRIANI RESPATI PUTRI, NY BPJS.RJ000 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 15:44:32 BPJS Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
577 2022/07/06/000058 071980 SUPADI, TN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1180326 dr. SISWIDIYATI, Sp.RAD. 06/07/2022 15:57:04 UMUM Poli Radiologi 40,431 26,569 0 3,000 0 0 0 70,000
001
578 2022/07/06/000058 071980 SUPADI, TN UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1180326 dr. SISWIDIYATI, Sp.RAD. 06/07/2022 15:57:04 UMUM Poli Radiologi 32,431 9,569 0 3,000 0 0 0 45,000
00110
579 2022/07/06/000058 071980 SUPADI, TN UMUM.RJ00 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1180326 dr. SISWIDIYATI, Sp.RAD. 06/07/2022 15:57:04 UMUM Poli Radiologi 31,451 10,549 0 3,000 0 0 0 45,000
0018
580 2022/07/06/000058 071980 SUPADI, TN UMUM.RJ00 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1180326 dr. SISWIDIYATI, Sp.RAD. 06/07/2022 15:57:04 UMUM Poli Radiologi 33,951 13,049 0 3,000 0 0 0 50,000
0019
581 2022/07/06/000058 071980 SUPADI, TN UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1180326 dr. SISWIDIYATI, Sp.RAD. 06/07/2022 15:56:10 UMUM Poli Radiologi 30,390 6,610 0 3,000 0 0 0 40,000
0021
582 2022/07/06/000062 038460 ALARIC ZAFRANDI ROSID, AN BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 01:05:14 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
583 2022/07/06/000062 038460 ALARIC ZAFRANDI ROSID, AN BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 01:05:14 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
584 2022/07/06/000063 053747 Diana Purbo Siwi, Ny BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 18:20:02 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
585 2022/07/06/000076 054038 ENIK TRIANA, NY BPJS.RJ000 Gula Darah Puasa 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 06/07/2022 09:50:13 BPJS Poli Penyakit 32,431 9,569 0 3,000 0 0 0 45,000
0210 Sp.PD. KESEHATAN Dalam
586 2022/07/06/000076 054038 ENIK TRIANA, NY BPJS.RJ000 Gula Darah 2 Jam PP 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 06/07/2022 09:50:13 BPJS Poli Penyakit 32,431 9,569 0 3,000 0 0 0 45,000
587 2022/07/06/000079 001596 Azhar Pandu Prahista, Tn UMUM.RJ00 Preparasi Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8170324 dr. EDWIN PRADANA, 06/07/2022 08:59:32 UMUM Poli Andrologi 161,771 738,229 350,000 0 0 50,000 0 1,300,000
0030 AMd.AK. Sp.And.
588 2022/07/06/000090 072005 SUPRIADI,TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8170324 dr. EDWIN PRADANA, 06/07/2022 11:13:17 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
589 2022/07/06/000091 061022 RISKA AYU WULANDARI, NY BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 08:01:01 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
590 2022/07/06/000091 061022 RISKA AYU WULANDARI, NY BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 16:26:19 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
591 2022/07/06/000091 061022 RISKA AYU WULANDARI, NY BPJS.K2UP1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 08:01:01 BPJS KS IGD 10 32,431 9,569 0 3,000 0 0 0 45,000
592 2022/07/06/000091 061022 RISKA AYU WULANDARI, NY BPJS.K2UP1 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 08:01:01 BPJS KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
593 2022/07/06/000091 061022 RISKA AYU WULANDARI, NY BPJS.K2UP1 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 08:01:01 BPJS KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
594 2022/07/06/000091 061022 RISKA AYU WULANDARI, NY BPJS.K2UP1 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 06/07/2022 07:59:16 BPJS KS IGD 10 44,800 35,200 0 5,000 5,000 0 0 90,000
595 2022/07/06/000092 072004 MARIA DIYAN TITISARI N.M, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 06/07/2022 08:53:58 UMUM Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
00110 AMd.AK. KARTIKARINI, Sp.OG
596 2022/07/06/000093 070906 PUSPARANI PRADANTIKA, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 08:04:46 UMUM IGD 30,390 6,610 0 3,000 0 0 0 40,000
0021
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597 2022/07/06/000093 070906 PUSPARANI PRADANTIKA, NY UMUM.RJ00 TPHA/Sipilis 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 08:04:46 UMUM IGD 37,951 34,049 0 3,000 0 0 0 75,000
0028
598 2022/07/06/000104 072008 MUHAMMAD AZZAM MAULIDIN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 08:56:45 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
IRKHAMI, An 001 AMd.AK. Sp.A. KESEHATAN
599 2022/07/06/000104 072008 MUHAMMAD AZZAM MAULIDIN BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 08:56:45 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
IRKHAMI, An 00110 AMd.AK. Sp.A. KESEHATAN
600 2022/07/06/000106 072009 GUNDAR KHIKAM AZHARI,TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8170324 dr. EDWIN PRADANA, 06/07/2022 11:13:59 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
601 2022/07/06/000107 056516 Yenis Pusdikawati, Ny. UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 06/07/2022 09:45:08 UMUM Poli Kandungan 37,900 47,600 0 7,500 5,000 0 0 98,000
602 2022/07/06/000111 064127 CATUR SETIAWAN, TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8170324 dr. EDWIN PRADANA, 06/07/2022 11:14:34 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
603 2022/07/06/000112 062558 INGGITH SASMITHA BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 06/07/2022 09:52:44 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
SYAMPUTRI, NY 001 AMd.AK. KARTIKARINI, Sp.OG KESEHATAN
604 2022/07/06/000112 062558 INGGITH SASMITHA BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 06/07/2022 09:52:44 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
605 2022/07/06/000112 062558 INGGITH SASMITHA BPJS.K1B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 06/07/2022 09:52:44 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
606 2022/07/06/000112 062558 INGGITH SASMITHA BPJS.K1B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 06/07/2022 09:52:44 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
607 2022/07/06/000112 062558 INGGITH SASMITHA BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 06/07/2022 09:53:03 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
608 2022/07/06/000115 103540 Eni Farida, Ny BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 06/07/2022 09:37:33 BPJS KS RR 2 40,431 26,569 0 3,000 0 0 0 70,000
609 2022/07/06/000115 103540 Eni Farida, Ny BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 06/07/2022 09:37:33 BPJS KS RR 2 32,431 9,569 0 3,000 0 0 0 45,000
610 2022/07/06/000115 103540 Eni Farida, Ny BPJS.K2B00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 06/07/2022 09:37:33 BPJS KS RR 2 37,951 38,049 0 4,000 0 0 0 80,000
611 2022/07/06/000115 103540 Eni Farida, Ny BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 06/07/2022 09:37:47 BPJS KS RR 2 44,800 35,200 0 5,000 5,000 0 0 90,000
612 2022/07/06/000115 103540 Eni Farida, Ny BPJS.K2B00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 06/07/2022 09:37:33 BPJS KS RR 2 37,951 38,049 0 4,000 0 0 0 80,000
613 2022/07/06/000117 072011 NUR VITAKHU By.Ny BPJS.KINS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 09:42:00 BPJS KS NICU 13 40,431 26,569 0 3,000 0 0 0 70,000
614 2022/07/06/000117 072011 NUR VITAKHU By.Ny BPJS.KINS0 Gula Darah 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 09:42:00 BPJS KS NICU 13 32,431 9,569 0 3,000 0 0 0 45,000
615 2022/07/06/000118 058622 FENNY APRIYAWATI UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 09:48:21 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
NAINGGOLAN, NY 001 AMd.AK. KESEHATAN
616 2022/07/06/000118 058622 FENNY APRIYAWATI UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 09:48:21 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
617 2022/07/06/000118 058622 FENNY APRIYAWATI UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 09:48:21 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
618 2022/07/06/000118 058622 FENNY APRIYAWATI UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 09:48:21 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
619 2022/07/06/000118 058622 FENNY APRIYAWATI UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 09:48:50 BPJS IGD 47,300 35,200 0 7,500 5,000 0 0 95,000
620 2022/07/06/000122 072013 ANANG WIJAYANTO, TN UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 06/07/2022 09:45:36 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
0047 AMd.AK.
621 2022/07/06/000125 066275 Riski Kusmayanti, Ny UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 06/07/2022 10:47:38 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK. WISANA, Sp.OG.
622 2022/07/06/000125 066275 Riski Kusmayanti, Ny UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 06/07/2022 10:47:38 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
623 2022/07/06/000125 066275 Riski Kusmayanti, Ny UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 06/07/2022 13:07:39 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
624 2022/07/06/000125 066275 Riski Kusmayanti, Ny UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 06/07/2022 10:47:38 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
625 2022/07/06/000125 066275 Riski Kusmayanti, Ny UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 06/07/2022 10:47:38 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
626 2022/07/06/000130 072014 HATIMAH, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 06/07/2022 11:10:10 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK.
627 2022/07/06/000130 072014 HATIMAH, NY UMUM. Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 06/07/2022 11:10:10 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
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RJ0000110 AMd.AK.
628 2022/07/06/000130 072014 HATIMAH, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 06/07/2022 13:07:56 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
629 2022/07/06/000130 072014 HATIMAH, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 06/07/2022 11:10:10 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
005 AMd.AK.
630 2022/07/06/000130 072014 HATIMAH, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 06/07/2022 11:10:10 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
006 AMd.AK.
631 2022/07/06/000136 019217 SRI INTAN IRGAWATI,NY BPJS.K3UP2 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 06/07/2022 12:03:45 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
00001 AMd.AK. KARTIKARINI, Sp.OG KESEHATAN 8/Ayodya 4
632 2022/07/06/000136 019217 SRI INTAN IRGAWATI,NY BPJS.K3UP2 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 06/07/2022 12:03:45 BPJS Dwarawati 32,431 9,569 0 3,000 0 0 0 45,000
633 2022/07/06/000136 019217 SRI INTAN IRGAWATI,NY BPJS.K3UP2 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 06/07/2022 12:03:45 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
634 2022/07/06/000136 019217 SRI INTAN IRGAWATI,NY BPJS.K3UP2 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 06/07/2022 12:03:45 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
635 2022/07/06/000136 019217 SRI INTAN IRGAWATI,NY BPJS.K3UP2 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 06/07/2022 12:04:25 BPJS Dwarawati 44,800 35,200 0 5,000 5,000 0 0 90,000
636 2022/07/06/000140 070751 NINIK TRIYANINGSIH, NY BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 06/07/2022 12:29:56 BPJS Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
637 2022/07/06/000143 085900 ARUM PRATIWI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 06/07/2022 12:00:04 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
638 2022/07/06/000143 085900 ARUM PRATIWI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 06/07/2022 18:11:44 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
639 2022/07/06/000143 085900 ARUM PRATIWI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 06/07/2022 12:00:04 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
640 2022/07/06/000143 085900 ARUM PRATIWI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 06/07/2022 12:00:04 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
641 2022/07/06/000143 085900 ARUM PRATIWI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 06/07/2022 12:00:04 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
642 2022/07/06/000143 085900 ARUM PRATIWI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 06/07/2022 12:01:37 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
643 2022/07/06/000146 042117 Oktavia Arno Yoeanita, Ny. BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 06/07/2022 18:47:44 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
001 ARDHIANSYAH, AMd.Ankes DWIJAYASA, Sp.OG (K) KESEHATAN
644 2022/07/06/000148 071976 DEWI HANDAYANI, NY UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 06/07/2022 23:30:13 UMUM KS IGD 2 50,431 26,569 0 3,000 0 0 0 75,000
645 2022/07/06/000150 072026 KHUSNUL KHOTIMAH, Ny UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 06/07/2022 12:45:37 UMUM KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
646 2022/07/06/000150 072026 KHUSNUL KHOTIMAH, Ny UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 06/07/2022 18:10:06 UMUM KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
0001 WISANA, Sp.OG.
647 2022/07/06/000150 072026 KHUSNUL KHOTIMAH, Ny UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 06/07/2022 12:45:37 UMUM KS IGD 10 32,431 9,569 0 3,000 0 0 0 45,000
648 2022/07/06/000150 072026 KHUSNUL KHOTIMAH, Ny UMUM.K3B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 06/07/2022 12:45:37 UMUM KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
649 2022/07/06/000150 072026 KHUSNUL KHOTIMAH, Ny UMUM.K3B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 06/07/2022 12:45:37 UMUM KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
650 2022/07/06/000150 072026 KHUSNUL KHOTIMAH, Ny UMUM.K3B0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 06/07/2022 12:45:49 UMUM KS IGD 10 47,300 35,200 0 7,500 5,000 0 0 95,000
651 2022/07/06/000154 052540 KAMEANOI JADA FACHRUDIN, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 06/07/2022 19:15:43 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
652 2022/07/06/000163 065684 ERNA DESI MELATI SUCI, NY BPJS.K1T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 06/07/2022 16:11:13 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
653 2022/07/06/000163 065684 ERNA DESI MELATI SUCI, NY BPJS.K1T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 06/07/2022 23:34:19 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
654 2022/07/06/000163 065684 ERNA DESI MELATI SUCI, NY BPJS.K1T20 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 06/07/2022 16:11:13 BPJS KS IGD 10 32,431 9,569 0 3,000 0 0 0 45,000
655 2022/07/06/000163 065684 ERNA DESI MELATI SUCI, NY BPJS.K1T20 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 06/07/2022 16:10:16 BPJS KS IGD 10 30,390 6,610 0 3,000 0 0 0 40,000
656 2022/07/06/000163 065684 ERNA DESI MELATI SUCI, NY BPJS.K1T20 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 06/07/2022 16:11:13 BPJS KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
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657 2022/07/06/000163 065684 ERNA DESI MELATI SUCI, NY BPJS.K1T20 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 06/07/2022 16:11:13 BPJS KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
658 2022/07/06/000163 065684 ERNA DESI MELATI SUCI, NY BPJS.K1T20 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 06/07/2022 16:10:32 BPJS KS IGD 10 44,800 35,200 0 5,000 5,000 0 0 90,000
659 2022/07/06/000168 003826 DYAH AYU GALUH BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 06/07/2022 15:45:58 BPJS Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
CANDRAKIRANA, NY 01 WISANA, Sp.OG. KESEHATAN
660 2022/07/06/000168 003826 DYAH AYU GALUH BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 06/07/2022 15:45:58 BPJS Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
661 2022/07/06/000168 003826 DYAH AYU GALUH BPJS.RJ000 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 06/07/2022 15:45:58 BPJS Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
662 2022/07/06/000168 003826 DYAH AYU GALUH BPJS.RJ000 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 06/07/2022 15:45:09 BPJS Laboratorium 44,800 35,200 0 5,000 5,000 0 0 90,000
663 2022/07/06/000168 003826 DYAH AYU GALUH BPJS.RJ000 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 06/07/2022 15:45:58 BPJS Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
664 2022/07/06/000172 074000 Veronika Widhi Astutik, Ny BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 15:39:39 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
01 KESEHATAN
665 2022/07/06/000172 074000 Veronika Widhi Astutik, Ny BPJS.RJ000 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 15:39:39 BPJS IGD 31,931 10,069 0 3,000 0 0 0 45,000
09 KESEHATAN
666 2022/07/06/000173 079639 Alghani Adya Padri, An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 17:57:36 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
667 2022/07/06/000173 079639 Alghani Adya Padri, An UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 17:57:36 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 Sp.A.
668 2022/07/06/000177 050898 ARALYN TABINDA BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 17:54:41 BPJS Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
MUBADILLAH, AN 01 Sp.A. KESEHATAN
669 2022/07/06/000177 050898 ARALYN TABINDA BPJS.RJ000 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 17:54:41 BPJS Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
MUBADILLAH, AN 09 Sp.A. KESEHATAN
670 2022/07/06/000178 072031 LENI KRISNAWATI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 06/07/2022 15:48:45 BPJS Amarta 8B 40,431 26,569 0 3,000 0 0 0 70,000
671 2022/07/06/000178 072031 LENI KRISNAWATI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 06/07/2022 15:48:45 BPJS Amarta 8B 32,431 9,569 0 3,000 0 0 0 45,000
672 2022/07/06/000178 072031 LENI KRISNAWATI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 06/07/2022 15:48:45 BPJS Amarta 8B 32,436 564 0 2,000 0 0 0 35,000
673 2022/07/06/000178 072031 LENI KRISNAWATI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 06/07/2022 15:48:45 BPJS Amarta 8B 32,436 564 0 2,000 0 0 0 35,000
674 2022/07/06/000178 072031 LENI KRISNAWATI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 06/07/2022 15:48:01 BPJS Amarta 8B 44,800 35,200 0 5,000 5,000 0 0 90,000
675 2022/07/06/000179 024996 ADZKIA GERALDINE, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 17:35:13 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A. KESEHATAN
676 2022/07/06/000179 024996 ADZKIA GERALDINE, AN BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 17:35:13 BPJS KS IGD 5 32,431 9,569 0 3,000 0 0 0 45,000
677 2022/07/06/000180 072027 OKTAVIA ARNO, BY.NY. BPJS.KFIS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 06/07/2022 19:44:58 BPJS KS Fisol 27 40,431 26,569 0 3,000 0 0 0 70,000
678 2022/07/06/000180 072027 OKTAVIA ARNO, BY.NY. BPJS.KFIS0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 06/07/2022 19:44:58 BPJS KS Fisol 27 32,431 9,569 0 3,000 0 0 0 45,000
679 2022/07/06/000180 072027 OKTAVIA ARNO, BY.NY. BPJS.KFIS0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 06/07/2022 20:40:52 BPJS KS Fisol 27 44,800 35,200 0 5,000 5,000 0 0 90,000
680 2022/07/06/000189 070304 NUR HANIK, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 06/07/2022 16:21:21 BPJS KS RR 5 40,431 26,569 0 3,000 0 0 0 70,000
681 2022/07/06/000189 070304 NUR HANIK, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 06/07/2022 16:21:21 BPJS KS RR 5 32,431 9,569 0 3,000 0 0 0 45,000
682 2022/07/06/000189 070304 NUR HANIK, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 06/07/2022 16:21:21 BPJS KS RR 5 32,436 564 0 2,000 0 0 0 35,000
683 2022/07/06/000189 070304 NUR HANIK, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 06/07/2022 16:21:21 BPJS KS RR 5 32,436 564 0 2,000 0 0 0 35,000
684 2022/07/06/000189 070304 NUR HANIK, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 06/07/2022 16:20:23 BPJS KS RR 5 44,800 35,200 0 5,000 5,000 0 0 90,000
685 2022/07/06/000195 029676 SRINI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 17:44:04 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001
686 2022/07/06/000195 029676 SRINI, NY UMUM.RJ00 IgG Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 17:44:04 UMUM IGD 41,951 46,549 0 1,500 0 0 0 90,000
0024
687 2022/07/06/000195 029676 SRINI, NY UMUM. IgM Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 17:44:04 UMUM IGD 41,951 46,549 0 1,500 0 0 0 90,000
8/1/22, 8:34 AM Page 23 of 107

RJ000025
688 2022/07/06/000204 072014 HATIMAH, NY BPJS.K3T10 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 06/07/2022 17:48:20 BPJS KS IGD 10 30,390 6,610 0 3,000 0 0 0 40,000
689 2022/07/06/000206 019240 IDA BAGUS ARSYANENDRA, AN ASKES.RJ00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 06/07/2022 19:22:06 ASURANSI Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
690 2022/07/06/000207 081415 NAOMI IKA HERAWATI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 19:06:37 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
691 2022/07/06/000207 081415 NAOMI IKA HERAWATI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 19:06:37 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
692 2022/07/06/000207 081415 NAOMI IKA HERAWATI, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 19:05:45 BPJS IGD 30,390 6,610 0 3,000 0 0 0 40,000
693 2022/07/06/000207 081415 NAOMI IKA HERAWATI, NY UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 19:06:37 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
694 2022/07/06/000207 081415 NAOMI IKA HERAWATI, NY UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 19:06:37 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
695 2022/07/06/000207 081415 NAOMI IKA HERAWATI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 19:04:43 BPJS IGD 47,300 35,200 0 7,500 5,000 0 0 95,000
696 2022/07/06/000208 072046 SITI NUR SAIDAH, NY UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 06/07/2022 18:54:37 UMUM Amarta 5A 40,431 26,569 0 3,000 0 0 0 70,000
0001 ARDHIANSYAH, AMd.Ankes INDRAWAN, Sp. OG (K)
697 2022/07/06/000208 072046 SITI NUR SAIDAH, NY UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 06/07/2022 18:54:37 UMUM Amarta 5A 32,431 9,569 0 3,000 0 0 0 45,000
698 2022/07/06/000208 072046 SITI NUR SAIDAH, NY UMUM.K3B0 SGOT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 06/07/2022 18:54:37 UMUM Amarta 5A 34,451 12,549 0 3,000 0 0 0 50,000
699 2022/07/06/000208 072046 SITI NUR SAIDAH, NY UMUM.K3B0 SGPT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 06/07/2022 18:54:37 UMUM Amarta 5A 34,451 12,549 0 3,000 0 0 0 50,000
700 2022/07/06/000208 072046 SITI NUR SAIDAH, NY UMUM.K3B0 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 06/07/2022 18:54:37 UMUM Amarta 5A 31,451 10,549 0 3,000 0 0 0 45,000
701 2022/07/06/000208 072046 SITI NUR SAIDAH, NY UMUM.K3B0 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 06/07/2022 18:54:37 UMUM Amarta 5A 33,951 13,049 0 3,000 0 0 0 50,000
702 2022/07/06/000208 072046 SITI NUR SAIDAH, NY UMUM.K3B0 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 06/07/2022 18:52:37 UMUM Amarta 5A 30,390 6,610 0 3,000 0 0 0 40,000
703 2022/07/06/000208 072046 SITI NUR SAIDAH, NY UMUM.K3B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 06/07/2022 18:54:37 UMUM Amarta 5A 32,436 564 0 2,000 0 0 0 35,000
704 2022/07/06/000208 072046 SITI NUR SAIDAH, NY UMUM.K3B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 06/07/2022 18:54:37 UMUM Amarta 5A 32,436 564 0 2,000 0 0 0 35,000
705 2022/07/06/000208 072046 SITI NUR SAIDAH, NY UMUM.K3B0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 06/07/2022 18:51:36 UMUM Amarta 5A 47,300 35,200 0 7,500 5,000 0 0 95,000
706 2022/07/06/000213 072050 FIRMANSYAH, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 06/07/2022 19:39:39 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
707 2022/07/06/000220 057791 AFYAZ AZKIA MAHESWARI BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 06/07/2022 20:30:23 BPJS Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
BRILLIANDY, AN 01 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN
708 2022/07/06/000224 072055 DINA ROSITA, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 20:36:42 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
709 2022/07/06/000224 072055 DINA ROSITA, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 20:36:42 UMUM IGD 32,431 9,569 0 3,000 0 0 0 45,000
710 2022/07/06/000224 072055 DINA ROSITA, NY UMUM.RJ00 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 21:50:40 UMUM IGD 31,451 10,549 0 3,000 0 0 0 45,000
0018
711 2022/07/06/000224 072055 DINA ROSITA, NY UMUM.RJ00 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 21:50:40 UMUM IGD 33,951 13,049 0 3,000 0 0 0 50,000
0019
712 2022/07/06/000224 072055 DINA ROSITA, NY UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 20:35:47 UMUM IGD 47,300 35,200 0 7,500 5,000 0 0 95,000
713 2022/07/06/000225 072054 ANISA AKILA, AN UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 06/07/2022 22:28:09 UMUM Amarta 1A 40,431 26,569 0 3,000 0 0 0 70,000
0001 Sp.A.
714 2022/07/06/000225 072054 ANISA AKILA, AN UMUM.K3B0 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 06/07/2022 21:44:53 UMUM Amarta 1A 37,900 47,600 0 7,500 5,000 0 0 98,000
00047 Sp.A.
715 2022/07/06/000232 072060 SONY SUSANTO, TN UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 21:42:17 UMUM IGD 37,900 47,600 0 7,500 5,000 0 0 98,000
0047
716 2022/07/06/000233 072059 M ALTHAFUR RAHMAN JAFAR, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 06/07/2022 23:27:47 BPJS Amarta 4A 40,431 26,569 0 3,000 0 0 0 70,000
717 2022/07/06/000233 072059 M ALTHAFUR RAHMAN JAFAR, BPJS.K3B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 06/07/2022 22:15:27 BPJS Amarta 4A 37,400 47,600 0 5,000 5,000 0 0 95,000
8/1/22, 8:34 AM Page 24 of 107

718 2022/07/06/000234 072061 SITI NUR S., BY NY UMUM.KINS Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 22:20:49 UMUM NICU 3 50,431 26,569 0 3,000 0 0 0 75,000
00001 Sp.A.
719 2022/07/06/000234 072061 SITI NUR S., BY NY UMUM.KINS Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 22:20:49 UMUM NICU 3 37,431 9,569 0 3,000 0 0 0 50,000
0000110 Sp.A.
720 2022/07/06/000234 072061 SITI NUR S., BY NY UMUM.KINS SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 06/07/2022 22:24:51 UMUM NICU 3 37,900 47,600 0 7,500 5,000 0 0 98,000
000047 Sp.A.
721 2022/07/06/000237 072064 ABDUS SALAM, TN UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 06/07/2022 23:24:27 UMUM IGD 37,900 47,600 0 7,500 5,000 0 0 98,000
0047
723 2022/07/05/000065 071947 SITI FATIMAH, Ny BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 07/07/2022 02:28:35 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
724 2022/07/05/000135 071610 ACHMAD REYHAN BPJS.K3B00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 10:20:09 BPJS KS IGD 10 33,931 13,069 0 3,000 0 0 0 50,000
725 2022/07/05/000140 098790 WILDAN SATRIA ABIMANYU, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 10:26:53 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
726 2022/07/05/000141 072936 NARA SATRIA ZILQIAH, An BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 10:24:44 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
727 2022/07/05/000177 040977 IRAWATI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 07/07/2022 06:11:44 BPJS Hastina 6 40,431 26,569 0 3,000 0 0 0 70,000
728 2022/07/06/000062 038460 ALARIC ZAFRANDI ROSID, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 10:22:31 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
729 2022/07/06/000112 062558 INGGITH SASMITHA BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 07/07/2022 23:24:54 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
SYAMPUTRI, NY 001 KARTIKARINI, Sp.OG KESEHATAN
730 2022/07/06/000115 103540 Eni Farida, Ny BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 07/07/2022 10:31:12 BPJS KS RR 2 40,431 26,569 0 3,000 0 0 0 70,000
731 2022/07/06/000136 019217 SRI INTAN IRGAWATI,NY BPJS.K3UP2 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 07/07/2022 06:06:56 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
00001 KARTIKARINI, Sp.OG KESEHATAN 8/Ayodya 4
732 2022/07/06/000162 022101 NI MADE AYU WULANSARI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 07/07/2022 10:47:07 BPJS KS RR 1 40,431 26,569 0 3,000 0 0 0 70,000
733 2022/07/06/000178 072031 LENI KRISNAWATI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 07/07/2022 06:09:50 BPJS Amarta 8B 40,431 26,569 0 3,000 0 0 0 70,000
734 2022/07/06/000189 070304 NUR HANIK, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 07/07/2022 12:06:18 BPJS KS RR 5 40,431 26,569 0 3,000 0 0 0 70,000
735 2022/07/06/000204 072014 HATIMAH, NY BPJS.K3T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 07/07/2022 06:02:41 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
736 2022/07/06/000207 081415 NAOMI IKA HERAWATI, NY BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 07/07/2022 12:17:08 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
737 2022/07/06/000208 072046 SITI NUR SAIDAH, NY UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 07/07/2022 05:54:54 UMUM Amarta 5A 40,431 26,569 0 3,000 0 0 0 70,000
0001 INDRAWAN, Sp. OG (K)
738 2022/07/06/000239 070906 PUSPARANI PRADANTIKA, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 07/07/2022 00:27:23 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
739 2022/07/06/000239 070906 PUSPARANI PRADANTIKA, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 07/07/2022 10:36:51 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
740 2022/07/06/000239 070906 PUSPARANI PRADANTIKA, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 07/07/2022 00:27:23 BPJS KS Kamar Bersalin 32,431 9,569 0 3,000 0 0 0 45,000
741 2022/07/06/000239 070906 PUSPARANI PRADANTIKA, NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 07/07/2022 00:27:23 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
742 2022/07/06/000239 070906 PUSPARANI PRADANTIKA, NY BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 07/07/2022 00:27:23 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
743 2022/07/06/000239 070906 PUSPARANI PRADANTIKA, NY BPJS.K2B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 07/07/2022 00:30:20 BPJS KS Kamar Bersalin 37,400 47,600 0 5,000 5,000 0 0 95,000
744 2022/07/07/000061 063695 INDRIANI RESPATI PUTRI, NY BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 07/07/2022 10:50:05 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
745 2022/07/07/000098 071683 ALVARO GHAISAN PRADAN, AN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 09:01:13 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
746 2022/07/07/000100 049764 DEWI ZAHROÙL AFIATI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 07/07/2022 09:02:35 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AnKes. INDRAWAN, Sp. OG (K)
747 2022/07/07/000100 049764 DEWI ZAHROÙL AFIATI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 07/07/2022 09:02:35 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
8/1/22, 8:34 AM Page 25 of 107

748 2022/07/07/000100 049764 DEWI ZAHROÙL AFIATI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 07/07/2022 09:26:04 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
749 2022/07/07/000100 049764 DEWI ZAHROÙL AFIATI, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 07/07/2022 09:02:35 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
750 2022/07/07/000100 049764 DEWI ZAHROÙL AFIATI, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 07/07/2022 09:02:35 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
751 2022/07/07/000101 044284 MUHAMMAD ISAAC JOVIC UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 09:32:55 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
PRAHARJO, AN 001 AMd.AnKes. Sp.A.
752 2022/07/07/000101 044284 MUHAMMAD ISAAC JOVIC UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 09:32:55 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
PRAHARJO, AN 009 AMd.AnKes. Sp.A.
753 2022/07/07/000104 071700 ARKHA ARDIANSYIAH, AN BPJS.RJ000 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 09:28:47 BPJS Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
754 2022/07/07/000125 038241 RAZKA SAGHARA ADITYA, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 12:26:19 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
755 2022/07/07/000125 038241 RAZKA SAGHARA ADITYA, AN BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 12:26:19 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
756 2022/07/07/000127 044284 MUHAMMAD ISAAC JOVIC BPJS.K2T30 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 11:54:06 BPJS KS IGD 5 32,431 9,569 0 3,000 0 0 0 45,000
PRAHARJO, AN 000110 AMd.AnKes. Sp.A. KESEHATAN
757 2022/07/07/000128 091553 SILVIATAS SHOFFI, NY BPJS.K2T30 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 07/07/2022 19:51:11 BPJS KS IGD 9 40,431 26,569 0 3,000 0 0 0 70,000
758 2022/07/07/000136 066275 Riski Kusmayanti, Ny BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10120217 dr. NYOMAN LUWANG 07/07/2022 19:47:33 BPJS KS IGD 7 40,431 26,569 0 3,000 0 0 0 70,000
00001 ARDHIANSYAH, AMd.Ankes WISANA, Sp.OG. KESEHATAN
759 2022/07/07/000138 003826 DYAH AYU GALUH BPJS.K2T30 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10120217 dr. NYOMAN LUWANG 07/07/2022 19:49:18 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
CANDRAKIRANA, NY 0001 ARDHIANSYAH, AMd.Ankes WISANA, Sp.OG. KESEHATAN
760 2022/07/07/000138 003826 DYAH AYU GALUH BPJS.RJ000 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 07/07/2022 12:22:32 BPJS IGD 30,390 6,610 0 3,000 0 0 0 40,000
CANDRAKIRANA, NY 021 AMd.AnKes. WISANA, Sp.OG. KESEHATAN
761 2022/07/07/000139 054724 HARDIANA DWI ANDINI, Ny UMUM.K2T3 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10120217 dr. NYOMAN LUWANG 07/07/2022 19:53:50 UMUM KS IGD 2 50,431 26,569 0 3,000 0 0 0 75,000
00001 ARDHIANSYAH, AMd.Ankes WISANA, Sp.OG.
762 2022/07/07/000139 054724 HARDIANA DWI ANDINI, Ny UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 07/07/2022 12:33:12 UMUM KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
763 2022/07/07/000139 054724 HARDIANA DWI ANDINI, Ny UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 07/07/2022 12:33:12 UMUM KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
764 2022/07/07/000139 054724 HARDIANA DWI ANDINI, Ny UMUM.K3B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 07/07/2022 12:33:12 UMUM KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
765 2022/07/07/000139 054724 HARDIANA DWI ANDINI, Ny UMUM.K3B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 07/07/2022 12:33:12 UMUM KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
766 2022/07/07/000139 054724 HARDIANA DWI ANDINI, Ny UMUM.K3B0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 07/07/2022 12:31:59 UMUM KS IGD 2 47,300 35,200 0 7,500 5,000 0 0 95,000
767 2022/07/07/000143 072772 Risna Dewi Aruan, Ny UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 07/07/2022 13:47:46 UMUM IGD 30,390 6,610 0 3,000 0 0 0 40,000
0021 AMd.AnKes.
768 2022/07/07/000144 072088 MUHAMMAD AFIF DARMAWAN, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 07/07/2022 14:26:35 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 ARDHIANSYAH, AMd.Ankes KESEHATAN
769 2022/07/07/000144 072088 MUHAMMAD AFIF DARMAWAN, UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 07/07/2022 14:26:35 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
AN 00110 ARDHIANSYAH, AMd.Ankes KESEHATAN
770 2022/07/07/000148 072092 GIBRAN NAUFAL RIZAL, AN UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 15:56:49 UMUM KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
771 2022/07/07/000148 072092 GIBRAN NAUFAL RIZAL, AN UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 15:56:49 UMUM KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
772 2022/07/07/000157 043185 MIKAYLA RAFANIA PUTRI,AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 18:01:32 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
773 2022/07/07/000157 043185 MIKAYLA RAFANIA PUTRI,AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 18:01:32 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
774 2022/07/07/000160 057302 HAMIZAN DAFIR TSABIT, AN. UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 17:59:24 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
775 2022/07/07/000160 057302 HAMIZAN DAFIR TSABIT, AN. UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 17:59:24 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
776 2022/07/07/000161 052633 AIRA PUTRI NIRMALA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 18:03:36 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
777 2022/07/07/000161 052633 AIRA PUTRI NIRMALA, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 18:03:36 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
8/1/22, 8:34 AM Page 26 of 107

778 2022/07/07/000163 051139 RAHMANIA DASHA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 18:06:22 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
779 2022/07/07/000163 051139 RAHMANIA DASHA, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 18:06:22 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
780 2022/07/07/000170 071965 NAZIA FARYAL NANEZZA,AN BPJS.K1T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 19:56:04 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
781 2022/07/07/000170 071965 NAZIA FARYAL NANEZZA,AN BPJS.K1T20 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 19:56:04 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
782 2022/07/07/000172 046218 RONA CANTIGI, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 19:20:37 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
783 2022/07/07/000172 046218 RONA CANTIGI, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 07/07/2022 19:20:37 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
784 2022/07/07/000181 071995 WARAS WATI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 07/07/2022 20:03:29 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
785 2022/07/07/000181 071995 WARAS WATI, NY UMUM.RJ00 Cholesterol 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 07/07/2022 20:03:29 UMUM IGD 29,951 12,049 0 3,000 0 0 0 45,000
786 2022/07/07/000181 071995 WARAS WATI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 07/07/2022 20:03:29 UMUM IGD 32,431 9,569 0 3,000 0 0 0 45,000
787 2022/07/07/000182 054305 NURLAILY OKHTAVIANA, Ny UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 07/07/2022 20:33:12 UMUM Poli Kandungan 30,390 6,610 0 3,000 0 0 0 40,000
0021 ARDHIANSYAH, AMd.Ankes SUSILO,Sp.OG.
788 2022/07/07/000184 034685 AZKAYRA NAYYARA AKFAN, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 07/07/2022 23:17:54 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A. KESEHATAN 3/Ayodya 2
789 2022/07/07/000184 034685 AZKAYRA NAYYARA AKFAN, AN BPJS.K2B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 07/07/2022 22:01:12 BPJS Dwarawati 37,400 47,600 0 5,000 5,000 0 0 95,000
790 2022/07/07/000185 007551 AR-RAYYAN ABRISAM BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 07/07/2022 23:16:02 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
ATHAFARIZ, AN 001 Sp.A. KESEHATAN 4/Ayodya 2
791 2022/07/07/000185 007551 AR-RAYYAN ABRISAM BPJS.K2B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 07/07/2022 21:58:04 BPJS Dwarawati 37,400 47,600 0 5,000 5,000 0 0 95,000
ATHAFARIZ, AN 0047 Sp.A. KESEHATAN 4/Ayodya 2
792 2022/07/07/000187 045367 HAMDAH SITI QOMARIYAH, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 07/07/2022 23:12:48 BPJS Amarta 2 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A. KESEHATAN
793 2022/07/07/000187 045367 HAMDAH SITI QOMARIYAH, AN BPJS.K3B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 07/07/2022 21:54:27 BPJS Amarta 2 37,400 47,600 0 5,000 5,000 0 0 95,000
794 2022/07/07/000189 072098 RIRIN WIDAYATI, Ny UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 07/07/2022 22:06:54 UMUM KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
0001 WISANA, Sp.OG.
795 2022/07/07/000189 072098 RIRIN WIDAYATI, Ny UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 07/07/2022 22:06:54 UMUM KS IGD 5 32,431 9,569 0 3,000 0 0 0 45,000
000110 WISANA, Sp.OG.
796 2022/07/07/000189 072098 RIRIN WIDAYATI, Ny UMUM.K3B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 07/07/2022 22:06:54 UMUM KS IGD 5 32,436 564 0 2,000 0 0 0 35,000
0003 WISANA, Sp.OG.
797 2022/07/07/000189 072098 RIRIN WIDAYATI, Ny UMUM.K3B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 07/07/2022 22:06:54 UMUM KS IGD 5 32,436 564 0 2,000 0 0 0 35,000
0004 WISANA, Sp.OG.
798 2022/07/07/000189 072098 RIRIN WIDAYATI, Ny UMUM.K3B0 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 07/07/2022 22:05:35 UMUM KS IGD 5 37,900 47,600 0 7,500 5,000 0 0 98,000
799 2022/07/01/000072 071746 DINA PRADIANA, BY NY BPJS.KINS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 08/07/2022 09:53:13 BPJS KS NICU 9 40,431 26,569 0 3,000 0 0 0 70,000
800 2022/07/01/000072 071746 DINA PRADIANA, BY NY BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 08/07/2022 09:53:13 BPJS KS NICU 9 33,931 13,069 0 3,000 0 0 0 50,000
801 2022/07/01/000072 071746 DINA PRADIANA, BY NY BPJS.KINS0 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 08/07/2022 09:53:13 BPJS KS NICU 9 31,936 6,064 0 2,000 0 0 0 40,000
803 2022/07/04/000211 073786 NUR VITAKHUROHMAH, NY BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 08/07/2022 10:05:02 BPJS KS RR 3 40,431 26,569 0 3,000 0 0 0 70,000
804 2022/07/05/000065 071947 SITI FATIMAH, Ny BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 08/07/2022 02:11:04 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
805 2022/07/05/000140 098790 WILDAN SATRIA ABIMANYU, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 08/07/2022 10:00:33 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
806 2022/07/05/000141 072936 NARA SATRIA ZILQIAH, An BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 08/07/2022 10:02:31 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
807 2022/07/07/000189 072098 RIRIN WIDAYATI, Ny UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 08/07/2022 06:00:01 UMUM KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
0001 WISANA, Sp.OG.
8/1/22, 8:34 AM Page 27 of 107

808 2022/07/08/000056 070186 IRMA AGRICA WARDHANI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 08/07/2022 06:11:37 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 KESEHATAN
809 2022/07/08/000056 070186 IRMA AGRICA WARDHANI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 08/07/2022 06:11:37 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
00110 KESEHATAN
810 2022/07/08/000056 070186 IRMA AGRICA WARDHANI, NY UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 08/07/2022 06:11:37 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
003 KESEHATAN
811 2022/07/08/000056 070186 IRMA AGRICA WARDHANI, NY UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 08/07/2022 06:11:37 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
004 KESEHATAN
812 2022/07/08/000056 070186 IRMA AGRICA WARDHANI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 08/07/2022 06:09:00 BPJS IGD 47,300 35,200 0 7,500 5,000 0 0 95,000
0050 KESEHATAN
813 2022/07/08/000057 007659 Muhammad Dwija El Barra, An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 08/07/2022 02:45:27 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 KESEHATAN
814 2022/07/08/000057 007659 Muhammad Dwija El Barra, An UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 08/07/2022 02:45:27 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
00110 KESEHATAN
815 2022/07/08/000084 061298 ATHA RAYHAN ALFARIZI, AN BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 9070009 dr. MOHAMMAD MUCHLIS, 08/07/2022 09:06:53 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
01 AMd.AnKes. Sp.A.
816 2022/07/08/000095 018028 Ria Gejora Permata Sari, Ny BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 08/07/2022 10:19:28 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
817 2022/07/08/000095 018028 Ria Gejora Permata Sari, Ny BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 08/07/2022 10:19:28 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
818 2022/07/08/000095 018028 Ria Gejora Permata Sari, Ny BPJS.K2B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 08/07/2022 18:31:27 BPJS KS IGD 1 30,390 6,610 0 3,000 0 0 0 40,000
819 2022/07/08/000095 018028 Ria Gejora Permata Sari, Ny BPJS.K2B00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 08/07/2022 10:19:28 BPJS KS IGD 1 37,951 38,049 0 4,000 0 0 0 80,000
820 2022/07/08/000095 018028 Ria Gejora Permata Sari, Ny BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 08/07/2022 10:57:41 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
821 2022/07/08/000095 018028 Ria Gejora Permata Sari, Ny BPJS.K2B00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 08/07/2022 10:19:28 BPJS KS IGD 1 37,951 38,049 0 4,000 0 0 0 80,000
822 2022/07/08/000106 067229 SITI AISYAH, NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 08/07/2022 14:48:03 BPJS KS IGD 2 30,390 6,610 0 3,000 0 0 0 40,000
823 2022/07/08/000106 067229 SITI AISYAH, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 08/07/2022 14:06:24 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
824 2022/07/08/000106 067229 SITI AISYAH, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 08/07/2022 14:05:49 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
825 2022/07/08/000106 067229 SITI AISYAH, NY BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 08/07/2022 14:05:49 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
826 2022/07/08/000106 067229 SITI AISYAH, NY BPJS.RJ000 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 08/07/2022 14:05:49 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
827 2022/07/08/000106 067229 SITI AISYAH, NY BPJS.RJ000 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 08/07/2022 14:05:49 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
828 2022/07/08/000107 071763 SULISTYOWATI, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4150215 dr. DEWI INDIASTARI, 08/07/2022 16:14:23 BPJS Poli Penyakit 40,431 26,569 0 3,000 0 0 0 70,000
01 AMd.AnKes. Sp.PD. KESEHATAN Dalam
829 2022/07/08/000127 072107 HURINA SALSABILA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 08/07/2022 16:17:55 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AnKes.
830 2022/07/08/000137 072112 INDAH PURWANTI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 08/07/2022 18:04:52 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
831 2022/07/08/000137 072112 INDAH PURWANTI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 08/07/2022 23:18:51 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
832 2022/07/08/000137 072112 INDAH PURWANTI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 08/07/2022 18:04:52 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
833 2022/07/08/000137 072112 INDAH PURWANTI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 08/07/2022 18:04:52 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
834 2022/07/08/000137 072112 INDAH PURWANTI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 08/07/2022 18:04:52 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
835 2022/07/08/000137 072112 INDAH PURWANTI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 08/07/2022 18:03:21 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
836 2022/07/08/000142 078032 Alifa Naufalyn Fikria Rabbani, An BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 3170266 I KETUT YOGA SEDANA, 9070009 dr. MOHAMMAD MUCHLIS, 08/07/2022 19:34:31 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
00001 S.Kep.Ns. Sp.A. KESEHATAN
837 2022/07/08/000142 078032 Alifa Naufalyn Fikria Rabbani, An BPJS.K2UP1 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 3170266 I KETUT YOGA SEDANA, 9070009 dr. MOHAMMAD MUCHLIS, 08/07/2022 19:39:38 BPJS KS IGD 1 37,400 47,600 0 5,000 5,000 0 0 95,000
000047 S.Kep.Ns. Sp.A. KESEHATAN
8/1/22, 8:34 AM Page 28 of 107

838 2022/07/08/000149 072114 RIA GEJORA, BY NY BPJS.KFIS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 08/07/2022 23:20:29 BPJS KS Fisol 10 40,431 26,569 0 3,000 0 0 0 70,000
839 2022/07/08/000149 072114 RIA GEJORA, BY NY BPJS.KFIS0 Gula Darah 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 08/07/2022 23:20:29 BPJS KS Fisol 10 32,431 9,569 0 3,000 0 0 0 45,000
840 2022/07/08/000150 102831 SILVIANA PRATIWI, NY UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 08/07/2022 22:44:48 UMUM KS RR 1 50,431 26,569 0 3,000 0 0 0 75,000
841 2022/07/08/000150 102831 SILVIANA PRATIWI, NY UMUM.K2B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 08/07/2022 22:44:48 UMUM KS RR 1 37,431 9,569 0 3,000 0 0 0 50,000
842 2022/07/08/000150 102831 SILVIANA PRATIWI, NY UMUM.K2B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 08/07/2022 22:44:48 UMUM KS RR 1 37,436 564 0 2,000 0 0 0 40,000
843 2022/07/08/000150 102831 SILVIANA PRATIWI, NY UMUM.K2B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 08/07/2022 22:44:48 UMUM KS RR 1 37,436 564 0 2,000 0 0 0 40,000
844 2022/07/08/000150 102831 SILVIANA PRATIWI, NY UMUM.K2B0 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 08/07/2022 22:45:23 UMUM KS RR 1 37,900 47,600 0 7,500 5,000 0 0 98,000
845 2022/07/08/000151 028645 MUHAMMAD HANIF BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 08/07/2022 22:52:40 BPJS Amarta 7A 40,431 26,569 0 3,000 0 0 0 70,000
RABBANI,AN 001 AMd.AK. Sp.A. KESEHATAN
846 2022/07/08/000151 028645 MUHAMMAD HANIF BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 08/07/2022 22:52:40 BPJS Amarta 7A 32,431 9,569 0 3,000 0 0 0 45,000
847 2022/07/08/000152 049869 CHOIRIAH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 08/07/2022 22:48:31 BPJS Amarta 6B 40,431 26,569 0 3,000 0 0 0 70,000
848 2022/07/08/000152 049869 CHOIRIAH, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 08/07/2022 22:48:31 BPJS Amarta 6B 32,431 9,569 0 3,000 0 0 0 45,000
849 2022/07/08/000152 049869 CHOIRIAH, NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 08/07/2022 22:48:31 BPJS Amarta 6B 30,390 6,610 0 3,000 0 0 0 40,000
850 2022/07/08/000152 049869 CHOIRIAH, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 08/07/2022 22:48:31 BPJS Amarta 6B 32,436 564 0 2,000 0 0 0 35,000
851 2022/07/08/000152 049869 CHOIRIAH, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 08/07/2022 22:48:31 BPJS Amarta 6B 32,436 564 0 2,000 0 0 0 35,000
852 2022/07/08/000152 049869 CHOIRIAH, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 08/07/2022 22:51:22 BPJS Amarta 6B 44,800 35,200 0 5,000 5,000 0 0 90,000
853 2022/07/04/000152 057893 ACHALENDRA FAAZ ALBIRRU, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 09/07/2022 06:47:46 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
854 2022/07/05/000140 098790 WILDAN SATRIA ABIMANYU, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 09/07/2022 12:09:04 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
855 2022/07/05/000141 072936 NARA SATRIA ZILQIAH, An BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 09/07/2022 12:05:44 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
856 2022/07/06/000062 038460 ALARIC ZAFRANDI ROSID, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 09/07/2022 12:14:10 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
857 2022/07/07/000104 071700 ARKHA ARDIANSYIAH, AN BPJS.KI0000 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 09/07/2022 12:03:58 BPJS KS NICU 14 31,936 6,064 0 2,000 0 0 0 40,000
858 2022/07/07/000104 071700 ARKHA ARDIANSYIAH, AN BPJS.KI0000 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 09/07/2022 12:03:58 BPJS KS NICU 14 31,436 6,564 0 2,000 0 0 0 40,000
859 2022/07/07/000104 071700 ARKHA ARDIANSYIAH, AN BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 09/07/2022 12:03:58 BPJS KS NICU 14 33,931 13,069 0 3,000 0 0 0 50,000
860 2022/07/07/000104 071700 ARKHA ARDIANSYIAH, AN BPJS.KINS0 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 09/07/2022 12:02:52 BPJS KS NICU 14 31,936 6,064 0 2,000 0 0 0 40,000
861 2022/07/07/000104 071700 ARKHA ARDIANSYIAH, AN BPJS.KINS0 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 09/07/2022 12:02:52 BPJS KS NICU 14 31,436 6,564 0 2,000 0 0 0 40,000
862 2022/07/08/000095 018028 Ria Gejora Permata Sari, Ny BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 09/07/2022 06:49:47 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
863 2022/07/08/000150 102831 SILVIANA PRATIWI, NY UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 09/07/2022 16:46:32 UMUM KS RR 1 50,431 26,569 0 3,000 0 0 0 75,000
864 2022/07/08/000152 049869 CHOIRIAH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 09/07/2022 06:51:59 BPJS Amarta 6B 40,431 26,569 0 3,000 0 0 0 70,000
865 2022/07/08/000154 068284 RAFADHAN ZHAFFARIZQI BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 09/07/2022 01:15:58 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
AMINULLAH, AN 0001 AMd.AK. Sp.A. KESEHATAN 7/Ayodya 4
866 2022/07/08/000154 068284 RAFADHAN ZHAFFARIZQI BPJS.K3T20 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 09/07/2022 01:15:58 BPJS Dwarawati 32,431 9,569 0 3,000 0 0 0 45,000
AMINULLAH, AN 000110 AMd.AK. Sp.A. KESEHATAN 7/Ayodya 4
867 2022/07/09/000013 071849 ALEXANDER JULIO NATANAEL, BPJS.RJ000 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 09/07/2022 16:43:08 BPJS Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
8/1/22, 8:34 AM Page 29 of 107

868 2022/07/09/000013 071849 ALEXANDER JULIO NATANAEL, BPJS.RJ000 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 09/07/2022 16:43:08 BPJS Poli Anak 31,936 6,064 0 2,000 0 0 0 40,000
869 2022/07/09/000013 071849 ALEXANDER JULIO NATANAEL, BPJS.RJ000 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 09/07/2022 16:43:08 BPJS Poli Anak 31,436 6,564 0 2,000 0 0 0 40,000
870 2022/07/09/000031 033127 QONITA FAIRUZ SYAHIRAH, NY UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 09/07/2022 02:03:20 UMUM KS IGD 1 50,431 26,569 0 3,000 0 0 0 75,000
871 2022/07/09/000031 033127 QONITA FAIRUZ SYAHIRAH, NY UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 09/07/2022 16:47:53 UMUM KS IGD 1 50,431 26,569 0 3,000 0 0 0 75,000
872 2022/07/09/000031 033127 QONITA FAIRUZ SYAHIRAH, NY UMUM.K2B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 09/07/2022 02:03:20 UMUM KS IGD 1 37,431 9,569 0 3,000 0 0 0 50,000
873 2022/07/09/000031 033127 QONITA FAIRUZ SYAHIRAH, NY UMUM.K2B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 09/07/2022 02:03:20 UMUM KS IGD 1 37,436 564 0 2,000 0 0 0 40,000
874 2022/07/09/000031 033127 QONITA FAIRUZ SYAHIRAH, NY UMUM.K2B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 09/07/2022 02:03:20 UMUM KS IGD 1 37,436 564 0 2,000 0 0 0 40,000
875 2022/07/09/000031 033127 QONITA FAIRUZ SYAHIRAH, NY UMUM.K2B0 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 09/07/2022 02:03:39 UMUM KS IGD 1 37,900 47,600 0 7,500 5,000 0 0 98,000
876 2022/07/09/000032 072117 ALFATH ADNAN GHIFAR, AN BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 09/07/2022 11:39:15 BPJS KS Fisol 9 40,431 26,569 0 3,000 0 0 0 70,000
877 2022/07/09/000032 072117 ALFATH ADNAN GHIFAR, AN BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 09/07/2022 11:39:15 BPJS KS Fisol 9 32,431 9,569 0 3,000 0 0 0 45,000
878 2022/07/09/000036 072119 HANIFAH UZLIFATUL JANNAH, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 09/07/2022 02:32:51 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
879 2022/07/09/000036 072119 HANIFAH UZLIFATUL JANNAH, BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 09/07/2022 02:32:51 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
880 2022/07/09/000036 072119 HANIFAH UZLIFATUL JANNAH, BPJS.K3B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 09/07/2022 02:33:06 BPJS KS IGD 1 37,400 47,600 0 5,000 5,000 0 0 95,000
881 2022/07/09/000055 096893 Ignatius Dimas Agung Setiawan, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 09/07/2022 08:23:37 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
An. 001 ARDHIANSYAH, AMd.Ankes KESEHATAN
882 2022/07/09/000055 096893 Ignatius Dimas Agung Setiawan, BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 09/07/2022 08:23:37 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
883 2022/07/09/000055 096893 Ignatius Dimas Agung Setiawan, BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 09/07/2022 09:16:30 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
An. 0050 ARDHIANSYAH, AMd.Ankes M.Biomed. KESEHATAN
884 2022/07/09/000055 096893 Ignatius Dimas Agung Setiawan, BPJS.K3B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 09/07/2022 08:23:37 BPJS KS IGD 1 31,931 10,069 0 3,000 0 0 0 45,000
885 2022/07/09/000066 072126 SATRIA BRYNA AHNAF M, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 09/07/2022 08:36:33 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
886 2022/07/09/000066 072126 SATRIA BRYNA AHNAF M, AN UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 09/07/2022 08:36:33 UMUM IGD 32,431 9,569 0 3,000 0 0 0 45,000
887 2022/07/09/000067 072128 ARIFAH, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 09/07/2022 09:02:27 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
888 2022/07/09/000067 072128 ARIFAH, NY BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 09/07/2022 09:02:27 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
889 2022/07/09/000074 072076 HABIBATUL ULA, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 09/07/2022 09:35:53 UMUM Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
890 2022/07/09/000074 072076 HABIBATUL ULA, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 09/07/2022 09:35:53 UMUM Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
891 2022/07/09/000074 072076 HABIBATUL ULA, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 09/07/2022 09:45:11 UMUM Poli Kandungan 37,900 47,600 0 7,500 5,000 0 0 98,000
892 2022/07/09/000074 072076 HABIBATUL ULA, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 09/07/2022 09:35:53 UMUM Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
893 2022/07/09/000074 072076 HABIBATUL ULA, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 09/07/2022 09:35:53 UMUM Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
894 2022/07/09/000085 091067 Devy Agista Syahputri, Ny. BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 09/07/2022 11:22:00 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
895 2022/07/09/000085 091067 Devy Agista Syahputri, Ny. BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 09/07/2022 11:22:00 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
896 2022/07/09/000085 091067 Devy Agista Syahputri, Ny. BPJS.RJ000 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 09/07/2022 11:22:00 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
897 2022/07/09/000085 091067 Devy Agista Syahputri, Ny. BPJS.RJ000 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 09/07/2022 11:22:00 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
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898 2022/07/09/000085 091067 Devy Agista Syahputri, Ny. BPJS.RJ000 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 09/07/2022 11:21:15 BPJS IGD 44,800 35,200 0 5,000 5,000 0 0 90,000
899 2022/07/09/000092 072128 ARIFAH, NY BPJS.K3B00 Gula Darah 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 09/07/2022 17:50:35 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
900 2022/07/09/000092 072128 ARIFAH, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4150215 dr. DEWI INDIASTARI, 09/07/2022 12:16:37 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
901 2022/07/09/000092 072128 ARIFAH, NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4150215 dr. DEWI INDIASTARI, 09/07/2022 13:35:37 BPJS KS IGD 2 30,390 6,610 0 3,000 0 0 0 40,000
902 2022/07/09/000092 072128 ARIFAH, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4150215 dr. DEWI INDIASTARI, 09/07/2022 12:16:51 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
903 2022/07/09/000100 033171 M. ARFA DHIYAULHAQ BPJS.K1T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 09/07/2022 13:41:28 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
PRABASUNU, AN 0001 ARDHIANSYAH, AMd.Ankes M.Biomed. KESEHATAN
904 2022/07/09/000100 033171 M. ARFA DHIYAULHAQ BPJS.K1T20 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 09/07/2022 13:40:22 BPJS KS IGD 5 44,800 35,200 0 5,000 5,000 0 0 90,000
905 2022/07/09/000100 033171 M. ARFA DHIYAULHAQ BPJS.K1T20 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 09/07/2022 13:41:28 BPJS KS IGD 5 31,931 10,069 0 3,000 0 0 0 45,000
906 2022/07/09/000100 033171 M. ARFA DHIYAULHAQ BPJS.K3000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 09/07/2022 13:41:28 BPJS KS IGD 5 32,431 9,569 0 3,000 0 0 0 45,000
907 2022/07/09/000105 044060 AQILA NURAINI IZMI, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 09/07/2022 13:38:09 BPJS KS IGD 7 40,431 26,569 0 3,000 0 0 0 70,000
908 2022/07/09/000105 044060 AQILA NURAINI IZMI, AN BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 09/07/2022 13:38:09 BPJS KS IGD 7 32,431 9,569 0 3,000 0 0 0 45,000
909 2022/07/09/000106 058442 NI LUH PUTU YUNITA RAHMA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 09/07/2022 13:28:15 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
DEWI, NY 001 ARDHIANSYAH, AMd.Ankes
910 2022/07/09/000106 058442 NI LUH PUTU YUNITA RAHMA UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 09/07/2022 13:28:15 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
911 2022/07/09/000106 058442 NI LUH PUTU YUNITA RAHMA UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 09/07/2022 13:30:15 UMUM Laboratorium 30,390 6,610 0 3,000 0 0 0 40,000
912 2022/07/09/000106 058442 NI LUH PUTU YUNITA RAHMA UMUM.RJ00 Anti HIV 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 09/07/2022 13:28:15 UMUM Laboratorium 38,951 34,049 0 2,000 0 0 0 75,000
913 2022/07/09/000106 058442 NI LUH PUTU YUNITA RAHMA UMUM.RJ00 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 09/07/2022 13:28:15 UMUM Laboratorium 38,951 34,049 0 2,000 0 0 0 75,000
914 2022/07/09/000106 058442 NI LUH PUTU YUNITA RAHMA UMUM.RJ00 TPHA/Sipilis 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 09/07/2022 13:28:15 UMUM Laboratorium 37,951 34,049 0 3,000 0 0 0 75,000
915 2022/07/09/000110 071879 AYDIN FIRHAN KURNIAWAN, UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 09/07/2022 16:26:15 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
AN 0020 M.Biomed.
916 2022/07/09/000110 071879 AYDIN FIRHAN KURNIAWAN, UMUM.RJ00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 09/07/2022 16:26:15 UMUM Poli Anak 31,936 6,064 0 2,000 0 0 0 40,000
AN 007 M.Biomed.
917 2022/07/09/000110 071879 AYDIN FIRHAN KURNIAWAN, UMUM.RJ00 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 09/07/2022 16:26:15 UMUM Poli Anak 31,436 6,564 0 2,000 0 0 0 40,000
AN 008 M.Biomed.
918 2022/07/09/000114 064278 MUHAMMAD YAZID ILMAN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 09/07/2022 16:39:12 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
NUGRAHA, AN 001 M.Biomed.
919 2022/07/09/000114 064278 MUHAMMAD YAZID ILMAN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 09/07/2022 16:39:12 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
NUGRAHA, AN 009 M.Biomed.
920 2022/07/09/000116 072141 AZALEA MAIZA XYNERVA,AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 09/07/2022 15:44:36 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001
921 2022/07/09/000119 054595 MUHAMMAD KEENAN DANIAL UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 09/07/2022 15:47:02 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
KARTAWIJAYA, AN 001
922 2022/07/09/000123 072143 IBADURROHMAN SOLIH, AN UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 09/07/2022 17:02:52 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
0047
923 2022/07/09/000126 015889 AURORA ALISHA ALMAHYRA, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 09/07/2022 18:24:40 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 M.Biomed.
924 2022/07/09/000126 015889 AURORA ALISHA ALMAHYRA, UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 09/07/2022 18:24:40 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
AN 009 M.Biomed.
925 2022/07/09/000128 037666 LIA APRIANTI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 09/07/2022 18:28:28 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
001 SUSILO,Sp.OG. KESEHATAN 9/Ayodya 5
926 2022/07/09/000128 037666 LIA APRIANTI, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 09/07/2022 18:28:28 BPJS Dwarawati 32,431 9,569 0 3,000 0 0 0 45,000
927 2022/07/09/000128 037666 LIA APRIANTI, NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 09/07/2022 18:28:28 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
928 2022/07/09/000128 037666 LIA APRIANTI, NY BPJS. CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO SUSILO, 09/07/2022 18:28:28 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
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K2B00004 Sp.OG. 9/Ayodya 5
929 2022/07/09/000128 037666 LIA APRIANTI, NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 09/07/2022 18:28:44 BPJS Dwarawati 44,800 35,200 0 5,000 5,000 0 0 90,000
930 2022/07/09/000141 059166 MUHAMMAD IQBAL, An. UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 09/07/2022 20:58:45 UMUM KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
0001 Sp.A.
931 2022/07/09/000141 059166 MUHAMMAD IQBAL, An. UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 09/07/2022 20:58:45 UMUM KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
000110 Sp.A.
932 2022/07/09/000143 072109 ZIONATHAN GANENDRA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 09/07/2022 21:44:33 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
OKTOVIO, AN 001 AMd.AK. KESEHATAN
933 2022/07/09/000144 072122 NADHEERA AISYAH HANDOYO, UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 09/07/2022 23:56:23 UMUM KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
934 2022/07/09/000144 072122 NADHEERA AISYAH HANDOYO, UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 09/07/2022 23:56:23 UMUM KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
935 2022/07/09/000145 060684 Yunita Rahmawati, Ny. BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 09/07/2022 23:53:19 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK. SUSILO,Sp.OG. KESEHATAN 1
936 2022/07/09/000145 060684 Yunita Rahmawati, Ny. BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 09/07/2022 23:53:19 BPJS KS Kamar Bersalin 32,431 9,569 0 3,000 0 0 0 45,000
937 2022/07/09/000145 060684 Yunita Rahmawati, Ny. BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 09/07/2022 23:53:19 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
938 2022/07/09/000145 060684 Yunita Rahmawati, Ny. BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 09/07/2022 23:53:19 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
939 2022/07/09/000145 060684 Yunita Rahmawati, Ny. BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 09/07/2022 23:53:55 BPJS KS Kamar Bersalin 44,800 35,200 0 5,000 5,000 0 0 90,000
940 2022/07/01/000072 071746 DINA PRADIANA, BY NY BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 10/07/2022 13:34:45 BPJS KS NICU 9 33,931 13,069 0 3,000 0 0 0 50,000
941 2022/07/05/000140 098790 WILDAN SATRIA ABIMANYU, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 10/07/2022 06:21:46 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
942 2022/07/05/000141 072936 NARA SATRIA ZILQIAH, An BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 10/07/2022 06:23:43 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
943 2022/07/05/000147 071973 EKA IRVATUL L., BY NY BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 10/07/2022 20:25:59 BPJS KS NICU 10 33,931 13,069 0 3,000 0 0 0 50,000
944 2022/07/05/000147 071973 EKA IRVATUL L., BY NY BPJS.KINS0 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 10/07/2022 20:25:59 BPJS KS NICU 10 31,936 6,064 0 2,000 0 0 0 40,000
945 2022/07/05/000147 071973 EKA IRVATUL L., BY NY BPJS.KINS0 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 10/07/2022 20:25:59 BPJS KS NICU 10 31,436 6,564 0 2,000 0 0 0 40,000
946 2022/07/07/000104 071700 ARKHA ARDIANSYIAH, AN BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 10/07/2022 11:15:12 BPJS KS NICU 14 33,931 13,069 0 3,000 0 0 0 50,000
947 2022/07/07/000127 044284 MUHAMMAD ISAAC JOVIC BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 10/07/2022 06:19:13 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
PRAHARJO, AN 00001 AMd.AK. Sp.A. KESEHATAN
948 2022/07/08/000106 067229 SITI AISYAH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 10/07/2022 00:22:29 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
949 2022/07/08/000151 028645 MUHAMMAD HANIF BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 10/07/2022 16:42:54 BPJS Amarta 7A 40,431 26,569 0 3,000 0 0 0 70,000
950 2022/07/09/000013 071849 ALEXANDER JULIO NATANAEL, BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 10/07/2022 16:53:07 BPJS KS IGD 2 33,931 13,069 0 3,000 0 0 0 50,000
951 2022/07/09/000031 033127 QONITA FAIRUZ SYAHIRAH, NY UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 10/07/2022 11:11:35 UMUM KS IGD 1 50,431 26,569 0 3,000 0 0 0 75,000
0001 AMd.AnKes. KARTIKARINI, Sp.OG
952 2022/07/09/000031 033127 QONITA FAIRUZ SYAHIRAH, NY UMUM.K2B0 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 10/07/2022 11:11:35 UMUM KS IGD 1 35,390 6,610 0 3,000 0 0 0 45,000
953 2022/07/09/000125 071879 AYDIN FIRHAN KURNIAWAN, UMUM.KINS Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 10/07/2022 16:54:32 UMUM KS IGD 1 38,931 13,069 0 3,000 0 0 0 55,000
AN 000020 AMd.AK. M.Biomed.
954 2022/07/09/000143 072109 ZIONATHAN GANENDRA BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 10/07/2022 00:20:07 BPJS Hastina 10 32,431 9,569 0 3,000 0 0 0 45,000
OKTOVIO, AN 00110 AMd.AK. Sp.A. KESEHATAN
955 2022/07/09/000143 072109 ZIONATHAN GANENDRA BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 10/07/2022 00:20:24 BPJS Hastina 10 44,800 35,200 0 5,000 5,000 0 0 90,000
OKTOVIO, AN 0050 AMd.AK. Sp.A. KESEHATAN
956 2022/07/09/000145 060684 Yunita Rahmawati, Ny. BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 10/07/2022 16:51:37 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
957 2022/07/10/000006 043916 AQILA ANINDIA KHANZA BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 10/07/2022 16:23:25 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
SHAQUEENA, AN 00001 AMd.AK. Sp.A. KESEHATAN
958 2022/07/10/000006 043916 AQILA ANINDIA KHANZA BPJS.K2UP1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 10/07/2022 16:23:25 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
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10
959 2022/07/10/000008 072076 HABIBATUL ULA, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 10/07/2022 16:50:04 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
960 2022/07/10/000009 071004 TRI UTAMI, NY BPJS.K3000 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 10/07/2022 07:08:11 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
961 2022/07/10/000009 071004 TRI UTAMI, NY BPJS.K3000 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 10/07/2022 07:08:11 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
962 2022/07/10/000009 071004 TRI UTAMI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 10/07/2022 07:08:11 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
963 2022/07/10/000009 071004 TRI UTAMI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 10/07/2022 16:45:09 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
964 2022/07/10/000009 071004 TRI UTAMI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 10/07/2022 07:08:11 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
965 2022/07/10/000009 071004 TRI UTAMI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 10/07/2022 07:08:34 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
966 2022/07/10/000013 072156 ALANO KHALIFI MIKA P, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 10/07/2022 10:06:01 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
967 2022/07/10/000013 072156 ALANO KHALIFI MIKA P, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 10/07/2022 10:06:01 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
968 2022/07/10/000014 058462 KIYARA KISSA CITRA FERARY, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 10/07/2022 10:11:37 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
969 2022/07/10/000014 058462 KIYARA KISSA CITRA FERARY, UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 10/07/2022 10:11:37 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
970 2022/07/10/000016 072157 YUNITA RAHMA., BY NY BPJS.KFIS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 10/07/2022 10:58:15 BPJS KS Fisol 21 40,431 26,569 0 3,000 0 0 0 70,000
971 2022/07/10/000018 051611 FIFI JANUAR, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 10/07/2022 10:28:43 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
972 2022/07/10/000018 051611 FIFI JANUAR, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 10/07/2022 22:39:39 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
973 2022/07/10/000018 051611 FIFI JANUAR, NY BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 10/07/2022 10:28:43 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
974 2022/07/10/000018 051611 FIFI JANUAR, NY BPJS.K1B00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 10/07/2022 10:28:43 BPJS KS IGD 1 37,951 38,049 0 4,000 0 0 0 80,000
975 2022/07/10/000018 051611 FIFI JANUAR, NY BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 10/07/2022 10:26:43 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
976 2022/07/10/000018 051611 FIFI JANUAR, NY BPJS.K1B00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 10/07/2022 10:28:43 BPJS KS IGD 1 37,951 38,049 0 4,000 0 0 0 80,000
977 2022/07/10/000020 101052 DWI HAPSARI PUTRI, Ny UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 10/07/2022 10:16:12 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
978 2022/07/10/000020 101052 DWI HAPSARI PUTRI, Ny UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 10/07/2022 10:16:12 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
979 2022/07/10/000020 101052 DWI HAPSARI PUTRI, Ny UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 10/07/2022 10:16:12 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
980 2022/07/10/000020 101052 DWI HAPSARI PUTRI, Ny UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 10/07/2022 10:16:46 UMUM Laboratorium 47,300 35,200 0 7,500 5,000 0 0 95,000
981 2022/07/10/000020 101052 DWI HAPSARI PUTRI, Ny UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 10/07/2022 10:16:12 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
982 2022/07/10/000021 072161 SALWA DAVINA ZAHIDI, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 10/07/2022 10:54:38 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
983 2022/07/10/000021 072161 SALWA DAVINA ZAHIDI, AN BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 10/07/2022 10:54:38 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
984 2022/07/10/000021 072161 SALWA DAVINA ZAHIDI, AN BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 10/07/2022 10:53:01 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
985 2022/07/10/000021 072161 SALWA DAVINA ZAHIDI, AN BPJS.K2B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 10/07/2022 10:54:38 BPJS KS IGD 2 31,931 10,069 0 3,000 0 0 0 45,000
986 2022/07/10/000022 072162 TRI UTAMI., BY NY BPJS.KFIS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 10/07/2022 13:34:13 BPJS KS Fisol 26 40,431 26,569 0 3,000 0 0 0 70,000
987 2022/07/10/000022 072162 TRI UTAMI., BY NY BPJS.KFIS0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 10/07/2022 13:34:13 BPJS KS Fisol 26 32,431 9,569 0 3,000 0 0 0 45,000
988 2022/07/10/000027 034071 NOVI ANITA SAFITRI, NN KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 10/07/2022 13:33:57 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
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989 2022/07/10/000031 072063 INÀM AFIFIN, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 10/07/2022 14:10:51 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AnKes. KARTIKARINI, Sp.OG KESEHATAN 1/Ayodya 1
990 2022/07/10/000031 072063 INÀM AFIFIN, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 10/07/2022 14:10:51 BPJS Dwarawati 32,431 9,569 0 3,000 0 0 0 45,000
991 2022/07/10/000031 072063 INÀM AFIFIN, NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 10/07/2022 14:10:51 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
992 2022/07/10/000031 072063 INÀM AFIFIN, NY BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 10/07/2022 14:10:51 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
993 2022/07/10/000031 072063 INÀM AFIFIN, NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 10/07/2022 14:03:35 BPJS Dwarawati 44,800 35,200 0 5,000 5,000 0 0 90,000
994 2022/07/10/000033 019974 AYUNINDYA DAVIRA FREDELLA BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 10/07/2022 15:27:52 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
HESTY, AN 001 AMd.AK. Sp.A. KESEHATAN
995 2022/07/10/000033 019974 AYUNINDYA DAVIRA FREDELLA BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 10/07/2022 15:27:52 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
HESTY, AN 00110 AMd.AK. Sp.A. KESEHATAN
996 2022/07/10/000034 010084 ALYA ADANNAYA SAHQUITA, BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 10/07/2022 14:56:25 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
An 01 AMd.AK. KESEHATAN
997 2022/07/10/000034 010084 ALYA ADANNAYA SAHQUITA, BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 10/07/2022 14:56:25 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
An 0110 AMd.AK. KESEHATAN
998 2022/07/10/000037 052536 IFATUL FITRIYAH, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 10/07/2022 16:14:59 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
999 2022/07/10/000037 052536 IFATUL FITRIYAH, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 10/07/2022 16:14:59 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
1000 2022/07/10/000037 052536 IFATUL FITRIYAH, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 10/07/2022 16:15:28 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
1001 2022/07/10/000037 052536 IFATUL FITRIYAH, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 10/07/2022 16:14:59 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1002 2022/07/10/000037 052536 IFATUL FITRIYAH, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 10/07/2022 16:14:59 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1003 2022/07/10/000039 072167 M. ABDULLAH SIDDIQ, AN UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 10/07/2022 17:02:41 UMUM KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
0001 AMd.AK. Sp.A.
1004 2022/07/10/000039 072167 M. ABDULLAH SIDDIQ, AN UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 10/07/2022 17:02:41 UMUM KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1005 2022/07/10/000045 048927 ALFARIZQI ZAFRAN ALHABSY, BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 10/07/2022 19:34:54 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1006 2022/07/10/000045 048927 ALFARIZQI ZAFRAN ALHABSY, BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 10/07/2022 19:34:54 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1007 2022/07/10/000046 030663 SYAUQI ALMAN, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 10/07/2022 20:47:56 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1008 2022/07/10/000046 030663 SYAUQI ALMAN, AN BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 10/07/2022 20:47:56 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1009 2022/07/10/000052 072173 SRI MUDALIFAH, NY UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 10/07/2022 23:18:08 UMUM KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
0001 AMd.AK. SUSILO,Sp.OG.
1010 2022/07/10/000052 072173 SRI MUDALIFAH, NY UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 10/07/2022 23:18:08 UMUM KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1011 2022/07/10/000052 072173 SRI MUDALIFAH, NY UMUM.K3B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 10/07/2022 23:18:08 UMUM KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1012 2022/07/10/000052 072173 SRI MUDALIFAH, NY UMUM.K3B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 10/07/2022 23:18:08 UMUM KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1013 2022/07/10/000052 072173 SRI MUDALIFAH, NY UMUM.K3B0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 10/07/2022 23:19:00 UMUM KS IGD 1 47,300 35,200 0 7,500 5,000 0 0 95,000
1014 2022/07/08/000134 41564 EVI DWI CAHYANINGTYAS, NY KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 11/07/2022 15:03:20 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
1015 2022/07/08/000147 041503 AVIL AIRINDIA GRESIA,NN KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 11/07/2022 15:01:27 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
52 ARDHIANSYAH, AMd.Ankes karyawan
1016 2022/07/09/000066 072126 SATRIA BRYNA AHNAF M, AN UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 11/07/2022 08:34:43 UMUM KS IGD 7 50,431 26,569 0 3,000 0 0 0 75,000
0001 AMd.AK. Sp.A.
1017 2022/07/09/000087 41561 WAHYU DWI ARDIANSYAH, KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 11/07/2022 15:02:59 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
SDR 52 ARDHIANSYAH, AMd.Ankes karyawan
1018 2022/07/09/000088 41577 WITA WIDAYANTI, Nn KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 11/07/2022 15:01:59 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
1019 2022/07/09/000089 086086 Dinny Kartika Putri Sudiyono, Ny KYN. HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 11/07/2022 15:04:42 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
ARDHIANSYAH,
8/1/22, 8:34 AM Page 34 of 107
RJ000052 AMd.Ankes karyawan
1020 2022/07/09/000108 002200 Indri Tri Setiawan, Ny KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 11/07/2022 15:02:37 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
1021 2022/07/10/000031 072063 INÀM AFIFIN, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 11/07/2022 06:34:47 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
1022 2022/07/11/000046 071806 MUHAMMAD KHALID, AN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 11/07/2022 17:50:14 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
1023 2022/07/11/000068 071696 EMRAN ELVANO PRADHANA, UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 11/07/2022 19:27:15 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
1024 2022/07/11/000077 017673 AULIA SALMA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 11/07/2022 09:10:42 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
1025 2022/07/11/000088 071707 BASUKI SETIAWAN, TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8170324 dr. EDWIN PRADANA, 11/07/2022 12:40:04 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
0031 Sp.And.
1026 2022/07/11/000101 072110 FESYA ALLEA GHEAFANY, AN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 11/07/2022 19:11:01 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
1027 2022/07/11/000119 068808 DIAN EKA PUSPITA, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 11/07/2022 08:37:06 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1028 2022/07/11/000119 068808 DIAN EKA PUSPITA, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1150219 dr. FATMASARI PERDANA 11/07/2022 01:01:47 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
01 AMd.AK. MENUR, Sp.OG KESEHATAN
1029 2022/07/11/000119 068808 DIAN EKA PUSPITA, NY BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1150219 dr. FATMASARI PERDANA 11/07/2022 01:01:47 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
1030 2022/07/11/000119 068808 DIAN EKA PUSPITA, NY BPJS.RJ000 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1150219 dr. FATMASARI PERDANA 11/07/2022 01:01:47 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
1031 2022/07/11/000119 068808 DIAN EKA PUSPITA, NY BPJS.RJ000 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1150219 dr. FATMASARI PERDANA 11/07/2022 01:01:47 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
1032 2022/07/11/000119 068808 DIAN EKA PUSPITA, NY BPJS.RJ000 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1150219 dr. FATMASARI PERDANA 11/07/2022 01:03:00 BPJS IGD 44,800 35,200 0 5,000 5,000 0 0 90,000
1033 2022/07/11/000121 072175 BANYU SAGARA BIRU, AN BPJS.KINS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 11/07/2022 01:58:07 BPJS KS NICU 14 40,431 26,569 0 3,000 0 0 0 70,000
1034 2022/07/11/000121 072175 BANYU SAGARA BIRU, AN BPJS.KINS0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 11/07/2022 01:58:07 BPJS KS NICU 14 32,431 9,569 0 3,000 0 0 0 45,000
1035 2022/07/11/000122 052536 IFATUL FITRIYAH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 11/07/2022 13:05:54 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1036 2022/07/11/000128 062002 PUTRI LARAS TRISNAWATI, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 11/07/2022 09:37:28 UMUM Poli Kandungan 30,390 6,610 0 3,000 0 0 0 40,000
0021 MENUR, Sp.OG
1037 2022/07/11/000136 048789 ARSYA DANIYAL DANINDRA,AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 11/07/2022 08:39:45 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A. KESEHATAN
1038 2022/07/11/000136 048789 ARSYA DANIYAL DANINDRA,AN BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 11/07/2022 08:39:45 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1039 2022/07/11/000137 052633 AIRA PUTRI NIRMALA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 11/07/2022 09:12:04 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
1040 2022/07/11/000137 052633 AIRA PUTRI NIRMALA, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 11/07/2022 09:12:04 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 Sp.A.
1041 2022/07/11/000138 041352 GALUH CANDRA DEWI, NY KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 11/07/2022 15:04:07 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
1042 2022/07/11/000140 41567 DHALIA ALIFAH PRATIWI, Nn KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 11/07/2022 15:03:45 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
1043 2022/07/11/000157 072183 MOHAMMAD ROFIÌ, TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8170324 dr. EDWIN PRADANA, 11/07/2022 12:40:49 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
0031 Sp.And.
1044 2022/07/11/000161 013435 Machiyah Sumartini, Ny BPJS.RJ000 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 11/07/2022 11:37:34 BPJS Laboratorium 30,390 6,610 0 3,000 0 0 0 40,000
1045 2022/07/11/000161 013435 Machiyah Sumartini, Ny BPJS.RJ000 Gula Darah Puasa 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 11/07/2022 11:37:34 BPJS Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
1046 2022/07/11/000161 013435 Machiyah Sumartini, Ny BPJS.RJ000 Gula Darah 2 Jam PP 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 11/07/2022 11:37:34 BPJS Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
1047 2022/07/11/000161 013435 Machiyah Sumartini, Ny BPJS.RJ000 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 11/07/2022 11:37:34 BPJS Laboratorium 31,936 6,064 0 2,000 0 0 0 40,000
07 Sp.PD. KESEHATAN
1048 2022/07/11/000163 072185 NOVAUJI WIJAYANTO, TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8170324 dr. EDWIN PRADANA, 11/07/2022 12:41:29 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
0031 Sp.And.
1049 2022/07/11/000165 072187 MUKHAMAD ADIF, TN UMUM. Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8170324 dr. EDWIN PRADANA, 11/07/2022 12:43:14 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
8/1/22, 8:34 AM Page 35 of 107

RJ000031
1050 2022/07/11/000172 101052 DWI HAPSARI PUTRI, Ny BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10120217 dr. NYOMAN LUWANG 11/07/2022 19:22:46 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1051 2022/07/11/000174 093500 EVIT YULIANA, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 11/07/2022 09:40:59 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1052 2022/07/11/000174 093500 EVIT YULIANA, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 11/07/2022 09:40:59 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1053 2022/07/11/000174 093500 EVIT YULIANA, NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 11/07/2022 09:40:59 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1054 2022/07/11/000174 093500 EVIT YULIANA, NY BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 11/07/2022 09:40:59 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1055 2022/07/11/000174 093500 EVIT YULIANA, NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 11/07/2022 09:39:58 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1056 2022/07/11/000177 058675 AFRAM UMAR RAHMAN, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 11/07/2022 10:20:37 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
1057 2022/07/11/000180 017673 AULIA SALMA, AN BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 11/07/2022 10:21:38 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1058 2022/07/11/000185 072198 INDAH RATNA SARI, NY UMUM.RJ00 Plano Test 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 11/07/2022 10:52:28 UMUM Poli Kandungan 33,140 4,860 0 2,000 0 0 0 40,000
1059 2022/07/11/000189 072201 PUTRI HAFLANI AL ANSORI, AN BPJS.KINS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 11/07/2022 10:56:57 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1060 2022/07/11/000189 072201 PUTRI HAFLANI AL ANSORI, AN BPJS.KINS0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 11/07/2022 10:56:57 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1061 2022/07/11/000192 062002 PUTRI LARAS TRISNAWATI, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 11/07/2022 11:41:57 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
1062 2022/07/11/000192 062002 PUTRI LARAS TRISNAWATI, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 11/07/2022 19:20:04 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
001 ARDHIANSYAH, AMd.Ankes MENUR, Sp.OG KESEHATAN
1063 2022/07/11/000192 062002 PUTRI LARAS TRISNAWATI, NY BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 11/07/2022 11:41:57 BPJS KS IGD 10 32,431 9,569 0 3,000 0 0 0 45,000
1064 2022/07/11/000192 062002 PUTRI LARAS TRISNAWATI, NY BPJS.K1B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 11/07/2022 11:41:57 BPJS KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
1065 2022/07/11/000192 062002 PUTRI LARAS TRISNAWATI, NY BPJS.K1B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 11/07/2022 11:41:57 BPJS KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
1066 2022/07/11/000192 062002 PUTRI LARAS TRISNAWATI, NY BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 11/07/2022 11:40:39 BPJS KS IGD 10 44,800 35,200 0 5,000 5,000 0 0 90,000
1067 2022/07/11/000194 061023 EKA VITJAYANTI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 11/07/2022 13:02:57 UMUM Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
001 WISANA, Sp.OG.
1068 2022/07/11/000194 061023 EKA VITJAYANTI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 11/07/2022 13:02:57 UMUM Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
1069 2022/07/11/000194 061023 EKA VITJAYANTI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 11/07/2022 13:36:17 UMUM Poli Kandungan 37,900 47,600 0 7,500 5,000 0 0 98,000
0047 WISANA, Sp.OG.
1070 2022/07/11/000194 061023 EKA VITJAYANTI, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 11/07/2022 13:02:57 UMUM Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
005 WISANA, Sp.OG.
1071 2022/07/11/000194 061023 EKA VITJAYANTI, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 11/07/2022 13:02:57 UMUM Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
006 WISANA, Sp.OG.
1072 2022/07/11/000196 070233 MAYA ANDRIANI, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 11/07/2022 11:47:16 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1073 2022/07/11/000196 070233 MAYA ANDRIANI, NY BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 11/07/2022 11:47:16 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
1074 2022/07/11/000196 070233 MAYA ANDRIANI, NY BPJS.K1B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 11/07/2022 11:49:21 BPJS KS IGD 2 30,390 6,610 0 3,000 0 0 0 40,000
1075 2022/07/11/000196 070233 MAYA ANDRIANI, NY BPJS.K1B00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 11/07/2022 11:47:16 BPJS KS IGD 2 37,951 38,049 0 4,000 0 0 0 80,000
1076 2022/07/11/000196 070233 MAYA ANDRIANI, NY BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 11/07/2022 11:47:44 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
1077 2022/07/11/000196 070233 MAYA ANDRIANI, NY BPJS.K1B00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 11/07/2022 11:47:16 BPJS KS IGD 2 37,951 38,049 0 4,000 0 0 0 80,000
1078 2022/07/11/000197 072203 RUMHANA, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 11/07/2022 12:16:27 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1079 2022/07/11/000197 072203 RUMHANA, NY BPJS. Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 11/07/2022 12:16:27 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
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K3B0000110 INDRAWAN, Sp. OG (K)
1080 2022/07/11/000197 072203 RUMHANA, NY BPJS.K3B00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 11/07/2022 12:16:27 BPJS KS IGD 2 37,951 38,049 0 4,000 0 0 0 80,000
1081 2022/07/11/000197 072203 RUMHANA, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 11/07/2022 13:36:42 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
1082 2022/07/11/000197 072203 RUMHANA, NY BPJS.K3B00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 11/07/2022 12:16:27 BPJS KS IGD 2 37,951 38,049 0 4,000 0 0 0 80,000
1083 2022/07/11/000200 009636 AGATHA SUHARTINI SATYA R., BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 11/07/2022 11:52:52 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
Ny 001 DWIJAYASA, Sp.OG (K) KESEHATAN
1084 2022/07/11/000200 009636 AGATHA SUHARTINI SATYA R., BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 11/07/2022 11:52:52 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
1085 2022/07/11/000200 009636 AGATHA SUHARTINI SATYA R., BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 11/07/2022 11:52:52 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
1086 2022/07/11/000200 009636 AGATHA SUHARTINI SATYA R., BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 11/07/2022 11:52:52 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
1087 2022/07/11/000200 009636 AGATHA SUHARTINI SATYA R., BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 11/07/2022 11:51:09 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
1088 2022/07/11/000213 067976 AZIZAH HASNA NAJWA BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 11/07/2022 13:49:29 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
MUMTAZAH, AN 001 M.Biomed. KESEHATAN
1089 2022/07/11/000213 067976 AZIZAH HASNA NAJWA BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 11/07/2022 13:49:29 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1090 2022/07/11/000213 067976 AZIZAH HASNA NAJWA BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 11/07/2022 13:39:55 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1091 2022/07/11/000215 061035 HILMI MAULUK DIAH BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 11/07/2022 13:34:01 BPJS Amarta 6A 40,431 26,569 0 3,000 0 0 0 70,000
MUSYARROFAH, NY 001 KARTIKARINI, Sp.OG KESEHATAN
1092 2022/07/11/000215 061035 HILMI MAULUK DIAH BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 11/07/2022 13:34:01 BPJS Amarta 6A 32,431 9,569 0 3,000 0 0 0 45,000
1093 2022/07/11/000215 061035 HILMI MAULUK DIAH BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 11/07/2022 13:35:21 BPJS Amarta 6A 30,390 6,610 0 3,000 0 0 0 40,000
1094 2022/07/11/000215 061035 HILMI MAULUK DIAH BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 11/07/2022 13:34:01 BPJS Amarta 6A 32,436 564 0 2,000 0 0 0 35,000
1095 2022/07/11/000215 061035 HILMI MAULUK DIAH BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 11/07/2022 13:34:01 BPJS Amarta 6A 32,436 564 0 2,000 0 0 0 35,000
1096 2022/07/11/000215 061035 HILMI MAULUK DIAH BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 11/07/2022 13:35:36 BPJS Amarta 6A 44,800 35,200 0 5,000 5,000 0 0 90,000
1097 2022/07/11/000218 072212 NAMIRA MEDINA PUTRI BPJS.KINS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 11/07/2022 19:15:49 BPJS NICU 7 40,431 26,569 0 3,000 0 0 0 70,000
WIDIGDA, AN 0001 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN
1098 2022/07/11/000218 072212 NAMIRA MEDINA PUTRI BPJS.KINS0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 11/07/2022 19:15:49 BPJS NICU 7 32,431 9,569 0 3,000 0 0 0 45,000
WIDIGDA, AN 000110 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN
1099 2022/07/11/000224 095710 Aulia Thusofia, Ny KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 11/07/2022 15:04:24 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
1100 2022/07/11/000226 045826 ALIS AMALIA PRIHUTARI, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 11/07/2022 19:39:02 BPJS Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
1101 2022/07/11/000227 41566 VENNA MELINDA, NN KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 11/07/2022 15:02:17 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
1102 2022/07/11/000243 100399 BISMA SANDI KUSUMA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 11/07/2022 19:31:33 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
1103 2022/07/11/000243 100399 BISMA SANDI KUSUMA, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 11/07/2022 19:31:33 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
1104 2022/07/11/000244 072095 ZIYAN NIZAMI JAYA, AN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 11/07/2022 19:35:47 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
1105 2022/07/11/000253 071852 MISTIANI, NY BPJS.RJ000 Anti HIV 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 11/07/2022 20:14:52 BPJS Poli Kandungan 38,951 34,049 0 2,000 0 0 0 75,000
1106 2022/07/11/000253 071852 MISTIANI, NY BPJS.RJ000 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 11/07/2022 20:14:52 BPJS Poli Kandungan 38,951 34,049 0 2,000 0 0 0 75,000
1107 2022/07/11/000253 071852 MISTIANI, NY BPJS.RJ000 TPHA/Sipilis 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 11/07/2022 20:14:52 BPJS Poli Kandungan 37,951 34,049 0 3,000 0 0 0 75,000
1108 2022/07/11/000259 005274 Farida Ayuningtyas, Nn KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 11/07/2022 19:09:05 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
1109 2022/07/11/000263 070963 IKE NOVIA RATNA BPJS. Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO SUSILO, 11/07/2022 20:21:43 BPJS Poli Kandungan 30,390 6,610 0 3,000 0 0 0 40,000
KARTIKASARI, ARDHIANSYAH,
8/1/22, 8:34 AM Page 37 of 107
NY RJ000021 AMd.Ankes Sp.OG.
1110 2022/07/11/000264 035426 Didik Setiyawanto, Tn KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 11/07/2022 19:25:07 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
1111 2022/07/11/000265 071205 Eka Verdian Putra Dharma, SDR KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 11/07/2022 19:24:52 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
1112 2022/07/11/000270 103269 Mega Lintang Raharja, An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 11/07/2022 20:26:49 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
1113 2022/07/11/000271 045826 ALIS AMALIA PRIHUTARI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 11/07/2022 20:13:09 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
1114 2022/07/11/000271 045826 ALIS AMALIA PRIHUTARI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 11/07/2022 20:13:09 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
1115 2022/07/11/000271 045826 ALIS AMALIA PRIHUTARI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 11/07/2022 20:13:09 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
1116 2022/07/11/000271 045826 ALIS AMALIA PRIHUTARI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 11/07/2022 20:32:56 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
1117 2022/07/11/000272 104997 Agustina Susanti, Ny KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 11/07/2022 20:28:47 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
1118 2022/07/11/000274 046656 SHAQUEENA AZALEA, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 11/07/2022 21:46:45 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
1119 2022/07/11/000274 046656 SHAQUEENA AZALEA, AN BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 11/07/2022 21:46:45 BPJS KS IGD 5 32,431 9,569 0 3,000 0 0 0 45,000
1120 2022/07/11/000275 037634 NAQYYA KAYLA ANEESA, AN UMUM.K2T1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 11/07/2022 21:48:51 UMUM KS IGD 1 50,431 26,569 0 3,000 0 0 0 75,000
1121 2022/07/11/000275 037634 NAQYYA KAYLA ANEESA, AN UMUM.K2T1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 11/07/2022 21:48:51 UMUM KS IGD 1 37,431 9,569 0 3,000 0 0 0 50,000
1122 2022/07/11/000277 41496 INTAN MEILIA SARI, NY KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 11/07/2022 21:41:04 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
52 karyawan
1123 2022/07/12/000320 070970 TIARA INTAN GRACIELLA, NY BPJS.K3000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 7110046 YENI ELITA DWI 10050002 dr. PANDE MADE 11/07/2022 23:27:03 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
01 HARDIYANTI, AMd.Keb DWIJAYASA, Sp.OG (K) KESEHATAN 2
1124 2022/07/12/000320 070970 TIARA INTAN GRACIELLA, NY BPJS.K3000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 7110046 YENI ELITA DWI 10050002 dr. PANDE MADE 11/07/2022 23:27:03 BPJS KS Kamar Bersalin 32,431 9,569 0 3,000 0 0 0 45,000
1125 2022/07/12/000320 070970 TIARA INTAN GRACIELLA, NY BPJS.K3000 BT 10210382 dr. RIMA AURELIA, Sp.PK. 7110046 YENI ELITA DWI 10050002 dr. PANDE MADE 11/07/2022 23:27:03 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
1126 2022/07/12/000320 070970 TIARA INTAN GRACIELLA, NY BPJS.K3000 CT 10210382 dr. RIMA AURELIA, Sp.PK. 7110046 YENI ELITA DWI 10050002 dr. PANDE MADE 11/07/2022 23:27:03 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
1127 2022/07/12/000320 070970 TIARA INTAN GRACIELLA, NY BPJS.K3000 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 7110046 YENI ELITA DWI 10050002 dr. PANDE MADE 11/07/2022 23:27:11 BPJS KS Kamar Bersalin 44,800 35,200 0 5,000 5,000 0 0 90,000
1128 2022/07/05/000147 071973 EKA IRVATUL L., BY NY BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 19:24:01 BPJS KS NICU 10 33,931 13,069 0 3,000 0 0 0 50,000
1129 2022/07/09/000066 072126 SATRIA BRYNA AHNAF M, AN UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 08:53:52 UMUM KS IGD 7 50,431 26,569 0 3,000 0 0 0 75,000
1130 2022/07/09/000100 033171 M. ARFA DHIYAULHAQ BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 12/07/2022 19:08:42 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
PRABASUNU, AN 001 AMd.AK. M.Biomed. KESEHATAN
1131 2022/07/09/000105 044060 AQILA NURAINI IZMI, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 05:39:34 BPJS KS IGD 7 40,431 26,569 0 3,000 0 0 0 70,000
1132 2022/07/10/000006 043916 AQILA ANINDIA KHANZA BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 16:17:55 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1133 2022/07/10/000034 010084 ALYA ADANNAYA SAHQUITA, BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 12:49:29 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
An 001 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN
1134 2022/07/10/000045 048927 ALFARIZQI ZAFRAN ALHABSY, BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 08:54:37 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1135 2022/07/10/000046 030663 SYAUQI ALMAN, AN BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 16:19:47 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1136 2022/07/11/000174 093500 EVIT YULIANA, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 12/07/2022 05:37:12 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AnKes. MENUR, Sp.OG KESEHATAN
1137 2022/07/11/000180 017673 AULIA SALMA, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 12/07/2022 08:52:13 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1138 2022/07/11/000183 052633 AIRA PUTRI NIRMALA, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 12/07/2022 08:53:04 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1139 2022/07/11/000189 072201 PUTRI HAFLANI AL ANSORI, AN BPJS. SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 15:43:21 BPJS KS IGD 1 37,400 47,600 0 5,000 5,000 0 0 95,000
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KINS000047 AMd.AK.
1140 2022/07/11/000196 070233 MAYA ANDRIANI, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 12/07/2022 19:14:56 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK. DWIJAYASA, Sp.OG (K) KESEHATAN
1141 2022/07/11/000197 072203 RUMHANA, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 12/07/2022 05:44:00 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1142 2022/07/11/000215 061035 HILMI MAULUK DIAH BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 12/07/2022 05:42:00 BPJS Amarta 6A 40,431 26,569 0 3,000 0 0 0 70,000
MUSYARROFAH, NY 001 AMd.AnKes. KARTIKARINI, Sp.OG KESEHATAN
1143 2022/07/11/000273 072095 ZIYAN NIZAMI JAYA, AN BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 12/07/2022 19:23:17 BPJS KS IGD 1 33,931 13,069 0 3,000 0 0 0 50,000
1144 2022/07/11/000280 070606 DWI WINARNI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 12/07/2022 16:21:44 BPJS KS IGD 7 40,431 26,569 0 3,000 0 0 0 70,000
1145 2022/07/11/000280 070606 DWI WINARNI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 12/07/2022 16:21:44 BPJS KS IGD 7 32,431 9,569 0 3,000 0 0 0 45,000
1146 2022/07/11/000280 070606 DWI WINARNI, NY BPJS.K3B00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 12/07/2022 16:21:44 BPJS KS IGD 7 37,951 38,049 0 4,000 0 0 0 80,000
1147 2022/07/11/000280 070606 DWI WINARNI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 12/07/2022 16:26:41 BPJS KS IGD 7 44,800 35,200 0 5,000 5,000 0 0 90,000
1148 2022/07/11/000280 070606 DWI WINARNI, NY BPJS.K3B00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 12/07/2022 16:21:44 BPJS KS IGD 7 37,951 38,049 0 4,000 0 0 0 80,000
1149 2022/07/12/000007 071861 KHAIRA SYAFA GANTARI, An UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 19:57:31 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
0020 AMd.AK. Sp.A.
1150 2022/07/12/000046 041448 BADRIATUS SOLIKHA, NY KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 12/07/2022 10:27:36 KARYAWAN Poli Kandungan 30,951 34,049 0 2,000 0 0 0 67,000
1151 2022/07/12/000063 052114 RIZKIANA, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 12/07/2022 01:08:32 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1152 2022/07/12/000063 052114 RIZKIANA, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 12/07/2022 01:08:32 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1153 2022/07/12/000063 052114 RIZKIANA, NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 12/07/2022 01:08:32 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1154 2022/07/12/000063 052114 RIZKIANA, NY BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 12/07/2022 01:08:32 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1155 2022/07/12/000063 052114 RIZKIANA, NY BPJS.K2B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 12/07/2022 01:07:13 BPJS KS IGD 1 37,400 47,600 0 5,000 5,000 0 0 95,000
1156 2022/07/12/000065 044232 SYAHIRA AULIA RAHMA, AN BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 03:19:52 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1157 2022/07/12/000065 044232 SYAHIRA AULIA RAHMA, AN BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 03:19:52 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1158 2022/07/12/000070 040685 MIRA AISYAH NENDYA, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 12/07/2022 06:38:55 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
1159 2022/07/12/000070 040685 MIRA AISYAH NENDYA, NY BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 12/07/2022 06:38:55 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
1160 2022/07/12/000070 040685 MIRA AISYAH NENDYA, NY BPJS.RJ000 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 12/07/2022 06:38:55 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
1161 2022/07/12/000070 040685 MIRA AISYAH NENDYA, NY BPJS.RJ000 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 12/07/2022 06:38:55 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
1162 2022/07/12/000070 040685 MIRA AISYAH NENDYA, NY BPJS.RJ000 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 12/07/2022 06:37:08 BPJS IGD 37,400 47,600 0 5,000 5,000 0 0 95,000
1163 2022/07/12/000082 056158 NAZURAZIA MEVISH BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 21:28:21 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
SHAQUEENA EL SHANUM, AN 001 AMd.AnKes. Sp.A. KESEHATAN 6/Ayodya 3
1164 2022/07/12/000082 056158 NAZURAZIA MEVISH BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 21:28:21 BPJS Dwarawati 32,431 9,569 0 3,000 0 0 0 45,000
SHAQUEENA EL SHANUM, AN 00110 AMd.AnKes. Sp.A. KESEHATAN 6/Ayodya 3
1165 2022/07/12/000083 072230 JEFRY ANTON PRAKOSO, TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8170324 dr. EDWIN PRADANA, 12/07/2022 10:28:40 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
0031 ARDHIANSYAH, AMd.Ankes Sp.And.
1166 2022/07/12/000084 072231 GANANG FIRMANSYAH, TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8170324 dr. EDWIN PRADANA, 12/07/2022 10:29:04 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
1167 2022/07/12/000097 072236 WILDA AKWILA NENOHARAN, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 12/07/2022 09:51:41 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
NY 001 ARDHIANSYAH, AMd.Ankes DWIJAYASA, Sp.OG (K) KESEHATAN
1168 2022/07/12/000097 072236 WILDA AKWILA NENOHARAN, BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 12/07/2022 09:51:41 BPJS KS IGD 5 32,431 9,569 0 3,000 0 0 0 45,000
1169 2022/07/12/000097 072236 WILDA AKWILA NENOHARAN, BPJS. BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 12/07/2022 09:51:41 BPJS KS IGD 5 32,436 564 0 2,000 0 0 0 35,000
ARDHIANSYAH, DWIJAYASA,
8/1/22, 8:34 AM Page 39 of 107
K3B00003 AMd.Ankes Sp.OG (K)
1170 2022/07/12/000097 072236 WILDA AKWILA NENOHARAN, BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 12/07/2022 09:51:41 BPJS KS IGD 5 32,436 564 0 2,000 0 0 0 35,000
1171 2022/07/12/000097 072236 WILDA AKWILA NENOHARAN, BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 12/07/2022 09:50:14 BPJS KS IGD 5 44,800 35,200 0 5,000 5,000 0 0 90,000
1172 2022/07/12/000103 062292 CHAIRA ARINA GULFAM, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 12/07/2022 09:42:59 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1173 2022/07/12/000103 062292 CHAIRA ARINA GULFAM, AN BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 12/07/2022 09:42:59 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1174 2022/07/12/000103 062292 CHAIRA ARINA GULFAM, AN BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 12/07/2022 09:42:18 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1175 2022/07/12/000109 104738 Rita Novita Sari, NY KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 12/07/2022 10:27:22 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
1176 2022/07/12/000110 041568 MEYLIN RIMBIKA SARI KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 12/07/2022 10:27:07 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
1177 2022/07/12/000114 072238 SHELY ARIYANTI NOOR, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 11:46:17 BPJS Amarta 4A 40,431 26,569 0 3,000 0 0 0 70,000
1178 2022/07/12/000114 072238 SHELY ARIYANTI NOOR, AN BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 11:46:17 BPJS Amarta 4A 32,431 9,569 0 3,000 0 0 0 45,000
1179 2022/07/12/000118 061023 EKA VITJAYANTI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 12/07/2022 19:12:13 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1180 2022/07/12/000121 068684 SYAUQI ATHAILLAH BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 12/07/2022 13:09:42 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
MUHAMMAD H., AN 00110 ARDHIANSYAH, AMd.Ankes M.Biomed. KESEHATAN
1181 2022/07/12/000121 068684 SYAUQI ATHAILLAH BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 12/07/2022 13:34:09 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1182 2022/07/12/000121 068684 SYAUQI ATHAILLAH BPJS.K1B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 12/07/2022 13:09:42 BPJS KS IGD 1 31,931 10,069 0 3,000 0 0 0 45,000
1183 2022/07/12/000121 068684 SYAUQI ATHAILLAH UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 12/07/2022 11:55:00 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
MUHAMMAD H., AN 001 ARDHIANSYAH, AMd.Ankes KESEHATAN
1184 2022/07/12/000121 068684 SYAUQI ATHAILLAH UMUM.RJ00 IgG Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 12/07/2022 11:55:00 BPJS IGD 41,951 46,549 0 1,500 0 0 0 90,000
1185 2022/07/12/000121 068684 SYAUQI ATHAILLAH UMUM.RJ00 IgM Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 12/07/2022 11:55:00 BPJS IGD 41,951 46,549 0 1,500 0 0 0 90,000
1186 2022/07/12/000125 057639 KIRANA ISWARA DANTI, NN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4150215 dr. DEWI INDIASTARI, 12/07/2022 14:54:37 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1187 2022/07/12/000125 057639 KIRANA ISWARA DANTI, NN BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4150215 dr. DEWI INDIASTARI, 12/07/2022 14:57:57 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1188 2022/07/12/000129 045307 JAYANTI WIDI PROBORINI, Ny BPJS.K2T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4150215 dr. DEWI INDIASTARI, 12/07/2022 18:23:41 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
1189 2022/07/12/000129 045307 JAYANTI WIDI PROBORINI, Ny BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 12/07/2022 14:57:25 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
1190 2022/07/12/000142 074229 ASHILA CALYSTA RABBANI, An UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 15:34:26 UMUM KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
0001 AMd.AK. Sp.A.
1191 2022/07/12/000142 074229 ASHILA CALYSTA RABBANI, An UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 15:34:26 UMUM KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
1192 2022/07/12/000282 072254 ARSHAKA KEVIN NUGRAHA, AN UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 12/07/2022 17:48:42 UMUM KS IGD 10 50,431 26,569 0 3,000 0 0 0 75,000
0001 AMd.AK. M.Biomed.
1193 2022/07/12/000282 072254 ARSHAKA KEVIN NUGRAHA, AN UMUM.K2B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 12/07/2022 17:48:42 UMUM KS IGD 10 37,431 9,569 0 3,000 0 0 0 50,000
1194 2022/07/12/000282 072254 ARSHAKA KEVIN NUGRAHA, AN UMUM.K2B0 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 12/07/2022 17:07:22 UMUM KS IGD 10 37,900 47,600 0 7,500 5,000 0 0 98,000
1195 2022/07/12/000282 072254 ARSHAKA KEVIN NUGRAHA, AN UMUM.K2B0 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 12/07/2022 17:48:42 UMUM KS IGD 10 36,931 10,069 0 3,000 0 0 0 50,000
1196 2022/07/12/000283 068250 TITIS RAHMA W. A., NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 12/07/2022 16:25:25 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
0047 AMd.AK.
1197 2022/07/12/000284 049495 KENT ELENIO ARIOSHA BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 19:35:05 BPJS Pandawa 7 40,431 26,569 0 3,000 0 0 0 70,000
FERNANDO, AN 0001 AMd.AK. Sp.A. KESEHATAN
1198 2022/07/12/000284 049495 KENT ELENIO ARIOSHA BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 19:35:05 BPJS Pandawa 7 32,431 9,569 0 3,000 0 0 0 45,000
FERNANDO, AN 000110 AMd.AK. Sp.A. KESEHATAN
1199 2022/07/12/000289 044659 NURHAYATI, NY BPJS. Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO SUSILO, 12/07/2022 18:34:14 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
8/1/22, 8:34 AM Page 40 of 107

K3B00001 AMd.AK. Sp.OG.
1200 2022/07/12/000289 044659 NURHAYATI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 12/07/2022 18:34:14 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1201 2022/07/12/000289 044659 NURHAYATI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 12/07/2022 18:34:14 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1202 2022/07/12/000289 044659 NURHAYATI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 12/07/2022 18:34:14 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1203 2022/07/12/000289 044659 NURHAYATI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 12/07/2022 18:34:58 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1204 2022/07/12/000289 044659 NURHAYATI, NY UMUM.RJ00 Plano Test 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 12/07/2022 17:06:41 BPJS IGD 33,140 4,860 0 2,000 0 0 0 40,000
1205 2022/07/12/000304 015496 M GAZZAL ABQORY AL- BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 21:25:31 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
BAYAN,AN 001 AMd.AnKes. Sp.A. KESEHATAN 5/Ayodya 3
1206 2022/07/12/000304 015496 M GAZZAL ABQORY AL- BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 21:25:31 BPJS Dwarawati 32,431 9,569 0 3,000 0 0 0 45,000
1207 2022/07/12/000313 096728 DZIKRI NABIEL PUTRA BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 21:36:18 BPJS Pandawa 8 40,431 26,569 0 3,000 0 0 0 70,000
PRATAMA, An 00001 AMd.AnKes. Sp.A. KESEHATAN
1208 2022/07/12/000313 096728 DZIKRI NABIEL PUTRA BPJS.K2UP1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 21:36:18 BPJS Pandawa 8 32,431 9,569 0 3,000 0 0 0 45,000
PRATAMA, An 0000110 AMd.AnKes. Sp.A. KESEHATAN
1209 2022/07/12/000315 072259 ALESHA ZOE QUEEN SAFA, AN UMUM.K1B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 23:02:04 UMUM Pandawa 8 42,431 9,569 0 3,000 0 0 0 55,000
1210 2022/07/12/000315 072259 ALESHA ZOE QUEEN SAFA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 12/07/2022 21:01:10 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK.
1211 2022/07/12/000316 016863 ISABELLA YUANISA ANWAR, AN BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 12/07/2022 22:58:56 BPJS Amarta 4A 32,431 9,569 0 3,000 0 0 0 45,000
1212 2022/07/12/000316 016863 ISABELLA YUANISA ANWAR, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 12/07/2022 21:11:53 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
1213 2022/07/12/000319 072261 LIYA FITRIYANA, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 12/07/2022 23:15:54 BPJS Amarta 6B 40,431 26,569 0 3,000 0 0 0 70,000
1214 2022/07/12/000319 072261 LIYA FITRIYANA, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 12/07/2022 23:15:54 BPJS Amarta 6B 32,431 9,569 0 3,000 0 0 0 45,000
1215 2022/07/12/000319 072261 LIYA FITRIYANA, NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 12/07/2022 23:15:54 BPJS Amarta 6B 30,390 6,610 0 3,000 0 0 0 40,000
1216 2022/07/12/000319 072261 LIYA FITRIYANA, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 12/07/2022 23:15:54 BPJS Amarta 6B 32,436 564 0 2,000 0 0 0 35,000
1217 2022/07/12/000319 072261 LIYA FITRIYANA, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 12/07/2022 23:15:54 BPJS Amarta 6B 32,436 564 0 2,000 0 0 0 35,000
1218 2022/07/10/000006 043916 AQILA ANINDIA KHANZA BPJS.K1000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 10:58:54 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
SHAQUEENA, AN 01 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN
1219 2022/07/10/000006 043916 AQILA ANINDIA KHANZA BPJS.K1000 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 10:58:54 BPJS KS IGD 1 31,931 10,069 0 3,000 0 0 0 45,000
1220 2022/07/10/000006 043916 AQILA ANINDIA KHANZA BPJS.K1B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 10:54:02 BPJS KS IGD 1 31,931 10,069 0 3,000 0 0 0 45,000
1221 2022/07/10/000045 048927 ALFARIZQI ZAFRAN ALHABSY, BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 08:45:49 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1222 2022/07/11/000252 071806 MUHAMMAD KHALID, AN BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 16:38:53 BPJS KS IGD 1 33,931 13,069 0 3,000 0 0 0 50,000
1223 2022/07/11/000252 071806 MUHAMMAD KHALID, AN BPJS.KINS0 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 16:38:53 BPJS KS IGD 1 31,936 6,064 0 2,000 0 0 0 40,000
1224 2022/07/11/000252 071806 MUHAMMAD KHALID, AN BPJS.KINS0 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 16:38:53 BPJS KS IGD 1 31,436 6,564 0 2,000 0 0 0 40,000
1225 2022/07/11/000269 072110 FESYA ALLEA GHEAFANY, AN BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 16:40:14 BPJS KS IGD 1 33,931 13,069 0 3,000 0 0 0 50,000
1226 2022/07/11/000269 072110 FESYA ALLEA GHEAFANY, AN BPJS.KINS0 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 16:40:14 BPJS KS IGD 1 31,936 6,064 0 2,000 0 0 0 40,000
1227 2022/07/11/000269 072110 FESYA ALLEA GHEAFANY, AN BPJS.KINS0 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 16:40:14 BPJS KS IGD 1 31,436 6,564 0 2,000 0 0 0 40,000
1228 2022/07/12/000063 052114 RIZKIANA, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 13/07/2022 06:32:01 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1229 2022/07/12/000070 040685 MIRA AISYAH NENDYA, NY BPJS. Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, AMd. 10050002 dr. PANDE MADE 13/07/2022 16:35:39 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
DWIJAYASA,
8/1/22, 8:34 AM Page 41 of 107
K3B00001 AnKes. Sp.OG (K)
1230 2022/07/12/000129 045307 JAYANTI WIDI PROBORINI, Ny BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4150215 dr. DEWI INDIASTARI, 13/07/2022 17:10:54 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1231 2022/07/12/000129 045307 JAYANTI WIDI PROBORINI, Ny BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4150215 dr. DEWI INDIASTARI, 13/07/2022 06:30:24 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
1232 2022/07/12/000318 072260 MUHAMMAD ELFATHAN AL BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 00:11:19 BPJS Pandawa 2 40,431 26,569 0 3,000 0 0 0 70,000
KAUTSAR, AN 0001 AMd.AnKes. Sp.A. KESEHATAN
1233 2022/07/12/000318 072260 MUHAMMAD ELFATHAN AL BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 00:11:19 BPJS Pandawa 2 32,431 9,569 0 3,000 0 0 0 45,000
KAUTSAR, AN 000110 AMd.AnKes. Sp.A. KESEHATAN
1234 2022/07/12/000319 072261 LIYA FITRIYANA, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 13/07/2022 19:55:36 BPJS Amarta 6B 40,431 26,569 0 3,000 0 0 0 70,000
1235 2022/07/12/000319 072261 LIYA FITRIYANA, NY BPJS.K3B00 SGOT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 13/07/2022 00:03:28 BPJS Amarta 6B 34,451 12,549 0 3,000 0 0 0 50,000
1236 2022/07/12/000319 072261 LIYA FITRIYANA, NY BPJS.K3B00 SGPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 13/07/2022 00:03:28 BPJS Amarta 6B 34,451 12,549 0 3,000 0 0 0 50,000
1237 2022/07/12/000319 072261 LIYA FITRIYANA, NY BPJS.K3B00 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 13/07/2022 00:03:28 BPJS Amarta 6B 31,451 10,549 0 3,000 0 0 0 45,000
1238 2022/07/12/000319 072261 LIYA FITRIYANA, NY BPJS.K3B00 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 13/07/2022 00:03:28 BPJS Amarta 6B 33,951 13,049 0 3,000 0 0 0 50,000
1239 2022/07/12/000320 070970 TIARA INTAN GRACIELLA, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 13/07/2022 00:08:30 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AnKes. DWIJAYASA, Sp.OG (K) KESEHATAN 2
1240 2022/07/12/000320 070970 TIARA INTAN GRACIELLA, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 13/07/2022 16:32:03 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AnKes. SUSILO,Sp.OG. KESEHATAN 2
1241 2022/07/12/000320 070970 TIARA INTAN GRACIELLA, NY BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 13/07/2022 00:08:30 BPJS KS Kamar Bersalin 32,431 9,569 0 3,000 0 0 0 45,000
1242 2022/07/12/000320 070970 TIARA INTAN GRACIELLA, NY BPJS.K1B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 13/07/2022 00:08:30 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
1243 2022/07/12/000320 070970 TIARA INTAN GRACIELLA, NY BPJS.K1B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 13/07/2022 00:08:30 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
1244 2022/07/12/000320 070970 TIARA INTAN GRACIELLA, NY BPJS.K1B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 13/07/2022 00:07:23 BPJS KS Kamar Bersalin 37,400 47,600 0 5,000 5,000 0 0 95,000
1245 2022/07/13/000029 061831 CHANDRA NUR AFIFAH, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 13/07/2022 14:27:13 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
1246 2022/07/13/000029 061831 CHANDRA NUR AFIFAH, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 13/07/2022 14:27:13 BPJS KS Kamar Bersalin 32,431 9,569 0 3,000 0 0 0 45,000
1247 2022/07/13/000029 061831 CHANDRA NUR AFIFAH, NY BPJS.K2B00 SGOT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 13/07/2022 14:27:13 BPJS KS Kamar Bersalin 34,451 12,549 0 3,000 0 0 0 50,000
1248 2022/07/13/000029 061831 CHANDRA NUR AFIFAH, NY BPJS.K2B00 SGPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 13/07/2022 14:27:13 BPJS KS Kamar Bersalin 34,451 12,549 0 3,000 0 0 0 50,000
1249 2022/07/13/000029 061831 CHANDRA NUR AFIFAH, NY BPJS.K2B00 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 13/07/2022 14:27:13 BPJS KS Kamar Bersalin 31,451 10,549 0 3,000 0 0 0 45,000
1250 2022/07/13/000029 061831 CHANDRA NUR AFIFAH, NY BPJS.K2B00 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 13/07/2022 14:27:13 BPJS KS Kamar Bersalin 33,951 13,049 0 3,000 0 0 0 50,000
1251 2022/07/13/000029 061831 CHANDRA NUR AFIFAH, NY BPJS.K2B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 13/07/2022 14:27:13 BPJS KS Kamar Bersalin 30,390 6,610 0 3,000 0 0 0 40,000
1252 2022/07/13/000029 061831 CHANDRA NUR AFIFAH, NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 13/07/2022 14:27:13 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
1253 2022/07/13/000029 061831 CHANDRA NUR AFIFAH, NY BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 13/07/2022 14:27:13 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
1254 2022/07/13/000029 061831 CHANDRA NUR AFIFAH, NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 13/07/2022 14:19:30 BPJS KS Kamar Bersalin 44,800 35,200 0 5,000 5,000 0 0 90,000
1255 2022/07/13/000066 101808 Tiyas Yulianingsih, Ny UMUM.RJ00 Gula Darah Puasa 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 13/07/2022 10:19:18 UMUM Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
00210 ARDHIANSYAH, AMd.Ankes KARTIKARINI, Sp.OG
1256 2022/07/13/000066 101808 Tiyas Yulianingsih, Ny UMUM.RJ00 Gula Darah 2 Jam PP 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 13/07/2022 10:19:18 UMUM Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
1257 2022/07/13/000074 041562 AULIA DWI ZHUKMANA, TN KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 13/07/2022 05:47:08 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
1258 2022/07/13/000075 039278 INDRIANI MAULIDIA, NY KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 13/07/2022 05:46:20 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
8/1/22, 8:34 AM Page 42 of 107

1259 2022/07/13/000076 099999 Rosie Kurnia Fitriani, Ny KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 13/07/2022 05:45:41 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
1260 2022/07/13/000077 054216 M ARIZAL RAFIS MUZAKI, SDR KYN.RJ0000 HBsAB 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 13/07/2022 05:44:55 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
1261 2022/07/13/000079 092746 KENZIE MAGIKA FARITAMA, An BPJS.K2T30 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 05:51:34 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1262 2022/07/13/000079 092746 KENZIE MAGIKA FARITAMA, An BPJS.K2T30 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 05:51:34 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
1263 2022/07/13/000083 092060 ARSYANA RAMADHAN, AN BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 05:53:57 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1264 2022/07/13/000083 092060 ARSYANA RAMADHAN, AN BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 05:53:57 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1265 2022/07/13/000091 028167 YOLA ALFIANI PUTRI, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 13/07/2022 07:48:12 UMUM Laboratorium 30,390 6,610 0 3,000 0 0 0 40,000
1266 2022/07/13/000092 088427 SRI YULIANI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 13/07/2022 08:41:50 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1267 2022/07/13/000092 088427 SRI YULIANI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 13/07/2022 16:33:19 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1268 2022/07/13/000092 088427 SRI YULIANI, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 13/07/2022 08:41:50 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1269 2022/07/13/000092 088427 SRI YULIANI, NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 13/07/2022 08:41:50 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1270 2022/07/13/000092 088427 SRI YULIANI, NY BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 13/07/2022 08:41:50 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1271 2022/07/13/000092 088427 SRI YULIANI, NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 13/07/2022 08:41:10 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1272 2022/07/13/000104 086086 Dinny Kartika Putri Sudiyono, Ny KYN.RJ0000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 13/07/2022 07:59:29 KARYAWAN Laboratorium 33,431 26,569 0 3,000 0 0 0 63,000
1273 2022/07/13/000104 086086 Dinny Kartika Putri Sudiyono, Ny KYN.RJ0000 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 13/07/2022 07:59:29 KARYAWAN Laboratorium 27,936 6,064 0 2,000 0 0 0 36,000
1274 2022/07/13/000112 072269 MOHAMMAD ARDI HAMZAH, TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 3170266 I KETUT YOGA SEDANA, 8170324 dr. EDWIN PRADANA, 13/07/2022 10:45:36 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
0031 S.Kep.Ns. Sp.And.
1275 2022/07/13/000116 060811 FIRMAN JUNIARDI PUTRA,TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 3170266 I KETUT YOGA SEDANA, 8170324 dr. EDWIN PRADANA, 13/07/2022 10:46:32 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
0031 S.Kep.Ns. Sp.And.
1276 2022/07/13/000117 072271 MUCHAMMAD FARCHAN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 3170266 I KETUT YOGA SEDANA, 8170324 dr. EDWIN PRADANA, 13/07/2022 10:47:10 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
TAMAMI, TN 0031 S.Kep.Ns. Sp.And.
1277 2022/07/13/000182 072295 MUHAMMAD ELNATHAN MILKY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 20:17:27 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
N., An 001 AMd.AnKes. Sp.A. KESEHATAN
1278 2022/07/13/000182 072295 MUHAMMAD ELNATHAN MILKY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 20:17:27 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
N., An 00110 AMd.AnKes. Sp.A. KESEHATAN
1279 2022/07/13/000184 071946 ULTRA MAVISHA MARYAM, AN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 18:03:38 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
1280 2022/07/13/000186 072298 ZHAFIRA SHAKINAH MECCA, BPJS.KINS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 9070009 dr. MOHAMMAD MUCHLIS, 13/07/2022 16:37:01 BPJS KS NICU 10 40,431 26,569 0 3,000 0 0 0 70,000
1281 2022/07/13/000186 072298 ZHAFIRA SHAKINAH MECCA, BPJS.KINS0 Gula Darah 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 9070009 dr. MOHAMMAD MUCHLIS, 13/07/2022 16:37:01 BPJS KS NICU 10 32,431 9,569 0 3,000 0 0 0 45,000
1282 2022/07/13/000190 074356 INDRAWATI, Ny. UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 13/07/2022 15:53:12 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
1283 2022/07/13/000190 074356 INDRAWATI, Ny. UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 13/07/2022 15:53:12 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
1284 2022/07/13/000190 074356 INDRAWATI, Ny. UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 13/07/2022 15:54:08 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
1285 2022/07/13/000190 074356 INDRAWATI, Ny. UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 13/07/2022 15:53:12 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1286 2022/07/13/000190 074356 INDRAWATI, Ny. UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 13/07/2022 15:53:12 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1287 2022/07/13/000194 072299 MIANAH, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 13/07/2022 17:05:26 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
1288 2022/07/13/000194 072299 MIANAH, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 13/07/2022 17:05:26 UMUM IGD 32,431 9,569 0 3,000 0 0 0 45,000
8/1/22, 8:34 AM Page 43 of 107

1289 2022/07/13/000194 072299 MIANAH, NY UMUM.RJ00 SGOT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 13/07/2022 17:05:26 UMUM IGD 34,451 12,549 0 3,000 0 0 0 50,000
1290 2022/07/13/000194 072299 MIANAH, NY UMUM.RJ00 SGPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 13/07/2022 17:05:26 UMUM IGD 34,451 12,549 0 3,000 0 0 0 50,000
1291 2022/07/13/000194 072299 MIANAH, NY UMUM.RJ00 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 13/07/2022 17:05:26 UMUM IGD 31,451 10,549 0 3,000 0 0 0 45,000
1292 2022/07/13/000194 072299 MIANAH, NY UMUM.RJ00 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 13/07/2022 17:05:26 UMUM IGD 33,951 13,049 0 3,000 0 0 0 50,000
1293 2022/07/13/000194 072299 MIANAH, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 13/07/2022 17:05:26 UMUM IGD 30,390 6,610 0 3,000 0 0 0 40,000
1294 2022/07/13/000194 072299 MIANAH, NY UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 13/07/2022 17:05:26 UMUM IGD 32,436 564 0 2,000 0 0 0 35,000
1295 2022/07/13/000194 072299 MIANAH, NY UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 13/07/2022 17:05:26 UMUM IGD 32,436 564 0 2,000 0 0 0 35,000
1296 2022/07/13/000194 072299 MIANAH, NY UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 13/07/2022 17:06:57 UMUM IGD 47,300 35,200 0 7,500 5,000 0 0 95,000
1297 2022/07/13/000197 068647 CITRA SUCIE RAISSA, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 13/07/2022 23:15:18 BPJS Amarta 5A 40,431 26,569 0 3,000 0 0 0 70,000
1298 2022/07/13/000197 068647 CITRA SUCIE RAISSA, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 13/07/2022 17:57:32 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
1299 2022/07/13/000197 068647 CITRA SUCIE RAISSA, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 13/07/2022 17:57:32 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
1300 2022/07/13/000197 068647 CITRA SUCIE RAISSA, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 13/07/2022 16:26:12 BPJS IGD 30,390 6,610 0 3,000 0 0 0 40,000
1301 2022/07/13/000197 068647 CITRA SUCIE RAISSA, NY UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 13/07/2022 17:57:32 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
1302 2022/07/13/000197 068647 CITRA SUCIE RAISSA, NY UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 13/07/2022 17:57:32 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
1303 2022/07/13/000197 068647 CITRA SUCIE RAISSA, NY UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 13/07/2022 17:58:22 BPJS IGD 47,300 35,200 0 7,500 5,000 0 0 95,000
1304 2022/07/13/000203 070315 HAFIZHA PUTRI ILMIRA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 20:12:52 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
1305 2022/07/13/000203 070315 HAFIZHA PUTRI ILMIRA, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 20:12:52 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
1306 2022/07/13/000204 052768 AZQIARA CLAUZIA HAFLAIKA, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 13/07/2022 18:01:56 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 AMd.AnKes. KESEHATAN
1307 2022/07/13/000204 052768 AZQIARA CLAUZIA HAFLAIKA, UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 13/07/2022 18:01:56 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
AN 00110 AMd.AnKes. KESEHATAN
1308 2022/07/13/000215 072296 BRAM KAIVAN ASEGAF, AN BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 20:15:46 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
0001 AMd.AnKes. Sp.A. KESEHATAN 7/Ayodya 4
1309 2022/07/13/000215 072296 BRAM KAIVAN ASEGAF, AN BPJS.K3T20 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 20:15:46 BPJS Dwarawati 32,431 9,569 0 3,000 0 0 0 45,000
000110 AMd.AnKes. Sp.A. KESEHATAN 7/Ayodya 4
1310 2022/07/13/000222 085390 MUHAMMAD UWAIS AL-QARNI, BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 21:17:48 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
1311 2022/07/13/000222 085390 MUHAMMAD UWAIS AL-QARNI, BPJS.K2UP1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 21:17:48 BPJS KS IGD 10 32,431 9,569 0 3,000 0 0 0 45,000
1312 2022/07/13/000224 069810 NUR AVNI SALISA MAULIDYA, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 13/07/2022 20:22:49 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
NY 001 AMd.AnKes. INDRAWAN, Sp. OG (K) KESEHATAN
1313 2022/07/13/000224 069810 NUR AVNI SALISA MAULIDYA, BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 13/07/2022 20:22:49 BPJS KS IGD 6 32,431 9,569 0 3,000 0 0 0 45,000
1314 2022/07/13/000224 069810 NUR AVNI SALISA MAULIDYA, BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 13/07/2022 20:22:49 BPJS KS IGD 6 32,436 564 0 2,000 0 0 0 35,000
1315 2022/07/13/000224 069810 NUR AVNI SALISA MAULIDYA, BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 13/07/2022 20:22:49 BPJS KS IGD 6 32,436 564 0 2,000 0 0 0 35,000
1316 2022/07/13/000224 069810 NUR AVNI SALISA MAULIDYA, BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 13/07/2022 20:23:02 BPJS KS IGD 6 44,800 35,200 0 5,000 5,000 0 0 90,000
1317 2022/07/13/000227 056604 MUHAMMAD SYAUQI AL AZIZI, BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 22:41:07 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
AN 0001 Sp.A. KESEHATAN 4/Ayodya 2
1318 2022/07/13/000227 056604 MUHAMMAD SYAUQI AL AZIZI, BPJS.K3T20 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 22:41:07 BPJS Dwarawati 32,431 9,569 0 3,000 0 0 0 45,000
AN 00011 Sp.A. KESEHATAN 4/Ayodya 2
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0
1319 2022/07/13/000229 070315 HAFIZHA PUTRI ILMIRA, AN BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 23:01:29 BPJS Hastina 1 40,431 26,569 0 3,000 0 0 0 70,000
1320 2022/07/13/000229 070315 HAFIZHA PUTRI ILMIRA, AN BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 13/07/2022 23:01:29 BPJS Hastina 1 32,431 9,569 0 3,000 0 0 0 45,000
1321 2022/07/13/000230 032197 TANTO EFENDI, TN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 13/07/2022 21:36:56 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 KESEHATAN
1322 2022/07/13/000230 032197 TANTO EFENDI, TN UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 13/07/2022 21:36:56 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
00110 KESEHATAN
1323 2022/07/10/000045 048927 ALFARIZQI ZAFRAN ALHABSY, BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 14/07/2022 08:24:23 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1324 2022/07/10/000045 048927 ALFARIZQI ZAFRAN ALHABSY, BPJS.K2B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 14/07/2022 08:24:23 BPJS KS IGD 1 31,931 10,069 0 3,000 0 0 0 45,000
1325 2022/07/11/000213 067976 AZIZAH HASNA NAJWA BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 14/07/2022 16:59:01 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
MUMTAZAH, AN 001 AMd.AK. M.Biomed. KESEHATAN
1326 2022/07/11/000280 070606 DWI WINARNI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 14/07/2022 06:25:25 BPJS KS IGD 7 40,431 26,569 0 3,000 0 0 0 70,000
1327 2022/07/12/000114 072238 SHELY ARIYANTI NOOR, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 14/07/2022 06:23:42 BPJS Amarta 4A 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A. KESEHATAN
1328 2022/07/12/000121 068684 SYAUQI ATHAILLAH BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 14/07/2022 17:36:28 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
MUHAMMAD H., AN 001 AMd.AK. M.Biomed. KESEHATAN
1329 2022/07/12/000304 015496 M GAZZAL ABQORY AL- BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 14/07/2022 08:22:24 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
1330 2022/07/12/000314 071861 KHAIRA SYAFA GANTARI, An BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 14/07/2022 16:57:13 BPJS KS IGD 2 33,931 13,069 0 3,000 0 0 0 50,000
1331 2022/07/12/000314 071861 KHAIRA SYAFA GANTARI, An BPJS.KINS0 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 14/07/2022 16:57:13 BPJS KS IGD 2 31,936 6,064 0 2,000 0 0 0 40,000
1332 2022/07/12/000314 071861 KHAIRA SYAFA GANTARI, An BPJS.KINS0 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 14/07/2022 16:57:13 BPJS KS IGD 2 31,436 6,564 0 2,000 0 0 0 40,000
1333 2022/07/12/000315 072259 ALESHA ZOE QUEEN SAFA, AN UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 14/07/2022 17:10:49 UMUM Pandawa 8 50,431 26,569 0 3,000 0 0 0 80,000
0001 AMd.AK. Sp.A.
1334 2022/07/12/000316 016863 ISABELLA YUANISA ANWAR, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 14/07/2022 17:08:53 BPJS Amarta 4A 40,431 26,569 0 3,000 0 0 0 70,000
1335 2022/07/13/000029 061831 CHANDRA NUR AFIFAH, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 14/07/2022 12:20:46 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
1336 2022/07/13/000029 061831 CHANDRA NUR AFIFAH, NY BPJS.K2B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 14/07/2022 07:48:09 BPJS KS Kamar Bersalin 30,390 6,610 0 3,000 0 0 0 40,000
1337 2022/07/13/000195 072299 MIANAH, NY UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 14/07/2022 06:22:09 UMUM KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
0001 WISANA, Sp.OG.
1338 2022/07/13/000215 072296 BRAM KAIVAN ASEGAF, AN BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 14/07/2022 18:18:09 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
0001 AMd.AK. Sp.A. KESEHATAN 7/Ayodya 4
1339 2022/07/13/000224 069810 NUR AVNI SALISA MAULIDYA, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 14/07/2022 06:20:46 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
NY 001 INDRAWAN, Sp. OG (K) KESEHATAN
1340 2022/07/14/000019 062708 VENY VERONICA MAULIDIA, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 14/07/2022 12:45:57 UMUM Poli Kandungan 30,390 6,610 0 3,000 0 0 0 40,000
1341 2022/07/14/000050 043216 AISYAH AYUDIA INARA,AN BPJS.K3T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 14/07/2022 06:39:36 BPJS KS IGD 8 40,431 26,569 0 3,000 0 0 0 70,000
1342 2022/07/14/000050 043216 AISYAH AYUDIA INARA,AN BPJS.K3T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 14/07/2022 06:39:36 BPJS KS IGD 8 32,431 9,569 0 3,000 0 0 0 45,000
1343 2022/07/14/000050 043216 AISYAH AYUDIA INARA,AN BPJS.K3T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 14/07/2022 10:36:06 BPJS KS IGD 8 44,800 35,200 0 5,000 5,000 0 0 90,000
1344 2022/07/14/000051 074356 INDRAWATI, Ny. BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 14/07/2022 17:05:42 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
1345 2022/07/14/000063 072325 ADNARETHA ARISTO KHRISTI, UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8170324 dr. EDWIN PRADANA, 14/07/2022 10:12:23 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
Tn 0031 AMd.AnKes. Sp.And.
1346 2022/07/14/000064 072328 KUKUH PRASETYO PANGUDI UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8170324 dr. EDWIN PRADANA, 14/07/2022 10:12:53 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
UTOMO, TN 0031 AMd.AnKes. Sp.And.
1347 2022/07/14/000070 072330 FENTI NURCAHYANI, Ny ASKES.RJ00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 14/07/2022 09:29:56 ASURANSI Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
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1348 2022/07/14/000070 072330 FENTI NURCAHYANI, Ny ASKES.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 14/07/2022 09:29:56 ASURANSI Poli Kandungan 30,390 6,610 0 3,000 0 0 0 40,000
1349 2022/07/14/000070 072330 FENTI NURCAHYANI, Ny ASKES.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 14/07/2022 09:27:17 ASURANSI Poli Kandungan 37,900 47,600 0 7,500 5,000 0 0 98,000
1350 2022/07/14/000077 086740 Liam Shakeil Haydar, An. UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 14/07/2022 17:57:30 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK. Sp.A.
1351 2022/07/14/000090 062444 PUTRI AMALIA, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 14/07/2022 10:08:19 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
1352 2022/07/14/000090 062444 PUTRI AMALIA, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 14/07/2022 10:08:19 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
1353 2022/07/14/000090 062444 PUTRI AMALIA, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 14/07/2022 10:27:06 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
1354 2022/07/14/000090 062444 PUTRI AMALIA, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 14/07/2022 10:08:19 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1355 2022/07/14/000090 062444 PUTRI AMALIA, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 14/07/2022 10:08:19 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1356 2022/07/14/000094 096079 SYAHIRA KANZIA ASHEEQA BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 14/07/2022 11:22:33 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
QIRANI, An 001 AMd.AnKes. Sp.A. KESEHATAN
1357 2022/07/14/000094 096079 SYAHIRA KANZIA ASHEEQA BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 14/07/2022 11:22:33 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
QIRANI, An 00110 AMd.AnKes. Sp.A. KESEHATAN
1358 2022/07/14/000099 029889 RAMADHAN DZAKY SYAFARY, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 14/07/2022 10:31:19 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 AMd.AnKes.
1359 2022/07/14/000099 029889 RAMADHAN DZAKY SYAFARY, UMUM.RJ00 SGOT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 14/07/2022 10:31:19 UMUM IGD 34,451 12,549 0 3,000 0 0 0 50,000
AN 0016 AMd.AnKes.
1360 2022/07/14/000099 029889 RAMADHAN DZAKY SYAFARY, UMUM.RJ00 SGPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 14/07/2022 10:31:19 UMUM IGD 34,451 12,549 0 3,000 0 0 0 50,000
AN 0017 AMd.AnKes.
1361 2022/07/14/000099 029889 RAMADHAN DZAKY SYAFARY, UMUM.RJ00 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 14/07/2022 10:31:19 UMUM IGD 38,951 34,049 0 2,000 0 0 0 75,000
AN 0027 AMd.AnKes.
1362 2022/07/14/000101 036985 ALVARO KASRO PURBA,AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 14/07/2022 11:24:58 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1363 2022/07/14/000101 036985 ALVARO KASRO PURBA,AN BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 14/07/2022 11:24:58 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
1364 2022/07/14/000111 072339 MARIA KLARIZA PUTRI BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 14/07/2022 11:39:03 BPJS Amarta 6C 40,431 26,569 0 3,000 0 0 0 70,000
KRISDIANA, Ny 001 AMd.AnKes. INDRAWAN, Sp. OG (K) KESEHATAN
1365 2022/07/14/000111 072339 MARIA KLARIZA PUTRI BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 14/07/2022 11:39:03 BPJS Amarta 6C 32,431 9,569 0 3,000 0 0 0 45,000
1366 2022/07/14/000111 072339 MARIA KLARIZA PUTRI BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 14/07/2022 11:39:03 BPJS Amarta 6C 32,436 564 0 2,000 0 0 0 35,000
1367 2022/07/14/000111 072339 MARIA KLARIZA PUTRI BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 14/07/2022 11:39:03 BPJS Amarta 6C 32,436 564 0 2,000 0 0 0 35,000
1368 2022/07/14/000111 072339 MARIA KLARIZA PUTRI BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 14/07/2022 11:37:21 BPJS Amarta 6C 44,800 35,200 0 5,000 5,000 0 0 90,000
1369 2022/07/14/000115 045454 UDHA NOVITA SARI, NY BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 14/07/2022 12:08:07 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
0001 AMd.AnKes. WISANA, Sp.OG. KESEHATAN
1370 2022/07/14/000115 045454 UDHA NOVITA SARI, NY BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10120217 dr. NYOMAN LUWANG 14/07/2022 20:00:52 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1371 2022/07/14/000115 045454 UDHA NOVITA SARI, NY BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 14/07/2022 12:08:07 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1372 2022/07/14/000115 045454 UDHA NOVITA SARI, NY BPJS.K2T10 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 14/07/2022 12:08:07 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1373 2022/07/14/000115 045454 UDHA NOVITA SARI, NY BPJS.K2T10 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 14/07/2022 12:08:07 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1374 2022/07/14/000115 045454 UDHA NOVITA SARI, NY BPJS.K2T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 14/07/2022 12:06:15 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1375 2022/07/14/000118 072345 DINA TASYA, NY UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10120217 dr. NYOMAN LUWANG 14/07/2022 14:44:59 UMUM KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1376 2022/07/14/000118 072345 DINA TASYA, NY UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10120217 dr. NYOMAN LUWANG 14/07/2022 20:03:38 UMUM KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1377 2022/07/14/000118 072345 DINA TASYA, NY UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10120217 dr. NYOMAN LUWANG 14/07/2022 14:44:59 UMUM KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
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1378 2022/07/14/000118 072345 DINA TASYA, NY UMUM.K3B0 Plano Test 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10120217 dr. NYOMAN LUWANG 14/07/2022 14:44:59 UMUM KS IGD 2 33,140 4,860 0 2,000 0 0 0 40,000
1379 2022/07/14/000118 072345 DINA TASYA, NY UMUM.K3B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10120217 dr. NYOMAN LUWANG 14/07/2022 14:44:59 UMUM KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
1380 2022/07/14/000118 072345 DINA TASYA, NY UMUM.K3B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10120217 dr. NYOMAN LUWANG 14/07/2022 14:44:59 UMUM KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
1381 2022/07/14/000129 068115 KIRANIA SHAKILLA JENAKA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 14/07/2022 15:46:35 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
1382 2022/07/14/000130 061824 HAIFA HUSEIN, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 14/07/2022 17:02:04 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1383 2022/07/14/000130 061824 HAIFA HUSEIN, NY BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 14/07/2022 17:02:04 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1384 2022/07/14/000130 061824 HAIFA HUSEIN, NY BPJS.K1B00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 14/07/2022 17:02:04 BPJS KS IGD 1 37,951 38,049 0 4,000 0 0 0 80,000
1385 2022/07/14/000130 061824 HAIFA HUSEIN, NY BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 14/07/2022 16:59:49 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1386 2022/07/14/000130 061824 HAIFA HUSEIN, NY BPJS.K1B00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 14/07/2022 17:02:04 BPJS KS IGD 1 37,951 38,049 0 4,000 0 0 0 80,000
1387 2022/07/14/000131 072149 MUHAMMAD ZHAFRAN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 14/07/2022 17:12:42 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
ALVARONIZAM, AN 001 AMd.AK. KESEHATAN
1388 2022/07/14/000131 072149 MUHAMMAD ZHAFRAN UMUM.RJ00 Gula Darah 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 14/07/2022 17:12:42 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
1389 2022/07/14/000131 072149 MUHAMMAD ZHAFRAN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 14/07/2022 17:12:42 BPJS IGD 31,931 10,069 0 3,000 0 0 0 45,000
1390 2022/07/14/000132 072346 MARIYAM, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 14/07/2022 19:03:15 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1391 2022/07/14/000132 072346 MARIYAM, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 14/07/2022 22:44:17 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1392 2022/07/14/000132 072346 MARIYAM, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 14/07/2022 19:03:15 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1393 2022/07/14/000132 072346 MARIYAM, NY BPJS.K3B00 SGOT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 14/07/2022 19:03:15 BPJS KS IGD 1 34,451 12,549 0 3,000 0 0 0 50,000
1394 2022/07/14/000132 072346 MARIYAM, NY BPJS.K3B00 SGPT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 14/07/2022 19:03:15 BPJS KS IGD 1 34,451 12,549 0 3,000 0 0 0 50,000
1395 2022/07/14/000132 072346 MARIYAM, NY BPJS.K3B00 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 14/07/2022 19:03:15 BPJS KS IGD 1 31,451 10,549 0 3,000 0 0 0 45,000
1396 2022/07/14/000132 072346 MARIYAM, NY BPJS.K3B00 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 14/07/2022 19:03:15 BPJS KS IGD 1 33,951 13,049 0 3,000 0 0 0 50,000
1397 2022/07/14/000132 072346 MARIYAM, NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 14/07/2022 19:36:21 BPJS KS IGD 1 30,390 6,610 0 3,000 0 0 0 40,000
1398 2022/07/14/000132 072346 MARIYAM, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 14/07/2022 19:03:15 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1399 2022/07/14/000132 072346 MARIYAM, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 14/07/2022 19:03:15 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1400 2022/07/14/000132 072346 MARIYAM, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 14/07/2022 18:59:06 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1401 2022/07/14/000135 097615 ALFARIZ AZRIL PRADITYA, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 14/07/2022 20:10:13 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1402 2022/07/14/000135 097615 ALFARIZ AZRIL PRADITYA, AN BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 14/07/2022 20:10:13 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1403 2022/07/14/000135 097615 ALFARIZ AZRIL PRADITYA, AN BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 14/07/2022 20:11:04 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1404 2022/07/14/000146 105181 Muhammad Hafis Alfaruki, An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 14/07/2022 19:08:24 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK. Sp.A.
1405 2022/07/14/000149 104299 MARYAM KAMILA MUMTAZA, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 14/07/2022 20:22:28 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
1406 2022/07/14/000149 104299 MARYAM KAMILA MUMTAZA, UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 14/07/2022 20:22:28 UMUM Poli Anak 30,390 6,610 0 3,000 0 0 0 40,000
1407 2022/07/14/000149 104299 MARYAM KAMILA MUMTAZA, UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 14/07/2022 20:22:28 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
1408 2022/07/14/000158 072353 ELZAHIRA DEVINA, AN BPJS. Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, AMd. 9070009 dr. MOHAMMAD MUCHLIS, 14/07/2022 20:36:33 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
Sp.
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RJ0000110 AK. A.
1409 2022/07/14/000158 072353 ELZAHIRA DEVINA, AN BPJS.RJ000 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 14/07/2022 20:49:02 BPJS IGD 44,800 35,200 0 5,000 5,000 0 0 90,000
1410 2022/07/14/000158 072353 ELZAHIRA DEVINA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 14/07/2022 20:16:28 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
1411 2022/07/14/000161 072357 GEFANDA AFRISSA SYAFAZEA, BPJS.KFIS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 14/07/2022 22:35:13 BPJS KS Fisol 2 40,431 26,569 0 3,000 0 0 0 70,000
1412 2022/07/14/000165 072360 SULASTRI,NY BPJS.K3B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 14/07/2022 23:58:17 BPJS KS Kamar Bersalin 37,400 47,600 0 5,000 5,000 0 0 95,000
0047 INDRAWAN, Sp. OG (K) KESEHATAN 1
1413 2022/07/12/000114 072238 SHELY ARIYANTI NOOR, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 15/07/2022 05:59:35 BPJS Amarta 4A 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A. KESEHATAN
1414 2022/07/12/000129 045307 JAYANTI WIDI PROBORINI, Ny BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 15/07/2022 07:56:36 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1415 2022/07/13/000219 071946 ULTRA MAVISHA MARYAM, AN BPJS.K2B00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 15/07/2022 16:30:29 BPJS KS IGD 10 33,931 13,069 0 3,000 0 0 0 50,000
1416 2022/07/13/000219 071946 ULTRA MAVISHA MARYAM, AN BPJS.K2B00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 15/07/2022 16:30:29 BPJS KS IGD 10 31,936 6,064 0 2,000 0 0 0 40,000
1417 2022/07/13/000219 071946 ULTRA MAVISHA MARYAM, AN BPJS.K2B00 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 15/07/2022 16:30:29 BPJS KS IGD 10 31,436 6,564 0 2,000 0 0 0 40,000
1418 2022/07/13/000227 056604 MUHAMMAD SYAUQI AL AZIZI, BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 15/07/2022 16:34:32 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
AN 0001 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN 4/Ayodya 2
1419 2022/07/13/000229 070315 HAFIZHA PUTRI ILMIRA, AN BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 15/07/2022 16:38:44 BPJS Hastina 1 40,431 26,569 0 3,000 0 0 0 70,000
1420 2022/07/14/000111 072339 MARIA KLARIZA PUTRI BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 15/07/2022 05:56:37 BPJS Amarta 6C 40,431 26,569 0 3,000 0 0 0 70,000
KRISDIANA, Ny 001 INDRAWAN, Sp. OG (K) KESEHATAN
1421 2022/07/14/000130 061824 HAIFA HUSEIN, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 15/07/2022 16:37:08 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1422 2022/07/14/000165 072360 SULASTRI,NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 15/07/2022 00:03:29 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
1423 2022/07/14/000165 072360 SULASTRI,NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 15/07/2022 10:12:01 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
1424 2022/07/14/000165 072360 SULASTRI,NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 15/07/2022 00:03:29 BPJS KS Kamar Bersalin 32,431 9,569 0 3,000 0 0 0 45,000
1425 2022/07/14/000165 072360 SULASTRI,NY BPJS.K3B00 SGOT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 15/07/2022 00:03:29 BPJS KS Kamar Bersalin 34,451 12,549 0 3,000 0 0 0 50,000
1426 2022/07/14/000165 072360 SULASTRI,NY BPJS.K3B00 SGPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 15/07/2022 00:03:29 BPJS KS Kamar Bersalin 34,451 12,549 0 3,000 0 0 0 50,000
1427 2022/07/14/000165 072360 SULASTRI,NY BPJS.K3B00 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 15/07/2022 00:03:29 BPJS KS Kamar Bersalin 31,451 10,549 0 3,000 0 0 0 45,000
1428 2022/07/14/000165 072360 SULASTRI,NY BPJS.K3B00 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 15/07/2022 00:03:29 BPJS KS Kamar Bersalin 33,951 13,049 0 3,000 0 0 0 50,000
1429 2022/07/14/000165 072360 SULASTRI,NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 15/07/2022 00:03:29 BPJS KS Kamar Bersalin 30,390 6,610 0 3,000 0 0 0 40,000
1430 2022/07/14/000165 072360 SULASTRI,NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 15/07/2022 00:03:29 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
1431 2022/07/14/000165 072360 SULASTRI,NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 15/07/2022 00:03:29 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
1432 2022/07/15/000007 047823 ZHIAN ELKHAFI RAFAEYZA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 15/07/2022 19:27:26 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
TRIMULYA, AN 001 Sp.A.
1433 2022/07/15/000031 070274 WENNY EKO SULESTYORINI, BPJS.RJ000 Gula Darah Puasa 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 15/07/2022 09:17:45 BPJS Poli Penyakit 32,431 9,569 0 3,000 0 0 0 45,000
NY 0210 Sp.PD. KESEHATAN Dalam
1434 2022/07/15/000031 070274 WENNY EKO SULESTYORINI, BPJS.RJ000 Gula Darah 2 Jam PP 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 15/07/2022 09:17:45 BPJS Poli Penyakit 32,431 9,569 0 3,000 0 0 0 45,000
NY 0310 Sp.PD. KESEHATAN Dalam
1435 2022/07/15/000054 010900 Supatemi, Ny BPJS.RJ000 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 15/07/2022 09:21:24 BPJS Poli Penyakit 30,390 6,610 0 3,000 0 0 0 40,000
1436 2022/07/15/000054 010900 Supatemi, Ny BPJS.RJ000 Gula Darah Puasa 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 15/07/2022 09:21:24 BPJS Poli Penyakit 32,431 9,569 0 3,000 0 0 0 45,000
1437 2022/07/15/000054 010900 Supatemi, Ny BPJS.RJ000 Gula Darah 2 Jam PP 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 15/07/2022 09:21:24 BPJS Poli Penyakit 32,431 9,569 0 3,000 0 0 0 45,000
1438 2022/07/15/000055 093964 LILIK KOMARIYATI,NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 15/07/2022 10:06:10 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
8/1/22, 8:34 AM Page 48 of 107

1439 2022/07/15/000055 093964 LILIK KOMARIYATI,NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 15/07/2022 10:06:10 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1440 2022/07/15/000055 093964 LILIK KOMARIYATI,NY BPJS.K3B00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 15/07/2022 10:06:10 BPJS KS IGD 1 37,951 38,049 0 4,000 0 0 0 80,000
1441 2022/07/15/000055 093964 LILIK KOMARIYATI,NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 15/07/2022 11:05:44 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1442 2022/07/15/000055 093964 LILIK KOMARIYATI,NY BPJS.K3B00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 15/07/2022 10:06:10 BPJS KS IGD 1 37,951 38,049 0 4,000 0 0 0 80,000
1443 2022/07/15/000056 062444 PUTRI AMALIA, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 15/07/2022 16:32:44 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1444 2022/07/15/000060 063124 NURUL AZIZA, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 15/07/2022 06:36:18 UMUM Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
1445 2022/07/15/000060 063124 NURUL AZIZA, NY UMUM.RJ00 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 15/07/2022 06:36:18 UMUM Poli Kandungan 31,451 10,549 0 3,000 0 0 0 45,000
1446 2022/07/15/000060 063124 NURUL AZIZA, NY UMUM.RJ00 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 15/07/2022 06:36:18 UMUM Poli Kandungan 33,951 13,049 0 3,000 0 0 0 50,000
1447 2022/07/15/000077 072073 GHANIYA CHAYRA ASSYABIA, UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 15/07/2022 08:15:22 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
AN 0020 Sp.A.
1448 2022/07/15/000082 072371 AMEERA AMER ALKATIRI, An BPJS.K3000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5170285 RUWAIDA HIDAYAT, 1160202 dr. DEWI NURINDAH, Sp.A, 15/07/2022 08:39:26 BPJS KS Fisol 12 40,431 26,569 0 3,000 0 0 0 70,000
01 AMd.Keb. M.Biomed. KESEHATAN
1451 2022/07/15/000082 072371 AMEERA AMER ALKATIRI, An BPJS.K3000 Gula Darah 10210382 dr. RIMA AURELIA, Sp.PK. 5170285 RUWAIDA HIDAYAT, 1160202 dr. DEWI NURINDAH, Sp.A, 15/07/2022 08:39:26 BPJS KS Fisol 12 32,431 9,569 0 3,000 0 0 0 45,000
1454 2022/07/15/000082 072371 AMEERA AMER ALKATIRI, An BPJS.KFIS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 15/07/2022 10:13:03 BPJS KS Fisol 12 40,431 26,569 0 3,000 0 0 0 70,000
1455 2022/07/15/000082 072371 AMEERA AMER ALKATIRI, An BPJS.KFIS0 Gula Darah 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 15/07/2022 10:13:03 BPJS KS Fisol 12 32,431 9,569 0 3,000 0 0 0 45,000
1456 2022/07/15/000085 072278 HALWA NAFISAH ADZKIYA BPJS.K2T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 15/07/2022 09:39:13 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
PUTRI, AN 00050 Sp.A. KESEHATAN
1457 2022/07/15/000085 072278 HALWA NAFISAH ADZKIYA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 15/07/2022 08:53:23 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
PUTRI, AN 001 KESEHATAN
1458 2022/07/15/000085 072278 HALWA NAFISAH ADZKIYA UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 15/07/2022 08:53:23 BPJS IGD 31,931 10,069 0 3,000 0 0 0 45,000
PUTRI, AN 009 KESEHATAN
1459 2022/07/15/000097 072373 LIANAH, NY UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 15/07/2022 10:58:07 UMUM Amarta 8B 40,431 26,569 0 3,000 0 0 0 70,000
1460 2022/07/15/000097 072373 LIANAH, NY UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 15/07/2022 10:58:07 UMUM Amarta 8B 32,431 9,569 0 3,000 0 0 0 45,000
1461 2022/07/15/000097 072373 LIANAH, NY UMUM.K3B0 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 15/07/2022 10:58:07 UMUM Amarta 8B 30,390 6,610 0 3,000 0 0 0 40,000
1462 2022/07/15/000097 072373 LIANAH, NY UMUM.K3B0 Anti HIV 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 15/07/2022 10:58:07 UMUM Amarta 8B 38,951 34,049 0 2,000 0 0 0 75,000
1463 2022/07/15/000097 072373 LIANAH, NY UMUM.K3B0 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 15/07/2022 10:58:07 UMUM Amarta 8B 38,951 34,049 0 2,000 0 0 0 75,000
1464 2022/07/15/000097 072373 LIANAH, NY UMUM.K3B0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 15/07/2022 11:00:15 UMUM Amarta 8B 47,300 35,200 0 7,500 5,000 0 0 95,000
1465 2022/07/15/000099 069275 MUHAMMAD ARKANANTA H., UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 15/07/2022 10:51:59 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
AN 001
1466 2022/07/15/000103 013436 AZZAHRA MECCAYLA SABIYA, BPJS.K3T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 15/07/2022 12:25:38 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1467 2022/07/15/000103 013436 AZZAHRA MECCAYLA SABIYA, BPJS.K3T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 15/07/2022 12:12:28 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1468 2022/07/15/000104 061104 AMIRA SOFIA CLARINTA, AN BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 15/07/2022 13:33:12 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
1469 2022/07/15/000104 061104 AMIRA SOFIA CLARINTA, AN BPJS. SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 15/07/2022 12:13:10 BPJS KS IGD 10 44,800 35,200 0 5,000 5,000 0 0 90,000
Sp.
8/1/22, 8:34 AM Page 49 of 107
K3T2000050 A.
1470 2022/07/15/000108 072375 MUHAMMAD SALAHUDDIN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 15/07/2022 11:53:52 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
GHADI, AN 001
1471 2022/07/15/000109 072320 RISKA ARINO FITRI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 15/07/2022 12:15:36 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1472 2022/07/15/000109 072320 RISKA ARINO FITRI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 15/07/2022 12:15:36 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1473 2022/07/15/000109 072320 RISKA ARINO FITRI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 15/07/2022 12:15:36 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1474 2022/07/15/000109 072320 RISKA ARINO FITRI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 15/07/2022 12:15:36 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1475 2022/07/15/000109 072320 RISKA ARINO FITRI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 15/07/2022 12:14:24 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1476 2022/07/15/000113 067677 ANJANI AMARA PRASETIA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 15/07/2022 14:00:46 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 M.Biomed.
1477 2022/07/15/000116 029889 RAMADHAN DZAKY SYAFARY, UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 15/07/2022 13:48:11 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
AN 0047
1478 2022/07/15/000122 069614 RISNA DEWI, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 15/07/2022 14:37:44 BPJS IGD 30,390 6,610 0 3,000 0 0 0 40,000
1479 2022/07/15/000130 072377 ACHMAD NAUFAL ALFAHRI, AN UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 15/07/2022 16:27:16 UMUM KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1480 2022/07/15/000130 072377 ACHMAD NAUFAL ALFAHRI, AN UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 15/07/2022 16:27:16 UMUM KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
1481 2022/07/15/000130 072377 ACHMAD NAUFAL ALFAHRI, AN UMUM.K3B0 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 15/07/2022 16:21:08 UMUM KS IGD 2 37,900 47,600 0 7,500 5,000 0 0 98,000
1482 2022/07/15/000130 072377 ACHMAD NAUFAL ALFAHRI, AN UMUM.K3B0 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 15/07/2022 16:27:16 UMUM KS IGD 2 31,931 10,069 0 3,000 0 0 0 45,000
1483 2022/07/15/000156 072378 AISYAH AZKYAH PUTRI, AN BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 15/07/2022 19:32:59 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1484 2022/07/15/000156 072378 AISYAH AZKYAH PUTRI, AN BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 15/07/2022 19:32:59 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1485 2022/07/15/000162 040167 HENI WAHYUNINGTYAS, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 15/07/2022 19:30:47 BPJS KS RR 5 40,431 26,569 0 3,000 0 0 0 70,000
1486 2022/07/15/000162 040167 HENI WAHYUNINGTYAS, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 15/07/2022 19:30:47 BPJS KS RR 5 32,431 9,569 0 3,000 0 0 0 45,000
1487 2022/07/15/000162 040167 HENI WAHYUNINGTYAS, NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 15/07/2022 19:30:47 BPJS KS RR 5 30,390 6,610 0 3,000 0 0 0 40,000
1488 2022/07/15/000162 040167 HENI WAHYUNINGTYAS, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 15/07/2022 19:30:47 BPJS KS RR 5 32,436 564 0 2,000 0 0 0 35,000
1489 2022/07/15/000162 040167 HENI WAHYUNINGTYAS, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 15/07/2022 19:30:47 BPJS KS RR 5 32,436 564 0 2,000 0 0 0 35,000
1490 2022/07/15/000162 040167 HENI WAHYUNINGTYAS, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 15/07/2022 19:31:36 BPJS KS RR 5 44,800 35,200 0 5,000 5,000 0 0 90,000
1491 2022/07/15/000172 099109 Amelia Erwinawati,Ny BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 15/07/2022 20:52:45 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
1492 2022/07/15/000172 099109 Amelia Erwinawati,Ny BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 15/07/2022 20:52:45 BPJS KS IGD 6 32,431 9,569 0 3,000 0 0 0 45,000
1493 2022/07/15/000172 099109 Amelia Erwinawati,Ny BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 15/07/2022 20:52:45 BPJS KS IGD 6 32,436 564 0 2,000 0 0 0 35,000
1494 2022/07/15/000172 099109 Amelia Erwinawati,Ny BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 15/07/2022 20:52:45 BPJS KS IGD 6 32,436 564 0 2,000 0 0 0 35,000
1495 2022/07/15/000172 099109 Amelia Erwinawati,Ny BPJS.K3B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 15/07/2022 20:54:08 BPJS KS IGD 6 37,400 47,600 0 5,000 5,000 0 0 95,000
1496 2022/07/15/000175 034592 WINDA KARISTA, Ny. UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 15/07/2022 22:09:15 UMUM Pandawa 5 50,431 26,569 0 3,000 0 0 0 80,000
0001 AMd.AK. MENUR, Sp.OG
1497 2022/07/15/000175 034592 WINDA KARISTA, Ny. UMUM.K1B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 15/07/2022 22:09:15 UMUM Pandawa 5 42,431 9,569 0 3,000 0 0 0 55,000
1498 2022/07/15/000175 034592 WINDA KARISTA, Ny. UMUM.K1B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 15/07/2022 22:09:15 UMUM Pandawa 5 42,436 564 0 2,000 0 0 0 45,000
1499 2022/07/15/000175 034592 WINDA KARISTA, Ny. UMUM. CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 15/07/2022 22:09:15 UMUM Pandawa 5 42,436 564 0 2,000 0 0 0 45,000
8/1/22, 8:34 AM Page 50 of 107

K1B00004 AMd.AK. MENUR, Sp.OG
1500 2022/07/15/000175 034592 WINDA KARISTA, Ny. UMUM.K1B0 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 15/07/2022 22:09:25 UMUM Pandawa 5 37,900 47,600 0 7,500 5,000 0 0 98,000
1501 2022/07/15/000176 054387 AL FATIH YUSUF, AN UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 15/07/2022 22:58:09 UMUM KS IGD 2 50,431 26,569 0 3,000 0 0 0 80,000
0001 AMd.AK. Sp.A.
1502 2022/07/15/000176 054387 AL FATIH YUSUF, AN UMUM.K1B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 15/07/2022 22:58:09 UMUM KS IGD 2 42,431 9,569 0 3,000 0 0 0 55,000
1503 2022/07/15/000178 061344 NOVI INDRIANI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 15/07/2022 23:02:11 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK.
1504 2022/07/15/000178 061344 NOVI INDRIANI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 15/07/2022 23:02:11 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
00110 AMd.AK.
1505 2022/07/15/000178 061344 NOVI INDRIANI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 15/07/2022 23:03:17 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
0047 AMd.AK.
1506 2022/07/15/000178 061344 NOVI INDRIANI, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 15/07/2022 23:02:11 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
005 AMd.AK.
1507 2022/07/15/000178 061344 NOVI INDRIANI, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 15/07/2022 23:02:11 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
006 AMd.AK.
1508 2022/07/15/000179 054315 DEWI SARTIKA SARI,NY BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 15/07/2022 23:50:07 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
1509 2022/07/15/000179 054315 DEWI SARTIKA SARI,NY BPJS.K3T20 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 15/07/2022 23:50:07 BPJS KS Kamar Bersalin 32,431 9,569 0 3,000 0 0 0 45,000
1510 2022/07/15/000179 054315 DEWI SARTIKA SARI,NY BPJS.K3T20 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 15/07/2022 23:50:07 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
1511 2022/07/15/000179 054315 DEWI SARTIKA SARI,NY BPJS.K3T20 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 15/07/2022 23:50:07 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
1512 2022/07/15/000179 054315 DEWI SARTIKA SARI,NY BPJS.K3T20 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 15/07/2022 23:50:18 BPJS KS Kamar Bersalin 44,800 35,200 0 5,000 5,000 0 0 90,000
1513 2022/07/12/000114 072238 SHELY ARIYANTI NOOR, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 16/07/2022 06:39:14 BPJS Amarta 4A 40,431 26,569 0 3,000 0 0 0 70,000
1514 2022/07/12/000129 045307 JAYANTI WIDI PROBORINI, Ny BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4150215 dr. DEWI INDIASTARI, 16/07/2022 11:12:33 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1515 2022/07/12/000304 015496 M GAZZAL ABQORY AL- BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 16/07/2022 10:55:23 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
BAYAN,AN 001 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN 5/Ayodya 3
1516 2022/07/12/000315 072259 ALESHA ZOE QUEEN SAFA, AN UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 16/07/2022 19:17:41 UMUM Pandawa 8 50,431 26,569 0 3,000 0 0 0 80,000
0001 Sp.A.
1517 2022/07/12/000316 016863 ISABELLA YUANISA ANWAR, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 16/07/2022 06:36:54 BPJS Amarta 4A 40,431 26,569 0 3,000 0 0 0 70,000
1518 2022/07/13/000083 092060 ARSYANA RAMADHAN, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 16/07/2022 11:14:54 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1519 2022/07/13/000215 072296 BRAM KAIVAN ASEGAF, AN BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 16/07/2022 11:04:27 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
0001 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN 7/Ayodya 4
1520 2022/07/13/000229 070315 HAFIZHA PUTRI ILMIRA, AN BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 16/07/2022 19:23:32 BPJS Hastina 1 40,431 26,569 0 3,000 0 0 0 70,000
1521 2022/07/14/000094 096079 SYAHIRA KANZIA ASHEEQA BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 16/07/2022 10:53:29 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
QIRANI, An 001 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN
1522 2022/07/14/000101 036985 ALVARO KASRO PURBA,AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 16/07/2022 06:38:04 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1523 2022/07/14/000131 072149 MUHAMMAD ZHAFRAN BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 16/07/2022 19:11:27 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
ALVARONIZAM, AN 00001 Sp.A. KESEHATAN
1524 2022/07/15/000055 093964 LILIK KOMARIYATI,NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 16/07/2022 19:14:55 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1525 2022/07/15/000055 093964 LILIK KOMARIYATI,NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10120217 dr. NYOMAN LUWANG 16/07/2022 10:43:44 BPJS KS IGD 1 30,390 6,610 0 3,000 0 0 0 40,000
1526 2022/07/15/000097 072373 LIANAH, NY UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 16/07/2022 11:19:23 UMUM Amarta 8B 40,431 26,569 0 3,000 0 0 0 70,000
1527 2022/07/15/000104 061104 AMIRA SOFIA CLARINTA, AN BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 16/07/2022 10:58:50 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
1528 2022/07/15/000109 072320 RISKA ARINO FITRI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 16/07/2022 06:32:41 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1529 2022/07/15/000162 040167 HENI WAHYUNINGTYAS, NY BPJS. Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO SUSILO, 16/07/2022 11:22:41 BPJS KS RR 5 40,431 26,569 0 3,000 0 0 0 70,000
ARDHIANSYAH,
8/1/22, 8:34 AM Page 51 of 107
K3B00001 AMd.Ankes Sp.OG.
1530 2022/07/15/000172 099109 Amelia Erwinawati,Ny BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 16/07/2022 06:34:07 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
1531 2022/07/15/000175 034592 WINDA KARISTA, Ny. UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 16/07/2022 11:08:50 UMUM Pandawa 5 50,431 26,569 0 3,000 0 0 0 80,000
1532 2022/07/15/000179 054315 DEWI SARTIKA SARI,NY BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 16/07/2022 06:35:39 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
1533 2022/07/16/000075 023180 NI KADEK WINDAYU NAYUNDA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 16/07/2022 00:10:49 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
ANDINI, NN 001 AMd.AK. KESEHATAN
1534 2022/07/16/000075 023180 NI KADEK WINDAYU NAYUNDA UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 16/07/2022 00:10:49 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
ANDINI, NN 00110 AMd.AK. KESEHATAN
1535 2022/07/16/000076 057838 KENZO AZKA PUTRA AFFANDI, BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 16/07/2022 04:09:45 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
1536 2022/07/16/000076 057838 KENZO AZKA PUTRA AFFANDI, BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 16/07/2022 04:09:45 BPJS KS IGD 10 32,431 9,569 0 3,000 0 0 0 45,000
1537 2022/07/16/000088 027203 AGNES KHUSNUL KHOTIMAH, BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 16/07/2022 12:43:53 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
NY 001 ARDHIANSYAH, AMd.Ankes MENUR, Sp.OG KESEHATAN
1538 2022/07/16/000088 027203 AGNES KHUSNUL KHOTIMAH, BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 16/07/2022 22:26:05 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
NY 001 MENUR, Sp.OG KESEHATAN
1539 2022/07/16/000088 027203 AGNES KHUSNUL KHOTIMAH, BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 16/07/2022 12:43:53 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1540 2022/07/16/000088 027203 AGNES KHUSNUL KHOTIMAH, BPJS.K1B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 16/07/2022 12:45:19 BPJS KS IGD 1 30,390 6,610 0 3,000 0 0 0 40,000
1541 2022/07/16/000088 027203 AGNES KHUSNUL KHOTIMAH, BPJS.K1B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 16/07/2022 12:43:53 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1542 2022/07/16/000088 027203 AGNES KHUSNUL KHOTIMAH, BPJS.K1B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 16/07/2022 12:43:53 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1543 2022/07/16/000088 027203 AGNES KHUSNUL KHOTIMAH, BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 16/07/2022 12:42:40 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1544 2022/07/16/000100 004885 Fabiansky Arsenio Gultom, An BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 16/07/2022 18:12:48 BPJS Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
1545 2022/07/16/000100 004885 Fabiansky Arsenio Gultom, An BPJS.RJ000 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 16/07/2022 18:12:48 BPJS Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
1546 2022/07/16/000103 024048 DIA HERAYU, NY UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 16/07/2022 08:26:01 UMUM KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1547 2022/07/16/000103 024048 DIA HERAYU, NY UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 16/07/2022 08:26:01 UMUM KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1548 2022/07/16/000103 024048 DIA HERAYU, NY UMUM.K3B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 16/07/2022 08:26:01 UMUM KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1549 2022/07/16/000103 024048 DIA HERAYU, NY UMUM.K3B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 16/07/2022 08:26:01 UMUM KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1550 2022/07/16/000103 024048 DIA HERAYU, NY UMUM.K3B0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 16/07/2022 08:25:14 UMUM KS IGD 1 47,300 35,200 0 7,500 5,000 0 0 95,000
1551 2022/07/16/000110 083181 HAFIZAH BRILIANI PUTRI N R, BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 16/07/2022 22:25:03 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1552 2022/07/16/000110 083181 HAFIZAH BRILIANI PUTRI N R, BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 16/07/2022 08:46:17 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
1553 2022/07/16/000110 083181 HAFIZAH BRILIANI PUTRI N R, BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 16/07/2022 08:46:17 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
1554 2022/07/16/000110 083181 HAFIZAH BRILIANI PUTRI N R, BPJS.RJ000 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 16/07/2022 08:46:31 BPJS IGD 44,800 35,200 0 5,000 5,000 0 0 90,000
1555 2022/07/16/000111 025252 ADREENA LAURA SEPTYA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 16/07/2022 08:45:44 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
AZZAHRA,AN 001 ARDHIANSYAH, AMd.Ankes KESEHATAN
1556 2022/07/16/000111 025252 ADREENA LAURA SEPTYA UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 16/07/2022 08:45:44 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
AZZAHRA,AN 00110 ARDHIANSYAH, AMd.Ankes KESEHATAN
1557 2022/07/16/000122 072410 AL FATIH ABBAS UMUM.K2T1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 16/07/2022 12:03:30 UMUM KS IGD 1 50,431 26,569 0 3,000 0 0 0 75,000
TYOWARDHANA, AN 00001 ARDHIANSYAH, AMd.Ankes Sp.A.
1558 2022/07/16/000122 072410 AL FATIH ABBAS UMUM.K2T1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 16/07/2022 12:03:30 UMUM KS IGD 1 37,431 9,569 0 3,000 0 0 0 50,000
TYOWARDHANA, AN 0000110 ARDHIANSYAH, AMd.Ankes Sp.A.
8/1/22, 8:34 AM Page 52 of 107

1559 2022/07/16/000123 045126 LINDA NOVIANA, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 16/07/2022 10:38:48 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
1560 2022/07/16/000123 045126 LINDA NOVIANA, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 16/07/2022 10:38:48 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
1561 2022/07/16/000123 045126 LINDA NOVIANA, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 16/07/2022 13:22:30 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
1562 2022/07/16/000123 045126 LINDA NOVIANA, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 16/07/2022 10:38:48 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1563 2022/07/16/000123 045126 LINDA NOVIANA, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 16/07/2022 10:38:48 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1564 2022/07/16/000131 072393 SRI MARIYANI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 16/07/2022 12:08:06 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1565 2022/07/16/000131 072393 SRI MARIYANI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 16/07/2022 19:28:47 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1566 2022/07/16/000131 072393 SRI MARIYANI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 16/07/2022 12:08:06 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1567 2022/07/16/000131 072393 SRI MARIYANI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 16/07/2022 12:08:06 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1568 2022/07/16/000131 072393 SRI MARIYANI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 16/07/2022 12:08:06 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1569 2022/07/16/000131 072393 SRI MARIYANI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 16/07/2022 12:06:56 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1570 2022/07/16/000138 068115 KIRANIA SHAKILLA JENAKA, AN BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 16/07/2022 14:40:03 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1571 2022/07/16/000138 068115 KIRANIA SHAKILLA JENAKA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 16/07/2022 13:59:44 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
1572 2022/07/16/000142 027513 ARABELLA KHANSA PERMATA BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 16/07/2022 15:19:52 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
CHANDRA, AN 0110 AMd.AnKes. Sp.A. KESEHATAN
1573 2022/07/16/000142 027513 ARABELLA KHANSA PERMATA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 16/07/2022 15:06:41 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
CHANDRA, AN 001 AMd.AnKes. KESEHATAN
1574 2022/07/16/000144 069621 HABIBAH AMELIA, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 16/07/2022 16:12:46 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
1575 2022/07/16/000144 069621 HABIBAH AMELIA, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 16/07/2022 16:12:46 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
1576 2022/07/16/000144 069621 HABIBAH AMELIA, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 16/07/2022 16:08:48 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
1577 2022/07/16/000144 069621 HABIBAH AMELIA, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 16/07/2022 16:12:46 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1578 2022/07/16/000144 069621 HABIBAH AMELIA, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 16/07/2022 16:12:46 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1579 2022/07/16/000157 042104 AZKA MAULANA AL FATIH, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 16/07/2022 19:39:39 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
1580 2022/07/16/000164 072422 RAGIL AYU PUSPITASARI,NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 16/07/2022 19:34:24 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
1581 2022/07/16/000164 072422 RAGIL AYU PUSPITASARI,NY BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 16/07/2022 19:34:24 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
1582 2022/07/16/000164 072422 RAGIL AYU PUSPITASARI,NY BPJS.RJ000 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 16/07/2022 19:34:24 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
1583 2022/07/16/000164 072422 RAGIL AYU PUSPITASARI,NY BPJS.RJ000 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 16/07/2022 19:34:24 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
1584 2022/07/16/000164 072422 RAGIL AYU PUSPITASARI,NY BPJS.RJ000 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 16/07/2022 19:32:52 BPJS IGD 37,400 47,600 0 5,000 5,000 0 0 95,000
1585 2022/07/16/000166 069275 MUHAMMAD ARKANANTA H., BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 16/07/2022 20:30:46 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
1586 2022/07/16/000166 069275 MUHAMMAD ARKANANTA H., BPJS.K2B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 16/07/2022 20:31:22 BPJS KS IGD 5 37,400 47,600 0 5,000 5,000 0 0 95,000
1587 2022/07/16/000172 060193 ANGGAR DWI MERDEKASARI, BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 16/07/2022 23:46:05 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
NY 00001 MENUR, Sp.OG KESEHATAN 2
1588 2022/07/16/000172 060193 ANGGAR DWI MERDEKASARI, BPJS.K2UP1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 16/07/2022 23:46:05 BPJS KS Kamar Bersalin 32,431 9,569 0 3,000 0 0 0 45,000
8/1/22, 8:34 AM Page 53 of 107

1589 2022/07/16/000172 060193 ANGGAR DWI MERDEKASARI, BPJS.K2UP1 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 16/07/2022 23:46:05 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
1590 2022/07/16/000172 060193 ANGGAR DWI MERDEKASARI, BPJS.K2UP1 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 16/07/2022 23:46:05 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
1591 2022/07/16/000172 060193 ANGGAR DWI MERDEKASARI, BPJS.K2UP1 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 16/07/2022 23:44:46 BPJS KS Kamar Bersalin 44,800 35,200 0 5,000 5,000 0 0 90,000
1592 2022/07/14/000101 036985 ALVARO KASRO PURBA,AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 17/07/2022 09:13:38 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1593 2022/07/15/000104 061104 AMIRA SOFIA CLARINTA, AN BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 9070009 dr. MOHAMMAD MUCHLIS, 17/07/2022 09:11:48 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
1594 2022/07/16/000110 083181 HAFIZAH BRILIANI PUTRI N R, BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 17/07/2022 16:36:46 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1595 2022/07/16/000159 061344 NOVI INDRIANI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 17/07/2022 05:58:03 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1596 2022/07/16/000172 060193 ANGGAR DWI MERDEKASARI, BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 17/07/2022 16:38:09 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
NY 00001 AMd.AK. MENUR, Sp.OG KESEHATAN 2
1597 2022/07/17/000028 045938 RENITA KHULFIANA,NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 17/07/2022 04:04:16 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
1598 2022/07/17/000028 045938 RENITA KHULFIANA,NY BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 17/07/2022 04:04:16 BPJS KS IGD 10 32,431 9,569 0 3,000 0 0 0 45,000
1599 2022/07/17/000028 045938 RENITA KHULFIANA,NY BPJS.K1B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 17/07/2022 04:04:16 BPJS KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
1600 2022/07/17/000028 045938 RENITA KHULFIANA,NY BPJS.K1B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 17/07/2022 04:04:16 BPJS KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
1601 2022/07/17/000028 045938 RENITA KHULFIANA,NY BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 17/07/2022 04:04:45 BPJS KS IGD 10 44,800 35,200 0 5,000 5,000 0 0 90,000
1602 2022/07/17/000032 045126 LINDA NOVIANA, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 17/07/2022 16:35:23 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1603 2022/07/17/000035 101873 TRIANA PRASETYA PUTRI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 17/07/2022 07:54:44 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1604 2022/07/17/000035 101873 TRIANA PRASETYA PUTRI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 17/07/2022 16:32:54 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1605 2022/07/17/000035 101873 TRIANA PRASETYA PUTRI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 17/07/2022 07:54:44 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1606 2022/07/17/000035 101873 TRIANA PRASETYA PUTRI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 17/07/2022 07:54:44 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1607 2022/07/17/000035 101873 TRIANA PRASETYA PUTRI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 17/07/2022 07:54:44 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1608 2022/07/17/000035 101873 TRIANA PRASETYA PUTRI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 17/07/2022 07:53:16 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1609 2022/07/17/000037 072429 SUYANTI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 17/07/2022 08:23:12 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1610 2022/07/17/000037 072429 SUYANTI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 17/07/2022 16:39:34 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1611 2022/07/17/000037 072429 SUYANTI, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 17/07/2022 08:23:12 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1612 2022/07/17/000037 072429 SUYANTI, NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 17/07/2022 08:23:12 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1613 2022/07/17/000037 072429 SUYANTI, NY BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 17/07/2022 08:23:12 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1614 2022/07/17/000037 072429 SUYANTI, NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 17/07/2022 08:21:47 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1615 2022/07/17/000041 072432 NAO DANADYAKSA, AN BPJS.KFIS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 17/07/2022 09:58:59 BPJS KS Fisol 3 40,431 26,569 0 3,000 0 0 0 70,000
1616 2022/07/17/000043 067407 NOVA ARI SANDRA, NY UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 17/07/2022 09:26:50 UMUM KS IGD 1 50,431 26,569 0 3,000 0 0 0 80,000
1617 2022/07/17/000043 067407 NOVA ARI SANDRA, NY UMUM.K1B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 17/07/2022 09:26:50 UMUM KS IGD 1 42,431 9,569 0 3,000 0 0 0 55,000
1618 2022/07/17/000043 067407 NOVA ARI SANDRA, NY UMUM.K1B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 17/07/2022 09:26:50 UMUM KS IGD 1 42,436 564 0 2,000 0 0 0 45,000
8/1/22, 8:34 AM Page 54 of 107

1619 2022/07/17/000043 067407 NOVA ARI SANDRA, NY UMUM.K1B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 17/07/2022 09:26:50 UMUM KS IGD 1 42,436 564 0 2,000 0 0 0 45,000
1620 2022/07/17/000043 067407 NOVA ARI SANDRA, NY UMUM.K1B0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1150219 dr. FATMASARI PERDANA 17/07/2022 09:25:39 UMUM KS IGD 1 47,300 35,200 0 7,500 5,000 0 0 95,000
1621 2022/07/17/000049 072436 PUJI ASTUTI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 17/07/2022 10:46:05 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
1622 2022/07/17/000049 072436 PUJI ASTUTI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 17/07/2022 10:46:05 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
1623 2022/07/17/000049 072436 PUJI ASTUTI, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 17/07/2022 10:46:05 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1624 2022/07/17/000049 072436 PUJI ASTUTI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 17/07/2022 10:46:36 UMUM Laboratorium 47,300 35,200 0 7,500 5,000 0 0 95,000
1625 2022/07/17/000049 072436 PUJI ASTUTI, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 17/07/2022 10:46:05 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1626 2022/07/17/000053 082680 NURUL LAILI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 17/07/2022 11:40:00 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
1627 2022/07/17/000053 082680 NURUL LAILI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 17/07/2022 11:40:00 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
1628 2022/07/17/000053 082680 NURUL LAILI, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 17/07/2022 11:40:00 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1629 2022/07/17/000053 082680 NURUL LAILI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 17/07/2022 11:40:31 UMUM Laboratorium 47,300 35,200 0 7,500 5,000 0 0 95,000
1630 2022/07/17/000053 082680 NURUL LAILI, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 17/07/2022 11:40:00 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1631 2022/07/17/000055 085679 ALVIRA PUTRI ARILIA, AN BPJS.K3UP2 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1160202 dr. DEWI NURINDAH, Sp.A, 17/07/2022 12:36:58 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1632 2022/07/17/000055 085679 ALVIRA PUTRI ARILIA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 17/07/2022 11:45:14 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
1633 2022/07/17/000055 085679 ALVIRA PUTRI ARILIA, AN UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 17/07/2022 11:45:14 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
1634 2022/07/17/000055 085679 ALVIRA PUTRI ARILIA, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 17/07/2022 11:45:14 BPJS IGD 31,931 10,069 0 3,000 0 0 0 45,000
1635 2022/07/17/000056 072437 SHEZA AULIA SALSABILA, AN UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 17/07/2022 13:26:18 UMUM KS IGD 2 50,431 26,569 0 3,000 0 0 0 75,000
1636 2022/07/17/000056 072437 SHEZA AULIA SALSABILA, AN UMUM.K2B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 17/07/2022 13:26:18 UMUM KS IGD 2 37,431 9,569 0 3,000 0 0 0 50,000
1637 2022/07/17/000061 071852 MISTIANI, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 17/07/2022 16:16:58 BPJS Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
1638 2022/07/17/000061 071852 MISTIANI, NY BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 17/07/2022 16:16:58 BPJS Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
1639 2022/07/17/000061 071852 MISTIANI, NY BPJS.RJ000 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 17/07/2022 16:16:58 BPJS Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1640 2022/07/17/000061 071852 MISTIANI, NY BPJS.RJ000 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 17/07/2022 16:28:55 BPJS Laboratorium 44,800 35,200 0 5,000 5,000 0 0 90,000
1641 2022/07/17/000061 071852 MISTIANI, NY BPJS.RJ000 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 17/07/2022 16:16:58 BPJS Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1642 2022/07/17/000073 047484 TUSIANTI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 17/07/2022 16:28:21 BPJS KS Amarta 3 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK. SUSILO,Sp.OG. KESEHATAN (ISOLASI)
1643 2022/07/17/000073 047484 TUSIANTI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 17/07/2022 16:28:21 BPJS KS Amarta 3 32,431 9,569 0 3,000 0 0 0 45,000
1644 2022/07/17/000073 047484 TUSIANTI, NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 17/07/2022 18:28:37 BPJS KS Amarta 3 30,390 6,610 0 3,000 0 0 0 40,000
1645 2022/07/17/000073 047484 TUSIANTI, NY BPJS.K3B00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 17/07/2022 16:28:21 BPJS KS Amarta 3 37,951 38,049 0 4,000 0 0 0 80,000
1646 2022/07/17/000073 047484 TUSIANTI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 17/07/2022 16:29:25 BPJS KS Amarta 3 44,800 35,200 0 5,000 5,000 0 0 90,000
1647 2022/07/17/000073 047484 TUSIANTI, NY BPJS.K3B00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 17/07/2022 16:28:21 BPJS KS Amarta 3 37,951 38,049 0 4,000 0 0 0 80,000
1648 2022/07/17/000075 071917 SULISTIYOWATI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 17/07/2022 16:56:17 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
8/1/22, 8:34 AM Page 55 of 107

1649 2022/07/17/000075 071917 SULISTIYOWATI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 17/07/2022 16:56:17 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
1650 2022/07/17/000075 071917 SULISTIYOWATI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 17/07/2022 17:22:17 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
1651 2022/07/17/000075 071917 SULISTIYOWATI, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 17/07/2022 16:56:17 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1652 2022/07/17/000075 071917 SULISTIYOWATI, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 17/07/2022 16:56:17 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1653 2022/07/17/000080 099609 HERA NUR DUNIARTI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 17/07/2022 17:30:31 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK.
1654 2022/07/17/000080 099609 HERA NUR DUNIARTI, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 17/07/2022 17:30:31 UMUM IGD 30,390 6,610 0 3,000 0 0 0 40,000
0021 AMd.AK.
1655 2022/07/17/000080 099609 HERA NUR DUNIARTI, NY UMUM.RJ00 Plano Test 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 17/07/2022 17:30:31 UMUM IGD 33,140 4,860 0 2,000 0 0 0 40,000
0022 AMd.AK.
1656 2022/07/17/000084 072443 AMIIRAH MUTHIA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 17/07/2022 20:34:26 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
RAHMAPUTRI, AN 001 AMd.AK. Sp.A.
1657 2022/07/17/000084 072443 AMIIRAH MUTHIA UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 17/07/2022 20:34:26 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
RAHMAPUTRI, AN 009 AMd.AK. Sp.A.
1658 2022/07/17/000092 072446 TIANA, NY UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 17/07/2022 20:24:35 UMUM KS IGD 1 50,431 26,569 0 3,000 0 0 0 80,000
1659 2022/07/17/000092 072446 TIANA, NY UMUM.K1B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 17/07/2022 20:24:35 UMUM KS IGD 1 42,431 9,569 0 3,000 0 0 0 55,000
1660 2022/07/17/000092 072446 TIANA, NY UMUM.K1B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 17/07/2022 20:24:35 UMUM KS IGD 1 42,436 564 0 2,000 0 0 0 45,000
1661 2022/07/17/000092 072446 TIANA, NY UMUM.K1B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 17/07/2022 20:24:35 UMUM KS IGD 1 42,436 564 0 2,000 0 0 0 45,000
1662 2022/07/17/000092 072446 TIANA, NY UMUM.K1B0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 17/07/2022 20:24:51 UMUM KS IGD 1 47,300 35,200 0 7,500 5,000 0 0 95,000
1663 2022/07/17/000095 072447 ATIK RETNO NUR PALUPIANTI, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 17/07/2022 20:37:04 BPJS Amarta 5A 40,431 26,569 0 3,000 0 0 0 70,000
NY 001 AMd.AK. KARTIKARINI, Sp.OG KESEHATAN
1664 2022/07/17/000095 072447 ATIK RETNO NUR PALUPIANTI, BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 17/07/2022 20:37:04 BPJS Amarta 5A 32,431 9,569 0 3,000 0 0 0 45,000
1665 2022/07/17/000095 072447 ATIK RETNO NUR PALUPIANTI, BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 17/07/2022 20:37:04 BPJS Amarta 5A 32,436 564 0 2,000 0 0 0 35,000
1666 2022/07/17/000095 072447 ATIK RETNO NUR PALUPIANTI, BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 17/07/2022 20:37:04 BPJS Amarta 5A 32,436 564 0 2,000 0 0 0 35,000
1667 2022/07/17/000095 072447 ATIK RETNO NUR PALUPIANTI, BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 17/07/2022 20:37:16 BPJS Amarta 5A 44,800 35,200 0 5,000 5,000 0 0 90,000
1668 2022/07/17/000097 034071 NOVI ANITA SAFITRI, NN KYN.RJ0000 Anti HIV 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 17/07/2022 20:54:45 KARYAWAN Laboratorium 30,951 34,049 0 2,000 0 0 0 67,000
26 AMd.AK. karyawan
1669 2022/07/17/000098 051817 MIKAILA RAMADHANI, AN UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 17/07/2022 21:40:47 UMUM KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
1670 2022/07/17/000098 051817 MIKAILA RAMADHANI, AN UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 17/07/2022 21:40:47 UMUM KS IGD 6 32,431 9,569 0 3,000 0 0 0 45,000
1671 2022/07/17/000100 067726 DITA ANGGRAENI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 17/07/2022 21:58:15 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
1672 2022/07/17/000100 067726 DITA ANGGRAENI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 17/07/2022 21:58:15 UMUM IGD 32,431 9,569 0 3,000 0 0 0 45,000
1673 2022/07/17/000100 067726 DITA ANGGRAENI, NY UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 17/07/2022 21:58:15 UMUM IGD 32,436 564 0 2,000 0 0 0 35,000
1674 2022/07/17/000100 067726 DITA ANGGRAENI, NY UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 17/07/2022 21:58:15 UMUM IGD 32,436 564 0 2,000 0 0 0 35,000
1675 2022/07/17/000100 067726 DITA ANGGRAENI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 17/07/2022 21:57:18 UMUM IGD 47,300 35,200 0 7,500 5,000 0 0 95,000
1676 2022/07/13/000215 072296 BRAM KAIVAN ASEGAF, AN BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 18/07/2022 13:46:15 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
1677 2022/07/14/000161 072357 GEFANDA AFRISSA SYAFAZEA, BPJS.KFIS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 18/07/2022 06:36:32 BPJS KS Fisol 2 40,431 26,569 0 3,000 0 0 0 70,000
1678 2022/07/14/000161 072357 GEFANDA AFRISSA SYAFAZEA, BPJS.KFIS0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 18/07/2022 06:36:32 BPJS KS Fisol 2 32,431 9,569 0 3,000 0 0 0 45,000
1679 2022/07/14/000161 072357 GEFANDA AFRISSA SYAFAZEA, BPJS. PPT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 18/07/2022 06:36:32 BPJS KS Fisol 2 37,951 38,049 0 4,000 0 0 0 80,000
ARDHIANSYAH, M.
8/1/22, 8:34 AM Page 56 of 107
KFIS00005 AMd.Ankes Biomed.
1680 2022/07/14/000161 072357 GEFANDA AFRISSA SYAFAZEA, BPJS.KFIS0 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 18/07/2022 06:36:32 BPJS KS Fisol 2 37,951 38,049 0 4,000 0 0 0 80,000
1681 2022/07/15/000104 061104 AMIRA SOFIA CLARINTA, AN BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 18/07/2022 10:29:49 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
1682 2022/07/16/000110 083181 HAFIZAH BRILIANI PUTRI N R, BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 18/07/2022 16:14:39 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1683 2022/07/16/000138 068115 KIRANIA SHAKILLA JENAKA, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 18/07/2022 16:11:52 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A. KESEHATAN
1684 2022/07/17/000028 045938 RENITA KHULFIANA,NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 18/07/2022 06:41:37 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
1685 2022/07/17/000043 067407 NOVA ARI SANDRA, NY UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 18/07/2022 19:41:25 UMUM KS IGD 1 50,431 26,569 0 3,000 0 0 0 80,000
0001 MENUR, Sp.OG
1686 2022/07/17/000057 082680 NURUL LAILI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10050002 dr. PANDE MADE 18/07/2022 06:43:13 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1687 2022/07/17/000057 082680 NURUL LAILI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 18/07/2022 13:43:51 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1688 2022/07/17/000062 071852 MISTIANI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 18/07/2022 13:54:46 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1689 2022/07/17/000073 047484 TUSIANTI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 18/07/2022 11:41:17 BPJS KS Amarta 3 40,431 26,569 0 3,000 0 0 0 70,000
001 SUSILO,Sp.OG. KESEHATAN (ISOLASI)
1690 2022/07/17/000073 047484 TUSIANTI, NY BPJS.K3B00 Gula Darah 2 Jam PP 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 18/07/2022 11:41:17 BPJS KS Amarta 3 32,431 9,569 0 3,000 0 0 0 45,000
1691 2022/07/17/000073 047484 TUSIANTI, NY BPJS.KI0000 Gula Darah Puasa 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 18/07/2022 11:41:17 BPJS KS Amarta 3 32,431 9,569 0 3,000 0 0 0 45,000
1692 2022/07/17/000095 072447 ATIK RETNO NUR PALUPIANTI, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 18/07/2022 06:30:20 BPJS Amarta 5A 40,431 26,569 0 3,000 0 0 0 70,000
NY 001 ARDHIANSYAH, AMd.Ankes KARTIKARINI, Sp.OG KESEHATAN
1693 2022/07/17/000100 067726 DITA ANGGRAENI, NY UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 18/07/2022 13:51:52 UMUM Amarta 6A 40,431 26,569 0 3,000 0 0 0 70,000
0001 SUSILO,Sp.OG.
1694 2022/07/18/000031 072096 MARYAM INNARA KHAYR, AN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 18/07/2022 19:43:06 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
0020 Sp.A.
1695 2022/07/18/000054 072090 RAKA ARZANKA RIZKY UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 18/07/2022 18:28:14 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
PURWANTO, AN 0020 Sp.A.
1696 2022/07/18/000078 070520 MUHIMMATIN BASYARIAH, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 18/07/2022 13:14:11 UMUM Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
001 WISANA, Sp.OG.
1697 2022/07/18/000078 070520 MUHIMMATIN BASYARIAH, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 18/07/2022 13:14:11 UMUM Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
1698 2022/07/18/000078 070520 MUHIMMATIN BASYARIAH, NY UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 18/07/2022 13:14:11 UMUM Poli Kandungan 32,436 564 0 2,000 0 0 0 35,000
003 WISANA, Sp.OG.
1699 2022/07/18/000078 070520 MUHIMMATIN BASYARIAH, NY UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 18/07/2022 13:14:11 UMUM Poli Kandungan 32,436 564 0 2,000 0 0 0 35,000
004 WISANA, Sp.OG.
1700 2022/07/18/000078 070520 MUHIMMATIN BASYARIAH, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 18/07/2022 13:13:03 UMUM Poli Kandungan 37,900 47,600 0 7,500 5,000 0 0 98,000
0047 WISANA, Sp.OG.
1701 2022/07/18/000079 062104 AGUSTINA PERMATA SARI, NY BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 18/07/2022 06:47:14 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1702 2022/07/18/000079 062104 AGUSTINA PERMATA SARI, NY BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 18/07/2022 13:49:38 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1703 2022/07/18/000079 062104 AGUSTINA PERMATA SARI, NY BPJS.K2UP1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 18/07/2022 06:47:14 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
1704 2022/07/18/000079 062104 AGUSTINA PERMATA SARI, NY BPJS.K2UP1 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 18/07/2022 06:47:14 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
1705 2022/07/18/000079 062104 AGUSTINA PERMATA SARI, NY BPJS.K2UP1 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 18/07/2022 06:47:14 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
1706 2022/07/18/000079 062104 AGUSTINA PERMATA SARI, NY BPJS.K2UP1 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 18/07/2022 06:46:25 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
1707 2022/07/18/000080 072449 SITI KOMARIYAH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 18/07/2022 05:03:54 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1708 2022/07/18/000080 072449 SITI KOMARIYAH, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 18/07/2022 05:03:54 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
8/1/22, 8:34 AM Page 57 of 107

1709 2022/07/18/000080 072449 SITI KOMARIYAH, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 18/07/2022 06:31:42 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1710 2022/07/18/000080 072449 SITI KOMARIYAH, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 18/07/2022 06:31:42 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1711 2022/07/18/000080 072449 SITI KOMARIYAH, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 18/07/2022 05:03:12 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1712 2022/07/18/000085 071917 SULISTIYOWATI, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 18/07/2022 16:18:02 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1713 2022/07/18/000090 072450 IRFAN RADITIYA, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 18/07/2022 08:45:00 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A. KESEHATAN
1714 2022/07/18/000090 072450 IRFAN RADITIYA, AN BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 18/07/2022 08:45:00 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1715 2022/07/18/000090 072450 IRFAN RADITIYA, AN BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 18/07/2022 08:44:04 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1716 2022/07/18/000096 072453 MUKAMMAD SUKRON, TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8170324 dr. EDWIN PRADANA, 18/07/2022 11:20:19 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
0031 Sp.And.
1717 2022/07/18/000105 071898 FARID WAHYU NUGROHO, TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8170324 dr. EDWIN PRADANA, 18/07/2022 11:20:48 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
0031 Sp.And.
1718 2022/07/18/000112 070781 NENA MARISCA ANGELINA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 18/07/2022 11:35:53 UMUM Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
USMAN, NY 001 DWIJAYASA, Sp.OG (K)
1719 2022/07/18/000112 070781 NENA MARISCA ANGELINA UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 18/07/2022 11:35:53 UMUM Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
1720 2022/07/18/000112 070781 NENA MARISCA ANGELINA UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 18/07/2022 11:35:53 UMUM Poli Kandungan 30,390 6,610 0 3,000 0 0 0 40,000
1721 2022/07/18/000112 070781 NENA MARISCA ANGELINA UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 18/07/2022 11:32:52 UMUM Poli Kandungan 37,900 47,600 0 7,500 5,000 0 0 98,000
1722 2022/07/18/000112 070781 NENA MARISCA ANGELINA UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 18/07/2022 11:35:53 UMUM Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
1723 2022/07/18/000112 070781 NENA MARISCA ANGELINA UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 18/07/2022 11:35:53 UMUM Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
1724 2022/07/18/000113 026207 ARISTA SUHARTANTI, Ny. BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 18/07/2022 08:54:41 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
001 MENUR, Sp.OG KESEHATAN 1/Ayodya 1
1725 2022/07/18/000113 026207 ARISTA SUHARTANTI, Ny. BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 18/07/2022 16:25:27 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK. MENUR, Sp.OG KESEHATAN 1/Ayodya 1
1726 2022/07/18/000113 026207 ARISTA SUHARTANTI, Ny. BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 18/07/2022 08:54:41 BPJS Dwarawati 32,431 9,569 0 3,000 0 0 0 45,000
1727 2022/07/18/000113 026207 ARISTA SUHARTANTI, Ny. BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 18/07/2022 08:54:41 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
1728 2022/07/18/000113 026207 ARISTA SUHARTANTI, Ny. BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 18/07/2022 08:54:41 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
1729 2022/07/18/000113 026207 ARISTA SUHARTANTI, Ny. BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 18/07/2022 08:53:13 BPJS Dwarawati 44,800 35,200 0 5,000 5,000 0 0 90,000
1730 2022/07/18/000120 027277 Winarsih Sri Rahayu, Ny BPJS.RJ000 Cholesterol 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 18/07/2022 12:43:16 BPJS Poli Penyakit 29,951 12,049 0 3,000 0 0 0 45,000
1731 2022/07/18/000120 027277 Winarsih Sri Rahayu, Ny BPJS.RJ000 HDL 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 18/07/2022 11:51:10 BPJS Poli Penyakit 34,951 22,049 0 3,000 0 0 0 60,000
1732 2022/07/18/000120 027277 Winarsih Sri Rahayu, Ny BPJS.RJ000 HDL 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 18/07/2022 12:43:16 BPJS Poli Penyakit 34,951 22,049 0 3,000 0 0 0 60,000
1733 2022/07/18/000120 027277 Winarsih Sri Rahayu, Ny BPJS.RJ000 LDL 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 18/07/2022 11:51:10 BPJS Poli Penyakit 34,951 22,049 0 3,000 0 0 0 60,000
1734 2022/07/18/000120 027277 Winarsih Sri Rahayu, Ny BPJS.RJ000 LDL 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 18/07/2022 12:43:16 BPJS Poli Penyakit 34,951 22,049 0 3,000 0 0 0 60,000
1735 2022/07/18/000120 027277 Winarsih Sri Rahayu, Ny BPJS.RJ000 Trigliserida 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 18/07/2022 11:51:10 BPJS Poli Penyakit 34,951 17,049 0 3,000 0 0 0 55,000
1736 2022/07/18/000120 027277 Winarsih Sri Rahayu, Ny BPJS.RJ000 Trigliserida 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 18/07/2022 12:43:16 BPJS Poli Penyakit 34,951 17,049 0 3,000 0 0 0 55,000
1737 2022/07/18/000120 027277 Winarsih Sri Rahayu, Ny BPJS.RJ000 Gula Darah Puasa 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 18/07/2022 11:51:10 BPJS Poli Penyakit 32,431 9,569 0 3,000 0 0 0 45,000
1738 2022/07/18/000120 027277 Winarsih Sri Rahayu, Ny BPJS.RJ000 Gula Darah Puasa 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 18/07/2022 12:43:16 BPJS Poli Penyakit 32,431 9,569 0 3,000 0 0 0 45,000
1739 2022/07/18/000120 027277 Winarsih Sri Rahayu, Ny BPJS. Gula Darah 2 Jam PP 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 18/07/2022 11:51:10 BPJS Poli Penyakit 32,431 9,569 0 3,000 0 0 0 45,000
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RJ0000310 Dalam
1740 2022/07/18/000120 027277 Winarsih Sri Rahayu, Ny BPJS.RJ000 Gula Darah 2 Jam PP 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 18/07/2022 12:43:16 BPJS Poli Penyakit 32,431 9,569 0 3,000 0 0 0 45,000
1741 2022/07/18/000133 072070 QUEENAYA ZELINE ARUNA,AN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 18/07/2022 19:52:34 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
0020 Sp.A.
1742 2022/07/18/000136 063191 FITLIN, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 18/07/2022 11:02:32 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001
1743 2022/07/18/000136 063191 FITLIN, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 18/07/2022 11:02:32 UMUM IGD 30,390 6,610 0 3,000 0 0 0 40,000
0021
1744 2022/07/18/000137 070251 NANUNG SOBIYAH,NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 18/07/2022 11:11:30 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1745 2022/07/18/000137 070251 NANUNG SOBIYAH,NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 18/07/2022 16:24:03 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1746 2022/07/18/000137 070251 NANUNG SOBIYAH,NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 18/07/2022 11:11:30 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1747 2022/07/18/000137 070251 NANUNG SOBIYAH,NY BPJS.K2B00 SGOT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 18/07/2022 11:11:30 BPJS KS IGD 1 34,451 12,549 0 3,000 0 0 0 50,000
1748 2022/07/18/000137 070251 NANUNG SOBIYAH,NY BPJS.K2B00 SGPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 18/07/2022 11:11:30 BPJS KS IGD 1 34,451 12,549 0 3,000 0 0 0 50,000
1749 2022/07/18/000137 070251 NANUNG SOBIYAH,NY BPJS.K2B00 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 18/07/2022 11:11:30 BPJS KS IGD 1 31,451 10,549 0 3,000 0 0 0 45,000
1750 2022/07/18/000137 070251 NANUNG SOBIYAH,NY BPJS.K2B00 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 18/07/2022 11:11:30 BPJS KS IGD 1 33,951 13,049 0 3,000 0 0 0 50,000
1751 2022/07/18/000137 070251 NANUNG SOBIYAH,NY BPJS.K2B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 18/07/2022 11:17:03 BPJS KS IGD 1 30,390 6,610 0 3,000 0 0 0 40,000
1752 2022/07/18/000137 070251 NANUNG SOBIYAH,NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 18/07/2022 11:11:30 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1753 2022/07/18/000137 070251 NANUNG SOBIYAH,NY BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 18/07/2022 11:11:30 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1754 2022/07/18/000137 070251 NANUNG SOBIYAH,NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 18/07/2022 11:11:45 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1755 2022/07/18/000149 012259 DEWI PERMATA SARI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 18/07/2022 11:48:28 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
001 SUSILO,Sp.OG.
1756 2022/07/18/000149 012259 DEWI PERMATA SARI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 18/07/2022 11:48:28 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
00110 SUSILO,Sp.OG.
1757 2022/07/18/000149 012259 DEWI PERMATA SARI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 18/07/2022 11:45:22 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
0047 SUSILO,Sp.OG.
1758 2022/07/18/000149 012259 DEWI PERMATA SARI, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 18/07/2022 11:48:28 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
005 SUSILO,Sp.OG.
1759 2022/07/18/000149 012259 DEWI PERMATA SARI, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 18/07/2022 11:48:28 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
006 SUSILO,Sp.OG.
1760 2022/07/18/000154 072478 JITA SARI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 18/07/2022 12:06:20 UMUM Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
001 WISANA, Sp.OG.
1761 2022/07/18/000156 072479 APRILIA ALIFVIAN, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 18/07/2022 11:04:32 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1762 2022/07/18/000156 072479 APRILIA ALIFVIAN, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 18/07/2022 16:20:18 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1763 2022/07/18/000156 072479 APRILIA ALIFVIAN, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 18/07/2022 11:04:32 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1764 2022/07/18/000156 072479 APRILIA ALIFVIAN, NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 18/07/2022 11:04:32 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1765 2022/07/18/000156 072479 APRILIA ALIFVIAN, NY BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 18/07/2022 11:04:32 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1766 2022/07/18/000156 072479 APRILIA ALIFVIAN, NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 18/07/2022 11:05:06 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1767 2022/07/18/000158 072382 ERNI YUNIATI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 18/07/2022 17:57:23 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
1768 2022/07/18/000158 072382 ERNI YUNIATI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 18/07/2022 17:57:23 BPJS KS IGD 5 32,431 9,569 0 3,000 0 0 0 45,000
1769 2022/07/18/000158 072382 ERNI YUNIATI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 18/07/2022 17:57:23 BPJS KS IGD 5 32,436 564 0 2,000 0 0 0 35,000
8/1/22, 8:34 AM Page 59 of 107

1770 2022/07/18/000158 072382 ERNI YUNIATI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 18/07/2022 17:57:23 BPJS KS IGD 5 32,436 564 0 2,000 0 0 0 35,000
1771 2022/07/18/000158 072382 ERNI YUNIATI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 18/07/2022 17:57:33 BPJS KS IGD 5 44,800 35,200 0 5,000 5,000 0 0 90,000
1772 2022/07/18/000169 061338 CHAMIDA NABILA, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 18/07/2022 12:21:57 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
001 DWIJAYASA, Sp.OG (K) KESEHATAN 2/Ayodya 1
1773 2022/07/18/000169 061338 CHAMIDA NABILA, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 18/07/2022 12:21:57 BPJS Dwarawati 32,431 9,569 0 3,000 0 0 0 45,000
1774 2022/07/18/000169 061338 CHAMIDA NABILA, NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 18/07/2022 12:21:57 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
1775 2022/07/18/000169 061338 CHAMIDA NABILA, NY BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 18/07/2022 12:21:57 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
1776 2022/07/18/000169 061338 CHAMIDA NABILA, NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 18/07/2022 12:53:07 BPJS Dwarawati 44,800 35,200 0 5,000 5,000 0 0 90,000
1777 2022/07/18/000169 061338 CHAMIDA NABILA, NY BPJS.K3000 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 18/07/2022 12:21:57 BPJS Dwarawati 30,390 6,610 0 3,000 0 0 0 40,000
1778 2022/07/18/000177 072370 SANDY REMA NUR CAHYA, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 18/07/2022 12:51:46 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1779 2022/07/18/000177 072370 SANDY REMA NUR CAHYA, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 18/07/2022 12:51:46 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1780 2022/07/18/000177 072370 SANDY REMA NUR CAHYA, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 18/07/2022 12:51:46 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1781 2022/07/18/000177 072370 SANDY REMA NUR CAHYA, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 18/07/2022 12:51:46 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1782 2022/07/18/000177 072370 SANDY REMA NUR CAHYA, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 18/07/2022 12:52:23 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1783 2022/07/18/000179 072482 NUR YENI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 18/07/2022 12:48:17 BPJS Amarta 5A 40,431 26,569 0 3,000 0 0 0 70,000
1784 2022/07/18/000179 072482 NUR YENI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 18/07/2022 12:48:17 BPJS Amarta 5A 32,431 9,569 0 3,000 0 0 0 45,000
1785 2022/07/18/000179 072482 NUR YENI, NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 18/07/2022 12:48:17 BPJS Amarta 5A 30,390 6,610 0 3,000 0 0 0 40,000
1786 2022/07/18/000179 072482 NUR YENI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 18/07/2022 12:48:17 BPJS Amarta 5A 32,436 564 0 2,000 0 0 0 35,000
1787 2022/07/18/000179 072482 NUR YENI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 18/07/2022 12:48:17 BPJS Amarta 5A 32,436 564 0 2,000 0 0 0 35,000
1788 2022/07/18/000179 072482 NUR YENI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 18/07/2022 12:44:32 BPJS Amarta 5A 44,800 35,200 0 5,000 5,000 0 0 90,000
1789 2022/07/18/000198 062689 QIANA ARSYILA FAQIH, An BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 18/07/2022 20:27:01 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
1790 2022/07/18/000198 062689 QIANA ARSYILA FAQIH, An BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 18/07/2022 20:27:01 BPJS KS IGD 5 32,431 9,569 0 3,000 0 0 0 45,000
1791 2022/07/18/000205 072490 NIFTAQUL WIDJAYANTI BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 18/07/2022 16:29:00 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
MASRUROH, NY 001 AMd.AK. KESEHATAN
1792 2022/07/18/000205 072490 NIFTAQUL WIDJAYANTI BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 18/07/2022 16:29:00 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
1793 2022/07/18/000205 072490 NIFTAQUL WIDJAYANTI BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 18/07/2022 16:29:00 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
1794 2022/07/18/000205 072490 NIFTAQUL WIDJAYANTI BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 18/07/2022 16:29:00 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
1795 2022/07/18/000205 072490 NIFTAQUL WIDJAYANTI BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 18/07/2022 16:32:28 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
1796 2022/07/18/000213 072493 MARINDA MARETA SAPUTRI,NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 18/07/2022 17:41:13 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK. INDRAWAN, Sp. OG (K) KESEHATAN 6/Ayodya 3
1797 2022/07/18/000213 072493 MARINDA MARETA SAPUTRI,NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 18/07/2022 17:41:13 BPJS Dwarawati 32,431 9,569 0 3,000 0 0 0 45,000
1798 2022/07/18/000213 072493 MARINDA MARETA SAPUTRI,NY BPJS.K2B00 Anti HIV 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 18/07/2022 17:44:58 BPJS Dwarawati 38,951 34,049 0 2,000 0 0 0 75,000
1799 2022/07/18/000213 072493 MARINDA MARETA SAPUTRI,NY BPJS.K2B00 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 18/07/2022 17:44:58 BPJS Dwarawati 38,951 34,049 0 2,000 0 0 0 75,000
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1800 2022/07/18/000213 072493 MARINDA MARETA SAPUTRI,NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 18/07/2022 17:41:13 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
1801 2022/07/18/000213 072493 MARINDA MARETA SAPUTRI,NY BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 18/07/2022 17:41:13 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
1802 2022/07/18/000213 072493 MARINDA MARETA SAPUTRI,NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 18/07/2022 17:43:15 BPJS Dwarawati 44,800 35,200 0 5,000 5,000 0 0 90,000
1803 2022/07/18/000223 066913 ABU BAKAR SHAFARAZ, AN BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 18/07/2022 18:30:42 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1804 2022/07/18/000223 066913 ABU BAKAR SHAFARAZ, AN BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 18/07/2022 18:30:42 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1805 2022/07/18/000229 053600 ABQORY HILYA HAFIZHA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 18/07/2022 20:23:04 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
1806 2022/07/18/000231 072489 M. FADHIL AL- FAJRI, AN UMUM.K3T1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 18/07/2022 20:18:48 UMUM Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
00001 Sp.A. 8/Ayodya 4
1807 2022/07/18/000231 072489 M. FADHIL AL- FAJRI, AN UMUM.K3T1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 18/07/2022 20:18:48 UMUM Dwarawati 32,431 9,569 0 3,000 0 0 0 45,000
0000110 Sp.A. 8/Ayodya 4
1808 2022/07/18/000240 069621 HABIBAH AMELIA, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 18/07/2022 19:38:43 BPJS KS IGD 6 44,800 35,200 0 5,000 5,000 0 0 90,000
1809 2022/07/18/000244 056453 CHALIYATUL KARIMAH, AN UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 18/07/2022 20:36:46 UMUM KS IGD 6 50,431 26,569 0 3,000 0 0 0 80,000
0001 Sp.A.
1810 2022/07/18/000244 056453 CHALIYATUL KARIMAH, AN UMUM.K1B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 18/07/2022 20:36:46 UMUM KS IGD 6 42,431 9,569 0 3,000 0 0 0 55,000
000110 Sp.A.
1811 2022/07/18/000250 086890 LAILATUL MAHFIROH, NY UMUM.K3B0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4150215 dr. DEWI INDIASTARI, 18/07/2022 22:32:09 UMUM Amarta 8B 47,300 35,200 0 7,500 5,000 0 0 95,000
1812 2022/07/18/000250 086890 LAILATUL MAHFIROH, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 18/07/2022 21:12:17 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001
1813 2022/07/18/000250 086890 LAILATUL MAHFIROH, NY UMUM.RJ00 Gula Darah 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 18/07/2022 21:12:17 UMUM IGD 32,431 9,569 0 3,000 0 0 0 45,000
0010
1814 2022/07/18/000250 086890 LAILATUL MAHFIROH, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 18/07/2022 21:12:17 UMUM IGD 30,390 6,610 0 3,000 0 0 0 40,000
0021
1815 2022/07/18/000250 086890 LAILATUL MAHFIROH, NY UMUM.RJ00 Plano Test 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 18/07/2022 21:12:17 UMUM IGD 33,140 4,860 0 2,000 0 0 0 40,000
0022
1816 2022/07/18/000258 072515 IDAWATI, NY UMUM.K3T1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 18/07/2022 23:16:50 UMUM KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
00001 AMd.AnKes. SUSILO,Sp.OG. 3
1817 2022/07/18/000258 072515 IDAWATI, NY UMUM.K3T1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 18/07/2022 23:16:50 UMUM KS Kamar Bersalin 32,431 9,569 0 3,000 0 0 0 45,000
1818 2022/07/18/000258 072515 IDAWATI, NY UMUM.K3T1 Anti HIV 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 18/07/2022 23:16:50 UMUM KS Kamar Bersalin 38,951 34,049 0 2,000 0 0 0 75,000
1819 2022/07/18/000258 072515 IDAWATI, NY UMUM.K3T1 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 18/07/2022 23:16:50 UMUM KS Kamar Bersalin 38,951 34,049 0 2,000 0 0 0 75,000
1820 2022/07/18/000258 072515 IDAWATI, NY UMUM.K3T1 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 18/07/2022 23:16:50 UMUM KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
1821 2022/07/18/000258 072515 IDAWATI, NY UMUM.K3T1 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 18/07/2022 23:16:50 UMUM KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
1822 2022/07/18/000258 072515 IDAWATI, NY UMUM.K3T1 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 18/07/2022 23:18:17 UMUM KS Kamar Bersalin 47,300 35,200 0 7,500 5,000 0 0 95,000
1823 2022/07/13/000215 072296 BRAM KAIVAN ASEGAF, AN BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 19/07/2022 12:12:00 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
0001 AMd.AK. Sp.A. KESEHATAN 7/Ayodya 4
1824 2022/07/15/000104 061104 AMIRA SOFIA CLARINTA, AN BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 19/07/2022 11:58:16 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
1825 2022/07/16/000110 083181 HAFIZAH BRILIANI PUTRI N R, BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 19/07/2022 18:01:08 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1826 2022/07/16/000164 072422 RAGIL AYU PUSPITASARI,NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 1110218 dr. NOVINA PURWITA 19/07/2022 07:03:00 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
1827 2022/07/17/000057 082680 NURUL LAILI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 19/07/2022 07:05:40 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1828 2022/07/17/000073 047484 TUSIANTI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 4160205 dr. WAHYUDI JOKO 19/07/2022 06:59:26 BPJS KS Amarta 3 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AnKes. SUSILO,Sp.OG. KESEHATAN (ISOLASI)
1829 2022/07/18/000169 061338 CHAMIDA NABILA, NY BPJS. Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 19/07/2022 20:44:17 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
8/1/22, 8:34 AM Page 61 of 107

K2B00001 Sp.OG (K) 2/Ayodya 1
1830 2022/07/18/000179 072482 NUR YENI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 00:12:50 BPJS Amarta 5A 40,431 26,569 0 3,000 0 0 0 70,000
1831 2022/07/18/000213 072493 MARINDA MARETA SAPUTRI,NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 12:10:18 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
1832 2022/07/18/000240 069621 HABIBAH AMELIA, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 07:00:58 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
1833 2022/07/18/000250 086890 LAILATUL MAHFIROH, NY UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 19/07/2022 18:03:35 UMUM Amarta 8B 40,431 26,569 0 3,000 0 0 0 70,000
0001 Sp.PD.
1834 2022/07/18/000255 072508 AZLAN MAHASINUL HAQQ, AN BPJS.KFIS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 19/07/2022 00:07:46 BPJS KS Fisol 33 40,431 26,569 0 3,000 0 0 0 70,000
1835 2022/07/18/000257 072514 GANDA OKTAVARO, AN UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 19/07/2022 00:14:41 UMUM Amarta 1B 40,431 26,569 0 3,000 0 0 0 70,000
1836 2022/07/18/000257 072514 GANDA OKTAVARO, AN UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 19/07/2022 00:14:41 UMUM Amarta 1B 32,431 9,569 0 3,000 0 0 0 45,000
1837 2022/07/18/000257 072514 GANDA OKTAVARO, AN UMUM.K3B0 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 19/07/2022 00:14:41 UMUM Amarta 1B 31,931 10,069 0 3,000 0 0 0 45,000
1838 2022/07/18/000258 072515 IDAWATI, NY UMUM.K3T1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 19/07/2022 12:05:33 UMUM KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
00001 AMd.AK. SUSILO,Sp.OG. 3
1839 2022/07/18/000263 064356 AGUSNETI, NY UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 00:35:11 UMUM KS Kamar Bersalin 50,431 26,569 0 3,000 0 0 0 80,000
0001 AMd.AnKes. INDRAWAN, Sp. OG (K) 5
1840 2022/07/18/000263 064356 AGUSNETI, NY UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 12:08:03 UMUM KS Kamar Bersalin 50,431 26,569 0 3,000 0 0 0 80,000
0001 AMd.AK. INDRAWAN, Sp. OG (K) 5
1841 2022/07/18/000263 064356 AGUSNETI, NY UMUM.K1B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 00:35:11 UMUM KS Kamar Bersalin 42,431 9,569 0 3,000 0 0 0 55,000
1842 2022/07/18/000263 064356 AGUSNETI, NY UMUM.K1B0 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 00:39:34 UMUM KS Kamar Bersalin 40,390 6,610 0 3,000 0 0 0 50,000
1843 2022/07/18/000263 064356 AGUSNETI, NY UMUM.K1B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 00:35:11 UMUM KS Kamar Bersalin 42,436 564 0 2,000 0 0 0 45,000
1844 2022/07/18/000263 064356 AGUSNETI, NY UMUM.K1B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 00:35:11 UMUM KS Kamar Bersalin 42,436 564 0 2,000 0 0 0 45,000
1845 2022/07/18/000263 064356 AGUSNETI, NY UMUM.K1B0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 00:16:47 UMUM KS Kamar Bersalin 47,300 35,200 0 7,500 5,000 0 0 95,000
1846 2022/07/19/000021 071446 ALKAF RAZQA MAHENDRA, AN BPJS.RJ000 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 13:47:27 BPJS Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
1847 2022/07/19/000021 071446 ALKAF RAZQA MAHENDRA, AN BPJS.RJ000 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 13:47:27 BPJS Poli Anak 31,936 6,064 0 2,000 0 0 0 40,000
1848 2022/07/19/000021 071446 ALKAF RAZQA MAHENDRA, AN BPJS.RJ000 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 13:47:27 BPJS Poli Anak 31,436 6,564 0 2,000 0 0 0 40,000
1849 2022/07/19/000029 072417 SIERRA NAYA BESTARI, AN UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 15:44:48 UMUM Poli Anak 32,431 9,569 0 3,000 0 0 0 45,000
00110 M.Biomed.
1850 2022/07/19/000029 072417 SIERRA NAYA BESTARI, AN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 15:44:48 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
0020 M.Biomed.
1851 2022/07/19/000040 072511 MACHFUD, TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8170324 dr. EDWIN PRADANA, 19/07/2022 14:07:22 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
1852 2022/07/19/000057 097707 MOCHAMAD ABYZAR FARDAN, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 19/07/2022 00:40:36 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
An 001 AMd.AnKes.
1853 2022/07/19/000058 035189 LINTANG AYU ISWARINI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 08:21:00 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
1854 2022/07/19/000058 035189 LINTANG AYU ISWARINI, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 08:21:00 BPJS KS IGD 6 32,431 9,569 0 3,000 0 0 0 45,000
1855 2022/07/19/000058 035189 LINTANG AYU ISWARINI, NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 08:21:00 BPJS KS IGD 6 32,436 564 0 2,000 0 0 0 35,000
1856 2022/07/19/000058 035189 LINTANG AYU ISWARINI, NY BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 08:21:00 BPJS KS IGD 6 32,436 564 0 2,000 0 0 0 35,000
1857 2022/07/19/000058 035189 LINTANG AYU ISWARINI, NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 08:19:53 BPJS KS IGD 6 44,800 35,200 0 5,000 5,000 0 0 90,000
1858 2022/07/19/000060 070781 NENA MARISCA ANGELINA BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 19/07/2022 12:02:33 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
USMAN, NY 0001 AMd.AK. DWIJAYASA, Sp.OG (K) KESEHATAN
1859 2022/07/19/000061 072337 AYDAN EVANO AKALESVARA, BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 19/07/2022 04:13:21 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
8/1/22, 8:34 AM Page 62 of 107

1860 2022/07/19/000061 072337 AYDAN EVANO AKALESVARA, BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 3150145 dr. ZAINUDDIN HAMIDI, 19/07/2022 04:13:21 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
1861 2022/07/19/000062 072436 PUJI ASTUTI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 12:16:21 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1862 2022/07/19/000064 012259 DEWI PERMATA SARI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 19/07/2022 12:14:26 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1863 2022/07/19/000068 051490 SRI WAHYUNI, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 19/07/2022 06:57:02 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1864 2022/07/19/000068 051490 SRI WAHYUNI, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10120217 dr. NYOMAN LUWANG 19/07/2022 12:32:14 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1865 2022/07/19/000068 051490 SRI WAHYUNI, NY BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 19/07/2022 06:57:02 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1866 2022/07/19/000068 051490 SRI WAHYUNI, NY BPJS.K1B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 19/07/2022 06:57:02 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1867 2022/07/19/000068 051490 SRI WAHYUNI, NY BPJS.K1B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 19/07/2022 06:57:02 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1868 2022/07/19/000068 051490 SRI WAHYUNI, NY BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10120217 dr. NYOMAN LUWANG 19/07/2022 06:55:37 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1869 2022/07/19/000069 094828 Zio Atharizz Alfarezy, An. UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 09210381 dr. KIKI RIZKI RACHMAT 19/07/2022 07:40:07 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AnKes.
1870 2022/07/19/000071 069532 ROIFATUL ALFIATI,NY BPJS.K3UP2 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 19/07/2022 07:46:42 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1871 2022/07/19/000071 069532 ROIFATUL ALFIATI,NY BPJS.K3UP2 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 19/07/2022 13:32:49 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1872 2022/07/19/000071 069532 ROIFATUL ALFIATI,NY BPJS.K3UP2 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 19/07/2022 07:46:42 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1873 2022/07/19/000071 069532 ROIFATUL ALFIATI,NY BPJS.K3UP2 BT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 19/07/2022 07:46:42 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1874 2022/07/19/000071 069532 ROIFATUL ALFIATI,NY BPJS.K3UP2 CT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 19/07/2022 07:46:42 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
1875 2022/07/19/000071 069532 ROIFATUL ALFIATI,NY BPJS.K3UP2 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10050002 dr. PANDE MADE 19/07/2022 07:44:12 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1876 2022/07/19/000072 072528 MUHAMMAD PUTRA UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8170324 dr. EDWIN PRADANA, 19/07/2022 14:05:46 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
RAMADHAN,TN 0031 AMd.AK. Sp.And.
1877 2022/07/19/000076 054065 PANDE MADE SEKAR, NY KYN.RJ0000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:26:09 KARYAWAN Laboratorium 33,431 26,569 0 3,000 0 0 0 63,000
1 AMd.AnKes.
1878 2022/07/19/000076 054065 PANDE MADE SEKAR, NY KYN.RJ0000 Cholesterol 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:26:09 KARYAWAN Laboratorium 24,951 12,049 0 3,000 0 0 0 40,000
11 AMd.AnKes.
1879 2022/07/19/000076 054065 PANDE MADE SEKAR, NY KYN.RJ0000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:26:09 KARYAWAN Laboratorium 27,431 9,569 0 3,000 0 0 0 40,000
110 AMd.AnKes.
1880 2022/07/19/000076 054065 PANDE MADE SEKAR, NY KYN.RJ0000 HDL 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:26:09 KARYAWAN Laboratorium 28,951 22,049 0 3,000 0 0 0 54,000
12 AMd.AnKes.
1881 2022/07/19/000076 054065 PANDE MADE SEKAR, NY KYN.RJ0000 LDL 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:26:09 KARYAWAN Laboratorium 28,951 22,049 0 3,000 0 0 0 54,000
13 AMd.AnKes.
1882 2022/07/19/000076 054065 PANDE MADE SEKAR, NY KYN.RJ0000 Trigliserida 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:26:09 KARYAWAN Laboratorium 28,951 17,049 0 3,000 0 0 0 49,000
14 AMd.AnKes.
1883 2022/07/19/000076 054065 PANDE MADE SEKAR, NY KYN.RJ0000 Asam Urat 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:26:09 KARYAWAN Laboratorium 27,951 9,049 0 3,000 0 0 0 40,000
15 AMd.AnKes.
1884 2022/07/19/000076 054065 PANDE MADE SEKAR, NY KYN.RJ0000 SGOT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:26:09 KARYAWAN Laboratorium 29,451 12,549 0 3,000 0 0 0 45,000
16 AMd.AnKes.
1885 2022/07/19/000076 054065 PANDE MADE SEKAR, NY KYN.RJ0000 SGPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:26:09 KARYAWAN Laboratorium 29,451 12,549 0 3,000 0 0 0 45,000
17 AMd.AnKes.
1886 2022/07/19/000076 054065 PANDE MADE SEKAR, NY KYN.RJ0000 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:26:09 KARYAWAN Laboratorium 26,451 10,549 0 3,000 0 0 0 40,000
18 AMd.AnKes.
1887 2022/07/19/000076 054065 PANDE MADE SEKAR, NY KYN.RJ0000 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:26:09 KARYAWAN Laboratorium 28,951 13,049 0 3,000 0 0 0 45,000
19 AMd.AnKes.
1888 2022/07/19/000076 054065 PANDE MADE SEKAR, NY KYN.RJ0000 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:29:36 KARYAWAN Laboratorium 26,390 6,610 0 3,000 0 0 0 36,000
21 AMd.AnKes.
1889 2022/07/19/000077 064680 Ni Luh Putu Suarningsih, Ny KYN.RJ0000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, AMd. 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:31:43 KARYAWAN Laboratorium 33,431 26,569 0 3,000 0 0 0 63,000
8/1/22, 8:34 AM Page 63 of 107

AnKes.
1890 2022/07/19/000077 064680 Ni Luh Putu Suarningsih, Ny KYN.RJ0000 Cholesterol 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:31:43 KARYAWAN Laboratorium 24,951 12,049 0 3,000 0 0 0 40,000
11 AMd.AnKes.
1891 2022/07/19/000077 064680 Ni Luh Putu Suarningsih, Ny KYN.RJ0000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:31:43 KARYAWAN Laboratorium 27,431 9,569 0 3,000 0 0 0 40,000
110 AMd.AnKes.
1892 2022/07/19/000077 064680 Ni Luh Putu Suarningsih, Ny KYN.RJ0000 HDL 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:31:43 KARYAWAN Laboratorium 28,951 22,049 0 3,000 0 0 0 54,000
12 AMd.AnKes.
1893 2022/07/19/000077 064680 Ni Luh Putu Suarningsih, Ny KYN.RJ0000 LDL 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:31:43 KARYAWAN Laboratorium 28,951 22,049 0 3,000 0 0 0 54,000
13 AMd.AnKes.
1894 2022/07/19/000077 064680 Ni Luh Putu Suarningsih, Ny KYN.RJ0000 Trigliserida 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:31:43 KARYAWAN Laboratorium 28,951 17,049 0 3,000 0 0 0 49,000
14 AMd.AnKes.
1895 2022/07/19/000077 064680 Ni Luh Putu Suarningsih, Ny KYN.RJ0000 Asam Urat 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:31:43 KARYAWAN Laboratorium 27,951 9,049 0 3,000 0 0 0 40,000
15 AMd.AnKes.
1896 2022/07/19/000077 064680 Ni Luh Putu Suarningsih, Ny KYN.RJ0000 SGOT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:31:43 KARYAWAN Laboratorium 29,451 12,549 0 3,000 0 0 0 45,000
16 AMd.AnKes.
1897 2022/07/19/000077 064680 Ni Luh Putu Suarningsih, Ny KYN.RJ0000 SGPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:31:43 KARYAWAN Laboratorium 29,451 12,549 0 3,000 0 0 0 45,000
17 AMd.AnKes.
1898 2022/07/19/000077 064680 Ni Luh Putu Suarningsih, Ny KYN.RJ0000 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:31:43 KARYAWAN Laboratorium 26,451 10,549 0 3,000 0 0 0 40,000
18 AMd.AnKes.
1899 2022/07/19/000077 064680 Ni Luh Putu Suarningsih, Ny KYN.RJ0000 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 10210382 dr. RIMA AURELIA, Sp.PK. 19/07/2022 07:31:43 KARYAWAN Laboratorium 28,951 13,049 0 3,000 0 0 0 45,000
19 AMd.AnKes.
1900 2022/07/19/000083 070636 DIO PRATAMA UBAYDILLAH, TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8170324 dr. EDWIN PRADANA, 19/07/2022 14:06:21 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
1901 2022/07/19/000085 072529 YOGA DANANG SEFTIAN,TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8170324 dr. EDWIN PRADANA, 19/07/2022 14:06:55 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
1902 2022/07/19/000089 072531 CHOIRUL RACHMAN,TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8170324 dr. EDWIN PRADANA, 19/07/2022 14:07:51 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
1903 2022/07/19/000107 072242 HAFIZAH NURSYIFA ILMI,AN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 14:57:55 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
1904 2022/07/19/000107 072242 HAFIZAH NURSYIFA ILMI,AN UMUM.RJ00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 14:57:55 UMUM Poli Anak 31,936 6,064 0 2,000 0 0 0 40,000
1905 2022/07/19/000107 072242 HAFIZAH NURSYIFA ILMI,AN UMUM.RJ00 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 14:57:55 UMUM Poli Anak 31,436 6,564 0 2,000 0 0 0 40,000
1906 2022/07/19/000113 072542 SELVI SUPRAPTIN NINGSIH, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 09:56:03 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
1907 2022/07/19/000113 072542 SELVI SUPRAPTIN NINGSIH, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 09:56:03 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
1908 2022/07/19/000113 072542 SELVI SUPRAPTIN NINGSIH, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 11:17:42 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
1909 2022/07/19/000113 072542 SELVI SUPRAPTIN NINGSIH, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 09:56:03 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1910 2022/07/19/000113 072542 SELVI SUPRAPTIN NINGSIH, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 8170296 INTAN MEILIA SARI, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 09:56:03 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1911 2022/07/19/000131 072546 PARTI,NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 11:32:57 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
1912 2022/07/19/000131 072546 PARTI,NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 11:32:57 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
1913 2022/07/19/000131 072546 PARTI,NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 11:31:40 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
1914 2022/07/19/000131 072546 PARTI,NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 11:32:57 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1915 2022/07/19/000131 072546 PARTI,NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 11:32:57 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1916 2022/07/19/000132 038778 MIRNA TIARA SANI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 19/07/2022 11:41:49 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
1917 2022/07/19/000132 038778 MIRNA TIARA SANI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 19/07/2022 11:41:49 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
1918 2022/07/19/000132 038778 MIRNA TIARA SANI, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 19/07/2022 11:41:49 UMUM Laboratorium 30,390 6,610 0 3,000 0 0 0 40,000
1919 2022/07/19/000132 038778 MIRNA TIARA SANI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 19/07/2022 12:57:42 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
8/1/22, 8:34 AM Page 64 of 107

1920 2022/07/19/000132 038778 MIRNA TIARA SANI, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 19/07/2022 11:41:49 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1921 2022/07/19/000132 038778 MIRNA TIARA SANI, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 19/07/2022 11:41:49 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1922 2022/07/19/000138 072549 MUHAMMAD HAJID KHOLIL, AN BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 13:15:07 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1923 2022/07/19/000138 072549 MUHAMMAD HAJID KHOLIL, AN BPJS.K3T20 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 13:15:07 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1924 2022/07/19/000138 072549 MUHAMMAD HAJID KHOLIL, AN BPJS.K3T20 IgG Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 13:15:07 BPJS KS IGD 1 41,951 46,549 0 1,500 0 0 0 90,000
1925 2022/07/19/000138 072549 MUHAMMAD HAJID KHOLIL, AN BPJS.K3T20 IgM Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 13:15:07 BPJS KS IGD 1 41,951 46,549 0 1,500 0 0 0 90,000
1926 2022/07/19/000138 072549 MUHAMMAD HAJID KHOLIL, AN BPJS.K3T20 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 13:13:59 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1927 2022/07/19/000153 072553 OLIVIA PANDINI,NN UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 19/07/2022 12:25:20 UMUM IGD 30,390 6,610 0 3,000 0 0 0 40,000
0021 AMd.AK.
1928 2022/07/19/000153 072553 OLIVIA PANDINI,NN UMUM.RJ00 Plano Test 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 19/07/2022 12:25:20 UMUM IGD 33,140 4,860 0 2,000 0 0 0 40,000
0022 AMd.AK.
1929 2022/07/19/000155 055273 ARKANA SADDAM HAMIZAN, BPJS.K3T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 19/07/2022 16:40:39 BPJS KS IGD 7 40,431 26,569 0 3,000 0 0 0 70,000
1930 2022/07/19/000155 055273 ARKANA SADDAM HAMIZAN, BPJS.K3T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 19/07/2022 16:40:39 BPJS KS IGD 7 32,431 9,569 0 3,000 0 0 0 45,000
1931 2022/07/19/000156 029262 RAUDHANIA ILMINISA, AN BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 15:41:52 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1932 2022/07/19/000156 029262 RAUDHANIA ILMINISA, AN BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 15:41:52 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
1933 2022/07/19/000156 029262 RAUDHANIA ILMINISA, AN BPJS.K2T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 15:40:03 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
1934 2022/07/19/000156 029262 RAUDHANIA ILMINISA, AN BPJS.K2T10 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 15:41:52 BPJS KS IGD 1 31,931 10,069 0 3,000 0 0 0 45,000
1935 2022/07/19/000165 069040 NADLYNE ELSANUM UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 19/07/2022 14:35:27 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
HUMAIROH, AN 001 ARDHIANSYAH, AMd.Ankes
1936 2022/07/19/000165 069040 NADLYNE ELSANUM UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 19/07/2022 14:35:27 UMUM IGD 32,431 9,569 0 3,000 0 0 0 45,000
HUMAIROH, AN 00110 ARDHIANSYAH, AMd.Ankes
1937 2022/07/19/000172 072555 ROVIE WIDIYANTI,NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150220 dr. IMELDA, Sp.OG. 19/07/2022 15:36:35 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
001 KESEHATAN
1938 2022/07/19/000172 072555 ROVIE WIDIYANTI,NY BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150220 dr. IMELDA, Sp.OG. 19/07/2022 15:36:35 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
00110 KESEHATAN
1939 2022/07/19/000172 072555 ROVIE WIDIYANTI,NY BPJS.K1B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150220 dr. IMELDA, Sp.OG. 19/07/2022 15:36:35 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
003 KESEHATAN
1940 2022/07/19/000172 072555 ROVIE WIDIYANTI,NY BPJS.K1B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150220 dr. IMELDA, Sp.OG. 19/07/2022 15:36:35 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
004 KESEHATAN
1941 2022/07/19/000172 072555 ROVIE WIDIYANTI,NY BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150220 dr. IMELDA, Sp.OG. 19/07/2022 15:33:01 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
0050 KESEHATAN
1942 2022/07/19/000177 091143 KRISTIN RAHAYU BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 19/07/2022 19:19:56 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
MANDALASARI, NY 001 SUSILO,Sp.OG. KESEHATAN
1943 2022/07/19/000177 091143 KRISTIN RAHAYU BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 19/07/2022 19:19:56 BPJS KS IGD 10 32,431 9,569 0 3,000 0 0 0 45,000
1944 2022/07/19/000177 091143 KRISTIN RAHAYU BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 19/07/2022 19:19:56 BPJS KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
1945 2022/07/19/000177 091143 KRISTIN RAHAYU BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 19/07/2022 19:19:56 BPJS KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
1946 2022/07/19/000177 091143 KRISTIN RAHAYU BPJS.K3B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 19/07/2022 19:17:01 BPJS KS IGD 10 37,400 47,600 0 5,000 5,000 0 0 95,000
1947 2022/07/19/000177 091143 KRISTIN RAHAYU UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 19/07/2022 15:52:39 BPJS IGD 30,390 6,610 0 3,000 0 0 0 40,000
MANDALASARI, NY 0021 KESEHATAN
1948 2022/07/19/000178 027975 SITI AMINATUS SA`DIYAH, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 19/07/2022 16:10:04 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
001 SUSILO,Sp.OG.
1949 2022/07/19/000178 027975 SITI AMINATUS SA`DIYAH, NY UMUM. Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO SUSILO, 19/07/2022 16:10:04 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
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RJ0000110 Sp.OG.
1950 2022/07/19/000178 027975 SITI AMINATUS SA`DIYAH, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 19/07/2022 16:35:39 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
0047 SUSILO,Sp.OG.
1951 2022/07/19/000178 027975 SITI AMINATUS SA`DIYAH, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 19/07/2022 16:10:04 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
005 SUSILO,Sp.OG.
1952 2022/07/19/000178 027975 SITI AMINATUS SA`DIYAH, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 19/07/2022 16:10:04 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
006 SUSILO,Sp.OG.
1953 2022/07/19/000181 039870 MUHAMMAD HAFIDZ EL ADHA, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 19/07/2022 16:27:24 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
An 001
1954 2022/07/19/000181 039870 MUHAMMAD HAFIDZ EL ADHA, UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 19/07/2022 16:27:24 UMUM IGD 31,931 10,069 0 3,000 0 0 0 45,000
An 009
1955 2022/07/19/000186 072564 SAPTA NIRMAWATI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 16:47:36 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
1956 2022/07/19/000186 072564 SAPTA NIRMAWATI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 16:47:36 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
1957 2022/07/19/000186 072564 SAPTA NIRMAWATI, NY UMUM.RJ00 Anti HIV 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 16:47:36 UMUM Laboratorium 38,951 34,049 0 2,000 0 0 0 75,000
1958 2022/07/19/000186 072564 SAPTA NIRMAWATI, NY UMUM.RJ00 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 16:47:36 UMUM Laboratorium 38,951 34,049 0 2,000 0 0 0 75,000
1959 2022/07/19/000186 072564 SAPTA NIRMAWATI, NY UMUM.RJ00 TPHA/Sipilis 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 16:47:36 UMUM Laboratorium 37,951 34,049 0 3,000 0 0 0 75,000
1960 2022/07/19/000186 072564 SAPTA NIRMAWATI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 16:38:46 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
1961 2022/07/19/000186 072564 SAPTA NIRMAWATI, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 16:47:36 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1962 2022/07/19/000186 072564 SAPTA NIRMAWATI, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 16:47:36 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
1963 2022/07/19/000190 099609 HERA NUR DUNIARTI, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 19/07/2022 19:32:39 BPJS Hastina 5 32,431 9,569 0 3,000 0 0 0 45,000
1964 2022/07/19/000190 099609 HERA NUR DUNIARTI, NY BPJS.K2B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 19/07/2022 19:55:54 BPJS Hastina 5 37,400 47,600 0 5,000 5,000 0 0 95,000
1965 2022/07/19/000190 099609 HERA NUR DUNIARTI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 19/07/2022 17:32:06 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 KESEHATAN
1966 2022/07/19/000191 102324 Johnson Cleandro Emry, An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 19/07/2022 17:55:26 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
1967 2022/07/19/000191 102324 Johnson Cleandro Emry, An UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 19/07/2022 17:55:26 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 Sp.A.
1968 2022/07/19/000206 087627 Kaelandra Marshall Dyaka, An. ASKES.RJ00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 19/07/2022 19:49:24 ASURANSI Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A. KESEHATAN
1969 2022/07/19/000206 087627 Kaelandra Marshall Dyaka, An. ASKES.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 19/07/2022 19:49:24 ASURANSI Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 Sp.A. KESEHATAN
1970 2022/07/19/000211 053275 CIARA ALODIE ZIANAVARO, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 19/07/2022 19:25:04 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001
1971 2022/07/19/000211 053275 CIARA ALODIE ZIANAVARO, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 19/07/2022 19:25:04 UMUM IGD 31,931 10,069 0 3,000 0 0 0 45,000
009
1972 2022/07/19/000216 097707 MOCHAMAD ABYZAR FARDAN, UMUM.K3T2 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 19/07/2022 20:53:10 UMUM KS IGD 2 37,900 47,600 0 7,500 5,000 0 0 98,000
An 000047 Sp.A.
1973 2022/07/19/000218 072571 KRISTIN RAHAYU M. By.Ny BPJS.KINS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 20:38:27 BPJS KS NICU 15 40,431 26,569 0 3,000 0 0 0 70,000
1974 2022/07/19/000218 072571 KRISTIN RAHAYU M. By.Ny BPJS.KINS0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 20:38:27 BPJS KS NICU 15 32,431 9,569 0 3,000 0 0 0 45,000
1975 2022/07/19/000218 072571 KRISTIN RAHAYU M. By.Ny BPJS.KINS0 SGOT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 20:38:27 BPJS KS NICU 15 34,451 12,549 0 3,000 0 0 0 50,000
1976 2022/07/19/000218 072571 KRISTIN RAHAYU M. By.Ny BPJS.KINS0 SGPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 20:38:27 BPJS KS NICU 15 34,451 12,549 0 3,000 0 0 0 50,000
1977 2022/07/19/000218 072571 KRISTIN RAHAYU M. By.Ny BPJS.KINS0 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 19/07/2022 20:39:55 BPJS KS NICU 15 37,400 47,600 0 5,000 5,000 0 0 95,000
1978 2022/07/19/000220 064515 LUSI INDRIANI, NY BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 19/07/2022 22:00:57 BPJS Amarta 6A 40,431 26,569 0 3,000 0 0 0 70,000
1979 2022/07/19/000220 064515 LUSI INDRIANI, NY BPJS. Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 19/07/2022 22:00:57 BPJS Amarta 6A 32,431 9,569 0 3,000 0 0 0 45,000
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K3T2000011 AMd.AK. KARTIKARINI, Sp.OG
0
1980 2022/07/19/000220 064515 LUSI INDRIANI, NY BPJS.K3T20 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 19/07/2022 22:00:57 BPJS Amarta 6A 32,436 564 0 2,000 0 0 0 35,000
1981 2022/07/19/000220 064515 LUSI INDRIANI, NY BPJS.K3T20 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 19/07/2022 22:00:57 BPJS Amarta 6A 32,436 564 0 2,000 0 0 0 35,000
1982 2022/07/19/000220 064515 LUSI INDRIANI, NY BPJS.K3T20 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 19/07/2022 22:10:40 BPJS Amarta 6A 44,800 35,200 0 5,000 5,000 0 0 90,000
1983 2022/07/19/000221 072573 SEPTIVA EKA PRATIWI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 23:49:09 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK. INDRAWAN, Sp. OG (K) KESEHATAN 2
1984 2022/07/19/000221 072573 SEPTIVA EKA PRATIWI, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 23:49:09 BPJS KS Kamar Bersalin 32,431 9,569 0 3,000 0 0 0 45,000
1985 2022/07/19/000221 072573 SEPTIVA EKA PRATIWI, NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 23:49:09 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
1986 2022/07/19/000221 072573 SEPTIVA EKA PRATIWI, NY BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 23:49:09 BPJS KS Kamar Bersalin 32,436 564 0 2,000 0 0 0 35,000
1987 2022/07/19/000221 072573 SEPTIVA EKA PRATIWI, NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 19/07/2022 23:49:43 BPJS KS Kamar Bersalin 44,800 35,200 0 5,000 5,000 0 0 90,000
1988 2022/07/14/000161 072357 GEFANDA AFRISSA SYAFAZEA, BPJS.KFIS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 06:25:54 BPJS KS Fisol 2 40,431 26,569 0 3,000 0 0 0 70,000
1989 2022/07/14/000161 072357 GEFANDA AFRISSA SYAFAZEA, BPJS.KFIS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 06:25:54 BPJS KS Fisol 2 33,931 13,069 0 3,000 0 0 0 50,000
1990 2022/07/16/000110 083181 HAFIZAH BRILIANI PUTRI N R, BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 20/07/2022 09:42:50 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
1991 2022/07/17/000055 085679 ALVIRA PUTRI ARILIA, AN BPJS.K3UP2 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 06:23:08 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
1992 2022/07/17/000073 047484 TUSIANTI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 20/07/2022 06:18:08 BPJS KS Amarta 3 40,431 26,569 0 3,000 0 0 0 70,000
1993 2022/07/17/000092 072446 TIANA, NY UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 20/07/2022 09:40:38 UMUM KS IGD 1 50,431 26,569 0 3,000 0 0 0 80,000
1994 2022/07/18/000247 072090 RAKA ARZANKA RIZKY BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 20/07/2022 17:28:15 BPJS KS IGD 9 33,931 13,069 0 3,000 0 0 0 50,000
PURWANTO, AN 00020 Sp.A. KESEHATAN
1995 2022/07/18/000249 072096 MARYAM INNARA KHAYR, AN BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 20/07/2022 17:24:16 BPJS KS IGD 1 33,931 13,069 0 3,000 0 0 0 50,000
1996 2022/07/18/000250 086890 LAILATUL MAHFIROH, NY UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4150215 dr. DEWI INDIASTARI, 20/07/2022 12:18:49 UMUM Amarta 8B 40,431 26,569 0 3,000 0 0 0 70,000
0001 AMd.AK. Sp.PD.
1997 2022/07/18/000251 072070 QUEENAYA ZELINE ARUNA,AN BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 20/07/2022 17:22:36 BPJS KS IGD 8 33,931 13,069 0 3,000 0 0 0 50,000
1998 2022/07/19/000021 071446 ALKAF RAZQA MAHENDRA, AN BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 17:14:10 BPJS KS IGD 10 33,931 13,069 0 3,000 0 0 0 50,000
1999 2022/07/19/000074 072526 MARINDA MARE., BY NY BPJS.KFIS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 20/07/2022 12:20:39 BPJS KS Fisol 4 40,431 26,569 0 3,000 0 0 0 70,000
2000 2022/07/19/000074 072526 MARINDA MARE., BY NY BPJS.KFIS0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 20/07/2022 12:20:39 BPJS KS Fisol 4 32,431 9,569 0 3,000 0 0 0 45,000
2001 2022/07/19/000138 072549 MUHAMMAD HAJID KHOLIL, AN BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 13:45:47 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2002 2022/07/19/000172 072555 ROVIE WIDIYANTI,NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150220 dr. IMELDA, Sp.OG. 20/07/2022 09:48:05 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
001 KESEHATAN
2004 2022/07/19/000177 091143 KRISTIN RAHAYU BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 20/07/2022 06:21:36 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
MANDALASARI, NY 001 AMd.AK. SUSILO,Sp.OG. KESEHATAN
2005 2022/07/19/000190 099609 HERA NUR DUNIARTI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 20/07/2022 20:23:48 BPJS Hastina 5 40,431 26,569 0 3,000 0 0 0 70,000
2006 2022/07/19/000190 099609 HERA NUR DUNIARTI, NY BPJS.K2B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4150215 dr. DEWI INDIASTARI, 20/07/2022 09:53:17 BPJS Hastina 5 30,390 6,610 0 3,000 0 0 0 40,000
2007 2022/07/19/000221 072573 SEPTIVA EKA PRATIWI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 07:59:25 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
2008 2022/07/20/000002 072376 HERLINA PUTRI NASTITI, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 20/07/2022 12:52:19 BPJS Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
2009 2022/07/20/000002 072376 HERLINA PUTRI NASTITI, NY BPJS. Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, AMd. 1110218 dr. NOVINA PURWITA 20/07/2022 12:52:19 BPJS Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
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RJ0000110 AK. KARTIKARINI, Sp.OG
2010 2022/07/20/000002 072376 HERLINA PUTRI NASTITI, NY BPJS.RJ000 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 20/07/2022 12:52:19 BPJS Poli Kandungan 30,390 6,610 0 3,000 0 0 0 40,000
2011 2022/07/20/000002 072376 HERLINA PUTRI NASTITI, NY BPJS.RJ000 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 20/07/2022 12:52:19 BPJS Poli Kandungan 31,936 6,064 0 2,000 0 0 0 40,000
2012 2022/07/20/000002 072376 HERLINA PUTRI NASTITI, NY BPJS.RJ000 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 20/07/2022 12:52:19 BPJS Poli Kandungan 31,436 6,564 0 2,000 0 0 0 40,000
2013 2022/07/20/000019 072207 ALCEO PUTRA SUCAHYONO, UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 20/07/2022 19:47:14 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
AN 0020 Sp.A.
2014 2022/07/20/000032 028167 YOLA ALFIANI PUTRI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 20/07/2022 13:10:00 UMUM Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
2015 2022/07/20/000032 028167 YOLA ALFIANI PUTRI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 20/07/2022 13:10:00 UMUM Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
2016 2022/07/20/000032 028167 YOLA ALFIANI PUTRI, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 20/07/2022 13:10:00 UMUM Poli Kandungan 30,390 6,610 0 3,000 0 0 0 40,000
2017 2022/07/20/000032 028167 YOLA ALFIANI PUTRI, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 20/07/2022 13:10:00 UMUM Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
2018 2022/07/20/000032 028167 YOLA ALFIANI PUTRI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 20/07/2022 13:11:25 UMUM Poli Kandungan 47,300 35,200 0 7,500 5,000 0 0 95,000
2019 2022/07/20/000032 028167 YOLA ALFIANI PUTRI, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 20/07/2022 13:10:00 UMUM Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
2020 2022/07/20/000035 072211 MAHIRA AISYAH PUTRI UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 20/07/2022 18:48:09 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
WIDIGDA, An 0020 Sp.A.
2021 2022/07/20/000058 063454 DIAN MAULANI, Ny BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 20:54:15 BPJS Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
2022 2022/07/20/000058 063454 DIAN MAULANI, Ny BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 20:54:15 BPJS Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
2023 2022/07/20/000058 063454 DIAN MAULANI, Ny BPJS.RJ000 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 20:54:15 BPJS Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
2024 2022/07/20/000058 063454 DIAN MAULANI, Ny BPJS.RJ000 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 20:50:43 BPJS Poli Kandungan 44,800 35,200 0 5,000 5,000 0 0 90,000
2025 2022/07/20/000058 063454 DIAN MAULANI, Ny BPJS.RJ000 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 20:54:15 BPJS Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
2026 2022/07/20/000066 023228 AJENG WAHYUNINGTIYAS, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150220 dr. IMELDA, Sp.OG. 20/07/2022 15:24:48 UMUM Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
001
2027 2022/07/20/000066 023228 AJENG WAHYUNINGTIYAS, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150220 dr. IMELDA, Sp.OG. 20/07/2022 15:24:48 UMUM Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
00110
2028 2022/07/20/000066 023228 AJENG WAHYUNINGTIYAS, NY UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150220 dr. IMELDA, Sp.OG. 20/07/2022 15:24:48 UMUM Poli Kandungan 32,436 564 0 2,000 0 0 0 35,000
003
2029 2022/07/20/000066 023228 AJENG WAHYUNINGTIYAS, NY UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150220 dr. IMELDA, Sp.OG. 20/07/2022 15:24:48 UMUM Poli Kandungan 32,436 564 0 2,000 0 0 0 35,000
004
2030 2022/07/20/000066 023228 AJENG WAHYUNINGTIYAS, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150220 dr. IMELDA, Sp.OG. 20/07/2022 16:30:41 UMUM Poli Kandungan 37,900 47,600 0 7,500 5,000 0 0 98,000
0047
2031 2022/07/20/000073 056948 IMROATUL MAHMUDAH, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 20/07/2022 07:25:45 BPJS Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
2032 2022/07/20/000086 035189 LINTANG AYU ISWARINI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 00:36:54 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2033 2022/07/20/000086 035189 LINTANG AYU ISWARINI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 09:50:34 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2034 2022/07/20/000086 035189 LINTANG AYU ISWARINI, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 00:36:54 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2035 2022/07/20/000086 035189 LINTANG AYU ISWARINI, NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 00:36:54 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2036 2022/07/20/000086 035189 LINTANG AYU ISWARINI, NY BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 00:36:54 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2037 2022/07/20/000086 035189 LINTANG AYU ISWARINI, NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 00:37:08 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2038 2022/07/20/000092 072542 SELVI SUPRAPTIN NINGSIH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 09:55:07 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2039 2022/07/20/000093 072564 SAPTA NIRMAWATI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 13:50:17 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
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2040 2022/07/20/000095 062547 NADIA SALSABILA, Ny BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 20/07/2022 05:28:32 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2041 2022/07/20/000095 062547 NADIA SALSABILA, Ny BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 20/07/2022 23:12:53 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2042 2022/07/20/000095 062547 NADIA SALSABILA, Ny BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 20/07/2022 05:28:32 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2043 2022/07/20/000095 062547 NADIA SALSABILA, Ny BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 20/07/2022 05:28:32 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2044 2022/07/20/000095 062547 NADIA SALSABILA, Ny BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 20/07/2022 05:28:32 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2045 2022/07/20/000095 062547 NADIA SALSABILA, Ny BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 20/07/2022 05:28:54 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2046 2022/07/20/000096 027975 SITI AMINATUS SA`DIYAH, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 20/07/2022 13:48:54 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2047 2022/07/20/000114 050012 ABHINARA FAWWAZ BPJS.K2T30 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 20/07/2022 11:33:30 BPJS Hastina 4 40,431 26,569 0 3,000 0 0 0 70,000
ALFAREZEL, AN 0001 AMd.AK. Sp.A. KESEHATAN
2048 2022/07/20/000114 050012 ABHINARA FAWWAZ BPJS.K2T30 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 20/07/2022 11:33:30 BPJS Hastina 4 32,431 9,569 0 3,000 0 0 0 45,000
2049 2022/07/20/000116 072582 SABRINA MARSA KIRANA, AN BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 09:26:30 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2050 2022/07/20/000116 072582 SABRINA MARSA KIRANA, AN BPJS.K2T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 09:26:45 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2051 2022/07/20/000116 072582 SABRINA MARSA KIRANA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 07:54:15 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
2052 2022/07/20/000116 072582 SABRINA MARSA KIRANA, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 07:54:15 BPJS IGD 31,931 10,069 0 3,000 0 0 0 45,000
2053 2022/07/20/000117 055334 C. ASTERLIA LUSIANA, Ny BPJS.RJ000 Gula Darah Puasa 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4150215 dr. DEWI INDIASTARI, 20/07/2022 10:23:34 BPJS Poli Penyakit 32,431 9,569 0 3,000 0 0 0 45,000
2054 2022/07/20/000117 055334 C. ASTERLIA LUSIANA, Ny BPJS.RJ000 Gula Darah 2 Jam PP 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4150215 dr. DEWI INDIASTARI, 20/07/2022 10:23:34 BPJS Poli Penyakit 32,431 9,569 0 3,000 0 0 0 45,000
2055 2022/07/20/000121 072546 PARTI,NY BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 17:19:30 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
2056 2022/07/20/000141 072509 ARGIE ZHAFIRAH, AN UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 20/07/2022 11:35:03 UMUM KS IGD 1 50,431 26,569 0 3,000 0 0 0 75,000
0001 AMd.AK. Sp.A.
2057 2022/07/20/000141 072509 ARGIE ZHAFIRAH, AN UMUM.K2B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 20/07/2022 11:35:03 UMUM KS IGD 1 37,431 9,569 0 3,000 0 0 0 50,000
2058 2022/07/20/000144 072586 PUTRI DIANA NIKMATUS UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 09:15:04 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
SOLIHA, NY 001 AMd.AK.
2059 2022/07/20/000144 072586 PUTRI DIANA NIKMATUS UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 09:15:04 UMUM IGD 32,431 9,569 0 3,000 0 0 0 45,000
2060 2022/07/20/000144 072586 PUTRI DIANA NIKMATUS UMUM.RJ00 Anti HIV 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 09:15:04 UMUM IGD 38,951 34,049 0 2,000 0 0 0 75,000
2061 2022/07/20/000144 072586 PUTRI DIANA NIKMATUS UMUM.RJ00 TPHA/Sipilis 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 09:15:04 UMUM IGD 37,951 34,049 0 3,000 0 0 0 75,000
2062 2022/07/20/000144 072586 PUTRI DIANA NIKMATUS UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 09:15:04 UMUM IGD 32,436 564 0 2,000 0 0 0 35,000
2063 2022/07/20/000144 072586 PUTRI DIANA NIKMATUS UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 09:15:04 UMUM IGD 32,436 564 0 2,000 0 0 0 35,000
2064 2022/07/20/000144 072586 PUTRI DIANA NIKMATUS UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 09:16:11 UMUM IGD 47,300 35,200 0 7,500 5,000 0 0 95,000
2065 2022/07/20/000146 099576 Maryam Kirana Mahmudah, An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 14:20:32 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
2066 2022/07/20/000146 099576 Maryam Kirana Mahmudah, An UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 14:20:32 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
2067 2022/07/20/000150 071239 PROBO YUDHA PRATAMA UMUM.RJ00 Preparasi Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8170324 dr. EDWIN PRADANA, 20/07/2022 13:00:56 UMUM Poli Andrologi 161,771 738,229 350,000 0 0 50,000 0 1,300,000
PUTRA, TN 0030 AMd.AK. Sp.And.
2068 2022/07/20/000156 078549 GWEN CLAIRINE GRACIELLA, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 20/07/2022 11:43:21 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2069 2022/07/20/000156 078549 GWEN CLAIRINE GRACIELLA, BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 20/07/2022 11:43:21 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
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2070 2022/07/20/000156 078549 GWEN CLAIRINE GRACIELLA, BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 20/07/2022 11:36:39 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2071 2022/07/20/000161 072589 RANGGA AGIL WIBOWO,TN UMUM.RJ00 Preparasi Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8170324 dr. EDWIN PRADANA, 20/07/2022 13:01:47 UMUM Poli Andrologi 161,771 738,229 350,000 0 0 50,000 0 1,300,000
2072 2022/07/20/000163 061596 SACHIO RYUGA AFRINDO, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 17:35:12 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2073 2022/07/20/000163 061596 SACHIO RYUGA AFRINDO, AN BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 17:35:12 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2074 2022/07/20/000163 061596 SACHIO RYUGA AFRINDO, AN BPJS.K3B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 17:36:14 BPJS KS IGD 1 37,400 47,600 0 5,000 5,000 0 0 95,000
2075 2022/07/20/000163 061596 SACHIO RYUGA AFRINDO, AN BPJS.K3B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 17:35:12 BPJS KS IGD 1 31,931 10,069 0 3,000 0 0 0 45,000
2076 2022/07/20/000166 038778 MIRNA TIARA SANI, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 20/07/2022 20:26:18 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
2077 2022/07/20/000166 038778 MIRNA TIARA SANI, NY BPJS.K1B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 20/07/2022 11:47:10 BPJS KS IGD 10 30,390 6,610 0 3,000 0 0 0 40,000
2078 2022/07/20/000168 072492 IVVATUL IHDA QURROTUL AINI, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 13:14:29 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
NY 001 AMd.AK. INDRAWAN, Sp. OG (K)
2079 2022/07/20/000168 072492 IVVATUL IHDA QURROTUL AINI, UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 13:14:29 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
2080 2022/07/20/000168 072492 IVVATUL IHDA QURROTUL AINI, UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 13:14:29 UMUM Laboratorium 32,436 564 0 2,000 0 0 0 35,000
2081 2022/07/20/000168 072492 IVVATUL IHDA QURROTUL AINI, UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 13:14:29 UMUM Laboratorium 32,436 564 0 2,000 0 0 0 35,000
2082 2022/07/20/000168 072492 IVVATUL IHDA QURROTUL AINI, UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 13:41:20 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
2083 2022/07/20/000171 037273 ARSYLA HUMAIRA SHANUM, BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 13:59:58 BPJS Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
2084 2022/07/20/000171 037273 ARSYLA HUMAIRA SHANUM, BPJS.RJ000 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 13:59:58 BPJS Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
2085 2022/07/20/000172 056269 ATHALLAH ZHAFRAN ARRIZKY, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 12:15:42 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 AMd.AK.
2086 2022/07/20/000173 067692 SASKIA DELLA SAFIRA, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 17:07:46 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 KESEHATAN
2087 2022/07/20/000173 067692 SASKIA DELLA SAFIRA, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 17:07:46 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
00110 KESEHATAN
2088 2022/07/20/000173 067692 SASKIA DELLA SAFIRA, NY UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 17:07:46 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
003 KESEHATAN
2089 2022/07/20/000173 067692 SASKIA DELLA SAFIRA, NY UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 17:07:46 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
004 KESEHATAN
2090 2022/07/20/000173 067692 SASKIA DELLA SAFIRA, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 17:06:14 BPJS IGD 37,900 47,600 0 7,500 5,000 0 0 98,000
0047 KESEHATAN
2091 2022/07/20/000175 072592 ZHAFRAN KENZIE NAUFAL,AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 15:14:49 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 M.Biomed.
2092 2022/07/20/000175 072592 ZHAFRAN KENZIE NAUFAL,AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 15:14:49 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 M.Biomed.
2093 2022/07/20/000177 040957 ADISTRA GENDHIS UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 12:28:36 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
PRAMESWARI, AN 001 AMd.AK.
2094 2022/07/20/000180 072594 BELLVANIA APRILIA EFENDI, BPJS.KINS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 17:31:23 BPJS ICU 3 40,431 26,569 0 3,000 0 0 0 70,000
2095 2022/07/20/000180 072594 BELLVANIA APRILIA EFENDI, BPJS.KINS0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 17:31:23 BPJS ICU 3 32,431 9,569 0 3,000 0 0 0 45,000
2096 2022/07/20/000180 072594 BELLVANIA APRILIA EFENDI, BPJS.KINS0 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 17:32:46 BPJS ICU 3 37,400 47,600 0 5,000 5,000 0 0 95,000
2097 2022/07/20/000180 072594 BELLVANIA APRILIA EFENDI, BPJS.KINS0 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 17:31:23 BPJS ICU 3 31,931 10,069 0 3,000 0 0 0 45,000
2098 2022/07/20/000192 053963 HAIBA ZIA ALMAHYRA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 13:42:44 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
2099 2022/07/20/000205 072606 AYUSHITA KHIRANIA PUTRI, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 15:15:55 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001
8/1/22, 8:34 AM Page 70 of 107

2100 2022/07/20/000205 072606 AYUSHITA KHIRANIA PUTRI, AN UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 15:15:55 UMUM IGD 32,431 9,569 0 3,000 0 0 0 45,000
00110
2101 2022/07/20/000211 021527 ARSYANENDRA NATASENNA BPJS.K2T30 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 19:31:59 BPJS Pandawa 1 40,431 26,569 0 3,000 0 0 0 70,000
WIDIANTO,AN 0001 M.Biomed. KESEHATAN
2102 2022/07/20/000211 021527 ARSYANENDRA NATASENNA BPJS.K2T30 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 19:31:59 BPJS Pandawa 1 32,431 9,569 0 3,000 0 0 0 45,000
2103 2022/07/20/000211 021527 ARSYANENDRA NATASENNA BPJS.K2T30 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 19:02:59 BPJS Pandawa 1 37,400 47,600 0 5,000 5,000 0 0 95,000
2104 2022/07/20/000211 021527 ARSYANENDRA NATASENNA BPJS.K2T30 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 19:31:59 BPJS Pandawa 1 31,931 10,069 0 3,000 0 0 0 45,000
2105 2022/07/20/000214 017774 GIBRAN AZRIL, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 16:28:31 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 KESEHATAN
2106 2022/07/20/000214 017774 GIBRAN AZRIL, AN UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 16:28:31 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
00110 KESEHATAN
2107 2022/07/20/000214 017774 GIBRAN AZRIL, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 16:28:31 BPJS IGD 31,931 10,069 0 3,000 0 0 0 45,000
009 KESEHATAN
2108 2022/07/20/000220 072610 WINARSIH, Ny BPJS.K3B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 20/07/2022 17:51:32 BPJS KS IGD 5 37,400 47,600 0 5,000 5,000 0 0 95,000
2109 2022/07/20/000220 072610 WINARSIH, Ny BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 20/07/2022 17:44:05 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
2110 2022/07/20/000220 072610 WINARSIH, Ny BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 20/07/2022 17:44:05 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
2111 2022/07/20/000220 072610 WINARSIH, Ny BPJS.RJ000 SGOT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 20/07/2022 17:44:05 BPJS IGD 34,451 12,549 0 3,000 0 0 0 50,000
2112 2022/07/20/000220 072610 WINARSIH, Ny BPJS.RJ000 SGPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 20/07/2022 17:44:05 BPJS IGD 34,451 12,549 0 3,000 0 0 0 50,000
2113 2022/07/20/000220 072610 WINARSIH, Ny BPJS.RJ000 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 20/07/2022 17:44:05 BPJS IGD 31,451 10,549 0 3,000 0 0 0 45,000
2114 2022/07/20/000220 072610 WINARSIH, Ny BPJS.RJ000 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 20/07/2022 17:44:05 BPJS IGD 33,951 13,049 0 3,000 0 0 0 50,000
2115 2022/07/20/000220 072610 WINARSIH, Ny BPJS.RJ000 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 20/07/2022 17:44:05 BPJS IGD 30,390 6,610 0 3,000 0 0 0 40,000
2116 2022/07/20/000220 072610 WINARSIH, Ny BPJS.RJ000 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 20/07/2022 17:44:05 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
2117 2022/07/20/000220 072610 WINARSIH, Ny BPJS.RJ000 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 20/07/2022 17:44:05 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
2118 2022/07/20/000224 072613 S. CHILLABELLE Z.A.P, An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 18:08:51 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001
2119 2022/07/20/000224 072613 S. CHILLABELLE Z.A.P, An UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 18:08:51 UMUM IGD 32,431 9,569 0 3,000 0 0 0 45,000
00110
2120 2022/07/20/000232 038283 FAJAR SUHARA, TN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 19:25:57 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 KESEHATAN
2121 2022/07/20/000232 038283 FAJAR SUHARA, TN UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 19:25:57 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
00110 KESEHATAN
2122 2022/07/20/000232 038283 FAJAR SUHARA, TN UMUM.RJ00 IgG Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 19:25:57 BPJS IGD 41,951 46,549 0 1,500 0 0 0 90,000
0024 KESEHATAN
2123 2022/07/20/000232 038283 FAJAR SUHARA, TN UMUM.RJ00 IgM Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 19:25:57 BPJS IGD 41,951 46,549 0 1,500 0 0 0 90,000
0025 KESEHATAN
2124 2022/07/20/000236 004574 MILAN ALTHAF EL SHAARAWY, BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 20/07/2022 20:33:04 BPJS Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
An 01 Sp.A. KESEHATAN
2125 2022/07/20/000236 004574 MILAN ALTHAF EL SHAARAWY, BPJS.RJ000 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 20/07/2022 20:33:04 BPJS Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
2126 2022/07/20/000239 072620 RIA RIZKI, NY BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 19:58:21 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2127 2022/07/20/000239 072620 RIA RIZKI, NY BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 19:58:21 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
2128 2022/07/20/000239 072620 RIA RIZKI, NY BPJS.K2T10 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 19:58:21 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
2129 2022/07/20/000239 072620 RIA RIZKI, NY BPJS.K2T10 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 19:58:21 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
8/1/22, 8:34 AM Page 71 of 107

2130 2022/07/20/000239 072620 RIA RIZKI, NY BPJS.K2T10 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 20/07/2022 20:01:23 BPJS KS IGD 2 37,400 47,600 0 5,000 5,000 0 0 95,000
2131 2022/07/20/000240 072621 SISCA APRILIA HANDAYANI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 20:09:09 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001
2132 2022/07/20/000240 072621 SISCA APRILIA HANDAYANI, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 20:09:09 UMUM IGD 30,390 6,610 0 3,000 0 0 0 40,000
0021
2133 2022/07/20/000248 072626 AKHMAD NAUVAL AL-FARIZKI, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 20:29:33 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
An 001
2134 2022/07/20/000248 072626 AKHMAD NAUVAL AL-FARIZKI, UMUM.RJ00 IgG Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 20:29:33 UMUM IGD 41,951 46,549 0 1,500 0 0 0 90,000
An 0024
2135 2022/07/20/000248 072626 AKHMAD NAUVAL AL-FARIZKI, UMUM.RJ00 IgM Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 20/07/2022 20:29:33 UMUM IGD 41,951 46,549 0 1,500 0 0 0 90,000
An 0025
2136 2022/07/20/000249 070829 ABIGAIL ROSABELLA CHRISTI BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 22:39:14 BPJS Hastina 6 40,431 26,569 0 3,000 0 0 0 70,000
KINASIH, AN 001 AMd.AK. M.Biomed. KESEHATAN
2137 2022/07/20/000249 070829 ABIGAIL ROSABELLA CHRISTI BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 22:39:14 BPJS Hastina 6 32,431 9,569 0 3,000 0 0 0 45,000
2138 2022/07/20/000249 070829 ABIGAIL ROSABELLA CHRISTI BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 22:39:27 BPJS Hastina 6 44,800 35,200 0 5,000 5,000 0 0 90,000
2139 2022/07/20/000249 070829 ABIGAIL ROSABELLA CHRISTI BPJS.K1B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 20/07/2022 22:39:14 BPJS Hastina 6 31,931 10,069 0 3,000 0 0 0 45,000
2140 2022/07/20/000256 042555 GEDE NANDA UTAMA, TN KYN.RJ0000 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10210382 dr. RIMA AURELIA, Sp.PK. 20/07/2022 22:07:29 KARYAWAN Laboratorium 30,900 47,600 0 7,500 5,000 0 0 91,000
47 AMd.AK.
2141 2022/07/13/000215 072296 BRAM KAIVAN ASEGAF, AN BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 21/07/2022 09:30:32 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
0001 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN 7/Ayodya 4
2142 2022/07/18/000223 066913 ABU BAKAR SHAFARAZ, AN BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 21/07/2022 09:36:44 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2143 2022/07/18/000250 086890 LAILATUL MAHFIROH, NY UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4150215 dr. DEWI INDIASTARI, 21/07/2022 13:00:33 UMUM Amarta 8B 40,431 26,569 0 3,000 0 0 0 70,000
0001 ARDHIANSYAH, AMd.Ankes Sp.PD.
2144 2022/07/19/000074 072526 MARINDA MARE., BY NY BPJS.KFIS0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 21/07/2022 07:59:51 BPJS KS Fisol 4 44,800 35,200 0 5,000 5,000 0 0 90,000
2145 2022/07/19/000138 072549 MUHAMMAD HAJID KHOLIL, AN BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 21/07/2022 13:03:43 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2146 2022/07/19/000182 072242 HAFIZAH NURSYIFA ILMI,AN BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 21/07/2022 16:02:47 BPJS KS IGD 5 33,931 13,069 0 3,000 0 0 0 50,000
2148 2022/07/20/000116 072582 SABRINA MARSA KIRANA, AN BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 21/07/2022 09:22:48 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2149 2022/07/20/000116 072582 SABRINA MARSA KIRANA, AN BPJS.K2T10 IgG Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 21/07/2022 09:22:48 BPJS KS IGD 1 41,951 46,549 0 1,500 0 0 0 90,000
2150 2022/07/20/000116 072582 SABRINA MARSA KIRANA, AN BPJS.K2T10 IgM Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 21/07/2022 09:22:48 BPJS KS IGD 1 41,951 46,549 0 1,500 0 0 0 90,000
2151 2022/07/20/000173 067692 SASKIA DELLA SAFIRA, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 21/07/2022 13:05:48 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
001 ARDHIANSYAH, AMd.Ankes MENUR, Sp.OG KESEHATAN 1/Ayodya 1
2152 2022/07/20/000205 072606 AYUSHITA KHIRANIA PUTRI, AN UMUM.K3B0 Rapid Antigen SD Biosensor 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 21/07/2022 00:58:12 UMUM KS IGD 10 38,380 89,120 0 7,500 5,000 0 0 140,000
00048 AMd.AK. Sp.A.
2153 2022/07/20/000205 072606 AYUSHITA KHIRANIA PUTRI, AN UMUM.K3B0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 21/07/2022 00:57:56 UMUM KS IGD 10 47,300 35,200 0 7,500 5,000 0 0 95,000
00050 AMd.AK. Sp.A.
2154 2022/07/20/000220 072610 WINARSIH, Ny BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 21/07/2022 06:48:19 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
2155 2022/07/20/000244 063454 DIAN MAULANI, Ny BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 21/07/2022 16:04:26 BPJS KS IGD 7 40,431 26,569 0 3,000 0 0 0 70,000
2156 2022/07/20/000249 070829 ABIGAIL ROSABELLA CHRISTI BPJS.K1B00 Faeces Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 21/07/2022 12:15:51 BPJS Hastina 6 31,940 5,060 0 3,000 0 0 0 40,000
KINASIH, AN 0023 ARDHIANSYAH, AMd.Ankes M.Biomed. KESEHATAN
2157 2022/07/21/000042 072478 JITA SARI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 21/07/2022 13:33:48 UMUM Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
2158 2022/07/21/000042 072478 JITA SARI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 21/07/2022 13:33:48 UMUM Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
2159 2022/07/21/000042 072478 JITA SARI, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 21/07/2022 13:37:32 UMUM Poli Kandungan 30,390 6,610 0 3,000 0 0 0 40,000
2160 2022/07/21/000042 072478 JITA SARI, NY UMUM. IgG Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 21/07/2022 13:33:48 UMUM Poli Kandungan 41,951 46,549 0 1,500 0 0 0 90,000
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RJ000024 AMd.Ankes MENUR, Sp.OG
2161 2022/07/21/000042 072478 JITA SARI, NY UMUM.RJ00 IgM Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 21/07/2022 13:33:48 UMUM Poli Kandungan 41,951 46,549 0 1,500 0 0 0 90,000
2162 2022/07/21/000042 072478 JITA SARI, NY UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 21/07/2022 13:33:48 UMUM Poli Kandungan 31,931 10,069 0 3,000 0 0 0 45,000
2163 2022/07/21/000049 072343 HIKARI MAYZURA SHEZA, AN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 21/07/2022 14:02:56 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
2164 2022/07/21/000049 072343 HIKARI MAYZURA SHEZA, AN UMUM.RJ00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 21/07/2022 14:02:56 UMUM Poli Anak 31,936 6,064 0 2,000 0 0 0 40,000
2165 2022/07/21/000049 072343 HIKARI MAYZURA SHEZA, AN UMUM.RJ00 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 21/07/2022 14:02:56 UMUM Poli Anak 31,436 6,564 0 2,000 0 0 0 40,000
2166 2022/07/21/000051 035242 Melshabira Nasya Kamila, An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 21/07/2022 02:09:37 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK.
2167 2022/07/21/000052 072359 YUNIAR VIERINDINI,NY BPJS.K3T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 21/07/2022 06:11:17 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2168 2022/07/21/000052 072359 YUNIAR VIERINDINI,NY BPJS.K3T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 21/07/2022 06:11:17 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2169 2022/07/21/000052 072359 YUNIAR VIERINDINI,NY BPJS.K3T10 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 21/07/2022 06:11:17 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2170 2022/07/21/000052 072359 YUNIAR VIERINDINI,NY BPJS.K3T10 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 21/07/2022 06:11:17 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2171 2022/07/21/000052 072359 YUNIAR VIERINDINI,NY BPJS.K3T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 21/07/2022 06:11:51 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2172 2022/07/21/000054 031804 Salma Zahira Isnania Putri, An BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 21/07/2022 06:13:24 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
01 AMd.AK.
2173 2022/07/21/000057 044402 MARLIYAH ISTIAWATI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150220 dr. IMELDA, Sp.OG. 21/07/2022 09:14:38 UMUM Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
2174 2022/07/21/000057 044402 MARLIYAH ISTIAWATI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150220 dr. IMELDA, Sp.OG. 21/07/2022 09:14:38 UMUM Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
2175 2022/07/21/000057 044402 MARLIYAH ISTIAWATI, NY UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150220 dr. IMELDA, Sp.OG. 21/07/2022 09:14:38 UMUM Poli Kandungan 32,436 564 0 2,000 0 0 0 35,000
2176 2022/07/21/000057 044402 MARLIYAH ISTIAWATI, NY UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150220 dr. IMELDA, Sp.OG. 21/07/2022 09:14:38 UMUM Poli Kandungan 32,436 564 0 2,000 0 0 0 35,000
2177 2022/07/21/000057 044402 MARLIYAH ISTIAWATI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150220 dr. IMELDA, Sp.OG. 21/07/2022 10:26:55 UMUM Poli Kandungan 37,900 47,600 0 7,500 5,000 0 0 98,000
2178 2022/07/21/000059 072634 SUMAH, Ny UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 07:55:08 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
2179 2022/07/21/000059 072634 SUMAH, Ny UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 07:55:08 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
2180 2022/07/21/000059 072634 SUMAH, Ny UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 08:18:53 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
2181 2022/07/21/000059 072634 SUMAH, Ny UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 07:55:08 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
2182 2022/07/21/000059 072634 SUMAH, Ny UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 07:55:08 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
2183 2022/07/21/000069 072637 DESI PRIANI NOFITA W, NY UMUM.RJ00 Plano Test 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150220 dr. IMELDA, Sp.OG. 21/07/2022 08:22:26 UMUM Poli Kandungan 33,140 4,860 0 2,000 0 0 0 40,000
2184 2022/07/21/000071 072638 SUPARMIN,TN UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 08:19:07 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
2185 2022/07/21/000080 072284 TRI LESTARI LANGGENG, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150220 dr. IMELDA, Sp.OG. 21/07/2022 20:10:31 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
001 KESEHATAN
2186 2022/07/21/000080 072284 TRI LESTARI LANGGENG, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 21/07/2022 12:57:49 BPJS Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
2187 2022/07/21/000080 072284 TRI LESTARI LANGGENG, NY BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 21/07/2022 12:57:49 BPJS Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
2188 2022/07/21/000080 072284 TRI LESTARI LANGGENG, NY BPJS.RJ000 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 21/07/2022 12:57:49 BPJS Poli Kandungan 32,436 564 0 2,000 0 0 0 35,000
2189 2022/07/21/000080 072284 TRI LESTARI LANGGENG, NY BPJS.RJ000 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 21/07/2022 12:57:49 BPJS Poli Kandungan 32,436 564 0 2,000 0 0 0 35,000
2190 2022/07/21/000080 072284 TRI LESTARI LANGGENG, NY BPJS. SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 21/07/2022 13:41:48 BPJS Poli Kandungan 44,800 35,200 0 5,000 5,000 0 0 90,000
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RJ000050 AMd.Ankes MENUR, Sp.OG
2191 2022/07/21/000081 072642 RENAVA WULAN SARI I, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 10:29:31 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
2192 2022/07/21/000081 072642 RENAVA WULAN SARI I, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 10:29:31 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
2193 2022/07/21/000081 072642 RENAVA WULAN SARI I, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10120217 dr. NYOMAN LUWANG 21/07/2022 10:29:58 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
0047 ARDHIANSYAH, AMd.Ankes WISANA, Sp.OG.
2194 2022/07/21/000081 072642 RENAVA WULAN SARI I, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 10:29:31 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
2195 2022/07/21/000081 072642 RENAVA WULAN SARI I, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 10:29:31 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
2196 2022/07/21/000093 093941 RAGIL ANGGRIANI MEI S, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 10:58:11 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
2197 2022/07/21/000093 093941 RAGIL ANGGRIANI MEI S, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 10:58:11 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
2198 2022/07/21/000093 093941 RAGIL ANGGRIANI MEI S, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 21/07/2022 13:15:52 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
2199 2022/07/21/000093 093941 RAGIL ANGGRIANI MEI S, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 10:58:11 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
2200 2022/07/21/000093 093941 RAGIL ANGGRIANI MEI S, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 10:58:11 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
2201 2022/07/21/000094 072647 GIBRAN KHAIRAN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 21/07/2022 14:47:57 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
ALZAIDAN,AN 001 M.Biomed.
2202 2022/07/21/000094 072647 GIBRAN KHAIRAN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 21/07/2022 14:47:57 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
2203 2022/07/21/000100 072651 LUCI ARI WIJAYA, Ny BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 21/07/2022 13:59:03 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2204 2022/07/21/000100 072651 LUCI ARI WIJAYA, Ny BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 21/07/2022 13:59:03 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
2205 2022/07/21/000100 072651 LUCI ARI WIJAYA, Ny BPJS.K1B00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 21/07/2022 13:59:03 BPJS KS IGD 2 37,951 38,049 0 4,000 0 0 0 80,000
2206 2022/07/21/000100 072651 LUCI ARI WIJAYA, Ny BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 21/07/2022 13:58:06 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
2207 2022/07/21/000100 072651 LUCI ARI WIJAYA, Ny BPJS.K1B00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 21/07/2022 13:59:03 BPJS KS IGD 2 37,951 38,049 0 4,000 0 0 0 80,000
2208 2022/07/21/000100 072651 LUCI ARI WIJAYA, Ny BPJS.RJ000 Plano Test 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10120217 dr. NYOMAN LUWANG 21/07/2022 12:52:49 BPJS Poli Kandungan 33,140 4,860 0 2,000 0 0 0 40,000
2209 2022/07/21/000107 072652 TASKIA NUR FITRIA, An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 21/07/2022 14:32:38 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
2210 2022/07/21/000107 072652 TASKIA NUR FITRIA, An UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 21/07/2022 14:32:38 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
2211 2022/07/21/000109 072658 RAFANI AISHA AHMAD, AN ASKES.RJ00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 21/07/2022 15:32:08 ASURANSI Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
2212 2022/07/21/000109 072658 RAFANI AISHA AHMAD, AN ASKES.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 21/07/2022 15:32:08 ASURANSI Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
2213 2022/07/21/000117 072647 GIBRAN KHAIRAN BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 21/07/2022 16:46:37 UMUM 44,800 35,200 0 5,000 5,000 0 0 90,000
2214 2022/07/21/000122 072659 ANGGARA PUTRA LESMANA, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 21/07/2022 16:33:28 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
AN 001
2215 2022/07/21/000122 072659 ANGGARA PUTRA LESMANA, UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 21/07/2022 16:33:28 UMUM IGD 31,931 10,069 0 3,000 0 0 0 45,000
AN 009
2216 2022/07/21/000123 073786 NUR VITAKHUROHMAH, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 21/07/2022 17:27:11 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2217 2022/07/21/000123 073786 NUR VITAKHUROHMAH, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 21/07/2022 17:27:11 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2218 2022/07/21/000123 073786 NUR VITAKHUROHMAH, NY BPJS.K2B00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 21/07/2022 17:27:11 BPJS KS IGD 1 37,951 38,049 0 4,000 0 0 0 80,000
2219 2022/07/21/000123 073786 NUR VITAKHUROHMAH, NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 21/07/2022 17:27:31 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2220 2022/07/21/000123 073786 NUR VITAKHUROHMAH, NY BPJS.K2B00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 21/07/2022 17:27:11 BPJS KS IGD 1 37,951 38,049 0 4,000 0 0 0 80,000
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2221 2022/07/21/000123 073786 NUR VITAKHUROHMAH, NY BPJS.K2B00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 21/07/2022 17:27:43 BPJS KS IGD 1 31,936 6,064 0 2,000 0 0 0 40,000
2222 2022/07/21/000123 073786 NUR VITAKHUROHMAH, NY BPJS.K2B00 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 21/07/2022 17:27:43 BPJS KS IGD 1 31,436 6,564 0 2,000 0 0 0 40,000
2223 2022/07/21/000134 035846 EZER EL SHARIQUE ERDOGAN, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 21/07/2022 18:24:21 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 Sp.A.
2224 2022/07/21/000134 035846 EZER EL SHARIQUE ERDOGAN, UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 21/07/2022 18:24:21 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
AN 009 Sp.A.
2225 2022/07/21/000136 085110 Asyifa Putri Kaira, An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 21/07/2022 20:04:48 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
2226 2022/07/21/000141 038283 FAJAR SUHARA, TN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 21/07/2022 18:44:26 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001
2227 2022/07/21/000142 072339 MARIA KLARIZA PUTRI BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 21/07/2022 19:58:56 BPJS Amarta 8B 40,431 26,569 0 3,000 0 0 0 70,000
2228 2022/07/21/000142 072339 MARIA KLARIZA PUTRI BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 21/07/2022 19:58:56 BPJS Amarta 8B 32,431 9,569 0 3,000 0 0 0 45,000
2229 2022/07/21/000142 072339 MARIA KLARIZA PUTRI BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 21/07/2022 19:58:56 BPJS Amarta 8B 32,436 564 0 2,000 0 0 0 35,000
2230 2022/07/21/000142 072339 MARIA KLARIZA PUTRI BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 21/07/2022 19:58:56 BPJS Amarta 8B 32,436 564 0 2,000 0 0 0 35,000
2231 2022/07/21/000142 072339 MARIA KLARIZA PUTRI BPJS.K3B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 21/07/2022 19:57:21 BPJS Amarta 8B 37,400 47,600 0 5,000 5,000 0 0 95,000
2232 2022/07/21/000147 064500 BENEDIKTA SANCHIA JANETA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 20:03:48 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
CHRISTI, NY 001
2233 2022/07/21/000147 064500 BENEDIKTA SANCHIA JANETA UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 20:03:48 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
CHRISTI, NY 00110
2234 2022/07/21/000147 064500 BENEDIKTA SANCHIA JANETA UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 20:53:37 UMUM Laboratorium 30,390 6,610 0 3,000 0 0 0 40,000
CHRISTI, NY 0021
2235 2022/07/21/000147 064500 BENEDIKTA SANCHIA JANETA UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 20:11:17 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
CHRISTI, NY 0047
2236 2022/07/21/000147 064500 BENEDIKTA SANCHIA JANETA UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 20:03:48 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
CHRISTI, NY 005
2237 2022/07/21/000147 064500 BENEDIKTA SANCHIA JANETA UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 21/07/2022 20:03:48 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
CHRISTI, NY 006
2238 2022/07/21/000152 100296 ADRIEL IVANO RAQILA PUTRA, BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 21/07/2022 22:16:48 BPJS Hastina 9 40,431 26,569 0 3,000 0 0 0 70,000
2239 2022/07/21/000152 100296 ADRIEL IVANO RAQILA PUTRA, BPJS.K2UP1 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 21/07/2022 22:22:50 BPJS Hastina 9 44,800 35,200 0 5,000 5,000 0 0 90,000
2240 2022/07/21/000155 072672 NUR AZIZAH, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 21/07/2022 21:14:52 UMUM IGD 30,390 6,610 0 3,000 0 0 0 40,000
0021
2241 2022/07/21/000155 072672 NUR AZIZAH, NY UMUM.RJ00 Plano Test 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 21/07/2022 21:14:52 UMUM IGD 33,140 4,860 0 2,000 0 0 0 40,000
0022
2242 2022/07/21/000156 070274 WENNY EKO SULESTYORINI, BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 21/07/2022 21:08:25 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
2243 2022/07/21/000156 070274 WENNY EKO SULESTYORINI, BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 21/07/2022 21:08:25 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
2244 2022/07/21/000156 070274 WENNY EKO SULESTYORINI, BPJS.RJ000 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 21/07/2022 21:08:25 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
2245 2022/07/21/000156 070274 WENNY EKO SULESTYORINI, BPJS.RJ000 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 21/07/2022 21:08:25 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
2246 2022/07/21/000156 070274 WENNY EKO SULESTYORINI, BPJS.RJ000 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 21/07/2022 21:06:57 BPJS IGD 37,400 47,600 0 5,000 5,000 0 0 95,000
2247 2022/07/21/000157 077501 NIZAM RAMADHANI, AN BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 21/07/2022 23:30:38 BPJS Ayodya 2 40,431 26,569 0 3,000 0 0 0 70,000
2248 2022/07/21/000157 077501 NIZAM RAMADHANI, AN BPJS.K3T20 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 21/07/2022 23:30:38 BPJS Ayodya 2 32,431 9,569 0 3,000 0 0 0 45,000
2249 2022/07/18/000250 086890 LAILATUL MAHFIROH, NY UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4150215 dr. DEWI INDIASTARI, 22/07/2022 06:12:51 UMUM Amarta 8B 40,431 26,569 0 3,000 0 0 0 70,000
0001 AMd.AK. Sp.PD.
2250 2022/07/20/000116 072582 SABRINA MARSA KIRANA, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 22/07/2022 08:30:25 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
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2251 2022/07/20/000180 072594 BELLVANIA APRILIA EFENDI, BPJS.KINS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 22/07/2022 09:15:04 BPJS ICU 3 40,431 26,569 0 3,000 0 0 0 70,000
2252 2022/07/20/000190 028167 YOLA ALFIANI PUTRI, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 22/07/2022 13:27:18 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2253 2022/07/20/000192 053963 HAIBA ZIA ALMAHYRA, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 08:28:23 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2254 2022/07/20/000243 072211 MAHIRA AISYAH PUTRI BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 15:50:24 BPJS KS IGD 6 33,931 13,069 0 3,000 0 0 0 50,000
WIDIGDA, An 00020 Sp.A. KESEHATAN
2255 2022/07/20/000243 072211 MAHIRA AISYAH PUTRI BPJS.KINS0 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 15:50:24 BPJS KS IGD 6 31,936 6,064 0 2,000 0 0 0 40,000
2256 2022/07/20/000243 072211 MAHIRA AISYAH PUTRI BPJS.KINS0 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 15:50:24 BPJS KS IGD 6 31,436 6,564 0 2,000 0 0 0 40,000
2257 2022/07/20/000250 072207 ALCEO PUTRA SUCAHYONO, BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 15:48:46 BPJS KS IGD 9 33,931 13,069 0 3,000 0 0 0 50,000
2258 2022/07/20/000250 072207 ALCEO PUTRA SUCAHYONO, BPJS.KINS0 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 15:48:46 BPJS KS IGD 9 31,936 6,064 0 2,000 0 0 0 40,000
2259 2022/07/20/000250 072207 ALCEO PUTRA SUCAHYONO, BPJS.KINS0 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 15:48:46 BPJS KS IGD 9 31,436 6,564 0 2,000 0 0 0 40,000
2260 2022/07/21/000052 072359 YUNIAR VIERINDINI,NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 22/07/2022 06:07:57 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2261 2022/07/21/000100 072651 LUCI ARI WIJAYA, Ny BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10120217 dr. NYOMAN LUWANG 22/07/2022 06:06:57 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2262 2022/07/21/000108 072343 HIKARI MAYZURA SHEZA, AN BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 22/07/2022 15:52:31 BPJS KS IGD 1 33,931 13,069 0 3,000 0 0 0 50,000
2263 2022/07/21/000123 073786 NUR VITAKHUROHMAH, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 22/07/2022 08:25:22 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2264 2022/07/21/000156 070274 WENNY EKO SULESTYORINI, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 22/07/2022 06:09:47 BPJS Amarta 5A 40,431 26,569 0 3,000 0 0 0 70,000
NY 001 AMd.AK. SUSILO,Sp.OG. KESEHATAN
2265 2022/07/21/000160 072676 WENNY EKO, By Ny BPJS.KINS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 22/07/2022 06:41:56 BPJS KS NICU 14 40,431 26,569 0 3,000 0 0 0 70,000
2266 2022/07/21/000160 072676 WENNY EKO, By Ny BPJS.KINS0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 22/07/2022 06:41:56 BPJS KS NICU 14 32,431 9,569 0 3,000 0 0 0 45,000
2267 2022/07/22/000001 072371 AMEERA AMER ALKATIRI, An UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 22/07/2022 14:57:44 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
0020 M.Biomed.
2268 2022/07/22/000001 072371 AMEERA AMER ALKATIRI, An UMUM.RJ00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 22/07/2022 14:57:44 UMUM Poli Anak 31,936 6,064 0 2,000 0 0 0 40,000
007 M.Biomed.
2269 2022/07/22/000001 072371 AMEERA AMER ALKATIRI, An UMUM.RJ00 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 22/07/2022 14:57:44 UMUM Poli Anak 31,436 6,564 0 2,000 0 0 0 40,000
008 M.Biomed.
2270 2022/07/22/000011 061699 MASIDA ROSITA, NY BPJS.RJ000 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 22/07/2022 10:25:27 BPJS Poli Kandungan 30,390 6,610 0 3,000 0 0 0 40,000
2271 2022/07/22/000025 072487 RETNO IMANINGSIH, NY UMUM.RJ00 Plano Test 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150220 dr. IMELDA, Sp.OG. 22/07/2022 15:25:21 UMUM Poli Kandungan 33,140 4,860 0 2,000 0 0 0 40,000
0022
2272 2022/07/22/000030 065021 MUHAMMAD ZHAFI AR RIFKI, BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 21:05:28 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2273 2022/07/22/000030 065021 MUHAMMAD ZHAFI AR RIFKI, BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 21:05:28 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2274 2022/07/22/000044 079230 ULIN SHARA, NY KYN.RJ0000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 22/07/2022 11:20:55 KARYAWAN Poli Kandungan 33,431 26,569 0 3,000 0 0 0 63,000
2275 2022/07/22/000063 072634 SUMAH, Ny BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 22/07/2022 15:41:34 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2276 2022/07/22/000063 072634 SUMAH, Ny BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 22/07/2022 07:05:09 BPJS KS IGD 1 30,390 6,610 0 3,000 0 0 0 40,000
2277 2022/07/22/000067 069277 UMI MASITOH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 22/07/2022 11:03:58 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2278 2022/07/22/000067 069277 UMI MASITOH, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 22/07/2022 11:03:58 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
2279 2022/07/22/000067 069277 UMI MASITOH, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 22/07/2022 11:03:58 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
2280 2022/07/22/000067 069277 UMI MASITOH, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 22/07/2022 11:03:58 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
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2281 2022/07/22/000067 069277 UMI MASITOH, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 22/07/2022 11:03:08 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
2282 2022/07/22/000073 093941 RAGIL ANGGRIANI MEI S, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 22/07/2022 15:45:06 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2283 2022/07/22/000094 047837 MUHAMMAD AL ZAHDAN, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 10:20:51 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
2284 2022/07/22/000094 047837 MUHAMMAD AL ZAHDAN, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 10:20:51 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 Sp.A.
2285 2022/07/22/000096 046771 RIZKI ANUGRAH PRATAMA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 09:48:02 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
2286 2022/07/22/000096 046771 RIZKI ANUGRAH PRATAMA, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 09:48:02 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 Sp.A.
2287 2022/07/22/000097 028878 JOANA ELIZABETH UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 09:49:06 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
KURNIAWAN, AN 001 Sp.A.
2288 2022/07/22/000097 028878 JOANA ELIZABETH UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 09:49:06 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
KURNIAWAN, AN 009 Sp.A.
2289 2022/07/22/000098 000764 Kirana Saraswati,An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 10:59:11 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
2290 2022/07/22/000098 000764 Kirana Saraswati,An UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 10:59:11 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 Sp.A.
2291 2022/07/22/000105 072686 ARLIN SHAKILA PUTRI, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 10:17:09 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
2292 2022/07/22/000105 072686 ARLIN SHAKILA PUTRI, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 10:17:09 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 Sp.A.
2293 2022/07/22/000109 015583 GARLINGGA GALANG BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 11:08:35 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
RAMADHAN,An 001 Sp.A. KESEHATAN
2294 2022/07/22/000109 015583 GARLINGGA GALANG BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 11:08:35 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2295 2022/07/22/000114 072329 SELINA PUTRI RAFIFA, AN BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 10:33:12 BPJS KS IGD 10 33,931 13,069 0 3,000 0 0 0 50,000
2296 2022/07/22/000114 072329 SELINA PUTRI RAFIFA, AN BPJS.KINS0 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 10:33:12 BPJS KS IGD 10 31,936 6,064 0 2,000 0 0 0 40,000
2297 2022/07/22/000114 072329 SELINA PUTRI RAFIFA, AN BPJS.KINS0 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 10:33:12 BPJS KS IGD 10 31,436 6,564 0 2,000 0 0 0 40,000
2298 2022/07/22/000119 067242 ZAHRA WIRA ADISTY, AN BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 11:02:29 BPJS Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
01 Sp.A. KESEHATAN
2299 2022/07/22/000119 067242 ZAHRA WIRA ADISTY, AN BPJS.RJ000 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 11:02:29 BPJS Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
09 Sp.A. KESEHATAN
2300 2022/07/22/000120 046771 RIZKI ANUGRAH PRATAMA, AN BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 11:50:23 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2301 2022/07/22/000122 072689 DINA FITRIA, Nn BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 22/07/2022 11:49:51 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2302 2022/07/22/000122 072689 DINA FITRIA, Nn BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 22/07/2022 19:43:56 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2303 2022/07/22/000122 072689 DINA FITRIA, Nn BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 22/07/2022 11:49:51 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
2304 2022/07/22/000122 072689 DINA FITRIA, Nn BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 22/07/2022 11:49:51 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
2305 2022/07/22/000122 072689 DINA FITRIA, Nn BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 22/07/2022 11:49:51 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
2306 2022/07/22/000123 062726 ELOK DWISETYORINI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 22/07/2022 13:22:51 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
001
2307 2022/07/22/000123 062726 ELOK DWISETYORINI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 22/07/2022 13:22:51 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
00110
2308 2022/07/22/000123 062726 ELOK DWISETYORINI, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 22/07/2022 13:58:08 UMUM Laboratorium 30,390 6,610 0 3,000 0 0 0 40,000
0021
2309 2022/07/22/000123 062726 ELOK DWISETYORINI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 22/07/2022 13:26:02 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
0047
2310 2022/07/22/000123 062726 ELOK DWISETYORINI, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 22/07/2022 13:22:51 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
005
2311 2022/07/22/000123 062726 ELOK DWISETYORINI, NY UMUM. APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 22/07/2022 13:22:51 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
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RJ00006
2312 2022/07/22/000126 072686 ARLIN SHAKILA PUTRI, AN BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 12:08:03 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2313 2022/07/22/000131 040957 ADISTRA GENDHIS BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 14:32:26 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
PRAMESWARI, AN 00110 Sp.A. KESEHATAN
2314 2022/07/22/000131 040957 ADISTRA GENDHIS UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 22/07/2022 12:07:26 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
PRAMESWARI, AN 001 KESEHATAN
2315 2022/07/22/000132 012020 NAURA AQUINA BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 22/07/2022 15:23:25 BPJS Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
PRABASWORO, AN 01 M.Biomed. KESEHATAN
2316 2022/07/22/000132 012020 NAURA AQUINA BPJS.RJ000 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 22/07/2022 15:23:25 BPJS Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
PRABASWORO, AN 09 M.Biomed. KESEHATAN
2317 2022/07/22/000141 072694 DINA FITRIA., BY NY BPJS.KINS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 22/07/2022 15:34:46 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2318 2022/07/22/000141 072694 DINA FITRIA., BY NY BPJS.KINS0 Gula Darah 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 22/07/2022 15:34:46 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2319 2022/07/22/000141 072694 DINA FITRIA., BY NY BPJS.KINS0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 22/07/2022 15:38:21 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2320 2022/07/22/000143 072697 MARSHALL PRAKA MAULANA, BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 22/07/2022 17:00:13 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2321 2022/07/22/000143 072697 MARSHALL PRAKA MAULANA, BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 22/07/2022 17:00:13 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2322 2022/07/22/000143 072697 MARSHALL PRAKA MAULANA, BPJS.K2T10 IgG Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 22/07/2022 17:00:13 BPJS KS IGD 1 41,951 46,549 0 1,500 0 0 0 90,000
2323 2022/07/22/000143 072697 MARSHALL PRAKA MAULANA, BPJS.K2T10 IgM Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 22/07/2022 17:00:13 BPJS KS IGD 1 41,951 46,549 0 1,500 0 0 0 90,000
2324 2022/07/22/000143 072697 MARSHALL PRAKA MAULANA, BPJS.K2T10 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 22/07/2022 15:15:19 BPJS KS IGD 1 37,400 47,600 0 5,000 5,000 0 0 95,000
2325 2022/07/22/000143 072697 MARSHALL PRAKA MAULANA, BPJS.K2T10 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 22/07/2022 17:00:13 BPJS KS IGD 1 31,931 10,069 0 3,000 0 0 0 45,000
001 KESEHATAN
2327 2022/07/22/000147 072555 ROVIE WIDIYANTI,NY BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150220 dr. IMELDA, Sp.OG. 22/07/2022 15:11:39 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
00110 KESEHATAN
2328 2022/07/22/000147 072555 ROVIE WIDIYANTI,NY BPJS.K1B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150220 dr. IMELDA, Sp.OG. 22/07/2022 15:09:38 BPJS KS IGD 1 37,400 47,600 0 5,000 5,000 0 0 95,000
0047 KESEHATAN
2329 2022/07/22/000147 072555 ROVIE WIDIYANTI,NY BPJS.K1B00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150220 dr. IMELDA, Sp.OG. 22/07/2022 15:11:39 BPJS KS IGD 1 37,951 38,049 0 4,000 0 0 0 80,000
005 KESEHATAN
2330 2022/07/22/000147 072555 ROVIE WIDIYANTI,NY BPJS.K1B00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150220 dr. IMELDA, Sp.OG. 22/07/2022 15:11:39 BPJS KS IGD 1 37,951 38,049 0 4,000 0 0 0 80,000
006 KESEHATAN
2331 2022/07/22/000152 022595 RULLY AITANA DEVITASARI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 22/07/2022 15:56:26 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
001
2332 2022/07/22/000152 022595 RULLY AITANA DEVITASARI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 22/07/2022 15:56:26 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
00110
2333 2022/07/22/000152 022595 RULLY AITANA DEVITASARI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 22/07/2022 17:00:48 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
0047 WISANA, Sp.OG.
2334 2022/07/22/000152 022595 RULLY AITANA DEVITASARI, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 22/07/2022 15:56:26 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
005
2335 2022/07/22/000152 022595 RULLY AITANA DEVITASARI, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 22/07/2022 15:56:26 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
006
2336 2022/07/22/000166 054117 MAJIDA DINA KAMILA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 18:06:48 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
2337 2022/07/22/000166 054117 MAJIDA DINA KAMILA, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 18:06:48 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 Sp.A.
2338 2022/07/22/000190 035822 SALMA AHZA NADHIFA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 19:53:41 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
2339 2022/07/22/000190 035822 SALMA AHZA NADHIFA, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 22/07/2022 19:53:41 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 Sp.A.
2340 2022/07/22/000201 072700 EKA WAHYUNI, NY UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 22/07/2022 20:50:06 UMUM KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2341 2022/07/22/000201 072700 EKA WAHYUNI, NY UMUM. Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 22/07/2022 20:50:06 UMUM KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
8/1/22, 8:34 AM Page 78 of 107

2342 2022/07/22/000201 072700 EKA WAHYUNI, NY UMUM.K3B0 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 22/07/2022 20:50:06 UMUM KS IGD 1 30,390 6,610 0 3,000 0 0 0 40,000
2343 2022/07/22/000201 072700 EKA WAHYUNI, NY UMUM.K3B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 22/07/2022 20:50:06 UMUM KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2344 2022/07/22/000201 072700 EKA WAHYUNI, NY UMUM.K3B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 22/07/2022 20:50:06 UMUM KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2345 2022/07/22/000201 072700 EKA WAHYUNI, NY UMUM.K3B0 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 22/07/2022 20:50:48 UMUM KS IGD 1 37,900 47,600 0 7,500 5,000 0 0 98,000
2346 2022/07/19/000190 099609 HERA NUR DUNIARTI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4150215 dr. DEWI INDIASTARI, 23/07/2022 11:15:25 BPJS Hastina 5 40,431 26,569 0 3,000 0 0 0 70,000
2347 2022/07/19/000190 099609 HERA NUR DUNIARTI, NY BPJS.K2B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4150215 dr. DEWI INDIASTARI, 23/07/2022 11:15:25 BPJS Hastina 5 31,931 10,069 0 3,000 0 0 0 45,000
2348 2022/07/20/000116 072582 SABRINA MARSA KIRANA, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 23/07/2022 08:28:48 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2349 2022/07/20/000163 061596 SACHIO RYUGA AFRINDO, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 23/07/2022 10:58:31 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2350 2022/07/20/000180 072594 BELLVANIA APRILIA EFENDI, BPJS.KINS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 23/07/2022 06:31:01 BPJS ICU 3 40,431 26,569 0 3,000 0 0 0 70,000
2351 2022/07/20/000180 072594 BELLVANIA APRILIA EFENDI, BPJS.KINS0 Hapusan darah 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 23/07/2022 16:20:58 BPJS ICU 3 65,431 10,569 50,000 4,000 0 0 0 130,000
2352 2022/07/21/000123 073786 NUR VITAKHUROHMAH, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 23/07/2022 08:20:32 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2353 2022/07/22/000143 072697 MARSHALL PRAKA MAULANA, BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 23/07/2022 15:36:21 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2354 2022/07/22/000170 064500 BENEDIKTA SANCHIA JANETA BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 23/07/2022 05:51:52 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
CHRISTI, NY 001 AMd.AK. INDRAWAN, Sp. OG (K) KESEHATAN
2355 2022/07/22/000202 072642 RENAVA WULAN SARI I, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 23/07/2022 05:57:27 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2356 2022/07/22/000207 037741 NIKE CHOLIFAH, NY ASKES.K1B Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1150219 dr. FATMASARI PERDANA 23/07/2022 01:27:49 ASURANSI KS IGD 10 50,431 26,569 0 3,000 0 0 0 80,000
2357 2022/07/22/000207 037741 NIKE CHOLIFAH, NY ASKES.K1B Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 23/07/2022 11:01:03 ASURANSI KS IGD 10 50,431 26,569 0 3,000 0 0 0 80,000
2358 2022/07/22/000207 037741 NIKE CHOLIFAH, NY ASKES.K1B Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1150219 dr. FATMASARI PERDANA 23/07/2022 01:27:49 ASURANSI KS IGD 10 42,431 9,569 0 3,000 0 0 0 55,000
2359 2022/07/22/000207 037741 NIKE CHOLIFAH, NY ASKES.K1B BT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1150219 dr. FATMASARI PERDANA 23/07/2022 01:27:49 ASURANSI KS IGD 10 42,436 564 0 2,000 0 0 0 45,000
2360 2022/07/22/000207 037741 NIKE CHOLIFAH, NY ASKES.K1B CT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1150219 dr. FATMASARI PERDANA 23/07/2022 01:27:49 ASURANSI KS IGD 10 42,436 564 0 2,000 0 0 0 45,000
2361 2022/07/22/000207 037741 NIKE CHOLIFAH, NY ASKES.K1B SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1150219 dr. FATMASARI PERDANA 23/07/2022 01:28:48 ASURANSI KS IGD 10 47,300 35,200 0 7,500 5,000 0 0 95,000
2362 2022/07/23/000068 072716 MUHAMMAD ALWI SIHAB, AN UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 23/07/2022 02:33:24 UMUM KS IGD 1 50,431 26,569 0 3,000 0 0 0 80,000
0001 AMd.AK. Sp.A.
2363 2022/07/23/000068 072716 MUHAMMAD ALWI SIHAB, AN UMUM.K1B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 23/07/2022 02:33:24 UMUM KS IGD 1 42,431 9,569 0 3,000 0 0 0 55,000
2364 2022/07/23/000070 038808 KEIYONA PRAMUDHITA BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 23/07/2022 06:27:34 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
ARMANDI, AN 001 AMd.AK. Sp.A. KESEHATAN
2365 2022/07/23/000070 038808 KEIYONA PRAMUDHITA BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 23/07/2022 06:27:34 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
ARMANDI, AN 00110 AMd.AK. Sp.A. KESEHATAN
2366 2022/07/23/000071 062726 ELOK DWISETYORINI, NY BPJS.K3UP2 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 23/07/2022 15:38:50 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2367 2022/07/23/000093 022595 RULLY AITANA DEVITASARI, NY BPJS.K3UP2 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10120217 dr. NYOMAN LUWANG 23/07/2022 18:23:57 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
2368 2022/07/23/000093 022595 RULLY AITANA DEVITASARI, NY BPJS.K3UP2 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 23/07/2022 08:31:42 BPJS KS IGD 10 30,390 6,610 0 3,000 0 0 0 40,000
2369 2022/07/23/000096 030915 ALMAN HARUN ABDULLAH, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 23/07/2022 19:54:55 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2370 2022/07/23/000096 030915 ALMAN HARUN ABDULLAH, AN BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 23/07/2022 19:54:55 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
2371 2022/07/23/000096 030915 ALMAN HARUN ABDULLAH, AN BPJS. SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 23/07/2022 19:21:57 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
ARDHIANSYAH, M.
8/1/22, 8:34 AM Page 79 of 107
K1B000050 AMd.Ankes Biomed.
2372 2022/07/23/000096 030915 ALMAN HARUN ABDULLAH, AN BPJS.K1B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 23/07/2022 19:54:55 BPJS KS IGD 2 31,931 10,069 0 3,000 0 0 0 45,000
2373 2022/07/23/000098 091445 Arti Nuvera, Ny UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 4150144 DINNY KARTIKA PUTRI 10120217 dr. NYOMAN LUWANG 23/07/2022 12:22:43 UMUM Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
00110 SUDIYONO, AMd. Keb WISANA, Sp.OG.
2374 2022/07/23/000098 091445 Arti Nuvera, Ny UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 23/07/2022 12:38:00 UMUM Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
2375 2022/07/23/000121 073289 UCIK NOFIA, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 23/07/2022 10:23:00 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2376 2022/07/23/000121 073289 UCIK NOFIA, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 23/07/2022 10:23:00 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2377 2022/07/23/000121 073289 UCIK NOFIA, NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 23/07/2022 10:23:00 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2378 2022/07/23/000121 073289 UCIK NOFIA, NY BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 23/07/2022 10:23:00 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2379 2022/07/23/000121 073289 UCIK NOFIA, NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 23/07/2022 10:23:22 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2380 2022/07/23/000122 085332 ISNAWATI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 23/07/2022 11:11:19 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2381 2022/07/23/000122 085332 ISNAWATI, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 23/07/2022 11:11:19 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2382 2022/07/23/000122 085332 ISNAWATI, NY BPJS.K2B00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 23/07/2022 11:11:19 BPJS KS IGD 1 37,951 38,049 0 4,000 0 0 0 80,000
2383 2022/07/23/000122 085332 ISNAWATI, NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 23/07/2022 11:11:38 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2384 2022/07/23/000122 085332 ISNAWATI, NY BPJS.K2B00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 23/07/2022 11:11:19 BPJS KS IGD 1 37,951 38,049 0 4,000 0 0 0 80,000
2385 2022/07/23/000123 092252 NUR FARIDA, NY BPJS.K3000 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 23/07/2022 11:05:18 BPJS KS IGD 5 37,951 38,049 0 4,000 0 0 0 80,000
2386 2022/07/23/000123 092252 NUR FARIDA, NY BPJS.K3000 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 23/07/2022 11:05:18 BPJS KS IGD 5 37,951 38,049 0 4,000 0 0 0 80,000
2387 2022/07/23/000123 092252 NUR FARIDA, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 23/07/2022 11:05:18 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
2388 2022/07/23/000123 092252 NUR FARIDA, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 23/07/2022 18:26:33 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
2389 2022/07/23/000123 092252 NUR FARIDA, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 23/07/2022 11:05:18 BPJS KS IGD 5 32,431 9,569 0 3,000 0 0 0 45,000
2390 2022/07/23/000123 092252 NUR FARIDA, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 23/07/2022 11:05:32 BPJS KS IGD 5 44,800 35,200 0 5,000 5,000 0 0 90,000
2391 2022/07/23/000127 006036 VELA VENANDA INDRAYANTI BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4150215 dr. DEWI INDIASTARI, 23/07/2022 12:32:21 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
FITRI, NY 0050 AMd.AK. Sp.PD. KESEHATAN
2392 2022/07/23/000127 006036 VELA VENANDA INDRAYANTI UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 23/07/2022 11:16:52 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
FITRI, NY 001 AMd.AK. KESEHATAN
2393 2022/07/23/000127 006036 VELA VENANDA INDRAYANTI UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 23/07/2022 11:16:52 BPJS IGD 31,931 10,069 0 3,000 0 0 0 45,000
FITRI, NY 009 AMd.AK. KESEHATAN
2394 2022/07/23/000136 054595 MUHAMMAD KEENAN DANIAL BPJS.K1T20 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 23/07/2022 13:08:16 BPJS Hastina 4 32,431 9,569 0 3,000 0 0 0 45,000
KARTAWIJAYA, AN 000110 Sp.A. KESEHATAN
2395 2022/07/23/000139 072724 RULLY AITANA, BY NY BPJS.KINS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 23/07/2022 14:05:57 BPJS NICU 2 40,431 26,569 0 3,000 0 0 0 70,000
2396 2022/07/23/000139 072724 RULLY AITANA, BY NY BPJS.KINS0 Gula Darah 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 23/07/2022 14:05:57 BPJS NICU 2 32,431 9,569 0 3,000 0 0 0 45,000
2397 2022/07/23/000140 072730 EKA YUNIARTI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 23/07/2022 14:07:35 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
2398 2022/07/23/000140 072730 EKA YUNIARTI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 23/07/2022 14:07:35 BPJS KS IGD 6 32,431 9,569 0 3,000 0 0 0 45,000
2399 2022/07/23/000140 072730 EKA YUNIARTI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 23/07/2022 14:07:35 BPJS KS IGD 6 32,436 564 0 2,000 0 0 0 35,000
2400 2022/07/23/000140 072730 EKA YUNIARTI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 23/07/2022 14:07:35 BPJS KS IGD 6 32,436 564 0 2,000 0 0 0 35,000
2401 2022/07/23/000140 072730 EKA YUNIARTI, NY BPJS. SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 23/07/2022 14:11:33 BPJS KS IGD 6 44,800 35,200 0 5,000 5,000 0 0 90,000
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K3B000050 AMd.AK. WISANA, Sp.OG.
2402 2022/07/23/000150 072740 M. ADVI NUR AL-HAQQI, An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 23/07/2022 17:29:31 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
2403 2022/07/23/000150 072740 M. ADVI NUR AL-HAQQI, An UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 23/07/2022 17:29:31 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
2404 2022/07/23/000161 043708 VEBY UTAMI RETNONINGTYAS, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 23/07/2022 17:28:41 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
Ny 001 ARDHIANSYAH, AMd.Ankes
2405 2022/07/23/000161 043708 VEBY UTAMI RETNONINGTYAS, UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 23/07/2022 17:27:59 UMUM IGD 47,300 35,200 0 7,500 5,000 0 0 95,000
Ny 0050 ARDHIANSYAH, AMd.Ankes
2406 2022/07/23/000164 028954 NISRINA NABILAH,NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 23/07/2022 17:54:36 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2407 2022/07/23/000164 028954 NISRINA NABILAH,NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 23/07/2022 17:54:36 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2408 2022/07/23/000164 028954 NISRINA NABILAH,NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 23/07/2022 17:54:36 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2409 2022/07/23/000164 028954 NISRINA NABILAH,NY BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 23/07/2022 17:54:36 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2410 2022/07/23/000164 028954 NISRINA NABILAH,NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 23/07/2022 17:53:52 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2411 2022/07/23/000168 072437 SHEZA AULIA SALSABILA, AN UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 23/07/2022 20:16:37 UMUM KS IGD 2 50,431 26,569 0 3,000 0 0 0 75,000
2412 2022/07/23/000168 072437 SHEZA AULIA SALSABILA, AN UMUM.K2B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 23/07/2022 20:16:37 UMUM KS IGD 2 37,431 9,569 0 3,000 0 0 0 50,000
2413 2022/07/23/000168 072437 SHEZA AULIA SALSABILA, AN UMUM.K2B0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 23/07/2022 19:23:14 UMUM KS IGD 2 47,300 35,200 0 7,500 5,000 0 0 95,000
2414 2022/07/23/000168 072437 SHEZA AULIA SALSABILA, AN UMUM.K2B0 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 23/07/2022 20:16:37 UMUM KS IGD 2 36,931 10,069 0 3,000 0 0 0 50,000
2415 2022/07/23/000170 070963 IKE NOVIA RATNA BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 23/07/2022 20:27:52 BPJS Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
KARTIKASARI, NY 01 ARDHIANSYAH, AMd.Ankes SUSILO,Sp.OG. KESEHATAN
2416 2022/07/23/000170 070963 IKE NOVIA RATNA BPJS.RJ000 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 23/07/2022 19:11:50 BPJS Poli Kandungan 30,390 6,610 0 3,000 0 0 0 40,000
KARTIKASARI, NY 021 ARDHIANSYAH, AMd.Ankes SUSILO,Sp.OG. KESEHATAN
2417 2022/07/23/000172 064883 ZINEDINE RAZIQ ZIDANE, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 23/07/2022 19:44:15 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
2418 2022/07/23/000174 036827 YENIE, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 23/07/2022 21:51:13 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
01 KESEHATAN
2419 2022/07/23/000175 072743 CARREN CHELSEA RAMDHAN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 23/07/2022 20:19:03 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
PRASTYA, AN 001 ARDHIANSYAH, AMd.Ankes
2420 2022/07/20/000192 053963 HAIBA ZIA ALMAHYRA, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 10:28:14 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2421 2022/07/20/000211 021527 ARSYANENDRA NATASENNA BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 24/07/2022 10:14:05 BPJS Pandawa 1 40,431 26,569 0 3,000 0 0 0 70,000
WIDIANTO,AN 001 AMd.AK. M.Biomed. KESEHATAN
2422 2022/07/22/000109 015583 GARLINGGA GALANG BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 10:24:20 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
RAMADHAN,An 001 AMd.AK. Sp.A. KESEHATAN
2423 2022/07/22/000114 072329 SELINA PUTRI RAFIFA, AN BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 10:12:55 BPJS KS IGD 10 33,931 13,069 0 3,000 0 0 0 50,000
2424 2022/07/22/000120 046771 RIZKI ANUGRAH PRATAMA, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 06:37:22 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A. KESEHATAN
2425 2022/07/22/000126 072686 ARLIN SHAKILA PUTRI, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 10:27:05 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2426 2022/07/22/000131 040957 ADISTRA GENDHIS BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 10:30:02 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
PRAMESWARI, AN 001 AMd.AK. Sp.A. KESEHATAN
2427 2022/07/22/000143 072697 MARSHALL PRAKA MAULANA, BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 24/07/2022 16:05:03 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2428 2022/07/22/000156 072371 AMEERA AMER ALKATIRI, An BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 24/07/2022 16:03:53 BPJS KS IGD 1 33,931 13,069 0 3,000 0 0 0 50,000
2429 2022/07/23/000121 073289 UCIK NOFIA, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 24/07/2022 06:40:17 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2430 2022/07/23/000122 085332 ISNAWATI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 24/07/2022 13:45:39 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2431 2022/07/23/000127 006036 VELA VENANDA INDRAYANTI BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 24/07/2022 13:46:51 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
FITRI, NY 001 Sp.PD. KESEHATAN
8/1/22, 8:34 AM Page 81 of 107

2432 2022/07/23/000164 028954 NISRINA NABILAH,NY BPJS.K2T30 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10120217 dr. NYOMAN LUWANG 24/07/2022 23:10:26 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2433 2022/07/24/000015 046804 FEZIA AYUDHIA INARA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 19:08:05 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
2434 2022/07/24/000015 046804 FEZIA AYUDHIA INARA, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 19:08:05 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 Sp.A.
2435 2022/07/24/000016 085171 SULASTRI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 24/07/2022 02:24:42 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2436 2022/07/24/000016 085171 SULASTRI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 24/07/2022 02:24:42 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2437 2022/07/24/000016 085171 SULASTRI, NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 24/07/2022 02:24:42 BPJS KS IGD 1 30,390 6,610 0 3,000 0 0 0 40,000
2438 2022/07/24/000016 085171 SULASTRI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 24/07/2022 02:24:42 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2439 2022/07/24/000016 085171 SULASTRI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 24/07/2022 02:24:42 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2440 2022/07/24/000016 085171 SULASTRI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 24/07/2022 02:22:14 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2441 2022/07/24/000020 071194 EKA DYAR WAHYUNI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150220 dr. IMELDA, Sp.OG. 24/07/2022 11:41:29 UMUM Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK.
2442 2022/07/24/000020 071194 EKA DYAR WAHYUNI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150220 dr. IMELDA, Sp.OG. 24/07/2022 11:41:29 UMUM Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
00110 AMd.AK.
2443 2022/07/24/000020 071194 EKA DYAR WAHYUNI, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150220 dr. IMELDA, Sp.OG. 24/07/2022 11:41:29 UMUM Poli Kandungan 30,390 6,610 0 3,000 0 0 0 40,000
0021 AMd.AK.
2444 2022/07/24/000020 071194 EKA DYAR WAHYUNI, NY UMUM.RJ00 Anti HIV 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150220 dr. IMELDA, Sp.OG. 24/07/2022 11:41:29 UMUM Poli Kandungan 38,951 34,049 0 2,000 0 0 0 75,000
0026 AMd.AK.
2445 2022/07/24/000020 071194 EKA DYAR WAHYUNI, NY UMUM.RJ00 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150220 dr. IMELDA, Sp.OG. 24/07/2022 11:41:29 UMUM Poli Kandungan 38,951 34,049 0 2,000 0 0 0 75,000
0027 AMd.AK.
2446 2022/07/24/000020 071194 EKA DYAR WAHYUNI, NY UMUM.RJ00 TPHA/Sipilis 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150220 dr. IMELDA, Sp.OG. 24/07/2022 11:41:29 UMUM Poli Kandungan 37,951 34,049 0 3,000 0 0 0 75,000
0028 AMd.AK.
2447 2022/07/24/000020 071194 EKA DYAR WAHYUNI, NY UMUM.RJ00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150220 dr. IMELDA, Sp.OG. 24/07/2022 11:41:29 UMUM Poli Kandungan 31,936 6,064 0 2,000 0 0 0 40,000
007 AMd.AK.
2448 2022/07/24/000023 024048 DIA HERAYU, NY UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 24/07/2022 07:22:46 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2449 2022/07/24/000023 024048 DIA HERAYU, NY UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 24/07/2022 07:22:46 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2450 2022/07/24/000023 024048 DIA HERAYU, NY UMUM.K3B0 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 24/07/2022 07:22:46 BPJS KS IGD 1 30,390 6,610 0 3,000 0 0 0 40,000
2451 2022/07/24/000023 024048 DIA HERAYU, NY UMUM.K3B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 24/07/2022 07:22:46 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2452 2022/07/24/000023 024048 DIA HERAYU, NY UMUM.K3B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 24/07/2022 07:22:46 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2453 2022/07/24/000023 024048 DIA HERAYU, NY UMUM.K3B0 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 24/07/2022 07:23:24 BPJS KS IGD 1 37,900 47,600 0 7,500 5,000 0 0 98,000
2454 2022/07/24/000034 072753 SANIYAH NISRIN, AN BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 11:44:33 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2455 2022/07/24/000034 072753 SANIYAH NISRIN, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 24/07/2022 10:06:13 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 KESEHATAN
2456 2022/07/24/000035 062524 ACHMAD AMIINULLAH, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 24/07/2022 10:08:51 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK.
2457 2022/07/24/000037 044429 KEN ALZIO RAFISQY, AN BPJS.K2T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 24/07/2022 11:55:57 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2458 2022/07/24/000037 044429 KEN ALZIO RAFISQY, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 24/07/2022 10:10:41 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
2459 2022/07/24/000041 072755 AGMENIA AYU YUNITHA, Ny UMUM.RJ00 TPHA/Sipilis 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 24/07/2022 10:24:57 BPJS IGD 37,951 34,049 0 3,000 0 0 0 75,000
2460 2022/07/24/000050 027742 FAIZ AYDIN RAMADHAN, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 19:03:49 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
2461 2022/07/24/000050 027742 FAIZ AYDIN RAMADHAN, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 19:03:49 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 Sp.A.
2462 2022/07/24/000051 072758 DIAN ROSDIANA DEWI, NY UMUM. Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 24/07/2022 13:42:47 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
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RJ00001
2463 2022/07/24/000052 072759 AYLA FAUZIA AZZAHRA, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 24/07/2022 13:41:21 UMUM KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
2464 2022/07/24/000052 072759 AYLA FAUZIA AZZAHRA, AN BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 24/07/2022 13:41:53 UMUM KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
0050 Sp.A.
2465 2022/07/24/000053 072760 ARWINDA ULFA ADRIAZANI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 24/07/2022 14:43:36 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001
2466 2022/07/24/000053 072760 ARWINDA ULFA ADRIAZANI, NY UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 24/07/2022 14:43:36 UMUM IGD 31,931 10,069 0 3,000 0 0 0 45,000
009
2467 2022/07/24/000056 023413 PRANAJATI AKMAL ABHINAYA, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 24/07/2022 15:35:56 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 Sp.A.
2468 2022/07/24/000059 072766 HASBI AFLAH ALHASAN, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 19:19:59 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
2469 2022/07/24/000059 072766 HASBI AFLAH ALHASAN, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 19:19:59 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 Sp.A.
2470 2022/07/24/000062 093131 RIZKY DWI KURNIASIH, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 24/07/2022 18:08:41 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001
2471 2022/07/24/000062 093131 RIZKY DWI KURNIASIH, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 24/07/2022 18:08:41 UMUM IGD 32,431 9,569 0 3,000 0 0 0 45,000
00110
2472 2022/07/24/000062 093131 RIZKY DWI KURNIASIH, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 24/07/2022 18:08:41 UMUM IGD 30,390 6,610 0 3,000 0 0 0 40,000
0021
2473 2022/07/24/000062 093131 RIZKY DWI KURNIASIH, NY UMUM.RJ00 Anti HIV 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 24/07/2022 18:08:41 UMUM IGD 38,951 34,049 0 2,000 0 0 0 75,000
0026
2474 2022/07/24/000062 093131 RIZKY DWI KURNIASIH, NY UMUM.RJ00 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 24/07/2022 18:08:41 UMUM IGD 38,951 34,049 0 2,000 0 0 0 75,000
0027
2475 2022/07/24/000062 093131 RIZKY DWI KURNIASIH, NY UMUM.RJ00 TPHA/Sipilis 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 24/07/2022 18:08:41 UMUM IGD 37,951 34,049 0 3,000 0 0 0 75,000
0028
2476 2022/07/24/000062 093131 RIZKY DWI KURNIASIH, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 24/07/2022 18:09:25 UMUM IGD 37,900 47,600 0 7,500 5,000 0 0 98,000
0047
2477 2022/07/24/000062 093131 RIZKY DWI KURNIASIH, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 24/07/2022 18:08:41 UMUM IGD 37,951 38,049 0 4,000 0 0 0 80,000
005
2478 2022/07/24/000062 093131 RIZKY DWI KURNIASIH, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 24/07/2022 18:08:41 UMUM IGD 37,951 38,049 0 4,000 0 0 0 80,000
006
2479 2022/07/24/000066 016586 Raden Malik Ibrahim, an BPJS.K2T10 IgG Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 18:59:20 BPJS KS IGD 1 41,951 46,549 0 1,500 0 0 0 90,000
2480 2022/07/24/000066 016586 Raden Malik Ibrahim, an BPJS.K2T10 IgM Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 18:59:20 BPJS KS IGD 1 41,951 46,549 0 1,500 0 0 0 90,000
2481 2022/07/24/000072 072774 FALISHA ASMYA SYAIFA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 18:58:28 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
2482 2022/07/24/000072 072774 FALISHA ASMYA SYAIFA, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 18:58:28 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 Sp.A.
2483 2022/07/24/000074 027742 FAIZ AYDIN RAMADHAN, AN BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 21:01:20 BPJS KS IGD 6 32,431 9,569 0 3,000 0 0 0 45,000
2484 2022/07/24/000075 091953 MUHAMMAD ZHAFRAN AQILA BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 21:25:18 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
DIRGANTARA, AN 001 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN
2485 2022/07/24/000075 091953 MUHAMMAD ZHAFRAN AQILA BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 21:25:18 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
DIRGANTARA, AN 00110 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN
2486 2022/07/24/000077 072775 RADITA GALIH PAWIYARTI, NY UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 24/07/2022 21:00:02 UMUM KS IGD 7 50,431 26,569 0 3,000 0 0 0 75,000
2487 2022/07/24/000077 072775 RADITA GALIH PAWIYARTI, NY UMUM.K2B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 24/07/2022 21:00:02 UMUM KS IGD 7 37,431 9,569 0 3,000 0 0 0 50,000
2488 2022/07/24/000077 072775 RADITA GALIH PAWIYARTI, NY UMUM.K2B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 24/07/2022 21:00:02 UMUM KS IGD 7 37,436 564 0 2,000 0 0 0 40,000
2489 2022/07/24/000077 072775 RADITA GALIH PAWIYARTI, NY UMUM.K2B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 24/07/2022 21:00:02 UMUM KS IGD 7 37,436 564 0 2,000 0 0 0 40,000
2490 2022/07/24/000077 072775 RADITA GALIH PAWIYARTI, NY UMUM.K2B0 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 24/07/2022 20:54:50 UMUM KS IGD 7 37,900 47,600 0 7,500 5,000 0 0 98,000
2491 2022/07/24/000077 072775 RADITA GALIH PAWIYARTI, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 24/07/2022 20:10:33 UMUM IGD 30,390 6,610 0 3,000 0 0 0 40,000
0021
2492 2022/07/24/000082 039899 WAHYU MUHAMMAD BPJS.K2T30 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 23:09:37 BPJS Amarta 4A 40,431 26,569 0 3,000 0 0 0 70,000
MAULADANA, AN 0001 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN
8/1/22, 8:34 AM Page 83 of 107

2493 2022/07/24/000082 039899 WAHYU MUHAMMAD BPJS.K2T30 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 24/07/2022 23:09:37 BPJS Amarta 4A 32,431 9,569 0 3,000 0 0 0 45,000
MAULADANA, AN 000110 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN
2495 2022/07/20/000249 070829 ABIGAIL ROSABELLA CHRISTI BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 25/07/2022 05:52:20 BPJS Hastina 6 40,431 26,569 0 3,000 0 0 0 70,000
KINASIH, AN 001 ARDHIANSYAH, AMd.Ankes M.Biomed. KESEHATAN
2496 2022/07/21/000123 073786 NUR VITAKHUROHMAH, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 25/07/2022 15:48:23 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2497 2022/07/22/000030 065021 MUHAMMAD ZHAFI AR RIFKI, BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 25/07/2022 10:24:18 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2498 2022/07/22/000109 015583 GARLINGGA GALANG BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 25/07/2022 10:11:20 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2499 2022/07/22/000126 072686 ARLIN SHAKILA PUTRI, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 25/07/2022 11:35:09 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A. KESEHATAN
2500 2022/07/23/000127 006036 VELA VENANDA INDRAYANTI BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 25/07/2022 13:21:13 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2501 2022/07/23/000127 006036 VELA VENANDA INDRAYANTI BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 25/07/2022 20:27:03 BPJS KS IGD 1 30,390 6,610 0 3,000 0 0 0 40,000
2502 2022/07/24/000037 044429 KEN ALZIO RAFISQY, AN BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 25/07/2022 10:21:58 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2503 2022/07/24/000083 073218 CHANIFAH, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 25/07/2022 01:04:02 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
2504 2022/07/24/000083 073218 CHANIFAH, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 25/07/2022 01:04:02 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
2505 2022/07/24/000083 073218 CHANIFAH, NY UMUM.RJ00 SGOT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 25/07/2022 01:04:02 BPJS IGD 34,451 12,549 0 3,000 0 0 0 50,000
2506 2022/07/24/000083 073218 CHANIFAH, NY UMUM.RJ00 SGPT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 25/07/2022 01:04:02 BPJS IGD 34,451 12,549 0 3,000 0 0 0 50,000
2507 2022/07/24/000083 073218 CHANIFAH, NY UMUM.RJ00 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 25/07/2022 01:04:02 BPJS IGD 31,451 10,549 0 3,000 0 0 0 45,000
2508 2022/07/24/000083 073218 CHANIFAH, NY UMUM.RJ00 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 25/07/2022 01:04:02 BPJS IGD 33,951 13,049 0 3,000 0 0 0 50,000
2509 2022/07/24/000083 073218 CHANIFAH, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 25/07/2022 00:51:20 BPJS IGD 30,390 6,610 0 3,000 0 0 0 40,000
2510 2022/07/24/000083 073218 CHANIFAH, NY UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 25/07/2022 01:04:02 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
2511 2022/07/24/000083 073218 CHANIFAH, NY UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 25/07/2022 01:04:02 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
2512 2022/07/24/000083 073218 CHANIFAH, NY UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 25/07/2022 00:50:14 BPJS IGD 47,300 35,200 0 7,500 5,000 0 0 95,000
2513 2022/07/25/000028 072438 ARTEMIS ALMERIA SETIAWAN, UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 25/07/2022 12:20:25 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
AN 0020 M.Biomed.
2514 2022/07/25/000028 072438 ARTEMIS ALMERIA SETIAWAN, UMUM.RJ00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 25/07/2022 12:20:25 UMUM Poli Anak 31,936 6,064 0 2,000 0 0 0 40,000
AN 007 M.Biomed.
2515 2022/07/25/000028 072438 ARTEMIS ALMERIA SETIAWAN, UMUM.RJ00 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 25/07/2022 12:20:25 UMUM Poli Anak 31,436 6,564 0 2,000 0 0 0 40,000
AN 008 M.Biomed.
2516 2022/07/25/000040 072017 SHANKARA KAIVAN MAHATMA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 25/07/2022 11:44:31 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
EL HAZMI, An 001 M.Biomed.
2517 2022/07/25/000040 072017 SHANKARA KAIVAN MAHATMA UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 25/07/2022 11:44:31 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
EL HAZMI, An 0020 M.Biomed.
2518 2022/07/25/000066 037288 WIDHA BRAMANTYAS, TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8170324 dr. EDWIN PRADANA, 25/07/2022 11:50:51 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
0031 Sp.And.
2519 2022/07/25/000068 093131 RIZKY DWI KURNIASIH, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 25/07/2022 13:28:56 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2520 2022/07/25/000069 066938 AINUN IKA PRATIWI, NY BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 25/07/2022 05:00:39 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2521 2022/07/25/000069 066938 AINUN IKA PRATIWI, NY BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 25/07/2022 10:32:11 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2522 2022/07/25/000069 066938 AINUN IKA PRATIWI, NY BPJS.K2UP1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 25/07/2022 05:00:39 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
8/1/22, 8:34 AM Page 84 of 107

2523 2022/07/25/000069 066938 AINUN IKA PRATIWI, NY BPJS.K2UP1 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 25/07/2022 05:00:39 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2524 2022/07/25/000069 066938 AINUN IKA PRATIWI, NY BPJS.K2UP1 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 25/07/2022 05:00:39 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2525 2022/07/25/000069 066938 AINUN IKA PRATIWI, NY BPJS.K2UP1 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 25/07/2022 04:59:51 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2526 2022/07/25/000070 064515 LUSI INDRIANI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 25/07/2022 06:00:42 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
2527 2022/07/25/000070 064515 LUSI INDRIANI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 25/07/2022 15:52:15 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
2528 2022/07/25/000070 064515 LUSI INDRIANI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 25/07/2022 06:00:42 BPJS KS IGD 10 32,431 9,569 0 3,000 0 0 0 45,000
2529 2022/07/25/000070 064515 LUSI INDRIANI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 25/07/2022 06:00:42 BPJS KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
2530 2022/07/25/000070 064515 LUSI INDRIANI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 25/07/2022 06:00:42 BPJS KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
2531 2022/07/25/000070 064515 LUSI INDRIANI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 25/07/2022 06:00:03 BPJS KS IGD 10 44,800 35,200 0 5,000 5,000 0 0 90,000
2532 2022/07/25/000071 072755 AGMENIA AYU YUNITHA, Ny BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 25/07/2022 05:57:35 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2533 2022/07/25/000071 072755 AGMENIA AYU YUNITHA, Ny BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 25/07/2022 15:50:07 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2534 2022/07/25/000071 072755 AGMENIA AYU YUNITHA, Ny BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 25/07/2022 05:57:35 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
2535 2022/07/25/000071 072755 AGMENIA AYU YUNITHA, Ny BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 25/07/2022 05:57:35 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
2536 2022/07/25/000071 072755 AGMENIA AYU YUNITHA, Ny BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 25/07/2022 05:57:35 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
2537 2022/07/25/000071 072755 AGMENIA AYU YUNITHA, Ny BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 25/07/2022 05:56:32 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
2538 2022/07/25/000075 072433 AKIRA NADISHA ALMIRA, AN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 25/07/2022 11:47:18 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
0020 M.Biomed.
2539 2022/07/25/000075 072433 AKIRA NADISHA ALMIRA, AN UMUM.RJ00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 25/07/2022 11:47:18 UMUM Poli Anak 31,936 6,064 0 2,000 0 0 0 40,000
007 M.Biomed.
2540 2022/07/25/000075 072433 AKIRA NADISHA ALMIRA, AN UMUM.RJ00 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 25/07/2022 11:47:18 UMUM Poli Anak 31,436 6,564 0 2,000 0 0 0 40,000
008 M.Biomed.
2541 2022/07/25/000078 072784 SUKARMI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4150215 dr. DEWI INDIASTARI, 25/07/2022 06:38:13 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
2542 2022/07/25/000078 072784 SUKARMI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4150215 dr. DEWI INDIASTARI, 25/07/2022 06:38:13 UMUM IGD 32,431 9,569 0 3,000 0 0 0 45,000
2543 2022/07/25/000078 072784 SUKARMI, NY UMUM.RJ00 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4150215 dr. DEWI INDIASTARI, 25/07/2022 06:38:13 UMUM IGD 31,451 10,549 0 3,000 0 0 0 45,000
2544 2022/07/25/000078 072784 SUKARMI, NY UMUM.RJ00 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4150215 dr. DEWI INDIASTARI, 25/07/2022 06:38:13 UMUM IGD 33,951 13,049 0 3,000 0 0 0 50,000
2545 2022/07/25/000078 072784 SUKARMI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4150215 dr. DEWI INDIASTARI, 25/07/2022 06:37:19 UMUM IGD 47,300 35,200 0 7,500 5,000 0 0 95,000
2546 2022/07/25/000084 068375 SIRRI RAHMANINGSIH, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 25/07/2022 07:58:11 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
2547 2022/07/25/000084 068375 SIRRI RAHMANINGSIH, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 25/07/2022 07:58:11 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
2548 2022/07/25/000084 068375 SIRRI RAHMANINGSIH, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 25/07/2022 10:22:32 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
2549 2022/07/25/000084 068375 SIRRI RAHMANINGSIH, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 25/07/2022 07:58:11 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
2550 2022/07/25/000084 068375 SIRRI RAHMANINGSIH, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 25/07/2022 07:58:11 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
2551 2022/07/25/000091 072786 WAHYU MAHA PURWITA, TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8170324 dr. EDWIN PRADANA, 25/07/2022 11:51:21 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
0031 Sp.And.
2552 2022/07/25/000106 072788 FARADIKA DWIKI AFISENA, TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8170324 dr. EDWIN PRADANA, 25/07/2022 11:52:00 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
0031 Sp.And.
8/1/22, 8:34 AM Page 85 of 107

2553 2022/07/25/000113 054117 MAJIDA DINA KAMILA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 25/07/2022 08:24:52 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001
2554 2022/07/25/000124 072792 AMINAH, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 25/07/2022 11:10:25 UMUM Poli Kandungan 30,390 6,610 0 3,000 0 0 0 40,000
0021 MENUR, Sp.OG
2555 2022/07/25/000129 072346 MARIYAM, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 25/07/2022 10:38:18 BPJS Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
2556 2022/07/25/000155 075980 MUHAMMAD RAEYHAN HAIKAL BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 25/07/2022 13:54:45 BPJS 44,800 35,200 0 5,000 5,000 0 0 90,000
RAMADHAN, AN 0050 M.Biomed. KESEHATAN
2557 2022/07/25/000179 012917 ROHICHUL MACHTUM, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 25/07/2022 19:55:38 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK. Sp.A.
2558 2022/07/25/000179 012917 ROHICHUL MACHTUM, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 25/07/2022 19:55:38 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 AMd.AK. Sp.A.
2559 2022/07/25/000191 007679 Naradipta Zian Artanabil, An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 25/07/2022 19:58:22 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK. Sp.A.
2560 2022/07/25/000191 007679 Naradipta Zian Artanabil, An UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 25/07/2022 19:58:22 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 AMd.AK. Sp.A.
2561 2022/07/25/000194 072806 PRINCESS FLORENCIA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 25/07/2022 19:52:44 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
KIMBERLY, AN 001 AMd.AK. Sp.A.
2562 2022/07/25/000194 072806 PRINCESS FLORENCIA UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 25/07/2022 19:52:44 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
2563 2022/07/25/000208 026740 MUHAMMAD ABIZAR AL UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 25/07/2022 19:46:36 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
GHIFARI ,An 001 AMd.AK. Sp.A.
2564 2022/07/25/000208 026740 MUHAMMAD ABIZAR AL UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 25/07/2022 19:46:36 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
GHIFARI ,An 009 AMd.AK. Sp.A.
2565 2022/07/25/000221 070175 IRMA SETIANI PUTRI, NY BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 25/07/2022 20:03:11 BPJS Hastina 6 40,431 26,569 0 3,000 0 0 0 70,000
2566 2022/07/25/000221 070175 IRMA SETIANI PUTRI, NY BPJS.K2UP1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 25/07/2022 20:03:11 BPJS Hastina 6 32,431 9,569 0 3,000 0 0 0 45,000
2567 2022/07/25/000221 070175 IRMA SETIANI PUTRI, NY BPJS.K2UP1 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 25/07/2022 20:03:11 BPJS Hastina 6 32,436 564 0 2,000 0 0 0 35,000
2568 2022/07/25/000221 070175 IRMA SETIANI PUTRI, NY BPJS.K2UP1 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 25/07/2022 20:03:11 BPJS Hastina 6 32,436 564 0 2,000 0 0 0 35,000
2569 2022/07/25/000221 070175 IRMA SETIANI PUTRI, NY BPJS.K2UP1 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 25/07/2022 20:05:04 BPJS Hastina 6 37,400 47,600 0 5,000 5,000 0 0 95,000
2570 2022/07/25/000222 055640 ARSYANA AISYAH MUSHOFFA, BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 25/07/2022 19:49:38 BPJS Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
2571 2022/07/25/000223 072811 ENDRA AGOES P, TN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 25/07/2022 18:43:23 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK.
2572 2022/07/25/000223 072811 ENDRA AGOES P, TN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 25/07/2022 18:43:23 UMUM IGD 31,931 10,069 0 3,000 0 0 0 45,000
009 AMd.AK.
2573 2022/07/25/000225 065658 YULIAN TRI FELANI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 25/07/2022 20:08:43 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 KESEHATAN
2574 2022/07/25/000225 065658 YULIAN TRI FELANI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 25/07/2022 20:08:43 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
00110 KESEHATAN
2575 2022/07/25/000225 065658 YULIAN TRI FELANI, NY UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 25/07/2022 20:08:43 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
003 KESEHATAN
2576 2022/07/25/000225 065658 YULIAN TRI FELANI, NY UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 25/07/2022 20:08:43 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
004 KESEHATAN
2577 2022/07/25/000236 072814 RIZKY IFAN FADILLAH, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 25/07/2022 20:22:16 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK. Sp.A.
2578 2022/07/25/000240 012917 ROHICHUL MACHTUM, AN UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 25/07/2022 21:54:39 UMUM KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
2579 2022/07/25/000241 072806 PRINCESS FLORENCIA UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 25/07/2022 21:55:24 UMUM KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
KIMBERLY, AN 000110 ARDHIANSYAH, AMd.Ankes Sp.A.
2580 2022/07/21/000160 072676 WENNY EKO, By Ny BPJS.KINS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 26/07/2022 16:10:10 BPJS KS NICU 14 40,431 26,569 0 3,000 0 0 0 70,000
2581 2022/07/21/000160 072676 WENNY EKO, By Ny BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 26/07/2022 16:10:10 BPJS KS NICU 14 33,931 13,069 0 3,000 0 0 0 50,000
2582 2022/07/23/000096 030915 ALMAN HARUN ABDULLAH, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 26/07/2022 18:41:22 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
8/1/22, 8:34 AM Page 86 of 107

2583 2022/07/23/000096 030915 ALMAN HARUN ABDULLAH, AN BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 26/07/2022 20:55:46 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
2584 2022/07/23/000127 006036 VELA VENANDA INDRAYANTI BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4150215 dr. DEWI INDIASTARI, 26/07/2022 05:18:47 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
FITRI, NY 001 ARDHIANSYAH, AMd.Ankes Sp.PD. KESEHATAN
2585 2022/07/24/000034 072753 SANIYAH NISRIN, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 26/07/2022 08:55:35 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2586 2022/07/24/000037 044429 KEN ALZIO RAFISQY, AN BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 26/07/2022 09:17:34 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2587 2022/07/24/000066 016586 Raden Malik Ibrahim, an BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 26/07/2022 16:01:07 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2588 2022/07/25/000221 070175 IRMA SETIANI PUTRI, NY BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 26/07/2022 09:18:47 BPJS Hastina 6 40,431 26,569 0 3,000 0 0 0 70,000
2589 2022/07/26/000006 072630 REYHAN ATHAILLAH UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 26/07/2022 17:21:02 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
SHAQUILLE CALIEF, AN 0020 M.Biomed.
2590 2022/07/26/000006 072630 REYHAN ATHAILLAH UMUM.RJ00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 26/07/2022 17:21:02 UMUM Poli Anak 31,936 6,064 0 2,000 0 0 0 40,000
2591 2022/07/26/000006 072630 REYHAN ATHAILLAH UMUM.RJ00 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 26/07/2022 17:21:02 UMUM Poli Anak 31,436 6,564 0 2,000 0 0 0 40,000
2592 2022/07/26/000023 072530 AURELIA SAFANIYA AZ- BPJS.RJ000 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 26/07/2022 10:07:23 BPJS Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
ZAURA,AN 020 AMd.AK. Sp.A. KESEHATAN
2593 2022/07/26/000072 019016 YOHANNA AUDRISA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 26/07/2022 09:20:30 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
PARASAYU, AN 001 AMd.AK. Sp.A.
2594 2022/07/26/000072 019016 YOHANNA AUDRISA UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 26/07/2022 09:20:30 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
PARASAYU, AN 009 AMd.AK. Sp.A.
2595 2022/07/26/000073 072818 DIAN PUSPITA RINI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 26/07/2022 02:23:43 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2596 2022/07/26/000073 072818 DIAN PUSPITA RINI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 26/07/2022 16:16:08 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2597 2022/07/26/000073 072818 DIAN PUSPITA RINI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 26/07/2022 02:23:43 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2598 2022/07/26/000073 072818 DIAN PUSPITA RINI, NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 26/07/2022 02:22:47 BPJS KS IGD 1 30,390 6,610 0 3,000 0 0 0 40,000
2599 2022/07/26/000073 072818 DIAN PUSPITA RINI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 26/07/2022 02:23:43 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2600 2022/07/26/000073 072818 DIAN PUSPITA RINI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 26/07/2022 02:23:43 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2601 2022/07/26/000073 072818 DIAN PUSPITA RINI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8140114 Dr.dr. I WAYAN AGUNG 26/07/2022 02:21:48 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2602 2022/07/26/000083 071903 ANGGA ADI PUTRA, Sdr UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8170324 dr. EDWIN PRADANA, 26/07/2022 09:52:23 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
2603 2022/07/26/000091 072823 SALSABILA AZKA INARA PUTRI, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 26/07/2022 08:21:51 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
2604 2022/07/26/000091 072823 SALSABILA AZKA INARA PUTRI, BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 26/07/2022 08:21:51 BPJS KS IGD 6 32,431 9,569 0 3,000 0 0 0 45,000
2605 2022/07/26/000091 072823 SALSABILA AZKA INARA PUTRI, BPJS.K3B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 26/07/2022 08:21:51 BPJS KS IGD 6 31,931 10,069 0 3,000 0 0 0 45,000
2606 2022/07/26/000094 038470 WARDAH CHOIRIYAH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 26/07/2022 08:23:31 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2607 2022/07/26/000094 038470 WARDAH CHOIRIYAH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 26/07/2022 18:54:39 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2608 2022/07/26/000094 038470 WARDAH CHOIRIYAH, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 26/07/2022 08:23:31 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
2609 2022/07/26/000094 038470 WARDAH CHOIRIYAH, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 26/07/2022 08:23:31 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
2610 2022/07/26/000094 038470 WARDAH CHOIRIYAH, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 26/07/2022 08:23:31 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
2611 2022/07/26/000094 038470 WARDAH CHOIRIYAH, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 26/07/2022 08:24:57 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
2612 2022/07/26/000104 084407 ALTHAFF ADBIZHAR PUTRA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 26/07/2022 09:23:24 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
LAKSAMANA, AN 001 AMd.AK. Sp.A.
2613 2022/07/26/000104 084407 ALTHAFF ADBIZHAR PUTRA UMUM. Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 26/07/2022 09:23:24 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
8/1/22, 8:34 AM Page 87 of 107

LAKSAMANA, AN RJ00009 AMd.AK.
2614 2022/07/26/000115 061924 RETNO EKO LISTYOWATI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 26/07/2022 09:57:28 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
2615 2022/07/26/000115 061924 RETNO EKO LISTYOWATI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 26/07/2022 09:57:28 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
2616 2022/07/26/000115 061924 RETNO EKO LISTYOWATI, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 26/07/2022 09:57:28 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
2617 2022/07/26/000115 061924 RETNO EKO LISTYOWATI, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 26/07/2022 09:57:28 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
2618 2022/07/26/000116 064450 Dikky Fanala, Ny UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 26/07/2022 10:11:25 UMUM KS IGD 1 50,431 26,569 0 3,000 0 0 0 75,000
0001 AMd.AK.
2619 2022/07/26/000116 064450 Dikky Fanala, Ny UMUM.K2B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 26/07/2022 10:11:25 UMUM KS IGD 1 37,431 9,569 0 3,000 0 0 0 50,000
000110 AMd.AK.
2620 2022/07/26/000116 064450 Dikky Fanala, Ny UMUM.K2B0 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 26/07/2022 10:11:25 UMUM KS IGD 1 36,451 10,549 0 3,000 0 0 0 50,000
00018 AMd.AK.
2621 2022/07/26/000116 064450 Dikky Fanala, Ny UMUM.K2B0 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 26/07/2022 10:11:25 UMUM KS IGD 1 38,951 13,049 0 3,000 0 0 0 55,000
00019 AMd.AK.
2622 2022/07/26/000116 064450 Dikky Fanala, Ny UMUM.K2B0 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 26/07/2022 10:16:24 UMUM KS IGD 1 35,390 6,610 0 3,000 0 0 0 45,000
00021 AMd.AK.
2623 2022/07/26/000116 064450 Dikky Fanala, Ny UMUM.K2B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 26/07/2022 10:11:25 UMUM KS IGD 1 37,436 564 0 2,000 0 0 0 40,000
0003 AMd.AK.
2624 2022/07/26/000116 064450 Dikky Fanala, Ny UMUM.K2B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 26/07/2022 10:11:25 UMUM KS IGD 1 37,436 564 0 2,000 0 0 0 40,000
0004 AMd.AK.
2625 2022/07/26/000116 064450 Dikky Fanala, Ny UMUM.K2B0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 26/07/2022 10:12:22 UMUM KS IGD 1 47,300 35,200 0 7,500 5,000 0 0 95,000
00050 AMd.AK.
2626 2022/07/26/000126 062241 NUNGKI NURITA SARI, Ny UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 26/07/2022 17:42:17 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
001
2627 2022/07/26/000126 062241 NUNGKI NURITA SARI, Ny UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 26/07/2022 17:42:17 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
00110
2628 2022/07/26/000126 062241 NUNGKI NURITA SARI, Ny UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 26/07/2022 17:38:16 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
0047
2629 2022/07/26/000126 062241 NUNGKI NURITA SARI, Ny UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 26/07/2022 17:42:17 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
005
2630 2022/07/26/000126 062241 NUNGKI NURITA SARI, Ny UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 26/07/2022 17:42:17 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
006
2631 2022/07/26/000129 068375 SIRRI RAHMANINGSIH, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10050002 dr. PANDE MADE 26/07/2022 18:48:50 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
2632 2022/07/26/000131 065879 ULIPAH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 26/07/2022 11:44:16 BPJS KS IGD 7 40,431 26,569 0 3,000 0 0 0 70,000
2633 2022/07/26/000131 065879 ULIPAH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 26/07/2022 18:52:04 BPJS KS IGD 7 40,431 26,569 0 3,000 0 0 0 70,000
2634 2022/07/26/000131 065879 ULIPAH, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 26/07/2022 11:44:16 BPJS KS IGD 7 32,431 9,569 0 3,000 0 0 0 45,000
2635 2022/07/26/000131 065879 ULIPAH, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 26/07/2022 11:44:16 BPJS KS IGD 7 32,436 564 0 2,000 0 0 0 35,000
2636 2022/07/26/000131 065879 ULIPAH, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 26/07/2022 11:44:16 BPJS KS IGD 7 32,436 564 0 2,000 0 0 0 35,000
2637 2022/07/26/000131 065879 ULIPAH, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 26/07/2022 11:44:53 BPJS KS IGD 7 44,800 35,200 0 5,000 5,000 0 0 90,000
2638 2022/07/26/000131 065879 ULIPAH, NY UMUM.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 26/07/2022 11:07:05 BPJS IGD 30,390 6,610 0 3,000 0 0 0 40,000
2639 2022/07/26/000154 061257 AYU FITRIYA, Ny. UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 26/07/2022 16:42:52 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
001
2640 2022/07/26/000154 061257 AYU FITRIYA, Ny. UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 26/07/2022 16:42:52 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
00110
2641 2022/07/26/000154 061257 AYU FITRIYA, Ny. UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 26/07/2022 16:40:27 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
0047
2642 2022/07/26/000154 061257 AYU FITRIYA, Ny. UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 26/07/2022 16:42:52 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
005
2643 2022/07/26/000154 061257 AYU FITRIYA, Ny. UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 26/07/2022 16:42:52 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
006
8/1/22, 8:34 AM Page 88 of 107

2644 2022/07/26/000170 079230 ULIN SHARA, NY KYN.KI0000 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 26/07/2022 16:34:46 KARYAWAN Laboratorium 29,951 38,049 0 4,000 0 0 0 72,000
2645 2022/07/26/000170 079230 ULIN SHARA, NY KYN.KI0000 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 26/07/2022 16:34:46 KARYAWAN Laboratorium 29,951 38,049 0 4,000 5,000 0 0 77,000
2646 2022/07/26/000170 079230 ULIN SHARA, NY KYN.RJ0000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 26/07/2022 16:34:46 KARYAWAN Laboratorium 33,431 26,569 0 3,000 0 0 0 63,000
2647 2022/07/26/000170 079230 ULIN SHARA, NY KYN.RJ0000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 26/07/2022 16:34:46 KARYAWAN Laboratorium 27,431 9,569 0 3,000 0 0 0 40,000
110
2648 2022/07/26/000170 079230 ULIN SHARA, NY KYN.RJ0000 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 26/07/2022 16:29:33 KARYAWAN Laboratorium 30,900 47,600 0 7,500 5,000 0 0 91,000
47
2649 2022/07/26/000174 028837 ZERINA SHAKILA NAFISA, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 26/07/2022 17:25:50 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2650 2022/07/26/000174 028837 ZERINA SHAKILA NAFISA, AN BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 26/07/2022 17:25:50 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2651 2022/07/26/000174 028837 ZERINA SHAKILA NAFISA, AN BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 26/07/2022 17:24:53 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2652 2022/07/26/000174 028837 ZERINA SHAKILA NAFISA, AN BPJS.K1B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 26/07/2022 17:25:50 BPJS KS IGD 1 31,931 10,069 0 3,000 0 0 0 45,000
2653 2022/07/26/000176 019240 IDA BAGUS ARSYANENDRA, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 26/07/2022 18:30:15 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2654 2022/07/26/000176 019240 IDA BAGUS ARSYANENDRA, AN BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 26/07/2022 18:30:15 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2655 2022/07/26/000176 019240 IDA BAGUS ARSYANENDRA, AN BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 26/07/2022 18:19:45 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2656 2022/07/26/000176 019240 IDA BAGUS ARSYANENDRA, AN BPJS.K1B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 26/07/2022 18:30:15 BPJS KS IGD 1 31,931 10,069 0 3,000 0 0 0 45,000
2657 2022/07/26/000181 072839 ARUNA GENDHIS MAHESWARI, BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 26/07/2022 18:27:34 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2658 2022/07/26/000181 072839 ARUNA GENDHIS MAHESWARI, BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 26/07/2022 18:27:34 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2659 2022/07/26/000181 072839 ARUNA GENDHIS MAHESWARI, BPJS.K1B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 26/07/2022 18:25:13 BPJS KS IGD 1 37,400 47,600 0 5,000 5,000 0 0 95,000
2660 2022/07/26/000181 072839 ARUNA GENDHIS MAHESWARI, BPJS.K1B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 26/07/2022 18:27:34 BPJS KS IGD 1 31,931 10,069 0 3,000 0 0 0 45,000
2661 2022/07/26/000184 072841 NATHANAEL JOSEPH BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 26/07/2022 18:11:15 BPJS Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
HARTANTO, AN 01 Sp.A. KESEHATAN
2662 2022/07/26/000184 072841 NATHANAEL JOSEPH BPJS.RJ000 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 26/07/2022 18:11:15 BPJS Poli Anak 32,436 564 0 2,000 0 0 0 35,000
2663 2022/07/26/000184 072841 NATHANAEL JOSEPH BPJS.RJ000 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 26/07/2022 18:11:15 BPJS Poli Anak 32,436 564 0 2,000 0 0 0 35,000
2664 2022/07/26/000187 056942 KALEELA KHUMAIRAH BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 26/07/2022 19:45:51 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
FIRDAUSI NUZULA, An 001 Sp.A. KESEHATAN
2665 2022/07/26/000187 056942 KALEELA KHUMAIRAH BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 26/07/2022 19:45:51 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
FIRDAUSI NUZULA, An 00110 Sp.A. KESEHATAN
2666 2022/07/26/000199 041043 DEVITA AYU KRISTINA, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 26/07/2022 20:20:52 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
2667 2022/07/26/000199 041043 DEVITA AYU KRISTINA, NY BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 26/07/2022 20:20:52 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
2668 2022/07/26/000199 041043 DEVITA AYU KRISTINA, NY BPJS.RJ000 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 26/07/2022 20:20:52 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
2669 2022/07/26/000199 041043 DEVITA AYU KRISTINA, NY BPJS.RJ000 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 26/07/2022 20:20:52 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
2670 2022/07/26/000199 041043 DEVITA AYU KRISTINA, NY BPJS.RJ000 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 26/07/2022 20:19:40 BPJS IGD 37,400 47,600 0 5,000 5,000 0 0 95,000
2671 2022/07/26/000200 036194 ZUHROTUS SOLICHAH, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 26/07/2022 20:24:58 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
01 KESEHATAN
2672 2022/07/26/000201 072845 SAVIRA EKA PUTRI BPJS.K3T20 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 26/07/2022 21:52:58 UMUM KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
MUSYAVANI, AN 000110 Sp.A.
2673 2022/07/26/000203 072846 WAHYU AGUS TUBARI, TN UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 26/07/2022 21:35:56 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
0047
2674 2022/07/26/000204 094348 VIVI AULA KUSUMA, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 26/07/2022 21:55:05 BPJS Hastina 5 40,431 26,569 0 3,000 0 0 0 70,000
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2675 2022/07/26/000204 094348 VIVI AULA KUSUMA, NY BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 26/07/2022 21:55:05 BPJS Hastina 5 32,431 9,569 0 3,000 0 0 0 45,000
2676 2022/07/26/000204 094348 VIVI AULA KUSUMA, NY BPJS.K1B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 26/07/2022 21:55:05 BPJS Hastina 5 32,436 564 0 2,000 0 0 0 35,000
2677 2022/07/26/000204 094348 VIVI AULA KUSUMA, NY BPJS.K1B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 26/07/2022 21:55:05 BPJS Hastina 5 32,436 564 0 2,000 0 0 0 35,000
2678 2022/07/26/000204 094348 VIVI AULA KUSUMA, NY BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 26/07/2022 21:55:19 BPJS Hastina 5 44,800 35,200 0 5,000 5,000 0 0 90,000
2679 2022/07/21/000123 073786 NUR VITAKHUROHMAH, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 27/07/2022 09:17:01 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2680 2022/07/22/000109 015583 GARLINGGA GALANG BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 09:10:06 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
RAMADHAN,An 001 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN
2681 2022/07/23/000168 072437 SHEZA AULIA SALSABILA, AN UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 27/07/2022 06:15:17 UMUM KS IGD 2 50,431 26,569 0 3,000 0 0 0 75,000
0001 M.Biomed.
2682 2022/07/24/000074 027742 FAIZ AYDIN RAMADHAN, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 17:23:16 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A. KESEHATAN
2683 2022/07/25/000239 026740 MUHAMMAD ABIZAR AL BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 17:28:46 BPJS ICU 2 40,431 26,569 0 3,000 0 0 0 70,000
GHIFARI ,An 001 Sp.A. KESEHATAN
2684 2022/07/25/000240 012917 ROHICHUL MACHTUM, AN UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 17:33:36 UMUM KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
0001 Sp.A.
2685 2022/07/25/000241 072806 PRINCESS FLORENCIA UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 17:31:01 UMUM KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
KIMBERLY, AN 0001 Sp.A.
2686 2022/07/26/000073 072818 DIAN PUSPITA RINI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10120217 dr. NYOMAN LUWANG 27/07/2022 10:22:32 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2687 2022/07/26/000073 072818 DIAN PUSPITA RINI, NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10120217 dr. NYOMAN LUWANG 27/07/2022 10:28:28 BPJS KS IGD 1 30,390 6,610 0 3,000 0 0 0 40,000
2688 2022/07/26/000091 072823 SALSABILA AZKA INARA PUTRI, BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 06:57:37 BPJS KS IGD 6 30,390 6,610 0 3,000 0 0 0 40,000
2689 2022/07/26/000192 072630 REYHAN ATHAILLAH BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 27/07/2022 17:38:40 BPJS KS IGD 2 33,931 13,069 0 3,000 0 0 0 50,000
SHAQUILLE CALIEF, AN 00020 M.Biomed. KESEHATAN
2690 2022/07/26/000199 041043 DEVITA AYU KRISTINA, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 27/07/2022 17:36:24 BPJS Amarta 6C 40,431 26,569 0 3,000 0 0 0 70,000
2691 2022/07/26/000204 094348 VIVI AULA KUSUMA, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 27/07/2022 09:14:21 BPJS Hastina 5 40,431 26,569 0 3,000 0 0 0 70,000
2692 2022/07/27/000055 072508 AZLAN MAHASINUL HAQQ, AN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 19:51:58 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
0020 Sp.A.
2693 2022/07/27/000086 059485 CHAYRA KAESA ATIYA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 27/07/2022 03:06:16 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
PERDANA, AN 001
2694 2022/07/27/000090 072852 HERIS ALFIANA, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 27/07/2022 06:18:53 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2695 2022/07/27/000090 072852 HERIS ALFIANA, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 27/07/2022 06:18:53 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2696 2022/07/27/000090 072852 HERIS ALFIANA, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 27/07/2022 06:18:53 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2697 2022/07/27/000090 072852 HERIS ALFIANA, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 27/07/2022 06:18:53 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2698 2022/07/27/000090 072852 HERIS ALFIANA, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 27/07/2022 06:17:41 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2699 2022/07/27/000092 072590 ARUNA PRAMESTI UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 27/07/2022 17:11:56 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
KUSMANAGARI, NY 0020 M.Biomed.
2700 2022/07/27/000092 072590 ARUNA PRAMESTI UMUM.RJ00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 27/07/2022 17:11:56 UMUM Poli Anak 31,936 6,064 0 2,000 0 0 0 40,000
2701 2022/07/27/000092 072590 ARUNA PRAMESTI UMUM.RJ00 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 27/07/2022 17:11:56 UMUM Poli Anak 31,436 6,564 0 2,000 0 0 0 40,000
2702 2022/07/27/000095 066347 MOCHAMMAD IKSAN, TN UMUM.RJ00 Preparasi Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 8170324 dr. EDWIN PRADANA, 27/07/2022 10:50:46 UMUM Poli Andrologi 161,771 738,229 350,000 0 0 50,000 0 1,300,000
2703 2022/07/27/000097 101029 Arsyla Adreenca Qurota Ayun, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 19:54:56 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
2704 2022/07/27/000097 101029 Arsyla Adreenca Qurota Ayun, UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 19:54:56 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 Sp.A.
2705 2022/07/27/000103 072036 NYJAH AYVY ROXALKA, AN UMUM. Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 18:29:53 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
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RJ00001
2706 2022/07/27/000109 052117 GHINA KHASYA S,AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 18:35:52 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
2707 2022/07/27/000109 052117 GHINA KHASYA S,AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 18:35:52 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 Sp.A.
2708 2022/07/27/000112 072790 ALTHAFARIZQI HAMZAH UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 27/07/2022 08:17:46 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
TSAQIF, AN 001 ARDHIANSYAH, AMd.Ankes Sp.A.
2709 2022/07/27/000118 070751 NINIK TRIYANINGSIH, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10120217 dr. NYOMAN LUWANG 27/07/2022 10:15:44 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
2710 2022/07/27/000118 070751 NINIK TRIYANINGSIH, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 27/07/2022 21:06:29 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
2711 2022/07/27/000118 070751 NINIK TRIYANINGSIH, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10120217 dr. NYOMAN LUWANG 27/07/2022 10:15:44 BPJS KS IGD 6 32,431 9,569 0 3,000 0 0 0 45,000
2712 2022/07/27/000118 070751 NINIK TRIYANINGSIH, NY BPJS.K2B00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10120217 dr. NYOMAN LUWANG 27/07/2022 10:15:44 BPJS KS IGD 6 37,951 38,049 0 4,000 0 0 0 80,000
2713 2022/07/27/000118 070751 NINIK TRIYANINGSIH, NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10120217 dr. NYOMAN LUWANG 27/07/2022 10:14:46 BPJS KS IGD 6 44,800 35,200 0 5,000 5,000 0 0 90,000
2714 2022/07/27/000118 070751 NINIK TRIYANINGSIH, NY BPJS.K2B00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10120217 dr. NYOMAN LUWANG 27/07/2022 10:15:44 BPJS KS IGD 6 37,951 38,049 0 4,000 0 0 0 80,000
2715 2022/07/27/000131 061924 RETNO EKO LISTYOWATI, NY BPJS.K3UP2 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10120217 dr. NYOMAN LUWANG 27/07/2022 22:48:37 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
2716 2022/07/27/000134 061257 AYU FITRIYA, Ny. UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10120217 dr. NYOMAN LUWANG 27/07/2022 17:41:04 UMUM KS IGD 2 50,431 26,569 0 3,000 0 0 0 80,000
0001 WISANA, Sp.OG.
2717 2022/07/27/000141 105080 NIRMALA GYTA LAILA BPJS.K2B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 27/07/2022 17:17:39 BPJS KS IGD 1 37,400 47,600 0 5,000 5,000 0 0 95,000
RAMADHANI, AN 0047 M.Biomed. KESEHATAN
2718 2022/07/27/000141 105080 NIRMALA GYTA LAILA BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 27/07/2022 14:48:54 BPJS Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
RAMADHANI, AN 01 ARDHIANSYAH, AMd.Ankes M.Biomed. KESEHATAN
2719 2022/07/27/000141 105080 NIRMALA GYTA LAILA BPJS.RJ000 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 27/07/2022 14:48:54 BPJS Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
2720 2022/07/27/000154 072862 HAMDAN SIDKIL AMAL,AN UMUM.KINS Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 13:43:18 UMUM ICU 1 50,431 26,569 0 3,000 0 0 0 75,000
2721 2022/07/27/000154 072862 HAMDAN SIDKIL AMAL,AN UMUM.KINS Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 13:43:18 UMUM ICU 1 37,431 9,569 0 3,000 0 0 0 50,000
2722 2022/07/27/000154 072862 HAMDAN SIDKIL AMAL,AN UMUM.KINS SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 13:42:26 UMUM ICU 1 47,300 35,200 0 7,500 5,000 0 0 95,000
2723 2022/07/27/000157 063280 SITI SUYATI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 27/07/2022 14:15:08 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
2724 2022/07/27/000157 063280 SITI SUYATI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 27/07/2022 14:15:08 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
2725 2022/07/27/000157 063280 SITI SUYATI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 27/07/2022 14:14:11 BPJS IGD 47,300 35,200 0 7,500 5,000 0 0 95,000
2726 2022/07/27/000166 065004 MUHAMMAD ZAIDAN AL RAFIF, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 18:38:52 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 Sp.A.
2727 2022/07/27/000166 065004 MUHAMMAD ZAIDAN AL RAFIF, UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 18:38:52 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
AN 009 Sp.A.
2728 2022/07/27/000168 072867 SOEKASIH, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 27/07/2022 17:04:28 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 KESEHATAN
2729 2022/07/27/000168 072867 SOEKASIH, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 27/07/2022 17:04:28 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
00110 KESEHATAN
2730 2022/07/27/000168 072867 SOEKASIH, NY UMUM.RJ00 Asam Urat 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 27/07/2022 17:04:28 BPJS IGD 32,951 9,049 0 3,000 0 0 0 45,000
0015 KESEHATAN
2731 2022/07/27/000168 072867 SOEKASIH, NY UMUM.RJ00 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 27/07/2022 17:04:28 BPJS IGD 31,451 10,549 0 3,000 0 0 0 45,000
0018 KESEHATAN
2732 2022/07/27/000168 072867 SOEKASIH, NY UMUM.RJ00 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 27/07/2022 17:04:28 BPJS IGD 33,951 13,049 0 3,000 0 0 0 50,000
0019 KESEHATAN
2733 2022/07/27/000173 002674 ACHMAD FAIZ AL ARKHAN, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 27/07/2022 16:57:01 BPJS Amarta 2 40,431 26,569 0 3,000 0 0 0 70,000
2734 2022/07/27/000173 002674 ACHMAD FAIZ AL ARKHAN, AN BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 27/07/2022 16:57:01 BPJS Amarta 2 32,431 9,569 0 3,000 0 0 0 45,000
2735 2022/07/27/000173 002674 ACHMAD FAIZ AL ARKHAN, AN BPJS. IgG Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 27/07/2022 18:03:10 BPJS Amarta 2 41,951 46,549 0 1,500 0 0 0 90,000
M.
8/1/22, 8:34 AM Page 91 of 107
K3B000024 Biomed.
2736 2022/07/27/000173 002674 ACHMAD FAIZ AL ARKHAN, AN BPJS.K3B00 IgM Anti Dengue 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 27/07/2022 18:03:10 BPJS Amarta 2 41,951 46,549 0 1,500 0 0 0 90,000
2737 2022/07/27/000173 002674 ACHMAD FAIZ AL ARKHAN, AN BPJS.K3B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 27/07/2022 16:57:57 BPJS Amarta 2 37,400 47,600 0 5,000 5,000 0 0 95,000
2738 2022/07/27/000173 002674 ACHMAD FAIZ AL ARKHAN, AN BPJS.K3B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 27/07/2022 16:57:01 BPJS Amarta 2 31,931 10,069 0 3,000 0 0 0 45,000
2739 2022/07/27/000177 055921 LEONATHAN NAHAWIRA SARIK, BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 27/07/2022 19:01:07 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2740 2022/07/27/000177 055921 LEONATHAN NAHAWIRA SARIK, BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 27/07/2022 19:01:07 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2741 2022/07/27/000177 055921 LEONATHAN NAHAWIRA SARIK, BPJS.K2B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 27/07/2022 17:15:01 BPJS KS IGD 1 37,400 47,600 0 5,000 5,000 0 0 95,000
2742 2022/07/27/000177 055921 LEONATHAN NAHAWIRA SARIK, BPJS.K2B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 27/07/2022 19:01:07 BPJS KS IGD 1 31,931 10,069 0 3,000 0 0 0 45,000
2743 2022/07/27/000178 009760 CAMELIA GHOZALI, NY UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 27/07/2022 17:08:19 UMUM KS IGD 10 50,431 26,569 0 3,000 0 0 0 80,000
2744 2022/07/27/000178 009760 CAMELIA GHOZALI, NY UMUM.K1B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 27/07/2022 17:08:19 UMUM KS IGD 10 42,431 9,569 0 3,000 0 0 0 55,000
2745 2022/07/27/000178 009760 CAMELIA GHOZALI, NY UMUM.K1B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 27/07/2022 17:08:19 UMUM KS IGD 10 42,436 564 0 2,000 0 0 0 45,000
2746 2022/07/27/000178 009760 CAMELIA GHOZALI, NY UMUM.K1B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 27/07/2022 17:08:19 UMUM KS IGD 10 42,436 564 0 2,000 0 0 0 45,000
2747 2022/07/27/000178 009760 CAMELIA GHOZALI, NY UMUM.K1B0 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 27/07/2022 17:09:19 UMUM KS IGD 10 37,900 47,600 0 7,500 5,000 0 0 98,000
2748 2022/07/27/000186 072506 SHABIRA ALULA KHANDRA, AN UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 19:19:01 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
0020 Sp.A.
2749 2022/07/27/000195 072878 YAHYA ABDURRAHMAN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 27/07/2022 19:33:17 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
MUSTHAFA, AN 001 Sp.A.
2750 2022/07/27/000198 075651 MUHAMAD KARIM BEN ZEEMA, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 27/07/2022 19:58:08 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 Sp.A.
2751 2022/07/27/000205 026788 I PUTU RIVAN ADIAWAN, AN BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 20:56:59 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
2752 2022/07/27/000205 026788 I PUTU RIVAN ADIAWAN, AN BPJS.K2UP1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 27/07/2022 20:56:59 BPJS KS IGD 5 32,431 9,569 0 3,000 0 0 0 45,000
2753 2022/07/27/000211 062257 RIA EVA AGUSTIN, NY BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 27/07/2022 22:03:11 BPJS KS RR 1 40,431 26,569 0 3,000 0 0 0 70,000
2754 2022/07/27/000211 062257 RIA EVA AGUSTIN, NY BPJS.K2UP1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 27/07/2022 22:03:11 BPJS KS RR 1 32,431 9,569 0 3,000 0 0 0 45,000
2755 2022/07/27/000211 062257 RIA EVA AGUSTIN, NY BPJS.K2UP1 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 27/07/2022 22:03:11 BPJS KS RR 1 32,436 564 0 2,000 0 0 0 35,000
2756 2022/07/27/000211 062257 RIA EVA AGUSTIN, NY BPJS.K2UP1 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 27/07/2022 22:03:11 BPJS KS RR 1 32,436 564 0 2,000 0 0 0 35,000
2757 2022/07/27/000211 062257 RIA EVA AGUSTIN, NY BPJS.K2UP1 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 27/07/2022 22:03:25 BPJS KS RR 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2758 2022/07/27/000212 062121 MAULIDINA FAQIATUL UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 27/07/2022 21:14:46 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
CHASANAH, AN 001
2759 2022/07/27/000212 062121 MAULIDINA FAQIATUL UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 27/07/2022 21:14:46 UMUM IGD 31,931 10,069 0 3,000 0 0 0 45,000
CHASANAH, AN 009
2760 2022/07/27/000217 041562 AULIA DWI ZHUKMANA, TN BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 27/07/2022 22:51:09 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
2761 2022/07/21/000160 072676 WENNY EKO, By Ny BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 28/07/2022 17:58:53 BPJS KS NICU 14 33,931 13,069 0 3,000 0 0 0 50,000
2762 2022/07/23/000168 072437 SHEZA AULIA SALSABILA, AN UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 28/07/2022 10:47:39 UMUM KS IGD 2 50,431 26,569 0 3,000 0 0 0 75,000
2763 2022/07/24/000034 072753 SANIYAH NISRIN, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 28/07/2022 10:45:23 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2764 2022/07/24/000066 016586 Raden Malik Ibrahim, an BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 28/07/2022 17:22:18 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
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2765 2022/07/25/000239 026740 MUHAMMAD ABIZAR AL BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 28/07/2022 12:30:40 BPJS ICU 2 40,431 26,569 0 3,000 0 0 0 70,000
GHIFARI ,An 001 AMd.AK. Sp.A. KESEHATAN
2766 2022/07/26/000201 072845 SAVIRA EKA PUTRI BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 28/07/2022 20:48:30 UMUM KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
MUSYAVANI, AN 0001 Sp.A.
2767 2022/07/27/000178 009760 CAMELIA GHOZALI, NY UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 06:45:08 UMUM KS IGD 10 50,431 26,569 0 3,000 0 0 0 80,000
2768 2022/07/27/000188 062241 NUNGKI NURITA SARI, Ny BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 28/07/2022 06:48:36 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2769 2022/07/27/000204 079230 ULIN SHARA, NY BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 28/07/2022 06:47:05 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2770 2022/07/27/000211 062257 RIA EVA AGUSTIN, NY BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 28/07/2022 17:42:01 BPJS KS RR 1 40,431 26,569 0 3,000 0 0 0 70,000
2771 2022/07/27/000213 072879 NUR INDAH RATNASARI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 28/07/2022 00:46:53 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2772 2022/07/27/000213 072879 NUR INDAH RATNASARI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 28/07/2022 20:32:17 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2773 2022/07/27/000213 072879 NUR INDAH RATNASARI, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 28/07/2022 00:46:53 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2774 2022/07/27/000213 072879 NUR INDAH RATNASARI, NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 28/07/2022 00:46:53 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2775 2022/07/27/000213 072879 NUR INDAH RATNASARI, NY BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 28/07/2022 00:46:53 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2776 2022/07/27/000213 072879 NUR INDAH RATNASARI, NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 28/07/2022 00:47:06 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2777 2022/07/28/000007 063139 DENI KURNIAWAN, TN UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8170324 dr. EDWIN PRADANA, 28/07/2022 09:50:17 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
2778 2022/07/28/000014 050012 ABHINARA FAWWAZ BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 28/07/2022 09:06:27 BPJS Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
2779 2022/07/28/000060 065485 KHADIJAH RUMAISHA, AN BPJS.K3T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 28/07/2022 05:15:08 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2780 2022/07/28/000060 065485 KHADIJAH RUMAISHA, AN BPJS.K3T20 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 28/07/2022 05:15:08 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2781 2022/07/28/000062 061699 MASIDA ROSITA, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 28/07/2022 06:23:59 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2782 2022/07/28/000062 061699 MASIDA ROSITA, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 28/07/2022 17:56:05 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2783 2022/07/28/000062 061699 MASIDA ROSITA, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 28/07/2022 06:23:59 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2784 2022/07/28/000062 061699 MASIDA ROSITA, NY BPJS.K3B00 SGOT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 28/07/2022 06:23:59 BPJS KS IGD 1 34,451 12,549 0 3,000 0 0 0 50,000
2785 2022/07/28/000062 061699 MASIDA ROSITA, NY BPJS.K3B00 SGPT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 28/07/2022 06:23:59 BPJS KS IGD 1 34,451 12,549 0 3,000 0 0 0 50,000
2786 2022/07/28/000062 061699 MASIDA ROSITA, NY BPJS.K3B00 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 28/07/2022 06:23:59 BPJS KS IGD 1 31,451 10,549 0 3,000 0 0 0 45,000
2787 2022/07/28/000062 061699 MASIDA ROSITA, NY BPJS.K3B00 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 28/07/2022 06:23:59 BPJS KS IGD 1 33,951 13,049 0 3,000 0 0 0 50,000
2788 2022/07/28/000062 061699 MASIDA ROSITA, NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 28/07/2022 06:23:59 BPJS KS IGD 1 30,390 6,610 0 3,000 0 0 0 40,000
2789 2022/07/28/000062 061699 MASIDA ROSITA, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 28/07/2022 06:27:26 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2790 2022/07/28/000064 029385 JEKTI KURNIAWATI DAUD, NY BPJS.RJ000 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1200361 dr. NINA NURARIFAH, 28/07/2022 10:56:15 BPJS Poli Penyakit 30,390 6,610 0 3,000 0 0 0 40,000
2791 2022/07/28/000064 029385 JEKTI KURNIAWATI DAUD, NY BPJS.RJ000 Gula Darah Puasa 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1200361 dr. NINA NURARIFAH, 28/07/2022 10:56:15 BPJS Poli Penyakit 32,431 9,569 0 3,000 0 0 0 45,000
2792 2022/07/28/000064 029385 JEKTI KURNIAWATI DAUD, NY BPJS.RJ000 Gula Darah 2 Jam PP 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1200361 dr. NINA NURARIFAH, 28/07/2022 10:56:15 BPJS Poli Penyakit 32,431 9,569 0 3,000 0 0 0 45,000
2793 2022/07/28/000067 072888 REYNATA AGNESIA, NY UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 06:55:29 UMUM KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2794 2022/07/28/000067 072888 REYNATA AGNESIA, NY UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 06:55:29 UMUM KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
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2795 2022/07/28/000067 072888 REYNATA AGNESIA, NY UMUM.K3B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 06:55:29 UMUM KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2796 2022/07/28/000067 072888 REYNATA AGNESIA, NY UMUM.K3B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 06:55:29 UMUM KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2797 2022/07/28/000067 072888 REYNATA AGNESIA, NY UMUM.K3B0 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 06:56:17 UMUM KS IGD 1 37,900 47,600 0 7,500 5,000 0 0 98,000
2798 2022/07/28/000071 042955 ATHALLAH MANNAF WIJAYA, BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 28/07/2022 09:33:57 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2799 2022/07/28/000071 042955 ATHALLAH MANNAF WIJAYA, BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 28/07/2022 09:33:57 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2800 2022/07/28/000072 063451 SUCIYATI, NY BPJS.RJ000 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150220 dr. IMELDA, Sp.OG. 28/07/2022 08:24:44 BPJS Poli Kandungan 30,390 6,610 0 3,000 0 0 0 40,000
2801 2022/07/28/000075 072891 SHAKILA MAULIDIYA, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 28/07/2022 10:58:49 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2802 2022/07/28/000075 072891 SHAKILA MAULIDIYA, AN BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 28/07/2022 10:58:49 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2803 2022/07/28/000079 072339 MARIA KLARIZA PUTRI BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 08:42:16 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
KRISDIANA, Ny 001 AMd.AK. INDRAWAN, Sp. OG (K) KESEHATAN
2804 2022/07/28/000079 072339 MARIA KLARIZA PUTRI BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 08:42:16 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
2805 2022/07/28/000079 072339 MARIA KLARIZA PUTRI BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 08:42:16 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
2806 2022/07/28/000079 072339 MARIA KLARIZA PUTRI BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 08:42:16 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
2807 2022/07/28/000079 072339 MARIA KLARIZA PUTRI BPJS.K3B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 08:43:13 BPJS KS IGD 2 37,400 47,600 0 5,000 5,000 0 0 95,000
2808 2022/07/28/000080 090837 WISMAN ARIYA MURTI, AN BPJS.K2T30 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 28/07/2022 09:35:02 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
2809 2022/07/28/000080 090837 WISMAN ARIYA MURTI, AN BPJS.K2T30 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 28/07/2022 09:35:02 BPJS KS IGD 10 32,431 9,569 0 3,000 0 0 0 45,000
2810 2022/07/28/000082 070885 REIGA MALIK AL FATHAN, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 28/07/2022 09:30:45 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK.
2811 2022/07/28/000082 070885 REIGA MALIK AL FATHAN, AN UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 28/07/2022 09:30:45 UMUM IGD 32,431 9,569 0 3,000 0 0 0 45,000
00110 AMd.AK.
2812 2022/07/28/000088 069277 UMI MASITOH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 28/07/2022 09:13:54 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2813 2022/07/28/000088 069277 UMI MASITOH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 28/07/2022 17:51:55 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2814 2022/07/28/000088 069277 UMI MASITOH, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 28/07/2022 09:13:54 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
2815 2022/07/28/000088 069277 UMI MASITOH, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 28/07/2022 09:13:54 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
2816 2022/07/28/000088 069277 UMI MASITOH, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 28/07/2022 09:13:54 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
2817 2022/07/28/000088 069277 UMI MASITOH, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 28/07/2022 09:18:03 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
2818 2022/07/28/000091 042398 ELMAIRA SHAZIA ZALFA BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 28/07/2022 11:02:43 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
PERMANA, AN 001 AMd.AK. Sp.A. KESEHATAN
2819 2022/07/28/000091 042398 ELMAIRA SHAZIA ZALFA BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 9070009 dr. MOHAMMAD MUCHLIS, 28/07/2022 11:03:20 BPJS KS IGD 5 44,800 35,200 0 5,000 5,000 0 0 90,000
2820 2022/07/28/000094 054044 DWI ARI ERNAWATI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1150219 dr. FATMASARI PERDANA 28/07/2022 09:23:41 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2821 2022/07/28/000094 054044 DWI ARI ERNAWATI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 28/07/2022 17:37:47 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2822 2022/07/28/000094 054044 DWI ARI ERNAWATI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1150219 dr. FATMASARI PERDANA 28/07/2022 09:23:41 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
2823 2022/07/28/000094 054044 DWI ARI ERNAWATI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1150219 dr. FATMASARI PERDANA 28/07/2022 09:23:41 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
2824 2022/07/28/000094 054044 DWI ARI ERNAWATI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1150219 dr. FATMASARI PERDANA 28/07/2022 09:23:41 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
8/1/22, 8:34 AM Page 94 of 107

2825 2022/07/28/000094 054044 DWI ARI ERNAWATI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1150219 dr. FATMASARI PERDANA 28/07/2022 09:24:54 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
2826 2022/07/28/000095 003441 IBNU ALKHATAMI, Tn UMUM.RJ00 Analisis Sperma 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8170324 dr. EDWIN PRADANA, 28/07/2022 09:50:44 UMUM Poli Andrologi 91,665 23,335 130,000 5,000 0 0 0 250,000
2827 2022/07/28/000103 072896 TATIK, NY BPJS.K2B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4150215 dr. DEWI INDIASTARI, 28/07/2022 17:33:18 BPJS KS IGD 1 30,390 6,610 0 3,000 0 0 0 40,000
2828 2022/07/28/000103 072896 TATIK, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4150215 dr. DEWI INDIASTARI, 28/07/2022 11:11:48 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
2829 2022/07/28/000103 072896 TATIK, NY BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 28/07/2022 09:28:34 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
2830 2022/07/28/000103 072896 TATIK, NY BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4150215 dr. DEWI INDIASTARI, 28/07/2022 11:11:48 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
2831 2022/07/28/000103 072896 TATIK, NY BPJS.RJ000 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4150215 dr. DEWI INDIASTARI, 28/07/2022 11:12:20 BPJS IGD 44,800 35,200 0 5,000 5,000 0 0 90,000
2832 2022/07/28/000108 070631 DESSY MARDIKAWATI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 10:16:20 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
2833 2022/07/28/000108 070631 DESSY MARDIKAWATI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 10:16:20 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
2834 2022/07/28/000108 070631 DESSY MARDIKAWATI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 10:18:45 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
2835 2022/07/28/000108 070631 DESSY MARDIKAWATI, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 10:16:20 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
2836 2022/07/28/000108 070631 DESSY MARDIKAWATI, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 10:16:20 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
2837 2022/07/28/000132 107431 ABAY BILAL EVANO, An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 28/07/2022 15:38:50 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 M.Biomed.
2838 2022/07/28/000132 107431 ABAY BILAL EVANO, An UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 28/07/2022 15:38:50 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 M.Biomed.
2839 2022/07/28/000133 019332 ENDARU DZAKI BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 28/07/2022 14:35:34 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
PRASETYAWAN, AN 001 M.Biomed. KESEHATAN
2840 2022/07/28/000133 019332 ENDARU DZAKI BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 28/07/2022 14:35:34 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2841 2022/07/28/000133 019332 ENDARU DZAKI BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 28/07/2022 13:56:08 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
PRASETYAWAN, AN 0050 AMd.AK. M.Biomed. KESEHATAN
2842 2022/07/28/000133 019332 ENDARU DZAKI BPJS.K2B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 28/07/2022 14:35:34 BPJS KS IGD 1 31,931 10,069 0 3,000 0 0 0 45,000
2843 2022/07/28/000137 036194 ZUHROTUS SOLICHAH, NY KYN.RJ0000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 28/07/2022 15:43:14 KARYAWAN Laboratorium 33,431 26,569 0 3,000 0 0 0 63,000
1 karyawan
2844 2022/07/28/000137 036194 ZUHROTUS SOLICHAH, NY KYN.RJ0000 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 28/07/2022 15:47:46 KARYAWAN Laboratorium 30,900 47,600 0 7,500 5,000 0 0 91,000
47 karyawan
2845 2022/07/28/000137 036194 ZUHROTUS SOLICHAH, NY KYN.RJ0000 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 28/07/2022 15:43:14 KARYAWAN Laboratorium 26,931 10,069 0 3,000 0 0 0 40,000
9 karyawan
2846 2022/07/28/000138 104349 Rianto, Tn KYN.RJ0000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 28/07/2022 15:41:00 KARYAWAN Laboratorium 33,431 26,569 0 3,000 0 0 0 63,000
1 karyawan
2847 2022/07/28/000138 104349 Rianto, Tn KYN.RJ0000 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 28/07/2022 15:36:59 KARYAWAN Laboratorium 30,900 47,600 0 7,500 5,000 0 0 91,000
47 karyawan
2848 2022/07/28/000138 104349 Rianto, Tn KYN.RJ0000 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 28/07/2022 15:41:00 KARYAWAN Laboratorium 26,931 10,069 0 3,000 0 0 0 40,000
9 karyawan
2849 2022/07/28/000145 072767 ALIZA ELYINA HANANA, AN BPJS.KINS0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 28/07/2022 17:26:19 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2850 2022/07/28/000145 072767 ALIZA ELYINA HANANA, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 28/07/2022 14:30:49 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 KESEHATAN
2851 2022/07/28/000158 049090 INDRIA PUSPITA SARI, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 16:58:25 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
2852 2022/07/28/000158 049090 INDRIA PUSPITA SARI, NY BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 16:58:25 BPJS KS IGD 10 32,431 9,569 0 3,000 0 0 0 45,000
2853 2022/07/28/000158 049090 INDRIA PUSPITA SARI, NY BPJS.K1B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 16:58:25 BPJS KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
2854 2022/07/28/000158 049090 INDRIA PUSPITA SARI, NY BPJS.K1B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 16:58:25 BPJS KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
8/1/22, 8:34 AM Page 95 of 107

2855 2022/07/28/000158 049090 INDRIA PUSPITA SARI, NY BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 28/07/2022 16:56:22 BPJS KS IGD 10 44,800 35,200 0 5,000 5,000 0 0 90,000
2856 2022/07/28/000159 057081 ABBYANKA RAYYANZA AL- BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 28/07/2022 17:25:07 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
KHAWARIZMI, AN 001 Sp.A. KESEHATAN
2857 2022/07/28/000159 057081 ABBYANKA RAYYANZA AL- BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 28/07/2022 17:25:07 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
KHAWARIZMI, AN 00110 Sp.A. KESEHATAN
2858 2022/07/28/000161 107434 ARKANA SHAKA ALVARENDRA, UMUM.K2T3 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 28/07/2022 18:59:11 UMUM Amarta 1B 50,431 26,569 0 3,000 0 0 0 75,000
AN 00001 M.Biomed.
2859 2022/07/28/000161 107434 ARKANA SHAKA ALVARENDRA, UMUM.K2T3 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 28/07/2022 18:59:11 UMUM Amarta 1B 37,431 9,569 0 3,000 0 0 0 50,000
AN 0000110 M.Biomed.
2860 2022/07/28/000161 107434 ARKANA SHAKA ALVARENDRA, UMUM.K2T3 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 28/07/2022 18:56:34 UMUM Amarta 1B 37,900 47,600 0 7,500 5,000 0 0 98,000
AN 000047 M.Biomed.
2861 2022/07/28/000161 107434 ARKANA SHAKA ALVARENDRA, UMUM.K2T3 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 28/07/2022 18:59:11 UMUM Amarta 1B 36,931 10,069 0 3,000 0 0 0 50,000
AN 00009 M.Biomed.
2862 2022/07/28/000162 088976 DIANA GEMITA PAMELIA, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 28/07/2022 17:03:05 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
001 MENUR, Sp.OG
2863 2022/07/28/000162 088976 DIANA GEMITA PAMELIA, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 28/07/2022 17:03:05 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
00110 MENUR, Sp.OG
2864 2022/07/28/000162 088976 DIANA GEMITA PAMELIA, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 28/07/2022 17:00:54 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
0047 MENUR, Sp.OG
2865 2022/07/28/000162 088976 DIANA GEMITA PAMELIA, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 28/07/2022 17:03:05 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
005 MENUR, Sp.OG
2866 2022/07/28/000162 088976 DIANA GEMITA PAMELIA, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 28/07/2022 17:03:05 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
006 MENUR, Sp.OG
2867 2022/07/28/000163 027471 SHIDQIA MAULIDIYAH, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 28/07/2022 17:05:49 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 M.Biomed.
2868 2022/07/28/000163 027471 SHIDQIA MAULIDIYAH, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 28/07/2022 17:05:49 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 M.Biomed.
2869 2022/07/28/000187 043333 CAITA VIDYA SARASWATI, An. KYN.RJ0000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 28/07/2022 19:27:41 KARYAWAN IGD 33,431 26,569 0 3,000 0 0 0 63,000
2870 2022/07/28/000187 043333 CAITA VIDYA SARASWATI, An. KYN.RJ0000 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 28/07/2022 19:25:18 KARYAWAN IGD 30,900 47,600 0 7,500 5,000 0 0 91,000
47
2871 2022/07/28/000190 072524 GAVIN ALVERO ARDIANSAH, BPJS.RJ000 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 28/07/2022 20:25:31 BPJS Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
2872 2022/07/28/000194 107441 ADREENA NASHA SHAQEENA, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 28/07/2022 21:30:18 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2873 2022/07/28/000194 107441 ADREENA NASHA SHAQEENA, BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 28/07/2022 21:30:18 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2874 2022/07/28/000195 090061 DEVI RATNA APRILIA, NY BPJS.K1T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 28/07/2022 21:26:51 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
2875 2022/07/28/000195 090061 DEVI RATNA APRILIA, NY BPJS.K1T20 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 28/07/2022 21:26:51 BPJS KS IGD 5 32,431 9,569 0 3,000 0 0 0 45,000
2876 2022/07/28/000195 090061 DEVI RATNA APRILIA, NY BPJS.K1T20 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 28/07/2022 21:26:51 BPJS KS IGD 5 32,436 564 0 2,000 0 0 0 35,000
2877 2022/07/28/000195 090061 DEVI RATNA APRILIA, NY BPJS.K1T20 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 28/07/2022 21:26:51 BPJS KS IGD 5 32,436 564 0 2,000 0 0 0 35,000
2878 2022/07/28/000195 090061 DEVI RATNA APRILIA, NY BPJS.K1T20 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 28/07/2022 21:25:43 BPJS KS IGD 5 44,800 35,200 0 5,000 5,000 0 0 90,000
2879 2022/07/21/000123 073786 NUR VITAKHUROHMAH, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 29/07/2022 12:14:27 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2880 2022/07/22/000109 015583 GARLINGGA GALANG BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 10:01:09 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
RAMADHAN,An 001 AMd.AK. Sp.A. KESEHATAN
2881 2022/07/23/000168 072437 SHEZA AULIA SALSABILA, AN UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 29/07/2022 12:24:02 UMUM KS IGD 2 50,431 26,569 0 3,000 0 0 0 75,000
2882 2022/07/24/000034 072753 SANIYAH NISRIN, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 10:08:09 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2883 2022/07/24/000074 027742 FAIZ AYDIN RAMADHAN, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 10:10:52 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
2884 2022/07/25/000239 026740 MUHAMMAD ABIZAR AL BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 02:20:25 BPJS ICU 2 40,431 26,569 0 3,000 0 0 0 70,000
GHIFARI ,An 001 Sp.A. KESEHATAN
8/1/22, 8:34 AM Page 96 of 107

2885 2022/07/25/000240 012917 ROHICHUL MACHTUM, AN UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 06:10:36 UMUM KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
0001 Sp.A.
2886 2022/07/25/000241 072806 PRINCESS FLORENCIA UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 06:08:35 UMUM KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
KIMBERLY, AN 0001 Sp.A.
2887 2022/07/25/000241 072806 PRINCESS FLORENCIA UMUM.K3B0 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 08:15:01 UMUM KS IGD 1 30,390 6,610 0 3,000 0 0 0 40,000
2888 2022/07/26/000174 028837 ZERINA SHAKILA NAFISA, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 29/07/2022 10:03:39 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2889 2022/07/27/000207 072506 SHABIRA ALULA KHANDRA, AN BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 18:07:11 BPJS KS IGD 6 33,931 13,069 0 3,000 0 0 0 50,000
2890 2022/07/27/000207 072506 SHABIRA ALULA KHANDRA, AN BPJS.KINS0 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 18:07:11 BPJS KS IGD 6 31,936 6,064 0 2,000 0 0 0 40,000
2891 2022/07/27/000207 072506 SHABIRA ALULA KHANDRA, AN BPJS.KINS0 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 18:07:11 BPJS KS IGD 6 31,436 6,564 0 2,000 0 0 0 40,000
2892 2022/07/27/000209 072508 AZLAN MAHASINUL HAQQ, AN BPJS.KINS0 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 18:08:43 BPJS KS IGD 7 33,931 13,069 0 3,000 0 0 0 50,000
2893 2022/07/27/000209 072508 AZLAN MAHASINUL HAQQ, AN BPJS.KINS0 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 18:08:43 BPJS KS IGD 7 31,936 6,064 0 2,000 0 0 0 40,000
2894 2022/07/27/000209 072508 AZLAN MAHASINUL HAQQ, AN BPJS.KINS0 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 18:08:43 BPJS KS IGD 7 31,436 6,564 0 2,000 0 0 0 40,000
2895 2022/07/28/000079 072339 MARIA KLARIZA PUTRI BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 29/07/2022 12:25:50 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2896 2022/07/28/000103 072896 TATIK, NY BPJS.K1000 Cholesterol 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4150215 dr. DEWI INDIASTARI, 29/07/2022 10:14:00 BPJS KS IGD 1 29,951 12,049 0 3,000 0 0 0 45,000
2897 2022/07/28/000103 072896 TATIK, NY BPJS.K1000 HDL 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4150215 dr. DEWI INDIASTARI, 29/07/2022 10:14:00 BPJS KS IGD 1 34,951 22,049 0 3,000 0 0 0 60,000
2898 2022/07/28/000103 072896 TATIK, NY BPJS.K1000 LDL 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4150215 dr. DEWI INDIASTARI, 29/07/2022 10:14:00 BPJS KS IGD 1 34,951 22,049 0 3,000 0 0 0 60,000
2899 2022/07/28/000103 072896 TATIK, NY BPJS.K1000 Trigliserida 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4150215 dr. DEWI INDIASTARI, 29/07/2022 10:14:00 BPJS KS IGD 1 34,951 17,049 0 3,000 0 0 0 55,000
2900 2022/07/28/000103 072896 TATIK, NY BPJS.K2B00 Gula Darah 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4150215 dr. DEWI INDIASTARI, 29/07/2022 10:14:00 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2901 2022/07/28/000133 019332 ENDARU DZAKI BPJS.K2B00 Faeces Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 29/07/2022 20:00:01 BPJS KS IGD 1 31,940 5,060 0 3,000 0 0 0 40,000
2902 2022/07/28/000195 090061 DEVI RATNA APRILIA, NY BPJS.K1T20 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 29/07/2022 06:07:27 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
2903 2022/07/29/000004 002627 AINUN NADHIFATUL UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150220 dr. IMELDA, Sp.OG. 29/07/2022 09:54:18 UMUM Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
MACHFUDZOH,NY 001 AMd.AK.
2904 2022/07/29/000004 002627 AINUN NADHIFATUL UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150220 dr. IMELDA, Sp.OG. 29/07/2022 09:54:18 UMUM Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
2905 2022/07/29/000004 002627 AINUN NADHIFATUL UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150220 dr. IMELDA, Sp.OG. 29/07/2022 09:55:00 UMUM Poli Kandungan 37,900 47,600 0 7,500 5,000 0 0 98,000
2906 2022/07/29/000004 002627 AINUN NADHIFATUL UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150220 dr. IMELDA, Sp.OG. 29/07/2022 09:54:18 UMUM Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
2907 2022/07/29/000004 002627 AINUN NADHIFATUL UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150220 dr. IMELDA, Sp.OG. 29/07/2022 09:54:18 UMUM Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
2908 2022/07/29/000071 107449 DWI LULUT NUR FATIMA, NY UMUM.RJ00 Plano Test 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 29/07/2022 00:19:03 UMUM IGD 33,140 4,860 0 2,000 0 0 0 40,000
0022
2909 2022/07/29/000073 066356 KARINA PANORAMA MIRAZ, Ny BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 29/07/2022 06:28:24 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2910 2022/07/29/000073 066356 KARINA PANORAMA MIRAZ, Ny BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 29/07/2022 06:28:24 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2911 2022/07/29/000073 066356 KARINA PANORAMA MIRAZ, Ny BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 29/07/2022 06:28:24 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2912 2022/07/29/000073 066356 KARINA PANORAMA MIRAZ, Ny BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 29/07/2022 06:28:24 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2913 2022/07/29/000073 066356 KARINA PANORAMA MIRAZ, Ny BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1110218 dr. NOVINA PURWITA 29/07/2022 06:27:17 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2914 2022/07/29/000076 070631 DESSY MARDIKAWATI, NY BPJS.K2T30 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 29/07/2022 13:15:47 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2915 2022/07/29/000077 106615 JUNI ASTUTI FITRIANI, NY BPJS. Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 29/07/2022 03:57:40 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
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RJ00001
2916 2022/07/29/000077 106615 JUNI ASTUTI FITRIANI, NY BPJS.RJ000 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 29/07/2022 03:56:39 BPJS IGD 44,800 35,200 0 5,000 5,000 0 0 90,000
050 KESEHATAN
2917 2022/07/29/000093 036816 JASMINE KIRANA RAMADHANI, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 29/07/2022 07:19:14 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 AMd.AK. KESEHATAN
2918 2022/07/29/000106 072476 MUHAMMAD ARSYAD IBRAHIM UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 09:31:09 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
HANUNG, AN 0020 AMd.AK. Sp.A.
2919 2022/07/29/000124 057870 IRMA KURNIAWATI, NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 29/07/2022 10:22:49 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
2920 2022/07/29/000124 057870 IRMA KURNIAWATI, NY BPJS.RJ000 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 29/07/2022 10:17:26 BPJS IGD 44,800 35,200 0 5,000 5,000 0 0 90,000
2921 2022/07/29/000128 070620 MAXIMILLIAN AUSTIN SKY, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 10:41:39 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2922 2022/07/29/000128 070620 MAXIMILLIAN AUSTIN SKY, AN BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 10:41:39 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
2923 2022/07/29/000136 088976 DIANA GEMITA PAMELIA, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 29/07/2022 18:10:27 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
2924 2022/07/29/000137 014644 GYANDRA ISYWARA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 29/07/2022 15:56:15 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
ARKADEWI,AN 001 M.Biomed.
2925 2022/07/29/000137 014644 GYANDRA ISYWARA UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 29/07/2022 15:56:15 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
ARKADEWI,AN 009 M.Biomed.
2926 2022/07/29/000138 069398 FANDA ARIANTIKA LUTHFI,NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 29/07/2022 19:54:04 BPJS Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
2927 2022/07/29/000139 107468 WAHYU APRILIA DEWI, Ny UMUM.RJ00 Plano Test 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150220 dr. IMELDA, Sp.OG. 29/07/2022 15:04:48 UMUM Poli Kandungan 33,140 4,860 0 2,000 0 0 0 40,000
0022
2928 2022/07/29/000140 036109 JENNAIRA NAWALA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 29/07/2022 12:17:44 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
DHANESWARI, AN 001 AMd.AK.
2929 2022/07/29/000140 036109 JENNAIRA NAWALA UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 29/07/2022 12:17:44 UMUM IGD 32,431 9,569 0 3,000 0 0 0 45,000
DHANESWARI, AN 00110 AMd.AK.
2930 2022/07/29/000142 033282 DIANA ENDAH RAHAYU, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 29/07/2022 13:08:21 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
2931 2022/07/29/000142 033282 DIANA ENDAH RAHAYU, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 29/07/2022 13:08:21 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
2932 2022/07/29/000142 033282 DIANA ENDAH RAHAYU, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 29/07/2022 13:12:56 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
2933 2022/07/29/000142 033282 DIANA ENDAH RAHAYU, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 29/07/2022 13:08:21 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
2934 2022/07/29/000142 033282 DIANA ENDAH RAHAYU, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 29/07/2022 13:08:21 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
2935 2022/07/29/000144 027712 NESYA KURNIAYANTI, NY BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 29/07/2022 22:50:20 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
2936 2022/07/29/000144 027712 NESYA KURNIAYANTI, NY BPJS.K2UP1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 29/07/2022 22:50:20 BPJS KS IGD 6 32,431 9,569 0 3,000 0 0 0 45,000
2937 2022/07/29/000144 027712 NESYA KURNIAYANTI, NY BPJS.K2UP1 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 29/07/2022 22:50:20 BPJS KS IGD 6 32,436 564 0 2,000 0 0 0 35,000
2938 2022/07/29/000144 027712 NESYA KURNIAYANTI, NY BPJS.K2UP1 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 29/07/2022 22:50:20 BPJS KS IGD 6 32,436 564 0 2,000 0 0 0 35,000
2939 2022/07/29/000144 027712 NESYA KURNIAYANTI, NY BPJS.K2UP1 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 29/07/2022 22:49:40 BPJS KS IGD 6 44,800 35,200 0 5,000 5,000 0 0 90,000
2940 2022/07/29/000146 079076 SAFANIA ZABRINA BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10120217 dr. NYOMAN LUWANG 29/07/2022 13:45:56 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
RAHMADIANTI, NY 0001 AMd.AK. WISANA, Sp.OG. KESEHATAN 6/Ayodya 3
2941 2022/07/29/000146 079076 SAFANIA ZABRINA BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10120217 dr. NYOMAN LUWANG 29/07/2022 13:45:56 BPJS Dwarawati 32,431 9,569 0 3,000 0 0 0 45,000
2942 2022/07/29/000146 079076 SAFANIA ZABRINA BPJS.K2T10 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10120217 dr. NYOMAN LUWANG 29/07/2022 13:45:56 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
2943 2022/07/29/000146 079076 SAFANIA ZABRINA BPJS.K2T10 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10120217 dr. NYOMAN LUWANG 29/07/2022 13:45:56 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
2944 2022/07/29/000146 079076 SAFANIA ZABRINA BPJS.K2T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10120217 dr. NYOMAN LUWANG 29/07/2022 13:47:15 BPJS Dwarawati 44,800 35,200 0 5,000 5,000 0 0 90,000
8/1/22, 8:34 AM Page 98 of 107

2945 2022/07/29/000150 095622 Azril Rahandika Alfariq, An. KYN.RJ0000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 18:21:32 KARYAWAN Poli Anak 33,431 26,569 0 3,000 0 0 0 63,000
2946 2022/07/29/000150 095622 Azril Rahandika Alfariq, An. KYN.RJ0000 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 18:21:32 KARYAWAN Poli Anak 26,931 10,069 0 3,000 0 0 0 40,000
2947 2022/07/29/000157 054884 INA SOFIANA, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 29/07/2022 14:23:58 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2948 2022/07/29/000157 054884 INA SOFIANA, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 29/07/2022 22:07:20 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2949 2022/07/29/000157 054884 INA SOFIANA, NY BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 29/07/2022 14:23:58 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2950 2022/07/29/000157 054884 INA SOFIANA, NY BPJS.K1B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 29/07/2022 14:23:58 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2951 2022/07/29/000157 054884 INA SOFIANA, NY BPJS.K1B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 29/07/2022 14:23:58 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
2952 2022/07/29/000157 054884 INA SOFIANA, NY BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1150219 dr. FATMASARI PERDANA 29/07/2022 14:25:14 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2953 2022/07/29/000163 016536 Almeera Sabhira Arifianto, An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 29/07/2022 15:52:57 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 M.Biomed.
2954 2022/07/29/000163 016536 Almeera Sabhira Arifianto, An UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 1160202 dr. DEWI NURINDAH, Sp.A, 29/07/2022 15:52:57 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 M.Biomed.
2955 2022/07/29/000166 000930 KHOIRUL UMMAH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 29/07/2022 16:47:43 BPJS KS RR 1 40,431 26,569 0 3,000 0 0 0 70,000
2956 2022/07/29/000166 000930 KHOIRUL UMMAH, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 29/07/2022 16:47:43 BPJS KS RR 1 32,431 9,569 0 3,000 0 0 0 45,000
2957 2022/07/29/000166 000930 KHOIRUL UMMAH, NY BPJS.K3B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 29/07/2022 16:50:48 BPJS KS RR 1 37,400 47,600 0 5,000 5,000 0 0 95,000
2958 2022/07/29/000166 000930 KHOIRUL UMMAH, NY BPJS.K3B00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 29/07/2022 16:47:43 BPJS KS RR 1 37,951 38,049 0 4,000 0 0 0 80,000
2959 2022/07/29/000166 000930 KHOIRUL UMMAH, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 29/07/2022 16:46:13 BPJS KS RR 1 44,800 35,200 0 5,000 5,000 0 0 90,000
2960 2022/07/29/000166 000930 KHOIRUL UMMAH, NY BPJS.K3B00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 29/07/2022 16:47:43 BPJS KS RR 1 37,951 38,049 0 4,000 0 0 0 80,000
2961 2022/07/29/000170 107477 HAIDAR RASYID GHUFRON UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 18:18:51 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
GUMILAR, AN 001 Sp.A.
2962 2022/07/29/000170 107477 HAIDAR RASYID GHUFRON UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 29/07/2022 18:18:51 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
GUMILAR, AN 009 Sp.A.
2963 2022/07/29/000182 055882 Mahira Dzakira Qisya, An. UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 29/07/2022 20:18:55 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 Sp.A.
2964 2022/07/29/000183 107481 SYAFIRA AULIA UDJIR, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 29/07/2022 20:22:18 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
001 KESEHATAN
2965 2022/07/29/000184 062540 ALVARO MAULANA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 29/07/2022 20:35:22 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
SAEFULLOH, AN 001 Sp.A.
2966 2022/07/29/000189 088838 AYESHA HANUN PUTRI BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 29/07/2022 22:03:44 BPJS Dwarawati 44,800 35,200 0 5,000 5,000 0 0 90,000
EFFENDY, AN 0050 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN 4/Ayodya 2
2967 2022/07/23/000168 072437 SHEZA AULIA SALSABILA, AN UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 30/07/2022 13:54:40 UMUM KS IGD 2 50,431 26,569 0 3,000 0 0 0 75,000
2968 2022/07/25/000239 026740 MUHAMMAD ABIZAR AL BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 07:53:23 BPJS ICU 2 40,431 26,569 0 3,000 0 0 0 70,000
2969 2022/07/25/000240 012917 ROHICHUL MACHTUM, AN UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 06:00:41 UMUM KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
2970 2022/07/25/000241 072806 PRINCESS FLORENCIA UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 06:01:35 UMUM KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
KIMBERLY, AN 0001 ARDHIANSYAH, AMd.Ankes Sp.A.
2971 2022/07/27/000141 105080 NIRMALA GYTA LAILA BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 30/07/2022 05:59:45 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2972 2022/07/27/000141 105080 NIRMALA GYTA LAILA BPJS.K2B00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 30/07/2022 05:59:45 BPJS KS IGD 1 31,931 10,069 0 3,000 0 0 0 45,000
2973 2022/07/27/000173 002674 ACHMAD FAIZ AL ARKHAN, AN BPJS.K2B00 Faeces Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 30/07/2022 19:16:13 BPJS Amarta 2 31,940 5,060 0 3,000 0 0 0 40,000
2974 2022/07/28/000075 072891 SHAKILA MAULIDIYA, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 06:02:42 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2975 2022/07/28/000091 042398 ELMAIRA SHAZIA ZALFA BPJS.K3UP2 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 30/07/2022 07:56:20 BPJS KS IGD 5 30,390 6,610 0 3,000 0 0 0 40,000
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2976 2022/07/28/000190 072524 GAVIN ALVERO ARDIANSAH, BPJS.K3B00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 16:51:09 BPJS KS IGD 6 33,931 13,069 0 3,000 0 0 0 50,000
2977 2022/07/28/000190 072524 GAVIN ALVERO ARDIANSAH, BPJS.K3B00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 16:51:09 BPJS KS IGD 6 31,936 6,064 0 2,000 0 0 0 40,000
2978 2022/07/28/000190 072524 GAVIN ALVERO ARDIANSAH, BPJS.K3B00 Rhesus 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 16:51:09 BPJS KS IGD 6 31,436 6,564 0 2,000 0 0 0 40,000
2979 2022/07/29/000073 066356 KARINA PANORAMA MIRAZ, Ny BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 30/07/2022 22:34:45 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2980 2022/07/29/000078 027471 SHIDQIA MAULIDIYAH, AN BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 01:15:01 BPJS Amarta 1A 40,431 26,569 0 3,000 0 0 0 70,000
2981 2022/07/29/000078 027471 SHIDQIA MAULIDIYAH, AN BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 01:15:01 BPJS Amarta 1A 32,431 9,569 0 3,000 0 0 0 45,000
2982 2022/07/29/000144 027712 NESYA KURNIAYANTI, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1110218 dr. NOVINA PURWITA 30/07/2022 10:13:30 BPJS KS IGD 6 40,431 26,569 0 3,000 0 0 0 70,000
2983 2022/07/29/000146 079076 SAFANIA ZABRINA BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 10120217 dr. NYOMAN LUWANG 30/07/2022 16:28:20 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
RAHMADIANTI, NY 0001 ARDHIANSYAH, AMd.Ankes WISANA, Sp.OG. KESEHATAN 6/Ayodya 3
2984 2022/07/29/000166 000930 KHOIRUL UMMAH, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 30/07/2022 13:50:34 BPJS KS RR 1 40,431 26,569 0 3,000 0 0 0 70,000
2985 2022/07/29/000185 087095 VENI WULANDARI, Ny BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 30/07/2022 01:13:50 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
2986 2022/07/29/000185 087095 VENI WULANDARI, Ny BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 30/07/2022 20:00:01 BPJS KS IGD 10 40,431 26,569 0 3,000 0 0 0 70,000
2987 2022/07/29/000185 087095 VENI WULANDARI, Ny BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 30/07/2022 01:13:50 BPJS KS IGD 10 32,431 9,569 0 3,000 0 0 0 45,000
2988 2022/07/29/000185 087095 VENI WULANDARI, Ny BPJS.K2T10 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 30/07/2022 01:13:50 BPJS KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
2989 2022/07/29/000185 087095 VENI WULANDARI, Ny BPJS.K2T10 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 30/07/2022 01:13:50 BPJS KS IGD 10 32,436 564 0 2,000 0 0 0 35,000
2990 2022/07/29/000185 087095 VENI WULANDARI, Ny BPJS.K2T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 30/07/2022 01:13:09 BPJS KS IGD 10 44,800 35,200 0 5,000 5,000 0 0 90,000
2991 2022/07/29/000189 088838 AYESHA HANUN PUTRI BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 30/07/2022 16:46:02 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
EFFENDY, AN 001 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN 4/Ayodya 2
2992 2022/07/29/000191 107457 LIA SUSANTI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 30/07/2022 00:46:57 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
2993 2022/07/29/000191 107457 LIA SUSANTI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 30/07/2022 00:46:57 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
2994 2022/07/29/000191 107457 LIA SUSANTI, NY UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 30/07/2022 00:46:57 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
2995 2022/07/29/000191 107457 LIA SUSANTI, NY UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1110218 dr. NOVINA PURWITA 30/07/2022 00:46:57 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
2996 2022/07/29/000191 107457 LIA SUSANTI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 30/07/2022 00:03:50 BPJS IGD 47,300 35,200 0 7,500 5,000 0 0 95,000
2997 2022/07/30/000034 107484 ALI SYAKIR YAHYA, AN BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 01:15:51 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
2998 2022/07/30/000034 107484 ALI SYAKIR YAHYA, AN BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 01:15:51 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
2999 2022/07/30/000035 107483 VARADHIBA OKTAVIA,NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 4160205 dr. WAHYUDI JOKO 30/07/2022 13:48:52 BPJS KS IGD 7 40,431 26,569 0 3,000 0 0 0 70,000
3000 2022/07/30/000035 107483 VARADHIBA OKTAVIA,NY BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 30/07/2022 00:22:12 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
3001 2022/07/30/000035 107483 VARADHIBA OKTAVIA,NY BPJS.RJ000 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 30/07/2022 00:22:12 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
3002 2022/07/30/000035 107483 VARADHIBA OKTAVIA,NY BPJS.RJ000 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 30/07/2022 00:22:12 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
3003 2022/07/30/000035 107483 VARADHIBA OKTAVIA,NY BPJS.RJ000 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 30/07/2022 00:22:12 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
3004 2022/07/30/000035 107483 VARADHIBA OKTAVIA,NY BPJS.RJ000 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 4160205 dr. WAHYUDI JOKO 30/07/2022 00:21:21 BPJS IGD 44,800 35,200 0 5,000 5,000 0 0 90,000
3005 2022/07/30/000037 107485 FAREL AZIZ PRADHIFTA,AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 30/07/2022 01:09:09 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
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3006 2022/07/30/000040 033282 DIANA ENDAH RAHAYU, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 30/07/2022 13:51:47 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
3007 2022/07/30/000041 107487 NESYA KURNIA, By,Ny BPJS.KFIS0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 30/07/2022 06:15:52 BPJS KS Fisol 27 40,431 26,569 0 3,000 0 0 0 70,000
3008 2022/07/30/000041 107487 NESYA KURNIA, By,Ny BPJS.KFIS0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 30/07/2022 06:15:52 BPJS KS Fisol 27 32,431 9,569 0 3,000 0 0 0 45,000
3009 2022/07/30/000041 107487 NESYA KURNIA, By,Ny BPJS.KFIS0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 30/07/2022 06:15:15 BPJS KS Fisol 27 44,800 35,200 0 5,000 5,000 0 0 90,000
3010 2022/07/30/000042 002627 AINUN NADHIFATUL BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 30/07/2022 13:53:14 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
MACHFUDZOH,NY 001 AMd.AK. KESEHATAN
3011 2022/07/30/000058 107492 IZMI SEPTRIANI PUTRI, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 30/07/2022 08:41:33 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
3012 2022/07/30/000064 053901 RAZETA BALQIS AZRAH, AN UMUM.K2T1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 09:38:27 UMUM KS IGD 1 50,431 26,569 0 3,000 0 0 0 75,000
00001 AMd.AK. Sp.A.
3013 2022/07/30/000064 053901 RAZETA BALQIS AZRAH, AN UMUM.K2T1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 09:38:27 UMUM KS IGD 1 37,431 9,569 0 3,000 0 0 0 50,000
0000110 AMd.AK. Sp.A.
3014 2022/07/30/000066 047238 MUHAMMAD HASAN AL FAQIH, BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 12:27:09 BPJS KS IGD 8 40,431 26,569 0 3,000 0 0 0 70,000
3015 2022/07/30/000066 047238 MUHAMMAD HASAN AL FAQIH, BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 12:27:09 BPJS KS IGD 8 32,431 9,569 0 3,000 0 0 0 45,000
3016 2022/07/30/000066 047238 MUHAMMAD HASAN AL FAQIH, BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 12:24:31 BPJS KS IGD 8 44,800 35,200 0 5,000 5,000 0 0 90,000
3017 2022/07/30/000068 063451 SUCIYATI, NY BPJS.K3000 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 30/07/2022 10:15:27 BPJS KS IGD 7 44,800 35,200 0 5,000 5,000 0 0 90,000
3018 2022/07/30/000068 063451 SUCIYATI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 30/07/2022 10:10:52 BPJS KS IGD 7 40,431 26,569 0 3,000 0 0 0 70,000
3019 2022/07/30/000068 063451 SUCIYATI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150220 dr. IMELDA, Sp.OG. 30/07/2022 19:58:55 BPJS KS IGD 7 40,431 26,569 0 3,000 0 0 0 70,000
3020 2022/07/30/000068 063451 SUCIYATI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 30/07/2022 10:10:52 BPJS KS IGD 7 32,431 9,569 0 3,000 0 0 0 45,000
3021 2022/07/30/000068 063451 SUCIYATI, NY BPJS.K3B00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 30/07/2022 10:10:52 BPJS KS IGD 7 30,390 6,610 0 3,000 0 0 0 40,000
3022 2022/07/30/000068 063451 SUCIYATI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 30/07/2022 10:10:52 BPJS KS IGD 7 32,436 564 0 2,000 0 0 0 35,000
3023 2022/07/30/000068 063451 SUCIYATI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 30/07/2022 10:10:52 BPJS KS IGD 7 32,436 564 0 2,000 0 0 0 35,000
3024 2022/07/30/000071 002132 MUHAMMAD FAHRIL MUZAKKI, BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 30/07/2022 12:48:17 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
3025 2022/07/30/000071 002132 MUHAMMAD FAHRIL MUZAKKI, BPJS.K2T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 30/07/2022 12:24:04 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
3026 2022/07/30/000075 002630 RAFFASA NAZRIL KURNIAWAN, UMUM.K3T1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 30/07/2022 12:50:07 UMUM KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
3027 2022/07/30/000075 002630 RAFFASA NAZRIL KURNIAWAN, UMUM.K3T1 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 30/07/2022 12:34:20 UMUM KS IGD 1 37,900 47,600 0 7,500 5,000 0 0 98,000
3028 2022/07/30/000076 051228 MUHAMMAD RAYN HAQQ, AN BPJS.K2T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 9070009 dr. MOHAMMAD MUCHLIS, 30/07/2022 12:23:40 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
3029 2022/07/30/000076 051228 MUHAMMAD RAYN HAQQ, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 30/07/2022 11:01:08 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
3030 2022/07/30/000076 051228 MUHAMMAD RAYN HAQQ, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 30/07/2022 11:01:08 BPJS IGD 31,931 10,069 0 3,000 0 0 0 45,000
3031 2022/07/30/000079 029984 AZZAMIR BASIRA GHAYDA, AN BPJS.K3T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 15:14:35 BPJS KS IGD 9 40,431 26,569 0 3,000 0 0 0 70,000
3032 2022/07/30/000079 029984 AZZAMIR BASIRA GHAYDA, AN BPJS.K3T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 15:14:35 BPJS KS IGD 9 32,431 9,569 0 3,000 0 0 0 45,000
3033 2022/07/30/000080 107499 ADRYAN FIQRIE YR, AN UMUM.K1B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 12:27:57 UMUM KS IGD 10 50,431 26,569 0 3,000 0 0 0 80,000
0001 AMd.AK. Sp.A.
3034 2022/07/30/000080 107499 ADRYAN FIQRIE YR, AN UMUM.K1B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 12:27:57 UMUM KS IGD 10 42,431 9,569 0 3,000 0 0 0 55,000
3035 2022/07/30/000080 107499 ADRYAN FIQRIE YR, AN UMUM.K1B0 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 12:29:25 UMUM KS IGD 10 37,900 47,600 0 7,500 5,000 0 0 98,000
00047 AMd.AK. Sp.A.
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3036 2022/07/30/000082 052361 KHADEEJAH ZAYYENA BPJS.K3T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 30/07/2022 15:12:08 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
ALMAHYRA, AN 0001 ARDHIANSYAH, AMd.Ankes M.Biomed. KESEHATAN
3037 2022/07/30/000082 052361 KHADEEJAH ZAYYENA BPJS.K3T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 30/07/2022 15:12:08 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
3038 2022/07/30/000082 052361 KHADEEJAH ZAYYENA BPJS.K3T10 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 30/07/2022 15:12:08 BPJS KS IGD 2 31,931 10,069 0 3,000 0 0 0 45,000
3039 2022/07/30/000083 053374 TRI PURWITASARI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150220 dr. IMELDA, Sp.OG. 30/07/2022 16:16:27 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
3040 2022/07/30/000083 053374 TRI PURWITASARI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150220 dr. IMELDA, Sp.OG. 30/07/2022 16:16:27 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
3041 2022/07/30/000083 053374 TRI PURWITASARI, NY UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150220 dr. IMELDA, Sp.OG. 30/07/2022 16:16:27 UMUM Laboratorium 32,436 564 0 2,000 0 0 0 35,000
3042 2022/07/30/000083 053374 TRI PURWITASARI, NY UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150220 dr. IMELDA, Sp.OG. 30/07/2022 16:16:27 UMUM Laboratorium 32,436 564 0 2,000 0 0 0 35,000
3043 2022/07/30/000083 053374 TRI PURWITASARI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150220 dr. IMELDA, Sp.OG. 30/07/2022 16:37:54 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
3044 2022/07/30/000090 049394 NATASYA AULYA JENSEN, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 30/07/2022 15:16:38 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
3045 2022/07/30/000090 049394 NATASYA AULYA JENSEN, AN BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 30/07/2022 13:47:15 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
3046 2022/07/30/000091 012090 RAMA CHANDRA VATARA, NY UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 30/07/2022 13:45:38 UMUM IGD 47,300 35,200 0 7,500 5,000 0 0 95,000
0050 AMd.AK.
3047 2022/07/30/000096 107502 IIN INDARWATI,NY UMUM.RJ00 Plano Test 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 30/07/2022 16:11:47 UMUM IGD 33,140 4,860 0 2,000 0 0 0 40,000
3048 2022/07/30/000097 066363 HAYUNING IRLIN ZANALIA, NY BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 30/07/2022 16:56:22 BPJS KS RR 1 40,431 26,569 0 3,000 0 0 0 70,000
3049 2022/07/30/000097 066363 HAYUNING IRLIN ZANALIA, NY BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 30/07/2022 16:56:22 BPJS KS RR 1 32,431 9,569 0 3,000 0 0 0 45,000
3050 2022/07/30/000097 066363 HAYUNING IRLIN ZANALIA, NY BPJS.K2T10 BT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 30/07/2022 16:56:22 BPJS KS RR 1 32,436 564 0 2,000 0 0 0 35,000
3051 2022/07/30/000097 066363 HAYUNING IRLIN ZANALIA, NY BPJS.K2T10 CT 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 30/07/2022 16:56:22 BPJS KS RR 1 32,436 564 0 2,000 0 0 0 35,000
3052 2022/07/30/000097 066363 HAYUNING IRLIN ZANALIA, NY BPJS.K2T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1150219 dr. FATMASARI PERDANA 30/07/2022 16:55:14 BPJS KS RR 1 44,800 35,200 0 5,000 5,000 0 0 90,000
3053 2022/07/30/000100 036109 JENNAIRA NAWALA BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 18:19:46 BPJS KS Kamar Bersalin 40,431 26,569 0 3,000 0 0 0 70,000
DHANESWARI, AN 001 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN 3
3054 2022/07/30/000100 036109 JENNAIRA NAWALA BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 18:19:46 BPJS KS Kamar Bersalin 32,431 9,569 0 3,000 0 0 0 45,000
DHANESWARI, AN 00110 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN 3
3055 2022/07/30/000103 107506 ALDEVITO GAVIN ABIZAM UMUM.K2B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 3150145 dr. ZAINUDDIN HAMIDI, 30/07/2022 20:00:36 UMUM KS IGD 5 37,431 9,569 0 3,000 0 0 0 50,000
WICAKSONO, AN 000110 ARDHIANSYAH, AMd.Ankes Sp.A.
3056 2022/07/30/000108 087310 Azriel Abrizam Wibowo, An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 30/07/2022 18:18:50 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
3057 2022/07/30/000108 087310 Azriel Abrizam Wibowo, An UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 30/07/2022 18:18:50 UMUM IGD 32,431 9,569 0 3,000 0 0 0 45,000
3058 2022/07/30/000110 107508 KIRANA ALISA BPJS.RJ000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 30/07/2022 19:18:44 BPJS FISOL 40,431 26,569 0 3,000 0 0 0 70,000
EARLYTARYNIN,AN 01 ARDHIANSYAH, AMd.Ankes Sp.A. KESEHATAN
3059 2022/07/30/000118 049176 NAURA TAKA AQILLY, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 30/07/2022 19:17:28 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
3060 2022/07/30/000118 049176 NAURA TAKA AQILLY, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 30/07/2022 19:18:00 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
3061 2022/07/30/000118 049176 NAURA TAKA AQILLY, AN UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 1160202 dr. DEWI NURINDAH, Sp.A, 30/07/2022 19:17:28 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
3062 2022/07/30/000124 034264 RAIZ AZKA AZZAM, AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 9070009 dr. MOHAMMAD MUCHLIS, 30/07/2022 20:16:51 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
3063 2022/07/30/000126 107514 ADELIA JIHAN ARIESTA,AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 2110052 AGYL FRAN 09210381 dr. KIKI RIZKI RACHMAT 30/07/2022 20:19:44 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
3064 2022/07/30/000129 069880 VANNISA AMALIA MEITA H,NY BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 30/07/2022 22:56:37 BPJS KS RR 1 40,431 26,569 0 3,000 0 0 0 70,000
3065 2022/07/30/000129 069880 VANNISA AMALIA MEITA H,NY BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 30/07/2022 22:56:37 BPJS KS RR 1 32,431 9,569 0 3,000 0 0 0 45,000
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0
3066 2022/07/30/000129 069880 VANNISA AMALIA MEITA H,NY BPJS.K2T10 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 30/07/2022 22:56:37 BPJS KS RR 1 32,436 564 0 2,000 0 0 0 35,000
3067 2022/07/30/000129 069880 VANNISA AMALIA MEITA H,NY BPJS.K2T10 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 30/07/2022 22:56:37 BPJS KS RR 1 32,436 564 0 2,000 0 0 0 35,000
3068 2022/07/30/000129 069880 VANNISA AMALIA MEITA H,NY BPJS.K2T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 30/07/2022 22:57:19 BPJS KS RR 1 44,800 35,200 0 5,000 5,000 0 0 90,000
3069 2022/07/30/000130 065378 VIRGINANTARI NATALIA, NY BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 30/07/2022 23:00:32 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
3070 2022/07/30/000130 065378 VIRGINANTARI NATALIA, NY BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 30/07/2022 23:00:32 BPJS Dwarawati 32,431 9,569 0 3,000 0 0 0 45,000
3071 2022/07/30/000130 065378 VIRGINANTARI NATALIA, NY BPJS.K2T10 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 30/07/2022 23:00:32 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
3072 2022/07/30/000130 065378 VIRGINANTARI NATALIA, NY BPJS.K2T10 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 30/07/2022 23:00:32 BPJS Dwarawati 32,436 564 0 2,000 0 0 0 35,000
3073 2022/07/30/000130 065378 VIRGINANTARI NATALIA, NY BPJS.K2T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 30/07/2022 23:01:14 BPJS Dwarawati 44,800 35,200 0 5,000 5,000 0 0 90,000
3074 2022/07/30/000131 107516 FATHIMAH KHUMDAILIY SANIA, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 30/07/2022 22:29:57 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
AN 001 AMd.AK.
3075 2022/07/30/000131 107516 FATHIMAH KHUMDAILIY SANIA, UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 30/07/2022 22:29:57 UMUM IGD 31,931 10,069 0 3,000 0 0 0 45,000
AN 009 AMd.AK.
3076 2022/07/23/000168 072437 SHEZA AULIA SALSABILA, AN UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1160202 dr. DEWI NURINDAH, Sp.A, 31/07/2022 13:30:00 UMUM KS IGD 2 50,431 26,569 0 3,000 0 0 0 75,000
3077 2022/07/25/000239 026740 MUHAMMAD ABIZAR AL BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 31/07/2022 16:32:33 BPJS ICU 2 40,431 26,569 0 3,000 0 0 0 70,000
3078 2022/07/27/000173 002674 ACHMAD FAIZ AL ARKHAN, AN BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 31/07/2022 19:31:16 BPJS Amarta 2 40,431 26,569 0 3,000 0 0 0 70,000
3079 2022/07/29/000189 088838 AYESHA HANUN PUTRI BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 31/07/2022 08:56:28 BPJS Dwarawati 40,431 26,569 0 3,000 0 0 0 70,000
EFFENDY, AN 001 AMd.AK. Sp.A. KESEHATAN 4/Ayodya 2
3080 2022/07/30/000076 051228 MUHAMMAD RAYN HAQQ, AN BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 9070009 dr. MOHAMMAD MUCHLIS, 31/07/2022 09:01:10 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
3081 2022/07/30/000082 052361 KHADEEJAH ZAYYENA BPJS.K3T10 Faeces Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1160202 dr. DEWI NURINDAH, Sp.A, 31/07/2022 06:46:15 BPJS KS IGD 2 31,940 5,060 0 3,000 0 0 0 40,000
ALMAHYRA, AN 00023 AMd.AK. M.Biomed. KESEHATAN
3082 2022/07/30/000097 066363 HAYUNING IRLIN ZANALIA, NY BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150220 dr. IMELDA, Sp.OG. 31/07/2022 19:59:19 BPJS KS RR 1 40,431 26,569 0 3,000 0 0 0 70,000
3083 2022/07/30/000129 069880 VANNISA AMALIA MEITA H,NY BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 31/07/2022 13:32:22 BPJS KS RR 1 40,431 26,569 0 3,000 0 0 0 70,000
3084 2022/07/30/000132 107520 YUNI NUR ISLAMIYAH, NY BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 31/07/2022 00:59:14 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
3085 2022/07/30/000132 107520 YUNI NUR ISLAMIYAH, NY BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 31/07/2022 08:55:26 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
3086 2022/07/30/000132 107520 YUNI NUR ISLAMIYAH, NY BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 31/07/2022 00:59:14 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
3087 2022/07/30/000132 107520 YUNI NUR ISLAMIYAH, NY BPJS.K2T10 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 31/07/2022 00:59:14 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
3088 2022/07/30/000132 107520 YUNI NUR ISLAMIYAH, NY BPJS.K2T10 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 31/07/2022 00:59:14 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
3089 2022/07/30/000132 107520 YUNI NUR ISLAMIYAH, NY BPJS.K2T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10050002 dr. PANDE MADE 31/07/2022 01:00:03 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
3090 2022/07/30/000135 038668 HEIJI AL FARROBI P.P,AN UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 31/07/2022 00:10:51 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
3091 2022/07/31/000019 107522 ASHRAF ALFATIH PRINGGA UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 31/07/2022 00:41:53 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
PUTRA, AN 001 AMd.AK.
3092 2022/07/31/000024 054063 NI NYOMAN SUSANTI, NY KYN.RJ0000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:40:11 KARYAWAN Laboratorium 33,431 26,569 0 3,000 0 0 0 63,000
1 AMd.AK.
3093 2022/07/31/000024 054063 NI NYOMAN SUSANTI, NY KYN.RJ0000 Cholesterol 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:40:11 KARYAWAN Laboratorium 24,951 12,049 0 3,000 0 0 0 40,000
11 AMd.AK.
3094 2022/07/31/000024 054063 NI NYOMAN SUSANTI, NY KYN.RJ0000 HDL 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:40:11 KARYAWAN Laboratorium 28,951 22,049 0 3,000 0 0 0 54,000
12 AMd.AK.
8/1/22, 8:34 AM Page 103 of 107

3095 2022/07/31/000024 054063 NI NYOMAN SUSANTI, NY KYN.RJ0000 LDL 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:40:11 KARYAWAN Laboratorium 28,951 22,049 0 3,000 0 0 0 54,000
13 AMd.AK.
3096 2022/07/31/000024 054063 NI NYOMAN SUSANTI, NY KYN.RJ0000 Trigliserida 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:40:11 KARYAWAN Laboratorium 28,951 17,049 0 3,000 0 0 0 49,000
14 AMd.AK.
3097 2022/07/31/000024 054063 NI NYOMAN SUSANTI, NY KYN.RJ0000 Asam Urat 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:40:11 KARYAWAN Laboratorium 27,951 9,049 0 3,000 0 0 0 40,000
15 AMd.AK.
3098 2022/07/31/000024 054063 NI NYOMAN SUSANTI, NY KYN.RJ0000 SGOT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:40:11 KARYAWAN Laboratorium 29,451 12,549 0 3,000 0 0 0 45,000
16 AMd.AK.
3099 2022/07/31/000024 054063 NI NYOMAN SUSANTI, NY KYN.RJ0000 SGPT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:40:11 KARYAWAN Laboratorium 29,451 12,549 0 3,000 0 0 0 45,000
17 AMd.AK.
3100 2022/07/31/000024 054063 NI NYOMAN SUSANTI, NY KYN.RJ0000 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:40:11 KARYAWAN Laboratorium 26,451 10,549 0 3,000 0 0 0 40,000
18 AMd.AK.
3101 2022/07/31/000024 054063 NI NYOMAN SUSANTI, NY KYN.RJ0000 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:40:11 KARYAWAN Laboratorium 28,951 13,049 0 3,000 0 0 0 45,000
19 AMd.AK.
3102 2022/07/31/000024 054063 NI NYOMAN SUSANTI, NY KYN.RJ0000 Gula Darah Puasa 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:40:11 KARYAWAN Laboratorium 27,431 9,569 0 3,000 0 0 0 40,000
210 AMd.AK.
3103 2022/07/31/000025 107524 LUH PUTU WIDYASWARI KYN.RJ0000 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:43:22 KARYAWAN Laboratorium 33,431 26,569 0 3,000 0 0 0 63,000
PUTRI, NN 1 AMd.AK.
3104 2022/07/31/000025 107524 LUH PUTU WIDYASWARI KYN.RJ0000 Cholesterol 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:43:22 KARYAWAN Laboratorium 24,951 12,049 0 3,000 0 0 0 40,000
PUTRI, NN 11 AMd.AK.
3105 2022/07/31/000025 107524 LUH PUTU WIDYASWARI KYN.RJ0000 HDL 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:43:22 KARYAWAN Laboratorium 28,951 22,049 0 3,000 0 0 0 54,000
3106 2022/07/31/000025 107524 LUH PUTU WIDYASWARI KYN.RJ0000 LDL 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:43:22 KARYAWAN Laboratorium 28,951 22,049 0 3,000 0 0 0 54,000
3107 2022/07/31/000025 107524 LUH PUTU WIDYASWARI KYN.RJ0000 Trigliserida 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:43:22 KARYAWAN Laboratorium 28,951 17,049 0 3,000 0 0 0 49,000
3108 2022/07/31/000025 107524 LUH PUTU WIDYASWARI KYN.RJ0000 Asam Urat 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:43:22 KARYAWAN Laboratorium 27,951 9,049 0 3,000 0 0 0 40,000
3109 2022/07/31/000025 107524 LUH PUTU WIDYASWARI KYN.RJ0000 SGOT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:43:22 KARYAWAN Laboratorium 29,451 12,549 0 3,000 0 0 0 45,000
3110 2022/07/31/000025 107524 LUH PUTU WIDYASWARI KYN.RJ0000 SGPT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:43:22 KARYAWAN Laboratorium 29,451 12,549 0 3,000 0 0 0 45,000
3111 2022/07/31/000025 107524 LUH PUTU WIDYASWARI KYN.RJ0000 Ureum 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:43:22 KARYAWAN Laboratorium 26,451 10,549 0 3,000 0 0 0 40,000
3112 2022/07/31/000025 107524 LUH PUTU WIDYASWARI KYN.RJ0000 Creatinin 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:43:22 KARYAWAN Laboratorium 28,951 13,049 0 3,000 0 0 0 45,000
3113 2022/07/31/000025 107524 LUH PUTU WIDYASWARI KYN.RJ0000 Gula Darah Puasa 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 06:43:22 KARYAWAN Laboratorium 27,431 9,569 0 3,000 0 0 0 40,000
3114 2022/07/31/000029 088546 Anggi Hijri Aghistni, Ny. ASKES.RJ00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 31/07/2022 11:00:26 ASURANSI Poli Kandungan 40,431 26,569 0 3,000 0 0 0 70,000
3115 2022/07/31/000029 088546 Anggi Hijri Aghistni, Ny. ASKES.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 31/07/2022 11:00:26 ASURANSI Poli Kandungan 32,431 9,569 0 3,000 0 0 0 45,000
3116 2022/07/31/000029 088546 Anggi Hijri Aghistni, Ny. ASKES.RJ00 Urine Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 31/07/2022 11:01:30 ASURANSI Poli Kandungan 30,390 6,610 0 3,000 0 0 0 40,000
3117 2022/07/31/000029 088546 Anggi Hijri Aghistni, Ny. ASKES.RJ00 Anti HIV 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 31/07/2022 11:01:30 ASURANSI Poli Kandungan 38,951 34,049 0 2,000 0 0 0 75,000
3118 2022/07/31/000029 088546 Anggi Hijri Aghistni, Ny. ASKES.RJ00 HBsAg 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 31/07/2022 11:01:30 ASURANSI Poli Kandungan 38,951 34,049 0 2,000 0 0 0 75,000
3119 2022/07/31/000029 088546 Anggi Hijri Aghistni, Ny. ASKES.RJ00 TPHA/Sipilis 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 31/07/2022 11:01:30 ASURANSI Poli Kandungan 37,951 34,049 0 3,000 0 0 0 75,000
3120 2022/07/31/000029 088546 Anggi Hijri Aghistni, Ny. ASKES.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 31/07/2022 11:00:26 ASURANSI Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
3121 2022/07/31/000029 088546 Anggi Hijri Aghistni, Ny. ASKES.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 31/07/2022 11:00:26 ASURANSI Poli Kandungan 37,951 38,049 0 4,000 0 0 0 80,000
3122 2022/07/31/000029 088546 Anggi Hijri Aghistni, Ny. ASKES.RJ00 Gol Darah ABO 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 3150220 dr. IMELDA, Sp.OG. 31/07/2022 11:01:30 ASURANSI Poli Kandungan 31,936 6,064 0 2,000 0 0 0 40,000
3123 2022/07/31/000030 072621 SISCA APRILIA HANDAYANI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 31/07/2022 07:04:22 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
3124 2022/07/31/000030 072621 SISCA APRILIA HANDAYANI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 31/07/2022 16:29:14 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
3125 2022/07/31/000030 072621 SISCA APRILIA HANDAYANI, NY BPJS. Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 31/07/2022 07:04:22 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
8/1/22, 8:34 AM Page 104 of 107

3126 2022/07/31/000030 072621 SISCA APRILIA HANDAYANI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 31/07/2022 07:04:22 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
3127 2022/07/31/000030 072621 SISCA APRILIA HANDAYANI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 31/07/2022 07:04:22 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
3128 2022/07/31/000030 072621 SISCA APRILIA HANDAYANI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 31/07/2022 07:05:07 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
3129 2022/07/31/000031 064155 MEGA RUSDIANA PUTRI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 31/07/2022 08:15:33 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
3130 2022/07/31/000031 064155 MEGA RUSDIANA PUTRI, NY BPJS.K3B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 4160205 dr. WAHYUDI JOKO 31/07/2022 16:34:09 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
3131 2022/07/31/000031 064155 MEGA RUSDIANA PUTRI, NY BPJS.K3B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 31/07/2022 08:15:33 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
3132 2022/07/31/000031 064155 MEGA RUSDIANA PUTRI, NY BPJS.K3B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 31/07/2022 08:15:33 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
3133 2022/07/31/000031 064155 MEGA RUSDIANA PUTRI, NY BPJS.K3B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 4160205 dr. WAHYUDI JOKO 31/07/2022 08:15:33 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
3134 2022/07/31/000031 064155 MEGA RUSDIANA PUTRI, NY BPJS.K3B00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210380 dr. NIA SILFIAWATI 31/07/2022 08:15:45 BPJS KS IGD 1 37,400 47,600 0 5,000 5,000 0 0 95,000
0047 KESEHATAN
3135 2022/07/31/000037 071443 NOVI RESTIANI, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 31/07/2022 08:18:41 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
3136 2022/07/31/000037 071443 NOVI RESTIANI, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 31/07/2022 08:18:41 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
3137 2022/07/31/000037 071443 NOVI RESTIANI, NY UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 31/07/2022 08:18:41 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
3138 2022/07/31/000037 071443 NOVI RESTIANI, NY UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210381 dr. KIKI RIZKI RACHMAT 31/07/2022 08:18:41 BPJS IGD 32,436 564 0 2,000 0 0 0 35,000
3139 2022/07/31/000037 071443 NOVI RESTIANI, NY UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210380 dr. NIA SILFIAWATI 31/07/2022 08:17:57 BPJS IGD 47,300 35,200 0 7,500 5,000 0 0 95,000
3140 2022/07/31/000052 032213 NAFIS DATUL MUHOYIMAH,NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 17:20:58 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK.
3141 2022/07/31/000052 032213 NAFIS DATUL MUHOYIMAH,NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 17:20:58 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
00110 AMd.AK.
3142 2022/07/31/000052 032213 NAFIS DATUL MUHOYIMAH,NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 17:21:51 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
0047 AMd.AK.
3143 2022/07/31/000052 032213 NAFIS DATUL MUHOYIMAH,NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 17:20:58 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
005 AMd.AK.
3144 2022/07/31/000052 032213 NAFIS DATUL MUHOYIMAH,NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 17:20:58 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
006 AMd.AK.
3145 2022/07/31/000054 107533 FILAFTUL MULIA SARI, NY UMUM.K3B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 31/07/2022 12:15:17 UMUM Amarta 5D 40,431 26,569 0 3,000 0 0 0 70,000
3146 2022/07/31/000054 107533 FILAFTUL MULIA SARI, NY UMUM.K3B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 31/07/2022 12:15:17 UMUM Amarta 5D 32,431 9,569 0 3,000 0 0 0 45,000
3147 2022/07/31/000054 107533 FILAFTUL MULIA SARI, NY UMUM.K3B0 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 31/07/2022 12:15:17 UMUM Amarta 5D 32,436 564 0 2,000 0 0 0 35,000
3148 2022/07/31/000054 107533 FILAFTUL MULIA SARI, NY UMUM.K3B0 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 10050002 dr. PANDE MADE 31/07/2022 12:15:17 UMUM Amarta 5D 32,436 564 0 2,000 0 0 0 35,000
3149 2022/07/31/000054 107533 FILAFTUL MULIA SARI, NY UMUM.K3B0 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 09210380 dr. NIA SILFIAWATI 31/07/2022 12:15:38 UMUM Amarta 5D 47,300 35,200 0 7,500 5,000 0 0 95,000
00050 AMd.AK.
3150 2022/07/31/000059 040922 INTAN MAHARANI HOESNY, NY BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 31/07/2022 12:19:43 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
3151 2022/07/31/000059 040922 INTAN MAHARANI HOESNY, NY BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 31/07/2022 12:19:43 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
3152 2022/07/31/000059 040922 INTAN MAHARANI HOESNY, NY BPJS.K2B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 31/07/2022 12:19:43 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
3153 2022/07/31/000059 040922 INTAN MAHARANI HOESNY, NY BPJS.K2B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 1150219 dr. FATMASARI PERDANA 31/07/2022 12:19:43 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
3154 2022/07/31/000059 040922 INTAN MAHARANI HOESNY, NY BPJS.K2B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 01220384 dr. PRAHITA ATYAN 31/07/2022 12:19:57 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
0050 AMd.AK. HAPSARI KESEHATAN
3155 2022/07/31/000061 065414 Hanny Ashar Agusta, Tn. UMUM.RJ00 Rapid Antigen SD Biosensor 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 12:20:38 UMUM Laboratorium 38,380 89,120 0 7,500 5,000 0 0 140,000
0048
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3156 2022/07/31/000063 071385 LIZA PUTRI DJOHAN, NY BPJS.K3T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 31/07/2022 13:25:40 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
3157 2022/07/31/000063 071385 LIZA PUTRI DJOHAN, NY BPJS.K3T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 8140114 Dr.dr. I WAYAN AGUNG 31/07/2022 22:52:10 BPJS KS IGD 1 40,431 26,569 0 3,000 0 0 0 70,000
3158 2022/07/31/000063 071385 LIZA PUTRI DJOHAN, NY BPJS.K3T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 31/07/2022 13:25:40 BPJS KS IGD 1 32,431 9,569 0 3,000 0 0 0 45,000
3159 2022/07/31/000063 071385 LIZA PUTRI DJOHAN, NY BPJS.K3T10 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 31/07/2022 13:25:40 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
3160 2022/07/31/000063 071385 LIZA PUTRI DJOHAN, NY BPJS.K3T10 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 31/07/2022 13:25:40 BPJS KS IGD 1 32,436 564 0 2,000 0 0 0 35,000
3161 2022/07/31/000063 071385 LIZA PUTRI DJOHAN, NY BPJS.K3T10 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1120056 HANNY ASHAR AGUSTA, 8140114 Dr.dr. I WAYAN AGUNG 31/07/2022 13:24:21 BPJS KS IGD 1 44,800 35,200 0 5,000 5,000 0 0 90,000
3162 2022/07/31/000075 107539 ANDI ASTUTI, NY UMUM.RJ00 Plano Test 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 31/07/2022 15:31:42 UMUM IGD 33,140 4,860 0 2,000 0 0 0 40,000
0022 AMd.AK.
3163 2022/07/31/000078 062817 AISYAH KHAIRA LUBNA, AN BPJS.K2T10 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 31/07/2022 17:37:34 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
3164 2022/07/31/000078 062817 AISYAH KHAIRA LUBNA, AN BPJS.K2T10 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 31/07/2022 17:37:34 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
3165 2022/07/31/000111 011464 Muhammad Ilham Alfarizqi, An UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 31/07/2022 20:15:26 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK. Sp.A.
3166 2022/07/31/000111 011464 Muhammad Ilham Alfarizqi, An UMUM.RJ00 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 31/07/2022 20:15:26 UMUM Poli Anak 31,931 10,069 0 3,000 0 0 0 45,000
009 AMd.AK. Sp.A.
3167 2022/07/31/000117 073760 AQILA QISYA ISNAINI,AN BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 31/07/2022 19:37:23 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
3168 2022/07/31/000117 073760 AQILA QISYA ISNAINI,AN BPJS.K2UP1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 31/07/2022 19:37:23 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
3169 2022/07/31/000117 073760 AQILA QISYA ISNAINI,AN BPJS.K2UP1 Widal 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 31/07/2022 19:37:23 BPJS KS IGD 2 31,931 10,069 0 3,000 0 0 0 45,000
3170 2022/07/31/000122 024048 DIA HERAYU, NY BPJS.K1B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 31/07/2022 18:53:04 BPJS KS IGD 2 40,431 26,569 0 3,000 0 0 0 70,000
3171 2022/07/31/000122 024048 DIA HERAYU, NY BPJS.K1B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 31/07/2022 18:53:04 BPJS KS IGD 2 32,431 9,569 0 3,000 0 0 0 45,000
3172 2022/07/31/000122 024048 DIA HERAYU, NY BPJS.K1B00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 31/07/2022 18:53:04 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
3173 2022/07/31/000122 024048 DIA HERAYU, NY BPJS.K1B00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 31/07/2022 18:53:04 BPJS KS IGD 2 32,436 564 0 2,000 0 0 0 35,000
3174 2022/07/31/000122 024048 DIA HERAYU, NY BPJS.K1B00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 1110218 dr. NOVINA PURWITA 31/07/2022 18:56:36 BPJS KS IGD 2 44,800 35,200 0 5,000 5,000 0 0 90,000
3175 2022/07/31/000123 107543 SALSABILA AISYAH ABDILLAH, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 31/07/2022 18:58:52 UMUM Poli Anak 40,431 26,569 0 3,000 0 0 0 70,000
3176 2022/07/31/000123 107543 SALSABILA AISYAH ABDILLAH, UMUM.RJ00 Bilirubin (Total, Direct, Indirect) 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 31/07/2022 18:58:52 UMUM Poli Anak 33,931 13,069 0 3,000 0 0 0 50,000
3177 2022/07/31/000124 020304 ADREENA NASHA SHAQEENA, BPJS.K2B00 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 31/07/2022 19:34:37 BPJS KS IGD 5 40,431 26,569 0 3,000 0 0 0 70,000
3178 2022/07/31/000124 020304 ADREENA NASHA SHAQEENA, BPJS.K2B00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 3150145 dr. ZAINUDDIN HAMIDI, 31/07/2022 19:34:37 BPJS KS IGD 5 32,431 9,569 0 3,000 0 0 0 45,000
3179 2022/07/31/000129 052015 ADIN NOVITASARI, NY BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 31/07/2022 20:17:41 BPJS Pandawa 5 40,431 26,569 0 3,000 0 0 0 70,000
3180 2022/07/31/000129 052015 ADIN NOVITASARI, NY BPJS.K2UP1 Gula Darah 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 31/07/2022 20:17:41 BPJS Pandawa 5 32,431 9,569 0 3,000 0 0 0 45,000
3181 2022/07/31/000129 052015 ADIN NOVITASARI, NY BPJS.K2UP1 BT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 31/07/2022 20:17:41 BPJS Pandawa 5 32,436 564 0 2,000 0 0 0 35,000
3182 2022/07/31/000129 052015 ADIN NOVITASARI, NY BPJS.K2UP1 CT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 8140114 Dr.dr. I WAYAN AGUNG 31/07/2022 20:17:41 BPJS Pandawa 5 32,436 564 0 2,000 0 0 0 35,000
3183 2022/07/31/000129 052015 ADIN NOVITASARI, NY BPJS.K2UP1 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 31/07/2022 20:18:46 BPJS Pandawa 5 44,800 35,200 0 5,000 5,000 0 0 90,000
3184 2022/07/31/000133 066749 IRSYAD RAHMAT WIDIYONO, UMUM. Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, AMd. 09210381 dr. KIKI RIZKI RACHMAT 31/07/2022 20:41:00 BPJS IGD 40,431 26,569 0 3,000 0 0 0 70,000
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RJ00001 AK.
3185 2022/07/31/000133 066749 IRSYAD RAHMAT WIDIYONO, UMUM.RJ00 Gula Darah 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 31/07/2022 20:56:54 BPJS IGD 32,431 9,569 0 3,000 0 0 0 45,000
3186 2022/07/31/000133 066749 IRSYAD RAHMAT WIDIYONO, UMUM.RJ00 SARS COV-2 Rapid Antigen ** 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 09210381 dr. KIKI RIZKI RACHMAT 31/07/2022 20:41:30 BPJS IGD 47,300 35,200 0 7,500 5,000 0 0 95,000
3187 2022/07/31/000134 107544 SITI KHOTIJAH, NY UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 20:49:59 UMUM Laboratorium 40,431 26,569 0 3,000 0 0 0 70,000
001 AMd.AK.
3188 2022/07/31/000134 107544 SITI KHOTIJAH, NY UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 20:49:59 UMUM Laboratorium 32,431 9,569 0 3,000 0 0 0 45,000
00110 AMd.AK.
3189 2022/07/31/000134 107544 SITI KHOTIJAH, NY UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 20:47:12 UMUM Laboratorium 37,900 47,600 0 7,500 5,000 0 0 98,000
0047 AMd.AK.
3190 2022/07/31/000134 107544 SITI KHOTIJAH, NY UMUM.RJ00 PPT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 20:49:59 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
005 AMd.AK.
3191 2022/07/31/000134 107544 SITI KHOTIJAH, NY UMUM.RJ00 APTT 10210382 dr. RIMA AURELIA, Sp.PK. 1190353 ENDANG SUDARTIK, 10210382 dr. RIMA AURELIA, Sp.PK. 31/07/2022 20:49:59 UMUM Laboratorium 37,951 38,049 0 4,000 0 0 0 80,000
006 AMd.AK.
3192 2022/07/31/000137 014644 GYANDRA ISYWARA BPJS.K2UP1 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 31/07/2022 23:46:57 BPJS Pandawa 3 40,431 26,569 0 3,000 0 0 0 70,000
ARKADEWI,AN 00001 Sp.A. KESEHATAN
3193 2022/07/31/000137 014644 GYANDRA ISYWARA BPJS.K2UP1 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 31/07/2022 23:46:57 BPJS Pandawa 3 32,431 9,569 0 3,000 0 0 0 45,000
ARKADEWI,AN 0000110 Sp.A. KESEHATAN
3194 2022/07/31/000140 001872 ISWARA KANAKA AKSAMALA, UMUM.K2B0 Darah Lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 31/07/2022 23:44:53 UMUM Dwarawati 50,431 26,569 0 3,000 0 0 0 75,000
AN 0001 Sp.A. 10/Ayodya 5
3195 2022/07/31/000140 001872 ISWARA KANAKA AKSAMALA, UMUM.K2B0 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 3150145 dr. ZAINUDDIN HAMIDI, 31/07/2022 23:44:53 UMUM Dwarawati 37,431 9,569 0 3,000 0 0 0 50,000
AN 000110 Sp.A. 10/Ayodya 5
3196 2022/07/31/000144 107546 DENOK WAHYUNI ANDAYANTI, UMUM.RJ00 Darah lengkap 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 31/07/2022 23:50:56 UMUM IGD 40,431 26,569 0 3,000 0 0 0 70,000
NY 001
3197 2022/07/31/000144 107546 DENOK WAHYUNI ANDAYANTI, UMUM.RJ00 Gula Darah Sewaktu 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 31/07/2022 23:50:56 UMUM IGD 32,431 9,569 0 3,000 0 0 0 45,000
NY 00110
3198 2022/07/31/000144 107546 DENOK WAHYUNI ANDAYANTI, UMUM.RJ00 BT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 31/07/2022 23:50:56 UMUM IGD 32,436 564 0 2,000 0 0 0 35,000
NY 003
3199 2022/07/31/000144 107546 DENOK WAHYUNI ANDAYANTI, UMUM.RJ00 CT 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 31/07/2022 23:50:56 UMUM IGD 32,436 564 0 2,000 0 0 0 35,000
NY 004
3200 2022/07/31/000144 107546 DENOK WAHYUNI ANDAYANTI, UMUM.RJ00 SARS COV-2 Rapid Antigen * 10210382 dr. RIMA AURELIA, Sp.PK. 5100049 NUR JANNAH, AMd.An.Kes. 09210381 dr. KIKI RIZKI RACHMAT 31/07/2022 23:47:30 UMUM IGD 37,900 47,600 0 7,500 5,000 0 0 98,000
NY 0047
Jumlah Total : 120,765,865 68,118,635 5,750,000 10,277,500 1,845,000 250,000 0 206,837,000
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Jl. Simpang Sulfat Utara No. 60 A, Malang, Jawa Timur

Detail Pemeriksaan Laborat

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8/1/22, 8:34 AM Page 68 of 107

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