You are on page 1of 4

REKAP BULAN SEPTERMBER 2016

Norm Klsrawat TariffRS Tglmsk Tglklr UmurThn Deskripsi TotalTarif NamaPasien DPJP
2016090290 1 2,307,500 9/19/2016 9/21/2016 25 GANGGUAN ANTEPARTUM RINGAN 2,654,100 ULFATUN HASANAH PURNAMASARI DR. ZAKKY SUKMAJAYA,SPOG
2016080381 1 6,891,000 9/3/2016 9/4/2016 17 PROSEDUR PADA KULIT, JARINGAN BAWAH KULIT DAN PAYUDARA RINGAN 3,863,500 INDAH OKTAVIANI ISKANDAR Dr. Muhammad Angga NM, SpB
2016090030 1 3,236,000 9/2/2016 9/3/2016 34 PERSALINAN VAGINAL RINGAN 2,562,800 WINARNI DR. ZAKKY SUKMAJAYA,SPOG

Norm Klsrawat TariffRS Tglmsk Tglklr UmurThn Deskripsi TotalTarif NamaPasien DPJP
2016090166 2 750,000 9/11/2016 9/11/2016 32 PERSALINAN FALSE LABOR RINGAN 1,106,900 sri wahyuni DR. ZAKKY SUKMAJAYA,SPOG
2016060044 2 2,786,000 9/9/2016 9/10/2016 29 PERSALINAN VAGINAL RINGAN 2,196,700 siti musriyati DR. ZAKKY SUKMAJAYA,SPOG
2016090040 2 1,917,500 9/5/2016 9/7/2016 30 GANGGUAN ANTEPARTUM RINGAN 2,274,900 SULAIHA DR. ZAKKY SUKMAJAYA,SPOG

Norm Klsrawat TariffRS Tglmsk Tglklr UmurThn Deskripsi TotalTarif NamaPasien DPJP
2016090401 3 160,800 9/30/2016 9/30/2016 39 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 LATIFAH DR. ZAKKY SUKMAJAYA,SPOG
2016090358 3 117,500 9/30/2016 9/30/2016 18 PERAWATAN LUKA 176,800 MAISAROH Dr. Muhammad Angga NM, SpB
2016060232 3 168,000 9/30/2016 9/30/2016 47 PENYAKIT KRONIS KECIL LAIN-LAIN 155,400 shofiyah DR. ZAKKY SUKMAJAYA,SPOG
2016090021 3 171,600 9/30/2016 9/30/2016 23 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 SUMARNI DR. ZAKKY SUKMAJAYA,SPOG
2016090225 3 1,226,500 9/28/2016 9/29/2016 30 GANGGUAN ANTEPARTUM RINGAN 1,895,800 HASANAH DR. ZAKKY SUKMAJAYA,SPOG
2016090116 3 130,500 9/29/2016 9/29/2016 24 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 NURUL KHOLIFAH DR. ZAKKY SUKMAJAYA,SPOG
2016090366 3 3,007,000 9/28/2016 9/29/2016 18 PERSALINAN VAGINAL SEDANG 2,166,600 SINIATI DR. ZAKKY SUKMAJAYA,SPOG
2016090373 3 173,500 9/28/2016 9/28/2016 52 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 NURUL HURRIYAH DR. ZAKKY SUKMAJAYA,SPOG
2016090358 3 123,500 9/27/2016 9/27/2016 18 PROSEDUR KECIL PADA NODUL LIMPA DAN TYMUS 224,500 MAISAROH Dr. Muhammad Angga NM, SpB
2016090306 3 118,500 9/27/2016 9/27/2016 25 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 SITI ROHMAH DR. ZAKKY SUKMAJAYA,SPOG
2016090362 3 141,500 9/27/2016 9/27/2016 38 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 NUR AINI DR. ZAKKY SUKMAJAYA,SPOG
2016080080 3 125,000 9/26/2016 9/26/2016 29 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 HANANAH DR. ZAKKY SUKMAJAYA,SPOG
2016090322 3 138,000 9/22/2016 9/22/2016 41 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 Hj. Fauzah DR. ZAKKY SUKMAJAYA,SPOG
2016090306 3 2,371,500 9/21/2016 9/21/2016 25 PROSEDUR DILATASI, KURET, INTRAUTERIN & SERVIK RINGAN 2,484,200 SITI ROHMAH DR. ZAKKY SUKMAJAYA,SPOG
2016090313 3 130,000 9/21/2016 9/21/2016 25 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 NOER MISTIAN HARDIANSYAH DR. ZAKKY SUKMAJAYA,SPOG
2016090301 3 149,000 9/20/2016 9/20/2016 54 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 siti hairani DR. ZAKKY SUKMAJAYA,SPOG
2016090286 3 135,000 9/19/2016 9/19/2016 31 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 musrifah DR. ZAKKY SUKMAJAYA,SPOG
2016090119 3 165,000 9/19/2016 9/19/2016 27 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 afina shifriyah DR. ZAKKY SUKMAJAYA,SPOG
2016090234 3 1,482,500 9/15/2016 9/17/2016 21 GANGGUAN ANTEPARTUM RINGAN 1,895,800 musdalifah DR. ZAKKY SUKMAJAYA,SPOG
2016090116 3 115,000 9/15/2016 9/15/2016 24 0 281,500 NURUL KHOLIFAH DR. ZAKKY SUKMAJAYA,SPOG
2016090160 3 121,500 9/15/2016 9/15/2016 51 PERAWATAN LUKA 176,800 kaprawi Dr. Muhammad Angga NM, SpB
2016070424 3 7,136,000 9/14/2016 9/15/2016 29 PROSEDUR DILATASI, KURET, INTRAUTERIN & SERVIK RINGAN 2,484,200 EVITA DIAH CANDRAWATI DR. ZAKKY SUKMAJAYA,SPOG
2016090172 3 2,371,000 9/13/2016 9/14/2016 23 PROSEDUR DILATASI, KURET, INTRAUTERIN & SERVIK RINGAN 2,484,200 ITA UZZAKAH DR. ZAKKY SUKMAJAYA,SPOG
2016080367 3 71,800 9/10/2016 9/10/2016 33 PENYAKIT KRONIS KECIL LAIN-LAIN 155,400 HINDUN SUHARTINI DR. ZAKKY SUKMAJAYA,SPOG
2016090160 3 5,681,000 9/9/2016 9/10/2016 51 PROSEDUR HERNIA INGUINAL DAN FEMORAL RINGAN 3,008,900 kaprawi Dr. Muhammad Angga NM, SpB
2016090116 3 169,000 9/8/2016 9/8/2016 23 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 NURUL KHOLIFAH DR. ZAKKY SUKMAJAYA,SPOG
2016090122 3 3,080,500 9/8/2016 9/8/2016 26 PERSALINAN VAGINAL RINGAN 1,830,600 mariyatul kiptiyah DR. ZAKKY SUKMAJAYA,SPOG
2016070290 3 175,000 9/8/2016 9/8/2016 30 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 NURUL HASANAH DR. ZAKKY SUKMAJAYA,SPOG
2016090132 3 125,000 9/8/2016 9/8/2016 23 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 NOVIATUS SALAMAH DR. ZAKKY SUKMAJAYA,SPOG
2016080223 3 2,574,500 9/7/2016 9/8/2016 32 PROSEDUR DILATASI, KURET, INTRAUTERIN & SERVIK RINGAN 2,484,200 farida DR. ZAKKY SUKMAJAYA,SPOG
2016080381 3 131,000 9/6/2016 9/6/2016 17 PERAWATAN LUKA 176,800 INDAH OKTAVIANI ISKANDAR Dr. Muhammad Angga NM, SpB
2016090024 3 136,000 9/5/2016 9/5/2016 33 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 MURNIA NINGSIH DR. ZAKKY SUKMAJAYA,SPOG
2016090060 3 1,900,000 9/4/2016 9/5/2016 25 GANGGUAN ANTEPARTUM RINGAN 1,895,800 MASLAHAH DR. ZAKKY SUKMAJAYA,SPOG
2016080367 3 2,900,000 9/2/2016 9/3/2016 33 GANGGUAN ANTEPARTUM SEDANG 2,535,200 HINDUN SUHARTINI DR. ZAKKY SUKMAJAYA,SPOG
2016080377 3 6,824,500 9/1/2016 9/2/2016 31 PROSEDUR AMPUTASI RINGAN 5,366,600 MOH IBROHIM Dr. Muhammad Angga NM, SpB

Total 61,634,700 51,042,200


Selisih 10,592,500
BULAN OKTOBER
Norm Klsrawat TariffRS Tglmsk Tglklr UmurThn Deskripsi TotalTarif NamaPasien DPJP
2016070361 1 2,647,000 10/20/2016 10/21/2016 35 PROSEDUR DILATASI, KURET, INTRAUTERIN & SERVIK RINGAN 3,477,800 st fatimatuz zuhroh DR. ZAKKY SUKMAJAYA,SPOG
2016090361 1 2,624,500 10/18/2016 10/19/2016 39 PROSEDUR DILATASI, KURET, INTRAUTERIN & SERVIK RINGAN 3,477,800 syamsiyati, SE DR. ZAKKY SUKMAJAYA,SPOG
2016090290 1 2,970,500 10/16/2016 10/19/2016 25 GANGGUAN ANTEPARTUM RINGAN 2,654,100 ULFATUN HASANAH PURNAMASARI DR. ZAKKY SUKMAJAYA,SPOG
2016080026 1 1,060,000 10/10/2016 10/11/2016 29 GANGGUAN ANTEPARTUM RINGAN 2,654,100 dwi citra resminingtyas febriani s DR. ZAKKY SUKMAJAYA,SPOG
2016090021 1 3,043,500 10/1/2016 10/2/2016 23 PERSALINAN VAGINAL RINGAN 2,562,800 SUMARNI DR. ZAKKY SUKMAJAYA,SPOG

Norm Klsrawat TariffRS Tglmsk Tglklr UmurThn Deskripsi TotalTarif NamaPasien DPJP
2016070663 2 2,991,500 10/14/2016 10/15/2016 24 PERSALINAN VAGINAL RINGAN 2,196,700 nur arifah DR. ZAKKY SUKMAJAYA,SPOG

Norm Klsrawat TariffRS Tglmsk Tglklr UmurThn Deskripsi TotalTarif NamaPasien DPJP
2016100264 3 3,098,000 10/22/2016 10/23/2016 30 PERSALINAN VAGINAL RINGAN 1,830,600 MUTMAINNAH DR. ZAKKY SUKMAJAYA,SPOG
2016100229 3 2,170,000 10/20/2016 10/22/2016 20 GASTRITIS & ULKUS PEPTIKUM RINGAN 1,299,900 NADHIYA ULFAH dr. M. Hidayatur Rohman, Sp. PD
2016100258 3 131,000 10/22/2016 10/22/2016 34 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 musyarrofah DR. ZAKKY SUKMAJAYA,SPOG
2016100227 3 2,596,000 10/20/2016 10/21/2016 42 PROSEDUR DILATASI, KURET, INTRAUTERIN & SERVIK RINGAN 2,484,200 ANIF DR. ZAKKY SUKMAJAYA,SPOG
2016060114 3 166,000 10/21/2016 10/21/2016 42 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 SITI FATIMATUZ ZAHRO DR. ZAKKY SUKMAJAYA,SPOG
2016060225 3 111,000 10/20/2016 10/20/2016 31 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 ratriageng ida DR. ZAKKY SUKMAJAYA,SPOG
2016100166 3 4,983,500 10/16/2016 10/19/2016 41 PERADANGAN DAN INFEKSI PERNAFASAN RINGAN 3,791,600 JATIM dr. Siti Juhairiyah Sp. P
2016100013 3 2,658,500 10/18/2016 10/19/2016 29 PROSEDUR DILATASI, KURET, INTRAUTERIN & SERVIK RINGAN 2,484,200 YAYU HARDIYARA DR. ZAKKY SUKMAJAYA,SPOG
2016100197 3 134,000 10/18/2016 10/18/2016 30 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 ST HUMAIROH DR. ZAKKY SUKMAJAYA,SPOG
2016100204 3 131,000 10/18/2016 10/18/2016 37 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 ismuliyati DR. ZAKKY SUKMAJAYA,SPOG
2016100200 3 100,000 10/18/2016 10/18/2016 31 PENYAKIT AKUT KECIL LAIN-LAIN 132,700 SEPTIANA DWI DAYANI Dr. Muhammad Angga NM, SpB
2016100183 3 180,000 10/17/2016 10/17/2016 38 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 SUNARTI DR. ZAKKY SUKMAJAYA,SPOG
2016100181 3 125,000 10/17/2016 10/17/2016 28 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 JUNAIDAH DR. ZAKKY SUKMAJAYA,SPOG
2016090322 3 121,000 10/17/2016 10/17/2016 41 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 Hj. Fauzah DR. ZAKKY SUKMAJAYA,SPOG
2016100191 3 131,000 10/17/2016 10/17/2016 16 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 SUMARNI DR. ZAKKY SUKMAJAYA,SPOG
2016100182 3 180,000 10/17/2016 10/17/2016 19 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 SITI WESILAH DR. ZAKKY SUKMAJAYA,SPOG
2016100118 3 3,593,500 10/11/2016 10/14/2016 66 GANGGUAN HATI SELAIN TUMOR, SIROSIS ATAU HEPATITIS ALKOHOLI 1,944,000 nirah dr. M. Hidayatur Rohman, Sp. PD
2016100102 3 3,519,200 10/10/2016 10/14/2016 66 KEGAGALAN JANTUNG RINGAN 2,385,600 hesim dr. M. Hidayatur Rohman, Sp. PD
2016100140 3 136,000 10/13/2016 10/13/2016 29 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 ZAINAB DR. ZAKKY SUKMAJAYA,SPOG
2016090358 3 90,000 10/13/2016 10/13/2016 18 PERAWATAN LUKA 176,800 MAISAROH Dr. Muhammad Angga NM, SpB
2016060114 3 166,000 10/13/2016 10/13/2016 42 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 SITI FATIMATUZ ZAHRO DR. ZAKKY SUKMAJAYA,SPOG
2016100044 3 126,000 10/12/2016 10/12/2016 21 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 JANNATUN DR. ZAKKY SUKMAJAYA,SPOG
2016070301 3 159,000 10/11/2016 10/11/2016 24 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 RINI FATMAWATI DR. ZAKKY SUKMAJAYA,SPOG
2016100122 3 129,000 10/11/2016 10/11/2016 30 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 NOR LAILA DR. ZAKKY SUKMAJAYA,SPOG
2016090220 3 119,000 10/10/2016 10/10/2016 24 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 NURLIYEH DR. ZAKKY SUKMAJAYA,SPOG
2016100097 3 2,671,500 10/8/2016 10/9/2016 38 PROSEDUR DILATASI, KURET, INTRAUTERIN & SERVIK RINGAN 2,484,200 SURYATI DR. ZAKKY SUKMAJAYA,SPOG
2016100059 3 2,754,500 10/5/2016 10/8/2016 53 GANGUAN PEMBULUH DARAH PERIFER LAIN-LAIN (RINGAN) 2,601,700 UMMAH dr. M. Hidayatur Rohman, Sp. PD
2016100060 3 3,112,000 10/5/2016 10/8/2016 40 PERADANGAN DAN INFEKSI PERNAFASAN RINGAN 3,791,600 sawati dr. Siti Juhairiyah Sp. P
2016090344 3 115,000 10/6/2016 10/6/2016 31 PROSEDUR ULTRASOUND LAIN-LAIN 345,800 EMI MARTI SURYANTI DR. ZAKKY SUKMAJAYA,SPOG
2016080381 3 110,000 10/6/2016 10/6/2016 18 PERAWATAN LUKA 176,800 INDAH OKTAVIANI ISKANDAR Dr. Muhammad Angga NM, SpB
2016100069 3 100,000 10/6/2016 10/6/2016 73 PENYAKIT KRONIS KECIL LAIN-LAIN 155,400 MOH BARDI Dr. Muhammad Angga NM, SpB
2016100045 3 175,000 10/5/2016 10/5/2016 25 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 HAMAMAH DR. ZAKKY SUKMAJAYA,SPOG
2016100044 3 177,800 10/5/2016 10/5/2016 21 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 JANNATUN DR. ZAKKY SUKMAJAYA,SPOG
2016100012 3 6,875,000 10/4/2016 10/5/2016 58 PROSEDUR PADA DARAH DAN ORGAN PEMBENTUK DARAH LAIN-LAIN 2,979,800 ZHEHRUN Dr. Muhammad Angga NM, SpB
2016100023 3 2,539,600 10/3/2016 10/5/2016 56 PERADANGAN DAN INFEKSI PERNAFASAN RINGAN 3,791,600 amir santoso dr. Siti Juhairiyah Sp. P
2016090358 3 140,000 10/4/2016 10/4/2016 18 PERAWATAN LUKA 176,800 MAISAROH Dr. Muhammad Angga NM, SpB
2016090220 3 2,807,500 10/3/2016 10/4/2016 24 PROSEDUR DILATASI, KURET, INTRAUTERIN & SERVIK RINGAN 2,484,200 NURLIYEH DR. ZAKKY SUKMAJAYA,SPOG
2016090176 3 119,000 10/1/2016 10/1/2016 31 PROSEDUR ULTRASOUND GINEKOLOGIK 281,500 SIVIANITA APRIANY DR. ZAKKY SUKMAJAYA,SPOG
2016090387 3 1,724,500 9/29/2016 10/1/2016 61 GANGGUAN SEL DARAH MERAH SELAIN KRISIS ANEMIA SEL SICKLE B 1,300,500 asmudah dr. M. Hidayatur Rohman, Sp. PD
Total 63,812,100 59,189,800
Selisih 4,622,300