Pending SEP Tanggal Pulang LOS Verifikasi Claim Asuransi CLAIM INACBG

Asuransi ( FPK BPJS ) ( FINAL CODING )

False 0125R0190719V000692 7/3/2019 7/5/2019 3 False 0 4569400
False 0125R0190719V003699 7/23/2019 7/25/2019 3 False 0 4569400
False 0125R0190719V004693 7/29/2019 7/31/2019 3 False 0 3807800
False 0125R0190719V001801 7/11/2019 7/13/2019 3 False 0 3807800
False 0125R0190619V003908 6/30/2019 7/2/2019 3 False 0 3807800
False 0125R0190619V003894 6/30/2019 7/2/2019 3 False 0 3807800
False 0125R0190719V003494 7/22/2019 7/24/2019 3 False 0 4569400
False 0125R0190719V003695 7/23/2019 7/25/2019 3 False 0 3807800
False 0125R0190719V001232 7/8/2019 7/10/2019 3 False 0 3807800
False 0125R0190719V003886 7/24/2019 7/26/2019 3 False 0 4569400
False 0125R0190619V003895 6/30/2019 7/2/2019 3 False 0 3807800
False 0125R0190719V001399 7/9/2019 7/12/2019 4 False 0 3807800
False 0125R0190719V001400 7/9/2019 7/11/2019 3 False 0 3807800
False 0125R0190719V001370 7/9/2019 7/12/2019 4 False 0 6098800
False 0125R0190719V003671 7/23/2019 7/29/2019 7 False 0 6434000
False 0125R0190619V003189 6/25/2019 7/6/2019 12 False 0 6434000
False 0125R0190619V003167 6/25/2019 7/3/2019 9 False 0 9007600
False 0125R0190719V000708 7/4/2019 7/7/2019 4 False 0 3378700
False 0125R0190719V003640 7/23/2019 7/24/2019 2 False 0 9494000
False 0125R0190719V003203 7/21/2019 7/23/2019 3 False 0 4569400
False 0125R0190719V003198 7/21/2019 7/23/2019 3 False 0 5370600
False 0125R0190719V000581 7/3/2019 7/8/2019 6 False 0 4793500
False 0125R0190719V002918 7/18/2019 7/19/2019 2 False 0 19210900
False 0125R0190719V001600 7/10/2019 7/11/2019 2 False 0 19210900
False 0125R0190719V000579 7/3/2019 7/8/2019 6 False 0 6098800
False 0125R0190719V003215 7/21/2019 7/25/2019 5 False 0 4977200
False 0125R0190719V002507 7/16/2019 7/18/2019 3 False 0 3807800
False INPUT MANUAL 7/8/2019 7/10/2019 3 False 0 0
False 0125R0190719V003206 7/21/2019 7/23/2019 3 False 0 3807800
False 0125R0190719V004381 7/28/2019 7/30/2019 3 False 0 3807800
False 0125R0190719V001231 7/8/2019 7/10/2019 3 False 0 3807800
False 0125R0190719V002712 7/17/2019 7/19/2019 3 False 0 3807800
False 0125R0190719V003686 7/23/2019 7/25/2019 3 False 0 4569400
False 0125R0190719V001607 7/10/2019 7/12/2019 3 False 0 3807800
False 0125R0190719V004114 7/25/2019 7/27/2019 3 False 0 3807800
False 0125R0190719V000710 7/4/2019 7/6/2019 3 False 0 3807800
False 0125R0190719V001406 7/9/2019 7/11/2019 3 False 0 3807800
False 0125R0190719V001804 7/11/2019 7/13/2019 3 False 0 4569400
False 0125R0190719V002929 7/18/2019 7/20/2019 3 False 0 3807800
False 0125R0190719V001800 7/11/2019 7/13/2019 3 False 0 3807800
False 0125R0190719V003485 7/22/2019 7/24/2019 3 False 0 3807800
False 0125R0190719V004380 7/28/2019 7/30/2019 3 False 0 3807800
False 0125R0190719V003201 7/21/2019 7/23/2019 3 False 0 5331000
False 0125R0190719V001394 7/8/2019 7/10/2019 3 False 0 3807800
False 0125R0190719V001602 7/10/2019 7/12/2019 3 False 0 3807800
False 0125R0190719V002333 7/15/2019 7/17/2019 3 False 0 3807800
False 0125R0190719V002335 7/15/2019 7/17/2019 3 False 0 3807800
False 0125R0190719V003202 7/21/2019 7/23/2019 3 False 0 3807800
False 0125R0190719V003487 7/22/2019 7/24/2019 3 False 0 3807800
False 0125R0190719V004681 7/29/2019 7/31/2019 3 False 0 3807800
False 0125R0190719V000709 7/4/2019 7/6/2019 3 False 0 3807800
False 0125R0190719V001239 7/8/2019 7/10/2019 3 False 0 3807800
False 0125R0190719V003873 7/24/2019 7/26/2019 3 False 0 3807800
False 0125R0190719V004379 7/28/2019 7/30/2019 3 False 0 3807800
False 0125R0190719V001407 7/9/2019 7/11/2019 3 False 0 3807800
False 0125R0190719V000565 7/3/2019 7/5/2019 3 False 0 3807800
False 0125R0190719V003872 7/24/2019 7/26/2019 3 False 0 3807800
0 274906600
 Reg Tagihan RM Pasien Diagnosa Description
161251 5039600 62811 SUHAEMI BT SAWAR #BENIGN NEOPLASM OF
164359 4290800.03 63541 WARGIYANTO BIN BREAST
#BENIGN NEOPLASM,
165670 4518800.03 28902 SUDIRMAN
ANISA BT RADIYAH CONNECTIVE AND OTHER SOFT
#BENIGN NEOPLASM,
CONNECTIVE AND OTHER SOFT
162091 4827500.03 62426 TARINAH BT DURJA #BENIGN NEOPLASM,
159824 4818150.03 62429 SAEPUDIN BIN TOWIL CONNECTIVE AND OTHER SOFT
#BENIGN NEOPLASM,
CONNECTIVE AND OTHER SOFT
160034 4233650.03 61822 MUHAMMAD VADIL #BENIGN NEOPLASM,
REYSANDI CONNECTIVE AND OTHER SOFT
162572 4705100.03 62864 AL'UYUN MELDRIYANSYAH #BENIGN NEOPLASM,
162576 4534650.03 62527 SIGIT BIN MARYANTO CONNECTIVE AND OTHER SOFT
#BENIGN NEOPLASM,
160067 4555350.03 62483 AHMAD JUNAEDI CONNECTIVE AND OTHER SOFT
#BENIGN NEOPLASM,
CONNECTIVE AND OTHER SOFT
164640 4551450.03 19655 ALVIN FAHREZA #BENIGN NEOPLASM, OTHER
160043 4477850.03 62476 TATI HARYATI SPECIFIED SITES
#BENIGN NEOPLASM, SKIN OF
161740 6237350.06 62486 ROKANI BT MUKI EAR AND NEOPLASM,
#BENIGN EXTERNAL SKIN OF
EAR AND EXTERNAL
161764 4884700.03 62113 AGAM NURMANSYAH #BENIGN NEOPLASM, SKIN OF
EAR AND EXTERNAL
162286 2116950 56719 MUHAMAD RAFATAR SETIADI #BRONCHOPNEUMONIA,
UNSPECIFIED#TYPHOID FEVER
164769 6960400 63627 SUKIRAH BINTI RAWAN #CEREBRAL INFARCTION,
UNSPECIFIED#ACUTE RENAL
159999 12223240 60706 WASNI #CEREBRAL INFARCTION,
160002 7391690 55298 ABDURAHMAN REKI UNSPECIFIED#BACTERIAL
#CEREBRAL INFARCTION,
161569 1579150 4651 RASWI BIN SARDANGI UNSPECIFIED#NON-INSULIN-
#CHRONIC OBSTRUCTIVE
164736 6492240 63616 RUKIAH BINTI RASTA PULMONARY DISEASE WITH
#ENCEPHALOPATHY,
UNSPECIFIED
162379 4381800.03 63112 NADIA AYU SRIKANDI #MUCOCELE OF SALIVARY
164269 2282300 48868 SUPENDI BIN ARSIM GLAND
#NON-INSULIN-DEPENDENT
161430 3570600 31954 JUNED BIN ABDULLAH DIABETES MELLITUS WITH
#NON-INSULIN-DEPENDENT
DIABETES MELLITUS WITHOUT
163955 5034300 63437 TANTONI BIN JUWAHIR #PEPTIC ULCER, CHRONIC OR
162524 5341800 63131 DIDING MUHIBBUDIN UNSPECIFIED
#PNEUMONIA,WITH
UNSPECIFIED#ACUTE RENAL
161429 4034750 46018 KADMI BINTI DARMIN #PNEUMONIA,
UNSPECIFIED#PEPTIC ULCER,
164291 2739900 6903 KURI BINTI DENAN #SEQUELAE OF RESPIRATORY
AND UNSPECIFIED
163284 7439816.02 63300 ADE KOSASIH #SOFT TISSUE DISORDER,
161937 7393600.03 1124 YAYAH SA"DIYAH (YAYAH UNSPECIFIED, ANKLE AND
#SOFT TISSUE DISORDER,
ROKAYAH) UNSPECIFIED, ANKLE AND
163756 4495100.03 63408 TARKUM BIN DULAIM #SOFT TISSUE DISORDER,
165074 4545750.03 63712 KURINAH BT WARTA UNSPECIFIED, ANKLE AND
#SOFT TISSUE DISORDER,
160350 4549750.03 62536 TARMINI BT ACIM UNSPECIFIED, ANKLE AND
#SOFT TISSUE DISORDER,
UNSPECIFIED, ANKLE AND
163327 4427500.03 63319 RIDWAN ISMAIL #SOFT TISSUE DISORDER,
UNSPECIFIED, ANKLE AND
164303 4446100.03 63536 ERNI ASIH #SOFT TISSUE DISORDER,
UNSPECIFIED, ANKLE AND
161071 4286450.03 62756 RIZKY RAYADIANSYAH #SOFT TISSUE DISORDER,
UNSPECIFIED, ANKLE AND
165007 4200550.03 63705 IRFAN MAULANA #SOFT TISSUE DISORDER,
UNSPECIFIED, ANKLE AND
161533 4106550.03 62871 MULYA YULIANA #SOFT TISSUE DISORDER,
160461 4282950.03 23712 REKSA SAPUTRA UNSPECIFIED, ANKLE AND
#SOFT TISSUE DISORDER,
162163 5177900 63069 EUIS NUR LAELA UNSPECIFIED, ANKLE AND
#SOFT TISSUE DISORDER,
163515 4225800.03 62975 ESIH RISMAWATI UNSPECIFIED, ANKLE AND
#SOFT TISSUE DISORDER,
UNSPECIFIED, ANKLE AND
162221 4667950.03 63073 SUHERMAN BIN SAMAD #SOFT TISSUE DISORDER,
162361 4789900.03 62862 ELSYA PUSPITA PRAHARANI UNSPECIFIED, ANKLE AND
#SOFT TISSUE DISORDER,
164848 4486650.03 63657 AYIM BIN DURYAT UNSPECIFIED, HAND
#SOFT TISSUE DISORDER,
162357 5534650 63108 ELA NURLAELA UNSPECIFIED, HAND
#SOFT TISSUE DISORDER,
162032 5396900.06 63031 DEBI A SYA'ADAH UNSPECIFIED, HAND
#SOFT TISSUE DISORDER,
UNSPECIFIED, HAND
161174 4542300.03 62772 SITI MAHMUDAH #SOFT TISSUE DISORDER,
UNSPECIFIED, HAND
162615 4325900.03 63156 WAHYU BIN ROSIKIN #SOFT TISSUE DISORDER,
UNSPECIFIED, HAND
162705 4420450.03 63167 INTAN NURUL AINI #SOFT TISSUE DISORDER,
162352 4656900.03 62812 SUNARTO BIN TAMUD UNSPECIFIED, HAND
#SOFT TISSUE DISORDER,
162567 4496550.03 57860 ANIH ANINGSIH UNSPECIFIED, OTHER SITE
#SOFT TISSUE DISORDER,
UNSPECIFIED, OTHER SITE
165550 4488250.03 63853 RAKSA BIN JAMAHA #SOFT TISSUE DISORDER,
UNSPECIFIED, OTHER SITE
161446 4120900.03 62861 IDA BT DUL #SOFT TISSUE DISORDER,
161933 4227600.03 33514 AGUS MUHBIDIN UNSPECIFIED, OTHER SITE
#SOFT TISSUE DISORDER,
164601 4470350.03 63597 DEDEN HENDANA UNSPECIFIED, OTHER SITE
#SOFT TISSUE DISORDER,
UNSPECIFIED, OTHER SITE
164827 4489250.03 63655 MULYA BIN ARUN #SOFT TISSUE DISORDER,
160511 4412100.03 62577 RUNTINI BT SUKRA UNSPECIFIED, OTHER SITE
#SOFT TISSUE DISORDER,
UNSPECIFIED, OTHER SITE
161259 4315500.03 62815 SANAH BT YAHYA #SOFT TISSUE DISORDER,
UNSPECIFIED, PELVIC AND
164306 4643050.03 63537 DAENI BT CASTRA #SYNOVIAL CYST OF
271887037.31 57 POPLITEAL SPACE [BAKER],
 Procedure Description Penjamin Ruangan Alamat Tgl Lahir L/P Telp Pasien
#Other local excision or BPJS RPB DUSUN 05 RT 035/010 3/10/1967 P 083120551888
destruction
#Other localofexcision
lesion orortissue of BPJS RPB SIGONG
BLOK 02 RT 011/003 3/24/1971 L 081211721971
destruction
#Other localofexcision
lesion orortissue of KIS RPU CIAWIJAPURA
DUSUN 03 RT. 002/006 12/28/1986 P 0895619331457
destruction of lesion or tissue of JAPURABAKTI
#Other local excision or KIS RPU DUSUN I RT 002/001 12/23/1972 P 081193069400
destruction
#Other localofexcision
lesion orortissue of BPJS RPU CURUG
DUSUN 01 RT 001/001 8/25/1997 L 085915285932
destruction of lesion or tissue of KALIPASUNG
#Other local excision or BPJS RPA DUSUN I RT 002/002 3/17/2007 L 082315119504
destruction of lesion or tissue of KARANGANYAR
#Other local excision or KIS RPA DUSUN 02 RT 001/004 9/28/2009 P 085294447515
destruction
#Other localofexcision
lesion orortissue of KIS RPA BUNTET
BLOK KARANG 2/21/2007 L 087828481030
destruction
#Other localofexcision
lesion orortissue of KIS RPU BERINGIN RT 001/007
DUSUN 04 RT 004/001 5/7/1985 L 0895391859594
destruction of lesion or tissue of JAPURABAKTI
#Other local excision or BPJS RPB DUSUN 03 RT 01/06 10/23/1994 L 082181490271
destruction
#Other localofexcision
lesion orortissue of KIS RPU 01/06
BLOK KARANG 5/5/1982 P 085321896929
destruction
#Other localofexcision
lesion orortissue of KIS RPU BERINGIN
BLOK WAGERTRT
004/001 10/21/1956 P 089602996280
destruction of lesion or tissue of 003/004 KENDAL
#Other local excision or KIS RPB BLOK 02 RT 003/003 6/24/1999 L 083824286084
destruction of lesion or tissue of SEDONG LOR
#Routine chest x-ray, so KIS RPA DUSUN I RT. 002/003 2/24/2019 L 081214542443
described#Microscopic CIAWI ASIH
#Insertion of indwelling urinary KIS RPU DUSUN II RT 03/02 11/10/1945 P 081324196712
catheter#Computerized axial PANGENAN
#Insertion of indwelling urinary KIS RPU DUSUN 01 BLOK 9/12/1947 P 085846746271
catheter#Computerized
#Computerized axial axial
MANIS
DUSUNRT
ASKES RPB 002/001 5/13/1945 L 081324145565
02 RT 003/003
tomography of head#Routine KIS RPU KARANGWANGI 1/17/1960 L 087866511135
#Routine chest x-ray, so BLOK KIWIYAR RT
described#Electrocardiogram#M
#Insertion of indwelling urinary KIS ICU 05/03
DUSUN SIDAMULYA
02 RT 10/04 7/1/1957 P 089660669179
catheter#Electrocardiogram#Ele SARAJAYA
#Other local excision or BPJS RPA BLOK A RT 003/001 9/13/2003 P 082310259800
destruction of lesion
#Routine chest x-ray,orsotissue of KIS RPU BELAWA
DUSUN II RT 003/003
9/3/1975 L 082324075844
described#Diagnostic ultrasound
#Electrocardiogram#Microscopi KIS RPU KUBANGDELEG
DUSUN MANIS 02 RT 6/14/1966 L 081381848279
c examination of blood, Other 001/003 JAPURA
#Insertion of indwelling urinary KIS ICU DUSUN 01 RT 03/01 8/1/2000 L 081221036393
catheter#Electrocardiogram#Ele
#Insertion of indwelling urinary BPJS ICU BENDUNGAN
DUSUN MANIS 5/5/1958 L 08977769205
catheter#Routine chest x-ray, so RT.002/001
#Electrocardiogram#Microscopi KIS RPU DUSUN 03 BLOK 6/17/1943 L 083805449094
c examination of blood, Other WAGE RT 03/06
#Electrocardiogram#Microscopi KIS RPU DUSUN 04 RT 03/06 9/4/1969 P 085318980114
c examination of blood, Other KANCI KULON
#Insertion of indwelling urinary KIS RPU BLOK PAKEMBARAN 5/11/1983 L 087875594324
catheter#Other local excision
#Other local excision or or ASKES RPB RT 003/001
BLOK PAHING 11/18/1967 P 081322987566
destruction
#Other localofexcision
lesion orortissue of 001/003
KIS RPU DUSUN 01 RT 003/001 8/9/1973 L 085659798044
destruction of lesion orortissue of GEBANG
#Other local excision BPJS RPU DUSUN 01UDIK
RT 001/001 9/17/1976 P 085315656927
destruction
#Other localofexcision
lesion orortissue of KIS RPU GAGASARI GEBANG 9/13/1971
DUSUN 02 BLOK P 083820024863
destruction of lesion orortissue of PUHUN RT 003/004
#Other local excision KIS RPU DUSUN 03 RT 010/005 3/24/1976 L 082320001413
destruction
#Other localofexcision
lesion orortissue of TUK
BPJS RPB DUSUN 02 RT 001/002 8/17/1989 P 082218615520
destruction of lesion or tissue of KANCI KULON
#Other local excision or BPJS RPU DUSUN 02 BLOK 3/19/2001 L 089637982496
destruction of lesion or tissue of MANIS RT 001/005
#Other local excision or KIS RPA BLOK 5/5/2007 L 083865564376
destruction of lesion or tissue of CANDANGPINGGAN
#Other local excision or JAMKESM RPB DUSUN 01 RT 005/004 7/6/1997 L 0813866549344
destruction
#Other localofexcision
lesion orortissue of AS
BPJS RPU CIAWI ASIH RT
BLOK MANIS 6/14/1998 L 08176742591
destruction
#Other localofexcision
lesion orortissue of BPJS RPB 002/001
DUSUN 02ASEM
RT 020/005 6/10/2001 P 085315771038
destruction of lesion orortissue of
#Other local excision KIS RPU SIGONG
BLOK PUHUN RT 4/3/2001 P 082321422772
destruction of lesion or tissue of 03/07 ASEM
#Other local excision or KIS RPU DUSUN II RT 002/004 6/16/1963 L 085320380011
destruction
#Other localofexcision
lesion orortissue of KIS RPU KERTAWANGUN
DUSUN 01 RT 002/001 6/26/2002 P 081214599791
destruction
#Other localofexcision
lesion orortissue of KIS RPU TAMBELANG
DUSUN II RT 002/003 12/11/1965 L 083113880451
destruction of lesion orortissue of
#Other local excision ASKES RPB PANGENAN
BLOK PAHING 11/8/1976 P 081224403557
destruction
#Other localofexcision
lesion orortissue of BPJS RPB DUSUN
DUSUN 2
01RT
RT003/006
001/004 6/6/2000 P 081395569993
destruction of lesion or tissue of MUNJUL
#Other local excision or KIS RPU DUSUN 02 RT 005/003 3/11/2003 P 083822114436
destruction of lesion or tissue of TUK
#Other local excision or KIS RPU BLOK 11/25/2000 L 08977022488
destruction of lesion or tissue of KANGKUNGAN RT
#Other local excision or KIS RPU BLOK KARANG 2/28/2002 P 085314494011
destruction
#Other localofexcision
lesion orortissue of KIS RPU RAHAYU
DUSUN 01RT
RT011/003
001/002 2/9/1972 L 000000000
destruction
#Other localofexcision
lesion orortissue of KIS RPU KANCI
DUSUN 2 BLOK 7/16/1983 P 082317294752
destruction of lesion or tissue of PAHING RT 005/002
#Other local excision or KIS RPU DUSUN CANTILAN 5/1/1966 L 082321828836
destruction of lesion or tissue of RT 002/009 JAPURA
#Other local excision or KIS RPU DUSUN 03 RT 003/004 7/25/1977 P 087831304260
destruction
#Other localofexcision
lesion orortissue of KIS RPU KANCI
DUSUNKULON
II RT 004/004 8/10/1986 L 087728964922
destruction
#Other localofexcision
lesion orortissue of BPJS RPU ENDER PANGENAN
BLOK MANIS RT 1/1/1989 L 082119472095
destruction of lesion or tissue of 003/001 RAWAURIP
#Other local excision or KIS RPU DUSUN CANTILAN 11/26/1972 L 00000000000
destruction
#Other localofexcision
lesion orortissue of KIS RPU RT 001/007
DUSUN JAPURA
02 BLOK 6/18/1979 P 08978569286
destruction of lesion or tissue of LEBAK RT 007/004
#Other local excision or KIS RPU DUSUN 03 RT 001/005 3/5/1973 P 083120656818
destruction of lesion or tissue of KUBANGDELEG
#Other local excision or BPJS RPU DUSUN 4 BLOK 4/5/1969 P 083120909862
destruction of lesion or tissue of PUHUN RT 002/003