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7/26/2019 irna april 2012.xls
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Rekap Pendapatan Rawat Inap
Maret 2012
3/26/2012
No. Nama Pasien Tindakan Admin JS Ratna
1 Yeni Nawangsari, Ny
- - -
2 Akil Aril A!!andi, An 2",### ",###
$elas 1 2 %ari &,### 2'2,###
(isite 1",###
%ematologi r)tin
golongan dara%
wakt) *emb(ek)anwakt) *erdara%an
kons)ltasi ",###
31,000 317,000 -
+ airell -%a!ran Ala)na, An 2",### ",###
$elas 2 + %ari &,### 2#,###
(isite 1",###
in!ant warmer 1+",###
%ematologi r)tin
golongan dara%
billir)bin totalbillir)bin dire/t0indire/t
31,000 395,000 -
iskat)r Ri!o%, An 2",### ",###
$elas + " %ari ",### 23#,###
%ematologi r)tin
widal
(isite 2",### 1"#,###
30,000 310,000 150,000
" 4asmina%, Ny 2",###
$elas + 2 %ari 2,### 112,###
)sg 1",### #,###
(isite 1#,### ,###
k)retase dengan narkose 1##,### "#,###
%ematologi r)tin
golongan dara%
%bs ag
27,000 237,000 550,000
& Tati 5ndayanti, Ny #,###
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$elas + %ari ,### 22,###
)sg 1",### #,###
(isite +",### '#,###
se/tio /aesaria 1,+##,### 3+,6"#
*emasangan katet%er &,"##
%ematologi r)tin
res)sitasi +#,###
kons)ltasi ",### +#,###
44,000 1,655,500 1,003,750
6 Royana%, Ny #,###
$elas + & %ari &,### ++&,###
)sg 1",### #,###
(isite "#,### 1"#,###
%ematologi r)tin
se/tio /aesaria 1,+##,### 3+,6"#
res)sitasi +#,###*emasangan katet%er &,"##
golongan dara%
%bs ag
46,000 1,777,500 1,033,750
3 Sri Ati, Ny
$elas + + %ari +,### 1&3,###
se/tio /aesaria 1,###,### '##,###
res)sitasi
*aket s/
dil)ar *aket s/(isite +#,### ,###
3,000 1,198,000 960,000
212,000 5,890,000 3,697,500
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okter Obgyn Dokter Anak Dokter 7eda% Dokter 5n
8erlambang -)!rial Ari! 7ambang S 4%anis a9ar -)maro :illy ;ko D9al) 5man Dar9ito
- - - - - - - - -
"#,###
2",###
- - - - - 75,000 - - -
12#,###
- - - 120,000 - - - - -
- - - - - - - - -
- - - - - - - - -
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12#,###
'#,###
- - - 210,000 - - - - -
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5/750
ternis Dokter =igi Dokter Syara! Anestesi Par) Psiko Rad
aretina Dian : Sangkan a/%ri >er Anton Soemartono Ari! 5r!an Dana Ali*
- - - - - - - - - -
- - - - - - - - - -
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Dokter >m)m
AnestesiD9alil 7oeing N)rbaity Teg)% 5 ade $%olid :indy Dewi Aros
- - - - - - - - - -
2",###
2",### 2",###
- - - - - 25,000 25,000 - 25,000 -
2",###
- - - - - - - - 25,000 -
2",###
- - - - 25,000 - - - - -
&6,"##
- - - - - - - - - 67,500
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2"+,12"
- - - - - - - - - 253,125
2"+,12"
- - - - - - - - - 253,125
2"#,###
- - - - - - - - - 250,000
- - - - 25,000 25,000 25,000 - 50,000 823,750
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Ass. O*rt Ass. Anestesi 7A8P armasi ?aborat Radiologi
Aske*
R)angan Adi =)ga%
- - - - - - - - -
266,1'+
+#,###
+&,3##
11,"##
',2##',2##
- - - 277,193 66,700 - 30,000 - -
"+,+1+
+&,###
+",2##
11,###
1',3##+',#
- - - 453,313 105,600 - 36,000 - -
33',3'#
",###
6#,##
++,###
- - - 889,890 103,400 - 45,000 - -
"31,6+"
13,###
+",2##
11,###
',"##
- - - 581,735 95,700 - 18,000 - -
1,&+,&'&
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+&,###
1&3,6"# 3,+6" 13#,###
+",2##
168,750 84,375 180,000 1,643,696 35,200 - 36,000 - -
1,&++,3+
",###
6#,##
1&3,6"# 3,+6" 13#,###
11,###
',"##
168,750 84,375 180,000 1,633,843 130,900 - 54,000 - -
26,###
12",### 6",###
1,###,### '',###
2"2,6'3
125,000 75,000 - 1,252,798 99,000 - 27,000 - -
462,500 243,750 360,000 6,732,468 636,500 - 246,000 - -
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Ari! A!it S)%ati :iwik 5ndra ;ko P Andini Roik%at)l Dewi 4andra $oti/%a
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
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13/750
Aisa% Ana ;ny ;ndang Pi*it S)/i Dinda Tika Retno :)lan
- - - - - - - - - -
- - - - - - - - - -
1",###
- - - - - - - - - 15,000
- - - - - - - - - -
- - - - - - - - - -
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14/750
1+,"##
- - - - 13,500 - - - - -
1+,"##
- - - - - - - - - 13,500
- - - - - - - - - -
- - - - 13,500 - - - - 28,500
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15/750
Diet Amb)lan/eR)9)kan ?ain0?ain Total $eringanan DPRawat 5na* ;kstra 77 So*ir
0 1,2##,###
- - - - - - - - 1,200,000
++2,1'+
62,### ##,### @2+",++'
11",###
+&,3##
11,"##
',2##',2##
+#,###
72,000 - - - - - 943,893 (235,339) -
"#3,+1+
'#,### +62,### @'#,###
1+",###
1"#,###
+",2##
11,###
1',3##+',#
90,000 - - - - - 1,270,913 (90,000) -
',3'#
1#",### +",###
6#,##
++,###
16",###
105,000 - - - - - 1,658,290 - -
&6,2+"
2,### 16,###
"",###
6#,###
""#,###
+",2##
11,###
',"##
42,000 - - - - - 1,618,935 - -
1,&3+,&'&
-
7/26/2019 irna april 2012.xls
16/750
3,### +3,###
"",###
2",###
2,3+#,###
,###
+",2##
12#,###
+",###
84,000 - - - - - 5,411,896 - -
1,&6+,3+
12&,### "22,###
"",###
+"#,###
6#,##
2,3+#,###
12#,###,###
11,###
',"##
126,000 - - - - - 5,741,743 - -
0
&+,### 2&1,###
2,+"#,###
3#,###
1,#'',###
2"2,6'321#,###
63,000 - - - - - 4,252,798 - -
582,000 - - - - - 20,898,468 (325,339) 1,200,000
0
0
0
0
0
0
0
0
0
0
0
0
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Pi)tang
Jamsostek =arda edika Jamkesmas Jasa Ra%ar9a Reli!e 7ringin
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
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18/750
- - - - - -
- - - - - -
- - - - - -
- - - - - -
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19/750
J)mla% 7ayarPos 5ndonesia As)ransi ?ain ybs
1,2##,###
- - - 1,200,000
++2,1'+
1&,&&1
11",###
+&,3##
11,"##
',2##',2##
+#,###
- - - 708,554
"#3,+1+
232,###
1+",###
1"#,###
+",2##
11,###
1',3##+',#
- - - 1,180,913
',3'#
+",###
6#,##
++,###
16",###
- - - 1,658,290
&6,2+"
16,###
"",###
6#,###
""#,###
+",2##
11,###
',"##
- - - 1,618,935
1,&3+,&'&
-
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20/750
+3,###
"",###
2",###
2,3+#,###
,###
+",2##
12#,###
+",###
- - - 5,411,896
1,&6+,3+
"22,###
"",###
+"#,###
6#,##
2,3+#,###
12#,###,###
11,###
',"##
- - - 5,741,743
0
2&1,###
2,+"#,###
3#,###
1,#'',###
2"2,6'321#,###
- - - 4,252,798
- - - 21,773,129
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
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21/750
Rekap Pendapatan Rawat Inap
Maret 2012
3/27/2012
No. Nama Pasien Tindakan Admin JS Ratna
1 Yeni Nawangsari, Ny DP 5 *asien
- - -
2 asria%, Ny #,###
$elas 2 + %ari &,### 2#,###
(isite 2",### 12#,###
se/tio /aesaria 1,+##,### 1,12",###
*emasangan katet%er "6,###
%ematologi r)tingolongan dara%
%bs ag
kons)ltasi ",### 2#,###
res)sitasi +#,###
46,000 1,657,000 1,265,000
+ -)lkarnaen, Tn 2",### ",###
$elas + 2 %ari 2,### 112,###
*emasangan katet%er &,"##
kons)ltasi 1#,###
(isite ",###%ematologi r)tin
)re)m
kreatinin
gl)kosa sewakt)
27,000 178,500 -
Sya!riyanti, Ny 2",###
$elas + 2 %ari 2,### 112,###
)sg 1",### #,###
(isite 1#,### ,###
k)retase dengan narkose 1##,### "#,###
%ematologi r)tin
golongan dara%
%bs ag
27,000 237,000 550,000
100,000 2,072,500 1,815,000
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okter Obgyn Dokter Anak Dokter 7eda% Dokter 5n
8erlambang -)!rial Ari! 7ambang S 4%anis a9ar -)maro :illy ;ko D9al) 5man Dar9ito
- - - - - - - - -
3#,###
12#,###
- - - 200,000 - - - - -
+#,###
+#,###
- - - - - - - - 60,000
- - - - - - - - -
- - - 200,000 - - - - 60,000
-
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24/750
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7/26/2019 irna april 2012.xls
25/750
ternis Dokter =igi Dokter Syara! Anestesi Par) Psiko Rad
aretina Dian : Sangkan a/%ri >er Anton Soemartono Ari! 5r!an Dana Ali*
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
-
7/26/2019 irna april 2012.xls
26/750
-
7/26/2019 irna april 2012.xls
27/750
Dokter >m)m
AnestesiD9alil 7oeing N)rbaity Teg)% 5 ade $%olid :indy Dewi Aros
- - - - - - - - - -
++6,"##
- - - - - - - - - 337,500
2",###
- - - - - - - - 25,000 -
- - - - - - - - - -
- - - - - - - - 25,000 337,500
-
7/26/2019 irna april 2012.xls
28/750
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29/750
Ass. O*rt Ass. Anestesi 7A8P armasi ?aborat Radiologi
Aske*
R)angan Adi =)ga%
- - - - - - - - -
2,+',+''
+&,###
22",### 112,"## &+#,###
+",2##11,###
',"##
225,000 112,500 630,000 2,349,399 95,700 - 36,000 - -
&2',&"6
13,###
+",2##
1',3##
1',3##
1",##
- - - 629,657 90,200 - 18,000 - -
&6,"## &&,6"3
13,###
+",2##
11,###
',"##
- 67,500 - 646,758 95,700 - 18,000 - -
225,000 180,000 630,000 3,625,814 281,600 - 72,000 - -
-
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30/750
-
7/26/2019 irna april 2012.xls
31/750
Ari! A!it S)%ati :iwik 5ndra ;ko P Andini Roik%at)l Dewi 4andra $oti/%a
- - - - - - - - - - -
- - - - - - - - - - -
1+,"##
- 13,500 - - - - - - - - -
- - - - - - - - - - -
- 13,500 - - - - - - - - -
-
7/26/2019 irna april 2012.xls
32/750
-
7/26/2019 irna april 2012.xls
33/750
Aisa% Ana ;ny ;ndang Pi*it S)/i Dinda Tika Retno :)lan
- - - - - - - - - -
13,###
- - 18,000 - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - 18,000 - - - - - - -
-
7/26/2019 irna april 2012.xls
34/750
-
7/26/2019 irna april 2012.xls
35/750
Diet Amb)lan/eR)9)kan ?ain0?ain Total $eringanan DPRawat 5na* ;kstra 77 So*ir
0 +,###,###
- - - - - - - - 3,000,000
2,+3',+''
'#,### +62,###
22",###
+,6+#,###
6",###
+",2##11,###
',"##
2",###
1"#,###
90,000 - - - - - 7,062,099 - -
&3,&"6
2,### 16,###
,###
#,###
+",###+",2##
1',3##
1',3##
1",##
42,000 - - - - - 1,083,857 - -
6+',2"3
2,### 16,###
"",###
6#,###
""#,###
+",2##
11,###
',"##
42,000 - - - - - 1,683,958 - -
174,000 - - - - - 9,829,914 - 3,000,000
0
0
0
00
-
7/26/2019 irna april 2012.xls
36/750
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
37/750
Pi)tang
Jamsostek =arda edika Jamkesmas Jasa Ra%ar9a Reli!e 7ringin
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
-
7/26/2019 irna april 2012.xls
38/750
-
7/26/2019 irna april 2012.xls
39/750
J)mla% 7ayarPos 5ndonesia As)ransi ?ain ybs
+,###,###
- - - 3,000,000
2,+3',+''
+62,###
22",###
+,6+#,###
6",###
+",2##11,###
',"##
2",###
1"#,###
- - - 7,062,099
&3,&"6
16,###
,###
#,###
+",###+",2##
1',3##
1',3##
1",##
- - - 1,083,857
6+',2"3
16,###
"",###
6#,###
""#,###
+",2##
11,###
',"##
- - - 1,683,958
- - - 12,829,914
0
0
0
00
-
7/26/2019 irna april 2012.xls
40/750
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
41/750
Rekap Pendapatan Rawat Inap
Maret 2012
3/28/2012
No. Nama Pasien Tindakan Admin JS Ratna
1 . Jibran Rabani, An 2",### ",###
$elas 1 + %ari ',### +3,###
(isite 1",###
kons)ltasi ",###
%ematologi r)tin
34,000 463,000 -
2 Riyanti, 7y 1",###
$elas 2 %ari 3,### +2#,###res)sitasi "6,###
(isite 2#,###
*asang tindik 1#,"##
%ematologi r)tin
billir)bin dire/t0indire/t
billir)bin total
23,000 407,500 -
+ Riyanti, Ny 2",###
$elas 2 " %ari 1#,### ##,###
(isite 2",### 1,###*er (agin)m #,### 6##,###
)sg 1",### #,###
laserasi 9alan la%ir ",### 13#,###
%ematologi r)tin
asam )rat
kons)ltasi ",### #,###
35,000 1,090,000 1,120,000
:ariti, Ny 2#,### ",### "#,###
$elas + 2 %ari 2,### 112,###
(isite ",### +#,###
kons)ltasi ",### +#,###
k)retase dengan narkose 1##,### "#,###
%ematologi r)tin
golongan dara%
%bs ag
22,000 227,000 560,000
" 8arsiat)n, 7y 1",###
$elas + %ari ,### 22,###
res)sitasi +#,###(isite 1",###
-
7/26/2019 irna april 2012.xls
42/750
19,000 269,000 -
& 8arsiat)n, Ny 2",###
$elas + %ari ,### 22,###
(isite 2#,### 12#,###
*emasangan katet%er &,"##
se/tio /aesaria 1,+##,### 3+,6"#
%ematologi r)tin
golongan dara%
%bs ag
29,000 1,590,500 963,750
6 N)rita, Ny
$elas + " %ari ",### 23#,###
se/tio /aesaria 1,###,### '##,###
res)sitasi(isite #,### 1"#,###
*aket s/
dil)ar *aket s/
)sg 1",### #,###
5,000 1,335,000 1,090,000
3 )tamima%, Ny
$elas + " %ari ",### 23#,###
se/tio /aesaria 1,###,### '##,###
res)siatsi
(isite #,### 1"#,###)sg 1",### #,###
*aket s/
dil)ar *aket s/
5,000 1,335,000 1,090,000
172,000 6,717,000 4,823,750
-
7/26/2019 irna april 2012.xls
43/750
okter Obgyn Dokter Anak Dokter 7eda% Dokter 5n
8erlambang -)!rial Ari! 7ambang S 4%anis a9ar -)maro :illy ;ko D9al) 5man Dar9ito
1"#,###
2",###
- - - 175,000 - - - - -
1,###
- - - 160,000 - - - - -
#,###
- - - - - 40,000 - - -
- - - - - - - - -
'#,###'#,###
-
7/26/2019 irna april 2012.xls
44/750
- - - 180,000 - - - - -
- - - - - - - - -
3#,###'#,###
- - - 170,000 - - - - -
3#,###
'#,###
- - - 170,000 - - - - -
- - - 855,000 - 40,000 - - -
-
7/26/2019 irna april 2012.xls
45/750
ternis Dokter =igi Dokter Syara! Anestesi Par) Psiko Rad
aretina Dian : Sangkan a/%ri >er Anton Soemartono Ari! 5r!an Dana Ali*
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
-
7/26/2019 irna april 2012.xls
46/750
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
-
7/26/2019 irna april 2012.xls
47/750
Dokter >m)m
AnestesiD9alil 7oeing N)rbaity Teg)% 5 ade $%olid :indy Dewi Aros
2",###
25,000 - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
-
7/26/2019 irna april 2012.xls
48/750
- - - - - - - - - -
2"+,12"
- - - - - - - - - 253,125
2"#,###
- - - - - - - - - 250,000
2"#,###
- - - - - - - - - 250,000
25,000 - - - - - - - - 753,125
-
7/26/2019 irna april 2012.xls
49/750
Ass. O*rt Ass. Anestesi 7A8P armasi ?aborat Radiologi
Aske*
R)angan Adi =)ga%
1,26&,&"2
",###
+&,3##
- - - 1,276,652 36,800 - 45,000 - -
"#,32'
3,###
+",2##
+',#
1',3##
- - - 450,829 94,600 - 48,000 - -
26,++
,###
11,2"#
+",2##
22,###
- - 411,250 427,334 57,200 - 60,000 - -
&6,"## +33,3+"
13,###
+",2##
11,###
',"##
- 67,500 - 388,835 95,700 - 18,000 - -
+#+,16
+&,###
-
7/26/2019 irna april 2012.xls
50/750
- - - 303,174 - - 36,000 - -
1,2",6"#
+&,###
1&3,6"# 3,+6" 13#,###
6#,##
11,###
',"##
168,750 84,375 180,000 1,425,750 130,900 - 36,000 - -
",###
12",### 6",###
1,###,### '',###
1"&,61 3+,#
125,000 75,000 - 1,156,471 182,600 - 45,000 - -
",###
12",### 6",###
1,###,### '',###
+#6,32 3+,#
125,000 75,000 - 1,307,482 182,600 - 45,000 - -
418,750 301,875 591,250 6,736,527 780,400 - 333,000 - -
-
7/26/2019 irna april 2012.xls
51/750
Ari! A!it S)%ati :iwik 5ndra ;ko P Andini Roik%at)l Dewi 4andra $oti/%a
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
-
7/26/2019 irna april 2012.xls
52/750
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
-
7/26/2019 irna april 2012.xls
53/750
Aisa% Ana ;ny ;ndang Pi*it S)/i Dinda Tika Retno :)lan
- - - - - - - - - -
13,###
,"##
- - 4,500 - - - 18,000 - - -
- - - - - - - - - -
- - - - - - - - - -
-
7/26/2019 irna april 2012.xls
54/750
- - - - - - - - - -
1+,"##
- - 13,500 - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - 18,000 - - - 18,000 - - -
-
7/26/2019 irna april 2012.xls
55/750
Diet Amb)lan/eR)9)kan ?ain0?ain Total $eringanan DPRawat 5na* ;kstra 77 So*ir
1,++1,&"2
1#3,### #,###
1&",###
+#,###
+&,3##
0
108,000 - - - - - 2,163,452 - -
0
&",32'
12#,### '&,### @'&,### 6",###
13#,###
1",###
+",2##
+',#
1',3##
120,000 - - - - - 1,326,429 (496,000) -
"2,++
1"#,### &2#,###
22",###1,611,2"#
"",###
22",###
+",2##
22,###
",###
150,000 - - - - - 3,390,784 - -
"+1,++"
2,### 16,###
+",###
+",###
""#,###
+",2##
11,###
',"##
42,000 - - - - - 1,421,035 - -
+13,16
3,### +3,### @+3,###
12#,###1#",###
-
7/26/2019 irna april 2012.xls
56/750
84,000 - - - - - 891,174 (348,000) -
1,"#,6"#
3,### +3,###
1#,###
,###
2,3+#,###
6#,##
11,###
',"##
84,000 - - - - - 4,959,650 - -
0
1#",### +",###
2,+"#,###
3#,###23#,###
1,#'',###
2#,#61
"",###
105,000 - - - - - 4,539,071 - -
0
1#",### +",###
2,+"#,###
3#,###
23#,###"",###
1,#'',###
+'1,#32
105,000 - - - - - 4,690,082 - -
798,000 - - - - - 23,381,677 (844,000) -
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
57/750
Pi)tang
Jamsostek =arda edika Jamkesmas Jasa Ra%ar9a Reli!e 7ringin
- - - - - -
- - - - - -
- - - - - -
- - - - - -
-
7/26/2019 irna april 2012.xls
58/750
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
-
7/26/2019 irna april 2012.xls
59/750
J)mla% 7ayarPos 5ndonesia As)ransi ?ain ybs
1,++1,&"2
#,###
1&",###
+#,###
+&,3##
- - - 2,163,452
&",32'
06",###
13#,###
1",###
+",2##
+',#
1',3##
- - - 830,429
"2,++
&2#,###
22",###1,611,2"#
"",###
22",###
+",2##
22,###
",###
- - - 3,390,784
"+1,++"
16,###
+",###
+",###
""#,###
+",2##
11,###
',"##
- - - 1,421,035
+13,16
0
12#,###1#",###
-
7/26/2019 irna april 2012.xls
60/750
- - - 543,174
1,"#,6"#
+3,###
1#,###
,###
2,3+#,###
6#,##
11,###
',"##
- - - 4,959,650
0
+",###
2,+"#,###
3#,###23#,###
1,#'',###
2#,#61
"",###
- - - 4,539,071
0
+",###
2,+"#,###
3#,###
23#,###"",###
1,#'',###
+'1,#32
- - - 4,690,082
- - - 22,537,677
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
61/750
Rekap Pendapatan Rawat Inap
Maret 2012
3/29/2012
No. Nama Pasien Tindakan Admin JS Ratna
1 7ryan ;meraldi P)tra, An 2",### ",###
$elas 1 + %ari ',### +3,###
widal
%ematologi r)tin
kons)ltasi ",###
(isite 1",###
34,000 463,000 -
2 N)r 8ayati, Ny #,###$elas 1 %ari 12,### "3,###
amb)lan/e
kons)ltasi 1#,###
e/g &,"##
(isite #,### 2##,###
%ematologi r)tin
*emasangan katet%er 63,###
res)sitasi +#,###
se/tio /aesaria 1,+##,### 1,&36,"##
52,000 2,088,500 1,887,500
86,000 2,551,500 1,887,500
-
7/26/2019 irna april 2012.xls
62/750
-
7/26/2019 irna april 2012.xls
63/750
okter Obgyn Dokter Anak Dokter 7eda% Dokter 5n
8erlambang -)!rial Ari! 7ambang S 4%anis a9ar -)maro :illy ;ko D9al) 5man Dar9ito
2#,###
12#,###
- - - 140,000 - - - - -
"#,###
1"#,### "#,###
13#,###
- - - 330,000 - - - - 100,000
- - - 470,000 - - - - 100,000
-
7/26/2019 irna april 2012.xls
64/750
-
7/26/2019 irna april 2012.xls
65/750
ternis Dokter =igi Dokter Syara! Anestesi Par) Psiko Rad
aretina Dian : Sangkan a/%ri >er Anton Soemartono Ari! 5r!an Dana Ali*
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
-
7/26/2019 irna april 2012.xls
66/750
-
7/26/2019 irna april 2012.xls
67/750
Dokter >m)m
AnestesiD9alil 7oeing N)rbaity Teg)% 5 ade $%olid :indy Dewi Aros
2",###
- - 25,000 - - - - - - -
"#&,2"#
- - - - - - - - - 506,250
- - 25,000 - - - - - - 506,250
-
7/26/2019 irna april 2012.xls
68/750
-
7/26/2019 irna april 2012.xls
69/750
Ass. O*rt Ass. Anestesi 7A8P armasi ?aborat Radiologi
Aske*
R)angan Adi =)ga%
+1,&1&
",###
++,###
+",2##
- - - 431,616 68,200 - 45,000 - -
2,'2,"''
+&,3##
++6,"## 1&3,6"# 13#,###
337,500 168,750 180,000 2,492,599 36,800 - - - -
337,500 168,750 180,000 2,924,215 105,000 - 45,000 - -
-
7/26/2019 irna april 2012.xls
70/750
-
7/26/2019 irna april 2012.xls
71/750
Ari! A!it S)%ati :iwik 5ndra ;ko P Andini Roik%at)l Dewi 4andra $oti/%a
- - - - - - - - - - -
1+,"##
- - - - - 13,500 - - - - -
- - - - - 13,500 - - - - -
-
7/26/2019 irna april 2012.xls
72/750
-
7/26/2019 irna april 2012.xls
73/750
Aisa% Ana ;ny ;ndang Pi*it S)/i Dinda Tika Retno :)lan
- - - - - - - - - -
26,###
- - - 27,000 - - - - - -
- - - 27,000 - - - - - -
-
7/26/2019 irna april 2012.xls
74/750
-
7/26/2019 irna april 2012.xls
75/750
Diet Amb)lan/eR)9)kan ?ain0?ain Total $eringanan DPRawat 5na* ;kstra 77 So*ir
3&,&1& @2",###
1#3,### #,### @223,###
++,###
+",2##
2",###
1+",###
108,000 - - - - - 1,314,816 (253,000) -
2,"+2,"''1,### 6#,###
",### 2",### 6#,###
,###
,###
#,###
+&,3##
1#",###
21#,###
,13#,###
144,000 - 45,000 25,000 - - 8,434,399 - -
252,000 - 45,000 25,000 - - 9,749,215 (253,000) -
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
-
7/26/2019 irna april 2012.xls
76/750
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
77/750
Pi)tang
Jamsostek =arda edika Jamkesmas Jasa Ra%ar9a Reli!e 7ringin
3#+,'&&
803,966 - - - - -
- - - - - -
803,966 - - - - -
-
7/26/2019 irna april 2012.xls
78/750
-
7/26/2019 irna april 2012.xls
79/750
J)mla% 7ayarPos 5ndonesia As)ransi ?ain ybs
&1,&1&
@+1,'&&
++,###
+",2##
2",###
1+",###
- - - 257,850
2,"+2,"''6#,###
6#,###
,###
,###
#,###
+&,3##
1#",###
21#,###
,13#,###
- - - 8,434,399
- - - 8,692,249
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
-
7/26/2019 irna april 2012.xls
80/750
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
81/750
Rekap Pendapatan Rawat Inap
Maret 2012
3/30/2012
No. Nama Pasien Tindakan Admin JS Ratna
1 Yeni Nawangsari, Ny DP 55 *asien
- - -
2 Yeni Nawangsari, Ny 2#,### ",### "#,###
$elas B5P & %ari 2,### 1,"##,###
se/tio /aesaria 1,+##,### 1,'&3,6"#
(isite +#,### +,###
golongan dara%
%bs ag%ematologi r)tin
44,000 2,835,000 2,378,750
+ ?eni Setiawati, Ny 2#,### ",### "#,###
kelas 1 2 %ari &,### 2'2,###
)sg 1",### #,###
k)retase dengan narkose 1##,### '##,###
(isite 1#,### 1##,###
26,000 422,000 1,090,000
?)t!i Ra%man =)nawan, An 2",### ",###
$elas 2 + %ari &,### 2#,###
widal
%ematologi r)tin
(isite 1#,###
31,000 255,000 -
" Dewi itriyani, Ny
$elas + %ari ,### 22,###
se/tio /aesaria 1,###,### '##,###
res)sitasi
(isite +#,### '#,###
*aket s/
dil)ar *aket s/
4,000 1,254,000 990,000
& Yeni Nawangsari, 7y 1",###
$elas B5P " %ari 2#,### 1,2"#,###
res)sitasi +#,###
gl)kosa sewakt)
(isite 2#,###
-
7/26/2019 irna april 2012.xls
82/750
35,000 1,300,000 -
6 )stab Siro%, Ny 2",###
$elas + 2 %ari 2,### 112,###
)sg 1",### #,###
b)sinasiClaminaria 1",### ",###
k)retase dengan narkose 1##,### "#,###
(isite 1#,### ,###
27,000 252,000 595,000
3 ;nda% Ay) Pratiwi, Ny 2#,### ",### "#,###
$elas + 2 %ari 2,### 112,###
%bs ag
golongan dara%
%ematologi r)tin
tindakan man)al *la/enta ,### 13#,###
*er (agin)m #,### "2",###k)retase dengan narkose 1##,### "#,###
(isite 1#,### ,###
22,000 887,000 1,265,000
189,000 7,205,000 6,318,750
-
7/26/2019 irna april 2012.xls
83/750
okter Obgyn Dokter Anak Dokter 7eda% Dokter 5n
8erlambang -)!rial Ari! 7ambang S 4%anis a9ar -)maro :illy ;ko D9al) 5man Dar9ito
- - - - - - - - -
- - - - - - - - -
- - - - - - - - -
3#,###
- - - 80,000 - - - - -
3#,###
-
7/26/2019 irna april 2012.xls
84/750
- - - 240,000 - - - - -
- - - - - - - - -
- - - - - - - - -
- - - 490,000 - - - - -
-
7/26/2019 irna april 2012.xls
85/750
ternis Dokter =igi Dokter Syara! Anestesi Par) Psiko Rad
aretina Dian : Sangkan a/%ri >er Anton Soemartono Ari! 5r!an Dana Ali*
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
21#,###
-
7/26/2019 irna april 2012.xls
86/750
- - - - - 210,000 - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - - 210,000 - - - -
-
7/26/2019 irna april 2012.xls
87/750
-
7/26/2019 irna april 2012.xls
88/750
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - 25,000 - 840,625
-
7/26/2019 irna april 2012.xls
89/750
Ass. O*rt Ass. Anestesi 7A8P armasi ?aborat Radiologi
Aske*
R)angan Adi =)ga%
- - - - - - - - -
2,6#,+'2
1#3,###
+"+,6"# 1'&,36" 22#,###
12,###
",###6&,3##
353,750 196,875 220,000 2,740,392 142,800 - 108,000 - -
1+",### +"3,#2#
+#,###
- 135,000 - 358,020 - - 30,000 - -
1,#'+,12
+&,###
++,###
+",2##
- - - 1,093,124 68,200 - 36,000 - -
+&,###
12",### 6",###
1,###,### '',###
11",#1&
125,000 75,000 - 1,115,016 99,000 - 36,000 - -
6',22"
'#,###
++,#
-
7/26/2019 irna april 2012.xls
90/750
- - - 79,225 33,600 - 90,000 - -
&6,"## &+#,"32
13,###
- 67,500 - 630,582 - - 18,000 - -
","#2
13,###
',"##
11,###
+",2##
113,6"#
- - 118,750 454,502 95,700 - 18,000 - -
478,750 474,375 338,750 6,470,861 439,300 - 336,000 - -
-
7/26/2019 irna april 2012.xls
91/750
Ari! A!it S)%ati :iwik 5ndra ;ko P Andini Roik%at)l Dewi 4andra $oti/%a
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
-
7/26/2019 irna april 2012.xls
92/750
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
-
7/26/2019 irna april 2012.xls
93/750
Aisa% Ana ;ny ;ndang Pi*it S)/i Dinda Tika Retno :)lan
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
-
7/26/2019 irna april 2012.xls
94/750
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
-
7/26/2019 irna april 2012.xls
95/750
Diet Amb)lan/eR)9)kan ?ain0?ain Total $eringanan DPRawat 5na* ;kstra 77 So*ir
0 ,+##,###
- - - - - - - - 4,300,000
2+,### 2,3+3,+'2
26#,### 1,'#2,### @23",+## @3,"##,###
,&+#,###
+'#,###
12,###
",###6&,3##
270,000 23,000 - - - - 9,903,192 (285,300) (8,500,000)
"&3,#2# @2#,###
62,### ##,###
"",###
1,###,###
11#,###
72,000 - - - - - 2,133,020 (20,000) -
1,13,12
'#,### +62,###
++,###
+",2##
'#,###
90,000 - - - - - 1,678,324 - -
0
3,### +3,###
2,+"#,###
3#,###
21#,###
1,#'',###
11",#1&
84,000 - - - - - 4,202,016 - -
',22"
22",### 1,"3",### @1,"3",###
2#,###
++,#
2,###
-
7/26/2019 irna april 2012.xls
96/750
225,000 - - - - - 2,212,825 (1,585,000) -
62+,#32
2,### 16,###
"",###
,###
""#,###
6#,###
42,000 - - - - - 1,632,082 - -
"2',"#2
2,### 16,###
',"##
11,###
+",2##
2#,###
1,2+,6"#""#,###
6#,###
42,000 - - - - - 2,902,952 - -
825,000 23,000 - - - - 24,664,411 (1,890,300) (4,200,000)
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
97/750
Pi)tang
Jamsostek =arda edika Jamkesmas Jasa Ra%ar9a Reli!e 7ringin
- - - - - -
- - - - - -
1,2&6,+'2
1,267,392 - - - - -
- - - - - -
- - - - - -
-
7/26/2019 irna april 2012.xls
98/750
- - - - - -
- - - - - -
- - - - - -
1,267,392 - - - - -
-
7/26/2019 irna april 2012.xls
99/750
J)mla% 7ayarPos 5ndonesia As)ransi ?ain ybs
,+##,###
- - - 4,300,000
2,3+3,+'2
@&,33+,+##
,&+#,###
+'#,###
12,###
",###6&,3##
- - - 1,117,892
@61',+62
##,###
"",###
1,###,###
11#,###
- - - 845,628
1,13,12
+62,###
++,###
+",2##
'#,###
- - - 1,678,324
0
+3,###
2,+"#,###
3#,###
21#,###
1,#'',###
11",#1&
0
- - - 4,202,016
0
',22"
0
2#,###
++,#
2,###
-
7/26/2019 irna april 2012.xls
100/750
- - - 627,825
62+,#32
16,###
"",###
,###
""#,###
6#,###
- - - 1,632,082
"2',"#2
16,###
',"##
11,###
+",2##
2#,###
1,2+,6"#""#,###
6#,###
- - - 2,902,952
- - - 17,306,719
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
101/750
Rekap Pendapatan Rawat Inap
Maret 2012
3/31/2012
No. Nama Pasien Tindakan Admin JS Ratna
1 S)swati, 7y 1",###
$elas 1 " %ari 1",### 6+#,###
res)sitasi +#,###
(isite 2#,###
30,000 780,000 -
2 S)swati, Ny 2",###
$elas 1 " %ari 1",### 6+#,###
*emasangan katet%er 63,###%bs ag
golongan dara%
%ematologi r)tin
se/tio /aesaria 1,+##,### 1,&36,"##
)rine lengka*
sg*t
sgot
kreatinin
)re)m
(isite 2",### 2"#,###
40,000 2,133,000 1,937,500
+ :atina%, 7y 1",###
$elas + 1 %ari 1,### "&,###
kons)ltasi ",###
(isite ",###
res)sitasi &,"##
16,000 112,500 -
:atina%, Ny 2",###
$elas + 2 %ari 2,### 112,###
%bs ag
golongan dara%
%ematologi r)tin
laserasi 9alan la%ir ",### 1+",###
)sg 1",### #,###
(isite 1#,### ,###
*er (agin)m #,### "2",###
27,000 782,000 760,000
113,000 3,807,500 2,697,500
-
7/26/2019 irna april 2012.xls
102/750
-
7/26/2019 irna april 2012.xls
103/750
okter Obgyn Dokter Anak Dokter 7eda% Dokter 5n
8erlambang -)!rial Ari! 7ambang S 4%anis a9ar -)maro :illy ;ko D9al) 5man Dar9ito
13#,###
2##,###
- - - 380,000 - - - - -
- - - - - - - - -
1",###
+#,###
- - 45,000 - - - - - -
- - - - - - - - -
- - 45,000 380,000 - - - - -
-
7/26/2019 irna april 2012.xls
104/750
-
7/26/2019 irna april 2012.xls
105/750
ternis Dokter =igi Dokter Syara! Anestesi Par) Psiko Rad
aretina Dian : Sangkan a/%ri >er Anton Soemartono Ari! 5r!an Dana Ali*
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
-
7/26/2019 irna april 2012.xls
106/750
-
7/26/2019 irna april 2012.xls
107/750
Dokter >m)m
AnestesiD9alil 7oeing N)rbaity Teg)% 5 ade $%olid :indy Dewi Aros
- - - - - - - - - -
"#&,2"#
- - - - - - - - - 506,250
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - 506,250
-
7/26/2019 irna april 2012.xls
108/750
-
7/26/2019 irna april 2012.xls
109/750
Ass. O*rt Ass. Anestesi 7A8P armasi ?aborat Radiologi
Aske*
R)angan Adi =)ga%
6,2&"
6",###
- - - 47,265 - - 75,000 - -
2,1#1,2++
6",###
"1,6"#
11,"##
6+,#
++6,"## 1&3,6"# 13#,###
23,6"#
2#,6##
2#,6##
2#,6##
2#,6##
337,500 168,750 180,000 2,101,233 248,400 - 75,000 - -
1&',162
',###
- - - 169,172 - - 9,000 - -
+#3,&1"
13,###
',"##
11,###
6#,##
113,6"#
- - 118,750 308,615 130,900 - 18,000 - -
337,500 168,750 298,750 2,626,285 379,300 - 177,000 - -
-
7/26/2019 irna april 2012.xls
110/750
-
7/26/2019 irna april 2012.xls
111/750
Ari! A!it S)%ati :iwik 5ndra ;ko P Andini Roik%at)l Dewi 4andra $oti/%a
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
-
7/26/2019 irna april 2012.xls
112/750
-
7/26/2019 irna april 2012.xls
113/750
Aisa% Ana ;ny ;ndang Pi*it S)/i Dinda Tika Retno :)lan
- - - - - - - - - -
26,###
- - 27,000 - - - - - - -
1+,"##
- - - - - - - - 13,500 -
- - - - - - - - - -
- - 27,000 - - - - - 13,500 -
-
7/26/2019 irna april 2012.xls
114/750
-
7/26/2019 irna april 2012.xls
115/750
Diet Amb)lan/eR)9)kan ?ain0?ain Total $eringanan DPRawat 5na* ;kstra 77 So*ir
&2,2&"
13#,### 1,###,### @1,###,###
21#,###
22#,###
180,000 - - - - - 1,492,265 (1,000,000) -
2,12&,2++
13#,### 1,###,###
1#",###"1,6"#
11,"##
6+,#
,13#,###
23,6"#
2#,6##
2#,6##
2#,6##
2#,6##
26",###
180,000 - - - - - 7,934,633 - -
13,162
21,### 36,### @36,###
2#,###
+",###
,###
21,000 - - - - - 386,172 (87,000) -
+++,&1"
2,### 16,###
',"##
11,###
6#,##
13#,###
"",###
6#,###
1,2+,6"#
42,000 - - - - - 2,187,265 - -
423,000 - - - - - 12,000,335 (1,087,000) -
00
-
7/26/2019 irna april 2012.xls
116/750
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
117/750
Pi)tang
Jamsostek =arda edika Jamkesmas Jasa Ra%ar9a Reli!e 7ringin
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
-
7/26/2019 irna april 2012.xls
118/750
-
7/26/2019 irna april 2012.xls
119/750
J)mla% 7ayarPos 5ndonesia As)ransi ?ain ybs
&2,2&"
0
21#,###
22#,###
- - - 492,265
2,12&,2++
1,###,###
1#",###"1,6"#
11,"##
6+,#
,13#,###
23,6"#
2#,6##
2#,6##
2#,6##
2#,6##
26",###
- - - 7,934,633
13,162
0
2#,###
+",###
,###
- - - 299,172
+++,&1"
16,###
',"##
11,###
6#,##
13#,###
"",###
6#,###
1,2+,6"#
- - - 2,187,265
- - - 10,913,335
00
-
7/26/2019 irna april 2012.xls
120/750
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
121/750
Rekap Pendapatan Rawat Inap
Maret 2012
4/1/2012
No. Nama Pasien Tindakan Admin JS Ratna
1 Siti N)r%ayati, 7y 1",###
$elas + 2 %ari 2,### 112,###
res)sitasi &,"##
kons)ltasi ",###
17,000 163,500 -
2 Siti N)r%ayati, Ny 2",###
$elas + 2 %ari 2,### 112,###
%bs ag%ematologi r)tin
golongan dara%
laserasi 9alan la%ir ",### 1+",###
kons)ltasi ",### +#,###
(isite ",### +#,###
*er (agin)m #,### "2",###
27,000 767,000 720,000
44,000 930,500 720,000
-
7/26/2019 irna april 2012.xls
122/750
-
7/26/2019 irna april 2012.xls
123/750
okter Obgyn Dokter Anak Dokter 7eda% Dokter 5n
8erlambang -)!rial Ari! 7ambang S 4%anis a9ar -)maro :illy ;ko D9al) 5man Dar9ito
1",###
- - 15,000 - - - - - -
- - - - - - - - -
- - 15,000 - - - - - -
-
7/26/2019 irna april 2012.xls
124/750
-
7/26/2019 irna april 2012.xls
125/750
ternis Dokter =igi Dokter Syara! Anestesi Par) Psiko Rad
aretina Dian : Sangkan a/%ri >er Anton Soemartono Ari! 5r!an Dana Ali*
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
-
7/26/2019 irna april 2012.xls
126/750
-
7/26/2019 irna april 2012.xls
127/750
Dokter >m)m
AnestesiD9alil 7oeing N)rbaity Teg)% 5 ade $%olid :indy Dewi Aros
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
-
7/26/2019 irna april 2012.xls
128/750
-
7/26/2019 irna april 2012.xls
129/750
Ass. O*rt Ass. Anestesi 7A8P armasi ?aborat Radiologi
Aske*
R)angan Adi =)ga%
6&,361
13,###
- - - 76,871 - - 18,000 - -
++,3&
13,###
"1,6"#+&,3##
11,"##
26",+12
- - 275,312 343,486 100,050 - 18,000 - -
- - 275,312 420,357 100,050 - 36,000 - -
-
7/26/2019 irna april 2012.xls
130/750
-
7/26/2019 irna april 2012.xls
131/750
Ari! A!it S)%ati :iwik 5ndra ;ko P Andini Roik%at)l Dewi 4andra $oti/%a
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
-
7/26/2019 irna april 2012.xls
132/750
-
7/26/2019 irna april 2012.xls
133/750
Aisa% Ana ;ny ;ndang Pi*it S)/i Dinda Tika Retno :)lan
1+,"##
- - - - - 13,500 - - - -
- - - - - - - - - -
- - - - - 13,500 - - - -
-
7/26/2019 irna april 2012.xls
134/750
-
7/26/2019 irna april 2012.xls
135/750
Diet Amb)lan/eR)9)kan ?ain0?ain Total $eringanan DPRawat 5na* ;kstra 77 So*ir
'1,361
2,### 16,### @16,###
,###
2#,###
42,000 - - - - - 345,871 (174,000) -
+&3,3&
2,### 16,###
"1,6"#+&,3##
11,"##
13#,###
+",###
+",###
1,##,+12
42,000 - - - - - 2,292,848 - -
84,000 - - - - - 2,638,719 (174,000) -
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
-
7/26/2019 irna april 2012.xls
136/750
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
137/750
Pi)tang
Jamsostek =arda edika Jamkesmas Jasa Ra%ar9a Reli!e 7ringin
- - - - - -
- - - - - -
- - - - - -
-
7/26/2019 irna april 2012.xls
138/750
-
7/26/2019 irna april 2012.xls
139/750
J)mla% 7ayarPos 5ndonesia As)ransi ?ain ybs
'1,361
0
,###
2#,###
- - - 171,871
+&3,3&
16,###
"1,6"#+&,3##
11,"##
13#,###
+",###
+",###
1,##,+12
- - - 2,292,848
- - - 2,464,719
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
-
7/26/2019 irna april 2012.xls
140/750
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
141/750
Rekap Pendapatan Rawat Inap
Maret 2012
4/1/2012
No. Nama Pasien Tindakan Admin JS Ratna
1 R)s*ad, Tn 2",### ",###
$elas 1 1 %ari +,### 1&,###
54> 1 %ari +,### 1&,###
kons)ltasi 1#,###
(isite 1",###
*emasangan katet%er 63,###
e/g &,"##
)re)m
kreatinin
sg*tsgot
gl)kosa sewakt)
%ematologi r)tin
t%ora
RJP 2#6,###
mobil 9enaa%
neb)lier 63,###
31,000 731,500 -
2 ?istiowati, Ny 2#,### ",### "#,###
$elas 1 + %ari ',### +3,###%bs ag
*rotein )rine
)re)m
kreatinin
sg*t
sgot
%ematologi r)tin
golongan dara%
*emasangan katet%er &,"##
laserasi 9alan la%ir ",### 1+",###
*er (agin)m #,### 1,#"#,###
(isite 1",### 1"#,###
29,000 1,149,500 1,385,000
+ ?istiowati, 7y 1",###
$elas 1 2 %ari &,### 2'2,###
res)sitasi 63,###
(isite ",### "#,###
21,000 375,000 50,000
$artika 5ndrasari, 7y 1",###$elas + + %ari +,### 1&3,###
-
7/26/2019 irna april 2012.xls
142/750
(isite 1",###
kons)ltasi ",###
res)sitasi &,"##
18,000 234,500 -
" $artika 5ndra Sari, Ny 2",###
$elas + %ari ,### 22,###
)sg 1",### #,###
%bs ag
golongan dara%
%ematologi r)tin
laserasi 9alan la%ir ",### 1+",###
*er (agin)m #,### "2",###
(isite 2#,### 12#,###
29,000 904,000 820,000
128,000 3,394,500 2,255,000
-
7/26/2019 irna april 2012.xls
143/750
okter Obgyn Dokter Anak Dokter 7eda% Dokter 5n
8erlambang -)!rial Ari! 7ambang S 4%anis a9ar -)maro :illy ;ko D9al) 5man Dar9ito
"#,###
"#,###
- - - - - - - - 100,000
- - - - - - - - -
- - - - - - - - -
-
7/26/2019 irna april 2012.xls
144/750
'#,###
1",###
- - 105,000 - - - - - -
- - - - - - - - -
- - 105,000 - - - - - 100,000
-
7/26/2019 irna april 2012.xls
145/750
ternis Dokter =igi Dokter Syara! Anestesi Par) Psiko Rad
aretina Dian : Sangkan a/%ri >er Anton Soemartono Ari! 5r!an Dana Ali*
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
-
7/26/2019 irna april 2012.xls
146/750
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
-
7/26/2019 irna april 2012.xls
147/750
Dokter >m)m
AnestesiD9alil 7oeing N)rbaity Teg)% 5 ade $%olid :indy Dewi Aros
2",###
-
7/26/2019 irna april 2012.xls
148/750
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - 158,000 25,000 -
-
7/26/2019 irna april 2012.xls
149/750
Ass. O*rt Ass. Anestesi 7A8P armasi ?aborat Radiologi
Aske*
R)angan Adi =)ga%
1,#"#,#2+
1",###
1",###
2#,6##
2#,6##
2#,6##2#,6##
1&,1##
+&,3##
&',###
- - - 1,050,023 135,700 69,000 30,000 - -
#,'+3
",###"1,6"#
',2##
1,##
1,##
1,##
1,##
6+,#
11,"##
,12"
- - 608,125 600,938 311,650 - 45,000 - -
2#,&6&
+#,###
- - - 240,676 - - 30,000 - -
11+,6'' 26,###
-
7/26/2019 irna april 2012.xls
150/750
- - - 113,799 - - 27,000 - -
1#,&'+
+&,###
',"##
11,###
+",2##
26",+12
- - 275,312 410,693 95,700 - 36,000 - -
- - 883,437 2,416,129 543,050 69,000 168,000 - -
-
7/26/2019 irna april 2012.xls
151/750
Ari! A!it S)%ati :iwik 5ndra ;ko P Andini Roik%at)l Dewi 4andra $oti/%a
26,###
1+,"##
26,###
40,500 - - - - - - - 27,000 - -
- - - - - - - - - - -
- - - - - - - - - - -
-
7/26/2019 irna april 2012.xls
152/750
- - - - - - - - - - -
- - - - - - - - - - -
40,500 - - - - - - - 27,000 - -
-
7/26/2019 irna april 2012.xls
153/750
Aisa% Ana ;ny ;ndang Pi*it S)/i Dinda Tika Retno :)lan
- - - - - - - - - -
1+,"##
- - - 13,500 - - - - - -
26,###
- - - - - - - - 27,000 -
-
7/26/2019 irna april 2012.xls
154/750
1+,"##
- - - - - - - - - 13,500
- - - - - - - - - -
- - - 13,500 - - - - 27,000 13,500
-
7/26/2019 irna april 2012.xls
155/750
Diet Amb)lan/eR)9)kan ?ain0?ain Total $eringanan DPRawat 5na* ;kstra 77 So*ir
++,"## 1,1+3,"2+
+&,### 2##,###
+&,### 2##,###
,###
11",###
1#",###
,###
2#,6##
2#,6##
2#,6##2#,6##
1&,1##
+&,3##
&',###
+1",###
"","## "","##
1#",###
72,000 33,500 55,500 - - - 2,558,723 - -
&6",'+3
1#3,### #,###"1,6"#
',2##
1,##
1,##
1,##
1,##
6+,#
11,"##
,###
13#,###
2,2"3,12"
1&",###
108,000 - - - - - 4,250,713 - -
2"",&6&
62,### ##,### @##,###
1#",###
"",###
72,000 - - - - - 815,676 (400,000) -
123,6''&+,### 2&1,### @2&1,###
-
7/26/2019 irna april 2012.xls
156/750
1#",###
2#,###
,###
63,000 - - - - - 574,799 (261,000) -
+",&'+
3,### +3,###
"",###
',"##
11,###
+",2##
13#,###
1,##,+12
1#,###
84,000 - - - - - 2,654,705 - -
399,000 33,500 55,500 - - - 10,854,616 (661,000) -
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
157/750
Pi)tang
Jamsostek =arda edika Jamkesmas Jasa Ra%ar9a Reli!e 7ringin
- - - - - -
- - - - - -
- - - - - -
-
7/26/2019 irna april 2012.xls
158/750
- - - - - -
- - - - - -
- - - - - -
-
7/26/2019 irna april 2012.xls
159/750
J)mla% 7ayarPos 5ndonesia As)ransi ?ain ybs
1,1+3,"2+
2##,###
2##,###
,###
11",###
1#",###
,###
2#,6##
2#,6##
2#,6##2#,6##
1&,1##
+&,3##
&',###
+1",###
"","##
1#",###
- - - 2,558,723
&6",'+3
#,###"1,6"#
',2##
1,##
1,##
1,##
1,##
6+,#
11,"##
,###
13#,###
2,2"3,12"
1&",###
- - - 4,250,713
2"",&6&
0
1#",###
"",###
- - - 415,676
123,6''0
-
7/26/2019 irna april 2012.xls
160/750
1#",###
2#,###
,###
- - - 313,799
+",&'+
+3,###
"",###
',"##
11,###
+",2##
13#,###
1,##,+12
1#,###
- - - 2,654,705
- - - 10,193,616
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
161/750
Rekap Pendapatan Rawat Inap
Maret 2012
4/3/2012
No. Nama Pasien Tindakan Admin JS Ratna
1 Desi, 7y 1",###
$elas 1 %ari 12,### "3,###
(isite 1",###
res)sitasi 63,###
27,000 677,000 -
2 Desi, Ny 2",###
$elas 1 %ari 12,### "3,###
laserasi 9alan la%ir ",### 26#,###%ematologi r)tin
*er (agin)m #,### 1,#"#,###
(isite 1",### 1"#,###
37,000 1,244,000 1,470,000
+ S)yati, Ny 2",### ",###
$elas + 2 %ari 2,### 112,###
kons)ltasi ",###
neb)lier 1+',"##
(isite 1#,###
t%ora%ematologi r)tin
27,000 271,500 -
91,000 2,192,500 1,470,000
-
7/26/2019 irna april 2012.xls
162/750
-
7/26/2019 irna april 2012.xls
163/750
okter Obgyn Dokter Anak Dokter 7eda% Dokter 5n
8erlambang -)!rial Ari! 7ambang S 4%anis a9ar -)maro :illy ;ko D9al) 5man Dar9ito
1"#,###
- - 150,000 - - - - - -
- - - - - - - - -
- - - - - - - - -
- - 150,000 - - - - - -
-
7/26/2019 irna april 2012.xls
164/750
-
7/26/2019 irna april 2012.xls
165/750
ternis Dokter =igi Dokter Syara! Anestesi Par) Psiko Rad
aretina Dian : Sangkan a/%ri >er Anton Soemartono Ari! 5r!an Dana Ali*
- - - - - - - - - -
- - - - - - - - - -
1",###
,###
75,000 - - - - - - - - -
75,000 - - - - - - - - -
-
7/26/2019 irna april 2012.xls
166/750
-
7/26/2019 irna april 2012.xls
167/750
Dokter >m)m
AnestesiD9alil 7oeing N)rbaity Teg)% 5 ade $%olid :indy Dewi Aros
- - - - - - - - - -
- - - - - - - - - -
2",###
25,000 - - - - - - - - -
25,000 - - - - - - - - -
-
7/26/2019 irna april 2012.xls
168/750
-
7/26/2019 irna april 2012.xls
169/750
Ass. O*rt Ass. Anestesi 7A8P armasi ?aborat Radiologi
Aske*
R)angan Adi =)ga%
+++,1#"
,###
- - - 333,105 - - 60,000 - -
,+&
,###
+&,3##
,12"
- - 608,125 460,364 36,800 - 60,000 - -
&3,+
13,###
&&,###+",2##
- - - 468,434 35,200 66,000 18,000 - -
- - 608,125 1,261,903 72,000 66,000 138,000 - -
-
7/26/2019 irna april 2012.xls
170/750
-
7/26/2019 irna april 2012.xls
171/750
Ari! A!it S)%ati :iwik 5ndra ;ko P Andini Roik%at)l Dewi 4andra $oti/%a
- - - - - - - - - - -
- - - - - - - - - - -
26,### 1+,"##
- - - - - - - - 27,000 - 13,500
- - - - - - - - 27,000 - 13,500
-
7/26/2019 irna april 2012.xls
172/750
-
7/26/2019 irna april 2012.xls
173/750
Aisa% Ana ;ny ;ndang Pi*it S)/i Dinda Tika Retno :)lan
26,###
- - - - 27,000 - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - 27,000 - - - - -
-
7/26/2019 irna april 2012.xls
174/750
-
7/26/2019 irna april 2012.xls
175/750
Diet Amb)lan/eR)9)kan ?ain0?ain Total $eringanan DPRawat 5na* ;kstra 77 So*ir
+3,1#"
1,### 3##,### @3##,###
1&",###
1#",###
144,000 - - - - - 1,418,105 (800,000) -
3",+&
1,### 3##,###
+1",###+&,3##
2,2"3,12"
1&",###
144,000 - - - - - 4,060,289 - -
"2+,+ @2",###
2,### 16,###
2#,###
13#,###
6#,###
&&,###+",2##
42,000 - - - - - 1,068,634 (25,000) -
330,000 - - - - - 6,547,028 (825,000) -
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
-
7/26/2019 irna april 2012.xls
176/750
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
177/750
Pi)tang
Jamsostek =arda edika Jamkesmas Jasa Ra%ar9a Reli!e 7ringin
- - - - - -
- - - - - -
1,#+2,#3+
1,032,083 - - - - -
1,032,083 - - - - -
-
7/26/2019 irna april 2012.xls
178/750
-
7/26/2019 irna april 2012.xls
179/750
J)mla% 7ayarPos 5ndonesia As)ransi ?ain ybs
+3,1#"
0
1&",###
1#",###
- - - 618,105
3",+&
3##,###
+1",###+&,3##
2,2"3,12"
1&",###
- - - 4,060,289
'3,+
16,###
@1,#12,#3+
13#,###
6#,###
&&,###+",2##
- - - 11,551
- - - 4,689,945
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
-
7/26/2019 irna april 2012.xls
180/750
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
181/750
Rekap Pendapatan Rawat Inap
Maret 2012
4/4/2012
No. Nama Pasien Tindakan Admin JS Ratna
1 Sri )lyatin, Ny 2#,### ",### "#,###
$elas B5P 2 %ari 3,### "##,###
)sg 1",### #,###
k)retase dengan narkose 1##,### 1,#"#,###
(isite 1#,### 12#,###
28,000 630,000 1,260,000
2 Riski Ana, Nn 2",### ",###
$elas 2 & %ari 12,### 3#,###kons)ltasi ",###
(isite +#,###
%ematologi r)tin
37,000 520,000 -
+ Siti $arisa%, Ny 2",### ",###
$elas 2 %ari 3,### +2#,###
e/g 62,###
kons)ltasi ",###
(isite 2#,###
gl)kosa sewakt)%ematologi r)tin
t%ora
33,000 422,000 -
Tarni, Ny 2",### ",###
$elas + %ari ,### 22,###
)re)m
kreatinin
sg*t
sgot
gl)kosa sewakt)
%ematologi r)tin
(isite 2#,###
kons)ltasi 1#,###
29,000 259,000 -
" Akil Aril A!andi, An 1",###
$elas 1 + %ari ',### +3,###
kons)ltasi 1#,###
(isite 1",###
o*erasi %erniatomy in/ar/erata '##,###
-
7/26/2019 irna april 2012.xls
182/750
24,000 1,363,000 -
151,000 3,194,000 1,260,000
-
7/26/2019 irna april 2012.xls
183/750
-
7/26/2019 irna april 2012.xls
184/750
okter Obgyn Dokter Anak Dokter 7eda% Dokter 5n
8erlambang -)!rial Ari! 7ambang S 4%anis a9ar -)maro :illy ;ko D9al) 5man Dar9ito
- - - - - - - - -
- - - - - - - - -
2#,###
1,###
- - - - - - - - 180,000
'#,###
+#,###
- - - - - - - - 120,000
2",###
1##,###
2,#2",###
-
7/26/2019 irna april 2012.xls
185/750
- - - - - 2,150,000 - - -
- - - - - 2,150,000 - - 300,000
-
7/26/2019 irna april 2012.xls
186/750
-
7/26/2019 irna april 2012.xls
187/750
ternis Dokter =igi Dokter Syara! Anestesi Par) Psiko
aretina Dian : Sangkan a/%ri >er Anton Soemartono Ari! 5r!an Dana
- - - - - - - - -
2#,###
2#,###
260,000 - - - - - - - -
- - - - - - - - -
- - - - - - - - -
-
7/26/2019 irna april 2012.xls
188/750
- - - - - - 75,000 - -
260,000 - - - - - 75,000 - -
-
7/26/2019 irna april 2012.xls
189/750
-
7/26/2019 irna april 2012.xls
190/750
Rad Dokter >m)m
AnestesiAli* D9alil 7oeing N)rbaity Teg)% 5 ade $%olid :indy Dewi Aros
1"6,"##
- - - - - - - - - - 157,500
2",###
- - - - - - 25,000 - - - -
2",###
- - - - - - - - - 25,000 -
2",###
1",###
- - - - - 25,000 - - - 15,000 -
,"##
-
7/26/2019 irna april 2012.xls
191/750
- - - - - - - - - - 607,500
- - - - - 25,000 25,000 - - 40,000 765,000
-
7/26/2019 irna april 2012.xls
192/750
-
7/26/2019 irna april 2012.xls
193/750
Ass. O*rt Ass. Anestesi 7A8P armasi ?aborat Radiologi
Aske*
R)angan Adi =)ga%
&,"1&
+&,###
"+6,"##
- - 537,500 464,516 - - 36,000 - -
1,+#",112
62,###
211,2##
- - - 1,305,112 211,200 - 72,000 - -
"66,6&
3,###
1",##+",2##
&&,###
- - - 577,764 50,600 66,000 48,000 - -
1,26",&6
+&,###
2#,6##
2#,6##
2#,6##
2#,6##
&,'##
+&,3##
- - - 1,275,647 166,500 - 36,000 - -
&+6,2&'
",###
#",### 2#2,"##
-
7/26/2019 irna april 2012.xls
194/750
405,000 202,500 - 637,269 - - 45,000 - -
405,000 202,500 537,500 4,260,308 428,300 66,000 237,000 - -
-
7/26/2019 irna april 2012.xls
195/750
-
7/26/2019 irna april 2012.xls
196/750
Ari! A!it S)%ati :iwik 5ndra ;ko P Andini Roik%at)l Dewi 4andra $oti/%a
- - - - - - - - - - -
- - - - - - - - - - -
',### ',###
9,000 - - - - 9,000 - - - - -
- - - - - - - - - - -
-
7/26/2019 irna april 2012.xls
197/750
- - - - - - - - - - -
9,000 - - - - 9,000 - - - - -
-
7/26/2019 irna april 2012.xls
198/750
-
7/26/2019 irna april 2012.xls
199/750
Aisa% Ana ;ny ;ndang Pi*it S)/i Dinda Tika Retno :)lan
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
-
7/26/2019 irna april 2012.xls
200/750
- - - - - - - - - -
- - - - - - - - - -
-
7/26/2019 irna april 2012.xls
201/750
-
7/26/2019 irna april 2012.xls
202/750
Diet Amb)lan/eR)9)kan ?ain0?ain Total $eringanan DPRawat 5na* ;kstra 77 So*ir
2#,### 616,#1&
'#,### &+,### @'",1##
"",###
1,&36,"##
1+#,###
90,000 20,000 - - - - 3,223,516 (95,100) -
1,+,112
13#,### 6,###2",###
26#,###
211,2##
180,000 - - - - - 2,610,312 - -
&+2,6&
12#,### '&,###
'#,###
2",###
13#,###
1",##+",2##
&&,###
120,000 - - - - - 1,540,364 - -
1,++#,&6
3,### +3,###
2#,6##
2#,6##
2#,6##
2#,6##
&,'##
+&,3##
12",###
#,###
84,000 - - - - - 2,010,147 - -
&"2,2&' @1",###
1#3,### #,###
,###
1&",###
,1#,###
-
7/26/2019 irna april 2012.xls
203/750
108,000 - - - - - 5,617,269 (15,000) -
582,000 20,000 - - - - 15,001,608 (110,100) -
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
-
7/26/2019 irna april 2012.xls
204/750
-
7/26/2019 irna april 2012.xls
205/750
Pi)tang
Jamsostek =arda edika Jamkesmas Jasa Ra%ar9a Reli!e 7ringin
- - - - - -
- - - - - -
- - - - - -
- - - - - -
,1#2,2&'
-
7/26/2019 irna april 2012.xls
206/750
4,102,269 - - - - -
4,102,269 - - - - -
-
7/26/2019 irna april 2012.xls
207/750
-
7/26/2019 irna april 2012.xls
208/750
J)mla% 7ayarPos 5ndonesia As)ransi ?ain ybs
616,#1&
"+3,'##
"",###
1,&36,"##
1+#,###
- - - 3,128,416
1,+,112
6,###2",###
26#,###
211,2##
- - - 2,610,312
&+2,6&
'&,###
'#,###
2",###
13#,###
1",##+",2##
&&,###
- - - 1,540,364
1,++#,&6
+3,###
2#,6##
2#,6##
2#,6##
2#,6##
&,'##
+&,3##
12",###
#,###
- - - 2,010,147
&+6,2&'
@+,"#2,2&'
,###
1&",###
,1#,###
-
7/26/2019 irna april 2012.xls
209/750
- - - 1,500,000
- - - 10,789,239
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
-
7/26/2019 irna april 2012.xls
210/750
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
211/750
Rekap Pendapatan Rawat Inap
Maret 2012
4/5/2012
No. Nama Pasien Tindakan Admin JS Ratna
1 Akil Aril A!!andi, An DP *asien
- - -
2 :iwin Triana, Ny 2#,### ",### "#,###
$elas 2 2 %ari ,### 1,###
b)sinasiClaminaria 1",### ,###
kons)ltasi ",### #,###
k)retase dengan narkose 1##,### #,###
%bs ag%ematologi r)tin
golongan dara%
(isite ",### #,###
24,000 290,000 790,000
+ Se*tiana, Ny 2",###
$elas + 1 %ari 1,### "&,###
%ematologi r)tin
laserasi 9alan la%ir ",### 1+",###
*er (agin)m #,### "2",###
(isite ",### +#,###
26,000 706,000 690,000
Se*tiana, 7y 1",###
$elas + 1 %ari 1,### "&,###
(isite ",###
res)sitasi &,"##
16,000 107,500 -
" O*i Ria Dini, Ny 2",###
$elas + " %ari ",### 23#,###
)sg 1",### #,###
%ematologi r)tin
*emasangan katet%er &,"##
se/tio /aesaria 1,+##,### 3+,6"#
(isite 2#,### 12#,###
30,000 1,661,500 1,003,750
& O*i Ria Dini, 7y 1",###
$elas + " %ari ",### 23#,###
(isite 2#,###res)sitasi +#,###
-
7/26/2019 irna april 2012.xls
212/750
20,000 330,000 -
6 Sa*)ro%, Ny 2",### ",###
$elas + 1 %ari 1,### "&,###
54> 2 %ari &,### 2'2,###
(isite 6#,###
t%ora
e/g 66,2"#
*)nksiCirigasi *le)ra ,###
tindakan neb)lier "11,"##
(ert t%orakal
kreatinin
)re)m
sg*t
sgot
%ematologi r)tin
gl)kosa sewakt)kons)ltasi 1",###
mobil 9enaa%
*emasangan wsd ",###
32,000 1,131,750 -
148,000 4,226,750 2,483,750
-
7/26/2019 irna april 2012.xls
213/750
okter Obgyn Dokter Anak Dokter 7eda% Dokter 5n
8erlambang -)!rial Ari! 7ambang S 4%anis a9ar -)maro :illy ;ko D9al) 5man Dar9ito
- - - - - - - - -
- - - - - - - - -
- - - - - - - - -
+#,###
- - 30,000 - - - - - -
- - - - - - - - -
12#,###'#,###
-
7/26/2019 irna april 2012.xls
214/750
- - 210,000 - - - - - -
1##,###
2",###
26#,###
- - - - - 395,000 - - -
- - 240,000 - - 395,000 - - -
-
7/26/2019 irna april 2012.xls
215/750
ternis Dokter =igi Dokter Syara! Anestesi Par) Psiko Rad
aretina Dian : Sangkan a/%ri >er Anton Soemartono Ari! 5r!an Dana Ali*
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
-
7/26/2019 irna april 2012.xls
216/750
- - - - - - - - - -
2"#,###
13#,###
#,###
470,000 - - - - - - - - -
470,000 - - - - - - - - -
-
7/26/2019 irna april 2012.xls
217/750
Dokter >m)m
AnestesiD9alil 7oeing N)rbaity Teg)% 5 ade $%olid :indy Dewi Aros
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
2"+,12"
- - - - - - - - - 253,125
-
7/26/2019 irna april 2012.xls
218/750
- - - - - - - - - -
2",###
2",### +#,### +#,###
- 25,000 - - 30,000 25,000 - - 30,000 -
- 25,000 - - 30,000 25,000 - - 30,000 253,125
-
7/26/2019 irna april 2012.xls
219/750
Ass. O*rt Ass. Anestesi 7A8P armasi ?aborat Radiologi
Aske*
R)angan Adi =)ga%
- - - - - - - - -
'#,### "22,111
2,###
',"##+",2##
11,###
- 90,000 - 522,111 95,700 - 24,000 - -
+6#,&1"
',###
+",2##
113,6"#
- - 118,750 370,615 35,200 - 9,000 - -
11",&16
',###
- - - 115,617 - - 9,000 - -
1,12,22
",###
+",2##
1&3,6"# 3,+6" 13#,###
168,750 84,375 180,000 1,412,242 35,200 - 45,000 - -
116,#6#
",###
-
7/26/2019 irna april 2012.xls
220/750
- - - 117,070 - - 45,000 - -
+,&+&,+#
',###
+#,###
&&,###
1",###
1',3##
1',3##
1',3##
1',3##
+",2##
1",##
1+",###
- - 135,000 3,636,430 129,800 220,000 39,000 - -
168,750 174,375 433,750 6,174,085 295,900 220,000 171,000 - -
-
7/26/2019 irna april 2012.xls
221/750
Ari! A!it S)%ati :iwik 5ndra ;ko P Andini Roik%at)l Dewi 4andra $oti/%a
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
-
7/26/2019 irna april 2012.xls
222/750
- - - - - - - - - - -
1+,"##
26,### 26,### ",###
- - - - - - - - 27,000 40,500 54,000
- - - - - - - - 27,000 40,500 54,000
-
7/26/2019 irna april 2012.xls
223/750
Aisa% Ana ;ny ;ndang Pi*it S)/i Dinda Tika Retno :)lan
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
1+,"##
- - - - - - - - 13,500 -
1+,"##
- - - - - 13,500 - - - -
-
7/26/2019 irna april 2012.xls
224/750
- - - - - - - - - -
&,6"#
#,"##
- 47,250 - - - - - - - -
- 47,250 - - - 13,500 - - 13,500 -
-
7/26/2019 irna april 2012.xls
225/750
Diet Amb)lan/eR)9)kan ?ain0?ain Total $eringanan DPRawat 5na* ;kstra 77 So*ir
0 1,"##,###
- - - - - - - - 1,500,000
&36,111
,### 23,###
6",###
",###
6##,###
',"##+",2##
11,###
",###
60,000 - - - - - 1,895,811 - -
+'",&1"
21,### 36,###
+",2##
13#,###
1,2+,6"#
+",###
21,000 - - - - - 1,976,565 - -
1+#,&16
21,### 36,### @36,###
+",###
,###
21,000 - - - - - 312,617 (87,000) -
1,+6,22
1#",### +",###
"",###
+",2##
,###
2,3+#,###
1#,###
105,000 - - - - - 4,992,442 - -
1+2,#6#
1#",### +",### @+",###
1#,###12#,###
-
7/26/2019 irna april 2012.xls
226/750
105,000 - - - - - 827,070 (435,000) -
++,"## +,62,'+# @2",###
21,### 36,###
62,### ##,###
"#",###
&&,###
'6,"##
2#,###
&,###
1",###
1',3##
1',3##
1',3##
1',3##
+",2##
1",##3#,###
"","## "","##
"#,###
93,000 33,500 55,500 - - - 6,649,730 (25,000) -
405,000 33,500 55,500 - - - 16,654,235 (547,000) 1,500,000
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
227/750
Pi)tang
Jamsostek =arda edika Jamkesmas Jasa Ra%ar9a Reli!e 7ringin
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
-
7/26/2019 irna april 2012.xls
228/750
- - - - - -
",&+2,&2#
5,632,620 - - - - -
5,632,620 - - - - -
-
7/26/2019 irna april 2012.xls
229/750
J)mla% 7ayarPos 5ndonesia As)ransi ?ain ybs
1,"##,###
- - - 1,500,000
&36,111
23,###
6",###
",###
6##,###
',"##+",2##
11,###
",###
- - - 1,895,811
+'",&1"
36,###
+",2##
13#,###
1,2+,6"#
+",###
- - - 1,976,565
1+#,&16
0
+",###
,###
- - - 225,617
1,+6,22
+",###
"",###
+",2##
,###
2,3+#,###
1#,###
- - - 4,992,442
1+2,#6#
0
1#,###12#,###
-
7/26/2019 irna april 2012.xls
230/750
- - - 392,070
@1,'+2,&'#
36,###
##,###
"#",###
&&,###
'6,"##
2#,###
&,###
1",###
1',3##
1',3##
1',3##
1',3##
+",2##
1",##3#,###
"","##
"#,###
- - - 992,110
- - - 11,974,615
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
231/750
-
7/26/2019 irna april 2012.xls
232/750
golongan dara%
28,000 203,000 130,000
& S)giarsi%, Ny
$elas + " %ari ",### 23#,###
se/tio /aesaria 1,###,### '##,###
res)sitasi
(isite ",### 1"#,###
*aket s/
dil)ar *aket s/
5,000 1,325,000 1,050,000
147,000 4,519,500 2,082,500
-
7/26/2019 irna april 2012.xls
233/750
okter Obgyn Dokter Anak Dokter 7eda%
8erlambang -)!rial Ari! 7ambang S 4%anis a9ar -)maro :illy ;ko D9al)
"#,###
1#,###
- - 190,000 - - - - -
2#,###
23#,###
- - - - 300,000 - - -
- - - - - - - -
+#,###
- - 30,000 - - - - -
-
7/26/2019 irna april 2012.xls
234/750
- - - - - - - -
3#,###
12#,###
- - 200,000 - - - - -
- - 420,000 - 300,000 - - -
-
7/26/2019 irna april 2012.xls
235/750
Dokter 5nternis Dokter =igi Dokter Syara! Anestesi Par)
5man Dar9ito aretina Dian : Sangkan a/%ri >er Anton Soemartono Ari! 5r!an
- - - - - - - - -
- - - - - - - - -
- - - - - - - - -
- - - - - - - - -
-
7/26/2019 irna april 2012.xls
236/750
- - - - - - - - -
- - - - - - - - -
- - - - - - - - -
-
7/26/2019 irna april 2012.xls
237/750
Psiko Rad Dokter >m)m
Dana Ali* D9alil 7oeing N)rbaity Teg)% 5 ade $%olid :indy Dewi Aros
- - - - - - - - - - -
2",###
- - - - - - - 25,000 - - -
- - - - - - - - - - -
- - - - - - - - - - -
2",###
-
7/26/2019 irna april 2012.xls
238/750
- - - 25,000 - - - - - - -
- - - - - - - - - - -
- - - 25,000 - - - 25,000 - - -
-
7/26/2019 irna april 2012.xls
239/750
Anestesi Ass. O*rt Ass. Anestesi 7A8P armasi ?aborat Radiologi
Aske*
R)angan Adi
1,#1',6
&+,###
12,"##
+6,"##
#,###
- - - - 1,019,744 90,000 - 63,000 -
1,#2#,6+2 3,###
2&,##
++,###
3,3##
1+,2##
- - - - 1,020,732 301,400 - 84,000 -
#',21"
26,###1#1,2"# &6,"## ++,6"#
6#,##
26",+12
',"##
11,###
101,250 67,500 33,750 275,312 409,215 130,900 - 27,000 -
3',2+"
13,###
- - - - 89,235 - - 18,000 -
23',322
26,###
',"##+",2##
-
7/26/2019 irna april 2012.xls
240/750
11,###
- - - - 289,822 95,700 - 27,000 -
",###
2"#,### 12",### 6",###
1,###,### '',###
&1+,2"
250,000 125,000 75,000 - 1,613,254 99,000 - 45,000 -
351,250 192,500 108,750 275,312 4,442,002 717,000 - 264,000 -
-
7/26/2019 irna april 2012.xls
241/750
=)ga% Ari! A!it S)%ati :iwik 5ndra ;ko P Andini Roik%at)l Dewi 4andra
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
-
7/26/2019 irna april 2012.xls
242/750
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
-
7/26/2019 irna april 2012.xls
243/750
$oti/%a Aisa% Ana ;ny ;ndang Pi*it S)/i Dinda Tika Retno :)lan
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
1+,"##
- - - - - - - 13,500 - - -
-
7/26/2019 irna april 2012.xls
244/750
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - 13,500 - - -
-
7/26/2019 irna april 2012.xls
245/750
Diet Amb)lan/eR)9)kan ?ain0?ain Total $eringanan DPRawat 5na* ;kstra 77 So*ir
+",### 1,12',6
1&",### 1,1+,### @161,"#
12,"##
1"#,###
+6,"##
#,###
165,000 35,000 - - - - 2,512,744 (171,450) -
1,#6#,6+221#,### 3&3,###
2",###
2&,##
+1",###
++,###
3,3##
1+,2##
210,000 - - - - - 2,580,132 - -
+,21"
&+,### 2&1,###62#,###
"",###
6#,##
1,##,+12
1#",###
2#,###
',"##
11,###
63,000 - - - - - 3,346,427 - -
1#,2+"
2,### 16,### @16,###
,###
+",###
42,000 - - - - - 373,235 (174,000) -
+,322
&+,### 2&1,###
"",###
1#",###
',"##+",2##
-
7/26/2019 irna april 2012.xls
246/750
11,###
63,000 - - - - - 861,522 - -
0
1#",### +",###
2,+"#,###
3#,###
+1",###
1,#'',###
&1+,2"
105,000 - - - - - 4,892,254 - -
648,000 35,000 - - - - 14,566,314 (345,450) -
0
0
00
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
247/750
Pi)tang
Jamsostek =arda edika Jamkesmas Jasa Ra%ar9a Reli!e 7ringin
- - - - - -
- - - - - -
- - - - - -
- - - - - -
-
7/26/2019 irna april 2012.xls
248/750
- - - - - -
- - - - - -
- - - - - -
-
7/26/2019 irna april 2012.xls
249/750
J)mla% 7ayarPos 5ndonesia As)ransi ?ain ybs
1,12',6
'61,""#
12,"##
1"#,###
+6,"##
#,###
- - - 2,341,294
1,#6#,6+23&3,###
2",###
2&,##
+1",###
++,###
3,3##
1+,2##
- - - 2,580,132
+,21"
2&1,###62#,###
"",###
6#,##
1,##,+12
1#",###
2#,###
',"##
11,###
- - - 3,346,427
1#,2+"
0
,###
+",###
- - - 199,235
+,322
2&1,###
"",###
1#",###
',"##+",2##
-
7/26/2019 irna april 2012.xls
250/750
11,###
- - - 861,522
0
+",###
2,+"#,###
3#,###
+1",###
1,#'',###
&1+,2"
- - - 4,892,254
- - - 14,220,864
0
0
00
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
251/750
Rekap Pendapatan Rawat Inap
Maret 2012
4/7/2012
No. Nama Pasien Tindakan Admin JS Ratna
1 Na(ida%, Ny 1",###
$elas BB5P %ari 2#,### 1,2##,###
(isite 1#,### 1#,###
*emasangan katet%er '',###
*erineora*%y "#,### '##,###
%bs ag
%ematologi r)tin
golongan dara%
b)sinasiClaminaria 1",### 12#,###
%ysteora*%y '##,### 1,3##,###k)retaseCdiratase narkose dengan n "#,### '##,###
35,000 3,124,000 3,860,000
2 ark%at)n, Ny
$elas + %ari ,### 22,###
se/tio /aesaria 1,###,### '##,###
res)sitasi
*aket s/
dil)ar *aket s/
(isite +",### 12#,###
4,000 1,259,000 1,020,000
39,000 4,383,000 4,880,000
-
7/26/2019 irna april 2012.xls
252/750
-
7/26/2019 irna april 2012.xls
253/750
okter Obgyn Dokter Anak Dokter 7eda% Dokter 5n
8erlambang -)!rial Ari! 7ambang S 4%anis a9ar -)maro :illy ;ko D9al) 5man Dar9ito
- - - - - - - - -
3#,###
'#,###
- - 170,000 - - - - - -
- - 170,000 - - - - - -
-
7/26/2019 irna april 2012.xls
254/750
-
7/26/2019 irna april 2012.xls
255/750
ternis Dokter =igi Dokter Syara! Anestesi Par) Psiko Rad
aretina Dian : Sangkan a/%ri >er Anton Soemartono Ari! 5r!an Dana Ali*
- - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - -
-
7/26/2019 irna april 2012.xls
256/750
-
7/26/2019 irna april 2012.xls
257/750
Dokter >m)m
AnestesiD9alil 7oeing N)rbaity Teg)% 5 ade $%olid :indy Dewi Aros
26#,###
"#,###26#,###
- - - - - - - - - 1,080,000
2"#,###
- - - - - - - - - 250,000
- - - - - - - - - 1,330,000
-
7/26/2019 irna april 2012.xls
258/750
-
7/26/2019 irna april 2012.xls
259/750
Ass. O*rt Ass. Anestesi 7A8P armasi ?aborat Radiologi
Aske*
R)angan Adi =)ga%
+,#63,"#'
3,###
13#,### '#,###
"&,2"#
#,###
12,"##
+,### 13#,###13#,### '#,###
720,000 360,000 - 3,078,509 108,750 - 84,000 - -
+&,###
12",### 6",###
1,###,### '',###
1+1,#&1
125,000 75,000 - 1,131,061 99,000 - 36,000 - -
845,000 435,000 - 4,209,570 207,750 - 120,000 - -
-
7/26/2019 irna april 2012.xls
260/750
-
7/26/2019 irna april 2012.xls
261/750
Ari! A!it S)%ati :iwik 5ndra ;ko P Andini Roik%at)l Dewi 4andra $oti/%a
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
-
7/26/2019 irna april 2012.xls
262/750
-
7/26/2019 irna april 2012.xls
263/750
Aisa% Ana ;ny ;ndang Pi*it S)/i Dinda Tika Retno :)lan
+&,###
- - - 36,000 - - - - - -
- - - - - - - - - -
- - - 36,000 - - - - - -
-
7/26/2019 irna april 2012.xls
264/750
-
7/26/2019 irna april 2012.xls
265/750
Diet Amb)lan/eR)9)kan ?ain0?ain Total $eringanan DPRawat 5na* ;kstra 77 So*ir
+&,### +,12',"#'
22#,### 1,"2,### @223,#
1"#,###
1+",###
1,3'#,###
"&,2"#
#,###
12,"##
1+",###
+,63#,###1,3'#,###
220,000 36,000 - - - - 12,742,259 (228,600) -
0
3,### +3,###
2,+"#,###
3#,###
1,#'',###
1+1,#&1
2",###
84,000 - - - - - 4,253,061 - -
304,000 36,000 - - - - 16,995,320 (228,600) -
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
-
7/26/2019 irna april 2012.xls
266/750
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
7/26/2019 irna april 2012.xls
267/750
Pi)tang
Jamsostek =arda edika Jamkesmas Jasa Ra%ar9a Reli!e 7ringin
- - - - - -
- - - - - -
- - - - - -
-
7/26/2019 irna april 2
