Download - Survei Harian Pasien Rawat Jalan BPJS IGD Per Mei Untuk Program

Lembar Kendali ManualCatatan Harin Pasien BPJS Rawat Jalan IGDBulanTahun2015Nama Dokter Umum:dr. Josepb SimarmataNo.Tanggal/ShiftIdentitas PasienDiagnosaTotal KlaimPotongan-PotonganNo. RMNamaDiagnosa Penyakit ICD XTindakanICD IXLaboratoriumRadiologiKonsul Spesialis101/05/2015, sore030336tn. AmadFaringitisj00133,800111Keterangan Pengisian:2045609tn. AndiBPH, Retensi Urinn40, r 33kateter57.94229600100Kolom Laboratorium:3025608tn dionasmaj45.9nebu93.94249,3000001= ada pemerriksaan lab; 0 = tidak ada pemeriksaan lab'4034568NY. AMINBDPz36.8148,8000005Kolom Radiologi:60= tidak ada periksa; 1 = x-ray; 2= usg, 3=CT Scan78Konsul Spesialis90=tidak konsul; 1=Konsul101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869707172737475

Program Kendali ManualCatatan Harin Pasien BPJS Rawat Jalan IGDBulanMeiTahun2015Nama Dokter Umum:dr. Josepb SimarmataNo.Tanggal/ShiftIdentitas PasienDiagnosaTotal KlaimJasa Awal DUPotongan-PotonganJasa Akhir DUNo. RMNamaDiagnosa Penyakit ICD XTindakanICD IXLaboratoriumRadiologiKonsul Spesialis101/05/2015, sore030336tn. AmadFaringitisj0000Rp133,800.00Rp24,084.00Rp4,816.80Rp7,225.20Rp4,816.80Rp7,225.20212/31/99045609tn. AndiBPH, Retensi Urinn40, r 33kateter57.94Rp229,600.00Rp41,328.00Rp8,265.60Rp0.00Rp0.00Rp33,062.40312/31/99025608tn dionasmaj45.9nebu93.94Rp249,300.00Rp44,874.00Rp0.00Rp0.00Rp0.00Rp44,874.00412/31/99034568NY. AMINBDPz36.800Rp148,800.00Rp26,784.00Rp0.00Rp0.00Rp0.00Rp26,784.00512/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00612/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00712/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00812/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00912/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.001012/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.001112/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.001212/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.001312/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.001412/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.001512/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.001612/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.001712/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.001812/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.001912/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.002012/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.002112/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.002212/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.002312/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.002412/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.002512/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.002612/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.002712/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.002812/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.002912/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.003012/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.003112/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.003212/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.003312/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.003412/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.003512/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.003612/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.003712/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.003812/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.003912/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.004012/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.004112/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.004212/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.004312/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.004412/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.004512/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.004612/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.004712/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.004812/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.004912/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.005012/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.005112/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.005212/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.005312/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.005412/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.005512/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.005612/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.005712/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.005812/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.005912/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.006012/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.006112/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.006212/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.006312/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.006412/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.006512/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.006612/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.006712/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.006812/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.006912/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.007012/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.007112/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.007212/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.007312/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.007412/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.007512/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.0012/31/99000000Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Rp0.00Total Jasa Akhir Dokter UmumRp111,945.60

Sheet2

Sheet3