| No. | No. Nota | No. Billing | No. RM | Nama Pasien | Nama Dokter | Kode Item | Nama Item | Harga | Jumlah | Total Harga | Status Eksekusi | Lokasi Eksekusi |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | REF20260121000001 | BIL20260121000001 | MR000001 | test_20260121x | Leonysa | A02 | Biaya Pendaftaran Rawat Jalan | 50.000 | 1 | 50.000 | ||
| 2 | REF20260121000001 | BIL20260121000001 | MR000001 | test_20260121x | Leonysa | A03 | Biaya Kartu Pasien | 20.000 | 1 | 20.000 | ||
| 3 | REF20260121000001 | BIL20260121000001 | MR000001 | test_20260121x | Leonysa | D000131 | Biaya dr. Umum | 50.000 | 1 | 50.000 |