📄 rkqkfkb(2006-08-31).htm
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<title>上传数据入库情况反馈表</title>
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上传数据入库情况反馈表</span>
<br>
<br>
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<td colspan="2">
<p align="left"> 医疗机构名称：朝阳医院</p>
</td>
</tr>
<tr>
<td width="80%">
<p align="left"> 打包日期：2006-08-31</p>
</td>
<td>（单位：元） </td>
</tr>
</table>
<table width="640" align="center" border="1" borderColorDark="#ffffff" borderColorLight="#aaaaaa" cellPadding="1" cellSpacing="0"><tr><td colspan="8" bgcolor='#dddddd'>
<p align="left">参保人报销地区：东城区</p>
</td></tr><tr>
<th width='30'>序号</th>
<th width='30'>类别</th>
<th width='150'>交易流水号</th>
<th width='65'>姓名</th>
<th width='90'>卡号/<br>手册号</th>
<th width='75'>费用<br>总金额</th>
<th width='65'>入库情况</th>
<th width='135'>拒付原因</th>
</tr><tr>
<td>1</td>
<td>公疗</td>
<td>05110001A06083043696</td>
<td>孙志青</td>
<td>00000693200G</td>
<td>18203.86</td>
<td>全额拒付</td>
<td>
<p align="left">交易流水号重复。</p>
</td>
</tr>
<tr>
<td colspan="5">
<p align="left">小计：1人次</p>
</td>
<td>18203.86</td>
<td> </td><td> </td>
</tr><tr><td colspan="8" bgcolor='#dddddd'>
<p align="left">参保人报销地区：西城区</p>
</td></tr><tr>
<th width='30'>序号</th>
<th width='30'>类别</th>
<th width='150'>交易流水号</th>
<th width='65'>姓名</th>
<th width='90'>卡号/<br>手册号</th>
<th width='75'>费用<br>总金额</th>
<th width='65'>入库情况</th>
<th width='135'>拒付原因</th>
</tr><tr>
<td>1</td>
<td>生育</td>
<td>05110001A06083143954</td>
<td>赵爱华</td>
<td>10042119200S</td>
<td>3800</td>
<td>全额拒付</td>
<td>
<p align="left">交易流水号重复。</p>
</td>
</tr>
<tr>
<td colspan="5">
<p align="left">小计：1人次</p>
</td>
<td>3800</td>
<td> </td><td> </td>
</tr><tr><td colspan="8" bgcolor='#dddddd'>
<p align="left">参保人报销地区：朝阳区</p>
</td></tr><tr>
<th width='30'>序号</th>
<th width='30'>类别</th>
<th width='150'>交易流水号</th>
<th width='65'>姓名</th>
<th width='90'>卡号/<br>手册号</th>
<th width='75'>费用<br>总金额</th>
<th width='65'>入库情况</th>
<th width='135'>拒付原因</th>
</tr><tr>
<td>1</td>
<td>公疗</td>
<td>05110001A06082843323</td>
<td>汪育森</td>
<td>00000053300G</td>
<td>9731.87</td>
<td>全额拒付</td>
<td>
<p align="left">交易流水号重复。</p>
</td>
</tr>
<tr>
<td>2</td>
<td>公疗</td>
<td>05110001A06083043700</td>
<td>吴克让</td>
<td>00000130800G</td>
<td>6774.56</td>
<td>全额拒付</td>
<td>
<p align="left">交易流水号重复。</p>
</td>
</tr>
<tr>
<td>3</td>
<td>公疗</td>
<td>05110001A06083043719</td>
<td>汪惠珊</td>
<td>00000127600G</td>
<td>6702.31</td>
<td>全额拒付</td>
<td>
<p align="left">交易流水号重复。</p>
</td>
</tr>
<tr>
<td>4</td>
<td>公疗</td>
<td>05110001A06083043768</td>
<td>梁文华</td>
<td>00000124000G</td>
<td>11693.01</td>
<td>全额拒付</td>
<td>
<p align="left">交易流水号重复。</p>
</td>
</tr>
<tr>
<td>5</td>
<td>公疗</td>
<td>05110001A06083143944</td>
<td>常英瑜</td>
<td>00000047300G</td>
<td>34248.67</td>
<td>全额拒付</td>
<td>
<p align="left">交易流水号重复。</p>
</td>
</tr>
<tr>
<td>6</td>
<td>普通</td>
<td>05110001A06082843380</td>
<td>徐宝建</td>
<td>10268515800S</td>
<td>3156.81</td>
<td>全额拒付</td>
<td>
<p align="left">自动二次审核－－肾移植末次手术日期或定额管理开始日期错误</p>
</td>
</tr>
<tr>
<td>7</td>
<td>普通</td>
<td>0511000106083103861B</td>
<td>安金灵</td>
<td>10213808700S</td>
<td>33510.28</td>
<td>审核状态</td>
<td>
<p align="left"> </p>
</td>
</tr>
<tr>
<td colspan="5">
<p align="left">小计：7人次</p>
</td>
<td>105817.51</td>
<td> </td><td> </td>
</tr><tr><td colspan="8" bgcolor='#dddddd'>
<p align="left">参保人报销地区：丰台区</p>
</td></tr><tr>
<th width='30'>序号</th>
<th width='30'>类别</th>
<th width='150'>交易流水号</th>
<th width='65'>姓名</th>
<th width='90'>卡号/<br>手册号</th>
<th width='75'>费用<br>总金额</th>
<th width='65'>入库情况</th>
<th width='135'>拒付原因</th>
</tr><tr>
<td>1</td>
<td>普通</td>
<td>0511000106083103719B</td>
<td>由保太</td>
<td>10016819300S</td>
<td>12391.54</td>
<td>审核状态</td>
<td>
<p align="left"> </p>
</td>
</tr>
<tr>
<td colspan="5">
<p align="left">小计：1人次</p>
</td>
<td>12391.54</td>
<td> </td><td> </td>
</tr><tr><td colspan="8" bgcolor='#dddddd'>
<p align="left">参保人报销地区：石景山区</p>
</td></tr><tr>
<th width='30'>序号</th>
<th width='30'>类别</th>
<th width='150'>交易流水号</th>
<th width='65'>姓名</th>
<th width='90'>卡号/<br>手册号</th>
<th width='75'>费用<br>总金额</th>
<th width='65'>入库情况</th>
<th width='135'>拒付原因</th>
</tr><tr>
<td>1</td>
<td>普通</td>
<td>0511000106083003775B</td>
<td>康宝娥</td>
<td>10242796100S</td>
<td>6763.05</td>
<td>审核状态</td>
<td>
<p align="left"> </p>
</td>
</tr>
<tr>
<td>2</td>
<td>普通</td>
<td>0511000106083103948B</td>
<td>张文玉</td>
<td>10248142400S</td>
<td>12907.6</td>
<td>审核状态</td>
<td>
<p align="left"> </p>
</td>
</tr>
<tr>
<td>3</td>
<td>生育</td>
<td>0511000106083103884B</td>
<td>文雅</td>
<td>10445921800S</td>
<td>2853.54</td>
<td>审核状态</td>
<td>
<p align="left"> </p>
</td>
</tr>
<tr>
<td colspan="5">
<p align="left">小计：3人次</p>
</td>
<td>22524.19</td>
<td> </td><td> </td>
</tr><tr><td colspan="8" bgcolor='#dddddd'>
<p align="left">参保人报销地区：海淀区</p>
</td></tr><tr>
<th width='30'>序号</th>
<th width='30'>类别</th>
<th width='150'>交易流水号</th>
<th width='65'>姓名</th>
<th width='90'>卡号/<br>手册号</th>
<th width='75'>费用<br>总金额</th>
<th width='65'>入库情况</th>
<th width='135'>拒付原因</th>
</tr><tr>
<td>1</td>
<td>普通</td>
<td>0511000106083103731B</td>
<td>林秀英</td>
<td>10157121700S</td>
<td>8741.1</td>
<td>审核状态</td>
<td>
<p align="left"> </p>
</td>
</tr>
<tr>
<td colspan="5">
<p align="left">小计：1人次</p>
</td>
<td>8741.1</td>
<td> </td><td> </td>
</tr><tr><td colspan="8" bgcolor='#dddddd'>
<p align="left">参保人报销地区：门头沟区</p>
</td></tr><tr>
<th width='30'>序号</th>
<th width='30'>类别</th>
<th width='150'>交易流水号</th>
<th width='65'>姓名</th>
<th width='90'>卡号/<br>手册号</th>
<th width='75'>费用<br>总金额</th>
<th width='65'>入库情况</th>
<th width='135'>拒付原因</th>
</tr><tr>
<td>1</td>
<td>普通</td>
<td>0511000106083003638B</td>
<td>杨春振</td>
<td>10520751400S</td>
<td>14388.6</td>
<td>审核状态</td>
<td>
<p align="left"> </p>
</td>
</tr>
<tr>
<td colspan="5">
<p align="left">小计：1人次</p>
</td>
<td>14388.6</td>
<td> </td><td> </td>
</tr>
<tr>
<td colspan="5">
<p align="left">合计：15人次</p>
</td>
<td>185866.80</td>
<td> </td><td> </td>
</tr>
</table>
<table border="0" align="center" width="640">
<tr>
<td height="16">制表日期：2006年9月1日</td>
</tr>
<tr>
<td>
<p align="left">注：入库情况包话：全额拒付、审核状态;
<br> 打包日期为医院端生成上报文件的日期。</p>
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