Actual / Admission Discharge Appointme Hospital Hospital

OT Date Patient ID Pt Name City Category

Estimate Date Date nt ID Code name

Actual 4/8/2023 4/8/2023 4/8/2023AQVLD31262

mOnOrRQMIk
u4GD7YgmaO
Sarjerao PanhalkarPune Ruby Hall Clinic
Proctology
Estimate ### ### ### BHZEB65174
vzOETAEJ3i
u4GD7YgmaOamol vilas Pune Ruby Hall Clinic Kidney Stone
Urology-
Actual ### ### ### ILQHF47610
ytNG4gJ2dV
u4GD7YgmaO
Vikash Kumar Pune Ruby Hall Clinic
Ophthalmology
Estimate ### ### ### HJFHD47556
fcxL0lm3ak
u4GD7YgmaOPrajwal Pune Ruby Hall Clinic
Proctology
Actual ### ### ### GFBMF55217
SzSjyVD1pZ
u4GD7YgmaORajendra Pune Ruby Hall Clinic Circumcision
Urology-
Actual ### ### ### GFBMF55217
SzSjyVD1pZ
u4GD7YgmaORajendra Pune Ruby Hall Clinic
Proctology
Estimate ### ### GzFvbdexF1
CRUGC78235 u4GD7YgmaOAkash A Pune Ruby Hall Clinic
Proctology
Actual ### ### ### rBElSCWi4p
IBGJF60630 u4GD7YgmaO Pune Ruby Hall
Ravindra Digambar Talole Clinic Circumcision
Urology-
Actual ### ### ### HCULC94341
36kHfXiy5Q
u4GD7YgmaO Pune Ruby Hall Clinic
Gauri Pradeep Shintre Ophthalmology
Estimate ### ### ### SDXFF33056
p4emKRFKKHu4GD7YgmaO
Arjun Ekshinge Pune Ruby Hall Clinic Kidney Stone
Urology-
Estimate ### ### ### DZAHD96556
KmuceIm2Gz
u4GD7YgmaO
Piyush AgrawalPune Ruby Hall Clinic Circumcision
Urology-
Actual ### ### ### QOYJE87405
hfLi6RuHEn
u4GD7YgmaOPradeep Pune Ruby Hall Clinic Circumcision
Urology-
Estimate ### ### yRgL4QAlH0
SUZIE79864 u4GD7YgmaO
Akash Padwal Pune Ruby Hall Clinic Circumcision
Urology-
Estimate ### ### DOl3ay6vjr
BKSLA93700 u4GD7YgmaO
Vishal GawandePune Ruby Hall Clinic
Proctology
Actual ### ### ### XCHGC17984
4udAtAr2AC
u4GD7YgmaO
Somnath Mule Pune Ruby Hall Clinic
Proctology
Actual ### ### ### DTIGG91398
3F40724DWC
u4GD7YgmaO Prafull Pune Ruby Hall Clinic Circumcision
Urology-
Estimate ### ### YIkXQ0S9GO
MABLD24665 u4GD7YgmaO
Mohit velani Pune Ruby Hall Clinic Circumcision
Urology-
Actual ### ### ### RJWFG95356
W2wQg1blHI
u4GD7YgmaO
Dayanand PawarPune Ruby Hall Clinic ENT
Actual ### ### ### NHSSA63775
UwTa8GUTo0
u4GD7YgmaO
Suryadev SinghPune Ruby Hall Clinic
Proctology
Actual ### ### ### KAZFC27061
MvqkGYgViF
u4GD7YgmaO
Nilesh Pol Pune Ruby Hall Clinic
Proctology
Actual ### ### ### BSALB15789
FMHGOjLHsw
u4GD7YgmaO Pune Ruby Hall
Guruprasad Gujrathi Clinic Circumcision
Urology-
Estimate ### ### ### UEXHG28001
aUvAIClry0
u4GD7YgmaO Nalani Pune Ruby Hall Clinic
Orthopaedics
Estimate ### ### 1acAOUBEex
BHUNF70398 u4GD7YgmaO Pune Ruby Hall
Satalingappa Shivsharan Clinic Kidney Stone
Urology-
Actual ### ### ### HCULC94341
jFGOvQhaFc
u4GD7YgmaO Pune Ruby Hall Clinic
Gauri Pradeep Shintre Ophthalmology
Actual ### ### ### MDTJA87055
8HMN8nyKtw
u4GD7YgmaOVaishnavi Pune Ruby Hall Clinic
Proctology
Actual ### ### ### ESRNF83647
IIwXeV0ttQ
u4GD7YgmaO Pune Ruby Hall Clinic
Manisha Sandeep Walunj Ophthalmology
Estimate ### ### dzoKYCOY8J
JFKMA97159 u4GD7YgmaORaunak Pune Ruby Hall Clinic
Proctology
Estimate ### ### InsVBbks8s
EHFHE81077 u4GD7YgmaO
Shubham Pune Ruby Hall Clinic
Proctology
Estimate ### ### Kag0QqAzCp
HEQGE96945 u4GD7YgmaO
Bandu Tupare Pune Ruby Hall Clinic
Ophthalmology
 OT
Payment Length of Initial Bill OT Anaesthes Room
Disease Final ATS Labs Medicine Consumabl
Mode stay Amount Charges ia Ch. Charges
e

Fistula Cashless 0 126444 127318 5,700

KIDNEY STONE
Cashless 1 42185 42185
Foreign monofocal Cashless
cataract 0 60260 50588
Fissure & Fistula
Cashless 1 128241 140950
Stapler Circumcision
Cashless 1 42900 42000 0
Abscess Cashless 1 80390 110040 7,000
Piles & Fissure
Cashless 90330 90100
Stapler Circumcision
Cashless 0 51971 54182 0
Foreign monofocal Cashless
cataract 0 45260 50110
RIRS Cashless 0 84563 86757
Laser Circumcision
Cashless 0 51102 52350
Stapler Circumcision
Cashless 0 31000 49550 7,500
Stapler Circumcision
Cashless 47992 52350
Piles & Fissure
Cashless 69205 72180
Fissure & Fistula
Cashless 1 117472 126000 6,000
Stapler Circumcision
Cashless 0 58292 58292 0
Stapler Circumcision
Cashless 51010 51010
Sinus Cashless 0 62575 70125 5,000
Piles & Fissure
Cashless 0 118114 120096 0
Piles & Fissure
Cashless 1 115064 133757 0
Stapler Circumcision
Cashless 1 50345 52965 0
TKR Unilateral
Cashless 1 328000 355200
Dj stent removal
Cashless 30000 44260
Foreign monofocal Cashless
cataract 0 44260 50110
Pilonidal Sinus
Cashless 1 52591 52756 0
PterygiumCashless 0 26615 26615
Fistula Cashless 96022 96022
Piles & Fissure
Cashless 75741 75741
Indian monofocal cataract
Cashless 26,000 26,000
 High Value High Value Estimated Net
HVC Rental
Consumabl Consumabl Extra Agreement Hospital Automated Rental Revenue
D&C Recoverabl Share with recoverabl with HVC
e Provided e Provided Charges Type value Charges
e HVC With e Without
By Hospital By GHV Rental Rental

44,999 Breakup 50699 50699

0 0
7,000 Flat 7000 7000
0 0
3,136 15,540 Breakup 15540 15540
3,136 38,125 Breakup 45125 45125
0 0
3,136 20,047 Breakup 20047 20047
7,000 Flat 7000 7000
0 0
3,136 0 0
3,136 15,559 Breakup 23059 23059
3,136 0 0
0 0
44,400 Breakup 50400 50400
3,136 21,568 Breakup 21568 21568
3,136 0 0
24,096 Breakup 29096 29096
44,436 Breakup 44436 44436
6,272 49,490 Breakup 49490 49490
3,136 19,597 Breakup 19597 19597
0 0
0 0
7,000 Flat 7000 7000
19,520 Breakup 19520 19520
7,000 Flat 7000 7000
0 0
0 0
0 0
 Net
Revenue Medicine
Hospital Doctor Lab
with HVC Take Rate Doctor IDInsurance Co
TPA Name
EMI/ Non EMI UID
Type Name Payable Payable
With
Rental

75745 60% 0 Dr. Milind

ICICIJoshi
DPC093 General Insurance
Lombard SELF Co. mOnOrRQMIkAQVLD31262
0
Ltd. 5,700
42185 100% 0 Dr. Gulhane
ICICIParag
DPC330 General Insurance
Lombard vzOETAEJ3iBHZEB65174
0
SELF Co. Ltd. Lab is Not Available
53260 88% 0 Dr. NehaCare
Sawant
DPC1480
Health Insurance Company ytNG4gJ2dVILQHF47610
SELF Limited0
128241 100% 0 Dr. Pankaj Waykole
DPC109
New Medi
IndiaAssist
Assurance
Insurance
Company fcxL0lm3akHJFHD47556
0
TPA Private Limited Lab is Not Available
27360 64% 0 Dr. PankajParamount
Waykole
DPC109
Oriental
Health
Insurance
Services
Company SzSjyVD1pZGFBMF55217
& Insurance0TPA Private Limited
35265 44% 0 Dr. PankajParamount
Waykole
DPC109
Oriental
Health
Insurance
Services
Company SzSjyVD1pZGFBMF55217
& Insurance0TPA Private Limited
7,000
90330 100% Dr.
0 Parmeshwar Bambrule
DPC510
New Family
India Assurance
Health Plan InsuranceGzFvbdexF1CRUGC78235
Company 0
TPA Limited Lab is Not Available
31924 61% 0 Dr. Pankaj Waykole
ICICI DPC109 General Insurance
Lombard r0BElSCWi4pIBGJF60630
SELF Co. Ltd.
38260 85% 0Dr. Chanchal Gadodiya
Care DPC812
Health Insurance Company 36kHfXiy5QHCULC94341
0
SELF Limited
84563 100% 0 Dr. Star
Gulhane Parag
Health DPC330 Company p4emKRFKKHSDXFF33056
and Allied InsuranceSELF 0
Limited Lab is Not Available
51102 100% Dr.
0 Parmeshwar Bambrule
DPC510
New Medi
IndiaAssist
Assurance
Insurance
Company KmuceIm2GzDZAHD96556
0
TPA Private Limited Lab is Not Available
7942 26% 0 Dr. PankajParamount
Waykole
DPC109
Oriental
Health
Insurance
Services & InsurancehfLi6RuHEnQOYJE87405
Company 0TPA Private Limited
7,500
47992 100% Dr.
0 Parmeshwar Bambrule
DPC510
National
Medi Assist
Insurance
Insurance
Company yRgL4QAlH0SUZIE79864
0
TPA Private Limited Lab is Not Available
69205 100% Dr.
0 Parmeshwar
ICICIBambrule
DPC510 General Insurance
Lombard DOl3ay6vjrBKSLA93700
0
SELF Co. Ltd. Lab is Not Available
67072 57% 0 Dr. Milind
Star JoshiDPC093
Health and Allied InsuranceSELF 4udAtAr2ACXCHGC17984
0
Company Limited 6,000
36724 63% 0 Dr. Pankaj Waykole
ICICI DPC109
Lombard
MD India
General
Health Insurance
Insurance Co. 3F40724DWCDTIGG91398
0
TPALtd.
Private Limited
51010 100% 0 Dr. Pankaj Waykole
Star Health DPC109 Company YIkXQ0S9GOMABLD24665
and Allied InsuranceSELF 0
Limited Lab is Not Available
33479 54% Dr. Poorva
0 Chandrasekhar
Star HealthDPC1422
andKale Company W2wQg1blHIRJWFG95356
Allied InsuranceSELF 0
Limited 5,000
73678 62% 0 Dr. MilindIffco
JoshiTokio
DPC093
MediGeneral
Assist Insurance
Insurance TPA UwTa8GUTo0NHSSA63775
Co Ltd 0
Private Limited
65574 57% 0 [Link]
Milind Joshi
DPC093
New Insurance
India Assurance
TPA (UHCP) UnitedMvqkGYgViFKAZFC27061
Company 0Health Care Parekh TPA
30748 61% 0 Dr. Milind
ICICIJoshi
DPC093 General Insurance
Lombard FMHGOjLHswBSALB15789
0
SELF Co. Ltd.
328000 100% 0 [Link]
Saurabh V Giri
Health DPC774
and Allied InsuranceSELF aUvAIClry0UEXHG28001
0
Company Limited Lab is Not Available
30000 100% 0 Dr. Star
Gulhane Parag
Health DPC330 Company 1acAOUBEexBHUNF70398
and Allied InsuranceSELF 0
Limited Lab is Not Available
37260 84% 0Dr. Chanchal Gadodiya
Care DPC812
Health Insurance Company jFGOvQhaFcHCULC94341
SELF Limited0
33071 63% 0 Dr. Pankaj Waykole
Star Health DPC109 Company8HMN8nyKtwMDTJA87055
and Allied InsuranceSELF 0
Limited
19615 74% 0Dr. Chanchal Gadodiya
Care DPC812
Health Insurance Company IIwXeV0ttQESRNF83647
SELF Limited0
96022 100% 0 Dr. Milind Joshi
Care DPC093
Health
Family
Insurance
Health Company
Plan Insurance dzoKYCOY8JJFKMA97159
0
Limited
TPA Limited Lab is Not Available
75741 100% 0 Dr. Milind Joshi
DPC093
New
East
India
WestAssurance
Assist Insurance
CompanyTPA InsVBbks8sEHFHE81077
0
Private Limited Lab is Not Available
26000 100% 0 [Link]
NehaHealth
Sawant
DPC1480 Company Kag0QqAzCpHEQGE96945
and Allied InsuranceSELF 0
Limited
 Standardis
ed/Non- Appointme Actual /
Remarks Checking
Hospital Ratecheck flat FLAT 2 FLAT 3 FInal MOP nt +
Standardis Patient ID Estimate
ed

1 0 #REF! mOnOrRQMIkAQVLD31262
No Estimate
Lab is Not Available0 0 #REF! vzOETAEJ3iBHZEB65174
No Estimate
0 0 #REF! ytNG4gJ2dVILQHF47610
Yes Estimate
Lab is Not Available0 0 #REF! fcxL0lm3akHJFHD47556
No Estimate
0 0 #REF! SzSjyVD1pZGFBMF55217
Yes Estimate
0 0 #REF! SzSjyVD1pZGFBMF55217
No Estimate
Lab is Not Available0 0 #REF! GzFvbdexF1CRUGC78235
No Estimate
0 0 #REF! rBElSCWi4pIBGJF60630
Yes Estimate
0 0 #REF! 36kHfXiy5QHCULC94341
Yes Estimate
Lab is Not Available0 0 #REF! p4emKRFKKHSDXFF33056
No Estimate
Lab is Not Available0 0 #REF! KmuceIm2GzDZAHD96556
No Estimate
0 0 #REF! hfLi6RuHEnQOYJE87405
No Estimate
Lab is Not Available0 0 #REF! yRgL4QAlH0SUZIE79864
No Estimate
Lab is Not Available0 0 #REF! DOl3ay6vjrBKSLA93700
No Estimate
0 0 #REF! 4udAtAr2ACXCHGC17984
No Estimate
0 0 #REF! 3F40724DWCDTIGG91398
Yes Estimate
Lab is Not Available0 0 #REF! YIkXQ0S9GOMABLD24665
No Estimate
0 0 #REF! W2wQg1blHIRJWFG95356
No Estimate
0 0 #REF! UwTa8GUTo0NHSSA63775
Yes Estimate
0 0 #REF! MvqkGYgViFKAZFC27061
Yes Estimate
0 0 #REF! FMHGOjLHswBSALB15789
Yes Estimate
Lab is Not Available0 0 #REF! aUvAIClry0UEXHG28001
No Estimate
Lab is Not Available0 0 #REF! 1acAOUBEexBHUNF70398
No Estimate
0 0 #REF! jFGOvQhaFcHCULC94341
Yes Estimate
0 0 #REF! 8HMN8nyKtwMDTJA87055
Yes Estimate
0 0 #REF! IIwXeV0ttQESRNF83647
Yes Estimate
Lab is Not Available0 0 #REF! dzoKYCOY8JJFKMA97159
No Estimate
Lab is Not Available0 0 #REF! InsVBbks8sEHFHE81077
No Estimate
0 0 Kag0QqAzCpHEQGE96945
#REF! Estimate Estimate
 Check After HVC Automated Length of
Final Test TR my use
Comment Removal Value Stay

0% - 1
0% - 1
0% 0
0% 2
0% 1
0% 1
0% 1
0% 1
0% 0
0% 1
0% 0
0% 0
0% 1
0% 1
0% 1
0% 0
0% 0
0% 1
0% 1
0% 1
0% 0
0% 6
0% 0
0% 0
0% 1
0%
0%
0%
0%