You are on page 1of 6

UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSUD CILILIN


Tingkat Pelayanan : RITL
Tgl.Pelayanan : 01 Juni 2017 s/d 30 Juni 2017

No No.SEP Tgl. Verifikasi

1 0464R00005170001421 * 22/08/2017
2 0464R00005170001447 * 22/08/2017
3 0464R00005170001508 * 22/08/2017
4 0464R00005170001510 * 22/08/2017
5 0464R00005170001512 * 22/08/2017
6 0464R00005170001526 * 22/08/2017
7 0464R00005170001614 * 22/08/2017
8 0464R00005170001617 * 22/08/2017
9 0464R00006170000002 * 22/08/2017
10 0464R00006170000012 * 22/08/2017
11 0464R00006170000014 * 22/08/2017
12 0464R00006170000016 * 22/08/2017
13 0464R00006170000017 * 22/08/2017
14 0464R00006170000018 * 22/08/2017
15 0464R00006170000019 * 22/08/2017
16 0464R00006170000086 * 22/08/2017
17 0464R00006170000167 * 22/08/2017
18 0464R00006170000171 * 22/08/2017
19 0464R00006170000187 * 22/08/2017
20 0464R00006170000189 * 22/08/2017
21 0464R00006170000203 * 22/08/2017
22 0464R00006170000252 * 22/08/2017
23 0464R00006170000256 * 22/08/2017
24 0464R00006170000257 * 22/08/2017
25 0464R00006170000265 * 22/08/2017
26 0464R00006170000305 * 22/08/2017
27 0464R00006170000336 * 22/08/2017
28 0464R00006170000337 * 22/08/2017
29 0464R00006170000339 * 22/08/2017
30 0464R00006170000340 * 22/08/2017
31 0464R00006170000373 * 22/08/2017
32 0464R00006170000491 * 22/08/2017
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSUD CILILIN


Tingkat Pelayanan : RITL
Tgl.Pelayanan : 01 Juni 2017 s/d 30 Juni 2017

33 0464R00006170000526 * 22/08/2017
34 0464R00006170000527 * 22/08/2017
35 0464R00006170000529 * 22/08/2017
36 0464R00006170000565 * 22/08/2017
37 0464R00006170000581 * 22/08/2017
38 0464R00006170000587 * 22/08/2017
39 0464R00006170000640 * 22/08/2017
40 0464R00006170000662 * 22/08/2017
41 0464R00006170000709 * 22/08/2017
42 0464R00006170000723 * 22/08/2017
43 0464R00006170000729 * 22/08/2017
44 0464R00006170000758 * 22/08/2017
45 0464R00006170000774 * 22/08/2017
46 0464R00006170000811 * 22/08/2017
47 0464R00006170000851 * 22/08/2017
48 0464R00006170000877 * 22/08/2017
49 0464R00006170000904 * 22/08/2017
50 0464R00006170000990 * 22/08/2017
51 0464R00006170001000 * 22/08/2017
52 0464R00006170001045 * 22/08/2017
53 0464R00006170001047 * 22/08/2017
54 0464R00006170001080 * 22/08/2017
55 0464R00006170001087 * 22/08/2017
56 0464R00006170001090 * 22/08/2017
57 0464R00006170001096 * 22/08/2017
58 0464R00006170001099 * 22/08/2017
59 0464R00006170001107 * 22/08/2017
60 0464R00006170001113 * 22/08/2017
61 0464R00006170001117 * 22/08/2017
62 0464R00006170001124 * 22/08/2017
63 0464R00006170001126 * 22/08/2017
64 0464R00006170001139 * 22/08/2017
TOTAL
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSUD CILILIN


Tingkat Pelayanan : RITL
Tgl.Pelayanan : 01 Juni 2017 s/d 30 Juni 2017

RESUME
Total Bea.Diajukan : 166,465,400
Total Bea.Disetujui : 166,465,400

Menyetujui Mengetahui
Direktur RS BPJS KESEHATAN

dr Jajang Hadianto SpAn, MARS Irfan Panji Lesmana


IFIKASI

Hal.1/1

Biaya
Diajukan Disetujui
4,293,500 4,293,500
4,293,500 4,293,500
2,913,700 2,913,700
1,445,700 1,445,700
3,166,000 3,166,000
3,799,700 3,799,700
3,225,200 3,225,200
2,225,600 2,225,600
4,293,500 4,293,500
3,166,000 3,166,000
4,293,500 4,293,500
2,653,600 2,653,600
2,225,600 2,225,600
1,445,700 1,445,700
1,445,700 1,445,700
1,467,600 1,467,600
1,912,300 1,912,300
2,399,100 2,399,100
1,401,900 1,401,900
4,293,500 4,293,500
1,467,600 1,467,600
1,737,000 1,737,000
1,737,000 1,737,000
2,225,600 2,225,600
3,164,100 3,164,100
753,800 753,800
5,227,900 5,227,900
5,227,900 5,227,900
4,293,500 4,293,500
1,467,600 1,467,600
1,467,600 1,467,600
1,737,000 1,737,000
IFIKASI

Hal.1/1

1,467,600 1,467,600
1,737,000 1,737,000
5,533,700 5,533,700
3,225,200 3,225,200
1,912,300 1,912,300
1,722,500 1,722,500
753,800 753,800
4,293,500 4,293,500
2,531,200 2,531,200
4,293,500 4,293,500
1,401,900 1,401,900
1,899,900 1,899,900
1,445,700 1,445,700
1,737,000 1,737,000
3,166,000 3,166,000
4,536,000 4,536,000
5,492,300 5,492,300
3,166,000 3,166,000
2,531,200 2,531,200
1,908,200 1,908,200
5,755,000 5,755,000
1,950,400 1,950,400
1,079,600 1,079,600
1,737,000 1,737,000
1,899,900 1,899,900
1,737,000 1,737,000
1,737,000 1,737,000
1,467,600 1,467,600
753,800 753,800
1,467,600 1,467,600
3,166,000 3,166,000
2,092,500 2,092,500
166,465,400 166,465,400
IFIKASI

Hal.1/1

Lesmana

You might also like