UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSUD CILILIN

Tingkat Pelayanan : RITL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017

No No.SEP Tgl. Verifikasi

1 0464R00006170001030 * 24/08/2017
2 0464R00006170001092 * 23/08/2017
3 0464R00006170001104 * 23/08/2017
4 0464R00006170001105 * 23/08/2017
5 0464R00006170001120 * 23/08/2017
6 0464R00006170001132 * 23/08/2017
7 0464R00006170001140 * 23/08/2017
8 0464R00006170001143 * 23/08/2017
9 0464R00006170001145 * 23/08/2017
10 0464R00006170001147 * 23/08/2017
11 0464R00006170001152 * 23/08/2017
12 0464R00006170001154 * 23/08/2017
13 0464R00007170000005 * 23/08/2017
14 0464R00007170000006 * 23/08/2017
15 0464R00007170000010 * 24/08/2017
16 0464R00007170000013 * 24/08/2017
17 0464R00007170000014 * 23/08/2017
18 0464R00007170000024 * 23/08/2017
19 0464R00007170000043 * 23/08/2017
20 0464R00007170000059 * 23/08/2017
21 0464R00007170000077 * 23/08/2017
22 0464R00007170000083 * 23/08/2017
23 0464R00007170000091 * 23/08/2017
24 0464R00007170000100 * 23/08/2017
25 0464R00007170000114 * 23/08/2017
26 0464R00007170000117 * 23/08/2017
27 0464R00007170000120 * 23/08/2017
28 0464R00007170000121 * 23/08/2017
29 0464R00007170000122 * 24/08/2017
30 0464R00007170000128 * 23/08/2017
31 0464R00007170000129 * 24/08/2017
32 0464R00007170000131 * 23/08/2017
 UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSUD CILILIN

Tingkat Pelayanan : RITL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017

33 0464R00007170000133 * 23/08/2017
34 0464R00007170000134 * 23/08/2017
35 0464R00007170000135 * 23/08/2017
36 0464R00007170000136 * 23/08/2017
37 0464R00007170000141 * 23/08/2017
38 0464R00007170000201 * 23/08/2017
39 0464R00007170000203 * 23/08/2017
40 0464R00007170000207 * 23/08/2017
41 0464R00007170000210 * 24/08/2017
42 0464R00007170000213 * 23/08/2017
43 0464R00007170000214 * 23/08/2017
44 0464R00007170000244 * 23/08/2017
45 0464R00007170000248 * 23/08/2017
46 0464R00007170000250 * 23/08/2017
47 0464R00007170000291 * 23/08/2017
48 0464R00007170000300 * 23/08/2017
49 0464R00007170000301 * 23/08/2017
50 0464R00007170000303 * 23/08/2017
51 0464R00007170000333 * 23/08/2017
52 0464R00007170000334 * 23/08/2017
53 0464R00007170000338 * 23/08/2017
54 0464R00007170000339 * 23/08/2017
55 0464R00007170000362 * 24/08/2017
56 0464R00007170000372 * 23/08/2017
57 0464R00007170000375 * 23/08/2017
58 0464R00007170000379 * 23/08/2017
59 0464R00007170000381 * 23/08/2017
60 0464R00007170000382 * 24/08/2017
61 0464R00007170000386 * 24/08/2017
62 0464R00007170000394 * 23/08/2017
63 0464R00007170000405 * 23/08/2017
64 0464R00007170000411 * 23/08/2017
65 0464R00007170000415 * 23/08/2017
66 0464R00007170000423 * 24/08/2017
67 0464R00007170000424 * 23/08/2017
 UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSUD CILILIN

Tingkat Pelayanan : RITL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017

68 0464R00007170000425 * 23/08/2017
69 0464R00007170000431 * 23/08/2017
70 0464R00007170000434 * 23/08/2017
71 0464R00007170000436 * 23/08/2017
72 0464R00007170000437 * 23/08/2017
73 0464R00007170000440 * 24/08/2017
74 0464R00007170000443 * 23/08/2017
75 0464R00007170000444 * 24/08/2017
76 0464R00007170000448 * 23/08/2017
77 0464R00007170000465 * 23/08/2017
78 0464R00007170000498 * 23/08/2017
79 0464R00007170000500 * 23/08/2017
80 0464R00007170000526 * 23/08/2017
81 0464R00007170000550 * 23/08/2017
82 0464R00007170000558 * 23/08/2017
83 0464R00007170000560 * 23/08/2017
84 0464R00007170000563 * 23/08/2017
85 0464R00007170000565 * 23/08/2017
86 0464R00007170000566 * 23/08/2017
87 0464R00007170000610 * 24/08/2017
88 0464R00007170000624 * 24/08/2017
89 0464R00007170000630 * 23/08/2017
90 0464R00007170000634 * 23/08/2017
91 0464R00007170000643 * 23/08/2017
92 0464R00007170000655 * 23/08/2017
93 0464R00007170000656 * 24/08/2017
94 0464R00007170000659 * 23/08/2017
95 0464R00007170000660 * 24/08/2017
96 0464R00007170000662 * 23/08/2017
97 0464R00007170000665 * 24/08/2017
98 0464R00007170000666 * 23/08/2017
99 0464R00007170000768 * 23/08/2017
100 0464R00007170000771 * 23/08/2017
101 0464R00007170000772 * 23/08/2017
102 0464R00007170000774 * 23/08/2017
 UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSUD CILILIN

Tingkat Pelayanan : RITL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017

103 0464R00007170000807 * 23/08/2017

104 0464R00007170000828 * 23/08/2017
105 0464R00007170000829 * 24/08/2017
106 0464R00007170000853 * 23/08/2017
107 0464R00007170000858 * 23/08/2017
108 0464R00007170000860 * 24/08/2017
109 0464R00007170000861 * 23/08/2017
110 0464R00007170000862 * 23/08/2017
111 0464R00007170000892 * 23/08/2017
112 0464R00007170000905 * 23/08/2017
113 0464R00007170000910 * 23/08/2017
114 0464R00007170000911 * 23/08/2017
115 0464R00007170000913 * 23/08/2017
116 0464R00007170000915 * 24/08/2017
117 0464R00007170000916 * 23/08/2017
118 0464R00007170000917 * 23/08/2017
119 0464R00007170000920 * 23/08/2017
120 0464R00007170000922 * 23/08/2017
121 0464R00007170000924 * 23/08/2017
122 0464R00007170000931 * 23/08/2017
123 0464R00007170000937 * 23/08/2017
124 0464R00007170000956 * 23/08/2017
125 0464R00007170000972 * 23/08/2017
126 0464R00007170000988 * 23/08/2017
127 0464R00007170000992 * 23/08/2017
128 0464R00007170001008 * 23/08/2017
129 0464R00007170001009 * 23/08/2017
130 0464R00007170001010 * 23/08/2017
131 0464R00007170001012 * 23/08/2017
132 0464R00007170001025 * 23/08/2017
133 0464R00007170001045 * 23/08/2017
134 0464R00007170001073 * 23/08/2017
135 0464R00007170001081 * 23/08/2017
136 0464R00007170001085 * 23/08/2017
137 0464R00007170001086 * 23/08/2017
 UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSUD CILILIN

Tingkat Pelayanan : RITL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017

138 0464R00007170001087 * 23/08/2017

139 0464R00007170001129 * 23/08/2017
140 0464R00007170001149 * 23/08/2017
141 0464R00007170001160 * 23/08/2017
142 0464R00007170001162 * 23/08/2017
143 0464R00007170001172 * 23/08/2017
144 0464R00007170001174 * 23/08/2017
145 0464R00007170001175 * 23/08/2017
146 0464R00007170001176 * 23/08/2017
147 0464R00007170001182 * 23/08/2017
148 0464R00007170001187 * 24/08/2017
149 0464R00007170001215 * 24/08/2017
150 0464R00007170001216 * 24/08/2017
151 0464R00007170001229 * 23/08/2017
152 0464R00007170001232 * 23/08/2017
153 0464R00007170001241 * 23/08/2017
154 0464R00007170001245 * 23/08/2017
155 0464R00007170001246 * 23/08/2017
156 0464R00007170001249 * 23/08/2017
157 0464R00007170001251 * 23/08/2017
158 0464R00007170001252 * 23/08/2017
159 0464R00007170001253 * 23/08/2017
160 0464R00007170001255 * 23/08/2017
161 0464R00007170001263 * 23/08/2017
162 0464R00007170001276 * 23/08/2017
163 0464R00007170001288 * 23/08/2017
164 0464R00007170001300 * 24/08/2017
165 0464R00007170001303 * 23/08/2017
166 0464R00007170001306 * 23/08/2017
167 0464R00007170001310 * 23/08/2017
168 0464R00007170001311 * 23/08/2017
169 0464R00007170001312 * 23/08/2017
170 0464R00007170001316 * 23/08/2017
171 0464R00007170001347 * 23/08/2017
172 0464R00007170001360 * 23/08/2017
 UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSUD CILILIN

Tingkat Pelayanan : RITL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017

173 0464R00007170001361 * 23/08/2017

174 0464R00007170001369 * 23/08/2017
175 0464R00007170001380 * 23/08/2017
176 0464R00007170001409 * 23/08/2017
177 0464R00007170001415 * 23/08/2017
178 0464R00007170001416 * 23/08/2017
179 0464R00007170001417 * 23/08/2017
180 0464R00007170001418 * 23/08/2017
181 0464R00007170001419 * 23/08/2017
182 0464R00007170001421 * 23/08/2017
183 0464R00007170001461 * 24/08/2017
184 0464R00007170001465 * 23/08/2017
185 0464R00007170001470 * 23/08/2017
186 0464R00007170001473 * 23/08/2017
187 0464R00007170001484 * 23/08/2017
188 0464R00007170001485 * 23/08/2017
189 0464R00007170001494 * 23/08/2017
190 0464R00007170001550 * 23/08/2017
191 0464R00007170001557 * 23/08/2017
192 0464R00007170001560 * 23/08/2017
193 0464R00007170001561 * 23/08/2017
194 0464R00007170001565 * 23/08/2017
195 0464R00007170001579 * 23/08/2017
196 0464R00007170001591 * 23/08/2017
197 0464R00007170001634 * 23/08/2017
198 0464R00007170001638 * 23/08/2017
199 0464R00007170001641 * 23/08/2017
200 0464R00007170001657 * 23/08/2017
201 0464R00007170001659 * 23/08/2017
202 0464R00007170001684 * 23/08/2017
203 0464R00007170001702 * 23/08/2017
204 0464R00007170001704 * 23/08/2017
205 0464R00007170001713 * 23/08/2017
206 0464R00007170001714 * 23/08/2017
207 0464R00007170001726 * 23/08/2017
 UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSUD CILILIN

Tingkat Pelayanan : RITL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017

208 0464R00007170001727 * 23/08/2017

209 0464R00007170001780 * 23/08/2017
210 0464R00007170001809 * 23/08/2017
211 0464R00007170001849 * 23/08/2017
212 0464R00007170001870 * 23/08/2017
TOTAL

RESUME
Total Bea.Diajukan : 457,965,600
Total Bea.Disetujui : 457,965,600

Menyetujui Mengetahui
Direktur RS BPJS KESEHATAN

dr Jajang Hadianto SpAn, MARS Irfan Panji Lesmana

IFIKASI

Hal.1/1

Biaya
Diajukan Disetujui
5,227,900 5,227,900
1,079,600 1,079,600
1,362,800 1,362,800
2,092,500 2,092,500
2,092,500 2,092,500
1,737,000 1,737,000
1,362,800 1,362,800
1,292,200 1,292,200
1,467,600 1,467,600
1,362,800 1,362,800
3,799,700 3,799,700
1,950,400 1,950,400
1,445,700 1,445,700
2,188,300 2,188,300
2,247,000 2,247,000
2,723,700 2,723,700
1,467,600 1,467,600
1,467,600 1,467,600
1,467,600 1,467,600
1,079,600 1,079,600
1,467,600 1,467,600
2,092,500 2,092,500
1,084,000 1,084,000
1,084,000 1,084,000
1,079,600 1,079,600
1,737,000 1,737,000
1,101,400 1,101,400
1,737,000 1,737,000
3,166,000 3,166,000
4,293,500 4,293,500
3,166,000 3,166,000
1,737,000 1,737,000
IFIKASI

Hal.1/1

3,166,000 3,166,000
1,079,600 1,079,600
1,079,600 1,079,600
1,101,400 1,101,400
1,467,600 1,467,600
2,247,000 2,247,000
2,247,000 2,247,000
1,467,600 1,467,600
1,716,800 1,716,800
4,293,500 4,293,500
1,445,700 1,445,700
2,653,600 2,653,600
1,467,600 1,467,600
2,092,500 2,092,500
3,166,000 3,166,000
1,467,600 1,467,600
1,737,000 1,737,000
2,653,600 2,653,600
1,467,600 1,467,600
1,047,100 1,047,100
3,225,200 3,225,200
3,225,200 3,225,200
3,340,300 3,340,300
1,737,000 1,737,000
4,293,500 4,293,500
1,362,800 1,362,800
2,653,600 2,653,600
2,131,900 2,131,900
3,915,400 3,915,400
1,047,100 1,047,100
1,899,900 1,899,900
2,653,600 2,653,600
1,467,600 1,467,600
2,653,600 2,653,600
1,079,600 1,079,600
IFIKASI

Hal.1/1

1,079,600 1,079,600
2,092,500 2,092,500
1,737,000 1,737,000
1,648,000 1,648,000
2,092,500 2,092,500
3,166,000 3,166,000
1,737,000 1,737,000
3,799,700 3,799,700
1,079,600 1,079,600
4,293,500 4,293,500
1,467,600 1,467,600
1,737,000 1,737,000
2,247,000 2,247,000
1,362,800 1,362,800
1,084,000 1,084,000
1,047,100 1,047,100
1,737,000 1,737,000
1,047,100 1,047,100
2,247,000 2,247,000
5,048,200 5,048,200
2,389,100 2,389,100
3,225,200 3,225,200
1,467,600 1,467,600
1,467,600 1,467,600
1,737,000 1,737,000
1,939,800 1,939,800
1,467,600 1,467,600
4,293,500 4,293,500
4,293,500 4,293,500
5,227,900 5,227,900
2,389,700 2,389,700
2,389,700 2,389,700
1,101,400 1,101,400
1,445,700 1,445,700
1,558,900 1,558,900
IFIKASI

Hal.1/1

3,225,200 3,225,200
1,737,000 1,737,000
1,899,900 1,899,900
1,737,000 1,737,000
3,164,100 3,164,100
2,289,400 2,289,400
2,653,600 2,653,600
1,840,800 1,840,800
2,247,000 2,247,000
1,445,700 1,445,700
4,542,200 4,542,200
4,293,500 4,293,500
2,247,000 2,247,000
3,166,000 3,166,000
3,492,300 3,492,300
1,467,600 1,467,600
1,939,800 1,939,800
1,445,700 1,445,700
2,653,600 2,653,600
1,467,600 1,467,600
1,950,400 1,950,400
3,799,700 3,799,700
1,737,000 1,737,000
2,653,600 2,653,600
1,737,000 1,737,000
3,164,100 3,164,100
1,445,700 1,445,700
1,047,100 1,047,100
1,907,200 1,907,200
4,293,500 4,293,500
1,737,000 1,737,000
3,225,200 3,225,200
1,939,800 1,939,800
1,939,800 1,939,800
4,293,500 4,293,500
IFIKASI

Hal.1/1

1,079,600 1,079,600
3,225,200 3,225,200
1,362,800 1,362,800
2,247,000 2,247,000
2,247,000 2,247,000
1,292,200 1,292,200
3,799,700 3,799,700
1,445,700 1,445,700
1,445,700 1,445,700
753,800 753,800
5,227,900 5,227,900
3,951,000 3,951,000
4,234,100 4,234,100
3,166,000 3,166,000
3,225,200 3,225,200
3,799,700 3,799,700
1,144,300 1,144,300
2,768,700 2,768,700
1,445,700 1,445,700
1,107,400 1,107,400
1,950,400 1,950,400
2,247,000 2,247,000
1,467,600 1,467,600
753,800 753,800
1,467,600 1,467,600
1,467,600 1,467,600
5,353,800 5,353,800
1,737,000 1,737,000
3,158,100 3,158,100
1,047,100 1,047,100
1,737,000 1,737,000
1,445,700 1,445,700
1,950,400 1,950,400
3,799,700 3,799,700
1,467,600 1,467,600
IFIKASI

Hal.1/1

1,467,600 1,467,600
1,899,900 1,899,900
1,079,600 1,079,600
1,079,600 1,079,600
2,434,700 2,434,700
1,899,900 1,899,900
1,079,600 1,079,600
1,047,100 1,047,100
3,087,200 3,087,200
1,079,600 1,079,600
3,225,200 3,225,200
3,225,200 3,225,200
1,737,000 1,737,000
1,950,400 1,950,400
1,805,800 1,805,800
1,467,600 1,467,600
1,445,700 1,445,700
3,225,200 3,225,200
1,945,000 1,945,000
1,445,700 1,445,700
1,445,700 1,445,700
1,467,600 1,467,600
3,225,200 3,225,200
1,079,600 1,079,600
1,950,400 1,950,400
1,737,000 1,737,000
2,247,000 2,247,000
4,293,500 4,293,500
2,092,500 2,092,500
1,737,000 1,737,000
1,467,600 1,467,600
1,899,900 1,899,900
1,079,600 1,079,600
1,737,000 1,737,000
1,084,000 1,084,000
IFIKASI

Hal.1/1

1,737,000 1,737,000
1,079,600 1,079,600
1,950,400 1,950,400
1,401,900 1,401,900
3,225,200 3,225,200
457,965,600 457,965,600

Lesmana