Format Utilisasi Covid Oktober 2020

Jenis
Kantor
No Provinsi Nama Rumah Sakit Kab/Kota Pelayanan
Cabang
(RJTL/RITL)
a b c d e f
1 Barabai Kalimantan Selatan RS PERTAMINA TANJUNG TABALONG RITL
RITL
RITL
RITL
RSUD BADARUDDIN KASIM TABALONG RITL
RITL
RSUD PAMBALAH BATUNG HULU SUNGAI UTARA RITL
RITL
RITL
RITL
RITL
RSUD H. HASAN BASRY HULU SUNGAI SELATAN RITL
RITL
RITL
RITL
RITL
RITL
RITL
RSUD DAHA SEJAHTERAH HULU SUNGAI SELATAN RITL
RITL
RITL
RJTL
RITL
RITL
RITL
RITL
RSUD H. DAMANHURI HULU SUNGAI TENGAH RITL
RITL
RITL
RITL
RITL
RITL
RITL
RITL
RITL
RJTL
RJTL
RSUD BALANGAN BALANGAN RJTL
RJTL
RITL
RITL
RJTL
RSUD DATU SANGGUL Tapin RITL
RITL
RJTL
RITL
RITL
RJTL
RITL
RJTL
RITL
RITL
RJTL
RITL
RITL
RITL
RJTL
RJTL
RITL
RJTL
RITL
RJTL
Keterangan
a sudah jelas
b sudah jelas
c sudah jelas
d sudah jelas
e sudah jelas
f diisi RJTL atau RITL (huruf besar)
g diisi REGULER atau DISPUTE (huruf besar)
h diisi dengan format date (jangan manual)
i diisi dengan format date (jangan manual)
j sesuai BAST
k sesuai BAST
l diisi dengan format date (jangan manual)
m sesuai BAHV
n sesuai BAHV
o sesuai BAHV
p sesuai BAHV
q sesuai BAHV
r sesuai BAHV
s diisi dengan format date (jangan manual)
t diisi bila perlu
Jenis Klaim
Bulan Tanggal Kasus
(REGULER/D Biaya diajukan Tanggal HV Kasus Sesuai
Pelayanan diajukan diajukan
ISPUTE)
g h i j k l m
REGULER JUNI 8/12/2020 6 Rp421,000,000 8/14/2020 2
REGULER JULI 8/12/2020 5 Rp658,600,000 8/14/2020 3
DISPUTE JUNI 10/5/2020 4 Rp308,500,000 10/6/2020 4
DISPUTE JULI 10/5/2020 2 Rp187,600,000 10/6/2020 2
REGULER MEI 8/31/2020 4 Rp207,000,000 9/1/2020 2
DISPUTE MEI 10/12/2020 2 Rp119,000 10/13/3030 2
REGULER JUNI 8/4/2020 9 Rp666,580,000 8/7/2020 4
DISPUTE JUNI 9/17/2020 5 Rp340,720,000 9/21/2020 5
REGULER JUNI 9/17/2020 23 Rp715,520,000 9/21/2020 11
REGULER JULI 9/17/2020 20 Rp1,344,800,000 9/21/2020 12
REGULER AGUSTUS 9/17/2020 5 Rp415,388,000 9/21/2020 1
REGULER APRIL 7/6/2020 18 Rp1,128,320,000 7/9/2020 0
DISPUTE APRIL 12/08/1010 18 Rp1,068,420,000 8/18/2020 11
REGULER MEI 9/18/2020 15 Rp1,171,140,000 9/22/2020 12
REGULER JUNI 9/18/2020 55 Rp5,912,520,000 9/22/2020 43
DISPUTE MEI 9/30/2020 3 Rp272,260,000 10/5/2020 3
DISPUTE JUNI 9/30/2020 12 Rp1,228,760,000 10/5/2020 3
REGULER JULI 15/10/20202 102 Rp13,452,240,000 10/20/2020 78
REGULER MEI 8/10/2020 6 Rp244,750,000 8/13/2020 3
DISPUTE MEI 9/3/2020 3 Rp92,150,000 9/8/2020 3
REGULER JUNI 9/14/2020 10 Rp549,400,000 9/16/2020 6
REGULER JUNI 9/14/2020 1 Rp377,100 9/16/2020 1
DISPUTE JUNI 9/29/2020 4 Rp274,500,000 9/30/2020 4
REGULER JULI 10/2/2020 29 Rp4,381,500,000 10/7/2020 24
DISPUTE JULI 10/19/2020 5 Rp856,000,000 10/20/2020 5
REGULER APRIL 8/14/2020 4 Rp227,500,000 8/25/2020 0
REGULER JUNI 8/14/2020 11 Rp567,060,000 8/25/2020 5
REGULER JULI 8/14/2020 10 Rp564,300,000 8/25/2020 2
DISPUTE APRIL 9/4/2020 3 Rp169,100,000 9/9/2020 2
DISPUTE JUNI 9/4/2020 6 Rp323,160,000 9/9/2020 4
DISPUTE JULI 9/4/2020 8 Rp422,700,000 9/9/2020 7
REGULER JULI 10/12/2020 22 Rp763,920,000 10/19/2020 19
REGULER AGUSTUS 10/12/2020 46 Rp1,885,560,000 10/19/2020 39
REGULER SEPTEMBER 10/12/2020 9 Rp441,000,000 10/19/2020 6
REGULER Maret 7/13/2020 2 Rp850,400 7/16/2020 1
REGULER APRIL 7/13/2020 1 Rp473,300 7/16/2020 1
REGULER MEI 8/13/2020 4 Rp379,500,000 8/13/2020 4
REGULER JUNI 10/12/2020 25 Rp1,969,380,000 10/14/2020 25
REGULER JUNI 10/12/2020 2 Rp665,800 10/14/2020 2
REGULER APRIL 5/26/2020 3 Rp91,200,000 5/28/2020 3
REGULER MEI 6/23/2020 6 Rp72,710,000 6/26/2020 1
REGULER MEI 6/23/2020 2 Rp665,800 6/26/2020 2
DISPUTE MEI 8/3/2020 5 Rp59,410,000 8/5/2020 3
REGULER JUNI 8/3/2020 10 Rp1,698,160,000 8/5/2020 8
REGULER JUNI 8/3/2020 1 Rp377,100 8/5/2020 1
DISPUTE MEI 8/31/2020 1 Rp13,300,000 9/2/2020 0
DISPUTE MEI 8/31/2020 1 Rp3,737,100 9/2/2020 0
DISPUTE JUNI 8/31/2020 2 Rp874,000,000 9/2/2020 0
REGULER JULI 8/31/2020 34 Rp5,986,440,000 9/2/2020 30
REGULER JULI 8/31/2020 4 Rp1,882,000 9/2/2020 3
DISPUTE MEI 9/29/2020 4 Rp517,500,000 9/30/2020 4
DISPUTE JUNI 9/29/2020 2 Rp874,000,000 9/30/2020 2
DISPUTE JULI 9/29/2020 1 Rp13,300,000 9/30/2020 1
DISPUTE MEI 9/29/2020 1 Rp515,800 9/30/2020 1
DISPUTE JULI 9/29/2020 1 Rp3,737,100 9/30/2020 1
REGULER Agustus 9/29/2020 23 Rp2,021,082,000 10/1/2020 21
REGULER Agustus 9/29/2020 2 Rp754,200 10/1/2020 2
REGULER SEPTEMBER 10/20/2020 27 Rp2,129,358,000 10/22/2020 26
Kasus Tidak Biaya Tidak
Tanggal Kirim
Biaya Sesuai Sesuai (Tidak Sesuai (Tidak Kasus Dispute Biaya Dispute
Kemenkes
Layak) Layak)
n o p q r s
Rp112,500,000 0 0 4 Rp308,500,000 8/24/2020
Rp471,000,000 0 0 2 Rp187,600,000 8/24/2020
Rp308,500,000 0 0 0 Rp0
Rp187,600,000 0 0 0 Rp0
Rp88,000,000 0 0 2 Rp119,000,000 9/2/2020
Rp119,000 0 0 0 Rp0 10/20/2020
Rp241,860,000 0 0 5 Rp424,720,000 8/12/2020
Rp340,720,000 0 0 0 Rp0 9/24/2020
Rp298,020,000 0 0 12 Rp417,500,000 9/24/2020
Rp663,300,000 0 0 8 Rp681,500,000 9/24/2020
Rp28,500,000 0 0 4 Rp386,888,000 9/24/2020
Rp0 0 0 18 Rp1,128,320,000 7/10/2020
Rp612,260,000 0 0 7 Rp456,160,000 8/24/2020
Rp916,880,000 0 0 3 Rp254,260,000 9/24/2020
Rp4,672,520,000 0 0 12 Rp1,240,000,000 9/24/2020
Rp272,260,000 0 0 0 Rp0 10/8/2020
Rp272,260,000 0 0 0 Rp0 10/8/2020
Rp11,646,000,000 0 0 24 Rp1,806,240,000 10/23/2020
Rp124,100,000 0 0 3 Rp120,650,000 8/14/2020
Rp92,150,000 0 0 0 Rp0 9/10/2020
Rp238,500,000 0 0 4 Rp310,900,000 9/18/2020
Rp377,100 0 0 0 Rp0 9/18/2020
Rp274,500,000 0 0 0 Rp0 10/6/2020
Rp3,567,500,000 0 0 5 Rp814,000,000 10/12/2020
Rp856,000,000 0 0 0 Rp0 10/22/2020
Rp247,500,000 0 0 0 Rp0
Rp0 0 0 4 Rp227,500,000 8/27/2020
Rp298,300,000 0 0 6 Rp268,760,000 8/27/2020
Rp152,000,000 0 0 8 Rp412,300,000 8/27/2020
Rp110,700,000 0 0 1 Rp58,400,000 9/11/2020
Rp268,900,000 0 0 2 Rp54,260,000 9/11/2020
Rp385,500,000 0 0 1 Rp37,200,000 9/11/2020
Rp711,800,000 0 0 3 Rp52,120,000 10/20/2020
Rp1,594,120,000 0 0 7 Rp291,440,000 10/20/2020
Rp274,600,000 0 0 3 Rp166,400,000 10/20/2020
Rp3,205,200 0 0 2 Rp850,400 10/20/2020
Rp3,490,100 0 0 9 Rp3,490,100 10/20/2020
Rp473,300 0 0 1 Rp377,100 7/17/2020
Rp473,300 0 0 0 Rp0 7/17/2020
Rp379,500,000 0 0 0 Rp0 8/15/2020
Rp1,969,380,000 0 0 0 Rp0 10/20/2020
Rp665,800 0 0 0 Rp0 10/20/2020
Rp91,200,000 0 0 0 Rp0 5/30/2020
Rp13,300,000 0 0 5 Rp59,410,000 7/4/2020
Rp665,800 0 0 0 Rp0 7/4/2020
Rp33,250,000 0 0 2 Rp2,616,000 8/7/2020
Rp824,160,000 0 0 2 Rp874,000,000 8/7/2020
Rp377,100 0 0 0 Rp0 8/7/2020
Rp0 0 0 1 Rp13,300,000 9/7/2020
Rp0 0 0 1 Rp3,737,100 9/7/2020
Rp0 0 0 2 Rp874,000,000 9/7/2020
Rp5,468,940,000 0 0 4 Rp517,500,000 9/7/2020
Rp1,366,200 0 0 1 Rp515,800 9/7/2020
Rp517,500,000 0 0 0 Rp0 10/7/2020
Rp874,000,000 0 0 0 Rp0 10/7/2020
Rp13,300,000 0 0 0 Rp0 10/7/2020
Rp515,800 0 0 0 Rp0 10/7/2020
Rp3,737,100 0 0 0 Rp0 10/7/2020
Rp1,989,359,000 0 0 2 Rp31,723,000 10/7/2020
Rp754,200 0 0 0 Rp0 10/7/2020
Rp2,108,829,000 0 0 1 Rp20,529,000
Rp3,838,700 0 0 0 Rp0
Ket
Jatuh tempo 13/10/2020

JATUH TEMPO 04/11/2020

No Nama RS Jenis Hasil Verifikasi NOMOR NOFPK
a b c d e
1 RS PERTAMINA TANJUNG SESUAI 1 17030820CV0005
6 RS PERTAMINA TANJUNG DISPUTE 1 17030820CV0005
12 RSUD BADARUDDIN KASIM SESUAI 1 17030820CV0009
14 RSUD BADARUDDIN KASIM DISPUTE 1 17030820CV0009
15 RSUD BADARUDDIN KASIM DISPUTE 2 17030820CV0009
16 RSUD Pambalah Batung SESUAI 1 17030820CV0003
20 RSUD Pambalah Batung DISPUTE 1 17030820CV0003
73 RSUD H. Hasan Basry DISPUTE 1 17030720CV0001
91 RSUD H. Hasan Basry SESUAI 1 17030920CV0005
161 RSUD Daha Sejahtera SESUAI 1 17030820CV0004
164 RSUD Daha Sejahtera DISPUTE 1 17030820CV0004
209 RSUD H. Damanhuri SESUAI 1 17030820CV0008
216 RSUD H. Damanhuri DISPUTE 1 17030820CV0008
339 RSUD Balangan SESUAI 1 17030720CV0002
341 RSUD Balangan DISPUTE 1 17030720CV0002
373 RSUD Datu Sanggul SESUAI 17 17030920CV0009
378 RSUD Datu Sanggul DISPUTE 1 17030920CV0009
NOREGISTER NOSURAT NOSURATSERAHTERIMA NOPENGAJUAN
f g h i
0289R0130820CV00001 2858/BA/VIII-05/0820 2829/BA/VIII-05/0820 6309025ICC2007000F
0289R0130820CV00001 2858/BA/VIII-05/0820 2829/BA/VIII-05/0820 6309025ICC20070006
0289R0130820CV00001 2858/BA/VIII-05/0820 2829/BA/VIII-05/0820 6309025ICC2007000B
0289R0130820CV00001 2858/BA/VIII-05/0820 2829/BA/VIII-05/0820 6309025ICC2007000E
0289R0130820CV00001 2858/BA/VIII-05/0820 2829/BA/VIII-05/0820 6309025ICC2007000A
1710R0100820CV00003 2708/BA/VIII-05/0820 2670/BA/VIII-05/0820 6308013ICC2006000C
1710R0100920CV00001 3457/BA/VIII-05/0920 3401/BA/VIII-05/0920 6308013ICC2006001D
TGLSEP TGLPULANG LOS JNSPEL NOIDENTITAS
j k l m n
2020-05-26 10:43:30 2020-06-04 10:43:30 10 INAP 6309044712690001
2020-06-05 13:38:51 2020-06-09 13:38:51 5 INAP 6309064812950002
2020-06-05 10:24:36 2020-07-11 10:24:36 37 INAP 6309062904720002
2020-06-30 15:42:28 2020-07-02 15:42:28 3 INAP 6309061304760004
2020-07-06 08:09:06 2020-07-23 08:09:06 18 INAP 6309045201680005
2020-05-18 13:25:16 2020-06-05 13:25:16 19 INAP 3306014801910003
2020-06-05 13:35:55 2020-06-12 13:35:55 8 INAP 6309061411690006
2020-06-16 13:30:17 2020-06-22 13:30:17 7 INAP 6213025306920001
2020-06-23 14:02:33 2020-07-15 14:02:33 23 INAP 35201126029550001
2020-06-26 13:32:54 2020-06-30 13:32:54 5 INAP 6309046004660006
2020-07-11 09:28:52 2020-07-12 09:28:52 2 INAP 6309040607680006
2020-05-23 16:12:42 2020-05-27 16:12:42 5 INAP 6471051909830012
2020-05-26 15:47:53 2020-05-28 15:47:53 3 INAP 6409012706650003
2020-05-19 16:34:34 2020-05-26 16:34:34 8 INAP 1671152206880001
2020-05-28 15:12:20 2020-05-29 15:12:20 2 INAP 6309042905500001
2020-05-28 10:14:50 2020-06-05 10:14:50 9 INAP 6308030704570003
2020-05-31 21:21:55 2020-06-08 09:28:17 9 INAP 6308046603660001
2020-06-02 08:50:56 2020-06-08 08:50:56 7 INAP 6308092106660001
2020-06-03 10:00:55 2020-06-04 10:00:55 2 INAP 6308011608790001
2020-05-08 08:12:20 2020-06-09 08:12:20 33 INAP 6213051006570002
2020-06-03 08:31:48 2020-06-04 08:31:48 2 INAP 6308021002530004
2020-06-04 13:26:30 2020-06-05 13:26:30 2 INAP 6308024603610002
2020-06-05 07:30:44 2020-06-09 07:30:44 5 INAP 6308071212570001
2020-06-10 10:27:04 2020-06-11 10:27:04 2 INAP 6308030704570003
2020-06-06 13:45:44 2020-06-07 13:45:44 2 INAP 6308031508470001
2020-06-06 14:00:44 2020-06-08 14:00:44 3 INAP 6308100404650001
2020-06-06 14:13:23 2020-06-06 14:13:23 1 INAP 6308084501420001
2020-06-06 08:49:36 2020-06-08 08:49:36 3 INAP 6308064107420137
2020-06-09 10:10:38 2020-06-11 10:10:38 3 INAP 6308061209640001
2020-06-11 11:15:20 2020-06-12 11:15:20 2 INAP 6308026407720001
2020-06-15 11:04:22 2020-06-17 11:04:22 3 INAP 6308041704690001
2020-06-16 06:53:26 2020-06-16 06:53:26 1 INAP 6308056912560001
2020-06-16 10:11:36 2020-06-16 10:11:36 1 INAP 6203012111780005
2020-06-20 13:54:32 2020-06-26 13:54:32 7 INAP 6308041504620002
2020-06-25 13:20:31 2020-06-29 13:20:31 5 INAP 6308036906450003
2020-06-27 13:55:15 2020-07-03 13:55:15 7 INAP 6308050202730001
2020-06-28 12:06:43 2020-07-01 12:06:43 4 INAP 6308050503740003
2020-06-29 13:02:34 2020-07-01 13:02:34 3 INAP 6308055008540001
2020-06-29 10:08:47 2020-07-09 10:08:47 11 INAP 6308070207940001
2020-06-30 09:46:03 2020-07-10 09:46:03 11 INAP 6308052702550005
2020-07-01 10:34:23 2020-07-06 10:34:23 6 INAP 6308064504630001
2020-07-01 12:29:42 2020-07-10 12:29:42 10 INAP 6308052011680001
2020-07-01 14:21:33 2020-07-11 14:21:33 11 INAP 6308063112700003
2020-07-11 12:12:27 2020-07-17 12:12:27 7 INAP 6308054110690001
2020-07-12 12:23:13 2020-07-12 12:23:13 1 INAP 6308050311740005
2020-07-15 10:07:39 2020-07-18 10:07:39 4 INAP 6308091502750001
2020-07-16 09:23:26 2020-07-18 09:23:26 3 INAP 6308052806620001
2020-08-07 13:26:36 2020-08-09 13:26:36 3 INAP 6308065108600003
2020-06-07 08:23:06 2020-06-09 10:15:00 3 INAP 63099115103870002
2020-06-08 09:04:11 2020-06-08 09:04:11 1 INAP 6308017008800001
2020-06-08 11:25:15 2020-06-12 11:25:15 5 INAP 6308055010610010
2020-06-09 09:42:18 2020-06-12 09:42:18 4 INAP 6308055305590001
2020-06-12 11:35:17 2020-06-13 11:35:17 2 INAP 6308076706770002
2020-06-12 10:32:59 2020-06-15 10:32:59 4 INAP 6308051108610004
2020-06-12 06:36:47 2020-06-17 06:36:47 6 INAP 6308056307640001
2020-06-12 09:34:57 2020-06-19 09:34:57 8 INAP 6308010808720002
2020-06-13 09:12:11 2020-07-01 09:12:11 19 INAP 6308052905800001
2020-06-18 10:07:03 2020-06-21 10:07:03 4 INAP 6308030808520002
2020-06-19 10:42:55 2020-06-24 10:42:55 6 INAP 6308052503550003
JENIS HASIL VERIFIK
2020-06-19 10:43:01 2020-06-22 10:43:01 4 INAP 6308040101780002
2020-06-19 08:26:05 2020-06-24 08:26:05 6 INAP 63080503030880000
2020-07-01 10:07:48 2020-07-10 10:07:48 10 INAP 6308051609800004
2020-07-06 08:46:59 2020-07-11 08:46:59 6 INAP 6306050106460001
2020-07-08 07:20:58 2020-07-25 07:20:58 18 INAP 6204062007740002
2020-07-10 11:48:54 2020-08-01 11:48:54 23 INAP 6308051112570001
2020-07-10 13:37:01 2020-07-16 13:37:01 7 INAP 6308056905110001
2020-07-11 13:41:12 2020-07-18 13:41:12 8 INAP 6308056212650004
2020-07-14 09:05:02 2020-07-18 09:05:02 5 INAP 6308044609030001
2020-07-20 10:52:00 2020-07-23 10:52:00 4 INAP 6308062104490001
2020-08-07 11:00:09 2020-08-19 11:00:09 13 INAP 6308030909640002
2020-08-19 10:24:00 2020-08-23 10:24:00 5 INAP 6311021009990002
2020-08-19 10:54:35 2020-08-24 10:54:35 6 INAP 6308061810500001
2020-04-10 09:42:20 2020-04-15 09:42:20 6 INAP 6306050407670004
2020-04-10 10:58:23 2020-04-15 10:58:23 6 INAP 6306014107550059
2020-04-11 10:48:50 2020-04-17 10:48:50 7 INAP 6306070105620001
2020-04-13 08:07:36 2020-04-17 08:07:36 5 INAP 6306070205860005
2020-04-14 06:55:27 2020-04-17 06:55:27 4 INAP 6306082006500001
2020-04-14 07:14:42 2020-04-27 07:14:42 14 INAP 6303040701880005
2020-04-15 06:58:32 2020-04-23 06:58:32 9 INAP 6307015207620008
2020-04-16 09:40:31 2020-04-28 09:40:31 13 INAP 6306020305080001
2020-04-16 11:13:55 2020-04-28 11:13:55 13 INAP 6306020211120005
2020-04-16 12:24:03 2020-04-19 12:24:03 4 INAP 6306022704780001
2020-04-17 11:40:47 2020-04-23 11:40:47 7 INAP 6307013012850001
2020-04-17 10:23:30 2020-04-22 10:23:30 6 INAP 6306052108770001
2020-04-18 08:49:41 2020-04-18 08:49:41 1 INAP 6306070112000002
2020-04-20 07:19:19 2020-04-24 07:19:19 5 INAP 6306065204690001
2020-04-22 09:57:45 2020-04-26 09:57:45 5 INAP 6305124204790001
2020-04-23 09:52:16 2020-04-26 09:52:16 4 INAP 6306090508980001
2020-04-24 11:43:05 2020-04-29 11:43:05 6 INAP 6306082102690001
2020-04-25 09:11:22 2020-04-28 09:11:22 4 INAP 6306081007970002
2020-05-01 08:17:02 2020-05-04 08:17:02 4 INAP 6302085509750001
2020-05-03 07:39:49 2020-05-13 07:39:49 11 INAP 6306050302610001
2020-05-03 07:01:06 2020-05-19 07:01:06 17 INAP 6306056806490002
2020-05-03 07:18:14 2020-05-13 07:18:14 11 INAP 6306052903650001
2020-05-05 09:25:25 2020-05-12 09:25:25 8 INAP 6306063108530001
2020-05-06 08:20:29 2020-05-14 08:20:29 9 INAP 6306020107750117
2020-05-07 09:10:13 2020-05-08 09:10:13 2 INAP 6271014807690004
2020-05-09 12:58:59 2020-05-16 12:58:59 8 INAP 6306073112700009
2020-05-12 10:04:08 2020-06-09 10:04:08 29 INAP 6306070201570002
2020-05-17 11:30:33 2020-05-30 11:30:33 14 INAP 6372025707000002
2020-05-18 08:24:26 2020-05-30 08:24:26 13 INAP 6371053112550058
2020-05-19 08:19:58 2020-06-01 08:19:58 14 INAP 6306062012800002
2020-05-21 12:38:46 2020-05-27 12:38:46 7 INAP 6306084505010002
2020-05-21 12:40:52 2020-06-04 12:40:52 15 INAP 6372021607750001
2020-05-22 09:05:26 2020-06-19 09:05:26 29 INAP 6305097009580001
2020-05-22 08:30:53 2020-06-19 08:30:53 29 INAP 6305020411560001
2020-05-22 08:48:11 2020-06-19 08:48:11 29 INAP 6305090303490001
2020-05-24 09:45:28 2020-05-25 09:45:28 2 INAP 6306080107500054
2020-05-26 09:46:30 2020-06-08 09:46:30 14 INAP 6306030804830001
2020-05-27 12:50:12 2020-06-18 12:50:12 23 INAP 6306094202500001
2020-05-29 10:08:49 2020-06-10 10:08:49 13 INAP 6307040708670003
2020-05-30 11:08:27 2020-06-12 11:08:27 14 INAP 630406108820001
2020-05-31 08:59:55 2020-06-25 08:59:55 26 INAP 6306051207570001
2020-06-03 09:01:29 2020-06-04 09:01:29 2 INAP 6307065710540002
2020-06-04 08:21:18 2020-06-19 08:21:18 16 INAP 6307064912680002
2020-06-05 12:54:37 2020-06-09 12:54:37 5 INAP 6306065510540001
2020-06-05 07:43:33 2020-06-13 07:43:33 9 INAP 6305030510610001
2020-06-06 10:34:53 2020-06-10 10:34:53 5 INAP 6306054802620001
2020-06-06 08:43:04 2020-06-14 08:43:04 9 INAP 6306085409950007
2020-06-07 13:11:03 2020-06-23 13:11:03 17 INAP 3316041408800002
2020-06-08 07:36:07 2020-06-16 07:36:07 9 INAP 6306023004560001
2020-06-09 07:48:19 2020-06-16 07:48:19 8 INAP 6306056502560002
2020-06-09 07:56:37 2020-06-13 07:56:37 5 INAP 6306080107570130
2020-06-09 07:19:04 2020-06-10 07:19:04 2 INAP 6371050706920003
2020-06-12 08:28:14 2020-06-20 08:28:14 9 INAP 6306064703860001
2020-06-12 08:35:44 2020-06-18 08:35:44 7 INAP 6306014205950001
2020-06-12 08:11:36 2020-06-20 08:11:36 9 INAP 6306064607620004
2020-06-12 09:11:55 2020-06-20 09:11:55 9 INAP 6306061007810001
2020-06-12 09:22:05 2020-06-20 09:22:05 9 INAP 6306092207880002
2020-06-12 11:08:23 2020-06-20 11:08:23 9 INAP 6306062204130001
2020-06-12 11:18:51 2020-06-20 11:18:51 9 INAP 6306065511940002
2020-06-14 08:52:11 2020-06-23 08:52:11 10 INAP 6306080101730003
2020-06-15 09:55:07 2020-06-22 09:55:07 8 INAP 6306061602660002
2020-06-15 09:08:45 2020-06-23 09:08:45 9 INAP 6306060202780001
2020-06-15 08:20:00 2020-06-23 08:20:00 9 INAP 6306045409710001
2020-06-15 11:06:11 2020-06-25 11:06:11 11 INAP 6306014508970001
2020-06-15 12:20:19 2020-06-25 12:20:19 11 INAP 6307066312930005
2020-06-16 08:07:40 2020-06-26 08:07:40 11 INAP 6306055902470001
2020-06-16 11:21:51 2020-06-25 11:21:51 10 INAP 6171014803780018
2020-06-16 07:44:38 2020-06-22 07:44:38 7 INAP 6307065604880007
2020-06-16 07:52:46 2020-06-22 07:52:46 7 INAP 6372056201880002
2020-06-16 12:42:55 2020-06-27 12:42:55 12 INAP 6306045005790002
2020-06-17 07:32:01 2020-06-19 07:32:01 3 INAP 6306051002540004
2020-06-23 08:33:02 2020-06-24 08:33:02 2 INAP 6306074104920002
2020-06-25 11:10:38 2020-06-27 11:10:38 3 INAP 6306050107670414
2020-04-21 09:58:36 2020-05-10 09:58:36 20 INAP 6306110712770001
2020-05-03 07:37:34 2020-05-13 07:37:34 11 INAP 6306085203660003
2020-05-11 08:49:47 2020-05-12 08:49:47 2 INAP 6310095801820008
2020-05-18 11:36:29 2020-06-12 11:36:29 26 INAP 6371044305840010
2020-05-19 10:55:12 2020-06-12 10:55:12 25 INAP 6371014404720012
2020-05-26 09:36:19 2020-06-08 09:36:19 14 INAP 6307064410630003
2020-05-27 10:55:54 2020-06-11 10:55:54 16 INAP 6306084102490002
2020-05-29 12:16:11 2020-06-12 12:16:11 15 INAP 6309044111940012
2020-06-09 08:00:06 2020-06-25 08:00:06 17 INAP 630609311260003
2020-06-11 11:16:45 2020-06-11 11:16:45 1 INAP 6306056503700001
2020-06-12 10:05:44 2020-06-20 10:05:44 9 INAP 6306061507610002
2020-06-15 11:11:14 2020-06-25 11:11:14 11 INAP 6306017005940004
2020-06-23 12:07:28 2020-06-24 12:07:28 2 INAP 6306024103650002
2020-06-23 11:09:31 2020-06-24 11:09:31 2 INAP 6306082102690001
2020-06-23 08:18:48 2020-06-24 08:18:48 2 INAP 6306026306810001
2020-05-18 11:00:00 2020-05-30 11:50:00 13 INAP 0002373752608
2020-05-23 16:32:14 2020-05-24 17:05:00 2 INAP 63-6080107500054
2020-05-30 16:15:00 2020-05-31 21:05:00 2 INAP 6306051207570001
2020-05-06 00:00:00 2020-05-10 00:00:00 5 INAP 0000892755685
2020-05-09 05:00:00 2020-05-09 21:05:00 1 INAP 0002620281969
2020-05-15 10:00:00 2020-05-21 21:20:00 7 INAP 0000892885544
2020-06-11 14:59:54 2020-06-18 09:00:54 8 INAP 6306084102490002
2020-06-11 18:40:26 2020-06-12 18:05:26 2 INAP 6306074203920005
2020-06-11 23:50:53 2020-06-13 13:00:53 3 INAP 6306084107830257
2020-06-12 18:30:37 2020-06-22 13:50:37 11 INAP 6309044111940012
2020-06-13 18:25:11 2020-06-19 09:32:11 7 INAP 6371044305840010
2020-06-18 00:20:20 2020-06-19 10:30:20 2 INAP 6306074608690001
2020-05-29 11:50:00 2020-06-01 13:00:00 4 INAP 6306114503510001
2020-05-30 16:30:14 2020-06-14 12:00:14 16 INAP 6306080101730003
2020-06-16 18:36:32 2020-06-30 13:00:32 15 INAP 6306045903100001
2020-06-16 15:30:00 2020-06-18 22:30:20 3 INAP 6306061111690003
2020-06-23 06:42:15 2020-06-23 06:42:15 1 JALAN 6306074104920002
2020-06-12 18:00:03 2020-07-04 13:20:03 23 INAP 6306046106820003
2020-06-12 18:00:48 2020-07-04 13:30:48 23 INAP 6371014404720012
2020-06-16 13:00:25 2020-07-04 13:30:25 19 INAP 6306071006810001
2020-06-18 18:12:27 2020-07-21 13:00:27 34 INAP 6306085812760002
2020-06-22 17:00:07 2020-07-21 13:20:07 30 INAP 6306085306040001
2020-06-22 12:00:37 2020-07-21 12:00:37 30 INAP 6306086003760001
2020-06-23 16:30:23 2020-07-21 12:45:23 29 INAP 6306080101730003
2020-06-30 17:30:03 2020-07-15 13:03:03 16 INAP 6306084310180001
2020-06-30 17:30:55 2020-07-23 11:30:55 24 INAP 6306084107640160
2020-07-03 08:55:41 2020-07-23 13:30:41 21 INAP 6306085010910002
2020-07-04 18:53:11 2020-07-23 12:40:11 20 INAP 6306084107520196
2020-07-04 14:00:23 2020-07-23 13:30:23 20 INAP 6306083112770001
2020-07-04 18:30:36 2020-07-23 12:00:36 20 INAP 6306085704960003
2020-07-04 18:30:00 2020-07-15 12:40:00 12 INAP 6306086108800001
2020-07-08 13:41:52 2020-07-23 13:20:52 16 INAP 6306074908670003
2020-07-08 12:00:23 2020-07-25 11:00:23 18 INAP 6306080107520115
2020-07-09 19:52:24 2020-07-24 13:05:24 16 INAP 6306080807700001
2020-07-09 13:25:56 2020-07-24 13:00:00 16 INAP 6371043012640013
2020-07-09 13:23:12 2020-07-24 13:00:12 16 INAP 6306080107520115
2020-07-15 05:30:00 2020-07-15 18:30:00 1 INAP 6306076707010001
2020-07-17 11:59:39 2020-07-30 13:30:39 14 INAP 6306080107740103
2020-07-17 12:30:52 2020-07-30 13:30:52 14 INAP 6306085404910003
2020-07-22 12:05:56 2020-07-30 13:30:56 9 INAP 6306070107670364
2020-07-23 18:30:10 2020-07-30 12:30:10 8 INAP 6306020502580001
2020-06-18 10:30:41 2020-07-04 13:30:41 17 INAP 6271011001790006
2020-06-18 18:00:47 2020-07-18 12:10:47 31 INAP 6306085206680001
2020-06-18 18:12:00 2020-07-21 13:15:00 34 INAP 6306080204960006
2020-06-23 17:30:32 2020-07-13 11:00:32 21 INAP 6306110112950001
2020-07-07 00:35:40 2020-07-07 13:40:40 1 INAP 6306054107450204
2020-08-06 23:35:26 2020-08-26 16:02:26 21 INAP 6307050107840103
2020-08-11 17:00:40 2020-08-22 18:37:40 12 INAP 6306070704030001
2020-06-03 08:14:12 2020-06-04 08:14:12 2 INAP 6307064912680002
2020-06-09 09:38:54 2020-06-16 09:38:54 8 INAP 6307061907770002
2020-06-12 09:39:20 2020-06-17 09:39:20 6 INAP 6307101508600001
2020-06-12 08:01:36 2020-06-19 08:01:36 8 INAP 6307044708680002
2020-06-18 09:10:56 2020-06-25 09:10:56 8 INAP 6306040710690003
2020-06-21 08:30:37 2020-07-01 08:30:37 11 INAP 6307065301660002
2020-07-05 08:06:30 2020-07-09 08:06:30 5 INAP 6307020809590002
2020-04-11 11:21:37 2020-04-13 11:21:37 3 INAP 6307045003000001
2020-04-13 07:59:46 2020-04-20 07:59:46 8 INAP 6307066905880004
2020-04-18 12:52:33 2020-04-26 12:52:33 9 INAP 6307064305530002
2020-04-20 07:51:47 2020-04-24 07:51:47 5 INAP 6371031605020009
2020-06-04 09:59:18 2020-06-07 09:59:18 4 INAP 630100604980005
2020-06-08 09:47:13 2020-06-10 09:47:13 3 INAP 6304026507870001
2020-06-09 08:56:38 2020-06-20 08:56:38 12 INAP 6307016811580002
2020-06-17 08:44:54 2020-06-18 08:44:54 2 INAP 6307060306540002
2020-06-18 09:03:44 2020-06-20 09:03:44 3 INAP 6307030510940002
2020-06-20 09:07:21 2020-06-24 09:07:21 5 INAP 6307060207590003
2020-06-24 08:23:12 2020-07-01 08:23:12 8 INAP 630702420170001
2020-06-25 08:46:40 2020-07-01 08:46:40 7 INAP 6307111607640001
2020-06-26 08:17:59 2020-07-01 08:17:59 6 INAP 6307064107650316
2020-06-29 08:22:07 2020-07-01 08:22:07 3 INAP 6307061708590006
2020-06-29 08:08:34 2020-07-07 08:08:34 9 INAP 6305090505840003
2020-06-30 07:55:57 2020-07-02 07:55:57 3 INAP 6307054609740001
2020-07-01 07:46:27 2020-07-06 07:46:27 6 INAP 6307062004770003
2020-07-17 08:28:43 2020-07-18 08:28:43 2 INAP 6371044305840010
2020-08-18 08:39:37 2020-08-18 08:39:37 1 JALAN 6307101707620001
2020-08-23 08:12:48 2020-08-23 08:12:48 1 JALAN 6307020304860004
2020-08-24 08:29:58 2020-08-24 08:29:58 1 JALAN 6307076707740002
2020-08-24 07:49:41 2020-08-24 07:49:41 1 JALAN 6307034207620015
2020-08-24 08:38:30 2020-08-24 08:38:30 1 JALAN 6307074107680285
2020-08-25 10:40:20 2020-08-25 10:40:20 1 JALAN 6307024107670112
2020-08-27 08:14:43 2020-08-27 08:14:43 1 JALAN 6311040901000001
2020-08-27 08:55:05 2020-08-27 08:55:05 1 JALAN 6307054107570207
2020-09-12 10:50:24 2020-09-12 10:50:24 1 JALAN 6307114511660002
2020-09-12 08:21:07 2020-09-12 08:21:07 1 JALAN 6307061107650008
2020-09-16 07:47:25 2020-09-16 07:47:25 1 JALAN 6307074910020003
2020-09-16 10:51:13 2020-09-16 10:51:13 1 JALAN 6307031101820003
2020-09-18 08:31:54 2020-09-18 08:31:54 1 JALAN 6307034912920002
2020-09-21 00:00:00 2020-09-21 00:00:00 1 JALAN 6307024104990001
2020-09-21 00:00:00 2020-09-21 00:00:00 1 JALAN 0002498092762
2020-09-21 11:00:34 2020-09-21 11:00:34 1 JALAN 6307046102960002
2020-09-27 10:49:21 2020-09-27 10:49:21 1 JALAN 6307042612770001
2020-08-28 09:13:37 2020-08-28 09:13:37 1 JALAN 6307110305710002
2020-08-29 00:00:00 2020-08-29 00:00:00 1 JALAN 6307060611020001
2020-09-02 07:45:08 2020-09-02 07:45:08 1 JALAN 6307061205690004
2020-09-03 00:00:00 2020-09-03 00:00:00 1 JALAN 6307060708650004
2020-09-09 00:00:00 2020-09-09 00:00:00 1 JALAN 6307110708570001
2020-09-10 10:41:31 2020-09-10 10:41:31 1 JALAN 6307064102750005
2020-09-12 08:39:44 2020-09-12 08:39:44 1 JALAN 6307066602910003
2020-09-22 10:47:12 2020-09-22 10:47:12 1 JALAN 6307072307730003
2020-09-22 11:10:26 2020-09-22 11:10:26 1 JALAN 6307064107820162
2020-09-22 10:36:44 2020-09-22 10:36:44 1 JALAN 6311044409700001
2020-09-24 00:00:00 2020-09-24 00:00:00 1 JALAN 6307110308760001
2020-07-08 08:41:45 2020-07-13 08:41:45 6 INAP 6307064107800158
2020-07-10 07:57:45 2020-07-14 07:57:45 5 INAP 630803509410001
2020-07-12 07:57:01 2020-07-17 07:57:01 6 INAP 6307066404790002
2020-07-15 07:37:10 2020-07-20 07:37:10 6 INAP 6307070201700003
2020-07-16 09:55:15 2020-07-20 09:55:15 5 INAP 6307034306720006
2020-07-17 07:53:50 2020-07-22 07:53:50 6 INAP 6307105307740001
2020-07-18 09:05:53 2020-07-22 09:05:53 5 INAP 6307045111840001
2020-07-18 08:05:41 2020-07-22 08:05:41 5 INAP 6307101307680001
2020-07-19 07:37:58 2020-07-22 07:37:58 4 INAP 6307071005520001
2020-07-20 07:50:36 2020-07-21 07:50:36 2 INAP 6307054406570001
2020-07-20 08:26:26 2020-07-23 08:26:26 4 INAP 6307062004770003
2020-07-21 09:01:33 2020-07-22 09:01:33 2 INAP 6307060108490001
2020-07-22 09:25:03 2020-07-22 09:25:03 1 INAP 6307062511650001
2020-07-22 09:30:26 2020-07-24 09:30:26 3 INAP 6311060304920003
2020-07-22 09:16:39 2020-07-23 09:16:39 2 INAP 6307025409610001
2020-07-23 08:45:45 2020-07-28 08:45:45 6 INAP 6307061511680002
2020-07-23 08:54:08 2020-07-27 08:54:08 5 INAP 6307021012750001
2020-07-26 08:36:34 2020-07-29 08:36:34 4 INAP 6307061212560002
2020-07-26 08:29:37 2020-08-03 08:29:37 9 INAP 6307082403580001
2020-07-28 09:39:00 2020-07-29 09:39:00 2 INAP 6307042009560002
2020-07-28 09:04:37 2020-08-01 09:04:37 5 INAP 6307060502690005
2020-07-30 08:02:15 2020-08-03 08:02:15 5 INAP 6307060602710002
2020-07-31 10:34:56 2020-08-01 10:34:56 2 INAP 6471030505530003
2020-08-01 08:10:15 2020-08-06 08:10:15 6 INAP 6307042804420002
2020-08-01 08:20:26 2020-08-09 08:20:26 9 INAP 6371032308680007
2020-08-02 07:52:56 2020-08-06 07:52:56 5 INAP 3502166612910002
2020-08-03 08:13:02 2020-08-07 08:13:02 5 INAP 3276056305550004
2020-08-04 08:29:28 2020-08-06 08:29:28 3 INAP 6307055510930007
2020-08-05 08:58:19 2020-08-08 08:58:19 4 INAP 6307014107570169
2020-08-06 07:23:03 2020-08-12 07:23:03 7 INAP 6307061007440002
2020-08-06 08:26:33 2020-08-13 08:26:33 8 INAP 6307071402640005
2020-08-07 07:37:57 2020-08-11 07:37:57 5 INAP 6307062412770002
2020-08-07 07:36:23 2020-08-11 07:36:23 5 INAP 6307075208610002
2020-08-10 08:11:24 2020-08-13 08:11:24 4 INAP 6307076104500002
2020-08-11 08:05:14 2020-08-19 08:05:14 9 INAP 6307065409660001
2020-08-12 08:01:19 2020-08-15 08:01:19 4 INAP 6307010106810002
2020-08-12 09:02:20 2020-08-14 09:02:20 3 INAP 6307066004680003
2020-08-14 08:18:12 2020-08-16 08:18:12 3 INAP 6307026104550001
2020-08-14 07:56:20 2020-08-17 07:56:20 4 INAP 6307034205600003
2020-08-14 08:00:41 2020-08-16 08:00:41 3 INAP 6307064512770006
2020-08-16 07:47:36 2020-08-18 07:47:36 3 INAP 6307074808680002
2020-08-17 07:36:21 2020-08-20 07:36:21 4 INAP 6307051205620004
2020-08-19 08:28:12 2020-08-26 08:28:12 8 INAP 63070505017500038
2020-08-20 09:17:49 2020-08-24 09:17:49 5 INAP 6307065505800002
2020-08-21 07:43:07 2020-08-26 07:43:07 6 INAP 6307040705620003
2020-08-21 08:37:16 2020-08-25 08:37:16 5 INAP 6307020402600001
2020-08-21 00:00:00 2020-08-24 00:00:00 4 INAP 3401033006670001
2020-08-22 08:05:04 2020-08-28 08:05:04 7 INAP 0000124622717
2020-08-22 08:11:54 2020-08-25 08:11:54 4 INAP 6307030808550002
2020-08-22 08:15:02 2020-08-25 08:15:02 4 INAP 6307035808540002
2020-08-22 08:50:58 2020-08-26 08:50:58 5 INAP 6307042712640002
2020-08-23 07:28:10 2020-08-26 07:28:10 4 INAP 6307065904640003
2020-08-23 07:19:28 2020-08-26 07:19:28 4 INAP 6307031007730005
2020-08-24 08:30:29 2020-08-26 08:30:29 3 INAP 6307014305780001
2020-08-25 08:12:12 2020-08-27 08:12:12 3 INAP 6307061903750006
2020-08-25 09:02:00 2020-08-26 09:02:00 2 INAP 6310106308690001
2020-08-27 09:15:03 2020-08-28 09:15:03 2 INAP 6307024203850004
2020-08-27 09:24:51 2020-09-01 09:24:51 6 INAP 6307032005740001
2020-08-27 10:59:54 2020-08-31 10:59:54 5 INAP 6307060107550070
2020-09-02 10:32:47 2020-09-05 10:32:47 4 INAP 63070090107650065
2020-09-04 09:07:24 2020-09-09 09:07:24 6 INAP 6307061111550010
2020-09-04 11:35:57 2020-09-10 11:35:57 7 INAP 6307034407670007
2020-09-06 09:00:19 2020-09-11 09:00:19 6 INAP 6307064411800002
2020-09-06 09:01:29 2020-09-10 09:01:29 5 INAP 6307020604770001
2020-07-11 08:04:55 2020-07-13 08:04:55 3 INAP 6307061801680003
2020-07-21 09:41:04 2020-07-22 09:41:04 2 INAP 6307061408500002
2020-07-23 08:40:18 2020-07-23 08:40:18 1 INAP 6307064204720005
2020-08-03 08:49:33 2020-08-05 08:49:33 3 INAP 6307021009510002
2020-08-07 08:04:00 2020-08-11 08:04:00 5 INAP 6307056111580002
2020-08-13 07:46:55 2020-08-23 07:46:55 11 INAP 6307065103660003
2020-08-16 09:06:22 2020-08-19 09:06:22 4 INAP 6307020607650003
2020-08-18 08:37:46 2020-08-19 08:37:46 2 INAP 3524051903920003
2020-08-21 09:25:40 2020-08-23 09:25:40 3 INAP 6307054309620001
2020-08-27 09:00:17 2020-09-03 09:00:17 8 INAP 630706700451000
2020-08-27 08:41:57 2020-08-28 08:41:57 2 INAP 6307060603750002
2020-09-02 09:26:13 2020-09-10 09:26:13 9 INAP 6307036301670002
2020-09-07 09:00:39 2020-09-09 09:00:39 3 INAP 6307024203850004
2020-03-23 10:56:38 2020-03-23 10:56:38 1 JALAN 6311074609980001
2020-04-06 11:02:23 2020-04-06 11:02:23 1 JALAN 6311080708600001
2020-03-28 10:56:40 2020-03-28 10:56:40 1 JALAN 6311010101700002
2020-04-24 00:00:00 2020-05-05 00:00:00 12 INAP 6311062806710001
2020-05-14 00:00:00 2020-05-31 00:00:00 18 INAP 6371050508820005
2020-05-18 14:06:32 2020-05-23 14:06:32 6 INAP 6309064106750003
2020-05-27 00:00:00 2020-05-31 00:00:00 5 INAP 6311056305910002
2020-05-27 13:00:25 2020-06-03 13:00:25 8 INAP 6311060708710001
2020-05-27 13:27:50 2020-06-07 13:27:50 12 INAP 6311060505690001
2020-05-29 13:43:45 2020-06-16 13:43:45 19 INAP 6311012405570001
2020-06-01 14:01:40 2020-06-16 14:01:40 16 INAP 631101070250001
2020-06-02 13:33:23 2020-06-11 13:33:23 10 INAP 6311014107630010
2020-06-02 13:37:20 2020-06-12 13:37:20 11 INAP 6311064805650002
2020-06-02 13:20:32 2020-06-07 13:20:32 6 INAP 6311066701920001
2020-06-04 11:38:59 2020-06-16 11:38:59 13 INAP 6311011708740001
2020-06-04 14:13:05 2020-06-19 14:13:05 16 INAP 6311070504590002
2020-06-07 12:26:55 2020-06-21 12:26:55 15 INAP 6311042602060002
2020-06-08 08:54:09 2020-06-29 08:54:09 22 INAP 6311014204710001
2020-06-10 08:00:37 2020-06-21 08:00:37 12 INAP 6372050601930001
2020-06-14 00:00:00 2020-06-16 00:00:00 3 INAP 6311020303700001
2020-06-16 09:09:58 2020-06-30 09:09:58 15 INAP 6311022707590001
2020-06-16 09:23:22 2020-06-30 09:23:22 15 INAP 6311026405630001
2020-06-18 12:53:43 2020-06-25 12:53:43 8 INAP 6311011512140001
2020-06-18 13:08:32 2020-06-25 13:08:32 8 INAP 6311016911090001
2020-06-18 13:21:02 2020-06-25 13:21:02 8 INAP 6311016401920001
2020-06-19 13:51:29 2020-06-25 13:51:29 7 INAP 6311066812900001
2020-06-19 12:09:42 2020-06-20 12:09:42 2 INAP 3310185909880002
2020-06-20 12:52:28 2020-06-24 12:52:28 5 INAP 6307084304920002
2020-06-23 00:00:00 2020-06-25 00:00:00 3 INAP 6309054809970002
2020-06-25 08:51:20 2020-06-29 08:51:20 5 INAP 6311024704950003
2020-06-26 00:00:00 2020-06-29 00:00:00 4 INAP 6311024206920001
2020-06-27 09:47:57 2020-06-30 09:47:57 4 INAP 6308016004800001
2020-06-14 00:41:00 2020-06-14 00:41:00 1 JALAN 6311012812690001
2020-06-14 00:41:00 2020-06-14 00:41:00 1 JALAN 6311010311880001
2020-08-17 02:00:00 2020-08-28 14:00:00 12 INAP 31740201108310101
2020-08-18 11:55:00 2020-08-25 12:00:00 8 INAP 6305011006780002
2020-08-19 14:40:00 2020-08-26 14:00:00 8 INAP 6305012302630001
2020-08-21 14:20:00 2020-08-26 12:00:00 6 INAP 6305095505650001
2020-08-24 18:00:00 2020-08-29 18:00:00 6 INAP 6371032309930007
2020-08-19 18:50:00 2020-08-21 15:50:00 3 INAP 6372066008840004
2020-08-28 13:20:00 2020-08-28 22:00:00 1 INAP 6305041409790003
2020-08-18 16:50:00 2020-08-18 16:50:00 1 JALAN 6305010310700002
2020-08-26 17:25:00 2020-08-26 17:25:00 1 JALAN 6305045001570001
2020-08-15 09:45:00 2020-09-07 13:00:00 24 INAP 6305094108660001
2020-08-29 08:40:00 2020-09-14 13:00:00 17 INAP 6305045705670001
2020-08-29 22:50:00 2020-09-14 13:00:00 17 INAP 6305124107630012
2020-09-01 19:25:00 2020-09-11 14:00:00 11 INAP 6305045504730001
2020-09-03 10:30:00 2020-09-07 11:00:00 5 INAP 6305120101600004
2020-09-05 14:00:00 2020-09-23 14:00:00 19 INAP 6305046011530002
2020-09-05 13:40:00 2020-09-12 13:00:00 8 INAP 6305020105660001
2020-09-07 21:45:00 2020-09-23 15:00:00 17 INAP 6305120912370001
2020-09-10 17:20:00 2020-09-23 14:00:00 14 INAP 6203046102840004
2020-09-10 17:30:00 2020-09-22 16:00:00 13 INAP 6305054906710002
2020-09-10 17:20:00 2020-09-12 09:00:00 3 INAP 6305041011830004
2020-09-12 10:20:00 2020-09-16 15:30:00 5 INAP 6305011708580002
2020-09-15 19:20:00 2020-09-19 11:00:00 5 INAP 6305021012580001
2020-09-16 10:30:00 2020-09-26 11:00:00 11 INAP 630504171280001
2020-09-16 23:35:00 2020-09-17 16:00:00 2 INAP 6371020603770010
2020-09-17 09:00:00 2020-09-23 12:00:00 7 INAP 6305010805560001
2020-09-17 19:00:00 2020-09-25 16:00:00 9 INAP 6305041204540001
2020-09-18 08:40:00 2020-09-25 16:00:00 8 INAP 630504510560002
2020-09-18 11:00:00 2020-09-28 15:00:00 11 INAP 6307020401810002
2020-09-18 05:00:00 2020-09-26 13:00:00 9 INAP 6305045701590002
2020-09-19 15:00:00 2020-09-26 13:30:00 8 INAP 6305040102600003
2020-09-19 09:30:00 2020-09-28 15:00:00 10 INAP 6305011905770001
2020-09-21 07:50:00 2020-09-26 13:00:00 6 INAP 6305034802680001
2020-09-21 09:10:00 2020-09-26 13:00:00 6 INAP 6305111106650001
2020-09-22 09:00:00 2020-09-26 13:00:00 5 INAP 6305120107520028
2020-09-25 09:45:00 2020-09-29 13:00:00 5 INAP 6305080405600001
2020-09-08 21:40:00 2020-09-09 16:00:00 2 INAP 6371055103630001
2020-09-01 10:35:00 2020-09-01 10:35:00 1 JALAN 6305014711870002
2020-09-01 10:15:00 2020-09-01 10:15:00 1 JALAN 6305066005650001
2020-09-07 10:00:00 2020-09-07 10:00:00 1 JALAN 3302112311940002
2020-09-12 08:33:45 2020-09-12 08:33:45 1 JALAN 6305010103740003
2020-09-12 10:00:00 2020-09-12 10:00:00 1 JALAN 3374112603890003
2020-09-14 10:00:00 2020-09-14 10:00:00 1 JALAN 6305046712850001
2020-09-14 10:00:00 2020-09-14 10:00:00 1 JALAN 6309061705180002
2020-09-14 10:00:00 2020-09-14 10:00:00 1 JALAN 6309064704900003
2020-09-14 10:00:00 2020-09-14 10:00:00 1 JALAN 6309062705150001
2020-09-16 10:00:00 2020-09-16 10:00:00 1 JALAN 6305046303790002
2020-09-30 21:23:00 2020-09-30 21:23:00 1 JALAN 6305101001550001
NMPESERTA TGLLAHIRPASIEN UMUR KDINACBG TARIPINACBG TOTALGRUPER
o p q r s t
MEGAWATI 1969-12-07 50 A-4-13-I 2069600.00 2069600
DESI LISNAWATI 1995-12-08 24 A-4-13-I 2069600.00 2069600
RUCI HENDRO GUNAWAN 1972-04-29 48 A-4-13-I 2069600.00 2069600
ARIES SUPRIYANTO 1976-04-13 44 Z-4-12-I 2092500.00 2092500
MAHFUZAH 1968-01-12 52 A-4-13-I 2069600.00 2069600
RATNA IKAWATI 1991-01-08 29 A-4-13-I 2069600.00 2069600
MANSYAH 1969-11-14 50 A-4-13-I 2069600.00 2069600
YULA 1992-06-16 28 A-4-13-I 2069600.00 2069600
FEBRYAN RADIX KENCANA 1995-02-26 25 A-4-13-I 2069600.00 2069600
SUMARNI 1966-04-20 54 Z-4-12-I 2092500.00 2092500
MADERIANI S. 1968-07-06 52 A-4-13-I 2069600.00 2069600
SONI SURYO PUTRO 1983-09-19 36 Z-4-12-III 8864100.00 8864100
ABDUL AZIS 1965-06-27 54 Z-4-12-I 2092500.00 2092500
HERLAN KOMANDO 1988-06-22 31 Z-4-12-I 2092500.00 2092500
TN KASRAN 1950-05-26 70 A-4-13-III 4389000.00 4389000
H. MUSA 1957-04-07 63 A-4-13-I 2069600.00 2069600
HJ.FATIMAH, NY 1966-03-26 54 Z-4-12-II 4201500.00 4201500
JAMSUNI 1966-06-21 53 A-4-13-I 2069600.00 2069600
AKHMAD BUSYAIRI 1979-08-16 40 A-4-13-I 2069600.00 2069600
UTUH ANWARI,H,TN 1957-06-10 62 A-4-13-III 4389000.00 4389000
ASRA 1953-02-10 67 A-4-13-III 4389000.00 4389000
HAMISAH 1961-03-06 59 Z-4-12-III 8864100.00 8864100
PARJIDI 1957-12-12 62 A-4-13-III 4389000.00 4389000
H. MUSA 1957-04-07 63 A-4-13-III 4389000.00 4389000
MARWAN.HS,TN 1947-08-15 72 A-4-13-I 2069600.00 2069600
SYUKERI 1965-04-04 55 A-4-13-I 2069600.00 2069600
SAYU 1942-01-05 78 Z-4-12-I 2092500.00 2092500
TIMAH 1942-07-01 77 Z-4-12-II 4201500.00 4201500
ZAINUDDIN 1964-09-12 55 Z-4-12-II 4201500.00 4201500
WARDINAH 1972-07-24 47 A-4-13-III 4389000.00 4389000
PURWANTO 1969-04-17 51 Z-4-12-I 2092500.00 2092500
RUSITA 1956-12-29 63 Z-4-12-I 2092500.00 2092500
NASRAN 1978-11-17 41 Z-4-12-III 8864100.00 8864100
RAHMAT 1962-04-15 58 A-4-13-II 3657500.00 3657500
SITI RUKAYAH 1945-06-29 74 Z-4-12-III 8864100.00 8864100
SUHAILI 1973-02-02 47 Z-4-12-III 8864100.00 8864100
RUDIANSYAH 1974-03-05 46 Z-4-12-II 4201500.00 4201500
RUSINAH 1954-06-10 66 Z-4-12-I 2092500.00 2092500
MUHAMMAS IQBAL HIDAYAT1994-07-02 25 Z-4-12-I 2092500.00 2092500
AHMAD HAIRANI, H 1955-02-27 65 Z-4-12-I 2092500.00 2092500
HAMSIAH 1963-04-05 57 Z-4-12-III 8864100.00 8864100
SYAKHBANIE HANIEF 1986-11-20 33 A-4-13-I 2069600.00 2069600
M. YUSUP 1970-12-31 49 Z-4-12-I 2092500.00 2092500
NURUL HIDAYAH 1969-10-10 50 A-4-13-II 3657500.00 3657500
NOOR EHSAN 1974-11-03 45 A-4-13-I 2069600.00 2069600
HASAN NOOR 1975-02-15 45 A-4-13-II 3657500.00 3657500
ALFIANNOR 1962-06-28 58 A-4-13-I 2069600.00 2069600
RUKMINI 1960-08-11 59 Z-4-12-II 4201500.00 4201500
FITRI 1987-03-01 33 A-4-13-I 2069600.00 2069600
JAIDAH 1980-06-30 39 Z-4-12-I 2092500.00 2092500
SITI SYAHRIAH 1961-10-10 58 A-4-13-I 2069600.00 2069600
ARSUNA 1959-02-13 61 A-4-13-I 2069600.00 2069600
ASIH NURWAHYUNI 1977-06-27 42 A-4-13-I 2069600.00 2069600
KARLAN 1961-08-11 58 A-4-13-I 2069600.00 2069600
ZULAIKHA 1964-07-23 55 A-4-13-II 3657500.00 3657500
TAUFIK HB 1972-08-08 47 Z-4-12-I 2092500.00 2092500
AHMADI 1980-05-29 40 A-4-13-II 3657500.00 3657500
KASTALANI 1952-08-08 67 A-4-13-I 2069600.00 2069600
JENIS HASIL VERIFIKASI
SYAHRIL, H. AHMAD 1955-03-25 65 A-4-13-II 3657500.00 3657500
H. RUSDI 1978-01-01 42 A-4-13-II 3657500.00 3657500
H. MUS'ADI 1980-08-03 39 A-4-13-I 2069600.00 2069600
Robiyadi 1980-09-16 39 A-4-13-I 2069600.00 2069600
MAHYUDIN NOOR 1946-06-01 74 A-4-13-I 2069600.00 2069600
GAZALI RAHMAN 1974-07-20 45 A-4-13-II 3657500.00 3657500
ARJURAHMAN 1957-12-11 62 A-4-13-II 3657500.00 3657500
NADRATUN NA'IM 2011-05-09 9 A-4-13-III 4389000.00 4389000
MAHFUZAH 1965-12-22 54 A-4-13-I 2069600.00 2069600
ROHANI 2003-09-06 16 A-4-13-III 4389000.00 4389000
ABDULLAH 1949-04-21 71 A-4-13-I 2069600.00 2069600
ABDUL MANAN 1963-11-06 56 A-4-13-I 2069600.00 2069600
ARIFIN SUSANTO 1999-09-10 20 A-4-13-I 2069600.00 2069600
ABDUL SANI, H 1950-10-18 69 A-4-13-II 3657500.00 3657500
SAIDINA HAMZAH 1967-07-04 52 Z-4-12-III 8864100.00 8864100
UMI 1955-07-01 64 Z-4-12-III 8864100.00 8864100
MATURIDI 1962-05-01 57 Z-4-12-III 8864100.00 8864100
JUHDI 1986-05-02 33 A-4-13-III 4389000.00 4389000
IBERAMSYAH 1950-06-20 69 A-4-13-III 4389000.00 4389000
QAMARIAH 1988-01-07 32 Z-4-12-III 8864100.00 8864100
NURASNI 1962-07-12 57 Z-4-12-III 8864100.00 8864100
MUHAMMAD RIFQI 2008-05-03 11 Z-4-12-I 2092500.00 2092500
MUHAMMAD YUSUF 2005-03-25 15 Z-4-12-I 2092500.00 2092500
ALIANSYAH 1978-04-27 41 A-4-13-III 4389000.00 4389000
ABDURRAHMAN 1985-12-30 34 Z-4-12-III 8864100.00 8864100
YUDA ARIADI 1974-01-04 46 Z-4-12-III 8864100.00 8864100
MUHAMMAD ARSYAD 2000-12-01 19 Z-4-12-III 8864100.00 8864100
PATIMAH 1969-04-12 51 Z-4-12-III 8864100.00 8864100
YENI PURWANTI 1979-04-02 41 Z-4-12-III 8864100.00 8864100
SURYANI 1998-08-05 21 Z-4-12-III 8864100.00 8864100
ABDUL MUIN 1969-02-21 51 Z-4-12-II 4201500.00 4201500
AZIZ 1997-07-10 22 Z-4-12-III 8864100.00 8864100
MARIANA 1975-09-15 44 Z-4-12-III 8864100.00 8864100
ABDUL MAJID 1961-02-03 59 Z-4-12-III 8864100.00 8864100
NORMALASIAH 1949-06-28 70 Z-4-12-III 8864100.00 8864100
MUHAMMAD KHAIRANI 1965-03-29 55 Z-4-12-III 8864100.00 8864100
MUHAMMAD SYAMSI 1963-08-31 56 Z-4-12-III 8864100.00 8864100
MUHAMMAD RUZI 1975-07-01 44 Z-4-12-III 8864100.00 8864100
HJ. AMINAH 1969-07-08 50 Z-4-12-III 8864100.00 8864100
THAMRIN 1970-12-31 49 Z-4-12-III 8864100.00 8864100
SURIANSYAH 1957-01-02 63 A-4-13-I 2069600.00 2069600
MIRNA MALINDA 2000-07-17 19 Z-4-12-III 8864100.00 8864100
ISRA 1955-12-31 64 Z-4-12-I 2092500.00 2092500
IBRAMSYAH 1980-12-20 39 Z-4-12-III 8864100.00 8864100
SITI WAQIAH 2001-06-05 18 Z-4-12-III 8864100.00 8864100
BAHRANI 1975-07-16 44 J-1-20-III 39455200.00 39455200
SITI RAHMAH 1958-09-30 61 A-4-13-I 2069600.00 2069600
M. BADRUN 1956-11-04 63 A-4-13-II 3657500.00 3657500
H. JURAIT-DJURAID 1949-03-03 71 A-4-13-III 4389000.00 4389000
MASJA 1950-07-01 69 Z-4-12-III 8864100.00 8864100
YUNANI 1983-04-08 37 Z-4-12-III 8864100.00 8864100
JURMIAH 1950-02-02 70 A-4-13-II 3657500.00 3657500
ASMUNI 1967-06-07 52 Z-4-12-II 4201500.00 4201500
ELMA 1982-08-21 37 A-4-13-I 2069600.00 2069600
MUHAMMAD RAMLI 1957-07-12 62 A-4-13-II 3657500.00 3657500
FARIDAH 1954-10-17 65 J-1-20-III 39455200.00 39455200
MURNIYATI 1968-12-09 51 A-4-13-II 3657500.00 3657500
MURLIM 1954-10-15 65 Z-4-12-III 8864100.00 8864100
SARPANDI 1961-10-05 58 Z-4-12-II 4201500.00 4201500
SRI PURNAMA DIAYATI 1962-02-08 58 A-4-13-II 3657500.00 3657500
HANI 1995-09-14 24 W-1-30-III 25329100.00 25329100
IMRON 1980-08-14 39 A-4-13-I 2069600.00 2069600
MUHAMMAD RASYIDI 1956-04-30 64 Z-4-12-II 4201500.00 4201500
DAHLIA HASANAH 1956-02-25 64 Z-4-12-II 4201500.00 4201500
SHALEH 1957-07-01 62 J-1-20-II 35059800.00 35059800
JUWANDI 1992-06-07 28 A-4-13-I 2069600.00 2069600
NANI YULIANTI 1986-03-07 34 A-4-13-I 2069600.00 2069600
MEGA ARIANTI 1995-05-02 25 Z-4-12-I 2092500.00 2092500
SITI ROKAYAH 1962-07-06 57 A-4-13-II 3657500.00 3657500
AHMAD MUKHTAR 1981-07-10 38 A-4-13-II 3657500.00 3657500
SYARIFUDIN 1988-07-22 31 A-4-13-I 2069600.00 2069600
MUHAMMAD ZAINUL FATAA 2013-04-22 7 A-4-13-I 2069600.00 2069600
RIZKA MAHMUDAH 1994-11-15 25 A-4-13-I 2069600.00 2069600
AHMAD NOOR 1973-01-01 47 A-4-13-II 3657500.00 3657500
NAJAMUDIN 1966-02-16 54 A-4-13-I 2069600.00 2069600
SUWANDI 1978-02-02 42 A-4-13-III 4389000.00 4389000
NANI PUDJI HASTUTI 1971-09-14 48 A-4-13-II 3657500.00 3657500
MUNAWARAH 1997-08-05 22 A-4-13-I 2069600.00 2069600
AHLIA NOOR CAHAYA 1993-12-23 26 A-4-13-I 2069600.00 2069600
RUSMANIAH 1947-02-19 73 A-4-13-III 4389000.00 4389000
S.K WINDU SUMERTINI 1978-03-10 42 A-4-13-II 3657500.00 3657500
WENNY RAHAYU 1988-04-16 32 A-4-13-I 2069600.00 2069600
DEVINTA IFANDARI 1988-01-22 32 A-4-13-I 2069600.00 2069600
MUSLIHANI 1979-05-10 41 A-4-13-II 3657500.00 3657500
FAKHRUDDIN NOOR 1954-02-10 66 Z-4-12-III 8864100.00 8864100
AMINAH 1992-04-01 28 Z-4-12-II 4201500.00 4201500
IMBERAN 1967-07-01 52 Z-4-12-III 8864100.00 8864100
RUNI 1977-12-07 42 A-4-13-I 2069600.00 2069600
SAPIAH 1966-03-12 54 Z-4-12-III 8864100.00 8864100
JALIHA ARTATI 1982-01-18 38 Z-4-12-III 8864100.00 8864100
MARIA 1984-05-03 36 A-4-13-II 3657500.00 3657500
RODIAH 1972-04-04 48 A-4-13-III 4389000.00 4389000
PATMAWATI 1963-10-04 56 Z-4-12-III 8864100.00 8864100
JAMILAH 1949-02-01 71 A-4-13-II 3657500.00 3657500
NORSAIDATUN NAFISAH 1994-11-01 25 A-4-13-I 2069600.00 2069600
ABDUL RAJAB 1960-12-31 59 A-4-13-I 2069600.00 2069600
ARBAINAH 1970-03-25 50 Z-4-12-II 4201500.00 4201500
H. KASNAN 1961-09-15 58 A-4-13-I 2069600.00 2069600
ANNISA SAWITRI NURIMANI 1994-05-30 26 A-4-13-I 2069600.00 2069600
JAM'AH 1965-03-01 55 Z-4-12-III 8864100.00 8864100
ABDUL MUIN 1969-02-21 51 Z-4-12-III 8864100.00 8864100
JAMIANI 1981-06-23 39 Z-4-12-III 8864100.00 8864100
ISMET 1978-06-20 41 Z-4-12-III 8864100.00 8864100
MASJA 1950-07-01 69 Z-4-12-III 8864100.00 8864100
RAMLI 1957-07-12 62 Z-4-12-III 8864100.00 8864100
KADERI 1963-10-10 56 Z-4-12-III 8864100.00 8864100
TAMRIN 1970-12-31 49 Z-4-12-III 8864100.00 8864100
SITI WAQI'AH 2001-05-01 19 Z-4-12-III 8864100.00 8864100
JAMILAH 1949-02-01 71 A-4-13-I 2069600.00 2069600
MARIA ULFAH 1992-03-02 28 Z-4-12-III 8864100.00 8864100
MERPATI 1983-07-01 36 Z-4-12-III 8864100.00 8864100
MARIA 1984-05-03 36 Z-4-12-I 2092500.00 2092500
LATIPAH HANI 1969-08-06 50 Z-4-12-I 2092500.00 2092500
JAMILAH 1961-03-05 59 Z-4-12-III 8864100.00 8864100
AHMAD NOOR 1973-01-01 47 A-4-13-III 4389000.00 4389000
REGINA PUTRI 2010-05-19 10 Z-4-12-III 8864100.00 8864100
ABDUL AZIZ 1969-11-11 50 A-4-13-III 4389000.00 4389000
AMINAH 1992-04-01 28 Q-5-44-0 377100.00 377100
HELMA 1982-08-21 37 A-4-13-I 2069600.00 2069600
RODIAH 1972-09-21 47 A-4-13-II 3657500.00 3657500
ELMI 1961-06-10 59 A-4-13-I 2069600.00 2069600
NOOR ZAKIAH 1976-12-18 43 A-4-13-I 2069600.00 2069600
ZAHRIA ZULFA 2004-06-13 16 A-4-13-I 2069600.00 2069600
HAINUN 1976-03-20 44 A-4-13-I 2069600.00 2069600
AHMAD NOOR 1973-01-01 47 A-4-13-I 2069600.00 2069600
SALMA KAMILA JAHRA 2018-10-03 1 A-4-13-I 2069600.00 2069600
NORHAYAH 1964-07-01 55 A-4-13-I 2069600.00 2069600
SITI ZULAIHA 1991-10-10 28 A-4-13-I 2069600.00 2069600
SYAMSIAH 1964-07-01 56 A-4-13-I 2069600.00 2069600
YUSUF 1977-12-31 42 A-4-13-I 2069600.00 2069600
JAMILAH 1996-04-17 24 A-4-13-I 2069600.00 2069600
MUSLIKAH 1980-08-21 39 A-4-13-I 2069600.00 2069600
DAULATUL HUSNIAH 1967-08-09 52 A-4-13-I 2069600.00 2069600
SUGIANTO 1986-01-31 34 A-4-13-I 2069600.00 2069600
ABDILLAH 1978-07-18 41 A-4-13-I 2069600.00 2069600
HAMIM 1964-12-20 55 A-4-13-I 2069600.00 2069600
MUHAMMAD JARKASI 1952-07-01 68 A-4-13-I 2069600.00 2069600
FITRI 2001-01-17 19 Z-4-12-I 2092500.00 2092500
ARBAIN 1974-07-01 46 A-4-13-I 2069600.00 2069600
LINAWATI 1991-04-14 29 A-4-13-I 2069600.00 2069600
ABAU 1967-07-01 53 Z-4-12-II 4201500.00 4201500
M ZAINAL ILMI 1958-02-05 62 Z-4-12-II 4201500.00 4201500
ABDUL GAFUR 1979-01-10 41 A-4-13-I 2069600.00 2069600
RUSDIANA 1968-06-12 52 A-4-13-I 2069600.00 2069600
MUHAMMAD DLIAURRAHMA1996-04-03 24 A-4-13-I 2069600.00 2069600
BASARUDIN 1995-12-01 24 A-4-13-I 2069600.00 2069600
MASIAH 1945-07-01 75 Z-4-12-I 2092500.00 2092500
SALAHUDIN EFENDI 1984-07-01 36 A-4-13-I 2069600.00 2069600
AFINDI 2003-04-07 17 Z-4-12-III 8864100.00 8864100
MURNIATI (PBI APBN) KELAS II1968-01-01 52 Z-4-12-II 4201500.00 4201500
SOVIA ARIANTO 1977-07-19 42 A-4-13-II 3657500.00 3657500
JAMHURI 1960-08-15 59 A-4-13-I 2069600.00 2069600
HJ. WAHIDAH 1968-08-07 51 A-4-13-II 3657500.00 3657500
MUKHTAR LOFI 1965-01-01 55 A-4-13-II 3657500.00 3657500
MUHIBAH 1966-01-13 54 Z-4-12-III 8864100.00 8864100
RUSLI 1959-09-08 60 Z-4-12-II 4201500.00 4201500
KARINA GITA ASNADITA 2000-03-10 20 Z-4-12-II 4201500.00 4201500
AGUSTINA NELLA MURNI 1987-05-29 32 Z-4-12-I 2092500.00 2092500
FATRAH, HJ 1953-05-03 66 Z-4-12-III 8864100.00 8864100
AKHMAD KAMAL NOOR 2002-05-16 17 Z-4-12-III 8864100.00 8864100
M. NOOR AINI 1998-04-06 22 Z-4-12-I 2092500.00 2092500
SRI YANOR 1987-07-25 32 O-6-10-II 6762600.00 6762600
KURNIAH 1958-12-01 61 Z-4-12-II 4201500.00 4201500
KASPUL ANWAR 1954-06-03 66 Z-4-12-III 8864100.00 8864100
MUHAMMAD RAHMADANI 1994-10-05 25 Z-4-12-II 4201500.00 4201500
SYAMSUDIN 1946-02-01 74 Z-4-12-III 8864100.00 8864100
JUMIATI 1970-01-02 50 A-4-13-III 4389000.00 4389000
SYARIFUDIN 1964-07-16 55 Z-4-12-III 8864100.00 8864100
SA'ADAH 1965-07-01 54 A-4-13-III 4389000.00 4389000
RUSMADIAN 1959-08-17 60 A-4-13-II 3657500.00 3657500
BAMBANG IRIANTO 1984-05-05 36 A-4-13-III 4389000.00 4389000
ISTIAH 1974-06-09 46 A-4-13-III 4389000.00 4389000
EDUARDI 1977-04-20 43 A-4-13-III 4389000.00 4389000
MARIA 1984-05-03 36 Z-4-12-III 8864100.00 8864100
ASUH 1962-07-17 58 J-3-13-0 473300.00 473300
ZAINAL ILMI 1986-04-03 34 Q-5-44-0 377100.00 377100
RANIAH 1974-07-27 46 Q-5-44-0 377100.00 377100
KAMALIAH 1962-07-02 58 J-3-13-0 473300.00 473300
PARIDAH 1968-07-01 52 Q-5-44-0 377100.00 377100
RUSMIATI 1967-07-01 53 Q-5-44-0 377100.00 377100
RANI 2000-09-01 19 L-3-12-0 373100.00 373100
MAGFIRAH 1957-07-01 63 Q-5-44-0 377100.00 377100
SITI JAWIAH 1966-11-05 53 J-3-13-0 473300.00 473300
M. SAYUTI 1965-07-11 55 Q-5-44-0 377100.00 377100
SITI HAIRUN NAZILA 2002-10-09 17 Q-5-44-0 377100.00 377100
MUHAMAD SALEH 1982-01-11 38 Q-5-44-0 377100.00 377100
NURHIKMAH 1992-12-09 27 Q-5-44-0 377100.00 377100
NURUL HIDAYAH 1999-02-22 21 Q-5-44-0 377100.00 377100
NORMAS 1963-12-20 56 Q-5-44-0 377100.00 377100
FITRIYYAH 1996-02-21 24 Q-5-44-0 377100.00 377100
MUZAIN 1977-12-26 42 Q-5-44-0 377100.00 377100
YAHYA KODARI 1971-05-03 49 Q-5-44-0 377100.00 377100
RAMADANI 2002-11-06 17 J-3-13-0 473300.00 473300
SASERA 1969-05-12 51 Q-5-44-0 377100.00 377100
SYAKERANIE 1965-08-07 55 Q-5-44-0 377100.00 377100
BADERI 1957-08-07 63 Q-5-44-0 377100.00 377100
AISYAH 1975-02-01 45 Q-5-44-0 377100.00 377100
RAUDATUL JANNAH (PBI/APBN)
1991-02-01 29 Q-5-44-0 377100.00 377100
ABDURRAHMAN 1973-07-23 47 J-3-13-0 473300.00 473300
WAHDANIAH 1976-10-06 43 Q-5-44-0 377100.00 377100
ZUBAIDAH 1970-09-04 50 Q-5-44-0 377100.00 377100
JURJANI 1976-08-03 44 Q-5-44-0 377100.00 377100
RASMI 1980-07-01 40 A-4-13-I 2069600.00 2069600
MUHAMMAD ANWAR-SALEH1941-09-05 78 Z-4-12-II 4201500.00 4201500
KARMILA 1979-04-24 41 Z-4-12-II 4201500.00 4201500
ABDUL RASYID 1970-01-02 50 A-4-13-II 3657500.00 3657500
RABIATUL ADAWIYAH 1972-06-03 48 A-4-13-I 2069600.00 2069600
SAMNAH 1974-07-13 46 A-4-13-II 3657500.00 3657500
RAHMAWATI 1984-11-11 35 A-4-13-II 3657500.00 3657500
MAJIDI RAHMAN 1968-07-13 52 A-4-13-III 4389000.00 4389000
AKHMAD JAMIDI 1952-05-10 68 A-4-13-I 2069600.00 2069600
ARBAINAH 1957-06-04 63 A-4-13-III 4389000.00 4389000
EDUARDI 1977-04-20 43 A-4-13-II 3657500.00 3657500
ABDULLAH 1949-08-01 70 A-4-13-I 2069600.00 2069600
SIGIT DODIRIWONDO 1965-11-25 54 A-4-13-II 3657500.00 3657500
IN'AMUL HASAN 1992-04-03 28 A-4-13-I 2069600.00 2069600
ASIAH 1961-09-14 58 A-4-13-II 3657500.00 3657500
EDY SUDARWANTO 1968-11-15 51 A-4-13-I 2069600.00 2069600
KHAIRUL 1975-12-10 44 A-4-13-I 2069600.00 2069600
MARKUNI 1956-12-12 63 Z-4-12-II 4201500.00 4201500
ASY'ARI 1958-03-24 62 A-4-13-III 4389000.00 4389000
MUSA 1956-09-20 63 Z-4-12-III 8864100.00 8864100
MUHAMMAD NOOR 1969-02-05 51 A-4-13-I 2069600.00 2069600
AHMAD SYATIBI, S.AG 1971-02-06 49 Z-4-12-II 4201500.00 4201500
FATHAN 1953-05-01 67 Z-4-12-I 2092500.00 2092500
MUHAMMAD BARKATI 1942-04-28 78 Z-4-12-II 4201500.00 4201500
DJUFRI AHMAD 1968-08-23 51 Z-4-12-II 4201500.00 4201500
DESY SULISDIANA WATI 1991-12-26 28 Z-4-12-I 2092500.00 2092500
ST ADDINIYAH HA 1955-05-23 65 A-4-13-II 3657500.00 3657500
SARI MULIANI 1993-10-15 26 A-4-13-II 3657500.00 3657500
HALIDAH 1957-07-01 63 A-4-13-II 3657500.00 3657500
SADERI MASERI 1944-07-10 76 A-4-13-I 2069600.00 2069600
MOHAMMAD HAITAMI (PNS DA 1964-02-14 56 A-4-13-III 4389000.00 4389000
AMRULLAH 1977-12-24 42 Z-4-12-II 4201500.00 4201500
SRI AGUSTINI 1961-08-12 58 A-4-13-II 3657500.00 3657500
RUSNA WATI 1950-04-21 70 Z-4-12-II 4201500.00 4201500
BASRIAH / PENSIUNAN TNI KLS1966-09-14 53 A-4-13-I 2069600.00 2069600
ABU JARIN AL GIFARI 1981-06-01 39 A-4-13-II 3657500.00 3657500
SARASIAH 1968-04-20 52 A-4-13-I 2069600.00 2069600
SANIAH 1955-04-21 65 A-4-13-II 3657500.00 3657500
RASIDAH 1960-05-02 60 Z-4-12-I 2092500.00 2092500
NOOR JAMILAH (PNS DAERAH)1977-12-05 42 A-4-13-I 2069600.00 2069600
ROSNI HERLIANI 1968-08-08 52 A-4-13-I 2069600.00 2069600
HAIRANSYAH 1962-05-12 58 Z-4-12-I 2092500.00 2092500
MURSALIN 1975-01-05 45 A-4-13-I 2069600.00 2069600
MAHMUDAH 1980-05-15 40 A-4-13-I 2069600.00 2069600
MUHAMMAD ASERANI 1962-05-07 58 A-4-13-III 4389000.00 4389000
RUSIAN 1960-02-04 60 A-4-13-I 2069600.00 2069600
DR. ARIS SUGIHARJO, SP.PD 1967-06-30 53 A-4-13-I 2069600.00 2069600
AMINUDDIN 1967-03-04 53 A-4-13-I 2069600.00 2069600
MUKHYAR HM 1955-08-08 65 Z-4-12-I 2092500.00 2092500
RUSMINAH 1954-08-18 66 A-4-13-II 3657500.00 3657500
BURHAN ARIFIN ( PNS DAERAH1964-12-27 55 Z-4-12-III 8864100.00 8864100
ERNI EFRIATY 1964-04-19 56 Z-4-12-I 2092500.00 2092500
MUHAMMAD AINI 1973-07-10 47 A-4-13-I 2069600.00 2069600
MASDAH 1978-05-03 42 Z-4-12-II 4201500.00 4201500
SOSILO YADI 1975-03-19 45 A-4-13-I 2069600.00 2069600
SARIFAH SYAKINAH 1969-08-23 51 Z-4-12-III 8864100.00 8864100
ANNISNA FIRDAUS 1985-03-02 35 A-4-13-II 3657500.00 3657500
MISWANTO 1974-05-20 46 A-4-13-I 2069600.00 2069600
MUHAMMAD YUSUF 1955-07-01 65 A-4-13-I 2069600.00 2069600
ISMAIL 1965-07-01 55 A-4-13-II 3657500.00 3657500
ALIYAS 1955-11-11 64 A-4-13-I 2069600.00 2069600
JUMA'AH 1967-07-04 53 A-4-13-I 2069600.00 2069600
FATIMAH (PNS DAERAH) KELAS1980-11-04 39 A-4-13-I 2069600.00 2069600
TAUFIKURRAHMAN (MANDIRI)1977-04-06 43 Z-4-12-I 2092500.00 2092500
FAHMI FAISAL 1968-01-18 52 A-4-13-I 2069600.00 2069600
MUHAMMAD MUCHTAR 1950-08-14 69 A-4-13-II 3657500.00 3657500
ASMAWATI 1972-04-02 48 A-4-13-III 4389000.00 4389000
CHAIRANSYAH 1951-09-10 68 A-4-13-II 3657500.00 3657500
HELMATUN FAUZA 1958-11-21 61 A-4-13-III 4389000.00 4389000
RUSDIANA 1966-03-11 54 Z-4-12-I 2092500.00 2092500
NORMAJIDI 1965-07-06 55 A-4-13-III 4389000.00 4389000
AFAN DENI ARIFIANTO 1992-03-19 28 A-4-13-I 2069600.00 2069600
SAPURA 1962-09-03 57 Z-4-12-I 2092500.00 2092500
SAPIAH 1951-04-30 69 A-4-13-III 4389000.00 4389000
HAIRUDIN 1975-03-06 45 A-4-13-I 2069600.00 2069600
MASITAH BAKHRI 1967-01-23 53 A-4-13-I 2069600.00 2069600
ANNISNA FIRDAUS 1985-03-02 35 A-4-13-I 2069600.00 2069600
HENY MARLINA 1998-09-06 21 J-3-13-0 473300.00 473300
JAILANI 1960-08-07 59 J-3-13-0 473300.00 473300
BAHRUDIN 1970-01-01 50 Q-5-44-0 377100.00 377100
ALIANI 1971-06-28 48 Z-4-12-III 8864100.00 8864100
SYARIFUDIN 1982-08-05 37 A-4-13-III 4389000.00 4389000
RABIATUL ADAWIYAH 1975-06-01 44 Z-4-12-III 8864100.00 8864100
HERMAYANTI 1990-03-14 30 A-4-13-I 2069600.00 2069600
SUMANTO 1971-08-07 48 A-4-13-III 4389000.00 4389000
M. YUSRAN 1969-05-05 51 A-4-13-I 2069600.00 2069600
MUSNI 1959-05-24 61 A-4-13-I 2069600.00 2069600
RAMSIDI 1958-05-28 62 A-4-13-I 2069600.00 2069600
ITI 1963-07-01 56 A-4-13-I 2069600.00 2069600
RUMINI 1965-05-08 55 A-4-13-I 2069600.00 2069600
SITI HADIJAH 1992-01-27 28 Z-4-12-II 4201500.00 4201500
MURJANI 1974-08-17 45 A-4-13-I 2069600.00 2069600
SUNDOYO 1959-04-05 61 Z-4-12-II 4201500.00 4201500
MUHAMMAD HAFIS 2006-02-01 14 Z-4-12-III 8864100.00 8864100
WAHIDAH 1971-04-02 49 A-4-13-I 2069600.00 2069600
MUHAMMAD IRFANI SYAR'IE 1993-01-06 27 A-4-13-I 2069600.00 2069600
ABDUL SALIM 1970-03-03 50 Z-4-12-I 2092500.00 2092500
MUSTAQIM 1967-05-27 53 A-4-13-I 2069600.00 2069600
MUNARSIH 1973-05-24 47 A-4-13-I 2069600.00 2069600
MUHAMMAD HAIKAL 2014-12-15 5 A-4-13-I 2069600.00 2069600
HUMAIRATUL HUSNA 2009-11-29 10 A-4-13-I 2069600.00 2069600
AINUN JARIAH 1992-01-24 28 A-4-13-I 2069600.00 2069600
DAHLIANA 1990-12-28 29 O-6-10-I 5253900.00 5253900
NIFA TRI HASTUTI 1988-09-19 31 Z-4-12-I 2092500.00 2092500
DEBBY RUSTANTIA ELINDA 1992-04-03 28 O-6-10-II 6762600.00 6762600
HARDIANTI 1997-09-08 22 O-6-10-I 5253900.00 5253900
NORMIATI 1995-05-12 25 O-6-10-I 5253900.00 5253900
NORMIATI 1992-06-02 28 O-6-10-I 5253900.00 5253900
ERNAWATI 1980-04-20 40 O-6-10-I 5253900.00 5253900
RUSDIANSYAH 1969-12-28 50 Q-5-42-0 332900.00 332900
KAMARUDIN 1988-11-03 31 Q-5-42-0 332900.00 332900
HENDRAWAN 1983-10-01 36 A-4-13-I 2069600.00 2069600
HUSNI RUSLAN AFLAN 1978-06-10 42 Z-4-12-II 4201500.00 4201500
SARIMIN 1963-02-23 57 Z-4-12-II 4201500.00 4201500
SITI AMINAH 1965-05-15 55 Z-4-12-I 2092500.00 2092500
REGIE SEPTIAN ARDY ANANT 1993-09-23 26 A-4-13-I 2069600.00 2069600
KASMAH 1984-08-20 35 Z-4-12-I 2092500.00 2092500
SARDIANSYAH 1979-09-14 40 A-4-13-I 2069600.00 2069600
BAIHAKI 1970-10-03 49 Q-5-44-0 377100.00 377100
RIAH,HJ 1957-01-10 63 Q-5-44-0 377100.00 377100
JANAH/NORJANAH 1971-04-01 52 A-4-13-I 2069600.00 2069600
SITI RAUDAH 1967-05-17 53 A-4-13-I 2069600.00 2069600
POJEM 1963-07-01 57 A-4-13-I 2069600.00 2069600
LATRIYIEM 1973-04-15 47 A-4-13-I 2069600.00 2069600
SAMSI 1960-01-01 60 Z-4-12-I 2092500.00 2092500
SITI AISYAH .HJ 1953-11-20 66 A-4-13-I 2069600.00 2069600
SUKAMDI, S.PT 1966-05-01 54 Z-4-12-III 8864100.00 8864100
DIWUD 1937-12-09 82 A-4-13-II 3657500.00 3657500
MALAHAYATI 1984-02-21 36 A-4-13-I 2069600.00 2069600
YANTI MEGAWATI 1971-06-09 49 A-4-13-I 2069600.00 2069600
RAKHMAT 1983-11-10 36 A-4-13-I 2069600.00 2069600
MUHAMMAD SYARKAWI 1958-06-17 62 A-4-13-II 3657500.00 3657500
H.A.JUMBERI 1958-04-06 62 Z-4-12-II 4201500.00 4201500
HERU KUSNADI 1980-12-17 39 A-4-13-I 2069600.00 2069600
BAMBANG BUDIONO 1977-03-06 43 Z-4-12-I 2092500.00 2092500
RASYIDI 1956-05-08 64 Z-4-12-II 4201500.00 4201500
KHAIRANI.H 1954-04-12 66 A-4-13-II 3657500.00 3657500
SYARKIAH 1956-04-11 64 A-4-13-I 2069600.00 2069600
MUHAMMAD IDERIS 1981-01-04 39 A-4-13-I 2069600.00 2069600
HJ. NOOR HALIPAH 1959-01-17 61 A-4-13-I 2069600.00 2069600
H. ENDANG RIDWAN,SP.MMA1960-02-01 60 A-4-13-I 2069600.00 2069600
RAHMADI 1977-05-19 43 A-4-13-I 2069600.00 2069600
MARDIANA 1968-02-08 52 Z-4-12-I 2092500.00 2092500
SUKARMAN 1965-06-11 55 Z-4-12-II 4201500.00 4201500
ARYO DUKUT 1952-07-01 68 Z-4-12-I 2092500.00 2092500
MAWARDI 1960-05-04 60 Z-4-12-I 2092500.00 2092500
MURIANI 1963-03-11 57 Z-4-12-I 2092500.00 2092500
SAMNAH 1982-06-03 38 Q-5-42-0 332900.00 332900
SANIAH 1965-05-20 55 Q-5-42-0 332900.00 332900
FAQIH BASKORO ADI 1994-11-23 25 Q-5-42-0 332900.00 332900
MUHAMMAD NOOR 1974-03-01 46 Q-5-44-0 377100.00 377100
REZAMARCH FANNY PUTRA 1989-03-26 31 Q-5-42-0 332900.00 332900
RISNI MAHLIANI 1985-12-27 34 Q-5-42-0 332900.00 332900
MUHAMMAD ARSAKHA ALTA2018-05-17 2 Q-5-42-0 332900.00 332900
DEVIANA SUNARYA 1990-04-07 30 Q-5-42-0 332900.00 332900
MUHAMMAD NAUFAL RADEVA 2015-05-27 5 Q-5-44-0 377100.00 377100
RINI RASTIYARTI 1979-03-23 41 Q-5-44-0 377100.00 377100
H. FITRI.AM 1955-01-10 65 Q-5-44-0 377100.00 377100
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47500000.00 47500000.00
47500000.00 47500000.00
38000000.00 38000000.00
85500000.00 85500000.00
29200000.00 29200000.00
22500000.00 22500000.00
28500000.00 28500000.00
29200000.00 29200000.00
28500000.00 28500000.00
22500000.00 22500000.00
29200000.00 29200000.00
60000000.00 60000000.00
47500000.00 47500000.00
43800000.00 43800000.00
47500000.00 47500000.00
30400000.00 30400000.00
52500000.00 52500000.00
30000000.00 30000000.00
38000000.00 38000000.00
47500000.00 47500000.00
29200000.00 29200000.00
38000000.00 38000000.00
28500000.00 28500000.00
17400000.00 17400000.00
17360000.00 17360000.00
14600000.00 14600000.00
45000000.00 45000000.00
47500000.00 47500000.00
38000000.00 38000000.00
43800000.00 43800000.00
66500000.00 66500000.00
43800000.00 43800000.00
37500000.00 37500000.00
22500000.00 0.00
17360000.00 0.00
12260000.00 0.00
30660000.00 0.00
50260000.00 0.00
104500000.00 0.00
40760000.00 0.00
17760000.00 0.00
28500000.00 0.00
58400000.00 0.00
19000000.00 0.00
85500000.00 0.00
22500000.00 0.00
473300.00 473300.00
473300.00 473300.00
377100.00 0.00
114000000.00 114000000.00
171000000.00 171000000.00
57000000.00 57000000.00
37500000.00 37500000.00
79360000.00 79360000.00
90000000.00 90000000.00
142500000.00 142500000.00
120000000.00 120000000.00
98360000.00 98360000.00
82500000.00 82500000.00
43800000.00 43800000.00
97500000.00 97500000.00
152000000.00 152000000.00
142500000.00 142500000.00
165000000.00 165000000.00
90000000.00 90000000.00
31860000.00 31860000.00
112500000.00 112500000.00
112500000.00 112500000.00
60000000.00 60000000.00
60000000.00 60000000.00
60000000.00 60000000.00
51100000.00 51100000.00
14600000.00 14600000.00
46500000.00 46500000.00
21900000.00 21900000.00
36500000.00 36500000.00
29200000.00 29200000.00
29200000.00 29200000.00
332900.00 332900.00
332900.00 332900.00
88169000.00 88169000.00
74169000.00 74169000.00
74169000.00 74169000.00
55169000.00 55169000.00
55169000.00 55169000.00
28304000.00 0.00
3419000.00 0.00
377100.00 377100.00
377100.00 377100.00
226169000.00 226169000.00
159669000.00 159669000.00
125669000.00 125669000.00
102669000.00 102669000.00
35669000.00 35669000.00
140669000.00 140669000.00
74169000.00 74169000.00
159669000.00 159669000.00
103054000.00 103054000.00
121669000.00 121669000.00
16169000.00 16169000.00
36194000.00 36194000.00
45669000.00 45669000.00
80669000.00 80669000.00
13169000.00 13169000.00
50669000.00 50669000.00
83669000.00 83669000.00
58194000.00 58194000.00
80669000.00 80669000.00
65669000.00 65669000.00
74169000.00 74169000.00
73169000.00 73169000.00
55169000.00 55169000.00
55169000.00 55169000.00
35669000.00 35669000.00
35669000.00 35669000.00
20529000.00 0.00
332900.00 332900.00
332900.00 332900.00
332900.00 332900.00
377100.00 377100.00
332900.00 332900.00
332900.00 332900.00
332900.00 332900.00
332900.00 332900.00
377100.00 377100.00
377100.00 377100.00
377100.00 377100.00
pada resume medis ruang perawatan anggrek? pada billing ruag perawatan tgl 19/5 s/d 23/05/2020 di ruang anggrek,tgl 2
rawat inap dilakukan di luar ruangan isolasi yang di tetap kan oleh direktur RS ( pada resume medis di rawat di ruang mela
Tgl.Lahir Tidak Sesuai dengan Identitas: NIK KTP Terlampir, Status RS Perujuk merujuk > 5 hari dari tanggal datang pasien y
Nik KTP yang di input atau di entry tidak sesuai dengan KTP ( identitas pasien ) yang Dilampirkan, Status RS Perujuk meruju
rawat inap di lakukan di luar ruangan isolasi yang di tetap kan oleh direktur RS, rawat inap di lakukan di luar ruangan isolas
top up disinfektan Mobil tidak terlampir rincian di billing tagihan?, Status RS Perujuk merujuk 6 > Jam - 2 hari dari tanggal
penetapan status PDP ?rapid test non reaktif ( tgl 19/5/2020 di IGD )dan swab pcr negatif? apakah memiliki riwayat perja
tgl lahir tdk sesuai,diklaim kan pasien Terkonfirmasi dengan komorbid tidak sesuai Resume medis PDP Berat ( tidak terlam
Pasien dirawat sd 09 juni 2020, tetapi hanya dilampirkan hasil pemeriksaan pasien di bulan Mei 2020 saja. mohon dilengka
dan
Dari Apakah kode pneumonia
hasil keterangan tidak perluSwab
hasil pemeriksaan dientrykan karenaharusnya
PCR Negatif, sdh satu kesatuan dg kode
pasien masuk covidnya?,
dengan kriteriaStatus
pasienRS Perujuk meruj
PDP.
Kode diagnosa yang dientrykan kode Z, Status RS Perujuk merujuk 6 > Jam - 2 hari dari tanggal datang pasien yg dirujuk ke
Tidak ada dilampirkan bukti pemeriksaan rapid test ketika pasien masuk, hanya dilampirkan hasil swab dari dinas kesehata
Tidak ada dilampirkan bukti pemeriksaan rapid test ketika pasien masuk, hanya dilampirkan hasil swab dari dinas kesehata
Karena tanda dan gejala Pneumonia merupakan sama dengan gejala diagnosa terkonfirmasi covid 19, maka seharusnya Pn
Hasil follow up kondisi pasien sebelum pulang tidak kelihatan diresume, yg dilampirkan buram dan tidak tertulis lengkap, S
LOS 1 Hari (pasien pulang APS) : tp di billing tertulis visit tgl 9 juni dan ada pindah ruangan 15 juni (tdk disertakan jam masu
(Pulang APS) Hasil follow up kondisi pasien sebelum pulang tidak kelihatan diresume, yg dilampirkan buram dan tidak tertu
Hasil Swab yg dilampirkan ada dilakukan 2 kali, dan berbeda hasil, apakah diambil dihari yg berbeda? Kemudian kondisi pa
Apakah ada hasil pemeriksaan ketika pasien masuk? Karena follow up kondisi pasien sebelum pulang tidak kelihatan diresu
Apakah ada hasil pemeriksaan ketika pasien masuk? Karena follow up kondisi pasien sebelum pulang tidak kelihatan diresu
Pulang APS : Hasil follow up kondisi pasien sebelum pulang tidak kelihatan diresume, yg dilampirkan buram dan tidak tertu
Pulang APS : Hasil follow up kondisi pasien sebelum pulang tidak kelihatan diresume, yg dilampirkan buram dan tidak tertu
Ringkasan Pasien
1. Apakah ada Pulang ditulis
pemeriksaan swab "Isolasi Mandiri
lanjutan di Rumah" negatif?
yg menyatakan apakah ada Hasildilampirkan,
Mohon follow up kondisi pasien sebelum
atau ditambahkan padapulang (kead
resume m
2. Atau apakah ada kondisi klinis pasien sehingga diperbolehkan pulang yg ditulis loeh DPJP? Karena di lembar ringkasan p
Ringkasan Pasien Pulang ditulis "Isolasi Mandiri di Rumah" apakah ada Hasil follow up kondisi pasien sebelum pulang? kare
Hasil follow
1. pasien up kondisi pasien
terkonfirmasi positif,sebelum
tetapi dipulang tidak kelihatan
cbgs hasilnya diresume,
suspek. Bisa yg dilampirkan
dicek kembali entryanburam dan tidak
disesuaikan tertulis
dg KMK 446lengkap, P
: Lampira
2. Mohon lengkapi hasil follow up kondisi pasien sebelum pulang, Pastikan pengurangan jumlah penunjang telah sesuai de
Hasil Pemeriksaan Swab/PCR belum dilampirkan diEklaim, Status RS Perujuk merujuk > 5 hari dari tanggal datang pasien yg
Hasil Pemeriksaan Swab/PCR belum dilampirkan diEklaim, Status RS Perujuk merujuk > 2-5 hari dari tanggal datang pasien
Hasil Pemeriksaan Swab/PCR belum dilampirkan diEklaim, Usia <60 tahun tanpa penyakit penyerta tidak masuk penjamina
Hasil Pemeriksaan Swab/PCR belum dilampirkan diEklaim, Status RS Perujuk merujuk <= 6 Jam dari tanggal datang pasien y
kapan tanggal
PDP dengan keluar hasil
Komorbid DM,swab kedientry
tetapi 3 dan swab ke 4?,
sebagai PDPStatus
tanpaRSKomorbid
Perujuk merujuk > 5 hari dari tanggal datang pasien yg diru
, Status RS Perujuk merujuk > 5 hari dari tanggal datang pasien yg dirujuk ke RS lain
Pneumonia dan LBP tidak termasuk dalam penyakit komorbid, Status RS Perujuk merujuk 6 > Jam - 2 hari dari tanggal dat
Status Pulang pasien tidak sesuai. Resume Medis pasien Alih Rawat ke RSUD Daha Sejahtera tetapi status pulang dicbgs At
Status Pulang pasien tidak sesuai. Resume Medis pasien Alih Rawat ke RSUD Daha Sejahtera tetapi status pulang dicbgs At
tidak ada keterangan tanggal pengambilan swab dan tanggal hasil swab keluar, Status RS Perujuk merujuk > 5 hari dari tan
tidak ada hasil pemeriksaan swab 1 dan swab 2 , Double Klaim RJTL / RITL, Status RS Perujuk merujuk > 5 hari dari tanggal
tidak ada tanggal pengambilan swab dan hasil pemeriksaan swab 1 dan 2, Double Klaim RJTL / RITL, Status RS Perujuk mer
NIK tidak valid dan tidak ada identitas pasien dilampirkan, Status RS Perujuk merujuk > 5 hari dari tanggal datang pasien yg
Resume medis yang dilampirkan an. Tn. Juwandi Pelayanan tgl 09/06/2020 - 10/06/2020, Status RS Perujuk merujuk <= 6 J
Diagnosa Komorbid tidak sesuai ketentuan, Status RS Perujuk merujuk > 5 hari dari tanggal datang pasien yg dirujuk ke RS
ODP <60 Thn tanpa komorbid namun dikoding dengan kode B34.2, Status RS Perujuk merujuk > 5 hari dari tanggal datang
pasien dengan diagnosa komorbid DM dan CHF tetapi dientry sebagai PDP tanpa Komorbid, Status RS Perujuk merujuk 6 >
Resume Medis Pasien tidak dilampirkan, Status RS Perujuk merujuk 6 > Jam - 2 hari dari tanggal datang pasien yg dirujuk k
Tidak ada Resume Medis, Status RS Perujuk merujuk 6 > Jam - 2 hari dari tanggal datang pasien yg dirujuk ke RS lain
pasien tidak dilakukan pemeriksaan rapid test diawal masuk RS, Status RS Perujuk merujuk > 2-5 hari dari tanggal datang p
belum dilakukan pemeriksaan swab/PCR, Usia <60 tahun tanpa penyakit penyerta tidak masuk penjaminan biaya wabah C
hasil swab antara resume medis dan lampiran pendukung tidak sesuai, Status RS Perujuk merujuk > 5 hari dari tanggal data
Pneumonia merupakan gejala dari covid 19 , Status RS Perujuk merujuk > 2-5 hari dari tanggal datang pasien yg dirujuk ke
Pneumonia merupakan manifestasi klinis covid 19 , Status RS Perujuk merujuk > 5 hari dari tanggal datang pasien yg diruju
Pneumonia bukan merupakan diagnosa komorbid Covid 19, Status RS Perujuk merujuk > 5 hari dari tanggal datang pasien
pneumonia masuk dalam manifestasi klinis covid 19 sehingga tidak perlu dikoding terpisah dari diagnosa utama, Status RS
Status Pulang Pasien seharusnya diRujuk bukan Atas Persetujuan Dokter, karena diResume Medis pasien tertulis pasien dir
Diresume Medis
Apakah sejak tertulis
hasil Swab RO Thorax15
1 tanggal Pneumonia, tetapi
juni 2020 itu diHasil
keluar RO Thorax
dengan yangsampai
hasil Positif dilampirkan tidak
dengan tgl ada
2 Julitanda-tanda adanya
2020 tidak ada P
dilaku
Pasien dengan
Tidak Ada Komorbid
Keterangan HT,Swab.
Hasil Status RS Perujuk merujuk > 5 hari dari tanggal datang pasien yg dirujuk ke RS lain
Diresume
Pasien Medis
dengan RO Thorax
Komorbid HTNormal, sedangkan
tetapi dientry hasil
pasien pemeriksaanTanpa
Terkonfirmasi RO yang dilampirkan Pneumonia Kiri, Status RS Perujuk
Komorbid.
Tidak
Kenapa pasien dirawat diisiloasi dan dapat perawatan covid 19 padahal awaldengan
Ada keterangan tanggal pemeriksaan Swab dan Indikasi dirawat Inap LOShasil
masuk RS yangRapid
lama.,Non Status RS Perujuk me
Reaktif?
, Status RS Perujuk merujuk 6 > Jam - 2 hari dari tanggal datang pasien yg dirujuk ke RS lain
ODP dengan Usia <60 tahun. Kriteria Penjaminan tidak sesuai, Diagnosa Dengue fever tidak masuk dalam kriteria komorbid
Terdapat diagnosa dan prosedure co-insiden yang belum dientri, Pasien Melahirkan secara SC, Usia <60 tahun tanpa penya
Kriteria Penjaminan tidak sesuai, Diagnosa Acute appendicitis tidak masuk dalam kriteria komorbid maupun komplikasi., P
Tanggal keluar yang dientri tidak sesuai dengan resume dan billing yaitu 25 April 2020, Pneumonia masuk dalam manifesta
NIK yang dientri tidak sesuai dengan NIK pada KTP yang seharusnya 6303100604980005, Kriteria Penjaminan tidak sesuai,
Pasien ODP dengan Co-insiden, pada resume dan pemeriksaan diawal masuk hasil Rapid non reaktif. Sehingga seharusnya
Tgl.Lahir Tidak Sesuai dengan Identitas: NIK, Tanggal keluar yang dientri di aplikasi tidak sesuai dengan resume dan billing t
Pneumonia dan gagal nafas masuk dalam manifestasi Klinis Covid 19, tidak perlu dientri., Rincian Billing Pemulasaran Jenaz
Tanggal keluar
Pneumonia yangdalam
masuk dientri tidak sesuai
manifestasi dengan
Klinis resume
Covid danperlu
19, tidak billing, Status RS Perujuk merujuk > 2-5 hari dari tanggal datan
dientri.
, Status RS Perujuk merujuk > 2-5 hari dari tanggal datang pasien yg dirujuk ke RS lain, PURIFIKASI *** Tgl.Lahir Tidak Sesua
Pneumonia masuk dalam manifestasi Klinis Covid 19, tidak perlu dientri, NIK yang dientri tidak sesuai dengan NIK pada KTP
Pneumonia masuk dalam manifestasi Klinis Covid 19, tidak perlu dientri., Status RS Perujuk merujuk > 5 hari dari tanggal da
Pneumonia masuk dalam manifestasi Klinis Covid 19, tidak perlu dientri. , Status RS Perujuk merujuk > 5 hari dari tanggal d
Kriteria Penjaminan tidak sesuai, Diagnosa Dyspepsia dan Hipokalaemia tidak masuk dalam kriteria komorbid maupun kom
Pneumonia masuk dalam manifestasi Klinis Covid 19, tidak perlu dientri. Sehingga klaim tersebut dientri konfirmasi covid t
Diagnosa Dyspepsia tidak masuk dalam kriteria komorbid maupun komplikasi., Tanggal masuk dan keluar tidak sesuai deng
Pneumonia masuk dalam manifestasi Klinis Covid 19, tidak perlu dientri, Status RS Perujuk merujuk > 5 hari dari tanggal da
Pneumonia masuk dalam manifestasi Klinis Covid 19, tidak perlu dientri. Sehingga klaim tersebut dientri PDP tanpa komorb
Tidak ada bukti x-ray foto thorax terlampir, Pastikan Pasien Suspek memiliki: a. riwayat perjalanan/kontak (+) dalam 1
Tidak ada bukti x-ray foto thorax terlampir, Pastikan pasien Probable memiliki: gambaran klinis yang meyakinkan deng
Tidak
Tidak ada
ada bukti
bukti x-ray
x-ray foto
foto thorax
thorax terlampir,
terlampir Pastikan pasien Probable memiliki: gambaran klinis yang meyakinkan deng
, Pastikan Pasien Suspek memiliki: a. riwayat perjalanan/kontak (+) dalam 14 hari sebelum timbul gejala/tanda ISPA/m
Sesuai resume medis, pasien dirawat sampai dengan tanggal 18 Juli 2020., Status RS Perujuk merujuk > 2-5 hari dari tangg
Terdapat diagnosa co-insiden pada resume medis (HYPONATREMIA), tetapi pada penagihan diaplikasi tidak dicentang co-i
Terdapat diagnosa co-insiden pada resume medis (AKI), tetapi pada penagihan diaplikasi tidak dicentang co-insiden. Kemu
Diagnosa komorbid tidak sesuai dengan kriteria komorbid pada RI NOMOR HK.01.07/MENKES/446/2020, Status RS Perujuk
Bukti pemulasaran jenazah tidak terlampirkan., Status RS Perujuk merujuk > 2-5 hari dari tanggal datang pasien yg dirujuk
Sesuai resume medis tanggal pulang 22 Agustus 2020., Status RS Perujuk merujuk > 5 hari dari tanggal datang pasien yg di
Bukti pemulasaran jenazah tidak terlampirkan, Terdapat diagnosa co-insiden pada resume medis (DYSPEPSIA), tetapi pada
Bukti pemulasaran jenazah tidak terlampirkan, Pastikan Pasien-RITL Konfirmasi memiliki: a. hasil Lab. RT-PCR/TCM(tes
Terdapat diagnosa co-insiden pada resume medis (GEA), tetapi pada penagihan diaplikasi tidak dicentang co-insiden., Pasti
Tanggal pulang yang dientri tidak sesuai dengan resume medis, DPJP memulangkan pasien pada resume medis tanggal 01
Kondisi pulang tidak sesuai dengan resume medis, pada resume medis pasien dirujuk, bukan atas persetujuan dokter. Sehi
Bukti pemulasaran jenazah tidak terlampirkan. Terdapat diagnosa co-insiden pada resume medis (DYSPEPSIA), tetapi pada
Sesuai resume medis, seharusnya pasien masuk dalam kriteria konfirmasi dengan co-insiden (diagnosa bagian Obgyn), teta
pemeriksaat lab tidak ada SGOT dan SGPT, Usia <60 tahun tanpa penyakit penyerta tidak masuk penjaminan biaya wabah
b. melampirkan bukti pemeriksaan laboratorium darah rutin dan x-ray foto thorax. Bukti x-ray foto thorax dikecualikan bag
Tagihan Peti jenazah Namun Pasien menolak sesuai protocol Covid 19, Pastikan Pasien Suspek memiliki: a. riwayat per
a. tidak ada hasil Lab. RT-PCR/TCM(tes cepat molekuler)/PIMS dengan hasil positif yang di upload., Pastikan Pasien-RITL Ko
hasil scan billing tagihan tidak jelas (Buram)
tidak keliatan billing tagihan pemulasaran jenazah, Pastikan Pasien Suspek memiliki: a. riwayat perjalanan/kontak (+) d
KRITERIA_DISPUTE
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C8-Rawat inap dilakukan di luar ruangan isolasi yang ditetapkan oleh Drektur RS, C8-Rawat inap dilakukan di luar ruangan
C8-Rawat inap dilakukan di luar ruangan isolasi yang ditetapkan oleh Drektur RS
C1-Identitas tidak sesuai ketentuan
C8-Rawat inap dilakukan di luar ruangan isolasi yang ditetapkan oleh Drektur RS, C8-Rawat inap dilakukan di luar ruangan
C5-Berkas Klaim Tidak lengkap
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C2-Kriteria Peserta Jaminan Covid tidak sesuai ketentuan
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C6-Diagnosa penyakit penyerta/komplikasi merupakan bahagian dari Diagnosa Utama (sign and symptom)
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C7-Diagnosa komorbid tidak sesuai ketentuan
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C31-Pemeriksaan Penunjang Laboratorium tidak sesuai ketentuan, RITL : tidak ada pemeriksaan swab (PCR)
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C7-Diagnosa komorbid tidak sesuai ketentuan, C2-Kriteria Peserta Jaminan Covid tidak sesuai ketentuan
C7-Diagnosa komorbid tidak sesuai ketentuan, C6-Diagnosa penyakit penyerta/komplikasi merupakan bahagian dari Diagn
C2-Kriteria Peserta Jaminan Covid tidak sesuai ketentuan, C6-Diagnosa penyakit penyerta/komplikasi merupakan bahagian
C1-Identitas tidak sesuai ketentuan, C7-Diagnosa komorbid tidak sesuai ketentuan, C2-Kriteria Peserta Jaminan Covid tidak
C1-Identitas tidak sesuai ketentuan, C2-Kriteria Peserta Jaminan Covid tidak sesuai ketentuan
C6-Diagnosa penyakit penyerta/komplikasi merupakan bahagian dari Diagnosa Utama (sign and symptom), C5-Berkas Klaim
C6-Diagnosa penyakit penyerta/komplikasi merupakan bahagian dari Diagnosa Utama (sign and symptom), C1-Identitas tid
C7-Diagnosa komorbid tidak sesuai ketentuan, C2-Kriteria Peserta Jaminan Covid tidak sesuai ketentuan
C7-Diagnosa komorbid tidak sesuai ketentuan, C2-Kriteria Peserta Jaminan Covid tidak sesuai ketentuan, C1-Identitas tidak
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C5-Berkas Klaim Tidak lengkap, C2-Kriteria Peserta Jaminan Covid tidak sesuai ketentuan
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C32-Pemeriksaan Penunjang Laboratorium tidak sesuai ketentuan, RJTL : tidak ada pemeriksaan darah rutin dan rontgen
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C5-Berkas Klaim Tidak lengkap, C5-Berkas Klaim Tidak lengkap, C2-Kriteria Peserta Jaminan Covid tidak sesuai ketentuan
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Covid tidak sesuai ketentuan
rta/komplikasi merupakan bahagian dari Diagnosa Utama (sign and symptom)

No Nama RS Jenis Hasil Verifikasi NOMOR NOFPK
a b c d e
NOREGISTER NOSURAT NOSURATSERAHTERIMA NOPENGAJUAN
f g h i
TGLSEP TGLPULANG LOS JNSPEL NOIDENTITAS
j k l m n
2020-05-18 13:25:16 2020-06-05 13:25:16 19 INAP 3306014801910003
2020-06-05 13:35:55 2020-06-12 13:35:55 8 INAP 6309061411690006
2020-06-16 13:30:17 2020-06-22 13:30:17 7 INAP 6213025306920001
2020-06-23 14:02:33 2020-07-15 14:02:33 23 INAP 3520112602950001
2020-06-26 13:32:54 2020-06-30 13:32:54 5 INAP 6309046004660006
2020-07-11 09:28:52 2020-07-12 09:28:52 2 INAP 6309040607680006
2020-05-19 16:34:34 2020-05-26 16:34:34 8 INAP 1671152206880001
2020-05-28 15:12:20 2020-05-29 15:12:20 2 INAP 6309042905500001
2020-05-08 08:12:20 2020-06-09 08:12:20 33 INAP 6213051006570002
2020-06-03 08:31:48 2020-06-04 08:31:48 2 INAP 6308021002530004
2020-06-04 13:26:30 2020-06-05 13:26:30 2 INAP 6308024603610002
2020-06-05 07:30:44 2020-06-09 07:30:44 5 INAP 6308071212570001
2020-06-10 10:27:04 2020-06-11 10:27:04 2 INAP 6308030704570003
2020-04-10 09:42:20 2020-04-15 09:42:20 6 INAP 6306050407670004
2020-04-10 10:58:23 2020-04-15 10:58:23 6 INAP 6306014107550059
2020-04-11 10:48:50 2020-04-17 10:48:50 7 INAP 6306070105620001
2020-04-13 08:07:36 2020-04-17 08:07:36 5 INAP 6306070205860005
2020-04-15 06:58:32 2020-04-23 06:58:32 9 INAP 6307015207620008
2020-04-17 11:40:47 2020-04-23 11:40:47 7 INAP 6307013012850001
2020-04-17 10:23:30 2020-04-22 10:23:30 6 INAP 6306052108770001
2020-04-20 07:19:19 2020-04-24 07:19:19 5 INAP 6306065204690001
2020-04-23 09:52:16 2020-04-26 09:52:16 4 INAP 6306090508980001
2020-04-24 11:43:05 2020-04-29 11:43:05 6 INAP 6306082102690001
2020-04-25 09:11:22 2020-04-28 09:11:22 4 INAP 6306081007970002
2020-04-14 06:55:27 2020-04-17 06:55:27 4 INAP 6306082006500001
2020-04-14 07:14:42 2020-04-27 07:14:42 14 INAP 6303040701880005
2020-04-16 09:40:31 2020-04-28 09:40:31 13 INAP 6306020305080001
2020-04-16 11:13:55 2020-04-28 11:13:55 13 INAP 6306020211120005
2020-04-16 12:24:03 2020-04-19 12:24:03 4 INAP 6306022704780001
2020-04-18 08:49:41 2020-04-18 08:49:41 1 INAP 6306070112000002
2020-04-22 09:57:45 2020-04-26 09:57:45 5 INAP 6305124204790001
2020-04-21 09:58:36 2020-05-10 09:58:36 20 INAP 6306110712770001
2020-05-03 07:37:34 2020-05-13 07:37:34 11 INAP 6306085203660003
2020-05-11 08:49:47 2020-05-12 08:49:47 2 INAP 6310095801820008
2020-05-18 11:36:29 2020-06-12 11:36:29 26 INAP 6371044305840010
2020-05-19 10:55:12 2020-06-12 10:55:12 25 INAP 6371014404720012
2020-05-26 09:36:19 2020-06-08 09:36:19 14 INAP 6307064410630003
2020-05-27 10:55:54 2020-06-11 10:55:54 16 INAP 6306084102490002
2020-05-29 12:16:11 2020-06-12 12:16:11 15 INAP 6309044111940012
2020-06-09 08:00:06 2020-06-25 08:00:06 17 INAP 6306093112000003
2020-06-11 11:16:45 2020-06-11 11:16:45 1 INAP 6306056503700001
2020-06-12 10:05:44 2020-06-20 10:05:44 9 INAP 6306061507610002
2020-06-15 11:11:14 2020-06-25 11:11:14 11 INAP 6306017005940004
2020-06-23 12:07:28 2020-06-24 12:07:28 2 INAP 6306024103650002
2020-06-23 11:09:31 2020-06-24 11:09:31 2 INAP 6306082102690001
2020-06-23 08:18:48 2020-06-24 08:18:48 2 INAP 6306026306810001
2020-05-08 11:06:00 2020-05-09 15:05:00 2 INAP 0000892755685
2020-05-09 05:00:00 2020-05-09 21:05:00 1 INAP 0002620281969
2020-05-15 10:00:00 2020-05-21 21:20:00 7 INAP 0000892885544
2020-05-29 11:50:00 2020-06-01 13:00:00 4 INAP 6306114503610001
2020-05-30 16:30:14 2020-06-14 12:00:14 16 INAP 6306080101730003
2020-06-16 15:30:00 2020-06-18 22:30:20 3 INAP 6306061111690003
2020-06-16 18:36:32 2020-06-30 13:00:32 15 INAP 6306045903100001
2020-06-18 10:30:41 2020-07-04 13:30:41 17 INAP 6271011001790006
2020-06-18 18:00:47 2020-07-18 12:10:47 31 INAP 6306085206680001
2020-06-18 18:12:00 2020-07-21 13:15:00 34 INAP 6306080204960006
2020-06-23 17:30:32 2020-07-13 11:00:32 21 INAP 6306110112950001
2020-07-07 00:35:40 2020-07-07 13:40:40 1 INAP 6306054107450204
2020-04-18 12:52:33 2020-04-26 12:52:33 9 INAP 6307064305530002
2020-04-20 07:51:47 2020-04-25 07:51:47 6 INAP 6371031605020009
2020-06-08 09:47:13 2020-06-10 09:47:13 3 INAP 6304026507870001
2020-06-09 08:56:38 2020-06-24 08:56:38 16 INAP 6307016811580002
2020-06-18 09:03:44 2020-06-23 09:03:44 6 INAP 6307030510940002
2020-06-20 09:07:21 2020-06-24 09:07:21 5 INAP 6307060207590003
2020-06-23 08:17:59 2020-07-01 08:17:59 9 INAP 6307064107650316
2020-06-24 08:23:12 2020-07-01 08:23:12 8 INAP 6307024201700001
2020-06-25 08:46:40 2020-07-01 08:46:40 7 INAP 6307111607640001
2020-06-28 07:55:57 2020-07-02 07:55:57 5 INAP 6307054609740001
2020-06-29 08:08:34 2020-07-07 08:08:34 9 INAP 6305090505840003
2020-07-01 07:46:27 2020-07-06 07:46:27 6 INAP 6307062004770003
2020-07-17 08:28:43 2020-07-18 08:28:43 2 INAP 6371044305840010
2020-04-13 07:59:46 2020-04-20 07:59:46 8 INAP 6307066905880004
2020-06-04 09:59:18 2020-06-08 09:59:18 5 INAP 6303100604980005
2020-06-17 08:44:54 2020-06-18 08:44:54 2 INAP 6307060306540002
2020-06-28 08:22:07 2020-07-01 08:22:07 4 INAP 6307061708590006
2020-04-24 17:30:00 2020-06-25 12:00:00 63 INAP 6305011808580003
2020-05-15 14:35:00 2020-06-12 12:00:00 29 INAP 6305050812800001
2020-05-21 18:45:00 2020-05-22 14:00:00 2 INAP 6305097009580001
2020-06-18 14:20:00 2020-07-09 11:00:00 22 INAP 6305030212810001
2020-06-20 21:40:00 2020-07-01 12:00:00 12 INAP 6305101011020002
2020-06-23 13:00:00 2020-07-15 18:00:00 23 INAP 6305034501540002
2020-07-17 16:40:00 2020-07-28 14:00:00 12 INAP 6305012406570003
2020-05-16 12:50:00 2020-05-16 12:50:00 1 JALAN 6303120807600003
2020-07-10 00:05:00 2020-07-10 00:05:00 1 JALAN 3510076210650001
NMPESERTA TGLLAHIRPASIEN UMUR KDINACBG TARIPINACBG TOTALGRUPER
o p q r s t
RATNA IKAWATI 1991-01-08 29 A-4-13-I 2069600.00 2069600
MANSYAH 1969-11-14 50 A-4-13-I 2069600.00 2069600
YULA 1992-06-13 28 A-4-13-I 2069600.00 2069600
FEBRYAN RADIX KENCANA 1995-02-26 25 A-4-13-I 2069600.00 2069600
SUMARNI 1966-04-20 54 Z-4-12-I 2092500.00 2092500
MADERIANI S. 1968-07-06 52 A-4-13-I 2069600.00 2069600
HERLAN KOMANDO 1988-06-22 31 Z-4-12-I 2092500.00 2092500
TN KASRAN 1950-05-29 69 A-4-13-I 2069600.00 2069600
UTUH ANWARI,H,TN 1957-06-10 62 A-4-13-I 2069600.00 2069600
ASRA 1953-02-10 67 Z-4-12-III 8864100.00 8864100
HAMISAH 1961-03-06 59 Z-4-12-I 2092500.00 2092500
PARJIDI 1957-12-12 62 A-4-13-I 2069600.00 2069600
H. MUSA 1957-04-07 63 A-4-13-I 2069600.00 2069600
SAIDINA HAMZAH 1967-07-04 52 Z-4-12-III 8864100.00 8864100
UMI 1955-07-01 64 Z-4-12-III 8864100.00 8864100
MATURIDI 1962-05-01 57 Z-4-12-III 8864100.00 8864100
JUHDI 1986-05-02 33 A-4-13-III 4389000.00 4389000
NURASNI 1962-07-12 57 Z-4-12-III 8864100.00 8864100
ABDURRAHMAN 1985-12-30 34 Z-4-12-III 8864100.00 8864100
YUDA ARIADI 1974-01-04 46 Z-4-12-III 8864100.00 8864100
PATIMAH 1969-04-12 51 Z-4-12-III 8864100.00 8864100
SURYANI 1998-08-05 21 Z-4-12-III 8864100.00 8864100
ABDUL MUIN 1969-02-21 51 Z-4-12-II 4201500.00 4201500
AZIS 1997-07-10 22 Z-4-12-III 8864100.00 8864100
IBERAMSYAH 1950-06-20 69 A-4-13-III 4389000.00 4389000
QAMARUDDIN 1988-01-07 32 Z-4-12-III 8864100.00 8864100
MUHAMMAD RIFQI 2008-05-03 11 Z-4-12-III 8864100.00 8864100
MUHAMMAD YUSUF 2005-03-25 15 Z-4-12-I 2092500.00 2092500
ALIANSYAH 1978-04-27 41 A-4-13-III 4389000.00 4389000
MUHAMMAD ARSYAD 2000-12-01 19 Z-4-12-III 8864100.00 8864100
YENI PURWANTI 1979-04-02 41 Z-4-12-III 8864100.00 8864100
RUNI 1977-12-07 42 A-4-13-I 2069600.00 2069600
SAPIAH 1966-03-12 54 Z-4-12-III 8864100.00 8864100
JALIHA ARTATI 1982-01-18 38 Z-4-12-III 8864100.00 8864100
MARIA 1984-05-03 36 A-4-13-II 3657500.00 3657500
RODIAH 1972-04-04 48 A-4-13-III 4389000.00 4389000
PATMAWATI 1963-10-04 56 Z-4-12-III 8864100.00 8864100
JAMILAH 1949-02-01 71 A-4-13-II 3657500.00 3657500
ABDUL RAJAB 1960-12-31 59 A-4-13-I 2069600.00 2069600
ARBAINAH 1970-03-25 50 Z-4-12-II 4201500.00 4201500
H. KASNAN 1961-09-15 58 A-4-13-I 2069600.00 2069600
ANNISA SAWITRI NURIMANI A1994-05-30 26 A-4-13-I 2069600.00 2069600
JAM'AH 1965-03-01 55 Z-4-12-III 8864100.00 8864100
ABDUL MUIN 1969-02-21 51 Z-4-12-III 8864100.00 8864100
JAMIANI 1981-06-23 39 Z-4-12-III 8864100.00 8864100
KADERI 1963-10-10 56 Z-4-12-III 8864100.00 8864100
TAMRIN 1970-12-31 49 Z-4-12-III 8864100.00 8864100
SITI WAQI'AH 2001-05-01 19 Z-4-12-III 8864100.00 8864100
JAMILAH 1961-03-05 59 Z-4-12-I 2092500.00 2092500
AHMAD NOOR 1973-01-01 47 A-4-13-II 3657500.00 3657500
ABDUL AZIZ 1969-11-11 50 A-4-13-III 4389000.00 4389000
REGINA PUTRI 2010-03-19 10 Z-4-12-I 2092500.00 2092500
ABDUL GAFUR 1979-01-10 41 A-4-13-I 2069600.00 2069600
RUSDIANA 1968-06-12 52 A-4-13-I 2069600.00 2069600
MUHAMMAD DLIAURRAHMAN1996-04-03 24 A-4-13-I 2069600.00 2069600
BASARUDIN 1995-12-01 24 A-4-13-I 2069600.00 2069600
MASIAH 1945-07-01 75 Z-4-12-I 2092500.00 2092500
FATRAH, HJ 1953-05-03 66 Z-4-12-I 2092500.00 2092500
AKHMAD KAMAL NOOR 2002-05-16 17 Z-4-12-I 2092500.00 2092500
SRI YANOR 1987-07-25 32 O-6-10-II 6762600.00 6762600
KURNIAH 1958-11-28 61 Z-4-12-II 4201500.00 4201500
MUHAMMAD RAHMADANI 1994-10-05 25 Z-4-12-II 4201500.00 4201500
SYAMSUDIN 1959-07-01 60 Z-4-12-III 8864100.00 8864100
SA'ADAH 1965-07-01 54 A-4-13-III 4389000.00 4389000
JUMIATI 1970-01-02 50 A-4-13-II 3657500.00 3657500
SYARIFUDIN 1964-07-16 55 Z-4-12-I 2092500.00 2092500
ISTIAH 1974-06-06 46 A-4-13-I 2069600.00 2069600
BAMBANG IRIANTO 1984-05-05 36 A-4-13-I 2069600.00 2069600
EDUARDI 1977-04-20 43 A-4-13-III 4389000.00 4389000
MARIA 1984-05-03 36 Z-4-12-I 2092500.00 2092500
AGUSTINA NELLA MURNI 1987-05-29 32 O-6-10-I 5253900.00 5253900
M. NOOR AINI 1998-04-06 22 Z-4-12-I 2092500.00 2092500
KASPUL ANWAR 1954-06-03 66 Z-4-12-I 2092500.00 2092500
RUSMADIAN 1959-08-17 60 A-4-13-II 3657500.00 3657500
M. IKHWAN, TN 1958-08-18 61 A-4-13-I 2069600.00 2069600
ARBANI, TN 1980-12-08 39 A-4-13-I 2069600.00 2069600
SITI RAHMAH 1958-09-30 61 A-4-13-III 4389000.00 4389000
FADLAN 1981-12-02 38 A-4-13-I 2069600.00 2069600
MUHAMMAD NAZHAN RAMAD2002-11-11 17 Z-4-12-I 2092500.00 2092500
MURLINAH 1954-01-05 66 A-4-13-I 2069600.00 2069600
TABRANI 1957-06-24 63 A-4-13-I 2069600.00 2069600
SUGIONO 1960-07-08 59 Q-5-44-0 377100.00 377100
INAYAH 1965-08-22 54 N-3-14-0 515800.00 515800
BYPENGAJUAN BYHASILVERIFIKASI
u v
142500000.00 142500000.00
76000000.00 76000000.00
52500000.00 52500000.00
172500000.00 172500000.00
37500000.00 37500000.00
15000000.00 15000000.00
100000000.00 100000000.00
19000000.00 19000000.00
247500000.00 247500000.00
22360000.00 22360000.00
18360000.00 18360000.00
37500000.00 37500000.00
15000000.00 15000000.00
57000000.00 57000000.00
57000000.00 57000000.00
69260000.00 69260000.00
47500000.00 47500000.00
85500000.00 85500000.00
66500000.00 66500000.00
57000000.00 57000000.00
47500000.00 47500000.00
38000000.00 38000000.00
57000000.00 57000000.00
30000000.00 30000000.00
30400000.00 0.00
133000000.00 0.00
97500000.00 0.00
97500000.00 0.00
38000000.00 0.00
12260000.00 0.00
47500000.00 0.00
150000000.00 150000000.00
104500000.00 104500000.00
17760000.00 17760000.00
247000000.00 247000000.00
237500000.00 237500000.00
133000000.00 133000000.00
152000000.00 152000000.00
112500000.00 112500000.00
127500000.00 127500000.00
12260000.00 12260000.00
67500000.00 67500000.00
82500000.00 82500000.00
19000000.00 19000000.00
19000000.00 19000000.00
19000000.00 19000000.00
19000000.00 19000000.00
6650000.00 6650000.00
66500000.00 66500000.00
24000000.00 24000000.00
120000000.00 120000000.00
18000000.00 18000000.00
112500000.00 112500000.00
161500000.00 161500000.00
232500000.00 232500000.00
255000000.00 255000000.00
199500000.00 199500000.00
7500000.00 7500000.00
65700000.00 65700000.00
45000000.00 45000000.00
21900000.00 21900000.00
152000000.00 152000000.00
57000000.00 57000000.00
38000000.00 38000000.00
85500000.00 85500000.00
76000000.00 76000000.00
52500000.00 52500000.00
36500000.00 36500000.00
67500000.00 67500000.00
57000000.00 57000000.00
10500000.00 10500000.00
58400000.00 0.00
36500000.00 0.00
17760000.00 0.00
37200000.00 0.00
598500000.00 598500000.00
275500000.00 275500000.00
13300000.00 13300000.00
165000000.00 165000000.00
90000000.00 90000000.00
172500000.00 172500000.00
90000000.00 90000000.00
3737100.00 3737100.00
515800.00 515800.00
Pneumonia tidak boleh dikoding terpisah.
Indikasi pasien dirujuk ke RS Ulin ?, Double Klaim RJTL / RITL, Status RS Perujuk merujuk > 2-5 hari dari tanggal datang pasien y
indikasi pasien
Terapi yang dirawatpada
diberikan inapsaat
sampai dengan
pasien tgl 27
dirawat April
inap apa2020,
saja?sedangkan pasien swab tgl 16 april 2020 negatif dengan kondisi
dan mohon
Terapi yang Resume
diberikanmedis
pada untuk dilengkapi.,
saat pasien dirawatDouble Klaim
inap apa RJTL / RITL, Status RS Perujuk merujuk > 5 hari dari tanggal datang
saja?
dan mohon tidak
Pneumonia Resume medis
boleh untukterpisah
dikoding dilengkapi.,
dari Double
diagnosaKlaim RJTL / RITL, Status RS Perujuk merujuk > 5 hari dari tanggal datang
utama.
, Double Klaim RJTL / RITL, Double Klaim RJTL / RITL, Status RS Perujuk merujuk > 2-5 hari dari tanggal datang pasien yg dirujuk
Mohon dilengkapi tanggal dan jam masuk /pulang pasien serta jam dilakukan pemeriksaan rapid/swab derta dilampirkan bukti
Mohon diresume medis dilengkapi/dijelaskan apakah pasien tersebut ODP/PDP/terkonfirmasi dan mohon pastikan kembali ta
Terdapat diagnosa komorbid (I10 - Essential (primary) hypertension) diresume dan sudah dientri, tetapi pada aplikasi tidak dic
Usia <60 tahun tanpa komorbid/penyakit penyerta tidak masuk dalam kriteria rawat inap, Usia <60 tahun tanpa penyakit peny
Tidak terlampir surat keterangan pelayanan pemulasaran Jenazah, Double Klaim RJTL / RITL, Status RS Perujuk merujuk 6 > Ja
Kriteria Penjaminan tidak sesuai, Diagnosa Dyspepsia dan Hipokalaemia tidak masuk dalam kriteria komorbid maupun komplik
KRITERIA_DISPUTE
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TL Kasus Dispute sebelum 15 Agustus
No Kantor Cabang
Nama Kegiatan Tanggal Pelaksanaan Peserta
1 Barabai Sosialiasi via Zoom terkait 6/18/2020 Seluruh FKRTL Wil KC Barabai
percepatan klaim covid di
wil KC Barabai
2 Barabai
TL Kasus Dispute setelah 15 Agustus
Nama Kegiatan Tanggal Pelaksanaan Peserta
Sosialisasi via zoom tindak lanjut

klaim dispute dan kendala d 8/3/2020 Verifikator KC Barabai
lapangan
Sosialisasi via zoom tindak lanjut

klaim dispute dan kendala d 8/31/2020 Verifikator KC Barabai
lapangan Part II

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Jenis

Jatuh tempo 13/10/2020

JATUH TEMPO 04/11/2020

rta/komplikasi merupakan bahagian dari Diagnosa Utama (sign and symptom)

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