RS TGL MASUK CM NAMA NO SJP TGL KELUAR CARA BAYARRUNGAN TOTAL

RS171203838 22/12/17 460922 KAMLA 2305R00212170002551 24/12/17 BPJS VIP B RP1327500

RS171203468 21/12/17 62332 SAIFUDDIN SP 2305R00212170002453 25/12/17 BPJS VIP B RP2938500
RS171203848 22/12/17 840630 ABD RAJAK 2305R00212170002808 25/12/17 BPJS VIP B RP1824000
RS171203842 22/12/17 63635 A HAMID 2305R00212170002580 26/12/17 BPJS VIP B RP1840000
RS171204199 23/12/17 88648 ST DAWIAH 2305R00212170002787 26/12/17 BPJS VIP B RP1712000
RS171204309 25/12/17 880165 BANDI 2305R00212170002788 27/12/17 BPJS VIP B RP507400
RS171203792 22/12/17 60780 IRWAN 2305R00212170002586 24/12/17 BPJS VIP B RP839200
RS171204205 23/12/17 87854 ROHANA 2305R00212170002744 27/12/17 BPJS VIP B RP2336500
RS171204191 26/12/17 390273 PATUWAI 2305R00212170002899 27/12/17 BPJS VIP B RP1138800
RS171204392 28/12/17 63287 MUH ALFARIS 29/12/17 UMUM VIP B RP870500
RS171203625 21/12/17 290696 DANNIS SULISTYOWATI 2305R00212170002432 26/12/17 BPJS VIP B RP2649000
RS171203876 23/12/17 221237 NUR AULIA 25/12/17 UMUM VIP B RP684000
RS171204242 24/12/17 451169 HABIBAH 2305R00212170002815 28/12/17 BPJS VIP B RP1841500
RS171204093 26/12/17 510750 FAUZI 2305R00212170002914 28/12/17 BPJS VIP B RP913300
RS171204271 24/12/17 110211 MASDAH 2305R00212170002774 28/12/17 BPJS VIP B RP1774400
RS171203816 22/12/17 221212 M SAID 25/12/17 UMUM VIP B RP811500
RS171203622 21/12/17 620122 HADIJAH 2305R00212170002540 25/12/17 BPJS VIP B RP3331000
RS171203856 22/12/17 431057 VENITA ALEXANDRIA BAGUS 2305R00212170002865 26/12/17 BPJS VIP B RP1912000
RS171203985 23/12/17 650887 ANI RUSTINA 2305R00212170002866 26/12/17 BPJS VIP B RP1795000
RS171204180 25/12/17 470995 NUR FIQRATUN NISA 2305R00212170002799 27/12/17 BPJS VIP B RP915000
RS171203611 21/12/17 790042 SYAMSUDDIN 2305R00212170002491 27/12/17 BPJS VIP B RP3208800
RS171203861 22/12/417 221226 NAUFAL UMAMAH 2305R00212170002730 27/12/17 BPJS VIP B RP1843500
RS171203945 23/12/17 221228 SITI ZAHRATUL AINI 2305R00212170002821 25/12/17 BPJS VIP B RP957000
RS171203761 22/12/17 55638 KARTINI DEWI 2305R00212170002574 24/12/17 BPJS VIP B RP3084000
RS171203107 19/12/17 201261 ANBAR FADHILLAH PUTRY 2305R00212170002455 23/12/17 BPJS VIP B RP1573000
RS171203459 20/12/17 75013 RAHMADIN SP 2305R00212170002247 23/12/17 BPJS VIP B RP1898500
RS171202142 13/12/17 490056 ST HADIJAH 2305R00212170001492 23/12/17 BPJS VIP B RP6158000
RS171202761 16/12/17 66634 DIAN KARTINI 2305R00212170002096 23/12/17 BPJS VIP B RP5185800
RS171204396 28/12/17 75878 ENDANG KUSMIATI 2305R00212170003104 29/12/17 BPJS VIP B RP665500
RS171204730 24/12/17 611134 HJ ANTE 30/12/17 UMUM VIP B RP2773000
RS171204256 2912/17 221270 NAJIH KHOLIF ARRAHMAN 2305R00212170002922 29/12/17 BPJS VIP B RP4041000
RS171203633 21/12/17 651 IBRAHIM H A BAKAR 2305R00212170002587 28/12/17 BPJS VIP B RP5584400
RS171204373 27/12/17 710163 SITI RAUDAH 2305R00212170003127 30/12/17 BPJS VIP B RP1060000
RS171202598 15/12/17 74298 ANSHORI 2305R00212170001998 24/12/17 BPJS VIP B Rp9051900
RS171204257 25/12/17 540773 MARINA 2305R00212170003318 28/12/17 BPJS VIP B Rp1517000
RS171204399 28/12/17 830710 NURFATIH 2305R00212170003087 31/12/17 BPJS VIPB Rp1185000
RS171201822 11/12/2017 210009 DRS SALADIN HASAN 2305R00212170001326 17/12/17 BPJS VIP B RP2849400
RS171202149 13/12/17 370138 HJ ASIAH 2305R00212170001565 17/12/17 BPJS VIP B RP1571000
RS171202189 13/12/17 89755 ST HAFNI 2305R00212170001461 17/12/17 BPJS VIP B RP1822400
 Illh TGL MASUK CM NAMA NO SJP TGL KELUARCARA BAYARRUNGAN TOTAL
RS171204074 26/12/17 801010 MUHAMMAD ALI 2305R00212170002928 1/1/2018 BPJS VIPB Rp1982500
RS171204074 25/12/17 62299 MAEMUNAH AHMAD 2305R00212170002803 1/1/2018 BPJS VIPB Rp3802500
RS171204380 27/12/17 110549 RAHMAN 2305R00212170003097 1/1/2018 BPJS VIPB Rp2191000
RS171204059 25/12/17 600055 JUWIAH 2305R00212170003014 1/1/2018 BPJS VIPB Rp5098500
RS171204399 28/12/17 830710 NURFATIH 2305R00212170003087 31/12/17 BPJS VIPB Rp1185000
RS171204993 30/12/17 510151 MARWAN 2305R00212170003283 2/1/2018 BPJS VIP B Rp1143500
RS171204215 25/12/17 210009 DRS SALADIN HASAN 2305R00212170002852 2/1/2018 BPJS VIPB Rp6542800
RS171204795 29/12/17 500840 H M AMIN JAFAR 3/1/2018 BPJS VIPB Rp3094000
RS171204067 26/12/17 79331 ISHAKA USMAN 2305R00212170002950 3/1/2018 BPJS VIPB Rp3813300
RS171204086 26/12/17 73813 KAIMUDIN HAR 2305R00212170002757 3/1/2018 BPJS VIPB Rp3154500
RS171204114 27/12/17 67565 AHMAD 2305R00212170002944 3/1/2018 BPJS VIPB Rp3211000
RS171205084 31/12/17 64883 NURDIN H JAFAR 2305R00212170003281 3/1/2018 BPJS VIP B Rp959000
RS171204819 29/12/17 961157 PUTU WIWIN APRIANI 2305R00212170003242 3/1/2018 BPJS VIPB RP
RS171205062 31/12/17 271213 NAURAH ADZKIYA 3/1/2018 UMUM VIPB RP
RS180100180 2/1/2018 640567 HJ SRI RAHAYU 2305R00201180000219 4/1/2018 BPJS VIPB Rp1441000
RS171205068 31/12/17 570027 M SALEH MUSA 2305R00212170003321 4/1/2018 BPJS VIP B Rp1945000
RS171204495 27/12/17 231247 OSLAN SYAHRIL 2305R00212170003058 4/1/2018 BPJS VIPB Rp6766500
RS180100198 2/1/2018 88882 ARSYAD MUHAMAD 5/1/2018 BPJS VIPB Rp928000
RS180100419 4/1/2018 241216 PUTRI NUR AKINAL 5/1/2018 BPJS VIPB RP251000
RS180100606 4/1/2018 420446 RENI WIDIARTI 2305R00201180000493 5/1/2018 BPJS VIPB Rp996500
RS171204742 29/12/17 420616 M SALEH 2305R00212170003186 5/1/2018 BPJS VIPB Rp3981000
RS171203830 22/12/17 390737 ISMAIL HASAN 2305R00212170002746 6/1/2018 VIP B Rp10762000
RS171204812 29/12/17 481103 M WAHYU RAMADHAN 6/1/2018 UMUM VIP B RP
RS180100356 3/1/2018 970299 ZAINAL FADLI 2305R00212180000379 6/1/2018 BPJS VIP B RP1614400
RS180100557 3/1/2018 3503569 TRI VIANANDA 2305R00201180000633 6/1/2018 BPJS VIP B
RS180100388 3/1/2018 241212 DAHLAN H YUSUF 2305R00201180000481 7/1/2018 BPJS VIPB Rp1351500
RS180100716 5/1/2018 57692 SARINA MUSTAKIM 2305R00201180000621 8/1/2018 BPJS VIPB Rp3443500
RS171205059 31/12/17 72147 SITI RUGAYA 2305R00212170003297 6/1/2018 BPJS VIPB Rp4516100
RS180100186 2/1/2018 231269 LAILA YUHANA 2305R00201180000404 8/1/2018 BPJS VIPB Rp6419000
RS180100714 5/1/2018 551156 HADIJAH 8/1/2018 BPJS VIP B Rp
RS180100391 4/1/2018 69966 AJMAN 2305R00201180000480 8/1/2018 BPJS VIP B Rp2098800
RS180100600 4/1/2018 700573 HJ ST SALMAH 2305R00201180000602 8/1/2018 BPJS VIPB Rp2162000
RS180100891 6/1/2018 440725 IFFA AMELYA 2305R00201180000759 8/1/2018 BPJS VIPB Rp780000
RS180100301 3/1/2018 231290 H A RAJAK 9/1/2018 BPJS VIPB Rp2139000
RS180100732 5/1/2018 241250 A HAMID 2305R00201180000571 10/1/2018 BPJS VIPB Rp2051000
RS180101017 7/1/2018 211108 IQLIMA SAFITRI 2305R00201170000976 10/1/2018 BPJS VIP B Rp1702500
RS180100708 5/1/2018 970897 SABLIN GIDRACH 10/1/2018 UMUM VIP B Rp1338000
RS180100972 7/1/2018 65013 M GIBRAN RIDHO 2305R00201180000779 10/1/2018 BPJS VIPB Rp1077000
RS180101013 7/1/2018 930073 AHMAD M TAHER 2305R00201180000935 9/1/2018 BPJS VIPB Rp1299000
RS180100722 5/1/2018 59781 ABDUL KAHIR 2305R00201180000846 9/1/2018 BPJS VIPB Rp1943500
RS180100862 6/1/2018 730845 MUHAMMAD HGAFAIZ 2305R00201180000749 9/1/2018 BPJS VIP B RP1276000
RS180100734 5/1/2018 30340 NOVI WARISMA NINGGRUM 2305R00201180000584 11/1/2018 BPJS VIP B Rp6722500
RS180101198 8/1/2018 72615 HEMON 2305R00201180000983 10/1/2018 BPJS VIPB Rp730000
RS180101268 9/1/2018 71144 ST HABIBAH 11/1/2017 UMUM VIPB Rp463000
RS180101138 8/1/2018 60760 ST ASMAH 2305R00201180000968 12/1/2018 BPJS VIPB Rp2862000
RS180101256 8/1/2018 79431 HARTATI MASDAR 2305R00201180000942 11/1/2018 BPJS VIP B Rp2161500
RS180101254 8/1/2018 530760 DODI FAKHRUDDIN 2305R00201180001110 12/1/2018 BPJS VIP B Rp1828000
RS180100187 2/1/2018 231270 ASIAH 2305R00201180000492 11/1/2018 BPJS V Rp3183300
RS180101592 10/1/2018 230570 ABDUL ARSYAD 2305R00201180001270 12/1/2018 BPJS VIP B Rp1073000
RS180101545 10/1/2018 360329 ASIAH 2305R00201180001271 12/1/2018 BPJS VIP B Rp995500
RS180101016 7/1/2018 251277 HAMDAN 2305R00201180001009 12/1/2018 BPJS VIP B RP398700
RS180101458 9/1/2018 801040 WAWAN SETIAWAN 2305R00201180001186 13/01/18 BPJS V Rp2019000
RS180102199 13/01/18 301213 NURLAELI SAKINAH 2305R00201180001608 14/01/18 BPJS VIP B Rp454000
RS180101642 10/1/2018 300433 NURLAILAH 2305R00201180001272 14/01/18 BPJS VIP B Rp1674900
RS180101764 11/1/2018 88874 SITI MARIAM UMUM VIP B Rp1243000
RS180101217 8/1/2018 960665 SAFIAH A MALIK 2305R00201180000934 13/01/18 BPJS VIP B Rp2379500
RS180101764 11/1/2018 88874 ST MARIAM 14/01/18 UMUM VIP B RP
RS180101799 11/1/2018 51443 H JAFAR AB 13/01/18 UMUM VIP B RP
RS180101470 10/1/2018 441177 M AGAM RAFFASYA 13/01/18 UMUM VIP B RP
RS180101458 9/1/2018 801040 WAWAN SETIAWAN 2305R00201180001186 13/01/18 BPJS VIP B RP2019000
RS180101245 8/1/2018 980349 ERNA PURNAMAWATI 13/01/18 UMUM VIP B RP
RS180101976 12/1/2018 440360 ALAMSYAH 2305R00201180001536 15/01/18 BPJS VIP B Rp1302000
RS180102004 12/1/2018 731190 MUHAMAD AL GIFARI 2305R00201180001680 15/01/18 BPJS VIP B Rp1006000
RS180100188 2/1/2018 700961 NUNUNG NURHAYATI 2305R00201180000409 15/01/18 BPJS VIP B Rp3079400
RS180101788 11/1/2018 50303 H ABDULLAH 2305R00201180001389 15/01/18 BPJS VIP B Rp5535600
RS180102191 13/01/18 301209 RUSDIN 2305R00201180001699 15/01/18 BPJS VIP B Rp824900
RS180101984 12/1/2018 790960 TURAYA 2305R00201180001750 16/01/18 BPJS VIP B Rp2817700
RS180102217 13/01/18 380223 ENDANG SULASTRI 2305R00201180001618 15/01/18 BPJS VIP B RP1008000
RS180101823 11/1/2018 750162 SRI SUSILAWATI 2305R00201180001549 15/01/18 BPJS VIP B RP1366000
RS180102227 14/01/18 970657 RYUZAKI 17/01/18 UMUM VIP B Rp713000
RS180102276 15/01/18 940909 M MIRZA 2305R00201180001842 17/01/18 BPJS VIP B Rp1018000
RS180102681 16/01/18 420405 ANITA PERTIWI 2305R00201180001975 17/01/18 BPJS VIP B Rp872500
RS180101453 9/1/2018 650025 M SAUD YASIN 2305R00201180001174 16/01/18 BPJS VIP B RP9855300
RS180101804 11/1/2018 500672 MUH EDON 2305R00201180001727 16/01/18 BPJS VIP B RP7328000
RS180101879 12/1/2018 73824 MASRIANI 2305R00201180001495 16/01/18 BPJS VIP B RP5478500
RS180102418 15/01/18 970856 M RIZQI 2305R00201180001836 17/01/18 BPJS VIP B RP3746000
RS180102308 15/01/18 560418 HJ SYARFIAH 2305R00201180001849 19/01/18 BPJS VIP B Rp1997500
RS180102258 14/01/18 651065 SYAMSUDIN 2305R00201180001882 19/01/18 BPJS VIP B Rp2776500
RS180102908 17/01/18 10361 HAIKAL 19/01/18 UMUM VIP B Rp620500
RS180102910 17/01/18 321212 ADILAH SYARFIAH 19/01/18 UMUM VIP B Rp439000
RS180102897 17/01/18 311259 M NHOER 2305R00201180002168 20/01/18 BPJS VIP B Rp1720000
RS180102204 13/01/18 301214 MUHSEN 2305R00201180001649 19/01/18 BPJS VIP B RP5404300
RS180102193 13/01/18 79701 NURFITRIANA 2305R00201180001668 19/01/18 BPJS VIP B RP3231000
RS180102182 13/01/18 77075 DAKHFIR PARSAN 2305R00201180001759 19/01/18 BPJS VIP B RP3452500
RS180102483 15/01/18 930393 YULI YANTI 2305R00201180001830 19/01/18 BPJS VIP B RP6313000
RS180102686 16/01/18 100432 MUH RIZKI ANUGRAH 2305R00201180001981 18/01/18 BPJS VIP B RP937500
RS180102514 15/01/18 900506 MUH IRSYAD 19/01/18 UMUM VIP B RP
RS180102443 15/01/18 301263 MUH RIZKA 18/01/18 UMUM VIP B RP
RS180102255 14/01/18 151269 ABIZAR RAMADHAN 2305R00201180001833 18/01/18 BPJS VIP B RP158000
RS180102398 15/01/18 510946 M ALFAUJIN PRATAMA 2305R00201180001965 18/01/18 BPJS VIP B RP1262500
RS180102212 13/01/18 441096 HUSAIN 2305R00201180001717 18/01/18 BPJS VIP B RP3371000
RS180103381 19/01/18 73899 FITRATUN JANNAH 2305R00201180002681 21/01/18 BPJS VIP B RP1240500
RS180102775 17/01/18 311256 ABIDIN 2305R00201180002239 20/01/18 BPJS VIP B RP1978500
RS180102898 17/01/18 490131 EMIER SURITNAH 2305R00201180002222 21/01/18 BPJS VIP B RP4775000
RS180103128 18/01/18 780030 IDA ROSMIATI 21/01/18 UMUM VIP B RP
RS180102924 17/01/18 311220 KHOFIFAH AHSYA NAYLA 2305R00201180002336 22/01/18 BPJS VIP B RP2207000
RS180103370 19/01/18 311294 AMIRA KHAYLA FARZANA 2305R00201180002445 22/01/18 BPJS VIP B RP1102500
RS180103395 19/01/18 321236 DWI FARISHA AZZAHRA 2305R00201180002639 22/01/18 BPJS VIP B RP1365000
RS180102785 17/01/18 271269 A RAJAK H AHMAD 2305R00201180002088 22/01/18 BPJS VIP B RP6588000
RS180103124 18/01/18 870222 SAMURI 2305R00201180002351 22/01/18 BPJS VIP B RP5211500
RS180102905 17/01/18 311263 MUHAMAD YUNUS 2305R00201180002363 22/01/18 BPJS VIP B RP3605000
RS180103608 21/01/18 451133 M RADIN 24/01/18 UMUM VIP B Rp851000
RS1801038560 22/01/18 900411 M FAQIH 2305R00201180002870 24/01/18 BPJS VIP B Rp1115000
RS180103389 19/01/18 59357 M FADLIN 2305R00201180002449 24/01/18 BPJS VIP B Rp1834100
RS180103131 18/01/18 770573 SUDIRMAN H S BE 2305R00201180002436 24/01/18 BPJS VIP B Rp6005300
RS180103966 21/01/18 73084 MURSIDAH 2305R00201180002893 25/01/18 BPJS VIP B Rp2994500
RS180104094 23/01/18 331270 ANISA NUR LATIFA 2305R00201180003050 26/01/18 BPJS VIP B Rp1394500
RS180103402 19/01/18 140521 SYUKRI 2305R00201180002498 26/01/18 BPJS VIP B Rp6404000
RS180103887 22/01/18 331246 ISRATUL HASANAH 2305R00201180003056 26/01/18 BPJS VIP B Rp1656000
RS180103385 19/01/18 50616 HJ FATIMAH 2305R00201180002492 26/01/18 BPJS VIP B Rp6737000
RS180103612 21/01/18 430653 RAHMAH 2305R00201180003039 26/01/18 BPJS VIP B Rp
RS180103691 21/01/18 911053 BURHANUDIN 29/01/18 UMUM VIP B Rp4432000
RS180104498 25/01/18 351207 MAANI 29/01/18 UMUM VIP B Rp2173000
21/01/18 331209 RAHMAT HIDAYAT 29/01/18 UMUM VIP B Rp2249000
RS180104495 25/01/18 480435 FALIHAH NUGRAHANTI 2305R00201180003686 29/01/18 BPJS VIP B Rp1095000
RS180104356 25/01/18 880165 BANDI 2305R00201180003246 29/01/18 BPJS VIP B Rp1486500
RS180103558 20/01/18 181238 MELLY INDRIANI 2305R00201180002551 27/01/18 BPJS VIP B Rp10631000
RS180102907 17/01/18 100921 NURLAELA 2305R00201180002105 29/01/18 BPJS VIP B Rp5438700
RS180104280 24/01/18 191097 ERNA YUSTIKA 2305R00201180003421 29/01/18 BPJS VIP B Rp7075000
RS180104498 25/01/18 351207 MAANI VIP B
RS180104881 27/01/18 881136 LISA FITRI HANDAYANI 29/01/18 UMUM VIP B
RS180104678 26/01/18 591186 HADIJAH 2305R00201180003441 31/01/18 BPJS VIP B Rp3050500
RS180105030 29/01/18 920999 M ALFAH 31/01/18 UMUM VIP B Rp
RS180104908 28/01/18 140612 SUPRIHATININGSIH 2305R00201180003813 31/01/18 BPJS VIP B Rp1805000
RS180103878 22/01/18 78757 WENI SUWANDARI 2305R00201180002841 26/01/18 BPJS VIP B Rp5276000
RS180104683 26/01/18 331285 RADIA 2305R00201180003449 30/01/18 BPJS VIP B Rp7145500
RS180104673 26/01/18 250111 CONSTANTY 2305R00201180003827 30/01/18 BPJS VIP B Rp3184000
RS180104549 26/01/18 351217 NURFURQANI 30/01/18 BPJS VIP B Rp6980000
RS180104670 26/01/18 331275 M JUBAIDIN 2305R00201180003475 30/01/18 BPJS VIP B Rp2056500
RS180105146 29/01/18 330024 M FAUZAN 2305R00201180003776 31/01/18 BPJS VIP B Rp3263000
RS180103565 20/01/18 89564 AYEM H ABDURRAHMAN 30/01/18 BPJS VIP B Rp6586500
 VIP B
RS950096 27/01/18 950096 ST SALMAH 30/01/18 UMUM
4
 TGL MASUK CM NAMA NO SJP TGL KELUAR CARA BAYAR RUNGAN TOTAL
RS180105456 31/01/18 351279 IKLAS SURYA 2305R00201180004014 2/2/2018 BPJS VIPB Rp3792000
RS180104292 24/01/18 301258 ABDUL KHAIR 2305R00201180003359 2/2/2018 BPJS VIPB Rp5632200
RS180105402 31/01/18 67551 ITRUN 2305R00201180004016 3/2/2018 BPJS VIPB Rp1200500
RS180200077 1/2/2018 640925 MUHAMAD JALALUDIN 2305R00202180000190 3/2/2018 BPJS VIPB Rp852500
RS180104916 28/01/18 480770 H BURHAN 3/2/2018 UMUM VIPB Rp
RS180104894 27/01/18 78161 SYARIFUDIN 5/2/2018 UMUM VIPB Rp2725500
RS180105383 31/01/18 360329 ASIAH 2305R00201180004049 4/2/2018 BPJS VIPB Rp1977000
RS180105186 29/01/18 361232 ASIAH 2305R00201180003998 4/2/2018 BPJS VIPB Rp5834600
RS180200140 1/2/2018 990924 NABILA SUFIANDANI 5/2/2018 UMUM VIPB Rp1690000
RS180200305 2/2/2018 680050 A BAKAR 2305R00202180000366 3/2/2018 BPJS VIPB Rp2527000
RS180200111 1/2/2018 770909 ISMI ANDRI ARWATI 2305R00202180000178 6/2/2018 BPJS VIPB Rp9369000
RS180105550 31/01/18 501047 KAMARUDIN 2305R00201180004021 3/2/2018 BPJS VIPB Rp1382000
RS180104873 27/01/18 110549 RAHMAN 2305R00201180003645 3/2/2018 BPJS VIPB Rp3553500
RS180105577 31/01/18 250630 ST HAJAR 2305R00202180000200 4/2/2018 BPJS VIPB Rp2638000
RS180104894 27/01/18 78161 SYARIFUDIN 4/2/2018 UMUM VIPB
RS180105569 31/01/18 371229 AMINAH 2305R00201180004034 2/2/2018 BPJS VIPB Rp1938500
RS180200539 3/2/2018 600839 M ISNAINI 2305R00202180000615 6/2/2018 BPJS VIPB RP1304000
RS180200611 4/2/2018 87593 LINA 2305R00202180000496 6/2/2018 BPJS VIPB RP1208000
RS180200232 2/2/2018 790163 MUTHOAH 2305R00202180000362 6/2/2018 BPJS VIPB RP5791500
RS180200642 4/2/2018 310470 FERDIN FERDIAN 2305R00202180000458 7/2/2018 BPJS VIPB RP984500
RS180105551 31/01/18 75677 MUHAMMAD HATTA 2305R00202180004057 7/2/2018 BPJS VIPB RP2865500
RS180105277 30/01/18 851175 MUSTAFA 2305R00202180003975 7/2/2018 BPJS VIPB RP3451000
RS180200601 3/2/2018 910909 ABDUL ARIQIN AKHYAR 2305R00202180000712 8/2/2018 BPJS VIPB RP2124000
RS180200950 5/2/2018 200557 SUHARTI RAHMAWATI 2305R00202180000663 8/2/2018 BPJS VIPB RP3586000
RS180200356 3/2/2018 69966 AJMAN 2305R00202180000463 7/2/2018 BPJS VIPB RP2553000
RS180200149 2/2/2018 371281 GERARD SEBASTIAN 2305R00202180000381 7/2/2018 BPJS VIPB RP2617000
RS180200636 4/2/2018 241019 HALIMAH 2305R00202180000524 8/2/2018 BPJS VIPB Rp2552000
RS180200937 5/2/2018 391286 SALAHUDIN 8/2/2018 UMUM VIPB
RS180201157 7/2/2018 561033 WAHYUNINGSIH 2305R00202180000872 9/2/2018 BPJS VIPB Rp808000
RS180201143 6/2/2018 391223 SIAFAH 9/2/2018 UMUM VIPB
RS180200658 4/2/2018 69653 NURHAYATI 2305R00202180000617
RS180104103 23/01/18 49 SUHARNI SARUJIN 2305R00201180003174 8/2/2018 BPJS VIPB Rp8482800
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RS180201365 8/2/2018 530212 SRI NURYATI 2305R00202180001039 9/2/2018 BPJS VIPB Rp399500
RS180200658 4/2/2018 69653 NURHAATI 2305R00202180000617 9/2/2018 BPJS VIPB Rp2122900
RS180200934 5/2/2018 200442 ANDHY WINARTO 2305R00202180000656 11/2/2018 BPJS VIPB Rp2107700
RS180201511 8/2/2018 910770 NUR SAADIAH 2305R00202180001137 11/2/2018 BPJS VIPB Rp1748500
RS180201153 6/2/2018 391211 JAFRAN U 11/2/2018 UMUM VIPB Rp1226500
RS180201358 8/2/2018 391268 MUH RIZKY 11/2/2018 UMUM VIPB Rp709000
RS180201340 7/2/2018 401165 AZIZUL AKBAR 2305R00202180001179 10/2/2018 BPJS VIPB Rp890500
RS180201137 6/2/2018 7817 HJ RAHMAWATI 2305R00202180000938 10/2/2018 BPJS VIPB Rp1941000
RS180201732 9/2/2018 440033 RUKMINI 2305R00202180001255 12/2/2018 BPJS VIPB Rp3045500
RS180200685 5/2/2018 731100 MUHMAD AL GAZALI 2305R00202180000744 10/2/2018 BPJS VIPB Rp1827000
RS180201519 8/2/2018 391256 MISYAH IZZATUL SOLEHAH 2305R00202180001274 12/2/2018 BPJS VIPB RP1177500
RS180104474 25/01/18 650025 M SAUD YASIN 2305R00201180003249 12/2/2018 BPJS VIPB Rp25889500
RS180200953 5/2/2018 67942 ABDULLAH ABUBAKAR 2305R00202180000778 12/2/2018 BPJS VIPB Rp4385500
RS180200926 5/2/2018 360211 MAUDY KURNIA 2305R00202180000697 13/02/18 BPJS VIPB Rp9998000
RS180201639 9/2/2018 401249 AMBARUKMA 14/02/18 UMUM VIPB Rp1836500
RS180200580 3/2/2018 90918 H IBRAHIM 2305R00202180000454 13/02/18 BPJS VIPB RP
RS180202003 11/2/2018 491019 MIZAN 13/02/18 UMUM VIPB RP
RS180201967 10/2/2018 71638 RAHMAWATI 2305R00202180001413 13/02/18 BPJS VIPB Rp1404000
RS180201353 7/2/2018 391250 M KHALID 13/02/18 UMUM VIPB Rp
RS180201746 9/2/2018 930923 DAFANKA EL RUMMI 2305R00202180001542 13/02/18 BPJS VIPB Rp1888500
RS180202284 12/2/2018 711098 RADIT 15/02/18 UMUM VIPB Rp722000
RS180201972 10/2/2018 950463 IKHLASDERMAWAN 2305R00202180001432 15/02/18 BPJS VIPB Rp8724100
RS180202041 12/2/2018 301004 VINA PUTRI 2305R00202180001630 14/02/18 BPJS VIPB Rp1047000
RS180200510 3/2/2018 281100 BILAL 2305R00202180000434 14/02/18 BPJS VIPB RP12135500
RS180105575 31/01/18 371257 DR ADHAR 4/2/2018 UMUM VIPB RP
RS180202001 11/2/2018 210009 DRS SALADIN 2305R00202180001619 16/02/18 BPJS VIPB RP2039500
RS180202268 12/2/2018 71328 SYAMSIAH 2305R00202180001692 16/02/18 BPJS VIPB RP2081000
RS180201527 14/02/18 401281 SUMIATI 17/02/18 UMUM VIPB RP3098000
RS180202785 5/2/2018 78954 ROSDIANA 2305R00202180002076 18/02/18 BPJS VIPB RP1136000
RS180202297 13/02/18 64505 AMINAH MUHAMMAD 2305R00202180001793 17/02/18 BPJS VIPB RP2230000
RS180202703 15/02/18 74533 FAUZI AKBAR 2305R00202180002020 19/02/18 BPJS VIPB RP1773200
RS180202904 16/02/18 440611 M FATHIR MUBARAK 2305R00202180002063 19/02/18 BPJS VIPB RP1550000
RS180201990 11/2/2018 630759 PRABU RAYYAN 2305R00202180001480 15/02/18 BPJS VIPB RP1954000
RS180202279 12/2/2018 63487 ASNI EFENDI 2305R00202180001657 16/02/18 BPJS VIPB RP1105700
RS180202407 13/02/18 251281 ROSA PUSPITA SARI 16/02/18 UMUM VIPB RP
RS180202480 13/02/18 900140 HJ SAFIAH 16/02//18 BPJS VIPB RP
RS180202878 15/02/18 421217 ST SARAFIAH 19/02/18 UMUM VIPB RP1046000
RS180201755 9/2/2018 68451 M YASIN SIDIK 2305R00202180001442 19/02/18 BPJS VIPB RP6525500
RS180202641 14/02/18 560865 SULAIMAN 2305R00202180002093 19/02/18 BPJS VIPB RP1881000
RS180202928 16/02/18 180737 HJ MAANI 2305R00202180002220 19/02/18 BPJS VIPB RP1457000
RS180201934 10/2/2018 68384 AMINAH 2305R00202180001645 19/02/18 BPJS VIPB RP3828000
RS180202899 16/02/18 140152 SALSABILA DARIYATUL 2305R00202180002026 19/02/18 BPJS VIPB RP1502000
RS180203202 18/02/18 271064 SEPTIAN SUCIYATI 2305R00202180002236 20/02/18 BPJS VIPB RP3936000
RS180202888 15/02/18 72697 DAE NURUL AULIA 2305R00202180002025 18/02/18 BPJS VIPB RP2105500
RS180201527 8/2/2018 790985 AHMAD 2305R00202180001330 16/02/18 BPJS VIPB RP6136400
RS180202008 11/2/2018 74351 LESTARI 2305R00202180001362 16/02/18 BPJS VIPB RP5604651
RS180203035 17/02/18 30754 NURBAYA BUNYAMIN 2305R00202180002277 22/02/18 BPJS VIPB Rp1842500
RS180202459 13/02/18 390509 AHMAD 2305R00202180001776 20/02/18 BPJS VIPB Rp6048000
RS180203197 1802/18 170477 NURAENIA NINGSIH 2305R00202180002444 21/02/18 BPJS VIPB Rp6550000
RS180203313 19/02/18 73829 MUHIDIN SPD 2305R00202180002420 21/02/18 BPJS VIPB Rp523500
RS180203116 17/02/18 640727 SRI TINA 2305R00202180002327 21/02/18 BPJS VIPB Rp2052000
RS180203207 18/02/18 89564 AYEM ABDURRAHMAN 2305R00202180002323 23/02/18 BPJS VIPB Rp1957000
RS180203084 16/02/18 610985 NURRAHMANIA 2305R00202180002250 23/02/18 BPJS VIPB Rp3708000
RS180202897 16/02/18 250507 HABIBAH 23/02/18 JAKKAD VIPB Rp1527100
RS180203014 17/02/18 660694 YAKUB 2305R00202180002242 22/02/18 BPJS VIPB Rp2588100
RS180203211 18/02/18 690851 JALALUDIN 2305R00202180002563 22/02/18 BPJS VIPB Rp1377500
RS180203212 18/02/18 510750 FAUZI 2305R00202180002328 22/02/18 BPJS VIPB
RS180203014 17/02/18 660694 YAKUB 2305R00202180002242 22/02/18 BPJS VIPB Rp2588100
RS180203523 20/02/18 760023 ST HALIMAH 2305R00202180002628 26/02/18 BPJS VIPB Rp4233300
RS180204287 23/02/18 740424 HARIS NASUTION 24/02/18 UMUM VIPB Rp970000
RS180203912 21/02/18 73447 ST HADIJAH 2305R00202180002848 24/02/18 BPJS VIPB Rp1320500
RS180204170 23/02/18 40822 NUR REGINA 25/02/18 UMUM VIPB Rp684000
RS180203682 20/02/18 441215 SITI MARYAM 2305R00202180002996 25/02/18 BPJS VIPB Rp2233000
RS180204275 22/02/18 21193 M TAUFIK RISKI 2305R00202180003221 25/02/18 BPJS VIPB Rp1416000
RS180204471 24/02/18 151265 FITRIANTI 25/02/18 UMUM VIPB Rp303000
RS180201943 10/2/2018 490056 ST HADIJAH 2305R00202180001403 23/02/18 BPJS VIPB RP12403000
RS180204263 23/02/18 451205 HADIJAH 27/02/18 UMUM VIPB RP1204000
RS180203921 21/02/18 441228 ADIBA AZZAHRA 2305R00202180002944 25/02/18 BPJS VIPB RP2016500
RS180204274 22/02/18 860825 H SUPARDIN 2305R00202180003103 25/02/18 BPJS VIPB RP1120500
RS180204471 24/02/18 151265 FITRIANTI 25/02/18 UMUM VIPB RP
RS180203720 21/02/18 401286 ST HARTATI 2305R00202180002797 24/02/18 BPJS VIPB RP4871000
RS180203899 21/02/18 210009 DRS SALADIN 2305R00202180002959 26/02/18 BPJS VIPB RP2652700
RS180204007 22/02/18 850963 NURFITRIANI 2305R00202180002807 24/02/18 BPJS VIPB RP4008000
RS180202869 15/02/18 51000 DRS ZAINUL ASIKIN 2305R00202180002014 24/02/18 BPJS VIPB RP7173800
RS180203926 21/02/18 430326 NAILULAWALIA 27/02/18 UMUM VIPB Rp1476500
RS180204631 25/02/18 52849 NURHAYATI 2305R00202180003260 26/02/18 BPJS VIPB Rp391000
RS180202631 14/02/18 960157 M YASIN ARSYAD 2305R00202180002027 25/02/18 BPJS VIPB Rp12094100
RS180204508 25/02/18 240042 DEVINA DAMAYANTI 2305R00202180003273 27/02/18 BPJS VIPB Rp911000
RS180204505 25/02/18 90694 LILI SURYANI 2305R00202180003257 28/02/18 BPJS VIPB Rp1115000
RS180203188 18/02/18 221287 MAEMUNAH 2305R00202180002581 28/02/18 BPJS VIPB Rp5765000
RS180204585 25/02/18 451209 FATIMAH 28/02/18 UMUM VIPB Rp
 TGL MASUK CM NAMA NO SJP TGL KELUARCARA BAYARRUNGAN TOTAL
RS180204732 26/02/18 INDAR DWIYANI 2305R0020218V000014 1/3/2018 BPJS VIPB Rp1830500
RS180204227 22/02/18 71435 NURAINI 2305R00202180002960 1/3/2018 BPJS VIPB Rp3315900
RS180204296 23/02/18 441298 IMRAN 2305R00202180003243 1/3/2018 BPJS VIPB Rp4523800
RS180205206 24/02/18 460707 RUSLAN 2305R00202180003344 1/3/2018 BPJS VIPB Rp4040500
RS180204734 26/02/18 411204 SAHARIAN 1/3/2018 UMUM VIPB Rp1309000
RS180204770 27/02/18 77389 AMINAH 2305R00202180003657 2/3/2018 BPJS VIPB Rp1935500
RS180204598 26/02/18 690805 NURDIN 2/3/2018 UMUM VIPB Rp1450000
RS180204479 24/02/18 940618 RAIHANAN 2305R00202180003393 1/3/2018 BPJS VIPB RP2093000
RS180204730 26/02/18 74112 SITI JAENAB 2305R00202180003414 2/3/2018 BPJS VIPB Rp2060500
RS180204961 27/02/18 68203 PITRIANI 2305R0020218V000031 2/3/2018 BPJS VIPB Rp1401000
RS180205168 28/02/18 620302 USMAN 2305R0020218V000024 3/3/2018 BPJS VIPB Rp1739000
RS180205163 28/02/18 870773 HARDIANTI ST 2305R0020218V000030 3/3/2018 BPJS VIPB Rp1484800
RS180205148 28/02/18 461229 AISYAH AYUNDA 3/3/2018 UMUM VIPB Rp1016500
RS180300303 2/3/2018 370935 HJ FATIMAH 2305R0020318V000325 3/3/2018 BPJS VIPB RP872500
RS180204897 27/02/18 260389 PATAR DAYU GUNA 2305R0020318V000133 5/3/2018 BPJS VIPB Rp6182000
RS180205144 28/02/18 73155 SITI AMINAH 2305R00202180V000046 4/3/2018 BPJS VIPB Rp1528000
RS180300083 1/3/2018 421297 HALIMAH 2305R0020318V000268 4/3/2018 BPJS VIPB Rp4479500
RS180300176 1/3/2018 230497 HAWIAH 2305R0020318V000330 4/3/2018 BPJS VIPB Rp1075000
RS180300169 1/3/2018 461214 HJ ST NURAHMAH 4/3/2018 UMUM VIPB Rp461214
RS180205155 28/02/18 330084 HJ ST JUBAIDAH 2305R0020218V000025 4/3/2018 BPJS VIPB Rp2078500
RS180204578 26/02/18 370776 BAMBANG IRAWAN 2305R00202180003410 4/3/2018 BPJS VIPB Rp4524500
RS180300616 4/3/2018 950332 ADE KURNIAWAN 6/3/2018 UMUM VIPB RP303000
RS180300234 2/3/2018 711007 ADRY RANGGA 2305R0020318V000597 6/3/2018 BPJS VIPB Rp1746000
RS180204956 27/03/18 441276 H YASIN 6/3/2018 BPJS VIPB Rp
RS180300367 2/3/2018 480882 A GANI 2305R0020318V000565 5/3/2018 BPJS VIPB Rp1792000
RS180300360 2/3/2018 180232 ABAS HASAN 2305R0020318V000385 5/3/2018 BPJS VIPB Rp3955109
RS180300123 1/3/2018 87339 SURYATI 2305R0020318V000188 6/3/2018 BPJS VIPB Rp7020500
RS180300855 6/3/2018 441263 ADITYA 8/3/2018 UMUM VIPB Rp
RS180300610 3/3/2018 570102 IBO 2305R0020318V000603 7/3/2018 BPJS VIPB Rp1495000
RS180300181 1/3/2018 481203 H YASIN H UMAR 7/3/2018 UMUM VIPB Rp2741500
RS180300626 5/3/2018 610899 SISIL APRILIA 2305R0020318V000803 6/3/2018 BPJS VIPB Rp630000
RS1803002355 2/3/2018 770744 MUH AMAR 2305R0020318V000570 7/3/2018 BPJS VIPB Rp1764000
RS180300551 3/3/2018 481167 NURMAYLANI 2305R0020318V000537 7/3/2018 BPJS VIPB Rp1327500
RS180301058 6/3/2018 51903 NILAFARIDA NINGSIH 2305R0020318V001014 9/3/2018 BPJS VIPB RP1361000
RS180204745 26/02/18 700961 NUNUNG NURHAYATI 2305R00202180003639 6/3/2018 BPJS VIPB RP3904000
RS180300612 4/3/2018 300969 SYAMSUDIN 2305R0020318V000776 8/3/2018 BPJS VIPB RP1446900
RS180300855 6/3/2018 441263 ADITYA IRFANUL 8/3/2018 UMUM VIPB RP
RS180300557 3/3/2018 260809 AMANAH MURNI 2305R0020318V000784 9/3/2018 BPJS VIPB Rp8462500
RS180301194 7/3/2018 181297 MIKAYLA LAILATUL 2305R0020318V000960 9/3/2018 BPJS VIPB Rp915500
RS180300351 2/3/2018 67942 ABDULLAH ABUBAKAR 2305R0020318V000384 8/3/2018 BPJS VIPB Rp4982900
RS180300743 5/3/2018 360329 ASIAH 2305R0020318V000972 9/3/2018 BPJS VIPB Rp2552500
RS180300605 4/3/2018 65916 ABDULLAH MUHAMMAD 2305R0020318V000598 10/3/2018 BPJS VIPB Rp2815300
RS180301474 9/3/2018 72311 KARMAN 2305R0020318V001310 10/3/2018 BPJS VIPB Rp896500
RS180301311 8/3/2018 30275 SITI SARIFAH 2305R0020318V001206 10/3/2018 BPJS VIPB Rp748000
RS180301280 7/3/2018 260243 SITI NURHAYATI 2305R0020318V001105 BPJS VIPB Rp1244000
RS
RS180301930 8/3/2018 69356 HAWASIAH 2305R0020318V001346 10/3/2018 BPJS VIPB Rp1267500
RS180301762 8/3/2018 951064 AHMAD ALFARISI 2305R0020318V001442 10/3/2018 BPJS VIPB Rp692500
RS180301904 8/3/2018 491223 LUH NADIEN BLUM ADA SEP 10/3/2018 BPJS VIPB Rp735000
RS180301423 8/3/2018 501203 ALIFA 10/3/2018 UMUM VIPB Rp
RS180301926 7/3/2018 491224 SELMA ANANDA 9/3/2018 UMUM VIPB Rp
RS180301946 10/3/2018 890011 SYAHRUL 2305R0020318V001567 13/03/18 BPJS VIPB Rp1638000
RS180301296 7/3/2018 990854 ASIAH 2305R0020318V001791 12/3/2018 BPJS VIPB RP3716200
RS180300632 5/3/2018 670531 SYAMSUDIN 2305R0020318V000984 12/3/2018 BPJS VIPB RP7258200
RS180301662 9/3/2018 950710 MUHAMAD Firdaus 2305R0020318V001584 12/3/2018 BPJS VIPB RP3383000
RS180301519 8/3/2018 130804 MUHAMAD NUR 12/3/2018 BPJS VIPB RP1321500
RS180301692 10/3/2018 501295 NAFISA CANTIKA ARABELA 2305R0020318V001536 12/3/2018 BPJS VIPB RP2870500
RS180301072 6/3/2018 65552 CICI PUTRI NOVIANTI 2305R0020318V001003 11/3/2018 BPJS VIPB RP1835000
RS180301279 7/3/2018 150531 ABDUL MALIK 2305R0020318V001015 11/3/2018 BPJS VIPB RP2023000
RS180301656 9/3/2018 790042 SYAMSUDIN 2305R0020318V001583 13/03/18 BPJS VIPB RP2450000
RS180302082 11/3/2018 71720 SUAEB SPD 2305R0020318V001705 13/03/18 BPJS VIPB RP1526500
RS180300819 5/3/2018 79331 ISHAKA USMAN 2305R0020318V000968 12/3/2018 BPJS VIPB RP5558900
RS180302050 10/3/2018 501271 H ABDULLAH 14/03/18 BPJS VIPB Rp1327500
RS180300597 4/3/2018 80049 HAFSAH ARIFUDIN 2305R0020318V000633 13/08/18 BPJS VIPB RP15028500
RS180301685 10/3/2018 210846 HASAN 13/03/18 UMUM VIPB RP
RS180300995 6/3/2018 481250 QONITA RIZKYATUN PRATIWI 13/03/18 JAKKAD VIPB RP3724500
RS180203643 20/02/18 660877 JALEHA 2305R00202180002857 7/3/2018 BPJS VIPB RP31393300
RS180301646 9/3/2018 501254 HASANUDIN 11/3/2018 UMUM VIPB RP
RS180302207 13/03/18 67336 ST MAEMUNAH 2305R0020318V001951 15/03/18 BPJS VIPB Rp1088000
RS180301647 9/3/2018 501253 ST HAWA 15/03/18 UMUM VIPB
RS180301786 11/3/2018 310032 EMISUPRI HARTINI 2305R0020318V001911 15/03/18 BPJS VIPB Rp1888400
RS180301969 12/3/2018 501291 RIRIN DYAS 2305R0020318V001692 16/03/18 BPJS VIPB Rp3534500
RS180302163 12/3/2015 87159 INDAH LSTARI 2305R0020318V002003 15/03/18 BPJS VIPB Rp1256000
RS180301788 11/3/2018 241067 YASIN H MUSA 2305R0020318V001452 15/03/18 BPJS VIPB Rp2286500
RS180302602 14/03/18 511269 RAIYAH 15/03/18 UMUM VIPB
RS180301746 10/3/2018 72804 IMAWATI 2305R0020318V001581 14/03/18 BPJS VIPB Rp6361500
RS180302522 14/03/18 71988 AMIRUDIN 2305R0020318V002155 16/03/18 BPJS VIPB Rp2916000
RS180302348 13/03/18 291101 QIRATUN 2305R0020318V002004 15/03/18 BPJS VIPB Rp678900
RS180301821 12/3/2018 981047 RENO ACHZANI 2305R0020318V001962 14/03/18 BPJS VIPB Rp1199000
RS180302852 15/03/18 750719 ABDULLAH 17/03/18 UMUM VIPB Rp778000
RS180302171 13/03/18 400292 IBRAHIM A GANI 2305R0020318V001978 17/03/18 BPJS VIPB Rp2353100
RS180302410 13/03/18 670423 MANSYUR H YASIN 2305R0020318V002186 19/03/18 BPJS VIPB Rp2948500
RS180302032 12/3/2018 460929 ABAS 2305R0020318V001919 19/03/18 BPJS VIPB Rp3729000
RS180302359 13/03/18 600529 HJ NURHAYATI 2305R0020318V002012 18/03/18 BPJS VIPB Rp3093500
RS180302328 13/03/18 850963 NURFITRIANI 2305R0020318V001943 18/03/18 BPJS VIPB Rp5758000
RS180302622 14/03/18 511237 NURANITA PURNAMASARI 18/03/18 JAKKAD VIPB Rp3764500
RS180303035 16/03/18 491287 MURTALIB MANSYUR 2305R0020318V002436 18/03/18 BPJS VIPB Rp976000
RS180302830 15/03/18 491253 SITI SARAH 2305R0020318V002376 17/03/18 BPJS VIPB Rp991000
RS180302839 15/03/18 55285 SITI AMINAH 2305R0020318V002575 17/03/18 BPJS VIPB Rp1272000
RS180302855 15/03/18 900692 SRI ASTUTI 2305R0020318V002365 17/03/18 BPJS VIPB Rp1219000
RS180302508 14/03/18 600296 AMINAH 2305R0020318V002268 17/03/18 BPJS VIPB Rp2064500
RS180303115 17/03/18 521278 DANU PRAWIRO 2305R0020318V002545 19/03/18 BPJS VIPB Rp1119500
RS180303072 16/03/18 77759 SRI HARMAMI 2305R0020318V002630 18/03/18 BPJS VIPB Rp1023000
RS180303025 16/03/18 340298 MISBAH 2305R0020318V002576 17/03/18 BPJS VIPB Rp699500
RS180303027 16/03/18 241019 HALIMAH 2305R0020318V002573 17/03/18 BPJS VIPB Rp603500
RS180302784 15/03/18 370946 ST RAHMANIA 2305R0020318V002377 17/03/18 BPJS VIPB Rp1159000
RS180302631 14/03/18 941130 ASIFATUL 2305R0020318V002327 16/03/18 BPJS VIPB Rp1027000
RS180302618 14/03/18 510922 MAANI 2305R002318V002333 16/03/18 BPJS VIPB Rp1094600
RS180301624 9/3/2018 311263 2305R0020318V001262 14/03/18 BPJS VIPB Rp7422600
RS180303064 16/03/18 181256 NAYEF 19/03/18 BPJS VIPB Rp
RS180303081 17/03/18 401298 MANSYUR 20/03/18 UMUM VIPB Rp808000
RS180302176 13/03/18 450951 SAHRIMAN 2305R0020318V001956 14/03/18 BPJS VIPB Rp651600
RS180303473 19/03/18 531245 H IBRAHIM 21/03/18 UMUM VIPB Rp634000
RS180301787 11/3/2018 451103 MAEMUNAH 2305R0020318V001723 20/03/18 BPJS VIPB Rp8874800
RS180303142 18/03/18 59869 YUNI FITRIANI 2305R0020318V002547 20/03/18 BPJS VIPB Rp1494500
RS180303057 16/03/18 71422 MUHAMAD SALEH 2305R0020318V002650 20/03/18 BPJS VIPB Rp1843000
RS180303141 18/03/18 230807 H ABDUL KARIM 2305R0020318V002592 20/03/18 BPJS VIPB Rp1016000
RS180303103 17/03/18 620231 ARDIANSYAH 2305R0020318V002820 21/03/18 BPJS VIPB Rp1827000
RS180303105 17/03/18 74476 ITJE 2305R0020318V002498 20/03/18 BPJS VIPB Rp1635500
RS180303102 17/03/18 55688 MASKURNIAH 2305R0020318V002493 21/03/18 BPJS VIPB Rp3083000
RS180301062 6/3/2018 370868 KAHARUDIN 2305R0020318V000956 9/3/2018 BPJS VIPB Rp1385000
RS180303447 19/03/18 531206 RIDHO LINTANG 22/03/18 UMUM VIPB Rp674000
RS180303178 19/03/18 820860 ALGIRASYAMI 2305R0020318V002791 22/03/18 BPJS VIPB Rp1577000
RS180303060 16/03/18 820439 ABIDIN 2305R0020318V003040 22/03/18 BPJS VIPB Rp2690600
RS180303542 20/03/18 51696 A BAKAR THALIB 2305R0020318V002974 22/03/18 BPJS VIPB Rp982000
RS180303452 19/03/18 41269 I KADEK TIRTA 2305R0020318V002954 21/03/18 BPJS VIPB Rp1302000
RS180303466 19/03/18 791107 LALU RIZKY 21/03/18 UMUM VIPB Rp
RS180303098 17/03/18 66727 ABDURAHMAN 2305R0020318V002582 22/03/18 BPJS VIPB Rp3598500
RS180303623 20/03/18 531226 LUKMAN 2305R0020318V002959 25/03/18 BPJS VIPB Rp1945300
RS180303689 20/03/18 56711 SUPRIYANTO 2305R0020318V003156 25/03/18 BPJS VIPB Rp6826000
RS180303998 22/03/18 800950 ST RATNA DIANA 2305R0020318V003287 25/03/18 BPJS VIPB Rp4479000
RS180303704 21/03/18 500160 ISMAIL 2305R0020318V003364 25/03/18 BPJS VIPB Rp1676500
RS180303607 20/03/18 71403 NINI ARYANI 2305R0020318V002962 24/03/18 BPJS VIPB Rp1462000
RS180303795 21/03/18 52403 SUMANTI 2305R0020318V003137 25/03/18 BPJS VIPB Rp5767500
RS180304027 22/03/18 471277 ST RATNA 2305R0020318V003315 25/03/18 BPJS VIPB Rp1514500
RS180303681 20/03/18 321051 RAIS ABDUL 2305R0020318V003111 26/03/18 BPJS VIPB Rp2640000
RS180303886 21/03/18 820003 ABAKAR USMAN 23/03/18 UMUM U
RS180302560 14/03/18 410200 WINDARTI 2305R0020318V002188 23/03/18 BPJS VIPB Rp7355800
RS180303325 19/03/18 88827 SUHARTATI 2305R0020318V002813 24/03/18 BPJS VIPB Rp2824500
RS180304022 22/03/18 980809 GIBRAN FAISAL 2305R0020318V003333 24/03/18 BPJS VIPB Rp1528000
RS180303384 19/03/18 821149 NUR AESEYAH 2305R0020318V002806 24/03/18 BPJS VIPB Rp2402000
RS180303971 22/03/18 630957 JASRA YUNITA 25/03/18 UMUM VIPB
RS180303715 21/03/18 450656 H M NUR 2305R0020318V003178 25/03/18 BPJS VIPB Rp3197000
RS180303844 21/03/18 531294 AL FATIN 28/03/18 UMUM VIPB RP1691500
RS180304353 24/03/18 611084 AMIRA FATHINA 26/03/18 BPJS VIPB Rp984000
RS180304281 24/03/18 720057 SITTI NURAINI 27/03/18 BPJS VIPB Rp1966000
RS180304235 23/03/18 351208 ENI ASTUTI 2305R0020318V003465 27/03/18 BPJS VIPB Rp1901500
RS180305013 27/03/18 56698 KHAIRUNISA 2305R0020318V003991 28/03/18 BPJS VIPB Rp1063000
RS180304068 22/03/18 471288 AZALIA MALIKA 26/03/18 BPJS VIPB Rp
RS180303454 19/03/18 531209 INDAH LSTARI 2305R0020318V003911 26/03/18 BPJS VIPB Rp9408000
RS180304432 24/03/18 76205 SITI HAJAR 2305R0020318V003697 26/03/18 BPJS VIPB Rp951500
RS180304450 24/03/18 551284 FUJIAH 2305R0020318V003767 28/03/18 BPJS VIPB Rp1270600
RS180304493 25/03/18 920226 ABDUL MUNAWAR 2305R0020318V003882 29/03/18 BPJS VIPB Rp2490000
RS180304251 23/03/18 471269 ISMAIL 2305R0020318V003754 29/03/18 BPJS VIPB Rp4325500
RS180304459 24/03/18 75900 KALSOM 2305R0020318V003729 28/03/18 BPJS VIPB Rp1517500
RS180304496 25/03/18 64117 DRS M YAMIN 2305R0020318V003834 28/03/18 BPJS VIPB Rp1080500`
RS180304464 24/03/18 511295 JUNAIDIN 2305R0020318V003750 28/03/18 BPJS VIPB Rp1413600
RS180304946 27/03/18 551251 CITRA WATI 30/03/18 BPJS VIPB Rp926500
RS180304321 24/03/18 281155 SITI MARIAMA 2305R0020318V003878 30/03/18 BPJS VIPB Rp3515000
RS180304261 24/03/18 87338 SITI MAEMUNAH 2305R0020318V003721 29/03/18 BPJS VIPB Rp4616500
RS180304733 26/03/18 451103 MAEMUNAH 2305R0020318V004270 29/03/18 BPJS VIPB Rp1197000
RS180304596 26/03/18 221234 MARSYA 29/03/18 UMUM VIPB Rp
RS180305465 29/03/18 640237 AISYAH ZANUBA 2305R0020318V004557 31/03/18 BPJS VIP B Rp890000
RS180305078 28/03/18 960269 AKMALASARI 2305R0020318V004206 31/03/18 BPJS VIP B Rp3337000
RS180304415 27/03/18 571210 NANANG 2305R0020318V004431 31/03/18 BPJS VIP B Rp5426000
RS180305410 29/03/18 960964 AISYAH AFIQAH 2305R0020318V004483 31/03/18 BPJS VIP B Rp2839500
 TGL MASUK CM NAMA NO SJP TGL KELUAR CARA BAYAR RUNGAN TOTAL
RS180404965 27/04/15 671223 IDRIS ARSYAT 9/5/2018 U ICU Rp8181000
RS181200573 6/5/2018 691222 BILAL AL FATHIR 8/5/2018 U ICU Rp2345000
RS181200568 6/5/2018 691299 RIWANTO 2305R0020518V000870 13/05/18 BPJS ICU Rp6449000
RS181200577 6/5/2018 691224 ST AMINAH 2305R0020518V000933 13/05/18 BPJS ICU Rp9537600
RS180404160 23/05/18 661231 ARSILA 7/5/2018 U ICU Rp10775000
RS180405109 28/04/18 960086 H SANAWI 3/5/2018 U ICU Rp3816500
RS180405175 28/04/18 671245 FARHAN 5/5/2018 U ICU Rp8433500
RS181202950 20/05/18 90252 BAHASAHA FAHMID 2305R0020518V002553 23/05/18 BPJS ICU Rp
RS181202458 17/05/18 72098 H IBRAHIM 18/05/18 U ICU Rp132300
RS181201648 12/8/2018 660452 YUNI FITRIANI 2305R0020518V001562 14/05/18 BPJS ICU Rp11157000
RS181203948 25/05/18 771264 AFRIADIN 26/05/18 U ICU
RS181203757 25/05/18 771240 DEDI ARDIANSYAH 26/05/18 U ICU Rp2028000
RS181202486 17/05/18 751220 ALBIANSYAH 28/05/18 U ICU RP5479000
RS181204767 30/05/18 801206 SARFIAH 2305R0020518V003920 31/05/18 BPJS ICU RP1380000
RS181204752 30/05/18 260959 HAJRAH 2305R0020518V003864 31/05/18 BPJS ICU Rp2455500
RS181405164 28/04/15 810682 M FAUZUL 2305R0020418V004138 1/5/2018 BPJS ICU Rp2434000
RS181205216 3/6/2018 801237 DOFI SAPUTRA 3/6/2018 U ICU Rp1762000
RS181204451 28/05/18 791229 ARIF 2305R0020518V003704 3/6/2018 BPJS ICU Rp3558500
RS181204966 6/6/2018 480770 H BURHAN 2305R0020618V000123 5/6/2018 BPJS ICU Rp4238000
RS181204786 31/05/18 801212 HJ SYAMSIAH 2305R0020518V004051 31/05/18 BPJS ICU Rp1961000
RS181205241 4/6/2008 581200 MUHAMAT FATAN 4/6/2018 U ICU Rp
RS181205166 2/6/2018 801291 SUDARNO A GANI 2305R0020618V000282 3/6/2018 BPJS ICU Rp1584000
RS181205175 2/6/2018 531222 SYAMSIAH M YUSUF 2305R0020618V000261 5/6/2018 BPJS ICU Rp6066000
RS181204474 29/05/18 791243 ABDUL KHAIR 29/5/18 U ICU Rp1314000
RS181204928 31/5/18 801222 SAFRIN 1/6/2018 U ICU
RS181205121 2/6/2018 560589 RAMLI 2305R0020618V000332 11/6/2018 BPJS ICU Rp4662500
RS181207481 22/06/18 611242 ASTINA 2305R0020618V002060 22/06/18 BPJS ICU Rp1929000
RS181206848 18/06/18 470045 SITI SAFIAH 2305R0020618V001358 21/06/18 BPJS ICU Rp4929500
RS181204768 30/05/18 801205 KALSOM 2305R0020518V004042 10/6/2018 BPJS ICU Rp5531000
RS181206428 10/6/2018 430990 MADE DIASE 2305R0020618V001168 15/06/18 BPJS ICU Rp6958000
RS181206427 10/6/2018 850747 ST AMINAH I GUSTI 2305R0020618V001148 11/6/2018 BPJS ICU Rp3331000
RS181206651 14/06/18 851291 PUTRI DZIKIRAH 15/06/18 BPJS ICU Rp649000
RS181206694 15/06/18 59893 ASRUL SANI 2305R0020618V001298 17/06/18 BPJS ICU Rp2190000
RS181206641 14/06/18 851286 ASIAH 14/06/18 BPJS ICU Rp1999000
RS181206484 11/6/2018 1042 ABAKAR 2305R0020618V001209 12/6/2018 BPJS ICU Rp1280000
RS181206034 7/6/2018 691287 NAURA ANITA 12/6/2018 U ICU Rp4752000
RS181206549 12/6/2018 831212 SALMAH ABAKAR 2305R0020618V001214 14/06/18 BPJS ICU RP1824000
RS181206747 16/06/18 851249 JULKIFLIN 19/06/18 U ICU RP2558000
RS181207741 23/06/18 830691 SURYADIN 2305R0020618V002177 26/06/18 BPJS ICU Rp1280000
RS181207838 25/06/18 871220 MUH ABDILLAH 26/06/18 ICU Rp383500
RS181209149 30/06/18 790402 NURHAYATI 2305R0020618V003189 1/7/2018 BPJS ICU RP3049000
RS181211042 10/7/2018 951232 CANDRA KIRANA 2305R0020718V001417 13/07/18 BPJS ICU RP5730000
RS181212332 16/07/18 971230 M IKBAL 21/07/18 U ICU RP3289000
RS181211591 12/7/2018 961203 AULIA 2305R0020718V001823 18/07/18 BPJS ICU RP4897500
RS181212341 16/07/18 971285 AYUB AL ANSARI 2305R0020718V002388 21/07/18 BPJS ICU RP5613500
RS181212389 15/07/18 921257 RUSLAN 2305R0020718V002355 15/07/18 BPJS ICU RP2535500
RS181213510 22/07/18 31315 FERI IRAWAN 24/07/18 BPJS ICU RP664000
RS181211402 11/7/2018 921204 JUMIATI 13/07/18 U ICU Rp1061500
RS181213714 21/07/18 131268 SEM BAJUBER 2305R0020718V003479 26/07/18 BPJS VIPB Rp10590000
RS181214614 28/077/18 78647 MUNARSIH 2305R0020718V004234 30/07/18 BPJS VIPB Rp3380500
RS181214370 26/07/18 601025 NURUL SWEINTA 2305R0020718V004147 30/07/18 BPJS VIPB Rp1432000
RS181214768 29/07/18 78406 IDA LAILA 2305R0020718V004202 30/07/18 BPJS VIPB Rp1914000
RS181214751 28/07/18 58353 ANNISA MANTIKA 2305R0020718V004256 30/07/18 BPJS VIPB Rp658500
RS181214714 28/07/18 951083 KARTINI 2305R0020718V004380 31/07/18 BPJS VIPB Rp1972500
RS181214816 30/07/18 130801 RUKAYAH 2305R0020718V004473 31/07/18 BPJS VIPB Rp471100
RS181214543 27/07/18 301214 MUHSEN 2305R0020718V004109 1/8/2018 BPJS VIPB Rp3550000
RS181214950 30/07/18 62960 AHALIK 2305R0020718V004523 1/8/2018 BPJS VIPB Rp1362000
RS181210603 8/7/2018 981220 AMIRUDIN 2305R0020718V001043 16/07/18 BPJS VIPB RP7814000
RS181213109 20/07/18 66728 HJ NURMI 20/07/18 BPJS VIPB RP
RS181214146 25/07/18 31378 JUNAIDIN 26/07/18 UMUM VIPB RP874000
RS181214796 29/07/18 41367 SUHARNI 2305R0020718V004538 31/07/18 BPJS VIPB RP2295000
RS181214766 28/07/18 940577 SYAFRUDIN 2305R0020718V004499 29/07/18 BPJS VIPB RP4286000
RS181214555 27/07/18 41336 NYOMAN KETI 2305R0020718V004094 29/07/18 BPJS VIPB RP4429500
RS181212755 16/07/18 901266 AGUS SUTIYO 2305R0020718V002711 30/07/18 BPJS VIPB RP15849500
 TGL MASUK CM NAMA NO SJP TGL KELUAR CARA BAYAR RUNGAN TOTAL
RS181213457 22/07/18 890227 MOH ARIPIN 2305R0020718V003100 1/8/2018 BPJS ICU RP
RS181215192 31/07/18 351035 ST HAWA 2305R0020718V004527 1/8/2018 BPJS ICU RP988000
RS181215546 2/8/2018 41343 AWALUDIN 2/8/2018 UMUM ICU RP1141500
RS181215577 2/8/2018 680920 NUR SUYATI 2305R0020818V000380 4/8/2018 BPJS ICU RP4213000
RS181216000 5/8/2018 91314 A HAFID 6/8/2018 UMUM ICU RP1719000
RS181216012 5/8/2018 91309 H ISMAIL 2305R0020818V000670 8/8/2018 BPJS ICU RP3577500
RS181217292 12/8/2018 11137 BAMBANG U 13/08/18 ICU Rp1855000
RS181217029 10/8/2018 121330 M AMIN 2305R0020818V001451 BPJS 12/8/2018 ICU Rp2036000
RS181216653 8/8/2018 680037 IKA WAHYUNI 2305R0020818V001197 BPJS 9/8/2018 ICU Rp1234000
RS181217955 15/08/18 141325 JAMILA U 20/08/18 ICU Rp2801500
RS181218451 19/08/18 120780 SITI MARIAM 2305R0020818V002623 BPJS 20/08/18 ICU Rp1876600
RS181216820 9/8/2018 88296 ADURIA 2305R0020818V001529 BPJS 22/08/18 ICU Rp10455500
RS181217225 11/8/2018 101383 BICE 2305R0020818V001573 BPJS 17/08/18 ICU Rp
RS181218453 19/08/18 141393 IBO U 20/08/18 ICU Rp1271500
RS181218196 18/08/18 650024 KIFAYATUL U 18/08/18 ICU Rp823000
RS181216274 6/8/2018 91365 AISAH U 16/18/18 ICU Rp9140500
RS181220022 28/08/18 930659 HASE 2305R0200818V003788 BPJS 29/08/18 ICU RP1484500
RS181219444 25/08/18 58431 LALU ARAS 2305R0020818V003446 BPJS 26/08/18 ICU RP2999000
RS181219548 25/08/18 490726 MUTIARA 2305R0020818V003445 BPJS 26/08/18 ICU RP1833500
RS181218934 22/08/18 871252 m fathi 2305r0020818v003170 BPJS 30/08/18 ICU RP5763000
RS181219565 26/08/18 53618 MAEMUNAH 2305R0020818V003530 BPJS 31/08/18 ICU RP5205500
 TGL MASUK CM NAMA NO SJP TGL KELUAR CARA BAYAR RUNGAN TOTAL
RS181220440 30/08/18 181379 ST MARIAM 3/9/2018 UMUM ICU RP2719000
RS181220863 2/9/2018 201354 AMIRUDIN 2305R0020918V000280 4/9/2018 BPJS ICU RP3814500
RS181222800 12/9/2018 471034 SITI SURIATI 2305R0020918V001504 12/9/2018 BPJS ICU Rp2008000
RS181222785 12/9/2018 231303 QAFIYA 2305R0020918V001498 14/09/18 BPJS ICU Rp1972500
RS181221594 5/19/2018 79571 ANI 2305R0020918V000691 17/09/18 BPJS ICU Rp4152000
RS181222525 10/9/2018 231354 SALMAH 2305R0020918V001409 11/9/2018 BPJS ICU Rp1327000
RS181223530 16/09/18 241340 RAHMAT 2305R0020918V002181 17/09/18 BPJS ICU RP2012800
RS181221150 3/9/2018 211305 MAHMUD 2305R0020918V000458 3/9/2018 BPJS ICU RP11493000
RS181222576 11/9/2018 770731 RUSMIATI 2305R0020918V001326 16/09/18 BPJS ICU RP7784000
RS181220462 30/08/18 201305 ENDANG KURNIATI 2305R0020818V004178 1/9/2018 BPJS ICU RP4484000
RS181224657 21/09/18 241386 M DIAS ERLANGGA 22/09/18 UMUM ICU RP1796000
RS181224260 19/09/18 811223 ARUJIN 2305R0020918V002818 24/09/18 BPJS ICU RP4269500
RS181224936 23/09/18 261346 JULIUS BAY 25/09/18 UMUM ICU RP3319500
RS181225181 24/09/18 511061 KALISOM 2305R0020918V003584 27/09/18 BPJS ICU RP2392000
RS181224021 18/09/18 251375 AZKAIRA 2305R0020918V002627 28/09/18 BPJS ICU RP12546000
RS181226048 28/09/18 291335 SYARIFUDIN 2305R0020918V003957 29/09/18 BPJS ICU RP1518000
RS181226184 29/09/18 800885 SALEH HAMID 2305R0021018V000308 30/09/18 BPJS ICU RP1580000
RS181220462 30/08/18 201305 ENDANG KURNIATI 2305R0020818V004178 1/9/2018 BPJS ICU RP4484000
RS181227177 4/10/2018 351340 RADIT 2305R0021018V000709 4/10/2018 BPJS ICU RP854000
RS181225815 27/09/18 271346 INSYAH 6/10/2018 BPJS ICU RP4259500
RS181228146 9/10/2018 311354 HJ KALSOM 10/10/2018 UMUM ICU RP1229000
RS181228486 10/10/2018 331322 DEWI ANGGRIANI 2305R0021018V001477 11/10/2018 BPJS ICU RP1445000
RS181228501 10/10/2018 451149 ST SARAH 2305R0021018V001540 11/10/2018 BPJS ICU RP1273000
RS181228482 10/10/2018 331300 MASNI 12/10/2018 UMUM ICU RP849000
RS181227967 8/10/2018 751057 AYUDIA 2305R0021018V001130 13/10/18 BPJS ICU RP5235000
RS181228882 12/10/2018 230960 RONI ADRIANSYAH 2305R0021018V001815 13/10/18 BPJS ICU RP2343500
 TGL MASUK CM NAMA NO SJP TGL KELUAR CARA BAYAR RUNGAN TOTAL
RS181228146 9/10/2018 311354 HJ KALSOM 10/10/2018 UMUM ICU RP1229000
RS181228486 10/10/2018 331322 DEWI ANGGRIANI 2305R0021018V001477 11/10/2018 BPJS ICU RP1445000
RS181228501 10/10/2018 451149 ST SARAH 2305R0021018V001540 11/10/2018 BPJS ICU RP1273000
RS181228482 10/10/2018 331300 MASNI 12/10/2018 UMUM ICU RP849000
RS181227967 8/10/2018 751057 AYUDIA 2305R0021018V001130 13/10/18 BPJS ICU RP5235000
RS181228882 12/10/2018 230960 RONI ADRIANSYAH 2305R0021018V001815 13/10/18 BPJS ICU RP2343500
RS181230066 18/10/18 341370 M GADAFI 2305R0021018V002712 19/10/18 BPJS ICU RP2014000
RS181228673 11/10/2018 331345 MIFTAHUL HUDA 2305R0021018V001917 11/10/2018 BPJS ICU RP1274000
RS181226315 30/09/18 70968 MUHDAR 2305R0021018V004145 17/10/18 BPJS ICU RP25953500
RS181229134 13/10/18 790050 LENI 2305R0021018V002095 20/10/18 BPJS ICU RP10942500
RS181230273 19/10/18 60043 SAKINAH 2305R0021018V002670 21/10/18 BPJS ICU RP1909000
RS181230513 21/10/*418 391333 ST HAJAR 2305R0021018V003037 22/10/18 BPJS ICU RP2957500
RS181231241 24/10/18 361393 ALDI 24/10/18 UMUM ICU RP1461000
RS181231255 24/10/18 321330 HADIJAH 25/10/18 UMUM ICU RP119000
RS181229413 15/10/18 341316 RIRIN JUNITA 2305R0021018V002470 28/10/18 BPJS ICU RP22936000
RS181231022 28/10/18 361384 AL AHYAT 28/10/18 UMUM ICU RP2009000
RS181232065 29/10/18 120542 MARIAM 2305R0021018V004256 30/10/18 BPJS ICU RP2833000
 TGL MASUK CM NAMA NO SJP TGL KELUAR CARA BAYAR RUNGAN TOTAL
RS181232755 31/10/18 431317 AFIFAH NAHDARA 2305R0021018V004559 1/11/2018 BPJS ICU RP866000
RS181233155 2/11/2018 54964 M SALEH HASAN 2305R0021118V000662 3/11/2018 BPJS ICU RP2157000
RS181232233 29/10/18 320154 SYAHRIR 2305R0021018V004461 5/11/2018 BPJS ICU RP8086500
RS181232756 31/10/18 600918 SARIFUDIN 2305R0021018V004515 5/11/2018 BPJS ICU RP7445000
RS181233934 6/11/2018 301343 SITO 2305R0021118V000737 8/11/2018 BPJS ICU RP3239500
RS181234446 9/11/2018 341335 JULKARNAIN 2305R0021118V001103 10/11/2018 BPJS ICU RP2066000
RS181234443 9/11/2018 461375 AMINAH 2305R0021118V001089 10/11/2018 BPJS ICU RP2037000
RS181232947 1/11/2018 271345 AHMAD HASIM 2305R0021118V000182 7/11/2018 BPJS ICU RP2175000
RS181234452 9/11/2018 271345 AHMAD HASIM 2305R0021118V000182 11/11/2018 BPJS ICU RP2136500
RS181235391 14/11/18 491319 SAODAH 15/11/18 U ICU Rp1006000
RS181234717 11/11/2018 441332 ALKIANSYAH 16/11/18 ICU RP2364000
RS181234438 9/11/2018 68158 JULKIFLI IBRAHIM 2305R0021118V001143 17/11/18 BPJS ICU RP5581000
RS181235852 17/11/18 78772 JAMILAH 2305R0021118V002337 17/11/18 BPJS ICU RP2340000
RS181235774 16/11/18 490552 SENA 2305R0021118V002343 17/11/18 BPJS ICU RP1845500
RS181235711 16/11/18 311381 USMAN 2305R0021118V002118 16/11/18 BPJS ICU Rp1753500
RS11236228 19/11/18 511310 BIMA SAPUTRA 21/11/18 U ICU Rp1444000
RS181236149 19/11/18 830941 SILVA ANEIRA 2305R0021118V002342 21/11/18 BPJS ICU Rp6259000
RS181236001 17/11/18 900922 V SUGIONO 2305R0021118V002523 21/11/18 BPJS ICU Rp3075000
RS181237210 24/11/18 511380 RATU RAFIDAH 25/11/18 U ICU Rp974000
RS181236345 20/11/18 920940 NURJANAH 2305R0021118V002614 23/11/18 BPJS ICU Rp4220000
RS181237266 25/11/18 521393 AFRIFUDIN 2305R0021118V003295 30/11/18 BPJS ICU RP9355000
 BAN CARA
Tanggal Cara Tanggal Tarif
No RM NAMA PASIEN NO JAMINAN GSA Tarif RS DPJP KELAS KELUA
Masuk Bayar Keluar Ina Cbg
L R

RS181238473 1/12/2018 541392 AGNES JOSERIVAL UMUM 2/12/2018 ICU Rp1331500

RS181238838 27/11/18 881230 NURHASANAH 2305R0021118V003745 BPJS 2/12/2018 ICU Rp7086000
RS181238472 1/12/2018 541157 MOCH ALFA 2305R0021218V000218 BPJS 3/12/2018 ICU Rp1320000
RS181238459 1/12/2018 541386 NURHAN 2305R0021218V000198 BPJS 3/12/2018 ICU Rp2184300
RS181238967 04/*12/18 331327 M RIZKI 2305R0021118V003326 BPJS 5/12/2018 ICU RP1272000
RS181238778 3/12/2018 541370 ANGGRIANINGSIH 2305R0021218V000371 BPJS 6/12/2018 ICU RP3570000
RS181238469 1/12/2018 191123 IZZUL HAQ 2305R0021218V000285 BPJS 7/12/2018 ICU RP3954000
RS181240008 10/12/2018 571314 AHMAD HIDIR 2305R0021218V001463 BPJS 13/12/18 ICU RP7730000
RS181240637 13/123/18 621312 NADHIRA FATMA UMUM 14/12/18 ICU RP1339000
RS181240742 13/12/18 621323 HASBI MUJAHIDIN UMUM 14/12/18 ICU RP1736500
RS181239844 9/12/2018 571307 NURCAHYANI UMUM 11/12/2018 ICU RP1254000
RS181241127 16/12/18 740926 MADE SATUPA 2305R0021218V002466 BPJS 17/12/18 ICU RP3888000
RS181240344 12/12/2018 61564 DAHLAN 2305R0021218V002024 BPJS 18/12/18 ICU RP5913500
RS181241542 18/12/18 631364 TATO SHOLIHIN 2305R0021218V002774 BPJS 22/12/18 ICU Rp2857100
RS181241418 17/12/18 450831 SURATNI 2305R0021218V002655 BPJS 26/12/18 ICU Rp10008500
RS181243122 27/12/18 661309 ARDIANSYAH 2305R0021218V003931 BPJS 27/12/18 ICU Rp1526000
RS181243138 27/12/18 651362 ST ASIAH 2305R0021218V003932 BPJS 28/12/18 ICU Rp1572000
RS181243144 27/12/18 190122 DR SANOKO 2305R0021218V003909 BPJS 30/12/18 ICU Rp3372000
 STATU
ZAAL
S
TUJUA
SETOR
N/DARI
AN
 Tanggal Cara Tanggal BANGS Tarif
No RM NAMA PASIEN NO JAMINAN Tarif RS
Masuk Bayar Keluar AL Ina Cbg

RS181243787 1/1/2019 651324 AHMAD 2305R0020119V000116 BPJS 1/1/2019 ICU 1445000

RS181243307 28/12/18 40238 ST MISBAH 2305R0021218V004399 BPJS 3/1/2019 ICU 9144000
RS181245212 7/1/2019 600297 JUANDA 2305R0020119V000932 BPJS 7/1/2019 ICU RP279500
RS181245650 9/1/2019 711381 DEVITA GRATIS 10/1/2019 ICU RP669000
RS181245132 8/1/2019 780709 I KADEK PUTRA 2305R0020119V001140 BPJS 11/1/2019 ICU RP2457000
RS181246333 13/01/19 600463 SAKINAH 2305R0020119V001917 BPJS 14/01/19 ICU RP1644000
RS181246086 11/1/2019 66796 IRNA FARHANI 2305R0020119V001807 BPJS 14/01/19 ICU Rp3635000
RS181246298 12/1/2019 721326 FERA 2305R0020119V002196 BPJS 18/01/18 ICU Rp7145000
RS181246334 13/01/19 990024 ST AMINAH 2305R0020119V002100 BPJS 19/01/18 ICU Rp5774500
RS181247299 17/01/19 660625 AINUN AHMAD 2305R0020119V003155 BPJS 22/01/19 ICU Rp4010000
RS181247758 20/01/19 741365 MUHAMAD NAUFAL 2305R0020119V003108 BPJS 24/01/19 ICU Rp4215000
RS181247034 16/01/19 731307 SURAFLIN 2305R0020119V002375 BPJS 25/01/19 ICU Rp11530000
RS181248073 21/01/19 751386 PARTINAH 2305R0020119V003501 BPJS 24/01/19 ICU Rp4751000
RS181245151 7/1/2019 62960 A HALIK 2305R0020119V001235 BPJS 20/01/19 ICU RP11565000
RS181248432 23/01/19 761305 SELVI ANANDA 2305R0020119V004052 BPJS 24/01/19 ICU RP2097000
RS181248696 24/01/19 761353 DEA UMUM 27/01/19 ICU RP2097000
RS181248837 25/01/19 151010 AHMAD 2305R0020119V004232 BPJS 28/01/19 ICU RP3556000
RS181248859 25/01/19 761385 JIRAN UMUM 29/01/19 ICU RP2171500
RS181249083 6/1/2019 391112 SALAHUDIN 2305R0020119V004546 BPJS 29/01/19 ICU RP6016000
RS181248835 25/01/19 63309 YETI RESMIATI 2305R0020119V003954 BPJS 30/01/19 ICU RP14272000
 STATU
CARA ZAAL
S
DPJP KELAS KELUA TUJUA
SETOR
R N/DARI
AN
 CARA
Tanggal Tanggal BANGS Tarif
No RM NAMA PASIEN NO JAMINAN Cara Bayar Tarif RS DPJP KELAS KELUA
Masuk Keluar AL Ina Cbg
R

RS181249631 29/02/19 581371 M AKASH 2305R0020119V004720 BPJS 1/2/2019 ICU Rp2849500

RS181250103 2/2/2019 730790 HERA FEBRIANTI UMUM 2/2/2019 ICU Rp1443000
RS181250539 2/2/2019 781358 EKAWATI 2305R0020219V000634 BPJS 2/2/2019 ICU RP2202000
RS181249625 29/01/19 581372 ADZKA SHAKEIL 2305R0020119V004950 BPJS 4/2/2019 ICU Rp2177000
RS181250536 2/2/2019 78479 ZULKIFLI 2305R0020219V000614 BPJS 4/2/2019 ICU Rp1913000
RS181249613 29/01/19 771359 YUSUF 2305R0020119V004766 BPJS 4/2/2019 ICU RP11782600
RS181250075 31/01/19 781345 SAHRATUL NISA UMUM 5/2/2019 ICU Rp4469000
RS181251033 5/2/2019 801396 JUMAIYAH 2305R0020219V000987 BPJS 6/2/2019 ICU Rp3076000
RS181251036 5/2/2019 890401 MAISAN OKPARA BPJS 6/2/2019 ICU Rp4969000
RS181251008 5/2/2019 801353 ARDIANTI JAMPERSAL 6/2/2019 ICU Rp6535000
RS181251360 6/2/2019 791382 PAULUS SANTOSA UMUM 7/2/2019 ICU Rp2703500
RS181251541 7/2/2019 791353 M FAHRU UMUM 11/2/2019 ICU Rp2899000
RS181252584 12/2/2019 831338 ROSTINA UMUM 16/02/19 ICU Rp3146500
RS181251009 5/2/2019 801354 AL KAIRAN UMUM 16/02/19 ICU Rp7784000
RS181251774 8/2/2019 811337 JONI 2305R0020219V001322 BPJS 11/2/2019 ICU Rp6838000
RS181250977 5/2/2019 500801 RAISYA 2305R0020219V001602 BPJS 12/2/2019 ICU Rp5044000
RS181252561 12/2/2019 770195 IRNA 2305R0020219V001861 BPJS 14/02/19 ICU Rp2266000
RS181250506 2/2/2019 781354 FATIMAH 2305R0020219V000482 BPJS 7/2/2019 ICU Rp7183000
RS181253521 16/2/19 851320 AHARIS UMUM 17/02/19 ICU Rp1250000
RS181253385 16/02/19 831387 M RIZNUL UMUM 16/02/19 ICU Rp1024000
RS181254029 19/02/19 790969 M AMIN 2305R0020219V003152 BPJS 21/02/19 ICU Rp2418000
RS181254284 20/02/19 861316 SRI SELVI UMUM 22/02/19 ICU Rp
RS181253257 15/02/19 831377 M LAKSIR UMUM 21/02/19 ICU Rp3362500
RS181253508 16/02/19 821266 KAMURIA 2305R0020219V002809 BPJS 20/02/19 ICU Rp7027400
RS181253242 15/02/19 661334 WAHYUDI 2305R0020219V002512 BPJS 19/02/19 ICU Rp3408500
RS181255383 25/02/19 73321 ITEN SUHARTI 2305R0020219V004632 BPJS 26/02/19 ICU Rp123000
RS181255632 26/02/19 891371 SAFRUDIN UMUM 28/02/19 ICU Rp2687000
RS181254376 21/02/19 69168 TUMINAH 2305R0020219V003478 BPJS 25/02/19 ICU Rp17539500
RS181254068 20/02/19 971247 RASHDAN 2305R0020219V003627 BPJS 26/02/19 ICU Rp8367800
RS181255596 26/02/19 9913532 ARIF 2305R0020219V004400 BPJS 26/02/19 ICU Rp1546000
RS181251543 7/2/2019 791379 M SABRIL UMUM 20/02/19 ICU Rp5684000
RS181254315 20/02/19 861324 ABAKAR 2305R0020219V003359 BPJS 23/02/19 ICU Rp3575000
RS181255075 24/02/19 871326 MUSTAAN UMUM 25/02/19 ICU Rp1334000
RS181254518 21/02/19 791379 M SABRIL UMUM 28/02/19 ICU RP3013000
 STATU
ZAAL
S
TUJUA
SETOR
N/DARI
AN
 Tanggal Cara Tanggal Tarif
No RM NAMA PASIEN NO JAMINAN BANGSAL Tarif RS DPJP KELAS
Masuk Bayar Keluar Ina Cbg

RS181256183 1/3/2019 791379 M SABRIL 2305R0020319V000073 BPJS 1/3/2019 ICU RP1341000

RS181255860 27/02/19 971395 ATHALIB UMUM 2/3/2019 ICU RP1684000
RS181255583 26/02/19 520067 ST NURAINI 2305R0020219V004398 BPJS 2/3/2019 ICU RP5927000
RS181256111 1/3/2019 901342 AAN ARDIANSYAH UMUM 4/3/2019 ICU RP5724500
RS181256827 4/3/2019 921387 ROHANI 2305R0020319V001132 BPJS 5/3/2019 ICU RP2153000
RS181257162 5/3/2019 1408 NURKOMALASARI 2305R0020319V000788 BPJS 6/3/2019 ICU RP3385000
RS181256844 4/3/2019 78566 UMI 2305R0020319V000627 BPJS 6/3/2019 ICU RP2511500
RS181257728 8/3/2019 941346 RUKMINI UMUM 9/3/2019 ICU RP1354000
RS181257699 085/03/19 110478 YUYUN PRATIWI UMUM 9/3/2019 ICU RP2192000
RS181255864 3/3/2019 320154 SYAHRIR 2305R0020319V000890 BPJS 12/3/2019 ICU RP17426500
RS181258326 11/3/2019 951376 SHEZATUL FATHIN 2305R0020319V001858 BPJS 13/03/19 ICU RP8571500
 STATU
CARA ZAAL
S
KELUA TUJUA
SETOR
R N/DARI
AN