NON-ITEMIZED SRC (SOURCE) : T=TERMINAL, W=WEB ENTRY PAGE 1 of 1

Claim ID Member No. Patient Name Cost RC Employee No. Visit Date Received MC Clinic Claim Status Approved Approval
Center Date Day Code Amount Amount Remarks
B1656 - MEGAKLINIK ZAHRAN 107.10 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
MUHAMMAD AIMAN BIN
A492931626 930916085931 P A1006 31-Mar-20 31-Mar-20 B1656 107.10 Pending 0.00
SUKIMAN
B1647 - KLINIK MEDIVIRON (DENAI ALAM) 133.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A433636615 730205035333 NAZRI BIN MAT NOR P A1057 09-Mar-20 09-Mar-20 B1647 133.00 Pending 0.00
B1636 - KLINIK BUKIT SERDANG 85.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
WAN MOHD FADLI BIN WAN
A185281250 861013465099 P A1161 29-Mar-20 29-Mar-20 B1636 85.00 Pending 0.00
JUSOH
B1632 - KLINIK MEDIVIRON (SETIA ALAM) 66.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
MOHD SALEHUDDIN BIN
A455056604 880423295225 P A1120 17-Mar-20 17-Mar-20 B1632 66.00 Pending 0.00
MUHAMAD PAUZI
B1577 - POLIKLINIK AL-NISAR 36.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A362866313 880306086360 HASRINA BINTI ZAINAL ABIDIN P A888 16-Mar-20 16-Mar-20 1 B1577 36.00 Pending 0.00
B1549 - POLIKLINIK DAMAI 24JAM 101.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A293178807 730212045185 MOHD FARID BIN AB RAHMAN P A613 12-Mar-20 12-Mar-20 B1549 101.00 Pending 0.00
B1530 - KLINIK PERTAMA 120.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A762286262 630102109127 ENG KIM SENG P A055 03-Mar-20 03-Mar-20 B1530 53.00 Pending 0.00
A762287262 851119105332 CHAN SHI YUN P A583 09-Mar-20 09-Mar-20 1 B1530 67.00 Pending 0.00
B1526 - KLINIK KELUARGA (PANTAI DALAM) 101.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
IBNIL HAJAT BIN ISMAIL @
A394321249 720918025021 P A295 09-Mar-20 09-Mar-20 B1526 20.00 Pending 0.00
ADNAN
MOHAMAD FAISAL BIN
A394322249 950204055345 P A1169 17-Mar-20 17-Mar-20 B1526 81.00 Pending 0.00
BURHANUDDIN
B1506 - POLIKLINIK ZAILINA 52.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
NURUL SYAHIRAH BTE MOHD
A403726633 870325115244 P A983 02-Mar-20 02-Mar-20 B1506 52.00 Pending 0.00
YUSOFF
B1501 - KLINIK KELUARGA DR.DAHLIA (BANDAR BARU
316.60 0.00
SELAYANG)
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A463231881 931006145637 MOHD AMAR BIN ANUAR P A1154 02-Mar-20 02-Mar-20 1 B1501 119.60 Pending 0.00
NUR DARWANI BINTI ABD
A463232881 890225035456 P A1051 09-Mar-20 09-Mar-20 1 B1501 63.00 Pending 0.00
RAHMAN
NUR DARWANI BINTI ABD
A463233881 890225035456 P A1051 10-Mar-20 10-Mar-20 B1501 134.00 Pending 0.00
RAHMAN
B1455 - POLIKLINIK CAHAYA 106.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A432244380 830916045181 HAMIR BIN MD SALEH P A1104 25-Mar-20 25-Mar-20 B1455 106.00 Pending 0.00
B1423 - POLIKLINIK IDEAL SDN.BHD 40.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
NUR IDZAATI SAFINAS BINTI
A365056626 900221105898 P A1132 04-Mar-20 04-Mar-20 B1423 40.00 Pending 0.00
MARLAN
B1350 - POLIKLINIK PRIMA 76.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A442246668 830911146207 MOHD RIDZUAN BIN MOHD SOM P A1117 13-Mar-20 13-Mar-20 2 B1350 76.00 Pending 0.00
B1212 - KLINIK AMAR (BUKIT SENTOSA) 52.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A304068659 770710016551 ROSZAIMI BIN ISAHARI P A884 16-Mar-20 16-Mar-20 1 B1212 52.00 Pending 0.00
B1148 - POLIKLINIK GOMEZ (AMPANG-HQ) 140.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
DIYANA MURNI BINTI ZAINAL
A400186601 920819146764 P A1157 02-Mar-20 02-Mar-20 1 B1148 35.00 Pending 0.00
ARIF
DIYANA MURNI BINTI ZAINAL
A400187601 920819146764 P A1157 16-Mar-20 16-Mar-20 B1148 60.00 Pending 0.00
ARIF
DIYANA MURNI BINTI ZAINAL
A400188601 920819146764 P A1157 17-Mar-20 17-Mar-20 B1148 45.00 Pending 0.00
ARIF
B1134 - KLINIK IDZHAM (SETAPAK) 272.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
3784231 550719105089 WONG KEE P A117 09-Mar-20 09-Mar-20 B1134 54.00 Pending 0.00
MUHAMMAD HAFIZ BIN MOHD
3792585 910925145651 P A1188 18-Mar-20 18-Mar-20 B1134 79.00 Pending 0.00
YUSOF
3796201 550719105089 WONG KEE P A117 24-Mar-20 24-Mar-20 B1134 139.00 Pending 0.00
B1133 - KLINIK IDZHAM (AMPANG) 84.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
3788080 890122146065 LAI CHEE YEAN P A816 13-Mar-20 13-Mar-20 B1133 84.00 Pending 0.00
B1132 - KLINIK IDZHAM (TMN SETIAWANGSA) 39.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A251236301 730812106295 MOHD FADZIL BIN IBRAHIM P A564 04-Mar-20 04-Mar-20 1 B1132 39.00 Pending 0.00
B1108 - KLINIK SERI MELAWATI 65.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
MUHAMMAD RASYDAN BIN
A405110317 920114085375 P A1185 25-Mar-20 25-Mar-20 B1108 65.00 Pending 0.00
AHMAD AZAM
B1083 - MEDI-KLINIK WONG ZUL (KLANG LAMA) 65.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A015601297 900806055187 TAN KIAN YEE P A1093 09-Mar-20 09-Mar-20 1 B1083 65.00 Pending 0.00
B1081 - KLINIK REDDY 100.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A432316679 930810126782 MICHELLE HII CHAI SHIEN P A1131 09-Mar-20 09-Mar-20 1 B1081 100.00 Pending 0.00
A1157 - KLINIK PURE TOUCH 355.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
NADIA LIANA BINTI BADRUL
A420909285 930310145848 P A1142 09-Mar-20 09-Mar-20 1 A1157 134.00 Pending 0.00
ZAHARIN
A449791331 770615086391 LOH KENG FATT P A150 17-Mar-20 17-Mar-20 A1157 85.00 Pending 0.00
MUHAMMAD MONTAZERI BIN
A449797331 870628035321 P A866 17-Mar-20 17-Mar-20 A1157 136.00 Pending 0.00
ZAKARIA
A1156 - KLINIK TAN & LEE 274.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A427786228 640830085281 CHANG YAU FATT P A098 07-Mar-20 07-Mar-20 1 A1156 161.00 Pending 0.00
A427787228 640830085281 CHANG YAU FATT P A098 21-Mar-20 21-Mar-20 A1156 113.00 Pending 0.00
A1155 - POLIKLINIK PARKLANE 25.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
8812050451 881205045193 AHMAD HARITHDIN BIN ROSLE P A1016 04-Mar-20 04-Mar-20 A1155 25.00 Pending 0.00
A1149 - KLINIK DAN SURGERI DANAU DESA 52.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A411752338 930901125283 JONATHAN TAN HSIEN AUN P A1111 31-Mar-20 31-Mar-20 A1149 52.00 Pending 0.00
A1145 - KLINIK MEDISINAR 393.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A421036324 640514085685 LEE PAK CHEONG P A702 05-Mar-20 05-Mar-20 A1145 58.00 Pending 0.00
MUHAMMAD SUHAIL BAZLI BIN
A421037324 900508016497 P A1146 06-Mar-20 06-Mar-20 1 A1145 95.00 Pending 0.00
YAACOB
A421038324 790621065157 HUE HAN KHEONG P A596 09-Mar-20 09-Mar-20 1 A1145 134.00 Pending 0.00
A421039324 790726136003 HAFIDY BIN RAZALI P A923 13-Mar-20 13-Mar-20 A1145 28.00 Pending 0.00
A421040324 741101105927 ONG BUN HOCK P A349 17-Mar-20 17-Mar-20 A1145 78.00 Pending 0.00
A1144 - KLINIK MEDIVIRON (KUCHAI LAMA) 187.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A447737245 900323126358 HASNIDAH BINTI ABDULLAH P A844 17-Mar-20 17-Mar-20 A1144 55.00 Pending 0.00
A447738245 900323126358 HASNIDAH BINTI ABDULLAH P A844 18-Mar-20 18-Mar-20 A1144 25.00 Pending 0.00
A447736245 811031085668 LIM MEI LEE P A926 18-Mar-20 18-Mar-20 1 A1144 107.00 Pending 0.00
A1142 - KLINIK LIM 100.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A410401284 730316145674 LEE SOW LAI P A1046 03-Mar-20 03-Mar-20 1 A1142 35.00 Pending 0.00
MOHD KHAIRUL ANWAR BIN
A410402284 860522295185 P A708 16-Mar-20 16-Mar-20 A1142 65.00 Pending 0.00
MANSHOR
A1131 - KLINIK SEGARA - BANGSAR 50.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A452041217 720808145399 MOHAMAD ABAS BIN IBRAHIM P A1102 17-Mar-20 17-Mar-20 A1131 50.00 Pending 0.00
A1117 - POLIKLINIK AN-NISA (BDR SRI PERMAISURI) 140.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A566266427 630201055291 KHARUDDIN BIN MD.YUSOFF P A137 14-Mar-20 14-Mar-20 A1117 44.00 Pending 0.00
A566268427 620813085855 CHIANG KIM HEAN P A615 16-Mar-20 16-Mar-20 A1117 60.00 Pending 0.00
MUHAMMAD NASYRIQ BIN
A566267427 930214065215 P A1153 16-Mar-20 16-Mar-20 A1117 36.00 Pending 0.00
AHMAD YUSRI
A1082 - KLINIK NG DAN LEE (KEPONG) (QUALITAS GROUP) 80.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A468631256 580317055311 WONG KAM SAN P A739 29-Mar-20 29-Mar-20 A1082 80.00 Pending 0.00
A1042 - POLIKLINIK PERTAMA (KAJANG) 15.00 0.00
UOA - ALLIED ENGINEERING CONSTRUCTION SDN BHD
A393991635 861111385084 CHAI MEI SIN P A936 03-Mar-20 03-Mar-20 1 A1042 15.00 Pending 0.00
Grand Total : 3,827.70 0.00
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