REKAPITULASI HASIL VERIFIKASI PASKA KLAIM

RSUD KUMPULAN PANE

Bulan Biaya yang sudah Biaya audit Biaya yang harus
No Pelayanan Jlh Kasus dibayar (Rp) (Rp) dikembalikan (Rp)
1 Jan-21 379 87,069,500 69,006,000 18,063,500
2 Feb-21 280 85,456,600 53,308,800 32,147,800
3 Mar-21 221 59,148,000 44,195,500 14,952,500
4 Apr-21 296 76,624,300 58,131,000 18,493,300
5 May-21 200 44,388,200 36,286,900 8,101,300
6 Jun-21 224 66,701,700 49,014,700 17,687,000
7 Jul-21 186 47,526,300 34,503,000 13,023,300
1,786 466,914,600 344,445,900 122,468,700
 HASIL VERIFIKASI PASKA KLAIM RSUD KUMPULAN PANE TEBING T
BULAN PELAYANAN JANUARI 2021
Biaya
No NoSJP TglDtgSJP TglPlgSJP CBG CBG Audit
Verifikasi

1 0206R0010121V000055 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000

2 0206R0010121V000760 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
3 0206R0010121V000707 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
4 0206R0010121V000030 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
5 0206R0010121V000821 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
6 0206R0010121V000459 January 13, 2021 January 13, 2021 H-3-12-0 Q-5-44-0 216,000
7 0206R0010121V000823 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
8 0206R0010121V000072 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
9 0206R0010121V000249 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
10 0206R0010121V000532 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
11 0206R0010121V000774 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
12 0206R0010121V001044 January 29, 2021 January 29, 2021 H-3-12-0 Q-5-44-0 216,000
13 0206R0010121V000690 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
14 0206R0010121V000966 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
15 0206R0010121V000094 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
16 0206R0010121V000517 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
17 0206R0010121V000814 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
18 0206R0010121V000222 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
19 0206R0010121V000504 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
20 0206R0010121V000763 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
21 0206R0010121V001042 January 29, 2021 January 29, 2021 H-3-12-0 Q-5-44-0 216,000
22 0206R0010121V000408 January 12, 2021 January 12, 2021 H-3-12-0 Q-5-44-0 216,000
23 0206R0010121V000646 January 19, 2021 January 19, 2021 H-3-12-0 Q-5-44-0 216,000
24 0206R0010121V000103 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
25 0206R0010121V000640 January 19, 2021 January 19, 2021 H-3-12-0 Q-5-44-0 216,000
26 0206R0010121V000104 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
27 0206R0010121V000413 January 12, 2021 January 12, 2021 H-3-12-0 Q-5-44-0 216,000
28 0206R0010121V000638 January 19, 2021 January 19, 2021 H-3-12-0 Q-5-44-0 216,000
29 0206R0010121V000986 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
30 0206R0010121V000280 January 8, 2021 January 8, 2021 H-3-12-0 Q-5-44-0 216,000
31 0206R0010121V000076 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
32 0206R0010121V000335 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
33 0206R0010121V000698 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
34 0206R0010121V000029 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
35 0206R0010121V000820 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
36 0206R0010121V000173 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
37 0206R0010121V000527 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
38 0206R0010121V000843 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
39 0206R0010121V000171 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
40 0206R0010121V000645 January 19, 2021 January 19, 2021 H-3-12-0 Q-5-44-0 216,000
41 0206R0010121V000692 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
42 0206R0010121V000057 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
43 0206R0010121V000602 January 18, 2021 January 18, 2021 H-3-12-0 Q-5-44-0 216,000
44 0206R0010121V000036 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
45 0206R0010121V000328 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
46 0206R0010121V000588 January 18, 2021 January 18, 2021 H-3-12-0 Q-5-44-0 216,000
47 0206R0010121V000825 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
48 0206R0010121V000124 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
49 0206R0010121V000279 January 8, 2021 January 8, 2021 H-3-12-0 Q-5-44-0 216,000
50 0206R0010121V000674 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
51 0206R0010121V001009 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
52 0206R0010121V000210 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
53 0206R0010121V000353 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
54 0206R0010121V000244 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
55 0206R0010121V000500 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
56 0206R0010121V000098 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
57 0206R0010121V000460 January 13, 2021 January 13, 2021 H-3-12-0 Q-5-44-0 216,000
58 0206R0010121V000694 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
59 0206R0010121V000945 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
60 0206R0010121V000501 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
61 0206R0010121V001040 January 29, 2021 January 29, 2021 H-3-12-0 Q-5-44-0 216,000
62 0206R0010121V000137 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
63 0206R0010121V000107 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
64 0206R0010121V001024 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
65 0206R0010121V000673 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
66 0206R0010121V000935 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
67 0206R0010121V000247 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
68 0206R0010121V000059 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
69 0206R0010121V000035 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
70 0206R0010121V000331 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
71 0206R0010121V000590 January 18, 2021 January 18, 2021 H-3-12-0 Q-5-44-0 216,000
72 0206R0010121V000826 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
73 0206R0010121V000406 January 12, 2021 January 12, 2021 H-3-12-0 Q-5-44-0 216,000
74 0206R0010121V000720 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
75 0206R0010121V000987 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
76 0206R0010121V000281 January 8, 2021 January 8, 2021 H-3-12-0 Q-5-44-0 216,000
77 0206R0010121V000680 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
78 0206R0010121V000524 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
79 0206R0010121V000106 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
80 0206R0010121V000410 January 12, 2021 January 12, 2021 H-3-12-0 Q-5-44-0 216,000
81 0206R0010121V000642 January 19, 2021 January 19, 2021 H-3-12-0 Q-5-44-0 216,000
82 0206R0010121V000101 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
83 0206R0010121V000627 January 19, 2021 January 19, 2021 H-3-12-0 Q-5-44-0 216,000
84 0206R0010121V000256 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
85 0206R0010121V000943 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
86 0206R0010121V000049 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
87 0206R0010121V000341 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
88 0206R0010121V000781 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
89 0206R0010121V000115 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
90 0206R0010121V000434 January 12, 2021 January 12, 2021 H-3-12-0 Q-5-44-0 216,000
91 0206R0010121V000900 January 26, 2021 January 26, 2021 H-3-12-0 Q-5-44-0 216,000
92 0206R0010121V000792 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
93 0206R0010121V000251 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
94 0206R0010121V000903 January 26, 2021 January 26, 2021 H-3-12-0 Q-5-44-0 216,000
95 0206R0010121V000282 January 8, 2021 January 8, 2021 H-3-12-0 Q-5-44-0 216,000
96 0206R0010121V000679 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
97 0206R0010121V000865 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
98 0206R0010121V000066 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
99 0206R0010121V000700 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
100 0206R0010121V001036 January 29, 2021 January 29, 2021 H-3-12-0 Q-5-44-0 216,000
101 0206R0010121V000234 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
102 0206R0010121V000495 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
103 0206R0010121V000769 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
104 0206R0010121V000506 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
105 0206R0010121V000997 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
106 0206R0010121V000218 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
107 0206R0010121V000033 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
108 0206R0010121V000519 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
109 0206R0010121V000767 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
110 0206R0010121V001038 January 29, 2021 January 29, 2021 H-3-12-0 Q-5-44-0 216,000
111 0206R0010121V000257 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
112 0206R0010121V000048 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
113 0206R0010121V000337 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
114 0206R0010121V000678 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
115 0206R0010121V000934 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
116 0206R0010121V000846 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
117 0206R0010121V000231 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
118 0206R0010121V000523 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
119 0206R0010121V000762 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
120 0206R0010121V000933 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
121 0206R0010121V000164 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
122 0206R0010121V000493 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
123 0206R0010121V000771 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
124 0206R0010121V001039 January 29, 2021 January 29, 2021 H-3-12-0 Q-5-44-0 216,000
125 0206R0010121V000168 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
126 0206R0010121V000457 January 13, 2021 January 13, 2021 H-3-12-0 Q-5-44-0 216,000
127 0206R0010121V000681 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
128 0206R0010121V000994 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
129 0206R0010121V000252 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
130 0206R0010121V000102 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
131 0206R0010121V000426 January 12, 2021 January 12, 2021 H-3-12-0 Q-5-44-0 216,000
132 0206R0010121V000639 January 19, 2021 January 19, 2021 H-3-12-0 Q-5-44-0 216,000
133 0206R0010121V001006 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
134 0206R0010121V000400 January 12, 2021 January 12, 2021 H-3-12-0 Q-5-44-0 216,000
135 0206R0010121V000174 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
136 0206R0010121V000449 January 13, 2021 January 13, 2021 H-3-12-0 Q-5-44-0 216,000
137 0206R0010121V000952 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
138 0206R0010121V000286 January 8, 2021 January 8, 2021 H-3-12-0 Q-5-44-0 216,000
139 0206R0010121V000556 January 15, 2021 January 15, 2021 H-3-12-0 Q-5-44-0 216,000
140 0206R0010121V000782 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
141 0206R0010121V001041 January 29, 2021 January 29, 2021 H-3-12-0 Q-5-44-0 216,000
142 0206R0010121V000415 January 12, 2021 January 12, 2021 H-3-12-0 Q-5-44-0 216,000
143 0206R0010121V000226 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
144 0206R0010121V000522 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
145 0206R0010121V000770 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
146 0206R0010121V000946 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
147 0206R0010121V000351 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
148 0206R0010121V000696 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
149 0206R0010121V000951 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
150 0206R0010121V000462 January 13, 2021 January 13, 2021 H-3-12-0 Q-5-44-0 216,000
151 0206R0010121V000246 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
152 0206R0010121V000902 January 26, 2021 January 26, 2021 H-3-12-0 Q-5-44-0 216,000
153 0206R0010121V000122 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
154 0206R0010121V000284 January 8, 2021 January 8, 2021 H-3-12-0 Q-5-44-0 216,000
155 0206R0010121V000841 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
156 0206R0010121V000675 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
157 0206R0010121V000894 January 26, 2021 January 26, 2021 H-3-12-0 Q-5-44-0 216,000
158 0206R0010121V000518 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
159 0206R0010121V000996 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
160 0206R0010121V000184 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
161 0206R0010121V000783 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
162 0206R0010121V000046 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
163 0206R0010121V000334 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
164 0206R0010121V000624 January 19, 2021 January 19, 2021 H-3-12-0 Q-5-44-0 216,000
165 0206R0010121V000404 January 12, 2021 January 12, 2021 H-3-12-0 Q-5-44-0 216,000
166 0206R0010121V000044 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
167 0206R0010121V000815 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
168 0206R0010121V000221 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
169 0206R0010121V000496 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
170 0206R0010121V000765 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
171 0206R0010121V000121 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
172 0206R0010121V000525 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
173 0206R0010121V000773 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
174 0206R0010121V001034 January 29, 2021 January 29, 2021 H-3-12-0 Q-5-44-0 216,000
175 0206R0010121V001035 January 29, 2021 January 29, 2021 H-3-12-0 Q-5-44-0 216,000
176 0206R0010121V000114 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
177 0206R0010121V000435 January 12, 2021 January 12, 2021 H-3-12-0 Q-5-44-0 216,000
178 0206R0010121V000697 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
179 0206R0010121V000040 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
180 0206R0010121V000403 January 12, 2021 January 12, 2021 H-3-12-0 Q-5-44-0 216,000
181 0206R0010121V000625 January 19, 2021 January 19, 2021 H-3-12-0 Q-5-44-0 216,000
182 0206R0010121V000888 January 26, 2021 January 26, 2021 H-3-12-0 Q-5-44-0 216,000
183 0206R0010121V000992 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
184 0206R0010121V000229 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
185 0206R0010121V000514 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
186 0206R0010121V000764 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
187 0206R0010121V000227 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
188 0206R0010121V000507 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
189 0206R0010121V001010 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
190 0206R0010121V000068 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
191 0206R0010121V000346 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
192 0206R0010121V000633 January 19, 2021 January 19, 2021 H-3-12-0 Q-5-44-0 216,000
193 0206R0010121V000899 January 26, 2021 January 26, 2021 H-3-12-0 Q-5-44-0 216,000
194 0206R0010121V000100 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
195 0206R0010121V000402 January 12, 2021 January 12, 2021 H-3-12-0 Q-5-44-0 216,000
196 0206R0010121V000886 January 26, 2021 January 26, 2021 H-3-12-0 Q-5-44-0 216,000
197 0206R0010121V000185 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
198 0206R0010121V000784 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
199 0206R0010121V000285 January 8, 2021 January 8, 2021 H-3-12-0 Q-5-44-0 216,000
200 0206R0010121V000632 January 19, 2021 January 19, 2021 H-3-12-0 Q-5-44-0 216,000
201 0206R0010121V000170 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
202 0206R0010121V000677 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
203 0206R0010121V000526 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
204 0206R0010121V000082 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
205 0206R0010121V000241 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
206 0206R0010121V000167 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
207 0206R0010121V000555 January 15, 2021 January 15, 2021 H-3-12-0 Q-5-44-0 216,000
208 0206R0010121V000937 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
209 0206R0010121V000242 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
210 0206R0010121V000593 January 18, 2021 January 18, 2021 H-3-12-0 Q-5-44-0 216,000
211 0206R0010121V000039 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
212 0206R0010121V000062 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
213 0206R0010121V000336 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
214 0206R0010121V000058 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
215 0206R0010121V000551 January 15, 2021 January 15, 2021 H-3-12-0 Q-5-44-0 216,000
216 0206R0010121V000778 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
217 0206R0010121V000123 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
218 0206R0010121V000407 January 12, 2021 January 12, 2021 H-3-12-0 Q-5-44-0 216,000
219 0206R0010121V000911 January 26, 2021 January 26, 2021 H-3-12-0 Q-5-44-0 216,000
220 0206R0010121V000893 January 26, 2021 January 26, 2021 H-3-12-0 Q-5-44-0 216,000
221 0206R0010121V000644 January 19, 2021 January 19, 2021 H-3-12-0 Q-5-44-0 216,000
222 0206R0010121V000347 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
223 0206R0010121V000689 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
224 0206R0010121V000965 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
225 0206R0010121V000626 January 19, 2021 January 19, 2021 H-3-12-0 Q-5-44-0 216,000
226 0206R0010121V000224 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
227 0206R0010121V001000 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
228 0206R0010121V000960 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
229 0206R0010121V000399 January 12, 2021 January 12, 2021 H-3-12-0 Q-5-44-0 216,000
230 0206R0010121V000628 January 19, 2021 January 19, 2021 H-3-12-0 Q-5-44-0 216,000
231 0206R0010121V000890 January 26, 2021 January 26, 2021 H-3-12-0 Q-5-44-0 216,000
232 0206R0010121V000158 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
233 0206R0010121V000941 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
234 0206R0010121V000343 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
235 0206R0010121V000648 January 19, 2021 January 19, 2021 H-3-12-0 Q-5-44-0 216,000
236 0206R0010121V000172 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
237 0206R0010121V000411 January 12, 2021 January 12, 2021 H-3-12-0 Q-5-44-0 216,000
238 0206R0010121V000032 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
239 0206R0010121V000350 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
240 0206R0010121V000587 January 18, 2021 January 18, 2021 H-3-12-0 Q-5-44-0 216,000
241 0206R0010121V000830 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
242 0206R0010121V001003 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
243 0206R0010121V000037 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
244 0206R0010121V000110 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
245 0206R0010121V000643 January 19, 2021 January 19, 2021 H-3-12-0 Q-5-44-0 216,000
246 0206R0010121V000901 January 26, 2021 January 26, 2021 H-3-12-0 Q-5-44-0 216,000
247 0206R0010121V000701 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
248 0206R0010121V000034 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
249 0206R0010121V000329 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
250 0206R0010121V000586 January 18, 2021 January 18, 2021 H-3-12-0 Q-5-44-0 216,000
251 0206R0010121V000819 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
252 0206R0010121V000325 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
253 0206R0010121V000166 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
254 0206R0010121V000510 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
255 0206R0010121V000932 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
256 0206R0010121V000550 January 15, 2021 January 15, 2021 H-3-12-0 Q-5-44-0 216,000
257 0206R0010121V000940 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
258 0206R0010121V000892 January 26, 2021 January 26, 2021 H-3-12-0 Q-5-44-0 216,000
259 0206R0010121V000990 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
260 0206R0010121V000354 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
261 0206R0010121V000606 January 18, 2021 January 18, 2021 H-3-12-0 Q-5-44-0 216,000
262 0206R0010121V000851 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
263 0206R0010121V000108 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
264 0206R0010121V000456 January 13, 2021 January 13, 2021 H-3-12-0 Q-5-44-0 216,000
265 0206R0010121V000703 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
266 0206R0010121V000240 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
267 0206R0010121V000521 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
268 0206R0010121V001023 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
269 0206R0010121V000180 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
270 0206R0010121V000243 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
271 0206R0010121V000401 January 12, 2021 January 12, 2021 H-3-12-0 Q-5-44-0 216,000
272 0206R0010121V000176 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
273 0206R0010121V000024 January 4, 2021 January 4, 2021 Z-4-12-I Q-5-44-0 1,843,900

274 0206R0010121V000683 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
275 0206R0010121V000333 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
276 0206R0010121V000704 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
277 0206R0010121V000548 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
278 0206R0010121V001004 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
279 0206R0010121V000201 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
280 0206R0010121V000971 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
281 0206R0010121V001028 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
282 0206R0010121V000028 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
283 0206R0010121V000327 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
284 0206R0010121V000589 January 18, 2021 January 18, 2021 H-3-12-0 Q-5-44-0 216,000
285 0206R0010121V000160 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
286 0206R0010121V000989 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
287 0206R0010121V000198 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
288 0206R0010121V000099 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
289 0206R0010121V000885 January 26, 2021 January 26, 2021 H-3-12-0 Q-5-44-0 216,000
290 0206R0010121V000756 January 21, 2021 January 21, 2021 Z-4-12-I Q-5-44-0 2,581,400

291 0206R0010121V000051 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000

292 0206R0010121V000592 January 18, 2021 January 18, 2021 H-3-12-0 Q-5-44-0 216,000
293 0206R0010121V000827 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
294 0206R0010121V000448 January 13, 2021 January 13, 2021 H-3-12-0 Q-5-44-0 216,000
295 0206R0010121V000676 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
296 0206R0010121V000816 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
297 0206R0010121V000097 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
298 0206R0010121V000398 January 12, 2021 January 12, 2021 H-3-12-0 Q-5-44-0 216,000
299 0206R0010121V000887 January 26, 2021 January 26, 2021 H-3-12-0 Q-5-44-0 216,000
300 0206R0010121V000228 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
301 0206R0010121V000498 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
302 0206R0010121V000761 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
303 0206R0010121V000956 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
304 0206R0010121V000230 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
305 0206R0010121V000494 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
306 0206R0010121V000772 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
307 0206R0010121V000775 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
308 0206R0010121V000152 January 6, 2021 January 6, 2021 H-3-12-0 Q-5-44-0 216,000
309 0206R0010121V001001 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
310 0206R0010121V000112 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
311 0206R0010121V000706 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
312 0206R0010121V000111 January 5, 2021 January 5, 2021 H-3-12-0 Q-5-44-0 216,000
313 0206R0010121V000705 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
314 0206R0010121V000464 January 13, 2021 January 13, 2021 H-3-12-0 Q-5-44-0 216,000
315 0206R0010121V000713 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
316 0206R0010121V000944 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
317 0206R0010121V000041 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
318 0206R0010121V000344 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
319 0206R0010121V000594 January 18, 2021 January 18, 2021 H-3-12-0 Q-5-44-0 216,000
320 0206R0010121V000829 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
321 0206R0010121V000052 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
322 0206R0010121V000777 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
323 0206R0010121V000053 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
324 0206R0010121V000991 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
325 0206R0010121V000031 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
326 0206R0010121V000338 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
327 0206R0010121V000591 January 18, 2021 January 18, 2021 H-3-12-0 Q-5-44-0 216,000
328 0206R0010121V000813 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
329 0206R0010121V000726 January 20, 2021 January 20, 2021 H-3-12-0 Q-5-44-0 216,000
330 0206R0010121V000979 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
331 0206R0010121V000631 January 19, 2021 January 19, 2021 H-3-12-0 Q-5-44-0 216,000
332 0206R0010121V000988 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
333 0206R0010121V000027 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
334 0206R0010121V000326 January 11, 2021 January 11, 2021 H-3-12-0 Q-5-44-0 216,000
335 0206R0010121V000585 January 18, 2021 January 18, 2021 H-3-12-0 Q-5-44-0 216,000
336 0206R0010121V000818 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
337 0206R0010121V000223 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
338 0206R0010121V000832 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
339 0206R0010121V000796 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
340 0206R0010121V000998 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
341 0206R0010121V001002 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
342 0206R0010121V000557 January 15, 2021 January 15, 2021 H-3-12-0 Q-5-44-0 216,000
343 0206R0010121V000947 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
344 0206R0010121V000233 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
345 0206R0010121V000508 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
346 0206R0010121V000897 January 26, 2021 January 26, 2021 H-3-12-0 Q-5-44-0 216,000
347 0206R0010121V000999 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
348 0206R0010121V000042 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
349 0206R0010121V000629 January 19, 2021 January 19, 2021 H-3-12-0 Q-5-44-0 216,000
350 0206R0010121V000253 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
351 0206R0010121V000499 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
352 0206R0010121V000766 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
353 0206R0010121V001037 January 29, 2021 January 29, 2021 H-3-12-0 Q-5-44-0 216,000
354 0206R0010121V000235 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
355 0206R0010121V000497 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
356 0206R0010121V000768 January 22, 2021 January 22, 2021 H-3-12-0 Q-5-44-0 216,000
357 0206R0010121V000864 January 25, 2021 January 25, 2021 H-3-12-0 Q-5-44-0 216,000
358 0206R0010121V000237 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
359 0206R0010121V000511 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
360 0206R0010121V000239 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
361 0206R0010121V000513 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
362 0206R0010121V000995 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
363 0206R0010121V000238 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
364 0206R0010121V000505 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
365 0206R0010121V001007 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
366 0206R0010121V000065 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
367 0206R0010121V000054 January 4, 2021 January 4, 2021 H-3-12-0 Q-5-44-0 216,000
368 0206R0010121V000458 January 13, 2021 January 13, 2021 H-3-12-0 Q-5-44-0 216,000
369 0206R0010121V000974 January 27, 2021 January 27, 2021 H-3-12-0 Q-5-44-0 216,000
370 0206R0010121V000236 January 7, 2021 January 7, 2021 H-3-12-0 Q-5-44-0 216,000
371 0206R0010121V000516 January 14, 2021 January 14, 2021 H-3-12-0 Q-5-44-0 216,000
372 0206R0010121V001008 January 28, 2021 January 28, 2021 H-3-12-0 Q-5-44-0 216,000
373 0206R0010121V001058 January 29, 2021 January 29, 2021 Q-5-42-0 Q-5-42-0 186,800
374 0206R0010121V000812 January 23, 2021 January 23, 2021 Q-5-42-0 Q-5-42-0 186,800

375 0206R0010121V000446 01/12/2021 01/12/2021 N-3-15-0 N-3-15-0 889,700

376 0206R0010121V000318 01/09/2021 01/09/2021 Q-5-44-0 Q-5-44-0 185,500

377 0206R0010121V000729 1/20/2021 1/20/2021 Q-5-42-0 Q-5-42-0 186,800
378 0206R0010121V001068 1/30/2021 1/30/2021 F-5-14-0 F-5-14-0 198,900

379 0206R0010121V001020 1/28/2021 1/28/2021 N-3-15-0 N-3-15-0 889,700

Total 87,069,500
PULAN PANE TEBING TINGGI
UARI 2021
Kelebihan
Biaya Audit Keterangan
Bayar

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 1,658,400 Pelayanan < 6 jam RJTL

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 2,395,900 Pelayanan < 6 jam RJTL

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
186,800 Tidak diagnosa emergency
186,800 Tidak diagnosa emergency
irisan rjtl dalam ritl dan menagihkan HD dalam
- 889,700 rawat inap
irisan rjtl dalam ritl dan menagihkan HD dalam
185,500 rawat inap
186,800 bukan kasus igd. Post op mata tgl 19
198,900 bukan kasus emergency
irisan rjtl dalam ritl dan menagihkan HD dalam
889,700 rawat inap
69,006,000 18,063,500
SANGGAHAN RSKP
dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli
mata yg wajib untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan
tersebut tidak dilakukan pengembalian uang kelebihan bayar, dan untuk kedepannya kami
menunggu keputusan menajemen.
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS
dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli
mata yg wajib untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan
tersebut tidak dilakukan pengembalian uang kelebihan bayar, dan untuk kedepannya kami
menunggu keputusan menajemen.
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
TIDAK ACC BPJS OS LEBIH 6 JAM DIRAWAT
dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli
mata yg wajib untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan
tersebut tidak dilakukan pengembalian uang kelebihan bayar, dan untuk kedepannya kami
menunggu keputusan menajemen.
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
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SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS
ACC BPJS

ACC BPJS

ACC BPJS
ACC BPJS
ACC BPJS

ACC BPJS
 HASIL VERIFIKASI PASKA KLAIM RSUD KUMPULAN PANE TEBING
BULAN PELAYANAN FEBRUARI 2021

CBG
No NoSJP TglDtgSJP TglPlgSJP CBG
Audit

1 0206R0010221V000424 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0

2 0206R0010221V000684 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
3 0206R0010221V000005 February 1, 2021 February 1, 2021 H-3-12-0 Q-5-44-0
4 0206R0010221V000428 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
5 0206R0010221V000631 February 22, 2021 February 22, 2021 H-3-12-0 Q-5-44-0
6 0206R0010221V000136 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
7 0206R0010221V000187 February 5, 2021 February 5, 2021 H-3-12-0 Q-5-44-0
8 0206R0010221V000183 February 5, 2021 February 5, 2021 H-3-12-0 Q-5-44-0
9 0206R0010221V000771 February 25, 2021 February 25, 2021 H-3-12-0 Q-5-44-0
10 0206R0010221V000688 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
11 0206R0010221V000141 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
12 0206R0010221V000142 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
13 0206R0010221V000371 February 11, 2021 February 11, 2021 H-3-12-0 Q-5-44-0
14 0206R0010221V000587 February 19, 2021 February 19, 2021 H-3-12-0 Q-5-44-0
15 0206R0010221V000572 February 18, 2021 February 18, 2021 H-3-12-0 Q-5-44-0
16 0206R0010221V000769 February 25, 2021 February 25, 2021 H-3-12-0 Q-5-44-0
17 0206R0010221V000101 February 3, 2021 February 3, 2021 H-3-12-0 Q-5-44-0
18 0206R0010221V000019 February 1, 2021 February 1, 2021 H-3-12-0 Q-5-44-0
19 0206R0010221V000259 February 8, 2021 February 8, 2021 H-3-12-0 Q-5-44-0
20 0206R0010221V000333 February 10, 2021 February 10, 2021 H-3-12-0 Q-5-44-0
21 0206R0010221V000008 February 1, 2021 February 1, 2021 H-3-12-0 Q-5-44-0
22 0206R0010221V000233 February 8, 2021 February 8, 2021 H-3-12-0 Q-5-44-0
23 0206R0010221V000427 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
24 0206R0010221V000630 February 22, 2021 February 22, 2021 H-3-12-0 Q-5-44-0
25 0206R0010221V000011 February 1, 2021 February 1, 2021 H-3-12-0 Q-5-44-0
26 0206R0010221V000294 February 9, 2021 February 9, 2021 H-3-12-0 Q-5-44-0
27 0206R0010221V000482 February 16, 2021 February 16, 2021 H-3-12-0 Q-5-44-0
28 0206R0010221V000703 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
29 0206R0010221V000592 February 19, 2021 February 19, 2021 H-3-12-0 Q-5-44-0
30 0206R0010221V000799 February 26, 2021 February 26, 2021 H-3-12-0 Q-5-44-0
31 0206R0010221V000354 February 11, 2021 February 11, 2021 H-3-12-0 Q-5-44-0
32 0206R0010221V000736 February 24, 2021 February 24, 2021 H-3-12-0 Q-5-44-0
33 0206R0010221V000016 February 1, 2021 February 1, 2021 H-3-12-0 Q-5-44-0
34 0206R0010221V000007 February 1, 2021 February 1, 2021 H-3-12-0 Q-5-44-0
35 0206R0010221V000232 February 8, 2021 February 8, 2021 H-3-12-0 Q-5-44-0
36 0206R0010221V000429 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
37 0206R0010221V000632 February 22, 2021 February 22, 2021 H-3-12-0 Q-5-44-0
38 0206R0010221V000180 February 5, 2021 February 5, 2021 H-3-12-0 Q-5-44-0
39 0206R0010221V000129 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
40 0206R0010221V000353 February 11, 2021 February 11, 2021 H-3-12-0 Q-5-44-0
41 0206R0010221V000445 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
42 0206R0010221V000114 February 3, 2021 February 3, 2021 H-3-12-0 Q-5-44-0
43 0206R0010221V000730 February 24, 2021 February 24, 2021 H-3-12-0 Q-5-44-0
44 0206R0010221V000103 February 3, 2021 February 3, 2021 H-3-12-0 Q-5-44-0
45 0206R0010221V000323 February 10, 2021 February 10, 2021 H-3-12-0 Q-5-44-0
46 0206R0010221V000535 February 17, 2021 February 17, 2021 H-3-12-0 Q-5-44-0
47 0206R0010221V000178 February 5, 2021 February 5, 2021 H-3-12-0 Q-5-44-0
48 0206R0010221V000494 February 16, 2021 February 16, 2021 H-3-12-0 Q-5-44-0
49 0206R0010221V000313 February 10, 2021 February 10, 2021 H-3-12-0 Q-5-44-0
50 0206R0010221V000006 February 1, 2021 February 1, 2021 H-3-12-0 Q-5-44-0
51 0206R0010221V000231 February 8, 2021 February 8, 2021 H-3-12-0 Q-5-44-0
52 0206R0010221V000430 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
53 0206R0010221V000629 February 22, 2021 February 22, 2021 H-3-12-0 Q-5-44-0
54 0206R0010221V000135 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
55 0206R0010221V000356 February 11, 2021 February 11, 2021 H-3-12-0 Q-5-44-0
56 0206R0010221V000560 February 18, 2021 February 18, 2021 H-3-12-0 Q-5-44-0
57 0206R0010221V000237 February 8, 2021 February 8, 2021 H-3-12-0 Q-5-44-0
58 0206R0010221V000693 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
59 0206R0010221V000116 February 3, 2021 February 3, 2021 H-3-12-0 Q-5-44-0
60 0206R0010221V000058 February 2, 2021 February 2, 2021 H-3-12-0 Q-5-44-0
61 0206R0010221V000479 February 16, 2021 February 16, 2021 H-3-12-0 Q-5-44-0
62 0206R0010221V000701 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
63 0206R0010221V000059 February 2, 2021 February 2, 2021 H-3-12-0 Q-5-44-0
64 0206R0010221V000477 February 16, 2021 February 16, 2021 H-3-12-0 Q-5-44-0
65 0206R0010221V000731 February 24, 2021 February 24, 2021 H-3-12-0 Q-5-44-0
66 0206R0010221V000716 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
67 0206R0010221V000065 February 2, 2021 February 2, 2021 H-3-12-0 Q-5-44-0
68 0206R0010221V000303 February 9, 2021 February 9, 2021 H-3-12-0 Q-5-44-0
69 0206R0010221V000493 February 16, 2021 February 16, 2021 H-3-12-0 Q-5-44-0
70 0206R0010221V000714 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
71 0206R0010221V000075 February 2, 2021 February 2, 2021 H-3-12-0 Q-5-44-0
72 0206R0010221V000236 February 8, 2021 February 8, 2021 H-3-12-0 Q-5-44-0
73 0206R0010221V000694 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
74 0206R0010221V000346 February 10, 2021 February 10, 2021 H-3-12-0 Q-5-44-0
75 0206R0010221V000839 February 27, 2021 February 27, 2021 Z-4-12-I Q-5-44-0
76 0206R0010221V000191 February 5, 2021 February 5, 2021 H-3-12-0 Q-5-44-0
77 0206R0010221V000591 February 19, 2021 February 19, 2021 H-3-12-0 Q-5-44-0
78 0206R0010221V000177 February 5, 2021 February 5, 2021 H-3-12-0 Q-5-44-0
79 0206R0010221V000419 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
80 0206R0010221V000634 February 22, 2021 February 22, 2021 H-3-12-0 Q-5-44-0
81 0206R0010221V000531 February 17, 2021 February 17, 2021 H-3-12-0 Q-5-44-0
82 0206R0010221V000444 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
83 0206R0010221V000355 February 11, 2021 February 11, 2021 H-3-12-0 Q-5-44-0
84 0206R0010221V000559 February 18, 2021 February 18, 2021 H-3-12-0 Q-5-44-0
85 0206R0010221V000780 February 25, 2021 February 25, 2021 H-3-12-0 Q-5-44-0
86 0206R0010221V000357 February 11, 2021 February 11, 2021 H-3-12-0 Q-5-44-0
87 0206R0010221V000704 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
88 0206R0010221V000052 February 2, 2021 February 2, 2021 H-3-12-0 Q-5-44-0
89 0206R0010221V000282 February 9, 2021 February 9, 2021 H-3-12-0 Q-5-44-0
90 0206R0010221V000155 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
91 0206R0010221V000569 February 18, 2021 February 18, 2021 H-3-12-0 Q-5-44-0
92 0206R0010221V000537 February 17, 2021 February 17, 2021 H-3-12-0 Q-5-44-0
93 0206R0010221V000151 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
94 0206R0010221V000443 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
95 0206R0010221V000784 February 25, 2021 February 25, 2021 H-3-12-0 Q-5-44-0
96 0206R0010221V000189 February 5, 2021 February 5, 2021 H-3-12-0 Q-5-44-0
97 0206R0010221V000049 February 2, 2021 February 2, 2021 H-3-12-0 Q-5-44-0
98 0206R0010221V000277 February 9, 2021 February 9, 2021 H-3-12-0 Q-5-44-0
99 0206R0010221V000588 February 19, 2021 February 19, 2021 H-3-12-0 Q-5-44-0
100 0206R0010221V000805 February 26, 2021 February 26, 2021 H-3-12-0 Q-5-44-0
101 0206R0010221V000188 February 5, 2021 February 5, 2021 H-3-12-0 Q-5-44-0
102 0206R0010221V000698 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
103 0206R0010221V000181 February 5, 2021 February 5, 2021 H-3-12-0 Q-5-44-0
104 0206R0010221V000420 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
105 0206R0010221V000626 February 22, 2021 February 22, 2021 H-3-12-0 Q-5-44-0
106 0206R0010221V000289 February 9, 2021 February 9, 2021 H-3-12-0 Q-5-44-0
107 0206R0010221V000523 February 17, 2021 February 17, 2021 H-3-12-0 Q-5-44-0
108 0206R0010221V000732 February 24, 2021 February 24, 2021 H-3-12-0 Q-5-44-0
109 0206R0010221V000244 February 8, 2021 February 8, 2021 H-3-12-0 Q-5-44-0
110 0206R0010221V000193 February 5, 2021 February 5, 2021 H-3-12-0 Q-5-44-0
111 0206R0010221V000598 February 19, 2021 February 19, 2021 H-3-12-0 Q-5-44-0
112 0206R0010221V000316 February 10, 2021 February 10, 2021 H-3-12-0 Q-5-44-0
113 0206R0010221V000563 February 18, 2021 February 18, 2021 H-3-12-0 Q-5-44-0
114 0206R0010221V000035 February 1, 2021 February 1, 2021 H-3-12-0 Q-5-44-0
115 0206R0010221V000146 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
116 0206R0010221V000352 February 11, 2021 February 11, 2021 H-3-12-0 Q-5-44-0
117 0206R0010221V000198 February 5, 2021 February 5, 2021 H-3-12-0 Q-5-44-0
118 0206R0010221V000196 February 5, 2021 February 5, 2021 H-3-12-0 Q-5-44-0
119 0206R0010221V000589 February 19, 2021 February 19, 2021 H-3-12-0 Q-5-44-0
120 0206R0010221V000048 February 2, 2021 February 2, 2021 H-3-12-0 Q-5-44-0
121 0206R0010221V000281 February 9, 2021 February 9, 2021 H-3-12-0 Q-5-44-0
122 0206R0010221V000475 February 16, 2021 February 16, 2021 H-3-12-0 Q-5-44-0
123 0206R0010221V000689 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
124 0206R0010221V000106 February 3, 2021 February 3, 2021 H-3-12-0 Q-5-44-0
125 0206R0010221V000190 February 5, 2021 February 5, 2021 H-3-12-0 Q-5-44-0
126 0206R0010221V000590 February 19, 2021 February 19, 2021 H-3-12-0 Q-5-44-0
127 0206R0010221V000131 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
128 0206R0010221V000518 February 17, 2021 February 17, 2021 H-3-12-0 Q-5-44-0
129 0206R0010221V000733 February 24, 2021 February 24, 2021 H-3-12-0 Q-5-44-0
130 0206R0010221V000149 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
131 0206R0010221V000315 February 10, 2021 February 10, 2021 H-3-12-0 Q-5-44-0
132 0206R0010221V000060 February 2, 2021 February 2, 2021 H-3-12-0 Q-5-44-0
133 0206R0010221V000288 February 9, 2021 February 9, 2021 H-3-12-0 Q-5-44-0
134 0206R0010221V000492 February 16, 2021 February 16, 2021 H-3-12-0 Q-5-44-0
135 0206R0010221V000705 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
136 0206R0010221V000117 February 3, 2021 February 3, 2021 H-3-12-0 Q-5-44-0
137 0206R0010221V000279 February 9, 2021 February 9, 2021 H-3-12-0 Q-5-44-0
138 0206R0010221V000692 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
139 0206R0010221V000028 February 1, 2021 February 1, 2021 H-3-12-0 Q-5-44-0
140 0206R0010221V000421 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
141 0206R0010221V000194 February 5, 2021 February 5, 2021 H-3-12-0 Q-5-44-0
142 0206R0010221V000597 February 19, 2021 February 19, 2021 H-3-12-0 Q-5-44-0
143 0206R0010221V000036 February 1, 2021 February 1, 2021 H-3-12-0 Q-5-44-0
144 0206R0010221V000655 February 22, 2021 February 22, 2021 H-3-12-0 Q-5-44-0
145 0206R0010221V000102 February 3, 2021 February 3, 2021 H-3-12-0 Q-5-44-0
146 0206R0010221V000012 February 1, 2021 February 1, 2021 H-3-12-0 Q-5-44-0
147 0206R0010221V000765 February 25, 2021 February 25, 2021 H-3-12-0 Q-5-44-0
148 0206R0010221V000369 February 11, 2021 February 11, 2021 H-3-12-0 Q-5-44-0
149 0206R0010221V000362 February 11, 2021 February 11, 2021 H-3-12-0 Q-5-44-0
150 0206R0010221V000147 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
151 0206R0010221V000521 February 17, 2021 February 17, 2021 H-3-12-0 Q-5-44-0
152 0206R0010221V000568 February 18, 2021 February 18, 2021 H-3-12-0 Q-5-44-0
153 0206R0010221V000803 February 26, 2021 February 26, 2021 H-3-12-0 Q-5-44-0
154 0206R0010221V000628 February 22, 2021 February 22, 2021 H-3-12-0 Q-5-44-0
155 0206R0010221V000067 February 2, 2021 February 2, 2021 H-3-12-0 Q-5-44-0
156 0206R0010221V000707 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
157 0206R0010221V000098 February 3, 2021 February 3, 2021 H-3-12-0 Q-5-44-0
158 0206R0010221V000186 February 5, 2021 February 5, 2021 H-3-12-0 Q-5-44-0
159 0206R0010221V000437 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
160 0206R0010221V000639 February 22, 2021 February 22, 2021 H-3-12-0 Q-5-44-0
161 0206R0010221V000706 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
162 0206R0010221V000280 February 9, 2021 February 9, 2021 H-3-12-0 Q-5-44-0
163 0206R0010221V000150 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
164 0206R0010221V000756 February 25, 2021 February 25, 2021 H-3-12-0 Q-5-44-0
165 0206R0010221V000053 February 2, 2021 February 2, 2021 H-3-12-0 Q-5-44-0
166 0206R0010221V000425 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
167 0206R0010221V000004 February 1, 2021 February 1, 2021 H-3-12-0 Q-5-44-0
168 0206R0010221V000713 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
169 0206R0010221V000487 February 16, 2021 February 16, 2021 H-3-12-0 Q-5-44-0
170 0206R0010221V000807 February 26, 2021 February 26, 2021 Z-3-25-0 Q-5-44-0
171 0206R0010221V000038 February 1, 2021 February 1, 2021 H-3-12-0 Q-5-44-0
172 0206R0010221V000224 February 8, 2021 February 8, 2021 H-3-12-0 Q-5-44-0
173 0206R0010221V000432 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
174 0206R0010221V000635 February 22, 2021 February 22, 2021 H-3-12-0 Q-5-44-0
175 0206R0010221V000772 February 25, 2021 February 25, 2021 H-3-12-0 Q-5-44-0
176 0206R0010221V000710 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
177 0206R0010221V000074 February 2, 2021 February 2, 2021 H-3-12-0 Q-5-44-0
178 0206R0010221V000489 February 16, 2021 February 16, 2021 H-3-12-0 Q-5-44-0
179 0206R0010221V000717 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
180 0206R0010221V000001 February 1, 2021 February 1, 2021 H-3-12-0 Q-5-44-0
181 0206R0010221V000234 February 8, 2021 February 8, 2021 H-3-12-0 Q-5-44-0
182 0206R0010221V000426 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
183 0206R0010221V000633 February 22, 2021 February 22, 2021 H-3-12-0 Q-5-44-0
184 0206R0010221V000585 February 18, 2021 February 18, 2021 H-3-12-0 Q-5-44-0
185 0206R0010221V000317 February 10, 2021 February 10, 2021 H-3-12-0 Q-5-44-0
186 0206R0010221V000578 February 18, 2021 February 18, 2021 H-3-12-0 Q-5-44-0
187 0206R0010221V000594 February 19, 2021 February 19, 2021 H-3-12-0 Q-5-44-0
188 0206R0010221V000130 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
189 0206R0010221V000366 February 11, 2021 February 11, 2021 H-3-12-0 Q-5-44-0
190 0206R0010221V000768 February 25, 2021 February 25, 2021 H-3-12-0 Q-5-44-0
191 0206R0010221V000072 February 2, 2021 February 2, 2021 H-3-12-0 Q-5-44-0
192 0206R0010221V000307 February 9, 2021 February 9, 2021 H-3-12-0 Q-5-44-0
193 0206R0010221V000447 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
194 0206R0010221V000168 February 4, 2021 February 4, 2021 A-4-10-III Q-5-44-0

195 0206R0010221V000105 February 3, 2021 February 3, 2021 H-3-12-0 Q-5-44-0

196 0206R0010221V000570 February 18, 2021 February 18, 2021 H-3-12-0 Q-5-44-0
197 0206R0010221V000758 February 25, 2021 February 25, 2021 H-3-12-0 Q-5-44-0
198 0206R0010221V000763 February 25, 2021 February 25, 2021 H-3-12-0 Q-5-44-0
199 0206R0010221V000022 February 1, 2021 February 1, 2021 H-3-12-0 Q-5-44-0
200 0206R0010221V000257 February 8, 2021 February 8, 2021 H-3-12-0 Q-5-44-0
201 0206R0010221V000442 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
202 0206R0010221V000370 February 11, 2021 February 11, 2021 H-3-12-0 Q-5-44-0
203 0206R0010221V000104 February 3, 2021 February 3, 2021 H-3-12-0 Q-5-44-0
204 0206R0010221V000056 February 2, 2021 February 2, 2021 H-3-12-0 Q-5-44-0
205 0206R0010221V000522 February 17, 2021 February 17, 2021 H-3-12-0 Q-5-44-0
206 0206R0010221V000735 February 24, 2021 February 24, 2021 H-3-12-0 Q-5-44-0
207 0206R0010221V000134 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
208 0206R0010221V000682 February 22, 2021 February 26, 2021 J-4-17-I Q-5-44-0
209 0206R0010221V000140 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
210 0206R0010221V000377 February 11, 2021 February 11, 2021 H-3-12-0 Q-5-44-0
211 0206R0010221V000455 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
212 0206R0010221V000643 February 22, 2021 February 22, 2021 H-3-12-0 Q-5-44-0
213 0206R0010221V000144 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
214 0206R0010221V000530 February 17, 2021 February 17, 2021 H-3-12-0 Q-5-44-0
215 0206R0010221V000245 February 7, 2021 February 7, 2021 K-4-18-I Q-5-44-0

216 0206R0010221V000687 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
217 0206R0010221V000015 February 1, 2021 February 1, 2021 H-3-12-0 Q-5-44-0
218 0206R0010221V000223 February 8, 2021 February 8, 2021 H-3-12-0 Q-5-44-0
219 0206R0010221V000434 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
220 0206R0010221V000525 February 17, 2021 February 17, 2021 H-3-12-0 Q-5-44-0
221 0206R0010221V000051 February 2, 2021 February 2, 2021 H-3-12-0 Q-5-44-0
222 0206R0010221V000179 February 5, 2021 February 5, 2021 H-3-12-0 Q-5-44-0
223 0206R0010221V000422 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
224 0206R0010221V000593 February 19, 2021 February 19, 2021 H-3-12-0 Q-5-44-0
225 0206R0010221V000138 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
226 0206R0010221V000351 February 11, 2021 February 11, 2021 H-3-12-0 Q-5-44-0
227 0206R0010221V000561 February 18, 2021 February 18, 2021 H-3-12-0 Q-5-44-0
228 0206R0010221V000073 February 2, 2021 February 2, 2021 H-3-12-0 Q-5-44-0
229 0206R0010221V000490 February 16, 2021 February 16, 2021 H-3-12-0 Q-5-44-0
230 0206R0010221V000491 February 16, 2021 February 16, 2021 H-3-12-0 Q-5-44-0
231 0206R0010221V000483 February 16, 2021 February 16, 2021 H-3-12-0 Q-5-44-0
232 0206R0010221V000836 February 27, 2021 February 27, 2021 J-4-16-I Q-5-44-0

233 0206R0010221V000010 February 1, 2021 February 1, 2021 H-3-12-0 Q-5-44-0

234 0206R0010221V000239 February 8, 2021 February 8, 2021 H-3-12-0 Q-5-44-0
235 0206R0010221V000433 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
236 0206R0010221V000221 February 8, 2021 February 8, 2021 H-3-12-0 Q-5-44-0
237 0206R0010221V000436 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
238 0206R0010221V000132 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
239 0206R0010221V000519 February 17, 2021 February 17, 2021 H-3-12-0 Q-5-44-0
240 0206R0010221V000481 February 16, 2021 February 16, 2021 H-3-12-0 Q-5-44-0
241 0206R0010221V000697 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
242 0206R0010221V000153 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
243 0206R0010221V000003 February 1, 2021 February 1, 2021 H-3-12-0 Q-5-44-0
244 0206R0010221V000431 February 15, 2021 February 15, 2021 H-3-12-0 Q-5-44-0
245 0206R0010221V000320 February 10, 2021 February 10, 2021 H-3-12-0 Q-5-44-0
246 0206R0010221V000532 February 17, 2021 February 17, 2021 H-3-12-0 Q-5-44-0
247 0206R0010221V000119 February 3, 2021 February 3, 2021 H-3-12-0 Q-5-44-0
248 0206R0010221V000145 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
249 0206R0010221V000358 February 11, 2021 February 11, 2021 H-3-12-0 Q-5-44-0
250 0206R0010221V000738 February 24, 2021 February 24, 2021 H-3-12-0 Q-5-44-0
251 0206R0010221V000729 February 24, 2021 February 24, 2021 Z-4-12-I Q-5-44-0

252 0206R0010221V000009 February 1, 2021 February 1, 2021 H-3-12-0 Q-5-44-0

253 0206R0010221V000473 February 16, 2021 February 16, 2021 H-3-12-0 Q-5-44-0
254 0206R0010221V000686 February 23, 2021 February 23, 2021 H-3-12-0 Q-5-44-0
255 0206R0010221V000800 February 26, 2021 February 26, 2021 H-3-12-0 Q-5-44-0
256 0206R0010221V000100 February 3, 2021 February 3, 2021 H-3-12-0 Q-5-44-0
257 0206R0010221V000524 February 17, 2021 February 17, 2021 H-3-12-0 Q-5-44-0
258 0206R0010221V000128 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
259 0206R0010221V000529 February 17, 2021 February 17, 2021 H-3-12-0 Q-5-44-0
260 0206R0010221V000133 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
261 0206R0010221V000520 February 17, 2021 February 17, 2021 H-3-12-0 Q-5-44-0
262 0206R0010221V000734 February 24, 2021 February 24, 2021 H-3-12-0 Q-5-44-0
263 0206R0010221V000324 February 10, 2021 February 10, 2021 H-3-12-0 Q-5-44-0
264 0206R0010221V000143 February 4, 2021 February 4, 2021 H-3-12-0 Q-5-44-0
265 0206R0010221V000528 February 17, 2021 February 17, 2021 H-3-12-0 Q-5-44-0
266 0206R0010221V000327 February 10, 2021 February 10, 2021 H-3-12-0 Q-5-44-0
267 0206R0010221V000741 February 24, 2021 February 24, 2021 H-3-12-0 Q-5-44-0
268 0206R0010221V000534 February 17, 2021 February 17, 2021 H-3-12-0 Q-5-44-0
269 0206R0010221V000050 February 2, 2021 February 2, 2021 H-3-12-0 Q-5-44-0
270 0206R0010221V000653 February 22, 2021 February 22, 2021 H-3-12-0 Q-5-44-0
271 0206R0010221V000185 February 5, 2021 February 5, 2021 H-3-12-0 Q-5-44-0
272 0206R0010221V000184 February 5, 2021 February 5, 2021 H-3-12-0 Q-5-44-0
273 0206R0010221V000125 February 3, 2021 February 3, 2021 H-3-12-0 Q-5-44-0
274 0206R0010221V000359 February 11, 2021 February 11, 2021 H-3-12-0 Q-5-44-0
275 0206R0010221V000533 February 17, 2021 February 17, 2021 H-3-12-0 Q-5-44-0
276 0206R0010221V000796 February 25, 2021 February 25, 2021 Z-4-12-I Q-5-44-0
277 0206R0010221V000516 February 16, 2021 February 16, 2021 Q-5-42-0 Q-5-42-0
278 0206R0010221V000502 2/16/2021 2/16/2021 N-3-15-0 N-3-15-0
279 0206R0010221V000747 2/24/2021 2/24/2021 Q-5-44-0 Q-5-44-0
280 0206R0010221V000836 February 27, 2021 February 27, 2021 J-4-16-I J-4-16-I
Total
AIM RSUD KUMPULAN PANE TEBING TINGGI
LAYANAN FEBRUARI 2021

Biaya Biaya Kelebihan

Keterangan
Verifikasi Audit Bayar

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
 216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
1,843,900 185,500 1,658,400 Pelayanan < 6 jam RJTL
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
319,100 185,500 133,600 2x USG, hanya kode kontrol
 216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
6,883,900 185,500 6,698,400 Pelayanan < 6 jam RJTL

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
3,624,300 2,296,300 1,328,000 J44 tanpa spirometri
 216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
1,427,400 185,500 1,241,900 Pelayanan < 6 jam RJTL

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
4,260,100 185,500 4,074,600 Pelayanan < 6 jam RJTL

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
 216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
1,843,900 185,500 1,658,400 Pelayanan < 6 jam RJTL

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
1,843,900 185,500 1,658,400 Pelayanan < 6 jam RJTL
186,800 186,800 Tidak diagnosa emergency
889,700 - 889,700 irisan rjtl dalam ritl dan menagihkan HD dalam rawat i
185,500 185,500 irisan rjtl ke ritl
4,260,100 4,260,100 resort yang di berikan tidak sesuai
85,456,600 53,308,800 32,147,800
SANGGAHAN RSKP

dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli
mata yg wajib untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan
tersebut tidak dilakukan pengembalian uang kelebihan bayar, dan untuk kedepannya kami
menunggu keputusan menajemen.

SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS
dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli
mata yg wajib untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan
tersebut tidak dilakukan pengembalian uang kelebihan bayar, dan untuk kedepannya kami
menunggu keputusan menajemen.
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
TIDAK ACC OS LEBIH 6 JAM PERAWATAN (MASUK JAM 03.00 EXIT 14.43)
dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli
mata yg wajib untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan
tersebut tidak dilakukan pengembalian uang kelebihan bayar, dan untuk kedepannya kami
menunggu keputusan menajemen.
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS
dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli
mata yg wajib untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan
tersebut tidak dilakukan pengembalian uang kelebihan bayar, dan untuk kedepannya kami
menunggu keputusan menajemen.
SDA
SDA
SDA
SDA
SDA
ACC BPJS
dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli
mata yg wajib untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan
tersebut tidak dilakukan pengembalian uang kelebihan bayar, dan untuk kedepannya kami
menunggu keputusan menajemen.
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
TIDAK ACC OS LEBIH 6 JAM PERAWATAN (MASUK JAM 10.00 PAPS 19.43)
dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli
mata yg wajib untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan
tersebut tidak dilakukan pengembalian uang kelebihan bayar, dan untuk kedepannya kami
menunggu keputusan menajemen.
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS
dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli
mata yg wajib untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan
tersebut tidak dilakukan pengembalian uang kelebihan bayar, dan untuk kedepannya kami
menunggu keputusan menajemen.
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
TIDAK ACC OS LEBIH 6 JAM PERAWATAN (MASUK JAM 10.40 EXIT 20.15)
ACC BPJS
ACC BPJS
ACC BPJS
TIDAK ACC KODE Z03.8
 HASIL VERIFIKASI PASKA KLAIM RSUD KUMPULAN PANE TEBING TI
BULAN PELAYANAN MARET 2021

CBG Biaya
No NoSJP TglDtgSJP TglPlgSJP CBG
Audit Verifikasi

1 0206R0010321V000004 March 1, 2021 March 1, 2021 H-3-12-0 Q-5-44-0 216,000

2 0206R0010321V000164 March 8, 2021 March 8, 2021 H-3-12-0 Q-5-44-0 216,000
3 0206R0010321V000353 March 15, 2021 March 15, 2021 H-3-12-0 Q-5-44-0 216,000
4 0206R0010321V000567 March 22, 2021 March 22, 2021 H-3-12-0 Q-5-44-0 216,000
5 0206R0010321V000514 March 19, 2021 March 19, 2021 H-3-12-0 Q-5-44-0 216,000
6 0206R0010321V000748 March 26, 2021 March 26, 2021 H-3-12-0 Q-5-44-0 216,000
7 0206R0010321V000373 March 15, 2021 March 15, 2021 H-3-12-0 Q-5-44-0 216,000
8 0206R0010321V000489 March 18, 2021 March 18, 2021 H-3-12-0 Q-5-44-0 216,000
9 0206R0010321V000306 March 12, 2021 March 12, 2021 H-3-12-0 Q-5-44-0 216,000
10 0206R0010321V000513 March 19, 2021 March 19, 2021 H-3-12-0 Q-5-44-0 216,000
11 0206R0010321V000746 March 26, 2021 March 26, 2021 H-3-12-0 Q-5-44-0 216,000
12 0206R0010321V000039 March 2, 2021 March 2, 2021 H-3-12-0 Q-5-44-0 216,000
13 0206R0010321V000211 March 9, 2021 March 9, 2021 H-3-12-0 Q-5-44-0 216,000
14 0206R0010321V000420 March 16, 2021 March 16, 2021 H-3-12-0 Q-5-44-0 216,000
15 0206R0010321V000627 March 23, 2021 March 23, 2021 H-3-12-0 Q-5-44-0 216,000
16 0206R0010321V000901 March 31, 2021 March 31, 2021 H-3-12-0 Q-5-44-0 216,000
17 0206R0010321V000309 March 12, 2021 March 12, 2021 H-3-12-0 Q-5-44-0 216,000
18 0206R0010321V000683 March 24, 2021 March 24, 2021 H-3-12-0 Q-5-44-0 216,000
19 0206R0010321V000305 March 12, 2021 March 12, 2021 H-3-12-0 Q-5-44-0 216,000
20 0206R0010321V000518 March 19, 2021 March 19, 2021 H-3-12-0 Q-5-44-0 216,000
21 0206R0010321V000751 March 26, 2021 March 26, 2021 H-3-12-0 Q-5-44-0 216,000
22 0206R0010321V000347 March 13, 2021 March 19, 2021 J-4-17-II 4,340,200

23 0206R0010321V000334 March 12, 2021 March 12, 2021 H-3-12-0 Q-5-44-0 216,000
24 0206R0010321V000003 March 1, 2021 March 1, 2021 H-3-12-0 Q-5-44-0 216,000
25 0206R0010321V000618 March 22, 2021 March 22, 2021 H-3-12-0 Q-5-44-0 216,000
26 0206R0010321V000852 March 30, 2021 March 30, 2021 H-3-12-0 Q-5-44-0 216,000
27 0206R0010321V000048 March 2, 2021 March 2, 2021 H-3-12-0 Q-5-44-0 216,000
28 0206R0010321V000221 March 9, 2021 March 9, 2021 H-3-12-0 Q-5-44-0 216,000
29 0206R0010321V000487 March 18, 2021 March 18, 2021 H-3-12-0 Q-5-44-0 216,000
30 0206R0010321V000689 March 24, 2021 March 24, 2021 U-3-13-0 Q-5-44-0 320,100
31 0206R0010321V000002 March 1, 2021 March 1, 2021 H-3-12-0 Q-5-44-0 216,000
32 0206R0010321V000161 March 8, 2021 March 8, 2021 H-3-12-0 Q-5-44-0 216,000
33 0206R0010321V000355 March 15, 2021 March 15, 2021 H-3-12-0 Q-5-44-0 216,000
34 0206R0010321V000570 March 22, 2021 March 22, 2021 H-3-12-0 Q-5-44-0 216,000
35 0206R0010321V000799 March 29, 2021 March 29, 2021 H-3-12-0 Q-5-44-0 216,000
36 0206R0010321V000034 March 1, 2021 March 1, 2021 H-3-12-0 Q-5-44-0 216,000
37 0206R0010321V000360 March 15, 2021 March 15, 2021 H-3-12-0 Q-5-44-0 216,000
38 0206R0010321V000259 March 10, 2021 March 10, 2021 H-3-12-0 Q-5-44-0 216,000
39 0206R0010321V000676 March 24, 2021 March 24, 2021 H-3-12-0 Q-5-44-0 216,000
40 0206R0010321V000920 March 31, 2021 March 31, 2021 H-3-12-0 Q-5-44-0 216,000
41 0206R0010321V000709 March 25, 2021 March 25, 2021 H-3-12-0 Q-5-44-0 216,000
42 0206R0010321V000916 March 31, 2021 March 31, 2021 H-3-12-0 Q-5-44-0 216,000
43 0206R0010321V000668 March 23, 2021 March 23, 2021 H-3-12-0 Q-5-44-0 216,000
44 0206R0010321V000232 March 9, 2021 March 9, 2021 H-3-12-0 Q-5-44-0 216,000
45 0206R0010321V000908 March 31, 2021 March 31, 2021 H-3-12-0 Q-5-44-0 216,000
46 0206R0010321V000747 March 26, 2021 March 26, 2021 H-3-12-0 Q-5-44-0 216,000
47 0206R0010321V000043 March 2, 2021 March 2, 2021 H-3-12-0 Q-5-44-0 216,000
48 0206R0010321V000209 March 9, 2021 March 9, 2021 H-3-12-0 Q-5-44-0 216,000
49 0206R0010321V000077 March 3, 2021 March 3, 2021 H-3-12-0 Q-5-44-0 216,000
50 0206R0010321V000258 March 10, 2021 March 10, 2021 H-3-12-0 Q-5-44-0 216,000
51 0206R0010321V000455 March 17, 2021 March 17, 2021 H-3-12-0 Q-5-44-0 216,000
52 0206R0010321V000214 March 9, 2021 March 9, 2021 H-3-12-0 Q-5-44-0 216,000
53 0206R0010321V000900 March 31, 2021 March 31, 2021 H-3-12-0 Q-5-44-0 216,000
54 0206R0010321V000049 March 2, 2021 March 2, 2021 H-3-12-0 Q-5-44-0 216,000
55 0206R0010321V000422 March 16, 2021 March 16, 2021 H-3-12-0 Q-5-44-0 216,000
56 0206R0010321V000855 March 30, 2021 March 30, 2021 H-3-12-0 Q-5-44-0 216,000
57 0206R0010321V000714 March 25, 2021 March 25, 2021 H-3-12-0 Q-5-44-0 216,000
58 0206R0010321V000585 March 22, 2021 March 22, 2021 U-3-16-0 Q-5-44-0 290,300

59 0206R0010321V000628 March 23, 2021 March 23, 2021 H-3-12-0 Q-5-44-0 216,000
60 0206R0010321V000850 March 30, 2021 March 30, 2021 H-3-12-0 Q-5-44-0 216,000
61 0206R0010321V000470 March 17, 2021 March 17, 2021 H-3-12-0 Q-5-44-0 216,000
62 0206R0010321V000711 March 25, 2021 March 25, 2021 H-3-12-0 Q-5-44-0 216,000
63 0206R0010321V000213 March 9, 2021 March 9, 2021 H-3-12-0 Q-5-44-0 216,000
64 0206R0010321V000486 March 18, 2021 March 18, 2021 H-3-12-0 Q-5-44-0 216,000
65 0206R0010321V000899 March 31, 2021 March 31, 2021 H-3-12-0 Q-5-44-0 216,000
66 0206R0010321V000753 March 26, 2021 March 26, 2021 H-3-12-0 Q-5-44-0 216,000
67 0206R0010321V000126 March 5, 2021 March 5, 2021 H-3-12-0 Q-5-44-0 216,000
68 0206R0010321V000569 March 22, 2021 March 22, 2021 H-3-12-0 Q-5-44-0 216,000
69 0206R0010321V000255 March 10, 2021 March 10, 2021 H-3-12-0 Q-5-44-0 216,000
70 0206R0010321V000042 March 2, 2021 March 2, 2021 H-3-12-0 Q-5-44-0 216,000
71 0206R0010321V000041 March 2, 2021 March 2, 2021 H-3-12-0 Q-5-44-0 216,000
72 0206R0010321V000104 March 4, 2021 March 4, 2021 H-3-12-0 Q-5-44-0 216,000
73 0206R0010321V000308 March 12, 2021 March 12, 2021 H-3-12-0 Q-5-44-0 216,000
74 0206R0010321V000519 March 19, 2021 March 19, 2021 H-3-12-0 Q-5-44-0 216,000
75 0206R0010321V000830 March 29, 2021 March 29, 2021 H-3-12-0 Q-5-44-0 216,000
76 0206R0010321V000511 March 18, 2021 March 18, 2021 H-3-12-0 Q-5-44-0 216,000
77 0206R0010321V000260 March 10, 2021 March 10, 2021 H-3-12-0 Q-5-44-0 216,000
78 0206R0010321V000458 March 17, 2021 March 17, 2021 H-3-12-0 Q-5-44-0 216,000
79 0206R0010321V000757 March 26, 2021 March 26, 2021 H-3-12-0 Q-5-44-0 216,000
80 0206R0010321V000267 March 10, 2021 March 10, 2021 H-3-12-0 Q-5-44-0 216,000
81 0206R0010321V000860 March 30, 2021 March 30, 2021 H-3-12-0 Q-5-44-0 216,000
82 0206R0010321V000444 March 16, 2021 March 16, 2021 H-3-12-0 Q-5-44-0 216,000
83 0206R0010321V000642 March 23, 2021 March 23, 2021 H-3-12-0 Q-5-44-0 216,000
84 0206R0010321V000307 March 12, 2021 March 12, 2021 H-3-12-0 Q-5-44-0 216,000
85 0206R0010321V000131 March 5, 2021 March 5, 2021 H-3-12-0 Q-5-44-0 216,000
86 0206R0010321V000523 March 19, 2021 March 19, 2021 H-3-12-0 Q-5-44-0 216,000
87 0206R0010321V000914 March 31, 2021 March 31, 2021 H-3-12-0 Q-5-44-0 216,000
88 0206R0010321V000719 March 25, 2021 March 25, 2021 H-3-12-0 Q-5-44-0 216,000
89 0206R0010321V000005 March 1, 2021 March 1, 2021 H-3-12-0 Q-5-44-0 216,000
90 0206R0010321V000857 March 30, 2021 March 30, 2021 H-3-12-0 Q-5-44-0 216,000
91 0206R0010321V000094 March 4, 2021 March 4, 2021 H-3-12-0 Q-5-44-0 216,000
92 0206R0010321V000856 March 30, 2021 March 30, 2021 H-3-12-0 Q-5-44-0 216,000
93 0206R0010321V000272 March 10, 2021 March 10, 2021 H-3-12-0 Q-5-44-0 216,000
94 0206R0010321V000417 March 16, 2021 March 16, 2021 H-3-12-0 Q-5-44-0 216,000
95 0206R0010321V000127 March 5, 2021 March 5, 2021 H-3-12-0 Q-5-44-0 216,000
96 0206R0010321V000044 March 2, 2021 March 2, 2021 H-3-12-0 Q-5-44-0 216,000
97 0206R0010321V000210 March 9, 2021 March 9, 2021 H-3-12-0 Q-5-44-0 216,000
98 0206R0010321V000423 March 16, 2021 March 16, 2021 H-3-12-0 Q-5-44-0 216,000
99 0206R0010321V000625 March 23, 2021 March 23, 2021 H-3-12-0 Q-5-44-0 216,000
100 0206R0010321V000851 March 30, 2021 March 30, 2021 H-3-12-0 Q-5-44-0 216,000
101 0206R0010321V000319 March 12, 2021 March 12, 2021 H-3-12-0 Q-5-44-0 216,000
102 0206R0010321V000125 March 5, 2021 March 5, 2021 H-3-12-0 Q-5-44-0 216,000
103 0206R0010321V000076 March 3, 2021 March 3, 2021 H-3-12-0 Q-5-44-0 216,000
104 0206R0010321V000262 March 10, 2021 March 10, 2021 H-3-12-0 Q-5-44-0 216,000
105 0206R0010321V000677 March 24, 2021 March 24, 2021 H-3-12-0 Q-5-44-0 216,000
106 0206R0010321V000254 March 10, 2021 March 10, 2021 H-3-12-0 Q-5-44-0 216,000
107 0206R0010321V000890 March 31, 2021 March 31, 2021 H-3-12-0 Q-5-44-0 216,000
108 0206R0010321V000461 March 17, 2021 March 17, 2021 H-3-12-0 Q-5-44-0 216,000
109 0206R0010321V000723 March 25, 2021 March 25, 2021 H-3-12-0 Q-5-44-0 216,000
110 0206R0010321V000419 March 16, 2021 March 16, 2021 H-3-12-0 Q-5-44-0 216,000
111 0206R0010321V000739 March 25, 2021 March 25, 2021 H-3-12-0 Q-5-44-0 216,000
112 0206R0010321V000130 March 5, 2021 March 5, 2021 H-3-12-0 Q-5-44-0 216,000
113 0206R0010321V000522 March 19, 2021 March 19, 2021 H-3-12-0 Q-5-44-0 216,000
114 0206R0010321V000915 March 31, 2021 March 31, 2021 H-3-12-0 Q-5-44-0 216,000
115 0206R0010321V000361 March 15, 2021 March 15, 2021 H-3-12-0 Q-5-44-0 216,000
116 0206R0010321V000639 March 23, 2021 March 23, 2021 H-3-12-0 Q-5-44-0 216,000
117 0206R0010321V000383 March 15, 2021 March 15, 2021 H-3-12-0 Q-5-44-0 216,000
118 0206R0010321V000526 March 19, 2021 March 19, 2021 H-3-12-0 Q-5-44-0 216,000
119 0206R0010321V000861 March 30, 2021 March 30, 2021 H-3-12-0 Q-5-44-0 216,000
120 0206R0010321V000897 March 31, 2021 March 31, 2021 H-3-12-0 Q-5-44-0 216,000
121 0206R0010321V000577 March 22, 2021 March 22, 2021 H-3-12-0 Q-5-44-0 216,000
122 0206R0010321V000924 March 31, 2021 March 31, 2021 H-3-12-0 Q-5-44-0 216,000
123 0206R0010321V000097 March 4, 2021 March 4, 2021 H-3-12-0 Q-5-44-0 216,000
124 0206R0010321V000428 March 16, 2021 March 16, 2021 H-3-12-0 Q-5-44-0 216,000
125 0206R0010321V000493 March 18, 2021 March 18, 2021 H-3-12-0 Q-5-44-0 216,000
126 0206R0010321V000095 March 4, 2021 March 4, 2021 H-3-12-0 Q-5-44-0 216,000
127 0206R0010321V000640 March 23, 2021 March 23, 2021 H-3-12-0 Q-5-44-0 216,000
128 0206R0010321V000853 March 30, 2021 March 30, 2021 H-3-12-0 Q-5-44-0 216,000
129 0206R0010321V000633 March 23, 2021 March 23, 2021 H-3-12-0 Q-5-44-0 216,000
130 0206R0010321V000001 March 1, 2021 March 1, 2021 H-3-12-0 Q-5-44-0 216,000
131 0206R0010321V000351 March 15, 2021 March 15, 2021 H-3-12-0 Q-5-44-0 216,000
132 0206R0010321V000565 March 22, 2021 March 22, 2021 H-3-12-0 Q-5-44-0 216,000
133 0206R0010321V000800 March 29, 2021 March 29, 2021 H-3-12-0 Q-5-44-0 216,000
134 0206R0010321V000212 March 9, 2021 March 9, 2021 H-3-12-0 Q-5-44-0 216,000
135 0206R0010321V000635 March 23, 2021 March 23, 2021 H-3-12-0 Q-5-44-0 216,000
136 0206R0010321V000679 March 24, 2021 March 24, 2021 H-3-12-0 Q-5-44-0 216,000
137 0206R0010321V000011 March 1, 2021 March 1, 2021 H-3-12-0 Q-5-44-0 216,000
138 0206R0010321V000573 March 22, 2021 March 22, 2021 H-3-12-0 Q-5-44-0 216,000
139 0206R0010321V000079 March 3, 2021 March 3, 2021 H-3-12-0 Q-5-44-0 216,000
140 0206R0010321V000678 March 24, 2021 March 24, 2021 H-3-12-0 Q-5-44-0 216,000
141 0206R0010321V000046 March 2, 2021 March 2, 2021 H-3-12-0 Q-5-44-0 216,000
142 0206R0010321V000225 March 9, 2021 March 9, 2021 H-3-12-0 Q-5-44-0 216,000
143 0206R0010321V000413 March 16, 2021 March 16, 2021 H-3-12-0 Q-5-44-0 216,000
144 0206R0010321V000636 March 23, 2021 March 23, 2021 H-3-12-0 Q-5-44-0 216,000
145 0206R0010321V000854 March 30, 2021 March 30, 2021 H-3-12-0 Q-5-44-0 216,000
146 0206R0010321V000217 March 9, 2021 March 9, 2021 H-3-12-0 Q-5-44-0 216,000
147 0206R0010321V000637 March 23, 2021 March 23, 2021 H-3-12-0 Q-5-44-0 216,000
148 0206R0010321V000848 March 30, 2021 March 30, 2021 H-3-12-0 Q-5-44-0 216,000
149 0206R0010321V000096 March 4, 2021 March 4, 2021 H-3-12-0 Q-5-44-0 216,000
150 0206R0010321V000433 March 16, 2021 March 16, 2021 H-3-12-0 Q-5-44-0 216,000
151 0206R0010321V000715 March 25, 2021 March 25, 2021 H-3-12-0 Q-5-44-0 216,000
152 0206R0010321V000234 March 9, 2021 March 9, 2021 H-3-12-0 Q-5-44-0 216,000
153 0206R0010321V000531 March 19, 2021 March 19, 2021 H-3-12-0 Q-5-44-0 216,000
154 0206R0010321V000015 March 1, 2021 March 1, 2021 H-3-12-0 Q-5-44-0 216,000
155 0206R0010321V000162 March 8, 2021 March 8, 2021 H-3-12-0 Q-5-44-0 216,000
156 0206R0010321V000572 March 22, 2021 March 22, 2021 H-3-12-0 Q-5-44-0 216,000
157 0206R0010321V000803 March 29, 2021 March 29, 2021 H-3-12-0 Q-5-44-0 216,000
158 0206R0010321V000632 March 23, 2021 March 23, 2021 H-3-12-0 Q-5-44-0 216,000
159 0206R0010321V000468 March 17, 2021 March 17, 2021 H-3-12-0 Q-5-44-0 216,000
160 0206R0010321V000051 March 2, 2021 March 2, 2021 H-3-12-0 Q-5-44-0 216,000
161 0206R0010321V000227 March 9, 2021 March 9, 2021 H-3-12-0 Q-5-44-0 216,000
162 0206R0010321V000431 March 16, 2021 March 16, 2021 H-3-12-0 Q-5-44-0 216,000
163 0206R0010321V000007 March 1, 2021 March 1, 2021 H-3-12-0 Q-5-44-0 216,000
164 0206R0010321V000165 March 8, 2021 March 8, 2021 H-3-12-0 Q-5-44-0 216,000
165 0206R0010321V000358 March 15, 2021 March 15, 2021 H-3-12-0 Q-5-44-0 216,000
166 0206R0010321V000568 March 22, 2021 March 22, 2021 H-3-12-0 Q-5-44-0 216,000
167 0206R0010321V000801 March 29, 2021 March 29, 2021 H-3-12-0 Q-5-44-0 216,000
168 0206R0010321V000372 March 15, 2021 March 15, 2021 H-3-12-0 Q-5-44-0 216,000
169 0206R0010321V000732 March 25, 2021 March 25, 2021 H-3-12-0 Q-5-44-0 216,000
170 0206R0010321V000092 March 4, 2021 March 4, 2021 H-3-12-0 Q-5-44-0 216,000
171 0206R0010321V000257 March 10, 2021 March 10, 2021 H-3-12-0 Q-5-44-0 216,000
172 0206R0010321V000356 March 15, 2021 March 15, 2021 H-3-12-0 Q-5-44-0 216,000
173 0206R0010321V000681 March 24, 2021 March 24, 2021 H-3-12-0 Q-5-44-0 216,000
174 0206R0010321V000128 March 5, 2021 March 5, 2021 H-3-12-0 Q-5-44-0 216,000
175 0206R0010321V000758 March 26, 2021 March 26, 2021 H-3-12-0 Q-5-44-0 216,000
176 0206R0010321V000460 March 17, 2021 March 17, 2021 H-3-12-0 Q-5-44-0 216,000
177 0206R0010321V000222 March 9, 2021 March 9, 2021 H-3-12-0 Q-5-44-0 216,000
178 0206R0010321V000078 March 3, 2021 March 3, 2021 H-3-12-0 Q-5-44-0 216,000
179 0206R0010321V000261 March 10, 2021 March 10, 2021 H-3-12-0 Q-5-44-0 216,000
180 0206R0010321V000223 March 9, 2021 March 9, 2021 H-3-12-0 Q-5-44-0 216,000
181 0206R0010321V000103 March 4, 2021 March 4, 2021 H-3-12-0 Q-5-44-0 216,000
182 0206R0010321V000465 March 17, 2021 March 17, 2021 H-3-12-0 Q-5-44-0 216,000
183 0206R0010321V000913 March 31, 2021 March 31, 2021 H-3-12-0 Q-5-44-0 216,000
184 0206R0010321V000363 March 15, 2021 March 15, 2021 H-3-12-0 Q-5-44-0 216,000
185 0206R0010321V000641 March 23, 2021 March 23, 2021 H-3-12-0 Q-5-44-0 216,000
186 0206R0010321V000889 March 31, 2021 March 31, 2021 H-3-12-0 Q-5-44-0 216,000
187 0206R0010321V000680 March 24, 2021 March 24, 2021 H-3-12-0 Q-5-44-0 216,000
188 0206R0010321V000172 March 8, 2021 March 8, 2021 H-3-12-0 Q-5-44-0 216,000
189 0206R0010321V000426 March 16, 2021 March 16, 2021 H-3-12-0 Q-5-44-0 216,000
190 0206R0010321V000091 March 4, 2021 March 4, 2021 H-3-12-0 Q-5-44-0 216,000
191 0206R0010321V000052 March 2, 2021 March 2, 2021 H-3-12-0 Q-5-44-0 216,000
192 0206R0010321V000430 March 16, 2021 March 16, 2021 H-3-12-0 Q-5-44-0 216,000
193 0206R0010321V000124 March 5, 2021 March 5, 2021 H-3-12-0 Q-5-44-0 216,000
194 0206R0010321V000713 March 25, 2021 March 25, 2021 H-3-12-0 Q-5-44-0 216,000
195 0206R0010321V000009 March 1, 2021 March 1, 2021 H-3-12-0 Q-5-44-0 216,000
196 0206R0010321V000173 March 8, 2021 March 8, 2021 H-3-12-0 Q-5-44-0 216,000
197 0206R0010321V000357 March 15, 2021 March 15, 2021 H-3-12-0 Q-5-44-0 216,000
198 0206R0010321V000576 March 22, 2021 March 22, 2021 H-3-12-0 Q-5-44-0 216,000
199 0206R0010321V000152 March 5, 2021 March 5, 2021 U-4-13-I Q-5-44-0 1,945,500

200 0206R0010321V000014 March 1, 2021 March 1, 2021 H-3-12-0 Q-5-44-0 216,000

201 0206R0010321V000045 March 2, 2021 March 2, 2021 H-3-12-0 Q-5-44-0 216,000
202 0206R0010321V000218 March 9, 2021 March 9, 2021 H-3-12-0 Q-5-44-0 216,000
203 0206R0010321V000911 March 31, 2021 March 31, 2021 H-3-12-0 Q-5-44-0 216,000
204 0206R0010321V000466 March 17, 2021 March 17, 2021 H-3-12-0 Q-5-44-0 216,000
205 0206R0010321V000586 March 22, 2021 March 22, 2021 H-3-12-0 Q-5-44-0 216,000
206 0206R0010321V000040 March 2, 2021 March 2, 2021 H-3-12-0 Q-5-44-0 216,000
207 0206R0010321V000352 March 15, 2021 March 15, 2021 H-3-12-0 Q-5-44-0 216,000
208 0206R0010321V000566 March 22, 2021 March 22, 2021 H-3-12-0 Q-5-44-0 216,000
209 0206R0010321V000802 March 29, 2021 March 29, 2021 H-3-12-0 Q-5-44-0 216,000
210 0206R0010321V000366 March 15, 2021 March 15, 2021 H-3-12-0 Q-5-44-0 216,000
211 0206R0010321V000742 March 25, 2021 March 25, 2021 U-3-16-0 Q-5-44-0 290,300
212 0206R0010321V000418 March 16, 2021 March 16, 2021 H-3-12-0 Q-5-44-0 216,000
213 0206R0010321V000912 March 31, 2021 March 31, 2021 H-3-12-0 Q-5-44-0 216,000
214 0206R0010321V000706 March 25, 2021 March 25, 2021 H-3-12-0 Q-5-44-0 216,000
215 0206R0010321V000354 March 15, 2021 March 15, 2021 H-3-12-0 Q-5-44-0 216,000
216 0206R0010321V000894 March 31, 2021 March 31, 2021 H-3-12-0 Q-5-44-0 216,000
217 0206R0010321V000062 March 2, 2021 March 2, 2021 H-3-12-0 Q-5-44-0 216,000
218 0206R0010321V000540 March 19, 2021 March 20, 2021 W-4-16-I W-4-16-I 2,130,400
219 0206R0010321V000507 March 15, 2021 March 15, 2021 P-8-17-I P-8-17-I 3,591,800
220 0206R0010321V000703 March 24, 2021 March 24, 2021 Q-5-42-0 Q-5-42-0 186,800
221 0206R0010321V000674 3/23/2021 3/23/2021 K-5-18-0 Q-5-44-0 260,600
Total 59,148,000
MPULAN PANE TEBING TINGGI
ARET 2021

Biaya Kelebihan
Keterangan
Audit Bayar

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
2,296,300 2,043,900 J44 tanpa spirometri

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 134,600 naso endoskopi berulang, kode kontrol saja
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
- 290,300 Pelayanan Tambal Gigi di FKTP

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 1,760,000 Pelayanan < 6 jam RJTL

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 104,800 Pelayanan Tambal Gigi di FKTP
 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
1,645,700 484,700 pasien persalinan Normal DU O800
185,500 3,406,300 Pelayanan < 6 jam RJTL
- 186,800 Tidak diagnosa emergency
185,500 75,100 tgl 1 ke IGD ganti kode Z
44,195,500 14,952,500
SANGGAHAN RSKP

dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib untuk
dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan pengembalian uang
kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.

SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS
dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib untuk
dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan pengembalian uang
kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS
dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib untuk
dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan pengembalian uang
kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
TIDAK ACC PERAWATAN LEBIH 6 JAM OS MASUK JAM 00.18 SD 10.22)
dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib untuk
dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan pengembalian uang
kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS
dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib untuk
dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan pengembalian uang
kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.
SDA
SDA
SDA
SDA
SDA
ACC BPJS
TIDAK ACC PERAWATAN LEBIH 6 JAM OS MASUK JAM 14.18 SD 22.22)
ACC BPJS
ACC BPJS
 HASIL VERIFIKASI PASKA KLAIM RSUD KUMPULA
BULAN PELAYANAN APRIL 2

No NoSJP TglDtgSJP TglPlgSJP

1 0206R0010421V000697 April 21, 2021 April 21, 2021

2 0206R0010421V000698 April 21, 2021 April 21, 2021

3 0206R0010421V000804 April 23, 2021 April 23, 2021
4 0206R0010421V001053 April 30, 2021 April 30, 2021
5 0206R0010421V000066 April 5, 2021 April 5, 2021
6 0206R0010421V000326 April 12, 2021 April 12, 2021
7 0206R0010421V000592 April 19, 2021 April 19, 2021
8 0206R0010421V000851 April 26, 2021 April 26, 2021
9 0206R0010421V000073 April 5, 2021 April 5, 2021
10 0206R0010421V000319 April 12, 2021 April 12, 2021
11 0206R0010421V000604 April 19, 2021 April 19, 2021
12 0206R0010421V000843 April 26, 2021 April 26, 2021
13 0206R0010421V000152 April 6, 2021 April 6, 2021
14 0206R0010421V000382 April 13, 2021 April 13, 2021
15 0206R0010421V000135 April 6, 2021 April 6, 2021
16 0206R0010421V000995 April 29, 2021 April 29, 2021
17 0206R0010421V000069 April 5, 2021 April 5, 2021
18 0206R0010421V000323 April 12, 2021 April 12, 2021
19 0206R0010421V000585 April 19, 2021 April 19, 2021
20 0206R0010421V000857 April 26, 2021 April 26, 2021
21 0206R0010421V000206 April 8, 2021 April 8, 2021
22 0206R0010421V000547 April 16, 2021 April 16, 2021
23 0206R0010421V000335 April 12, 2021 April 12, 2021
24 0206R0010421V000921 April 27, 2021 April 27, 2021
25 0206R0010421V000960 April 28, 2021 April 28, 2021
26 0206R0010421V000497 April 15, 2021 April 15, 2021
27 0206R0010421V000756 April 22, 2021 April 22, 2021
28 0206R0010421V000980 April 28, 2021 April 28, 2021
29 0206R0010421V000328 April 12, 2021 April 12, 2021
30 0206R0010421V000952 April 28, 2021 April 28, 2021
31 0206R0010421V000185 April 7, 2021 April 7, 2021
32 0206R0010421V000417 April 14, 2021 April 14, 2021
33 0206R0010421V000717 April 21, 2021 April 21, 2021
34 0206R0010421V000966 April 28, 2021 April 28, 2021
35 0206R0010421V000327 April 12, 2021 April 12, 2021
36 0206R0010421V000594 April 19, 2021 April 19, 2021
37 0206R0010421V000849 April 26, 2021 April 26, 2021
38 0206R0010421V000120 April 6, 2021 April 6, 2021
39 0206R0010421V000643 April 20, 2021 April 20, 2021
40 0206R0010421V000213 April 8, 2021 April 8, 2021
41 0206R0010421V000503 April 15, 2021 April 15, 2021
42 0206R0010421V000068 April 5, 2021 April 5, 2021
43 0206R0010421V000313 April 12, 2021 April 12, 2021
44 0206R0010421V000593 April 19, 2021 April 19, 2021
45 0206R0010421V000847 April 26, 2021 April 26, 2021
46 0206R0010421V000694 April 21, 2021 April 21, 2021
47 0206R0010421V000247 April 8, 2021 April 8, 2021
48 0206R0010421V000491 April 15, 2021 April 15, 2021
49 0206R0010421V000982 April 28, 2021 April 28, 2021
50 0206R0010421V000182 April 7, 2021 April 7, 2021
51 0206R0010421V000416 April 14, 2021 April 14, 2021
52 0206R0010421V000343 April 12, 2021 April 12, 2021

53 0206R0010421V000165 April 7, 2021 April 7, 2021

54 0206R0010421V000409 April 14, 2021 April 14, 2021

55 0206R0010421V000947 April 28, 2021 April 28, 2021
56 0206R0010421V000080 April 5, 2021 April 5, 2021
57 0206R0010421V000546 April 16, 2021 April 16, 2021
58 0206R0010421V000801 April 23, 2021 April 23, 2021
59 0206R0010421V000006 April 1, 2021 April 1, 2021
60 0206R0010421V000232 April 8, 2021 April 8, 2021
61 0206R0010421V000311 April 12, 2021 April 12, 2021
62 0206R0010421V000962 April 28, 2021 April 28, 2021
63 0206R0010421V000280 April 9, 2021 April 9, 2021
64 0206R0010421V000513 April 15, 2021 April 15, 2021
65 0206R0010421V000121 April 6, 2021 April 6, 2021
66 0206R0010421V000377 April 13, 2021 April 13, 2021
67 0206R0010421V000924 April 27, 2021 April 27, 2021
68 0206R0010421V000014 April 1, 2021 April 1, 2021
69 0206R0010421V000238 April 8, 2021 April 8, 2021
70 0206R0010421V000506 April 15, 2021 April 15, 2021
71 0206R0010421V000771 April 22, 2021 April 22, 2021
72 0206R0010421V001023 April 29, 2021 April 29, 2021
73 0206R0010421V000031 April 1, 2021 April 1, 2021
74 0206R0010421V000223 April 8, 2021 April 8, 2021
75 0206R0010421V000309 April 12, 2021 April 12, 2021
76 0206R0010421V000958 April 28, 2021 April 28, 2021
77 0206R0010421V000149 April 6, 2021 April 6, 2021
78 0206R0010421V000845 April 26, 2021 April 26, 2021
79 0206R0010421V000033 April 1, 2021 April 1, 2021
80 0206R0010421V000208 April 8, 2021 April 8, 2021
81 0206R0010421V000473 April 15, 2021 April 15, 2021
82 0206R0010421V000746 April 22, 2021 April 22, 2021
83 0206R0010421V000997 April 29, 2021 April 29, 2021
84 0206R0010421V000744 April 22, 2021 April 22, 2021
85 0206R0010421V000015 April 1, 2021 April 1, 2021
86 0206R0010421V000925 April 27, 2021 April 27, 2021
87 0206R0010421V000028 April 1, 2021 April 1, 2021
88 0206R0010421V000211 April 8, 2021 April 8, 2021
89 0206R0010421V000498 April 15, 2021 April 15, 2021
90 0206R0010421V000959 April 28, 2021 April 28, 2021
91 0206R0010421V000641 April 20, 2021 April 20, 2021
92 0206R0010421V000016 April 1, 2021 April 1, 2021
93 0206R0010421V000221 April 8, 2021 April 8, 2021
94 0206R0010421V000504 April 15, 2021 April 15, 2021
95 0206R0010421V001008 April 29, 2021 April 29, 2021
96 0206R0010421V000032 April 1, 2021 April 1, 2021
97 0206R0010421V000215 April 8, 2021 April 8, 2021
98 0206R0010421V000478 April 15, 2021 April 15, 2021
99 0206R0010421V000469 April 15, 2021 April 15, 2021
100 0206R0010421V000682 April 21, 2021 April 21, 2021
101 0206R0010421V000941 April 28, 2021 April 28, 2021
102 0206R0010421V000076 April 5, 2021 April 5, 2021
103 0206R0010421V000325 April 12, 2021 April 12, 2021
104 0206R0010421V000598 April 19, 2021 April 19, 2021
105 0206R0010421V000855 April 26, 2021 April 26, 2021
106 0206R0010421V000181 April 7, 2021 April 7, 2021
107 0206R0010421V000419 April 14, 2021 April 14, 2021
108 0206R0010421V000864 April 26, 2021 April 26, 2021
109 0206R0010421V000524 April 15, 2021 April 15, 2021
110 0206R0010421V000996 April 29, 2021 April 29, 2021
111 0206R0010421V000544 April 16, 2021 April 16, 2021
112 0206R0010421V000796 April 23, 2021 April 23, 2021
113 0206R0010421V001051 April 30, 2021 April 30, 2021
114 0206R0010421V000518 April 15, 2021 April 15, 2021
115 0206R0010421V000270 April 9, 2021 April 9, 2021
116 0206R0010421V001061 April 30, 2021 April 30, 2021
117 0206R0010421V000025 April 1, 2021 April 1, 2021
118 0206R0010421V000242 April 8, 2021 April 8, 2021
119 0206R0010421V000772 April 22, 2021 April 22, 2021
120 0206R0010421V000216 April 8, 2021 April 8, 2021
121 0206R0010421V000474 April 15, 2021 April 15, 2021
122 0206R0010421V000953 April 28, 2021 April 28, 2021
123 0206R0010421V000693 April 21, 2021 April 21, 2021
124 0206R0010421V000882 April 26, 2021 April 26, 2021
125 0206R0010421V000122 April 6, 2021 April 6, 2021
126 0206R0010421V000005 April 1, 2021 April 1, 2021
127 0206R0010421V000218 April 8, 2021 April 8, 2021
128 0206R0010421V000470 April 15, 2021 April 15, 2021
129 0206R0010421V000948 April 28, 2021 April 28, 2021
130 0206R0010421V000166 April 7, 2021 April 7, 2021
131 0206R0010421V000695 April 21, 2021 April 21, 2021
132 0206R0010421V000784 April 22, 2021 April 22, 2021
133 0206R0010421V000026 April 1, 2021 April 1, 2021
134 0206R0010421V000236 April 8, 2021 April 8, 2021
135 0206R0010421V000512 April 15, 2021 April 15, 2021
136 0206R0010421V000767 April 22, 2021 April 22, 2021
137 0206R0010421V001014 April 29, 2021 April 29, 2021
138 0206R0010421V000222 April 8, 2021 April 8, 2021
139 0206R0010421V000475 April 15, 2021 April 15, 2021
140 0206R0010421V000976 April 28, 2021 April 28, 2021
141 0206R0010421V000381 April 13, 2021 April 13, 2021
142 0206R0010421V000186 April 7, 2021 April 7, 2021
143 0206R0010421V000422 April 14, 2021 April 14, 2021
144 0206R0010421V000716 April 21, 2021 April 21, 2021
145 0206R0010421V000965 April 28, 2021 April 28, 2021
146 0206R0010421V000271 April 9, 2021 April 9, 2021
147 0206R0010421V001059 April 30, 2021 April 30, 2021
148 0206R0010421V000430 April 14, 2021 April 14, 2021
149 0206R0010421V000187 April 7, 2021 April 7, 2021
150 0206R0010421V001072 April 30, 2021 April 30, 2021
151 0206R0010421V000081 April 5, 2021 April 5, 2021
152 0206R0010421V000545 April 16, 2021 April 16, 2021
153 0206R0010421V000800 April 23, 2021 April 23, 2021
154 0206R0010421V000332 April 12, 2021 April 12, 2021
155 0206R0010421V000683 April 21, 2021 April 21, 2021
156 0206R0010421V000903 April 27, 2021 April 27, 2021
157 0206R0010421V000176 April 7, 2021 April 7, 2021
158 0206R0010421V000413 April 14, 2021 April 14, 2021
159 0206R0010421V000407 April 14, 2021 April 14, 2021
160 0206R0010421V000844 April 26, 2021 April 26, 2021
161 0206R0010421V000129 April 6, 2021 April 6, 2021
162 0206R0010421V000063 April 5, 2021 April 5, 2021
163 0206R0010421V000312 April 12, 2021 April 12, 2021
164 0206R0010421V000591 April 19, 2021 April 19, 2021
165 0206R0010421V000852 April 26, 2021 April 26, 2021
166 0206R0010421V000552 April 16, 2021 April 16, 2021
167 0206R0010421V000777 April 22, 2021 April 22, 2021
168 0206R0010421V000168 April 7, 2021 April 7, 2021
169 0206R0010421V001007 April 29, 2021 April 29, 2021
170 0206R0010421V000126 April 6, 2021 April 6, 2021
171 0206R0010421V000410 April 14, 2021 April 14, 2021
172 0206R0010421V000709 April 21, 2021 April 21, 2021
173 0206R0010421V000955 April 28, 2021 April 28, 2021
174 0206R0010421V000316 April 12, 2021 April 12, 2021
175 0206R0010421V000798 April 23, 2021 April 23, 2021
176 0206R0010421V000017 April 1, 2021 April 1, 2021
177 0206R0010421V000321 April 12, 2021 April 12, 2021
178 0206R0010421V000601 April 19, 2021 April 19, 2021
179 0206R0010421V000492 April 15, 2021 April 15, 2021
180 0206R0010421V000757 April 22, 2021 April 22, 2021
181 0206R0010421V000650 April 20, 2021 April 20, 2021
182 0206R0010421V000067 April 5, 2021 April 5, 2021
183 0206R0010421V000602 April 19, 2021 April 19, 2021
184 0206R0010421V000856 April 26, 2021 April 26, 2021
185 0206R0010421V000078 April 5, 2021 April 5, 2021
186 0206R0010421V000646 April 20, 2021 April 20, 2021
187 0206R0010421V000235 April 8, 2021 April 8, 2021
188 0206R0010421V000489 April 15, 2021 April 15, 2021
189 0206R0010421V000750 April 22, 2021 April 22, 2021
190 0206R0010421V001005 April 29, 2021 April 29, 2021
191 0206R0010421V000482 April 15, 2021 April 15, 2021
192 0206R0010421V000754 April 22, 2021 April 22, 2021
193 0206R0010421V000751 April 22, 2021 April 22, 2021
194 0206R0010421V000064 April 5, 2021 April 5, 2021
195 0206R0010421V000315 April 12, 2021 April 12, 2021
196 0206R0010421V000597 April 19, 2021 April 19, 2021
197 0206R0010421V000846 April 26, 2021 April 26, 2021
198 0206R0010421V000439 April 14, 2021 April 14, 2021
199 0206R0010421V000207 April 8, 2021 April 8, 2021
200 0206R0010421V000466 April 15, 2021 April 15, 2021
201 0206R0010421V000745 April 22, 2021 April 22, 2021
202 0206R0010421V001009 April 29, 2021 April 29, 2021
203 0206R0010421V000305 April 10, 2021 April 13, 2021
204 0206R0010421V001040 April 29, 2021 May 1, 2021

205 0206R0010421V000999 April 29, 2021 April 29, 2021

206 0206R0010421V000237 April 8, 2021 April 8, 2021

207 0206R0010421V000510 April 15, 2021 April 15, 2021
208 0206R0010421V000072 April 5, 2021 April 5, 2021
209 0206R0010421V000748 April 22, 2021 April 22, 2021
210 0206R0010421V000008 April 1, 2021 April 1, 2021

211 0206R0010421V000030 April 1, 2021 April 1, 2021

212 0206R0010421V000217 April 8, 2021 April 8, 2021
213 0206R0010421V000468 April 15, 2021 April 15, 2021
214 0206R0010421V000951 April 28, 2021 April 28, 2021
215 0206R0010421V000759 April 22, 2021 April 22, 2021
216 0206R0010421V000239 April 8, 2021 April 8, 2021
217 0206R0010421V000212 April 8, 2021 April 8, 2021
218 0206R0010421V000541 April 16, 2021 April 16, 2021
219 0206R0010421V000998 April 29, 2021 April 29, 2021
220 0206R0010421V000203 April 7, 2021 April 7, 2021
221 0206R0010421V000425 April 14, 2021 April 14, 2021
222 0206R0010421V000705 April 21, 2021 April 21, 2021
223 0206R0010421V000964 April 28, 2021 April 28, 2021
224 0206R0010421V000234 April 8, 2021 April 8, 2021
225 0206R0010421V000495 April 15, 2021 April 15, 2021
226 0206R0010421V000001 April 1, 2021 April 1, 2021
227 0206R0010421V000228 April 8, 2021 April 8, 2021
228 0206R0010421V000406 April 14, 2021 April 14, 2021
229 0206R0010421V001011 April 29, 2021 April 29, 2021
230 0206R0010421V000411 April 14, 2021 April 14, 2021
231 0206R0010421V000904 April 27, 2021 April 27, 2021
232 0206R0010421V000476 April 15, 2021 April 15, 2021
233 0206R0010421V000743 April 22, 2021 April 22, 2021
234 0206R0010421V001000 April 29, 2021 April 29, 2021
235 0206R0010421V000084 April 5, 2021 April 5, 2021
236 0206R0010421V000441 April 14, 2021 April 14, 2021
237 0206R0010421V000696 April 21, 2021 April 21, 2021
238 0206R0010421V000969 April 28, 2021 April 28, 2021
239 0206R0010421V000077 April 5, 2021 April 5, 2021
240 0206R0010421V000021 April 1, 2021 April 1, 2021
241 0206R0010421V000514 April 15, 2021 April 15, 2021
242 0206R0010421V000071 April 5, 2021 April 5, 2021
243 0206R0010421V000329 April 12, 2021 April 12, 2021
244 0206R0010421V000070 April 5, 2021 April 5, 2021
245 0206R0010421V000318 April 12, 2021 April 12, 2021
246 0206R0010421V000902 April 27, 2021 April 27, 2021
247 0206R0010421V000423 April 14, 2021 April 14, 2021
248 0206R0010421V000766 April 22, 2021 April 22, 2021
249 0206R0010421V000993 April 29, 2021 April 29, 2021
250 0206R0010421V000125 April 6, 2021 April 6, 2021
251 0206R0010421V000426 April 14, 2021 April 14, 2021
252 0206R0010421V000719 April 21, 2021 April 21, 2021
253 0206R0010421V000989 April 28, 2021 April 28, 2021
254 0206R0010421V000892 April 26, 2021 April 26, 2021
255 0206R0010421V000065 April 5, 2021 April 5, 2021

256 0206R0010421V000314 April 12, 2021 April 12, 2021

257 0206R0010421V000595 April 19, 2021 April 19, 2021
258 0206R0010421V000010 April 1, 2021 April 1, 2021
259 0206R0010421V000229 April 8, 2021 April 8, 2021
260 0206R0010421V000477 April 15, 2021 April 15, 2021
261 0206R0010421V000753 April 22, 2021 April 22, 2021
262 0206R0010421V001001 April 29, 2021 April 29, 2021
263 0206R0010421V000020 April 1, 2021 April 1, 2021
264 0206R0010421V000652 April 20, 2021 April 20, 2021

265 0206R0010421V000004 April 1, 2021 April 1, 2021

266 0206R0010421V000226 April 8, 2021 April 8, 2021

267 0206R0010421V000483 April 15, 2021 April 15, 2021
268 0206R0010421V000994 April 29, 2021 April 29, 2021
269 0206R0010421V000002 April 1, 2021 April 1, 2021
270 0206R0010421V000227 April 8, 2021 April 8, 2021
271 0206R0010421V000485 April 15, 2021 April 15, 2021
272 0206R0010421V000150 April 6, 2021 April 6, 2021
273 0206R0010421V000472 April 15, 2021 April 15, 2021
274 0206R0010421V001004 April 29, 2021 April 29, 2021
275 0206R0010421V000488 April 15, 2021 April 15, 2021
276 0206R0010421V000957 April 28, 2021 April 28, 2021
277 0206R0010421V000858 April 26, 2021 April 26, 2021
278 0206R0010421V000003 April 1, 2021 April 1, 2021
279 0206R0010421V000225 April 8, 2021 April 8, 2021
280 0206R0010421V000487 April 15, 2021 April 15, 2021
281 0206R0010421V000961 April 28, 2021 April 28, 2021
282 0206R0010421V000027 April 1, 2021 April 1, 2021
283 0206R0010421V000823 April 23, 2021 April 23, 2021
284 0206R0010421V001062 April 30, 2021 April 30, 2021
285 0206R0010421V000706 April 21, 2021 April 21, 2021
286 0206R0010421V000496 April 15, 2021 April 15, 2021
287 0206R0010421V000758 April 22, 2021 April 22, 2021
288 0206R0010421V000854 April 26, 2021 April 26, 2021
289 0206R0010421V000029 April 1, 2021 April 1, 2021
290 0206R0010421V000210 April 8, 2021 April 8, 2021
291 0206R0010421V000494 April 15, 2021 April 15, 2021
292 0206R0010421V001006 April 29, 2021 April 29, 2021
293 0206R0010421V000116 April 5, 2021 April 5, 2021
294 0206R0010421V000854 4/26/2021 4/26/2021
295 0206R0010421V000892 4/26/2021 4/26/2021
296 0206R0010421V001065 30/04/2021 30/04/2021
Total
HASIL VERIFIKASI PASKA KLAIM RSUD KUMPULAN PANE TEBING TINGGI
BULAN PELAYANAN APRIL 2021

Biaya Biaya
CBG CBG Audit Kelebihan Bayar
Verifikasi Audit

H-3-12-0 Q-5-44-0 216,000 185,500 30,500

H-3-12-0 Q-5-44-0 216,000 185,500 30,500

H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
U-3-13-0 Q-5-44-0 320,100 185,500 134,600

H-3-12-0 Q-5-44-0 216,000 185,500 30,500

H-3-12-0 Q-5-44-0 216,000 185,500 30,500

H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
J-4-17-I Q-5-44-0 3,624,300 2,296,300 1,328,000
J-4-17-I Q-5-44-0 3,624,300 2,296,300 1,328,000

H-3-12-0 Q-5-44-0 216,000 185,500 30,500

H-3-12-0 Q-5-44-0 216,000 185,500 30,500

H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
Z-4-12-I Q-5-44-0 1,843,900 185,500 1,658,400

H-3-12-0 Q-5-44-0 216,000 185,500 30,500

H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
Q-5-42-0 Q-5-44-0 186,800 114,400 72,400
H-3-12-0 Q-5-44-0 216,000 185,500 30,500

H-3-12-0 Q-5-44-0 216,000 185,500 30,500

H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
U-3-16-0 U-3-16-0 290,300 - 290,300
U-3-16-0 U-3-16-0 290,300 - 290,300

H-3-12-0 Q-5-44-0 216,000 185,500 30,500

H-3-12-0 Q-5-44-0 216,000 185,500 30,500

H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
H-3-12-0 Q-5-44-0 216,000 185,500 30,500
P-8-17-I Q-5-44-0 3,591,800 185,500 3,406,300
H-3-12-0 216,000 216,000
Q-5-42-0 186,800 186,800
N-3-15-0 889,700 889,700
76,624,300 58,131,000 18,493,300
 Keterangan

Kode Kontrol, Prosedur tidak perlu dientri

Kode Kontrol, Prosedur tidak perlu dientri

Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
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Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
naso endoskopi berulang, kode kontrol saja

Kode Kontrol, Prosedur tidak perlu dientri

Kode Kontrol, Prosedur tidak perlu dientri

Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
J44 tanpa spirometri
J44 tanpa spirometri

Kode Kontrol, Prosedur tidak perlu dientri

Kode Kontrol, Prosedur tidak perlu dientri

Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Pelayanan < 6 jam RJTL

Kode Kontrol, Prosedur tidak perlu dientri

Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
poli IRM fiisoterapi
Kode Kontrol, Prosedur tidak perlu dientri

Kode Kontrol, Prosedur tidak perlu dientri

Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Pelayanan Tambal Gigi di FKTP
Pelayanan Tambal Gigi di FKTP

Kode Kontrol, Prosedur tidak perlu dientri

Kode Kontrol, Prosedur tidak perlu dientri

Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Kode Kontrol, Prosedur tidak perlu dientri
Pelayanan < 6 jam RJTL
irisan rjtl ke ritl
fisioterapi tanpa prosedur
dalam RITL ada RJTL
SANGGAHAN RSKP

dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib untuk dilaksanakan
oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan pengembalian uang kelebihan bayar, dan
untuk kedepannya kami menunggu keputusan menajemen.

SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS
dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib untuk dilaksanakan
oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan pengembalian uang kelebihan bayar, dan
untuk kedepannya kami menunggu keputusan menajemen.
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS
ACC BPJS
dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib untuk dilaksanakan
oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan pengembalian uang kelebihan bayar, dan
untuk kedepannya kami menunggu keputusan menajemen.
SDA
SDA
SDA
SDA
TIDAK ACC PERAWATAN LEBIH 6 JAM OS MASUK JAM 01.41 SD 15.18 )
dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib untuk dilaksanakan
oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan pengembalian uang kelebihan bayar, dan
untuk kedepannya kami menunggu keputusan menajemen.
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS
dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib untuk dilaksanakan
oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan pengembalian uang kelebihan bayar, dan
untuk kedepannya kami menunggu keputusan menajemen.
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS
ACC BPJS
dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib untuk dilaksanakan
oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan pengembalian uang kelebihan bayar, dan
untuk kedepannya kami menunggu keputusan menajemen.
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS
ACC BPJS
ACC BPJS
ACC BPJS
 HASIL VERIFIKASI PASKA KLAIM RSUD KUMPULAN PANE TEB
BULAN PELAYANAN MEI 2021

No NoSJP TglDtgSJP TglPlgSJP CBG CBG Audit

1 0206R0010521V000108 May 5, 2021 May 5, 2021 H-3-12-0 Q-5-44-0

2 0206R0010521V000538 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0

3 0206R0010521V000216 May 7, 2021 May 7, 2021 H-3-12-0 Q-5-44-0
4 0206R0010521V000291 May 10, 2021 May 10, 2021 H-3-12-0 Q-5-44-0
5 0206R0010521V000018 May 3, 2021 May 3, 2021 H-3-12-0 Q-5-44-0
6 0206R0010521V000282 May 10, 2021 May 10, 2021 H-3-12-0 Q-5-44-0
7 0206R0010521V000747 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
8 0206R0010521V000079 May 4, 2021 May 4, 2021 H-3-12-0 Q-5-44-0
9 0206R0010521V000525 May 18, 2021 May 18, 2021 H-3-12-0 Q-5-44-0
10 0206R0010521V000093 May 5, 2021 May 5, 2021 H-3-12-0 Q-5-44-0
11 0206R0010521V000426 May 17, 2021 May 17, 2021 H-3-12-0 Q-5-44-0
12 0206R0010521V000692 May 24, 2021 May 24, 2021 H-3-12-0 Q-5-44-0
13 0206R0010521V000901 May 31, 2021 May 31, 2021 H-3-12-0 Q-5-44-0
14 0206R0010521V000459 May 17, 2021 May 17, 2021 H-3-12-0 Q-5-44-0
15 0206R0010521V000110 May 5, 2021 May 5, 2021 H-3-12-0 Q-5-44-0
16 0206R0010521V000480 May 18, 2021 May 18, 2021 H-3-12-0 Q-5-44-0
17 0206R0010521V000806 May 27, 2021 May 27, 2021 H-3-12-0 Q-5-44-0
18 0206R0010521V000548 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0
19 0206R0010521V000494 May 18, 2021 May 18, 2021 H-3-12-0 Q-5-44-0
20 0206R0010521V000754 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
21 0206R0010521V000621 May 21, 2021 May 21, 2021 Q-5-42-0 Q-5-44-0

22 0206R0010521V000103 May 5, 2021 May 5, 2021 H-3-12-0 Q-5-44-0

23 0206R0010521V000425 May 17, 2021 May 17, 2021 H-3-12-0 Q-5-44-0

24 0206R0010521V000702 May 24, 2021 May 24, 2021 H-3-12-0 Q-5-44-0
25 0206R0010521V000903 May 31, 2021 May 31, 2021 H-3-12-0 Q-5-44-0
26 0206R0010521V000191 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0
27 0206R0010521V000449 May 17, 2021 May 17, 2021 H-3-12-0 Q-5-44-0
28 0206R0010521V000760 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
29 0206R0010521V000015 May 3, 2021 May 3, 2021 H-3-12-0 Q-5-44-0
30 0206R0010521V000288 May 10, 2021 May 10, 2021 H-3-12-0 Q-5-44-0
31 0206R0010521V000746 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
32 0206R0010521V000069 May 4, 2021 May 4, 2021 H-3-12-0 Q-5-44-0
33 0206R0010521V000176 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0
34 0206R0010521V000598 May 20, 2021 May 20, 2021 H-3-12-0 Q-5-44-0
35 0206R0010521V000017 May 3, 2021 May 3, 2021 H-3-12-0 Q-5-44-0
36 0206R0010521V000283 May 10, 2021 May 10, 2021 H-3-12-0 Q-5-44-0
37 0206R0010521V000485 May 18, 2021 May 18, 2021 H-3-12-0 Q-5-44-0
38 0206R0010521V000745 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
39 0206R0010521V000215 May 7, 2021 May 7, 2021 H-3-12-0 Q-5-44-0
40 0206R0010521V000115 May 5, 2021 May 5, 2021 H-3-12-0 Q-5-44-0
41 0206R0010521V000536 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0
42 0206R0010521V000814 May 27, 2021 May 27, 2021 H-3-12-0 Q-5-44-0
43 0206R0010521V000743 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
44 0206R0010521V000096 May 5, 2021 May 5, 2021 H-3-12-0 Q-5-44-0
45 0206R0010521V000543 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0
46 0206R0010521V000918 May 31, 2021 May 31, 2021 H-3-12-0 Q-5-44-0
47 0206R0010521V000704 May 24, 2021 May 24, 2021 H-3-12-0 Q-5-44-0
48 0206R0010521V000904 May 31, 2021 May 31, 2021 H-3-12-0 Q-5-44-0
49 0206R0010521V000600 May 20, 2021 May 20, 2021 H-3-12-0 Q-5-44-0
50 0206R0010521V000809 May 27, 2021 May 27, 2021 H-3-12-0 Q-5-44-0
51 0206R0010521V000232 May 7, 2021 May 7, 2021 H-3-12-0 Q-5-44-0
52 0206R0010521V000607 May 20, 2021 May 20, 2021 H-3-12-0 Q-5-44-0
53 0206R0010521V000185 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0
54 0206R0010521V000505 May 18, 2021 May 18, 2021 H-3-12-0 Q-5-44-0
55 0206R0010521V000753 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
56 0206R0010521V000102 May 5, 2021 May 5, 2021 H-3-12-0 Q-5-44-0
57 0206R0010521V000545 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0
58 0206R0010521V000321 May 11, 2021 May 11, 2021 H-3-12-0 Q-5-44-0
59 0206R0010521V000846 May 28, 2021 May 28, 2021 H-3-12-0 Q-5-44-0
60 0206R0010521V000172 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0
61 0206R0010521V000554 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0
62 0206R0010521V000214 May 7, 2021 May 7, 2021 H-3-12-0 Q-5-44-0
63 0206R0010521V000281 May 10, 2021 May 10, 2021 H-3-12-0 Q-5-44-0
64 0206R0010521V000488 May 18, 2021 May 18, 2021 H-3-12-0 Q-5-44-0
65 0206R0010521V000749 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
66 0206R0010521V000601 May 20, 2021 May 20, 2021 H-3-12-0 Q-5-44-0
67 0206R0010521V000811 May 27, 2021 May 27, 2021 H-3-12-0 Q-5-44-0
68 0206R0010521V000428 May 17, 2021 May 17, 2021 H-3-12-0 Q-5-44-0
69 0206R0010521V000062 May 4, 2021 May 4, 2021 H-3-12-0 Q-5-44-0
70 0206R0010521V000323 May 11, 2021 May 11, 2021 H-3-12-0 Q-5-44-0
71 0206R0010521V000223 May 7, 2021 May 7, 2021 H-3-12-0 Q-5-44-0
72 0206R0010521V000286 May 10, 2021 May 10, 2021 H-3-12-0 Q-5-44-0
73 0206R0010521V000500 May 18, 2021 May 18, 2021 H-3-12-0 Q-5-44-0
74 0206R0010521V000751 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
75 0206R0010521V000557 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0
76 0206R0010521V000797 May 27, 2021 May 27, 2021 H-3-12-0 Q-5-44-0
77 0206R0010521V000014 May 3, 2021 May 3, 2021 H-3-12-0 Q-5-44-0
78 0206R0010521V000766 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
79 0206R0010521V000022 May 3, 2021 May 3, 2021 H-3-12-0 Q-5-44-0
80 0206R0010521V000539 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0
81 0206R0010521V000167 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0
82 0206R0010521V000531 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0
83 0206R0010521V000798 May 27, 2021 May 27, 2021 H-3-12-0 Q-5-44-0
84 0206R0010521V000091 May 5, 2021 May 5, 2021 H-3-12-0 Q-5-44-0
85 0206R0010521V000430 May 17, 2021 May 17, 2021 H-3-12-0 Q-5-44-0
86 0206R0010521V000700 May 24, 2021 May 24, 2021 H-3-12-0 Q-5-44-0
87 0206R0010521V000895 May 31, 2021 May 31, 2021 H-3-12-0 Q-5-44-0
88 0206R0010521V000530 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0
89 0206R0010521V000844 May 28, 2021 May 28, 2021 H-3-12-0 Q-5-44-0
90 0206R0010521V000848 May 28, 2021 May 28, 2021 H-3-12-0 Q-5-44-0
91 0206R0010521V000186 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0
92 0206R0010521V000799 May 27, 2021 May 27, 2021 H-3-12-0 Q-5-44-0
 93 0206R0010521V000496 May 18, 2021 May 18, 2021 H-3-12-0 Q-5-44-0
94 0206R0010521V000748 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
95 0206R0010521V000783 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
96 0206R0010521V000039 May 3, 2021 May 3, 2021 H-3-12-0 Q-5-44-0
97 0206R0010521V000298 May 10, 2021 May 10, 2021 H-3-12-0 Q-5-44-0
98 0206R0010521V000527 May 18, 2021 May 18, 2021 H-3-12-0 Q-5-44-0
99 0206R0010521V000106 May 5, 2021 May 5, 2021 H-3-12-0 Q-5-44-0
100 0206R0010521V000540 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0
101 0206R0010521V000182 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0
102 0206R0010521V000499 May 18, 2021 May 18, 2021 H-3-12-0 Q-5-44-0
103 0206R0010521V000768 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
104 0206R0010521V000483 May 18, 2021 May 18, 2021 H-3-12-0 Q-5-44-0
105 0206R0010521V000750 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
106 0206R0010521V000192 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0
107 0206R0010521V000446 May 17, 2021 May 17, 2021 H-3-12-0 Q-5-44-0
108 0206R0010521V000759 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
109 0206R0010521V000849 May 28, 2021 May 28, 2021 H-3-12-0 Q-5-44-0
110 0206R0010521V000109 May 5, 2021 May 5, 2021 H-3-12-0 Q-5-44-0
111 0206R0010521V000552 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0
112 0206R0010521V000556 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0
113 0206R0010521V000710 May 24, 2021 May 24, 2021 H-3-12-0 Q-5-44-0
114 0206R0010521V000427 May 17, 2021 May 17, 2021 H-3-12-0 Q-5-44-0
115 0206R0010521V000913 May 31, 2021 May 31, 2021 H-3-12-0 Q-5-44-0
116 0206R0010521V000322 May 11, 2021 May 11, 2021 H-3-12-0 Q-5-44-0
117 0206R0010521V000504 May 18, 2021 May 18, 2021 H-3-12-0 Q-5-44-0
118 0206R0010521V000786 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
119 0206R0010521V000289 May 10, 2021 May 10, 2021 H-3-12-0 Q-5-44-0
120 0206R0010521V000422 May 17, 2021 May 17, 2021 H-3-12-0 Q-5-44-0
121 0206R0010521V000701 May 24, 2021 May 24, 2021 H-3-12-0 Q-5-44-0
122 0206R0010521V000908 May 31, 2021 May 31, 2021 H-3-12-0 Q-5-44-0
123 0206R0010521V000435 May 17, 2021 May 17, 2021 H-3-12-0 Q-5-44-0
124 0206R0010521V000171 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0
125 0206R0010521V000097 May 5, 2021 May 5, 2021 H-3-12-0 Q-5-44-0
126 0206R0010521V000730 May 24, 2021 May 24, 2021 H-3-12-0 Q-5-44-0
127 0206R0010521V000156 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0
128 0206R0010521V000515 May 18, 2021 May 18, 2021 H-3-12-0 Q-5-44-0
129 0206R0010521V000781 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
130 0206R0010521V000492 May 18, 2021 May 18, 2021 H-3-12-0 Q-5-44-0
131 0206R0010521V000778 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
132 0206R0010521V000016 May 3, 2021 May 3, 2021 H-3-12-0 Q-5-44-0
133 0206R0010521V000284 May 10, 2021 May 10, 2021 H-3-12-0 Q-5-44-0
134 0206R0010521V000699 May 24, 2021 May 24, 2021 H-3-12-0 Q-5-44-0
135 0206R0010521V000068 May 4, 2021 May 4, 2021 H-3-12-0 Q-5-44-0
136 0206R0010521V000447 May 17, 2021 May 17, 2021 H-3-12-0 Q-5-44-0
137 0206R0010521V000695 May 24, 2021 May 24, 2021 H-3-12-0 Q-5-44-0
138 0206R0010521V000891 May 31, 2021 May 31, 2021 H-3-12-0 Q-5-44-0
139 0206R0010521V000181 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0
140 0206R0010521V000558 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0
141 0206R0010521V000533 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0
142 0206R0010521V000788 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
143 0206R0010521V000240 May 7, 2021 May 7, 2021 U-3-16-0 Q-5-44-0
144 0206R0010521V000213 May 7, 2021 May 7, 2021 H-3-12-0 Q-5-44-0

145 0206R0010521V000636 May 21, 2021 May 21, 2021 H-3-12-0 Q-5-44-0
146 0206R0010521V000843 May 28, 2021 May 28, 2021 H-3-12-0 Q-5-44-0
147 0206R0010521V000917 May 31, 2021 May 31, 2021 H-3-12-0 Q-5-44-0
148 0206R0010521V000174 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0
149 0206R0010521V000590 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0
150 0206R0010521V000180 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0
151 0206R0010521V000456 May 17, 2021 May 17, 2021 H-3-12-0 Q-5-44-0
152 0206R0010521V000725 May 24, 2021 May 24, 2021 H-3-12-0 Q-5-44-0
153 0206R0010521V000909 May 31, 2021 May 31, 2021 H-3-12-0 Q-5-44-0
154 0206R0010521V000098 May 5, 2021 May 5, 2021 H-3-12-0 Q-5-44-0
155 0206R0010521V000703 May 24, 2021 May 24, 2021 H-3-12-0 Q-5-44-0
156 0206R0010521V000705 May 24, 2021 May 24, 2021 H-3-12-0 Q-5-44-0
157 0206R0010521V000094 May 5, 2021 May 5, 2021 H-3-12-0 Q-5-44-0
158 0206R0010521V000489 May 18, 2021 May 18, 2021 H-3-12-0 Q-5-44-0
159 0206R0010521V000780 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
160 0206R0010521V000285 May 10, 2021 May 10, 2021 H-3-12-0 Q-5-44-0
161 0206R0010521V000744 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
162 0206R0010521V000112 May 5, 2021 May 5, 2021 H-3-12-0 Q-5-44-0
163 0206R0010521V000437 May 17, 2021 May 17, 2021 H-3-12-0 Q-5-44-0
164 0206R0010521V000697 May 24, 2021 May 24, 2021 H-3-12-0 Q-5-44-0
165 0206R0010521V000173 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0
166 0206R0010521V000490 May 18, 2021 May 18, 2021 H-3-12-0 Q-5-44-0
167 0206R0010521V000120 May 5, 2021 May 5, 2021 H-3-12-0 Q-5-44-0
168 0206R0010521V000842 May 28, 2021 May 28, 2021 H-3-12-0 Q-5-44-0
169 0206R0010521V000063 May 4, 2021 May 4, 2021 H-3-12-0 Q-5-44-0
170 0206R0010521V000487 May 18, 2021 May 18, 2021 H-3-12-0 Q-5-44-0
171 0206R0010521V000170 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0
172 0206R0010521V000628 May 21, 2021 May 21, 2021 H-3-12-0 Q-5-44-0
173 0206R0010521V000840 May 28, 2021 May 28, 2021 H-3-12-0 Q-5-44-0
174 0206R0010521V000105 May 5, 2021 May 5, 2021 H-3-12-0 Q-5-44-0
175 0206R0010521V000431 May 17, 2021 May 17, 2021 H-3-12-0 Q-5-44-0
176 0206R0010521V000696 May 24, 2021 May 24, 2021 H-3-12-0 Q-5-44-0
177 0206R0010521V000896 May 31, 2021 May 31, 2021 H-3-12-0 Q-5-44-0
178 0206R0010521V000452 May 17, 2021 May 17, 2021 H-3-12-0 Q-5-44-0
179 0206R0010521V000159 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0
180 0206R0010521V000577 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0
181 0206R0010521V000341 May 11, 2021 May 11, 2021 H-3-12-0 Q-5-44-0
182 0206R0010521V000752 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
183 0206R0010521V000193 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0
184 0206R0010521V000756 May 25, 2021 May 25, 2021 H-2-22-0 Q-5-44-0

185 0206R0010521V000169 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0

186 0206R0010521V000560 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0
187 0206R0010521V000157 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0
188 0206R0010521V000542 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0
189 0206R0010521V000119 May 5, 2021 May 5, 2021 H-3-12-0 Q-5-44-0
190 0206R0010521V000856 May 28, 2021 May 28, 2021 H-3-12-0 Q-5-44-0
191 0206R0010521V000467 May 17, 2021 May 17, 2021 U-3-16-0 Q-5-44-0
192 0206R0010521V000687 May 24, 2021 May 24, 2021 U-3-16-0 Q-5-44-0

193 0206R0010521V000532 May 19, 2021 May 19, 2021 H-3-12-0 Q-5-44-0

194 0206R0010521V000225 May 7, 2021 May 7, 2021 H-3-12-0 Q-5-44-0

195 0206R0010521V000517 May 18, 2021 May 18, 2021 H-3-12-0 Q-5-44-0
196 0206R0010521V000782 May 25, 2021 May 25, 2021 H-3-12-0 Q-5-44-0
197 0206R0010521V000154 May 6, 2021 May 6, 2021 H-3-12-0 Q-5-44-0
198 0206R0010521V000493 May 18, 2021 May 18, 2021 H-3-12-0 Q-5-44-0
199 0206R0010521V000465 May 17, 2021 May 17, 2021 H-3-12-0 Q-5-44-0
200 0206R0010521V000621 5/21/2021 5/21/2021 Q-5-42-0
Total
 SUD KUMPULAN PANE TEBING TINGGI
AYANAN MEI 2021

Biaya Kelebihan
Biaya Audit Keterangan
Verifikasi Bayar

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
186,800 114,400 72,400 poli IRM fiisoterapi

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
290,300 - 290,300 Pelayanan Tambal Gigi di FKTP
 216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
1,239,700 185,500 1,054,200 salah kode, lebih tepat 9821

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
 216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
290,300 - 290,300 Pelayanan Tambal Gigi di FKTP
290,300 - 290,300 Pelayanan Tambal Gigi di FKTP

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
186,800 186,800 fisioterapi tanpa prosedur
44,388,200 36,286,900 8,101,300
SANGGAHAN RSKP

dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib untuk
dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan pengembalian
uang kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.

SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS

dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib untuk
dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan pengembalian
uang kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.

SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS
dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib untuk
dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan pengembalian
uang kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.

SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS

dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib untuk
dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan pengembalian
uang kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.

SDA
SDA
SDA
SDA
SDA
ACC BPJS
ACC BPJS

dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib untuk
dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan pengembalian
uang kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.

SDA
SDA
SDA
SDA
SDA
SDA
 HASIL VERIFIKASI PASKA KLAIM RSUD KUMPULAN PANE TEBING
BULAN PELAYANAN JUNI 2021

No NoSJP TglDtgSJP TglPlgSJP CBG CBG Audit

Q-5-44-0

1 0206R0010621V000034 June 2, 2021 June 2, 2021 H-3-12-0

2 0206R0010621V000769 June 23, 2021 June 23, 2021 H-3-12-0 Q-5-44-0
3 0206R0010621V000027 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
4 0206R0010621V000255 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
5 0206R0010621V000516 June 16, 2021 June 16, 2021 H-3-12-0 Q-5-44-0
6 0206R0010621V000750 June 23, 2021 June 23, 2021 H-3-12-0 Q-5-44-0
7 0206R0010621V000958 June 30, 2021 June 30, 2021 H-3-12-0 Q-5-44-0
8 0206R0010621V000023 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
9 0206R0010621V000656 June 21, 2021 June 21, 2021 H-3-12-0 Q-5-44-0
10 0206R0010621V000885 June 28, 2021 June 28, 2021 H-3-12-0 Q-5-44-0
11 0206R0010621V000029 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
12 0206R0010621V000738 June 22, 2021 June 22, 2021 H-3-12-0 Q-5-44-0
13 0206R0010621V000083 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
14 0206R0010621V000588 June 17, 2021 June 17, 2021 H-3-12-0 Q-5-44-0
15 0206R0010621V000811 June 24, 2021 June 24, 2021 H-3-12-0 Q-5-44-0
16 0206R0010621V000185 June 7, 2021 June 7, 2021 H-3-12-0 Q-5-44-0
17 0206R0010621V000430 June 14, 2021 June 14, 2021 H-3-12-0 Q-5-44-0
18 0206R0010621V000096 June 3, 2021 June 3, 2021 H-3-12-0 Q-5-44-0
19 0206R0010621V000442 June 14, 2021 June 14, 2021 H-3-12-0 Q-5-44-0
20 0206R0010621V000016 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
21 0206R0010621V000707 June 22, 2021 June 22, 2021 H-3-12-0 Q-5-44-0
22 0206R0010621V000050 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
23 0206R0010621V000279 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
24 0206R0010621V000560 June 16, 2021 June 16, 2021 H-3-12-0 Q-5-44-0
25 0206R0010621V000755 June 23, 2021 June 23, 2021 H-3-12-0 Q-5-44-0
26 0206R0010621V000966 June 30, 2021 June 30, 2021 H-3-12-0 Q-5-44-0
27 0206R0010621V000395 June 11, 2021 June 11, 2021 H-3-12-0 Q-5-44-0
28 0206R0010621V000045 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
29 0206R0010621V000024 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
30 0206R0010621V000259 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
31 0206R0010621V000518 June 16, 2021 June 16, 2021 H-3-12-0 Q-5-44-0
32 0206R0010621V000751 June 23, 2021 June 23, 2021 H-3-12-0 Q-5-44-0
33 0206R0010621V000956 June 30, 2021 June 30, 2021 H-3-12-0 Q-5-44-0
34 0206R0010621V000661 June 21, 2021 June 21, 2021 H-3-12-0 Q-5-44-0
35 0206R0010621V000026 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
36 0206R0010621V000256 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
37 0206R0010621V000520 June 16, 2021 June 16, 2021 H-3-12-0 Q-5-44-0
38 0206R0010621V000752 June 23, 2021 June 23, 2021 H-3-12-0 Q-5-44-0
39 0206R0010621V000957 June 30, 2021 June 30, 2021 H-3-12-0 Q-5-44-0
40 0206R0010621V000257 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
41 0206R0010621V000840 June 24, 2021 June 24, 2021 H-3-12-0 Q-5-44-0
42 0206R0010621V000837 June 24, 2021 June 24, 2021 H-3-12-0 Q-5-44-0
43 0206R0010621V000719 June 22, 2021 June 22, 2021 H-3-12-0 Q-5-44-0
44 0206R0010621V000018 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
45 0206R0010621V000342 June 10, 2021 June 10, 2021 H-3-12-0 Q-5-44-0
46 0206R0010621V000747 June 23, 2021 June 23, 2021 H-3-12-0 Q-5-44-0
47 0206R0010621V000963 June 30, 2021 June 30, 2021 H-3-12-0 Q-5-44-0
48 0206R0010621V000335 June 10, 2021 June 10, 2021 H-3-12-0 Q-5-44-0
49 0206R0010621V000576 June 17, 2021 June 17, 2021 H-3-12-0 Q-5-44-0
50 0206R0010621V000931 June 29, 2021 June 29, 2021 H-3-12-0 Q-5-44-0
51 0206R0010621V000277 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
52 0206R0010621V000033 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
53 0206R0010621V000331 June 10, 2021 June 10, 2021 H-3-12-0 Q-5-44-0
54 0206R0010621V000591 June 17, 2021 June 17, 2021 H-3-12-0 Q-5-44-0
55 0206R0010621V000893 June 28, 2021 June 28, 2021 H-3-12-0 Q-5-44-0
56 0206R0010621V000839 June 24, 2021 June 24, 2021 A-4-10-II Q-5-44-0

Q-5-44-0

57 0206R0010621V000017 June 2, 2021 June 2, 2021 H-3-12-0

58 0206R0010621V000708 June 22, 2021 June 22, 2021 H-3-12-0 Q-5-44-0
59 0206R0010621V000434 June 14, 2021 June 14, 2021 H-3-12-0 Q-5-44-0
60 0206R0010621V000585 June 17, 2021 June 17, 2021 H-3-12-0 Q-5-44-0
61 0206R0010621V000266 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
62 0206R0010621V000056 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
63 0206R0010621V000281 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
64 0206R0010621V000717 June 22, 2021 June 22, 2021 H-3-12-0 Q-5-44-0
65 0206R0010621V000055 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
66 0206R0010621V000273 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
67 0206R0010621V000533 June 16, 2021 June 16, 2021 H-3-12-0 Q-5-44-0
68 0206R0010621V000771 June 23, 2021 June 23, 2021 H-3-12-0 Q-5-44-0
69 0206R0010621V000988 June 30, 2021 June 30, 2021 H-3-12-0 Q-5-44-0
70 0206R0010621V000015 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
71 0206R0010621V000709 June 22, 2021 June 22, 2021 H-3-12-0 Q-5-44-0
72 0206R0010621V000187 June 7, 2021 June 7, 2021 H-3-12-0 Q-5-44-0
73 0206R0010621V000414 June 11, 2021 June 13, 2021 W-4-16-I Q-5-44-0

Q-5-44-0

74 0206R0010621V000253 June 9, 2021 June 9, 2021 H-3-12-0

75 0206R0010621V000019 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
76 0206R0010621V000269 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
77 0206R0010621V000749 June 23, 2021 June 23, 2021 H-3-12-0 Q-5-44-0
78 0206R0010621V000040 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
79 0206R0010621V000534 June 16, 2021 June 16, 2021 H-3-12-0 Q-5-44-0
80 0206R0010621V000263 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
81 0206R0010621V000514 June 16, 2021 June 16, 2021 H-3-12-0 Q-5-44-0
82 0206R0010621V000684 June 21, 2021 June 21, 2021 H-3-12-0 Q-5-44-0
83 0206R0010621V000905 June 28, 2021 June 28, 2021 H-3-12-0 Q-5-44-0
84 0206R0010621V000477 June 15, 2021 June 15, 2021 H-3-12-0 Q-5-44-0
85 0206R0010621V000987 June 30, 2021 June 30, 2021 H-3-12-0 Q-5-44-0
86 0206R0010621V000528 June 16, 2021 June 16, 2021 H-3-12-0 Q-5-44-0
87 0206R0010621V000433 June 14, 2021 June 14, 2021 H-3-12-0 Q-5-44-0
88 0206R0010621V000670 June 21, 2021 June 21, 2021 H-3-12-0 Q-5-44-0
89 0206R0010621V000515 June 16, 2021 June 16, 2021 H-3-12-0 Q-5-44-0
90 0206R0010621V000748 June 23, 2021 June 23, 2021 H-3-12-0 Q-5-44-0
91 0206R0010621V000184 June 7, 2021 June 7, 2021 H-3-12-0 Q-5-44-0
92 0206R0010621V000427 June 14, 2021 June 14, 2021 H-3-12-0 Q-5-44-0
93 0206R0010621V000660 June 21, 2021 June 21, 2021 H-3-12-0 Q-5-44-0
94 0206R0010621V000385 June 11, 2021 June 11, 2021 H-3-12-0 Q-5-44-0
95 0206R0010621V000851 June 25, 2021 June 25, 2021 H-3-12-0 Q-5-44-0
96 0206R0010621V000590 June 17, 2021 June 17, 2021 H-3-12-0 Q-5-44-0
97 0206R0010621V000150 June 4, 2021 June 4, 2021 H-3-12-0 Q-5-44-0
98 0206R0010621V000387 June 11, 2021 June 11, 2021 H-3-12-0 Q-5-44-0
99 0206R0010621V000673 June 21, 2021 June 21, 2021 H-3-12-0 Q-5-44-0
100 0206R0010621V000900 June 28, 2021 June 28, 2021 H-3-12-0 Q-5-44-0
101 0206R0010621V000021 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
102 0206R0010621V000265 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
103 0206R0010621V000345 June 10, 2021 June 10, 2021 H-3-12-0 Q-5-44-0
104 0206R0010621V000596 June 17, 2021 June 17, 2021 H-3-12-0 Q-5-44-0
105 0206R0010621V000841 June 24, 2021 June 24, 2021 H-3-12-0 Q-5-44-0
106 0206R0010621V000669 June 21, 2021 June 21, 2021 H-3-12-0 Q-5-44-0
107 0206R0010621V000261 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
108 0206R0010621V000519 June 16, 2021 June 16, 2021 H-3-12-0 Q-5-44-0
109 0206R0010621V000039 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
110 0206R0010621V000359 June 10, 2021 June 10, 2021 H-3-12-0 Q-5-44-0
111 0206R0010621V000600 June 17, 2021 June 17, 2021 H-3-12-0 Q-5-44-0
112 0206R0010621V000818 June 24, 2021 June 24, 2021 H-3-12-0 Q-5-44-0
113 0206R0010621V000148 June 4, 2021 June 4, 2021 H-3-12-0 Q-5-44-0
114 0206R0010621V000047 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
115 0206R0010621V000506 June 16, 2021 June 16, 2021 H-3-12-0 Q-5-44-0
116 0206R0010621V000384 June 11, 2021 June 11, 2021 H-3-12-0 Q-5-44-0
117 0206R0010621V000850 June 25, 2021 June 25, 2021 H-3-12-0 Q-5-44-0
118 0206R0010621V000164 June 4, 2021 June 4, 2021 H-3-12-0 Q-5-44-0
119 0206R0010621V000155 June 4, 2021 June 4, 2021 H-3-12-0 Q-5-44-0
120 0206R0010621V000143 June 4, 2021 June 4, 2021 H-3-12-0 Q-5-44-0
121 0206R0010621V000480 June 15, 2021 June 15, 2021 H-3-12-0 Q-5-44-0
122 0206R0010621V000240 June 7, 2021 June 7, 2021 Z-4-12-I Q-5-44-0

Q-5-44-0

123 0206R0010621V000190 June 7, 2021 June 7, 2021 H-3-12-0

124 0206R0010621V000254 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
125 0206R0010621V000913 June 28, 2021 June 28, 2021 H-3-12-0 Q-5-44-0
126 0206R0010621V000607 June 17, 2021 June 17, 2021 H-3-12-0 Q-5-44-0
127 0206R0010621V000200 June 7, 2021 June 7, 2021 H-3-12-0 Q-5-44-0
128 0206R0010621V000586 June 17, 2021 June 17, 2021 H-3-12-0 Q-5-44-0
129 0206R0010621V000801 June 24, 2021 June 24, 2021 H-3-12-0 Q-5-44-0
130 0206R0010621V000777 June 23, 2021 June 23, 2021 H-3-12-0 Q-5-44-0
131 0206R0010621V000986 June 30, 2021 June 30, 2021 H-3-12-0 Q-5-44-0
132 0206R0010621V000819 June 24, 2021 June 24, 2021 H-3-12-0 Q-5-44-0
133 0206R0010621V000575 June 17, 2021 June 17, 2021 H-3-12-0 Q-5-44-0
134 0206R0010621V000424 June 14, 2021 June 14, 2021 H-3-12-0 Q-5-44-0
135 0206R0010621V000666 June 21, 2021 June 21, 2021 H-3-12-0 Q-5-44-0
136 0206R0010621V000884 June 28, 2021 June 28, 2021 H-3-12-0 Q-5-44-0
137 0206R0010621V000584 June 17, 2021 June 17, 2021 H-3-12-0 Q-5-44-0
138 0206R0010621V000803 June 24, 2021 June 24, 2021 H-3-12-0 Q-5-44-0
139 0206R0010621V000650 June 21, 2021 June 21, 2021 H-3-12-0 Q-5-44-0
140 0206R0010621V000183 June 7, 2021 June 7, 2021 H-3-12-0 Q-5-44-0
141 0206R0010621V000888 June 28, 2021 June 28, 2021 H-3-12-0 Q-5-44-0
142 0206R0010621V000431 June 14, 2021 June 14, 2021 H-3-12-0 Q-5-44-0
143 0206R0010621V000089 June 3, 2021 June 3, 2021 H-3-12-0 Q-5-44-0
144 0206R0010621V000436 June 14, 2021 June 14, 2021 H-3-12-0 Q-5-44-0
145 0206R0010621V000723 June 22, 2021 June 22, 2021 H-3-12-0 Q-5-44-0
146 0206R0010621V000960 June 30, 2021 June 30, 2021 H-3-12-0 Q-5-44-0
147 0206R0010621V000048 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
148 0206R0010621V000341 June 10, 2021 June 10, 2021 H-3-12-0 Q-5-44-0
149 0206R0010621V000663 June 21, 2021 June 21, 2021 H-3-12-0 Q-5-44-0
150 0206R0010621V000147 June 4, 2021 June 4, 2021 H-3-12-0 Q-5-44-0
151 0206R0010621V000186 June 7, 2021 June 7, 2021 H-3-12-0 Q-5-44-0
152 0206R0010621V000425 June 14, 2021 June 14, 2021 H-3-12-0 Q-5-44-0
153 0206R0010621V000659 June 21, 2021 June 21, 2021 H-3-12-0 Q-5-44-0
154 0206R0010621V000881 June 28, 2021 June 28, 2021 H-3-12-0 Q-5-44-0
155 0206R0010621V000229 June 7, 2021 June 7, 2021 H-3-12-0 Q-5-44-0
156 0206R0010621V000429 June 14, 2021 June 14, 2021 H-3-12-0 Q-5-44-0
157 0206R0010621V000838 June 24, 2021 June 24, 2021 H-3-12-0 Q-5-44-0
158 0206R0010621V000035 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
159 0206R0010621V000337 June 10, 2021 June 10, 2021 H-3-12-0 Q-5-44-0
160 0206R0010621V000141 June 4, 2021 June 4, 2021 H-3-12-0 Q-5-44-0
161 0206R0010621V000767 June 23, 2021 June 23, 2021 H-3-12-0 Q-5-44-0
162 0206R0010621V000137 June 4, 2021 June 4, 2021 H-3-12-0 Q-5-44-0
163 0206R0010621V000664 June 21, 2021 June 21, 2021 H-3-12-0 Q-5-44-0
164 0206R0010621V000861 June 25, 2021 June 25, 2021 H-3-12-0 Q-5-44-0
165 0206R0010621V000652 June 21, 2021 June 21, 2021 H-3-12-0 Q-5-44-0
166 0206R0010621V000577 June 17, 2021 June 17, 2021 H-3-12-0 Q-5-44-0
167 0206R0010621V000565 June 15, 2021 June 20, 2021 J-4-17-I J-4-17-I

Q-5-44-0

168 0206R0010621V000084 June 2, 2021 June 2, 2021 H-3-12-0

169 0206R0010621V000583 June 17, 2021 June 17, 2021 H-3-12-0 Q-5-44-0
170 0206R0010621V000806 June 24, 2021 June 24, 2021 H-3-12-0 Q-5-44-0
171 0206R0010621V000386 June 10, 2021 June 14, 2021 W-4-16-II W-4-16-II

Q-5-44-0

172 0206R0010621V000614 June 17, 2021 June 17, 2021 H-3-12-0

173 0206R0010621V000807 June 24, 2021 June 24, 2021 H-3-12-0 Q-5-44-0
174 0206R0010621V000049 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
175 0206R0010621V000278 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
176 0206R0010621V000307 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
177 0206R0010621V000441 June 14, 2021 June 14, 2021 H-3-12-0 Q-5-44-0
178 0206R0010621V000878 June 28, 2021 June 28, 2021 H-3-12-0 Q-5-44-0
179 0206R0010621V000028 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
180 0206R0010621V000657 June 21, 2021 June 21, 2021 H-3-12-0 Q-5-44-0
181 0206R0010621V000886 June 28, 2021 June 28, 2021 H-3-12-0 Q-5-44-0
182 0206R0010621V000268 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
183 0206R0010621V000505 June 16, 2021 June 16, 2021 H-3-12-0 Q-5-44-0
184 0206R0010621V000764 June 23, 2021 June 23, 2021 H-3-12-0 Q-5-44-0
185 0206R0010621V000961 June 30, 2021 June 30, 2021 H-3-12-0 Q-5-44-0
186 0206R0010621V000052 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
187 0206R0010621V000280 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
188 0206R0010621V000095 June 3, 2021 June 3, 2021 H-3-12-0 Q-5-44-0
189 0206R0010621V000651 June 21, 2021 June 21, 2021 H-3-12-0 Q-5-44-0
190 0206R0010621V000589 June 17, 2021 June 17, 2021 H-3-12-0 Q-5-44-0
191 0206R0010621V000802 June 24, 2021 June 24, 2021 H-3-12-0 Q-5-44-0
192 0206R0010621V000136 June 4, 2021 June 4, 2021 H-3-12-0 Q-5-44-0
193 0206R0010621V000194 June 7, 2021 June 7, 2021 H-3-12-0 Q-5-44-0
194 0206R0010621V000420 June 14, 2021 June 14, 2021 H-3-12-0 Q-5-44-0
195 0206R0010621V000662 June 21, 2021 June 21, 2021 H-3-12-0 Q-5-44-0
196 0206R0010621V000883 June 28, 2021 June 28, 2021 H-3-12-0 Q-5-44-0
197 0206R0010621V000347 June 10, 2021 June 10, 2021 H-3-12-0 Q-5-44-0
198 0206R0010621V000582 June 17, 2021 June 17, 2021 H-3-12-0 Q-5-44-0
199 0206R0010621V000025 June 2, 2021 June 2, 2021 H-3-12-0 Q-5-44-0
200 0206R0010621V000270 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
201 0206R0010621V000262 June 9, 2021 June 9, 2021 H-3-12-0 Q-5-44-0
202 0206R0010621V000517 June 16, 2021 June 16, 2021 H-3-12-0 Q-5-44-0
203 0206R0010621V000667 June 21, 2021 June 21, 2021 H-3-12-0 Q-5-44-0
204 0206R0010621V000343 June 10, 2021 June 10, 2021 H-3-12-0 Q-5-44-0
205 0206R0010621V000592 June 17, 2021 June 17, 2021 H-3-12-0 Q-5-44-0
206 0206R0010621V000330 June 10, 2021 June 10, 2021 H-3-12-0 Q-5-44-0
207 0206R0010621V000579 June 17, 2021 June 17, 2021 H-3-12-0 Q-5-44-0
208 0206R0010621V000815 June 24, 2021 June 24, 2021 H-3-12-0 Q-5-44-0
209 0206R0010621V000203 June 7, 2021 June 7, 2021 H-3-12-0 Q-5-44-0
210 0206R0010621V000536 June 16, 2021 June 16, 2021 H-3-12-0 Q-5-44-0
211 0206R0010621V000327 June 10, 2021 June 10, 2021 H-3-12-0 Q-5-44-0
212 0206R0010621V000805 June 24, 2021 June 24, 2021 H-3-12-0 Q-5-44-0
213 0206R0010621V000763 June 23, 2021 June 23, 2021 H-3-12-0 Q-5-44-0
214 0206R0010621V000849 June 25, 2021 June 25, 2021 H-3-12-0 Q-5-44-0
215 0206R0010621V000808 June 24, 2021 June 24, 2021 H-3-12-0 Q-5-44-0
216 0206R0010621V000160 June 4, 2021 June 4, 2021 H-3-12-0 Q-5-44-0
217 0206R0010621V000397 June 11, 2021 June 11, 2021 H-3-12-0 Q-5-44-0
218 0206R0010621V000694 June 21, 2021 June 21, 2021 H-3-12-0 Q-5-44-0
219 0206R0010621V000507 June 16, 2021 June 16, 2021 H-3-12-0 Q-5-44-0
220 0206R0010621V000542 June 16, 2021 June 16, 2021 H-3-12-0 Q-5-44-0
221 0206R0010621V000809 June 24, 2021 June 24, 2021 H-3-12-0 Q-5-44-0
222 0206R0010621V000870 June 26, 2021 June 26, 2021 Q-5-42-0 Q-5-42-0
223 0206R0010621V000745 June 22, 2021 June 22, 2021 Q-5-42-0 Q-5-42-0
224 0206R0010621V000302 June 9, 2021 June 9, 2021 J-4-16-I J-4-17-I
Total
 AIM RSUD KUMPULAN PANE TEBING TINGGI
N PELAYANAN JUNI 2021
Biaya Kelebihan
Biaya Audit Keterangan
Verifikasi Bayar

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
 216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
4,254,600 185,500 4,069,100 Pelayanan < 6 jam RJTL

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
2,130,400 1,645,700 484,700 pasien persalinan Normal DU O800

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
 216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
1,843,900 185,500 1,658,400 Pelayanan < 6 jam RJTL

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
 216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
3,624,300 2,296,300 1,328,000 J44 tanpa spirometri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
2,848,800 2,337,400 511,400 pasien persalinan Normal DU O800

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
 216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
216,000 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
186,800 186,800 Tidak diagnosa emergency
186,800 186,800 Tidak diagnosa emergency
4,970,100 2,296,300 2,673,800 resort yang di berikan tidak sesuai
66,701,700 49,014,700 17,687,000
SANGGAHAN RSKP

dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib
untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan
pengembalian uang kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.

SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
TIDAK ACC PERAWATAN LEBIH 6 JAM OS MASUK JAM 02.16 KELUAR 14.08

dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib
untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan
pengembalian uang kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.

SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS

dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib
untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan
pengembalian uang kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.

SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS

dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib
untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan
pengembalian uang kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.

SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS

dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib
untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan
pengembalian uang kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.

SDA
SDA
ACC BPJS

dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib
untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan
pengembalian uang kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.

SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS
ACC BPJS
KODE GANTI SUSPEK Z03.8
 HASIL VERIFIKASI PASKA KLAIM RSUD KUMPULAN PANE TEB
BULAN PELAYANAN JUNI 2021

Biaya
No NoSJP TglDtgSJP TglPlgSJP CBG CBG Audit
Verifikasi

Q-5-44-0

1 0206R0010721V000821 July 28, 2021 July 28, 2021 H-3-12-0 216,000

2 0206R0010721V000817 July 28, 2021 July 28, 2021 H-3-12-0 Q-5-44-0 216,000
3 0206R0010721V000808 July 28, 2021 July 28, 2021 H-3-12-0 Q-5-44-0 216,000
4 0206R0010721V000094 July 5, 2021 July 5, 2021 H-3-12-0 Q-5-44-0 216,000
5 0206R0010721V000309 July 12, 2021 July 12, 2021 H-3-12-0 Q-5-44-0 216,000
6 0206R0010721V000528 July 19, 2021 July 19, 2021 H-3-12-0 Q-5-44-0 216,000
7 0206R0010721V000730 July 26, 2021 July 26, 2021 H-3-12-0 Q-5-44-0 216,000
8 0206R0010721V000368 July 13, 2021 July 13, 2021 H-3-12-0 Q-5-44-0 216,000
9 0206R0010721V000026 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
10 0206R0010721V000849 July 29, 2021 July 29, 2021 H-3-12-0 Q-5-44-0 216,000
11 0206R0010721V000893 July 30, 2021 July 30, 2021 H-3-12-0 Q-5-44-0 216,000
12 0206R0010721V000151 July 6, 2021 July 6, 2021 H-3-12-0 Q-5-44-0 216,000
13 0206R0010721V000433 July 15, 2021 July 15, 2021 H-3-12-0 Q-5-44-0 216,000
14 0206R0010721V000673 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
15 0206R0010721V000868 July 29, 2021 July 29, 2021 H-3-12-0 Q-5-44-0 216,000
16 0206R0010721V000157 July 6, 2021 July 6, 2021 H-3-12-0 Q-5-44-0 216,000
17 0206R0010721V000167 July 7, 2021 July 7, 2021 H-3-12-0 Q-5-44-0 216,000
18 0206R0010721V000587 July 21, 2021 July 21, 2021 H-3-12-0 Q-5-44-0 216,000
19 0206R0010721V000809 July 28, 2021 July 28, 2021 H-3-12-0 Q-5-44-0 216,000
20 0206R0010721V000166 July 7, 2021 July 7, 2021 H-3-12-0 Q-5-44-0 216,000
21 0206R0010721V000386 July 14, 2021 July 14, 2021 H-3-12-0 Q-5-44-0 216,000
22 0206R0010721V000807 July 28, 2021 July 28, 2021 H-3-12-0 Q-5-44-0 216,000
23 0206R0010721V000385 July 14, 2021 July 14, 2021 H-3-12-0 Q-5-44-0 216,000
24 0206R0010721V000473 July 15, 2021 July 15, 2021 H-3-12-0 Q-5-44-0 216,000
25 0206R0010721V000641 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
26 0206R0010721V000225 July 8, 2021 July 8, 2021 H-3-12-0 Q-5-44-0 216,000
27 0206R0010721V000441 July 15, 2021 July 15, 2021 H-3-12-0 Q-5-44-0 216,000
28 0206R0010721V000854 July 29, 2021 July 29, 2021 H-3-12-0 Q-5-44-0 216,000
29 0206R0010721V000011 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
30 0206R0010721V000179 July 7, 2021 July 7, 2021 H-3-12-0 Q-5-44-0 216,000
31 0206R0010721V000392 July 14, 2021 July 14, 2021 H-3-12-0 Q-5-44-0 216,000
32 0206R0010721V000662 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
33 0206R0010721V000865 July 29, 2021 July 29, 2021 H-3-12-0 Q-5-44-0 216,000
34 0206R0010721V000017 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
35 0206R0010721V000439 July 15, 2021 July 15, 2021 H-3-12-0 Q-5-44-0 216,000
36 0206R0010721V000221 July 8, 2021 July 8, 2021 H-3-12-0 Q-5-44-0 216,000
37 0206R0010721V000447 July 15, 2021 July 15, 2021 H-3-12-0 Q-5-44-0 216,000
38 0206R0010721V000652 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
39 0206R0010721V000874 July 29, 2021 July 29, 2021 H-3-12-0 Q-5-44-0 216,000
40 0206R0010721V000140 July 6, 2021 July 6, 2021 H-3-12-0 Q-5-44-0 216,000
41 0206R0010721V000158 July 6, 2021 July 6, 2021 H-3-12-0 Q-5-44-0 216,000
42 0206R0010721V000436 July 15, 2021 July 15, 2021 H-3-12-0 Q-5-44-0 216,000
43 0206R0010721V000227 July 8, 2021 July 8, 2021 H-3-12-0 Q-5-44-0 216,000
44 0206R0010721V000015 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
45 0206R0010721V000258 July 8, 2021 July 8, 2021 H-3-12-0 Q-5-44-0 216,000
46 0206R0010721V000566 July 19, 2021 July 19, 2021 H-3-12-0 Q-5-44-0 216,000
47 0206R0010721V000741 July 26, 2021 July 26, 2021 H-3-12-0 Q-5-44-0 216,000
48 0206R0010721V000109 July 5, 2021 July 5, 2021 H-3-12-0 Q-5-44-0 216,000
49 0206R0010721V000437 July 15, 2021 July 15, 2021 H-3-12-0 Q-5-44-0 216,000
50 0206R0010721V000069 July 2, 2021 July 2, 2021 H-3-12-0 Q-5-44-0 216,000
51 0206R0010721V000182 July 7, 2021 July 7, 2021 H-3-12-0 Q-5-44-0 216,000
52 0206R0010721V000455 July 15, 2021 July 15, 2021 H-3-12-0 Q-5-44-0 216,000
53 0206R0010721V000661 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
54 0206R0010721V000869 July 29, 2021 July 29, 2021 H-3-12-0 Q-5-44-0 216,000
55 0206R0010721V000009 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
56 0206R0010721V000636 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
57 0206R0010721V000855 July 29, 2021 July 29, 2021 H-3-12-0 Q-5-44-0 216,000
58 0206R0010721V000053 July 2, 2021 July 2, 2021 H-3-12-0 Q-5-44-0 216,000
59 0206R0010721V000159 July 6, 2021 July 6, 2021 H-3-12-0 Q-5-44-0 216,000
60 0206R0010721V000106 July 5, 2021 July 5, 2021 H-3-12-0 Q-5-44-0 216,000
61 0206R0010721V000350 July 12, 2021 July 12, 2021 H-3-12-0 Q-5-44-0 216,000
62 0206R0010721V000590 July 21, 2021 July 21, 2021 H-3-12-0 Q-5-44-0 216,000
63 0206R0010721V000892 July 30, 2021 July 30, 2021 H-3-12-0 Q-5-44-0 216,000
64 0206R0010721V000331 July 12, 2021 July 12, 2021 H-3-12-0 Q-5-44-0 216,000
65 0206R0010721V000428 July 14, 2021 July 14, 2021 H-3-12-0 Q-5-44-0 216,000
66 0206R0010721V000853 July 29, 2021 July 29, 2021 H-3-12-0 Q-5-44-0 216,000
67 0206R0010721V000153 July 6, 2021 July 6, 2021 H-3-12-0 Q-5-44-0 216,000
68 0206R0010721V000442 July 15, 2021 July 15, 2021 H-3-12-0 Q-5-44-0 216,000
69 0206R0010721V000744 July 26, 2021 July 26, 2021 H-3-12-0 Q-5-44-0 216,000
70 0206R0010721V000384 July 14, 2021 July 14, 2021 H-3-12-0 Q-5-44-0 216,000
71 0206R0010721V000091 July 5, 2021 July 5, 2021 H-3-12-0 Q-5-44-0 216,000
72 0206R0010721V000540 July 19, 2021 July 19, 2021 H-3-12-0 Q-5-44-0 216,000
73 0206R0010721V000735 July 26, 2021 July 26, 2021 H-3-12-0 Q-5-44-0 216,000
74 0206R0010721V000265 July 9, 2021 July 9, 2021 H-3-12-0 Q-5-44-0 216,000
75 0206R0010721V000530 July 19, 2021 July 19, 2021 H-3-12-0 Q-5-44-0 216,000
76 0206R0010721V000089 July 5, 2021 July 5, 2021 H-3-12-0 Q-5-44-0 216,000
77 0206R0010721V000305 July 12, 2021 July 12, 2021 H-3-12-0 Q-5-44-0 216,000
78 0206R0010721V000727 July 26, 2021 July 26, 2021 H-3-12-0 Q-5-44-0 216,000
79 0206R0010721V000272 July 9, 2021 July 9, 2021 H-3-12-0 Q-5-44-0 216,000
80 0206R0010721V000911 July 30, 2021 July 30, 2021 H-3-12-0 Q-5-44-0 216,000
81 0206R0010721V000031 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
82 0206R0010721V000674 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
83 0206R0010721V000852 July 29, 2021 July 29, 2021 H-3-12-0 Q-5-44-0 216,000
84 0206R0010721V000337 July 12, 2021 July 12, 2021 H-3-12-0 Q-5-44-0 216,000
85 0206R0010721V000745 July 26, 2021 July 26, 2021 H-3-12-0 Q-5-44-0 216,000
86 0206R0010721V000022 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
87 0206R0010721V000555 July 19, 2021 July 19, 2021 H-3-12-0 Q-5-44-0 216,000
88 0206R0010721V000097 July 5, 2021 July 5, 2021 H-3-12-0 Q-5-44-0 216,000
89 0206R0010721V000037 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
90 0206R0010721V000256 July 8, 2021 July 8, 2021 H-3-12-0 Q-5-44-0 216,000
91 0206R0010721V000461 July 15, 2021 July 15, 2021 H-3-12-0 Q-5-44-0 216,000
92 0206R0010721V000648 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
93 0206R0010721V000875 July 29, 2021 July 29, 2021 H-3-12-0 Q-5-44-0 216,000
94 0206R0010721V000709 July 23, 2021 July 23, 2021 H-3-12-0 Q-5-44-0 216,000
95 0206R0010721V000332 July 12, 2021 July 12, 2021 H-3-12-0 Q-5-44-0 216,000
 96 0206R0010721V000273 July 9, 2021 July 9, 2021 H-3-12-0 Q-5-44-0 216,000
97 0206R0010721V000910 July 30, 2021 July 30, 2021 H-3-12-0 Q-5-44-0 216,000
98 0206R0010721V000046 July 2, 2021 July 2, 2021 H-3-12-0 Q-5-44-0 216,000
99 0206R0010721V000444 July 15, 2021 July 15, 2021 H-3-12-0 Q-5-44-0 216,000
100 0206R0010721V000637 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
101 0206R0010721V000266 July 9, 2021 July 9, 2021 H-2-33-0 Q-5-44-0 261,100

Q-5-44-0

102 0206R0010721V000006 July 1, 2021 July 1, 2021 H-3-12-0 216,000

103 0206R0010721V000467 July 15, 2021 July 15, 2021 H-3-12-0 Q-5-44-0 216,000
104 0206R0010721V000004 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
105 0206R0010721V000870 July 29, 2021 July 29, 2021 H-3-12-0 Q-5-44-0 216,000
106 0206R0010721V000543 July 19, 2021 July 19, 2021 H-3-12-0 Q-5-44-0 216,000
107 0206R0010721V000088 July 5, 2021 July 5, 2021 H-3-12-0 Q-5-44-0 216,000
108 0206R0010721V000306 July 12, 2021 July 12, 2021 H-3-12-0 Q-5-44-0 216,000
109 0206R0010721V000527 July 19, 2021 July 19, 2021 H-3-12-0 Q-5-44-0 216,000
110 0206R0010721V000007 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
111 0206R0010721V000150 July 6, 2021 July 6, 2021 H-3-12-0 Q-5-44-0 216,000
112 0206R0010721V000813 July 28, 2021 July 28, 2021 H-3-12-0 Q-5-44-0 216,000
113 0206R0010721V000023 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
114 0206R0010721V000675 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
115 0206R0010721V000486 July 16, 2021 July 16, 2021 N-4-10-II Q-5-44-0 5,683,800

Q-5-44-0

116 0206R0010721V000734 July 26, 2021 July 26, 2021 H-3-12-0 216,000
117 0206R0010721V000005 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
118 0206R0010721V000240 July 8, 2021 July 8, 2021 H-3-12-0 Q-5-44-0 216,000
119 0206R0010721V000453 July 15, 2021 July 15, 2021 H-3-12-0 Q-5-44-0 216,000
120 0206R0010721V000645 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
121 0206R0010721V000190 July 7, 2021 July 7, 2021 H-3-12-0 Q-5-44-0 216,000
122 0206R0010721V000303 July 12, 2021 July 12, 2021 H-3-12-0 Q-5-44-0 216,000
123 0206R0010721V000728 July 26, 2021 July 26, 2021 H-3-12-0 Q-5-44-0 216,000
124 0206R0010721V000883 July 29, 2021 July 29, 2021 H-3-12-0 Q-5-44-0 216,000
125 0206R0010721V000443 July 15, 2021 July 15, 2021 H-3-12-0 Q-5-44-0 216,000
126 0206R0010721V000643 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
127 0206R0010721V000044 July 2, 2021 July 2, 2021 H-3-12-0 Q-5-44-0 216,000
128 0206R0010721V000304 July 12, 2021 July 12, 2021 H-3-12-0 Q-5-44-0 216,000
129 0206R0010721V000729 July 26, 2021 July 26, 2021 H-3-12-0 Q-5-44-0 216,000
130 0206R0010721V000503 July 16, 2021 July 16, 2021 H-3-12-0 Q-5-44-0 216,000
131 0206R0010721V000754 July 26, 2021 July 26, 2021 H-3-12-0 Q-5-44-0 216,000
132 0206R0010721V000895 July 30, 2021 July 30, 2021 H-3-12-0 Q-5-44-0 216,000
133 0206R0010721V000010 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
134 0206R0010721V000640 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
135 0206R0010721V000650 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
136 0206R0010721V000872 July 29, 2021 July 29, 2021 H-3-12-0 Q-5-44-0 216,000
137 0206R0010721V000429 July 14, 2021 July 14, 2021 H-3-12-0 Q-5-44-0 216,000
138 0206R0010721V000169 July 7, 2021 July 7, 2021 H-3-12-0 Q-5-44-0 216,000
139 0206R0010721V000370 July 13, 2021 July 13, 2021 H-3-12-0 Q-5-44-0 216,000
140 0206R0010721V000644 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
141 0206R0010721V000308 July 12, 2021 July 12, 2021 H-3-12-0 Q-5-44-0 216,000
142 0206R0010721V000733 July 26, 2021 July 26, 2021 H-3-12-0 Q-5-44-0 216,000
143 0206R0010721V000351 July 12, 2021 July 12, 2021 H-3-12-0 Q-5-44-0 216,000
144 0206R0010721V000532 July 19, 2021 July 19, 2021 H-3-12-0 Q-5-44-0 216,000
145 0206R0010721V000736 July 26, 2021 July 26, 2021 H-3-12-0 Q-5-44-0 216,000
146 0206R0010721V000008 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
147 0206R0010721V000432 July 15, 2021 July 15, 2021 H-3-12-0 Q-5-44-0 216,000
148 0206R0010721V000638 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
149 0206R0010721V000856 July 29, 2021 July 29, 2021 H-3-12-0 Q-5-44-0 216,000
150 0206R0010721V000020 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
151 0206R0010721V000233 July 8, 2021 July 8, 2021 H-3-12-0 Q-5-44-0 216,000
152 0206R0010721V000859 July 29, 2021 July 29, 2021 H-3-12-0 Q-5-44-0 216,000
153 0206R0010721V000086 July 5, 2021 July 5, 2021 H-3-12-0 Q-5-44-0 216,000
154 0206R0010721V000526 July 19, 2021 July 19, 2021 H-3-12-0 Q-5-44-0 216,000
155 0206R0010721V000725 July 26, 2021 July 26, 2021 H-3-12-0 Q-5-44-0 216,000
156 0206R0010721V000810 July 28, 2021 July 28, 2021 H-3-12-0 Q-5-44-0 216,000
157 0206R0010721V000108 July 5, 2021 July 5, 2021 H-3-12-0 Q-5-44-0 216,000
158 0206R0010721V000435 July 15, 2021 July 15, 2021 H-3-12-0 Q-5-44-0 216,000
159 0206R0010721V000193 July 7, 2021 July 7, 2021 H-3-12-0 Q-5-44-0 216,000
160 0206R0010721V000327 July 12, 2021 July 12, 2021 H-3-12-0 Q-5-44-0 216,000
161 0206R0010721V000035 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
162 0206R0010721V000224 July 8, 2021 July 8, 2021 H-3-12-0 Q-5-44-0 216,000
163 0206R0010721V000798 July 27, 2021 July 27, 2021 H-3-12-0 Q-5-44-0 216,000
164 0206R0010721V000003 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
165 0206R0010721V000228 July 8, 2021 July 8, 2021 H-3-12-0 Q-5-44-0 216,000
166 0206R0010721V000851 July 29, 2021 July 29, 2021 H-3-12-0 Q-5-44-0 216,000
167 0206R0010721V000016 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
168 0206R0010721V000064 July 2, 2021 July 2, 2021 H-3-12-0 Q-5-44-0 216,000
169 0206R0010721V000421 July 14, 2021 July 14, 2021 H-3-12-0 Q-5-44-0 216,000
170 0206R0010721V000537 July 19, 2021 July 19, 2021 H-3-12-0 Q-5-44-0 216,000
171 0206R0010721V000160 July 6, 2021 July 6, 2021 H-3-12-0 Q-5-44-0 216,000
172 0206R0010721V000390 July 14, 2021 July 14, 2021 H-3-12-0 Q-5-44-0 216,000
173 0206R0010721V000647 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
174 0206R0010721V000867 July 29, 2021 July 29, 2021 H-3-12-0 Q-5-44-0 216,000
175 0206R0010721V000217 July 7, 2021 July 7, 2021 A-4-13-I Q-5-44-0 2,053,400

Q-5-44-0

176 0206R0010721V000074 July 2, 2021 July 2, 2021 H-3-12-0 216,000

177 0206R0010721V000682 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
178 0206R0010721V000642 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
179 0206R0010721V000861 July 29, 2021 July 29, 2021 H-3-12-0 Q-5-44-0 216,000
180 0206R0010721V000012 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
181 0206R0010721V000232 July 8, 2021 July 8, 2021 H-3-12-0 Q-5-44-0 216,000
182 0206R0010721V000438 July 15, 2021 July 15, 2021 H-3-12-0 Q-5-44-0 216,000
183 0206R0010721V000646 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
184 0206R0010721V000038 July 1, 2021 July 1, 2021 H-3-12-0 Q-5-44-0 216,000
185 0206R0010721V000445 July 15, 2021 July 15, 2021 H-3-12-0 Q-5-44-0 216,000
186 0206R0010721V000639 July 22, 2021 July 22, 2021 H-3-12-0 Q-5-44-0 216,000
Total 47,526,300
RSUD KUMPULAN PANE TEBING TINGGI
AYANAN JUNI 2021

Kelebihan
Biaya Audit Keterangan
Bayar

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 75,600 prosedur 1251 out, salah input sebenarnya dx I251

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 5,498,300 Pelayanan < 6 jam RJTL

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
 185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 1,867,900 Pelayanan < 6 jam RJTL

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri

185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
185,500 30,500 Kode Kontrol, Prosedur tidak perlu dientri
34,503,000 13,023,300
SANGGAHAN RSKP

dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib
untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan
pengembalian uang kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.

SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
ACC BPJS

dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib
untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan
pengembalian uang kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.

SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA

dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib
untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan
pengembalian uang kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.

SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
TIDAK ACC PERAWTAN LEBIH 6 JAM OS MASUK JAM 13.03 SD 22.00 WIB

dari hasil konfirmasi dr mata, pemeriksaan tersebut merupakan standar pemeriksaan dipoli mata yg wajib
untuk dilaksanakan oleh sebab itu kami memohon kepada bpjs agar tindakan tersebut tidak dilakukan
pengembalian uang kelebihan bayar, dan untuk kedepannya kami menunggu keputusan menajemen.

SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA
SDA