RptUmpanBalik RJ

UMPAN BALIK HASIL VERIFIKASI
Nama RS
Tingkat Pelayanan
:
:
Tgl.Pelayanan
RS PERMATA MADINA SIBUHUAN

RJTL
01 September 2014 s/d 30 September 2014
No
No.SEP
Tgl. Verifikasi
0475R00009140000001
29/10/2014
0475R00009140000002
29/10/2014
0475R00009140000003
29/10/2014
0475R00009140000004
29/10/2014
0475R00009140000005
29/10/2014
0475R00009140000006
29/10/2014
0475R00009140000007
29/10/2014
0475R00009140000008
29/10/2014
0475R00009140000009
29/10/2014
10
0475R00009140000010
29/10/2014
11
0475R00009140000011
29/10/2014
12
0475R00009140000012
29/10/2014
13
0475R00009140000013
29/10/2014
14
0475R00009140000014
29/10/2014
15
0475R00009140000015
29/10/2014
16
0475R00009140000016
29/10/2014
17
0475R00009140000017
29/10/2014
18
0475R00009140000018
29/10/2014
19
0475R00009140000019
29/10/2014
20
0475R00009140000020
29/10/2014
21
0475R00009140000021
29/10/2014
22
0475R00009140000022
29/10/2014
23
0475R00009140000023
29/10/2014
24
0475R00009140000024
29/10/2014
25
0475R00009140000025
29/10/2014
26
0475R00009140000026
29/10/2014
27
0475R00009140000027
29/10/2014
28
0475R00009140000028
29/10/2014
29
0475R00009140000029
29/10/2014
30
0475R00009140000030
29/10/2014
31
0475R00009140000031
29/10/2014
32
0475R00009140000032
29/10/2014
33
0475R00009140000033
29/10/2014
34
0475R00009140000034
29/10/2014
35
0475R00009140000035
29/10/2014
36
0475R00009140000036
29/10/2014
37
0475R00009140000038
29/10/2014
38
0475R00009140000039
29/10/2014
39
0475R00009140000040
29/10/2014

Nama RS
Tingkat Pelayanan
:
:
Tgl.Pelayanan

RJTL
40
0475R00009140000041
29/10/2014
41
0475R00009140000042
29/10/2014
42
0475R00009140000043
29/10/2014
43
0475R00009140000044
29/10/2014
44
0475R00009140000045
29/10/2014
45
0475R00009140000046
29/10/2014
46
0475R00009140000047
29/10/2014
47
0475R00009140000048
29/10/2014
48
0475R00009140000049
29/10/2014
49
0475R00009140000050
29/10/2014
50
0475R00009140000051
29/10/2014
51
0475R00009140000052
29/10/2014
52
0475R00009140000053
29/10/2014
53
0475R00009140000054
29/10/2014
54
0475R00009140000055
29/10/2014
55
0475R00009140000056
29/10/2014
56
0475R00009140000057
29/10/2014
57
0475R00009140000058
29/10/2014
58
0475R00009140000059
29/10/2014
59
0475R00009140000060
29/10/2014
60
0475R00009140000061
29/10/2014
61
0475R00009140000062
29/10/2014
62
0475R00009140000063
29/10/2014
63
0475R00009140000064
29/10/2014
64
0475R00009140000065
29/10/2014
65
0475R00009140000066
29/10/2014
66
0475R00009140000067
29/10/2014
67
0475R00009140000068
29/10/2014
68
0475R00009140000069
29/10/2014
69
0475R00009140000070
29/10/2014
70
0475R00009140000071
29/10/2014
71
0475R00009140000072
29/10/2014
72
0475R00009140000073
29/10/2014
73
0475R00009140000074
29/10/2014
74
0475R00009140000075
29/10/2014
75
0475R00009140000076
29/10/2014
76
0475R00009140000077
29/10/2014
77
0475R00009140000078
29/10/2014
78
0475R00009140000079
29/10/2014
79
0475R00009140000080
29/10/2014
80
0475R00009140000081
29/10/2014

Nama RS
Tingkat Pelayanan
:
:
Tgl.Pelayanan

RJTL
81
0475R00009140000082
29/10/2014
82
0475R00009140000083
29/10/2014
83
0475R00009140000084
29/10/2014
84
0475R00009140000085
29/10/2014
85
0475R00009140000086
29/10/2014
86
0475R00009140000087
29/10/2014
87
0475R00009140000088
29/10/2014
88
0475R00009140000089
29/10/2014
89
0475R00009140000090
29/10/2014
90
0475R00009140000091
29/10/2014
91
0475R00009140000092
29/10/2014
92
0475R00009140000093
29/10/2014
93
0475R00009140000094
29/10/2014
94
0475R00009140000095
29/10/2014
95
0475R00009140000096
29/10/2014
96
0475R00009140000097
29/10/2014
97
0475R00009140000098
29/10/2014
98
0475R00009140000099
29/10/2014
99
0475R00009140000100
29/10/2014
100
0475R00009140000102
29/10/2014
101
0475R00009140000103
29/10/2014
102
0475R00009140000104
29/10/2014
103
0475R00009140000105
29/10/2014
104
0475R00009140000106
29/10/2014
105
0475R00009140000107
29/10/2014
106
0475R00009140000108
29/10/2014
107
0475R00009140000109
29/10/2014
108
0475R00009140000110
29/10/2014
109
0475R00009140000111
29/10/2014
110
0475R00009140000112
29/10/2014
111
0475R00009140000113
29/10/2014
112
0475R00009140000114
29/10/2014
113
0475R00009140000115
29/10/2014
114
0475R00009140000116
29/10/2014
115
0475R00009140000117
29/10/2014
116
0475R00009140000118
29/10/2014
117
0475R00009140000119
29/10/2014
118
0475R00009140000120
29/10/2014
119
0475R00009140000121
29/10/2014
120
0475R00009140000122
29/10/2014
121
0475R00009140000123
29/10/2014

Nama RS
Tingkat Pelayanan
:
:
Tgl.Pelayanan

RJTL
122
0475R00009140000124
29/10/2014
123
0475R00009140000125
29/10/2014
124
0475R00009140000126
29/10/2014
125
0475R00009140000127
29/10/2014
126
0475R00009140000128
29/10/2014
127
0475R00009140000129
29/10/2014
128
0475R00009140000130
29/10/2014
129
0475R00009140000131
29/10/2014
130
0475R00009140000132
29/10/2014
131
0475R00009140000133
29/10/2014
132
0475R00009140000134
29/10/2014
133
0475R00009140000135
29/10/2014
134
0475R00009140000136
29/10/2014
135
0475R00009140000137
29/10/2014
136
0475R00009140000138
29/10/2014
137
0475R00009140000139
29/10/2014
138
0475R00009140000140
29/10/2014
139
0475R00009140000141
29/10/2014
140
0475R00009140000142
29/10/2014
141
0475R00009140000143
29/10/2014
142
0475R00009140000144
29/10/2014
143
0475R00009140000145
29/10/2014
144
0475R00009140000146
29/10/2014
145
0475R00009140000147
29/10/2014
146
0475R00009140000148
29/10/2014
147
0475R00009140000149
29/10/2014
148
0475R00009140000150
29/10/2014
149
0475R00009140000151
29/10/2014
150
0475R00009140000152
29/10/2014
151
0475R00009140000153
29/10/2014
152
0475R00009140000154
29/10/2014
153
0475R00009140000155
29/10/2014
154
0475R00009140000156
29/10/2014
155
0475R00009140000157
29/10/2014
156
0475R00009140000159
29/10/2014
157
0475R00009140000161
29/10/2014
158
0475R00009140000162
29/10/2014
159
0475R00009140000163
29/10/2014
160
0475R00009140000164
29/10/2014
161
0475R00009140000165
29/10/2014
162
0475R00009140000166
29/10/2014

Nama RS
Tingkat Pelayanan
:
:
Tgl.Pelayanan

RJTL
163
0475R00009140000167
29/10/2014
164
0475R00009140000168
29/10/2014
165
0475R00009140000169
29/10/2014
166
0475R00009140000170
29/10/2014
167
0475R00009140000171
29/10/2014
168
0475R00009140000172
29/10/2014
169
0475R00009140000173
29/10/2014
170
0475R00009140000174
29/10/2014
171
0475R00009140000175
29/10/2014
172
0475R00009140000176
29/10/2014
173
0475R00009140000177
29/10/2014
174
0475R00009140000178
29/10/2014
175
0475R00009140000179
29/10/2014
176
0475R00009140000180
29/10/2014
177
0475R00009140000181
29/10/2014
178
0475R00009140000182
29/10/2014
179
0475R00009140000183
29/10/2014
180
0475R00009140000184
29/10/2014
181
0475R00009140000185
29/10/2014
182
0475R00009140000187
29/10/2014
183
0475R00009140000188
29/10/2014
184
0475R00009140000189
29/10/2014
185
0475R00009140000190
29/10/2014
186
0475R00009140000191
29/10/2014
187
0475R00009140000192
29/10/2014
188
0475R00009140000193
29/10/2014
189
0475R00009140000194
29/10/2014
190
0475R00009140000195
29/10/2014
191
0475R00009140000196
29/10/2014
192
0475R00009140000197
29/10/2014
193
0475R00009140000198
29/10/2014
194
0475R00009140000199
29/10/2014
195
0475R00009140000200
29/10/2014
196
0475R00009140000201
29/10/2014
197
0475R00009140000202
29/10/2014
198
0475R00009140000204
29/10/2014
199
0475R00009140000205
29/10/2014
200
0475R00009140000206
29/10/2014
201
0475R00009140000207
29/10/2014
202
0475R00009140000208
29/10/2014
203
0475R00009140000209
29/10/2014

Nama RS
Tingkat Pelayanan
:
:
Tgl.Pelayanan

RJTL
204
0475R00009140000210
29/10/2014
205
0475R00009140000211
29/10/2014
206
0475R00009140000212
29/10/2014
207
0475R00009140000213
29/10/2014
208
0475R00009140000214
29/10/2014
209
0475R00009140000215
29/10/2014
210
0475R00009140000216
29/10/2014
211
0475R00009140000217
29/10/2014
212
0475R00009140000218
29/10/2014
213
0475R00009140000219
29/10/2014
214
0475R00009140000220
29/10/2014
215
0475R00009140000221
29/10/2014
216
0475R00009140000222
29/10/2014
217
0475R00009140000223
29/10/2014
218
0475R00009140000224
29/10/2014
219
0475R00009140000225
29/10/2014
220
0475R00009140000226
29/10/2014
221
0475R00009140000227
29/10/2014
222
0475R00009140000228
29/10/2014
223
0475R00009140000229
29/10/2014
224
0475R00009140000230
29/10/2014
225
0475R00009140000231
29/10/2014
226
0475R00009140000232
29/10/2014
227
0475R00009140000233
29/10/2014
228
0475R00009140000234
29/10/2014
229
0475R00009140000235
29/10/2014
230
0475R00009140000236
29/10/2014
231
0475R00009140000237
29/10/2014
232
0475R00009140000238
29/10/2014
233
0475R00009140000239
29/10/2014
234
0475R00009140000240
29/10/2014
235
0475R00009140000241
29/10/2014
236
0475R00009140000242
29/10/2014
237
0475R00009140000243
29/10/2014
238
0475R00009140000244
29/10/2014
239
0475R00009140000245
29/10/2014
240
0475R00009140000246
29/10/2014
241
0475R00009140000247
29/10/2014
242
0475R00009140000248
29/10/2014
243
0475R00009140000249
29/10/2014
244
0475R00009140000250
29/10/2014

Nama RS
Tingkat Pelayanan
:
:
Tgl.Pelayanan

RJTL
245
0475R00009140000251
29/10/2014
246
0475R00009140000252
29/10/2014
247
0475R00009140000253
29/10/2014
248
0475R00009140000254
29/10/2014
249
0475R00009140000255
29/10/2014
250
0475R00009140000256
29/10/2014
251
0475R00009140000257
29/10/2014
252
0475R00009140000258
29/10/2014
253
0475R00009140000260
29/10/2014
254
0475R00009140000261
29/10/2014
255
0475R00009140000262
29/10/2014
256
0475R00009140000263
29/10/2014
257
0475R00009140000264
29/10/2014
258
0475R00009140000265
29/10/2014

Nama RS
Tingkat Pelayanan
:
:
Tgl.Pelayanan

RJTL
259
0475R00009140000266
29/10/2014
260
0475R00009140000268
29/10/2014
261
0475R00009140000269
29/10/2014
262
0475R00009140000270
29/10/2014
263
0475R00009140000271
29/10/2014
264
0475R00009140000272
29/10/2014
265
0475R00009140000273
29/10/2014
266
0475R00009140000274
29/10/2014
267
0475R00009140000275
29/10/2014
268
0475R00009140000277
29/10/2014
269
0475R00009140000278
29/10/2014
270
0475R00009140000279
29/10/2014
271
0475R00009140000280
29/10/2014
272
0475R00009140000281
29/10/2014
273
0475R00009140000282
29/10/2014
274
0475R00009140000283
29/10/2014
275
0475R00009140000284
29/10/2014
276
0475R00009140000286
29/10/2014
277
0475R00009140000287
29/10/2014
278
0475R00009140000288
29/10/2014
279
0475R00009140000289
29/10/2014
280
0475R00009140000290
29/10/2014
281
0475R00009140000291
29/10/2014
282
0475R00009140000292
29/10/2014
283
0475R00009140000293
29/10/2014
284
0475R00009140000294
29/10/2014
285
0475R00009140000295
29/10/2014
286
0475R00009140000296
29/10/2014
287
0475R00009140000297
29/10/2014
288
0475R00009140000298
29/10/2014
289
0475R00009140000299
29/10/2014
290
0475R00009140000300
29/10/2014
291
0475R00009140000301
29/10/2014
292
0475R00009140000302
29/10/2014
293
0475R00009140000303
29/10/2014
294
0475R00009140000304
29/10/2014
295
0475R00009140000305
29/10/2014
296
0475R00009140000306
29/10/2014
297
0475R00009140000307
29/10/2014
298
0475R00009140000308
29/10/2014
299
0475R00009140000309
29/10/2014

Nama RS
Tingkat Pelayanan
:
:
Tgl.Pelayanan

RJTL
300
0475R00009140000310
29/10/2014
301
0475R00009140000311
29/10/2014
302
0475R00009140000312
29/10/2014
303
0475R00009140000313
29/10/2014
304
0475R00009140000314
29/10/2014
305
0475R00009140000315
29/10/2014
306
0475R00009140000316
29/10/2014
307
0475R00009140000317
29/10/2014
308
0475R00009140000318
29/10/2014
309
0475R00009140000319
29/10/2014
310
0475R00009140000320
29/10/2014
311
0475R00009140000321
29/10/2014
312
0475R00009140000322
29/10/2014
313
0475R00009140000323
29/10/2014
314
0475R00009140000324
29/10/2014
315
0475R00009140000325
29/10/2014
316
0475R00009140000326
29/10/2014
317
0475R00009140000327
29/10/2014
318
0475R00009140000328
29/10/2014
319
0475R00009140000329
29/10/2014
320
0475R00009140000330
29/10/2014
321
0475R00009140000331
29/10/2014
322
0475R00009140000332
29/10/2014
323
0475R00009140000333
29/10/2014
324
0475R00009140000334
29/10/2014
325
0475R00009140000336
29/10/2014
326
0475R00009140000338
29/10/2014
327
0475R00009140000339
29/10/2014
328
0475R00009140000340
29/10/2014
329
0475R00009140000341
29/10/2014
330
0475R00009140000342
29/10/2014
331
0475R00009140000343
29/10/2014
332
0475R00009140000344
29/10/2014
333
0475R00009140000345
29/10/2014
334
0475R00009140000346
29/10/2014
335
0475R00009140000347
29/10/2014
336
0475R00009140000348
29/10/2014
337
0475R00009140000349
29/10/2014
338
0475R00009140000350
29/10/2014
339
0475R00009140000351
29/10/2014
340
0475R00009140000352
29/10/2014

Nama RS
Tingkat Pelayanan
:
:
Tgl.Pelayanan

RJTL
341
0475R00009140000353
29/10/2014
342
0475R00009140000354
29/10/2014
343
0475R00009140000355
29/10/2014
344
0475R00009140000356
29/10/2014
345
0475R00009140000357
29/10/2014
346
0475R00009140000358
29/10/2014
347
0475R00009140000359
29/10/2014
348
0475R00009140000360
29/10/2014
349
0475R00009140000361
29/10/2014
350
0475R00009140000362
29/10/2014
351
0475R00009140000363
29/10/2014
352
0475R00009140000364
29/10/2014
353
0475R00009140000365
29/10/2014
354
0475R00009140000366
29/10/2014
355
0475R00009140000367
29/10/2014
356
0475R00009140000368
29/10/2014
357
0475R00009140000369
29/10/2014
358
0475R00009140000370
29/10/2014
359
0475R00009140000371
29/10/2014
360
0475R00009140000372
29/10/2014
361
0475R00009140000373
29/10/2014
362
0475R00009140000374
29/10/2014
363
0475R00009140000375
29/10/2014
364
0475R00009140000378
29/10/2014
365
0475R00009140000379
29/10/2014
366
0475R00009140000380
29/10/2014
367
0475R00009140000382
29/10/2014
368
0475R00009140000383
29/10/2014
369
0475R00009140000384
29/10/2014
370
0475R00009140000385
29/10/2014
371
0475R00009140000386
29/10/2014
372
0475R00009140000387
29/10/2014
373
0475R00009140000388
29/10/2014
374
0475R00009140000389
29/10/2014
375
0475R00009140000390
29/10/2014
376
0475R00009140000391
29/10/2014
377
0475R00009140000392
29/10/2014
378
0475R00009140000393
29/10/2014
379
0475R00009140000394
29/10/2014
380
0475R00009140000395
29/10/2014
381
0475R00009140000396
29/10/2014

Nama RS
Tingkat Pelayanan
:
:
Tgl.Pelayanan

RJTL
382
0475R00009140000397
29/10/2014
383
0475R00009140000398
29/10/2014
384
0475R00009140000399
29/10/2014
385
0475R00009140000400
29/10/2014
386
0475R00009140000401
29/10/2014
387
0475R00009140000402
29/10/2014
388
0475R00009140000404
29/10/2014

Nama RS
Tingkat Pelayanan
:
:
Tgl.Pelayanan

RJTL
389
0475R00009140000405
29/10/2014
390
0475R00009140000406
29/10/2014
391
0475R00009140000407
29/10/2014
392
0475R00009140000408
29/10/2014
393
0475R00009140000409
29/10/2014
394
0475R00009140000410
29/10/2014
395
0475R00009140000411
29/10/2014
396
0475R00009140000412
29/10/2014
397
0475R00009140000413
29/10/2014
398
0475R00009140000414
29/10/2014
399
0475R00009140000415
29/10/2014
400
0475R00009140000416
29/10/2014
401
0475R00009140000417
29/10/2014
402
0475R00009140000418
29/10/2014
403
0475R00009140000419
29/10/2014
404
0475R00009140000420
29/10/2014
405
0475R00009140000421
29/10/2014
406
0475R00009140000422
29/10/2014
407
0475R00009140000423
29/10/2014
408
0475R00009140000424
29/10/2014
409
0475R00009140000425
29/10/2014
410
0475R00009140000426
29/10/2014
411
0475R00009140000428
29/10/2014
412
0475R00009140000429
29/10/2014
413
0475R00009140000430
29/10/2014
414
0475R00009140000431
29/10/2014
415
0475R00009140000432
29/10/2014
416
0475R00009140000433
29/10/2014
417
0475R00009140000434
29/10/2014
418
0475R00009140000435
29/10/2014
419
0475R00009140000437
29/10/2014
420
0475R00009140000438
29/10/2014
421
0475R00009140000439
29/10/2014
422
0475R00009140000441
29/10/2014
423
0475R00009140000442
29/10/2014
424
0475R00009140000443
29/10/2014
425
0475R00009140000444
29/10/2014
426
0475R00009140000445
29/10/2014
427
0475R00009140000446
29/10/2014
428
0475R00009140000447
29/10/2014
429
0475R00009140000449
29/10/2014

Nama RS
Tingkat Pelayanan
:
:
Tgl.Pelayanan

RJTL
430
0475R00009140000450
29/10/2014
431
0475R00009140000451
29/10/2014
432
0475R00009140000452
29/10/2014
433
0475R00009140000453
29/10/2014
434
0475R00009140000454
29/10/2014
435
0475R00009140000455
29/10/2014
436
0475R00009140000456
29/10/2014
437
0475R00009140000457
29/10/2014
438
0475R00009140000458
29/10/2014
439
0475R00009140000459
29/10/2014
440
0475R00009140000460
29/10/2014
441
0475R00009140000461
29/10/2014
442
0475R00009140000462
29/10/2014
443
0475R00009140000463
29/10/2014
444
0475R00009140000464
29/10/2014
445
0475R00009140000465
29/10/2014
446
0475R00009140000466
29/10/2014
447
0475R00009140000467
29/10/2014
448
0475R00009140000468
29/10/2014
449
0475R00009140000469
29/10/2014
450
0475R00009140000470
29/10/2014
451
0475R00009140000471
29/10/2014
452
0475R00009140000472
29/10/2014
453
0475R00009140000473
29/10/2014

Nama RS
Tingkat Pelayanan
:
:
Tgl.Pelayanan

RJTL
454
0475R00009140000474
29/10/2014
455
0475R00009140000475
29/10/2014
456
0475R00009140000476
29/10/2014
457
0475R00009140000477
29/10/2014
458
0475R00009140000478
29/10/2014
459
0475R00009140000479
29/10/2014
460
0475R00009140000480
29/10/2014
461
0475R00009140000481
29/10/2014
462
0475R00009140000482
29/10/2014
463
0475R00009140000483
29/10/2014
464
0475R00009140000484
29/10/2014
465
0475R00009140000485
29/10/2014
466
0475R00009140000486
29/10/2014
467
0475R00009140000487
29/10/2014
468
0475R00009140000489
29/10/2014
469
0475R00009140000490
29/10/2014
470
0475R00009140000491
29/10/2014
471
0475R00009140000492
29/10/2014
472
0475R00009140000493
29/10/2014
473
0475R00009140000494
29/10/2014
474
0475R00009140000495
29/10/2014
475
0475R00009140000496
29/10/2014
476
0475R00009140000497
29/10/2014
477
0475R00009140000498
29/10/2014
478
0475R00009140000499
29/10/2014
479
0475R00009140000500
29/10/2014
480
0475R00009140000501
29/10/2014
481
0475R00009140000502
29/10/2014
482
0475R00009140000503
29/10/2014
483
0475R00009140000504
29/10/2014
484
0475R00009140000505
29/10/2014
485
0475R00009140000506
29/10/2014
486
0475R00009140000507
29/10/2014
487
0475R00009140000508
29/10/2014
488
0475R00009140000509
29/10/2014
489
0475R00009140000511
29/10/2014
490
0475R00009140000512
29/10/2014
491
0475R00009140000513
29/10/2014
492
0475R00009140000514
29/10/2014
493
0475R00009140000515
29/10/2014
494
0475R00009140000516
29/10/2014

Nama RS
Tingkat Pelayanan
:
:
Tgl.Pelayanan

RJTL
495
0475R00009140000517
29/10/2014
496
0475R00009140000518
29/10/2014
497
0475R00009140000519
29/10/2014
498
0475R00009140000520
29/10/2014
499
0475R00009140000521
29/10/2014
500
0475R00009140000522
29/10/2014
501
0475R00009140000523
29/10/2014
502
0475R00009140000524
29/10/2014
503
0475R00009140000525
29/10/2014
504
0475R00009140000526
29/10/2014
505
0475R00009140000527
29/10/2014
506
0475R00009140000528
29/10/2014
507
0475R00009140000529
29/10/2014
508
0475R00009140000530
29/10/2014
509
0475R00009140000531
29/10/2014
510
0475R00009140000532
29/10/2014
511
0475R00009140000533
29/10/2014
512
0475R00009140000534
29/10/2014
513
0475R00009140000535
29/10/2014
514
0475R00009140000537
29/10/2014
515
0475R00009140000538
29/10/2014
516
0475R00009140000539
29/10/2014
517
0475R00009140000540
29/10/2014
518
0475R00009140000541
29/10/2014

Nama RS
Tingkat Pelayanan
:
:
Tgl.Pelayanan

RJTL
519
0475R00009140000542
29/10/2014
520
0475R00009140000543
29/10/2014
521
0475R00009140000544
29/10/2014
522
0475R00009140000545
29/10/2014
523
0475R00009140000546
29/10/2014
524
0475R00009140000547
29/10/2014
525
0475R00009140000548
29/10/2014
526
0475R00009140000549
29/10/2014
527
0475R00009140000550
29/10/2014
528
0475R00009140000551
29/10/2014
529
0475R00009140000552
29/10/2014
530
0475R00009140000553
29/10/2014
531
0475R00009140000554
29/10/2014
532
0475R00009140000555
29/10/2014
533
0475R00009140000556
29/10/2014
534
0475R00009140000557
29/10/2014
535
0475R00009140000558
29/10/2014
536
0475R00009140000559
29/10/2014
537
0475R00009140000560
29/10/2014
538
0475R00009140000561
29/10/2014
539
0475R00009140000562
29/10/2014
540
0475R00009140000563
29/10/2014
541
0475R00009140000564
29/10/2014
542
0475R00009140000565
29/10/2014
543
0475R00009140000566
29/10/2014
544
0475R00009140000567
29/10/2014
545
0475R00009140000568
29/10/2014
546
0475R00009140000569
29/10/2014
547
0475R00009140000570
29/10/2014
548
0475R00009140000571
29/10/2014
549
0475R00009140000572
29/10/2014
550
0475R00009140000573
29/10/2014
551
0475R00009140000574
29/10/2014
552
0475R00009140000575
29/10/2014
553
0475R00009140000576
29/10/2014
554
0475R00009140000577
29/10/2014
555
0475R00009140000578
29/10/2014
556
0475R00009140000579
29/10/2014
557
0475R00009140000580
29/10/2014
558
0475R00009140000581
29/10/2014
559
0475R00009140000582
29/10/2014

Nama RS
Tingkat Pelayanan
:
:
Tgl.Pelayanan

RJTL
560
0475R00009140000583
29/10/2014
561
0475R00009140000584
29/10/2014
562
0475R00009140000585
29/10/2014
563
0475R00009140000586
29/10/2014
564
0475R00009140000587
29/10/2014
565
0475R00009140000588
29/10/2014
566
0475R00009140000589
29/10/2014
567
0475R00009140000590
29/10/2014
568
0475R00009140000591
29/10/2014
569
0475R00009140000592
29/10/2014
570
0475R00009140000593
29/10/2014
571
0475R00009140000594
29/10/2014
572
0475R00009140000595
29/10/2014
573
0475R00009140000596
29/10/2014
574
0475R00009140000597
29/10/2014
575
0475R00009140000598
29/10/2014
576
0475R00009140000599
29/10/2014
577
0475R00009140000600
29/10/2014
578
0475R00009140000601
29/10/2014
579
0475R00009140000602
29/10/2014
580
0475R00009140000603
29/10/2014
581
0475R00009140000604
29/10/2014
582
0475R00009140000605
29/10/2014
583
0475R00009140000606
29/10/2014
584
0475R00009140000607
29/10/2014
585
0475R00009140000608
29/10/2014
586
0475R00009140000609
29/10/2014
587
0475R00009140000610
29/10/2014
588
0475R00009140000611
29/10/2014
589
0475R00009140000627
29/10/2014
590
0475R00009140000635
29/10/2014
591
0475R00009140000636
29/10/2014
592
0475R00009140000709
29/10/2014
593
0475R00009140000710
29/10/2014
594
0475R00009140000711
29/10/2014
595
0475R00009140000712
29/10/2014
596
0475R00009140000713
29/10/2014
597
0475R00009140000714
29/10/2014
598
0475R00009140000715
29/10/2014
599
0475R00009140000716
29/10/2014
600
0475R00009140000717
29/10/2014

Nama RS
Tingkat Pelayanan
:
:
Tgl.Pelayanan

RJTL
601
0475R00009140000718
29/10/2014
602
0475R00009140000719
29/10/2014
603
0475R00009140000721
29/10/2014
604
0475R00009140000733
29/10/2014
605
0475R00009140000734
29/10/2014
606
0475R00009140000735
29/10/2014
607
0475R00009140000736
29/10/2014
608
0475R00009140000737
29/10/2014
TOTAL
RESUME
Total Bea.Diajukan
120,064,452
Total Bea.Disetujui
120,064,452
Menyetujui
Direktur RS
Mengetahui
BPJS KESEHATAN
dr. Hendra Taufiq Hasibuan
Epin Yunanta
014
Hal.1/1
Biaya
Diajukan
Disetujui
162,400
162,400
162,400
162,400
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
162,400
162,400
138,900
138,900
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
138,900
138,900
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
138,900
138,900
162,400
162,400
162,400
162,400
177,100
177,100
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
325,600
325,600
162,400
162,400
162,400
162,400
014
Hal.1/1
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
325,600
325,600
162,400
162,400
162,400
162,400
399,900
399,900
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
255,800
255,800
162,400
162,400
399,900
399,900
399,900
399,900
162,400
162,400
138,900
138,900
198,700
198,700
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
198,700
198,700
316,300
316,300
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
316,300
316,300
316,300
316,300
162,400
162,400
316,300
316,300
162,400
162,400
014
Hal.1/1
162,400
162,400
399,900
399,900
316,300
316,300
162,400
162,400
198,700
198,700
399,900
399,900
162,400
162,400
325,600
325,600
162,400
162,400
399,900
399,900
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
198,700
198,700
162,400
162,400
136,900
136,900
162,400
162,400
162,400
162,400
162,400
162,400
316,300
316,300
316,300
316,300
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
399,900
399,900
316,300
316,300
399,900
399,900
162,400
162,400
162,400
162,400
162,400
162,400
399,900
399,900
138,400
138,400
162,400
162,400
162,400
162,400
399,900
399,900
014
Hal.1/1
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
160,474
160,474
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
198,700
198,700
162,400
162,400
162,400
162,400
198,700
198,700
162,400
162,400
162,400
162,400
160,474
160,474
177,100
177,100
162,400
162,400
325,600
325,600
325,600
325,600
162,400
162,400
162,400
162,400
325,600
325,600
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
177,100
177,100
138,900
138,900
162,400
162,400
162,400
162,400
133,100
133,100
133,100
133,100
160,474
160,474
160,474
160,474
014
Hal.1/1
160,474
160,474
160,474
160,474
126,806
126,806
325,600
325,600
325,600
325,600
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
312,558
312,558
160,474
160,474
191,788
191,788
160,474
160,474
160,474
160,474
160,474
160,474
201,031
201,031
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
131,533
131,533
160,474
160,474
160,474
160,474
160,474
160,474
175,031
175,031
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
196,308
196,308
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
312,558
312,558
014
Hal.1/1
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
201,031
201,031
160,474
160,474
160,474
160,474
399,900
399,900
160,474
160,474
399,900
399,900
160,474
160,474
196,308
196,308
325,600
325,600
160,474
160,474
399,900
399,900
399,900
399,900
295,504
295,504
136,735
136,735
160,474
160,474
399,900
399,900
312,558
312,558
160,474
160,474
160,474
160,474
198,700
198,700
162,400
162,400
162,400
162,400
162,400
162,400
203,400
203,400
316,300
316,300
138,400
138,400
162,400
162,400
138,900
138,900
399,900
399,900
160,474
160,474
160,474
160,474
162,400
162,400
162,400
162,400
133,100
133,100
325,600
325,600
325,600
325,600
162,400
162,400
014
Hal.1/1
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
399,900
399,900
399,900
399,900
194,251
194,251
316,300
316,300
162,400
162,400
316,300
316,300
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
014
Hal.1/1
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
201,031
201,031
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
399,900
399,900
316,300
316,300
162,400
162,400
198,700
198,700
399,900
399,900
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
137,259
137,259
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
196,308
196,308
312,558
312,558
160,474
160,474
399,900
399,900
316,300
316,300
162,400
162,400
160,474
160,474
014
Hal.1/1
160,474
160,474
160,474
160,474
160,474
160,474
126,806
126,806
160,474
160,474
325,600
325,600
160,474
160,474
131,533
131,533
87,900
87,900
128,300
128,300
128,300
128,300
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
399,900
399,900
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
399,900
399,900
325,600
325,600
162,400
162,400
162,400
162,400
399,900
399,900
162,400
162,400
399,900
399,900
399,900
399,900
316,300
316,300
162,400
162,400
203,400
203,400
138,400
138,400
014
Hal.1/1
316,300
316,300
399,900
399,900
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
203,400
203,400
162,400
162,400
162,400
162,400
399,900
399,900
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
399,900
399,900
162,400
162,400
162,400
162,400
316,300
316,300
162,400
162,400
325,600
325,600
325,600
325,600
136,900
136,900
399,900
399,900
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
312,558
312,558
312,558
312,558
312,558
312,558
312,558
312,558
160,474
160,474
160,474
160,474
196,308
196,308
135,319
135,319
160,474
160,474
160,474
160,474
196,308
196,308
312,558
312,558
014
Hal.1/1
160,474
160,474
399,900
399,900
399,900
399,900
160,474
160,474
312,558
312,558
312,558
312,558
160,474
160,474
014
Hal.1/1
160,474
160,474
160,474
160,474
312,558
312,558
160,474
160,474
160,474
160,474
160,474
160,474
312,558
312,558
160,474
160,474
160,474
160,474
312,558
312,558
162,400
162,400
162,400
162,400
162,400
162,400
160,474
160,474
169,993
169,993
162,400
162,400
203,400
203,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
194,251
194,251
160,474
160,474
160,474
160,474
160,474
160,474
399,900
399,900
160,474
160,474
312,558
312,558
160,474
160,474
201,031
201,031
014
Hal.1/1
312,558
312,558
160,474
160,474
160,474
160,474
131,533
131,533
137,259
137,259
131,533
131,533
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
137,259
137,259
160,474
160,474
160,474
160,474
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
198,700
198,700
162,400
162,400
316,300
316,300
162,400
162,400
162,400
162,400
162,400
162,400
014
Hal.1/1
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
399,900
399,900
138,900
138,900
162,400
162,400
316,300
316,300
194,100
194,100
316,300
316,300
399,900
399,900
138,900
138,900
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
316,300
316,300
162,400
162,400
162,400
162,400
399,900
399,900
316,300
316,300
162,400
162,400
162,400
162,400
162,400
162,400
131,400
131,400
162,400
162,400
299,100
299,100
162,400
162,400
399,900
399,900
162,400
162,400
198,700
198,700
162,400
162,400
162,400
162,400
162,400
162,400
316,300
316,300
194,100
194,100
316,300
316,300
014
Hal.1/1
399,900
399,900
399,900
399,900
399,900
399,900
316,300
316,300
316,300
316,300
325,600
325,600
162,400
162,400
325,600
325,600
162,400
162,400
325,600
325,600
325,600
325,600
325,600
325,600
325,600
325,600
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
203,400
203,400
014
Hal.1/1
162,400
162,400
198,700
198,700
399,900
399,900
162,400
162,400
160,474
160,474
137,259
137,259
223,434
223,434
160,474
160,474
196,308
196,308
196,308
196,308
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
312,558
312,558
160,474
160,474
160,474
160,474
196,308
196,308
136,735
136,735
160,474
160,474
160,474
160,474
312,558
312,558
160,474
160,474
312,558
312,558
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
201,031
201,031
201,031
201,031
399,900
399,900
160,474
160,474
162,400
162,400
194,251
194,251
160,474
160,474
203,400
203,400
014
Hal.1/1
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
399,900
399,900
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
312,558
312,558
160,474
160,474
160,474
160,474
312,558
312,558
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
160,474
399,900
399,900
160,474
160,474
201,031
201,031
136,735
136,735
160,474
160,474
203,400
203,400
138,900
138,900
138,900
138,900
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
138,900
138,900
162,400
162,400
162,400
162,400
014
Hal.1/1
Mengetahui
BPJS KESEHATAN
Epin Yunanta
162,400
162,400
162,400
162,400
162,400
162,400
162,400
162,400
138,900
138,900
138,900
138,900
138,900
138,900
162,400
162,400
120,064,452
120,064,452

RptUmpanBalik RJ

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UMPAN BALIK HASIL VERIFIKASI

RS PERMATA MADINA SIBUHUAN

UMPAN BALIK HASIL VERIFIKASI

RS PERMATA MADINA SIBUHUAN

UMPAN BALIK HASIL VERIFIKASI

RS PERMATA MADINA SIBUHUAN

UMPAN BALIK HASIL VERIFIKASI

RS PERMATA MADINA SIBUHUAN

UMPAN BALIK HASIL VERIFIKASI

RS PERMATA MADINA SIBUHUAN

UMPAN BALIK HASIL VERIFIKASI

RS PERMATA MADINA SIBUHUAN

UMPAN BALIK HASIL VERIFIKASI

RS PERMATA MADINA SIBUHUAN

UMPAN BALIK HASIL VERIFIKASI

RS PERMATA MADINA SIBUHUAN

UMPAN BALIK HASIL VERIFIKASI

RS PERMATA MADINA SIBUHUAN

UMPAN BALIK HASIL VERIFIKASI

RS PERMATA MADINA SIBUHUAN

UMPAN BALIK HASIL VERIFIKASI

RS PERMATA MADINA SIBUHUAN

UMPAN BALIK HASIL VERIFIKASI

RS PERMATA MADINA SIBUHUAN

UMPAN BALIK HASIL VERIFIKASI

RS PERMATA MADINA SIBUHUAN

UMPAN BALIK HASIL VERIFIKASI

RS PERMATA MADINA SIBUHUAN

UMPAN BALIK HASIL VERIFIKASI

RS PERMATA MADINA SIBUHUAN

UMPAN BALIK HASIL VERIFIKASI

RS PERMATA MADINA SIBUHUAN

UMPAN BALIK HASIL VERIFIKASI

RS PERMATA MADINA SIBUHUAN

UMPAN BALIK HASIL VERIFIKASI

RS PERMATA MADINA SIBUHUAN

dr. Hendra Taufiq Hasibuan

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