FPK RJTL Vs PENGAJUAN PELAYANAN BULAN FEBRUARI 2017

No. No. MR NAMA PASIEN NO. SEP

1 2689 ZULKARNAEN 0065R00302170000001

2 2692 SUWARNI 0065R00302170000005
3 1250 SUPRONO 0065R00302170000008
4 2695 AZKA NUR NABILA 0065R00302170000011
5 2696 SOLODOMU MANURUNG 0065R00302170000016

6 2333 ANNISA FRANSISCA ZEBUA 0065R00302170000023

7 2700 SUYANTO 0065R00302170000025
8 2701 WAGINI 0065R00302170000026
9 2260 SUBAGIO 0065R00302170000031
10 999 BRAJA DIKA ANGGARA PUTRA SIMARMATA 0065R00302170000033
11 2704 MUHAMMAD YASIN HARAHAP 0065R00302170000034
12 2705 AKASAH ARSYILA HARAHAP 0065R00302170000035
13 2706 SUPARNO DON 0065R00302170000036
14 2707 SUGIRO 0065R00302170000037
15 2708 TUTI ANJASMANI 0065R00302170000038
16 2710 ARIPIN 0065R00302170000042
17 2711 LANI YANTI 0065R00302170000045
18 2714 IRWAN TAMBUNAN 0065R00302170000049
19 2716 DEMAK ROY FERNANDO 0065R00302170000051
20 2059 NANA SRIKANA 0065R00302170000058
21 1803 FAISAL PANGGABAEN 0065R00302170000061
22 2111 ROEMAH 0065R00302170000063
23 2720 SAMAN SINAGA 0065R00302170000067
24 2724 KASMAWATI 0065R00302170000071
25 2725 PATMI KRISTIAWATI 0065R00302170000074
26 2727 AJENG PUSPA NINGRUM 0065R00302170000076
27 2729 MARICE BR SITUMORANG 0065R00302170000081
28 2730 NABIT 0065R00302170000084
29 2735 SUPIYANI 0065R00302170000093
30 2217 KOMRI SIREGAR 0065R00302170000094
31 2469 JORNAULI BR TOHANG 0065R00302170000096
32 2697 KHODIJAH THULQUBRO AISHARIDHO NAINGGO 0065R00302170000100
33 2601 FERRY YUSTINUS 0065R00302170000101
34 2738 JARATA SITOHANG 0065R00302170000103
35 2740 PORMAIDA NAINGGOLAN 0065R00302170000112
36 2568 NIMA PUTRI ZAKYAN HARAHAP 0065R00302170000113
37 299 BASIRUN BINTANG 0065R00302170000115
38 112 SITI FARIDAH BR REGAR 0065R00302170000116
39 1435 RAMLAN 0065R00302170000117
40 2746 ROSIANNA BR PAKPAHAN 0065R00302170000129
41 2750 NANANG SUHENDRA 0065R00302170000133
42 2703 MISNAN SAMOSIR 0065R00302170000144
43 2756 ANAS WIDIANTO PANGABEAN 0065R00302170000147
44 2697 KHODIJAH THULQUBRO AISHARIDHO NAINGGO 0065R00302170000158
45 2762 JULIANA 0065R00302170000160
46 2763 DESI RAMAYANTI 0065R00302170000161
47 2764 SUWARDI 0065R00302170000162
48 2765 MUTIARA HALWA SETIAWAN 0065R00302170000163
49 2767 AHMAD PARLINDUNGAN 0065R00302170000165
50 2703 MISNAN SAMOSIR 0065R00302170000166
51 2768 SAMSIA 0065R00302170000170
52 2769 SELAMAT 0065R00302170000171
53 2770 SOUNTILON HUTAHAEAN 0065R00302170000172
54 1411 PARIANTO 0065R00302170000194
55 2775 SONDANG HUTABARAT 0065R00302170000197
56 2778 DIMAN PURBA 0065R00302170000200
57 2779 YUNITA NASUTION 0065R00302170000202
58 1783 FAHMI 0065R00302170000207
59 451 SARMAN 0065R00302170000210
60 1803 FAISAL PANGGABAEN 0065R00302170000211
61 1250 SUPRONO 0065R00302170000213
62 2783 PARTIWI 0065R00302170000214
63 2791 FIRMAULI BR TAMBUNAN 0065R00302170000239
64 2792 NENENG HAPSAH 0065R00302170000240
65 2793 TIOLAN GALINGGING 0065R00302170000242
66 2765 MUTIARA HALWA SETIAWAN 0065R00302170000243
67 2521 MUHAMMAD ANDA 0065R00302170000245
68 1721 KARTISEM 0065R00302170000246
69 2677 ABELSA AGATA BR SINAGA 0065R00302170000247
70 2797 SUDARTI 0065R00302170000249
71 112 SITI FARIDAH BR REGAR 0065R00302170000254
72 299 BASIRUN BINTANG 0065R00302170000255
73 2568 NIMA PUTRI ZAKYAN HARAHAP 0065R00302170000256
74 2798 EPIDARMAN NDURU 0065R00302170000258
75 2801 TIORI 0065R00302170000263
76 2746 ROSIANNA BR PAKPAHAN 0065R00302170000267
77 741 H. MARULI SIHOMBING 0065R00302170000268
78 2813 GOKMA PARAPAT 0065R00302170000280

GRAND TOTAL
FEBRUARI 2017

BIAYA
Diajukan Disetujui
186,700 186,700
186,700 186,700
186,700 186,700
183,800 183,800
183,800 183,800
298,200 298,200
186,700 186,700
132,900 132,900
186,700 186,700
186,700 186,700
183,800 183,800
183,800 183,800
538,400 538,400
186,700 186,700
186,700 186,700
186,700 186,700
538,400 538,400
186,700 186,700
263,600 263,600
186,700 186,700
186,700 186,700
186,700 186,700
186,700 186,700
186,700 186,700
186,700 186,700
183,800 183,800
186,700 186,700
132,900 132,900
186,700 186,700
186,700 186,700
186,700 186,700
85,200 85,200
186,700 186,700
538,400 538,400
186,700 186,700
186,700 186,700
186,700 186,700
186,700 186,700
186,700 186,700
186,700 186,700
186,700 186,700
132,900 132,900
186,700 186,700
186,700 186,700
186,700 186,700
186,700 186,700
186,700 186,700
183,800 183,800
186,700 186,700
186,700 186,700
 186,700 186,700
538,400 538,400
538,400 538,400
186,700 186,700
538,400 538,400
243,500 243,500
186,700 186,700
186,700 186,700
538,400 538,400
186,700 186,700
186,700 186,700
298,200 298,200
186,700 186,700
538,400 538,400
186,700 186,700
186,700 186,700
538,400 538,400
538,400 538,400
186,700 186,700
186,700 186,700
186,700 186,700
186,700 186,700
186,700 186,700
186,700 186,700
538,400 538,400
186,700 186,700
186,700 186,700
186,700 186,700

18,507,700 18,507,700
 FPK RITL Vs PENGAJUAN PELAYANAN BULAN FEBRUARI 2017

No NO. MR NAMA PASIEN No.SEP

1 1247 SITI AMINAH BR SIHOMBING 0065R00301170000226

2 2674 WARDA NINGSIH 0065R00301170000242

3 2676 JHONY AMAN SINAGA 0065R00301170000246

4 2679 PINA PRAMITA 0065R00301170000255

5 2681 MINURIA NAINGGOLAN 0065R00301170000259

6 842 USMAN 0065R00301170000261

7 2683 TUKIMAN 0065R00301170000265

8 469 NURHAYANI 0065R00301170000274

9 2688 SARI HAFNI SARAGIH 0065R00301170000277

10 2686 ANDRE SYAHPUTRA 0065R00301170000279

11 2687 MAWAR LESTARI 0065R00301170000281

12 2690 HAMIDI,S.PDI 0065R00302170000003

13 2691 RAJA MUDA HARAHAP 0065R00302170000006

14 2693 SUCINO 0065R00302170000009

15 2694 SUSANTI 0065R00302170000012

16 2697 KHODIJAH THULQUBRO AISHARIDHO NA 0065R00302170000018

17 2699 NURMANSYAH 0065R00302170000022

18 2454 ELYDA SARI HARAHAP 0065R00302170000030

19 2703 MISNAN SAMOSIR 0065R00302170000039

20 2712 ASIMA TAMBUNAN 0065R00302170000047

21 2342 DERJANA PASARIBU 0065R00302170000053

22 2717 AHMAD HUSEIN SIREGAR 0065R00302170000055

23 2715 RIANA 0065R00302170000056

24 2713 KASMIDAH 0065R00302170000057

25 2718 NOVITASARI 0065R00302170000060

26 2721 BENI MULIADI 0065R00302170000066

27 2722 KIKI WULAN SARI 0065R00302170000069

28 2723 SIMAN 0065R00302170000072

29 2719 NUR HAMIDA 0065R00302170000073

30 2704 MUHAMMAD YASIN HARAHAP 0065R00302170000080

31 2726 SUMMAWATI 0065R00302170000083

32 2732 BAYI NYONYA SURYANI 0065R00302170000086

33 2731 ADE YUWENDA TANJUNG 0065R00302170000090

34 2733 ABDUL WAHAB 0065R00302170000092

35 2736 NALISYA ARMINDA BR.DAMANIK 0065R00302170000098

36 2737 ARDIANSYAH 0065R00302170000099

37 2654 LOKOT HARAHAP 0065R00302170000107

38 2739 RIATI 0065R00302170000109

39 2601 FERRY YUSTINUS 0065R00302170000111

40 2741 AISYAH AKILAH 0065R00302170000120

41 2742 CHINTA BR GINTING 0065R00302170000122

42 111 M. YACOB TUPANNO 0065R00302170000124

43 2743 LESTI PARDAMEAN SIREGAR 0065R00302170000125

44 2745 SULISMA 0065R00302170000128

45 450 MANGALATUA SIAHAAN 0065R00302170000136

46 2744 SURYA SUBRATA 0065R00302170000138

47 2753 TILIA LASE 0065R00302170000146

48 2759 WILLIANA 0065R00302170000154

49 2760 BULAN 0065R00302170000156

50 984 TIMBANG SITORUS 0065R00302170000167

51 1581 ITA 0065R00302170000168

52 2766 YATINO 0065R00302170000176

53 2318 HENTON SIHOTANG 0065R00302170000177

54 2761 ICHAWAN FENDRA 0065R00302170000179

55 2505 EDIANTO SITUMEANG 0065R00302170000180

56 610 RASMI ROTUA GULTOM 0065R00302170000181

57 2772 SRIYANI 0065R00302170000186

58 2773 IMRONI 0065R00302170000193

59 2771 RASNO 0065R00302170000195

60 2751 BUDI SARWONO 0065R00302170000196

61 2752 SONDANG MATIUR 0065R00302170000203

62 2776 LAMINEM BR SINAGGA 0065R00302170000205

63 2780 EVI KLARA MAYSARI 0065R00302170000209

64 2781 M.IKBAL HARAHAP 0065R00302170000215

65 2782 ISMA 0065R00302170000216

66 2696 SOLODOMU MANURUNG 0065R00302170000218

67 2784 SUPRIATIK 0065R00302170000220

68 2785 SRI RAHAYU NURHAYANI 0065R00302170000222

69 2455 UCY NIRMALA SARI 0065R00302170000224

70 2787 ROSLAINI 0065R00302170000226

71 2789 RATNA SARI MANURUNG 0065R00302170000228

72 2786 WARSUN 0065R00302170000230

73 2790 ROHINSA BR. LUMBAGAOL 0065R00302170000236

74 2796 DELMA BR.SIANTURI 0065R00302170000262

75 2709 ASWIN SYAH SANI 0065R00302170000282

TOTAL
FEBRUARI 2017

Biaya
Diajukan Disetujui
3,288,300 3,288,300
5,354,600 5,354,600
3,946,000 3,946,000
5,354,600 5,354,600
2,083,500 2,083,500
3,946,000 3,946,000
2,335,200 2,335,200
2,083,500 2,083,500
5,354,600 5,354,600
783,400 783,400
1,802,900 1,802,900
3,468,800 3,468,800
4,738,700 4,738,700
2,973,300 2,973,300
4,462,200 4,462,200
5,354,600 5,354,600
2,609,600 2,609,600
1,802,900 1,802,900
3,946,000 3,946,000
1,736,300 1,736,300
2,973,300 2,973,300
2,957,300 2,957,300
5,354,600 5,354,600
1,802,900 1,802,900
4,462,200 4,462,200
2,973,300 2,973,300
2,973,300 2,973,300
940,100 940,100
5,354,600 5,354,600
2,163,800 2,163,800
1,802,900 1,802,900
5,433,200 5,433,200
4,462,200 4,462,200
1,736,300 1,736,300
2,163,800 2,163,800
2,973,300 2,973,300
2,534,900 2,534,900
1,748,300 1,748,300
2,413,300 2,413,300
1,346,400 1,346,400
3,946,000 3,946,000
3,861,000 3,861,000
3,309,400 3,309,400
5,354,600 5,354,600
4,594,800 4,594,800
3,036,300 3,036,300
1,802,900 1,802,900
5,354,600 5,354,600
5,354,600 5,354,600
2,425,600 2,425,600
2,335,200 2,335,200
2,973,300 2,973,300
3,152,600 3,152,600
3,850,100 3,850,100
2,483,600 2,483,600
6,247,000 6,247,000
5,354,600 5,354,600
2,973,300 2,973,300
2,534,900 2,534,900
3,351,900 3,351,900
2,534,900 2,534,900
3,946,000 3,946,000
5,354,600 5,354,600
2,413,300 2,413,300
2,335,200 2,335,200
2,083,500 2,083,500
 6,676,900 6,676,900
2,609,600 2,609,600
5,354,600 5,354,600
4,462,200 4,462,200
783,400 783,400
2,534,900 2,534,900
1,427,100 1,427,100
1,802,900 1,802,900
2,957,300 2,957,300

247,567,700 247,567,700