DATA KLAIM PENDING

NO BULAN PELAYANAN TANGGAL PELAYANAN NO SEP NAMA PASIEN DPJP TARIF

1 Dec-16 2 DES - 5 DES 0309R0011216000080 MASRA dr. BOY HUTAPERI, Sp. PD Rp 4,707,600
2 9 DES - 12 DES 0309R0011216000333 ARVANO PUTRA ERMAN dr. MARLIA MORISKA Rp 11,318,300

3 Jan-17 11 JAN - 12 JAN 0309R00101170000428 AISAH dr. RENO SARI CANIAGO, Sp. S Rp 5,617,100
14 JAN - 18 JAN 0309R00101170000562 MISNAWATI dr. RANNI FISTRI, Sp. OG Rp 4,873,700
6 17 JAN - 18 JAN 0309R00101170000611 NURLELA dr. AFIYARNI IBRAHIM, Sp. A Rp 5,119,000
17 JAN - 20 JAN 0309R00101170000696 DESMI FITRI dr. DODY FAISAL, Sp. OG Rp 5,147,900
7 18 JAN - 21 JAN 0309R00101170000745 PATRIS YULIANTO dr. RIKHO ADE PUTERA, Sp. JP Rp 10,548,000
20 JAN -26 JAN 0309R00101170000917 MUAS dr. SITI CHADIJAH, Sp. PD Rp 5,060,800
8 29 DES 1 JAN 0309R00112160000999 SISTRI MARNI dr. RANNI FISTRI KHAISARI, Sp. OG Rp 6,177,500
28 DES - 5 JAN 0309R00112160001031 M. AFDAL dr. MARLIA MORISKA, Sp. A Rp 3,330,100
9
Feb-17 30 JAN - 2 FEB 0309R00101170001227 KUNAN dr. RIKHO ADE PUTERA, Sp. JP Rp 7,653,000
10 4 FEB - 7 FEB 0309R00102170000148 ABDUL AZIZ dr. RIKHO ADE PUTERA, Sp. JP Rp 3,614,800
22 FEB - 25 FEB 0309R00102170000821 MARIA GUSTIN dr. RIKHO ADE PUTERA, Sp. JP Rp 3,614,800
11 26 FEB - 27 FEB 0309R00102170000913 ROMAWI dr. RENO SARI CANIAGO, Sp. S Rp 5,021,700
12
13 Mar-17 1 MAR - 5 MAR 0309R00103170000088 MIMI ROSMAYANTI dr. DODY FAISAL, Sp. OG Rp 5,147,900
14 13 MAR - 16 MAR 0309R00103170000563 RAID dr. RIKHO ADE PUTERA, Sp. JP Rp 5,274,800
15 24 MAR - 30 MAR 0309R00103170001086 UMAR BK dr. ELDA DESFITA HARSA, Sp. P Rp 3,309,800
24 MAR - 27 MAR 0309R00103170001086 YELSA VIRMASARI dr. RANNI FISTRI, Sp. OG Rp 6,177,500
16
17 Apr-17 6 APR - 6 APR 0309R00104170000335 HASBUL HUSNA dr. RANNI FISTRI, Sp. OG Rp 182,000
18
19 May-17 26 APR - 4 MEI 0309R00104170001125 LILIS ROHAYATI dr. RENO SARI CANIAGO, Sp. S Rp 5,195,000
20 28 APR - 5 MEI 0309R00104170001224 NURLINIS dr. ELDA DESFITA HARSA, Sp. P Rp 4,821,500
21 1 MEI - 8 MEI 0309R00105170000173 DARA HIDAYATULLAH dr. MARLIA MORISKA, Sp. A Rp 9,431,900
8 MEI - 12 MEI 0309R00105170000450 SYAHRIAL dr. RIKHO ADE PUTERA, Sp. JP Rp 7,560,000
8 MEI - 12 MEI 0309R00105170000485 ROSTINA dr. RIKHO ADE PUTERA, Sp. JP Rp 7,560,000
29 MEI - 31 MEI 0309R00105170001312 IBRA ALIANSYAH dr. YOPI TRIPUTRA, Sp. B Rp 3,874,900

Jun-17 5 JUN - 9 JUN 0309R00106170000160 BAIDAR dr. SITI CHADIJAH, Sp. PD Rp 2,328,800
10 JUN - 15 JUN 0309R00106170000425 JARNETI dr. SITI CHADIJAH, Sp. PD Rp 2,328,800
 15 JUN - 15 JUN 0309R00106170000662 SUKRI JAMAL dr. RENO SARI CANIAGO, Sp. S Rp 2,211,700
14 JUN - 15 JUN 0309R00106170000685 JASMIARTI dr. RENO SARI CANIAGO, Sp. S Rp 3,756,200
24 JUN - 26 JUN 0309R00106170001034 EDI RISYANTO dr. RIKHO ADE PUTERA, Sp. JP Rp 5,466,500

Aug-17 27 JUL - 1 AGUS 0309R00107170001510 ASTRI APRLIA YOLANDA dr. ROSLAINI Rp2,174,800
29 JUL - 1 AGUS 0309R00107170001600 SANTIAR dr. ROSLAINI Rp4,695,800
2 AGUS - 5 AGUS 0309R00108170000178 SISKAMAWATI dr. DODY FAISAL, Sp. OG Rp4,873,700
10 AGUS - 14 AGUS 0309R00108170000671 ERMA dr. ROSLAINI Rp1,253,800
24 AGUS - 29 AGUS 0309R00108170001390 DAHNIAL ST. MARAJO dr. RISA MUSRITA, Sp. JP Rp4,113,800
23 AGUS - 26 AGUS 0309R00108170001427 TAUFIK HIDAYAT dr. ROSLAINI Rp1,418,900

Sep-17 1 SEPT - 2 SEPT 0309R00109170000002 BOY dr. SITI CHADIJAH, Sp. PD Rp2,532,200
24 SEPT - 26 SEPT 0309R00109170001162 M. ALFAIZAR dr. HENDRA HERIZAL, Sp. B Rp2,963,200

Oct-17 3-Oct 0309R00110170000194 AILANI dr. YOPI TRIPUTRA, Sp. B Rp 183,000

11-Oct 0309R00110170000692 MUSALMA dr. RIKHO ADE PUTERA, Sp. JP Rp 183,000
11-Oct 0309R00110170000705 NAWIN dr. RIKHO ADE PUTERA, Sp. JP Rp 183,000
14-Oct 0309R00110170000879 RANDI IKHSANUL PUTRA dr. HENDRA HERIZAL, Sp. B Rp 183,000
17-Oct 0309R00110170001030 MARIANI dr. AFIYARNI IBRAHIM, Sp. A Rp 231,100
31-Oct 0309R00110170001030 AILANI dr. RIKHO ADE PUTERA, Sp. JP Rp 183,000
29 SEPT - 4 OKT 0309R00109170001529 GUSRI dr. ELDA DESFITA, Sp. P Rp 3,309,800
29 SEPT - 7 OKT 0309R00109170001556 ORA KAMESI dr. RIKHO ADE PUTERA, Sp. JP Rp 6,284,600
5 OKT - 7 OKT 0309R00110170000368 FADILAHI NOFENDRI dr. MARLIA MORISKA, Sp. A Rp 2,111,400
9 OKT - 14 OKT 0309R00110170000562 MAWARDI dr. RIKHO ADE PUTERA, Sp. JP Rp 3,614,800
15 OKT - 21 OKT 0309R00110170000899 RATNA WILIS dr. RISA MUSRITA, Sp.JP Rp 2,938,400
16 OKT - 22 OKT 0309R00110170001002 SARIPUDIN dr. RIKHO ADE PUTERA, Sp. JP Rp 7,560,000
18 OKT - 20 OKT 0309R00110170001184 ERWIN GOWASA dr. RIKHO ADE PUTERA, Sp. JP Rp 9,072,000
25 OKT - 27 OKT 0309R00110170001582 BY. NY. ALMIYANTI dr. MARLIA MORISKA, Sp. A Rp 5,034,500

Nov-17 30 Okt - 2 Nov 0309R00111170001707 EVA dr. DODY FAISAL, Sp. OG Rp 4,873,700
26 OKT - 1 NOV 0309R00111170001746 SARAH AZHARI dr. SITI CHADIJAH, Sp. B Rp 1,781,700
28 OKT - 1 NOV 0309R00111170001783 M. FATHAN RABBANI SHELDINANDA dr. MARLIA MORISKA Rp 3,853,900
31 OKT - 2 NOV 0309R00111170001948 ICE HASNUL FAUZI dr. SITI CHADIJAH, Sp. PD Rp 2,111,400
2 NOV - 7 NOV 0309R00111170000172 AFNI DENTI dr. RAHMEN SHAHNUM, Sp.B Rp 3,954,700
6 NOV - 9 NOV 0309R00111170000340 DESNIFAL dr. RIKHO ADE PUTERA, Sp. JP Rp 6,410,600
7 NOV - 12 NOV 0309R00111170000532 M. HAIKAL NOFRIADI dr. MARLIA MORISKA Rp 1,803,000
 8 NOV - 12 NOV 0309R00111170000586 SYAFRIL dr. RIKHO ADE PUTERA, Sp. JP Rp 7,560,000
9 NOV - 14 NOV 0309R00111170000637 DHANDI STAMOS dr. RAHMEN SHAHNUM, Sp.B Rp 2,766,900
12 NOV - 21 NOV 0309R00111170000685 FEBRI RAMDHAN SUSANTO dr. SITI CHADIJAH, Sp. PD Rp 7,477,700
13 NOV - 16 NOV 0309R00111170000783 RISDAYENTI dr. YOPI TRIPUTRA, Sp. B Rp 5,876,400
14 NOV - 19 NOV 0309R00111170000888 MARLISA JULIANA SYAHFITRI dr. MARLIA MORISKA Rp 2,111,400
15 NOV - 18 NOV 0309R00111170000933 MAWI dr. RIKHO ADE PUTERA, Sp. JP Rp 5,246,900
16 NOV - 17 NOV 0309R00111170001085 ELMI WIZA dr. RANNI FISTRI, Sp. OG Rp 1,844,900
15 NOV - 19 NOV 0309R00111170001088 BY. NY. SUSI DELMI YUNITA dr. MARLIA MORISKA Rp 3,356,300
16 NOV - 18 NOV 0309R00111170001091 SRI ARGAFIA dr. RANNI FISTRI, Sp. OG Rp 2,213,900
18 NOV - 25 NOV 0309R00111170001187 RUSLAN dr. RISA MUSRITA, Sp. JP Rp 3,118,600
20 NOV - 24 NOV 0309R00111170001221 JON HENDRA dr. SITI CHADIJAH, Sp. PD Rp 4,695,800
17 NOV - 21 NOV 0309R00111170001250 YUSNA dr. SITI CHADIJAH, Sp. PD Rp 3,313,100
21 NOV - 25 NOV 0309R00111170001334 MARLISA JULIANA SYAHFITRI dr. MARLIA MORISKA Rp 3,954,700
19 NOV - 22 NOV 0309R00111170001354 H. AZMI NURDIN dr. HENDRA HERIZAL, Sp. B Rp 3,868,500
19 NOV - 23 NOV 0309R00111170001357 ERMAWATI dr. RIKHO ADE PUTERA, Sp. JP Rp 7,541,500
23 NOV - 24 NOV 0309R00111170001488 FEBRI ISWANDI dr. AFIYARNI IBRAHIM, Sp. M Rp 5,972,200
27 NOV - 28 NOV 0309R00111170001585 RESHY GUSMITA dr. DODY FAISAL, Sp. OG Rp 1,870,500
26 NOV - 28 NOV 0309R00111170001613 ABDUL RAHMAT HAZRIL dr. DENI AMRI, Sp. THT Rp 2,963,200
16 NOV - 17 NOV 0309R00111170001742 RIKA SYAFERA dr. RAHMEN SHAHNUM, Sp.B Rp 1,412,000
16 NOV - 18 NOV 0309R0011117V000004 NOVI SUSANTI dr. RANNI FISTRI, Sp. OG Rp 1,516,600
2 NOV - 3 NOV 0309R0011117V000005 RIA RAHAYU UTAMI dr. RANNI FISTRI, Sp. OG Rp 1,558,800

Dec-17 5 DES - 5 DES 0309R00112170000114 SYAMSURI dr. SITI CHADIJAH, Sp. PD Rp 3,003,200
0309R00112170000166 BY. NY. GIKA YULIANI dr. MARLIA MORISKA, Sp. A Rp 5,500,100
6 DES - 9 NOV 0309R0011217V000076 NURHANIFAH PRITAMA JUFI dr. MARLIA MORISKA, Sp. A Rp 3,075,400
17 DES - 19 DES 0309R0011217V000746 ELI WARNIS dr. DENI AMRI, Sp. THT Rp 5,913,200
20 DES - 23 DES 0309R0011217V001177 DASMAN dr. RIKHO ADE PUTERA, Sp. JP Rp 7,560,000
24 DES - 28 DES 0309R0011217V001211 ERNI dr. RANNI FISTRI, Sp. OG Rp 5,147,900
9 DES - 12 DES 0309R0011217V001535 KARMIDIS dr. RENO SARI CANIAGO, Sp. S Rp 1,604,000
10 DES - 22 DES 0309R0011217V001536 MAY ZULHENDRI dr. SITI CHADIJAH, Sp. PD Rp 1,940,700
TOTAL Rp 360,302,800