PENGAJUAN FEE MARKETING S/D BULAN JANUARI 2019

PASIEN ASURANSI & PERUSAHAAN

TOTAL BILLING TGL MARKETING

NO. NAMA TGL MRS KLAIM MARGIN RS (40%)
(SISTEM) PENCAIRAN (60%)

RAWAT JALAN
1 PT Indolakto
An. Saiful 29/Oct/18 3,881,716 4,724,002 27/Nov/18 842,286 505,372 336,914
An. Waliati 1 2/Nov/18 292,586 405,362 27/Nov/18 112,776 67,666 45,110
An. Waliati 2 7/Nov/18 288,860 399,318 19/Dec/18 110,458 66,275 44,183
An. Waliati 3 12/Nov/18 427,090 579,017 19/Dec/18 151,927 91,156 60,771

2 Asuransi LIPPO
An. Windatry Amanda 30/Oct/18 182,650 253,254 12/Nov/18 70,604 42,362 28,242
An. Diandra Kayla (admedika) 22/Nov/18 381,145 540,499 31/Dec/18 159,354 95,612 63,742
Sofii 1 29/Nov/18 130,000 214,225 29/Nov/18 84,225 50,535 33,690
Sofii 2 6/Dec/18 268,435 389,773 21/Dec/18 121,338 72,803 48,535
Sofii 3 13/Dec/18 156,590 246,997 7/Jan/19 90,407 54,244 36,163
Sulihati 18/Jan/19 1,356,825 1,785,608 4/Feb/19 428,783 257,270 171,513
Tatik 22/Jan/19 159,200 251,009 4/Feb/19 91,809 55,085 36,724
Zuraini 23/Jan/19 678,530 915,055 4/Feb/19 236,525 141,915 94,610

3 Asuransi CAR
M. Yudi Susanto 1 20/Jan/19 356,583 491,993 26/Feb/19 135,410 81,246 54,164
M. Yudi Susanto 2 22/Jan/19 158,510 239,960 26/Feb/19 81,450 48,870 32,580
M. Yudi Susanto 3 25/Jan/19 195,158 286,295 26/Feb/19 91,137 54,682 36,455
M. Yudi Susanto 4 28/Jan/19 115,000 185,488 26/Feb/19 70,488 42,293 28,195

Total 2,878,976 1,727,385 1,151,590

RAWAT INAP
1 PT Indolakto
An. Waliati 31/Oct/18 22,267,737 25,590,980 27/Nov/18 3,323,243 1,993,946 1,329,297

2 Asuransi LIPPO
An. Jovelino Naufal Alif 5/Aug/18 3,397,300 3,409,944 3/Sep/18 12,644 7,586 5,058
Tn. Herman Rosadi 3/Sep/18 17,801,115 18,046,172 17/Sep/18 245,057 147,034 98,023
Sdr. Sulakhul Fuad 8/Sep/18 3,142,123 3,268,146 1/Oct/18 126,023 75,614 50,409
 An. Shaqilla Aisalyn Fahmi 14/Sep/18 3,396,393 3,584,505 8/Oct/18 188,112 112,867 75,245
An. Shaqilla Aisalyn Fahmi 2/Oct/18 3,001,721 3,053,497 22/Oct/18 51,776 31,066 20,710
An. Al- Ghifari Nakhlan S. 4/Oct/18 4,731,041 4,776,404 22/Oct/18 45,363 27,218 18,145
Ny. Ira Dwi Sukmawati 8/Oct/18 13,353,829 13,421,334 22/Oct/18 67,505 40,503 27,002
Tn, Rachmat Hidayat 20/Oct/18 9,643,716 9,912,042 5/Nov/18 268,326 160,996 107,330
An.Windatry Amanda 27/Oct/18 6,011,662 6,272,197 12/Nov/18 260,535 156,321 104,214
An.Muchtar Arifin 8/Nov/18 4,721,041 4,952,417 26/Nov/18 231,376 138,826 92,550
Sdr. Nur Andrian 26/Nov/18 2,072,240 2,289,114 17/Dec/18 216,874 130,124 86,750
An. Javier Aqtam 25/Nov/18 3,934,235 4,175,057 17/Dec/18 240,822 144,493 96,329
Tn. Sofii 26/Nov/18 6,120,755 6,560,561 17/Dec/18 439,806 263,884 175,922
Haniati 2/Dec/18 4,719,465 4,907,429 17/Dec/18 187,964 112,778 75,186
An. Araya Ayudia S 4/Jan/19 3,702,533 3,974,485 14/Jan/19 271,952 163,171 108,781
Ny. Sulihati 15/Jan/19 6,886,463 7,366,471 4/Feb/19 480,008 288,005 192,003
Tn. Naf*an 15/Jan/19 6,201,518 6,462,702 4/Feb/19 261,184 156,710 104,474
Tn. Hasan 16/Jan/19 8,692,707 9,603,032 4/Feb/19 910,325 546,195 364,130
Ny. Tatik 19/Jan/19 3,725,768 4,061,444 11/Feb/19 335,676 201,406 134,270
Ny. Zuraini 20/Jan/19 4,735,853 5,120,307 11/Feb/19 384,454 230,672 153,782
Nn. Sarah 21/Jan/19 6,865,576 7,121,965 11/Feb/19 256,389 153,833 102,556
Safa T 20/Jan/19 2,566,623 2,842,873 11/Feb/19 276,250 165,750 110,500
M. Naufal Aditya 24/Jan/19 4,877,108 5,217,965 11/Feb/19 340,857 204,514 136,343
Tn. Iksan 24/Jan/19 2,259,022 2,473,604 11/Feb/19 214,582 128,749 85,833
Sdr. Raffi Bintang 26/Jan/19 7,879,608 8,247,958 18/Feb/19 368,350 221,010 147,340
Tn. Leendhy Julian 26/Jan/19 6,324,897 6,765,997 18/Feb/19 441,100 264,660 176,440

3 PT HM Sampoerna
Ny. Sumini 4/Oct/18 6,523,139 7,243,496 24/Oct/19 720,357 432,214 288,143
Ny. Dewi Setijaningsih 6/Oct/18 7,052,093 8,379,720 24/Oct/19 1,327,627 796,576 531,051
An. Meyrinda Putri 12/Oct/18 6,171,132 6,691,377 24/Oct/19 520,245 312,147 208,098
An, Fakhirah Shakila Putri Z. 22/Oct/18 3,870,780 4,252,428 7/Nov/18 381,648 228,989 152,659
An, wiwit puji astutik 6/Nov/18 2,857,588 3,167,868 21/Nov/18 310,280 186,168 124,112
An.Alifia zhuina shofi 8/Nov/18 4,709,271 5,213,288 26/Nov/18 504,017 302,410 201,607
An.nurur rohmatul inayah 11/Nov/18 5,736,237 6,258,107 26/Nov/18 521,870 313,122 208,748
Nn. Firly Celia Andriana 12/Nov/18 7,613,668 8,144,545 5/Dec/18 530,877 318,526 212,351
Nn. Alifia Zhuina Shofi 17/Nov/18 4,442,349 4,982,119 5/Dec/18 539,770 323,862 215,908
Tn. Dedy Indrayana 21/Nov/18 8,626,153 9,398,321 12/Dec/18 772,168 463,301 308,867
Ny. Yulaikah 27/Nov/18 2,135,255 2,408,742 12/Dec/18 273,487 164,092 109,395
Tn. Zazuli 28/Nov/18 6,193,172 7,244,631 12/Dec/18 1,051,459 630,875 420,584
An. M. Dzikri D 29/Nov/18 4,246,388 4,662,027 30/Jan/19 415,639 249,383 166,256
Ny. Sumini 3/Dec/18 9,410,273 10,465,488 19/Dec/18 1,055,215 633,129 422,086
 Tn. Nur Salim 5/Dec/18 4,401,033 4,821,856 19/Dec/18 420,823 252,494 168,329
Ny. Tria Setiya 9/Dec/18 7,273,566 7,967,124 9/Jan/19 693,558 416,135 277,423
Ny. Sumilah 11/Dec/18 10,098,142 11,211,918 9/Jan/19 1,113,776 668,266 445,510
An. Syakilla Almahyra 15/Dec/18 4,576,174 4,977,182 2/Jan/19 401,008 240,605 160,403
Ny. Lilik Amiati 25/Dec/18 2,675,164 3,039,055 16/Jan/19 363,891 218,335 145,556
Ny. Muhayanah 28/Dec/18 12,151,747 14,562,534 16/Jan/19 2,410,787 1,446,472 964,315
Sdr. Muhammad Andrie 31/Dec/18 5,959,803 6,570,539 16/Jan/19 610,736 366,442 244,294
Tn. Suryadi 31/Dec/18 6,358,240 6,966,335 16/Jan/19 608,095 364,857 243,238
Tn. Hariyadi 4/Jan/19 4,877,375 5,391,544 16/Jan/19 514,169 308,501 205,668
Ny. Lailina Rohmatika 9/Jan/19 3,193,849 3,552,819 30/Jan/19 358,970 215,382 143,588
Ny. Suharmi 10/Jan/19 6,081,596 6,712,373 30/Jan/19 630,777 378,466 252,311
An. M. Haikal A 19/Jan/19 5,218,256 5,758,622 2/Jun/19 540,366 324,220 216,146
M. Chorul as'ad 22/Jan/19 6,324,530 6,899,428 2/Jun/19 574,898 344,939 229,959
An. M. Rafif A 22/Jan/19 3,987,149 4,350,294 2/Jun/19 363,145 217,887 145,258
Ny. Nuril Amalia Afifatus 21/Jan/19 4,258,291 4,695,066 2/Jun/19 436,775 262,065 174,710
An. Yusfinda 27/Jan/19 4,322,685 4,750,545 20/Feb/19 427,860 256,716 171,144

4 Asuransi Jasa Raharja

Tn. Soekarto 13/Jul/18 2,680,900 3,118,175 15/Aug/18 437,275 262,365 174,910
Tn. Aang Parahiyang 3/Aug/18 20,209,966 23,248,264 5/Sep/18 3,038,298 1,822,979 1,215,319
An. Raehan Syah 16/Aug/18 16,843,416 19,491,437 5/Nov/18 2,648,021 1,588,813 1,059,208
Tn. Ali Imron 27/Aug/18 3,706,247 4,116,109 22/Oct/18 409,862 245,917 163,945
Tn. Jumadi 1/Sep/18 13,180,069 15,825,532 22/Oct/18 2,645,463 1,587,278 1,058,185
Ny. Nikmawati 2/Sep/18 9,210,410 10,819,331 22/Oct/18 1,608,921 965,353 643,568
Tn. Purwanto 3/Sep/18 29,407,333 33,432,800 22/Oct/18 4,025,467 2,415,280 1,610,187
Nn. Yeni Rohmatul Mufida 8/Sep/18 3,576,783 4,690,022 22/Oct/18 1,113,239 667,943 445,296
Tn. Satrio Hafidz 11/Sep/18 7,357,600 10,135,730 22/Oct/18 2,778,130 1,666,878 1,111,252
Sdr. M. Ishaq 4/Oct/18 20,687,536 23,721,413 22/Oct/18 3,033,877 1,820,326 1,213,551
Tn. Didik Rahman 10/Oct/18 2,280,061 3,357,179 26/Oct/18 1,077,118 646,271 430,847
Tn. Fauzi Gunawan 17/Oct/18 2,651,358 3,684,773 6/Nov/18 1,033,415 620,049 413,366
Tn. Sutrisno 17/Oct/18 11,935,356 15,442,549 6/Nov/18 3,507,193 2,104,316 1,402,877
Tn. Agung Setiya Budi 18/Oct/18 21,482,302 26,304,817 6/Nov/18 4,822,515 2,893,509 1,929,006
Tn. M Suyanto 21/Oct/18 5,111,030 6,416,637 6/Nov/18 1,305,607 783,364 522,243
Ny. Anita Susiyowati 10/Nov/18 13,729,417 17,428,535 7/Jan/19 3,699,118 2,219,471 1,479,647
Tn. Kardi 10/Dec/18 21,135,628 25,323,409 7/Jan/19 4,187,781 2,512,669 1,675,112
Tn. Ahmad Deni Krisdise 17/Dec/18 12,564,614 15,951,509 7/Jan/19 3,386,895 2,032,137 1,354,758
Chodijah 18/Dec/18 19,912,327 24,016,365 13/Feb/19 4,104,038 2,462,423 1,641,615
Tn. Abd Somad 31/Dec/18 6,979,955 8,958,775 6/Feb/19 1,978,820 1,187,292 791,528
Tn. Wahyu Widodo 31/Dec/18 16,530,452 20,509,925 6/Feb/19 3,979,473 2,387,684 1,591,789
Ny. Zuhrotul Aini 8/Jan/19 11,412,244 13,602,052 6/Feb/19 2,189,808 1,313,885 875,923
Anang Basori 24/Jan/19 8,870,247 11,683,484 12/Feb/19 2,813,237 1,687,942 1,125,295

Total 89,664,418 53,798,651 35,865,767

 TOTAL
PLAFOND SELISIH TGL
NAMA TGL MRS BILLING KLAIM MARGIN MARKETING RS (40%)
BPJS PLAFOND PENCAIRAN
(SISTEM) (60%)

PT Indolakto (BPJS)
Tn. Wahyudi 24/Nov/18 3,302,341 3,623,197 2,760,300 (862,897) 28/Jan/19 320,856 192,514 128,342
Pitono 7/Dec/18 2,735,699 3,044,000 1,556,780 (1,487,220) 9/Jan/19 308,301 184,981 123,320
Ny. Anisa Subagio 1 16/Dec/19 3,879,772 4,574,711 2,504,800 (2,069,911) 9/Jan/19 694,939 416,963 277,976
Tn. Durasit 1 15/Dec/18 8,676,324 10,385,266 7,461,400 (2,923,866) 9/Jan/19 1,708,942 1,025,365 683,577
An. Dzakia Eka Rahmadani 18/Dec/18 3,079,433 4,212,443 3,079,433 (1,133,010) 29/Jan/19 1,133,010 679,806 453,204
Ny. Anisa Subagio 2 8/Jan/19 8,489,342 10,041,400 2,300,000 (7,741,400) 11/Jan/19 1,552,058 931,235 620,823
Tn. Durasit 2 8/Jan/19 6,596,249 8,033,305 4,031,500 (4,001,805) 12/Jan/19 1,437,056 862,234 574,822

Total 7,155,162 4,293,097 2,862,065

Total Pengajuan Fee Marketing 59,819,133