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UMPAN BALIK HASIL VERIFIKASI

Nama RS : RS BHAKTI RAHAYU - KOTA AMBON
Tingkat Pelayanan : RITL
Bulan Pelayanan : Januari 2019

No No.SEP Tgl. Verifikasi Biaya

Diajukan Disetujui
1 2501R0040119V000004 2019-04-03 2,553,600 2,553,600
2 2501R0040119V000006 2019-04-03 2,553,600 2,553,600
3 2501R0040119V000007 2019-04-03 3,937,500 3,937,500
4 2501R0040119V000008 2019-04-03 3,124,500 3,124,500
5 2501R0040119V000009 2019-04-03 4,163,200 4,163,200
6 2501R0040119V000011 2019-04-03 2,957,800 2,957,800
7 2501R0040119V000012 2019-04-03 2,541,500 2,541,500
8 2501R0040119V000017 2019-04-03 8,395,100 8,395,100
9 2501R0040119V000018 2019-04-03 4,246,700 4,246,700
10 2501R0040119V000019 2019-04-03 2,498,800 2,498,800
11 2501R0040119V000020 2019-04-03 2,553,600 2,553,600
12 2501R0040119V000023 2019-04-03 2,553,600 2,553,600
13 2501R0040119V000024 2019-04-03 5,145,000 5,145,000
14 2501R0040119V000028 2019-04-03 6,800,400 6,800,400
15 2501R0040119V000030 2019-04-03 4,687,700 4,687,700
16 2501R0040119V000031 2019-04-03 6,562,800 6,562,800
17 2501R0040119V000032 2019-04-03 2,926,000 2,926,000
18 2501R0040119V000034 2019-04-03 3,361,900 3,361,900
19 2501R0040119V000035 2019-04-03 6,934,200 6,934,200
20 2501R0040119V000036 2019-04-03 2,926,000 2,926,000
21 2501R0040119V000041 2019-04-03 5,547,300 5,547,300
22 2501R0040119V000042 2019-04-03 4,850,000 4,850,000
23 2501R0040119V000043 2019-04-03 4,687,700 4,687,700
24 2501R0040119V000044 2019-04-03 1,178,700 1,178,700
25 2501R0040119V000045 2019-04-03 8,183,400 8,183,400
26 2501R0040119V000047 2019-04-03 5,896,000 5,896,000
27 2501R0040119V000051 2019-04-03 2,652,000 2,652,000
28 2501R0040119V000052 2019-04-03 4,977,800 4,977,800
29 2501R0040119V000057 2019-04-03 3,299,800 3,299,800
30 2501R0040119V000064 2019-04-03 8,387,900 8,387,900
31 2501R0040119V000068 2019-04-03 5,176,500 5,176,500
32 2501R0040119V000069 2019-04-03 5,304,800 5,304,800
Nama RS : RS BHAKTI RAHAYU - KOTA AMBON
Tingkat Pelayanan : RITL
Bulan Pelayanan : Januari 2019

33 2501R0040119V000074 2019-04-03 1,922,800 1,922,800

34 2501R0040119V000080 2019-04-03 2,117,900 2,117,900
35 2501R0040119V000081 2019-04-03 4,420,600 4,420,600
36 2501R0040119V000089 2019-04-03 6,039,200 6,039,200
37 2501R0040119V000091 2019-04-03 4,313,700 4,313,700
38 2501R0040119V000094 2019-04-03 4,857,400 4,857,400
39 2501R0040119V000095 2019-04-03 4,313,700 4,313,700
40 2501R0040119V000098 2019-04-03 1,202,500 1,202,500
41 2501R0040119V000099 2019-04-03 4,687,700 4,687,700
42 2501R0040119V000100 2019-04-03 4,313,700 4,313,700
43 2501R0040119V000101 2019-04-03 2,926,000 2,926,000
44 2501R0040119V000103 2019-04-03 2,926,000 2,926,000
45 2501R0040119V000104 2019-04-03 7,716,300 7,716,300
46 2501R0040119V000105 2019-04-03 6,471,900 6,471,900
47 2501R0040119V000106 2019-04-03 4,225,500 4,225,500
48 2501R0040119V000107 2019-04-03 1,922,800 1,922,800
49 2501R0040119V000108 2019-04-03 5,625,200 5,625,200
50 2501R0040119V000111 2019-04-03 5,511,600 5,511,600
51 2501R0040119V000113 2019-04-03 1,178,700 1,178,700
52 2501R0040119V000114 2019-04-03 2,773,800 2,773,800
53 2501R0040119V000115 2019-04-03 1,650,200 1,650,200
54 2501R0040119V000116 2019-04-03 3,642,000 3,642,000
55 2501R0040119V000117 2019-04-03 2,981,200 2,981,200
56 2501R0040119V000123 2019-04-03 4,836,300 4,836,300
57 2501R0040119V000124 2019-04-03 2,553,600 2,553,600
58 2501R0040119V000127 2019-04-03 5,625,200 5,625,200
59 2501R0040119V000131 2019-04-03 4,687,700 4,687,700
60 2501R0040119V000132 2019-04-03 1,650,200 1,650,200
61 2501R0040119V000133 2019-04-03 2,243,300 2,243,300
62 2501R0040119V000145 2019-04-03 2,926,000 2,926,000
63 2501R0040119V000152 2019-04-03 2,090,000 2,090,000
64 2501R0040119V000153 2019-04-03 2,658,200 2,658,200
65 2501R0040119V000155 2019-04-03 2,209,800 2,209,800
66 2501R0040119V000163 2019-04-03 4,225,500 4,225,500
Nama RS : RS BHAKTI RAHAYU - KOTA AMBON
Tingkat Pelayanan : RITL
Bulan Pelayanan : Januari 2019

67 2501R0040119V000165 2019-04-03 3,731,200 3,731,200

68 2501R0040119V000166 2019-04-03 1,908,600 1,908,600
69 2501R0040119V000169 2019-04-03 2,553,600 2,553,600
70 2501R0040119V000170 2019-04-03 2,926,000 2,926,000
71 2501R0040119V000171 2019-04-03 6,143,000 6,143,000
72 2501R0040119V000172 2019-04-03 4,687,700 4,687,700
73 2501R0040119V000173 2019-04-03 5,053,700 5,053,700
74 2501R0040119V000174 2019-04-03 1,410,800 1,410,800
75 2501R0040119V000175 2019-04-03 2,812,500 2,812,500
76 2501R0040119V000176 2019-04-03 5,896,000 5,896,000
77 2501R0040119V000179 2019-04-03 2,553,600 2,553,600
78 2501R0040119V000182 2019-04-03 2,904,000 2,904,000
79 2501R0040119V000184 2019-04-03 2,658,200 2,658,200
80 2501R0040119V000185 2019-04-03 6,614,000 6,614,000
81 2501R0040119V000188 2019-04-03 5,121,000 5,121,000
82 2501R0040119V000190 2019-04-03 2,957,800 2,957,800
83 2501R0040119V000192 2019-04-03 2,209,800 2,209,800
84 2501R0040119V000193 2019-04-03 2,553,600 2,553,600
85 2501R0040119V000194 2019-04-03 4,959,200 4,959,200
86 2501R0040119V000199 2019-04-03 6,614,000 6,614,000
87 2501R0040119V000201 2019-04-03 1,922,800 1,922,800
88 2501R0040119V000205 2019-04-03 5,845,300 5,845,300
89 2501R0040119V000207 2019-04-03 6,014,000 6,014,000
90 2501R0040119V000208 2019-04-03 4,687,700 4,687,700
91 2501R0040119V000213 2019-04-03 6,614,000 6,614,000
92 2501R0040119V000214 2019-04-03 7,077,800 7,077,800
93 2501R0040119V000222 2019-04-03 4,687,700 4,687,700
94 2501R0040119V000224 2019-04-03 5,055,600 5,055,600
95 2501R0040119V000225 2019-04-03 4,929,800 4,929,800
96 2501R0040119V000226 2019-04-03 3,721,400 3,721,400
97 2501R0040119V000227 2019-04-03 2,508,000 2,508,000
98 2501R0040119V000238 2019-04-03 2,489,100 2,489,100
99 2501R0040119V000243 2019-04-03 2,090,000 2,090,000
100 2501R0040119V000244 2019-04-03 7,800,000 7,800,000
Nama RS : RS BHAKTI RAHAYU - KOTA AMBON
Tingkat Pelayanan : RITL
Bulan Pelayanan : Januari 2019

101 2501R0040119V000247 2019-04-03 4,929,800 4,929,800

102 2501R0040119V000249 2019-04-03 4,687,700 4,687,700
103 2501R0040119V000250 2019-04-03 1,602,300 1,602,300
104 2501R0040119V000253 2019-04-03 2,957,800 2,957,800
105 2501R0040119V000254 2019-04-03 1,602,300 1,602,300
106 2501R0040119V000255 2019-04-03 2,928,800 2,928,800
107 2501R0040119V000258 2019-04-03 2,508,000 2,508,000
108 2501R0040119V000262 2019-04-03 3,521,300 3,521,300
109 2501R0040119V000263 2019-04-03 5,316,400 5,316,400
110 2501R0040119V000264 2019-04-03 4,225,500 4,225,500
111 2501R0040119V000266 2019-04-03 2,614,100 2,614,100
112 2501R0040119V000267 2019-04-03 1,487,900 1,487,900
113 2501R0040119V000268 2019-04-03 1,143,200 1,143,200
114 2501R0040119V000270 2019-04-03 4,044,700 4,044,700
115 2501R0040119V000277 2019-04-03 4,313,700 4,313,700
116 2501R0040119V000281 2019-04-03 3,454,500 3,454,500
117 2501R0040119V000282 2019-04-03 3,521,300 3,521,300
118 2501R0040119V000283 2019-04-03 3,187,700 3,187,700
119 2501R0040119V000286 2019-04-03 2,541,500 2,541,500
120 2501R0040119V000289 2019-04-03 4,273,400 4,273,400
121 2501R0040119V000293 2019-04-03 1,602,300 1,602,300
122 2501R0040119V000298 2019-04-03 2,226,600 2,226,600
123 2501R0040119V000304 2019-04-03 4,687,700 4,687,700
124 2501R0040119V000306 2019-04-03 6,379,700 6,379,700
125 2501R0040119V000314 2019-04-03 2,835,000 2,835,000
126 2501R0040119V000315 2019-04-03 3,521,300 3,521,300
127 2501R0040119V000316 2019-04-03 2,663,000 2,663,000
128 2501R0040119V000317 2019-04-03 4,622,800 4,622,800
129 2501R0040119V000318 2019-04-03 2,926,000 2,926,000
130 2501R0040119V000319 2019-04-03 1,371,900 1,371,900
131 2501R0040119V000322 2019-04-03 5,511,600 5,511,600
132 2501R0040119V000325 2019-04-03 1,922,800 1,922,800
133 2501R0040119V000327 2019-04-03 3,312,000 3,312,000
134 2501R0040119V000328 2019-04-03 5,511,600 5,511,600
Nama RS : RS BHAKTI RAHAYU - KOTA AMBON
Tingkat Pelayanan : RITL
Bulan Pelayanan : Januari 2019

135 2501R0040119V000329 2019-04-03 2,658,200 2,658,200

136 2501R0040119V000331 2019-04-03 8,183,400 8,183,400
137 2501R0040119V000337 2019-04-03 2,090,000 2,090,000
138 2501R0040119V000341 2019-04-03 4,622,800 4,622,800
139 2501R0040119V000342 2019-04-03 5,625,200 5,625,200
140 2501R0040119V000343 2019-04-03 8,555,700 8,555,700
141 2501R0040119V000344 2019-04-03 5,469,100 5,469,100
142 2501R0040119V000345 2019-04-03 5,996,500 5,996,500
143 2501R0040119V000346 2019-04-03 5,511,600 5,511,600
144 2501R0040119V000350 2019-04-03 4,622,800 4,622,800
145 2501R0040119V000352 2019-04-03 2,926,000 2,926,000
146 2501R0040119V000356 2019-04-03 4,410,000 4,410,000
147 2501R0040119V000357 2019-04-03 5,547,300 5,547,300
148 2501R0040119V000358 2019-04-03 3,521,300 3,521,300
149 2501R0040119V000359 2019-04-03 1,922,800 1,922,800
150 2501R0040119V000366 2019-04-03 5,053,700 5,053,700
151 2501R0040119V000367 2019-04-03 3,189,800 3,189,800
152 2501R0040119V000387 2019-04-03 2,498,800 2,498,800
153 2501R0040119V000390 2019-04-03 1,602,300 1,602,300
154 2501R0040119V000391 2019-04-03 2,508,000 2,508,000
155 2501R0040119V000396 2019-04-03 1,692,700 1,692,700
156 2501R0040119V000401 2019-04-03 1,692,700 1,692,700
157 2501R0040119V000402 2019-04-03 6,471,900 6,471,900
158 2501R0040119V000407 2019-04-03 2,741,600 2,741,600
159 2501R0040119V000408 2019-04-03 3,721,400 3,721,400
160 2501R0040119V000425 2019-04-03 1,602,300 1,602,300
161 2501R0040119V000429 2019-04-03 2,243,300 2,243,300
162 2501R0040119V000445 2019-04-03 4,370,400 4,370,400
163 2501R0040119V000446 2019-04-03 2,243,300 2,243,300
164 2501R0041218V000284 2019-04-03 5,839,700 5,839,700
165 2501R0041218V000286 2019-04-03 5,511,600 5,511,600
166 2501R0041218V000300 2019-04-03 2,812,500 2,812,500
167 2501R0041218V000305 2019-04-03 2,090,000 2,090,000
168 2501R0041218V000308 2019-04-03 2,926,000 2,926,000
Nama RS : RS BHAKTI RAHAYU - KOTA AMBON
Tingkat Pelayanan : RITL
Bulan Pelayanan : Januari 2019

169 2501R0041218V000313 2019-04-03 3,564,700 3,564,700

TOTAL 656,718,700 656,718,700

RESUME
Total Bea.Diajukan : 656,718,700
Total Bea.Disetujui : 656,718,700
Menyetujui Mengetahui
Direktur RS BPJS KESEHATAN
dr. Maytha Pesik