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UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.1/145

No No.SEP Tgl. Verifikasi Biaya


Diajukan Disetujui
1 0810R00107170000001 * 04/09/2017 184,900 184,900
2 0810R00107170000002 * 04/09/2017 184,900 184,900
3 0810R00107170000004 * 04/09/2017 184,900 184,900
4 0810R00107170000005 * 04/09/2017 184,900 184,900
5 0810R00107170000006 * 25/08/2017 184,900 184,900
6 0810R00107170000007 * 04/09/2017 186,300 186,300
7 0810R00107170000008 * 04/09/2017 887,100 887,100
8 0810R00107170000009 * 04/09/2017 887,100 887,100
9 0810R00107170000010 * 04/09/2017 887,100 887,100
10 0810R00107170000011 * 04/09/2017 887,100 887,100
11 0810R00107170000012 * 25/08/2017 184,900 184,900
12 0810R00107170000013 * 04/09/2017 887,100 887,100
13 0810R00107170000014 * 04/09/2017 887,100 887,100
14 0810R00107170000015 * 04/09/2017 887,100 887,100
15 0810R00107170000016 * 04/09/2017 887,100 887,100
16 0810R00107170000017 * 04/09/2017 887,100 887,100
17 0810R00107170000018 * 04/09/2017 887,100 887,100
18 0810R00107170000019 * 04/09/2017 887,100 887,100
19 0810R00107170000020 * 04/09/2017 887,100 887,100
20 0810R00107170000021 * 04/09/2017 887,100 887,100
21 0810R00107170000022 * 04/09/2017 887,100 887,100
22 0810R00107170000023 * 04/09/2017 184,900 184,900
23 0810R00107170000024 * 04/09/2017 887,100 887,100
24 0810R00107170000025 * 04/09/2017 887,100 887,100
25 0810R00107170000026 * 04/09/2017 887,100 887,100
26 0810R00107170000027 * 04/09/2017 887,100 887,100
27 0810R00107170000029 * 04/09/2017 887,100 887,100
28 0810R00107170000030 * 04/09/2017 887,100 887,100
29 0810R00107170000031 * 04/09/2017 887,100 887,100
30 0810R00107170000032 * 04/09/2017 184,900 184,900
31 0810R00107170000033 * 04/09/2017 887,100 887,100
32 0810R00107170000034 * 04/09/2017 887,100 887,100
33 0810R00107170000035 * 04/09/2017 887,100 887,100
34 0810R00107170000036 * 25/08/2017 128,700 128,700
35 0810R00107170000037 * 04/09/2017 184,900 184,900
36 0810R00107170000039 * 25/08/2017 184,900 184,900
37 0810R00107170000041 * 30/08/2017 289,400 289,400
38 0810R00107170000042 * 04/09/2017 184,900 184,900
39 0810R00107170000050 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.2/145

40 0810R00107170000052 * 25/08/2017 184,900 184,900


41 0810R00107170000059 * 04/09/2017 186,300 186,300
42 0810R00107170000062 * 04/09/2017 186,300 186,300
43 0810R00107170000064 * 04/09/2017 138,700 138,700
44 0810R00107170000065 * 25/08/2017 255,700 255,700
45 0810R00107170000068 * 04/09/2017 138,700 138,700
46 0810R00107170000070 * 04/09/2017 186,300 186,300
47 0810R00107170000072 * 04/09/2017 148,000 148,000
48 0810R00107170000075 * 04/09/2017 186,300 186,300
49 0810R00107170000078 * 04/09/2017 186,300 186,300
50 0810R00107170000085 * 25/08/2017 259,800 259,800
51 0810R00107170000087 * 25/08/2017 184,900 184,900
52 0810R00107170000093 * 04/09/2017 186,300 186,300
53 0810R00107170000096 * 29/08/2017 342,700 342,700
54 0810R00107170000099 * 25/08/2017 314,500 314,500
55 0810R00107170000103 * 25/08/2017 342,700 342,700
56 0810R00107170000106 * 04/09/2017 186,300 186,300
57 0810R00107170000107 * 29/08/2017 208,700 208,700
58 0810R00107170000108 * 04/09/2017 141,300 141,300
59 0810R00107170000115 * 04/09/2017 314,500 314,500
60 0810R00107170000124 * 04/09/2017 186,300 186,300
61 0810R00107170000127 * 04/09/2017 184,900 184,900
62 0810R00107170000129 * 04/09/2017 184,900 184,900
63 0810R00107170000130 * 04/09/2017 186,300 186,300
64 0810R00107170000132 * 04/09/2017 184,900 184,900
65 0810R00107170000133 * 04/09/2017 184,900 184,900
66 0810R00107170000134 * 04/09/2017 184,900 184,900
67 0810R00107170000135 * 04/09/2017 184,900 184,900
68 0810R00107170000137 * 04/09/2017 114,100 114,100
69 0810R00107170000138 * 04/09/2017 184,900 184,900
70 0810R00107170000139 * 04/09/2017 184,900 184,900
71 0810R00107170000141 * 04/09/2017 184,900 184,900
72 0810R00107170000142 * 04/09/2017 184,900 184,900
73 0810R00107170000143 * 04/09/2017 114,100 114,100
74 0810R00107170000144 * 04/09/2017 155,100 155,100
75 0810R00107170000145 * 04/09/2017 114,100 114,100
76 0810R00107170000146 * 04/09/2017 114,100 114,100
77 0810R00107170000147 * 28/08/2017 200,700 200,700
78 0810R00107170000149 * 04/09/2017 114,100 114,100
79 0810R00107170000150 * 04/09/2017 155,100 155,100
80 0810R00107170000151 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.3/145

81 0810R00107170000152 * 04/09/2017 114,100 114,100


82 0810R00107170000153 * 28/08/2017 184,900 184,900
83 0810R00107170000154 * 04/09/2017 184,900 184,900
84 0810R00107170000155 * 28/08/2017 200,700 200,700
85 0810R00107170000156 * 04/09/2017 184,900 184,900
86 0810R00107170000158 * 04/09/2017 184,900 184,900
87 0810R00107170000159 * 04/09/2017 184,900 184,900
88 0810R00107170000160 * 04/09/2017 184,900 184,900
89 0810R00107170000161 * 04/09/2017 114,100 114,100
90 0810R00107170000162 * 04/09/2017 184,900 184,900
91 0810R00107170000163 * 28/08/2017 184,900 184,900
92 0810R00107170000164 * 04/09/2017 114,100 114,100
93 0810R00107170000165 * 04/09/2017 114,100 114,100
94 0810R00107170000166 * 04/09/2017 155,100 155,100
95 0810R00107170000167 * 04/09/2017 114,100 114,100
96 0810R00107170000168 * 04/09/2017 114,100 114,100
97 0810R00107170000169 * 04/09/2017 114,100 114,100
98 0810R00107170000171 * 04/09/2017 184,900 184,900
99 0810R00107170000172 * 04/09/2017 184,900 184,900
100 0810R00107170000173 * 04/09/2017 184,900 184,900
101 0810R00107170000174 * 04/09/2017 184,900 184,900
102 0810R00107170000175 * 04/09/2017 184,900 184,900
103 0810R00107170000176 * 28/08/2017 184,900 184,900
104 0810R00107170000177 * 04/09/2017 184,900 184,900
105 0810R00107170000178 * 04/09/2017 184,900 184,900
106 0810R00107170000179 * 04/09/2017 114,100 114,100
107 0810R00107170000180 * 04/09/2017 184,900 184,900
108 0810R00107170000181 * 04/09/2017 114,100 114,100
109 0810R00107170000182 * 28/08/2017 184,900 184,900
110 0810R00107170000183 * 04/09/2017 114,100 114,100
111 0810R00107170000184 * 28/08/2017 200,700 200,700
112 0810R00107170000185 * 04/09/2017 114,100 114,100
113 0810R00107170000186 * 04/09/2017 184,900 184,900
114 0810R00107170000187 * 28/08/2017 184,900 184,900
115 0810R00107170000188 * 04/09/2017 184,900 184,900
116 0810R00107170000189 * 04/09/2017 184,900 184,900
117 0810R00107170000190 * 04/09/2017 184,900 184,900
118 0810R00107170000192 * 04/09/2017 184,900 184,900
119 0810R00107170000193 * 04/09/2017 184,900 184,900
120 0810R00107170000194 * 04/09/2017 184,900 184,900
121 0810R00107170000195 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.4/145

122 0810R00107170000196 * 04/09/2017 114,100 114,100


123 0810R00107170000197 * 04/09/2017 114,100 114,100
124 0810R00107170000198 * 04/09/2017 184,900 184,900
125 0810R00107170000199 * 04/09/2017 184,900 184,900
126 0810R00107170000200 * 04/09/2017 184,900 184,900
127 0810R00107170000201 * 04/09/2017 114,100 114,100
128 0810R00107170000202 * 04/09/2017 184,900 184,900
129 0810R00107170000203 * 04/09/2017 114,100 114,100
130 0810R00107170000204 * 04/09/2017 184,900 184,900
131 0810R00107170000205 * 04/09/2017 184,900 184,900
132 0810R00107170000206 * 28/08/2017 184,900 184,900
133 0810R00107170000207 * 04/09/2017 184,900 184,900
134 0810R00107170000208 * 04/09/2017 114,100 114,100
135 0810R00107170000209 * 04/09/2017 155,100 155,100
136 0810R00107170000210 * 04/09/2017 155,100 155,100
137 0810R00107170000212 * 04/09/2017 114,100 114,100
138 0810R00107170000213 * 04/09/2017 184,900 184,900
139 0810R00107170000214 * 04/09/2017 184,900 184,900
140 0810R00107170000215 * 04/09/2017 114,100 114,100
141 0810R00107170000217 * 04/09/2017 184,900 184,900
142 0810R00107170000219 * 04/09/2017 184,900 184,900
143 0810R00107170000220 * 04/09/2017 184,900 184,900
144 0810R00107170000222 * 28/08/2017 200,700 200,700
145 0810R00107170000223 * 28/08/2017 215,300 215,300
146 0810R00107170000224 * 28/08/2017 215,300 215,300
147 0810R00107170000225 * 04/09/2017 114,100 114,100
148 0810R00107170000226 * 04/09/2017 184,900 184,900
149 0810R00107170000227 * 28/08/2017 184,900 184,900
150 0810R00107170000228 * 04/09/2017 114,100 114,100
151 0810R00107170000229 * 28/08/2017 210,700 210,700
152 0810R00107170000230 * 28/08/2017 184,900 184,900
153 0810R00107170000231 * 28/08/2017 184,900 184,900
154 0810R00107170000232 * 04/09/2017 184,900 184,900
155 0810R00107170000233 * 04/09/2017 184,900 184,900
156 0810R00107170000234 * 04/09/2017 184,900 184,900
157 0810R00107170000236 * 04/09/2017 184,900 184,900
158 0810R00107170000237 * 04/09/2017 184,900 184,900
159 0810R00107170000238 * 04/09/2017 114,100 114,100
160 0810R00107170000240 * 04/09/2017 114,100 114,100
161 0810R00107170000241 * 04/09/2017 184,900 184,900
162 0810R00107170000242 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.5/145

163 0810R00107170000243 * 28/08/2017 184,900 184,900


164 0810R00107170000244 * 04/09/2017 184,900 184,900
165 0810R00107170000245 * 04/09/2017 184,900 184,900
166 0810R00107170000246 * 04/09/2017 114,100 114,100
167 0810R00107170000247 * 04/09/2017 184,900 184,900
168 0810R00107170000248 * 04/09/2017 114,100 114,100
169 0810R00107170000251 * 04/09/2017 114,100 114,100
170 0810R00107170000252 * 04/09/2017 114,100 114,100
171 0810R00107170000253 * 04/09/2017 184,900 184,900
172 0810R00107170000254 * 04/09/2017 114,100 114,100
173 0810R00107170000255 * 04/09/2017 184,900 184,900
174 0810R00107170000257 * 04/09/2017 184,900 184,900
175 0810R00107170000258 * 28/08/2017 443,700 443,700
176 0810R00107170000260 * 28/08/2017 184,900 184,900
177 0810R00107170000261 * 28/08/2017 184,900 184,900
178 0810R00107170000262 * 04/09/2017 184,900 184,900
179 0810R00107170000263 * 04/09/2017 114,100 114,100
180 0810R00107170000264 * 04/09/2017 114,100 114,100
181 0810R00107170000266 * 28/08/2017 184,900 184,900
182 0810R00107170000267 * 04/09/2017 114,100 114,100
183 0810R00107170000268 * 04/09/2017 114,100 114,100
184 0810R00107170000269 * 30/08/2017 295,100 295,100
185 0810R00107170000270 * 04/09/2017 114,100 114,100
186 0810R00107170000271 * 28/08/2017 184,900 184,900
187 0810R00107170000272 * 04/09/2017 155,100 155,100
188 0810R00107170000273 * 04/09/2017 184,900 184,900
189 0810R00107170000274 * 04/09/2017 114,100 114,100
190 0810R00107170000275 * 04/09/2017 184,900 184,900
191 0810R00107170000276 * 04/09/2017 114,100 114,100
192 0810R00107170000277 * 04/09/2017 184,900 184,900
193 0810R00107170000279 * 28/08/2017 184,900 184,900
194 0810R00107170000280 * 04/09/2017 114,100 114,100
195 0810R00107170000281 * 04/09/2017 184,900 184,900
196 0810R00107170000282 * 04/09/2017 114,100 114,100
197 0810R00107170000283 * 04/09/2017 114,100 114,100
198 0810R00107170000284 * 04/09/2017 114,100 114,100
199 0810R00107170000285 * 04/09/2017 114,100 114,100
200 0810R00107170000286 * 04/09/2017 184,900 184,900
201 0810R00107170000287 * 04/09/2017 114,100 114,100
202 0810R00107170000288 * 04/09/2017 114,100 114,100
203 0810R00107170000289 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.6/145

204 0810R00107170000290 * 04/09/2017 114,100 114,100


205 0810R00107170000291 * 04/09/2017 114,100 114,100
206 0810R00107170000292 * 04/09/2017 114,100 114,100
207 0810R00107170000293 * 04/09/2017 155,100 155,100
208 0810R00107170000294 * 04/09/2017 114,100 114,100
209 0810R00107170000295 * 04/09/2017 114,100 114,100
210 0810R00107170000296 * 04/09/2017 114,100 114,100
211 0810R00107170000297 * 04/09/2017 114,100 114,100
212 0810R00107170000299 * 04/09/2017 114,100 114,100
213 0810R00107170000300 * 28/08/2017 210,700 210,700
214 0810R00107170000301 * 04/09/2017 155,100 155,100
215 0810R00107170000303 * 04/09/2017 887,100 887,100
216 0810R00107170000304 * 04/09/2017 887,100 887,100
217 0810R00107170000305 * 04/09/2017 887,100 887,100
218 0810R00107170000306 * 04/09/2017 887,100 887,100
219 0810R00107170000307 * 04/09/2017 184,900 184,900
220 0810R00107170000308 * 04/09/2017 184,900 184,900
221 0810R00107170000309 * 04/09/2017 887,100 887,100
222 0810R00107170000311 * 04/09/2017 887,100 887,100
223 0810R00107170000312 * 28/08/2017 200,700 200,700
224 0810R00107170000313 * 04/09/2017 184,900 184,900
225 0810R00107170000314 * 04/09/2017 887,100 887,100
226 0810R00107170000315 * 04/09/2017 184,900 184,900
227 0810R00107170000316 * 04/09/2017 887,100 887,100
228 0810R00107170000317 * 04/09/2017 887,100 887,100
229 0810R00107170000318 * 04/09/2017 887,100 887,100
230 0810R00107170000319 * 04/09/2017 887,100 887,100
231 0810R00107170000320 * 04/09/2017 887,100 887,100
232 0810R00107170000321 * 04/09/2017 887,100 887,100
233 0810R00107170000322 * 04/09/2017 887,100 887,100
234 0810R00107170000323 * 28/08/2017 184,900 184,900
235 0810R00107170000324 * 04/09/2017 887,100 887,100
236 0810R00107170000325 * 28/08/2017 184,900 184,900
237 0810R00107170000326 * 04/09/2017 887,100 887,100
238 0810R00107170000327 * 04/09/2017 184,900 184,900
239 0810R00107170000328 * 04/09/2017 887,100 887,100
240 0810R00107170000329 * 04/09/2017 184,900 184,900
241 0810R00107170000330 * 04/09/2017 887,100 887,100
242 0810R00107170000331 * 04/09/2017 887,100 887,100
243 0810R00107170000332 * 04/09/2017 887,100 887,100
244 0810R00107170000333 * 04/09/2017 887,100 887,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.7/145

245 0810R00107170000334 * 04/09/2017 887,100 887,100


246 0810R00107170000335 * 04/09/2017 887,100 887,100
247 0810R00107170000336 * 28/08/2017 200,700 200,700
248 0810R00107170000337 * 04/09/2017 887,100 887,100
249 0810R00107170000338 * 28/08/2017 184,900 184,900
250 0810R00107170000340 * 04/09/2017 184,900 184,900
251 0810R00107170000348 * 28/08/2017 255,700 255,700
252 0810R00107170000354 * 04/09/2017 887,100 887,100
253 0810R00107170000360 * 28/08/2017 186,300 186,300
254 0810R00107170000361 * 28/08/2017 314,500 314,500
255 0810R00107170000363 * 04/09/2017 140,500 140,500
256 0810R00107170000392 * 28/08/2017 267,200 267,200
257 0810R00107170000404 * 28/08/2017 960,400 960,400
258 0810R00107170000405 * 04/09/2017 148,000 148,000
259 0810R00107170000407 * 04/09/2017 186,300 186,300
260 0810R00107170000408 * 04/09/2017 184,900 184,900
261 0810R00107170000409 * 04/09/2017 184,900 184,900
262 0810R00107170000410 * 04/09/2017 184,900 184,900
263 0810R00107170000411 * 04/09/2017 184,900 184,900
264 0810R00107170000412 * 04/09/2017 184,900 184,900
265 0810R00107170000413 * 04/09/2017 184,900 184,900
266 0810R00107170000414 * 04/09/2017 184,900 184,900
267 0810R00107170000415 * 04/09/2017 184,900 184,900
268 0810R00107170000416 * 04/09/2017 184,900 184,900
269 0810R00107170000417 * 04/09/2017 184,900 184,900
270 0810R00107170000418 * 04/09/2017 114,100 114,100
271 0810R00107170000419 * 04/09/2017 155,100 155,100
272 0810R00107170000420 * 04/09/2017 114,100 114,100
273 0810R00107170000421 * 04/09/2017 114,100 114,100
274 0810R00107170000422 * 04/09/2017 114,100 114,100
275 0810R00107170000423 * 04/09/2017 184,900 184,900
276 0810R00107170000424 * 28/08/2017 215,300 215,300
277 0810R00107170000425 * 28/08/2017 184,900 184,900
278 0810R00107170000426 * 04/09/2017 184,900 184,900
279 0810R00107170000427 * 04/09/2017 184,900 184,900
280 0810R00107170000428 * 04/09/2017 184,900 184,900
281 0810R00107170000429 * 04/09/2017 184,900 184,900
282 0810R00107170000431 * 28/08/2017 200,700 200,700
283 0810R00107170000432 * 04/09/2017 184,900 184,900
284 0810R00107170000433 * 04/09/2017 184,900 184,900
285 0810R00107170000434 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.8/145

286 0810R00107170000435 * 04/09/2017 344,900 344,900


287 0810R00107170000436 * 04/09/2017 184,900 184,900
288 0810R00107170000437 * 04/09/2017 184,900 184,900
289 0810R00107170000438 * 04/09/2017 184,900 184,900
290 0810R00107170000439 * 28/08/2017 184,900 184,900
291 0810R00107170000440 * 04/09/2017 184,900 184,900
292 0810R00107170000441 * 04/09/2017 184,900 184,900
293 0810R00107170000442 * 04/09/2017 184,900 184,900
294 0810R00107170000444 * 28/08/2017 184,900 184,900
295 0810R00107170000445 * 04/09/2017 184,900 184,900
296 0810R00107170000446 * 30/08/2017 200,700 200,700
297 0810R00107170000447 * 28/08/2017 184,900 184,900
298 0810R00107170000448 * 04/09/2017 184,900 184,900
299 0810R00107170000449 * 04/09/2017 114,100 114,100
300 0810R00107170000450 * 04/09/2017 114,100 114,100
301 0810R00107170000451 * 04/09/2017 114,100 114,100
302 0810R00107170000452 * 04/09/2017 114,100 114,100
303 0810R00107170000453 * 31/08/2017 314,500 314,500
304 0810R00107170000455 * 04/09/2017 184,900 184,900
305 0810R00107170000456 * 04/09/2017 114,100 114,100
306 0810R00107170000457 * 04/09/2017 114,100 114,100
307 0810R00107170000458 * 04/09/2017 114,100 114,100
308 0810R00107170000459 * 04/09/2017 114,100 114,100
309 0810R00107170000460 * 04/09/2017 114,100 114,100
310 0810R00107170000461 * 28/08/2017 184,900 184,900
311 0810R00107170000462 * 28/08/2017 200,700 200,700
312 0810R00107170000463 * 04/09/2017 114,100 114,100
313 0810R00107170000465 * 04/09/2017 184,900 184,900
314 0810R00107170000466 * 28/08/2017 215,300 215,300
315 0810R00107170000467 * 04/09/2017 184,900 184,900
316 0810R00107170000468 * 04/09/2017 184,900 184,900
317 0810R00107170000469 * 28/08/2017 184,900 184,900
318 0810R00107170000470 * 04/09/2017 184,900 184,900
319 0810R00107170000471 * 04/09/2017 184,900 184,900
320 0810R00107170000472 * 04/09/2017 184,900 184,900
321 0810R00107170000473 * 28/08/2017 200,700 200,700
322 0810R00107170000474 * 04/09/2017 186,300 186,300
323 0810R00107170000475 * 04/09/2017 186,300 186,300
324 0810R00107170000476 * 30/08/2017 184,900 184,900
325 0810R00107170000477 * 04/09/2017 114,100 114,100
326 0810R00107170000478 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.9/145

327 0810R00107170000479 * 04/09/2017 114,100 114,100


328 0810R00107170000480 * 04/09/2017 114,100 114,100
329 0810R00107170000481 * 28/08/2017 184,900 184,900
330 0810R00107170000482 * 04/09/2017 155,100 155,100
331 0810R00107170000483 * 28/08/2017 412,900 412,900
332 0810R00107170000484 * 28/08/2017 569,300 569,300
333 0810R00107170000487 * 04/09/2017 114,100 114,100
334 0810R00107170000488 * 04/09/2017 114,100 114,100
335 0810R00107170000489 * 04/09/2017 184,900 184,900
336 0810R00107170000490 * 04/09/2017 114,100 114,100
337 0810R00107170000491 * 04/09/2017 184,900 184,900
338 0810R00107170000492 * 28/08/2017 184,900 184,900
339 0810R00107170000493 * 04/09/2017 114,100 114,100
340 0810R00107170000494 * 30/08/2017 184,900 184,900
341 0810R00107170000495 * 04/09/2017 186,300 186,300
342 0810R00107170000496 * 28/08/2017 184,900 184,900
343 0810R00107170000497 * 28/08/2017 184,900 184,900
344 0810R00107170000498 * 04/09/2017 155,100 155,100
345 0810R00107170000499 * 28/08/2017 184,900 184,900
346 0810R00107170000500 * 04/09/2017 114,100 114,100
347 0810R00107170000501 * 04/09/2017 184,900 184,900
348 0810R00107170000502 * 04/09/2017 184,900 184,900
349 0810R00107170000504 * 04/09/2017 184,900 184,900
350 0810R00107170000505 * 04/09/2017 114,100 114,100
351 0810R00107170000506 * 04/09/2017 184,900 184,900
352 0810R00107170000507 * 04/09/2017 114,100 114,100
353 0810R00107170000508 * 04/09/2017 186,300 186,300
354 0810R00107170000509 * 04/09/2017 155,100 155,100
355 0810R00107170000510 * 04/09/2017 114,100 114,100
356 0810R00107170000511 * 04/09/2017 184,900 184,900
357 0810R00107170000512 * 04/09/2017 114,100 114,100
358 0810R00107170000513 * 04/09/2017 184,900 184,900
359 0810R00107170000514 * 04/09/2017 114,100 114,100
360 0810R00107170000516 * 04/09/2017 114,100 114,100
361 0810R00107170000517 * 04/09/2017 184,900 184,900
362 0810R00107170000518 * 04/09/2017 114,100 114,100
363 0810R00107170000519 * 04/09/2017 184,900 184,900
364 0810R00107170000520 * 04/09/2017 155,100 155,100
365 0810R00107170000521 * 04/09/2017 184,900 184,900
366 0810R00107170000522 * 04/09/2017 155,100 155,100
367 0810R00107170000523 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.10/145

368 0810R00107170000524 * 28/08/2017 200,700 200,700


369 0810R00107170000525 * 04/09/2017 184,900 184,900
370 0810R00107170000526 * 28/08/2017 215,300 215,300
371 0810R00107170000527 * 28/08/2017 200,700 200,700
372 0810R00107170000530 * 04/09/2017 114,100 114,100
373 0810R00107170000531 * 04/09/2017 184,900 184,900
374 0810R00107170000533 * 04/09/2017 114,100 114,100
375 0810R00107170000534 * 28/08/2017 200,700 200,700
376 0810R00107170000535 * 04/09/2017 184,900 184,900
377 0810R00107170000536 * 04/09/2017 114,100 114,100
378 0810R00107170000537 * 04/09/2017 184,900 184,900
379 0810R00107170000538 * 04/09/2017 155,100 155,100
380 0810R00107170000539 * 28/08/2017 215,300 215,300
381 0810R00107170000540 * 04/09/2017 114,100 114,100
382 0810R00107170000541 * 04/09/2017 184,900 184,900
383 0810R00107170000542 * 04/09/2017 184,900 184,900
384 0810R00107170000544 * 04/09/2017 184,900 184,900
385 0810R00107170000545 * 28/08/2017 443,700 443,700
386 0810R00107170000546 * 04/09/2017 184,900 184,900
387 0810R00107170000547 * 04/09/2017 184,900 184,900
388 0810R00107170000548 * 04/09/2017 184,900 184,900
389 0810R00107170000549 * 04/09/2017 114,100 114,100
390 0810R00107170000550 * 04/09/2017 184,900 184,900
391 0810R00107170000551 * 04/09/2017 114,100 114,100
392 0810R00107170000552 * 28/08/2017 200,700 200,700
393 0810R00107170000553 * 04/09/2017 114,100 114,100
394 0810R00107170000554 * 04/09/2017 114,100 114,100
395 0810R00107170000555 * 04/09/2017 114,100 114,100
396 0810R00107170000557 * 04/09/2017 155,100 155,100
397 0810R00107170000558 * 04/09/2017 114,100 114,100
398 0810R00107170000559 * 04/09/2017 184,900 184,900
399 0810R00107170000560 * 30/08/2017 200,700 200,700
400 0810R00107170000561 * 04/09/2017 114,100 114,100
401 0810R00107170000562 * 04/09/2017 184,900 184,900
402 0810R00107170000563 * 04/09/2017 114,100 114,100
403 0810R00107170000565 * 04/09/2017 114,100 114,100
404 0810R00107170000566 * 28/08/2017 200,700 200,700
405 0810R00107170000567 * 04/09/2017 184,900 184,900
406 0810R00107170000568 * 04/09/2017 114,100 114,100
407 0810R00107170000569 * 04/09/2017 184,900 184,900
408 0810R00107170000570 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.11/145

409 0810R00107170000571 * 04/09/2017 114,100 114,100


410 0810R00107170000572 * 04/09/2017 114,100 114,100
411 0810R00107170000573 * 04/09/2017 184,900 184,900
412 0810R00107170000574 * 04/09/2017 114,100 114,100
413 0810R00107170000575 * 04/09/2017 149,500 149,500
414 0810R00107170000576 * 04/09/2017 114,100 114,100
415 0810R00107170000577 * 04/09/2017 184,900 184,900
416 0810R00107170000578 * 04/09/2017 184,900 184,900
417 0810R00107170000579 * 04/09/2017 114,100 114,100
418 0810R00107170000580 * 04/09/2017 114,100 114,100
419 0810R00107170000581 * 04/09/2017 184,900 184,900
420 0810R00107170000582 * 04/09/2017 114,100 114,100
421 0810R00107170000583 * 04/09/2017 184,900 184,900
422 0810R00107170000585 * 04/09/2017 184,900 184,900
423 0810R00107170000586 * 04/09/2017 184,900 184,900
424 0810R00107170000589 * 04/09/2017 184,900 184,900
425 0810R00107170000590 * 04/09/2017 184,900 184,900
426 0810R00107170000591 * 04/09/2017 114,100 114,100
427 0810R00107170000592 * 04/09/2017 114,100 114,100
428 0810R00107170000593 * 04/09/2017 184,900 184,900
429 0810R00107170000594 * 04/09/2017 114,100 114,100
430 0810R00107170000595 * 28/08/2017 186,300 186,300
431 0810R00107170000596 * 04/09/2017 114,100 114,100
432 0810R00107170000598 * 04/09/2017 114,100 114,100
433 0810R00107170000600 * 04/09/2017 184,900 184,900
434 0810R00107170000601 * 04/09/2017 114,100 114,100
435 0810R00107170000602 * 30/08/2017 184,900 184,900
436 0810R00107170000603 * 04/09/2017 114,100 114,100
437 0810R00107170000604 * 28/08/2017 200,700 200,700
438 0810R00107170000605 * 04/09/2017 114,100 114,100
439 0810R00107170000606 * 04/09/2017 114,100 114,100
440 0810R00107170000607 * 28/08/2017 200,700 200,700
441 0810R00107170000608 * 04/09/2017 114,100 114,100
442 0810R00107170000609 * 28/08/2017 314,500 314,500
443 0810R00107170000610 * 04/09/2017 184,900 184,900
444 0810R00107170000611 * 04/09/2017 114,100 114,100
445 0810R00107170000612 * 28/08/2017 184,900 184,900
446 0810R00107170000613 * 28/08/2017 184,900 184,900
447 0810R00107170000614 * 04/09/2017 184,900 184,900
448 0810R00107170000616 * 28/08/2017 242,700 242,700
449 0810R00107170000617 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.12/145

450 0810R00107170000618 * 28/08/2017 200,700 200,700


451 0810R00107170000619 * 04/09/2017 114,100 114,100
452 0810R00107170000620 * 04/09/2017 184,900 184,900
453 0810R00107170000621 * 04/09/2017 155,100 155,100
454 0810R00107170000622 * 04/09/2017 184,900 184,900
455 0810R00107170000623 * 04/09/2017 184,900 184,900
456 0810R00107170000624 * 04/09/2017 184,900 184,900
457 0810R00107170000625 * 04/09/2017 186,300 186,300
458 0810R00107170000626 * 04/09/2017 184,900 184,900
459 0810R00107170000627 * 28/08/2017 184,900 184,900
460 0810R00107170000628 * 04/09/2017 186,300 186,300
461 0810R00107170000629 * 04/09/2017 184,900 184,900
462 0810R00107170000630 * 04/09/2017 184,900 184,900
463 0810R00107170000631 * 04/09/2017 184,900 184,900
464 0810R00107170000632 * 04/09/2017 184,900 184,900
465 0810R00107170000633 * 04/09/2017 186,300 186,300
466 0810R00107170000634 * 04/09/2017 184,900 184,900
467 0810R00107170000635 * 28/08/2017 200,700 200,700
468 0810R00107170000636 * 04/09/2017 184,900 184,900
469 0810R00107170000638 * 28/08/2017 184,900 184,900
470 0810R00107170000639 * 04/09/2017 114,100 114,100
471 0810R00107170000640 * 04/09/2017 184,900 184,900
472 0810R00107170000641 * 04/09/2017 184,900 184,900
473 0810R00107170000642 * 04/09/2017 184,900 184,900
474 0810R00107170000643 * 28/08/2017 184,900 184,900
475 0810R00107170000644 * 04/09/2017 114,100 114,100
476 0810R00107170000645 * 28/08/2017 215,300 215,300
477 0810R00107170000646 * 28/08/2017 186,300 186,300
478 0810R00107170000647 * 04/09/2017 184,900 184,900
479 0810R00107170000648 * 28/08/2017 215,300 215,300
480 0810R00107170000649 * 04/09/2017 140,500 140,500
481 0810R00107170000650 * 04/09/2017 184,900 184,900
482 0810R00107170000651 * 04/09/2017 184,900 184,900
483 0810R00107170000654 * 28/08/2017 295,100 295,100
484 0810R00107170000655 * 04/09/2017 184,900 184,900
485 0810R00107170000656 * 04/09/2017 184,900 184,900
486 0810R00107170000657 * 04/09/2017 184,900 184,900
487 0810R00107170000658 * 04/09/2017 184,900 184,900
488 0810R00107170000659 * 04/09/2017 184,900 184,900
489 0810R00107170000660 * 04/09/2017 184,900 184,900
490 0810R00107170000661 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.13/145

491 0810R00107170000662 * 28/08/2017 184,900 184,900


492 0810R00107170000663 * 04/09/2017 184,900 184,900
493 0810R00107170000664 * 04/09/2017 184,900 184,900
494 0810R00107170000665 * 04/09/2017 184,900 184,900
495 0810R00107170000666 * 28/08/2017 242,700 242,700
496 0810R00107170000667 * 28/08/2017 184,900 184,900
497 0810R00107170000669 * 28/08/2017 200,700 200,700
498 0810R00107170000671 * 04/09/2017 184,900 184,900
499 0810R00107170000672 * 04/09/2017 184,900 184,900
500 0810R00107170000673 * 28/08/2017 200,700 200,700
501 0810R00107170000675 * 04/09/2017 184,900 184,900
502 0810R00107170000678 * 04/09/2017 184,900 184,900
503 0810R00107170000679 * 04/09/2017 184,900 184,900
504 0810R00107170000681 * 28/08/2017 184,900 184,900
505 0810R00107170000683 * 04/09/2017 184,900 184,900
506 0810R00107170000684 * 04/09/2017 186,300 186,300
507 0810R00107170000685 * 04/09/2017 184,900 184,900
508 0810R00107170000686 * 28/08/2017 200,700 200,700
509 0810R00107170000687 * 04/09/2017 184,900 184,900
510 0810R00107170000688 * 04/09/2017 184,900 184,900
511 0810R00107170000689 * 04/09/2017 184,900 184,900
512 0810R00107170000690 * 04/09/2017 184,900 184,900
513 0810R00107170000691 * 04/09/2017 184,900 184,900
514 0810R00107170000692 * 04/09/2017 184,900 184,900
515 0810R00107170000693 * 04/09/2017 184,900 184,900
516 0810R00107170000696 * 04/09/2017 887,100 887,100
517 0810R00107170000697 * 04/09/2017 887,100 887,100
518 0810R00107170000698 * 04/09/2017 887,100 887,100
519 0810R00107170000699 * 04/09/2017 887,100 887,100
520 0810R00107170000700 * 04/09/2017 887,100 887,100
521 0810R00107170000701 * 04/09/2017 887,100 887,100
522 0810R00107170000703 * 04/09/2017 887,100 887,100
523 0810R00107170000705 * 04/09/2017 887,100 887,100
524 0810R00107170000706 * 04/09/2017 887,100 887,100
525 0810R00107170000707 * 04/09/2017 887,100 887,100
526 0810R00107170000708 * 04/09/2017 887,100 887,100
527 0810R00107170000709 * 04/09/2017 887,100 887,100
528 0810R00107170000710 * 04/09/2017 887,100 887,100
529 0810R00107170000711 * 04/09/2017 887,100 887,100
530 0810R00107170000712 * 04/09/2017 887,100 887,100
531 0810R00107170000713 * 04/09/2017 887,100 887,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.14/145

532 0810R00107170000714 * 04/09/2017 887,100 887,100


533 0810R00107170000715 * 04/09/2017 887,100 887,100
534 0810R00107170000716 * 04/09/2017 887,100 887,100
535 0810R00107170000717 * 04/09/2017 887,100 887,100
536 0810R00107170000718 * 04/09/2017 887,100 887,100
537 0810R00107170000719 * 04/09/2017 887,100 887,100
538 0810R00107170000720 * 04/09/2017 887,100 887,100
539 0810R00107170000721 * 04/09/2017 887,100 887,100
540 0810R00107170000747 * 28/08/2017 186,300 186,300
541 0810R00107170000748 * 04/09/2017 184,900 184,900
542 0810R00107170000771 * 28/08/2017 314,500 314,500
543 0810R00107170000772 * 04/09/2017 184,900 184,900
544 0810R00107170000778 * 04/09/2017 155,100 155,100
545 0810R00107170000779 * 04/09/2017 114,100 114,100
546 0810R00107170000780 * 04/09/2017 114,100 114,100
547 0810R00107170000781 * 04/09/2017 114,100 114,100
548 0810R00107170000782 * 04/09/2017 114,100 114,100
549 0810R00107170000783 * 04/09/2017 184,900 184,900
550 0810R00107170000784 * 04/09/2017 114,100 114,100
551 0810R00107170000786 * 04/09/2017 114,100 114,100
552 0810R00107170000788 * 04/09/2017 184,900 184,900
553 0810R00107170000789 * 04/09/2017 184,900 184,900
554 0810R00107170000790 * 04/09/2017 184,900 184,900
555 0810R00107170000791 * 29/08/2017 569,300 569,300
556 0810R00107170000792 * 04/09/2017 184,900 184,900
557 0810R00107170000793 * 04/09/2017 184,900 184,900
558 0810R00107170000794 * 04/09/2017 184,900 184,900
559 0810R00107170000796 * 04/09/2017 114,100 114,100
560 0810R00107170000797 * 04/09/2017 114,100 114,100
561 0810R00107170000798 * 04/09/2017 184,900 184,900
562 0810R00107170000799 * 04/09/2017 114,100 114,100
563 0810R00107170000800 * 04/09/2017 184,900 184,900
564 0810R00107170000801 * 04/09/2017 114,100 114,100
565 0810R00107170000802 * 04/09/2017 114,100 114,100
566 0810R00107170000803 * 29/08/2017 184,900 184,900
567 0810R00107170000804 * 04/09/2017 114,100 114,100
568 0810R00107170000805 * 29/08/2017 215,300 215,300
569 0810R00107170000807 * 04/09/2017 184,900 184,900
570 0810R00107170000808 * 04/09/2017 114,100 114,100
571 0810R00107170000809 * 04/09/2017 184,900 184,900
572 0810R00107170000810 * 29/08/2017 200,700 200,700
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.15/145

573 0810R00107170000812 * 04/09/2017 184,900 184,900


574 0810R00107170000813 * 04/09/2017 184,900 184,900
575 0810R00107170000815 * 29/08/2017 215,300 215,300
576 0810R00107170000817 * 04/09/2017 184,900 184,900
577 0810R00107170000818 * 29/08/2017 184,900 184,900
578 0810R00107170000821 * 04/09/2017 114,100 114,100
579 0810R00107170000822 * 29/08/2017 289,400 289,400
580 0810R00107170000823 * 04/09/2017 155,100 155,100
581 0810R00107170000824 * 04/09/2017 184,900 184,900
582 0810R00107170000826 * 04/09/2017 114,100 114,100
583 0810R00107170000827 * 04/09/2017 114,100 114,100
584 0810R00107170000828 * 04/09/2017 114,100 114,100
585 0810R00107170000829 * 04/09/2017 114,100 114,100
586 0810R00107170000830 * 04/09/2017 114,100 114,100
587 0810R00107170000831 * 04/09/2017 114,100 114,100
588 0810R00107170000832 * 29/08/2017 443,700 443,700
589 0810R00107170000834 * 04/09/2017 114,100 114,100
590 0810R00107170000835 * 04/09/2017 184,900 184,900
591 0810R00107170000836 * 04/09/2017 184,900 184,900
592 0810R00107170000837 * 29/08/2017 569,300 569,300
593 0810R00107170000838 * 04/09/2017 184,900 184,900
594 0810R00107170000839 * 29/08/2017 215,300 215,300
595 0810R00107170000840 * 04/09/2017 184,900 184,900
596 0810R00107170000842 * 04/09/2017 184,900 184,900
597 0810R00107170000843 * 04/09/2017 184,900 184,900
598 0810R00107170000844 * 04/09/2017 184,900 184,900
599 0810R00107170000845 * 04/09/2017 114,100 114,100
600 0810R00107170000847 * 04/09/2017 184,900 184,900
601 0810R00107170000848 * 29/08/2017 184,900 184,900
602 0810R00107170000849 * 04/09/2017 114,100 114,100
603 0810R00107170000850 * 04/09/2017 114,100 114,100
604 0810R00107170000851 * 04/09/2017 114,100 114,100
605 0810R00107170000852 * 04/09/2017 114,100 114,100
606 0810R00107170000854 * 04/09/2017 114,100 114,100
607 0810R00107170000855 * 04/09/2017 114,100 114,100
608 0810R00107170000857 * 04/09/2017 184,900 184,900
609 0810R00107170000859 * 04/09/2017 184,900 184,900
610 0810R00107170000860 * 04/09/2017 114,100 114,100
611 0810R00107170000861 * 04/09/2017 184,900 184,900
612 0810R00107170000862 * 04/09/2017 155,100 155,100
613 0810R00107170000863 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.16/145

614 0810R00107170000864 * 04/09/2017 114,100 114,100


615 0810R00107170000865 * 04/09/2017 184,900 184,900
616 0810R00107170000866 * 04/09/2017 114,100 114,100
617 0810R00107170000868 * 29/08/2017 215,300 215,300
618 0810R00107170000869 * 04/09/2017 155,100 155,100
619 0810R00107170000870 * 04/09/2017 155,100 155,100
620 0810R00107170000871 * 04/09/2017 184,900 184,900
621 0810R00107170000872 * 04/09/2017 114,100 114,100
622 0810R00107170000873 * 04/09/2017 184,900 184,900
623 0810R00107170000874 * 04/09/2017 114,100 114,100
624 0810R00107170000876 * 04/09/2017 114,100 114,100
625 0810R00107170000877 * 04/09/2017 184,900 184,900
626 0810R00107170000878 * 04/09/2017 184,900 184,900
627 0810R00107170000879 * 04/09/2017 184,900 184,900
628 0810R00107170000881 * 04/09/2017 184,900 184,900
629 0810R00107170000882 * 04/09/2017 114,100 114,100
630 0810R00107170000883 * 04/09/2017 184,900 184,900
631 0810R00107170000884 * 04/09/2017 114,100 114,100
632 0810R00107170000886 * 04/09/2017 184,900 184,900
633 0810R00107170000887 * 04/09/2017 114,100 114,100
634 0810R00107170000888 * 04/09/2017 184,900 184,900
635 0810R00107170000890 * 04/09/2017 114,100 114,100
636 0810R00107170000891 * 04/09/2017 114,100 114,100
637 0810R00107170000892 * 04/09/2017 184,900 184,900
638 0810R00107170000893 * 04/09/2017 184,900 184,900
639 0810R00107170000894 * 04/09/2017 114,100 114,100
640 0810R00107170000895 * 04/09/2017 114,100 114,100
641 0810R00107170000896 * 04/09/2017 114,100 114,100
642 0810R00107170000897 * 04/09/2017 114,100 114,100
643 0810R00107170000898 * 04/09/2017 114,100 114,100
644 0810R00107170000899 * 04/09/2017 114,100 114,100
645 0810R00107170000900 * 04/09/2017 114,100 114,100
646 0810R00107170000901 * 04/09/2017 114,100 114,100
647 0810R00107170000902 * 29/08/2017 569,300 569,300
648 0810R00107170000903 * 04/09/2017 114,100 114,100
649 0810R00107170000904 * 29/08/2017 184,900 184,900
650 0810R00107170000905 * 04/09/2017 114,100 114,100
651 0810R00107170000906 * 04/09/2017 184,900 184,900
652 0810R00107170000907 * 04/09/2017 114,100 114,100
653 0810R00107170000908 * 29/08/2017 200,700 200,700
654 0810R00107170000909 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.17/145

655 0810R00107170000910 * 04/09/2017 184,900 184,900


656 0810R00107170000911 * 04/09/2017 184,900 184,900
657 0810R00107170000912 * 29/08/2017 314,500 314,500
658 0810R00107170000913 * 29/08/2017 184,900 184,900
659 0810R00107170000914 * 04/09/2017 114,100 114,100
660 0810R00107170000915 * 04/09/2017 184,900 184,900
661 0810R00107170000916 * 04/09/2017 114,100 114,100
662 0810R00107170000917 * 04/09/2017 184,900 184,900
663 0810R00107170000918 * 04/09/2017 184,900 184,900
664 0810R00107170000919 * 04/09/2017 114,100 114,100
665 0810R00107170000920 * 04/09/2017 184,900 184,900
666 0810R00107170000923 * 04/09/2017 184,900 184,900
667 0810R00107170000924 * 04/09/2017 184,900 184,900
668 0810R00107170000926 * 29/08/2017 184,900 184,900
669 0810R00107170000927 * 29/08/2017 255,700 255,700
670 0810R00107170000928 * 04/09/2017 184,900 184,900
671 0810R00107170000929 * 04/09/2017 184,900 184,900
672 0810R00107170000930 * 04/09/2017 114,100 114,100
673 0810R00107170000931 * 04/09/2017 184,900 184,900
674 0810R00107170000932 * 04/09/2017 114,100 114,100
675 0810R00107170000933 * 04/09/2017 184,900 184,900
676 0810R00107170000934 * 04/09/2017 114,100 114,100
677 0810R00107170000935 * 04/09/2017 114,100 114,100
678 0810R00107170000936 * 29/08/2017 569,300 569,300
679 0810R00107170000937 * 04/09/2017 114,100 114,100
680 0810R00107170000938 * 04/09/2017 184,900 184,900
681 0810R00107170000939 * 04/09/2017 114,100 114,100
682 0810R00107170000940 * 04/09/2017 184,900 184,900
683 0810R00107170000941 * 04/09/2017 184,900 184,900
684 0810R00107170000943 * 04/09/2017 184,900 184,900
685 0810R00107170000946 * 04/09/2017 184,900 184,900
686 0810R00107170000947 * 29/08/2017 184,900 184,900
687 0810R00107170000948 * 04/09/2017 114,100 114,100
688 0810R00107170000949 * 04/09/2017 184,900 184,900
689 0810R00107170000950 * 04/09/2017 184,900 184,900
690 0810R00107170000951 * 04/09/2017 184,900 184,900
691 0810R00107170000952 * 04/09/2017 184,900 184,900
692 0810R00107170000953 * 04/09/2017 155,100 155,100
693 0810R00107170000955 * 04/09/2017 155,100 155,100
694 0810R00107170000956 * 04/09/2017 114,100 114,100
695 0810R00107170000957 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.18/145

696 0810R00107170000959 * 04/09/2017 155,100 155,100


697 0810R00107170000960 * 04/09/2017 114,100 114,100
698 0810R00107170000961 * 29/08/2017 184,900 184,900
699 0810R00107170000962 * 04/09/2017 114,100 114,100
700 0810R00107170000963 * 29/08/2017 184,900 184,900
701 0810R00107170000964 * 29/08/2017 184,900 184,900
702 0810R00107170000965 * 04/09/2017 114,100 114,100
703 0810R00107170000966 * 04/09/2017 186,300 186,300
704 0810R00107170000968 * 04/09/2017 114,100 114,100
705 0810R00107170000971 * 04/09/2017 114,100 114,100
706 0810R00107170000972 * 04/09/2017 184,900 184,900
707 0810R00107170000973 * 04/09/2017 114,100 114,100
708 0810R00107170000974 * 04/09/2017 184,900 184,900
709 0810R00107170000975 * 04/09/2017 114,100 114,100
710 0810R00107170000976 * 04/09/2017 184,900 184,900
711 0810R00107170000977 * 04/09/2017 155,100 155,100
712 0810R00107170000978 * 04/09/2017 184,900 184,900
713 0810R00107170000979 * 04/09/2017 155,100 155,100
714 0810R00107170000980 * 04/09/2017 114,100 114,100
715 0810R00107170000982 * 29/08/2017 569,300 569,300
716 0810R00107170000983 * 04/09/2017 184,900 184,900
717 0810R00107170000985 * 04/09/2017 184,900 184,900
718 0810R00107170000988 * 29/08/2017 184,900 184,900
719 0810R00107170000989 * 29/08/2017 184,900 184,900
720 0810R00107170000991 * 04/09/2017 184,900 184,900
721 0810R00107170000992 * 29/08/2017 184,900 184,900
722 0810R00107170000993 * 04/09/2017 184,900 184,900
723 0810R00107170000994 * 04/09/2017 184,900 184,900
724 0810R00107170000995 * 29/08/2017 569,300 569,300
725 0810R00107170000996 * 04/09/2017 184,900 184,900
726 0810R00107170000998 * 04/09/2017 887,100 887,100
727 0810R00107170001000 * 29/08/2017 184,900 184,900
728 0810R00107170001001 * 04/09/2017 887,100 887,100
729 0810R00107170001002 * 04/09/2017 184,900 184,900
730 0810R00107170001003 * 04/09/2017 887,100 887,100
731 0810R00107170001005 * 04/09/2017 887,100 887,100
732 0810R00107170001006 * 04/09/2017 887,100 887,100
733 0810R00107170001007 * 04/09/2017 184,900 184,900
734 0810R00107170001008 * 04/09/2017 887,100 887,100
735 0810R00107170001009 * 04/09/2017 887,100 887,100
736 0810R00107170001010 * 29/08/2017 569,300 569,300
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.19/145

737 0810R00107170001011 * 29/08/2017 215,300 215,300


738 0810R00107170001012 * 04/09/2017 887,100 887,100
739 0810R00107170001013 * 04/09/2017 887,100 887,100
740 0810R00107170001014 * 04/09/2017 184,900 184,900
741 0810R00107170001015 * 29/08/2017 184,900 184,900
742 0810R00107170001016 * 04/09/2017 184,900 184,900
743 0810R00107170001017 * 04/09/2017 184,900 184,900
744 0810R00107170001019 * 04/09/2017 887,100 887,100
745 0810R00107170001021 * 04/09/2017 887,100 887,100
746 0810R00107170001022 * 04/09/2017 887,100 887,100
747 0810R00107170001023 * 04/09/2017 887,100 887,100
748 0810R00107170001024 * 30/08/2017 184,900 184,900
749 0810R00107170001025 * 04/09/2017 887,100 887,100
750 0810R00107170001026 * 29/08/2017 215,300 215,300
751 0810R00107170001027 * 04/09/2017 887,100 887,100
752 0810R00107170001028 * 29/08/2017 184,900 184,900
753 0810R00107170001029 * 04/09/2017 887,100 887,100
754 0810R00107170001030 * 04/09/2017 887,100 887,100
755 0810R00107170001032 * 04/09/2017 887,100 887,100
756 0810R00107170001033 * 04/09/2017 887,100 887,100
757 0810R00107170001034 * 29/08/2017 200,700 200,700
758 0810R00107170001035 * 04/09/2017 887,100 887,100
759 0810R00107170001036 * 04/09/2017 887,100 887,100
760 0810R00107170001037 * 04/09/2017 887,100 887,100
761 0810R00107170001038 * 04/09/2017 114,100 114,100
762 0810R00107170001039 * 04/09/2017 184,900 184,900
763 0810R00107170001040 * 04/09/2017 887,100 887,100
764 0810R00107170001042 * 29/08/2017 569,300 569,300
765 0810R00107170001043 * 04/09/2017 887,100 887,100
766 0810R00107170001044 * 04/09/2017 887,100 887,100
767 0810R00107170001045 * 04/09/2017 887,100 887,100
768 0810R00107170001046 * 04/09/2017 184,900 184,900
769 0810R00107170001047 * 04/09/2017 184,900 184,900
770 0810R00107170001048 * 04/09/2017 184,900 184,900
771 0810R00107170001051 * 29/08/2017 184,900 184,900
772 0810R00107170001052 * 04/09/2017 184,900 184,900
773 0810R00107170001056 * 29/08/2017 569,300 569,300
774 0810R00107170001058 * 04/09/2017 184,900 184,900
775 0810R00107170001060 * 04/09/2017 184,900 184,900
776 0810R00107170001068 * 04/09/2017 184,900 184,900
777 0810R00107170001087 * 29/08/2017 259,800 259,800
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.20/145

778 0810R00107170001090 * 04/09/2017 186,300 186,300


779 0810R00107170001098 * 04/09/2017 184,900 184,900
780 0810R00107170001100 * 04/09/2017 186,300 186,300
781 0810R00107170001110 * 29/08/2017 209,900 209,900
782 0810R00107170001126 * 25/08/2017 255,700 255,700
783 0810R00107170001127 * 04/09/2017 184,900 184,900
784 0810R00107170001129 * 04/09/2017 184,900 184,900
785 0810R00107170001131 * 04/09/2017 186,300 186,300
786 0810R00107170001132 * 04/09/2017 184,900 184,900
787 0810R00107170001133 * 04/09/2017 184,900 184,900
788 0810R00107170001134 * 04/09/2017 184,900 184,900
789 0810R00107170001135 * 04/09/2017 155,100 155,100
790 0810R00107170001136 * 04/09/2017 184,900 184,900
791 0810R00107170001137 * 04/09/2017 114,100 114,100
792 0810R00107170001138 * 04/09/2017 184,900 184,900
793 0810R00107170001139 * 04/09/2017 155,100 155,100
794 0810R00107170001140 * 04/09/2017 114,100 114,100
795 0810R00107170001141 * 04/09/2017 184,900 184,900
796 0810R00107170001142 * 04/09/2017 114,100 114,100
797 0810R00107170001143 * 04/09/2017 184,900 184,900
798 0810R00107170001144 * 04/09/2017 114,100 114,100
799 0810R00107170001145 * 04/09/2017 184,900 184,900
800 0810R00107170001146 * 04/09/2017 184,900 184,900
801 0810R00107170001147 * 04/09/2017 184,900 184,900
802 0810R00107170001148 * 04/09/2017 184,900 184,900
803 0810R00107170001149 * 04/09/2017 184,900 184,900
804 0810R00107170001150 * 04/09/2017 184,900 184,900
805 0810R00107170001151 * 04/09/2017 114,100 114,100
806 0810R00107170001152 * 04/09/2017 114,100 114,100
807 0810R00107170001153 * 04/09/2017 114,100 114,100
808 0810R00107170001154 * 04/09/2017 155,100 155,100
809 0810R00107170001155 * 04/09/2017 184,900 184,900
810 0810R00107170001156 * 04/09/2017 184,900 184,900
811 0810R00107170001157 * 04/09/2017 184,900 184,900
812 0810R00107170001159 * 04/09/2017 114,100 114,100
813 0810R00107170001160 * 04/09/2017 184,900 184,900
814 0810R00107170001161 * 04/09/2017 114,100 114,100
815 0810R00107170001162 * 04/09/2017 184,900 184,900
816 0810R00107170001163 * 04/09/2017 114,100 114,100
817 0810R00107170001164 * 04/09/2017 184,900 184,900
818 0810R00107170001166 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.21/145

819 0810R00107170001167 * 04/09/2017 155,100 155,100


820 0810R00107170001168 * 04/09/2017 114,100 114,100
821 0810R00107170001170 * 04/09/2017 114,100 114,100
822 0810R00107170001171 * 04/09/2017 184,900 184,900
823 0810R00107170001172 * 04/09/2017 186,300 186,300
824 0810R00107170001173 * 04/09/2017 184,900 184,900
825 0810R00107170001174 * 04/09/2017 184,900 184,900
826 0810R00107170001175 * 04/09/2017 184,900 184,900
827 0810R00107170001176 * 04/09/2017 184,900 184,900
828 0810R00107170001177 * 04/09/2017 184,900 184,900
829 0810R00107170001178 * 04/09/2017 184,900 184,900
830 0810R00107170001179 * 25/08/2017 186,300 186,300
831 0810R00107170001180 * 04/09/2017 184,900 184,900
832 0810R00107170001183 * 04/09/2017 184,900 184,900
833 0810R00107170001184 * 04/09/2017 184,900 184,900
834 0810R00107170001186 * 04/09/2017 184,900 184,900
835 0810R00107170001187 * 04/09/2017 184,900 184,900
836 0810R00107170001188 * 04/09/2017 184,900 184,900
837 0810R00107170001189 * 04/09/2017 114,100 114,100
838 0810R00107170001190 * 04/09/2017 184,900 184,900
839 0810R00107170001191 * 04/09/2017 184,900 184,900
840 0810R00107170001192 * 04/09/2017 114,100 114,100
841 0810R00107170001193 * 04/09/2017 184,900 184,900
842 0810R00107170001194 * 04/09/2017 114,100 114,100
843 0810R00107170001195 * 04/09/2017 184,900 184,900
844 0810R00107170001196 * 04/09/2017 184,900 184,900
845 0810R00107170001197 * 04/09/2017 184,900 184,900
846 0810R00107170001198 * 25/08/2017 184,900 184,900
847 0810R00107170001199 * 04/09/2017 114,100 114,100
848 0810R00107170001200 * 04/09/2017 184,900 184,900
849 0810R00107170001201 * 04/09/2017 184,900 184,900
850 0810R00107170001202 * 04/09/2017 114,100 114,100
851 0810R00107170001203 * 25/08/2017 200,700 200,700
852 0810R00107170001204 * 04/09/2017 184,900 184,900
853 0810R00107170001205 * 04/09/2017 114,100 114,100
854 0810R00107170001206 * 04/09/2017 184,900 184,900
855 0810R00107170001207 * 04/09/2017 184,900 184,900
856 0810R00107170001209 * 04/09/2017 184,900 184,900
857 0810R00107170001210 * 25/08/2017 184,900 184,900
858 0810R00107170001211 * 04/09/2017 184,900 184,900
859 0810R00107170001212 * 04/09/2017 186,300 186,300
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.22/145

860 0810R00107170001213 * 04/09/2017 184,900 184,900


861 0810R00107170001214 * 04/09/2017 184,900 184,900
862 0810R00107170001215 * 04/09/2017 184,900 184,900
863 0810R00107170001216 * 04/09/2017 184,900 184,900
864 0810R00107170001217 * 25/08/2017 200,700 200,700
865 0810R00107170001218 * 04/09/2017 114,100 114,100
866 0810R00107170001219 * 04/09/2017 186,300 186,300
867 0810R00107170001220 * 04/09/2017 114,100 114,100
868 0810R00107170001221 * 25/08/2017 184,900 184,900
869 0810R00107170001222 * 04/09/2017 184,900 184,900
870 0810R00107170001223 * 04/09/2017 184,900 184,900
871 0810R00107170001225 * 25/08/2017 186,300 186,300
872 0810R00107170001226 * 04/09/2017 114,100 114,100
873 0810R00107170001227 * 04/09/2017 184,900 184,900
874 0810R00107170001228 * 25/08/2017 184,900 184,900
875 0810R00107170001229 * 04/09/2017 114,100 114,100
876 0810R00107170001231 * 04/09/2017 114,100 114,100
877 0810R00107170001232 * 04/09/2017 184,900 184,900
878 0810R00107170001233 * 04/09/2017 184,900 184,900
879 0810R00107170001234 * 04/09/2017 114,100 114,100
880 0810R00107170001235 * 04/09/2017 184,900 184,900
881 0810R00107170001236 * 04/09/2017 114,100 114,100
882 0810R00107170001237 * 25/08/2017 242,700 242,700
883 0810R00107170001238 * 04/09/2017 114,100 114,100
884 0810R00107170001239 * 04/09/2017 184,900 184,900
885 0810R00107170001240 * 04/09/2017 184,900 184,900
886 0810R00107170001242 * 04/09/2017 114,100 114,100
887 0810R00107170001243 * 04/09/2017 186,300 186,300
888 0810R00107170001244 * 04/09/2017 114,100 114,100
889 0810R00107170001245 * 04/09/2017 184,900 184,900
890 0810R00107170001246 * 04/09/2017 114,100 114,100
891 0810R00107170001247 * 04/09/2017 184,900 184,900
892 0810R00107170001248 * 04/09/2017 114,100 114,100
893 0810R00107170001249 * 25/08/2017 186,300 186,300
894 0810R00107170001250 * 04/09/2017 114,100 114,100
895 0810R00107170001251 * 04/09/2017 184,900 184,900
896 0810R00107170001252 * 25/08/2017 215,300 215,300
897 0810R00107170001253 * 04/09/2017 184,900 184,900
898 0810R00107170001254 * 04/09/2017 184,900 184,900
899 0810R00107170001255 * 04/09/2017 184,900 184,900
900 0810R00107170001256 * 25/08/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.23/145

901 0810R00107170001257 * 04/09/2017 184,900 184,900


902 0810R00107170001258 * 29/08/2017 184,900 184,900
903 0810R00107170001259 * 04/09/2017 184,900 184,900
904 0810R00107170001260 * 04/09/2017 184,900 184,900
905 0810R00107170001261 * 04/09/2017 184,900 184,900
906 0810R00107170001262 * 04/09/2017 184,900 184,900
907 0810R00107170001263 * 25/08/2017 242,700 242,700
908 0810R00107170001264 * 04/09/2017 184,900 184,900
909 0810R00107170001266 * 04/09/2017 184,900 184,900
910 0810R00107170001268 * 04/09/2017 155,100 155,100
911 0810R00107170001270 * 04/09/2017 155,100 155,100
912 0810R00107170001271 * 04/09/2017 184,900 184,900
913 0810R00107170001272 * 04/09/2017 184,900 184,900
914 0810R00107170001273 * 04/09/2017 114,100 114,100
915 0810R00107170001274 * 04/09/2017 184,900 184,900
916 0810R00107170001275 * 04/09/2017 114,100 114,100
917 0810R00107170001276 * 04/09/2017 184,900 184,900
918 0810R00107170001277 * 04/09/2017 184,900 184,900
919 0810R00107170001278 * 04/09/2017 114,100 114,100
920 0810R00107170001279 * 04/09/2017 114,100 114,100
921 0810R00107170001280 * 04/09/2017 184,900 184,900
922 0810R00107170001281 * 04/09/2017 114,100 114,100
923 0810R00107170001282 * 04/09/2017 184,900 184,900
924 0810R00107170001283 * 04/09/2017 184,900 184,900
925 0810R00107170001284 * 04/09/2017 155,100 155,100
926 0810R00107170001285 * 04/09/2017 184,900 184,900
927 0810R00107170001286 * 04/09/2017 184,900 184,900
928 0810R00107170001287 * 04/09/2017 184,900 184,900
929 0810R00107170001288 * 04/09/2017 184,900 184,900
930 0810R00107170001289 * 25/08/2017 200,700 200,700
931 0810R00107170001291 * 25/08/2017 184,900 184,900
932 0810R00107170001292 * 04/09/2017 184,900 184,900
933 0810R00107170001293 * 04/09/2017 184,900 184,900
934 0810R00107170001294 * 04/09/2017 114,100 114,100
935 0810R00107170001295 * 25/08/2017 443,700 443,700
936 0810R00107170001296 * 04/09/2017 114,100 114,100
937 0810R00107170001297 * 04/09/2017 184,900 184,900
938 0810R00107170001298 * 04/09/2017 114,100 114,100
939 0810R00107170001299 * 04/09/2017 184,900 184,900
940 0810R00107170001300 * 04/09/2017 114,100 114,100
941 0810R00107170001302 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.24/145

942 0810R00107170001303 * 04/09/2017 184,900 184,900


943 0810R00107170001304 * 04/09/2017 114,100 114,100
944 0810R00107170001305 * 04/09/2017 184,900 184,900
945 0810R00107170001306 * 04/09/2017 114,100 114,100
946 0810R00107170001307 * 04/09/2017 184,900 184,900
947 0810R00107170001308 * 04/09/2017 114,100 114,100
948 0810R00107170001309 * 25/08/2017 200,700 200,700
949 0810R00107170001310 * 04/09/2017 114,100 114,100
950 0810R00107170001311 * 04/09/2017 184,900 184,900
951 0810R00107170001312 * 04/09/2017 114,100 114,100
952 0810R00107170001313 * 04/09/2017 114,100 114,100
953 0810R00107170001314 * 25/08/2017 280,800 280,800
954 0810R00107170001315 * 04/09/2017 114,100 114,100
955 0810R00107170001316 * 25/08/2017 184,900 184,900
956 0810R00107170001317 * 04/09/2017 184,900 184,900
957 0810R00107170001318 * 04/09/2017 184,900 184,900
958 0810R00107170001319 * 04/09/2017 155,100 155,100
959 0810R00107170001321 * 04/09/2017 184,900 184,900
960 0810R00107170001323 * 25/08/2017 184,900 184,900
961 0810R00107170001324 * 04/09/2017 184,900 184,900
962 0810R00107170001325 * 25/08/2017 314,500 314,500
963 0810R00107170001327 * 04/09/2017 184,900 184,900
964 0810R00107170001329 * 25/08/2017 242,700 242,700
965 0810R00107170001330 * 04/09/2017 184,900 184,900
966 0810R00107170001333 * 04/09/2017 184,900 184,900
967 0810R00107170001334 * 04/09/2017 184,900 184,900
968 0810R00107170001335 * 04/09/2017 114,100 114,100
969 0810R00107170001336 * 04/09/2017 186,300 186,300
970 0810R00107170001337 * 04/09/2017 200,700 200,700
971 0810R00107170001338 * 04/09/2017 184,900 184,900
972 0810R00107170001340 * 04/09/2017 184,900 184,900
973 0810R00107170001341 * 04/09/2017 242,700 242,700
974 0810R00107170001342 * 04/09/2017 184,900 184,900
975 0810R00107170001344 * 04/09/2017 184,900 184,900
976 0810R00107170001345 * 25/08/2017 184,900 184,900
977 0810R00107170001346 * 04/09/2017 184,900 184,900
978 0810R00107170001347 * 04/09/2017 114,100 114,100
979 0810R00107170001348 * 04/09/2017 184,900 184,900
980 0810R00107170001349 * 04/09/2017 114,100 114,100
981 0810R00107170001350 * 04/09/2017 114,100 114,100
982 0810R00107170001351 * 25/08/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.25/145

983 0810R00107170001352 * 04/09/2017 155,100 155,100


984 0810R00107170001353 * 04/09/2017 114,100 114,100
985 0810R00107170001355 * 25/08/2017 184,900 184,900
986 0810R00107170001356 * 04/09/2017 114,100 114,100
987 0810R00107170001357 * 04/09/2017 184,900 184,900
988 0810R00107170001358 * 04/09/2017 114,100 114,100
989 0810R00107170001359 * 04/09/2017 114,100 114,100
990 0810R00107170001362 * 04/09/2017 114,100 114,100
991 0810R00107170001363 * 04/09/2017 186,300 186,300
992 0810R00107170001364 * 04/09/2017 186,300 186,300
993 0810R00107170001365 * 04/09/2017 184,900 184,900
994 0810R00107170001366 * 04/09/2017 114,100 114,100
995 0810R00107170001367 * 04/09/2017 184,900 184,900
996 0810R00107170001368 * 04/09/2017 155,100 155,100
997 0810R00107170001369 * 04/09/2017 184,900 184,900
998 0810R00107170001370 * 04/09/2017 184,900 184,900
999 0810R00107170001372 * 04/09/2017 114,100 114,100
1000 0810R00107170001374 * 04/09/2017 184,900 184,900
1001 0810R00107170001375 * 04/09/2017 114,100 114,100
1002 0810R00107170001376 * 04/09/2017 114,100 114,100
1003 0810R00107170001377 * 04/09/2017 184,900 184,900
1004 0810R00107170001378 * 04/09/2017 184,900 184,900
1005 0810R00107170001380 * 25/08/2017 200,700 200,700
1006 0810R00107170001381 * 25/08/2017 242,700 242,700
1007 0810R00107170001382 * 04/09/2017 114,100 114,100
1008 0810R00107170001383 * 04/09/2017 184,900 184,900
1009 0810R00107170001384 * 04/09/2017 184,900 184,900
1010 0810R00107170001385 * 04/09/2017 155,100 155,100
1011 0810R00107170001386 * 04/09/2017 184,900 184,900
1012 0810R00107170001388 * 04/09/2017 184,900 184,900
1013 0810R00107170001389 * 04/09/2017 114,100 114,100
1014 0810R00107170001390 * 25/08/2017 184,900 184,900
1015 0810R00107170001391 * 04/09/2017 184,900 184,900
1016 0810R00107170001392 * 04/09/2017 184,900 184,900
1017 0810R00107170001393 * 04/09/2017 184,900 184,900
1018 0810R00107170001395 * 04/09/2017 184,900 184,900
1019 0810R00107170001396 * 25/08/2017 200,700 200,700
1020 0810R00107170001398 * 04/09/2017 184,900 184,900
1021 0810R00107170001399 * 04/09/2017 114,100 114,100
1022 0810R00107170001401 * 04/09/2017 184,900 184,900
1023 0810R00107170001402 * 04/09/2017 186,300 186,300
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.26/145

1024 0810R00107170001403 * 25/08/2017 242,700 242,700


1025 0810R00107170001404 * 04/09/2017 184,900 184,900
1026 0810R00107170001405 * 04/09/2017 887,100 887,100
1027 0810R00107170001407 * 04/09/2017 186,300 186,300
1028 0810R00107170001408 * 04/09/2017 887,100 887,100
1029 0810R00107170001409 * 04/09/2017 887,100 887,100
1030 0810R00107170001410 * 04/09/2017 887,100 887,100
1031 0810R00107170001411 * 04/09/2017 184,900 184,900
1032 0810R00107170001412 * 04/09/2017 887,100 887,100
1033 0810R00107170001413 * 04/09/2017 184,900 184,900
1034 0810R00107170001414 * 04/09/2017 184,900 184,900
1035 0810R00107170001415 * 04/09/2017 887,100 887,100
1036 0810R00107170001417 * 04/09/2017 184,900 184,900
1037 0810R00107170001418 * 04/09/2017 114,100 114,100
1038 0810R00107170001419 * 04/09/2017 887,100 887,100
1039 0810R00107170001420 * 04/09/2017 184,900 184,900
1040 0810R00107170001421 * 04/09/2017 887,100 887,100
1041 0810R00107170001422 * 04/09/2017 887,100 887,100
1042 0810R00107170001423 * 04/09/2017 184,900 184,900
1043 0810R00107170001424 * 04/09/2017 887,100 887,100
1044 0810R00107170001425 * 04/09/2017 184,900 184,900
1045 0810R00107170001426 * 04/09/2017 887,100 887,100
1046 0810R00107170001427 * 04/09/2017 280,800 280,800
1047 0810R00107170001428 * 04/09/2017 887,100 887,100
1048 0810R00107170001429 * 04/09/2017 184,900 184,900
1049 0810R00107170001430 * 25/08/2017 186,300 186,300
1050 0810R00107170001431 * 25/08/2017 184,900 184,900
1051 0810R00107170001432 * 04/09/2017 887,100 887,100
1052 0810R00107170001433 * 29/08/2017 200,700 200,700
1053 0810R00107170001434 * 04/09/2017 887,100 887,100
1054 0810R00107170001435 * 04/09/2017 887,100 887,100
1055 0810R00107170001436 * 04/09/2017 887,100 887,100
1056 0810R00107170001437 * 04/09/2017 887,100 887,100
1057 0810R00107170001438 * 04/09/2017 887,100 887,100
1058 0810R00107170001439 * 04/09/2017 887,100 887,100
1059 0810R00107170001440 * 04/09/2017 887,100 887,100
1060 0810R00107170001441 * 04/09/2017 887,100 887,100
1061 0810R00107170001442 * 04/09/2017 887,100 887,100
1062 0810R00107170001443 * 04/09/2017 887,100 887,100
1063 0810R00107170001444 * 04/09/2017 887,100 887,100
1064 0810R00107170001445 * 04/09/2017 887,100 887,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.27/145

1065 0810R00107170001446 * 04/09/2017 887,100 887,100


1066 0810R00107170001447 * 04/09/2017 184,900 184,900
1067 0810R00107170001448 * 04/09/2017 184,900 184,900
1068 0810R00107170001449 * 04/09/2017 184,900 184,900
1069 0810R00107170001452 * 25/08/2017 259,800 259,800
1070 0810R00107170001457 * 04/09/2017 186,300 186,300
1071 0810R00107170001469 * 04/09/2017 184,900 184,900
1072 0810R00107170001497 * 29/08/2017 569,300 569,300
1073 0810R00107170001498 * 04/09/2017 184,900 184,900
1074 0810R00107170001499 * 04/09/2017 184,900 184,900
1075 0810R00107170001500 * 04/09/2017 114,100 114,100
1076 0810R00107170001501 * 04/09/2017 184,900 184,900
1077 0810R00107170001502 * 04/09/2017 114,100 114,100
1078 0810R00107170001503 * 04/09/2017 184,900 184,900
1079 0810R00107170001504 * 04/09/2017 114,100 114,100
1080 0810R00107170001505 * 04/09/2017 184,900 184,900
1081 0810R00107170001506 * 04/09/2017 114,100 114,100
1082 0810R00107170001507 * 04/09/2017 184,900 184,900
1083 0810R00107170001508 * 04/09/2017 114,100 114,100
1084 0810R00107170001509 * 04/09/2017 114,100 114,100
1085 0810R00107170001510 * 04/09/2017 114,100 114,100
1086 0810R00107170001511 * 04/09/2017 184,900 184,900
1087 0810R00107170001512 * 04/09/2017 184,900 184,900
1088 0810R00107170001513 * 04/09/2017 184,900 184,900
1089 0810R00107170001514 * 04/09/2017 114,100 114,100
1090 0810R00107170001515 * 04/09/2017 184,900 184,900
1091 0810R00107170001516 * 04/09/2017 184,900 184,900
1092 0810R00107170001517 * 04/09/2017 114,100 114,100
1093 0810R00107170001518 * 04/09/2017 184,900 184,900
1094 0810R00107170001519 * 04/09/2017 155,100 155,100
1095 0810R00107170001520 * 04/09/2017 184,900 184,900
1096 0810R00107170001521 * 04/09/2017 114,100 114,100
1097 0810R00107170001522 * 04/09/2017 184,900 184,900
1098 0810R00107170001524 * 04/09/2017 114,100 114,100
1099 0810R00107170001525 * 25/08/2017 443,700 443,700
1100 0810R00107170001526 * 04/09/2017 184,900 184,900
1101 0810R00107170001527 * 04/09/2017 114,100 114,100
1102 0810R00107170001528 * 04/09/2017 114,100 114,100
1103 0810R00107170001529 * 04/09/2017 114,100 114,100
1104 0810R00107170001530 * 04/09/2017 184,900 184,900
1105 0810R00107170001531 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.28/145

1106 0810R00107170001533 * 04/09/2017 155,100 155,100


1107 0810R00107170001534 * 04/09/2017 114,100 114,100
1108 0810R00107170001535 * 04/09/2017 184,900 184,900
1109 0810R00107170001536 * 04/09/2017 184,900 184,900
1110 0810R00107170001537 * 04/09/2017 184,900 184,900
1111 0810R00107170001538 * 04/09/2017 184,900 184,900
1112 0810R00107170001540 * 04/09/2017 114,100 114,100
1113 0810R00107170001541 * 04/09/2017 184,900 184,900
1114 0810R00107170001542 * 04/09/2017 114,100 114,100
1115 0810R00107170001543 * 25/08/2017 184,900 184,900
1116 0810R00107170001545 * 04/09/2017 114,100 114,100
1117 0810R00107170001546 * 04/09/2017 184,900 184,900
1118 0810R00107170001548 * 04/09/2017 184,900 184,900
1119 0810R00107170001549 * 04/09/2017 184,900 184,900
1120 0810R00107170001551 * 04/09/2017 114,100 114,100
1121 0810R00107170001552 * 04/09/2017 184,900 184,900
1122 0810R00107170001553 * 04/09/2017 184,900 184,900
1123 0810R00107170001554 * 25/08/2017 184,900 184,900
1124 0810R00107170001555 * 04/09/2017 184,900 184,900
1125 0810R00107170001556 * 04/09/2017 184,900 184,900
1126 0810R00107170001557 * 04/09/2017 184,900 184,900
1127 0810R00107170001558 * 04/09/2017 184,900 184,900
1128 0810R00107170001559 * 04/09/2017 184,900 184,900
1129 0810R00107170001561 * 04/09/2017 184,900 184,900
1130 0810R00107170001562 * 04/09/2017 114,100 114,100
1131 0810R00107170001563 * 25/08/2017 314,500 314,500
1132 0810R00107170001564 * 25/08/2017 215,300 215,300
1133 0810R00107170001565 * 04/09/2017 114,100 114,100
1134 0810R00107170001566 * 04/09/2017 114,100 114,100
1135 0810R00107170001567 * 04/09/2017 114,100 114,100
1136 0810R00107170001568 * 04/09/2017 114,100 114,100
1137 0810R00107170001569 * 25/08/2017 184,900 184,900
1138 0810R00107170001570 * 04/09/2017 184,900 184,900
1139 0810R00107170001572 * 25/08/2017 184,900 184,900
1140 0810R00107170001574 * 04/09/2017 184,900 184,900
1141 0810R00107170001575 * 04/09/2017 114,100 114,100
1142 0810R00107170001576 * 04/09/2017 184,900 184,900
1143 0810R00107170001577 * 04/09/2017 114,100 114,100
1144 0810R00107170001578 * 04/09/2017 155,100 155,100
1145 0810R00107170001579 * 04/09/2017 114,100 114,100
1146 0810R00107170001580 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.29/145

1147 0810R00107170001581 * 04/09/2017 114,100 114,100


1148 0810R00107170001582 * 04/09/2017 114,100 114,100
1149 0810R00107170001583 * 04/09/2017 114,100 114,100
1150 0810R00107170001584 * 04/09/2017 114,100 114,100
1151 0810R00107170001585 * 04/09/2017 114,100 114,100
1152 0810R00107170001586 * 04/09/2017 184,900 184,900
1153 0810R00107170001587 * 04/09/2017 114,100 114,100
1154 0810R00107170001588 * 04/09/2017 114,100 114,100
1155 0810R00107170001589 * 04/09/2017 114,100 114,100
1156 0810R00107170001590 * 04/09/2017 184,900 184,900
1157 0810R00107170001591 * 25/08/2017 242,700 242,700
1158 0810R00107170001592 * 04/09/2017 184,900 184,900
1159 0810R00107170001593 * 04/09/2017 114,100 114,100
1160 0810R00107170001594 * 04/09/2017 114,100 114,100
1161 0810R00107170001595 * 04/09/2017 114,100 114,100
1162 0810R00107170001596 * 04/09/2017 114,100 114,100
1163 0810R00107170001597 * 04/09/2017 114,100 114,100
1164 0810R00107170001598 * 04/09/2017 114,100 114,100
1165 0810R00107170001600 * 04/09/2017 155,100 155,100
1166 0810R00107170001601 * 04/09/2017 114,100 114,100
1167 0810R00107170001602 * 04/09/2017 114,100 114,100
1168 0810R00107170001603 * 04/09/2017 114,100 114,100
1169 0810R00107170001604 * 04/09/2017 114,100 114,100
1170 0810R00107170001605 * 04/09/2017 114,100 114,100
1171 0810R00107170001607 * 04/09/2017 114,100 114,100
1172 0810R00107170001609 * 04/09/2017 114,100 114,100
1173 0810R00107170001610 * 04/09/2017 184,900 184,900
1174 0810R00107170001612 * 04/09/2017 114,100 114,100
1175 0810R00107170001613 * 04/09/2017 114,100 114,100
1176 0810R00107170001614 * 04/09/2017 114,100 114,100
1177 0810R00107170001615 * 04/09/2017 155,100 155,100
1178 0810R00107170001616 * 04/09/2017 114,100 114,100
1179 0810R00107170001617 * 04/09/2017 114,100 114,100
1180 0810R00107170001618 * 04/09/2017 114,100 114,100
1181 0810R00107170001619 * 04/09/2017 255,900 255,900
1182 0810R00107170001620 * 04/09/2017 114,100 114,100
1183 0810R00107170001621 * 04/09/2017 155,100 155,100
1184 0810R00107170001622 * 04/09/2017 114,100 114,100
1185 0810R00107170001623 * 25/08/2017 200,700 200,700
1186 0810R00107170001624 * 04/09/2017 114,100 114,100
1187 0810R00107170001625 * 25/08/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.30/145

1188 0810R00107170001626 * 04/09/2017 114,100 114,100


1189 0810R00107170001627 * 04/09/2017 114,100 114,100
1190 0810R00107170001628 * 04/09/2017 114,100 114,100
1191 0810R00107170001629 * 04/09/2017 155,100 155,100
1192 0810R00107170001630 * 04/09/2017 114,100 114,100
1193 0810R00107170001631 * 04/09/2017 114,100 114,100
1194 0810R00107170001632 * 04/09/2017 114,100 114,100
1195 0810R00107170001634 * 04/09/2017 155,100 155,100
1196 0810R00107170001636 * 04/09/2017 114,100 114,100
1197 0810R00107170001637 * 04/09/2017 184,900 184,900
1198 0810R00107170001638 * 04/09/2017 114,100 114,100
1199 0810R00107170001640 * 04/09/2017 114,100 114,100
1200 0810R00107170001641 * 04/09/2017 184,900 184,900
1201 0810R00107170001642 * 04/09/2017 114,100 114,100
1202 0810R00107170001643 * 04/09/2017 184,900 184,900
1203 0810R00107170001645 * 04/09/2017 184,900 184,900
1204 0810R00107170001646 * 04/09/2017 114,100 114,100
1205 0810R00107170001647 * 04/09/2017 114,100 114,100
1206 0810R00107170001648 * 04/09/2017 114,100 114,100
1207 0810R00107170001649 * 04/09/2017 114,100 114,100
1208 0810R00107170001650 * 04/09/2017 114,100 114,100
1209 0810R00107170001651 * 29/08/2017 267,200 267,200
1210 0810R00107170001652 * 04/09/2017 114,100 114,100
1211 0810R00107170001653 * 04/09/2017 184,900 184,900
1212 0810R00107170001654 * 04/09/2017 114,100 114,100
1213 0810R00107170001655 * 04/09/2017 114,100 114,100
1214 0810R00107170001656 * 25/08/2017 184,900 184,900
1215 0810R00107170001657 * 04/09/2017 114,100 114,100
1216 0810R00107170001658 * 04/09/2017 155,100 155,100
1217 0810R00107170001659 * 04/09/2017 155,100 155,100
1218 0810R00107170001660 * 04/09/2017 114,100 114,100
1219 0810R00107170001661 * 04/09/2017 184,900 184,900
1220 0810R00107170001662 * 04/09/2017 184,900 184,900
1221 0810R00107170001663 * 04/09/2017 887,100 887,100
1222 0810R00107170001664 * 25/08/2017 242,700 242,700
1223 0810R00107170001665 * 04/09/2017 887,100 887,100
1224 0810R00107170001666 * 04/09/2017 887,100 887,100
1225 0810R00107170001667 * 25/08/2017 184,900 184,900
1226 0810R00107170001669 * 04/09/2017 887,100 887,100
1227 0810R00107170001670 * 04/09/2017 155,100 155,100
1228 0810R00107170001671 * 04/09/2017 887,100 887,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.31/145

1229 0810R00107170001673 * 04/09/2017 887,100 887,100


1230 0810R00107170001674 * 04/09/2017 887,100 887,100
1231 0810R00107170001675 * 04/09/2017 184,900 184,900
1232 0810R00107170001676 * 04/09/2017 887,100 887,100
1233 0810R00107170001677 * 04/09/2017 887,100 887,100
1234 0810R00107170001678 * 04/09/2017 887,100 887,100
1235 0810R00107170001679 * 04/09/2017 184,900 184,900
1236 0810R00107170001680 * 04/09/2017 887,100 887,100
1237 0810R00107170001681 * 04/09/2017 887,100 887,100
1238 0810R00107170001682 * 04/09/2017 887,100 887,100
1239 0810R00107170001683 * 25/08/2017 569,300 569,300
1240 0810R00107170001685 * 04/09/2017 887,100 887,100
1241 0810R00107170001686 * 04/09/2017 887,100 887,100
1242 0810R00107170001688 * 04/09/2017 887,100 887,100
1243 0810R00107170001690 * 04/09/2017 887,100 887,100
1244 0810R00107170001691 * 04/09/2017 887,100 887,100
1245 0810R00107170001692 * 04/09/2017 887,100 887,100
1246 0810R00107170001693 * 04/09/2017 887,100 887,100
1247 0810R00107170001695 * 04/09/2017 887,100 887,100
1248 0810R00107170001696 * 04/09/2017 887,100 887,100
1249 0810R00107170001697 * 04/09/2017 887,100 887,100
1250 0810R00107170001698 * 04/09/2017 114,100 114,100
1251 0810R00107170001703 * 04/09/2017 184,900 184,900
1252 0810R00107170001708 * 04/09/2017 184,900 184,900
1253 0810R00107170001719 * 04/09/2017 141,300 141,300
1254 0810R00107170001722 * 04/09/2017 887,100 887,100
1255 0810R00107170001731 * 04/09/2017 184,900 184,900
1256 0810R00107170001732 * 29/08/2017 186,300 186,300
1257 0810R00107170001733 * 29/08/2017 314,500 314,500
1258 0810R00107170001736 * 25/08/2017 314,500 314,500
1259 0810R00107170001744 * 29/08/2017 314,500 314,500
1260 0810R00107170001747 * 29/08/2017 215,300 215,300
1261 0810R00107170001748 * 04/09/2017 184,900 184,900
1262 0810R00107170001749 * 29/08/2017 184,900 184,900
1263 0810R00107170001751 * 04/09/2017 184,900 184,900
1264 0810R00107170001752 * 29/08/2017 184,900 184,900
1265 0810R00107170001753 * 29/08/2017 184,900 184,900
1266 0810R00107170001754 * 04/09/2017 114,100 114,100
1267 0810R00107170001755 * 04/09/2017 184,900 184,900
1268 0810R00107170001756 * 29/08/2017 569,300 569,300
1269 0810R00107170001757 * 04/09/2017 155,100 155,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.32/145

1270 0810R00107170001758 * 29/08/2017 314,500 314,500


1271 0810R00107170001759 * 04/09/2017 184,900 184,900
1272 0810R00107170001760 * 30/08/2017 184,900 184,900
1273 0810R00107170001761 * 04/09/2017 114,100 114,100
1274 0810R00107170001762 * 04/09/2017 155,100 155,100
1275 0810R00107170001763 * 29/08/2017 184,900 184,900
1276 0810R00107170001764 * 04/09/2017 114,100 114,100
1277 0810R00107170001765 * 04/09/2017 114,100 114,100
1278 0810R00107170001766 * 04/09/2017 114,100 114,100
1279 0810R00107170001767 * 04/09/2017 114,100 114,100
1280 0810R00107170001768 * 04/09/2017 114,100 114,100
1281 0810R00107170001769 * 04/09/2017 114,100 114,100
1282 0810R00107170001770 * 04/09/2017 114,100 114,100
1283 0810R00107170001771 * 04/09/2017 114,100 114,100
1284 0810R00107170001772 * 04/09/2017 114,100 114,100
1285 0810R00107170001773 * 04/09/2017 114,100 114,100
1286 0810R00107170001774 * 04/09/2017 184,900 184,900
1287 0810R00107170001775 * 04/09/2017 114,100 114,100
1288 0810R00107170001776 * 30/08/2017 184,900 184,900
1289 0810R00107170001777 * 04/09/2017 114,100 114,100
1290 0810R00107170001778 * 04/09/2017 184,900 184,900
1291 0810R00107170001779 * 04/09/2017 114,100 114,100
1292 0810R00107170001780 * 29/08/2017 184,900 184,900
1293 0810R00107170001781 * 29/08/2017 569,300 569,300
1294 0810R00107170001782 * 29/08/2017 184,900 184,900
1295 0810R00107170001783 * 04/09/2017 184,900 184,900
1296 0810R00107170001785 * 04/09/2017 186,300 186,300
1297 0810R00107170001786 * 30/08/2017 184,900 184,900
1298 0810R00107170001787 * 04/09/2017 184,900 184,900
1299 0810R00107170001788 * 04/09/2017 184,900 184,900
1300 0810R00107170001790 * 04/09/2017 155,100 155,100
1301 0810R00107170001791 * 30/08/2017 184,900 184,900
1302 0810R00107170001792 * 29/08/2017 569,300 569,300
1303 0810R00107170001793 * 04/09/2017 114,100 114,100
1304 0810R00107170001794 * 04/09/2017 184,900 184,900
1305 0810R00107170001795 * 04/09/2017 114,100 114,100
1306 0810R00107170001796 * 04/09/2017 114,100 114,100
1307 0810R00107170001797 * 04/09/2017 114,100 114,100
1308 0810R00107170001799 * 04/09/2017 114,100 114,100
1309 0810R00107170001800 * 04/09/2017 114,100 114,100
1310 0810R00107170001801 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.33/145

1311 0810R00107170001802 * 04/09/2017 114,100 114,100


1312 0810R00107170001803 * 04/09/2017 114,100 114,100
1313 0810R00107170001804 * 29/08/2017 184,900 184,900
1314 0810R00107170001805 * 04/09/2017 184,900 184,900
1315 0810R00107170001806 * 04/09/2017 114,100 114,100
1316 0810R00107170001807 * 04/09/2017 114,100 114,100
1317 0810R00107170001808 * 04/09/2017 184,900 184,900
1318 0810R00107170001809 * 04/09/2017 114,100 114,100
1319 0810R00107170001810 * 04/09/2017 114,100 114,100
1320 0810R00107170001811 * 04/09/2017 114,100 114,100
1321 0810R00107170001812 * 04/09/2017 184,900 184,900
1322 0810R00107170001813 * 04/09/2017 114,100 114,100
1323 0810R00107170001814 * 04/09/2017 184,900 184,900
1324 0810R00107170001815 * 04/09/2017 114,100 114,100
1325 0810R00107170001816 * 04/09/2017 184,900 184,900
1326 0810R00107170001817 * 04/09/2017 155,100 155,100
1327 0810R00107170001818 * 29/08/2017 184,900 184,900
1328 0810R00107170001819 * 04/09/2017 184,900 184,900
1329 0810R00107170001820 * 04/09/2017 114,100 114,100
1330 0810R00107170001821 * 04/09/2017 114,100 114,100
1331 0810R00107170001822 * 04/09/2017 155,100 155,100
1332 0810R00107170001824 * 04/09/2017 215,300 215,300
1333 0810R00107170001826 * 04/09/2017 184,900 184,900
1334 0810R00107170001827 * 04/09/2017 184,900 184,900
1335 0810R00107170001828 * 04/09/2017 114,100 114,100
1336 0810R00107170001829 * 04/09/2017 155,100 155,100
1337 0810R00107170001830 * 04/09/2017 114,100 114,100
1338 0810R00107170001831 * 04/09/2017 184,900 184,900
1339 0810R00107170001832 * 04/09/2017 114,100 114,100
1340 0810R00107170001833 * 04/09/2017 184,900 184,900
1341 0810R00107170001834 * 04/09/2017 114,100 114,100
1342 0810R00107170001835 * 29/08/2017 200,700 200,700
1343 0810R00107170001836 * 04/09/2017 184,900 184,900
1344 0810R00107170001837 * 04/09/2017 155,100 155,100
1345 0810R00107170001838 * 04/09/2017 114,100 114,100
1346 0810R00107170001839 * 04/09/2017 184,900 184,900
1347 0810R00107170001841 * 04/09/2017 114,100 114,100
1348 0810R00107170001842 * 04/09/2017 184,900 184,900
1349 0810R00107170001843 * 29/08/2017 713,400 713,400
1350 0810R00107170001844 * 04/09/2017 114,100 114,100
1351 0810R00107170001845 * 29/08/2017 569,300 569,300
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.34/145

1352 0810R00107170001846 * 04/09/2017 114,100 114,100


1353 0810R00107170001847 * 04/09/2017 114,100 114,100
1354 0810R00107170001848 * 29/08/2017 184,900 184,900
1355 0810R00107170001849 * 04/09/2017 114,100 114,100
1356 0810R00107170001850 * 04/09/2017 114,100 114,100
1357 0810R00107170001851 * 30/08/2017 184,900 184,900
1358 0810R00107170001853 * 04/09/2017 184,900 184,900
1359 0810R00107170001854 * 04/09/2017 114,100 114,100
1360 0810R00107170001856 * 04/09/2017 114,100 114,100
1361 0810R00107170001859 * 04/09/2017 114,100 114,100
1362 0810R00107170001860 * 04/09/2017 114,100 114,100
1363 0810R00107170001861 * 04/09/2017 114,100 114,100
1364 0810R00107170001862 * 04/09/2017 114,100 114,100
1365 0810R00107170001863 * 04/09/2017 114,100 114,100
1366 0810R00107170001864 * 04/09/2017 114,100 114,100
1367 0810R00107170001865 * 04/09/2017 114,100 114,100
1368 0810R00107170001866 * 04/09/2017 155,100 155,100
1369 0810R00107170001867 * 04/09/2017 114,100 114,100
1370 0810R00107170001868 * 04/09/2017 184,900 184,900
1371 0810R00107170001870 * 04/09/2017 114,100 114,100
1372 0810R00107170001871 * 04/09/2017 887,100 887,100
1373 0810R00107170001872 * 04/09/2017 887,100 887,100
1374 0810R00107170001873 * 04/09/2017 114,100 114,100
1375 0810R00107170001874 * 04/09/2017 887,100 887,100
1376 0810R00107170001875 * 04/09/2017 114,100 114,100
1377 0810R00107170001876 * 04/09/2017 887,100 887,100
1378 0810R00107170001877 * 04/09/2017 114,100 114,100
1379 0810R00107170001878 * 04/09/2017 887,100 887,100
1380 0810R00107170001879 * 04/09/2017 114,100 114,100
1381 0810R00107170001880 * 04/09/2017 887,100 887,100
1382 0810R00107170001881 * 04/09/2017 114,100 114,100
1383 0810R00107170001882 * 04/09/2017 887,100 887,100
1384 0810R00107170001883 * 04/09/2017 155,100 155,100
1385 0810R00107170001884 * 04/09/2017 887,100 887,100
1386 0810R00107170001885 * 04/09/2017 887,100 887,100
1387 0810R00107170001886 * 04/09/2017 114,100 114,100
1388 0810R00107170001887 * 04/09/2017 887,100 887,100
1389 0810R00107170001888 * 04/09/2017 114,100 114,100
1390 0810R00107170001889 * 04/09/2017 887,100 887,100
1391 0810R00107170001890 * 04/09/2017 887,100 887,100
1392 0810R00107170001891 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.35/145

1393 0810R00107170001892 * 04/09/2017 887,100 887,100


1394 0810R00107170001893 * 04/09/2017 887,100 887,100
1395 0810R00107170001894 * 04/09/2017 114,100 114,100
1396 0810R00107170001895 * 04/09/2017 887,100 887,100
1397 0810R00107170001896 * 04/09/2017 114,100 114,100
1398 0810R00107170001897 * 04/09/2017 887,100 887,100
1399 0810R00107170001898 * 04/09/2017 887,100 887,100
1400 0810R00107170001899 * 04/09/2017 887,100 887,100
1401 0810R00107170001900 * 04/09/2017 887,100 887,100
1402 0810R00107170001901 * 04/09/2017 114,100 114,100
1403 0810R00107170001902 * 04/09/2017 887,100 887,100
1404 0810R00107170001903 * 04/09/2017 887,100 887,100
1405 0810R00107170001904 * 04/09/2017 114,100 114,100
1406 0810R00107170001905 * 04/09/2017 887,100 887,100
1407 0810R00107170001906 * 04/09/2017 887,100 887,100
1408 0810R00107170001907 * 04/09/2017 887,100 887,100
1409 0810R00107170001908 * 04/09/2017 114,100 114,100
1410 0810R00107170001909 * 04/09/2017 184,900 184,900
1411 0810R00107170001910 * 04/09/2017 184,900 184,900
1412 0810R00107170001911 * 04/09/2017 114,100 114,100
1413 0810R00107170001912 * 04/09/2017 114,100 114,100
1414 0810R00107170001913 * 04/09/2017 114,100 114,100
1415 0810R00107170001914 * 04/09/2017 114,100 114,100
1416 0810R00107170001915 * 04/09/2017 114,100 114,100
1417 0810R00107170001916 * 04/09/2017 114,100 114,100
1418 0810R00107170001917 * 04/09/2017 114,100 114,100
1419 0810R00107170001918 * 04/09/2017 114,100 114,100
1420 0810R00107170001919 * 04/09/2017 114,100 114,100
1421 0810R00107170001920 * 04/09/2017 155,100 155,100
1422 0810R00107170001921 * 04/09/2017 114,100 114,100
1423 0810R00107170001922 * 04/09/2017 114,100 114,100
1424 0810R00107170001923 * 04/09/2017 114,100 114,100
1425 0810R00107170001924 * 04/09/2017 114,100 114,100
1426 0810R00107170001925 * 04/09/2017 114,100 114,100
1427 0810R00107170001926 * 04/09/2017 114,100 114,100
1428 0810R00107170001927 * 04/09/2017 114,100 114,100
1429 0810R00107170001928 * 29/08/2017 314,500 314,500
1430 0810R00107170001929 * 04/09/2017 114,100 114,100
1431 0810R00107170001930 * 04/09/2017 114,100 114,100
1432 0810R00107170001931 * 04/09/2017 114,100 114,100
1433 0810R00107170001932 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.36/145

1434 0810R00107170001933 * 04/09/2017 114,100 114,100


1435 0810R00107170001934 * 04/09/2017 114,100 114,100
1436 0810R00107170001935 * 04/09/2017 114,100 114,100
1437 0810R00107170001936 * 04/09/2017 114,100 114,100
1438 0810R00107170001937 * 04/09/2017 155,100 155,100
1439 0810R00107170001938 * 04/09/2017 114,100 114,100
1440 0810R00107170001939 * 04/09/2017 114,100 114,100
1441 0810R00107170001940 * 04/09/2017 184,900 184,900
1442 0810R00107170001941 * 29/08/2017 314,500 314,500
1443 0810R00107170001942 * 29/08/2017 314,500 314,500
1444 0810R00107170001943 * 30/08/2017 184,900 184,900
1445 0810R00107170001944 * 04/09/2017 186,300 186,300
1446 0810R00107170001945 * 29/08/2017 184,900 184,900
1447 0810R00107170001946 * 04/09/2017 184,900 184,900
1448 0810R00107170001948 * 29/08/2017 314,500 314,500
1449 0810R00107170001952 * 29/08/2017 255,700 255,700
1450 0810R00107170001954 * 29/08/2017 184,900 184,900
1451 0810R00107170001964 * 29/08/2017 259,800 259,800
1452 0810R00107170001972 * 29/08/2017 138,700 138,700
1453 0810R00107170001974 * 04/09/2017 148,000 148,000
1454 0810R00107170001975 * 04/09/2017 186,300 186,300
1455 0810R00107170001988 * 04/09/2017 186,300 186,300
1456 0810R00107170001990 * 29/08/2017 255,700 255,700
1457 0810R00107170001992 * 04/09/2017 186,300 186,300
1458 0810R00107170001995 * 04/09/2017 186,300 186,300
1459 0810R00107170001999 * 04/09/2017 186,300 186,300
1460 0810R00107170002005 * 04/09/2017 186,300 186,300
1461 0810R00107170002007 * 04/09/2017 148,000 148,000
1462 0810R00107170002018 * 04/09/2017 148,000 148,000
1463 0810R00107170002019 * 29/08/2017 314,500 314,500
1464 0810R00107170002023 * 04/09/2017 289,400 289,400
1465 0810R00107170002024 * 29/08/2017 184,900 184,900
1466 0810R00107170002025 * 29/08/2017 280,800 280,800
1467 0810R00107170002026 * 04/09/2017 184,900 184,900
1468 0810R00107170002027 * 04/09/2017 184,900 184,900
1469 0810R00107170002028 * 04/09/2017 184,900 184,900
1470 0810R00107170002029 * 29/08/2017 267,200 267,200
1471 0810R00107170002030 * 29/08/2017 215,300 215,300
1472 0810R00107170002031 * 29/08/2017 215,300 215,300
1473 0810R00107170002032 * 04/09/2017 184,900 184,900
1474 0810R00107170002033 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.37/145

1475 0810R00107170002034 * 04/09/2017 184,900 184,900


1476 0810R00107170002035 * 04/09/2017 184,900 184,900
1477 0810R00107170002037 * 04/09/2017 114,100 114,100
1478 0810R00107170002038 * 04/09/2017 114,100 114,100
1479 0810R00107170002039 * 04/09/2017 114,100 114,100
1480 0810R00107170002040 * 04/09/2017 114,100 114,100
1481 0810R00107170002041 * 04/09/2017 114,100 114,100
1482 0810R00107170002042 * 04/09/2017 186,300 186,300
1483 0810R00107170002043 * 29/08/2017 184,900 184,900
1484 0810R00107170002044 * 04/09/2017 114,100 114,100
1485 0810R00107170002046 * 29/08/2017 184,900 184,900
1486 0810R00107170002048 * 04/09/2017 155,100 155,100
1487 0810R00107170002050 * 04/09/2017 114,100 114,100
1488 0810R00107170002051 * 04/09/2017 114,100 114,100
1489 0810R00107170002053 * 29/08/2017 289,400 289,400
1490 0810R00107170002054 * 29/08/2017 184,900 184,900
1491 0810R00107170002055 * 30/08/2017 200,700 200,700
1492 0810R00107170002057 * 29/08/2017 184,900 184,900
1493 0810R00107170002058 * 25/08/2017 242,700 242,700
1494 0810R00107170002059 * 04/09/2017 184,900 184,900
1495 0810R00107170002060 * 04/09/2017 114,100 114,100
1496 0810R00107170002061 * 29/08/2017 215,300 215,300
1497 0810R00107170002062 * 04/09/2017 114,100 114,100
1498 0810R00107170002063 * 04/09/2017 184,900 184,900
1499 0810R00107170002064 * 29/08/2017 215,300 215,300
1500 0810R00107170002065 * 04/09/2017 114,100 114,100
1501 0810R00107170002066 * 04/09/2017 184,900 184,900
1502 0810R00107170002067 * 30/08/2017 184,900 184,900
1503 0810R00107170002068 * 04/09/2017 184,900 184,900
1504 0810R00107170002069 * 04/09/2017 184,900 184,900
1505 0810R00107170002070 * 04/09/2017 184,900 184,900
1506 0810R00107170002071 * 04/09/2017 114,100 114,100
1507 0810R00107170002072 * 04/09/2017 184,900 184,900
1508 0810R00107170002073 * 04/09/2017 184,900 184,900
1509 0810R00107170002074 * 04/09/2017 184,900 184,900
1510 0810R00107170002075 * 04/09/2017 184,900 184,900
1511 0810R00107170002076 * 04/09/2017 184,900 184,900
1512 0810R00107170002078 * 04/09/2017 184,900 184,900
1513 0810R00107170002079 * 04/09/2017 184,900 184,900
1514 0810R00107170002084 * 29/08/2017 210,700 210,700
1515 0810R00107170002085 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.38/145

1516 0810R00107170002087 * 04/09/2017 184,900 184,900


1517 0810R00107170002088 * 04/09/2017 184,900 184,900
1518 0810R00107170002089 * 04/09/2017 184,900 184,900
1519 0810R00107170002091 * 04/09/2017 184,900 184,900
1520 0810R00107170002092 * 29/08/2017 215,300 215,300
1521 0810R00107170002093 * 29/08/2017 215,300 215,300
1522 0810R00107170002094 * 04/09/2017 184,900 184,900
1523 0810R00107170002095 * 04/09/2017 184,900 184,900
1524 0810R00107170002097 * 04/09/2017 114,100 114,100
1525 0810R00107170002098 * 04/09/2017 114,100 114,100
1526 0810R00107170002099 * 04/09/2017 184,900 184,900
1527 0810R00107170002100 * 04/09/2017 114,100 114,100
1528 0810R00107170002101 * 04/09/2017 184,900 184,900
1529 0810R00107170002102 * 04/09/2017 184,900 184,900
1530 0810R00107170002104 * 29/08/2017 184,900 184,900
1531 0810R00107170002106 * 04/09/2017 114,100 114,100
1532 0810R00107170002107 * 29/08/2017 215,300 215,300
1533 0810R00107170002108 * 04/09/2017 114,100 114,100
1534 0810R00107170002109 * 04/09/2017 114,100 114,100
1535 0810R00107170002110 * 04/09/2017 114,100 114,100
1536 0810R00107170002111 * 04/09/2017 114,100 114,100
1537 0810R00107170002112 * 04/09/2017 114,100 114,100
1538 0810R00107170002113 * 04/09/2017 184,900 184,900
1539 0810R00107170002114 * 04/09/2017 184,900 184,900
1540 0810R00107170002115 * 04/09/2017 114,100 114,100
1541 0810R00107170002116 * 04/09/2017 184,900 184,900
1542 0810R00107170002117 * 04/09/2017 184,900 184,900
1543 0810R00107170002118 * 29/08/2017 267,200 267,200
1544 0810R00107170002119 * 29/08/2017 242,700 242,700
1545 0810R00107170002120 * 04/09/2017 114,100 114,100
1546 0810R00107170002121 * 04/09/2017 184,900 184,900
1547 0810R00107170002122 * 04/09/2017 184,900 184,900
1548 0810R00107170002123 * 29/08/2017 200,700 200,700
1549 0810R00107170002124 * 04/09/2017 114,100 114,100
1550 0810R00107170002125 * 04/09/2017 184,900 184,900
1551 0810R00107170002126 * 29/08/2017 295,500 295,500
1552 0810R00107170002127 * 04/09/2017 114,100 114,100
1553 0810R00107170002128 * 04/09/2017 184,900 184,900
1554 0810R00107170002129 * 04/09/2017 184,900 184,900
1555 0810R00107170002130 * 29/08/2017 184,900 184,900
1556 0810R00107170002131 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.39/145

1557 0810R00107170002132 * 29/08/2017 342,700 342,700


1558 0810R00107170002133 * 04/09/2017 114,100 114,100
1559 0810R00107170002136 * 04/09/2017 184,900 184,900
1560 0810R00107170002138 * 04/09/2017 184,900 184,900
1561 0810R00107170002139 * 04/09/2017 184,900 184,900
1562 0810R00107170002141 * 04/09/2017 114,100 114,100
1563 0810R00107170002143 * 04/09/2017 184,900 184,900
1564 0810R00107170002144 * 04/09/2017 184,900 184,900
1565 0810R00107170002145 * 04/09/2017 114,100 114,100
1566 0810R00107170002146 * 04/09/2017 114,100 114,100
1567 0810R00107170002147 * 04/09/2017 114,100 114,100
1568 0810R00107170002148 * 04/09/2017 114,100 114,100
1569 0810R00107170002149 * 29/08/2017 184,900 184,900
1570 0810R00107170002151 * 04/09/2017 114,100 114,100
1571 0810R00107170002152 * 04/09/2017 184,900 184,900
1572 0810R00107170002153 * 04/09/2017 155,100 155,100
1573 0810R00107170002154 * 04/09/2017 184,900 184,900
1574 0810R00107170002155 * 04/09/2017 114,100 114,100
1575 0810R00107170002156 * 04/09/2017 184,900 184,900
1576 0810R00107170002157 * 04/09/2017 155,100 155,100
1577 0810R00107170002158 * 04/09/2017 184,900 184,900
1578 0810R00107170002159 * 04/09/2017 155,100 155,100
1579 0810R00107170002162 * 04/09/2017 114,100 114,100
1580 0810R00107170002163 * 04/09/2017 114,100 114,100
1581 0810R00107170002166 * 04/09/2017 114,100 114,100
1582 0810R00107170002167 * 30/08/2017 215,300 215,300
1583 0810R00107170002168 * 04/09/2017 114,100 114,100
1584 0810R00107170002169 * 04/09/2017 114,100 114,100
1585 0810R00107170002170 * 04/09/2017 114,100 114,100
1586 0810R00107170002171 * 04/09/2017 114,100 114,100
1587 0810R00107170002172 * 04/09/2017 114,100 114,100
1588 0810R00107170002173 * 04/09/2017 289,400 289,400
1589 0810R00107170002174 * 04/09/2017 114,100 114,100
1590 0810R00107170002175 * 04/09/2017 114,100 114,100
1591 0810R00107170002176 * 04/09/2017 184,900 184,900
1592 0810R00107170002177 * 04/09/2017 114,100 114,100
1593 0810R00107170002178 * 04/09/2017 114,100 114,100
1594 0810R00107170002182 * 04/09/2017 114,100 114,100
1595 0810R00107170002183 * 04/09/2017 155,100 155,100
1596 0810R00107170002185 * 04/09/2017 114,100 114,100
1597 0810R00107170002186 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.40/145

1598 0810R00107170002188 * 04/09/2017 114,100 114,100


1599 0810R00107170002190 * 04/09/2017 114,100 114,100
1600 0810R00107170002191 * 04/09/2017 184,900 184,900
1601 0810R00107170002192 * 04/09/2017 114,100 114,100
1602 0810R00107170002195 * 04/09/2017 114,100 114,100
1603 0810R00107170002196 * 04/09/2017 184,900 184,900
1604 0810R00107170002197 * 04/09/2017 114,100 114,100
1605 0810R00107170002198 * 04/09/2017 114,100 114,100
1606 0810R00107170002199 * 04/09/2017 184,900 184,900
1607 0810R00107170002200 * 29/08/2017 215,300 215,300
1608 0810R00107170002201 * 04/09/2017 114,100 114,100
1609 0810R00107170002202 * 29/08/2017 184,900 184,900
1610 0810R00107170002203 * 29/08/2017 215,300 215,300
1611 0810R00107170002204 * 04/09/2017 114,100 114,100
1612 0810R00107170002205 * 04/09/2017 184,900 184,900
1613 0810R00107170002206 * 04/09/2017 114,100 114,100
1614 0810R00107170002207 * 04/09/2017 114,100 114,100
1615 0810R00107170002208 * 04/09/2017 155,100 155,100
1616 0810R00107170002209 * 04/09/2017 114,100 114,100
1617 0810R00107170002210 * 04/09/2017 114,100 114,100
1618 0810R00107170002211 * 04/09/2017 114,100 114,100
1619 0810R00107170002212 * 04/09/2017 114,100 114,100
1620 0810R00107170002213 * 04/09/2017 114,100 114,100
1621 0810R00107170002214 * 04/09/2017 114,100 114,100
1622 0810R00107170002216 * 04/09/2017 114,100 114,100
1623 0810R00107170002217 * 04/09/2017 114,100 114,100
1624 0810R00107170002218 * 04/09/2017 114,100 114,100
1625 0810R00107170002219 * 04/09/2017 114,100 114,100
1626 0810R00107170002220 * 04/09/2017 114,100 114,100
1627 0810R00107170002221 * 04/09/2017 114,100 114,100
1628 0810R00107170002222 * 04/09/2017 184,900 184,900
1629 0810R00107170002223 * 04/09/2017 114,100 114,100
1630 0810R00107170002224 * 04/09/2017 184,900 184,900
1631 0810R00107170002225 * 04/09/2017 155,100 155,100
1632 0810R00107170002226 * 04/09/2017 114,100 114,100
1633 0810R00107170002227 * 04/09/2017 114,100 114,100
1634 0810R00107170002228 * 04/09/2017 114,100 114,100
1635 0810R00107170002229 * 04/09/2017 114,100 114,100
1636 0810R00107170002230 * 04/09/2017 114,100 114,100
1637 0810R00107170002231 * 04/09/2017 184,900 184,900
1638 0810R00107170002232 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.41/145

1639 0810R00107170002233 * 04/09/2017 184,900 184,900


1640 0810R00107170002234 * 04/09/2017 114,100 114,100
1641 0810R00107170002235 * 04/09/2017 114,100 114,100
1642 0810R00107170002236 * 04/09/2017 114,100 114,100
1643 0810R00107170002237 * 04/09/2017 114,100 114,100
1644 0810R00107170002238 * 04/09/2017 114,100 114,100
1645 0810R00107170002239 * 04/09/2017 155,100 155,100
1646 0810R00107170002240 * 04/09/2017 114,100 114,100
1647 0810R00107170002241 * 04/09/2017 114,100 114,100
1648 0810R00107170002242 * 04/09/2017 184,900 184,900
1649 0810R00107170002243 * 04/09/2017 155,100 155,100
1650 0810R00107170002244 * 04/09/2017 114,100 114,100
1651 0810R00107170002245 * 04/09/2017 114,100 114,100
1652 0810R00107170002246 * 04/09/2017 114,100 114,100
1653 0810R00107170002247 * 04/09/2017 114,100 114,100
1654 0810R00107170002248 * 04/09/2017 114,100 114,100
1655 0810R00107170002249 * 04/09/2017 155,100 155,100
1656 0810R00107170002250 * 04/09/2017 114,100 114,100
1657 0810R00107170002252 * 04/09/2017 114,100 114,100
1658 0810R00107170002253 * 04/09/2017 114,100 114,100
1659 0810R00107170002254 * 04/09/2017 114,100 114,100
1660 0810R00107170002256 * 04/09/2017 114,100 114,100
1661 0810R00107170002257 * 04/09/2017 114,100 114,100
1662 0810R00107170002258 * 04/09/2017 114,100 114,100
1663 0810R00107170002259 * 04/09/2017 114,100 114,100
1664 0810R00107170002261 * 04/09/2017 114,100 114,100
1665 0810R00107170002262 * 04/09/2017 114,100 114,100
1666 0810R00107170002263 * 04/09/2017 114,100 114,100
1667 0810R00107170002264 * 04/09/2017 114,100 114,100
1668 0810R00107170002266 * 29/08/2017 215,300 215,300
1669 0810R00107170002267 * 04/09/2017 114,100 114,100
1670 0810R00107170002268 * 04/09/2017 887,100 887,100
1671 0810R00107170002269 * 29/08/2017 200,700 200,700
1672 0810R00107170002270 * 04/09/2017 887,100 887,100
1673 0810R00107170002271 * 04/09/2017 887,100 887,100
1674 0810R00107170002272 * 04/09/2017 887,100 887,100
1675 0810R00107170002273 * 04/09/2017 887,100 887,100
1676 0810R00107170002274 * 04/09/2017 887,100 887,100
1677 0810R00107170002275 * 04/09/2017 887,100 887,100
1678 0810R00107170002276 * 04/09/2017 887,100 887,100
1679 0810R00107170002277 * 04/09/2017 887,100 887,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.42/145

1680 0810R00107170002278 * 04/09/2017 887,100 887,100


1681 0810R00107170002280 * 04/09/2017 887,100 887,100
1682 0810R00107170002282 * 04/09/2017 887,100 887,100
1683 0810R00107170002283 * 04/09/2017 887,100 887,100
1684 0810R00107170002284 * 04/09/2017 887,100 887,100
1685 0810R00107170002286 * 04/09/2017 887,100 887,100
1686 0810R00107170002287 * 04/09/2017 887,100 887,100
1687 0810R00107170002288 * 04/09/2017 887,100 887,100
1688 0810R00107170002289 * 04/09/2017 887,100 887,100
1689 0810R00107170002290 * 04/09/2017 887,100 887,100
1690 0810R00107170002291 * 04/09/2017 887,100 887,100
1691 0810R00107170002292 * 04/09/2017 887,100 887,100
1692 0810R00107170002293 * 04/09/2017 289,400 289,400
1693 0810R00107170002294 * 04/09/2017 887,100 887,100
1694 0810R00107170002295 * 04/09/2017 887,100 887,100
1695 0810R00107170002296 * 04/09/2017 887,100 887,100
1696 0810R00107170002297 * 04/09/2017 887,100 887,100
1697 0810R00107170002314 * 04/09/2017 184,900 184,900
1698 0810R00107170002315 * 29/08/2017 184,900 184,900
1699 0810R00107170002316 * 04/09/2017 186,300 186,300
1700 0810R00107170002317 * 29/08/2017 314,500 314,500
1701 0810R00107170002320 * 29/08/2017 314,500 314,500
1702 0810R00107170002321 * 04/09/2017 186,300 186,300
1703 0810R00107170002331 * 29/08/2017 314,500 314,500
1704 0810R00107170002338 * 04/09/2017 184,900 184,900
1705 0810R00107170002339 * 04/09/2017 184,900 184,900
1706 0810R00107170002340 * 04/09/2017 184,900 184,900
1707 0810R00107170002341 * 04/09/2017 184,900 184,900
1708 0810R00107170002342 * 04/09/2017 184,900 184,900
1709 0810R00107170002343 * 04/09/2017 184,900 184,900
1710 0810R00107170002344 * 04/09/2017 114,100 114,100
1711 0810R00107170002345 * 04/09/2017 114,100 114,100
1712 0810R00107170002346 * 04/09/2017 184,900 184,900
1713 0810R00107170002347 * 04/09/2017 155,100 155,100
1714 0810R00107170002348 * 04/09/2017 114,100 114,100
1715 0810R00107170002349 * 04/09/2017 184,900 184,900
1716 0810R00107170002350 * 04/09/2017 114,100 114,100
1717 0810R00107170002351 * 04/09/2017 114,100 114,100
1718 0810R00107170002352 * 04/09/2017 114,100 114,100
1719 0810R00107170002353 * 04/09/2017 114,100 114,100
1720 0810R00107170002354 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.43/145

1721 0810R00107170002355 * 04/09/2017 114,100 114,100


1722 0810R00107170002356 * 04/09/2017 114,100 114,100
1723 0810R00107170002357 * 04/09/2017 114,100 114,100
1724 0810R00107170002358 * 04/09/2017 155,100 155,100
1725 0810R00107170002359 * 04/09/2017 184,900 184,900
1726 0810R00107170002360 * 04/09/2017 184,900 184,900
1727 0810R00107170002361 * 04/09/2017 184,900 184,900
1728 0810R00107170002362 * 04/09/2017 184,900 184,900
1729 0810R00107170002363 * 28/08/2017 412,900 412,900
1730 0810R00107170002364 * 04/09/2017 184,900 184,900
1731 0810R00107170002365 * 04/09/2017 184,900 184,900
1732 0810R00107170002366 * 04/09/2017 184,900 184,900
1733 0810R00107170002367 * 04/09/2017 184,900 184,900
1734 0810R00107170002368 * 04/09/2017 114,100 114,100
1735 0810R00107170002369 * 28/08/2017 184,900 184,900
1736 0810R00107170002370 * 04/09/2017 114,100 114,100
1737 0810R00107170002371 * 04/09/2017 114,100 114,100
1738 0810R00107170002372 * 04/09/2017 184,900 184,900
1739 0810R00107170002373 * 04/09/2017 184,900 184,900
1740 0810R00107170002374 * 28/08/2017 184,900 184,900
1741 0810R00107170002375 * 04/09/2017 155,100 155,100
1742 0810R00107170002376 * 04/09/2017 184,900 184,900
1743 0810R00107170002377 * 04/09/2017 184,900 184,900
1744 0810R00107170002378 * 04/09/2017 184,900 184,900
1745 0810R00107170002379 * 04/09/2017 114,100 114,100
1746 0810R00107170002380 * 04/09/2017 184,900 184,900
1747 0810R00107170002381 * 28/08/2017 200,700 200,700
1748 0810R00107170002383 * 04/09/2017 114,100 114,100
1749 0810R00107170002384 * 04/09/2017 114,100 114,100
1750 0810R00107170002385 * 04/09/2017 114,100 114,100
1751 0810R00107170002386 * 04/09/2017 184,900 184,900
1752 0810R00107170002387 * 04/09/2017 114,100 114,100
1753 0810R00107170002388 * 30/08/2017 184,900 184,900
1754 0810R00107170002390 * 04/09/2017 184,900 184,900
1755 0810R00107170002392 * 04/09/2017 114,100 114,100
1756 0810R00107170002393 * 04/09/2017 184,900 184,900
1757 0810R00107170002394 * 04/09/2017 114,100 114,100
1758 0810R00107170002396 * 04/09/2017 184,900 184,900
1759 0810R00107170002397 * 04/09/2017 184,900 184,900
1760 0810R00107170002398 * 04/09/2017 184,900 184,900
1761 0810R00107170002399 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.44/145

1762 0810R00107170002400 * 04/09/2017 184,900 184,900


1763 0810R00107170002404 * 28/08/2017 215,300 215,300
1764 0810R00107170002405 * 28/08/2017 184,900 184,900
1765 0810R00107170002406 * 04/09/2017 184,900 184,900
1766 0810R00107170002407 * 28/08/2017 184,900 184,900
1767 0810R00107170002409 * 28/08/2017 289,400 289,400
1768 0810R00107170002410 * 04/09/2017 114,100 114,100
1769 0810R00107170002411 * 04/09/2017 184,900 184,900
1770 0810R00107170002412 * 04/09/2017 184,900 184,900
1771 0810R00107170002413 * 04/09/2017 114,100 114,100
1772 0810R00107170002414 * 04/09/2017 184,900 184,900
1773 0810R00107170002415 * 28/08/2017 569,300 569,300
1774 0810R00107170002416 * 04/09/2017 114,100 114,100
1775 0810R00107170002417 * 04/09/2017 184,900 184,900
1776 0810R00107170002418 * 04/09/2017 114,100 114,100
1777 0810R00107170002419 * 28/08/2017 186,300 186,300
1778 0810R00107170002420 * 28/08/2017 184,900 184,900
1779 0810R00107170002421 * 04/09/2017 184,900 184,900
1780 0810R00107170002422 * 04/09/2017 184,900 184,900
1781 0810R00107170002423 * 04/09/2017 184,900 184,900
1782 0810R00107170002425 * 28/08/2017 184,900 184,900
1783 0810R00107170002426 * 04/09/2017 114,100 114,100
1784 0810R00107170002427 * 28/08/2017 184,900 184,900
1785 0810R00107170002428 * 04/09/2017 114,100 114,100
1786 0810R00107170002429 * 04/09/2017 114,100 114,100
1787 0810R00107170002430 * 04/09/2017 114,100 114,100
1788 0810R00107170002431 * 04/09/2017 184,900 184,900
1789 0810R00107170002432 * 04/09/2017 114,100 114,100
1790 0810R00107170002433 * 04/09/2017 184,900 184,900
1791 0810R00107170002434 * 28/08/2017 569,300 569,300
1792 0810R00107170002435 * 04/09/2017 114,100 114,100
1793 0810R00107170002436 * 04/09/2017 114,100 114,100
1794 0810R00107170002437 * 04/09/2017 184,900 184,900
1795 0810R00107170002438 * 30/08/2017 184,900 184,900
1796 0810R00107170002439 * 04/09/2017 155,100 155,100
1797 0810R00107170002440 * 28/08/2017 200,700 200,700
1798 0810R00107170002441 * 28/08/2017 215,300 215,300
1799 0810R00107170002442 * 04/09/2017 155,100 155,100
1800 0810R00107170002443 * 04/09/2017 114,100 114,100
1801 0810R00107170002444 * 04/09/2017 155,100 155,100
1802 0810R00107170002445 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.45/145

1803 0810R00107170002446 * 04/09/2017 184,900 184,900


1804 0810R00107170002447 * 04/09/2017 184,900 184,900
1805 0810R00107170002448 * 28/08/2017 242,700 242,700
1806 0810R00107170002449 * 04/09/2017 184,900 184,900
1807 0810R00107170002450 * 04/09/2017 184,900 184,900
1808 0810R00107170002452 * 04/09/2017 184,900 184,900
1809 0810R00107170002453 * 04/09/2017 186,300 186,300
1810 0810R00107170002454 * 28/08/2017 114,100 114,100
1811 0810R00107170002456 * 28/08/2017 184,900 184,900
1812 0810R00107170002457 * 04/09/2017 186,300 186,300
1813 0810R00107170002458 * 04/09/2017 184,900 184,900
1814 0810R00107170002459 * 04/09/2017 114,100 114,100
1815 0810R00107170002460 * 04/09/2017 184,900 184,900
1816 0810R00107170002461 * 04/09/2017 114,100 114,100
1817 0810R00107170002462 * 04/09/2017 114,100 114,100
1818 0810R00107170002463 * 28/08/2017 215,300 215,300
1819 0810R00107170002464 * 04/09/2017 114,100 114,100
1820 0810R00107170002465 * 28/08/2017 184,900 184,900
1821 0810R00107170002466 * 04/09/2017 114,100 114,100
1822 0810R00107170002467 * 04/09/2017 114,100 114,100
1823 0810R00107170002468 * 28/08/2017 184,900 184,900
1824 0810R00107170002469 * 04/09/2017 114,100 114,100
1825 0810R00107170002470 * 04/09/2017 114,100 114,100
1826 0810R00107170002471 * 04/09/2017 184,900 184,900
1827 0810R00107170002474 * 04/09/2017 184,900 184,900
1828 0810R00107170002475 * 04/09/2017 114,100 114,100
1829 0810R00107170002476 * 04/09/2017 186,300 186,300
1830 0810R00107170002477 * 04/09/2017 184,900 184,900
1831 0810R00107170002478 * 28/08/2017 346,900 346,900
1832 0810R00107170002479 * 04/09/2017 114,100 114,100
1833 0810R00107170002480 * 04/09/2017 184,900 184,900
1834 0810R00107170002481 * 04/09/2017 114,100 114,100
1835 0810R00107170002482 * 04/09/2017 186,300 186,300
1836 0810R00107170002483 * 04/09/2017 184,900 184,900
1837 0810R00107170002484 * 28/08/2017 184,900 184,900
1838 0810R00107170002485 * 04/09/2017 184,900 184,900
1839 0810R00107170002486 * 04/09/2017 184,900 184,900
1840 0810R00107170002487 * 04/09/2017 114,100 114,100
1841 0810R00107170002488 * 04/09/2017 114,100 114,100
1842 0810R00107170002489 * 04/09/2017 184,900 184,900
1843 0810R00107170002490 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.46/145

1844 0810R00107170002491 * 04/09/2017 184,900 184,900


1845 0810R00107170002492 * 04/09/2017 114,100 114,100
1846 0810R00107170002493 * 04/09/2017 184,900 184,900
1847 0810R00107170002494 * 04/09/2017 114,100 114,100
1848 0810R00107170002495 * 28/08/2017 184,900 184,900
1849 0810R00107170002496 * 04/09/2017 114,100 114,100
1850 0810R00107170002497 * 04/09/2017 114,100 114,100
1851 0810R00107170002498 * 28/08/2017 184,900 184,900
1852 0810R00107170002499 * 04/09/2017 114,100 114,100
1853 0810R00107170002500 * 04/09/2017 184,900 184,900
1854 0810R00107170002501 * 04/09/2017 155,100 155,100
1855 0810R00107170002502 * 04/09/2017 114,100 114,100
1856 0810R00107170002503 * 04/09/2017 186,300 186,300
1857 0810R00107170002505 * 04/09/2017 184,900 184,900
1858 0810R00107170002506 * 04/09/2017 184,900 184,900
1859 0810R00107170002507 * 04/09/2017 184,900 184,900
1860 0810R00107170002508 * 28/08/2017 314,500 314,500
1861 0810R00107170002509 * 04/09/2017 184,900 184,900
1862 0810R00107170002510 * 04/09/2017 114,100 114,100
1863 0810R00107170002512 * 04/09/2017 114,100 114,100
1864 0810R00107170002513 * 04/09/2017 155,100 155,100
1865 0810R00107170002514 * 04/09/2017 114,100 114,100
1866 0810R00107170002515 * 04/09/2017 184,900 184,900
1867 0810R00107170002516 * 04/09/2017 114,100 114,100
1868 0810R00107170002517 * 04/09/2017 184,900 184,900
1869 0810R00107170002518 * 04/09/2017 184,900 184,900
1870 0810R00107170002519 * 04/09/2017 114,100 114,100
1871 0810R00107170002520 * 04/09/2017 155,100 155,100
1872 0810R00107170002521 * 28/08/2017 184,900 184,900
1873 0810R00107170002523 * 28/08/2017 200,700 200,700
1874 0810R00107170002524 * 04/09/2017 114,100 114,100
1875 0810R00107170002525 * 04/09/2017 114,100 114,100
1876 0810R00107170002526 * 04/09/2017 184,900 184,900
1877 0810R00107170002527 * 04/09/2017 184,900 184,900
1878 0810R00107170002528 * 04/09/2017 184,900 184,900
1879 0810R00107170002529 * 04/09/2017 114,100 114,100
1880 0810R00107170002530 * 04/09/2017 114,100 114,100
1881 0810R00107170002531 * 04/09/2017 114,100 114,100
1882 0810R00107170002532 * 28/08/2017 184,900 184,900
1883 0810R00107170002533 * 04/09/2017 184,900 184,900
1884 0810R00107170002534 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.47/145

1885 0810R00107170002535 * 04/09/2017 114,100 114,100


1886 0810R00107170002536 * 04/09/2017 200,700 200,700
1887 0810R00107170002537 * 04/09/2017 114,100 114,100
1888 0810R00107170002538 * 04/09/2017 114,100 114,100
1889 0810R00107170002539 * 04/09/2017 114,100 114,100
1890 0810R00107170002540 * 04/09/2017 184,900 184,900
1891 0810R00107170002541 * 04/09/2017 114,100 114,100
1892 0810R00107170002542 * 04/09/2017 184,900 184,900
1893 0810R00107170002543 * 04/09/2017 184,900 184,900
1894 0810R00107170002544 * 04/09/2017 184,900 184,900
1895 0810R00107170002546 * 04/09/2017 184,900 184,900
1896 0810R00107170002547 * 04/09/2017 184,900 184,900
1897 0810R00107170002548 * 04/09/2017 155,100 155,100
1898 0810R00107170002549 * 04/09/2017 114,100 114,100
1899 0810R00107170002550 * 04/09/2017 114,100 114,100
1900 0810R00107170002551 * 04/09/2017 184,900 184,900
1901 0810R00107170002552 * 04/09/2017 155,100 155,100
1902 0810R00107170002553 * 04/09/2017 114,100 114,100
1903 0810R00107170002554 * 04/09/2017 186,300 186,300
1904 0810R00107170002555 * 04/09/2017 184,900 184,900
1905 0810R00107170002556 * 04/09/2017 184,900 184,900
1906 0810R00107170002557 * 04/09/2017 184,900 184,900
1907 0810R00107170002558 * 04/09/2017 184,900 184,900
1908 0810R00107170002560 * 04/09/2017 184,900 184,900
1909 0810R00107170002561 * 28/08/2017 184,900 184,900
1910 0810R00107170002562 * 04/09/2017 114,100 114,100
1911 0810R00107170002563 * 04/09/2017 184,900 184,900
1912 0810R00107170002564 * 28/08/2017 200,700 200,700
1913 0810R00107170002565 * 04/09/2017 186,300 186,300
1914 0810R00107170002566 * 28/08/2017 184,900 184,900
1915 0810R00107170002567 * 28/08/2017 184,900 184,900
1916 0810R00107170002568 * 04/09/2017 114,100 114,100
1917 0810R00107170002569 * 04/09/2017 184,900 184,900
1918 0810R00107170002570 * 04/09/2017 184,900 184,900
1919 0810R00107170002572 * 04/09/2017 184,900 184,900
1920 0810R00107170002573 * 28/08/2017 184,900 184,900
1921 0810R00107170002575 * 04/09/2017 184,900 184,900
1922 0810R00107170002576 * 04/09/2017 184,900 184,900
1923 0810R00107170002577 * 04/09/2017 184,900 184,900
1924 0810R00107170002578 * 04/09/2017 184,900 184,900
1925 0810R00107170002581 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.48/145

1926 0810R00107170002582 * 04/09/2017 184,900 184,900


1927 0810R00107170002584 * 04/09/2017 186,300 186,300
1928 0810R00107170002585 * 04/09/2017 184,900 184,900
1929 0810R00107170002586 * 04/09/2017 184,900 184,900
1930 0810R00107170002588 * 04/09/2017 186,300 186,300
1931 0810R00107170002589 * 04/09/2017 184,900 184,900
1932 0810R00107170002591 * 04/09/2017 184,900 184,900
1933 0810R00107170002592 * 04/09/2017 184,900 184,900
1934 0810R00107170002593 * 04/09/2017 186,300 186,300
1935 0810R00107170002594 * 04/09/2017 186,300 186,300
1936 0810R00107170002595 * 04/09/2017 184,900 184,900
1937 0810R00107170002596 * 04/09/2017 184,900 184,900
1938 0810R00107170002597 * 28/08/2017 215,300 215,300
1939 0810R00107170002598 * 04/09/2017 186,300 186,300
1940 0810R00107170002599 * 04/09/2017 184,900 184,900
1941 0810R00107170002600 * 04/09/2017 184,900 184,900
1942 0810R00107170002601 * 04/09/2017 184,900 184,900
1943 0810R00107170002602 * 04/09/2017 184,900 184,900
1944 0810R00107170002603 * 04/09/2017 114,100 114,100
1945 0810R00107170002604 * 25/08/2017 184,900 184,900
1946 0810R00107170002605 * 04/09/2017 184,900 184,900
1947 0810R00107170002606 * 04/09/2017 184,900 184,900
1948 0810R00107170002608 * 04/09/2017 184,900 184,900
1949 0810R00107170002609 * 25/08/2017 200,700 200,700
1950 0810R00107170002610 * 04/09/2017 184,900 184,900
1951 0810R00107170002611 * 04/09/2017 186,300 186,300
1952 0810R00107170002615 * 25/08/2017 184,900 184,900
1953 0810R00107170002616 * 04/09/2017 184,900 184,900
1954 0810R00107170002617 * 04/09/2017 184,900 184,900
1955 0810R00107170002618 * 04/09/2017 887,100 887,100
1956 0810R00107170002620 * 04/09/2017 887,100 887,100
1957 0810R00107170002621 * 04/09/2017 184,900 184,900
1958 0810R00107170002623 * 25/08/2017 184,900 184,900
1959 0810R00107170002624 * 04/09/2017 186,300 186,300
1960 0810R00107170002625 * 04/09/2017 887,100 887,100
1961 0810R00107170002626 * 04/09/2017 887,100 887,100
1962 0810R00107170002628 * 04/09/2017 887,100 887,100
1963 0810R00107170002629 * 04/09/2017 887,100 887,100
1964 0810R00107170002630 * 04/09/2017 887,100 887,100
1965 0810R00107170002631 * 04/09/2017 184,900 184,900
1966 0810R00107170002632 * 04/09/2017 887,100 887,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.49/145

1967 0810R00107170002634 * 04/09/2017 184,900 184,900


1968 0810R00107170002635 * 04/09/2017 887,100 887,100
1969 0810R00107170002636 * 04/09/2017 184,900 184,900
1970 0810R00107170002637 * 04/09/2017 887,100 887,100
1971 0810R00107170002639 * 04/09/2017 887,100 887,100
1972 0810R00107170002640 * 04/09/2017 186,300 186,300
1973 0810R00107170002641 * 04/09/2017 184,900 184,900
1974 0810R00107170002642 * 04/09/2017 887,100 887,100
1975 0810R00107170002645 * 04/09/2017 887,100 887,100
1976 0810R00107170002646 * 04/09/2017 887,100 887,100
1977 0810R00107170002649 * 04/09/2017 887,100 887,100
1978 0810R00107170002651 * 04/09/2017 887,100 887,100
1979 0810R00107170002652 * 04/09/2017 887,100 887,100
1980 0810R00107170002654 * 04/09/2017 887,100 887,100
1981 0810R00107170002655 * 25/08/2017 186,300 186,300
1982 0810R00107170002656 * 04/09/2017 887,100 887,100
1983 0810R00107170002657 * 04/09/2017 887,100 887,100
1984 0810R00107170002658 * 04/09/2017 887,100 887,100
1985 0810R00107170002659 * 04/09/2017 887,100 887,100
1986 0810R00107170002660 * 04/09/2017 887,100 887,100
1987 0810R00107170002662 * 04/09/2017 887,100 887,100
1988 0810R00107170002663 * 04/09/2017 887,100 887,100
1989 0810R00107170002666 * 04/09/2017 184,900 184,900
1990 0810R00107170002668 * 04/09/2017 184,900 184,900
1991 0810R00107170002669 * 04/09/2017 114,100 114,100
1992 0810R00107170002678 * 25/08/2017 208,700 208,700
1993 0810R00107170002696 * 04/09/2017 186,300 186,300
1994 0810R00107170002699 * 28/08/2017 314,500 314,500
1995 0810R00107170002705 * 28/08/2017 314,500 314,500
1996 0810R00107170002706 * 04/09/2017 184,900 184,900
1997 0810R00107170002707 * 04/09/2017 184,900 184,900
1998 0810R00107170002710 * 04/09/2017 184,900 184,900
1999 0810R00107170002711 * 04/09/2017 184,900 184,900
2000 0810R00107170002712 * 04/09/2017 184,900 184,900
2001 0810R00107170002713 * 04/09/2017 184,900 184,900
2002 0810R00107170002714 * 04/09/2017 184,900 184,900
2003 0810R00107170002715 * 04/09/2017 184,900 184,900
2004 0810R00107170002716 * 04/09/2017 184,900 184,900
2005 0810R00107170002717 * 04/09/2017 184,900 184,900
2006 0810R00107170002718 * 28/08/2017 184,900 184,900
2007 0810R00107170002719 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.50/145

2008 0810R00107170002720 * 28/08/2017 184,900 184,900


2009 0810R00107170002721 * 04/09/2017 114,100 114,100
2010 0810R00107170002722 * 04/09/2017 184,900 184,900
2011 0810R00107170002723 * 04/09/2017 155,100 155,100
2012 0810R00107170002724 * 28/08/2017 200,700 200,700
2013 0810R00107170002725 * 28/08/2017 184,900 184,900
2014 0810R00107170002727 * 04/09/2017 114,100 114,100
2015 0810R00107170002728 * 04/09/2017 184,900 184,900
2016 0810R00107170002730 * 25/08/2017 184,900 184,900
2017 0810R00107170002731 * 04/09/2017 114,100 114,100
2018 0810R00107170002732 * 04/09/2017 114,100 114,100
2019 0810R00107170002733 * 04/09/2017 184,900 184,900
2020 0810R00107170002734 * 04/09/2017 155,100 155,100
2021 0810R00107170002735 * 04/09/2017 114,100 114,100
2022 0810R00107170002736 * 04/09/2017 184,900 184,900
2023 0810R00107170002737 * 04/09/2017 114,100 114,100
2024 0810R00107170002738 * 04/09/2017 114,100 114,100
2025 0810R00107170002740 * 04/09/2017 114,100 114,100
2026 0810R00107170002741 * 04/09/2017 114,100 114,100
2027 0810R00107170002742 * 04/09/2017 186,300 186,300
2028 0810R00107170002743 * 04/09/2017 114,100 114,100
2029 0810R00107170002745 * 04/09/2017 114,100 114,100
2030 0810R00107170002746 * 28/08/2017 289,400 289,400
2031 0810R00107170002747 * 04/09/2017 114,100 114,100
2032 0810R00107170002748 * 28/08/2017 184,900 184,900
2033 0810R00107170002749 * 04/09/2017 114,100 114,100
2034 0810R00107170002750 * 04/09/2017 184,900 184,900
2035 0810R00107170002751 * 28/08/2017 200,700 200,700
2036 0810R00107170002752 * 04/09/2017 184,900 184,900
2037 0810R00107170002754 * 04/09/2017 114,100 114,100
2038 0810R00107170002755 * 04/09/2017 184,900 184,900
2039 0810R00107170002756 * 28/08/2017 184,900 184,900
2040 0810R00107170002757 * 28/08/2017 184,900 184,900
2041 0810R00107170002759 * 04/09/2017 114,100 114,100
2042 0810R00107170002760 * 28/08/2017 215,300 215,300
2043 0810R00107170002761 * 04/09/2017 114,100 114,100
2044 0810R00107170002763 * 04/09/2017 184,900 184,900
2045 0810R00107170002764 * 28/08/2017 186,300 186,300
2046 0810R00107170002765 * 28/08/2017 200,700 200,700
2047 0810R00107170002766 * 04/09/2017 114,100 114,100
2048 0810R00107170002767 * 28/08/2017 215,300 215,300
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.51/145

2049 0810R00107170002768 * 04/09/2017 114,100 114,100


2050 0810R00107170002770 * 04/09/2017 184,900 184,900
2051 0810R00107170002771 * 28/08/2017 184,900 184,900
2052 0810R00107170002772 * 04/09/2017 184,900 184,900
2053 0810R00107170002773 * 04/09/2017 184,900 184,900
2054 0810R00107170002774 * 04/09/2017 184,900 184,900
2055 0810R00107170002775 * 04/09/2017 184,900 184,900
2056 0810R00107170002777 * 04/09/2017 114,100 114,100
2057 0810R00107170002778 * 28/08/2017 289,400 289,400
2058 0810R00107170002779 * 04/09/2017 114,100 114,100
2059 0810R00107170002780 * 28/08/2017 184,900 184,900
2060 0810R00107170002781 * 28/08/2017 569,300 569,300
2061 0810R00107170002782 * 04/09/2017 114,100 114,100
2062 0810R00107170002783 * 04/09/2017 114,100 114,100
2063 0810R00107170002784 * 04/09/2017 114,100 114,100
2064 0810R00107170002786 * 28/08/2017 289,400 289,400
2065 0810R00107170002787 * 04/09/2017 155,100 155,100
2066 0810R00107170002789 * 04/09/2017 184,900 184,900
2067 0810R00107170002790 * 28/08/2017 184,900 184,900
2068 0810R00107170002791 * 04/09/2017 114,100 114,100
2069 0810R00107170002792 * 04/09/2017 184,900 184,900
2070 0810R00107170002793 * 28/08/2017 184,900 184,900
2071 0810R00107170002794 * 28/08/2017 443,700 443,700
2072 0810R00107170002796 * 04/09/2017 569,300 569,300
2073 0810R00107170002797 * 04/09/2017 184,900 184,900
2074 0810R00107170002798 * 04/09/2017 114,100 114,100
2075 0810R00107170002799 * 28/08/2017 184,900 184,900
2076 0810R00107170002800 * 04/09/2017 155,100 155,100
2077 0810R00107170002802 * 04/09/2017 114,100 114,100
2078 0810R00107170002803 * 04/09/2017 184,900 184,900
2079 0810R00107170002804 * 04/09/2017 184,900 184,900
2080 0810R00107170002805 * 04/09/2017 184,900 184,900
2081 0810R00107170002806 * 28/08/2017 184,900 184,900
2082 0810R00107170002807 * 04/09/2017 114,100 114,100
2083 0810R00107170002808 * 04/09/2017 114,100 114,100
2084 0810R00107170002809 * 04/09/2017 114,100 114,100
2085 0810R00107170002810 * 04/09/2017 114,100 114,100
2086 0810R00107170002811 * 04/09/2017 114,100 114,100
2087 0810R00107170002812 * 04/09/2017 184,900 184,900
2088 0810R00107170002814 * 04/09/2017 114,100 114,100
2089 0810R00107170002815 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.52/145

2090 0810R00107170002816 * 04/09/2017 184,900 184,900


2091 0810R00107170002817 * 28/08/2017 184,900 184,900
2092 0810R00107170002819 * 28/08/2017 569,300 569,300
2093 0810R00107170002820 * 30/08/2017 184,900 184,900
2094 0810R00107170002821 * 04/09/2017 131,100 131,100
2095 0810R00107170002822 * 28/08/2017 184,900 184,900
2096 0810R00107170002823 * 04/09/2017 184,900 184,900
2097 0810R00107170002825 * 28/08/2017 289,400 289,400
2098 0810R00107170002826 * 28/08/2017 215,300 215,300
2099 0810R00107170002827 * 28/08/2017 569,300 569,300
2100 0810R00107170002828 * 04/09/2017 114,100 114,100
2101 0810R00107170002829 * 04/09/2017 184,900 184,900
2102 0810R00107170002830 * 04/09/2017 184,900 184,900
2103 0810R00107170002831 * 04/09/2017 184,900 184,900
2104 0810R00107170002833 * 04/09/2017 184,900 184,900
2105 0810R00107170002834 * 04/09/2017 114,100 114,100
2106 0810R00107170002835 * 04/09/2017 184,900 184,900
2107 0810R00107170002837 * 04/09/2017 155,100 155,100
2108 0810R00107170002839 * 04/09/2017 114,100 114,100
2109 0810R00107170002840 * 04/09/2017 114,100 114,100
2110 0810R00107170002841 * 04/09/2017 184,900 184,900
2111 0810R00107170002842 * 04/09/2017 114,100 114,100
2112 0810R00107170002843 * 28/08/2017 569,300 569,300
2113 0810R00107170002844 * 04/09/2017 114,100 114,100
2114 0810R00107170002845 * 04/09/2017 114,100 114,100
2115 0810R00107170002846 * 28/08/2017 215,300 215,300
2116 0810R00107170002847 * 04/09/2017 114,100 114,100
2117 0810R00107170002848 * 04/09/2017 184,900 184,900
2118 0810R00107170002849 * 04/09/2017 114,100 114,100
2119 0810R00107170002850 * 04/09/2017 184,900 184,900
2120 0810R00107170002851 * 04/09/2017 184,900 184,900
2121 0810R00107170002853 * 28/08/2017 184,900 184,900
2122 0810R00107170002854 * 28/08/2017 184,900 184,900
2123 0810R00107170002855 * 04/09/2017 114,100 114,100
2124 0810R00107170002856 * 04/09/2017 114,100 114,100
2125 0810R00107170002858 * 04/09/2017 184,900 184,900
2126 0810R00107170002859 * 04/09/2017 114,100 114,100
2127 0810R00107170002860 * 04/09/2017 184,900 184,900
2128 0810R00107170002861 * 04/09/2017 114,100 114,100
2129 0810R00107170002862 * 04/09/2017 114,100 114,100
2130 0810R00107170002865 * 28/08/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.53/145

2131 0810R00107170002866 * 04/09/2017 114,100 114,100


2132 0810R00107170002867 * 04/09/2017 114,100 114,100
2133 0810R00107170002869 * 04/09/2017 114,100 114,100
2134 0810R00107170002870 * 04/09/2017 114,100 114,100
2135 0810R00107170002871 * 04/09/2017 184,900 184,900
2136 0810R00107170002872 * 04/09/2017 114,100 114,100
2137 0810R00107170002873 * 28/08/2017 569,300 569,300
2138 0810R00107170002875 * 04/09/2017 184,900 184,900
2139 0810R00107170002876 * 04/09/2017 184,900 184,900
2140 0810R00107170002878 * 04/09/2017 155,100 155,100
2141 0810R00107170002879 * 04/09/2017 114,100 114,100
2142 0810R00107170002882 * 04/09/2017 114,100 114,100
2143 0810R00107170002884 * 04/09/2017 184,900 184,900
2144 0810R00107170002885 * 04/09/2017 184,900 184,900
2145 0810R00107170002886 * 04/09/2017 184,900 184,900
2146 0810R00107170002887 * 04/09/2017 114,100 114,100
2147 0810R00107170002888 * 28/08/2017 184,900 184,900
2148 0810R00107170002889 * 04/09/2017 114,100 114,100
2149 0810R00107170002890 * 04/09/2017 114,100 114,100
2150 0810R00107170002892 * 04/09/2017 114,100 114,100
2151 0810R00107170002893 * 04/09/2017 184,900 184,900
2152 0810R00107170002894 * 04/09/2017 114,100 114,100
2153 0810R00107170002896 * 04/09/2017 184,900 184,900
2154 0810R00107170002897 * 04/09/2017 114,100 114,100
2155 0810R00107170002898 * 04/09/2017 184,900 184,900
2156 0810R00107170002899 * 04/09/2017 114,100 114,100
2157 0810R00107170002902 * 04/09/2017 184,900 184,900
2158 0810R00107170002903 * 04/09/2017 114,100 114,100
2159 0810R00107170002904 * 04/09/2017 114,100 114,100
2160 0810R00107170002905 * 28/08/2017 184,900 184,900
2161 0810R00107170002906 * 04/09/2017 114,100 114,100
2162 0810R00107170002907 * 04/09/2017 184,900 184,900
2163 0810R00107170002908 * 04/09/2017 114,100 114,100
2164 0810R00107170002909 * 04/09/2017 184,900 184,900
2165 0810R00107170002911 * 28/08/2017 215,300 215,300
2166 0810R00107170002912 * 04/09/2017 114,100 114,100
2167 0810R00107170002913 * 04/09/2017 114,100 114,100
2168 0810R00107170002914 * 04/09/2017 184,900 184,900
2169 0810R00107170002915 * 04/09/2017 184,900 184,900
2170 0810R00107170002916 * 28/08/2017 184,900 184,900
2171 0810R00107170002917 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.54/145

2172 0810R00107170002918 * 28/08/2017 215,300 215,300


2173 0810R00107170002919 * 04/09/2017 114,100 114,100
2174 0810R00107170002920 * 04/09/2017 114,100 114,100
2175 0810R00107170002922 * 04/09/2017 114,100 114,100
2176 0810R00107170002924 * 04/09/2017 114,100 114,100
2177 0810R00107170002925 * 04/09/2017 184,900 184,900
2178 0810R00107170002926 * 04/09/2017 114,100 114,100
2179 0810R00107170002928 * 04/09/2017 114,100 114,100
2180 0810R00107170002930 * 04/09/2017 140,500 140,500
2181 0810R00107170002931 * 04/09/2017 114,100 114,100
2182 0810R00107170002932 * 04/09/2017 114,100 114,100
2183 0810R00107170002934 * 04/09/2017 184,900 184,900
2184 0810R00107170002935 * 04/09/2017 114,100 114,100
2185 0810R00107170002936 * 04/09/2017 114,100 114,100
2186 0810R00107170002937 * 04/09/2017 184,900 184,900
2187 0810R00107170002938 * 04/09/2017 184,900 184,900
2188 0810R00107170002939 * 04/09/2017 114,100 114,100
2189 0810R00107170002941 * 04/09/2017 114,100 114,100
2190 0810R00107170002942 * 04/09/2017 184,900 184,900
2191 0810R00107170002943 * 04/09/2017 114,100 114,100
2192 0810R00107170002944 * 04/09/2017 114,100 114,100
2193 0810R00107170002945 * 04/09/2017 184,900 184,900
2194 0810R00107170002948 * 04/09/2017 114,100 114,100
2195 0810R00107170002949 * 04/09/2017 114,100 114,100
2196 0810R00107170002950 * 04/09/2017 114,100 114,100
2197 0810R00107170002951 * 04/09/2017 114,100 114,100
2198 0810R00107170002952 * 04/09/2017 114,100 114,100
2199 0810R00107170002955 * 04/09/2017 114,100 114,100
2200 0810R00107170002956 * 04/09/2017 114,100 114,100
2201 0810R00107170002957 * 04/09/2017 114,100 114,100
2202 0810R00107170002958 * 04/09/2017 114,100 114,100
2203 0810R00107170002959 * 04/09/2017 569,300 569,300
2204 0810R00107170002960 * 04/09/2017 114,100 114,100
2205 0810R00107170002961 * 04/09/2017 114,100 114,100
2206 0810R00107170002963 * 04/09/2017 114,100 114,100
2207 0810R00107170002964 * 04/09/2017 114,100 114,100
2208 0810R00107170002966 * 04/09/2017 114,100 114,100
2209 0810R00107170002967 * 04/09/2017 155,100 155,100
2210 0810R00107170002968 * 04/09/2017 114,100 114,100
2211 0810R00107170002969 * 04/09/2017 114,100 114,100
2212 0810R00107170002970 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.55/145

2213 0810R00107170002971 * 04/09/2017 114,100 114,100


2214 0810R00107170002972 * 04/09/2017 184,900 184,900
2215 0810R00107170002974 * 28/08/2017 184,900 184,900
2216 0810R00107170002975 * 04/09/2017 184,900 184,900
2217 0810R00107170002976 * 04/09/2017 184,900 184,900
2218 0810R00107170002977 * 28/08/2017 215,300 215,300
2219 0810R00107170002979 * 04/09/2017 184,900 184,900
2220 0810R00107170002980 * 04/09/2017 184,900 184,900
2221 0810R00107170002981 * 04/09/2017 184,900 184,900
2222 0810R00107170002982 * 30/08/2017 569,300 569,300
2223 0810R00107170002983 * 04/09/2017 184,900 184,900
2224 0810R00107170002985 * 04/09/2017 184,900 184,900
2225 0810R00107170002991 * 28/08/2017 569,300 569,300
2226 0810R00107170002992 * 04/09/2017 887,100 887,100
2227 0810R00107170002993 * 04/09/2017 887,100 887,100
2228 0810R00107170002994 * 28/08/2017 184,900 184,900
2229 0810R00107170002995 * 04/09/2017 887,100 887,100
2230 0810R00107170002996 * 04/09/2017 887,100 887,100
2231 0810R00107170002997 * 04/09/2017 887,100 887,100
2232 0810R00107170002998 * 04/09/2017 887,100 887,100
2233 0810R00107170003000 * 04/09/2017 887,100 887,100
2234 0810R00107170003001 * 04/09/2017 887,100 887,100
2235 0810R00107170003002 * 04/09/2017 887,100 887,100
2236 0810R00107170003003 * 04/09/2017 887,100 887,100
2237 0810R00107170003005 * 04/09/2017 887,100 887,100
2238 0810R00107170003006 * 04/09/2017 887,100 887,100
2239 0810R00107170003007 * 04/09/2017 887,100 887,100
2240 0810R00107170003008 * 04/09/2017 184,900 184,900
2241 0810R00107170003009 * 04/09/2017 887,100 887,100
2242 0810R00107170003010 * 04/09/2017 887,100 887,100
2243 0810R00107170003011 * 04/09/2017 887,100 887,100
2244 0810R00107170003012 * 04/09/2017 887,100 887,100
2245 0810R00107170003013 * 04/09/2017 887,100 887,100
2246 0810R00107170003014 * 04/09/2017 887,100 887,100
2247 0810R00107170003015 * 04/09/2017 887,100 887,100
2248 0810R00107170003016 * 04/09/2017 887,100 887,100
2249 0810R00107170003018 * 04/09/2017 887,100 887,100
2250 0810R00107170003019 * 04/09/2017 887,100 887,100
2251 0810R00107170003020 * 04/09/2017 887,100 887,100
2252 0810R00107170003021 * 04/09/2017 887,100 887,100
2253 0810R00107170003025 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.56/145

2254 0810R00107170003027 * 28/08/2017 267,200 267,200


2255 0810R00107170003030 * 28/08/2017 186,300 186,300
2256 0810R00107170003036 * 04/09/2017 138,700 138,700
2257 0810R00107170003047 * 04/09/2017 186,300 186,300
2258 0810R00107170003057 * 28/08/2017 314,500 314,500
2259 0810R00107170003059 * 28/08/2017 295,100 295,100
2260 0810R00107170003066 * 04/09/2017 186,300 186,300
2261 0810R00107170003071 * 29/08/2017 314,500 314,500
2262 0810R00107170003073 * 29/08/2017 314,500 314,500
2263 0810R00107170003077 * 04/09/2017 184,900 184,900
2264 0810R00107170003079 * 29/08/2017 184,900 184,900
2265 0810R00107170003080 * 04/09/2017 184,900 184,900
2266 0810R00107170003081 * 29/08/2017 184,900 184,900
2267 0810R00107170003082 * 04/09/2017 184,900 184,900
2268 0810R00107170003083 * 29/08/2017 184,900 184,900
2269 0810R00107170003084 * 04/09/2017 184,900 184,900
2270 0810R00107170003085 * 04/09/2017 184,900 184,900
2271 0810R00107170003086 * 04/09/2017 184,900 184,900
2272 0810R00107170003087 * 29/08/2017 569,300 569,300
2273 0810R00107170003088 * 30/08/2017 184,900 184,900
2274 0810R00107170003089 * 29/08/2017 184,900 184,900
2275 0810R00107170003090 * 04/09/2017 184,900 184,900
2276 0810R00107170003091 * 04/09/2017 184,900 184,900
2277 0810R00107170003092 * 29/08/2017 184,900 184,900
2278 0810R00107170003093 * 04/09/2017 186,300 186,300
2279 0810R00107170003094 * 04/09/2017 114,100 114,100
2280 0810R00107170003096 * 04/09/2017 114,100 114,100
2281 0810R00107170003097 * 04/09/2017 184,900 184,900
2282 0810R00107170003098 * 04/09/2017 114,100 114,100
2283 0810R00107170003099 * 04/09/2017 184,900 184,900
2284 0810R00107170003100 * 04/09/2017 114,100 114,100
2285 0810R00107170003101 * 04/09/2017 184,900 184,900
2286 0810R00107170003102 * 04/09/2017 184,900 184,900
2287 0810R00107170003103 * 04/09/2017 114,100 114,100
2288 0810R00107170003104 * 04/09/2017 184,900 184,900
2289 0810R00107170003105 * 04/09/2017 114,100 114,100
2290 0810R00107170003106 * 29/08/2017 184,900 184,900
2291 0810R00107170003107 * 04/09/2017 114,100 114,100
2292 0810R00107170003108 * 04/09/2017 114,100 114,100
2293 0810R00107170003109 * 04/09/2017 184,900 184,900
2294 0810R00107170003110 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.57/145

2295 0810R00107170003111 * 04/09/2017 184,900 184,900


2296 0810R00107170003112 * 04/09/2017 184,900 184,900
2297 0810R00107170003113 * 04/09/2017 114,100 114,100
2298 0810R00107170003114 * 04/09/2017 184,900 184,900
2299 0810R00107170003115 * 04/09/2017 114,100 114,100
2300 0810R00107170003116 * 04/09/2017 184,900 184,900
2301 0810R00107170003117 * 04/09/2017 184,900 184,900
2302 0810R00107170003118 * 29/08/2017 184,900 184,900
2303 0810R00107170003119 * 04/09/2017 184,900 184,900
2304 0810R00107170003120 * 04/09/2017 184,900 184,900
2305 0810R00107170003121 * 04/09/2017 184,900 184,900
2306 0810R00107170003122 * 04/09/2017 184,900 184,900
2307 0810R00107170003123 * 04/09/2017 184,900 184,900
2308 0810R00107170003124 * 29/08/2017 200,700 200,700
2309 0810R00107170003125 * 04/09/2017 114,100 114,100
2310 0810R00107170003126 * 04/09/2017 114,100 114,100
2311 0810R00107170003127 * 04/09/2017 114,100 114,100
2312 0810R00107170003129 * 04/09/2017 114,100 114,100
2313 0810R00107170003130 * 04/09/2017 155,100 155,100
2314 0810R00107170003131 * 04/09/2017 114,100 114,100
2315 0810R00107170003132 * 04/09/2017 114,100 114,100
2316 0810R00107170003133 * 04/09/2017 184,900 184,900
2317 0810R00107170003134 * 29/08/2017 184,900 184,900
2318 0810R00107170003135 * 04/09/2017 114,100 114,100
2319 0810R00107170003136 * 04/09/2017 114,100 114,100
2320 0810R00107170003137 * 04/09/2017 114,100 114,100
2321 0810R00107170003138 * 04/09/2017 114,100 114,100
2322 0810R00107170003139 * 04/09/2017 114,100 114,100
2323 0810R00107170003140 * 04/09/2017 114,100 114,100
2324 0810R00107170003141 * 04/09/2017 155,100 155,100
2325 0810R00107170003143 * 04/09/2017 184,900 184,900
2326 0810R00107170003144 * 04/09/2017 114,100 114,100
2327 0810R00107170003145 * 04/09/2017 184,900 184,900
2328 0810R00107170003146 * 04/09/2017 184,900 184,900
2329 0810R00107170003147 * 04/09/2017 184,900 184,900
2330 0810R00107170003148 * 29/08/2017 184,900 184,900
2331 0810R00107170003149 * 29/08/2017 184,900 184,900
2332 0810R00107170003150 * 04/09/2017 184,900 184,900
2333 0810R00107170003151 * 04/09/2017 184,900 184,900
2334 0810R00107170003152 * 04/09/2017 184,900 184,900
2335 0810R00107170003153 * 29/08/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.58/145

2336 0810R00107170003154 * 04/09/2017 186,300 186,300


2337 0810R00107170003155 * 29/08/2017 569,300 569,300
2338 0810R00107170003156 * 29/08/2017 280,800 280,800
2339 0810R00107170003158 * 04/09/2017 184,900 184,900
2340 0810R00107170003159 * 29/08/2017 569,300 569,300
2341 0810R00107170003160 * 04/09/2017 155,100 155,100
2342 0810R00107170003161 * 04/09/2017 114,100 114,100
2343 0810R00107170003162 * 04/09/2017 114,100 114,100
2344 0810R00107170003164 * 04/09/2017 114,100 114,100
2345 0810R00107170003165 * 04/09/2017 114,100 114,100
2346 0810R00107170003166 * 04/09/2017 155,100 155,100
2347 0810R00107170003167 * 04/09/2017 184,900 184,900
2348 0810R00107170003168 * 04/09/2017 114,100 114,100
2349 0810R00107170003169 * 04/09/2017 184,900 184,900
2350 0810R00107170003170 * 04/09/2017 114,100 114,100
2351 0810R00107170003171 * 04/09/2017 184,900 184,900
2352 0810R00107170003172 * 04/09/2017 114,100 114,100
2353 0810R00107170003173 * 29/08/2017 215,300 215,300
2354 0810R00107170003174 * 04/09/2017 114,100 114,100
2355 0810R00107170003176 * 04/09/2017 114,100 114,100
2356 0810R00107170003177 * 04/09/2017 114,100 114,100
2357 0810R00107170003178 * 04/09/2017 184,900 184,900
2358 0810R00107170003179 * 04/09/2017 184,900 184,900
2359 0810R00107170003180 * 04/09/2017 114,100 114,100
2360 0810R00107170003181 * 29/08/2017 267,200 267,200
2361 0810R00107170003182 * 29/08/2017 215,300 215,300
2362 0810R00107170003183 * 04/09/2017 114,100 114,100
2363 0810R00107170003184 * 29/08/2017 289,400 289,400
2364 0810R00107170003185 * 04/09/2017 114,100 114,100
2365 0810R00107170003187 * 29/08/2017 200,700 200,700
2366 0810R00107170003188 * 04/09/2017 114,100 114,100
2367 0810R00107170003189 * 04/09/2017 114,100 114,100
2368 0810R00107170003190 * 04/09/2017 184,900 184,900
2369 0810R00107170003191 * 04/09/2017 114,100 114,100
2370 0810R00107170003192 * 04/09/2017 184,900 184,900
2371 0810R00107170003193 * 04/09/2017 114,100 114,100
2372 0810R00107170003194 * 04/09/2017 184,900 184,900
2373 0810R00107170003195 * 29/08/2017 184,900 184,900
2374 0810R00107170003196 * 04/09/2017 114,100 114,100
2375 0810R00107170003197 * 04/09/2017 184,900 184,900
2376 0810R00107170003198 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.59/145

2377 0810R00107170003199 * 04/09/2017 114,100 114,100


2378 0810R00107170003200 * 04/09/2017 184,900 184,900
2379 0810R00107170003202 * 04/09/2017 114,100 114,100
2380 0810R00107170003203 * 04/09/2017 114,100 114,100
2381 0810R00107170003205 * 04/09/2017 114,100 114,100
2382 0810R00107170003206 * 29/08/2017 184,900 184,900
2383 0810R00107170003207 * 04/09/2017 114,100 114,100
2384 0810R00107170003209 * 04/09/2017 114,100 114,100
2385 0810R00107170003210 * 29/08/2017 184,900 184,900
2386 0810R00107170003211 * 04/09/2017 184,900 184,900
2387 0810R00107170003212 * 04/09/2017 184,900 184,900
2388 0810R00107170003213 * 04/09/2017 114,100 114,100
2389 0810R00107170003214 * 04/09/2017 184,900 184,900
2390 0810R00107170003215 * 04/09/2017 114,100 114,100
2391 0810R00107170003216 * 04/09/2017 184,900 184,900
2392 0810R00107170003218 * 04/09/2017 114,100 114,100
2393 0810R00107170003219 * 04/09/2017 184,900 184,900
2394 0810R00107170003220 * 04/09/2017 114,100 114,100
2395 0810R00107170003221 * 29/08/2017 215,300 215,300
2396 0810R00107170003222 * 04/09/2017 114,100 114,100
2397 0810R00107170003223 * 29/08/2017 186,300 186,300
2398 0810R00107170003224 * 04/09/2017 184,900 184,900
2399 0810R00107170003225 * 04/09/2017 114,100 114,100
2400 0810R00107170003226 * 29/08/2017 280,800 280,800
2401 0810R00107170003227 * 04/09/2017 114,100 114,100
2402 0810R00107170003228 * 04/09/2017 184,900 184,900
2403 0810R00107170003229 * 04/09/2017 184,900 184,900
2404 0810R00107170003230 * 04/09/2017 155,100 155,100
2405 0810R00107170003231 * 04/09/2017 184,900 184,900
2406 0810R00107170003232 * 04/09/2017 114,100 114,100
2407 0810R00107170003233 * 04/09/2017 186,300 186,300
2408 0810R00107170003234 * 04/09/2017 114,100 114,100
2409 0810R00107170003235 * 04/09/2017 114,100 114,100
2410 0810R00107170003236 * 29/08/2017 184,900 184,900
2411 0810R00107170003237 * 04/09/2017 184,900 184,900
2412 0810R00107170003238 * 04/09/2017 186,300 186,300
2413 0810R00107170003239 * 04/09/2017 114,100 114,100
2414 0810R00107170003240 * 29/08/2017 184,900 184,900
2415 0810R00107170003241 * 04/09/2017 184,900 184,900
2416 0810R00107170003242 * 04/09/2017 155,100 155,100
2417 0810R00107170003243 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.60/145

2418 0810R00107170003244 * 04/09/2017 114,100 114,100


2419 0810R00107170003247 * 04/09/2017 184,900 184,900
2420 0810R00107170003248 * 29/08/2017 184,900 184,900
2421 0810R00107170003249 * 29/08/2017 184,900 184,900
2422 0810R00107170003250 * 04/09/2017 186,300 186,300
2423 0810R00107170003251 * 04/09/2017 114,100 114,100
2424 0810R00107170003253 * 04/09/2017 155,100 155,100
2425 0810R00107170003254 * 04/09/2017 184,900 184,900
2426 0810R00107170003255 * 04/09/2017 114,100 114,100
2427 0810R00107170003256 * 04/09/2017 114,100 114,100
2428 0810R00107170003257 * 04/09/2017 186,300 186,300
2429 0810R00107170003258 * 04/09/2017 186,300 186,300
2430 0810R00107170003259 * 04/09/2017 155,100 155,100
2431 0810R00107170003260 * 04/09/2017 184,900 184,900
2432 0810R00107170003261 * 04/09/2017 114,100 114,100
2433 0810R00107170003262 * 04/09/2017 184,900 184,900
2434 0810R00107170003263 * 04/09/2017 155,100 155,100
2435 0810R00107170003264 * 04/09/2017 184,900 184,900
2436 0810R00107170003266 * 04/09/2017 184,900 184,900
2437 0810R00107170003267 * 04/09/2017 114,100 114,100
2438 0810R00107170003269 * 04/09/2017 155,100 155,100
2439 0810R00107170003270 * 04/09/2017 114,100 114,100
2440 0810R00107170003271 * 04/09/2017 114,100 114,100
2441 0810R00107170003273 * 04/09/2017 114,100 114,100
2442 0810R00107170003275 * 04/09/2017 114,100 114,100
2443 0810R00107170003276 * 04/09/2017 114,100 114,100
2444 0810R00107170003277 * 30/08/2017 184,900 184,900
2445 0810R00107170003279 * 04/09/2017 155,100 155,100
2446 0810R00107170003281 * 04/09/2017 184,900 184,900
2447 0810R00107170003285 * 29/08/2017 255,700 255,700
2448 0810R00107170003286 * 29/08/2017 184,900 184,900
2449 0810R00107170003290 * 04/09/2017 184,900 184,900
2450 0810R00107170003291 * 04/09/2017 186,300 186,300
2451 0810R00107170003292 * 04/09/2017 184,900 184,900
2452 0810R00107170003293 * 29/08/2017 184,900 184,900
2453 0810R00107170003294 * 04/09/2017 186,300 186,300
2454 0810R00107170003295 * 04/09/2017 184,900 184,900
2455 0810R00107170003296 * 29/08/2017 184,900 184,900
2456 0810R00107170003297 * 04/09/2017 184,900 184,900
2457 0810R00107170003298 * 04/09/2017 184,900 184,900
2458 0810R00107170003299 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.61/145

2459 0810R00107170003300 * 29/08/2017 184,900 184,900


2460 0810R00107170003301 * 04/09/2017 184,900 184,900
2461 0810R00107170003302 * 04/09/2017 184,900 184,900
2462 0810R00107170003303 * 04/09/2017 184,900 184,900
2463 0810R00107170003304 * 29/08/2017 184,900 184,900
2464 0810R00107170003305 * 04/09/2017 184,900 184,900
2465 0810R00107170003306 * 04/09/2017 184,900 184,900
2466 0810R00107170003307 * 04/09/2017 184,900 184,900
2467 0810R00107170003308 * 04/09/2017 184,900 184,900
2468 0810R00107170003309 * 04/09/2017 184,900 184,900
2469 0810R00107170003313 * 04/09/2017 184,900 184,900
2470 0810R00107170003317 * 29/08/2017 184,900 184,900
2471 0810R00107170003318 * 04/09/2017 184,900 184,900
2472 0810R00107170003319 * 04/09/2017 184,900 184,900
2473 0810R00107170003320 * 29/08/2017 184,900 184,900
2474 0810R00107170003321 * 04/09/2017 184,900 184,900
2475 0810R00107170003322 * 29/08/2017 200,700 200,700
2476 0810R00107170003323 * 29/08/2017 280,800 280,800
2477 0810R00107170003324 * 04/09/2017 184,900 184,900
2478 0810R00107170003325 * 04/09/2017 184,900 184,900
2479 0810R00107170003327 * 29/08/2017 184,900 184,900
2480 0810R00107170003328 * 04/09/2017 887,100 887,100
2481 0810R00107170003329 * 04/09/2017 155,100 155,100
2482 0810R00107170003330 * 04/09/2017 887,100 887,100
2483 0810R00107170003331 * 04/09/2017 887,100 887,100
2484 0810R00107170003332 * 04/09/2017 114,100 114,100
2485 0810R00107170003333 * 04/09/2017 887,100 887,100
2486 0810R00107170003335 * 04/09/2017 887,100 887,100
2487 0810R00107170003336 * 04/09/2017 184,900 184,900
2488 0810R00107170003337 * 04/09/2017 887,100 887,100
2489 0810R00107170003339 * 04/09/2017 887,100 887,100
2490 0810R00107170003340 * 04/09/2017 887,100 887,100
2491 0810R00107170003341 * 04/09/2017 184,900 184,900
2492 0810R00107170003342 * 04/09/2017 887,100 887,100
2493 0810R00107170003343 * 04/09/2017 114,100 114,100
2494 0810R00107170003345 * 04/09/2017 186,300 186,300
2495 0810R00107170003346 * 04/09/2017 887,100 887,100
2496 0810R00107170003347 * 04/09/2017 887,100 887,100
2497 0810R00107170003348 * 04/09/2017 887,100 887,100
2498 0810R00107170003349 * 04/09/2017 184,900 184,900
2499 0810R00107170003350 * 04/09/2017 887,100 887,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.62/145

2500 0810R00107170003351 * 04/09/2017 887,100 887,100


2501 0810R00107170003352 * 04/09/2017 184,900 184,900
2502 0810R00107170003353 * 04/09/2017 887,100 887,100
2503 0810R00107170003354 * 04/09/2017 887,100 887,100
2504 0810R00107170003355 * 04/09/2017 887,100 887,100
2505 0810R00107170003356 * 04/09/2017 887,100 887,100
2506 0810R00107170003357 * 04/09/2017 887,100 887,100
2507 0810R00107170003358 * 04/09/2017 887,100 887,100
2508 0810R00107170003359 * 04/09/2017 887,100 887,100
2509 0810R00107170003360 * 04/09/2017 887,100 887,100
2510 0810R00107170003361 * 04/09/2017 887,100 887,100
2511 0810R00107170003363 * 04/09/2017 887,100 887,100
2512 0810R00107170003364 * 04/09/2017 887,100 887,100
2513 0810R00107170003365 * 04/09/2017 887,100 887,100
2514 0810R00107170003378 * 04/09/2017 148,000 148,000
2515 0810R00107170003379 * 04/09/2017 186,300 186,300
2516 0810R00107170003384 * 29/08/2017 314,500 314,500
2517 0810R00107170003390 * 04/09/2017 138,700 138,700
2518 0810R00107170003399 * 04/09/2017 114,100 114,100
2519 0810R00107170003400 * 28/08/2017 184,900 184,900
2520 0810R00107170003401 * 04/09/2017 184,900 184,900
2521 0810R00107170003402 * 28/08/2017 184,900 184,900
2522 0810R00107170003404 * 28/08/2017 184,900 184,900
2523 0810R00107170003405 * 04/09/2017 114,100 114,100
2524 0810R00107170003406 * 04/09/2017 155,100 155,100
2525 0810R00107170003407 * 28/08/2017 569,300 569,300
2526 0810R00107170003408 * 04/09/2017 114,100 114,100
2527 0810R00107170003409 * 28/08/2017 184,900 184,900
2528 0810R00107170003410 * 04/09/2017 114,100 114,100
2529 0810R00107170003411 * 28/08/2017 184,900 184,900
2530 0810R00107170003412 * 04/09/2017 114,100 114,100
2531 0810R00107170003413 * 04/09/2017 184,900 184,900
2532 0810R00107170003414 * 04/09/2017 184,900 184,900
2533 0810R00107170003415 * 04/09/2017 114,100 114,100
2534 0810R00107170003416 * 04/09/2017 114,100 114,100
2535 0810R00107170003417 * 04/09/2017 114,100 114,100
2536 0810R00107170003418 * 04/09/2017 114,100 114,100
2537 0810R00107170003419 * 04/09/2017 114,100 114,100
2538 0810R00107170003420 * 04/09/2017 114,100 114,100
2539 0810R00107170003421 * 04/09/2017 184,900 184,900
2540 0810R00107170003423 * 28/08/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.63/145

2541 0810R00107170003424 * 04/09/2017 114,100 114,100


2542 0810R00107170003425 * 04/09/2017 184,900 184,900
2543 0810R00107170003426 * 04/09/2017 114,100 114,100
2544 0810R00107170003427 * 04/09/2017 184,900 184,900
2545 0810R00107170003428 * 04/09/2017 114,100 114,100
2546 0810R00107170003430 * 04/09/2017 184,900 184,900
2547 0810R00107170003431 * 04/09/2017 114,100 114,100
2548 0810R00107170003432 * 04/09/2017 114,100 114,100
2549 0810R00107170003433 * 04/09/2017 184,900 184,900
2550 0810R00107170003434 * 04/09/2017 114,100 114,100
2551 0810R00107170003435 * 04/09/2017 114,100 114,100
2552 0810R00107170003436 * 04/09/2017 184,900 184,900
2553 0810R00107170003437 * 04/09/2017 114,100 114,100
2554 0810R00107170003438 * 04/09/2017 184,900 184,900
2555 0810R00107170003440 * 04/09/2017 184,900 184,900
2556 0810R00107170003442 * 04/09/2017 114,100 114,100
2557 0810R00107170003443 * 04/09/2017 114,100 114,100
2558 0810R00107170003444 * 04/09/2017 114,100 114,100
2559 0810R00107170003445 * 04/09/2017 184,900 184,900
2560 0810R00107170003446 * 04/09/2017 114,100 114,100
2561 0810R00107170003447 * 04/09/2017 114,100 114,100
2562 0810R00107170003449 * 04/09/2017 114,100 114,100
2563 0810R00107170003451 * 04/09/2017 114,100 114,100
2564 0810R00107170003453 * 04/09/2017 184,900 184,900
2565 0810R00107170003454 * 04/09/2017 114,100 114,100
2566 0810R00107170003455 * 04/09/2017 155,100 155,100
2567 0810R00107170003456 * 04/09/2017 184,900 184,900
2568 0810R00107170003457 * 04/09/2017 114,100 114,100
2569 0810R00107170003458 * 04/09/2017 114,100 114,100
2570 0810R00107170003459 * 04/09/2017 114,100 114,100
2571 0810R00107170003460 * 28/08/2017 184,900 184,900
2572 0810R00107170003461 * 04/09/2017 114,100 114,100
2573 0810R00107170003462 * 04/09/2017 114,100 114,100
2574 0810R00107170003463 * 04/09/2017 114,100 114,100
2575 0810R00107170003464 * 04/09/2017 184,900 184,900
2576 0810R00107170003465 * 04/09/2017 114,100 114,100
2577 0810R00107170003466 * 04/09/2017 114,100 114,100
2578 0810R00107170003467 * 04/09/2017 184,900 184,900
2579 0810R00107170003468 * 04/09/2017 114,100 114,100
2580 0810R00107170003469 * 04/09/2017 114,100 114,100
2581 0810R00107170003471 * 28/08/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.64/145

2582 0810R00107170003472 * 04/09/2017 114,100 114,100


2583 0810R00107170003473 * 04/09/2017 114,100 114,100
2584 0810R00107170003474 * 04/09/2017 114,100 114,100
2585 0810R00107170003475 * 04/09/2017 184,900 184,900
2586 0810R00107170003476 * 04/09/2017 114,100 114,100
2587 0810R00107170003477 * 04/09/2017 114,100 114,100
2588 0810R00107170003478 * 04/09/2017 114,100 114,100
2589 0810R00107170003479 * 04/09/2017 114,100 114,100
2590 0810R00107170003481 * 04/09/2017 114,100 114,100
2591 0810R00107170003482 * 04/09/2017 114,100 114,100
2592 0810R00107170003483 * 28/08/2017 184,900 184,900
2593 0810R00107170003484 * 04/09/2017 114,100 114,100
2594 0810R00107170003485 * 04/09/2017 114,100 114,100
2595 0810R00107170003486 * 04/09/2017 114,100 114,100
2596 0810R00107170003487 * 04/09/2017 114,100 114,100
2597 0810R00107170003488 * 04/09/2017 114,100 114,100
2598 0810R00107170003489 * 04/09/2017 114,100 114,100
2599 0810R00107170003490 * 04/09/2017 114,100 114,100
2600 0810R00107170003491 * 04/09/2017 114,100 114,100
2601 0810R00107170003492 * 04/09/2017 184,900 184,900
2602 0810R00107170003493 * 04/09/2017 114,100 114,100
2603 0810R00107170003494 * 04/09/2017 114,100 114,100
2604 0810R00107170003495 * 30/08/2017 184,900 184,900
2605 0810R00107170003496 * 04/09/2017 114,100 114,100
2606 0810R00107170003498 * 04/09/2017 114,100 114,100
2607 0810R00107170003499 * 04/09/2017 114,100 114,100
2608 0810R00107170003501 * 04/09/2017 184,900 184,900
2609 0810R00107170003502 * 04/09/2017 114,100 114,100
2610 0810R00107170003503 * 04/09/2017 114,100 114,100
2611 0810R00107170003504 * 28/08/2017 289,400 289,400
2612 0810R00107170003505 * 04/09/2017 114,100 114,100
2613 0810R00107170003506 * 04/09/2017 155,100 155,100
2614 0810R00107170003507 * 04/09/2017 114,100 114,100
2615 0810R00107170003508 * 04/09/2017 184,900 184,900
2616 0810R00107170003509 * 04/09/2017 184,900 184,900
2617 0810R00107170003510 * 04/09/2017 114,100 114,100
2618 0810R00107170003511 * 04/09/2017 184,900 184,900
2619 0810R00107170003512 * 04/09/2017 114,100 114,100
2620 0810R00107170003513 * 04/09/2017 114,100 114,100
2621 0810R00107170003514 * 04/09/2017 184,900 184,900
2622 0810R00107170003515 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.65/145

2623 0810R00107170003516 * 04/09/2017 114,100 114,100


2624 0810R00107170003517 * 04/09/2017 184,900 184,900
2625 0810R00107170003518 * 04/09/2017 155,100 155,100
2626 0810R00107170003519 * 04/09/2017 114,100 114,100
2627 0810R00107170003520 * 04/09/2017 114,100 114,100
2628 0810R00107170003521 * 04/09/2017 114,100 114,100
2629 0810R00107170003522 * 04/09/2017 114,100 114,100
2630 0810R00107170003524 * 04/09/2017 114,100 114,100
2631 0810R00107170003525 * 04/09/2017 155,100 155,100
2632 0810R00107170003526 * 04/09/2017 114,100 114,100
2633 0810R00107170003527 * 04/09/2017 114,100 114,100
2634 0810R00107170003528 * 04/09/2017 114,100 114,100
2635 0810R00107170003529 * 04/09/2017 114,100 114,100
2636 0810R00107170003530 * 04/09/2017 114,100 114,100
2637 0810R00107170003531 * 28/08/2017 184,900 184,900
2638 0810R00107170003532 * 04/09/2017 114,100 114,100
2639 0810R00107170003534 * 04/09/2017 184,900 184,900
2640 0810R00107170003535 * 04/09/2017 114,100 114,100
2641 0810R00107170003536 * 04/09/2017 155,100 155,100
2642 0810R00107170003537 * 04/09/2017 155,100 155,100
2643 0810R00107170003538 * 04/09/2017 114,100 114,100
2644 0810R00107170003541 * 28/08/2017 184,900 184,900
2645 0810R00107170003543 * 28/08/2017 960,400 960,400
2646 0810R00107170003544 * 28/08/2017 184,900 184,900
2647 0810R00107170003545 * 28/08/2017 184,900 184,900
2648 0810R00107170003546 * 28/08/2017 346,900 346,900
2649 0810R00107170003547 * 28/08/2017 184,900 184,900
2650 0810R00107170003548 * 28/08/2017 314,500 314,500
2651 0810R00107170003549 * 04/09/2017 184,900 184,900
2652 0810R00107170003550 * 04/09/2017 184,900 184,900
2653 0810R00107170003551 * 04/09/2017 184,900 184,900
2654 0810R00107170003552 * 04/09/2017 184,900 184,900
2655 0810R00107170003553 * 04/09/2017 184,900 184,900
2656 0810R00107170003554 * 04/09/2017 184,900 184,900
2657 0810R00107170003555 * 04/09/2017 184,900 184,900
2658 0810R00107170003556 * 04/09/2017 184,900 184,900
2659 0810R00107170003557 * 04/09/2017 184,900 184,900
2660 0810R00107170003558 * 28/08/2017 184,900 184,900
2661 0810R00107170003559 * 04/09/2017 155,100 155,100
2662 0810R00107170003560 * 04/09/2017 184,900 184,900
2663 0810R00107170003562 * 28/08/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.66/145

2664 0810R00107170003563 * 04/09/2017 184,900 184,900


2665 0810R00107170003564 * 04/09/2017 184,900 184,900
2666 0810R00107170003565 * 28/08/2017 200,700 200,700
2667 0810R00107170003567 * 28/08/2017 184,900 184,900
2668 0810R00107170003568 * 04/09/2017 114,100 114,100
2669 0810R00107170003569 * 04/09/2017 887,100 887,100
2670 0810R00107170003570 * 04/09/2017 184,900 184,900
2671 0810R00107170003571 * 04/09/2017 887,100 887,100
2672 0810R00107170003572 * 28/08/2017 184,900 184,900
2673 0810R00107170003573 * 04/09/2017 887,100 887,100
2674 0810R00107170003574 * 04/09/2017 184,900 184,900
2675 0810R00107170003575 * 04/09/2017 184,900 184,900
2676 0810R00107170003576 * 04/09/2017 114,100 114,100
2677 0810R00107170003577 * 04/09/2017 184,900 184,900
2678 0810R00107170003578 * 28/08/2017 184,900 184,900
2679 0810R00107170003579 * 04/09/2017 887,100 887,100
2680 0810R00107170003580 * 04/09/2017 184,900 184,900
2681 0810R00107170003581 * 04/09/2017 887,100 887,100
2682 0810R00107170003582 * 04/09/2017 887,100 887,100
2683 0810R00107170003584 * 28/08/2017 184,900 184,900
2684 0810R00107170003585 * 04/09/2017 887,100 887,100
2685 0810R00107170003586 * 04/09/2017 887,100 887,100
2686 0810R00107170003587 * 04/09/2017 887,100 887,100
2687 0810R00107170003588 * 04/09/2017 887,100 887,100
2688 0810R00107170003589 * 04/09/2017 887,100 887,100
2689 0810R00107170003590 * 04/09/2017 887,100 887,100
2690 0810R00107170003591 * 04/09/2017 887,100 887,100
2691 0810R00107170003592 * 04/09/2017 887,100 887,100
2692 0810R00107170003593 * 04/09/2017 887,100 887,100
2693 0810R00107170003594 * 04/09/2017 184,900 184,900
2694 0810R00107170003595 * 04/09/2017 887,100 887,100
2695 0810R00107170003596 * 04/09/2017 887,100 887,100
2696 0810R00107170003597 * 04/09/2017 887,100 887,100
2697 0810R00107170003598 * 04/09/2017 887,100 887,100
2698 0810R00107170003599 * 04/09/2017 887,100 887,100
2699 0810R00107170003600 * 04/09/2017 887,100 887,100
2700 0810R00107170003601 * 04/09/2017 887,100 887,100
2701 0810R00107170003602 * 04/09/2017 887,100 887,100
2702 0810R00107170003603 * 04/09/2017 887,100 887,100
2703 0810R00107170003604 * 04/09/2017 887,100 887,100
2704 0810R00107170003605 * 04/09/2017 887,100 887,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.67/145

2705 0810R00107170003606 * 28/08/2017 184,900 184,900


2706 0810R00107170003607 * 04/09/2017 887,100 887,100
2707 0810R00107170003608 * 04/09/2017 114,100 114,100
2708 0810R00107170003609 * 04/09/2017 114,100 114,100
2709 0810R00107170003611 * 28/08/2017 569,300 569,300
2710 0810R00107170003612 * 04/09/2017 114,100 114,100
2711 0810R00107170003614 * 04/09/2017 114,100 114,100
2712 0810R00107170003616 * 04/09/2017 186,300 186,300
2713 0810R00107170003621 * 04/09/2017 114,100 114,100
2714 0810R00107170003627 * 04/09/2017 186,300 186,300
2715 0810R00107170003628 * 04/09/2017 184,900 184,900
2716 0810R00107170003641 * 28/08/2017 314,500 314,500
2717 0810R00107170003642 * 04/09/2017 186,300 186,300
2718 0810R00107170003646 * 25/08/2017 184,900 184,900
2719 0810R00107170003647 * 04/09/2017 184,900 184,900
2720 0810R00107170003648 * 04/09/2017 184,900 184,900
2721 0810R00107170003649 * 04/09/2017 184,900 184,900
2722 0810R00107170003651 * 04/09/2017 114,100 114,100
2723 0810R00107170003652 * 25/08/2017 184,900 184,900
2724 0810R00107170003653 * 25/08/2017 184,900 184,900
2725 0810R00107170003654 * 04/09/2017 114,100 114,100
2726 0810R00107170003655 * 04/09/2017 184,900 184,900
2727 0810R00107170003656 * 04/09/2017 184,900 184,900
2728 0810R00107170003657 * 04/09/2017 184,900 184,900
2729 0810R00107170003658 * 25/08/2017 569,300 569,300
2730 0810R00107170003659 * 04/09/2017 184,900 184,900
2731 0810R00107170003660 * 04/09/2017 184,900 184,900
2732 0810R00107170003661 * 04/09/2017 184,900 184,900
2733 0810R00107170003662 * 04/09/2017 114,100 114,100
2734 0810R00107170003663 * 04/09/2017 184,900 184,900
2735 0810R00107170003664 * 04/09/2017 184,900 184,900
2736 0810R00107170003665 * 04/09/2017 184,900 184,900
2737 0810R00107170003666 * 04/09/2017 184,900 184,900
2738 0810R00107170003667 * 04/09/2017 184,900 184,900
2739 0810R00107170003668 * 04/09/2017 184,900 184,900
2740 0810R00107170003669 * 04/09/2017 114,100 114,100
2741 0810R00107170003670 * 04/09/2017 114,100 114,100
2742 0810R00107170003671 * 04/09/2017 184,900 184,900
2743 0810R00107170003672 * 04/09/2017 114,100 114,100
2744 0810R00107170003673 * 04/09/2017 184,900 184,900
2745 0810R00107170003674 * 04/09/2017 155,100 155,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.68/145

2746 0810R00107170003675 * 04/09/2017 114,100 114,100


2747 0810R00107170003676 * 04/09/2017 114,100 114,100
2748 0810R00107170003677 * 04/09/2017 114,100 114,100
2749 0810R00107170003678 * 04/09/2017 184,900 184,900
2750 0810R00107170003679 * 04/09/2017 114,100 114,100
2751 0810R00107170003680 * 25/08/2017 184,900 184,900
2752 0810R00107170003681 * 04/09/2017 114,100 114,100
2753 0810R00107170003682 * 04/09/2017 114,100 114,100
2754 0810R00107170003683 * 04/09/2017 114,100 114,100
2755 0810R00107170003684 * 04/09/2017 114,100 114,100
2756 0810R00107170003685 * 25/08/2017 215,300 215,300
2757 0810R00107170003686 * 04/09/2017 114,100 114,100
2758 0810R00107170003688 * 04/09/2017 114,100 114,100
2759 0810R00107170003689 * 04/09/2017 114,100 114,100
2760 0810R00107170003691 * 04/09/2017 114,100 114,100
2761 0810R00107170003692 * 04/09/2017 114,100 114,100
2762 0810R00107170003693 * 04/09/2017 114,100 114,100
2763 0810R00107170003694 * 04/09/2017 114,100 114,100
2764 0810R00107170003695 * 04/09/2017 114,100 114,100
2765 0810R00107170003697 * 04/09/2017 155,100 155,100
2766 0810R00107170003698 * 04/09/2017 114,100 114,100
2767 0810R00107170003699 * 04/09/2017 184,900 184,900
2768 0810R00107170003700 * 04/09/2017 114,100 114,100
2769 0810R00107170003701 * 04/09/2017 184,900 184,900
2770 0810R00107170003702 * 25/08/2017 184,900 184,900
2771 0810R00107170003703 * 04/09/2017 184,900 184,900
2772 0810R00107170003704 * 04/09/2017 114,100 114,100
2773 0810R00107170003705 * 04/09/2017 184,900 184,900
2774 0810R00107170003706 * 04/09/2017 114,100 114,100
2775 0810R00107170003707 * 04/09/2017 184,900 184,900
2776 0810R00107170003708 * 04/09/2017 114,100 114,100
2777 0810R00107170003709 * 04/09/2017 114,100 114,100
2778 0810R00107170003710 * 04/09/2017 184,900 184,900
2779 0810R00107170003711 * 04/09/2017 114,100 114,100
2780 0810R00107170003713 * 04/09/2017 114,100 114,100
2781 0810R00107170003714 * 04/09/2017 155,100 155,100
2782 0810R00107170003715 * 04/09/2017 114,100 114,100
2783 0810R00107170003716 * 04/09/2017 114,100 114,100
2784 0810R00107170003717 * 04/09/2017 114,100 114,100
2785 0810R00107170003718 * 04/09/2017 114,100 114,100
2786 0810R00107170003719 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.69/145

2787 0810R00107170003720 * 04/09/2017 184,900 184,900


2788 0810R00107170003721 * 04/09/2017 114,100 114,100
2789 0810R00107170003722 * 04/09/2017 114,100 114,100
2790 0810R00107170003723 * 04/09/2017 114,100 114,100
2791 0810R00107170003724 * 25/08/2017 184,900 184,900
2792 0810R00107170003725 * 04/09/2017 114,100 114,100
2793 0810R00107170003727 * 04/09/2017 114,100 114,100
2794 0810R00107170003728 * 04/09/2017 114,100 114,100
2795 0810R00107170003729 * 04/09/2017 184,900 184,900
2796 0810R00107170003730 * 04/09/2017 186,300 186,300
2797 0810R00107170003731 * 25/08/2017 346,900 346,900
2798 0810R00107170003733 * 04/09/2017 184,900 184,900
2799 0810R00107170003734 * 04/09/2017 155,100 155,100
2800 0810R00107170003735 * 04/09/2017 114,100 114,100
2801 0810R00107170003737 * 04/09/2017 114,100 114,100
2802 0810R00107170003738 * 04/09/2017 114,100 114,100
2803 0810R00107170003739 * 04/09/2017 114,100 114,100
2804 0810R00107170003740 * 04/09/2017 114,100 114,100
2805 0810R00107170003741 * 04/09/2017 114,100 114,100
2806 0810R00107170003742 * 04/09/2017 114,100 114,100
2807 0810R00107170003743 * 04/09/2017 184,900 184,900
2808 0810R00107170003744 * 04/09/2017 114,100 114,100
2809 0810R00107170003745 * 04/09/2017 114,100 114,100
2810 0810R00107170003746 * 04/09/2017 114,100 114,100
2811 0810R00107170003747 * 04/09/2017 184,900 184,900
2812 0810R00107170003748 * 04/09/2017 114,100 114,100
2813 0810R00107170003749 * 04/09/2017 114,100 114,100
2814 0810R00107170003750 * 04/09/2017 114,100 114,100
2815 0810R00107170003751 * 04/09/2017 114,100 114,100
2816 0810R00107170003752 * 04/09/2017 114,100 114,100
2817 0810R00107170003753 * 04/09/2017 114,100 114,100
2818 0810R00107170003754 * 04/09/2017 114,100 114,100
2819 0810R00107170003756 * 04/09/2017 184,900 184,900
2820 0810R00107170003757 * 04/09/2017 114,100 114,100
2821 0810R00107170003758 * 04/09/2017 114,100 114,100
2822 0810R00107170003759 * 04/09/2017 114,100 114,100
2823 0810R00107170003760 * 04/09/2017 114,100 114,100
2824 0810R00107170003761 * 04/09/2017 114,100 114,100
2825 0810R00107170003762 * 04/09/2017 114,100 114,100
2826 0810R00107170003763 * 04/09/2017 155,100 155,100
2827 0810R00107170003764 * 04/09/2017 183,900 183,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.70/145

2828 0810R00107170003765 * 04/09/2017 114,100 114,100


2829 0810R00107170003766 * 04/09/2017 114,100 114,100
2830 0810R00107170003767 * 04/09/2017 114,100 114,100
2831 0810R00107170003768 * 04/09/2017 114,100 114,100
2832 0810R00107170003769 * 04/09/2017 114,100 114,100
2833 0810R00107170003770 * 04/09/2017 114,100 114,100
2834 0810R00107170003771 * 04/09/2017 114,100 114,100
2835 0810R00107170003772 * 04/09/2017 114,100 114,100
2836 0810R00107170003773 * 04/09/2017 114,100 114,100
2837 0810R00107170003774 * 04/09/2017 114,100 114,100
2838 0810R00107170003775 * 04/09/2017 114,100 114,100
2839 0810R00107170003776 * 04/09/2017 114,100 114,100
2840 0810R00107170003777 * 04/09/2017 114,100 114,100
2841 0810R00107170003778 * 04/09/2017 114,100 114,100
2842 0810R00107170003779 * 04/09/2017 155,100 155,100
2843 0810R00107170003780 * 04/09/2017 114,100 114,100
2844 0810R00107170003781 * 04/09/2017 114,100 114,100
2845 0810R00107170003782 * 04/09/2017 114,100 114,100
2846 0810R00107170003783 * 04/09/2017 114,100 114,100
2847 0810R00107170003784 * 04/09/2017 887,100 887,100
2848 0810R00107170003785 * 04/09/2017 114,100 114,100
2849 0810R00107170003786 * 04/09/2017 114,100 114,100
2850 0810R00107170003787 * 04/09/2017 155,100 155,100
2851 0810R00107170003788 * 04/09/2017 114,100 114,100
2852 0810R00107170003789 * 04/09/2017 114,100 114,100
2853 0810R00107170003790 * 04/09/2017 155,100 155,100
2854 0810R00107170003791 * 04/09/2017 114,100 114,100
2855 0810R00107170003792 * 04/09/2017 155,100 155,100
2856 0810R00107170003793 * 04/09/2017 114,100 114,100
2857 0810R00107170003794 * 04/09/2017 155,100 155,100
2858 0810R00107170003795 * 04/09/2017 155,100 155,100
2859 0810R00107170003796 * 04/09/2017 114,100 114,100
2860 0810R00107170003797 * 04/09/2017 114,100 114,100
2861 0810R00107170003798 * 25/08/2017 184,900 184,900
2862 0810R00107170003799 * 04/09/2017 887,100 887,100
2863 0810R00107170003800 * 04/09/2017 887,100 887,100
2864 0810R00107170003801 * 04/09/2017 887,100 887,100
2865 0810R00107170003802 * 04/09/2017 887,100 887,100
2866 0810R00107170003803 * 04/09/2017 887,100 887,100
2867 0810R00107170003804 * 04/09/2017 887,100 887,100
2868 0810R00107170003805 * 04/09/2017 887,100 887,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.71/145

2869 0810R00107170003806 * 04/09/2017 887,100 887,100


2870 0810R00107170003807 * 04/09/2017 887,100 887,100
2871 0810R00107170003808 * 04/09/2017 887,100 887,100
2872 0810R00107170003809 * 04/09/2017 887,100 887,100
2873 0810R00107170003811 * 04/09/2017 887,100 887,100
2874 0810R00107170003812 * 04/09/2017 887,100 887,100
2875 0810R00107170003813 * 04/09/2017 887,100 887,100
2876 0810R00107170003814 * 04/09/2017 887,100 887,100
2877 0810R00107170003815 * 04/09/2017 887,100 887,100
2878 0810R00107170003816 * 04/09/2017 887,100 887,100
2879 0810R00107170003817 * 04/09/2017 887,100 887,100
2880 0810R00107170003818 * 04/09/2017 887,100 887,100
2881 0810R00107170003819 * 04/09/2017 887,100 887,100
2882 0810R00107170003820 * 04/09/2017 887,100 887,100
2883 0810R00107170003821 * 04/09/2017 887,100 887,100
2884 0810R00107170003822 * 04/09/2017 887,100 887,100
2885 0810R00107170003824 * 04/09/2017 887,100 887,100
2886 0810R00107170003827 * 04/09/2017 148,000 148,000
2887 0810R00107170003838 * 04/09/2017 184,900 184,900
2888 0810R00107170003839 * 25/08/2017 314,500 314,500
2889 0810R00107170003843 * 04/09/2017 186,300 186,300
2890 0810R00107170003844 * 04/09/2017 184,900 184,900
2891 0810R00107170003848 * 04/09/2017 186,300 186,300
2892 0810R00107170003849 * 04/09/2017 186,300 186,300
2893 0810R00107170003850 * 04/09/2017 186,300 186,300
2894 0810R00107170003853 * 04/09/2017 186,300 186,300
2895 0810R00107170003863 * 04/09/2017 186,300 186,300
2896 0810R00107170003869 * 04/09/2017 186,300 186,300
2897 0810R00107170003870 * 25/08/2017 208,700 208,700
2898 0810R00107170003871 * 25/08/2017 314,500 314,500
2899 0810R00107170003872 * 04/09/2017 138,700 138,700
2900 0810R00107170003873 * 04/09/2017 186,300 186,300
2901 0810R00107170003875 * 04/09/2017 184,900 184,900
2902 0810R00107170003877 * 04/09/2017 184,900 184,900
2903 0810R00107170003880 * 04/09/2017 186,300 186,300
2904 0810R00107170003882 * 04/09/2017 184,900 184,900
2905 0810R00107170003891 * 04/09/2017 114,100 114,100
2906 0810R00107170003892 * 04/09/2017 114,100 114,100
2907 0810R00107170003893 * 04/09/2017 114,100 114,100
2908 0810R00107170003894 * 28/08/2017 215,300 215,300
2909 0810R00107170003895 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.72/145

2910 0810R00107170003896 * 04/09/2017 155,100 155,100


2911 0810R00107170003897 * 04/09/2017 114,100 114,100
2912 0810R00107170003898 * 28/08/2017 289,400 289,400
2913 0810R00107170003899 * 04/09/2017 184,900 184,900
2914 0810R00107170003900 * 28/08/2017 184,900 184,900
2915 0810R00107170003901 * 04/09/2017 114,100 114,100
2916 0810R00107170003902 * 04/09/2017 184,900 184,900
2917 0810R00107170003903 * 04/09/2017 114,100 114,100
2918 0810R00107170003904 * 04/09/2017 114,100 114,100
2919 0810R00107170003905 * 28/08/2017 215,300 215,300
2920 0810R00107170003906 * 04/09/2017 114,100 114,100
2921 0810R00107170003907 * 28/08/2017 184,900 184,900
2922 0810R00107170003908 * 04/09/2017 114,100 114,100
2923 0810R00107170003909 * 28/08/2017 184,900 184,900
2924 0810R00107170003910 * 04/09/2017 114,100 114,100
2925 0810R00107170003911 * 04/09/2017 184,900 184,900
2926 0810R00107170003912 * 28/08/2017 184,900 184,900
2927 0810R00107170003913 * 04/09/2017 114,100 114,100
2928 0810R00107170003914 * 04/09/2017 114,100 114,100
2929 0810R00107170003915 * 04/09/2017 184,900 184,900
2930 0810R00107170003916 * 28/08/2017 184,900 184,900
2931 0810R00107170003917 * 04/09/2017 184,900 184,900
2932 0810R00107170003919 * 28/08/2017 184,900 184,900
2933 0810R00107170003921 * 28/08/2017 184,900 184,900
2934 0810R00107170003922 * 04/09/2017 114,100 114,100
2935 0810R00107170003923 * 04/09/2017 184,900 184,900
2936 0810R00107170003924 * 04/09/2017 114,100 114,100
2937 0810R00107170003925 * 25/08/2017 215,300 215,300
2938 0810R00107170003926 * 04/09/2017 114,100 114,100
2939 0810R00107170003927 * 28/08/2017 184,900 184,900
2940 0810R00107170003928 * 04/09/2017 184,900 184,900
2941 0810R00107170003929 * 04/09/2017 114,100 114,100
2942 0810R00107170003930 * 28/08/2017 184,900 184,900
2943 0810R00107170003931 * 04/09/2017 114,100 114,100
2944 0810R00107170003932 * 04/09/2017 200,700 200,700
2945 0810R00107170003933 * 04/09/2017 114,100 114,100
2946 0810R00107170003934 * 04/09/2017 184,900 184,900
2947 0810R00107170003935 * 28/08/2017 184,900 184,900
2948 0810R00107170003936 * 04/09/2017 114,100 114,100
2949 0810R00107170003937 * 28/08/2017 184,900 184,900
2950 0810R00107170003938 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.73/145

2951 0810R00107170003939 * 04/09/2017 114,100 114,100


2952 0810R00107170003940 * 04/09/2017 114,100 114,100
2953 0810R00107170003941 * 04/09/2017 114,100 114,100
2954 0810R00107170003942 * 04/09/2017 114,100 114,100
2955 0810R00107170003943 * 04/09/2017 114,100 114,100
2956 0810R00107170003944 * 04/09/2017 114,100 114,100
2957 0810R00107170003945 * 04/09/2017 155,100 155,100
2958 0810R00107170003946 * 04/09/2017 114,100 114,100
2959 0810R00107170003947 * 04/09/2017 114,100 114,100
2960 0810R00107170003948 * 04/09/2017 114,100 114,100
2961 0810R00107170003949 * 04/09/2017 114,100 114,100
2962 0810R00107170003950 * 04/09/2017 114,100 114,100
2963 0810R00107170003951 * 04/09/2017 114,100 114,100
2964 0810R00107170003952 * 28/08/2017 184,900 184,900
2965 0810R00107170003953 * 04/09/2017 114,100 114,100
2966 0810R00107170003955 * 04/09/2017 114,100 114,100
2967 0810R00107170003956 * 04/09/2017 184,900 184,900
2968 0810R00107170003957 * 04/09/2017 184,900 184,900
2969 0810R00107170003958 * 04/09/2017 114,100 114,100
2970 0810R00107170003959 * 04/09/2017 114,100 114,100
2971 0810R00107170003960 * 04/09/2017 114,100 114,100
2972 0810R00107170003961 * 04/09/2017 114,100 114,100
2973 0810R00107170003962 * 04/09/2017 114,100 114,100
2974 0810R00107170003963 * 04/09/2017 114,100 114,100
2975 0810R00107170003964 * 04/09/2017 114,100 114,100
2976 0810R00107170003965 * 28/08/2017 184,900 184,900
2977 0810R00107170003966 * 04/09/2017 184,900 184,900
2978 0810R00107170003967 * 04/09/2017 184,900 184,900
2979 0810R00107170003968 * 04/09/2017 184,900 184,900
2980 0810R00107170003969 * 04/09/2017 184,900 184,900
2981 0810R00107170003970 * 04/09/2017 184,900 184,900
2982 0810R00107170003971 * 04/09/2017 184,900 184,900
2983 0810R00107170003972 * 04/09/2017 184,900 184,900
2984 0810R00107170003973 * 04/09/2017 114,100 114,100
2985 0810R00107170003974 * 04/09/2017 184,900 184,900
2986 0810R00107170003975 * 04/09/2017 184,900 184,900
2987 0810R00107170003976 * 04/09/2017 114,100 114,100
2988 0810R00107170003977 * 04/09/2017 114,100 114,100
2989 0810R00107170003978 * 04/09/2017 184,900 184,900
2990 0810R00107170003979 * 04/09/2017 184,900 184,900
2991 0810R00107170003980 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.74/145

2992 0810R00107170003981 * 04/09/2017 184,900 184,900


2993 0810R00107170003982 * 04/09/2017 114,100 114,100
2994 0810R00107170003983 * 28/08/2017 184,900 184,900
2995 0810R00107170003984 * 04/09/2017 184,900 184,900
2996 0810R00107170003985 * 28/08/2017 184,900 184,900
2997 0810R00107170003987 * 04/09/2017 184,900 184,900
2998 0810R00107170003988 * 04/09/2017 114,100 114,100
2999 0810R00107170003989 * 04/09/2017 114,100 114,100
3000 0810R00107170003990 * 04/09/2017 114,100 114,100
3001 0810R00107170003991 * 04/09/2017 114,100 114,100
3002 0810R00107170003992 * 04/09/2017 114,100 114,100
3003 0810R00107170003994 * 04/09/2017 114,100 114,100
3004 0810R00107170003995 * 04/09/2017 114,100 114,100
3005 0810R00107170003996 * 04/09/2017 186,300 186,300
3006 0810R00107170003997 * 04/09/2017 114,100 114,100
3007 0810R00107170003998 * 04/09/2017 114,100 114,100
3008 0810R00107170003999 * 04/09/2017 114,100 114,100
3009 0810R00107170004000 * 04/09/2017 184,900 184,900
3010 0810R00107170004001 * 04/09/2017 184,900 184,900
3011 0810R00107170004002 * 04/09/2017 184,900 184,900
3012 0810R00107170004003 * 04/09/2017 114,100 114,100
3013 0810R00107170004004 * 30/08/2017 184,900 184,900
3014 0810R00107170004005 * 28/08/2017 215,300 215,300
3015 0810R00107170004006 * 04/09/2017 184,900 184,900
3016 0810R00107170004007 * 04/09/2017 114,100 114,100
3017 0810R00107170004009 * 04/09/2017 184,900 184,900
3018 0810R00107170004010 * 04/09/2017 184,900 184,900
3019 0810R00107170004011 * 04/09/2017 114,100 114,100
3020 0810R00107170004012 * 04/09/2017 184,900 184,900
3021 0810R00107170004013 * 04/09/2017 114,100 114,100
3022 0810R00107170004014 * 04/09/2017 114,100 114,100
3023 0810R00107170004015 * 04/09/2017 184,900 184,900
3024 0810R00107170004016 * 04/09/2017 114,100 114,100
3025 0810R00107170004017 * 04/09/2017 184,900 184,900
3026 0810R00107170004018 * 04/09/2017 184,900 184,900
3027 0810R00107170004019 * 04/09/2017 114,100 114,100
3028 0810R00107170004020 * 04/09/2017 184,900 184,900
3029 0810R00107170004021 * 04/09/2017 114,100 114,100
3030 0810R00107170004022 * 04/09/2017 114,100 114,100
3031 0810R00107170004023 * 28/08/2017 443,700 443,700
3032 0810R00107170004024 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.75/145

3033 0810R00107170004025 * 04/09/2017 184,900 184,900


3034 0810R00107170004026 * 04/09/2017 114,100 114,100
3035 0810R00107170004027 * 28/08/2017 184,900 184,900
3036 0810R00107170004028 * 04/09/2017 114,100 114,100
3037 0810R00107170004030 * 04/09/2017 114,100 114,100
3038 0810R00107170004032 * 04/09/2017 114,100 114,100
3039 0810R00107170004033 * 04/09/2017 114,100 114,100
3040 0810R00107170004034 * 04/09/2017 184,900 184,900
3041 0810R00107170004035 * 04/09/2017 184,900 184,900
3042 0810R00107170004036 * 04/09/2017 114,100 114,100
3043 0810R00107170004037 * 04/09/2017 184,900 184,900
3044 0810R00107170004038 * 04/09/2017 114,100 114,100
3045 0810R00107170004039 * 04/09/2017 184,900 184,900
3046 0810R00107170004040 * 04/09/2017 114,100 114,100
3047 0810R00107170004041 * 04/09/2017 114,100 114,100
3048 0810R00107170004042 * 04/09/2017 114,100 114,100
3049 0810R00107170004043 * 04/09/2017 114,100 114,100
3050 0810R00107170004045 * 04/09/2017 114,100 114,100
3051 0810R00107170004048 * 04/09/2017 114,100 114,100
3052 0810R00107170004049 * 04/09/2017 114,100 114,100
3053 0810R00107170004050 * 04/09/2017 155,100 155,100
3054 0810R00107170004052 * 04/09/2017 114,100 114,100
3055 0810R00107170004053 * 04/09/2017 155,100 155,100
3056 0810R00107170004054 * 04/09/2017 114,100 114,100
3057 0810R00107170004055 * 30/08/2017 188,000 188,000
3058 0810R00107170004056 * 04/09/2017 184,900 184,900
3059 0810R00107170004058 * 04/09/2017 184,900 184,900
3060 0810R00107170004059 * 04/09/2017 114,100 114,100
3061 0810R00107170004060 * 04/09/2017 155,100 155,100
3062 0810R00107170004061 * 04/09/2017 114,100 114,100
3063 0810R00107170004062 * 04/09/2017 114,100 114,100
3064 0810R00107170004063 * 04/09/2017 114,100 114,100
3065 0810R00107170004064 * 04/09/2017 114,100 114,100
3066 0810R00107170004065 * 04/09/2017 114,100 114,100
3067 0810R00107170004067 * 28/08/2017 184,900 184,900
3068 0810R00107170004069 * 28/08/2017 215,300 215,300
3069 0810R00107170004070 * 28/08/2017 184,900 184,900
3070 0810R00107170004071 * 04/09/2017 184,900 184,900
3071 0810R00107170004073 * 04/09/2017 184,900 184,900
3072 0810R00107170004074 * 04/09/2017 184,900 184,900
3073 0810R00107170004075 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.76/145

3074 0810R00107170004076 * 28/08/2017 215,300 215,300


3075 0810R00107170004077 * 04/09/2017 184,900 184,900
3076 0810R00107170004079 * 04/09/2017 184,900 184,900
3077 0810R00107170004080 * 04/09/2017 184,900 184,900
3078 0810R00107170004082 * 28/08/2017 242,700 242,700
3079 0810R00107170004086 * 28/08/2017 184,900 184,900
3080 0810R00107170004087 * 04/09/2017 184,900 184,900
3081 0810R00107170004090 * 04/09/2017 184,900 184,900
3082 0810R00107170004091 * 04/09/2017 184,900 184,900
3083 0810R00107170004092 * 04/09/2017 186,300 186,300
3084 0810R00107170004093 * 04/09/2017 184,900 184,900
3085 0810R00107170004095 * 04/09/2017 184,900 184,900
3086 0810R00107170004097 * 28/08/2017 569,300 569,300
3087 0810R00107170004101 * 04/09/2017 184,900 184,900
3088 0810R00107170004102 * 04/09/2017 887,100 887,100
3089 0810R00107170004104 * 04/09/2017 887,100 887,100
3090 0810R00107170004105 * 04/09/2017 887,100 887,100
3091 0810R00107170004106 * 04/09/2017 887,100 887,100
3092 0810R00107170004107 * 04/09/2017 887,100 887,100
3093 0810R00107170004108 * 04/09/2017 887,100 887,100
3094 0810R00107170004109 * 04/09/2017 887,100 887,100
3095 0810R00107170004110 * 04/09/2017 887,100 887,100
3096 0810R00107170004111 * 04/09/2017 887,100 887,100
3097 0810R00107170004112 * 04/09/2017 887,100 887,100
3098 0810R00107170004113 * 04/09/2017 887,100 887,100
3099 0810R00107170004114 * 04/09/2017 887,100 887,100
3100 0810R00107170004115 * 04/09/2017 887,100 887,100
3101 0810R00107170004116 * 04/09/2017 887,100 887,100
3102 0810R00107170004117 * 04/09/2017 887,100 887,100
3103 0810R00107170004118 * 04/09/2017 887,100 887,100
3104 0810R00107170004119 * 04/09/2017 887,100 887,100
3105 0810R00107170004120 * 04/09/2017 887,100 887,100
3106 0810R00107170004121 * 04/09/2017 887,100 887,100
3107 0810R00107170004122 * 04/09/2017 887,100 887,100
3108 0810R00107170004123 * 04/09/2017 887,100 887,100
3109 0810R00107170004124 * 04/09/2017 887,100 887,100
3110 0810R00107170004125 * 04/09/2017 887,100 887,100
3111 0810R00107170004126 * 04/09/2017 887,100 887,100
3112 0810R00107170004127 * 04/09/2017 887,100 887,100
3113 0810R00107170004128 * 04/09/2017 887,100 887,100
3114 0810R00107170004129 * 28/08/2017 314,500 314,500
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.77/145

3115 0810R00107170004133 * 04/09/2017 184,900 184,900


3116 0810R00107170004141 * 04/09/2017 186,300 186,300
3117 0810R00107170004147 * 30/08/2017 960,400 960,400
3118 0810R00107170004150 * 28/08/2017 314,500 314,500
3119 0810R00107170004151 * 04/09/2017 148,000 148,000
3120 0810R00107170004156 * 04/09/2017 186,300 186,300
3121 0810R00107170004160 * 04/09/2017 184,900 184,900
3122 0810R00107170004175 * 04/09/2017 184,900 184,900
3123 0810R00107170004177 * 04/09/2017 184,900 184,900
3124 0810R00107170004178 * 28/08/2017 267,200 267,200
3125 0810R00107170004179 * 04/09/2017 184,900 184,900
3126 0810R00107170004181 * 04/09/2017 184,900 184,900
3127 0810R00107170004182 * 04/09/2017 184,900 184,900
3128 0810R00107170004183 * 04/09/2017 184,900 184,900
3129 0810R00107170004184 * 04/09/2017 184,900 184,900
3130 0810R00107170004185 * 04/09/2017 184,900 184,900
3131 0810R00107170004186 * 04/09/2017 184,900 184,900
3132 0810R00107170004187 * 04/09/2017 184,900 184,900
3133 0810R00107170004188 * 04/09/2017 184,900 184,900
3134 0810R00107170004189 * 28/08/2017 184,900 184,900
3135 0810R00107170004191 * 28/08/2017 210,700 210,700
3136 0810R00107170004192 * 04/09/2017 184,900 184,900
3137 0810R00107170004193 * 04/09/2017 184,900 184,900
3138 0810R00107170004194 * 04/09/2017 184,900 184,900
3139 0810R00107170004195 * 04/09/2017 184,900 184,900
3140 0810R00107170004196 * 04/09/2017 184,900 184,900
3141 0810R00107170004198 * 28/08/2017 184,900 184,900
3142 0810R00107170004199 * 04/09/2017 184,900 184,900
3143 0810R00107170004200 * 28/08/2017 184,900 184,900
3144 0810R00107170004201 * 04/09/2017 184,900 184,900
3145 0810R00107170004202 * 28/08/2017 200,700 200,700
3146 0810R00107170004203 * 04/09/2017 184,900 184,900
3147 0810R00107170004204 * 04/09/2017 184,900 184,900
3148 0810R00107170004205 * 28/08/2017 184,900 184,900
3149 0810R00107170004206 * 04/09/2017 184,900 184,900
3150 0810R00107170004207 * 04/09/2017 184,900 184,900
3151 0810R00107170004208 * 04/09/2017 184,900 184,900
3152 0810R00107170004209 * 04/09/2017 184,900 184,900
3153 0810R00107170004210 * 04/09/2017 184,900 184,900
3154 0810R00107170004211 * 04/09/2017 184,900 184,900
3155 0810R00107170004213 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.78/145

3156 0810R00107170004215 * 04/09/2017 114,100 114,100


3157 0810R00107170004216 * 04/09/2017 114,100 114,100
3158 0810R00107170004217 * 04/09/2017 184,900 184,900
3159 0810R00107170004218 * 28/08/2017 184,900 184,900
3160 0810R00107170004220 * 04/09/2017 114,100 114,100
3161 0810R00107170004221 * 04/09/2017 184,900 184,900
3162 0810R00107170004223 * 04/09/2017 114,100 114,100
3163 0810R00107170004224 * 04/09/2017 114,100 114,100
3164 0810R00107170004225 * 04/09/2017 184,900 184,900
3165 0810R00107170004226 * 04/09/2017 155,100 155,100
3166 0810R00107170004227 * 04/09/2017 184,900 184,900
3167 0810R00107170004228 * 04/09/2017 114,100 114,100
3168 0810R00107170004229 * 04/09/2017 184,900 184,900
3169 0810R00107170004230 * 04/09/2017 114,100 114,100
3170 0810R00107170004231 * 04/09/2017 114,100 114,100
3171 0810R00107170004232 * 04/09/2017 114,100 114,100
3172 0810R00107170004233 * 04/09/2017 114,100 114,100
3173 0810R00107170004234 * 04/09/2017 184,900 184,900
3174 0810R00107170004235 * 04/09/2017 114,100 114,100
3175 0810R00107170004236 * 04/09/2017 184,900 184,900
3176 0810R00107170004237 * 28/08/2017 184,900 184,900
3177 0810R00107170004239 * 28/08/2017 267,200 267,200
3178 0810R00107170004240 * 28/08/2017 184,900 184,900
3179 0810R00107170004241 * 04/09/2017 184,900 184,900
3180 0810R00107170004242 * 04/09/2017 114,100 114,100
3181 0810R00107170004243 * 28/08/2017 215,300 215,300
3182 0810R00107170004244 * 28/08/2017 184,900 184,900
3183 0810R00107170004245 * 30/08/2017 184,900 184,900
3184 0810R00107170004246 * 28/08/2017 200,700 200,700
3185 0810R00107170004247 * 04/09/2017 114,100 114,100
3186 0810R00107170004248 * 04/09/2017 114,100 114,100
3187 0810R00107170004249 * 04/09/2017 114,100 114,100
3188 0810R00107170004250 * 04/09/2017 184,900 184,900
3189 0810R00107170004251 * 04/09/2017 114,100 114,100
3190 0810R00107170004252 * 04/09/2017 114,100 114,100
3191 0810R00107170004253 * 04/09/2017 184,900 184,900
3192 0810R00107170004254 * 04/09/2017 184,900 184,900
3193 0810R00107170004256 * 04/09/2017 184,900 184,900
3194 0810R00107170004258 * 04/09/2017 114,100 114,100
3195 0810R00107170004260 * 04/09/2017 184,900 184,900
3196 0810R00107170004261 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.79/145

3197 0810R00107170004262 * 04/09/2017 184,900 184,900


3198 0810R00107170004263 * 04/09/2017 184,900 184,900
3199 0810R00107170004264 * 04/09/2017 114,100 114,100
3200 0810R00107170004265 * 04/09/2017 114,100 114,100
3201 0810R00107170004266 * 30/08/2017 184,900 184,900
3202 0810R00107170004267 * 28/08/2017 184,900 184,900
3203 0810R00107170004268 * 04/09/2017 114,100 114,100
3204 0810R00107170004269 * 28/08/2017 184,900 184,900
3205 0810R00107170004271 * 04/09/2017 114,100 114,100
3206 0810R00107170004272 * 04/09/2017 184,900 184,900
3207 0810R00107170004273 * 04/09/2017 114,100 114,100
3208 0810R00107170004274 * 04/09/2017 114,100 114,100
3209 0810R00107170004275 * 04/09/2017 184,900 184,900
3210 0810R00107170004276 * 04/09/2017 114,100 114,100
3211 0810R00107170004277 * 04/09/2017 184,900 184,900
3212 0810R00107170004278 * 04/09/2017 114,100 114,100
3213 0810R00107170004279 * 04/09/2017 114,100 114,100
3214 0810R00107170004280 * 04/09/2017 184,900 184,900
3215 0810R00107170004281 * 04/09/2017 184,900 184,900
3216 0810R00107170004282 * 04/09/2017 184,900 184,900
3217 0810R00107170004283 * 04/09/2017 184,900 184,900
3218 0810R00107170004284 * 04/09/2017 114,100 114,100
3219 0810R00107170004285 * 04/09/2017 114,100 114,100
3220 0810R00107170004286 * 04/09/2017 114,100 114,100
3221 0810R00107170004287 * 04/09/2017 114,100 114,100
3222 0810R00107170004288 * 04/09/2017 114,100 114,100
3223 0810R00107170004289 * 04/09/2017 184,900 184,900
3224 0810R00107170004290 * 04/09/2017 114,100 114,100
3225 0810R00107170004291 * 04/09/2017 184,900 184,900
3226 0810R00107170004292 * 04/09/2017 184,900 184,900
3227 0810R00107170004293 * 04/09/2017 114,100 114,100
3228 0810R00107170004294 * 04/09/2017 114,100 114,100
3229 0810R00107170004295 * 04/09/2017 184,900 184,900
3230 0810R00107170004296 * 04/09/2017 155,100 155,100
3231 0810R00107170004297 * 04/09/2017 184,900 184,900
3232 0810R00107170004298 * 28/08/2017 184,900 184,900
3233 0810R00107170004299 * 04/09/2017 184,900 184,900
3234 0810R00107170004300 * 30/08/2017 184,900 184,900
3235 0810R00107170004302 * 04/09/2017 184,900 184,900
3236 0810R00107170004303 * 04/09/2017 114,100 114,100
3237 0810R00107170004304 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.80/145

3238 0810R00107170004305 * 04/09/2017 184,900 184,900


3239 0810R00107170004306 * 28/08/2017 215,300 215,300
3240 0810R00107170004307 * 28/08/2017 184,900 184,900
3241 0810R00107170004308 * 28/08/2017 184,900 184,900
3242 0810R00107170004309 * 04/09/2017 184,900 184,900
3243 0810R00107170004310 * 04/09/2017 184,900 184,900
3244 0810R00107170004312 * 28/08/2017 184,900 184,900
3245 0810R00107170004314 * 04/09/2017 184,900 184,900
3246 0810R00107170004315 * 28/08/2017 184,900 184,900
3247 0810R00107170004316 * 04/09/2017 184,900 184,900
3248 0810R00107170004317 * 30/08/2017 184,900 184,900
3249 0810R00107170004318 * 28/08/2017 267,200 267,200
3250 0810R00107170004319 * 28/08/2017 186,300 186,300
3251 0810R00107170004320 * 04/09/2017 184,900 184,900
3252 0810R00107170004321 * 04/09/2017 184,900 184,900
3253 0810R00107170004323 * 04/09/2017 184,900 184,900
3254 0810R00107170004325 * 04/09/2017 184,900 184,900
3255 0810R00107170004326 * 04/09/2017 184,900 184,900
3256 0810R00107170004327 * 04/09/2017 184,900 184,900
3257 0810R00107170004328 * 04/09/2017 114,100 114,100
3258 0810R00107170004329 * 28/08/2017 184,900 184,900
3259 0810R00107170004330 * 04/09/2017 114,100 114,100
3260 0810R00107170004331 * 04/09/2017 184,900 184,900
3261 0810R00107170004332 * 04/09/2017 184,900 184,900
3262 0810R00107170004333 * 04/09/2017 114,100 114,100
3263 0810R00107170004334 * 28/08/2017 184,900 184,900
3264 0810R00107170004335 * 04/09/2017 114,100 114,100
3265 0810R00107170004336 * 04/09/2017 184,900 184,900
3266 0810R00107170004337 * 04/09/2017 184,900 184,900
3267 0810R00107170004338 * 04/09/2017 184,900 184,900
3268 0810R00107170004340 * 04/09/2017 114,100 114,100
3269 0810R00107170004341 * 04/09/2017 184,900 184,900
3270 0810R00107170004342 * 04/09/2017 114,100 114,100
3271 0810R00107170004343 * 28/08/2017 184,900 184,900
3272 0810R00107170004344 * 04/09/2017 184,900 184,900
3273 0810R00107170004345 * 04/09/2017 155,100 155,100
3274 0810R00107170004346 * 04/09/2017 184,900 184,900
3275 0810R00107170004348 * 04/09/2017 114,100 114,100
3276 0810R00107170004349 * 04/09/2017 184,900 184,900
3277 0810R00107170004350 * 04/09/2017 140,500 140,500
3278 0810R00107170004351 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.81/145

3279 0810R00107170004352 * 04/09/2017 184,900 184,900


3280 0810R00107170004353 * 04/09/2017 114,100 114,100
3281 0810R00107170004354 * 28/08/2017 184,900 184,900
3282 0810R00107170004355 * 04/09/2017 114,100 114,100
3283 0810R00107170004357 * 04/09/2017 184,900 184,900
3284 0810R00107170004358 * 04/09/2017 114,100 114,100
3285 0810R00107170004359 * 04/09/2017 114,100 114,100
3286 0810R00107170004361 * 04/09/2017 184,900 184,900
3287 0810R00107170004362 * 28/08/2017 184,900 184,900
3288 0810R00107170004363 * 04/09/2017 114,100 114,100
3289 0810R00107170004364 * 04/09/2017 184,900 184,900
3290 0810R00107170004366 * 04/09/2017 114,100 114,100
3291 0810R00107170004367 * 04/09/2017 155,100 155,100
3292 0810R00107170004368 * 04/09/2017 114,100 114,100
3293 0810R00107170004369 * 28/08/2017 184,900 184,900
3294 0810R00107170004370 * 04/09/2017 114,100 114,100
3295 0810R00107170004372 * 04/09/2017 114,100 114,100
3296 0810R00107170004373 * 04/09/2017 114,100 114,100
3297 0810R00107170004374 * 04/09/2017 114,100 114,100
3298 0810R00107170004375 * 04/09/2017 155,100 155,100
3299 0810R00107170004376 * 04/09/2017 186,300 186,300
3300 0810R00107170004377 * 04/09/2017 184,900 184,900
3301 0810R00107170004378 * 28/08/2017 184,900 184,900
3302 0810R00107170004379 * 04/09/2017 184,900 184,900
3303 0810R00107170004380 * 04/09/2017 114,100 114,100
3304 0810R00107170004381 * 04/09/2017 184,900 184,900
3305 0810R00107170004382 * 04/09/2017 184,900 184,900
3306 0810R00107170004383 * 04/09/2017 114,100 114,100
3307 0810R00107170004384 * 04/09/2017 184,900 184,900
3308 0810R00107170004385 * 28/08/2017 215,300 215,300
3309 0810R00107170004386 * 04/09/2017 114,100 114,100
3310 0810R00107170004387 * 04/09/2017 114,100 114,100
3311 0810R00107170004388 * 04/09/2017 184,900 184,900
3312 0810R00107170004389 * 28/08/2017 184,900 184,900
3313 0810R00107170004390 * 04/09/2017 114,100 114,100
3314 0810R00107170004391 * 28/08/2017 267,200 267,200
3315 0810R00107170004392 * 04/09/2017 184,900 184,900
3316 0810R00107170004393 * 04/09/2017 184,900 184,900
3317 0810R00107170004394 * 04/09/2017 114,100 114,100
3318 0810R00107170004395 * 04/09/2017 184,900 184,900
3319 0810R00107170004396 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.82/145

3320 0810R00107170004398 * 04/09/2017 184,900 184,900


3321 0810R00107170004399 * 04/09/2017 114,100 114,100
3322 0810R00107170004401 * 04/09/2017 184,900 184,900
3323 0810R00107170004402 * 04/09/2017 184,900 184,900
3324 0810R00107170004403 * 04/09/2017 114,100 114,100
3325 0810R00107170004404 * 04/09/2017 114,100 114,100
3326 0810R00107170004405 * 04/09/2017 114,100 114,100
3327 0810R00107170004406 * 04/09/2017 184,900 184,900
3328 0810R00107170004407 * 04/09/2017 114,100 114,100
3329 0810R00107170004408 * 04/09/2017 184,900 184,900
3330 0810R00107170004409 * 04/09/2017 114,100 114,100
3331 0810R00107170004410 * 04/09/2017 114,100 114,100
3332 0810R00107170004411 * 04/09/2017 184,900 184,900
3333 0810R00107170004412 * 28/08/2017 184,900 184,900
3334 0810R00107170004414 * 04/09/2017 114,100 114,100
3335 0810R00107170004415 * 16/08/2017 184,900 184,900
3336 0810R00107170004416 * 04/09/2017 184,900 184,900
3337 0810R00107170004417 * 04/09/2017 114,100 114,100
3338 0810R00107170004418 * 04/09/2017 184,900 184,900
3339 0810R00107170004419 * 28/08/2017 184,900 184,900
3340 0810R00107170004420 * 28/08/2017 184,900 184,900
3341 0810R00107170004421 * 04/09/2017 184,900 184,900
3342 0810R00107170004422 * 04/09/2017 114,100 114,100
3343 0810R00107170004423 * 28/08/2017 569,300 569,300
3344 0810R00107170004424 * 04/09/2017 114,100 114,100
3345 0810R00107170004425 * 04/09/2017 184,900 184,900
3346 0810R00107170004426 * 04/09/2017 114,100 114,100
3347 0810R00107170004427 * 04/09/2017 114,100 114,100
3348 0810R00107170004428 * 04/09/2017 184,900 184,900
3349 0810R00107170004429 * 28/08/2017 184,900 184,900
3350 0810R00107170004430 * 04/09/2017 114,100 114,100
3351 0810R00107170004432 * 28/08/2017 184,900 184,900
3352 0810R00107170004433 * 04/09/2017 184,900 184,900
3353 0810R00107170004434 * 04/09/2017 184,900 184,900
3354 0810R00107170004435 * 04/09/2017 184,900 184,900
3355 0810R00107170004437 * 04/09/2017 184,900 184,900
3356 0810R00107170004438 * 04/09/2017 184,900 184,900
3357 0810R00107170004439 * 28/08/2017 184,900 184,900
3358 0810R00107170004442 * 04/09/2017 114,100 114,100
3359 0810R00107170004443 * 04/09/2017 114,100 114,100
3360 0810R00107170004444 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.83/145

3361 0810R00107170004445 * 04/09/2017 155,100 155,100


3362 0810R00107170004446 * 28/08/2017 259,800 259,800
3363 0810R00107170004448 * 04/09/2017 184,900 184,900
3364 0810R00107170004449 * 04/09/2017 114,100 114,100
3365 0810R00107170004450 * 04/09/2017 114,100 114,100
3366 0810R00107170004451 * 04/09/2017 114,100 114,100
3367 0810R00107170004452 * 04/09/2017 155,100 155,100
3368 0810R00107170004453 * 04/09/2017 155,100 155,100
3369 0810R00107170004454 * 04/09/2017 114,100 114,100
3370 0810R00107170004456 * 28/08/2017 569,300 569,300
3371 0810R00107170004458 * 04/09/2017 184,900 184,900
3372 0810R00107170004459 * 04/09/2017 184,900 184,900
3373 0810R00107170004463 * 04/09/2017 114,100 114,100
3374 0810R00107170004464 * 04/09/2017 155,100 155,100
3375 0810R00107170004465 * 28/08/2017 200,700 200,700
3376 0810R00107170004467 * 04/09/2017 184,900 184,900
3377 0810R00107170004470 * 04/09/2017 887,100 887,100
3378 0810R00107170004472 * 04/09/2017 155,100 155,100
3379 0810R00107170004473 * 04/09/2017 155,100 155,100
3380 0810R00107170004475 * 04/09/2017 155,100 155,100
3381 0810R00107170004477 * 04/09/2017 155,100 155,100
3382 0810R00107170004478 * 04/09/2017 887,100 887,100
3383 0810R00107170004479 * 04/09/2017 887,100 887,100
3384 0810R00107170004480 * 04/09/2017 887,100 887,100
3385 0810R00107170004481 * 04/09/2017 887,100 887,100
3386 0810R00107170004482 * 04/09/2017 887,100 887,100
3387 0810R00107170004484 * 04/09/2017 887,100 887,100
3388 0810R00107170004485 * 04/09/2017 887,100 887,100
3389 0810R00107170004486 * 04/09/2017 887,100 887,100
3390 0810R00107170004487 * 04/09/2017 887,100 887,100
3391 0810R00107170004488 * 04/09/2017 887,100 887,100
3392 0810R00107170004489 * 04/09/2017 887,100 887,100
3393 0810R00107170004490 * 04/09/2017 887,100 887,100
3394 0810R00107170004491 * 04/09/2017 887,100 887,100
3395 0810R00107170004492 * 04/09/2017 887,100 887,100
3396 0810R00107170004493 * 04/09/2017 887,100 887,100
3397 0810R00107170004494 * 04/09/2017 887,100 887,100
3398 0810R00107170004495 * 04/09/2017 887,100 887,100
3399 0810R00107170004497 * 04/09/2017 887,100 887,100
3400 0810R00107170004498 * 04/09/2017 887,100 887,100
3401 0810R00107170004499 * 04/09/2017 887,100 887,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.84/145

3402 0810R00107170004500 * 04/09/2017 887,100 887,100


3403 0810R00107170004501 * 04/09/2017 887,100 887,100
3404 0810R00107170004502 * 04/09/2017 887,100 887,100
3405 0810R00107170004503 * 04/09/2017 887,100 887,100
3406 0810R00107170004511 * 28/08/2017 569,300 569,300
3407 0810R00107170004512 * 28/08/2017 314,500 314,500
3408 0810R00107170004513 * 28/08/2017 314,500 314,500
3409 0810R00107170004516 * 28/08/2017 259,800 259,800
3410 0810R00107170004520 * 04/09/2017 184,900 184,900
3411 0810R00107170004526 * 04/09/2017 186,300 186,300
3412 0810R00107170004529 * 28/08/2017 188,000 188,000
3413 0810R00107170004532 * 04/09/2017 186,300 186,300
3414 0810R00107170004534 * 28/08/2017 342,700 342,700
3415 0810R00107170004539 * 04/09/2017 184,900 184,900
3416 0810R00107170004540 * 29/08/2017 569,300 569,300
3417 0810R00107170004541 * 04/09/2017 184,900 184,900
3418 0810R00107170004542 * 04/09/2017 184,900 184,900
3419 0810R00107170004543 * 04/09/2017 184,900 184,900
3420 0810R00107170004544 * 29/08/2017 184,900 184,900
3421 0810R00107170004545 * 04/09/2017 184,900 184,900
3422 0810R00107170004546 * 29/08/2017 184,900 184,900
3423 0810R00107170004547 * 04/09/2017 184,900 184,900
3424 0810R00107170004548 * 04/09/2017 184,900 184,900
3425 0810R00107170004549 * 04/09/2017 184,900 184,900
3426 0810R00107170004550 * 04/09/2017 184,900 184,900
3427 0810R00107170004552 * 29/08/2017 569,300 569,300
3428 0810R00107170004553 * 04/09/2017 184,900 184,900
3429 0810R00107170004554 * 04/09/2017 184,900 184,900
3430 0810R00107170004555 * 04/09/2017 184,900 184,900
3431 0810R00107170004556 * 04/09/2017 184,900 184,900
3432 0810R00107170004557 * 29/08/2017 569,300 569,300
3433 0810R00107170004558 * 04/09/2017 184,900 184,900
3434 0810R00107170004559 * 29/08/2017 289,400 289,400
3435 0810R00107170004561 * 04/09/2017 184,900 184,900
3436 0810R00107170004562 * 29/08/2017 184,900 184,900
3437 0810R00107170004563 * 04/09/2017 114,100 114,100
3438 0810R00107170004564 * 29/08/2017 569,300 569,300
3439 0810R00107170004565 * 29/08/2017 184,900 184,900
3440 0810R00107170004566 * 04/09/2017 114,100 114,100
3441 0810R00107170004567 * 29/08/2017 184,900 184,900
3442 0810R00107170004568 * 29/08/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.85/145

3443 0810R00107170004569 * 04/09/2017 184,900 184,900


3444 0810R00107170004570 * 04/09/2017 114,100 114,100
3445 0810R00107170004571 * 04/09/2017 114,100 114,100
3446 0810R00107170004572 * 04/09/2017 184,900 184,900
3447 0810R00107170004573 * 04/09/2017 114,100 114,100
3448 0810R00107170004575 * 29/08/2017 184,900 184,900
3449 0810R00107170004576 * 29/08/2017 215,300 215,300
3450 0810R00107170004577 * 04/09/2017 114,100 114,100
3451 0810R00107170004578 * 04/09/2017 184,900 184,900
3452 0810R00107170004579 * 29/08/2017 184,900 184,900
3453 0810R00107170004580 * 04/09/2017 184,900 184,900
3454 0810R00107170004581 * 30/08/2017 184,900 184,900
3455 0810R00107170004582 * 04/09/2017 184,900 184,900
3456 0810R00107170004583 * 04/09/2017 114,100 114,100
3457 0810R00107170004584 * 04/09/2017 114,100 114,100
3458 0810R00107170004585 * 04/09/2017 114,100 114,100
3459 0810R00107170004586 * 29/08/2017 184,900 184,900
3460 0810R00107170004587 * 04/09/2017 155,100 155,100
3461 0810R00107170004588 * 29/08/2017 184,900 184,900
3462 0810R00107170004589 * 29/08/2017 289,400 289,400
3463 0810R00107170004590 * 29/08/2017 184,900 184,900
3464 0810R00107170004591 * 04/09/2017 184,900 184,900
3465 0810R00107170004592 * 04/09/2017 114,100 114,100
3466 0810R00107170004593 * 29/08/2017 184,900 184,900
3467 0810R00107170004595 * 29/08/2017 569,300 569,300
3468 0810R00107170004596 * 29/08/2017 184,900 184,900
3469 0810R00107170004597 * 04/09/2017 184,900 184,900
3470 0810R00107170004598 * 04/09/2017 184,900 184,900
3471 0810R00107170004599 * 04/09/2017 184,900 184,900
3472 0810R00107170004601 * 29/08/2017 259,800 259,800
3473 0810R00107170004602 * 04/09/2017 184,900 184,900
3474 0810R00107170004603 * 29/08/2017 184,900 184,900
3475 0810R00107170004604 * 04/09/2017 184,900 184,900
3476 0810R00107170004605 * 29/08/2017 242,700 242,700
3477 0810R00107170004606 * 04/09/2017 114,100 114,100
3478 0810R00107170004608 * 04/09/2017 184,900 184,900
3479 0810R00107170004609 * 04/09/2017 114,100 114,100
3480 0810R00107170004610 * 04/09/2017 184,900 184,900
3481 0810R00107170004611 * 04/09/2017 184,900 184,900
3482 0810R00107170004612 * 04/09/2017 184,900 184,900
3483 0810R00107170004613 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.86/145

3484 0810R00107170004616 * 04/09/2017 114,100 114,100


3485 0810R00107170004617 * 04/09/2017 184,900 184,900
3486 0810R00107170004618 * 29/08/2017 184,900 184,900
3487 0810R00107170004619 * 04/09/2017 114,100 114,100
3488 0810R00107170004620 * 29/08/2017 200,700 200,700
3489 0810R00107170004622 * 04/09/2017 114,100 114,100
3490 0810R00107170004623 * 04/09/2017 184,900 184,900
3491 0810R00107170004624 * 04/09/2017 155,100 155,100
3492 0810R00107170004626 * 04/09/2017 114,100 114,100
3493 0810R00107170004627 * 29/08/2017 569,300 569,300
3494 0810R00107170004628 * 04/09/2017 114,100 114,100
3495 0810R00107170004630 * 04/09/2017 114,100 114,100
3496 0810R00107170004631 * 04/09/2017 141,300 141,300
3497 0810R00107170004632 * 04/09/2017 114,100 114,100
3498 0810R00107170004633 * 04/09/2017 114,100 114,100
3499 0810R00107170004634 * 04/09/2017 155,100 155,100
3500 0810R00107170004635 * 04/09/2017 184,900 184,900
3501 0810R00107170004636 * 04/09/2017 114,100 114,100
3502 0810R00107170004637 * 29/08/2017 289,400 289,400
3503 0810R00107170004639 * 04/09/2017 184,900 184,900
3504 0810R00107170004640 * 04/09/2017 114,100 114,100
3505 0810R00107170004641 * 29/08/2017 184,900 184,900
3506 0810R00107170004642 * 04/09/2017 114,100 114,100
3507 0810R00107170004643 * 29/08/2017 184,900 184,900
3508 0810R00107170004644 * 04/09/2017 114,100 114,100
3509 0810R00107170004645 * 29/08/2017 242,700 242,700
3510 0810R00107170004646 * 04/09/2017 155,100 155,100
3511 0810R00107170004647 * 04/09/2017 114,100 114,100
3512 0810R00107170004648 * 04/09/2017 184,900 184,900
3513 0810R00107170004652 * 04/09/2017 318,200 318,200
3514 0810R00107170004653 * 04/09/2017 184,900 184,900
3515 0810R00107170004655 * 04/09/2017 184,900 184,900
3516 0810R00107170004656 * 04/09/2017 184,900 184,900
3517 0810R00107170004657 * 04/09/2017 114,100 114,100
3518 0810R00107170004658 * 04/09/2017 184,900 184,900
3519 0810R00107170004659 * 04/09/2017 114,100 114,100
3520 0810R00107170004660 * 04/09/2017 114,100 114,100
3521 0810R00107170004661 * 04/09/2017 114,100 114,100
3522 0810R00107170004662 * 04/09/2017 114,100 114,100
3523 0810R00107170004663 * 04/09/2017 184,900 184,900
3524 0810R00107170004664 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.87/145

3525 0810R00107170004665 * 04/09/2017 184,900 184,900


3526 0810R00107170004666 * 04/09/2017 114,100 114,100
3527 0810R00107170004667 * 04/09/2017 114,100 114,100
3528 0810R00107170004668 * 04/09/2017 184,900 184,900
3529 0810R00107170004669 * 04/09/2017 155,100 155,100
3530 0810R00107170004670 * 04/09/2017 184,900 184,900
3531 0810R00107170004671 * 29/08/2017 184,900 184,900
3532 0810R00107170004672 * 04/09/2017 114,100 114,100
3533 0810R00107170004673 * 29/08/2017 242,700 242,700
3534 0810R00107170004675 * 04/09/2017 114,100 114,100
3535 0810R00107170004676 * 04/09/2017 114,100 114,100
3536 0810R00107170004677 * 29/08/2017 569,300 569,300
3537 0810R00107170004678 * 04/09/2017 114,100 114,100
3538 0810R00107170004679 * 04/09/2017 114,100 114,100
3539 0810R00107170004680 * 04/09/2017 114,100 114,100
3540 0810R00107170004681 * 29/08/2017 184,900 184,900
3541 0810R00107170004682 * 04/09/2017 114,100 114,100
3542 0810R00107170004683 * 04/09/2017 114,100 114,100
3543 0810R00107170004684 * 04/09/2017 184,900 184,900
3544 0810R00107170004686 * 04/09/2017 114,100 114,100
3545 0810R00107170004687 * 04/09/2017 184,900 184,900
3546 0810R00107170004688 * 04/09/2017 114,100 114,100
3547 0810R00107170004689 * 04/09/2017 184,900 184,900
3548 0810R00107170004690 * 04/09/2017 184,900 184,900
3549 0810R00107170004691 * 04/09/2017 114,100 114,100
3550 0810R00107170004692 * 04/09/2017 114,100 114,100
3551 0810R00107170004695 * 04/09/2017 114,100 114,100
3552 0810R00107170004696 * 04/09/2017 184,900 184,900
3553 0810R00107170004697 * 04/09/2017 184,900 184,900
3554 0810R00107170004698 * 04/09/2017 184,900 184,900
3555 0810R00107170004699 * 04/09/2017 114,100 114,100
3556 0810R00107170004701 * 04/09/2017 114,100 114,100
3557 0810R00107170004702 * 04/09/2017 114,100 114,100
3558 0810R00107170004703 * 04/09/2017 114,100 114,100
3559 0810R00107170004705 * 04/09/2017 114,100 114,100
3560 0810R00107170004707 * 04/09/2017 184,900 184,900
3561 0810R00107170004708 * 29/08/2017 184,900 184,900
3562 0810R00107170004709 * 04/09/2017 184,900 184,900
3563 0810R00107170004713 * 29/08/2017 314,500 314,500
3564 0810R00107170004715 * 29/08/2017 210,700 210,700
3565 0810R00107170004717 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.88/145

3566 0810R00107170004718 * 29/08/2017 569,300 569,300


3567 0810R00107170004719 * 04/09/2017 114,100 114,100
3568 0810R00107170004720 * 29/08/2017 184,900 184,900
3569 0810R00107170004721 * 04/09/2017 184,900 184,900
3570 0810R00107170004722 * 04/09/2017 114,100 114,100
3571 0810R00107170004723 * 04/09/2017 184,900 184,900
3572 0810R00107170004724 * 04/09/2017 184,900 184,900
3573 0810R00107170004725 * 04/09/2017 184,900 184,900
3574 0810R00107170004726 * 29/08/2017 289,400 289,400
3575 0810R00107170004727 * 04/09/2017 114,100 114,100
3576 0810R00107170004728 * 04/09/2017 114,100 114,100
3577 0810R00107170004729 * 04/09/2017 114,100 114,100
3578 0810R00107170004731 * 29/08/2017 184,900 184,900
3579 0810R00107170004732 * 04/09/2017 114,100 114,100
3580 0810R00107170004733 * 04/09/2017 184,900 184,900
3581 0810R00107170004734 * 04/09/2017 128,700 128,700
3582 0810R00107170004735 * 04/09/2017 184,900 184,900
3583 0810R00107170004736 * 04/09/2017 184,900 184,900
3584 0810R00107170004737 * 04/09/2017 887,100 887,100
3585 0810R00107170004738 * 04/09/2017 887,100 887,100
3586 0810R00107170004739 * 04/09/2017 887,100 887,100
3587 0810R00107170004740 * 04/09/2017 887,100 887,100
3588 0810R00107170004741 * 04/09/2017 887,100 887,100
3589 0810R00107170004742 * 04/09/2017 887,100 887,100
3590 0810R00107170004743 * 04/09/2017 887,100 887,100
3591 0810R00107170004745 * 04/09/2017 887,100 887,100
3592 0810R00107170004746 * 04/09/2017 887,100 887,100
3593 0810R00107170004747 * 04/09/2017 887,100 887,100
3594 0810R00107170004748 * 04/09/2017 887,100 887,100
3595 0810R00107170004749 * 04/09/2017 887,100 887,100
3596 0810R00107170004750 * 04/09/2017 887,100 887,100
3597 0810R00107170004751 * 04/09/2017 184,900 184,900
3598 0810R00107170004752 * 04/09/2017 887,100 887,100
3599 0810R00107170004753 * 04/09/2017 887,100 887,100
3600 0810R00107170004754 * 04/09/2017 887,100 887,100
3601 0810R00107170004755 * 04/09/2017 887,100 887,100
3602 0810R00107170004756 * 04/09/2017 887,100 887,100
3603 0810R00107170004757 * 04/09/2017 887,100 887,100
3604 0810R00107170004758 * 04/09/2017 887,100 887,100
3605 0810R00107170004759 * 04/09/2017 887,100 887,100
3606 0810R00107170004760 * 04/09/2017 887,100 887,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.89/145

3607 0810R00107170004761 * 04/09/2017 887,100 887,100


3608 0810R00107170004762 * 04/09/2017 887,100 887,100
3609 0810R00107170004764 * 04/09/2017 887,100 887,100
3610 0810R00107170004769 * 04/09/2017 114,100 114,100
3611 0810R00107170004770 * 04/09/2017 114,100 114,100
3612 0810R00107170004771 * 04/09/2017 114,100 114,100
3613 0810R00107170004773 * 04/09/2017 114,100 114,100
3614 0810R00107170004774 * 04/09/2017 114,100 114,100
3615 0810R00107170004775 * 04/09/2017 114,100 114,100
3616 0810R00107170004776 * 04/09/2017 114,100 114,100
3617 0810R00107170004778 * 04/09/2017 114,100 114,100
3618 0810R00107170004779 * 04/09/2017 155,100 155,100
3619 0810R00107170004780 * 04/09/2017 114,100 114,100
3620 0810R00107170004781 * 04/09/2017 114,100 114,100
3621 0810R00107170004783 * 04/09/2017 114,100 114,100
3622 0810R00107170004784 * 04/09/2017 114,100 114,100
3623 0810R00107170004786 * 04/09/2017 114,100 114,100
3624 0810R00107170004787 * 04/09/2017 114,100 114,100
3625 0810R00107170004789 * 04/09/2017 114,100 114,100
3626 0810R00107170004792 * 04/09/2017 114,100 114,100
3627 0810R00107170004793 * 04/09/2017 114,100 114,100
3628 0810R00107170004794 * 04/09/2017 114,100 114,100
3629 0810R00107170004795 * 04/09/2017 114,100 114,100
3630 0810R00107170004796 * 04/09/2017 114,100 114,100
3631 0810R00107170004797 * 04/09/2017 114,100 114,100
3632 0810R00107170004798 * 04/09/2017 114,100 114,100
3633 0810R00107170004799 * 04/09/2017 114,100 114,100
3634 0810R00107170004800 * 04/09/2017 114,100 114,100
3635 0810R00107170004802 * 04/09/2017 114,100 114,100
3636 0810R00107170004804 * 04/09/2017 114,100 114,100
3637 0810R00107170004805 * 04/09/2017 114,100 114,100
3638 0810R00107170004806 * 04/09/2017 114,100 114,100
3639 0810R00107170004807 * 04/09/2017 114,100 114,100
3640 0810R00107170004808 * 04/09/2017 114,100 114,100
3641 0810R00107170004809 * 04/09/2017 114,100 114,100
3642 0810R00107170004810 * 04/09/2017 114,100 114,100
3643 0810R00107170004811 * 04/09/2017 114,100 114,100
3644 0810R00107170004812 * 04/09/2017 114,100 114,100
3645 0810R00107170004813 * 04/09/2017 114,100 114,100
3646 0810R00107170004814 * 04/09/2017 114,100 114,100
3647 0810R00107170004815 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.90/145

3648 0810R00107170004816 * 04/09/2017 114,100 114,100


3649 0810R00107170004817 * 04/09/2017 114,100 114,100
3650 0810R00107170004818 * 04/09/2017 114,100 114,100
3651 0810R00107170004819 * 04/09/2017 155,100 155,100
3652 0810R00107170004820 * 04/09/2017 114,100 114,100
3653 0810R00107170004821 * 04/09/2017 114,100 114,100
3654 0810R00107170004822 * 04/09/2017 114,100 114,100
3655 0810R00107170004823 * 04/09/2017 114,100 114,100
3656 0810R00107170004824 * 04/09/2017 114,100 114,100
3657 0810R00107170004825 * 04/09/2017 114,100 114,100
3658 0810R00107170004828 * 04/09/2017 114,100 114,100
3659 0810R00107170004832 * 04/09/2017 186,300 186,300
3660 0810R00107170004850 * 28/08/2017 314,500 314,500
3661 0810R00107170004851 * 28/08/2017 131,100 131,100
3662 0810R00107170004854 * 04/09/2017 186,300 186,300
3663 0810R00107170004855 * 04/09/2017 114,100 114,100
3664 0810R00107170004856 * 04/09/2017 114,100 114,100
3665 0810R00107170004857 * 04/09/2017 114,100 114,100
3666 0810R00107170004858 * 04/09/2017 114,100 114,100
3667 0810R00107170004859 * 04/09/2017 114,100 114,100
3668 0810R00107170004860 * 04/09/2017 114,100 114,100
3669 0810R00107170004861 * 04/09/2017 114,100 114,100
3670 0810R00107170004862 * 04/09/2017 114,100 114,100
3671 0810R00107170004863 * 04/09/2017 114,100 114,100
3672 0810R00107170004864 * 04/09/2017 114,100 114,100
3673 0810R00107170004865 * 04/09/2017 114,100 114,100
3674 0810R00107170004867 * 04/09/2017 114,100 114,100
3675 0810R00107170004868 * 04/09/2017 114,100 114,100
3676 0810R00107170004869 * 04/09/2017 155,100 155,100
3677 0810R00107170004870 * 04/09/2017 114,100 114,100
3678 0810R00107170004871 * 28/08/2017 184,900 184,900
3679 0810R00107170004872 * 28/08/2017 569,300 569,300
3680 0810R00107170004873 * 04/09/2017 184,900 184,900
3681 0810R00107170004874 * 04/09/2017 184,900 184,900
3682 0810R00107170004875 * 04/09/2017 114,100 114,100
3683 0810R00107170004876 * 04/09/2017 114,100 114,100
3684 0810R00107170004877 * 04/09/2017 184,900 184,900
3685 0810R00107170004878 * 28/08/2017 184,900 184,900
3686 0810R00107170004879 * 04/09/2017 184,900 184,900
3687 0810R00107170004880 * 04/09/2017 184,900 184,900
3688 0810R00107170004881 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.91/145

3689 0810R00107170004882 * 04/09/2017 114,100 114,100


3690 0810R00107170004883 * 04/09/2017 114,100 114,100
3691 0810R00107170004884 * 04/09/2017 155,100 155,100
3692 0810R00107170004885 * 04/09/2017 114,100 114,100
3693 0810R00107170004886 * 04/09/2017 114,100 114,100
3694 0810R00107170004887 * 04/09/2017 184,900 184,900
3695 0810R00107170004888 * 04/09/2017 184,900 184,900
3696 0810R00107170004889 * 04/09/2017 184,900 184,900
3697 0810R00107170004890 * 04/09/2017 184,900 184,900
3698 0810R00107170004891 * 04/09/2017 184,900 184,900
3699 0810R00107170004892 * 04/09/2017 184,900 184,900
3700 0810R00107170004893 * 04/09/2017 114,100 114,100
3701 0810R00107170004894 * 04/09/2017 184,900 184,900
3702 0810R00107170004895 * 04/09/2017 114,100 114,100
3703 0810R00107170004897 * 04/09/2017 114,100 114,100
3704 0810R00107170004898 * 04/09/2017 184,900 184,900
3705 0810R00107170004899 * 04/09/2017 114,100 114,100
3706 0810R00107170004900 * 04/09/2017 114,100 114,100
3707 0810R00107170004901 * 04/09/2017 184,900 184,900
3708 0810R00107170004902 * 04/09/2017 114,100 114,100
3709 0810R00107170004903 * 04/09/2017 184,900 184,900
3710 0810R00107170004904 * 28/08/2017 184,900 184,900
3711 0810R00107170004905 * 04/09/2017 114,100 114,100
3712 0810R00107170004907 * 04/09/2017 184,900 184,900
3713 0810R00107170004908 * 04/09/2017 114,100 114,100
3714 0810R00107170004909 * 04/09/2017 184,900 184,900
3715 0810R00107170004910 * 04/09/2017 114,100 114,100
3716 0810R00107170004911 * 04/09/2017 114,100 114,100
3717 0810R00107170004912 * 04/09/2017 114,100 114,100
3718 0810R00107170004913 * 04/09/2017 114,100 114,100
3719 0810R00107170004914 * 04/09/2017 114,100 114,100
3720 0810R00107170004915 * 04/09/2017 114,100 114,100
3721 0810R00107170004916 * 28/08/2017 184,900 184,900
3722 0810R00107170004917 * 04/09/2017 184,900 184,900
3723 0810R00107170004918 * 04/09/2017 184,900 184,900
3724 0810R00107170004920 * 04/09/2017 114,100 114,100
3725 0810R00107170004921 * 04/09/2017 114,100 114,100
3726 0810R00107170004922 * 04/09/2017 114,100 114,100
3727 0810R00107170004923 * 04/09/2017 114,100 114,100
3728 0810R00107170004924 * 04/09/2017 184,900 184,900
3729 0810R00107170004925 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.92/145

3730 0810R00107170004926 * 04/09/2017 114,100 114,100


3731 0810R00107170004929 * 04/09/2017 114,100 114,100
3732 0810R00107170004930 * 04/09/2017 184,900 184,900
3733 0810R00107170004931 * 04/09/2017 184,900 184,900
3734 0810R00107170004932 * 08/09/2017 184,900 184,900
3735 0810R00107170004933 * 28/08/2017 215,300 215,300
3736 0810R00107170004935 * 28/08/2017 200,700 200,700
3737 0810R00107170004936 * 04/09/2017 184,900 184,900
3738 0810R00107170004937 * 04/09/2017 184,900 184,900
3739 0810R00107170004938 * 04/09/2017 184,900 184,900
3740 0810R00107170004939 * 28/08/2017 184,900 184,900
3741 0810R00107170004940 * 04/09/2017 184,900 184,900
3742 0810R00107170004941 * 04/09/2017 184,900 184,900
3743 0810R00107170004942 * 04/09/2017 184,900 184,900
3744 0810R00107170004943 * 04/09/2017 184,900 184,900
3745 0810R00107170004945 * 04/09/2017 184,900 184,900
3746 0810R00107170004946 * 25/08/2017 184,900 184,900
3747 0810R00107170004947 * 30/08/2017 184,900 184,900
3748 0810R00107170004948 * 28/08/2017 184,900 184,900
3749 0810R00107170004949 * 04/09/2017 184,900 184,900
3750 0810R00107170004950 * 28/08/2017 210,700 210,700
3751 0810R00107170004952 * 28/08/2017 215,300 215,300
3752 0810R00107170004954 * 04/09/2017 114,100 114,100
3753 0810R00107170004955 * 04/09/2017 184,900 184,900
3754 0810R00107170004957 * 04/09/2017 184,900 184,900
3755 0810R00107170004958 * 04/09/2017 114,100 114,100
3756 0810R00107170004959 * 04/09/2017 184,900 184,900
3757 0810R00107170004960 * 04/09/2017 114,100 114,100
3758 0810R00107170004961 * 04/09/2017 186,300 186,300
3759 0810R00107170004962 * 04/09/2017 184,900 184,900
3760 0810R00107170004963 * 04/09/2017 114,100 114,100
3761 0810R00107170004964 * 28/08/2017 200,700 200,700
3762 0810R00107170004965 * 04/09/2017 114,100 114,100
3763 0810R00107170004966 * 04/09/2017 184,900 184,900
3764 0810R00107170004967 * 04/09/2017 114,100 114,100
3765 0810R00107170004968 * 04/09/2017 184,900 184,900
3766 0810R00107170004969 * 04/09/2017 114,100 114,100
3767 0810R00107170004970 * 04/09/2017 184,900 184,900
3768 0810R00107170004972 * 04/09/2017 155,100 155,100
3769 0810R00107170004973 * 04/09/2017 184,900 184,900
3770 0810R00107170004974 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.93/145

3771 0810R00107170004976 * 04/09/2017 155,100 155,100


3772 0810R00107170004977 * 28/08/2017 184,900 184,900
3773 0810R00107170004978 * 04/09/2017 184,900 184,900
3774 0810R00107170004979 * 04/09/2017 184,900 184,900
3775 0810R00107170004980 * 04/09/2017 114,100 114,100
3776 0810R00107170004981 * 04/09/2017 114,100 114,100
3777 0810R00107170004983 * 04/09/2017 114,100 114,100
3778 0810R00107170004984 * 28/08/2017 215,300 215,300
3779 0810R00107170004985 * 04/09/2017 155,100 155,100
3780 0810R00107170004986 * 04/09/2017 155,100 155,100
3781 0810R00107170004987 * 28/08/2017 184,900 184,900
3782 0810R00107170004988 * 04/09/2017 114,100 114,100
3783 0810R00107170004989 * 04/09/2017 114,100 114,100
3784 0810R00107170004990 * 04/09/2017 114,100 114,100
3785 0810R00107170004991 * 04/09/2017 184,900 184,900
3786 0810R00107170004992 * 04/09/2017 114,100 114,100
3787 0810R00107170004993 * 28/08/2017 184,900 184,900
3788 0810R00107170004994 * 04/09/2017 184,900 184,900
3789 0810R00107170004995 * 04/09/2017 114,100 114,100
3790 0810R00107170004997 * 28/08/2017 184,900 184,900
3791 0810R00107170004998 * 04/09/2017 184,900 184,900
3792 0810R00107170004999 * 28/08/2017 184,900 184,900
3793 0810R00107170005000 * 04/09/2017 184,900 184,900
3794 0810R00107170005001 * 04/09/2017 184,900 184,900
3795 0810R00107170005002 * 04/09/2017 184,900 184,900
3796 0810R00107170005004 * 28/08/2017 184,900 184,900
3797 0810R00107170005005 * 28/08/2017 215,300 215,300
3798 0810R00107170005007 * 04/09/2017 184,900 184,900
3799 0810R00107170005008 * 04/09/2017 184,900 184,900
3800 0810R00107170005009 * 04/09/2017 184,900 184,900
3801 0810R00107170005010 * 04/09/2017 184,900 184,900
3802 0810R00107170005011 * 28/08/2017 280,800 280,800
3803 0810R00107170005012 * 28/08/2017 184,900 184,900
3804 0810R00107170005013 * 04/09/2017 184,900 184,900
3805 0810R00107170005014 * 04/09/2017 184,900 184,900
3806 0810R00107170005015 * 04/09/2017 184,900 184,900
3807 0810R00107170005016 * 04/09/2017 184,900 184,900
3808 0810R00107170005018 * 04/09/2017 141,300 141,300
3809 0810R00107170005019 * 04/09/2017 184,900 184,900
3810 0810R00107170005020 * 04/09/2017 184,900 184,900
3811 0810R00107170005021 * 28/08/2017 200,700 200,700
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.94/145

3812 0810R00107170005022 * 04/09/2017 184,900 184,900


3813 0810R00107170005023 * 28/08/2017 184,900 184,900
3814 0810R00107170005024 * 04/09/2017 184,900 184,900
3815 0810R00107170005025 * 28/08/2017 200,700 200,700
3816 0810R00107170005026 * 04/09/2017 184,900 184,900
3817 0810R00107170005027 * 28/08/2017 184,900 184,900
3818 0810R00107170005029 * 04/09/2017 184,900 184,900
3819 0810R00107170005030 * 04/09/2017 184,900 184,900
3820 0810R00107170005031 * 04/09/2017 184,900 184,900
3821 0810R00107170005032 * 04/09/2017 184,900 184,900
3822 0810R00107170005033 * 04/09/2017 184,900 184,900
3823 0810R00107170005034 * 04/09/2017 184,900 184,900
3824 0810R00107170005035 * 04/09/2017 184,900 184,900
3825 0810R00107170005036 * 04/09/2017 114,100 114,100
3826 0810R00107170005037 * 04/09/2017 184,900 184,900
3827 0810R00107170005038 * 04/09/2017 114,100 114,100
3828 0810R00107170005040 * 04/09/2017 184,900 184,900
3829 0810R00107170005041 * 04/09/2017 114,100 114,100
3830 0810R00107170005042 * 04/09/2017 114,100 114,100
3831 0810R00107170005043 * 28/08/2017 215,300 215,300
3832 0810R00107170005044 * 04/09/2017 114,100 114,100
3833 0810R00107170005045 * 04/09/2017 184,900 184,900
3834 0810R00107170005046 * 04/09/2017 184,900 184,900
3835 0810R00107170005047 * 04/09/2017 114,100 114,100
3836 0810R00107170005048 * 04/09/2017 184,900 184,900
3837 0810R00107170005049 * 04/09/2017 184,900 184,900
3838 0810R00107170005050 * 28/08/2017 184,900 184,900
3839 0810R00107170005051 * 28/08/2017 184,900 184,900
3840 0810R00107170005052 * 04/09/2017 184,900 184,900
3841 0810R00107170005053 * 04/09/2017 184,900 184,900
3842 0810R00107170005054 * 28/08/2017 200,700 200,700
3843 0810R00107170005055 * 04/09/2017 184,900 184,900
3844 0810R00107170005056 * 04/09/2017 184,900 184,900
3845 0810R00107170005057 * 04/09/2017 184,900 184,900
3846 0810R00107170005059 * 28/08/2017 184,900 184,900
3847 0810R00107170005060 * 04/09/2017 184,900 184,900
3848 0810R00107170005061 * 04/09/2017 114,100 114,100
3849 0810R00107170005062 * 04/09/2017 155,100 155,100
3850 0810R00107170005063 * 04/09/2017 184,900 184,900
3851 0810R00107170005065 * 04/09/2017 184,900 184,900
3852 0810R00107170005066 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.95/145

3853 0810R00107170005067 * 04/09/2017 114,100 114,100


3854 0810R00107170005068 * 30/08/2017 184,900 184,900
3855 0810R00107170005069 * 04/09/2017 155,100 155,100
3856 0810R00107170005070 * 04/09/2017 184,900 184,900
3857 0810R00107170005071 * 04/09/2017 114,100 114,100
3858 0810R00107170005072 * 04/09/2017 114,100 114,100
3859 0810R00107170005073 * 04/09/2017 114,100 114,100
3860 0810R00107170005074 * 04/09/2017 114,100 114,100
3861 0810R00107170005075 * 28/08/2017 184,900 184,900
3862 0810R00107170005076 * 04/09/2017 114,100 114,100
3863 0810R00107170005077 * 04/09/2017 114,100 114,100
3864 0810R00107170005078 * 04/09/2017 114,100 114,100
3865 0810R00107170005079 * 28/08/2017 198,300 198,300
3866 0810R00107170005081 * 04/09/2017 114,100 114,100
3867 0810R00107170005082 * 04/09/2017 114,100 114,100
3868 0810R00107170005083 * 04/09/2017 184,900 184,900
3869 0810R00107170005084 * 04/09/2017 114,100 114,100
3870 0810R00107170005085 * 28/08/2017 215,300 215,300
3871 0810R00107170005086 * 04/09/2017 114,100 114,100
3872 0810R00107170005087 * 04/09/2017 114,100 114,100
3873 0810R00107170005088 * 04/09/2017 184,900 184,900
3874 0810R00107170005089 * 04/09/2017 184,900 184,900
3875 0810R00107170005090 * 28/08/2017 184,900 184,900
3876 0810R00107170005091 * 04/09/2017 184,900 184,900
3877 0810R00107170005092 * 28/08/2017 200,700 200,700
3878 0810R00107170005094 * 04/09/2017 114,100 114,100
3879 0810R00107170005095 * 28/08/2017 184,900 184,900
3880 0810R00107170005097 * 04/09/2017 114,100 114,100
3881 0810R00107170005099 * 04/09/2017 114,100 114,100
3882 0810R00107170005100 * 04/09/2017 184,900 184,900
3883 0810R00107170005101 * 04/09/2017 186,300 186,300
3884 0810R00107170005102 * 04/09/2017 155,100 155,100
3885 0810R00107170005104 * 04/09/2017 114,100 114,100
3886 0810R00107170005105 * 28/08/2017 184,900 184,900
3887 0810R00107170005107 * 04/09/2017 114,100 114,100
3888 0810R00107170005108 * 04/09/2017 114,100 114,100
3889 0810R00107170005109 * 04/09/2017 114,100 114,100
3890 0810R00107170005110 * 04/09/2017 114,100 114,100
3891 0810R00107170005111 * 04/09/2017 114,100 114,100
3892 0810R00107170005112 * 04/09/2017 114,100 114,100
3893 0810R00107170005113 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.96/145

3894 0810R00107170005114 * 04/09/2017 155,100 155,100


3895 0810R00107170005119 * 04/09/2017 184,900 184,900
3896 0810R00107170005121 * 04/09/2017 184,900 184,900
3897 0810R00107170005122 * 04/09/2017 184,900 184,900
3898 0810R00107170005123 * 04/09/2017 186,300 186,300
3899 0810R00107170005124 * 28/08/2017 184,900 184,900
3900 0810R00107170005125 * 04/09/2017 155,100 155,100
3901 0810R00107170005126 * 04/09/2017 184,900 184,900
3902 0810R00107170005127 * 04/09/2017 184,900 184,900
3903 0810R00107170005128 * 28/08/2017 198,300 198,300
3904 0810R00107170005130 * 04/09/2017 184,900 184,900
3905 0810R00107170005131 * 04/09/2017 184,900 184,900
3906 0810R00107170005132 * 28/08/2017 215,300 215,300
3907 0810R00107170005133 * 04/09/2017 186,300 186,300
3908 0810R00107170005134 * 04/09/2017 184,900 184,900
3909 0810R00107170005135 * 04/09/2017 184,900 184,900
3910 0810R00107170005136 * 04/09/2017 186,300 186,300
3911 0810R00107170005138 * 04/09/2017 184,900 184,900
3912 0810R00107170005139 * 28/08/2017 184,900 184,900
3913 0810R00107170005141 * 04/09/2017 184,900 184,900
3914 0810R00107170005144 * 04/09/2017 184,900 184,900
3915 0810R00107170005145 * 04/09/2017 184,900 184,900
3916 0810R00107170005147 * 04/09/2017 184,900 184,900
3917 0810R00107170005148 * 04/09/2017 184,900 184,900
3918 0810R00107170005149 * 04/09/2017 184,900 184,900
3919 0810R00107170005150 * 04/09/2017 114,100 114,100
3920 0810R00107170005152 * 04/09/2017 184,900 184,900
3921 0810R00107170005155 * 04/09/2017 887,100 887,100
3922 0810R00107170005157 * 04/09/2017 887,100 887,100
3923 0810R00107170005158 * 04/09/2017 887,100 887,100
3924 0810R00107170005159 * 04/09/2017 887,100 887,100
3925 0810R00107170005160 * 04/09/2017 887,100 887,100
3926 0810R00107170005161 * 04/09/2017 887,100 887,100
3927 0810R00107170005162 * 04/09/2017 887,100 887,100
3928 0810R00107170005163 * 04/09/2017 887,100 887,100
3929 0810R00107170005164 * 04/09/2017 887,100 887,100
3930 0810R00107170005165 * 04/09/2017 887,100 887,100
3931 0810R00107170005166 * 04/09/2017 887,100 887,100
3932 0810R00107170005167 * 04/09/2017 887,100 887,100
3933 0810R00107170005168 * 04/09/2017 887,100 887,100
3934 0810R00107170005169 * 04/09/2017 887,100 887,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.97/145

3935 0810R00107170005170 * 04/09/2017 887,100 887,100


3936 0810R00107170005171 * 04/09/2017 887,100 887,100
3937 0810R00107170005172 * 04/09/2017 887,100 887,100
3938 0810R00107170005173 * 04/09/2017 887,100 887,100
3939 0810R00107170005174 * 04/09/2017 887,100 887,100
3940 0810R00107170005175 * 04/09/2017 887,100 887,100
3941 0810R00107170005176 * 04/09/2017 887,100 887,100
3942 0810R00107170005177 * 04/09/2017 887,100 887,100
3943 0810R00107170005178 * 04/09/2017 887,100 887,100
3944 0810R00107170005179 * 04/09/2017 887,100 887,100
3945 0810R00107170005180 * 04/09/2017 887,100 887,100
3946 0810R00107170005188 * 04/09/2017 186,300 186,300
3947 0810R00107170005193 * 04/09/2017 186,300 186,300
3948 0810R00107170005197 * 28/08/2017 314,500 314,500
3949 0810R00107170005198 * 04/09/2017 186,300 186,300
3950 0810R00107170005207 * 04/09/2017 114,100 114,100
3951 0810R00107170005208 * 04/09/2017 114,100 114,100
3952 0810R00107170005209 * 04/09/2017 114,100 114,100
3953 0810R00107170005210 * 28/08/2017 184,900 184,900
3954 0810R00107170005211 * 04/09/2017 114,100 114,100
3955 0810R00107170005212 * 04/09/2017 184,900 184,900
3956 0810R00107170005213 * 04/09/2017 114,100 114,100
3957 0810R00107170005214 * 04/09/2017 184,900 184,900
3958 0810R00107170005215 * 04/09/2017 114,100 114,100
3959 0810R00107170005216 * 04/09/2017 114,100 114,100
3960 0810R00107170005217 * 28/08/2017 184,900 184,900
3961 0810R00107170005218 * 04/09/2017 114,100 114,100
3962 0810R00107170005219 * 04/09/2017 114,100 114,100
3963 0810R00107170005220 * 04/09/2017 114,100 114,100
3964 0810R00107170005221 * 04/09/2017 184,900 184,900
3965 0810R00107170005222 * 04/09/2017 114,100 114,100
3966 0810R00107170005223 * 28/08/2017 184,900 184,900
3967 0810R00107170005224 * 04/09/2017 114,100 114,100
3968 0810R00107170005225 * 28/08/2017 184,900 184,900
3969 0810R00107170005226 * 04/09/2017 114,100 114,100
3970 0810R00107170005227 * 28/08/2017 184,900 184,900
3971 0810R00107170005228 * 04/09/2017 114,100 114,100
3972 0810R00107170005229 * 04/09/2017 184,900 184,900
3973 0810R00107170005230 * 04/09/2017 114,100 114,100
3974 0810R00107170005231 * 04/09/2017 114,100 114,100
3975 0810R00107170005232 * 28/08/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.98/145

3976 0810R00107170005233 * 04/09/2017 114,100 114,100


3977 0810R00107170005236 * 28/08/2017 184,900 184,900
3978 0810R00107170005237 * 04/09/2017 114,100 114,100
3979 0810R00107170005238 * 04/09/2017 114,100 114,100
3980 0810R00107170005239 * 28/08/2017 184,900 184,900
3981 0810R00107170005240 * 04/09/2017 155,100 155,100
3982 0810R00107170005241 * 04/09/2017 114,100 114,100
3983 0810R00107170005242 * 04/09/2017 114,100 114,100
3984 0810R00107170005243 * 04/09/2017 114,100 114,100
3985 0810R00107170005244 * 04/09/2017 114,100 114,100
3986 0810R00107170005245 * 04/09/2017 114,100 114,100
3987 0810R00107170005246 * 04/09/2017 114,100 114,100
3988 0810R00107170005247 * 04/09/2017 114,100 114,100
3989 0810R00107170005248 * 04/09/2017 114,100 114,100
3990 0810R00107170005250 * 04/09/2017 114,100 114,100
3991 0810R00107170005251 * 04/09/2017 155,100 155,100
3992 0810R00107170005252 * 04/09/2017 114,100 114,100
3993 0810R00107170005253 * 04/09/2017 114,100 114,100
3994 0810R00107170005254 * 04/09/2017 114,100 114,100
3995 0810R00107170005255 * 04/09/2017 114,100 114,100
3996 0810R00107170005256 * 04/09/2017 114,100 114,100
3997 0810R00107170005257 * 28/08/2017 215,300 215,300
3998 0810R00107170005258 * 04/09/2017 114,100 114,100
3999 0810R00107170005259 * 04/09/2017 114,100 114,100
4000 0810R00107170005260 * 04/09/2017 184,900 184,900
4001 0810R00107170005261 * 04/09/2017 114,100 114,100
4002 0810R00107170005262 * 04/09/2017 114,100 114,100
4003 0810R00107170005263 * 28/08/2017 184,900 184,900
4004 0810R00107170005264 * 04/09/2017 114,100 114,100
4005 0810R00107170005265 * 04/09/2017 114,100 114,100
4006 0810R00107170005267 * 04/09/2017 114,100 114,100
4007 0810R00107170005268 * 04/09/2017 114,100 114,100
4008 0810R00107170005269 * 04/09/2017 114,100 114,100
4009 0810R00107170005270 * 28/08/2017 184,900 184,900
4010 0810R00107170005271 * 04/09/2017 114,100 114,100
4011 0810R00107170005272 * 04/09/2017 155,100 155,100
4012 0810R00107170005273 * 04/09/2017 114,100 114,100
4013 0810R00107170005274 * 04/09/2017 184,900 184,900
4014 0810R00107170005275 * 04/09/2017 114,100 114,100
4015 0810R00107170005276 * 04/09/2017 114,100 114,100
4016 0810R00107170005277 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.99/145

4017 0810R00107170005278 * 04/09/2017 184,900 184,900


4018 0810R00107170005279 * 04/09/2017 184,900 184,900
4019 0810R00107170005280 * 04/09/2017 114,100 114,100
4020 0810R00107170005281 * 04/09/2017 114,100 114,100
4021 0810R00107170005282 * 04/09/2017 114,100 114,100
4022 0810R00107170005283 * 28/08/2017 184,900 184,900
4023 0810R00107170005284 * 04/09/2017 114,100 114,100
4024 0810R00107170005285 * 04/09/2017 114,100 114,100
4025 0810R00107170005286 * 28/08/2017 184,900 184,900
4026 0810R00107170005287 * 04/09/2017 114,100 114,100
4027 0810R00107170005288 * 04/09/2017 114,100 114,100
4028 0810R00107170005289 * 04/09/2017 114,100 114,100
4029 0810R00107170005290 * 04/09/2017 114,100 114,100
4030 0810R00107170005291 * 04/09/2017 114,100 114,100
4031 0810R00107170005292 * 04/09/2017 114,100 114,100
4032 0810R00107170005293 * 04/09/2017 114,100 114,100
4033 0810R00107170005294 * 04/09/2017 114,100 114,100
4034 0810R00107170005295 * 04/09/2017 114,100 114,100
4035 0810R00107170005297 * 04/09/2017 184,900 184,900
4036 0810R00107170005298 * 04/09/2017 184,900 184,900
4037 0810R00107170005299 * 28/08/2017 569,300 569,300
4038 0810R00107170005300 * 04/09/2017 114,100 114,100
4039 0810R00107170005301 * 28/08/2017 184,900 184,900
4040 0810R00107170005302 * 04/09/2017 114,100 114,100
4041 0810R00107170005303 * 04/09/2017 114,100 114,100
4042 0810R00107170005304 * 04/09/2017 114,100 114,100
4043 0810R00107170005305 * 04/09/2017 114,100 114,100
4044 0810R00107170005306 * 04/09/2017 114,100 114,100
4045 0810R00107170005308 * 04/09/2017 114,100 114,100
4046 0810R00107170005309 * 04/09/2017 114,100 114,100
4047 0810R00107170005310 * 04/09/2017 155,100 155,100
4048 0810R00107170005312 * 04/09/2017 184,900 184,900
4049 0810R00107170005313 * 04/09/2017 184,900 184,900
4050 0810R00107170005315 * 28/08/2017 342,700 342,700
4051 0810R00107170005316 * 04/09/2017 184,900 184,900
4052 0810R00107170005317 * 28/08/2017 200,700 200,700
4053 0810R00107170005318 * 04/09/2017 186,300 186,300
4054 0810R00107170005320 * 04/09/2017 184,900 184,900
4055 0810R00107170005321 * 04/09/2017 184,900 184,900
4056 0810R00107170005322 * 04/09/2017 184,900 184,900
4057 0810R00107170005324 * 28/08/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.100/145

4058 0810R00107170005325 * 28/08/2017 215,300 215,300


4059 0810R00107170005327 * 04/09/2017 184,900 184,900
4060 0810R00107170005329 * 28/08/2017 184,900 184,900
4061 0810R00107170005330 * 04/09/2017 114,100 114,100
4062 0810R00107170005331 * 04/09/2017 114,100 114,100
4063 0810R00107170005332 * 04/09/2017 114,100 114,100
4064 0810R00107170005334 * 04/09/2017 114,100 114,100
4065 0810R00107170005336 * 04/09/2017 114,100 114,100
4066 0810R00107170005337 * 04/09/2017 114,100 114,100
4067 0810R00107170005339 * 04/09/2017 114,100 114,100
4068 0810R00107170005340 * 28/08/2017 184,900 184,900
4069 0810R00107170005341 * 28/08/2017 569,300 569,300
4070 0810R00107170005342 * 04/09/2017 184,900 184,900
4071 0810R00107170005343 * 04/09/2017 184,900 184,900
4072 0810R00107170005346 * 28/08/2017 242,700 242,700
4073 0810R00107170005347 * 04/09/2017 114,100 114,100
4074 0810R00107170005348 * 04/09/2017 184,900 184,900
4075 0810R00107170005349 * 04/09/2017 184,900 184,900
4076 0810R00107170005350 * 04/09/2017 114,100 114,100
4077 0810R00107170005354 * 04/09/2017 184,900 184,900
4078 0810R00107170005355 * 04/09/2017 114,100 114,100
4079 0810R00107170005356 * 04/09/2017 184,900 184,900
4080 0810R00107170005357 * 04/09/2017 184,900 184,900
4081 0810R00107170005358 * 04/09/2017 184,900 184,900
4082 0810R00107170005359 * 04/09/2017 184,900 184,900
4083 0810R00107170005360 * 28/08/2017 184,900 184,900
4084 0810R00107170005361 * 04/09/2017 184,900 184,900
4085 0810R00107170005362 * 04/09/2017 184,900 184,900
4086 0810R00107170005365 * 04/09/2017 887,100 887,100
4087 0810R00107170005366 * 04/09/2017 887,100 887,100
4088 0810R00107170005367 * 04/09/2017 887,100 887,100
4089 0810R00107170005368 * 04/09/2017 887,100 887,100
4090 0810R00107170005369 * 04/09/2017 887,100 887,100
4091 0810R00107170005370 * 04/09/2017 887,100 887,100
4092 0810R00107170005371 * 04/09/2017 887,100 887,100
4093 0810R00107170005372 * 04/09/2017 887,100 887,100
4094 0810R00107170005373 * 04/09/2017 887,100 887,100
4095 0810R00107170005374 * 04/09/2017 887,100 887,100
4096 0810R00107170005376 * 04/09/2017 184,900 184,900
4097 0810R00107170005377 * 04/09/2017 887,100 887,100
4098 0810R00107170005378 * 04/09/2017 887,100 887,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.101/145

4099 0810R00107170005379 * 04/09/2017 887,100 887,100


4100 0810R00107170005388 * 04/09/2017 887,100 887,100
4101 0810R00107170005389 * 04/09/2017 887,100 887,100
4102 0810R00107170005390 * 04/09/2017 887,100 887,100
4103 0810R00107170005391 * 04/09/2017 887,100 887,100
4104 0810R00107170005392 * 04/09/2017 887,100 887,100
4105 0810R00107170005393 * 04/09/2017 887,100 887,100
4106 0810R00107170005394 * 04/09/2017 887,100 887,100
4107 0810R00107170005395 * 04/09/2017 887,100 887,100
4108 0810R00107170005396 * 04/09/2017 887,100 887,100
4109 0810R00107170005397 * 04/09/2017 887,100 887,100
4110 0810R00107170005399 * 04/09/2017 887,100 887,100
4111 0810R00107170005400 * 04/09/2017 887,100 887,100
4112 0810R00107170005408 * 04/09/2017 186,300 186,300
4113 0810R00107170005416 * 04/09/2017 186,300 186,300
4114 0810R00107170005427 * 25/08/2017 259,800 259,800
4115 0810R00107170005430 * 04/09/2017 184,900 184,900
4116 0810R00107170005431 * 25/08/2017 569,300 569,300
4117 0810R00107170005432 * 25/08/2017 184,900 184,900
4118 0810R00107170005433 * 04/09/2017 184,900 184,900
4119 0810R00107170005434 * 04/09/2017 114,100 114,100
4120 0810R00107170005435 * 04/09/2017 114,100 114,100
4121 0810R00107170005436 * 04/09/2017 184,900 184,900
4122 0810R00107170005437 * 04/09/2017 114,100 114,100
4123 0810R00107170005438 * 04/09/2017 184,900 184,900
4124 0810R00107170005439 * 04/09/2017 114,100 114,100
4125 0810R00107170005440 * 04/09/2017 114,100 114,100
4126 0810R00107170005441 * 04/09/2017 114,100 114,100
4127 0810R00107170005443 * 04/09/2017 114,100 114,100
4128 0810R00107170005444 * 04/09/2017 155,100 155,100
4129 0810R00107170005445 * 04/09/2017 184,900 184,900
4130 0810R00107170005446 * 04/09/2017 184,900 184,900
4131 0810R00107170005447 * 04/09/2017 184,900 184,900
4132 0810R00107170005448 * 04/09/2017 114,100 114,100
4133 0810R00107170005450 * 04/09/2017 184,900 184,900
4134 0810R00107170005451 * 04/09/2017 184,900 184,900
4135 0810R00107170005452 * 04/09/2017 114,100 114,100
4136 0810R00107170005453 * 04/09/2017 184,900 184,900
4137 0810R00107170005454 * 04/09/2017 184,900 184,900
4138 0810R00107170005456 * 25/08/2017 346,900 346,900
4139 0810R00107170005457 * 25/08/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.102/145

4140 0810R00107170005458 * 04/09/2017 186,300 186,300


4141 0810R00107170005459 * 04/09/2017 184,900 184,900
4142 0810R00107170005460 * 04/09/2017 184,900 184,900
4143 0810R00107170005461 * 04/09/2017 184,900 184,900
4144 0810R00107170005462 * 04/09/2017 184,900 184,900
4145 0810R00107170005463 * 04/09/2017 184,900 184,900
4146 0810R00107170005464 * 25/08/2017 184,900 184,900
4147 0810R00107170005466 * 04/09/2017 114,100 114,100
4148 0810R00107170005468 * 25/08/2017 569,300 569,300
4149 0810R00107170005469 * 04/09/2017 184,900 184,900
4150 0810R00107170005470 * 04/09/2017 155,100 155,100
4151 0810R00107170005472 * 04/09/2017 114,100 114,100
4152 0810R00107170005473 * 04/09/2017 184,900 184,900
4153 0810R00107170005474 * 04/09/2017 184,900 184,900
4154 0810R00107170005475 * 04/09/2017 184,900 184,900
4155 0810R00107170005476 * 04/09/2017 184,900 184,900
4156 0810R00107170005478 * 04/09/2017 114,100 114,100
4157 0810R00107170005479 * 04/09/2017 114,100 114,100
4158 0810R00107170005480 * 04/09/2017 114,100 114,100
4159 0810R00107170005481 * 04/09/2017 184,900 184,900
4160 0810R00107170005482 * 25/08/2017 184,900 184,900
4161 0810R00107170005483 * 04/09/2017 114,100 114,100
4162 0810R00107170005484 * 04/09/2017 114,100 114,100
4163 0810R00107170005485 * 25/08/2017 184,900 184,900
4164 0810R00107170005486 * 04/09/2017 114,100 114,100
4165 0810R00107170005487 * 04/09/2017 184,900 184,900
4166 0810R00107170005488 * 04/09/2017 114,100 114,100
4167 0810R00107170005490 * 04/09/2017 184,900 184,900
4168 0810R00107170005491 * 04/09/2017 114,100 114,100
4169 0810R00107170005492 * 04/09/2017 184,900 184,900
4170 0810R00107170005493 * 04/09/2017 114,100 114,100
4171 0810R00107170005494 * 04/09/2017 155,100 155,100
4172 0810R00107170005495 * 04/09/2017 114,100 114,100
4173 0810R00107170005496 * 04/09/2017 184,900 184,900
4174 0810R00107170005497 * 04/09/2017 114,100 114,100
4175 0810R00107170005499 * 04/09/2017 114,100 114,100
4176 0810R00107170005500 * 25/08/2017 215,300 215,300
4177 0810R00107170005502 * 04/09/2017 114,100 114,100
4178 0810R00107170005503 * 04/09/2017 114,100 114,100
4179 0810R00107170005504 * 04/09/2017 114,100 114,100
4180 0810R00107170005505 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.103/145

4181 0810R00107170005506 * 04/09/2017 114,100 114,100


4182 0810R00107170005508 * 04/09/2017 114,100 114,100
4183 0810R00107170005509 * 04/09/2017 114,100 114,100
4184 0810R00107170005510 * 04/09/2017 114,100 114,100
4185 0810R00107170005511 * 04/09/2017 114,100 114,100
4186 0810R00107170005512 * 04/09/2017 114,100 114,100
4187 0810R00107170005513 * 04/09/2017 184,900 184,900
4188 0810R00107170005514 * 04/09/2017 184,900 184,900
4189 0810R00107170005515 * 04/09/2017 114,100 114,100
4190 0810R00107170005516 * 04/09/2017 184,900 184,900
4191 0810R00107170005517 * 04/09/2017 114,100 114,100
4192 0810R00107170005518 * 04/09/2017 184,900 184,900
4193 0810R00107170005519 * 04/09/2017 114,100 114,100
4194 0810R00107170005520 * 04/09/2017 184,900 184,900
4195 0810R00107170005521 * 04/09/2017 114,100 114,100
4196 0810R00107170005522 * 04/09/2017 114,100 114,100
4197 0810R00107170005523 * 04/09/2017 114,100 114,100
4198 0810R00107170005524 * 04/09/2017 184,900 184,900
4199 0810R00107170005525 * 04/09/2017 114,100 114,100
4200 0810R00107170005527 * 04/09/2017 114,100 114,100
4201 0810R00107170005528 * 04/09/2017 114,100 114,100
4202 0810R00107170005529 * 04/09/2017 114,100 114,100
4203 0810R00107170005530 * 04/09/2017 184,900 184,900
4204 0810R00107170005531 * 04/09/2017 114,100 114,100
4205 0810R00107170005532 * 04/09/2017 114,100 114,100
4206 0810R00107170005533 * 04/09/2017 114,100 114,100
4207 0810R00107170005534 * 04/09/2017 114,100 114,100
4208 0810R00107170005535 * 04/09/2017 114,100 114,100
4209 0810R00107170005536 * 04/09/2017 114,100 114,100
4210 0810R00107170005537 * 04/09/2017 184,900 184,900
4211 0810R00107170005538 * 04/09/2017 114,100 114,100
4212 0810R00107170005539 * 04/09/2017 114,100 114,100
4213 0810R00107170005540 * 25/08/2017 184,900 184,900
4214 0810R00107170005541 * 04/09/2017 114,100 114,100
4215 0810R00107170005542 * 04/09/2017 114,100 114,100
4216 0810R00107170005543 * 04/09/2017 184,900 184,900
4217 0810R00107170005544 * 04/09/2017 114,100 114,100
4218 0810R00107170005545 * 04/09/2017 114,100 114,100
4219 0810R00107170005546 * 04/09/2017 184,900 184,900
4220 0810R00107170005547 * 04/09/2017 114,100 114,100
4221 0810R00107170005548 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.104/145

4222 0810R00107170005549 * 04/09/2017 114,100 114,100


4223 0810R00107170005550 * 04/09/2017 184,900 184,900
4224 0810R00107170005551 * 04/09/2017 184,900 184,900
4225 0810R00107170005552 * 04/09/2017 114,100 114,100
4226 0810R00107170005553 * 25/08/2017 184,900 184,900
4227 0810R00107170005554 * 04/09/2017 114,100 114,100
4228 0810R00107170005555 * 04/09/2017 114,100 114,100
4229 0810R00107170005556 * 04/09/2017 114,100 114,100
4230 0810R00107170005557 * 04/09/2017 114,100 114,100
4231 0810R00107170005558 * 04/09/2017 114,100 114,100
4232 0810R00107170005560 * 04/09/2017 114,100 114,100
4233 0810R00107170005561 * 04/09/2017 114,100 114,100
4234 0810R00107170005562 * 04/09/2017 184,900 184,900
4235 0810R00107170005563 * 04/09/2017 114,100 114,100
4236 0810R00107170005564 * 04/09/2017 114,100 114,100
4237 0810R00107170005565 * 04/09/2017 114,100 114,100
4238 0810R00107170005566 * 04/09/2017 114,100 114,100
4239 0810R00107170005567 * 04/09/2017 114,100 114,100
4240 0810R00107170005568 * 04/09/2017 114,100 114,100
4241 0810R00107170005569 * 25/08/2017 184,900 184,900
4242 0810R00107170005570 * 04/09/2017 114,100 114,100
4243 0810R00107170005571 * 04/09/2017 114,100 114,100
4244 0810R00107170005572 * 04/09/2017 155,100 155,100
4245 0810R00107170005573 * 04/09/2017 114,100 114,100
4246 0810R00107170005574 * 04/09/2017 114,100 114,100
4247 0810R00107170005575 * 04/09/2017 114,100 114,100
4248 0810R00107170005576 * 04/09/2017 114,100 114,100
4249 0810R00107170005577 * 04/09/2017 184,900 184,900
4250 0810R00107170005578 * 04/09/2017 114,100 114,100
4251 0810R00107170005579 * 04/09/2017 114,100 114,100
4252 0810R00107170005580 * 04/09/2017 114,100 114,100
4253 0810R00107170005581 * 04/09/2017 184,900 184,900
4254 0810R00107170005582 * 04/09/2017 114,100 114,100
4255 0810R00107170005583 * 04/09/2017 114,100 114,100
4256 0810R00107170005584 * 04/09/2017 184,900 184,900
4257 0810R00107170005585 * 04/09/2017 114,100 114,100
4258 0810R00107170005586 * 04/09/2017 114,100 114,100
4259 0810R00107170005587 * 04/09/2017 114,100 114,100
4260 0810R00107170005588 * 04/09/2017 184,900 184,900
4261 0810R00107170005589 * 04/09/2017 114,100 114,100
4262 0810R00107170005590 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.105/145

4263 0810R00107170005591 * 04/09/2017 114,100 114,100


4264 0810R00107170005592 * 04/09/2017 114,100 114,100
4265 0810R00107170005593 * 04/09/2017 114,100 114,100
4266 0810R00107170005595 * 04/09/2017 114,100 114,100
4267 0810R00107170005596 * 04/09/2017 184,900 184,900
4268 0810R00107170005597 * 04/09/2017 114,100 114,100
4269 0810R00107170005598 * 04/09/2017 184,900 184,900
4270 0810R00107170005599 * 04/09/2017 114,100 114,100
4271 0810R00107170005600 * 04/09/2017 114,100 114,100
4272 0810R00107170005601 * 04/09/2017 155,100 155,100
4273 0810R00107170005602 * 04/09/2017 184,900 184,900
4274 0810R00107170005603 * 04/09/2017 114,100 114,100
4275 0810R00107170005604 * 04/09/2017 184,900 184,900
4276 0810R00107170005605 * 04/09/2017 114,100 114,100
4277 0810R00107170005606 * 04/09/2017 114,100 114,100
4278 0810R00107170005607 * 04/09/2017 114,100 114,100
4279 0810R00107170005608 * 04/09/2017 114,100 114,100
4280 0810R00107170005609 * 04/09/2017 114,100 114,100
4281 0810R00107170005610 * 25/08/2017 200,700 200,700
4282 0810R00107170005611 * 04/09/2017 887,100 887,100
4283 0810R00107170005613 * 04/09/2017 186,300 186,300
4284 0810R00107170005614 * 04/09/2017 184,900 184,900
4285 0810R00107170005615 * 04/09/2017 887,100 887,100
4286 0810R00107170005616 * 04/09/2017 887,100 887,100
4287 0810R00107170005617 * 04/09/2017 186,300 186,300
4288 0810R00107170005618 * 04/09/2017 887,100 887,100
4289 0810R00107170005619 * 04/09/2017 887,100 887,100
4290 0810R00107170005620 * 04/09/2017 887,100 887,100
4291 0810R00107170005621 * 04/09/2017 887,100 887,100
4292 0810R00107170005622 * 04/09/2017 887,100 887,100
4293 0810R00107170005623 * 04/09/2017 887,100 887,100
4294 0810R00107170005624 * 04/09/2017 887,100 887,100
4295 0810R00107170005625 * 04/09/2017 887,100 887,100
4296 0810R00107170005626 * 04/09/2017 887,100 887,100
4297 0810R00107170005627 * 04/09/2017 887,100 887,100
4298 0810R00107170005628 * 04/09/2017 887,100 887,100
4299 0810R00107170005629 * 04/09/2017 887,100 887,100
4300 0810R00107170005630 * 04/09/2017 114,100 114,100
4301 0810R00107170005631 * 04/09/2017 887,100 887,100
4302 0810R00107170005632 * 04/09/2017 887,100 887,100
4303 0810R00107170005633 * 04/09/2017 887,100 887,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.106/145

4304 0810R00107170005635 * 04/09/2017 887,100 887,100


4305 0810R00107170005636 * 04/09/2017 184,900 184,900
4306 0810R00107170005639 * 04/09/2017 887,100 887,100
4307 0810R00107170005640 * 04/09/2017 887,100 887,100
4308 0810R00107170005642 * 04/09/2017 887,100 887,100
4309 0810R00107170005643 * 04/09/2017 887,100 887,100
4310 0810R00107170005644 * 04/09/2017 887,100 887,100
4311 0810R00107170005645 * 04/09/2017 887,100 887,100
4312 0810R00107170005651 * 04/09/2017 184,900 184,900
4313 0810R00107170005655 * 04/09/2017 186,300 186,300
4314 0810R00107170005656 * 04/09/2017 186,300 186,300
4315 0810R00107170005666 * 29/08/2017 295,100 295,100
4316 0810R00107170005669 * 04/09/2017 186,300 186,300
4317 0810R00107170005670 * 04/09/2017 186,300 186,300
4318 0810R00107170005674 * 28/08/2017 259,800 259,800
4319 0810R00107170005678 * 28/08/2017 314,500 314,500
4320 0810R00107170005680 * 28/08/2017 960,400 960,400
4321 0810R00107170005682 * 04/09/2017 186,300 186,300
4322 0810R00107170005683 * 28/08/2017 316,300 316,300
4323 0810R00107170005687 * 04/09/2017 148,000 148,000
4324 0810R00107170005692 * 28/08/2017 255,700 255,700
4325 0810R00107170005699 * 28/08/2017 960,400 960,400
4326 0810R00107170005704 * 04/09/2017 186,300 186,300
4327 0810R00107170005706 * 04/09/2017 184,900 184,900
4328 0810R00107170005714 * 04/09/2017 140,500 140,500
4329 0810R00107170005716 * 04/09/2017 184,900 184,900
4330 0810R00107170005717 * 28/08/2017 184,900 184,900
4331 0810R00107170005718 * 04/09/2017 184,900 184,900
4332 0810R00107170005719 * 04/09/2017 114,100 114,100
4333 0810R00107170005720 * 28/08/2017 184,900 184,900
4334 0810R00107170005721 * 04/09/2017 184,900 184,900
4335 0810R00107170005722 * 04/09/2017 114,100 114,100
4336 0810R00107170005723 * 04/09/2017 184,900 184,900
4337 0810R00107170005724 * 04/09/2017 114,100 114,100
4338 0810R00107170005725 * 04/09/2017 114,100 114,100
4339 0810R00107170005726 * 04/09/2017 184,900 184,900
4340 0810R00107170005727 * 04/09/2017 114,100 114,100
4341 0810R00107170005728 * 04/09/2017 114,100 114,100
4342 0810R00107170005729 * 04/09/2017 186,300 186,300
4343 0810R00107170005730 * 04/09/2017 114,100 114,100
4344 0810R00107170005731 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.107/145

4345 0810R00107170005732 * 04/09/2017 114,100 114,100


4346 0810R00107170005733 * 04/09/2017 114,100 114,100
4347 0810R00107170005734 * 04/09/2017 184,900 184,900
4348 0810R00107170005735 * 04/09/2017 114,100 114,100
4349 0810R00107170005736 * 04/09/2017 184,900 184,900
4350 0810R00107170005738 * 04/09/2017 114,100 114,100
4351 0810R00107170005740 * 28/08/2017 569,300 569,300
4352 0810R00107170005741 * 04/09/2017 184,900 184,900
4353 0810R00107170005742 * 04/09/2017 184,900 184,900
4354 0810R00107170005743 * 28/08/2017 215,300 215,300
4355 0810R00107170005744 * 04/09/2017 140,500 140,500
4356 0810R00107170005745 * 04/09/2017 184,900 184,900
4357 0810R00107170005746 * 04/09/2017 2,400,800 2,400,800
4358 0810R00107170005747 * 04/09/2017 184,900 184,900
4359 0810R00107170005749 * 04/09/2017 184,900 184,900
4360 0810R00107170005750 * 04/09/2017 114,100 114,100
4361 0810R00107170005753 * 04/09/2017 184,900 184,900
4362 0810R00107170005754 * 28/08/2017 200,700 200,700
4363 0810R00107170005755 * 04/09/2017 184,900 184,900
4364 0810R00107170005756 * 28/08/2017 215,300 215,300
4365 0810R00107170005757 * 04/09/2017 114,100 114,100
4366 0810R00107170005759 * 04/09/2017 184,900 184,900
4367 0810R00107170005760 * 04/09/2017 114,100 114,100
4368 0810R00107170005761 * 04/09/2017 184,900 184,900
4369 0810R00107170005762 * 04/09/2017 114,100 114,100
4370 0810R00107170005763 * 04/09/2017 184,900 184,900
4371 0810R00107170005764 * 04/09/2017 114,100 114,100
4372 0810R00107170005765 * 04/09/2017 184,900 184,900
4373 0810R00107170005766 * 04/09/2017 114,100 114,100
4374 0810R00107170005767 * 28/08/2017 184,900 184,900
4375 0810R00107170005768 * 04/09/2017 114,100 114,100
4376 0810R00107170005769 * 04/09/2017 114,100 114,100
4377 0810R00107170005770 * 28/08/2017 713,400 713,400
4378 0810R00107170005771 * 04/09/2017 114,100 114,100
4379 0810R00107170005773 * 04/09/2017 184,900 184,900
4380 0810R00107170005775 * 04/09/2017 184,900 184,900
4381 0810R00107170005776 * 04/09/2017 114,100 114,100
4382 0810R00107170005777 * 04/09/2017 184,900 184,900
4383 0810R00107170005779 * 04/09/2017 114,100 114,100
4384 0810R00107170005780 * 04/09/2017 184,900 184,900
4385 0810R00107170005782 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.108/145

4386 0810R00107170005783 * 04/09/2017 114,100 114,100


4387 0810R00107170005784 * 04/09/2017 114,100 114,100
4388 0810R00107170005785 * 04/09/2017 184,900 184,900
4389 0810R00107170005786 * 04/09/2017 114,100 114,100
4390 0810R00107170005787 * 04/09/2017 114,100 114,100
4391 0810R00107170005788 * 28/08/2017 215,300 215,300
4392 0810R00107170005789 * 28/08/2017 184,900 184,900
4393 0810R00107170005791 * 28/08/2017 184,900 184,900
4394 0810R00107170005792 * 28/08/2017 184,900 184,900
4395 0810R00107170005793 * 28/08/2017 289,400 289,400
4396 0810R00107170005794 * 28/08/2017 184,900 184,900
4397 0810R00107170005795 * 04/09/2017 184,900 184,900
4398 0810R00107170005798 * 04/09/2017 184,900 184,900
4399 0810R00107170005800 * 04/09/2017 184,900 184,900
4400 0810R00107170005802 * 04/09/2017 114,100 114,100
4401 0810R00107170005803 * 04/09/2017 184,900 184,900
4402 0810R00107170005804 * 04/09/2017 184,900 184,900
4403 0810R00107170005805 * 04/09/2017 184,900 184,900
4404 0810R00107170005806 * 04/09/2017 184,900 184,900
4405 0810R00107170005807 * 04/09/2017 184,900 184,900
4406 0810R00107170005808 * 04/09/2017 114,100 114,100
4407 0810R00107170005809 * 04/09/2017 184,900 184,900
4408 0810R00107170005810 * 04/09/2017 184,900 184,900
4409 0810R00107170005811 * 04/09/2017 184,900 184,900
4410 0810R00107170005812 * 04/09/2017 184,900 184,900
4411 0810R00107170005813 * 28/08/2017 215,300 215,300
4412 0810R00107170005816 * 04/09/2017 184,900 184,900
4413 0810R00107170005817 * 04/09/2017 184,900 184,900
4414 0810R00107170005818 * 28/08/2017 200,700 200,700
4415 0810R00107170005819 * 04/09/2017 114,100 114,100
4416 0810R00107170005820 * 04/09/2017 184,900 184,900
4417 0810R00107170005821 * 04/09/2017 114,100 114,100
4418 0810R00107170005822 * 18/08/2017 114,100 114,100
4419 0810R00107170005824 * 04/09/2017 114,100 114,100
4420 0810R00107170005826 * 04/09/2017 114,100 114,100
4421 0810R00107170005827 * 04/09/2017 184,900 184,900
4422 0810R00107170005828 * 04/09/2017 184,900 184,900
4423 0810R00107170005829 * 04/09/2017 114,100 114,100
4424 0810R00107170005830 * 28/08/2017 200,700 200,700
4425 0810R00107170005831 * 04/09/2017 114,100 114,100
4426 0810R00107170005832 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.109/145

4427 0810R00107170005833 * 04/09/2017 114,100 114,100


4428 0810R00107170005834 * 04/09/2017 114,100 114,100
4429 0810R00107170005835 * 04/09/2017 114,100 114,100
4430 0810R00107170005836 * 04/09/2017 114,100 114,100
4431 0810R00107170005837 * 04/09/2017 114,100 114,100
4432 0810R00107170005838 * 04/09/2017 114,100 114,100
4433 0810R00107170005839 * 04/09/2017 114,100 114,100
4434 0810R00107170005840 * 04/09/2017 184,900 184,900
4435 0810R00107170005841 * 04/09/2017 114,100 114,100
4436 0810R00107170005842 * 04/09/2017 114,100 114,100
4437 0810R00107170005843 * 04/09/2017 184,900 184,900
4438 0810R00107170005844 * 04/09/2017 114,100 114,100
4439 0810R00107170005845 * 04/09/2017 114,100 114,100
4440 0810R00107170005846 * 04/09/2017 184,900 184,900
4441 0810R00107170005847 * 04/09/2017 184,900 184,900
4442 0810R00107170005849 * 04/09/2017 155,100 155,100
4443 0810R00107170005850 * 04/09/2017 184,900 184,900
4444 0810R00107170005851 * 04/09/2017 114,100 114,100
4445 0810R00107170005852 * 28/08/2017 184,900 184,900
4446 0810R00107170005853 * 04/09/2017 114,100 114,100
4447 0810R00107170005854 * 04/09/2017 114,100 114,100
4448 0810R00107170005855 * 04/09/2017 114,100 114,100
4449 0810R00107170005856 * 04/09/2017 114,100 114,100
4450 0810R00107170005857 * 04/09/2017 114,100 114,100
4451 0810R00107170005858 * 04/09/2017 114,100 114,100
4452 0810R00107170005859 * 04/09/2017 114,100 114,100
4453 0810R00107170005860 * 04/09/2017 114,100 114,100
4454 0810R00107170005861 * 28/08/2017 200,700 200,700
4455 0810R00107170005862 * 04/09/2017 114,100 114,100
4456 0810R00107170005863 * 04/09/2017 184,900 184,900
4457 0810R00107170005864 * 04/09/2017 114,100 114,100
4458 0810R00107170005865 * 04/09/2017 186,300 186,300
4459 0810R00107170005866 * 04/09/2017 114,100 114,100
4460 0810R00107170005867 * 04/09/2017 184,900 184,900
4461 0810R00107170005868 * 04/09/2017 114,100 114,100
4462 0810R00107170005869 * 04/09/2017 114,100 114,100
4463 0810R00107170005870 * 04/09/2017 114,100 114,100
4464 0810R00107170005871 * 04/09/2017 114,100 114,100
4465 0810R00107170005872 * 04/09/2017 155,100 155,100
4466 0810R00107170005873 * 04/09/2017 155,100 155,100
4467 0810R00107170005874 * 28/08/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.110/145

4468 0810R00107170005875 * 04/09/2017 114,100 114,100


4469 0810R00107170005876 * 04/09/2017 184,900 184,900
4470 0810R00107170005877 * 04/09/2017 114,100 114,100
4471 0810R00107170005878 * 04/09/2017 114,100 114,100
4472 0810R00107170005879 * 28/08/2017 114,100 114,100
4473 0810R00107170005880 * 04/09/2017 114,100 114,100
4474 0810R00107170005881 * 04/09/2017 114,100 114,100
4475 0810R00107170005882 * 04/09/2017 155,100 155,100
4476 0810R00107170005883 * 04/09/2017 114,100 114,100
4477 0810R00107170005885 * 04/09/2017 155,100 155,100
4478 0810R00107170005886 * 04/09/2017 114,100 114,100
4479 0810R00107170005887 * 04/09/2017 114,100 114,100
4480 0810R00107170005888 * 04/09/2017 186,300 186,300
4481 0810R00107170005889 * 04/09/2017 114,100 114,100
4482 0810R00107170005890 * 04/09/2017 114,100 114,100
4483 0810R00107170005891 * 04/09/2017 114,100 114,100
4484 0810R00107170005892 * 04/09/2017 114,100 114,100
4485 0810R00107170005893 * 04/09/2017 114,100 114,100
4486 0810R00107170005894 * 04/09/2017 114,100 114,100
4487 0810R00107170005895 * 04/09/2017 114,100 114,100
4488 0810R00107170005896 * 04/09/2017 114,100 114,100
4489 0810R00107170005897 * 28/08/2017 184,900 184,900
4490 0810R00107170005899 * 04/09/2017 114,100 114,100
4491 0810R00107170005900 * 04/09/2017 114,100 114,100
4492 0810R00107170005901 * 04/09/2017 114,100 114,100
4493 0810R00107170005902 * 04/09/2017 114,100 114,100
4494 0810R00107170005903 * 04/09/2017 155,100 155,100
4495 0810R00107170005905 * 04/09/2017 114,100 114,100
4496 0810R00107170005906 * 04/09/2017 114,100 114,100
4497 0810R00107170005907 * 04/09/2017 114,100 114,100
4498 0810R00107170005908 * 04/09/2017 114,100 114,100
4499 0810R00107170005909 * 04/09/2017 114,100 114,100
4500 0810R00107170005910 * 04/09/2017 114,100 114,100
4501 0810R00107170005911 * 04/09/2017 114,100 114,100
4502 0810R00107170005912 * 04/09/2017 114,100 114,100
4503 0810R00107170005913 * 04/09/2017 114,100 114,100
4504 0810R00107170005914 * 04/09/2017 155,100 155,100
4505 0810R00107170005915 * 04/09/2017 887,100 887,100
4506 0810R00107170005916 * 04/09/2017 114,100 114,100
4507 0810R00107170005917 * 04/09/2017 887,100 887,100
4508 0810R00107170005918 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.111/145

4509 0810R00107170005919 * 04/09/2017 186,300 186,300


4510 0810R00107170005920 * 04/09/2017 114,100 114,100
4511 0810R00107170005921 * 04/09/2017 114,100 114,100
4512 0810R00107170005922 * 04/09/2017 184,900 184,900
4513 0810R00107170005923 * 04/09/2017 114,100 114,100
4514 0810R00107170005925 * 04/09/2017 184,900 184,900
4515 0810R00107170005926 * 04/09/2017 155,100 155,100
4516 0810R00107170005928 * 04/09/2017 887,100 887,100
4517 0810R00107170005929 * 04/09/2017 155,100 155,100
4518 0810R00107170005930 * 04/09/2017 114,100 114,100
4519 0810R00107170005932 * 04/09/2017 114,100 114,100
4520 0810R00107170005933 * 04/09/2017 114,100 114,100
4521 0810R00107170005934 * 04/09/2017 887,100 887,100
4522 0810R00107170005935 * 04/09/2017 114,100 114,100
4523 0810R00107170005936 * 04/09/2017 155,100 155,100
4524 0810R00107170005937 * 04/09/2017 114,100 114,100
4525 0810R00107170005939 * 04/09/2017 114,100 114,100
4526 0810R00107170005940 * 04/09/2017 114,100 114,100
4527 0810R00107170005941 * 04/09/2017 114,100 114,100
4528 0810R00107170005942 * 04/09/2017 114,100 114,100
4529 0810R00107170005943 * 04/09/2017 184,900 184,900
4530 0810R00107170005944 * 04/09/2017 887,100 887,100
4531 0810R00107170005946 * 04/09/2017 114,100 114,100
4532 0810R00107170005947 * 04/09/2017 114,100 114,100
4533 0810R00107170005950 * 04/09/2017 184,900 184,900
4534 0810R00107170005959 * 04/09/2017 887,100 887,100
4535 0810R00107170005963 * 04/09/2017 887,100 887,100
4536 0810R00107170005966 * 04/09/2017 887,100 887,100
4537 0810R00107170005969 * 04/09/2017 186,300 186,300
4538 0810R00107170005970 * 04/09/2017 887,100 887,100
4539 0810R00107170005971 * 04/09/2017 887,100 887,100
4540 0810R00107170005972 * 04/09/2017 887,100 887,100
4541 0810R00107170005973 * 04/09/2017 887,100 887,100
4542 0810R00107170005975 * 04/09/2017 887,100 887,100
4543 0810R00107170005976 * 04/09/2017 887,100 887,100
4544 0810R00107170005977 * 04/09/2017 887,100 887,100
4545 0810R00107170005978 * 04/09/2017 887,100 887,100
4546 0810R00107170005979 * 04/09/2017 314,500 314,500
4547 0810R00107170005983 * 04/09/2017 887,100 887,100
4548 0810R00107170005986 * 04/09/2017 887,100 887,100
4549 0810R00107170005987 * 04/09/2017 887,100 887,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.112/145

4550 0810R00107170005988 * 04/09/2017 887,100 887,100


4551 0810R00107170005989 * 04/09/2017 887,100 887,100
4552 0810R00107170005990 * 04/09/2017 887,100 887,100
4553 0810R00107170005991 * 04/09/2017 887,100 887,100
4554 0810R00107170005992 * 04/09/2017 887,100 887,100
4555 0810R00107170005993 * 04/09/2017 887,100 887,100
4556 0810R00107170006009 * 28/08/2017 259,800 259,800
4557 0810R00107170006010 * 04/09/2017 184,900 184,900
4558 0810R00107170006012 * 04/09/2017 186,300 186,300
4559 0810R00107170006013 * 04/09/2017 186,300 186,300
4560 0810R00107170006015 * 04/09/2017 184,900 184,900
4561 0810R00107170006019 * 04/09/2017 184,900 184,900
4562 0810R00107170006020 * 04/09/2017 186,300 186,300
4563 0810R00107170006021 * 04/09/2017 186,300 186,300
4564 0810R00107170006022 * 04/09/2017 186,300 186,300
4565 0810R00107170006023 * 28/08/2017 250,600 250,600
4566 0810R00107170006032 * 04/09/2017 184,900 184,900
4567 0810R00107170006033 * 04/09/2017 114,100 114,100
4568 0810R00107170006034 * 29/08/2017 184,900 184,900
4569 0810R00107170006036 * 04/09/2017 184,900 184,900
4570 0810R00107170006037 * 04/09/2017 184,900 184,900
4571 0810R00107170006038 * 04/09/2017 114,100 114,100
4572 0810R00107170006039 * 04/09/2017 184,900 184,900
4573 0810R00107170006040 * 25/08/2017 184,900 184,900
4574 0810R00107170006041 * 04/09/2017 114,100 114,100
4575 0810R00107170006042 * 04/09/2017 184,900 184,900
4576 0810R00107170006043 * 04/09/2017 114,100 114,100
4577 0810R00107170006044 * 25/08/2017 184,900 184,900
4578 0810R00107170006045 * 04/09/2017 184,900 184,900
4579 0810R00107170006046 * 04/09/2017 184,900 184,900
4580 0810R00107170006047 * 25/08/2017 200,700 200,700
4581 0810R00107170006049 * 04/09/2017 184,900 184,900
4582 0810R00107170006050 * 04/09/2017 184,900 184,900
4583 0810R00107170006051 * 04/09/2017 184,900 184,900
4584 0810R00107170006052 * 04/09/2017 184,900 184,900
4585 0810R00107170006053 * 25/08/2017 184,900 184,900
4586 0810R00107170006054 * 04/09/2017 184,900 184,900
4587 0810R00107170006055 * 04/09/2017 184,900 184,900
4588 0810R00107170006056 * 04/09/2017 184,900 184,900
4589 0810R00107170006057 * 25/08/2017 267,200 267,200
4590 0810R00107170006058 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.113/145

4591 0810R00107170006059 * 04/09/2017 184,900 184,900


4592 0810R00107170006060 * 04/09/2017 184,900 184,900
4593 0810R00107170006061 * 04/09/2017 7,628,000 7,628,000
4594 0810R00107170006062 * 04/09/2017 184,900 184,900
4595 0810R00107170006063 * 04/09/2017 184,900 184,900
4596 0810R00107170006065 * 04/09/2017 184,900 184,900
4597 0810R00107170006066 * 04/09/2017 184,900 184,900
4598 0810R00107170006067 * 25/08/2017 200,700 200,700
4599 0810R00107170006068 * 25/08/2017 215,300 215,300
4600 0810R00107170006069 * 04/09/2017 184,900 184,900
4601 0810R00107170006070 * 04/09/2017 114,100 114,100
4602 0810R00107170006071 * 04/09/2017 184,900 184,900
4603 0810R00107170006072 * 25/08/2017 200,700 200,700
4604 0810R00107170006073 * 04/09/2017 184,900 184,900
4605 0810R00107170006074 * 04/09/2017 186,300 186,300
4606 0810R00107170006075 * 25/08/2017 322,900 322,900
4607 0810R00107170006076 * 04/09/2017 114,100 114,100
4608 0810R00107170006077 * 04/09/2017 114,100 114,100
4609 0810R00107170006078 * 04/09/2017 184,900 184,900
4610 0810R00107170006079 * 04/09/2017 114,100 114,100
4611 0810R00107170006080 * 04/09/2017 155,100 155,100
4612 0810R00107170006081 * 29/08/2017 184,900 184,900
4613 0810R00107170006082 * 04/09/2017 114,100 114,100
4614 0810R00107170006083 * 04/09/2017 114,100 114,100
4615 0810R00107170006084 * 04/09/2017 184,900 184,900
4616 0810R00107170006085 * 04/09/2017 114,100 114,100
4617 0810R00107170006086 * 04/09/2017 184,900 184,900
4618 0810R00107170006087 * 04/09/2017 155,100 155,100
4619 0810R00107170006088 * 04/09/2017 184,900 184,900
4620 0810R00107170006089 * 04/09/2017 155,100 155,100
4621 0810R00107170006090 * 04/09/2017 184,900 184,900
4622 0810R00107170006091 * 04/09/2017 114,100 114,100
4623 0810R00107170006092 * 04/09/2017 114,100 114,100
4624 0810R00107170006093 * 04/09/2017 184,900 184,900
4625 0810R00107170006094 * 04/09/2017 114,100 114,100
4626 0810R00107170006096 * 04/09/2017 184,900 184,900
4627 0810R00107170006097 * 04/09/2017 184,900 184,900
4628 0810R00107170006098 * 04/09/2017 114,100 114,100
4629 0810R00107170006099 * 04/09/2017 114,100 114,100
4630 0810R00107170006100 * 04/09/2017 7,628,000 7,628,000
4631 0810R00107170006101 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.114/145

4632 0810R00107170006102 * 04/09/2017 114,100 114,100


4633 0810R00107170006103 * 04/09/2017 184,900 184,900
4634 0810R00107170006104 * 25/08/2017 184,900 184,900
4635 0810R00107170006105 * 04/09/2017 114,100 114,100
4636 0810R00107170006107 * 04/09/2017 114,100 114,100
4637 0810R00107170006108 * 04/09/2017 184,900 184,900
4638 0810R00107170006110 * 04/09/2017 114,100 114,100
4639 0810R00107170006111 * 04/09/2017 114,100 114,100
4640 0810R00107170006112 * 04/09/2017 184,900 184,900
4641 0810R00107170006113 * 04/09/2017 184,900 184,900
4642 0810R00107170006114 * 25/08/2017 242,700 242,700
4643 0810R00107170006115 * 25/08/2017 184,900 184,900
4644 0810R00107170006116 * 04/09/2017 184,900 184,900
4645 0810R00107170006118 * 29/08/2017 295,100 295,100
4646 0810R00107170006119 * 25/08/2017 200,700 200,700
4647 0810R00107170006120 * 04/09/2017 114,100 114,100
4648 0810R00107170006121 * 04/09/2017 184,900 184,900
4649 0810R00107170006122 * 04/09/2017 184,900 184,900
4650 0810R00107170006123 * 04/09/2017 184,900 184,900
4651 0810R00107170006124 * 04/09/2017 184,900 184,900
4652 0810R00107170006126 * 04/09/2017 184,900 184,900
4653 0810R00107170006127 * 25/08/2017 184,900 184,900
4654 0810R00107170006128 * 04/09/2017 114,100 114,100
4655 0810R00107170006131 * 04/09/2017 184,900 184,900
4656 0810R00107170006132 * 04/09/2017 184,900 184,900
4657 0810R00107170006133 * 04/09/2017 184,900 184,900
4658 0810R00107170006135 * 04/09/2017 186,300 186,300
4659 0810R00107170006136 * 04/09/2017 184,900 184,900
4660 0810R00107170006137 * 04/09/2017 184,900 184,900
4661 0810R00107170006138 * 04/09/2017 186,300 186,300
4662 0810R00107170006139 * 04/09/2017 184,900 184,900
4663 0810R00107170006140 * 04/09/2017 184,900 184,900
4664 0810R00107170006142 * 04/09/2017 184,900 184,900
4665 0810R00107170006143 * 04/09/2017 186,300 186,300
4666 0810R00107170006145 * 04/09/2017 184,900 184,900
4667 0810R00107170006146 * 04/09/2017 184,900 184,900
4668 0810R00107170006147 * 04/09/2017 184,900 184,900
4669 0810R00107170006148 * 04/09/2017 184,900 184,900
4670 0810R00107170006149 * 04/09/2017 184,900 184,900
4671 0810R00107170006150 * 29/08/2017 184,900 184,900
4672 0810R00107170006151 * 29/08/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.115/145

4673 0810R00107170006154 * 04/09/2017 184,900 184,900


4674 0810R00107170006155 * 04/09/2017 114,100 114,100
4675 0810R00107170006156 * 25/08/2017 184,900 184,900
4676 0810R00107170006157 * 04/09/2017 114,100 114,100
4677 0810R00107170006158 * 04/09/2017 114,100 114,100
4678 0810R00107170006159 * 25/08/2017 184,900 184,900
4679 0810R00107170006160 * 04/09/2017 114,100 114,100
4680 0810R00107170006161 * 04/09/2017 184,900 184,900
4681 0810R00107170006162 * 04/09/2017 114,100 114,100
4682 0810R00107170006163 * 04/09/2017 184,900 184,900
4683 0810R00107170006164 * 04/09/2017 114,100 114,100
4684 0810R00107170006165 * 04/09/2017 114,100 114,100
4685 0810R00107170006166 * 04/09/2017 186,300 186,300
4686 0810R00107170006168 * 04/09/2017 114,100 114,100
4687 0810R00107170006169 * 04/09/2017 184,900 184,900
4688 0810R00107170006170 * 04/09/2017 114,100 114,100
4689 0810R00107170006172 * 04/09/2017 114,100 114,100
4690 0810R00107170006173 * 04/09/2017 184,900 184,900
4691 0810R00107170006174 * 04/09/2017 114,100 114,100
4692 0810R00107170006175 * 04/09/2017 114,100 114,100
4693 0810R00107170006176 * 25/08/2017 184,900 184,900
4694 0810R00107170006177 * 04/09/2017 114,100 114,100
4695 0810R00107170006178 * 04/09/2017 114,100 114,100
4696 0810R00107170006179 * 04/09/2017 114,100 114,100
4697 0810R00107170006180 * 25/08/2017 200,700 200,700
4698 0810R00107170006182 * 04/09/2017 184,900 184,900
4699 0810R00107170006183 * 04/09/2017 184,900 184,900
4700 0810R00107170006184 * 04/09/2017 114,100 114,100
4701 0810R00107170006185 * 04/09/2017 184,900 184,900
4702 0810R00107170006186 * 04/09/2017 114,100 114,100
4703 0810R00107170006187 * 04/09/2017 114,100 114,100
4704 0810R00107170006188 * 04/09/2017 184,900 184,900
4705 0810R00107170006189 * 04/09/2017 114,100 114,100
4706 0810R00107170006190 * 04/09/2017 114,100 114,100
4707 0810R00107170006191 * 04/09/2017 184,900 184,900
4708 0810R00107170006192 * 04/09/2017 114,100 114,100
4709 0810R00107170006193 * 04/09/2017 184,900 184,900
4710 0810R00107170006194 * 04/09/2017 155,100 155,100
4711 0810R00107170006195 * 04/09/2017 184,900 184,900
4712 0810R00107170006196 * 04/09/2017 155,100 155,100
4713 0810R00107170006197 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.116/145

4714 0810R00107170006198 * 04/09/2017 114,100 114,100


4715 0810R00107170006199 * 04/09/2017 114,100 114,100
4716 0810R00107170006200 * 04/09/2017 184,900 184,900
4717 0810R00107170006201 * 04/09/2017 155,100 155,100
4718 0810R00107170006202 * 04/09/2017 184,900 184,900
4719 0810R00107170006203 * 04/09/2017 114,100 114,100
4720 0810R00107170006204 * 04/09/2017 114,100 114,100
4721 0810R00107170006205 * 04/09/2017 114,100 114,100
4722 0810R00107170006206 * 04/09/2017 114,100 114,100
4723 0810R00107170006207 * 04/09/2017 114,100 114,100
4724 0810R00107170006208 * 04/09/2017 114,100 114,100
4725 0810R00107170006209 * 04/09/2017 155,100 155,100
4726 0810R00107170006210 * 25/08/2017 200,700 200,700
4727 0810R00107170006211 * 04/09/2017 155,100 155,100
4728 0810R00107170006212 * 04/09/2017 114,100 114,100
4729 0810R00107170006213 * 04/09/2017 186,300 186,300
4730 0810R00107170006214 * 04/09/2017 114,100 114,100
4731 0810R00107170006215 * 04/09/2017 155,100 155,100
4732 0810R00107170006216 * 04/09/2017 184,900 184,900
4733 0810R00107170006217 * 04/09/2017 184,900 184,900
4734 0810R00107170006218 * 04/09/2017 114,100 114,100
4735 0810R00107170006219 * 04/09/2017 155,100 155,100
4736 0810R00107170006220 * 04/09/2017 184,900 184,900
4737 0810R00107170006221 * 04/09/2017 114,100 114,100
4738 0810R00107170006222 * 04/09/2017 184,900 184,900
4739 0810R00107170006223 * 04/09/2017 184,900 184,900
4740 0810R00107170006224 * 04/09/2017 184,900 184,900
4741 0810R00107170006225 * 04/09/2017 114,100 114,100
4742 0810R00107170006226 * 04/09/2017 184,900 184,900
4743 0810R00107170006227 * 04/09/2017 114,100 114,100
4744 0810R00107170006228 * 04/09/2017 186,300 186,300
4745 0810R00107170006229 * 04/09/2017 114,100 114,100
4746 0810R00107170006230 * 25/08/2017 200,700 200,700
4747 0810R00107170006232 * 04/09/2017 114,100 114,100
4748 0810R00107170006233 * 25/08/2017 200,700 200,700
4749 0810R00107170006234 * 04/09/2017 155,100 155,100
4750 0810R00107170006235 * 04/09/2017 184,900 184,900
4751 0810R00107170006236 * 04/09/2017 114,100 114,100
4752 0810R00107170006237 * 04/09/2017 184,900 184,900
4753 0810R00107170006238 * 04/09/2017 114,100 114,100
4754 0810R00107170006239 * 25/08/2017 200,700 200,700
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.117/145

4755 0810R00107170006240 * 04/09/2017 114,100 114,100


4756 0810R00107170006241 * 04/09/2017 184,900 184,900
4757 0810R00107170006242 * 04/09/2017 114,100 114,100
4758 0810R00107170006243 * 04/09/2017 114,100 114,100
4759 0810R00107170006244 * 04/09/2017 155,100 155,100
4760 0810R00107170006245 * 04/09/2017 184,900 184,900
4761 0810R00107170006246 * 04/09/2017 114,100 114,100
4762 0810R00107170006247 * 25/08/2017 184,900 184,900
4763 0810R00107170006248 * 25/08/2017 200,700 200,700
4764 0810R00107170006249 * 04/09/2017 184,900 184,900
4765 0810R00107170006250 * 04/09/2017 114,100 114,100
4766 0810R00107170006251 * 25/08/2017 200,700 200,700
4767 0810R00107170006252 * 04/09/2017 114,100 114,100
4768 0810R00107170006253 * 25/08/2017 184,900 184,900
4769 0810R00107170006254 * 04/09/2017 114,100 114,100
4770 0810R00107170006255 * 04/09/2017 114,100 114,100
4771 0810R00107170006256 * 04/09/2017 114,100 114,100
4772 0810R00107170006257 * 04/09/2017 114,100 114,100
4773 0810R00107170006258 * 04/09/2017 114,100 114,100
4774 0810R00107170006260 * 04/09/2017 114,100 114,100
4775 0810R00107170006261 * 04/09/2017 114,100 114,100
4776 0810R00107170006263 * 04/09/2017 114,100 114,100
4777 0810R00107170006264 * 04/09/2017 114,100 114,100
4778 0810R00107170006265 * 04/09/2017 184,900 184,900
4779 0810R00107170006267 * 25/08/2017 184,900 184,900
4780 0810R00107170006268 * 04/09/2017 114,100 114,100
4781 0810R00107170006269 * 04/09/2017 114,100 114,100
4782 0810R00107170006270 * 04/09/2017 114,100 114,100
4783 0810R00107170006271 * 04/09/2017 184,900 184,900
4784 0810R00107170006272 * 04/09/2017 114,100 114,100
4785 0810R00107170006273 * 04/09/2017 184,900 184,900
4786 0810R00107170006274 * 25/08/2017 200,700 200,700
4787 0810R00107170006277 * 25/08/2017 186,300 186,300
4788 0810R00107170006279 * 04/09/2017 114,100 114,100
4789 0810R00107170006280 * 04/09/2017 114,100 114,100
4790 0810R00107170006281 * 04/09/2017 114,100 114,100
4791 0810R00107170006282 * 04/09/2017 155,100 155,100
4792 0810R00107170006283 * 04/09/2017 114,100 114,100
4793 0810R00107170006284 * 04/09/2017 114,100 114,100
4794 0810R00107170006285 * 04/09/2017 114,100 114,100
4795 0810R00107170006287 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.118/145

4796 0810R00107170006288 * 04/09/2017 155,100 155,100


4797 0810R00107170006289 * 04/09/2017 114,100 114,100
4798 0810R00107170006290 * 04/09/2017 114,100 114,100
4799 0810R00107170006291 * 04/09/2017 114,100 114,100
4800 0810R00107170006292 * 29/08/2017 295,100 295,100
4801 0810R00107170006318 * 04/09/2017 186,300 186,300
4802 0810R00107170006330 * 04/09/2017 186,300 186,300
4803 0810R00107170006331 * 04/09/2017 186,300 186,300
4804 0810R00107170006332 * 04/09/2017 184,900 184,900
4805 0810R00107170006350 * 04/09/2017 184,900 184,900
4806 0810R00107170006352 * 25/08/2017 184,900 184,900
4807 0810R00107170006353 * 04/09/2017 184,900 184,900
4808 0810R00107170006354 * 25/08/2017 215,300 215,300
4809 0810R00107170006355 * 04/09/2017 184,900 184,900
4810 0810R00107170006356 * 04/09/2017 184,900 184,900
4811 0810R00107170006357 * 04/09/2017 184,900 184,900
4812 0810R00107170006358 * 25/08/2017 184,900 184,900
4813 0810R00107170006359 * 25/08/2017 569,300 569,300
4814 0810R00107170006360 * 04/09/2017 184,900 184,900
4815 0810R00107170006361 * 25/08/2017 215,300 215,300
4816 0810R00107170006362 * 25/08/2017 184,900 184,900
4817 0810R00107170006363 * 04/09/2017 184,900 184,900
4818 0810R00107170006364 * 25/08/2017 200,700 200,700
4819 0810R00107170006365 * 25/08/2017 184,900 184,900
4820 0810R00107170006366 * 04/09/2017 114,100 114,100
4821 0810R00107170006368 * 04/09/2017 184,900 184,900
4822 0810R00107170006369 * 04/09/2017 184,900 184,900
4823 0810R00107170006370 * 04/09/2017 184,900 184,900
4824 0810R00107170006371 * 04/09/2017 184,900 184,900
4825 0810R00107170006373 * 29/08/2017 184,900 184,900
4826 0810R00107170006374 * 25/08/2017 569,300 569,300
4827 0810R00107170006375 * 29/08/2017 7,628,000 7,628,000
4828 0810R00107170006376 * 04/09/2017 184,900 184,900
4829 0810R00107170006377 * 04/09/2017 114,100 114,100
4830 0810R00107170006378 * 04/09/2017 184,900 184,900
4831 0810R00107170006379 * 04/09/2017 184,900 184,900
4832 0810R00107170006380 * 04/09/2017 114,100 114,100
4833 0810R00107170006381 * 04/09/2017 155,100 155,100
4834 0810R00107170006382 * 04/09/2017 114,100 114,100
4835 0810R00107170006383 * 25/08/2017 215,300 215,300
4836 0810R00107170006384 * 25/08/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.119/145

4837 0810R00107170006385 * 04/09/2017 114,100 114,100


4838 0810R00107170006386 * 04/09/2017 184,900 184,900
4839 0810R00107170006388 * 04/09/2017 184,900 184,900
4840 0810R00107170006389 * 25/08/2017 184,900 184,900
4841 0810R00107170006390 * 04/09/2017 114,100 114,100
4842 0810R00107170006391 * 25/08/2017 569,300 569,300
4843 0810R00107170006392 * 04/09/2017 114,100 114,100
4844 0810R00107170006393 * 04/09/2017 114,100 114,100
4845 0810R00107170006394 * 25/08/2017 289,400 289,400
4846 0810R00107170006395 * 04/09/2017 114,100 114,100
4847 0810R00107170006396 * 04/09/2017 114,100 114,100
4848 0810R00107170006397 * 04/09/2017 184,900 184,900
4849 0810R00107170006398 * 04/09/2017 114,100 114,100
4850 0810R00107170006399 * 04/09/2017 184,900 184,900
4851 0810R00107170006400 * 04/09/2017 114,100 114,100
4852 0810R00107170006401 * 04/09/2017 184,900 184,900
4853 0810R00107170006402 * 04/09/2017 114,100 114,100
4854 0810R00107170006403 * 04/09/2017 184,900 184,900
4855 0810R00107170006404 * 04/09/2017 114,100 114,100
4856 0810R00107170006405 * 04/09/2017 184,900 184,900
4857 0810R00107170006406 * 04/09/2017 114,100 114,100
4858 0810R00107170006407 * 04/09/2017 184,900 184,900
4859 0810R00107170006408 * 04/09/2017 184,900 184,900
4860 0810R00107170006409 * 04/09/2017 114,100 114,100
4861 0810R00107170006410 * 04/09/2017 114,100 114,100
4862 0810R00107170006412 * 04/09/2017 114,100 114,100
4863 0810R00107170006413 * 04/09/2017 114,100 114,100
4864 0810R00107170006414 * 04/09/2017 114,100 114,100
4865 0810R00107170006415 * 25/08/2017 215,300 215,300
4866 0810R00107170006416 * 25/08/2017 289,400 289,400
4867 0810R00107170006417 * 04/09/2017 114,100 114,100
4868 0810R00107170006419 * 04/09/2017 114,100 114,100
4869 0810R00107170006420 * 25/08/2017 7,628,000 7,628,000
4870 0810R00107170006421 * 25/08/2017 215,300 215,300
4871 0810R00107170006422 * 04/09/2017 114,100 114,100
4872 0810R00107170006423 * 25/08/2017 289,400 289,400
4873 0810R00107170006424 * 04/09/2017 114,100 114,100
4874 0810R00107170006425 * 04/09/2017 184,900 184,900
4875 0810R00107170006426 * 04/09/2017 114,100 114,100
4876 0810R00107170006427 * 25/08/2017 184,900 184,900
4877 0810R00107170006429 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.120/145

4878 0810R00107170006431 * 04/09/2017 184,900 184,900


4879 0810R00107170006432 * 25/08/2017 569,300 569,300
4880 0810R00107170006434 * 04/09/2017 184,900 184,900
4881 0810R00107170006435 * 25/08/2017 184,900 184,900
4882 0810R00107170006436 * 04/09/2017 114,100 114,100
4883 0810R00107170006437 * 04/09/2017 114,100 114,100
4884 0810R00107170006439 * 04/09/2017 114,100 114,100
4885 0810R00107170006440 * 25/08/2017 184,900 184,900
4886 0810R00107170006441 * 25/08/2017 569,300 569,300
4887 0810R00107170006442 * 04/09/2017 114,100 114,100
4888 0810R00107170006443 * 04/09/2017 114,100 114,100
4889 0810R00107170006444 * 04/09/2017 114,100 114,100
4890 0810R00107170006445 * 04/09/2017 184,900 184,900
4891 0810R00107170006446 * 04/09/2017 114,100 114,100
4892 0810R00107170006447 * 04/09/2017 184,900 184,900
4893 0810R00107170006448 * 04/09/2017 114,100 114,100
4894 0810R00107170006451 * 04/09/2017 184,900 184,900
4895 0810R00107170006452 * 04/09/2017 114,100 114,100
4896 0810R00107170006453 * 25/08/2017 184,900 184,900
4897 0810R00107170006454 * 04/09/2017 184,900 184,900
4898 0810R00107170006455 * 04/09/2017 184,900 184,900
4899 0810R00107170006456 * 04/09/2017 184,900 184,900
4900 0810R00107170006458 * 04/09/2017 114,100 114,100
4901 0810R00107170006460 * 04/09/2017 184,900 184,900
4902 0810R00107170006461 * 04/09/2017 114,100 114,100
4903 0810R00107170006462 * 04/09/2017 184,900 184,900
4904 0810R00107170006463 * 04/09/2017 184,900 184,900
4905 0810R00107170006464 * 04/09/2017 114,100 114,100
4906 0810R00107170006465 * 04/09/2017 114,100 114,100
4907 0810R00107170006466 * 04/09/2017 184,900 184,900
4908 0810R00107170006467 * 04/09/2017 155,100 155,100
4909 0810R00107170006468 * 25/08/2017 184,900 184,900
4910 0810R00107170006469 * 25/08/2017 242,700 242,700
4911 0810R00107170006470 * 04/09/2017 114,100 114,100
4912 0810R00107170006471 * 04/09/2017 184,900 184,900
4913 0810R00107170006472 * 25/08/2017 184,900 184,900
4914 0810R00107170006473 * 04/09/2017 114,100 114,100
4915 0810R00107170006474 * 25/08/2017 184,900 184,900
4916 0810R00107170006475 * 04/09/2017 114,100 114,100
4917 0810R00107170006477 * 25/08/2017 184,900 184,900
4918 0810R00107170006478 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.121/145

4919 0810R00107170006479 * 04/09/2017 114,100 114,100


4920 0810R00107170006480 * 04/09/2017 114,100 114,100
4921 0810R00107170006481 * 04/09/2017 141,300 141,300
4922 0810R00107170006482 * 25/08/2017 314,500 314,500
4923 0810R00107170006483 * 04/09/2017 114,100 114,100
4924 0810R00107170006484 * 04/09/2017 184,900 184,900
4925 0810R00107170006485 * 04/09/2017 114,100 114,100
4926 0810R00107170006486 * 04/09/2017 114,100 114,100
4927 0810R00107170006487 * 04/09/2017 184,900 184,900
4928 0810R00107170006488 * 04/09/2017 184,900 184,900
4929 0810R00107170006489 * 04/09/2017 114,100 114,100
4930 0810R00107170006493 * 25/08/2017 215,300 215,300
4931 0810R00107170006494 * 04/09/2017 114,100 114,100
4932 0810R00107170006495 * 04/09/2017 114,100 114,100
4933 0810R00107170006496 * 04/09/2017 184,900 184,900
4934 0810R00107170006497 * 04/09/2017 155,100 155,100
4935 0810R00107170006498 * 04/09/2017 184,900 184,900
4936 0810R00107170006499 * 04/09/2017 114,100 114,100
4937 0810R00107170006500 * 25/08/2017 242,700 242,700
4938 0810R00107170006501 * 04/09/2017 114,100 114,100
4939 0810R00107170006502 * 04/09/2017 184,900 184,900
4940 0810R00107170006503 * 04/09/2017 114,100 114,100
4941 0810R00107170006504 * 04/09/2017 184,900 184,900
4942 0810R00107170006505 * 04/09/2017 184,900 184,900
4943 0810R00107170006506 * 04/09/2017 114,100 114,100
4944 0810R00107170006507 * 25/08/2017 184,900 184,900
4945 0810R00107170006508 * 04/09/2017 184,900 184,900
4946 0810R00107170006509 * 04/09/2017 184,900 184,900
4947 0810R00107170006510 * 04/09/2017 114,100 114,100
4948 0810R00107170006511 * 04/09/2017 114,100 114,100
4949 0810R00107170006512 * 04/09/2017 155,100 155,100
4950 0810R00107170006515 * 04/09/2017 114,100 114,100
4951 0810R00107170006516 * 04/09/2017 114,100 114,100
4952 0810R00107170006517 * 04/09/2017 184,900 184,900
4953 0810R00107170006518 * 04/09/2017 114,100 114,100
4954 0810R00107170006519 * 04/09/2017 184,900 184,900
4955 0810R00107170006520 * 04/09/2017 114,100 114,100
4956 0810R00107170006521 * 04/09/2017 114,100 114,100
4957 0810R00107170006522 * 04/09/2017 114,100 114,100
4958 0810R00107170006524 * 04/09/2017 114,100 114,100
4959 0810R00107170006525 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.122/145

4960 0810R00107170006526 * 04/09/2017 114,100 114,100


4961 0810R00107170006527 * 04/09/2017 184,900 184,900
4962 0810R00107170006528 * 04/09/2017 114,100 114,100
4963 0810R00107170006530 * 25/08/2017 215,300 215,300
4964 0810R00107170006531 * 25/08/2017 184,900 184,900
4965 0810R00107170006532 * 25/08/2017 215,300 215,300
4966 0810R00107170006533 * 25/08/2017 215,300 215,300
4967 0810R00107170006534 * 04/09/2017 114,100 114,100
4968 0810R00107170006535 * 04/09/2017 114,100 114,100
4969 0810R00107170006536 * 04/09/2017 114,100 114,100
4970 0810R00107170006537 * 04/09/2017 114,100 114,100
4971 0810R00107170006538 * 04/09/2017 114,100 114,100
4972 0810R00107170006539 * 04/09/2017 114,100 114,100
4973 0810R00107170006540 * 04/09/2017 114,100 114,100
4974 0810R00107170006541 * 04/09/2017 114,100 114,100
4975 0810R00107170006542 * 04/09/2017 114,100 114,100
4976 0810R00107170006543 * 04/09/2017 114,100 114,100
4977 0810R00107170006547 * 04/09/2017 155,100 155,100
4978 0810R00107170006548 * 04/09/2017 114,100 114,100
4979 0810R00107170006549 * 04/09/2017 114,100 114,100
4980 0810R00107170006550 * 04/09/2017 155,100 155,100
4981 0810R00107170006551 * 04/09/2017 184,900 184,900
4982 0810R00107170006552 * 04/09/2017 114,100 114,100
4983 0810R00107170006553 * 04/09/2017 184,900 184,900
4984 0810R00107170006555 * 04/09/2017 114,100 114,100
4985 0810R00107170006556 * 04/09/2017 155,100 155,100
4986 0810R00107170006557 * 04/09/2017 114,100 114,100
4987 0810R00107170006558 * 04/09/2017 114,100 114,100
4988 0810R00107170006559 * 04/09/2017 114,100 114,100
4989 0810R00107170006560 * 04/09/2017 114,100 114,100
4990 0810R00107170006562 * 04/09/2017 114,100 114,100
4991 0810R00107170006564 * 25/08/2017 569,300 569,300
4992 0810R00107170006565 * 04/09/2017 114,100 114,100
4993 0810R00107170006566 * 04/09/2017 114,100 114,100
4994 0810R00107170006567 * 04/09/2017 155,100 155,100
4995 0810R00107170006568 * 04/09/2017 184,900 184,900
4996 0810R00107170006569 * 04/09/2017 114,100 114,100
4997 0810R00107170006570 * 04/09/2017 114,100 114,100
4998 0810R00107170006571 * 04/09/2017 114,100 114,100
4999 0810R00107170006572 * 04/09/2017 114,100 114,100
5000 0810R00107170006573 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.123/145

5001 0810R00107170006574 * 04/09/2017 114,100 114,100


5002 0810R00107170006575 * 04/09/2017 114,100 114,100
5003 0810R00107170006576 * 04/09/2017 114,100 114,100
5004 0810R00107170006577 * 04/09/2017 155,100 155,100
5005 0810R00107170006578 * 04/09/2017 155,100 155,100
5006 0810R00107170006580 * 25/08/2017 289,400 289,400
5007 0810R00107170006582 * 25/08/2017 184,900 184,900
5008 0810R00107170006584 * 04/09/2017 184,900 184,900
5009 0810R00107170006585 * 25/08/2017 887,100 887,100
5010 0810R00107170006586 * 04/09/2017 887,100 887,100
5011 0810R00107170006587 * 04/09/2017 887,100 887,100
5012 0810R00107170006588 * 04/09/2017 887,100 887,100
5013 0810R00107170006589 * 04/09/2017 887,100 887,100
5014 0810R00107170006591 * 04/09/2017 887,100 887,100
5015 0810R00107170006592 * 04/09/2017 457,300 457,300
5016 0810R00107170006593 * 04/09/2017 887,100 887,100
5017 0810R00107170006594 * 04/09/2017 887,100 887,100
5018 0810R00107170006595 * 04/09/2017 887,100 887,100
5019 0810R00107170006596 * 04/09/2017 887,100 887,100
5020 0810R00107170006598 * 04/09/2017 887,100 887,100
5021 0810R00107170006599 * 04/09/2017 887,100 887,100
5022 0810R00107170006600 * 04/09/2017 887,100 887,100
5023 0810R00107170006601 * 04/09/2017 887,100 887,100
5024 0810R00107170006602 * 04/09/2017 887,100 887,100
5025 0810R00107170006603 * 04/09/2017 887,100 887,100
5026 0810R00107170006604 * 04/09/2017 887,100 887,100
5027 0810R00107170006605 * 04/09/2017 887,100 887,100
5028 0810R00107170006606 * 04/09/2017 887,100 887,100
5029 0810R00107170006607 * 04/09/2017 887,100 887,100
5030 0810R00107170006608 * 04/09/2017 887,100 887,100
5031 0810R00107170006609 * 04/09/2017 887,100 887,100
5032 0810R00107170006610 * 04/09/2017 887,100 887,100
5033 0810R00107170006611 * 04/09/2017 887,100 887,100
5034 0810R00107170006612 * 04/09/2017 887,100 887,100
5035 0810R00107170006614 * 04/09/2017 887,100 887,100
5036 0810R00107170006615 * 04/09/2017 887,100 887,100
5037 0810R00107170006616 * 04/09/2017 887,100 887,100
5038 0810R00107170006617 * 04/09/2017 887,100 887,100
5039 0810R00107170006618 * 04/09/2017 887,100 887,100
5040 0810R00107170006619 * 04/09/2017 887,100 887,100
5041 0810R00107170006620 * 04/09/2017 887,100 887,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.124/145

5042 0810R00107170006621 * 04/09/2017 887,100 887,100


5043 0810R00107170006622 * 04/09/2017 887,100 887,100
5044 0810R00107170006624 * 04/09/2017 887,100 887,100
5045 0810R00107170006625 * 04/09/2017 569,300 569,300
5046 0810R00107170006626 * 04/09/2017 887,100 887,100
5047 0810R00107170006627 * 04/09/2017 887,100 887,100
5048 0810R00107170006628 * 04/09/2017 887,100 887,100
5049 0810R00107170006629 * 04/09/2017 887,100 887,100
5050 0810R00107170006630 * 04/09/2017 887,100 887,100
5051 0810R00107170006631 * 04/09/2017 887,100 887,100
5052 0810R00107170006632 * 04/09/2017 887,100 887,100
5053 0810R00107170006633 * 04/09/2017 887,100 887,100
5054 0810R00107170006635 * 04/09/2017 887,100 887,100
5055 0810R00107170006636 * 04/09/2017 887,100 887,100
5056 0810R00107170006637 * 04/09/2017 887,100 887,100
5057 0810R00107170006638 * 04/09/2017 887,100 887,100
5058 0810R00107170006640 * 04/09/2017 887,100 887,100
5059 0810R00107170006642 * 04/09/2017 184,900 184,900
5060 0810R00107170006643 * 04/09/2017 887,100 887,100
5061 0810R00107170006644 * 04/09/2017 887,100 887,100
5062 0810R00107170006650 * 25/08/2017 314,500 314,500
5063 0810R00107170006663 * 25/08/2017 259,800 259,800
5064 0810R00107170006664 * 04/09/2017 183,900 183,900
5065 0810R00107170006674 * 25/08/2017 314,500 314,500
5066 0810R00107170006683 * 04/09/2017 184,900 184,900
5067 0810R00107170006684 * 04/09/2017 186,300 186,300
5068 0810R00107170006686 * 25/08/2017 314,500 314,500
5069 0810R00107170006692 * 04/09/2017 184,900 184,900
5070 0810R00107170006694 * 25/08/2017 184,900 184,900
5071 0810R00107170006695 * 25/08/2017 184,900 184,900
5072 0810R00107170006696 * 25/08/2017 184,900 184,900
5073 0810R00107170006697 * 04/09/2017 184,900 184,900
5074 0810R00107170006698 * 04/09/2017 184,900 184,900
5075 0810R00107170006700 * 04/09/2017 184,900 184,900
5076 0810R00107170006703 * 04/09/2017 184,900 184,900
5077 0810R00107170006704 * 04/09/2017 184,900 184,900
5078 0810R00107170006705 * 25/08/2017 184,900 184,900
5079 0810R00107170006706 * 25/08/2017 184,900 184,900
5080 0810R00107170006707 * 04/09/2017 184,900 184,900
5081 0810R00107170006708 * 25/08/2017 184,900 184,900
5082 0810R00107170006709 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.125/145

5083 0810R00107170006710 * 04/09/2017 114,100 114,100


5084 0810R00107170006711 * 04/09/2017 114,100 114,100
5085 0810R00107170006712 * 04/09/2017 114,100 114,100
5086 0810R00107170006713 * 04/09/2017 114,100 114,100
5087 0810R00107170006714 * 04/09/2017 114,100 114,100
5088 0810R00107170006715 * 04/09/2017 184,900 184,900
5089 0810R00107170006716 * 04/09/2017 114,100 114,100
5090 0810R00107170006717 * 04/09/2017 184,900 184,900
5091 0810R00107170006718 * 04/09/2017 114,100 114,100
5092 0810R00107170006719 * 04/09/2017 184,900 184,900
5093 0810R00107170006720 * 04/09/2017 184,900 184,900
5094 0810R00107170006721 * 04/09/2017 155,100 155,100
5095 0810R00107170006722 * 04/09/2017 114,100 114,100
5096 0810R00107170006723 * 04/09/2017 155,100 155,100
5097 0810R00107170006724 * 04/09/2017 184,900 184,900
5098 0810R00107170006725 * 04/09/2017 141,300 141,300
5099 0810R00107170006726 * 25/08/2017 215,300 215,300
5100 0810R00107170006727 * 04/09/2017 184,900 184,900
5101 0810R00107170006728 * 04/09/2017 184,900 184,900
5102 0810R00107170006729 * 04/09/2017 184,900 184,900
5103 0810R00107170006730 * 25/08/2017 184,900 184,900
5104 0810R00107170006731 * 04/09/2017 184,900 184,900
5105 0810R00107170006732 * 04/09/2017 184,900 184,900
5106 0810R00107170006733 * 25/08/2017 184,900 184,900
5107 0810R00107170006734 * 04/09/2017 184,900 184,900
5108 0810R00107170006735 * 04/09/2017 184,900 184,900
5109 0810R00107170006737 * 25/08/2017 184,900 184,900
5110 0810R00107170006738 * 04/09/2017 184,900 184,900
5111 0810R00107170006739 * 04/09/2017 184,900 184,900
5112 0810R00107170006740 * 04/09/2017 184,900 184,900
5113 0810R00107170006741 * 04/09/2017 114,100 114,100
5114 0810R00107170006742 * 04/09/2017 114,100 114,100
5115 0810R00107170006747 * 04/09/2017 114,100 114,100
5116 0810R00107170006748 * 04/09/2017 114,100 114,100
5117 0810R00107170006750 * 04/09/2017 184,900 184,900
5118 0810R00107170006752 * 04/09/2017 114,100 114,100
5119 0810R00107170006753 * 04/09/2017 184,900 184,900
5120 0810R00107170006754 * 04/09/2017 184,900 184,900
5121 0810R00107170006755 * 04/09/2017 184,900 184,900
5122 0810R00107170006756 * 04/09/2017 114,100 114,100
5123 0810R00107170006757 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.126/145

5124 0810R00107170006758 * 04/09/2017 114,100 114,100


5125 0810R00107170006759 * 25/08/2017 289,400 289,400
5126 0810R00107170006760 * 04/09/2017 114,100 114,100
5127 0810R00107170006761 * 25/08/2017 184,900 184,900
5128 0810R00107170006762 * 04/09/2017 114,100 114,100
5129 0810R00107170006763 * 04/09/2017 114,100 114,100
5130 0810R00107170006765 * 04/09/2017 114,100 114,100
5131 0810R00107170006766 * 04/09/2017 114,100 114,100
5132 0810R00107170006767 * 04/09/2017 184,900 184,900
5133 0810R00107170006768 * 04/09/2017 114,100 114,100
5134 0810R00107170006769 * 04/09/2017 184,900 184,900
5135 0810R00107170006770 * 25/08/2017 184,900 184,900
5136 0810R00107170006771 * 04/09/2017 155,100 155,100
5137 0810R00107170006772 * 04/09/2017 184,900 184,900
5138 0810R00107170006773 * 04/09/2017 114,100 114,100
5139 0810R00107170006774 * 04/09/2017 184,900 184,900
5140 0810R00107170006776 * 04/09/2017 184,900 184,900
5141 0810R00107170006777 * 04/09/2017 184,900 184,900
5142 0810R00107170006778 * 25/08/2017 184,900 184,900
5143 0810R00107170006779 * 04/09/2017 155,100 155,100
5144 0810R00107170006780 * 04/09/2017 184,900 184,900
5145 0810R00107170006782 * 04/09/2017 184,900 184,900
5146 0810R00107170006783 * 04/09/2017 114,100 114,100
5147 0810R00107170006784 * 04/09/2017 184,900 184,900
5148 0810R00107170006785 * 04/09/2017 184,900 184,900
5149 0810R00107170006786 * 04/09/2017 114,100 114,100
5150 0810R00107170006787 * 04/09/2017 184,900 184,900
5151 0810R00107170006789 * 04/09/2017 114,100 114,100
5152 0810R00107170006790 * 04/09/2017 114,100 114,100
5153 0810R00107170006791 * 04/09/2017 114,100 114,100
5154 0810R00107170006792 * 04/09/2017 114,100 114,100
5155 0810R00107170006793 * 04/09/2017 114,100 114,100
5156 0810R00107170006795 * 04/09/2017 114,100 114,100
5157 0810R00107170006796 * 04/09/2017 114,100 114,100
5158 0810R00107170006797 * 04/09/2017 184,900 184,900
5159 0810R00107170006798 * 04/09/2017 114,100 114,100
5160 0810R00107170006799 * 04/09/2017 114,100 114,100
5161 0810R00107170006800 * 04/09/2017 184,900 184,900
5162 0810R00107170006801 * 04/09/2017 155,100 155,100
5163 0810R00107170006802 * 04/09/2017 184,900 184,900
5164 0810R00107170006803 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.127/145

5165 0810R00107170006804 * 25/08/2017 184,900 184,900


5166 0810R00107170006805 * 04/09/2017 155,100 155,100
5167 0810R00107170006806 * 04/09/2017 184,900 184,900
5168 0810R00107170006807 * 04/09/2017 114,100 114,100
5169 0810R00107170006808 * 04/09/2017 184,900 184,900
5170 0810R00107170006809 * 04/09/2017 114,100 114,100
5171 0810R00107170006810 * 04/09/2017 184,900 184,900
5172 0810R00107170006811 * 25/08/2017 184,900 184,900
5173 0810R00107170006812 * 04/09/2017 155,100 155,100
5174 0810R00107170006813 * 04/09/2017 184,900 184,900
5175 0810R00107170006814 * 04/09/2017 184,900 184,900
5176 0810R00107170006815 * 25/08/2017 184,900 184,900
5177 0810R00107170006816 * 04/09/2017 184,900 184,900
5178 0810R00107170006817 * 04/09/2017 184,900 184,900
5179 0810R00107170006818 * 25/08/2017 215,300 215,300
5180 0810R00107170006819 * 04/09/2017 184,900 184,900
5181 0810R00107170006820 * 25/08/2017 184,900 184,900
5182 0810R00107170006821 * 04/09/2017 184,900 184,900
5183 0810R00107170006822 * 04/09/2017 184,900 184,900
5184 0810R00107170006823 * 25/08/2017 184,900 184,900
5185 0810R00107170006826 * 04/09/2017 184,900 184,900
5186 0810R00107170006827 * 04/09/2017 184,900 184,900
5187 0810R00107170006828 * 25/08/2017 184,900 184,900
5188 0810R00107170006829 * 04/09/2017 184,900 184,900
5189 0810R00107170006830 * 04/09/2017 186,300 186,300
5190 0810R00107170006831 * 04/09/2017 184,900 184,900
5191 0810R00107170006832 * 04/09/2017 184,900 184,900
5192 0810R00107170006833 * 04/09/2017 184,900 184,900
5193 0810R00107170006834 * 04/09/2017 114,100 114,100
5194 0810R00107170006835 * 04/09/2017 114,100 114,100
5195 0810R00107170006836 * 04/09/2017 155,100 155,100
5196 0810R00107170006837 * 04/09/2017 155,100 155,100
5197 0810R00107170006838 * 04/09/2017 114,100 114,100
5198 0810R00107170006839 * 04/09/2017 114,100 114,100
5199 0810R00107170006840 * 04/09/2017 114,100 114,100
5200 0810R00107170006841 * 04/09/2017 114,100 114,100
5201 0810R00107170006842 * 04/09/2017 114,100 114,100
5202 0810R00107170006843 * 04/09/2017 114,100 114,100
5203 0810R00107170006844 * 04/09/2017 114,100 114,100
5204 0810R00107170006845 * 04/09/2017 114,100 114,100
5205 0810R00107170006846 * 25/08/2017 295,500 295,500
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.128/145

5206 0810R00107170006847 * 04/09/2017 114,100 114,100


5207 0810R00107170006848 * 04/09/2017 114,100 114,100
5208 0810R00107170006849 * 04/09/2017 114,100 114,100
5209 0810R00107170006850 * 04/09/2017 114,100 114,100
5210 0810R00107170006851 * 04/09/2017 114,100 114,100
5211 0810R00107170006853 * 04/09/2017 114,100 114,100
5212 0810R00107170006854 * 04/09/2017 114,100 114,100
5213 0810R00107170006855 * 04/09/2017 114,100 114,100
5214 0810R00107170006856 * 04/09/2017 114,100 114,100
5215 0810R00107170006858 * 04/09/2017 314,500 314,500
5216 0810R00107170006859 * 04/09/2017 155,100 155,100
5217 0810R00107170006860 * 04/09/2017 114,100 114,100
5218 0810R00107170006862 * 04/09/2017 114,100 114,100
5219 0810R00107170006863 * 04/09/2017 114,100 114,100
5220 0810R00107170006864 * 04/09/2017 114,100 114,100
5221 0810R00107170006865 * 04/09/2017 114,100 114,100
5222 0810R00107170006866 * 04/09/2017 114,100 114,100
5223 0810R00107170006867 * 04/09/2017 114,100 114,100
5224 0810R00107170006870 * 04/09/2017 184,900 184,900
5225 0810R00107170006871 * 04/09/2017 186,300 186,300
5226 0810R00107170006873 * 04/09/2017 184,900 184,900
5227 0810R00107170006874 * 04/09/2017 184,900 184,900
5228 0810R00107170006875 * 25/08/2017 184,900 184,900
5229 0810R00107170006877 * 04/09/2017 184,900 184,900
5230 0810R00107170006878 * 04/09/2017 184,900 184,900
5231 0810R00107170006879 * 04/09/2017 184,900 184,900
5232 0810R00107170006880 * 04/09/2017 155,100 155,100
5233 0810R00107170006881 * 04/09/2017 114,100 114,100
5234 0810R00107170006882 * 04/09/2017 114,100 114,100
5235 0810R00107170006883 * 04/09/2017 114,100 114,100
5236 0810R00107170006885 * 04/09/2017 184,900 184,900
5237 0810R00107170006886 * 04/09/2017 114,100 114,100
5238 0810R00107170006888 * 04/09/2017 114,100 114,100
5239 0810R00107170006889 * 04/09/2017 114,100 114,100
5240 0810R00107170006890 * 04/09/2017 184,900 184,900
5241 0810R00107170006891 * 04/09/2017 114,100 114,100
5242 0810R00107170006892 * 04/09/2017 184,900 184,900
5243 0810R00107170006893 * 04/09/2017 155,100 155,100
5244 0810R00107170006894 * 25/08/2017 184,900 184,900
5245 0810R00107170006895 * 04/09/2017 114,100 114,100
5246 0810R00107170006896 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.129/145

5247 0810R00107170006897 * 04/09/2017 114,100 114,100


5248 0810R00107170006898 * 04/09/2017 155,100 155,100
5249 0810R00107170006899 * 04/09/2017 184,900 184,900
5250 0810R00107170006900 * 04/09/2017 114,100 114,100
5251 0810R00107170006901 * 04/09/2017 114,100 114,100
5252 0810R00107170006902 * 04/09/2017 114,100 114,100
5253 0810R00107170006903 * 04/09/2017 184,900 184,900
5254 0810R00107170006904 * 04/09/2017 114,100 114,100
5255 0810R00107170006905 * 04/09/2017 114,100 114,100
5256 0810R00107170006906 * 04/09/2017 184,900 184,900
5257 0810R00107170006907 * 04/09/2017 114,100 114,100
5258 0810R00107170006908 * 04/09/2017 184,900 184,900
5259 0810R00107170006909 * 04/09/2017 114,100 114,100
5260 0810R00107170006910 * 04/09/2017 184,900 184,900
5261 0810R00107170006911 * 04/09/2017 114,100 114,100
5262 0810R00107170006912 * 04/09/2017 114,100 114,100
5263 0810R00107170006913 * 04/09/2017 155,100 155,100
5264 0810R00107170006914 * 04/09/2017 114,100 114,100
5265 0810R00107170006915 * 04/09/2017 114,100 114,100
5266 0810R00107170006916 * 04/09/2017 114,100 114,100
5267 0810R00107170006917 * 04/09/2017 184,900 184,900
5268 0810R00107170006918 * 04/09/2017 114,100 114,100
5269 0810R00107170006920 * 04/09/2017 184,900 184,900
5270 0810R00107170006922 * 04/09/2017 114,100 114,100
5271 0810R00107170006923 * 25/08/2017 569,300 569,300
5272 0810R00107170006924 * 04/09/2017 114,100 114,100
5273 0810R00107170006925 * 04/09/2017 114,100 114,100
5274 0810R00107170006926 * 04/09/2017 114,100 114,100
5275 0810R00107170006928 * 04/09/2017 114,100 114,100
5276 0810R00107170006929 * 04/09/2017 114,100 114,100
5277 0810R00107170006930 * 04/09/2017 114,100 114,100
5278 0810R00107170006931 * 04/09/2017 184,900 184,900
5279 0810R00107170006932 * 04/09/2017 114,100 114,100
5280 0810R00107170006933 * 04/09/2017 114,100 114,100
5281 0810R00107170006934 * 04/09/2017 114,100 114,100
5282 0810R00107170006935 * 25/08/2017 184,900 184,900
5283 0810R00107170006936 * 04/09/2017 114,100 114,100
5284 0810R00107170006937 * 04/09/2017 114,100 114,100
5285 0810R00107170006938 * 04/09/2017 114,100 114,100
5286 0810R00107170006939 * 04/09/2017 887,100 887,100
5287 0810R00107170006940 * 25/08/2017 280,800 280,800
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.130/145

5288 0810R00107170006941 * 04/09/2017 114,100 114,100


5289 0810R00107170006942 * 04/09/2017 114,100 114,100
5290 0810R00107170006943 * 04/09/2017 887,100 887,100
5291 0810R00107170006945 * 04/09/2017 887,100 887,100
5292 0810R00107170006946 * 04/09/2017 887,100 887,100
5293 0810R00107170006948 * 04/09/2017 887,100 887,100
5294 0810R00107170006950 * 04/09/2017 887,100 887,100
5295 0810R00107170006951 * 04/09/2017 887,100 887,100
5296 0810R00107170006952 * 04/09/2017 887,100 887,100
5297 0810R00107170006953 * 04/09/2017 887,100 887,100
5298 0810R00107170006954 * 04/09/2017 887,100 887,100
5299 0810R00107170006955 * 04/09/2017 887,100 887,100
5300 0810R00107170006956 * 04/09/2017 887,100 887,100
5301 0810R00107170006957 * 04/09/2017 887,100 887,100
5302 0810R00107170006958 * 04/09/2017 887,100 887,100
5303 0810R00107170006959 * 04/09/2017 887,100 887,100
5304 0810R00107170006960 * 04/09/2017 887,100 887,100
5305 0810R00107170006961 * 04/09/2017 887,100 887,100
5306 0810R00107170006962 * 04/09/2017 887,100 887,100
5307 0810R00107170006963 * 04/09/2017 887,100 887,100
5308 0810R00107170006964 * 04/09/2017 887,100 887,100
5309 0810R00107170006965 * 04/09/2017 887,100 887,100
5310 0810R00107170006966 * 04/09/2017 887,100 887,100
5311 0810R00107170006967 * 04/09/2017 887,100 887,100
5312 0810R00107170006968 * 04/09/2017 887,100 887,100
5313 0810R00107170006976 * 04/09/2017 184,900 184,900
5314 0810R00107170006977 * 04/09/2017 186,300 186,300
5315 0810R00107170006978 * 04/09/2017 186,300 186,300
5316 0810R00107170006980 * 04/09/2017 186,300 186,300
5317 0810R00107170006986 * 25/08/2017 314,500 314,500
5318 0810R00107170006991 * 25/08/2017 314,500 314,500
5319 0810R00107170006996 * 04/09/2017 186,300 186,300
5320 0810R00107170006997 * 25/08/2017 314,500 314,500
5321 0810R00107170006999 * 04/09/2017 186,300 186,300
5322 0810R00107170007008 * 25/08/2017 314,500 314,500
5323 0810R00107170007017 * 25/08/2017 569,300 569,300
5324 0810R00107170007019 * 25/08/2017 184,900 184,900
5325 0810R00107170007020 * 25/08/2017 184,900 184,900
5326 0810R00107170007021 * 04/09/2017 184,900 184,900
5327 0810R00107170007022 * 04/09/2017 184,900 184,900
5328 0810R00107170007023 * 25/08/2017 289,400 289,400
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.131/145

5329 0810R00107170007024 * 25/08/2017 184,900 184,900


5330 0810R00107170007025 * 04/09/2017 184,900 184,900
5331 0810R00107170007026 * 04/09/2017 184,900 184,900
5332 0810R00107170007027 * 04/09/2017 114,100 114,100
5333 0810R00107170007028 * 04/09/2017 114,100 114,100
5334 0810R00107170007029 * 04/09/2017 114,100 114,100
5335 0810R00107170007031 * 04/09/2017 114,100 114,100
5336 0810R00107170007032 * 04/09/2017 114,100 114,100
5337 0810R00107170007033 * 04/09/2017 184,900 184,900
5338 0810R00107170007034 * 04/09/2017 114,100 114,100
5339 0810R00107170007035 * 04/09/2017 184,900 184,900
5340 0810R00107170007036 * 25/08/2017 184,900 184,900
5341 0810R00107170007037 * 25/08/2017 184,900 184,900
5342 0810R00107170007038 * 04/09/2017 184,900 184,900
5343 0810R00107170007039 * 25/08/2017 184,900 184,900
5344 0810R00107170007040 * 04/09/2017 114,100 114,100
5345 0810R00107170007042 * 04/09/2017 114,100 114,100
5346 0810R00107170007043 * 04/09/2017 114,100 114,100
5347 0810R00107170007044 * 04/09/2017 114,100 114,100
5348 0810R00107170007045 * 04/09/2017 114,100 114,100
5349 0810R00107170007046 * 04/09/2017 114,100 114,100
5350 0810R00107170007047 * 04/09/2017 114,100 114,100
5351 0810R00107170007048 * 04/09/2017 114,100 114,100
5352 0810R00107170007049 * 04/09/2017 184,900 184,900
5353 0810R00107170007050 * 04/09/2017 114,100 114,100
5354 0810R00107170007051 * 04/09/2017 114,100 114,100
5355 0810R00107170007052 * 04/09/2017 114,100 114,100
5356 0810R00107170007053 * 04/09/2017 114,100 114,100
5357 0810R00107170007054 * 04/09/2017 114,100 114,100
5358 0810R00107170007055 * 04/09/2017 114,100 114,100
5359 0810R00107170007056 * 04/09/2017 114,100 114,100
5360 0810R00107170007057 * 04/09/2017 114,100 114,100
5361 0810R00107170007058 * 04/09/2017 114,100 114,100
5362 0810R00107170007059 * 04/09/2017 114,100 114,100
5363 0810R00107170007060 * 04/09/2017 114,100 114,100
5364 0810R00107170007061 * 04/09/2017 114,100 114,100
5365 0810R00107170007062 * 04/09/2017 114,100 114,100
5366 0810R00107170007063 * 04/09/2017 114,100 114,100
5367 0810R00107170007064 * 04/09/2017 184,900 184,900
5368 0810R00107170007065 * 04/09/2017 114,100 114,100
5369 0810R00107170007066 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.132/145

5370 0810R00107170007068 * 25/08/2017 184,900 184,900


5371 0810R00107170007069 * 04/09/2017 114,100 114,100
5372 0810R00107170007070 * 04/09/2017 114,100 114,100
5373 0810R00107170007071 * 25/08/2017 184,900 184,900
5374 0810R00107170007072 * 04/09/2017 114,100 114,100
5375 0810R00107170007073 * 04/09/2017 114,100 114,100
5376 0810R00107170007074 * 04/09/2017 114,100 114,100
5377 0810R00107170007076 * 04/09/2017 114,100 114,100
5378 0810R00107170007077 * 04/09/2017 184,900 184,900
5379 0810R00107170007078 * 25/08/2017 184,900 184,900
5380 0810R00107170007079 * 04/09/2017 114,100 114,100
5381 0810R00107170007080 * 04/09/2017 155,100 155,100
5382 0810R00107170007081 * 25/08/2017 184,900 184,900
5383 0810R00107170007082 * 04/09/2017 114,100 114,100
5384 0810R00107170007083 * 04/09/2017 114,100 114,100
5385 0810R00107170007084 * 04/09/2017 114,100 114,100
5386 0810R00107170007085 * 04/09/2017 114,100 114,100
5387 0810R00107170007086 * 04/09/2017 114,100 114,100
5388 0810R00107170007087 * 04/09/2017 114,100 114,100
5389 0810R00107170007088 * 04/09/2017 114,100 114,100
5390 0810R00107170007089 * 04/09/2017 114,100 114,100
5391 0810R00107170007091 * 04/09/2017 114,100 114,100
5392 0810R00107170007092 * 04/09/2017 114,100 114,100
5393 0810R00107170007093 * 04/09/2017 184,900 184,900
5394 0810R00107170007094 * 04/09/2017 114,100 114,100
5395 0810R00107170007095 * 04/09/2017 114,100 114,100
5396 0810R00107170007096 * 04/09/2017 114,100 114,100
5397 0810R00107170007097 * 04/09/2017 114,100 114,100
5398 0810R00107170007098 * 04/09/2017 114,100 114,100
5399 0810R00107170007099 * 04/09/2017 184,900 184,900
5400 0810R00107170007100 * 04/09/2017 114,100 114,100
5401 0810R00107170007101 * 04/09/2017 184,900 184,900
5402 0810R00107170007102 * 04/09/2017 155,100 155,100
5403 0810R00107170007103 * 25/08/2017 184,900 184,900
5404 0810R00107170007104 * 25/08/2017 215,300 215,300
5405 0810R00107170007106 * 04/09/2017 155,100 155,100
5406 0810R00107170007107 * 04/09/2017 114,100 114,100
5407 0810R00107170007109 * 25/08/2017 184,900 184,900
5408 0810R00107170007110 * 25/08/2017 215,300 215,300
5409 0810R00107170007111 * 25/08/2017 184,900 184,900
5410 0810R00107170007112 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.133/145

5411 0810R00107170007113 * 04/09/2017 114,100 114,100


5412 0810R00107170007114 * 04/09/2017 114,100 114,100
5413 0810R00107170007115 * 04/09/2017 155,100 155,100
5414 0810R00107170007116 * 04/09/2017 114,100 114,100
5415 0810R00107170007117 * 04/09/2017 155,100 155,100
5416 0810R00107170007118 * 04/09/2017 114,100 114,100
5417 0810R00107170007119 * 04/09/2017 114,100 114,100
5418 0810R00107170007120 * 04/09/2017 114,100 114,100
5419 0810R00107170007121 * 04/09/2017 114,100 114,100
5420 0810R00107170007122 * 04/09/2017 114,100 114,100
5421 0810R00107170007123 * 04/09/2017 184,900 184,900
5422 0810R00107170007124 * 04/09/2017 114,100 114,100
5423 0810R00107170007125 * 04/09/2017 114,100 114,100
5424 0810R00107170007126 * 25/08/2017 569,300 569,300
5425 0810R00107170007127 * 04/09/2017 114,100 114,100
5426 0810R00107170007128 * 04/09/2017 114,100 114,100
5427 0810R00107170007129 * 04/09/2017 114,100 114,100
5428 0810R00107170007131 * 04/09/2017 114,100 114,100
5429 0810R00107170007132 * 04/09/2017 114,100 114,100
5430 0810R00107170007134 * 04/09/2017 114,100 114,100
5431 0810R00107170007135 * 04/09/2017 114,100 114,100
5432 0810R00107170007136 * 04/09/2017 114,100 114,100
5433 0810R00107170007137 * 25/08/2017 184,900 184,900
5434 0810R00107170007138 * 04/09/2017 114,100 114,100
5435 0810R00107170007139 * 04/09/2017 114,100 114,100
5436 0810R00107170007140 * 04/09/2017 114,100 114,100
5437 0810R00107170007141 * 04/09/2017 114,100 114,100
5438 0810R00107170007142 * 04/09/2017 114,100 114,100
5439 0810R00107170007143 * 04/09/2017 114,100 114,100
5440 0810R00107170007144 * 04/09/2017 114,100 114,100
5441 0810R00107170007145 * 25/08/2017 184,900 184,900
5442 0810R00107170007146 * 25/08/2017 215,300 215,300
5443 0810R00107170007147 * 04/09/2017 184,900 184,900
5444 0810R00107170007148 * 04/09/2017 114,100 114,100
5445 0810R00107170007149 * 04/09/2017 186,300 186,300
5446 0810R00107170007150 * 04/09/2017 114,100 114,100
5447 0810R00107170007152 * 25/08/2017 184,900 184,900
5448 0810R00107170007153 * 04/09/2017 887,100 887,100
5449 0810R00107170007154 * 25/08/2017 184,900 184,900
5450 0810R00107170007155 * 25/08/2017 184,900 184,900
5451 0810R00107170007156 * 04/09/2017 141,300 141,300
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.134/145

5452 0810R00107170007157 * 04/09/2017 184,900 184,900


5453 0810R00107170007158 * 04/09/2017 114,100 114,100
5454 0810R00107170007160 * 04/09/2017 887,100 887,100
5455 0810R00107170007161 * 04/09/2017 887,100 887,100
5456 0810R00107170007165 * 04/09/2017 887,100 887,100
5457 0810R00107170007166 * 04/09/2017 887,100 887,100
5458 0810R00107170007167 * 04/09/2017 887,100 887,100
5459 0810R00107170007168 * 04/09/2017 887,100 887,100
5460 0810R00107170007169 * 04/09/2017 887,100 887,100
5461 0810R00107170007170 * 04/09/2017 887,100 887,100
5462 0810R00107170007171 * 04/09/2017 887,100 887,100
5463 0810R00107170007172 * 04/09/2017 887,100 887,100
5464 0810R00107170007173 * 04/09/2017 887,100 887,100
5465 0810R00107170007174 * 04/09/2017 887,100 887,100
5466 0810R00107170007175 * 04/09/2017 887,100 887,100
5467 0810R00107170007176 * 04/09/2017 887,100 887,100
5468 0810R00107170007177 * 04/09/2017 887,100 887,100
5469 0810R00107170007178 * 04/09/2017 887,100 887,100
5470 0810R00107170007179 * 04/09/2017 887,100 887,100
5471 0810R00107170007180 * 04/09/2017 887,100 887,100
5472 0810R00107170007181 * 04/09/2017 887,100 887,100
5473 0810R00107170007182 * 04/09/2017 887,100 887,100
5474 0810R00107170007183 * 04/09/2017 887,100 887,100
5475 0810R00107170007184 * 04/09/2017 887,100 887,100
5476 0810R00107170007185 * 04/09/2017 887,100 887,100
5477 0810R00107170007186 * 04/09/2017 887,100 887,100
5478 0810R00107170007187 * 04/09/2017 887,100 887,100
5479 0810R00107170007188 * 04/09/2017 887,100 887,100
5480 0810R00107170007189 * 04/09/2017 887,100 887,100
5481 0810R00107170007192 * 04/09/2017 148,000 148,000
5482 0810R00107170007194 * 25/08/2017 314,500 314,500
5483 0810R00107170007211 * 04/09/2017 186,300 186,300
5484 0810R00107170007215 * 04/09/2017 148,000 148,000
5485 0810R00107170007218 * 25/08/2017 259,800 259,800
5486 0810R00107170007219 * 29/08/2017 531,300 531,300
5487 0810R00107170007225 * 04/09/2017 184,900 184,900
5488 0810R00107170007231 * 04/09/2017 186,300 186,300
5489 0810R00107170007232 * 25/08/2017 184,900 184,900
5490 0810R00107170007233 * 04/09/2017 184,900 184,900
5491 0810R00107170007234 * 04/09/2017 184,900 184,900
5492 0810R00107170007235 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.135/145

5493 0810R00107170007236 * 04/09/2017 114,100 114,100


5494 0810R00107170007238 * 04/09/2017 155,100 155,100
5495 0810R00107170007239 * 04/09/2017 155,100 155,100
5496 0810R00107170007240 * 04/09/2017 114,100 114,100
5497 0810R00107170007241 * 04/09/2017 184,900 184,900
5498 0810R00107170007244 * 04/09/2017 114,100 114,100
5499 0810R00107170007245 * 04/09/2017 184,900 184,900
5500 0810R00107170007246 * 04/09/2017 184,900 184,900
5501 0810R00107170007247 * 04/09/2017 114,100 114,100
5502 0810R00107170007248 * 04/09/2017 184,900 184,900
5503 0810R00107170007249 * 04/09/2017 114,100 114,100
5504 0810R00107170007250 * 04/09/2017 184,900 184,900
5505 0810R00107170007251 * 04/09/2017 114,100 114,100
5506 0810R00107170007252 * 04/09/2017 114,100 114,100
5507 0810R00107170007254 * 04/09/2017 184,900 184,900
5508 0810R00107170007255 * 04/09/2017 114,100 114,100
5509 0810R00107170007256 * 25/08/2017 7,628,000 7,628,000
5510 0810R00107170007257 * 25/08/2017 7,628,000 7,628,000
5511 0810R00107170007258 * 04/09/2017 114,100 114,100
5512 0810R00107170007259 * 04/09/2017 114,100 114,100
5513 0810R00107170007260 * 04/09/2017 184,900 184,900
5514 0810R00107170007261 * 04/09/2017 114,100 114,100
5515 0810R00107170007262 * 04/09/2017 184,900 184,900
5516 0810R00107170007263 * 04/09/2017 155,100 155,100
5517 0810R00107170007264 * 04/09/2017 114,100 114,100
5518 0810R00107170007265 * 04/09/2017 184,900 184,900
5519 0810R00107170007267 * 04/09/2017 184,900 184,900
5520 0810R00107170007269 * 04/09/2017 114,100 114,100
5521 0810R00107170007270 * 04/09/2017 184,900 184,900
5522 0810R00107170007271 * 04/09/2017 114,100 114,100
5523 0810R00107170007272 * 04/09/2017 114,100 114,100
5524 0810R00107170007273 * 04/09/2017 114,100 114,100
5525 0810R00107170007274 * 04/09/2017 184,900 184,900
5526 0810R00107170007275 * 25/08/2017 184,900 184,900
5527 0810R00107170007276 * 04/09/2017 114,100 114,100
5528 0810R00107170007277 * 25/08/2017 200,700 200,700
5529 0810R00107170007278 * 04/09/2017 184,900 184,900
5530 0810R00107170007279 * 04/09/2017 114,100 114,100
5531 0810R00107170007280 * 04/09/2017 114,100 114,100
5532 0810R00107170007281 * 04/09/2017 184,900 184,900
5533 0810R00107170007282 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.136/145

5534 0810R00107170007283 * 04/09/2017 114,100 114,100


5535 0810R00107170007284 * 04/09/2017 114,100 114,100
5536 0810R00107170007285 * 04/09/2017 114,100 114,100
5537 0810R00107170007287 * 04/09/2017 155,100 155,100
5538 0810R00107170007288 * 04/09/2017 114,100 114,100
5539 0810R00107170007289 * 04/09/2017 114,100 114,100
5540 0810R00107170007290 * 04/09/2017 155,100 155,100
5541 0810R00107170007291 * 04/09/2017 114,100 114,100
5542 0810R00107170007292 * 04/09/2017 114,100 114,100
5543 0810R00107170007293 * 04/09/2017 114,100 114,100
5544 0810R00107170007294 * 04/09/2017 114,100 114,100
5545 0810R00107170007295 * 04/09/2017 114,100 114,100
5546 0810R00107170007296 * 04/09/2017 114,100 114,100
5547 0810R00107170007298 * 04/09/2017 114,100 114,100
5548 0810R00107170007299 * 25/08/2017 184,900 184,900
5549 0810R00107170007300 * 04/09/2017 114,100 114,100
5550 0810R00107170007301 * 04/09/2017 184,900 184,900
5551 0810R00107170007302 * 04/09/2017 155,100 155,100
5552 0810R00107170007303 * 04/09/2017 114,100 114,100
5553 0810R00107170007304 * 04/09/2017 114,100 114,100
5554 0810R00107170007305 * 04/09/2017 114,100 114,100
5555 0810R00107170007306 * 04/09/2017 114,100 114,100
5556 0810R00107170007307 * 04/09/2017 114,100 114,100
5557 0810R00107170007308 * 04/09/2017 114,100 114,100
5558 0810R00107170007309 * 04/09/2017 114,100 114,100
5559 0810R00107170007310 * 04/09/2017 184,900 184,900
5560 0810R00107170007311 * 04/09/2017 114,100 114,100
5561 0810R00107170007312 * 04/09/2017 184,900 184,900
5562 0810R00107170007313 * 25/08/2017 215,300 215,300
5563 0810R00107170007314 * 04/09/2017 114,100 114,100
5564 0810R00107170007315 * 04/09/2017 184,900 184,900
5565 0810R00107170007318 * 04/09/2017 184,900 184,900
5566 0810R00107170007319 * 04/09/2017 114,100 114,100
5567 0810R00107170007320 * 04/09/2017 114,100 114,100
5568 0810R00107170007321 * 04/09/2017 114,100 114,100
5569 0810R00107170007322 * 04/09/2017 114,100 114,100
5570 0810R00107170007324 * 04/09/2017 114,100 114,100
5571 0810R00107170007325 * 04/09/2017 114,100 114,100
5572 0810R00107170007326 * 04/09/2017 114,100 114,100
5573 0810R00107170007327 * 04/09/2017 114,100 114,100
5574 0810R00107170007328 * 25/08/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.137/145

5575 0810R00107170007329 * 04/09/2017 114,100 114,100


5576 0810R00107170007330 * 04/09/2017 114,100 114,100
5577 0810R00107170007331 * 04/09/2017 114,100 114,100
5578 0810R00107170007332 * 04/09/2017 114,100 114,100
5579 0810R00107170007333 * 04/09/2017 114,100 114,100
5580 0810R00107170007334 * 04/09/2017 114,100 114,100
5581 0810R00107170007335 * 04/09/2017 114,100 114,100
5582 0810R00107170007336 * 04/09/2017 887,100 887,100
5583 0810R00107170007337 * 04/09/2017 114,100 114,100
5584 0810R00107170007338 * 04/09/2017 114,100 114,100
5585 0810R00107170007339 * 04/09/2017 114,100 114,100
5586 0810R00107170007340 * 04/09/2017 114,100 114,100
5587 0810R00107170007341 * 25/08/2017 184,900 184,900
5588 0810R00107170007342 * 04/09/2017 114,100 114,100
5589 0810R00107170007343 * 04/09/2017 114,100 114,100
5590 0810R00107170007345 * 04/09/2017 114,100 114,100
5591 0810R00107170007346 * 04/09/2017 184,900 184,900
5592 0810R00107170007347 * 04/09/2017 114,100 114,100
5593 0810R00107170007348 * 04/09/2017 114,100 114,100
5594 0810R00107170007349 * 04/09/2017 114,100 114,100
5595 0810R00107170007350 * 04/09/2017 155,100 155,100
5596 0810R00107170007351 * 04/09/2017 114,100 114,100
5597 0810R00107170007352 * 04/09/2017 114,100 114,100
5598 0810R00107170007353 * 04/09/2017 155,100 155,100
5599 0810R00107170007354 * 04/09/2017 114,100 114,100
5600 0810R00107170007355 * 04/09/2017 155,100 155,100
5601 0810R00107170007356 * 04/09/2017 114,100 114,100
5602 0810R00107170007357 * 04/09/2017 114,100 114,100
5603 0810R00107170007358 * 04/09/2017 114,100 114,100
5604 0810R00107170007359 * 04/09/2017 114,100 114,100
5605 0810R00107170007360 * 04/09/2017 114,100 114,100
5606 0810R00107170007361 * 04/09/2017 114,100 114,100
5607 0810R00107170007363 * 04/09/2017 114,100 114,100
5608 0810R00107170007364 * 04/09/2017 114,100 114,100
5609 0810R00107170007365 * 04/09/2017 887,100 887,100
5610 0810R00107170007366 * 04/09/2017 114,100 114,100
5611 0810R00107170007367 * 04/09/2017 114,100 114,100
5612 0810R00107170007368 * 04/09/2017 887,100 887,100
5613 0810R00107170007369 * 04/09/2017 114,100 114,100
5614 0810R00107170007370 * 04/09/2017 887,100 887,100
5615 0810R00107170007371 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.138/145

5616 0810R00107170007372 * 04/09/2017 887,100 887,100


5617 0810R00107170007373 * 04/09/2017 887,100 887,100
5618 0810R00107170007374 * 04/09/2017 114,100 114,100
5619 0810R00107170007375 * 04/09/2017 887,100 887,100
5620 0810R00107170007376 * 04/09/2017 887,100 887,100
5621 0810R00107170007377 * 04/09/2017 114,100 114,100
5622 0810R00107170007378 * 04/09/2017 887,100 887,100
5623 0810R00107170007379 * 04/09/2017 114,100 114,100
5624 0810R00107170007380 * 04/09/2017 887,100 887,100
5625 0810R00107170007381 * 04/09/2017 887,100 887,100
5626 0810R00107170007382 * 04/09/2017 114,100 114,100
5627 0810R00107170007383 * 04/09/2017 887,100 887,100
5628 0810R00107170007384 * 04/09/2017 887,100 887,100
5629 0810R00107170007385 * 04/09/2017 114,100 114,100
5630 0810R00107170007386 * 04/09/2017 887,100 887,100
5631 0810R00107170007387 * 04/09/2017 114,100 114,100
5632 0810R00107170007389 * 04/09/2017 887,100 887,100
5633 0810R00107170007390 * 04/09/2017 155,100 155,100
5634 0810R00107170007391 * 04/09/2017 887,100 887,100
5635 0810R00107170007392 * 04/09/2017 114,100 114,100
5636 0810R00107170007394 * 04/09/2017 887,100 887,100
5637 0810R00107170007395 * 04/09/2017 155,100 155,100
5638 0810R00107170007396 * 04/09/2017 114,100 114,100
5639 0810R00107170007397 * 04/09/2017 887,100 887,100
5640 0810R00107170007398 * 04/09/2017 887,100 887,100
5641 0810R00107170007399 * 04/09/2017 887,100 887,100
5642 0810R00107170007400 * 04/09/2017 114,100 114,100
5643 0810R00107170007401 * 04/09/2017 887,100 887,100
5644 0810R00107170007402 * 04/09/2017 887,100 887,100
5645 0810R00107170007403 * 04/09/2017 155,100 155,100
5646 0810R00107170007404 * 04/09/2017 887,100 887,100
5647 0810R00107170007405 * 04/09/2017 114,100 114,100
5648 0810R00107170007406 * 04/09/2017 114,100 114,100
5649 0810R00107170007407 * 04/09/2017 887,100 887,100
5650 0810R00107170007408 * 04/09/2017 184,900 184,900
5651 0810R00107170007409 * 04/09/2017 114,100 114,100
5652 0810R00107170007410 * 04/09/2017 114,100 114,100
5653 0810R00107170007411 * 04/09/2017 114,100 114,100
5654 0810R00107170007412 * 04/09/2017 114,100 114,100
5655 0810R00107170007418 * 04/09/2017 186,300 186,300
5656 0810R00107170007421 * 29/08/2017 314,500 314,500
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.139/145

5657 0810R00107170007423 * 25/08/2017 259,800 259,800


5658 0810R00107170007434 * 29/08/2017 208,700 208,700
5659 0810R00107170007438 * 25/08/2017 314,500 314,500
5660 0810R00107170007441 * 25/08/2017 314,500 314,500
5661 0810R00107170007448 * 04/09/2017 184,900 184,900
5662 0810R00107170007450 * 04/09/2017 184,900 184,900
5663 0810R00107170007452 * 04/09/2017 186,300 186,300
5664 0810R00107170007453 * 04/09/2017 148,000 148,000
5665 0810R00107170007454 * 04/09/2017 186,300 186,300
5666 0810R00107170007462 * 04/09/2017 184,900 184,900
5667 0810R00107170007468 * 04/09/2017 186,300 186,300
5668 0810R00107170007469 * 04/09/2017 186,300 186,300
5669 0810R00107170007470 * 04/09/2017 186,300 186,300
5670 0810R00107170007475 * 25/08/2017 255,700 255,700
5671 0810R00107170007479 * 28/08/2017 215,300 215,300
5672 0810R00107170007480 * 04/09/2017 184,900 184,900
5673 0810R00107170007481 * 04/09/2017 184,900 184,900
5674 0810R00107170007482 * 04/09/2017 184,900 184,900
5675 0810R00107170007483 * 28/08/2017 200,700 200,700
5676 0810R00107170007484 * 28/08/2017 184,900 184,900
5677 0810R00107170007485 * 28/08/2017 242,700 242,700
5678 0810R00107170007486 * 28/08/2017 184,900 184,900
5679 0810R00107170007487 * 28/08/2017 184,900 184,900
5680 0810R00107170007488 * 28/08/2017 184,900 184,900
5681 0810R00107170007489 * 04/09/2017 184,900 184,900
5682 0810R00107170007490 * 28/08/2017 569,300 569,300
5683 0810R00107170007491 * 28/08/2017 443,700 443,700
5684 0810R00107170007492 * 28/08/2017 267,200 267,200
5685 0810R00107170007493 * 04/09/2017 155,100 155,100
5686 0810R00107170007494 * 04/09/2017 114,100 114,100
5687 0810R00107170007495 * 04/09/2017 186,300 186,300
5688 0810R00107170007496 * 04/09/2017 114,100 114,100
5689 0810R00107170007497 * 04/09/2017 114,100 114,100
5690 0810R00107170007498 * 04/09/2017 114,100 114,100
5691 0810R00107170007499 * 04/09/2017 114,100 114,100
5692 0810R00107170007501 * 04/09/2017 114,100 114,100
5693 0810R00107170007502 * 04/09/2017 114,100 114,100
5694 0810R00107170007503 * 04/09/2017 114,100 114,100
5695 0810R00107170007504 * 04/09/2017 184,900 184,900
5696 0810R00107170007506 * 04/09/2017 114,100 114,100
5697 0810R00107170007507 * 28/08/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.140/145

5698 0810R00107170007508 * 04/09/2017 184,900 184,900


5699 0810R00107170007510 * 04/09/2017 184,900 184,900
5700 0810R00107170007511 * 28/08/2017 184,900 184,900
5701 0810R00107170007513 * 04/09/2017 184,900 184,900
5702 0810R00107170007514 * 28/08/2017 215,300 215,300
5703 0810R00107170007516 * 04/09/2017 184,900 184,900
5704 0810R00107170007517 * 04/09/2017 184,900 184,900
5705 0810R00107170007518 * 28/08/2017 184,900 184,900
5706 0810R00107170007519 * 04/09/2017 184,900 184,900
5707 0810R00107170007520 * 04/09/2017 114,100 114,100
5708 0810R00107170007521 * 28/08/2017 215,300 215,300
5709 0810R00107170007522 * 04/09/2017 184,900 184,900
5710 0810R00107170007523 * 04/09/2017 114,100 114,100
5711 0810R00107170007524 * 04/09/2017 184,900 184,900
5712 0810R00107170007525 * 04/09/2017 114,100 114,100
5713 0810R00107170007526 * 28/08/2017 569,300 569,300
5714 0810R00107170007527 * 04/09/2017 114,100 114,100
5715 0810R00107170007529 * 04/09/2017 114,100 114,100
5716 0810R00107170007530 * 04/09/2017 184,900 184,900
5717 0810R00107170007531 * 04/09/2017 114,100 114,100
5718 0810R00107170007532 * 28/08/2017 200,700 200,700
5719 0810R00107170007533 * 04/09/2017 114,100 114,100
5720 0810R00107170007534 * 04/09/2017 184,900 184,900
5721 0810R00107170007535 * 04/09/2017 114,100 114,100
5722 0810R00107170007536 * 28/08/2017 200,700 200,700
5723 0810R00107170007537 * 04/09/2017 184,900 184,900
5724 0810R00107170007538 * 04/09/2017 114,100 114,100
5725 0810R00107170007539 * 28/08/2017 184,900 184,900
5726 0810R00107170007540 * 04/09/2017 114,100 114,100
5727 0810R00107170007541 * 28/08/2017 184,900 184,900
5728 0810R00107170007542 * 04/09/2017 184,900 184,900
5729 0810R00107170007543 * 28/08/2017 200,700 200,700
5730 0810R00107170007544 * 04/09/2017 184,900 184,900
5731 0810R00107170007545 * 04/09/2017 114,100 114,100
5732 0810R00107170007546 * 28/08/2017 184,900 184,900
5733 0810R00107170007547 * 04/09/2017 114,100 114,100
5734 0810R00107170007548 * 28/08/2017 242,700 242,700
5735 0810R00107170007549 * 04/09/2017 155,100 155,100
5736 0810R00107170007550 * 28/08/2017 242,700 242,700
5737 0810R00107170007551 * 04/09/2017 184,900 184,900
5738 0810R00107170007552 * 04/09/2017 184,900 184,900
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.141/145

5739 0810R00107170007553 * 28/08/2017 184,900 184,900


5740 0810R00107170007554 * 04/09/2017 114,100 114,100
5741 0810R00107170007555 * 04/09/2017 184,900 184,900
5742 0810R00107170007556 * 04/09/2017 114,100 114,100
5743 0810R00107170007558 * 04/09/2017 184,900 184,900
5744 0810R00107170007559 * 04/09/2017 114,100 114,100
5745 0810R00107170007562 * 04/09/2017 114,100 114,100
5746 0810R00107170007564 * 04/09/2017 114,100 114,100
5747 0810R00107170007565 * 04/09/2017 184,900 184,900
5748 0810R00107170007566 * 04/09/2017 114,100 114,100
5749 0810R00107170007567 * 28/08/2017 200,700 200,700
5750 0810R00107170007568 * 04/09/2017 114,100 114,100
5751 0810R00107170007569 * 04/09/2017 184,900 184,900
5752 0810R00107170007570 * 04/09/2017 114,100 114,100
5753 0810R00107170007571 * 28/08/2017 184,900 184,900
5754 0810R00107170007572 * 04/09/2017 184,900 184,900
5755 0810R00107170007573 * 28/08/2017 184,900 184,900
5756 0810R00107170007574 * 04/09/2017 114,100 114,100
5757 0810R00107170007575 * 04/09/2017 114,100 114,100
5758 0810R00107170007576 * 04/09/2017 184,900 184,900
5759 0810R00107170007578 * 04/09/2017 114,100 114,100
5760 0810R00107170007579 * 04/09/2017 114,100 114,100
5761 0810R00107170007580 * 04/09/2017 114,100 114,100
5762 0810R00107170007581 * 04/09/2017 155,100 155,100
5763 0810R00107170007582 * 04/09/2017 114,100 114,100
5764 0810R00107170007583 * 04/09/2017 114,100 114,100
5765 0810R00107170007584 * 04/09/2017 155,100 155,100
5766 0810R00107170007585 * 04/09/2017 114,100 114,100
5767 0810R00107170007586 * 28/08/2017 245,500 245,500
5768 0810R00107170007587 * 04/09/2017 114,100 114,100
5769 0810R00107170007588 * 04/09/2017 184,900 184,900
5770 0810R00107170007589 * 04/09/2017 114,100 114,100
5771 0810R00107170007590 * 28/08/2017 569,300 569,300
5772 0810R00107170007591 * 04/09/2017 186,300 186,300
5773 0810R00107170007592 * 04/09/2017 114,100 114,100
5774 0810R00107170007593 * 04/09/2017 184,900 184,900
5775 0810R00107170007595 * 28/08/2017 184,900 184,900
5776 0810R00107170007596 * 28/08/2017 114,100 114,100
5777 0810R00107170007597 * 04/09/2017 184,900 184,900
5778 0810R00107170007598 * 04/09/2017 114,100 114,100
5779 0810R00107170007599 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.142/145

5780 0810R00107170007600 * 04/09/2017 114,100 114,100


5781 0810R00107170007601 * 28/08/2017 289,400 289,400
5782 0810R00107170007602 * 04/09/2017 184,900 184,900
5783 0810R00107170007603 * 28/08/2017 184,900 184,900
5784 0810R00107170007604 * 04/09/2017 184,900 184,900
5785 0810R00107170007605 * 30/08/2017 289,400 289,400
5786 0810R00107170007606 * 04/09/2017 114,100 114,100
5787 0810R00107170007607 * 04/09/2017 114,100 114,100
5788 0810R00107170007608 * 04/09/2017 186,300 186,300
5789 0810R00107170007610 * 04/09/2017 114,100 114,100
5790 0810R00107170007611 * 04/09/2017 184,900 184,900
5791 0810R00107170007612 * 04/09/2017 184,900 184,900
5792 0810R00107170007613 * 04/09/2017 184,900 184,900
5793 0810R00107170007615 * 04/09/2017 184,900 184,900
5794 0810R00107170007616 * 04/09/2017 114,100 114,100
5795 0810R00107170007617 * 04/09/2017 114,100 114,100
5796 0810R00107170007619 * 28/08/2017 200,700 200,700
5797 0810R00107170007620 * 04/09/2017 114,100 114,100
5798 0810R00107170007621 * 04/09/2017 114,100 114,100
5799 0810R00107170007622 * 04/09/2017 114,100 114,100
5800 0810R00107170007623 * 04/09/2017 114,100 114,100
5801 0810R00107170007624 * 04/09/2017 114,100 114,100
5802 0810R00107170007625 * 04/09/2017 184,900 184,900
5803 0810R00107170007626 * 04/09/2017 114,100 114,100
5804 0810R00107170007627 * 04/09/2017 184,900 184,900
5805 0810R00107170007628 * 04/09/2017 114,100 114,100
5806 0810R00107170007629 * 28/08/2017 569,300 569,300
5807 0810R00107170007630 * 28/08/2017 184,900 184,900
5808 0810R00107170007632 * 28/08/2017 184,900 184,900
5809 0810R00107170007633 * 04/09/2017 114,100 114,100
5810 0810R00107170007634 * 04/09/2017 114,100 114,100
5811 0810R00107170007635 * 04/09/2017 114,100 114,100
5812 0810R00107170007636 * 04/09/2017 114,100 114,100
5813 0810R00107170007637 * 04/09/2017 114,100 114,100
5814 0810R00107170007638 * 04/09/2017 114,100 114,100
5815 0810R00107170007639 * 04/09/2017 155,100 155,100
5816 0810R00107170007640 * 04/09/2017 114,100 114,100
5817 0810R00107170007641 * 04/09/2017 114,100 114,100
5818 0810R00107170007642 * 04/09/2017 114,100 114,100
5819 0810R00107170007643 * 04/09/2017 114,100 114,100
5820 0810R00107170007644 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.143/145

5821 0810R00107170007645 * 04/09/2017 114,100 114,100


5822 0810R00107170007646 * 04/09/2017 114,100 114,100
5823 0810R00107170007647 * 04/09/2017 114,100 114,100
5824 0810R00107170007648 * 04/09/2017 114,100 114,100
5825 0810R00107170007649 * 04/09/2017 114,100 114,100
5826 0810R00107170007652 * 04/09/2017 155,100 155,100
5827 0810R00107170007653 * 04/09/2017 114,100 114,100
5828 0810R00107170007655 * 04/09/2017 155,100 155,100
5829 0810R00107170007656 * 04/09/2017 114,100 114,100
5830 0810R00107170007657 * 04/09/2017 114,100 114,100
5831 0810R00107170007658 * 04/09/2017 114,100 114,100
5832 0810R00107170007659 * 04/09/2017 114,100 114,100
5833 0810R00107170007660 * 04/09/2017 155,100 155,100
5834 0810R00107170007661 * 28/08/2017 184,900 184,900
5835 0810R00107170007662 * 04/09/2017 114,100 114,100
5836 0810R00107170007663 * 04/09/2017 114,100 114,100
5837 0810R00107170007664 * 04/09/2017 184,900 184,900
5838 0810R00107170007665 * 04/09/2017 114,100 114,100
5839 0810R00107170007667 * 04/09/2017 155,100 155,100
5840 0810R00107170007668 * 04/09/2017 114,100 114,100
5841 0810R00107170007669 * 04/09/2017 114,100 114,100
5842 0810R00107170007670 * 04/09/2017 114,100 114,100
5843 0810R00107170007671 * 04/09/2017 114,100 114,100
5844 0810R00107170007673 * 04/09/2017 114,100 114,100
5845 0810R00107170007675 * 04/09/2017 114,100 114,100
5846 0810R00107170007677 * 04/09/2017 114,100 114,100
5847 0810R00107170007678 * 04/09/2017 114,100 114,100
5848 0810R00107170007679 * 04/09/2017 114,100 114,100
5849 0810R00107170007680 * 04/09/2017 114,100 114,100
5850 0810R00107170007681 * 04/09/2017 114,100 114,100
5851 0810R00107170007683 * 04/09/2017 114,100 114,100
5852 0810R00107170007684 * 04/09/2017 184,900 184,900
5853 0810R00107170007685 * 04/09/2017 114,100 114,100
5854 0810R00107170007687 * 04/09/2017 114,100 114,100
5855 0810R00107170007688 * 04/09/2017 155,100 155,100
5856 0810R00107170007689 * 04/09/2017 114,100 114,100
5857 0810R00107170007692 * 04/09/2017 114,100 114,100
5858 0810R00107170007693 * 04/09/2017 114,100 114,100
5859 0810R00107170007694 * 04/09/2017 114,100 114,100
5860 0810R00107170007695 * 28/08/2017 314,500 314,500
5861 0810R00107170007697 * 04/09/2017 114,100 114,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.144/145

5862 0810R00107170007699 * 04/09/2017 114,100 114,100


5863 0810R00107170007700 * 04/09/2017 186,300 186,300
5864 0810R00107170007701 * 04/09/2017 114,100 114,100
5865 0810R00107170007704 * 04/09/2017 155,100 155,100
5866 0810R00107170007705 * 28/08/2017 215,300 215,300
5867 0810R00107170007706 * 04/09/2017 114,100 114,100
5868 0810R00107170007707 * 04/09/2017 114,100 114,100
5869 0810R00107170007708 * 04/09/2017 155,100 155,100
5870 0810R00107170007709 * 04/09/2017 186,300 186,300
5871 0810R00107170007711 * 04/09/2017 114,100 114,100
5872 0810R00107170007713 * 04/09/2017 114,100 114,100
5873 0810R00107170007715 * 04/09/2017 114,100 114,100
5874 0810R00107170007716 * 30/08/2017 114,100 114,100
5875 0810R00107170007717 * 28/08/2017 114,100 114,100
5876 0810R00107170007718 * 28/08/2017 114,100 114,100
5877 0810R00107170007719 * 30/08/2017 114,100 114,100
5878 0810R00107170007720 * 28/08/2017 114,100 114,100
5879 0810R00107170007721 * 28/08/2017 569,300 569,300
5880 0810R00107170007722 * 28/08/2017 114,100 114,100
5881 0810R00107170007723 * 28/08/2017 114,100 114,100
5882 0810R00107170007724 * 28/08/2017 114,100 114,100
5883 0810R00107170007725 * 28/08/2017 155,100 155,100
5884 0810R00107170007729 * 28/08/2017 186,300 186,300
5885 0810R00107170007730 * 28/08/2017 569,300 569,300
5886 0810R00107170007737 * 28/08/2017 887,100 887,100
5887 0810R00107170007739 * 28/08/2017 887,100 887,100
5888 0810R00107170007740 * 04/09/2017 186,300 186,300
5889 0810R00107170007741 * 28/08/2017 887,100 887,100
5890 0810R00107170007742 * 28/08/2017 887,100 887,100
5891 0810R00107170007743 * 28/08/2017 887,100 887,100
5892 0810R00107170007745 * 28/08/2017 887,100 887,100
5893 0810R00107170007746 * 28/08/2017 887,100 887,100
5894 0810R00107170007747 * 28/08/2017 887,100 887,100
5895 0810R00107170007748 * 28/08/2017 887,100 887,100
5896 0810R00107170007749 * 28/08/2017 887,100 887,100
5897 0810R00107170007751 * 28/08/2017 887,100 887,100
5898 0810R00107170007752 * 28/08/2017 887,100 887,100
5899 0810R00107170007753 * 28/08/2017 887,100 887,100
5900 0810R00107170007754 * 28/08/2017 887,100 887,100
5901 0810R00107170007755 * 28/08/2017 887,100 887,100
5902 0810R00107170007756 * 28/08/2017 887,100 887,100
UMPAN BALIK HASIL VERIFIKASI

Nama RS : RSU.A.YANI METRO


Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01 Juli 2017 s/d 31 Juli 2017 Hal.145/145

5903 0810R00107170007757 * 28/08/2017 887,100 887,100


5904 0810R00107170007758 * 28/08/2017 887,100 887,100
5905 0810R00107170007759 * 28/08/2017 887,100 887,100
5906 0810R00107170007760 * 28/08/2017 887,100 887,100
5907 0810R00107170007761 * 28/08/2017 887,100 887,100
5908 0810R00107170007762 * 28/08/2017 887,100 887,100
5909 0810R00107170007763 * 28/08/2017 887,100 887,100
5910 0810R00107170007764 * 28/08/2017 887,100 887,100
5911 0810R00107170007765 * 28/08/2017 887,100 887,100
5912 0810R00107170007779 * 04/09/2017 186,300 186,300
5913 0810R00107170007782 * 04/09/2017 141,300 141,300
5914 0810R00107170007784 * 04/09/2017 186,300 186,300
5915 0810R00107170007786 * 28/08/2017 259,800 259,800
5916 0810R00107170007788 * 30/08/2017 314,500 314,500
5917 0810R00107170007795 * 28/08/2017 314,500 314,500
5918 0810R00107170007802 * 28/08/2017 264,700 264,700
5919 0810R00107170007803 * 04/09/2017 114,100 114,100
5920 0810R00107170007804 * 04/09/2017 114,100 114,100
5921 0810R00107170007809 * 04/09/2017 155,100 155,100
5922 0810R00107170007810 * 04/09/2017 155,100 155,100
5923 0810R00107170007811 * 04/09/2017 155,100 155,100
5924 0810R00107170007812 * 04/09/2017 155,100 155,100
TOTAL 1,492,814,900 1,492,814,900

RESUME
Total Bea.Diajukan : 1.492.814.900

Total Bea.Disetujui : 1.492.814.900

Menyetujui Diperiksa oleh Verifikator


Direktur RSU A.Yani Kabid PMR BPJS Kesehatan

Drg. Erla Andrianti, MARS Bellza Rizki Ananta Zul Sofyan Efendi

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