BPJS Kesehatan Cab.

PARE PARE
HASIL VERIFIKASI
PENGAJUAN KLAIM TINGKAT PERTAMA

Nomor FPK : P2301000000169

Provider : PANGKAJENE

Bulan Pelayanan : January 2023

Pelayanan : Promotif

Pelayanan Verifikasi

Total Data : 170 Total Data : 170 Layak : 170 Tidak Layak : 0

Total Tagihan : Rp. 1.700.000 Total Tagihan : Rp. 1.700.000 Pending : 0 DIspute : 0

NO TRANSAKSI NAMA PESERTA TGL MASUK TGL PULANG BIAYA STAT KETERANGAN

181602010123P000232 ANDI HASBI (0001081184646) 03/01/2023 03/01/2023 Rp. 10.000 Layak

ANDI MUSTAFA MANGGAU

181602010123P000234 03/01/2023 03/01/2023 Rp. 10.000 Layak
(0000130023393)
ANDI NURHAYATI. L
181602010123P000235 03/01/2023 03/01/2023 Rp. 10.000 Layak
(0000129836316)

181602010123P000237 ANDI RAHMAN S. (0000130047658) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000238 ABD. RAUF (0000198882404) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000240 ABD. RAHMAN R. (0000129941583) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000241 ABIDIN LADJU (0000129610293) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000243 ARI (0002298078731) 03/01/2023 03/01/2023 Rp. 10.000 Layak

SYAMSUDDIN KASAU
181602010123P000244 03/01/2023 03/01/2023 Rp. 10.000 Layak
(0000129865138)

181602010123P000245 ABDUL RASYID (0000129875319) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000246 SYAHRIR (0000129878302) 03/01/2023 03/01/2023 Rp. 10.000 Layak

ENDANG FITRIYANI
181602010123P000247 03/01/2023 03/01/2023 Rp. 10.000 Layak
(0002364311665)

181602010123P000249 HAYANI (0001071489958) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000250 HARTANI (0002249248972) 03/01/2023 03/01/2023 Rp. 10.000 Layak

NURDIN BADERRU
181602010123P000251 03/01/2023 03/01/2023 Rp. 10.000 Layak
(0002090575978)

181602010123P000252 HAMZAH T.SE, H. (0000129945802) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000253 BAHRIA (0001430551901) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000254 BOLONG (0002266357994) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000255 HATIMAH (0000129915562) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000256 SOHRA (0001453283019) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000257 ST. DAHRIAH (0000130026791) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000258 ITAKKO (0001933752947) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000259 ITATI (0002087582512) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000260 TRISNAWATI (0001071496956) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000261 ANDI HAMKA (0001313572601) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000262 IRAMIA (0001933694302) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000263 ISUWAINI (0001933698205) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000264 M. HUSNI (0001878091795) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000265 NURSALAM (0000129872529) 03/01/2023 03/01/2023 Rp. 10.000 Layak

 NO TRANSAKSI NAMA PESERTA TGL MASUK TGL PULANG BIAYA STAT KETERANGAN

181602010123P000266 SURIATI ARSYAD (0002043380924) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000267 ASLINDA (0001071489802) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000268 AMINGNGE (0000936723047) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000269 JAMALUDDIN (0000130045184) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000270 KAMBO (0000129960999) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000271 LADDAE (0001868862453) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000272 LAPONDONG (0000130040245) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000273 LATOGA (0000130027498) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000274 MAHMUD (0001849692745) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000275 MARDAWIAH (0000129986504) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000276 MASTENG (0000937708817) 03/01/2023 03/01/2023 Rp. 10.000 Layak

MUHAMMAD ARSYAD
181602010123P000277 03/01/2023 03/01/2023 Rp. 10.000 Layak
(0000130049638)
MUHammad SALEH
181602010123P000278 03/01/2023 03/01/2023 Rp. 10.000 Layak
(0001843872175)

181602010123P000279 MULYATI (0001449466705) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000280 NADIRA (0000938053539) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000281 NASIRA (0001071500984) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000282 NURDAYA (0000130027509) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000283 NURHAYATI S (0001933732506) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000284 RABANIA (0001933739032) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000285 ROSDIANA (0001895948965) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000286 RUSMAINI (0001933739291) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000287 RUSMIATI. L (0000200858139) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000288 SEDERHANA. L (0000129863924) 03/01/2023 03/01/2023 Rp. 10.000 Layak

ST. KANIRAH SAING

181602010123P000289 03/01/2023 03/01/2023 Rp. 10.000 Layak
(0001933709084)

181602010123P000290 SUARDI (0000129831254) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000291 SUDIRMAN (0002035169651) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000292 SUMARNI (0001081009541) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000293 SUNDUSIAH (0000129610304) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000294 SURIANI (0001933717792) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000295 SAMSINAR (0002365214242) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000296 SARIBULAN (0001933697891) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000297 TAKIMA (0000938071001) 03/01/2023 03/01/2023 Rp. 10.000 Layak

181602010123P000298 IDRIS ARANG (0001885880463) 03/01/2023 03/01/2023 Rp. 10.000 Layak

ABD. MASSAR LATJANG

181602010123P000364 04/01/2023 04/01/2023 Rp. 10.000 Layak
(0000204354538)

181602010123P000365 DARMAWATI (0001933695808) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000366 DARNIWATI (0000163450899) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000367 ABDU SAFA (0000129930513) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000368 PACHRI RAHMAN (0000129932684) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000369 RAMLI. HB (0000148189048) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000370 ERNIWATI (0000129928509) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000371 ELVIAH YEPIN (0000129955375) 04/01/2023 04/01/2023 Rp. 10.000 Layak

 NO TRANSAKSI NAMA PESERTA TGL MASUK TGL PULANG BIAYA STAT KETERANGAN

181602010123P000372 ABD.MUIS MS (0000129915314) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000373 LAMAMMA (0000130025608) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000374 DEWI MAILANY (0000171565479) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000375 HAJI ALIMIN (0000130025924) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000376 MADE AMIN (0000130001984) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000377 HABIBA (0000129943675) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000378 HADASIA (0001450870029) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000379 HAMIDAH (0001933721943) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000380 HARMUDIN (0000129855284) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000381 HATIMA P. LUTE (0000130026161) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000382 DARMIAH (0001971243257) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000383 HASNI (0002365382823) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000384 I WANI (0000130051967) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000385 MASTURA (0000040707562) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000386 HARTATI (0000129915303) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000387 MINI (0001432472962) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000388 NORMA (0000129936903) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000389 ISADDIA (0000938479869) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000390 ISENNANG (0000937258751) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000391 MUSTAPENG (0001793953315) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000392 JUM'ATI (0000931933596) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000393 FARIDAH (0000129877222) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000394 HJ. NURHAYATI (0000005194157) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000395 HASNIATI (0000129917226) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000396 JUANG (0001933744432) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000397 KAMSIA (0001933766381) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000398 KASMAH (0001071495505) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000399 LAIDI (0001071500365) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000400 LOBBO (0002421468527) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000401 MARWATANG (0000129928904) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000402 MASRI SANUSI (0000129834281) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000403 MUH. ASRI ALI (0001960069048) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000404 MUH. NURDIN (0002365337452) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000405 MUHTAR (0001453284483) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000406 MULIATI (0000129976514) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000407 MULYATI (0001933744465) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000408 MURNI (0002191036105) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000409 MURNI ADAMA (0002322269548) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000410 NATIJAH (0000938257042) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000411 NASIR (0000937275816) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000412 NORMA (0002073892487) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000413 NUR ABD. HARIS (0001886951564) 04/01/2023 04/01/2023 Rp. 10.000 Layak
 NO TRANSAKSI NAMA PESERTA TGL MASUK TGL PULANG BIAYA STAT KETERANGAN

181602010123P000414 PAHIMA (0002365176666) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000415 SAKKAWATI (0002911862013) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000416 SALMIAH (0000938497487) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000417 SENANGHATI (0000129918881) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000418 SYAHRIL (0000129830591) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000419 SYAHRIR. W (0000129836452) 04/01/2023 04/01/2023 Rp. 10.000 Layak

181602010123P000420 SYARIFUDDIN (0000129987865) 04/01/2023 04/01/2023 Rp. 10.000 Layak

KARTINI LAUPE MANSUR

181602010123P000421 05/01/2023 05/01/2023 Rp. 10.000 Layak
(0001933736231)

181602010123P000454 AMIRUDDIN (0001855268245) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000455 ABDUL KADIR (0000937768342) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000457 ANDRIANA (0002365284969) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000458 DENI SUMASDENI (0000129983837) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000460 NURHAYATI (0001889177613) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000461 nani (0002365267151) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000463 ALLA (0001933709444) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000465 ISAKKA (0001969160354) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000466 IMARA (0002430986938) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000468 SAKKA (0002365203688) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000470 ISINI (0002300460838) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000471 JUMAINI (0002079401218) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000472 KASMAWATI (0001071497777) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000473 LARODDING (0002172145814) 05/01/2023 05/01/2023 Rp. 10.000 Layak

MUH. EDY ABDULLAH

181602010123P000476 05/01/2023 05/01/2023 Rp. 10.000 Layak
(0001933765536)

181602010123P000478 MUHDAT BAHI (0000129645538) 05/01/2023 05/01/2023 Rp. 10.000 Layak

MUHAMMAD MEJANG
181602010123P000479 05/01/2023 05/01/2023 Rp. 10.000 Layak
(0000130014415)

181602010123P000480 MAHMUD (0000130049109) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000482 RAHMATIA (0000937322875) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000483 SYAMSIAH (0000130024495) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000485 MUSDALIFA (0002364283607) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000486 BACHTIAR (0000195456925) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000488 SUMARNI. S (0000129852235) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000490 HANNONG (0001933733564) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000491 KASMAWATI (0002050906432) 05/01/2023 05/01/2023 Rp. 10.000 Layak

SABENNA DOLLAH
181602010123P000493 05/01/2023 05/01/2023 Rp. 10.000 Layak
(0002365160782)

181602010123P000494 HAMZAH (0000129940345) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000495 ATIJAH (0001790951117) 05/01/2023 05/01/2023 Rp. 10.000 Layak

ANDI WAHYUDDIN, ST
181602010123P000522 05/01/2023 05/01/2023 Rp. 10.000 Layak
(0002055429797)

181602010123P000523 SULTAN LAOBO (0000129879369) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000524 SRI MURTI (0000129879371) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000525 MARWAH (0002365339285) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000526 HAYATI (0000938403639) 05/01/2023 05/01/2023 Rp. 10.000 Layak

 NO TRANSAKSI NAMA PESERTA TGL MASUK TGL PULANG BIAYA STAT KETERANGAN

181602010123P000527 KEMAL (0002052274059) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000528 NANI (0003070760782) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000529 NURHAYATI (0001933735375) 05/01/2023 05/01/2023 Rp. 10.000 Layak

KAHARUDDIN YAHYA
181602010123P000530 05/01/2023 05/01/2023 Rp. 10.000 Layak
(0002365378806)

181602010123P000531 SURIANTI (0002365236887) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000532 INA MANG (0000937227925) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000533 ABD. KADIR (0000937258143) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000534 MELLAH (0001933737849) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000535 B. S. PARAMEAN (0000130023628) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000536 DOLLAH MANDO (0000130007002) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000537 HAMKA (0001933739436) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000538 NURSIAH ALI (0000129834988) 05/01/2023 05/01/2023 Rp. 10.000 Layak

181602010123P000539 NURHAYATI. U (0000129917981) 05/01/2023 05/01/2023 Rp. 10.000 Layak

NAHARIA DG. REWA

181602010123P000540 05/01/2023 05/01/2023 Rp. 10.000 Layak
(0000938080563)

181602010123P000541 ILOMO,S.PD (0000129855341) 05/01/2023 05/01/2023 Rp. 10.000 Layak

MUHAMMAD NASIR
181602010123P000542 05/01/2023 05/01/2023 Rp. 10.000 Layak
(0003272367598)

181602010123P000543 RASIDAH (0000129974714) 05/01/2023 05/01/2023 Rp. 10.000 Layak

Hasil Verifikasi Telah disetujui oleh FKTP

Tanggal Selesai Verifikasi 30/01/2023 Pada Tanggal 30/01/2023

Verifikator BPJS Kesehatan, Pimpinan / Penanggung Jawab FKTP,

Nur Radhiyah Riska , Amd. Keb