Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI

Tingkat Pelayanan : RJTL

Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

No No SEP Tgl Msk Tgl Plg No.Kartu Nm Pst LP Kd CBGs Nm Cbgs

1 0108R00708160002171 10-08-2016 10-08-2016 0000025380595 NISDANIAR P U-3-16-0 DENTAL OPERATIONS

2 0108R00708160001422 22-08-2016 22-08-2016 0000027307394 WENNY HATITI PUTRI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
3 0108R00708160000152 02-08-2016 02-08-2016 0000027781514 KW. EFENDI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
4 0108R00708160001806 26-08-2016 26-08-2016 0000027788949 INDRI AGUSWANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
5 0108R00708160000074 01-08-2016 01-08-2016 0000027789906 NINI HERYANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
6 0108R00708160002016 30-08-2016 30-08-2016 0000027791559 SUFRIDAYERI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
7 0108R00708160001661 25-08-2016 25-08-2016 0000027793708 ERA HENDRI NUNYA L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
8 0108R00708160001024 15-08-2016 15-08-2016 0000027793989 IKA PRAYUNI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
9 0108R00708160000545 08-08-2016 08-08-2016 0000027794575 SUBARNO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
10 0108R00708160001935 29-08-2016 29-08-2016 0000027794676 KURDIANTO,SH L U-3-16-0 DENTAL OPERATIONS
11 0108R00708160000760 10-08-2016 10-08-2016 0000027800752 MASWAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
12 0108R00708160002108 31-08-2016 31-08-2016 0000027800954 SITI ASBARI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
13 0108R00708160002179 19-08-2016 19-08-2016 0000027802067 APRIANINGSIH P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
14 0108R00708160000639 09-08-2016 09-08-2016 0000027802449 YATI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
15 0108R00708160001815 26-08-2016 26-08-2016 0000027803384 SAHIRIN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
16 0108R00708160000158 02-08-2016 02-08-2016 0000027806949 DIAN MUSTIKA WARDANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
17 0108R00708160001364 20-08-2016 20-08-2016 0000027806949 DIAN MUSTIKA WARDANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
18 0108R00708160000465 06-08-2016 06-08-2016 0000027806949 DIAN MUSTIKA WARDANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

19 0108R00708160000965 13-08-2016 13-08-2016 0000027806949 DIAN MUSTIKA WARDANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
20 0108R00708160001358 19-08-2016 19-08-2016 0000027810674 IZHAR L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
21 0108R00708160000773 10-08-2016 10-08-2016 0000027811708 WILIS ERI YUNITA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
22 0108R00708160001875 29-08-2016 29-08-2016 0000027815398 HERIANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
23 0108R00708160000737 10-08-2016 10-08-2016 0000027815398 HERIANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
24 0108R00708160001434 22-08-2016 22-08-2016 0000027815398 HERIANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
25 0108R00708160000160 01-08-2016 01-08-2016 0000027815973 MARTINI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
26 0108R00708160000286 04-08-2016 04-08-2016 0000027817075 MARYANI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
27 0108R00708160001833 29-08-2016 29-08-2016 0000027821575 SITI AINI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
28 0108R00708160000009 01-08-2016 01-08-2016 0000027821575 SITI AINI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
29 0108R00708160002153 31-08-2016 31-08-2016 0000027824275 HERIYANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
30 0108R00708160000330 04-08-2016 04-08-2016 0000027824973 MELIA SETI SATYA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
31 0108R00708160000494 06-08-2016 06-08-2016 0000027826075 SUMARTINI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
32 0108R00708160001078 15-08-2016 15-08-2016 0000027826075 SUMARTINI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
33 0108R00708160001521 23-08-2016 23-08-2016 0000027829743 KASIYAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
34 0108R00708160001420 22-08-2016 22-08-2016 0000027829743 KASIYAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
35 0108R00708160002226 04-08-2016 04-08-2016 0000027836695 TASLIMAH P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
36 0108R00708160000090 01-08-2016 01-08-2016 0000027844097 RIA ANTIKA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
37 0108R00708160000256 03-08-2016 03-08-2016 0000027844097 RIA ANTIKA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
38 0108R00708160000313 04-08-2016 04-08-2016 0000027844255 YUSNANI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

39 0108R00708160000137 02-08-2016 02-08-2016 0000027849418 ISNAINI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
40 0108R00708160001378 22-08-2016 22-08-2016 0000027854919 KEMAS UMAR L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
41 0108R00708160001379 22-08-2016 22-08-2016 0000027854921 SRI RAHAYU P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
42 0108R00708160000902 12-08-2016 12-08-2016 0000027856045 M.DACHLAN L N-3-15-0 DIALYSIS
43 0108R00708160001288 19-08-2016 19-08-2016 0000027856045 M.DACHLAN L N-3-15-0 DIALYSIS
44 0108R00708160000133 02-08-2016 02-08-2016 0000027856045 M.DACHLAN L N-3-15-0 DIALYSIS
45 0108R00708160001732 26-08-2016 26-08-2016 0000027856045 M.DACHLAN L N-3-15-0 DIALYSIS
46 0108R00708160000755 10-08-2016 10-08-2016 0000027856719 MAHDI SJUKRI,B.SC. L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
47 0108R00708160002125 31-08-2016 31-08-2016 0000027856719 MAHDI SJUKRI,B.SC. L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
48 0108R00708160002126 31-08-2016 31-08-2016 0000027856721 JUSNIMAR P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
49 0108R00708160000743 10-08-2016 10-08-2016 0000027863864 SUMARNI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
50 0108R00708160000248 03-08-2016 03-08-2016 0000027863864 SUMARNI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
51 0108R00708160000136 02-08-2016 02-08-2016 0000027863864 SUMARNI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
52 0108R00708160002198 02-08-2016 02-08-2016 0000027864584 SYAFRIDAH P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
53 0108R00708160000315 04-08-2016 04-08-2016 0000027867205 BINAHAR TAMBUNAN P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
54 0108R00708160001432 22-08-2016 22-08-2016 0000027869512 BUDIWATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
55 0108R00708160000338 04-08-2016 04-08-2016 0000027869771 H.A. EFFENDI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MATTJIK,BBA MINOR CHRONIC DISEASES
56 0108R00708160001117 15-08-2016 15-08-2016 0000027869771 H.A. EFFENDI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MATTJIK,BBA MINOR CHRONIC DISEASES
57 0108R00708160000498 06-08-2016 06-08-2016 0000027871211 ROPIAH P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
58 0108R00708160000582 08-08-2016 08-08-2016 0000027871479 HAITA ASMAWATI P Q-5-43-0 AMBULATORY VISIT FOR OTHER
MAJOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

59 0108R00708160001687 25-08-2016 25-08-2016 0000027872087 SARNUBI L N-3-15-0 DIALYSIS

60 0108R00708160000169 02-08-2016 02-08-2016 0000027872087 SARNUBI L N-3-15-0 DIALYSIS
61 0108R00708160000666 09-08-2016 09-08-2016 0000027872087 SARNUBI L N-3-15-0 DIALYSIS
62 0108R00708160000835 11-08-2016 11-08-2016 0000027872087 SARNUBI L N-3-15-0 DIALYSIS
63 0108R00708160000987 13-08-2016 13-08-2016 0000027872087 SARNUBI L N-3-15-0 DIALYSIS
64 0108R00708160001146 16-08-2016 16-08-2016 0000027872087 SARNUBI L N-3-15-0 DIALYSIS
65 0108R00708160001223 18-08-2016 18-08-2016 0000027872087 SARNUBI L N-3-15-0 DIALYSIS
66 0108R00708160001365 20-08-2016 20-08-2016 0000027872087 SARNUBI L N-3-15-0 DIALYSIS
67 0108R00708160001817 27-08-2016 27-08-2016 0000027872087 SARNUBI L N-3-15-0 DIALYSIS
68 0108R00708160001868 29-08-2016 29-08-2016 0000027872087 SARNUBI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
69 0108R00708160002020 30-08-2016 30-08-2016 0000027872087 SARNUBI L N-3-15-0 DIALYSIS
70 0108R00708160001539 23-08-2016 23-08-2016 0000027872458 ALAIDAH A RUSTAM P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
71 0108R00708160001214 18-08-2016 18-08-2016 0000027874089 NURDIANA A HAMID P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
72 0108R00708160001508 22-08-2016 22-08-2016 0000027885532 SYAFRI ZAHROM L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
73 0108R00708160001349 18-08-2016 18-08-2016 0000027893981 RUSTAM ZAINAL L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
74 0108R00708160000388 05-08-2016 05-08-2016 0000027894396 NANI LIDIATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
75 0108R00708160001509 22-08-2016 22-08-2016 0000027895825 JUMHANA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
76 0108R00708160001060 15-08-2016 15-08-2016 0000027897311 RISKY SAPUTRA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
77 0108R00708160000217 03-08-2016 03-08-2016 0000027899379 ROSMALA A P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
78 0108R00708160002177 27-08-2016 27-08-2016 0000027899436 DIAH AMALIA YULITA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

79 0108R00708160001977 29-08-2016 29-08-2016 0000027900832 SUTINI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
80 0108R00708160000644 09-08-2016 09-08-2016 0000027908897 UMI SUMIATI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
81 0108R00708160000283 04-08-2016 04-08-2016 0000027909786 MUCHLIS.AR L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
82 0108R00708160000004 01-08-2016 01-08-2016 0000027909786 MUCHLIS.AR L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
83 0108R00708160001623 24-08-2016 24-08-2016 0000027910765 KUSNAINI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
84 0108R00708160001844 29-08-2016 29-08-2016 0000027910765 KUSNAINI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
85 0108R00708160000375 04-08-2016 04-08-2016 0000027911193 SUMARNO ASRI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
86 0108R00708160001316 19-08-2016 19-08-2016 0000027911867 ROMIA P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
87 0108R00708160001665 25-08-2016 25-08-2016 0000027912284 RUSMINA SIRAIT P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
88 0108R00708160002180 19-08-2016 19-08-2016 0000027913779 TJONG DJUN NIE P Q-5-41-0 AMBULATORY VISIT FOR OTHER
COMPLEX ACUTE DISORDER
89 0108R00708160001418 22-08-2016 22-08-2016 0000027913779 TJONG DJUN NIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
90 0108R00708160001056 15-08-2016 15-08-2016 0000027913779 TJONG DJUN NIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
91 0108R00708160000651 09-08-2016 09-08-2016 0000027913779 TJONG DJUN NIE P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
92 0108R00708160000585 08-08-2016 08-08-2016 0000027914736 RUDOLF SIMANJUNTAK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
93 0108R00708160001601 24-08-2016 24-08-2016 0000027914736 RUDOLF SIMANJUNTAK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
94 0108R00708160001777 26-08-2016 26-08-2016 0000027914736 RUDOLF SIMANJUNTAK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
95 0108R00708160002056 30-08-2016 30-08-2016 0000027914736 RUDOLF SIMANJUNTAK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
96 0108R00708160001502 22-08-2016 22-08-2016 0000027914736 RUDOLF SIMANJUNTAK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
97 0108R00708160000061 01-08-2016 01-08-2016 0000027914736 RUDOLF SIMANJUNTAK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
98 0108R00708160000356 04-08-2016 04-08-2016 0000027914736 RUDOLF SIMANJUNTAK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

99 0108R00708160000826 11-08-2016 11-08-2016 0000027914736 RUDOLF SIMANJUNTAK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
100 0108R00708160001064 15-08-2016 15-08-2016 0000027914736 RUDOLF SIMANJUNTAK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
101 0108R00708160001235 18-08-2016 18-08-2016 0000027914736 RUDOLF SIMANJUNTAK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
102 0108R00708160000261 03-08-2016 03-08-2016 0000027914736 RUDOLF SIMANJUNTAK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
103 0108R00708160002105 31-08-2016 31-08-2016 0000027914758 ERWAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
104 0108R00708160000030 01-08-2016 01-08-2016 0000027914758 ERWAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
105 0108R00708160002058 30-08-2016 30-08-2016 0000027915129 DIANA BT ABDULLAH P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
106 0108R00708160002005 30-08-2016 30-08-2016 0000027918101 RAULI HUTAPEA P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
107 0108R00708160001154 16-08-2016 16-08-2016 0000027918101 RAULI HUTAPEA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
108 0108R00708160001274 18-08-2016 18-08-2016 0000027918101 RAULI HUTAPEA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
109 0108R00708160000291 03-08-2016 03-08-2016 0000027920518 JUNAIDAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
110 0108R00708160000236 03-08-2016 03-08-2016 0000027922926 SRI NURVIKA P U-3-16-0 DENTAL OPERATIONS
111 0108R00708160000683 09-08-2016 09-08-2016 0000027922926 SRI NURVIKA P U-3-16-0 DENTAL OPERATIONS
112 0108R00708160002057 30-08-2016 30-08-2016 0000027922926 SRI NURVIKA P U-3-16-0 DENTAL OPERATIONS
113 0108R00708160001673 24-08-2016 24-08-2016 0000027925119 RUHAMAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
114 0108R00708160001969 29-08-2016 29-08-2016 0000027928438 KUSNADI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
115 0108R00708160001041 15-08-2016 15-08-2016 0000027928438 KUSNADI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
116 0108R00708160000501 06-08-2016 06-08-2016 0000027928552 SILVIA P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
117 0108R00708160000384 04-08-2016 04-08-2016 0000027929114 SOLIFAH RAKHMADANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
118 0108R00708160002146 31-08-2016 31-08-2016 0000027932038 YUNIARTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

119 0108R00708160001961 29-08-2016 29-08-2016 0000027933322 SALMAH P U-3-13-0 OTHER EAR NOSE MOUTH &
THROAT DIAGNOSTIC
120 0108R00708160001960 29-08-2016 29-08-2016 0000027933355 RIZKI ANJINI P U-3-16-0 DENTAL OPERATIONS
121 0108R00708160000332 04-08-2016 04-08-2016 0000027937585 ROSMIATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
122 0108R00708160000819 11-08-2016 11-08-2016 0000027937585 ROSMIATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
123 0108R00708160002205 22-08-2016 22-08-2016 0000027937585 ROSMIATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
124 0108R00708160001864 29-08-2016 29-08-2016 0000027938529 NANIK YUNIASIH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
125 0108R00708160000231 03-08-2016 03-08-2016 0000027938529 NANIK YUNIASIH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
126 0108R00708160000856 11-08-2016 11-08-2016 0000027938608 IMAN TAUFIK L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
127 0108R00708160000118 02-08-2016 02-08-2016 0000027939802 AHMAD TARMIZI BIN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
TASMIR MINOR CHRONIC DISEASES
128 0108R00708160000224 03-08-2016 03-08-2016 0000027939846 DALIA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
129 0108R00708160001520 23-08-2016 23-08-2016 0000027940061 FARIDA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
130 0108R00708160000214 03-08-2016 03-08-2016 0000027940061 FARIDA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
131 0108R00708160001993 30-08-2016 30-08-2016 0000027940948 RINITA DRA P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
132 0108R00708160000296 04-08-2016 04-08-2016 0000027942333 MAULIDA P U-3-15-0 OTHER EAR NOSE MOUTH &
THROAT OPERATIONS
133 0108R00708160000855 11-08-2016 11-08-2016 0000027945527 ERIKHO lumban gaol L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
134 0108R00708160001913 29-08-2016 29-08-2016 0000027945527 ERIKHO lumban gaol L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
135 0108R00708160000594 08-08-2016 08-08-2016 0000027945527 ERIKHO lumban gaol L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
136 0108R00708160000064 01-08-2016 01-08-2016 0000027945527 ERIKHO lumban gaol L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
137 0108R00708160002026 30-08-2016 30-08-2016 0000027945663 TITIK ENDARWATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
138 0108R00708160001895 29-08-2016 29-08-2016 0000027946719 SRI SUSANTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

139 0108R00708160000366 04-08-2016 04-08-2016 0000027946719 SRI SUSANTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
140 0108R00708160001894 29-08-2016 29-08-2016 0000027984328 RIFKI YUSTISIO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
141 0108R00708160001835 29-08-2016 29-08-2016 0000028066926 RIELIZA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
142 0108R00708160001277 19-08-2016 19-08-2016 0000028074993 SUPONO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
143 0108R00708160002069 31-08-2016 31-08-2016 0000028092093 YUSNAINI AKBAR P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
144 0108R00708160000146 01-08-2016 01-08-2016 0000028107764 TRIADI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
145 0108R00708160000745 10-08-2016 10-08-2016 0000028181518 ACHMAD SAIE L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
146 0108R00708160001904 29-08-2016 29-08-2016 0000028181766 AHMAD SUNAINI,DRS. L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
147 0108R00708160000091 01-08-2016 01-08-2016 0000028199373 SUAIMI ZAINAL P N-3-15-0 DIALYSIS
148 0108R00708160000605 08-08-2016 08-08-2016 0000028199373 SUAIMI ZAINAL P N-3-15-0 DIALYSIS
149 0108R00708160000869 11-08-2016 11-08-2016 0000028199373 SUAIMI ZAINAL P N-3-15-0 DIALYSIS
150 0108R00708160001109 15-08-2016 15-08-2016 0000028199373 SUAIMI ZAINAL P N-3-15-0 DIALYSIS
151 0108R00708160001254 18-08-2016 18-08-2016 0000028199373 SUAIMI ZAINAL P N-3-15-0 DIALYSIS
152 0108R00708160001496 22-08-2016 22-08-2016 0000028199373 SUAIMI ZAINAL P N-3-15-0 DIALYSIS
153 0108R00708160001708 25-08-2016 25-08-2016 0000028199373 SUAIMI ZAINAL P N-3-15-0 DIALYSIS
154 0108R00708160001952 29-08-2016 29-08-2016 0000028199373 SUAIMI ZAINAL P N-3-15-0 DIALYSIS
155 0108R00708160000021 01-08-2016 01-08-2016 0000028204097 MASUPA P N-3-15-0 DIALYSIS
156 0108R00708160000289 04-08-2016 04-08-2016 0000028204097 MASUPA P N-3-15-0 DIALYSIS
157 0108R00708160000476 06-08-2016 06-08-2016 0000028204097 MASUPA P N-3-15-0 DIALYSIS
158 0108R00708160000530 08-08-2016 08-08-2016 0000028204097 MASUPA P N-3-15-0 DIALYSIS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

159 0108R00708160000832 11-08-2016 11-08-2016 0000028204097 MASUPA P N-3-15-0 DIALYSIS

160 0108R00708160000960 13-08-2016 13-08-2016 0000028204097 MASUPA P N-3-15-0 DIALYSIS
161 0108R00708160001025 15-08-2016 15-08-2016 0000028204097 MASUPA P N-3-15-0 DIALYSIS
162 0108R00708160001187 18-08-2016 18-08-2016 0000028204097 MASUPA P N-3-15-0 DIALYSIS
163 0108R00708160001341 20-08-2016 20-08-2016 0000028204097 MASUPA P N-3-15-0 DIALYSIS
164 0108R00708160001405 22-08-2016 22-08-2016 0000028204097 MASUPA P N-3-15-0 DIALYSIS
165 0108R00708160001657 25-08-2016 25-08-2016 0000028204097 MASUPA P N-3-15-0 DIALYSIS
166 0108R00708160001789 27-08-2016 27-08-2016 0000028204097 MASUPA P N-3-15-0 DIALYSIS
167 0108R00708160001854 29-08-2016 29-08-2016 0000028204097 MASUPA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
168 0108R00708160001984 30-08-2016 30-08-2016 0000028214515 SUTINI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
169 0108R00708160000002 01-08-2016 01-08-2016 0000028214515 SUTINI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
170 0108R00708160000167 02-08-2016 02-08-2016 0000028214717 ERWINA P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
171 0108R00708160002084 31-08-2016 31-08-2016 0000028215696 MUSAYAT L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
172 0108R00708160000527 08-08-2016 08-08-2016 0000028215696 MUSAYAT L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
173 0108R00708160001871 29-08-2016 29-08-2016 0000028215707 KUSMALADEWI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
174 0108R00708160001486 22-08-2016 22-08-2016 0000028215922 RESI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
175 0108R00708160002054 30-08-2016 30-08-2016 0000028215922 RESI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
176 0108R00708160002015 30-08-2016 30-08-2016 0000028216539 SYAFEI L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
177 0108R00708160001786 26-08-2016 26-08-2016 0000028222582 DADI L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
178 0108R00708160001332 19-08-2016 19-08-2016 0000028246814 FIRDA SAFIRA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

179 0108R00708160001965 29-08-2016 29-08-2016 0000028247646 DEONUGRAH PRATAMA L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
180 0108R00708160001847 29-08-2016 29-08-2016 0000028263071 M SENEN BAIDJURI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
181 0108R00708160000016 01-08-2016 01-08-2016 0000028263071 M SENEN BAIDJURI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
182 0108R00708160000729 10-08-2016 10-08-2016 0000028263813 RUDI ARDIANSYAH L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
183 0108R00708160000211 03-08-2016 03-08-2016 0000028281295 SUKARMAN L N-3-15-0 DIALYSIS
184 0108R00708160000467 06-08-2016 06-08-2016 0000028281295 SUKARMAN L N-3-15-0 DIALYSIS
185 0108R00708160000709 10-08-2016 10-08-2016 0000028281295 SUKARMAN L N-3-15-0 DIALYSIS
186 0108R00708160001213 17-08-2016 17-08-2016 0000028281295 SUKARMAN L N-3-15-0 DIALYSIS
187 0108R00708160001342 20-08-2016 20-08-2016 0000028281295 SUKARMAN L N-3-15-0 DIALYSIS
188 0108R00708160001581 24-08-2016 24-08-2016 0000028281295 SUKARMAN L N-3-15-0 DIALYSIS
189 0108R00708160001802 27-08-2016 27-08-2016 0000028281295 SUKARMAN L N-3-15-0 DIALYSIS
190 0108R00708160002113 31-08-2016 31-08-2016 0000028281295 SUKARMAN L N-3-15-0 DIALYSIS
191 0108R00708160000222 03-08-2016 03-08-2016 0000028306888 SANTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
192 0108R00708160001758 26-08-2016 26-08-2016 0000028323516 SUHARDI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
193 0108R00708160001823 27-08-2016 27-08-2016 0000028323516 SUHARDI L N-3-15-0 DIALYSIS
194 0108R00708160000260 03-08-2016 03-08-2016 0000028323516 SUHARDI L N-3-15-0 DIALYSIS
195 0108R00708160000744 10-08-2016 10-08-2016 0000028323516 SUHARDI L N-3-15-0 DIALYSIS
196 0108R00708160000981 13-08-2016 13-08-2016 0000028323516 SUHARDI L N-3-15-0 DIALYSIS
197 0108R00708160001518 23-08-2016 23-08-2016 0000028352351 MASAYU AZIZAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
198 0108R00708160002154 31-08-2016 31-08-2016 0000028354768 PASTI L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

199 0108R00708160002182 09-08-2016 09-08-2016 0000028375007 SAIDAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
200 0108R00708160001669 25-08-2016 25-08-2016 0000028377551 SUGINA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
201 0108R00708160001523 23-08-2016 23-08-2016 0000028402907 DEWI FERIYANTI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
202 0108R00708160001310 19-08-2016 19-08-2016 0000028408331 SUNARDI L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
203 0108R00708160000681 09-08-2016 09-08-2016 0000028428952 EKA NOVIANTY P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
204 0108R00708160000292 04-08-2016 04-08-2016 0000049684713 ROBERT SYIRMAN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
205 0108R00708160001247 18-08-2016 18-08-2016 0000148330822 FESSY ANGELA P Z-3-25-0 ULTRASOUND FOR
HERDANITA, A.MD GYNAECOLOGY DISORDERS
206 0108R00708160000237 03-08-2016 03-08-2016 0000148332791 FIKRY JULIANSYAH L Q-5-25-0 AMBULATORY VISIT FOR ACUTE
HERMAN GASTROINTESTINAL DISORDER
207 0108R00708160000145 02-08-2016 02-08-2016 0000148421272 HENI ARYANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
208 0108R00708160000956 13-08-2016 13-08-2016 0000148421272 HENI ARYANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
209 0108R00708160001269 18-08-2016 18-08-2016 0000149030684 FRISCA P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
210 0108R00708160000096 01-08-2016 01-08-2016 0000149261501 SOPJUDIN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
211 0108R00708160000097 01-08-2016 01-08-2016 0000149261534 FAKHRY ALI MUBAROK L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
212 0108R00708160000088 01-08-2016 01-08-2016 0000159699519 SOEKAMIE L U-3-16-0 DENTAL OPERATIONS
213 0108R00708160000613 08-08-2016 08-08-2016 0000159699519 SOEKAMIE L U-3-16-0 DENTAL OPERATIONS
214 0108R00708160001959 29-08-2016 29-08-2016 0000159699519 SOEKAMIE L U-3-16-0 DENTAL OPERATIONS
215 0108R00708160002144 31-08-2016 31-08-2016 0000165645044 MERYANCE P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
216 0108R00708160001929 29-08-2016 29-08-2016 0000166251227 YURISMANSYAH L Q-5-43-0 AMBULATORY VISIT FOR OTHER
MAJOR CHRONIC DISEASES
217 0108R00708160000595 08-08-2016 08-08-2016 0000168831898 SRI SUJANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
218 0108R00708160002039 30-08-2016 30-08-2016 0000169714135 SITI AISYAH P Q-5-25-0 AMBULATORY VISIT FOR ACUTE
GASTROINTESTINAL DISORDER
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

219 0108R00708160002068 31-08-2016 31-08-2016 0000169720457 SUMAINI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
220 0108R00708160001435 22-08-2016 22-08-2016 0000169720457 SUMAINI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
221 0108R00708160001585 24-08-2016 24-08-2016 0000169786269 YENNY P Q-5-42-0 AMBULATORY VISIT FOR OTHER
MINOR ACUTE DISORDER
222 0108R00708160000208 03-08-2016 03-08-2016 0000172719955 RENA WULANDARI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
223 0108R00708160001865 29-08-2016 29-08-2016 0000173095492 LINDA SASWITA, SE P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
224 0108R00708160000378 04-08-2016 04-08-2016 0000193626191 KHANZASYAH DINDA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
PUTRI MINOR CHRONIC DISEASES
225 0108R00708160001662 25-08-2016 25-08-2016 0000193626191 KHANZASYAH DINDA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
PUTRI MINOR CHRONIC DISEASES
226 0108R00708160001132 16-08-2016 16-08-2016 0000196278513 YULILI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
227 0108R00708160000873 11-08-2016 11-08-2016 0000200570703 SUHARDIYANTO L U-3-15-0 OTHER EAR NOSE MOUTH &
THROAT OPERATIONS
228 0108R00708160000436 05-08-2016 05-08-2016 0000201075884 FARRA NILA SARI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
229 0108R00708160001784 26-08-2016 26-08-2016 0000201135982 WAHYUDI L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
230 0108R00708160001653 25-08-2016 25-08-2016 0000201721072 NESFIATESI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
231 0108R00708160001144 16-08-2016 16-08-2016 0000201760828 TRI SELAWATIE, AM.KEP P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
232 0108R00708160001558 23-08-2016 23-08-2016 0000202603689 SYLFIANA TARIGAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
233 0108R00708160001015 15-08-2016 15-08-2016 0000202605096 LISYANCE P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
234 0108R00708160001361 20-08-2016 20-08-2016 0000202770573 HALIMAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
235 0108R00708160001447 22-08-2016 22-08-2016 0000202770573 HALIMAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
236 0108R00708160001127 16-08-2016 16-08-2016 0000202821254 KARTINI,A.MD P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
237 0108R00708160000401 04-08-2016 04-08-2016 0000203715437 KORNELIA SINAGA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
238 0108R00708160002040 30-08-2016 30-08-2016 0000204707518 ARIYAH P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

239 0108R00708160001705 25-08-2016 25-08-2016 0000206735207 RIZKI PUSPITA, S.PI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
240 0108R00708160001940 29-08-2016 29-08-2016 0000206735207 RIZKI PUSPITA, S.PI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
241 0108R00708160001162 16-08-2016 16-08-2016 0000206735207 RIZKI PUSPITA, S.PI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
242 0108R00708160000177 02-08-2016 02-08-2016 0000207562836 MEIRINDA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
243 0108R00708160001756 26-08-2016 26-08-2016 0000208357356 SUSI KIRANA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
244 0108R00708160001108 15-08-2016 15-08-2016 0000208558765 PUSPITA SARI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
245 0108R00708160000513 06-08-2016 06-08-2016 0000210370882 IRMA YUSNITA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
246 0108R00708160000442 05-08-2016 05-08-2016 0000210982746 WIDARIYAH P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
247 0108R00708160001933 29-08-2016 29-08-2016 0000360994037 CHAI SUN JIT L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
248 0108R00708160002120 31-08-2016 31-08-2016 0000361067624 SIMPEN P N-3-15-0 DIALYSIS
249 0108R00708160000083 01-08-2016 01-08-2016 0000361067624 SIMPEN P N-3-15-0 DIALYSIS
250 0108R00708160000419 05-08-2016 05-08-2016 0000361067624 SIMPEN P N-3-15-0 DIALYSIS
251 0108R00708160000606 08-08-2016 08-08-2016 0000361067624 SIMPEN P N-3-15-0 DIALYSIS
252 0108R00708160000753 10-08-2016 10-08-2016 0000361067624 SIMPEN P N-3-15-0 DIALYSIS
253 0108R00708160000899 12-08-2016 12-08-2016 0000361067624 SIMPEN P N-3-15-0 DIALYSIS
254 0108R00708160001099 15-08-2016 15-08-2016 0000361067624 SIMPEN P N-3-15-0 DIALYSIS
255 0108R00708160001200 17-08-2016 17-08-2016 0000361067624 SIMPEN P N-3-15-0 DIALYSIS
256 0108R00708160001294 19-08-2016 19-08-2016 0000361067624 SIMPEN P N-3-15-0 DIALYSIS
257 0108R00708160001491 22-08-2016 22-08-2016 0000361067624 SIMPEN P N-3-15-0 DIALYSIS
258 0108R00708160001597 24-08-2016 24-08-2016 0000361067624 SIMPEN P N-3-15-0 DIALYSIS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

259 0108R00708160001747 26-08-2016 26-08-2016 0000361067624 SIMPEN P N-3-15-0 DIALYSIS

260 0108R00708160001957 29-08-2016 29-08-2016 0000361067624 SIMPEN P N-3-15-0 DIALYSIS
261 0108R00708160000041 01-08-2016 01-08-2016 0000361192779 SUSILAWANA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
262 0108R00708160001931 29-08-2016 29-08-2016 0000361224325 TJEW KHIN HOI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
263 0108R00708160001753 26-08-2016 26-08-2016 0000361257603 RISKI L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
264 0108R00708160001918 29-08-2016 29-08-2016 0000361257603 RISKI L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
265 0108R00708160000063 01-08-2016 01-08-2016 0000361257603 RISKI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
266 0108R00708160000608 08-08-2016 08-08-2016 0000361404999 RAHMAN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
267 0108R00708160000876 11-08-2016 11-08-2016 0000361551778 DESTRI RISTIANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
268 0108R00708160000069 01-08-2016 01-08-2016 0000361586856 KAM KIM DJIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
269 0108R00708160001617 24-08-2016 24-08-2016 0000361586856 KAM KIM DJIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
270 0108R00708160001761 26-08-2016 26-08-2016 0000361606792 JUNAINI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
271 0108R00708160000654 09-08-2016 09-08-2016 0000361606814 RUBDI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
272 0108R00708160002123 31-08-2016 31-08-2016 0000361646335 PHU SIAK WAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
273 0108R00708160001436 22-08-2016 22-08-2016 0000361678983 ROHANA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
274 0108R00708160000657 09-08-2016 09-08-2016 0000361809472 LENI INDRAWATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
275 0108R00708160000570 08-08-2016 08-08-2016 0000361809472 LENI INDRAWATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
276 0108R00708160001009 15-08-2016 15-08-2016 0000361809472 LENI INDRAWATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
277 0108R00708160000609 08-08-2016 08-08-2016 0000361817065 SUWANDI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
278 0108R00708160001130 16-08-2016 16-08-2016 0000361871076 WATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

279 0108R00708160000092 01-08-2016 01-08-2016 0000361871223 ANWAR L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
280 0108R00708160000418 05-08-2016 05-08-2016 0000361959851 MARRINA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
281 0108R00708160000925 12-08-2016 12-08-2016 0000361959851 MARRINA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
282 0108R00708160001044 15-08-2016 15-08-2016 0000361967692 AISU P Q-5-27-0 AMBULATORY VISIT FOR ACUTE
CENTRAL NERVOUS SYSTEM
283 0108R00708160002103 31-08-2016 31-08-2016 0000362000913 ROJUNA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
284 0108R00708160001611 24-08-2016 24-08-2016 0000362000913 ROJUNA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
285 0108R00708160000403 04-08-2016 04-08-2016 0000362033864 ISNAINI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
286 0108R00708160001065 15-08-2016 15-08-2016 0000362082824 APRILIA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
287 0108R00708160000510 06-08-2016 06-08-2016 0000362219894 HANIFA FATMA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
288 0108R00708160000070 01-08-2016 01-08-2016 0000362297529 PUJA NABELA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
289 0108R00708160000982 13-08-2016 13-08-2016 0000362336916 MELVIN ANDREAS L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
290 0108R00708160001090 15-08-2016 15-08-2016 0000362418491 YESI TAMILASARI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
291 0108R00708160001181 18-08-2016 18-08-2016 0000362418491 YESI TAMILASARI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
292 0108R00708160002095 31-08-2016 31-08-2016 0000997778597 PHUNG KONG FO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
293 0108R00708160000809 11-08-2016 11-08-2016 0000997778597 PHUNG KONG FO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
294 0108R00708160001279 19-08-2016 19-08-2016 0000997778597 PHUNG KONG FO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
295 0108R00708160001569 23-08-2016 23-08-2016 0000997778766 LO MUK NA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
296 0108R00708160001271 18-08-2016 18-08-2016 0001079939485 NURUL TRI HANDAYANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
297 0108R00708160001278 19-08-2016 19-08-2016 0001080373678 MUHAMMAD FAYIZ L Q-5-44-0 AMBULATORY VISIT FOR OTHER
HAIDAR MINOR CHRONIC DISEASES
298 0108R00708160001374 22-08-2016 22-08-2016 0001081686047 ABDUL KARIM L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

299 0108R00708160000029 01-08-2016 01-08-2016 0001082416689 MUHAMMAD NIZAM S L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
300 0108R00708160001770 26-08-2016 26-08-2016 0001093719418 ANGGA SAPUTRA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
301 0108R00708160001745 26-08-2016 26-08-2016 0001094444493 LIA DWIANA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
302 0108R00708160000184 02-08-2016 02-08-2016 0001096497674 DITA OKTARINA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
303 0108R00708160001873 29-08-2016 29-08-2016 0001102805201 HARUN EFENDI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
304 0108R00708160001920 29-08-2016 29-08-2016 0001107391162 RAFLI ALLUTHFI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
305 0108R00708160001516 23-08-2016 23-08-2016 0001107422662 MARYUNITA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
306 0108R00708160000615 08-08-2016 08-08-2016 0001107856034 FERDI KUSUMA JAYA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
307 0108R00708160001876 29-08-2016 29-08-2016 0001110090339 AKHMAD AL KHUSYAIRI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
308 0108R00708160001005 15-08-2016 15-08-2016 0001124203173 YUDA PURNAMA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
309 0108R00708160001738 25-08-2016 25-08-2016 0001137637787 SUYONO SASTRO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
310 0108R00708160001927 29-08-2016 29-08-2016 0001137637787 SUYONO SASTRO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
311 0108R00708160001546 23-08-2016 23-08-2016 0001137637787 SUYONO SASTRO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
312 0108R00708160001398 22-08-2016 22-08-2016 0001140853173 UTAMI DEWI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
313 0108R00708160002193 12-08-2016 12-08-2016 0001142788465 FERGITA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
314 0108R00708160000385 04-08-2016 04-08-2016 0001143249963 ARI CAHYONO L Q-5-42-0 AMBULATORY VISIT FOR OTHER
MINOR ACUTE DISORDER
315 0108R00708160000172 02-08-2016 02-08-2016 0001144800718 RIA HEPTA DEWI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
SIHOMBING MINOR CHRONIC DISEASES
316 0108R00708160000441 05-08-2016 05-08-2016 0001144800718 RIA HEPTA DEWI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
SIHOMBING MINOR CHRONIC DISEASES
317 0108R00708160001583 24-08-2016 24-08-2016 0001145930139 WIRA OKTARINA, SE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
318 0108R00708160001830 29-08-2016 29-08-2016 0001145930139 WIRA OKTARINA, SE P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

319 0108R00708160001678 25-08-2016 25-08-2016 0001145930139 WIRA OKTARINA, SE P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
320 0108R00708160001433 22-08-2016 22-08-2016 0001152139307 FAUZI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
321 0108R00708160000056 01-08-2016 01-08-2016 0001164104673 RAVIALDO RIVALDI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
322 0108R00708160001751 26-08-2016 26-08-2016 0001173509673 RITA YUSNILA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
323 0108R00708160000125 02-08-2016 02-08-2016 0001177891806 OKTAVIANIE FOE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
324 0108R00708160001986 30-08-2016 30-08-2016 0001181246747 ESSY DESVITArini P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
325 0108R00708160001149 16-08-2016 16-08-2016 0001184399752 LARASATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
326 0108R00708160001161 16-08-2016 16-08-2016 0001185184607 OCCA ROANNISCA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
327 0108R00708160001173 16-08-2016 16-08-2016 0001190540968 SRI YULI MAYANTI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
328 0108R00708160000836 11-08-2016 11-08-2016 0001193065615 EVI SUYANTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
329 0108R00708160000889 12-08-2016 12-08-2016 0001193700047 MEGA WIDYA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
330 0108R00708160000481 06-08-2016 06-08-2016 0001195825116 YULIA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
331 0108R00708160000980 13-08-2016 13-08-2016 0001195825116 YULIA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
332 0108R00708160000758 10-08-2016 10-08-2016 0001196840114 NICO ERICO P U-3-16-0 DENTAL OPERATIONS
333 0108R00708160001967 29-08-2016 29-08-2016 0001196840147 MAHESWARA ORINO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
334 0108R00708160001615 24-08-2016 24-08-2016 0001199716143 FITRIYANTI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
335 0108R00708160000036 01-08-2016 01-08-2016 0001200786129 TSAFIRA MAGDHA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
PERTIWI MINOR CHRONIC DISEASES
336 0108R00708160002128 31-08-2016 31-08-2016 0001202845937 Akram Fathin Al Latief L Q-5-42-0 AMBULATORY VISIT FOR OTHER
MINOR ACUTE DISORDER
337 0108R00708160000241 03-08-2016 03-08-2016 0001203863106 DESSY DWIYASTUTI P U-3-16-0 DENTAL OPERATIONS
338 0108R00708160000583 08-08-2016 08-08-2016 0001203863106 DESSY DWIYASTUTI P U-3-16-0 DENTAL OPERATIONS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

339 0108R00708160000748 10-08-2016 10-08-2016 0001203863106 DESSY DWIYASTUTI P U-3-16-0 DENTAL OPERATIONS
340 0108R00708160001964 29-08-2016 29-08-2016 0001203863106 DESSY DWIYASTUTI P U-3-16-0 DENTAL OPERATIONS
341 0108R00708160000493 06-08-2016 06-08-2016 0001225071279 NURAINI HUSIN P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
342 0108R00708160000848 11-08-2016 11-08-2016 0001226624894 R ADI SASONGKO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
343 0108R00708160001944 29-08-2016 29-08-2016 0001226624894 R ADI SASONGKO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
344 0108R00708160000037 01-08-2016 01-08-2016 0001226624894 R ADI SASONGKO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
345 0108R00708160000625 08-08-2016 08-08-2016 0001226879076 MUTIARA TONDANI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INDRA INVESTIGATIONS
346 0108R00708160001917 29-08-2016 29-08-2016 0001226879076 MUTIARA TONDANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
INDRA MINOR CHRONIC DISEASES
347 0108R00708160002221 18-08-2016 18-08-2016 0001226879076 MUTIARA TONDANI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INDRA INVESTIGATIONS
348 0108R00708160000614 08-08-2016 08-08-2016 0001227363129 YATINAH P U-3-16-0 DENTAL OPERATIONS
349 0108R00708160002055 30-08-2016 30-08-2016 0001227363129 YATINAH P U-3-16-0 DENTAL OPERATIONS
350 0108R00708160002124 31-08-2016 31-08-2016 0001227363129 YATINAH P U-3-16-0 DENTAL OPERATIONS
351 0108R00708160000112 02-08-2016 02-08-2016 0001230248327 RICHE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
352 0108R00708160000464 06-08-2016 06-08-2016 0001230248327 RICHE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
353 0108R00708160000140 01-08-2016 01-08-2016 0001240329317 Bima Arya L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
354 0108R00708160000022 01-08-2016 01-08-2016 0001261026999 TJHIN DJIN SIONG L N-3-15-0 DIALYSIS
355 0108R00708160000531 08-08-2016 08-08-2016 0001261026999 TJHIN DJIN SIONG L N-3-15-0 DIALYSIS
356 0108R00708160000831 11-08-2016 11-08-2016 0001261026999 TJHIN DJIN SIONG L N-3-15-0 DIALYSIS
357 0108R00708160001023 15-08-2016 15-08-2016 0001261026999 TJHIN DJIN SIONG L N-3-15-0 DIALYSIS
358 0108R00708160001188 18-08-2016 18-08-2016 0001261026999 TJHIN DJIN SIONG L N-3-15-0 DIALYSIS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

359 0108R00708160001403 22-08-2016 22-08-2016 0001261026999 TJHIN DJIN SIONG L N-3-15-0 DIALYSIS
360 0108R00708160001428 20-08-2016 20-08-2016 0001261026999 TJHIN DJIN SIONG L N-3-15-0 DIALYSIS
361 0108R00708160001658 25-08-2016 25-08-2016 0001261026999 TJHIN DJIN SIONG L N-3-15-0 DIALYSIS
362 0108R00708160001956 29-08-2016 29-08-2016 0001261026999 TJHIN DJIN SIONG L N-3-15-0 DIALYSIS
363 0108R00708160002191 06-08-2016 06-08-2016 0001261026999 TJHIN DJIN SIONG L N-3-15-0 DIALYSIS
364 0108R00708160002196 13-08-2016 13-08-2016 0001261026999 TJHIN DJIN SIONG L N-3-15-0 DIALYSIS
365 0108R00708160000131 02-08-2016 02-08-2016 0001261679949 BOEN MIN SIAT L N-3-15-0 DIALYSIS
366 0108R00708160000290 04-08-2016 04-08-2016 0001261679949 BOEN MIN SIAT L N-3-15-0 DIALYSIS
367 0108R00708160000474 06-08-2016 06-08-2016 0001261679949 BOEN MIN SIAT L N-3-15-0 DIALYSIS
368 0108R00708160000642 09-08-2016 09-08-2016 0001261679949 BOEN MIN SIAT L N-3-15-0 DIALYSIS
369 0108R00708160000830 11-08-2016 11-08-2016 0001261679949 BOEN MIN SIAT L N-3-15-0 DIALYSIS
370 0108R00708160000962 13-08-2016 13-08-2016 0001261679949 BOEN MIN SIAT L N-3-15-0 DIALYSIS
371 0108R00708160001139 16-08-2016 16-08-2016 0001261679949 BOEN MIN SIAT L N-3-15-0 DIALYSIS
372 0108R00708160001190 18-08-2016 18-08-2016 0001261679949 BOEN MIN SIAT L N-3-15-0 DIALYSIS
373 0108R00708160001335 20-08-2016 20-08-2016 0001261679949 BOEN MIN SIAT L N-3-15-0 DIALYSIS
374 0108R00708160001530 23-08-2016 23-08-2016 0001261679949 BOEN MIN SIAT L N-3-15-0 DIALYSIS
375 0108R00708160001656 25-08-2016 25-08-2016 0001261679949 BOEN MIN SIAT L N-3-15-0 DIALYSIS
376 0108R00708160001793 27-08-2016 27-08-2016 0001261679949 BOEN MIN SIAT L N-3-15-0 DIALYSIS
377 0108R00708160002009 30-08-2016 30-08-2016 0001261679949 BOEN MIN SIAT L N-3-15-0 DIALYSIS
378 0108R00708160000800 11-08-2016 11-08-2016 0001263128602 HERMANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

379 0108R00708160001728 26-08-2016 26-08-2016 0001263128602 HERMANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
380 0108R00708160000482 06-08-2016 06-08-2016 0001264356371 GUSTINA P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
381 0108R00708160001312 19-08-2016 19-08-2016 0001265554618 HAFIZH FAIZAN RIZKI L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
382 0108R00708160002052 30-08-2016 30-08-2016 0001265554866 ERDYANA TISNA P Z-3-25-0 ULTRASOUND FOR
SYAMSU GYNAECOLOGY DISORDERS
383 0108R00708160000879 11-08-2016 11-08-2016 0001267529332 SENDY TRIGUNA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
FEBRIANI MINOR CHRONIC DISEASES
384 0108R00708160000810 11-08-2016 11-08-2016 0001267763152 MUHAMMAD KENZO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
ARDI MINOR CHRONIC DISEASES
385 0108R00708160001860 29-08-2016 29-08-2016 0001268449154 RINA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
386 0108R00708160000847 11-08-2016 11-08-2016 0001268449154 RINA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
387 0108R00708160001998 30-08-2016 30-08-2016 0001270557909 NIRMALA SARI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
388 0108R00708160000301 04-08-2016 04-08-2016 0001271578239 KIM FEN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
389 0108R00708160000803 11-08-2016 11-08-2016 0001271578239 KIM FEN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
390 0108R00708160001676 25-08-2016 25-08-2016 0001271578239 KIM FEN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
391 0108R00708160000802 11-08-2016 11-08-2016 0001271578915 ENY P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
392 0108R00708160001939 28-08-2016 28-08-2016 0001271731882 SUTARTO TOBINAN L Q-5-39-0 AMBULATORY VISIT FOR
COMPLEX SOFT TISSUE INJURY
393 0108R00708160000694 10-08-2016 10-08-2016 0001271731882 SUTARTO TOBINAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
394 0108R00708160001881 29-08-2016 29-08-2016 0001273307984 TJEN WE TIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
395 0108R00708160001467 22-08-2016 22-08-2016 0001273307984 TJEN WE TIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
396 0108R00708160000881 11-08-2016 11-08-2016 0001273904763 NOUVALDY ALINSKIE L Q-5-42-0 AMBULATORY VISIT FOR OTHER
MINOR ACUTE DISORDER
397 0108R00708160000018 01-08-2016 01-08-2016 0001274286846 TJIN MIE TJIN P N-3-15-0 DIALYSIS
398 0108R00708160000524 08-08-2016 08-08-2016 0001274286846 TJIN MIE TJIN P N-3-15-0 DIALYSIS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

399 0108R00708160000828 11-08-2016 11-08-2016 0001274286846 TJIN MIE TJIN P N-3-15-0 DIALYSIS
400 0108R00708160001028 15-08-2016 15-08-2016 0001274286846 TJIN MIE TJIN P N-3-15-0 DIALYSIS
401 0108R00708160001192 18-08-2016 18-08-2016 0001274286846 TJIN MIE TJIN P N-3-15-0 DIALYSIS
402 0108R00708160001383 22-08-2016 22-08-2016 0001274286846 TJIN MIE TJIN P N-3-15-0 DIALYSIS
403 0108R00708160001692 25-08-2016 25-08-2016 0001274286846 TJIN MIE TJIN P N-3-15-0 DIALYSIS
404 0108R00708160001852 29-08-2016 29-08-2016 0001274286846 TJIN MIE TJIN P N-3-15-0 DIALYSIS
405 0108R00708160001388 22-08-2016 22-08-2016 0001275081996 SAMSIDI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
406 0108R00708160002070 31-08-2016 31-08-2016 0001275388233 TJHAI KIM KIOEK P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
407 0108R00708160001386 22-08-2016 22-08-2016 0001275388233 TJHAI KIM KIOEK P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
408 0108R00708160001805 26-08-2016 26-08-2016 0001276047145 HERNI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
409 0108R00708160002213 30-08-2016 30-08-2016 0001276051329 MARNI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
410 0108R00708160000616 08-08-2016 08-08-2016 0001276501825 AKHIUK P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
411 0108R00708160001058 15-08-2016 15-08-2016 0001277257397 BONG MIE SUAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
412 0108R00708160001088 15-08-2016 15-08-2016 0001277959803 della felita P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
413 0108R00708160000733 10-08-2016 10-08-2016 0001278326812 liaw piang liat L N-3-15-0 DIALYSIS
414 0108R00708160000040 01-08-2016 01-08-2016 0001278326812 liaw piang liat L N-3-15-0 DIALYSIS
415 0108R00708160000226 03-08-2016 03-08-2016 0001278326812 liaw piang liat L N-3-15-0 DIALYSIS
416 0108R00708160000397 05-08-2016 05-08-2016 0001278326812 liaw piang liat L N-3-15-0 DIALYSIS
417 0108R00708160000920 12-08-2016 12-08-2016 0001278326812 liaw piang liat L N-3-15-0 DIALYSIS
418 0108R00708160001043 15-08-2016 15-08-2016 0001278326812 liaw piang liat L N-3-15-0 DIALYSIS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

419 0108R00708160001212 17-08-2016 17-08-2016 0001278326812 liaw piang liat L N-3-15-0 DIALYSIS
420 0108R00708160001304 19-08-2016 19-08-2016 0001278326812 liaw piang liat L N-3-15-0 DIALYSIS
421 0108R00708160001424 22-08-2016 22-08-2016 0001278326812 liaw piang liat L N-3-15-0 DIALYSIS
422 0108R00708160001589 24-08-2016 24-08-2016 0001278326812 liaw piang liat L N-3-15-0 DIALYSIS
423 0108R00708160001731 26-08-2016 26-08-2016 0001278326812 liaw piang liat L N-3-15-0 DIALYSIS
424 0108R00708160001855 29-08-2016 29-08-2016 0001278326812 liaw piang liat L N-3-15-0 DIALYSIS
425 0108R00708160002117 31-08-2016 31-08-2016 0001278326812 liaw piang liat L N-3-15-0 DIALYSIS
426 0108R00708160000849 11-08-2016 11-08-2016 0001278513123 theo renato abigail s L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
427 0108R00708160001859 29-08-2016 29-08-2016 0001279258604 TJHAI HON KHIAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
428 0108R00708160000027 01-08-2016 01-08-2016 0001279258604 TJHAI HON KHIAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
429 0108R00708160001414 22-08-2016 22-08-2016 0001280115933 THEN MUK LAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
430 0108R00708160000697 10-08-2016 10-08-2016 0001280115933 THEN MUK LAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
431 0108R00708160000328 04-08-2016 04-08-2016 0001280199879 NURSYAMY P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
432 0108R00708160001983 30-08-2016 30-08-2016 0001280199879 NURSYAMY P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
433 0108R00708160000574 08-08-2016 08-08-2016 0001281403833 LIE TJIN SIONG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
434 0108R00708160001577 24-08-2016 24-08-2016 0001281416365 FARID KARYADI L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
435 0108R00708160000573 08-08-2016 08-08-2016 0001281416365 FARID KARYADI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
436 0108R00708160002178 23-08-2016 23-08-2016 0001281416365 FARID KARYADI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
437 0108R00708160000024 01-08-2016 01-08-2016 0001282451984 LIANARSAK L Q-5-44-0 AMBULATORY VISIT FOR OTHER
DJOJODIPURO MINOR CHRONIC DISEASES
438 0108R00708160000736 10-08-2016 10-08-2016 0001283457655 TJHIN LIE JIN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

439 0108R00708160000440 05-08-2016 05-08-2016 0001283458612 TJHIN LIE TJHIANG P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
440 0108R00708160000346 04-08-2016 04-08-2016 0001283892816 MUKRIYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
441 0108R00708160001796 27-08-2016 27-08-2016 0001283892816 MUKRIYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
442 0108R00708160002041 30-08-2016 30-08-2016 0001283892816 MUKRIYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
443 0108R00708160001018 15-08-2016 15-08-2016 0001283892816 MUKRIYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
444 0108R00708160001333 20-08-2016 20-08-2016 0001283892816 MUKRIYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
445 0108R00708160000529 08-08-2016 08-08-2016 0001283892816 MUKRIYATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
446 0108R00708160001390 22-08-2016 22-08-2016 0001283892816 MUKRIYATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
447 0108R00708160001527 23-08-2016 23-08-2016 0001284488212 FARIDA P N-3-15-0 DIALYSIS
448 0108R00708160000156 02-08-2016 02-08-2016 0001284488212 FARIDA P N-3-15-0 DIALYSIS
449 0108R00708160001280 19-08-2016 19-08-2016 0001284488212 FARIDA P N-3-15-0 DIALYSIS
450 0108R00708160000660 09-08-2016 09-08-2016 0001284488212 FARIDA P N-3-15-0 DIALYSIS
451 0108R00708160000907 12-08-2016 12-08-2016 0001284488212 FARIDA P N-3-15-0 DIALYSIS
452 0108R00708160001141 16-08-2016 16-08-2016 0001284488212 FARIDA P N-3-15-0 DIALYSIS
453 0108R00708160001744 26-08-2016 26-08-2016 0001284488212 FARIDA P N-3-15-0 DIALYSIS
454 0108R00708160002006 30-08-2016 30-08-2016 0001284488212 FARIDA P N-3-15-0 DIALYSIS
455 0108R00708160001958 29-08-2016 29-08-2016 0001284620905 JUMINAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
456 0108R00708160001437 22-08-2016 22-08-2016 0001284620905 JUMINAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
457 0108R00708160000326 04-08-2016 04-08-2016 0001284940596 TJHIA A FET P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
458 0108R00708160001928 29-08-2016 29-08-2016 0001285362461 BONG MIE TJHOEN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

459 0108R00708160000182 02-08-2016 02-08-2016 0001285362461 BONG MIE TJHOEN P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
460 0108R00708160001625 24-08-2016 24-08-2016 0001285362461 BONG MIE TJHOEN P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
461 0108R00708160002021 30-08-2016 30-08-2016 0001285362461 BONG MIE TJHOEN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
462 0108R00708160000676 09-08-2016 09-08-2016 0001285362461 BONG MIE TJHOEN P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
463 0108R00708160001228 18-08-2016 18-08-2016 0001285362461 BONG MIE TJHOEN P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
464 0108R00708160000023 01-08-2016 01-08-2016 0001285719063 HAMDAN L N-3-15-0 DIALYSIS
465 0108R00708160000204 03-08-2016 03-08-2016 0001285719063 HAMDAN L N-3-15-0 DIALYSIS
466 0108R00708160000472 06-08-2016 06-08-2016 0001285719063 HAMDAN L N-3-15-0 DIALYSIS
467 0108R00708160000532 08-08-2016 08-08-2016 0001285719063 HAMDAN L N-3-15-0 DIALYSIS
468 0108R00708160000714 10-08-2016 10-08-2016 0001285719063 HAMDAN L N-3-15-0 DIALYSIS
469 0108R00708160000964 13-08-2016 13-08-2016 0001285719063 HAMDAN L N-3-15-0 DIALYSIS
470 0108R00708160001026 15-08-2016 15-08-2016 0001285719063 HAMDAN L N-3-15-0 DIALYSIS
471 0108R00708160001216 17-08-2016 17-08-2016 0001285719063 HAMDAN L N-3-15-0 DIALYSIS
472 0108R00708160001340 20-08-2016 20-08-2016 0001285719063 HAMDAN L N-3-15-0 DIALYSIS
473 0108R00708160001400 22-08-2016 22-08-2016 0001285719063 HAMDAN L N-3-15-0 DIALYSIS
474 0108R00708160001591 24-08-2016 24-08-2016 0001285719063 HAMDAN L N-3-15-0 DIALYSIS
475 0108R00708160001790 27-08-2016 27-08-2016 0001285719063 HAMDAN L N-3-15-0 DIALYSIS
476 0108R00708160001851 29-08-2016 29-08-2016 0001285719063 HAMDAN L N-3-15-0 DIALYSIS
477 0108R00708160002115 31-08-2016 31-08-2016 0001285719063 HAMDAN L N-3-15-0 DIALYSIS
478 0108R00708160000824 11-08-2016 11-08-2016 0001285905914 AMBO RAPE L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

479 0108R00708160000805 11-08-2016 11-08-2016 0001285981312 HERNI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
480 0108R00708160002059 30-08-2016 30-08-2016 0001286506541 TUBAGUS KOSASIH L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
481 0108R00708160002065 31-08-2016 31-08-2016 0001286506541 TUBAGUS KOSASIH L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
482 0108R00708160001350 18-08-2016 18-08-2016 0001286506541 TUBAGUS KOSASIH L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
483 0108R00708160002060 30-08-2016 30-08-2016 0001286507542 BANUN LIZAL P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
484 0108R00708160002064 31-08-2016 31-08-2016 0001286507542 BANUN LIZAL P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
485 0108R00708160001627 24-08-2016 24-08-2016 0001286507542 BANUN LIZAL P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
486 0108R00708160001746 26-08-2016 26-08-2016 0001286507542 BANUN LIZAL P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
487 0108R00708160001803 27-08-2016 27-08-2016 0001286507542 BANUN LIZAL P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
488 0108R00708160001843 29-08-2016 29-08-2016 0001286507542 BANUN LIZAL P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
489 0108R00708160000872 11-08-2016 11-08-2016 0001286507542 BANUN LIZAL P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
490 0108R00708160001531 23-08-2016 23-08-2016 0001286507542 BANUN LIZAL P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
491 0108R00708160001672 25-08-2016 25-08-2016 0001286507542 BANUN LIZAL P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
492 0108R00708160001404 22-08-2016 22-08-2016 0001286507542 BANUN LIZAL P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
493 0108R00708160001352 18-08-2016 18-08-2016 0001286507542 BANUN LIZAL P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
494 0108R00708160000203 03-08-2016 03-08-2016 0001286578541 HAMBALI L N-3-15-0 DIALYSIS
495 0108R00708160000471 06-08-2016 06-08-2016 0001286578541 HAMBALI L N-3-15-0 DIALYSIS
496 0108R00708160000716 10-08-2016 10-08-2016 0001286578541 HAMBALI L N-3-15-0 DIALYSIS
497 0108R00708160000961 13-08-2016 13-08-2016 0001286578541 HAMBALI L N-3-15-0 DIALYSIS
498 0108R00708160001203 17-08-2016 17-08-2016 0001286578541 HAMBALI L N-3-15-0 DIALYSIS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

499 0108R00708160001339 20-08-2016 20-08-2016 0001286578541 HAMBALI L N-3-15-0 DIALYSIS

500 0108R00708160001794 27-08-2016 27-08-2016 0001286578541 HAMBALI L N-3-15-0 DIALYSIS
501 0108R00708160002116 31-08-2016 31-08-2016 0001286578541 HAMBALI L N-3-15-0 DIALYSIS
502 0108R00708160000696 10-08-2016 10-08-2016 0001287638695 TJOENG A MEN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
503 0108R00708160000725 10-08-2016 10-08-2016 0001287639202 DJIE SIAN NYUN P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
504 0108R00708160001185 18-08-2016 18-08-2016 0001287639202 DJIE SIAN NYUN P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
505 0108R00708160001651 25-08-2016 25-08-2016 0001287639202 DJIE SIAN NYUN P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
506 0108R00708160000284 04-08-2016 04-08-2016 0001287639202 DJIE SIAN NYUN P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
507 0108R00708160000303 04-08-2016 04-08-2016 0001287867914 VEREN P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
508 0108R00708160001012 15-08-2016 15-08-2016 0001287867914 VEREN P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
509 0108R00708160000946 12-08-2016 12-08-2016 0001288980167 BUN KHIE PAU L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
510 0108R00708160001970 29-08-2016 29-08-2016 0001288980167 BUN KHIE PAU L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
511 0108R00708160000488 06-08-2016 06-08-2016 0001288984241 MOK MIE NIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
512 0108R00708160000560 08-08-2016 08-08-2016 0001290600516 SUAINI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
513 0108R00708160000816 11-08-2016 11-08-2016 0001291266988 A. AHMAD L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
514 0108R00708160000851 11-08-2016 11-08-2016 0001292691519 LIAUW KWET KIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
515 0108R00708160001934 29-08-2016 29-08-2016 0001292691519 LIAUW KWET KIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
516 0108R00708160000706 10-08-2016 10-08-2016 0001292692454 TJOENG A DJIT P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
517 0108R00708160002121 31-08-2016 31-08-2016 0001292698359 HELLY SoeSPyATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
518 0108R00708160000499 06-08-2016 06-08-2016 0001294785404 ZAINAB P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

519 0108R00708160000662 09-08-2016 09-08-2016 0001294827478 RENIWIARTY P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
520 0108R00708160001861 29-08-2016 29-08-2016 0001295665997 MOHAMMAD BADRI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
521 0108R00708160001849 29-08-2016 29-08-2016 0001295666087 MEUTIA FARIDA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
522 0108R00708160000058 01-08-2016 01-08-2016 0001295666087 MEUTIA FARIDA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
523 0108R00708160002184 04-08-2016 04-08-2016 0001295817074 MO FATIMAH P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
524 0108R00708160001911 29-08-2016 29-08-2016 0001296732879 FITRI DWI FELANO P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
525 0108R00708160001827 29-08-2016 29-08-2016 0001297596993 TJHIN DJOENG KHIN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
526 0108R00708160000287 04-08-2016 04-08-2016 0001297596993 TJHIN DJOENG KHIN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
527 0108R00708160001019 15-08-2016 15-08-2016 0001298228084 INDRAYANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
528 0108R00708160001710 25-08-2016 25-08-2016 0001298516409 TJUNG A BOEN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
529 0108R00708160001111 15-08-2016 15-08-2016 0001298516409 TJUNG A BOEN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
530 0108R00708160000202 03-08-2016 03-08-2016 0001299756328 SUSINAH P N-3-15-0 DIALYSIS
531 0108R00708160000475 06-08-2016 06-08-2016 0001299756328 SUSINAH P N-3-15-0 DIALYSIS
532 0108R00708160000715 10-08-2016 10-08-2016 0001299756328 SUSINAH P N-3-15-0 DIALYSIS
533 0108R00708160000963 13-08-2016 13-08-2016 0001299756328 SUSINAH P N-3-15-0 DIALYSIS
534 0108R00708160001204 17-08-2016 17-08-2016 0001299756328 SUSINAH P N-3-15-0 DIALYSIS
535 0108R00708160001336 20-08-2016 20-08-2016 0001299756328 SUSINAH P N-3-15-0 DIALYSIS
536 0108R00708160001598 24-08-2016 24-08-2016 0001299756328 SUSINAH P N-3-15-0 DIALYSIS
537 0108R00708160001792 27-08-2016 27-08-2016 0001299756328 SUSINAH P N-3-15-0 DIALYSIS
538 0108R00708160002114 31-08-2016 31-08-2016 0001299756328 SUSINAH P N-3-15-0 DIALYSIS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

539 0108R00708160000065 01-08-2016 01-08-2016 0001302150802 HAGUS SALIM L Q-5-32-0 AMBULATORY VISIT FOR ACUTE
URINARY TRACT DISORDER
540 0108R00708160000434 05-08-2016 05-08-2016 0001302154176 YAN A LAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
541 0108R00708160001553 23-08-2016 23-08-2016 0001302242995 H. SUHERMAN,SH L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
542 0108R00708160000804 11-08-2016 11-08-2016 0001302368398 KONG FA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
543 0108R00708160001362 20-08-2016 20-08-2016 0001302587032 JONI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
544 0108R00708160000267 03-08-2016 03-08-2016 0001303434775 gesya kardela P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
545 0108R00708160001822 27-08-2016 27-08-2016 0001304308539 WE RIE P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
546 0108R00708160000938 12-08-2016 12-08-2016 0001304308539 WE RIE P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
547 0108R00708160000055 01-08-2016 01-08-2016 0001304308539 WE RIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
548 0108R00708160000672 09-08-2016 09-08-2016 0001304396111 NURHAYATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
549 0108R00708160001002 15-08-2016 15-08-2016 0001304998975 SUMIATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
550 0108R00708160000997 15-08-2016 15-08-2016 0001306130062 LIM MEN KWET L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
551 0108R00708160000728 10-08-2016 10-08-2016 0001306318274 JAP TJOEN HOA P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
552 0108R00708160001787 27-08-2016 27-08-2016 0001306318274 JAP TJOEN HOA P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
553 0108R00708160002001 30-08-2016 30-08-2016 0001306318274 JAP TJOEN HOA P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
554 0108R00708160000221 03-08-2016 03-08-2016 0001306318274 JAP TJOEN HOA P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
555 0108R00708160001526 23-08-2016 23-08-2016 0001306318274 JAP TJOEN HOA P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
556 0108R00708160000031 01-08-2016 01-08-2016 0001306318274 JAP TJOEN HOA P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
557 0108R00708160000500 06-08-2016 06-08-2016 0001306318274 JAP TJOEN HOA P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
558 0108R00708160000969 13-08-2016 13-08-2016 0001306318274 JAP TJOEN HOA P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

559 0108R00708160000541 08-08-2016 08-08-2016 0001306318274 JAP TJOEN HOA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
560 0108R00708160001034 15-08-2016 15-08-2016 0001306318274 JAP TJOEN HOA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
561 0108R00708160001421 22-08-2016 22-08-2016 0001306479914 TJHIN KHIN FO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
562 0108R00708160000629 09-08-2016 09-08-2016 0001306515374 NG TET TJIE L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
563 0108R00708160002203 18-08-2016 18-08-2016 0001307051076 KOEI KONG L Q-5-41-0 AMBULATORY VISIT FOR OTHER
COMPLEX ACUTE DISORDER
564 0108R00708160002138 31-08-2016 31-08-2016 0001307932659 SITI MARIAH P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
565 0108R00708160000264 03-08-2016 03-08-2016 0001307982137 SURYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
566 0108R00708160000674 09-08-2016 09-08-2016 0001307982137 SURYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
567 0108R00708160000931 12-08-2016 12-08-2016 0001307982137 SURYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
568 0108R00708160001631 24-08-2016 24-08-2016 0001307982137 SURYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
569 0108R00708160001769 26-08-2016 26-08-2016 0001307982137 SURYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
570 0108R00708160002033 30-08-2016 30-08-2016 0001307982137 SURYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
571 0108R00708160000587 08-08-2016 08-08-2016 0001307982137 SURYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
572 0108R00708160000389 05-08-2016 05-08-2016 0001307982137 SURYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
573 0108R00708160000699 10-08-2016 10-08-2016 0001307982137 SURYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
574 0108R00708160000967 13-08-2016 13-08-2016 0001307982137 SURYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
575 0108R00708160001083 15-08-2016 15-08-2016 0001307982137 SURYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
576 0108R00708160001430 22-08-2016 22-08-2016 0001307982137 SURYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
577 0108R00708160000012 01-08-2016 01-08-2016 0001307982137 SURYATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
578 0108R00708160000354 04-08-2016 04-08-2016 0001307982137 SURYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

579 0108R00708160000808 11-08-2016 11-08-2016 0001308420494 ROBET L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
580 0108R00708160000620 08-08-2016 08-08-2016 0001309600844 TAN NGIAT SIA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
581 0108R00708160002204 22-08-2016 22-08-2016 0001309600844 TAN NGIAT SIA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
582 0108R00708160000783 11-08-2016 11-08-2016 0001309605963 MOEK KIOEN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
583 0108R00708160000469 06-08-2016 06-08-2016 0001309608167 DJONG DJIT NIT P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
584 0108R00708160002081 31-08-2016 31-08-2016 0001310268216 DJAP MIE HIONG P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
585 0108R00708160000762 10-08-2016 10-08-2016 0001310275258 EMANUEL SUTANTO L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
586 0108R00708160001307 19-08-2016 19-08-2016 0001310275258 EMANUEL SUTANTO L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
587 0108R00708160001818 27-08-2016 27-08-2016 0001310275258 EMANUEL SUTANTO L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
588 0108R00708160000922 12-08-2016 12-08-2016 0001310275258 EMANUEL SUTANTO L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
589 0108R00708160001487 22-08-2016 22-08-2016 0001310275258 EMANUEL SUTANTO L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
590 0108R00708160001942 29-08-2016 29-08-2016 0001310275258 EMANUEL SUTANTO L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
591 0108R00708160001115 15-08-2016 15-08-2016 0001310275258 EMANUEL SUTANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
592 0108R00708160000062 01-08-2016 01-08-2016 0001310275258 EMANUEL SUTANTO L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
593 0108R00708160000505 06-08-2016 06-08-2016 0001310275258 EMANUEL SUTANTO L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
594 0108R00708160001151 16-08-2016 16-08-2016 0001310275258 EMANUEL SUTANTO L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
595 0108R00708160000534 08-08-2016 08-08-2016 0001310275258 EMANUEL SUTANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
596 0108R00708160000381 04-08-2016 04-08-2016 0001310275258 EMANUEL SUTANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
597 0108R00708160001721 25-08-2016 25-08-2016 0001310275258 EMANUEL SUTANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
598 0108R00708160001857 29-08-2016 29-08-2016 0001310288534 LIE HON MIN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

599 0108R00708160001856 29-08-2016 29-08-2016 0001310288589 LIAN MIE TJIOE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
600 0108R00708160000490 06-08-2016 06-08-2016 0001310289309 LIE MIE LAN P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
601 0108R00708160000799 11-08-2016 11-08-2016 0001310400178 DJAHUN DJOHANA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
602 0108R00708160000719 10-08-2016 10-08-2016 0001311460402 MEI LING P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
603 0108R00708160002067 31-08-2016 31-08-2016 0001311992785 TJHIN MUK LIONG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
604 0108R00708160001010 15-08-2016 15-08-2016 0001311992785 TJHIN MUK LIONG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
605 0108R00708160001771 26-08-2016 26-08-2016 0001312066675 THEN TJHUN KONG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
606 0108R00708160001225 18-08-2016 18-08-2016 0001312066675 THEN TJHUN KONG L Q-5-25-0 AMBULATORY VISIT FOR ACUTE
GASTROINTESTINAL DISORDER
607 0108R00708160000430 05-08-2016 05-08-2016 0001312219146 NGOEI SAK PO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
608 0108R00708160001377 20-08-2016 20-08-2016 0001312645555 BONG NGIAN FUK L Q-5-32-0 AMBULATORY VISIT FOR ACUTE
URINARY TRACT DISORDER
609 0108R00708160002035 30-08-2016 30-08-2016 0001312645555 BONG NGIAN FUK L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
610 0108R00708160001324 19-08-2016 19-08-2016 0001312652507 HERMAYUDA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
611 0108R00708160001903 29-08-2016 29-08-2016 0001315267828 NURHAYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
612 0108R00708160000548 08-08-2016 08-08-2016 0001315267828 NURHAYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
613 0108R00708160000042 01-08-2016 01-08-2016 0001315267828 NURHAYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
614 0108R00708160000359 04-08-2016 04-08-2016 0001315267828 NURHAYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
615 0108R00708160000968 13-08-2016 13-08-2016 0001315267828 NURHAYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
616 0108R00708160001046 15-08-2016 15-08-2016 0001315267828 NURHAYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
617 0108R00708160001648 25-08-2016 25-08-2016 0001315267828 NURHAYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
618 0108R00708160000390 05-08-2016 05-08-2016 0001315267828 NURHAYATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

619 0108R00708160001828 29-08-2016 29-08-2016 0001315525116 TJHIN MOEK NIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
620 0108R00708160001160 16-08-2016 16-08-2016 0001315546828 SINTA LESTARI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
621 0108R00708160000325 04-08-2016 04-08-2016 0001316355186 HERAWATI, S.FARM.,APT. P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
622 0108R00708160001152 16-08-2016 16-08-2016 0001316841917 DEWI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
623 0108R00708160000986 13-08-2016 13-08-2016 0001317141472 MEILIANI TEKURUDIN P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
624 0108R00708160000374 04-08-2016 04-08-2016 0001317407635 siska P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
625 0108R00708160001007 15-08-2016 15-08-2016 0001317491651 TJOE A DJIOE L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
626 0108R00708160000013 01-08-2016 01-08-2016 0001317542354 SAMSI MUHAZIR L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
627 0108R00708160002104 31-08-2016 31-08-2016 0001317657025 LIONG SIAP PON P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
628 0108R00708160000285 04-08-2016 04-08-2016 0001317666486 SAHAK BOENAWAN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
629 0108R00708160001975 29-08-2016 29-08-2016 0001317704872 SANDINEM P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
630 0108R00708160001355 19-08-2016 19-08-2016 0001317704872 SANDINEM P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
631 0108R00708160000567 08-08-2016 08-08-2016 0001318001602 silvia fransisca P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
632 0108R00708160000738 10-08-2016 10-08-2016 0001318001602 silvia fransisca P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
633 0108R00708160001406 22-08-2016 22-08-2016 0001318001602 silvia fransisca P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
634 0108R00708160001061 15-08-2016 15-08-2016 0001318001602 silvia fransisca P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
635 0108R00708160001572 24-08-2016 24-08-2016 0001318152622 LODI HARSONO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
636 0108R00708160002074 31-08-2016 31-08-2016 0001318182254 TJHAI NAM SEN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
637 0108R00708160000200 03-08-2016 03-08-2016 0001318182254 TJHAI NAM SEN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
638 0108R00708160000311 04-08-2016 04-08-2016 0001318429888 MULIANI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

639 0108R00708160000521 08-08-2016 08-08-2016 0001318835485 BOEN A NIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
640 0108R00708160000723 09-08-2016 09-08-2016 0001318842472 TUTI ARYANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
641 0108R00708160000919 12-08-2016 12-08-2016 0001318925766 TIARA SONITA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
642 0108R00708160001916 29-08-2016 29-08-2016 0001318925889 LIM KIN KHIOEK P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
643 0108R00708160000630 09-08-2016 09-08-2016 0001318926982 LIM SOE KHIUN P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
644 0108R00708160000555 08-08-2016 08-08-2016 0001319187925 NURFAHMI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
645 0108R00708160000671 09-08-2016 09-08-2016 0001319187925 NURFAHMI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
646 0108R00708160001936 29-08-2016 29-08-2016 0001319573507 BUN KONG TE L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
647 0108R00708160000572 08-08-2016 08-08-2016 0001319717147 KASELI L Q-5-27-0 AMBULATORY VISIT FOR ACUTE
CENTRAL NERVOUS SYSTEM
648 0108R00708160000186 02-08-2016 02-08-2016 0001319720141 SIOE FA P N-3-15-0 DIALYSIS
649 0108R00708160000454 05-08-2016 05-08-2016 0001319720141 SIOE FA P N-3-15-0 DIALYSIS
650 0108R00708160000678 09-08-2016 09-08-2016 0001319720141 SIOE FA P N-3-15-0 DIALYSIS
651 0108R00708160000940 12-08-2016 12-08-2016 0001319720141 SIOE FA P N-3-15-0 DIALYSIS
652 0108R00708160001179 16-08-2016 16-08-2016 0001319720141 SIOE FA P N-3-15-0 DIALYSIS
653 0108R00708160001326 19-08-2016 19-08-2016 0001319720141 SIOE FA P N-3-15-0 DIALYSIS
654 0108R00708160001566 23-08-2016 23-08-2016 0001319720141 SIOE FA P N-3-15-0 DIALYSIS
655 0108R00708160001779 26-08-2016 26-08-2016 0001319720141 SIOE FA P N-3-15-0 DIALYSIS
656 0108R00708160002051 30-08-2016 30-08-2016 0001319720141 SIOE FA P N-3-15-0 DIALYSIS
657 0108R00708160000443 05-08-2016 05-08-2016 0001320679798 DEFI EKA YANTI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
658 0108R00708160001322 19-08-2016 19-08-2016 0001320679798 DEFI EKA YANTI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

659 0108R00708160002131 31-08-2016 31-08-2016 0001320688697 BONG PHAN YUN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
660 0108R00708160001031 15-08-2016 15-08-2016 0001320688697 BONG PHAN YUN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
661 0108R00708160000324 04-08-2016 04-08-2016 0001320965177 SITI NURBAYANI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
662 0108R00708160002014 30-08-2016 30-08-2016 0001320965177 SITI NURBAYANI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
663 0108R00708160001759 26-08-2016 26-08-2016 0001321076823 TUTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
664 0108R00708160002036 30-08-2016 30-08-2016 0001321076823 TUTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
665 0108R00708160001580 24-08-2016 24-08-2016 0001321733013 LIOE SOEI DJIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
666 0108R00708160001396 22-08-2016 22-08-2016 0001321733013 LIOE SOEI DJIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
667 0108R00708160001652 25-08-2016 25-08-2016 0001321733013 LIOE SOEI DJIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
668 0108R00708160000686 09-08-2016 09-08-2016 0001321756075 TJEN DJUNG KHIAN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
669 0108R00708160001506 22-08-2016 22-08-2016 0001321756075 TJEN DJUNG KHIAN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
670 0108R00708160000193 02-08-2016 02-08-2016 0001321756075 TJEN DJUNG KHIAN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
671 0108R00708160001932 29-08-2016 29-08-2016 0001321765119 TJEN MEN FAT P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
672 0108R00708160002049 30-08-2016 30-08-2016 0001321765119 TJEN MEN FAT P N-3-15-0 DIALYSIS
673 0108R00708160000188 02-08-2016 02-08-2016 0001321765119 TJEN MEN FAT P N-3-15-0 DIALYSIS
674 0108R00708160000456 05-08-2016 05-08-2016 0001321765119 TJEN MEN FAT P N-3-15-0 DIALYSIS
675 0108R00708160000682 09-08-2016 09-08-2016 0001321765119 TJEN MEN FAT P N-3-15-0 DIALYSIS
676 0108R00708160000943 12-08-2016 12-08-2016 0001321765119 TJEN MEN FAT P N-3-15-0 DIALYSIS
677 0108R00708160001167 16-08-2016 16-08-2016 0001321765119 TJEN MEN FAT P N-3-15-0 DIALYSIS
678 0108R00708160001311 19-08-2016 19-08-2016 0001321765119 TJEN MEN FAT P N-3-15-0 DIALYSIS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

679 0108R00708160002187 09-08-2016 09-08-2016 0001322653509 ELIAWATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
680 0108R00708160001603 24-08-2016 24-08-2016 0001322814936 YULIANA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
681 0108R00708160000915 12-08-2016 12-08-2016 0001322816815 UMAR L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
682 0108R00708160000695 10-08-2016 10-08-2016 0001322859273 DJIE HIE PHIN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
683 0108R00708160002063 31-08-2016 31-08-2016 0001322859273 DJIE HIE PHIN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
684 0108R00708160001042 15-08-2016 15-08-2016 0001322859273 DJIE HIE PHIN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
685 0108R00708160000812 11-08-2016 11-08-2016 0001322960139 JUSTIN FEBRIELLO L U-3-15-0 OTHER EAR NOSE MOUTH &
THROAT OPERATIONS
686 0108R00708160002222 30-08-2016 30-08-2016 0001323227755 MARLITA,SH P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
687 0108R00708160000379 04-08-2016 04-08-2016 0001323746403 TJHIN A MIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
688 0108R00708160000793 11-08-2016 11-08-2016 0001323770444 LIOE ME LIE P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
689 0108R00708160001831 29-08-2016 29-08-2016 0001323792268 LIONG SIN LAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
690 0108R00708160000786 11-08-2016 11-08-2016 0001323792268 LIONG SIN LAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
691 0108R00708160000526 08-08-2016 08-08-2016 0001323823127 BECCE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
692 0108R00708160001177 16-08-2016 16-08-2016 0001323865012 ARUM LESTARY P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
693 0108R00708160000854 11-08-2016 11-08-2016 0001324955643 MOEK TJIN P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
694 0108R00708160001033 15-08-2016 15-08-2016 0001325005198 MARTHANIA PRISILIA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
695 0108R00708160000026 01-08-2016 01-08-2016 0001325879695 BONG LIE LIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
696 0108R00708160001456 22-08-2016 22-08-2016 0001326130514 LAURA CASSANDRA EKI P Q-5-26-0 AMBULATORY VISIT FOR ACUTE
BRONCHIAL DISORDER
697 0108R00708160000797 11-08-2016 11-08-2016 0001326327232 SOEN LIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
698 0108R00708160000011 01-08-2016 01-08-2016 0001326327232 SOEN LIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

699 0108R00708160001393 22-08-2016 22-08-2016 0001326327232 SOEN LIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
700 0108R00708160001402 22-08-2016 22-08-2016 0001326722455 HERRY SUKAMTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
701 0108R00708160001570 23-08-2016 23-08-2016 0001326722455 HERRY SUKAMTO L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
702 0108R00708160001641 24-08-2016 24-08-2016 0001326722455 HERRY SUKAMTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
703 0108R00708160002090 31-08-2016 31-08-2016 0001327994594 chin cun djit P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
704 0108R00708160000215 03-08-2016 03-08-2016 0001327994594 chin cun djit P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
705 0108R00708160001257 18-08-2016 18-08-2016 0001328486376 BONG HIAN MOEI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
706 0108R00708160000701 10-08-2016 10-08-2016 0001328842124 AIJ JEN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
707 0108R00708160000238 03-08-2016 03-08-2016 0001339441986 LIU A SUNG P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
708 0108R00708160001347 18-08-2016 18-08-2016 0001339546386 YUNARI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
709 0108R00708160001119 15-08-2016 15-08-2016 0001339753465 PHAN NGIAT JAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
710 0108R00708160000015 01-08-2016 01-08-2016 0001339781376 FOE SOEI NON P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
711 0108R00708160000489 06-08-2016 06-08-2016 0001339781376 FOE SOEI NON P N-3-15-0 DIALYSIS
712 0108R00708160000611 08-08-2016 08-08-2016 0001339781376 FOE SOEI NON P N-3-15-0 DIALYSIS
713 0108R00708160000868 11-08-2016 11-08-2016 0001339781376 FOE SOEI NON P N-3-15-0 DIALYSIS
714 0108R00708160001105 15-08-2016 15-08-2016 0001339781376 FOE SOEI NON P N-3-15-0 DIALYSIS
715 0108R00708160001260 18-08-2016 18-08-2016 0001339781376 FOE SOEI NON P N-3-15-0 DIALYSIS
716 0108R00708160001499 22-08-2016 22-08-2016 0001339781376 FOE SOEI NON P N-3-15-0 DIALYSIS
717 0108R00708160001664 25-08-2016 25-08-2016 0001339781376 FOE SOEI NON P N-3-15-0 DIALYSIS
718 0108R00708160001951 29-08-2016 29-08-2016 0001339781376 FOE SOEI NON P N-3-15-0 DIALYSIS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

719 0108R00708160001945 29-08-2016 29-08-2016 0001340073022 LAIJ TJITJAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
720 0108R00708160001249 18-08-2016 18-08-2016 0001340179885 REHANDY SELLINA L Q-5-42-0 AMBULATORY VISIT FOR OTHER
CHENDRA MINOR ACUTE DISORDER
721 0108R00708160000005 01-08-2016 01-08-2016 0001340181652 HIOE TJO SANG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
722 0108R00708160001348 18-08-2016 18-08-2016 0001340245888 NURHAYATI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
723 0108R00708160002186 04-08-2016 04-08-2016 0001340245888 NURHAYATI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
724 0108R00708160002212 30-08-2016 30-08-2016 0001340245888 NURHAYATI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
725 0108R00708160000367 04-08-2016 04-08-2016 0001377123849 GIAND ELMADAHLIA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
TUSARA MINOR CHRONIC DISEASES
726 0108R00708160000179 02-08-2016 02-08-2016 0001377123849 GIAND ELMADAHLIA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
TUSARA MINOR CHRONIC DISEASES
727 0108R00708160000795 11-08-2016 11-08-2016 0001380045655 KHIUN NYONG P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
728 0108R00708160001622 24-08-2016 24-08-2016 0001380045655 KHIUN NYONG P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
729 0108R00708160000638 09-08-2016 09-08-2016 0001380045655 KHIUN NYONG P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
730 0108R00708160001070 15-08-2016 15-08-2016 0001380045655 KHIUN NYONG P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
731 0108R00708160001112 15-08-2016 15-08-2016 0001380459633 TJHANG TJIN FEN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
732 0108R00708160000093 01-08-2016 01-08-2016 0001380459633 TJHANG TJIN FEN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
733 0108R00708160000731 10-08-2016 10-08-2016 0001381195337 SOPIAN S L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
734 0108R00708160001877 29-08-2016 29-08-2016 0001381797257 EKAYATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
735 0108R00708160001606 24-08-2016 24-08-2016 0001381797257 EKAYATI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
736 0108R00708160000409 05-08-2016 05-08-2016 0001381813389 ANIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
737 0108R00708160001804 27-08-2016 27-08-2016 0001382188195 VERDA NURUL P Q-5-44-0 AMBULATORY VISIT FOR OTHER
KAMILLAH MINOR CHRONIC DISEASES
738 0108R00708160002100 31-08-2016 31-08-2016 0001382188195 VERDA NURUL P Q-5-44-0 AMBULATORY VISIT FOR OTHER
KAMILLAH MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

739 0108R00708160001079 15-08-2016 15-08-2016 0001382188195 VERDA NURUL P Z-3-25-0 ULTRASOUND FOR
KAMILLAH GYNAECOLOGY DISORDERS
740 0108R00708160001899 29-08-2016 29-08-2016 0001382275708 NYUK SIW P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
741 0108R00708160000838 11-08-2016 11-08-2016 0001382275708 NYUK SIW P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
742 0108R00708160001559 23-08-2016 23-08-2016 0001382275708 NYUK SIW P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
743 0108R00708160001703 25-08-2016 25-08-2016 0001382275708 NYUK SIW P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
744 0108R00708160002046 30-08-2016 30-08-2016 0001382275708 NYUK SIW P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
745 0108R00708160000342 04-08-2016 04-08-2016 0001382275708 NYUK SIW P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
746 0108R00708160000670 09-08-2016 09-08-2016 0001382275708 NYUK SIW P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
747 0108R00708160001136 16-08-2016 16-08-2016 0001382275708 NYUK SIW P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
748 0108R00708160001241 18-08-2016 18-08-2016 0001382275708 NYUK SIW P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
749 0108R00708160000579 08-08-2016 08-08-2016 0001382275708 NYUK SIW P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
750 0108R00708160001037 15-08-2016 15-08-2016 0001382275708 NYUK SIW P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
751 0108R00708160001443 22-08-2016 22-08-2016 0001382275708 NYUK SIW P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
752 0108R00708160000302 04-08-2016 04-08-2016 0001382348867 BONG SOEI KHIOEN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
753 0108R00708160001772 26-08-2016 26-08-2016 0001383549669 TJHAIJ LIE LIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
754 0108R00708160000318 04-08-2016 04-08-2016 0001383613143 LIAUW SUN HO L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
755 0108R00708160000317 04-08-2016 04-08-2016 0001383614425 TJHIN NO TJIT P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
756 0108R00708160001449 22-08-2016 22-08-2016 0001383752114 YUSWATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
757 0108R00708160001234 18-08-2016 18-08-2016 0001383853959 suwandi L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
758 0108R00708160000444 05-08-2016 05-08-2016 0001384038415 YULIAWATI P M-3-16-0 PHYSICAL THERAPY & MINOR
SURYANINGSIH MUSCULOSKELETAL
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

759 0108R00708160001459 22-08-2016 22-08-2016 0001384038415 YULIAWATI P M-3-16-0 PHYSICAL THERAPY & MINOR
SURYANINGSIH MUSCULOSKELETAL
760 0108R00708160000071 01-08-2016 01-08-2016 0001384405964 LIOE DJIM SOEN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
761 0108R00708160000010 01-08-2016 01-08-2016 0001384469537 BONG DJUNG LIONG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
762 0108R00708160001399 22-08-2016 22-08-2016 0001384469537 BONG DJUNG LIONG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
763 0108R00708160000631 09-08-2016 09-08-2016 0001384469537 BONG DJUNG LIONG L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
764 0108R00708160000168 02-08-2016 02-08-2016 0001384689486 ROSLAN H.S L N-3-15-0 DIALYSIS
765 0108R00708160000432 05-08-2016 05-08-2016 0001384689486 ROSLAN H.S L N-3-15-0 DIALYSIS
766 0108R00708160000664 09-08-2016 09-08-2016 0001384689486 ROSLAN H.S L N-3-15-0 DIALYSIS
767 0108R00708160000913 12-08-2016 12-08-2016 0001384689486 ROSLAN H.S L N-3-15-0 DIALYSIS
768 0108R00708160001156 16-08-2016 16-08-2016 0001384689486 ROSLAN H.S L N-3-15-0 DIALYSIS
769 0108R00708160001302 19-08-2016 19-08-2016 0001384689486 ROSLAN H.S L N-3-15-0 DIALYSIS
770 0108R00708160001536 23-08-2016 23-08-2016 0001384689486 ROSLAN H.S L N-3-15-0 DIALYSIS
771 0108R00708160001735 26-08-2016 26-08-2016 0001384689486 ROSLAN H.S L N-3-15-0 DIALYSIS
772 0108R00708160002008 30-08-2016 30-08-2016 0001384689486 ROSLAN H.S L N-3-15-0 DIALYSIS
773 0108R00708160001176 16-08-2016 16-08-2016 0001385004958 PUSPITA SARI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
774 0108R00708160001299 19-08-2016 19-08-2016 0001386300014 SISKA FEBRILIA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
775 0108R00708160000811 11-08-2016 11-08-2016 0001386504145 APRIANA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
776 0108R00708160001840 29-08-2016 29-08-2016 0001386505484 sak a tjit P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
777 0108R00708160001668 25-08-2016 25-08-2016 0001386505484 sak a tjit P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
778 0108R00708160001639 24-08-2016 24-08-2016 0001386839395 TJHIN KIM SAN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

779 0108R00708160001356 19-08-2016 19-08-2016 0001386839395 TJHIN KIM SAN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
780 0108R00708160000383 04-08-2016 04-08-2016 0001387306844 TJUNG IAT DJIN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
781 0108R00708160000039 01-08-2016 01-08-2016 0001387306844 TJUNG IAT DJIN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
782 0108R00708160001706 25-08-2016 25-08-2016 0001387326881 tjhin a djiuw P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
783 0108R00708160001979 30-08-2016 30-08-2016 0001387329006 TJEN A NGIAM P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
784 0108R00708160001366 20-08-2016 20-08-2016 0001387653175 LAM KHOIJ FOE L N-3-15-0 DIALYSIS
785 0108R00708160000087 01-08-2016 01-08-2016 0001387653175 LAM KHOIJ FOE L N-3-15-0 DIALYSIS
786 0108R00708160000517 06-08-2016 06-08-2016 0001387653175 LAM KHOIJ FOE L N-3-15-0 DIALYSIS
787 0108R00708160000827 11-08-2016 11-08-2016 0001387653175 LAM KHOIJ FOE L N-3-15-0 DIALYSIS
788 0108R00708160000992 13-08-2016 13-08-2016 0001387653175 LAM KHOIJ FOE L N-3-15-0 DIALYSIS
789 0108R00708160001059 15-08-2016 15-08-2016 0001387653175 LAM KHOIJ FOE L N-3-15-0 DIALYSIS
790 0108R00708160001189 18-08-2016 18-08-2016 0001387653175 LAM KHOIJ FOE L N-3-15-0 DIALYSIS
791 0108R00708160001412 22-08-2016 22-08-2016 0001387653175 LAM KHOIJ FOE L N-3-15-0 DIALYSIS
792 0108R00708160001663 25-08-2016 25-08-2016 0001387653175 LAM KHOIJ FOE L N-3-15-0 DIALYSIS
793 0108R00708160001890 27-08-2016 27-08-2016 0001387653175 LAM KHOIJ FOE L N-3-15-0 DIALYSIS
794 0108R00708160001923 29-08-2016 29-08-2016 0001387653175 LAM KHOIJ FOE L N-3-15-0 DIALYSIS
795 0108R00708160001968 29-08-2016 29-08-2016 0001387994242 FUNG FA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
796 0108R00708160000281 04-08-2016 04-08-2016 0001387994242 FUNG FA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
797 0108R00708160000293 04-08-2016 04-08-2016 0001388046159 BUN NGIT LIE P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
798 0108R00708160000787 11-08-2016 11-08-2016 0001388627133 LIE NGIT KHIONG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

799 0108R00708160001096 15-08-2016 15-08-2016 0001388678218 ROHAYA P Z-3-25-0 ULTRASOUND FOR

GYNAECOLOGY DISORDERS
800 0108R00708160002220 10-08-2016 10-08-2016 0001388871224 djun khiuk P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
801 0108R00708160001451 22-08-2016 22-08-2016 0001388966848 SARIFADILA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
802 0108R00708160002073 31-08-2016 31-08-2016 0001389085536 TJHIN A NA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
803 0108R00708160000329 04-08-2016 04-08-2016 0001389137444 DJAP A KAIJ P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
804 0108R00708160001427 22-08-2016 22-08-2016 0001389572649 PHAN A NIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
805 0108R00708160000507 06-08-2016 06-08-2016 0001389641051 H. TARTINI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
806 0108R00708160001608 24-08-2016 24-08-2016 0001389641051 H. TARTINI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
807 0108R00708160001813 27-08-2016 27-08-2016 0001389641051 H. TARTINI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
808 0108R00708160000316 04-08-2016 04-08-2016 0001389641051 H. TARTINI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
809 0108R00708160001715 25-08-2016 25-08-2016 0001389641051 H. TARTINI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
810 0108R00708160000979 13-08-2016 13-08-2016 0001389641051 H. TARTINI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
811 0108R00708160000846 11-08-2016 11-08-2016 0001389765104 BONG SIN TET L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
812 0108R00708160001725 25-08-2016 25-08-2016 0001389865432 HASANAH P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
813 0108R00708160001825 29-08-2016 29-08-2016 0001390630421 M. YUSUF YUNUS L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
814 0108R00708160001586 24-08-2016 24-08-2016 0001390853193 INDAH SILVIA,AM.KEB P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
815 0108R00708160000707 10-08-2016 10-08-2016 0001401792063 ASMAWI YAHYA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
816 0108R00708160000357 04-08-2016 04-08-2016 0001401794842 LISA RAMADHANI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
817 0108R00708160000361 04-08-2016 04-08-2016 0001406425893 ROSNA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
818 0108R00708160002227 18-08-2016 18-08-2016 0001406425893 ROSNA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

819 0108R00708160000656 09-08-2016 09-08-2016 0001407121806 RISKI SEPTI ANGGA L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
820 0108R00708160000740 10-08-2016 10-08-2016 0001407128117 RAFIYANTI AGUSTINI P U-3-16-0 DENTAL OPERATIONS
821 0108R00708160002132 31-08-2016 31-08-2016 0001407128117 RAFIYANTI AGUSTINI P U-3-16-0 DENTAL OPERATIONS
822 0108R00708160001807 27-08-2016 27-08-2016 0001407782924 SILKA SEPTALIA SARI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
823 0108R00708160000372 04-08-2016 04-08-2016 0001407786287 NIRSYAFITRI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
824 0108R00708160001150 16-08-2016 16-08-2016 0001407789819 NATHAN PRIMA L Q-5-25-0 AMBULATORY VISIT FOR ACUTE
BASSANG GASTROINTESTINAL DISORDER
825 0108R00708160000242 03-08-2016 03-08-2016 0001407790179 M ERAWAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
826 0108R00708160000034 01-08-2016 01-08-2016 0001407790179 M ERAWAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
827 0108R00708160000307 04-08-2016 04-08-2016 0001407790585 SYURGHONI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
828 0108R00708160000815 11-08-2016 11-08-2016 0001407790585 SYURGHONI L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
829 0108R00708160000181 02-08-2016 02-08-2016 0001408045476 Nashifa Ayyasi P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
830 0108R00708160002129 31-08-2016 31-08-2016 0001408119186 VILA DELPHIA P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
831 0108R00708160001799 27-08-2016 27-08-2016 0001408223373 Irfan Saputra L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
832 0108R00708160001343 20-08-2016 20-08-2016 0001408223373 Irfan Saputra L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
833 0108R00708160001217 18-08-2016 18-08-2016 0001408326603 ABIDIN B DULAMIN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
834 0108R00708160000139 02-08-2016 02-08-2016 0001408581742 NABIL RAMADHANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
835 0108R00708160002202 29-08-2016 29-08-2016 0001408581898 FELIKA IRREYNE P Q-5-42-0 AMBULATORY VISIT FOR OTHER
MARGRIT OKTAVIA MINOR ACUTE DISORDER
836 0108R00708160000770 10-08-2016 10-08-2016 0001408585746 ALI HANAFIAH L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
837 0108R00708160002223 09-08-2016 09-08-2016 0001408585768 DELLA PUSPITA SARI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
838 0108R00708160001468 22-08-2016 22-08-2016 0001408658624 DESY SRIWAHYUNI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

839 0108R00708160000537 08-08-2016 08-08-2016 0001420862128 PIT DJUN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
840 0108R00708160000209 03-08-2016 03-08-2016 0001421290258 H ABDUL MANAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
841 0108R00708160001839 29-08-2016 29-08-2016 0001421319328 BONG NGIT NON P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
842 0108R00708160001691 25-08-2016 25-08-2016 0001421985925 ANNA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
843 0108R00708160001098 15-08-2016 15-08-2016 0001421985925 ANNA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
844 0108R00708160000218 03-08-2016 03-08-2016 0001421991707 MURATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
845 0108R00708160000565 08-08-2016 08-08-2016 0001422134144 LIAUW THU SAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
846 0108R00708160001892 29-08-2016 29-08-2016 0001422134144 LIAUW THU SAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
847 0108R00708160000294 04-08-2016 04-08-2016 0001422191564 TJONG LIE LIE P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
848 0108R00708160000019 01-08-2016 01-08-2016 0001422267862 pariono L N-3-15-0 DIALYSIS
849 0108R00708160000829 11-08-2016 11-08-2016 0001422267862 pariono L N-3-15-0 DIALYSIS
850 0108R00708160001027 15-08-2016 15-08-2016 0001422267862 pariono L N-3-15-0 DIALYSIS
851 0108R00708160001170 16-08-2016 16-08-2016 0001422267862 pariono L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
852 0108R00708160001191 18-08-2016 18-08-2016 0001422267862 pariono L N-3-15-0 DIALYSIS
853 0108R00708160001384 22-08-2016 22-08-2016 0001422267862 pariono L N-3-15-0 DIALYSIS
854 0108R00708160001659 25-08-2016 25-08-2016 0001422267862 pariono L N-3-15-0 DIALYSIS
855 0108R00708160001720 25-08-2016 25-08-2016 0001422667337 JHONny A KINDANGEN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
856 0108R00708160001701 25-08-2016 25-08-2016 0001422670612 LIE SUI SAN L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
857 0108R00708160001898 29-08-2016 29-08-2016 0001422670612 LIE SUI SAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
858 0108R00708160000165 02-08-2016 02-08-2016 0001422670612 LIE SUI SAN L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

859 0108R00708160000340 04-08-2016 04-08-2016 0001422670612 LIE SUI SAN L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
860 0108R00708160000840 11-08-2016 11-08-2016 0001422670612 LIE SUI SAN L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
861 0108R00708160001561 23-08-2016 23-08-2016 0001422670612 LIE SUI SAN L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
862 0108R00708160002048 30-08-2016 30-08-2016 0001422670612 LIE SUI SAN L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
863 0108R00708160000668 09-08-2016 09-08-2016 0001422670612 LIE SUI SAN L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
864 0108R00708160001135 16-08-2016 16-08-2016 0001422670612 LIE SUI SAN L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
865 0108R00708160001243 18-08-2016 18-08-2016 0001422670612 LIE SUI SAN L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
866 0108R00708160000050 01-08-2016 01-08-2016 0001422670612 LIE SUI SAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
867 0108R00708160000577 08-08-2016 08-08-2016 0001422670612 LIE SUI SAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
868 0108R00708160001035 15-08-2016 15-08-2016 0001422670612 LIE SUI SAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
869 0108R00708160001446 22-08-2016 22-08-2016 0001422670612 LIE SUI SAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
870 0108R00708160000223 03-08-2016 03-08-2016 0001422671782 VERAWATI TJONG P U-3-16-0 DENTAL OPERATIONS
871 0108R00708160000833 11-08-2016 11-08-2016 0001422674774 MEINA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
872 0108R00708160000741 10-08-2016 10-08-2016 0001423445589 sapril L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
873 0108R00708160001089 15-08-2016 15-08-2016 0001423445589 sapril L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
874 0108R00708160001699 25-08-2016 25-08-2016 0001423579667 YUNITA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
875 0108R00708160000082 01-08-2016 01-08-2016 0001423584101 KARYA BUNTAR L N-3-15-0 DIALYSIS
876 0108R00708160000455 05-08-2016 05-08-2016 0001423584101 KARYA BUNTAR L N-3-15-0 DIALYSIS
877 0108R00708160000600 08-08-2016 08-08-2016 0001423584101 KARYA BUNTAR L N-3-15-0 DIALYSIS
878 0108R00708160000759 10-08-2016 10-08-2016 0001423584101 KARYA BUNTAR L N-3-15-0 DIALYSIS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

879 0108R00708160000941 12-08-2016 12-08-2016 0001423584101 KARYA BUNTAR L N-3-15-0 DIALYSIS

880 0108R00708160001101 15-08-2016 15-08-2016 0001423584101 KARYA BUNTAR L N-3-15-0 DIALYSIS
881 0108R00708160001199 17-08-2016 17-08-2016 0001423584101 KARYA BUNTAR L N-3-15-0 DIALYSIS
882 0108R00708160001318 19-08-2016 19-08-2016 0001423584101 KARYA BUNTAR L N-3-15-0 DIALYSIS
883 0108R00708160001707 25-08-2016 25-08-2016 0001423584101 KARYA BUNTAR L N-3-15-0 DIALYSIS
884 0108R00708160001948 29-08-2016 29-08-2016 0001423584101 KARYA BUNTAR L N-3-15-0 DIALYSIS
885 0108R00708160002147 31-08-2016 31-08-2016 0001423584101 KARYA BUNTAR L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
886 0108R00708160001292 19-08-2016 19-08-2016 0001423585719 FATIMAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
887 0108R00708160001238 18-08-2016 18-08-2016 0001423585719 FATIMAH P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
888 0108R00708160001642 24-08-2016 24-08-2016 0001423585719 FATIMAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
889 0108R00708160001371 22-08-2016 22-08-2016 0001423585719 FATIMAH P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
890 0108R00708160001541 23-08-2016 23-08-2016 0001423585719 FATIMAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
891 0108R00708160000404 04-08-2016 04-08-2016 0001423799065 rohmah` P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
892 0108R00708160001550 23-08-2016 23-08-2016 0001423799245 junarni P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
893 0108R00708160001504 22-08-2016 22-08-2016 0001423799245 junarni P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
894 0108R00708160002075 31-08-2016 31-08-2016 0001423813926 yenny surviana P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
895 0108R00708160000282 04-08-2016 04-08-2016 0001424214933 moei ngioen P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
896 0108R00708160000789 11-08-2016 11-08-2016 0001424349437 KEVIN CHRIS FARLEY L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
897 0108R00708160001824 29-08-2016 29-08-2016 0001424366302 EFFENLY L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
898 0108R00708160000785 11-08-2016 11-08-2016 0001425008158 SU FUI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

899 0108R00708160000721 09-08-2016 09-08-2016 0001426658973 TJHIN SUI PHIN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
900 0108R00708160001635 24-08-2016 24-08-2016 0001426734549 LIOE SIN DJOENG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
901 0108R00708160000944 12-08-2016 12-08-2016 0001426736171 SOEI TJIN P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
902 0108R00708160001178 16-08-2016 16-08-2016 0001426736171 SOEI TJIN P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
903 0108R00708160000380 04-08-2016 04-08-2016 0001426736171 SOEI TJIN P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
904 0108R00708160000610 08-08-2016 08-08-2016 0001426736171 SOEI TJIN P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
905 0108R00708160001718 25-08-2016 25-08-2016 0001426736171 SOEI TJIN P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
906 0108R00708160001900 29-08-2016 29-08-2016 0001427528676 tjhin kong hian L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
907 0108R00708160000164 02-08-2016 02-08-2016 0001427528676 tjhin kong hian L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
908 0108R00708160000343 04-08-2016 04-08-2016 0001427528676 tjhin kong hian L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
909 0108R00708160000841 11-08-2016 11-08-2016 0001427528676 tjhin kong hian L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
910 0108R00708160001562 23-08-2016 23-08-2016 0001427528676 tjhin kong hian L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
911 0108R00708160001702 25-08-2016 25-08-2016 0001427528676 tjhin kong hian L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
912 0108R00708160002047 30-08-2016 30-08-2016 0001427528676 tjhin kong hian L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
913 0108R00708160000669 09-08-2016 09-08-2016 0001427528676 tjhin kong hian L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
914 0108R00708160001133 16-08-2016 16-08-2016 0001427528676 tjhin kong hian L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
915 0108R00708160001244 18-08-2016 18-08-2016 0001427528676 tjhin kong hian L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
916 0108R00708160000051 01-08-2016 01-08-2016 0001427528676 tjhin kong hian L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
917 0108R00708160000578 08-08-2016 08-08-2016 0001427528676 tjhin kong hian L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
918 0108R00708160001036 15-08-2016 15-08-2016 0001427528676 tjhin kong hian L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

919 0108R00708160001444 22-08-2016 22-08-2016 0001427528676 tjhin kong hian L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
920 0108R00708160002061 31-08-2016 31-08-2016 0001428397165 TRESIA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
921 0108R00708160000801 11-08-2016 11-08-2016 0001430520265 siti fatimah P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
922 0108R00708160002076 31-08-2016 31-08-2016 0001431739552 MC MASIRAT P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
923 0108R00708160001454 22-08-2016 22-08-2016 0001431739552 MC MASIRAT P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
924 0108R00708160000364 04-08-2016 04-08-2016 0001432400207 AMINAH P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
925 0108R00708160000650 09-08-2016 09-08-2016 0001432424575 TJEW SIU TJIN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
926 0108R00708160000127 02-08-2016 02-08-2016 0001433057433 LA ASIA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
927 0108R00708160002142 31-08-2016 31-08-2016 0001433057433 LA ASIA L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
928 0108R00708160000126 02-08-2016 02-08-2016 0001433152574 miko aliska putra L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
929 0108R00708160001995 30-08-2016 30-08-2016 0001433152574 miko aliska putra L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
930 0108R00708160001429 22-08-2016 22-08-2016 0001433500479 pit soeng P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
931 0108R00708160000633 08-08-2016 08-08-2016 0001434343364 HALILAH NUR FAUZIAH L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
932 0108R00708160002185 04-08-2016 04-08-2016 0001434845439 lo a djim L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
933 0108R00708160001524 23-08-2016 23-08-2016 0001434845439 lo a djim L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
934 0108R00708160000584 08-08-2016 08-08-2016 0001434849491 lo a boei P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
935 0108R00708160000007 01-08-2016 01-08-2016 0001435056265 MARIETJE SOUISA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
936 0108R00708160000025 01-08-2016 01-08-2016 0001435254748 THEN A MOEY P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
937 0108R00708160001599 24-08-2016 24-08-2016 0001436480245 MUHAMMAD DANISH L Q-5-44-0 AMBULATORY VISIT FOR OTHER
KUNCORO MINOR CHRONIC DISEASES
938 0108R00708160000351 04-08-2016 04-08-2016 0001436608113 LIOE A TJU P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

939 0108R00708160000014 01-08-2016 01-08-2016 0001437399044 ASNIYATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
940 0108R00708160001534 23-08-2016 23-08-2016 0001437802424 THAM TJAUW LIONG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
941 0108R00708160000244 03-08-2016 03-08-2016 0001438061872 MERRY P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
942 0108R00708160001039 15-08-2016 15-08-2016 0001439038348 SOEI DJIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
943 0108R00708160001040 15-08-2016 15-08-2016 0001439039259 ISHAK L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
944 0108R00708160001320 19-08-2016 19-08-2016 0001439410836 BONG SOEN TIK P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
945 0108R00708160000692 10-08-2016 10-08-2016 0001439417079 A. HAMID SALEH L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
946 0108R00708160002160 31-08-2016 31-08-2016 0001439513559 HERLITA TERISTIANA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
947 0108R00708160000044 01-08-2016 01-08-2016 0001439883393 HENDRIX L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
948 0108R00708160001469 22-08-2016 22-08-2016 0001439980694 HJ. ROSDIANA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
949 0108R00708160001016 15-08-2016 15-08-2016 0001440699636 SITI AISYAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
950 0108R00708160000712 10-08-2016 10-08-2016 0001440852603 BOEN A TJHIT L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
951 0108R00708160002158 30-08-2016 30-08-2016 0001441167491 HALI L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
952 0108R00708160002011 30-08-2016 30-08-2016 0001441412853 MIYAH P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
953 0108R00708160001448 22-08-2016 22-08-2016 0001441695508 SOLNI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
954 0108R00708160001879 29-08-2016 29-08-2016 0001441695508 SOLNI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
955 0108R00708160000788 11-08-2016 11-08-2016 0001441955441 TJIUW SAK LIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
956 0108R00708160001884 29-08-2016 29-08-2016 0001442027968 SUTINA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
957 0108R00708160000254 03-08-2016 03-08-2016 0001442116833 DHIAN UTAMA HANURA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
958 0108R00708160000046 01-08-2016 01-08-2016 0001442116833 DHIAN UTAMA HANURA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

959 0108R00708160000568 08-08-2016 08-08-2016 0001442116833 DHIAN UTAMA HANURA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
960 0108R00708160000453 05-08-2016 05-08-2016 0001442198406 SINTIANI P N-3-15-0 DIALYSIS
961 0108R00708160000866 11-08-2016 11-08-2016 0001442198406 SINTIANI P N-3-15-0 DIALYSIS
962 0108R00708160001172 16-08-2016 16-08-2016 0001442198406 SINTIANI P N-3-15-0 DIALYSIS
963 0108R00708160001325 19-08-2016 19-08-2016 0001442198406 SINTIANI P N-3-15-0 DIALYSIS
964 0108R00708160001773 26-08-2016 26-08-2016 0001442198406 SINTIANI P N-3-15-0 DIALYSIS
965 0108R00708160001763 26-08-2016 26-08-2016 0001442525681 JEANE LAWREN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
966 0108R00708160000523 08-08-2016 08-08-2016 0001442659904 SUKIRMAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
967 0108R00708160000703 10-08-2016 10-08-2016 0001443316678 TJONG A DJIOE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
968 0108R00708160001500 22-08-2016 22-08-2016 0001443475956 FUADY P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
969 0108R00708160000017 01-08-2016 01-08-2016 0001444006732 SURYANI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
970 0108R00708160000314 04-08-2016 04-08-2016 0001444006732 SURYANI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
971 0108R00708160000779 11-08-2016 11-08-2016 0001445135995 LIM NGIAM SE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
972 0108R00708160000780 11-08-2016 11-08-2016 0001445136131 YANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
973 0108R00708160000109 02-08-2016 02-08-2016 0001445401923 WINDASARI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
974 0108R00708160000149 02-08-2016 02-08-2016 0001445791048 RAILIANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
975 0108R00708160000150 02-08-2016 02-08-2016 0001445791476 VIESENZIA P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
976 0108R00708160002106 31-08-2016 31-08-2016 0001445804886 HENNI SUITA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
977 0108R00708160000807 11-08-2016 11-08-2016 0001445804886 HENNI SUITA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
978 0108R00708160000103 01-08-2016 01-08-2016 0001446263976 boen lian moi P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

979 0108R00708160000767 10-08-2016 10-08-2016 0001446263976 boen lian moi P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
980 0108R00708160001972 29-08-2016 29-08-2016 0001446263976 boen lian moi P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
981 0108R00708160001331 19-08-2016 19-08-2016 0001446263976 boen lian moi P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
982 0108R00708160001122 16-08-2016 16-08-2016 0001447019436 DEVY LESTARI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
983 0108R00708160002092 31-08-2016 31-08-2016 0001447482655 FAM CIT SIAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
984 0108R00708160001573 24-08-2016 24-08-2016 0001447694065 HO SOEN HON L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
985 0108R00708160001980 30-08-2016 30-08-2016 0001447750574 SUKANDAR L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
986 0108R00708160001210 18-08-2016 18-08-2016 0001448783245 KON SIAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
987 0108R00708160001227 18-08-2016 18-08-2016 0001449849576 ALI IMRON L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
988 0108R00708160000422 05-08-2016 05-08-2016 0001450709289 FOENG NGIAT MIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
989 0108R00708160001896 29-08-2016 29-08-2016 0001450883169 SUTARSIH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
990 0108R00708160000727 10-08-2016 10-08-2016 0001450883169 SUTARSIH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
991 0108R00708160001426 22-08-2016 22-08-2016 0001450883169 SUTARSIH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
992 0108R00708160001285 19-08-2016 19-08-2016 0001451112052 YUNILA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
993 0108R00708160000320 04-08-2016 04-08-2016 0001451712431 LETI TAURISA UBAI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
994 0108R00708160000790 11-08-2016 11-08-2016 0001452082691 TJEN A CHI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
995 0108R00708160001357 19-08-2016 19-08-2016 0001453235894 MUK KHIAN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
996 0108R00708160000796 11-08-2016 11-08-2016 0001453771045 TJONG LIAN KOEK P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
997 0108R00708160002032 29-08-2016 29-08-2016 0001453771045 TJONG LIAN KOEK P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
998 0108R00708160000114 02-08-2016 02-08-2016 0001453771045 TJONG LIAN KOEK P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

999 0108R00708160001389 22-08-2016 22-08-2016 0001453771045 TJONG LIAN KOEK P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1000 0108R00708160000774 11-08-2016 11-08-2016 0001453771664 BONG SOEI FO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1001 0108R00708160000198 03-08-2016 03-08-2016 0001453771664 BONG SOEI FO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1002 0108R00708160001000 15-08-2016 15-08-2016 0001453771664 BONG SOEI FO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1003 0108R00708160001475 22-08-2016 22-08-2016 0001453774026 MAHILIN BONOWARSITO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1004 0108R00708160000239 03-08-2016 03-08-2016 0001454364483 ANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1005 0108R00708160002028 30-08-2016 30-08-2016 0001454638792 FALINA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1006 0108R00708160000075 01-08-2016 01-08-2016 0001454638792 FALINA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1007 0108R00708160000522 08-08-2016 08-08-2016 0001454638869 LIM JUN LIONG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1008 0108R00708160001266 18-08-2016 18-08-2016 0001454652707 FEBRIYANTO L Q-5-42-0 AMBULATORY VISIT FOR OTHER
MINOR ACUTE DISORDER
1009 0108R00708160000406 05-08-2016 05-08-2016 0001454751336 YARNO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1010 0108R00708160000688 09-08-2016 09-08-2016 0001454752642 NORPA MINARTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1011 0108R00708160000859 11-08-2016 11-08-2016 0001454753733 RINA YULIANTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1012 0108R00708160001528 23-08-2016 23-08-2016 0001454755217 MAKMUR. K L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1013 0108R00708160001832 29-08-2016 29-08-2016 0001454789845 JUMADI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1014 0108R00708160000151 02-08-2016 02-08-2016 0001454850988 THONG DJUN TJHAY L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1015 0108R00708160000308 04-08-2016 04-08-2016 0001454850988 THONG DJUN TJHAY L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1016 0108R00708160001003 15-08-2016 15-08-2016 0001454850988 THONG DJUN TJHAY L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1017 0108R00708160001719 25-08-2016 25-08-2016 0001454850988 THONG DJUN TJHAY L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1018 0108R00708160000497 06-08-2016 06-08-2016 0001454851135 MILIANI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1019 0108R00708160000060 01-08-2016 01-08-2016 0001454880464 FOENG KIM TJHAIJ L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1020 0108R00708160000048 01-08-2016 01-08-2016 0001455197231 BUN A NA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1021 0108R00708160001253 18-08-2016 18-08-2016 0001455298312 SUN NGIT FO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1022 0108R00708160001252 18-08-2016 18-08-2016 0001455299133 BONG MOEI NGIT P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1023 0108R00708160000998 15-08-2016 15-08-2016 0001455301135 TJONG MIE SIOE L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1024 0108R00708160001382 22-08-2016 22-08-2016 0001455386848 MIA MURYANTI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1025 0108R00708160000297 04-08-2016 04-08-2016 0001455388547 SOEN NIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1026 0108R00708160001220 18-08-2016 18-08-2016 0001455413973 AGUNG ALAN ARTAWAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1027 0108R00708160000973 13-08-2016 13-08-2016 0001455413973 AGUNG ALAN ARTAWAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1028 0108R00708160000552 08-08-2016 08-08-2016 0001455763443 PAULUS L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1029 0108R00708160000553 08-08-2016 08-08-2016 0001455795189 LUSIA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1030 0108R00708160000551 08-08-2016 08-08-2016 0001455799184 SHIYANRI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1031 0108R00708160001246 18-08-2016 18-08-2016 0001456044963 SJAMSUDIN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1032 0108R00708160000072 01-08-2016 01-08-2016 0001456215581 LIE DJIT NJONG P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1033 0108R00708160000331 04-08-2016 04-08-2016 0001456614009 BOEI SIAN NIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1034 0108R00708160000124 02-08-2016 02-08-2016 0001456615787 DESI ROSITA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1035 0108R00708160000556 08-08-2016 08-08-2016 0001456674513 AMEN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1036 0108R00708160000428 05-08-2016 05-08-2016 0001456692715 NGIAT NGO P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1037 0108R00708160000144 02-08-2016 02-08-2016 0001456755502 SIOE KONG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1038 0108R00708160000806 11-08-2016 11-08-2016 0001456755502 SIOE KONG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1039 0108R00708160001275 19-08-2016 19-08-2016 0001456909672 LIE KONG BU L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1040 0108R00708160002174 04-08-2016 04-08-2016 0001457292767 MUK HO L Q-5-42-0 AMBULATORY VISIT FOR OTHER
MINOR ACUTE DISORDER
1041 0108R00708160001303 19-08-2016 19-08-2016 0001457320577 EVIANA LITA SAW L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1042 0108R00708160000798 11-08-2016 11-08-2016 0001457602211 YAYAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1043 0108R00708160002209 31-08-2016 31-08-2016 0001457732327 NUR WAHYUDA P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1044 0108R00708160002094 31-08-2016 31-08-2016 0001458232402 HENDI BUNARI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1045 0108R00708160001233 18-08-2016 18-08-2016 0001458437141 VIOLA MAURETA P Q-5-42-0 AMBULATORY VISIT FOR OTHER
MINOR ACUTE DISORDER
1046 0108R00708160000949 12-08-2016 12-08-2016 0001458440515 ANGLEY DEVI OLANIKA P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1047 0108R00708160001125 16-08-2016 16-08-2016 0001458839788 SIM DJAT FUN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1048 0108R00708160001537 23-08-2016 23-08-2016 0001458839788 SIM DJAT FUN P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1049 0108R00708160001994 30-08-2016 30-08-2016 0001458914556 PHANG TJIT TJAI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1050 0108R00708160002134 31-08-2016 31-08-2016 0001458914556 PHANG TJIT TJAI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1051 0108R00708160001842 29-08-2016 29-08-2016 0001459303389 LIE A JOEN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1052 0108R00708160001538 23-08-2016 23-08-2016 0001459303503 MARIANI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1053 0108R00708160000689 09-08-2016 09-08-2016 0001459374873 SANDRA MINON MIE P H-3-13-0 DIAGNOSTIC & IMAGING EYE
NYONG INVESTIGATIONS
1054 0108R00708160000192 02-08-2016 02-08-2016 0001459374873 SANDRA MINON MIE P H-3-13-0 DIAGNOSTIC & IMAGING EYE
NYONG INVESTIGATIONS
1055 0108R00708160002031 30-08-2016 30-08-2016 0001459475932 TJHIN MEI TJIT P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1056 0108R00708160001453 22-08-2016 22-08-2016 0001459788085 CENG SUN NGIAM P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1057 0108R00708160000045 01-08-2016 01-08-2016 0001459788085 CENG SUN NGIAM P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1058 0108R00708160001878 29-08-2016 29-08-2016 0001459790065 FERIYATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1059 0108R00708160000424 05-08-2016 05-08-2016 0001459790065 FERIYATI P Z-3-25-0 ULTRASOUND FOR

GYNAECOLOGY DISORDERS
1060 0108R00708160001001 15-08-2016 15-08-2016 0001459790065 FERIYATI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1061 0108R00708160001654 25-08-2016 25-08-2016 0001459790065 FERIYATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1062 0108R00708160001974 29-08-2016 29-08-2016 0001459860276 GLORIA NOVENA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
PEDROSA MINOR CHRONIC DISEASES
1063 0108R00708160000691 10-08-2016 10-08-2016 0001459954168 KIM THIN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1064 0108R00708160001284 19-08-2016 19-08-2016 0001460042234 LIE DJOEN NA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1065 0108R00708160002140 31-08-2016 31-08-2016 0001460042234 LIE DJOEN NA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1066 0108R00708160002188 12-08-2016 12-08-2016 0001460042234 LIE DJOEN NA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1067 0108R00708160000350 04-08-2016 04-08-2016 0001460098563 TJONG KAP HO P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1068 0108R00708160002190 08-08-2016 08-08-2016 0001460125811 ALDE TRIWIDARI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1069 0108R00708160001423 22-08-2016 22-08-2016 0001460145126 RIKA AMELIA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1070 0108R00708160001327 19-08-2016 19-08-2016 0001460404732 LIE SIOE DJIN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1071 0108R00708160000649 09-08-2016 09-08-2016 0001460437784 LIU NYIUK LIN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1072 0108R00708160000700 10-08-2016 10-08-2016 0001460699368 LIE NGIAT TJHIN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1073 0108R00708160000818 11-08-2016 11-08-2016 0001460918351 A.DANSIR.AM L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1074 0108R00708160000386 04-08-2016 04-08-2016 0001461452387 ROSIANA TUHIR P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1075 0108R00708160001248 18-08-2016 18-08-2016 0001461452387 ROSIANA TUHIR P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1076 0108R00708160001196 18-08-2016 18-08-2016 0001463113732 DESI SUSANTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1077 0108R00708160000216 03-08-2016 03-08-2016 0001463113732 DESI SUSANTI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1078 0108R00708160000268 03-08-2016 03-08-2016 0001463402092 ASSIFA FARADILLA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
PUTRI AUDI MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1079 0108R00708160001155 16-08-2016 16-08-2016 0001463402092 ASSIFA FARADILLA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
PUTRI AUDI MINOR CHRONIC DISEASES
1080 0108R00708160001231 18-08-2016 18-08-2016 0001463402092 ASSIFA FARADILLA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
PUTRI AUDI MINOR CHRONIC DISEASES
1081 0108R00708160000702 10-08-2016 10-08-2016 0001463609766 HO MEN LIM P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1082 0108R00708160001688 25-08-2016 25-08-2016 0001463701307 TJUNG SIW JIN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1083 0108R00708160000435 05-08-2016 05-08-2016 0001463705829 DESIANNI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1084 0108R00708160000391 05-08-2016 05-08-2016 0001463709071 PUTRI RAHMADINI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1085 0108R00708160000477 06-08-2016 06-08-2016 0001463709071 PUTRI RAHMADINI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1086 0108R00708160000230 03-08-2016 03-08-2016 0001463831864 LIONG FEN TJHAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1087 0108R00708160002078 31-08-2016 31-08-2016 0001463845318 TJHAIJ SIN LIP L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1088 0108R00708160000154 02-08-2016 02-08-2016 0001463845318 TJHAIJ SIN LIP L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1089 0108R00708160000234 03-08-2016 03-08-2016 0001463845318 TJHAIJ SIN LIP L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1090 0108R00708160000730 10-08-2016 10-08-2016 0001464118222 SUSANTO SUFAM L N-3-15-0 DIALYSIS
1091 0108R00708160000232 03-08-2016 03-08-2016 0001464118222 SUSANTO SUFAM L N-3-15-0 DIALYSIS
1092 0108R00708160000996 13-08-2016 13-08-2016 0001464118222 SUSANTO SUFAM L N-3-15-0 DIALYSIS
1093 0108R00708160001207 17-08-2016 17-08-2016 0001464118222 SUSANTO SUFAM L N-3-15-0 DIALYSIS
1094 0108R00708160001375 20-08-2016 20-08-2016 0001464118222 SUSANTO SUFAM L N-3-15-0 DIALYSIS
1095 0108R00708160001596 24-08-2016 24-08-2016 0001464118222 SUSANTO SUFAM L N-3-15-0 DIALYSIS
1096 0108R00708160001888 27-08-2016 27-08-2016 0001464118222 SUSANTO SUFAM L N-3-15-0 DIALYSIS
1097 0108R00708160002112 31-08-2016 31-08-2016 0001464118222 SUSANTO SUFAM L N-3-15-0 DIALYSIS
1098 0108R00708160002189 06-08-2016 06-08-2016 0001464118222 SUSANTO SUFAM L N-3-15-0 DIALYSIS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1099 0108R00708160000171 02-08-2016 02-08-2016 0001464600082 SITI BULQIS P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1100 0108R00708160001800 27-08-2016 27-08-2016 0001465596966 HERAWATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1101 0108R00708160002077 31-08-2016 31-08-2016 0001465730987 HO TJIT HIONG P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1102 0108R00708160000008 01-08-2016 01-08-2016 0001465730987 HO TJIT HIONG P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1103 0108R00708160000205 03-08-2016 03-08-2016 0001465932824 SYAMSUMIN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1104 0108R00708160000099 01-08-2016 01-08-2016 0001466555872 AHMAD SOBRI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1105 0108R00708160000777 11-08-2016 11-08-2016 0001467024219 SUI LUN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1106 0108R00708160000775 11-08-2016 11-08-2016 0001467024232 YANTO TANDRA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1107 0108R00708160001647 24-08-2016 24-08-2016 0001467028203 EFA P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1108 0108R00708160000627 09-08-2016 09-08-2016 0001467331896 DJAP KIOEN BONG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1109 0108R00708160000718 10-08-2016 10-08-2016 0001467546489 TJOENG KHIN NA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1110 0108R00708160001741 25-08-2016 25-08-2016 0001467546759 TRI MURNI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1111 0108R00708160000194 02-08-2016 02-08-2016 0001467593109 TJIN DJAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1112 0108R00708160000431 05-08-2016 05-08-2016 0001467593109 TJIN DJAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1113 0108R00708160001236 18-08-2016 18-08-2016 0001467593109 TJIN DJAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1114 0108R00708160000724 10-08-2016 10-08-2016 0001467593111 SANDY L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1115 0108R00708160000195 02-08-2016 02-08-2016 0001467593111 SANDY L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1116 0108R00708160000635 09-08-2016 09-08-2016 0001467593111 SANDY L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1117 0108R00708160000626 08-08-2016 08-08-2016 0001467593111 SANDY L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1118 0108R00708160000720 09-08-2016 09-08-2016 0001469104997 NELSON YUDANA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1119 0108R00708160000852 11-08-2016 11-08-2016 0001469432597 DANIEL KAPA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1120 0108R00708160001309 19-08-2016 19-08-2016 0001469432619 AZARYA NATHANAEL L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1121 0108R00708160001646 24-08-2016 24-08-2016 0001469610369 SUI LIAN P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1122 0108R00708160001069 15-08-2016 15-08-2016 0001469987302 LIM SUN KOEI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1123 0108R00708160001712 25-08-2016 25-08-2016 0001470823323 SA LIEM L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1124 0108R00708160000939 12-08-2016 12-08-2016 0001470823323 SA LIEM L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1125 0108R00708160000102 01-08-2016 01-08-2016 0001470823323 SA LIEM L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1126 0108R00708160001632 24-08-2016 24-08-2016 0001470823323 SA LIEM L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1127 0108R00708160001097 15-08-2016 15-08-2016 0001470823323 SA LIEM L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1128 0108R00708160001087 15-08-2016 15-08-2016 0001470963385 TANTANIA PERMATA P Z-3-25-0 ULTRASOUND FOR
SARI GYNAECOLOGY DISORDERS
1129 0108R00708160001381 22-08-2016 22-08-2016 0001470967683 TJHIN SOEI NGIT P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1130 0108R00708160001836 29-08-2016 29-08-2016 0001471414149 PHAN KIT MIN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1131 0108R00708160000640 08-08-2016 08-08-2016 0001471414149 PHAN KIT MIN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1132 0108R00708160001902 29-08-2016 29-08-2016 0001471767761 SYAIFUL. FZ L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1133 0108R00708160001578 24-08-2016 24-08-2016 0001471872047 MARLENA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1134 0108R00708160000334 04-08-2016 04-08-2016 0001472479773 TJHIA KAP SIONG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1135 0108R00708160000857 11-08-2016 11-08-2016 0001472479773 TJHIA KAP SIONG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1136 0108R00708160000066 01-08-2016 01-08-2016 0001472479773 TJHIA KAP SIONG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1137 0108R00708160000581 08-08-2016 08-08-2016 0001472479773 TJHIA KAP SIONG L Q-5-32-0 AMBULATORY VISIT FOR ACUTE
URINARY TRACT DISORDER
1138 0108R00708160001232 18-08-2016 18-08-2016 0001472479773 TJHIA KAP SIONG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1139 0108R00708160001183 18-08-2016 18-08-2016 0001472857716 RATNA DEWI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1140 0108R00708160000575 08-08-2016 08-08-2016 0001475108583 TJHIN MUK LU P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1141 0108R00708160000327 04-08-2016 04-08-2016 0001476871929 KURDI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1142 0108R00708160001685 25-08-2016 25-08-2016 0001476871929 KURDI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1143 0108R00708160002089 31-08-2016 31-08-2016 0001477169098 EDDY SUDARTA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1144 0108R00708160000228 03-08-2016 03-08-2016 0001477169098 EDDY SUDARTA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1145 0108R00708160000769 10-08-2016 10-08-2016 0001477169098 EDDY SUDARTA L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1146 0108R00708160002087 31-08-2016 31-08-2016 0001477169447 DIAN CISKA LIM P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1147 0108R00708160000227 03-08-2016 03-08-2016 0001477169447 DIAN CISKA LIM P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1148 0108R00708160001754 26-08-2016 26-08-2016 0001477169447 DIAN CISKA LIM P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1149 0108R00708160001062 15-08-2016 15-08-2016 0001477529594 HIAN TJIN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1150 0108R00708160002181 03-08-2016 03-08-2016 0001477694362 JOAN JAGRAYA L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1151 0108R00708160000480 06-08-2016 06-08-2016 0001477694362 JOAN JAGRAYA L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1152 0108R00708160001858 29-08-2016 29-08-2016 0001478148794 CHRISTIN P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1153 0108R00708160000554 08-08-2016 08-08-2016 0001478153733 INAS RAZZAQU ALAM P U-3-16-0 DENTAL OPERATIONS
1154 0108R00708160001981 30-08-2016 30-08-2016 0001480488851 KHIOEN DJAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1155 0108R00708160001116 15-08-2016 15-08-2016 0001480570389 SUHARLI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1156 0108R00708160000245 03-08-2016 03-08-2016 0001480570389 SUHARLI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1157 0108R00708160000344 04-08-2016 04-08-2016 0001480570389 SUHARLI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1158 0108R00708160001057 15-08-2016 15-08-2016 0001481294283 SUSANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1159 0108R00708160001273 18-08-2016 18-08-2016 0001481762485 DAVID ANTONI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1160 0108R00708160001680 25-08-2016 25-08-2016 0001482396344 SUMARNI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1161 0108R00708160000658 09-08-2016 09-08-2016 0001505212839 RUSFINI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1162 0108R00708160001740 25-08-2016 25-08-2016 0001505229849 SASMITO TRI HANDOKO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1163 0108R00708160001258 18-08-2016 18-08-2016 0001505670175 Yuliati P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1164 0108R00708160002017 30-08-2016 30-08-2016 0001505670175 Yuliati P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1165 0108R00708160000115 02-08-2016 02-08-2016 0001505869288 DJUN FO L N-3-15-0 DIALYSIS
1166 0108R00708160000645 09-08-2016 09-08-2016 0001505869288 DJUN FO L N-3-15-0 DIALYSIS
1167 0108R00708160000885 12-08-2016 12-08-2016 0001505869288 DJUN FO L N-3-15-0 DIALYSIS
1168 0108R00708160001319 19-08-2016 19-08-2016 0001505869288 DJUN FO L N-3-15-0 DIALYSIS
1169 0108R00708160002025 30-08-2016 30-08-2016 0001505869288 DJUN FO L N-3-15-0 DIALYSIS
1170 0108R00708160002080 31-08-2016 31-08-2016 0001505869288 DJUN FO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1171 0108R00708160001477 22-08-2016 22-08-2016 0001506372614 ZALELA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1172 0108R00708160001943 29-08-2016 29-08-2016 0001506372614 ZALELA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1173 0108R00708160001767 26-08-2016 26-08-2016 0001506372862 JUNIATI SIANTURI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1174 0108R00708160000349 04-08-2016 04-08-2016 0001506374346 AJAW P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1175 0108R00708160001045 15-08-2016 15-08-2016 0001506375718 ASNAH P Q-5-27-0 AMBULATORY VISIT FOR ACUTE
CENTRAL NERVOUS SYSTEM
1176 0108R00708160001368 20-08-2016 20-08-2016 0001506507928 Yunila P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1177 0108R00708160002137 31-08-2016 31-08-2016 0001601799412 LIONG PIANG KHIE L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1178 0108R00708160000306 04-08-2016 04-08-2016 0001601799412 LIONG PIANG KHIE L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1179 0108R00708160001011 15-08-2016 15-08-2016 0001601799412 LIONG PIANG KHIE L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1180 0108R00708160000240 03-08-2016 03-08-2016 0001601800143 LIE SAK MIN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1181 0108R00708160001901 29-08-2016 29-08-2016 0001601800211 BONG TU FUK L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1182 0108R00708160000163 02-08-2016 02-08-2016 0001601800211 BONG TU FUK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1183 0108R00708160000341 04-08-2016 04-08-2016 0001601800211 BONG TU FUK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1184 0108R00708160000839 11-08-2016 11-08-2016 0001601800211 BONG TU FUK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1185 0108R00708160001560 23-08-2016 23-08-2016 0001601800211 BONG TU FUK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1186 0108R00708160001700 25-08-2016 25-08-2016 0001601800211 BONG TU FUK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1187 0108R00708160002045 30-08-2016 30-08-2016 0001601800211 BONG TU FUK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1188 0108R00708160000667 09-08-2016 09-08-2016 0001601800211 BONG TU FUK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1189 0108R00708160001134 16-08-2016 16-08-2016 0001601800211 BONG TU FUK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1190 0108R00708160001242 18-08-2016 18-08-2016 0001601800211 BONG TU FUK L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1191 0108R00708160000468 06-08-2016 06-08-2016 0001601800211 BONG TU FUK L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1192 0108R00708160001038 15-08-2016 15-08-2016 0001601800211 BONG TU FUK L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1193 0108R00708160001445 22-08-2016 22-08-2016 0001601800211 BONG TU FUK L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1194 0108R00708160000705 10-08-2016 10-08-2016 0001601800356 JULIANA WAHI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1195 0108R00708160000134 02-08-2016 02-08-2016 0001601802033 SARIMA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1196 0108R00708160001564 23-08-2016 23-08-2016 0001601803315 SUAINI P N-3-15-0 DIALYSIS
1197 0108R00708160001780 26-08-2016 26-08-2016 0001601803315 SUAINI P N-3-15-0 DIALYSIS
1198 0108R00708160002053 30-08-2016 30-08-2016 0001601803315 SUAINI P N-3-15-0 DIALYSIS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1199 0108R00708160002022 30-08-2016 30-08-2016 0001601815342 Masdinar Bolu Siregar P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1200 0108R00708160002038 30-08-2016 30-08-2016 0001601825501 SUPRIYONO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1201 0108R00708160001153 16-08-2016 16-08-2016 0001601825501 SUPRIYONO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1202 0108R00708160002107 31-08-2016 31-08-2016 0001601830157 RIA AYU WAN P U-3-16-0 DENTAL OPERATIONS
1203 0108R00708160001535 23-08-2016 23-08-2016 0001601833544 Nurjani P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1204 0108R00708160000355 04-08-2016 04-08-2016 0001601836402 SARTIKA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1205 0108R00708160000220 03-08-2016 03-08-2016 0001601838538 Harianto Ngiswadi L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1206 0108R00708160002079 31-08-2016 31-08-2016 0001601838538 Harianto Ngiswadi L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1207 0108R00708160000483 06-08-2016 06-08-2016 0001601838538 Harianto Ngiswadi L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1208 0108R00708160000970 13-08-2016 13-08-2016 0001601838538 Harianto Ngiswadi L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1209 0108R00708160001276 19-08-2016 19-08-2016 0001601838538 Harianto Ngiswadi L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1210 0108R00708160000371 04-08-2016 04-08-2016 0001601853625 H.M.YUNUS MENTOH L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1211 0108R00708160001452 22-08-2016 22-08-2016 0001601853682 SISKA FEBIOLA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1212 0108R00708160002002 30-08-2016 30-08-2016 0001601855774 DARMIYANTI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1213 0108R00708160001729 26-08-2016 26-08-2016 0001601856235 SIAK FI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1214 0108R00708160000251 03-08-2016 03-08-2016 0001601858002 Siti Aisah P U-3-13-0 OTHER EAR NOSE MOUTH &
THROAT DIAGNOSTIC
1215 0108R00708160000621 08-08-2016 08-08-2016 0001601858002 Siti Aisah P U-3-16-0 DENTAL OPERATIONS
1216 0108R00708160000569 08-08-2016 08-08-2016 0001603389104 MARJULIA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1217 0108R00708160001863 29-08-2016 29-08-2016 0001603395843 LINDA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1218 0108R00708160001885 29-08-2016 29-08-2016 0001603398936 Sunarnuarti P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1219 0108R00708160000073 01-08-2016 01-08-2016 0001603398936 Sunarnuarti P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1220 0108R00708160000255 03-08-2016 03-08-2016 0001603403223 EFFENDI L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1221 0108R00708160001587 24-08-2016 24-08-2016 0001603601831 ASMANU L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1222 0108R00708160001240 18-08-2016 18-08-2016 0001603740082 ILIA SAPITRI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1223 0108R00708160000411 05-08-2016 05-08-2016 0001603788647 ERDA P N-3-15-0 DIALYSIS
1224 0108R00708160001552 23-08-2016 23-08-2016 0001603788647 ERDA P N-3-15-0 DIALYSIS
1225 0108R00708160000189 02-08-2016 02-08-2016 0001603788647 ERDA P N-3-15-0 DIALYSIS
1226 0108R00708160000663 09-08-2016 09-08-2016 0001603788647 ERDA P N-3-15-0 DIALYSIS
1227 0108R00708160000914 12-08-2016 12-08-2016 0001603788647 ERDA P N-3-15-0 DIALYSIS
1228 0108R00708160001142 16-08-2016 16-08-2016 0001603788647 ERDA P N-3-15-0 DIALYSIS
1229 0108R00708160001296 19-08-2016 19-08-2016 0001603788647 ERDA P N-3-15-0 DIALYSIS
1230 0108R00708160001736 26-08-2016 26-08-2016 0001603788647 ERDA P N-3-15-0 DIALYSIS
1231 0108R00708160002010 30-08-2016 30-08-2016 0001603788647 ERDA P N-3-15-0 DIALYSIS
1232 0108R00708160001921 29-08-2016 29-08-2016 0001603795544 KARIANA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1233 0108R00708160001866 29-08-2016 29-08-2016 0001603807389 Kon Djin P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1234 0108R00708160000153 02-08-2016 02-08-2016 0001603808019 Lim A Pian P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1235 0108R00708160002086 31-08-2016 31-08-2016 0001603810271 CHAI A THIN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1236 0108R00708160001655 25-08-2016 25-08-2016 0001603810271 CHAI A THIN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1237 0108R00708160001401 22-08-2016 22-08-2016 0001603814139 HAPSAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1238 0108R00708160000665 09-08-2016 09-08-2016 0001604271532 MUHAMMAD RASYID L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1239 0108R00708160000033 01-08-2016 01-08-2016 0001604271532 MUHAMMAD RASYID L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1240 0108R00708160000310 04-08-2016 04-08-2016 0001604274467 BUNIYAH P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1241 0108R00708160000538 08-08-2016 08-08-2016 0001604274467 BUNIYAH P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1242 0108R00708160000958 13-08-2016 13-08-2016 0001604274467 BUNIYAH P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1243 0108R00708160000049 01-08-2016 01-08-2016 0001604274467 BUNIYAH P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1244 0108R00708160001029 15-08-2016 15-08-2016 0001604275569 RR.SRI WAHYU P Q-5-44-0 AMBULATORY VISIT FOR OTHER
ERLINAWATI MINOR CHRONIC DISEASES
1245 0108R00708160000272 03-08-2016 03-08-2016 0001604275569 RR.SRI WAHYU P N-3-15-0 DIALYSIS
ERLINAWATI
1246 0108R00708160000761 10-08-2016 10-08-2016 0001604275569 RR.SRI WAHYU P N-3-15-0 DIALYSIS
ERLINAWATI
1247 0108R00708160000994 13-08-2016 13-08-2016 0001604275569 RR.SRI WAHYU P N-3-15-0 DIALYSIS
ERLINAWATI
1248 0108R00708160001202 17-08-2016 17-08-2016 0001604275569 RR.SRI WAHYU P N-3-15-0 DIALYSIS
ERLINAWATI
1249 0108R00708160001633 24-08-2016 24-08-2016 0001604275569 RR.SRI WAHYU P N-3-15-0 DIALYSIS
ERLINAWATI
1250 0108R00708160001887 27-08-2016 27-08-2016 0001604275569 RR.SRI WAHYU P N-3-15-0 DIALYSIS
ERLINAWATI
1251 0108R00708160002152 31-08-2016 31-08-2016 0001604275569 RR.SRI WAHYU P N-3-15-0 DIALYSIS
ERLINAWATI
1252 0108R00708160001370 20-08-2016 20-08-2016 0001604275569 RR.SRI WAHYU P N-3-15-0 DIALYSIS
ERLINAWATI
1253 0108R00708160000647 07-08-2016 07-08-2016 0001604558439 ERNI P N-3-15-0 DIALYSIS
1254 0108R00708160000749 10-08-2016 10-08-2016 0001604751761 FAIZAL L U-3-16-0 DENTAL OPERATIONS
1255 0108R00708160001785 26-08-2016 26-08-2016 0001604771796 Adzanah Firyal Nabilah P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1256 0108R00708160000680 09-08-2016 09-08-2016 0001606738858 DIKA DWI WIANSANA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1257 0108R00708160001367 20-08-2016 20-08-2016 0001609930833 Subarini P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1258 0108R00708160001549 23-08-2016 23-08-2016 0001609930833 Subarini P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1259 0108R00708160001991 30-08-2016 30-08-2016 0001609931171 KARYOTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1260 0108R00708160001743 26-08-2016 26-08-2016 0001609931171 KARYOTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1261 0108R00708160000057 01-08-2016 01-08-2016 0001613929037 RAHMAD L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1262 0108R00708160000178 02-08-2016 02-08-2016 0001716391945 REVAN RIYANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1263 0108R00708160000929 12-08-2016 12-08-2016 0001716391945 REVAN RIYANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1264 0108R00708160001937 29-08-2016 29-08-2016 0001716391945 REVAN RIYANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1265 0108R00708160001259 18-08-2016 18-08-2016 0001717343807 HENDRA IRAWAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1266 0108R00708160001503 22-08-2016 22-08-2016 0001717343807 HENDRA IRAWAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1267 0108R00708160001315 19-08-2016 19-08-2016 0001717343829 THEONA VALA ELYSIA P Q-5-26-0 AMBULATORY VISIT FOR ACUTE
BRONCHIAL DISORDER
1268 0108R00708160001912 29-08-2016 29-08-2016 0001717343829 THEONA VALA ELYSIA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1269 0108R00708160000726 10-08-2016 10-08-2016 0001717874853 TERESIA TUGINEM P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1270 0108R00708160001788 27-08-2016 27-08-2016 0001718023634 MARITA P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1271 0108R00708160000966 13-08-2016 13-08-2016 0001718023634 MARITA P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1272 0108R00708160001330 19-08-2016 19-08-2016 0001718725307 KRISNA P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1273 0108R00708160001462 22-08-2016 22-08-2016 0001719856574 TOMINA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1274 0108R00708160000597 08-08-2016 08-08-2016 0001720243361 MU'ALDI YANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1275 0108R00708160001169 16-08-2016 16-08-2016 0001720243361 MU'ALDI YANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1276 0108R00708160000543 08-08-2016 08-08-2016 0001720560295 NOVERA MISDIARTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1277 0108R00708160002118 30-08-2016 30-08-2016 0001720684067 YANG XIEN ANGELINA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1278 0108R00708160000875 11-08-2016 11-08-2016 0001720684067 YANG XIEN ANGELINA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1279 0108R00708160001978 30-08-2016 30-08-2016 0001720922343 INDRI PUTRI P Z-3-25-0 ULTRASOUND FOR
PERMATASARI GYNAECOLOGY DISORDERS
1280 0108R00708160001391 22-08-2016 22-08-2016 0001721034303 MARTINI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1281 0108R00708160000348 04-08-2016 04-08-2016 0001721047149 VERYANTI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1282 0108R00708160000822 11-08-2016 11-08-2016 0001721210139 TJEW SIN THIT L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1283 0108R00708160001996 30-08-2016 30-08-2016 0001721500817 MARIATI ANGGRAINI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1284 0108R00708160000959 13-08-2016 13-08-2016 0001721500817 MARIATI ANGGRAINI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1285 0108R00708160000275 03-08-2016 03-08-2016 0001721504068 NG SUN NYONG P N-3-15-0 DIALYSIS
1286 0108R00708160000765 10-08-2016 10-08-2016 0001721504068 NG SUN NYONG P N-3-15-0 DIALYSIS
1287 0108R00708160001206 17-08-2016 17-08-2016 0001721504068 NG SUN NYONG P N-3-15-0 DIALYSIS
1288 0108R00708160001376 20-08-2016 20-08-2016 0001721504068 NG SUN NYONG P N-3-15-0 DIALYSIS
1289 0108R00708160001634 24-08-2016 24-08-2016 0001721504068 NG SUN NYONG P N-3-15-0 DIALYSIS
1290 0108R00708160001886 27-08-2016 27-08-2016 0001721504068 NG SUN NYONG P N-3-15-0 DIALYSIS
1291 0108R00708160002155 31-08-2016 31-08-2016 0001721504068 NG SUN NYONG P N-3-15-0 DIALYSIS
1292 0108R00708160002192 06-08-2016 06-08-2016 0001721504068 NG SUN NYONG P N-3-15-0 DIALYSIS
1293 0108R00708160002197 13-08-2016 13-08-2016 0001721504068 NG SUN NYONG P N-3-15-0 DIALYSIS
1294 0108R00708160001810 27-08-2016 27-08-2016 0001721591234 NOVITA SARI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1295 0108R00708160002043 29-08-2016 29-08-2016 0001721591245 VERRA SAPHIRA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
PERMATA SARI MINOR CHRONIC DISEASES
1296 0108R00708160001137 16-08-2016 16-08-2016 0001721911184 WALUYATRI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1297 0108R00708160001666 25-08-2016 25-08-2016 0001722102491 KHOIJ PIN L Q-5-25-0 AMBULATORY VISIT FOR ACUTE
GASTROINTESTINAL DISORDER
1298 0108R00708160001548 23-08-2016 23-08-2016 0001722199893 AZMI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1299 0108R00708160001618 24-08-2016 24-08-2016 0001722276876 TITIK WULANDARI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1300 0108R00708160000098 01-08-2016 01-08-2016 0001785410392 PADILAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1301 0108R00708160000173 02-08-2016 02-08-2016 0001785494351 ASAN L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1302 0108R00708160000257 03-08-2016 03-08-2016 0001785494351 ASAN L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1303 0108R00708160001893 29-08-2016 29-08-2016 0001785503507 DEVI YOLANDA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1304 0108R00708160001094 15-08-2016 15-08-2016 0001785593891 HENNY ASTUTI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1305 0108R00708160000821 11-08-2016 11-08-2016 0001785816977 M. GHOZALI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1306 0108R00708160002224 09-08-2016 09-08-2016 0001785816977 M. GHOZALI L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1307 0108R00708160001208 17-08-2016 17-08-2016 0001786781024 amira ratifa zahra P Q-5-42-0 AMBULATORY VISIT FOR OTHER
MINOR ACUTE DISORDER
1308 0108R00708160001290 19-08-2016 19-08-2016 0001786781024 amira ratifa zahra P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1309 0108R00708160001602 24-08-2016 24-08-2016 0001786781024 amira ratifa zahra P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1310 0108R00708160001841 29-08-2016 29-08-2016 0001786781024 amira ratifa zahra P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1311 0108R00708160000619 08-08-2016 08-08-2016 0001787245806 THERESIA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1312 0108R00708160001924 29-08-2016 29-08-2016 0001787542716 INDAH FAJARWATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1313 0108R00708160001551 23-08-2016 23-08-2016 0001787542716 INDAH FAJARWATI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1314 0108R00708160001643 24-08-2016 24-08-2016 0001787916745 gandung sudiantoro L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1315 0108R00708160000279 03-08-2016 03-08-2016 0001788001323 MACHMUD L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1316 0108R00708160001180 18-08-2016 18-08-2016 0001788862691 KARMAWATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1317 0108R00708160000844 11-08-2016 11-08-2016 0001790099853 MAN NING P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1318 0108R00708160002066 31-08-2016 31-08-2016 0001790955606 phan a hin L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1319 0108R00708160000006 01-08-2016 01-08-2016 0001790955606 phan a hin L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1320 0108R00708160001300 19-08-2016 19-08-2016 0001791048565 hennita P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1321 0108R00708160001392 22-08-2016 22-08-2016 0001791048565 hennita P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1322 0108R00708160001295 19-08-2016 19-08-2016 0001791370258 TOHIRIN L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1323 0108R00708160002127 31-08-2016 31-08-2016 0001791370258 TOHIRIN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1324 0108R00708160001540 23-08-2016 23-08-2016 0001791370258 TOHIRIN L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1325 0108R00708160001103 15-08-2016 15-08-2016 0001791370258 TOHIRIN L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1326 0108R00708160001256 18-08-2016 18-08-2016 0001792169763 hioe soei lan P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1327 0108R00708160002097 31-08-2016 31-08-2016 0001792248028 bong jevan raphael L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1328 0108R00708160000321 04-08-2016 04-08-2016 0001792391218 ERLIJANTI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1329 0108R00708160000485 06-08-2016 06-08-2016 0001792430223 SUSANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1330 0108R00708160000484 06-08-2016 06-08-2016 0001792434047 ENNY VERENNICA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
HASIM MINOR CHRONIC DISEASES
1331 0108R00708160001264 18-08-2016 18-08-2016 0001792655032 SIN TJHONG L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1332 0108R00708160001494 22-08-2016 22-08-2016 0001792655032 SIN TJHONG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1333 0108R00708160001268 18-08-2016 18-08-2016 0001792829327 RIDhO ILLAHI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1334 0108R00708160000874 11-08-2016 11-08-2016 0001793099259 FITA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1335 0108R00708160001726 25-08-2016 25-08-2016 0001793129692 FANNI FEBRIYANI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1336 0108R00708160000333 04-08-2016 04-08-2016 0001793255354 marsuki L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1337 0108R00708160001946 29-08-2016 29-08-2016 0001793255354 marsuki L H-2-36-0 CATARACT OPERATIONS
1338 0108R00708160001620 24-08-2016 24-08-2016 0001793400579 RIKA FERLIA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1339 0108R00708160001321 19-08-2016 19-08-2016 0001793400579 RIKA FERLIA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1340 0108R00708160000634 09-08-2016 09-08-2016 0001793578577 ANDI SUJANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1341 0108R00708160001845 29-08-2016 29-08-2016 0001794198712 LIN SOET MOI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1342 0108R00708160000210 03-08-2016 03-08-2016 0001794216644 INDRAWATI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1343 0108R00708160000106 01-08-2016 01-08-2016 0001794220121 JUNAIDI L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1344 0108R00708160000623 08-08-2016 08-08-2016 0001794220121 JUNAIDI L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1345 0108R00708160001267 18-08-2016 18-08-2016 0001794220121 JUNAIDI L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1346 0108R00708160002210 29-08-2016 29-08-2016 0001794220121 JUNAIDI L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1347 0108R00708160000105 01-08-2016 01-08-2016 0001794220479 NURJANAH P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1348 0108R00708160000624 08-08-2016 08-08-2016 0001794220479 NURJANAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1349 0108R00708160002099 31-08-2016 31-08-2016 0001794677995 MUHADI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1350 0108R00708160000053 01-08-2016 01-08-2016 0001794677995 MUHADI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1351 0108R00708160001778 26-08-2016 26-08-2016 0001794874601 MAYLANIE P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1352 0108R00708160000589 08-08-2016 08-08-2016 0001794999047 QORI RAMADHANIVA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1353 0108R00708160000509 06-08-2016 06-08-2016 0001794999047 QORI RAMADHANIVA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1354 0108R00708160001230 18-08-2016 18-08-2016 0001795289051 LIE KWAN NJONG P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1355 0108R00708160000643 09-08-2016 09-08-2016 0001795806685 sitti P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1356 0108R00708160000972 13-08-2016 13-08-2016 0001795947096 yuliatin P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1357 0108R00708160001797 27-08-2016 27-08-2016 0001796071296 YULIANTIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1358 0108R00708160001006 15-08-2016 15-08-2016 0001796071296 YULIANTIE P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1359 0108R00708160001582 24-08-2016 24-08-2016 0001796155367 DJAUW MIE JIN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1360 0108R00708160001008 15-08-2016 15-08-2016 0001796155367 DJAUW MIE JIN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1361 0108R00708160000199 03-08-2016 03-08-2016 0001796291245 DJONIANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1362 0108R00708160000883 12-08-2016 12-08-2016 0001796618834 SISKA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1363 0108R00708160000566 08-08-2016 08-08-2016 0001796687302 dzihan najibah kansya L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1364 0108R00708160002024 30-08-2016 30-08-2016 0001796692083 BUYUNG DULYADI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1365 0108R00708160000249 02-08-2016 02-08-2016 0001796701151 IIS TIARI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1366 0108R00708160001369 20-08-2016 20-08-2016 0001796769753 ROHAYU NIYATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1367 0108R00708160001164 16-08-2016 16-08-2016 0001796769753 ROHAYU NIYATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1368 0108R00708160001982 30-08-2016 30-08-2016 0001797287657 SAMSUMIN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1369 0108R00708160001742 25-08-2016 25-08-2016 0001797533998 NATANAEL VINNA P H-3-13-0 DIAGNOSTIC & IMAGING EYE
TJOENG INVESTIGATIONS
1370 0108R00708160001372 22-08-2016 22-08-2016 0001798453001 CHIN SIAN LIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1371 0108R00708160001629 24-08-2016 24-08-2016 0001798965494 BUN MIE YUN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1372 0108R00708160002218 02-08-2016 02-08-2016 0001799317563 indriati thamrin P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1373 0108R00708160000539 08-08-2016 08-08-2016 0001799317563 indriati thamrin P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1374 0108R00708160000862 11-08-2016 11-08-2016 0001799436374 MUHAMMAD ROSIDI L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1375 0108R00708160001750 26-08-2016 26-08-2016 0001799726668 TJHIN MOEK PO L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1376 0108R00708160001282 19-08-2016 19-08-2016 0001799726668 TJHIN MOEK PO L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1377 0108R00708160000921 12-08-2016 12-08-2016 0001799726668 TJHIN MOEK PO L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1378 0108R00708160000393 05-08-2016 05-08-2016 0001799726668 TJHIN MOEK PO L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1379 0108R00708160000312 04-08-2016 04-08-2016 0001799726668 TJHIN MOEK PO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1380 0108R00708160001966 29-08-2016 29-08-2016 0001800024748 ng sui hiong P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1381 0108R00708160000095 01-08-2016 01-08-2016 0001800024748 ng sui hiong P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1382 0108R00708160000792 11-08-2016 11-08-2016 0001801420277 lie mat L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1383 0108R00708160001667 25-08-2016 25-08-2016 0001801479543 made novi P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1384 0108R00708160001110 15-08-2016 15-08-2016 0001801776374 DJAHIDIN HATOP L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1385 0108R00708160000794 11-08-2016 11-08-2016 0001802622137 maria nelli P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1386 0108R00708160000111 02-08-2016 02-08-2016 0001802622137 maria nelli P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1387 0108R00708160000763 10-08-2016 10-08-2016 0001802670197 Ildha Yuni Sihara, AMK L U-3-16-0 DENTAL OPERATIONS
1388 0108R00708160002122 31-08-2016 31-08-2016 0001802670197 Ildha Yuni Sihara, AMK L U-3-16-0 DENTAL OPERATIONS
1389 0108R00708160001466 22-08-2016 22-08-2016 0001802683449 AYU NORA, AMKEP P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1390 0108R00708160000076 01-08-2016 01-08-2016 0001802766295 BUDI HARTONO L U-3-13-0 OTHER EAR NOSE MOUTH &
THROAT DIAGNOSTIC
1391 0108R00708160000607 08-08-2016 08-08-2016 0001802934371 RAMDANI L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1392 0108R00708160001686 25-08-2016 25-08-2016 0001802999136 ANITA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1393 0108R00708160000825 11-08-2016 11-08-2016 0001803056771 YUDI BAGUSRIANTO L Q-5-42-0 AMBULATORY VISIT FOR OTHER
MINOR ACUTE DISORDER
1394 0108R00708160000387 04-08-2016 04-08-2016 0001803076637 JOHAN L U-3-15-0 OTHER EAR NOSE MOUTH &
THROAT OPERATIONS
1395 0108R00708160002183 04-08-2016 04-08-2016 0001803125057 JONG NGIAT PO L U-3-15-0 OTHER EAR NOSE MOUTH &
THROAT OPERATIONS
1396 0108R00708160000262 03-08-2016 03-08-2016 0001803650624 DEDE DJAMALUDIN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1397 0108R00708160001781 26-08-2016 26-08-2016 0001804081015 SERLY KUSRIANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1398 0108R00708160000392 05-08-2016 05-08-2016 0001805116476 MARCELLINO ORLANDO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
BOEN MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1399 0108R00708160001084 15-08-2016 15-08-2016 0001807436013 DJAMUIE L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1400 0108R00708160001638 24-08-2016 24-08-2016 0001807439455 suhardi L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1401 0108R00708160000123 02-08-2016 02-08-2016 0001807484567 ZHEFAN HAFIDH L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1402 0108R00708160000948 12-08-2016 12-08-2016 0001807670046 FELEN SANDALIA P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1403 0108R00708160001626 24-08-2016 24-08-2016 0001808238339 ASMAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1404 0108R00708160001567 23-08-2016 23-08-2016 0001808502445 TJHIN SUI SIAN P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1405 0108R00708160000814 11-08-2016 11-08-2016 0001808856955 ho kiun liaw L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1406 0108R00708160000861 11-08-2016 11-08-2016 0001809111846 dwi eka purbarani P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1407 0108R00708160001630 24-08-2016 24-08-2016 0001809111846 dwi eka purbarani P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1408 0108R00708160000052 01-08-2016 01-08-2016 0001809111846 dwi eka purbarani P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1409 0108R00708160000746 10-08-2016 10-08-2016 0001809429524 lim kim moy P U-3-16-0 DENTAL OPERATIONS
1410 0108R00708160001955 29-08-2016 29-08-2016 0001809429524 lim kim moy P U-3-16-0 DENTAL OPERATIONS
1411 0108R00708160000298 04-08-2016 04-08-2016 0001809429524 lim kim moy P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1412 0108R00708160000628 09-08-2016 09-08-2016 0001809429524 lim kim moy P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1413 0108R00708160001004 15-08-2016 15-08-2016 0001809532282 wei tjhing P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1414 0108R00708160000934 12-08-2016 12-08-2016 0001809923308 KHANZEA AQUINA P Q-5-42-0 AMBULATORY VISIT FOR OTHER
PITRAH MINOR ACUTE DISORDER
1415 0108R00708160000722 09-08-2016 09-08-2016 0001810075094 MARYANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1416 0108R00708160001684 25-08-2016 25-08-2016 0001810976409 nathan chrys abraham L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1417 0108R00708160001363 20-08-2016 20-08-2016 0001811572525 KEZIA ANGELICA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1418 0108R00708160001460 22-08-2016 22-08-2016 0001811572525 KEZIA ANGELICA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1419 0108R00708160000984 13-08-2016 13-08-2016 0001811572525 KEZIA ANGELICA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1420 0108R00708160000547 07-08-2016 07-08-2016 0001811785566 MARDIANA P Q-5-42-0 AMBULATORY VISIT FOR OTHER
MINOR ACUTE DISORDER
1421 0108R00708160000817 11-08-2016 11-08-2016 0001811922006 FERY EKO PRASETIYO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
YULIANTO MINOR CHRONIC DISEASES
1422 0108R00708160000104 01-08-2016 01-08-2016 0001813175987 juma'ah P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1423 0108R00708160000858 11-08-2016 11-08-2016 0001813291604 RENI ZULAILA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1424 0108R00708160000157 02-08-2016 02-08-2016 0001813569388 ALDISYA TSABITA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1425 0108R00708160000400 04-08-2016 04-08-2016 0001814288106 DEDI HATA MULYANA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1426 0108R00708160001612 24-08-2016 24-08-2016 0001815056212 AGNAR ANDRIAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1427 0108R00708160000180 02-08-2016 02-08-2016 0001815056212 AGNAR ANDRIAN P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1428 0108R00708160000933 12-08-2016 12-08-2016 0001815056212 AGNAR ANDRIAN P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1429 0108R00708160001313 19-08-2016 19-08-2016 0001815056212 AGNAR ANDRIAN P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1430 0108R00708160001766 26-08-2016 26-08-2016 0001815056212 AGNAR ANDRIAN P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1431 0108R00708160001949 29-08-2016 29-08-2016 0001815056212 AGNAR ANDRIAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1432 0108R00708160001168 16-08-2016 16-08-2016 0001815056212 AGNAR ANDRIAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1433 0108R00708160001470 22-08-2016 22-08-2016 0001815056212 AGNAR ANDRIAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1434 0108R00708160001820 27-08-2016 27-08-2016 0001815793468 RIDWAN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1435 0108R00708160000953 12-08-2016 12-08-2016 0001815939922 kok sioe moy P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1436 0108R00708160000335 04-08-2016 04-08-2016 0001817910382 TRIANA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1437 0108R00708160000080 01-08-2016 01-08-2016 0001817910382 TRIANA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1438 0108R00708160001086 15-08-2016 15-08-2016 0001819021252 TJHIN NGIAT NIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1439 0108R00708160001473 22-08-2016 22-08-2016 0001819122974 tjhang asian P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1440 0108R00708160002027 30-08-2016 30-08-2016 0001819153844 djap ngiat mi P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1441 0108R00708160002175 08-08-2016 08-08-2016 0001819222929 ari gunawan L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1442 0108R00708160001739 25-08-2016 25-08-2016 0001819222929 ari gunawan L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1443 0108R00708160001609 24-08-2016 24-08-2016 0001819962292 MIE SIAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1444 0108R00708160002071 31-08-2016 31-08-2016 0001819962292 MIE SIAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1445 0108R00708160001314 18-08-2016 18-08-2016 0001820063957 mukhlis anggara L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1446 0108R00708160001305 19-08-2016 19-08-2016 0001820527233 melisa P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1447 0108R00708160001419 22-08-2016 22-08-2016 0001820527233 melisa P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1448 0108R00708160000369 04-08-2016 04-08-2016 0001820573728 musolihin L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1449 0108R00708160000860 11-08-2016 11-08-2016 0001820573728 musolihin L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1450 0108R00708160001510 22-08-2016 22-08-2016 0001820745977 H. USMAN L Q-5-27-0 AMBULATORY VISIT FOR ACUTE
CENTRAL NERVOUS SYSTEM
1451 0108R00708160002019 30-08-2016 30-08-2016 0001822582034 FAUZIAH P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1452 0108R00708160000382 04-08-2016 04-08-2016 0001822588288 LO KIM TJOENG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1453 0108R00708160002228 10-08-2016 10-08-2016 0001823496682 salsabila zalfa azalia P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1454 0108R00708160002101 31-08-2016 31-08-2016 0001823781161 m. febrian pratama L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1455 0108R00708160001308 19-08-2016 19-08-2016 0001823788449 TEGAR AKBARI L Q-5-31-0 AMBULATORY VISIT FOR
SIGNIFICANT FRACTURES
1456 0108R00708160002215 28-08-2016 28-08-2016 0001823792308 M REFFAN DWI ZAKIRAN L Q-5-42-0 AMBULATORY VISIT FOR OTHER
MINOR ACUTE DISORDER
1457 0108R00708160000877 11-08-2016 11-08-2016 0001823795177 DESTY MARDIA PUTRI P U-3-15-0 OTHER EAR NOSE MOUTH &
THROAT OPERATIONS
1458 0108R00708160001724 25-08-2016 25-08-2016 0001823811232 NURYANTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1459 0108R00708160000089 01-08-2016 01-08-2016 0001823811232 NURYANTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1460 0108R00708160000617 08-08-2016 08-08-2016 0001823811232 NURYANTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1461 0108R00708160001118 15-08-2016 15-08-2016 0001823811232 NURYANTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1462 0108R00708160001882 29-08-2016 29-08-2016 0001823814101 RIZQY MUDHAFFAR L Q-5-42-0 AMBULATORY VISIT FOR OTHER
MINOR ACUTE DISORDER
1463 0108R00708160001621 24-08-2016 24-08-2016 0001823814922 DEVAN MIZANO L H-3-13-0 DIAGNOSTIC & IMAGING EYE
MUDHAFFAR INVESTIGATIONS
1464 0108R00708160000206 03-08-2016 03-08-2016 0001823815912 vanessa holly P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1465 0108R00708160001816 27-08-2016 27-08-2016 0001823819951 AZKA RAMADHAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1466 0108R00708160000081 01-08-2016 01-08-2016 0001824467747 YAHYA M. L N-3-15-0 DIALYSIS
1467 0108R00708160000360 04-08-2016 04-08-2016 0001824467747 YAHYA M. L N-3-15-0 DIALYSIS
1468 0108R00708160000603 08-08-2016 08-08-2016 0001824467747 YAHYA M. L N-3-15-0 DIALYSIS
1469 0108R00708160000781 11-08-2016 11-08-2016 0001824467747 YAHYA M. L N-3-15-0 DIALYSIS
1470 0108R00708160001106 15-08-2016 15-08-2016 0001824467747 YAHYA M. L N-3-15-0 DIALYSIS
1471 0108R00708160001255 18-08-2016 18-08-2016 0001824467747 YAHYA M. L N-3-15-0 DIALYSIS
1472 0108R00708160001501 22-08-2016 22-08-2016 0001824467747 YAHYA M. L N-3-15-0 DIALYSIS
1473 0108R00708160001714 25-08-2016 25-08-2016 0001824467747 YAHYA M. L N-3-15-0 DIALYSIS
1474 0108R00708160001926 29-08-2016 29-08-2016 0001824467747 YAHYA M. L N-3-15-0 DIALYSIS
1475 0108R00708160001976 29-08-2016 29-08-2016 0001824504884 sinta nurhalisa P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1476 0108R00708160001834 29-08-2016 29-08-2016 0001826195398 RIDWAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1477 0108R00708160000376 04-08-2016 04-08-2016 0001826195962 ROHAYA P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1478 0108R00708160001511 23-08-2016 23-08-2016 0001826796047 MARDIANA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1479 0108R00708160000138 02-08-2016 02-08-2016 0001829049579 ERLIZY ALPRADITA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1480 0108R00708160000870 11-08-2016 11-08-2016 0001829203108 then thian siong L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1481 0108R00708160000101 01-08-2016 01-08-2016 0001829256579 TJHIN FAT LOIJ L Q-5-31-0 AMBULATORY VISIT FOR
SIGNIFICANT FRACTURES
1482 0108R00708160001032 15-08-2016 15-08-2016 0001830834854 hartati P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1483 0108R00708160001114 15-08-2016 15-08-2016 0001830886907 sri suryani P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1484 0108R00708160001645 24-08-2016 24-08-2016 0001831192402 SUJATMI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1485 0108R00708160002102 31-08-2016 31-08-2016 0001831382109 sari meliana silvia P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1486 0108R00708160002145 31-08-2016 31-08-2016 0001831427684 lia P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1487 0108R00708160001076 15-08-2016 15-08-2016 0001833708115 NURHAYATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1488 0108R00708160001640 24-08-2016 24-08-2016 0001833818646 eliana margaretta P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1489 0108R00708160001971 29-08-2016 29-08-2016 0001834166261 REZKIA MARITA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
EStivanny MINOR CHRONIC DISEASES
1490 0108R00708160001293 19-08-2016 19-08-2016 0001834617159 PHUNG PIANG TJUNG L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1491 0108R00708160001471 22-08-2016 22-08-2016 0001835674176 YELLY P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1492 0108R00708160001568 23-08-2016 23-08-2016 0001837299554 roshayu saliu P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1493 0108R00708160002194 09-08-2016 09-08-2016 0001838531169 eli hodiyah P U-3-16-0 DENTAL OPERATIONS
1494 0108R00708160000632 09-08-2016 09-08-2016 0001838684518 TENDERIUS L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1495 0108R00708160001590 24-08-2016 24-08-2016 0001840054421 ICE SUSILAWATI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1496 0108R00708160001519 23-08-2016 23-08-2016 0001840272884 ike yunus archan P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1497 0108R00708160000113 02-08-2016 02-08-2016 0001842553359 kamti P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1498 0108R00708160001272 18-08-2016 18-08-2016 0001842557139 DARWANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1499 0108R00708160001556 23-08-2016 23-08-2016 0001844458402 tommy L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1500 0108R00708160000546 08-08-2016 08-08-2016 0001844510591 arjuna P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1501 0108R00708160001063 15-08-2016 15-08-2016 0001845411658 MAI FA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1502 0108R00708160001869 29-08-2016 29-08-2016 0001845431019 BUN TEN LAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1503 0108R00708160001221 18-08-2016 18-08-2016 0001845431019 BUN TEN LAN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1504 0108R00708160000834 11-08-2016 11-08-2016 0001845569935 TJEN A NON P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1505 0108R00708160000470 06-08-2016 06-08-2016 0001845806916 SETYO RIYANTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1506 0108R00708160001897 29-08-2016 29-08-2016 0001845940228 TJHANG KHUN DJIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1507 0108R00708160000130 02-08-2016 02-08-2016 0001847729676 SIAN FUI L N-3-15-0 DIALYSIS
1508 0108R00708160000396 05-08-2016 05-08-2016 0001847729676 SIAN FUI L N-3-15-0 DIALYSIS
1509 0108R00708160000641 09-08-2016 09-08-2016 0001847729676 SIAN FUI L N-3-15-0 DIALYSIS
1510 0108R00708160000890 12-08-2016 12-08-2016 0001847729676 SIAN FUI L N-3-15-0 DIALYSIS
1511 0108R00708160001138 16-08-2016 16-08-2016 0001847729676 SIAN FUI L N-3-15-0 DIALYSIS
1512 0108R00708160001289 19-08-2016 19-08-2016 0001847729676 SIAN FUI L N-3-15-0 DIALYSIS
1513 0108R00708160001529 23-08-2016 23-08-2016 0001847729676 SIAN FUI L N-3-15-0 DIALYSIS
1514 0108R00708160001730 26-08-2016 26-08-2016 0001847729676 SIAN FUI L N-3-15-0 DIALYSIS
1515 0108R00708160002007 30-08-2016 30-08-2016 0001847729676 SIAN FUI L N-3-15-0 DIALYSIS
1516 0108R00708160000580 08-08-2016 08-08-2016 0001847886849 maksum zaenudin L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1517 0108R00708160001198 18-08-2016 18-08-2016 0001847886849 maksum zaenudin L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1518 0108R00708160000161 02-08-2016 02-08-2016 0001848087404 ACHMAD SANI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1519 0108R00708160002206 18-08-2016 18-08-2016 0001848549497 surandi L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1520 0108R00708160002062 31-08-2016 31-08-2016 0001849918162 hanipah P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1521 0108R00708160001675 25-08-2016 25-08-2016 0001850944691 SUGIYO BIN KEMIS L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1522 0108R00708160001938 27-08-2016 27-08-2016 0001851243658 astari dwi amanda P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1523 0108R00708160001930 29-08-2016 29-08-2016 0001851659493 aniah P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1524 0108R00708160001129 16-08-2016 16-08-2016 0001852205624 M. NADIP HAMDI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1525 0108R00708160000159 02-08-2016 02-08-2016 0001852206298 murti P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1526 0108R00708160000653 09-08-2016 09-08-2016 0001852206298 murti P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1527 0108R00708160001128 16-08-2016 16-08-2016 0001852206298 murti P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1528 0108R00708160002110 30-08-2016 30-08-2016 0001852402296 MEILLISA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1529 0108R00708160001891 28-08-2016 28-08-2016 0001853052671 aida P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1530 0108R00708160002217 22-08-2016 22-08-2016 0001853052671 aida P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1531 0108R00708160000196 03-08-2016 03-08-2016 0001853072785 jhoni nainggolan L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1532 0108R00708160000197 03-08-2016 03-08-2016 0001853073483 maria magdalena P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1533 0108R00708160001498 22-08-2016 22-08-2016 0001853080154 suaibah P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1534 0108R00708160000219 03-08-2016 03-08-2016 0001853736298 TJEN SIU FA P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1535 0108R00708160001328 19-08-2016 19-08-2016 0001853979221 farima P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1536 0108R00708160001575 24-08-2016 24-08-2016 0001854453093 ISTER PIRAWATI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1537 0108R00708160000128 02-08-2016 02-08-2016 0001854559833 HIDJAYA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1538 0108R00708160000336 04-08-2016 04-08-2016 0001855054034 graciella clorinda nafeza P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1539 0108R00708160001579 24-08-2016 24-08-2016 0001855175005 YULITA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1540 0108R00708160001148 16-08-2016 16-08-2016 0001855175005 YULITA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1541 0108R00708160001963 29-08-2016 29-08-2016 0001855283848 REzA OKTOVIANI L U-3-16-0 DENTAL OPERATIONS
1542 0108R00708160000734 10-08-2016 10-08-2016 0001855283848 REzA OKTOVIANI L U-3-16-0 DENTAL OPERATIONS
1543 0108R00708160001120 15-08-2016 15-08-2016 0001855300127 ROSINA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1544 0108R00708160000452 05-08-2016 05-08-2016 0001855841409 efendi L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1545 0108R00708160001495 22-08-2016 22-08-2016 0001855841409 efendi L N-3-15-0 DIALYSIS
1546 0108R00708160000269 03-08-2016 03-08-2016 0001855841409 efendi L N-3-15-0 DIALYSIS
1547 0108R00708160000473 06-08-2016 06-08-2016 0001855841409 efendi L N-3-15-0 DIALYSIS
1548 0108R00708160000708 10-08-2016 10-08-2016 0001855841409 efendi L N-3-15-0 DIALYSIS
1549 0108R00708160001113 15-08-2016 15-08-2016 0001855841409 efendi L N-3-15-0 DIALYSIS
1550 0108R00708160001163 16-08-2016 16-08-2016 0001855841409 efendi L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1551 0108R00708160001205 17-08-2016 17-08-2016 0001855841409 efendi L N-3-15-0 DIALYSIS
1552 0108R00708160001334 20-08-2016 20-08-2016 0001855841409 efendi L N-3-15-0 DIALYSIS
1553 0108R00708160001574 24-08-2016 24-08-2016 0001855841409 efendi L N-3-15-0 DIALYSIS
1554 0108R00708160001791 27-08-2016 27-08-2016 0001855841409 efendi L N-3-15-0 DIALYSIS
1555 0108R00708160001950 29-08-2016 29-08-2016 0001855841409 efendi L N-3-15-0 DIALYSIS
1556 0108R00708160002111 31-08-2016 31-08-2016 0001855841409 efendi L N-3-15-0 DIALYSIS
1557 0108R00708160000399 05-08-2016 05-08-2016 0001856324777 ABDUL GUSZALI MALIK L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1558 0108R00708160001765 26-08-2016 26-08-2016 0001856424341 EKA WAHYUNI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1559 0108R00708160000339 04-08-2016 04-08-2016 0001859114441 SOFWAN USMAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1560 0108R00708160000520 08-08-2016 08-08-2016 0001859465709 NORMAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1561 0108R00708160001014 15-08-2016 15-08-2016 0001859759177 AHMAD SAPAR L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1562 0108R00708160001051 15-08-2016 15-08-2016 0001859949292 faizah amami P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1563 0108R00708160002093 31-08-2016 31-08-2016 0001860115713 ABDUL HADIAR L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1564 0108R00708160002023 30-08-2016 30-08-2016 0001860123666 lioe tjhoi hioeng L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1565 0108R00708160000976 13-08-2016 13-08-2016 0001860123666 lioe tjhoi hioeng L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1566 0108R00708160000094 01-08-2016 01-08-2016 0001860123666 lioe tjhoi hioeng L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1567 0108R00708160000162 02-08-2016 02-08-2016 0001860160026 rosmini P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1568 0108R00708160001532 23-08-2016 23-08-2016 0001860160026 rosmini P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1569 0108R00708160001872 29-08-2016 29-08-2016 0001860160026 rosmini P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1570 0108R00708160000398 05-08-2016 05-08-2016 0001860160026 rosmini P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1571 0108R00708160002098 31-08-2016 31-08-2016 0001860160026 rosmini P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1572 0108R00708160000648 09-08-2016 09-08-2016 0001860160026 rosmini P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1573 0108R00708160000974 13-08-2016 13-08-2016 0001860160026 rosmini P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1574 0108R00708160001147 16-08-2016 16-08-2016 0001860160026 rosmini P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1575 0108R00708160000698 10-08-2016 10-08-2016 0001860197387 minaini P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1576 0108R00708160000319 04-08-2016 04-08-2016 0001860752902 umi kalsum P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1577 0108R00708160000823 11-08-2016 11-08-2016 0001860978958 muchsan slamet L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1578 0108R00708160001478 22-08-2016 22-08-2016 0001861540187 KRISTIN NATALIA S. P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1579 0108R00708160000213 03-08-2016 03-08-2016 0001861544373 MUHAMMAD SEPTIAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
PRATAMA MINOR CHRONIC DISEASES
1580 0108R00708160001346 18-08-2016 18-08-2016 0001861575772 arash fabian satyanagara L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1581 0108R00708160000003 01-08-2016 01-08-2016 0001861640998 LUNDU TAMPUBOLON L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1582 0108R00708160000528 08-08-2016 08-08-2016 0001861640998 LUNDU TAMPUBOLON L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1583 0108R00708160000853 11-08-2016 11-08-2016 0001861863344 VIRGINIA SABRINA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1584 0108R00708160001696 25-08-2016 25-08-2016 0001861863344 VIRGINIA SABRINA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1585 0108R00708160001962 29-08-2016 29-08-2016 0001862051973 MASIDAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1586 0108R00708160000602 08-08-2016 08-08-2016 0001862051973 MASIDAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1587 0108R00708160000265 03-08-2016 03-08-2016 0001862976047 yanti marini P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1588 0108R00708160000820 11-08-2016 11-08-2016 0001862976047 yanti marini P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1589 0108R00708160000952 12-08-2016 12-08-2016 0001863764583 UTI HIDAYATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1590 0108R00708160001068 15-08-2016 15-08-2016 0001863799413 amkiyah P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1591 0108R00708160001126 16-08-2016 16-08-2016 0001864197606 ZULFIKAR L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1592 0108R00708160001604 24-08-2016 24-08-2016 0001865010644 ARNI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1593 0108R00708160001605 24-08-2016 24-08-2016 0001865012106 LUKMAN HAKIM L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1594 0108R00708160001517 23-08-2016 23-08-2016 0001865260585 TUMPAL SIHOMBING L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1595 0108R00708160000147 02-08-2016 02-08-2016 0001865460003 ANGGI AUDIA SHINTA L U-3-16-0 DENTAL OPERATIONS
1596 0108R00708160001711 25-08-2016 25-08-2016 0001865482839 SUANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1597 0108R00708160000445 05-08-2016 05-08-2016 0001865669861 WINSEN HUTABARAT L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1598 0108R00708160000368 04-08-2016 04-08-2016 0001865669861 WINSEN HUTABARAT L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1599 0108R00708160001505 22-08-2016 22-08-2016 0001865764923 suryanti P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1600 0108R00708160001614 24-08-2016 24-08-2016 0001867473527 YULITA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1601 0108R00708160001783 26-08-2016 26-08-2016 0001867700259 TJU DJIM NJONG P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1602 0108R00708160001522 23-08-2016 23-08-2016 0001868384553 RIZKI WINDARI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1603 0108R00708160000536 08-08-2016 08-08-2016 0001868390526 SURYA RASIMIN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1604 0108R00708160000843 11-08-2016 11-08-2016 0001868620072 RESKA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1605 0108R00708160000784 11-08-2016 11-08-2016 0001868740514 tjhin a nit P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1606 0108R00708160002195 09-08-2016 09-08-2016 0001869136176 DEMSI SILALAHI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1607 0108R00708160001722 25-08-2016 25-08-2016 0001869136176 DEMSI SILALAHI P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1608 0108R00708160000253 03-08-2016 03-08-2016 0001869672036 KHALINA ALYAHNI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1609 0108R00708160000100 01-08-2016 01-08-2016 0001870545846 M. SOLEH SAID L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1610 0108R00708160001814 27-08-2016 27-08-2016 0001870668696 MIRZA IZZATI ARDANI L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1611 0108R00708160000246 03-08-2016 03-08-2016 0001870668696 MIRZA IZZATI ARDANI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1612 0108R00708160000492 06-08-2016 06-08-2016 0001870668696 MIRZA IZZATI ARDANI L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1613 0108R00708160000978 13-08-2016 13-08-2016 0001870668696 MIRZA IZZATI ARDANI L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1614 0108R00708160001297 19-08-2016 19-08-2016 0001870668696 MIRZA IZZATI ARDANI L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1615 0108R00708160001922 29-08-2016 29-08-2016 0001872937811 ZAILANI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1616 0108R00708160001465 22-08-2016 22-08-2016 0001872937811 ZAILANI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1617 0108R00708160001182 18-08-2016 18-08-2016 0001875174085 YULI SETIANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1618 0108R00708160000322 04-08-2016 04-08-2016 0001875334577 JUWADI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1619 0108R00708160000117 02-08-2016 02-08-2016 0001876177102 ciu co sak L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1620 0108R00708160000116 02-08-2016 02-08-2016 0001876177438 leny P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1621 0108R00708160001748 26-08-2016 26-08-2016 0001876892624 SADIKIN L L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1622 0108R00708160000989 13-08-2016 13-08-2016 0001876892624 SADIKIN L L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1623 0108R00708160001513 23-08-2016 23-08-2016 0001877619058 rani puspita P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1624 0108R00708160001681 25-08-2016 25-08-2016 0001880443631 nurhasanah P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1625 0108R00708160001752 26-08-2016 26-08-2016 0001880443631 nurhasanah P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1626 0108R00708160002219 15-08-2016 15-08-2016 0001880497945 vince sudijono P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1627 0108R00708160002030 30-08-2016 30-08-2016 0001880723147 CHristine JOVIAN L Q-5-42-0 AMBULATORY VISIT FOR OTHER
MINOR ACUTE DISORDER
1628 0108R00708160000592 08-08-2016 08-08-2016 0001881030317 feby oktavia P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1629 0108R00708160001461 22-08-2016 22-08-2016 0001883603103 teguh raffasya L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1630 0108R00708160001988 30-08-2016 30-08-2016 0001883631464 yunita rahayu P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1631 0108R00708160000756 10-08-2016 10-08-2016 0001885735495 leo chundra L Q-5-25-0 AMBULATORY VISIT FOR ACUTE
GASTROINTESTINAL DISORDER
1632 0108R00708160001990 30-08-2016 30-08-2016 0001886094189 WAYAN SABAR L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1633 0108R00708160001525 23-08-2016 23-08-2016 0001887586334 yessy nogianti P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1634 0108R00708160001474 22-08-2016 22-08-2016 0001887738039 tjen a wan P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1635 0108R00708160000782 11-08-2016 11-08-2016 0001889961693 hendry gunawan L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1636 0108R00708160001925 29-08-2016 29-08-2016 0001889961693 hendry gunawan L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1637 0108R00708160001073 15-08-2016 15-08-2016 0001889961693 hendry gunawan L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1638 0108R00708160001226 18-08-2016 18-08-2016 0001889961693 hendry gunawan L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1639 0108R00708160001464 22-08-2016 22-08-2016 0001889961693 hendry gunawan L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1640 0108R00708160001689 25-08-2016 25-08-2016 0001889961693 hendry gunawan L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1641 0108R00708160000107 02-08-2016 02-08-2016 0001889961693 hendry gunawan L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1642 0108R00708160000637 09-08-2016 09-08-2016 0001890111183 vera bunyamin P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1643 0108R00708160001674 24-08-2016 24-08-2016 0001890504022 YUNIAR P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1644 0108R00708160001555 23-08-2016 23-08-2016 0001890696249 BEAN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1645 0108R00708160000047 01-08-2016 01-08-2016 0001892888111 rosidah P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1646 0108R00708160001054 15-08-2016 15-08-2016 0001893494395 samsidar P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1647 0108R00708160000402 04-08-2016 04-08-2016 0001893885311 zuhra rahmatullah P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1648 0108R00708160001323 19-08-2016 19-08-2016 0001894827352 nursiah P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1649 0108R00708160001211 16-08-2016 16-08-2016 0001895659841 muslihat L Q-5-41-0 AMBULATORY VISIT FOR OTHER
COMPLEX ACUTE DISORDER
1650 0108R00708160000693 10-08-2016 10-08-2016 0001895844712 hildayati P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1651 0108R00708160001476 22-08-2016 22-08-2016 0001900940681 LILIS SURYANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1652 0108R00708160002044 30-08-2016 30-08-2016 0001900940681 LILIS SURYANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1653 0108R00708160000421 05-08-2016 05-08-2016 0001900940681 LILIS SURYANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1654 0108R00708160001576 24-08-2016 24-08-2016 0001902143261 DANIATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1655 0108R00708160001795 27-08-2016 27-08-2016 0001902143261 DANIATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1656 0108R00708160001337 20-08-2016 20-08-2016 0001902143261 DANIATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1657 0108R00708160000247 03-08-2016 03-08-2016 0001902240156 widya asodepa P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1658 0108R00708160000512 06-08-2016 06-08-2016 0001903862125 ELLA AGUSTINA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1659 0108R00708160001081 15-08-2016 15-08-2016 0001903862125 ELLA AGUSTINA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1660 0108R00708160001052 15-08-2016 15-08-2016 0001904598483 JUSAK TJIMKO L Q-5-29-0 AMBULATORY VISIT FOR
CONGESTIVE HEART FAILURE &
1661 0108R00708160000525 08-08-2016 08-08-2016 0001905243412 PITHRIADY L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1662 0108R00708160000878 11-08-2016 11-08-2016 0001907476806 patimah P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1663 0108R00708160001329 19-08-2016 19-08-2016 0001907476806 patimah P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1664 0108R00708160001457 22-08-2016 22-08-2016 0001908004601 daniel prasetya eki L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1665 0108R00708160001066 15-08-2016 15-08-2016 0001908004601 daniel prasetya eki L Q-5-26-0 AMBULATORY VISIT FOR ACUTE
BRONCHIAL DISORDER
1666 0108R00708160000936 12-08-2016 12-08-2016 0001958889611 ASTINAH P N-3-15-0 DIALYSIS
1667 0108R00708160000373 04-08-2016 04-08-2016 0001958889611 ASTINAH P N-3-15-0 DIALYSIS
1668 0108R00708160001171 16-08-2016 16-08-2016 0001958889611 ASTINAH P N-3-15-0 DIALYSIS
1669 0108R00708160001317 19-08-2016 19-08-2016 0001958889611 ASTINAH P N-3-15-0 DIALYSIS
1670 0108R00708160001565 23-08-2016 23-08-2016 0001958889611 ASTINAH P N-3-15-0 DIALYSIS
1671 0108R00708160001775 26-08-2016 26-08-2016 0001958889611 ASTINAH P N-3-15-0 DIALYSIS
1672 0108R00708160002050 30-08-2016 30-08-2016 0001958889611 ASTINAH P N-3-15-0 DIALYSIS
1673 0108R00708160000942 12-08-2016 12-08-2016 0001958998803 herlina P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1674 0108R00708160001543 23-08-2016 23-08-2016 0001959287692 rahayu P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1675 0108R00708160002225 23-08-2016 23-08-2016 0001959288941 febby yuda pratama L Q-5-26-0 AMBULATORY VISIT FOR ACUTE
BRONCHIAL DISORDER
1676 0108R00708160000420 05-08-2016 05-08-2016 0001959706326 SUPRIYATIN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1677 0108R00708160000926 12-08-2016 12-08-2016 0001960249421 misiani P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1678 0108R00708160001157 16-08-2016 16-08-2016 0001960674412 M.FAEYZA ABIZAR L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1679 0108R00708160001286 19-08-2016 19-08-2016 0001960763038 soraya P Z-3-25-0 ULTRASOUND FOR

GYNAECOLOGY DISORDERS
1680 0108R00708160001616 24-08-2016 24-08-2016 0001961089637 adibah khansa inara P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1681 0108R00708160000880 11-08-2016 11-08-2016 0001961100426 BONG KHUN NON P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1682 0108R00708160000732 10-08-2016 10-08-2016 0001961100426 BONG KHUN NON P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1683 0108R00708160002207 22-08-2016 22-08-2016 0001961100426 BONG KHUN NON P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1684 0108R00708160000358 04-08-2016 04-08-2016 0001961109584 SELAMAT PAKPAHAN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1685 0108R00708160001637 24-08-2016 24-08-2016 0001964911689 BAINUDIN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1686 0108R00708160001593 24-08-2016 24-08-2016 0001964911882 ZAINABUN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1687 0108R00708160000259 03-08-2016 03-08-2016 0001966240247 MINARYANTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1688 0108R00708160000842 11-08-2016 11-08-2016 0001967920244 zuryati P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1689 0108R00708160000170 02-08-2016 02-08-2016 0001968880342 IQBAL FAUZAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1690 0108R00708160000988 13-08-2016 13-08-2016 0001969353448 diyoo mardiana rachman P Q-5-43-0 AMBULATORY VISIT FOR OTHER
MAJOR CHRONIC DISEASES
1691 0108R00708160000252 03-08-2016 03-08-2016 0001970473566 meyrita P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1692 0108R00708160000496 06-08-2016 06-08-2016 0001970473566 meyrita P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1693 0108R00708160001416 22-08-2016 22-08-2016 0001971829091 yulia yulianti P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1694 0108R00708160001821 27-08-2016 27-08-2016 0002032422243 fitriA NINGSIH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1695 0108R00708160001610 24-08-2016 24-08-2016 0002032422243 fitriA NINGSIH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1696 0108R00708160000020 01-08-2016 01-08-2016 0002032719489 koe tjhin san P N-3-15-0 DIALYSIS
1697 0108R00708160000558 08-08-2016 08-08-2016 0002032719489 koe tjhin san P N-3-15-0 DIALYSIS
1698 0108R00708160000867 11-08-2016 11-08-2016 0002032719489 koe tjhin san P N-3-15-0 DIALYSIS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1699 0108R00708160001022 15-08-2016 15-08-2016 0002032719489 koe tjhin san P N-3-15-0 DIALYSIS
1700 0108R00708160001197 18-08-2016 18-08-2016 0002032719489 koe tjhin san P N-3-15-0 DIALYSIS
1701 0108R00708160001394 22-08-2016 22-08-2016 0002032719489 koe tjhin san P N-3-15-0 DIALYSIS
1702 0108R00708160001649 25-08-2016 25-08-2016 0002032719489 koe tjhin san P N-3-15-0 DIALYSIS
1703 0108R00708160001850 29-08-2016 29-08-2016 0002032719489 koe tjhin san P N-3-15-0 DIALYSIS
1704 0108R00708160001870 29-08-2016 29-08-2016 0002032766741 RASYA NANDIKA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1705 0108R00708160001159 16-08-2016 16-08-2016 0002032846738 veny nursela P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1706 0108R00708160000927 12-08-2016 12-08-2016 0002032846738 veny nursela P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1707 0108R00708160000415 05-08-2016 05-08-2016 0002032957765 fika ulisti hanani P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1708 0108R00708160000747 10-08-2016 10-08-2016 0002032957765 fika ulisti hanani P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1709 0108R00708160000571 08-08-2016 08-08-2016 0002032957765 fika ulisti hanani P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1710 0108R00708160001013 15-08-2016 15-08-2016 0002033534608 silpana P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1711 0108R00708160000717 10-08-2016 10-08-2016 0002033614034 marsya nathasya P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1712 0108R00708160001287 19-08-2016 19-08-2016 0002033614034 marsya nathasya P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1713 0108R00708160000438 05-08-2016 05-08-2016 0002033627242 a. nursiah P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1714 0108R00708160000304 04-08-2016 04-08-2016 0002035046733 MASLIN L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1715 0108R00708160000207 03-08-2016 03-08-2016 0002035516241 DIANA NOVITA ASIH P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1716 0108R00708160001619 24-08-2016 24-08-2016 0002038240495 ISWANDI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1717 0108R00708160001298 19-08-2016 19-08-2016 0002038270915 novita P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1718 0108R00708160000776 11-08-2016 11-08-2016 0002038559905 TJHAI FUT KHIUN P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1719 0108R00708160000778 11-08-2016 11-08-2016 0002038561672 DENI SATRIADI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1720 0108R00708160001075 15-08-2016 15-08-2016 0002039033237 VENI SUSANTRIA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1721 0108R00708160000576 08-08-2016 08-08-2016 0002039041664 DANIEL ANDREAN L Q-5-26-0 AMBULATORY VISIT FOR ACUTE
BRONCHIAL DISORDER
1722 0108R00708160001074 15-08-2016 15-08-2016 0002039041664 DANIEL ANDREAN L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1723 0108R00708160001760 26-08-2016 26-08-2016 0002039194146 PHUNG NON NIE P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1724 0108R00708160001723 25-08-2016 25-08-2016 0002041448218 EPI GUSTRIYANTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1725 0108R00708160000675 09-08-2016 09-08-2016 0002041515483 endro harjanto L H-2-34-0 MAJOR POSTERIOR SEGMENT
EYE OPERATION
1726 0108R00708160001354 18-08-2016 18-08-2016 0002041515483 endro harjanto L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1727 0108R00708160001594 24-08-2016 24-08-2016 0002041843048 LIAN KARTIKA SARI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1728 0108R00708160000174 02-08-2016 02-08-2016 0002043023354 SUCI AMELIA SAfITRI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
SIMAMORA MINOR CHRONIC DISEASES
1729 0108R00708160000652 09-08-2016 09-08-2016 0002043023354 SUCI AMELIA SAfITRI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
SIMAMORA MINOR CHRONIC DISEASES
1730 0108R00708160000871 11-08-2016 11-08-2016 0002044438683 Siti Nurazijah P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1731 0108R00708160001438 22-08-2016 22-08-2016 0002044461442 septiani P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1732 0108R00708160001165 16-08-2016 16-08-2016 0002044540484 CALVIN SAVERIO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1733 0108R00708160001283 18-08-2016 18-08-2016 0002045182555 siong khin L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1734 0108R00708160001093 15-08-2016 15-08-2016 0002045754191 yenny wisnawati P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1735 0108R00708160002042 30-08-2016 30-08-2016 0002047454087 IHWAN SIREGAR L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1736 0108R00708160001698 25-08-2016 25-08-2016 0002047454087 IHWAN SIREGAR L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1737 0108R00708160001613 24-08-2016 24-08-2016 0002048032361 keysha syahputri P Q-5-26-0 AMBULATORY VISIT FOR ACUTE
BRONCHIAL DISORDER
1738 0108R00708160002133 31-08-2016 31-08-2016 0002048032361 keysha syahputri P J-3-13-0 RESPIRATORY THERAPY
OPERATIONS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1739 0108R00708160002000 30-08-2016 30-08-2016 0002048568063 RAHAK SARMODO L H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1740 0108R00708160000463 06-08-2016 06-08-2016 0002048568063 RAHAK SARMODO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1741 0108R00708160001999 30-08-2016 30-08-2016 0002048568557 BONG SIOE NIE P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1742 0108R00708160000612 08-08-2016 08-08-2016 0002049184427 ANDIKA ALVINO L U-3-16-0 DENTAL OPERATIONS
RACHADIAN
1743 0108R00708160002135 31-08-2016 31-08-2016 0002049184427 ANDIKA ALVINO L U-3-16-0 DENTAL OPERATIONS
RACHADIAN
1744 0108R00708160002201 13-08-2016 13-08-2016 0002049187735 rado al fariq wijaya L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1745 0108R00708160002082 31-08-2016 31-08-2016 0002049873006 DEVIANA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1746 0108R00708160001281 19-08-2016 19-08-2016 0002049873006 DEVIANA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1747 0108R00708160000954 12-08-2016 12-08-2016 0002050043793 MERI IRMANIA P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1748 0108R00708160001417 22-08-2016 22-08-2016 0002050374003 INDRA AGUS SETIAWAN L Q-5-41-0 AMBULATORY VISIT FOR OTHER
LI COMPLEX ACUTE DISORDER
1749 0108R00708160001450 22-08-2016 22-08-2016 0002050797093 HARRIS VITER JAMSON L Q-5-40-0 AMBULATORY VISIT FOR ACUTE
URINARY TRACT INFECTION
1750 0108R00708160000845 11-08-2016 11-08-2016 0002051082066 PRIYONO SANTOSO L Q-5-29-0 AMBULATORY VISIT FOR
CONGESTIVE HEART FAILURE &
1751 0108R00708160000985 13-08-2016 13-08-2016 0002052708783 syawila darajatina putri P Q-5-42-0 AMBULATORY VISIT FOR OTHER
MINOR ACUTE DISORDER
1752 0108R00708160001353 18-08-2016 18-08-2016 0002056155704 kodir derakup L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1753 0108R00708160000886 12-08-2016 12-08-2016 0002056486206 siau hong P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1754 0108R00708160000143 02-08-2016 02-08-2016 0002056486206 siau hong P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1755 0108R00708160000416 05-08-2016 05-08-2016 0002056778188 LINA HARYATI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1756 0108R00708160001158 16-08-2016 16-08-2016 0002057329798 SYAMSIAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1757 0108R00708160001554 23-08-2016 23-08-2016 0002057762946 shella nur amelia putri P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1758 0108R00708160001644 24-08-2016 24-08-2016 0002057762946 shella nur amelia putri P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1759 0108R00708160001910 29-08-2016 29-08-2016 0002058126849 jeehan ulfa surbakti P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1760 0108R00708160000768 10-08-2016 10-08-2016 0002059261896 SUPRIYADI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1761 0108R00708160001989 30-08-2016 30-08-2016 0002059620265 SYAHRONI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1762 0108R00708160001600 24-08-2016 24-08-2016 0002060060095 HOLIPAH ROPIATUN P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1763 0108R00708160000448 05-08-2016 05-08-2016 0002062646695 keisha hanif al- dasya P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1764 0108R00708160001693 25-08-2016 25-08-2016 0002062859433 RISKA ROSTIKA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1765 0108R00708160001905 29-08-2016 29-08-2016 0002062859433 RISKA ROSTIKA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1766 0108R00708160000559 08-08-2016 08-08-2016 0002062894781 firly ammar shafy L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1767 0108R00708160002150 31-08-2016 31-08-2016 0002063153496 DEWIGO P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1768 0108R00708160000975 13-08-2016 13-08-2016 0002063202388 HAYATI P N-3-15-0 DIALYSIS
1769 0108R00708160000086 01-08-2016 01-08-2016 0002063202388 HAYATI P N-3-15-0 DIALYSIS
1770 0108R00708160000618 08-08-2016 08-08-2016 0002063202388 HAYATI P N-3-15-0 DIALYSIS
1771 0108R00708160001107 15-08-2016 15-08-2016 0002063202388 HAYATI P N-3-15-0 DIALYSIS
1772 0108R00708160001250 18-08-2016 18-08-2016 0002063202388 HAYATI P N-3-15-0 DIALYSIS
1773 0108R00708160001489 22-08-2016 22-08-2016 0002063202388 HAYATI P N-3-15-0 DIALYSIS
1774 0108R00708160001709 25-08-2016 25-08-2016 0002063202388 HAYATI P N-3-15-0 DIALYSIS
1775 0108R00708160001953 29-08-2016 29-08-2016 0002063202388 HAYATI P N-3-15-0 DIALYSIS
1776 0108R00708160000447 05-08-2016 05-08-2016 0002063477777 AISAH P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1777 0108R00708160001848 29-08-2016 29-08-2016 0002063557686 HERIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1778 0108R00708160001650 25-08-2016 25-08-2016 0002063557686 HERIE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1779 0108R00708160000479 06-08-2016 06-08-2016 0002063557686 HERIE P Z-3-25-0 ULTRASOUND FOR

GYNAECOLOGY DISORDERS
1780 0108R00708160001184 18-08-2016 18-08-2016 0002063557686 HERIE P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1781 0108R00708160000155 02-08-2016 02-08-2016 0002064253713 CITRAWATI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1782 0108R00708160002037 30-08-2016 30-08-2016 0002064524365 YENNI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1783 0108R00708160000129 02-08-2016 02-08-2016 0002064524365 YENNI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1784 0108R00708160001441 22-08-2016 22-08-2016 0002064524365 YENNI P M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1785 0108R00708160000032 01-08-2016 01-08-2016 0002064524365 YENNI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1786 0108R00708160000588 08-08-2016 08-08-2016 0002064746709 SHAFA ADELIA PUTRI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1787 0108R00708160000352 04-08-2016 04-08-2016 0002064746709 SHAFA ADELIA PUTRI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1788 0108R00708160001819 27-08-2016 27-08-2016 0002064746709 SHAFA ADELIA PUTRI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1789 0108R00708160000928 12-08-2016 12-08-2016 0002065457755 BAYI NY VENY NURSELA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1790 0108R00708160001338 20-08-2016 20-08-2016 0002066284888 calon bayi ny daniati P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1791 0108R00708160001053 15-08-2016 15-08-2016 0002066292189 BONG NGIT TJHAUW L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1792 0108R00708160001095 15-08-2016 15-08-2016 0002066513207 ASTRI MALONA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1793 0108R00708160001458 22-08-2016 22-08-2016 0002067642279 varisha azalea halwa P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1794 0108R00708160001359 20-08-2016 20-08-2016 0002068325886 calon bayi ny noviyana P Q-5-42-0 AMBULATORY VISIT FOR OTHER
MINOR ACUTE DISORDER
1795 0108R00708160001481 22-08-2016 22-08-2016 0002068693773 BAYI NY YULIANA I P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1796 0108R00708160001480 22-08-2016 22-08-2016 0002068694493 BAYI NY YULIANA II P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1797 0108R00708160000347 04-08-2016 04-08-2016 0002069001167 ROPISAH P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1798 0108R00708160001992 30-08-2016 30-08-2016 0002069247249 JOLIANI JOHAN P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1799 0108R00708160000478 06-08-2016 06-08-2016 0002069247249 JOLIANI JOHAN P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1800 0108R00708160000132 02-08-2016 02-08-2016 0002069262797 fahira azra ramadhani P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1801 0108R00708160001533 23-08-2016 23-08-2016 0002069415944 NORA INDRIANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1802 0108R00708160000999 15-08-2016 15-08-2016 0002069415944 NORA INDRIANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1803 0108R00708160000906 12-08-2016 12-08-2016 0002069415944 NORA INDRIANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1804 0108R00708160001123 16-08-2016 16-08-2016 0002069415944 NORA INDRIANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1805 0108R00708160000752 10-08-2016 10-08-2016 0002069500397 SOEI TJOE P H-2-32-0 MODERATE ANTERIOR
SEGMENT EYE OPERATION
1806 0108R00708160000596 08-08-2016 08-08-2016 0002069500397 SOEI TJOE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1807 0108R00708160000950 12-08-2016 12-08-2016 0002069500397 SOEI TJOE P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1808 0108R00708160001270 18-08-2016 18-08-2016 0002069500397 SOEI TJOE P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1809 0108R00708160000119 02-08-2016 02-08-2016 0002069500397 SOEI TJOE P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1810 0108R00708160000466 06-08-2016 06-08-2016 0002069500397 SOEI TJOE P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1811 0108R00708160001717 25-08-2016 25-08-2016 0002069578091 TJHIN MUK JOENG L Q-5-27-0 AMBULATORY VISIT FOR ACUTE
CENTRAL NERVOUS SYSTEM
1812 0108R00708160001914 29-08-2016 29-08-2016 0002069578091 TJHIN MUK JOENG L M-3-16-0 PHYSICAL THERAPY & MINOR
MUSCULOSKELETAL
1813 0108R00708160000791 11-08-2016 11-08-2016 0002069998345 FENDI L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1814 0108R00708160000503 06-08-2016 06-08-2016 0002070297764 YUNIARTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1815 0108R00708160000901 12-08-2016 12-08-2016 0002070297764 YUNIARTI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1816 0108R00708160001557 23-08-2016 23-08-2016 0002070460844 IMA SURYANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1817 0108R00708160001175 16-08-2016 16-08-2016 0002070460844 IMA SURYANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1818 0108R00708160000059 01-08-2016 01-08-2016 0002070788758 YANTO L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1819 0108R00708160000122 02-08-2016 02-08-2016 0002070824319 WANTI P Z-3-25-0 ULTRASOUND FOR

GYNAECOLOGY DISORDERS
1820 0108R00708160001017 15-08-2016 15-08-2016 0002070824319 WANTI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1821 0108R00708160000362 04-08-2016 04-08-2016 0002070961277 BONG SIAU MING L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1822 0108R00708160001683 25-08-2016 25-08-2016 0002071133774 EMA P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1823 0108R00708160001439 22-08-2016 22-08-2016 0002071195874 BAYI NY SEPTIANI L Q-5-42-0 AMBULATORY VISIT FOR OTHER
MINOR ACUTE DISORDER
1824 0108R00708160000446 05-08-2016 05-08-2016 0002071869838 VIONA CLARISSA P Q-5-26-0 AMBULATORY VISIT FOR ACUTE
BRONCHIAL DISORDER
1825 0108R00708160000121 02-08-2016 02-08-2016 0002073451408 bayi ny riche P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1826 0108R00708160000511 06-08-2016 06-08-2016 0002074071914 bayi ny ella agustin P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1827 0108R00708160001082 15-08-2016 15-08-2016 0002074071914 bayi ny ella agustin P Q-5-25-0 AMBULATORY VISIT FOR ACUTE
GASTROINTESTINAL DISORDER
1828 0108R00708160001727 26-08-2016 26-08-2016 0002074306443 MARIA ERNA WIDAyANTY P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1829 0108R00708160001512 23-08-2016 23-08-2016 0002074306443 MARIA ERNA WIDAyANTY P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1830 0108R00708160001515 23-08-2016 23-08-2016 0002074313968 SUSIWANTI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
1831 0108R00708160001463 22-08-2016 22-08-2016 0002074331698 AMINA P H-3-13-0 DIAGNOSTIC & IMAGING EYE
INVESTIGATIONS
1832 0108R00708160001514 23-08-2016 23-08-2016 0002074331698 AMINA P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1833 0108R00708160001607 24-08-2016 24-08-2016 0002074422238 MURIYANI P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1834 0108R00708160000417 05-08-2016 05-08-2016 0002074490572 franccesca falencia P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1835 0108R00708160001301 19-08-2016 19-08-2016 0002074490572 franccesca falencia P Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1836 0108R00708160000897 12-08-2016 12-08-2016 0002075276529 shaqya alfatunisa P Q-5-42-0 AMBULATORY VISIT FOR OTHER
MINOR ACUTE DISORDER
1837 0108R00708160000918 12-08-2016 12-08-2016 0002075741695 bayi ny ima suryani L Q-5-42-0 AMBULATORY VISIT FOR OTHER
MINOR ACUTE DISORDER
1838 0108R00708160001774 26-08-2016 26-08-2016 0002075989026 RAHMA ARYANI P Z-3-25-0 ULTRASOUND FOR
GYNAECOLOGY DISORDERS
Nama RS : ARSANI LAPORAN HASIL VERIFIKASI SECARA ADMINISTRASI
Tingkat Pelayanan : RJTL
Tgl.Pelayanan : 01-08-2016 s/d 31-08-2016
Status : Layak

1839 0108R00708160001749 26-08-2016 26-08-2016 0002077069331 KEREH RENNY OLVI P Z-3-25-0 ULTRASOUND FOR
FRELLY GYNAECOLOGY DISORDERS
1840 0108R00708160001808 27-08-2016 27-08-2016 0002077225064 BAYI NY RISKA ROSTIKA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
1 MINOR CHRONIC DISEASES
1841 0108R00708160001809 27-08-2016 27-08-2016 0002077225481 BAYI NY RISKA ROSTIKA L Q-5-44-0 AMBULATORY VISIT FOR OTHER
2 MINOR CHRONIC DISEASES
1842 0108R00708160002083 31-08-2016 31-08-2016 0002077339487 BAYI NY DEVIANA P Q-5-42-0 AMBULATORY VISIT FOR OTHER
MINOR ACUTE DISORDER
1843 0108R00708160001624 24-08-2016 24-08-2016 0002077588967 bayi ny rika ferlia L Q-5-41-0 AMBULATORY VISIT FOR OTHER
COMPLEX ACUTE DISORDER
1844 0108R00708160001768 26-08-2016 26-08-2016 0002078356443 gusto abednego sirait L Q-5-44-0 AMBULATORY VISIT FOR OTHER
MINOR CHRONIC DISEASES
1845 0108R00708160001954 29-08-2016 29-08-2016 0002078982044 REFANO RADITYA L Q-5-41-0 AMBULATORY VISIT FOR OTHER
COMPLEX ACUTE DISORDER

Mengetahui
BPJS KESEHATAN

Eka Sulistya
HASIL VERIFIKASI SECARA ADMINISTRASI

Nm Cbgs CMG Tarif Gruper Tarif Biaya Klaim Tarip

(59) (Grp+CMG) (59+CMG)
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 203,400 203,400 203,400 203,400
MAJOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500

Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 181,300 181,300 181,300 181,300
COMPLEX ACUTE DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

OTHER EAR NOSE MOUTH & SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 194,500 194,500 194,500 194,500
THROAT DIAGNOSTIC Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
OTHER EAR NOSE MOUTH & SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 156,600 156,600 156,600 156,600
THROAT OPERATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500

Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 140,200 140,200 140,200 140,200
GASTROINTESTINAL DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 203,400 203,400 203,400 203,400
MAJOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 140,200 140,200 140,200 140,200
GASTROINTESTINAL DISORDER Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
OTHER EAR NOSE MOUTH & SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 156,600 156,600 156,600 156,600
THROAT OPERATIONS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500

Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 141,700 141,700 141,700 141,700
CENTRAL NERVOUS SYSTEM Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800

Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500

Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 132,700 132,700 132,700 132,700
COMPLEX SOFT TISSUE INJURY Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500

Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500

Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500

Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 155,800 155,800 155,800 155,800
URINARY TRACT DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 181,300 181,300 181,300 181,300
COMPLEX ACUTE DISORDER Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 140,200 140,200 140,200 140,200
GASTROINTESTINAL DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 155,800 155,800 155,800 155,800
URINARY TRACT DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 141,700 141,700 141,700 141,700
CENTRAL NERVOUS SYSTEM Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
OTHER EAR NOSE MOUTH & SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 156,600 156,600 156,600 156,600
THROAT OPERATIONS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 198,700 198,700 198,700 198,700
BRONCHIAL DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300

GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300

GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 140,200 140,200 140,200 140,200
GASTROINTESTINAL DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500

Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300

GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300

GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 155,800 155,800 155,800 155,800
URINARY TRACT DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300

GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 141,700 141,700 141,700 141,700
CENTRAL NERVOUS SYSTEM Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
OTHER EAR NOSE MOUTH & SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 194,500 194,500 194,500 194,500
THROAT DIAGNOSTIC Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 198,700 198,700 198,700 198,700
BRONCHIAL DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300

GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 140,200 140,200 140,200 140,200
GASTROINTESTINAL DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300

GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
CATARACT OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 3,589,700 3,589,700 3,589,700 3,589,700
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
OTHER EAR NOSE MOUTH & SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 194,500 194,500 194,500 194,500
THROAT DIAGNOSTIC Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
OTHER EAR NOSE MOUTH & SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 156,600 156,600 156,600 156,600
THROAT OPERATIONS Rp.0,SD: Rp.0
OTHER EAR NOSE MOUTH & SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 156,600 156,600 156,600 156,600
THROAT OPERATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 141,700 141,700 141,700 141,700
CENTRAL NERVOUS SYSTEM Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 134,600 134,600 134,600 134,600
SIGNIFICANT FRACTURES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
OTHER EAR NOSE MOUTH & SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 156,600 156,600 156,600 156,600
THROAT OPERATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300

GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 134,600 134,600 134,600 134,600
SIGNIFICANT FRACTURES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 140,200 140,200 140,200 140,200
GASTROINTESTINAL DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 181,300 181,300 181,300 181,300
COMPLEX ACUTE DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 323,800 323,800 323,800 323,800
CONGESTIVE HEART FAILURE & Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 198,700 198,700 198,700 198,700
BRONCHIAL DISORDER Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 198,700 198,700 198,700 198,700
BRONCHIAL DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300

GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 203,400 203,400 203,400 203,400
MAJOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500

Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 198,700 198,700 198,700 198,700
BRONCHIAL DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
MAJOR POSTERIOR SEGMENT SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 556,100 556,100 556,100 556,100
EYE OPERATION Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 198,700 198,700 198,700 198,700
BRONCHIAL DISORDER Rp.0,SD: Rp.0
RESPIRATORY THERAPY SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 255,200 255,200 255,200 255,200
OPERATIONS Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
DENTAL OPERATIONS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 176,800 176,800 176,800 176,800
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 181,300 181,300 181,300 181,300
COMPLEX ACUTE DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 130,400 130,400 130,400 130,400
URINARY TRACT INFECTION Rp.0,SD: Rp.0
AMBULATORY VISIT FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 323,800 323,800 323,800 323,800
CONGESTIVE HEART FAILURE & Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
DIALYSIS SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 925,500 925,500 925,500 925,500
Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300

GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
MODERATE ANTERIOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 104,500 104,500 104,500 104,500
SEGMENT EYE OPERATION Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 141,700 141,700 141,700 141,700
CENTRAL NERVOUS SYSTEM Rp.0,SD: Rp.0
PHYSICAL THERAPY & MINOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 158,200 158,200 158,200 158,200
MUSCULOSKELETAL Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300

GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 198,700 198,700 198,700 198,700
BRONCHIAL DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR ACUTE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 140,200 140,200 140,200 140,200
GASTROINTESTINAL DISORDER Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
DIAGNOSTIC & IMAGING EYE SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 195,800 195,800 195,800 195,800
INVESTIGATIONS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300
GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
HASIL VERIFIKASI SECARA ADMINISTRASI

ULTRASOUND FOR SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 333,300 333,300 333,300 333,300

GYNAECOLOGY DISORDERS Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 142,200 142,200 142,200 142,200
MINOR ACUTE DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 181,300 181,300 181,300 181,300
COMPLEX ACUTE DISORDER Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 166,300 166,300 166,300 166,300
MINOR CHRONIC DISEASES Rp.0,SD: Rp.0
AMBULATORY VISIT FOR OTHER SA: Rp.0,SP: Rp.0,SR:Rp.0,SI: 181,300 181,300 181,300 181,300
COMPLEX ACUTE DISORDER Rp.0,SD: Rp.0
TOTAL 567,072,000 567,072,000 567072000 567072000

stya