Tanda Terima PSM

No Nama Rawatan Op Katarak Jumlah
1 Agas 9 Rp 225,000 Rp - Rp 225,000

2 Ahmad Zaini 1 Rp 25,000 Rp - Rp 25,000
3 Aje 1 Rp 25,000 Rp - Rp 25,000
4 Aking (18.904.000) 472500 Rp - Rp - Rp 472,500
5 Aman 2 Rp 50,000 Rp - Rp 50,000
6 Amin 1 Rp 25,000 Rp - Rp 25,000
7 Atikah 2 Rp 50,000 Rp - Rp 50,000
8 Cecep 1 Rp 25,000 Rp - Rp 25,000
9 Dadi D 6 Rp 150,000 1 Rp 75,000 Rp 225,000
10 Dae Rp - 1 Rp 75,000 Rp 75,000
11 Darta 1 Rp 25,000 Rp - Rp 25,000
12 Dody 2 Rp 50,000 Rp - Rp 50,000
13 Durahman Rp - 1 Rp 75,000 Rp 75,000
14 ejang 1 Rp 25,000 Rp - Rp 25,000
15 Endang 3 Rp 75,000 Rp - Rp 75,000
16 Enjang 2 Rp 50,000 Rp - Rp 50,000
17 Eman 2 Rp 50,000 Rp - Rp 50,000
18 Fitri Rp - 1 Rp 75,000 Rp 75,000
19 Ganda Suganda 2 Rp 50,000 Rp - Rp 50,000
20 Ijo Rp - 4 Rp 300,000 Rp 300,000
21 Iman 2 Rp 50,000 Rp - Rp 50,000
22 Iwan TD 3 Rp 75,000 Rp - Rp 75,000
23 Jaman S 1 Rp 25,000 Rp - Rp 25,000
24 Joging (7.926.000) 198000 1 Rp 25,000 Rp - Rp 223,000
25 juju Juarsih 1 Rp 25,000 Rp - Rp 25,000
26 Jumsari (4.376.000) 109000 8 Rp 200,000 Rp - Rp 309,000
27 Kosasih (2.144.200 53500 1 Rp 25,000 Rp - Rp 78,500
28 Kasdi 3 Rp 75,000 Rp - Rp 75,000
29 Kosdi 1 Rp 25,000 Rp - Rp 25,000
30 Maana 1 Rp 25,000 Rp - Rp 25,000
31 Maan Rp - 6 Rp 450,000 Rp 450,000
32 Mesin Rp - 2 Rp 150,000 Rp 150,000
33 Muksin (4.566.000) 114000 2 Rp 50,000 Rp - Rp 164,000
34 Nano 5 Rp 125,000 2 Rp 150,000 Rp 275,000
35 Nawangsih 1 Rp 25,000 Rp - Rp 25,000
36 Nurasih 3 Rp 75,000 Rp - Rp 75,000
37 Nurkomalasari 1 Rp 25,000 Rp - Rp 25,000
38 Oman Rp - 2 Rp 150,000 Rp 150,000
39 Oman Rp - 1 Rp 75,000 Rp 75,000
40 Rainta 2 Rp 50,000 Rp - Rp 50,000
41 Radita 6 Rp 150,000 Rp - Rp 150,000
42 Riki 3 Rp 75,000 Rp - Rp 75,000
43 Rohmat Rp - Rp - Rp -
44 Rt Aja 7 Rp 175,000 Rp - Rp 175,000
45 Rt Joging 1 Rp 25,000 Rp - Rp 25,000
46 Sadi Rp - 1 Rp 75,000 Rp 75,000
47 Salamah 12 Rp 300,000 Rp - Rp 300,000
48 Sanin sasmita 3 Rp 75,000 Rp - Rp 75,000
49 Sari Rp - 2 Rp 150,000 Rp 150,000
50 Sari (6.808.000) 170000 4 Rp 100,000 Rp - Rp 270,000
51 Sudir Rp - 1 Rp 75,000 Rp 75,000
52 Sule 1 Rp 25,000 Rp - Rp 25,000
53 Suri Rp - 1 Rp 75,000 Rp 75,000
54 Sodir 1 Rp 25,000 Rp - Rp 25,000
55 Syarif 1 Rp 25,000 Rp - Rp 25,000
56 Tini 2 Rp 50,000 Rp - Rp 50,000
57 Tosim 4 Rp 100,000 Rp - Rp 100,000
58 Ujang mulyana 1 Rp 25,000 Rp - Rp 25,000
59 Umar 2 Rp 50,000 Rp - Rp 50,000
60 Wakil Rp - 1 Rp 75,000 Rp 75,000
61 Wawan H 3 Rp 75,000 Rp - Rp 75,000
62 Yati KS 1 Rp 25,000 Rp - Rp 25,000
Nama Alamat Rawatan Op. Katarak Jumlah
Adang - Rp - 1 Rp 75,000 Rp 75,000
Adang Suteja 1 Rp 25,000 - Rp - Rp 25,000
Ae Saefudin 1 Rp 25,000 - Rp - Rp 25,000
Agas (3.132.000) 78000 3 Rp 75,000 - Rp - Rp 153,000
Ai Hartati 1 Rp 25,000 - Rp - Rp 25,000
Ahmad Zaini 1 Rp 25,000 - Rp - Rp 25,000
Aman S 2 Rp 50,000 - Rp - Rp 50,000
Amin 1 Rp 25,000 - Rp - Rp 25,000
Atikah 3 Rp 75,000 1 Rp 75,000 Rp 150,000
Bu Nina 1 Rp 25,000 - Rp - Rp 25,000
Cecep 1 Rp 25,000 - Rp - Rp 25,000
Ciming - Rp - - Rp - Rp -
Dadi 5 Rp 125,000 - Rp - Rp 125,000
Damin 1 Rp 25,000 - Rp - Rp 25,000
Darta 1 Rp 25,000 - Rp - Rp 25,000
Deni K (19.591.000) 489500 3 Rp 75,000 - Rp - Rp 564,500
Dede 3 Rp 75,000 - Rp - Rp 75,000
Durahman - Rp - - Rp - Rp -
Endah 4 Rp 100,000 - Rp - Rp 100,000
Endang 1 Rp 25,000 - Rp - Rp 25,000
Goleur 2 Rp 50,000 - Rp - Rp 50,000
Heriyanto 3 Rp 75,000 - Rp - Rp 75,000
Iwan 1 Rp 25,000 - Rp - Rp 25,000
Joging 1 Rp 25,000 - Rp - Rp 25,000
Juju - Rp - - Rp - Rp -
Jumsari (4.990.000) 124500 8 Rp 200,000 - Rp - Rp 324,500
Karman - Rp - - Rp - Rp -
Karti 1 Rp 25,000 - Rp - Rp 25,000
Kosasih 2 Rp 50,000 - Rp - Rp 50,000
Kong Ijo - Rp - 3 Rp 225,000 Rp 225,000
Kustini 7 Rp 175,000 - Rp - Rp 175,000
Ma Elah 1 Rp 25,000 - Rp - Rp 25,000
Ma eneng 2 Rp 50,000 - Rp - Rp 50,000
Maesin 1 Rp 25,000 - Rp - Rp 25,000
Mislan 4 Rp 100,000 - Rp - Rp 100,000
Mukri - Rp - - Rp - Rp -
Muksin abah 2 Rp 50,000 - Rp - Rp 50,000
Nanang - Rp - - Rp - Rp -
Nano 9 Rp 225,000 1 Rp 75,000 Rp 300,000
Omponk 1 Rp 25,000 - Rp - Rp 25,000
Ojos(2.530.000) 63000 - Rp - - Rp - Rp 63,000
Pa Damin - Rp - 1 Rp 75,000 Rp 75,000
Pa Omat - Rp - 1 Rp 75,000 Rp 75,000
Radita 9 Rp 225,000 - Rp - Rp 225,000
Rasmin 1 Rp 25,000 - Rp - Rp 25,000
Rainta - Rp - - Rp - Rp -
Rowi Z - Rp - - Rp - Rp -
RT aja (11.360 &1.177) 313000 5 Rp 125,000 - Rp - Rp 438,000
Rt Iman - Rp - - Rp - Rp -
Rt Iming 3 Rp 75,000 - Rp - Rp 75,000
Saen - Rp - - Rp - Rp -
Salamah 2 Rp 50,000 - Rp - Rp 50,000
Salimis 1 Rp 25,000 - Rp - Rp 25,000
Samsudin 1 Rp 25,000 - Rp - Rp 25,000
sanim - Rp - - Rp - Rp -
Sari (1.850. dan 4.566) 160000 10 Rp 250,000 3 Rp 225,000 Rp 635,000
Sholeh M 1 Rp 25,000 - Rp - Rp 25,000
Sri Hartati 2 Rp 50,000 - Rp - Rp 50,000
Suri - Rp - 2 Rp 150,000 Rp 150,000
Sudir 2 Rp 50,000 1 Rp 75,000 Rp 125,000
Sulaeman - Rp - - Rp - Rp -
Sule 1 Rp 25,000 - Rp - Rp 25,000
Suri 2 Rp 50,000 - Rp - Rp 50,000
Syarief H 1 Rp 25,000 - Rp - Rp 25,000
Tini 8 Rp 200,000 - Rp - Rp 200,000
Tosim (2.233.000) 55500 3 Rp 75,000 - Rp - Rp 130,500
Umar Jaya 1 Rp 25,000 - Rp - Rp 25,000
Wati Maesaroh 1 Rp 25,000 - Rp - Rp 25,000
Wawan H 1 Rp 25,000 - Rp - Rp 25,000
Wiwin 10 Rp 250,000 - Rp - Rp 250,000
143 3,575,000 13 975,000 5,833,500
Rp 4,550,000 Rp 5,833,500
Rp 1,283,500
Nama Alamat Rawatan Op. Katarak Jumlah
Agas 9 Rp 225,000 Rp - Rp 225,000 1
Ahmad Zaini 1 Rp 25,000 Rp - Rp 25,000 2
Aje 1 Rp 25,000 Rp - Rp 25,000 3
Aking (18.904.000) 472500 Rp - Rp - Rp 472,500 4
Aman 2 Rp 50,000 Rp - Rp 50,000 5
Amin 1 Rp 25,000 Rp - Rp 25,000 6
Atikah 2 Rp 50,000 Rp - Rp 50,000 7
Cecep 1 Rp 25,000 Rp - Rp 25,000 8
Dadi D 6 Rp 150,000 1 Rp 75,000 Rp 225,000 9
Dae Rp - 1 Rp 75,000 Rp 75,000 10
Darta 1 Rp 25,000 Rp - Rp 25,000 11
Dody 2 Rp 50,000 Rp - Rp 50,000 12
Durahman Rp - 1 Rp 75,000 Rp 75,000 13
ejang 1 Rp 25,000 Rp - Rp 25,000 14
Endang 3 Rp 75,000 Rp - Rp 75,000 15
Enjang 2 Rp 50,000 Rp - Rp 50,000 16
Eman 2 Rp 50,000 Rp - Rp 50,000 17
Fitri Rp - 1 Rp 75,000 Rp 75,000 18
Ganda Suganda 2 Rp 50,000 Rp - Rp 50,000 19
Ijo Rp - 4 Rp 300,000 Rp 300,000 20
Iman 2 Rp 50,000 Rp - Rp 50,000 21
Iwan TD 3 Rp 75,000 Rp - Rp 75,000 22
Jaman S 1 Rp 25,000 Rp - Rp 25,000 23
Joging (7.926.000) 198000 1 Rp 25,000 Rp - Rp 223,000 24
juju Juarsih 1 Rp 25,000 Rp - Rp 25,000 25
Jumsari (4.376.000) 109000 8 Rp 200,000 Rp - Rp 309,000 26
Kosasih (2.144.200 53500 1 Rp 25,000 Rp - Rp 78,500 27
Kasdi 3 Rp 75,000 Rp - Rp 75,000 28
Kosdi 1 Rp 25,000 Rp - Rp 25,000 29
Maana 1 Rp 25,000 Rp - Rp 25,000 30
Maan Rp - 6 Rp 450,000 Rp 450,000 31
Mesin Rp - 2 Rp 150,000 Rp 150,000 32
Muksin (4.566.000) 114000 2 Rp 50,000 Rp - Rp 164,000 33
Nano 5 Rp 125,000 2 Rp 150,000 Rp 275,000 34
Nawangsih 1 Rp 25,000 Rp - Rp 25,000 35
Nurasih 3 Rp 75,000 Rp - Rp 75,000 36
Nurkomalasari 1 Rp 25,000 Rp - Rp 25,000 37
Oman Rp - 2 Rp 150,000 Rp 150,000 38
Oman Rp - 1 Rp 75,000 Rp 75,000 39
Rainta 2 Rp 50,000 Rp - Rp 50,000 40
Radita 6 Rp 150,000 Rp - Rp 150,000 41
Riki 3 Rp 75,000 Rp - Rp 75,000 42
Rohmat Rp - Rp - Rp - 43
Rt Aja 7 Rp 175,000 Rp - Rp 175,000 44
Rt Joging 1 Rp 25,000 Rp - Rp 25,000 45
Sadi Rp - 1 Rp 75,000 Rp 75,000 46
Salamah 12 Rp 300,000 Rp - Rp 300,000 47
Sanin sasmita 3 Rp 75,000 Rp - Rp 75,000 48
Sari Rp - 2 Rp 150,000 Rp 150,000 49
Sari (6.808.000) 170000 4 Rp 100,000 Rp - Rp 270,000 50
Sudir Rp - 1 Rp 75,000 Rp 75,000 51
Sule 1 Rp 25,000 Rp - Rp 25,000 52
Suri Rp - 1 Rp 75,000 Rp 75,000 53
Sodir 1 Rp 25,000 Rp - Rp 25,000 54
Syarif 1 Rp 25,000 Rp - Rp 25,000 55
Tini 2 Rp 50,000 Rp - Rp 50,000 56
Tosim 4 Rp 100,000 Rp - Rp 100,000 57
Ujang mulyana 1 Rp 25,000 Rp - Rp 25,000 58
Umar 2 Rp 50,000 Rp - Rp 50,000 59
Wakil Rp - 1 Rp 75,000 Rp 75,000 60
Wawan H 3 Rp 75,000 Rp - Rp 75,000 61
Yati KS 1 Rp 25,000 Rp - Rp 25,000 62
Adang - Rp - 1 Rp 75,000 Rp 75,000
Adang Suteja 1 Rp 25,000 - Rp - Rp 25,000
Ae Saefudin 1 Rp 25,000 - Rp - Rp 25,000
Agas (3.132.000) 78000 3 Rp 75,000 - Rp - Rp 153,000
Ai Hartati 1 Rp 25,000 - Rp - Rp 25,000
Ahmad Zaini 1 Rp 25,000 - Rp - Rp 25,000
Aman S 2 Rp 50,000 - Rp - Rp 50,000
Amin 1 Rp 25,000 - Rp - Rp 25,000
Atikah 3 Rp 75,000 1 Rp 75,000 Rp 150,000
Bu Nina 1 Rp 25,000 - Rp - Rp 25,000
Cecep 1 Rp 25,000 - Rp - Rp 25,000
Ciming - Rp - - Rp - Rp -
Dadi 5 Rp 125,000 - Rp - Rp 125,000
Damin 1 Rp 25,000 - Rp - Rp 25,000
Darta 1 Rp 25,000 - Rp - Rp 25,000
Deni K (19.591.000) 489500 3 Rp 75,000 - Rp - Rp 564,500
Dede 3 Rp 75,000 - Rp - Rp 75,000
Durahman - Rp - - Rp - Rp -
Endah 4 Rp 100,000 - Rp - Rp 100,000
Endang 1 Rp 25,000 - Rp - Rp 25,000
Goleur 2 Rp 50,000 - Rp - Rp 50,000
Heriyanto 3 Rp 75,000 - Rp - Rp 75,000
Iwan 1 Rp 25,000 - Rp - Rp 25,000
Joging 1 Rp 25,000 - Rp - Rp 25,000
Juju - Rp - - Rp - Rp -
Jumsari (4.990.000) 124500 8 Rp 200,000 - Rp - Rp 324,500
Karman - Rp - - Rp - Rp -
Karti 1 Rp 25,000 - Rp - Rp 25,000
Kosasih 2 Rp 50,000 - Rp - Rp 50,000
Kong Ijo - Rp - 3 Rp 225,000 Rp 225,000
Kustini 7 Rp 175,000 - Rp - Rp 175,000
Ma Elah 1 Rp 25,000 - Rp - Rp 25,000
Ma eneng 2 Rp 50,000 - Rp - Rp 50,000
Maesin 1 Rp 25,000 - Rp - Rp 25,000
Mislan 4 Rp 100,000 - Rp - Rp 100,000
Mukri - Rp - - Rp - Rp -
Muksin abah 2 Rp 50,000 - Rp - Rp 50,000
Nanang - Rp - - Rp - Rp -
Nano 9 Rp 225,000 1 Rp 75,000 Rp 300,000
Omponk 1 Rp 25,000 - Rp - Rp 25,000
Ojos(2.530.000) 63000 - Rp - - Rp - Rp 63,000
Pa Damin - Rp - 1 Rp 75,000 Rp 75,000
Pa Omat - Rp - 1 Rp 75,000 Rp 75,000
Radita 9 Rp 225,000 - Rp - Rp 225,000
Rasmin 1 Rp 25,000 - Rp - Rp 25,000
Rainta - Rp - - Rp - Rp -
Rowi Z - Rp - - Rp - Rp -
RT aja (11.360 &1.177) 313000 5 Rp 125,000 - Rp - Rp 438,000
Rt Iman - Rp - - Rp - Rp -
Rt Iming 3 Rp 75,000 - Rp - Rp 75,000
Saen - Rp - - Rp - Rp -
Salamah 2 Rp 50,000 - Rp - Rp 50,000
Salimis 1 Rp 25,000 - Rp - Rp 25,000
Samsudin 1 Rp 25,000 - Rp - Rp 25,000
sanim - Rp - - Rp - Rp -
Sari (1.850. dan 4.566) 160000 10 Rp 250,000 3 Rp 225,000 Rp 635,000
Sholeh M 1 Rp 25,000 - Rp - Rp 25,000
Sri Hartati 2 Rp 50,000 - Rp - Rp 50,000
Suri - Rp - 2 Rp 150,000 Rp 150,000
Sudir 2 Rp 50,000 1 Rp 75,000 Rp 125,000
Sulaeman - Rp - - Rp - Rp -
Sule 1 Rp 25,000 - Rp - Rp 25,000
Suri 2 Rp 50,000 - Rp - Rp 50,000
Syarief H 1 Rp 25,000 - Rp - Rp 25,000
Tini 8 Rp 200,000 - Rp - Rp 200,000
Tosim (2.233.000) 55500 3 Rp 75,000 - Rp - Rp 130,500
Umar Jaya 1 Rp 25,000 - Rp - Rp 25,000
Wati Maesaroh 1 Rp 25,000 - Rp - Rp 25,000
Wawan H 1 Rp 25,000 - Rp - Rp 25,000
Wiwin 10 Rp 250,000 - Rp - Rp 250,000
143 3,575,000 13 975,000 5,833,500
Rp 4,550,000 Rp 5,833,500
Rp 1,283,500
Nama
Adang
Adang Suteja
Ae Saefudin
Agas
Ai Hartati
Ahmad Zaini
Aman S
Amin
Atikah
Bu Nina
Cecep
Dadi
Damin
Darta
Deni K
Dede
Endah
Endang
Goleur
Heriyanto
Iwan
Joging
Jumsari
Karti
Kosasih
Kong Ijo
Kustini
Ma Elah
Ma eneng
Maesin
Mislan
Muksin abah
Nano
Omponk
Ojos
Pa Damin
Pa Omat
Radita
Rasmin
RT aja
Rt Iming
Salamah
Salimis
Samsudin
Sari (1.850. dan 4.566)
Sholeh M
Sri Hartati
Suri
Sudir
Sule
Syarief H
Tini
Tosim
Umar Jaya
Wati Maesaroh
Wawan H
Wiwin
alamat Nama PSM no telp nama pasien no Mr
1 ABAY 9 Rp 225,000 Rp -
2 ADANG SINDANG MULYA Rp - 1 Rp 75,000
3 ADIS 1 Rp 25,000 Rp -
4 AGAS 6 Rp 150,000 Rp -
5 AHMAD DAELAMI 1 Rp 25,000 Rp -
6 AMO 4 Rp 100,000 1 Rp 75,000
7 ASEP 1 Rp 25,000 Rp -
8 ASEP ANDI 1 Rp 25,000 Rp -
9 ASEP RASAWIJAYA 1 Rp 25,000 Rp -
10 ATIKAH 135000 2 Rp 50,000 Rp -
11 AYU LESTARI 1 Rp 25,000 Rp -
12 AYU SUCIATI 4 Rp 100,000 Rp -
13 BAH DADI 7 Rp 175,000 2 Rp 150,000
14 BOBI 1 Rp 25,000 Rp -
15 CECEP 6 Rp 150,000 Rp -
16 D SOLEH 1 Rp 25,000 Rp -
17 DARTA TURI 1 Rp 25,000 1 Rp 75,000
18 DEDE Rp - 4 Rp 300,000
19 DENI JAYA L 8 Rp 200,000 Rp -
20 DIDI ISKANDAR 1 Rp 25,000 Rp -
21 DODY 5 Rp 125,000 Rp -
22 DURAHMAN 1 Rp 25,000 Rp -
23 ENDANG 4 Rp 100,000 2 Rp 150,000
24 ENDI Rp - 1 Rp 75,000
25 ENGKUS KUSNADI 1 Rp 25,000 Rp -
26 EUIS R 2 Rp 50,000 Rp -
27 EWING 2 Rp 50,000 Rp -
28 GABRIL/RIPA 1 Rp 25,000 Rp -
29 HERU HERDIAN 1 Rp 25,000 Rp -
30 IWAN TD 5 Rp 125,000 1 Rp 75,000
31 JAJANG(11.509&787) 308000 0 Rp - Rp -
32 JAKA 1 Rp 25,000 Rp -
33 JAKA KOMARA 3 Rp 75,000 Rp -
34 JEJEN Rp - 1 Rp 75,000
35 JOGING Rp - 1 Rp 75,000
36 JUJU 5 Rp 125,000 Rp -
37 JUMA 2 Rp 50,000 Rp -
38 JUMSARI 10 Rp 250,000 Rp -
39 KAJA SUJANA 1 Rp 25,000 Rp -
40 KARDI 1 Rp 25,000 Rp -
41 KARTI 2 Rp 50,000 Rp -
42 KONG IJO Rp - 1 Rp 75,000
43 KOSIM SUHARI 3 Rp 75,000 1 Rp 75,000
44 KUSTINI 3 Rp 75,000 Rp -
45 LUDI Rp - 1 Rp 75,000
46 LUDI HERMAWAN 1 Rp 25,000 Rp -
47 MA AYAT 10 Rp 250,000 Rp -
48 MA ELAH 14 Rp 350,000 3 Rp 225,000
49 MA ENENG 1 Rp 25,000 Rp -
50 MUKSIN 1 Rp 25,000 Rp -
51 MULYADI 1 Rp 25,000 Rp -
52 NANO 4 Rp 100,000 4 Rp 300,000
53 NATI Rp - 1 Rp 75,000
54 NAWANGSIH 1 Rp 25,000 Rp -
55 NURSIFA 9 Rp 225,000 Rp -
56 OMPONG 2 Rp 50,000 Rp -
57 RADITA 6 Rp 150,000 Rp -
58 RASTI 1 Rp 25,000 Rp -
59 RHENO 4 Rp 100,000 Rp -
60 RIKI 2 Rp 50,000 Rp -
61 ROHAYATI 1 Rp 25,000 Rp -
62 ROWI Z 5 Rp 125,000 Rp -
63 RT AJA 13 Rp 325,000 Rp -
64 RT IMAN 9 Rp 225,000 Rp -
65 RUSPAN 1 Rp 25,000 Rp -
66 RW RAHMAT 2 Rp 50,000 Rp -
67 SAHRUDIN 5 Rp 125,000 Rp -
68 SALAMAH 7 Rp 175,000 1 Rp 75,000
69 SALIM S 3 Rp 75,000 Rp -
70 SARI 7 Rp 175,000 2 Rp 150,000
71 SRI HARTATI 1 Rp 25,000 Rp -
72 SRI ISDI 5 Rp 125,000 Rp -
73 SRI MAESAROH 2 Rp 50,000 Rp -
74 SUKARDI 1 Rp 25,000 Rp -
75 SURIH Rp - 3 Rp 225,000
76 SYARIEF H 3 Rp 75,000 Rp -
77 TARSO 1 Rp 25,000 Rp -
78 TIGOR 2 Rp 50,000 Rp -
79 TINI 6 Rp 150,000 Rp -
80 TOSIM 4 Rp 100,000 Rp -
81 UJANG NURJAYA 1 Rp 25,000 Rp -
82 UMAR 1 Rp 25,000 Rp -
83 WAKIL AKUNG 11 Rp 275,000 Rp -
84 WANDA 1 Rp 25,000 Rp -
85 WAWAN H 1 Rp 25,000 Rp -
86 WIWIN H 12 Rp 300,000 Rp -
87 YAYA (8298 208000 1 Rp 25,000 Rp -
88 YOYO Rp - 1 Rp 75,000
89 ZENAL ABIDIN 1 Rp 25,000 Rp -
Jumlah Keterangan
9 Rp 225,000 Januari 2, 2022
1 Rp 75,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
6 Rp 150,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
5 Rp 175,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
3 Rp 185,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
4 Rp 100,000 Januari 2, 2022
9 Rp 325,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
6 Rp 150,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
2 Rp 100,000 Januari 2, 2022
4 Rp 300,000 Januari 2, 2022
8 Rp 200,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
5 Rp 125,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
6 Rp 250,000 Januari 2, 2022
1 Rp 75,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
2 Rp 50,000 Januari 2, 2022
2 Rp 50,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
6 Rp 200,000 Januari 2, 2022
2 Rp 308,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
3 Rp 75,000 Januari 2, 2022
1 Rp 75,000 Januari 2, 2022
1 Rp 75,000 Januari 2, 2022
5 Rp 125,000 Januari 2, 2022
2 Rp 50,000 Januari 2, 2022
10 Rp 250,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
2 Rp 50,000 Januari 2, 2022
1 Rp 75,000 Januari 2, 2022
4 Rp 150,000 Januari 2, 2022
3 Rp 75,000 Januari 2, 2022
1 Rp 75,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
10 Rp 250,000 Januari 2, 2022
17 Rp 575,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
8 Rp 400,000 Januari 2, 2022
1 Rp 75,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
9 Rp 225,000 Januari 2, 2022
2 Rp 50,000 Januari 2, 2022
6 Rp 150,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
4 Rp 100,000 Januari 2, 2022
2 Rp 50,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
5 Rp 125,000 Januari 2, 2022
13 Rp 325,000 Januari 2, 2022
9 Rp 225,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
2 Rp 50,000 Januari 2, 2022
5 Rp 125,000 Januari 2, 2022
8 Rp 250,000 Januari 2, 2022
3 Rp 75,000 Januari 2, 2022
9 Rp 325,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
5 Rp 125,000 Januari 2, 2022
2 Rp 50,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
3 Rp 225,000 Januari 2, 2022
3 Rp 75,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
2 Rp 50,000 Januari 2, 2022
6 Rp 150,000 Januari 2, 2022
4 Rp 100,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
11 Rp 275,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
12 Rp 300,000 Januari 2, 2022
2 Rp 233,000 Januari 2, 2022
1 Rp 75,000 Januari 2, 2022
1 Rp 25,000 Januari 2, 2022
nama
alamat Nama PSM no telp pasien no Mr
1 ABAY 8 -
2 ADANG SUTEJA 1 -
3 AGAS 1 -
4 AJ 2 1
5 AJA MIHARJA 2 -
6 AMO 5 -
7 ARFIN HIDAYAT 7 -
8 ASEP ANDI 1 -
9 AYU SUCIYANTI 9 -
10 BAH DADI 4 1
11 BOBI 4 -
12 CASMITA 2 -
13 CECEP 10 -
14 D SALEH 4 -
15 DARTA TURI - 1
16 DEDE 2 5
17 DENI 2 -
18 DENI JAYA L 12 -
19 DODY 7 -
20 E NARSIM 1 -
21 EJANG 4 -
22 EKA BAGYA S 5 -
23 EKA PERMANA 1 -
24 ENDANG 3 1
25 EWING 2 -
26 HARTONO 1
27 HARUN 2 -
28 HASAN BASRI 1 -
29 HERDI 3 -
30 ICONG 1 -
31 IWAN TD 2 -
32 JAJANG 1 -
33 JAKA KOMARA 3 -
34 JUJU 4 -
35 JUMSARI 15 2
36 KARTI 1 -
37 KASMAN 1 -
38 KENTING 3 -
39 KOSASIH 4 -
40 KOSIM SUHARI 2 2
41 KRISNA 2
42 KUSTINI 1 -
43 LUDI HERMAWAN 1 -
44 MA AYATI 2 -
45 MA ELAH 13 -
46 MA ENENG 3 -
47 MAAN 1
48 MAESIN 1 -
49 MARYATI 1 -
50 MISLAN 1 -
51 MUKSIN 1
52 NANO 16 -
53 NAWANGSIH 2 -
54 NURASIH 1 -
55 NURSIFA 5 -
56 ODANG 1 -
57 OJOS 3 -
58 OMAT 2
59 ONDIH 1 -
60 RADITA 4 -
61 RIKI 2 -
62 ROHAYATI 3 -
63 ROHMAN 1 -
64 ROHMAT 1 -
65 ROMLI 1 1
66 ROSIN 5 -
67 ROWI Z 2 -
68 RT AJA 5 -
69 RT BUDI 3 -
70 RT IMAN 5 -
71 RT NURDIN 1
72 RW EDO 1 -
73 RW RAHMAT 1 -
74 SAHRUDIN 3 -
75 SALAMAH 12 1
76 SANA P 2 -
77 SARI 10 1
78 SITI KURNAESIH 4 -
79 SOBLENG 1 -
80 SOBUR 2 -
81 SRI ISDI 4 -
82 SRI MAESAROH 2 -
83 SYARIF 3 -
84 TARSO 1 -
85 TINI 3 -
86 TOSIM 1
87 U GOLER 4 -
88 UMAR 4 -
89 WADIN 1 -
90 WAGIMAN 1 -
91 WAKIL AKUNG 10 -
92 WANDA 6 -
93 WANTA WARDIMAN 2 -
94 WIWIN H 25 -
95 YAYA 1 -
Jumlah Keterangan
Rp 200,000 29 JANUARI - 17 FEBRUARI 2022
nama
alamat Nama PSM no telp pasien no Mr
1 ABAY 6 -
2 AGAS 1 -
3 AGUNG NUGRAHA 1 -
4 AHMAD DAELAMI 2 -
5 AJANG SUWANDI 1 -
6 ANDIL 2
7 ASEP PARID 1 -
8 ASEP RASAWIJAYA 1 -
9 ATEM 2 -
10 ATIKAH 1 -
11 BAH DADI 3 1
12 CASMITA 2 -
13 CECEP 14 -
14 D SALEH 3 -
15 DAMIN 4 -
16 DARMAN SUHARDI 1 -
17 DARTA KIMING 2 -
18 DARTA TURI 3 -
19 DEDE 4
20 DEDE ANWAR 2 -
21 DEDENG SUWARYO 1 -
22 DENI JAYA L 2 -
23 DODY 6 -
24 EKA BAGYA 3 -
25 ENDANG 6 2
26 ICONG 2 -
27 IWAN MAULANA 1 -
28 IWAN SISWANDI 1 -
29 IWAN TD 6 -
30 JAKA K 2 -
31 JEJEN - 1
32 JUJU 2 -
33 JUMSARI 3 -
34 JUNAEDI 3
35 KARDI 2 -
36 KARTI 7 -
37 KASMAN 5 -
38 KONG IJO 1
39 KOSASIH 1 -
40 KOSIM SUHARI 2 -
41 KRISNA 2
42 MA ELAH 9 -
43 MA ENENG 3 -
44 MAAN 1 -
45 MULYADI/DAMONG 3 -
46 NANO 2 1
47 NASIR 3 -
48 NAWANGSIH 1 -
49 NURASIH 1 -
50 NURSIFA 5 -
51 ODANG 1 -
52 OJOS 6 -
53 RADITA 1
54 RAINTA 1 -
55 RASIH 3 -
56 ROHAYATI 4 -
57 ROHMAN 1 -
58 ROMLI 2 2
59 ROSIN 1 -
60 RT AJA 13 -
61 RT BUDI 4 -
62 RT IMAN 5 -
63 RT NIONG -
64 RW RUSTAM 1
65 SAI MUSTOPA 1 -
66 SALAMAH 3 -
67 SARI 10 4
68 SOBLENG 2 -
69 SOBUR 3 -
70 SRI ISDI 4 -
71 SRI MAESAROH 2 -
72 SUKARDI 1 -
73 SYARIEF 9 -
74 TARSO 2 -
75 UMAR 1 -
76 WAHYUDIN 1 -
77 WAKIL AKUNG 15 -
78 WANDA 5 -
79 WANTA WARDIMAN 2 -
80 WIWIN H 9 -
81 YAYA 1 -
82 YOYO 1 -
83
84
85
86
87
88
89
90
91
92
93
94
95
Jumlah Keterangan
Rp 150,000 PERIODE 18 FEBRUARI - 07 MARET 2022
1 ABAY (5397000) 3 1 Rp 135,000
2 ABDUL ROSYID 1
3 ADANG SINDANGMULYA 2 1
4 AGAS 1
5 AHMAD DAELAMI 6
6 AHMAD HASIM ASHARI 1
7 AHMAD RADIMAN 2
8 AMO 1
9 ATA 6
10 ATIKAH 2
11 BAH DADI 1
12 CECEP 1
13 D SALEH 9
14 DAMIN 2
15 DARTA KIMING 4
16 DARTA TURI 2
17 DEDE 2
18 DENI JAYA LEKSANA 1
19 DIDI ISKANDAR 2
20 DODY (4984560) 9 1 Rp 124,500
21 EKA PERMANA 2
22 ENAN 2
23 ENDANG 6
24 ENDI SUHENDI 1
25 EWING 1
26 FAISAL RIFQI 1
27 ICONG (14084960) 2 1 Rp 352,000
28 IWAN MAULANA 1
29 JAJANG 5 1
30 JAKA K 4 1
31 JENAL ABIDIN 2
32 JUJU J 5
33 JUMA 2
34 JUMSARI 28
35 JUNAEDI 5
36 KONG IJO 1
37 KOSASIH 3
38 KOSIM SUHARI 3
39 KUSNADI 1
40 KUSTINI 2
41 LUDI H 1
42 MA ELAH (4012000) 14 1 Rp 100,500
43 MA ELAH 1
44 MA ENENG 3
45 MARYATI 1
46 MUKSIN 2
47 MULYADI/DAMONG 3
48 MUSTADI 1
49 NANO 8
50 NURASIH 1
51 NURSIFA 2
52 OJOS 2
53 OMAT 2 1
54 OMIN 3
55 RADITA 1 3
56 RAHMAT MG JAYA 1
57 RAINTA 2
58 RIKI (7910300+11250360) 3 2 Rp 479,000
59 ROHMAN 2
60 ROSIN 3
61 ROWI Z 7
62 RT AJA 9
63 RT BUDI 3
64 RT IMAN 7
65 RT NURDIN 1
66 RUSDIN 1
67 SALAMAH 3
68 SALIM S 2
69 SAMSUDIN 1
70 SARI 12 1
71 SOBLENG 3
72 SOBUR 1
73 SRI ISDI 7
74 SRI MAESAROH (7098280) 2 1 Rp 177,500
75 SUKARDI 1
76 SYARIEF 4
77 TARSO 2
78 TINI 2
79 TOSIM 1
80 U GOLER 2
81 UJANG MULYANA 1
82 UJANG NURJAYA 1
83 WAHID 1
84 WAKIL AKUNG (1724000) 18 1 Rp 43,000
85 WANDA 1
WIWIN H (7850000+
86 787000+10074450) 7 3 Rp 291,000
87 YUDI 3
Jumlah Keterangan
Rp 210,000 PERIODE 8-24 MARET 2022

No Nama perujuk alamat no telp nama pasien
1 klinik changshin klinik changshin Ny. Putri
2 dr Budi Suharyanto PKM Curug Ny. Atika Lesmana
3 dr Suseno hartono Cengkong Ny. Syiva Tiarani
4 dr heppy klinik griya medika denasya
5 dr heni yulia pkm Majalaya karnelis
6 klinik zhafira zarifa klinik zhafira zarifa karyati
7 klinik Rangga medika , mekarjaya
bd hj tita ckp utara santi
8 bd dea pkm Telagasari aas asipah
9 klinik zhafira zarifa klinik zhafira zarifa mutiasari
10 bd intan ratna bengle majalaya narsiah
11 bd risa mahardika pasir panjang ayu sintia
12 bd ai lani duren klari, 0857 8165 0883 kunirih
13 bd sri nurhidayati kosambi klari hani suhartini
1 bd ernita by ny tri winarti

2 bd nidaul vk callseni
3 bd nidaul vk gladis
4 klinik alhuda tegalwaru isah
5 klinik syamil medika tempuran titi
6 klinik wadas medika lemah abang wadas marah
7 klinik karyamukti medika buahhaseum karta
8 klinik sifa medika gintung kerta anah
9 bd siti nurjanah sumur gede cilamaya najwan
10 bd jeannie walidjo kotapohaci ciampel rosi
11
dr mardsi erlyta azis klinik sahidin, pusakajaya cilebar kasih
12 dr tommy nugraha rs sentul ckp ionenes
13 dr hasan basri klinik mecca sanjaya feri
14 dr kiki rizki klinik dora medika, tempuran toip
15 bd hj juwariyah KALIJAYA arum
MR keterangan Tindakan Jumlah
277615 maret 2022 SC Rp 100,000
311320 maret 2022 SC Rp 100,000
maret 2022 Rawat Rp 25,000
311141 maret 2022 Rawat Rp 25,000
311105 maret 2022 SC Rp 100,000
138339 maret 2022 SC Rp 100,000
maret 2022 Rawat Rp 25,000

310891 maret 2022 SC Rp 100,000
155309 maret 2022 SC Rp 100,000
310686 maret 2022 SC Rp 100,000
310697 maret 2022 SC Rp 100,000
maret 2022 Kur Rp 50,000
310256 maret 2022 SC Rp 100,000
maret 2022 Rawatan Rp25,000


maret 2022 SC Rp100,000
1 Bd.Hj Yayat Bd Hj Yayat Purwasari Ny Sari
2 Bdn.Hj Yayat Bd Hj Yayat Purwasari Ny.Euis
3 Bdn.Ai Lani Bdn Ai Lani Ny.Kurinih
4 Bdn Indah (VK) Bdn VK RSCSH Ny.Novi Jesica
5 PKM Cikampek Cikampek Ny.Irmawati
6 Bdn Lia Dahlia ds Karangsari Ny.Pera
7 dr.Annisa Yulia Klinik Amanda Ny.Yeti Yumiati
8 dr.Dodi Haryanto Klinik Andina Ny.Putri
9 dr.gressila Klinik Assalam Ny.Onasih
10 dr.Gressila Klinik Assalam Ny.Komariyah
11 dr.Lindawati Klinik Assalam Ny.Mahma
12 Klinik Changshin Klinik Changshin Ny.Ria Pratiwi
13 Klinik Changsin Klinik Changshin Ny Cucu Cahyati
14 dr.Annisa Klinik Fikri Medika Ny.Fitri
15 Bd.Tria Rahmawati Klinik Graha Medis Ny.Witriyani
16 Bd Tria Klinik Graha Medis Ny Susilowati
17 dr. Heppy yhos widodo Klinik Graha Medis Ny.Siti Aminah
18 Bd,Rafika Klinik Graha Medis Kopel Ny.Sri Winarti
19 dr.Heppy Klinik Graha Medis Kopel Ny.Noni
20 Dr Handi Nurbiyanto Klinik Kinasih Ny Diana
21 Klinik Mitra Sehat Klinik Mita Sehat Ny.Ari K
22 dr.Reza Indianto Klinik Mitra Sehat Ny.Ari Susanti
23 Dr Dimas Prabu S Klinik Mustika Ny Neneng
24 dr.Arnis Klinik Novia Ny.Dita Pratiwi
25 Bdn Ervina Klinik Nursepta Ny.Siti Romlah
26 dr.Dita T Klinik Safira Medika Ny.Nyei Aos
27 dr.Fitriadi Klinik Vidya Medika Ny.Entin
28 dr.Velly Malihah Klinik Zahira Ny.Darliana
29 Dr. Lastriati dewi Klinik Zhafira Zafira Ny.Intan
30 Bdn Lastriati Klinik Zhafira Zarifa Ny.Eka Novita
31 dr.Pocut Slanga Klinik Zhafira Zarifa Ny.Sutini
32 dr.Pocut Slanga Klinik Zhafira Zarifa Ny.Vera
33 Bd.Sri Nurhidayati Kosambi Ny Martini
34 dr.KhrismawanSp.Og Kosambi Ny.Rianti
35 Bd. Mimin Rusmiah Mekarjaya Rawamerta Ny Ika
36 Bdn.Suryamah Pancawati Ny.Cucu
37 Bdn.Suryamah Pancawati Ny.Ela Nurlela
38 Bdn.Siti Aisyah Pasir konci Ny.Rina
39 Bdn Ani Bayu Perum Villa Duta Ny.Siti Nuraliah
40 Bdn.Ani Bayu perum Villa duta Ny.Neni Sulastri
41 dr Astri Lovita PKM Balongsari Ny.Dawi
42 PKM Ciampel PKM Ciampel Ny.Yani N
43 PKM Ciampel PKM Ciampel Ny Kasih
44 PUSKESMAS Ciampel PKM Ciampel Ny.Sri Mulyati
45 Puskesmas cicande PKM cicande Ny Fikriyah
46 Dr. Febi Dwi PKM CURUG Ny.Siti Nurlela
47 dr.Febi Dwi PKM Curug Ny.Tina S
48 PUSKESMAS Curug PKM Curug Ny.Mulyani
49 dr.Eni S PKM Klari Ny.Asmayati
50 dr.Diding PKM Kutawaluya Ny.Komariah
51 dr.Farida PKM Majalaya Ny.Hartiwi
52 dr.Heni Yulia PKM Majalaya Ny.Karnelis
53 dr.Tuti H PKM Plawad Ny.Halimah
54 dr.Lindawati PKM Purwasari Ny.Nurlela
55 Dr. Sutardi PKM Rawamerta Ny.Wati Suryani
56 dr.Devi PKM Telagasari Ny.Nur Kartika
57 PONED Cikampek PONED Cikampek Ny.Rosalina
58 Bdn Dian (VK) Puri Kosambi Ny.Maya
274093 MARET 2022 SC Rp 100,000
309317 MARET 2022 SC Rp 100,000
310336 MARET 2022 Curet Rp 50,000
111793 MARET 2022 SC Rp 100,000
311015 MARET 2022 Rawatan Rp 25,000
304305 MARET 2022 SC Rp 100,000
311095 MARET 2022 SC Rp 100,000
166722 MARET 2022 SC Rp 100,000
310776 MARET 2022 rawatan Rp 25,000
308353 MARET 2022 SC Rp 100,000
171160 MARET 2022 SC Rp 100,000
189511 MARET 2022 Curet Rp 50,000
310825 MARET 2022 SC Rp 100,000
215712 MARET 2022 Sc Rp 100,000
310457 MARET 2022 Insisi Abses Rp 100,000
204451 MARET 2022 Curet Rp 50,000
99194 MARET 2022 Curet Rp 50,000
286171 MARET 2022 SC Rp 100,000
310230 MARET 2022 SC Rp 100,000
310289 MARET 2022 Sc Rp 100,000
310218 MARET 2022 SC Rp 100,000
307690 MARET 2022 SC Rp 100,000
171118 MARET 2022 SC Rp 100,000
306150 MARET 2022 P.Penyulit Rp 50,000
213100 MARET 2022 SC Rp 100,000
81741 MARET 2022 SC Rp 100,000
159080 MARET 2022 SC Rp 100,000
310388 MARET 2022 P.Normal Rp 50,000
310113 MARET 2022 P.Penyulit Rp 50,000
310079 MARET 2022 SC Rp 100,000
101484 MARET 2022 SC Rp 100,000
178154 MARET 2022 SC Rp 100,000
82457 MARET 2022 SC Rp 100,000
310553 MARET 2022 SC Rp 100,000
310402 MARET 2022 P.Normal
310062 MARET 2022 P N Penyulit Rp 50,000
212787 MARET 2022 SC Rp 100,000
310976 MARET 2022 SC Rp 100,000
310267 MARET 2022 SC Rp 100,000
192152 MARET 2022 SC Rp 100,000
310750 MARET 2022 SC Rp 100,000
311105 MARET 2022 SC Rp 100,000
306986 MARET 2022 SC Rp 100,000
180171 MARET 2022 SC Rp 100,000
310466 MARET 2022 curet Rp 50,000
310066 MARET 2022 SC Rp 100,000
310325 MARET 2022 SC Rp 100,000
nama
No Nama perujuk alamat no telp pasien MR
1 Kapus Anggadita PKM Anggadita
1 Dokter Anggadita PKM Anggadita
1 Pendaftaran Anggadita PKM Anggadita
2 Kapus Curug PKM Curug
2 Dokter Curug PKM Curug
2 Pendaftaran Curug PKM Curug
3 Kapus PKM Ciampel PKM Ciampel
3 Dokter PKM Ciampel PKM Ciampel
3 Pendaftaran PKM Ciampel PKM Ciampel
4 Kapus Klari PKM Klari
4 Dokter Klari PKM Klari
4 Pendaftaran Klari PKM Klari
5 Kapus Telagasari PKM Telagasari
5 Dokter Telagasari PKM Telagasari
5 Pendaftaran Telagasari PKM Telagasari
6 Kapus PKM Majalaya PKM Majalaya
6 Dokter PKM Majalaya PKM Majalaya
6 Pendaftaran PKM Majalaya PKM Majalaya
7 Kapus Lemah Abang PKM Lemah Abang
7 Dokter Lemah Abang PKM Lemah Abang
7 Pendaftaran Lemah Abang PKM Lemah Abang
8 Kapus PKM Lemah Duhur PKM Lemah Duhur
8 Dokter PKM Lemah Duhur PKM Lemah Duhur
8 Pendaftaran PKM Lemah Duhur PKM Lemah Duhur
9 Kapus PKM Rawamerta PKM Rawamerta
9 Dokter PKM Rawamerta PKM Rawamerta
9 Pendaftaran PKM Rawamerta PKM Rawamerta
10 Kapus PKM Tempuran PKM Tempuran
10 Dokter PKM Tempuran PKM Tempuran
10 Pendafatran PKM Tempuran PKM Tempuran
11 Kapus PKM Kertamukti PKM Kertamukti
11 Dokter PKM Kertamukti PKM Kertamukti
11 Pendaftaran PKM Kertamukti PKM Kertamukti
1 dr Nurlina
2 Klinik Amanda
3 Klinik Andina
4 Klinik Assalam
5 Klinik Aulia
6 Klinik Curug Rahayu
7 Klinik Dimas Medika
8 Klinik Dota Medika
9 Klinik Graha Medis Kopel
10 Klinik Graha Medis Kosambi
11 Klinik Harapan Baru
12 Klinik Kinasih
13 Klinik Kondang Medika
14 Klinik Mitra Sehat
15 Klinik Mustika
16 Klinik Nursepta
17 Klinik Puri Asih Kosambi
18 Klinik Sri Sukma
19 Klinik Telagasari
20 Klinik Vidya Medika
21 Klinik Zahira
22 Klinik Zhafira Zarifa
keterangan Tindakan Jumlah
Fee Periode Maret 2022
No Nama perujuk alamat no telp nama pasien MR
1 RS Proklamasi RS Proklamasi Ny Neni Septiani 311793
2 bd Intan C Ny yuyun 311706
3 dr Poppi herawati PKM Ciampel Ny Siti Julaeha 311759
4 dr M Judin Klinik Puri Asih Ny Yayah Nurliah 311498
5 dr Dodi haryanto Klinik Andina Ny Rini Handayani 295284
6 bd Erlis Gintungkebon Ny Anita 231926
7 Poned Cikampek Poned Cikampek Ny Ileum 311154
8 Poned Cikampek Poned Cikampek Ny Huzaipah 311157
9 bd ani VK (Voucher 25.000) Ny maelatul 297657
10 bd Titi 0856 9285 1484 Ny wiwin 311311
11 bd sri bd dewi 0857 7470 4355 Ny Priyani 311454
12 bd Ernita Kotabaru (Voucher 50.000) Ny Halah 311463
13 bd yulia permatasari neglasari lemahduhur Ny Rika Ratna 311935
14 klinik Zhafira zarifa Klinik zhafira zarifa Ny Uun Kurniasih 285594
15 bd sri nyrhidayati klinik Navia Ny Wati 312038
16 klinik aisah medika jarakah lemahduhur Ny Hana 311513
17 klinik tempuran medika Tempuran An Aleya 240583
18 bd Sri Hastuti Hendra Daryono 311458
19 bd Nidaul Duren Klari Tri Joko 204848
20 dr suseno H dapur Areng cengkong annisa 311588
21 dr Enung Y Klinik Bhakti Medika fitriyani 192432
22 dr Hermantoni klinik Nur Asy syifa Ganda 311701
23 dr Hermantoni klinik Nur Asy syifa Tasya 270820
24 dr Rita B Klinik Yafi Medika, Pedes sahroi 311583
25 dr Asep Klinik Yafi Medika, Pedes Sri Rahayu 036103
26 dr Irma Nur PKM Cilamaya Tuti Susana 279744
27 dr Astri Lovita PKM Balongsari tarmah 303315
28 dr annisa yulia Klinik Fikri medika u070 syavilla ekya 310736
03/04/2022 PN Rp 50,000
01/4/2022 PN Rp 50,000
2/4/2022 Kuret Rp 50,000
30/3/2022 Kuret Rp 50,000
4/1/2022 SC Rp 100,000
1/4/2022 SC Rp 100,000
3/24/2022 PN Rp 50,000
3/25/2022 SC Rp 100,000
3/27/2022 SC Rp 575,000
3/28/2022 SC Rp 100,000
29/3/202 SC Rp 100,000
29/3/202 SC Rp 50,000
4/5/2022 SC Rp 100,000
4/5/2022 Kuret Rp 50,000
4/6/2022 kuret Rp 50,000
3/30/2022 Rawat Rp 25,000
3/17/2022 Rawat Rp 25,000
3/30/2022 Rawat Rp 25,000
3/19/2022 Rawat Rp 25,000
3/31/2022 Rawat Rp 25,000
4/4/2022 Rawat Rp 25,000
4/1/2022 Rawat Rp 25,000
4/3/2022 Rawat Rp 25,000
3/31/2022 Rawat Rp 25,000
4/3/2022 Rawat Rp 25,000
3/27/2022 Rawat Rp 25,000
3/22/2022 Rawat Rp 25,000
3/18/2022 Rawat Rp 25,000
1 ABAY 2
2 ABDUL SYUKUR 1
3 ADANG SUTEJA 2
4 AGAS 2
5 AGUS CIKAMPEK 2
6 AMO 4
7 ASIM 2
8 ATIKAH 1
9 AYU SUCIANTI 1
10 CECEP 4
11 DARTA TURI 1
12 DASEM 1
13 DEDE 3
14 DENI JAYA LEKSANA 4
15 DENI JAYALEKSANA 1
16 DINI ANDRIYANI 1
17 DODY 4
18 E NARSIM S 1
19 EDAH 1
20 ENAN 1
21 ENDANG 2
22 ENDI SUHENDI 1
23 IDA TM 1
24 IWAN TD
25 JAKA K 1
26 JENAL ABIDIN 1
27 JUJU 4
28 JUMSARI 8
29 JUNAEDI 3
30 KARTI 1
31 KENTING 1
32 KOSASIH 3
33 KOSIM 1
34 MA ELAH 4
35 MARYATI 1
36 MISLAN 1
37 NANO 5 4
38 NASIR 1
39 NURJAYA 1
40 OJOS 3
41 OMAT 1
42 OMIN 1
43 RAHMAT MG JAYA 1 1
44 RAINTA 1
45 RIKI 3
46 ROSIN 2
47 RT AJA 6
48 RT IMAN 8
49 RW EDO 1
50 SALAMAH 8
51 SALIM S 2 1
52 SANIN S 1
53 SANIN SASMITA 1
54 SARI 6
55 SOBLENG 1
56 SRI MAESAROH 1
57 SUWANDI 1
58 SYARIEF 4
59 TARSO 4
60 TINI 2
61 TOSIM 1 1
62 UJANG MULYANA 1
63 UJANG NURJAYA 1
64 UMAR 3
65 WAHID 1
66 WAKIL AKUNG 9
67 WANDA 8
68 YAYA 2
Jumlah Keterangan
Rp 50,000 PERIODE 25 MARET - 5 April 2022
1 RS Proklamasi RS Proklamasi 03/04/2022 Ny Neni Septiani
2 bd Intan C 01/4/2022 Ny yuyun
3 dr Poppi herawati PKM Ciampel 2/4/2022 Ny Siti Julaeha
4 dr M Judin Klinik Puri Asih 30/3/2022 Ny Yayah Nurliah
5 dr Dodi haryanto Klinik Andina 4/1/2022 Ny Rini Handayani
6 bd Erlis Gintungkebon 1/4/2022 Ny Anita
7 Poned Cikampek Poned Cikampek 3/24/2022 Ny Ileum
8 Poned Cikampek Poned Cikampek 3/25/2022 Ny Huzaipah
9 bd ani VK (Voucher 25.000) 3/27/2022 Ny maelatul
10 bd Titi 0856 9285 1484 3/28/2022 Ny wiwin
11 bd sri bd dewi 0857 7470 4355 29/3/202 Ny Priyani
12 bd Ernita Kotabaru (Voucher 50.000) 29/3/202 Ny Halah
13 bd yulia permatasari neglasari lemahduhur 4/5/2022 Ny Rika Ratna
14 klinik Zhafira zarifa Klinik zhafira zarifa 4/5/2022 Ny Uun Kurniasih
15 bd sri nyrhidayati klinik Navia 4/6/2022 Ny Wati
16 klinik aisah medika jarakah lemahduhur 3/30/2022 Ny Hana
17 klinik tempuran medika Tempuran 3/17/2022 An Aleya
18 bd Sri Hastuti Hendra 3/30/2022 Daryono
19 bd Nidaul Duren Klari 3/19/2022 Tri Joko
20 dr suseno H dapur Areng cengkong 3/31/2022 annisa
21 dr Enung Y Klinik Bhakti Medika 4/4/2022 fitriyani
22 dr Hermantoni klinik Nur Asy syifa 4/1/2022 Ganda
23 dr Hermantoni klinik Nur Asy syifa 4/3/2022 Tasya
24 dr Rita B Klinik Yafi Medika, Pedes 3/31/2022 sahroi
25 dr Asep Klinik Yafi Medika, Pedes 4/3/2022 Sri Rahayu
26 dr Irma Nur PKM Cilamaya 3/27/2022 Tuti Susana
27 dr Astri Lovita PKM Balongsari 3/22/2022 tarmah
28 dr annisa yulia Klinik Fikri medika u070 3/18/2022 syavilla ekya
311793 BPJS PN Rp 50,000
311706 BPJS PN Rp 50,000
311759 BPJS Kuret Rp 50,000
295284 BPJS SC Rp 100,000
231926 BPJS SC Rp 100,000
311154 BPJS PN Rp 50,000
311157 BPJS SC Rp 100,000
297657 asuransi SC Rp 575,000
311311 BPJS SC Rp 100,000
311454 BPJS SC Rp 100,000
311463 BPJS SC Rp 50,000
311935 BPJS SC Rp 100,000
312038 BPJS kuret Rp 50,000
311513 BPJS Rawat Rp 25,000
alamat Nama PSM no telp nama pasien RANAP no Mr KATARAK
1 ABAY 2 50000
2 ADANG RUSMANA 1 25000
3 ADANG SINDANG MULYA 1 0
4 AGAS 6 150000
5 AGUS 3 75000
6 AJE 1 0
7 AMO 2 50000
8 ARPIN HIDAYAT 1 25000
9 ATA BANCIN 5 125000
10 ATIKAH 2 50000
11 AYU LESTARI 3 75000
12 AYU SUCIYANTI 1 25000
13 BENI 1 0
14 BOBI 2 50000
15 CASMITA 1 25000
16 CECEP 3 75000
17 D SALEH 4 100000
18 DANA MAHESA 1 25000
19 DARTA TURI 1 25000
20 DEDE 2 0
21 DENI 1 25000
22 DIDI ISKANDAR 2 50000
23 DODY 3 75000
24 EJANG 2 50000
25 EKA BAGYA 2 50000
26 ENAN 4 100000
27 ENDANG 2 50000
28 EWING 2 50000
29 GIRI S 1 25000
30 HARUN H 1 25000
31 HASAN BASRI 2 50000
32 HENDI F 1 25000
33 HERI KUSAERI 2 50000
34 HERU 1 25000
35 IDA 1 1 25000
36 IWAN TD 1 25000
37 JAJANG 2 50000
38 JAKA KOMARA 1 25000
39 JENAL ABIDIN 1 25000
40 JUJU 3 75000
41 JUMSARI 16 400000
42 JUNAEDI 1 0
43 KARNI 1 25000
44 KARTI 1 25000
45 KARYA SUNARYA 1 25000
46 KASIH 1 25000
47 KENTING 3 75000
48 KUBIL (4.864) 0
49 LUDI HERMAWAN 1 25000
50 MA AYAT 11 275000
51 MA ELAH 10 250000
52 MA ENENG 1 25000
53 MAAN 1 0
54 MADIMAN 1 25000
55 MARYATI 1 25000
56 MESIN 2 0
57 MULYADI/DAMONG 1 25000
58 NANANG 2 0
59 NANO 5 3 125000
60 NASIR 5 125000
61 NAWANGSIH 2 50000
62 NENI 3 75000
63 NINA 2 50000
64 NURSIFA 1 25000
65 ODANG 2 50000
66 OJOS 2 50000
67 OMAT 8 1 200000
68 RADITA 2 1 50000
69 RHENO 5 125000
70 RIKI (1.805+10.137+787) 13 325000
71 ROHMAN 1 25000
72 ROMLI 1 25000
73 ROSIN 2 50000
74 RT AJA 5 125000
75 RT BUDI (10.037) 2 50000
76 RT IMAN 6 150000
77 RUSPAN 1 25000
78 RW EDO 6 150000
79 SAHRUDIN 1 25000
80 SALAMAH 3 1 75000
81 SARI (4.433+773) 11 275000
82 SOBLENG 6 150000
83 SOBUR 1 25000
84 SRI MAESAROH 4 100000
85 SURYADI 1 25000
86 SUTARMAN 1 25000
87 SYARIEF 3 75000
88 TATANG 1 0
89 TATANG SOMANTRI 1 25000
90 TINI 5 125000
91 TOSIM 1 25000
92 UJANG NURJAYA 3 75000
93 WAKIL AKUNG (3.377) 8 200000
94 WANDA 2 50000
95 YANTO 1 25000
96 YAYA 4 100000
97 YOYO FIRMANSYAH 2 50000
98 YUNUS 1 25000
Jumlah Keterangan
Rp 50,000 PERIODE 5-20 April 2022
Rp 121,500 Rp 121,500 PERIODE 5-20 April 2022
nama
No Nama perujuk alamat no telp pasien MR
1 Kapus Anggadita PKM Anggadita
1 Dokter Anggadita PKM Anggadita
1 Pendaftaran Anggadita PKM Anggadita
2 Kapus Curug PKM Curug
2 Dokter Curug PKM Curug
2 Pendaftaran Curug PKM Curug
3 Kapus PKM Ciampel PKM Ciampel
3 Dokter PKM Ciampel PKM Ciampel
3 Pendaftaran PKM Ciampel PKM Ciampel
4 Kapus Klari PKM Klari
4 Dokter Klari PKM Klari
4 Pendaftaran Klari PKM Klari
5 Kapus Telagasari PKM Telagasari
5 Dokter Telagasari PKM Telagasari
5 Pendaftaran Telagasari PKM Telagasari
6 Kapus PKM Majalaya PKM Majalaya
6 Dokter PKM Majalaya PKM Majalaya
6 Pendaftaran PKM Majalaya PKM Majalaya
7 Kapus Lemah Abang PKM Lemah Abang
7 Dokter Lemah Abang PKM Lemah Abang
7 Pendaftaran Lemah Abang PKM Lemah Abang
8 Kapus PKM Lemah Duhur PKM Lemah Duhur
8 Dokter PKM Lemah Duhur PKM Lemah Duhur
8 Pendaftaran PKM Lemah Duhur PKM Lemah Duhur
9 Kapus PKM Rawamerta PKM Rawamerta
9 Dokter PKM Rawamerta PKM Rawamerta
9 Pendaftaran PKM Rawamerta PKM Rawamerta
10 Kapus PKM Tempuran PKM Tempuran
10 Dokter PKM Tempuran PKM Tempuran
10 Pendafatran PKM Tempuran PKM Tempuran
11 Kapus PKM Kertamukti PKM Kertamukti
11 Dokter PKM Kertamukti PKM Kertamukti
11 Pendaftaran PKM Kertamukti PKM Kertamukti
1 dr Nurlina
2 Klinik Amanda
3 Klinik Andina
4 Klinik Assalam
5 Klinik Aulia
6 Klinik Curug Rahayu
7 Klinik Dimas Medika
8 Klinik Dota Medika
9 Klinik Graha Medis Kopel
10 Klinik Graha Medis Kosambi
11 Klinik Harapan Baru
12 Klinik Kinasih
13 Klinik Kondang Medika
14 Klinik Mitra Sehat
15 Klinik Mustika
16 Klinik Nursepta
17 Klinik Puri Asih Kosambi
18 Klinik Sri Sukma
19 Klinik Telagasari
20 Klinik Vidya Medika
21 Klinik Zahira
22 Klinik Zhafira Zarifa
Fee Periode April 2022
No Nama perujuk alamat no telp
1 BD NELIS VILLA KARAWANGI
2 BD HJ NURHAYATI DARAWOLONG
3 BD SRI N KOSAMBI
4 BD N UNIRAH BALONGSARI RAWAMERTA
5 DR SISKA E KLINIK SITI AZARIA
6 dr abdul PKM PEDES
7 DR SITI HAMIDAH KLINIK DIMAS MEDIKA
8 BD RITA SUTANTRI KLINIK NURSEPTA
9 DR NURHUSEN KLINIK HASANAH WIJAYA
10 DR SISKA E KLINIK SITI AZARIA
11 M THARIQ KLINIK ASSALAM
12 M JUDIN KLINIK PURI ASIH KSB
13 DR ANGGA M KLINIK DARAWOLONG
14 BD SRI NURHIDAYATI KLINIK NAVIA
15 DR DWI INGGIANY DR DWI INGGIANY
16 BD NUNUNG KLINIK AL FATIH
17 DR ANGGA M KLINIK DARAWOLONG
18 DR KHRISMAWAN DR KHRISMAWAN
19 DR DIDING R PKM KUTAWALUYA
20 DR PURNA IRAWAN KLINIK ASSALAM
21 BD NILA PKM PACING
22 DR DIDING R PKM KUTAWALUYA
23 BD N UNIRAH BD N UNIRAH
24 BD NURHALIMAH CURUG CIMAHI
25 BD LINA ROSLINA DUREN
nama pasien MR keterangan Tindakan Jumlah
ISWATUN SOLIHAH 312039 ### KUR Rp 50,000
YENI WIDIA 306089 ### SC Rp 100,000
DEWI 312081 ### SC Rp 100,000
SITI JULAEHA 312086 ### SC Rp 100,000
ROH ULIYATI 274707 ### SC Rp 100,000
SITI ROHIMAH 312373 ### SC Rp 100,000
NENENG PARIDA 106655 ### SC Rp 100,000
MELI ANDAYANI 195118 ### SC Rp 100,000
ELIS 311568 ### KUR Rp 50,000
SITI MURMIYATI 312170 ### SC Rp 100,000
RATNA WATI 311943 ### SC Rp 100,000
ACAH HANDAYANI 007190 ### RAWATAN Rp 25,000
YOYOH 312228 ### RAWATAN Rp 25,000
DEWI 312081 ### SC Rp 100,000
ALISAH 0.81027 ### RAWATAN Rp 25,000
TATI 312474 ### SC Rp 100,000
ANITA L 158549 ### SC Rp 100,000
WARNI 151427 ### SC Rp 100,000
KARTIKA K 312434 ### SC Rp 100,000
ONASIH 310654 ### SC Rp 100,000
AI SULASTRI 312572 ### SC Rp 100,000
AISYAH 312642 ### SC Rp 100,000
DARTEM 228598 ### SC Rp 100,000
ACIH 312756 ### SC Rp 100,000
ACIH 198085 ### SC Rp 100,000
alamat Nama PSM no telp nama pasien RANAP no Mr KATARAK Jumlah
1 AAN IRAWAN 1 25000
2 ABAY 2 50000
3 ABDUL ROSYID 1 25000
4 ADANG SUTEJA 2 50000
5 AGAS 1 25000
6 AHMAD DAELAMI 2 50000
7 AHMAD R 1 25000
8 AMO 2 50000
10 AYU SUCIANTI 1 25000
11 BENI 1 75000
12 BOBI 1 75000
13 CASMITA 1 75000
14 CECEP 5 125000
15 D SALEH 1 25000
16 DAREM 1 75000
18 DEDE 2 150000
19 DENI JAYA L 2 50000
20 DODY 3 75000
21 E NARSIM S 3 75000
22 EJANG 1 25000
23 ENAN 2 50000
24 ENDANG 5 125000
25 ENDANG KHAERUDIN 1 25000
27 IWAN TD 1 25000
28 JAKA K 1 25000
29 JUJU 5 125000
30 JUMSARI 3 75000
31 JUNAEDI 1 75000
32 KASMAN 3 75000
33 KOSASIH 2 50000
34 MA ELAH 9 225000
35 MA ENENG 2 50000
36 MAAN 1 75000
37 MESIN 1 75000
38 MISLAN 1 25000
39 NANO 3 3 300000
40 NASIR 3 75000
42 NENENG 1 75000
43 NURJAYA WIJAYA 2 50000
44 NURSIFA 3 75000
45 ODANG 5 125000
46 OJOS 1 25000
47 OMAT 1 75000
48 RADITA 1 25000
49 RANIN 1 75000
50 RIKI 2 50000
51 ROHIM 1 25000
52 ROSIDIN 1 25000
53 ROSIN 3 75000
54 RT AJA 4 100000
55 RT IMAN 1 25000
56 RW EDO 1 25000
57 SAHRUDIN 1 25000
58 SALAMAH 4 1 175000
59 SARI 4 100000
60 SARI 1 25000
61 SOBLENG (1.076) 27000
62 SRI ISDI 2 50000
63 SUKARDI 1 1 100000
64 SULAEMAN 3 75000
65 SUWANDI 1 25000
66 SYARIEF 3 75000
67 TINI 3 75000
68 TOSIM (1.058) 1 51500
69 WAKIL AKUNG 4 100000
Keterangan
PERIODE 21 April - 3 mei 2022
1 BD YULIA PERMATASARI NEGLASARI LEMAH DUHUR DINA R
2 BD DIAN ANISA DUREN SANTI
3 BD YULIA DEWI
4 BD NIDAUL DUREN KLARI ADE Y
5 BD SRI HASTUTI INARA
6 BD INA PUTRIANA GRIYA PANORAMA INDAH PURWASARI SYIFA
7 BD HJ NURHAYATI DARAWOLONG IDAH SITI
8 BD HJ NURHAYATI DARAWOLONG AAN MINTAR
9 BD HJ NURHAYATI DARAWOLONG MIA JUMIATUN
10 BD SRI NURHIDAYATI KOSAMBI DIANE
11 BD SRI NURHIDAYATI KOSAMBI ISMAYANTI
12 DR AGUNG KLINIK ANABI PANI
13 DR SRI HARTOYO KLINIK BHAKTI MEDIKA MIMIN M
14 DR ANGGA KLINIK DARAWOLONG NURLELA
15 DR ANGGA KLINIK DARAWOLONG DHEFIN
16 DR ANGGA KLINIK DARAWOLONG LISNAWATI
17 DR TASWAN KLINIK DOTA MEDIKA SINTIA
18 DR RAHMATIKA KLINIK NABILA SAKEB
19 DR FALIA KLINIK SYAMIL MEDICAL ANDINI
20 DR ASEP SUPRIATNA KLINIK TEMPURAN MEDIKA JULAEHA
21 BD HJ SOFIATUN KLINIK ZAHIRA FAJRI SAIBAH
22 DR HJ FATIMAH PKM KOTABARU WAHYU SUB
23 PKM RAWAMERTA PKM RAWAMERTA BANDIYAH
24 DR NIDIA AFRAH PKM PURWASARI NATI
25 DR ANITA P PKM PAKISJAYA TASINAH
26 DR SUTARDI PKM RAWAMERTA SARIMANAH
27 DR ABDUL KODIR PKM PEDES MARYAM
254879 4/24/2022 PN Rp 50,000
4/22/2022 -
179169 4/22/2022 PN Rp 50,000
4/21/2022 RAWATAN Rp 25,000
245203 4/16/2022 RAWATAN Rp 25,000
276382 4/30/2022 PN Rp 50,000
313404 4/30/2022 KUR Rp 50,000
313161 4/25/2022 SC Rp 100,000
313408 4/30/2022 PN Rp 50,000
313367 4/29/2022 SC Rp 100,000
179186 31/4/2022 SC Rp 100,000
312399 4/13/2022 RAWATAN Rp 25,000
312964 4/22/2022 RAWATAN Rp 25,000
175000 4/19/2022 RAWATAN Rp 25,000
272819 4/17/2022 RAWATAN Rp 25,000
310768 5/2/2022 RAWATAN Rp 25,000
312594 4/18/2022 PN Rp 50,000
287429 4/19/2022 RAWATAN Rp 25,000
312382 4/13/2022 RAWATAN Rp 25,000
304337 4/12/2022 RAWATAN Rp 25,000
4/25/2022 PN Rp 50,000
313440 5/1/2022 PN Rp 50,000
313218 4/26/2022 SC Rp 100,000
312963 4/22/2022 SC Rp 100,000
264417 4/18/2022 RAWATAN Rp 25,000
094968 4/19/2022 SC Rp 100,000
312383 4/13/2022 SC Rp 100,000
ABAY (5.560 & 3.874
1 & 5.954) 14 734500
2 ABDUL ROSID 2 50000
3 ADANG SUTEJA 1 25000
4 AGAS 3 75000
5 AGUS CIKAMPEK 2 50000
6 AHMAD DAELAMI 2 50000
7 AJE 1 25000
8 AMIN CIBAL 7 175000
9 AMO 8 200000
10 APANDI 1 25000
12 ATEM 2 50000
13 ATIKAH 1 25000
14 AYU LESTARI 1 25000
15 AYU SUCIANTI 3 75000
16 BAH DADI 5 125000
17 BOBI 2 50000
18 CASMITA 1 25000
19 CECEP 3 75000
20 D SALEH 5 125000
21 DARSAM 3 75000
23 DEDE ANWAR 4 100000
24 DEDE SUPRIATNA 1 25000
25 DENI JAYA L 5 125000
26 DINI ANDRIYANI 1 25000
27 DODY (6.946) 9 398500
28 E NARSIM S 1 25000
29 EBENLI 2 50000
30 EKA BAGYA 1 25000
31 ENAN 11 275000
32 ENDANG 10 1 325000
33 EWING 3 75000
34 HERI ISKANDAR 1 25000
36 HERI SUMARNA 1 25000
37 ICONG 4 100000
38 IDA 2 50000
39 ITA 1 25000
40 IWAN TD 5 125000
41 JAJANG (11.429) 3 360500
42 JAKA KOMARA 4 100000
43 JENAL ABIDIN 1 25000
44 JUJNAEDI 1 75000
45 JUJU J 16 400000
46 JUMSARI 34 850000
47 JUNAEDI 1 75000
48 KARTI 2 50000
49 KASMAN 1 25000
50 KOSASIH 4 100000
51 KOSIM SUHARI 7 175000
52 LUDI HERMAWAN 2 50000
53 MA ELAH 17 425000
54 MA ENENG 2 50000
55 MAHRUDIN 1 25000
56 MISJU 1 25000
57 MISLAN 4 100000
58 NANO (7197) 3 255000
59 NASIR 2 50000
61 NENI 11 275000
62 NINA 1 25000
63 NURASIH 2 50000
64 NURSIFA 3 75000
65 ODANG 3 75000
66 OJOS 4 100000
67 OMPONG 5 125000
68 RADITA 2 50000
69 RASIH 1 25000
70 RIKI 11 275000
71 ROHAYATI 1 25000
72 ROMLI 2 50000
73 ROSIDIN (11.077) 252000
74 ROSIN 6 150000
75 ROWI Z 1 25000
76 RT AJA 6 150000
77 RT BUDI 11 275000
78 RT IMAN 7 175000
79 RT NURDIN 1 75000
80 SAHRUDIN 5 125000
81 SAI MUSTOPA 2 50000
82 SALAMAH 14 350000
83 SALIM S 4 100000
84 SAMSUDIN 1 25000
85 SARI (3.514 & 6.667) 12 554500
86 SITI KURNAESIH 2 50000
87 SOBARI 1 25000
88 SOBLENG (10.102) 8 400500
89 SRI ISDI 1 25000
91 SUHERMAN 2 50000
92 SUKARDI 3 75000
93 SURAHMAN 1 25000
94 SURTADI 1 25000
95 SURYADI 2 50000
96 suwandi (13.419) 310500
97 SYARIEF 6 150000
98 TARMEDI 1 25000
99 TATA 1 25000
100 TATANG 1 25000
101 TINI 2 50000
102 TOSIM (5.589) 10 338500
103 UDIN S 1 25000
104 UPAY 2 50000
105 WAHYUDI 1 25000
107 WANDA 2 50000
108 WANTA WADIMAN 4 100000
109 WIWIN H (3.906) 19 572500
110 YAYA 1 25000
111 YAYA 3 75000
Keterangan
PERIODE 4-26 MEI 2022

1 Bd yulia permatsari Lemahduhur Ny Ratnasari
2 Dr Asep Riansyah Pasir panjang Ny Eti nurhayati
3 Puskesmas Cikampek Puskesmas Cikampek Ny Hindun
4 Klinik Assalam Cengkong Dian febrianti
5 Klinik Nursepta Purwasari Iis istoqomah
6 Bd hj carnah Majalaya Ny merry
7 ny dasem
8 Dr Asep Riansyah Pasir panjang Azzizah
9 Bd Titin Fatimah Dayeuhluhur Ny Sri rahayu
10 Bd Dian anisa juniar Perum puri kosambi 2 Ny Ayu
11 Bd hj Nurhayati Purwasari Ny Siska oktaviani
12 Klinik Nursepta Purwasari Ny neneng
13 Puskesmas Cikampek Cikampek Ny Ainun
14 Bd Yani Ny midah
15 Bd Elin herlina Purwasari kp.pedes Ny Peni rahayu
16 Puskesmas Rawamerta puskesmas Rawamerta Ny Siti kodariah
17 Puskesmas Telagasari puskesmas Telagasari Ny Nira Suryani
18 bd lina roslina klari safitri ?
19 Bd Yayat H Purwasari Ny Dahlia
20 Pkm Rawamerta Poned pkm rawamerta Ny Devi chertini
21 Bd Titin fatimah Dayeuh luhur Ny latipah N
22 Bd Wiwit supriati perum terangsari Ny siti n
23 Bd Rosidah perum trully pws estate Ny wida putri
24 Bd eva susanti perum grand mutiara Ny iim rohimah 231962
25 Bd N unairah rawamerta Ny rini 013445
26 dr chandra kli darawolong usg gratis wulan 314674
27 hj st sofiyatun kli zahira Ny cicih 314675
28 bd nita Lia 313410
29 Bd iyos rosmala cimahi klari Ny suryani
30 Bd yulia permatsari Neglasari lemah duhur Ny ika
31 Bd Tati lestari Ny uwon ?
32 Puskesmas Tempuran Tempuran Ny ice trisnawati ?
33 bd casinih syarif barubug jatisari Ny aan
34 dr devi Puskesmas Telagasari Nomih 313698
35 dr arifin klinik curug rahayu Kartika 179669
36 dr devi navia Puskesmas telagasari Neneng 304608
37 dr heni yulia Klinik puri rahayu, puri kosambi 1 ny sin 204455
38 Klinik Tempuran medika Tempuran Kenan januar 306604
39 Bd siti maryam dsn ciranggon moch fadlan 313398
40 Bd Dian anisa juniar Puri kosambi 2 Ny sondang 96629
41 Klinik pratama al-huda cilamaya wetan Ny keni 313452
42 dr haerudin PKM Pasirukem Rini 227606
43 Klinik Nur asy-syfa Pancawati Ano s 275367
44 Klinik Jatisari klinik jatisari Sinta Apsari 313168
45 dr fenny aliska Klinik kimia farma Hafizhan abqory 259236
46 dr rinaldi Klinik fikri medika Lilis irmawati 311082
47 Klinik assalam Pancawati 179880
48 Klinik assalam Pancawati Aldo 295415
49 klinik curug rahayu curug Dian putri lestari ?
50 Klinik Dimas medika Tamelang Gibran al khair 313376
51 dr gina noviana Klinik graha medis ksb Bintoro sandi legowo 52355
52 dr heppy yhos Klinik graha medis kopel Ardika septian 211916
53 dr vina Klinik graha medis ksb ismail 153285
54 dr vina Klinik graha medis ksb Gilang gustomi 313416
55 dr moh arif Klinik graha medis ksb lazuardi
56 dr gina noviana Klinik graha medis ksb Nathan agatha 289792
57 dr ririn kli kinasih Bintang satriyo d 168074
58 dr dimaz kli mustika Safiah azahra f 313559
59 dr meutia kli mitra sehat Kirana ikmalia callista 296668
60 dr reza i Klinik Mitra sehat Wafiq rihadatul aisya 157537
61 dr purna irawan klinik purwa medika Abidah 313050
62 Klinik vidya medika kalen aren Tempuran Riadira 313472
63 Klinik Telagasari Klinik Telagasari kelia 306064
64 Klinik Telagasari Klinik Telagasari Roby 205576
65 Klinik Telagasari Klinik Telagasari Giovani sigemma 299558
66 Klinik Telagasari Klinik Telagasari Nasliza azizah 313373
67 dr h wahyudin Puskesmas Tempuran Rohim 312975
68 dr tian puskesmas ciampel m.aprizal 313134
69 dr nidia puskesmas purwasari Eti 237674
70 puskesmas purwasari puskesmas purwasari Anggi anggraeni 307201
71 Bdn.Rita Klinik Nursepta Ny.Hastuti 312763
72 dr.AG Aang Klinik Aulia Ny.Sarmi 312809
73 Bdn.Tria Klinik Graha Medis Ksb Ny.Nengsih 305391
74 dr.Meutia Klinik Mitra Sehat Ny.Suci 250432
75 dr.Ana Permata S Klinik Puri asih Ksb Ny.Desy 296324
76 Bdn Umi Yukmini Klinik Nur Annisa Ny.St Nurhalimah 312949
77 Klinik Tempuran Kli Tempuran Medika Ny.Laela 313166
78 dr.Tian Gustiani PKM Ciampel Ny.Titin Maryani 277963
79 dr.Bobzi Klinik Zahira Ny.Maryatin 196845
80 Bdn.Tria Klinik Graha Medis Ksb Ny.Nurhalimah 296129
81 Bdn.Tria Klinik Graha Medis Ksb Ny.Titin Koswati 313249
82 dr.Natasya Klinik Azzahra Ny.Sri Hartini 313339
83 dr.Sutardi PKM Rawamerta Ny.Tita Rosita 313427
84 dr.Dudi Humaedi PKM Telagasari Ny.Sri Puspa P 313413
85 Bdn Nok Rina Klinik Sri Sukma Ny.Itar Sutarsih 93417
86 dr.Sutardi PKM Rawamerta Ny.Imas Masuroh 269025
87 Bdn Annisa R Klinik Fikri Medika Ny.Eka Septiani 36842
88 dr.Meutia Klinik Mitra Sehat Ny.Ratna Ningsih 150568
89 dr.Devi Navindari PKM Telagasari Ny.Rosidah 223628
90 dr.M Judin Klinik Puri Asih Ksb Ny.Acah Handayani 7190
91 dr.Taswan S Klinik Dota Medika Ny.Wanti Wijianti 314040
92 dr.M Judin Klinik Puri Asih Ksb Ny.Siti Nurjanah 314036
93 dr.Emin Nuriman Klinik Telagasari Ny.Maria Ulfa 314135
94 dr.M Judin Klinik Puri Asih Ksb Ny.Ratnasari 314140
95 dr.Wahyudin PKM Tempuran Ny.Cawi 145498
96 dr.Budi S PKM Curug Ny.Fitri Sulastri 256810
97 dr. Tian Gustiani PKM Ciampel Ny.Nining 314217
98 dr.Devi Navindari PKM Telagasari Ny.Rastini 314248
99 Bdn Tria Rahma Klinik Graha Medis Ksb Ny.Tina Anjeli 123225
100 Bdn.Jeannie PONED CIAMPEL Ny.Cami 272861
101 dr.Rinaldi Klinik Fikri Medica Ny.Windi 314538
102 dr.Arya Wibawa Klinik Purwa Medica Ny.Desiana 157302
103 Bdn.Lastriati Klinik Zhafira Zarifa Ny.Aulia 314774
104 Bdn.Rafika Klinik Graha Medis Ny.Intan Permatasari 221443
105 dr.Sutardi PKM Rawamerta Ny.Tarsih 260777
106 dr.Farida PKM Majalaya Ny.Dewi Nurfauziah 314843
5-May-22 Rawatan Rp 25,000 85717484334
4-May-22 SC Rp 100,000 85781977772
4-May-22 SC Rp 100,000
4-May-22 PN Rp 50,000
6-May-22 SC Rp 100,000
6-May-22 PN Rp 50,000
PN Rp 50,000
9-May-22 Rawatan Rp 25,000
9-May-22 SC Rp 100,000 85814213118
10-May-22 SC Rp 100,000
9-May-22 SC Rp 100,000
8-May-22 Rawatan -
6-May-22 SC Rp 100,000
10-May-22 SC Rp 100,000
7-May-22 SC Rp 100,000
10-May-22 SC Rp 100,000
22-May-22 SC Rp 100,000
21-May-22 SC Rp 100,000
21-May-22 sc Rp 100,000
19-May-22 sc Rp 100,000 0812 9641 5717
17-May-22 rawatan Rp 25,000 085748226006
16-May-22 sc Rp 100,000
19-May-22 pn Rp 50,000
14-May-22 SC Rp 100,000
29-Apr-22 PN Rp 50,000
15-May-22 sc Rp 100,000 0857 1748 4334
14-May-22 SC Rp 100,000
15-May-22 Kur Rp 50,000
15-May-22 SC Rp 100,000 089513355177
7-May-22 sc Rp 100,000
9-May-22 sc Rp 100,000
29-Mar-22 sc Rp 100,000
26-Apr-22 Rawatan Rp 25,000
29-Apr-22 Rawatan Rp 25,000 0896 4718 1102
2-Apr-22 Rawatan Rp 25,000 0815 958 3601
23-Apr-22 Rawatan Rp 25,000 0812 8627 4999
9-Apr-22 SC Rp 100,000
5-May-22 SC Rp 100,000
24-Apr-22 PN Rp 50,000
2-Apr-22 rawatan Rp 25,000
Rawatan Rp 25,000 0813 8061 8928
25-Apr-22 SC Rp 100,000
4/20/2022 SC Rp 100,000
4/21/2022 Rawatan Rp 25,000
4/23/2022 SC Rp 100,000
4/23/2022 SC Rp 100,000
4/23/2022 SC Rp 100,000
4/23/2022 Rawatan Rp 25,000
4/25/2022 Curetase Rp 50,000
4/26/2022 P.Penyulit Rp 50,000
4/26/2022 Rawatan Rp 25,000
4/27/2022 SC Rp 100,000
4/27/2022 SC Rp 100,000
4/28/2022 Rawatan Rp 25,000
4/30/2022 Rawatan Rp 25,000
4/30/2022 Rawatan Rp 25,000
4/4/2022 SC Rp 100,000
5/5/2022 SC Rp 100,000
5/5/2022 SC Rp 100,000
5/5/2022 Rawatan Rp 25,000
5/11/2022 SC Rp 100,000
5/11/2022 SC Rp 100,000
5/11/2022 SC Rp 100,000
5/11/2022 SC Rp 100,000
5/12/2022 SC Rp 100,000
5/12/2022 SC Rp 100,000
5/13/2022 Rawatan Rp 25,000
5/13/2022 SC Rp 100,000
5/13/2022 SC Rp 100,000
5/13/2022 SC Rp 100,000
5/11/2022 SC Rp 100,000
5/17/2022 SC Rp 100,000
5/17/2022 SC Rp 100,000
5/17/2022 Rawatan Rp 25,000
5/20/2022 SC Rp 100,000
5/20/2022 SC Rp 100,000
5/20/2022 SC Rp 100,000
5/21/2022 Curetase Rp 50,000
Rp 6,550,000
1 Bd yulia permatsari Lemahduhur Ny Ratnasari
2 Dr Asep Riansyah Pasir panjang Ny Eti nurhayati
3 Puskesmas Cikampek Puskesmas Cikampek Ny Hindun
4 Klinik Assalam Cengkong Dian febrianti
5 Klinik Nursepta Purwasari Iis istoqomah
6 Bd hj carnah Majalaya Ny merry
7 ny dasem
8 Dr Asep Riansyah Pasir panjang Azzizah
9 Bd Titin Fatimah Dayeuhluhur Ny Sri rahayu
10 Bd Dian anisa juniar Perum puri kosambi 2 Ny Ayu
11 Bd hj Nurhayati Purwasari Ny Siska oktaviani
12 Klinik Nursepta Purwasari Ny neneng
13 Puskesmas Cikampek Cikampek Ny Ainun
14 Bd Yani Ny midah
15 Bd Elin herlina Purwasari kp.pedes Ny Peni rahayu
16 Puskesmas Rawamerta puskesmas Rawamerta Ny Siti kodariah
17 Puskesmas Telagasari puskesmas Telagasari Ny Nira Suryani
18 bd lina roslina klari safitri ?
19 Bd Yayat H Purwasari Ny Dahlia
20 Pkm Rawamerta Poned pkm rawamerta Ny Devi chertini
21 Bd Titin fatimah Dayeuh luhur Ny latipah N
22 Bd Wiwit supriati perum terangsari Ny siti n
23 Bd Rosidah perum trully pws estate Ny wida putri
24 Bd eva susanti perum grand mutiara Ny iim rohimah 231962
25 Bd N unairah rawamerta Ny rini 013445
26 dr chandra kli darawolong usg gratis wulan 314674
27 hj st sofiyatun kli zahira Ny cicih 314675
28 bd nita Lia 313410
29 Bd iyos rosmala cimahi klari Ny suryani
30 Bd yulia permatsari Neglasari lemah duhur Ny ika
31 Bd Tati lestari Ny uwon ?
32 Puskesmas Tempuran Tempuran Ny ice trisnawati ?
33 bd casinih syarif barubug jatisari Ny aan
34 dr devi Puskesmas Telagasari Nomih 313698
35 dr arifin klinik curug rahayu Kartika 179669
36 dr devi navia Puskesmas telagasari Neneng 304608
37 dr heni yulia Klinik puri rahayu, puri kosambi 1 ny sin 204455
38 Klinik Tempuran medika Tempuran Kenan januar 306604
39 Bd siti maryam dsn ciranggon moch fadlan 313398
40 Bd Dian anisa juniar Puri kosambi 2 Ny sondang 96629
41 Klinik pratama al-huda cilamaya wetan Ny keni 313452
42 dr haerudin PKM Pasirukem Rini 227606
43 Klinik Nur asy-syfa Pancawati Ano s 275367
44 Klinik Jatisari klinik jatisari Sinta Apsari 313168
45 dr fenny aliska Klinik kimia farma Hafizhan abqory 259236
46 dr rinaldi Klinik fikri medika Lilis irmawati 311082
47 Klinik assalam Pancawati 179880
48 Klinik assalam Pancawati Aldo 295415
49 klinik curug rahayu curug Dian putri lestari ?
50 Klinik Dimas medika Tamelang Gibran al khair 313376
51 dr gina noviana Klinik graha medis ksb Bintoro sandi legowo 52355
52 dr heppy yhos Klinik graha medis kopel Ardika septian 211916
53 dr vina Klinik graha medis ksb ismail 153285
54 dr vina Klinik graha medis ksb Gilang gustomi 313416
55 dr moh arif Klinik graha medis ksb lazuardi
56 dr gina noviana Klinik graha medis ksb Nathan agatha 289792
57 dr ririn kli kinasih Bintang satriyo d 168074
58 dr dimaz kli mustika Safiah azahra f 313559
59 dr meutia kli mitra sehat Kirana ikmalia callista 296668
60 dr reza i Klinik Mitra sehat Wafiq rihadatul aisya 157537
61 dr purna irawan klinik purwa medika Abidah 313050
62 Klinik vidya medika kalen aren Tempuran Riadira 313472
63 Klinik Telagasari Klinik Telagasari kelia 306064
64 Klinik Telagasari Klinik Telagasari Roby 205576
65 Klinik Telagasari Klinik Telagasari Giovani sigemma 299558
66 Klinik Telagasari Klinik Telagasari Nasliza azizah 313373
67 dr h wahyudin Puskesmas Tempuran Rohim 312975
68 dr tian puskesmas ciampel m.aprizal 313134
69 dr nidia puskesmas purwasari Eti 237674
70 puskesmas purwasari puskesmas purwasari Anggi anggraeni 307201
71 Bdn.Rita Klinik Nursepta Ny.Hastuti 312763
72 dr.AG Aang Klinik Aulia Ny.Sarmi 312809
73 Bdn.Tria Klinik Graha Medis Ksb Ny.Nengsih 305391
74 dr.Meutia Klinik Mitra Sehat Ny.Suci 250432
75 dr.Ana Permata S Klinik Puri asih Ksb Ny.Desy 296324
76 Bdn Umi Yukmini Klinik Nur Annisa Ny.St Nurhalimah 312949
77 Klinik Tempuran Kli Tempuran Medika Ny.Laela 313166
78 dr.Tian Gustiani PKM Ciampel Ny.Titin Maryani 277963
79 dr.Bobzi Klinik Zahira Ny.Maryatin 196845
80 Bdn.Tria Klinik Graha Medis Ksb Ny.Nurhalimah 296129
81 Bdn.Tria Klinik Graha Medis Ksb Ny.Titin Koswati 313249
82 dr.Natasya Klinik Azzahra Ny.Sri Hartini 313339
83 dr.Sutardi PKM Rawamerta Ny.Tita Rosita 313427
84 dr.Dudi Humaedi PKM Telagasari Ny.Sri Puspa P 313413
85 Bdn Nok Rina Klinik Sri Sukma Ny.Itar Sutarsih 93417
86 dr.Sutardi PKM Rawamerta Ny.Imas Masuroh 269025
87 Bdn Annisa R Klinik Fikri Medika Ny.Eka Septiani 36842
88 dr.Meutia Klinik Mitra Sehat Ny.Ratna Ningsih 150568
89 dr.Devi Navindari PKM Telagasari Ny.Rosidah 223628
90 dr.M Judin Klinik Puri Asih Ksb Ny.Acah Handayani 7190
91 dr.Taswan S Klinik Dota Medika Ny.Wanti Wijianti 314040
92 dr.M Judin Klinik Puri Asih Ksb Ny.Siti Nurjanah 314036
93 dr.Emin Nuriman Klinik Telagasari Ny.Maria Ulfa 314135
94 dr.M Judin Klinik Puri Asih Ksb Ny.Ratnasari 314140
95 dr.Wahyudin PKM Tempuran Ny.Cawi 145498
96 dr.Budi S PKM Curug Ny.Fitri Sulastri 256810
97 dr. Tian Gustiani PKM Ciampel Ny.Nining 314217
98 dr.Devi Navindari PKM Telagasari Ny.Rastini 314248
99 Bdn Tria Rahma Klinik Graha Medis Ksb Ny.Tina Anjeli 123225
100 Bdn.Jeannie PONED CIAMPEL Ny.Cami 272861
101 dr.Rinaldi Klinik Fikri Medica Ny.Windi 314538
102 dr.Arya Wibawa Klinik Purwa Medica Ny.Desiana 157302
103 Bdn.Lastriati Klinik Zhafira Zarifa Ny.Aulia 314774
104 Bdn.Rafika Klinik Graha Medis Ny.Intan Permatasari 221443
105 dr.Sutardi PKM Rawamerta Ny.Tarsih 260777
106 dr.Farida PKM Majalaya Ny.Dewi Nurfauziah 314843
5-May-22 Rawatan Rp 25,000 85717484334
4-May-22 SC Rp 100,000 85781977772
4-May-22 SC Rp 100,000
4-May-22 PN Rp 50,000
6-May-22 SC Rp 100,000
6-May-22 PN Rp 50,000
PN Rp 50,000
9-May-22 SC Rp 100,000 85814213118
10-May-22 SC Rp 100,000
9-May-22 SC Rp 100,000
8-May-22 Rawatan -
6-May-22 SC Rp 100,000
10-May-22 SC Rp 100,000
7-May-22 SC Rp 100,000
10-May-22 SC Rp 100,000
22-May-22 SC Rp 100,000
21-May-22 SC Rp 100,000
21-May-22 sc Rp 100,000
19-May-22 sc Rp 100,000 0812 9641 5717
17-May-22 rawatan Rp 25,000 085748226006
16-May-22 sc Rp 100,000
19-May-22 pn Rp 50,000
14-May-22 SC Rp 100,000
29-Apr-22 PN Rp 50,000
15-May-22 sc Rp 100,000 0857 1748 4334
14-May-22 SC Rp 100,000
15-May-22 Kur Rp 50,000
15-May-22 SC Rp 100,000 089513355177
7-May-22 sc Rp 100,000
9-May-22 sc Rp 100,000
29-Mar-22 sc Rp 100,000
29-Apr-22 Rawatan Rp 25,000 0896 4718 1102
2-Apr-22 Rawatan Rp 25,000 0815 958 3601
23-Apr-22 Rawatan Rp 25,000 0812 8627 4999
9-Apr-22 SC Rp 100,000
5-May-22 SC Rp 100,000
24-Apr-22 PN Rp 50,000
2-Apr-22 rawatan Rp 25,000
Rawatan Rp 25,000 0813 8061 8928
25-Apr-22 SC Rp 100,000
4/20/2022 SC Rp 100,000
4/21/2022 Rawatan Rp 25,000
4/23/2022 SC Rp 100,000
4/23/2022 SC Rp 100,000
4/23/2022 SC Rp 100,000
4/23/2022 Rawatan Rp 25,000
4/25/2022 Curetase Rp 50,000
4/26/2022 P.Penyulit Rp 50,000
4/26/2022 Rawatan Rp 25,000
4/27/2022 SC Rp 100,000
4/27/2022 SC Rp 100,000
4/28/2022 Rawatan Rp 25,000
4/30/2022 Rawatan Rp 25,000
4/30/2022 Rawatan Rp 25,000
4/4/2022 SC Rp 100,000
5/5/2022 SC Rp 100,000
5/5/2022 SC Rp 100,000
5/5/2022 Rawatan Rp 25,000
5/11/2022 SC Rp 100,000
5/11/2022 SC Rp 100,000
5/11/2022 SC Rp 100,000
5/11/2022 SC Rp 100,000
5/12/2022 SC Rp 100,000
5/12/2022 SC Rp 100,000
5/13/2022 Rawatan Rp 25,000
5/13/2022 SC Rp 100,000
5/13/2022 SC Rp 100,000
5/13/2022 SC Rp 100,000
5/11/2022 SC Rp 100,000
5/17/2022 SC Rp 100,000
5/17/2022 SC Rp 100,000
5/17/2022 Rawatan Rp 25,000
5/20/2022 SC Rp 100,000
5/20/2022 SC Rp 100,000
5/20/2022 SC Rp 100,000
5/21/2022 Curetase Rp 50,000
Rp 6,550,000
No
Nama perujuk alamat no telp nama pasien MR
1 Bdn Wulanda PKM Ciampel Ny.Yanah 111369
2 Dr.Sutardi PKM Rawamerta Ny.Pebya Elvandari 315206
3- PURWASARI Ny.Siti Labibah 315288
4 Bdn Febi Dwi PKM Curug Ny.Dewi Fitriani 315277
5 Dr.Dodi Klinik Andina Ny.Vivit Novitasari 173432
6 Bdn Tria Rahmawati Klinik Graha Medis Ny.Tria Marida 117108
7 dr Dara Klinik Mustika Ny Tati Hartati 85143
8 dr.Evi Purwati Klinik Kondang Medica Ny.Kartini 315285
9 dr.Bhakti Wiranti Klinik Safira Medika Ny.Ana Oktavia 217641
10 dr.Diding PKM Kutawaluya Ny.Iyoh 315744
11 Bdn Ina Handayanti Pasir Buah Ny.Siti Kusmayanti 315735
12 dr.Yutini Kurnia PKM Pacing Ny.Lia 296042
13 Bdn Teti Rostika Klinik aster Ny.Teti Sitatun 315837
14 dr.Sutardi PKM Rawamerta Ny.Sari 315795
15 dr.Melitha Fathia Klinik Mitra Sehat Ny.Sri Astuti 290837
16 dr.Aang Klinik Aulia Ny.Sulastri 315827
17 dr.Ade Surjeli PKM Lemah abang Ny.Yeyen 260277
18 Bdn Pocut Slanga Klinik Zhafira Zarifa Ny.Indar Ariliawati 273677
19 dr.Astri Lovita PKM Balongsari Ny.Dea Suryadi 315902
20 BDd hj yayat PURWASARI nurleni 315960
21 bd Lina Roslina kosmbi duren siti tias 177807
22 bd Lina Roslina kosmbi duren holipah 315231
23 bd nurhayati indri 315217
24 bd nidaul duren tanti 142455
25 bd irka klinik musytasyfah nurfarida 315842
26 bd irka klinik musytasyfah nurliani 315217
27 bd saadah pkm kertamukti nurhayati 314951
28 bd sri nurhayati kosambi rani rahmawati 315079
29 bd wiwin pebya 315206
30 bd Lia kokom komariah 237742
31 bd Yati S sri ayu 259709
32 bd ratna rw ckm bengle pemiyanti 315607
33 bd hj nina puri kosambi titi andriyani 315933
34 bd titin patimah dayeuhluhur ayu solehah 315617
35 bd hj carnah majalaya martinah 315872
36 bd lia dahlia karangsari purwasari nuraini 315427
37 dr dhian klinik assifa cilamaya pitria dewi 315213
38 pkm ciampel pkm ciampel yanah
39 dr sutardi PKM Rawamerta reni s 314944
40 dr sutardi PKM Rawamerta nining 315670
41 pkm kutawaluya PKM Kutawaluya marlina 315851
42 pkm telagasari pkm telagasari yulianti 206987
43 pkm telagasari pkm telagasari Lia 315052
44 dr panji pati RS Sentul cikampek ahmad arvio 312782
45 dr kinanti klinik musytasyfah kasyfa 313065
46 dr rina hasriana klinik johar baru nara 259536
47 dr falia klinik syamil medika by julaeha 312443
48 klinik GM kosambi klinik graha medis ksb hanipah 142818
49 dr irsyad klinik darawolong siti nurjanah 290323
50 dr munawirawan klinik fikri medika mia pebrian 167892
51 klinik tempuran medika klinik tempuran medika juhariah 313508
52 klinik tempuran medika klinik tempuran medika by ny riri s 312195
53 dr pocut klinik zharifa zafira euis p 011126
54 graha medis ckp klinik graha medis cikampek usih 314638
55 dr dodi klinik andina iim halimah 009020
56 poned klari poned klari fina ernanda 314639
57 poned klari poned klari ade nursafitri 314075
58 poned klari poned klari reza nur mala 156570
59 pkm ciampel PKM Ciampel lilis 314227
5/26/2022 PPN Rp 50,000
5/26/2022 PPN Rp 50,000
5/27/2022 SC Rp 100,000
5/27/2022 SC Rp 100,000
5/27/2022 SC Rp 100,000
5/27/2022 SC Rp 100,000
5/27/2022 SC Rp 100,000
5/27/2022 SC Rp 100,000
5/30/2022 Rawatan Rp 25,000
6/2/2022 P.Penyulit Rp 50,000
6/2/2022 SC Rp 100,000
6/2/2022 SC Rp 100,000
6/3/2022 SC Rp 100,000
6/3/2022 SC Rp 100,000
6/3/2022 SC Rp 100,000
6/3/2022 curetase Rp 50,000
6/4/2022 curetase Rp 50,000
6/4/2022 SC Rp 100,000
6/4/2022 SC Rp 100,000
curetase Rp 50,000
5/30/2022 curetase Rp 50,000
5/27/2022 PN Rp 50,000
5/26/2022 Rawatan Rp 25,000
5/19/2022 SC Rp 100,000
SC Rp 100,000
Curetase Rp 50,000
SC Rp 100,000
5/24/2022 SC Rp 100,000
5/26/2022 PN Rp 50,000
5/27/2022 SC Rp 100,000
6/3/2022 SC Rp 100,000
5/31/2022 SC Rp 100,000
6/4/2022 Rawatan Rp 25,000
5/31/2022 SC Rp 100,000
6/3/2022 SC Rp 100,000
5/29/2022 SC Rp 100,000
5/26/2022 SC Rp 100,000
PN Rp 50,000
5/27/2022 Rawatan Rp 25,000
6/1/2022 SC Rp 100,000
6/2/2022 SC Rp 100,000
6/3/2022 Rawatan Rp 25,000
24/5/02022 SC Rp 100,000
5/18/2022 Rawatan Rp 25,000
5/4/2022 Rawatan Rp 25,000
5/14/2022 Rawatan Rp 25,000
5/18/2022 Rawatan Rp 25,000
5/17/2022 SC Rp 100,000
5/19/2022 Rawatan Rp 25,000
5/20/2022 curetase Rp 50,000
5/3/2022 Rawatan Rp 25,000
5/9/2022 Rawatan Rp 25,000
5/16/2022 SC Rp 100,000
5/18/2022 SC Rp 100,000
5/16/2022 curetase Rp 50,000
5/18/2022 SC Rp 100,000
5/11/2022 Rawatan Rp 25,000
5/17/2022 SC Rp 100,000
5/12/2022 SC Rp 100,000
TOTAL Rp 4,275,000
1 ABAY 2
2 ADANG SUTEJA 2
3 AGAS 4
4 AHMAD DAELAMI 2
5 AHMAD JAENI 1
6 AJANG S 1
7 AMIN 2
8 AMIN CIBAL 2
9 AMO 6
10 ASEP RASAWIJAYA 1
11 ASIM 2
12 ATA BACIN 2
13 AYU SUCIANTI 3
14 AYU SUCIATI 2
15 BOBI 4
16 CASMITA 4
17 CECEP 2
18 D SALEH 8
19 DADI 7
20 DARSAM 4
21 DARTA TURI 1
22 DEDE ANWAR 9
23 DENI JAYA L 2
24 DENI OMPONG 2
25 DINI ANDRIYANI 1
26 DODY 4
27 DURAHMAN 2
28 E NARSIM 2
29 EBENG 2
30 EJANG 3
31 EKA PERMANA 2
32 ENAN 6
33 ENDAH 1
34 ENDANG 11
35 EUIS RAHMAWATI 1
36 EWING 1
37 GABRIEL 1
38 HERI KUSAERI 9
39 HJ RASIH 1
40 ICONG 4
41 IDA 1
42 IWAN TD 5
43 JAJANG 4
44 JAKA K 6
45 JOGING 2
46 JUJU 11
47 JUJU 1
48 JUMSARI 16
49 KAJA SUJANA 2
50 KARMAN/KOPRAL 5
51 KARNA S 6
52 KARTI 2
53 KASMAN 3
54 KENTING 8
55 KLARI 1
56 KOSASIH 2
57 KUSTINI 5
58 LILI SUHENDI 1
59 LUDI H 1
60 MA AYAT 4
61 MA ELAH 16
62 MADIMAN 3
63 MISLAN 2
64 MUKSIN 6
65 MULYADI DAMONG 1
66 NANO 7
67 NASIR 5
68 NAWANGSIH 6
69 NENI 10
70 NINA 1
71 NURSIFA 8
72 ODANG 1
73 OMAT 4
74 OMIN 3
75 OMPONG 5
76 RADITA 2
77 RAHMAT MG 1
78 RAINTA 5
79 RHENO 1
80 RIKI (12.388) 19
81 ROSIN 9
82 RT AJA (8.739) 3
83 RT BUDI 8
84 RT IMAN 10
85 RW EDO 1
86 SAHRUDIN 6
87 SALAMAH 13
88 SALIM S 1
89 SAMIN 1
90 SARI 2
91 SOBLENG 3
92 SOBUR 1
93 SRI HARTATI 1
94 SRI ISDI 11
95 SRI MAESAROH 4
96 TARMEDI 1
97 TINI 2
98 TOSIM 5
99 UJANG NURJAYA 2
100 UMAR 5
WAKIL AKUNG (3.897
101 & 5.975) 14
102 WANTA WARDIMAN 2
WIWIN (6.447 & 5.981

103 & 13.918 & 6.563) 16
104 WIWIN 1
105 YAYA S (1.414) 7
106 YOYO 1
107 YUNUS 2
Jumlah Keterangan
Rp 50,000 periode 6-25 juni 2022
Rp 100,000 periode 6-25 juni 2022
Rp 150,000 periode 6-25 juni 2022
Rp 100,000 periode 6-25 juni 2022
Rp 100,000 periode 6-25 juni 2022
Rp 200,000 periode 6-25 juni 2022
Rp 175,000 periode 6-25 juni 2022
Rp 100,000 periode 6-25 juni 2022
Rp 225,000 periode 6-25 juni 2022
Rp 100,000 periode 6-25 juni 2022
Rp 150,000 periode 6-25 juni 2022
Rp 275,000 periode 6-25 juni 2022
Rp 225,000 periode 6-25 juni 2022
Rp 100,000 periode 6-25 juni 2022
Rp 125,000 periode 6-25 juni 2022
Rp 100,000 periode 6-25 juni 2022
Rp 150,000 periode 6-25 juni 2022
Rp 275,000 periode 6-25 juni 2022
Rp 400,000 periode 6-25 juni 2022
Rp 125,000 periode 6-25 juni 2022
Rp 150,000 periode 6-25 juni 2022
Rp 200,000 periode 6-25 juni 2022
Rp 125,000 periode 6-25 juni 2022
Rp 100,000 periode 6-25 juni 2022
Rp 400,000 periode 6-25 juni 2022
Rp 150,000 periode 6-25 juni 2022
Rp 175,000 periode 6-25 juni 2022
Rp 125,000 periode 6-25 juni 2022
Rp 150,000 periode 6-25 juni 2022
Rp 250,000 periode 6-25 juni 2022
Rp 200,000 periode 6-25 juni 2022
Rp 100,000 periode 6-25 juni 2022
Rp 125,000 periode 6-25 juni 2022
Rp 125,000 periode 6-25 juni 2022
Rp 784,500 periode 6-25 juni 2022
Rp 225,000 periode 6-25 juni 2022
Rp 293,500 periode 6-25 juni 2022
Rp 200,000 periode 6-25 juni 2022
Rp 250,000 periode 6-25 juni 2022
Rp 150,000 periode 6-25 juni 2022
Rp 325,000 periode 6-25 juni 2022
Rp 275,000 periode 6-25 juni 2022
Rp 100,000 periode 6-25 juni 2022
Rp 125,000 periode 6-25 juni 2022
Rp 125,000 periode 6-25 juni 2022
Rp 597,000 periode 6-25 juni 2022

Rp 1,223,000 periode 6-25 juni 2022

Rp 210,500 periode 6-25 juni 2022
1 Bdn Wulanda PKM Ciampel Ny.Yanah
1 dr zaharaida klinik Yakesti Ny siska
2 dr zaharaida klinik Yakesti Ny Cicih
3 dr haerudin PKM Pasirukeum ny lia apriyanti
4 dr sutardi poned Rawamerta ny olivia
5 dr emin klinik Telagasari ny komariah
6 klinik Mustika klinik mustika ny kartini
7 dr lindawati klinik Assalam ny rosida
8 dr wahyudin PKM Tempuran ny tati n
9 dr dita klinik safira medika ny iin marlina
10 dr riswan klinik Telagasari ny iim dwi
11 bd siti hardiyanti langen sari cilamaya kulon kasmin
12 dr aang klinik aulia rohaeni
13 dr ela klinik darawolong nai nur
14 usg dr chandra pkm kutawaluya iyoh
15 bd yulia permata lemahduhur siti magfiroh
16 bd risa mahardika pasir panjang siti hamidah
17 bidan suherti kertamukti cilebar ondeh
18 klinik Zahira klinik zahira fita sari
19 dr asep pasir panjang tika nardila
20 dr septiani pkm telagasari siti rosidah
21 poned Klari poned klari eko kumiati
22 dr tian pkm Ciampel sri wulandari
23 Bd. Yayat.H Bd. Yayat.H, Purwasari ny. Asih
24 Bd. Yayat.H Bd. Yayat.H, Purwasari ny. Desi
25 Bd. Ai Lani Nurlaeni Duren Klari ny. Helentina
26 Irka Pramukani Klinik Musytasyfah ny. Siti Khomsiyah
27 Bd. Yuli ny. St Nurjanah
28 Bd. Hj. Nina Herlina Bd. Hj. Nina, Puri Kosambi ny. Dwi Novianti
29 Klinik Zhafira Zarifa Klinik Zhafira Zarifa ny. Dewi Andini
30 Puskesmas Poned Cicinde Poned Cicinde ny. Hilda
31 Bd. Hj. Carnah Bd. Hj. Carnah, Lemah Mulya ny. Imas Maitoh
32 Puskesmas Lemah Duhur Puskesmas Lemah Duhur ny. Nining
33 Dr. Heni Yulia Cahyaningtyas Puskesmas Majalaya ny. Juangsih
34 dr. Lindawati Puskesmas Purwasari ny. Yulianti Dwi Pertiwi
35 Lastriati Dewi Ayudarista Klinik Zhafira Zarifa ny. Saripah
36 Pocut Slanga Klinik Zhafira Zarifa ny. Ine Siti Mutmainnah
37 dr. Bobzi Razvidi klinik zahira ny. Tuti Permata Sari
38 Velly Malihah Oknuita klinik zahira ny. Ita Juwitasari
39 Nok Rina Listiani klinik Sri Sukma ny. Karti Kartika
40 Tita Puspitasari klinik Nursepta ny. Mami Maryami
41 dr. Dara Mustika Dewi klinik Mustika ny. Sulelawati
42 dr. Dara Mustika Dewi klinik Mustika ny. Dini Opiyanti
43 dr. Monica Adyah Permata Puskesmas Lemah Duhur ny. Yulianti
44 dr. Nurhasanah Siregar Klinik Andina ny. Nurhayati
45 dr. Lindawati klinik Assalam Ny. Siti Romlah
46 dr. Ela Agustin klinik darawolong Ny. Wahyuning
47 Tria Rahmawati Klinik Graha Medis Kosambi Ny. Sumiyati
48 dr. Vina Pebria Dwiresa Klinik Graha Medis Kosambi Ny. Junasih
49 Bdn.Tria R Klinik Graha Medis Kosambi Ny.Geeby
50 Bdn.Lastriati D Klinik Zhafira Zharifa Ny.Dewi A
51 Klinik Assalam Klinik Assalam Ny.Iim
52 Bdn.Nok Rina Klinik Sri Sukma Ny.Siti Nurjaah
53 dr Irma N PUSKESMAS Cilamaya Ny.Dinda
54 dr. Diding PUSKESMAS Kutawaluya Ny. Patimah
55 dr. Meutia Klinik Mitra Sehat Ny. Nani
56 dr. Siska Klinik Siti Azaria Ny. Lia Nurmala
57 bd nelis a villa karawangi ny tanjung
58 bd n unirah rawamerta ny siti komiah
59 bd yulia permata lemahduhur tempuran Eli Sri
60 bd yulia permata lemahduhur tempuran lulu hasnah
61 dr sutardi poned Rawamerta dewi Rosidi
62 dr budiyanto klinik Telagasari sarah
63 Klinik Zhafira Zarifa klinik zharifa zafira anita
64 pkm kotabaru pkm Kotabaru siti basanah
65 bd hj nurhayati darawolong sri septi
66 bd hj nurhayati darawolong kartika
67 bd risa mahardika pasir panjang nurmala
111369 5/26/2022 PPN Rp 50,000
086032 6/7/2022 SC Rp 100,000
201270 6/6/2022 SC Rp 100,000
316141 6/7/2022 SC Rp 100,000
316206 6/9/2022 PN Rp 50,000
316230 6/9/2022 SC Rp 100,000
316388 6/11/2022 R Rp 25,000
284073 6/8/2022 SC Rp 100,000
017201 6/11/2022 SC Rp 100,000
316356 6/11/2022 SC Rp 100,000
316373 6/11/2022 SC Rp 100,000
298200 6/1/2022 R Rp 25,000
95072 6/2/2022 SC Rp 100,000
198465 6/1/2022 SC Rp 100,000
315744 6/2/2022 SC Rp 100,000
271724 6/12/2022 R Rp 25,000
316369 6/11/2022 SC Rp 100,000
274480 SC Rp 100,000
316461 6/12/2022 R Rp 25,000
216100 6/9/2022 SC Rp 100,000
316309 6/10/2022 SC Rp 100,000
316190 6/8/2022 Kuret Rp 50,000
316158 6/8/2022 PN Rp 50,000
5/11/2022 SC Rp 100,000
5/11/2022 PN Rp 50,000
5/11/2022 SC Rp 100,000
316575 SC Rp 100,000
316926 6/20/2022 SC Rp 100,000
236244 6/20/2022 Kuret Rp 50,000
317055 6/21/2022 SC Rp 100,000
316923 SC Rp 100,000
226608 6/18/2022 SC Rp 100,000
316547 6/14/2022 SC Rp 100,000
6/11/2022 SC Rp 100,000
108778 6/11/2022 SC Rp 100,000
081659 6/17/2022 SC Rp 100,000
123849 6/2/2022 SC Rp 100,000
306044 6/14/2022 R Rp 25,000
258452 6/17/2022 SC Rp 100,000
316604 6/15/2022 SC Rp 100,000
316442 6/12/2022 SC Rp 100,000
6/14/2022 SC Rp 100,000
110177 6/16/2022 SC Rp 100,000
206987 6/13/2022 SC Rp 100,000
240214 6/5/2022 SC Rp 100,000
182786 6/12/2022 R Rp 25,000
6/17/2022 SC Rp 100,000
248727 6/6/2022 Kuret Rp 50,000
295683 6/11/2022 SC Rp 100,000
268388 6/21/2022 SC Rp 100,000
317055 6/21/2022 SC Rp 100,000
316708 6/16/2022 SC Rp 100,000
316926 6/20/2022 SC Rp 100,000
317070 31/06/2022 Rawatan Rp 25,000
317288 6/24/2022 SC Rp 100,000
216265 6/24/2022 Rawatan Rp 25,000
276113 6/24/2022 Kuret Rp 50,000
201755 6/26/2022 Kuret Rp 50,000
317251 6/24/2022 SC Rp 100,000
317293 6/24/2022 SC Rp 100,000
317321 6/24/2022 R Rp 25,000
317102 6/21/2022 PN Rp 50,000
317087 6/1/2022 SC Rp 100,000
317419 6/27/2022 SC Rp 100,000
317393 6/26/2022 SC Rp 100,000
158689 6/23/2022 SC Rp 100,000
177631 6/23/2022 SC Rp 100,000
091559 6/24/2022 SC Rp 100,000
No Masuk Perujuk PX MR Tindakan Cara Bayar
31 6/18/2022 Bd. Hj. Carnah ny. Imas Maitoh 226608 SC BPJS
28 6/20/2022 Bd. Hj. Nina Herlina ny. Dwi Novianti 236244 Kuret BPJS
23 5/11/2022 Bd. Yayat.H ny. Asih SC BPJS
24 5/11/2022 Bd. Yayat.H ny. Desi PN BPJS
65 6/23/2022 bd hj nurhayati sri septi 158689 SC BPJS
66 6/23/2022 bd hj nurhayati kartika 177631 SC BPJS
25 5/11/2022 Bd. Ai Lani Nurlaeni ny. Helentina SC BPJS
17 bidan suherti ondeh 274480 SC BPJS
44 6/5/2022 dr. Nurhasanah Siregar ny. Nurhayati 240214 SC BPJS
7 6/8/2022 dr lindawati ny rosida 284073 SC BPJS
45 6/12/2022 dr. Lindawati Ny. Siti Romlah 182786 R BPJS
51 6/16/2022 Klinik Assalam Ny.Iim 316708 SC BPJS
12 6/2/2022 dr aang rohaeni 95072 SC BPJS
13 6/1/2022 dr ela nai nur 198465 SC BPJS
46 6/17/2022 dr. Ela Agustin Ny. Wahyuning SC BPJS
47 6/6/2022 Tria Rahmawati Ny. Sumiyati 248727 Kuret BPJS
48 6/11/2022 dr. Vina Pebria Dwiresa Ny. Junasih 295683 SC BPJS
49 6/21/2022 Bdn.Tria R Ny.Geeby 268388 SC BPJS
55 6/24/2022 dr. Meutia Ny. Nani 216265 Rawatan BPJS
6 6/11/2022 klinik Mustika ny kartini 316388 R BPJS
41 6/14/2022 dr. Dara Mustika Dewi ny. Sulelawati SC BPJS
42 6/16/2022 dr. Dara Mustika Dewi ny. Dini Opiyanti 110177 SC BPJS
26 Irka Pramukani ny. Siti Khomsiyah 316575 SC BPJS
40 6/12/2022 Tita Puspitasari ny. Mami Maryami 316442 SC BPJS
9 6/11/2022 dr dita ny iin marlina 316356 SC BPJS
56 6/24/2022 dr. Siska Ny. Lia Nurmala 276113 Kuret BPJS
39 6/15/2022 Nok Rina Listiani ny. Karti Kartika 316604 SC BPJS
52 6/20/2022 Bdn.Nok Rina Ny.Siti Nurjaah 316926 SC BPJS
5 6/9/2022 dr emin ny komariah 316230 SC BPJS
10 6/11/2022 dr riswan ny iim dwi 316373 SC BPJS
62 6/1/2022 dr budiyanto sarah 317087 SC BPJS
1 6/7/2022 dr zaharaida Ny siska 086032 SC BPJS
2 6/6/2022 dr zaharaida Ny Cicih 201270 SC BPJS
18 6/12/2022 klinik Zahira fita sari 316461 R BPJS
37 6/14/2022 dr. Bobzi Razvidi ny. Tuti Permata Sari 306044 R BPJS
38 6/17/2022 Velly Malihah Oknuita ny. Ita Juwitasari 258452 SC BPJS
29 6/21/2022 Klinik Zhafira Zarifa ny. Dewi Andini 317055 SC BPJS
35 6/17/2022 Lastriati Dewi Ayudarista ny. Saripah 081659 SC BPJS
36 6/2/2022 Pocut Slanga ny. Ine Siti Mutmainnah 123849 SC BPJS
50 6/21/2022 Bdn.Lastriati D Ny.Dewi A 317055 SC BPJS
63 6/27/2022 Klinik Zhafira Zarifa anita 317419 SC BPJS
11 6/1/2022 bd siti hardiyanti kasmin 298200 R BPJS
15 6/12/2022 bd yulia permata siti magfiroh 271724 R BPJS
59 6/24/2022 bd yulia permata Eli Sri 317293 SC BPJS
60 6/24/2022 bd yulia permata lulu hasnah 317321 R BPJS
16 6/11/2022 bd risa mahardika siti hamidah 316369 SC BPJS
19 6/9/2022 dr asep tika nardila 216100 SC BPJS
67 6/24/2022 bd risa mahardika nurmala 091559 SC BPJS
22 6/8/2022 dr tian sri wulandari 316158 PN BPJS
64 6/26/2022 pkm kotabaru siti basanah 317393 SC BPJS
14 6/2/2022 usg dr chandra iyoh 315744 SC BPJS
3 6/7/2022 dr haerudin ny lia apriyanti 316141 SC BPJS
20 6/10/2022 dr septiani siti rosidah 316309 SC BPJS
8 6/11/2022 dr wahyudin ny tati n 017201 SC BPJS
30 Puskesmas Poned Cicinde ny. Hilda 316923 SC BPJS
21 6/8/2022 poned Klari eko kumiati 316190 Kuret BPJS
4 6/9/2022 dr sutardi ny olivia 316206 PN BPJS
61 6/21/2022 dr sutardi dewi Rosidi 317102 PN BPJS
53 31/06/2022 dr Irma N Ny.Dinda 317070 Rawatan BPJS
54 6/24/2022 dr. Diding Ny. Patimah 317288 SC BPJS
32 6/14/2022 Puskesmas Lemah Duhur ny. Nining 316547 SC BPJS
43 6/13/2022 dr. Monica Adyah Permata ny. Yulianti 206987 SC BPJS
33 6/11/2022 Dr. Heni Yulia Cahyaningtyas ny. Juangsih SC BPJS
34 6/11/2022 dr. Lindawati ny. Yulianti Dwi Pertiwi 108778 SC BPJS
58 6/24/2022 bd n unirah ny siti komiah 317251 SC BPJS
57 6/26/2022 bd nelis a ny tanjung 201755 Kuret BPJS
27 6/20/2022 Bd. Yulia ny. St Nurjanah 316926 SC BPJS
Nominal Alamat No Masuk Perujuk PX MR
Rp 100,000 Bd. Hj. Carnah, Lemah Mulya 23 5/11/2022 Bd. Yayat.H ny. Asih
Rp 50,000 Bd. Hj. Nina, Puri Kosambi 24 5/11/2022 Bd. Yayat.H ny. Desi
Rp 100,000 Bd. Yayat.H, Purwasari
Rp 50,000 Bd. Yayat.H, Purwasari
Rp 100,000 darawolong
Rp 100,000 darawolong
Rp 100,000 Duren Klari
Rp 100,000 kertamukti cilebar
Rp 100,000 Klinik Andina
Rp 100,000 klinik Assalam
Rp 25,000 klinik Assalam
Rp 100,000 Klinik Assalam
Rp 100,000 klinik aulia
Rp 100,000 klinik darawolong
Rp 100,000 klinik darawolong
Rp 50,000 Klinik Graha Medis Kosambi
Rp 25,000 Klinik Mitra Sehat
Rp 25,000 klinik mustika
Rp 100,000 klinik Mustika
Rp 100,000 klinik Mustika
Rp 100,000 Klinik Musytasyfah
Rp 100,000 klinik Nursepta
Rp 100,000 klinik safira medika
Rp 50,000 Klinik Siti Azaria
Rp 100,000 klinik Sri Sukma
Rp 100,000 Klinik Sri Sukma
Rp 100,000 klinik Telagasari
Rp 100,000 klinik Yakesti
Rp 100,000 klinik Yakesti
Rp 25,000 klinik zahira
Rp 100,000 Klinik Zhafira Zarifa
Rp 100,000 Klinik Zhafira Zharifa
Rp 100,000 klinik zharifa zafira
Rp 25,000 langen sari cilamaya kulon
Rp 25,000 lemahduhur
Rp 100,000 lemahduhur tempuran
Rp 25,000 lemahduhur tempuran
Rp 100,000 pasir panjang
Rp 50,000 pkm Ciampel
Rp 100,000 pkm Kotabaru
Rp 100,000 pkm kutawaluya
Rp 100,000 PKM Pasirukeum
Rp 100,000 pkm telagasari
Rp 100,000 PKM Tempuran
Rp 100,000 Poned Cicinde
Rp 50,000 poned klari
Rp 50,000 poned Rawamerta
Rp 50,000 poned Rawamerta
Rp 25,000 PUSKESMAS Cilamaya
Rp 100,000 PUSKESMAS Kutawaluya
Rp 100,000 Puskesmas Lemah Duhur
Rp 100,000 Puskesmas Lemah Duhur
Rp 100,000 Puskesmas Majalaya
Rp 100,000 Puskesmas Purwasari
Rp 100,000 rawamerta
Rp 50,000 villa karawangi
Rp 100,000
Tindakan Cara Bayar Nominal Alamat No Masuk Perujuk
SC BPJS Rp 100,000 Bd. Yayat.H, Purwasari 65 6/23/2022 bd hj nurhayati
PN BPJS Rp 50,000 Bd. Yayat.H, Purwasari 66 6/23/2022 bd hj nurhayati
PX MR Tindakan Cara Bayar Nominal Alamat
sri septi 158689 SC BPJS Rp 100,000 darawolong
kartika 177631 SC BPJS Rp 100,000 darawolong
no No u Nama perujuk alamat no telp
1 31 Bd. Hj. Carnah Bd. Hj. Carnah, Lemah Mulya
2 28 Bd. Hj. Nina Herlina Bd. Hj. Nina, Puri Kosambi
3 23 Bd. Yayat.H Bd. Yayat.H, Purwasari
4 24 Bd. Yayat.H Bd. Yayat.H, Purwasari
5 65 bd hj nurhayati darawolong
6 66 bd hj nurhayati darawolong
7 25 Bd. Ai Lani Nurlaeni Duren Klari
8 17 bidan suherti kertamukti cilebar
9 44 dr. Nurhasanah Siregar Klinik Andina
10 7 dr lindawati klinik Assalam
11 45 dr. Lindawati klinik Assalam
12 51 Klinik Assalam Klinik Assalam
13 12 dr aang klinik aulia
14 13 dr ela klinik darawolong
15 46 dr. Ela Agustin klinik darawolong
16 47 Tria Rahmawati Klinik Graha Medis Kosambi
17 48 dr. Vina Pebria Dwiresa Klinik Graha Medis Kosambi
18 49 Bdn.Tria R Klinik Graha Medis Kosambi
19 55 dr. Meutia Klinik Mitra Sehat
20 6 klinik Mustika klinik mustika
21 41 dr. Dara Mustika Dewi klinik Mustika
22 42 dr. Dara Mustika Dewi klinik Mustika
23 26 Irka Pramukani Klinik Musytasyfah
24 40 Tita Puspitasari klinik Nursepta
25 9 dr dita klinik safira medika
26 56 dr. Siska Klinik Siti Azaria
27 39 Nok Rina Listiani klinik Sri Sukma
28 52 Bdn.Nok Rina Klinik Sri Sukma
29 5 dr emin klinik Telagasari
30 10 dr riswan klinik Telagasari
31 62 dr budiyanto klinik Telagasari
32 1 dr zaharaida klinik Yakesti
33 2 dr zaharaida klinik Yakesti
34 18 klinik Zahira klinik zahira
35 37 dr. Bobzi Razvidi klinik zahira
36 38 Velly Malihah Oknuita klinik zahira
37 29 Klinik Zhafira Zarifa Klinik Zhafira Zarifa
38 35 Lastriati Dewi Ayudarista Klinik Zhafira Zarifa
39 36 Pocut Slanga Klinik Zhafira Zarifa
40 50 Bdn.Lastriati D Klinik Zhafira Zharifa
41 63 Klinik Zhafira Zarifa klinik zharifa zafira
42 11 bd siti hardiyanti langen sari cilamaya kulon
43 15 bd yulia permata lemahduhur
44 59 bd yulia permata lemahduhur tempuran
45 60 bd yulia permata lemahduhur tempuran
46 16 bd risa mahardika pasir panjang
47 19 dr asep pasir panjang
48 67 bd risa mahardika pasir panjang
49 22 dr tian pkm Ciampel
50 64 pkm kotabaru pkm Kotabaru
51 14 usg dr chandra pkm kutawaluya
52 3 dr haerudin PKM Pasirukeum
53 20 dr septiani pkm telagasari
54 8 dr wahyudin PKM Tempuran
55 30 Puskesmas Poned Cicinde Poned Cicinde
56 21 poned Klari poned klari
57 4 dr sutardi poned Rawamerta
58 61 dr sutardi poned Rawamerta
59 53 dr Irma N PUSKESMAS Cilamaya
60 54 dr. Diding PUSKESMAS Kutawaluya
61 32 Puskesmas Lemah Duhur Puskesmas Lemah Duhur
62 43 dr. Monica Adyah Permata Puskesmas Lemah Duhur
63 33 Dr. Heni Yulia Cahyaningtyas Puskesmas Majalaya
64 34 dr. Lindawati Puskesmas Purwasari
65 58 bd n unirah rawamerta
66 57 bd nelis a villa karawangi
67 27 Bd. Yuli
ny. Imas Maitoh 226608 6/18/2022 SC Rp 100,000
ny. Dwi Novianti 236244 6/20/2022 Kuret Rp 50,000
ny. Asih 5/11/2022 SC Rp 100,000
ny. Desi 5/11/2022 PN Rp 50,000
sri septi 158689 6/23/2022 SC Rp 100,000
kartika 177631 6/23/2022 SC Rp 100,000
ny. Helentina 5/11/2022 SC Rp 100,000
ondeh 274480 SC Rp 100,000
ny. Nurhayati 240214 6/5/2022 SC Rp 100,000
ny rosida 284073 6/8/2022 SC Rp 100,000
Ny. Siti Romlah 182786 6/12/2022 R Rp 25,000
Ny.Iim 316708 6/16/2022 SC Rp 100,000
rohaeni 95072 6/2/2022 SC Rp 100,000
nai nur 198465 6/1/2022 SC Rp 100,000
Ny. Wahyuning 6/17/2022 SC Rp 100,000
Ny. Sumiyati 248727 6/6/2022 Kuret Rp 50,000
Ny. Junasih 295683 6/11/2022 SC Rp 100,000
Ny.Geeby 268388 6/21/2022 SC Rp 100,000
Ny. Nani 216265 6/24/2022 Rawatan Rp 25,000
ny kartini 316388 6/11/2022 R Rp 25,000
ny. Sulelawati 6/14/2022 SC Rp 100,000
ny. Dini Opiyanti 110177 6/16/2022 SC Rp 100,000
ny. Siti Khomsiyah 316575 SC Rp 100,000
ny. Mami Maryami 316442 6/12/2022 SC Rp 100,000
ny iin marlina 316356 6/11/2022 SC Rp 100,000
Ny. Lia Nurmala 276113 6/24/2022 Kuret Rp 50,000
ny. Karti Kartika 316604 6/15/2022 SC Rp 100,000
Ny.Siti Nurjaah 316926 6/20/2022 SC Rp 100,000
ny komariah 316230 6/9/2022 SC Rp 100,000
ny iim dwi 316373 6/11/2022 SC Rp 100,000
sarah 317087 6/1/2022 SC Rp 100,000
Ny siska 086032 6/7/2022 SC Rp 100,000
Ny Cicih 201270 6/6/2022 SC Rp 100,000
fita sari 316461 6/12/2022 R Rp 25,000
ny. Tuti Permata Sari 306044 6/14/2022 R Rp 25,000
ny. Ita Juwitasari 258452 6/17/2022 SC Rp 100,000
ny. Dewi Andini 317055 6/21/2022 SC Rp 100,000
ny. Saripah 081659 6/17/2022 SC Rp 100,000
ny. Ine Siti Mutmainnah 123849 6/2/2022 SC Rp 100,000
Ny.Dewi A 317055 6/21/2022 SC Rp 100,000
anita 317419 6/27/2022 SC Rp 100,000
kasmin 298200 6/1/2022 R Rp 25,000
siti magfiroh 271724 6/12/2022 R Rp 25,000
Eli Sri 317293 6/24/2022 SC Rp 100,000
lulu hasnah 317321 6/24/2022 R Rp 25,000
siti hamidah 316369 6/11/2022 SC Rp 100,000
tika nardila 216100 6/9/2022 SC Rp 100,000
nurmala 091559 6/24/2022 SC Rp 100,000
sri wulandari 316158 6/8/2022 PN Rp 50,000
siti basanah 317393 6/26/2022 SC Rp 100,000
iyoh 315744 6/2/2022 SC Rp 100,000
ny lia apriyanti 316141 6/7/2022 SC Rp 100,000
siti rosidah 316309 6/10/2022 SC Rp 100,000
ny tati n 017201 6/11/2022 SC Rp 100,000
ny. Hilda 316923 SC Rp 100,000
eko kumiati 316190 6/8/2022 Kuret Rp 50,000
ny olivia 316206 6/9/2022 PN Rp 50,000
dewi Rosidi 317102 6/21/2022 PN Rp 50,000
Ny.Dinda 317070 31/06/2022 Rawatan Rp 25,000
Ny. Patimah 317288 6/24/2022 SC Rp 100,000
ny. Nining 316547 6/14/2022 SC Rp 100,000
ny. Yulianti 206987 6/13/2022 SC Rp 100,000
ny. Juangsih 6/11/2022 SC Rp 100,000
ny. Yulianti Dwi Pertiwi 108778 6/11/2022 SC Rp 100,000
ny siti komiah 317251 6/24/2022 SC Rp 100,000
ny tanjung 201755 6/26/2022 Kuret Rp 50,000
ny. St Nurjanah 316926 6/20/2022 SC Rp 100,000
no
alamat telp Rajal No Rajal Ranap No Ranap
KLINIK GRAHA MEDIS KOSAMBI 1 43 Rp 215,000 4 Rp 100,000
KLINIK TELAGA SARI 2 41 Rp 205,000 Rp -
KLINIK ASSALAM 3 35 Rp 175,000 3 Rp 75,000
KLINIK MITRA SEHAT 4 34 Rp 170,000 2 Rp 50,000
KLINIK GRAHA MEDIS KOPEL 5 31 Rp 155,000 1 Rp 25,000
KLINIK FIKRI MEDIKA 6 26 Rp 130,000 Rp -
KLINIK DARAWOLONG 7 25 Rp 125,000 6 Rp 150,000
KLINIK FIKRI MEDIKA 2 8 24 Rp 120,000 Rp -
KLINIK ZAHIRA 9 23 Rp 115,000 Rp -
KLINIK PURI ASIH KOSAMBI 10 21 Rp 105,000 Rp -
KLINIK YAKESTI 11 21 Rp 105,000 Rp -
KLINIK VIDYA MEDIKA 12 20 Rp 100,000 1 Rp 25,000
KLINIK ZHAFIRA ZARIFA 13 20 Rp 100,000 1 Rp 25,000
KLINIK SRI SUKMA 14 19 Rp 95,000 Rp -
KLINIK ANDINA 15 16 Rp 80,000 1 Rp 25,000
KLINIK MUSTIKA 16 15 Rp 75,000 Rp -
KLINIK PURWA MEDIKA 17 15 Rp 75,000 2 Rp 50,000
KLINIK AULIA 18 12 Rp 60,000 Rp -
KLINIK TEMPURAN MEDIKA 19 11 Rp 55,000 Rp -
Klinik Nursepta 20 10 Rp 50,000 Rp -
KLINIK MITRA KONDANG UTAMA 21 8 Rp 40,000 Rp -
KLINIK WADAS MEDIKA 22 8 Rp 40,000 Rp -
KLINIK CURUG RAHAYU 23 7 Rp 35,000 1 Rp 25,000
KLINIK AMANDA 24 6 Rp 30,000 Rp -
KLINIK KINASIH 25 6 Rp 30,000 Rp -
Klinik Novia 26 6 Rp 30,000 Rp -
KLINIK SAFIRA MEDIKA 27 6 Rp 30,000 Rp -
KLINIK KONDANG MEDIKA 28 5 Rp 25,000 Rp -
KLINIK ANNISA KUTAGANDOK 29 4 Rp 20,000 1 Rp 25,000
KLINIK ASTER 30 4 Rp 20,000 Rp -
KLINIK DIMAS MEDIKA 31 4 Rp 20,000 Rp -
KLINIK DOTA MEDIKA 32 4 Rp 20,000 1 Rp 25,000
KLINIK GRIYA MEDIKA 33 4 Rp 20,000 Rp -
KLINIK LAMARAN 34 4 Rp 20,000 Rp -
KLINIK PURI ASIH CIKAMPEK 35 4 Rp 20,000 Rp -
klinik siti azaria 36 4 Rp 20,000 Rp -
KLINIK SITI KHADIJAH 37 4 Rp 20,000 Rp -
KLINIK ASTRI 38 3 Rp 15,000 Rp -
KLINIK GRAHA MEDIS CIKAMPEK 39 3 Rp 15,000 Rp -
KLINIK GRAHA MEDIS CILAMAYA 40 3 Rp 15,000 Rp -
KLINIK HASTIEN 41 3 Rp 15,000 Rp -
KLINIK NUR'ANNISA 3 Rp 15,000 Rp -
KLINIK SYAFIRA 2 8 3 Rp 15,000 Rp -
KLINIK ANGGADITA MEDIKA 4 2 Rp 10,000 Rp -
KLINIK AR-RAHMAN MEDIKA 5 2 Rp 10,000 Rp -
KLINIK ASSYIFA CILAMAYA 2 2 Rp 10,000 Rp -
KLINIK BHAKTI MEDIKA 9 2 Rp 10,000 Rp -
KLINIK KARYA MEDIKA 2 2 Rp 10,000 Rp -
KLINIK MEDISKA PT.KAI CIKAMPEK 3 2 Rp 10,000 Rp -
KLINIK PURI ASIH TL.JAMBE 11 2 Rp 10,000 Rp -
KLINIK RAGA SEHAT 2 Rp 10,000 Rp -
KLINIK KARYAMUKTI MEDIKA 2 Rp 50,000
KLINIK PELITA JAYA 1 Rp 25,000
KLINIK SURYA MEDIKA 2 Rp 50,000
KLINIK DOKTER SUHENDRI 1 Rp 25,000
KLINIK PRATAMA MECCA SANJAYA 1 Rp 25,000
Dr. Nur Linawati 1 Rp 25,000
Bidan Sri 1 Rp 25,000
Nama PKM U B Rajal RAWATAN

RAWAMERTA 133 37 Rp 185,000 Rp -
PURWASARI 158 33 Rp 165,000 1 Rp 25,000
TELAGASARI 155 33 Rp 165,000 1 Rp 25,000
MAJALAYA 127 32 Rp 160,000 1 Rp 25,000
KLARI 153 28 Rp 140,000 1 Rp 25,000
LEMAH ABANG 82 21 Rp 105,000 Rp -
LEMAH DUHUR 60 21 Rp 105,000 Rp -
CIAMPEL 92 20 Rp 100,000 1 Rp 25,000
KUTAWALUYA 18 15 Rp 75,000 Rp -
CURUG 68 12 Rp 60,000 Rp -
KERTAMUKTI 56 11 Rp 55,000 Rp -
BALONGSARI 25 10 Rp 50,000 Rp -
TEMPURAN 70 10 Rp 50,000 1 Rp 25,000
ANGGADITA 29 8 Rp 40,000 Rp -
PEDES 37 7 Rp 35,000 Rp -
BATUJAYA 16 6 Rp 30,000 Rp -
PASIRRUKEM 33 6 Rp 30,000 Rp -
CIKAMPEK 11 5 Rp 25,000 Rp -
CILAMAYA 22 4 Rp 20,000 Rp -
CIBUAYA 7 3 Rp 15,000 Rp -
JATISARI 5 3 Rp 15,000 Rp -
SUNGAI BUNTU 3 3 Rp 15,000 Rp -
BAYUR LOR 28 2 Rp 10,000 Rp -
PAKISJAYA 7 2 Rp 10,000 Rp -
TIRTAJAYA
PKM MAJALAYA (kepala puskesmas 4 2 Rp 10,000 Rp -
TIRTAMULYA
Rp
PKM300.000, pendaftaran
KLARI (kepala 150.000,
puskesmas Rp 5 2 Rp 10,000 Rp -
dokter 2@
300.000, 200.000 =
pendaftaran Rp 400.000)
150.000, dokter
PKM TELAGASARI (kepala puskesmas
2@ 200.000 pendaftaran
Rp 300.000, = Rp 400.000)
150.000,
dokter 2@ 200.000 = Rp 400.000)
Jumlah Keterangan
Rp 315,000 periode 26 mei - 25 juni 2022
periode 26 mei - 25 juni 2022
total periode 26 mei - 25 juni 2022
1 ABAY 1
2 ADANG SUTEJA 1
3 AGAS 3
4 AHMAD DAELAMI 1
5 AJANG 1
6 AMO 2
7 AYU LESTARI 2
8 CASMITA 2
9 CECEP 1
10 DADI 4
11 DARSAM 2
12 DARTA TURI 1
13 DEDE ANWAR 1
14 DODY 3
15 ENAN 4
16 ENDANG 7
17 ENDI TELAGASARI 2
18 GABRIL 3
19 HERI KUSAERI 1
20 ICONG (5.937) 1 2
21 IWAN TD 1
22 JAJANG 3
23 JUJU 5
24 JUMSARI 33
25 KAJA SUJANA 1
26 KARANG MAJA 1
27 KARDI 1
28 KARNA 2
29 KARTI 1
30 KASMAN 1
31 KOSASIH 1
32 MA ELAH 5
33 NANO 2
34 NASIR 2
35 NAWANGSIH 4
36 NENI 4
37 NURSIFA 3
38 ODANG 1
39 OJOS 2
40 OMAT 2
41 OMPONG 2
42 RAINTA 3
43 RHENO 2
44 ROSIN 3
45 RT AJA 2
46 RT BUDI 1
47 SALAMAH (15.172) 1 6
48 SALIM S 1
49 SARI 9
50 SOBLENG 3
51 SOBUR 1
52 SRI HARTATI 1
53 SUKRI 1
54 SYARIF 2
55 U GOLER 2
56 WAKIL AKUNG (3.695) 1 7
57 WANTA WARDIMAN 1
58 WARDA 1
WIWIN (13.139 & 6.143
59 &1.123 3 4
60 YAYA 3
Jumlah Keterangan
25000 Periode 26 juni - 3 juli 2022

1 11 bdn. Hj. Nurhayati bdn. Hj. Nurhayati 6/19/2022
2 16 bdn. Nur Endah Sariyani bdn. Nur Endah Sariyani 6/20/2022
3 13 bdn. Nurhayati Bdn. Nurhayati 7/1/2022
4 14 bdn. Nurhayati Bdn. Nurhayati 6/20/2022
5 8 bdn.N unirah Desa Pasirawi 6/2/2022
6 12 bdn. Winda Melyana Dusun. Karanganyar 6/25/2022
7 15 bdn. Winda Melyana Dusun. Karanganyar 6/30/2022
8 6 dr.Nurhasanah Klinik Andina 7/1/2022
9 20 dr. Nurhasanah Siregar Klinik Andina 6/23/2022
10 24 Linda Oktaviani Klinik Assalam 6/23/2022
11 22 dr. Ela Agustin Klinik Darawolong 6/27/2022
12 1 dr.Dhia Prima Klinik Dimas Medika 6/27/2022
13 5 dr.Taswan Klinik Dota Medika 6/27/2022
14 4 dr.Haerudin Klinik Fikri Medika 6/30/2022
15 18 dr. Septian Hari Tugi W Klinik Graha Medis Kopel 6/25/2022
16 17 Tria Rahmawati Klinik Graha Medis Kosambi 6/27/2022
17 21 dr. Meutia Fathia Rahmah Klinik Mitra Sehat 6/17/2022
18 19 dr. Dimaz Prabu G. Setiadi Klinik Mustika 6/20/2022
19 3 dr.Bobzi Klinik Zahira 6/28/2022
20 23 dr. Bobzi Razvidi Klinik Zahira 6/16/2022
21 2 dr.Reza Klink Mitra Sehat 6/27/2022
22 25 dr. Astri Lovita PKM Balongsari 6/20/2022
23 7 dr.Poppy PKM Ciampel 6/30/2022
24 9 dr.Farida PKM Majalaya 7/2/2022
25 27 Bdn. Anita PKM Pasirukem
26 26 dr, Sutardi PKM Rawamerta 7/3/2022
27 10 bdn. Nelis Anggraeni Villa Karawangi 7/2/2022
Ny. Ipit 316912 BPJS PN Rp 50,000
Ny. Siti Hotimah 316981 BPJS SC Rp 100,000
Ny. Yuyun 018216 BPJS SC Rp 100,000
Ny. Siti Nurjanah 316926 BPJS SC Rp 100,000
Ny.Sunarti 317844 BPJS Rawatan Rp 25,000
Ny. Sarinengsih 317325 BPJS Rawatan Rp 25,000
Ny. Fitriyani 302089 BPJS SC Rp 100,000
Ny.Elis 317794 BPJS SC Rp 100,000
Ny. Siti Tias Kurnia 177807 BPJS Kuret Rp 50,000
Ny. Nelawati 202947 BPJS Rawatan Rp 25,000
Ny. Ratna Agustina 311758 BPJS PN Rp 50,000
Ny.Pitri Apriliani 210335 BPJS SC Rp 100,000
Ny.Idah Badriah 317448 BPJS Rawatan Rp 25,000
Ny.Tirsya Paulany 316219 BPJS SC Rp 100,000
Ny. Titik Mustika 186828 BPJS Kuret Rp 50,000
Ny. Nyai Arum Sari 302433 BPJS Kuret Rp 50,000
Ny. Lia Dahlia 085535 BPJS Rawatan Rp 25,000
Ny. Elasari 317015 BPJS SC Rp 100,000
Ny.Desy 150709 BPJS SC Rp 100,000
Ny. Siti Hapsoh 316743 BPJS SC Rp 100,000
Ny.Shintya 281460 BPJS Rawatan Rp 25,000
Ny. Ekasari 316933 BPJS SC Rp 100,000
Ny.Uum Karmila 110086 BPJS SC Rp 100,000
Ny.Gitta Lela 307131 BPJS SC Rp 100,000
Ny. Yuliyanti 317943 BPJS Rawatan Rp 25,000
Ny. Karni 317976 BPJS Rawatan Rp 25,000
Ny. Veri 317911 BPJS Rawatan Rp 25,000
No
u
no Nama perujuk alamat no telp nama pasien MR keter
1 28 bd risa mahardika 0821 1140 5979 7/13/2022 nuraini 180357 BPJS
2 26 bd hj tini adiarsa perumnas 7/16/2022 Ny.Sri Hartati 297448 BPJS
3 23 klinik musytasyfah CKM 7/8/2022 nurul khobatul 318942 BPJS
4 19 bd sri hastuti curug 6/28/2022 aldrian 245644 BPJS
5 22 bd hj nurhayati darawolong 7/12/2022 namah 318687 BPJS
6 31 bidan ati de kraton 7/19/2022 ajeng 246875 BPJS
7 32 bd dian anisa duren 7/9/2022 arumi 302754 BPJS
8 33 bd nidaul duren 7/5/2022 lia sutiati 102698 BPJS
9 18 bdn.Lina Klari 7/17/2022 Ny.Eko Yuniarsih 318851 BPJS
10 35 dr lindawati Klinik Assalam 7/5/2022 rikka 318132 BPJS
11 4 dr.Gresila Klinik Assalam 7/5/2022 Ny.Mida l 156797 BPJS
12 30 dr aang klinik aulia 6/2/2022 rohaeni 095072 BPJS
13 13 bdn.Rafika A Klinik Graha Medis Kopel 7/13/2022 Ny.Siti Aisyah 130530 BPJS
14 2 Bdn.Tria R Klinik Graha Medis Kosambi 7/5/2022 Ny.Yeni Y 217188 BPJS
15 36 dr sunuhardo klinik graha medis kosambi 7/5/2022 nengsih 053943 BPJS
16 12 dr.Annisa Y Klinik Griya Medika 7/12/2022 Ny.Dewi L 12022 BPJS
17 38 bd fifi klinik kinasih 7/11/2022 teti 312955 BPJS
18 37 dr handi klinik kinasih 7/2/2022 nining 164274 BPJS
19 20 bd sri nurhidayati klinik navia 7/12/2022 nur azizah 318530 BPJS
20 21 bd sri nurhidayati klinik navia 7/15/2022 hernawati 213815 BPJS
21 8 Bdn.Rita S Klinik Nursepta 7/8/2022 Ny.Dewi R 318227 BPJS
22 5 d.Ana Permatasari Klinik Puri Asih 7/6/2022 Ny.Mirnawati 286886 BPJS
23 10 dr.Ana Permata Klinik Puri Asih 7/11/2022 Ny.Suryati 82355 BPJS
24 16 bdn.Nokrina Klinik Sri Sukma 7/16/2022 Ny.Sri Hartati 297448 BPJS
25 25 hj laila klinik syamil medical 7/15/2022 uwar 318834 BPJS
26 39 dr bobzi klinik zahira 7/4/2022 nuraeni 317997 BPJS
27 3 dr.Bobzi Klinik Zahira 7/5/2022 Ny.Yuni P 141189 BPJS
28 6 Bdn.Lastriati Klinik Zhafira Zhafira 7/7/2022 NySri Hamilih 275309 BPJS
29 7 dr.Raina Klinik Zhafira Zhafira 7/8/2022 Ny.Hartika Alam 190867 BPJS
30 24 bd hj carnah lemahmulya majalaya 7/12/2022 wiwin 204152 BPJS
31 29 bd risa mahardika pasir panjang 7/14/2022 lailan azizah 292490 BPJS
32 50 bd ati perum grand permata 7/9/2022 yanti jayanti 306201 BPJS
33 14 dr.Dwi I PKM Klari 7/16/2022 Ny.Yulia Ratna 318772 BPJS
34 15 dr.Diding PKM Kutawaluya 7/16/2022 Ny.Nuriyom 318785 BPJS
35 43 pkm kutawaliuya PKM Kutawaluya 7/15/2022 uar suwartini 318834 BPJS
36 9 Bdn.Yayat PKM Purwasari 7/9/2022 Ny.Intan 124013 BPJS
37 42 pkm rawamerta pkm rawamerta 7/12/2022 mumun 318581 BPJS
38 17 dr.Devi Naviandra PKM Telagasari 7/16/2022 Ny.Riyani 318817 BPJS
39 40 poned cikampek poned cikampek 7/14/2022 dewi kania 318736 BPJS
40 41 poned cikampek poned cikampek 7/17/2022 fitri eka 318928 BPJS
41 44 bd yayat purwasari 7/6/2022 nurjanah 282170 BPJS
42 45 bd yayat purwasari 7/5/2022 selviyeni 318137 BPJS
43 1 dr .Sutardi PUSKESMAS Rawamera 7/4/2022 Ny.Wati 317937 BPJS
44 11 dr.Intan N PUSKESMAS Rawamerta 7/12/2022 Ny.Ida Farida 318453 BPJS
45 47 bd iis rohmawati tamelang majalaya 7//2022 fitri 159853 BPJS
46 34 bd erna kurniasari tamelang purwasari 7/13/2022 linawati 318604 BPJS
47 46 bd yuyun sunarsih tegalsari pwsr 5/7/2022 maryati 318138 BPJS
48 27 bd anisa alsamsiah tempuran 7/13/2022 mutiara 318652 BPJS
49 48 bd anisa 7/7/2022 elawati 317954 BPJS
50 49 bd ineu komala 7/9/2022 ai sulastri 318398 BPJS
Tindakan Jumlah
SC Rp 100,000
SC Rp 100,000
Rawatan Rp 25,000
Rawatan Rp 25,000
Rawatan Rp 25,000
SC Rp 100,000
Rawatan Rp 25,000
Rawatan Rp 25,000
P.Normal Rp 50,000
SC Rp 100,000
P.Penyulit Rp 50,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
Rawatan Rp 25,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
Rawatan Rp 25,000
SC Rp 100,000
Rawatan Rp 25,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
PN Rp 50,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
Rawatan Rp 25,000
SC Rp 100,000
PN Rp 50,000
SC Rp 100,000
SC Rp 100,000
PN Rp 50,000
Kuret Rp 50,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
PN Rp 50,000
SC Rp 100,000
SC Rp 100,000
Jumlah Keterangan
alamat
KLINIK GRAHA MEDIS KOSAMBI
KLINIK ASSALAM
KLINIK TELAGA SARI
KLINIK FIKRI MEDIKA
KLINIK DARAWOLONG
KLINIK MITRA SEHAT
KLINIK GRAHA MEDIS KOPEL
KLINIK PURI ASIH KOSAMBI
KLINIK VIDYA MEDIKA
KLINIK FIKRI MEDIKA 2
KLINIK PURWA MEDIKA
KLINIK DIMAS MEDIKA
KLINIK SRI SUKMA
KLINIK CURUG RAHAYU
KLINIK ZHAFIRA ZARIFA
KLINIK AULIA
KLINIK YAKESTI
KLINIK MITRA KONDANG UTAMA
Klinik Nursepta
KLINIK ZAHIRA
KLINIK TEMPURAN MEDIKA
KLINIK DOTA MEDIKA
KLINIK ANDINA
KLINIK MUSTIKA
KLINIK AMANDA
Klinik Novia
KLINIK SAFIRA MEDIKA
KLINIK KINASIH
KLINIK WADAS MEDIKA
klinik siti azaria
KLINIK GRIYA MEDIKA
KLINIK PURI ASIH CIKAMPEK
KLINIK HASTIEN
KLINIK SYAFIRA 2
KLINIK ANGGADITA MEDIKA
KLINIK ASSYIFA CILAMAYA
KLINIK PATEN
KLINIK GEMPOL
KLINIK ASTER
KLINIK GRAHA MEDIS CILAMAYA
KLINIK AR-RAHMAN MEDIKA
KLINIK BHAKTI MEDIKA
KLINIK CILAMAYA MEDIKA
Dr. Nur Linawati
KLINIK HARAPAN BARU
KLINIK MECCA SANJAYA
KLINIK NUR ASY SYIFA
KLINIK SAHIDIN, CILEBAR
TELAGASARI
PURWASARI
MAJALAYA
LEMAH DUHUR
RAWAMERTA
KLARI
LEMAH ABANG
BALONGSARI
TEMPURAN
CURUG
CIAMPEL
KUTAWALUYA
KERTAMUKTI
PEDES
KUTAMUKTI
PASIRRUKEM
ANGGADITA
CILAMAYA
TIRTAMULYA
CIKAMPEK
CIBUAYA
PLAWAD
BAYUR LOR
PAKISJAYA
PKM MAJALAYA (kepala puskesmas Rp 300.000, pendaftaran 150.000, dokter 2@ 200.000 = Rp 400.000)
PKM KLARI (kepala puskesmas Rp 300.000, pendaftaran 150.000, dokter 2@ 200.000 = Rp 400.000)
PKM TELAGASARI (kepala puskesmas Rp 300.000, pendaftaran 150.000, dokter 2@ 200.000 = Rp 400.000)
no telp Rajal No Rajal Ranap No Ranap Jumlah Keterangan
1 35 Rp 175,000 14 Rp 350,000 Rp 525,000 periode 3-23 juli 2022
3 33 Rp 165,000 Rp - Rp 165,000 periode 3-23 juli 2022
44 2 Rp 50,000 Rp 50,000 periode 3-23 juli 2022
25 periode 3-23 juli 2022
KATARA
alamat Nama PSM no telp nama pasien RANAP no Mr K
1 ABAY 2 2
2 ADANG HAMBALI 3 3
3 ADANG SUTEJA 3 3
4 ADE HIDAIAT 1 1
5 AGAS 2 2
6 AHMAD DAELAMI 2 2
7 AJANG 7 7
8 AMIN CIBAL 14 14
9 AMING 1 1
10 AMO 7 7
11 ATA BACIN 4 4
13 CASMITA 1 1
14 CECEP 6 6
15 D SALEH 2 2
16 DADI 3 3
17 DAMIN 1 1
18 DARSAM 3 3
19 DARTA TURI 4 4
20 DEDE ANWAR 11 11
21 DEDENG 1 1
22 DENI JAYA L 7 7
23 DENI OMPONG 1 1
24 DEWI 1 1
26 DODY 5 5
27 DURAHMAN 2 2
28 EJANG 4 4
29 EKA BAGYA 1 1
30 ENAN 12 12
31 ENARSIM 1 1
32 ENDANG 12 12
33 GABRIL 2 2
34 HASAN 1 1
35 HERI KUSAERI 3 3
36 ICONG (6.348) 10 1 Rp 159,000 11
37 IMAS 1 1
38 IWAN MAULANA 1 1
39 IWAN TD 4 4
40 JAJANG 7 7
41 JOGING 2 2
42 JUJU 15 15
43 JUMSARI (8.002) 31 1 Rp 200,000 32
44 KARDI 3 3
45 KARMAN 1 1
46 KARTI 2 2
47 KASMAN 1 1
48 KENTING 2 2
49 KOSASIH 2 2
50 KOSIM SUHARI 2 2
51 KUSTINI 2 2
52 LUDI H 1 1
53 MA ELAH 13 13
54 MA ENENG 1 1
55 MUKSIN 1 1
56 MULYADI/DAMONG 2 2
57 NANO 13 13
58 NASIR 8 8
59 NAWANGSIH 2 2
60 NENDI 2 2
61 NENI 10 10
62 NURASIH 2 2
63 NURSIFA 3 3
64 ODANG 5 5
65 OJOS 2 2
66 OMAT 3 3
67 OMIN 3 3
68 RADITA 4 4
70 RAINTA 1 1
71 RASIH 1 1
72 RIKI (9.210) 27 1 Rp 230,500 28
73 ROHAYATI 5 5
74 ROSIDIN 2 2
75 ROSIN (12.498+1.200) 6 2 Rp 342,500 8
76 RT AJA 9 9
77 RT BUDI (10.635) 4 1 Rp 266,000 5
78 RT IMAN 3 3
79 RW EDO 6 6
80 SAHRUDIN 2 2
81 SALAMAH 20 20
82 SALIM 1 1
83 SALIM S 1 1
84 SANIN SASMITA 1 1
85 SARI 22 22
86 SOBLENG 7 7
87 SOBUR 2 2
88 SRI HARTATI 5 5
89 SRI ISDI 1 1
90 SRI MAESAROH 2 2
91 SUDIR 2 2
92 SULAEMAN 2 2
93 SUWANDI 1 1
94 SYARIF (13.292+4.260) 16 2 Rp 439,000 18
95 TARMEDI 4 4
96 TINI 9 9
97 TOSIM 3 3
98 UMAR SANJAYA 3 3
99 UPAY 1 1
101 WANDA 2 2
102 WANTA WARDIMAN 2 2
103 WARDA 1 1
104 WIWIN H 29 29
105 YAYA 13 13
534 8 Rp 1,637,000 542

Jumlah Keterangan
Rp 50,000 periode 3-23 JULI 2022
Rp 175,000 periode 3-23 JULI 2022
Rp 350,000 periode 3-23 JULI 2022
Rp 175,000 periode 3-23 JULI 2022
Rp 100,000 periode 3-23 JULI 2022
Rp 100,000 periode 3-23 JULI 2022
Rp 150,000 periode 3-23 JULI 2022
Rp 100,000 periode 3-23 JULI 2022
Rp 275,000 periode 3-23 JULI 2022
Rp 175,000 periode 3-23 JULI 2022
Rp 125,000 periode 3-23 JULI 2022
Rp 100,000 periode 3-23 JULI 2022
Rp 300,000 periode 3-23 JULI 2022
Rp 300,000 periode 3-23 JULI 2022
Rp 409,000 periode 3-23 JULI 2022
Rp 100,000 periode 3-23 JULI 2022
Rp 175,000 periode 3-23 JULI 2022
Rp 375,000 periode 3-23 JULI 2022
Rp 975,000 periode 3-23 JULI 2022
Rp 325,000 periode 3-23 JULI 2022
Rp 325,000 periode 3-23 JULI 2022
Rp 200,000 periode 3-23 JULI 2022
Rp 250,000 periode 3-23 JULI 2022
Rp 125,000 periode 3-23 JULI 2022
Rp 100,000 periode 3-23 JULI 2022
Rp 905,500 periode 3-23 JULI 2022
Rp 125,000 periode 3-23 JULI 2022
Rp 492,500 periode 3-23 JULI 2022
Rp 225,000 periode 3-23 JULI 2022
Rp 366,000 periode 3-23 JULI 2022
Rp 150,000 periode 3-23 JULI 2022
Rp 500,000 periode 3-23 JULI 2022
Rp 550,000 periode 3-23 JULI 2022
Rp 175,000 periode 3-23 JULI 2022
Rp 125,000 periode 3-23 JULI 2022
Rp 839,000 periode 3-23 JULI 2022
Rp 100,000 periode 3-23 JULI 2022
Rp 225,000 periode 3-23 JULI 2022
Rp 500,000 periode 3-23 JULI 2022
Rp 725,000 periode 3-23 JULI 2022
Rp 325,000 periode 3-23 JULI 2022
1 AJANG S 2 50000
2 AMIN CIBAL 3 75000
3 AMO 5 125000
4 ASEP KALIBUAYA 1 25000
5 ATIKAH 2 50000
7 CASMITA 1 25000
8 CECEP 4 100000
9 D SALEH 6 150000
10 DADAH SA'ADAH 2 50000
11 DADI 2 50000
12 DAMIN 1 25000
13 DARSAM 3 75000
15 DEDE ANWAR 6 150000
16 DEDENG CILAMAYA 5 125000
17 DENI JAYA L 1 25000
19 DODY 5 125000
20 E NARSIM 1 25000
21 EJANG 2 50000
22 ENDANG 9 225000
23 ENDE WANDA 1 25000
24 GABRIL 2 50000
26 ICONG 1 25000
27 IWAN TD 2 50000
28 JAJANG 3 75000
29 JOGING 2 50000
30 JUJU 3 75000
31 JUMSARI 30 750000
32 KARTI 4 100000
33 KOSASIH 1 25000
34 KUSTINI 0 1
35 MA AYAT 5 125000
36 MA ELAH 12 300000
37 MA ENENG 2 50000
38 MUKSIN 4 100000
39 NASIR 1 25000
40 NASROH 1 25000
42 NENI 4 100000 1
43 NURASIH 1 25000
44 ODANG 1 25000
45 OJOS 1 25000
46 OMIN 1 25000
47 OMPONG 1 25000
48 RADITA 4 100000
50 RAINTA 1 25000
51 rheno 1 25000
52 rheno' 1 25000
53 RIKI 5 125000
54 ROHAYATI 1 25000
55 ROHIM 1 25000
56 ROHISAN 1 25000
57 ROSIDIN 2 50000
58 ROSIIN 1 25000
59 ROSIN 3 75000
60 ROWI Z 3 75000
61 RT AJA 2 50000
62 RT BUDI 2 50000
63 RW EDO 4 100000
64 SAHRUDIN 3 75000
65 SALAMAH 16 400000
66 SALIM 2 50000
67 SANIN SASMITA 1 25000
68 SARI 7 175000
69 SIGIT NURSETA 1 25000
70 SOBLENG 5 125000
71 SOBUR 2 50000
73 SUKARDI 1 25000
74 SULAEMAN 1 25000
75 SURYADI 0 1
76 SYARIF 16 400000
77 TATANG 1 25000
78 TIGOR 1 25000
79 TINI 2 50000
80 TOSIM 3 75000 1
81 U GOLER 1 25000
82 UMAR JAYA 3 75000
84 WAKIL HERI 1 25000
85 WANDA 1 25000
86 WANTA WARDIMAN 2 50000
87 WIWIN 20 500000
88 YAYA 11 275000 1
Jumlah Keterangan
Rp 50,000 periode 24 Juli - 7 agustus 2022
167500 Rp 167,500 periode 24 Juli - 7 agustus 2022
alamat Nama PSM no telp nama pasi RANAP no Mr KATARAK
1 ABAY 2
2 AGAS 4
3 AJANG 1
4 AMIN CIBAL 2
5 AMO 2
6 ATIKAH 1
7 AYU SUCIANTI 1
8 CASMITA 1
9 CECEP 1
10 D SALEH 2
11 DADI 5
12 DAMIN 4
13 DARSAM 2
14 DARTA TURI 1
15 DEDE ANWAR 6
16 DENI JAYA L 10
17 DINI ANDRIYANI 2
18 DODY 2
19 E NARSIM S 1
20 EJANG 3
21 EKA PERMANA 1
22 ENAN 2
23 ENDANG 6
24 GABRIL 6
25 HERI KUSAERI 9
26 ICONG 1
27 IDA 2
28 IWAN MAULANA 1
29 IWAN TD 4
30 JOGING 1
31 JUJU 6
32 JUMSARI 40
33 KASMAN 1
34 KENTING 2
35 KOSASIH 2
36 KOSIM 1
37 KOSIM SUTISNA 1
38 MA AYATI 2
39 MA ELAH 6
40 NANO 9
41 NASIR 2
42 NENI 1
43 NINA SUSILAWATI 2
44 NURASIH 2
45 NURSIFA 16
46 ODING RT 1
47 OMPONG 3
48 RADITA 2
49 RAHMAT MG JAYA 1
50 RAINTA 2
51 RIKI 3 2
52 ROWI Z 1
53 RT AJA 7
54 RT BUDI 9
55 RT IMAN 4
56 RUSDI 1
57 RUSPAN 1
58 RW EDO 4
59 SAHRUDIN 3
60 SALAMAH 14 1
61 SALIM S 13
62 SANIN SASMITA 1
63 SARI 21 1
64 SOBLEG 1
65 SOBLENG 10
66 SOBUR 2
67 SRI HARTATI 12
68 SRI ISDI 4
69 SRI MAESAROH 1
70 SYARIF 20 1
71 TINI 2
72 TOSIM 5 1
73 U GOLER 1
74 UJANG MULYANA 1
75 UMAR S 5
76 UPAY 1
77 WAKIL AKUNG 3 1
78 WANTA WARDIMAN 5
79 WIWIN 33
80 YAYA 8
81 YAYA 3
82 YAYAN 1
Jumlah Keterangan
Rp 50,000 periode 8- 24 Agustus 2022
Rp 1,000,000 periode 8- 24 Agustus 2022
Rp 2,261,500 periode 8- 24 Agustus 2022
Rp 13,006,500
alamat Nama PSM no telp nama pasi RANAP no Mr KATARAK
1 ABAY 5
2 AGAS 8
3 AGDANG RUSMANA 1
4 AHMAD SOPIAN 1
5 AJANG S 1
6 AMIN CIBAL 6
7 ATA BACHIN 1
8 ATA BANCIN 5
9 ATEM 1
10 AYU LESTARI 1
12 CASMITA 2
13 D SALEH 10
14 DAMIN 1
15 DARSAM 2
16 DARTA TURI 1
17 DEDE ANWAR 4
18 DEDEH KURNIASIH 4
19 DENI JAYA L 4
20 DIDI ISKANDAR 1
21 DINI ANDRIYANI 2
22 DODY 6
23 DURAHMAN 2
24 ENAN 5
25 ENDANG 5
26 EZUS 1
27 GABRIL 3
28 HERI KUSAERI 6
29 ICONG 2
30 IWAN TD 3
31 JAJA 1
32 JAJANG 2
33 JAKA KOMARA 3
34 JUJU 8
35 JUMSARI 10
36 KARMAN/KOPRAL 2
37 KARTI 1
38 KASMAN 2
39 KOSASIH 6
40 MA AYAT 4
41 MA ELAH 9
42 MAAN 1
43 MADIMAN 1
44 NANO 2 1
45 NASIR 3
46 NAWANGSIH 8
47 NENI 2
48 NURASIH 1
49 NURSIFA 1
50 ODANG 1
51 OMPONG 1
52 PAYO T 1
53 RIKI 10 3
54 ROSIN 1
55 RT AJA 9
56 RT IMAN 4
57 RUSDI 1
58 RW EDO 1
59 SAHRUDIN 2
60 SAI MUSTOPA 1
61 SALAMAH 7
62 SARI 13 1
63 SOBLENG 7
64 SOBUR 1
65 SRI HARTATI 1
66 SRI ISDI 2 1
67 SRI MAESAROH 2
68 SUTARDI 1
69 SYARIEF 15
70 TARMEDI 1
71 TATA 1
72 TINI 6
73 TOSIM 9
74 U GOLER 6
75 UMAR 1
76 UMAR 1 1
77 WAKIL AKUNG 10
78 WAKIL DAMIN 1
79 WANDA 4
80 WANTA WARDIMAN 6
81 WIWIN 8
82 YAYA 14
83 YAYU SUWANDIRA 1
Jumlah Keterangan
Rp 125,000 periode 25 Agust - 6 Sept 2022
no No u Nama perujuk alamat no telp nama pasien MR
1 Bdn.Ranti Eka Klinik Assalam 7/15/2022 Ny.Eka H 240075
2 drBudi S PUSKESMAS Curug 7/19/2022 Ny.Dedeh 319108
3 Bdn.Ranti Eka Kinik Assaam 7/19/2022 Ny.Gina D 234623
4 dr.Ana Permatasari Klinik Puri Asih Kosambi 7/20/2022 Ny.Nita S 319093
5 dr.Dudi Klinik Central Mediks 7/18/2022 Ny.Yupita 308834
6 dr.Abdul Kodir Klinik Pedes 7/20/2022 Ny.Wartini 319132
7 dr.Yunan S Klinik Fikri Medika 7/21/2022 Ny.Rametapia 319163
8 dr.Milah Klinik Lamaran 7/23/2022 Ny.Enni Andini 319289
9 Bdn.Nok Rina Klinik Sri Sukma 7/23/2022 Ny.Umiyati 199701
10 klinik zhafira zarifa klinik zhafira zarifa 7/18/2022 ny arfi 288706
11 klinik zhafira zarifa klinik zhafira zarifa 7/24/2022 ny nurul 317854
12 klinik zhafira zarifa klinik zhafira zarifa 7/28/2022 ny ayus 319606
13 klinik zhafira zarifa klinik zhafira zarifa 7/24/2022 Ny naila 319344
14 klinik zhafira zarifa klinik zhafira zarifa 7/25/2022 ny yusnita 319352
15 klinik zhafira zarifa klinik zhafira zarifa 7/24/2022 ny eka 319343
16 bd yuyun sunarsih pakopen tegalsari 7/24/2022 ny sumarni 319324
17 bd nurhalimah cimahi klari 7/26/2022 ny desi yuliani 290764
18 dr dimaz prabu klinik mustika 7/27/2022 ny wirah 122347
19 pkm kertamukti pkm kertamukti ny ekawati 319484
20 bd hj yayat purwasari 7/7/2022 nenda 318285
21 bd hj yayat purwasari 7/18/2022 nur 319007
22 bd meita sri rahayu 7/21/2022 iin khoer 319178
23 dr purna irawan klinik assalam 7/19/2022 anitia 319060
24 bd iis rohmawati tamelang majalaya 7/19/2022 yuni kartika 319015
25 bd linda pkm klari 7/18/2022 nurairani 318971
26 bd rosidah purwasari 7/20/2022 dian hasanah 317739
27 dr diding pkm kutawaluya 7/19/2022 narsih 319082
28 bd sri nurhidayati klari 8/3/2022 karrtinah 320013
29 bd ai Fitriani darawolong purwasari 8/1/2022 siti holipah 319887
30 bd hj yayat purwasari 7/31/2022 fitri 317794
31 bd hj yayat purwasari 7/28/2022 by ny nurul 319664
32 poned kota baru poned kotabaru 8/2/2022 sepia 319988
33 bd nidaul fitri klari 8/4/2022 fitri 320146
34 bd dian anisa duren 7/25/2022 noktik 319698
35 bd dian anisa duren 7/21/2022 by andakara 313790
36 bd hj carnah majalaya 8/7/2022 rukmini 061513
37 bd nok rina klinik sri sukma 8/7/2022 sutirani
38 bd lina roslina duren 7/16/2022 by ny neneng 318874
39 dr heni yulia pkm majalaya 7/14/2022 sri sulastri 318740
40 bd ita klinik andina 7/13/2022 romlah 318623
41 dr febri F pkm curug 7/26/2022 ny susi marlina 319480
42 dr nidia pkm purwasari 7/23/2022 siti badriah 319285
43 bd hj nurhayati darawolong purwasari 7/26/2022 namah 318587
44 dr lindawati pkm purwasari 7/28/2022 tanti 319646
45 dr gina pkm purwasari 8/1/2022 siti almah 300429
46 dr velly a klinik zahira 7/30/2022 devi s 319674
47 dr tria klinik GM Kosambi 8/1/2022 ani sri 188428
48 dr ela klinik darawolong 8/2/2022 sumiati 288275
49 dr nidia pkm purwasari 8/2/2022 indriyani 137037
50 dr bobzi klinik zahira 8/1/2022 nia k 319938
51 dr purna irawan Klinik Assalam 8/3/2022 meati 292305
52 dr zulkarnain pkm tempuran 8/3/2022 tarwiyah 248342
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS Rawatan Rp 25,000
BPJS Curetase Rp 50,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS PN Rp 50,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS PN Rp 50,000
BPJS Kuretase Rp 50,000
BPJS Kuretase Rp 50,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
bpjs rawatan Rp 25,000
BPJS SC Rp 100,000
BPJS PN Rp 50,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
BPJS SC Rp 100,000
1 ABAY 3
2 AGAS 1
3 AHMAD SOPIAN 1
4 AJANG S 4
5 AMO 2
6 ASEP KALIBUAYA 1
7 ATA BANCIN 1
8 AYU LESTARI 1
9 AYU SUCIANTI 4
10 D SALEH 4
11 DADI 1
12 DARSAM 7
13 DARTA KIMING 1
14 DARTA TURI 2
15 DEDE ANWAR 13
16 DEDE S 2
17 DEDI DAWUAN 1
18 DENI JAYA L 1
19 DIDI ISKANDAR 5
20 DINI ANDRIYANI 1
21 DODY 11
22 DURAHMAN 2
23 EDAH 2
24 EJANG 3
25 ENAN 1
26 ENDANG 2
27 FAISAL RIFQI 1
28 GABRIL 2
29 HERI KUSAERI 2
30 IWAN 2
31 IWAN TD 2
32 JAJANG 2
33 JOGING 1
34 JUJU 7
35 JUMSARI 20 1
36 KARMAN KOPRAL 1
37 KARMAWAN 3
38 KASMAN 9
39 KOSIM SUHARI 1
40 MA AYATI 6
41 MA ELAH 3
42 MARYATI 1
43 MESIN 2
44 MISLAN 1
45 MUKSIN 3
46 MULYADI/ DAMONG (4.541) 1 1
47 NANANG 2
48 NANO 3
49 NASIR 1
50 NAWANGSIH 10
51 OJOS 2
52 OMAT 2
53 OMIN 2
54 PAYO T 4
55 RADITA 3
56 RAHMAT MG JAYA (1.233) 1
57 RIKI (4.672) 11 1
58 ROSIN 2
59 ROWI Z 1
60 RT AJA 3
61 RT IMAN 6
62 RW EDO 2
63 SAHRUDIN 2
64 SALAMAH 10
65 SALIM S 1
66 SANA PRIYATNA 2
67 SARI (7.057 & 7.196) 20 2
68 SIGIT NURSETA 2
69 SITI KURNAESIH 1
70 SOBLENG (15.365) 3 1
71 SOBUR 3
72 SRI HARTATI 2
73 SRI ISDI (3.117) 1
74 SRI MAESAROH 1
75 SYARIEF 15
76 SYIFA (13.354 & 1.076) 2
77 TIGOR 1
78 TINI 3
79 TOSIM (3.459) 11 1
80 U GOLER 1
81 UMAR 4
82 WAKIL AKUNG 18
83 WANDA 4
84 WANTA WADIMAN (9.360) 1 1
85 WAWAN H 3
86 WIWIN 23
87 YAYA 14
88 YAYU SUWANDIARA 3
Jumlah Keterangan
Rp 75,000 periode 7-23 Sept 2022
Rp 100,000 periode 7-23 Sept 2022
Rp 100,000 periode 7-23 Sept 2022
Rp 100,000 periode 7-23 Sept 2022
Rp 175,000 periode 7-23 Sept 2022
Rp 325,000 periode 7-23 Sept 2022
Rp 125,000 periode 7-23 Sept 2022
Rp 275,000 periode 7-23 Sept 2022
Rp 175,000 periode 7-23 Sept 2022
Rp 643,000 periode 7-23 Sept 2022
Rp 225,000 periode 7-23 Sept 2022
Rp 150,000 periode 7-23 Sept 2022
Rp 138,500 periode 7-23 Sept 2022
Rp 250,000 periode 7-23 Sept 2022
Rp 100,000 periode 7-23 Sept 2022
Rp 308,500 periode 7-23 Sept 2022
Rp 392,000 periode 7-23 Sept 2022
Rp 150,000 periode 7-23 Sept 2022
Rp 250,000 periode 7-23 Sept 2022
Rp 856,500 periode 7-23 Sept 2022
Rp 459,000 periode 7-23 Sept 2022
Rp 375,000 periode 7-23 Sept 2022
Rp 360,500 periode 7-23 Sept 2022
Rp 361,500 periode 7-23 Sept 2022
Rp 100,000 periode 7-23 Sept 2022
Rp 450,000 periode 7-23 Sept 2022
Rp 100,000 periode 7-23 Sept 2022
Rp 259,000 periode 7-23 Sept 2022
Rp 575,000 periode 7-23 Sept 2022
Rp 350,000 periode 7-23 Sept 2022
no No u Nama perujuk alamat no telp nama pasien MR keterangan
1 17 bd wiwit s (terangsari?) 8/12/2022 ny siti khodijah 117289 BPJS
2 23 bd tutilawati cikampek 8/16/2022 ny heni 320982 BPJS
3 20 bd lina roslina duren kosambi 8/19/2022 ny ika fitriah 320249 BPJS
4 29 bd nidaul f duren kosambi 8/21/2022 ny sarah alfianita321316 BPJS
5 33 Bidan Sri maelasari
kerja di Puskesmas nagasari
7/13/2022 Sri sulastri 318740 Bpjs
6 24 bd ayu hermianti kiarapayung 8/12/2022 ny wulan 153950 BPJS
Klinik Curug
37 Klinik Curug Rahayu Rahayu, Curug 8/14/2022 Fitri setiawi 277095 Bpjs
7 kosambi
8 15 bd siti nurjanahklinik gita medika, sumur gede
8/12/2022 ny dewi rosita 320709 BPJS
9 5 bdn.Tria Klinik Graha Medis 8/11/2022 Ny.Ratnakomala182894 BPJS
10 38 bd upik cahyaningrumKlinik Graha Medis ksb8/10/2022 asiyah 139160 Bpjs
11 13 dr.Eli Lestari Klinik Mitra Kondang8/18/2022 Ny.Rika M 178675 BPJS
12 9 dr.Meutia Klinik Mitra Sehat 8/12/2022 Ny.Esih 320721 BPJS
13 2 dr.Dara M Klinik Mustika 9/8/2022 Ny.Ratnasari 320322 BPJS
14 3 dr.Dara Mustika Klinik Mustika 8/10/2022 Ny.Fadia 320605 BPJS
15 32 dr dimaz prabu Klinik mustika, Ciampel7/25/2022 Krisma aulia 319441 Bpjs
16 39 dr irsyad klinik rscsh 8/10/2022 niah hasanah 234524 BPJS
17 19 klinik zhafira zarifa klinik zhafira zarifa 8/14/2022 ny arti 320807 BPJS
18 34 Klinik Zhafira zarifa Klinik Zhafira zarifa 7/26/2022 Nia nurhayati 093102 Bpjs
19 28 bd mimin rusmiati mekarjaya rawamerta 8/22/2022 ny dian lestari 321400 BPJS
20 22 bd nur endah sariyani pasir panjang 8/12/2022 ny nurega 320768 BPJS
21 7 bdn.Desi Perum BKR 8/12/2022 Ny.Erni 320741 BPJS
22 18 bd nelis anggraeni perum villa karawangi8/12/2022 ny nurhasanah 320694 BPJS
23 25 bd nelis anggraeni perum villa karawangi8/20/2022ny evi puspitasari321256 BPJS
24 42 dr tian gustiani pkm ciampel 8/2/2022 widiawati 200200 Bpjs
25 31 Puskesmas klari PKM Klari 7/25/2022 Sari 319493 Bpjs
26 8 dr.Heni PKM Majalaya 8/12/2022 Ny.Cahyati 252843 BPJS
27 6 dr.Abdul Kodir PKM Pedes 8/10/2022Ny.Siti Kholiyah 305002 BPJS
28 30 Puskesmas purwasari PKM Purwasari 7/13/2022 Mutiara ade s 302902 Bpjs
29 1 dr.Intan N PKM Rawamerta 9/8/2022 Ny.Odeh 320379 BPJS
30 4 dr.Intan N PKM Rawamerta 8/10/2022 Ny.Diah 260090 BPJS
31 10 dr.Sutardi PKM Rawamerta 8/12/2022 Ny.Atin P 320705 BPJS
32 16 dr sutardi PKM Rawamerta 8/15/2022 ny liminar 320870 BPJS
33 43 dr cahya dinata pkm sungaibuntu 8/4/2022 tarmah 315076 BPJS
34 40 Poned Ciampel Poned Ciampel 8/7/2022 dedeh dahlia 229719 BPJS
35 41 Poned Ciampel Poned Ciampel 8/1/2022 asriyati 153934 BPJS
36 26 bd poned poned cikampek 8/20/2022ny ira Rahmawati321224 BPJS
37 27 bd yayat haryatini purwasari 8/22/2022 ny saroh 321375 BPJS
38 11 dr.Tian G PUSKESMAS Ciampel8/16/2022 Ny.Elly T 320967 BPJS
39 35 Puskesmas Cikampek Puskesmas Cikampek 8/16/2022 Milna Anastasya320980 Bpjs
40 36 Puskesmas Cikampek Puskesmas Cikampek 8/16/2022 Tresna 320985 Bpjs
41 12 dr.Mardsi PUSKESMAS Kertamukti 8/16/2022 Ny.Evi N 320945 BPJS
42 14 dr.Sutardi PUSKESMAS Rawamerta 8/19/2022 Ny.Hindun 321208 BPJS
43 21 bd titin patimah tempuran 8/19/2022 ny ika 320249 BPJS
Tindakan Jumlah
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
Rawatan Rp 25,000
SC Rp 100,000
PN Rp 50,000
SC Rp 100,000
Rawatan Rp 25,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
Rawatan Rp 25,000
Rawatan 25000
Rawatan Rp 25,000
SC Rp 100,000
Kuret Rp 50,000
PN Rp 50,000
Rawatan Rp 25,000
Curet Rp 50,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
Kuret Rp 50,000
SC Rp 100,000
Rawatan Rp 25,000
Kuret Rp 50,000
SC Rp 100,000
SC Rp 100,000
Curet Rp 50,000
SC Rp 100,000
SC Rp 100,000
PN Rp 50,000
Rawatan Rp 25,000
PN Rp 50,000
SC Rp 100,000
SC Rp 100,000
Kuret Rp 50,000
SC Rp 100,000
Rawatan Rp 25,000
Rawatan Rp 25,000
SC Rp 100,000
1 46 dr apex PKM Anggadita 8/9/2022 seneng 185754
2 44 dr bobzi r klinik zahira 8/3/2022 by ny ita 316867
3 45 dr bobzi r klinik zahira 8/5/2022 sutyah 310359
cadaskertajaya,
4 43 dr dwi inggiany telagsari 7/31/2022 anih 250516
5 47 dr sutardi PKM Rawamerta 7/25/2022 acah cahyati 319402
dsn sindang palay
6 21 Dr.Oki mashera telagasari 7/15/2022 Abdul fan 217893
perum griya pesona
7 6 Hj Fatimah zahra asri 7/27/2022 Nevka ayuri e 255195
8 17 Klinik Amanda Lemahabang 7/25/2022 bayi ny indah lestari 305408
9 1 Klinik Anabi Lemah duhur 19-Jul-22 Tn.Cikan
10 23 Klinik Assalam Cengkong 7/15/2022 Felycia Azeta 318795
11 24 Klinik Assalam Cengkong 7/11/2022 Azlan 282257
12 25 Klinik Assalam Cengkong 7/20/2022 Maya 317747
13 26 Klinik Assalam Cengkong 7/26/2022 Aisyah 094613
14 27 Klinik Assalam Cengkong 7/25/2022 Azam 306804
15 28 Klinik Assalam Cengkong 6/10/2022 Rafesya 318412
16 29 Klinik Assalam Cengkong 7/20/2022 Sutrisnao 192958
17 22 Klinik Aulia Purwasari 7/12/2022 Dasih 274934
18 7 Klinik Graha medis Kosambi 7/18/2022 Fadhil muhammad 318741
19 8 Klinik Graha medis Kosambi 7/23/2022 Siti jubaedah 319317
20 9 Klinik Graha medis Kosambi 7/27/2022 Aa Herman 319572
21 10 Klinik Graha medis Kosambi 7/26/2022 Naura anindya 319494
22 11 Klinik Graha medis Kosambi 7/28/2022 Nazwa 319627
23 12 Klinik Graha medis Kosambi 7/18/2022 Andrean maulana 143712
24 13 Klinik Graha medis Kosambi 7/19/2022 imam wicaksono dp 319083
25 14 Klinik Graha medis Kosambi 8/9/2022 Al habsyie 179757
26 15 Klinik Graha medis Kosambi 8/12/2022 Rojali 320720
27 16 Klinik Graha medis Kosambi 8/2/2022 Ridwan 319959
28 30 klinik mustika ciampel 8/6/2022 rosmini 246880
29 31 Klinik Nursepta Purwasari 7/13/2022 Ading 262550
30 36 Klinik Puri asih cikampek Cikampek 8/13/2022 Sujiah 755429
31 32 Klinik Purwa medika Tamelang 7/14/2022 Maulana ilyas 318736
32 33 Klinik Purwa medika Tamelang 7/25/2022 Reinata 218129
33 34 Klinik Purwa medika Tamelang 7/23/2022 Byi ny siti romlah 317309
34 35 Klinik Purwa medika Tamelang 8/8/2022 Dzaki taufik N 302621
35 19 Klinik Siti khadizah Johar 7/14/2022 Doni setiawan 318745
36 41 Klinik Soja medika cilebar 7/25/2022 Ocem 164828
37 42 Klinik Sukatani medika Cilamaya wetan 8/13/2022 Kaibah 320823
38 18 Klinik Telagasari Telagasari 7/29/2022 Syehn abirahma 159005
39 37 Klinik vidya medika Telagasari 7/15/2022 Suryani 268560
40 38 Klinik vidya medika Telagasari 7/20/2022 ijah 258072
41 39 Klinik vidya medika Telagasari 7/19/2022 Embay 215965
42 5 Klinik Zhafira zarifa klari 7/31/2022 Bayi ny ayu 319807
43 4 Puskesmas Ciampel ciampel 7/25/2022 Fitriani 319419
44 3 Puskesmas Lemah abang Lemahabang Rahmat 168761
45 20 Puskesmas Lemah abang Lemahabang Epe safei 318706
46 2 Puskesmas majalaya Majalaya Ny. karnila 116046
47 40 Syamil medical center Tempuran 7/31/2022 Tati 319781
Aug-22 Rawatan 25000


alamat no telp no telp 1 Rajal No Rajal Ranap No Ranap
PURWASARI 1 P 42 210000
RAWAMERTA 2 P 31 155000
TELAGASARI 3 P 31 155000
LEMAH DUHUR 4 P 28 140000
KLARI 5 P 23 115000
MAJALAYA 6 P 20 100000
TEMPURAN 7 P 18 90000
CURUG 8 P 15 75000
CIAMPEL 9 P 14 70000
LEMAH ABANG 10 P 13 65000
KERTAMUKTI 11 P 11 55000
ANGGADITA 12 P 10 50000
BALONGSARI 13 P 10 50000
RS CITRA SARI HUSADA (JST) 14 P 9 45000
PASIRRUKEM 15 P 8 40000
KUTAWALUYA 16 P 7 35000
BATUJAYA 17 P 6 30000
CILAMAYA 18 P 6 30000
PEDES 19 P 6 30000
CIKAMPEK 20 P 5 25000
JAYAKERTA 21 P 5 25000
ADIARSA 22 P 4 20000
BAYUR LOR 23 P 3 15000
CIBUAYA 24 P 2 10000
GEMPOL 25 P 2 10000
KUTAMUKTI 26 P 2 10000
PLAWAD 27 P 2 10000
RS CITRA SARI HUSADA 28 P 2 10000
KALANGSARI 29 P 1 5000
KOTABARU 30 P 1 5000
PAKISJAYA 31 P 1 5000
PANCASAN 32 P 1 5000
PKM CIASEM 33 P 1 5000
PKM PATOKBEUSI 34 P 1 5000
PUSKESMAS ADIARSA 35 P 1 5000
RS HERMINA KEMAYORAN 36 P 1 5000
RS MEDIKA BSD 37 P 1 5000
SINDANGKASIH 38 P 1 5000
SIRNAJAYA 39 P 1 5000
SUKASARI 40 P 1 5000
SUKATANI 41 P 1 5000
SUKMAJAYA 42 P 1 5000
WANAKERTA 43 P 1 5000
KLINIK GRAHA MEDIS KOSAMBI 1 K 50 250000
KLINIK TELAGA SARI 2 K 40 200000
KLINIK FIKRI MEDIKA 2 3 K 36 180000
KLINIK ASSALAM 4 K 35 175000
KLINIK FIKRI MEDIKA 5 K 34 170000
KLINIK GRAHA MEDIS KOPEL 6 K 27 135000
KLINIK DARAWOLONG 7 K 25 125000
KLINIK MITRA SEHAT 8 K 25 125000
KLINIK VIDYA MEDIKA 9 K 24 120000
KLINIK ZHAFIRA ZARIFA 10 K 24 120000
KLINIK ANDINA 11 K 21 105000
KLINIK SRI SUKMA 12 K 21 105000
KLINIK AULIA 13 K 19 95000
KLINIK YAKESTI 14 K 19 95000
KLINIK DIMAS MEDIKA 15 K 18 90000
KLINIK PURI ASIH KOSAMBI 16 K 15 75000
KLINIK TEMPURAN MEDIKA 17 K 15 75000
KLINIK PURWA MEDIKA 18 K 12 60000
Klinik Nursepta 19 K 11 55000
KLINIK CURUG RAHAYU 20 K 10 50000
KLINIK MUSTIKA 21 K 10 50000
klinik siti azaria 22 K 10 50000
KLINIK ZAHIRA 23 K 10 50000
KLINIK AMANDA 24 K 7 35000
KLINIK DOTA MEDIKA 25 K 7 35000
KLINIK GRIYA MEDIKA 26 K 7 35000
Klinik Novia 27 K 7 35000
KLINIK GRAHA MEDIS CIKAMPEK 28 K 6 30000
KLINIK MITRA KONDANG UTAMA 29 K 6 30000
KLINIK SAFIRA MEDIKA 30 K 6 30000
KLINIK WADAS MEDIKA 31 K 6 30000
KLINIK ANNISA KUTAGANDOK 32 K 5 25000
KLINIK HASTIEN 33 K 5 25000
KLINIK KINASIH 34 K 5 25000
KLINIK ASTER 35 K 4 20000
KLINIK JATISARI 36 K 3 15000
Klinik Kimia Farma Kosambi 37 K 3 15000
KLINIK PURI ASIH CIKAMPEK 38 K 3 15000
KLINIK ANGGADITA MEDIKA 39 K 2 10000
KLINIK BEN-MARI 40 K 2 10000
KLINIK BHAKTI MEDIKA 41 K 2 10000
KLINIK GRAHA MEDIS CILAMAYA 42 K 2 10000
KLINIK GRIYA AZ-ZAHRA 43 K 2 10000
KLINIK KUSUMA MEDIKA 44 K 2 10000
KLINIK NAURAH MEDIKA 45 K 2 10000
KLINIK SYAFIRA 46 K 2 10000
KLINIK SYAFIRA 2 47 K 2 10000
Jumlah Keterangan
210000 periode 25 juli - 25 agustus 2022
1 ABAY 10
2 AGAS 1
3 AJA MIHARJA 1
4 AJANG S 1
5 AMO 2
6 ATIKAH 1
7 BOBY 2
8 CASMITA 2
9 DADI 1
10 DANI 1
11 DARTA TURI 1
12 DEDE ANWAR 8 1
13 DENI JAYA L 3 1
14 DIDI ISKANDAR 1
15 DODY 11
16 E NARSIM 1
17 EJANG 1
18 ENAN 3
19 ENDAH 3
20 ENDANG 3
21 GABRIEL 2
22 HERI KUSAERI 8
23 JAJANG 2
24 JAJANG H 1
25 JOGING 1
26 JUJU 13 1
27 JUMSARI 12 2
28 KARDI S. P 2
29 KOSASIH 2
30 KOSIM SUHARI 5
31 MA ELAH 5
32 MISLAN 2
33 NANO 9
34 NASIR 4
35 NAWANGSIH 7
36 OMIN 5
37 OMPONG 5
38 RADITA 2
39 RT AJA 6
40 RT IMAN 3
41 RW EDO 4
42 SAHRUDIN 2
43 SALAMAH 9
44 SALIM S 2
45 SARI 7 2
46 SIFA 1
47 SOBLENG 6
48 SOBUR 2
49 SRI HARTATI 2
50 SRI MAESAROH 3
51 SURYADI 1
52 SYARIEF 11
53 TOSIM 12
54 UMAR 4
55 WAKIL AKUNG 1
56 WANTA WARDIMAN 2
57 WIWIN 2
58 YAYA 12 1
Jumlah Keterangan
250000 periode 26 Sept - 6 okto 2022
198500.025 periode 26 Sept - 6 okto 2022
RAWAMERTA 1 P 39 Rp 195,000
TELAGASARI 2 P 37 Rp 185,000
KLARI 3 P 29 Rp 145,000
PURWASARI 4 P 28 Rp 140,000
MAJALAYA 5 P 23 Rp 115,000
CIAMPEL 6 P 17 Rp 85,000
KUTAWALUYA 7 P 13 Rp 65,000
LEMAH DUHUR 8 P 13 Rp 65,000
CURUG 9 P 10 Rp 50,000
PASIRRUKEM 10 P 10 Rp 50,000
TEMPURAN 11 P 10 Rp 50,000
BALONGSARI 12 P 9 Rp 45,000
KERTAMUKTI 13 P 9 Rp 45,000
LEMAH ABANG 14 P 8 Rp 40,000
PEDES 15 P 8 Rp 40,000
RS CITRA SARI HUSADA 16 P 8 Rp 40,000
PAKISJAYA 17 P 6 Rp 30,000
ANGGADITA 18 P 5 Rp 25,000
BATUJAYA 19 P 5 Rp 25,000
CIKAMPEK 20 P 5 Rp 25,000
SUNGAI BUNTU 21 P 4 Rp 20,000
BAYUR LOR 22 P 3 Rp 15,000
CIBUAYA 23 P 3 Rp 15,000
KUTAMUKTI 24 P 3 Rp 15,000
SUKATANI 25 P 3 Rp 15,000
TIRTAMULYA 26 P 3 Rp 15,000
CILAMAYA 27 P 2 Rp 10,000
PANGKALAN 28 P 2 Rp 10,000
KLINIK ASSALAM 1 K 51 Rp 255,000
KLINIK GRAHA MEDIS KOSAMBI 2 K 43 Rp 215,000
KLINIK FIKRI MEDIKA 3 K 38 Rp 190,000
KLINIK FIKRI MEDIKA 2 4 K 33 Rp 165,000
KLINIK VIDYA MEDIKA 5 K 31 Rp 155,000
KLINIK TELAGA SARI 6 K 29 Rp 145,000
KLINIK ZHAFIRA ZARIFA 7 K 27 Rp 135,000
KLINIK ZAHIRA 8 K 24 Rp 120,000
KLINIK YAKESTI 9 K 23 Rp 115,000
KLINIK ANDINA 10 K 22 Rp 110,000
KLINIK DARAWOLONG 11 K 21 Rp 105,000
KLINIK GRAHA MEDIS KOPEL 12 K 20 Rp 100,000
KLINIK PURI ASIH KOSAMBI 13 K 20 Rp 100,000
KLINIK CURUG RAHAYU 14 K 17 Rp 85,000
KLINIK MITRA SEHAT 15 K 17 Rp 85,000
KLINIK MUSTIKA 16 K 16 Rp 80,000
KLINIK PURWA MEDIKA 17 K 16 Rp 80,000
KLINIK AULIA 18 K 15 Rp 75,000
KLINIK SRI SUKMA 19 K 13 Rp 65,000
KLINIK TEMPURAN MEDIKA 20 K 11 Rp 55,000
KLINIK AMANDA 21 K 9 Rp 45,000
KLINIK MITRA KONDANG UTAMA 22 K 9 Rp 45,000
KLINIK DIMAS MEDIKA 23 K 8 Rp 40,000
Klinik Novia 24 K 8 Rp 40,000
KLINIK GRAHA MEDIS CIKAMPEK 25 K 7 Rp 35,000
KLINIK WADAS MEDIKA 26 K 7 Rp 35,000
KLINIK HASTIEN 27 K 6 Rp 30,000
KLINIK KINASIH 28 K 6 Rp 30,000
KLINIK NAURAH MEDIKA 29 K 5 Rp 25,000
KLINIK BINA MEDIKA 30 K 4 Rp 20,000
KLINIK DOTA MEDIKA 31 K 4 Rp 20,000
KLINIK GRIYA MEDIKA 32 K 4 Rp 20,000
Klinik Kimia Farma Kosambi 33 K 4 Rp 20,000
KLINIK SAFIRA MEDIKA 34 K 4 Rp 20,000
KLINIK ANGGADITA MEDIKA 35 K 3 Rp 15,000
KLINIK GRAHA MEDIS CILAMAYA 36 K 3 Rp 15,000
Klinik Nursepta 37 K 3 Rp 15,000
KLINIK POLRES KARAWANG 38 K 3 Rp 15,000
KLINIK SYAFIRA 2 39 K 3 Rp 15,000
KLINIK ANNISA KUTAGANDOK 40 K 2 Rp 10,000
KLINIK BHAKTI MEDIKA 41 K 2 Rp 10,000
KLINIK KEKAR 42 K 2 Rp 10,000
KLINIK MITRA SEHAT CIMAREME 43 K 2 Rp 10,000
KLINIK PUPUK KUJANG 44 K 2 Rp 10,000
KLINIK PURI ASIH CIKAMPEK 45 K 2 Rp 10,000
klinik siti azaria 46 K 2 Rp 10,000
Jumlah Keterangan
195000 periode 26 agust - 25 sept 2022
periode 26 agust - 25 sept 2022
1 Dr. Nurhasanah Klinik Andina 9/2/2022
4 Dr. Reza Indiarto Klinik Anggadita Medika 9/10/2022
5 Dr. Purna Irawan klinik assalam 8/31/2022
6 Dr. Lindawati klinik assalam 7/29/2022
7 Dr. Theresia Lestari K klinik aulia 8/31/2022
8 Dr. Theresia Lestari K klinik aulia 8/9/2022
9 Dr. Muhammad Alvin R Klinik Curug Rahayu 8/11/2022
10 Dr. Essy Marina M.kes Klinik Curug Rahayu 8/18/2022
11 Dr. Arifin Klinik Curug Rahayu 8/27/2022
12 Dr. Ela Agustin Klinik Darawolong 8/4/2022
18 Dr. Dhita Prima Anggita Klinik Dimas Medika 8/21/2022
19 Dr. Dhita Prima Anggita Klinik Dimas Medika 8/21/2022
20 Yunan Syahban M Klinik Fikri Medika 8/21/2022
21 Dr. Herudin Klinik Fikri Medika 2 9/6/2022
22 Dr. Herudin Klinik Fikri Medika 2 8/30/2022
23 Dr. DK Bara Klinik Fikri Medika 2 8/19/2022
24 Sunuhardo Ep, dr., M.kes Klinik Graha Medis 8/2/2022
25 Dr. Gina Noviana Klinik Graha Medis 8/3/2022
26 Dr. Vina Pebria Klinik Graha Medis 8/6/2022
34 Dr. Wulan Febriarty Klinik Hastien 8/8/2022
35 Dr. Handi Nurbiyanto Klinik Kinasih 9/17/2022
36 Dr. Fauzi Andiwinata Klinik Kimia Farma
37 Dr. Reza Indiarto Klinik Mitra Sehat 9/5/2022
38 Dr. Reza Indiarto Klinik Mitra Sehat 8/24/2022
39 Ricoh Andalas Klinik Mitra Sehat 8/21/2022
40 Dr. Meutia Fathia Rahmah Klinik Mitra Sehat 9/2/2022
41 Dr. Elly Lestari K Klinik Mitra Kondang 8/4/2022
42 Dr. Meutia Fathia Rahmah Klinik Mitra Sehat 8/25/2022
43 Dr. Hasan Sanjaya Klinik Pratama Mecca Sanjaya 8/31/2022
44 Dr. Hasan Sanjaya Klinik Pratama Mecca Sanjaya 8/17/2022
45 Rita Sutantri, Amd.Keb Klinik Nursepta 9/5/2022
46 Dr.H. Hermantoni Klinik Nur Asy-Syifa 8/6/2022
47 Dr. Hendra Gunawan Klinik Wadas Medika 8/23/2022
48 Dina Putri Handayani Klinik Puri Medika 9/14/2022
49 Dr. Ana Permatasari.MM klinik puri Asih 8/27/2022
50 Rs izza Rs Izza 8/5/2022
51 Dr. Dessy Anitasari,Sp.A RSIA Dr. Djoko Pramono 8/5/2022
52 DR. Dr. Kiki Lukman Rumah Sakit Hasan Sadikin 8/1/2022
53 Dr. Muhammad Irsyad Rumah Sakit Citra Sari Husada 8/12/2022
54 dr siska elpiyanti klinik siti Azaria 26/8/2022
55 klinik siti khadijah klinik siti khadijah 1/9/2022
56 dr mohamad jazuli klinik soja medika 4/9/2022
57 dr mohamad jazuli klinik soja medika 16/8/2022
58 dr usep klinik tempuran medika 2/8/2022
59 bd sri s klinik Telagasari 12/9/2022
60 dr Riswan diharjo klinik Telagasari
61 dr Riswan diharjo klinik Telagasari 5/9/2022
62 dr Riswan diharjo klinik Telagasari 2/8/2022
63 dr lukman endro klinik Telagasari 5/9/2022
64 dr emin nuriman klinik Telagasari 11/8/2022
65 dr hasan basri klinik tegalurung medika
66 dr fitriadi klinik vidya medika 17/8/2022
67 dr fitriadi klinik vidya medika
68 dr hasan basri klinik vidya medika 20/8/2022
69 dr m jihsad ramadhan klinik yafi medika 26/8/2022
70 dr elly lestari klinik yakesti 5/9/2022
73 dr sri hartoyo klinik yakesti 4/9/2022
74 dr enung yuliati klinik yakesti 1/9/2022
75 dr bobzi klinik zahira 7/9/2022
76 velly malihah klinik zahira 23/9/2022
77 DR NANIK klinik zahira 13/8/2022
78 velly malihah klinik zahira 28/8/2022
79 dr bobzi klinik zahira 29/8/2022
80 dr mer dolok pkm anggadita 22/8/2022
81 dr astri lovita pkm balongsari 4/8/2022
82 dr ira sugiyarti pkm balongsari 10/9/2022
83 dr irma nurlaelasari pkm cilamaya 7/8/2022
84 poned cikampek poned cikampek 30/8/2022
88 dr tian gustiani pkm ciampel 1/9/2022
89 poned ciampel pkm ciampel 9/9/2022
90 dr poppy h pkm ciampel 21/9/2022
91 poned ciampel pkm ciampel 20/9/2022
92 dr tian gustiani pkm ciampel 11/9/2022
93 pkm curug pkm curug 11/8/2022
94 dr irvan firmansyah pkm kertamukti 19/8/2022
95 dr eni susanti pkm klari 25/8/2022
96 dr diding rusnaedi pkm kutawaluya 29/8/2022
97 dr haerudin pkm pasirukeum 4/9/2022
nama pasien MR keterangan Tindakan
Ny Maesaroh 322275 26 agustus - 25 september sc
Tn Giandra faeyza anaqi 319972 26 agustus - 25 september Rawatan
Ny Melieliza 321372 26 agustus - 25 september Sc
Ny. Verani Dayanshah 322808 26 agustus - 25 september Rawatan
Tn sucipto 322136 26 agustus - 25 september Rawatan
Tn Gilang aditya 233906 26 agustus - 25 september Rawatan
Tn Fazia syafiqa budiman 255311 26 agustus - 25 september Rawatan
Tn Athar rizqi al-husain 166729 26 agustus - 25 september Rawatan
Ny Nurjanah 143588 26 agustus - 25 september Rawatan
Ny ayi yuni komariah 286456 26 agustus - 25 september sc
Tn abizard muttaqi 220814 26 agustus - 25 september Rawatan
Sdr. Budi M.S 26 agustus - 25 september Rawatan
Ny Oyeh 143955 26 agustus - 25 september Rawatan
Ny Siti Sopiah 321126 26 agustus - 25 september Rawatan
Tn. RM Malibul 127031 26 agustus - 25 september Rawatan
Ny Imas Istiadah Ismawati 240464 26 agustus - 25 september sc
Tn Raswid 172336 26 agustus - 25 september Rawatan
Ny Siti Sumirah 204829 26 agustus - 25 september sc
Tn Nana mardiana 321353 26 agustus - 25 september sc
Ny Eka Mustika H 015016 26 agustus - 25 september Sc
Ny Yeni 322523 26 agustus - 25 september sc
Ny Fitri Nur H 228283 26 agustus - 25 september SC
An M adnan Wijaya 300088 26 agustus - 25 september Rawatan
Ny Reni Septiani Halimi P 208446 26 agustus - 25 september Sc
Sdr Rahayu 26 agustus - 25 september Rawatan
An Azzura Amara A 301310 26 agustus - 25 september Rawatan
An M Faturrahmah 320490 26 agustus - 25 september Rawatan
Ny Vien 346689 26 agustus - 25 september Rawatan
Ny Niken Tri 180707 26 agustus - 25 september Rawatan
Ny Tarni 212388 26 agustus - 25 september Rawatan
Ny Eni Iswati 322464 26 agustus - 25 september Rawatan
Ny Rets 110621 26 agustus - 25 september Rawatan
Ny Ayu 26 agustus - 25 september Rawatan
An Rayhan Irawan 166622 26 agustus - 25 september Rawatan
Ny Apuy Suhartini 323296 26 agustus - 25 september Curret
Nn Laela Komlasari 188761 26 agustus - 25 september Rawatan
Tn Sumarna 264633 26 agustus - 25 september Rawatan
Ny Susilawati 171133 26 agustus - 25 september Rawatan
Ny Euis Rismawati 285109 26 agustus - 25 september Sc
Ny Sopiah 322294 26 agustus - 25 september Curret
Tn Mochammad Anggara K 231773 26 agustus - 25 september Rawatan
Ny Nani Rosmawati 216265 26 agustus - 25 september sc
Sdr Sofyan 26 agustus - 25 september Rawatan
Ny. Utiyah 321037 26 agustus - 25 september Rawatan
Ny Tri lestari 156027 26 agustus - 25 september Rawatan
Tn Suhamru 26 agustus - 25 september Rawatan
An Nia 26 agustus - 25 september Rawatan
Ny Nining Kartika 283215 26 agustus - 25 september Curret
Ny Lilis Sesiawati 193336 26 agustus - 25 september Rawatan
Ny Maemunah 063117 26 agustus - 25 september Rawatan
An Albyanda 320231 26 agustus - 25 september Rawatan
Ny. Kosiah 2035303 26 agustus - 25 september Rawatan
Tn Deni Apriatin 237699 26 agustus - 25 september Rawatan
neni mulyani 098180 26 agustus - 25 september Rawatan
sumiati 26 agustus - 25 september Rawatan
carmat 322377 26 agustus - 25 september Rawatan
Ocem 164828 26 agustus - 25 september Rawatan
indah komalasari 319933 26 agustus - 25 september Rawatan
yuliana 322934 26 agustus - 25 september SC
roni 321773 26 agustus - 25 september Rawatan
putri nurliyani 320170 26 agustus - 25 september Rawatan
rasya aprilia 180230 26 agustus - 25 september Rawatan
mella eliska 311232 26 agustus - 25 september SC
rahkmat susanto 066137 26 agustus - 25 september Rawatan
wala 311967 26 agustus - 25 september Rawatan
lilis lisnawati 272383 26 agustus - 25 september Rawatan
udin 26 agustus - 25 september Rawatan
tuti alawiyah 321269 26 agustus - 25 september Rawatan
nazra 321643 26 agustus - 25 september Rawatan
m keenan 263183 26 agustus - 25 september Rawatan
desi meilani 265465 26 agustus - 25 september Rawatan
ernawati 152175 26 agustus - 25 september Rawatan
amelia khanza 322418 26 agustus - 25 september Rawatan
galih putra 250664 26 agustus - 25 september Rawatan
ayra nurul 279202 26 agustus - 25 september Rawatan
selvi n 323741 26 agustus - 25 september SC
m abizar 313062 26 agustus - 25 september Rawatan
lilis a 193336 26 agustus - 25 september Rawatan
dendi aidil 190520 26 agustus - 25 september Rawatan
aprilia s 321364 26 agustus - 25 september Rawatan
ikah 320106 26 agustus - 25 september SC
anyi n 322825 26 agustus - 25 september kuret
amirudin 131409 26 agustus - 25 september Rawatan
rika fauzana 322027 26 agustus - 25 september Rawatan
dheby 321477 26 agustus - 25 september SC
maisaroh 322709 26 agustus - 25 september PN
siti rodiah 323028 26 agustus - 25 september PN
herni ningsih 303250 26 agustus - 25 september Rawatan
elsa 322771 26 agustus - 25 september SC
indah shafira 323534 26 agustus - 25 september SC
siti kursiah 113544 26 agustus - 25 september SC
erna yulianti 219029 26 agustus - 25 september SC
ainun nisa 156033 26 agustus - 25 september Rawatan
siti hasanah 233139 26 agustus - 25 september SC
awang b 159031 26 agustus - 25 september SC
kaman 321902 26 agustus - 25 september Rawatan
endi 322365 26 agustus - 25 september Rawatan
Jumlah
Rp 100,000
Rp 25,000
Rp 100,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 100,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 100,000
Rp 25,000
Rp 100,000
Rp 100,000
Rp 100,000
Rp 100,000
Rp 100,000
Rp 25,000
Rp 100,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 50,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 100,000
Rp 50,000
Rp 25,000
Rp 100,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 50,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 100,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 100,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 100,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 100,000
Rp 50,000
Rp 25,000
Rp 25,000
Rp 100,000
Rp 50,000
Rp 50,000
Rp 25,000
Rp 100,000
Rp 100,000
Rp 100,000
Rp 100,000
Rp 25,000
Rp 100,000
Rp 100,000
Rp 25,000
Rp 25,000
no No u Nama perujuk alamat no telp nama pasien
1 Bd Dedeh supriatin Ciranggon majalaya 9/5/2022 Ny sri andini
2 Bd sri hastuti hendra 8/28/2022 Tn Rayyan A
3 Bd Titi mulyani Perum mustika prakarsa 8/5/2022 Ny Dhefin
4 Klinik Babusalam kp krajan jomin timur 8/23/2022 Ny novi maulita
5 pkm lemahduhur pkm lemah duhur 8/6/2022 parni
6 bd nunung nurhayati klinik al fatih 9/12/2022 teti fitri
7 bd anisa a 9/10/2022 imas masrial
8 bd anisa a tempuran 9/23/2022 entin
9 bd yulia permatasari lemahduhur 9/12/2022 titin tiyana
10 ba ai siti telagasari 9/10/2022 astrid
11 bd selly indah 0812 1992 0004 9/23/2022 nurohmah
12 bd selly indah 0812 1992 0004 22//9/2022 lilis k
13 poned cikampek poned cikampek 9/24/2022 komulyati
14 poned klari poned klari 9/23/2022 hertati
15 bd suryamah ds pancawati 4/8/2022 siti rohmawati
16 bd dian anisa j puri kosambi duren 8/8/2022 rita
17 bd novi chandra bengle majalaya 9/8/2022 dedeh j
18 bd risa mahardika pasir panjang 8/8/2022 rahmadani
19 bd risa mahardika pasir panjang 28/8/2022 dian
20 bd risa mahardika pasir panjang 20/9/2022 aprilia
21 dr asep riansyah pasir panjang 25/8/2022 wafa
22 bd ade nuraini klinik zahrotul ummah 17/7//2022 tuti permatasari
23 bd dedeh supriatin ciranggon majalaya 5/9/2022 sri andini
24 bd sri nurhidayati jl raya kosambi klari 30/8/2022 nenden mustika
25 bd nelis anggraeni vila karawangi 4/9/2022 dede
26 bd rosidah perum trully purwasari 31/8/2022 dede sulastri
27 bd yayat haryatini purwasari 1/9/2022 dina
28 bd yayat haryatini purwasari siska mard
29 bd yayat haryatini purwasari 18/9/2022 tiara
30 hj neneng suciati klinik cariu 20/9/2022 dahlia
31 bd eka hidayah aulia perum griya permata indah blok b5 19/9/2022 marfungatul
32 bd anisa a tempuran 20/9/2022 dedeh j
33 bd anisa a tempuran 6/8/2022 desi
34 bd yulia permatasari neglasari lemahduhur 19/9/2022 yuyun yunengsih
35 bd ita herawati kalihurip ckp 19/9/2022 siti komala
36 bd ai lani duren klari 18/9/2022 lasria
37 bd n unirah dirujuk 15/9/2022 devina
38 bd nelis anggraeni meninggal 16/9/2022 agustiningsih
39 bd hj carnah lemahmulya majalaya 16/9/2022 nurhadiah
40 klinik zhafira zarifa klinik zhafira zarifa 2/9/2022 siti latifah
41 klinik zhafira zarifa klinik zhafira zarifa 8/9/2022 putri eka
42 klinik zhafira zarifa klinik zhafira zarifa 4/9/2022 siti nurhana
43 klinik zhafira zarifa klinik zhafira zarifa 26/8/2022 necih
44 klinik zhafira zarifa klinik zhafira zarifa 26/8/2022 fitri
45 klinik zhafira zarifa klinik zhafira zarifa 24/8/2022 tuti
46 klinik zhafira zarifa klinik zhafira zarifa 9/9/2022 fiqi nurmalina
47 klinik zhafira zarifa klinik zhafira zarifa 17/9/2022 eva farda
48 klinik zhafira zarifa klinik zhafira zarifa 9/9/2022 isnawati m
49 klinik zhafira zarifa klinik zhafira zarifa 23/9/2022 anis marsela
50 klinik zhafira zarifa klinik zhafira zarifa 6/9/2022 by ny winda
51 klinik zhafira zarifa klinik zhafira zarifa 9/25/2022 sugiwati
52 dr diding rusnaedi pkm kutawaluya 22/9/2022 aryeni
53 dr diding rusnaedi pkm kutawaluya 30/8/2022 iin intan
54 dr diding rusnaedi pkm kutawaluya 13/9/2022 nursiah
55 dr diding rusnaedi pkm kutawaluya 10/9/2022 fitrianingsih
56 dr maesari ahmad pkm kutamukti 24/8/2022 santi dewi
57 dr maesari ahmad pkm kutamukti 25/8/2022 herny sulastry
58 dr lindawati pkm purwasari 22/8/2022 ade aprilia
59 dr lindawati pkm purwasari 2/9/2022 masitoh
60 dr sutardi pkm rawamerta 30/8/2022 suarsih
61 dr devi n pkm telagasari 29/8/2022 acih suarsih
62 dr dudi pkm telagasari 22/8/2022 karni karniti
63 dr dudi pkm telagasari 12/9/2022 ema nurmala
64 dr melisa pkm telagasari 6/9/2022 kurniawati
65 dr devi n poned telagasari 3/9/2022 imas masitoh
66 dr wahyudin pkm tempuran 31/8/2022 asih
67 poned tempuran poned tempuran 14/9/2022 rina vitri
306422 Sc Rp 100,000
321813 Rawatan Rp 25,000
286747 Rawatan Rp 25,000
124968 sc Rp 100,000
320230 Sc Rp 100,000
322939 Sc Rp 100,000
318699 Sc Rp 100,000
323755 PN Rp 50,000
322966 Sc Rp 100,000
068941 Rawatan Rp 25,000
279573 Sc Rp 100,000
808197 Sc Rp 100,000
323774 PN Rp 50,000
323845 PN Rp 50,000
320068 curet Rp 50,000
320418 SC Rp 100,000
320501 SC Rp 100,000
320348 SC Rp 100,000
321836 SC Rp 100,000
266099 Rawatan Rp 25,000
317212 rawatan Rp 25,000
306044 SC Rp 100,000
306422 SC Rp 100,000
118529 SC Rp 100,000
284772 rawatan Rp 25,000
284772 SC Rp 100,000
322212 SC Rp 100,000
307302 SC Rp 100,000
323333 rawatan Rp 25,000
299652 curet Rp 50,000
260069 curet Rp 50,000
323528 rawatan Rp 25,000
265465 SC Rp 100,000
323427 SC Rp 100,000
289987 Rawatan Rp 25,000
323369 SC Rp 100,000
188772 SC Rp 100,000
311832 Rawatan Rp 25,000
322681 SC Rp 100,000
304455 Rawatan Rp 25,000
321699 SC Rp 100,000
322349 SC Rp 100,000
174888 SC Rp 100,000
254347 SC Rp 100,000
325266 SC Rp 100,000
226974 curet Rp 50,000
323753 SC Rp 100,000
322521 Rawatan Rp 25,000
049578 SC Rp 100,000
323686 SC Rp 100,000
321961 SC Rp 100,000
285260 curet Rp 50,000
322827 SC Rp 100,000
151306 SC Rp 100,000
322057 SC Rp 100,000
321430 SC Rp 100,000
207147 Rawatan Rp 25,000
322043 SC Rp 100,000
320902 SC Rp 100,000
226518 SC Rp 100,000
249011 SC Rp 100,000
322525 SC Rp 100,000
322343 Rawatan Rp 25,000
321178 Rawatan Rp 25,000
323054 curet Rp 50,000
1 ADANG RUSMANA 2
2 ADANG SUTEJA 2
3 AGAS 11
4 AHMAD DAELAMI 2
5 AJANG S 2
6 AMO 4
7 ANTA 2
8 ASEP ANDI 3
9 ATA BANCIN 6
10 BOBI 1
11 BOBY 2
12 CASMITA 1
13 D SALEH 13
14 DADI 2
15 DARTA KIMING 2
16 DARTA TURI 1
17 DEDE ANWAR 20
18 DEDE S 4
19 DENI K 4
20 DIDI ISKANDAR 8
21 DINI ANDRIYANI 3
22 DODY 5
23 DURAHMAN 1
24 E NARSIM S 1
25 EJANG 4
26 ENDANG 11
27 GIRI S 1
28 HERI KUSAERI 6
29 IDA 1
30 IMAN 8
31 IWAN TD 4
32 JAKA K 1
33 JOGING 2
34 JUJU 19
35 JUMSARI 15
36 KAJA 1
37 KARYA S 1
38 KASMAN 2
39 KOSASIH 2
40 KOSIM SUHARI 6
41 MA AYATI 13
42 MA ELAH 7 1
43 MUKSIN 1
44 NANO 11
45 NASIR 8 1
46 NAWANGSIH 7
47 NENI 7
48 NURASIH 2
49 NURSIFA 8
50 OJOS 3
51 OMAT 4
52 OMIN 3
53 OMPONG 1
54 RADITA 5
55 RHENO 5
56 RIKI 9
57 ROHAYATI 2
58 ROHMAN 1
59 ROHYATI 1
60 ROSIN 4
61 ROWI Z 1
62 RT AJA 7
63 RT AJA 1
64 RTIMAN 1
65 SAHRUDIN 1
66 SALAMAH 14
67 SANA PRIYATI 2
68 SARI 14 1
69 SOBLENG 9
70 SOBUR 2
71 SRI HARTATI 4 1
72 SRI ISDI 4
73 SRI MAESAROH 1 1
74 SUKARDI 1
75 SULAEMAN 1
76 SUWARSIH 2
77 SYARIEF 16
78 TINI 1
79 TOSIM 1 1
80 U GOLER 2
81 UDEN 2
82 UMAR S 1
83 UPAY 1
84 WAKIL AKUNG 7 1
85 WANDA 2
86 WIWIN 28 1
87 YAYA 20
88 YAYU 3
Jumlah Keterangan
50,000 periode 5-25 oktober 2022
1 bd ai lani 0857 8165 0883 10/1/2022
2 BD YAYAT HARYATINI CENGKONG PWS 10/14/2022
5 BD WIWIT SUPRAPTI CIBALONGSARI, oerum terangsari 10/16/2022
6 BD WIWIT SUPRAPTI CIBALONGSARI, oerum terangsari 10/2/2022
7 BD SULASTRI CIKANDE 10/7/2022
8 bd Fatimah Cilebar, Rawasari 10/15/2022
9 BD INTAN RATNA WATI CKM BENGLE, 0856 9463 7299 10/16/2022
10 bd Sri hastuti curug 9/29/2022
11 BD HJ NURHAYATI DARAWOLONG 10/8/2022
12 Bd dewi sartika jatisari 9/28/2022
13 bd nidaul f Klari Duren 10/1/2022
14 bd nunung n KLINIK AL FATIH MEDIKA 9/29/2022
15 bd nunung n KLINIK AL FATIH MEDIKA 9/27/2022
16 DR NURHASANAH KLINIK ANDINA 9/27/2022
17 DR NURHASANAH KLINIK ANDINA 10/4/2022
18 DR LINDAWATI KLINIK ASSALAM 9/19/2022
19 DR PURNA IRAWAN EKO KLINIK ASSALAM 10/5/2022
20 BD RANTI EKA KLINIK ASSALAM 10/10/2022
21 DR ELA AGUSTIN KLINIK DARAWOLONG 10/7/2022
22 DR YUNAN SYAHBAN KLINIK FIKRI MEDIKA 9/26/2022
23 BD RAFIKA AZIZA KLINIK GM KOPEL 10/4/2022
24 DR ANNISA YULIA KLINIK GRIYA MEDIKA 9/29/2022
25 BD IRKA P KLINIK MUSYTASYFAH
26 BD RITA S KLINIK NURSEPTA 9/1/2022
27 DR ANA p KLINIK PURI ASIH KOSAMBI 10/10/2022
28 DR ANA p KLINIK PURI ASIH KOSAMBI 10/10/2022
29 DR NURLISHA KLINIK TELAGASARI 9/24/2022
30 DR RINALDI KLINIK YAKESTI 10/6/2022
31 DR NANIK RETNOWATI KLINIK ZAHIRA 9/25/2022
32 BD ADE NURAINI KLINIK ZAHROTUL UMMAH 10/9/2022
33 KLINIK ZHAFIRA ZARIFA KLINIK ZHAFIRA ZARIFA 9/28/2022
34 DR M IRFAN R KLINK ASTRI 10/10/2022
35 BD YULIA PERMATASARI LEMAHDUHUR, DUSUN NEGLASARI 10/12/2022
36 BD YULIA PERMATASARI LEMAHDUHUR, DUSUN NEGLASARI 10/8/2022
37 DR ASTRI LOVITA PKM BALONGSARI 9/29/2022
41 DR ENI S PKM KLARI 9/20/2022
42 DR DIDING PKM KUTAWALUYA 10/2/2022
43 DR MONICA ADYAH PKM LEMAH DUHUR 9/19/2022
44 DR FARIDA NURDIN PKM MAJALAYA 9/26/2022
45 BD HJ NURHAYATI PKM PURWASARI
46 BD HJ NURHAYATI PKM PURWASARI 10/4/2022
47 dr lindawati PKM PURWASARI 10/10/2022
48 dr lindawati PKM PURWASARI 10/15/2022
49 BD HJ NURHAYATI PKM PURWASARI, DARAWOLONG 10/14/2022
50 DR INTAN NOORMAYANTI PKM RAWAMERTA 10/10/2022
51 DR Sutardi PKM RAWAMERTA 10/10/2022
54 DR SUTARDI PKM RAWAMERTA 10/7/2022
55 dr devi naviandari PKM TELAGASARI 10/12/2022
56 dr devi naviandari PKM TELAGASARI 10/12/2022
57 DR POPY HERAWATI PONED CIAMPEL 10/6/2022
58 BD JEANNIE PONED CIAMPEL 10/1/2022
59 DR TIAN G PONED PKM CIAMPEL 10/4/2022
60 DR MARDSI E PPKM KERTAMUKTI 10/10/2022
61 DR IRVAN F PPKM KERTAMUKTI 10/15/2022
62 Bd Mimin rusmiati Rawamerta, mekarjaya 10/4/2022
63 bd N Unirah Rawamerta, Pasir awi 10/3/2022
64 BD WINDA 10/10/2022
65 DR POCUT KLINIK ZHAFIRA ZARIFA 10/17/2022
66 DR EKA KLINIK TEMPURAN MEDIKA 10/17/2022
67 DR HAERUDIN KLINIK FIKRI MEDIKA 10/18/2022
68 DR VINA KLINIK GM KOSAMBI 10/17/2022
69 DR CHANDRA PKM LEMAH DUHUR 10/21/2022
70 bd ina putriana k perum griya panorama 9/18/2022
tina novia 073387 Rawatan Rp 25,000
ARTIKA 323401 SC Rp 100,000
SANIA 324992 KURET Rp 50,000
MASITA 324891 SC Rp 100,000
NOFSI 197811 SC Rp 100,000
siti s 324386 PN Rp 50,000
MAYMUNAH 324805 SC Rp 100,000
yani 325334 SC Rp 100,000
KOMALASARI 325412 RAWATAN Rp 25,000
wulan sari 324191 Rawatan Rp 25,000
IKA KRISTINA 324825 SC Rp 100,000
dewy susilawaty 312499 SC Rp 100,000
endang dwi 071960 Kuret Rp 50,000
rukiyah 324189 PN Rp 50,000
PUPUT CAHYANI 323997 SC Rp 100,000
BY NY RICNA LUSIANA 318482 RAWATAN Rp 25,000
IIS ISMAWATI 262377 SC Rp 100,000
WINDA SANTOSO 32419 SC Rp 100,000
SISKA DWI 324595 SC Rp 100,000
LINDA EKA 300769 RAWATAN Rp 25,000
GINA PURNAMA 130038 SC Rp 100,000
NENENG NURHAYATI 161828 SC Rp 100,000
IIS ROSYDAH 217618 PN Rp 50,000
TINAH 194416 SC Rp 100,000
MARNI
TUTI H 176585 RAWATAN Rp 25,000
ny intan c 181828 SC Rp 100,000
ny euis n 211353 SC Rp 100,000
ANGGI SAFITRI 078969 SC Rp 100,000
IMAS P 316506 RAWATAN Rp 25,000
ALFINA DEWI 229820 SC Rp 100,000
LIA 324907 SC Rp 100,000
UCIK NENY 324108 SC Rp 100,000
SITI FATIMAH 234296 RAWATAN Rp 25,000
NY SITI HAMIDAH 325184 SC Rp 100,000
ratnasari 246131 SC Rp 100,000
NURSARIPAH 324125 SC Rp 100,000
EEM 324311 SC Rp 100,000
NURHAYATI 324973 SC Rp 100,000
WARTINI 279694 SC Rp 100,000
ASIH 307325 Rawatan Rp 25,000
MILA RANTIKA 324359 Rawatan Rp 25,000
NURHAYATI 222471 KURET Rp 50,000
AYU LATIPAH 288909 SC Rp 100,000
NINA M 324744 SC Rp 100,000
LALA NUR 324538 SC Rp 100,000
ny yuli y 143729 SC Rp 100,000
ny intan y 148476 SC Rp 100,000
YAYAH RODIAH 325303 RAWATAN Rp 25,000
LELI N 223769 Kuret Rp 50,000
ny indri 143686 SC Rp 100,000
ny sinta 325317 PN Rp 50,000
NAMI 324711 SC Rp 100,000
AISYAH 324815 PN Rp 50,000
ny windi 223238 SC Rp 100,000
ny citra 325132 SC Rp 100,000
WACEM 318069 RAWATAN Rp 25,000
CUCU rajal Rp -
PRISKA P 324527 SC Rp 100,000
MARIAH 324995 SC Rp 100,000
YANI 325334 SC Rp 100,000
iin irnawati 324508 SC Rp 100,000
tita nurhasanah 298955 SC Rp 100,000
UUN 224201 SC Rp 100,000
NY YOSI 210727 SC Rp 100,000
NY IIN 325452 SC Rp 100,000
NY SUGATI 204889 SC Rp 100,000
NY ANISAH 128693 SC Rp 100,000
NY YULIANTY 325791 SC Rp 100,000
andina SC Rp 100,000
alamat Nama PSM no telp nama pasi RANAP no Mr KATARAK Jumlah
1 ABAY 2 Rp 50,000
2 ADIS 1 Rp 25,000
3 AGAS 1 Rp 25,000
4 AHMAD DAELAMI 2 Rp 50,000
5 AJANG S 3 Rp 75,000
6 AMO 2 Rp 50,000
7 ASEP PERMANA 1 Rp 25,000
8 D SALEH 1 Rp 25,000
9 DARTA TURI 3 Rp 75,000
10 DEDE ANWAR 15 Rp 375,000
11 DEDE S 1 Rp 25,000
12 DEDEH KURNIASIH 4 Rp 100,000
13 DENI K 1 Rp 25,000
14 DIDI ISKANDAR 4 Rp 100,000
15 DODY 6 Rp 150,000
16 ENAN 5 2 Rp 556,000
17 ENDANG 4 Rp 100,000
18 EUIS R 2 Rp 50,000
19 FAISAL RIFQI 1 Rp 25,000
20 GABRIEL 1 Rp 25,000
21 HERI KUSAERI 2 Rp 50,000
22 IMAN 1 Rp 25,000
23 JOGING 3 Rp 75,000
24 JUJU 6 Rp 150,000
25 JUMSARI 11 Rp 275,000
26 KAJA SUJANA 1 Rp 25,000
27 KARMAWA 1 Rp 25,000
28 KENTING 2 Rp 50,000
29 KOSASIH 5 Rp 125,000
30 MA AYATI 3 Rp 75,000
31 MA ELAH 5 1 Rp 205,000
32 MISLAN 2 Rp 50,000
33 NANO 5 Rp 125,000
34 NAWANGSIH 7 Rp 175,000
35 NENI 2 Rp 50,000
36 NURASIH 2 Rp 50,000
37 NURMALIK 1 Rp 25,000
38 ODING R 1 Rp 25,000
39 OMIN 2 Rp 50,000
40 OMPONK 3 Rp 75,000
41 RADITA 3 Rp 75,000
42 ROHIM 1 Rp 25,000
43 ROHMAN 3 Rp 75,000
44 ROSIN 1 Rp 25,000
45 ROWI Z 1 Rp 25,000
46 RT AJA 7 Rp 175,000
47 RW EDO 2 Rp 50,000
48 SAHRUDIN 2 Rp 50,000
49 SAIN 3 Rp 75,000
50 SALAMAH 10 Rp 250,000
51 SALIM S 1 Rp 25,000
52 SARI 1 Rp 25,000
53 SIFA 4 Rp 100,000
54 SOBLENG 4 Rp 100,000
55 SRI HARTATI 4 Rp 100,000
56 SRI ISDI 1 Rp 25,000
57 SUKARDI 3 Rp 75,000
58 SYARIEF 12 Rp 300,000
59 TARMEDI 1 Rp 25,000
60 TARSO 2 Rp 50,000
61 TINI 4 Rp 100,000
62 TOSIM 1 Rp 25,000
63 U GOLER 1 Rp 25,000
64 UJANG NURJAYA 2 Rp 50,000
65 UPAY 1 Rp 25,000
66 WAKIL AKUNG 6 Rp 150,000
67 WANDA 4 Rp 100,000
68 WANTA WARDIMAN 1 Rp 25,000
69 WIWIN 11 1 Rp 568,500
70 YAYA 3 Rp 75,000
71 YAYU S 1 Rp 25,000
72 YUDI 3 Rp 75,000
Keterangan
periode 26 oktober - 6 oktober 2022
1 ABAY 6 150000 6
2 AGAS 8 200000 8
3 AHMAD ROFEI 4 100000 4
4 AJANG S 4 100000 4
5 AMO 2 50000 2
6 ASEP ANDI 1 25000 1
7 ASEP PERMANA 1 25000 1
8 ASEP SUKARYA 1 25000 1
9 AYU SUCIYANTI 4 100000 4
10 BOBY 1 25000 1
11 D SALEH 14 350000 14
12 DADI 7 175000 7
13 DARSAM 2 50000 2
14 DEDE ANWAR 14 350000 75000 1 15
15 DEDENG 1 25000 1
16 DENI JAYA L 2 50000 2
17 DENI K 1 25000 1
18 DIDI ISKANDAR 4 100000 4
19 DINI ANDRIYANI 1 25000 1
20 DODY 4 100000 4
21 EDAH 3 75000 3
22 EJANG 3 75000 3
23 ELING/KARLIM 1 25000 1
24 ENAN 2 50000 2
25 ENDANG 7 175000 7
26 GABRIL 3 75000 3
27 GADRIL 1 25000 1
28 HERI KUSAERI 1 25000 1
29 IWAN MAULANA 1 25000 1
30 IWAN TD 2 50000 2
31 JAJANG 10 250000 10
32 JAKA KOMARA 1 25000 1
33 JOGING 2 50000 2
34 JUJU 21 525000 21
35 JUMSARI 32 800000 220000 1 33
36 KAJA SUJANA 3 75000 3
37 KARMAWAN 2 50000 2
38 KARTI 2 50000 2
39 KASMAN 5 125000 5
40 KONG IJO 1 25000 1
41 KOSASIH 9 225000 9
42 KOSIM SUHARI 4 100000 4
43 MA AYAT 4 100000 4
44 MA ELAH 10 250000 10
45 MISLAN 1 25000 1
46 NALIM 1 25000 1
47 NANANG 2 50000 2
48 NANO 5 125000 5
49 NAWANGSIH 4 100000 4
50 NURSIFA 5 125000 255000 1 6
51 ODANG 1 25000 1
52 OJOS 1 25000 1
53 OMPONG 4 100000 4
54 RADITA 9 225000 9
55 RAHMAT MG JAYA 1 25000 1
56 RIKI 15 375000 15
57 ROHAYATI 0 274500 1 1
58 ROHIM 1 25000 1
59 ROHMAN 2 50000 2
60 ROHMAT 1 25000 1
61 ROSIN 4 100000 4
62 ROWI ZAENAL 1 25000 1
63 RT ABDULLOH 2 50000 2
64 RT AJA 6 150000 6
65 RT IMAN 10 250000 10
66 RUSPAN 1 25000 1
67 RW EDO 1 25000 1
68 SAIN 2 50000 2
69 SALAMAH 16 400000 16
70 SALIM 2 50000 2
71 SARI 5 125000 5
72 SIFA 3 75000 3
73 SOBLENG 4 100000 4
74 SUPARDI 1 25000 1
75 SYARIEF 12 300000 130500 1 13
76 TINI 3 75000 3
77 TOSIM 5 125000 5
78 U GOLER 1 25000 1
79 UJANG NURJAYA 1 25000 1
80 UMAR 4 100000 4
81 UPAY 1 25000 1
82 WAKIL AKUNG 11 275000 194500 1 12
83 WANDA 6 150000 6
84 WANTA WARDIMAN 3 75000 3
85 WIWIN 10 250000 10
86 YAYA 6 150000 6
87 YAYU 3 75000 3
88 YUDI 2 50000 2
Jumlah Keterangan
Rp 150,000 periode 6-24 oktober 2022
Rp 1,020,000 periode 6-24 oktober 2022
1 ABAY 2 50000
2 ADI TRISUYATNO 2 50000
3 AGAS 2 50000
4 AHMAD ROFEI 6 150000
5 AJANG S 2 50000
6 AMO 2 50000
7 ASEP ANDI 2 50000
8 AYU SUCI YANTI 3 75000
9 BOBY 3 75000
10 CASMITA 1 25000
11 D SALEH 7 175000
12 DADI 1 25000
14 DEDE ANWAR 11 275000
15 DEDEH KURNIASIH 1 25000
16 DENI K 4 100000
17 EJANG 1 25000
18 ENAN 1 25000
19 ENDANG 9 225000
20 EWING 1 25000
21 GABRIL 4 100000
22 HERI SETIAWAN 2 50000
23 IDA 2 50000
24 JAJANG 1 25000
25 JOGING 2 50000
26 JUJU 8 200000
27 JUMSARI 14 350000
28 KARTI 2 50000
29 KENTING 2 50000
30 KOKOM 3 75000
31 KOSASIH 3 75000
32 KOSIM 4 100000
33 KUSTINI 1 25000
34 MA AYATI 6 150000
35 MA ELAH 7 175000
36 NANO 5 125000
37 NASIR 3 75000
39 NURSIFA 3 75000
40 OMPONG 2 50000
41 OMPONK 6 150000
42 RADITA 3 75000
44 RHENO 1 25000
45 RIKI 10 250000
46 ROHIM 1 25000
47 ROWI Z 1 25000
48 RT AJA 5 125000
49 SAHRUDIN 2 50000
50 SALAMAH 4 100000
51 SANA PRIYATI 1 25000
52 SARI 9 225000
53 SRI HARTATI 4 100000
54 SRI ISDI 5 125000
55 SUKARDI 3 75000
56 SUPARDI 3 75000
57 SYARIEF 2 50000
58 TOSIM 2 50000
60 WIWIN 21 525000
61 YAYA 6 150000
Jumlah Keterangan
50000 periode 25 Nov - 5 Des 2022
50000 periode 25 Nov - 5 Des 2022
50000 periode 25 Nov - 5 Des 2022
150000 periode 25 Nov - 5 Des 2022
50000 periode 25 Nov - 5 Des 2022
50000 periode 25 Nov - 5 Des 2022
50000 periode 25 Nov - 5 Des 2022
75000 periode 25 Nov - 5 Des 2022
75000 periode 25 Nov - 5 Des 2022
25000 periode 25 Nov - 5 Des 2022
175000 periode 25 Nov - 5 Des 2022
25000 periode 25 Nov - 5 Des 2022
25000 periode 25 Nov - 5 Des 2022
275000 periode 25 Nov - 5 Des 2022
25000 periode 25 Nov - 5 Des 2022
100000 periode 25 Nov - 5 Des 2022
25000 periode 25 Nov - 5 Des 2022
25000 periode 25 Nov - 5 Des 2022
225000 periode 25 Nov - 5 Des 2022
25000 periode 25 Nov - 5 Des 2022
100000 periode 25 Nov - 5 Des 2022
50000 periode 25 Nov - 5 Des 2022
50000 periode 25 Nov - 5 Des 2022
25000 periode 25 Nov - 5 Des 2022
50000 periode 25 Nov - 5 Des 2022
200000 periode 25 Nov - 5 Des 2022
350000 periode 25 Nov - 5 Des 2022
50000 periode 25 Nov - 5 Des 2022
50000 periode 25 Nov - 5 Des 2022
75000 periode 25 Nov - 5 Des 2022
75000 periode 25 Nov - 5 Des 2022
100000 periode 25 Nov - 5 Des 2022
25000 periode 25 Nov - 5 Des 2022
150000 periode 25 Nov - 5 Des 2022
175000 periode 25 Nov - 5 Des 2022
125000 periode 25 Nov - 5 Des 2022
75000 periode 25 Nov - 5 Des 2022
25000 periode 25 Nov - 5 Des 2022
75000 periode 25 Nov - 5 Des 2022
50000 periode 25 Nov - 5 Des 2022
150000 periode 25 Nov - 5 Des 2022
75000 periode 25 Nov - 5 Des 2022
25000 periode 25 Nov - 5 Des 2022
25000 periode 25 Nov - 5 Des 2022
250000 periode 25 Nov - 5 Des 2022
25000 periode 25 Nov - 5 Des 2022
25000 periode 25 Nov - 5 Des 2022
125000 periode 25 Nov - 5 Des 2022
50000 periode 25 Nov - 5 Des 2022
100000 periode 25 Nov - 5 Des 2022
25000 periode 25 Nov - 5 Des 2022
225000 periode 25 Nov - 5 Des 2022
100000 periode 25 Nov - 5 Des 2022
125000 periode 25 Nov - 5 Des 2022
75000 periode 25 Nov - 5 Des 2022
75000 periode 25 Nov - 5 Des 2022
50000 periode 25 Nov - 5 Des 2022
50000 periode 25 Nov - 5 Des 2022
275000 periode 25 Nov - 5 Des 2022
525000 periode 25 Nov - 5 Des 2022
150000 periode 25 Nov - 5 Des 2022
1 ABAY 2 50000 2
2 AGAS 5 125000 5
3 AJANG S 4 100000 4
4 AMO 4 100000 4
5 ANTA 1 25000 1
6 ASEP ANDI 2 50000 2
7 AYU SUCIYANTI 2 50000 2
8 BOBY 8 200000 8
9 CASMITA 1 25000 1
10 CECEP 4 100000 4
11 D SALEH 7 175000 7
12 DADI 2 50000 2
13 DAMIN 2 50000 2
14 DARSAM 1 25000 1
15 DARTA KIMING 1 25000 1
16 DEDE ANWAR 12 300000 12
17 DEDEH KURNIASIH 3 75000 3
18 DIDI ISKANDAR 2 50000 2
19 EJANG 3 75000 3
20 ENAN 2 50000 2
21 ENDANG 4 100000 4
22 ENER 1 25000 1
23 EWING 1 25000 1
24 GABRIEL 1 25000 1
25 HERI KUSAERI 4 100000 4
26 IING 1 25000 1
27 JAKA KOMARA 2 50000 2
28 JOGING 3 75000 3
29 JUJU 6 150000 6
30 JUMSARI 13 325000 13
31 KARMAWAN 1 25000 1
32 KASMAN TEMPURAN 2 50000 2
33 KENTING 3 75000 3
34 KONG IJO 1 25000 1
35 KOSASIH 1 25000 1
36 KOSIM SUHARI 4 100000 4
37 MA ELAH 12 300000 12
38 MISLAN 1 25000 1
39 MUIN HIDAYAT 1 25000 1
40 NANANG 1 25000 1
41 NANO 9 225000 9
42 NASIR 4 100000 4
43 NAWANGSIH 4 100000 4
44 NURSIFA 2 50000 2
45 OMIN 3 75000 3
46 OMPONG 2 50000 2
47 OTOY/TATA 2 50000 2
48 RADITA 4 100000 4
49 ROHIM 1 25000 1
50 ROWI Z 2 50000 2
51 RT AJA 11 275000 11
52 RT IMAN 7 175000 7
53 RW EDO 2 50000 2
54 SAIN 1 25000 1
55 SALAMAH 6 150000 6
56 SALIM S 1 25000 1
57 SARI 8 200000 8
58 SITI KURNIASIH 1 25000 1
59 SOBLENG 2 50000 2
60 SRI HARTATI 6 150000 6
61 SRI ISDI 8 200000 8
62 SUKARDI 2 50000 2
63 SUPANDI 1 25000 1
64 SYARIEF 7 175000 7
65 TINI 3 75000 3
66 UJANG NURJAYA 1 25000 1
67 UMARJAYA 3 75000 3
68 VIAN 1 25000 1
69 WAKIL AKUNG 13 325000 13
70 WAKIL RT DIDI 1 25000 1
71 WANDA 2 50000 2
72 WANTA WARDIMAN 2 50000 2
73 WIWIN 15 375000 15
74 WIWIN 1 25000 1
Jumlah Keterangan
50000 periode 6-25 Des 2022
125000 periode 6-25 Des 2022
100000 periode 6-25 Des 2022
100000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
50000 periode 6-25 Des 2022
50000 periode 6-25 Des 2022
200000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
100000 periode 6-25 Des 2022
175000 periode 6-25 Des 2022
50000 periode 6-25 Des 2022
50000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
300000 periode 6-25 Des 2022
75000 periode 6-25 Des 2022
50000 periode 6-25 Des 2022
75000 periode 6-25 Des 2022
50000 periode 6-25 Des 2022
100000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
100000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
50000 periode 6-25 Des 2022
75000 periode 6-25 Des 2022
150000 periode 6-25 Des 2022
325000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
50000 periode 6-25 Des 2022
75000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
100000 periode 6-25 Des 2022
300000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
225000 periode 6-25 Des 2022
100000 periode 6-25 Des 2022
100000 periode 6-25 Des 2022
50000 periode 6-25 Des 2022
75000 periode 6-25 Des 2022
50000 periode 6-25 Des 2022
50000 periode 6-25 Des 2022
100000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
50000 periode 6-25 Des 2022
275000 periode 6-25 Des 2022
175000 periode 6-25 Des 2022
50000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
150000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
200000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
50000 periode 6-25 Des 2022
150000 periode 6-25 Des 2022
200000 periode 6-25 Des 2022
50000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
175000 periode 6-25 Des 2022
75000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
75000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
325000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
50000 periode 6-25 Des 2022
50000 periode 6-25 Des 2022
375000 periode 6-25 Des 2022
25000 periode 6-25 Des 2022
TELAGASARI 1 P 43 Rp 215,000
RS CITRA SARI HUSADA (JST) 2 P 32 Rp 160,000
KLARI 3 P 28 Rp 140,000
PURWASARI 4 P 25 Rp 125,000
CIAMPEL 5 P 24 Rp 120,000
RAWAMERTA 6 P 24 Rp 120,000
LEMAH DUHUR 7 P 18 Rp 90,000
MAJALAYA 8 P 18 Rp 90,000
LEMAH ABANG 9 P 17 Rp 85,000
CURUG 10 P 16 Rp 80,000
KUTAWALUYA 11 P 16 Rp 80,000
TEMPURAN 12 P 12 Rp 60,000
KERTAMUKTI 13 P 10 Rp 50,000
BALONGSARI 14 P 8 Rp 40,000
PASIRRUKEM 15 P 8 Rp 40,000
BAYUR LOR 16 P 6 Rp 30,000
ANGGADITA 17 P 4 Rp 20,000
CILAMAYA 18 P 4 Rp 20,000
BATUJAYA 19 P 3 Rp 15,000
CIKAMPEK 20 P 3 Rp 15,000
GEMPOL 21 P 3 Rp 15,000
CICINDE 22 P 2 Rp 10,000
PAKISJAYA 23 P 2 Rp 10,000
PEDES 24 P 2 Rp 10,000
KLINIK GRAHA MEDIS KOSAMBI 1 K 46 Rp 230,000
KLINIK ASSALAM 2 K 44 Rp 220,000
KLINIK FIKRI MEDIKA 3 K 35 Rp 175,000
KLINIK TELAGA SARI 4 K 34 Rp 170,000
KLINIK ZHAFIRA ZARIFA 5 K 29 Rp 145,000
KLINIK FIKRI MEDIKA 2 6 K 26 Rp 130,000
KLINIK VIDYA MEDIKA 7 K 26 Rp 130,000
KLINIK SRI SUKMA 8 K 25 Rp 125,000
KLINIK ANDINA 9 K 22 Rp 110,000
KLINIK GRAHA MEDIS KOPEL 10 K 20 Rp 100,000
KLINIK AULIA 11 K 18 Rp 90,000
KLINIK DARAWOLONG 12 K 18 Rp 90,000
KLINIK MITRA SEHAT 13 K 17 Rp 85,000
KLINIK MUSTIKA 14 K 17 Rp 85,000
KLINIK PURWA MEDIKA 15 K 17 Rp 85,000
KLINIK PURI ASIH KOSAMBI 16 K 16 Rp 80,000
KLINIK YAKESTI 17 K 16 Rp 80,000
KLINIK DIMAS MEDIKA 18 K 13 Rp 65,000
KLINIK ZAHIRA 19 K 12 Rp 60,000
KLINIK AMANDA 20 K 11 Rp 55,000
KLINIK CURUG RAHAYU 21 K 10 Rp 50,000
Klinik Nursepta 22 K 8 Rp 40,000
KLINIK MITRA KONDANG UTAMA 23 K 7 Rp 35,000
KLINIK TEMPURAN MEDIKA 24 K 7 Rp 35,000
Klinik Novia 25 K 6 Rp 30,000
KLINIK WADAS MEDIKA 26 K 6 Rp 30,000
KLINIK BHAKTI MEDIKA 27 K 5 Rp 25,000
KLINIK DOTA MEDIKA 28 K 5 Rp 25,000
KLINIK GRAHA MEDIS CIKAMPEK 29 K 5 Rp 25,000
KLINIK LAMARAN 30 K 5 Rp 25,000
klinik siti azaria 31 K 5 Rp 25,000
Klinik Kimia Farma Kosambi 32 K 3 Rp 15,000
KLINIK KONDANG MEDIKA 33 K 3 Rp 15,000
KLINIK SAFIRA MEDIKA 34 K 3 Rp 15,000
KLINIK ARMINTA 35 K 2 Rp 10,000
KLINIK ASTER 36 K 2 Rp 10,000
KLINIK BAROKAH AL-BADAR 37 K 2 Rp 10,000
KLINIK GRAHA MEDIS CILAMAYA 38 K 2 Rp 10,000
KLINIK HASTIEN 39 K 2 Rp 10,000
KLINIK KINASIH 40 K 2 Rp 10,000
KLINIK MIRACLE 41 K 2 Rp 10,000
KLINIK NAURAH MEDIKA 42 K 2 Rp 10,000
KLINIK PURI ASIH CIKAMPEK 43 K 2 Rp 10,000
KLINIK PURI ASIH TL.JAMBE 44 K 2 Rp 10,000
Jumlah Keterangan
Rp 215,000 periode 26 sept - 25 Okto 2022
1 klinik Aster cikampek 10/21/2022
2 RSU SARASWATI cikampek 11/17/2022
3 dr teguh sudrajat dr nur linawati 10/23/2022
4 dr djoko pramono jl panatayuda 10/26/2022
5 DR M THARIQ klinik assalam 11/12/2022
6 dr lindawati klinik assalam 11/10/2022
9 klinik assalam klinik assalam 11/2/2022
10 dr nurlina juniar Klinik aulia 10/21/2022
11 dr theresia lestari k Klinik aulia 11/2/2022
12 DR ESSY MARINA KLINIK CURUG RAHAYU 11/22/2022
13 dr ela agustin klinik darawolong 10/27/2022
16 DR YUNAN SYAHBAN klinik fikri medika, kosambi 10/17/2022
17 DR LIA LAELATUL klinik fikri medika, kosambi 11/12/2022
18 dr septian hari tugi wibowo KLINIK GM KOPEL 11/21/2022
19 dr kharis mamun klinik graha medis kopel 10/21/2022
20 dr septian hari tugi wibowo klinik graha medis kopel 10/25/2022
21 dr gina noviana gunawan klinik graha medis kosambi 10/17/2022
25 dr vina pebria dwiresa klinik graha medis kosambi 10/30/2022
26 DR GINA NAVIANA klinik graha medis kosambi 11/11/2022
28 dr hikma ayu klinik hastien 10/22/2022
30 dr Adrian p klinik jatisari
31 dr hasan basri klinik mecca sanjaya 11/5/2022
32 dr meutia fathia rahmah klinik mitra sehat 10/20/2022
33 DR REZA INDIARTO klinik mitra sehat 11/15/2022
35 dr dara mustika dewi klinik mustika 10/23/2022
36 dr putry bayu rini klinik mustika 10/31/2022
38 dr arnis putri rosyani klinik novia 10/25/2022
39 dr iin indriati Klinik nursepta 10/21/2022
40 dr purna irawan eko s klinik purwa medika 10/17/2022
41 dr maulida tiara Klinik sri sukma 11/7/2022
42 dr falia magfirotunnisa klinik syamil medical center 10/23/2022
43 klinik soja medika KLINIK SOJA MEDIKA 11/19/2022
44 DR EMIN NURIMAN KLINIK TELAGASARI 11/9/2022
45 dr hasan basri KLINIK VIDYA MEDIKA 11/10/2022
46 dr bobzi razvidi klinik zahira 10/28/2022
47 DR OKI MASHERA PASIRMUKTI TELAGASARI 11/6/2022
48 PONED CIKAMPEK PONED CIKAMPEK
49 dr poppy herawati puskesmas ciampel 10/19/2022
50 DR DWI ANGGIANY PUSKESMAS KLARI 11/11/2022
51 dr hj herlita puskesmas klari 10/20/2022
52 dr haerudin puskesmas pasirukeum 10/28/2022
53 dr abdul kodir puskesmas pedes 10/29/2022
54 dr nidia afrah puskesmas purwasari 11/2/2022
55 PUSEKSMAS TELAGASARI PUSKESMAS TELAGASARI
57 DR HENDRA PRANATA RS KARYA HUSADA 11/8/2022
Kiki agustin 325816 26 september - 25 oktober 2022 Rawatan
ADI 26 september - 25 oktober 2022 Rawatan
delisha 185718 26 september - 25 oktober 2022 Rawatan
m raffasya 326126 26 september - 25 oktober 2022 Rawatan
CAHYA 327420 26 september - 25 oktober 2022 Rawatan
BY NY TIA N 26 september - 25 oktober 2022 Rawatan
cika L 319597 26 september - 25 oktober 2022 Rawatan
m asyraf adlan 325578 26 september - 25 oktober 2022 Rawatan
alma 26 september - 25 oktober 2022
nurhayati 132044 26 september - 25 oktober 2022 Rawatan
Nur elawati 326653 26 september - 25 oktober 2022 SC
IQBAL AL 281651 26 september - 25 oktober 2022 Rawatan
sartika 26 september - 25 oktober 2022
bayi ny setya astuti 317253 26 september - 25 oktober 2022 Rawatan
suhendar hermawan 225459 26 september - 25 oktober 2022 Rawatan
RISA JUNI 015292 26 september - 25 oktober 2022 Rawatan
KHAYLA PUTRI 26 september - 25 oktober 2022 Rawatan
EMIN 173368 26 september - 25 oktober 2022 Rawatan
arkan putra zaidan 127181 26 september - 25 oktober 2022
yanti 073089 26 september - 25 oktober 2022 Rawatan
asep bahrul 321171 26 september - 25 oktober 2022 Rawatan
rima s 171048 26 september - 25 oktober 2022 Rawatan
agus endang 069519 26 september - 25 oktober 2022 Rawatan
m dendi 326122 26 september - 25 oktober 2022 Rawatan
erlyana chikita 116332 26 september - 25 oktober 2022 Rawatan
KAIFA 327318 26 september - 25 oktober 2022 Rawatan
SITI KASMI 123520 26 september - 25 oktober 2022 Rawatan
Gina dwi angelina 26 september - 25 oktober 2022
26 september - 25 oktober 2022
Maemunah 325950 26 september - 25 oktober 2022
acim 326834 26 september - 25 oktober 2022 Rawatan
abizar alghifari 325713 26 september - 25 oktober 2022 Rawatan
DEWI YASINIA 26 september - 25 oktober 2022 Rawatan
SITI NURPATWA 327337 26 september - 25 oktober 2022 Rawatan
ananda rafa anggara 313487 26 september - 25 oktober 2022
iing sutisna 326470 26 september - 25 oktober 2022 Rawatan
ANIS 26 september - 25 oktober 2022
by ny ayu pratiwi 302791 26 september - 25 oktober 2022 Rawatan
by ny anisa resti 26 september - 25 oktober 2022 Rawatan
felyshadi nada 26 september - 25 oktober 2022 Rawatan
khalisa novarina 225161 26 september - 25 oktober 2022 Rawatan
m akbar baihaki 315513 26 september - 25 oktober 2022 Rawatan
TIARA OKTARIANA 325595 26 september - 25 oktober 2022 Rawatan
SHARKAN ALIF 26 september - 25 oktober 2022 Rawatan
INAH 274017 26 september - 25 oktober 2022 Rawatan
m dylan mulyana 210158 26 september - 25 oktober 2022 Rawatan
SOPIA 326891 26 september - 25 oktober 2022 Rawatan
IRMAYANTI 26 september - 25 oktober 2022
Patmawati 325620 26 september - 25 oktober 2022
IKAH 326300 26 september - 25 oktober 2022 Rawatan
Karmo 26 september - 25 oktober 2022
yuliah 326190 26 september - 25 oktober 2022 Rawatan
khanza hana aqila 218305 26 september - 25 oktober 2022 Rawatan
suhaebatul 181104 26 september - 25 oktober 2022 Rawatan
SAMIAH 26 september - 25 oktober 2022 Rawatan
WARSIM 26 september - 25 oktober 2022 Rawatan
UPI 26 september - 25 oktober 2022 Rawatan
Jumlah
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 100,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
1 bd yayat haryatini cengong 10/26/2022 wulan 326128
2 bd yayat haryatini cengong 10/26/2022 Aan darwati 326127
3 bd yayat haryatini cengong 10/19/2022 dewi 373609
4 bd yayat haryatini cengong 10/24/2022 Elisah 325947
5 bd sri nurhidayati klari 11/3/2022 ipit 110500
6 bd sri nurhidayati klari 11/4/2022 euis 1700+6
7 bd sri nurhidayati klari 11/1/2022 siti waliyah 301298
8 bd sri nurhidayati 11/14/2022 YANTI HAYATI 074565
9 dr siti hamidah Klinik dimas medika 11/2/2022 Siti mutiah 326657
10 DR TASWAN KLINIK DOTA MEDIKA 10/24/2022 NILA NYIUR 257642
11 bd irka pramukarni klinik musytasyfah 11/7/2022 baroyah 327008
12 Bd sutantri Klinik nursepta 11/3/2022 Rini juliatun m 326746
13 bd Rita sutantri Klinik nursepta 10/27/2022 Karwati 313475
14 dr arya wibaya klinik purwa medika 10/23/2022 susi suryani 325897
15 dr purna irawan eko s klinik purwa medika 10/27/2022 Wulan aulia okt 274896
16 Bd nok rina listanti Klinik sri sukma 11/4/2022 Thania sri yulia 326745
17 DR IRNIPURWANTARI KLINIK SITI AZARIA 11/7/2022 MELLIN A 327043
18 DR RISWAN DIHARJO KLINIK TELAGASARI 11/13/2022 SUSI SUSILAWA 154332
19 dr Hasa basri Klinik vidya medika 10/3/2022 Neni Qonaatur 324426
20 Klinik zhafira zarifa klinik zhafira zarifa 11/4/2022 Cahya ningrat 286391
21 Klinik zhafira zarifa klinik zhafira zarifa 10/27/2022 Anung 326226
22 Klinik zhafira zarifa klinik zhafira zarifa 10/31/2022 Dita sulistiani 172538
23 Klinik zhafira zarifa klinik zhafira zarifa 10/29/2022 itoh masitoh 323699
24 bd titin fatimah lemahduhur 10/22/2022 siti nurjanah 325981
25 bd Dian anisa juniar puri kosambi 11/5/2022 Bahriyah 157655
26 bd hj nurhayati PKM PURWASARI nurhayati 200871
27 bd N unairah Rawamerta 11/7/2022 kokom 326998
28 bd N unairah Rawamerta 11/10/2022 Taryati 327194
29 bd Hj juwariyah Telagasari 11/9/2022 mirani puspita 89648
30 puskesmas telagasari telagasari 11/10/2022 cahyati 327209
31 bd anisa alsamsiah 11/4/2022 caswi 326839
32 bd anisa alsamsiah 10/21/2022 maesaroh 325824
33 bd anisa alsamsiah 10/20/2022 wiwin 185841
34 BD WINDA MELYANA DUREN 11/14/2022 CUCU 286804
35 TALAGASARI, 0857 7903
BD EVI INDRIANI 9438 11/13/2022 IIS 326858
36 BD ERLIS HERLIATI GINTUNG KEBON 11/12/2022 WANGSIH 327358
37 BD IIS ROHMAWATI TAMELANG BENGLE 11/12/2022 NANI ROSITA 327400
38 bd yuyun 11/13/2022 AMIH 327446
39 bd nunung 11/13/2022 yeni 327445
40 bd ai lani 0857 8165 0883 10/1/2022 tina novia 073387
41 dr Astri lovita puskesmas balongsari 11/2/2022 Kartini 326603
42 dr Astri lovita puskesmas balongsari 10/28/2022 Titin fatmawati 326249
43 dr Budi suharyanto Puskesmas curug 11/4/2022 Sri devi 326755
44 dr tian gustiani Puskemas ciampel 11/1/2022 Ratna nengsih 263198
45 dr hj herlita puskesmas klari 10/24/2022 sulastri 325872
46
dr diding rusnedi puskesmas kutawaluya 11/7/2022 nurhayati 326980
47
dr diding rusnaedi puskesmas kutawaluya 10/21/2022 winariah agusti 325812
48 dr Heni yulia c Puskesmas majalaya MikaEla 297203
49 dr sutardi puskesmas rawamerta 11/5/2022 iis risti 326858
50 dr sutardi puskesmas rawamerta 10/19/2022 Rita mulyani 325683
51 dr sutardi puskesmas rawamerta 10/27/2022 umiyani 326151
52 WIDIANINGSI
dr sutardi puskesmas rawamerta 11/13/2022 H 327462
53 bd Dian anisa juniar puri kosambi 11/11/2022 TRI WAHYUNI 122976
54 BD LINA ROSLINA DUREN 10/10/2022 REYHAN 327196
55 DR GINA NOVIANA KLINIK GM KOSAMBI 11/18/2022 EKA RUSTIAN 327850
56 DR MEUTIA FATHIA KLINIK MITRA SEHAT 11/19/2022 LINDA NURMAL 226225
57 DR DARA MUSTIKA KLINIK MUSTIKA 11/21/2022 ARI WAHYUNI 261006
58 BD AYU ROHAETI Klinik nursepta 20/.11/2022 ELA AGISNAWA 327861
59 Bd nok rina listanti Klinik sri sukma 11/14/2022 JUBAEDAH 146976
60 DR BOBZI KLINIK ZAHIRA 11/15/2022 INDAH WULAN 196500
kuret Rp 50,000
SC Rp 100,000
SC Rp 100,000
Rawatan Rp 25,000
Rawatan Rp 25,000
SC Rp 100,000
PN Rp 50,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
PN Rp 50,000
sc Rp 100,000
sc Rp 100,000
SC Rp 100,000
sc Rp 100,000
sc Rp 100,000
SC Rp 100,000
SC Rp 100,000
Rawatan Rp 25,000
SC Rp 100,000
sc Rp 100,000
sc Rp 100,000
kuret Rp 50,000
PN Rp 50,000
SC Rp 100,000
PN Rp 50,000
PN Rp 50,000
SC Rp 100,000
Rawatan Rp 25,000
SC Rp 100,000
SC Rp 100,000
Rawatan Rp 25,000
SC Rp 100,000
SC Rp 100,000
Rp 25,000
Rawatan
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
kuret Rp 50,000
Rawatan Rp 25,000
SC Rp 100,000
SC Rp 100,000
sc Rp 100,000
SC Rp 100,000
kuret Rp 50,000
Rp 50,000
PN
Rp 100,000
sc
SC Rp 100,000
Rawatan 25000
kuret 50000
sc 100000
Rp 25,000
Rawatan
SC Rp 100,000
Rawatan Rp 25,000
kuret Rp 50,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
SC Rp 100,000
no No u Nama perujuk alamat no telp nama pasien
1 bidan lia dahlia kp pedes purwasari 12/21/2022 ade erni suryan
2 bd ade mulyani anggadita klari 11/16/2022 wiwin winengsi
3 bidan dudeh bengle majalaya 12/19/2022 tuti sri mulyati
4 bd yayat haryatini cengkong 10/30/2022 lilis
5 bd erna kurniasari desa tamelang purwasari 12/9/2022 linda astria
6
bd fia siti aminah dsn pasir buah majalaya 12/3/2022 endah
7 bidan risa mahardika jl pasir panjang klari 12/11/2022 yeni puji astuti
8 bidan nunung nurhayati klinik al fatih medika 12/24/2022 esi hanali
9 bd ranti eka putri klinik assalam 11/16/2022 nuraeni
10 dr lindawati klinik assalam 12/23/2022 rosdiana
11 dr lindawati klinik assalam 12/23/2022 siti nuraeni
12 dr siti hamidah klinik dimas medika 11/25/2022 Purwati
13 dr siti hamidah klinik dimas medika 11/25/2022 yuliawati
14 dr annisa yulia f klinik fikri medika 12/17/2022 hannah marya
15 dr juliya klinik fikri medika 2 12/10/2022 wiwi yunengsih
16 bidan tria rahmawati klinik graha medis koambi 12/12/2022 fitriyani
17 dr Gina noviana G klinik graha medis kosambi 11/9/2022 irnalis
18 dr vina pebria d klinik graha medis kosambi 12/19/2022 fitria halidazia
19 dr wulan febriarty Klinik hastien 11/26/2022 Gustini andelin
20 dr ana permatasari klinik puri ash kosamni 11/14/2022 rini andriani
21 dr ana permatasari klinik puri asih kosambi 12/6/2022 neneng komari
22 dr purnairawan eko s klinik purwa medika 11/24/2022 yani maryani
23 dr dita tifaniadi klinik safira medika 12/12/2022 marni
24 dr siska klinik siti azaria 11/25/2022 rulik anjarwati
25 bidan nok rina listiani klinik sri sukma 12/7/2022 umayah
26 bidan nok rina listiani klinik sri sukma 11/26/2022 lilis
27 bd nok rina listiani klinik sri sukma 11/9/2022 yayah marwiah
28 dr lukman endro s klinik telagasari 12/12/2022 anita agustiani
29 dr lukman f susilo klinik telagasari 11/29/2022 maryati
30 dr lukma endro s klinik telagasari 12/19/2022 ida paida
31 klinik zhafira zarifa klinik zhafira zarifa 12/17/2022 tri wahyuni
32 klinik zhafira zarifa klinik zhafira zarifa 11/27/2022 tiara ayu
33 bidan sri nurhidayati kosambi 12/18/2022 cucu
34 bd sri nurhidayati kosambi 11/21/2022 keni rohani
35 bd sri nurhidayati kosambi 11/2/2022 shintia tarulu
36 bd hj carnah nurhasanah majalaya 11/23/2022 cucu
37 bd hj carnah nurhasanah majalaya 11/30/2022 ana
38 bd hj carnah nurhasanah majalaya 11/22/2022 siti nurhasanah
39 bd wiwin rusmiati mekarjaya rawamerta 12/19/2022 sari ningsih
40 bd risa mahardika pasir panjang 11/28/2022 tia
41 bd risa mahardika pasir panjang 11/16/2022 siti wahyuni
42 bidan yati perum bumi sukasari indah 12/15/2022 wida
43 bidan yati perum bumi sukasari indah 12/16/2022 neli
44 bd dini eva susanti perum grand mutiara 11/27/2022 sutari
45 bd ai lani perum istana kosambi 11/13/2022 shintia
46 bd dian anisa juniar perum puri kosambi 2 12/29/2022 manunggal
47 bd wiwit suprapti perum teragsari 12/7/2022 vemilia
48 bidan hj yayat purwasari 12/13/2022 nuryati
49
bd hj nurhayati PUSKESMAS PURWASARI 12/6/2022 siti haerani
50 bd hj yayat purwasari 12/23/2022 iis
51 dr tian puskesmas ciampel 11/19/2022 handriyana vili
52 poned cikampek puskesmas cikampek 12/1/2022 suci oktaviani
53 dr Budi suharyanto puskesmas curug 11/19/2022 ritawati
54 bd hj aan puskesmas kertamukti warsih
55 bd hj aan puskesmas kertamukti komah
56
puskesmas lemahabang puskesmas lemahabang 11/26/2022 yayah rodiyah
57 bd mela puskesmas pasirrukem 12/28/2022 SITI NUROHMA
58 dr Lindawati puskesmas purwasari 10/11/2022 Arem suwarsih
59 bd N unirah rawamerta 12/9/2022 dasiah
60 dr sutardi puskesmas rawamerta 1/22/2022 epa fatimah
61 dr sutardi puskesmas rawamerta 11/28/2022 iis risti
62 dr sutardi puskesmas rawamerta 12/10/2022 yanti
63 dr sutardi puskesmas rawamerta 12/10/2022 rosimah
64 dr sutardi puskesmas rawamerta 11/29/2022 umaya
65 dr sutardi puskesmas rawamerta 11/23/2022 rustini
66 dr sutardi puskesmas rawamerta 11/28/2022 puji astuti
67 dr dedi humatedi puskesmas telagasari 1/21/2022 Odahlia
68 dr melisa yantriasari puskesmas telagasari 11/10/2022 nuraliah
69 dr mardsi erlyta pusksmas kertamukti 12/15/2022 lutfah
70 bdan meita sri rahayu majalaya 12/12/2022 safitri rohmawa
71 bd yuli RSCSH 11/11/2022 meti
72 BD ADE KLARI 11/16/2022 EPI OKTAPIANI
73 BD ELIN 11/5/2022 NIA NURAENI
74 BD SITI MARYAM CIRANGGON MAJALAYA 11/4/2022 TITI MUTIAH
75 BD OMIH TEMPURAN FITRIA
76 BD ANISA TEMPURAN 12/10/2022 HERLINA
77 BD ANISA TEMPURAN 11/4/2022 TIVANA
78 DR TIAN GUSTIANI PUSKESMAS CIAMPEL 11/7/2022 LIA DARYATI
336031 curet Rp 50,000
283479 sc Rp 100,000
105351 rawatan Rp 25,000
326349 SC Rp 100,000
329211 pn Rp 50,000
328819 kuret Rp 50,000

329374 SC Rp 100,000
330181 pn Rp 50,000
319517 SC Rp 100,000
267592 rawatan Rp 25,000
324049 sc Rp 100,000
201829 sc Rp 100,000
155970 SC Rp 100,000
153136 sc Rp 100,000
323372 rawatan Rp 25,000
228670 sc Rp 100,000
156623 sc Rp 100,000
147334 sc Rp 100,000
321437 sc Rp 100,000
325974 sc Rp 100,000
11.73.85 rawatan Rp 25,000
128572 PN Rp 50,000
281181 sc Rp 100,000
328276 kuret Rp 50,000
20.88.47 SC Rp 100,000
288588 SC Rp 100,000
291992 sc Rp 100,000
329376 sc Rp 100,000
217569 sc Rp 100,000
326574 sc Rp 100,000
329779 SC Rp 100,000
275808 SC Rp 100,000
225368 PN Rp 50,000
327982 SC Rp 100,000
314873 SC Rp 100,000
328191 sc Rp 100,000
131515 sc Rp 100,000
130914 PN Rp 50,000
329955 sc Rp 100,000
328437 SC Rp 100,000
234921 SC Rp 100,000
329630 SC Rp 100,000
329745 rawatan Rp 25,000
328420 kuret Rp 50,000
281460 SC Rp 100,000
72857 sc Rp 100,000
329147 SC Rp 100,000
329533 SC Rp 100,000
329046 SC Rp 100,000
330178 pn Rp 50,000
121761 KURET Rp 50,000
328722 SC Rp 100,000
327860 sc Rp 100,000
328395 SC Rp 100,000
328869 SC Rp 100,000
325303 SC Rp 100,000
308910 rawatan Rp 25,000
166523 sc Rp 100,000
327596 sc Rp 100,000
149724 PN Rp 50,000
326858 PN Rp 50,000
285945 rawatan Rp 25,000
327246 sc Rp 100,000
328537 sc Rp 100,000
328132 sc Rp 100,000
328483 SC Rp 100,000
295945 sc Rp 100,000
327218 sc Rp 100,000
329655 sc Rp 100,000
329458 sc Rp 100,000
329348 pn Rp 50,000
OKTAPIANI rawatan Rp 25,000
328292 SC Rp 100,000
239179 SC Rp 100,000
328638 SC Rp 100,000
245565 SC Rp 100,000
328883 SC Rp 100,000
213867 rawatan Rp 25,000
alamat no telp no telp 1 Rajal No Rajal
KLINIK GRAHA MEDIS KOSAMBI 1 K 47
KLINIK ASSALAM 2 K 36
KLINIK TELAGA SARI 3 K 35
KLINIK VIDYA MEDIKA 4 K 35
KLINIK MITRA SEHAT 5 K 34
KLINIK FIKRI MEDIKA 6 K 32
KLINIK ANDINA 7 K 29
KLINIK PURI ASIH KOSAMBI 8 K 26
KLINIK ZHAFIRA ZARIFA 9 K 25
KLINIK SRI SUKMA 10 K 22
KLINIK FIKRI MEDIKA 2 11 K 21
KLINIK YAKESTI 12 K 20
KLINIK PURWA MEDIKA 13 K 20
KLINIK TEMPURAN MEDIKA 14 K 20
KLINIK DARAWOLONG 15 K 19
KLINIK GRAHA MEDIS KOPEL 16 K 18
KLINIK AULIA 17 K 18
KLINIK DIMAS MEDIKA 18 K 15
KLINIK CURUG RAHAYU 19 K 15
Klinik Nursepta 20 K 15
KLINIK SAFIRA MEDIKA 21 K 13
KLINIK MITRA KONDANG UTAMA 22 K 11
KLINIK ZAHIRA 23 K 11
KLINIK AMANDA 24 K 11
KLINIK MUSTIKA 25 K 11
KLINIK WADAS MEDIKA 26 K 11
klinik siti azaria 27 K 9
KLINIK ASTER 28 K 8
KLINIK GRAHA MEDIS CILAMAYA 29 K 8
KLINIK DOTA MEDIKA 30 K 7
KLINIK GRIYA MEDIKA 31 K 7
KLINIK KINASIH 32 K 6
KLINIK BHAKTI MEDIKA 33 K 6
KLINIK KONDANG MEDIKA 34 K 5
Klinik Kimia Farma Kosambi 35 K 5
KLINIK GRAHA MEDIS CIKAMPEK 36 K 4
KLINIK KEKAR 37 K 4
KLINIK PUTRA GEMILANG 38 K 4
KLINIK NAURAH MEDIKA 39 K 4
KLINIK HASTIEN 40 K 3
Klinik Novia 41 K 3
KLINIK NUR'ANNISA 42 K 3
KLINIK SYAFIRA 2 43 K 3
KLINIK ANNISA KUTAGANDOK 44 K 3
KLINIK POLRES KARAWANG 45 K 3
KLINIK BINA MEDIKA 46 K 3
KLINIK LAMARAN 47 K 3
KLINIK ASTRI 48 K 3
KLINIK CILAMAYA MEDIKA 49 K 3
KLINIK PURI ASIH TL.JAMBE 50 K 3
KLINIK ANDINA CIKAMPEK 51 K 3
KLINIK ANGGADITA MEDIKA 52 K 3
KLINIK BEN-MARI 53 K 3
KLINIK PURI ASIH CIKAMPEK 54 K 2
KLINIK AR-RAHMAN MEDIKA 55 K 2
KLINIK CENTRAL MEDIKA WRB 56 K 2
KLINIK GEMPOL 57 K 2
KLINIK CARIU 58 K 2
KLINIK ASSYIFA CILAMAYA 59 K 2
KLINIK CENTRAL MEDIKA BDM 60 K 2
KLINIK MITRA GEMPOL 61 K 2
KLINIK PUPUK KUJANG 62 K 2
KLINIK JATISARI 63 K 2
KLINIK PUTRA MEDIKA 64 K 2
KLINIK KUSUMA MEDIKA 65 K 2
KLINIK MUTIARA SYAFIRA 66 K 2
KLINIK PATEN 67 K 2
KLINIK RAGA SEHAT 68 K 2
PURWASARI 1 P 47
RAWAMERTA 2 P 41
TELAGASARI 3 P 34
KLARI 4 P 31
MAJALAYA 5 P 25
LEMAH ABANG 6 P 22
TEMPURAN 7 P 19
LEMAH DUHUR 8 P 18
CURUG 9 P 18
CIAMPEL 10 P 16
KERTAMUKTI 11 P 14
KUTAWALUYA 12 P 14
PASIRRUKEM 13 P 13
ANGGADITA 14 P 10
BALONGSARI 15 P 10
PEDES 16 P 9
PAKISJAYA 17 P 8
BAYUR LOR 18 P 6
TIRTAMULYA 19 P 10
CIBUAYA 20 P 8
SUKATANI 21 P 5
JAYAKERTA 22 P 3
CIKAMPEK 23 P 3
CILAMAYA 24 P 11
BATUJAYA 25 P 7
KUTAMUKTI 26 P 6
RS IZZA 27 P 5
ADIARSA 28 P 2
CICINDE 29 P 2
GEMPOL 30 P 4
Ranap No Ranap Jumlah Keterangan
Rp 235,000 periode 26 Okto - 25 Nov 2022
1 klinik Aster cikampek 10/21/2022
2 RSU SARASWATI cikampek 11/17/2022
3 dr teguh sudrajat dr nur linawati 10/23/2022
4 dr djoko pramono jl panatayuda 10/26/2022
5 DR M THARIQ klinik assalam 11/12/2022
9 klinik assalam klinik assalam 11/2/2022
10 dr nurlina juniar Klinik aulia 10/21/2022
11 dr theresia lestari k Klinik aulia 11/2/2022
12 DR ESSY MARINA KLINIK CURUG RAHAYU 11/22/2022
16 DR YUNAN SYAHBAN klinik fikri medika, kosambi 10/17/2022
17 DR LIA LAELATUL klinik fikri medika, kosambi 11/12/2022
18 dr septian hari tugi wibowo KLINIK GM KOPEL 11/21/2022
19 dr kharis mamun klinik graha medis kopel 10/21/2022
20 dr septian hari tugi wibowo klinik graha medis kopel 10/25/2022
26 DR GINA NAVIANA klinik graha medis kosambi 11/11/2022
30 dr Adrian p klinik jatisari
31 dr hasan basri klinik mecca sanjaya 11/5/2022
33 DR REZA INDIARTO klinik mitra sehat 11/15/2022
36 dr putry bayu rini klinik mustika 10/31/2022
38 dr arnis putri rosyani klinik novia 10/25/2022
39 dr iin indriati Klinik nursepta 10/21/2022
40 dr purna irawan eko s klinik purwa medika 10/17/2022
41 dr maulida tiara Klinik sri sukma 11/7/2022
42 dr falia magfirotunnisa klinik syamil medical center 10/23/2022
43 klinik soja medika KLINIK SOJA MEDIKA 11/19/2022
44 DR EMIN NURIMAN KLINIK TELAGASARI 11/9/2022
45 dr hasan basri KLINIK VIDYA MEDIKA 11/10/2022
46 dr bobzi razvidi klinik zahira 10/28/2022
47 DR OKI MASHERA PASIRMUKTI TELAGASARI 11/6/2022
48 PONED CIKAMPEK PONED CIKAMPEK
49 dr poppy herawati puskesmas ciampel 10/19/2022
50 DR DWI ANGGIANY PUSKESMAS KLARI 11/11/2022
51 dr hj herlita puskesmas klari 10/20/2022
52 dr haerudin puskesmas pasirukeum 10/28/2022
53 dr abdul kodir puskesmas pedes 10/29/2022
54 dr nidia afrah puskesmas purwasari 11/2/2022
57 DR HENDRA PRANATA RS KARYA HUSADA 11/8/2022
Kiki agustin 325816 26 oktober -25 November 2022 Rawatan Rp 25,000
ADI 26 oktober -25 November 2022 Rawatan Rp 25,000
delisha 185718 26 oktober -25 November 2022 Rawatan Rp 25,000
m raffasya 326126 26 oktober -25 November 2022 Rawatan Rp 25,000
CAHYA 327420 26 oktober -25 November 2022 Rawatan Rp 25,000
BY NY TIA N 26 oktober -25 November 2022 Rawatan Rp 25,000
cika L 319597 26 oktober -25 November 2022 Rawatan Rp 25,000
m asyraf adlan 325578 26 oktober -25 November 2022 Rawatan Rp 25,000
alma 26 oktober -25 November 2022 Rp 25,000
nurhayati 132044 26 oktober -25 November 2022 Rawatan Rp 25,000
Nur elawati 326653 26 oktober -25 November 2022 SC Rp 100,000
IQBAL AL 281651 26 oktober -25 November 2022 Rawatan Rp 25,000
sartika 26 oktober -25 November 2022 Rp 25,000
bayi ny setya as 317253 26 oktober -25 November 2022 Rawatan Rp 25,000
suhendar her 225459 26 oktober -25 November 2022 Rawatan Rp 25,000
RISA JUNI 015292 26 oktober -25 November 2022 Rawatan Rp 25,000
KHAYLA PUTRI 26 oktober -25 November 2022 Rawatan Rp 25,000
EMIN 173368 26 oktober -25 November 2022 Rawatan Rp 25,000
arkan putra zai 127181 26 oktober -25 November 2022 Rp 25,000
yanti 073089 26 oktober -25 November 2022 Rawatan Rp 25,000
asep bahrul 321171 26 oktober -25 November 2022 Rawatan Rp 25,000
rima s 171048 26 oktober -25 November 2022 Rawatan Rp 25,000
agus endang 069519 26 oktober -25 November 2022 Rawatan Rp 25,000
m dendi 326122 26 oktober -25 November 2022 Rawatan Rp 25,000
erlyana chikita 116332 26 oktober -25 November 2022 Rawatan Rp 25,000
KAIFA 327318 26 oktober -25 November 2022 Rawatan Rp 25,000
SITI KASMI 123520 26 oktober -25 November 2022 Rawatan Rp 25,000
Gina dwi angelina 26 oktober -25 November 2022 Rp 25,000
26 oktober -25 November 2022 Rp 25,000
Maemunah 325950 26 oktober -25 November 2022 Rp 25,000
acim 326834 26 oktober -25 November 2022 Rawatan Rp 25,000
abizar alghifari 325713 26 oktober -25 November 2022 Rawatan Rp 25,000
DEWI YASINIA 26 oktober -25 November 2022 Rawatan Rp 25,000
SITI NURPATW 327337 26 oktober -25 November 2022 Rawatan Rp 25,000
ananda rafa an 313487 26 oktober -25 November 2022 Rp 25,000
iing sutisna 326470 26 oktober -25 November 2022 Rawatan Rp 25,000
ANIS 26 oktober -25 November 2022 Rp 25,000
by ny ayu prati 302791 26 oktober -25 November 2022 Rawatan Rp 25,000
by ny anisa resti 26 oktober -25 November 2022 Rawatan Rp 25,000
felyshadi nada 26 oktober -25 November 2022 Rawatan Rp 25,000
khalisa novarin 225161 26 oktober -25 November 2022 Rawatan Rp 25,000
m akbar baihak 315513 26 oktober -25 November 2022 Rawatan Rp 25,000
TIARA OKTARI 325595 26 oktober -25 November 2022 Rawatan Rp 25,000
SHARKAN ALIF 26 oktober -25 November 2022 Rawatan Rp 25,000
INAH 274017 26 oktober -25 November 2022 Rawatan Rp 25,000
m dylan mulya 210158 26 oktober -25 November 2022 Rawatan Rp 25,000
SOPIA 326891 26 oktober -25 November 2022 Rawatan Rp 25,000
IRMAYANTI 26 oktober -25 November 2022 Rp 25,000
Patmawati 325620 26 oktober -25 November 2022 Rp 25,000
IKAH 326300 26 oktober -25 November 2022 Rawatan Rp 25,000
Karmo 26 oktober -25 November 2022 Rp 25,000
yuliah 326190 26 oktober -25 November 2022 Rawatan Rp 25,000
khanza hana aq 218305 26 oktober -25 November 2022 Rawatan Rp 25,000
suhaebatul 181104 26 oktober -25 November 2022 Rawatan Rp 25,000
SAMIAH 26 oktober -25 November 2022 Rawatan Rp 25,000
WARSIM 26 oktober -25 November 2022 Rawatan Rp 25,000
UPI 26 oktober -25 November 2022 Rawatan Rp 25,000
KLINIK GRAHA MEDIS KOSAMBI 1 K 95
KLINIK TELAGA SARI 2 K 77
KLINIK FIKRI MEDIKA 3 K 60
KLINIK ASSALAM 4 K 59
KLINIK DARAWOLONG 5 K 47
KLINIK PURI ASIH KOSAMBI 6 K 47
KLINIK VIDYA MEDIKA 7 K 45
KLINIK MITRA SEHAT 8 K 42
KLINIK GRAHA MEDIS KOPEL 9 K 40
KLINIK SRI SUKMA 10 K 39
KLINIK FIKRI MEDIKA 2 11 K 38
KLINIK YAKESTI 12 K 38
KLINIK ANDINA 13 K 34
KLINIK ZHAFIRA ZARIFA 14 K 33
KLINIK DIMAS MEDIKA 15 K 30
KLINIK MUSTIKA 16 K 28
KLINIK CURUG RAHAYU 17 K 24
KLINIK PURWA MEDIKA 18 K 22
KLINIK ZAHIRA 19 K 22
KLINIK AULIA 20 K 17
Klinik Nursepta 21 K 16
KLINIK MITRA KONDANG UTAMA 22 K 14
KLINIK AMANDA 23 K 12
Klinik Novia 24 K 12
KLINIK GRAHA MEDIS CILAMAYA 25 K 10
KLINIK WADAS MEDIKA 26 K 10
KLINIK HASTIEN 27 K 9
KLINIK KINASIH 28 K 8
KLINIK SAFIRA MEDIKA 29 K 8
klinik siti azaria 30 K 8
KLINIK DOTA MEDIKA 31 K 6
KLINIK GRAHA MEDIS CIKAMPEK 32 K 6
KLINIK LAMARAN 33 K 6
KLINIK AR-RAHMAN MEDIKA 34 K 5
KLINIK GITA MEDIKA 35 K 5
KLINIK NUR'ANNISA 36 K 5
KLINIK ASTER 37 K 4
KLINIK KONDANG MEDIKA 38 K 4
KLINIK SYAFIRA 2 39 K 4
KLINIK CENTRAL MEDIKA WRB 40 K 3
KLINIK GRIYA MEDIKA 41 K 3
KLINIK JATISARI 42 K 3
KLINIK PURI ASIH CIKAMPEK 43 K 3
KLINIK TEMPURAN MEDIKA 44 K 3
KLINIK YAFI MEDIKA 45 K 3
KLINIK ANDINA CIKAMPEK 46 K 2
KLINIK ANGGADITA MEDIKA 47 K 2
KLINIK ANNISA KUTAGANDOK 48 K 2
KLINIK BHAKTI MEDIKA 49 K 2
KLINIK PATEN 50 K 2
KLINIK SYAFIRA 51 K 2
TELAGASARI 1 P 113
PURWASARI 2 P 106
RAWAMERTA 3 P 93
KLARI 4 P 89
MAJALAYA 5 P 76
CURUG 6 P 54
CIAMPEL 7 P 53
LEMAH ABANG 8 P 52
KERTAMUKTI 9 P 40
LEMAH DUHUR 10 P 35
TEMPURAN 11 P 31
BALONGSARI 12 P 22
KUTAWALUYA 13 P 20
ANGGADITA 14 P 18
PASIRRUKEM 15 P 18
CILAMAYA 16 P 14
CIBUAYA 17 P 11
BAYUR LOR 18 P 10
PEDES 19 P 9
BATUJAYA 20 P 7
KUTAMUKTI 21 P 6
RS CITRA SARI HUSADA (JST) 22 P 5
SUKATANI 23 P 5
CIKAMPEK 24 P 4
JAYAKERTA 25 P 4
PAKISJAYA 26 P 4
TIRTAMULYA 27 P 4
CICINDE 28 P 3
ADIARSA 29 P 2
GEMPOL 30 P 2
JATISARI 31 P 2
KALANGSARI 32 P 2
MEDANG ASEM 33 P 2
PLAWAD 34 P 2
RENGASDENGKLOK 35 P 2
SUNGAI BUNTU 36 P 2
Jumlah Keterangan
Rp 475,000 periode 26 Nov - 25 Des 2022
- periode 26 Nov - 25 Des 2022
1 DR TEGUH SUDRAJAT KLINIK RIBELINA 12/10/2022
2 DR SALIM MULYANA KLINIK AMANAH 11/29/2022
3 dr m.farid ghazali sadamalun krw 12/17/2022
4 dr nurhasanah siregar klinik andina 12/2/2022
5 dr nurhasanah siregar klinik andina 12/5/2022
6 dr sigit aryanto klinik ar-rahman medika 11/23/2022
7 dr M Thariq klinik assalam 11/21/2022
11 dr elly lestari kabakoran klinik bhakti medika 11/20/2022
13 klinik fikri medika klinik fikri medika 12/8/2022
14 dr vina febria dwiresa klinik graha medis kosambi 12/3/2022
15 dr sony mulya klinik graha medis kosambi 11/30/2022
17 dr sony mulya klinik graha medis cilamaya 12/5/2022
18 dr sony mulya klinik graha medis cilamaya 12/10/2022
19 dr gina noviana g klinik graha medis kosambi 12/14/2022
21 dr khans mamun klinik graha medis kopel 12/9/2022
22 dr vina febria dwiresa klinik graha medis kopel 11/27/2022
23 dr melanita hardiyati klinik nur anisa 11/23/2022
24 dr ana permatasari klinik puri asih kosambi 11/18/2022
25 dr lukman endro susilo klinik telagasari 11/21/2022
26 dr emin nuriman klinik telagasari 11/23/2022
27 dr riswan dinarjo klinik telagasari 11/22/2022
28 dr emin nuriman klinik telagasari 11/24/2022
29 dr dudi humaedi klinik telagasari 11/21/2022
30 dr zaharaida klinik yakesti 12/9/2022
31 dr enung yuliati klinik yakesti 12/7/2022
32 klinik zhafira zarifa klinik zhafira zarifa 11/12/2022
33 klinik zhafira zarifa klinik zhafira zarifa 11/18/2022
34 dr tian gustiani puskesmas ciampel 12/15/2022
M WILDAN periode 26 Nov - 25 Des 2022 RAWATAN
SAMIN periode 26 Nov - 25 Des 2022 RAWATAN
elfrida periode 26 Nov - 25 Des 2022 RAWATAN
ayuni fitrian 22.20.04 periode 26 Nov - 25 Des 2022 RAWATAN
siti rosmala 20.09.99 periode 26 Nov - 25 Des 2022 RAWATAN
endang susanto periode 26 Nov - 25 Des 2022 RAWATAN
fauzi anwar 252888 periode 26 Nov - 25 Des 2022 RAWATAN
bagus 328033 periode 26 Nov - 25 Des 2022 RAWATAN
citra amelia ramadhani 15.75.15 periode 26 Nov - 25 Des 2022 RAWATAN
arfan banyu 231639 periode 26 Nov - 25 Des 2022 RAWATAN
felicia halwatu zahra 327940 periode 26 Nov - 25 Des 2022 RAWATAN
mariya eva 329654 periode 26 Nov - 25 Des 2022 RAWATAN
astim ahmad yasin periode 26 Nov - 25 Des 2022 RAWATAN
muhamad fathan n 28.87.45 periode 26 Nov - 25 Des 2022 RAWATAN
bayi ny tria marida 31.53.17 periode 26 Nov - 25 Des 2022 RAWATAN
reihan prasetio 21.91.60 periode 26 Nov - 25 Des 2022 RAWATAN
uun sumiati periode 26 Nov - 25 Des 2022 RAWATAN
wasni 329305 periode 26 Nov - 25 Des 2022 RAWATAN
zaidan periode 26 Nov - 25 Des 2022 RAWATAN
yuna periode 26 Nov - 25 Des 2022 RAWATAN
shinta 32.92.51 periode 26 Nov - 25 Des 2022 RAWATAN
imas p 22.69.63 periode 26 Nov - 25 Des 2022 RAWATAN
iis sitimasitoh 328306 periode 26 Nov - 25 Des 2022 RAWATAN
bima hafidzul ahkam 227422 periode 26 Nov - 25 Des 2022 RAWATAN
byi ny nina suryani 327971 periode 26 Nov - 25 Des 2022 RAWATAN
desti aulia 328155 periode 26 Nov - 25 Des 2022 RAWATAN
muhamad rizki periode 26 Nov - 25 Des 2022 RAWATAN
keynan sidiq andrian periode 26 Nov - 25 Des 2022 RAWATAN
bani koto periode 26 Nov - 25 Des 2022 RAWATAN
nabia syifa oktanina 31.64.24 periode 26 Nov - 25 Des 2022 RAWATAN
israel r 13.09.11 periode 26 Nov - 25 Des 2022 RAWATAN
dara faiga subagja 327409 periode 26 Nov - 25 Des 2022 RAWATAN
marianta amarise T periode 26 Nov - 25 Des 2022 RAWATAN
rodiah periode 26 Nov - 25 Des 2022 RAWATAN
Jumlah
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
Rp 25,000
1 ABAY 0 1 105000 1 Rp 105,000
2 AGAS 2 50000 1 88500 3 Rp 138,500
3 AMO 4 100000 4 Rp 100,000
4 AT AJA 1 25000 1 Rp 25,000
5 ATA BANCIN 4 100000 4 Rp 100,000
6 BOBY 4 100000 4 Rp 100,000
7 CASMITA 2 50000 2 Rp 50,000
8 D SALEH 2 50000 2 Rp 50,000
9 DADI 2 50000 2 Rp 50,000
10 DARSAM 4 100000 4 Rp 100,000
11 DARTA TURI 1 25000 1 Rp 25,000
12 DEDE ANWAR 10 250000 10 Rp 250,000
13 DEDEH K 4 100000 4 Rp 100,000
14 ENDANG 4 100000 4 Rp 100,000
15 ENDNAG 1 25000 1 Rp 25,000
16 GABRIL 2 50000 2 Rp 50,000
17 HERI KUSAERI 1 25000 1 Rp 25,000
18 ICONG 1 25000 1 Rp 25,000
19 JAKA K 2 50000 2 Rp 50,000
20 JUMSARI 14 350000 14 Rp 350,000
21 KARMAN/KOPRAL 1 25000 1 Rp 25,000
22 KARMAWAN 4 100000 4 Rp 100,000
23 KARTI 1 25000 1 Rp 25,000
24 KASMAN TEMPURAN 4 100000 4 Rp 100,000
25 KOSASIH 3 75000 3 Rp 75,000
26 KOSIM SUHARI 2 50000 2 Rp 50,000
27 MA ELAH 6 150000 6 Rp 150,000
28 NANO 4 100000 4 Rp 100,000
29 NASIR 2 50000 2 Rp 50,000
30 NAWANGSIH 2 50000 2 Rp 50,000
31 NENI 4 100000 4 Rp 100,000
32 NURJAYA W 1 25000 1 Rp 25,000
33 NURSIFA 4 100000 1 79000 5 Rp 179,000
34 ODANG 2 50000 2 Rp 50,000
35 OMAT 1 25000 1 Rp 25,000
36 OMIN 3 75000 3 Rp 75,000
37 OMPONG 2 50000 2 Rp 50,000
38 RADITA 3 75000 3 Rp 75,000
39 RAHMAT MG JAYA 1 25000 1 Rp 25,000
40 RIKI 17 425000 17 Rp 425,000
41 ROHAYATI 1 25000 1 Rp 25,000
42 ROSIN 5 125000 5 Rp 125,000
43 RT AJA 3 75000 3 Rp 75,000
44 RT IMAN 7 175000 7 Rp 175,000
45 SAHRUDIN 3 75000 3 Rp 75,000
46 SALAMAH 11 275000 1 317000 12 Rp 592,000
47 SARI 6 150000 6 Rp 150,000
48 SOBLENG 2 50000 2 Rp 50,000
49 SOBUR 1 25000 1 Rp 25,000
50 SRI HARTATI 6 150000 6 Rp 150,000
51 SRI ISDI 1 25000 1 Rp 25,000
52 SUKARDI 4 100000 4 Rp 100,000
53 SULAEMAN 2 50000 2 Rp 50,000
54 SUPARDI 1 25000 1 Rp 25,000
55 SYARIEF 12 300000 12 Rp 300,000
56 TOSIM 10 250000 1 82500 11 Rp 332,500
57 U GOLER 3 75000 3 Rp 75,000
58 UJANG 1 25000 1 Rp 25,000
59 UMAR 3 75000 3 Rp 75,000
60 WAKIL AKUNG 4 100000 4 Rp 100,000
61 WANDA 2 50000 2 Rp 50,000
62 WAWAN H 1 25000 1 Rp 25,000
63 WIWIN 5 125000 5 Rp 125,000
64 YAYA 4 100000 4 Rp 100,000
Keterangan
periode 26 Des - 5 Jan 2022

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No Nama Rawatan Op Katarak Jumlah

1 Agas 9 Rp 225,000 Rp - Rp 225,000

Rp 466,000 PERIODE 8-24 MARET 2022

1 bd ernita by ny tri winarti

maret 2022 Rawat Rp 25,000

maret 2022 Rawatan Rp25,000

maret 2022 Rawatan Rp25,000

PERIODE 4-26 MEI 2022

WIWIN (6.447 & 5.981

Rp 597,000 periode 6-25 juni 2022

Rp 1,223,000 periode 6-25 juni 2022

Nama PKM U B Rajal RAWATAN

610000 Periode 26 juni - 3 juli 2022

534 8 Rp 1,637,000 542

Aug-22 Rawatan 25000

Aug-22 Rawatan 25000

Aug-22 Rawatan 25000

328819 kuret Rp 50,000

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