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  1. BPJS Kesehatan Cab. DUMAI UMPAN BALIK VERIFIKASI PENGAJUAN KLAIM TINGKAT PERTAMA Nomor FPK : P1610000048913 Provider : SEI SEMBILAN Bulan Pelayanan : October, 2016 Pelayanan : RITP Pengajuan Verifikasi Total Data : 2 Total Data : 2 Total Tagihan : 160,000 Total Tagihan : 760,000 NO TRANSAKSI NAMA PESERTA TANGGAL BIAYA STAT. KETERANGAN 040804011016Y000622 DENI WIBOWO 28/10/201 60,000 Setuju 040804011016Y000660 Nurhayati 29/10/201 100,000 Setuju Tanggal, 14 March 2018 Tanggal terima hasil verifikasi, Verifikator, Pengaju Klaim, 14/03/2018 14.24.53

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