2025_KLAIM JKN.xlsx

	A	B	C	D	E	F	G	H	M	N	O	P	Q	R	S	T	U	V	W	X	Y	Z
1	Rekapitulasi Berkas Pending dan dispute
2	KLAIM PELAYANAN dan FARMASI
3	Bulan		Pengajuan		FPK 1		FPK 2		Total FPK		Pending		Dispute		Tidak Layak		Ket	Capaian kualitas klaim		Nilai Billing	selisih	Capaian KMKB

4			Kasus	Rp	Kasus	Rp	Kasus	Rp	Kasus	Rp	Kasus	Rp	Kasus	Rp	Kasus	Rp		Kasus	Rp
5	Des-23	Rawat Jalan	507	107.405.700	507	107.405.700			507	107.405.700									100,0%	98.930.100	8.475.600	108,57%
6	Des-23	Obat Kronis	104	23.229.982	104	23.229.982			104	23.229.982									100,0%	27.359.586	-4.129.604	84,91%
7	Jumlah		611	130.635.682	611	130.635.682			611	130.635.682								100,0%	100,0%	126.289.686	4.345.996	103,44%
8	Januari	Rawat Jalan	593	129.525.500	593	129.525.500			593	129.525.500									100,0%	128.022.800	1.502.700	101,17%
9	Januari	Obat Kronis	103	22.549.867	103	22.549.867			103	22.549.867									100,0%	27.637.500	-5.087.633	81,59%
10	Jumlah		696	152.075.367	696	152.075.367			696	152.075.367								100,0%	100,0%	155.660.300	-3.584.933	97,70%
11	Februari	Rawat Jalan	489	100.007.200	489	100.007.200			489	100.007.200									100,0%	96.080.700	3.926.500	104,09%
12	Februari	Obat Kronis	102	21.389.543	102	21.389.543			102	21.389.543									100,0%	26.291.300	-4.901.757	81,36%
13	Jumlah		591	121.396.743	591	121.396.743			591	121.396.743								100,0%	100,0%	122.372.000	-975.257	99,20%
14	Maret	Rawat Jalan	468	99.413.300	468	99.413.300			468	99.413.300									100,0%	84.145.800	15.267.500	118,14%
15	Maret	Obat Kronis	110	22.999.094	110	22.999.094			110	22.999.094									100,0%	27.884.700	-4.885.606	82,48%
16	Jumlah		578	122.412.394	578	122.412.394			578	122.412.394								100,0%	100,0%	112.030.500	10.381.894	109,27%
17	April	Rawat Jalan	518	103.954.800	518	103.954.800			518	103.954.800									100,0%	96.598.800	7.356.000	107,62%
18	April	Obat Kronis	117	24.612.455	117	24.612.455			117	24.612.455									100,0%	31.489.100	-6.876.645	78,16%
19	Jumlah		635	128.567.255	635	128.567.255			635	128.567.255								100,0%	100,0%	128.087.900	479.355	100,37%
20	Mei	Rawat Jalan	695	149.015.400	695	149.015.400			695	149.015.400									100,0%	133.741.500	15.273.900	111,42%
21	Mei	Obat Kronis	135	30.648.288	135	30.648.288			135	30.648.288									100,0%	40.058.000	-9.409.712	76,51%
22	Jumlah		830	179.663.688	830	179.663.688			830	179.663.688								100,0%	100,0%	173.799.500	5.864.188	103,37%
23	Juni	Rawat Jalan	579	119.335.200	541	112.373.600	18	3.297.600	559	115.671.200					20	3.664.000	dianggap 1 episode pelayanan dg yang sebelumnya	96,5%	96,9%	103.508.300	12.162.900	111,75%
24	Juni	Obat Kronis	110	25.190.814	110	25.190.814			110	25.190.814								100,0%	100,0%	34.036.800	-8.845.986	74,01%
25	Jumlah		689	144.526.014	651	137.564.414	18	3.297.600	669	140.862.014								97,1%	97,5%	137.545.100	3.316.914	102,41%
26	Juli	Rawat Jalan	736	157.383.900	601	132.651.900	87	15.938.400	688	148.590.300					48	8.793.600		93,5%	94,4%	134.502.300	14.088.000	110,47%
27	Juli	Obat Kronis	144	33.690.646	144	33.690.646			144	33.690.646								100,0%	100,0%	44.516.400	-10.825.754	75,68%
28	Jumlah		880	191.074.546	745	166.342.546	87	15.938.400	832	182.280.946					48	8.793.600		94,5%	95,4%	179.018.700	3.262.246	101,82%
29	Agustus	Rawat Jalan	652	132.348.300	555	114.577.900	61	11.175.200	616	125.753.100					36	6.595.200		94,5%	95,0%	127.107.300	-1.354.200	98,93%
30	Agustus	Obat Kronis	137	29.875.573	137	29.875.573			137	29.875.573								100,0%	100,0%	39.673.140	-9.797.567	75,30%
31	Jumlah		789	162.223.873	692	144.453.473	61	11.175.200	753	155.628.673					36	6.595.200		95,4%	95,9%	166.780.440	-11.151.767	93,31%
32	September	Rawat Jalan	655	133.179.600	572	117.974.000	43	7.877.600	615	125.851.600					40	7.328.000		93,9%	94,5%	144.745.957	-18.894.357	86,95%
33	September	Obat Kronis	142	34.162.526	142	34.162.526			142	34.162.526								100,0%	100,0%	46.506.430	-12.343.904	73,46%
34	Jumlah		797	167.342.126	714	152.136.526	43	7.877.600	757	160.014.126					40	7.328.000		95,0%	95,6%	191.252.387	-31.238.261	83,67%
35	Oktober	Rawat Jalan	698	145.617.100	519	101.434.700	61	21.079.500	580	122.514.200					118	23.102.900		83,1%	84,1%	165.486.464	-42.972.264	74,03%
36	Oktober	Obat Kronis	134	34.424.826	134	34.424.826			134	34.424.826								100,0%	100,0%	47.258.833	-12.834.007	72,84%
37	Jumlah		832	180.041.926	653	135.859.526	61	21.079.500	714	156.939.026					118	23.102.900		85,8%	87,2%	212.745.297	-55.806.271	73,77%
38	November	Rawat Jalan	700	146.717.400	456	95.161.100	232	49.806.600	688	144.967.700					12	1.749.700		98,3%	98,8%	168.006.481	-23.038.781	86,29%
39	November	Obat Kronis	152	38.314.817	152	38.314.817			152	38.314.817								100,0%	100,0%	56.013.189	-17.698.372	68,40%
40	Jumlah		852	185.032.217	456	95.161.100	232	49.806.600	840	183.282.517					12	1.749.700		98,6%	99,1%	224.019.670	-40.737.153	81,82%
41	Desember	Rawat Jalan	684	140.181.000	489	102.144.200	195	37.123.300	684	139.267.500								100,0%	99,3%	166.375.221	-27.107.721	83,71%
42	Desember	Obat Kronis	138	34.836.740	138	34.836.740			138	34.836.740								100,0%	100,0%	47.612.388	-12.775.648	73,17%
43	Jumlah		822	175.017.740	489	102.144.200			822	174.104.240								100,0%	99,5%	213.987.609	-39.883.369	81,36%
44	Total	Rawat Jalan	7.974	1.664.084.400	7.003	1.465.639.300	697	146.298.200	7.700	1.611.937.500					274	51.233.400		96,6%	96,9%	1.647.251.723	-35.314.223	97,86%
45	Total	Obat Kronis	1.628	375.925.171	1.628	375.925.171			1.628	375.925.171					0	0		100,0%	100,0%	496.337.366	-120.412.195	75,74%
46	Akumulasi		9.602	2.040.009.571	7.003	1.465.639.300	697	146.298.200	7.700	1.987.862.671					274	51.233.400		80,2%	97,4%	2.143.589.089	-155.726.418	92,74%
47
48						72,93%				80,19%
49						71,84%				97,44%									93,1%
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