Policy Number Membership No.

Member Name
YUANTA 171101168 - A ACHMAD AULIA
YUANTA 150901096 - A Adhi Fauzan
YUANTA 150901096 - B PUTRI MELISA AZRA
YUANTA 150801068 - A Agus Ariyanto
YUANTA 150801068 - B Minarni
YUANTA 150701056 - A Agussanti
YUANTA 150701057 -A Alberto Herman Mangkusasono
YUANTA 161117127 -A AMELIA HUSADA
YUANTA 170501149 - A ANDI FAJARUDIN
YUANTA 170501149 - B NUR FAIZAH
YUANTA 150810087 - A Bunga Marischa Gipi S
YUANTA 150423006 - A Cecilia Warsokoesoemo
YUANTA 150423009 - A Desyyana
YUANTA 150423010 - A Dina Primadini
YUANTA 171101169 - A DWI ANGRIYANI MAKFIRA
YUANTA 150423012 - A Eka Cahya Putra
YUANTA 150423012 - B AUDINI PANGESTI
YUANTA 170103135 - A EKO WAHYUDI
YUANTA 170103135 - B RACHMAWATY ASSAGAF
YUANTA 161213132 - A ENDANG ROYANI
YUANTA 161213132 - B DEDEH KURNIASIH
YUANTA 151019106 - A ERWAN HERMAWAN
YUANTA 150609051 - A Erwin Junus
YUANTA 150828095 - A Firmansyah
YUANTA 170125139 - A FAUZIA ULFAH
YUANTA 161007120 - A Friscaline Elisabeth
YUANTA 150608050 - A Ganes Darmawan
YUANTA 150423015 - A Guruh Sulistiono
YUANTA 161213133 - A HELDA GUNAWAN
YUANTA 170313143 - A HELMINA YOSEPHINE SIANIPAR
YUANTA 170501150 - A HARDIMAN ALEXANDER
YUANTA 150803073 - A Hendra Budi Satrio
YUANTA 150803073 - B Melawati Sari
YUANTA 170904159 - A INTA NUGRAHENI
YUANTA 160725114 - A IRNAWATI
YUANTA 150423018 - A Jimmi Sanjaya
YUANTA 150701059 - A Jansudi
YUANTA 150701059 - B So Ivon
YUANTA 150609052 - A Jose Andrew Suharto
YUANTA 150609052 - B Dewi Puspita
YUANTA 150423019 - A Juliana Gunawan
YUANTA 150703063 - A Justin Wijaya Liong
YUANTA 150703063 - B Mesalina
YUANTA 150701060 - A Kenny Lie
YUANTA 170801156 - A LISA STELYANTO
YUANTA 180112173 - A LUKI SURYANTO
YUANTA 150803075 - A Maman Firman
YUANTA 150803076 - A Marianti Hidayat
YUANTA 160718113 - A MARTHALINA
YUANTA 150619054 - A Mimi Listiyani
YUANTA 181115192 - A Muhamad Fauzi
YUANTA 181115192 - B AYU SYAFRA MAZONA
YUANTA 190301197 - A MUHAMMAD SHODIKIN
YUANTA 190301197 - B NGATIYEM
YUANTA 150423027 - A Noviana Era S
YUANTA 200916230 - A Nur Aeni
YUANTA 171005164 - A Nica Charter
YUANTA 150423028 - A Purbono
YUANTA 150423029 - A Putri Ken Ratri
YUANTA 170830158 - A RAHMAT ROMDONI
YUANTA 150423030 - A Randi Rifansyah Rachman
YUANTA 150423030 - B Sofa Azmi
YUANTA 150819092 - A RENATA CATALIA SENJAYA
YUANTA 151001103 - A Restu Pamuji
YUANTA 151001103 - B Nona Afriyana
YUANTA 151005104 - A Riza Hamdani
YUANTA 151005104 - B Intan Tanti Tri Utami
YUANTA 150803078 - A RONALD
YUANTA 150803078 - B TIFANNY
YUANTA 150423035 - A Rugun Juwita Putri
YUANTA 150423036 - A Ruslih
YUANTA 161122128 - A SATRIA RAMA DIANSYAH BAHARI
YUANTA 170515152 - A Sigit Prasetyo
YUANTA 171127171 - A SITI NURAENI
YUANTA 150423037 - A Saman Gusti
YUANTA 161101125 - A Samsul
YUANTA 160808116 - A SESILIA WIDIARTI WIDARTO
YUANTA 180112174 - A SETIAWAN DARMAWIDJAJA
YUANTA 150701061 - A Siau Ping
YUANTA 150903100 - A Soewarno Soenardhy
YUANTA 170308142 - A SRI INDAH REZEKI
YUANTA 150803081 - A Sri Mulyoko
YUANTA 150803081 - B Reni Susilowati
YUANTA 150818091 - A Sudarsih
YUANTA 150803082 - A Sugianto Ali Boediman
YUANTA 150901099 - A Suita Susanti Maksum
YUANTA 170308142 - A SULAEMAN
YUANTA 150423040 - A Surya Widjaja
YUANTA 150424047 - A Suryana
YUANTA 160725115 - A TANU FEBRIADI
YUANTA 150423041 - A Tobiin
YUANTA 150423041 - B Badriyah
YUANTA 150928102 - A Victor Ferdianto
YUANTA 150423043 - A Wawan Setiawan
YUANTA 160201110 - A Y.Gunastuti Purwaningsih
YUANTA 150803078 - A Yandhika Mardi Haposan
YUANTA 150803078 - B ANGELA EPIPHANI REFORMANDA
YUANTA 150423046 - A Yap Swie Cu
YUANTA 161128130 - A YERICO PERDANA
YUANTA 161128130 - B EUNIKE PRISKILA
YUANTA 191204211 - A Aloysius Kristianto Wicaksono
YUANTA 191204211 - B Febry Olivia
YUANTA 170327146 - A POSMA MARTIN LUMBAN TOBING
YUANTA 170327146 - B RUTH NARINDA MUMPUNI
YUANTA 150423004 - A Arya Jatmiko
YUANTA 170401147 - A DJOKO PRATOMO
YUANTA 150423014 - A Fresilla Juwita Santi
YUANTA 150810088 - A Henry Setiawan Asali
YUANTA 150810089 - A Ie Efendi Santoso
YUANTA 150423022 - A Lukman Hakim
YUANTA 150423031 - A Retno Endang WK
YUANTA 150423032 - A Rike Lesmana Tan
YUANTA 150727067 - A Zainudin Zuri
YUANTA 150727067 - B DIAN MEILIA RIZKI ANGGRAINI
Member DOB Gender Membership start date Membership End Date Date Terminated
19690718 M 20210401 20220331
19910202 M 20210401 20220331
19910504 F 20210401 20220331
19811204 M 20210401 20220331
19931107 F 20210401 20220331
19830825 F 20210401 20220331
19761206 M 20210401 20220331
19720502 F 20210401 20220331
19710303 M 20210401 20220331
19760616 F 20210401 20220331
19850731 F 20210401 20220331
19670929 F 20210401 20220331
19751206 F 20210401 20220331
19710323 F 20210401 20220331
19940717 F 20210401 20220331
19910705 M 20210401 20220331
19950728 F 20210401 20220331
19781030 M 20210401 20220331
19790725 F 20210401 20220331
19740110 M 20210401 20220331
19761202 F 20210401 20220331
19740505 M 20210401 20220331
19771211 M 20210401 20220331
19710714 M 20210401 20220331
19800120 F 20210401 20220331
19940214 F 20210401 20220331
19790921 M 20210401 20220331
19750324 M 20210401 20220331
19700929 F 20210401 20220331
19930805 F 20210401 20220331
19921030 M 20210401 20220331
19781003 M 20210401 20220331
19900531 F 20210401 20220331
19770426 F 20210401 20220331
19931028 F 20210401 20220331
19651113 M 20210401 20220331
19770228 M 20210401 20220331
19790814 F 20210401 20220331
19851102 M 20210401 20220331
19910224 F 20210401 20220331
19720704 F 20210401 20220331
19830616 M 20210401 20220331
19830523 F 20210401 20220331
19640324 M 20210401 20220331
19901110 F 20210401 20220331
19691129 M 20210401 20220331
19690512 M 20210401 20220331
19880420 F 20210401 20220331
19701124 F 20210401 20220331
19710526 F 20210401 20220331
19891114 M 20210401 20220331
19940426 F 20210401 20220331
19831229 M 20210401 20220331
19870222 F 20210401 20220331
19751109 F 20210401 20220331
19910117 F 20210401 20220331
19850228 M 20210401 20220331
19710728 M 20210401 20220331
19680404 F 20210401 20220331
19920313 M 20210401 20220331
19860503 M 20210401 20220331
19860830 F 20210401 20220331
19740831 F 20210401 20220331
19850201 M 20210401 20220331
19890411 F 20210401 20220331
19940507 M 20210401 20220331
19950922 F 20210401 20220331
19870909 M 20210401 20220331
19910825 F 20210401 20220331
19900601 F 20210401 20220331
19681230 M 20210401 20220331
19920313 M 20210401 20220331
19880716 M 20210401 20220331
19861215 F 20210401 20220331
19730220 M 20210401 20220331
19680824 M 20210401 20220331
19660103 F 20210401 20220331
19690421 M 20210401 20220331
19780204 F 20210401 20220331
19830729 M 20210401 20220331
19840811 F 20210401 20220331
19690523 M 20210401 20220331
19760814 F 20210401 20220331
19810225 F 20210401 20220331
19720303 M 20210401 20220331
19820929 F 20210401 20220331
19760310 M 20210401 20220331
19671025 M 20210401 20220331
19750614 M 20210401 20220331
19880227 M 20210401 20220331
19790613 M 20210401 20220331
19770501 F 20210401 20220331
19860714 M 20210401 20220331
19770329 M 20210401 20220331
19660515 F 20210401 20220331
19900102 M 20210401 20220331
19900716 F 20210401 20220331
19761205 F 20210401 20220331
19850907 M 20210401 20220331
19890712 F 20210401 20220331
19900518 M 20210401 20220331
19910223 F 20210401 20220331
19810304 M 20210401 20220331
19811107 F 20210401 20220331
19840617 M 20210401 20220331
19720303 M 20210401 20220331
19761207 F 20210401 20220331
19660922 M 20210401 20220331
19660206 M 20210401 20220331
19790704 M 20210401 20220331
19750514 F 20210401 20220331
19820614 F 20210401 20220331
19841027 M 20210401 20220331
19910517 F 20210401 20220331
Plan Code (PROD CODE) Benefit Code User Phone Number Record Mode Mapping ID
MCU14000 MCU14000 6281365390055 1
MCU14000 MCU14000 6289652865957 1
MATRB600 MATRB600 1 150901096 - A
MCU14000 MCU14000 6285777535326 1
MATRB400 MATRB400 1 150801068 - A
MATRB700, MCU14000 MATRB700, MCU6287883057817 1
MCU14000 MCU14000 6582161000688 1
MCU14000 MCU14000 628111904172 1
MCU14000 MCU14000 628128766759 1
MATRB700 MATRB700 1 170501149 - A
MCU14000 MCU14000 6287889230999 1
MCU14000 MCU14000 628129687983 1
MATRB600, MCU14000 MATRB600, MCU6281807209349 1
MCU14000 MCU14000 62811864335 1
MATRB600, MCU14000 MATRB600, MCU6285921235160 1
MCU14000 MCU14000 6285778270796 1
MATRB600 MATRB600 1 150423012 - A
MCU14000 MCU14000 6281513958582 1
MATRB700 MATRB700 1 170103135 - A
MCU14000 MCU14000 6289619494779 1
MATRB400 MATRB400 1 161213132 - A
MCU14000 MCU14000 6287878613463 1
MCU14000 MCU14000 62818222599 1
MCU14000 MCU14000 6287888098279 1
MATRB700, MCU14000 MATRB700, MCU6282114266283 1
MCU14000 MCU14000 6281291877714 1
MCU14000 MCU14000 6281808271212 1
MCU14000 MCU14000 6285312368658 1
MCU14000 MCU14000 628129926428 1
MCU14000 MCU14000 6287781305693 1
MCU14000 MCU14000 6281288977647 1
MCU14000 MCU14000 628811312129 1
MATRB400 MATRB400 1 150803073 - A
MCU14000 MCU14000 62817274491 1
MCU14000 MCU14000 6282111121178 1
MCU14000 MCU14000 62816703023 1
MCU14000 MCU14000 6282245188558 1
MATRB900 MATRB900 1 150701059 - A
MCU14000 MCU14000 6281932525262 1
MATRB700 MATRB700 1 150609052 - A
MCU14000 MCU14000 6281280937782 1
MCU14000 MCU14000 62818117707 1
MATRB900 MATRB900 1 150703063 - A
MCU14000 MCU14000 6282190009888 1
MCU14000 MCU14000 6281283761616 1
MCU14000 MCU14000 628119291169 1
MCU14000 MCU14000 628118667259 1
MATRB900, MCU14000 MATRB900, MCU6281297480023 1
MCU14000 MCU14000 6282110011287 1
MCU14000 MCU14000 62816710526 1
NOPLAN NOPLAN 6289660869868 1
MATRB600 MATRB600 1 181115192 - A
NOPLAN NOPLAN 6285745407422 1
MATRB400 MATRB400 1 190301197 - A
MCU14000 MCU14000 62811887507 1
MATRB600 MATRB600 6281319872735 1
MCU14000 MCU14000 6281364115208 1
MCU14000 MCU14000 6281386586571 1
MCU14000 MCU14000 6281218965587 1
MCU14000 MCU14000 1
MCU14000 MCU14000 6281286795678 1
MATRB400 MATRB400 1 150423030 - A
MCU14000 MCU14000 628118074427 1
MCU14000 MCU14000 6282122522951 1
MATRB600 MATRB600 1 151001103 - A
MCU14000 MCU14000 62853178222270 1
MATRB600 MATRB600 1 151005104 - A
MCU14000 MCU14000 62811929990 1
MATRB700 MATRB700 1 150803078 - A
MCU14000 MCU14000 6285775700600 1
MCU14000 MCU14000 6281316947875 1
MCU14000 MCU14000 628119475913 1
MCU14000 MCU14000 6281383346461 1
MATRB600, MCU14000 MATRB600, MCU6281319272758 1
MCU14000 MCU14000 6285333337168 1
MCU14000 MCU14000 628174998833 1
MCU14000 MCU14000 62816994550 1
MCU14000 MCU14000 1
MCU14000 MCU14000 628159933811 1
MCU14000 MCU14000 6281289897517 1
MATRB600, MCU14000 MATRB600, MCU6285777455666 1
MCU14000 MCU14000 628159986388 1
MATRB600 MATRB600 1 150803081 - A
MATRB600, MCU14000 MATRB600, MCU6285286765245 1
MCU14000 MCU14000 62816951074 1
MATRB700, MCU14000 MATRB700, MCU62818929302 1
MCU14000 MCU14000 6281288168751 1
MCU14000 MCU14000 1
MCU14000 MCU14000 6281212735876 1
MCU14000 MCU14000 6281290907760 1
MCU14000 MCU14000 6285694377312 1
MATRB400 MATRB400 1 150423041 - A
MCU14000 MCU14000 6287877702229 1
MCU14000 MCU14000 6281292285786 1
MCU14000 MCU14000 628158102511 1
MCU14000 MCU14000 6282284340843 1
MATRB900 MATRB900 1 150803078 - A
MATRB900, MCU14000 MATRB900, MCU6285211001990 1
MCU14000 MCU14000 6281212319228 1
MATRB700 MATRB700 1 161128130 - A
0 0 6281380752420 1
MATRB600 MATRB600 1 191204211 - A
MCU14000 MCU14000 628569090024 1
MATRB700 MATRB700 1 170327146 - A
MCU14000 MCU14000 628983619857 1
MCU14000 MCU14000 1
MATRB700, MCU14000 MATRB700, MCU6285859887755 1
MCU14000 MCU14000 628123013838 1
MCU14000 MCU14000 6281333238876 1
MCU14000 MCU14000 628179159675 1
MCU14000 MCU14000 6282136809348 1
MCU14000 MCU14000 6281952003298 1
MCU14000 MCU14000 628563316113 1
MATRB600 MATRB600 1 150727067 - A
Relationship Bank Account
E CIMB NIAGA!700650803400
E BCA!0060211914
S BCA!0060211914
E BCA!5015168061
S BCA!5015168061
E BCA!5270648012
E BCA!2671318368
E BCA!4580211106
E MAYBANK INDONESIA!1170183626
S MAYBANK INDONESIA!1170183626
E BCA!4212473158
E BCA!0711221297
E BANK MEGA!010740020089571
E BCA!0060327581
E BCA!5680404731
E BCA!4731290746
S BCA!4731290746
E MAYBANK INDONESIA!1170196912
S MAYBANK INDONESIA!1170196912
E BANK MANDIRI!1010000095719
S BANK MANDIRI!1010000095719
E CIMB NIAGA!762232654700
E CIMB NIAGA!5020123679115
E BCA!2211191351
E BCA!0060354120
E BCA!6470362985
E BCA!5460291889
E BRI!020601103585507
E BCA!0350482890
E BRI!067101015669505
E BCA!8830718444
E BCA!0060216720
S BCA!0060216720
E BCA!8770399506
E BCA!6040996468
E BCA!7340092257
E BCA!0061956351
S BCA!0061956351
E BCA!0831274866
S BCA!0831274866
E BCA!4580161702
E DBS!1701480595
S DBS!1701480595
E BCA!0060189889
E BCA!4582252037
E BCA!7340082537
E BCA!3451751741
E BCA!5270153935
E BANK MANDIRI!1040001018758
E BCA!4580077248
E BCA!4940104373
S BCA!4940104373
E BCA!0060735468
S BCA!0060735468
E BCA!5810440289
E BCA!4960098353
E BCA!8210052381
E BCA!5345129747
E CIMB NIAGA!0640100478157
E CIMB NIAGA!703067074100
E BCA!0060340781
S BCA!0060340781
E BCA!0061997031
E CIMB NIAGA!0640110941182
S CIMB NIAGA!0640110941182
E BCA!7090312671
S BCA!7090312671
E BCA!0060296961
S BCA!0060296961
E BCA!3910077375
E BCA!5345015261
E BCA!4582305955
E BCA!5240250383
E CIMB NIAGA!705030824000
E BNI 46!1669693338
E BCA!4580412616
E BCA!2211230233
E BCA!5415106022
E BCA!0061978045
E BCA!2551215794
E BANK MANDIRI!1040004916586
E BCA!6790242848
S BCA!6790242848
E BRI!067101000412531
E BCA!0060115354
E BCA!3721217785
E BCA!0060363404
E BCA!3841302361
E BNI 46!0209433325
E BCA!0060335729
E BANK DKI!11320130030
S BANK DKI!11320130030
E BCA!5310285368
E BCA!0060356351
E BCA!4580328968
E BANK MANDIRI!1090007197254
S BANK MANDIRI!1090007197254
E BCA!6070104448
E BCA!0060348065
S BCA!0060348065
E CIMB NIAGA!702603025800
S CIMB NIAGA!702603025800
E BCA!1090522929
S BCA!1090522929
E BCA!0102058389
E BCA!4780084176
E BANK MANDIRI!1420014190416
E BCA!7880882818
E BCA!5620037089
E BCA!0885332833
E BCA!5550085871
E BCA!0887065393
E BCA!2710812236
S BCA!2710812236
Record Mode Record Type Payor ID Member ID Mapping ID Admedika Member Id
1P YUANTA 171101168 - A
1P YUANTA 150901096 - A
1D YUANTA 150901096 - B 150901096 - A
1P YUANTA 150801068 - A
1D YUANTA 150801068 - B 150801068 - A
1P YUANTA 150701056 - A
1P YUANTA 150701057 -A
1P YUANTA 161117127 -A
1P YUANTA 170501149 - A
1D YUANTA 170501149 - B
1P YUANTA 150810087 - A
1P YUANTA 150423006 - A
1P YUANTA 150423009 - A
1P YUANTA 150423010 - A
1P YUANTA 171101169 - A
1P YUANTA 150423012 - A
1D YUANTA 150423012 - B
1P YUANTA 170103135 - A
1D YUANTA 170103135 - B
1P YUANTA 161213132 - A
1D YUANTA 161213132 - B
1P YUANTA 151019106 - A
1P YUANTA 150609051 - A
1P YUANTA 150828095 - A
1P YUANTA 170125139 - A
1P YUANTA 161007120 - A
1P YUANTA 150608050 - A
1P YUANTA 150423015 - A
1P YUANTA 161213133 - A
1P YUANTA 170313143 - A
1P YUANTA 170501150 - A
1P YUANTA 150803073 - A
1D YUANTA 150803073 - B
1P YUANTA 170904159 - A
1P YUANTA 160725114 - A
1P YUANTA 150423018 - A
1P YUANTA 150701059 - A
1D YUANTA 150701059 - B
1P YUANTA 150609052 - A
1D YUANTA 150609052 - B
1P YUANTA 150423019 - A
1P YUANTA 150703063 - A
1D YUANTA 150703063 - B
1P YUANTA 150701060 - A
1P YUANTA 170801156 - A
1P YUANTA 180112173 - A
1P YUANTA 150803075 - A
1P YUANTA 150803076 - A
1P YUANTA 160718113 - A
1P YUANTA 150619054 - A
1P YUANTA 181115192 - A
1D YUANTA 181115192 - B
1P YUANTA 190301197 - A
1D YUANTA 190301197 - B
1P YUANTA 150423027 - A
1P YUANTA 200916230 - A
1P YUANTA 171005164 - A
1P YUANTA 150423028 - A
1P YUANTA 150423029 - A
1P YUANTA 170830158 - A
1P YUANTA 150423030 - A
1D YUANTA 150423030 - B
1P YUANTA 150819092 - A
1P YUANTA 151001103 - A
1D YUANTA 151001103 - B
1P YUANTA 151005104 - A
1D YUANTA 151005104 - B
1P YUANTA 150803078 - A
1D YUANTA 150803078 - B
1P YUANTA 150423035 - A
1P YUANTA 150423036 - A
1P YUANTA 161122128 - A
1P YUANTA 170515152 - A
1P YUANTA 171127171 - A
1P YUANTA 150423037 - A
1P YUANTA 161101125 - A
1P YUANTA 160808116 - A
1P YUANTA 180112174 - A
1P YUANTA 150701061 - A
1P YUANTA 150903100 - A
1P YUANTA 170308142 - A
1P YUANTA 150803081 - A
1D YUANTA 150803081 - B
1P YUANTA 150818091 - A
1P YUANTA 150803082 - A
1P YUANTA 150901099 - A
1P YUANTA 170308142 - A
1P YUANTA 150423040 - A
1P YUANTA 150424047 - A
1P YUANTA 160725115 - A
1P YUANTA 150423041 - A
1D YUANTA 150423041 - B
1P YUANTA 150928102 - A
1P YUANTA 150423043 - A
1P YUANTA 160201110 - A
1P YUANTA 150803078 - A
1D YUANTA 150803078 - B
1P YUANTA 150423046 - A
1P YUANTA 161128130 - A
1D YUANTA 161128130 - B
1P YUANTA 191204211 - A
1D YUANTA 191204211 - B
1P YUANTA 170327146 - A
1D YUANTA 170327146 - B
1P YUANTA 150423004 - A
1P YUANTA 170401147 - A
1P YUANTA 150423014 - A
1P YUANTA 150810088 - A
1P YUANTA 150810089 - A
1P YUANTA 150423022 - A
1P YUANTA 150423031 - A
1P YUANTA 150423032 - A
1P YUANTA 150727067 - A
1D YUANTA 150727067 - B
Corporate ID NIK Division Branch Code Bank Info Language
CIMB NIAGA!700650803400
BCA!0060211914
BCA!0060211914
BCA!5015168061
BCA!5015168061
BCA!5270648012
BCA!2671318368
BCA!4580211106
MAYBANK INDONESIA!1170183626
MAYBANK INDONESIA!1170183626
BCA!4212473158
BCA!0711221297
BANK MEGA!010740020089571
BCA!0060327581
BCA!5680404731
BCA!4731290746
BCA!4731290746
MAYBANK INDONESIA!1170196912
MAYBANK INDONESIA!1170196912
BANK MANDIRI!1010000095719
BANK MANDIRI!1010000095719
CIMB NIAGA!762232654700
CIMB NIAGA!5020123679115
BCA!2211191351
BCA!0060354120
BCA!6470362985
BCA!5460291889
BRI!020601103585507
BCA!0350482890
BRI!067101015669505
BCA!8830718444
BCA!0060216720
BCA!0060216720
BCA!8770399506
BCA!6040996468
BCA!7340092257
BCA!0061956351
BCA!0061956351
BCA!0831274866
BCA!0831274866
BCA!4580161702
DBS!1701480595
DBS!1701480595
BCA!0060189889
BCA!4582252037
BCA!7340082537
BCA!3451751741
BCA!5270153935
BANK MANDIRI!1040001018758
BCA!4580077248
BCA!4940104373
BCA!4940104373
BCA!0060735468
BCA!0060735468
BCA!5810440289
BCA!4960098353
BCA!8210052381
BCA!5345129747
CIMB NIAGA!0640100478157
CIMB NIAGA!703067074100
BCA!0060340781
BCA!0060340781
BCA!0061997031
CIMB NIAGA!0640110941182
CIMB NIAGA!0640110941182
BCA!7090312671
BCA!7090312671
BCA!0060296961
BCA!0060296961
BCA!3910077375
BCA!5345015261
BCA!4582305955
BCA!5240250383
CIMB NIAGA!705030824000
BNI 46!1669693338
BCA!4580412616
BCA!2211230233
BCA!5415106022
BCA!0061978045
BCA!2551215794
BANK MANDIRI!1040004916586
BCA!6790242848
BCA!6790242848
BRI!067101000412531
BCA!0060115354
BCA!3721217785
BCA!0060363404
BCA!3841302361
BNI 46!0209433325
BCA!0060335729
BANK DKI!11320130030
BANK DKI!11320130030
BCA!5310285368
BCA!0060356351
BCA!4580328968
BANK MANDIRI!1090007197254
BANK MANDIRI!1090007197254
BCA!6070104448
BCA!0060348065
BCA!0060348065
CIMB NIAGA!702603025800
CIMB NIAGA!702603025800
BCA!1090522929
BCA!1090522929
BCA!0102058389
BCA!4780084176
BANK MANDIRI!1420014190416
BCA!7880882818
BCA!5620037089
BCA!0885332833
BCA!5550085871
BCA!0887065393
BCA!2710812236
BCA!2710812236
Type of Work Race Policy Number Material Status Relationship
YUANTA E
YUANTA E
YUANTA S
YUANTA E
YUANTA S
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA S
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA S
YUANTA E
YUANTA S
YUANTA E
YUANTA S
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA S
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA S
YUANTA E
YUANTA S
YUANTA E
YUANTA E
YUANTA S
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA S
YUANTA E
YUANTA S
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA S
YUANTA E
YUANTA E
YUANTA S
YUANTA E
YUANTA S
YUANTA E
YUANTA S
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA S
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA S
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA S
YUANTA E
YUANTA E
YUANTA S
YUANTA E
YUANTA S
YUANTA E
YUANTA S
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA E
YUANTA S
Member's Effective Date Members Expiry Date Faskes FKTP (First Level Provider)
20210401 20220331
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20210401 20220331
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20210401 20220331
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20210401 20220331
20210401 20220331
20210401 20220331
Faskes FKRTL (Next Level Provider) The Right Classes Room Of BPJS Participants
Name of Faskes Rule BPJSK ('Y' or 'N') Internal Use
Member Name Address1 Address2
ACHMAD AULIA
Adhi Fauzan
PUTRI MELISA AZRA
Agus Ariyanto
Minarni
Agussanti
Alberto Herman Mangkusasono
AMELIA HUSADA
ANDI FAJARUDIN
NUR FAIZAH
Bunga Marischa Gipi S
Cecilia Warsokoesoemo
Desyyana
Dina Primadini
DWI ANGRIYANI MAKFIRA
Eka Cahya Putra
AUDINI PANGESTI
EKO WAHYUDI
RACHMAWATY ASSAGAF
ENDANG ROYANI
DEDEH KURNIASIH
ERWAN HERMAWAN
Erwin Junus
Firmansyah
FAUZIA ULFAH
Friscaline Elisabeth
Ganes Darmawan
Guruh Sulistiono
HELDA GUNAWAN
HELMINA YOSEPHINE SIANIPAR
HARDIMAN ALEXANDER
Hendra Budi Satrio
Melawati Sari
INTA NUGRAHENI
IRNAWATI
Jimmi Sanjaya
Jansudi
So Ivon
Jose Andrew Suharto
Dewi Puspita
Juliana Gunawan
Justin Wijaya Liong
Mesalina
Kenny Lie
LISA STELYANTO
LUKI SURYANTO
Maman Firman
Marianti Hidayat
MARTHALINA
Mimi Listiyani
Muhamad Fauzi
AYU SYAFRA MAZONA
MUHAMMAD SHODIKIN
NGATIYEM
Noviana Era S
Nur Aeni
Nica Charter
Purbono
Putri Ken Ratri
RAHMAT ROMDONI
Randi Rifansyah Rachman
Sofa Azmi
RENATA CATALIA SENJAYA
Restu Pamuji
Nona Afriyana
Riza Hamdani
Intan Tanti Tri Utami
RONALD
TIFANNY
Rugun Juwita Putri
Ruslih
SATRIA RAMA DIANSYAH BAHARI
Sigit Prasetyo
SITI NURAENI
Saman Gusti
Samsul
SESILIA WIDIARTI WIDARTO
SETIAWAN DARMAWIDJAJA
Siau Ping
Soewarno Soenardhy
SRI INDAH REZEKI
Sri Mulyoko
Reni Susilowati
Sudarsih
Sugianto Ali Boediman
Suita Susanti Maksum
SULAEMAN
Surya Widjaja
Suryana
TANU FEBRIADI
Tobiin
Badriyah
Victor Ferdianto
Wawan Setiawan
Y.Gunastuti Purwaningsih
Yandhika Mardi Haposan
ANGELA EPIPHANI REFORMANDA
Yap Swie Cu
YERICO PERDANA
EUNIKE PRISKILA
Aloysius Kristianto Wicaksono
Febry Olivia
POSMA MARTIN LUMBAN TOBING
RUTH NARINDA MUMPUNI
Arya Jatmiko
DJOKO PRATOMO
Fresilla Juwita Santi
Henry Setiawan Asali
Ie Efendi Santoso
Lukman Hakim
Retno Endang WK
Rike Lesmana Tan
Zainudin Zuri
DIAN MEILIA RIZKI ANGGRAINI
Address3 Address4 City Post Code Telephone - Mobile Telephone - REs
6281365390055
6289652865957

6285777535326

6287883057817
6582161000688
628111904172
628128766759

6287889230999
628129687983
6281807209349
62811864335
6285921235160
6285778270796

6281513958582

6289619494779

6287878613463
62818222599
6287888098279
6282114266283
6281291877714
6281808271212
6285312368658
628129926428
6287781305693
6281288977647
628811312129

62817274491
6282111121178
62816703023
6282245188558

6281932525262
6281280937782
62818117707

6282190009888
6281283761616
628119291169
628118667259
6281297480023
6282110011287
62816710526
6289660869868

6285745407422

62811887507
6281319872735
6281364115208
6281386586571
6281218965587

6281286795678

628118074427
6282122522951

62853178222270

62811929990

6285775700600
6281316947875
628119475913
6281383346461
6281319272758
6285333337168
628174998833
62816994550

628159933811
6281289897517
6285777455666
628159986388

6285286765245
62816951074
62818929302
6281288168751

6281212735876
6281290907760
6285694377312

6287877702229
6281292285786
628158102511
6282284340843

6285211001990
6281212319228

6281380752420

628569090024

628983619857

6285859887755
628123013838
6281333238876
628179159675
6282136809348
6281952003298
628563316113
Telephone - Office NRIC Passport No. Passport Country
Email Identification Code Internal Use
Date of Birth Sex Internal Use Plan-ID Empolyement-Status Internal Use
19690718 M MCU14000
19910202 M MCU14000
19910504 F MATRB600
19811204 M MCU14000
19931107 F MATRB400
19830825 F MATRB700, MCU14000
19761206 M MCU14000
19720502 F MCU14000
19710303 M MCU14000
19760616 F MATRB700
19850731 F MCU14000
19670929 F MCU14000
19751206 F MATRB600, MCU14000
19710323 F MCU14000
19940717 F MATRB600, MCU14000
19910705 M MCU14000
19950728 F MATRB600
19781030 M MCU14000
19790725 F MATRB700
19740110 M MCU14000
19761202 F MATRB400
19740505 M MCU14000
19771211 M MCU14000
19710714 M MCU14000
19800120 F MATRB700, MCU14000
19940214 F MCU14000
19790921 M MCU14000
19750324 M MCU14000
19700929 F MCU14000
19930805 F MCU14000
19921030 M MCU14000
19781003 M MCU14000
19900531 F MATRB400
19770426 F MCU14000
19931028 F MCU14000
19651113 M MCU14000
19770228 M MCU14000
19790814 F MATRB900
19851102 M MCU14000
19910224 F MATRB700
19720704 F MCU14000
19830616 M MCU14000
19830523 F MATRB900
19640324 M MCU14000
19901110 F MCU14000
19691129 M MCU14000
19690512 M MCU14000
19880420 F MATRB900, MCU14000
19701124 F MCU14000
19710526 F MCU14000
19891114 M NOPLAN
19940426 F MATRB600
19831229 M NOPLAN
19870222 F MATRB400
19751109 F MCU14000
19910117 F MATRB600
19850228 M MCU14000
19710728 M MCU14000
19680404 F MCU14000
19920313 M MCU14000
19860503 M MCU14000
19860830 F MATRB400
19740831 F MCU14000
19850201 M MCU14000
19890411 F MATRB600
19940507 M MCU14000
19950922 F MATRB600
19870909 M MCU14000
19910825 F MATRB700
19900601 F MCU14000
19681230 M MCU14000
19920313 M MCU14000
19880716 M MCU14000
19861215 F MATRB600, MCU14000
19730220 M MCU14000
19680824 M MCU14000
19660103 F MCU14000
19690421 M MCU14000
19780204 F MCU14000
19830729 M MCU14000
19840811 F MATRB600, MCU14000
19690523 M MCU14000
19760814 F MATRB600
19810225 F MATRB600, MCU14000
19720303 M MCU14000
19820929 F MATRB700, MCU14000
19760310 M MCU14000
19671025 M MCU14000
19750614 M MCU14000
19880227 M MCU14000
19790613 M MCU14000
19770501 F MATRB400
19860714 M MCU14000
19770329 M MCU14000
19660515 F MCU14000
19900102 M MCU14000
19900716 F MATRB900
19761205 F MATRB900, MCU14000
19850907 M MCU14000
19890712 F MATRB700
19900518 M 0
19910223 F MATRB600
19810304 M MCU14000
19811107 F MATRB700
19840617 M MCU14000
19720303 M MCU14000
19761207 F MATRB700, MCU14000
19660922 M MCU14000
19660206 M MCU14000
19790704 M MCU14000
19750514 F MCU14000
19820614 F MCU14000
19841027 M MCU14000
19910517 F MATRB600
Internal Use Internal Use Date Terminated Pre Existing BPJS ID Endorsement Date
Remarks Internal Use Member Since Internal Use Policy in Force Member Suspended
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
I N
Activation Date Internal Use Internal Use Internal Usem Option Mode Benefit Code
MCU14000
MCU14000
MATRB600
MCU14000
MATRB400
MATRB700, MCU14000
MCU14000
MCU14000
MCU14000
MATRB700
MCU14000
MCU14000
MATRB600, MCU14000
MCU14000
MATRB600, MCU14000
MCU14000
MATRB600
MCU14000
MATRB700
MCU14000
MATRB400
MCU14000
MCU14000
MCU14000
MATRB700, MCU14000
MCU14000
MCU14000
MCU14000
MCU14000
MCU14000
MCU14000
MCU14000
MATRB400
MCU14000
MCU14000
MCU14000
MCU14000
MATRB900
MCU14000
MATRB700
MCU14000
MCU14000
MATRB900
MCU14000
MCU14000
MCU14000
MCU14000
MATRB900, MCU14000
MCU14000
MCU14000
NOPLAN
MATRB600
NOPLAN
MATRB400
MCU14000
MATRB600
MCU14000
MCU14000
MCU14000
MCU14000
MCU14000
MATRB400
MCU14000
MCU14000
MATRB600
MCU14000
MATRB600
MCU14000
MATRB700
MCU14000
MCU14000
MCU14000
MCU14000
MATRB600, MCU14000
MCU14000
MCU14000
MCU14000
MCU14000
MCU14000
MCU14000
MATRB600, MCU14000
MCU14000
MATRB600
MATRB600, MCU14000
MCU14000
MATRB700, MCU14000
MCU14000
MCU14000
MCU14000
MCU14000
MCU14000
MATRB400
MCU14000
MCU14000
MCU14000
MCU14000
MATRB900
MATRB900, MCU14000
MCU14000
MATRB700
0
MATRB600
MCU14000
MATRB700
MCU14000
MCU14000
MATRB700, MCU14000
MCU14000
MCU14000
MCU14000
MCU14000
MCU14000
MCU14000
MATRB600
TRB700, MCU14000

TRB600, MCU14000

TRB600, MCU14000

TRB700, MCU14000
TRB900, MCU14000

TRB600, MCU14000

TRB600, MCU14000
TRB600, MCU14000

TRB700, MCU14000

TRB900, MCU14000

TRB700, MCU14000
No. Kolom Type
1 Policy Number Char
2 Membership No. Char

3 Member Name Text

4 Member DOB Date
5 Gender Char
6 Membership start date Date
7 Membership End Date Date
8 Date Terminated Date
9 Plan Code Char
10 Benefit Code Char
11 User Phone Number Char
12 Record Mode Number

13 Mapping ID Char

14 Relationship Char
 Description Sample Remarks
Policy Number POLISIDV
Unique code for Member as Linking information, please make sure TEST-1
each member is aware of this number. Without character space and
"/"

Member Name Pay JO

Format YYYYMMDD atau YYYY-MM-DD 19951028
Male = M or Female = F M
Format YYYYMMDD 19951028
Format YYYYMMDD 19951028
Format YYYYMMDD, Mandatory if Record Mode 3 is used 19951028
Plan code used by the user (can be created by Halodoc)
Benefit code used by the user (can be created by Halodoc)
Use 62 in front of, not use 0 628112211221
1 : New Member 1
2 : Change Member Detail (Endorsemen), Changing the detail data
(Name, DOB, start and end date, plan and benefit, EXCEPT Member
No.
3 : Delete Member
5 : Renewal

For family limit or information of Family, for Spouse and Children TEST-1
needs to be inputed by the Member ID of the Principle

Mandatory for Dependent record H=Husband W=Wife S=Son D

D=Daughter