VHJVH M

NO NAMA NO RM TANGGAL RAWAT
29 APRIL 2018
1 NARSIH, NY 00-15-96
02 MEI 2018
29 APRIL 2018
2 HASANUL RIZQA, TN 00-16-16
03 MEI 2018
30 APRIL 2018
3 ALDI SADEWO, TN 00-16-35
03 MEI 2018
4 HERMAN, TN 00-14-96
04 MEI 2018
01 MEI 2018
5 SUMINAH, NY 00-06-40
04 MEI 2018
02 MEI 2018
6 ANGGA SAWALUDIN, AN 00-16-11
04 MEI 2018
30 APRIL 2018
7 RAZIQ HANNAN, AN 00-16-06
04 MEI 2018
02 MEI 2018
8 HARSONO, TN 00-16-70
04 MEI 2018
01 MEI 2018
9 AISYAH HUMAIRA, AN 00-16-69

9 AISYAH HUMAIRA, AN 00-16-69
04 MEI 2018
02 MEI 2018
10 RONCI, NY 00-16-84
04 MEI 2018
02 MEI 2018
11 KHYARA MAYULIDIA, AN 00-14-82
01 MEI 2018
12 MINAH, NY 00-10-02
02 MEI 2018
13 JENNAIRA VARDA, AN 00-16-75
29 APRIL 2018
30 APRIL 2018
14 JERRIX CRISTIAN, AN 00-16-38
01 MEI 2018
15 LIUNG, TN 00-01-98
02 MEI 2018
16 NABILA CHAERUNNISA, NN 00-16-75
03 MEI 2018
17 DARWATI, NY 00-17-07
02 MEI 2018
18 LAMI, NY 00-16-87
04 MEI 2018
19 BONIH, NY 00-05-87
03 MEI 2018
20 AUFA RAMADHIYANT, NN 00-17-08
20 AUFA RAMADHIYANT, NN 00-17-08
05 MEI 2018
21 KUNEM, TN 00-17-09
07 MEI 2018
05 MEI 2018
22 HAMIZAN MANSOOR, AN 00-17-47
07 MEI 2018
04 MEI 2018
23 M. GIBRAN GHAILANI 00-17-46
05 MEI 2018
24 LATIF MUNAWWAR, TN 00-17-63
07 MEI 2018
03 MEI 2018
04 MEI 2018
25 EGI PUJI PRASETYO, TN 00-16-93
05 MEI 2018
06 MEI 2018
07 MEI 2018
03 MEI 2018
04 MEI 2018
26 MUHAMMAD DEDE YUSUF, AN 00-17-19 05 MEI 2018
06 MEI 2018
07 MEI 2018
05 MEI 2018
27 UTA, TN 00-17-18 06 MEI 2018
07 MEI 2018
06 MEI 2018
28 FAQIH RAHMAN HUSEN, AN 00-17-79
07 MEI 2018
08 MEI 2018
07 MEI 2018
29 ALYKA NURJASMIN, AN 00-18-10 08 MEI 2018
09 MEI 2018
08 MEI 2018
08 MEI 2018
30 TITANIH, NY 00-18-22
09 MEI 2018
10 MEI 2018
07 MEI 2018
08 MEI 2018
31 HABIBIE AQSO, AN 00-18-09 09 MEI 2018
10 MEI 2018
11 MEI 2018
08 MEI 2018
32 PAMELA TALITA, AN 00-16-88

09 MEI 2018
32 PAMELA TALITA, AN 00-16-88
10 MEI 2018
11 MEI 2018
08 MEI 2018
09 MEI 2018
33 CAHAYA PUTRI, AN 00-05-48 10 MEI 2018
11 MEI 2018
09 MEI 2018
34 GUMIH, NY 00-18-56 10 MEI 2018

11 MEI 2018
08 MEI 2018
09 MEI 2018
35 RATIM SUJOWONO, TN 00-18-37
10 MEI 2018
11 MEI 2018
09 MEI 2018
10 MEI 2018
36 ZEA ALMAIRA, AN 00-18-66 11 MEI 2018
12 MEI 2018
10 MEI 2018
37 ALVARO RAHANDIKA ARSYAD, AN 00-18-99 11 MEI 2018

12 MEI 2018
11 MEI 2018
38 ANOH, NY 00-19-12
12 MEI 2018
10 MEI 2018
39 TRIAGUSTIN NAWANG SASI, AN 00-18-79 11 MEI 2018

12 MEI 2018
13 MEI 2018
11 MEI 2018
40 ALIF SANJAYA, AN 00-19-24
12 MEI 2018
13 MEI 2018
10 MEI 2018
41 DASRIL RIVAL, TN 00-19-06 11 MEI 2018
12 MEI 2018
09 MEI 2018
10 MEI 2018
42 RANO, TN 00-18-55
42 RANO, TN 00-18-55
11 MEI 2018
12 MEI 2018
13 MEI 2018
11 MEI 2018
43 RIO RAMA SETYAWAN, AN 00-19-25
12 MEI 2018
13 MEI 2018
11 MEI 2018
44 INDAH, NN 00-15-95 12 MEI 2018

13 MEI 2018
14 MEI 2018
12 MEI 2018
45 ARKANA DESTA IRAWAN, AN 00-04-98 13 MEI 2018
14 MEI 2018
11 MEI 2018
12 MEI 2018
46 GIYARSONO, TN 00-19-21
13 MEI 2018
14 MEI 2018
15 MEI 2018
12 MEI 2018
47 RAZIQ MUZAKI ASSAJID, AN 00-02-59 13 MEI 2018

14 MEI 2018
15 MEI 2018
14 MEI 2018
48 JAINUDIN ALFAQIH, AN 00-19-54
15 MEI 2018
13 MEI 2018
14 MEI 2018
15 MEI 2018
49 KLAUDIA KHAIRUNNISA, AN 00-19-28
16 MEI 2018
17 MEI 2018
14 MEI 2018
50 MARSIH, NY 00-19-87
17 MEI 2018
14 MEI 2018
15 MEI 2018
51 VINA NUR ROHMAN, AN 00-19-81 16 MEI 2018
17 MEI 2018
17 MEI 2018
15 MEI 2018
52 SARI, NY 00-07-47
52 SARI, NY 00-07-47
16 MEI 2018
15 MEI 2018
53 MAMAD, TN 00-20-04
16 MEI 2018
15 MEI 2018
54 HAFIDZ, AN 00-20-05
16 MEI 2018
17 MEI 2018
15 MEI 2018
16 MEI 2018
55 TRIAGUSTIN NAWANG, AN 00-18-79 17 MEI 2018
18 MEI 2018
18 MEI 2018
14 MEI 2018
15 MEI 2018
56 BINTANG ATMAJAYA, AN 00-19-70 16 MEI 2018
17 MEI 2018
18 MEI 2018
18 MEI 2018
16 MEI 2018
57 MARTINI DAYANTI, NY 00-21-77
17 MEI 2018
18 MEI 2018
17 MEI 2018
58 EDI WARTONO, TN 00-20-59 18 MEI 2018
19 MEI 2018
16 MEI 2018
59 MUHAMMAD FATHIR, AN 00-20-43 17 MEI 2018

18 MEI 2018
19 MEI 2018
17 MEI 2018
60 JULYANDRA LUTFIANA ULFA, AN 00-20-47 18 MEI 2018
19 MEI 2018
17 MEI 2018
61 AHMAD GHANI, AN 00-20-58
18 MEI 2018
19 MEI 2018
17 MEI 2018
18 MEI 2018
62 EROM, NY 00-20-74
19 MEI 2018
20 MEI 2018
17 MEI 2018
18 MEI 2018
63 SRI LESTARI, NY 00-20-71
63 SRI LESTARI, NY 00-20-71
19 MEI 2018
20 MEI 2018
16 MEI 2018
17 MEI 2018
18 MEI 2018
64 SITI SALAMAH, NY 00-20-17
19 MEI 2018
20 MEI 2018
21 MEI 2018
20 MEI 2018
65 EKA NOVIANTI, NY 00-21-01
21 MEI 2018
20 MEI 2018
21 MEI 2018
66 AGUNG DARMA, AN 00-03-98
22 MEI 2018
17 MEI 2018
17 MEI 2018
18 MEI 2018
19 MEI 2018
67 KHALIKA ADEVA, AN 00-12-45
20 MEI 2018
21 MEI 2018
22 MEI 2018
17 MEI 2018
18 MEI 2018
19 MEI 2018
68 HABIBIE AQSO SURADI, AN 00-18-09
20 MEI 2018
21 MEI 2018
22 MEI 2018
18 MEI 2018
19 MEI 2018
69 NABILA TRI WULANDARI, AN 00-20-81 20 MEI 2018

21 MEI 2018
22 MEI 2018
21 MEI 2018
70 WASINI, NY 00-19-73
22 MEI 2018
23 MEI 2018
22 MEI 2018
71 ROSIYAH FIJI KOMALA, NY 00-17-71 23 MEI 2018
24 MEI 2018
22 MEI 2018
72 NIMAH, NY 00-21-91 23 MEI 2018
24 MEI 2018
19 MEI 2018
20 MEI 2018
21 MEI 2018
73 WAHIDIN HADI SAMSURI, TN 00-20-79
22 MEI 2018
23 MEI 2018
24 MEI 2018
24 MEI 2018
25 MEI 2018
74 MUNAH, NY 00-16-39
22 MEI 2018
23 MEI 2018
75 ALFIAH KHOSIBAH, NN 00-21-86
24 MEI 2018
25 MEI 2018
22 MEI 2018
23 MEI 2018
76 ADHEN BAGUS ARWANA, AN 00-08-56
24 MEI 2018
25 MEI 2018
23 MEI 2018
77 MASAH, NY 00-21-94
24 MEI 2018
25 MEI 2018
25 MEI 2018
78 ISRA MIRADINA, AN 00-10-10
27 MEI 2018
25 MEI 2018
79 NANA, TN 00-22-39 26 MEI 2018

27 MEI 2018
28 MEI 2018
28 MEI 2018
80 YAYAN DIANA, NY 00-22-52 29 MEI 2018
30 MEI 2018
00-22-97 28 MEI 2018
81 NUR AFIFAH, AN 29 MEI 2018

30 MEI 2018
31 MEI 2018
00-23-03 28 MEI 2018
82 QOWMI LAYLA, AN 29 MEI 2018

30 MEI 2018
31 MEI 2018
00-22-87 28 MEI 2018
29 MEI 2018
83 AULIA NUR RAMASHANI, AN
30 MEI 2018
31 MEI 2018
83 AULIA NUR RAMASHANI, AN
29 MEI 2018
30 MEI 2018
84 KHALIFI RAZIQ ALFAREZA, AN 00-22-89 31 MEI 2018
01 JUNI 2018
29 MEI 2018
30 MEI 2018
85 ABIDZAR RASYID, AN 00-22-88
31 MEI 2018
01 JUNI 2018
28 MEI 2018
29 MEI 2018
86 ANGELINA BELLA ABIWARDHANA, NN 00-23-00
30 MEI 2018
31 MEI 2018
01 JUNI 2018
28 MEI 2018
29 MEI 2018
87 NABILA TRIWULANDARI, AN 00-20-81 30 MEI 2018

31 MEI 2018
01 JUNI 2018
02 JUNI 2018
31 MEI 2018
01 JUNI 2018
88 KONIN KUSWANDI, TN 00-22-86 02 JUNI 2018
03 JUNI 2018
04 JUNI 2018
NAMA DOKTER ADMINISTRASI / TARIF KAMAR VISIT DOKTER VISIT BY PHONE
UGD
DR. KRISTY JUNITA 125,000 150,000

DR. LIHANRI SEPSESA 150,000 50,000
DR. MILA DESVITA 150,000 50,000
DR. ANGGRA FILANI Sp. PD 150,000 50,000
DR. NURALISA SAFITRI 150,000 50,000
600,000
DR. ANGGRA FILANI Sp. PD 150,000

DR. LIHANRI SEPSESA 70,000
600,000
150,000
DR. SRI WAHYUNI Sp. A 50,000
DR. SRI WAHYUNI Sp. A 150,000 150,000
DR. LIHANRI SEPSESA 125,000 150,000 50,000
150,000
225,000 150,000
DR. LIHANRI SEPSESA 136,000 150,000 50,000
DR. MILA DESVITA 50,000

150,000
DR. RUTH FERRONICA Sp. B 600,000 250,000
150,000
150,000
DR. ANGGA FILANI Sp. PD 150,000 150,000
DR. NURLALILY MUTHIAH 135,000 150,000
DR. ANGGA FILANI Sp. PD 150,000 150,000
150,000
DR. LIHANRI SEPSESA, MARS 135,000 150,000 150,000
DR. ANGGRA FILANI, Sp. PD 150,000 50,000
DR. ANGGRA FILANI, Sp. PD
DR. LIHANRI SEPSESA, MARS 135,000 150,000
DR. SRI WAHYUNI Sp. A 235,000 150,000 150,000

150,000
DR. OSI RAMADIA 135,000 150,000

DR. NURLAILY MUTHIAH 135,000 150,000
150,000
600,000
DR. SRI WAHYUNI, Sp.A 600,000 250,000
600,000
DR. OSI RAMADIA 135,000 150,000
150,000
DR. SRI WAHYUNI, Sp.A 150,000
DR. ANGGRA FILANI, Sp. PD 150,000
150,000
150,000
150,000
600,000
600,000
DR. DWI PUTRA SETIANTO 125,000 150,000
150,000
150,000
DR. OSI RAMADIA 125,000 150,000
150,000
150,000
150,000
150,000
150,000
DR. OSI RAMADIA 150,000 50,000
DR. RENE Y RUMBAYAN 150,000
150,000
DR. HERMAN, Sp. OG 150,000 150,000
150,000
150,000
DR. HERMAN, Sp. OG 150,000 150,000
DR. OSI RAMADIA 150,000 150,000
DR. RENE Y RUMBAYAN 125,000 600,000
600,000
600,000
150,000 150,000
DR. SRI WAHYUNI, Sp.A
DR. HERMAN, Sp. OG 150,000 50,000
150,000
DR. OSI RAMADIA 125,000 150,000
150,000
150,000
DR. RUTH FERRONICA, Sp.B 150,000 150,000
DR. HARLYJOY, Sp.An 50,000
150,000
150,000
150,000
DR. ANGGRA FILANI. Sp. PD 150,000 150,000
150,000
DR. NURALISA SAFITRI 155,000 150,000 150,000
DR. SRI WAHYUNI, Sp.A
150,000
DR. SRI WAHYUNI, Sp. A 150,000 150,000

150,000
DR. LIHANRI SEPSESA, MARS 50,000

150,000
150,000 50,000
OBAT DAN
NEBULIZER / TRANSFUSI TINDAKAN ASUHAN
GANTI PERBAN ALKES
INHALASI DARAH RUANGAN KEPERAWATAN (FARMASI)
100,000 624,135
100,000 126,325
100,000 499,341
100,000 856,090
100,000 62,356
80,000 100,000 498,393
200,000 35,637
200,000 2,238,449
200,000
100,000
1,386,324
100,000 425,278
100,000
84,144
100,000 116,689
637,260
75,000 200,000 431,099
720,000 225,000 200,000 1,951,908

75,000 200,000 336,928
200,000 75,544
60,000 100,000
100,000 539,394
100,000 451,596
100,000
60,000 100,000 589,368
100,000 340,929
60,000 100,000 513,754
100,000 367,888
100,000 91,179
100,000 319,631
100,000 377,328
100,000 183,083
100,000 1,164,665
60,000 100,000 186,199
100,000 218,302
100,000 119,773
100,000 492,571
100,000 398,608
100,000
100,000 1,398,811
100,000 1,082,060
100,000 939,026
100,000 1,062,433
100,000 521,528
100,000 48,399
60,000 100,000 414,811
100,000 70,444
120,000 100,000 683,475
240,000 100,000 66,972

320,000 100,000 1,441,562
80,000 100,000 454,480

200,000 61,083
75,000 200,000 576,196
75,000 100,000 100,000 1,440,057

100,000 1,261,721
100,000 1,254,152
100,000
100,000 735,516
100,000 432,551
100,000 97,576
100,000 572,521
480,000 100,000 457,896
100,000 196,129
100,000
100,000 1,228,885
60,000 100,000 440,168
100,000 816,192
100,000
100,000 545,770
100,000 95,772
60,000 100,000 540,720
100,000 824,096
100,000 680,659
100,000 409,917
100,000 120,424
80,000 100,000 593,680
240,000 100,000 275,272
80,000 100,000 72,937
100,000
100,000 1,052,416
100,000 555,004
100,000 43,408
100,000 64,820
100,000 1,387,740
100,000 5,980
100,000 707,639
100,000 580,224
100,000 409,923
100,000 714,036
100,000 75,544
720,000 200,000
480,000 200,000 443,720
200,000 501,554
200,000 299,533
200,000 40,400
100,000
100,000 642,005
100,000 118,195
80,000 100,000 779,952
240,000 100,000 153,659

80,000 143,684
100,000
100,000 795,765
205,306
100,000 535,395
100,000
60,000 100,000 70,196
60,000 330,724
100,000 759,780
60,000 100,000 404,903

100,000 398,858
100,000 310,570
100,000 319,054
100,000 416,148
240,000 100,000 384,154
100,000 235,770
100,000 194,660
60,000 100,000 582,811

240,000 60,000 100,000 213,062
100,000 257,655
80,000 100,000 81,241
100,000 716,833
100,000 478,043
100,000 558,025
60,000 100,000 866,113
100,000 513,897
100,000 651,622
100,000 799,482
100,000 130,211
100,000 284,215
100,000 372,630
100,000 172,046
100,000 110,435
60,000 100,000 422,790
100,000 287,156
100,000 86,703
100,000 588,402
100,000 590,389
100,000 235,105
100,000 226,706
100,000 525,688
100,000 509,965
240,000 100,000 486,263

240,000 100,000 532,300
150,000
150,000 131,079
150,000 33,572
100,000 611,590
100,000 369,182
100,000 310,564
100,000 306,186
100,000 406,306
100,000 565,141
100,000 903,903
100,000 352,023
200,000 273,053
200,000 228,281
200,000 71,056
200,000 270,877
100,000 386,008
100,000 582,975
100,000 245,342
100,000 582,149
100,000 866,480
100,000 411,666
200,000 326,160
100,000 518,986
100,000 359,134
100,000 443,645
100,000 176,956
100,000 300,537
100,000 543,219
100,000 388,197
100,000
100,000 440,477
100,000 293,840
100,000 435,654
212,970
100,000
100,000 857,713
60,000 100,000 338,717
100,000 68,495
100,000
100,000 811,255
100,000 422,766
100,000 388,547
100,000 437,720
100,000 308,549
100,000 584,286
100,000 339,557
60,000 100,000 375,920
100,000 670,203
100,000 486,509
100,000 871,659
100,000
100,000
100,000 553,582
100,000 213,460
100,000 436,247
100,000 165,652
100,000 274,640
100,000 197,464
100,000
100,000 619,688
100,000 259,546
100,000 335,157
100,000 308,002
100,000 42,462
100,000 69,816
100,000 217,050
100,000 5,150
100,000 397,515
100,000
100,000 874,762
100,000 473,537
100,000 782,961
100,000 336,380
100,000 416,434
100,000 98,413
100,000 657,323
100,000 293,061
100,000 580,051
100,000
100,000 873,137
100,000 325,549
100,000 805,436
100,000 278,281
100,000 148,955
100,000 100,000 514,512
100,000 211,249
100,000 427,469
100,000 100,000 571,170
100,000 765,961
100,000 632,707
100,000
100,000 396,000
100,000 441,344
200,000 997,376
200,000 843,577
200,000 102,644
200,000 705,976
200,000 331,878
200,000
100,000 248,759
100,000 1,116,077
100,000 369,082
100,000 1,027,547
100,000 411,878
100,000 316,846
100,000 158,475
100,000 880,854
80,000 100,000 267,826
100,000 705,701
100,000 73,745
100,000 624,329
60,000 100,000 659,774
100,000
100,000 152,171
100,000 114,258
100,000
100,000 567,698
100,000 318,792
100,000
100,000 1,027,405
100,000 352,164
100,000 300,098
60,000 100,000 625,657
100,000 363,674
360,000 100,000 1,411,390
180,000 100,000 141,529
100,000
100,000 496,683
100,000 919,821
100,000
100,000 321,704
100,000 151,616
100,000 202,901
100,000 29,811
100,000 452,892
100,000 71,958
100,000 226,512
100,000 606,183
100,000 117,745
100,000 338,458
100,000 890,330
100,000 611,416
100,000 566,810
100,000 494,842
100,000 406,186
100,000 622,788
100,000 100,024
160,000 100,000 671,982
240,000 100,000 426,576

160,000 100,000 298,772
80,000 100,000 97,261
100,000
100,000 902,158
100,000 59,840
100,000 313,534
100,000
527,282
100,000 505,997
100,000
100,000 253,437
100,000 573,408
100,000 127,908
100,000 501,624
100,000 393,867
100,000 470,125
100,000 148,122
100,000 468,798
100,000 336,994
100,000 496,287
100,000 347,549
720,000 100,000 513,192
100,000 539,423
100,000 260,593
100,000
100,000 1,638,931
100,000 59,840
100,000 317,950
100,000 477,350
64,447
100,000 396,740
100,000 701,405
100,000 394,768
100,000 75,544
100,000 319,092
RETUR OBAT LABORATORIUM RADIOLOGI JUMLAH BIAYA RANAP
50,000
2,990,523
50,000
(540,368) 50,000
155,000 120,000
6,245,740
(339,095)
100,000
100,000
3,470,746
100,000
155,000
1,171,909
(112,040)
250,000
7,964,946
100,000
(251,533)
155,000
2,067,364
(113,626)
155,000
60,000
3,809,899
(62,040)
150,000
2,082,893
(30,245)
155,000
135,000
3,483,357
(93,892)
3,483,357
150,000
50,000 2,370,952
50,000
619,000
3,447,165
(827,706)
250,000
2,594,299
(543,160) 50,000
150,000
135,000 2,554,738
100,000 135,000
4,625,970
219,000
(829,963)
252,622
8,239,151
100,000
100,000
(381,680) 150,000
100,000
100,000 2,960,713
100,000
(189,930) 100,000
100,000 2,991,546
100,000
150,000
115,000
3,718,566
50,000
(516,679) 50,000
100,000 120,000
1,566,736
(34,034)
100,000
2,302,623
2,302,623
(402,965)
150,000
2,036,972
(259,028)
155,000 135,000
2,516,889
421,000 135,000
3,377,452
65,000
(229,376) 100,000
100,000
2,248,695
(294,845)
100,000
100,000
4,285,568
(353,360) 100,000
200,000
(233,438) 100,000
310,000
100,000
7,441,817
(88,390)
100,000 220,000 2,100,894

(14,306)
50,000 120,000
2,491,468
100,000
(310,827)
100,000
1,957,309
(103,762) 135,000
150,000
2,607,315
105,000
50,000
155,000 135,000
60,000
4,528,239
(9,926)
100,000
3,084,875
3,084,875
(10,857)
421,000 135,000
65,000 3,576,257
(94,512)
205,000
50,000 3,074,387
(258,514) 50,000
165,000
4,936,976
100,000
(29,138) 100,000
210,000
135,000 2,765,050
(74,052)
220,000 135,000 2,315,590
(204,791)
150,000 120,000
1,805,105
155,000
331,000 135,000 3,623,901
(199,987)
100,000
3,072,058
(271,470)
150,000 120,000 3,388,651

219,000
150,000
100,000
4,463,255
4,463,255
200,000
200,000
(175,573) 200,000
100,000 135,000
3,132,159
321,000
(479,908)
145,000
4,372,758
(160,509)
215,000 135,000
2,524,777
(264,548)
200,000
200,000
5,905,300
200,000
200,000
(260,141) 200,000
155,000
2,549,156
(261,116)
100,000
2,041,015
(15,401) 100,000
155,000
60,000
3,048,162
(224,779)
350,000
300,000 3,587,656
(212,269) 200,000
155,000
65,000 135,000
3,220,908
(291,660)
300,000
1,972,462
1,972,462
(23,807)
150,000 120,000
2,129,817
(14,026)
155,000
2,791,267
60,000
(216,365)
280,000
3,290,988
(59,253) 120,000
100,000 135,000
200,000
200,000 4,360,177
200,000
(137,286) 220,000
150,000
2,487,974
200,000
(16,260) 100,000
200,000
100,000 2,151,444
(19,177)
155,000
60,000 2,749,531
135,000
100,000
155,000 135,000 2,627,282
(136,017)
215,000
2,946,038
135,000
(124,737)
100,000
3,128,848
150,000
3,554,122
3,554,122
100,000
100,000
150,000
100,000
5,197,556
100,000
200,000
(129,080) 200,000
155,000
2,275,903
(137,765) 60,000
260,000 135,000
2,167,901
(199,443)
420,000
(209,969) 65,000
60,000
9,085,656
(225,826)
220,000 245,000
65,000
60,000
5,515,197
(323,146)
100,000
60,000 135,000
4,423,176
(266,526)
150,000 120,000
65,000
3,170,674
100,000
(107,174) 100,000
150,000 1,468,020
(68,409)
150,000 2,058,764
(37,726)
155,000
200,000
200,000
5,791,810
200,000
100,000
(67,188) 200,000
288,000 120,000
50,000
3,395,908
(130,011) 50,000
50,000
100,000
3,342,922
200,000
(23,582) 200,000
100,000 135,000
331,000
2,877,032
150,000
2,149,085
50,000
(77,277) 50,000
155,000 135,000
331,000 2,755,486
(42,900)
200,000
100,000 4,597,291
200,000
(251,107) 200,000
315,000
180,000 2,743,453
(130,545) 50,000
155,000 135,000
4,119,591
160,000 2,862,315
(78,217)
100,000
115,000
65,000 135,000
3,234,282
(82,434)
3,234,282
100,000 135,000
60,000
3,299,773
(197,034)
100,000
60,000
2,992,005
(197,034)
200,000
200,000
6,562,044
200,000
1,010,000
200,000
426,000
5,139,518
400,000
200,000 3,933,088
200,000
(304,461) 100,000
TOTAL PEMBAYARAN
ADM 6 % JUMLAH
KARTU SEHAT
179,431.38 3,169,954 3,169,954
374,744.40 6,620,484 6,620,484
208,244.76 3,678,991 3,678,991
70,314.54 1,242,224 1,242,224
477,896.76 8,442,843 8,442,843
124,041.84 2,191,406 2,191,406
228,593.94 4,038,493 4,038,493
124,973.58 2,207,867 2,207,867
209,001.42 3,692,358 3,692,358

209,001.42 3,692,358 3,692,358
142,257.12 2,513,209 2,513,209
206,829.90 3,653,995 3,653,995
155,657.94 2,749,957 2,749,957
153,284.28 2,708,022 2,708,022
277,558.20 4,903,528 4,903,528
494,349.06 8,733,500 8,733,500
177,642.78 3,138,356 3,138,356
179,492.76 3,171,039 3,171,039
223,113.96 3,941,680 3,941,680
94,004.16 1,660,740 1,660,740
138,157.38 2,440,780 2,440,780

138,157.38 2,440,780 2,440,780
122,218.32 2,159,190 2,159,190
151,013.34 2,667,902 2,667,902
202,647.12 3,580,099 3,580,099
134,921.70 2,383,617 2,383,617
257,134.08 4,542,702 4,542,702
446,509.02 7,888,326 7,888,326
126,053.64 2,226,948 2,226,948
149,488.08 2,640,956 2,640,956
117,438.54 2,074,748 2,074,748
156,438.90 2,763,754 2,763,754
271,694.34 4,799,933 4,799,933
185,092.50 3,269,968 3,269,968

185,092.50 3,269,968 3,269,968
214,575.42 3,790,832 3,790,832
184,463.22 3,258,850 3,258,850
296,218.56 5,233,195 5,233,195
165,903.00 2,930,953 2,930,953
138,935.40 2,454,525 2,454,525
108,306.30 1,913,411 1,913,411
217,434.06 3,841,335 3,841,335
184,323.48 3,256,381 3,256,381
203,319.06 3,591,970 3,591,970
267,795.30 4,731,050 4,731,050

267,795.30 4,731,050 4,731,050
187,929.54 3,320,089 3,320,089
262,365.48 4,635,123 4,635,123
151,486.62 2,676,264 2,676,264
354,318.00 6,259,618 6,259,618
152,949.36 2,702,105 2,702,105
122,460.90 2,163,476 2,163,476
182,889.72 3,231,052 3,231,052
215,259.36 3,802,915 3,802,915
193,254.48 3,414,162 3,414,162
118,347.72 2,090,810 2,090,810

118,347.72 2,090,810 2,090,810
127,789.02 2,257,606 2,257,606
167,476.02 2,958,743 2,958,743
197,459.28 3,488,447 3,488,447
261,610.62 4,621,788 4,621,788
149,278.44 2,637,252 2,637,252
129,086.64 2,280,531 2,280,531
164,971.86 2,914,503 2,914,503
157,636.92 2,784,919 2,784,919
176,762.28 3,122,800 3,122,800
187,730.88 3,316,579 3,316,579
213,247.32 3,767,369 3,767,369

213,247.32 3,767,369 3,767,369
311,853.36 5,509,409 5,509,409
136,554.18 2,412,457 2,412,457
130,074.06 2,297,975 2,297,975
545,139.36 9,630,795 9,630,795
330,911.82 5,846,109 5,846,109
265,390.56 4,688,567 4,688,567
190,240.44 3,360,914 3,360,914
88,081.20 1,556,101 1,556,101
123,525.84 2,182,290 2,182,290

347,508.60 6,139,319 6,139,319
203,754.48 3,599,662 3,599,662
200,575.32 3,543,497 3,543,497
172,621.92 3,049,654 3,049,654
128,945.10 2,278,030 2,278,030
165,329.16 2,920,815 2,920,815
275,837.46 4,873,128 4,873,128
164,607.18 2,908,060 2,908,060
247,175.46 4,366,766 4,366,766
171,738.90 3,034,054 3,034,054
194,056.92 3,428,339 3,428,339

194,056.92 3,428,339 3,428,339
197,986.38 3,497,759 3,497,759
179,520.30 3,171,525 3,171,525
393,722.64 6,955,767 6,955,767
308,371.08 5,447,889 5,447,889
235,985.28 4,169,073 4,169,073
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NO NAMA NO RM TANGGAL RAWAT NAMA DOKTER
1 SAMIH, NY 00-18-69 09 MEI 2018 DR. NURALISA SAFITRI

10 MEI 2018
2 TIORIA BR PAKPAHAN, NY 00-11-15 01 MEI 2018 DR. LIHANRI SEPSESA
02 MEI 2018
3 SARTONO SUPOMO, TN 00-16-31 09 MEI 2018 DR. NURALISA SAFITRI
DR. ANGGRA FILANI
10 MEI 2018
4 MAMAT BIN MASIM, TN 00-18-75 09 MEI 2018 DR. NURLAILY MUTHIAH
10 MEI 2018
5 DEWI RINI RAHAYU, NY 00-22-02 23 MEI 2018 DR. LIHANRI SEPSESA
24 MEI 2018
6 MAYA SOPHA, NY 00-22-30 25 MEI 2018 DR. LIHANRI SEPSESA
26 MEI 2018
7 SRI HARTATI LIBRIANI, NY 00-21-05 23 MEI 2018 DR. LIHANRI SEPSESA
24 MEI 2018
8 MARFUATUN, NY 00-21-51 21 MEI 2018 DR. LIHANRI SEPSESA
22 MEI 2018
9 FERA NAJWA, AN 00-21-51 21 MEI 2018 DR. LIHANRI SEPSESA
22 MEI 2018
ADMINISTRASI / TARIF VISIT BY NEBULIZER / TRANSFUSI
VISIT DOKTER
UGD KAMAR PHONE INHALASI DARAH
125,000 150,000
135,000 150,000
135,000 150,000
150,000
135,000 150,000
135,000 150,000
146,000 150,000
146,000 150,000
135,000 150,000
165,000 150,000
TINDAKAN ASUHAN OBAT DAN ALKES LABORATORIUM
GANTI PERBAN RADIOLOGI
RUANGAN KEPERAWATAN (FARMASI)
150,000 100,000 180,970 150,000
150,000 100,000 119,062
100,000 328,067
61,000 100,000 46,073 390,000
150,000 100,000 165,653 100,000
150,000 100,000 220,487 100,000
230,000 100,000 141,433 150,000
150,000 100,000 156,004 100,000
150,000 100,000 217,440

TOTAL PEMBAYARAN
JUMLAH ADM 6 % JUMLAH PEMBULATAN DEPOSITE
BIAYA RANAP
CASH
675,000 40,500.00 715,500
654,062 39,243.72 693,306
863,067 51,784.02 914,851
836,000 50,160.00 886,160
800,653 48,039.18 848,692
866,487 51,989.22 918,476
917,433 55,045.98 972,479
791,004 47,460.24 838,464
782,440 46,946.40 829,386
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- -
- -
- -
- -
- -
- -
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL PEMBAYARAN
KARTU SEHAT BANK
715,500
693,306
914,851
886,160
848,692
918,476
972,479
838,464
829,386
-
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04 JUNI 2018
1 TIMIH, NY 00-23-91
05 JUNI 2018
01 JUNI 2018
02 JUNI 2018
2 FEBRI ARDIANSYAH, TN 00-23-45
03 JUNI 2018
04 JUNI 2018
05 JUNI 2018
04 JUNI 2018
3 MUHAMMAD AZKA RABBANI, AN 00-11-54 05 JUNI 2018
06 JUNI 2018
06 JUNI 2018
4 TALIB SUGIONO, TN 00-24-31
07 JUNI 2018
06 JUNI 2018
5 HJ. SITI HINDUN, NY 00-02-98 07 JUNI 2018
05 JUNI 2018
6 ADILA SEPTIANI, AN 00-15-74 06 JUNI 2018
07 JUNI 2018
07 JUNI 2018
7 MARIAH, NY 00-24-53 08 JUNI 2018
09 JUNI 2018
07 JUNI 2018
08 JUNI 2018
09 JUNI 2018
8 ICIH ROSTINA, NY 00-24-37 10 JUNI 2018
11 JUNI 2018
12 JUNI 2018
13 JUNI 2018
11 JUNI 2018
9 FILDZA HANA, AN 00-25-09
12 JUNI 2018
13 JUNI 2018
11 JUNI 2018
10 ANANDYA SETYANINGTYAS, AN 00-25-11 12 JUNI 2018
13 JUNI 2018
14 JUNI 2018
12 JUNI 2018
11 RIZKI RAMADHAN, AN 00-25-15 13 JUNI 2018

14 JUNI 2018
15 JUNI 2018
10 JUNI 2018
11 JUNI 2018
12 JUNI 2018
13 JUNI 2018
12 MARWAN RADITYA IRAWAN, AN 00-24-84 14 JUNI 2018
15 JUNI 2018
16 JUNI 2018
17 JUNI 2018
20 JUNI 2018
21 JUNI 2018
13 KENI NURAS RIANI, NY 00-26-18
22 JUNI 2018
23 JUNI 2018
21 JUNI 2018
22 JUNI 2018
14 AROH, NY 00-26-45
23 JUNI 2018
24 JUNI 2018
22 JUNI 2018
23 JUNI 2018
15 SUTISNA, TN 00-07-24
24 JUNI 2018
25 JUNI 2018
23 JUNI 2018
24 JUNI 2018
16 NANDANG SUJARWO, TN 00-26-54 25 JUNI 2018
26 JUNI 2018
23 JUNI 2018
24 JUNI 2018
17 AKBAR BAGAS SATRIO, AN 00-12-71
25 JUNI 2018
26 JUNI 2018
24 JUNI 2018
25 JUNI 2018
18 RIZKY NURFITRIYANI, AN 00-26-77
26 JUNI 2018
27 JUNI 2018
26 JUNI 2018
19 MIROH, NY 00-26-20
27 JUNI 2018
27 JUNI 2018
20 GREGORIUS LIONEL, AN 00-25-65 28 JUNI 2018
29 JUNI 2018
28 JUNI 2018
29 JUNI 2018
21 SUNAH, NY 00-27-33
21 SUNAH, NY 00-27-33 30 JUNI 2018
01 JULI 2018
ADMINISTRASI / TARIF KAMAR
NAMA DOKTER VISIT DOKTER VISIT BY PHONE
UGD
DR. MEDIANTO 136,000 150,000

DR. MEDIANTO 125,000 600,000
600,000
600,000
150,000
DR. HARYO WIBOWO, M.Hkes 135,000 150,000
DR. RUTH FERONICA, Sp.B 150,000 50,000
DR. LIHANRI SEPSESA, MARS 125,000 600,000 250,000
DR. ANGGRA FILANI Sp. PD 600,000 250,000 70,000
DR. NURLAILY MUTHIAH 70,000
DR. ANGGRA FILANI Sp. PD 235,000 150,000 150,000
DR. RUTH FERONICA, Sp.B 150,000
150,000
600,000
DR. RUTH FERONICA, Sp.B 150,000 150,000
150,000
DR. HARYO WIBOWO, M.Hkes 70,000
150,000
600,000
150,000

150,000
150,000
DR. NURLAILY MUTHIAH 211,000 150,000
150,000
NEBULIZER / TRANSFUSI TINDAKAN TARIF
GANTI PERBAN TARIF OPERASI
INHALASI DARAH RUANGAN AMBULANCE
60,000
80,000
240,000
80,000
480,000
750,000
75,000
240,000
30,000
30,000
30,000
80,000
4,500,000 30,000
30,000
80,000 80,000
80,000 800,000
720,000
90,000
560,000
80,000
80,000 480,000
80,000 480,000
320,000 480,000
240,000
160,000
480,000
330,000
105,000
30,000
80,000
60,000
200,000
OBAT DAN
ASUHAN ALKES RETUR OBAT LABORATORIUM RADIOLOGI
KEPERAWATAN (FARMASI)
100,000 482,418 205,000
100,000 449,010 (155,730) 250,000

200,000 1,152,483 65,000
200,000 333,812 100,000

200,000 19,747 200,000
200,000 542,096 200,000
200,000 205,727 (190,519) 200,000
100,000 665,819 100,000 135,000
100,000 85,752
100,000
100,000 150,000
100,000 226,242 (132,702)
200,000 1,470,026 150,000
200,000 750,054 821,000 120,000
100,000
100,000 654,807 486,000 135,000
100,000 89,253 (199,432)
100,000 152,114
100,000 502,917
100,000 (188,912)
100,000 1,597,669 150,000 195,000
100,000 942,532 50,000 120,000
100,000 750,395 100,000

100,000 52,360 50,000
200,000 964,936 100,000
200,000 1,403,139 1,056,500

100,000 1,567,024 (350,061) 50,000
100,000 99,034 155,000 135,000
100,000 829,019 200,000

100,000 420,470 (363,073) 200,000
100,000 155,000
200,000 854,249 902,900 135,000
200,000 544,534 100,000

200,000 418,699 (421,700) 100,000
100,000 166,712 155,000 135,000
100,000 554,462 170,000

100,000 267,497
244,048 (243,725)
100,000 776,438
100,000 282,413 220,000
100,000 437,730 265,432
200,000 1,062,336 328,440
200,000 1,073,809 400,000
200,000 1,218,823 200,000 135,000
200,000 1,278,256 200,000
200,000 317,276 (557,429) 200,000
100,000 870,152 150,000 120,000

100,000 466,597
100,000 69,437
100,000 627,435 (138,721) 100,000
100,000 657,641 503,500 120,000
100,000 8,976 50,000
100,000 338,535 182,600
100,000 362,970 (46,630) 50,000
100,000 1,517,639 200,000 120,000
200,000 869,519 200,000

200,000 332,980 100,000
200,000 1,128,874 (213,450) 100,000
100,000 309,872 200,000

100,000 123,984 200,000
100,000 254,040 200,000
` (12,996) 200,000
100,000 421,701 100,000 135,000
100,000 239,210
100,000 345,958
100,000 368,576 (295,619)
100,000 484,760 622,600
100,000 165,618 135,000
100,000 409,909
100,000 7,053 (106,611)
100,000 838,188 150,000
100,000 374,362 (353,140)
100,000 472,852 100,000
100,000
100,000 477,786 (54,921) 120,000
100,000 547,800 120,000
100,000 47,105 50,000
100,000 221,788 50,000
100,000 929,008 (217,847) 50,000
JUMLAH BIAYA RANAP ADM 6 % JUMLAH
2,166,698 130,001.88 2,166,698
7,763,346 465,800.76 8,229,147
2,541,571 152,494.26 2,694,065
928,540 55,712.40 984,252
6,906,080 414,364.80 7,320,445
2,685,628 161,137.68 2,846,766
1,551,119 93,067.14 1,644,186
17,864,494 1,071,869.64 18,936,364
2,940,450 176,427.00 3,116,877
8,143,682 488,620.92 8,632,303

2,863,994 171,839.64 3,035,834
14,708,524 882,511.44 15,591,035
5,709,900 342,594.00 6,052,494
3,692,592 221,555.52 3,914,148
8,575,562 514,533.72 9,090,096
2,549,900 152,994.00 2,702,894
2,849,826 170,989.56 3,020,816
3,233,329 193,999.74 3,427,329
1,784,410 107,064.60 1,891,475
2,320,717 139,243.02 2,459,960
3,458,854 207,531.24 3,666,385

3,458,854 207,531.24 3,666,385
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TOTAL PEMBAYARAN
KARTU SEHAT
2,166,698
8,229,147
2,694,065
984,252
7,320,445
2,846,766
1,644,186
18,936,364
3,116,877
8,632,303
3,035,834
15,591,035
6,052,494
3,914,148
9,090,096
2,702,894
3,020,816
3,427,329
1,891,475
2,459,960
3,666,385
3,666,385
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1 LIDYA KUMALASARI, NY 00-23-86 03 JUNI 2018

04 JUNI 2018
2 JAMILAH, NY 00-25-04 17 JUNI 2018
18 JUNI 2018
3 SYIFA HAYATUN NUFUS, NN 00-25-84 17 JUNI 2018
18 JUNI 2018
4 DWI OCTARIA, NY 00-25-97 17 JUNI 2018
18 JUNI 2018
5 MARDIANTO, TN 00-25-41 14 JUNI 2018
15 JUNI 2018
6 NUR LATHIFAH KHAIRUNNISA, NN 00-25-08 11 JUNI 208
12 JUNI 2018
7 NURRIKA FEBRIYANTI, NN 00-26-16 20 JUNI 2018
21 JUNI 2018
8 SANTA, TN 00-26-01 19 JUNI 2018
20 JUNI 2018
9 SEELIH, NY 00-25-05 11 JUNI 208
12 JUNI 2018
10 SIFA, NN 00-24-00 04 JUNI 2018
05 JUNI 2018
11 JUMAT, TN 00-25-20 12 JUNI 2018
13 JUNI 2018
12 REVA, NN 00-25-19 12 JUNI 2018
13 JUNI 2018
13 CENIH BT KEMEN, NY 00-02-19 21 JUNI 2018
22 JUNI 2018
14 JAMILAH, NY 00-25-04 14 JUNI 2018
15 JUNI 2018
15 VIRGI YANI, NN 00-25-23 12 JUNI 2018
13 JUNI 2018
16 KETUT WIDODO, TN 00-24-52 07 JUNI 2018
08 JUNI 2018
17 MANGAPUL SIREGAR, TN 00-05-78 18 JUNI 2018
19 JUNI 2018
18 MINAH BT NAAN, NY 00-25-93 18 JUNI 2018
19 JUNI 2018
19 TAWI, TN 00-24-48 18 JUNI 2018
19 JUNI 2018
20 SARKUM, TN 00-25-92 18 JUNI 2018
19 JUNI 2018
21 DINDA NURUL PRITANIA, NN 00-23-64 01 JUNI 2018
02 JUNI 2018
22 JUMAIYAH, NY 00-27-24 28 JUNI 2018
29 JUNI 2018
23 SITI ATIKAH, NY 00-21-41 29 JUNI 2018
30 JUNI 2018
ADMINISTRASI / VISIT BY
NAMA DOKTER TARIF KAMAR VISIT DOKTER
UGD PHONE
DR. HARYO WIBOWO, M. KES 125,000 150,000
dr. NURALISA SAFITRI 135,000 150,000
dr. NURALISA SAFITRI 125,000 150,000

NEBULIZER / TRANSFUSI TINDAKAN TARIF
GANTI PERBAN TARIF OPERASI
INHALASI DARAH RUANGAN AMBULANCE
261,000
175,000
175,000
175,000
175,000
175,000
150,000
175,000
170,000
175,000
175,000
150,000
275,000
150,000
150,000
150,000
161,000
181,000
161,000
161,000
161,000
500,000
285,000
ASUHAN OBAT DAN ALKES RETUR OBAT LABORATORIUM RADIOLOGI
KEPERAWATAN (FARMASI)
100,000 144,692
100,000 158,917
100,000 208,818
100,000 199,245
100,000 176,458
100,000 161,950 100,000
100,000 20,190 150,000
100,000 158,780 155,000
100,000 189,139 100,000
100,000 95,512 100,000
100,000 296,331 100,000
100,000 84,880
100,000 82,590 150,000
100,000 136,501 100,000
100,000 162,275 100,000
100,000 164,818
100,000 162,200
100,000 192,752
100,000 78,967
100,000 100,217
100,000 190,892
100,000 50,000 50,000
100,000 190,959
TOTAL PEMBAYARAN
JUMLAH BIAYA ADM 6 % JUMLAH PEMBULATAN DEPOSITE KARTU
RANAP
CASH SEHAT
43,842 774,534 774,534
730,692
- - -
42,535 751,452 751,452
708,917
- - -
45,529 804,347 804,347
758,818
- - -
45,555 804,800 804,800
759,245
- - -
44,187 780,645 780,645
736,458
- - -
49,317 871,267 871,267
821,950
- - -
41,711 736,901 736,901
695,190
- - -
52,427 926,207 926,207
873,780
- - -
50,048 884,187 884,187
834,139
- - -
45,331 800,843 800,843
755,512
- - -
57,380 1,013,711 1,013,711
956,331
- - -
37,193 657,073 657,073
619,880
- - -
52,955 935,545 935,545
882,590
- - -
45,690 807,191 807,191
761,501
- - -
47,837 845,112 845,112
797,275
- - -
41,989 741,807 741,807
699,818
- - -
41,892 740,092 740,092
698,200
- - -
44,925 793,677 793,677
748,752
- - -
36,898 651,865 651,865
614,967
- - -
38,173 674,390 674,390
636,217
- - -
43,614 770,506 770,506
726,892
- - -
58,500 1,033,500 1,033,500
975,000
- - -
51,058 902,017 902,017
850,959
850,959
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AL PEMBAYARAN
BANK

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NO NAMA NO RM TANGGAL RAWAT

2 HASANUL RIZQA, TN 00-16-16

3 ALDI SADEWO, TN 00-16-35

7 RAZIQ HANNAN, AN 00-16-06

9 AISYAH HUMAIRA, AN 00-16-69

11 KHYARA MAYULIDIA, AN 00-14-82

13 JENNAIRA VARDA, AN 00-16-75

14 JERRIX CRISTIAN, AN 00-16-38

16 NABILA CHAERUNNISA, NN 00-16-75

32 PAMELA TALITA, AN 00-16-88

34 GUMIH, NY 00-18-56 10 MEI 2018

37 ALVARO RAHANDIKA ARSYAD, AN 00-18-99 11 MEI 2018

39 TRIAGUSTIN NAWANG SASI, AN 00-18-79 11 MEI 2018

44 INDAH, NN 00-15-95 12 MEI 2018

45 ARKANA DESTA IRAWAN, AN 00-04-98 13 MEI 2018

47 RAZIQ MUZAKI ASSAJID, AN 00-02-59 13 MEI 2018

58 EDI WARTONO, TN 00-20-59 18 MEI 2018

59 MUHAMMAD FATHIR, AN 00-20-43 17 MEI 2018

69 NABILA TRI WULANDARI, AN 00-20-81 20 MEI 2018

79 NANA, TN 00-22-39 26 MEI 2018

81 NUR AFIFAH, AN 29 MEI 2018

82 QOWMI LAYLA, AN 29 MEI 2018

87 NABILA TRIWULANDARI, AN 00-20-81 30 MEI 2018

DR. KRISTY JUNITA 125,000 150,000

DR. LIHANRI SEPSESA 125,000 150,000

DR. NURALISA SAFITRI 136,000 600,000

DR. KRISTY JUNITA 125,000 150,000

DR. SRI WAHYUNI Sp. A 235,000 150,000 150,000

DR. OSI RAMADIA 135,000 150,000

DR. LIHANRI SEPSESA, MARS 155,000 150,000

DR. MILA DESVITA 150,000

720,000 225,000 200,000 1,951,908

240,000 100,000 66,972

80,000 100,000 454,480

75,000 100,000 100,000 1,440,057

240,000 100,000 153,659

60,000 100,000 404,903

60,000 100,000 582,811

60,000 100,000 866,113

60,000 100,000 422,790

240,000 100,000 486,263

240,000 100,000 426,576

100,000 220,000 2,100,894

220,000 135,000 2,315,590

331,000 135,000 3,623,901

150,000 120,000 3,388,651

179,431.38 3,169,954 3,169,954

374,744.40 6,620,484 6,620,484

208,244.76 3,678,991 3,678,991

70,314.54 1,242,224 1,242,224

477,896.76 8,442,843 8,442,843

124,041.84 2,191,406 2,191,406

228,593.94 4,038,493 4,038,493

124,973.58 2,207,867 2,207,867

209,001.42 3,692,358 3,692,358

142,257.12 2,513,209 2,513,209

206,829.90 3,653,995 3,653,995

155,657.94 2,749,957 2,749,957

153,284.28 2,708,022 2,708,022

277,558.20 4,903,528 4,903,528

494,349.06 8,733,500 8,733,500

177,642.78 3,138,356 3,138,356

179,492.76 3,171,039 3,171,039