sheet1 -1

LAPORAN REKAP KLAIM - RSU SANSANI 28 JUNI 2022

No. Tgl. Masuk No. RM Nama Pasien No. Klaim / SEP Total Tarif
1 28 Jun 2022 192311 SANITA ADHA 0069R0450622V007688 256,500
2 28 Jun 2022 223014 OLIVIA 0069R0450622V007690 256,500
3 28 Jun 2022 058503 FIRMANSYAH SUGIMAN 0069R0450622V007430 194,900
4 28 Jun 2022 082622 BIDASARI 0069R0450622V007458 194,900
5 28 Jun 2022 128678 NURANA 0069R0450622V007411 192,100
6 28 Jun 2022 165942 BENI YAMIN 0069R0450622V007410 194,900
7 28 Jun 2022 190855 ANZELI HUTAURUK 0069R0450622V007434 194,900
8 28 Jun 2022 198594 TIRA NOVITA 0069R0450622V007481 194,900
9 28 Jun 2022 207558 AZARAH RAMADONA 0069R0450622V007382 194,900
10 28 Jun 2022 210732 YUNI NURPITA SARI 0069R0450622V007409 194,900
11 28 Jun 2022 213743 FAISAL PRATAMA 0069R0450622V007377 194,900
12 28 Jun 2022 215023 ADNAN TANJUNG 0069R0450622V007405 194,900
13 28 Jun 2022 215812 ALI AKBAR 0069R0450622V007403 194,900
14 28 Jun 2022 215822 SUHARNO 0069R0450622V007412 194,900
15 28 Jun 2022 220246 WIRA INSANI 0069R0450622V007495 192,100
16 28 Jun 2022 086963 MASNA, NY 0069R0450622V007595 192,100
17 28 Jun 2022 107250 SYAMSUL BAHRI, TN 0069R0450622V007585 192,100
18 28 Jun 2022 166501 SURYATI 0069R0450622V007584 192,100
19 28 Jun 2022 183273 AFGUSRI 0069R0450622V007629 192,100
20 28 Jun 2022 063680 KUAL HENDRI TINAMBUNAN, TN 0069R0450622V007384 192,100
21 28 Jun 2022 070062 NURUL ARIF, TN 0069R0450622V007394 192,100
22 28 Jun 2022 074044 AMAT ILYAS 0069R0450622V007422 192,100
23 28 Jun 2022 074504 ALI BAKRI 0069R0450622V007413 192,100
24 28 Jun 2022 084119 JUANLY MARULI TUA MARINGGA 0069R0450622V007417 192,100
25 28 Jun 2022 088546 LIE LIE 0069R0450622V007386 192,100
26 28 Jun 2022 104717 ERNA 0069R0450622V007381 192,100
27 28 Jun 2022 124352 HALIMAH TUSSA'DIAH 0069R0450622V007389 192,100
28 28 Jun 2022 135267 NURHAYATI 0069R0450622V007408 192,100
29 28 Jun 2022 135804 HARLEN WARNERIN 0069R0450622V007387 192,100
30 28 Jun 2022 153909 ZULIDARNIS 0069R0450622V007401 192,100
31 28 Jun 2022 154948 KAMIRUDDIN 0069R0450622V007380 192,100
32 28 Jun 2022 159496 ZURAIDAH 0069R0450622V007445 192,100
33 28 Jun 2022 161974 ELY DAWATI 0069R0450622V007442 192,100
34 28 Jun 2022 163087 IBRAHIM 0069R0450622V007404 192,100
35 28 Jun 2022 180329 WAKIJO 0069R0450622V007392 192,100
36 28 Jun 2022 182372 MUHAMMAD YUNUS 0069R0450622V007371 192,100
37 28 Jun 2022 188502 YUNIARTI 0069R0450622V007436 192,100
38 28 Jun 2022 196028 MARIANI 0069R0450622V007421 192,100
39 28 Jun 2022 196108 RANIWATI 0069R0450622V007385 277,600
40 28 Jun 2022 204150 YULIANA 0069R0450622V007427 192,100
41 28 Jun 2022 205091 NADIA WULANDARI 0069R0450622V007483 192,100
42 28 Jun 2022 210703 NURHAYATI 0069R0450622V007461 192,100
43 28 Jun 2022 210713 NURWILIS 0069R0450622V007441 192,100
44 28 Jun 2022 210876 YANTI TEOLOGIA SIBARANI 0069R0450622V007444 192,100

Page 1
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45 28 Jun 2022 215794 NURAINI 0069R0450622V007435 192,100

46 28 Jun 2022 220238 ETI 0069R0450622V007459 256,500
47 28 Jun 2022 073441 YUSLINAR, NY 0069R0450622V007606 192,100
48 28 Jun 2022 087073 NURHALIZA, NY 0069R0450622V007610 192,100
49 28 Jun 2022 087833 NASRUL 0069R0450622V007609 192,100
50 28 Jun 2022 108874 ARI GUNAWAN 0069R0450622V007605 192,100
51 28 Jun 2022 129735 KASMAWATI R, NY 0069R0450622V007608 192,100
52 28 Jun 2022 157851 MASRIZAL AHMAD 0069R0450622V007646 192,100
53 28 Jun 2022 169399 SRI FATMIWATI 0069R0450622V007631 192,100
54 28 Jun 2022 205355 KAINEN 0069R0450622V007651 192,100
55 28 Jun 2022 206198 AHMAD NAZARI 0069R0450622V007645 192,100
56 28 Jun 2022 206803 MEILA YULIANA 0069R0450622V007648 192,100
57 28 Jun 2022 207930 MUHAMMAD ISIS 0069R0450622V007611 192,100
58 28 Jun 2022 213278 NINING YUNINGSIH 0069R0450622V007622 192,100
59 28 Jun 2022 220121 APANG 0069R0450622V007431 203,900
60 28 Jun 2022 041439 INDRA SURBAKTI 0069R0450622V007686 192,100
61 28 Jun 2022 169977 ZULKIFLI 0069R0450622V007620 143,700
62 28 Jun 2022 023853 SUTRI 0069R0450622V007626 192,100
63 28 Jun 2022 071277 TUTI 0069R0450622V007603 192,100
64 28 Jun 2022 086605 MARJUNA 0069R0450622V007643 192,100
65 28 Jun 2022 096998 AFRINA SUSANTI 0069R0450622V007625 192,100
66 28 Jun 2022 102753 DALIPAH, NY 0069R0450622V007601 192,100
67 28 Jun 2022 134131 NURHASANAH 0069R0450622V007639 192,100
68 28 Jun 2022 183965 ROTBIN BAGARIANG 0069R0450622V007602 192,100
69 28 Jun 2022 189536 RUSMIATI 0069R0450622V007604 192,100
70 28 Jun 2022 206067 AMRAN RANA 0069R0450622V007640 192,100
71 28 Jun 2022 213756 DEDI SYAHPUTRA 0069R0450622V007612 192,100
72 28 Jun 2022 155052 HEMAWATI SIDABUTAR 0069R0450622V007439 192,100
73 28 Jun 2022 214464 JUJUR SAHAT MARULI TAMBUNAN 0069R0450622V007414 192,100
74 28 Jun 2022 215576 YOLANDA MONIKA SARI 0069R0450622V007497 192,100
75 28 Jun 2022 220237 RIFKI RAHMATUN HIDAYAH 0069R0450622V007463 192,100
76 28 Jun 2022 065309 ARI PRAYUDA 0069R0450622V007476 300,700
77 28 Jun 2022 073949 RENI 0069R0450622V007440 300,700
78 28 Jun 2022 109674 JEFRIANSYAH 0069R0450622V007492 300,700
79 28 Jun 2022 182304 FITRIA EKA KURNIA WATI 0069R0450622V007464 300,700
80 28 Jun 2022 213795 HADI RIDHO PRATAMA 0069R0450622V007396 300,700
81 28 Jun 2022 220235 ROSMIATI 0069R0450622V007447 219,000
82 28 Jun 2022 211795 DARYATI 0069R0450622V007433 192,100
83 28 Jun 2022 208590 ILMIRAH YASMIN 0069R0450622V007674 265,900
84 28 Jun 2022 013780 SAPUTRI DESIANA 0069R0450622V007678 582,100
85 28 Jun 2022 105422 DEPRI ANIKA 0069R0450622V007661 314,100
86 28 Jun 2022 215786 GATIRA MENDROFA 0069R0450622V007662 314,100
87 28 Jun 2022 220252 PIPIT NURIANA 0069R0450622V007668 582,100
88 28 Jun 2022 164008 YANI SAHFITRI 0069R0450622V007562 193,500
89 28 Jun 2022 220244 RANTY ARNAS 0069R0450622V007587 192,100
90 28 Jun 2022 220245 HELNA ELISYA 0069R0450622V007590 193,500

Page 2
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91 28 Jun 2022 220248 TETY HERAWATI 0069R0450622V007589 193,500

92 28 Jun 2022 021642 YUHERNI, NY 0069R0450622V007504 833,000
93 28 Jun 2022 045165 OZUGO LAIA 0069R0450622V007657 833,000
94 28 Jun 2022 068407 ELIANI 0069R0450622V007376 833,000
95 28 Jun 2022 070167 NURHAYATI, NY 0069R0450622V007437 833,000
96 28 Jun 2022 078418 NURUL ENTRIYA 0069R0450622V007511 833,000
97 28 Jun 2022 086760 SYAMSINAR, NY 0069R0450622V007507 833,000
98 28 Jun 2022 106216 SUPRIYANTO, TN 0069R0450622V007493 833,000
99 28 Jun 2022 158359 MURNI 0069R0450622V007654 833,000
100 28 Jun 2022 201284 GUMANTI 0069R0450622V007375 833,000
101 28 Jun 2022 204571 MELI HARTATI 0069R0450622V007438 833,000
102 28 Jun 2022 205756 DALSIS FORDIANA 0069R0450622V007647 833,000
103 28 Jun 2022 064268 SULTAN RAYHAN ELFENDRI 0069R0450622V007672 192,100
104 28 Jun 2022 214957 AZHAR SHIDQI FADHOLI 0069R0450622V007665 194,900
105 28 Jun 2022 215733 SAWIN 0069R0450622V007666 194,900
106 28 Jun 2022 073902 INDUN 0069R0450622V007425 113,800
107 28 Jun 2022 136069 ANJAR SUHARMINI 0069R0450622V007429 113,800
108 28 Jun 2022 143225 HASNANI SIREGAR HJ 0069R0450622V007452 113,800
109 28 Jun 2022 151852 NURAINI 0069R0450622V007466 113,800
110 28 Jun 2022 201784 NUR SRIFYANTI 0069R0450622V007426 113,800
111 28 Jun 2022 210718 INDRAWATI 0069R0450622V007484 113,800
112 28 Jun 2022 212609 RITA SUNINGSIH 0069R0450622V007432 146,600
113 28 Jun 2022 214996 SEREMINNA SILABAN 0069R0450622V007503 113,800
114 28 Jun 2022 215712 SAID WILDAN SALIM 0069R0450622V007474 192,100
115 28 Jun 2022 215936 AHMAD NADHIF ASSHADIQ 0069R0450622V007473 192,100
116 28 Jun 2022 065003 ARMADA SURUHEN MAMANA S 0069R0450622V007391 192,100
117 28 Jun 2022 220106 RAFA' ELVIARDI 0069R0450622V007367 193,500
118 28 Jun 2022 103141 NATAYYA ZULAIKHA ARSY 0069R0450622V007591 192,100
119 28 Jun 2022 166306 PUAN HAFSAH ALMAHYRA OSMAN 0069R0450622V007598 326,800
120 28 Jun 2022 166911 INTAN HUTRIA SULISTYOWATY 0069R0450622V007628 192,100
121 28 Jun 2022 177078 ARJUNA RAHMADAN 0069R0450622V007580 192,100
122 28 Jun 2022 188811 NAYRA AQILA NAFISHA 0069R0450622V007596 192,100
123 28 Jun 2022 209414 ARSYIFA JAZILAH OSMAN 0069R0450622V007599 326,800
124 28 Jun 2022 214309 NAURAH SYAHIRAH AREIF 0069R0450622V007684 192,100
125 28 Jun 2022 215706 CELCIUS EUKHARISTA 0069R0450622V007641 192,100
126 28 Jun 2022 215734 ABIGAEL GRESIA SIMARMATA 0069R0450622V007623 192,100
127 28 Jun 2022 215837 JIHAN TALITA ULFANI 0069R0450622V007634 192,100
128 28 Jun 2022 215904 MUHAMMAD JADID AL-HAKIM 0069R0450622V007621 192,100
129 28 Jun 2022 215916 BAYI NYONYA RATNA WILIS 0069R0450622V007636 311,600
130 28 Jun 2022 215922 BAYI NYONYA ELVI SAFITRI 0069R0450622V007617 311,600
131 28 Jun 2022 080735 SHAULI IMAM GULTOM 0069R0450622V007677 192,100
132 28 Jun 2022 095817 ASNAH 0069R0450622V007419 582,100
133 28 Jun 2022 200836 HELMIN MARIANNA 0069R0450622V007478 582,100
134 28 Jun 2022 206472 MBAN SURYA RAMADANI 0069R0450622V007491 314,100
135 28 Jun 2022 214974 NELI RAPITA 0069R0450622V007465 314,100
136 28 Jun 2022 215567 MAYARNI 0069R0450622V007475 194,900

Page 3
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137 28 Jun 2022 215645 LIYANA WATI 0069R0450622V007488 194,900

138 28 Jun 2022 068343 LUFTI 0069R0450622V007364 256,500
139 28 Jun 2022 192413 PUTRI NEVIOLA 0069R0450622V007383 203,900
140 28 Jun 2022 193307 AIDIL FITRIADI 0069R0450622V007360 256,500
141 28 Jun 2022 021409 DELIZA ZAKIR 0069R0450622V007569 265,900
142 28 Jun 2022 161672 MUHAMMAD ALFATIH FIRZA 0069R0450622V007571 265,900
143 28 Jun 2022 187613 PANDAPOTAN ARITONANG 0069R0450622V007570 265,900
144 28 Jun 2022 213849 WENY ADE LESTARI 0069R0450622V007568 331,600
145 28 Jun 2022 076293 NUR AJIJAH BR. SIREGAR 0069R0450622V007538 192,100
146 28 Jun 2022 077110 ERNIZAR 0069R0450622V007540 192,100
147 28 Jun 2022 081574 ROSLINA BR MARBUN 0069R0450622V007551 192,100
148 28 Jun 2022 083148 FIFI JUMIATI FAJRI 0069R0450622V007553 192,100
149 28 Jun 2022 084035 ZUBAIDA 0069R0450622V007549 192,100
150 28 Jun 2022 086425 TUTI ENDRAWATI 0069R0450622V007550 192,100
151 28 Jun 2022 093680 ENA MARLINA 0069R0450622V007541 192,100
152 28 Jun 2022 132196 SAHRIF SUMEDI BUKIT 0069R0450622V007548 192,100
153 28 Jun 2022 139606 MARTA ADRIANA HUTABARAT 0069R0450622V007556 192,100
154 28 Jun 2022 157267 ALVIA ZURCHAIRA 0069R0450622V007567 192,100
155 28 Jun 2022 165121 HALIMATUSSAKDIAH HASIBUAN 0069R0450622V007632 192,100
156 28 Jun 2022 174031 NILA AGUSTI 0069R0450622V007545 192,100
157 28 Jun 2022 179726 ERMAWATI 0069R0450622V007543 192,100
158 28 Jun 2022 183327 ZULBAKRI 0069R0450622V007552 192,100
159 28 Jun 2022 184594 NUROCHMAN 0069R0450622V007561 192,100
160 28 Jun 2022 198027 URIP SUWARSO 0069R0450622V007563 192,100
161 28 Jun 2022 200583 AZIZAH TRI WAHYUNI 0069R0450622V007546 192,100
162 28 Jun 2022 204552 RATNA WILIS 0069R0450622V007542 192,100
163 28 Jun 2022 204783 FRISJON 0069R0450622V007547 192,100
164 28 Jun 2022 205207 SIWIR 0069R0450622V007554 192,100
165 28 Jun 2022 206373 SUPRIADI 0069R0450622V007564 192,100
166 28 Jun 2022 206907 AMINAH 0069R0450622V007557 192,100
167 28 Jun 2022 207202 ABASRI 0069R0450622V007559 192,100
168 28 Jun 2022 214644 DEWI LIRI LINORA 0069R0450622V007633 192,100
169 28 Jun 2022 214999 MISIMANA GEA 0069R0450622V007544 192,100
170 28 Jun 2022 103977 AYU FRISKA 0069R0450622V007675 300,700
171 28 Jun 2022 049760 NURLAYLI 0069R0450622V007428 192,100
172 28 Jun 2022 070144 YANUAR LAIA 0069R0450622V007471 192,100
173 28 Jun 2022 072313 MUKHLIS 0069R0450622V007400 192,100
174 28 Jun 2022 078850 KIDAN MASRI 0069R0450622V007416 192,100
175 28 Jun 2022 082134 BAKHTIAR 0069R0450622V007393 192,100
176 28 Jun 2022 083549 ZULIDAR 0069R0450622V007494 192,100
177 28 Jun 2022 085828 DESLINA ZEGA 0069R0450622V007472 192,100
178 28 Jun 2022 086578 ROSY APRINA SARI 0069R0450622V007457 192,100
179 28 Jun 2022 107458 SADARI ZEGA 0069R0450622V007469 192,100
180 28 Jun 2022 124401 ATRYOFITA 0069R0450622V007397 192,100
181 28 Jun 2022 128981 RAYU YUSTINA 0069R0450622V007402 192,100
182 28 Jun 2022 142543 SYAIFUL HANAS 0069R0450622V007415 192,100

Page 4
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183 28 Jun 2022 150169 AHMAD ALFICO 0069R0450622V007455 192,100

184 28 Jun 2022 161073 SARIPA 0069R0450622V007373 192,100
185 28 Jun 2022 162154 SRI UTAMI INDRIANI PUTRI 0069R0450622V007420 192,100
186 28 Jun 2022 165390 HERLIN HERLIANA 0069R0450622V007450 192,100
187 28 Jun 2022 187292 DAFRIZAL 0069R0450622V007490 192,100
188 28 Jun 2022 191917 TETI ERLINA 0069R0450622V007501 192,100
189 28 Jun 2022 194552 KHAIRUL BADHRI LUBIS 0069R0450622V007398 192,100
190 28 Jun 2022 196998 RATNA 0069R0450622V007388 192,100
191 28 Jun 2022 197078 IRNA NADILLA 0069R0450622V007453 192,100
192 28 Jun 2022 202444 JENNI BINAHATI SITOHANG 0069R0450622V007499 192,100
193 28 Jun 2022 206456 MASNANG SRIMAIYARTI 0069R0450622V007407 192,100
194 28 Jun 2022 206747 ERNIZA PRATIWI 0069R0450622V007423 192,100
195 28 Jun 2022 214059 ZURNIATI 0069R0450622V007418 192,100
196 28 Jun 2022 214328 ANIK SETIA WATININGSIH 0069R0450622V007448 192,100
197 28 Jun 2022 214375 ANDI 0069R0450622V007449 192,100
198 28 Jun 2022 214769 MENUR 0069R0450622V007424 192,100
199 28 Jun 2022 215018 ROIDA SIHOMBING 0069R0450622V007399 582,100
200 28 Jun 2022 215804 BUDIANTO 0069R0450622V007443 192,100
201 28 Jun 2022 190494 ENDANG RAHMAWATI 0069R0450622V007683 192,100
202 28 Jun 2022 205736 HENDRAWAN 0069R0450622V007671 192,100
203 28 Jun 2022 185930 TIKA RAMENDRA 0069R0450622V007575 314,100
204 28 Jun 2022 213616 YUNI ANGELIA RUSDIANI 0069R0450622V007581 582,100
205 28 Jun 2022 214862 MENIATI HALAWA 0069R0450622V007578 582,100
206 28 Jun 2022 215001 SULASMI 0069R0450622V007576 582,100
207 28 Jun 2022 215080 YASNI 0069R0450622V007573 194,900
208 28 Jun 2022 215729 PUTRI ANGGRAINI 0069R0450622V007630 194,900
209 28 Jun 2022 200165 ALIZAR 0069R0450622V007669 192,100
210 28 Jun 2022 212860 ASRIL 0069R0450622V007676 192,100
211 28 Jun 2022 062332 SITI FATIMAH 0069R0450622V007613 192,100
212 28 Jun 2022 070404 HELMINA SARAGIH 0069R0450622V007527 192,100
213 28 Jun 2022 083267 AMUNIR 0069R0450622V007524 192,100
214 28 Jun 2022 086447 YUFRIZA BINTI ZAHRUDDIN 0069R0450622V007519 192,100
215 28 Jun 2022 094004 YUSTINO 0069R0450622V007526 192,100
216 28 Jun 2022 099152 ERNITA SEFNIYENTI 0069R0450622V007514 192,100
217 28 Jun 2022 101589 SARNIS 0069R0450622V007597 192,100
218 28 Jun 2022 136779 WAGIMIN 0069R0450622V007520 192,100
219 28 Jun 2022 153491 MISRIANTO 0069R0450622V007607 192,100
220 28 Jun 2022 170740 DARMINA 0069R0450622V007638 192,100
221 28 Jun 2022 173264 SITI ROHANA 0069R0450622V007522 192,100
222 28 Jun 2022 179027 YUSNIAR 0069R0450622V007523 192,100
223 28 Jun 2022 179620 NAYA KHAIRUNNISA PUTRI KHAILIN 0069R0450622V007525 192,100
224 28 Jun 2022 196321 DARUL KHOIRI 0069R0450622V007515 192,100
225 28 Jun 2022 196387 SURYANI 0069R0450622V007516 192,100
226 28 Jun 2022 201141 RUMIA MANURUNG 0069R0450622V007534 192,100
227 28 Jun 2022 201930 SURYANI TELAMBANUA 0069R0450622V007528 192,100
228 28 Jun 2022 202557 SRI SUHASTI NINGSIH 0069R0450622V007521 192,100

Page 5
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229 28 Jun 2022 207045 NURHASTA 0069R0450622V007579 192,100

230 28 Jun 2022 213518 RAMADHAN. J 0069R0450622V007555 192,100
231 28 Jun 2022 220247 EKA RISTIA NINGSIH 0069R0450622V007517 193,500
232 28 Jun 2022 082855 HARUN AR RASYID 0069R0450622V007619 300,700
233 28 Jun 2022 086783 RIDAMAWATI ZEGA 0069R0450622V007536 300,700
234 28 Jun 2022 088506 DANIEL EDWARD HOZAKI 0069R0450622V007539 219,000
235 28 Jun 2022 105489 MERISA HADINATA 0069R0450622V007618 300,700
236 28 Jun 2022 156827 ELINA SURYANI 0069R0450622V007624 300,700
237 28 Jun 2022 194412 BAHREIN RAMBE 0069R0450622V007635 300,700
238 28 Jun 2022 214600 MUHAMMAD RIO ALFIQRI MUNITA 0069R0450622V007577 300,700
239 28 Jun 2022 215818 NOPRIANI 0069R0450622V007510 300,700
240 28 Jun 2022 215831 RUNDIYATI 0069R0450622V007537 300,700
241 28 Jun 2022 215842 AZWINSYAH 0069R0450622V007509 300,700
Total 59,545,600

Page 6
 sheet1 -1

Tarif RS Selisih DPJP

172,911 83,589 ALFINA KUMALA SARI.DR
79,034 177,466 ALFINA KUMALA SARI.DR
249,869 - 54,969 ANDI RIZALDI.SP.B.DR
128,106 66,794 ANDI RIZALDI.SP.B.DR
157,583 34,517 ANDI RIZALDI.SP.B.DR
119,223 75,677 ANDI RIZALDI.SP.B.DR
275,992 - 81,092 ANDI RIZALDI.SP.B.DR
174,060 20,840 ANDI RIZALDI.SP.B.DR
245,074 - 50,174 ANDI RIZALDI.SP.B.DR
119,223 75,677 ANDI RIZALDI.SP.B.DR
245,749 - 50,849 ANDI RIZALDI.SP.B.DR
245,074 - 50,174 ANDI RIZALDI.SP.B.DR
151,066 43,834 ANDI RIZALDI.SP.B.DR
315,546 - 120,646 ANDI RIZALDI.SP.B.DR
305,195 - 113,095 ANDI RIZALDI.SP.B.DR
123,073 69,027 ANWAR BET,DR,SPPD
311,124 - 119,024 ANWAR BET,DR,SPPD
169,826 22,274 ANWAR BET,DR,SPPD
180,151 11,949 ANWAR BET,DR,SPPD
244,960 - 52,860 ARJUNAIDI. SPPD.DR
240,877 - 48,777 ARJUNAIDI. SPPD.DR
264,138 - 72,038 ARJUNAIDI. SPPD.DR
200,621 - 8,521 ARJUNAIDI. SPPD.DR
206,500 - 14,400 ARJUNAIDI. SPPD.DR
174,914 17,186 ARJUNAIDI. SPPD.DR
193,928 - 1,828 ARJUNAIDI. SPPD.DR
259,686 - 67,586 ARJUNAIDI. SPPD.DR
282,102 - 90,002 ARJUNAIDI. SPPD.DR
129,372 62,728 ARJUNAIDI. SPPD.DR
287,254 - 95,154 ARJUNAIDI. SPPD.DR
204,755 - 12,655 ARJUNAIDI. SPPD.DR
199,877 - 7,777 ARJUNAIDI. SPPD.DR
172,417 19,683 ARJUNAIDI. SPPD.DR
207,631 - 15,531 ARJUNAIDI. SPPD.DR
351,822 - 159,722 ARJUNAIDI. SPPD.DR
292,764 - 100,664 ARJUNAIDI. SPPD.DR
178,762 13,338 ARJUNAIDI. SPPD.DR
192,575 - 475 ARJUNAIDI. SPPD.DR
307,560 - 29,960 ARJUNAIDI. SPPD.DR
87,548 104,552 ARJUNAIDI. SPPD.DR
165,447 26,653 ARJUNAIDI. SPPD.DR
160,796 31,304 ARJUNAIDI. SPPD.DR
245,503 - 53,403 ARJUNAIDI. SPPD.DR
117,517 74,583 ARJUNAIDI. SPPD.DR

Page 7
 sheet1 -1

150,303 41,797 ARJUNAIDI. SPPD.DR

180,447 76,053 ARJUNAIDI. SPPD.DR
242,090 - 49,990 ARJUNAIDI. SPPD.DR. SR
284,789 - 92,689 ARJUNAIDI. SPPD.DR. SR
198,907 - 6,807 ARJUNAIDI. SPPD.DR. SR
256,845 - 64,745 ARJUNAIDI. SPPD.DR. SR
270,683 - 78,583 ARJUNAIDI. SPPD.DR. SR
207,161 - 15,061 ARJUNAIDI. SPPD.DR. SR
617,146 - 425,046 ARJUNAIDI. SPPD.DR. SR
153,175 38,925 ARJUNAIDI. SPPD.DR. SR
241,711 - 49,611 ARJUNAIDI. SPPD.DR. SR
138,169 53,931 ARJUNAIDI. SPPD.DR. SR
238,885 - 46,785 ARJUNAIDI. SPPD.DR. SR
203,133 - 11,033 ARJUNAIDI. SPPD.DR. SR
119,681 84,219 CHEVIN IMAM NASUTION.DR
66,914 125,186 DEDE KURNIAWAN. DR
83,418 60,282 DEDE KURNIAWAN. DR
459,345 - 267,245 DEDI RINALDI. SP.P.DR
238,722 - 46,622 DEDI RINALDI. SP.P.DR
160,721 31,379 DEDI RINALDI. SP.P.DR
174,041 18,059 DEDI RINALDI. SP.P.DR
213,639 - 21,539 DEDI RINALDI. SP.P.DR
118,053 74,047 DEDI RINALDI. SP.P.DR
149,831 42,269 DEDI RINALDI. SP.P.DR
132,410 59,690 DEDI RINALDI. SP.P.DR
87,409 104,691 DEDI RINALDI. SP.P.DR
196,730 - 4,630 DEDI RINALDI. SP.P.DR
201,348 - 9,248 DENDI,SP.KK.DR
230,459 - 38,359 DENDI,SP.KK.DR
229,316 - 37,216 DENDI,SP.KK.DR
100,000 92,100 DENDI,SP.KK.DR
238,726 61,974 FAHRO RIZKI.DRG
198,447 102,253 FAHRO RIZKI.DRG
194,642 106,058 FAHRO RIZKI.DRG
198,447 102,253 FAHRO RIZKI.DRG
198,447 102,253 FAHRO RIZKI.DRG
68,359 150,641 FAHRO RIZKI.DRG
114,564 77,536 FAISAL,SP,THT.DR
251,938 13,962 FAISAL,SP,THT.DR ML
175,761 406,339 ICHSAN ERFANDI. SP.OG.DR
201,319 112,781 ICHSAN ERFANDI. SP.OG.DR
198,283 115,817 ICHSAN ERFANDI. SP.OG.DR
237,758 344,342 ICHSAN ERFANDI. SP.OG.DR
155,191 38,309 ISFIYANTO, SP. M. DR
127,262 64,838 ISFIYANTO, SP. M. DR
151,708 41,792 ISFIYANTO, SP. M. DR

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127,262 66,238 ISFIYANTO, SP. M. DR

813,239 19,761 IZWAR ANWAR, SPPD.DR
805,381 27,619 IZWAR ANWAR, SPPD.DR
819,304 13,696 IZWAR ANWAR, SPPD.DR
819,282 13,718 IZWAR ANWAR, SPPD.DR
813,239 19,761 IZWAR ANWAR, SPPD.DR
813,239 19,761 IZWAR ANWAR, SPPD.DR
819,912 13,088 IZWAR ANWAR, SPPD.DR
812,524 20,476 IZWAR ANWAR, SPPD.DR
872,418 - 39,418 IZWAR ANWAR, SPPD.DR
872,418 - 39,418 IZWAR ANWAR, SPPD.DR
812,524 20,476 IZWAR ANWAR, SPPD.DR
209,122 - 17,022 MAGDI AYUZA.SPB.DR.M
119,223 75,677 MAGDI AYUZA.SPB.DR.M
132,681 62,219 MAGDI AYUZA.SPB.DR.M
40,000 73,800 NEIDYA KARLA, SP.KFR. DR
40,000 73,800 NEIDYA KARLA, SP.KFR. DR
40,000 73,800 NEIDYA KARLA, SP.KFR. DR
40,000 73,800 NEIDYA KARLA, SP.KFR. DR
40,000 73,800 NEIDYA KARLA, SP.KFR. DR
40,000 73,800 NEIDYA KARLA, SP.KFR. DR
40,000 106,600 NEIDYA KARLA, SP.KFR. DR
40,000 73,800 NEIDYA KARLA, SP.KFR. DR
161,365 30,735 NOLITRIANI, SP. A. DR
198,472 - 6,372 NOLITRIANI, SP. A. DR
93,821 98,279 NOVITA SRI MULYATI.DR
90,071 103,429 NOVITA SRI MULYATI.DR
173,785 18,315 PENGEKUTEN,SPA.DR
289,551 37,249 PENGEKUTEN,SPA.DR
122,390 69,710 PENGEKUTEN,SPA.DR
138,579 53,521 PENGEKUTEN,SPA.DR
154,403 37,697 PENGEKUTEN,SPA.DR
296,359 30,441 PENGEKUTEN,SPA.DR
146,285 45,815 PENGEKUTEN,SPA.DR
85,000 107,100 PENGEKUTEN,SPA.DR
134,847 57,253 PENGEKUTEN,SPA.DR
151,678 40,422 PENGEKUTEN,SPA.DR
109,474 82,626 PENGEKUTEN,SPA.DR
85,000 226,600 PENGEKUTEN,SPA.DR
85,000 226,600 PENGEKUTEN,SPA.DR
119,548 72,552 PENGEKUTEN,SPA.DR. SR
170,000 412,100 PUTRI WIDNIS, SP. OG.DR
275,517 306,583 PUTRI WIDNIS, SP. OG.DR
218,773 95,327 PUTRI WIDNIS, SP. OG.DR
178,702 135,398 PUTRI WIDNIS, SP. OG.DR
123,552 71,348 PUTRI WIDNIS, SP. OG.DR

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123,552 71,348 PUTRI WIDNIS, SP. OG.DR

82,779 173,721 RAJA DARMAWAN HARAHAP. DR
99,021 104,879 RAJA DARMAWAN HARAHAP. DR
92,896 163,604 RAJA DARMAWAN HARAHAP. DR
232,687 33,213 RENOLD YURENSA. SP. THT
175,946 89,954 RENOLD YURENSA. SP. THT
255,707 10,193 RENOLD YURENSA. SP. THT
297,468 34,132 RENOLD YURENSA. SP. THT
134,567 57,533 SONYA NOVIANA, SP.P.DR
134,253 57,847 SONYA NOVIANA, SP.P.DR
123,120 68,980 SONYA NOVIANA, SP.P.DR
147,682 44,418 SONYA NOVIANA, SP.P.DR
151,926 40,174 SONYA NOVIANA, SP.P.DR
150,958 41,142 SONYA NOVIANA, SP.P.DR
178,360 13,740 SONYA NOVIANA, SP.P.DR
108,239 83,861 SONYA NOVIANA, SP.P.DR
116,082 76,018 SONYA NOVIANA, SP.P.DR
151,700 40,400 SONYA NOVIANA, SP.P.DR
287,281 - 95,181 SONYA NOVIANA, SP.P.DR
133,353 58,747 SONYA NOVIANA, SP.P.DR
132,236 59,864 SONYA NOVIANA, SP.P.DR
129,139 62,961 SONYA NOVIANA, SP.P.DR
124,162 67,938 SONYA NOVIANA, SP.P.DR
105,525 86,575 SONYA NOVIANA, SP.P.DR
126,453 65,647 SONYA NOVIANA, SP.P.DR
152,912 39,188 SONYA NOVIANA, SP.P.DR
174,560 17,540 SONYA NOVIANA, SP.P.DR
169,160 22,940 SONYA NOVIANA, SP.P.DR
109,552 82,548 SONYA NOVIANA, SP.P.DR
187,578 4,522 SONYA NOVIANA, SP.P.DR
136,881 55,219 SONYA NOVIANA, SP.P.DR
127,596 64,504 SONYA NOVIANA, SP.P.DR
112,228 79,872 SONYA NOVIANA, SP.P.DR
194,223 106,477 SUSAN YULANDARI.DRG
95,295 96,805 WELLY VITRIA. SPPD.DR
150,179 41,921 WELLY VITRIA. SPPD.DR
212,190 - 20,090 WELLY VITRIA. SPPD.DR
152,296 39,804 WELLY VITRIA. SPPD.DR
265,374 - 73,274 WELLY VITRIA. SPPD.DR
126,860 65,240 WELLY VITRIA. SPPD.DR
352,024 - 159,924 WELLY VITRIA. SPPD.DR
179,373 12,727 WELLY VITRIA. SPPD.DR
188,315 3,785 WELLY VITRIA. SPPD.DR
240,074 - 47,974 WELLY VITRIA. SPPD.DR
235,601 - 43,501 WELLY VITRIA. SPPD.DR
132,703 59,397 WELLY VITRIA. SPPD.DR

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267,562 - 75,462 WELLY VITRIA. SPPD.DR

302,218 - 110,118 WELLY VITRIA. SPPD.DR
195,497 - 3,397 WELLY VITRIA. SPPD.DR
307,814 - 115,714 WELLY VITRIA. SPPD.DR
203,809 - 11,709 WELLY VITRIA. SPPD.DR
143,508 48,592 WELLY VITRIA. SPPD.DR
211,709 - 19,609 WELLY VITRIA. SPPD.DR
399,382 - 207,282 WELLY VITRIA. SPPD.DR
223,070 - 30,970 WELLY VITRIA. SPPD.DR
134,746 57,354 WELLY VITRIA. SPPD.DR
273,637 - 81,537 WELLY VITRIA. SPPD.DR
145,523 46,577 WELLY VITRIA. SPPD.DR
178,240 13,860 WELLY VITRIA. SPPD.DR
288,371 - 96,271 WELLY VITRIA. SPPD.DR
147,130 44,970 WELLY VITRIA. SPPD.DR
275,416 - 83,316 WELLY VITRIA. SPPD.DR
433,050 149,050 WELLY VITRIA. SPPD.DR
133,055 59,045 WELLY VITRIA. SPPD.DR
146,285 45,815 WELLY VITRIA. SPPD.DR MLM
241,604 - 49,504 WELLY VITRIA. SPPD.DR MLM
275,884 38,216 WIWIN SUHANDRI SP.OG.DR
176,194 405,906 WIWIN SUHANDRI SP.OG.DR
208,528 373,572 WIWIN SUHANDRI SP.OG.DR
328,830 253,270 WIWIN SUHANDRI SP.OG.DR
153,683 41,217 WIWIN SUHANDRI SP.OG.DR
144,071 50,829 WIWIN SUHANDRI SP.OG.DR
288,415 - 96,315 YANDRA DARUSMAN.SP.P.DR
300,096 - 107,996 YANDRA DARUSMAN.SP.P.DR
103,345 88,755 YOSSI MARYANTI. SP. S.DR
219,424 - 27,324 YOSSI MARYANTI. SP. S.DR
286,865 - 94,765 YOSSI MARYANTI. SP. S.DR
165,145 26,955 YOSSI MARYANTI. SP. S.DR
234,672 - 42,572 YOSSI MARYANTI. SP. S.DR
216,624 - 24,524 YOSSI MARYANTI. SP. S.DR
167,826 24,274 YOSSI MARYANTI. SP. S.DR
359,656 - 167,556 YOSSI MARYANTI. SP. S.DR
158,924 33,176 YOSSI MARYANTI. SP. S.DR
220,959 - 28,859 YOSSI MARYANTI. SP. S.DR
275,818 - 83,718 YOSSI MARYANTI. SP. S.DR
292,045 - 99,945 YOSSI MARYANTI. SP. S.DR
180,303 11,797 YOSSI MARYANTI. SP. S.DR
103,345 88,755 YOSSI MARYANTI. SP. S.DR
164,772 27,328 YOSSI MARYANTI. SP. S.DR
256,367 - 64,267 YOSSI MARYANTI. SP. S.DR
264,012 - 71,912 YOSSI MARYANTI. SP. S.DR
127,062 65,038 YOSSI MARYANTI. SP. S.DR

Page 11
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133,608 58,492 YOSSI MARYANTI. SP. S.DR

171,513 20,587 YOSSI MARYANTI. SP. S.DR
155,109 38,391 YOSSI MARYANTI. SP. S.DR
197,459 103,241 YUNISA SYAFITRI.DRG
199,135 101,565 YUNISA SYAFITRI.DRG
54,976 164,024 YUNISA SYAFITRI.DRG
194,223 106,477 YUNISA SYAFITRI.DRG
194,223 106,477 YUNISA SYAFITRI.DRG
194,223 106,477 YUNISA SYAFITRI.DRG
193,252 107,448 YUNISA SYAFITRI.DRG
194,223 106,477 YUNISA SYAFITRI.DRG
193,252 107,448 YUNISA SYAFITRI.DRG
194,223 106,477 YUNISA SYAFITRI.DRG
51,747,454 7,798,146

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