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LAPORAN REKAP KLAIM - RSUD TALAN

Pasien Rawat Inap dan Rawat Jalan, Periode Tanggal Pulang: 1 F
Filter: / Kelas Rawat = Semua / Severity = Semua / Cara Pulang = Semua / Jenis T
No. Tgl. Masuk Tgl. Pulang No. RM Nama Pasien
1 1 Feb 2023 1 Feb 2023 037867 ASTITI
2 1 Feb 2023 1 Feb 2023 037471 FREDY PURBOWASISO
3 1 Feb 2023 1 Feb 2023 014362 ATMANA
4 1 Feb 2023 1 Feb 2023 034768 AZZAM SHAKA PUTRA
5 1 Feb 2023 1 Feb 2023 041229 SALVINA
6 1 Feb 2023 1 Feb 2023 036185 SUPARMAN
7 1 Feb 2023 1 Feb 2023 041234 RAIYA APRILIA CHANZA
8 1 Feb 2023 1 Feb 2023 002696 HASAN PENDI
9 1 Feb 2023 1 Feb 2023 041232 SRI WAHYUNI
10 1 Feb 2023 1 Feb 2023 033351 LENI
11 1 Feb 2023 1 Feb 2023 001877 DARNIUS
12 1 Feb 2023 1 Feb 2023 008612 SURYATI
13 1 Feb 2023 1 Feb 2023 028364 ZELFA SEFTRIANI
14 1 Feb 2023 1 Feb 2023 000238 NOVI KARENI
15 1 Feb 2023 1 Feb 2023 040371 MUHAMMAD ARKAN AL GHAZALI
16 1 Feb 2023 1 Feb 2023 030305 A REPA'I
17 1 Feb 2023 1 Feb 2023 000269 LENI MARLINA
18 1 Feb 2023 1 Feb 2023 040896 WALUYO
19 1 Feb 2023 1 Feb 2023 033419 MARTONI
20 1 Feb 2023 1 Feb 2023 041238 NATIPA DARA JULIANDA
21 1 Feb 2023 1 Feb 2023 036874 DIANA
22 1 Feb 2023 1 Feb 2023 021740 ILHAM KURNIAWAN
23 2 Feb 2023 2 Feb 2023 039548 DIANDRA YULIA AZZAHRA
24 2 Feb 2023 2 Feb 2023 040571 TOMMI KURNIAWAN
25 2 Feb 2023 2 Feb 2023 041251 KHUSNUL KHOTIMAH
26 2 Feb 2023 2 Feb 2023 041243 SOFIAH
27 2 Feb 2023 2 Feb 2023 018826 ALRI GASI
28 2 Feb 2023 2 Feb 2023 025233 ENDANG BHARTATI
29 2 Feb 2023 2 Feb 2023 037012 SRI HARTUTI
30 2 Feb 2023 2 Feb 2023 016229 SITI MUSRIPA
31 2 Feb 2023 2 Feb 2023 040354 YENI ELMIDA SARI
32 2 Feb 2023 2 Feb 2023 041257 NURBAITI
33 2 Feb 2023 2 Feb 2023 041242 CIK MENA
34 2 Feb 2023 2 Feb 2023 021883 ULIA
35 2 Feb 2023 2 Feb 2023 004141 TRI WALUYO
36 2 Feb 2023 2 Feb 2023 004928 JOKO SUMARNO
37 2 Feb 2023 2 Feb 2023 041250 KUSTONI
38 2 Feb 2023 2 Feb 2023 027660 INDI RAGANDI
39 3 Feb 2023 3 Feb 2023 035733 HIZAM APRILIONO RAMADHAN

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40 3 Feb 2023 3 Feb 2023 012410 AL FATTAAH DAHWAN LATIIF HALIIM

41 3 Feb 2023 3 Feb 2023 041269 YUSDELI
42 3 Feb 2023 3 Feb 2023 041276 JEFFERSON ARNOLD MONONUTU
43 3 Feb 2023 3 Feb 2023 041267 RAFINDRA SYAHPUTRA
44 3 Feb 2023 3 Feb 2023 041103 NANDA PUTRI PUSPITA
45 3 Feb 2023 3 Feb 2023 041272 RIDUAN
46 3 Feb 2023 3 Feb 2023 015762 AMIR SYARIFUDIN
47 3 Feb 2023 3 Feb 2023 041268 BITMEN HUTABARAT
48 3 Feb 2023 3 Feb 2023 003797 AHMAD TADJRI
49 3 Feb 2023 3 Feb 2023 031763 ADI FITRIANSYAH
50 3 Feb 2023 3 Feb 2023 041262 TAUFIK HIDAYAT
51 4 Feb 2023 4 Feb 2023 009179 WAHID HASYIM
52 4 Feb 2023 4 Feb 2023 008048 DAMIN
53 4 Feb 2023 4 Feb 2023 003427 EKO SUROSO
54 4 Feb 2023 4 Feb 2023 014075 ARIL APRIZA
55 4 Feb 2023 4 Feb 2023 009746 HAKAN RAFISQY
56 4 Feb 2023 4 Feb 2023 038667 PATIMAH
57 4 Feb 2023 4 Feb 2023 039188 M ZAINI
58 4 Feb 2023 4 Feb 2023 041277 YAYAN SYAH
59 5 Feb 2023 5 Feb 2023 001612 TITIN SUMARNI
60 5 Feb 2023 5 Feb 2023 027758 EDY KURNIAWAN
61 5 Feb 2023 5 Feb 2023 038812 SINDUNG
62 5 Feb 2023 5 Feb 2023 036013 MUJI BURRAHMAN
63 5 Feb 2023 5 Feb 2023 017625 FAHRUL ROZI
64 5 Feb 2023 5 Feb 2023 023000 SLAMET RISKI
65 5 Feb 2023 5 Feb 2023 022744 MUHAMMAD RIDWAN
66 5 Feb 2023 5 Feb 2023 041311 RATNA
67 5 Feb 2023 5 Feb 2023 004431 WIWIK YUNARNI
68 5 Feb 2023 5 Feb 2023 005945 DEWI INDRAYANI
69 5 Feb 2023 5 Feb 2023 041307 LESTARI
70 6 Feb 2023 6 Feb 2023 040653 DEWI SINTA
71 6 Feb 2023 6 Feb 2023 030931 SUPRIYADI
72 6 Feb 2023 6 Feb 2023 012165 BEJO ADI SUNARYO
73 6 Feb 2023 6 Feb 2023 004582 SEPTIA RAMADANI
74 6 Feb 2023 6 Feb 2023 000535 SAINA
75 6 Feb 2023 6 Feb 2023 010807 UPIT SARI MANA
76 6 Feb 2023 6 Feb 2023 041096 SRI RUBIATMI
77 6 Feb 2023 6 Feb 2023 033971 INTAN KEMALASARI
78 6 Feb 2023 6 Feb 2023 041337 RUSMAN
79 6 Feb 2023 6 Feb 2023 040959 MARINA
80 6 Feb 2023 6 Feb 2023 038952 NURDIN
81 6 Feb 2023 6 Feb 2023 036027 FATHIRA RIZKY RAMADHANY
82 6 Feb 2023 6 Feb 2023 041317 PUTRI AYU

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83 6 Feb 2023 6 Feb 2023 040804 NANDANG SUHENDAR

84 6 Feb 2023 6 Feb 2023 012015 SITI PATONAH
85 6 Feb 2023 6 Feb 2023 041315 SAMSURI
86 6 Feb 2023 6 Feb 2023 000834 SUKIMAN
87 6 Feb 2023 6 Feb 2023 013166 RUSMA WATI
88 6 Feb 2023 6 Feb 2023 027365 RIZKI ULANDARI
89 6 Feb 2023 6 Feb 2023 002348 SYARIFUDDIN DAHOLAN
90 6 Feb 2023 6 Feb 2023 041341 ROZAILI
91 6 Feb 2023 6 Feb 2023 041129 AZIZAN RADITYA SAPUTRA
92 7 Feb 2023 7 Feb 2023 040744 RISWANTO
93 7 Feb 2023 7 Feb 2023 041140 SUHAIDIR
94 7 Feb 2023 7 Feb 2023 041167 SANTI
95 7 Feb 2023 7 Feb 2023 003427 EKO SUROSO
96 7 Feb 2023 7 Feb 2023 041377 RINI YUSTIANA
97 7 Feb 2023 7 Feb 2023 015381 RANTI
98 7 Feb 2023 7 Feb 2023 032953 MUHAMMAD KABIR PUTRA ZHUAN
99 7 Feb 2023 7 Feb 2023 000952 UMAR SALEH
100 7 Feb 2023 7 Feb 2023 016557 SULASTRI
101 7 Feb 2023 7 Feb 2023 014905 PIRA YUNIAR
102 7 Feb 2023 7 Feb 2023 040874 HUSWATUN HASANAH
103 7 Feb 2023 7 Feb 2023 015704 M.YAMIN.AR
104 7 Feb 2023 7 Feb 2023 041113 SUSAN WAHYUNI
105 7 Feb 2023 7 Feb 2023 039056 NORMAN NOMADIO
106 7 Feb 2023 7 Feb 2023 021136 ARLIYADI
107 7 Feb 2023 7 Feb 2023 005782 FAIZAL PANCA PURNA
108 7 Feb 2023 7 Feb 2023 041050 HADI ABDULLAH
109 7 Feb 2023 7 Feb 2023 041399 KHALIDHIA FAZA
110 7 Feb 2023 7 Feb 2023 041353 ANGLELIKA PUTRI
111 7 Feb 2023 7 Feb 2023 041197 IDI CANDRA
112 7 Feb 2023 7 Feb 2023 025488 AYU YURESNA
113 7 Feb 2023 7 Feb 2023 041260 SARJAK
114 7 Feb 2023 7 Feb 2023 041393 ENDANG KURNIA
115 7 Feb 2023 7 Feb 2023 041362 MEGA ROYANI
116 7 Feb 2023 7 Feb 2023 005775 SITI LASMI
117 7 Feb 2023 7 Feb 2023 041367 KARTIKA
118 7 Feb 2023 7 Feb 2023 001559 M KHOTIP
119 7 Feb 2023 7 Feb 2023 036829 SUSILAWATI
120 7 Feb 2023 7 Feb 2023 038689 MARDIANA
121 8 Feb 2023 8 Feb 2023 041156 BY NY NURUL KHASANAH
122 8 Feb 2023 8 Feb 2023 036948 SAIMAN
123 8 Feb 2023 8 Feb 2023 014203 MULYADI
124 8 Feb 2023 8 Feb 2023 017793 ARYA BIMA TEJA
125 8 Feb 2023 8 Feb 2023 007264 UJANG IRAWAN

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126 8 Feb 2023 8 Feb 2023 041409 SUARTINI

127 8 Feb 2023 8 Feb 2023 041418 FAYRA DZIKRA
128 8 Feb 2023 8 Feb 2023 020557 M. EFFENDI
129 8 Feb 2023 8 Feb 2023 038436 UNTUNG SAPUTRA
130 8 Feb 2023 8 Feb 2023 040522 IDIH SUPRIADIH
131 8 Feb 2023 8 Feb 2023 032988 MURNI DEWIANA
132 8 Feb 2023 8 Feb 2023 010206 KARTINI AFRIANA
133 8 Feb 2023 8 Feb 2023 028245 EDY YUSMAN
134 8 Feb 2023 8 Feb 2023 008114 FIKRIADI
135 8 Feb 2023 8 Feb 2023 0414044 SURYA
136 8 Feb 2023 8 Feb 2023 003067 PEPI SARI
137 8 Feb 2023 8 Feb 2023 001753 FEBI WULAN HARTATI
138 8 Feb 2023 8 Feb 2023 041406 ANA
139 8 Feb 2023 8 Feb 2023 006302 DENSRI
140 8 Feb 2023 8 Feb 2023 041421 KIKI DWI ANTONO
141 9 Feb 2023 9 Feb 2023 040571 TOMMI KURNIAWAN
142 9 Feb 2023 9 Feb 2023 016151 TATIK DIAN SULISTIA
143 9 Feb 2023 9 Feb 2023 018826 ALRI GASI
144 9 Feb 2023 9 Feb 2023 041430 ADI GANI
145 9 Feb 2023 9 Feb 2023 073745 SUTRINI
146 9 Feb 2023 9 Feb 2023 022219 IKANG PAUZI
147 9 Feb 2023 9 Feb 2023 033779 SOLIKIN
148 9 Feb 2023 9 Feb 2023 034962 IRMA SURYANI
149 9 Feb 2023 9 Feb 2023 001505 AYYU CRISTA VELLA
150 9 Feb 2023 9 Feb 2023 003798 MASHAR
151 9 Feb 2023 9 Feb 2023 041243 SOFIAH
152 9 Feb 2023 9 Feb 2023 003587 ROSMAWAN
153 9 Feb 2023 9 Feb 2023 041451 NABILA
154 9 Feb 2023 9 Feb 2023 041432 ZAKIR MUSYAFFA ATHALLAH
155 10 Feb 2023 10 Feb 2023 039749 TUKIRAN
156 10 Feb 2023 10 Feb 2023 041461 SURATMI
157 10 Feb 2023 10 Feb 2023 041462 ROHANI
158 10 Feb 2023 10 Feb 2023 022071 DODY SETIADY
159 10 Feb 2023 10 Feb 2023 022202 FANNY SELFINA
160 10 Feb 2023 10 Feb 2023 041458 KOMARIYATI
161 11 Feb 2023 11 Feb 2023 041474 NADYA AZZAHRA LATHIFAH
162 11 Feb 2023 11 Feb 2023 041470 AMMAR FAKRULLAH
163 11 Feb 2023 11 Feb 2023 031087 MUAMMAR GHADAFI
164 12 Feb 2023 12 Feb 2023 035078 SUYUTNO
165 12 Feb 2023 12 Feb 2023 041477 HOIMA
166 12 Feb 2023 12 Feb 2023 041476 ZALIKA DESTAYANI
167 12 Feb 2023 12 Feb 2023 018550 REFANO ZAKIR AL FARIZI
168 12 Feb 2023 12 Feb 2023 041483 AGUS BUANA

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169 12 Feb 2023 12 Feb 2023 034475 FAHRIZA FEBRIANDIKA

170 12 Feb 2023 12 Feb 2023 041482 SIV FANI RIANTI
171 12 Feb 2023 12 Feb 2023 041481 SUMARNI
172 12 Feb 2023 12 Feb 2023 021024 SINTIYA RAHMAWATI
173 12 Feb 2023 12 Feb 2023 002396 IDA SAKIYAKIRTI
174 12 Feb 2023 12 Feb 2023 011911 JUNIA
175 13 Feb 2023 13 Feb 2023 011409 NATASYA ANJANI PRATIWI
176 13 Feb 2023 13 Feb 2023 041346 NAZARUDIN
177 13 Feb 2023 13 Feb 2023 030596 RATI'A
178 13 Feb 2023 13 Feb 2023 023626 ATIKA
179 13 Feb 2023 13 Feb 2023 036147 MURNI
180 13 Feb 2023 13 Feb 2023 019091 EDO ADICHANDRA
181 13 Feb 2023 13 Feb 2023 041281 ERDI NATA
182 13 Feb 2023 13 Feb 2023 002401 SUHARDIN
183 13 Feb 2023 13 Feb 2023 041485 HENDRA AMSA
184 13 Feb 2023 13 Feb 2023 038812 SINDUNG
185 13 Feb 2023 13 Feb 2023 041505 HABIBI EKA HADAYA
186 13 Feb 2023 13 Feb 2023 033541 ETIK SARTIKA
187 13 Feb 2023 13 Feb 2023 041219 WAGIMIN
188 14 Feb 2023 14 Feb 2023 041398 IMAM FAISAL ADI NEGARA
189 14 Feb 2023 14 Feb 2023 041348 EMOK
190 14 Feb 2023 14 Feb 2023 031150 EDI SUPARDI
191 14 Feb 2023 14 Feb 2023 037157 RETNO TRI SETYANINGRUM
192 14 Feb 2023 14 Feb 2023 004810 MERRYDIAN
193 14 Feb 2023 14 Feb 2023 041340 LENI MARLINA
194 14 Feb 2023 14 Feb 2023 041515 MAHELA
195 14 Feb 2023 14 Feb 2023 022030 MAKMUN
196 14 Feb 2023 14 Feb 2023 017373 KASMAN
197 14 Feb 2023 14 Feb 2023 041511 SAWALUDIN
198 14 Feb 2023 14 Feb 2023 040866 NURNI
199 14 Feb 2023 14 Feb 2023 041516 ERLINA
200 14 Feb 2023 14 Feb 2023 041325 FEGRI YOSAH
201 14 Feb 2023 14 Feb 2023 031848 SRI WAGINI
202 14 Feb 2023 14 Feb 2023 038812 SINDUNG
203 14 Feb 2023 14 Feb 2023 041379 SAMIUN SIREGAR
204 14 Feb 2023 14 Feb 2023 030049 BELLA PUSPITA
205 14 Feb 2023 14 Feb 2023 041514 USILAH
206 14 Feb 2023 14 Feb 2023 041506 ROBA AS
207 14 Feb 2023 14 Feb 2023 041510 PRIMA YOGIE YAMAHA
208 14 Feb 2023 14 Feb 2023 041299 SUMIATI
209 14 Feb 2023 14 Feb 2023 041274 IRMA SURYANI
210 14 Feb 2023 14 Feb 2023 032402 ROSIDA
211 14 Feb 2023 14 Feb 2023 031763 ADI FITRIANSYAH

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212 14 Feb 2023 14 Feb 2023 041512 SUTARMAN

213 14 Feb 2023 14 Feb 2023 041404 RUSLI
214 14 Feb 2023 14 Feb 2023 034329 YON ROBINSON
215 15 Feb 2023 15 Feb 2023 009240 MELANI
216 15 Feb 2023 15 Feb 2023 041329 SAVIA GUSTIANA
217 15 Feb 2023 15 Feb 2023 038952 NURDIN
218 15 Feb 2023 15 Feb 2023 005775 SITI LASMI
219 15 Feb 2023 15 Feb 2023 004518 PONISAH
220 15 Feb 2023 15 Feb 2023 040804 NANDANG SUHENDAR
221 15 Feb 2023 15 Feb 2023 008354 ANIES RAHMAWATI RUKMANA
222 15 Feb 2023 15 Feb 2023 002570 ENI NOPIANTI
223 15 Feb 2023 15 Feb 2023 020929 ANTONI LATIF
224 15 Feb 2023 15 Feb 2023 026604 MELIYA DARMIYANTI
225 15 Feb 2023 15 Feb 2023 041486 RUSNAINI
226 15 Feb 2023 15 Feb 2023 001180 ANIZAR
227 15 Feb 2023 15 Feb 2023 022538 TEGAR JAGAT SAMUDRA
228 15 Feb 2023 15 Feb 2023 018017 SRI AGUSTINA
229 15 Feb 2023 15 Feb 2023 041101 SUYANTO
230 15 Feb 2023 15 Feb 2023 021841 SHODIKIN
231 15 Feb 2023 15 Feb 2023 001298 IIS SUDIANTI
232 15 Feb 2023 15 Feb 2023 041451 NABILA
233 15 Feb 2023 15 Feb 2023 041419 AISYAH ANANTA
234 15 Feb 2023 15 Feb 2023 041529 SIYAM SUPRIHATIN
235 15 Feb 2023 15 Feb 2023 013261 MEYLINDA RAHAYU
236 15 Feb 2023 15 Feb 2023 041386 ABIDILLAH AL GHIBRAN
237 16 Feb 2023 16 Feb 2023 000534 MUKTI
238 16 Feb 2023 16 Feb 2023 020488 PARYANI
239 16 Feb 2023 16 Feb 2023 041252 AJRUL
240 16 Feb 2023 16 Feb 2023 012218 HAZENO
241 16 Feb 2023 16 Feb 2023 040571 TOMMI KURNIAWAN
242 16 Feb 2023 16 Feb 2023 016151 TATIK DIAN SULISTIA
243 16 Feb 2023 16 Feb 2023 008676 AZKA PROZA AL-THORIZ
244 16 Feb 2023 16 Feb 2023 005176 FETRA TALITA
245 16 Feb 2023 16 Feb 2023 008313 ERVIN SANGKUT
246 16 Feb 2023 16 Feb 2023 041554 FITRI PERMATA SARI
247 16 Feb 2023 16 Feb 2023 002579 EMMI MARIYANI
248 16 Feb 2023 16 Feb 2023 041407 SUHARTO
249 16 Feb 2023 16 Feb 2023 0415 SONETA
250 16 Feb 2023 16 Feb 2023 041548 SALAMUN
251 16 Feb 2023 16 Feb 2023 041550 IRMALA DWI JANETA
252 17 Feb 2023 17 Feb 2023 022934 SUDIONO.
253 17 Feb 2023 17 Feb 2023 007265 SUBAIDA
254 17 Feb 2023 17 Feb 2023 038730 GUSTI RANDA

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255 17 Feb 2023 17 Feb 2023 002348 SYARIFUDDIN DAHOLAN

256 17 Feb 2023 17 Feb 2023 004895 JUMADI
257 17 Feb 2023 17 Feb 2023 012122 WARTINI
258 17 Feb 2023 17 Feb 2023 003797 AHMAD TADJRI
259 17 Feb 2023 17 Feb 2023 041563 ARKA DIRGA SAPUTRA
260 17 Feb 2023 17 Feb 2023 037040 ELDA JUNIARTI
261 17 Feb 2023 17 Feb 2023 041568 MOURA ATHALLA TIRTA
262 17 Feb 2023 17 Feb 2023 041558 ELVA KRISTINI
263 17 Feb 2023 17 Feb 2023 040241 RINDA DAMAYANTI
264 17 Feb 2023 17 Feb 2023 041562 IRA DWI NINGSIH
265 17 Feb 2023 17 Feb 2023 036598 FRENKY PRANATA
266 18 Feb 2023 18 Feb 2023 041572 SUHARTO
267 18 Feb 2023 18 Feb 2023 033813 GAVIN AL GHIFFARI
268 18 Feb 2023 18 Feb 2023 041577 YAYAN JUNIAN PRATAMA
269 19 Feb 2023 19 Feb 2023 041582 LINDA BETI
270 19 Feb 2023 19 Feb 2023 041581 ERWIN SAPUTRA
271 19 Feb 2023 19 Feb 2023 027098 PRAPANCA WIRATAMA
272 19 Feb 2023 19 Feb 2023 002252 ALETTA KHAYARRA
273 20 Feb 2023 20 Feb 2023 008812 RUSNIWATI
274 20 Feb 2023 20 Feb 2023 041612 HERU DARMAWAN
275 20 Feb 2023 20 Feb 2023 041595 ARIANTO
276 20 Feb 2023 20 Feb 2023 026611 FARIDA ARIANI
277 20 Feb 2023 20 Feb 2023 021440 SULBANIAH
278 20 Feb 2023 20 Feb 2023 041590 ERNAWATI
279 20 Feb 2023 20 Feb 2023 031576 IRAWATI
280 20 Feb 2023 20 Feb 2023 019751 ICE PRISKA
281 20 Feb 2023 20 Feb 2023 036573 JOKO HARTOYO
282 20 Feb 2023 20 Feb 2023 041597 ALIYUL
283 20 Feb 2023 20 Feb 2023 041596 DIANA PAPILAYAH
284 20 Feb 2023 20 Feb 2023 030273 NADYA ANGGRAINI
285 20 Feb 2023 20 Feb 2023 041481 SUMARNI
286 20 Feb 2023 20 Feb 2023 041607 DENI
287 20 Feb 2023 20 Feb 2023 012419 SUMARDI
288 20 Feb 2023 20 Feb 2023 041598 AHMAD SOLIHIN
289 20 Feb 2023 20 Feb 2023 041593 MULYATI
290 20 Feb 2023 20 Feb 2023 040150 TARSIAH
291 20 Feb 2023 20 Feb 2023 041589 IKA MAYASARI
292 20 Feb 2023 20 Feb 2023 041352 PUTRI SOVIA MUTIARANI
293 20 Feb 2023 20 Feb 2023 001733 ISKANDAR
294 20 Feb 2023 20 Feb 2023 032037 ARMAN AGUSTIAN
295 21 Feb 2023 21 Feb 2023 035610 JAJANG
296 21 Feb 2023 21 Feb 2023 015349 DEA SAPUTRI
297 21 Feb 2023 21 Feb 2023 038188 DIANA DWI ANANTA

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298 21 Feb 2023 21 Feb 2023 009832 GITA KUMALASARI

299 21 Feb 2023 21 Feb 2023 041616 DIAH RESTU PITALOKA
300 21 Feb 2023 21 Feb 2023 041594 ZHENGKI MIKAIL ZHAFAR
301 21 Feb 2023 21 Feb 2023 008258 SUARDINI
302 21 Feb 2023 21 Feb 2023 010042 FRANSISKA ANGGRAINI
303 21 Feb 2023 21 Feb 2023 037810 YESI SUSANTI
304 21 Feb 2023 21 Feb 2023 019178 CIK MING
305 21 Feb 2023 21 Feb 2023 041613 WATI RINA SUSANTI
306 21 Feb 2023 21 Feb 2023 035067 HARYATI
307 21 Feb 2023 21 Feb 2023 036829 SUSILAWATI
308 21 Feb 2023 21 Feb 2023 040247 RIZAL EFFENDI
309 21 Feb 2023 21 Feb 2023 040568 RAYSA HAFIZA
310 21 Feb 2023 21 Feb 2023 041432 ZAKIR MUSYAFFA ATHALLAH
311 22 Feb 2023 22 Feb 2023 008867 SAIMAN
312 22 Feb 2023 22 Feb 2023 036938 NAJWA SASKIRANA CAHAYA
313 22 Feb 2023 22 Feb 2023 028878 SUSI SUSANTI
314 22 Feb 2023 22 Feb 2023 041636 BAYI NYONYA DEPITA SARI 1
315 22 Feb 2023 22 Feb 2023 041638 BAYI NYONYA DEPITA SARI 2
316 22 Feb 2023 22 Feb 2023 037780 MUHAMMAD ARSAKHA ADHINATHA
317 22 Feb 2023 22 Feb 2023 039145 JOKO SUSILO
318 22 Feb 2023 22 Feb 2023 041642 RESKO SANJAYA
319 22 Feb 2023 22 Feb 2023 041629 RANI YUNISYAH
320 22 Feb 2023 22 Feb 2023 041592 WISMA RINI
321 22 Feb 2023 22 Feb 2023 004518 PONISAH
322 22 Feb 2023 22 Feb 2023 041499 SUSILAWATI
323 22 Feb 2023 22 Feb 2023 030162 MUHAMMAD BARRA ALFARO
324 22 Feb 2023 22 Feb 2023 041351 JULIUS
325 22 Feb 2023 22 Feb 2023 016485 GUNTUR
326 22 Feb 2023 22 Feb 2023 073745 SUTRINI
327 22 Feb 2023 22 Feb 2023 041475 JIMI SETIAWAN
328 22 Feb 2023 22 Feb 2023 041628 RUSLAN EFENDI
329 22 Feb 2023 22 Feb 2023 013828 LIJA
330 22 Feb 2023 22 Feb 2023 021159 ATHALLAH HAMIZAN JASUKI
331 22 Feb 2023 22 Feb 2023 041527 SURNAINI
332 22 Feb 2023 22 Feb 2023 021740 ILHAM KURNIAWAN
333 22 Feb 2023 22 Feb 2023 041492 MAHURIP
334 22 Feb 2023 22 Feb 2023 029732 DAHNIAR
335 22 Feb 2023 22 Feb 2023 004982 ERLENI
336 22 Feb 2023 22 Feb 2023 041633 TIRAH ARTIKA
337 23 Feb 2023 23 Feb 2023 013896 PARIDAH
338 23 Feb 2023 23 Feb 2023 041649 SULKONI
339 23 Feb 2023 23 Feb 2023 022934 SUDIONO.
340 23 Feb 2023 23 Feb 2023 036343 NOPIKA SARI

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341 23 Feb 2023 23 Feb 2023 012929 HAWAI RAFIK

342 23 Feb 2023 23 Feb 2023 039550 ARNIWATI
343 23 Feb 2023 23 Feb 2023 006413 INDRAWATY
344 23 Feb 2023 23 Feb 2023 039371 WARTI JULIYA
345 23 Feb 2023 23 Feb 2023 000535 SAINA
346 23 Feb 2023 23 Feb 2023 004438 DWI ISNAINI
347 23 Feb 2023 23 Feb 2023 003206 ANDARINI S
348 23 Feb 2023 23 Feb 2023 021154 HABIB HIBATULLAH
349 23 Feb 2023 23 Feb 2023 008709 MAIMUNAH
350 23 Feb 2023 23 Feb 2023 041534 SITI MUTMAINAH
351 23 Feb 2023 23 Feb 2023 023516 EFFENDI
352 23 Feb 2023 23 Feb 2023 041647 TEGUH
353 24 Feb 2023 24 Feb 2023 027944 MARYATI SIHOMBING
354 24 Feb 2023 24 Feb 2023 002499 HOLIPA
355 24 Feb 2023 24 Feb 2023 041543 FAWIT TIYA
356 24 Feb 2023 24 Feb 2023 041124 BENI SAPUTRA PANJAITAN
357 24 Feb 2023 24 Feb 2023 037046 SURYATI
358 24 Feb 2023 24 Feb 2023 041667 IBNU HAJAR
359 24 Feb 2023 24 Feb 2023 005332 PARIDA
360 24 Feb 2023 24 Feb 2023 000331 DEWI SARTIKA
361 24 Feb 2023 24 Feb 2023 041602 HASMAWTI
362 25 Feb 2023 25 Feb 2023 041688 CHARISYAH FALAMIFTHA
363 25 Feb 2023 25 Feb 2023 081508 KARSIWA
364 25 Feb 2023 25 Feb 2023 041687 AYAT ASWARA
365 25 Feb 2023 25 Feb 2023 013871 VENY EFNI DIANI
366 25 Feb 2023 25 Feb 2023 041684 HUSNAH
367 25 Feb 2023 25 Feb 2023 022359 MIFTAHUL HUSNA
368 25 Feb 2023 25 Feb 2023 021206 SAINAH
369 25 Feb 2023 25 Feb 2023 041683 DESI ARISANDI
370 26 Feb 2023 26 Feb 2023 041697 MARWANSYAH
371 26 Feb 2023 26 Feb 2023 012326 RINI ASTUTI
372 26 Feb 2023 26 Feb 2023 003303 AJIS CANDRA
373 27 Feb 2023 27 Feb 2023 035397 SULAIDA
374 27 Feb 2023 27 Feb 2023 041699 SUHARTONO
375 27 Feb 2023 27 Feb 2023 007529 RIKA ELISA
376 27 Feb 2023 27 Feb 2023 041611 ERTEWI
377 27 Feb 2023 27 Feb 2023 007264 UJANG IRAWAN
378 27 Feb 2023 27 Feb 2023 012784 ANIRA FIRDA
379 27 Feb 2023 27 Feb 2023 000164 SUNARMIN
380 27 Feb 2023 27 Feb 2023 021440 SULBANIAH
381 27 Feb 2023 27 Feb 2023 041704 RUBIYANTI
382 27 Feb 2023 27 Feb 2023 011982 YUMIATI
383 27 Feb 2023 27 Feb 2023 003232 SUJIONO

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384 27 Feb 2023 27 Feb 2023 041163 SHILFA MARLISHA

385 27 Feb 2023 27 Feb 2023 041583 VANIA PUTRI THALIA
386 27 Feb 2023 27 Feb 2023 039893 INAYATULLAH SALSABILA
387 27 Feb 2023 27 Feb 2023 014169 ASSYFA BILQISH MALAYEKA
388 27 Feb 2023 27 Feb 2023 041571 SAREH
389 27 Feb 2023 27 Feb 2023 041714 MUHAMAD THOHA
390 27 Feb 2023 27 Feb 2023 008508 MUHAMMAD MESSI
391 28 Feb 2023 28 Feb 2023 038683 MUHAMMAD KENZI AL ATTASHI
392 28 Feb 2023 28 Feb 2023 014281 ISMAIL
393 28 Feb 2023 28 Feb 2023 041630 MAT SIANI
394 28 Feb 2023 28 Feb 2023 041622 KEVIN PRAYOGA
395 28 Feb 2023 28 Feb 2023 031345 NESI
396 28 Feb 2023 28 Feb 2023 032433 SUKMAWATI
397 28 Feb 2023 28 Feb 2023 028364 ZELFA SEFTRIANI
398 28 Feb 2023 28 Feb 2023 041492 MAHURIP
399 28 Feb 2023 28 Feb 2023 041624 UJIK
400 28 Feb 2023 28 Feb 2023 010846 BHAIHAQI OZILIO SAPUTRA
401 28 Feb 2023 28 Feb 2023 041731 HARMUCTY FAJRIN
402 28 Feb 2023 28 Feb 2023 041566 SOBIANTO
403 28 Feb 2023 28 Feb 2023 006495 ANI

Kode RS: 1603085

Page 10
 sheet1

KLAIM - RSUD TALANG UBI

riode Tanggal Pulang: 1 Feb 2023 s/d 28 Feb 2023
Pulang = Semua / Jenis Tarif = TARIF RS KELAS D PEMERINTAH
No. Klaim / SEP INACBG Top Up Total Tarif Tarif RS Jenis
0609R0060223V000004 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000008 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000002 Q-5-44-0 188,200 182,224 RJ
0609R0060223V000013 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000018 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000003 Q-5-43-0 258,400 55,000 RJ
0609R0060223V000024 Q-5-28-0 213,100 406,948 RJ
0609R0060223V000005 Q-5-44-0 188,200 127,000 RJ
0609R0060223V000020 Z-3-25-0 304,600 145,480 RJ
0609R0060223V000009 Z-3-25-0 304,600 156,497 RJ
0609R0060223V000022 Q-5-42-0 185,200 214,954 RJ
0609R0060223V000023 K-5-18-0 236,300 270,420 RJ
0609R0060223V000015 Q-5-44-0 188,200 560,540 RJ
0609R0060223V000006 Q-5-44-0 188,200 563,840 RJ
0609R0060223V000012 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000011 Q-5-42-0 185,200 87,435 RJ
0609R0060223V000016 Q-5-44-0 188,200 563,840 RJ
0609R0060223V000017 Q-5-44-0 188,200 311,640 RJ
0609R0060223V000019 Q-5-44-0 188,200 76,576 RJ
0609R0060223V000025 K-5-18-0 236,300 286,599 RJ
0609R0060223V000014 Q-5-44-0 188,200 333,840 RJ
0609R0060223V000001 Q-5-44-0 188,200 290,273 RJ
0609R0060223V000044 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000047 Q-5-44-0 188,200 199,006 RJ
0609R0060223V000041 Q-5-44-0 188,200 337,670 RJ
0609R0060223V000032 J-3-15-0 429,500 274,940 RJ
0609R0060223V000037 Q-5-44-0 188,200 337,670 RJ
0609R0060223V000035 Z-3-27-0 187,100 175,410 RJ
0609R0060223V000045 Q-5-44-0 188,200 222,173 RJ
0609R0060223V000056 K-5-18-0 236,300 270,133 RJ
0609R0060223V000055 Q-5-20-0 203,200 615,736 RJ
0609R0060223V000053 K-5-18-0 236,300 270,359 RJ
0609R0060223V000031 Q-5-44-0 188,200 244,846 RJ
0609R0060223V000036 Q-5-44-0 188,200 142,642 RJ
0609R0060223V000034 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000039 Q-5-44-0 188,200 174,892 RJ
0609R0060223V000038 Q-5-42-0 185,200 310,950 RJ
0609R0060223V000042 Q-5-44-0 188,200 66,216 RJ
0609R0060223V000068 Q-5-42-0 185,200 183,927 RJ

Page 11
 sheet1

0609R0060223V000072 Q-5-42-0 185,200 269,149 RJ

0609R0060223V000066 Q-5-44-0 188,200 145,480 RJ
0609R0060223V000075 Q-5-42-0 185,200 426,315 RJ
0609R0060223V000069 Q-5-42-0 185,200 586,733 RJ
0609R0060223V000063 Q-5-44-0 188,200 330,880 RJ
0609R0060223V000073 Q-5-42-0 185,200 468,322 RJ
0609R0060223V000062 Q-5-44-0 188,200 109,686 RJ
0609R0060223V000065 Q-5-44-0 188,200 298,248 RJ
0609R0060223V000064 Q-5-44-0 188,200 69,208 RJ
0609R0060223V000061 K-5-18-0 236,300 282,560 RJ
0609R0060223V000067 Q-5-39-0 167,200 659,524 RJ
0609R0060223V000084 K-5-18-0 236,300 204,745 RJ
0609R0060223V000090 Q-5-44-0 188,200 1,484,091 RJ
0609R0060223V000088 K-5-18-0 236,300 293,619 RJ
0609R0060223V000089 J-3-13-0 314,800 259,538 RJ
0609R0060223V000086 J-3-13-0 314,800 173,546 RJ
0609R0060223V000083 K-5-18-0 236,300 369,458 RJ
0609R0060223V000080 Q-5-32-0 244,700 210,355 RJ
0609R0060223V000079 K-5-18-0 236,300 264,173 RJ
0609R0060223V000100 Q-5-42-0 185,200 50,000 RJ
0609R0060223V000101 Q-5-42-0 185,200 230,732 RJ
0609R0060223V000096 N-3-14-0 355,500 377,276 RJ
0609R0060223V000092 Q-5-42-0 185,200 364,879 RJ
0609R0060223V000102 N-3-14-0 355,500 397,611 RJ
0609R0060223V000099 Q-5-39-0 167,200 231,205 RJ
0609R0060223V000094 Q-5-42-0 185,200 316,048 RJ
0609R0060223V000104 K-5-18-0 236,300 294,183 RJ
0609R0060223V000095 K-5-18-0 236,300 267,973 RJ
0609R0060223V000097 Q-5-23-0 134,500 335,110 RJ
0609R0060223V000093 Q-5-39-0 167,200 440,574 RJ
0609R0060223V000138 Z-3-27-0 187,100 55,000 RJ
0609R0060223V000111 Q-5-44-0 188,200 64,578 RJ
0609R0060223V000136 Q-5-44-0 188,200 225,095 RJ
0609R0060223V000119 Q-5-44-0 188,200 104,515 RJ
0609R0060223V000134 Z-3-27-0 187,100 218,550 RJ
0609R0060223V000107 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000132 Q-5-44-0 188,200 291,023 RJ
0609R0060223V000131 Q-5-44-0 188,200 58,885 RJ
0609R0060223V000135 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000129 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000152 J-3-13-0 314,800 244,135 RJ
0609R0060223V000108 Q-5-42-0 185,200 126,273 RJ
0609R0060223V000109 Q-5-44-0 188,200 78,293 RJ

Page 12
 sheet1

0609R0060223V000112 Z-3-27-0 187,100 223,995 RJ

0609R0060223V000118 Q-5-44-0 188,200 285,948 RJ
0609R0060223V000106 K-5-18-0 236,300 195,000 RJ
0609R0060223V000126 Q-5-44-0 188,200 243,803 RJ
0609R0060223V000122 Q-5-44-0 188,200 63,316 RJ
0609R0060223V000117 Q-5-44-0 188,200 70,180 RJ
0609R0060223V000121 Q-5-43-0 258,400 55,000 RJ
0609R0060223V000142 Q-5-44-0 188,200 219,628 RJ
0609R0060223V000110 Q-5-44-0 188,200 139,408 RJ
0609R0060223V000187 Q-5-44-0 188,200 231,592 RJ
0609R0060223V000163 Q-5-44-0 188,200 118,886 RJ
0609R0060223V000181 Q-5-44-0 188,200 82,072 RJ
0609R0060223V000191 Q-5-44-0 188,200 84,150 RJ
0609R0060223V000174 Q-5-44-0 188,200 60,880 RJ
0609R0060223V000180 Q-5-44-0 188,200 57,954 RJ
0609R0060223V000182 Q-5-44-0 188,200 87,478 RJ
0609R0060223V000177 Q-5-44-0 188,200 65,975 RJ
0609R0060223V000185 Q-5-42-0 185,200 149,386 RJ
0609R0060223V000159 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000173 Q-5-44-0 188,200 198,260 RJ
0609R0060223V000164 Q-5-44-0 188,200 94,443 RJ
0609R0060223V000183 Q-5-44-0 188,200 394,337 RJ
0609R0060223V000186 Q-5-42-0 185,200 539,010 RJ
0609R0060223V000197 Q-5-42-0 185,200 653,526 RJ
0609R0060223V000158 Q-5-44-0 188,200 532,523 RJ
0609R0060223V000162 Q-5-44-0 188,200 400,702 RJ
0609R0060223V000198 K-5-18-0 236,300 79,435 RJ
0609R0060223V000160 Q-5-25-0 152,700 65,000 RJ
0609R0060223V000188 Q-5-32-0 244,700 111,255 RJ
0609R0060223V000168 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000170 Z-3-27-0 187,100 198,260 RJ
0609R0060223V000190 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000167 Z-3-23-0 544,500 202,012 RJ
0609R0060223V000166 Q-5-44-0 188,200 75,202 RJ
0609R0060223V000171 Z-3-25-0 304,600 226,997 RJ
0609R0060223V000165 Q-5-44-0 188,200 66,102 RJ
0609R0060223V000184 Q-5-44-0 188,200 198,260 RJ
0609R0060223V000195 Q-5-41-0 282,400 82,516 RJ
0609R0060223V000209 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000213 K-5-18-0 236,300 55,000 RJ
0609R0060223V000215 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000200 Q-5-44-0 188,200 106,000 RJ
0609R0060223V000229 J-3-13-0 314,800 176,671 RJ

Page 13
 sheet1

0609R0060223V000224 Q-5-42-0 185,200 475,588 RJ

0609R0060223V000227 Q-5-42-0 185,200 442,948 RJ
0609R0060223V000220 Q-5-44-0 188,200 103,615 RJ
0609R0060223V000210 Q-5-42-0 185,200 343,821 RJ
0609R0060223V000205 Q-5-44-0 188,200 209,072 RJ
0609R0060223V000204 Q-5-44-0 188,200 442,075 RJ
0609R0060223V000222 Q-5-44-0 188,200 78,721 RJ
0609R0060223V000206 Q-5-44-0 188,200 490,359 RJ
0609R0060223V000201 Q-5-44-0 188,200 60,707 RJ
0609R0060223V000212 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000219 Q-5-44-0 188,200 183,855 RJ
0609R0060223V000211 Z-3-25-0 304,600 140,000 RJ
0609R0060223V000208 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000203 Q-5-44-0 188,200 96,620 RJ
0609R0060223V000225 Q-5-42-0 185,200 414,148 RJ
0609R0060223V000248 Q-5-44-0 188,200 222,028 RJ
0609R0060223V000243 Q-5-44-0 188,200 222,028 RJ
0609R0060223V000247 Q-5-44-0 188,200 171,550 RJ
0609R0060223V000236 K-5-18-0 236,300 287,943 RJ
0609R0060223V000235 J-3-13-0 314,800 362,669 RJ
0609R0060223V000241 Q-5-44-0 188,200 104,604 RJ
0609R0060223V000239 Q-5-44-0 188,200 65,551 RJ
0609R0060223V000245 Z-3-25-0 304,600 811,000 RJ
0609R0060223V000242 Q-5-44-0 188,200 567,140 RJ
0609R0060223V000253 K-5-18-0 236,300 280,415 RJ
0609R0060223V000240 Q-5-42-0 185,200 279,045 RJ
0609R0060223V000254 K-5-18-0 236,300 222,780 RJ
0609R0060223V000255 K-5-18-0 236,300 144,554 RJ
0609R0060223V000238 U-3-13-0 384,300 253,000 RJ
0609R0060223V000267 Q-5-44-0 188,200 70,311 RJ
0609R0060223V000264 Q-5-44-0 188,200 393,550 RJ
0609R0060223V000265 Q-5-44-0 188,200 282,480 RJ
0609R0060223V000266 Q-5-44-0 188,200 60,572 RJ
0609R0060223V000268 K-5-18-0 236,300 79,932 RJ
0609R0060223V000263 Q-5-44-0 188,200 57,646 RJ
0609R0060223V000282 Q-5-42-0 185,200 141,744 RJ
0609R0060223V000280 Q-5-25-0 152,700 77,914 RJ
0609R0060223V000278 K-5-18-0 236,300 253,899 RJ
0609R0060223V000290 Q-5-42-0 185,200 57,264 RJ
0609R0060223V000288 K-5-18-0 236,300 303,154 RJ
0609R0060223V000287 Q-5-42-0 185,200 265,338 RJ
0609R0060223V000294 Q-5-42-0 185,200 82,831 RJ
0609R0060223V000298 Q-5-25-0 152,700 331,442 RJ

Page 14
 sheet1

0609R0060223V000295 Q-5-42-0 185,200 144,378 RJ

0609R0060223V000296 Q-5-42-0 185,200 77,062 RJ
0609R0060223V000292 Q-5-42-0 185,200 1,278,860 RJ
0609R0060223V000291 Q-5-42-0 185,200 53,384 RJ
0609R0060223V000293 Q-5-44-0 188,200 108,216 RJ
0609R0060223V000297 Q-5-42-0 185,200 205,394 RJ
0609R0060223V000306 Q-5-44-0 188,200 157,000 RJ
0609R0060223V000308 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000309 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000304 Q-5-44-0 188,200 88,869 RJ
0609R0060223V000305 Q-5-44-0 188,200 283,337 RJ
0609R0060223V000301 Q-5-44-0 188,200 66,984 RJ
0609R0060223V000303 Q-5-44-0 188,200 75,216 RJ
0609R0060223V000302 Q-5-44-0 188,200 75,859 RJ
0609R0060223V000299 Q-5-37-0 253,300 974,112 RJ
0609R0060223V000313 N-3-14-0 355,500 320,947 RJ
0609R0060223V000319 Q-5-42-0 185,200 159,789 RJ
0609R0060223V000317 Q-5-42-0 185,200 553,739 RJ
0609R0060223V000310 Q-5-43-0 258,400 152,500 RJ
0609R0060223V000345 Q-5-44-0 188,200 74,250 RJ
0609R0060223V000327 Q-5-44-0 188,200 67,041 RJ
0609R0060223V000340 Q-5-44-0 188,200 121,207 RJ
0609R0060223V000348 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000333 Q-5-44-0 188,200 536,780 RJ
0609R0060223V000347 Q-5-44-0 188,200 170,626 RJ
0609R0060223V000338 Q-5-44-0 188,200 236,673 RJ
0609R0060223V000322 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000323 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000341 Q-5-44-0 188,200 186,921 RJ
0609R0060223V000344 Q-5-41-0 282,400 111,427 RJ
0609R0060223V000346 Z-3-23-0 544,500 175,425 RJ
0609R0060223V000330 Z-3-27-0 187,100 232,760 RJ
0609R0060223V000342 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000343 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000321 Z-3-27-0 187,100 179,325 RJ
0609R0060223V000332 Q-5-43-0 258,400 55,000 RJ
0609R0060223V000337 Q-5-44-0 188,200 570,440 RJ
0609R0060223V000320 J-3-13-0 314,800 228,460 RJ
0609R0060223V000336 Q-5-42-0 185,200 535,508 RJ
0609R0060223V000331 Q-5-44-0 188,200 347,415 RJ
0609R0060223V000339 Q-5-44-0 188,200 84,126 RJ
0609R0060223V000335 K-5-18-0 236,300 456,348 RJ
0609R0060223V000326 Q-5-44-0 188,200 67,100 RJ

Page 15
 sheet1

0609R0060223V000328 Q-5-26-0 197,700 184,674 RJ

0609R0060223V000329 Z-3-27-0 187,100 189,000 RJ
0609R0060223V000350 K-5-18-0 236,300 419,551 RJ
0609R0060223V000365 Z-3-25-0 304,600 460,780 RJ
0609R0060223V000376 Z-3-27-0 187,100 149,410 RJ
0609R0060223V000364 Q-5-44-0 188,200 57,380 RJ
0609R0060223V000366 Q-5-44-0 188,200 88,011 RJ
0609R0060223V000374 Q-5-44-0 188,200 73,147 RJ
0609R0060223V000360 Q-5-44-0 188,200 222,070 RJ
0609R0060223V000375 Z-3-23-0 544,500 510,925 RJ
0609R0060223V000393 Q-5-25-0 152,700 281,584 RJ
0609R0060223V000370 Q-5-44-0 188,200 86,425 RJ
0609R0060223V000363 Q-5-44-0 188,200 179,201 RJ
0609R0060223V000378 Q-5-44-0 188,200 62,219 RJ
0609R0060223V000382 Q-5-44-0 188,200 212,935 RJ
0609R0060223V000358 Q-5-42-0 185,200 70,329 RJ
0609R0060223V000369 Q-5-42-0 185,200 194,639 RJ
0609R0060223V000371 Q-5-44-0 188,200 60,880 RJ
0609R0060223V000383 Q-5-42-0 185,200 744,307 RJ
0609R0060223V000379 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000362 Q-5-44-0 188,200 102,900 RJ
0609R0060223V000377 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000372 Z-3-25-0 304,600 460,300 RJ
0609R0060223V000380 Z-3-25-0 304,600 455,000 RJ
0609R0060223V000373 Z-3-27-0 187,100 166,000 RJ
0609R0060223V000404 Q-5-44-0 188,200 246,143 RJ
0609R0060223V000401 Q-5-44-0 188,200 561,970 RJ
0609R0060223V000399 Q-5-44-0 188,200 394,135 RJ
0609R0060223V000406 Q-5-44-0 188,200 107,097 RJ
0609R0060223V000408 Q-5-44-0 188,200 190,976 RJ
0609R0060223V000400 Q-5-44-0 188,200 195,226 RJ
0609R0060223V000396 U-3-15-0 244,900 258,550 RJ
0609R0060223V000403 Z-3-27-0 187,100 175,410 RJ
0609R0060223V000407 J-3-13-0 314,800 163,112 RJ
0609R0060223V000412 K-5-18-0 236,300 167,650 RJ
0609R0060223V000402 Q-5-44-0 188,200 290,307 RJ
0609R0060223V000398 Q-5-44-0 188,200 213,319 RJ
0609R0060223V000394 K-5-18-0 236,300 81,285 RJ
0609R0060223V000410 Q-5-42-0 185,200 139,747 RJ
0609R0060223V000411 Q-5-42-0 185,200 120,842 RJ
0609R0060223V000423 Q-5-42-0 185,200 290,770 RJ
0609R0060223V000420 Q-5-44-0 188,200 636,162 RJ
0609R0060223V000419 Q-5-44-0 188,200 602,644 RJ

Page 16
 sheet1

0609R0060223V000426 Q-5-44-0 188,200 95,829 RJ

0609R0060223V000433 K-5-18-0 236,300 274,581 RJ
0609R0060223V000425 Q-5-44-0 188,200 353,254 RJ
0609R0060223V000422 Q-5-44-0 188,200 85,641 RJ
0609R0060223V000428 U-3-15-0 244,900 255,218 RJ
0609R0060223V000430 K-5-18-0 236,300 217,796 RJ
0609R0060223V000434 Q-5-42-0 185,200 153,641 RJ
0609R0060223V000418 Q-5-23-0 134,500 197,082 RJ
0609R0060223V000424 Z-3-27-0 187,100 175,460 RJ
0609R0060223V000427 Z-3-23-0 544,500 182,170 RJ
0609R0060223V000421 Q-5-44-0 188,200 554,057 RJ
0609R0060223V000439 K-5-18-0 236,300 212,687 RJ
0609R0060223V000440 Q-5-42-0 185,200 147,560 RJ
0609R0060223V000443 Q-5-42-0 185,200 681,074 RJ
0609R0060223V000449 Q-5-42-0 185,200 806,428 RJ
0609R0060223V000446 Q-5-42-0 185,200 271,104 RJ
0609R0060223V000451 J-3-13-0 314,800 183,130 RJ
0609R0060223V000452 Q-5-42-0 185,200 186,762 RJ
0609R0060223V000457 J-3-13-0 314,800 209,326 RJ
0609R0060223V000488 Q-5-42-0 185,200 53,465 RJ
0609R0060223V000468 Q-5-44-0 188,200 515,000 RJ
0609R0060223V000458 Q-5-44-0 188,200 241,407 RJ
0609R0060223V000478 Q-5-43-0 258,400 58,229 RJ
0609R0060223V000464 Q-5-25-0 152,700 112,940 RJ
0609R0060223V000462 Q-5-44-0 188,200 59,921 RJ
0609R0060223V000476 Q-5-44-0 188,200 80,025 RJ
0609R0060223V000461 Q-5-44-0 188,200 132,290 RJ
0609R0060223V000471 Z-3-25-0 304,600 142,500 RJ
0609R0060223V000469 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000470 Q-5-44-0 188,200 111,316 RJ
0609R0060223V000480 Q-5-42-0 185,200 135,100 RJ
0609R0060223V000482 Q-5-25-0 152,700 77,582 RJ
0609R0060223V000474 Q-5-44-0 188,200 63,771 RJ
0609R0060223V000473 Q-5-44-0 188,200 172,415 RJ
0609R0060223V000466 Q-5-44-0 188,200 62,224 RJ
0609R0060223V000456 Q-5-44-0 188,200 315,890 RJ
0609R0060223V000459 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000463 Q-5-44-0 188,200 83,728 RJ
0609R0060223V000481 Q-5-44-0 188,200 76,140 RJ
0609R0060223V000477 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000491 Q-5-42-0 185,200 57,214 RJ
0609R0060223V000513 Q-5-23-0 134,500 246,007 RJ
0609R0060223V000502 K-5-18-0 236,300 55,000 RJ

Page 17
 sheet1

0609R0060223V000495 Z-3-23-0 544,500 172,500 RJ

0609R0060223V000504 Z-3-25-0 304,600 285,908 RJ
0609R0060223V000501 F-5-16-0 300,000 55,000 RJ
0609R0060223V000514 Q-5-42-0 185,200 367,783 RJ
0609R0060223V000496 Z-3-23-0 544,500 231,500 RJ
0609R0060223V000500 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000492 Z-3-23-0 544,500 107,500 RJ
0609R0060223V000493 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000499 Q-5-44-0 188,200 120,430 RJ
0609R0060223V000498 Q-5-44-0 188,200 285,620 RJ
0609R0060223V000505 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000503 Q-5-44-0 188,200 70,340 RJ
0609R0060223V000494 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000516 N-3-14-0 355,500 414,765 RJ
0609R0060223V000542 J-3-13-0 314,800 131,000 RJ
0609R0060223V000525 Q-5-44-0 188,200 76,860 RJ
0609R0060223V000537 Q-5-41-0 282,400 55,000 RJ
0609R0060223V000538 Q-5-41-0 282,400 55,000 RJ
0609R0060223V000539 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000521 Q-5-44-0 188,200 108,340 RJ
0609R0060223V000548 Q-5-42-0 185,200 709,750 RJ
0609R0060223V000524 J-3-13-0 314,800 176,524 RJ
0609R0060223V000530 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000541 Q-5-44-0 188,200 96,538 RJ
0609R0060223V000519 Q-5-44-0 188,200 172,594 RJ
0609R0060223V000532 Q-5-44-0 188,200 80,984 RJ
0609R0060223V000518 Z-3-27-0 187,100 216,630 RJ
0609R0060223V000543 Q-5-44-0 188,200 123,670 RJ
0609R0060223V000526 Q-5-44-0 188,200 162,316 RJ
0609R0060223V000535 Q-5-44-0 188,200 76,686 RJ
0609R0060223V000520 Q-5-44-0 188,200 205,089 RJ
0609R0060223V000529 Q-5-44-0 188,200 60,880 RJ
0609R0060223V000517 Q-5-41-0 282,400 55,000 RJ
0609R0060223V000522 Q-5-44-0 188,200 99,749 RJ
0609R0060223V000531 Q-5-44-0 188,200 311,764 RJ
0609R0060223V000534 Q-5-44-0 188,200 67,808 RJ
0609R0060223V000523 Q-5-44-0 188,200 93,929 RJ
0609R0060223V000527 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000533 Q-5-44-0 188,200 351,372 RJ
0609R0060223V000560 K-5-18-0 236,300 337,295 RJ
0609R0060223V000569 Q-5-30-0 589,400 1,170,167 RJ
0609R0060223V000554 Q-5-44-0 188,200 73,750 RJ
0609R0060223V000567 Q-5-44-0 188,200 89,845 RJ

Page 18
 sheet1

0609R0060223V000558 Q-5-44-0 188,200 78,144 RJ

0609R0060223V000559 Q-5-44-0 188,200 324,660 RJ
0609R0060223V000561 Q-5-44-0 188,200 200,984 RJ
0609R0060223V000564 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000557 Q-5-44-0 188,200 74,434 RJ
0609R0060223V000565 Q-5-44-0 188,200 539,636 RJ
0609R0060223V000563 Q-5-44-0 188,200 533,480 RJ
0609R0060223V000556 Q-5-42-0 185,200 253,000 RJ
0609R0060223V000562 Q-5-44-0 188,200 134,245 RJ
0609R0060223V000568 Q-5-44-0 188,200 201,110 RJ
0609R0060223V000553 Q-5-44-0 188,200 261,250 RJ
0609R0060223V000552 N-3-14-0 355,500 359,688 RJ
0609R0060223V000583 Q-5-44-0 188,200 211,339 RJ
0609R0060223V000589 J-3-13-0 314,800 508,264 RJ
0609R0060223V000578 U-3-13-0 384,300 150,000 RJ
0609R0060223V000577 Q-5-44-0 188,200 170,872 RJ
0609R0060223V000584 Q-5-44-0 188,200 273,630 RJ
0609R0060223V000657 Q-5-37-0 253,300 1,490,905 RJ
0609R0060223V000581 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000580 Z-3-25-0 304,600 140,000 RJ
0609R0060223V000582 Q-5-44-0 188,200 182,669 RJ
0609R0060223V000607 Q-5-42-0 185,200 219,965 RJ
0609R0060223V000599 Q-5-42-0 185,200 673,688 RJ
0609R0060223V000606 J-2-21-0 1,995,200 1,744,022 RJ
0609R0060223V000596 Z-3-25-0 304,600 140,000 RJ
0609R0060223V000604 Q-5-42-0 185,200 273,084 RJ
0609R0060223V000605 Q-5-39-0 167,200 260,609 RJ
0609R0060223V000601 Q-5-37-0 253,300 613,000 RJ
0609R0060223V000603 K-5-18-0 236,300 305,426 RJ
0609R0060223V000613 Q-5-42-0 185,200 252,659 RJ
0609R0060223V000612 J-3-13-0 314,800 310,673 RJ
0609R0060223V000611 Q-5-39-0 167,200 250,515 RJ
0609R0060223V000635 Q-5-42-0 185,200 149,201 RJ
0609R0060223V000622 Q-5-38-0 239,900 201,740 RJ
0609R0060223V000629 Q-5-44-0 188,200 71,921 RJ
0609R0060223V000627 Q-5-44-0 188,200 83,560 RJ
0609R0060223V000630 Q-5-44-0 188,200 113,328 RJ
0609R0060223V000618 Q-5-44-0 188,200 539,840 RJ
0609R0060223V000633 Q-5-44-0 188,200 87,500 RJ
0609R0060223V000626 Q-5-44-0 188,200 72,915 RJ
0609R0060223V000632 Q-5-44-0 188,200 184,846 RJ
0609R0060223V000620 Q-5-43-0 258,400 72,110 RJ
0609R0060223V000623 Q-5-44-0 188,200 110,906 RJ

Page 19
 sheet1

0609R0060223V000628 Q-5-44-0 188,200 231,787 RJ

0609R0060223V000621 Q-5-44-0 188,200 134,000 RJ
0609R0060223V000619 Q-5-42-0 185,200 55,000 RJ
0609R0060223V000631 Q-5-42-0 185,200 282,112 RJ
0609R0060223V000636 N-3-14-0 355,500 341,827 RJ
0609R0060223V000644 Q-5-44-0 188,200 1,209,884 RJ
0609R0060223V000645 J-3-13-0 314,800 177,658 RJ
0609R0060223V000651 Q-5-42-0 185,200 298,014 RJ
0609R0060223V000649 Q-5-44-0 188,200 99,094 RJ
0609R0060223V000652 Q-5-44-0 188,200 68,064 RJ
0609R0060223V000655 Q-5-44-0 188,200 55,000 RJ
0609R0060223V000667 J-3-13-0 314,800 171,077 RJ
0609R0060223V000660 Q-5-44-0 188,200 274,750 RJ
0609R0060223V000658 Q-5-44-0 188,200 560,540 RJ
0609R0060223V000659 Q-5-44-0 188,200 76,868 RJ
0609R0060223V000654 Q-5-44-0 188,200 76,686 RJ
0609R0060223V000664 Q-5-44-0 188,200 111,856 RJ
0609R0060223V000668 Q-5-42-0 185,200 751,247 RJ
0609R0060223V000653 Q-5-44-0 188,200 80,244 RJ
0609R0060223V000656 Q-5-44-0 188,200 185,266 RJ
Total 87,824,500 91,956,451

Page 20