Patient Name BUSTAMANTE, ALVIN

18,552.96 - amount to be divided

NAME OF PF % PF PF
DR. OSCA/PWD NET (for distribution) (balance still to pay)

DEL POSO, 9,407.13 50.70% 9,407.13 0.00

LEYRITANA 9,145.83 49.30% 9,145.83 0.00
0.00% 0.00 0.00
0.00% 0.00 0.00
0.00% 0.00 0.00
0.00% 0.00 0.00
0.00% 0.00 0.00
0.00% 0.00 0.00
0.00% 0.00 0.00
18,552.96 100.00% 18,552.96 0.00

not yet ref

Total .00 0.00

Grand Total .00 18,552.96 amount to be refunded
* see attached PF list (lpf) 18,552.96
Or # 2627907 5-10-22 2022-07-1278 50K DATE REFUNDED
11. Jul. 2022

Patient Name BUSTAMANTE, ALVIN

18,552.96 - amount to be divided

NAME OF PF % PF PF
DR. OSCA/PWD NET (for distribution) (balance still to pay)

DEL POSO, 9,407.13 50.70% 9,407.13 0.00

LEYRITANA 9,145.83 49.30% 9,145.83 0.00
0.00% 0.00 0.00
0.00% 0.00 0.00
0.00% 0.00 0.00
0.00% 0.00 0.00
0.00% 0.00 0.00
0.00% 0.00 0.00
0.00% 0.00 0.00
18,552.96 100.00% 18,552.96 0.00

not yet ref

Total .00 0.00

Grand Total .00 18,552.96 amount to be refunded
* see attached PF list (lpf) 18,552.96
Or # 2627907 5-10-22 2022-07-1278 50K DATE REFUNDED
11. Jul. 2022
 Patient Name NICOLAS, MARIO
' 0.00 amount to be divided

NAME OF PF % PF PF
DR. OSCA/PWD NET (for distribution) (balance still to pay)

MEJIA 32,000.00 100.00% 0.00 32,000.00

0.00% 0.00 0.00
0.00% 0.00 0.00
0.00% 0.00 0.00
0.00% 0.00 0.00
0.00% 0.00 0.00
0.00% 0.00 0.00
0.00% 0.00 0.00
32,000.00 100.00% 0.00 32,000.00

not yet ref

RF 3,240.00
MARTINEZ 800.00
MELENDREZ 400.00
LEYRITANA 800.00
PHC CAS 12,000.00
PHC CAS 20,000.00
BANZON 20,000.00
SALANDANAN 12,000.00

Total 64,000.00 5,240.00

Grand Total 96,000.00 5,240.00 amount to be refunded
* see attached PF list
DATE REFUNDED
Reference # 2021-11-0868 20K 24. Nov. 2021
5,240.00