Mix

KODE_RS KELAS_RS KELAS_RAWAT KODE_TARIF PTD ADMISSION_DATE
DISCHARGE_DATE BIRTH_DATE BIRTH_WEIGHT SEX DISCHARGE_STATUS

DIAGLIST PROCLIST ADL1 ADL2 IN_SP IN_SR IN_SI IN_SD INACBG
SUBACUTE CHRONIC SP SR SI SD DESKRIPSI_INACBG TARIF_INACBG
TARIF_SUBACUTE TARIF_CHRONIC DESKRIPSI_SP TARIF_SP DESKRIPSI_SR
TARIF_SR DESKRIPSI_SI TARIF_SI DESKRIPSI_SD TARIF_SD
TOTAL_TARIF TARIF_RS TARIF_POLI_EKS LOS ICU_INDIKATOR ICU_LOS
VENT_HOUR NAMA_PASIEN MRN UMUR_TAHUN UMUR_HARI DPJP SEP NOKARTU
PAYOR_ID CODER_ID VERSI_INACBG VERSI_GROUPER C1 C2 C3
C4 PROSEDUR_NON_BEDAH PROSEDUR_BEDAH KONSULTASI TENAGA_AHLI
KEPERAWATAN PENUNJANG RADIOLOGI LABORATORIUM PELAYANAN_DARAH
REHABILITASI KAMAR_AKOMODASI RAWAT_INTENSIF OBAT ALKES BMHP
SEWA_ALAT OBAT_KRONIS OBAT_KEMO
3372030 C 3 CP 2 01/03/2022 01/03/2022 31/12/1958 0 2
1 Z09.8;I50.0;E11.4;G59.0 - - - None None None None Q-5-
44-0 None None None None None None PENYAKIT KRONIS KECIL LAIN-LAIN 181400
0 0 - 0 - 0 - 0 - 0 181400 319988
0 1 0 0 0 SUKIRAH.NY 080728 63 23071 DR. TEKY
WIDYARINI, SP.PD 1124R0020322V000006 0001101013953 3;JKN
yani;3302226402970001; 5.6.4.202203071701 4 357213
1#0##0#0#0.0#2022-03-09
09:11:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
043040a686a1ba96680b64157bafc8a5 150000 0 0 0 0 0
0 44900 0 0 15000 0 110088 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 25/04/2000 0 2
1 A46 - - - None None None None Q-5-42-0 None None
None None None None PENYAKIT AKUT KECIL LAIN-LAIN 182600 0 0
- 0 - 0 - 0 - 0 182600 274768 0
1 0 0 0 LAURENSIA ANGGI.NN 102174 21 7980 DR.
RINA DIANA,SP.DV 1124R0020322V000007 0002047397466 3;JKN
yani;3302226402970001; 5.6.4.202203071701 4 357214
1#0##0#0#0.0#2022-03-09
09:30:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
22b2fc5b37104fb6d901e1811a29428d 150000 0 0 0 48000 0
0 0 0 0 25000 0 51768 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 10/09/1959 0 1
1 Z09.8;E11.2;N03.6;I11.9;E78.5 - - - None None None None
Q-5-44-0 None None None None None None PENYAKIT KRONIS KECIL LAIN-
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
580430 0 1 0 0 0 SUPOMO, TN 017413 62 22818
DR. TEKY WIDYARINI, SP.PD 1124R0020322V000008 0001103814246 3;JKN
yani;3302226402970001; 5.6.4.202203071701 4 357215
1#0##0#0#0.0#2022-03-09
09:32:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
73cc82ce702c12e9a004e75868001c0d 150000 0 0 0 0 0
0 89650 0 0 15000 0 325780 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 12/01/1958 0 1
1 Z09.8;E11.4;G59.0;I10 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 283472
0 1 0 0 0 ARWAN.TN 089358 64 23424 DR. TEKY
yani;3302226402970001; 5.6.4.202203071701 4 357216
1#0##0#0#0.0#2022-03-09
09:33:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a43dadcaedbf03d24f3b148055832cc2 150000 0 0 0 0 0
0 76595 0 0 15000 0 41877 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 23/11/1963 0 1
1 Z09.8;B06.9 - - - None None None None Q-5-44-0 None
None None None None None PENYAKIT KRONIS KECIL LAIN-LAIN 181400
0 0 - 0 - 0 - 0 - 0 181400 329393
0 1 0 0 0 JOKO NUGROHO., BP 043758 58 21283 DR.
yani;3302226402970001; 5.6.4.202203071701 4 357217
1#0##0#0#0.0#2022-03-09
09:34:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
47993908058674265df38f5830af5a5f 150000 0 0 0 96000 0
0 0 0 0 15000 0 68393 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 13/03/1944 0 1
1 Z09.8;K74.6 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 312894
0 1 0 0 0 SUBANDIJO.TN 083578 77 28477 DR.
TEKY WIDYARINI, SP.PD 1124R0020322V000012 0000089964911 3;JKN
yani;3302226402970001; 5.6.4.202203071701 4 357218
1#0##0#0#0.0#2022-03-09
09:35:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3a3ed6548a1acb86ff68758a77e85da5 150000 0 0 0 0 0
0 89500 0 0 15000 0 58394 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 16/09/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 339753
0 1 0 0 0 KWIN ARIANTO ., BP 053925 48 17698
yani;3302226402970001; 5.6.4.202203071701 4 357219
1#0##0#0#0.0#2022-03-09
09:36:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
411b9d77b6b99c69ef87cc4aef8d800c 150000 0 0 0 0 0
0 63690 0 0 15000 0 111063 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 17/07/1946 0 2
1 Z09.8;M75.0;M19.98 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 338298
0 1 0 0 0 JOE TJAY NIO.NY 101961 75 27621 DR.
ARIA CHANDRA GTS, SP.S., M.KES 1124R0020322V000015 0002299971712 3;JKN
yani;3302226402970001; 5.6.4.202203071701 4 357220
1#0##0#0#0.0#2022-03-09
09:37:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aa436d0c641b2307cfce52f3752b04b3 150000 0 0 0 0 0
0 121345 0 0 15000 0 51953 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 31/01/1961 0 2
1 Z09.8;I25.9 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 383937
0 1 0 0 0 UMI BAROKAH, NY 101743 61 22309 DR.
GALIH RAKASIWI SOEKARNO,SP.JP 1124R0020322V000017 0002581068205 3;JKN
yani;3302226402970001; 5.6.4.202203071701 4 357221
1#0##0#0#0.0#2022-03-09
09:38:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ec1b15748e7eeb13d432b7de25189d05 150000 0 0 0 0 0
0 120795 0 0 15000 0 98142 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 21/07/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 568884
0 1 0 0 0 SRI MURSIYATI.NY 081422 63 23234 DR.
yani;3302226402970001; 5.6.4.202203071701 4 357222
1#0##0#0#0.0#2022-03-09
09:41:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
922721e010fa6d44a17318471e2357bb 300000 0 0 0 0 0
0 120795 0 0 15000 0 133089 0 0 0 0
0
3372030 C 3 CP 2 01/03/2022 01/03/2022 14/11/1964 0 2
1 Z09.8;E11.4;G59.0;I10;E78.5 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
631413 0 1 0 0 0 NOVEANI WARIGALIATI.NY 094864
57 20926 DR. TEKY WIDYARINI, SP.PD 1124R0020322V000019
0000091486091 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357223 1#0##0#0#0.0#2022-03-09
09:42:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
82cbc1ee19d05092ac037d43afaa3fae 150000 0 0 0 0 0
0 139735 0 0 15000 0 326678 0 0 0 0
0
3372030 C 3 CP 2 01/03/2022 01/03/2022 31/12/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 239138
0 1 0 0 0 HARTINI, NY 099691 58 21245 DR. TEKY
yani;3302226402970001; 5.6.4.202203071701 4 357224
1#0##0#0#0.0#2022-03-09
09:42:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c171ae445e4455efa627e081163f1e0f 150000 0 0 0 0 0
0 44750 0 0 15000 0 29388 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 07/01/1965 0 1
1 Z09.8;E11.4;G59.0;I11.9;E78.5 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
787449 0 1 0 0 0 JAHURI BAKRI, TN 072140 57
20872 DR. TEKY WIDYARINI, SP.PD 1124R0020322V000021 0001530385525
3;JKN yani;3302226402970001; 5.6.4.202203071701 4 357225
1#0##0#0#0.0#2022-03-09
09:53:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fddda9a115ab7dda25bb8b55e5d513dc 150000 0 0 0 0 0
0 76595 0 0 15000 0 545854 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 10/12/1944 0 1
1 Z09.8;M25.51 93.35;93.39 - - None None None None M-3-
16-0 None None None None None None PROSEDUR THERAPI FISIK DAN PROSEDUR KECIL
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUWARSONO.TN
101625 77 28205 DR. LINDA SUGIARTO, SP.FKR 1124R0020322V000022
0002296249738 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357118 1#0##0#0#0.0#2022-03-09
09:54:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
77e6fd7cfc8ea1f083dfc1b31647fff1 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 31/12/1964 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
473576 0 1 0 0 0 TRI MARGINI,(NY) 034217 57
3;JKN yani;3302226402970001; 5.6.4.202203071701 4 357226
1#0##0#0#0.0#2022-03-09
09:55:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aa87a61483032057085cc1a75b2ced7a 150000 0 0 0 0 0
0 76045 0 0 15000 0 232531 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 25/02/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 675038
0 1 0 0 0 SUWARYADI BP 088697 71 25937 DR.
yani;3302226402970001; 5.6.4.202203071701 4 357227
1#0##0#0#0.0#2022-03-09
09:56:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4f74c05963622f5d0f18ac7e7a8316af 150000 0 0 0 0 0
0 76145 0 0 15000 0 433893 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 29/09/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 346524
0 1 0 0 0 SUHARDI, TN 018629 62 22799 DR. TEKY
yani;3302226402970001; 5.6.4.202203071701 4 357228
1#0##0#0#0.0#2022-03-09
09:58:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8b4c8a9711a46cad9ff41e3d51ccc42a 150000 0 0 0 0 0
0 76045 0 0 15000 0 105479 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 31/05/1972 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ENDANG HARSO SRI
P., NY 071636 49 18171 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000026 0000639771715 3;JKN yani;3302226402970001;
5.6.4.202203071701 4 357130 1#0##0#0#0.0#2022-03-09
09:59:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bcecb1d832751251341cc225ae5b0eea 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 16/06/1945 0 2
1 Z09.8;I11.9;K30 - - - None None None None Q-5-44-0
None None None None None None PENYAKIT KRONIS KECIL LAIN-LAIN 181400
0 0 - 0 - 0 - 0 - 0 181400 322542
0 1 0 0 0 SUWARTI.NY 085230 76 28017 DR. TEKY
yani;3302226402970001; 5.6.4.202203071701 4 357229
1#0##0#0#0.0#2022-03-09
10:00:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dbb8ade25034793f86157d8e0fb81d43 150000 0 0 0 0 0
0 89500 0 0 15000 0 68042 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 22/04/1960 0 2
1 Z09.8;E11.4;G59.0;I11.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 329969
0 1 0 0 0 TUMINI, NY 039188 61 22593 DR. TEKY
yani;3302226402970001; 5.6.4.202203071701 4 357230
1#0##0#0#0.0#2022-03-09
10:01:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e670ca977ff5afee1244d11e8476e883 150000 0 0 0 0 0
0 49590 0 0 15000 0 115379 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 11/05/1943 0 2
1 Z09.8;M54.59;M25.51 93.35;93.39 - - None None None None
M-3-16-0 None None None None None None PROSEDUR THERAPI FISIK DAN
PROSEDUR KECIL MUSKULOSKLETAL 107400 0 0 - 0 - 0 -
0 - 0 107400 262000 0 1 0 0 0
MURYATI.NY 094215 78 28784 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000029 0000091214796 3;JKN yani;3302226402970001;
5.6.4.202203071701 4 357125 1#0##0#0#0.0#2022-03-09
10:01:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aa292c07f533002692b3b3a4e60fe4c2 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 19/09/1958 0 1
1 Z09.8;L28.0 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 258859
0 1 0 0 0 DJOKO SRIWAHYU INDRATMOKO.TN 097650 63
23174 DR. RINA DIANA,SP.DV 1124R0020322V000030 0001483412387 3;JKN
yani;3302226402970001; 5.6.4.202203071701 4 357231
1#0##0#0#0.0#2022-03-09
10:02:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d05fbbf66f4122dabe8e95b97cf4c8d5 150000 0 0 0 48000 0
0 0 0 0 15000 0 45859 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 13/06/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 258632
0 1 0 0 0 SITI MARDLIYAH.NY 084457 50 18524 DR.
yani;3302226402970001; 5.6.4.202203071701 4 357232
1#0##0#0#0.0#2022-03-09
10:03:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5d64bfae8d1971674a0036d285d9aad1 150000 0 0 0 48000 0
0 0 0 0 15000 0 45632 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 31/12/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI SUWANTI, NY
0001967417043 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357122 1#0##0#0#0.0#2022-03-09
10:04:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
58fb9caa975c438fe7863b8c46ea4953 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 05/06/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ASIYAH INTAN
TRIANA.NY 098457 58 21454 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000033 0002050989456 3;JKN yani;3302226402970001;
5.6.4.202203071701 4 357134 1#0##0#0#0.0#2022-03-09
10:12:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9a9e09f641cc22504fa49605697f3ba2 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 05/02/1956 0 2
1 Z09.8;L91.0 99.23 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 232987
0 1 0 0 0 MARIA YULIANA SUDHARSIH.NY 099983 66
yani;3302226402970001; 5.6.4.202203071701 4 357233
1#0##0#0#0.0#2022-03-09
10:13:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a26b2b4be51b632ea7dbf4cc964bbb0e 150000 0 0 0 48000 0
0 0 0 0 15000 0 19987 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 18/01/1955 0 2
1 Z09.8;M75.0 93.35;93.39 - - None None None None M-3-16-0
None None None None None None PROSEDUR THERAPI FISIK DAN PROSEDUR KECIL
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 HARDJANINGSIH, NY
0000090992327 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357128 1#0##0#0#0.0#2022-03-09
11:15:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
99760eb3d70e7ce8e59d5774eaad7d6b 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 08/06/1950 0 2
1 Z09.8;E11.4;G59.0;I11.9;E79.0 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
382406 0 1 0 0 0 LAMIYEM.NY 087484 71 26199
novia;3313125201940001; 5.6.7.202204241238 4 357234
1#0##0#0#0.0#2022-05-19
10:39:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
5972295cd310ca9e03291df47fe6341d 150000 0 0 0 0 0
0 76595 0 0 15000 0 140811 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 07/07/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ENI PUJI ASTUTI
0002477029059 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357123 1#0##0#0#0.0#2022-03-09
11:19:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5d6857d99b482826e23f41042971be16 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 23/07/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 596760
0 1 0 0 0 SARTONO.TN 098856 48 17753 DR. TEKY
yani;3302226402970001; 5.6.4.202203071701 4 357235
1#0##0#0#0.0#2022-03-09
11:19:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4569c2ff32a2e3f84440c8610503f1a6 150000 0 0 0 0 0
0 31845 0 0 15000 0 399915 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 08/03/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 341462
0 1 0 0 0 WISNU SUPRANTO SIWI.NY 098906 59 21908
yani;3302226402970001; 5.6.4.202203071701 4 357236
1#0##0#0#0.0#2022-03-09
11:24:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c31e119e9cdab951bbf512408fc444f6 150000 0 0 0 0 0
0 63690 0 0 15000 0 112772 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 02/04/1952 0 2
1 Z09.8;I11.9;G62.9;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 342300
0 1 0 0 0 SRI SISMIATUN., NY 046455 69 25535
yani;3302226402970001; 5.6.4.202203071701 4 357237
1#0##0#0#0.0#2022-03-09
11:26:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a5b656366c84f24172dbb1efbce605dc 150000 0 0 0 0 0
0 76045 0 0 15000 0 101255 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 06/07/1954 0 2
0 - 0 107400 273000 0 1 0 0 0
SUMARNI.NY 086963 67 24710 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000041 0002347072604 3;JKN yani;3302226402970001;
5.6.4.202203071701 4 357133 1#0##0#0#0.0#2022-03-09
11:28:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
71423677913993f2af76aa381434cf42 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 10/01/1958 0 2
1 Z09.8;E11.9;I11.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 436425
0 1 0 0 0 HARYANI PARLUKI.NY 101094 64 23426
DR. SUHARTO, SP.PD 1124R0020322V000042 0000090923815 3;JKN
yani;3302226402970001; 5.6.4.202203071701 4 357238
1#0##0#0#0.0#2022-03-09
11:29:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
119f8ec1371f292141d0be0d78b7115d 150000 0 0 0 0 0
0 31845 0 0 15000 0 239580 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 17/04/1952 0 2
1 Z09.8;I11.9;M17.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 226710
0 1 0 0 0 ISMIYATI, NY 094052 69 25520 DR.
yani;3302226402970001; 5.6.4.202203071701 4 357239
1#0##0#0#0.0#2022-03-09
11:30:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6d8f8269d25533e974e4c705153f5561 150000 0 0 0 0 0
0 0 0 0 15000 0 61710 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 07/04/1958 0 2
1 Z09.8;K30;M17.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 441327
0 1 0 0 0 SUDARYANTI.NY 091986 63 23339 DR.
yani;3302226402970001; 5.6.4.202203071701 4 357240
1#0##0#0#0.0#2022-03-09
11:31:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a68d9fc39633c1c3aa890d97b5f08fbf 150000 0 0 0 0 0
0 0 0 0 15000 0 276327 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 03/07/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SOLICHATI, NY
0000091471465 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357129 1#0##0#0#0.0#2022-03-09
11:34:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
be05d9d78034209896c640194b70c4fa 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 11/09/1947 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 TUKIMAN.TN 098571
74 27200 DR. LINDA SUGIARTO, SP.FKR 1124R0020322V000046
0000555611016 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357137 1#0##0#0#0.0#2022-03-09
11:34:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a50167bc1eaa9a46a7de77ba00abf2b3 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 31/12/1951 0 1
1 Z09.8;G59.0;K76.0;K80.2 88.76 - - None None None None Z-3-
23-0 None None None None None None PROSEDUR ULTRASOUND LAIN-LAIN 549400
0 0 - 0 - 0 - 0 - 0 549400 325285
0 1 0 0 0 SUHARJO.TN 087887 70 25628 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 362012
1#0##0#0#0.0#2022-04-08
13:02:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0e6ddd5ab15f2e4d6014f6f8654ba205 150000 0 0 0 0 0
0 31845 0 0 15000 0 128440 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 17/05/1980 0 1
2 Z09.8;H26.8 90.29 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 250802
0 1 0 0 0 MOCHAMMAD SYAHRIZAL FAJRI, TN 101745 41
15263 DR. YUDHI DORANDES, SP.M 1124R0020322V000048 0002087755446
3;JKN yani;3302226402970001; 5.6.4.202203071701 4 357241
1#0##0#0#0.0#2022-03-09
11:36:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
966be92dfb8afa8c25adfea6a625f46c 203000 0 0 0 0 0
0 0 0 0 15000 0 32802 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 31/10/1967 0 1
1 Z09.8;E11.4;G59.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 196433
0 1 0 0 0 WISNU HARDONO, TN 057662 54 19845 DR.
SUHARTO, SP.PD 1124R0020322V000049 0001899941128 3;JKN
yani;3302226402970001; 5.6.4.202203071701 4 357242
1#0##0#0#0.0#2022-03-09
11:38:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2704662dfdac05b71a614c65eb459b66 150000 0 0 0 0 0
0 0 0 0 15000 0 31433 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 10/07/1992 0 1
1 Z09.8;L30.9;B35.3 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 231574
0 1 0 0 0 ADY SURYONO.SDR 099058 29 10826 DR.
yani;3302226402970001; 5.6.4.202203071701 4 357243
1#0##0#0#0.0#2022-03-09
11:41:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8f3673fac35c78a8fb4c58d80d787877 150000 0 0 0 0 0
0 0 0 0 15000 0 66574 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 29/09/1970 0 2
1 Z09.8;G81.9;M62.89 93.35;93.39 - - None None None None
0 - 0 107400 273000 0 1 0 0 0 MARIA
DIAH ANGGARAWATI ., NY 059667 51 18781 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000051 0001211692601 3;JKN yani;3302226402970001;
5.6.4.202203071701 4 357131 1#0##0#0#0.0#2022-03-09
11:42:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3ab800be56829db857c1b59c7a700b07 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 24/03/2004 0 1
0 0 - 0 - 0 - 0 - 0 181400 213000
0 1 0 0 0 RAIDYAN DAFFA ADNAN MANIAGA, SDR 101730
17 6551 DR. RINA DIANA,SP.DV 1124R0020322V000052 0001108014039
3;JKN yani;3302226402970001; 5.6.4.202203071701 4 357244
1#0##0#0#0.0#2022-03-09
11:43:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5cc18380648f1ad14f9ee776d4df19b8 150000 0 0 0 48000 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 10/06/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 297770
0 1 0 0 0 MISA AYUNINGTYAS, NY 053406 48 17796
yani;3302226402970001; 5.6.4.202203071701 4 357245
1#0##0#0#0.0#2022-03-09
11:44:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
40c898ece2671c50b484638eebf13962 150000 0 0 0 0 0
0 31845 0 0 15000 0 100925 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 22/09/1959 0 1
1 Z09.8;M54.59;G62.9 93.35;93.39 - - None None None None
0 - 0 107400 273000 0 1 0 0 0
SUMARSONO ,TN 087561 62 22806 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000055 0001032587199 3;JKN yani;3302226402970001;
5.6.4.202203071701 4 357119 1#0##0#0#0.0#2022-03-09
11:46:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
630baed4b946f52511a314b3f44c92d3 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 07/12/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 567810
0 1 0 0 0 DJUNAIDI BUDI SANTOSA.TN 092210 66
3;JKN yani;3302226402970001; 5.6.4.202203071701 4 357246
1#0##0#0#0.0#2022-03-09
11:51:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
66fc81104ca68ba434dbbf87d94de70f 150000 0 0 0 0 0
0 63690 0 0 15000 0 339120 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 10/01/1994 0 2
0 0 - 0 - 0 - 0 - 0 181400 335939
0 1 0 0 0 RETNO WULANDARI,NN 085096 28 10277
yani;3302226402970001; 5.6.4.202203071701 4 357247
1#0##0#0#0.0#2022-03-09
11:52:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
10b54c9e8de4c3284e478e5ca770c38e 150000 0 0 0 0 0
0 44300 0 0 15000 0 126639 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 09/08/1956 0 2
1 Z09.8;B35.4;B35.3 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 ARIS BUDI SUBARDINI,(NY) 032842 65
yani;3302226402970001; 5.6.4.202203071701 4 357248
1#0##0#0#0.0#2022-03-09
11:52:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
23d5dc4b80ec60aca3a6a230370936a0 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 29/12/1952 0 2
1 Z09.8;I69.3;E11.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 360295
0 1 0 0 0 DRA. SRI SUPADMINI, NY 064608 69 25264
yani;3302226402970001; 5.6.4.202203071701 4 357249
1#0##0#0#0.0#2022-03-09
11:53:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c357e7058caf33eb951883ddea7c45ba 150000 0 0 0 0 0
0 0 0 0 15000 0 195295 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 17/04/1946 0 1
0 0 - 0 - 0 - 0 - 0 181400 732686
0 1 0 0 0 GIGIK SUGIARTO, BP 062125 75 27712
yani;3302226402970001; 5.6.4.202203071701 4 357250
1#0##0#0#0.0#2022-03-09
12:00:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3c8d3ec9b069c134a68b14d59434f809 150000 0 0 0 0 0
0 0 0 0 15000 0 567686 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 14/04/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI MULYANI, NY
0000640565201 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357138 1#0##0#0#0.0#2022-03-09
12:06:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1f5117c619df82668e90827c1ea24499 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 04/04/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 565221
0 1 0 0 0 TENTREM.NY 089387 60 22246 DR. GALIH
RAKASIWI SOEKARNO,SP.JP 1124R0020322V000062 0001446726971 3;JKN
yani;3302226402970001; 5.6.4.202203071701 4 357251
1#0##0#0#0.0#2022-03-09
12:08:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8a4e4c7acfed493d50a22bbb87c0520a 300000 0 0 0 0 0
0 120795 0 0 15000 0 129426 0 0 0 0
0
3372030 C 3 CP 2 01/03/2022 01/03/2022 13/08/1947 0 1
0 0 - 0 - 0 - 0 - 0 181400 359658
0 1 0 0 0 SUDIBYONO, TN 102007 74 27229 DR.
yani;3302226402970001; 5.6.4.202203071701 4 357252
1#0##0#0#0.0#2022-03-09
12:10:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5cbc911064ab86a6b4825458a028b018 150000 0 0 0 0 0
0 108440 0 0 15000 0 86218 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 15/10/1951 0 2
1 Z09.8;I50.0;M19.98 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 263868
0 1 0 0 0 SRI SUKATMI,(NY) 015356 70 25705 DR.
yani;3302226402970001; 5.6.4.202203071701 4 357253
1#0##0#0#0.0#2022-03-09
12:14:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0e76a78877cc3e0e6cb3212323e1ef2d 150000 0 0 0 0 0
0 0 0 0 15000 0 98868 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 03/03/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 335583
0 1 0 0 0 SUPATMI, NY 042845 53 19721 DR. TEKY
yani;3302226402970001; 5.6.4.202203071701 4 357254
1#0##0#0#0.0#2022-03-09
12:15:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d1ebabc9fa60ec6053442264fc404ece 150000 0 0 0 0 0
0 0 0 0 15000 0 170583 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 09/01/1972 0 2
1 Z09.8;I10;M19.98 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 262911
0 1 0 0 0 AMINI, NY 007326 50 18314 DR. TEKY
yani;3302226402970001; 5.6.4.202203071701 4 357255
1#0##0#0#0.0#2022-03-09
12:16:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ae47e41ac612eb600bf7753951f4c505 150000 0 0 0 0 0
0 0 0 0 15000 0 97911 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 01/02/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 345774
0 1 0 0 0 ASIH SAWITRI, NY 097067 57 20847 DR.
yani;3302226402970001; 5.6.4.202203071701 4 357256
1#0##0#0#0.0#2022-03-09
12:26:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8ec7476cd1aad673913b1928a71e34b1 150000 0 0 0 0 0
0 0 0 0 15000 0 180774 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 19/12/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 501192
0 1 0 0 0 SURATNO, TN 092135 72 26370 DR. TEKY
yani;3302226402970001; 5.6.4.202203071701 4 357257
1#0##0#0#0.0#2022-03-09
12:29:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
912670e00dbbd88aacd576d8a26a98fe 150000 0 0 0 0 0
0 76595 0 0 15000 0 259597 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 16/01/1951 0 2
1 Z09.8;Z96.1;H35.0;H53.1 90.29 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 360171
0 1 0 0 0 SOFIAH.NY 087944 71 25977 DR. YUDHI
DORANDES, SP.M 1124R0020322V000069 0001387339514 3;JKN
yani;3302226402970001; 5.6.4.202203071701 4 357258
1#0##0#0#0.0#2022-03-09
12:30:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aaca57cf96cf96f9c3e671405880d80c 203000 0 0 0 0 0
0 0 0 0 15000 0 142171 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 24/07/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUTAMI.NY 099959
0000640553196 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357139 1#0##0#0#0.0#2022-03-09
12:31:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
beb8df7f5e2c81be0cf9f20f30fd99df 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 12/04/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARIYAM.NY 084306
0001302703266 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357124 1#0##0#0#0.0#2022-03-09
12:32:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e3127a08faf95aa72e391d3a2ffdfcd0 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 02/02/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUJIYEM, NY 090600
0001696847466 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357141 1#0##0#0#0.0#2022-03-09
12:34:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
09bf4ee636e08877adf6daf57976f4af 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 19/07/1950 0 2
0 - 0 107400 262000 0 1 0 0 0 SITI
WARSINI.NY 098844 71 26158 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000073 0001387776519 3;JKN yani;3302226402970001;
5.6.4.202203071701 4 357117 1#0##0#0#0.0#2022-03-09
12:35:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0616ce9698a03f7703a7aa2f6ec4559d 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 28/08/1974 0 2
1 Z09.8;I10;K21.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 236248
0 1 0 0 0 DIYATI.NY 085749 47 17352 DR. TEKY
yani;3302226402970001; 5.6.4.202203071701 4 357259
1#0##0#0#0.0#2022-03-09
12:37:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
35c151fec2216a2a67d7393358e0d775 150000 0 0 0 0 0
0 0 0 0 15000 0 71248 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 20/05/1946 0 1
0 0 - 0 - 0 - 0 - 0 181400 227733
0 1 0 0 0 MUHADI,(BP) 011312 75 27679 DR. TEKY
yani;3302226402970001; 5.6.4.202203071701 4 357260
1#0##0#0#0.0#2022-03-09
12:38:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f0c1056cd287021f1e1ae8d6cb24a4a1 150000 0 0 0 0 0
0 31845 0 0 15000 0 30888 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 17/02/1962 0 2
1 Z09.8;B90.9;J02.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 260769
0 1 0 0 0 MARYAMTI.NY 101976 60 21927 DR. ANITA
MUNTAFIAH, SP.P., M.KES 1124R0020322V000076 0000640164014 3;JKN
yani;3302226402970001; 5.6.4.202203071701 4 357261
1#0##0#0#0.0#2022-03-09
12:39:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ce45a8443bd0c51a3f931d41ef9e5aeb 150000 0 0 0 0 0
0 0 0 0 15000 0 95769 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 28/08/1964 0 1
1 B60.8 - - - None None None None Q-5-42-0 None None
- 0 - 0 - 0 - 0 182600 232800 0
1 0 0 0 SLAMET RUDI SETYAWAN, TN 000730 57 21004
DR. RINA DIANA,SP.DV 1124R0020322V000077 0001102659748 3;JKN
yani;3302226402970001; 5.6.4.202203071701 4 357262
1#0##0#0#0.0#2022-03-09
12:46:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
26b7acda79e94253d76ead7956e5ad67 150000 0 0 0 0 0
0 0 0 0 15000 0 67800 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 04/03/2008 0 1
0 0 - 0 - 0 - 0 - 0 181400 264589
0 1 0 0 0 ALESSANDRE SANTOSO, AN 097927 13 5110
yani;3302226402970001; 5.6.4.202203071701 4 357263
1#0##0#0#0.0#2022-03-09
13:25:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1864abc90e73517cb297e1e7080b5bcd 150000 0 0 0 48000 0
0 0 0 0 15000 0 51589 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 08/12/1992 0 1
1 Z09.8;G62.9 93.35;93.39 - - None None None None M-3-16-0
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ARIS ABDULLAH, BP
0000091323292 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357114 1#0##0#0#0.0#2022-03-09
13:28:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
928753d9c6a328cc6eabb445f50c8e03 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 06/09/1958 0 1
1 Z09.8;Z96.1;H40.9;H26.9;H04.1 90.29 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
391174 0 1 0 0 0 HARYATNO.TN 101375 63 23187
DR. YUDHI DORANDES, SP.M 1124R0020322V000080 0002376414775 3;JKN
yani;3302226402970001; 5.6.4.202203071701 4 357264
1#0##0#0#0.0#2022-03-09
13:31:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0c127a633dedcef12479efc59048b570 203000 0 0 0 21000 0
0 0 0 0 15000 0 152174 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 15/04/1973 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TATAS BUDIONO.TN
0001440938553 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357113 1#0##0#0#0.0#2022-03-09
13:34:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2eef8aa78cfa48736e2e74ed5168539c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 30/05/1945 0 1
1 Z09.8;A16.2;J06.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 300094
0 1 0 0 0 MURSID MUH WINOTO, TN 081013 76 28034
DR. ANITA MUNTAFIAH, SP.P., M.KES 1124R0020322V000082 0001429879048
3;JKN yani;3302226402970001; 5.6.4.202203071701 4 357265
1#0##0#0#0.0#2022-03-09
13:34:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e116b9bb85376788eec9abf5c5c303a7 150000 0 0 0 0 0
0 0 0 0 15000 0 135094 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 27/02/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SITI ZUHDIAH
0000091320906 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357142 1#0##0#0#0.0#2022-03-09
13:35:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3f9672c200f06c2f55db4886f530957c 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 29/05/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 240713
0 1 0 0 0 SUDJIATI.NY 099136 65 24017 DR. SUHARTO,
SP.PD 1124R0020322V000087 0001032589192 3;JKN yani;3302226402970001;
5.6.4.202203071701 4 357266 1#0##0#0#0.0#2022-03-09
13:40:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
591335079c57bec169cd06c63b6ced7f 150000 0 0 0 0 0
0 0 0 0 15000 0 75713 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 03/06/1974 0 1
2 Z09.8;N18.5 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SUGIYANTO.TN 094850 47 17438 DR.
reni;3313147010930001; 5.6.7.202204241238 4 357267
1#0##0#0#0.0#2022-07-05
09:05:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
f46f47680733f06c6c09553ce43e9572 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 24/02/1954 0 2
1 Z09.8;M53.19 93.39 - - None None None None M-3-16-0
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 208000 0 1 0 0 0 SRI PURWANI.NY
0001125886228 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357121 1#0##0#0#0.0#2022-03-09
13:43:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
16ee34c7ed573afb9878b6f9f13363c4 193000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 24/05/1945 0 2
1 Z09.8;R60.0;I84.9;I11.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 235912
0 1 0 0 0 SUTARMI DARSO., NY 043041 76 28040
yani;3302226402970001; 5.6.4.202203071701 4 357268
1#0##0#0#0.0#2022-03-09
13:44:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f671ba4a75ba6389150d43dbc6730b55 150000 0 0 0 0 0
0 0 0 0 15000 0 70912 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 30/08/1961 0 2
0 - 0 107400 262000 0 1 0 0 0 RIA
TRI RASMANI. NY 089448 60 22098 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000092 0001729980966 3;JKN yani;3302226402970001;
5.6.4.202203071701 4 357140 1#0##0#0#0.0#2022-03-09
13:47:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
373b74d65ec2e826f5f01ae07771eac7 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 03/08/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 RINA WIDHIASTUTIK, NY 072253 59 21760
yani;3302226402970001; 5.6.4.202203071701 4 357269
1#0##0#0#0.0#2022-03-09
13:48:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3da7c98baeb3fb1c6e73a8ce6a73f1db 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 22/04/1967 0 1
1 Z09.8;K80.2;N20.0;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 520498
0 1 0 0 0 BAGYO PRAPTANTO., BP 042554 54 20037
yani;3302226402970001; 5.6.4.202203071701 4 357270
1#0##0#0#0.0#2022-03-09
13:49:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b22f68d1b43cd0a8fa3e27a391d3c618 150000 0 0 0 0 0
0 0 0 0 15000 0 355498 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 06/04/1963 0 2
1 Z09.8;I10;G44.2 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 231759
0 1 0 0 0 IMBRIAKSI HENI ASTUTI (NY) 038025 58
3;JKN yani;3302226402970001; 5.6.4.202203071701 4 357271
1#0##0#0#0.0#2022-03-09
13:49:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4eca2affe25560dde351d1f83a97fcd8 150000 0 0 0 0 0
0 0 0 0 15000 0 66759 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 01/01/2000 0 2
0 0 - 0 - 0 - 0 - 0 181400 336857
0 1 0 0 0 TITAVIANA RAE ISWARI,(NN) 034173 22
8095 DR. ARIA CHANDRA GTS, SP.S., M.KES 1124R0020322V000097
0001466732463 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357272 1#0##0#0#0.0#2022-03-09
13:51:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e5464d897d58ddea1838916961a76d22 150000 0 0 0 0 0
0 121345 0 0 15000 0 50512 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 01/01/2000 0 1
1 M54.39;M19.99 88.27 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 473357
0 1 0 0 0 RASIM., BP 044706 22 8095 DR. ARIA
CHANDRA GTS, SP.S., M.KES 1124R0020322V000098 0001692988852 3;JKN
yani;3302226402970001; 5.6.5.202203091509 4 357629
1#0##0#0#0.0#2022-03-10
11:06:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6da49ad80c6ea4bf286b73043c4896d2 150000 0 0 0 0 0
248000 0 0 0 15000 0 60357 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 05/06/1956 0 2
1 Z09.8;I10;E11.4;G59.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 317757
0 1 0 0 0 SRI DARWANTI, NY 088347 65 24010 DR.
yani;3302226402970001; 5.6.4.202203071701 4 357273
1#0##0#0#0.0#2022-03-09
13:51:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aba69d3caee7eccd72fa1127e53f6d46 150000 0 0 0 0 0
0 31845 0 0 15000 0 120912 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 28/05/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 915368
0 1 0 0 0 ROMITA NURRATRIANA,(NY) 015145 58 21462
yani;3302226402970001; 5.6.4.202203071701 4 357274
1#0##0#0#0.0#2022-03-09
13:52:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4c949ccf74f928b9efc4b04278c359e6 150000 0 0 0 0 0
0 120795 0 0 15000 0 629573 0 0 0 0
0
3372030 C 3 CP 2 01/03/2022 01/03/2022 25/02/1972 0 1
1 Z09.8;M21.3 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 330175
0 1 0 0 0 FRANS POKAREM.TN 101944 50 18267 DR.
yani;3302226402970001; 5.6.4.202203071701 4 357275
1#0##0#0#0.0#2022-03-09
13:54:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a4c7587afcad0fdae848c7c3c04d3669 150000 0 0 0 0 0
0 120795 0 0 15000 0 44380 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 07/04/1951 0 1
1 Z09.8;J44.9;E79.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 344877
0 1 0 0 0 MUCH RODJIM SALEH, TN 101969 70 25896
3;JKN yani;3302226402970001; 5.6.4.202203071701 4 357276
1#0##0#0#0.0#2022-03-09
13:55:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
30b73e1ad8cfd9d50fb486f8b45c1c82 150000 0 0 0 0 0
0 120795 0 0 15000 0 59082 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 13/04/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 537641
0 1 0 0 0 SULINAH, NY 101460 63 23333 DR. TEKY
yani;3302226402970001; 5.6.4.202203071701 4 357277
1#0##0#0#0.0#2022-03-09
13:59:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4d9d39decf5cee554823b24fcce06006 150000 0 0 0 0 0
0 89050 0 0 15000 0 283591 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 17/01/1940 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SITI JAHIDJAH, NY
0000091261743 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357143 1#0##0#0#0.0#2022-03-09
14:00:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
139ffb7c789392ef39bdd209ceed399f 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 31/12/1958 0 1
2 L40.9 - - - None None None None Q-5-44-0 None None
None None None None PENYAKIT KRONIS KECIL LAIN-LAIN 181400 0
0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SARYANTO.,TN 075306 63 23071 DR.
yani;3302226402970001; 5.6.4.202203071701 4 357278
1#0##0#0#0.0#2022-03-09
14:01:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d1ce5f38b2f20554be30120d1f4e70af 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 25/03/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 237183
0 1 0 0 0 SUTIYEM, NY 053535 58 21526 DR. TEKY
yani;3302226402970001; 5.6.4.202203071701 4 357279
1#0##0#0#0.0#2022-03-09
14:02:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5df143cf1e611fd7b0a1a859819bd979 150000 0 0 0 0 0
0 0 0 0 15000 0 72183 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 15/12/1964 0 1
1 Z09.8;E11.9;J06.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 209767
0 1 0 0 0 R.WAHJONO PRASETYOADI, TN 094407 57
20895 DR. SUHARTO, SP.PD 1124R0020322V000107 0000640610829 3;JKN
yani;3302226402970001; 5.6.4.202203071701 4 357280
1#0##0#0#0.0#2022-03-09
14:03:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
88fa72d6f99947477ff789d55a3ad254 150000 0 0 0 0 0
0 0 0 0 15000 0 44767 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 22/08/1947 0 2
0 - 0 107400 262000 0 1 0 0 0 DYAH
NURJANTI,(NY) 042222 74 27220 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000108 0000091082722 3;JKN yani;3302226402970001;
5.6.4.202203071701 4 357115 1#0##0#0#0.0#2022-03-09
14:05:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4cea5effcd13610658b2a404ba2821fe 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 18/02/1942 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DARTINAH,NY 030952
0001021779674 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357127 1#0##0#0#0.0#2022-03-09
14:06:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e3727bebe456ea9c2a5152e48c605b06 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 19/02/1965 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 DANU MARGONO.,BP
0000640154136 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357145 1#0##0#0#0.0#2022-03-09
14:07:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d9ec19edd1034bb458edbe8bf7a185ae 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 03/07/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 LUCIA SRI
YULIANTI,(NY) 020318 52 19234 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000111 0000639909854 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 357120 1#0##0#0#0.0#2022-05-18
10:51:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
82d9b6e55768f3e65b9d738860020618 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 28/12/1949 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 NURHAYATI.NY
0001848729036 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357132 1#0##0#0#0.0#2022-03-09
14:11:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a361bc5294d0b2d5559df4b7e858328a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 20/07/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SITI ZUHRIYAH,(NY)
0000091194276 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357116 1#0##0#0#0.0#2022-03-09
14:12:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d12c62e6973261220ff7355a16e22e8b 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 05/05/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SURYATI, NY 090097
0001479655326 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357112 1#0##0#0#0.0#2022-03-09
14:14:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e36fce97db40107e4e011418181b61a6 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 21/10/1972 0 1
1 Z09.8;I10 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 229152
0 1 0 0 0 BAMBANG WASKITO.TN 100177 49 18028
yani;3302226402970001; 5.6.4.202203071701 4 357281
1#0##0#0#0.0#2022-03-09
14:14:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1756113c570d0b1a4ca1b0fffd524955 150000 0 0 0 0 0
0 0 0 0 15000 0 64152 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 25/12/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WAHJUNINGSIH
KARMADJAJA.NY 042202 64 23442 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000117 0001647209711 3;JKN yani;3302226402970001;
5.6.4.202203071701 4 357126 1#0##0#0#0.0#2022-03-09
14:15:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
67474b9ba78010c86f685bc61b66642c 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 24/02/1973 0 1
0 - 0 107400 273000 0 1 0 0 0 TRI
BUDI SUWARTO. TN 095037 49 17902 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000119 0002169435251 3;JKN yani;3302226402970001;
5.6.4.202203071701 4 357106 1#0##0#0#0.0#2022-03-09
14:16:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
083c36da4ea980307de3a0c6c78d9c65 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 20/01/1963 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 RESPATI DWI
HANANTO, TN 101981 59 21590 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000120 0001865287618 3;JKN yani;3302226402970001;
5.6.4.202203071701 4 357144 1#0##0#0#0.0#2022-03-09
14:17:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7e2d2e0a21c708ad8f035b1e5f282587 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 15/07/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 258841
0 1 0 0 0 ERLINA HERAWATI. NY 100168 50 18492
yani;3302226402970001; 5.6.4.202203071701 4 357282
1#0##0#0#0.0#2022-03-09
14:20:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
33781054b463427936c7bce235e5e9b9 150000 0 0 0 0 0
0 0 0 0 15000 0 93841 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 12/06/1979 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 TRI CAHYANINGSIH,
NY 092685 42 15603 DR. LINDA SUGIARTO, SP.FKR 1124R0020322V000122
0001530445239 3;JKN yani;3302226402970001; 5.6.4.202203071701 4
357136 1#0##0#0#0.0#2022-03-09
14:21:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a03418b2ac80270bd504a0bfb26980ac 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 01/07/1964 0 2
1 Z09.8;J18.0;R07.3 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 293571
0 1 0 0 0 WAHYUNI, NY 070031 57 21062 DR. ANITA
yani;3302226402970001; 5.6.4.202203071701 4 357283
1#0##0#0#0.0#2022-03-09
14:23:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
569ca0c60c5d0d1b264c6175af76f785 150000 0 0 0 0 0
0 0 0 0 15000 0 128571 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 05/02/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 EKO CAHYANI
PURWANINGSIH, NY 065567 49 17921 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000124 0001100445232 3;JKN yani;3302226402970001;
5.6.4.202203071701 4 357135 1#0##0#0#0.0#2022-03-09
14:26:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6ca57ebf5cefc6f9f0764e55f8629f5c 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 01/06/1944 0 2
1 Z09.8;N18.9 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 232617
0 1 0 0 0 SUJINEM,NY 086697 77 28397 DR. TEKY
yani;3302226402970001; 5.6.4.202203071701 4 357284
1#0##0#0#0.0#2022-03-09
14:30:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f2af676bbb4928984ee619a2bd59c6aa 150000 0 0 0 0 0
0 0 0 0 15000 0 67617 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 13/08/1958 0 2
1 Z09.8;G56.0 93.39 - - None None None None M-3-16-0 None
None None None None None PROSEDUR THERAPI FISIK DAN PROSEDUR KECIL
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 254000 0 1 0 0 0 TRI UTAMI
AGUSTINI, NY 048735 63 23211 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000128 0001380313934 3;JKN yani;3302226402970001;
5.6.4.202203071701 4 357107 1#0##0#0#0.0#2022-03-09
14:32:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5aa3a54db5d29785192c705b8fe01f9e 239000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 12/06/1972 0 1
1 Z49.1;N18.5 39.95 - - None None None None N-3-15-0 None
None None None None None PROSEDUR DIALISIS 786200 0 0 -
0 - 0 - 0 - 0 786200 721976 0 1
0 0 0 ICHSAN KAMIL, TN 055519 49 18159 DR. TEKY
yani;3302226402970001; 5.6.4.202203071701 4 357146
1#0##0#0#0.0#2022-03-09
14:33:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5bad7304320c227a0fe4dae6e2c45ea3 662676 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 17/04/1961 0 2
0 - 0 - 0 - 0 786200 523130 0 1
0 0 0 SUMIYATI, NY 046648 60 22233 DR. TEKY
yani;3302226402970001; 5.6.4.202203071701 4 357147
1#0##0#0#0.0#2022-03-09
14:34:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9bc18f56bc6417a4ded66ff3917e9841 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 12/08/1953 0 1
1 Z09.8;I25.9;H81.3;K30 88.27 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 496215
0 1 0 0 0 DRS SURYATMOJO.TN 095031 68 25038 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357630
1#0##0#0#0.0#2022-03-10
11:07:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
93e9aa68962d9eb429939b039c15eb5b 150000 0 0 0 0 0
248000 0 0 0 15000 0 83215 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 01/04/1981 0 1
0 - 0 - 0 - 0 786200 523130 0 1
0 0 0 GUNAWAN, TN 048814 40 14944 DR. TEKY WIDYARINI,
SP.PD 1124R0020322V000133 0001904830593 3;JKN yani;3302226402970001;
5.6.4.202203071701 4 357148 1#0##0#0#0.0#2022-03-09
14:34:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cdd058ead9668a69dc1478ce301b135e 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 06/11/2012 0 1
1 T14.1;W45.9 99.56 - - None None None None Q-5-42-0 None
None None None None None PENYAKIT AKUT KECIL LAIN-LAIN 182600 0
0 - 0 - 0 - 0 - 0 182600 393848
0 1 0 0 0 GATOT D W PRATAMA., AN 051671 9 3402
DR. SUROSO 1124R0020322V000134 0001079552338 3;JKN
reni;3313147010930001; 5.6.6.202203301209 4 360981
1#0##0#0#0.0#2022-04-04
16:45:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b3a6696f51f6b5bf6113ca6398d89736 155000 0 0 0 0 0
0 0 0 0 15000 0 223848 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 01/12/1958 0 2
0 - 0 - 0 - 0 786200 523130 0 1
0 0 0 SUNARTI, NY 067509 63 23101 DR. TEKY WIDYARINI,
SP.PD 1124R0020322V000135 0001436949538 3;JKN yani;3302226402970001;
5.6.4.202203071701 4 357149 1#0##0#0#0.0#2022-03-09
14:37:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ef189587ccb60ff6685a49300063728a 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 14/04/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 396528
0 1 0 0 0 AMIR HAUDI,(BP) 029404 64 23697 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357285
1#0##0#0#0.0#2022-03-10
07:20:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d2ec6f76977479c2fe63d0ff19901111 150000 0 0 0 0 0
0 0 0 0 15000 0 231528 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 20/08/1959 0 1
0 - 0 - 0 - 0 786200 721976 0 1
0 0 0 KARDI, TN 075513 62 22839 DR. TEKY WIDYARINI,
SP.PD 1124R0020322V000137 0000571256594 3;JKN yani;3302226402970001;
5.6.5.202203091509 4 357150 1#0##0#0#0.0#2022-03-10
07:21:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0a2efcde934226bbd117ae20183f3c19 662676 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 26/04/1964 0 1
0 - 0 - 0 - 0 786200 556987 0 1
0 0 0 SUPRIYANTO, TN 063549 57 21128 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357151
1#0##0#0#0.0#2022-03-10
07:22:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
06c7979d23ec4da0a061fe9fecd7bb19 463830 0 0 0 0 0
0 44300 0 0 15000 0 33857 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 01/12/1980 0 2
0 - 0 - 0 - 0 786200 523130 0 1
0 0 0 SUMARNI.NY 087775 41 15065 DR. TEKY WIDYARINI,
SP.PD 1124R0020322V000140 0000640230884 3;JKN yani;3302226402970001;
5.6.5.202203091509 4 357152 1#0##0#0#0.0#2022-03-10
07:22:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f124cabfecc99974ab7f3e5ae7b4e1dc 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 08/03/1967 0 1
0 - 0 - 0 - 0 786200 523130 0 1
0 0 0 JOKO PRIHATIN, TN 086133 54 20082 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357153
1#0##0#0#0.0#2022-03-10
07:22:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ef72f69fed0587dba6d3ec4e845de5ab 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 01/12/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 213147
0 1 0 0 0 ANIS ISMIATUN. NY 093561 59 21640 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357286
1#0##0#0#0.0#2022-03-10
07:23:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3cb4dfb6d31efefb225a054b43b2b18d 150000 0 0 0 0 0
0 0 0 0 15000 0 48147 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 01/05/1975 0 1
0 - 0 - 0 - 0 786200 523130 0 1
0 0 0 MAIWAN., BP 047087 46 17106 DR. TEKY WIDYARINI,
SP.PD 1124R0020322V000143 0001790328262 3;JKN yani;3302226402970001;
5.6.5.202203091509 4 357154 1#0##0#0#0.0#2022-03-10
07:24:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bf41fd95aa9d57aea498f1909203355a 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 02/09/1976 0 1
0 - 0 - 0 - 0 786200 523130 0 1
0 0 0 YOYOK BAGUS HARTONO. TN 093496 45 16616 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357156
1#0##0#0#0.0#2022-03-10
07:24:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8ea035f2d6244997134aa57e0ef9c78c 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 08/10/1957 0 1
1 Z09.8;B90.9;R06.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 302896
0 1 0 0 0 MARYANTO., BP 041763 64 23520 DR.
ANITA MUNTAFIAH, SP.P., M.KES 1124R0020322V000146 0000090898593 3;JKN
yani;3302226402970001; 5.6.5.202203091509 4 357287
1#0##0#0#0.0#2022-03-10
07:25:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1d0dda7791c8a724bad93fadf598adcd 150000 0 0 0 0 0
0 0 0 0 15000 0 137896 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 14/10/1972 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 LUSIA ANDRI, NY 048146 49 18035 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357163
1#0##0#0#0.0#2022-03-10
07:26:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e68e60271c9b906fbcc445cdce3135f9 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 08/08/2002 0 2
1 Z09.0;I84.2 96.59 - - None None None None Z-3-27-0 None
None None None None None PERAWATAN LUKA 183900 0 0 -
0 - 0 - 0 - 0 183900 243624 0 1
0 0 0 VIDYA PRISCILLA, NN 102146 19 7145 DR.
ZULFADLY, SP.B 1124R0020322V000148 0001266286015 3;JKN
yani;3302226402970001; 5.6.5.202203091509 4 357288
1#0##0#0#0.0#2022-03-10
07:27:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7d5034f9f55260633b97d3e44c3b8851 150000 0 0 0 48000 0
0 0 0 0 15000 0 30624 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 02/01/1964 0 2
1 Z09.8;I10;K30 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 477200
0 1 0 0 0 TIEN SUMARTININGSIH, NY 035771 58 21243
agung;3313092303950002; 5.6.7.202204241238 4 357289
1#0##0#0#0.0#2022-05-25
09:35:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
48cfb457d6371e7dde2ecec071d746d7 150000 0 0 0 0 0
0 312200 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 31/12/1971 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 SUYATMI, NY 051869 50 18323 DR. TEKY WIDYARINI,
SP.PD 1124R0020322V000150 0000555344774 3;JKN yani;3302226402970001;
5.6.5.202203091509 4 357164 1#0##0#0#0.0#2022-03-10
07:29:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bd417fb103d75e4ae0a7d0764a5f466d 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 23/03/1976 0 2
0 - 0 - 0 - 0 786200 677676 0 1
0 0 0 SRI YATUN, NY 056231 45 16779 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357165
1#0##0#0#0.0#2022-03-10
07:30:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0cb987b308ba595da857d796fcc055cc 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 17/04/1973 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 M KUSAENI, TN 050711 48 17850 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357166
1#0##0#0#0.0#2022-03-10
07:30:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2d692dc32db3817194502e5fdaa1b9de 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 09/10/2011 0 1
2 D66 - - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 REVAN PRATAMA A, AN 074211 10 3796
DR. ANI SURYANTI WISYASTUTI, SP.A., M.KES 1124R0020322V000153
0001281648205 3;JKN yani;3302226402970001; 5.6.5.202203091509 4
357290 1#0##0#0#0.0#2022-03-10
07:31:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
60c8e5ddfc7930685ce70d155563bd9f 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 29/01/2015 0 1
2 Z09.8;D66 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 RAFFA FAEYZA ARZIKY.AN 087732 7 2588
0001699506213 3;JKN yani;3302226402970001; 5.6.5.202203091509 4
357291 1#0##0#0#0.0#2022-03-10
07:32:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
783cd2ed8df1ba5866208ea60fbd45db 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 18/03/1988 0 1
0 - 0 - 0 - 0 786200 677676 0 1
0 0 0 EKA MARDIANTO., BP 046711 33 12401 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357167
1#0##0#0#0.0#2022-03-10
07:32:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1743b8ce090f7d5218ec39579584306e 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 23/02/2020 0 1
1 Z09.8;J06.9;A09.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 188898
0 1 0 0 0 FEBRIANDRA H P, AN 100214 2 737
0002924794811 3;JKN yani;3302226402970001; 5.6.5.202203091509 4
357295 1#0##0#0#0.0#2022-03-10
07:33:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8fd42ae2cce453da4f1219f93f9980bb 150000 0 0 0 0 0
0 0 0 0 15000 0 23898 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 10/12/1982 0 1
0 - 0 - 0 - 0 786200 677676 0 1
0 0 0 DEKKY LESMANA, TN 071695 39 14326 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357168
1#0##0#0#0.0#2022-03-10
07:34:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e0ee56c07cce2923f274c294d2a5408b 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 09/03/1969 0 1
1 R10.4 88.76 - - None None None None Z-3-23-0 None None
None None None None PROSEDUR ULTRASOUND LAIN-LAIN 549400 0 0
- 0 - 0 - 0 - 0 549400 870000 0
1 0 0 0 RINDARMADI.TN 089698 52 19350 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357296
1#0##0#0#0.0#2022-03-10
07:37:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e9e22560b6b232eb5791c81151655954 150000 0 0 0 48000 0
657000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 12/10/1987 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 ANDRI WIDIYANTO TN 067488 34 12559 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357169
1#0##0#0#0.0#2022-03-10
07:39:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d55eb87316a2e7d3ddf396ef39883446 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 25/06/1970 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 YUNI WIDIYATI, NY 032391 51 18877 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357170
1#0##0#0#0.0#2022-03-10
07:40:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2bf21b8aa55cda25421c0d7901240f68 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 15/10/1982 0 2
0 0 - 0 - 0 - 0 - 0 181400 213365
0 1 0 0 0 RATIH SETYAWATI.NY 102177 39 14382
DR. ARIA CHANDRA GTS, SP.S., M.KES 1124R0020322V000161 0001161024851
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357297
1#0##0#0#0.0#2022-03-10
07:40:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b7032997dd719d86add0dfcf31c05e7c 150000 0 0 0 0 0
0 0 0 0 25000 0 38365 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 04/09/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 ARIS HARDJENDRO,(BP) 040065 57 20997 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357171
1#0##0#0#0.0#2022-03-10
07:41:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
18991f52fc430122e4d6dc4dc0344411 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 10/07/1955 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 SUNARNI, NY 040167 66 24341 DR. TEKY WIDYARINI,
SP.PD 1124R0020322V000163 0001032581823 3;JKN yani;3302226402970001;
5.6.5.202203091509 4 357172 1#0##0#0#0.0#2022-03-10
07:42:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5e897a7a8144398b40d5edf6dea30957 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 04/05/1958 0 2
0 - 0 - 0 - 0 786200 490000 0 1
0 0 0 WORO HARTATI.NY 098597 63 23312 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357173
1#0##0#0#0.0#2022-03-10
07:42:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a40ae2c0fd61798e1752c4a1f7295983 475000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 21/09/1953 0 1
1 Z09.8;G81.9;M25.51 93.89 - - None None None None Z-3-
12-0 None None None None None None PROSEDUR REHABILITASI 138400 0
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 SLAMET DARSONO.TN 084729 68 24998 DR.
LINDA SUGIARTO, SP.FKR 1124R0020322V000165 0002199915988 3;JKN
yani;3302226402970001; 5.6.5.202203091509 4 357111
1#0##0#0#0.0#2022-03-10
07:43:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e8c16d65d6ae868d1e39f61ba8e6f5bd 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 20/11/1985 0 1
0 0 - 0 - 0 - 0 - 0 181400 304865
0 1 0 0 0 MUHAMMAD HERI SUSANTO.TN 084491 36
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357298
1#0##0#0#0.0#2022-03-10
07:44:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
898e210da0663fa3c0cde232c832ed8d 150000 0 0 0 0 0
0 0 0 0 15000 0 139865 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 03/08/1963 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 SITI ROCHMAH, NY 039323 58 21395 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357174
1#0##0#0#0.0#2022-03-10
07:45:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7a4acf213e158e9ba25167b0f9c7f706 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 20/03/1961 0 2
0 - 0 107400 262000 0 1 0 0 0 SRI
MIYATUN.NY 089374 60 22261 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000171 0000076431947 3;JKN yani;3302226402970001;
5.6.5.202203091509 4 357110 1#0##0#0#0.0#2022-03-10
07:45:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f79f11ee6aa0f46c50f5e3dc510a958b 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 22/10/1959 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 Dra. TUTUT DARYANI.NY 087431 62 22776 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357175
1#0##0#0#0.0#2022-03-10
07:46:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
507916632f8e1260107cd1306c7e9f30 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 03/03/1949 0 2
1 Z09.8;M17.9 93.89 - - None None None None Z-3-12-0 None
None None None None None PROSEDUR REHABILITASI 138400 0 0
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 MUYAS SAROH, NY 064719 72 26661 DR. LINDA
SUGIARTO, SP.FKR 1124R0020322V000176 0000091167748 3;JKN
yani;3302226402970001; 5.6.5.202203091509 4 357108
1#0##0#0#0.0#2022-03-10
07:46:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
30be49fec9d1728ea7d8cd6807d863c4 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 23/04/1960 0 2
0 - 0 107400 262000 0 1 0 0 0 SRI
WAHYUNI, NY 087660 61 22592 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000177 0000091421842 3;JKN yani;3302226402970001;
5.6.5.202203091509 4 357109 1#0##0#0#0.0#2022-03-10
07:47:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
063d122db4d2e53681df54b285c53d23 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 12/12/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 M. SARBIAN, TN 090907 57 20898 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357176
1#0##0#0#0.0#2022-03-10
07:48:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a77d915ef2b74191f5ef10e1b3e5927b 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 12/07/1966 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 UNTUNG SUMARJONO, TN 024024 55 20321 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357177
1#0##0#0#0.0#2022-03-10
07:48:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
080b2452d830ecd1777dc37ec0daa1df 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 04/08/1948 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 NGATIMIN MARTOWIYONO, TN 070607 73 26872 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357178
1#0##0#0#0.0#2022-03-10
07:49:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
829e2ffafc46793ce8166a7a2797537c 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 26/09/1963 0 1
1 Z09.8;M53.19;M19.98 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 221601
0 1 0 0 0 BAJURI, TN 000197 58 21341 DR. ARIA
novia;3313125201940001; 5.6.7.202204241238 4 357299
1#0##0#0#0.0#2022-05-18
10:09:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
1c7574f83ac855ec7c29d1e4aa173eeb 150000 0 0 0 0 0
0 0 0 0 15000 0 56601 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 01/01/1972 0 2
1 M75.0 87.49 - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 386335
0 1 0 0 0 Ny. Endang Widyaningsih 42014 50 18322 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357626
1#0##0#0#0.0#2022-03-10
07:55:57#0#00:00:01#00:00:01#13:34:44#{"co_insidense_ind":"0"} 1
fcab929a7937f507172ff49750602e65 150000 0 0 0 0 0
200000 0 0 0 15000 0 21335 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 22/04/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 376309
0 1 0 0 0 GUNARSI 079686 61 22593 DR. ARIA
yani;3302226402970001; 5.6.5.202203091509 4 357300
1#0##0#0#0.0#2022-03-10
08:00:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
18d1a86f4a8b5dbaa7993826755412af 150000 0 0 0 0 0
0 120795 0 0 15000 0 90514 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 25/11/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 327844
0 1 0 0 0 SRI WIDODO.TN 094807 53 19454 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357301
1#0##0#0#0.0#2022-03-10
08:01:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c0af6d7d1dc78f1aa3c5566aa79a7aa6 150000 0 0 0 0 0
0 0 0 0 15000 0 162844 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 26/03/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 222943
0 1 0 0 0 L M BASUKI, NY 048110 53 19698 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357302
1#0##0#0#0.0#2022-03-10
08:02:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
be0bd59ec2b4aaad0545d2c51f250206 150000 0 0 0 0 0
0 0 0 0 15000 0 57943 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 11/03/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 235169
0 1 0 0 0 SRI MULYANI,NY 069401 60 22270 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357303
1#0##0#0#0.0#2022-03-10
08:09:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
552fce3f53cef0c32df47f39bba274a2 150000 0 0 0 0 0
0 0 0 0 15000 0 70169 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 16/02/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 225874
0 1 0 0 0 THERESIA MARIA SAPTANINGRUM, NY 051521
63 23024 DR. ARIA CHANDRA GTS, SP.S., M.KES 1124R0020322V000194
0000090964833 3;JKN yani;3302226402970001; 5.6.5.202203091509 4
357304 1#0##0#0#0.0#2022-03-10
08:10:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b2126a7a912da92cc9d235282f5d9b8e 150000 0 0 0 0 0
0 0 0 0 15000 0 60874 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 02/03/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 229345
0 1 0 0 0 SUMARNI, NY 101618 58 21549 DR. ARIA
yani;3302226402970001; 5.6.5.202203091509 4 357305
1#0##0#0#0.0#2022-03-10
08:10:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b9a9a9203f5f89cb23a599bbe6867f21 150000 0 0 0 0 0
0 0 0 0 15000 0 64345 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 20/01/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 218482
0 1 0 0 0 WIWIK ERNAWATI ., NY 055264 54 19764
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357306
1#0##0#0#0.0#2022-03-10
08:12:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
520ff48420907603068d842835260e8a 150000 0 0 0 0 0
0 0 0 0 15000 0 53482 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 27/07/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 293524
0 1 0 0 0 ANDI AHMAD, TN 074066 48 17749 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357307
1#0##0#0#0.0#2022-03-10
08:14:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5fd74adde27c0d3d03f7b407362c3210 150000 0 0 0 0 0
0 0 0 0 15000 0 128524 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 10/11/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 197874
0 1 0 0 0 DIDIK SUGIYARTA.TN 098213 56 20565
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357308
1#0##0#0#0.0#2022-03-10
08:46:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
28ed2d3f69c861f737a533b7c5378837 150000 0 0 0 0 0
0 0 0 0 15000 0 32874 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 17/01/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 275667
0 1 0 0 0 INDAH PURNAMA SARI, NY 096428 45 16479
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357309
1#0##0#0#0.0#2022-03-10
08:54:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ee3f0cc96128026d01e112978c91a583 150000 0 0 0 0 0
0 0 0 0 15000 0 110667 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 22/06/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 226050
0 1 0 0 0 SRI WAHYUNI, NY 079904 67 24724 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357310
1#0##0#0#0.0#2022-03-10
08:55:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
06e676994e86e298581e308dde5234fa 150000 0 0 0 0 0
0 0 0 0 15000 0 61050 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 31/12/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 229504
0 1 0 0 0 MOCHAMMAD SALEH.NY 094814 79 28915
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357311
1#0##0#0#0.0#2022-03-10
08:56:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e812fc748e2050be45d1e7ee86a3e1ad 150000 0 0 0 0 0
0 0 0 0 15000 0 64504 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 15/05/1965 0 2
1 Z09.8;G40.9;G47.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 388796
0 1 0 0 0 PUJI SURIS TANTI NY 057197 56 20744
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357312
1#0##0#0#0.0#2022-03-10
08:56:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ef713989afa7354c994b67e9be3e6509 150000 0 0 0 0 0
0 0 0 0 15000 0 223796 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 06/11/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 225874
0 1 0 0 0 SRI HANDIKIN, (NY) 014579 79 28970
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357313
1#0##0#0#0.0#2022-03-10
08:57:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0db5a60ad4f65fc0c74ee3c464940949 150000 0 0 0 0 0
0 0 0 0 15000 0 60874 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 08/12/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 298078
0 1 0 0 0 SISWO SARJONO,(BP) 028784 72 26381
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357314
1#0##0#0#0.0#2022-03-10
08:58:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
afad388935b2e383fe2628a13b66b96a 150000 0 0 0 0 0
0 0 0 0 15000 0 133078 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 07/02/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 234520
0 1 0 0 0 SRI SULARMI NY (080054) 080088 51 18650
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357315
1#0##0#0#0.0#2022-03-10
09:03:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c16e2a21468165b96c009ab637f44b75 150000 0 0 0 0 0
0 0 0 0 15000 0 69520 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 07/05/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 255695
0 1 0 0 0 SUYAMTI, NY 071234 71 26231 DR. ARIA
yani;3302226402970001; 5.6.5.202203091509 4 357316
1#0##0#0#0.0#2022-03-10
09:04:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d23e341a8dc6a87c5c7990f31b2e9c73 150000 0 0 0 0 0
0 0 0 0 15000 0 90695 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 04/02/1966 0 1
1 Z09.8;G56.0;M19.98 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 MUJAYIN, BP 060310 56 20479 DR. ARIA
yani;3302226402970001; 5.6.5.202203091509 4 357317
1#0##0#0#0.0#2022-03-10
09:05:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
64dccd5c779697712b71d77228bfd18b 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 28/10/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 269258
0 1 0 0 0 SRI MARYANI. NY 067664 64 23500 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357318
1#0##0#0#0.0#2022-03-10
09:06:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fa5b33f6a66c8b5a6614045127b48ace 150000 0 0 0 0 0
0 0 0 0 15000 0 104258 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 16/05/1976 0 1
0 0 - 0 - 0 - 0 - 0 181400 433312
0 1 0 0 0 TEGUH PRAYITNO, TN 069729 45 16725
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357319
1#0##0#0#0.0#2022-03-10
09:07:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7fdae84ca3cda66fa1ea03c13be8fd24 150000 0 0 0 0 0
0 0 0 0 15000 0 268312 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 31/12/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 273923
0 1 0 0 0 SASTRO SUMARNO, TN 096451 76 27819
yani;3302226402970001; 5.6.5.202203091509 4 357320
1#0##0#0#0.0#2022-03-10
09:09:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fd1f52cde11713b656f814a80382bf0f 150000 0 0 0 0 0
0 0 0 0 15000 0 108923 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 20/07/1947 0 1
0 0 - 0 - 0 - 0 - 0 181400 221947
0 1 0 0 0 SOEDARMO SUPANGAT, TN 063535 74 27253
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357322
1#0##0#0#0.0#2022-03-10
09:09:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
654d95050d213e507d379abd66fcb627 150000 0 0 0 0 0
0 0 0 0 15000 0 56947 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 31/12/1996 0 2
1 Z09.8;G44.2 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 227931
0 1 0 0 0 BUNGA CHAIRUNISA CH, Ny 055808 25 9191
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357323
1#0##0#0#0.0#2022-03-10
09:16:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5a3cba4ed8439f4e5d6ad6282f65e4a2 150000 0 0 0 0 0
0 0 0 0 15000 0 62931 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 24/01/1945 0 2
1 Z09.8;I69.3;M54.39;M19.98 81.92 - - None None None None
M-3-11-0 None None None None None None PROSEDUR DIAGNOSTIK DAN
TERAPEUTIK MUSKULOSKELETAL 404900 0 0 - 0 - 0 -
0 - 0 404900 484077 0 1 0 0 0 SRI
SURASMI 085160 77 28160 DR. ARIA CHANDRA GTS, SP.S., M.KES
1124R0020322V000215 0000091328174 3;JKN yani;3302226402970001;
5.6.5.202203091509 4 357324 1#0##0#0#0.0#2022-03-10
09:17:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4a9b584089dc59b8b3791ccb29432454 150000 0 0 0 0 0
0 0 0 0 15000 0 319077 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 23/09/1954 0 2
1 Z09.8;I69.3;G44.2 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 245108
0 1 0 0 0 ROCHYATI.NY 059452 67 24631 DR. ARIA
yani;3302226402970001; 5.6.5.202203091509 4 357325
1#0##0#0#0.0#2022-03-10
09:17:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3cbc620a1b4b1bd7d6b175fceb61d31e 150000 0 0 0 0 0
0 0 0 0 15000 0 80108 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 13/10/1962 0 2
1 Z09.8;M54.39;M19.98 81.92 - - None None None None M-3-
11-0 None None None None None None PROSEDUR DIAGNOSTIK DAN TERAPEUTIK
MUSKULOSKELETAL 404900 0 0 - 0 - 0 - 0 -
0 404900 165000 0 1 0 0 0 NUNUK SUNDARI,(NY)
018287 59 21689 DR. ARIA CHANDRA GTS, SP.S., M.KES
1124R0020322V000218 0000639756303 3;JKN yani;3302226402970001;
5.6.5.202203091509 4 357326 1#0##0#0#0.0#2022-03-10
09:19:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9b3aedb2a57daf66bc769513f8072171 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 20/11/1959 0 2
1 Z09.8;I69.3;F03 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 398646
0 1 0 0 0 SRI WAHYUTRI,.NY 049706 62 22747 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357327
1#0##0#0#0.0#2022-03-10
09:20:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c7cdf30b9eb4c46873165f11e592dfd8 150000 0 0 0 0 0
0 0 0 0 15000 0 233646 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 28/04/1954 0 2
1 Z09.8;G50.9;I69.3 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 307164
0 1 0 0 0 TURIDJAH, (NY) 016034 67 24779 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357328
1#0##0#0#0.0#2022-03-10
09:20:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b27a8e91df0dab7073ddce3715de5c07 150000 0 0 0 0 0
0 0 0 0 15000 0 142164 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 05/03/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 225357
0 1 0 0 0 DANIK KARTIKA SUSILOWATI, NY 100481 48
0001445069981 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357329 1#0##0#0#0.0#2022-05-20
08:34:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
392e5fa318f21778d3a28e9dda748d54 150000 0 0 0 0 0
0 0 0 0 15000 0 60357 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 04/05/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 210733
0 1 0 0 0 WINARTO., BP 052445 66 24408 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357330
1#0##0#0#0.0#2022-03-10
09:24:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
20c188bb4e134a3a49c43684b705565b 150000 0 0 0 0 0
0 0 0 0 15000 0 45733 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 14/06/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 204375
0 1 0 0 0 SRI MURNIYANTI, NY 054964 62 22906
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357331
1#0##0#0#0.0#2022-03-10
09:27:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0956577ba999763e31f4b9fd03d8e966 150000 0 0 0 0 0
0 0 0 0 15000 0 39375 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 23/11/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 247187
0 1 0 0 0 DALIMAN, TN 073804 61 22378 DR. ARIA
yani;3302226402970001; 5.6.5.202203091509 4 357332
1#0##0#0#0.0#2022-03-10
09:27:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4c5c387c7ebde742b0b36f23c3898ace 150000 0 0 0 0 0
0 0 0 0 15000 0 82187 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 05/08/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 271535
0 1 0 0 0 SURATMI, NY 074252 60 22123 DR. ARIA
yani;3302226402970001; 5.6.5.202203091509 4 357333
1#0##0#0#0.0#2022-03-10
09:30:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d1eea4d575a7fa218c6e5a4254853792 150000 0 0 0 0 0
0 0 0 0 15000 0 106535 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 24/10/1963 0 2
1 Z09.8;I69.3;H81.4 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 322625
0 1 0 0 0 ENDANG HAPSARI ,(NY) 040328 58 21313
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357334
1#0##0#0#0.0#2022-03-10
09:32:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3607a8a6efe4087281746688f559ceb6 150000 0 0 0 0 0
0 0 0 0 15000 0 157625 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 06/09/1976 0 1
0 0 - 0 - 0 - 0 - 0 181400 215144
0 1 0 0 0 ALI WAHYANTO.TN 095695 45 16612 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357335
1#0##0#0#0.0#2022-03-10
09:32:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9f29feccf69bfbad9f800ade4048a8f8 150000 0 0 0 0 0
0 0 0 0 15000 0 50144 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 03/03/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 233024
0 1 0 0 0 SUYATMI, NY 100114 71 26296 DR. ARIA
yani;3302226402970001; 5.6.5.202203091509 4 357336
1#0##0#0#0.0#2022-03-10
09:34:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7dae19eb587e6c0f7baac8f1ecd249c2 150000 0 0 0 0 0
0 0 0 0 15000 0 68024 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 09/07/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 235109
0 1 0 0 0 SUROTO.TN 087121 62 22881 DR. ARIA
yani;3302226402970001; 5.6.5.202203091509 4 357337
1#0##0#0#0.0#2022-03-10
09:41:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6573fd6975da282f50531fe74753c47b 150000 0 0 0 0 0
0 0 0 0 15000 0 70109 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 12/06/1960 0 2
1 Z09.8;H26.9;H04.1 90.29 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 284875
0 1 0 0 0 SUWARNI.,NY 053593 61 22542 DR. YUDHI
agung;3313092303950002; 5.6.6.202203301209 4 357338
1#0##0#0#0.0#2022-04-11
11:39:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
176976a8c14190d40b296e4088a95b64 203000 0 0 0 0 0
0 0 0 0 15000 0 66875 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 07/08/1988 0 2
1 Z09.8;J45.9;J18.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 388795
0 1 0 0 0 ERIKA DEFIANA, NY 101884 33 12259 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357339
1#0##0#0#0.0#2022-03-10
09:43:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a0e449251e09c5a23d9c0dac0dda11fb 150000 0 0 0 0 0
0 0 0 0 15000 0 223795 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 24/04/2003 0 1
0 0 - 0 - 0 - 0 - 0 181400 257182
0 1 0 0 0 ASWIN PRAYOGA, SDR 101578 18 6886
yani;3302226402970001; 5.6.5.202203091509 4 357340
1#0##0#0#0.0#2022-03-10
09:43:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a4e5e577aea433c9711ef26767d204e0 203000 0 0 0 0 0
0 0 0 0 15000 0 39182 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 12/06/1952 0 1
1 J44.0 - - - None None None None Q-5-38-0 None None
None None None None GANGGUAN PARU AKUT 245800 0 0 -
0 - 0 - 0 - 0 245800 433828 0 1
0 0 0 DARMONO, TN 101015 69 25464 DR. ANITA MUNTAFIAH,
SP.P., M.KES 1124R0020322V000233 0002753154156 3;JKN
yani;3302226402970001; 5.6.5.202203091509 4 357342
1#0##0#0#0.0#2022-03-10
09:53:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c4a00591aaa341e0289c03b0d6ac1dc6 150000 0 0 0 0 0
0 0 0 0 15000 0 268828 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 14/04/1952 0 1
1 Z09.8;J44.9;I11.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 438183
0 1 0 0 0 DAUD WIDODO DHARMA WIYOTO., BP 051387
69 25523 DR. ANITA MUNTAFIAH, SP.P., M.KES 1124R0020322V000234
0002064972677 3;JKN yani;3302226402970001; 5.6.5.202203091509 4
357343 1#0##0#0#0.0#2022-03-10
09:53:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7fe7b5b25707a7ae38ec8a844623c7ce 150000 0 0 0 0 0
0 0 0 0 15000 0 273183 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 23/01/2013 0 2
0 0 - 0 - 0 - 0 - 0 181400 341514
0 1 0 0 0 ALEXZANDRIA HENDRIKA FATAHSANEE.AN 102165
9 3324 DR. YUDHI DORANDES, SP.M 1124R0020322V000235
0001854486426 3;JKN yani;3302226402970001; 5.6.5.202203091509 4
357344 1#0##0#0#0.0#2022-03-10
09:54:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c8d4b01520ab0b7683cfc693d77fdf78 203000 0 0 0 0 0
0 0 0 0 15000 0 123514 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 02/12/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 472275
0 1 0 0 0 IRIANTI, (NY) 041097 58 21274 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357346
1#0##0#0#0.0#2022-03-10
09:57:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6fc10c8ae22247b6dac85e591847d412 150000 0 0 0 0 0
0 0 0 0 15000 0 307275 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 05/02/1967 0 2
1 Z09.8;A18.0;K21.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 206949
0 1 0 0 0 SURATI, NY 041300 55 20113 DR. ANITA
yani;3302226402970001; 5.6.5.202203091509 4 357347
1#0##0#0#0.0#2022-03-10
10:00:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b3dbfc1b1e28b8ae5e5afaaf43532ee1 150000 0 0 0 0 0
0 0 0 0 15000 0 41949 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 15/05/1997 0 1
0 0 - 0 - 0 - 0 - 0 181400 421248
0 1 0 0 0 KRIS SETYOARI PAMUNGKAS.SDR 101951 24
9056 DR. ANITA MUNTAFIAH, SP.P., M.KES 1124R0020322V000239
0000562916283 3;JKN yani;3302226402970001; 5.6.5.202203091509 4
357348 1#0##0#0#0.0#2022-03-10
10:01:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ee3e396f94bfef9caa40b477bc11765f 150000 0 0 0 0 0
0 0 0 0 15000 0 256248 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 13/11/1960 0 1
1 Z09.8;Z96.1;H52.4;H04.1 90.29;95.01 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
295952 0 1 0 0 0 JOKO SETYANTO 092583 61
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357349
1#0##0#0#0.0#2022-03-10
10:02:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c7c22e8a1b614c610ee6c09b4df91047 203000 0 0 0 0 0
0 0 0 0 15000 0 77952 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 10/06/1954 0 1
1 Z09.8;J44.9;K21.9;I10 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 417178
0 1 0 0 0 PRASETYO BUDI UTOMO., BP 050807 67
0001806103236 3;JKN yani;3302226402970001; 5.6.5.202203091509 4
357350 1#0##0#0#0.0#2022-03-10
10:03:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d0ef7bd53392e4460c9083a187e2cc90 150000 0 0 0 0 0
0 0 0 0 15000 0 252178 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 03/05/1951 0 2
1 Z09.8;H26.9;H04.1;H11.0 90.29 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 252073
0 1 0 0 0 SIH WINARNI.NY 100739 70 25870 DR.
YUDHI DORANDES, SP.M 1124R0020322V000242 0000091466076 3;JKN
yani;3302226402970001; 5.6.5.202203091509 4 357351
1#0##0#0#0.0#2022-03-10
10:03:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a46d4995f120fea221923867004497cf 203000 0 0 0 0 0
0 0 0 0 15000 0 34073 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 04/06/1952 0 1
1 Z09.8;B90.9;K21.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 259575
0 1 0 0 0 SURATMAN 029384 69 25472 DR. ANITA
yani;3302226402970001; 5.6.5.202203091509 4 357352
1#0##0#0#0.0#2022-03-10
10:07:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ceb85b5649533366899f89a759e835d7 150000 0 0 0 0 0
0 0 0 0 15000 0 94575 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 05/07/1951 0 2
1 Z09.8;H26.9;H52.4;H35.0 90.29;95.01 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
284875 0 1 0 0 0 SUYANTI ., NY 000490 70
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357353
1#0##0#0#0.0#2022-03-10
10:07:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
08fe280f7edb966522a3e45fc9065f7b 203000 0 0 0 0 0
0 0 0 0 15000 0 66875 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 15/07/1972 0 2
1 Z09.8;J45.9;N39.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 482229
0 1 0 0 0 SUTARMI, NY 065115 49 18126 DR. ANITA
yani;3302226402970001; 5.6.5.202203091509 4 357354
1#0##0#0#0.0#2022-03-10
10:08:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b1d8832d092d98e918cee9e18edfc08c 150000 0 0 0 0 0
0 0 0 0 15000 0 317229 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 31/12/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 406443
0 1 0 0 0 SUMIRAH.NY 079983 66 24167 DR. GALIH
yani;3302226402970001; 5.6.5.202203091509 4 357355
1#0##0#0#0.0#2022-03-10
10:11:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cc229f1d90f98796982245c3f57fb474 300000 0 0 0 0 0
0 0 0 0 15000 0 91443 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 13/08/1951 0 2
1 Z09.8;J18.9;R07.3 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 301736
0 1 0 0 0 SUNARNI.(NY) 030534 70 25768 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357356
1#0##0#0#0.0#2022-03-10
10:11:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9782100f4a45b9d77ac7581439885caa 150000 0 0 0 0 0
0 0 0 0 15000 0 136736 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 29/04/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 KODICK SRIMULYO, TN 068587 70 25874
DR. GALIH RAKASIWI SOEKARNO,SP.JP 1124R0020322V000251 0001448103306
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357357
1#0##0#0#0.0#2022-03-10
10:12:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a5ef97400aa64ecab8d62d7e7cf150b0 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 25/05/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 460216
0 1 0 0 0 SITI ZAENAB,(NY) 033419 60 22195 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357358
1#0##0#0#0.0#2022-03-10
10:15:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
24dd6118ecfb24e95f4e99f12abe32b0 150000 0 0 0 0 0
0 0 0 0 15000 0 295216 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 11/06/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 450245
0 1 0 0 0 MUSLIMAH, NY 049121 52 19256 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357359
1#0##0#0#0.0#2022-03-10
10:15:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ff41c7fa852d795f736f35957fb4aa70 300000 0 0 0 0 0
0 0 0 0 15000 0 135245 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 03/10/1985 0 1
0 0 - 0 - 0 - 0 - 0 181400 483047
0 1 0 0 0 BRIAN MHAHENDRATA, TN 100674 36 13298
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357360
1#0##0#0#0.0#2022-03-10
10:16:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
819895d16d79a39f7a1954ed1563d7bf 150000 0 0 0 0 0
0 0 0 0 15000 0 318047 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 28/01/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 289872
0 1 0 0 0 RISTIYANTO,TN 029882 63 23043 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357361
1#0##0#0#0.0#2022-03-10
10:16:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cf74bf90da71d4f058a167c7f32a5421 150000 0 0 0 0 0
0 0 0 0 15000 0 124872 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 08/03/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 574842
0 1 0 0 0 ASMAWI (TN) 016954 64 23734 DR. GALIH
yani;3302226402970001; 5.6.5.202203091509 4 357362
1#0##0#0#0.0#2022-03-10
10:17:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
049133f1689090efae1dcacb06854c86 300000 0 0 0 0 0
0 0 0 0 15000 0 259842 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 07/04/1948 0 1
0 - 0 - 0 - 0 786200 523130 0 1
0 0 0 HARDJOKO, TN 055933 73 26991 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357160
1#0##0#0#0.0#2022-03-10
10:17:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d06e53f478903166c9f16138dffc1268 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 01/09/1964 0 1
0 - 0 - 0 - 0 786200 523130 0 1
0 0 0 WARSITO.TN 057229 57 21000 DR. TEKY WIDYARINI,
SP.PD 1124R0020322V000259 0000639614597 3;JKN yani;3302226402970001;
5.6.5.202203091509 4 357161 1#0##0#0#0.0#2022-03-10
10:18:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
480ee5a48fb3fd24d820a9a69aa76f7b 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 25/03/1978 0 2
0 - 0 - 0 - 0 786200 523130 0 1
0 0 0 SRI SURYANI.NY 084728 43 16047 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357157
1#0##0#0#0.0#2022-03-10
10:20:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c53fa136a9fa84dd7d8175ac3c45f230 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 15/05/1953 0 1
0 - 0 - 0 - 0 786200 587272 0 1
0 0 0 YOHANES HARNO D,BP 084296 68 25127 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357158
1#0##0#0#0.0#2022-03-10
10:21:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
58e3a2f66b319ea84ed62940e8ac7522 463830 0 0 0 0 0
0 44300 0 0 15000 0 64142 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 12/08/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 HERGIUS GIYONO, TN 051343 44 16272 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357162
1#0##0#0#0.0#2022-03-10
10:21:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
acab5a9d6311d7e57071924c7b31d57a 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 25/05/1972 0 1
0 - 0 - 0 - 0 786200 721976 0 1
0 0 0 SULARSO,TN 062923 49 18177 DR. TEKY WIDYARINI,
SP.PD 1124R0020322V000263 0002431552465 3;JKN yani;3302226402970001;
5.6.5.202203091509 4 357155 1#0##0#0#0.0#2022-03-10
10:22:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3ce658b42775f92fa205f03a03a9b502 662676 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 16/07/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 211327
0 1 0 0 0 APIN S ARIPIN, TN 058842 48 17760 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357363
1#0##0#0#0.0#2022-03-10
10:23:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
512e70def5d71e28b5a26a44c746c532 150000 0 0 0 0 0
0 0 0 0 15000 0 46327 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 23/12/1977 0 2
0 - 0 - 0 - 0 786200 523130 0 1
0 0 0 WIJI SUDARTI,NY 064377 44 16139 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357159
1#0##0#0#0.0#2022-03-10
10:23:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d356a0a55defb239777d9f176526fc88 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 18/03/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 192346
0 1 0 0 0 RAHARJO .TN 092313 73 27011 DR. ARIA
yani;3302226402970001; 5.6.5.202203091509 4 357364
1#0##0#0#0.0#2022-03-10
10:24:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
76e0116c82cb4597f7ffbcd5ce29da9f 150000 0 0 0 0 0
0 0 0 0 15000 0 27346 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 16/12/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 209215
0 1 0 0 0 BAMBANG WARAS SUDIBYO, TN 065239 65
0002463219077 3;JKN yani;3302226402970001; 5.6.5.202203091509 4
357365 1#0##0#0#0.0#2022-03-10
10:41:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1df29c7267704509f807ca8f5daaf108 150000 0 0 0 0 0
0 0 0 0 15000 0 44215 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 07/08/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 235730
0 1 0 0 0 SUNARNI, NY 073854 57 21025 DR. ARIA
yani;3302226402970001; 5.6.5.202203091509 4 357366
1#0##0#0#0.0#2022-03-10
10:41:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1422d66e99301e952e15b0267aa3ea07 150000 0 0 0 0 0
0 0 0 0 15000 0 70730 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 08/06/1971 0 1
1 I63.9 87.03 - - None None None None Z-3-18-0 None None
None None None None CT-SCAN KEPALA 894800 0 0 - 0
- 0 - 0 - 0 894800 217900 0 1 0
0 0 I WAYAN KADER,(BP) 015543 50 18529 DR. ARIA CHANDRA
GTS, SP.S., M.KES 1124R0020322V000269 0001104411104 3;JKN
reni;3313147010930001; 5.6.6.202203301209 4 361152
1#0##0#0#0.0#2022-04-05
09:48:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4135054900b03aa25904ac58ebac88d0 150000 0 0 0 0 0
0 0 0 0 15000 0 52900 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 31/12/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 221976
0 1 0 0 0 PARYATUN, NY 051446 70 25628 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357367
1#0##0#0#0.0#2022-03-10
10:42:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e758ee818fdaf30cc39273baed6f512f 150000 0 0 0 0 0
0 0 0 0 15000 0 56976 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 18/04/1968 0 1
1 Z09.8;G56.0;M19.98 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 218383
0 1 0 0 0 RAHMADI.TN 096843 53 19675 DR. ARIA
novia;3313125201940001; 5.6.7.202204241238 4 357368
1#0##0#0#0.0#2022-05-19
13:44:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
7b696ead758aa6f15716ac2c2e9dfa4a 150000 0 0 0 0 0
0 0 0 0 15000 0 53383 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 22/07/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 416871
0 1 0 0 0 YULIYATUN, NY 054254 55 20311 DR.
yani;3302226402970001; 5.6.5.202203091509 4 357369
1#0##0#0#0.0#2022-03-10
10:45:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6a52550c5c9d11e4d39b4d15da8d7981 300000 0 0 0 0 0
0 0 0 0 15000 0 101871 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 27/09/1948 0 1
1 Z09.8;J44.9;B48.8 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 269366
0 1 0 0 0 SLAMET MULYONO, TN 098720 73 26818
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357370
1#0##0#0#0.0#2022-03-10
10:45:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e2ffbe37a94e815e547a8e07e67e2e5c 150000 0 0 0 0 0
0 0 0 0 15000 0 104366 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 07/08/1964 0 1
0 - 0 - 0 - 0 183900 294003 0 1
0 0 0 ANDRI WIYONO.TN 101807 57 21025 DR. ZULFADLY, SP.B
1124R0020322V000277 0001094666567 3;JKN yani;3302226402970001;
5.6.5.202203091509 4 357371 1#0##0#0#0.0#2022-03-10
10:53:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6f6e1f6866505334c915ce450cbee5c9 150000 0 0 0 104000
0 0 0 0 0 15000 0 25003 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 04/07/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 617466
0 1 0 0 0 SUNARMI, NY 049475 64 23616 DR. TEKY
yani;3302226402970001; 5.6.5.202203091509 4 357372
1#0##0#0#0.0#2022-03-10
10:54:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fe7dcae544d18aef973b27922b593e6f 150000 0 0 0 0 0
0 0 0 0 15000 0 452466 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 16/09/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 225000
0 1 0 0 0 MULYANI, NY 097536 55 20255 DR. ARIA
yani;3302226402970001; 5.6.5.202203091509 4 357373
1#0##0#0#0.0#2022-03-10
10:55:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
86566277f13b250c9c4c525106e1b6c7 150000 0 0 0 0 0
0 0 0 0 15000 0 60000 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 31/12/1951 0 1
1 Z09.8;J44.9;K21.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 449996
0 1 0 0 0 ROCHMADI GITAWIYONO,(BP) 032793 70
0001614177325 3;JKN yani;3302226402970001; 5.6.5.202203091509 4
357374 1#0##0#0#0.0#2022-03-10
10:55:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3e49ece500ea83aa612ba8b63ec35a9e 150000 0 0 0 0 0
0 0 0 0 15000 0 284996 0 0 0 0 0
3372030 C 3 CP 2 01/03/2022 01/03/2022 10/06/1952 0 1
1 Z09.8;I25.9 87.49 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 673962
0 1 0 0 0 SUWANTO, TN 102251 69 25466 DR. GALIH
yani;3302226402970001; 5.6.5.202203091509 4 357375
1#0##0#0#0.0#2022-03-10
10:59:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8a53ba192b64566c40f62e693f85ad33 300000 0 0 0 0 0
200000 0 0 0 25000 0 148962 0 0 0 0
0
3372030 C 3 CP 2 01/03/2022 01/03/2022 17/06/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 SUKIMIN HADI SUMARTO.TN 090676 65 23998
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357376
1#0##0#0#0.0#2022-03-10
10:59:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
684de1400ac1466666d6dfd3682e0f07 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 02/01/1964 0 2
1 Z09.8;I10;J40 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 165000
agung;3313092303950002; 5.6.7.202204241238 4 357469
1#0##0#0#0.0#2022-05-25
09:35:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
dfd3a55f8295ac15ad66935967816566 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 10/12/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 783586
0 1 0 0 0 JOKO USMANTO 050988 61 22362 DR.
agung;3313092303950002; 5.6.5.202203091509 4 357470
1#0##0#0#0.0#2022-03-10
11:13:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
12c0f3efe373633e4d0c27d249553231 150000 0 0 0 0 0
0 31845 0 0 15000 0 586741 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 08/06/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 326010
0 1 0 0 0 HARYATI.NY 077252 72 26565 DR. TEKY
agung;3313092303950002; 5.6.5.202203091509 4 357472
1#0##0#0#0.0#2022-03-10
11:15:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
84aca32b7ef818e50ecf3cf93b98096b 150000 0 0 0 0 0
0 76145 0 0 15000 0 84865 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 31/12/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 339135
0 1 0 0 0 SLAMET, TN 071208 67 24533 DR. TEKY
agung;3313092303950002; 5.6.5.202203091509 4 357471
1#0##0#0#0.0#2022-03-10
11:14:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
71b82d342b57abec946a0b1a2cc451b9 150000 0 0 0 0 0
0 89500 0 0 15000 0 84635 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 31/12/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 570097
0 1 0 0 0 SRI SLAMET ZAENAL ARIFIN.TN 084429 63
3;JKN agung;3313092303950002; 5.6.5.202203091509 4 357473
1#0##0#0#0.0#2022-03-10
11:16:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bf7c71df13d36e0b03758adbc0e25825 150000 0 0 0 0 0
0 31845 0 0 15000 0 373252 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 15/12/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 550903
0 1 0 0 0 INDRATMOKO. TN 085811 53 19435 DR.
agung;3313092303950002; 5.6.5.202203091509 4 357474
1#0##0#0#0.0#2022-03-10
11:16:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f5a8e5f892d09c761dd6776f4c4d900f 150000 0 0 0 0 0
0 63690 0 0 15000 0 322213 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 06/06/1963 0 1
1 Z09.8;E11.2;N08.3;E79.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 857171
0 1 0 0 0 SUPARMAN, (BP) 004954 58 21454 DR.
agung;3313092303950002; 5.6.5.202203091509 4 357475
1#0##0#0#0.0#2022-03-10
11:18:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4cb2c38b1d70ca738124745e23057420 150000 0 0 0 0 0
0 121345 0 0 15000 0 570826 0 0 0 0
0
3372030 C 3 CP 2 02/03/2022 02/03/2022 26/05/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 565783
0 1 0 0 0 JUMADI ABDUL WAHAD.TN 094212 61 22560
agung;3313092303950002; 5.6.5.202203091509 4 357476
1#0##0#0#0.0#2022-03-10
11:18:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
395eaff8e893e34abefcb871f3c01844 0 0 0 0 0 0 0
76595 0 0 15000 0 474188 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 12/11/1945 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ENDANG SURTIANAH,
0000063294052 3;JKN agung;3313092303950002; 5.6.4.202203071701 4
357192 1#0##0#0#0.0#2022-03-09
14:30:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d75500b19b627452b5fbe5d23b1dd7af 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 25/07/1989 0 2
1 Z35.8;O34.2;O32.2 - - None None None None Q-5-23-0
None None None None None None PEMERIKSAAN ANTEPARTUM 127200 0
0 - 0 - 0 - 0 - 0 127200 387035
0 1 0 0 0 SAM ISNARDIANTINI, NY 061324 32 11908
DR. GUNAWAN, SP.OG 1124R0020322V000297 0001873247196 3;JKN
novia;3313125201940001; 5.6.7.202204241238 4 357478
1#0##0#0#0.0#2022-05-19
09:03:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
60b6ca0afabed120766799b67b1cfe00 350000 0 0 0 0 0
0 0 0 0 15000 0 22035 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 01/12/1952 0 2
1 Z09.8;I11.9;K30;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 403900
0 1 0 0 0 SAMIYATI,(NY) 035364 69 25293 DR.
agung;3313092303950002; 5.6.5.202203091509 4 357479
1#0##0#0#0.0#2022-03-10
11:20:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d6cad40cd22a42b5a9818c7f61565db1 300000 0 0 0 0 0
0 88900 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 09/12/1962 0 2
1 N81.4 - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 387803
0 1 0 0 0 DRA. N MULYAWATI, NY 102234 59 21633
novia;3313125201940001; 5.6.7.202204241238 4 357480
1#0##0#0#0.0#2022-05-20
10:26:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
1dd5ceeede762ef014e52933c73b129f 350000 0 0 0 0 0
0 0 0 0 15000 0 22803 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 28/11/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 649275
0 1 0 0 0 SRI SUMARTI, NY 055652 59 21644 DR.
agung;3313092303950002; 5.6.5.202203091509 4 357481
1#0##0#0#0.0#2022-03-10
11:22:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8b4f751031b1f6ee76b6ad298457a6d6 150000 0 0 0 0 0
0 31845 0 0 15000 0 452430 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 01/08/1961 0 1
1 Z09.8;E11.9;I12.0;E79.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 538946
0 1 0 0 0 NURSUKO,(BP) 033073 60 22128 DR.
agung;3313092303950002; 5.6.5.202203091509 4 357482
1#0##0#0#0.0#2022-03-10
11:28:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d5a9d4e0f1eae1384d532c077da1bacb 150000 0 0 0 0 0
0 121345 0 0 15000 0 252601 0 0 0 0
0
3372030 C 3 CP 2 02/03/2022 02/03/2022 06/04/1945 0 2
1 Z09.8;I11.0;Z96.1;H04.1 90.29 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 295952
0 1 0 0 0 YULIANA LIDWINA SUHARTI.NY 101115 76
3;JKN agung;3313092303950002; 5.6.5.202203091509 4 357483
1#0##0#0#0.0#2022-03-10
11:29:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d7536803c832b06b1ba5021ee131185a 203000 0 0 0 0 0
0 0 0 0 15000 0 77952 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 26/11/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 551917
0 1 0 0 0 SUPADMI,NY 052901 62 22742 DR. TEKY
agung;3313092303950002; 5.6.5.202203091509 4 357484
1#0##0#0#0.0#2022-03-10
11:30:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c733a1319209597ef7b57b2554638478 150000 0 0 0 0 0
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3372030 C 3 CP 2 02/03/2022 02/03/2022 24/10/1986 0 1
0 0 - 0 - 0 - 0 - 0 181400 607710
0 1 0 0 0 SATRIYO WIBOWO, TN 008478 35 12913
agung;3313092303950002; 5.6.5.202203091509 4 357485
1#0##0#0#0.0#2022-03-10
11:31:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dfb0c8dba47c4bd3905413116d729d7c 300000 0 0 0 0 0
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3372030 C 3 CP 2 02/03/2022 02/03/2022 01/05/1967 0 1
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agung;3313092303950002; 5.6.5.202203091509 4 357486
1#0##0#0#0.0#2022-03-10
11:31:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/03/2022 02/03/2022 12/07/1948 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
590791 0 1 0 0 0 SADHAM, TN 101197 73 26896
agung;3313092303950002; 5.6.5.202203091509 4 357487
1#0##0#0#0.0#2022-03-10
11:33:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/03/2022 02/03/2022 18/05/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SAMIYATI.NY 094791
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357193 1#0##0#0#0.0#2022-03-09
14:32:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ddef6f090beed08dd9191f007ef23a72 247000 0 0 0 0 0
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3372030 C 3 CP 2 02/03/2022 02/03/2022 31/12/1949 0 2
1 Z09.8;I10;K30 - - - None None None None Q-5-44-0
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agung;3313092303950002; 5.6.5.202203091509 4 357488
1#0##0#0#0.0#2022-03-10
11:34:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8dca114c94252e9bfbd67bfd7688a8aa 150000 0 0 0 0 0
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3372030 C 3 CP 2 02/03/2022 02/03/2022 25/08/1955 0 1
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agung;3313092303950002; 5.6.5.202203091509 4 357489
1#0##0#0#0.0#2022-03-10
11:35:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8c089f4e9e836942f18c659627bb9459 150000 0 0 0 0 0
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3372030 C 3 CP 2 02/03/2022 02/03/2022 06/03/1961 0 1
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agung;3313092303950002; 5.6.5.202203091509 4 357490
1#0##0#0#0.0#2022-03-10
11:36:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/03/2022 02/03/2022 06/07/1979 0 2
1 Z09.8;E05.9 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 186846
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agung;3313092303950002; 5.6.5.202203091509 4 357491
1#0##0#0#0.0#2022-03-10
11:38:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/03/2022 02/03/2022 12/02/1977 0 2
1 Z09.8;N75.0 88.79 - - None None None None Z-3-23-0 None
None None None None None PROSEDUR ULTRASOUND LAIN-LAIN 549400 0
0 - 0 - 0 - 0 - 0 549400 377650
0 1 0 0 0 SARI MUJI HASTUTI, NY 038135 45 16454
agung;3313092303950002; 5.6.5.202203091509 4 357492
1#0##0#0#0.0#2022-03-10
11:39:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e8163f4084fd6f42f8a92924abeca580 350000 0 0 0 0 0
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3372030 C 3 CP 2 02/03/2022 02/03/2022 11/08/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 543193
0 1 0 0 0 MARDIKANINGSIH,(NY) 009149 73 26866
agung;3313092303950002; 5.6.5.202203091509 4 357505
1#0##0#0#0.0#2022-03-10
11:40:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c1965d92f97b225f113d36169638fcd9 300000 0 0 0 0 0
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3372030 C 3 CP 2 02/03/2022 02/03/2022 12/04/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 523283
0 1 0 0 0 SITI ASKHURIYAH, NY 086692 53 19682
agung;3313092303950002; 5.6.5.202203091509 4 357508
1#0##0#0#0.0#2022-03-10
11:41:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
623bbcca755bd14edae5f02c9c04ab24 150000 0 0 0 0 0
0 107890 0 0 15000 0 250393 0 0 0 0
0
3372030 C 3 CP 2 02/03/2022 02/03/2022 07/12/1943 0 1
0 0 - 0 - 0 - 0 - 0 181400
1347991 0 1 0 0 0 SUBAGIO WARYADI,(BP) 007604
0000067277845 3;JKN agung;3313092303950002; 5.6.5.202203091509 4
357513 1#0##0#0#0.0#2022-03-10
11:42:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1fe2a6acee2a7f787d424e5f88dbfa61 150000 0 0 0 0 0
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3372030 C 3 CP 2 02/03/2022 02/03/2022 23/07/1972 0 2
1 Z09.8;I10;E11.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 508682
0 1 0 0 0 TRI YULIARTI 001163 49 18119 DR.
agung;3313092303950002; 5.6.5.202203091509 4 357514
1#0##0#0#0.0#2022-03-10
11:43:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cedd981d71980f2a2fcb1d8b978c9997 450000 0 0 0 0 0
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3372030 C 3 CP 2 02/03/2022 02/03/2022 10/08/1982 0 1
0 0 - 0 - 0 - 0 - 0 181400 377673
0 1 0 0 0 AGUS WIYANTO.TN 100707 39 14449 DR.
agung;3313092303950002; 5.6.5.202203091509 4 357515
1#0##0#0#0.0#2022-03-10
11:43:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4fa21d70bc66630f4dd636d22ba2917e 300000 0 0 0 0 0
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3372030 C 3 CP 2 02/03/2022 02/03/2022 31/12/1949 0 2
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agung;3313092303950002; 5.6.5.202203091509 4 357529
1#0##0#0#0.0#2022-03-10
12:32:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a13b057c005fed75130bd5be960bcaa2 150000 0 0 0 0 0
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3372030 C 3 CP 2 02/03/2022 02/03/2022 05/06/1947 0 2
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agung;3313092303950002; 5.6.5.202203091509 4 357530
1#0##0#0#0.0#2022-03-10
12:34:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ce1365b696729ae4437474a24132dd8b 150000 0 0 0 0 0
0 31845 0 0 15000 0 64053 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 30/07/1939 0 2
1 Z09.8;J40 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 355783
0 1 0 0 0 ASTITI 066027 82 30166 DR. TEKY
agung;3313092303950002; 5.6.5.202203091509 4 357531
1#0##0#0#0.0#2022-03-10
12:35:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1eb5254d77cc58cb64ac61c4378acc83 300000 0 0 0 0 0
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3372030 C 3 CP 2 02/03/2022 02/03/2022 24/03/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 206741
0 1 0 0 0 TITIK HARYANI.NY 101147 51 18971 DR.
agung;3313092303950002; 5.6.5.202203091509 4 357532
1#0##0#0#0.0#2022-03-10
12:35:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3bb2cdcb53a4011ca699bf8f4e802a55 150000 0 0 0 0 0
0 0 0 0 15000 0 41741 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 07/12/1991 0 2
1 Z35.8 88.78 - - None None None None Z-3-25-0 None None
None None None None PROSEDUR ULTRASOUND GINEKOLOGIK 296400 0
0 - 0 - 0 - 0 - 0 296400 382248
0 1 0 0 0 DESI ARIYANTI,NY 040622 30 11043 DR.
GUNAWAN, SP.OG 1124R0020322V000328 0001105944581 3;JKN
agung;3313092303950002; 5.6.5.202203091509 4 357533
1#0##0#0#0.0#2022-03-10
12:36:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0503e09962aca9cb84766d7b0571e778 350000 0 0 0 0 0
0 0 0 0 15000 0 17248 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 27/05/1966 0 2
1 Z09.8;E11.4;G59.0;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 372697
0 1 0 0 0 WATIYEM, NY 062691 55 20368 DR. TEKY
agung;3313092303950002; 5.6.5.202203091509 4 357534
1#0##0#0#0.0#2022-03-10
12:37:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
20b7637d5126882a1495e3664cf266b6 150000 0 0 0 0 0
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3372030 C 3 CP 2 02/03/2022 02/03/2022 03/07/1969 0 2
1 Z09.8;I11.9 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 190344
0 1 0 0 0 LUCIA SRI YULIANTI,(NY) 020318 52 19235
novia;3313125201940001; 5.6.7.202204241238 4 357535
1#0##0#0#0.0#2022-05-18
10:52:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 02/03/2022 02/03/2022 15/06/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 290940
0 1 0 0 0 ROMLAH IRWATI.NY 087125 64 23636 DR.
agung;3313092303950002; 5.6.5.202203091509 4 357536
1#0##0#0#0.0#2022-03-10
12:43:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
76ce6b5fb8bd75310d8cd66018d86261 150000 0 0 0 0 0
0 31845 0 0 15000 0 94095 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 25/12/1952 0 1
- 0 - 0 - 0 - 0 549400 1224690 0
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agung;3313092303950002; 5.6.5.202203091509 4 357660
1#0##0#0#0.0#2022-03-10
14:48:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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890000 0 0 0 15000 0 19690 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 02/11/1967 0 2
1 N85.8 88.79 - - None None None None Z-3-23-0 None None
- 0 - 0 - 0 - 0 549400 430196 0
1 0 0 0 TIEN INDARWATI, (NY) 012989 54 19844 DR.
agung;3313092303950002; 5.6.7.202204241238 4 361153
1#0##0#0#0.0#2022-05-25
10:53:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
6bd60cd7f03807469c618432fdc4a3b4 350000 0 0 0 0 0
0 0 0 0 15000 0 65196 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 23/03/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARSINI., NY
0001032584782 3;JKN agung;3313092303950002; 5.6.4.202203071701 4
357194 1#0##0#0#0.0#2022-03-09
14:33:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/03/2022 02/03/2022 04/09/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 418257
0 1 0 0 0 JUWITA.NY 096212 57 20998 DR. TEKY
agung;3313092303950002; 5.6.5.202203091509 4 357537
1#0##0#0#0.0#2022-03-10
12:44:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/03/2022 02/03/2022 13/01/1961 0 2
1 Z09.8;E11.4;I10;G59.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 283910
0 1 0 0 0 SARJIYEM.NY 100740 61 22328 DR. TEKY
agung;3313092303950002; 5.6.5.202203091509 4 357538
1#0##0#0#0.0#2022-03-10
12:47:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
57c658cfd6cd235121482764d1a97d7d 150000 0 0 0 0 0
0 31845 0 0 15000 0 87065 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 31/12/1965 0 1
1 H04.1;H11.1 90.29;95.01 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 344785
0 1 0 0 0 KASERI, TN 025433 56 20515 DR. YUDHI
agung;3313092303950002; 5.6.5.202203091509 4 357539
1#0##0#0#0.0#2022-03-10
13:25:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
28b2c613f368b8d34ea592129123e49e 203000 0 0 0 0 0
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3372030 C 3 CP 2 02/03/2022 02/03/2022 19/09/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 705028
0 1 0 0 0 UDIAH SISWANINGSIH . NY 062310 61 22444
agung;3313092303950002; 5.6.5.202203091509 4 357540
1#0##0#0#0.0#2022-03-10
13:27:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8182983e034315b86145dab8aca809fb 300000 0 0 0 0 0
0 31845 0 0 15000 0 358183 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 05/02/1943 0 2
0 0 - 0 - 0 - 0 - 0 181400 207350
0 1 0 0 0 CHRISTINA SURATMI.NY 084460 79 28880
agung;3313092303950002; 5.6.5.202203091509 4 357541
1#0##0#0#0.0#2022-03-10
13:55:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
22eb08cbe729937a7a76134a3f69d089 150000 0 0 0 0 0
0 0 0 0 15000 0 42350 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 03/01/1976 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUGILAH.NY 085281
0001166564171 3;JKN agung;3313092303950002; 5.6.5.202203091509 4
357196 1#0##0#0#0.0#2022-03-10
08:25:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7d681789a52c800c230ae26c08f73d8c 247000 0 0 0 0 0
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3372030 C 3 CP 2 02/03/2022 02/03/2022 30/04/1946 0 2
0 0 - 0 - 0 - 0 - 0 181400 416460
0 1 0 0 0 WARTINI, NY 094394 75 27700 DR. TEKY
agung;3313092303950002; 5.6.5.202203091509 4 357542
1#0##0#0#0.0#2022-03-10
13:56:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
34eb873126e4f324e5ad4f0e9b4c2781 150000 0 0 0 0 0
0 31845 0 0 15000 0 219615 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 15/11/1993 0 2
0 - 0 - 0 - 0 - 0 296400 382248
0 1 0 0 0 AJENG FITRIA N.D , NY 001222 28 10334
agung;3313092303950002; 5.6.5.202203091509 4 357543
1#0##0#0#0.0#2022-03-10
13:58:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
71b7398062dfb20a1e56754856609ce8 350000 0 0 0 0 0
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3372030 C 3 CP 2 02/03/2022 02/03/2022 14/04/1993 0 2
1 Z35.8;O34.2 88.78 - - None None None None Z-3-25-0 None
None None None None None PROSEDUR ULTRASOUND GINEKOLOGIK 296400
0 0 - 0 - 0 - 0 - 0 296400 379465
0 1 0 0 0 LITA SUGIARTI, NY 100936 28 10549 DR.
novia;3313125201940001; 5.6.7.202204241238 4 357544
1#0##0#0#0.0#2022-05-20
09:15:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
dcfa2fcaaadf13f4b0066017081c72e5 350000 0 0 0 0 0
0 0 0 0 15000 0 14465 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 05/03/1985 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 284000 0 1 0 0 0 DIAN USWATUN
HASANAH, NY 063907 36 13511 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000352 0000977864152 3;JKN agung;3313092303950002;
5.6.5.202203091509 4 357195 1#0##0#0#0.0#2022-03-10
08:26:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6ad2333870e95988aaec7665d21b3875 269000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 08/11/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ENDAH PURWANTI, NY
0001692526781 3;JKN agung;3313092303950002; 5.6.5.202203091509 4
357197 1#0##0#0#0.0#2022-03-10
08:27:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/03/2022 02/03/2022 05/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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SUSILOWATI, NY 100481 48 17894 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000356 0001445069981 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 357207 1#0##0#0#0.0#2022-05-20
08:34:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 02/03/2022 02/03/2022 11/07/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI PARYATI, NY
0000091170516 3;JKN agung;3313092303950002; 5.6.5.202203091509 4
357203 1#0##0#0#0.0#2022-03-10
08:29:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ffe7c515972dd59deb8a249e10956228 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 18/04/1968 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 RAHMADI.TN 096843
0002169726311 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357208 1#0##0#0#0.0#2022-05-19
13:44:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
24db24a90f6f2f3a7cf04cdaa08248fe 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 07/10/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 NUR LASMI, NY
0000639913318 3;JKN agung;3313092303950002; 5.6.5.202203091509 4
357188 1#0##0#0#0.0#2022-03-10
08:30:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5da33b34f833e92a361ba1a431d292c1 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 03/06/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 410662
0 1 0 0 0 RUBIJANTO, TN 099383 66 24379 DR.
agung;3313092303950002; 5.6.5.202203091509 4 357545
1#0##0#0#0.0#2022-03-10
14:00:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ab9e10ab984722b56609a259dc179d17 203000 0 0 0 0 0
0 0 0 0 15000 0 192662 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 28/04/1986 0 2
None None None None None PEMERIKSAAN POSTPARTUM 86900 0 0 -
0 - 0 - 0 - 0 86900 443664 0 1 0
0 0 USWATUN KHASANAH.NY 100768 35 13092 DR. GUNAWAN, SP.OG
1124R0020322V000362 0002933748516 3;JKN agung;3313092303950002;
5.6.5.202203091509 4 357546 1#0##0#0#0.0#2022-03-10
14:01:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ba4d60dc1908ad295d9955a064356b4c 350000 0 0 0 0 0
0 0 0 0 15000 0 78664 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 14/04/1960 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARTINAH., NY
0001084606863 3;JKN agung;3313092303950002; 5.6.5.202203091509 4
357205 1#0##0#0#0.0#2022-03-10
08:31:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
53b6cb9d5a4714b1eff5ae691629abc0 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 08/07/1963 0 2
1 H26.9;H11.0;H04.1 90.29 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 335370
0 1 0 0 0 HANANI,(NY) 039060 58 21422 DR. YUDHI
agung;3313092303950002; 5.6.5.202203091509 4 357547
1#0##0#0#0.0#2022-03-10
14:02:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
95215f93fc9ddf7806dc5e5cf5b55c17 203000 0 0 0 0 0
0 0 0 0 15000 0 117370 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 09/05/1949 0 1
1 Z09.8;Z96.1;H26.9 90.29 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 310076
0 1 0 0 0 TRIYONO TRI DARMA W, TN 064721 72 26595
agung;3313092303950002; 5.6.5.202203091509 4 357548
1#0##0#0#0.0#2022-03-10
14:03:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a9804cadb64ee289c4bdf989b187113d 203000 0 0 0 0 0
0 0 0 0 15000 0 92076 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 16/08/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TRI WINARNI, NY
0000640206066 3;JKN agung;3313092303950002; 5.6.5.202203091509 4
357204 63#0##0#0#0.0#2022-03-10
08:31:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
18067e993b3f28c737609850c3f0ce9b 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 03/12/1950 0 1
0 - 0 - 0 - 0 786200 523130 0 1
0 0 0 WARSO DIHARJO, BP 050194 71 26022 DR. TEKY
agung;3313092303950002; 5.6.5.202203091509 4 357179
1#0##0#0#0.0#2022-03-10
08:32:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1792ebaf735f3bc7682402656a4104d2 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 09/09/1944 0 1
0 - 0 - 0 - 0 786200 523130 0 1
0 0 0 HARWOKO, TN 063244 77 28298 DR. TEKY WIDYARINI,
SP.PD 1124R0020322V000368 0000100867893 3;JKN agung;3313092303950002;
5.6.5.202203091509 4 357180 1#0##0#0#0.0#2022-03-10
08:33:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a2ef98820a833c5f35dc60636a1cebef 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 13/07/2003 0 1
0 0 - 0 - 0 - 0 - 0 181400 258282
0 1 0 0 0 FRIDO FUAD HERAWAN, SDR 098652 18 6807
agung;3313092303950002; 5.6.5.202203091509 4 357549
1#0##0#0#0.0#2022-03-10
14:04:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5935222cef204164545155c40a9dd735 203000 0 0 0 0 0
0 0 0 0 15000 0 40282 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 18/07/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 SUNARNO, BP 062099 57 21046 DR. TEKY WIDYARINI,
SP.PD 1124R0020322V000370 0002425018184 3;JKN agung;3313092303950002;
5.6.5.202203091509 4 357627 1#0##0#0#0.0#2022-03-10
08:34:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9b1486bc5aad41be72a95abf7c4ed2e2 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 31/12/1981 0 2
0 - 0 - 0 - 0 786200 523130 0 1
0 0 0 SULASTRI, NY 067303 40 14671 DR. TEKY
agung;3313092303950002; 5.6.5.202203091509 4 357182
1#0##0#0#0.0#2022-03-10
08:34:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5fc612b63549f888f54d51bf0a760f3b 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 12/12/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 362773
0 1 0 0 0 SITI CHOSIYAH., NY 045191 74 27109
agung;3313092303950002; 5.6.5.202203091509 4 357550
1#0##0#0#0.0#2022-03-10
14:06:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
caa3ec2718509b628083cf218c8f3193 203000 0 0 0 0 0
0 0 0 0 15000 0 144773 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 02/02/1972 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 MUSIYEM.NY 084045 50 18291 DR. TEKY WIDYARINI,
SP.PD 1124R0020322V000373 0002070978546 3;JKN agung;3313092303950002;
5.6.5.202203091509 4 357628 1#0##0#0#0.0#2022-03-10
08:36:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d65b5b3c1a6893f6907e5a7017bb70da 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 28/03/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MV SUMARNI, NY
0002209650344 3;JKN agung;3313092303950002; 5.6.5.202203091509 4
357210 1#0##0#0#0.0#2022-03-10
08:59:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
927589f9eda7dd8f5ab8ac5d81b708b7 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 12/03/1955 0 2
0 - 0 - 0 - 0 786200 721976 0 1
0 0 0 SRI PONIMAH., NY 043214 66 24462 DR. TEKY
agung;3313092303950002; 5.6.5.202203091509 4 357183
1#0##0#0#0.0#2022-03-10
08:59:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eb9f080ca13effd51b88f39dd7e089bc 662676 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 01/05/1972 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MARIJAN.TN 101629
0002579827296 3;JKN agung;3313092303950002; 5.6.5.202203091509 4
357189 1#0##0#0#0.0#2022-03-10
09:00:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
df422c75e9433d2256517b99aa63f4de 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 02/02/1971 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 SITI NURJANAH, NY 094470 51 18656 DR. TEKY
novia;3313125201940001; 5.6.7.202204241238 4 357185
1#0##0#0#0.0#2022-05-20
11:20:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
d99e407a973bf842bb7ce865a5b1ad43 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 12/12/1966 0 1
1 Z09.8;M79.18 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 201966
0 1 0 0 0 WASIMIN.TN 102280 55 20169 DR. INDRIANY
WIDHOWATY, SP.S, SP.AK 1124R0020322V000378 0001102708383 3;JKN
agung;3313092303950002; 5.6.5.202203091509 4 357551
1#0##0#0#0.0#2022-03-10
14:12:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cbbb6cf8c98100d230763f6d88482e75 150000 0 0 0 0 0
0 0 0 0 15000 0 36966 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 18/12/1966 0 1
1 I64 - - - None None None None Q-5-27-0 None None
None None None None SISTEM SARAF PUSAT AKUT 137000 0 0 -
0 - 0 - 0 - 0 137000 255789 0 1
0 0 0 SULISTIANTO.TN 102281 55 20163 DR. INDRIANY
agung;3313092303950002; 5.6.5.202203091509 4 357552
1#0##0#0#0.0#2022-03-10
14:13:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cacf3a9f13ba2271f356e3ce622bbf02 150000 0 0 0 0 0
0 0 0 0 15000 0 90789 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 19/08/1953 0 1
1 Z09.8;S93.4 93.39;93.35 - - None None None None M-3-16-0
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DJOKO PRAPTONO, TN
0000089786147 3;JKN agung;3313092303950002; 5.6.5.202203091509 4
357211 1#0##0#0#0.0#2022-03-10
09:09:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4c067412052c9b001314d7e8624112b1 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 24/05/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 203242
0 1 0 0 0 MUSINEM.NY 078681 64 23658 DR. INDRIANY
agung;3313092303950002; 5.6.5.202203091509 4 357557
1#0##0#0#0.0#2022-03-10
14:14:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1691395aefe5e43f6ce5640dca3c9689 150000 0 0 0 0 0
0 0 0 0 15000 0 38242 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 31/12/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 289121
0 1 0 0 0 YATMI ., NY 058574 56 20515 DR. YUDHI
agung;3313092303950002; 5.6.5.202203091509 4 357560
1#0##0#0#0.0#2022-03-10
14:14:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7c12fc9a52458f97843aa01a92271f44 203000 0 0 0 0 0
0 0 0 0 15000 0 71121 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 01/04/1956 0 2
1 Z09.8;H83.8 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 187358
0 1 0 0 0 ROBIKATUN,(NY) 033635 65 24076 DR.
INDRIANY WIDHOWATY, SP.S, SP.AK 1124R0020322V000383 0000640507847 3;JKN
agung;3313092303950002; 5.6.5.202203091509 4 357562
1#0##0#0#0.0#2022-03-10
14:15:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0242ecdeab9ed5e9056c9c1b1e321ccd 150000 0 0 0 0 0
0 0 0 0 15000 0 22358 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 31/01/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 218000
0 1 0 0 0 ARGA KUSUMA.SDR 100752 20 7335 DR.
agung;3313092303950002; 5.6.5.202203091509 4 357565
1#0##0#0#0.0#2022-03-10
14:16:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
23ae3e943038f9494805423c04faa65c 203000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 30/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 197340
0 1 0 0 0 SUWARNI.NY 095035 67 24534 DR. INDRIANY
agung;3313092303950002; 5.6.5.202203091509 4 357567
1#0##0#0#0.0#2022-03-10
14:17:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c2e244a15c8eceb7ae8667d2c906363f 150000 0 0 0 0 0
0 0 0 0 15000 0 32340 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 20/01/1962 0 2
1 Z09.8;G62.8;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 198996
0 1 0 0 0 GIYANI PUTRI, NY 100081 60 21956 DR.
agung;3313092303950002; 5.6.5.202203091509 4 357569
1#0##0#0#0.0#2022-03-10
14:18:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cdbb2b3713080dd5b4148a4fe5064158 150000 0 0 0 0 0
0 0 0 0 15000 0 33996 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 24/04/2002 0 2
0 0 - 0 - 0 - 0 - 0 181400 190573
0 1 0 0 0 DIAN KARTIKA WULAN SARI, NN 102194 19
7252 DR. INDRIANY WIDHOWATY, SP.S, SP.AK 1124R0020322V000389
0000638695629 3;JKN agung;3313092303950002; 5.6.5.202203091509 4
357572 1#0##0#0#0.0#2022-03-10
14:25:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
64823a164ec84241077494b31e9a6a61 150000 0 0 0 0 0
0 0 0 0 15000 0 25573 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 14/05/1933 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 KOESWANTO BA.TN
0000091081451 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357206 1#0##0#0#0.0#2022-05-20
11:34:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
c82da608bbfe9ebbdf0c5fd3fffc32c2 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 02/08/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ISWINDARI., NY
0001792902148 3;JKN agung;3313092303950002; 5.6.5.202203091509 4
357202 1#0##0#0#0.0#2022-03-10
09:13:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
31099f9ab8131c7d49c0664b930c8270 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 22/04/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 252463
0 1 0 0 0 SRI MULYANI, NY 101283 58 21499 DR.
agung;3313092303950002; 5.6.5.202203091509 4 357576
1#0##0#0#0.0#2022-03-10
14:21:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4b51d636079b7f81f5496739243823eb 203000 0 0 0 0 0
0 0 0 0 15000 0 34463 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 31/08/1962 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI HARTINA
IRIAWATI.NY 094182 59 21733 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000394 0001958592576 3;JKN agung;3313092303950002;
5.6.5.202203091509 4 357201 1#0##0#0#0.0#2022-03-10
09:14:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
affe979ca560ae948f44c98c65a93fd3 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 17/07/1978 0 2
0 0 - 0 - 0 - 0 - 0 296400 385143
0 1 0 0 0 RUWANI.NY 101744 43 15934 DR. GUNAWAN,
SP.OG 1124R0020322V000395 0001530396178 3;JKN agung;3313092303950002;
5.6.7.202204241238 4 357574 1#0##0#0#0.0#2022-05-25
11:09:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
b7bf5c40ab1404d667185326159c62e3 350000 0 0 0 0 0
0 0 0 0 15000 0 20143 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 11/07/2004 0 1
0 - 0 - 0 - 0 183900 654634 0 1
0 0 0 MAULANA IBNU FARID.SDR 102157 17 6443 DR. DAMAR
ARYO, SP.B 1124R0020322V000396 0001108928586 3;JKN agung;3313092303950002;
5.6.5.202203091509 4 357578 1#0##0#0#0.0#2022-03-10
14:22:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c419d3c4b4a239efda0f53d7543a742e 235000 0 0 0 0 0
0 0 0 0 15000 0 404634 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 20/11/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 694999
0 1 0 0 0 DIANI MARHAENITA ., NY 000489 55 20191
agung;3313092303950002; 5.6.5.202203091509 4 357580
1#0##0#0#0.0#2022-03-10
14:23:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0e14e53deedbf666186bc67db62d6623 300000 0 0 0 0 0
0 76145 0 0 15000 0 303854 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 01/01/2000 0 2
1 Z09.8;R51 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 191895
0 1 0 0 0 SUSIATI,(NY) 025557 22 8096 DR.
agung;3313092303950002; 5.6.5.202203091509 4 357571
1#0##0#0#0.0#2022-03-10
14:24:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d1f40f5f439cb61069d6a6d4463b0e66 150000 0 0 0 0 0
0 0 0 0 15000 0 26895 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 11/09/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 271744
0 1 0 0 0 ENDANG SUSMIYATI,(NY) 026343 55 20261
agung;3313092303950002; 5.6.5.202203091509 4 357581
1#0##0#0#0.0#2022-03-10
14:25:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f5bb579390a6b1fec451d574b23e96b1 150000 0 0 0 0 0
0 0 0 0 15000 0 106744 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 03/04/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 213136
0 1 0 0 0 RIPTYAWATI. NY 053697 57 21152 DR.
agung;3313092303950002; 5.6.5.202203091509 4 357582
1#0##0#0#0.0#2022-03-10
14:26:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f46d6f7d24c7e4ce405f3df28870e740 150000 0 0 0 0 0
0 0 0 0 15000 0 48136 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 24/08/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 264275
0 1 0 0 0 SUPARNO BP 085087 73 26853 DR. INDRIANY
agung;3313092303950002; 5.6.5.202203091509 4 357583
1#0##0#0#0.0#2022-03-10
14:27:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5a495e9c913c871aac58ccd2d88db4ba 150000 0 0 0 0 0
0 0 0 0 15000 0 99275 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 31/05/1993 0 2
1 Z09.8;N61 96.59 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 222430 0 1
0 0 0 VITA LARASATI.NY 081498 28 10502 DR. DAMAR ARYO,
SP.B 1124R0020322V000402 0000640414394 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 357585 94#0##0#0#0.0#2022-03-29
08:54:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
0d07f59fcb1f55777354d517ac58c8b3 150000 0 0 0 0 0
0 0 0 0 15000 0 57430 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 20/10/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 202367
0 1 0 0 0 SARTI.NY 099768 48 17665 DR. INDRIANY
agung;3313092303950002; 5.6.5.202203091509 4 357586
1#0##0#0#0.0#2022-03-10
14:28:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f50d8b4348fb91ae7e003d9ed23fb38e 150000 0 0 0 0 0
0 0 0 0 15000 0 37367 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 06/05/1983 0 2
0 - 0 - 0 - 0 - 0 296400 379465
0 1 0 0 0 ANIK ARI SETYOWATI,.NY 047272 38 14180
agung;3313092303950002; 5.6.5.202203091509 4 357587
1#0##0#0#0.0#2022-03-10
14:29:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ce690bca02be70051e2618d2304f83e2 350000 0 0 0 0 0
0 0 0 0 15000 0 14465 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 10/10/1962 0 1
0 - 0 - 0 - 0 183900 219948 0 1
0 0 0 ISHAK HIDAYAT.TN 101798 59 21693 DR. DAMAR ARYO,
SP.B 1124R0020322V000406 0002981745235 3;JKN agung;3313092303950002;
5.6.5.202203091509 4 357588 1#0##0#0#0.0#2022-03-10
14:30:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
de79be7efd53a7a61577c9eb49577efa 150000 0 0 0 0 0
0 0 0 0 15000 0 54948 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 08/06/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 LAMIYEM.NY 087484
0001316300512 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357199 1#0##0#0#0.0#2022-05-19
10:40:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
3fafba8c3c5fb9e30d783971efe94880 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 10/10/1953 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TUTIK SARASWATI .,
0001449355893 3;JKN agung;3313092303950002; 5.6.5.202203091509 4
357200 1#0##0#0#0.0#2022-03-10
09:16:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
04ae062628aa53f4328aeed9bc0da957 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 17/03/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUNARTI, (NY)
0000088913171 3;JKN agung;3313092303950002; 5.6.5.202203091509 4
357209 1#0##0#0#0.0#2022-03-10
09:22:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
39141fc041b8f1276fe0ab5e54983ac4 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 18/01/1966 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 IVO MUMPUNI
WIJAYANINGRUM, NY 095874 56 20497 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000411 0002169780873 3;JKN agung;3313092303950002;
5.6.5.202203091509 4 357187 1#0##0#0#0.0#2022-03-10
09:22:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6b79da540b0ca20606c5c898575252ab 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 27/02/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 204380
0 1 0 0 0 CHRISTINA, NY 102064 44 16074 DR.
DAMAR ARYO, SP.B 1124R0020322V000413 0000639487866 3;JKN
agung;3313092303950002; 5.6.6.202203301209 4 357589
1#0##0#0#0.0#2022-04-11
11:41:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
67325079afb094ce02bac2112756091a 150000 0 0 0 0 0
0 0 0 0 15000 0 39380 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 26/09/1963 0 1
0 - 0 107400 273000 0 1 0 0 0
BAJURI, TN 000197 58 21342 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000415 0001104121822 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 357198 1#0##0#0#0.0#2022-05-18
10:10:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
d3f03513a08b7b45fbc3e37df6f15e17 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 11/12/2003 0 1
None None None None None PROSEDUR BESAR RADIOGRAFI 700800 0
0 - 0 - 0 - 0 - 0 700800 271355
0 1 0 0 0 BINTANG PERDANA, SDR 101933 18 6656
DR. DAMAR ARYO, SP.B 1124R0020322V000416 0002696035599 3;JKN
agung;3313092303950002; 5.6.5.202203091509 4 357591
1#0##0#0#0.0#2022-03-10
14:32:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
19a3d6ac32e2c7cfb1289dbcfc7b0b57 235000 0 0 0 0 0
0 0 0 0 15000 0 21355 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 05/07/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 239845
0 1 0 0 0 MARIA THERESIA RUBINEM.NY 061567 74
3;JKN agung;3313092303950002; 5.6.5.202203091509 4 357593
1#0##0#0#0.0#2022-03-10
14:33:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
60dafa1ea3644cae3598e04c17d21d10 150000 0 0 0 0 0
0 0 0 0 15000 0 74845 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 02/06/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 586281
0 1 0 0 0 RUSTAMI. NY 017382 58 21458 DR. TEKY
agung;3313092303950002; 5.6.5.202203091509 4 357595
1#0##0#0#0.0#2022-03-10
14:33:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a6116fc0b0615b57fee23e9f9181f166 150000 0 0 0 0 0
0 0 0 0 15000 0 421281 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 08/11/2006 0 1
0 0 - 0 - 0 - 0 - 0 181400 267218
0 1 0 0 0 PRASTA RIZQY ADITYA.AN 083671 15 5593
agung;3313092303950002; 5.6.5.202203091509 4 357598
1#0##0#0#0.0#2022-03-10
14:34:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3b57bd0d63d2c91c7716a90125dfcb9b 203000 0 0 0 0 0
0 0 0 0 15000 0 49218 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 15/03/2005 0 1
1 R11;K52.9 - - - None None None None Q-5-25-0 None
None None None None None GASTROINTESTINAL AKUT 135700 0 0
- 0 - 0 - 0 - 0 135700 243376 0
1 0 0 0 FAIZ FADHIL A, AN 092557 16 6196 DR. SUROSO
1124R0020322V000420 0001106741665 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 360982 1#0##0#0#0.0#2022-04-04
16:46:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
df37ca92987d2069562d735f2737f7a6 130000 0 0 0 0 0
0 0 0 0 15000 0 98376 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 30/10/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 289121
0 1 0 0 0 NURINI.NY 098894 62 22769 DR. YUDHI
agung;3313092303950002; 5.6.5.202203091509 4 357600
1#0##0#0#0.0#2022-03-10
14:35:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
26c6396f6013b6059c56fdd36acdb2e2 203000 0 0 0 0 0
0 0 0 0 15000 0 71121 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 27/11/1948 0 2
1 Z09.8;M17.9;I11.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 231187
0 1 0 0 0 SARSIYAH.NY 090773 73 26758 DR. TEKY
agung;3313092303950002; 5.6.5.202203091509 4 357602
1#0##0#0#0.0#2022-03-10
14:36:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
879666cdc7849d65ad1e5ed6d35cff43 150000 0 0 0 0 0
0 0 0 0 15000 0 66187 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 15/04/1941 0 1
1 Z09.8;N40;G44.2;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 246126
0 1 0 0 0 SUMALI, TN 100130 80 29541 DR. TEKY
agung;3313092303950002; 5.6.5.202203091509 4 357605
1#0##0#0#0.0#2022-03-10
14:37:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7625e6960ac1e221565c4f13ec6a86ea 150000 0 0 0 0 0
0 0 0 0 15000 0 81126 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 12/06/1981 0 2
0 0 - 0 - 0 - 0 - 0 181400 221331
0 1 0 0 0 SRI SAYEKTI.NY 098714 40 14873 DR.
agung;3313092303950002; 5.6.5.202203091509 4 357608
1#0##0#0#0.0#2022-03-10
14:38:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8d5887de4c2605c9229ce55f50a5f508 150000 0 0 0 0 0
0 0 0 0 15000 0 56331 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 06/04/1969 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUPARWAN, TN
0001104843161 3;JKN agung;3313092303950002; 5.6.5.202203091509 4
357186 1#0##0#0#0.0#2022-03-10
09:37:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
daee69493a5ce5c464ed44f619c2c912 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 07/04/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 231886
0 1 0 0 0 MARTHA LEOPENO. NY 005709 61 22609
agung;3313092303950002; 5.6.5.202203091509 4 357612
1#0##0#0#0.0#2022-03-10
14:39:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
67df7ea946b50a07df88d1adc36c2404 150000 0 0 0 0 0
0 0 0 0 15000 0 66886 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 29/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 AGNES WIDHA
THESIANA, NY 090586 48 17870 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000428 0002168632721 3;JKN agung;3313092303950002;
5.6.5.202203091509 4 357190 1#0##0#0#0.0#2022-03-10
09:37:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f469ba6eb01159af34431a004207d36a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 11/12/1975 0 1
0 0 - 0 - 0 - 0 - 0 181400 561756
0 1 0 0 0 ISDIANTO, (BP) 020830 46 16883 DR.
agung;3313092303950002; 5.6.5.202203091509 4 357614
1#0##0#0#0.0#2022-03-10
14:40:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9b61514fad64c359ffe914d006c9368f 450000 0 0 0 0 0
0 0 0 0 15000 0 96756 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 26/09/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 NUR HARYANTI, NY
0002611312075 3;JKN agung;3313092303950002; 5.6.5.202203091509 4
357191 1#0##0#0#0.0#2022-03-10
09:38:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d5749394a84f02462a130e33b5a62890 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 07/04/1970 0 2
1 Z09.8;M79.18;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 231979
0 1 0 0 0 TARSINI.NY 102282 51 18957 DR. INDRIANY
agung;3313092303950002; 5.6.5.202203091509 4 357616
1#0##0#0#0.0#2022-03-10
14:41:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3204c7a17d5bea32faa9d96f9d064097 150000 0 0 0 0 0
0 0 0 0 15000 0 66979 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 31/12/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 210876
0 1 0 0 0 SRI SUHARNI., NY 045839 52 19054 DR.
agung;3313092303950002; 5.6.5.202203091509 4 357617
1#0##0#0#0.0#2022-03-10
10:59:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9c6e20fee7234c9ceb123000ad4c7ee6 150000 0 0 0 0 0
0 0 0 0 15000 0 45876 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 06/02/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 358688
0 1 0 0 0 S.TRI HASTUTI,(NY) 040869 46 16826
agung;3313092303950002; 5.6.5.202203091509 4 357618
1#0##0#0#0.0#2022-03-10
10:59:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8d24cbf0e4f4d9f03b554ec68fe8cdfe 300000 0 0 0 0 0
0 0 0 0 15000 0 43688 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 01/09/1995 0 1
1 Z09.8;R59.0 97.89 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 272457
0 1 0 0 0 INDRA, SDR 068766 26 9679 DR. DAMAR
ARYO, SP.B 1124R0020322V000435 0000564894213 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 357619 1#0##0#0#0.0#2022-05-19
09:27:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
4348e752df724d13159f81ac57920aba 235000 0 0 0 0 0
0 0 0 0 15000 0 22457 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 20/03/2007 0 2
1 Z09.8;K04.1 23.2 - - None None None None U-3-16-0 None
None None None None None PROSEDUR PADA GIGI 283800 0 0
- 0 - 0 - 0 - 0 283800 165000 0
1 0 0 0 CHALISA SALSABILA PURNOMO.AN 098898 14 5461
DRG. VERAWATY, SP.KG 1124R0020322V000436 0001525060967 3;JKN
agung;3313092303950002; 5.6.5.202203091509 4 357620
1#0##0#0#0.0#2022-03-10
10:57:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b35ba6b423994276b6a3367037c9ab70 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 07/07/1999 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 FITASSA KUSUMA DEWI.NN 101099 22 8274 DRG.
VERAWATY, SP.KG 1124R0020322V000437 0000640339413 3;JKN
agung;3313092303950002; 5.6.5.202203091509 4 357621
1#0##0#0#0.0#2022-03-10
10:56:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
05a61eb435653ec9585a091e5ca5884d 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 25/06/2000 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RISA LARAS KUSUMA DEWI, NN 101326 21 7920
agung;3313092303950002; 5.6.5.202203091509 4 357622
1#0##0#0#0.0#2022-03-10
10:55:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
298bb3d636e8b8f6887d62c995bd0e32 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 21/01/2007 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 DANIEL WAHYU SETYAWAN, SDR 102149 15 5519
agung;3313092303950002; 5.6.5.202203091509 4 357623
1#0##0#0#0.0#2022-03-10
10:55:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
193acc22b7e2b1f60332b10db5201046 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 30/07/1985 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SRI MULYANINGSIH.,NY 072864 36 13364 DRG.
agung;3313092303950002; 5.6.5.202203091509 4 357624
1#0##0#0#0.0#2022-03-10
10:54:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5f51647a4d6b38b5fb5417fdccd6b79a 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/03/2022 02/03/2022 16/09/1967 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 LASIYANTO, (BP) 008459 54 19891 DRG.
agung;3313092303950002; 5.6.5.202203091509 4 357625
1#0##0#0#0.0#2022-03-10
10:52:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1ec5de22fa98eb17431537d93cfb998d 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/03/2022 03/03/2022 02/02/1971 0 2
0 - 0 - 0 - 0 786200 1051340 0 1
novia;3313125201940001; 5.6.7.202204241238 4 357088
1#0##0#0#0.0#2022-05-20
11:20:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
d49f972bc7261185238cb8b501c5af08 662676 0 0 0 0 0
0 44300 0 0 15000 0 329364 0 0 0 0 0
3372030 C 3 CP 2 03/03/2022 03/03/2022 04/05/1958 0 2
0 - 0 - 0 - 0 786200 523130 0 1
novia;3313125201940001; 5.6.3.202201201500 4 357099
1#0##0#0#0.0#2022-03-07
12:59:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7e4c77870c53ec4262b083d8f10c1929 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/03/2022 03/03/2022 10/07/1955 0 2
0 - 0 - 0 - 0 786200 526210 0 1
SP.PD 1124R0020322V000457 0001032581823 3;JKN novia;3313125201940001;
5.6.3.202201201500 4 357098 1#0##0#0#0.0#2022-03-07
12:59:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f63e2c9df2b74959eb7d8189787ee68e 463830 0 0 0 0 0
0 44300 0 0 15000 0 3080 0 0 0 0 0
3372030 C 3 CP 2 03/03/2022 03/03/2022 04/09/1964 0 1
0 - 0 - 0 - 0 786200 523130 0 1
novia;3313125201940001; 5.6.3.202201201500 4 357097
1#0##0#0#0.0#2022-03-07
13:01:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d95697086e544a9384e996607dd658a0 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/03/2022 03/03/2022 25/06/1970 0 2
0 - 0 - 0 - 0 786200 523130 0 1
novia;3313125201940001; 5.6.3.202201201500 4 357096
1#0##0#0#0.0#2022-03-07
13:02:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
692c1f0423a1b3e595896ce13375c8d8 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/03/2022 03/03/2022 10/12/1982 0 1
0 - 0 - 0 - 0 786200 523130 0 1
novia;3313125201940001; 5.6.3.202201201500 4 357095
1#0##0#0#0.0#2022-03-07
13:03:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f3fa9eb57f2ae6bccc82a6c75320b38b 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/03/2022 03/03/2022 18/03/1988 0 1
0 - 0 - 0 - 0 786200 523130 0 1
novia;3313125201940001; 5.6.3.202201201500 4 357094
1#0##0#0#0.0#2022-03-07
13:03:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
21694ac592257109c900b36a10278cf5 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/03/2022 03/03/2022 17/04/1973 0 1
0 - 0 - 0 - 0 786200 523130 0 1
novia;3313125201940001; 5.6.3.202201201500 4 357093
1#0##0#0#0.0#2022-03-07
13:04:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4f1bb649bbafdfc4ea1107dc4ba0001c 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/03/2022 03/03/2022 23/03/1976 0 2
0 - 0 - 0 - 0 786200 523130 0 1
novia;3313125201940001; 5.6.3.202201201500 4 357091
1#0##0#0#0.0#2022-03-07
13:05:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1866318c7db2d4dcc893c2f19fc322cc 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/03/2022 03/03/2022 31/12/1971 0 2
0 - 0 - 0 - 0 786200 529829 0 1
SP.PD 1124R0020322V000465 0000555344774 3;JKN novia;3313125201940001;
5.6.3.202201201500 4 357090 1#0##0#0#0.0#2022-03-07
13:05:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1bb09eaf9d2c08ef99b561a10443f2c6 463830 0 0 0 0 0
0 44300 0 0 15000 0 6699 0 0 0 0 0
3372030 C 3 CP 2 03/03/2022 03/03/2022 14/10/1972 0 2
0 - 0 - 0 - 0 786200 523130 0 1
novia;3313125201940001; 5.6.3.202201201500 4 357089
1#0##0#0#0.0#2022-03-07
13:06:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
78829ddcba813a614dc2f1e7f9bd7213 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/03/2022 03/03/2022 12/10/1987 0 1
0 - 0 - 0 - 0 786200 523130 0 1
novia;3313125201940001; 5.6.3.202201201500 4 357092
1#0##0#0#0.0#2022-03-07
13:06:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cd8947bb3ea554d74a95024473e41b9d 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/03/2022 03/03/2022 03/08/1963 0 2
0 - 0 - 0 - 0 786200 523130 0 1
novia;3313125201940001; 5.6.3.202201201500 4 357105
1#0##0#0#0.0#2022-03-07
13:07:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
264f2a99f18afc6820c7842cd32049b3 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/03/2022 03/03/2022 12/08/1977 0 1
0 - 0 - 0 - 0 786200 523130 0 1
novia;3313125201940001; 5.6.3.202201201500 4 357104
1#0##0#0#0.0#2022-03-07
13:08:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1d3009f6f9d68f545c87b8be655bdd45 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/03/2022 03/03/2022 22/10/1959 0 2
0 - 0 - 0 - 0 786200 523130 0 1
novia;3313125201940001; 5.6.3.202201201500 4 357103
1#0##0#0#0.0#2022-03-07
13:08:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5d6b2cc0a6a8fbabc29addb938f3504d 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/03/2022 03/03/2022 12/12/1964 0 1
0 - 0 - 0 - 0 786200 523130 0 1
novia;3313125201940001; 5.6.3.202201201500 4 357102
1#0##0#0#0.0#2022-03-07
13:09:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e085d5484993694127d72263b9cfe7e3 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/03/2022 03/03/2022 12/07/1966 0 1
0 - 0 - 0 - 0 786200 523130 0 1
novia;3313125201940001; 5.6.3.202201201500 4 357100
1#0##0#0#0.0#2022-03-07
13:09:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
afb80960e4d62d690bf48785c1c05ce2 463830 0 0 0 0 0
0 44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/03/2022 03/03/2022 04/08/1948 0 1
0 - 0 - 0 - 0 786200 259300 0 1
novia;3313125201940001; 5.6.3.202201201500 4 357101
1#0##0#0#0.0#2022-03-07
13:10:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ef227b43380d8587ceb6e74f1c0f3f9b 0 0 0 0 0 0 200000
44300 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 16/05/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 269960
0 1 0 0 0 MINAN, TN 064501 64 23668 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 357951
1#0##0#0#0.0#2022-03-16
14:32:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
7cd3ab56445d88577330e061563635b2 150000 0 0 0 0 0
0 31845 0 0 15000 0 73115 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 16/05/1964 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
398971 0 1 0 0 0 MAELANI., NY 046177 57
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 357953
1#0##0#0#0.0#2022-03-16
14:33:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
82c63eb43318595402602e16d1ad9cc9 150000 0 0 0 0 0
0 76045 0 0 15000 0 157926 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 08/01/2015 0 1
1 S82.30;W51.3 - - - None None None None Q-5-31-0
None None None None None None FRAKTUR 129600 0 0 -
0 - 0 - 0 - 0 129600 182062 0 1
0 0 0 BARRA ACHMAD ADZUHRI,(AN) 037374 7 2612 DR.
WAHYU PURNOMO, SP.OT 1124R0020322V000486 0001846423607 3;JKN
yani;3302226402970001; 5.6.5.202203091809 4 357954
1#0##0#0#0.0#2022-03-16
14:34:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
afe9a463637b14e916b4931157b29915 150000 0 0 0 0 0
0 0 0 0 15000 0 17062 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 21/08/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 364914
0 1 0 0 0 SRI MUNAWARTI, (NY) 002036 64 23571
yani;3302226402970001; 5.6.5.202203091809 4 357955
1#0##0#0#0.0#2022-03-16
14:41:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d720c1cab53cfd49ebfa5f69cb56dfc5 150000 0 0 0 0 0
0 120745 0 0 15000 0 79169 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 09/08/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 990344
0 1 0 0 0 SITI JUWARIYAH,(NY) 011285 47 17374
yani;3302226402970001; 5.6.5.202203091809 4 357956
1#0##0#0#0.0#2022-03-16
14:42:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
41bbab423477a52091397f7bc742e513 150000 0 0 0 0 0
0 107890 0 0 15000 0 717454 0 0 0 0
0
3372030 C 3 CP 2 04/03/2022 04/03/2022 20/08/1955 0 2
1 Z09.8;E11.4;G59.0;I10;M17.9 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
347182 0 1 0 0 0 AINUN DJARIYAH, NY 069314
0002300076707 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357957 1#0##0#0#0.0#2022-03-16
14:44:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9ffc8012cc486f5ee151fdab84776bbc 150000 0 0 0 0 0
0 76595 0 0 15000 0 105587 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 24/06/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 558373
0 1 0 0 0 SITI ARBAIYAH, NY 073903 68 25090 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357959
1#0##0#0#0.0#2022-03-16
14:44:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5313eea6d2b05a2a170df917354f6970 150000 0 0 0 0 0
0 31845 0 0 15000 0 361528 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 20/07/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 406907
0 1 0 0 0 SUPRAPTI.NY 082274 59 21777 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 357961
1#0##0#0#0.0#2022-03-16
14:47:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0d4807ff5fb37c401fdcb5678bbd1ef1 150000 0 0 0 0 0
0 31845 0 0 15000 0 210062 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 12/11/1945 0 2
1 Z09.8;K80.2;K30 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 412735
0 1 0 0 0 ENDANG SURTIANAH, NY 098168 76 27871
novia;3313125201940001; 5.6.7.202204241238 4 357963
1#0##0#0#0.0#2022-05-19
13:54:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
ab91ca8a4c6c7789a6f1520d5da811e6 150000 0 0 0 0 0
0 89500 0 0 15000 0 158235 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 02/12/1957 0 2
1 Z09.8;E11.4;G59.0 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 357387
0 1 0 0 0 ENDANG MARDIASMANI.NY 090524 64 23468
novia;3313125201940001; 5.6.7.202204241238 4 357965
1#0##0#0#0.0#2022-05-19
11:02:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
cfe72cffb4831f98cb6ec8c6f636f83e 150000 0 0 0 0 0
0 76045 0 0 15000 0 116342 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 01/08/1981 0 1
0 0 - 0 - 0 - 0 - 0 181400 203577
0 1 0 0 0 AGUS RIYANTO.SDR 079932 40 14825 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357967
1#0##0#0#0.0#2022-03-16
14:51:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b3dd4ade189700df175c7910ee74bc96 150000 0 0 0 0 0
0 0 0 0 15000 0 38577 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 22/12/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 234944
0 1 0 0 0 SUNARTI 095046 62 22718 DR. ARIA
yani;3302226402970001; 5.6.5.202203091809 4 357969
1#0##0#0#0.0#2022-03-16
14:53:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dc581c7d15478a321bb714e2df3502d8 150000 0 0 0 0 0
0 0 0 0 15000 0 69944 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 11/08/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 226360
0 1 0 0 0 SRI MURNI 69141 73 26868 DR. WAHYU PURNOMO,
SP.OT 1124R0020322V000497 0001890165082 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 358227 1#0##0#0#0.0#2022-03-16
14:54:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f37f900b9c632c99d37243334005a115 150000 0 0 0 0 0
0 0 0 0 15000 0 61360 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 19/07/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 222653
0 1 0 0 0 SITI WARSINI.NY 098844 71 26161 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357973
1#0##0#0#0.0#2022-03-16
14:55:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
25a149947030651700fadc65219c46db 150000 0 0 0 0 0
0 0 0 0 15000 0 57653 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 13/03/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 425174
0 1 0 0 0 SRI LESTARI.NY 093144 58 21541 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357974
1#0##0#0#0.0#2022-03-16
14:56:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
83dc298d7a444c543a943c001590a2a1 150000 0 0 0 0 0
0 89500 0 0 15000 0 170674 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 12/01/1978 0 2
1 Z09.8;S82.20 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 201179
0 1 0 0 0 UNIK DEWI RAHAYU,(NY) 025580 44 16122
DR. WAHYU PURNOMO, SP.OT 1124R0020322V000500 0001279867307 3;JKN
yani;3302226402970001; 5.6.5.202203091809 4 357975
1#0##0#0#0.0#2022-03-16
14:57:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9e92dbb339f401297f4ea4d24277d45d 150000 0 0 0 0 0
0 0 0 0 15000 0 36179 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 15/05/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 196845
0 1 0 0 0 WARTANTI HANDONO, NY 081889 54 20017
yani;3302226402970001; 5.6.5.202203091809 4 357976
1#0##0#0#0.0#2022-03-16
14:58:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7e2348f7a06b5036ea9bbdf3bc77678f 150000 0 0 0 0 0
0 31845 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 10/08/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 228690
0 1 0 0 0 SRI MURTININGSIH, NY 085007 59 21756
yani;3302226402970001; 5.6.5.202203091809 4 357977
1#0##0#0#0.0#2022-03-16
15:00:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7a00bd27c862c02f1ccfe8723d7380be 150000 0 0 0 0 0
0 31845 0 0 15000 0 31845 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 14/08/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 326054
0 1 0 0 0 SRI LESTARI 056183 53 19560 DR. WAHYU
PURNOMO, SP.OT 1124R0020322V000505 0000640595687 3;JKN
yani;3302226402970001; 5.6.5.202203091809 4 357978
1#0##0#0#0.0#2022-03-16
15:01:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
687a418bcc2f069fa98507ad35e6de5e 273500 0 0 0 0 0
0 0 0 0 15000 0 37554 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 07/05/1954 0 2
1 Z09.8;M17.9 88.27 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 456747
0 1 0 0 0 R. AJ KOESTRINI, NY 100934 67 24773
yani;3302226402970001; 5.6.5.202203091809 4 357979
1#0##0#0#0.0#2022-03-16
15:04:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
93d68e0c3f427c170592edbf7f8c57cc 150000 0 0 0 0 0
248000 0 0 0 15000 0 43747 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 12/02/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 219989
0 1 0 0 0 SUNARTI,(NY) 015594 57 20839 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357980
1#0##0#0#0.0#2022-03-16
15:05:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
281dd30601e535170b86d7d10bfe9c09 150000 0 0 0 0 0
0 0 0 0 15000 0 54989 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 26/11/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 206250
0 1 0 0 0 SUPARNI.NY 081394 67 24570 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 357981
1#0##0#0#0.0#2022-03-16
15:06:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
323935436f69efef5fd9471c3ac1fc88 150000 0 0 0 0 0
0 0 0 0 15000 0 41250 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 13/11/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 585588
0 1 0 0 0 JOKO SETYANTO 092583 61 22391 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357982
1#0##0#0#0.0#2022-03-16
15:07:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
de2217e9d7d2e9481aa5bedf868c07fd 150000 0 0 0 0 0
0 210295 0 0 15000 0 210293 0 0 0 0
0
3372030 C 3 CP 2 04/03/2022 04/03/2022 04/05/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 456507
0 1 0 0 0 HARI WURYANTO, (BP) 002149 62 22950
yani;3302226402970001; 5.6.5.202203091809 4 357983
1#0##0#0#0.0#2022-03-16
15:14:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
afa0a10ab8c503dc65627c9d32a7415c 150000 0 0 0 0 0
248000 0 0 0 15000 0 43507 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 13/12/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 198583
0 1 0 0 0 SUGIYO, TN 092623 64 23457 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 357984
1#0##0#0#0.0#2022-03-16
15:15:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6434ca2041c196e88536deba85a98e82 150000 0 0 0 0 0
0 0 0 0 15000 0 33583 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 28/04/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 267616
0 1 0 0 0 YUNNI SRI LESTARI, NY 068471 62 22956
yani;3302226402970001; 5.6.5.202203091809 4 357985
1#0##0#0#0.0#2022-03-16
15:16:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a6432dfe57dedfa2e759883a0016422a 150000 0 0 0 0 0
0 31845 0 0 15000 0 70771 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 18/04/1971 0 2
1 Z09.8;I10;K80.2;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 345287
0 1 0 0 0 NGATMIYATUN,(NY) 033520 50 18583 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357986
1#0##0#0#0.0#2022-03-16
15:18:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
31f039e15fec2b8bfd9dcbbe99b099f7 150000 0 0 0 0 0
0 0 0 0 15000 0 180287 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 18/01/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000090992327 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357924 1#0##0#0#0.0#2022-03-16
15:19:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9d26ea732d14051dac8e8166d3eff747 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 29/09/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARIA DIAH
ANGGARAWATI ., NY 059667 51 18784 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000515 0001211692601 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357914 1#0##0#0#0.0#2022-03-16
15:20:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
54c9f69152b88a2f02917180d2bbb013 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 22/08/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 490162
0 1 0 0 0 HARTINI., NY 048885 60 22109 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357987
1#0##0#0#0.0#2022-03-16
15:21:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b66d35a73d80962d98f45ad493872e0a 150000 0 0 0 0 0
0 76045 0 0 15000 0 249117 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 15/05/1958 0 2
1 Z09.8;S52.50 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 205183
0 1 0 0 0 YAHMINI ., NY 055426 63 23304 DR.
novia;3313125201940001; 5.6.7.202204241238 4 357988
1#0##0#0#0.0#2022-05-19
08:39:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
2d0537d80a44fa501c7c1debb3cc331d 150000 0 0 0 0 0
0 0 0 0 15000 0 40183 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 05/07/1946 0 1
1 Z09.8;E11.4;G59.0;M17.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 387576
0 1 0 0 0 SUGENG EFFENDI ., BP 050586 75 27636
yani;3302226402970001; 5.6.5.202203091809 4 358250
1#0##0#0#0.0#2022-03-16
15:24:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7f832fb5bcf4ad8eefaa5a6fb5d0c81d 150000 0 0 0 0 0
0 31845 0 0 15000 0 190731 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 01/09/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 210873
0 1 0 0 0 SUDARSI, NY 087904 58 21369 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 357990
1#0##0#0#0.0#2022-03-16
15:25:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7eb6f2fbfadb0d9f7d64ec7a0acbd611 150000 0 0 0 0 0
0 0 0 0 15000 0 45873 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 04/06/1948 0 1
1 Z09.8;E11.4;G59.0;I10;N18.9 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
917049 0 1 0 0 0 SLAMET, TN 068904 73 26936
yani;3302226402970001; 5.6.5.202203091809 4 357991
1#0##0#0#0.0#2022-03-16
15:26:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
00edfa104abcd1784dcfee986e66b048 150000 0 0 0 0 0
0 31845 0 0 15000 0 720204 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 16/05/1997 0 2
1 Z09.4;S42.30 88.21 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 479722
0 1 0 0 0 MEI NUR SAPUTRI, NN 100901 24 9058
novia;3313125201940001; 5.6.7.202204241238 4 357992
1#0##0#0#0.0#2022-05-20
08:57:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
1fd83d5d8923661d7a351f562ca16f5c 176000 0 0 0 0 0
248000 0 0 0 15000 0 40722 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 26/10/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 541494
0 1 0 0 0 SRI SUWARNI., NY 042244 62 22775 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357993
1#0##0#0#0.0#2022-03-16
15:29:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
163731750c0d2c06410a869bce1896fa 150000 0 0 0 0 0
0 76545 0 0 15000 0 299949 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 10/12/1944 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUWARSONO.TN
0002296249738 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357916 1#0##0#0#0.0#2022-03-16
15:30:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
79ba7ebf368d1d4ac5a89bfb328b1808 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 11/05/1943 0 2
0 0 - 0 - 0 - 0 - 0 181400 221960
0 1 0 0 0 MURYATI.NY 094215 78 28787 DR. WAHYU
novia;3313125201940001; 5.6.7.202204241238 4 357994
1#0##0#0#0.0#2022-05-19
13:12:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
63c4f98b09611868b735213b7840d5b5 150000 0 0 0 0 0
0 0 0 0 15000 0 56960 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 20/01/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 199430
0 1 0 0 0 RIYADI.TN 091191 54 19767 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 357995
1#0##0#0#0.0#2022-03-16
15:32:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
90c71a185016653d74ed08d0180e6e6d 150000 0 0 0 0 0
0 0 0 0 15000 0 34430 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 29/05/1979 0 2
1 Z09.8;N83.2;N80.0 88.79 - - None None None None Z-3-23-0
None None None None None None PROSEDUR ULTRASOUND LAIN-LAIN 549400
0 0 - 0 - 0 - 0 - 0 549400 165000
0 1 0 0 0 NURITA ARIWILUJENG.NY 093207 42 15620
yani;3302226402970001; 5.6.5.202203091809 4 357996
1#0##0#0#0.0#2022-03-16
15:33:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
32e194f5b4bba687b45d49817714b7a6 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 31/05/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 394157
0 1 0 0 0 RAHAYU, NY 098361 63 23288 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 357997
1#0##0#0#0.0#2022-03-16
15:35:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cacf34c04af6d551ff453366c85b36ac 150000 0 0 0 0 0
0 76045 0 0 15000 0 153112 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 22/03/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 213499
0 1 0 0 0 ISTRI SUDARYATI 093584 51 18975 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357998
1#0##0#0#0.0#2022-03-16
15:36:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
232d4b620988167952cb721ee7a0788f 150000 0 0 0 0 0
0 0 0 0 15000 0 48499 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 06/03/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 632882
0 1 0 0 0 KUS HARSANTI.,NY 074896 62 23009 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357999
1#0##0#0#0.0#2022-03-16
15:37:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ccc30f33c009f77434afc8007db650a7 150000 0 0 0 0 0
0 63690 0 0 15000 0 404192 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 19/04/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 276035
0 1 0 0 0 ERIE ARISTOT MULAT.TN 097789 65 24060
yani;3302226402970001; 5.6.5.202203091809 4 358000
1#0##0#0#0.0#2022-03-16
15:44:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d01700ab77eed013bfc9920b323a5e5f 150000 0 0 0 0 0
0 31845 0 0 15000 0 79190 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 24/04/2007 0 1
1 Z47.0 93.57;96.59 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 255820 0 1
0 0 0 M ARYZZA FIKRATUHA, AN 076005 14 5428 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 358001
1#0##0#0#0.0#2022-03-16
15:45:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e6517755dedfbadce4c3a94aca26b03e 215000 0 0 0 0 0
0 0 0 0 15000 0 25820 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 20/10/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 204107
0 1 0 0 0 BADRIYAH MUNAWARAH,(NY) 043414 71 26068
yani;3302226402970001; 5.6.5.202203091809 4 358002
1#0##0#0#0.0#2022-03-16
15:46:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6faa2cda7e18aa0f8770144563f13b53 150000 0 0 0 0 0
0 0 0 0 15000 0 39107 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 25/12/1992 0 1
0 0 - 0 - 0 - 0 - 0 181400 209429
0 1 0 0 0 ARIANTO SAPUTRO, SDR 056251 29 10661
yani;3302226402970001; 5.6.5.202203091809 4 358003
1#0##0#0#0.0#2022-03-16
15:47:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b6162a1aa44bebc3d6ea511795904c8c 150000 0 0 0 0 0
0 0 0 0 15000 0 44429 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 26/10/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 236072
0 1 0 0 0 BAMBANG SUYOSO ., BP 053077 57 20948
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358004
1#0##0#0#0.0#2022-03-16
15:48:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3006b3155d5b1b3825c6c94e8d720873 150000 0 0 0 0 0
0 0 0 0 15000 0 71072 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 03/06/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 520972
0 1 0 0 0 SUDJIYEM., NY 045838 64 23650 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358005
1#0##0#0#0.0#2022-03-16
15:50:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
138e265eb4fec5562005967ef392967e 150000 0 0 0 0 0
0 107890 0 0 15000 0 248082 0 0 0 0
0
3372030 C 3 CP 2 04/03/2022 04/03/2022 30/08/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 203643
0 1 0 0 0 RIA TRI RASMANI. NY 089448 60 22101
yani;3302226402970001; 5.6.5.202203091809 4 358008
1#0##0#0#0.0#2022-03-16
15:51:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
925b8cf6df52ccba1bd1f6f76f92e04a 150000 0 0 0 0 0
0 0 0 0 15000 0 38643 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 31/12/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI SUWANTI, NY
0001967417043 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357926 1#0##0#0#0.0#2022-03-16
15:52:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
956543b0d92289ef8da9642a5ae2e891 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 10/04/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 213534
0 1 0 0 0 SRI HARTATI.NY 082567 63 23339 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358010
1#0##0#0#0.0#2022-03-16
15:53:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
08ad8a83a5cd7c3d358188063fef9d26 150000 0 0 0 0 0
0 0 0 0 15000 0 48534 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 10/02/1964 0 2
1 Z09.8;E11.4;G59.0;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 927469
0 1 0 0 0 THEODORA SARFIAH,(NY) 045285 58 21207
yani;3302226402970001; 5.6.5.202203091809 4 358011
1#0##0#0#0.0#2022-03-16
15:55:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bd3a0a15a35376baeef8f770cc81a87d 150000 0 0 0 0 0
0 31845 0 0 15000 0 730624 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 04/07/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 316762
0 1 0 0 0 SUTARTO,TN 097881 62 22889 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 358013
1#0##0#0#0.0#2022-03-16
15:57:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
721d9c754339c418f46de440fe4a47ba 150000 0 0 0 0 0
0 120745 0 0 15000 0 31017 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 15/08/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 196845
0 1 0 0 0 SRI PARTINI., NY 051632 62 22847 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358014
1#0##0#0#0.0#2022-03-16
15:58:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a260f13265834d46420f795e08ab1666 150000 0 0 0 0 0
0 31845 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 14/04/1957 0 1
1 Z09.8;M17.9 81.92 - - None None None None M-3-11-0 None
None None None None None PROSEDUR DIAGNOSTIK DAN TERAPEUTIK
0 404900 398120 0 1 0 0 0 AMIR HAUDI,(BP)
029404 64 23700 DR. WAHYU PURNOMO, SP.OT 1124R0020322V000545
0001304571712 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358015 1#0##0#0#0.0#2022-03-16
15:58:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e2346c4bab44f5c7358029bee00380e1 351500 0 0 0 0 0
0 0 0 0 15000 0 31620 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 09/05/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 482068
0 1 0 0 0 SARSINI.NY 089203 67 24771 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 358016
1#0##0#0#0.0#2022-03-16
16:00:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2cefe009bef01a9594afb2b498b9eb8d 150000 0 0 0 0 0
220000 0 0 0 15000 0 97068 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 18/05/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SAMIYATI.NY 094791
0000046966566 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357903 1#0##0#0#0.0#2022-03-16
16:07:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a231dfa470a94bb034d69f605e98eefe 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 12/08/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 224523
0 1 0 0 0 FX DARSINAH .,NY 074934 69 25406 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358017
1#0##0#0#0.0#2022-03-16
16:08:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eaa91a86e1a53cf834fab551998d71b0 150000 0 0 0 0 0
0 0 0 0 15000 0 59523 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 03/08/1963 0 2
1 Z09.8;M17.9;M75.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 197991
0 1 0 0 0 TENTREM.NY 089445 58 21398 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 358018
1#0##0#0#0.0#2022-03-16
16:09:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
24e16ac37a8a37a28cb83f3847782a96 150000 0 0 0 0 0
0 0 0 0 15000 0 32991 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 08/12/1960 0 2
1 Z09.8;E11.4;G59.0;I11.9;M19.98 - - - None None None
None Q-5-44-0 None None None None None None PENYAKIT KRONIS KECIL
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 351984 0 1 0 0 0 SARNI. NY 091223
0001032603085 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358019 1#0##0#0#0.0#2022-03-16
16:10:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f963e1ae8498ea8306b86c10f16b5de6 150000 0 0 0 0 0
0 107990 0 0 15000 0 78994 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 16/06/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 199683
0 1 0 0 0 WIDIYASTUTI, NY 090543 60 22176 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358021
1#0##0#0#0.0#2022-03-16
16:11:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dc8f0682f566c50c387ad6e8943d2332 150000 0 0 0 0 0
0 0 0 0 15000 0 34683 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 10/10/1959 0 2
0 - 0 - 0 - 0 183900 353986 0 1
0 0 0 SRI REJEKI, NY 095056 62 22791 DR. WAHYU PURNOMO,
SP.OT 1124R0020322V000552 0001093341104 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 358022 1#0##0#0#0.0#2022-03-16
16:13:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
07b10691a3e56543fdd6b2671dd08186 300000 0 0 0 0 0
0 0 0 0 15000 0 38986 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 16/01/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 253950
0 1 0 0 0 YHANI HARDININGSIH.NY 094162 61 22327
yani;3302226402970001; 5.6.5.202203091809 4 358023
1#0##0#0#0.0#2022-03-16
16:14:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ff54e4d3e0c671a18cacba525512820e 150000 0 0 0 0 0
0 88950 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 12/09/2013 0 2
0 - 0 - 0 - 0 183900 207781 0 1
0 0 0 REVIANA SAFA SEPTIANI.AN 099209 8 3095 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358024
1#0##0#0#0.0#2022-03-16
16:17:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cff52988b80688b5d0464e34924aa703 176000 0 0 0 0 0
0 0 0 0 15000 0 16781 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 18/01/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 206714
0 1 0 0 0 IVO MUMPUNI WIJAYANINGRUM, NY 095874 56
20499 DR. WAHYU PURNOMO, SP.OT 1124R0020322V000555 0002169780873
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358026
1#0##0#0#0.0#2022-03-16
16:17:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
88541f142d5a11ac622c3882c847bb52 150000 0 0 0 0 0
0 0 0 0 15000 0 41714 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 07/08/1962 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
326349 0 1 0 0 0 MUSINAH, NY 100232 59 21759
yani;3302226402970001; 5.6.5.202203091809 4 358030
1#0##0#0#0.0#2022-03-16
16:19:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
96fcca0a42645a484eb0614c33c34702 150000 0 0 0 0 0
0 89050 0 0 15000 0 72299 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 25/02/1972 0 1
1 Z09.8;M47.86 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 213534
novia;3313125201940001; 5.6.7.202204241238 4 358028
1#0##0#0#0.0#2022-05-20
10:09:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
a10d213d14e888e37fb36ca0c0915ad2 150000 0 0 0 0 0
0 0 0 0 15000 0 48534 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 23/12/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 378359
0 1 0 0 0 RIYANI.NY 080489 42 15412 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 358032
1#0##0#0#0.0#2022-03-16
16:21:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2bde23134f047c0082faa949b523d209 150000 0 0 0 0 0
0 76145 0 0 15000 0 137214 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 24/05/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 531478
0 1 0 0 0 PRAPTONO.TN 081895 61 22564 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 358034
1#0##0#0#0.0#2022-03-16
16:22:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
051e93288e849cf4dd7c4cbf657567bd 150000 0 0 0 0 0
0 76045 0 0 15000 0 290433 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 16/08/1975 0 2
1 Z09.8;K80.2;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 315366
0 1 0 0 0 TRIFOSA ROIDA.NY 095537 46 17002 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358038
1#0##0#0#0.0#2022-03-16
16:23:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d957e71381ff1a282bdfba2d84b822a8 150000 0 0 0 0 0
0 0 0 0 15000 0 150366 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 12/07/1982 0 2
0 - 0 - 0 - 0 - 0 549400 239948
0 1 0 0 0 ANI ASMOROWATI, NY 065602 39 14480
DR. DEWI ANGGOROWATI, SP.OG 1124R0020322V000561 0002458131254 3;JKN
yani;3302226402970001; 5.6.5.202203091809 4 358040
1#0##0#0#0.0#2022-03-16
16:25:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ee6e303553c66df6d4193035a9f725b2 200000 0 0 0 0 0
0 0 0 0 15000 0 24948 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 16/10/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 211398
0 1 0 0 0 MURSIHWATI.NY 089241 63 23150 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358041
1#0##0#0#0.0#2022-03-16
16:25:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aaad86c61aeb78184a2a2c855fa9ec11 150000 0 0 0 0 0
0 0 0 0 15000 0 46398 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 11/09/1947 0 1
0 0 - 0 - 0 - 0 - 0 181400 221793
0 1 0 0 0 TUKIMAN.TN 098571 74 27203 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 358043
1#0##0#0#0.0#2022-03-16
16:27:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5f0932d52c8b5b4b6fe9ec65b2feaa3f 150000 0 0 0 0 0
0 0 0 0 15000 0 56793 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 28/02/1962 0 1
1 Z09.8;E11.4;G59.0;M17.9;M54.59 - - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 433218 0 1 0 0 0 SUPRAPTO., TN 069741
0000555771958 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358047 1#0##0#0#0.0#2022-03-16
16:28:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bdaf3bd463acbd5b97db9d4e015e328f 150000 0 0 0 0 0
0 108440 0 0 15000 0 159778 0 0 0 0
0
3372030 C 3 CP 2 04/03/2022 04/03/2022 14/04/1960 0 2
1 Z09.8;E11.4;G59.0;I10 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 264189
0 1 0 0 0 MARTINAH., NY 072061 61 22604 DR.
novia;3313125201940001; 5.6.7.202204241238 4 358049
1#0##0#0#0.0#2022-05-19
10:02:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
213bef47616ed21f80c77df2e214d7ce 150000 0 0 0 0 0
0 76045 0 0 15000 0 23144 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 07/10/1995 0 1
1 Z09.8;S83.5 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 220363
0 1 0 0 0 MUHAMMAD IMRON ROSADI.SDR 101626 26
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358051
1#0##0#0#0.0#2022-03-16
16:30:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
486ea40aeba411fe5d9bdc7824facdf2 150000 0 0 0 0 0
0 0 0 0 15000 0 55363 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 15/04/1973 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 TATAS BUDIONO.TN
0001440938553 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357907 1#0##0#0#0.0#2022-03-16
16:33:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
3755fdbde5cce3fb26e80fb9a00d3805 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 23/07/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 219000 0 1 0 0 0 ERNIE HADIANTI, NY
0001868943565 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357906 1#0##0#0#0.0#2022-03-16
16:34:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
94b9448aa067b6e1407c4f4b684f49da 204000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 03/02/1955 0 2
1 Z09.8;E11.9;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 342568
0 1 0 0 0 SUMARSIH,NY 085983 67 24501 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 358052
1#0##0#0#0.0#2022-03-16
16:35:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b593edeb0049f32ff7f60bc1099f9c70 150000 0 0 0 0 0
0 76045 0 0 15000 0 101523 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 23/03/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARSINI., NY
0001032584782 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357902 1#0##0#0#0.0#2022-03-16
16:36:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
36eb070bd5699a0399fced7a1a9d97d1 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 16/06/1980 0 2
0 0 - 0 - 0 - 0 - 0 181400 238574
0 1 0 0 0 MARSINI, NY 101212 41 15236 DR. ARIA
yani;3302226402970001; 5.6.5.202203091809 4 358053
1#0##0#0#0.0#2022-03-16
16:37:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
048b410cc1b454ba30e4123e6be229ec 150000 0 0 0 0 0
0 0 0 0 15000 0 73574 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 04/03/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 327090
0 1 0 0 0 SETIJOKO.TN 085866 72 26663 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 358055
1#0##0#0#0.0#2022-03-16
16:39:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
51f965265aba39d0076c4beb6ff0931b 150000 0 0 0 0 0
0 120795 0 0 15000 0 41295 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 24/07/1968 0 2
0 - 0 107400 273000 0 1 0 0 0
SUTAMI.NY 099959 53 19581 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000573 0000640553196 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357932 1#0##0#0#0.0#2022-03-16
16:40:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4ea66a7fd48335b540350ee5b5e51594 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 02/02/1963 0 2
0 - 0 107400 262000 0 1 0 0 0
SUJIYEM, NY 090600 59 21580 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000574 0001696847466 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357928 1#0##0#0#0.0#2022-03-17
07:20:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9a9d410fadefea57ec334d2f0443e311 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 01/01/2000 0 2
0 - 0 - 0 - 0 - 0 549400 175307
0 1 0 0 0 MARIA WIDYANINGSIH,(NN) 050173 22 8098
yani;3302226402970001; 5.6.5.202203091809 4 358057
1#0##0#0#0.0#2022-03-17
07:26:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6375c5d44ce366c932b166d5f9cbe9d3 150000 0 0 0 0 0
0 0 0 0 15000 0 10307 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 22/03/2005 0 2
0 0 - 0 - 0 - 0 - 0 181400 325544
0 1 0 0 0 ZANNA MAGHFIROH.AN 101311 16 6191
yani;3302226402970001; 5.6.5.202203091809 4 358058
1#0##0#0#0.0#2022-03-17
07:32:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
28d49669c3c408101b86221c213d6ad7 305000 0 0 0 0 0
0 0 0 0 15000 0 5544 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 19/02/1956 0 2
1 Z09.8;K30;R10.4 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 471810
0 1 0 0 0 TUMINAH.NY 093575 66 24120 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 358062
1#0##0#0#0.0#2022-03-17
07:33:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
26054fa97321a2288418609e0aa461fe 150000 0 0 0 0 0
0 241590 0 0 15000 0 65220 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 21/08/1948 0 2
1 Z09.8;M17.9 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 213087
0 1 0 0 0 MUSNATIN., NY 071462 73 26858 DR.
novia;3313125201940001; 5.6.7.202204241238 4 358064
1#0##0#0#0.0#2022-05-19
10:00:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
a6cc1ddcab00521efd3df17bbf673aec 150000 0 0 0 0 0
0 0 0 0 15000 0 48087 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 29/10/1965 0 1
1 Z09.8;J44.9;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 210618
0 1 0 0 0 SANTOSO. TN 038094 56 20580 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 358066
1#0##0#0#0.0#2022-03-17
08:13:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a210153e2aecd892558adc8a8e7fcf9c 150000 0 0 0 0 0
0 0 0 0 15000 0 45618 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 14/06/1974 0 1
0 0 - 0 - 0 - 0 - 0 181400 676387
0 1 0 0 0 HANDOKO.TN 082490 47 17430 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 358067
1#0##0#0#0.0#2022-03-17
08:17:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4a75227cf8283d1cbf5ded6e3a658c4a 150000 0 0 0 0 0
0 153190 0 0 15000 0 358197 0 0 0 0
0
3372030 C 3 CP 2 04/03/2022 04/03/2022 20/10/1971 0 2
1 Z09.8;I10;K30 88.76 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400 676937
0 1 0 0 0 RITA SETYANINGSIH.NY 100773 50 18398
yani;3302226402970001; 5.6.5.202203091809 4 358069
1#0##0#0#0.0#2022-03-17
08:18:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
284e373105d99f92f77b3b73b58b2a9c 150000 0 0 0 0 0
350000 0 0 0 15000 0 161937 0 0 0 0
0
3372030 C 3 CP 2 04/03/2022 04/03/2022 06/06/2008 0 2
0 0 - 0 - 0 - 0 - 0 181400 445991
0 1 0 0 0 BALQIS CHURYN MAYSA A, AN 099729 13
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358071
1#0##0#0#0.0#2022-03-17
08:19:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1f314074c37fe1407479599aed10043d 150000 0 0 0 0 0
248000 0 0 0 15000 0 32991 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 14/06/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 509303
0 1 0 0 0 GIYATNO,BP 009104 49 18160 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 358073
1#0##0#0#0.0#2022-03-17
08:37:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0b4456208bbda6144d29caea12077eec 150000 0 0 0 0 0
0 242690 0 0 15000 0 101613 0 0 0 0
0
3372030 C 3 CP 2 04/03/2022 04/03/2022 16/09/1970 0 1
1 Z09.8;I10;K30;E79.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 298782
0 1 0 0 0 EKO HERIYANTO,BP 073484 51 18797 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358074
1#0##0#0#0.0#2022-03-17
08:47:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b4802ba0bddefc7289ba5eb2c6aaa36c 150000 0 0 0 0 0
0 0 0 0 15000 0 133782 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 12/04/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARIYAM.NY 084306
0001302703266 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357935 1#0##0#0#0.0#2022-03-18
08:11:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9384d42ad9a723b25fe4d5b7ff743b81 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 08/10/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 185922
0 1 0 0 0 ENDANG KRISTIANY S, NY 068253 79 29002
yani;3302226402970001; 5.6.5.202203091809 4 358079
1#0##0#0#0.0#2022-03-18
08:10:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
38174db631759264267d4deb3c4b72c3 150000 0 0 0 0 0
0 0 0 0 15000 0 20922 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 05/06/1961 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MARSIATUN, NY
0002311256204 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357930 1#0##0#0#0.0#2022-03-18
08:17:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
260e06bf266eaee902fff4005aebb1ab 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 27/04/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 211266
0 1 0 0 0 SUMARDI TASRIF 093401 65 24052 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358081
1#0##0#0#0.0#2022-04-08
08:23:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
d5ab8f8caf1a22a7c4d342106b48ea31 150000 0 0 0 0 0
0 0 0 0 15000 0 46266 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 22/04/1986 0 1
1 Z09.8;K30;K21.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 189289
0 1 0 0 0 AWAN DIKO NUGROHO, SDR 092174 35 13100
yani;3302226402970001; 5.6.5.202203091809 4 358094
1#0##0#0#0.0#2022-03-18
08:20:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fe084a5a60e1834c9be4437d0eab047e 150000 0 0 0 0 0
0 0 0 0 15000 0 24289 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 12/06/1972 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 357850
1#0##0#0#0.0#2022-03-18
08:22:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
83e319b388ca69c0d6a5257e158a6f68 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 22/09/1959 0 1
0 - 0 107400 273000 0 1 0 0 0
1124R0020322V000593 0001032587199 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357934 1#0##0#0#0.0#2022-03-18
08:23:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ca784b96a8ad2cc22333c1fc9e6839eb 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 17/04/1961 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 357851
1#0##0#0#0.0#2022-03-18
08:25:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8a2a8ac5f169cb8405e22f76a7ab60ea 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 22/04/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 427768
0 1 0 0 0 DJUWARSO, (BP) 008057 72 26614 DR.
novia;3313125201940001; 5.6.7.202204241238 4 358096
1#0##0#0#0.0#2022-05-18
10:44:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
a935a2a89297721c96c155bb1e79836a 150000 0 0 0 0 0
0 0 0 0 15000 0 262768 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 01/04/1981 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V000596 0001904830593 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357852 1#0##0#0#0.0#2022-03-18
08:29:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
19250b425d86239f817f3205f0df73e9 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 05/01/1951 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ACHMAD SUPARDI.,
TN 061983 71 25991 DR. LINDA SUGIARTO, SP.FKR 1124R0020322V000597
0001693922106 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357919 1#0##0#0#0.0#2022-03-18
08:30:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
242162e42dffecf6f11df480b3049ca7 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 01/12/1958 0 2
0 - 0 - 0 - 0 786200 677676 0 1
SP.PD 1124R0020322V000598 0001436949538 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357853 1#0##0#0#0.0#2022-03-18
08:32:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4e33e715d8d2d5251bdda53f7d18cfdd 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 25/05/1972 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V000599 0002431552465 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 357854 1#0##0#0#0.0#2022-04-08
08:29:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
aed3c4a4d87e4e753ae3bd637af2862d 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 20/08/1959 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V000600 0000571256594 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357855 1#0##0#0#0.0#2022-03-18
08:34:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bdcd3a90d017d17009d602256f9cd030 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 21/06/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 254544
0 1 0 0 0 SAIMIN,(BP) 016600 77 28380 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 358098
1#0##0#0#0.0#2022-03-18
08:36:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
481fc8f21a32eefa29b78ba0d56e5a03 150000 0 0 0 0 0
0 0 0 0 15000 0 89544 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 26/04/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 357856
1#0##0#0#0.0#2022-03-18
08:40:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cc399319afafd8df630efc5c71d428a5 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 01/12/1980 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V000604 0000640230884 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357857 1#0##0#0#0.0#2022-03-18
08:43:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4681b77d4011a9d2b3a89cbeb847adb2 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 25/09/1944 0 1
1 Z09.8;I10;J44.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 273606
0 1 0 0 0 MOSIDI MARTOWIYONO, TN 022679 77 28284
yani;3302226402970001; 5.6.5.202203091809 4 358100
1#0##0#0#0.0#2022-03-25
14:43:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0cd83b12f32902ab8a5a3db99c3ac0ee 150000 0 0 0 0 0
0 0 0 0 15000 0 108606 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 08/03/1967 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 357858
1#0##0#0#0.0#2022-03-25
14:50:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
89927b5691d0e01056fbb760d3b6f425 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 06/02/1941 0 2
0 0 - 0 - 0 - 0 - 0 181400 241931
0 1 0 0 0 KATIYEM,(NY) 019745 81 29611 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358102
1#0##0#0#0.0#2022-03-25
14:51:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ec8908fdf09875b5d5a1ab513be510b4 150000 0 0 0 0 0
0 0 0 0 15000 0 76931 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 01/05/1975 0 1
0 - 0 - 0 - 0 786200 677676 0 1
SP.PD 1124R0020322V000608 0001790328262 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357859 1#0##0#0#0.0#2022-03-25
14:53:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f05cfb4fddf540cd7bc0baba40fefe65 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 07/12/1946 0 1
0 - 0 - 0 - 0 786200 618576 0 1
0 0 0 HADI SUKIR,TN 083931 75 27481 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 357849
1#0##0#0#0.0#2022-03-25
14:54:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6fc5c9fc9b9038fab94408128f8025f3 463830 0 0 0 0 0
0 44300 0 0 15000 0 95446 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 08/09/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 220451
0 1 0 0 0 DARMINI,(NY) 021691 76 27936 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358104
1#0##0#0#0.0#2022-03-25
14:56:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e202038f268ddcd3cf122153c0a6c4b1 150000 0 0 0 0 0
0 0 0 0 15000 0 55451 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 05/05/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SURYATI, NY 090097
0001479655326 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357922 1#0##0#0#0.0#2022-03-25
14:57:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
94278fd2160ef0f292b4ec3f9d8d6746 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 29/09/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 461606
0 1 0 0 0 HUSMARYANTO 36573 60 22071 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 360148
1#0##0#0#0.0#2022-03-25
14:58:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9289f3739a69cd9f7bb005df4a300fb6 150000 0 0 0 0 0
0 152090 0 0 15000 0 144516 0 0 0 0
0
3372030 C 3 CP 2 04/03/2022 04/03/2022 11/09/1954 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMARNO.TN 095054
0001425421326 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357901 1#0##0#0#0.0#2022-03-25
15:07:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1f85876fb42ebd4a609307c1b67386e5 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 24/07/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 475709
0 1 0 0 0 HARRY.TN 078186 67 24695 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 358106
1#0##0#0#0.0#2022-04-08
08:34:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
83cf56b8852f1b76ba8893c28fec98ac 150000 0 0 0 0 0
0 0 0 0 15000 0 310709 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 03/03/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 205354
0 1 0 0 0 JAMIATUL KIROM., NY 050640 69 25203
yani;3302226402970001; 5.6.5.202203091809 4 358107
1#0##0#0#0.0#2022-03-25
15:13:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b9fff4ca598080a7804f13d07e205918 150000 0 0 0 0 0
0 0 0 0 15000 0 40354 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 05/12/1956 0 2
1 Z09.8;H81.3;G62.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 190561
0 1 0 0 0 KRISTIYANI PUJIASTUTI, NY 068903 65
0000091025436 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358108 1#0##0#0#0.0#2022-03-25
15:23:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
934886c02f5b8d92e747963be0045cc2 150000 0 0 0 0 0
0 0 0 0 15000 0 25561 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 07/06/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 219926
0 1 0 0 0 ISROWIYAH, NY 091060 64 23646 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358109
1#0##0#0#0.0#2022-03-25
15:24:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f9774c00e2f92e5e173b22c85f76d9d3 150000 0 0 0 0 0
0 0 0 0 15000 0 54926 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 01/05/1943 0 2
1 Z09.8;E11.4;G59.0;I10;K30 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
844393 0 1 0 0 0 SUTARTI NY 049566 78 28797
yani;3302226402970001; 5.6.5.202203091809 4 358110
1#0##0#0#0.0#2022-03-25
15:26:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
812bb30aa2d76a1cfb89f899020bb691 150000 0 0 0 0 0
0 0 0 0 15000 0 679393 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 10/11/1965 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 TOTOK HERU SUPRIYANTO 44918 56 20568 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360155
1#0##0#0#0.0#2022-03-25
15:29:01#0#00:00:01#00:00:01#14:37:31#{"co_insidense_ind":"0"} 1
b9a3250fe8d12c3d3096751bdcae7912 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 03/08/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 939896
0 1 0 0 0 SUMINAH.NY 096054 60 22128 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 358112
1#0##0#0#0.0#2022-03-25
15:31:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2c063c55daa21c204ded58b88b3a3255 150000 0 0 0 0 0
0 0 0 0 15000 0 774896 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 21/02/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 316029
0 1 0 0 0 EDWAR TANJUNG. TN 093650 56 20465 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358113
1#0##0#0#0.0#2022-03-25
15:35:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3d396dba9912ad33722e3c2a4160a3b3 150000 0 0 0 0 0
0 76045 0 0 15000 0 74984 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 06/09/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 332283
0 1 0 0 0 SUGIARTI.NY 102162 62 22825 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 358114
1#0##0#0#0.0#2022-03-25
15:37:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fa1e65afc0d734ee0800765c0586be5f 150000 0 0 0 0 0
0 0 0 0 15000 0 167283 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 26/06/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MARKAMAH,NY 085323
0001102473909 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357900 1#0##0#0#0.0#2022-03-25
15:38:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
40197d464d952197159a5e8ab494ef8a 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 01/02/1942 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DARTINAH 30952
0001021779674 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
360160 1#0##0#0#0.0#2022-03-25
15:41:26#0#00:00:01#00:00:01#13:57:26#{"co_insidense_ind":"0"} 1
b68037cb934ad41f78e1ea7327d92028 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 06/09/1976 0 1
0 0 - 0 - 0 - 0 - 0 181400 378602
yani;3302226402970001; 5.6.5.202203091809 4 358115
1#0##0#0#0.0#2022-03-25
15:45:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
22303197391b3fe6dafab84f1812f379 150000 0 0 0 0 0
0 76595 0 0 15000 0 137007 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 07/10/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 585991
0 1 0 0 0 SUPARDI., BP 041629 58 21333 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358116
1#0##0#0#0.0#2022-03-25
15:47:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f89d303331fd2b745cc5ac35ab323fe0 150000 0 0 0 0 0
0 31845 0 0 15000 0 389146 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 07/10/1970 0 2
1 Z09.8;I69.3;M53.19 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 234801
0 1 0 0 0 NUR LASMI, NY 072492 51 18776 DR.
novia;3313125201940001; 5.6.7.202204241238 4 358117
1#0##0#0#0.0#2022-05-19
10:04:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
c4734d7f5ffcf4f3e0a75d73a9e31bc3 150000 0 0 0 0 0
0 0 0 0 15000 0 69801 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 13/04/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 215567
0 1 0 0 0 DENNY SUTARSIH, NY 071249 63 23336
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358118
1#0##0#0#0.0#2022-03-25
15:51:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e9ec4c1f39d3f0e535d59b6b22cf0717 150000 0 0 0 0 0
0 0 0 0 15000 0 50567 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 31/07/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400
1162876 0 1 0 0 0 Bp. Agus Junaedi 16721 51 18844
yani;3302226402970001; 5.6.5.202203091809 4 360165
1#0##0#0#0.0#2022-03-25
15:53:40#0#00:00:01#00:00:01#09:47:22#{"co_insidense_ind":"0"} 1
4c09183c93ccba2295b8a5c7f6446dae 150000 0 0 0 0 0
0 31845 0 0 15000 0 966031 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 22/02/1964 0 1
1 Z09.8;G20;I69.3 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 978547
0 1 0 0 0 AJI RAHMAT ., BP 053281 58 21195 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358120
1#0##0#0#0.0#2022-03-25
16:11:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cd470203710444450745b0a89d3c535a 150000 0 0 0 0 0
0 0 0 0 15000 0 813547 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 14/05/1933 0 1
0 0 - 0 - 0 - 0 - 0 181400 209561
0 1 0 0 0 KOESWANTO BA.TN 095635 88 32436 DR.
novia;3313125201940001; 5.6.7.202204241238 4 358121
1#0##0#0#0.0#2022-05-20
11:34:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
ea54aca0fbd6f0420a5b01d5eb542db2 150000 0 0 0 0 0
0 0 0 0 15000 0 44561 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 26/06/1978 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RINDIYATI.NY 101781 43 15957 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 358122
1#0##0#0#0.0#2022-03-25
16:14:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3918f7692ccbaa005db0ff41c49dddd8 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 07/07/1949 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MATHEUS SRIWIYONO, BP 100715 72 26538 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 358123
1#0##0#0#0.0#2022-04-08
08:37:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
848cbe4860da313cf56d5a03a925f30c 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 14/10/1998 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SUNAN ADI RACHMADI.TN 098775 23 8542 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 358124
1#0##0#0#0.0#2022-03-25
16:27:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4904e9e2eb3979004c8bcef0575956cb 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 06/07/1993 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SITI NUR CHASANAH.NY 101502 28 10468 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 358125
1#0##0#0#0.0#2022-03-25
16:28:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
33c1ea39c96aa4d887f90f5b0f2e7f00 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 14/10/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 253391
0 1 0 0 0 S ANINDA ASTUTI 52771 61 22421 DR. ARIA
yani;3302226402970001; 5.6.5.202203091809 4 360171
1#0##0#0#0.0#2022-03-25
16:30:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
94fd9b814212ec71555b781c11ec46fe 150000 0 0 0 0 0
0 0 0 0 15000 0 88391 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 12/12/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 254463
0 1 0 0 0 SUPARTINI.NY 084915 73 26745 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358127
1#0##0#0#0.0#2022-03-25
16:36:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d4945a8c10775c54ab91be4b5a7b5533 150000 0 0 0 0 0
0 0 0 0 15000 0 89463 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 06/09/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 244893
0 1 0 0 0 YESSY SUSILOWATI.NY 088633 47 17346
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358128
1#0##0#0#0.0#2022-03-25
16:37:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
543cc5be66e1d096a2c179f2387a0066 150000 0 0 0 0 0
0 0 0 0 15000 0 79893 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 25/12/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WAHJUNINGSIH
1124R0020322V000641 0001647209711 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357898 1#0##0#0#0.0#2022-03-25
16:38:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f90e207e553ea6f4a36231752f716a51 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 08/12/1949 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SISWO SARJONO
0000564473013 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
360175 1#0##0#0#0.0#2022-03-25
16:39:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ad31c11fa8ba69fbe1a21cc10cfb0188 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 10/11/1969 0 1
None None None None None CT-SCAN KEPALA 894800 0 0 -
0 - 0 - 0 - 0 894800 1449375 0 1
0 0 0 BAMBANG RUSPANTO.TN 101606 52 19107 DR. ARIA
yani;3302226402970001; 5.6.5.202203091809 4 358129
1#0##0#0#0.0#2022-03-25
16:41:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
9625afcefca1f0e5c92119293ac3e042 150000 0 0 0 0 0
1250000 0 0 0 15000 0 34375 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 19/08/1962 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ARNOLD MANIK,TN 083945 59 21747 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 358130
1#0##0#0#0.0#2022-03-25
16:43:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5b7b050a15ff6183e3d2d3156248927c 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 05/11/1970 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MARKABAN ZAINI.TN 101782 51 18747 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 358132
1#0##0#0#0.0#2022-03-25
16:45:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e3e88e7fda9a543d29651b9cf7203162 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 09/11/1971 0 2
- 0 - 0 - 0 - 0 283800 342533 0
1 0 0 0 SUHASTI,(NY) 038243 50 18378 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 358133
1#0##0#0#0.0#2022-03-25
16:46:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
de01ff78ea70eaa774e46403d3610bbe 300000 0 0 0 0 0
0 0 0 0 15000 0 27533 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 29/04/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 222926
0 1 0 0 0 SRI HARIYANTI.NY 090167 53 19667 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358134
1#0##0#0#0.0#2022-03-25
16:47:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ca9e47f9c4cd1bcac88fde6b5e73871a 150000 0 0 0 0 0
0 0 0 0 15000 0 57926 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 24/07/1960 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SITI NOERSYAMSIYAH, NY 101777 61 22503 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 358135
1#0##0#0#0.0#2022-03-25
16:49:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
80dc70f1f29ac1fda82503205c2d0c01 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 20/04/1954 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 LUCIA SUMINEM, NY 101328 67 24790 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 358136
1#0##0#0#0.0#2022-03-28
07:28:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4db3b13ae0eeb47811d308b6357811e0 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 21/06/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 224010
0 1 0 0 0 MUCHAMAD NUGROHO ERIYANTO.TN 101249 51
0001692524654 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358137 1#0##0#0#0.0#2022-03-28
07:31:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fd7e14dfd092526c288da7d3dd3580b6 150000 0 0 0 0 0
0 0 0 0 15000 0 59010 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 10/04/1943 0 2
0 0 - 0 - 0 - 0 - 0 181400 248160
0 1 0 0 0 SRIYANTI, (NY) 033740 78 28818 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358138
1#0##0#0#0.0#2022-03-28
07:32:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
522cf177cae48e88896ac746a680e181 150000 0 0 0 0 0
0 0 0 0 15000 0 83160 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 18/08/1981 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 YENI SULAIKAH, NY 100541 40 14808 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 358139
1#0##0#0#0.0#2022-03-28
07:33:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5677a6e50ffc0237ccbdeb9341b2bf18 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 17/03/1976 0 1
0 0 - 0 - 0 - 0 - 0 181400 263467
0 1 0 0 0 BAMBANG ARIANTO A, SDR 100192 45 16788
3;JKN novia;3313125201940001; 5.6.7.202204241238 4 358140
1#0##0#0#0.0#2022-05-20
08:32:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
b8f05e39dc896fded559202c11e5ce68 150000 0 0 0 0 0
0 0 0 0 15000 0 98467 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 15/12/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 258382
0 1 0 0 0 TRI HERU SAPTONO.TN 098451 56 20533
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358141
1#0##0#0#0.0#2022-03-28
07:34:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8ae91d895d8f1b1444a284751516474c 150000 0 0 0 0 0
0 0 0 0 15000 0 93382 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 08/08/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 233365
0 1 0 0 0 GIYANTI.NY 100284 50 18471 DR. ARIA
yani;3302226402970001; 5.6.5.202203091809 4 358142
1#0##0#0#0.0#2022-03-28
07:35:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9db9e0c51ae37f4e5d2aa553cb9f4d5c 150000 0 0 0 0 0
0 0 0 0 15000 0 68365 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 02/08/2003 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 LAVERDA DANISWARA SULISTYA ATMOKO., AN 053272
18 6789 DRG. VERAWATY, SP.KG 1124R0020322V000657 0001281217015
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 360189
1#0##0#0#0.0#2022-03-28
07:40:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
01353666e663e53a87c15c2b11727891 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 01/09/1967 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 DARYONO, TN 018372 54 19908 DRG. VERAWATY,
SP.KG 1124R0020322V000659 0001966857344 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 358144 1#0##0#0#0.0#2022-03-28
07:41:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6e3102b9a4be2129dd71c2e083cd656e 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 01/01/2000 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 NADYA NURHALIZA,(AN) 006004 22 8098 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 358145
1#0##0#0#0.0#2022-03-28
07:42:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a2c44871da4dfab19c8c091d309d0160 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 01/01/2000 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SUDIRMAN LAMSI., BP 041571 22 8098 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 358146
1#0##0#0#0.0#2022-03-28
07:43:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b39b4626ac56d417f04e57f48c97180a 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 01/11/1961 0 2
0 - 0 107400 273000 0 1 0 0 0
KUSTIATI, NY 048553 60 22038 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000663 0000090942546 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357896 1#0##0#0#0.0#2022-03-28
07:44:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0d75efc703cc54e376726b70af2069f1 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 17/01/1977 0 2
1 K12.2 27.0 - - None None None None U-2-32-0 None None
None None None None PROSEDUR KECIL PADA MULUT DAN LIDAH 254400 0
0 - 0 - 0 - 0 - 0 254400 339233
yani;3302226402970001; 5.6.5.202203091809 4 358147
1#0##0#0#0.0#2022-03-28
08:39:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
34d773c281e66eca6d8adf90dbb28d8e 300000 0 0 0 0 0
0 0 0 0 15000 0 24233 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 25/05/2000 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ROSYIDA ALFIANI, NN 101353 21 7953 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 358148
1#0##0#0#0.0#2022-03-28
08:40:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
85883d06def3421cc82e9c3d641f4b38 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 27/06/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI MARGANI.NY
0000091413112 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357936 1#0##0#0#0.0#2022-03-28
08:41:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4f4a063bfb8be4ecebdc4ba83a2a7092 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 08/05/1989 0 1
None None None None PROSEDUR PADA GIGI 283800 0 0 -
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 FARIZ CANDRA K, TN 102275 32 11988 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 358149
1#0##0#0#0.0#2022-03-28
08:42:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
824b0f0d8516f5a17c5d8420bee5cd76 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 02/05/2017 0 2
1 Z09.8;A49.9 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 228252
0 1 0 0 0 AQILA MEISEI WIJAYANTI, AN 076092 4
1767 DR. ANI SURYANTI WISYASTUTI, SP.A., M.KES 1124R0020322V000669
0002466229151 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358150 1#0##0#0#0.0#2022-03-28
08:43:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ba2aeb0ed6b559397957c5fcb63585bc 150000 0 0 0 48000 0
0 0 0 0 15000 0 15252 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 05/08/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 360945
0 1 0 0 0 SUKARYANI, (NY) 003181 52 19204 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358151
1#0##0#0#0.0#2022-03-28
08:44:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
50138354be8ef92eb4beaac0e61f6b19 150000 0 0 0 0 0
0 120795 0 0 15000 0 75150 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 09/12/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400
1353961 0 1 0 0 0 SUPRIYANTO, (BP) 012565 54
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358152
1#0##0#0#0.0#2022-03-28
08:46:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
63d3e45c9bff5d06d2a31b532f5b3943 150000 0 0 0 0 0
0 107890 0 0 15000 0 1081071 0 0 0 0
0
3372030 C 3 CP 2 04/03/2022 04/03/2022 12/08/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 224906
0 1 0 0 0 TITIEK MULYANI., NY 051274 58 21389
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358153
1#0##0#0#0.0#2022-03-28
08:48:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f27dbde6e8478ddd653bedca9fce6400 150000 0 0 0 0 0
0 0 0 0 15000 0 59906 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 30/04/1969 0 2
1 Z09.8;H81.4;M19.98 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 217872
0 1 0 0 0 ANIK SRI WAHYUNINGRUM, NY 058382 52
0001084023909 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358154 1#0##0#0#0.0#2022-03-28
08:50:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f6770d555611346a3394b1f55afad7bc 150000 0 0 0 0 0
0 0 0 0 15000 0 52872 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 02/04/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 232870
0 1 0 0 0 SRI SISMIATUN., NY 046455 69 25538
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358155
1#0##0#0#0.0#2022-03-28
08:50:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
77fd56c03de4dc6a8d414f042a9a8b9f 150000 0 0 0 0 0
0 0 0 0 15000 0 67870 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 31/10/1990 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 WAHITA RISKIKA UMAMI., (NY) 041375 31 11447
yani;3302226402970001; 5.6.5.202203091809 4 358156
1#0##0#0#0.0#2022-03-28
08:51:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bd353dd25985900c9d6f881b066089da 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 21/04/1997 0 2
1 H81.3 - - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 297654
0 1 0 0 0 ANISYAH NILAM., NN 050907 24 9083
DR. GREETA 1124R0020322V000676 0001106456692 3;JKN
reni;3313147010930001; 5.6.6.202203301209 4 360983
1#0##0#0#0.0#2022-04-04
16:47:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2ae19b650aa79cb7cb8c151d24135e1a 195000 0 0 0 0 0
0 0 0 0 15000 0 87654 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 13/04/1982 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 YUSRINA APRIYANTI,(NY) 017846 39 14570
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358157
1#0##0#0#0.0#2022-03-28
08:53:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9e8ba3a572bbf4deabe57465e6672fce 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 02/06/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 241340
0 1 0 0 0 KUS SULISTYO.TN 097613 55 20364 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358158
1#0##0#0#0.0#2022-03-28
08:54:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bbcfffdf689530ae4b9c1c8702ba39f9 150000 0 0 0 0 0
0 0 0 0 15000 0 76340 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 25/02/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 294641
0 1 0 0 0 SUYANTI., NY 046730 57 20826 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358159
1#0##0#0#0.0#2022-03-28
08:55:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
87b53214a2f4a57e865518fe6f244874 150000 0 0 0 0 0
0 0 0 0 15000 0 129641 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 27/12/1967 0 2
1 Z09.8;I69.3;M17.9 88.27 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 500390
0 1 0 0 0 ISTRIYATI, NY 100792 54 19791 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360215
1#0##0#0#0.0#2022-03-28
09:04:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6ec97d0def5ce04da026474c3cf2e776 150000 0 0 0 0 0
248000 0 0 0 15000 0 87390 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 31/12/1966 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SLAMET RIYADI, TN 101733 55 20152 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 358161
1#0##0#0#0.0#2022-03-28
09:01:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d793463c9e32b9532dd46795eec538bd 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 31/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 227574
0 1 0 0 0 ASLAMIYAH., NY 043938 67 24535 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358162
1#0##0#0#0.0#2022-03-28
09:06:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
ea79ab197f4da03957f9d0cebc3b5792 150000 0 0 0 0 0
0 0 0 0 15000 0 62574 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 11/03/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 330881
0 1 0 0 0 BUDIMAN,BP 078815 60 22273 DR. ARIA
yani;3302226402970001; 5.6.5.202203091809 4 358163
1#0##0#0#0.0#2022-03-28
09:07:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6c6ce549a737a8eb26fddb1cf2397c51 150000 0 0 0 0 0
0 0 0 0 15000 0 165881 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 22/07/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 254271
0 1 0 0 0 TRIYONO, TN 052165 50 18488 DR. ARIA
yani;3302226402970001; 5.6.5.202203091809 4 358164
1#0##0#0#0.0#2022-03-28
09:08:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a5c71b93130e2fa877c6e12117f46651 150000 0 0 0 0 0
0 0 0 0 15000 0 89271 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 01/09/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 194365
0 1 0 0 0 MARIA VERENA SINTOWATI.NY 089293 69
0000091422044 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358165 1#0##0#0#0.0#2022-03-28
09:09:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b227d105fe43af8d8049df2732d1646e 150000 0 0 0 0 0
0 0 0 0 15000 0 29365 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 12/06/1979 0 2
1 Z09.8;G44.0;M19.98 87.11 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 477052
0 1 0 0 0 TRI CAHYANINGSIH, NY 092685 42 15606
3;JKN novia;3313125201940001; 5.6.7.202204241238 4 358166
1#0##0#0#0.0#2022-05-19
11:14:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
2d7d784971cfe21c92fe283128209f68 150000 0 0 0 0 0
260000 0 0 0 15000 0 52052 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 14/12/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 222596
0 1 0 0 0 SRI DARMINI, NY 093216 70 25648 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358167
1#0##0#0#0.0#2022-03-28
09:10:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5587b140d51ca35163789ddb5ed74dfd 150000 0 0 0 0 0
0 0 0 0 15000 0 57596 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 03/03/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 231864
0 1 0 0 0 SRI MULYANI,(NY) 040379 62 22646 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358168
1#0##0#0#0.0#2022-03-28
09:12:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a048c0a5d5d959570e024b656716f652 150000 0 0 0 0 0
0 0 0 0 15000 0 66864 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 13/06/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 227849
novia;3313125201940001; 5.6.7.202204241238 4 358169
1#0##0#0#0.0#2022-05-19
10:24:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
288ccb4de0e7ad6d0ec7a7a3c4b0c1f3 150000 0 0 0 0 0
0 0 0 0 15000 0 62849 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 02/06/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 256256
0 1 0 0 0 JUNI SUYANTO.TN 098551 63 23286 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358170
1#0##0#0#0.0#2022-03-28
09:14:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d333107544b9c9e26527f1e2f96ba75f 150000 0 0 0 0 0
0 0 0 0 15000 0 91256 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 12/01/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 222822
0 1 0 0 0 EKO RINI.NY 093223 53 19409 DR. ARIA
novia;3313125201940001; 5.6.7.202204241238 4 358171
1#0##0#0#0.0#2022-05-19
11:16:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
5cdcd82cc17391b9a231b706f0f636b8 150000 0 0 0 0 0
0 0 0 0 15000 0 57822 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 07/07/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 236235
0 1 0 0 0 HARTONO.TN 094669 55 20329 DR. INDRIANY
yani;3302226402970001; 5.6.5.202203091809 4 358172
1#0##0#0#0.0#2022-03-28
09:16:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
52d1aa7b739aeda4342ed4b0914964f6 150000 0 0 0 0 0
0 0 0 0 15000 0 71235 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 13/06/1981 0 1
0 0 - 0 - 0 - 0 - 0 181400 240295
0 1 0 0 0 ARIS SUPRIYANTO, BP 090897 40 14874
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 360228
1#0##0#0#0.0#2022-03-28
09:17:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3e89b177c7049176ef3d98f0aeb0f1b5 150000 0 0 0 0 0
0 0 0 0 15000 0 75295 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 18/08/1980 0 2
1 Z09.8;D25.9;N83.2 88.79 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400 165000
0 1 0 0 0 NISRINA MURKUMARARINI, (NY) 014130 41
15173 DR. DEWI ANGGOROWATI, SP.OG 1124R0020322V000695 0001102694657
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358174
1#0##0#0#0.0#2022-03-28
09:18:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8df8f9a7693d0c01addf538448e0f7da 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 23/04/1960 0 2
1 Z09.8;M53.19;M19.99 87.22 - - None None None None Z-3-
26-0 None None None None None None PROSEDUR BESAR RADIOGRAFI 700800
0 0 - 0 - 0 - 0 - 0 700800 514895
0 1 0 0 0 SRI WAHYUNI, NY 087660 61 22595 DR.
novia;3313125201940001; 5.6.7.202204241238 4 358175
1#0##0#0#0.0#2022-05-19
10:51:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
2702418f73d202e85168dc5439e92bf8 150000 0 0 0 0 0
285000 0 0 0 15000 0 64895 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 08/06/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 225716
0 1 0 0 0 LAMIYEM.NY 087484 71 26202 DR. ARIA
yani;3302226402970001; 5.6.5.202203091809 4 358176
1#0##0#0#0.0#2022-03-28
09:20:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
863358cc1f1a6e48e56e968a46872145 150000 0 0 0 0 0
0 0 0 0 15000 0 60716 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 13/05/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 288250
0 1 0 0 0 ENI WIDIASTUTI, NY 100725 51 18923
3;JKN novia;3313125201940001; 5.6.7.202204241238 4 358177
1#0##0#0#0.0#2022-05-20
08:51:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
a1a9660782b45a9dc5bd4a1f2cba8c70 150000 0 0 0 0 0
0 0 0 0 15000 0 123250 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 21/10/1950 0 1
1 Z09.8;I69.3;G20;M54.39 87.24 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 242002
0 1 0 0 0 R DJOKO SURANTO, TN 073204 71 26067
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358179
1#0##0#0#0.0#2022-03-28
09:22:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
09145ab70c15a11bdd3527360d95972c 150000 0 0 0 0 0
0 0 0 0 15000 0 77002 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 14/06/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 209732
0 1 0 0 0 SRI YUNI ASTUTI.NY 095924 45 16699
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358180
1#0##0#0#0.0#2022-03-28
09:23:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ace15d9206419d368b8e9b4d83df0cba 150000 0 0 0 0 0
0 0 0 0 15000 0 44732 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 21/03/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 251372
0 1 0 0 0 BASUKI WIDODO, TN 060757 64 23724 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358181
1#0##0#0#0.0#2022-03-28
09:24:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b62cdd54b2487682389e8aa5448c5052 150000 0 0 0 0 0
0 0 0 0 15000 0 86372 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 15/11/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 239256
0 1 0 0 0 ANIK RUSMINAH, (NY) 050080 56 20563
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358182
1#0##0#0#0.0#2022-03-28
09:25:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
45a56c36ed04a922ef1ca72542a81c46 150000 0 0 0 0 0
0 0 0 0 15000 0 74256 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 12/11/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 262114
0 1 0 0 0 MUH GUNTUR NALURI, TN 091409 58 21297
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358183
1#0##0#0#0.0#2022-03-28
09:25:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0e66a2f91e1327d7f8fee92860957ec9 150000 0 0 0 0 0
0 0 0 0 15000 0 97114 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 08/12/1992 0 1
0 0 - 0 - 0 - 0 - 0 181400 198088
0 1 0 0 0 ARIS ABDULLAH, BP 088781 29 10678 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358184
1#0##0#0#0.0#2022-03-28
09:26:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1f68c5c727a760abc249aec0add59733 150000 0 0 0 0 0
0 0 0 0 15000 0 33088 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 14/03/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 432634
0 1 0 0 0 M ZAINAL ARIFIN, TN 097952 56 20809
yani;3302226402970001; 5.6.5.202203091809 4 358185
1#0##0#0#0.0#2022-03-28
09:27:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b3c5f5fd1eaa280c5bf15214cb101123 150000 0 0 0 0 0
0 121345 0 0 15000 0 146289 0 0 0 0
0
3372030 C 3 CP 2 04/03/2022 04/03/2022 30/11/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 245795
0 1 0 0 0 VERONICA SRI DARNI,(NY) 028552 65 23835
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 360242
1#0##0#0#0.0#2022-03-28
09:28:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7d409c09c13a9cf8b5f6cc3a77f2c531 150000 0 0 0 0 0
0 0 0 0 15000 0 80795 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 01/01/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 231341
0 1 0 0 0 ROCHMADIN ASGAR TN 049605 59 21612
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358187
1#0##0#0#0.0#2022-03-28
09:30:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f18d4fc851e0830fb6ffd97afea54fb0 150000 0 0 0 0 0
0 0 0 0 15000 0 66341 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 16/06/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 291357
0 1 0 0 0 SUWARTI.NY 085230 76 28020 DR. ARIA
novia;3313125201940001; 5.6.7.202204241238 4 358188
1#0##0#0#0.0#2022-05-19
10:30:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
da15fa50f3ff47567e34efd3f12b598c 150000 0 0 0 0 0
0 0 0 0 15000 0 126357 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 25/07/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 309161
0 1 0 0 0 SRI WIDODO, TN 101762 53 19580 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358189
1#0##0#0#0.0#2022-03-28
09:31:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ed92029f39825c88ee51326e37f7480b 150000 0 0 0 0 0
0 0 0 0 15000 0 144161 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 11/09/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 207295
0 1 0 0 0 SUPARNO,BP 084400 66 24281 DR. ARIA
yani;3302226402970001; 5.6.5.202203091809 4 358190
1#0##0#0#0.0#2022-03-28
09:32:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8d6068938f1ab178dfe576c094e4e2fa 150000 0 0 0 0 0
0 0 0 0 15000 0 42295 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 21/09/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SLAMET DARSONO.TN
0002199915988 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357937 1#0##0#0#0.0#2022-03-28
09:33:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
44e6163c31af56f7e48c136764608d02 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 19/07/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 215457
0 1 0 0 0 SWANTIKAH,(NY) 040450 71 26161 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358191
1#0##0#0#0.0#2022-03-28
09:34:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2d69df990fffea7679f6d12209e7ed85 150000 0 0 0 0 0
0 0 0 0 15000 0 50457 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 12/07/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 220083
0 1 0 0 0 SARWONO, BP 087488 66 24342 DR. ARIA
yani;3302226402970001; 5.6.5.202203091809 4 358192
1#0##0#0#0.0#2022-03-28
09:37:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
801a26bee080414ca0b8526d70a061b7 150000 0 0 0 0 0
0 0 0 0 15000 0 55083 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 13/03/2018 0 1
2 F80.9 - - - None None None None F-5-16-0 None None
None None None None PSIKOTHERAPI INDIVIDU PADA KANAK-KANAK DENGAN MASALAH
KESEHATAN MENTAL 262800 0 0 - 0 - 0 - 0 -
0 262800 223000 0 1 0 0 0 ALSYAZANI RASYID
RAFAEYZA,AN 102276 3 1452 DR. ANI SURYANTI WISYASTUTI, SP.A., M.KES
1124R0020322V000715 0003068444878 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 358193 1#0##0#0#0.0#2022-03-28
09:38:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
491e3870104cee508c100588904e87d4 150000 0 0 0 48000 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 11/08/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 238447
0 1 0 0 0 SRI MARYATI, NY 036506 56 20659 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358194
1#0##0#0#0.0#2022-03-28
09:39:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b6162921f76da52d5a05d7553fd9ccda 150000 0 0 0 0 0
0 0 0 0 15000 0 73447 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 26/02/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 244959
0 1 0 0 0 SUNARNI,(NY) 031205 68 24843 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358195
1#0##0#0#0.0#2022-03-28
09:40:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
979121b3f7440e21f5eeb4d0cf09f8ce 150000 0 0 0 0 0
0 0 0 0 15000 0 79959 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 31/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 218818
0 1 0 0 0 TUMINAH NY 088417 67 24535 DR. ARIA
yani;3302226402970001; 5.6.5.202203091809 4 358196
1#0##0#0#0.0#2022-03-28
09:41:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
658dcc10d6abbc7a1894d688d18452f0 150000 0 0 0 0 0
0 0 0 0 15000 0 53818 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 31/08/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 261774
0 1 0 0 0 SRI HARTINA IRIAWATI.NY 094182 59 21735
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358197
1#0##0#0#0.0#2022-03-28
09:42:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
94b049d2f0330ded11724f118caaa1f7 150000 0 0 0 0 0
0 0 0 0 15000 0 96774 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 10/10/1953 0 2
0 - 0 107400 273000 0 1 0 0 0 TUTIK
SARASWATI ., NY 054196 68 24982 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000720 0001449355893 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 357938 1#0##0#0#0.0#2022-05-19
08:33:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
6f8ed977c2b4fe3574f1bab20319c63b 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 02/02/2017 0 2
0 0 - 0 - 0 - 0 - 0 181400 263592
0 1 0 0 0 AMIRA QURRATUAIN.AN 093568 5 1856
0002345975447 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358198 1#0##0#0#0.0#2022-03-28
09:45:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
66836f3ae572c1b9e09911a3464edeb6 150000 0 0 0 48000 0
0 0 0 0 15000 0 50592 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 20/09/2019 0 2
1 Z09.8;J18.0 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 222534
0 1 0 0 0 SAVINA NUR AMALINA, AN 094314 2 896
0002894507605 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358199 1#0##0#0#0.0#2022-03-28
09:45:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f115e3b366c6a553a9d76fbc2f24bf44 150000 0 0 0 48000 0
0 0 0 0 15000 0 9534 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 01/03/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 236621
0 1 0 0 0 SUPADMI,NY 057827 53 19361 DR. ARIA
yani;3302226402970001; 5.6.5.202203091809 4 358200
1#0##0#0#0.0#2022-03-28
09:46:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5bd5bdb19c831eeefb411308cef7aff8 150000 0 0 0 0 0
0 0 0 0 15000 0 71621 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 04/10/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 245108
0 1 0 0 0 SLAMETO.TN 096660 76 27910 DR. ARIA
yani;3302226402970001; 5.6.5.202203091809 4 358201
1#0##0#0#0.0#2022-03-28
09:47:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
14b9835cec9d9efcfe2b079928e4834d 150000 0 0 0 0 0
0 0 0 0 15000 0 80108 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 23/04/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 SURYATI, NY 037498 53 19673 DRG.
agung;3313092303950002; 5.6.6.202203301209 4 358203
1#0##0#0#0.0#2022-04-11
11:40:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
befd614d60eb43143c8b2877a312c554 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 04/04/1992 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 HUSIN FIKRI.SDR 101100 29 10926 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360264
1#0##0#0#0.0#2022-03-28
09:49:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8146e89316b1a66dab5e4250c7efd20e 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 19/02/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 299574
0 1 0 0 0 DANU MARGONO.,BP 056891 57 20832 DR.
novia;3313125201940001; 5.6.7.202204241238 4 358204
1#0##0#0#0.0#2022-05-19
08:41:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
afd077199f80a8c6c12723eb5095bdbc 150000 0 0 0 0 0
0 0 0 0 15000 0 134574 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 29/05/1992 0 2
1 Z09.8;G56.0 88.21 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 463907
0 1 0 0 0 RIBKAH EVI N, NY 102273 29 10871 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358205
1#0##0#0#0.0#2022-03-28
09:51:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6ce0e1d4a797387961d2475206b53c0f 150000 0 0 0 0 0
248000 0 0 0 15000 0 50907 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 05/07/1992 0 2
0 0 - 0 - 0 - 0 - 0 181400 189289
0 1 0 0 0 NURJANAH., NN 048362 29 10834 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358206
1#0##0#0#0.0#2022-03-28
09:51:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a4bc0dc6e51d3f0d4222d6b4abaa2a7e 150000 0 0 0 0 0
0 0 0 0 15000 0 24289 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 07/04/1948 0 1
0 - 0 - 0 - 0 786200 541949 0 1
yani;3302226402970001; 5.6.5.202203091809 4 357860
1#0##0#0#0.0#2022-03-28
09:52:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
17aecad738132568ed3af465e919d944 463830 0 0 0 0 0
0 0 0 0 15000 0 63119 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 01/09/1964 0 1
0 - 0 - 0 - 0 786200 506350 0 1
SP.PD 1124R0020322V000734 0000639614597 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357861 1#0##0#0#0.0#2022-03-28
09:53:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
011dce1c4a80d8d53383a6c31da6aedb 463830 0 0 0 0 0
0 0 0 0 15000 0 27520 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 23/12/1977 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 357884
1#0##0#0#0.0#2022-03-28
09:54:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5c010dde488a28d28755a4eebde9fc39 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 25/03/1978 0 2
0 - 0 - 0 - 0 786200 585120 0 1
yani;3302226402970001; 5.6.5.202203091809 4 357885
1#0##0#0#0.0#2022-03-28
09:55:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
52664a8816efee52395d0b7954672c07 463830 0 0 0 0 0
0 0 0 0 15000 0 106290 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 24/02/1954 0 2
1 R90.0;G44.2 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 214885
0 1 0 0 0 SRI PURWANI.NY 101247 68 24845 DR.
novia;3313125201940001; 5.6.7.202204241238 4 358207
1#0##0#0#0.0#2022-05-20
09:25:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
c3be22bf09871e9fc3a0d82be96bd762 150000 0 0 0 0 0
0 0 0 0 15000 0 49885 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 02/09/1976 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 357891
1#0##0#0#0.0#2022-03-28
09:57:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7d8c1b35a4a871e6b98f3509a1b30914 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 15/05/1953 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 357893
1#0##0#0#0.0#2022-03-28
10:00:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
18e10514b496e12691c955e16960947f 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 04/09/1960 0 1
0 - 0 - 0 - 0 786200 516813 0 1
0 0 0 WAHYUDI, TN 101463 61 22461 DR. TEKY WIDYARINI,
SP.PD 1124R0020322V000740 0000640142684 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357895 1#0##0#0#0.0#2022-03-28
10:00:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9b042a1ed406c9e6f8d58ea4119d72fe 463830 0 0 0 0 0
0 0 0 0 15000 0 37983 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 18/10/1972 0 1
1 Z09.8;R90.0;R51 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 217305
0 1 0 0 0 BAMBANG SUPRAPTOMO, TN 073265 49 18034
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358208
1#0##0#0#0.0#2022-03-28
10:01:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2ec9fbaacdff637b95cbeb4ad5d631d8 150000 0 0 0 0 0
0 0 0 0 15000 0 52305 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 24/02/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 267471
0 1 0 0 0 TRI BUDI SUWARTO. TN 095037 49 17905
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358209
1#0##0#0#0.0#2022-03-28
10:02:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2db2738be54c94788c515ea7d5fe47f7 150000 0 0 0 0 0
0 0 0 0 15000 0 102471 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 03/03/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 441742
0 1 0 0 0 MURTAKI.TN 091350 74 27029 DR. ARIA
yani;3302226402970001; 5.6.5.202203091809 4 358210
1#0##0#0#0.0#2022-03-28
10:04:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ec109bcdac3a4c23d8ee8799625b4bae 150000 0 0 0 0 0
0 0 0 0 15000 0 276742 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 06/07/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 221282
0 1 0 0 0 SUMARNI.NY 086963 67 24713 DR. ARIA
novia;3313125201940001; 5.6.7.202204241238 4 358211
1#0##0#0#0.0#2022-05-19
10:34:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
f57d5b6ec51f5dc6dd73b392b3f59bb3 150000 0 0 0 0 0
0 0 0 0 15000 0 56282 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 04/08/1968 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 WAHYUNINGSIH WIDI RAHAYU.NY 099618 53 19570
yani;3302226402970001; 5.6.5.202203091809 4 358212
1#0##0#0#0.0#2022-03-28
10:05:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f82c7c7bb02fdec31f135720db892b9b 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/03/2022 04/03/2022 14/02/1997 0 1
2 R10.4;K35.8 87.95;88.76 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400
1428724 0 1 0 0 0 IBNU ROZAQ FANANI, SDR 102330
25 9149 DR. GREETA 1124R0020322V000749 0000083377719 3;JKN
reni;3313147010930001; 5.6.6.202203301209 4 360984
1#0##0#0#0.0#2022-04-04
16:48:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dca1c6f2b3c0636c2a7c0d2f697c5888 235000 0 0 0 0 0
857000 175145 0 0 25000 0 136579 0 0 0
0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 04/06/1962 0 1
1 Z09.8;N28.1;K76.0 87.49 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 624562
0 1 0 0 0 HENDI SUHENDRA. TN 087859 59 21824
novia;3313125201940001; 5.6.5.202203091509 4 357447
1#0##0#0#0.0#2022-03-11
08:32:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
cb0e28d3bc31d4d51f58234d4c30fba3 150000 0 0 0 0 0
200000 133650 0 0 15000 0 125912 0 0 0
0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 18/04/1974 0 1
0 0 - 0 - 0 - 0 - 0 181400 251045
0 1 0 0 0 JOKO SANTOSO.TN 101122 47 17488 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357448
1#0##0#0#0.0#2022-03-10
09:17:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ed78dda1380465f28deede3686917b74 150000 0 0 0 0 0
0 44300 0 0 15000 0 41745 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 12/12/1964 0 1
1 Z09.8;E11.4;G59.0;R07.4 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 708417
0 1 0 0 0 SUPARDI. BP 049524 57 20902 DR. SUHARTO,
SP.PD 1124R0020322V000758 0002298244397 3;JKN novia;3313125201940001;
5.6.5.202203091509 4 357449 1#0##0#0#0.0#2022-03-10
09:18:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a423e04816d5022ae8afa086503818aa 150000 0 0 0 0 0
0 31845 0 0 15000 0 511572 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 08/11/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 294492
0 1 0 0 0 IRAN RAHAYU, NY 099708 54 19841 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357450
1#0##0#0#0.0#2022-03-10
09:19:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f905a6fc9d315f35a96c3f581834b9f3 150000 0 0 0 0 0
0 0 0 0 15000 0 129492 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 04/02/1939 0 2
0 0 - 0 - 0 - 0 - 0 181400 353718
0 1 0 0 0 SRI SARSINI. NY 101941 83 30345 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357451
1#0##0#0#0.0#2022-03-10
09:19:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
00f7bc19626dcc88846f0276f2c1285c 150000 0 0 0 0 0
0 133650 0 0 15000 0 55068 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 03/01/1976 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUGILAH.NY 085281
0001166564171 3;JKN novia;3313125201940001; 5.6.5.202203091509 4
357436 1#0##0#0#0.0#2022-03-10
09:20:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
abc906d19953f6a6e24d46d480d50e15 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 23/05/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 280000
0 1 0 0 0 NURHENI KRISTYANINGRUM, NY 101018 48
17818 DR. GALIH RAKASIWI SOEKARNO,SP.JP 1124R0020322V000763
0002700693641 3;JKN novia;3313125201940001; 5.6.5.202203091509 4
357452 1#0##0#0#0.0#2022-03-10
09:21:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
212906cdb949702db1d2ce106e74af90 165000 0 0 0 0 100000
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 12/11/1945 0 2
0 - 0 107400 273000 0 1 0 0 0 ENDANG
SURTIANAH, NY 098168 76 27872 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000764 0000063294052 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 357432 1#0##0#0#0.0#2022-05-19
13:55:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
9c0ed55ae97c2cced72fcbde11e2ba80 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 20/06/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 290633
0 1 0 0 0 TUGIYEM, NY 090349 64 23634 DR. WAHYU
novia;3313125201940001; 5.6.5.202203091509 4 357453
1#0##0#0#0.0#2022-03-10
09:22:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f6e1d7ad81512974dd030b9cc19608ab 150000 0 0 0 0 0
0 0 0 0 15000 0 125633 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 22/08/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 302089
0 1 0 0 0 DYAH NURJANTI,(NY) 042222 74 27224
novia;3313125201940001; 5.6.5.202203091509 4 357454
1#0##0#0#0.0#2022-03-10
09:27:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d7e044fd2b68a7cf1d47bab1935bbd7b 150000 0 0 0 0 0
0 0 0 0 15000 0 137089 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 08/04/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 277046
0 1 0 0 0 WIDODO, TN 007403 67 24803 DR. GALIH
novia;3313125201940001; 5.6.5.202203091509 4 357455
1#0##0#0#0.0#2022-03-10
09:28:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
566b701580b5de6dacea277c75810fe3 150000 0 0 0 0 0
0 0 0 0 15000 0 112046 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 30/06/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 243942
0 1 0 0 0 SUPARSIH, NY 091866 61 22528 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357456
1#0##0#0#0.0#2022-03-10
09:28:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9c0765a9a1a1dc72dee7bac533b499d1 150000 0 0 0 0 0
0 0 0 0 15000 0 78942 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 29/03/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 283285
0 1 0 0 0 SUTARDI.,NY 074646 73 27004 DR. GALIH
novia;3313125201940001; 5.6.5.202203091509 4 357457
1#0##0#0#0.0#2022-03-10
09:29:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7fd801197b32074da7116bba6b32b540 150000 0 0 0 0 0
0 0 0 0 15000 0 118285 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 02/09/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 276575
0 1 0 0 0 SRIYADI. TN 090091 50 18447 DR. GALIH
novia;3313125201940001; 5.6.5.202203091509 4 357458
1#0##0#0#0.0#2022-03-10
09:40:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a37ab7046fd6c829258341ca1a75c04f 150000 0 0 0 0 0
0 0 0 0 15000 0 111575 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 06/07/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMARNI.NY 086963
0002347072604 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357424 1#0##0#0#0.0#2022-05-19
10:34:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
10788a9a6f143dec174990f66b4b8dd1 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 09/03/1969 0 1
1 Z09.8;R10.4 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 191090
0 1 0 0 0 RINDARMADI.TN 089698 52 19354 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357459
1#0##0#0#0.0#2022-03-10
09:45:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5e952720243c1caae5ee97e19666ce3a 150000 0 0 0 0 0
0 0 0 0 15000 0 26090 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 23/02/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 329750
0 1 0 0 0 YUSUF SUKIRNO, TN 100732 67 24482 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357460
1#0##0#0#0.0#2022-03-10
09:51:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f5eb3e510a110fc6c1628d1422380aba 150000 0 0 0 0 0
0 31845 0 0 15000 0 132905 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 13/08/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 207286
0 1 0 0 0 ENDANG MARYATI 085348 64 23580 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357461
1#0##0#0#0.0#2022-03-10
09:52:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5416c3fac8f694d228847abd2d2f2ee8 150000 0 0 0 0 0
0 0 0 0 15000 0 42286 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 31/12/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 274520
0 1 0 0 0 MARINAH, NY 052302 72 26362 DR. WAHYU
novia;3313125201940001; 5.6.5.202203091509 4 357462
1#0##0#0#0.0#2022-03-10
09:55:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0e9bd5816f2a8c22d5247a406a978e93 150000 0 0 0 0 0
0 0 0 0 15000 0 109520 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 13/12/1941 0 2
0 0 - 0 - 0 - 0 - 0 181400 223201
0 1 0 0 0 FATIMAH.NY 077901 80 29302 DR. WAHYU
novia;3313125201940001; 5.6.5.202203091509 4 357463
1#0##0#0#0.0#2022-03-10
09:56:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
724310e4ec4f056f404bc6f6f0c73d78 150000 0 0 0 0 0
0 0 0 0 15000 0 58201 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 18/06/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 211808
0 1 0 0 0 JEMI.NY 076504 65 24001 DR. WAHYU
novia;3313125201940001; 5.6.5.202203091509 4 357464
1#0##0#0#0.0#2022-03-10
09:57:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3eeb09aa7aa383ba214c937c338b68c8 150000 0 0 0 0 0
0 0 0 0 15000 0 46808 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 11/08/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 300000
0 1 0 0 0 TOTO MARDIYANTO.TN 101367 53 19564
3;JKN novia;3313125201940001; 5.6.5.202203091509 4 357465
1#0##0#0#0.0#2022-03-10
10:00:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
26157a0109cb60a46e4c8a3be8e170d2 185000 0 0 0 0 100000
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 31/12/1944 0 2
0 0 - 0 - 0 - 0 - 0 181400 219760
0 1 0 0 0 WAGINAH,(NY) 017177 77 28188 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357466
1#0##0#0#0.0#2022-03-10
10:01:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9401a7480f036422d5b81d786cfbe941 150000 0 0 0 0 0
0 0 0 0 15000 0 54760 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 01/07/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 234280
0 1 0 0 0 SARIYEM, NY 091999 79 29102 DR. WAHYU
novia;3313125201940001; 5.6.5.202203091509 4 357493
1#0##0#0#0.0#2022-03-10
10:02:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
036b00b61b232f00075615ccd2ccc2d5 150000 0 0 0 0 0
0 0 0 0 15000 0 69280 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 11/02/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 271000
0 1 0 0 0 MULYANI,(NY) 039619 62 22668 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357494
1#0##0#0#0.0#2022-03-10
10:03:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a123f93e6f7a75e6f72acc036bbef50c 150000 0 0 0 0 0
0 0 0 0 15000 0 106000 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 01/09/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 213534
0 1 0 0 0 SRI YAMTI.NY 089240 50 18448 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357495
1#0##0#0#0.0#2022-03-10
10:04:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f7023204e571b4c20efa0813ef36f338 150000 0 0 0 0 0
0 0 0 0 15000 0 48534 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 17/04/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 274410
0 1 0 0 0 SRI HASTUTI.NY 100500 65 24063 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357496
1#0##0#0#0.0#2022-03-10
10:05:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
417dac05ed28735b118adf1614a6ecb6 150000 0 0 0 0 0
0 0 0 0 15000 0 109410 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 27/09/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 297173
0 1 0 0 0 MARSONO,BP 054157 59 21709 DR. GALIH
novia;3313125201940001; 5.6.5.202203091509 4 357497
1#0##0#0#0.0#2022-03-10
10:48:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
65b5537e5d51d74a21b5048fe90048c4 150000 0 0 0 0 0
0 0 0 0 15000 0 132173 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 06/09/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 196845
0 1 0 0 0 YUDI MARJONO,(BP) 032557 56 20634 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357498
1#0##0#0#0.0#2022-03-10
10:49:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
acfed24ce4a4dac1064114626954e214 150000 0 0 0 0 0
0 31845 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 28/02/1939 0 1
1 Z09.8;M25.06 88.26 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 489717
0 1 0 0 0 SLAMET SUDARMO.TN 101254 83 30321 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357667
1#0##0#0#0.0#2022-03-11
08:23:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a0477a0ea8cf7efa015f60bf08e92b0b 150000 0 0 0 0 0
280000 0 0 0 15000 0 44717 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 02/12/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ENDANG
MARDIASMANI.NY 090524 64 23469 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000787 0000086714471 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 357431 1#0##0#0#0.0#2022-05-19
11:02:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
9f1b82638f764f1690c1fd1832469d77 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 16/10/1949 0 2
1 Z09.8;I25.9 89.52;87.49 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 328046
0 1 0 0 0 SRI YEKTI ISMADI,(NY) 040545 72 26438
3;JKN novia;3313125201940001; 5.6.5.202203091509 4 357499
1#0##0#0#0.0#2022-03-11
08:32:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
cafd1d5e7ac113d2a3bc29b1f5be4e92 0 0 0 0 0 0 200000
0 0 0 15000 0 113046 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 04/06/1989 0 1
1 I84.9 - - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 214235
0 1 0 0 0 NANA RADITIANA.TN 102292 32 11962 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357500
1#0##0#0#0.0#2022-03-10
10:52:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eb6cb28e29a7dd8ba76279cb9ba6a94e 150000 0 0 0 0 0
0 0 0 0 25000 0 39235 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 05/09/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 331366
0 1 0 0 0 SUPARMI., NY 050493 55 20270 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357501
1#0##0#0#0.0#2022-03-10
11:01:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a31bc9395c3438c3b36a739431f1a1d4 150000 0 0 0 0 0
0 0 0 0 15000 0 166366 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 09/07/1959 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUROTO.TN 087121
0003116443004 3;JKN novia;3313125201940001; 5.6.5.202203091509 4
357433 1#0##0#0#0.0#2022-03-10
11:06:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
748dbd3e5a4cc35dad96ceb422f824a2 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 13/05/1970 0 2
1 Z09.8;G81.9 93.89 - - None None None None Z-3-12-0 None
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 ENI WIDIASTUTI, NY 100725 51 18924 DR.
novia;3313125201940001; 5.6.7.202204241238 4 357430
1#0##0#0#0.0#2022-05-20
08:51:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
aca004224eb21cf6aeb15ec3cefb4e9c 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 26/05/2001 0 2
0 0 - 0 - 0 - 0 - 0 181400 477834
0 1 0 0 0 MEIDYA MITA MAHARTIN,(NN) 000957 20
3;JKN novia;3313125201940001; 5.6.5.202203091509 4 357670
1#0##0#0#0.0#2022-03-11
08:28:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
141aaf5cd70886c2d8ceafa92de63837 150000 0 0 0 0 0
248000 0 0 0 15000 0 64834 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 16/06/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 207253
0 1 0 0 0 SUWARTI.NY 085230 76 28021 DR. WAHYU
novia;3313125201940001; 5.6.7.202204241238 4 357502
1#0##0#0#0.0#2022-05-19
10:30:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
9f873c7ca5cf6e344caa788c8c4bf799 150000 0 0 0 0 0
0 0 0 0 15000 0 42253 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 06/07/1953 0 2
1 Z09.8;E11.4;G59.0;M54.59 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
344572 0 1 0 0 0 YULIWATI,NY 087435 68 25079
novia;3313125201940001; 5.6.5.202203091509 4 357503
1#0##0#0#0.0#2022-03-10
11:10:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cb5840b004b24ef82ee45e8151a9f465 150000 0 0 0 0 0
0 31845 0 0 15000 0 147727 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 05/02/1964 0 1
1 Z09.8;E83.5;N29.8 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 364541
0 1 0 0 0 SUTIMIN.TN 012169 58 21213 DR. SUHARTO,
SP.PD 1124R0020322V000796 0001103900141 3;JKN novia;3313125201940001;
5.6.5.202203091509 4 357504 1#0##0#0#0.0#2022-03-10
11:28:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
19006e089ec025fdb4f04f231954a0c4 150000 0 0 0 0 0
0 120795 0 0 15000 0 78746 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 11/05/1943 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 MURYATI.NY 094215 78 28788 DR. LINDA
novia;3313125201940001; 5.6.7.202204241238 4 357427
1#0##0#0#0.0#2022-05-19
13:13:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
ecba3095b0d01de35d39acc12a47b27a 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 12/06/1979 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 TRI CAHYANINGSIH,
0001530445239 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357434 1#0##0#0#0.0#2022-05-19
11:15:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
557b2559d7f466f253e37b741ed81429 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 23/07/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 233921
0 1 0 0 0 SUMARSIH.NY 100303 61 22505 DR. GALIH
novia;3313125201940001; 5.6.5.202203091509 4 357507
1#0##0#0#0.0#2022-03-10
11:33:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
2b4d273c497b855b1c7bfb5538f07747 150000 0 0 0 0 0
0 0 0 0 15000 0 68921 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 15/04/1963 0 2
1 Z09.8;I11.9;E78.5;K30;M19.98 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
283560 0 1 0 0 0 SUMINI, NY 047378 58 21509
novia;3313125201940001; 5.6.5.202203091509 4 357509
1#0##0#0#0.0#2022-03-10
11:35:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
33ee83ab7759fa9ee61bbfe3559abbc3 150000 0 0 0 0 0
0 31845 0 0 15000 0 86715 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 25/04/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 263003
0 1 0 0 0 ADILESTIANTORO MAMIT ANANTO. TN 092824
61 22594 DR. GALIH RAKASIWI SOEKARNO,SP.JP 1124R0020322V000801
0001731843549 3;JKN novia;3313125201940001; 5.6.5.202203091509 4
357510 1#0##0#0#0.0#2022-03-10
11:36:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b840514e07a84c791c00956ae8d70036 150000 0 0 0 0 0
0 0 0 0 15000 0 98003 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 31/12/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 205735
0 1 0 0 0 SURANI, NY 063638 59 21614 DR. WAHYU
novia;3313125201940001; 5.6.5.202203091509 4 357511
1#0##0#0#0.0#2022-03-10
11:36:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0ccd0b45b9baad0bc9c0e7960df86b57 150000 0 0 0 0 0
0 0 0 0 15000 0 40735 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 13/06/1971 0 2
1 Z09.8;M25.51 93.89 - - None None None None Z-3-12-0
None None None None None None PROSEDUR REHABILITASI 138400 0
0 - 0 - 0 - 0 - 0 138400 285000
novia;3313125201940001; 5.6.7.202204241238 4 357440
1#0##0#0#0.0#2022-05-19
10:24:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
ef67cbec972fa5c17fcee12038179a5d 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 27/01/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 368069
0 1 0 0 0 ORYZA WARDHANI.NY 093625 51 18665 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357512
1#0##0#0#0.0#2022-03-10
11:40:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
77c08c4c7b3f636fb9d83acd226d3670 150000 0 0 0 0 0
0 31845 0 0 15000 0 171224 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 07/07/1957 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 ENI PUJI ASTUTI 093122 64 23617 DR. LINDA
novia;3313125201940001; 5.6.5.202203091509 4 357428
1#0##0#0#0.0#2022-03-10
11:48:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3b1e72e6935c5c74cb4ce2b4fcf48088 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 21/02/2015 0 1
0 0 - 0 - 0 - 0 - 0 181400 15000
0 1 0 0 0 PRANAJA SETYA AZKA A.AN 099752 7 2569
novia;3313125201940001; 5.6.7.202204241238 4 357664
1#0##0#0#0.0#2022-05-20
08:18:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
f8f5094eba475c2286f85fdcb17fbd33 0 0 0 0 0 0 0
0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 26/03/1968 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 L M BASUKI, NY 048110 53 19702 DR. LINDA
novia;3313125201940001; 5.6.5.202203091509 4 357426
1#0##0#0#0.0#2022-03-10
12:46:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3fa71e346667b6741b4641fa49abf7c7 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 21/08/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400
1061349 0 1 0 0 0 MUHAMMAD HIDAYAT ANHARI. TN 084872
70 25764 DR. SUHARTO, SP.PD 1124R0020322V000809 0000091308407
3;JKN novia;3313125201940001; 5.6.5.202203091509 4 357516
1#0##0#0#0.0#2022-03-10
12:46:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
302990a1e95d598ac6419348ed7dcee1 150000 0 0 0 0 0
0 31845 0 0 15000 0 864504 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 25/08/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 265527
0 1 0 0 0 SRI SUHARYATI NY 084849 68 25029 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357517
1#0##0#0#0.0#2022-03-10
12:47:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
69075947d5c7591a663351370700ca61 150000 0 0 0 0 0
0 0 0 0 15000 0 100527 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 25/08/1955 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 BAMBANG AGUS
SURONO.TN 100627 66 24299 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000811 0001812274413 3;JKN novia;3313125201940001;
5.6.5.202203091509 4 357441 1#0##0#0#0.0#2022-03-10
12:54:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0ee285ab67ad2930521ed13f176cbe9d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 27/12/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 226144
0 1 0 0 0 SRI HARTINAH, NY 060277 66 24175 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357518
1#0##0#0#0.0#2022-03-10
12:55:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
718a041bdc97af3b55e37727d8fac70e 150000 0 0 0 0 0
0 0 0 0 15000 0 61144 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 26/05/1970 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 MENIK PUJIWATI, NY 073634 51 18911
DR. LINDA SUGIARTO, SP.FKR 1124R0020322V000813 0001474646354 3;JKN
novia;3313125201940001; 5.6.5.202203091509 4 357437
1#0##0#0#0.0#2022-03-10
12:56:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8e0dce7d5f6bc279fb09a433884cd86b 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 15/08/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 213534
0 1 0 0 0 SURATMAN ADI RATMANTO.TN 101974 77
3;JKN novia;3313125201940001; 5.6.5.202203091509 4 357519
1#0##0#0#0.0#2022-03-10
12:57:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
84f0f29066457d4306582c02650cc156 150000 0 0 0 0 0
0 0 0 0 15000 0 48534 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 04/02/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 347844
0 1 0 0 0 MUJAYIN, BP 060310 56 20483 DR. GALIH
novia;3313125201940001; 5.6.5.202203091509 4 357520
1#0##0#0#0.0#2022-03-10
12:58:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f34cd42e84b00515654c31233f3f69eb 150000 0 0 0 0 0
0 0 0 0 15000 0 182844 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 15/02/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 326225
0 1 0 0 0 BAMBANG SANTOSO.TN 088657 53 19376
3;JKN novia;3313125201940001; 5.6.5.202203091509 4 357521
1#0##0#0#0.0#2022-03-10
12:59:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c872952ab5509f120690fb49282de940 150000 0 0 0 0 0
0 0 0 0 15000 0 161225 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 04/09/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 221036
0 1 0 0 0 TRI WIDAYATI, NY 065284 56 20636 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357522
1#0##0#0#0.0#2022-03-10
13:00:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cbd20e03b85a16278ad262d8a7cf1086 150000 0 0 0 0 0
0 0 0 0 15000 0 56036 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 30/09/1937 0 2
0 0 - 0 - 0 - 0 - 0 181400 482566
0 1 0 0 0 SRI RAHAYU, NY 102172 84 30837 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357669
1#0##0#0#0.0#2022-03-11
08:17:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9710a58f32f17f74b49dc2ed4a1b525a 150000 0 0 0 0 0
248000 0 0 0 15000 0 69566 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 20/10/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 865760
0 1 0 0 0 SITI TARTINI ., NY 056182 66 24243
novia;3313125201940001; 5.6.5.202203091509 4 357665
1#0##0#0#0.0#2022-03-11
08:25:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7af5c0940bb0aa900e458009207bea55 300000 0 0 0 0 0
496000 0 0 0 15000 0 54760 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 13/06/1990 0 1
0 0 - 0 - 0 - 0 - 0 181400 197417
0 1 0 0 0 DWI CAHYONO., TN 069682 31 11588 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357523
1#0##0#0#0.0#2022-03-10
13:01:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8f717c8149348d6e11a413a0f093548b 150000 0 0 0 0 0
0 0 0 0 15000 0 32417 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 14/05/1958 0 2
0 404900 410478 0 1 0 0 0 M. KRISTIANAWATI,
NY 092163 63 23306 DR. WAHYU PURNOMO, SP.OT 1124R0020322V000821
0000091441506 3;JKN novia;3313125201940001; 5.6.5.202203091509 4
357524 1#0##0#0#0.0#2022-03-10
13:01:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d3038f658ba43518e02141aa07ed1bbe 150000 0 0 0 0 0
0 0 0 0 15000 0 245478 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 16/08/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TRI WINARNI 093256
0000640206066 3;JKN novia;3313125201940001; 5.6.5.202203091509 4
357425 1#0##0#0#0.0#2022-03-11
07:34:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a3c1b72b5da6cf8d687e770e14398b56 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 20/02/2009 0 2
0 - 0 - 0 - 0 - 0 181400 447973
0 1 0 0 0 GREETHA SULISTYO SAPUTRI.NN 102291 13
3;JKN novia;3313125201940001; 5.6.5.202203091509 4 357668
1#0##0#0#0.0#2022-03-11
08:19:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4e40e440191144cf30d32e15189b0598 150000 0 0 0 0 0
233000 0 0 0 15000 0 49973 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 28/02/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 228087
0 1 0 0 0 TARWOKO.TN 088292 67 24477 DR. WAHYU
novia;3313125201940001; 5.6.5.202203091509 4 357525
1#0##0#0#0.0#2022-03-10
13:02:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c8a9fc008c04dcafcc87993774eee045 150000 0 0 0 0 0
0 0 0 0 15000 0 63087 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 04/02/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 194678
0 1 0 0 0 DERMAWAN SITORUS.NY 101593 52 19022
novia;3313125201940001; 5.6.5.202203091509 4 357526
1#0##0#0#0.0#2022-03-10
13:03:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
81ba6c71dcafee689e1fdd63ebdc1034 150000 0 0 0 0 0
0 0 0 0 15000 0 29678 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 09/11/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 DALIYEM., NY
0001032593466 3;JKN novia;3313125201940001; 5.6.5.202203091509 4
357442 1#0##0#0#0.0#2022-03-10
13:04:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f33b59a04839e802104268659f1a900b 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 25/04/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 250812
0 1 0 0 0 MUJIYATI,NY 005071 54 20038 DR. SUHARTO,
SP.PD 1124R0020322V000827 0001267695246 3;JKN novia;3313125201940001;
5.6.5.202203091509 4 357527 1#0##0#0#0.0#2022-03-10
13:14:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
44a4bc6eb3d77aa09967298a4fb7aef5 150000 0 0 0 0 0
0 0 0 0 15000 0 85812 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 11/06/1953 0 2
0 - 0 107400 273000 0 1 0 0 0 TRI
DJANAH, NY 095470 68 25104 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000828 0000091176996 3;JKN novia;3313125201940001;
5.6.5.202203091509 4 357435 1#0##0#0#0.0#2022-03-10
13:15:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
72463366bf8e01b03fd95321cf35702c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 05/08/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI LESTARI, NY
0000639740812 3;JKN novia;3313125201940001; 5.6.5.202203091509 4
357443 1#0##0#0#0.0#2022-03-10
13:44:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
33dc50b37e99640280a7089760337afe 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 19/02/1965 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 DANU MARGONO.,BP
0000640154136 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357411 1#0##0#0#0.0#2022-05-19
08:41:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
195f83057f0c80ef1b12a2b3478429c7 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 10/10/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 188483
0 1 0 0 0 TUTIK SARASWATI ., NY 054196 68 24983
novia;3313125201940001; 5.6.7.202204241238 4 357528
1#0##0#0#0.0#2022-05-19
08:33:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
1acb3fcc8ab36cc752025d0aaf5e9c1f 150000 0 0 0 0 0
0 0 0 0 15000 0 23483 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 21/12/1960 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 NURSANTO BP 085741
0001622326994 3;JKN novia;3313125201940001; 5.6.5.202203091509 4
357393 1#0##0#0#0.0#2022-03-10
13:46:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bfccbda42802416599ec11bbdac7f0e4 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 31/12/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 297840
0 1 0 0 0 SRI REJEKI 092215 73 26727 DR. GALIH
novia;3313125201940001; 5.6.5.202203091509 4 357553
1#0##0#0#0.0#2022-03-10
13:47:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
662537b7c970b6db4d8b9e46e15c3a3e 150000 0 0 0 0 0
0 0 0 0 15000 0 132840 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 27/02/1973 0 2
0 - 0 - 0 - 0 - 0 181400 467760
0 1 0 0 0 ANIK WIJAYANTI.NY 064540 49 17903 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357666
1#0##0#0#0.0#2022-03-11
08:24:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a6c8647b33817e51451306cf8b48dd38 150000 0 0 0 0 0
248000 0 0 0 15000 0 54760 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 12/01/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 EKO RINI.NY 093223
0000091524159 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357422 1#0##0#0#0.0#2022-05-19
11:26:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
23ca6c7f4c3dcfc645d3dc6bcf8f2bf7 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 21/05/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 278379
0 1 0 0 0 SUTRISNO, TN 088415 62 22934 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357554
1#0##0#0#0.0#2022-03-10
13:49:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
03d4a64ca331409295f5e6d0a34001b4 150000 0 0 0 0 0
0 31845 0 0 15000 0 81534 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 02/10/1970 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 ASRI LISTYARINI.NY 098990 51 18782
novia;3313125201940001; 5.6.5.202203091509 4 357408
1#0##0#0#0.0#2022-03-10
13:52:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
24d555a2ca5b65a469140d71cdf04e01 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 23/04/1960 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI WAHYUNI, NY
0000091421842 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357405 1#0##0#0#0.0#2022-05-19
10:51:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
8d675be68edbd317a72b8903bf362597 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 04/06/1967 0 2
1 Z09.8;E11.9;K30;R51 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 401973
0 1 0 0 0 SRI HARTATI,(NY) 005917 54 19998 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357555
1#0##0#0#0.0#2022-03-10
13:53:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0165d9cbc26c6ad57c4fce2e1318c5c2 150000 0 0 0 0 0
0 31845 0 0 15000 0 205128 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 13/08/1958 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 TRI UTAMI AGUSTINI, NY 048735 63 23215 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357400
1#0##0#0#0.0#2022-03-10
13:54:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b69a89f996b56405d8a47cac1b3b6b80 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 05/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 DANIK KARTIKA
1124R0020322V000842 0001445069981 3;JKN novia;3313125201940001;
5.6.5.202203091509 4 357395 1#0##0#0#0.0#2022-03-10
13:55:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
24d62727af0619ba8e8e1a0df937853a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 31/12/1954 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 WARSINI, NY 095108 67 24536 DR. LINDA
novia;3313125201940001; 5.6.5.202203091509 4 357438
1#0##0#0#0.0#2022-03-10
13:55:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d0e8e50bdd57d6154371268ad0e769dc 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 31/12/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SOEMARKO.,BP 053597 72 26362 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357556
1#0##0#0#0.0#2022-03-10
13:56:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
71fd776205e355298b3985bf8f26cd34 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 14/06/1959 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 SRI MURNIYANTI, NY 054964 62 22910 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357429
1#0##0#0#0.0#2022-03-10
14:00:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d0cd6358753ac08e008f4763189522b5 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 01/09/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 234322
0 1 0 0 0 SUYAMI,NY 063751 45 16621 DR. SUHARTO,
SP.PD 1124R0020322V000847 0000639550361 3;JKN novia;3313125201940001;
5.6.5.202203091509 4 357558 1#0##0#0#0.0#2022-03-10
14:01:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
628fc8fd78ad6a63d349fd8fe3a66f40 150000 0 0 0 0 0
0 0 0 0 15000 0 69322 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 23/11/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 192885
0 1 0 0 0 PURNOMO WULANDARI.TN 085874 43 15808
novia;3313125201940001; 5.6.5.202203091509 4 357559
1#0##0#0#0.0#2022-03-11
07:24:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
7903b3fed637c61da75d2cd4b1ad1ef0 150000 0 0 0 0 0
0 0 0 0 15000 0 27885 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 13/09/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 209122
0 1 0 0 0 NGADIMAN.TN 101786 52 19166 DR. WAHYU
agung;3313092303950002; 5.6.7.202204241238 4 367808
1#0##0#0#0.0#2022-05-20
10:22:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
25f90c2b2016df4dd22c45102c2408e7 150000 0 0 0 0 0
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3372030 C 3 CP 2 05/03/2022 05/03/2022 25/09/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 197516
0 1 0 0 0 SRI SATITI.NY 094831 72 26459 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357561
1#0##0#0#0.0#2022-03-10
14:03:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
15e2ceb1cd2a08cf1c6df80a3df0589c 150000 0 0 0 0 0
0 0 0 0 15000 0 32516 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 17/01/1940 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 SITI JAHIDJAH, NY 101286 82 29998 DR. LINDA
novia;3313125201940001; 5.6.5.202203091509 4 357413
1#0##0#0#0.0#2022-03-10
14:04:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d2d68f2b213e0966a1f69fe9e1ef7994 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 05/10/1978 0 1
0 - 0 - 0 - 0 - 0 181400 313908
0 1 0 0 0 MARTINUS ARI DWI RIANTO.TN 102290 43
3;JKN novia;3313125201940001; 5.6.5.202203091509 4 357663
1#0##0#0#0.0#2022-03-11
08:26:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f5999865550aff62430998ffa86a9b04 0 0 0 0 0 0 248000
0 0 0 15000 0 50908 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 06/08/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 216409
0 1 0 0 0 MEISKE Y L SULENDORONG. NY 101790 65
3;JKN novia;3313125201940001; 5.6.5.202203091509 4 357563
1#0##0#0#0.0#2022-03-10
14:05:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c45b023e15a69ee3d98cf6d45c96dfaf 150000 0 0 0 0 0
0 0 0 0 15000 0 51409 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 19/02/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400
1102751 0 1 0 0 0 SIMAN, TN 099921 55 20103
novia;3313125201940001; 5.6.5.202203091509 4 357564
1#0##0#0#0.0#2022-03-10
14:06:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aeca508eb1a903a017f4180600451eae 150000 0 0 0 0 0
0 0 0 0 15000 0 937751 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 22/04/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 237545
0 1 0 0 0 DJUWARSO, (BP) 008057 72 26615 DR.
novia;3313125201940001; 5.6.7.202204241238 4 357566
1#0##0#0#0.0#2022-05-18
10:45:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
2eb12b4fef6a124c6b28defc25eab716 150000 0 0 0 0 0
0 0 0 0 15000 0 72545 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 10/02/1951 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 JIYEM, NY 094913 71 25956 DR. LINDA
novia;3313125201940001; 5.6.5.202203091509 4 357439
1#0##0#0#0.0#2022-03-10
14:08:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8c03740bc7ec34a17435fe0b85be34e8 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 13/06/1992 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 LUKI SABILLA WITTEVEEN,NN 069906 29
10857 DR. LINDA SUGIARTO, SP.FKR 1124R0020322V000857 0001084671257
3;JKN novia;3313125201940001; 5.6.5.202203091509 4 357412
1#0##0#0#0.0#2022-03-10
14:09:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4631987e7e3a2b2c104b3558c4895081 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 17/03/1976 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 BAMBANG ARIANTO A,
SDR 100192 45 16789 DR. LINDA SUGIARTO, SP.FKR 1124R0020322V000858
0000563317132 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357444 1#0##0#0#0.0#2022-05-20
08:32:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
80151bf3e4a9b68080ff1ea96a3a4c99 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 29/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 AGNES WIDHA
1124R0020322V000859 0002168632721 3;JKN novia;3313125201940001;
5.6.5.202203091509 4 357446 1#0##0#0#0.0#2022-03-10
14:10:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dc691a6195694f5e0a00dbbdd925ae60 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 16/05/1997 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 251000 0 1 0 0 0 MEI NUR SAPUTRI,
NN 100901 24 9059 DR. LINDA SUGIARTO, SP.FKR 1124R0020322V000860
0002220808432 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357403 1#0##0#0#0.0#2022-05-20
08:58:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
8e91d095602e85bd3387378b29e342c8 236000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 01/01/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 RUSDI.,TN 049658 45 16499 DR. TEKY WIDYARINI,
SP.PD 1124R0020322V000861 0001147281805 3;JKN novia;3313125201940001;
5.6.5.202203091509 4 357384 1#0##0#0#0.0#2022-03-10
14:12:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8870dc005ed3333259c187a262fb710c 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 03/12/1950 0 1
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.5.202203091509 4 357391
1#0##0#0#0.0#2022-03-10
14:14:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
659bf10e9a8793cfbad033e328f7539a 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 09/09/1940 0 1
0 0 - 0 - 0 - 0 - 0 181400 207466
0 1 0 0 0 SALEH MUHAMMAD HATRAS.TN 101366 81
3;JKN novia;3313125201940001; 5.6.5.202203091509 4 357568
1#0##0#0#0.0#2022-03-10
14:17:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5f3a5dc72d18c6096346e312128ce09f 150000 0 0 0 0 0
0 0 0 0 15000 0 42466 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 09/09/1944 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V000864 0000100867893 3;JKN novia;3313125201940001;
5.6.5.202203091509 4 357390 1#0##0#0#0.0#2022-03-10
14:19:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3ba3d7ae6ae8746d2df347075806eb14 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 18/07/1964 0 1
0 - 0 - 0 - 0 786200 502500 0 1
SP.PD 1124R0020322V000865 0002425018184 3;JKN novia;3313125201940001;
5.6.5.202203091509 4 357389 1#0##0#0#0.0#2022-03-10
14:20:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a5421c02ba5ce43101c9dced941e4891 487500 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 31/12/1981 0 2
0 - 0 - 0 - 0 786200 677676 0 1
novia;3313125201940001; 5.6.5.202203091509 4 357388
1#0##0#0#0.0#2022-03-10
14:21:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
da26b25c26c9d7c9f4b0f4db15168ad7 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 02/02/1972 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V000867 0002070978546 3;JKN novia;3313125201940001;
5.6.5.202203091509 4 357387 1#0##0#0#0.0#2022-03-10
14:22:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
14281ddace6e46d908d7fdace23269ca 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 12/05/1983 0 1
0 0 - 0 - 0 - 0 - 0 181400 451711
0 1 0 0 0 TRI JOKO HERU WIBOWO, TN 031060 38
3;JKN reni;3313147010930001; 5.6.6.202203301209 4 361154
1#0##0#0#0.0#2022-04-05
09:50:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cd9126a39ca9cd98603d54d12979a006 0 0 138000 0 0 0
248000 0 0 0 15000 0 50711 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 14/03/1977 0 1
0 - 0 - 0 - 0 786200 273000 0 1
0 0 0 SOEHARTANTO.TN 083920 44 16427 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 357392
1#0##0#0#0.0#2022-04-11
11:42:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 6
5aee745d054caf5e30fb10907f343462 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 15/10/1964 0 1
0 - 0 - 0 - 0 786200 782220 0 1
0 0 0 SLAMET WIDODO, TN 088539 57 20960 DR. TEKY
novia;3313125201940001; 5.6.5.202203091509 4 357658
1#0##0#0#0.0#2022-03-10
14:25:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
40027c1dd4652655aa02f49b130eb2ff 782220 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 12/03/1955 0 2
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.5.202203091509 4 357386
1#0##0#0#0.0#2022-03-10
14:26:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a3e5fb1247c807f363afa4a1fa3c5f1c 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 07/02/1980 0 1
2 I25.1 89.52 - - None None None None Q-5-43-0 None None
None None None None PENYAKIT KRONIS BESAR LAIN-LAIN 262000 0
0 - 0 - 0 - 0 - 0 262000 175000
0 1 0 0 0 RETNA FEBRI ARIFIATI.NY 102295 42 15367
3;JKN novia;3313125201940001; 5.6.5.202203091509 4 357570
1#0##0#0#0.0#2022-03-10
14:27:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d355f330f9a347d7084db9e9adcdde8b 150000 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 14/05/1933 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 KOESWANTO BA.TN
0000091081451 3;JKN novia;3313125201940001; 5.6.5.202203091509 4
357659 1#0##0#0#0.0#2022-03-10
14:33:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
01a907af67a70f443cfe115f89ace69c 262000 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 18/04/1968 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 RAHMADI.TN 096843
0002169726311 3;JKN novia;3313125201940001; 5.6.5.202203091509 4
357394 1#0##0#0#0.0#2022-03-10
14:35:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5f73e42d5ceeab8a7d1359c8b7c73f19 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 21/08/1948 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MUSNATIN., NY
0000091314876 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357417 1#0##0#0#0.0#2022-05-19
10:01:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
6421d301ccfedac4640210c2606b225a 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 10/11/1965 0 1
1 Z09.8;M54.22;R47.1 93.89 - - None None None None Z-3-
0 - 0 - 0 - 0 - 0 138400 271000
novia;3313125201940001; 5.6.5.202203091509 4 357418
1#0##0#0#0.0#2022-03-10
14:38:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7473afd27c52fa7a2bd80a338d6955fc 256000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 20/07/1952 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 SITI ZUHRIYAH,(NY) 039654 69 25430
novia;3313125201940001; 5.6.5.202203091509 4 357414
1#0##0#0#0.0#2022-03-10
14:42:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
53e25e8edf9ab72e220cc6ce492a32e9 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 07/10/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 NUR LASMI, NY
0000639913318 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357397 1#0##0#0#0.0#2022-05-19
10:04:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
cfb1321116621aa9646bb3fc79923a64 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 28/01/1959 0 1
2 Z09.8;R10.4;K27.9;I11.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 240848
0 1 0 0 0 RISTIYANTO,TN 029882 63 23047 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357573
1#0##0#0#0.0#2022-03-10
14:43:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
46a87449e76ac26d290c7aaeec5f4812 150000 0 0 0 0 0
0 0 0 0 15000 0 75848 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 01/06/1944 0 2
0 - 0 107400 262000 0 1 0 0 0
SUJINEM,NY 086697 77 28401 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000882 0000091171091 3;JKN novia;3313125201940001;
5.6.5.202203091509 4 357404 1#0##0#0#0.0#2022-03-10
14:44:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cb63622c54d61ff20d8b31a58704cfa5 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 23/01/1956 0 1
1 Z09.8;I11.9;L50.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 268481
0 1 0 0 0 SYAMSUL BACHRI TANTHOKO, TN 100860 66
novia;3313125201940001; 5.6.5.202203091509 4 357575
1#0##0#0#0.0#2022-03-11
07:34:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b196e863bbbad99c1ef37eca4953852e 150000 0 0 0 0 0
0 0 0 0 15000 0 103481 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 05/03/1979 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 SRI WULAN.NY 099062 43 15706 DR. LINDA
novia;3313125201940001; 5.6.5.202203091509 4 357420
1#0##0#0#0.0#2022-03-11
07:35:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c798c20c670863aad45e508419fc3dda 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 04/08/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUNARTI.,NY 054610
0000091515857 3;JKN novia;3313125201940001; 5.6.5.202203091509 4
357398 1#0##0#0#0.0#2022-03-11
07:36:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1d2788ed5823fa92d48b7b9ceb2af2ce 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 16/05/1956 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WIDI WINARSI.NY
0001849841414 3;JKN novia;3313125201940001; 5.6.5.202203091509 4
357401 1#0##0#0#0.0#2022-03-11
07:37:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
787a70af2a788b6b1242a9f153a11ec7 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 07/07/1964 0 1
0 - 0 107400 458000 0 1 0 0 0
WIRADI.TN 098841 57 21060 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000889 0000640484785 3;JKN novia;3313125201940001;
5.6.5.202203091509 4 357407 1#0##0#0#0.0#2022-03-11
07:38:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eb21ad1519d962cc9912d1aba667e19d 443000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 15/05/1958 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 YAHMINI ., NY 055426 63 23305 DR.
novia;3313125201940001; 5.6.7.202204241238 4 357415
1#0##0#0#0.0#2022-05-19
08:39:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
7ccf6fdce7385859209a355154a8e6f2 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 31/12/1938 0 1
0 0 - 0 - 0 - 0 - 0 181400 211306
0 1 0 0 0 WAGE PRAPTODIHARJO,TN 060514 83 30380
novia;3313125201940001; 5.6.5.202203091509 4 357577
1#0##0#0#0.0#2022-03-11
07:39:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
432664fddc52442e469fc434b7318283 150000 0 0 0 0 0
0 0 0 0 15000 0 46306 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 24/02/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 208000 0 1 0 0 0 SRI PURWANI.NY
0001125886228 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357410 1#0##0#0#0.0#2022-05-20
09:25:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
ed35f85f0e1c84fc53fbc48fce9ba61b 193000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 14/04/1960 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARTINAH., NY
0001084606863 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357402 1#0##0#0#0.0#2022-05-19
10:02:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
efbc433b5311937cf5a40a2c66427b1a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 09/09/1982 0 1
1 Z09.8;F20.0 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 219464
0 1 0 0 0 MUHAMMAD ARIEF BUDIMAN. SDR 077063 39
14422 DR. IBRAHIM NASRUL, SP.KJ 1124R0020322V000895 0001274170026
3;JKN novia;3313125201940001; 5.6.5.202203091509 4 357579
1#0##0#0#0.0#2022-03-11
07:41:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dbe1bdf6b9aa64cff5266919b5df33be 0 0 0 0 0 0 0
0 0 0 15000 0 204464 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 23/07/2000 0 2
0 0 - 0 - 0 - 0 - 0 181400 197604
0 1 0 0 0 FATHAYAH AFIFATUR ROBBI, NN 102173 21
3;JKN novia;3313125201940001; 5.6.5.202203091509 4 357584
1#0##0#0#0.0#2022-03-11
07:42:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5077f14844d1639e724d7ce9e0c28404 150000 0 0 0 0 0
0 0 0 0 15000 0 32604 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 25/02/1972 0 1
0 - 0 - 0 - 0 - 0 138400 285000
novia;3313125201940001; 5.6.7.202204241238 4 357419
1#0##0#0#0.0#2022-05-20
10:09:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
dac76b2c58dde537953d2e66c9789875 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 18/06/1936 0 2
1 I11.9;M54.59 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 202026
0 1 0 0 0 DALIYEM.NY 077842 85 31306 DR. SUHARTO,
SP.PD 1124R0020322V000899 0001084498558 3;JKN novia;3313125201940001;
5.6.5.202203091509 4 357590 1#0##0#0#0.0#2022-03-11
07:43:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4251a93fe364e79d2a99f54443924c58 150000 0 0 0 0 0
0 0 0 0 15000 0 37026 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 12/02/1964 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 DARWATI, NY 094471 58 21206 DR. LINDA
novia;3313125201940001; 5.6.5.202203091509 4 357421
1#0##0#0#0.0#2022-03-11
07:44:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6b04a4749a819638180d886f67905b05 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 17/06/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 277542
0 1 0 0 0 BAMBANG SUGIHARJO, TN 091843 64 23637
novia;3313125201940001; 5.6.5.202203091509 4 357592
1#0##0#0#0.0#2022-03-11
07:48:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8f20157788dbfbbafec6c0256164cb44 150000 0 0 0 0 0
0 0 0 0 15000 0 112542 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 05/06/1975 0 2
0 - 0 - 0 - 0 - 0 138400 135000
0 1 0 0 0 YUNI NURJAYATI.NY 098879 46 17075 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357409
1#0##0#0#0.0#2022-03-11
07:49:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d362d4e74b92bd9dd88253496e4ffe18 120000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 28/06/1956 0 2
1 Z09.8;K80.2;R51;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 192583
0 1 0 0 0 SRI SARASWATI.NY 088967 65 23991 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357594
1#0##0#0#0.0#2022-03-11
07:50:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d85dad8a2523c28d218e1d70690defd5 150000 0 0 0 0 0
0 0 0 0 15000 0 27583 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 23/09/1954 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 ROCHYATI.NY 059452 67 24635 DR. LINDA
novia;3313125201940001; 5.6.5.202203091509 4 357399
1#0##0#0#0.0#2022-03-11
07:51:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0d337548c66e5323eca65b573d80d961 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 07/10/1961 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 208000 0 1 0 0 0 AGUNG RUMAMBI, TN
0001528617734 3;JKN novia;3313125201940001; 5.6.5.202203091509 4
357396 1#0##0#0#0.0#2022-03-11
07:53:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
01c620f26a907277d5d1976eade53630 193000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 13/08/1951 0 2
1 Z09.8;K30;E78.5;M54.59 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 218847
0 1 0 0 0 SUNARNI.(NY) 030534 70 25772 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357596
1#0##0#0#0.0#2022-03-11
07:54:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ae2b5b9fa1f3c279d69d0f6eb542625f 150000 0 0 0 0 0
0 0 0 0 15000 0 53847 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 23/03/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 374366
0 1 0 0 0 SITI WIARNI.NY 078569 58 21532 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357597
1#0##0#0#0.0#2022-03-11
07:54:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
58d00b202c18c3efe0a4ce21835a74cc 150000 0 0 0 0 0
0 0 0 0 15000 0 209366 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 30/10/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 187392
0 1 0 0 0 TRI KARTINI 089553 56 20580 DR. SUHARTO,
SP.PD 1124R0020322V000911 0002168611222 3;JKN novia;3313125201940001;
5.6.5.202203091509 4 357599 1#0##0#0#0.0#2022-03-11
07:55:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5d6d83f071341681acf8ed823929dde0 150000 0 0 0 0 0
0 0 0 0 15000 0 22392 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 01/09/1988 0 2
1 Z09.8;K30;K27.9;M54.59 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 216866
0 1 0 0 0 SEPTIANINGSIH.NY 101954 33 12238 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357601
1#0##0#0#0.0#2022-03-11
07:56:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ffbf8e0c6752c8d2a67f3fecbbf94f96 150000 0 0 0 0 0
0 0 0 0 15000 0 51866 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 03/04/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 238106
0 1 0 0 0 ENDANG PURWANTI 091405 52 19329 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357603
1#0##0#0#0.0#2022-03-11
07:57:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7ad00b94d0bc0d954b18a69ab7cfffc9 150000 0 0 0 0 0
0 0 0 0 15000 0 73106 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 20/04/1947 0 1
1 Z09.8;K30;G91.2 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 270090
0 1 0 0 0 DJIJO BASUKI 077000 74 27348 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357604
1#0##0#0#0.0#2022-03-11
07:57:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7483a2486510feea41564f830ef2d752 150000 0 0 0 0 0
0 0 0 0 15000 0 105090 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 06/06/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 212081
0 1 0 0 0 SRI SULISTYOWATI.NY 100259 55 20361
novia;3313125201940001; 5.6.5.202203091509 4 357606
1#0##0#0#0.0#2022-03-11
07:58:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
00898a6d448eaf803c11eb79a7ce66d1 150000 0 0 0 0 0
0 0 0 0 15000 0 47081 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 15/03/1953 0 1
1 Z09.8;I48 89.52 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 277735
0 1 0 0 0 PAIMIN, TN 057678 68 25192 DR. GALIH
novia;3313125201940001; 5.6.5.202203091509 4 357607
1#0##0#0#0.0#2022-03-11
07:59:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b4e72379329fbf7931079032c5142c86 150000 0 0 0 0 0
0 0 0 0 15000 0 112735 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 06/04/2019 0 2
1 T14.1;W19.0 - - - None None None None Q-5-42-0 None
0 - 0 - 0 - 0 - 0 182600 184527
0 1 0 0 0 ALNAIRA NAJWA AZKADINA, AN 102339 2
1064 DR. RIZA ABDILLAH 1124R0020322V000917 0002909946521 3;JKN
reni;3313147010930001; 5.6.6.202203301209 4 360992
1#0##0#0#0.0#2022-04-04
16:59:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9d2b13834c221dd4269d264429999ad1 0 0 75000 0 0 0 0
0 0 0 25000 0 84527 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 07/05/2001 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 LIANA AYU DEWANTRI
0001264309694 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361912 1#0##0#0#0.0#2022-04-07
13:02:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1f8636fefa57d7257d6985ea72356ea6 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 20/01/1963 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 204000 0 1 0 0 0 RESPATI DWI
1124R0020322V000919 0001865287618 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 361910 1#0##0#0#0.0#2022-04-07
13:05:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
824870919f2be21f97f627b51b4c8e8a 189000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 08/01/1965 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
276155 0 1 0 0 0 SRI SAMSINI.NY 099962 57
novia;3313125201940001; 5.6.5.202203091509 4 357609
1#0##0#0#0.0#2022-03-11
07:59:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
02a1389410026176cee4f54fa3b0fc51 150000 0 0 0 0 0
0 31845 0 0 15000 0 79310 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 12/05/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 194783
0 1 0 0 0 SUWARSO.TN 100320 61 22577 DR. SUHARTO,
SP.PD 1124R0020322V000921 0002420994914 3;JKN novia;3313125201940001;
5.6.5.202203091509 4 357610 1#0##0#0#0.0#2022-03-11
08:00:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d74a4f78f619c50ef410b02f29142ef8 150000 0 0 0 0 0
0 0 0 0 15000 0 29783 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 28/09/1965 0 2
1 E11.9;L50.9 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 188883
0 1 0 0 0 UMAR SANTI, NY 091741 56 20612 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357611
1#0##0#0#0.0#2022-03-11
08:01:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5954fe105ba41248207b36ab6110411c 150000 0 0 0 0 0
0 0 0 0 15000 0 23883 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 24/04/1990 0 1
0 0 - 0 - 0 - 0 - 0 181400 186753
0 1 0 0 0 EKO SETYANTO, TN 066247 31 11638 DR.
novia;3313125201940001; 5.6.5.202203091509 4 357613
1#0##0#0#0.0#2022-03-11
08:01:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
828d4fc0d22e8e8f3a721d6d3d75768d 150000 0 0 0 0 0
0 0 0 0 15000 0 21753 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 23/04/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 245966
0 1 0 0 0 SUKATNI, NY 091172 65 24057 DR. SUHARTO,
SP.PD 1124R0020322V000924 0001811084253 3;JKN novia;3313125201940001;
5.6.5.202203091509 4 357615 1#0##0#0#0.0#2022-03-11
08:02:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
198432b36d1fb21125b4050d2167c609 150000 0 0 0 0 0
0 0 0 0 15000 0 80966 0 0 0 0 0
3372030 C 3 CP 2 05/03/2022 05/03/2022 16/12/1956 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 BAMBANG WARAS
SUDIBYO, TN 065239 65 23820 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000925 0002463219077 3;JKN novia;3313125201940001;
5.6.5.202203091509 4 357445 1#0##0#0#0.0#2022-03-11
08:03:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
af94030a9dd3fd88f0453b43f55bd03f 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 05/02/1958 0 1
1 M54.59 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 206081
0 1 0 0 0 TAJUDIN M.NOER ., TN 059287 64 23406
DR. INDRIANY WIDHOWATY, SP.S, SP.AK 1124R0020322V000950 0001084480266
3;JKN yani;3302226402970001; 5.6.5.202203091509 4 357679
1#0##0#0#0.0#2022-03-11
15:09:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a0b8792b1252545f0051aed470678717 150000 0 0 0 0 0
0 0 0 0 15000 0 41081 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 07/09/1986 0 2
1 Z09.8;E11.4;G59.0;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 503689
0 1 0 0 0 ANIS DWI HASTUTI,(NY) 028206 35 12965
yani;3302226402970001; 5.6.5.202203091509 4 357680
1#0##0#0#0.0#2022-03-11
15:19:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
38a6693b0985537c443c83c3d35f6c7e 150000 0 0 0 0 0
0 171170 0 0 15000 0 167519 0 0 0 0
0
3372030 C 3 CP 2 07/03/2022 07/03/2022 14/09/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 380998
0 1 0 0 0 MARINO ., BP 055616 62 22820 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357681
1#0##0#0#0.0#2022-03-15
07:48:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0672e72611bde2c32a86b5db83a67fc7 150000 0 0 0 0 0
0 76045 0 0 15000 0 139953 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 17/03/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 278124
0 1 0 0 0 MUHARSIH (NY) 021793 59 21905 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357682
1#0##0#0#0.0#2022-03-15
07:48:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f2905d50ac8043bf6dc9cb0379f04255 150000 0 0 0 0 0
0 31845 0 0 15000 0 81279 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 11/02/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 274329
0 1 0 0 0 TATIT KUSTATI.NY 102139 77 28148 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357683
1#0##0#0#0.0#2022-03-15
07:50:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
42828edd15b30d9f8334b61a980d170c 150000 0 0 0 0 0
0 89050 0 0 15000 0 20279 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 12/07/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 236561
0 1 0 0 0 SLAMET SANTOSO, BP 082095 55 20327
yani;3302226402970001; 5.6.5.202203091809 4 357684
1#0##0#0#0.0#2022-03-15
07:50:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b4e34f9948ef0b3df6415fa47b0e8524 150000 0 0 0 0 0
0 0 0 0 15000 0 71561 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 08/12/1957 0 2
1 Z09.8;E11.4;G59.0;I10;H81.3 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
458142 0 1 0 0 0 PANINGSIH,(NY) 005331 64
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 357685
1#0##0#0#0.0#2022-03-15
07:51:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
97446f7d40c574cbff7a2308fdb254e6 150000 0 0 0 0 0
0 76045 0 0 15000 0 217097 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 09/01/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 502758
0 1 0 0 0 SRI SUYAMTI., NY 047144 57 20876 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357686
1#0##0#0#0.0#2022-03-15
07:53:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4fe3504944b6d91d4c026ec1e6a6c710 150000 0 0 0 0 0
0 31845 0 0 15000 0 305913 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 20/11/1999 0 2
0 0 - 0 - 0 - 0 - 0 296400 233183
0 1 0 0 0 AINUN WAHYU,NY 001169 22 8143 DR.
novia;3313125201940001; 5.6.7.202204241238 4 357687
1#0##0#0#0.0#2022-05-18
10:21:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
367e9609a43219745e028125ac5bc8c8 200000 0 0 0 0 0
0 0 0 0 15000 0 18183 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 02/07/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 395993
0 1 0 0 0 BAMBANG EKO SUHARDAYA,TN 080045 57
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 357688
1#0##0#0#0.0#2022-03-15
07:55:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
24a20d7408bd132c7def64ab5c62d668 150000 0 0 0 0 0
0 120795 0 0 15000 0 110198 0 0 0 0
0
3372030 C 3 CP 2 07/03/2022 07/03/2022 04/11/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 477645
0 1 0 0 0 ISMIYATUN.NY 094256 60 22038 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357689
1#0##0#0#0.0#2022-03-15
07:56:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1613c6f50fbaca8f6bdd6c681ef8f9c6 150000 0 0 0 0 0
0 107890 0 0 15000 0 204755 0 0 0 0
0
3372030 C 3 CP 2 07/03/2022 07/03/2022 23/03/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 358778
0 1 0 0 0 ERDIANA.NY 087879 48 17881 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 357690
1#0##0#0#0.0#2022-03-15
07:57:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
43d4e09dfc251d88529f76a9bfabbfa7 150000 0 0 0 0 0
0 133650 0 0 15000 0 60128 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 24/03/1951 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
249964 0 1 0 0 0 SUGIYONO ., TN 057327 70
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 357691
1#0##0#0#0.0#2022-03-15
07:59:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
02d93559675697f177b85698b4f38b94 150000 0 0 0 0 0
0 31845 0 0 15000 0 53119 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 02/02/1952 0 1
1 Z09.8;I11.9;N40 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 230463
0 1 0 0 0 SUWITO, TN 060006 70 25601 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 357693
1#0##0#0#0.0#2022-03-15
08:00:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
edd385ff99c6437b96edc6ca2ff9108f 150000 0 0 0 0 0
0 17745 0 0 15000 0 47718 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 14/10/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 299684
0 1 0 0 0 STELLA ANINDA ASTUTI ,NY 034846 61
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 357694
1#0##0#0#0.0#2022-03-15
08:01:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4e9e210eaa489f417a84d49b244c6bf0 150000 0 0 0 0 0
0 63690 0 0 15000 0 70994 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 20/10/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 BADRIYAH
MUNAWARAH,(NY) 043414 71 26071 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000967 0000091089088 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357639 1#0##0#0#0.0#2022-03-15
08:02:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
82547cf81ae15ee2ea0da76efba1925d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 10/08/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 417153
0 1 0 0 0 SRI SUYATMI.NY 081082 67 24681 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357695
1#0##0#0#0.0#2022-03-15
08:03:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b476b2c57415d4eaefbeeb08219ee2d8 150000 0 0 0 0 0
0 31845 0 0 15000 0 220308 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 09/10/1966 0 1
1 E11.4;G59.0;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 280599
0 1 0 0 0 TAUFIK HIDAYAT.TN 073663 55 20238 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357696
1#0##0#0#0.0#2022-03-15
08:03:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5dd5af751accb66c4a1cbe19156bffde 150000 0 0 0 0 0
0 31845 0 0 15000 0 83754 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 07/03/1965 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
460110 0 1 0 0 0 TUGINEM.NY 080874 56 20819
yani;3302226402970001; 5.6.5.202203091809 4 357697
1#0##0#0#0.0#2022-03-15
08:05:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
74db0c75254ecec9acae9f1e326a24db 150000 0 0 0 0 0
0 76045 0 0 15000 0 219065 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 13/11/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 208982
0 1 0 0 0 LIDIA HERAWATI 090523 76 27873 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361162
1#0##0#0#0.0#2022-04-05
09:55:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
21d73cde661506f29019aa61b5187971 0 0 138000 0 0 0
0 0 0 0 15000 0 55982 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 13/05/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 819536
0 1 0 0 0 ENI WIDIASTUTI, NY 100725 51 18926
yani;3302226402970001; 5.6.5.202203091809 4 357698
1#0##0#0#0.0#2022-03-15
08:06:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0bbbd900d2151fb370e0e2aaceca387f 150000 0 0 0 0 0
0 107890 0 0 15000 0 546646 0 0 0 0
0
3372030 C 3 CP 2 07/03/2022 07/03/2022 25/02/1960 0 1
1 Z09.8;E11.2;N08.3;I10 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 577131
0 1 0 0 0 SUHADAK.,TN 075282 62 22656 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 357699
1#0##0#0#0.0#2022-03-15
08:08:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fc9b7dafad248c5db44f6758312d144a 150000 0 0 0 0 0
0 76595 0 0 15000 0 335536 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 23/02/1976 0 2
- 0 - 0 - 0 - 0 549400 298377 0
1 0 0 0 NUR HIKMAH.NY 102296 46 16814 DR. GUNAWAN,
SP.OG 1124R0020322V000974 0002983122685 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357700 1#0##0#0#0.0#2022-03-15
08:13:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
73dd1870eadd959fb387fb6b1835a9ef 200000 0 0 0 0 0
0 0 0 0 25000 0 73377 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 21/10/2003 0 2
1 Z47.0 - - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 192242
0 1 0 0 0 OKTAVIANA PUTRI RAHMAWATI, (AN) 016163
18 6712 DR. WAHYU PURNOMO, SP.OT 1124R0020322V000975
0001108014219 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357701 1#0##0#0#0.0#2022-03-15
08:13:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a07dcd1e2a3c10c06e25db86660a1b95 150000 0 0 0 0 0
0 0 0 0 15000 0 27242 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 02/01/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 482281
0 1 0 0 0 MUH DAROJAT., BP 001091 52 19057 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357702
1#0##0#0#0.0#2022-03-15
08:14:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c8c13a30b23a1e83ec6b3ccc6bd58bac 203000 0 0 0 0 0
0 0 0 0 15000 0 264281 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 29/09/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 395236
0 1 0 0 0 MARIA DIAH ANGGARAWATI ., NY 059667 51
3;JKN novia;3313125201940001; 5.6.7.202204241238 4 357703
1#0##0#0#0.0#2022-05-19
08:57:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
70b4c680f06d975be722cb1210083764 150000 0 0 0 0 0
0 165545 0 0 15000 0 64691 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 31/12/1958 0 2
0 - 0 107400 273000 0 1 0 0 0 SRI
SUWANTI, NY 091754 63 23077 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000978 0001967417043 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357638 1#0##0#0#0.0#2022-03-15
08:17:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1c00cc005a7ce360eb3a66e76e222496 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 07/10/1983 0 2
1 Z09.8;E11.2;N08.3;I10 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 276370
0 1 0 0 0 IKA NURUL WARDANI.,NN 075648 38 14031
yani;3302226402970001; 5.6.5.202203091809 4 357704
1#0##0#0#0.0#2022-03-15
08:19:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1261164c811638a5bccc80d746363cb7 150000 0 0 0 0 0
0 0 0 0 15000 0 111370 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 23/04/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 553470
0 1 0 0 0 SRI WAHYUNI, NY 087660 61 22598 DR.
novia;3313125201940001; 5.6.7.202204241238 4 357705
1#0##0#0#0.0#2022-05-19
10:51:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
de12aa3c51aefb756a20ccb96ca26d14 150000 0 0 0 0 0
0 76045 0 0 15000 0 312425 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 12/02/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 355443
0 1 0 0 0 SRI SUMARSI, NY 099382 63 23034 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357706
1#0##0#0#0.0#2022-03-15
08:20:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b155cd3cc7804b3cb033648e323b55b5 150000 0 0 0 0 0
0 133650 0 0 15000 0 56793 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 07/11/1944 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
394842 0 1 0 0 0 SUNARTI, NY 071085 77 28244
yani;3302226402970001; 5.6.5.202203091809 4 357707
1#0##0#0#0.0#2022-03-15
08:22:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2ee7542a2f597449691bbed495188e39 150000 0 0 0 0 0
0 31845 0 0 15000 0 197997 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 16/02/1970 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
943731 0 1 0 0 0 TRIONO.TN 100731 52 19012
yani;3302226402970001; 5.6.5.202203091809 4 357708
1#0##0#0#0.0#2022-03-15
08:22:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2c1caaab3dc077c325bb77b9b7650202 150000 0 0 0 0 0
0 120795 0 0 15000 0 657936 0 0 0 0
0
3372030 C 3 CP 2 07/03/2022 07/03/2022 26/10/1964 0 1
1 Z09.8;I10;K30;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 386995
yani;3302226402970001; 5.6.5.202203091809 4 357709
1#0##0#0#0.0#2022-03-15
08:24:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
512244a89862f2fcf59d4aef1572bde2 150000 0 0 0 0 0
0 44200 0 0 15000 0 177795 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 14/03/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 626461
0 1 0 0 0 SUHARNI., NY 042396 56 20812 DR.
novia;3313125201940001; 5.6.7.202204241238 4 357710
1#0##0#0#0.0#2022-05-19
08:22:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
a51c3db9ed34e073370a0457d6f74bce 150000 0 0 0 0 0
0 63690 0 0 15000 0 397771 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 21/05/1943 0 1
0 0 - 0 - 0 - 0 - 0 181400 339963
0 1 0 0 0 SUPYANI, TN 097143 78 28780 DR. YUDHI
yani;3302226402970001; 5.6.5.202203091809 4 357711
1#0##0#0#0.0#2022-03-15
08:25:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3d746023f83bf1910078d263391a812e 203000 0 0 0 0 0
0 0 0 0 15000 0 121963 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 03/08/1963 0 2
0 - 0 107400 262000 0 1 0 0 0
TENTREM.NY 089445 58 21401 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V000989 0000640219601 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357637 1#0##0#0#0.0#2022-03-15
08:26:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
43451d24f349d3562a206f3bf9725ad8 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 05/06/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ASIYAH INTAN
1124R0020322V000990 0002050989456 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 357635 1#0##0#0#0.0#2022-05-19
14:01:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
06b7472a9c26020832551fbebf384f5e 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 29/09/1962 0 2
1 Z09.8;H26.9;E11.3;H36.0;H04.1 90.29 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
286921 0 1 0 0 0 SRI LESTARI,NY 061339 59
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 357712
1#0##0#0#0.0#2022-03-15
08:29:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
31ce59f74dda4209d9c49ee9133f74e4 203000 0 0 0 0 0
0 0 0 0 15000 0 68921 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 17/06/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 261427
0 1 0 0 0 MUGIYANTO, (BP) 003261 60 22178 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357714
1#0##0#0#0.0#2022-03-15
08:35:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e30af628145e29bb9cc4e509188fc9f6 150000 0 0 0 0 0
0 31845 0 0 15000 0 64582 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 06/05/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 275748
0 1 0 0 0 SUTAMI., NY 004711 59 21855 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 357715
1#0##0#0#0.0#2022-03-15
08:36:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
607ccbbbda99012868f7ba99890559b0 150000 0 0 0 0 0
0 31845 0 0 15000 0 78903 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 24/11/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 924706
0 1 0 0 0 TITIEK MUKARROMAH, NY 066166 57 20922
yani;3302226402970001; 5.6.5.202203091809 4 357716
1#0##0#0#0.0#2022-03-15
08:37:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
74045ea46e40a857244b8cce95b4c08c 150000 0 0 0 0 0
0 63690 0 0 15000 0 696016 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 10/10/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 301344
0 1 0 0 0 SUMARNI, NY 087562 66 24255 DR. TEKY
reni;3313147010930001; 5.6.7.202204241238 4 357717
1#0##0#0#0.0#2022-07-05
09:02:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
90c9a929d9d79f0dc1c5d895a2561948 150000 0 0 0 0 0
0 89500 0 0 15000 0 46844 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 19/11/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 261096
0 1 0 0 0 SUNARDI,(BP) 002851 61 22388 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357718
1#0##0#0#0.0#2022-03-15
08:42:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a1a5f09fbe3901a05c6b6c33905e02ec 150000 0 0 0 0 0
0 31845 0 0 15000 0 64251 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 10/05/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 312367
0 1 0 0 0 SRI WAHYUNI,(NY) 019814 56 20755 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357719
1#0##0#0#0.0#2022-03-15
08:42:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
890b1986ec51b25f1a1c989e2ba9ed65 150000 0 0 0 0 0
0 0 0 0 15000 0 147367 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 15/04/1973 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TATAS BUDIONO.TN
0001440938553 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357641 1#0##0#0#0.0#2022-03-15
08:43:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cc0fd0b4c64e789a48b24b78f29ee3cd 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 28/10/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 346482
0 1 0 0 0 HANDRIATI DARMASTUTI.(NY) 032024 64
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 357720
1#0##0#0#0.0#2022-03-15
08:44:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
391abe2f5a4d788eae48e081b0364644 150000 0 0 0 0 0
0 120795 0 0 15000 0 60687 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 30/08/1961 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 RIA TRI RASMANI.
0001729980966 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357634 1#0##0#0#0.0#2022-03-15
08:45:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3f142d0f30d3a9231ed50eaa0d6224f7 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 15/04/1959 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
484135 0 1 0 0 0 SURATINI MIASIH, NY 067261
0001700300968 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357721 1#0##0#0#0.0#2022-03-15
08:45:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e1a4f09d163d136ad0dc1b49616eb431 150000 0 0 0 0 0
0 76595 0 0 15000 0 242540 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 01/01/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 375577
0 1 0 0 0 SITI MARDIYATI ., NY 056049 71 25998
yani;3302226402970001; 5.6.5.202203091809 4 357722
1#0##0#0#0.0#2022-03-15
08:46:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
117efc500c06c60035fd0d62da945f00 150000 0 0 0 0 0
0 88950 0 0 15000 0 121627 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 12/01/1974 0 2
- 0 - 0 - 0 - 0 549400 215000 0
1 0 0 0 SRI HARIYANTI.NY 098585 48 17586 DR. GUNAWAN,
SP.OG 1124R0020322V001006 0001108875341 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357723 1#0##0#0#0.0#2022-03-15
08:47:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f553c270a7f3cd8ec2eb7c90b0d632c0 200000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 22/04/1949 0 1
1 Z09.8;H26.9;E11.3;H36.0 90.29 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 286921
0 1 0 0 0 DJUWARSO, (BP) 008057 72 26617 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357724
1#0##0#0#0.0#2022-03-15
08:50:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a53fce5ff6b36e84a557abc65d9b893a 203000 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 22/05/1982 0 2
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09:07:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
7aa6337117a577c7843e5d8b6716d09c 200000 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 17/08/2016 0 1
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0 1 0 0 0 HAFIZ HERLANDIKA SUSANTO.AN 077009 5
0002078395648 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
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08:51:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/03/2022 07/03/2022 14/07/1973 0 2
1 Z09.8;E11.3;H04.1 90.29 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 252848
0 1 0 0 0 NUGRAHENI NUR ASMARA,(NN) 020978 48
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 357727
1#0##0#0#0.0#2022-03-15
08:52:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/03/2022 07/03/2022 30/08/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 342163
0 1 0 0 0 SUTARDI.TN 093260 61 22469 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 357728
1#0##0#0#0.0#2022-03-15
08:53:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0920e3498bf804da217b5bb44da51d9e 150000 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 31/12/1958 0 2
1 H26.9;H04.1 90.29 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 218000
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yani;3302226402970001; 5.6.5.202203091809 4 357729
1#0##0#0#0.0#2022-03-15
08:56:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b87f9d93a4b8a3398f563ff28e06a691 203000 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 28/11/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 286921
0 1 0 0 0 TULADI, TN 101284 68 24936 DR. YUDHI
yani;3302226402970001; 5.6.5.202203091809 4 357730
1#0##0#0#0.0#2022-03-15
08:56:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
176dc33fee88b87993699f5063e37c5e 203000 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 19/03/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 419047
0 1 0 0 0 FITRA WALUYANDI, TN 073763 43 16059
novia;3313125201940001; 5.6.7.202204241238 4 357731
1#0##0#0#0.0#2022-05-19
10:08:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
bbc27ddb596943b57358957e932d8998 150000 0 0 0 0 0
220000 0 0 0 15000 0 34047 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 16/06/1965 0 1
1 Z09.8;I10;M17.9 88.27 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 421229
0 1 0 0 0 JOKO SUKARNO PARHADI.TN 094154 56 20718
yani;3302226402970001; 5.6.5.202203091809 4 357732
1#0##0#0#0.0#2022-03-15
09:05:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2c39fa8b85ae5688a1b8ded312c88db2 150000 0 0 0 0 0
220000 0 0 0 15000 0 36229 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 13/08/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 302332
0 1 0 0 0 TRI UTAMI AGUSTINI, NY 048735 63 23217
yani;3302226402970001; 5.6.5.202203091809 4 357733
1#0##0#0#0.0#2022-03-15
09:06:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/03/2022 07/03/2022 10/10/1953 0 2
0 - 0 107400 273000 0 1 0 0 0 TUTIK
1124R0020322V001018 0001449355893 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357636 1#0##0#0#0.0#2022-03-15
09:07:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/03/2022 07/03/2022 02/10/1990 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 357734
1#0##0#0#0.0#2022-03-15
09:08:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
ad242753c670f2db04ac1d17d0116615 150000 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 12/02/1959 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 357735
1#0##0#0#0.0#2022-03-15
09:09:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/03/2022 07/03/2022 28/12/1949 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 NURHAYATI.NY
0001848729036 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357640 1#0##0#0#0.0#2022-03-15
09:21:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/03/2022 07/03/2022 31/01/1954 0 2
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0 1 0 0 0 DEWI MURTYANINGSIH.,NY 074565 68 24872
yani;3302226402970001; 5.6.5.202203091809 4 357736
1#0##0#0#0.0#2022-03-15
09:22:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/03/2022 07/03/2022 04/05/1958 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 357654
1#0##0#0#0.0#2022-03-15
09:28:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
29e06ec138f6d53903264b13a0ad07b7 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 04/09/1964 0 1
0 - 0 - 0 - 0 786200 677676 0 1
yani;3302226402970001; 5.6.5.202203091809 4 357653
1#0##0#0#0.0#2022-03-15
09:35:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7e56ba7cf56998932af15d347fb84a4c 662676 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 25/06/1970 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 357652
1#0##0#0#0.0#2022-03-15
09:36:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d32b509195f3d26f127b74588548fa71 662676 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 12/10/1987 0 1
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yani;3302226402970001; 5.6.5.202203091809 4 357651
1#0##0#0#0.0#2022-03-15
09:39:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
58963141798eb0d91d0491f1f290e76a 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 10/12/1982 0 1
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yani;3302226402970001; 5.6.5.202203091809 4 357650
1#0##0#0#0.0#2022-03-15
09:40:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cc0222f8992d9649fe9fdf2db32b47dd 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 18/03/1988 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 357649
1#0##0#0#0.0#2022-03-15
13:27:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
40a4aff21ca01f7a77368c22a19199fe 463830 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 20/07/1952 0 2
0 - 0 107400 262000 0 1 0 0 0 SITI
ZUHRIYAH,(NY) 039654 69 25432 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V001029 0000091194276 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357642 1#0##0#0#0.0#2022-03-15
09:41:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ccc2d3b2ddc4e3cfe443f4b75ad508c9 247000 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 14/10/1972 0 2
0 - 0 - 0 - 0 786200 753510 0 1
yani;3302226402970001; 5.6.5.202203091809 4 357648
1#0##0#0#0.0#2022-03-15
13:29:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/03/2022 07/03/2022 17/10/1957 0 1
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yani;3302226402970001; 5.6.5.202203091809 4 357737
1#0##0#0#0.0#2022-03-15
09:43:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a9c03b655a76ccd3b667c1cd252cb752 150000 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 31/12/1952 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 357738
1#0##0#0#0.0#2022-03-15
09:47:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2bdcc7751954f79e71d9a9d31749335a 150000 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 08/02/1940 0 1
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yani;3302226402970001; 5.6.5.202203091809 4 357739
1#0##0#0#0.0#2022-03-15
09:48:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
76d3e1a6ab17345e0f929614c7084314 150000 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 21/07/1954 0 1
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yani;3302226402970001; 5.6.5.202203091809 4 357740
1#0##0#0#0.0#2022-03-15
09:49:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8d22e7aa2bdffdb54d5e316f1ee8a333 150000 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 11/02/1941 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 357741
1#0##0#0#0.0#2022-03-15
09:50:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a4fabfae9d97a39c0c51e500e211ced1 150000 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 30/06/1979 0 2
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3;JKN yani;3302226402970001; 5.6.5.202203091809 4 357743
1#0##0#0#0.0#2022-03-15
09:50:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8f3cfbf5ebbe7d2aa3e904321886f1cf 150000 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 30/06/1955 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 357744
1#0##0#0#0.0#2022-03-15
09:52:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b2360ce51c0f94ba6b17beabaee3bdd6 150000 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 07/09/1962 0 1
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3;JKN yani;3302226402970001; 5.6.5.202203091809 4 357745
1#0##0#0#0.0#2022-03-15
10:29:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/03/2022 07/03/2022 17/06/1957 0 1
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3;JKN yani;3302226402970001; 5.6.5.202203091809 4 357746
1#0##0#0#0.0#2022-03-15
10:38:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/03/2022 07/03/2022 21/06/1995 0 1
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357747 1#0##0#0#0.0#2022-03-15
10:42:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/03/2022 07/03/2022 23/05/1963 0 2
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0 1 0 0 0 SRI RAHAYU.NY 083756 58 21473 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357748
1#0##0#0#0.0#2022-03-15
10:43:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
269fadccd7b551137af659a85a9c16a0 150000 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 11/02/1959 0 2
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3;JKN yani;3302226402970001; 5.6.5.202203091809 4 357749
1#0##0#0#0.0#2022-03-15
10:44:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/03/2022 07/03/2022 13/03/1947 0 2
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0 0 - 0 - 0 - 0 - 0 181400 301219
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yani;3302226402970001; 5.6.5.202203091809 4 357751
1#0##0#0#0.0#2022-03-15
10:46:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/03/2022 07/03/2022 26/08/1971 0 2
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0001530376389 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357750 1#0##0#0#0.0#2022-03-15
10:45:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
21585cda3f6144869901d494e6cc628c 150000 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 27/11/1961 0 2
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novia;3313125201940001; 5.6.7.202204241238 4 357752
1#0##0#0#0.0#2022-05-19
10:18:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
3d22999dff47c291285e3abb0b4a783b 150000 0 0 0 0 0
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3372030 C 3 CP 2 07/03/2022 07/03/2022 28/05/1955 0 1
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yani;3302226402970001; 5.6.5.202203091809 4 357753
1#0##0#0#0.0#2022-03-15
10:52:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/03/2022 07/03/2022 24/02/1954 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 357754
1#0##0#0#0.0#2022-03-15
10:53:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/03/2022 07/03/2022 25/12/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 226360
0 1 0 0 0 WAHJUNINGSIH KARMADJAJA.NY 042202 64
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 357755
1#0##0#0#0.0#2022-03-15
10:54:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e32a3d63020679561e189987cef2f479 150000 0 0 0 0 0
0 0 0 0 15000 0 61360 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 08/10/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 230406
0 1 0 0 0 SYAMSIYAH.NY 094677 54 19874 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357756
1#0##0#0#0.0#2022-03-15
10:58:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3b5037ec7f92bfe4afac9386431028c5 150000 0 0 0 0 0
0 0 0 0 15000 0 65406 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 07/11/1965 0 1
1 Z09.8;M14.6;M17.9 88.27 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 452710
0 1 0 0 0 NGADINO,TN 040402 56 20574 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 357757
1#0##0#0#0.0#2022-03-15
10:59:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b1f2b164a5d53ed6a4baf256560ac25a 150000 0 0 0 0 0
248000 0 0 0 15000 0 39710 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 31/12/1939 0 2
0 0 - 0 - 0 - 0 - 0 181400 215221
0 1 0 0 0 SAIDAH, NY 088097 82 30017 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 357758
1#0##0#0#0.0#2022-03-15
11:00:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d0be77baa036530614d9291f278ad24c 150000 0 0 0 0 0
0 0 0 0 15000 0 50221 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 17/03/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 197991
0 1 0 0 0 SRI LESTARI, NY 099302 57 21174 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357759
1#0##0#0#0.0#2022-03-15
11:01:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
091e7124eb5af12121b31e743dbae25a 150000 0 0 0 0 0
0 0 0 0 15000 0 32991 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 21/10/1950 0 1
1 Z09.8;M54.59 04.81 - - None None None None G-3-11-0
None None None None None None PROSEDUR INJEKSI PADA SARAF PERIFER 317600
0 0 - 0 - 0 - 0 - 0 317600 318104
yani;3302226402970001; 5.6.5.202203091809 4 357760
1#0##0#0#0.0#2022-03-15
11:02:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
59ad56507bafef7fe384d882ca0df535 150000 0 0 0 0 0
0 0 0 0 15000 0 153104 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 27/02/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 212203
0 1 0 0 0 SITI ZUHDIAH 015745 68 24845 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357761
1#0##0#0#0.0#2022-03-15
11:16:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4bf76145daa6a87950c65725d9000302 150000 0 0 0 0 0
0 0 0 0 15000 0 47203 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 28/03/1951 0 2
2 C50.9 - - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 ENDANG SAMIYATI, NY 066320 70 25912
yani;3302226402970001; 5.6.5.202203091809 4 357762
1#0##0#0#0.0#2022-03-15
11:17:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9264bd31746649280f62178e48e0654a 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 02/06/1976 0 2
1 D21.6 - - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 188450
0 1 0 0 0 ESTER KUUMAWATI ., NY 000824 45 16714
reni;3313147010930001; 5.6.6.202203301209 4 361164
1#0##0#0#0.0#2022-04-05
09:56:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ee73fcc0f4882460b3d8595d5fb5a3dd 150000 0 0 0 0 0
0 0 0 0 15000 0 23450 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 27/07/1950 0 1
0 404900 412678 0 1 0 0 0 H. BEKTI KAREBET,
TN 099894 71 26156 DR. WAHYU PURNOMO, SP.OT 1124R0020322V001060
0001800750519 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357763 1#0##0#0#0.0#2022-03-15
11:18:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a924d1d1b9013c15a4627a6fbe782ae0 150000 0 0 0 0 0
0 0 0 0 15000 0 247678 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 21/09/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 215470
0 1 0 0 0 SUDARNO, TN 091269 51 18795 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 357764
1#0##0#0#0.0#2022-03-15
11:19:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5c17f227dfc7d90e0925c3fb34d75c09 150000 0 0 0 0 0
0 0 0 0 15000 0 50470 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 05/02/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 289121
0 1 0 0 0 ATI KUSMIARTI.NY 078663 70 25598 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357765
1#0##0#0#0.0#2022-03-15
11:20:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d4ebb0946b43e08919d4a8137b64f199 203000 0 0 0 0 0
0 0 0 0 15000 0 71121 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 15/03/1970 0 2
0 404900 206423 0 1 0 0 0 SRI LESTARI.NY
0001526823189 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357766 1#0##0#0#0.0#2022-03-15
11:25:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
415e437fcebb44e381b0043ef83cfc34 150000 0 0 0 0 0
0 0 0 0 15000 0 41423 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 31/12/1953 0 2
0 404900 201407 0 1 0 0 0 SITI MUTMAINAH .NY
0000640765495 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357767 1#0##0#0#0.0#2022-03-15
11:26:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
702a78d7d55ed6cfc7386008276ec1fb 150000 0 0 0 0 0
0 0 0 0 15000 0 36407 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 21/02/2015 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 PRANAJA SETYA AZKA A.AN 099752 7 2571
novia;3313125201940001; 5.6.7.202204241238 4 357768
1#0##0#0#0.0#2022-05-20
08:18:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
d1811521cf295f719eba97bd57a868f5 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 12/03/1975 0 2
0 - 0 - 0 - 0 - 0 296400 384207
0 1 0 0 0 MAMI SUGESTI, NY 102347 46 17162 DR.
DEWI ANGGOROWATI, SP.OG 1124R0020322V001070 0002169234977 3;JKN
yani;3302226402970001; 5.6.5.202203091809 4 357769
1#0##0#0#0.0#2022-03-15
11:30:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0b54e22a635593baaf8339e4aa4bdef6 350000 0 0 0 0 0
0 0 0 0 25000 0 9207 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 31/12/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 226580
0 1 0 0 0 INDRAYATI, NY 091755 58 21251 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357770
1#0##0#0#0.0#2022-03-15
11:30:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8fb4abeb1a8dce47b4c6d2bf508e8242 150000 0 0 0 0 0
0 0 0 0 15000 0 61580 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 01/01/2000 0 1
0 0 - 0 - 0 - 0 - 0 181400 179862
0 1 0 0 0 DANENDRA DENI A,(AN) 033915 22 8101
yani;3302226402970001; 5.6.5.202203091809 4 357771
1#0##0#0#0.0#2022-03-15
11:31:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7e8bfeb725f54a94d88f3790b247a408 150000 0 0 0 0 0
0 0 0 0 15000 0 14862 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 12/04/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARIYAM.NY 084306
0001302703266 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357631 1#0##0#0#0.0#2022-05-19
10:22:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 4
b661545d89d993d1d46b358e58a6dde8 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 30/07/1994 0 1
0 - 0 - 0 - 0 - 0 181400 214720
0 1 0 0 0 RUSTAM YULIANTO, SDR 101647 27 10082
yani;3302226402970001; 5.6.5.202203091809 4 357772
1#0##0#0#0.0#2022-03-15
11:32:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
68c18ab3163127c0aaa56f483c364fe5 150000 0 0 0 0 0
0 0 0 0 15000 0 49720 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 26/04/1969 0 1
0 404900 198677 0 1 0 0 0 SUDARTI.NY 101588
0001868668029 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357773 1#0##0#0#0.0#2022-03-15
11:33:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a694c9747d5b28bdd792cd271053d761 150000 0 0 0 0 0
0 0 0 0 15000 0 33677 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 19/10/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 421456
0 1 0 0 0 WAGIMAN, TN 100076 49 18036 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 357775
1#0##0#0#0.0#2022-03-15
11:45:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
769ff53e2067fdce09a0bbc4f86e038f 351500 0 0 0 0 0
0 0 0 0 15000 0 54956 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 16/09/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 609198
0 1 0 0 0 INDAH SETIYANINGSIH. NY 084608 48 17704
yani;3302226402970001; 5.6.5.202203091809 4 357774
1#0##0#0#0.0#2022-03-15
11:34:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
58381342da0d0ea4239075eaaebee3f7 150000 0 0 0 0 0
356000 0 0 0 15000 0 88198 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 04/07/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 723439
0 1 0 0 0 YULIATI.NY 101624 52 19239 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 357776
1#0##0#0#0.0#2022-03-15
11:46:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0e971eba4054a93b04483826c6bcb25f 150000 0 0 0 0 0
0 31845 0 0 15000 0 526594 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 18/02/1942 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DARTINAH,NY 030952
0001021779674 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357632 1#0##0#0#0.0#2022-05-18
11:19:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
4824e013eb15ae594e31f22e620a094d 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 20/06/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 254166
0 1 0 0 0 SOENARTI, NY 088723 65 24001 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357777
1#0##0#0#0.0#2022-03-15
11:48:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3f3787d27dd92138221a692899e0f03a 150000 0 0 0 0 0
0 0 0 0 15000 0 89166 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 22/09/1959 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMARSONO ,TN
0001032587199 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357633 1#0##0#0#0.0#2022-03-15
11:49:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b81d0935d074b11c120d7f3eb56a15a1 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 23/08/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 212322
0 1 0 0 0 HJ.RAHAYU SUTINI,(NY) 021403 74 27225
yani;3302226402970001; 5.6.5.202203091809 4 357778
1#0##0#0#0.0#2022-03-15
11:50:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c702d8a7517c2ba757dae48808c7b0aa 150000 0 0 0 0 0
0 0 0 0 15000 0 47322 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 06/11/1960 0 2
1 S52.50;W01.0 88.21 - - None None None None Q-5-31-0
0 - 0 - 0 - 0 129600 451007 0 1
0 0 0 SITI UNTARI, NY 102351 61 22401 DR. WAHYU PURNOMO,
SP.OT 1124R0020322V001083 0001032583893 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 357779 1#0##0#0#0.0#2022-03-15
11:52:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3212ff805a4bf4b642509addc0ccd22e 150000 0 0 0 0 0
248000 0 0 0 15000 0 38007 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 07/01/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 234047
0 1 0 0 0 SARIDJO ISWANTO (BP) 025604 80 29279
yani;3302226402970001; 5.6.5.202203091809 4 357780
1#0##0#0#0.0#2022-03-15
12:48:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
837640b66ca748a0dbf028a151dc218c 150000 0 0 0 0 0
0 0 0 0 15000 0 69047 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 24/12/1950 0 2
1 Z09.8;I10;G62.9;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 260535
0 1 0 0 0 SUGIYARTI, NY 101521 71 26006 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357781
1#0##0#0#0.0#2022-03-15
12:49:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
67bddd97cb652f0a0f6f3114c9c291a2 150000 0 0 0 0 0
0 0 0 0 15000 0 95535 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 18/06/1980 0 1
1 Z09.8;K80.2;R10.4 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 410185
0 1 0 0 0 GUNADI.TN 099997 41 15237 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 357782
1#0##0#0#0.0#2022-03-15
12:50:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6d53542f7255ba89a7064fa3bc575592 150000 0 0 0 0 0
0 0 0 0 15000 0 245185 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 17/12/1979 0 1
1 H81.3;G44.2;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 190176
0 1 0 0 0 SURANTO PONCO NUGROHO.TN 082986 42
0002036612799 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357783 1#0##0#0#0.0#2022-03-15
12:52:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dac9094b7e41a1e2f3f33f5b93950540 150000 0 0 0 0 0
0 0 0 0 15000 0 25176 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 15/05/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 376785
0 1 0 0 0 SUMI, NY 100128 66 24403 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 357784
1#0##0#0#0.0#2022-03-15
12:54:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1f2db2065640539774ca0dc3594f7eb5 150000 0 0 0 0 0
0 76045 0 0 15000 0 135740 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 20/02/1971 0 1
0 - 0 - 0 - 0 - 0 181400 475637
0 1 0 0 0 KAYUN, TN 102348 51 18643 DR. WAHYU
agung;3313092303950002; 5.6.6.202203301209 4 357785
1#0##0#0#0.0#2022-04-11
11:43:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
1da5515d14c4984406549cd7e578e2e3 150000 0 0 0 0 0
248000 0 0 0 25000 0 52637 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 26/06/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 194552
0 1 0 0 0 MARKAMAH,NY 085323 52 19247 DR. WAHYU
agung;3313092303950002; 5.6.7.202204241238 4 367809
1#0##0#0#0.0#2022-05-20
10:22:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6bcfbf71c9a7009f8d45465675f8a8a5 150000 0 0 0 0 0
0 0 0 0 15000 0 29552 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 31/12/1959 0 2
1 Z47.0 97.89 - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 327369
0 1 0 0 0 HARYANTI, NY 094139 62 22712 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357786
1#0##0#0#0.0#2022-03-15
12:57:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
764aeb1f656e9ea9ee1c80a69203c2d7 273500 0 0 0 0 0
0 0 0 0 15000 0 38869 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 01/09/1995 0 1
1 Z09.0;R59.0 97.89 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 264691
0 1 0 0 0 INDRA, SDR 068766 26 9684 DR. DAMAR
5.6.7.202204241238 4 357787 1#0##0#0#0.0#2022-05-19
09:28:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
5e3baa5046bca8b98667a2f9c97b4a70 235000 0 0 0 0 0
0 0 0 0 15000 0 14691 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 04/07/1959 0 2
1 Z09.8;E11.9;I10;M19.98 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 465234
0 1 0 0 0 HARIYATI.NY 101580 62 22892 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 357788
1#0##0#0#0.0#2022-03-15
13:00:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
72a2c6a0d109bb62e9608e1eb750335d 150000 0 0 0 0 0
0 130845 0 0 15000 0 169389 0 0 0 0
0
3372030 C 3 CP 2 07/03/2022 07/03/2022 01/09/2009 0 2
- 0 - 0 - 0 - 0 549400 237308 0
1 0 0 0 ANDARA JESIKA OS, (AN) 014552 12 4570 DR.
agung;3313092303950002; 5.6.7.202204241238 4 357789
1#0##0#0#0.0#2022-05-25
10:54:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
06f05cd32db60a3d837897eff97b3473 200000 0 0 0 0 0
0 0 0 0 15000 0 22308 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 07/01/2010 0 2
1 K12.1 - - - None None None None Q-5-42-0 None None
- 0 - 0 - 0 - 0 182600 200137 0
1 0 0 0 FAIRUZ ZAHIRAH, AN 080818 12 4442 DR.
ANI SURYANTI WISYASTUTI, SP.A., M.KES 1124R0020322V001101 0000194162466
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 357790
1#0##0#0#0.0#2022-03-15
13:12:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
815c4ff91d22b9637f5f362c3d8193f8 150000 0 0 0 0 0
0 0 0 0 15000 0 35137 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 15/10/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 246590
0 1 0 0 0 DRA. SRI HANDAYANI LESTARI 101487 61
3;JKN reni;3313147010930001; 5.6.6.202203301209 4 361460
1#0##0#0#0.0#2022-04-06
08:47:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b36e9a62ec87109b9a437caf1016c7b0 150000 0 0 0 0 0
0 0 0 0 15000 0 81590 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 11/05/1934 0 2
0 0 - 0 - 0 - 0 - 0 181400 437118
0 1 0 0 0 Hj. SITI CHOTIMAH, NY 100244 87 32077
yani;3302226402970001; 5.6.5.202203091809 4 357791
1#0##0#0#0.0#2022-03-15
13:13:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0a1841172394946515b5b10706ca7a57 150000 0 0 0 0 0
0 0 0 0 15000 0 272118 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 06/08/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 230417
0 1 0 0 0 ANTONIUS SRI MULYONO,(BP) 032742 59
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 357793
1#0##0#0#0.0#2022-03-15
13:15:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a472c58f8c21038d06fae6e843acb6b8 150000 0 0 0 0 0
0 0 0 0 15000 0 65417 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 18/11/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 334691
0 1 0 0 0 MUHAMMAD RIZKY RAMADHANI, SDR 101401 19
7049 DR. DAMAR ARYO, SP.B 1124R0020322V001105 0001268937483 3;JKN
yani;3302226402970001; 5.6.5.202203091809 4 357792
1#0##0#0#0.0#2022-03-15
13:14:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4fb01e124f134c954375777088b27e50 305000 0 0 0 0 0
0 0 0 0 15000 0 14691 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 13/08/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 236231
0 1 0 0 0 SRI LESTARI . NY 068663 71 26139 DR.
yani;3302226402970001; 5.6.5.202203091809 4 357794
1#0##0#0#0.0#2022-03-15
13:15:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3c6efc38e7fd72bd7411d9fcc6b8a4fa 150000 0 0 0 0 0
0 0 0 0 15000 0 71231 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 02/12/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 381130
0 1 0 0 0 YOHANES SUTRISNO SUBAGYO.TN 098269 61
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 357795
1#0##0#0#0.0#2022-03-15
13:16:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9917b1d5db8a3873b0fe88a41133de96 150000 0 0 0 0 0
0 76045 0 0 15000 0 140085 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 06/02/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 162591
0 1 0 0 0 IWAN EDI SUTEMAN. TN 048724 53 19387
yani;3302226402970001; 5.6.6.202203301209 4 358748
1#0##0#0#0.0#2022-04-07
14:18:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
691c44d24f6d87dc8c4d5040ad2e315e 0 0 0 0 0 0 0
89500 0 0 15000 0 58091 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 24/02/2007 0 1
2 Z09.8;Q21.1 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 MARHAEN ARIF RACHMAN, AN 060759 15
0000640245666 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357796 1#0##0#0#0.0#2022-03-15
13:17:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4b8bdba269a95fc1d7121dd8b56a9f51 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 05/03/1983 0 1
0 0 - 0 - 0 - 0 - 0 181400 386826
0 1 0 0 0 JAYADI.TN 101160 39 14247 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 357797
1#0##0#0#0.0#2022-03-15
13:17:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
81ffd74aafbae129ef2a02959ae23a1a 150000 0 0 0 0 0
0 0 0 0 15000 0 221826 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 28/01/1971 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
361119 0 1 0 0 0 SUNARMI 007615 51 18666
yani;3302226402970001; 5.6.5.202203091809 4 357798
1#0##0#0#0.0#2022-03-15
13:18:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
123d0d850e70262661ee4ca7743b7f72 150000 0 0 0 0 0
0 0 0 0 15000 0 196119 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 09/11/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 211037
0 1 0 0 0 SUMIYATI, NY 100486 56 20572 DR.
novia;3313125201940001; 5.6.7.202204241238 4 357799
1#0##0#0#0.0#2022-05-20
08:39:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
bf02a44469dcdc7593f72d2fec346ccb 150000 0 0 0 0 0
0 0 0 0 15000 0 46037 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 12/07/1966 0 1
0 - 0 - 0 - 0 786200 800568 0 1
yani;3302226402970001; 5.6.5.202203091809 4 357644
1#0##0#0#0.0#2022-03-15
13:23:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6b1872df7869eeccf1de7d584013b40b 662676 0 0 0 0 0
0 0 0 0 15000 0 122892 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 12/12/1964 0 1
0 - 0 - 0 - 0 786200 500082 0 1
yani;3302226402970001; 5.6.5.202203091809 4 357643
1#0##0#0#0.0#2022-03-15
13:23:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
582df812687f74562d6d86f145c02e44 463830 0 0 0 0 0
0 0 0 0 15000 0 21252 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 22/10/1959 0 2
0 - 0 - 0 - 0 786200 795046 0 1
yani;3302226402970001; 5.6.5.202203091809 4 357646
1#0##0#0#0.0#2022-03-15
13:24:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9a259bca16e93cded5c2d4a45899e121 662676 0 0 0 0 0
0 0 0 0 15000 0 117370 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 12/08/1977 0 1
0 - 0 - 0 - 0 786200 677676 0 1
yani;3302226402970001; 5.6.5.202203091809 4 357645
1#0##0#0#0.0#2022-03-15
13:24:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
259b5c5cc36497d0d87ddba51634a8d1 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 03/08/1963 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 357647
1#0##0#0#0.0#2022-03-15
13:25:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2d736c6e1352f760ad4fc4c757bbe1ea 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 28/02/2008 0 1
1 Z09.4;S83.1 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 232947
0 1 0 0 0 BERLY GAVIN J, AN 102005 14 5121 DR.
novia;3313125201940001; 5.6.7.202204241238 4 357801
1#0##0#0#0.0#2022-05-20
10:23:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
675720111065e5600cbb2d9af36d5db9 150000 0 0 0 0 0
0 0 0 0 15000 0 67947 0 0 0 0 0
3372030 C 3 CP 2 07/03/2022 07/03/2022 18/01/1963 0 2
0 404900 201636 0 1 0 0 0 SUNARTI.NY 082131
0001735219653 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
357800 1#0##0#0#0.0#2022-03-15
13:26:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d513dea116f725e484cda767bf0826bf 150000 0 0 0 0 0
0 0 0 0 15000 0 36636 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 31/12/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 423719
0 1 0 0 0 PARMI, NY 054631 47 17234 DR. TEKY
agung;3313092303950002; 5.6.5.202203091809 4 358749
3#0##0#0#0.0#2022-03-30
14:33:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
534589292c49fe9794bfa64069211968 300000 0 0 0 0 0
0 31845 0 0 15000 0 76874 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 14/07/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 459712
0 1 0 0 0 PONIYEM ., NY 058483 60 22152 DR.
agung;3313092303950002; 5.6.5.202203091809 4 358750
4#0##0#0#0.0#2022-03-30
14:33:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
46c6d22b143e79565c547a4bde1b91c2 150000 0 0 0 0 0
0 63690 0 0 15000 0 231022 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 13/03/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 206786
0 1 0 0 0 SUBANDIJO.TN 083578 77 28484 DR.
agung;3313092303950002; 5.6.5.202203091809 4 358751
5#0##0#0#0.0#2022-03-30
14:34:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1e74ea95c73d0bb588ad386a56ceb41b 150000 0 0 0 0 0
0 0 0 0 15000 0 41786 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 27/11/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 649063
0 1 0 0 0 NGATIYEM,NY 084267 60 22016 DR. TEKY
novia;3313125201940001; 5.6.7.202204241238 4 358752
1#0##0#0#0.0#2022-05-19
10:21:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
4644e1db585a7466dc8a35b99d7fe443 300000 0 0 0 0 0
0 121345 0 0 15000 0 212718 0 0 0 0
0
3372030 C 3 CP 2 08/03/2022 08/03/2022 25/04/1985 0 1
1 Z09.8;K74.6;M47.86 87.24 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 577099
0 1 0 0 0 NUR TAMRIN SULISTYO.TN 005480 36 13466
agung;3313092303950002; 5.6.5.202203091809 4 358753
7#0##0#0#0.0#2022-03-30
14:37:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
32bab3f67d29f54856e37ac80c290c80 150000 0 0 0 0 0
220000 133650 0 0 15000 0 58449 0 0 0 0
0
3372030 C 3 CP 2 08/03/2022 08/03/2022 01/01/2000 0 2
0 0 - 0 - 0 - 0 - 0 181400 221070
0 1 0 0 0 OKTARINA,(NY) 039266 22 8102 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358754
1#0##0#0#0.0#2022-04-11
11:45:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
8bc8df72a1ab002f7590fa0ea1286f53 150000 0 0 0 0 0
0 0 0 0 15000 0 56070 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 19/01/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 275371
0 1 0 0 0 HENNI SRIWULAN, NY 000445 49 17945
agung;3313092303950002; 5.6.5.202203091809 4 358757
9#0##0#0#0.0#2022-03-30
14:42:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5d6545d65bf3cc195c28a5320d59bbed 0 0 0 0 0 0 0
63690 0 0 15000 0 196681 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 13/07/1968 0 2
- 0 - 0 - 0 - 0 182600 215036 0
1 0 0 0 PURWANINGSIH.NY 102302 53 19596 DR. RINA
DIANA,SP.DV 1124R0020322V001138 0002581070376 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358758 10#0##0#0#0.0#2022-03-30
14:42:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
864bdf87deaa022dc84bfff5d8387121 150000 0 0 0 0 0
0 0 0 0 15000 0 50036 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 03/07/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 451206
0 1 0 0 0 IWAN SUGENG ARYANTO, TN 093096 50 18511
agung;3313092303950002; 5.6.5.202203091809 4 358759
11#0##0#0#0.0#2022-03-30
14:43:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3bf36666db47658152cdd2cae0f67e80 150000 0 0 0 0 0
0 76045 0 0 15000 0 210161 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 22/11/1975 0 2
1 Z09.8;E11.4;E78.5;I10;G59.0 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
384212 0 1 0 0 0 SRI SUMARNI, NY 082382 46
3;JKN agung;3313092303950002; 5.6.5.202203091809 4 358760
12#0##0#0#0.0#2022-03-30
14:44:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
37e124cdb08d4e5fcb0e67fc2a9b7b15 150000 0 0 0 0 0
0 76045 0 0 15000 0 143167 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 12/11/1945 0 2
0 - 0 107400 273000 0 1 0 0 0 ENDANG
SURTIANAH, NY 098168 76 27875 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V001141 0000063294052 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358698 13#0##0#0#0.0#2022-03-30
13:03:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ab9fe63a9627964acecf9d7cf6149ecb 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 21/11/1982 0 2
0 - 0 - 0 - 0 - 0 549400 385174
0 1 0 0 0 ELLY PAMUNGKAS., NY 000332 39 14352
agung;3313092303950002; 5.6.5.202203091809 4 358761
14#0##0#0#0.0#2022-03-30
14:45:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
48cc001889d4c8934ef562940d837421 350000 0 0 0 0 0
0 0 0 0 15000 0 20174 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 29/09/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARIA DIAH
1124R0020322V001143 0001211692601 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 358719 1#0##0#0#0.0#2022-05-19
08:57:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
d41a16a81f2e0aac2f1d6660c036e443 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 31/12/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 531000 0 1 0 0 0 SRI ISWATIYARSI,
0001694440719 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358699 16#0##0#0#0.0#2022-03-30
13:03:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a2f046cf7bfa83c4414c98dacd59d09a 516000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 18/01/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000090992327 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
358713 1#0##0#0#0.0#2022-04-11
11:44:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
fe6e925c9710155b71beb3711b1befc1 350000 0 0 0 0 0
0 0 0 0 15000 0 14091 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 25/03/1976 0 2
0 - 0 - 0 - 0 - 0 549400 215000
0 1 0 0 0 MARTINI, NY 101532 45 16784 DR. GUNAWAN,
SP.OG 1124R0020322V001146 0002585277696 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360638 1#0##0#0#0.0#2022-03-30
14:48:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e568cda8f4fae1740e3a4b815a414197 200000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 19/07/1984 0 2
0 0 - 0 - 0 - 0 - 0 181400
1738068 0 1 0 0 0 YULIA KURNIATI SARI ., NY 055861
0001178154843 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358762 18#0##0#0#0.0#2022-03-30
14:49:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
166ec05ddd11868906368efc75a113d4 150000 0 0 0 0 0
0 63690 0 0 15000 0 1509378 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 09/01/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 198535
0 1 0 0 0 ARI ANUGRAHENI.NY 100623 45 16494 DR.
agung;3313092303950002; 5.6.5.202203091809 4 358763
19#0##0#0#0.0#2022-03-30
14:49:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
03a67998971dacceb689a81b17e9664d 150000 0 0 0 0 0
0 0 0 0 15000 0 33535 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 19/07/1950 0 2
0 - 0 107400 262000 0 1 0 0 0 SITI
1124R0020322V001149 0001387776519 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358700 20#0##0#0#0.0#2022-03-30
13:04:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
11d509237d1911692143a3c004ec6aec 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 25/04/2000 0 2
1 Z09.8;A46 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 184173
0 1 0 0 0 LAURENSIA ANGGI.NN 102174 21 7987
agung;3313092303950002; 5.6.5.202203091809 4 358764
21#0##0#0#0.0#2022-03-30
14:50:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
76dfe8d246f29edc7c159e89a05297ab 150000 0 0 0 0 0
0 0 0 0 15000 0 19173 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 30/08/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 238667
0 1 0 0 0 AGUS PURWO NUGROHO.TN 077269 60 22105
agung;3313092303950002; 5.6.5.202203091809 4 358765
22#0##0#0#0.0#2022-03-30
14:51:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
0878850e6bce89d89a2f99d473612e8c 150000 0 0 0 0 0
0 31845 0 0 15000 0 41822 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 20/01/1963 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 RESPATI DWI
1124R0020322V001152 0001865287618 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358716 23#0##0#0#0.0#2022-03-30
13:21:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
63e409995ff2148f26a91b6eeaed08be 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 03/09/1946 0 1
0 0 - 0 - 0 - 0 - 0 181400 315623
0 1 0 0 0 SUDJIMAN,TN 092271 75 27580 DR. SUHARTO,
SP.PD 1124R0020322V001153 0000091143123 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358766 24#0##0#0#0.0#2022-03-30
14:51:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cd5f9b19d79e5dbed5c01da780f24476 150000 0 0 0 0 0
0 31845 0 0 15000 0 118778 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 30/03/1983 0 2
0 0 - 0 - 0 - 0 - 0 181400 312443
0 1 0 0 0 RETNANINGSIH.NY 096048 38 14223 DR.
agung;3313092303950002; 5.6.5.202203091809 4 358767
25#0##0#0#0.0#2022-03-30
14:51:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1472bc83e47beb9daaa6d27ccf7b2a74 150000 0 0 0 0 0
0 121345 0 0 15000 0 26098 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 20/11/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 280624
0 1 0 0 0 MUGIYONO, TN 101718 55 20197 DR.
agung;3313092303950002; 5.6.5.202203091809 4 358768
26#0##0#0#0.0#2022-03-30
14:52:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2779e245d09141e5f2b59543721e70dc 235000 0 0 0 0 0
0 0 0 0 15000 0 30624 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 16/05/1997 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MEI NUR SAPUTRI,
0002220808432 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358745 27#0##0#0#0.0#2022-03-30
13:51:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a523262e47c766c68fcf7ebf182dcad5 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 02/09/1980 0 2
0 0 - 0 - 0 - 0 - 0 181400 696593
0 1 0 0 0 FITRIYANA HANDAYANI.NY 003924 41 15162
agung;3313092303950002; 5.6.5.202203091809 4 358769
28#0##0#0#0.0#2022-03-30
14:52:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9d6b117e16feee2c17cd985015fb6960 0 0 0 0 0 0 0
121345 0 0 15000 0 560248 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 13/06/1992 0 2
0 0 - 0 - 0 - 0 - 0 181400 198575
agung;3313092303950002; 5.6.6.202203301209 4 358770
31#0##0#0#0.0#2022-03-31
08:36:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
128ba83cf0b33ed27af661a2249770a4 150000 0 0 0 0 0
0 0 0 0 15000 0 33575 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 11/05/1943 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MURYATI.NY 094215
0000091214796 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358715 29#0##0#0#0.0#2022-03-30
13:20:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a91157d7bdbc3f3200ab5ae82498ebf5 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 16/08/1947 0 2
1 Z09.8;E11.4;G59.0;I10 88.27 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 524943
0 1 0 0 0 ROCHYATI ., NY 000225 74 27233 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358771
33#0##0#0#0.0#2022-03-31
08:41:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e363f6e6d2cd1d6a8be83f43474112fc 150000 0 0 0 0 0
248000 31845 0 0 15000 0 80098 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 26/09/1950 0 1
1 Z09.8;L30.9;A46 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 227568
0 1 0 0 0 BAMBANG SETYASTO.,BP 059238 71 26096
agung;3313092303950002; 5.6.6.202203301209 4 358773
1#0##0#0#0.0#2022-03-31
08:43:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6913bca87f1291e4f2fac1f3bdc84307 150000 0 0 0 0 0
0 0 0 0 15000 0 62568 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 19/01/1967 0 2
1 L91.0 86.02 - - None None None None L-3-12-0 None None
None None None None PROSEDUR KECIL PADA KULIT 204700 0 0
- 0 - 0 - 0 - 0 204700 319695 0
1 0 0 0 ZAHRATUN, NY 102369 55 20137 DR. RINA
5.6.6.202203301209 4 358774 35#0##0#0#0.0#2022-03-31
08:43:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c0bab5977321365d2c1e62085336a6e5 150000 0 0 0 0 0
0 0 0 0 25000 0 144695 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 11/09/1954 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMARNO.TN 095054
0001425421326 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358703 30#0##0#0#0.0#2022-03-30
13:06:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3e83a648ef3b5396eedce4303bbddea6 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 16/10/1994 0 1
1 Z09.8;L91.0 86.02 - - None None None None L-3-12-0 None
None None None None None PROSEDUR KECIL PADA KULIT 204700 0
0 - 0 - 0 - 0 - 0 204700 555694
0 1 0 0 0 ADITYAS DWINA HASTANTYA,SDR 094566 27
agung;3313092303950002; 5.6.6.202203301209 4 358775
37#0##0#0#0.0#2022-03-31
08:44:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
767aa7c2533ff58b99969cfb9513246d 415000 0 0 0 0 0
0 0 0 0 15000 0 125694 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 19/05/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 224356
0 1 0 0 0 BAMBANG PURWOKO.TN 075794 60 22208
agung;3313092303950002; 5.6.6.202203301209 4 358776
38#0##0#0#0.0#2022-03-31
08:45:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5f44e072239d427827993087eb5af5ad 150000 0 0 0 0 0
0 0 0 0 15000 0 59356 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 12/11/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 256993
0 1 0 0 0 NGATIYEM,NY 049849 54 19840 DR. SUHARTO,
SP.PD 1124R0020322V001166 0000639735772 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 358777 39#0##0#0#0.0#2022-03-31
08:45:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
793f68a23239fedc551dab0fdd6db693 150000 0 0 0 0 0
0 31845 0 0 15000 0 60148 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 07/07/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ENI PUJI ASTUTI
0002477029059 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358702 31#0##0#0#0.0#2022-03-30
13:05:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7c2af274462374b77dc19c596ab90361 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 11/06/1973 0 1
0 - 0 - 0 - 0 - 0 204700 375000
0 1 0 0 0 SETYO LANGGENG, TN 090865 48 17802
agung;3313092303950002; 5.6.6.202203301209 4 358778
41#0##0#0#0.0#2022-03-31
08:46:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c36ff9d33bdd6b95cb8ce342868d4af3 360000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 04/06/1952 0 1
1 Z09.8;I11.9;E78.5 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 140018
0 1 0 0 0 SURATMAN 029384 69 25479 DR. SUHARTO,
SP.PD 1124R0020322V001169 0001614176932 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 358780 1#0##0#0#0.0#2022-05-18
11:14:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
910a7c79a6ef89d64ca2be2162eb1d63 0 0 0 0 0 0 0
0 0 0 15000 0 125018 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 05/10/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 276732
0 1 0 0 0 SRI HARNANI DWI HASTUTI.NY 098490 57
agung;3313092303950002; 5.6.6.202203301209 4 358781
43#0##0#0#0.0#2022-03-31
08:47:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b0e5839b55ccf0d1fa42381f820b769f 0 0 0 0 0 0 0
120745 0 0 15000 0 140987 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 04/08/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUNARTI.,NY 054610
0000091515857 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358722 32#0##0#0#0.0#2022-03-30
13:23:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
57f816740619df9fbaa6c229917b6a66 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 20/03/1961 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SLAMET RIYADI.TN
0001303435192 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358717 33#0##0#0#0.0#2022-03-30
13:21:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4bf29237e08ac4f96df92330cf5358a9 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 15/05/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 254000 0 1 0 0 0 YAHMINI ., NY
0001692527163 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358711 34#0##0#0#0.0#2022-03-30
13:18:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e8ad11cad1e3a101a7dc7fc96d771dd7 239000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 03/09/1977 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI WIDODO.TN
0001104478468 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358707 35#0##0#0#0.0#2022-03-30
13:37:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c391568657cf103b056551ac7a76bbec 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 06/03/1996 0 1
None None None None PERAWATAN LUKA 183900 0 0 - 0
- 0 - 0 - 0 183900 391451 0 1 0
0 0 AGNES CANDRA PENISIA, NY 085121 26 9498 DR. GUNAWAN,
SP.OG 1124R0020322V001176 0000640361171 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 358782 48#0##0#0#0.0#2022-03-31
08:53:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
de16610608678b6dbb09152f799030f0 275000 0 0 0 0 0
0 0 0 0 15000 0 101451 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 24/07/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 15000 0 1 0 0 0 SUTAMI.NY 099959
0000640553196 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358721 36#0##0#0#0.0#2022-03-30
13:23:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
06cf4e6042c059bad70238467bcf34d5 0 0 0 0 0 0 0
0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 02/03/1963 0 2
0 - 0 - 0 - 0 - 0 138400 834456
0 1 0 0 0 SUMARNI, NY 101618 59 21556 DR. LINDA
agung;3313092303950002; 5.6.5.202203091809 4 358690
37#0##0#0#0.0#2022-03-30
14:06:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
61512953dd7a86073c5cd9a2408145c5 528000 0 0 0 0 0
0 0 0 0 15000 0 291456 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 23/04/1960 0 2
0 - 0 107400 262000 0 1 0 0 0 SRI
1124R0020322V001179 0000091421842 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 358729 1#0##0#0#0.0#2022-05-19
10:51:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
ff47b7aed7c86d449c7adb70f60c07ff 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 18/04/1968 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 RAHMADI.TN 096843
0002169726311 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358710 39#0##0#0#0.0#2022-03-30
13:17:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cf351a3df55e399eb8f2512dcfd50469 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 07/10/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 112000 0 1 0 0 0 YATINI 094257
0001083705715 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358739 40#0##0#0#0.0#2022-03-30
13:41:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0dbf2eb92028b1c1adf146ebd995fefd 97000 0 0 0 0 0 0
0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 21/11/1939 0 1
1 Z09.8;J40;J30.3 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 262761
0 1 0 0 0 MOCHAMAD SALEH.TN 088898 82 30058 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358784
54#0##0#0#0.0#2022-03-31
08:54:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8183685b6567ab141a352e8166c36a26 150000 0 0 0 0 0
0 0 0 0 15000 0 97761 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 29/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 AGNES WIDHA
1124R0020322V001183 0002168632721 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358720 41#0##0#0#0.0#2022-03-30
13:22:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
324d5969369b33b9ef71b2f2a33d49a6 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 05/03/1985 0 2
1 Z09.4;S82.10 93.39 - - None None None None M-3-16-0
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 DIAN USWATUN
1124R0020322V001184 0000977864152 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358714 42#0##0#0#0.0#2022-03-30
13:20:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8aa01fa1907349d023262360f2fc84bf 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 28/08/1959 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ABDUL ROSYID.TN
0001282946062 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358725 43#0##0#0#0.0#2022-03-30
13:25:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
82b6c3bf6033cd7ec18eee3f62adfa6c 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 02/02/1963 0 2
0 - 0 107400 262000 0 1 0 0 0
SUJIYEM, NY 090600 59 21584 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V001186 0001696847466 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358737 44#0##0#0#0.0#2022-03-30
13:40:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
59e7e0d391902db9b9d9d906c6a0fe5c 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 27/01/1974 0 1
1 Z09.8;I10;M17.9;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 169180
0 1 0 0 0 KURDI.TN 020341 48 17572 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 358785
59#0##0#0#0.0#2022-03-31
08:54:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6c150b55cda24ccc547a6df4bac7d139 0 0 0 0 0 0 0
120795 0 0 15000 0 33385 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 08/08/1971 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 GIYANTI.NY 100284
0000639911507 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358691 45#0##0#0#0.0#2022-03-30
14:07:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0f238aa3f37e05185f09a617fcc67446 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 05/03/1979 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI WULAN.NY
0001286475028 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358697 1#0##0#0#0.0#2022-03-30
13:02:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
98ffa448d4b2249e385eca99fe857d1f 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 24/02/1973 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TRI BUDI SUWARTO.
0002169435251 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358742 47#0##0#0#0.0#2022-03-30
13:50:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
845b7e7318b72591908bdc445d8e7e4d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 04/11/1994 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 RAUHULLOH
AYATULLOH KHOMEINI.SDR 096022 27 9986 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V001192 0001796644269 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358709 48#0##0#0#0.0#2022-03-30
13:38:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
32cc9c5b134792240dec0f283ede5ce3 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 22/08/1947 0 2
0 - 0 107400 262000 0 1 0 0 0 DYAH
1124R0020322V001193 0000091082722 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 358736 1#0##0#0#0.0#2022-05-19
08:12:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
b3fd8ea0fa2ac2ef804687b47ae29ec1 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 05/06/1961 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARSIATUN, NY
0002311256204 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358723 50#0##0#0#0.0#2022-03-30
13:24:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
10fe3a9d57f784e91454ab043f44893d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 08/12/1992 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ARIS ABDULLAH, BP
0000091323292 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358735 1#0##0#0#0.0#2022-03-30
13:39:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
521beb5cbaabdc6e4160bbf77c5ce9fe 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 01/11/1961 0 2
0 - 0 107400 273000 0 1 0 0 0
1124R0020322V001197 0000090942546 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358726 52#0##0#0#0.0#2022-03-30
13:25:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6063d705db5114d3b00c5c21c5df7f9f 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 03/07/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 LUCIA SRI
1124R0020322V001198 0000639909854 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358704 53#0##0#0#0.0#2022-03-30
13:14:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bb8f4ee906306ce9d031086f6d3234c3 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 28/10/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TEMU MUJIYEM, NY
0000638873605 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358706 54#0##0#0#0.0#2022-03-30
13:16:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c2e2d5a9e4fbef1875e24e4d376a5e03 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 02/08/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ISWINDARI., NY
0001792902148 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358712 55#0##0#0#0.0#2022-03-30
13:18:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5e655537e8283e8ea87ecb256e6ab243 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 08/06/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 LAMIYEM.NY 087484
0001316300512 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358727 56#0##0#0#0.0#2022-03-30
13:25:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c53701d8fdd07743563da46a3c7213e6 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 21/08/1948 0 2
0 - 0 107400 273000 0 1 0 0 0
MUSNATIN., NY 071462 73 26862 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V001202 0000091314876 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358705 57#0##0#0#0.0#2022-03-30
13:15:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3926f1a35c74ee5466843021bed0e388 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 06/07/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMARNI.NY 086963
0002347072604 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358738 58#0##0#0#0.0#2022-03-30
13:41:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2e64406dfa5c40b6e926f962009fef00 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 25/02/1972 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 FRANS POKAREM.TN
0001032586479 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358701 59#0##0#0#0.0#2022-03-30
13:05:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e7f8bc5b3a9c5727c8c7cebc7f99b1a1 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 14/06/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI MURNIYANTI, NY
0001429190267 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358708 60#0##0#0#0.0#2022-03-30
13:17:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9024c0462d70d200984bf04a4b40afe9 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 03/06/1987 0 2
- 0 - 0 - 0 183900 717789 0 1 0
0 0 SHOPIAH.NY 099940 34 12697 DR. GUNAWAN, SP.OG
1124R0020322V001206 0001179069985 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 358786 76#0##0#0#0.0#2022-03-31
08:55:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
517281748ab165310ed39134f1530115 625000 0 0 0 0 0
0 0 0 0 15000 0 77789 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 05/09/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 402340
0 1 0 0 0 WULANDARI,(NY) 016562 50 18447 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358787
77#0##0#0#0.0#2022-03-31
08:56:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7af04487a16d137c1e236d8e1154b60b 150000 0 0 0 0 0
0 120795 0 0 15000 0 116545 0 0 0 0
0
3372030 C 3 CP 2 08/03/2022 08/03/2022 12/06/1972 0 1
0 - 0 - 0 - 0 786200 579744 0 1
agung;3313092303950002; 5.6.5.202203091809 4 358673
61#0##0#0#0.0#2022-03-30
13:52:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c8856c0451833099527935ffefa45751 463830 0 0 0 0 0
0 0 0 0 15000 0 100914 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 02/06/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 323032
0 1 0 0 0 SITI NURKHAYATI., NY 065344 59 21829
agung;3313092303950002; 5.6.6.202203301209 4 358789
1#0##0#0#0.0#2022-03-31
09:11:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
29c71e18af047b49d551b397ad89595e 150000 0 0 0 0 0
0 0 0 0 15000 0 158032 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 21/04/1950 0 1
1 Z09.8;E78.5;E79.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 177870
0 1 0 0 0 RINDUAN JANNUWAR, TN 052069 71 26254
agung;3313092303950002; 5.6.6.202203301209 4 358790
80#0##0#0#0.0#2022-03-31
09:12:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
551693c48428fd0abb274ad87c6941d8 150000 0 0 0 0 0
0 0 0 0 15000 0 12870 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 17/04/1961 0 2
0 - 0 - 0 - 0 786200 677676 0 1
agung;3313092303950002; 5.6.5.202203091809 4 358674
62#0##0#0#0.0#2022-03-30
13:53:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
df05d4568bd4b679263c8f2707dfd37b 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 01/04/1981 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V001212 0001904830593 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358675 63#0##0#0#0.0#2022-03-30
13:53:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ecad071d3504eaa0324fa0ac3556f1c7 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 12/08/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 279225
0 1 0 0 0 SUYAMI.NY 088115 71 26141 DR. SUHARTO,
SP.PD 1124R0020322V001213 0002898872076 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 358791 83#0##0#0#0.0#2022-03-31
09:13:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
645941e9f3420b2c9db0b750d40e1920 150000 0 0 0 0 0
0 0 0 0 15000 0 114225 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 13/10/1987 0 2
0 0 - 0 - 0 - 0 - 0 181400 709467
0 1 0 0 0 IRA PURWANTI, NY 101739 34 12565 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358792
84#0##0#0#0.0#2022-03-31
09:13:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1ed36cbe210dc74fe5da76a657e72b5f 600000 0 0 0 0 0
0 0 0 0 15000 0 94467 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 01/12/1958 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V001215 0001436949538 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358676 64#0##0#0#0.0#2022-03-30
13:54:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
520255aaa765ac5e9383151369f3a5af 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 15/07/1983 0 1
0 0 - 0 - 0 - 0 - 0 181400 210771
0 1 0 0 0 HARYO PONCO SILO AGENG PANJI, BP 093803
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358793
86#0##0#0#0.0#2022-03-31
09:14:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
85d94395c6b822548aaa0c71a720a74a 150000 0 0 0 0 0
0 31845 0 0 15000 0 13926 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 25/05/1972 0 1
0 - 0 - 0 - 0 786200 527395 0 1
SP.PD 1124R0020322V001217 0002431552465 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358677 65#0##0#0#0.0#2022-03-30
13:54:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
483f76f1e6a7605db3fbf6ee71156c12 463830 0 0 0 0 0
0 0 0 0 15000 0 48565 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 20/08/1959 0 1
0 - 0 - 0 - 0 786200 561264 0 1
SP.PD 1124R0020322V001218 0000571256594 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358678 66#0##0#0#0.0#2022-03-30
13:56:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9c4a581d49db188e4e71135d4c1357c5 463830 0 0 0 0 0
0 0 0 0 15000 0 82434 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 15/08/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 241791
0 1 0 0 0 SITI SULASTRI.,NY 073736 76 27964 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358794
89#0##0#0#0.0#2022-03-31
09:14:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f8482b3125ca3ef551540e0708fc550e 150000 0 0 0 0 0
0 0 0 0 15000 0 76791 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 26/04/1964 0 1
0 - 0 - 0 - 0 786200 876006 0 1
agung;3313092303950002; 5.6.5.202203091809 4 358679
67#0##0#0#0.0#2022-03-30
13:56:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
652290736c770ed86ccbf15284ce904c 662676 0 0 0 0 0
0 0 0 0 15000 0 198330 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 01/12/1980 0 2
0 - 0 - 0 - 0 786200 677676 0 1
SP.PD 1124R0020322V001221 0000640230884 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358680 68#0##0#0#0.0#2022-03-30
13:57:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
221b0c08e536d2a70a5a072b95af3b78 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 08/03/1967 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.5.202203091809 4 358681
69#0##0#0#0.0#2022-03-30
13:57:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
462710cbc23134266cec6fca81ee9f85 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 01/05/1975 0 1
0 - 0 - 0 - 0 786200 559251 0 1
SP.PD 1124R0020322V001224 0001790328262 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358682 70#0##0#0#0.0#2022-03-30
13:58:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c46f628d6f40cf94743dd551c968f20e 463830 0 0 0 0 0
0 0 0 0 15000 0 80421 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 09/12/1986 0 2
0 - 0 - 0 - 0 - 0 549400 215000
0 1 0 0 0 SITI FATIMAH DESHI ROES.NY 101095 35
12873 DR. GUNAWAN, SP.OG 1124R0020322V001225 0001447299595 3;JKN
agung;3313092303950002; 5.6.6.202203301209 4 360675
2#0##0#0#0.0#2022-03-31
09:15:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cfa1fb50424901d0e8658ad02b6863da 200000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 09/05/1949 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
459508 0 1 0 0 0 SUDARSONO, TN 066776 72
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358795
94#0##0#0#0.0#2022-03-31
09:16:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
685f01063e84beb8723f0333becee06e 150000 0 0 0 0 0
0 121345 0 0 15000 0 173163 0 0 0 0
0
3372030 C 3 CP 2 08/03/2022 08/03/2022 28/09/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 INDRO SUPRIYANTO.TN 082308 64 23537
agung;3313092303950002; 5.6.6.202203301209 4 360677
3#0##0#0#0.0#2022-03-31
09:21:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e5b7802c5b012b40eacaa7de4806267d 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 24/10/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 208428
0 1 0 0 0 SULASTRI.NY 096464 48 17667 DR. SUHARTO,
SP.PD 1124R0020322V001228 0001108064654 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 358797 95#0##0#0#0.0#2022-03-31
09:21:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7e1a127580803fec6d924a2628a2e373 150000 0 0 0 0 0
0 0 0 0 15000 0 43428 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 09/06/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 231330
0 1 0 0 0 MARJOKO.TN 096463 49 18169 DR. SUHARTO,
SP.PD 1124R0020322V001229 0001104313498 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 358798 96#0##0#0#0.0#2022-03-31
09:22:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
653ef694738378d9ace4fd9e8500d48d 150000 0 0 0 0 0
0 0 0 0 15000 0 66330 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 04/07/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 237272
0 1 0 0 0 SULIYEM, NY 052010 59 21797 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 358799
97#0##0#0#0.0#2022-03-31
09:22:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6ebc83b5018b44e6cd4f93f12bf31ec6 150000 0 0 0 0 0
0 0 0 0 15000 0 72272 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 05/10/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 WASIRAH.NY 088217 73 26817 DR. RINA
5.6.6.202203301209 4 358800 98#0##0#0#0.0#2022-03-31
09:23:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
739d4519956244515568547d705869a0 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 06/09/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 524153
0 1 0 0 0 HARYATNO.TN 101375 63 23194 DR. YUDHI
agung;3313092303950002; 5.6.6.202203301209 4 358801
99#0##0#0#0.0#2022-03-31
09:23:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e51f74e6842ed371b31f28808056de79 406000 0 0 0 0 0
0 0 0 0 15000 0 103153 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 19/09/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 238872
0 1 0 0 0 SRI SUDARSI.,NY 053164 69 25372 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358803
100#0##0#0#0.0#2022-03-31
09:24:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
068cb152f4bc3b9a513f0c639ba482e3 150000 0 0 0 0 0
0 0 0 0 15000 0 73872 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 25/06/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 237160
0 1 0 0 0 LUCIA ROSARI SRI ASTUTI., NY 071633 64
agung;3313092303950002; 5.6.6.202203301209 4 358804
101#0##0#0#0.0#2022-03-31
09:31:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ca2a4a4300b6691d1aa38b49c1ce6ece 150000 0 0 0 0 0
0 0 0 0 15000 0 72160 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 20/12/1991 0 2
0 - 0 - 0 - 0 - 0 296400 390641
0 1 0 0 0 NUR AISAH.NY 096035 30 11036 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358805
102#0##0#0#0.0#2022-03-31
09:32:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
33bf4e8b3b2c22dbea9883a662e9ac49 350000 0 0 0 0 0
0 0 0 0 15000 0 25641 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 12/12/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 204743
0 1 0 0 0 SITI CHOSIYAH., NY 045191 74 27115
agung;3313092303950002; 5.6.6.202203301209 4 358806
103#0##0#0#0.0#2022-03-31
09:32:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ad6081993504fc6ad1d11a6f12464a8b 150000 0 0 0 0 0
0 0 0 0 15000 0 39743 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 05/08/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 264776
0 1 0 0 0 SRI REJEKI.NY 097797 65 23956 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358807
104#0##0#0#0.0#2022-03-31
09:32:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f00bd2ec0e13cdbdd84842895d72189f 150000 0 0 0 0 0
0 0 0 0 15000 0 99776 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 10/11/1974 0 1
1 Z09.8;N18.9;K80.2 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 410515
0 1 0 0 0 ABU HAMID, (BP) 003341 47 17285 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358808
105#0##0#0#0.0#2022-03-31
09:33:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
687849fa9b3d6122cd4bb981c8d4d99a 150000 0 0 0 0 0
0 0 0 0 15000 0 245515 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 15/12/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 208362
agung;3313092303950002; 5.6.6.202203301209 4 358810
106#0##0#0#0.0#2022-03-31
09:33:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7bb6ca5d4cd0fa2b40059df124949dcd 150000 0 0 0 0 0
0 0 0 0 15000 0 43362 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 11/12/2015 0 1
0 0 - 0 - 0 - 0 - 0 181400 285117
0 1 0 0 0 MUHAMMAD FADLAN HAKIKI, AN 093192 6
0002344729476 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
358812 107#0##0#0#0.0#2022-03-31
09:34:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9328220ef57ad32a6a790cf2e4cedef8 150000 0 0 0 0 0
0 0 0 0 15000 0 120117 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 16/12/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 260832
agung;3313092303950002; 5.6.6.202203301209 4 358813
108#0##0#0#0.0#2022-03-31
09:34:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
05b878402325caa48f13a6a36d150d3b 150000 0 0 0 0 0
0 0 0 0 15000 0 95832 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 04/05/1954 0 1
1 Z09.8;I69.3;K03.6 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 419727
0 1 0 0 0 SUKONO ., BP 054796 67 24780 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358814
109#0##0#0#0.0#2022-03-31
09:34:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4f90a5520f0499abb16880d490ee6c97 150000 0 0 0 0 0
0 0 0 0 15000 0 254727 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 20/05/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 264737
0 1 0 0 0 SITI NGAISAH 074431 76 28051 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358815
110#0##0#0#0.0#2022-03-31
09:35:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
35ddb10f9347c541e59dd5b0686bf3a7 150000 0 0 0 0 0
0 0 0 0 15000 0 99737 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 04/02/1968 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 SRI PURWANTI.NY 088987 54 19756 DR. LINDA
agung;3313092303950002; 5.6.5.202203091809 4 358692
71#0##0#0#0.0#2022-03-30
14:08:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
80d258fe9898c7d4236fab18f8bfbb72 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 23/05/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 238106
0 1 0 0 0 SARJONO.TN 094849 50 18552 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358816
112#0##0#0#0.0#2022-03-31
09:35:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3e12b9e16084bde0955b6c7f496b9f04 150000 0 0 0 0 0
0 0 0 0 15000 0 73106 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 18/09/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 227574
0 1 0 0 0 INDRIYANI, NY 093214 64 23547 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358817
113#0##0#0#0.0#2022-03-31
09:36:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
29c7e03f9ef08492a756bbb1063d1307 150000 0 0 0 0 0
0 0 0 0 15000 0 62574 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 31/08/1998 0 2
0 0 - 0 - 0 - 0 - 0 181400 230857
0 1 0 0 0 RARAS DANASTRI 083059 23 8590 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358818
114#0##0#0#0.0#2022-03-31
09:36:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f2f8d9cf20d5d1b57f4ec2e830d989b5 150000 0 0 0 0 0
0 0 0 0 15000 0 65857 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 01/10/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 232947
0 1 0 0 0 SUDIYANA,TN 000468 58 21343 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358819
115#0##0#0#0.0#2022-03-31
09:37:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
53d7f273b7bc2e075045b654de3ce6f2 150000 0 0 0 0 0
0 0 0 0 15000 0 67947 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 19/02/1965 0 1
- 0 - 0 - 0 - 0 138400 339000 0
1 0 0 0 DANU MARGONO.,BP 056891 57 20836 DR. LINDA
yani;3302226402970001; 5.6.6.202203301209 4 358693
1#0##0#0#0.0#2022-04-07
14:16:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 4
8e085610cd50109e851decd5989a55de 324000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 12/11/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 471812
0 1 0 0 0 SUGIYOTO..BP 048116 67 24588 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358820
117#0##0#0#0.0#2022-03-31
09:37:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ed5cd4a2215e315ec2a9f27ae06aa59f 150000 0 0 0 0 0
0 0 0 0 15000 0 306812 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 12/04/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 712269
0 1 0 0 0 MARJIATI, NY 080213 44 16401 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358821
118#0##0#0#0.0#2022-03-31
09:38:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3dad82c27af7d3af00875c2c114165cb 660000 0 0 0 0 0
0 0 0 0 15000 0 37269 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 16/02/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 247522
0 1 0 0 0 DARYANTO, TN 048045 58 21205 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358822
119#0##0#0#0.0#2022-03-31
09:43:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
177b7ba8d8b3a53e331b7be9325ec139 150000 0 0 0 0 0
0 0 0 0 15000 0 82522 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 11/09/1947 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TUKIMAN.TN 098571
0000555611016 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358728 73#0##0#0#0.0#2022-03-30
13:26:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7bead41cf2b761018cece8ccae769942 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 01/01/2000 0 2
0 0 - 0 - 0 - 0 - 0 181400 227722
0 1 0 0 0 SUMARMI ., NY 053373 22 8102 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358823
121#0##0#0#0.0#2022-03-31
09:38:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7313f6076f6bcaea0ca34fb484c16c51 150000 0 0 0 0 0
0 0 0 0 15000 0 62722 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 19/04/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 241296
0 1 0 0 0 SRI SUSILOWATI., NY 045749 50 18586
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358824
122#0##0#0#0.0#2022-03-31
09:38:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
686c75d5f5dd81fc354b5b7d6ddd3399 150000 0 0 0 0 0
0 0 0 0 15000 0 76296 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 24/11/1940 0 2
0 0 - 0 - 0 - 0 - 0 181400 224642
0 1 0 0 0 SOESI PATONAH., NY 063627 81 29689
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358825
123#0##0#0#0.0#2022-03-31
09:49:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
df30076ad58e10ca8714490f6343e9a6 150000 0 0 0 0 0
0 0 0 0 15000 0 59642 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 05/06/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 195569
0 1 0 0 0 ASIYAH INTAN TRIANA.NY 098457 58 21461
novia;3313125201940001; 5.6.7.202204241238 4 358826
1#0##0#0#0.0#2022-05-19
14:02:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
14e40df69391b2bc5ec80ff95a6089ca 150000 0 0 0 0 0
0 0 0 0 15000 0 30569 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 27/04/1974 0 1
0 0 - 0 - 0 - 0 - 0 181400 257059
0 1 0 0 0 AHMAD SURAHMAN,(BP) 040030 47 17482
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358827
125#0##0#0#0.0#2022-03-31
09:50:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
44ce3f71ea90b6a556ecca1938f65fae 150000 0 0 0 0 0
0 0 0 0 15000 0 92059 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 03/03/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 219522
0 1 0 0 0 MUYAS SAROH, NY 064719 73 26668 DR.
novia;3313125201940001; 5.6.7.202204241238 4 358828
1#0##0#0#0.0#2022-05-19
09:09:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
3fbdb4dc88e57d4ecfae9de6d153f08c 150000 0 0 0 0 0
0 0 0 0 15000 0 54522 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 11/08/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 221498
0 1 0 0 0 AGUS WIRYADI 089419 61 22489 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358829
127#0##0#0#0.0#2022-03-31
09:51:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a35b35077849df03909d80eda274fc23 150000 0 0 0 0 0
0 0 0 0 15000 0 56498 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 16/10/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 305140
0 1 0 0 0 SRI YEKTI ISMADI,(NY) 040545 72 26441
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358830
128#0##0#0#0.0#2022-03-31
09:52:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e2be1a3f091bcf26004b8316538bca55 150000 0 0 0 0 0
0 0 0 0 15000 0 140140 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 08/10/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 254385
0 1 0 0 0 DWI DARMOYO, TN 100965 56 20605 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358831
129#0##0#0#0.0#2022-03-31
09:52:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
12f63d5953ac06624ec70731ae7926cb 150000 0 0 0 0 0
0 0 0 0 15000 0 89385 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 02/03/1941 0 2
1 Z09.8;S82.80 93.35;93.39 - - None None None None M-3-
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DIYAH 101274
0000091192274 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358740 74#0##0#0#0.0#2022-03-30
13:49:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4eaad8fbad8107ee5080103642556586 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 31/10/1955 0 1
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 DAL HARI PURNOMO.TN 078559 66 24235
agung;3313092303950002; 5.6.5.202203091809 4 358694
75#0##0#0#0.0#2022-03-30
14:10:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c325d280baf45b857a5a43c617d923f5 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 25/10/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 225881
0 1 0 0 0 SUWARNI.NY 087525 52 19127 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358832
132#0##0#0#0.0#2022-03-31
09:52:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1a8ee68b59b782fb9d397718ba974b63 150000 0 0 0 0 0
0 0 0 0 15000 0 60881 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 17/01/1977 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 INDAH PURNAMA
SARI, NY 096428 45 16486 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V001273 0000640491568 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358696 76#0##0#0#0.0#2022-03-30
14:11:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d8b8520243dd354686e2202cc0800e29 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 28/04/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 249090
0 1 0 0 0 KURDI., BP 052526 77 28438 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358833
134#0##0#0#0.0#2022-03-31
09:53:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
de280f23e7c34ae17fd6487d8719b1e2 150000 0 0 0 0 0
0 0 0 0 15000 0 84090 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 23/03/1948 0 2
1 Z09.8;E11.9;I11.9;M19.98 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
178774 0 1 0 0 0 SRI SUTANTI. NY 084749 73
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358834
135#0##0#0#0.0#2022-03-31
09:53:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
481bc3eec05c6ea8b8c529f3a7992cc4 0 0 0 0 0 0 0
130845 0 0 15000 0 32929 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 10/09/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 208890
0 1 0 0 0 SARINAH.NY 085018 62 22825 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358835
136#0##0#0#0.0#2022-03-31
09:54:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b511ad6589a50f110b676573197c630c 150000 0 0 0 0 0
0 0 0 0 15000 0 43890 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 01/08/1972 0 2
2 Z09.8;L80 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 JUCHROTUNISAK.NY 089166 49 18116 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358837
137#0##0#0#0.0#2022-03-31
09:55:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0a7bff9d8315815e29dc22146c4411c7 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 05/08/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 221331
0 1 0 0 0 WAGIMIN, BP 085630 64 23591 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358838
138#0##0#0#0.0#2022-03-31
09:55:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1d1c5248fb9d695f5aaf301c75e66e4d 150000 0 0 0 0 0
0 0 0 0 15000 0 56331 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 05/06/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 204127
agung;3313092303950002; 5.6.6.202203301209 4 358839
139#0##0#0#0.0#2022-03-31
09:55:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dad0a8d2d8c48ce6c3caea5df462c2ab 150000 0 0 0 0 0
0 0 0 0 15000 0 39127 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 15/09/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 214495
0 1 0 0 0 TRI ATMODJO, TN 094462 61 22454 DR.
novia;3313125201940001; 5.6.7.202204241238 4 358841
1#0##0#0#0.0#2022-05-19
13:20:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
b05152d0c4ab4f74bfb57bc0e93cfd77 150000 0 0 0 0 0
0 0 0 0 15000 0 49495 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 06/06/1950 0 2
1 Z09.8;M54.39;I69.3;M19.99 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
252545 0 1 0 0 0 SUTARMI (NY) 025332 71
0000091177738 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
358843 141#0##0#0#0.0#2022-03-31
09:57:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
334fdb2fc146add61d2035ced54c9a5d 150000 0 0 0 0 0
0 0 0 0 15000 0 87545 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 13/06/1983 0 2
0 0 - 0 - 0 - 0 - 0 181400 239180
0 1 0 0 0 RINA KUSTANTI 093486 38 14148 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358844
142#0##0#0#0.0#2022-03-31
09:57:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b19f92f05617c4e6245823b43b231b32 150000 0 0 0 0 0
0 0 0 0 15000 0 74180 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 05/08/2002 0 2
1 B09 - - - None None None None Q-5-42-0 None None
- 0 - 0 - 0 - 0 182600 200737 0
1 0 0 0 RIZKY AULIA AGUSTIN.NN 102303 19 7155 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358840
143#0##0#0#0.0#2022-03-31
09:56:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
311defc32d2ebdb063fcdf603522f910 150000 0 0 0 0 0
0 0 0 0 15000 0 35737 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 08/08/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 221887
0 1 0 0 0 SUMINI, NY 057720 67 24684 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358845
144#0##0#0#0.0#2022-03-31
09:57:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
227353c4b364b75c80bb59b0417e1238 150000 0 0 0 0 0
0 0 0 0 15000 0 56887 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 31/12/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 308000 0 1 0 0 0 NGATIYEM.NY 067636
0000640358291 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358744 77#0##0#0#0.0#2022-03-30
13:51:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f6a172d7f64009ef693782cfcda04c9c 293000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 17/04/1946 0 1
0 0 - 0 - 0 - 0 - 0 181400 246857
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358846
146#0##0#0#0.0#2022-03-31
09:58:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e590c2da90789c1b54eefff443b2264d 150000 0 0 0 0 0
0 0 0 0 15000 0 81857 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 09/11/1965 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMIYATI, NY
0000091584066 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
358743 1#0##0#0#0.0#2022-05-20
08:39:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
c1fcb48284226afb7d74899a7faab7d7 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 27/09/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 437492
0 1 0 0 0 SUKATI., NY 049501 67 24634 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358847
148#0##0#0#0.0#2022-03-31
09:58:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c70dcba8fad2078181f1961790c98f99 150000 0 0 0 0 0
0 0 0 0 15000 0 272492 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 14/04/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 285000 0 1 0 0 0 SRI MULYANI, NY
0000640565201 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358746 79#0##0#0#0.0#2022-03-30
13:52:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
517a591dc4cc460b655fa915c8ccfebe 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 24/12/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI SUTANTI, NY
0000639837347 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358741 80#0##0#0#0.0#2022-03-30
13:49:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c05f1b5ea6a30a9d961695638d79562b 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 31/12/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 254991
0 1 0 0 0 SRI REJEKI 092215 73 26730 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358848
151#0##0#0#0.0#2022-03-31
09:59:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5b8111025d4c7d2b47fe41bf2f5ee06f 150000 0 0 0 0 0
0 0 0 0 15000 0 89991 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 05/06/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 243837
0 1 0 0 0 YENI YUNI ASTUTI, NY 069907 56 20730
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358849
152#0##0#0#0.0#2022-03-31
09:59:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f5f8e86ec9d50a34ac7bb6873a02af4b 150000 0 0 0 0 0
0 0 0 0 15000 0 78837 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 15/08/1942 0 1
1 Z09.8;I11.9;N40 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 195459
0 1 0 0 0 LASITO., BP 041779 79 29060 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 358850
153#0##0#0#0.0#2022-03-31
10:00:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
552ff90bb9463ca46430d0c0876b1b42 150000 0 0 0 0 0
0 0 0 0 15000 0 30459 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 11/11/1946 0 2
0 0 - 0 - 0 - 0 - 0 181400 518076
0 1 0 0 0 THERESIA SUYATMI ,(NY) 041736 75 27511
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358851
154#0##0#0#0.0#2022-03-31
10:00:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
929274ef176635dbdce02ae2d4397044 150000 0 0 0 0 0
0 0 0 0 15000 0 353076 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 31/12/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 208626
0 1 0 0 0 MISNEM. NY 021157 65 23808 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358852
155#0##0#0#0.0#2022-03-31
10:08:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e83a44fb81c0efb40210cd9ab520fae9 150000 0 0 0 0 0
0 0 0 0 15000 0 43626 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 30/06/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 225291
0 1 0 0 0 ISTUTIK, NY 093527 63 23262 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358853
156#0##0#0#0.0#2022-03-31
10:01:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
678253a21d85696ebcec51affa537654 150000 0 0 0 0 0
0 0 0 0 15000 0 60291 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 16/02/1959 0 1
1 Z09.8;G20;G47.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 305624
0 1 0 0 0 MARZUQI.TN 095738 63 23031 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358854
157#0##0#0#0.0#2022-03-31
10:01:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f7d669ffabeb4b167f886bf9e0141446 150000 0 0 0 0 0
0 0 0 0 15000 0 140624 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 24/01/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 206237
0 1 0 0 0 PUJI AMBAR RUSTAMI, NY 085163 56 20497
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358855
158#0##0#0#0.0#2022-03-31
10:02:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8cb9261f2e3300ac629ccf1e3468e747 150000 0 0 0 0 0
0 0 0 0 15000 0 41237 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 29/12/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 685905
0 1 0 0 0 SUBAKDI,TN 075900 63 23080 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358856
159#0##0#0#0.0#2022-03-31
10:02:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7d8affa36e8dc9a048e985a5938dcdbe 150000 0 0 0 0 0
0 0 0 0 15000 0 520905 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 31/01/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 214500
0 1 0 0 0 HASTI MULATSIH,(NY) 021552 43 15742
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358857
160#0##0#0#0.0#2022-03-31
10:49:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f96f2a839a93b68d6b6ea153a230f76c 150000 0 0 0 0 0
0 0 0 0 15000 0 49500 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 24/08/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 211344
0 1 0 0 0 SLAMET.TN 083350 79 29051 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358858
161#0##0#0#0.0#2022-03-31
10:49:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
15f5610b438da9e2a7fdf693521329d9 150000 0 0 0 0 0
0 0 0 0 15000 0 46344 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 25/07/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 224070
0 1 0 0 0 SRI WIDODO, TN 101762 53 19584 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358859
162#0##0#0#0.0#2022-03-31
10:50:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
666c06e6e0dda29fddf57355912e5d91 150000 0 0 0 0 0
0 0 0 0 15000 0 59070 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 21/09/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 231248
agung;3313092303950002; 5.6.6.202203301209 4 358860
163#0##0#0#0.0#2022-03-31
10:50:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cb5eeb3b64389ce9ed3b12eabc5b55bf 150000 0 0 0 0 0
0 0 0 0 15000 0 66248 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 14/02/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 220655
0 1 0 0 0 SUPARTINAH, NY 048644 67 24494 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358861
164#0##0#0#0.0#2022-03-31
10:51:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
192a2bf6aae07b05a9f139c050282868 150000 0 0 0 0 0
0 0 0 0 15000 0 55655 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 04/09/1965 0 1
1 Z09.8;K40.9 93.57 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 282285 0 1
0 0 0 TARTO, TN 082903 56 20639 DR. ZULFADLY, SP.B
1124R0020322V001308 0000090944627 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 358863 165#0##0#0#0.0#2022-03-31
10:51:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
360ff53311629e62258f9ec9e7a2367f 235000 0 0 0 0 0
0 0 0 0 15000 0 32285 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 31/12/1928 0 2
1 Z09.8;C22.0 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 208926
0 1 0 0 0 WALIYEM., NY 048473 93 34035 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358864
166#0##0#0#0.0#2022-03-31
10:52:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
49940cef8cba6176418618684d00d778 150000 0 0 0 0 0
0 0 0 0 15000 0 43926 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 04/08/1954 0 2
1 Z09.8;G40.9;I69.3;M54.39 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
295796 0 1 0 0 0 SRI SUPARTI, NY 070614 67
0001967662721 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
358865 167#0##0#0#0.0#2022-03-31
10:52:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0649d14e8cb9161ae546967c7d1e7a3d 150000 0 0 0 0 0
0 0 0 0 15000 0 130796 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 27/04/2007 0 2
1 Z09.0;D18.0 93.57 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 277401 0 1
0 0 0 DEVI NUR SAFITRI, AN 101298 14 5429 DR. OEDJANG
SETIJAWAN, MSI.MED.,SP.B 1124R0020322V001312 0001183366618 3;JKN
agung;3313092303950002; 5.6.6.202203301209 4 358866
168#0##0#0#0.0#2022-03-31
10:53:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a61c43e0faed355b567d18b245c9ae1b 235000 0 0 0 0 0
0 0 0 0 15000 0 27401 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 23/05/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 114286
0 1 0 0 0 SUDARNI.NY 084470 62 22935 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358867
169#0##0#0#0.0#2022-03-31
10:53:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b3b1db50d795a93e3f5ecebfb9e5018f 0 0 0 0 0 0 0
0 0 0 15000 0 99286 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 04/09/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 199472
0 1 0 0 0 KOMARIYATUL KIPTIYAH., NY 042678 48
0001422112375 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
358868 170#0##0#0#0.0#2022-03-31
10:53:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
54ff3b5fa248146b029d80d455e36f0c 150000 0 0 0 0 0
0 0 0 0 15000 0 34472 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 31/12/1941 0 2
0 0 - 0 - 0 - 0 - 0 181400 247914
0 1 0 0 0 UMI ANDJARIYAH ,(NY) 040495 80 29287
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358869
171#0##0#0#0.0#2022-03-31
10:54:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
816cac2b1c0a213f428c178c0080e487 150000 0 0 0 0 0
0 0 0 0 15000 0 82914 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 07/07/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 259512
0 1 0 0 0 SRI WINARSIH ., NY 056271 55 20333
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358870
172#0##0#0#0.0#2022-03-31
10:54:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6e73751311f44dc8f9ac2f7bdb0344b8 150000 0 0 0 0 0
0 0 0 0 15000 0 94512 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 07/11/2001 0 2
0 0 - 0 - 0 - 0 - 0 181400 224978
0 1 0 0 0 CLAUDEA DIVA ISKANDAR, NN 030322 20
0001107836379 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
358871 173#0##0#0#0.0#2022-03-31
10:55:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c83b791e2462673dee94230662df285a 150000 0 0 0 0 0
0 0 0 0 15000 0 59978 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 29/03/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 290103
0 1 0 0 0 SIH MARTANTI.NY 096811 56 20798 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358872
174#0##0#0#0.0#2022-03-31
10:55:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
da54000f0c9a96b0af9990a44af98438 150000 0 0 0 0 0
0 0 0 0 15000 0 125103 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 11/07/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 390460
0 1 0 0 0 DARYATI, NY 089873 65 23981 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358873
175#0##0#0#0.0#2022-03-31
10:55:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
176e5c37cacdedc879b6783425c20675 300000 0 0 0 0 0
0 0 0 0 15000 0 75460 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 10/08/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 400455
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358874
176#0##0#0#0.0#2022-03-31
10:56:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2b7c46c0e5c34b656f3ae6e8c598191d 300000 0 0 0 0 0
0 0 0 0 15000 0 85455 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 20/12/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 288288
0 1 0 0 0 SUSIYATI.NY 100590 55 20167 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358875
177#0##0#0#0.0#2022-03-31
10:56:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 123288 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 13/03/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 15000
0 1 0 0 0 SUHARI, TN 070582 68 25197 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 358876
178#0##0#0#0.0#2022-03-31
10:57:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bee780d41b068e6c17875cc306880cc8 0 0 0 0 0 0 0
0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 30/01/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 244838
0 1 0 0 0 YANITA AMBARWATI RETNANINGTYAS, NY 089461
0001526003381 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
358877 179#0##0#0#0.0#2022-03-31
12:32:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
22bbfe5f54b87f643acbca98d0395ff7 150000 0 0 0 0 0
0 0 0 0 15000 0 79838 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 02/04/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 232645
0 1 0 0 0 NARMINI.,NY 073983 52 19333 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358878
180#0##0#0#0.0#2022-03-31
12:52:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d4d657c585a83e40dfcf0b041748ad12 150000 0 0 0 0 0
0 0 0 0 15000 0 67645 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 13/12/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 226754
0 1 0 0 0 LINAWATI LINUR INAYAH., NY 042854 56
0001426207241 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
358879 181#0##0#0#0.0#2022-03-31
13:49:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7dcd67c91a7b5522ada6f9a519ccc763 150000 0 0 0 0 0
0 0 0 0 15000 0 61754 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 05/07/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 194976
0 1 0 0 0 HIDAYATULLAH.TN 100744 72 26544 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358880
182#0##0#0#0.0#2022-03-31
13:50:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 29976 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 29/09/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 292919
0 1 0 0 0 SRI HANDAYANI.NY 099989 60 22075 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358881
183#0##0#0#0.0#2022-03-31
13:50:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2c9c85ee78a97d73d8fa483c69e7e27a 150000 0 0 0 0 0
0 0 0 0 15000 0 127919 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 24/04/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 239635
0 1 0 0 0 INDRIYATI 060952 62 22964 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358882
184#0##0#0#0.0#2022-03-31
13:51:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
28393f9fe85247cd6247924b4b8b23d1 150000 0 0 0 0 0
0 0 0 0 15000 0 74635 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 04/07/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 204419
0 1 0 0 0 SUKRAMTO.TN 101783 66 24354 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358883
185#0##0#0#0.0#2022-03-31
13:51:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/03/2022 08/03/2022 07/04/1960 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
250949 0 1 0 0 0 MARTHA LEOPENO. NY 005709
0001105905699 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
358884 186#0##0#0#0.0#2022-03-31
13:52:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ffe2caede4acd67f981b70c60532a2ce 150000 0 0 0 0 0
0 0 0 0 15000 0 85949 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 31/12/1969 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
313137 0 1 0 0 0 PAINEM NY 091225 52 19060
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358886
187#0##0#0#0.0#2022-03-31
14:51:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1fc75f0f40652cd48c8ae8c63fb91ef3 150000 0 0 0 0 0
0 0 0 0 15000 0 148137 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 25/08/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 535321
0 1 0 0 0 BAMBANG AGUS SURONO.TN 100627 66 24302
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358887
188#0##0#0#0.0#2022-03-31
13:52:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b38f78a3a09a7efc998c4bb67e010929 450000 0 0 0 0 0
0 0 0 0 15000 0 70321 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 18/02/1942 0 2
1 Z09.8;K30;K27.9 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 190263
0 1 0 0 0 DARTINAH,NY 030952 80 29238 DR. TEKY
novia;3313125201940001; 5.6.7.202204241238 4 358888
1#0##0#0#0.0#2022-05-18
11:19:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
6d26606b7c54305a6017647402c947f1 150000 0 0 0 0 0
0 0 0 0 15000 0 25263 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 17/08/1970 0 1
1 Z09.8;J44.9;J30.3;M54.39 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
241076 0 1 0 0 0 YOUNG HENDRIK., BP 046165
0000564962084 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
358889 190#0##0#0#0.0#2022-03-31
13:53:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
46ef646a4a01e0ab6f49d61df61d9a01 0 0 0 0 0 0 0
0 0 0 15000 0 226076 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 07/02/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 327476
0 1 0 0 0 BONAWAN.TN 089880 53 19387 DR. ANITA
agung;3313092303950002; 5.6.6.202203301209 4 358890
191#0##0#0#0.0#2022-03-31
13:53:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
09843f332dbf91f31764bd9d93480ec2 150000 0 0 0 0 0
0 0 0 0 15000 0 162476 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 19/08/1960 0 2
1 Z09.8;J45.9;J06.9;K21.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 293002
0 1 0 0 0 RR INA HERTATI AGUSTINA, NY 071244 61
0001298938511 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
358891 192#0##0#0#0.0#2022-03-31
13:54:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
63277e9727a5af7ee54294cdc71ea776 150000 0 0 0 0 0
0 0 0 0 15000 0 128002 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 03/08/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 461249
0 1 0 0 0 SUPARMI, NY 070450 61 22497 DR. ANITA
agung;3313092303950002; 5.6.6.202203301209 4 358893
193#0##0#0#0.0#2022-03-31
13:54:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3ab56cda545263ca537837582b049560 150000 0 0 0 0 0
0 0 0 0 15000 0 296249 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 29/10/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 411605
0 1 0 0 0 SANTOSO. TN 038094 56 20584 DR. ANITA
agung;3313092303950002; 5.6.6.202203301209 4 358894
194#0##0#0#0.0#2022-03-31
13:55:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 246605 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 23/04/1968 0 2
1 Z09.8;J44.9;J06.9;I10 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 15000
0 1 0 0 0 SURYATI, NY 037498 53 19677 DR. ANITA
agung;3313092303950002; 5.6.6.202203301209 4 358895
195#0##0#0#0.0#2022-03-31
13:55:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
179381bb7aa034264a34313f94d5e9d5 0 0 0 0 0 0 0
0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 02/10/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 258236
0 1 0 0 0 BUDI SULISTIYORINI., NY 060578 62 22803
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358896
196#0##0#0#0.0#2022-03-31
13:55:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5604da7dfd2bd9e6e07f99a3426c3da3 150000 0 0 0 0 0
0 0 0 0 15000 0 93236 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 05/12/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 201278
0 1 0 0 0 SATIYEM, NY 073918 63 23104 DR. ANITA
agung;3313092303950002; 5.6.6.202203301209 4 358897
197#0##0#0#0.0#2022-03-31
13:56:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
77688a16a48689f07930859cea195608 150000 0 0 0 0 0
0 0 0 0 15000 0 36278 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 12/04/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 240852
0 1 0 0 0 MARIYAM.NY 084306 64 23706 DR. ARIA
novia;3313125201940001; 5.6.7.202204241238 4 358898
1#0##0#0#0.0#2022-05-19
10:22:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
0b3cd6ba494fed938de8c61a47a10e31 150000 0 0 0 0 0
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3372030 C 3 CP 2 08/03/2022 08/03/2022 16/07/1997 0 2
1 Z09.8;J45.9;J06.9;J11.1 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 266929
0 1 0 0 0 KRISTANTI INDAH,.NY 055917 24 9001
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358899
199#0##0#0#0.0#2022-03-31
14:40:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c8e000c0d1167014e81bdc8e16825998 150000 0 0 0 0 0
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3372030 C 3 CP 2 08/03/2022 08/03/2022 10/07/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 265958
0 1 0 0 0 SRI MURNI.NY 096027 68 25078 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358900
200#0##0#0#0.0#2022-03-31
14:41:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/03/2022 08/03/2022 26/06/1954 0 1
1 Z09.8;J44.9;I50.0;K21.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 235181
0 1 0 0 0 YOHANES ISMU WIDJARTO.TN 085343 67
0001692529143 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
358901 201#0##0#0#0.0#2022-03-31
14:41:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9242e25bd970406dc8b09dfbb2f2e269 150000 0 0 0 0 0
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3372030 C 3 CP 2 08/03/2022 08/03/2022 03/01/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 427061
0 1 0 0 0 NURYADI HADI SUMARTO.TN 090476 70 25632
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358902
202#0##0#0#0.0#2022-03-31
14:41:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5281ea153ed95e9721b628607c253bdd 150000 0 0 0 0 0
0 0 0 0 15000 0 262061 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 16/08/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 237787
0 1 0 0 0 TRI WINARNI, NY 093256 52 19197 DR.
novia;3313125201940001; 5.6.7.202204241238 4 358903
1#0##0#0#0.0#2022-05-19
12:31:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
d7d8866e929886fd28bc807497d0f22f 150000 0 0 0 0 0
0 0 0 0 15000 0 72787 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 15/10/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 224010
0 1 0 0 0 TH. ENNY MOEWARNI BOEDI 092847 63 23155
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358904
204#0##0#0#0.0#2022-03-31
14:42:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5aa9984495d65c83118a4b4a154e10d3 150000 0 0 0 0 0
0 0 0 0 15000 0 59010 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 25/04/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 397671
0 1 0 0 0 SRI SURYATI 059369 63 23328 DR. ANITA
agung;3313092303950002; 5.6.6.202203301209 4 358905
205#0##0#0#0.0#2022-03-31
14:43:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
73a03b76a547a5f9b86a3c6e9e4dd156 150000 0 0 0 0 0
0 0 0 0 15000 0 232671 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 31/12/1935 0 2
1 Z09.8;B90.8;K21.9;I10 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 430124
0 1 0 0 0 PAIDJEM, NY 071271 86 31479 DR. ANITA
agung;3313092303950002; 5.6.6.202203301209 4 358906
206#0##0#0#0.0#2022-03-31
14:43:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4df1ee83d7cf00520725c6f1b929dca0 150000 0 0 0 0 0
0 0 0 0 15000 0 265124 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 17/04/1973 0 2
2 Z09.8;Q85.9;M19.98 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 236088
0 1 0 0 0 ERNA DWI HASTUTI,(NY) 004757 48 17857
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358907
207#0##0#0#0.0#2022-03-31
14:43:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
496373ce76e9ef44d376d2ab2ca3c45e 150000 0 0 0 0 0
0 0 0 0 15000 0 71088 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 16/05/1952 0 2
0 - 0 - 0 - 0 894800 234999 0 1
0 0 0 SETIATI.,NY 073095 69 25498 DR. ARIA CHANDRA GTS,
SP.S., M.KES 1124R0020322V001355 0002169437466 3;JKN
agung;3313092303950002; 5.6.6.202203301209 4 358908
208#0##0#0#0.0#2022-03-31
14:44:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1dcdfcd57ba8b055eca391368b15df08 150000 0 0 0 0 0
0 0 0 0 15000 0 69999 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 27/02/1965 0 1
1 Z09.8;J44.9;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 186217
0 1 0 0 0 HERI SUPRIYANTO.TN 092270 57 20828
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358909
209#0##0#0#0.0#2022-03-31
14:45:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f1017cd5851b949c18384ca966d087d2 150000 0 0 0 0 0
0 0 0 0 15000 0 21217 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 31/12/1956 0 2
1 Z09.8;B90.8;K21.9;I10 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 247149
0 1 0 0 0 SUPARNI, NY 089829 65 23808 DR. ANITA
agung;3313092303950002; 5.6.6.202203301209 4 358910
210#0##0#0#0.0#2022-03-31
14:59:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0a549a92299d00078e7c11911275c2f8 150000 0 0 0 0 0
0 0 0 0 15000 0 82149 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 31/12/1959 0 2
1 Z09.8;H10.4;H04.1 90.29;95.01 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 300198
0 1 0 0 0 VERONIKA SRI SUMARNI, NY 101834 62
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358911
211#0##0#0#0.0#2022-03-31
15:00:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9631fea1b0e7fa5c550458435c663feb 203000 0 0 0 0 0
0 0 0 0 15000 0 82198 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 29/12/1959 0 2
1 Z09.8;B90.8;K21.9;M19.99 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
217395 0 1 0 0 0 SUPARMI.NY 079485 62 22715
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358912
212#0##0#0#0.0#2022-03-31
15:00:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3a2b0e409460e1534004af7376f3ad64 150000 0 0 0 0 0
0 0 0 0 15000 0 52395 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 23/01/2013 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 ALEXZANDRIA HENDRIKA FATAHSANEE.AN 102165
0001854486426 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
358913 213#0##0#0#0.0#2022-03-31
15:01:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f6a466f92e34d1a417ae347bbde7f7aa 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 25/02/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 427242
0 1 0 0 0 ROSIDAH. NY 087797 70 25579 DR. ANITA
agung;3313092303950002; 5.6.6.202203301209 4 358914
214#0##0#0#0.0#2022-03-31
15:02:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b518ae154b5772218b64cdc43150bd1c 150000 0 0 0 0 0
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3372030 C 3 CP 2 08/03/2022 08/03/2022 20/02/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 490309
0 1 0 0 0 HARYANTO, TN 070918 55 20105 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358915
215#0##0#0#0.0#2022-03-31
15:02:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2c64a98becd6a2aaeb30ccba75b0f9ab 150000 0 0 0 0 0
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3372030 C 3 CP 2 08/03/2022 08/03/2022 02/12/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 687320
0 1 0 0 0 NURYADI,BP 074107 55 20185 DR. ANITA
agung;3313092303950002; 5.6.6.202203301209 4 358916
216#0##0#0#0.0#2022-03-31
15:03:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
de1e2a6afdc80a86c5be8c18f48895ee 150000 0 0 0 0 0
0 0 0 0 15000 0 522320 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 30/09/1977 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ERNA SETYOWATI, NY
0000207436206 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358695 81#0##0#0#0.0#2022-03-30
14:10:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dda05183199a1b40058344b4eb1eb814 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 07/04/1948 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.5.202203091809 4 358683
82#0##0#0#0.0#2022-03-30
13:59:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
54a6f699fe54f374fe8c6f0b73ac92c8 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 01/09/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V001368 0000639614597 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 358684 83#0##0#0#0.0#2022-03-30
13:59:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
08c52c7d4de374f304a9f6a3e9177385 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 23/12/1977 0 2
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.5.202203091809 4 358685
84#0##0#0#0.0#2022-03-30
14:04:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2fc1d24e62779aa87f23b50cb7836f39 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 25/03/1978 0 2
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.5.202203091809 4 358686
85#0##0#0#0.0#2022-03-30
14:04:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6937a3b3a66b2aad1db46da19eecb150 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 02/09/1976 0 1
0 - 0 - 0 - 0 786200 545765 0 1
agung;3313092303950002; 5.6.5.202203091809 4 358687
86#0##0#0#0.0#2022-03-30
14:05:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
62c73c0f7d593d53639698a12b8b2922 463830 0 0 0 0 0
0 0 0 0 15000 0 66935 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 15/05/1953 0 1
1 Z49.1;N18.5 93.35 - - None None None None M-3-16-0 None
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 518830 0 1 0 0 0 YOHANES HARNO D,BP
084296 68 25134 DR. TEKY WIDYARINI, SP.PD 1124R0020322V001372
0001966589561 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
358688 87#0##0#0#0.0#2022-03-30
14:05:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2ed15bec034a546090958641059d1cda 503830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 22/04/1960 0 2
1 Z09.8;E11.9;I10;M19.98 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 343805
0 1 0 0 0 GUNARSI 079686 61 22600 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 358918
224#0##0#0#0.0#2022-03-31
15:04:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fe5a2f733fb94c3b785ccdbe2863d458 150000 0 0 0 0 0
0 0 0 0 15000 0 178805 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 02/04/1985 0 1
0 0 - 0 - 0 - 0 - 0 181400 198836
0 1 0 0 0 TOTOK SUPRI NUROHADI, TN 016139 36
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 358919
225#0##0#0#0.0#2022-03-31
15:04:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d2e6d75121fea5589c18ddbf64fe7d40 150000 0 0 0 0 0
0 0 0 0 15000 0 33836 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 28/02/2008 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 BERLY GAVIN J, AN
0001106709579 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
358689 1#0##0#0#0.0#2022-05-20
10:23:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
7c21cbbe4138e4771937a4f97dfe5c1b 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 04/10/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 507554
0 1 0 0 0 AHMADI ., BP 000350 62 22801 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358920
227#0##0#0#0.0#2022-03-31
15:04:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a905fad07ccdf30e07ff1b393845e9ac 150000 0 0 0 0 0
0 31845 0 0 15000 0 310709 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 17/04/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 237680
0 1 0 0 0 SUYATNO, TN 092870 53 19683 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 358921
228#0##0#0#0.0#2022-03-31
15:05:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2d9266b6a5d84d0b970b591a6ce4703b 150000 0 0 0 0 0
0 0 0 0 15000 0 72680 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 02/03/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 289121
0 1 0 0 0 ZAIDUN ELLY,(NY) 012944 58 21190 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358922
229#0##0#0#0.0#2022-03-31
15:05:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2bc0f9479fb7d4d21d5cf70f84bcb5f3 203000 0 0 0 0 0
0 0 0 0 15000 0 71121 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 10/09/1953 0 2
1 E11.4;G59.0;I11.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 193139
0 1 0 0 0 HARSI MUDJI RAHAYU,NY 063780 68 25016
agung;3313092303950002; 5.6.6.202203301209 4 358923
230#0##0#0#0.0#2022-03-31
15:06:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4eca75278679f8ecf3efa9b1c79467f0 150000 0 0 0 0 0
0 0 0 0 15000 0 28139 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 25/04/1965 0 2
1 I69.3;I64 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 228778
0 1 0 0 0 MUGIYATI.NY 102301 56 20771 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358924
231#0##0#0#0.0#2022-03-31
15:06:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
60fdda1b52d2be3e202fbffe8ae9d5d4 150000 0 0 0 0 0
0 0 0 0 15000 0 63778 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 03/04/1971 0 1
0 - 0 - 0 - 0 - 0 181400 230907
0 1 0 0 0 TEGUH.TN 043393 50 18602 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358925
232#0##0#0#0.0#2022-03-31
15:07:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3d8a4ec9ca6308276d0a672bff531507 150000 0 0 0 0 0
0 0 0 0 15000 0 65907 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 06/01/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 192605
0 1 0 0 0 RINA EKOWATI, NY 095845 53 19419 DR.
agung;3313092303950002; 5.6.6.202203301209 4 358926
233#0##0#0#0.0#2022-03-31
15:07:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6271a772da12ac276fa32aad8d1c7bd2 150000 0 0 0 0 0
0 0 0 0 15000 0 27605 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 01/12/1944 0 2
0 0 - 0 - 0 - 0 - 0 181400 252560
0 1 0 0 0 WANTIYEM.NY 078888 77 28221 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 358927
234#0##0#0#0.0#2022-03-31
15:08:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
562b2f4801e806ae668c43066681909b 150000 0 0 0 0 0
0 0 0 0 15000 0 87560 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 01/02/1946 0 1
1 Z09.8;E11.4;G59.0;I10;J06.9 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
383065 0 1 0 0 0 RACHMAD, (BP) 003994 76
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 357904
1#0##0#0#0.0#2022-03-16
13:47:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b62591f21422264127fe94597a47d538 150000 0 0 0 0 0
0 31845 0 0 15000 0 186220 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 12/09/1942 0 2
1 Z09.8;H26.9;Z96.1 90.29 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 297998
0 1 0 0 0 SUNARYATI, NY 058012 79 29033 DR.
novia;3313125201940001; 5.6.7.202204241238 4 357905
1#0##0#0#0.0#2022-05-19
08:56:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
ba9644e67f2d133d24cf978f58e028a7 203000 0 0 0 0 0
0 0 0 0 15000 0 79998 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 14/02/1951 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
351992 0 1 0 0 0 WALINI., NY 047579 71 25956
novia;3313125201940001; 5.6.5.202203091809 4 357908
1#0##0#0#0.0#2022-03-16
13:50:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
01e3a81bd7fed03b2ae6922e46aa6c33 150000 0 0 0 0 0
0 76045 0 0 15000 0 110947 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 09/01/1970 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
378226 0 1 0 0 0 RAHAYUNING PRAPTI, NY 098701
0001127646821 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
357910 1#0##0#0#0.0#2022-03-16
14:05:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0bbfa7b98af803854d6a6862aac1e309 150000 0 0 0 0 0
0 76045 0 0 15000 0 137181 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 25/07/1989 0 2
0 0 - 0 - 0 - 0 - 0 296400 151905
reni;3313147010930001; 5.6.7.202204241238 4 357917
1#0##0#0#0.0#2022-06-13
09:04:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
370470aaf55cbb46ae78d21287ff2473 0 0 0 0 124000 0
0 0 0 0 15000 0 12905 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 17/11/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 280082
0 1 0 0 0 WIWIK WIDOWATI PONCORETNO S. NY 087095
0000085201165 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
357911 1#0##0#0#0.0#2022-03-16
14:08:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
86924a1abba2df15ae244f768f6d2612 150000 0 0 0 0 0
0 63690 0 0 15000 0 51392 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 04/06/1952 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SURATMAN 029384
0001614176932 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
358202 1#0##0#0#0.0#2022-05-18
11:14:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
e4177724db79f004b0048b8f307f443f 262000 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 03/03/1949 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 277000 0 1 0 0 0 MUYAS SAROH, NY
0000091167748 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357892 1#0##0#0#0.0#2022-05-19
09:09:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
116b977d17e07fc97f12d7fe51799526 262000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 24/04/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 560599
0 1 0 0 0 HABIB WINARTO, TN 097988 63 23330 DR.
novia;3313125201940001; 5.6.5.202203091809 4 357912
1#0##0#0#0.0#2022-03-16
14:11:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
09c125151ad5bf7b8f84ad1eeb4ca035 300000 0 0 0 0 0
0 76045 0 0 15000 0 169554 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 28/03/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 RINTO ANGGORO.TN 095388 43 16052 DR.
novia;3313125201940001; 5.6.5.202203091809 4 357913
1#0##0#0#0.0#2022-03-16
14:17:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
148383c29d75967a170fbcc2af58b805 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 10/08/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 197221
0 1 0 0 0 KASMINAH ., NY 000269 60 22126 DR.
novia;3313125201940001; 5.6.5.202203091809 4 357915
1#0##0#0#0.0#2022-03-16
14:18:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d47aa8892327886ea9528c25442b6dc4 150000 0 0 0 0 0
0 0 0 0 15000 0 32221 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 06/01/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 265343
0 1 0 0 0 SRI SUTARNINGSIH.NY 086730 69 25264
novia;3313125201940001; 5.6.5.202203091809 4 357918
1#0##0#0#0.0#2022-03-16
14:21:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bf64fdda476141b1f1188f40176caf82 150000 0 0 0 0 0
0 31845 0 0 15000 0 68498 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 13/04/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 404419
0 1 0 0 0 DIYONO.TN 089252 70 25898 DR. TEKY
novia;3313125201940001; 5.6.5.202203091809 4 357920
1#0##0#0#0.0#2022-03-16
14:21:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2c527e9a704025a738c18de85f5f58c7 300000 0 0 0 0 0
0 0 0 0 15000 0 89419 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 21/12/1962 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
600357 0 1 0 0 0 ENDANG PUJIASTUTI,(NY) 040727
0000640076769 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
357921 1#0##0#0#0.0#2022-03-16
14:23:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c946a4db6e0ef1a6734638b4b4178545 150000 0 0 0 0 0
0 76045 0 0 15000 0 359312 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 30/07/1963 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
324634 0 1 0 0 0 TUKINAH. NY 088785 58 21407
novia;3313125201940001; 5.6.5.202203091809 4 357923
1#0##0#0#0.0#2022-03-16
14:27:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3c5c8d12d981f34a100c33474d47f99c 150000 0 0 0 0 0
0 76045 0 0 15000 0 83589 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 05/04/1971 0 2
1 Z09.8;I10;N39.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 288037
0 1 0 0 0 SUCIATI,(NY) 011820 50 18601 DR.
novia;3313125201940001; 5.6.5.202203091809 4 357925
1#0##0#0#0.0#2022-03-16
14:28:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c154101f78fe5d7aa3bee6593fb9a4e5 150000 0 0 0 0 0
0 0 0 0 15000 0 123037 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 12/03/1959 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
280854 0 1 0 0 0 YOHANES JAMARI, TN 074904
0001423481837 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
357927 1#0##0#0#0.0#2022-03-16
14:29:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8a26ef8464aa69069f1528835c5b0d7d 150000 0 0 0 0 0
0 76595 0 0 15000 0 39259 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 01/03/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 354724
0 1 0 0 0 HERMAN HADI SRIYANTO.TN 088772 62 22653
novia;3313125201940001; 5.6.5.202203091809 4 357929
1#0##0#0#0.0#2022-03-16
14:29:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a7c3e0d9b8eb7d57d66f74217a0259b3 150000 0 0 0 0 0
0 134250 0 0 15000 0 55474 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 29/11/1943 0 2
0 0 - 0 - 0 - 0 - 0 181400 302181
0 1 0 0 0 SUNARNI (NY) 051905 78 28590 DR.
novia;3313125201940001; 5.6.5.202203091809 4 357931
1#0##0#0#0.0#2022-03-16
14:30:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
520c94f2564dfa907766bc21ff87d853 150000 0 0 0 0 0
0 0 0 0 15000 0 137181 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 23/04/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 228470
0 1 0 0 0 PAIYAH, NY 048246 68 25157 DR. TEKY
novia;3313125201940001; 5.6.5.202203091809 4 357933
1#0##0#0#0.0#2022-03-16
14:31:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b19d91b5dbce865e24fc90d817ed5a8d 150000 0 0 0 0 0
0 0 0 0 15000 0 63470 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 25/05/1949 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
304460 0 1 0 0 0 HENDRO PRABOWO,(BP) 040050
0001422080662 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
357939 1#0##0#0#0.0#2022-03-16
14:32:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
38728101fe048922acb4b7f0d5a73a0f 150000 0 0 0 0 0
0 108440 0 0 15000 0 31020 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 16/03/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 362732
0 1 0 0 0 ENDANG SRI HARTATI.NY 080361 69 25560
novia;3313125201940001; 5.6.5.202203091809 4 357940
1#0##0#0#0.0#2022-03-16
14:33:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c4377a9d464ff373124583e8f5bcc965 150000 0 0 0 0 0
0 76545 0 0 15000 0 121187 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 03/03/1960 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
540973 0 1 0 0 0 SRI MULYANI,(NY) 040379 62
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 357941
1#0##0#0#0.0#2022-03-16
14:35:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
33dc1b157324d1520b5ae4593c476c0d 150000 0 0 0 0 0
0 120795 0 0 15000 0 255178 0 0 0 0
0
3372030 C 3 CP 2 09/03/2022 09/03/2022 15/05/1961 0 2
1 Z09.8;K20 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 233729
0 1 0 0 0 TUKIRAH AL KAMISAH.NY 101756 60 22213
novia;3313125201940001; 5.6.5.202203091809 4 357942
1#0##0#0#0.0#2022-03-16
14:36:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
649ff08b157442fceddfbbf5b5d92bae 150000 0 0 0 0 0
0 0 0 0 15000 0 68729 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 18/08/1963 0 2
1 Z09.8;I11.9;M17.9;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 214611
0 1 0 0 0 IKE PRIWATI DANELLA.NY 098611 58 21388
novia;3313125201940001; 5.6.5.202203091809 4 357943
1#0##0#0#0.0#2022-03-16
14:37:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ee403e20ad397f6709f65746a7c4a165 150000 0 0 0 0 0
0 0 0 0 15000 0 49611 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 31/12/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400
1188855 0 1 0 0 0 MARIKEM .NY 038228 52 19061
novia;3313125201940001; 5.6.5.202203091809 4 357944
1#0##0#0#0.0#2022-03-16
14:37:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
47781519d8be5e0f26ae1cfed5d0b5f9 150000 0 0 0 0 0
0 31845 0 0 15000 0 992010 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 21/04/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 435732
0 1 0 0 0 SARTINI 092871 56 20776 DR. TEKY
novia;3313125201940001; 5.6.5.202203091809 4 357945
1#0##0#0#0.0#2022-03-16
14:38:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fc66aeeb843b9616d1bfce6e519c4684 150000 0 0 0 0 0
0 0 0 0 15000 0 270732 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 22/08/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 286921
0 1 0 0 0 DYAH NURJANTI,(NY) 042222 74 27228
novia;3313125201940001; 5.6.7.202204241238 4 357946
1#0##0#0#0.0#2022-05-19
08:12:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
31c8a9dafa456bc63bd0ee6b5ae05ded 203000 0 0 0 0 0
0 0 0 0 15000 0 68921 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 07/08/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 496383
0 1 0 0 0 GIYANI., NY 049228 73 26877 DR. TEKY
novia;3313125201940001; 5.6.5.202203091809 4 357947
1#0##0#0#0.0#2022-03-16
14:42:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9dc2c0af647d54187aed776ac752b1ba 300000 0 0 0 0 0
0 89500 0 0 15000 0 91883 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 11/04/1967 0 2
1 Z09.0;H11.0;E11.3;H36.0 97.89;90.29 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
944536 0 1 0 0 0 SUMIYATI, NY 051426 54
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 357948
1#0##0#0#0.0#2022-03-16
14:43:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5760485390243c8470e503aebbe87bb2 866000 0 0 0 0 0
0 0 0 0 15000 0 63536 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 04/02/1983 0 2
0 0 - 0 - 0 - 0 - 0 181400 295033
0 1 0 0 0 TRI WIYANTI . NY 063218 39 14278 DR.
novia;3313125201940001; 5.6.5.202203091809 4 357949
1#0##0#0#0.0#2022-03-16
14:44:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bfc2569916eeb667a8a27187a15a5e47 150000 0 0 0 0 0
0 76595 0 0 15000 0 53438 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 10/10/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 351165
novia;3313125201940001; 5.6.7.202204241238 4 357950
1#0##0#0#0.0#2022-05-19
08:34:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
09d260cc0adf73b3a2679bf2b458cc41 203000 0 0 0 0 0
0 0 0 0 15000 0 133165 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 21/04/1952 0 2
1 Z09.8;E11.4;G59.0;I11.9;H81.3 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
468111 0 1 0 0 0 SUTINI, NY 008773 69 25524
novia;3313125201940001; 5.6.5.202203091809 4 357952
1#0##0#0#0.0#2022-03-16
14:47:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
569acaac8f6a5962056689e91d6a7f5d 300000 0 0 0 0 0
0 76045 0 0 15000 0 77066 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 23/03/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 558155
0 1 0 0 0 DJARWOSRI PADMOSUWITO.TN 094793 71
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 357958
1#0##0#0#0.0#2022-03-16
14:48:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1fb02707e0cb9d1a935a0ddc57b7fecb 150000 0 0 0 0 0
0 62495 0 0 15000 0 330660 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 14/04/1993 0 2
0 0 - 0 - 0 - 0 - 0 296400 164335
0 1 0 0 0 LITA SUGIARTI, NY 100936 28 10556 DR.
novia;3313125201940001; 5.6.7.202204241238 4 357960
1#0##0#0#0.0#2022-05-20
09:15:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
6ebc6574c29e0d1ef03530de389d5994 0 0 0 0 124000 0
0 0 0 0 15000 0 25335 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 10/06/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 661926
0 1 0 0 0 SULIYEM.NY 100299 57 21091 DR. TEKY
novia;3313125201940001; 5.6.5.202203091809 4 357962
1#0##0#0#0.0#2022-03-16
14:54:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d74d597cf27a23d402cd0034641d4dcb 150000 0 0 0 0 0
0 31845 0 0 15000 0 465081 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 18/11/1962 0 2
1 Z09.8;I11.9;M54.59;G62.8 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
259590 0 1 0 0 0 SRIMPI ISWANTI,(NY) 014279
0000088602783 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
357964 1#0##0#0#0.0#2022-03-16
14:55:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8f5c9f39290ffdab0e3b88d4dae83333 150000 0 0 0 0 0
0 0 0 0 15000 0 94590 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 26/03/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 L M BASUKI, NY
0000641664819 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
358230 1#0##0#0#0.0#2022-03-16
14:56:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2db216b1dc5fce984cb6c887aa6e7fce 262000 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 10/04/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 208935
0 1 0 0 0 TRISNO SUJARWADI.TN 098559 49 18230
novia;3313125201940001; 5.6.5.202203091809 4 357966
1#0##0#0#0.0#2022-03-16
14:57:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0df3ec561248ef923628147c80ac739f 150000 0 0 0 0 0
0 0 0 0 15000 0 43935 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 12/01/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 EKO RINI.NY 093223
0000091524159 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
357864 1#0##0#0#0.0#2022-03-16
15:03:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
70d41763eed75bf2b8927c07c644b0c0 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 29/12/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 441838
0 1 0 0 0 SIDIK PRAMONO, BP 057770 62 22716 DR.
novia;3313125201940001; 5.6.5.202203091809 4 357968
1#0##0#0#0.0#2022-03-16
15:04:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0f93cef2380190298cfed03f562364cf 150000 0 0 0 0 0
0 31845 0 0 15000 0 244993 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 31/12/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 199458
0 1 0 0 0 SRI SUWANTI, NY 091754 63 23079 DR.
novia;3313125201940001; 5.6.5.202203091809 4 357970
1#0##0#0#0.0#2022-03-16
15:07:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
be5dd8e634e99027a6222442a8ea6f80 150000 0 0 0 0 0
0 0 0 0 15000 0 34458 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 14/04/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 286921
0 1 0 0 0 MARTINAH., NY 072061 61 22609 DR.
novia;3313125201940001; 5.6.5.202203091809 4 357972
1#0##0#0#0.0#2022-03-16
15:16:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d84bd86e78fa20c5fea1e031d452b96c 203000 0 0 0 0 0
0 0 0 0 15000 0 68921 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 13/06/1971 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SITI MARDLIYAH.NY
0002169781694 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
358242 1#0##0#0#0.0#2022-03-16
15:17:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
57cc1509b7f3fae99c6e86d8ac4c3103 262000 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 03/06/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 295946
0 1 0 0 0 RUBIJANTO, TN 099383 66 24386 DR.
novia;3313125201940001; 5.6.5.202203091809 4 358006
1#0##0#0#0.0#2022-03-16
15:18:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
94044a1ad3a610393ad89647ad2e5c1b 203000 0 0 0 0 0
0 0 0 0 15000 0 77946 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 16/08/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TRI WINARNI, NY
0000640206066 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
358245 1#0##0#0#0.0#2022-05-19
12:31:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
53db26d2c1206696e360c7d05bf22f4d 273000 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 26/09/1963 0 1
0 - 0 107400 273000 0 1 0 0 0
1124R0020322V001440 0001104121822 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 357868 1#0##0#0#0.0#2022-05-18
10:10:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
7442dc0b794d3ec5ce87c88c8f9bedc0 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 27/02/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SITI ZUHDIAH
0000091320906 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
357869 1#0##0#0#0.0#2022-03-16
15:23:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e594831f69c9192db872e11f1c812905 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 13/07/1968 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 EDY SANTOSO, TN
0002169773807 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
357894 1#0##0#0#0.0#2022-03-16
15:24:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7af2ac65a8286a7c0d4d6f4cfd8a1006 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 23/09/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ROCHYATI.NY 059452
0001813968753 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
357862 1#0##0#0#0.0#2022-03-16
15:25:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e91074585fa92d58938648266aca8f1c 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 01/05/1972 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MARIJAN.TN 101629
0002579827296 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357870 1#0##0#0#0.0#2022-05-20
09:34:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
39f9c90a00c6f36caba874dd4edcb0a6 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 24/02/1954 0 2
1 Z09.8;H02.4 93.35 - - None None None None M-3-16-0 None
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI PURWANI.NY
0001125886228 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
357871 1#0##0#0#0.0#2022-03-16
15:31:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0889544e42ce10ad0bc212bcf5cc7463 247000 0 0 0 0 0
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3372030 C 3 CP 2 09/03/2022 09/03/2022 17/01/1940 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SITI JAHIDJAH, NY
0000091261743 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357865 1#0##0#0#0.0#2022-05-20
09:30:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
932ff5e629381816224da22d30364c8d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 07/10/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 NUR LASMI, NY
0000639913318 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
357875 1#0##0#0#0.0#2022-03-16
15:34:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c3f597242996b63bf6d4277da1164bd4 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 19/07/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 487812
0 1 0 0 0 ESTI MURYANI,NY 101548 53 19591 DR.
novia;3313125201940001; 5.6.5.202203091809 4 358007
1#0##0#0#0.0#2022-03-16
15:34:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f2224802fea122f643057a6efc775b76 300000 0 0 0 0 0
0 107890 0 0 15000 0 64922 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 16/05/1956 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WIDI WINARSI.NY
0001849841414 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
357874 1#0##0#0#0.0#2022-03-16
15:35:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a04211557a99c20123b11447e720c1bc 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 10/11/1965 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DIDIK SUGIYARTA.TN
0002165956975 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
357863 1#0##0#0#0.0#2022-03-16
15:37:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5adbb14052fe2b842f8167d15b3533bd 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 11/07/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI PARYATI, NY
0000091170516 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
357872 1#0##0#0#0.0#2022-03-16
15:44:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8799734c911903593a4b748d4da6e1e0 247000 0 0 0 0 0
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3372030 C 3 CP 2 09/03/2022 09/03/2022 31/08/1962 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI HARTINA
1124R0020322V001454 0001958592576 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 357873 1#0##0#0#0.0#2022-03-16
15:46:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dea568d65dc4d47310443a74ac67aefe 247000 0 0 0 0 0
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3372030 C 3 CP 2 09/03/2022 09/03/2022 08/11/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001692526781 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
357866 1#0##0#0#0.0#2022-03-16
15:47:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
181d3f7e08594c0d53ed42fe2b8ddc44 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 15/09/1960 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TRI ATMODJO, TN
0001620260728 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
357890 1#0##0#0#0.0#2022-05-19
13:21:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
8432ffb80589efb468f2ff20b8927877 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 25/03/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUPINAH 091220
0000639810066 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
357867 1#0##0#0#0.0#2022-03-16
15:49:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4f00ab0c3e23b8951f9ccb892c17cb61 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 23/06/2016 0 2
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 KHANIFA MARYAM ZIVANA., AN 048753 5
0002068149756 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
358009 1#0##0#0#0.0#2022-03-16
15:50:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
824d6d1e695a102ea62f3cdbc6f29b69 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 11/07/2004 0 1
0 - 0 - 0 - 0 183900 787874 0 1
0 0 0 MAULANA IBNU FARID.SDR 102157 17 6450 DR. DAMAR
5.6.5.202203091809 4 358012 1#0##0#0#0.0#2022-03-16
15:51:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cc44369ab55a2f9a72099779f272b335 455000 0 0 0 0 0
0 0 0 0 15000 0 317874 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 11/07/1962 0 2
1 Z09.0;D24 96.59 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 315000 0 1
0 0 0 LASMINI,(NY) 036882 59 21791 DR. DAMAR ARYO,
SP.B 1124R0020322V001460 0000639000731 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 358020 1#0##0#0#0.0#2022-03-16
15:54:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1a6b2237e690d26cadf86eb16a3184f8 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 28/04/1986 0 2
- 0 - 0 - 0 183900 208050 0 1 0
1124R0020322V001461 0002933748516 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 358025 1#0##0#0#0.0#2022-03-16
15:54:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d48a7c623a7928fe2174286d5fa1d5a6 0 0 0 0 154000 0
0 0 0 0 15000 0 39050 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 05/01/1951 0 1
1 Z09.8;M54.59;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 273035
0 1 0 0 0 ACHMAD SUPARDI., TN 061983 71 25996
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 358027
1#0##0#0#0.0#2022-03-16
15:55:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ee16add64b50f28683f58dd0a08feb0f 150000 0 0 0 48000 0
0 0 0 0 15000 0 60035 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 02/09/1998 0 1
1 Z09.8;H81.3;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 246880
0 1 0 0 0 IVAN SEPTIANO INDRO WINARNO, SDR 057208
23 8589 DR. INDRIANY WIDHOWATY, SP.S, SP.AK 1124R0020322V001463
0000638961377 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
358029 1#0##0#0#0.0#2022-03-16
15:56:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ff96bf288648c588b37ac1e5cbe4ec31 150000 0 0 0 48000 0
0 0 0 0 15000 0 33880 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 21/02/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 741536
0 1 0 0 0 SRI HARYATI.NY 099070 62 22662 DR.
novia;3313125201940001; 5.6.5.202203091809 4 358031
1#0##0#0#0.0#2022-03-16
15:58:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ea4cca610003ee553db5082df28618eb 663000 0 0 0 0 0
0 0 0 0 15000 0 63536 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 27/02/1987 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RAHMAWATY,(NY) 035918 35 12794 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358033
1#0##0#0#0.0#2022-03-16
15:59:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a6fbe7e2038688d16c2a0022981132a2 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 01/01/1977 0 1
0 - 0 - 0 - 0 786200 537680 0 1
SP.PD 1124R0020322V001466 0001147281805 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 357882 1#0##0#0#0.0#2022-03-16
16:00:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0b2f93a342c3c344d6a6ebe3e3a1a0dd 463830 0 0 0 0 0
0 0 0 0 15000 0 58850 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 15/09/2002 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 NITA NOVITA, NN 101324 19 7115 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358035
1#0##0#0#0.0#2022-03-16
16:01:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
06162b70717e237a925eb79de57f6cf9 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 12/03/1955 0 2
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.5.202203091809 4 357881
1#0##0#0#0.0#2022-03-16
16:02:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9efb372bd4c9d85c84e0478d31392ca4 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 14/03/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.5.202203091809 4 357880
1#0##0#0#0.0#2022-03-16
16:04:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5ad19a082578c5a824c7d3527974e55c 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 29/05/1976 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ERNI DWI PANGESTUNINGSIH.NY 101352 45 16720
novia;3313125201940001; 5.6.5.202203091809 4 358036
1#0##0#0#0.0#2022-03-16
16:04:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
70569f894486465f98da4856de11f8a3 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 02/02/1972 0 2
0 - 0 - 0 - 0 786200 942660 0 1
SP.PD 1124R0020322V001471 0002070978546 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 357879 1#0##0#0#0.0#2022-03-16
16:05:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8718f21877a3df1068d2292cfd707611 927660 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 18/07/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V001472 0002425018184 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 357878 1#0##0#0#0.0#2022-03-16
16:06:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ae4d40a62b65ace2838e79ed8eb1b0f3 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 09/09/1944 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V001473 0000100867893 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 357877 1#0##0#0#0.0#2022-03-16
16:07:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6f7612cd34dd10221c8cd45868e4be41 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 16/09/1967 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 LASIYANTO, (BP) 008459 54 19898 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358037
1#0##0#0#0.0#2022-03-16
16:08:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b6a387b43b431be8b88335b079702a24 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 13/01/1998 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 GADANG JATI KUNCORO 101710 24 8821 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358039
1#0##0#0#0.0#2022-03-16
16:10:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ba74875a2a5f0a573c0b95a64a9bb38f 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 03/12/1950 0 1
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.5.202203091809 4 357876
1#0##0#0#0.0#2022-03-16
16:11:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d865069f43897e88a13504fd20452979 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 23/07/1972 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 TRI YULIARTI 001163 49 18126 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358042
1#0##0#0#0.0#2022-03-16
16:12:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
553bbb997838ef47d0e588736bae63fc 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 12/07/1966 0 1
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.5.202203091809 4 357889
1#0##0#0#0.0#2022-03-16
16:13:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
749544bc51648b4a8e8f2d6a3dfb8479 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 12/12/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.5.202203091809 4 357888
1#0##0#0#0.0#2022-03-16
16:14:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9a08788791bc1b3070750e54decd5a3d 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 22/10/1959 0 2
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.5.202203091809 4 357887
1#0##0#0#0.0#2022-03-16
16:15:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
64e657ffdc9b07e22086291b9dfa14c1 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 01/01/2000 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 YEYET MURNIATI,(NY) 014829 22 8103 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358044
1#0##0#0#0.0#2022-03-16
16:18:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2e3358c5d498d51b8eb3de92ad558f29 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 06/10/1993 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MUHAMMAD YUSUF GANARISLA.SDR 096449 28 10381
novia;3313125201940001; 5.6.5.202203091809 4 358045
1#0##0#0#0.0#2022-03-16
16:19:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f75943c33372dbfd464ac0aff1480311 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 12/08/1977 0 1
0 - 0 - 0 - 0 786200 535546 0 1
novia;3313125201940001; 5.6.5.202203091809 4 357886
1#0##0#0#0.0#2022-03-16
16:19:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6873dbf9ba929c16d85b02579bf5c3d2 463830 0 0 0 0 0
0 0 0 0 15000 0 56716 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 03/08/1963 0 2
0 - 0 - 0 - 0 786200 677676 0 1
novia;3313125201940001; 5.6.5.202203091809 4 357883
1#0##0#0#0.0#2022-03-16
16:20:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
66007d98c85aa9a228583c251bf40599 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 08/03/1993 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 DAMARIKA BUDI OETAMI 101734 29 10593 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358046
1#0##0#0#0.0#2022-03-16
16:21:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7b1b8c067efe1f89cd8c6e83eef356ac 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 12/10/1979 0 2
1 S09.9 24.11 - - None None None None U-3-13-0 None None
None None None None PROSEDUR DIAGNOSTIK LAIN-LAIN PADA TELINGA, HIDUNG,
MULUT DAN TENGGOROKAN 313000 0 0 - 0 - 0 - 0
- 0 313000 319440 0 1 0 0 0 WIWIK TRI
HANDAYANI, NY 071497 42 15489 DRG. VERAWATY, SP.KG
1124R0020322V001486 0000639423202 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361287 1#0##0#0#0.0#2022-04-05
12:24:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
31a69c463e86cce32f7427ed0b96023d 300000 0 0 0 0 0
0 0 0 0 15000 0 4440 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 29/09/1970 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MARIA DIAH ANGGARAWATI ., NY 059667 51 18789
novia;3313125201940001; 5.6.7.202204241238 4 358048
1#0##0#0#0.0#2022-05-19
08:58:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
56140b083fe5b6e191262d42bf48f698 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 30/03/1980 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 JEMY ROCHADITAMA TRISNANINGRUM.NY 100583 41
15319 DRG. VERAWATY, SP.KG 1124R0020322V001488 0001285856537 3;JKN
novia;3313125201940001; 5.6.5.202203091809 4 358050
1#0##0#0#0.0#2022-03-16
16:22:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d39c9b68ec7887d9c40e7979a3836fbf 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 16/06/1980 0 1
1 Z09.8;K80.2;E78.5 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 268120
0 1 0 0 0 YUSRON FAHRUDY ATRINO, TN 101658 41
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 358054
1#0##0#0#0.0#2022-03-16
16:23:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0f214d50ec473b8fe7623d42236dc072 150000 0 0 0 0 0
0 0 0 0 15000 0 103120 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 21/06/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 195377
0 1 0 0 0 JUNIAR SETIAWAN.TN 093456 43 15967
novia;3313125201940001; 5.6.5.202203091809 4 358056
1#0##0#0#0.0#2022-03-16
16:25:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1fd1bd749448c853e13bcfd90a429a8e 150000 0 0 0 0 0
0 0 0 0 15000 0 30377 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 30/05/2004 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MOCHAMMAD EKO PRASETYO.SDR 101810 17 6492
novia;3313125201940001; 5.6.5.202203091809 4 358059
1#0##0#0#0.0#2022-03-16
16:26:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
43918c775d9e2ac16e222b706955e7e1 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 18/04/1969 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MASHUDI,(BP) 010250 52 19318 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358060
1#0##0#0#0.0#2022-03-16
16:27:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3c67d59bae561150e3dece71fa44d105 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 15/02/1969 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ENDAH PUJIASIH, NY 002102 53 19380 DRG.
novia;3313125201940001; 5.6.7.202204241238 4 358061
1#0##0#0#0.0#2022-05-18
10:30:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
983b8577465452c6e56f756e398018d7 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 31/12/1965 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 KASERI, TN 025433 56 20522 DRG. VERAWATY,
SP.KG 1124R0020322V001495 0001103827476 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 358063 1#0##0#0#0.0#2022-03-16
16:28:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e10017cf49d0b688853fe5edc4195eb3 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 19/09/1983 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MURDI.TN 099347 38 14051 DRG. VERAWATY,
SP.KG 1124R0020322V001496 0001298346715 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 358065 1#0##0#0#0.0#2022-03-16
16:29:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
643e1635aa9212b6b9c2ee3da5d7d536 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 01/02/1973 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 PURJIYANTO, TN 019800 49 17933 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358068
1#0##0#0#0.0#2022-03-16
16:31:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
058b2230dfd32d28ce59ae83531d8a78 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 09/08/1995 0 2
- 0 - 0 - 0 - 0 549400 251139 0
1 0 0 0 WULAN SUCI AGUSTINA .NN 038599 26 9709 DR.
novia;3313125201940001; 5.6.5.202203091809 4 358070
1#0##0#0#0.0#2022-03-16
16:32:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dba5c072d0b91c2feb15eff9a6662bfe 0 0 185000 0 0 0
0 0 0 0 15000 0 51139 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 11/08/1958 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 IR ERNA UTARI.NY 101958 63 23221 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358072
1#0##0#0#0.0#2022-03-16
16:33:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
387e9b998bc62b7d0c2c6777299dc87b 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 03/01/1979 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MARJANAH, NY 101603 43 15771 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358075
1#0##0#0#0.0#2022-03-16
16:34:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f96e483a364c3041eea698b27271a35c 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 02/10/1969 0 1
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 EDY HARTANTO, TN 097993 52 19151 DRG. VERAWATY,
SP.KG 1124R0020322V001501 0001437925926 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 358076 1#0##0#0#0.0#2022-03-16
16:34:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c67a384a7562b4a3ed1dab8627eeb674 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 14/06/1993 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 ISNAINI FARIDA ., NY 054684 28 10495 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358077
1#0##0#0#0.0#2022-03-16
16:35:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dc9d4e9cccbf7d5515cfcf307ce5e8f7 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 23/12/1971 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 KRIS HARJANTI ., NY 055477 50 18339 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358078
1#0##0#0#0.0#2022-03-16
16:35:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c247bf2c264f394f9ee290f23d436a58 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 10/05/1960 0 2
1 Z09.8;H81.3;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 107501
0 1 0 0 0 SITI FATIMAH, NY 101791 61 22583 DR.
novia;3313125201940001; 5.6.5.202203091809 4 358080
1#0##0#0#0.0#2022-03-17
07:15:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b54d62cdf3798e20422e738c07891e0d 0 0 0 0 48000 0 0
0 0 0 15000 0 44501 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 22/08/1973 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SRI SUYATNI.NY 101501 48 17731 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358082
1#0##0#0#0.0#2022-03-17
07:16:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
53faef4f35853b85c12d88ba5328b98e 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 20/11/1986 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MUHAMMAD ARIFIN, TN 101519 35 12893 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358083
1#0##0#0#0.0#2022-03-17
07:19:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0bf5a30d4e3e673d89df5cfee9e6bfc5 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 23/03/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 AYUB BAINKABEL.TN 101787 71 26284 DR.
novia;3313125201940001; 5.6.5.202203091809 4 358084
1#0##0#0#0.0#2022-03-17
07:33:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
38356b9bb3ded0aef7554c37532910dc 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 10/10/1962 0 1
0 - 0 - 0 - 0 183900 136461 0 1
0 0 0 ISHAK HIDAYAT.TN 101798 59 21700 DR. DAMAR ARYO,
SP.B 1124R0020322V001509 0002981745235 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 358085 1#0##0#0#0.0#2022-03-17
07:34:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cc2a222428d0dee1f93c7c23afe7ef9f 85000 0 0 0 0 0 0
0 0 0 15000 0 36461 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 29/10/2001 0 1
1 Z09.8;R10.4 88.76 - - None None None None Z-3-23-0 None
0 - 0 - 0 - 0 - 0 549400 837150
0 1 0 0 0 ROLANDO SILALAHI, SDR 100540 20 7436
reni;3313147010930001; 5.6.6.202203301209 4 361461
1#0##0#0#0.0#2022-04-06
08:48:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aee6f7c169c19fb7e69204c70148b54f 150000 0 0 0 0 0
657000 0 0 0 15000 0 15150 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 29/06/1997 0 2
1 K80.2 88.76 - - None None None None Z-3-23-0 None None
- 0 - 0 - 0 - 0 549400 843230 0
1 0 0 0 RINA MAWAR WATI,NY 039296 24 9019 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361171
1#0##0#0#0.0#2022-04-05
10:01:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ad3905fa85c5cfbed6508f06844758d4 0 0 138000 0 0 0
657000 0 0 0 15000 0 33230 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 23/09/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 217174
0 1 0 0 0 DIAH NUR PAMILIYANTI.NY 084310 66 24274
novia;3313125201940001; 5.6.5.202203091809 4 358086
1#0##0#0#0.0#2022-03-17
07:36:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3565bedfa47dec23b5abf0032a8fa618 150000 0 0 0 0 0
0 0 0 0 15000 0 52174 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 19/05/2002 0 2
- 0 - 0 - 0 - 0 549400 244848 0
1 0 0 0 LISSET ANITA SEPTI.NY 102313 19 7234 DR.
novia;3313125201940001; 5.6.5.202203091809 4 358087
1#0##0#0#0.0#2022-03-17
07:41:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f3cc6605ba6301af4607095699886c7d 0 0 185000 0 0 0
0 0 0 0 25000 0 34848 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 27/08/1981 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 IKA PUJIASTUTI, NY 016888 40 14804 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358088
1#0##0#0#0.0#2022-03-17
07:42:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f9528e558ad877c50def6beb29c0aa22 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 15/02/1981 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ACHMAD CHUZAINURI.TN 102152 41 14997 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358089
1#0##0#0#0.0#2022-03-17
07:43:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
018c126f6c2acfcd9c73f73b672f6661 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 12/11/1993 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MUHAMMAD ABDUL KHAFID.TN 102151 28 10344
novia;3313125201940001; 5.6.5.202203091809 4 358090
1#0##0#0#0.0#2022-03-17
07:43:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0ca4308a69b082db71836db258db7ba6 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 06/05/2003 0 2
0 - 0 - 0 - 0 - 0 204700 432447
0 1 0 0 0 JEA AGRIZTA ELVARETTA.NN 096829 18
6882 DR. DAMAR ARYO, SP.B 1124R0020322V001520 0001691907928 3;JKN
novia;3313125201940001; 5.6.5.202203091809 4 358091
1#0##0#0#0.0#2022-03-17
07:44:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6b50246ea5f00bc4dd0a11d7928b378a 310000 0 0 0 0 0
0 0 0 0 15000 0 107447 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 15/02/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 181632
0 1 0 0 0 NGATIJO HADI WARSITO.TN 079349 67 24494
novia;3313125201940001; 5.6.5.202203091809 4 358092
1#0##0#0#0.0#2022-03-17
07:44:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
506c9aaefc7a8bfc9eef24bf3257243d 150000 0 0 0 0 0
0 0 0 0 15000 0 16632 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 18/06/2003 0 1
0 - 0 - 0 - 0 183900 264183 0 1
0 0 0 YOAN AUDREY HAVISA, SDR 102150 18 6839 DR. DAMAR
5.6.5.202203091809 4 358093 1#0##0#0#0.0#2022-03-17
07:45:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6d9a581178ff2c32f0e2108e7833a9f5 235000 0 0 0 0 0
0 0 0 0 15000 0 14183 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 25/01/2011 0 2
1 E07.8 87.49;88.71 - - None None None None Z-3-23-0 None
0 - 0 - 0 - 0 - 0 549400 1103796
0 1 0 0 0 JELINA SATITI .(AN) 026654 11 4061
0000203886898 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
361169 1#0##0#0#0.0#2022-05-18
10:56:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
ddc8a0df695c8459e46af9d7eac4996e 150000 0 0 0 0 0
880000 58796 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 24/04/1969 0 1
1 Z09.8;N20.0;N40 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 274859
0 1 0 0 0 SUMARNO,TN 002176 52 19312 DR. TEKY
novia;3313125201940001; 5.6.5.202203091809 4 358095
1#0##0#0#0.0#2022-03-17
07:46:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3534e7b8376e212c77702f09f6d5c861 150000 0 0 0 0 0
0 0 0 0 15000 0 109859 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 05/07/1957 0 1
1 Z09.8;R51;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 239329
0 1 0 0 0 HARI ISTANTO,(BP) 033848 64 23623 DR.
novia;3313125201940001; 5.6.5.202203091809 4 358097
1#0##0#0#0.0#2022-03-17
07:47:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f452ba4c1734abee40b1047d9c06e4d5 150000 0 0 0 48000 0
0 0 0 0 15000 0 26329 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 11/10/1980 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 KANTHI NUGROHO.TN 101351 41 15124 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358099
1#0##0#0#0.0#2022-03-17
07:48:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a9fba34a31dab325b7361e57546b6fbe 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 01/05/1984 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 SAWIJI WINANTI,(NY) 015392 37 13826 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358101
1#0##0#0#0.0#2022-03-17
07:48:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
268222abd5ead1da511c8bed735d5d86 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 16/11/1983 0 1
None None None None GIGI DAN PERMASALAHANNYA 206700 0 0
- 0 - 0 - 0 - 0 206700 165000 0
1 0 0 0 BUDI WASKITO,(BP) 016065 38 13993 DRG.
novia;3313125201940001; 5.6.5.202203091809 4 358103
1#0##0#0#0.0#2022-03-17
07:49:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1d05cc311eb3efcd80db38744ed0bb2b 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/03/2022 09/03/2022 29/05/1994 0 2
1 R10.4 - - - None None None None Q-5-25-0 None None
None None None None GASTROINTESTINAL AKUT 135700 0 0 -
0 - 0 - 0 - 0 135700 224071 0 1
0 0 0 BERTA DIAN CHRISTANTI,NY 087907 27 10146 DR.
EVA PRATAMA SUTRISNA 1124R0020322V001534 0002214467019 3;JKN
reni;3313147010930001; 5.6.6.202203301209 4 360993
1#0##0#0#0.0#2022-04-04
16:59:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7521e9e93c2c90ab18dda0cef32ada47 180000 0 0 0 0 0
0 0 0 0 15000 0 29071 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 22/10/1959 0 2
1 R50.9;N18.5 - - None None None None Q-5-42-0 None
0 - 0 - 0 - 0 - 0 182600 211486
0 1 0 0 0 Dra. TUTUT DARYANI.NY 087431 62 22785
DR. DANISWARA ADHITIA RAHMAN 1124R0020322V001538 0000086902986 3;JKN
novia;3313125201940001; 5.6.7.202204241238 4 360995
1#0##0#0#0.0#2022-05-20
11:10:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
f23f92bf3f0e1d8157041eb0e71da2eb 165000 0 0 0 0 0
0 0 0 0 15000 0 31486 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 14/09/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 180000
0 1 0 0 0 SUPRAPTO.TN 095047 55 20266 DR. WAHYU
novia;3313125201940001; 5.6.5.202203091809 4 358979
1#0##0#0#0.0#2022-03-28
15:41:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
25139f3dd2af00dc5cb958a1d634738b 165000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 16/07/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 365622
0 1 0 0 0 SUWIJI, NY 066854 66 24344 DR. SUHARTO,
SP.PD 1124R0020322V001542 0000046980292 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 358980 6#0##0#0#0.0#2022-03-28
15:57:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ba3bd88199d92f3af1f2fa2829d7ca75 150000 0 0 0 0 0
0 121345 0 0 15000 0 79277 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 31/12/1960 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
332882 0 1 0 0 0 KAMINO HADI., TN 059514 61
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 358981
1#0##0#0#0.0#2022-03-28
15:58:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2abdbcff73436408b2ce989d952fb92c 150000 0 0 0 0 0
0 63690 0 0 15000 0 104192 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 31/12/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 288270
0 1 0 0 0 YATMI ., NY 058574 56 20523 DR. TEKY
novia;3313125201940001; 5.6.5.202203091809 4 358982
8#0##0#0#0.0#2022-03-28
15:59:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bda4eae6eb579a402fceb0174a84aff6 150000 0 0 0 0 0
0 63690 0 0 15000 0 59580 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 02/12/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 211607
novia;3313125201940001; 5.6.5.202203091809 4 358983
1#0##0#0#0.0#2022-03-29
10:39:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e909272c73fbc52afc1f626b67828388 150000 0 0 0 0 0
0 0 0 0 15000 0 46607 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 15/01/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 216009
0 1 0 0 0 SITI RAHAYU, NY 084960 71 25987 DR.
novia;3313125201940001; 5.6.5.202203091809 4 358984
10#0##0#0#0.0#2022-03-29
10:42:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5cbd1031c482aa86112bc2c0553dcb56 150000 0 0 0 0 0
0 0 0 0 15000 0 51009 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 01/05/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 466709
0 1 0 0 0 JOKO HARMIANTO.TN 088393 54 20037 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359208
11#0##0#0#0.0#2022-03-29
10:42:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7a983e96bd57aafc3bae274082fb2dd2 150000 0 0 0 0 0
0 31845 0 0 15000 0 269864 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 15/12/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 308839
0 1 0 0 0 PRIHATIN, NY 026624 68 24922 DR.
novia;3313125201940001; 5.6.5.202203091809 4 358985
1#0##0#0#0.0#2022-03-29
10:43:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
78432e9f9304b2d8a80fb005ab4efd7f 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 30/12/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 224743
0 1 0 0 0 NURYATI.NY 084776 71 26003 DR. WAHYU
novia;3313125201940001; 5.6.5.202203091809 4 358986
13#0##0#0#0.0#2022-03-29
10:44:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9ce218be518df753fdf2ae8bbbb9d30e 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 10/12/1944 0 1
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novia;3313125201940001; 5.6.5.202203091809 4 358987
1#0##0#0#0.0#2022-03-29
10:45:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 03/07/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 197991
0 1 0 0 0 SRI LESTARI ., NY 058610 60 22165 DR.
novia;3313125201940001; 5.6.5.202203091809 4 358988
1#0##0#0#0.0#2022-03-29
10:46:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 17/02/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 317466
0 1 0 0 0 RADIAN MIYADI,.TN 045602 73 26684 DR.
novia;3313125201940001; 5.6.5.202203091809 4 358989
1#0##0#0#0.0#2022-03-29
10:47:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
41493e83f6398fac46cdd651350bf01c 0 0 138000 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 18/11/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 207760
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novia;3313125201940001; 5.6.5.202203091809 4 358990
1#0##0#0#0.0#2022-03-29
10:50:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5dfb5434f6407d0bfb3021d14f6df07b 0 0 138000 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 11/11/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 192523
0 1 0 0 0 SUMARDI.TN 101737 69 25321 DR. WAHYU
novia;3313125201940001; 5.6.5.202203091809 4 358991
1#0##0#0#0.0#2022-03-29
10:51:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1b2642036edf4aefbc68af00ce33b238 0 0 138000 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 21/04/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 219582
0 1 0 0 0 MUH SAFEI, TN 054162 43 16029 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359219
1#0##0#0#0.0#2022-03-29
10:51:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9208e3377f0ca84330ed5cfa3bf9029e 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 23/04/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 222289
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5.6.5.202203091809 4 359221 20#0##0#0#0.0#2022-03-29
10:52:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d22a58aebaa5ad3c4b88d837583d116a 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 10/07/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 353819
0 1 0 0 0 PIPIEK KHOIRIAH., NY 043694 64 23619
novia;3313125201940001; 5.6.5.202203091809 4 359223
21#0##0#0#0.0#2022-03-29
11:09:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 18/12/1957 0 1
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novia;3313125201940001; 5.6.5.202203091809 4 359224
22#0##0#0#0.0#2022-03-29
11:11:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 13/08/1957 0 1
1 Z09.8;I11.9;E11.9;M25.58 - - - None None None None
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novia;3313125201940001; 5.6.5.202203091809 4 359225
1#0##0#0#0.0#2022-03-29
11:13:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 26/02/1948 0 1
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novia;3313125201940001; 5.6.5.202203091809 4 359226
1#0##0#0#0.0#2022-03-29
11:29:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 11/11/1946 0 2
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novia;3313125201940001; 5.6.5.202203091809 4 359227
1#0##0#0#0.0#2022-03-29
11:29:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 31/12/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 438411
0 1 0 0 0 WARSINAH., NY 049905 61 22349 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359231
26#0##0#0#0.0#2022-03-29
11:40:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 28/04/1944 0 1
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novia;3313125201940001; 5.6.5.202203091809 4 359233
27#0##0#0#0.0#2022-03-29
11:40:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 23/07/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 197991
0 1 0 0 0 ERNIE HADIANTI, NY 097917 64 23606
novia;3313125201940001; 5.6.5.202203091809 4 359235
1#0##0#0#0.0#2022-03-29
11:41:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
482b938f18ced584cbf106e6d89929c8 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 20/07/1957 0 2
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0 1 0 0 0 ENDANG NURHADININGSIH., NY 047800 64
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359236
1#0##0#0#0.0#2022-03-29
11:45:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
672ebf346b810d9af1307649d5055224 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 21/12/1949 0 2
1 Z09.8;L30.9;L28.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 199016
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novia;3313125201940001; 5.6.5.202203091809 4 359238
1#0##0#0#0.0#2022-03-29
11:47:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d9ca6c897694ccdb596e37270deb643a 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 31/12/1965 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
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novia;3313125201940001; 5.6.5.202203091809 4 359241
1#0##0#0#0.0#2022-03-29
11:53:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 30/05/1959 0 2
1 Z09.8;K80.2;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 361724
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5.6.5.202203091809 4 359243 32#0##0#0#0.0#2022-03-29
11:54:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 23/08/1978 0 2
0 404900 303508 0 1 0 0 0 IKE PUSPITARINI.NY
0002451096887 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
359246 33#0##0#0#0.0#2022-03-29
11:55:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dd2045c2640173fee7d47d6fd56a1a9f 0 0 138000 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 04/03/1957 0 1
0 - 0 - 0 - 0 - 0 181400 213534
0 1 0 0 0 SUTENG SUPRIYANTORO.TN 102316 65 23747
novia;3313125201940001; 5.6.5.202203091809 4 359247
34#0##0#0#0.0#2022-03-29
11:55:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a29d3238f1cdba9f2168ca8ecce6e646 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 07/07/1957 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
383075 0 1 0 0 0 ENI PUJI ASTUTI 093122 64
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359248
35#0##0#0#0.0#2022-03-29
11:56:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1e68ea2f0a88761338b96aa32d6bf8d0 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 16/06/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 216777
0 1 0 0 0 WALUYO SLAMET.TN 080416 67 24739 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359251
36#0##0#0#0.0#2022-03-29
12:05:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0d1e55204fbb7080ad56a3d9d460c549 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 02/06/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 200706
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novia;3313125201940001; 5.6.5.202203091809 4 359253
37#0##0#0#0.0#2022-03-29
12:06:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8f27eb9f93440da0157736b984f3fc19 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 25/12/1970 0 2
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0 1 0 0 0 NATALIANA HENI KUSTIWI.NY 101484 51
0002579778606 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
359254 38#0##0#0#0.0#2022-03-29
12:06:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
62cad5cd0774f36b54dd3d89945faf66 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 23/01/1981 0 1
0 0 - 0 - 0 - 0 - 0 181400
1300556 0 1 0 0 0 HARTANTO FREDY KURNIAWAN,(BP) 039571
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359255 39#0##0#0#0.0#2022-03-29
12:07:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 18/01/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 193776
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novia;3313125201940001; 5.6.5.202203091809 4 359256
40#0##0#0#0.0#2022-03-29
12:41:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 28/08/1959 0 1
0 404900 208599 0 1 0 0 0 ABDUL ROSYID.TN
0001282946062 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
359257 41#0##0#0#0.0#2022-03-29
12:42:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 19/02/1954 0 1
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5.6.5.202203091809 4 359258 42#0##0#0#0.0#2022-03-29
12:44:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1db9097d34bd7edd0343f90f12780a42 0 0 138000 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 15/02/1969 0 2
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novia;3313125201940001; 5.6.7.202204241238 4 359259
1#0##0#0#0.0#2022-05-18
10:31:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 10/03/2022 10/03/2022 07/02/1972 0 2
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359260 44#0##0#0#0.0#2022-03-29
12:53:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 26/09/1963 0 1
1 Z09.8;E11.4;G59.0;N40 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 282286
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novia;3313125201940001; 5.6.7.202204241238 4 359261
1#0##0#0#0.0#2022-05-18
10:10:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 10/03/2022 10/03/2022 17/03/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 221793
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novia;3313125201940001; 5.6.5.202203091809 4 359262
46#0##0#0#0.0#2022-03-29
12:55:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dec058a7b1a30079558ff65d94d503ef 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 04/08/1955 0 2
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novia;3313125201940001; 5.6.5.202203091809 4 359263
47#0##0#0#0.0#2022-03-29
12:55:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2d68eae3b1166734cab672cd716ace44 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 28/09/1973 0 2
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5.6.5.202203091809 4 359264 48#0##0#0#0.0#2022-03-29
12:56:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 05/03/1944 0 1
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0 1 0 0 0 SANTOSO. TN 088783 78 28494 DR. WAHYU
novia;3313125201940001; 5.6.5.202203091809 4 359265
49#0##0#0#0.0#2022-03-29
12:57:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 03/07/1963 0 2
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novia;3313125201940001; 5.6.5.202203091809 4 359266
50#0##0#0#0.0#2022-03-29
12:58:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 21/05/1959 0 1
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novia;3313125201940001; 5.6.5.202203091809 4 359267
51#0##0#0#0.0#2022-03-29
12:59:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 31/05/1972 0 2
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novia;3313125201940001; 5.6.5.202203091809 4 359268
52#0##0#0#0.0#2022-03-29
12:59:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f73a7d8a8a8081de507d337051a02b5f 150000 0 0 0 0 0
0 0 0 0 15000 0 39930 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 03/08/1963 0 2
0 - 0 107400 262000 0 1 0 0 0
TENTREM.NY 089445 58 21404 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V001589 0000640219601 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 358959 1#0##0#0#0.0#2022-03-29
13:03:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
39207361ecb815b4669e7815a41c42dd 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 25/04/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400
1082739 0 1 0 0 0 SUNARTO (Bp) 019174 67
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359269
54#0##0#0#0.0#2022-03-29
13:04:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cde59351ca2e2be0cdb9a754ca2615af 150000 0 0 0 0 0
0 0 0 0 15000 0 917739 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 01/06/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 548243
0 1 0 0 0 JONI MARGONO., TN 036787 49 18179 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359270
55#0##0#0#0.0#2022-03-29
13:06:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c7c3a12dc0c8de3989acb7e48f30931a 150000 0 0 0 0 0
0 76045 0 0 15000 0 307198 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 30/09/2017 0 1
2 Z09.8;Q66.0 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 MUHAMMAD RIZKY PRATAMA 093525 4 1622
novia;3313125201940001; 5.6.5.202203091809 4 359271
56#0##0#0#0.0#2022-03-29
13:07:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
018fb92ebd6b53677c62b818d3391471 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 31/12/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 15000
0 1 0 0 0 SUDARMI.NY 101340 63 23080 DR. WAHYU
novia;3313125201940001; 5.6.5.202203091809 4 359272
57#0##0#0#0.0#2022-03-29
13:08:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8f16ac802fa4c91092ad6b96ff947eb7 0 0 0 0 0 0 0
0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 29/12/1963 0 2
1 Z09.8;E11.4;G59.0;I10;E78.5;M19.98 - - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 921812 0 1 0 0 0 SAMINI.NY 083352
0001848121953 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
359273 58#0##0#0#0.0#2022-03-29
13:09:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3be3defdc6465739a865fa83ea5111a0 0 0 138000 0 0 0
0 76045 0 0 15000 0 692767 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 15/03/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 794748
0 1 0 0 0 SUSANTO (BP) 030725 59 21910 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359274
1#0##0#0#0.0#2022-03-29
13:10:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5be742c2c0f1794595fd0eb94862df16 450000 0 0 0 0 0
0 31845 0 0 15000 0 297903 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 02/01/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 309539
0 1 0 0 0 DOAN ARIYAWAN.TN 102166 52 19060 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359275
60#0##0#0#0.0#2022-03-29
14:14:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
55df43480d5c14f771873f18a80c23f8 150000 0 0 0 0 0
0 89500 0 0 15000 0 55039 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 09/03/1956 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
342088 0 1 0 0 0 KAMIYEM.NY 102161 66 24107
novia;3313125201940001; 5.6.5.202203091809 4 359276
61#0##0#0#0.0#2022-03-29
14:18:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a2d929ca74ced4c73b8d3999ce51fa6e 150000 0 0 0 0 0
0 120795 0 0 15000 0 56293 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 18/05/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 213534
0 1 0 0 0 SAMIYATI.NY 094791 71 26229 DR. WAHYU
novia;3313125201940001; 5.6.5.202203091809 4 359286
62#0##0#0#0.0#2022-03-29
14:21:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7427d7038eabcb27be5378af0ed61698 150000 0 0 0 0 0
0 0 0 0 15000 0 48534 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 22/07/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 243509
0 1 0 0 0 YULIANTIN ARASTINI.NY 098245 59 21781
novia;3313125201940001; 5.6.5.202203091809 4 359291
63#0##0#0#0.0#2022-03-29
14:22:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
832622487d048d663884290f961560c9 150000 0 0 0 0 0
0 0 0 0 15000 0 78509 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 04/06/1959 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
428384 0 1 0 0 0 BAMBANG INDARTO.TN 096080
0002292648096 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
359293 64#0##0#0#0.0#2022-03-29
14:23:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d29cccbf376dbda8e45f9e43ce7170fd 150000 0 0 0 0 0
0 76145 0 0 15000 0 187239 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 21/12/1961 0 1
1 Z09.8;E11.4;G59.0;L50.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 394735
0 1 0 0 0 SUYATNO.TN 091027 60 21994 DR. SUHARTO,
SP.PD 1124R0020322V001601 0001699124218 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 359295 65#0##0#0#0.0#2022-03-29
14:33:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5ff7a31186159c185f27b192b67b1d95 150000 0 0 0 0 0
0 31845 0 0 15000 0 197890 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 18/05/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 198772
0 1 0 0 0 SARJONO.TN 102160 51 18924 DR. WAHYU
novia;3313125201940001; 5.6.5.202203091809 4 359298
66#0##0#0#0.0#2022-03-29
14:35:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e8feb63552e7e92a510830b4f46f7ade 150000 0 0 0 0 0
0 0 0 0 15000 0 33772 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 19/06/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 199047
0 1 0 0 0 ENDANG TRININGSIH, NY 091052 66 24371
novia;3313125201940001; 5.6.5.202203091809 4 359305
67#0##0#0#0.0#2022-03-29
14:36:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f9481b6d1edff604537564f7a330c161 150000 0 0 0 0 0
0 0 0 0 15000 0 34047 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 28/04/1997 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 MUHAMMAD APRIANTO 084847 24 9082 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359310
68#0##0#0#0.0#2022-03-29
14:37:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
bca8c4f7eeccfba4f10bdce4afae44a6 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 17/01/1940 0 2
0 0 - 0 - 0 - 0 - 0 181400 216009
0 1 0 0 0 SITI JAHIDJAH, NY 101286 82 30003 DR.
novia;3313125201940001; 5.6.7.202204241238 4 359364
1#0##0#0#0.0#2022-05-20
09:30:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
37709455eb07a0898aa472715217282f 150000 0 0 0 0 0
0 0 0 0 15000 0 51009 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 23/11/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 201609
0 1 0 0 0 MURNI RETNONINGSIH, NY 099847 54 19831
novia;3313125201940001; 5.6.5.202203091809 4 359323
70#0##0#0#0.0#2022-03-29
14:40:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b328cfc164613d03b7074be6213b28c9 150000 0 0 0 0 0
0 0 0 0 15000 0 36609 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 11/11/1957 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
381304 0 1 0 0 0 RUBALIYATI.NY 091690 64
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359360
71#0##0#0#0.0#2022-03-29
14:42:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4641d4895bd9ad1de89ab1ec094bc5a5 150000 0 0 0 0 0
0 31845 0 0 15000 0 184459 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 28/03/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 218829
0 1 0 0 0 MV SUMARNI, NY 094104 64 23723 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359362
72#0##0#0#0.0#2022-03-29
14:43:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
389e43f7e383bd7534b3706b62abb75a 150000 0 0 0 0 0
0 0 0 0 15000 0 53829 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 26/09/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 221793
0 1 0 0 0 NUR HARYANTI, NY 072077 62 22811 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359366
73#0##0#0#0.0#2022-03-29
14:45:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8700f10f8d344abb32533cf7d825a69b 150000 0 0 0 0 0
0 0 0 0 15000 0 56793 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 15/10/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 686531
0 1 0 0 0 HARDATIN.NY 099609 53 19504 DR. SUHARTO,
SP.PD 1124R0020322V001610 0001426540408 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 359368 74#0##0#0#0.0#2022-03-29
14:47:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1a309f49e8cd1d86258ccf24f417bba8 150000 0 0 0 0 0
0 31845 0 0 15000 0 489686 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 07/06/1963 0 2
1 Z09.8;E78.5;J06.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 201091
0 1 0 0 0 WARSINI TURMUDZI ,(NY) 039273 58 21461
novia;3313125201940001; 5.6.5.202203091809 4 359369
75#0##0#0#0.0#2022-03-29
14:48:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1b4602713a5e3f9064a2fb4e90df48c7 150000 0 0 0 0 0
0 0 0 0 15000 0 36091 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 03/02/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 206461
0 1 0 0 0 SUMARSIH,NY 085983 67 24507 DR. WAHYU
novia;3313125201940001; 5.6.5.202203091809 4 359371
76#0##0#0#0.0#2022-03-29
14:49:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
458a85087fd485a90d4ffd764dc27f7a 150000 0 0 0 0 0
0 0 0 0 15000 0 41461 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 28/10/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 213534
0 1 0 0 0 MARUTA TIRANA,(BP) 040357 77 28257
novia;3313125201940001; 5.6.5.202203091809 4 359373
1#0##0#0#0.0#2022-03-29
14:49:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
94137018639c4d58c3a1d93ff1e8c47e 150000 0 0 0 0 0
0 0 0 0 15000 0 48534 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 31/12/1963 0 1
1 Z09.8;E11.2;N08.3;I10;G59.0 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
420565 0 1 0 0 0 DALIYO NURWAHID., BP 041210
0000565072615 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
359377 78#0##0#0#0.0#2022-03-29
14:51:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
959073f5f70274476b96a3ddc766eea6 150000 0 0 0 0 0
0 121345 0 0 15000 0 134220 0 0 0 0
0
3372030 C 3 CP 2 10/03/2022 10/03/2022 18/02/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 189635
0 1 0 0 0 DARTINAH,NY 030952 80 29240 DR. RINA
5.6.5.202203091809 4 359379 79#0##0#0#0.0#2022-03-29
14:59:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1ce4c1facbb0fa58b31ddce451474423 150000 0 0 0 0 0
0 0 0 0 15000 0 24635 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 22/05/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 258363
0 1 0 0 0 ANIK FATMAWATI, NY 101280 61 22572
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359381
80#0##0#0#0.0#2022-03-29
15:01:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0f24a580521f9a5ad0553c46e899fc4a 150000 0 0 0 0 0
0 31845 0 0 15000 0 61518 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 18/08/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 717209
0 1 0 0 0 SRI AMBARWATI.NY 096097 53 19562 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359383
81#0##0#0#0.0#2022-03-29
15:01:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2a67a7487f3c5883d50a3b11acbc2b20 150000 0 0 0 0 0
0 31845 0 0 15000 0 520364 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 06/07/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 218768
0 1 0 0 0 SUMARNI.NY 086963 67 24719 DR. SUHARTO,
SP.PD 1124R0020322V001618 0002347072604 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 359391 82#0##0#0#0.0#2022-03-29
15:02:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d4c0f1cd36dd35b13f1a2ce64ad7abf9 150000 0 0 0 0 0
0 0 0 0 15000 0 53768 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 18/06/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 209970
0 1 0 0 0 HARTATIK MARDI WIYONO, NY 101384 73
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359392
83#0##0#0#0.0#2022-03-29
15:04:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
166fcf79a5196c44f625ca0be765547f 150000 0 0 0 0 0
0 0 0 0 15000 0 44970 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 11/06/1953 0 2
1 Z09.8;M17.9;S72.80 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 212146
0 1 0 0 0 TRI DJANAH, NY 095470 68 25109 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359395
84#0##0#0#0.0#2022-03-29
15:05:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bcfef7536bed2cf580b1369480204839 150000 0 0 0 0 0
0 0 0 0 15000 0 47146 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 05/06/1975 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 YUNI NURJAYATI.NY
0001272616569 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
358964 85#0##0#0#0.0#2022-03-29
15:05:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9f37668969bc4690549fd392bf15d56d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 27/10/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 490810
0 1 0 0 0 UDIN ARJONO.TN 082976 51 18762 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359396
86#0##0#0#0.0#2022-03-29
15:08:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c2da6f6a8cf92b3d6cca32df3895d01d 150000 0 0 0 0 0
0 76045 0 0 15000 0 249765 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 06/06/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 15000
0 1 0 0 0 UMI NAFIAH. NY 076253 47 17444 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359398
87#0##0#0#0.0#2022-03-29
15:09:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b694b7c47fd4335c48e807d14b5951ef 0 0 0 0 0 0 0
0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 27/01/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 331890
0 1 0 0 0 SAMIDI, TN 098145 69 25244 DR. SUHARTO,
SP.PD 1124R0020322V001624 0001084306329 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 359403 88#0##0#0#0.0#2022-03-29
15:09:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
66ef3bc74e0665d7d1124820edbe7ce1 150000 0 0 0 0 0
0 88900 0 0 15000 0 77990 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 16/02/2007 0 1
0 0 - 0 - 0 - 0 - 0 181400 202455
0 1 0 0 0 NICO SAPUTRA.AN 101118 15 5501 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359404
89#0##0#0#0.0#2022-03-29
15:10:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b6192fd38798afdb092503ce93efc5c9 150000 0 0 0 0 0
0 0 0 0 15000 0 37455 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 06/04/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 466229
0 1 0 0 0 SUPARWAN, TN 038631 52 19331 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359407
90#0##0#0#0.0#2022-03-30
10:58:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
5e68c173866b7cb4856e397e29286cf7 150000 0 0 0 0 0
248000 0 0 0 15000 0 53229 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 25/02/1972 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 FRANS POKAREM.TN
0001032586479 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358963 1#0##0#0#0.0#2022-04-07
11:49:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
38ab02e21dbd256f40603b1a998e1ff5 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 14/05/1933 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 KOESWANTO BA.TN
0000091081451 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
358962 92#0##0#0#0.0#2022-03-30
10:59:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9ffa05f0f9aac2dbb2a11381aacde55a 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 19/08/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000089786147 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
358960 93#0##0#0#0.0#2022-03-30
11:05:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0f88c1268e8b0be210b599319a1d61c4 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 20/02/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 238527
0 1 0 0 0 RUMTANINGSIH(NY) 032276 65 23759 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359410
94#0##0#0#0.0#2022-03-30
11:05:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
55385cfa9bcdf58d46135df72bd74d7f 150000 0 0 0 0 0
0 0 0 0 15000 0 73527 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 19/02/1991 0 1
0 0 - 0 - 0 - 0 - 0 181400 198627
0 1 0 0 0 TRI PRAKOSO FEBRIANTO, TN 101768 31
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359411
95#0##0#0#0.0#2022-03-30
11:06:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
70ed68dce433b2c2b5d1486e1aa06ff2 150000 0 0 0 0 0
0 0 0 0 15000 0 33627 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 14/10/1972 0 2
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.5.202203091809 4 358974
96#0##0#0#0.0#2022-03-30
11:07:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0f19ba07d6e5e57ccb228397782b13de 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 13/11/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 319627
0 1 0 0 0 ROCHJATI,(NY) 001392 73 26780 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359414
97#0##0#0#0.0#2022-03-30
11:07:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2b8bb01129b94983fd35fbe84beeb314 150000 0 0 0 0 0
0 31845 0 0 15000 0 122782 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 14/02/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 295581
0 1 0 0 0 PARTINI,NY 040519 71 25957 DR. ANITA
novia;3313125201940001; 5.6.5.202203091809 4 359417
98#0##0#0#0.0#2022-03-30
11:08:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
889361d716f6352fc031f05b3e406d95 150000 0 0 0 0 0
0 0 0 0 15000 0 130581 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 31/12/1971 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V001635 0000555344774 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 358973 99#0##0#0#0.0#2022-03-30
11:09:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
544c17508050d091662f3eeefe3f9cbd 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 04/11/1994 0 1
0 0 - 0 - 0 - 0 - 0 181400 346097
0 1 0 0 0 RAUHULLOH AYATULLOH KHOMEINI.SDR 096022
0001796644269 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
359419 1#0##0#0#0.0#2022-05-19
13:39:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
f1bb4d4d2c169fc05601b8ce72dce353 150000 0 0 0 0 0
0 120795 0 0 15000 0 60302 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 23/03/1976 0 2
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.5.202203091809 4 358972
101#0##0#0#0.0#2022-03-30
11:10:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
79f0850417fd97a98ea43d12ff23705b 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 04/08/1948 0 1
1 R33 57.94 - - None None None None N-3-14-0 None None
None None None None PROSEDUR KECIL ENDOSKOPI PADA SALURAN KEMIH 336100
0 0 - 0 - 0 - 0 - 0 336100 385029
0 1 0 0 0 NGATIMIN MARTOWIYONO, TN 070607 73
26881 DR ANDANG SUSILO 1124R0020322V001638 0000640601043 3;JKN
reni;3313147010930001; 5.6.6.202203301209 4 360996
1#0##0#0#0.0#2022-04-04
17:02:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5318e9b6889a6916af163e7e806d16c8 310000 0 0 0 0 0
0 0 0 0 15000 0 60029 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 13/09/1966 0 2
1 M54.59;M17.9 81.92 - - None None None None M-3-11-0
None None None None None None PROSEDUR DIAGNOSTIK DAN TERAPEUTIK
0 404900 212163 0 1 0 0 0 ENDANG
KRISTIANINGSIH.NY 102315 55 20267 DR. WAHYU PURNOMO, SP.OT
1124R0020322V001639 0001534432871 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 359428 102#0##0#0#0.0#2022-03-30
11:11:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
47fd76e8ac07d8f13db8ca3bc4299dd3 150000 0 0 0 0 0
0 0 0 0 15000 0 47163 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 18/03/1988 0 1
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.5.202203091809 4 358970
103#0##0#0#0.0#2022-03-30
12:48:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3e2b227a32688d4e393838d421810caa 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 10/12/1982 0 1
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.5.202203091809 4 358969
104#0##0#0#0.0#2022-03-30
12:49:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f96a93aeabc514958500590d21db5e96 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 12/10/1987 0 1
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.5.202203091809 4 358968
105#0##0#0#0.0#2022-03-30
12:50:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9b732a7720a0724e8d4ec2520175ee75 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 25/06/1970 0 2
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.5.202203091809 4 358967
106#0##0#0#0.0#2022-03-30
12:51:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
708a4c83011d4ee1b2daa32498459a78 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 10/10/1957 0 1
1 Z09.8;R05;I11.9;R51 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 243015
0 1 0 0 0 SULUT, TN 082030 64 23527 DR. SUHARTO,
SP.PD 1124R0020322V001646 0000640434914 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 359433 107#0##0#0#0.0#2022-03-30
12:52:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bcc1270ea4b21c370d8f948ba2d42755 150000 0 0 0 0 0
0 0 0 0 15000 0 78015 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 04/05/1958 0 2
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.5.202203091809 4 358965
108#0##0#0#0.0#2022-03-30
12:52:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
85541ec2b721dd8a201439001a001c91 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 10/06/1961 0 2
1 Z09.8;M19.98;I50.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 230230
0 1 0 0 0 PARINEM.NY 083383 60 22188 DR. SUHARTO,
SP.PD 1124R0020322V001649 0002261302165 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 359436 109#0##0#0#0.0#2022-03-30
12:53:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
66d695fda0d035c4dcdf7ef1f0af2297 150000 0 0 0 0 0
0 0 0 0 15000 0 65230 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 13/08/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ENDANG MARYATI
0001806020504 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
358961 110#0##0#0#0.0#2022-03-30
12:54:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a6cfe26c0c4302d64e997465e858d110 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 01/09/1964 0 1
0 - 0 - 0 - 0 786200 504999 0 1
SP.PD 1124R0020322V001651 0000639614597 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 358978 111#0##0#0#0.0#2022-03-30
12:54:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4626180e8ed94b836d2fd1c126130253 463830 0 0 0 0 0
0 0 0 0 15000 0 26169 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 23/12/1977 0 2
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.5.202203091809 4 358977
112#0##0#0#0.0#2022-03-30
12:55:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1a2dea4c4517aab7d2a810839c40dca2 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 25/03/1978 0 2
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.5.202203091809 4 358976
113#0##0#0#0.0#2022-03-30
12:56:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
312f751d88c2abc0ab445932267e915f 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 25/09/1959 0 1
1 Z09.8;K80.2;J18.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 336501
0 1 0 0 0 SLAMET SUNARJO.TN 036285 62 22812 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359438
114#0##0#0#0.0#2022-03-30
12:57:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a9d0cba1c18f53efead7652fd1aa2f72 150000 0 0 0 0 0
0 0 0 0 15000 0 171501 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 02/09/1976 0 1
0 - 0 - 0 - 0 786200 942660 0 1
novia;3313125201940001; 5.6.5.202203091809 4 358975
115#0##0#0#0.0#2022-03-30
13:07:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b97f796cd8a436852488d9dec29c84a6 927660 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 13/08/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 354235
0 1 0 0 0 SRI DADIYONO ., TN 007779 56 20663
novia;3313125201940001; 5.6.5.202203091809 4 359440
1#0##0#0#0.0#2022-03-30
13:07:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
90cba5feb74c5df19378147a5ad1c1c8 300000 0 0 0 0 0
0 0 0 0 15000 0 39235 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 17/04/1973 0 1
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.5.202203091809 4 358971
117#0##0#0#0.0#2022-03-30
13:08:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
40be650524f7a2ad671853c1ad37e06d 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 10/07/1969 0 2
1 Z09.8;K76.0;G44.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 200481
0 1 0 0 0 UMUL KHOIRIYAH, NY 090348 52 19236
novia;3313125201940001; 5.6.5.202203091809 4 359442
118#0##0#0#0.0#2022-03-30
13:09:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1f2722fabad74eb1528b977e484196d8 150000 0 0 0 0 0
0 0 0 0 15000 0 35481 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 28/11/1979 0 2
1 I10;N13.2 88.76 - - None None None None Z-3-23-0 None
0 - 0 - 0 - 0 - 0 549400 1070205
0 1 0 0 0 DWI SARDIYANTI, NY 065837 42 15443
novia;3313125201940001; 5.6.5.202203091809 4 359447
119#0##0#0#0.0#2022-03-30
13:10:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5d580996ffcd18ce3aeffa8b66bd26d9 150000 0 0 0 0 0
857000 0 0 0 15000 0 48205 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 10/07/1955 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V001660 0001032581823 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 358966 120#0##0#0#0.0#2022-03-30
13:10:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
29c8771b68cf324ae42136a37407d7c1 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 05/07/1937 0 2
1 Z09.8;I11.9;M19.98;G62.8 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
257083 0 1 0 0 0 SITI NIMAH.NY 086337 84
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359450
121#0##0#0#0.0#2022-03-30
13:12:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
771c4df8ac70e8b4d6da5a3ca7bcccbe 150000 0 0 0 0 0
0 0 0 0 15000 0 92083 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 05/03/1985 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 DIAN USWATUN HASANAH, NY 063907 37
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 358954
122#0##0#0#0.0#2022-03-30
13:23:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0de1a385a90f368471c99e5d8149fd32 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 07/07/1966 0 2
1 Z09.8;I10;R51 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 259412
0 1 0 0 0 RIDAR SURYANDARI.NY 076914 55 20335
novia;3313125201940001; 5.6.5.202203091809 4 359452
123#0##0#0#0.0#2022-03-30
13:24:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eda56f77a1252261ce2c4641258473d9 150000 0 0 0 0 0
0 0 0 0 15000 0 94412 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 17/08/1934 0 2
0 0 - 0 - 0 - 0 - 0 181400 241375
0 1 0 0 0 KASMINAH SASTROWIJOYO NY 088501 87
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359467
124#0##0#0#0.0#2022-03-30
13:24:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
63dd11894c3838a4f85b60ddb0f26625 150000 0 0 0 0 0
0 0 0 0 15000 0 76375 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 04/04/1984 0 2
0 0 - 0 - 0 - 0 - 0 181400 382075
0 1 0 0 0 DIAH PADMANIK.NY 100256 37 13854 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359469
125#0##0#0#0.0#2022-03-30
13:25:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
91cd1db3f4a2a118a871704ded32a62e 150000 0 0 0 0 0
0 0 0 0 15000 0 217075 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 31/12/1963 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 INDRAYATI, NY 091755 58 21254 DR.
novia;3313125201940001; 5.6.7.202204241238 4 358946
1#0##0#0#0.0#2022-05-19
11:08:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
17d8dd681ddd515e89999701da8a96f2 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 15/04/1973 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TATAS BUDIONO.TN
0001440938553 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
358952 127#0##0#0#0.0#2022-03-30
13:12:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a849d468785e0704765dfcecced595cd 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 04/05/1972 0 1
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 301070 0 1 0 0 0 BUDI WIRANTO, TN 101008
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359471
128#0##0#0#0.0#2022-03-30
13:27:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0df1f5a86d511e2efb6f037c467d9807 150000 0 0 0 0 0
0 0 0 0 15000 0 136070 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 13/08/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 TRI UTAMI
1124R0020322V001669 0001380313934 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 358948 129#0##0#0#0.0#2022-03-30
13:27:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f371e82942e8565ed6519b63e4c8a03b 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 28/05/1974 0 1
0 0 - 0 - 0 - 0 - 0 181400 489274
0 1 0 0 0 SAPTO HARYANTO, TN 100336 47 17453
novia;3313125201940001; 5.6.5.202203091809 4 359480
130#0##0#0#0.0#2022-03-30
13:30:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b422753e8cdcbf909818761c88d88ecf 0 0 0 0 0 0 0
0 0 0 15000 0 474274 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 16/05/1997 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 251000 0 1 0 0 0 MEI NUR SAPUTRI,
0002220808432 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
358957 131#0##0#0#0.0#2022-03-30
13:31:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a4f5108334c49f0e7960ac9f565895e2 236000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 18/01/1966 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 IVO MUMPUNI
1124R0020322V001672 0002169780873 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 358958 132#0##0#0#0.0#2022-03-30
13:32:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f0d57d069cd4a94248db2c1abeae32e7 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 05/08/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 403414
0 1 0 0 0 RIZA THALIB(BP) 031388 68 25054 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359483
133#0##0#0#0.0#2022-03-30
13:33:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bc72704582e376c6dfa52406d230c168 150000 0 0 0 0 0
0 0 0 0 15000 0 238414 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 12/02/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 290422
0 1 0 0 0 MUSTOFA ANTON RIYADI,TN 037570 61 22306
novia;3313125201940001; 5.6.5.202203091809 4 359486
134#0##0#0#0.0#2022-03-30
13:33:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
08fef1572c657017431f19e727d9b279 150000 0 0 0 0 0
0 0 0 0 15000 0 125422 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 03/03/1979 0 1
1 Z09.8;G40.9;G47.0 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 246159
0 1 0 0 0 ANDRIANUS PRIADI.S, TN 007676 43 15713
3;JKN novia;3313125201940001; 5.6.7.202204241238 4 359489
1#0##0#0#0.0#2022-05-18
10:38:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
3b80c9f849cf2cbced484e1bfb65217c 150000 0 0 0 0 0
0 0 0 0 15000 0 81159 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 04/07/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 213659
0 1 0 0 0 SUKRAMTO.TN 101783 66 24356 DR. SUHARTO,
SP.PD 1124R0020322V001677 0000091587789 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 359496 136#0##0#0#0.0#2022-03-30
13:36:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9ed822e3f0684fddfa579db495e9f4b6 150000 0 0 0 0 0
0 0 0 0 15000 0 48659 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 01/07/1956 0 2
0 - 0 - 0 - 0 894800 1415000 0 1
0 0 0 SAMI, NY 032471 65 23993 DR. ARIA CHANDRA GTS,
SP.S., M.KES 1124R0020322V001678 0002049514402 3;JKN
novia;3313125201940001; 5.6.5.202203091809 4 359497
137#0##0#0#0.0#2022-03-30
13:38:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fd926fd70a2cd72846e13aefa987bc6f 150000 0 0 0 0 0
1250000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 24/01/1964 0 2
1 Z09.8;K21.9;K27.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 212277
0 1 0 0 0 SUKARMI., NY 045414 58 21230 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359498
138#0##0#0#0.0#2022-03-30
13:38:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
436fbf36854f60e4faa17201b4a15f9a 150000 0 0 0 0 0
0 0 0 0 15000 0 47277 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 15/07/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 LILIK ANDRIYANI. NY 093353 55 20327
novia;3313125201940001; 5.6.5.202203091809 4 359499
139#0##0#0#0.0#2022-03-30
13:39:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ee1c030ded4eb5254c82d19035f00777 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 08/12/1945 0 2
1 Z09.8;E11.2;N08.3;G59.0;I10 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
461156 0 1 0 0 0 MADIYEM.NY 077277 76 27851
novia;3313125201940001; 5.6.5.202203091809 4 359501
1#0##0#0#0.0#2022-03-30
13:51:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
618b26cb5af3806ec0bc3c563afea7c3 150000 0 0 0 0 0
0 0 0 0 15000 0 296156 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 06/06/1957 0 1
1 Z09.8;K80.2;M54.59 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SUPARNO, TN 087947 64 23653 DR. SUHARTO,
SP.PD 1124R0020322V001683 0002166934702 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 359503 141#0##0#0#0.0#2022-03-30
13:53:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
48555e10690319bd357e7ecf5c36c1bc 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 01/09/1947 0 1
1 Z09.8;I11.9;E78.5;E79.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 276111
0 1 0 0 0 HADIL CHOIRI, BP 055875 74 27219 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359505
142#0##0#0#0.0#2022-03-30
13:56:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
03bb2101fd0455015af1bc0e00a68701 150000 0 0 0 0 0
0 0 0 0 15000 0 111111 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 19/03/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 266305
0 1 0 0 0 SRI UNTARI, NY 087563 61 22636 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359507
143#0##0#0#0.0#2022-03-30
13:57:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
45434e280ec59a4df79c1fa2ca269b2f 150000 0 0 0 0 0
0 0 0 0 15000 0 101305 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 17/04/2000 0 2
1 N70.9;R10.4 - - - None None None None Q-5-42-0 None
0 - 0 - 0 - 0 - 0 182600 169260
0 1 0 0 0 PRISKILA AYU S, NN 102239 21 7997
reni;3313147010930001; 5.6.6.202203301209 4 361174
1#0##0#0#0.0#2022-04-05
10:03:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
17c7ab426904cd7e07967561467dd3a2 0 0 138000 0 0 0
0 0 0 0 15000 0 16260 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 23/05/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 325000
0 1 0 0 0 RUMHAYATI.NY 080038 43 15997 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359508
144#0##0#0#0.0#2022-03-30
13:57:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fdc8f9ae9afa8a7fc76e6dbec54359aa 310000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 28/02/2008 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 BERLY GAVIN J, AN
0001106709579 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
358949 145#0##0#0#0.0#2022-03-30
15:14:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e9b72622a8ae65ec2b94ec6fdb5d9800 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 07/10/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 220256
0 1 0 0 0 ZUHROH TUNNISA, HJ,(NY) 050322 73 26817
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359510
146#0##0#0#0.0#2022-03-30
13:58:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e7282fa02087efaecd70e56af1a39b39 150000 0 0 0 0 0
0 0 0 0 15000 0 55256 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 27/12/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 268145
0 1 0 0 0 WORO WIDYASTUTI.NY 095052 46 16875
novia;3313125201940001; 5.6.5.202203091809 4 359512
147#0##0#0#0.0#2022-03-30
13:59:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c83384b255266a7a70b418657bdff57b 150000 0 0 0 0 0
0 0 0 0 15000 0 103145 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 27/03/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 203793
0 1 0 0 0 SUHARTO JOKO.P (BP) 050087 67 24820
novia;3313125201940001; 5.6.5.202203091809 4 359513
148#0##0#0#0.0#2022-03-30
13:59:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4d700730d3273f8ffb1030f0d754fa67 150000 0 0 0 0 0
0 0 0 0 15000 0 38793 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 12/03/2004 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 ARINDRA YUDHO PRAKOSO.SDR 100775 17
6572 DR. ZULFADLY, SP.B 1124R0020322V001692 0002764243945 3;JKN
novia;3313125201940001; 5.6.5.202203091809 4 359514
149#0##0#0#0.0#2022-03-30
14:00:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a02a0ccc02f3358386f6ec5e43d3e7b6 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 15/09/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 666906
0 1 0 0 0 BERO ANTINI NY 067917 54 19900 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359515
150#0##0#0#0.0#2022-03-30
14:03:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
26ab271a3a1f97e44d58edef20a76cab 150000 0 0 0 0 0
0 0 0 0 15000 0 501906 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 01/03/1981 0 1
0 0 - 0 - 0 - 0 - 0 181400 192918
0 1 0 0 0 SIGIT MARIYADI, TN 100053 41 14984
novia;3313125201940001; 5.6.5.202203091809 4 359518
151#0##0#0#0.0#2022-03-30
14:05:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6b802a9b0bc66a51e87993de64e5bd99 150000 0 0 0 0 0
0 0 0 0 15000 0 27918 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 29/11/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 415320
0 1 0 0 0 WIDASTIWI. NY 010733 59 21651 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359521
152#0##0#0#0.0#2022-03-30
14:06:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
83289bc432759023c0a8f287dee3b23e 150000 0 0 0 0 0
0 0 0 0 15000 0 250320 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 27/06/1967 0 1
0 - 0 - 0 - 0 183900 280624 0 1
0 0 0 SUTARMAN.TN 102176 54 19980 DR. ZULFADLY, SP.B
1124R0020322V001696 0001785055353 3;JKN novia;3313125201940001;
5.6.5.202203091809 4 359523 153#0##0#0#0.0#2022-03-30
14:06:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9398f128b295cf990e4d5824d82acd7a 235000 0 0 0 0 0
0 0 0 0 15000 0 30624 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 16/06/2020 0 1
0 0 - 0 - 0 - 0 - 0 181400 344588
0 1 0 0 0 ARKA SATYA ALFARISKY, AN 102214 1
0002937739781 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
359525 154#0##0#0#0.0#2022-03-30
14:08:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5b2af6511956614c8f0a159156ccd58d 300000 0 0 0 0 0
0 0 0 0 15000 0 29588 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 11/08/2020 0 1
0 0 - 0 - 0 - 0 - 0 181400 349595
0 1 0 0 0 DEVANKA NAWASENA ARIFIN, AN 102265 1
0003046375776 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
359527 155#0##0#0#0.0#2022-03-30
14:09:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2d8ddedb8d5bc4eca8d2ac7ddb909839 300000 0 0 0 0 0
0 0 0 0 15000 0 34595 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 16/10/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400
1215210 0 1 0 0 0 NANIK MASLICHAH,B.A, NY 091595
0000045303131 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
359528 156#0##0#0#0.0#2022-03-30
14:09:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9239b62c6eaf8c1a25e30c905c5a1bc9 150000 0 0 0 0 0
0 121345 0 0 15000 0 928865 0 0 0 0
0
3372030 C 3 CP 2 10/03/2022 10/03/2022 15/05/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 258748
0 1 0 0 0 SRI MULYANI 033515 64 23675 DR. ARIA
novia;3313125201940001; 5.6.5.202203091809 4 359530
157#0##0#0#0.0#2022-03-30
14:10:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
453c5e479a161471c19d989f9ad88714 150000 0 0 0 0 0
0 0 0 0 15000 0 93748 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 20/04/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 231913
0 1 0 0 0 DWI PURNOMO SIGIT ., BP 054206 49 18221
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359533
158#0##0#0#0.0#2022-03-30
14:11:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a28d01a53a9df2105e45c3c38421a13f 150000 0 0 0 0 0
0 0 0 0 15000 0 66913 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 20/03/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 202786
0 1 0 0 0 JOKO MULYONO, TN 038517 63 23366 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359536
159#0##0#0#0.0#2022-03-30
14:11:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e53029eb54436bddb0627839217e51d8 150000 0 0 0 0 0
0 0 0 0 15000 0 37786 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 21/06/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 276678
0 1 0 0 0 ANJAR SETYAWATI,DRA 093261 58 21447
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359539
160#0##0#0#0.0#2022-03-30
14:12:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e19b0d405195d6eca63e37e5435be9cd 150000 0 0 0 0 0
0 0 0 0 15000 0 111678 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 13/03/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 237282
0 1 0 0 0 SUHARI, TN 070582 68 25199 DR. ARIA
novia;3313125201940001; 5.6.5.202203091809 4 359542
161#0##0#0#0.0#2022-03-30
14:14:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
911511830e1fd8bad7db191540fe2cba 150000 0 0 0 0 0
0 0 0 0 15000 0 72282 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 25/05/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 259585
0 1 0 0 0 SITI MARDHIYAH.NY 097607 70 25857 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359544
162#0##0#0#0.0#2022-03-30
14:15:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e5056a38ad46404d94e8e04a6c5207dc 150000 0 0 0 0 0
0 0 0 0 15000 0 94585 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 02/04/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 284505
0 1 0 0 0 SUGIARTI, NY 091922 63 23353 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359546
163#0##0#0#0.0#2022-03-30
14:16:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b8452c11793579d5f781e5aae04f163c 150000 0 0 0 0 0
0 0 0 0 15000 0 119505 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 18/11/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 219109
0 1 0 0 0 PARNANTO.TN 099751 67 24584 DR. ARIA
novia;3313125201940001; 5.6.5.202203091809 4 359548
164#0##0#0#0.0#2022-03-30
14:16:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
24a99249174014e298f0cf7482527ec3 150000 0 0 0 0 0
0 0 0 0 15000 0 54109 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 31/12/1944 0 2
0 0 - 0 - 0 - 0 - 0 181400 229330
0 1 0 0 0 HJ.DJOEMIATI,(NY) 044744 77 28193 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359551
165#0##0#0#0.0#2022-03-30
14:17:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
60b217fee3c36cf05d5ae780d36c8d61 150000 0 0 0 0 0
0 0 0 0 15000 0 64330 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 31/12/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 293728
0 1 0 0 0 SAPTO WAHYUNINGSIH.NY 090819 50 18332
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359553
166#0##0#0#0.0#2022-03-30
14:18:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8a47be6f399f260d8c80445f3f5e20a1 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 18/08/1943 0 1
0 0 - 0 - 0 - 0 - 0 181400 210518
0 1 0 0 0 MARNO RAHARJO, BP 054909 78 28694 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359555
167#0##0#0#0.0#2022-03-30
14:18:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7fec22ba4b990e4e05d50380663135a7 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 08/06/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 455069
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novia;3313125201940001; 5.6.5.202203091809 4 359556
168#0##0#0#0.0#2022-03-30
14:19:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 28/02/1948 0 1
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novia;3313125201940001; 5.6.5.202203091809 4 359558
169#0##0#0#0.0#2022-03-30
14:20:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 29/12/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 240433
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359559
170#0##0#0#0.0#2022-03-30
14:21:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 01/07/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 240713
0 1 0 0 0 YULIANI KUNHARYATI,(NY) 028277 56 20706
novia;3313125201940001; 5.6.5.202203091809 4 359561
171#0##0#0#0.0#2022-03-30
14:22:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 20/01/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 240206
0 1 0 0 0 R SRI SUHARJANI.NY 093251 63 23060
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359563
172#0##0#0#0.0#2022-03-30
14:23:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4e70918907728e6ffbf207ad3845de73 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 02/08/1951 0 1
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0 1 0 0 0 SUTARNO, TN 048927 70 25788 DR. ARIA
novia;3313125201940001; 5.6.5.202203091809 4 359565
173#0##0#0#0.0#2022-03-30
14:23:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3b120476cc52345ca085780ebe202f7f 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 20/07/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 225357
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3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359567
174#0##0#0#0.0#2022-03-30
14:24:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7124757b30ca05c8797bced613d7c475 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 02/08/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 226254
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novia;3313125201940001; 5.6.5.202203091809 4 359570
175#0##0#0#0.0#2022-03-30
14:25:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 25/12/1957 0 2
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0001647209711 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
359572 176#0##0#0#0.0#2022-03-30
14:26:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9e9691684fbec1d8e16078f7a60832f6 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 23/08/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 229581
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novia;3313125201940001; 5.6.5.202203091809 4 359576
177#0##0#0#0.0#2022-03-30
14:27:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ab60407f67162cfec19fb8203dd077d0 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 27/09/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
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novia;3313125201940001; 5.6.5.202203091809 4 359578
178#0##0#0#0.0#2022-03-30
14:32:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 01/10/1937 0 1
0 0 - 0 - 0 - 0 - 0 181400 211992
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novia;3313125201940001; 5.6.5.202203091809 4 359574
179#0##0#0#0.0#2022-03-30
14:26:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 20/03/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 245647
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novia;3313125201940001; 5.6.5.202203091809 4 359580
180#0##0#0#0.0#2022-03-30
14:42:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c186823c1446c8f87c808cb75296f691 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 02/07/1955 0 2
1 Z09.8;I69.3;M19.98 87.03 - - None None None None Z-3-
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novia;3313125201940001; 5.6.5.202203091809 4 359582
181#0##0#0#0.0#2022-03-30
14:43:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 10/12/1982 0 1
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3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359587
182#0##0#0#0.0#2022-03-30
14:44:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 20/03/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 MARDIYONO,TN 093361 50 18618 DR.
novia;3313125201940001; 5.6.5.202203091809 4 360625
1#0##0#0#0.0#2022-03-30
14:45:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3337b31e9c6cb1fb445ba440d0827eaa 165000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 16/11/1999 0 2
0 0 - 0 - 0 - 0 - 0 181400 337772
0 1 0 0 0 MAYA NOVITASARI.NN 079873 22 8150
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359591
183#0##0#0#0.0#2022-03-30
14:46:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0b09be3edb2ca2ebacc99027a3cbfe39 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 24/11/1960 0 2
1 Z09.8;M54.39;G50.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 330506
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novia;3313125201940001; 5.6.5.202203091809 4 359592
184#0##0#0#0.0#2022-03-30
14:46:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e833d403c0906cdf0500978d4cfcadc1 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 07/11/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 15000
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novia;3313125201940001; 5.6.5.202203091809 4 359594
185#0##0#0#0.0#2022-03-30
14:47:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 17/09/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 279562
0 1 0 0 0 DAKA AHMAD MUSYAROF, TN 066016 66 24281
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359596
186#0##0#0#0.0#2022-03-30
14:47:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7be5e5f4f99c905fa78685917a5b5ef0 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 12/08/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 208401
0 1 0 0 0 IDA NURSANTI, NY 100228 57 21029 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359598
187#0##0#0#0.0#2022-03-30
14:48:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 25/12/1944 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
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novia;3313125201940001; 5.6.5.202203091809 4 360639
2#0##0#0#0.0#2022-03-30
14:48:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
116ec8e59af1c3984b589bd2010eea0b 165000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 18/11/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
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novia;3313125201940001; 5.6.5.202203091809 4 359599
188#0##0#0#0.0#2022-03-30
14:49:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 09/05/1949 0 1
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0 1 0 0 0 SUDARSONO, TN 066776 72 26603 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359600
189#0##0#0#0.0#2022-03-30
14:49:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 25/04/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 243144
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3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359601
190#0##0#0#0.0#2022-03-30
14:50:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 25/05/1959 0 2
1 Z09.8;G20;I69.3;M19.98 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 859159
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novia;3313125201940001; 5.6.5.202203091809 4 359602
191#0##0#0#0.0#2022-03-30
14:51:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 09/11/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 243953
0 1 0 0 0 DALIYEM., NY 042563 66 24228 DR.
novia;3313125201940001; 5.6.5.202203091809 4 359603
192#0##0#0#0.0#2022-03-30
14:52:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 07/05/1959 0 2
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0 1 0 0 0 SUGIYATI.NY 101341 62 22953 DR. ARIA
novia;3313125201940001; 5.6.5.202203091809 4 359604
193#0##0#0#0.0#2022-03-30
14:52:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 25/01/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 265645
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359605 194#0##0#0#0.0#2022-03-30
14:52:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 13/02/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 297924
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novia;3313125201940001; 5.6.5.202203091809 4 359606
195#0##0#0#0.0#2022-03-30
14:54:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 05/02/1977 0 2
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novia;3313125201940001; 5.6.5.202203091809 4 359607
196#0##0#0#0.0#2022-03-30
14:56:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 01/05/1972 0 1
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novia;3313125201940001; 5.6.7.202204241238 4 359608
1#0##0#0#0.0#2022-05-20
09:35:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 10/03/2022 10/03/2022 17/01/1955 0 1
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358950 198#0##0#0#0.0#2022-03-30
14:58:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 12/05/1977 0 2
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reni;3313147010930001; 5.6.6.202203301209 4 361176
1#0##0#0#0.0#2022-04-05
10:04:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 17/02/1977 0 2
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14:58:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 17/11/1945 0 1
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novia;3313125201940001; 5.6.5.202203091809 4 360641
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15:00:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 27/03/1998 0 2
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359612 200#0##0#0#0.0#2022-03-30
14:59:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 17/08/1946 0 1
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novia;3313125201940001; 5.6.5.202203091809 4 359615
201#0##0#0#0.0#2022-03-30
15:01:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3e8a0af061c0d68e07e46df5ac09873e 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 14/01/1983 0 2
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novia;3313125201940001; 5.6.5.202203091809 4 359618
202#0##0#0#0.0#2022-03-30
15:01:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 31/12/1953 0 2
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novia;3313125201940001; 5.6.5.202203091809 4 359621
203#0##0#0#0.0#2022-03-30
15:02:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 08/04/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 368481
0 1 0 0 0 KATINI., NY 045388 62 22982 DR. ANITA
novia;3313125201940001; 5.6.5.202203091809 4 359623
204#0##0#0#0.0#2022-03-30
15:02:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
adce870b640a168b480bd543dad650c6 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 15/06/1936 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SUWITO DINOMO.TN 081116 85 31314 DR.
novia;3313125201940001; 5.6.5.202203091809 4 360643
4#0##0#0#0.0#2022-03-30
15:03:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b8b262186e6d757037430770fdbb37f3 165000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 09/05/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 361800
0 1 0 0 0 MUH ALWANI NGISOM, TN 064944 76 28064
3;JKN novia;3313125201940001; 5.6.5.202203091809 4 359626
205#0##0#0#0.0#2022-03-30
15:03:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 21/04/1960 0 1
1 J44.9;J06.9;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 404328
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novia;3313125201940001; 5.6.5.202203091809 4 359627
206#0##0#0#0.0#2022-03-30
15:04:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3312764066dc212c65bcf7cecdfb0c9d 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 28/05/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 368959
0 1 0 0 0 NUNUK YUNIARTI LISTIYANI, NY 044669 58
0001021679278 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
359629 207#0##0#0#0.0#2022-03-30
15:05:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0ae6c7bbac90e78a284693ac26c23aaf 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 02/02/2017 0 2
1 Z09.8;A49.9;J06.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 183088
0 1 0 0 0 AMIRA QURRATUAIN.AN 093568 5 1862
0002345975447 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
359630 208#0##0#0#0.0#2022-03-30
15:05:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 08/12/1949 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SISWO SARJONO,(BP)
0000564473013 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
358953 209#0##0#0#0.0#2022-03-30
15:06:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 18/06/1953 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 WIDIJARNI, NY 095042 68 25102 DR.
novia;3313125201940001; 5.6.5.202203091809 4 358947
210#0##0#0#0.0#2022-03-30
15:07:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 07/10/1961 0 1
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1 0 0 0 AGUNG RUMAMBI, TN 097338 60 22069 DR. LINDA
novia;3313125201940001; 5.6.5.202203091809 4 358951
1#0##0#0#0.0#2022-03-30
15:07:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 10/10/1953 0 2
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novia;3313125201940001; 5.6.7.202204241238 4 358956
1#0##0#0#0.0#2022-05-19
08:34:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 10/03/2022 10/03/2022 01/12/1944 0 2
1 Z09.8;G81.9;R47.1 93.39 - - None None None None M-3-16-0
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 219000 0 1 0 0 0 WANTIYEM.NY 078888
0000640044099 3;JKN novia;3313125201940001; 5.6.5.202203091809 4
358955 213#0##0#0#0.0#2022-03-30
15:09:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 04/07/1974 0 1
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0 1 0 0 0 SAMSURI 075141 47 17416 DR. TEKY
novia;3313125201940001; 5.6.5.202203091809 4 359631
214#0##0#0#0.0#2022-03-30
15:09:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 03/04/1969 0 2
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novia;3313125201940001; 5.6.5.202203091809 4 359632
215#0##0#0#0.0#2022-03-30
15:10:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1a05ea0dd0b58cd46d48821686ea21b9 150000 0 0 0 0 0
0 0 0 0 15000 0 51541 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 08/11/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 252489
0 1 0 0 0 SRIYONO.TN 094853 67 24594 DR. ARIA
novia;3313125201940001; 5.6.5.202203091809 4 359633
216#0##0#0#0.0#2022-03-30
15:11:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/03/2022 10/03/2022 24/07/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 213154
0 1 0 0 0 SUTAMI.NY 099959 53 19587 DR. ARIA
novia;3313125201940001; 5.6.7.202204241238 4 359635
1#0##0#0#0.0#2022-05-20
08:19:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
969888eb3aa25b97ad76098cf6666d0e 0 0 138000 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 25/05/1965 0 2
1 I69.3;M53.19 87.22 - - None None None None Z-3-26-0
None None None None None None PROSEDUR BESAR RADIOGRAFI 700800
0 0 - 0 - 0 - 0 - 0 700800 732869
0 1 0 0 0 SUMINAH.NY 102300 56 20743 DR. ARIA
novia;3313125201940001; 5.6.5.202203091809 4 359636
218#0##0#0#0.0#2022-03-30
15:12:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e7b7875e544e1c1373a148746e02c861 300000 0 0 0 0 0
285000 0 0 0 15000 0 132869 0 0 0 0
0
3372030 C 3 CP 2 10/03/2022 10/03/2022 22/09/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 235664
0 1 0 0 0 SUMARSONO ,TN 087561 62 22815 DR.
novia;3313125201940001; 5.6.7.202204241238 4 359639
1#0##0#0#0.0#2022-05-19
10:41:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
aadddedc08a4885a5419e3578dcf930a 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/03/2022 10/03/2022 23/11/2016 0 1
1 R50.9 - - None None None None Q-5-42-0 None None
- 0 - 0 - 0 - 0 182600 219301 0
1 0 0 0 FARIZ ILHAM PRATAMA, AN 098638 5 1933 DR
ANDANG SUSILO 1124R0020322V001783 0002216069199 3;JKN
novia;3313125201940001; 5.6.7.202204241238 4 360997
1#0##0#0#0.0#2022-05-20
11:11:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
1ef8f64d4068bbf75689582a5d45a8a3 145000 0 0 0 0 0
0 44300 0 0 15000 0 15001 0 0 0 0 0
3372030 C 3 CP 2 10/03/2022 10/03/2022 30/12/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 RABIJEM NY 070138 73 26733 DR. ARIA
novia;3313125201940001; 5.6.5.202203091809 4 359641
220#0##0#0#0.0#2022-03-30
15:13:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eb722ddb95be2cc14fa36404686cf9c1 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 28/02/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 378177
0 1 0 0 0 ASRI WIJAYANTI, (NY) 003826 51 18639
yani;3302226402970001; 5.6.5.202203091809 4 359867
1#0##0#0#0.0#2022-03-30
13:07:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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0 133650 0 0 15000 0 79527 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 17/08/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 379432
0 1 0 0 0 SARTIMAH,(NY) 037210 69 25408 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359868
1#0##0#0#0.0#2022-03-30
13:10:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9cbf3c1ed95c1bf8e9fb4410e4fa617b 150000 0 0 0 0 0
0 133650 0 0 15000 0 80782 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 09/11/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 268475
0 1 0 0 0 SUHASTI,(NY) 038243 50 18385 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359869
1#0##0#0#0.0#2022-03-30
13:11:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0d90bb1f644e3d3aaaedf5a66e760a06 150000 0 0 0 0 0
0 63690 0 0 15000 0 39785 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 07/08/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 504445
0 1 0 0 0 SRI SUWARNI,NY 079551 56 20670 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359870
1#0##0#0#0.0#2022-03-30
13:12:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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0 120745 0 0 15000 0 218700 0 0 0 0
0
3372030 C 3 CP 2 11/03/2022 11/03/2022 07/05/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 285816
0 1 0 0 0 SUWARSONO.TN 084554 68 25145 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359871
1#0##0#0#0.0#2022-03-30
13:14:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/03/2022 11/03/2022 12/11/1945 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000063294052 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359813 1#0##0#0#0.0#2022-03-30
13:15:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/03/2022 11/03/2022 27/08/1960 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
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yani;3302226402970001; 5.6.5.202203091809 4 359872
1#0##0#0#0.0#2022-03-30
13:16:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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0 76045 0 0 15000 0 125316 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 22/12/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 757815
0 1 0 0 0 UMI QOYYIMAH, (NY) 039287 53 19437
yani;3302226402970001; 5.6.5.202203091809 4 359874
1#0##0#0#0.0#2022-03-30
13:17:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d7263b2ceedd68b0fac2c37a0986bec0 150000 0 0 0 0 0
0 121345 0 0 15000 0 471470 0 0 0 0
0
3372030 C 3 CP 2 11/03/2022 11/03/2022 24/12/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI SUTANTI, NY
0000639837347 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359809 1#0##0#0#0.0#2022-03-30
13:18:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
55edd58eaebc395553cee36d7566fe09 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 30/05/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 478363
0 1 0 0 0 SRI MULYATI 092853 49 18182 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 359875
1#0##0#0#0.0#2022-03-30
13:19:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
14237478bf58a59d717f3a88372ed952 150000 0 0 0 0 0
0 76045 0 0 15000 0 237318 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 06/06/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 355443
0 1 0 0 0 SUPARMAN, (BP) 004954 58 21463 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359876
1#0##0#0#0.0#2022-03-30
13:20:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7acf67d22739c05d38836b46b3333b4c 150000 0 0 0 0 0
0 133650 0 0 15000 0 56793 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 14/05/1944 0 2
0 0 - 0 - 0 - 0 - 0 181400 228221
0 1 0 0 0 MOERSITI KPKN ., NY 055813 77 28425
yani;3302226402970001; 5.6.5.202203091809 4 359877
1#0##0#0#0.0#2022-03-30
13:21:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9649e2f64010be419739450a7b84ce2f 150000 0 0 0 0 0
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3372030 C 3 CP 2 11/03/2022 11/03/2022 25/07/1989 0 2
0 0 - 0 - 0 - 0 - 0 296400 166661
reni;3313147010930001; 5.6.7.202204241238 4 359878
1#0##0#0#0.0#2022-06-13
09:04:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
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3372030 C 3 CP 2 11/03/2022 11/03/2022 05/06/1943 0 1
0 0 - 0 - 0 - 0 - 0 181400 207286
0 1 0 0 0 SOEPARTO BROTOATMOJO, TN 071688 78
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 359879
1#0##0#0#0.0#2022-03-30
13:23:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
78e8d569119855d9228b1198f107464a 150000 0 0 0 0 0
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3372030 C 3 CP 2 11/03/2022 11/03/2022 29/09/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARIA DIAH
1124R0020322V001802 0001211692601 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359799 15#0##0#0#0.0#2022-03-30
13:24:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9608915fdd0ddb73565d1cf8815ba3a1 258000 0 0 0 0 0
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3372030 C 3 CP 2 11/03/2022 11/03/2022 30/05/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 261298
0 1 0 0 0 SUNARYO. TN 100283 60 22200 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 359880
1#0##0#0#0.0#2022-03-30
13:25:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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0 76145 0 0 15000 0 20153 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 31/12/1976 0 2
0 - 0 - 0 - 0 - 0 549400 166661
0 1 0 0 0 WINDARTI.NY 095916 45 16506 DR. GUNAWAN,
SP.OG 1124R0020322V001804 0001127649295 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359881 1#0##0#0#0.0#2022-03-30
13:26:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/03/2022 11/03/2022 14/03/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 252629
0 1 0 0 0 SUYANTO,TN 029914 73 27025 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 359882
1#0##0#0#0.0#2022-03-30
13:27:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/03/2022 11/03/2022 20/02/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 198627
0 1 0 0 0 SUTARNO.TN 099981 54 19743 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 359883
1#0##0#0#0.0#2022-03-30
13:27:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
81998bdfdd9cd7f19f94aed46ff5662e 150000 0 0 0 0 0
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3372030 C 3 CP 2 11/03/2022 11/03/2022 18/12/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 221793
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yani;3302226402970001; 5.6.5.202203091809 4 359884
1#0##0#0#0.0#2022-03-30
13:28:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cd877a7142f1681c036ab98112d8705c 150000 0 0 0 0 0
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3372030 C 3 CP 2 11/03/2022 11/03/2022 20/10/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 288970
0 1 0 0 0 JAMHAR ROSYDI.TN 056006 58 21327 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359885
1#0##0#0#0.0#2022-03-30
13:32:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1fb743ea9889bc90dcaffdedc9e97740 150000 0 0 0 48000 0
0 31845 0 0 15000 0 44125 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 14/06/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 221793
0 1 0 0 0 TASLIM, TN 062892 65 24011 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 359886
1#0##0#0#0.0#2022-03-30
13:32:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
79ee91bdc587c09437792c7efd2fa6f4 150000 0 0 0 0 0
0 0 0 0 15000 0 56793 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 13/08/1979 0 1
0 0 - 0 - 0 - 0 - 0 181400 500481
0 1 0 0 0 YUSUF ARIMATEA ARIAN GUS BENU.TN 101151
0001105376455 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359887 1#0##0#0#0.0#2022-03-30
13:33:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
abff734784f5afe02fbd8ce0d0784958 150000 0 0 0 0 0
0 63690 0 0 15000 0 271791 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 02/05/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 221793
0 1 0 0 0 ANISA KURNIASARI, NY 093665 58 21498
yani;3302226402970001; 5.6.5.202203091809 4 359888
1#0##0#0#0.0#2022-03-30
13:34:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
446edbe78dc38cbe429a43efe3d99723 150000 0 0 0 0 0
0 0 0 0 15000 0 56793 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 26/05/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 208747
0 1 0 0 0 SRI REJEKI,NY 010002 59 21839 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359889
1#0##0#0#0.0#2022-03-30
13:38:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d3b275526ec6d54959a3b347d737eb97 150000 0 0 0 0 0
0 0 0 0 15000 0 43747 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 13/06/1992 0 2
1 Z09.8;K21.9 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 199618
3;JKN novia;3313125201940001; 5.6.7.202204241238 4 359890
1#0##0#0#0.0#2022-05-19
09:46:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
c8f8ef65f8b0bf5bba4050058af0eebc 150000 0 0 0 0 0
0 0 0 0 15000 0 34618 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 22/08/1947 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DYAH NURJANTI,(NY)
0000091082722 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359807 1#0##0#0#0.0#2022-03-30
13:39:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e596d225e8191748388600f16600c1e3 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 14/06/1957 0 2
1 Z09.8;E11.5 96.59 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 389852 0 1
0 0 0 SUPRIYATI.NY 102283 64 23646 DR. DAMAR ARYO,
SP.B 1124R0020322V001815 0000042745274 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359891 1#0##0#0#0.0#2022-03-30
13:42:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
92a94ea36ccf550a19f872f877f82221 235000 0 0 0 0 0
0 107890 0 0 15000 0 31962 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 07/07/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 213534
0 1 0 0 0 ENI PUJI ASTUTI 093122 64 23623 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359892
1#0##0#0#0.0#2022-03-30
13:43:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5c5f7b025671ac25f6ed3bed678495bb 150000 0 0 0 0 0
0 0 0 0 15000 0 48534 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 14/05/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 264290
0 1 0 0 0 SUPARNI, NY 098436 61 22581 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 359893
1#0##0#0#0.0#2022-03-30
13:51:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
87a6ef7c06f52b5cae42cd23746efe4a 150000 0 0 0 0 0
0 31845 0 0 15000 0 67445 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 15/05/2020 0 2
0 0 - 0 - 0 - 0 - 0 181400 179862
0 1 0 0 0 AQHILA KEYZHA PUTRI KUSUMA.AN 102131 1
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 359894
1#0##0#0#0.0#2022-03-30
13:52:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
267f8b50f7abe3856123cba3fc77649c 150000 0 0 0 0 0
0 0 0 0 15000 0 14862 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 08/11/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 400195
0 1 0 0 0 MARYADI.TN 099762 69 25325 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 359895
1#0##0#0#0.0#2022-03-30
13:53:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0c737767ba56afdfb06430d9ba06b58e 150000 0 0 0 48000 0
0 88900 0 0 15000 0 98295 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 13/06/1971 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002169781694 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359793 1#0##0#0#0.0#2022-03-30
13:55:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
13734a1851d33e83eb956d00d0e358ae 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 01/11/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 219760
0 1 0 0 0 KUSTIATI, NY 048553 60 22045 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359896
1#0##0#0#0.0#2022-03-30
13:55:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
16e0ae2217d5c8ce092a3ba66696b882 150000 0 0 0 0 0
0 0 0 0 15000 0 54760 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 07/01/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 264946
0 1 0 0 0 NANIK PARINI, NY 090085 49 17960 DR.
novia;3313125201940001; 5.6.7.202204241238 4 359897
1#0##0#0#0.0#2022-05-19
10:58:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
93358985bc9517d65bb0e13c15136903 150000 0 0 0 0 0
0 0 0 0 15000 0 99946 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 25/12/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 221793
0 1 0 0 0 BAMBANG RISTANTO.TN 087710 50 18339
yani;3302226402970001; 5.6.5.202203091809 4 359898
1#0##0#0#0.0#2022-03-30
13:57:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c96c40f64d3311fd6ea2409a00855eda 150000 0 0 0 0 0
0 0 0 0 15000 0 56793 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 06/06/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 206250
0 1 0 0 0 SUPARMAN, BP 045790 67 24750 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359899
1#0##0#0#0.0#2022-03-30
13:58:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7c4234e2a3d9df83d182c261bb2509fe 150000 0 0 0 0 0
0 0 0 0 15000 0 41250 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 20/10/1950 0 2
0 - 0 107400 273000 0 1 0 0 0
BADRIYAH MUNAWARAH,(NY) 043414 71 26075 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V001825 0000091089088 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359802 1#0##0#0#0.0#2022-03-30
13:59:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
147d9d9192d13742b8da4e4a63ffa501 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 22/09/1959 0 1
0 - 0 107400 273000 0 1 0 0 0
1124R0020322V001826 0001032587199 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 359805 1#0##0#0#0.0#2022-05-19
10:43:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
962a45fd9993f43fdd1cb73482e1d87c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 07/02/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 323196
0 1 0 0 0 BONAWAN.TN 089880 53 19390 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 359900
1#0##0#0#0.0#2022-03-30
14:07:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3f6d39363da68f54b6ee1590ef304284 150000 0 0 0 0 0
0 89500 0 0 15000 0 68696 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 31/12/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 201014
0 1 0 0 0 SITI MARYAM, NY 093234 68 24907 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359901
1#0##0#0#0.0#2022-03-30
14:08:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
867f477fd01d883e8d30e5449c702984 150000 0 0 0 0 0
0 0 0 0 15000 0 36014 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 09/11/1969 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
1397723 0 1 0 0 0 HARI SANTOSO.TN 079533 52
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 359902
1#0##0#0#0.0#2022-03-30
14:08:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5411bb8d285eaf7895ebd36517228b64 150000 0 0 0 0 0
0 76045 0 0 15000 0 1156678 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 25/03/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 206714
0 1 0 0 0 SUPINAH 091220 66 24458 DR. WAHYU
novia;3313125201940001; 5.6.7.202204241238 4 359903
1#0##0#0#0.0#2022-05-19
11:04:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
2a5396a077ced10e43e8ef18e8a584c1 150000 0 0 0 0 0
0 0 0 0 15000 0 41714 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 11/09/1947 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 TUKIMAN.TN 098571
0000555611016 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359800 1#0##0#0#0.0#2022-03-30
14:10:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4288711dd6c7b62b6b45337ac990bd9b 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 06/04/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 221793
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 359904
1#0##0#0#0.0#2022-03-30
14:11:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
af2ecb154c8ac712de2da2b8242adc0f 150000 0 0 0 0 0
0 0 0 0 15000 0 56793 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 26/02/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 504990
0 1 0 0 0 SRIYANTI SUGENG LESTARI 085690 64 23389
yani;3302226402970001; 5.6.5.202203091809 4 359905
1#0##0#0#0.0#2022-03-30
14:13:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9470dda360b4ea17ceab3d37761d3d97 150000 0 0 0 0 0
0 0 0 0 15000 0 339990 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 12/01/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 200112
0 1 0 0 0 WAKIRAH 054586 64 23434 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 359906
1#0##0#0#0.0#2022-03-30
14:14:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7539be505ffec452babc0cb0e6cf3cbf 150000 0 0 0 0 0
0 0 0 0 15000 0 35112 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 31/12/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI SUWANTI, NY
0001967417043 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359804 1#0##0#0#0.0#2022-03-30
14:15:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ef42a07cd84950b6f7e3459ae4b283e1 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 20/06/1943 0 2
0 0 - 0 - 0 - 0 - 0 181400 219760
0 1 0 0 0 HARTINI.NY 079458 78 28754 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 359907
1#0##0#0#0.0#2022-03-30
14:17:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
50dc428ac3f0ea0491388f4df1d42afb 150000 0 0 0 0 0
0 0 0 0 15000 0 54760 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 27/09/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 299804
0 1 0 0 0 LESTARI RAHAYU, NY 086211 64 23541
yani;3302226402970001; 5.6.5.202203091809 4 359908
1#0##0#0#0.0#2022-03-30
14:18:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5a0523a2b5034a4a2f22032d725b99a4 150000 0 0 0 0 0
0 31845 0 0 15000 0 102959 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 11/11/1965 0 2
2 N85.8 - - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 193446
0 1 0 0 0 SRI YANI, NY 071324 56 20574 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359909
1#0##0#0#0.0#2022-03-30
14:19:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
81d2639d6ca1e46de7b8cc53ea4dd5d0 150000 0 0 0 0 0
0 0 0 0 15000 0 28446 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 26/08/2020 0 2
0 0 - 0 - 0 - 0 - 0 181400 174040
0 1 0 0 0 DEFARA SHANUM S, AN 101903 1 562
yani;3302226402970001; 5.6.5.202203091809 4 359910
1#0##0#0#0.0#2022-03-30
14:20:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4505ab79bc07b33356f90cb3d20f3e78 150000 0 0 0 0 0
0 0 0 0 15000 0 9040 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 31/10/1955 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 DAL HARI
PURNOMO.TN 078559 66 24238 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V001841 0001703140593 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359815 1#0##0#0#0.0#2022-03-30
14:21:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dfc5b62b6a9862f504891c24cda70518 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 07/03/1998 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 NOERMALA DWI R, NN 008273 24 8770
yani;3302226402970001; 5.6.5.202203091809 4 359911
1#0##0#0#0.0#2022-03-30
14:22:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
340e1663bb0aaff926f48441e08d0743 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 01/01/2000 0 1
0 0 - 0 - 0 - 0 - 0 181400 248952
0 1 0 0 0 SUPOMO., BP 044186 22 8105 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 359912
1#0##0#0#0.0#2022-03-30
14:23:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d7b715144028628ca40a87daddce7a2a 150000 0 0 0 0 0
0 0 0 0 15000 0 83952 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 20/07/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SITI ZUHRIYAH,(NY)
0000091194276 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359827 1#0##0#0#0.0#2022-03-30
14:24:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
76cff688bde49f9ca1640111aa6fe633 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 04/11/1994 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 RAUHULLOH
1124R0020322V001846 0001796644269 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 359824 1#0##0#0#0.0#2022-05-19
13:39:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
1fef58195e98e09c5044a301a49b8e51 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 02/02/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUJIYEM, NY 090600
0001696847466 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359818 1#0##0#0#0.0#2022-03-30
14:26:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8e922a5fb73ed16c13ac03e76f60268b 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 06/06/1983 0 2
0 0 - 0 - 0 - 0 - 0 181400 361804
0 1 0 0 0 ERNA RAHAYU, (NY) 000037 38 14158 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359913
1#0##0#0#0.0#2022-03-30
14:26:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
744a9ff4971c357902b6839ecefff162 150000 0 0 0 0 0
0 120795 0 0 15000 0 76009 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 24/02/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 208000 0 1 0 0 0 SRI PURWANI.NY
0001125886228 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359820 1#0##0#0#0.0#2022-03-30
14:27:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9c3d195e861517337f6e20b78bca04c5 193000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 23/03/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 226127
0 1 0 0 0 SUMARNI, NY 074054 62 22999 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 359914
1#0##0#0#0.0#2022-03-30
14:28:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6d59e48c1024a583c788c49a8aa81612 150000 0 0 0 0 0
0 0 0 0 15000 0 61127 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 29/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 AGNES WIDHA
1124R0020322V001851 0002168632721 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359795 1#0##0#0#0.0#2022-03-30
14:29:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c424740734a01596154398b5fb565871 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 05/05/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SURYATI, NY 090097
0001479655326 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359814 1#0##0#0#0.0#2022-03-30
14:30:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6ba5a7c68bd14f27c033ef9b9800923e 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 17/01/1940 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SITI JAHIDJAH, NY
0000091261743 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359826 1#0##0#0#0.0#2022-03-30
14:34:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e8c943aebed4b5856e3fa324ed219845 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 05/01/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 221793
0 1 0 0 0 SUPARTI.NY 101245 51 18693 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 359915
1#0##0#0#0.0#2022-03-30
14:36:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
394e5ecce1159adf963a7c2afbb7bef7 150000 0 0 0 0 0
0 0 0 0 15000 0 56793 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 08/06/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 LAMIYEM.NY 087484
0001316300512 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359821 1#0##0#0#0.0#2022-03-30
14:37:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6c340fb78d262bf97d15e5810e101c19 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 03/09/1973 0 2
1 Z09.8;F03;G47.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 273829
0 1 0 0 0 ASQORIAH,(NY) 031366 48 17721 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359916
1#0##0#0#0.0#2022-03-30
14:38:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9a6fc4c78c1055cfc3cea9a5d91195d7 150000 0 0 0 0 0
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3372030 C 3 CP 2 11/03/2022 11/03/2022 05/01/1951 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ACHMAD SUPARDI.,
0001693922106 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359819 1#0##0#0#0.0#2022-03-30
14:40:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1fca39c64a9623f6245ad16b4dd04fe5 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 09/11/1965 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUMIYATI, NY
0000091584066 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359829 1#0##0#0#0.0#2022-03-30
14:42:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b4cb577a365dff3720b75bec92e7ca96 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 12/01/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 EKO RINI.NY 093223
0000091524159 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359816 1#0##0#0#0.0#2022-03-30
14:43:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aeb6f2699b93fbd2bc4f81971a251369 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 02/08/1952 0 2
0 - 0 - 0 - 0 129600 216250 0 1
0 0 0 SUTARNI.NY 102327 69 25423 DR. WAHYU PURNOMO, SP.OT
1124R0020322V001863 0000091171991 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359917 1#0##0#0#0.0#2022-03-30
14:45:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
157f1d8d29666f885fa041ef6f383830 150000 0 0 0 0 0
0 0 0 0 25000 0 41250 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 23/06/2014 0 1
0 0 - 0 - 0 - 0 - 0 181400 190820
0 1 0 0 0 MUH REYHAN HAFIDZ.AN 099069 7 2818
yani;3302226402970001; 5.6.5.202203091809 4 359918
1#0##0#0#0.0#2022-03-30
14:47:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5e3492787859da4fab96000ed7702fb8 150000 0 0 0 0 0
0 0 0 0 15000 0 25820 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 20/11/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 314689
0 1 0 0 0 MUGIYONO, TN 101718 55 20200 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359919
1#0##0#0#0.0#2022-03-30
14:51:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b902faef3f234a27b06e5090d7a4ad40 150000 0 0 0 0 0
0 0 0 0 15000 0 149689 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 14/04/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 203247
0 1 0 0 0 MARTINAH., NY 072061 61 22611 DR.
novia;3313125201940001; 5.6.7.202204241238 4 359920
1#0##0#0#0.0#2022-05-19
10:02:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
c430b76399581bb2244310984df4c1a5 150000 0 0 0 0 0
0 0 0 0 15000 0 38247 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 01/09/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 221793
0 1 0 0 0 MURSAMTORO 086759 68 25028 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 359921
1#0##0#0#0.0#2022-03-30
14:53:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1a99bfa67941a0aadb1f79cfe9f2faef 150000 0 0 0 0 0
0 0 0 0 15000 0 56793 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 10/05/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 218587
0 1 0 0 0 SURATMI, NY 101469 62 22951 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 359922
1#0##0#0#0.0#2022-03-30
14:54:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6f0bc86794c616373157e8d4f221d134 150000 0 0 0 0 0
0 31845 0 0 15000 0 21742 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 13/04/1952 0 1
1 Z09.8;D64.8;K21.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 204090
0 1 0 0 0 SUKIMAN PRIYOSUKARTO, TN 070987 69
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 359923
1#0##0#0#0.0#2022-03-30
14:55:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
75e67bb959a491f96ec87e1066915631 150000 0 0 0 0 0
0 0 0 0 15000 0 39090 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 24/07/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 531000 0 1 0 0 0 SUTAMI.NY 099959
0000640553196 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
359817 1#0##0#0#0.0#2022-05-20
08:20:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
b600dfd7dcd6aa758cc341b87be43131 516000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 12/08/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 195360
0 1 0 0 0 SRI HARTATI.NY 091544 54 19935 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359924
1#0##0#0#0.0#2022-03-30
15:04:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e346365f64ef2c35eb592c8e8e3c9dd3 150000 0 0 0 0 0
0 0 0 0 15000 0 30360 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 17/06/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 191714
0 1 0 0 0 PARTINI.NY 099592 55 20356 DR. INDRIANY
yani;3302226402970001; 5.6.5.202203091809 4 359925
1#0##0#0#0.0#2022-03-30
15:06:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a63a3bac84b3967aa2e503698d1f01b3 150000 0 0 0 0 0
0 0 0 0 15000 0 26714 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 17/07/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 289000
0 1 0 0 0 LIANA ANGGRIANI, NY 102061 44 16308
agung;3313092303950002; 5.6.6.202203301209 4 362027
1#0##0#0#0.0#2022-04-11
12:24:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e7fa479ce06a515978775d5037a3ed66 274000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 13/06/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 182543
0 1 0 0 0 ELIDA EFFIANI, NY 099176 51 18899 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359927
1#0##0#0#0.0#2022-03-30
15:09:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4245b667f1aed3519f8cf7bb0717bcdd 150000 0 0 0 0 0
0 0 0 0 15000 0 17543 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 14/07/1959 0 2
1 Z09.8;H81.3;K52.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 178111
0 1 0 0 0 MARDIYAH, NY 043267 62 22886 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359928
1#0##0#0#0.0#2022-03-30
15:12:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5eb06775c5aec59825d88d076054e3b1 150000 0 0 0 0 0
0 0 0 0 15000 0 13111 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 09/05/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 212546
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 359929
1#0##0#0#0.0#2022-03-30
15:13:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a3b0cb554f307e8214597fb83b245e9d 150000 0 0 0 0 0
0 0 0 0 15000 0 47546 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 02/03/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 204963
0 1 0 0 0 WIRYANTI.NY 099756 50 18271 DR. INDRIANY
yani;3302226402970001; 5.6.5.202203091809 4 359930
1#0##0#0#0.0#2022-03-30
15:14:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3504f431fec05ee594c6ee24b1fab77a 150000 0 0 0 0 0
0 0 0 0 15000 0 39963 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 17/11/1959 0 1
- 0 - 0 - 0 - 0 283800 376952 0
1 0 0 0 AKHMAD ISNANTO.TN 086414 62 22760 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 359931
1#0##0#0#0.0#2022-03-30
15:15:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
59c230dfe26c98a9a9c6f50b75b07ec6 300000 0 0 0 0 0
0 0 0 0 15000 0 61952 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 26/06/1967 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MARUTO.TN 006163 54 19982 DRG. VERAWATY,
SP.KG 1124R0020322V001884 0001103428361 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359932 1#0##0#0#0.0#2022-03-30
15:16:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ffffd8962d22d2b4b7ae29d5e00482a4 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 15/06/1986 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SITI ROCHANI.NY 100171 35 13053 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359933
1#0##0#0#0.0#2022-03-31
08:54:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2733fd44757675da9679dc11af798c76 300000 0 0 0 0 0
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3372030 C 3 CP 2 11/03/2022 11/03/2022 23/04/1994 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 SINTA APRILIYA, NY 077321 27 10184 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359934
1#0##0#0#0.0#2022-03-31
08:55:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1a51697532881099cf668881c87d2e66 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 13/03/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 252967
0 1 0 0 0 CHRISTINA MARGARETNA, NY 043869 43
0001292319922 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359935 1#0##0#0#0.0#2022-03-31
08:57:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b57702c6be24fa6742660e38a66a1abc 150000 0 0 0 0 0
0 0 0 0 15000 0 87967 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 21/04/1950 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RINDUAN JANNUWAR, TN 052069 71 26257 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359936
1#0##0#0#0.0#2022-03-31
08:58:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f92f26e94342a421bbdc553466349061 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 02/02/1995 0 1
0 - 0 - 0 - 0 283800 317046 0 1
0 0 0 RUDI PRIYANTO, SDR 102277 27 9899 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359937
1#0##0#0#0.0#2022-03-31
08:58:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
32a21260ef3ed714c455cbb9cc6f8347 300000 0 0 0 0 0
0 0 0 0 15000 0 2046 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 30/10/2000 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 WAHYU PUTRI HASANAH.NY 101780 21 7802 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359938
1#0##0#0#0.0#2022-03-31
08:59:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e29c69099814b98a09c7fba23279b3f3 300000 0 0 0 0 0
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3372030 C 3 CP 2 11/03/2022 11/03/2022 10/06/1998 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SIA WIDYANINGRUM 100974 23 8675 DRG.
agung;3313092303950002; 5.6.6.202203301209 4 359939
1#0##0#0#0.0#2022-04-11
12:02:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
6514beac23851a8802e5a19a548270fa 300000 0 0 0 0 0
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3372030 C 3 CP 2 11/03/2022 11/03/2022 31/05/1954 0 1
- 0 - 0 - 0 - 0 206700 165000 0
1 0 0 0 MURYONO.TN 102320 67 24756 DRG. VERAWATY,
SP.KG 1124R0020322V001893 0001529735321 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359940 1#0##0#0#0.0#2022-03-31
09:01:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4cedee3473b94632b863a40c8d3d34c6 150000 0 0 0 0 0
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3372030 C 3 CP 2 11/03/2022 11/03/2022 30/07/1985 0 2
- 0 - 0 - 0 - 0 283800 315000 0
yani;3302226402970001; 5.6.6.202203301209 4 359941
1#0##0#0#0.0#2022-03-31
09:02:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b77545908f7fb6414691c664357aa935 300000 0 0 0 0 0
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3372030 C 3 CP 2 11/03/2022 11/03/2022 09/05/1945 0 1
- 0 - 0 - 0 - 0 283800 320830 0
1 0 0 0 MUH ALWANI NGISOM, TN 064944 76 28065 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359942
1#0##0#0#0.0#2022-03-31
09:03:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8f08d52590b4be94d869cfc2c9bb0e4c 300000 0 0 0 0 0
0 0 0 0 15000 0 5830 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 12/11/1996 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 NOVIANA SARI DEWI.NN 102321 25 9250 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359943
1#0##0#0#0.0#2022-03-31
09:07:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ad36cb2cf017ff5e9450ed5bf819aecc 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 21/08/2003 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 HERLINDA DWI AGUSTIN 100930 18 6777 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359944
1#0##0#0#0.0#2022-03-31
09:08:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3478739aa743e8480a6e2d865dd300db 300000 0 0 0 0 0
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3372030 C 3 CP 2 11/03/2022 11/03/2022 21/02/1960 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0001302917049 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
359828 1#0##0#0#0.0#2022-05-20
07:58:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 11/03/2022 11/03/2022 28/07/2003 0 2
0 0 - 0 - 0 - 0 - 0 181400 225192
0 1 0 0 0 TARIA SYLVIA NABILA.NN 101251 18 6801
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359945
1#0##0#0#0.0#2022-03-31
09:09:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
729a34c083b15502f535b34e3b9d81a6 150000 0 0 0 0 0
0 0 0 0 15000 0 60192 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 16/02/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 243166
0 1 0 0 0 SUTRASMI.NY 093458 72 26321 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 359946
1#0##0#0#0.0#2022-03-31
09:10:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8fc828d42af14755031a2bc193253c6b 150000 0 0 0 0 0
0 0 0 0 15000 0 78166 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 16/01/1971 0 1
0 - 0 - 0 - 0 283800 325000 0 1
0 0 0 MUCHAIMIN BACHRI.TN 102328 51 18682 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359947
1#0##0#0#0.0#2022-03-31
09:11:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7c677a1ddfef0fe2ec3132abb16289d2 300000 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 13/08/1986 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ETI DEKAWATI, NY 102148 35 12994 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359948
1#0##0#0#0.0#2022-03-31
09:12:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5fc601a74edf4d372410e6d18391b3dd 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 01/07/1973 0 1
0 - 0 - 0 - 0 283800 320830 0 1
0 0 0 LILIK TRI HENDRAWANTO.TN 102322 48 17785 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359949
1#0##0#0#0.0#2022-03-31
09:12:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
428cbd990a47f099be5593f312764202 300000 0 0 0 0 0
0 0 0 0 15000 0 5830 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 03/08/2002 0 1
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 WAFI IZZULHAQ.SDR 102323 19 7160 DRG. VERAWATY,
SP.KG 1124R0020322V001906 0001478735245 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359950 1#0##0#0#0.0#2022-03-31
09:13:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
69883032b7c58a7d02116028004a8cee 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 29/03/1968 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ARI SURYANI.NY 100179 53 19705 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359951
1#0##0#0#0.0#2022-03-31
09:13:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e4be193c39f27195e0de95876ac4e6f1 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 08/11/1981 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 RESKI NOVIASARI.NY 100289 40 14733
yani;3302226402970001; 5.6.6.202203301209 4 360585
1#0##0#0#0.0#2022-03-31
09:14:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1633cbc02146839f6bddb8fc34f1f0b4 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 20/04/1988 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SRI SUYAMTI, NY 101812 33 12378 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359952
1#0##0#0#0.0#2022-03-31
09:15:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0a9ae24f115969777972bd06a40199bc 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 28/02/1992 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 LINA PRIH HARYATI.NY 101932 30 10969 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359953
1#0##0#0#0.0#2022-03-31
09:16:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8081e33b7db3ebcdbee88c0f9fb3a902 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 01/04/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 203430
0 1 0 0 0 SRI MULYANI.NY 102329 50 18607 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359954
1#0##0#0#0.0#2022-03-31
09:17:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
57b2ce88c087520ee4096d56987c7c8e 150000 0 0 0 0 0
0 0 0 0 25000 0 28430 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 31/10/1989 0 2
0 0 - 0 - 0 - 0 - 0 296400 182248
0 1 0 0 0 NIKEN ANGGRAINI, NY 069304 32 11819
novia;3313125201940001; 5.6.7.202204241238 4 359955
1#0##0#0#0.0#2022-05-19
09:32:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
ad7bbeef50eaba0199134e05c9645ecc 150000 0 0 0 0 0
0 0 0 0 15000 0 17248 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 09/01/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 490008
0 1 0 0 0 SONDAH SRI PATMOKO.TN 100513 57 20880
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359956
1#0##0#0#0.0#2022-03-31
09:19:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
661e713bc11425399fdb909e7002e3f9 150000 0 0 0 0 0
0 0 0 0 15000 0 325008 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 21/04/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 277373
0 1 0 0 0 SITI MAISAROH,(NY) 039887 70 25892
yani;3302226402970001; 5.6.6.202203301209 4 359957
1#0##0#0#0.0#2022-03-31
09:19:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a6c9f827854131711f76c3f1a8930469 150000 0 0 0 0 0
0 0 0 0 15000 0 112373 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 31/10/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 215785
0 1 0 0 0 SUKAMTI.NY 099960 62 22777 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 359958
1#0##0#0#0.0#2022-03-31
09:20:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
859d057ba78d02663210c8d2e20ce4b2 150000 0 0 0 0 0
0 0 0 0 15000 0 50785 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 31/12/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 208362
0 1 0 0 0 INDRAYATI, NY 091755 58 21255 DR.
novia;3313125201940001; 5.6.7.202204241238 4 359959
1#0##0#0#0.0#2022-05-19
11:08:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
87d059368fc68bc0610a5495861afb9a 150000 0 0 0 0 0
0 0 0 0 15000 0 43362 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 03/03/1979 0 1
1 K05.3 - - None None None None Q-5-12-0 None None
- 0 - 0 - 0 - 0 206700 165000 0
1 0 0 0 ANDRIANUS PRIADI.S, TN 007676 43 15714 DRG.
novia;3313125201940001; 5.6.7.202204241238 4 359960
1#0##0#0#0.0#2022-05-18
10:38:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
0c4808ac4643a8a87575fd3a5c0d387f 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 31/05/1985 0 2
- 0 - 0 - 0 - 0 283800 322645 0
1 0 0 0 KHOMSAH JANNATUM.M, NY 033867 36 13433 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359961
1#0##0#0#0.0#2022-03-31
09:22:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1ae3207e8274fc4d7bec82ad430250b9 300000 0 0 0 0 0
0 0 0 0 15000 0 7645 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 01/11/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 251279
0 1 0 0 0 NUNUK WINARNI, NY 100435 62 22776 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359962
1#0##0#0#0.0#2022-03-31
09:23:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
65987ce477b80a68fee761ba577af647 150000 0 0 0 0 0
0 0 0 0 15000 0 86279 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 11/08/1989 0 1
0 0 - 0 - 0 - 0 - 0 181400 206778
0 1 0 0 0 YUSUF SANDIYANTO.TN 096055 32 11900
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359963
1#0##0#0#0.0#2022-03-31
09:24:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2b175509eeae7000d270f7979d80e24d 150000 0 0 0 0 0
0 0 0 0 15000 0 41778 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 07/10/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 468079
0 1 0 0 0 YATINI 094257 51 18783 DR. ARIA
novia;3313125201940001; 5.6.7.202204241238 4 359964
1#0##0#0#0.0#2022-05-19
13:13:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
6ff727f5e0465c01faf27ab2a01757f3 150000 0 0 0 0 0
230000 0 0 0 15000 0 73079 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 30/08/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 198611
0 1 0 0 0 SRI LESTARI. NY 072132 55 20282 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359965
1#0##0#0#0.0#2022-03-31
09:25:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9900d06680f4fea78b30aa9b2c2fa423 150000 0 0 0 0 0
0 0 0 0 15000 0 33611 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 31/12/1946 0 2
0 0 - 0 - 0 - 0 - 0 181400 280859
0 1 0 0 0 HARTATI,(NY) 034422 75 27464 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359966
1#0##0#0#0.0#2022-03-31
09:27:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7d15a471cba255af4eae4f41bd1ffb40 150000 0 0 0 0 0
0 0 0 0 15000 0 115859 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 02/08/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 237347
0 1 0 0 0 SITI MAJIAH, NY 094003 69 25423 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359967
1#0##0#0#0.0#2022-03-31
09:28:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
40fff9cdcb7c611f143551a24be3dd3f 150000 0 0 0 0 0
0 0 0 0 15000 0 72347 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 12/06/1972 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359851
1#0##0#0#0.0#2022-03-31
09:31:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
894607fee253e05322f5b6fe47b8d8c6 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 17/04/1961 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359849
1#0##0#0#0.0#2022-03-31
09:31:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4931bb6352cd47a3b716941793be1a1c 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 01/04/1981 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V001928 0001904830593 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359844 1#0##0#0#0.0#2022-03-31
09:32:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fcec8b18cc291f2e36da66f48350d828 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 01/12/1958 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V001929 0001436949538 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359843 1#0##0#0#0.0#2022-03-31
09:32:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fdb05d01f82f10eedcb73a8c30ab0af4 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 25/05/1972 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V001930 0002431552465 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359842 1#0##0#0#0.0#2022-03-31
09:33:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ef6a544d4c3d593b9dd7856f9932f114 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 20/08/1959 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V001931 0000571256594 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359840 1#0##0#0#0.0#2022-03-31
09:33:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
412ee2f21dc810bf1c3b5fcd5d33a5df 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 26/04/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359836
1#0##0#0#0.0#2022-03-31
09:34:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
844c880823b0ba9f4c7f5a402101ac5a 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 01/12/1980 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V001933 0000640230884 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359834 1#0##0#0#0.0#2022-03-31
09:35:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
db41b35ec7eec993f2638e208dd119fe 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 08/03/1967 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359831
1#0##0#0#0.0#2022-03-31
09:35:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
945a68a6375d8f09602e87515904996e 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 03/12/1950 0 1
0 - 0 - 0 - 0 786200 684243 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359866
1#0##0#0#0.0#2022-03-31
09:36:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cd56dc8d175d759f3e0db9ac4d1d3053 662676 0 0 0 0 0
0 0 0 0 15000 0 6567 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 09/09/1944 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V001936 0000100867893 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359865 1#0##0#0#0.0#2022-03-31
09:37:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a20aa02f415e1bac8da576d12f3241f8 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 18/07/1964 0 1
0 - 0 - 0 - 0 786200 572748 0 1
SP.PD 1124R0020322V001937 0002425018184 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359864 1#0##0#0#0.0#2022-03-31
09:38:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
56b661ad4de5c2b21e5c332322853da2 463830 0 0 0 0 0
0 0 0 0 15000 0 93918 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 31/12/1981 0 2
0 - 0 - 0 - 0 786200 493690 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359862
1#0##0#0#0.0#2022-03-31
09:38:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
accf29928eabdec9626398f852c74a8a 463830 0 0 0 0 0
0 0 0 0 15000 0 14860 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 02/02/1972 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V001939 0002070978546 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359861 1#0##0#0#0.0#2022-03-31
09:39:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ffb6846f29cd9e0f01049e2958b417e5 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 14/03/1977 0 1
0 - 0 - 0 - 0 786200 521796 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359858
1#0##0#0#0.0#2022-03-31
09:40:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eee37d341aa91e7a6f2b0ff22222ef08 463830 0 0 0 0 0
0 0 0 0 15000 0 42966 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 12/03/1955 0 2
0 - 0 - 0 - 0 786200 587202 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359857
1#0##0#0#0.0#2022-03-31
09:41:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7dc8694163d1f203220267c4468164d4 463830 0 0 0 0 0
0 0 0 0 15000 0 108372 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 01/01/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V001942 0001147281805 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359854 1#0##0#0#0.0#2022-03-31
09:41:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
28940ca810b08486b6e98dc911908287 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 21/08/1985 0 2
0 0 - 0 - 0 - 0 - 0 181400 207863
0 1 0 0 0 EMI ERNAWATI, NY 100379 36 13351 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359968
1#0##0#0#0.0#2022-03-31
09:42:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
11f676fbc9e88fc9db848ac2af8bac6a 150000 0 0 0 0 0
0 0 0 0 15000 0 42863 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 15/11/1985 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SRI LESTRARI, NY 101712 36 13265 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359969
1#0##0#0#0.0#2022-03-31
09:43:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0fdc14add401314f970f7e822189f2a6 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 15/04/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 205090
0 1 0 0 0 SUMARSI.NY 102132 55 20419 DR. INDRIANY
yani;3302226402970001; 5.6.6.202203301209 4 359970
1#0##0#0#0.0#2022-03-31
09:45:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
50461fd156d9bc6aeea543bca16e0c20 150000 0 0 0 0 0
0 0 0 0 15000 0 40090 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 05/04/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 200790
0 1 0 0 0 ABDUL KHARIS, TN 017985 52 19333 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359971
1#0##0#0#0.0#2022-03-31
09:46:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fb71e9542fe47a15de69dca8cd8c0eeb 150000 0 0 0 0 0
0 0 0 0 15000 0 35790 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 25/01/2011 0 2
1 Z03.8;A16.2 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 JELINA SATITI .(AN) 026654 11 4063
0000203886898 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
359972 1#0##0#0#0.0#2022-05-18
10:56:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
22a04bc495b60301288ce8df80c298d7 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 01/01/2000 0 1
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 ANAK AGUNG ARYA PUTRA., AN 042919 22 8105 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359973
1#0##0#0#0.0#2022-03-31
09:49:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c6e672e7b4627213ca82fb591a5ab158 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 12/09/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 233437
0 1 0 0 0 ENDANG SRIWIDIASTUTI,NY 088712 50 18443
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359974
1#0##0#0#0.0#2022-03-31
09:50:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
da56b98462176656379bc9e775317899 150000 0 0 0 0 0
0 0 0 0 15000 0 68437 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 06/07/1993 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SITI NUR CHASANAH.NY 101502 28 10475 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359975
1#0##0#0#0.0#2022-03-31
09:56:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a21438ca20cf873d49ee9eb03a0ac22f 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 02/08/2003 0 2
- 0 - 0 - 0 - 0 283800 315000 0
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359976
1#0##0#0#0.0#2022-03-31
09:57:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4028488bcc9ee2d2734f3ba29c8e5a77 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 08/05/1989 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 FARIZ CANDRA K, TN 102275 32 11995 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359977
1#0##0#0#0.0#2022-03-31
09:58:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b15ffdee273091b05bcfe2b95f7ec4d3 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 01/09/1967 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 DARYONO, TN 018372 54 19915 DRG. VERAWATY,
SP.KG 1124R0020322V001959 0001966857344 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359978 1#0##0#0#0.0#2022-03-31
09:58:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
81496bff7357cfca81dfe88cd7c795b1 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 10/11/1965 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 TOTOK HERU S., BP 044918 56 20575 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359979
1#0##0#0#0.0#2022-03-31
09:59:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
24e6cf0fbc9f10d8a370293797edd70c 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 18/08/1981 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 YENI SULAIKAH, NY 100541 40 14815 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359980
1#0##0#0#0.0#2022-03-31
10:01:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2067d662499c3ee43e5d31c7199a9f6d 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 09/11/1975 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 WIDI ASTUTI, NY 101242 46 16924 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359981
1#0##0#0#0.0#2022-03-31
10:02:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b7747d0bb8adf65654b65f2074f16990 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/03/2022 11/03/2022 31/07/1982 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RITA INDRIYANI, NY 066587 39 14468 DRG.
yani;3302226402970001; 5.6.6.202203301209 4 359982
1#0##0#0#0.0#2022-03-31
10:02:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6a1221cb4d00538fd079b161352a78cd 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 25/04/1992 0 2
1 R11 - - - None None None None Q-5-25-0 None None
0 - 0 - 0 - 0 135700 208144 0 1
0 0 0 GALUH FITRIA KHARIS.NN 005110 29 10913 DR. YOSSI
REZA GIMAWAN 1124R0020322V001974 0001106194509 3;JKN
reni;3313147010930001; 5.6.6.202203301209 4 361001
1#0##0#0#0.0#2022-04-04
17:12:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e73469c7d4ad9305d8702d049558587a 155000 0 0 0 0 0
0 0 0 0 15000 0 38144 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 02/05/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 206714
0 1 0 0 0 RUMIATI 086640 49 18211 DR. WAHYU
yani;3302226402970001; 5.6.6.202203301209 4 358380
1#0##0#0#0.0#2022-04-01
14:27:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9c20aad1b3a38cc0a8fd6fd697bf5bc5 150000 0 0 0 0 0
0 0 0 0 15000 0 41714 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 31/12/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 222849
0 1 0 0 0 SARSIYEM.NY 091368 72 26369 DR. WAHYU
reni;3313147010930001; 5.6.5.202203091809 4 358379
1#0##0#0#0.0#2022-03-18
09:27:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f01d754bc2bf1b15dee9d11674e6ce7e 150000 0 0 0 0 0
0 0 0 0 15000 0 57849 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 01/01/2000 0 1
1 M54.59;W01.0 87.24 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 422392
0 1 0 0 0 AGUNG .,BP 049539 22 8106 DR. WAHYU
yani;3302226402970001; 5.6.6.202203301209 4 360779
1#0##0#0#0.0#2022-04-01
14:35:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
715350c706d20415876a3c365c371f0f 150000 0 0 0 0 0
220000 0 0 0 15000 0 37392 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 03/03/1949 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MUYAS SAROH, NY
0000091167748 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
360803 1#0##0#0#0.0#2022-04-01
14:40:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bff4306f585ebab6ac3ed8ed17067bee 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 25/05/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 221793
0 1 0 0 0 ABDUL BASIT. TN 083887 61 22571 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358381
1#0##0#0#0.0#2022-04-01
14:41:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d260328c93b1760ca377bf55a672b2bc 150000 0 0 0 0 0
0 0 0 0 15000 0 56793 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 21/06/2005 0 1
1 Z09.4;S52.50 97.88 - - None None None None M-3-11-0
0 404900 194843 0 1 0 0 0 TEUNGKU
BUDIYANSYAH, AN 015597 16 6108 DR. WAHYU PURNOMO, SP.OT
1124R0020322V001980 0001108062527 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358382 1#0##0#0#0.0#2022-04-01
14:42:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c674571865db370fc37a851fca156de0 150000 0 0 0 0 0
0 0 0 0 15000 0 29843 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 03/07/1963 0 2
- 0 - 0 - 0 - 0 138400 240000 0
1 0 0 0 SOLICHATI, NY 089498 58 21437 DR. LINDA
yani;3302226402970001; 5.6.6.202203301209 4 358359
1#0##0#0#0.0#2022-04-01
14:42:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
965308744e109aed8b83538398b63751 225000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 21/02/1960 0 2
1 Z09.8;E11.9;I11.9 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 310871
0 1 0 0 0 SRI HARYATI.NY 099070 62 22665 DR.
novia;3313125201940001; 5.6.7.202204241238 4 358383
1#0##0#0#0.0#2022-05-20
07:58:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
0ba6922d6a25cccc4c0744a084a449ca 150000 0 0 0 0 0
0 31845 0 0 15000 0 114026 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 02/04/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 211037
0 1 0 0 0 WARSITI, NY 078337 48 17876 DR. WAHYU
yani;3302226402970001; 5.6.6.202203301209 4 358384
1#0##0#0#0.0#2022-04-01
14:45:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aef387d40b3f450644ef7f0235f69a47 150000 0 0 0 0 0
0 0 0 0 15000 0 46037 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 01/01/2000 0 2
1 Z09.8;E11.9;M19.98;M75.0 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
475054 0 1 0 0 0 BUDI WIJAYANTI, (NY) 003068
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 358385
1#0##0#0#0.0#2022-04-01
14:45:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fa650883fcab7fceeb6c8bab454803aa 150000 0 0 0 0 0
0 31845 0 0 15000 0 278209 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 17/11/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 214634
0 1 0 0 0 INDRARIADI, TN 098885 55 20204 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358386
1#0##0#0#0.0#2022-04-01
14:46:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
90545edca8b5c6637a3f943c0a88906b 150000 0 0 0 0 0
0 0 0 0 15000 0 49634 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 12/08/1958 0 1
1 Z09.8;E11.9;K27.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 360649
0 1 0 0 0 SUKANDAR,(BP) 012431 63 23223 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358387
1#0##0#0#0.0#2022-04-01
14:47:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d933a25579446226c6b6f578747b6eeb 150000 0 0 0 0 0
0 31845 0 0 15000 0 163804 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 02/12/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 285000 0 1 0 0 0 ENDANG
1124R0020322V001987 0000086714471 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358347 1#0##0#0#0.0#2022-04-01
14:48:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d31f813f64110db95e8c270a1cacf7ed 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 30/04/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 259260
0 1 0 0 0 SUWARYATI.NY 084810 68 25153 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358388
1#0##0#0#0.0#2022-04-01
14:50:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6bbd6afffae24a10dacd5ca3a3bc088a 150000 0 0 0 0 0
0 31845 0 0 15000 0 62415 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 10/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 197991
0 1 0 0 0 DESI IRAWATI.NY 083433 67 24564 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358393
1#0##0#0#0.0#2022-04-01
14:51:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
663235ef90c7885752581db2899d9cca 150000 0 0 0 0 0
0 0 0 0 15000 0 32991 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 11/04/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 242864
0 1 0 0 0 SUWANTINI.NY 084809 74 27364 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358389
1#0##0#0#0.0#2022-04-01
14:51:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d6bf80ec80a5ab4bac26567158dfe723 150000 0 0 0 0 0
0 0 0 0 15000 0 77864 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 10/02/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 461282
0 1 0 0 0 JIYEM, NY 094913 71 25963 DR. WAHYU
yani;3302226402970001; 5.6.6.202203301209 4 358390
1#0##0#0#0.0#2022-04-01
14:52:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a7afecea017e1ad1d6df33efe0550a3a 150000 0 0 0 0 0
248000 0 0 0 15000 0 48282 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 03/09/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 457122
0 1 0 0 0 WAGIYAH ., NY 059289 58 21375 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358391
1#0##0#0#0.0#2022-04-01
14:53:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
91143aa2700ce4887236151ec71ea597 150000 0 0 0 0 0
248000 0 0 0 15000 0 44122 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 29/02/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 447719
0 1 0 0 0 SRI UTAMI.NY 095373 50 18274 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358392
1#0##0#0#0.0#2022-04-01
14:54:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a1f33d073681ff4de26cf1d116e7edb6 150000 0 0 0 0 0
0 31845 0 0 15000 0 250874 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 25/02/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 208241
0 1 0 0 0 ROSIDAH. NY 087797 70 25583 DR. WAHYU
yani;3302226402970001; 5.6.6.202203301209 4 358394
1#0##0#0#0.0#2022-04-01
14:55:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
de0c7c75a5c5701d399067c77eb29ffb 150000 0 0 0 0 0
0 0 0 0 15000 0 43241 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 10/04/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 207306
0 1 0 0 0 MOEMINAH., NY 046939 71 26269 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358395
1#0##0#0#0.0#2022-04-01
15:22:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
362665ffd9026dc23182c2ee9d12ebb3 150000 0 0 0 0 0
0 0 0 0 15000 0 42306 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 31/12/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 213534
0 1 0 0 0 NGATIYEM.NY 067636 69 25273 DR. WAHYU
yani;3302226402970001; 5.6.6.202203301209 4 358396
1#0##0#0#0.0#2022-04-01
15:23:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4508da621b1b05864106b2374e57d7e1 150000 0 0 0 0 0
0 0 0 0 15000 0 48534 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 15/05/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 254000 0 1 0 0 0 YAHMINI ., NY
0001692527163 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358324 1#0##0#0#0.0#2022-04-01
15:25:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0173a5c4d04f328f9fff5cf23e86be51 239000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 20/03/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 355443
0 1 0 0 0 SRI MIYATUN.NY 089374 60 22272 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358397
1#0##0#0#0.0#2022-04-01
15:25:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a52a4c67eeb134874420aa1bc7c36848 150000 0 0 0 0 0
0 133650 0 0 15000 0 56793 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 26/05/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MENIK PUJIWATI, NY
0001474646354 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358355 1#0##0#0#0.0#2022-04-01
15:27:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c14c9510b558c93f66ae9e657de30b14 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 17/06/1959 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
251265 0 1 0 0 0 JOKO PRAYITNO.TN 084157 62
yani;3302226402970001; 5.6.6.202203301209 4 358398
1#0##0#0#0.0#2022-04-01
15:29:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e27009c7d21245562f4574021dddc86c 150000 0 0 0 0 0
0 31845 0 0 15000 0 54420 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 11/01/1967 0 2
1 Z09.8;E11.9;M19.98 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 339458
0 1 0 0 0 PRAPTI INDRINI 069334 55 20149 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358399
1#0##0#0#0.0#2022-04-01
15:32:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f346123a827a1b19df6c4c044112c90d 150000 0 0 0 0 0
0 31845 0 0 15000 0 142613 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 10/01/1963 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
335859 0 1 0 0 0 NANING HARTINI., NY 048822
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 358400
1#0##0#0#0.0#2022-04-04
08:08:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d469d310c88afdfbe3b74c232f2ba8c8 150000 0 0 0 0 0
0 31845 0 0 15000 0 139014 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 02/03/1941 0 2
0 0 - 0 - 0 - 0 - 0 181400 203869
0 1 0 0 0 DIYAH 101274 81 29595 DR. WAHYU PURNOMO,
SP.OT 1124R0020322V002005 0000091192274 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358401 1#0##0#0#0.0#2022-04-04
08:09:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6cf0f7e06248f5a1e4eb7149f5a8efe8 150000 0 0 0 0 0
0 0 0 0 15000 0 38869 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 06/07/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 219000 0 1 0 0 0 SUMARNI.NY 086963
0002347072604 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358352 1#0##0#0#0.0#2022-04-04
08:09:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9efea1bf4ac458c03b90600d04c439a9 204000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 28/09/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 453091
0 1 0 0 0 UMAR SANTI, NY 091741 56 20619 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358402
1#0##0#0#0.0#2022-04-04
08:10:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bb00978320d7cd92df48f25acb9f7e6c 150000 0 0 0 0 0
0 229900 0 0 15000 0 58191 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 26/05/1968 0 2
1 Z09.8;I11.9;E11.9;M54.59 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
261422 0 1 0 0 0 SRI LESTARI, NY 066305 53
yani;3302226402970001; 5.6.6.202203301209 4 358403
1#0##0#0#0.0#2022-04-04
08:13:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
771a725020ea98b596a335601c8ac6c5 150000 0 0 0 0 0
0 31845 0 0 15000 0 64577 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 13/05/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ENI WIDIASTUTI, NY
0001429538578 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358356 1#0##0#0#0.0#2022-04-04
08:15:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
42a67870264cb2885e829ae9ddd51797 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 31/10/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 282134
0 1 0 0 0 YUNLIS SETYOWATI, (NY) 001924 50 18395
yani;3302226402970001; 5.6.6.202203301209 4 358404
1#0##0#0#0.0#2022-04-04
08:16:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8e2ebab797fca4c614c3bb07b9c8d51e 150000 0 0 0 0 0
0 0 0 0 15000 0 117134 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 14/05/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 207804
0 1 0 0 0 WINARNO.TN 093273 56 20756 DR. WAHYU
yani;3302226402970001; 5.6.6.202203301209 4 358405
1#0##0#0#0.0#2022-04-04
08:16:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
34a727166f83b7d61a27492e08e604e6 150000 0 0 0 0 0
0 0 0 0 15000 0 42804 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 15/03/1938 0 2
0 0 - 0 - 0 - 0 - 0 181400 298474
0 1 0 0 0 SETIYARSIH, NY 069247 83 30678 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358406
1#0##0#0#0.0#2022-04-04
08:17:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3e6c20fc837464d7828d8c75b677a60c 150000 0 0 0 0 0
0 31845 0 0 15000 0 101629 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 19/07/1950 0 2
0 - 0 107400 262000 0 1 0 0 0 SITI
1124R0020322V002013 0001387776519 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358353 1#0##0#0#0.0#2022-04-04
08:21:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
76c2ffc652f4724a3d5d26a75cf12a4c 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 11/11/1952 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMARDI.TN 101737
0000640283771 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358333 1#0##0#0#0.0#2022-04-04
08:21:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6545a819455c15eb36a542707aaf291f 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 18/09/2002 0 1
0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 LUTFI AHMAD RIFAI.SDR 012114 19 7115
DR. ZULFADLY, SP.B 1124R0020322V002015 0001081396326 3;JKN
yani;3302226402970001; 5.6.6.202203301209 4 358407
1#0##0#0#0.0#2022-04-04
08:27:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4ffd35b80e076fbe4c8f2cd03b126106 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 26/03/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 L M BASUKI, NY
0000641664819 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358354 1#0##0#0#0.0#2022-04-04
08:25:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e46efa93245925a4203584658adf3aee 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 29/11/1979 0 1
0 0 - 0 - 0 - 0 - 0 181400 195624
0 1 0 0 0 YUSI FIRMANSYAH.TN 100705 42 15444
yani;3302226402970001; 5.6.6.202203301209 4 358408
1#0##0#0#0.0#2022-04-04
08:26:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8a882fbcf3b81bbbd5374822b274e733 150000 0 0 0 0 0
0 0 0 0 15000 0 30624 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 07/01/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 NANIK PARINI, NY
0001188329253 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
358343 1#0##0#0#0.0#2022-05-19
10:58:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
1692e5ed890f5458b426b1f80e44df20 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 16/04/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 196845
0 1 0 0 0 ENY RIDKHAYATI, NY 057124 63 23341
yani;3302226402970001; 5.6.6.202203301209 4 358409
1#0##0#0#0.0#2022-04-04
08:33:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b3d5b773a31fc841220522a9b41f95d8 150000 0 0 0 0 0
0 31845 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 01/07/1951 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WARSINAH
SUMARWANI, NY 092218 70 25822 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V002021 0000087200616 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358361 1#0##0#0#0.0#2022-04-04
08:34:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3690160c6343b09465288ec1a4a38ed3 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 23/04/1960 0 2
0 - 0 107400 262000 0 1 0 0 0 SRI
1124R0020322V002022 0000091421842 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358351 1#0##0#0#0.0#2022-04-04
08:39:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fd4a76954edb37b5143f70af513866a0 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 25/06/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 KERNI,(NY) 033080
0001316373355 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358360 1#0##0#0#0.0#2022-04-04
08:40:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
edf32a93ab19db617366e9dab9d35a71 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 31/12/1954 0 2
0 - 0 107400 262000 0 1 0 0 0
TUMINAH NY 088417 67 24543 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V002024 0002581070231 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358348 1#0##0#0#0.0#2022-04-04
08:40:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
18d33ec229f0d96072c4dce2aea2f152 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 25/03/1955 0 2
0 - 0 107400 262000 0 1 0 0 0
SUPINAH 091220 66 24459 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V002025 0000639810066 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 358344 1#0##0#0#0.0#2022-05-19
11:05:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
ced9b5d294c889b163a61c65a46ac91c 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 31/12/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 WARSINI, NY 095108
0001084784139 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358378 1#0##0#0#0.0#2022-04-04
08:42:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d0c8cd258ea4d18b45eb02a9a474f6df 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 02/05/1958 0 2
1 Z09.8;E11.9;M75.0;I11.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 675480
0 1 0 0 0 ENY MURWANINGSIH ,(NY) 042511 63 23325
yani;3302226402970001; 5.6.6.202203301209 4 358410
1#0##0#0#0.0#2022-04-04
08:43:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d564d72ebdc927e8d6f93842bc554d82 150000 0 0 0 0 0
0 31845 0 0 15000 0 478635 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 27/09/1965 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 MARYATI., NY 064970 56 20620 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358332
1#0##0#0#0.0#2022-04-04
08:45:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
924cf03e082ff47aaad5d634adcfaedd 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 05/03/1973 0 2
0 - 0 - 0 - 0 - 0 138400 285000
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 358357
1#0##0#0#0.0#2022-04-04
08:45:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b4f2fea74e39e96c527063269ba54f2f 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 07/10/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 YATINI 094257
0001083705715 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
358330 1#0##0#0#0.0#2022-05-19
13:14:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
a456ef5427e10521efb46b5703de398a 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 26/09/1963 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 BAJURI, TN 000197
0001104121822 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358329 1#0##0#0#0.0#2022-04-04
08:47:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
80e5485e85cebbfb5baa78a309ee47af 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 05/06/1961 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 MARSIATUN, NY 085335 60 22195 DR. LINDA
yani;3302226402970001; 5.6.6.202203301209 4 358369
1#0##0#0#0.0#2022-04-04
08:48:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f04c1c298c33e26700052a2d5d983418 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 30/08/1961 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 RIA TRI RASMANI. NY 089448 60 22109 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358358
1#0##0#0#0.0#2022-04-04
08:48:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
46cd895a11f40876dc8ff9fd0bf2234c 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 16/08/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TRI WINARNI, NY
0000640206066 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358363 1#0##0#0#0.0#2022-04-04
08:50:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6c86b48caa41869503620d7d84a60fa6 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 07/10/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 NUR LASMI, NY
0000639913318 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358331 1#0##0#0#0.0#2022-04-04
08:52:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
84ad9ab8d227eb3510b5f8694c68ab3a 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 02/08/1973 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 ISWINDARI., NY 047078 48 17754 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358339
1#0##0#0#0.0#2022-04-04
08:53:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
461a17d8bcbf7aa8af902ce37b216ae3 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 07/11/1971 0 1
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 NUZUL HAKIM, TN 101343 50 18388 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358362
1#0##0#0#0.0#2022-04-04
08:53:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8520af2dd94e3c967a2b87fed48a7b2f 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 23/09/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ROCHYATI.NY 059452
0001813968753 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358335 1#0##0#0#0.0#2022-04-04
08:54:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e6f3f2ea5bbdbce6b263510609ff4926 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 29/12/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 285000 0 1 0 0 0 DRA. SRI
SUPADMINI, NY 064608 69 25275 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V002041 0000091527388 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358349 1#0##0#0#0.0#2022-04-04
08:54:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
297308e4fdc1bd1a57c627542f90b7cb 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 14/04/1960 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 MARTINAH., NY 072061 61 22612 DR.
novia;3313125201940001; 5.6.7.202204241238 4 358370
1#0##0#0#0.0#2022-05-19
10:03:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
7f26a7963141e2df6f9cfcd217fe71c6 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 27/02/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SITI ZUHDIAH
0000091320906 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358376 1#0##0#0#0.0#2022-04-04
08:55:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b332b7a7bd830700cceb207495ce8ee3 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 14/05/1933 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 KOESWANTO BA.TN
0000091081451 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358328 1#0##0#0#0.0#2022-04-04
08:56:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
63c8ee47a20e93302d4f4e8cf4e48ce0 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 10/11/1965 0 1
1 Z09.8;M54.22;R47.1 93.35;93.39 - - None None None None
0 - 0 107400 262000 0 1 0 0 0 DIDIK
SUGIYARTA.TN 098213 56 20576 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V002047 0002165956975 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358334 1#0##0#0#0.0#2022-04-04
08:57:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
147dac56088031040cd4dfe0fa62d739 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 13/06/1992 0 2
0 - 0 107400 262000 0 1 0 0 0 LUKI
SABILLA WITTEVEEN,NN 069906 29 10864 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V002048 0001084671257 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 358350 1#0##0#0#0.0#2022-05-19
09:46:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
8a6ba524d06fe7702e3e234f6efb57b2 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 02/03/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMARNI, NY 101618
0000089014184 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358336 1#0##0#0#0.0#2022-04-04
08:58:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
54cc37784d88b4141ea31b1bbc5d85d8 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 02/10/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ASRI LISTYARINI.NY
0000640236058 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358346 1#0##0#0#0.0#2022-04-04
08:59:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c945dca25a9a858ec1ca0ba21aa77672 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 09/07/1959 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUROTO.TN 087121
0003116443004 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358373 1#0##0#0#0.0#2022-04-04
08:59:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
45958f062a746da2508a3cac2337fe1e 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 25/12/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WAHJUNINGSIH
1124R0020322V002053 0001647209711 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358325 1#0##0#0#0.0#2022-04-04
09:00:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9d64fdd48aff67a0fa890c135328ac88 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 21/09/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002199915988 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358341 1#0##0#0#0.0#2022-04-04
09:01:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6e8548f3d5389285d21228ffcd15af69 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 25/08/1955 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 BAMBANG AGUS
SURONO.TN 100627 66 24306 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V002055 0001812274413 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358377 1#0##0#0#0.0#2022-04-04
09:01:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0ec28cdd81beac9b88daef86140faa64 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 01/10/1937 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SOEKROJONO, TN
0000091322357 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358327 1#0##0#0#0.0#2022-04-04
09:02:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9955a7ce50eca71ac4f5978fb7b9c251 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 08/12/1992 0 1
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 ARIS ABDULLAH, BP 088781 29 10686 DR. LINDA
yani;3302226402970001; 5.6.6.202203301209 4 358368
1#0##0#0#0.0#2022-04-04
09:02:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e4962755395e87aa20d9fb08464689ff 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 18/05/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SAMIYATI.NY 094791
0000046966566 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358375 1#0##0#0#0.0#2022-04-04
09:03:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e92a2ec7755090c0e6077d13678d3fa2 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 01/06/1944 0 2
0 - 0 - 0 - 0 - 0 138400 576456
0 1 0 0 0 SUJINEM,NY 086697 77 28408 DR. LINDA
yani;3302226402970001; 5.6.6.202203301209 4 358372
1#0##0#0#0.0#2022-04-04
09:06:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e506bb7491420ba315a744c2894c93e9 270000 0 0 0 0 0
0 0 0 0 15000 0 291456 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 02/01/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 519165
0 1 0 0 0 HENDRAYANI., NY 053231 56 20523 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358411
1#0##0#0#0.0#2022-04-04
09:06:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ce6c8886b66f5fd652152eeca5f7dec1 150000 0 0 0 0 0
0 0 0 0 15000 0 354165 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 22/02/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 395153
0 1 0 0 0 SURUR, TN 010814 58 21203 DR. IBRAHIM
NASRUL, SP.KJ 1124R0020322V002062 0001104414309 3;JKN
yani;3302226402970001; 5.6.6.202203301209 4 358412
1#0##0#0#0.0#2022-04-04
09:07:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4d6d5c9c0b08a7490442b1208f582a33 150000 0 0 0 0 0
0 0 0 0 15000 0 230153 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 28/07/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 288134
0 1 0 0 0 SRI KARYATI.NY 077254 49 18124 DR.
IBRAHIM NASRUL, SP.KJ 1124R0020322V002063 0002344219705 3;JKN
yani;3302226402970001; 5.6.6.202203301209 4 358413
1#0##0#0#0.0#2022-04-04
09:07:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5fb06091b4465f1e45d2879a93489b43 150000 0 0 0 0 0
0 0 0 0 15000 0 123134 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 16/05/1956 0 2
1 Z09.8;M75.0;M17.9 93.89 - - None None None None Z-3-12-0
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 WIDI WINARSI.NY 075698 65 24041 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358340
1#0##0#0#0.0#2022-04-04
09:09:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0c2821300f53ba026141aa4d7d70363f 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 24/10/1981 0 2
0 0 - 0 - 0 - 0 - 0 181400 263353
0 1 0 0 0 SUMIYATI.NY 049462 40 14749 DR. IBRAHIM
yani;3302226402970001; 5.6.6.202203301209 4 358414
1#0##0#0#0.0#2022-04-04
09:09:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
269e3ba1103fbb2855d5fd52661d23dd 150000 0 0 0 0 0
0 0 0 0 15000 0 98353 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 28/12/1949 0 2
0 - 0 - 0 - 0 - 0 138400 576456
0 1 0 0 0 NURHAYATI.NY 081101 72 26372 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358367
1#0##0#0#0.0#2022-04-04
09:10:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
93cbf29f45d46c0cefa1daf8494ac46d 270000 0 0 0 0 0
0 0 0 0 15000 0 291456 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 25/10/1969 0 2
1 Z09.8;K21.9;R51 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 244371
0 1 0 0 0 SUWARNI.NY 087525 52 19131 DR. SUHARTO,
SP.PD 1124R0020322V002067 0002205741431 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358415 1#0##0#0#0.0#2022-04-04
09:11:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
deea3d5d185f699ee6f7578898360253 150000 0 0 0 0 0
0 0 0 0 15000 0 79371 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 05/03/1944 0 1
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 SANTOSO. TN 088783 78 28496 DR. LINDA
yani;3302226402970001; 5.6.6.202203301209 4 358365
1#0##0#0#0.0#2022-04-04
09:11:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
08b8a572695cb86ce34ae0f84ea3718d 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 22/06/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 199233
0 1 0 0 0 SUDARMADI .BP 037072 43 15969 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358416
1#0##0#0#0.0#2022-04-04
09:12:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4ad0a02ab138e910431cdaa9337cf178 150000 0 0 0 0 0
0 0 0 0 15000 0 34233 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 31/08/1962 0 2
0 - 0 - 0 - 0 - 0 138400 285000
yani;3302226402970001; 5.6.6.202203301209 4 358337
1#0##0#0#0.0#2022-04-04
09:13:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
728917f8d56ba0290e2c71ea498a8b9a 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 15/06/1964 0 2
1 Z09.8;I11.9;R07.4 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 229155
0 1 0 0 0 MUYASARAH, NY 094107 57 21089 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358418
1#0##0#0#0.0#2022-04-04
09:15:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1fda2f6dc06e436d84c12a4f495d8298 150000 0 0 0 0 0
0 0 0 0 15000 0 64155 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 12/04/1957 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 MARIYAM.NY 084306 64 23710 DR. LINDA
yani;3302226402970001; 5.6.6.202203301209 4 358366
1#0##0#0#0.0#2022-04-04
09:16:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
16fcd0f984c982b9723e2fb359ceb851 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 10/06/1955 0 1
1 R10.4;M75.0 - - - None None None None Q-5-25-0 None
- 0 - 0 - 0 - 0 135700 199334 0
1 0 0 0 MUNGKAR WALIYAT, TN 102359 66 24382 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358417
1#0##0#0#0.0#2022-04-04
09:14:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b745e88ffd358c785fb57b62420af591 150000 0 0 0 0 0
0 0 0 0 15000 0 34334 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 31/08/1998 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 RARAS DANASTRI 083059 23 8594 DR. LINDA
yani;3302226402970001; 5.6.6.202203301209 4 358338
1#0##0#0#0.0#2022-04-04
09:17:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4bedc4b03c139d10fa2e56ec511bf76a 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 13/10/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 401322
0 1 0 0 0 NUNUK SUNDARI,(NY) 018287 59 21700
yani;3302226402970001; 5.6.6.202203301209 4 358419
1#0##0#0#0.0#2022-04-04
09:18:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
180a785894fc94921604fa9b39ed47a8 150000 0 0 0 0 0
0 0 0 0 15000 0 236322 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 01/10/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 276697
0 1 0 0 0 DALTI, NY 055299 71 26095 DR. SUHARTO,
SP.PD 1124R0020322V002076 0002224502728 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358420 1#0##0#0#0.0#2022-04-04
09:19:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e090988ababf4887109c3eadbb269760 150000 0 0 0 0 0
0 0 0 0 15000 0 111697 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 03/06/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 252419
0 1 0 0 0 SUYOTO, TN 099549 51 18910 DR. SUHARTO,
SP.PD 1124R0020322V002077 0002041057473 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358421 1#0##0#0#0.0#2022-04-04
09:20:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f03e16fc45ffc819224d8f5426db9383 150000 0 0 0 0 0
0 0 0 0 15000 0 87419 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 17/01/1955 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001107700209 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358364 1#0##0#0#0.0#2022-04-04
09:20:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fcb464cc3c5f002e791c24e1b72de4c5 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 29/01/1999 0 1
1 Z09.8;R10.4;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 249029
0 1 0 0 0 WIDIYANTO BAYU ADI, SDR 102342 23 8443
agung;3313092303950002; 5.6.6.202203301209 4 358422
1#0##0#0#0.0#2022-04-11
12:03:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
f013867c70e7bca7074c42c4e4cecb17 150000 0 0 0 0 0
0 0 0 0 15000 0 84029 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 18/04/1968 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 RAHMADI.TN 096843
0002169726311 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358374 1#0##0#0#0.0#2022-04-04
09:21:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
850fe0ebf741a15d027c4813d90916be 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/03/2022 13/03/2022 01/02/1972 0 2
1 T20.0;X14.0 96.59 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 452014 0 1
0 0 0 ENDANG SURYANI, NY 102409 50 18303 DR. NIKE
1124R0020322V002095 0000640071832 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361002 1#0##0#0#0.0#2022-04-04
17:15:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cc841ee10fa9f8ff6c024c07a6692c41 335000 0 0 0 0 0
0 0 0 0 25000 0 92014 0 0 0 0 0
3372030 C 3 CP 2 13/03/2022 13/03/2022 19/10/1965 0 2
1 S80.0;W19.0 - - - None None None None Q-5-39-0 None
None None None None None CEDERA PADA JARINGAN LUNAK KOMPLEK 128800
0 0 - 0 - 0 - 0 - 0 128800 184403
0 1 0 0 0 SRI SUDARTI, (NY) 002232 56 20599 DR.
RIZA ABDILLAH 1124R0020322V002099 0001108995489 3;JKN
reni;3313147010930001; 5.6.6.202203301209 4 361003
1#0##0#0#0.0#2022-04-04
17:19:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3d5a9f4e527857023c3204c0a6d26aef 130000 0 0 0 0 0
0 0 0 0 15000 0 39403 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 23/01/1975 0 1
0 - 0 - 0 - 0 135700 235175 0 1
0 0 0 IWAN SETYAWAN, TN 093296 47 17217 DR. DANISWARA
ADHITIA RAHMAN 1124R0020322V002102 0001104003775 3;JKN
reni;3313147010930001; 5.6.6.202203301209 4 361004
1#0##0#0#0.0#2022-04-04
17:20:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
388512179f8f78fdd80defc14beff402 155000 0 0 0 0 0
0 0 0 0 15000 0 65175 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 28/02/1979 0 2
0 - 0 - 0 - 0 - 0 296400 184448
0 1 0 0 0 ENI KUSTIYAH,(NY) 034451 43 15720 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358469
1#0##0#0#0.0#2022-03-28
10:29:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f0369da4e118f766969b9aab9897ca61 150000 0 0 0 0 0
0 0 0 0 15000 0 19448 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 23/03/1965 0 2
0 - 0 107400 273000 0 1 0 0 0 SRI
LESTARI,(NY) 035396 56 20810 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V002105 0000564742912 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 358443 1#0##0#0#0.0#2022-03-28
10:30:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e13b01ed5daa5f520f8d68d572eb267a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 19/02/1965 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 254000 0 1 0 0 0 DANU MARGONO.,BP
0000640154136 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
360283 1#0##0#0#0.0#2022-03-28
10:31:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5a83a35c1aedff39b7550a47880cbf8d 239000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 03/06/1987 0 2
- 0 - 0 - 0 183900 185097 0 1 0
0 0 SHOPIAH.NY 099940 34 12703 DR. GUNAWAN, SP.OG
1124R0020322V002107 0001179069985 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 358470 1#0##0#0#0.0#2022-03-28
10:31:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f34ed44702d1d351838881fcecf89dae 150000 0 0 0 0 0
0 0 0 0 15000 0 20097 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 13/08/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 TRI UTAMI
1124R0020322V002108 0001380313934 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 358441 1#0##0#0#0.0#2022-03-28
10:32:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fea03ecf4c3d8e7c6b245664355ed272 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 28/04/1986 0 2
- 0 - 0 - 0 183900 222519 0 1 0
1124R0020322V002109 0002933748516 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 358471 1#0##0#0#0.0#2022-03-28
10:33:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8366ed16f9a0ba064f245f4444ad330e 200000 0 0 0 0 0
0 0 0 0 15000 0 7519 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 17/06/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WARIH ANJARIANI,
0001964529066 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358445 1#0##0#0#0.0#2022-03-28
10:34:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
854eb727a439bacaafab783de578dc83 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 06/03/1996 0 1
- 0 - 0 - 0 183900 172809 0 1 0
0 0 AGNES CANDRA PENISIA, NY 085121 26 9504 DR. GUNAWAN,
SP.OG 1124R0020322V002111 0000640361171 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 358472 1#0##0#0#0.0#2022-03-28
10:36:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
2db875ab46001cf293bcc11c4e91d9ca 150000 0 0 0 0 0
0 0 0 0 15000 0 7809 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 29/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 AGNES WIDHA
1124R0020322V002112 0002168632721 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 358444 1#0##0#0#0.0#2022-03-28
10:37:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c6e5feccce892ecf136ff1f82817b969 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 11/07/2004 0 1
0 0 - 0 - 0 - 0 - 0 181400 321339
0 1 0 0 0 MAULANA IBNU FARID.SDR 102157 17 6455
yani;3302226402970001; 5.6.5.202203091809 4 358473
1#0##0#0#0.0#2022-03-28
10:37:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2215db2071387771225920b9240bcd78 220000 0 0 0 0 0
0 0 0 0 15000 0 86339 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 14/06/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001429190267 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358442 1#0##0#0#0.0#2022-03-28
10:38:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c5f0c540438f5267fae7b2c2099a6a29 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 12/09/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 196724
0 1 0 0 0 WIDJAYANTI KUSUMA SALIM.NY 101590 70
0002198271161 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358474 1#0##0#0#0.0#2022-03-28
10:39:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d731fbc9aa86c4e39aa8e9703157ffc6 150000 0 0 0 0 0
0 0 0 0 15000 0 31724 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 21/08/1948 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MUSNATIN., NY
0000091314876 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358451 1#0##0#0#0.0#2022-03-28
10:40:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
208620f49234b8fca136e6073a40cb2e 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 25/02/1972 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 FRANS POKAREM.TN
0001032586479 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
358454 1#0##0#0#0.0#2022-05-20
10:10:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
56ac59cf09b46693520e8e8c3b95a8fc 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 29/06/1959 0 1
0 - 0 - 0 - 0 137000 259479 0 1
0 0 0 SARWONO, TN 102337 62 22904 DR. INDRIANY WIDHOWATY,
SP.S, SP.AK 1124R0020322V002120 0000639537614 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 358475 1#0##0#0#0.0#2022-03-28
10:41:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1d1b91fb78ab1fe1fb10cacb85dcea7a 150000 0 0 0 0 0
0 0 0 0 15000 0 94479 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 20/07/1952 0 2
0 - 0 107400 262000 0 1 0 0 0 SITI
ZUHRIYAH,(NY) 039654 69 25439 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V002121 0000091194276 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 358450 1#0##0#0#0.0#2022-03-28
10:42:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
86a0a8c4888e1a340e36cded0ad9af3c 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 31/10/1955 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 DAL HARI
1124R0020322V002123 0001703140593 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 358455 1#0##0#0#0.0#2022-03-28
10:43:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9401768a744377bc6d477f2244021bdd 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 10/04/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 183662
0 1 0 0 0 SRI RAHAYU.NY 084543 60 22253 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358476
1#0##0#0#0.0#2022-03-28
10:43:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2159b97e662bf2f2c3bf16bb5db327a3 150000 0 0 0 0 0
0 0 0 0 15000 0 18662 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 13/06/1971 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002169781694 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
358453 1#0##0#0#0.0#2022-05-19
10:24:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
8d80890841441f44f1ee4586ffe3183b 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 18/01/1966 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 IVO MUMPUNI
1124R0020322V002126 0002169780873 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 358449 1#0##0#0#0.0#2022-03-28
10:45:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
315a7ab89911f05b3c619c65d5395795 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 10/10/1953 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TUTIK SARASWATI .,
0001449355893 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358448 1#0##0#0#0.0#2022-03-28
10:45:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e046665612e5735b27af72fad9b9e0ab 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 16/05/1997 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 251000 0 1 0 0 0 MEI NUR SAPUTRI,
0002220808432 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
360284 1#0##0#0#0.0#2022-03-28
10:46:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e773799f92a2a77ceff79c2a21d0f826 236000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 16/09/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 276299
0 1 0 0 0 WARSI HARTANI.NY 099234 64 23555 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358477
1#0##0#0#0.0#2022-03-28
10:47:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e71199f3d630d3eb1c21e7cd605f3fc4 150000 0 0 0 0 0
0 0 0 0 15000 0 111299 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 01/09/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 179286
0 1 0 0 0 SAMBUDI,(BP) 037461 59 21744 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358478
1#0##0#0#0.0#2022-03-28
10:48:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b41a4cef8c84366373680342bb532adb 150000 0 0 0 0 0
0 0 0 0 15000 0 14286 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 13/12/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 195162
0 1 0 0 0 SATRIYATI. NY 072569 56 20545 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358479
1#0##0#0#0.0#2022-03-28
10:49:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d84541a6967017fdd134e7cce84d1b40 150000 0 0 0 0 0
0 0 0 0 15000 0 30162 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 17/01/1955 0 1
0 - 0 - 0 - 0 137000 267197 0 1
0 0 0 SUTARYANTO, TN 102419 67 24528 DR. INDRIANY
yani;3302226402970001; 5.6.5.202203091809 4 358480
1#0##0#0#0.0#2022-03-28
10:51:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
997cd1bf69d8cd4d1bd88a28c7360ac5 150000 0 0 0 0 0
0 0 0 0 25000 0 92197 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 11/09/1954 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 284000 0 1 0 0 0 SUMARNO.TN 095054
0001425421326 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
358447 1#0##0#0#0.0#2022-05-20
11:32:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
dc6fc1900b4bf26055b9772d958d4a1c 269000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 17/11/1966 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 INDRARIADI, TN
0001797112102 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358452 1#0##0#0#0.0#2022-03-28
10:53:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
729260e0ecf2471ec6934a69b3d8d41c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 05/06/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ASIYAH INTAN
1124R0020322V002136 0002050989456 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 358446 1#0##0#0#0.0#2022-03-28
10:54:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f9c1b72548da7c96c6177f99bc29f236 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 05/03/1985 0 2
0 0 - 0 - 0 - 0 - 0 181400 202356
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358481
1#0##0#0#0.0#2022-03-28
10:54:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
814e38d617d6916e04dc8162ba8fc8b2 150000 0 0 0 0 0
0 0 0 0 15000 0 37356 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 04/07/1962 0 2
0 404900 410478 0 1 0 0 0 SULIYEM, NY 052010
0001836873279 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358482 1#0##0#0#0.0#2022-03-28
10:55:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dcf22d4ad29ad54a3b4fdc5a9d951118 150000 0 0 0 0 0
0 0 0 0 15000 0 245478 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 21/11/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 213534
0 1 0 0 0 SRI UTAMI, NY 070322 61 22393 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358483
1#0##0#0#0.0#2022-03-28
10:55:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a16b828dc54043ea451b3e9fdda917e0 150000 0 0 0 0 0
0 0 0 0 15000 0 48534 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 20/07/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 474580
0 1 0 0 0 SRI YULIATI.NY 080565 59 21787 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360289
1#0##0#0#0.0#2022-03-28
10:56:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
01cc8b063d2a6380c7862cd8420fa694 150000 0 0 0 0 0
248000 0 0 0 15000 0 61580 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 27/02/2019 0 1
0 0 - 0 - 0 - 0 - 0 181400 279003
0 1 0 0 0 ADHITAMA ELVAN SYAHREZA, AN 084144 3
0002753319058 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358484 1#0##0#0#0.0#2022-03-28
10:57:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6aca1715ced3a693d73c40aa459931c1 150000 0 0 0 0 0
0 0 0 0 15000 0 114003 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 10/12/1996 0 2
1 Z39.2;R33 88.79;57.94 - - None None None None N-3-14-0
None None None None None None PROSEDUR KECIL ENDOSKOPI PADA SALURAN
KEMIH 336100 0 0 - 0 - 0 - 0 - 0 336100
194679 0 1 0 0 0 FICKY EKA SAFITRI.NY 102435
25 9225 DR. GUNAWAN, SP.OG 1124R0020322V002143 0002313980717
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 358485
1#0##0#0#0.0#2022-03-28
10:58:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
792cbf6e5b19f33c1733521dd509c630 150000 0 0 0 0 0
0 0 0 0 25000 0 19679 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 17/12/1977 0 2
- 0 - 0 - 0 - 0 549400 165000 0
1 0 0 0 RAHAYUNINGSIH,NY 078926 44 16158 DR. DEWI
ANGGOROWATI, SP.OG 1124R0020322V002145 0001530249333 3;JKN
yani;3302226402970001; 5.6.5.202203091809 4 358486
1#0##0#0#0.0#2022-03-28
10:59:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a6d06c9f5d1bf3845a4dd34db5c8ff6f 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 02/06/1976 0 2
1 Z09.8;D21.9 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 185614
0 1 0 0 0 ESTER KUUMAWATI ., NY 000824 45 16721
yani;3302226402970001; 5.6.5.202203091809 4 358487
1#0##0#0#0.0#2022-03-28
11:00:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7be1165d640a7b3d37a86469a6a04728 150000 0 0 0 0 0
0 0 0 0 15000 0 20614 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 12/12/1964 0 1
0 - 0 - 0 - 0 786200 677676 0 1
yani;3302226402970001; 5.6.5.202203091809 4 358468
1#0##0#0#0.0#2022-03-28
11:00:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
85061b03e0bd2787721509017f538c70 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 22/10/1959 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 358467
1#0##0#0#0.0#2022-03-28
11:01:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bdf904dde4cd9cd3ed67cfe67b713f64 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 12/08/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 358466
1#0##0#0#0.0#2022-03-28
11:01:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1b66040c6c69590fb91508d0810f9e50 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 03/08/1963 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 358465
1#0##0#0#0.0#2022-03-28
11:02:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
621fffb5a0d2c5a6653c5801097aeb86 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 03/08/1975 0 2
- 0 - 0 - 0 - 0 549400 213093 0
1 0 0 0 YATMINI.NY 102437 46 17025 DR. GUNAWAN, SP.OG
1124R0020322V002152 0001530248196 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 358488 1#0##0#0#0.0#2022-03-28
11:03:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c1813dbbd5b5b62924dcff161d03969c 150000 0 0 0 0 0
0 0 0 0 25000 0 38093 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 08/03/1972 0 2
0 - 0 - 0 - 0 - 0 181400 471534
0 1 0 0 0 SUPRAPTI.NY 102438 50 18268 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 360286
43#0##0#0#0.0#2022-03-28
11:03:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0cab85f5e6b4e0217a592256e29d73a9 150000 0 0 0 0 0
248000 0 0 0 25000 0 48534 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 04/05/1958 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 358463
1#0##0#0#0.0#2022-03-28
11:05:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
921275e66c5cfe6baee17b47ca1cbc2b 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 25/06/1970 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 358462
1#0##0#0#0.0#2022-03-28
11:05:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b67bf9013e2814447091a2f150977dc7 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 12/10/1987 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 358461
1#0##0#0#0.0#2022-03-28
11:07:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c7f7aeab132b9ea1554cea920d52de6a 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 10/12/1982 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 358460
1#0##0#0#0.0#2022-03-28
11:09:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c3e046041a69072026117a63dc67dee1 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 18/03/1988 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 358459
1#0##0#0#0.0#2022-03-28
11:11:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5808dcb545152624bdc4436db6c49708 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 17/04/1973 0 1
0 - 0 - 0 - 0 786200 677676 0 1
yani;3302226402970001; 5.6.5.202203091809 4 358457
1#0##0#0#0.0#2022-03-28
11:12:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
39afd19ca6aa3b264b2cc48ea8cc868e 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 23/03/1976 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 358458
1#0##0#0#0.0#2022-03-28
11:12:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
abaa2f7b4773aa71ca9da6900800c36a 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 31/12/1971 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V002163 0000555344774 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 358456 1#0##0#0#0.0#2022-03-28
11:13:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8929723c0ec22b89c7890d996bf4d78d 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 08/04/1964 0 1
0 - 0 - 0 - 0 786200 522655 0 1
0 0 0 BAKTIYAR ZUNAN, TN 101891 57 21159 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 358464
1#0##0#0#0.0#2022-03-28
11:14:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4206add2840198eef761e91213732f44 463830 0 0 0 0 0
0 0 0 0 15000 0 43825 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 22/07/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 212003
0 1 0 0 0 YULIYATUN, NY 054254 55 20324 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360287
1#0##0#0#0.0#2022-03-28
11:15:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
83b8b28ff16abdbf17cd3de97c79ec4c 150000 0 0 0 0 0
0 0 0 0 15000 0 47003 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 05/10/1975 0 2
0 0 - 0 - 0 - 0 - 0 296400 165000
0 1 0 0 0 NIKEN WAHYU PS., NY 044859 46 16962
yani;3302226402970001; 5.6.5.202203091809 4 358489
1#0##0#0#0.0#2022-03-28
11:18:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0aea8c42a91361b7da172873f1b81790 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 17/08/2016 0 1
0 0 - 0 - 0 - 0 - 0 181400 206527
0 1 0 0 0 HAFIZ HERLANDIKA SUSANTO.AN 077009 5
0002078395648 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358490 1#0##0#0#0.0#2022-03-28
11:18:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3b2c9cb2bee423a63d76bef51c47ceca 150000 0 0 0 0 0
0 0 0 0 15000 0 41527 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 25/08/1959 0 2
1 Z09.8;M19.98;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 214022
0 1 0 0 0 R SRI SUNDARI, NY 072334 62 22847 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358491
1#0##0#0#0.0#2022-03-28
11:20:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fb2d93a34eee9b4726edcada9b11c8ef 150000 0 0 0 0 0
0 0 0 0 15000 0 49022 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 02/01/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 426263
0 1 0 0 0 KISWARDANI.NY 086811 54 19795 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360288
1#0##0#0#0.0#2022-03-28
11:20:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a06ffbbb56dbd97c8499206344bce5d9 150000 0 0 0 0 0
220000 0 0 0 15000 0 41263 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 29/03/2019 0 2
0 0 - 0 - 0 - 0 - 0 181400 195933
0 1 0 0 0 ATHIFAH KAYSHA NURJANNAH,AN 076001 2
0002756997415 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
358492 1#0##0#0#0.0#2022-03-28
11:21:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
398ee0d705718bbe9f4e0bba846a73c5 150000 0 0 0 0 0
0 0 0 0 15000 0 30933 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 20/12/2002 0 1
- 0 - 0 - 0 - 0 549400 876878 0
1 0 0 0 DIVANA YOGA LARAS.SDR 097629 19 7024 DR.
HERMAWAN, SP.B 1124R0020322V002175 0002263744293 3;JKN
yani;3302226402970001; 5.6.5.202203091809 4 360285
1#0##0#0#0.0#2022-03-28
11:22:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
20e8a064b989437bb9dc42757f039616 150000 0 0 0 0 0
680000 0 0 0 15000 0 31878 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 12/10/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 348975
0 1 0 0 0 HANDOYO, TN 072336 65 23894 DR. INDRIANY
yani;3302226402970001; 5.6.5.202203091809 4 358493
1#0##0#0#0.0#2022-03-28
11:23:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ac60b9a8b1f48ab1b8daff7cba419d7c 150000 0 0 0 0 0
0 0 0 0 15000 0 183975 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 18/10/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 460003
0 1 0 0 0 YUSTINUS AGUS SUSAMTO.BP 061196 54
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 360290
1#0##0#0#0.0#2022-03-28
11:31:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
073de7a60208e164f2394d9a36cfbb32 150000 0 0 0 0 0
248000 0 0 0 15000 0 47003 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 29/10/2001 0 1
0 0 - 0 - 0 - 0 - 0 181400 562419
0 1 0 0 0 ROLANDO SILALAHI, SDR 100540 20 7441
DR. HERMAWAN, SP.B 1124R0020322V002179 0002476434431 3;JKN
yani;3302226402970001; 5.6.5.202203091809 4 358494
1#0##0#0#0.0#2022-03-28
11:32:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
54d9b843eacdd9d2774df0c32edc7070 150000 0 0 0 0 0
0 0 0 0 15000 0 397419 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 01/10/1955 0 1
1 K40.9 - - - None None None None K-5-18-0 None None
None None None None PENYAKIT SISTEM PENCERNAAN LAIN-LAIN 242100
0 0 - 0 - 0 - 0 - 0 242100 197908
0 1 0 0 0 TUGIMIN.TN 102442 66 24271 DR.
yani;3302226402970001; 5.6.5.202203091809 4 358495
1#0##0#0#0.0#2022-03-28
11:32:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e8540aaa9e090aa1ad7a9d9951e467e6 150000 0 0 0 0 0
0 0 0 0 25000 0 22908 0 0 0 0 0
3372030 C 3 CP 2 12/03/2022 12/03/2022 07/05/2001 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001264309694 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
360778 1#0##0#0#0.0#2022-04-04
09:22:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
964e9bc53f6854a7e4b0d17c73447006 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 15/02/1952 0 1
0 - 0 - 0 - 0 129600 217143 0 1
0 0 0 HERY SANTOSO.TN 102443 70 25595 DR. WAHYU PURNOMO,
SP.OT 1124R0020322V002185 0002276809942 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 358496 1#0##0#0#0.0#2022-03-28
11:33:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
376f8007a13f6a1bda1db498ea4ca1ea 150000 0 0 0 0 0
0 0 0 0 25000 0 42143 0 0 0 0 0
3372030 C 3 CP 2 14/03/2022 14/03/2022 16/10/1980 0 2
None None None None INFEKSI SALURAN KEMIH AKUT 126600 0 0
- 0 - 0 - 0 - 0 126600 217277 0
1 0 0 0 PRIHATINA, NY 009030 41 15124 DR. GREETA
1124R0020322V002186 0001107294175 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361005 1#0##0#0#0.0#2022-04-04
17:21:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c3bd27c17e94b58b75a5cfc5289ae38a 155000 0 0 0 0 0
0 0 0 0 15000 0 47277 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 24/12/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI SUTANTI, NY
0000639837347 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358561 1#0##0#0#0.0#2022-04-04
09:55:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
62a98214bf7f82ab80d6f41ca05ae1f5 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 23/11/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 197582
yani;3302226402970001; 5.6.6.202203301209 4 358568
1#0##0#0#0.0#2022-04-04
09:56:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
94562ef3d61404d6c2fe563d79df52d3 150000 0 0 0 0 0
0 0 0 0 15000 0 32582 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 31/12/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 232134
0 1 0 0 0 SUNARTO ,BP 084994 66 24181 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 358569
1#0##0#0#0.0#2022-04-04
09:58:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f1b683d84163d19ca9ff57721e8a9ecb 150000 0 0 0 0 0
0 0 0 0 15000 0 67134 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 23/04/1968 0 2
1 Z09.8;K30;M54.59;M19.98;R51 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
224776 0 1 0 0 0 SURYATI, NY 037498 53 19684
yani;3302226402970001; 5.6.6.202203301209 4 358570
1#0##0#0#0.0#2022-04-04
10:00:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1edb6544c3d3e5fcd514126bdcf14cf5 150000 0 0 0 0 0
0 0 0 0 15000 0 59776 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 31/03/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 269368
0 1 0 0 0 SUPARENG.TN 061675 58 21534 DR. SUHARTO,
SP.PD 1124R0020322V002194 0001898526971 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358571 1#0##0#0#0.0#2022-04-04
10:01:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
508371dcb31fd7a9f57683d17dd294ed 150000 0 0 0 0 0
0 31845 0 0 15000 0 72523 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 03/03/1949 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MUYAS SAROH, NY
0000091167748 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358538 1#0##0#0#0.0#2022-04-04
10:02:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8e2d4b3681db55b366c321312e5af3da 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 31/12/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI ISWATIYARSI,
0001694440719 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358554 1#0##0#0#0.0#2022-04-04
10:02:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0f83bf72fc23d2016089e232f013de74 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 29/09/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARIA DIAH
1124R0020322V002197 0001211692601 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 358553 1#0##0#0#0.0#2022-05-19
08:58:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
023f9f21f89273b17e1fe46cb4216ae1 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 11/05/1943 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MURYATI.NY 094215
0000091214796 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358539 1#0##0#0#0.0#2022-04-04
10:04:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
47aff6e3a90b336d28cbe282b3a1b885 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 13/07/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 209853
0 1 0 0 0 PURWANINGSIH.NY 102302 53 19603 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358572
1#0##0#0#0.0#2022-04-04
10:06:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
da34956bf567639857fb1e9dfe531938 150000 0 0 0 0 0
0 0 0 0 15000 0 44853 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 31/12/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 323021
0 1 0 0 0 SUMINAH.NY 097751 62 22720 DR. SUHARTO,
SP.PD 1124R0020322V002201 0002071516072 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358573 1#0##0#0#0.0#2022-04-04
10:08:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
74b18a9eae1f1cc41b41a9528a1dc5a0 150000 0 0 0 0 0
0 31845 0 0 15000 0 126176 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 22/07/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 237551
0 1 0 0 0 SLAMET INDARMADI.TN 100416 66 24343
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 358574
1#0##0#0#0.0#2022-04-04
10:09:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2b99c97828607735a0f524fed1dccf07 150000 0 0 0 0 0
0 0 0 0 15000 0 72551 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 05/04/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 RUKMINTO.TN 099249 59 21894 DR. RINA
DIANA,SP.DV 1124R0020322V002203 0000093106539 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358575 1#0##0#0#0.0#2022-04-04
10:10:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dbcb554d9668ea932ea6b0ee2d8bad8c 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 07/01/1951 0 1
1 Z09.8;G20;I69.3;M19.99 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 495484
0 1 0 0 0 MUH NUKMAN.TN 080746 71 26000 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358576
1#0##0#0#0.0#2022-04-04
10:10:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
67de7dd97d42bc408524b5ec44589b9e 150000 0 0 0 0 0
0 0 0 0 15000 0 330484 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 03/07/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SOLICHATI, NY
0000091471465 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358560 1#0##0#0#0.0#2022-04-04
10:11:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9ce3269130ceb0f53e794fb2f19e1c8b 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 05/02/1956 0 2
0 - 0 - 0 - 0 - 0 204700 500694
yani;3302226402970001; 5.6.6.202203301209 4 358577
1#0##0#0#0.0#2022-04-04
10:12:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
65191f64df4bf240eb182f90ec159d5d 360000 0 0 0 0 0
0 0 0 0 15000 0 125694 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 16/02/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 965470
0000090964833 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361862 1#0##0#0#0.0#2022-04-07
13:01:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e82f38f8fa5f73cff33b499bd151da9c 150000 0 0 0 0 0
744000 0 0 0 15000 0 56470 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 26/03/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 232920
0 1 0 0 0 L M BASUKI, NY 048110 53 19712 DR.
novia;3313125201940001; 5.6.7.202204241238 4 358578
1#0##0#0#0.0#2022-05-19
08:23:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
1cdbee78281a03d69d88c13c5acf8ee8 150000 0 0 0 0 0
0 0 0 0 15000 0 67920 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 03/06/1973 0 2
- 0 - 0 - 0 - 0 182600 196196 0
1 0 0 0 NUK JUWARIAH, NY 086195 48 17817 DR. RINA
5.6.6.202203301209 4 358579 1#0##0#0#0.0#2022-04-04
10:16:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
792244c1f393ce9ce70327873dea9842 150000 0 0 0 0 0
0 0 0 0 15000 0 31196 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 07/07/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ENI PUJI ASTUTI
0002477029059 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358555 1#0##0#0#0.0#2022-04-04
10:17:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
477099937072977ed119a4ab129c2eb7 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 06/04/1969 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUPARWAN, TN
0001104843161 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
360887 1#0##0#0#0.0#2022-04-04
10:18:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1ec897d1b0d5d9d61c84367d4aabc401 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 21/02/1960 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI HARYATI.NY
0001302917049 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
360884 1#0##0#0#0.0#2022-05-20
07:58:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
71e18cc6caa9272a96865c7f48947538 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 14/04/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI MULYANI, NY
0000640565201 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358557 1#0##0#0#0.0#2022-04-04
10:19:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1cab431db150e22dd15cb75006424ecc 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 13/06/1971 0 2
1 Z09.8;L30.9 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 198476
novia;3313125201940001; 5.6.7.202204241238 4 358580
1#0##0#0#0.0#2022-05-19
10:25:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
c78051224b5560c85e97950f39435e42 150000 0 0 0 0 0
0 0 0 0 15000 0 33476 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 18/07/1986 0 2
0 - 0 - 0 - 0 - 0 549400 864099
0 1 0 0 0 RIA TRI HARTANTI.NY 098484 35 13024
yani;3302226402970001; 5.6.6.202203301209 4 358581
1#0##0#0#0.0#2022-04-04
10:22:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
879044beada9657b5c91bf07104cfdef 150000 0 0 0 0 0
678000 0 0 0 15000 0 21099 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 01/01/2000 0 1
0 0 - 0 - 0 - 0 - 0 181400 341697
0 1 0 0 0 RASIM., BP 044706 22 8109 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 358582
1#0##0#0#0.0#2022-04-04
10:23:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
db1fe28927f694b244cc42b3985dec33 150000 0 0 0 0 0
0 121345 0 0 15000 0 55352 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 20/03/1961 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI MIYATUN.NY
0000076431947 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358556 1#0##0#0#0.0#2022-04-04
10:59:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
50701531a8a16c50919112c39f20eaf3 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 08/06/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 263340
0 1 0 0 0 ZUMRONI, TN 075055 61 22560 DR. SUHARTO,
SP.PD 1124R0020322V002219 0000017205647 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 360900 1#0##0#0#0.0#2022-04-04
11:00:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
770df7254717219382d523f94d96ef89 150000 0 0 0 0 0
0 0 0 0 15000 0 98340 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 17/03/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 244706
0 1 0 0 0 SLAMETO, BP 087612 51 18991 DR. SUHARTO,
SP.PD 1124R0020322V002220 0001125846876 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358583 1#0##0#0#0.0#2022-04-04
11:01:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
857f22f1224df7a2b435f6f427978440 150000 0 0 0 0 0
0 0 0 0 15000 0 79706 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 29/12/1965 0 1
1 Z09.8;E11.9;N40 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 267333
0 1 0 0 0 SARWO EDHIE, TN 092522 56 20530 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358584
1#0##0#0#0.0#2022-04-04
11:02:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
79ea0922d9bb4948a6415402e9fbbcc9 150000 0 0 0 0 0
0 0 0 0 15000 0 102333 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 22/04/1967 0 1
1 Z09.8;R10.4;K80.2 88.76 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400
1019926 0 1 0 0 0 BAGYO PRAPTANTO., BP 042554
3;JKN agung;3313092303950002; 5.6.7.202204241238 4 360886
1#0##0#0#0.0#2022-06-17
15:24:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 8
79d6cbc9b686de9f0e3a978c33852441 150000 0 0 0 0 0
657000 0 0 0 15000 0 197926 0 0 0 0
0
3372030 C 3 CP 2 15/03/2022 15/03/2022 07/08/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 348891
yani;3302226402970001; 5.6.6.202203301209 4 358585
1#0##0#0#0.0#2022-04-04
11:11:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5a31beb41aa2d16e1d9d5a9cd4d05cab 150000 0 0 0 0 0
0 120795 0 0 15000 0 63096 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 11/06/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 194888
0 1 0 0 0 ENY SULASTRI,(NY) 033228 46 17079 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358586
1#0##0#0#0.0#2022-04-04
11:12:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d3cce15494a7c91666ff092759d7c2a1 150000 0 0 0 0 0
0 0 0 0 15000 0 29888 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 18/09/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
yani;3302226402970001; 5.6.6.202203301209 4 358587
1#0##0#0#0.0#2022-04-04
11:13:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5578532cf8023efc39dd23ec937485ec 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 28/10/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 TEMU MUJIYEM, NY
0000638873605 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358540 1#0##0#0#0.0#2022-04-04
11:15:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
3f2a9fe6aead7802b9d6e6c16d16fa9e 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 30/09/1997 0 2
0 - 0 - 0 - 0 183900 262840 0 1
0 0 0 YENI SUCI LESTARI, NY 102235 24 8932 DR.
yani;3302226402970001; 5.6.6.202203301209 4 360889
1#0##0#0#0.0#2022-04-04
11:16:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7a213ec326bfde5fc541ade6a814e149 220000 0 0 0 0 0
0 0 0 0 15000 0 27840 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 14/04/1960 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MARTINAH., NY
0001084606863 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358558 1#0##0#0#0.0#2022-04-04
11:17:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ceaa7eb51f9d67bca276cc360cf712b8 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 12/05/1958 0 1
1 H02.0;H18.8;H04.1 90.29 - - None None None None Q-5-42-0
None None None None None None PENYAKIT AKUT KECIL LAIN-LAIN 182600
0 0 - 0 - 0 - 0 - 0 182600 381025
0 1 0 0 0 TASLIM, TN 040885 63 23318 DR. YUDHI
novia;3313125201940001; 5.6.7.202204241238 4 358588
1#0##0#0#0.0#2022-05-19
08:11:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
33d470a8fb73ae1968976d31eac9ddd7 150000 0 0 0 69000 0
0 0 0 0 15000 0 147025 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 05/02/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 EKO CAHYANI
PURWANINGSIH, NY 065567 49 17935 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V002237 0001100445232 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358542 1#0##0#0#0.0#2022-04-04
11:19:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6da3bd3affec79a5d4e8edb92b5e9425 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 03/07/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 475600
0 1 0 0 0 WALUYO HADI SURYO,BP 084416 76 28014
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 358589
1#0##0#0#0.0#2022-04-04
11:20:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dd09509ff107a26b9bcdba37ecc102e5 150000 0 0 0 0 0
0 120795 0 0 15000 0 189805 0 0 0 0
0
3372030 C 3 CP 2 15/03/2022 15/03/2022 15/05/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 254000 0 1 0 0 0 YAHMINI ., NY
0001692527163 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358548 1#0##0#0#0.0#2022-04-04
11:20:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e234fc67f5f97c3697a4270c594559f1 239000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 07/11/1971 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 NUZUL HAKIM, TN
0002169296897 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358559 1#0##0#0#0.0#2022-04-04
11:21:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
913a207bd51d4c12356e0f821fcccad9 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 09/11/1965 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUMIYATI, NY
0000091584066 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358541 1#0##0#0#0.0#2022-04-04
11:22:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
27e880431817270d59090f8f66f80cdd 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 27/09/1965 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MARYATI., NY
0000640162157 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358552 1#0##0#0#0.0#2022-04-04
11:23:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fa13d96e50e341dadd3e4db63206e406 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 30/08/1961 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 RIA TRI RASMANI.
0001729980966 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358543 1#0##0#0#0.0#2022-04-04
11:23:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9ad413bde046a97c97e6081cf23d44e4 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 25/12/1957 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 WAHJUNINGSIH KARMADJAJA.NY 042202 64 23456
yani;3302226402970001; 5.6.6.202203301209 4 358518
1#0##0#0#0.0#2022-04-04
11:24:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0f9f98594a24ab2a1b3f533615d90940 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 08/08/1971 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 GIYANTI.NY 100284
0000639911507 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358529 1#0##0#0#0.0#2022-04-04
11:25:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d15b3b08afacad78ec2bb246347a2989 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 20/03/1961 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SLAMET RIYADI.TN
0001303435192 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358544 1#0##0#0#0.0#2022-04-04
11:26:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bdf6e356563fa93c9b640133cce63368 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 06/12/1990 0 1
1 M06.98 88.27 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 444930
0 1 0 0 0 TEGUH WALUYO.TN 102447 31 11422 DR.
novia;3313125201940001; 5.6.7.202204241238 4 361193
1#0##0#0#0.0#2022-05-20
10:30:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
3300b22068a04d260ebd146430dc1233 150000 0 0 0 0 0
248000 0 0 0 25000 0 21930 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 22/05/1989 0 2
0 - 0 - 0 - 0 - 0 296400 178794
0 1 0 0 0 FERY NUR MARLIN, NY 100422 32 11985
yani;3302226402970001; 5.6.6.202203301209 4 358590
1#0##0#0#0.0#2022-04-04
11:27:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2b5b7beb81e0f3053e826df210de7eec 150000 0 0 0 0 0
0 0 0 0 15000 0 13794 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 17/06/1983 0 2
0 - 0 - 0 - 0 - 0 549400 172238
0 1 0 0 0 DEWI KRISTYANINGSIH, NY 029845 38 14151
yani;3302226402970001; 5.6.6.202203301209 4 358591
1#0##0#0#0.0#2022-04-04
11:28:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
36de084ebdc7b2f4ec46d2a9c93c886d 150000 0 0 0 0 0
0 0 0 0 15000 0 7238 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 13/01/2018 0 1
0 0 - 0 - 0 - 0 - 0 181400 190166
0 1 0 0 0 ALWI NURROHIM ATMADJA,AN 061502 4
0002419579719 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358592 1#0##0#0#0.0#2022-04-04
11:29:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
19904715183f92310c8bb6488032b248 150000 0 0 0 0 0
0 0 0 0 15000 0 25166 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 01/11/1961 0 2
0 - 0 107400 273000 0 1 0 0 0
1124R0020322V002256 0000090942546 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358550 1#0##0#0#0.0#2022-04-04
11:29:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
47213c33486335ad6f7c37134585d2c6 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 18/02/1942 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 DARTINAH,NY 030952 80 29245 DR. LINDA
yani;3302226402970001; 5.6.6.202203301209 4 358520
1#0##0#0#0.0#2022-04-04
11:31:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bf4e2f057765909fc51ab9735cfb6039 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 18/04/1968 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 RAHMADI.TN 096843
0002169726311 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358547 1#0##0#0#0.0#2022-04-04
11:32:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
50c5b42da78674bdbc822e94fa030d2f 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 11/07/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI PARYATI, NY
0000091170516 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358545 1#0##0#0#0.0#2022-04-04
11:32:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
46a3cf4d4926132b4d92f037d89cd450 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 18/05/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 230000 0 1 0 0 0 SAMIYATI.NY 094791
0000046966566 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358519 1#0##0#0#0.0#2022-04-04
11:33:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c43be8319bdbfea68f8599c32fdc202c 215000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 31/12/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 281523
0 1 0 0 0 MADIYONO.TN 101732 66 24181 DR. GALIH
yani;3302226402970001; 5.6.6.202203301209 4 358593
1#0##0#0#0.0#2022-04-04
11:34:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
826403d8289c5278380afc58c057f473 150000 0 0 0 0 0
0 31845 0 0 15000 0 84678 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 28/05/1946 0 1
2 D12.8 - - - None None None None K-5-18-0 None None
0 0 - 0 - 0 - 0 - 0 242100 175000
0 1 0 0 0 ROMDHANI BLHK.TN 102448 75 27685 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358594
1#0##0#0#0.0#2022-04-04
11:36:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cbbaa3a1bcdcb0d9be3910d7dd004434 150000 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 12/06/1972 0 1
0 - 0 - 0 - 0 786200 495297 0 1
yani;3302226402970001; 5.6.6.202203301209 4 358500
1#0##0#0#0.0#2022-04-04
11:37:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1714048b89255312cc427490051ab321 463830 0 0 0 0 0
0 0 0 0 15000 0 16467 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 17/04/1961 0 2
0 - 0 - 0 - 0 786200 566148 0 1
yani;3302226402970001; 5.6.6.202203301209 4 358501
1#0##0#0#0.0#2022-04-04
11:38:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
60f7b868da108981809295175510b026 463830 0 0 0 0 0
0 0 0 0 15000 0 87318 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 18/04/1981 0 1
0 0 - 0 - 0 - 0 - 0 181400 274080
0 1 0 0 0 DUL RAHMAN EFEMDI.TN 102293 40 14941
yani;3302226402970001; 5.6.6.202203301209 4 360888
1#0##0#0#0.0#2022-04-04
11:39:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eaaade3a1163d1c8416b27075b105a8e 235000 0 0 0 0 0
0 0 0 0 15000 0 24080 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 01/04/1981 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V002269 0001904830593 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358502 1#0##0#0#0.0#2022-04-04
11:40:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9235f9e2e53290499671004e82887a59 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 09/07/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 465000
0 1 0 0 0 DARYANTO,(BP) 030707 59 21799 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358595
1#0##0#0#0.0#2022-04-04
11:41:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
85d2a7e6075c331c754e613fbc46e081 450000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 12/03/2004 0 1
0 0 - 0 - 0 - 0 - 0 181400 516255
0 1 0 0 0 ARINDRA YUDHO PRAKOSO.SDR 100775 18
yani;3302226402970001; 5.6.6.202203301209 4 358596
1#0##0#0#0.0#2022-04-04
11:41:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a8a2b5706a6a8572260956aa5ddbd66c 150000 0 0 0 0 0
0 0 0 0 15000 0 351255 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 05/06/1961 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARSIATUN, NY
0002311256204 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358551 1#0##0#0#0.0#2022-04-04
11:42:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
701ca5d0c9c7bf5aa081a407e15727f6 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 01/12/1958 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V002275 0001436949538 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358503 1#0##0#0#0.0#2022-04-04
11:43:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c0b64ba5ecec83149d80218d8c7f6660 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 25/05/1972 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V002276 0002431552465 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358504 1#0##0#0#0.0#2022-04-04
11:44:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cf6424db28370bbaf7525a21616c631e 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 12/04/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARIYAM.NY 084306
0001302703266 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358549 1#0##0#0#0.0#2022-04-04
11:45:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a37a45d9523df16d3b49424b3b1ef61e 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 04/04/1991 0 1
0 - 0 - 0 - 0 - 0 181400 209143
0 1 0 0 0 TRIYANTO SETYO PRABOWO,(SDR) 030025 30
yani;3302226402970001; 5.6.6.202203301209 4 358597
1#0##0#0#0.0#2022-04-04
11:46:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a88d985b6f6a626fd46866c1508f7634 150000 0 0 0 0 0
0 0 0 0 15000 0 44143 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 01/05/1975 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V002279 0001790328262 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358509 1#0##0#0#0.0#2022-04-04
11:47:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dcd4fcc554d5450c3675d8c0ca009e39 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 05/03/1979 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI WULAN.NY
0001286475028 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358546 1#0##0#0#0.0#2022-04-04
12:26:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9a9775aafdbdaf327ae09aa5c0c306a6 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 08/03/1967 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 358508
1#0##0#0#0.0#2022-04-04
12:27:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
158e37e7312a609fc0d5386a7da31903 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 01/12/1980 0 2
0 - 0 - 0 - 0 786200 528825 0 1
SP.PD 1124R0020322V002282 0000640230884 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358507 1#0##0#0#0.0#2022-04-04
12:30:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
10080956e2e6d9596d0f9264aa608789 463830 0 0 0 0 0
0 0 0 0 15000 0 49995 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 15/04/1973 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TATAS BUDIONO.TN
0001440938553 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358531 1#0##0#0#0.0#2022-04-04
12:32:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9835651df44585a2a5e672c4cf38c602 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 26/04/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 358506
1#0##0#0#0.0#2022-04-04
12:34:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a210099f0bff7d85a3cb0dc48f7fe1e0 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 31/12/1963 0 2
0 - 0 107400 262000 0 1 0 0 0
INDRAYATI, NY 091755 58 21259 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V002285 0002926021015 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358522 1#0##0#0#0.0#2022-04-04
12:35:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b00ccfe30b7bc5a21250bbb34687f7be 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 17/03/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUNARTI, (NY)
0000088913171 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358564 1#0##0#0#0.0#2022-04-04
12:38:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
41963425db9846fc0016a964c7defc01 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 20/08/1959 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V002287 0000571256594 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358505 1#0##0#0#0.0#2022-04-04
12:39:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
595fe67e1286df45a1ef8676f716259b 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 17/03/1962 0 1
0 - 0 - 0 - 0 894800 1485480 0 1
0 0 0 AHMAD RIYANTO 090597 59 21913 DR. ARIA CHANDRA
reni;3313147010930001; 5.6.6.202203301209 4 361473
1#0##0#0#0.0#2022-04-06
08:51:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d329686478dccfb3c9fbf23c204788cd 150000 0 0 0 0 0
1250000 0 0 0 15000 0 70480 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 04/02/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 213796
yani;3302226402970001; 5.6.6.202203301209 4 358599
1#0##0#0#0.0#2022-04-04
12:42:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5b686cd341feee82c2b97528458fc264 150000 0 0 0 0 0
0 0 0 0 15000 0 48796 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 18/01/1955 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 HARDJANINGSIH, NY 098784 67 24528 DR. LINDA
yani;3302226402970001; 5.6.6.202203301209 4 358536
1#0##0#0#0.0#2022-04-04
12:44:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a48af9c8b962532e88dce70bc5f0c0b6 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 26/09/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 219742
0 1 0 0 0 BAJURI, TN 000197 58 21355 DR. ARIA
novia;3313125201940001; 5.6.7.202204241238 4 358600
1#0##0#0#0.0#2022-05-18
10:11:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
60733c1e3c153bac7be44a90cb83f1aa 150000 0 0 0 0 0
0 0 0 0 15000 0 54742 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 06/07/1954 0 2
0 - 0 - 0 - 0 - 0 138400 576456
0 1 0 0 0 SUMARNI.NY 086963 67 24724 DR. LINDA
yani;3302226402970001; 5.6.6.202203301209 4 358537
1#0##0#0#0.0#2022-04-04
12:45:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7ca750545e856288f78a7eb646619e73 270000 0 0 0 0 0
0 0 0 0 15000 0 291456 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 06/05/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 218169
0 1 0 0 0 SUPRIHATIN, NY 095649 70 25881 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358601
1#0##0#0#0.0#2022-04-04
12:46:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
83cca7aabf8669b81be8e818e46cc209 150000 0 0 0 0 0
0 0 0 0 15000 0 53169 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 23/04/1960 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 SRI WAHYUNI, NY 087660 61 22606 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358535
1#0##0#0#0.0#2022-04-04
12:47:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4476005ad2857fa2607d7cfc84bbfb3e 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 15/06/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 252494
0 1 0 0 0 SUPIYEM, NY 011053 73 26936 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 358602
1#0##0#0#0.0#2022-04-04
12:50:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
743a3bfb5eaceeeb7077b6dcac33376e 150000 0 0 0 0 0
0 0 0 0 15000 0 87494 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 31/12/1958 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 SRI SUWANTI, NY 091754 63 23085 DR. LINDA
yani;3302226402970001; 5.6.6.202203301209 4 358526
1#0##0#0#0.0#2022-04-04
12:51:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b73d864d2a46692c95908370638ac6a4 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 03/07/1969 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 LUCIA SRI YULIANTI,(NY) 020318 52 19248 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358527
1#0##0#0#0.0#2022-04-04
12:51:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a6521389ee61e48e30dc90647d190995 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 17/01/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 265826
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 358603
1#0##0#0#0.0#2022-04-04
12:53:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f3762d3fe0c75ff25f1fd6195d18c065 150000 0 0 0 0 0
0 0 0 0 15000 0 100826 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 02/02/1963 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 SUJIYEM, NY 090600 59 21591 DR. LINDA
yani;3302226402970001; 5.6.6.202203301209 4 358532
1#0##0#0#0.0#2022-04-04
12:54:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c3be7c54048324910da878e50fcc0658 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 28/09/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 345764
0 1 0 0 0 RITA ZAHARA.NY 088962 57 20987 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358604
1#0##0#0#0.0#2022-04-04
12:54:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2c286738c621ddec2b09b160f6310b56 150000 0 0 0 0 0
0 0 0 0 15000 0 180764 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 03/08/1963 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 TENTREM.NY 089445 58 21409 DR. LINDA
yani;3302226402970001; 5.6.6.202203301209 4 358530
1#0##0#0#0.0#2022-04-04
12:55:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
293949f83be061bc261447c92daac704 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 15/07/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 208527
0 1 0 0 0 HERNAWAN, TN 101171 65 23984 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358605
1#0##0#0#0.0#2022-04-04
12:57:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
10a8be8c71950fc33b0d9be195fec423 150000 0 0 0 0 0
0 0 0 0 15000 0 43527 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 30/01/1975 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 CHOIRUN NISYA, NY 093236 47 17211 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358516
1#0##0#0#0.0#2022-04-04
12:57:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
70f76f8ec321fff42e59e59eb42acede 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 24/02/1973 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TRI BUDI SUWARTO.
0002169435251 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358563 1#0##0#0#0.0#2022-04-04
12:59:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
210724439fda63f7134122ea19571408 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 09/11/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 DALIYEM., NY
0001032593466 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358565 1#0##0#0#0.0#2022-04-04
13:00:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
57fa601af6f97fa79451957b00263943 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 20/01/1963 0 1
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 RESPATI DWI HANANTO, TN 101981 59 21604
yani;3302226402970001; 5.6.6.202203301209 4 358533
1#0##0#0#0.0#2022-04-04
13:01:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d898d02e98b3939503ca42cd09fd3e30 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 22/09/1959 0 1
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 SUMARSONO ,TN 087561 62 22820 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358523
1#0##0#0#0.0#2022-04-04
13:01:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
475b1526d16f6b8e69f5532b0b6e4f53 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 10/04/1950 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 MOEMINAH., NY 046939 71 26272 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358524
1#0##0#0#0.0#2022-04-04
13:02:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
71715cc31d71a5e7751fee4388274133 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 13/10/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 230087
0 1 0 0 0 NUNUK SUNDARI,(NY) 018287 59 21703
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 358606
1#0##0#0#0.0#2022-04-04
13:03:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8a01bec581568b5445b04adf882deb27 150000 0 0 0 0 0
0 0 0 0 15000 0 65087 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 05/03/1944 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SANTOSO. TN 088783
0000091319657 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358566 1#0##0#0#0.0#2022-04-04
13:05:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e537aa9edc2cfc6cdfdd14efdfabfcbb 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 23/11/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 246884
yani;3302226402970001; 5.6.6.202203301209 4 358607
1#0##0#0#0.0#2022-04-04
13:05:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
74fdcddbd141d2ad3736bd7e03f4c031 150000 0 0 0 0 0
0 0 0 0 15000 0 81884 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 12/01/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 EKO RINI.NY 093223
0000091524159 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358562 1#0##0#0#0.0#2022-04-04
13:06:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2d1bf8ed794fe074b8976a7bd2f2f53a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 03/04/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 250041
0 1 0 0 0 SUPARTI, NY 083297 52 19339 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 358608
1#0##0#0#0.0#2022-04-04
13:06:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3f74e14628ade494a43398fd89d8d75e 150000 0 0 0 0 0
0 0 0 0 15000 0 85041 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 07/07/1964 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 254000 0 1 0 0 0 WIRADI.TN 098841
0000640484785 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358534 1#0##0#0#0.0#2022-04-04
13:09:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
05b8adedd13550a77051cc1023f12ff5 239000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 01/12/1944 0 2
1 Z09.8;R47.1 93.35;93.39 - - None None None None M-3-16-0
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 284000 0 1 0 0 0 WANTIYEM.NY 078888
0000640044099 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358528 1#0##0#0#0.0#2022-04-04
13:10:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e2a76dc619aa3243207cb0e2bf289e6c 269000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 17/07/1946 0 2
0 0 - 0 - 0 - 0 - 0 181400 217910
0 1 0 0 0 JOE TJAY NIO.NY 101961 75 27635 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358609
1#0##0#0#0.0#2022-04-04
13:10:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
28f64d6760eaa9f1c0e9581e1aab068d 150000 0 0 0 0 0
0 0 0 0 15000 0 52910 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 27/01/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 202345
0 1 0 0 0 PONIRAH., NY 043666 71 25980 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358610
1#0##0#0#0.0#2022-04-04
13:11:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
757629c820c946a6c957a08e5502b323 150000 0 0 0 0 0
0 0 0 0 15000 0 37345 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 07/05/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 253198
yani;3302226402970001; 5.6.6.202203301209 4 358611
1#0##0#0#0.0#2022-04-04
13:12:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4b27e67d6b4e79ec45a9ab8ae17049fa 150000 0 0 0 0 0
0 0 0 0 15000 0 88198 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 13/06/1972 0 2
23-0 None None None None None None PROSEDUR ULTRASOUND LAIN-LAIN 549400
0 0 - 0 - 0 - 0 - 0 549400 447840
0 1 0 0 0 ERNA SUSANTI PUSPONINGRUM, NY 092657 49
0000163055294 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
360885 1#0##0#0#0.0#2022-04-04
13:13:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a33c1199386c23614170315fca75de3c 150000 0 0 0 0 0
220000 0 0 0 15000 0 62840 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 30/11/1962 0 1
1 Z09.8;I69.3;G20 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 453299
0 1 0 0 0 KUS HARYONO, TN 091114 59 21655 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358612
1#0##0#0#0.0#2022-04-04
13:15:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
86027af295667259c1bdd42e2d08139a 150000 0 0 0 0 0
0 0 0 0 15000 0 288299 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 03/03/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 240493
yani;3302226402970001; 5.6.6.202203301209 4 358613
1#0##0#0#0.0#2022-04-04
13:16:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2840c0da3c5c5ec81f1b3969ac6e1aaa 150000 0 0 0 0 0
0 0 0 0 15000 0 75493 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 04/08/1950 0 2
1 Z09.8;I69.3;G47.0 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 249909
0 1 0 0 0 SUNARTI.,NY 054610 71 26156 DR. ARIA
agung;3313092303950002; 5.6.7.202204241238 4 358615
1#0##0#0#0.0#2022-05-25
09:34:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
8270bfc4650a52f819947a4693fa2bb9 150000 0 0 0 0 0
0 0 0 0 15000 0 84909 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 31/12/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 248743
0 1 0 0 0 SUPIATUN 035437 72 26372 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 358616
1#0##0#0#0.0#2022-04-04
13:17:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e1028aa108cecfc53f9e0b4c8396719d 150000 0 0 0 0 0
0 0 0 0 15000 0 83743 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 28/04/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 336573
0 1 0 0 0 TURIDJAH, (NY) 016034 67 24793 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358617
1#0##0#0#0.0#2022-04-04
13:18:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c14403ad02d50e5c46bbbfaceedbfcbd 150000 0 0 0 0 0
0 0 0 0 15000 0 171573 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 05/03/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 231864
0001445069981 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358618 1#0##0#0#0.0#2022-04-04
13:19:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
50c05c77deb5bb890c6153a094171749 150000 0 0 0 0 0
0 0 0 0 15000 0 66864 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 27/07/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 213791
0 1 0 0 0 ANDI AHMAD, TN 074066 48 17763 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358619
1#0##0#0#0.0#2022-04-04
13:20:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
55b5a84dc7c9e53cd8e78c6bb5a1aefe 150000 0 0 0 0 0
0 0 0 0 15000 0 48791 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 20/07/1947 0 1
0 0 - 0 - 0 - 0 - 0 181400 243590
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 358620
1#0##0#0#0.0#2022-04-04
13:20:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5537a0557df6c8b756fde032138ee76e 150000 0 0 0 0 0
0 0 0 0 15000 0 78590 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 24/10/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 269055
0 1 0 0 0 ENDANG HAPSARI ,(NY) 040328 58 21327
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 358621
1#0##0#0#0.0#2022-04-04
13:21:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ec43772a18eb349729f695a069a33ec4 150000 0 0 0 0 0
0 0 0 0 15000 0 104055 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 31/12/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 207136
0 1 0 0 0 PARYATUN, NY 051446 70 25642 DR.
yani;3302226402970001; 5.6.6.202203301209 4 357820
1#0##0#0#0.0#2022-04-04
13:22:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
10f20f3bf47a077b8d27ab6a1292d926 150000 0 0 0 0 0
0 0 0 0 15000 0 42136 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 23/09/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 278938
yani;3302226402970001; 5.6.6.202203301209 4 358622
1#0##0#0#0.0#2022-04-04
13:25:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
543d61a06a34a16402fdc9d7d5382c9a 150000 0 0 0 0 0
0 0 0 0 15000 0 113938 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 18/03/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 237644
0 1 0 0 0 RAHARJO .TN 092313 73 27025 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 358623
1#0##0#0#0.0#2022-04-04
13:26:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
439f92dad21fb712dd11a9b97e497578 150000 0 0 0 0 0
0 0 0 0 15000 0 72644 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 13/06/1992 0 2
0 0 - 0 - 0 - 0 - 0 181400 215281
0001084671257 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358624 1#0##0#0#0.0#2022-04-04
13:28:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bc31825fc1f966ed1e136cc9e16f1a02 150000 0 0 0 0 0
0 0 0 0 15000 0 50281 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 26/05/1962 0 2
0 404900 418629 0 1 0 0 0 SRI REJEKI,NY
010002 59 21843 DR. ARIA CHANDRA GTS, SP.S., M.KES
1124R0020322V002340 0001084669997 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358625 1#0##0#0#0.0#2022-04-04
13:29:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c0e688c180c2bb71e7448caaf656ed7e 150000 0 0 0 0 0
0 0 0 0 15000 0 253629 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 02/03/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 228795
novia;3313125201940001; 5.6.7.202204241238 4 358627
1#0##0#0#0.0#2022-05-20
09:34:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
cb213ca4431b8f2674e0f780d6308ba7 150000 0 0 0 0 0
0 0 0 0 15000 0 63795 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 03/06/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 245729
0 1 0 0 0 ENDANG TRI YUNINGSIH.NY 089720 48 17817
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 358626
1#0##0#0#0.0#2022-04-04
13:31:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d0338d407ea7990af917845613899a62 150000 0 0 0 0 0
0 0 0 0 15000 0 80729 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 06/09/1976 0 1
0 0 - 0 - 0 - 0 - 0 181400 226028
yani;3302226402970001; 5.6.6.202203301209 4 358628
1#0##0#0#0.0#2022-04-04
13:34:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cf5ab5350783f62b9d60bb117b8a43de 150000 0 0 0 0 0
0 0 0 0 15000 0 61028 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 21/12/1946 0 1
0 0 - 0 - 0 - 0 - 0 181400 185055
0 1 0 0 0 SUTARMIN ATMO SUWITO,(TN) 028643 75
0001021693713 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358629 1#0##0#0#0.0#2022-04-04
13:34:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cabca7013a5c8b69299fbc7d7b802924 150000 0 0 0 0 0
0 0 0 0 15000 0 20055 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 11/03/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 239954
0 1 0 0 0 SRI MULYANI,NY 069401 61 22284 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358630
1#0##0#0#0.0#2022-04-04
13:35:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b32b2edf111da1e0f75a673d2cc0d378 150000 0 0 0 0 0
0 0 0 0 15000 0 74954 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 31/03/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 302198
0 1 0 0 0 WIWIED SETYARI SAMUANINGSIH., NY 047885
0000564477647 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358631 1#0##0#0#0.0#2022-04-04
13:37:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4a0579a2950b4ab8b79ad9925dc677ad 150000 0 0 0 0 0
0 0 0 0 15000 0 137198 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 30/09/1977 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000207436206 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358567 1#0##0#0#0.0#2022-04-04
13:38:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ec31d269c8f9e302c3410a6f0755f243 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 07/12/1943 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
286921 0 1 0 0 0 SUBAGIO WARYADI,(BP) 007604
0000067277845 3;JKN agung;3313092303950002; 5.6.7.202204241238 4
358632 1#0##0#0#0.0#2022-05-25
10:48:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
cd5321b80c34a2ca40c774027377c0a8 203000 0 0 0 0 0
0 0 0 0 15000 0 68921 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 08/08/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 286921
0 1 0 0 0 HJ ENDANG SRI ., NY 054099 71 26152
yani;3302226402970001; 5.6.6.202203301209 4 358633
1#0##0#0#0.0#2022-04-04
13:41:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4eea67da0966019ea2cf8393e368b644 203000 0 0 0 0 0
0 0 0 0 15000 0 68921 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 13/07/2003 0 1
0 0 - 0 - 0 - 0 - 0 181400 257182
yani;3302226402970001; 5.6.6.202203301209 4 358634
1#0##0#0#0.0#2022-04-04
13:41:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
13b1c751dcd220a1717e0864482b6eb1 203000 0 0 0 0 0
0 0 0 0 15000 0 39182 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 19/04/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 332070
0 1 0 0 0 ERIE ARISTOT MULAT.TN 097789 65 24071
yani;3302226402970001; 5.6.6.202203301209 4 358635
1#0##0#0#0.0#2022-04-04
13:47:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b5ba7ebafece7717c17633dd28e4fc53 203000 0 0 0 0 0
0 0 0 0 15000 0 114070 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 06/06/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 291255
0 1 0 0 0 ELISABETH EKO SRIMARTUTIK.,NY 061879 55
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 358636
1#0##0#0#0.0#2022-04-04
13:48:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
06b221c00d681594e6f9bc19bcb18eeb 203000 0 0 0 0 0
0 0 0 0 15000 0 73255 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 17/08/1977 0 2
1 Z09.8;E11.3;H36.0;H04.1 90.29 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 319819
0 1 0 0 0 SUWARNI, NY 079454 44 16281 DR. YUDHI
yani;3302226402970001; 5.6.6.202203301209 4 358637
1#0##0#0#0.0#2022-04-04
13:49:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
40f75578baeb3f8142ef268a6425d891 203000 0 0 0 0 0
0 0 0 0 15000 0 101819 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 15/10/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 218000
0 1 0 0 0 GOTOT SLAMET MULYONO.TN 096034 63 23162
yani;3302226402970001; 5.6.6.202203301209 4 358638
1#0##0#0#0.0#2022-04-04
13:49:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
51fcd86b8705f1be18a38716f67984d3 203000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 06/06/1955 0 2
1 Z09.8;E11.3;H36.0;Z96.1;H04.1 90.29 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
225836 0 1 0 0 0 SARWIJI.NY 095370 66 24389
yani;3302226402970001; 5.6.6.202203301209 4 358639
1#0##0#0#0.0#2022-04-04
13:51:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
57f96c602f85d519ac6d53c397da357a 203000 0 0 0 0 0
0 0 0 0 15000 0 7836 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 07/10/1963 0 1
1 Z09.8;E11.3;H36.0;H26.9;H04.1 90.29 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
286921 0 1 0 0 0 SUPARDI., BP 041629 58
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 358640
1#0##0#0#0.0#2022-04-04
13:53:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b46a21f1dcf8fb5a3238c63b92b17a68 203000 0 0 0 0 0
0 0 0 0 15000 0 68921 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 05/02/1943 0 2
0 0 - 0 - 0 - 0 - 0 181400 351165
0 1 0 0 0 CHRISTINA SURATMI.NY 084460 79 28893
yani;3302226402970001; 5.6.6.202203301209 4 358641
1#0##0#0#0.0#2022-04-04
13:54:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a599e856872fb6b65d0b0f9df4338a0b 203000 0 0 0 0 0
0 0 0 0 15000 0 133165 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 19/07/1950 0 2
1 Z09.8;H40.9;H18.8;Z96.1 90.29 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 443746
yani;3302226402970001; 5.6.6.202203301209 4 358642
1#0##0#0#0.0#2022-04-04
13:55:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5c33d1ed20b9c7c11948670e0a02ae49 203000 0 0 0 0 0
0 0 0 0 15000 0 225746 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 12/08/1958 0 2
1 Z09.8;Z96.1;E11.3;H36.0;H04.1 90.29 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
225836 0 1 0 0 0 RUT SRI SULISNING,NY 075204
0002092337864 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358643 1#0##0#0#0.0#2022-04-04
13:56:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b91ab752996253392f618ecaf53819ad 203000 0 0 0 0 0
0 0 0 0 15000 0 7836 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 06/01/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 286921
0 1 0 0 0 SRI SUTARNINGSIH.NY 086730 69 25270
yani;3302226402970001; 5.6.6.202203301209 4 358644
1#0##0#0#0.0#2022-04-04
13:59:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
80ae0d998a375c57c9a23b395c6cd509 203000 0 0 0 0 0
0 0 0 0 15000 0 68921 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 25/06/1962 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
286921 0 1 0 0 0 DARNI WIDAYATI 092677 59
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 358645
1#0##0#0#0.0#2022-04-04
14:00:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8eab39874fb8f49d4e7898f2b70db009 203000 0 0 0 0 0
0 0 0 0 15000 0 68921 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 13/05/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 297998
0 1 0 0 0 SUKO BASUKI.,TN 072721 67 24778 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358646
1#0##0#0#0.0#2022-04-04
14:01:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b49512b411488e130c656e7beaccc307 203000 0 0 0 0 0
0 0 0 0 15000 0 79998 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 01/07/1955 0 2
1 Z09.0;H11.0;Z96.1 90.29;97.89 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 282460
0 1 0 0 0 SUGENG, NY 100575 66 24364 DR. YUDHI
yani;3302226402970001; 5.6.6.202203301209 4 358647
1#0##0#0#0.0#2022-04-04
14:02:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b124e36448098963bc1a67b21afc8a01 203000 0 0 0 0 0
0 0 0 0 15000 0 64460 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 08/09/1948 0 2
1 Z09.8;H26.9;Z96.1;H04.1 90.29 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 277241
0 1 0 0 0 SUNARMI, NY 073823 73 26851 DR. YUDHI
yani;3302226402970001; 5.6.6.202203301209 4 358648
1#0##0#0#0.0#2022-04-04
14:03:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
92c47992c039309f1d9d9a143701b9cc 203000 0 0 0 0 0
0 0 0 0 15000 0 59241 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 14/06/2003 0 2
1 H00.0 90.29 - - None None None None Q-5-42-0 None None
- 0 - 0 - 0 - 0 182600 229097 0
1 0 0 0 SONIA DEWI K, NN 011278 18 6849 DR. YUDHI
novia;3313125201940001; 5.6.7.202204241238 4 358649
1#0##0#0#0.0#2022-05-18
10:47:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
6d36cefd704066e399a6fdffbe8ff782 203000 0 0 0 0 0
0 0 0 0 15000 0 11097 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 02/08/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 434460
0 1 0 0 0 YULI PURNOMO.TN 090489 61 22505 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358650
1#0##0#0#0.0#2022-04-07
13:35:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
7960165d79e624a741a6beadf7ca6267 300000 0 0 0 0 0
0 0 0 0 15000 0 119460 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 08/03/1947 0 1
0 0 - 0 - 0 - 0 - 0 181400 546505
0 1 0 0 0 SARONO PRIYO MARTONO, TN 089852 75
27401 DR. GALIH RAKASIWI SOEKARNO,SP.JP 1124R0020322V002371
0002344726034 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358651 1#0##0#0#0.0#2022-04-04
14:18:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0ffd70b25f15bb250c5d323a1a08a257 450000 0 0 0 0 0
0 0 0 0 15000 0 81505 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 04/09/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 427399
0 1 0 0 0 IPIED SUPADMI.NY 091931 64 23568 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358652
1#0##0#0#0.0#2022-04-04
14:20:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0b876b82b5758db812bdf0f4044c8a01 300000 0 0 0 0 0
0 0 0 0 15000 0 112399 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 14/08/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 370358
0 1 0 0 0 NINUL SUTARNI.NY 090668 66 24320 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358653
1#0##0#0#0.0#2022-04-04
14:20:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3f740fa8ae901401567352ee13dac5d9 300000 0 0 0 0 0
0 0 0 0 15000 0 55358 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 07/04/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 396093
0 1 0 0 0 SUTRISNO, BP 069129 55 20431 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358654
1#0##0#0#0.0#2022-04-04
14:21:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9fa41157aed35bc35b404025096a56ec 300000 0 0 0 0 0
0 0 0 0 15000 0 81093 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 18/08/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 386478
0 1 0 0 0 AGUS WIYONO, TN 061975 69 25411 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358655
1#0##0#0#0.0#2022-04-04
14:21:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5479cf1477be7119232e56623f1ba94e 300000 0 0 0 0 0
0 0 0 0 15000 0 71478 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 15/10/1979 0 1
0 0 - 0 - 0 - 0 - 0 181400 369285
0 1 0 0 0 SLAMET SURATNO, TN 098824 42 15492
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 358656
1#0##0#0#0.0#2022-04-04
14:23:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cddd1b86a2d84abfa602a17fd0ae599d 300000 0 0 0 0 0
0 0 0 0 15000 0 54285 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 03/09/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 411290
0 1 0 0 0 BERNAND PAAIS BP 078046 58 21378 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358657
1#0##0#0#0.0#2022-04-04
14:24:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a5824559b1191b1122dc9f72c77ab7d4 300000 0 0 0 0 0
0 0 0 0 15000 0 96290 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 10/06/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 550103
0 1 0 0 0 SUWANTO, TN 102251 69 25480 DR. GALIH
agung;3313092303950002; 5.6.7.202204241238 4 358658
1#0##0#0#0.0#2022-05-25
11:03:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
a5ea3a4b36f7566f7ef59f32e5997b56 300000 0 0 0 0 0
0 0 0 0 15000 0 235103 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 09/05/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 377464
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 358659
1#0##0#0#0.0#2022-04-04
14:27:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d29498eb4f96bba3afe23ed7b73937f6 300000 0 0 0 0 0
0 0 0 0 15000 0 62464 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 31/10/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 370864
3;JKN agung;3313092303950002; 5.6.7.202204241238 4 358660
1#0##0#0#0.0#2022-05-25
09:32:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
37cfda1846414fa086ede011d9c12101 300000 0 0 0 0 0
0 0 0 0 15000 0 55864 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 03/01/1946 0 1
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 IR. PRIYANTO. TN 088698 76 27830 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358661
1#0##0#0#0.0#2022-04-04
14:30:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dc42fad2023a547146d974b5dadd60b7 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 01/09/1964 0 1
0 - 0 - 0 - 0 786200 765654 0 1
SP.PD 1124R0020322V002383 0000639614597 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358515 1#0##0#0#0.0#2022-04-04
14:31:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
106c93d50a86a73071edd54917800995 662676 0 0 0 0 0
0 0 0 0 15000 0 87978 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 23/12/1977 0 2
0 - 0 - 0 - 0 786200 677676 0 1
yani;3302226402970001; 5.6.6.202203301209 4 358514
1#0##0#0#0.0#2022-04-04
14:32:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f6991c27557c5b24944898727ac11401 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 25/03/1978 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 358513
1#0##0#0#0.0#2022-04-04
14:32:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dd81115ee9098e54d62f9071e098dcb5 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 09/03/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 RINDARMADI.TN 089698 53 19364 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361928
1#0##0#0#0.0#2022-04-07
12:56:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3e423d50c2d2283c1e5a6de4727dd37f 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 02/09/1976 0 1
0 - 0 - 0 - 0 786200 677676 0 1
yani;3302226402970001; 5.6.6.202203301209 4 358512
1#0##0#0#0.0#2022-04-04
14:33:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7e7791b2e5d0087ef05a17e07b80a267 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 15/05/1953 0 1
0 - 0 - 0 - 0 786200 694854 0 1
yani;3302226402970001; 5.6.6.202203301209 4 358511
1#0##0#0#0.0#2022-04-04
14:33:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d3c46679e062485c0c96c157bd87ec5b 662676 0 0 0 0 0
0 0 0 0 15000 0 17178 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 10/12/1952 0 1
1 Z09.8;I69.3;F03 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 361183
0 1 0 0 0 SUPARMAN, TN 098419 69 25297 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358662
1#0##0#0#0.0#2022-04-04
14:34:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bf9dc5d32d91aed4fa8b5d62715a3ed9 150000 0 0 0 0 0
0 0 0 0 15000 0 196183 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 20/12/1960 0 2
1 Z09.8;H26.9;E11.3;H36.0;H11.0;H04.1 90.29 - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 286921 0 1 0 0 0 KASIH ANGGRAENI, NY
093093 61 22365 DR. YUDHI DORANDES, SP.M 1124R0020322V002393
0002580682533 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
358663 1#0##0#0#0.0#2022-04-04
14:35:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
67fd8d77e03f309df291ddd4dd18b70d 203000 0 0 0 0 0
0 0 0 0 15000 0 68921 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 09/05/1975 0 1
0 - 0 - 0 - 0 786200 694854 0 1
0 0 0 RAHMAN, TN 097908 46 17112 DR. TEKY WIDYARINI,
SP.PD 1124R0020322V002394 0001105378571 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358510 1#0##0#0#0.0#2022-04-04
14:36:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
203b4157e88423cfa87bb13ea13a318b 662676 0 0 0 0 0
0 0 0 0 15000 0 17178 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 25/02/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 220869
novia;3313125201940001; 5.6.7.202204241238 4 358664
1#0##0#0#0.0#2022-05-20
10:10:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
9dd4b66ed8e51570d42fee361da6c0ed 150000 0 0 0 0 0
0 0 0 0 15000 0 55869 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 15/01/1981 0 1
0 0 - 0 - 0 - 0 - 0 181400 264198
0 1 0 0 0 JONI TURAHYO., BP 049289 41 15034 DR.
yani;3302226402970001; 5.6.6.202203301209 4 358665
1#0##0#0#0.0#2022-04-04
14:39:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3e3b52247fa918f9c926a5479523a155 150000 0 0 0 0 0
0 0 0 0 15000 0 99198 0 0 0 0 0
3372030 C 3 CP 2 15/03/2022 15/03/2022 31/12/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 286921
0 1 0 0 0 NGATIYEM.NY 067636 69 25276 DR. YUDHI
yani;3302226402970001; 5.6.6.202203301209 4 358666
1#0##0#0#0.0#2022-04-04
14:40:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 15/03/2022 15/03/2022 28/02/2008 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0001106709579 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
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14:40:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 15/03/2022 15/03/2022 11/09/1947 0 1
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yani;3302226402970001; 5.6.6.202203301209 4 358517
1#0##0#0#0.0#2022-04-04
14:41:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 15/03/2022 15/03/2022 02/04/1948 0 2
1 G81.9;W19.0 - - - None None None None Q-5-43-0 None
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reni;3313147010930001; 5.6.6.202203301209 4 361006
1#0##0#0#0.0#2022-04-04
17:23:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 03/12/1998 0 2
1 R10.4;R51 - - - None None None None Q-5-25-0 None
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reni;3313147010930001; 5.6.6.202203301209 4 361007
1#0##0#0#0.0#2022-04-04
17:24:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3ab054b8cf87f6f33c17ee29464d0a09 155000 0 0 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 15/01/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 336269
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yani;3302226402970001; 5.6.5.202203091809 4 360014
1#0##0#0#0.0#2022-03-29
09:11:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d1adfaab7099bae3ddf3816a57588be2 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 02/06/1966 0 1
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yani;3302226402970001; 5.6.5.202203091809 4 360015
1#0##0#0#0.0#2022-03-29
09:12:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0b4a6dc4f39a4a7e11c7706ca472c0cc 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 25/04/1959 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 360016
1#0##0#0#0.0#2022-03-29
09:13:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 06/06/1956 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 360017
1#0##0#0#0.0#2022-03-29
09:14:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 16/10/1964 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 360018
1#0##0#0#0.0#2022-03-29
09:14:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 17/07/1961 0 2
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3;JKN yani;3302226402970001; 5.6.5.202203091809 4 360019
1#0##0#0#0.0#2022-03-29
09:16:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 31/12/1963 0 1
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yani;3302226402970001; 5.6.5.202203091809 4 360020
1#0##0#0#0.0#2022-03-29
09:17:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1fa9dbfbf088fb4fd21bb87ecf7c56ac 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 01/04/1962 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
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3;JKN yani;3302226402970001; 5.6.5.202203091809 4 360021
1#0##0#0#0.0#2022-03-29
09:20:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 01/09/2009 0 2
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agung;3313092303950002; 5.6.7.202204241238 4 360022
1#0##0#0#0.0#2022-05-25
10:54:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 16/03/2022 16/03/2022 24/10/1961 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 360023
1#0##0#0#0.0#2022-03-29
09:22:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 26/01/1969 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 360024
1#0##0#0#0.0#2022-03-29
09:23:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a70c8ed4f67554ec1fdcb139d7c54939 0 0 138000 0 0 0
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0
3372030 C 3 CP 2 16/03/2022 16/03/2022 02/11/1964 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 360025
1#0##0#0#0.0#2022-03-29
09:24:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e52b5cff49cf24f1c8035872102277c7 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 31/07/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 572960
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yani;3302226402970001; 5.6.5.202203091809 4 360026
1#0##0#0#0.0#2022-03-29
09:25:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f4852831ec9c92e449129818bd677b42 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 02/10/1964 0 2
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0 1 0 0 0 ESTUNINGSIH ., NY 054786 57 20984 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360027
1#0##0#0#0.0#2022-03-29
09:26:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 01/05/1965 0 1
1 Z09.8;E11.4;G59.0;I10 87.49 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 787597
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yani;3302226402970001; 5.6.5.202203091809 4 360028
1#0##0#0#0.0#2022-03-29
09:27:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 14/07/1973 0 2
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3;JKN yani;3302226402970001; 5.6.5.202203091809 4 360029
1#0##0#0#0.0#2022-03-29
09:27:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b8531ec40b5e026950cbae265d99a1dc 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 22/11/1960 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 360030
1#0##0#0#0.0#2022-03-29
09:28:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3d88b59fd4aeabedb07fa96def186a57 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 29/09/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 763992
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yani;3302226402970001; 5.6.5.202203091809 4 360031
1#0##0#0#0.0#2022-03-29
09:29:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
acc3fc27ea39574014486fa05caff6d4 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 20/03/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 300835
0 1 0 0 0 SUPARNI,(NY) 015342 62 23007 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360032
1#0##0#0#0.0#2022-03-29
09:30:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
204e9213914822285d0519059442b12a 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 22/08/1947 0 2
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1124R0020322V002435 0000091082722 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 360012 1#0##0#0#0.0#2022-03-29
09:31:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ef29bd14a0269118f8c31c8c6d2b129e 247000 0 0 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 09/04/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 373153
0 1 0 0 0 AFIDA SUSILOWATI.NY 084451 57 21160
yani;3302226402970001; 5.6.5.202203091809 4 360033
1#0##0#0#0.0#2022-03-29
09:32:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
792ebe3869c11e866c86ada34f480dbc 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 31/12/1966 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 360034
1#0##0#0#0.0#2022-03-29
09:33:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 30/08/1960 0 1
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yani;3302226402970001; 5.6.5.202203091809 4 360035
1#0##0#0#0.0#2022-03-29
09:34:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7d5bfd509cacdb72f969a65e7a58cab3 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 13/02/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 387352
0 1 0 0 0 ATIK SUNARNI, NY 100495 59 21581 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360036
1#0##0#0#0.0#2022-03-29
09:35:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
067e4d7ed9c32e9af6dfaf2baa35e5ab 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 12/08/1941 0 1
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0 1 0 0 0 BUKARI NATASUT JIPTO, TN 101453 80
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 360037
1#0##0#0#0.0#2022-03-29
09:35:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
de7d2de4c56eb74b53f31849e8926365 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 11/08/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 312299
0 1 0 0 0 SUGIYARTO, TN 076307 58 21402 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360038
1#0##0#0#0.0#2022-03-29
09:36:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6b62dc0f7af06addfa56ac5faed47344 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 30/08/1942 0 2
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0 1 0 0 0 SRI MURNI BUKARI,NY 095710 79 29053
yani;3302226402970001; 5.6.5.202203091809 4 360039
1#0##0#0#0.0#2022-03-29
09:36:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 21/02/1960 0 2
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3;JKN novia;3313125201940001; 5.6.7.202204241238 4 360529
1#0##0#0#0.0#2022-05-20
07:59:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
51b9d1a98db059d3dd06c344cd24a3c2 0 0 185000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 10/11/1954 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 360040
1#0##0#0#0.0#2022-03-29
09:44:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
28339e9f563e08049aa5c1af0321f080 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 14/04/1993 0 2
1 Z35.8;O34.2 - - None None None None Q-5-23-0 None
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SP.OG 1124R0020322V002445 0003130048247 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 360041 1#0##0#0#0.0#2022-05-20
09:15:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
2001a97c3335f4893aacc6b6e54bad79 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 26/03/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0000641664819 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
360011 1#0##0#0#0.0#2022-05-19
08:24:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
4998b7f02a8f011738f257a766f17370 258000 0 0 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 08/03/1962 0 1
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yani;3302226402970001; 5.6.5.202203091809 4 360042
1#0##0#0#0.0#2022-03-29
09:46:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
925710867ad1c0fb6edec4dd8bf9dbea 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 19/11/1951 0 1
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yani;3302226402970001; 5.6.5.202203091809 4 360043
1#0##0#0#0.0#2022-03-29
09:47:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
03abce6074ce270b535babf133ea4178 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 21/06/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 219981
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yani;3302226402970001; 5.6.5.202203091809 4 360044
1#0##0#0#0.0#2022-03-29
09:48:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 25/06/1966 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 360045
1#0##0#0#0.0#2022-03-29
09:49:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 17/11/1946 0 2
0 0 - 0 - 0 - 0 - 0 181400 188750
0 1 0 0 0 YOSEFHINA KASINEM POKAREM.NY 089527 75
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 360046
1#0##0#0#0.0#2022-03-29
09:50:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
17be5d1bf31d48c3f15f50acfc1cc359 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 18/08/1982 0 1
0 0 - 0 - 0 - 0 - 0 181400 207922
0 1 0 0 0 ENDRO PRASETYO, BP 085044 39 14455
yani;3302226402970001; 5.6.5.202203091809 4 360047
1#0##0#0#0.0#2022-03-29
09:51:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9d69cab8a7937872fe4122a04be03a0c 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 10/03/1924 0 1
0 0 - 0 - 0 - 0 - 0 181400 330609
0 1 0 0 0 SIKIR PADMOSOEKIRNO ,TN 053614 98 35800
yani;3302226402970001; 5.6.5.202203091809 4 360048
1#0##0#0#0.0#2022-03-29
09:52:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b5e283fc90ee7b23f4101224af95ee78 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 06/03/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 235245
0 1 0 0 0 DARMINI, NY 087821 68 24847 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 360049
1#0##0#0#0.0#2022-03-29
09:52:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
925916e090d3933748b55d2e81ba6bd1 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 23/07/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 196667
0 1 0 0 0 TRI YULIARTI 001163 49 18133 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360050
1#0##0#0#0.0#2022-03-29
09:53:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9d9ca68b73ad7d6dd065cf5a89fafa38 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 05/05/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 213476
0 1 0 0 0 PARYADI, TN 100666 51 18943 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 360051
1#0##0#0#0.0#2022-03-29
09:53:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
90436f5ea31280a700a1a0d70c86fa34 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 30/10/1981 0 2
0 - 0 - 0 - 0 - 0 549400 421177
0 1 0 0 0 DEVI EKOWATI. NY 011107 40 14747 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360052
1#0##0#0#0.0#2022-03-29
09:54:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 56177 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 31/12/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400
1008545 0 1 0 0 0 SUBARDJO, TN 098793 65
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 360053
1#0##0#0#0.0#2022-03-29
09:55:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fc244ffd30ed92d3bf7700e560e0b967 0 0 138000 0 0 0
0 76045 0 0 15000 0 779500 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 23/07/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001868943565 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
360010 1#0##0#0#0.0#2022-03-29
09:56:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
44baeb2561be49a243f27bd4c8ac7102 204000 0 0 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 14/06/1957 0 2
0 - 0 - 0 - 0 183900 331576 0 1
0 0 0 SUPRIYATI.NY 102283 64 23651 DR. DAMAR ARYO,
SP.B 1124R0020322V002463 0000042745274 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 360054 1#0##0#0#0.0#2022-03-29
09:57:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2495b65d5bcd87ef42ba107f0dc83bd4 235000 0 0 0 0 0
0 0 0 0 15000 0 81576 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 03/12/1960 0 1
1 Z09.8;I10;F88 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 189088
0 1 0 0 0 SURAHMAN, TN 099728 61 22383 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360055
1#0##0#0#0.0#2022-03-29
09:58:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e482ab13ccfd9ac41a214c64f42f1e69 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 01/03/1936 0 2
0 0 - 0 - 0 - 0 - 0 181400 203826
0 1 0 0 0 SOELASIH.NY 084493 86 31426 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 360056
1#0##0#0#0.0#2022-03-29
10:00:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
074b6213df4f64587764c7a56e307987 150000 0 0 0 0 0
0 0 0 0 15000 0 38826 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 18/08/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 255947
0 1 0 0 0 RINI PUSPITA, NY 058002 70 25778 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360057
1#0##0#0#0.0#2022-03-29
10:01:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
236f8fdc032c8ab408036d470f58f838 0 0 138000 0 0 0
0 0 0 0 15000 0 102947 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 31/03/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 387337
0 1 0 0 0 ENDANG WAHYUNINGSIH.,NY 072454 52 19343
yani;3302226402970001; 5.6.5.202203091809 4 360058
1#0##0#0#0.0#2022-03-29
10:02:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d71b6d19da611dfb48f4b82a19826b2e 150000 0 0 0 0 0
0 76595 0 0 15000 0 145742 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 02/03/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 231983
0 1 0 0 0 SAWAL WIRANTO.TN 100747 56 20468 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360059
1#0##0#0#0.0#2022-03-29
10:03:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3b3961aedf8f1371da80f5f3cfdb5dcf 150000 0 0 0 0 0
0 31845 0 0 15000 0 35138 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 24/04/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 300732
0 1 0 0 0 KAYADI, TN 080553 77 28450 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 360060
1#0##0#0#0.0#2022-03-29
10:04:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6563af755b404b7dbd7ffa08c5eee74b 0 0 138000 0 0 0
0 76045 0 0 15000 0 71687 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 23/03/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 384967
0 1 0 0 0 SRI LESTARI,(NY) 035396 56 20812 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360061
1#0##0#0#0.0#2022-03-29
10:05:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
18d7f88f252563256df7e831e8f3314d 150000 0 0 0 0 0
0 121345 0 0 15000 0 98622 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 08/11/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001692526781 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
360013 1#0##0#0#0.0#2022-03-29
10:06:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5d278b05469c766996600571e0bc7a8b 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 29/02/1972 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
268921 0 1 0 0 0 SRI UTAMI.NY 095373 50
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 360063
1#0##0#0#0.0#2022-03-29
10:07:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dc488634a721c987f4fc2ce7cfb49534 0 0 185000 0 0 0
0 0 0 0 15000 0 68921 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 06/06/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 215224
0 1 0 0 0 JOKO WALUYO, BP 074713 71 26216 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360064
1#0##0#0#0.0#2022-03-29
10:09:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ed4b0ea1f4138f380b09bfe8ae599b7c 150000 0 0 0 0 0
0 0 0 0 15000 0 50224 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 09/10/1987 0 2
0 0 - 0 - 0 - 0 - 0 296400 170248
0 1 0 0 0 CHUSNA MAULIDA, NY 097735 34 12577
yani;3302226402970001; 5.6.5.202203091809 4 360065
1#0##0#0#0.0#2022-03-29
10:25:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e392e5cf6f5959e024583936da4a7846 0 0 138000 0 0 0
0 0 0 0 15000 0 17248 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 06/09/1958 0 1
1 Z09.8;H26.9;Z96.1;H40.9;H04.1 90.29 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
289551 0 1 0 0 0 HARYATNO.TN 101375 63 23202
yani;3302226402970001; 5.6.5.202203091809 4 360062
1#0##0#0#0.0#2022-03-29
10:06:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3151f00dc9e0a914903a737ca24e895b 0 0 185000 0 0 0
0 0 0 0 15000 0 89551 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 19/03/1976 0 1
0 0 - 0 - 0 - 0 - 0 181400 271012
0 1 0 0 0 MULYADI.TN 092230 45 16798 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 360066
1#0##0#0#0.0#2022-03-29
10:26:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cd11180558736088bf5e51b5dd2cf19a 0 0 138000 0 0 0
0 0 0 0 15000 0 118012 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 17/07/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 462583
0 1 0 0 0 PANIJEM.NY 064795 69 25444 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 360067
1#0##0#0#0.0#2022-03-29
10:27:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f09688159ba81b927f32e086512e0ea5 0 0 138000 0 0 0
0 120795 0 0 15000 0 188788 0 0 0 0
0
3372030 C 3 CP 2 16/03/2022 16/03/2022 06/08/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 234161
0 1 0 0 0 TRI WIDIYATI. NY 000842 47 17389 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360068
60#0##0#0#0.0#2022-03-29
10:28:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
54fa1c131342c4bcc0ae56a1fc2f31f5 0 0 138000 0 0 0
0 0 0 0 15000 0 81161 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 31/12/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 318051
0 1 0 0 0 AMINAH, NY 072466 64 23451 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 360069
1#0##0#0#0.0#2022-03-29
10:29:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
887cb07a1b709099ca7dec3f7bb5079d 0 0 138000 0 0 0
0 0 0 0 15000 0 165051 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 17/07/1978 0 2
None None None None PEMERIKSAAN POSTPARTUM 86900 0 0 - 0
- 0 - 0 - 0 86900 306768 0 1 0 0
0 RUWANI.NY 101744 43 15948 DR. GUNAWAN, SP.OG
1124R0020322V002483 0001530396178 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 360070 1#0##0#0#0.0#2022-03-29
10:30:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
48c605c62cb5ff3d83ea034cc3f761ee 0 0 184000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 24/04/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 240633
0 1 0 0 0 HABIB WINARTO, TN 097988 63 23337 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360071
1#0##0#0#0.0#2022-03-29
10:31:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
66824af5137be652fe40c34b0916dcf9 0 0 185000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 21/03/1983 0 1
1 Z09.8;I11.0;N18.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 499391
0 1 0 0 0 ARIS WARSITO, TN 100676 38 14240 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360072
1#0##0#0#0.0#2022-03-29
10:33:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1db339e3a9965b955fa7b562ea699783 0 0 138000 0 0 0
0 0 0 0 15000 0 346391 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 01/04/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 626056
0 1 0 0 0 SURIP HADI SUTRISNO, (BP) 032273 71
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 360073
1#0##0#0#0.0#2022-03-29
10:33:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5a0150c2ecc815fb09f48be824f04374 0 0 138000 0 0 0
0 31845 0 0 15000 0 441211 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 11/09/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 460699
0 1 0 0 0 SUSI ASIH.NY 089998 49 18083 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360074
1#0##0#0#0.0#2022-03-29
10:34:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1cdab3c3c28d4126e26dd65c5574b4db 0 0 138000 0 0 0
0 63690 0 0 15000 0 244009 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 28/08/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 241477
0 1 0 0 0 ABDUL ROSYID.TN 085474 62 22846 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360075
1#0##0#0#0.0#2022-03-29
10:43:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
586c4c97284e4c52d7d31cd0691442e2 0 0 138000 0 0 0
0 0 0 0 15000 0 88477 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 12/09/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 381932
0 1 0 0 0 ISKANDAR BUDI RAHARJO,BP 088368 53
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 360076
1#0##0#0#0.0#2022-03-29
10:45:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
03f56a73cd2cb00c33c99cde3cc9c50a 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 27/04/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 268921
0 1 0 0 0 SRI HARTATI, NY 070715 72 26621 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360077
1#0##0#0#0.0#2022-03-29
10:50:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
31029c15c4d4ee39d3f6e7eaab9d0572 0 0 185000 0 0 0
0 0 0 0 15000 0 68921 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 28/04/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 169534
0 1 0 0 0 SENO SARJITO, TN 092457 55 20411 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360078
1#0##0#0#0.0#2022-03-29
10:50:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cd41922c443166789c1b1856e5c333f0 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 07/07/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 267886
0 1 0 0 0 SURATNO MITRO.S 064129 76 28011 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360079
1#0##0#0#0.0#2022-03-29
10:51:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b3e0ed49fb25f917c9e9fe5116a1d1a0 0 0 138000 0 0 0
0 0 0 0 15000 0 114886 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 21/06/1982 0 2
1 Z35.8;O32.9 - - - None None None None Q-5-23-0 None
None None None None None PEMERIKSAAN ANTEPARTUM 127200 0 0
- 0 - 0 - 0 - 0 127200 170248 0
1 0 0 0 SRI YANI, (NY) 011952 39 14513 DR. GUNAWAN,
SP.OG 1124R0020322V002494 0001903329156 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 360080 1#0##0#0#0.0#2022-03-29
10:52:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9d006fa07d55bee56c85d082dad0478d 0 0 138000 0 0 0
0 0 0 0 15000 0 17248 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 13/06/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 702223
0 1 0 0 0 SARDJITO,TN 084189 60 22191 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 360081
1#0##0#0#0.0#2022-04-07
14:41:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bfb316e50d6bf256b53011eff951f4a8 0 0 138000 0 0 0
0 121345 0 0 15000 0 427878 0 0 0 0
0
3372030 C 3 CP 2 16/03/2022 16/03/2022 03/06/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 207704
0 1 0 0 0 RUBIYEM, NY 067364 68 25123 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 360082
1#0##0#0#0.0#2022-03-29
10:54:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ed844d268bf6c0f34fcea52c5f638073 0 0 138000 0 0 0
0 0 0 0 15000 0 54704 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 02/04/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 211021
0 1 0 0 0 KARMILA SUGIYANTI,NY 036072 49 18245
yani;3302226402970001; 5.6.5.202203091809 4 360083
1#0##0#0#0.0#2022-03-29
11:05:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1577c56cc15fcd47547076b4ee8d481f 0 0 138000 0 0 0
0 0 0 0 15000 0 58021 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 25/03/1955 0 2
0 - 0 107400 262000 0 1 0 0 0
1124R0020322V002499 0000639810066 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359994 1#0##0#0#0.0#2022-03-29
11:14:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f0f04b5a5249e16684af6452be5bfc76 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 28/09/1940 0 2
0 0 - 0 - 0 - 0 - 0 181400 268921
0 1 0 0 0 IMAKULATA UTAMI, NY 056961 81 29754
yani;3302226402970001; 5.6.5.202203091809 4 360084
1#0##0#0#0.0#2022-03-29
11:27:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d0f7e6e3546ad91cfd6e39160024932a 0 0 185000 0 0 0
0 0 0 0 15000 0 68921 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 10/01/1994 0 2
0 0 - 0 - 0 - 0 - 0 181400 282609
novia;3313125201940001; 5.6.6.202203301209 4 360085
77#0##0#0#0.0#2022-03-31
08:50:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
1a25e24c0293eb44efc68542a6040dec 0 0 138000 0 0 0
0 0 0 0 15000 0 129609 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 31/08/1998 0 2
0 - 0 107400 262000 0 1 0 0 0 RARAS
DANASTRI 083059 23 8598 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V002503 0001279114907 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359993 1#0##0#0#0.0#2022-03-29
11:31:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
37f524133b512950d436e0a5e324de6c 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 15/09/1960 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TRI ATMODJO, TN
0001620260728 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
360008 1#0##0#0#0.0#2022-03-29
11:32:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8f2d6a820839b3d79c0c648f51f82c1c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 08/06/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 LAMIYEM.NY 087484
0001316300512 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
360009 1#0##0#0#0.0#2022-03-29
11:33:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8edec159611e98588ef3917bc6d8fe0e 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 31/08/1962 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI HARTINA
1124R0020322V002506 0001958592576 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 360007 1#0##0#0#0.0#2022-03-29
11:41:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a7455caa8008f592f1a24bfd40c50c97 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 14/05/1987 0 2
0 0 - 0 - 0 - 0 - 0 296400 170248
0 1 0 0 0 RINI PUJI HASTUTI.NY 098270 34 12725
novia;3313125201940001; 5.6.6.202203301209 4 360086
82#0##0#0#0.0#2022-04-01
11:50:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
349f370fd91085b3611411f039f37b2a 0 0 138000 0 0 0
0 0 0 0 15000 0 17248 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 08/12/1949 0 1
1 Z09.8;G81.9;M75.0 93.35;93.39 - - None None None None M-3-
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SISWO SARJONO,(BP)
0000564473013 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
360006 1#0##0#0#0.0#2022-03-29
11:47:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
595b30469fe97e47e08d26219c843a01 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 11/04/1967 0 2
1 Z09.8;E11.3;H36.0;H04.1;H52.4 90.29;95.01 - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 279848 0 1 0 0 0 SUMIYATI, NY 051426
0000564974245 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
360087 1#0##0#0#0.0#2022-03-29
11:48:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3c48f202c4a09b71a5c632c27a80d708 0 0 230000 0 0 0
0 0 0 0 15000 0 34848 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 17/09/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 268921
0 1 0 0 0 WARNO.TN 097648 61 22460 DR. YUDHI
yani;3302226402970001; 5.6.5.202203091809 4 360088
1#0##0#0#0.0#2022-03-29
11:49:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
65bed080e6f7ab77829bd547f9656156 0 0 185000 0 0 0
0 0 0 0 15000 0 68921 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 02/08/1973 0 2
0 - 0 107400 273000 0 1 0 0 0
ISWINDARI., NY 047078 48 17758 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V002513 0001792902148 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 360005 1#0##0#0#0.0#2022-03-29
11:54:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
379258c50792d0a95f2591dad60b0e54 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 05/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DANIK KARTIKA
1124R0020322V002514 0001445069981 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359995 1#0##0#0#0.0#2022-03-29
12:14:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b3cea21e83cf7d44a10a01873463923f 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 16/05/1956 0 2
1 Z09.8;M75.0;M17.9 93.35;93.39 - - None None None None M-3-
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WIDI WINARSI.NY
0001849841414 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359992 1#0##0#0#0.0#2022-03-29
12:16:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
51e67fde9da862780074c0dca50d9295 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 04/07/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 314070
0 1 0 0 0 SUKRAMTO.TN 101783 66 24362 DR. YUDHI
yani;3302226402970001; 5.6.5.202203091809 4 360089
1#0##0#0#0.0#2022-03-29
14:28:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d126c9a7dced6c82ebce3c096fcce148 0 0 185000 0 0 0
0 0 0 0 15000 0 114070 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 17/01/1940 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SITI JAHIDJAH, NY
0000091261743 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
360004 1#0##0#0#0.0#2022-03-29
14:30:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6bc16d1b985bfe5072a035c53bcf8e48 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 02/03/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 213800 0 1 0 0 0 SUMARNI, NY 101618
0000089014184 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
359997 1#0##0#0#0.0#2022-05-20
09:34:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
2b36cdbce2fe043af2ea36d6778fae62 0 0 198800 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 19/08/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000089786147 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359998 1#0##0#0#0.0#2022-03-29
14:54:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ed5f25795890cc32ad95af889fdcc904 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 15/11/2018 0 1
1 F80.9 - - None None None None F-5-16-0 None None
None None None None PSIKOTHERAPI INDIVIDU PADA KANAK-KANAK DENGAN MASALAH
KESEHATAN MENTAL 262800 0 0 - 0 - 0 - 0 -
0 262800 153000 0 1 0 0 0 ARIQ MAUZA
ALFAREZI, AN 086682 3 1217 DR. ANI SURYANTI WISYASTUTI, SP.A., M.KES
1124R0020322V002521 0002579775748 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 360090 1#0##0#0#0.0#2022-05-19
10:33:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
7a267f158b6fe2578e503d097a495453 0 0 138000 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 04/05/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 416189
0 1 0 0 0 EDY SUNARYO, TN 095163 57 21135 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360091
1#0##0#0#0.0#2022-03-29
14:57:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9d8aa3f45aced3552e407398c0f280de 0 0 138000 0 0 0
0 88950 0 0 15000 0 174239 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 24/02/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 208000 0 1 0 0 0 SRI PURWANI.NY
0001125886228 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
360002 1#0##0#0#0.0#2022-03-29
14:58:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9de784d851d5c4ceed415e0cebb67262 193000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 04/03/2022 0 1
1 Q66.0 - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 153000
0 1 0 0 0 BAYI NYONYA DWI PRIHATIN 102463 0
0003258469798 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
360092 1#0##0#0#0.0#2022-05-20
10:44:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
1b936a4c9dd1455c1124ddcad9df3c03 0 0 138000 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 01/05/1972 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MARIJAN.TN 101629
0002579827296 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
360003 1#0##0#0#0.0#2022-03-29
15:02:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dd6640726185b7f5b8792aa709c37d3e 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 05/06/1975 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001272616569 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
360001 1#0##0#0#0.0#2022-03-29
15:03:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
da7cf04edabb9480feadb598b0ab90bf 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 14/05/1933 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 207500 0 1 0 0 0 KOESWANTO BA.TN
0000091081451 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359999 1#0##0#0#0.0#2022-03-29
15:05:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8244b319d525074ce636cf7a8a3e04c2 0 0 192500 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 26/09/1963 0 1
0 - 0 107400 273000 0 1 0 0 0
1124R0020322V002530 0001104121822 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 360000 1#0##0#0#0.0#2022-05-18
10:11:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
4a7a9ec8e735d15f9013e4e0e5ef8b88 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 18/06/1953 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WIDIJARNI, NY
0000091364973 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359996 1#0##0#0#0.0#2022-03-29
15:07:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c3b1b610d138b70403a779a956c4cbd5 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 06/02/1997 0 2
0 0 - 0 - 0 - 0 - 0 181400 200409
0 1 0 0 0 MARINA TRI MULIAWATI.NY 093630 25 9169
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 360093
1#0##0#0#0.0#2022-03-29
15:08:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0f15f354b1d9cd7e394ae394c36c5f79 150000 0 0 0 0 0
0 0 0 0 15000 0 35409 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 30/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 186110
yani;3302226402970001; 5.6.5.202203091809 4 360094
1#0##0#0#0.0#2022-03-29
15:08:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
240064e029f8dc00d0342938dcbb8ab0 0 0 138000 0 0 0
0 0 0 0 15000 0 33110 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 18/12/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 240629
0 1 0 0 0 SULISTIANTO.TN 102281 55 20177 DR.
yani;3302226402970001; 5.6.5.202203091809 4 360095
1#0##0#0#0.0#2022-03-29
15:09:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a3c600c65d620ae607d968f68532d5e1 0 0 138000 0 0 0
0 0 0 0 15000 0 87629 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 03/12/1950 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 359984
1#0##0#0#0.0#2022-03-30
09:32:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2e5ce651fbb01d0490ede96791c10ef0 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 07/06/2002 0 1
- 0 - 0 - 0 - 0 206700 144000 0
1 0 0 0 SAAD AR RASYID.SDR 102464 19 7222 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360096
1#0##0#0#0.0#2022-03-30
09:33:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fcf4b044357dfe2b5e5cb77f14a27846 0 0 129000 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 09/09/1944 0 1
0 - 0 - 0 - 0 786200 677676 0 1
SP.PD 1124R0020322V002538 0000100867893 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359985 1#0##0#0#0.0#2022-03-30
09:33:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d1c7dd20a0f72d4e57cd4396f356cd35 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 18/07/1964 0 1
0 - 0 - 0 - 0 786200 677676 0 1
SP.PD 1124R0020322V002539 0002425018184 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359986 1#0##0#0#0.0#2022-03-30
09:34:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cd51f25824c68581a98c562684e9dd58 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 31/12/1981 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 359987
1#0##0#0#0.0#2022-03-30
09:35:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0fcf71e67f2b9cc0772c37baaac4b7de 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 16/06/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 366109
0 1 0 0 0 SUHARNI.NY 057461 56 20727 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 360097
1#0##0#0#0.0#2022-03-30
09:36:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
010db4fc7204dbd3d6ad295a13081741 0 0 138000 0 0 0
0 31845 0 0 15000 0 181264 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 02/02/1972 0 2
0 - 0 - 0 - 0 786200 607342 0 1
SP.PD 1124R0020322V002542 0002070978546 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359988 1#0##0#0#0.0#2022-03-30
09:36:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
500fad55a835ff1e53f4110530cf2289 463830 0 0 0 0 0
0 0 0 0 15000 0 128512 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 14/03/1977 0 1
0 - 0 - 0 - 0 786200 677676 0 1
yani;3302226402970001; 5.6.5.202203091809 4 359989
1#0##0#0#0.0#2022-03-30
09:37:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c0424ab63285f27dbf45419dbec1af3d 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/03/2022 16/03/2022 25/03/1992 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ERIKAH PRAHTAMA,(NY) 039894 29 10948 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360098
1#0##0#0#0.0#2022-03-30
09:38:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 12/03/1955 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 359990
1#0##0#0#0.0#2022-03-30
09:39:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 01/01/1977 0 1
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SP.PD 1124R0020322V002546 0001147281805 3;JKN yani;3302226402970001;
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09:39:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
22391695511c7df25fdffb188272edf0 463830 0 0 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 06/04/1985 0 2
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0 0 0 DIFIA KRISTANTI ARUM SARI.NY 102460 36 13493 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360099
1#0##0#0#0.0#2022-03-30
09:40:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 01/10/1957 0 2
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1 0 0 0 NITA DETA.NY 102465 64 23542 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360100
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09:41:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 06/07/1968 0 2
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09:42:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.6.5.202203091809 4 360102
1#0##0#0#0.0#2022-03-30
09:51:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 12/04/2001 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 360103
1#0##0#0#0.0#2022-03-30
09:54:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 26/06/1955 0 2
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0 0 0 SUMIYATI.NY 102453 66 24370 DRG. VERAWATY, SP.KG
1124R0020322V002552 0000090701965 3;JKN yani;3302226402970001;
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09:55:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 21/01/2007 0 1
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yani;3302226402970001; 5.6.5.202203091809 4 360105
1#0##0#0#0.0#2022-03-30
09:55:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 04/08/1968 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 360106
1#0##0#0#0.0#2022-03-30
09:58:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d9608a86e334c5189311625de6542cf5 300000 0 0 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 18/06/2005 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ARFIA AISYA RACHMA, NN 101778 16 6115 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360107
1#0##0#0#0.0#2022-03-30
09:58:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 13/05/1979 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 UTIK DWI RISTANTI, NY 101600 42 15648 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360108
1#0##0#0#0.0#2022-03-30
09:59:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a5500f526f3d4f417178fd40e1b38fbf 300000 0 0 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 20/01/1990 0 2
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5.6.5.202203091809 4 360109 1#0##0#0#0.0#2022-03-30
10:01:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 06/06/1992 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 360110
1#0##0#0#0.0#2022-03-30
10:06:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
765850f3cf54694b31eb752d91edde7c 300000 0 0 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 11/06/1948 0 1
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0 0 0 ISTIADJID.TN 102455 73 26941 DRG. VERAWATY,
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5.6.5.202203091809 4 360111 1#0##0#0#0.0#2022-03-30
10:07:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 31/12/1974 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 360112
1#0##0#0#0.0#2022-03-30
10:07:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 20/04/1985 0 2
0 - 0 - 0 - 0 - 0 549400 522325
0 1 0 0 0 DWI PRIHATIN.NY 102462 36 13479 DR.
agung;3313092303950002; 5.6.6.202203301209 4 360113
1#0##0#0#0.0#2022-04-11
12:03:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
5358f48259fa5e1301bceaef81db05ae 425000 0 0 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 31/12/1947 0 2
1 Z09.8;N83.2;D25.9 88.79 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400 371138
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yani;3302226402970001; 5.6.5.202203091809 4 360114
1#0##0#0#0.0#2022-03-30
10:10:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 20/09/1983 0 1
0 - 0 - 0 - 0 283800 339233 0 1
0 0 0 JAUHAF PERSADANI SAPUTRA.TN 102458 38 14057 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360115
1#0##0#0#0.0#2022-03-30
10:11:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5b1ea25f9b285522ec7b2fa115c3768c 300000 0 0 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 26/01/1999 0 2
0 - 0 - 0 - 0 283800 339233 0 1
0 0 0 UMMU SALAMAH.NN 102461 23 8450 DRG. VERAWATY,
SP.KG 1124R0020322V002566 0001021686399 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 360116 1#0##0#0#0.0#2022-03-30
10:11:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 20/02/1996 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 IDA FITRIYAH, NN 102489 26 9521 DRG. VERAWATY,
SP.KG 1124R0020322V002567 0000590111346 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 360117 1#0##0#0#0.0#2022-03-30
10:12:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 31/12/1948 0 2
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yani;3302226402970001; 5.6.5.202203091809 4 360118
1#0##0#0#0.0#2022-03-30
10:13:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 21/12/1978 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 NUR WIJAYANTI.NY 100003 43 15791 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360119
1#0##0#0#0.0#2022-03-30
10:15:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 22/08/2006 0 1
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 MUHAMAD ARADIANSYAH PUTRA.AN 102456 15 5685 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360120
1#0##0#0#0.0#2022-03-30
10:16:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4cb53f856f61451af56452605c4bb559 300000 0 0 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 01/10/1975 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 SUSY ARY PPURNAMI.NY 101819 46 16968 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360121
1#0##0#0#0.0#2022-03-30
10:16:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 12/07/1966 0 1
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yani;3302226402970001; 5.6.5.202203091809 4 359983
1#0##0#0#0.0#2022-03-30
10:17:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c9fff2164d03129adf39fd11bc7e212f 463830 0 0 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 02/01/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 167046
yani;3302226402970001; 5.6.5.202203091809 4 360122
1#0##0#0#0.0#2022-03-30
10:17:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2b43d9d703f324618a260d836a056513 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 08/10/1982 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 YOVIKA OKTORIANA, (NY) 010284 39 14404 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360123
1#0##0#0#0.0#2022-03-30
10:21:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d15a20fb1e04cd926f04ba91283a2091 300000 0 0 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 20/02/1979 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SUKARNO.TN 088700 43 15730 DR. TEKY
yani;3302226402970001; 5.6.5.202203091809 4 360124
1#0##0#0#0.0#2022-03-30
10:21:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
873767b06cd08a0544664163f97c16a2 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 05/03/2004 0 1
0 - 0 - 0 - 0 283800 325000 0 1
0 0 0 HAIDAR DZAKI.SDR 102467 18 6585 DRG. VERAWATY,
SP.KG 1124R0020322V002577 0001289161585 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 360125 1#0##0#0#0.0#2022-03-30
10:23:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6a9c5d6d7ec4741f528b5646ab8bca19 300000 0 0 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 06/07/1988 0 2
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0002235908362 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
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10:23:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 15/07/1970 0 1
1 Z09.8;G20 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400
1325982 0 1 0 0 0 RUDY MANTIRI,(BP) 020515 51
0001104686324 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
360127 1#0##0#0#0.0#2022-03-30
10:26:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 12/05/2013 0 2
- 0 - 0 - 0 - 0 549400 153000 0
1 0 0 0 AYUK FITRIA.AN 092081 8 3230 DR. ANI
SURYANTI WISYASTUTI, SP.A., M.KES 1124R0020322V002581 0002346301348 3;JKN
agung;3313092303950002; 5.6.6.202203301209 4 360128
1#0##0#0#0.0#2022-04-07
11:24:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 16/03/2022 16/03/2022 19/09/1983 0 1
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1 0 0 0 MURDI.TN 099347 38 14058 DRG. VERAWATY,
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5.6.5.202203091809 4 360129 1#0##0#0#0.0#2022-03-30
10:33:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
187ba408765af889ef5a806a47a68c9c 200000 0 0 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 11/08/1958 0 2
- 0 - 0 - 0 - 0 283800 273000 0
1 0 0 0 IR ERNA UTARI.NY 101958 63 23228 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360130
1#0##0#0#0.0#2022-03-30
10:33:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b57b177636c18da4503bc23b03908575 0 0 258000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 29/09/1970 0 2
- 0 - 0 - 0 - 0 283800 273000 0
novia;3313125201940001; 5.6.7.202204241238 4 360131
1#0##0#0#0.0#2022-05-19
08:58:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 16/03/2022 16/03/2022 23/12/1971 0 2
- 0 - 0 - 0 - 0 283800 273000 0
yani;3302226402970001; 5.6.5.202203091809 4 360132
1#0##0#0#0.0#2022-03-30
10:35:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5b098c7e12c6052e99655032dfc05365 0 0 258000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 22/08/1973 0 2
- 0 - 0 - 0 - 0 283800 273000 0
1 0 0 0 SRI SUYATNI.NY 101501 48 17738 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360133
1#0##0#0#0.0#2022-03-30
10:36:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f97608b1663d57fe0bf3bee42d89836a 0 0 258000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 01/01/2000 0 2
- 0 - 0 - 0 - 0 283800 273000 0
yani;3302226402970001; 5.6.5.202203091809 4 360134
1#0##0#0#0.0#2022-03-30
10:37:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a47e80a6da5303914085a634be1cea22 0 0 258000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 15/02/1969 0 2
- 0 - 0 - 0 - 0 283800 273000 0
1 0 0 0 ENDAH PUJIASIH, NY 002102 53 19387 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360135
1#0##0#0#0.0#2022-03-30
10:45:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 13/01/1998 0 1
- 0 - 0 - 0 - 0 283800 273000 0
1 0 0 0 GADANG JATI KUNCORO 101710 24 8828 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360136
1#0##0#0#0.0#2022-03-30
10:54:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
313d7c83216bca33c3e8d3ae87c35ab0 0 0 258000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 29/05/1976 0 2
- 0 - 0 - 0 - 0 283800 273000 0
yani;3302226402970001; 5.6.5.202203091809 4 360137
1#0##0#0#0.0#2022-03-30
10:58:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
773a202e77c0530e698c3b44b455454f 0 0 258000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 15/09/2002 0 2
- 0 - 0 - 0 - 0 283800 273000 0
1 0 0 0 NITA NOVITA, NN 101324 19 7122 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360138
156#0##0#0#0.0#2022-03-30
11:05:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/03/2022 16/03/2022 01/02/1973 0 1
- 0 - 0 - 0 - 0 283800 273000 0
1 0 0 0 PURJIYANTO, TN 019800 49 17940 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360139
1#0##0#0#0.0#2022-03-30
11:06:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5ca655c325a3d4bf97dc5e875a3fe896 0 0 258000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 30/07/1998 0 2
- 0 - 0 - 0 - 0 283800 273000 0
1 0 0 0 RISKA INDAH, (NN) 009714 23 8630 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360140
1#0##0#0#0.0#2022-03-30
11:07:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
106adb762dffdc1faaddd60cb7b675df 0 0 258000 0 0 0
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3372030 C 3 CP 2 16/03/2022 16/03/2022 17/03/1986 0 2
- 0 - 0 - 0 - 0 283800 339233 0
1 0 0 0 RATNA NILASARI, NY 001398 35 13148 DRG.
yani;3302226402970001; 5.6.5.202203091809 4 360141
1#0##0#0#0.0#2022-03-30
11:11:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
07aae177b722930d80501f70314ba983 300000 0 0 0 0 0
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3372030 C 3 CP 2 17/03/2022 17/03/2022 03/04/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 492634
0 1 0 0 0 PONIARSI, NY 100933 67 24820 DR.
yani;3302226402970001; 5.6.6.202203301209 4 360687
1#0##0#0#0.0#2022-03-31
10:52:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
337314847efbefd0217c593ecaf10528 150000 0 0 0 48000 0
230000 0 0 0 15000 0 49634 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 28/05/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 474580
0 1 0 0 0 SUGIYARSI, NY 092712 64 23669 DR.
yani;3302226402970001; 5.6.6.202203301209 4 360689
1#0##0#0#0.0#2022-03-31
10:58:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d1c0712e55376ab44ec9874a1237eaf0 150000 0 0 0 0 0
248000 0 0 0 15000 0 61580 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 04/03/2022 0 1
2 Q66.0 - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 BAYI NYONYA DWI PRIHATIN 102463 0
3;JKN novia;3313125201940001; 5.6.7.202204241238 4 359500
1#0##0#0#0.0#2022-05-20
10:44:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 17/03/2022 17/03/2022 21/12/2008 0 1
0 0 - 0 - 0 - 0 - 0 181400 184998
0 1 0 0 0 RIZKY KURNIA PRATAMA.AN 098931 13 4834
novia;3313125201940001; 5.6.7.202204241238 4 359502
1#0##0#0#0.0#2022-05-20
07:54:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
efe9074cf7dcc2ba0b050784cb731ccc 150000 0 0 0 0 0
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3372030 C 3 CP 2 17/03/2022 17/03/2022 20/07/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 221817
0 1 0 0 0 SITI ZUHRIYAH,(NY) 039654 69 25442
novia;3313125201940001; 5.6.7.202204241238 4 359504
1#0##0#0#0.0#2022-05-19
08:05:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 17/03/2022 17/03/2022 08/01/1962 0 2
0 404900 412678 0 1 0 0 0 TRI SUWARTI, NY
0000640243236 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359506 1#0##0#0#0.0#2022-03-31
11:06:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9bed06d1b6890c288b630913045ca842 150000 0 0 0 0 0
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3372030 C 3 CP 2 17/03/2022 17/03/2022 03/07/1935 0 2
0 0 - 0 - 0 - 0 - 0 181400 212726
0 1 0 0 0 MARFUNGATUN.NY 087156 86 31669 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359509
1#0##0#0#0.0#2022-03-31
11:07:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8e4f965bb8078fa896fcbe121a1dab64 150000 0 0 0 0 0
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3372030 C 3 CP 2 17/03/2022 17/03/2022 02/06/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 423671
0 1 0 0 0 MUDIYONO.TN 076273 49 18185 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 359511
1#0##0#0#0.0#2022-03-31
11:11:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b6d161ece6fc4dfe070395a16f65fc82 150000 0 0 0 48000 0
0 76045 0 0 15000 0 134626 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 12/04/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 215777
0 1 0 0 0 MARJIATI, NY 080213 44 16410 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359516
1#0##0#0#0.0#2022-03-31
11:12:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b35dbc950cdcc249143270e296baa237 150000 0 0 0 0 0
0 0 0 0 15000 0 50777 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 19/09/1949 0 1
1 Z09.8;I11.9;E78.5;E79.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 356207
0 1 0 0 0 SURIPNO, TN 067208 72 26477 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 359520
1#0##0#0#0.0#2022-03-31
11:14:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c6b13d9f719e7deeed8f2649e7e564fc 150000 0 0 0 0 0
0 88950 0 0 15000 0 102257 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 16/07/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 371825
0 1 0 0 0 ALEXIUS MARGONO., BP 047769 65 23985
yani;3302226402970001; 5.6.6.202203301209 4 359522
1#0##0#0#0.0#2022-03-31
11:14:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f7051f310e81d8873a96176b77a53932 150000 0 0 0 0 0
0 108440 0 0 15000 0 98385 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 13/05/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 310563
0 1 0 0 0 MOCH TAMRIN, TN 036678 60 22223 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359524
1#0##0#0#0.0#2022-03-31
11:17:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
be3f98b673601fd73bfc501b46338f30 150000 0 0 0 0 0
0 31845 0 0 15000 0 113718 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 17/03/2005 0 2
- 0 - 0 - 0 - 0 182600 224601 0
1 0 0 0 MARCA ROHMAHNASYROH U.AN 025380 16 6209
yani;3302226402970001; 5.6.6.202203301209 4 359529
1#0##0#0#0.0#2022-03-31
11:25:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
259389d46abc915a329520a9b36014c3 150000 0 0 0 0 0
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3372030 C 3 CP 2 17/03/2022 17/03/2022 04/10/1946 0 1
0 0 - 0 - 0 - 0 - 0 181400 372009
0 1 0 0 0 SUDARNO. TN 084750 75 27558 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 359532
1#0##0#0#0.0#2022-03-31
11:26:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a6e4df47a6eac1f6c150878aa067826b 150000 0 0 0 0 0
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3372030 C 3 CP 2 17/03/2022 17/03/2022 03/02/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 347400
0 1 0 0 0 DWI PRIYATMO SUHADI.TN 099409 68 24879
yani;3302226402970001; 5.6.6.202203301209 4 359526
1#0##0#0#0.0#2022-03-31
11:19:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e9efdae0e3557f05f38afed8c323eaef 150000 0 0 0 0 0
0 49590 0 0 15000 0 132810 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 27/03/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 255961
0 1 0 0 0 DEWI MARTININGSIH.NY 028769 52 19348
yani;3302226402970001; 5.6.6.202203301209 4 359535
1#0##0#0#0.0#2022-03-31
11:28:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cf03f4cb922ff5004348991ce3baf4f0 150000 0 0 0 0 0
0 76595 0 0 15000 0 14366 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 07/05/1950 0 2
1 M16.9;W19.0 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 215591
0 1 0 0 0 SUYAMTI, NY 071234 71 26247 DR. WAHYU
yani;3302226402970001; 5.6.6.202203301209 4 359537
1#0##0#0#0.0#2022-03-31
11:29:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c8bdcd5d400792d0b4d2a820bcc6957c 150000 0 0 0 0 0
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3372030 C 3 CP 2 17/03/2022 17/03/2022 27/11/1986 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 YARNI, NY 093021
0001480946409 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359475 1#0##0#0#0.0#2022-03-31
12:56:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3dce4d0a1dccbce0dd1922621633dc13 258000 0 0 0 0 0
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3372030 C 3 CP 2 17/03/2022 17/03/2022 08/07/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 212477
0 1 0 0 0 ALIEFINO ZALVA SURYA.SDR 087960 19
yani;3302226402970001; 5.6.6.202203301209 4 359540
1#0##0#0#0.0#2022-03-31
12:57:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3d06b7030b76d7309d939580e42b6de7 150000 0 0 0 0 0
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3372030 C 3 CP 2 17/03/2022 17/03/2022 08/06/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 213252
0 1 0 0 0 I WAYAN KADER,TN 102179 50 18545 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359543
1#0##0#0#0.0#2022-03-31
12:58:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f746de45a1b2ca1ef1ecc0ac313b99ac 150000 0 0 0 0 0
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3372030 C 3 CP 2 17/03/2022 17/03/2022 30/01/1975 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 CHOIRUN NISYA, NY
0002461992445 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359439 1#0##0#0#0.0#2022-03-31
12:59:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 17/03/2022 17/03/2022 27/08/1960 0 1
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0 1 0 0 0 MOCH ALI S , TN 00439 61 22482 DR. RINA
5.6.6.202203301209 4 359547 1#0##0#0#0.0#2022-03-31
12:59:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1700561df34ecc5d4e0c86d4029a8c39 150000 0 0 0 0 0
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3372030 C 3 CP 2 17/03/2022 17/03/2022 30/09/1960 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
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yani;3302226402970001; 5.6.6.202203301209 4 359557
1#0##0#0#0.0#2022-03-31
13:00:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8ccccaaaae0b2023bdb1e179a9669d63 150000 0 0 0 0 0
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3372030 C 3 CP 2 17/03/2022 17/03/2022 17/08/1970 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
579904 0 1 0 0 0 MULYANI, (NY) 002898 51
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359560
1#0##0#0#0.0#2022-03-31
13:02:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 17/03/2022 17/03/2022 01/01/2000 0 1
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yani;3302226402970001; 5.6.6.202203301209 4 359562
1#0##0#0#0.0#2022-03-31
13:02:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aacf492d1cc7130081a3f43ad147d9d0 150000 0 0 0 0 0
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3372030 C 3 CP 2 17/03/2022 17/03/2022 29/05/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 309814
0 1 0 0 0 WOERJATNO.TN 099442 71 26225 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359564
1#0##0#0#0.0#2022-03-31
13:04:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ab62fb6cce398263ff4930a77cdba5eb 150000 0 0 0 0 0
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3372030 C 3 CP 2 17/03/2022 17/03/2022 17/04/1974 0 1
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yani;3302226402970001; 5.6.6.202203301209 4 359566
1#0##0#0#0.0#2022-03-31
13:05:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 17/03/2022 17/03/2022 07/05/1960 0 1
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0 1 0 0 0 SUPARMAN.TN 085718 61 22594 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 359568
1#0##0#0#0.0#2022-03-31
13:21:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
05b2286e7a7922c05a442956b3d671ac 150000 0 0 0 0 0
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3372030 C 3 CP 2 17/03/2022 17/03/2022 10/06/1973 0 2
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5.6.6.202203301209 4 359569 1#0##0#0#0.0#2022-03-31
13:26:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a051a0021e0ca8821a82392643efa083 150000 0 0 0 0 0
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3372030 C 3 CP 2 17/03/2022 17/03/2022 13/10/1962 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359571
1#0##0#0#0.0#2022-03-31
13:27:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 17/03/2022 17/03/2022 11/08/1960 0 1
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yani;3302226402970001; 5.6.6.202203301209 4 359573
1#0##0#0#0.0#2022-03-31
13:27:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1e27862c04ec403a5408c5c30d8fd39b 150000 0 0 0 0 0
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3372030 C 3 CP 2 17/03/2022 17/03/2022 10/07/1992 0 1
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yani;3302226402970001; 5.6.6.202203301209 4 359575
1#0##0#0#0.0#2022-03-31
13:28:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 17/03/2022 17/03/2022 05/06/1961 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359577
1#0##0#0#0.0#2022-03-31
13:29:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 17/03/2022 17/03/2022 25/04/2000 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359579
1#0##0#0#0.0#2022-03-31
13:29:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 17/03/2022 17/03/2022 08/10/1976 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359581
1#0##0#0#0.0#2022-03-31
13:32:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cf9d2e364145b9167d2019e8f4d00642 150000 0 0 0 0 0
0 63690 0 0 15000 0 37950 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 02/06/1944 0 2
0 0 - 0 - 0 - 0 - 0 181400 244013
0 1 0 0 0 SUGENG WIRYO SUDIRO, NY 076724 77 28412
yani;3302226402970001; 5.6.6.202203301209 4 359583
1#0##0#0#0.0#2022-03-31
13:33:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
10b1917d18a31284b6e93dedb6a9b9a4 150000 0 0 0 0 0
0 63690 0 0 15000 0 15323 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 26/09/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 225245
0 1 0 0 0 BAMBANG SETYASTO.,BP 059238 71 26105
yani;3302226402970001; 5.6.6.202203301209 4 359585
1#0##0#0#0.0#2022-03-31
13:34:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
34ac90a634adecef8936f0f21717b8d0 150000 0 0 0 0 0
0 0 0 0 15000 0 60245 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 23/12/1966 0 2
1 Z09.8;I50.0;R51 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 BUDIARTI.,NY 044128 55 20173 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359588
1#0##0#0#0.0#2022-03-31
13:40:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a773c0434f01c70b14ac8086434efac8 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 15/05/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 258072
0 1 0 0 0 SLAMET MUJIANTO, TN 074051 57 21125
yani;3302226402970001; 5.6.6.202203301209 4 359589
1#0##0#0#0.0#2022-03-31
13:46:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e90af329c89a63ef5fa303d43be70c82 150000 0 0 0 0 0
0 31845 0 0 15000 0 61227 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 10/05/2004 0 1
0 - 0 - 0 - 0 - 0 181400 175000
0 1 0 0 0 MARIO FERNANDO TEIH.SDR 102470 17 6520
yani;3302226402970001; 5.6.6.202203301209 4 359590
1#0##0#0#0.0#2022-03-31
13:47:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8894ce0c2901167cee2bcd1453f811a6 150000 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 08/05/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 269066
0 1 0 0 0 SUSILOWATI, NY 075509 67 24785 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359593
1#0##0#0#0.0#2022-03-31
13:49:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b0726566e11f8d80495e3a013c751fde 150000 0 0 0 0 0
0 44200 0 0 15000 0 59866 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 08/02/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 378197
0 1 0 0 0 MULYANTO.,TN 075508 74 27066 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359595
1#0##0#0#0.0#2022-03-31
13:52:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6f946ab11473ed2f2cae4356e0288417 150000 0 0 0 0 0
0 107890 0 0 15000 0 105307 0 0 0 0
0
3372030 C 3 CP 2 17/03/2022 17/03/2022 20/10/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 477000 0 1 0 0 0 BADRIYAH
1124R0020322V002657 0000091089088 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359445 1#0##0#0#0.0#2022-03-31
13:53:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ab0a85ceac05fa2cb7ac7e0dc359b3c4 462000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 12/03/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 624807
0 1 0 0 0 ISMUHADI SUHARMANTO 089220 59 21555
yani;3302226402970001; 5.6.6.202203301209 4 359597
1#0##0#0#0.0#2022-03-31
13:54:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
efcca2738f5e632194339e7710061c31 150000 0 0 0 0 0
0 31845 0 0 15000 0 427962 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 13/06/1971 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002169781694 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
359448 1#0##0#0#0.0#2022-05-19
10:25:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
a03e85475e67e7673465166bb5c1c8e0 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 09/11/1965 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUMIYATI, NY
0000091584066 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359435 1#0##0#0#0.0#2022-03-31
13:56:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d964422aa07dd74ddce49c3010708f12 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 05/01/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 367717
0 1 0 0 0 DJOKO SUPRAPTO.TN 085032 65 23812 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359609
1#0##0#0#0.0#2022-03-31
13:57:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
413c04499fba68ad8f8a9996b0e0b026 150000 0 0 0 0 0
0 0 0 0 15000 0 202717 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 19/09/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 182127
0 1 0 0 0 DJOKO SRIWAHYU INDRATMOKO.TN 097650 63
yani;3302226402970001; 5.6.6.202203301209 4 359611
1#0##0#0#0.0#2022-03-31
13:57:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1c3de0e1b01b2af793b0af8cccfa6da9 150000 0 0 0 0 0
0 0 0 0 15000 0 17127 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 11/03/1961 0 1
1 Z09.8;E11.4;G59.0;I10;E78.5 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
354139 0 1 0 0 0 BUDIMAN,BP 078815 61 22286
novia;3313125201940001; 5.6.7.202204241238 4 359614
1#0##0#0#0.0#2022-05-19
10:14:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
53cc959b4e85d3d5ecf39168721d7150 150000 0 0 0 0 0
0 76045 0 0 15000 0 113094 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 02/06/1949 0 1
0 - 0 - 0 - 0 - 0 181400 197374
0 1 0 0 0 YANTO BULHARI.TN 102471 72 26586 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359617
1#0##0#0#0.0#2022-03-31
14:06:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1e2d52dc3f1e85715148224648aca291 150000 0 0 0 0 0
0 0 0 0 25000 0 22374 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 17/11/1966 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 INDRARIADI, TN
0001797112102 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359427 1#0##0#0#0.0#2022-03-31
14:08:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5121457d9cecc85645bd974db2a860da 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 15/07/1949 0 2
1 Z09.8;E11.9;M75.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 244195
0 1 0 0 0 SRI SUMARNI,(NY) 032180 72 26543 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359619
1#0##0#0#0.0#2022-03-31
14:09:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9e525c78b05c06ffc7b05cf36a242392 150000 0 0 0 0 0
0 0 0 0 15000 0 79195 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 14/09/1977 0 1
0 0 - 0 - 0 - 0 - 0 181400 212256
0 1 0 0 0 SRI SAWAL RIYADI.TN 096799 44 16255
yani;3302226402970001; 5.6.6.202203301209 4 359622
1#0##0#0#0.0#2022-03-31
14:10:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0c20bfaa57eee2f1fd4c2dbd26d7a557 150000 0 0 0 0 0
0 0 0 0 15000 0 47256 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 09/09/1940 0 1
0 0 - 0 - 0 - 0 - 0 181400 215716
0 1 0 0 0 SUDARKO,(BP) 039452 81 29774 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359624
1#0##0#0#0.0#2022-03-31
14:11:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1e93b56dfed7fdda00ad74b1a5122d20 150000 0 0 0 0 0
0 0 0 0 15000 0 50716 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 23/07/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 487552
0 1 0 0 0 TJIPTO WINARNI.NY 003182 65 23978 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359625
1#0##0#0#0.0#2022-03-31
14:12:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
de3787d552734069b79ed37546ae528d 150000 0 0 0 0 0
0 121345 0 0 15000 0 201207 0 0 0 0
0
3372030 C 3 CP 2 17/03/2022 17/03/2022 13/06/1992 0 2
0 - 0 107400 262000 0 1 0 0 0 LUKI
1124R0020322V002671 0001084671257 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359431 1#0##0#0#0.0#2022-03-31
14:13:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ba5437318640ba155f410871eaba0900 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 10/10/1953 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TUTIK SARASWATI .,
0001449355893 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359429 1#0##0#0#0.0#2022-03-31
14:15:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
53fcb76090efa1e267adc5e484d15fc4 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 28/10/1944 0 1
1 Z09.8;E11.4;G59.0;I10;N40 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
330979 0 1 0 0 0 MARUTA TIRANA,(BP) 040357
0000091212647 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359628 1#0##0#0#0.0#2022-03-31
14:20:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a28cdb65f0d014fd18eaf8d6855ef6d9 150000 0 0 0 0 0
0 76595 0 0 15000 0 89384 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 02/08/1952 0 2
0 - 0 107400 262000 0 1 0 0 0 SITI
MAJIAH, NY 094003 69 25429 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V002674 0000639393467 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359424 1#0##0#0#0.0#2022-03-31
14:24:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
65929424ca75bca75b690755ff10cc58 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 21/04/2016 0 1
- 0 - 0 - 0 - 0 182600 198638 0
1 0 0 0 EL PRASETYO, AN 046854 5 2156 DR. ANI
yani;3302226402970001; 5.6.6.202203301209 4 359637
1#0##0#0#0.0#2022-03-31
14:28:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
16b33bce264f3272f60d9c4019c84e62 150000 0 0 0 0 0
0 0 0 0 15000 0 33638 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 14/02/1997 0 2
0 0 - 0 - 0 - 0 - 0 181400 199016
0 1 0 0 0 FITRI ARDYANTI PUTRI.NN 093513 25 9162
yani;3302226402970001; 5.6.6.202203301209 4 359638
1#0##0#0#0.0#2022-03-31
14:29:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
431a528d46580e77681f66df66295677 150000 0 0 0 0 0
0 0 0 0 15000 0 34016 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 12/02/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 215865
0 1 0 0 0 DARWATI, NY 094471 58 21218 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 359634
1#0##0#0#0.0#2022-03-31
14:27:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
673f6712fdfee9a9b32a828605b40139 150000 0 0 0 0 0
0 0 0 0 15000 0 50865 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 25/06/1980 0 2
0 0 - 0 - 0 - 0 - 0 181400 497640
0 1 0 0 0 MARYANI.,NY 074207 41 15240 DR. SUHARTO,
SP.PD 1124R0020322V002678 0001288534217 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359640 1#0##0#0#0.0#2022-03-31
14:30:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
26c3de493c02e135c5e320f9340e91d4 150000 0 0 0 0 0
0 31845 0 0 15000 0 300795 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 28/11/1972 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
362318 0 1 0 0 0 SRI HARYANTI., NY 068700 49
yani;3302226402970001; 5.6.6.202203301209 4 359642
1#0##0#0#0.0#2022-03-31
14:32:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ab5732894a2fa384bb65a9149d09940a 150000 0 0 0 0 0
0 31845 0 0 15000 0 165473 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 30/08/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 443258
0 1 0 0 0 MARYATUN, NY 071640 49 18096 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359643
1#0##0#0#0.0#2022-03-31
14:33:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
78be98deaa4d05ef6819eb6178acb3aa 150000 0 0 0 0 0
0 31845 0 0 15000 0 246413 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 10/05/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 232421
0 1 0 0 0 SUKATI AL KATINEM, NY 065484 59 21861
yani;3302226402970001; 5.6.6.202203301209 4 359644
1#0##0#0#0.0#2022-03-31
14:34:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
abb860e6c58ffdd60011a73f15e235d8 150000 0 0 0 0 0
0 0 0 0 15000 0 67421 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 23/09/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ROCHYATI.NY 059452
0001813968753 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359408 1#0##0#0#0.0#2022-03-31
14:34:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5eb1daff478b5be0affce24120277da2 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 17/12/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 207134
0 1 0 0 0 SITI MARSANAH.NY 095887 47 17257 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359645
1#0##0#0#0.0#2022-03-31
14:36:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
240cfc9d74d9a48b789827dea9b1f125 150000 0 0 0 0 0
0 0 0 0 15000 0 42134 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 01/06/1944 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUJINEM,NY 086697
0000091171091 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359413 1#0##0#0#0.0#2022-03-31
14:40:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b929e2f6ebfc14185e5cc005c931e83e 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 13/08/1957 0 2
0 - 0 107400 273000 0 1 0 0 0 ENDANG
MARYATI 085348 64 23592 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V002686 0001806020504 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359423 1#0##0#0#0.0#2022-03-31
14:42:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d8ac607fc31f94465e123feacb6b844b 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 10/09/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 725675
0 1 0 0 0 HARSI MUDJI RAHAYU,NY 063780 68 25025
yani;3302226402970001; 5.6.6.202203301209 4 359646
1#0##0#0#0.0#2022-03-31
14:43:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b1758ab8aceb337056f65cd86be3fd17 150000 0 0 0 0 0
0 108440 0 0 15000 0 452235 0 0 0 0
0
3372030 C 3 CP 2 17/03/2022 17/03/2022 26/01/1998 0 2
0 0 - 0 - 0 - 0 - 0 181400 194150
0 1 0 0 0 ANISA MAHDA HABSARI.NN 096945 24 8816
yani;3302226402970001; 5.6.6.202203301209 4 359647
1#0##0#0#0.0#2022-03-31
14:44:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f9a2e89907ced51f49883419335d71e2 150000 0 0 0 0 0
0 0 0 0 15000 0 29150 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 01/01/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 170841
0 1 0 0 0 ENDANG WIDYANINGSIH., NY 042014 50
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359649
1#0##0#0#0.0#2022-03-31
14:46:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ba1465dbfa740440968c76541bdd44cd 150000 0 0 0 0 0
0 0 0 0 15000 0 5841 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 13/05/1971 0 2
1 Z09.8;K30;R53 88.76 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400 888516
0 1 0 0 0 SRI WAHYUNI, NY 102383 50 18571 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359648
1#0##0#0#0.0#2022-03-31
14:48:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
f6b1190c801cba4c935ffb88c8198b1d 150000 0 0 0 0 0
678000 0 0 0 15000 0 45516 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 13/12/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 439060
0 1 0 0 0 AHMAD NURHADI.TN 094191 58 21279 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359653
1#0##0#0#0.0#2022-03-31
14:49:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ee1b01d82157c3cd372ae692ef6736aa 150000 0 0 0 0 0
0 31845 0 0 15000 0 242215 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 01/02/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 237842
0 1 0 0 0 DIDIK NOERALIM, TN 016312 53 19402
yani;3302226402970001; 5.6.6.202203301209 4 359654
1#0##0#0#0.0#2022-03-31
14:50:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
acb5f67e85f4a514e4bf6a13a6a0e097 150000 0 0 0 0 0
0 0 0 0 15000 0 72842 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 26/09/1960 0 2
1 I10;M19.98 88.27 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 424843
0 1 0 0 0 WIDAYATI SETYANINGSIH.NY 102469 61
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 360686
1#0##0#0#0.0#2022-03-31
14:54:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8622e265b54da4bb61b7aa2e59e4555b 150000 0 0 0 0 0
248000 0 0 0 15000 0 11843 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 12/03/1968 0 2
1 I10;E05.9 87.16 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 859718
0 1 0 0 0 PURWANTI.NY 102468 54 19728 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 360685
1#0##0#0#0.0#2022-03-31
15:01:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a3e817ee5675abcdf3b37808a8ede0aa 150000 0 0 0 0 0
680000 0 0 0 15000 0 14718 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 28/08/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 284711
0 1 0 0 0 DIYATI.NY 085749 47 17368 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 359658
1#0##0#0#0.0#2022-03-31
15:02:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f8a6c277e86f0a05bfe5b8b9bf4beee0 150000 0 0 0 0 0
0 0 0 0 15000 0 119711 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 15/09/2021 0 1
2 Z09.8;G35 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 NUR RACHMAD MEGAWANTO, TN 098639 0
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359657
1#0##0#0#0.0#2022-03-31
15:04:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c00c440f38812f6cb936f25ca76510e8 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 31/12/1971 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V002698 0000555344774 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359453 1#0##0#0#0.0#2022-03-31
15:05:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e4fdf9d7f2dcc03cebd563056e625529 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 23/03/1976 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359454
1#0##0#0#0.0#2022-03-31
15:07:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8259f010edd8e45648bcb9ebf4831948 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 17/04/1973 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359455
1#0##0#0#0.0#2022-03-31
15:07:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b1d5e2f23ae23f80131268a5d1da3248 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 18/03/1988 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359456
1#0##0#0#0.0#2022-03-31
15:08:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2e6ed2bf65e9bb9fbd41092d02912a80 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 19/09/1986 0 1
0 0 - 0 - 0 - 0 - 0 181400 175560
0 1 0 0 0 IRSYADUL IBAD, SDR 081289 35 12963
yani;3302226402970001; 5.6.6.202203301209 4 359660
1#0##0#0#0.0#2022-03-31
15:09:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8e5a77e450cc0345a27b83171c7d5a49 150000 0 0 0 0 0
0 0 0 0 15000 0 10560 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 10/12/1982 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359457
1#0##0#0#0.0#2022-03-31
15:10:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fc1c39dd5579591e60aab234bf50387e 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 09/09/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 233292
0 1 0 0 0 SARBINI, TN 052303 70 25757 DR. SUHARTO,
SP.PD 1124R0020322V002705 0000091234585 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359661 1#0##0#0#0.0#2022-03-31
15:11:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f6a72a7c4e10df769ae991b549763c35 150000 0 0 0 0 0
0 0 0 0 15000 0 68292 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 12/10/1987 0 1
0 - 0 - 0 - 0 786200 616427 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359458
1#0##0#0#0.0#2022-03-31
15:14:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
98f731f9de088e1fcfec7d519fc22ac9 463830 0 0 0 0 0
0 0 0 0 15000 0 137597 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 25/06/1970 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359459
1#0##0#0#0.0#2022-03-31
15:16:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2e8a3bed1181c09940387de50089ea78 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 10/07/1955 0 2
0 - 0 - 0 - 0 786200 1009602 0 1
SP.PD 1124R0020322V002708 0001032581823 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359461 1#0##0#0#0.0#2022-03-31
15:17:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fb8d29141d4808bc3f7169d7fc7c0b63 662676 0 0 0 0 0
0 0 0 0 15000 0 331926 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 04/05/1958 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359463
1#0##0#0#0.0#2022-03-31
15:18:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fbf6eefb85206e5f98d9f248cae6a0e4 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 26/05/1966 0 2
1 Z09.8;E11.9;I64;L03.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 245520
0 1 0 0 0 SRI HADIYATI, NY 101467 55 20384 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359662
1#0##0#0#0.0#2022-03-31
15:19:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5ba192acdcf32d880d955838a825ccc8 150000 0 0 0 0 0
0 0 0 0 15000 0 80520 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 03/08/1963 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359465
1#0##0#0#0.0#2022-03-31
15:21:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
22337b39cafc71d26d38bc454e050b9a 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 21/09/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002199915988 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359421 1#0##0#0#0.0#2022-04-07
11:52:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
3f0f107f90b16f70afe471be8b3348da 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 02/03/1941 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DIYAH 101274
0000091192274 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359378 1#0##0#0#0.0#2022-03-31
15:34:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7da003a65b8af95cf0bbde1b39dee99b 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 18/06/2003 0 1
1 Z09.8;I86.1 96.59;97.89 - - None None None None Z-3-27-0
None None None None None None PERAWATAN LUKA 183900 0 0
- 0 - 0 - 0 - 0 183900 195624 0
1 0 0 0 YOAN AUDREY HAVISA, SDR 102150 18 6847 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359663
1#0##0#0#0.0#2022-03-31
15:36:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f636798806cc18798095043bfa01b86f 150000 0 0 0 0 0
0 0 0 0 15000 0 30624 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 18/02/1942 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DARTINAH,NY 030952
0001021779674 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359380 1#0##0#0#0.0#2022-03-31
15:38:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fcb6fc49b2cd5472112605e780f6f432 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 18/07/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 424580
0 1 0 0 0 SURATMI TRINANINGSIH, NY 009602 58
0001102728688 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361485 1#0##0#0#0.0#2022-04-06
08:53:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
04dc279b1693a7ccafc4e7f661aeee0b 0 0 138000 0 0 0
220000 0 0 0 15000 0 51580 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 05/07/1946 0 2
0 0 - 0 - 0 - 0 - 0 181400 229009
0 1 0 0 0 SUMIYATI.NY 081384 75 27649 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 359664
1#0##0#0#0.0#2022-03-31
15:43:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
615fce363e648541c16a2b315e1eeaaf 150000 0 0 0 0 0
0 0 0 0 15000 0 64009 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 07/07/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 215430
yani;3302226402970001; 5.6.6.202203301209 4 359665
1#0##0#0#0.0#2022-03-31
15:46:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
34f212d220c27b4a04940187e5016a0a 150000 0 0 0 0 0
0 0 0 0 15000 0 50430 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 20/02/1990 0 1
0 0 - 0 - 0 - 0 - 0 181400 234647
0 1 0 0 0 SRIYONO, TN 099695 32 11713 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 359667
1#0##0#0#0.0#2022-04-01
07:59:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4ad8f635c549596afff0bce01943f506 150000 0 0 0 0 0
0 0 0 0 15000 0 69647 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 19/09/1967 0 2
1 D25.9 88.79 - - None None None None Z-3-23-0 None None
- 0 - 0 - 0 - 0 549400 179091 0
1 0 0 0 RA. SRIDONOWIYATI.NY 086418 54 19903 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359669
1#0##0#0#0.0#2022-04-01
08:01:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a81e35428892e0e884c16c00896e5e6e 150000 0 0 0 0 0
0 0 0 0 15000 0 14091 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 21/07/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 230436
0 1 0 0 0 SUMARYANI NY 085736 67 24711 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359672
1#0##0#0#0.0#2022-04-01
08:02:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a3f5ae6c58d37953787c3658ba25f45b 150000 0 0 0 0 0
0 0 0 0 15000 0 65436 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 11/09/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 254837
0 1 0 0 0 SUMARNO.TN 095054 67 24659 DR. ARIA
novia;3313125201940001; 5.6.7.202204241238 4 359674
1#0##0#0#0.0#2022-05-20
11:32:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
1bdabbb8bd84b58eb27f79930ca594d8 150000 0 0 0 0 0
0 0 0 0 15000 0 89837 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 31/12/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 227033
0 1 0 0 0 SURTINEM., NY 049118 64 23452 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359676
1#0##0#0#0.0#2022-04-01
08:06:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3c8a6590ebff0d08d5bec112033f2cff 150000 0 0 0 0 0
0 0 0 0 15000 0 62033 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 27/04/2007 0 2
0 0 - 0 - 0 - 0 - 0 181400 195624
0 1 0 0 0 DEVI NUR SAFITRI, AN 101298 14 5438
yani;3302226402970001; 5.6.6.202203301209 4 359678
1#0##0#0#0.0#2022-04-01
08:06:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b7a5187e392682912b6de3f1f17de3d9 150000 0 0 0 0 0
0 0 0 0 15000 0 30624 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 22/04/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 228558
0 1 0 0 0 GUNARSI 079686 61 22609 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 359681
1#0##0#0#0.0#2022-04-01
08:07:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ab4a6e6edf8be1b12063107268f24fe1 150000 0 0 0 0 0
0 0 0 0 15000 0 63558 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 21/10/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 326658
0 1 0 0 0 NGATIRIN, TN 092405 51 18775 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359683
1#0##0#0#0.0#2022-04-01
08:08:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0aa7f2c46bd9aae0bfb8fd89ba7c3be4 150000 0 0 0 0 0
0 0 0 0 15000 0 161658 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 24/12/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 250213
0 1 0 0 0 JUMILAH, NY 070343 61 22363 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 359684
1#0##0#0#0.0#2022-04-01
08:09:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
af2a9e80ef8536c5b5767b0524cc78d0 150000 0 0 0 0 0
0 0 0 0 15000 0 85213 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 26/05/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 318747
0 1 0 0 0 MENIK PUJIWATI, NY 073634 51 18923
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359686
1#0##0#0#0.0#2022-04-01
08:11:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
880662b4bece129bc81c80fc10afafc9 150000 0 0 0 48000 0
0 0 0 0 15000 0 105747 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 01/01/2000 0 1
0 0 - 0 - 0 - 0 - 0 181400 240774
0 1 0 0 0 TARMOYO .BP 010989 22 8111 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 359688
1#0##0#0#0.0#2022-04-01
08:12:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f29f9cf6e20cde03e187f9d6af776db8 150000 0 0 0 0 0
0 0 0 0 15000 0 75774 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 31/10/1955 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 DAL HARI
1124R0020322V002731 0001703140593 3;JKN agung;3313092303950002;
5.6.7.202204241238 4 359382 1#0##0#0#0.0#2022-06-17
15:26:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 4
2242219f1ebef3609544ef2501dc1306 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 04/05/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 210733
0 1 0 0 0 WINARTO., BP 052445 66 24424 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359689
1#0##0#0#0.0#2022-04-01
08:13:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
97b56e2ac9438aa7c82d39f24e67a8db 150000 0 0 0 0 0
0 0 0 0 15000 0 45733 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 14/06/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 214495
3;JKN novia;3313125201940001; 5.6.7.202204241238 4 359690
1#0##0#0#0.0#2022-05-19
08:38:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
cd6fa30f7acfe9d194bab4b8371c980e 150000 0 0 0 0 0
0 0 0 0 15000 0 49495 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 29/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 AGNES WIDHA
1124R0020322V002734 0002168632721 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359495 1#0##0#0#0.0#2022-04-01
08:15:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
040d9156bd5a1622ea0aa4b1e69d9322 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 01/05/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 227277
0 1 0 0 0 SITI JUARIYH., NY 048220 49 18217 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359692
1#0##0#0#0.0#2022-04-01
08:19:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cc84b2949d18dfae826e0325eab72dbb 150000 0 0 0 0 0
0 0 0 0 15000 0 62277 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 31/12/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 266888
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359693
1#0##0#0#0.0#2022-04-01
08:20:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2447e2d5e71cc0a784fd3688ebd93b1e 150000 0 0 0 0 0
0 0 0 0 15000 0 101888 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 12/04/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 187718
0 1 0 0 0 SURADI RAHAYU,(BP) 039567 68 25176
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359694
1#0##0#0#0.0#2022-04-01
08:21:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dbe3de07c5cceea997556c60ab87c010 150000 0 0 0 0 0
0 0 0 0 15000 0 22718 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 28/12/1949 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 NURHAYATI.NY
0001848729036 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359365 1#0##0#0#0.0#2022-04-01
08:23:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ff15ef2e31f5f127d056b6ad2da61e5a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 16/05/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 265914
0 1 0 0 0 MEIYANTO.TN 096828 52 19298 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 359696
1#0##0#0#0.0#2022-04-01
08:23:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
afba7057cfe4e4d0ce846e8ddf8d5471 150000 0 0 0 0 0
0 0 0 0 15000 0 100914 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 17/06/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WARIH ANJARIANI,
0001964529066 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359370 1#0##0#0#0.0#2022-04-01
08:24:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0b1c54ab6355f55c76ed1e0a8a7139bd 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 25/10/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 929736
0 1 0 0 0 SRI SUNARMI., NY 048878 64 23519 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359698
1#0##0#0#0.0#2022-04-01
08:25:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
20f6b06ce3c59d6519da8dbf5099a830 150000 0 0 0 48000 0
0 0 0 0 15000 0 716736 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 06/12/1990 0 1
0 404900 402525 0 1 0 0 0 TEGUH WALUYO.TN
102447 31 11424 DR. ZULFADLY, SP.B 1124R0020322V002743
0001866731084 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
361195 1#0##0#0#0.0#2022-05-20
10:30:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
564285d2d5d21f039c42d44e08e8643d 340000 0 0 0 0 0
0 0 0 0 15000 0 47525 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 11/08/1980 0 1
0 0 - 0 - 0 - 0 - 0 181400 235928
0 1 0 0 0 AGUS AKBAR .BP 030258 41 15193 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359700
1#0##0#0#0.0#2022-04-01
08:27:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5b4a65fb3751f4aae4ae306487eaa936 150000 0 0 0 0 0
0 0 0 0 15000 0 70928 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 21/10/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 415949
0 1 0 0 0 SRI RAHAYU ( NY ) 050034 60 22062 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359702
1#0##0#0#0.0#2022-04-01
08:34:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c44551c3a30d2b3901acdbc6016705c9 150000 0 0 0 0 0
0 31845 0 0 15000 0 219104 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 07/07/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 226375
0 1 0 0 0 WIRADI.TN 098841 57 21072 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 359707
1#0##0#0#0.0#2022-04-01
08:37:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fdafa5e3b81f79cd65172705865cc929 150000 0 0 0 0 0
0 0 0 0 15000 0 61375 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 18/11/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 363825
0 1 0 0 0 LILI PUJIASTUTI, NY 087566 64 23495
yani;3302226402970001; 5.6.6.202203301209 4 359706
1#0##0#0#0.0#2022-04-01
08:35:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
911dc6056d03c4b7ec23901f6efe026b 150000 0 0 0 0 0
0 76045 0 0 15000 0 122780 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 18/01/1966 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 IVO MUMPUNI
1124R0020322V002748 0002169780873 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 359367 1#0##0#0#0.0#2022-05-19
13:36:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
84f1b64649cabc81d02df80272dd6bfc 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 13/08/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 199427
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359708
1#0##0#0#0.0#2022-04-01
08:39:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
648b53f01e6c21138ee6a75f201b35d8 150000 0 0 0 0 0
0 0 0 0 15000 0 34427 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 19/02/1965 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 254000 0 1 0 0 0 DANU MARGONO.,BP
0000640154136 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
359449 1#0##0#0#0.0#2022-05-19
08:42:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
935848a03a9df8d12ea9ff0a54f39f94 239000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 24/01/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 230021
0 1 0 0 0 SRI SURASMI 085160 77 28176 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 359709
1#0##0#0#0.0#2022-04-01
08:42:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a12b0d5f758f1dddc78174a0cd82c479 150000 0 0 0 0 0
0 0 0 0 15000 0 65021 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 05/04/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 RUKMINTO.TN 099249 59 21896 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359719
1#0##0#0#0.0#2022-04-01
08:43:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
52cfc91c0c321e257fb6181c6c5204a0 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 05/06/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 ASIYAH INTAN TRIANA.NY 098457 58 21470
yani;3302226402970001; 5.6.6.202203301209 4 359491
1#0##0#0#0.0#2022-04-01
08:44:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
342beb80e23b6aeba44ca8e8971a053c 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 07/10/1970 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 YATINI 094257 51 18789 DR. LINDA
yani;3302226402970001; 5.6.6.202203301209 4 359488
1#0##0#0#0.0#2022-04-01
08:46:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3fb4b49225aefe23009ede1e18c00cab 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 15/11/2018 0 1
1 Z09.8;F80.9 93.35;93.39 - - None None None None M-3-16-0
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 254000 0 1 0 0 0 ARIQ MAUZA
ALFAREZI, AN 086682 3 1218 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V002757 0002579775748 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 359485 1#0##0#0#0.0#2022-05-19
10:33:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 01/12/1944 0 2
1 Z09.8;R47.1 93.39 - - None None None None M-3-16-0 None
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 219000 0 1 0 0 0 WANTIYEM.NY 078888
0000640044099 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359481 1#0##0#0#0.0#2022-04-01
09:12:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9bcaf5797b510692b1294cd9d890bd79 204000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 23/03/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 264135
0 1 0 0 0 SRI SISWANTI., NY 042109 55 20448 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359721
1#0##0#0#0.0#2022-04-01
09:16:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9475c29a50e8c0952be4d54ce1e3f024 150000 0 0 0 0 0
0 0 0 0 15000 0 99135 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 13/03/1953 0 1
1 Z09.8;J44.9;K21.9 87.49 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 468470
0 1 0 0 0 SUHARI, TN 070582 69 25206 DR. ANITA
yani;3302226402970001; 5.6.6.202203301209 4 360684
1#0##0#0#0.0#2022-04-01
09:17:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5041642a673f5fa8511e60dc941603c4 150000 0 0 0 0 0
200000 0 0 0 15000 0 103470 0 0 0 0
0
3372030 C 3 CP 2 17/03/2022 17/03/2022 25/11/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 319166
0 1 0 0 0 HASYIM, TN 078827 76 27871 DR. ANITA
yani;3302226402970001; 5.6.6.202203301209 4 359723
1#0##0#0#0.0#2022-04-01
09:19:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
287d6dea8bade3117fbc89ee87c82d53 150000 0 0 0 0 0
0 0 0 0 15000 0 154166 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 23/03/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 231795
0 1 0 0 0 RUSTANTI,NY 095672 42 15700 DR. ANITA
yani;3302226402970001; 5.6.6.202203301209 4 359724
1#0##0#0#0.0#2022-04-01
09:21:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c965a1dfa29e18208616785b45541509 150000 0 0 0 0 0
0 0 0 0 15000 0 66795 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 16/03/1946 0 2
1 Z09.8;J42;K21.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 443533
0 1 0 0 0 SRI BASOEKI, NY 030148 76 27760 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359726
1#0##0#0#0.0#2022-04-01
09:52:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c94db1a5f349e38bf033a3495ae6dd27 150000 0 0 0 0 0
0 0 0 0 15000 0 278533 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 31/12/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 444396
0 1 0 0 0 SUPARNO.TN 089179 58 21261 DR. ANITA
yani;3302226402970001; 5.6.6.202203301209 4 359729
1#0##0#0#0.0#2022-04-01
09:55:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
765755e42cec9c57b259c2ae4ed6274a 150000 0 0 0 0 0
0 0 0 0 15000 0 279396 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 08/05/1947 0 1
0 0 - 0 - 0 - 0 - 0 181400 452416
0 1 0 0 0 HARIYADI.,TN 072845 74 27342 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359728
1#0##0#0#0.0#2022-04-01
09:53:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a8d73fd2b6a8c3f3f4d77da327e2b2ba 150000 0 0 0 0 0
0 0 0 0 15000 0 287416 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 16/01/1986 0 2
1 Z09.8;B90.9;I11.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 511195
0 1 0 0 0 JAYANTI ARIYANA.NN 072922 36 13209
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359731
1#0##0#0#0.0#2022-04-01
09:58:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a73d78124e46861342c8312a3f097ef6 150000 0 0 0 0 0
0 0 0 0 15000 0 346195 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 13/04/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 412354
0 1 0 0 0 DIYONO.TN 089252 70 25906 DR. ANITA
yani;3302226402970001; 5.6.6.202203301209 4 359732
1#0##0#0#0.0#2022-04-01
10:01:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
77498d5535284388a542779b8e1d2297 150000 0 0 0 0 0
0 0 0 0 15000 0 247354 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 01/08/1942 0 1
1 Z09.8;J44.9;K21.9;J06.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 411445
0 1 0 0 0 SUTARKA BP 084552 79 29083 DR. ANITA
yani;3302226402970001; 5.6.6.202203301209 4 359733
1#0##0#0#0.0#2022-04-01
10:03:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ec9f01ae2cc80845a5898e9111cd2d80 150000 0 0 0 0 0
0 0 0 0 15000 0 246445 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 04/10/1944 0 2
0 0 - 0 - 0 - 0 - 0 181400 403730
0 1 0 0 0 HARI NURYANI.NY 084720 77 28288 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359735
1#0##0#0#0.0#2022-04-01
10:04:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2157f2bd461f38521ac4a6c15eab23a2 150000 0 0 0 0 0
0 0 0 0 15000 0 238730 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 30/08/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 263056
0 1 0 0 0 MUH. ROSYID RIDWAN, TN 080978 53 19557
yani;3302226402970001; 5.6.6.202203301209 4 359737
1#0##0#0#0.0#2022-04-01
10:06:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2a8ce7a8c67217e0b60d4e3914c6ef28 150000 0 0 0 48000 0
0 0 0 0 15000 0 50056 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 10/10/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 389282
0 1 0 0 0 ABDUL KHALIQ, TN 059593 50 18421 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359738
1#0##0#0#0.0#2022-04-01
10:15:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
87096398d7e2d9ca9e673803cf083aef 150000 0 0 0 0 0
0 0 0 0 15000 0 224282 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 25/05/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 537420
0 1 0 0 0 SUDARMO HADIMULYO M, TN 066357 73 26959
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359741
1#0##0#0#0.0#2022-04-01
10:18:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5d60328a4cf39da6c922c95655fa9fbe 150000 0 0 0 0 0
0 0 0 0 15000 0 372420 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 24/09/1975 0 1
0 0 - 0 - 0 - 0 - 0 181400 207273
0 1 0 0 0 ZULFIKRI, TN 101889 46 16976 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359743
1#0##0#0#0.0#2022-04-01
10:23:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b3cc649ebfe3863223efc31d1126d421 150000 0 0 0 0 0
0 0 0 0 15000 0 42273 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 10/12/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 475217
0 1 0 0 0 SUDJINO,(BP) 040675 69 25299 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359744
1#0##0#0#0.0#2022-04-01
10:24:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8fa311cb3ca6230460e0e9bf93b2049d 150000 0 0 0 0 0
0 0 0 0 15000 0 310217 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 04/02/1994 0 1
1 Z09.8;A16.2;E11.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 198983
0 1 0 0 0 YOGO SATRIA NUGROHO.TN 101943 28 10268
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359746
1#0##0#0#0.0#2022-04-01
10:25:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
471e4e60990d0f3d4202a01935b72b16 150000 0 0 0 0 0
0 0 0 0 15000 0 33983 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 21/01/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 365342
0 1 0 0 0 ATIE SUMIYATI ., NY 055664 60 21970
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359749
1#0##0#0#0.0#2022-04-01
10:26:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9f8c72ad4006b1171f001f57258ceff7 150000 0 0 0 0 0
0 0 0 0 15000 0 200342 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 01/07/1964 0 2
1 Z09.8;J18.9;K21.9;J06.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 234597
0 1 0 0 0 WAHYUNI, NY 070031 57 21078 DR. ANITA
yani;3302226402970001; 5.6.6.202203301209 4 359752
1#0##0#0#0.0#2022-04-01
10:27:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
829e2df66c1ee144e439b1dbb2eda928 150000 0 0 0 0 0
0 0 0 0 15000 0 69597 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 31/12/1991 0 2
0 - 0 - 0 - 0 - 0 549400 174207
0 1 0 0 0 JUWITA PARAPAGA, NY 086447 30 11034
yani;3302226402970001; 5.6.6.202203301209 4 359753
1#0##0#0#0.0#2022-04-01
10:34:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4d7882c64a5bc12e01845265afdb5f25 150000 0 0 0 0 0
0 0 0 0 15000 0 9207 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 14/12/2001 0 1
1 Z09.8;J18.0;R51 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 235142
0 1 0 0 0 RAHIMUDIN, SDR 102242 20 7398 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359755
1#0##0#0#0.0#2022-04-01
10:37:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2e83c542260f6a1df7615640583240ea 150000 0 0 0 0 0
0 0 0 0 15000 0 70142 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 16/12/1956 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 BAMBANG WARAS
1124R0020322V002782 0002463219077 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359444 1#0##0#0#0.0#2022-04-01
10:45:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f5c5b7382bc7b9ca93a66bfae9590aa5 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 28/01/1963 0 1
1 Z09.8;J18.0;I10 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 211983
0 1 0 0 0 DRS.SUWARNO, TN 077474 59 21598 DR.
novia;3313125201940001; 5.6.7.202204241238 4 359756
1#0##0#0#0.0#2022-05-19
10:12:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
1344f266853b8e2dcd4f59789ad0c6a9 150000 0 0 0 0 0
0 0 0 0 15000 0 46983 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 24/06/1957 0 2
1 Z09.8;N30.9;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 211168
0 1 0 0 0 ERMA NUNINGSIH.,NY 052662 64 23642
yani;3302226402970001; 5.6.6.202203301209 4 359759
1#0##0#0#0.0#2022-04-01
10:52:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
893fbfabf5d868760d706aab3b8f8a65 150000 0 0 0 0 0
0 0 0 0 15000 0 46168 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 25/03/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 277851
0 1 0 0 0 MURYANI AFFANDI NY 084882 76 28116
yani;3302226402970001; 5.6.6.202203301209 4 359761
1#0##0#0#0.0#2022-04-01
10:53:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6badcd7450083c6e2641b653fd0f0075 150000 0 0 0 0 0
0 0 0 0 15000 0 112851 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 07/02/1959 0 1
1 K21.9;N40 88.76 - - None None None None Z-3-23-0 None
0 - 0 - 0 - 0 - 0 549400 217957
0 1 0 0 0 JAHMANTO, TN 103272 63 23049 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359762
1#0##0#0#0.0#2022-04-08
08:57:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
fa8a15efba2e12233ff1865937d55cbc 150000 0 0 0 0 0
0 0 0 0 15000 0 52957 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 29/05/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 709105
0 1 0 0 0 KRISDARI BEKTI RAHAYU.NY 098201 45
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359764
1#0##0#0#0.0#2022-04-01
10:55:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8d025a22cae697f4a8c3a607c4fe12da 150000 0 0 0 0 0
0 0 0 0 15000 0 544105 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 08/04/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359472
1#0##0#0#0.0#2022-04-01
11:10:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f5c49010d4ef3051fe0005dfa9a2a55d 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 12/12/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359470
1#0##0#0#0.0#2022-04-01
11:13:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
386b351789fa17f902e643623250b487 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 22/10/1959 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359468
1#0##0#0#0.0#2022-04-01
11:14:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dab69776186c3118c53b07bbb1514c3d 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 12/08/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359466
1#0##0#0#0.0#2022-04-01
11:15:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
052178561f982d510d56a1efcd7f8685 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 16/05/1975 0 1
0 0 - 0 - 0 - 0 - 0 181400 273733
0 1 0 0 0 FAJAR JADMIKO.TN 087981 46 17107 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359766
1#0##0#0#0.0#2022-04-01
11:15:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a18def0e461bb0cec773d14b8ae86ae5 150000 0 0 0 0 0
0 0 0 0 15000 0 108733 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 28/12/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 226248
0 1 0 0 0 YULIA ENI SUMARTI.NY 098933 60 21994
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359768
1#0##0#0#0.0#2022-04-01
11:17:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e4d55fa63ae6205f1cb077d07a057159 150000 0 0 0 0 0
0 0 0 0 15000 0 61248 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 12/05/2013 0 2
0 0 - 0 - 0 - 0 - 0 181400 170837
0 1 0 0 0 AYUK FITRIA.AN 092081 8 3231 DR.
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359771
1#0##0#0#0.0#2022-04-01
11:18:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2a7880ab1c2c281adf2e13e42d6194aa 150000 0 0 0 0 0
0 0 0 0 15000 0 5837 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 06/07/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 234328
0 1 0 0 0 SUMARNI.NY 086963 67 24726 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 359772
1#0##0#0#0.0#2022-04-01
11:19:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5d69b40a8525cbb6b3eb70d4136e7fd1 150000 0 0 0 0 0
0 0 0 0 15000 0 69328 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 28/10/1988 0 2
1 Z09.8;J18.0;D68.5 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 258599
0 1 0 0 0 YANI OKTAVIANI, (NY) 031008 33 12193
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359774
1#0##0#0#0.0#2022-04-01
11:24:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
227e38a4ea12952f4c9b9d6b153f215e 150000 0 0 0 0 0
0 0 0 0 15000 0 93599 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 11/02/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 252271
0 1 0 0 0 SUMARJONO., BP 050498 59 21584 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359779
1#0##0#0#0.0#2022-04-01
11:25:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e9fa01e1db94bef056085db771335045 150000 0 0 0 0 0
0 0 0 0 15000 0 87271 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 20/02/1997 0 1
0 0 - 0 - 0 - 0 - 0 181400 302734
0 1 0 0 0 MEGI ARUM.TN 102478 25 9156 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359780
1#0##0#0#0.0#2022-04-01
11:26:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
585afd0ea4f384047d5da004ae268fac 150000 0 0 0 48000 0
0 0 0 0 25000 0 79734 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 18/04/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 244046
0 1 0 0 0 RAHMADI.TN 096843 53 19691 DR. ARIA
novia;3313125201940001; 5.6.7.202204241238 4 359781
1#0##0#0#0.0#2022-05-19
13:45:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
81fb6cad36c310013e0fb03f9ad87eb6 150000 0 0 0 0 0
0 0 0 0 15000 0 79046 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 31/12/1956 0 2
1 Z09.8;A16.2;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 181226
0 1 0 0 0 PONIYEM, NY 099368 65 23817 DR. ANITA
yani;3302226402970001; 5.6.6.202203301209 4 359782
1#0##0#0#0.0#2022-04-01
11:28:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
374fccff53754838ece4aa22443795db 150000 0 0 0 0 0
0 0 0 0 15000 0 16226 0 0 0 0 0
3372030 C 3 CP 2 17/03/2022 17/03/2022 28/02/2008 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 BERLY GAVIN J, AN
0001106709579 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359493 1#0##0#0#0.0#2022-04-01
11:29:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dd42c1fe378492353079d2f9252fc7d6 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 18/10/1967 0 1
1 Z09.8;E11.4;G59.0;R51;I10 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
479368 0 1 0 0 0 YUSTINUS AGUS SUSAMTO.BP 061196
0000090418893 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359356 3#0##0#0#0.0#2022-04-01
10:04:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c8a82bbbd1b9c6fdc1849de8af962752 150000 0 0 0 0 0
0 31845 0 0 15000 0 282523 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 15/12/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 314564
0 1 0 0 0 MAHENDRO RIYANTO,TN 060324 64 23469
agung;3313092303950002; 5.6.6.202203301209 4 359357
4#0##0#0#0.0#2022-04-01
10:05:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
822118a5a3277583da51d62aafe6803e 150000 0 0 0 0 0
0 88900 0 0 15000 0 60664 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 02/06/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 113547
0 1 0 0 0 YOENANTI NINGSIH.NY 101824 64 23665
agung;3313092303950002; 5.6.6.202203301209 4 359358
5#0##0#0#0.0#2022-04-01
10:05:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c714f89020616b1fce60847f46aa52b0 0 0 0 0 0 0 0
88900 0 0 15000 0 9647 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 01/08/1981 0 1
0 0 - 0 - 0 - 0 - 0 181400 206250
0 1 0 0 0 AGUS RIYANTO.SDR 079932 40 14839 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359359
6#0##0#0#0.0#2022-04-01
10:06:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b0c4b1ff77a5b8f7d9a2a66f87713607 150000 0 0 0 0 0
0 0 0 0 15000 0 41250 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 08/01/2015 0 1
0 0 - 0 - 0 - 0 - 0 181400 179862
0 1 0 0 0 BARRA ACHMAD ADZUHRI,(AN) 037374 7
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359361
7#0##0#0#0.0#2022-04-01
10:06:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
be41351c52964086ce726869530960c8 150000 0 0 0 0 0
0 0 0 0 15000 0 14862 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 20/01/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 179345
0 1 0 0 0 RIYADI.TN 091191 54 19781 DR. WAHYU
agung;3313092303950002; 5.6.6.202203301209 4 359363
8#0##0#0#0.0#2022-04-01
10:07:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f5b3d42623fb6b9748374437b1b934b6 0 0 138000 0 0 0
0 0 0 0 15000 0 26345 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 19/05/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 549341
0 1 0 0 0 MEI SRI REJEKI.NY 084698 45 16739 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359372
9#0##0#0#0.0#2022-04-01
10:07:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0e0e18922448b9bade1b081ce7776e75 150000 0 0 0 0 0
0 121345 0 0 15000 0 262996 0 0 0 0
0
3372030 C 3 CP 2 18/03/2022 18/03/2022 02/01/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 454281
0 1 0 0 0 BAMBANG HERU TETUKO.TN 084462 63 23086
agung;3313092303950002; 5.6.6.202203301209 4 359374
10#0##0#0#0.0#2022-04-01
10:09:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6ea488f0b1e3b4377cdebe11dc7c7e0b 150000 0 0 0 0 0
0 63690 0 0 15000 0 225591 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 03/03/1949 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MUYAS SAROH, NY
0000091167748 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359066 11#0##0#0#0.0#2022-04-01
08:40:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cf4fbefa6987f67646fd175e98e49d19 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 16/05/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 311498
0 1 0 0 0 MINAN, TN 064501 64 23682 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 359384
12#0##0#0#0.0#2022-04-01
10:10:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d0c1bdd07400c6bb8f1f193b9c5efc66 150000 0 0 0 0 0
0 63690 0 0 15000 0 82808 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 11/08/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 230458
0 1 0 0 0 SRI MURNI, NY 069141 73 26882 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359376
13#0##0#0#0.0#2022-04-01
10:10:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
40fbfa601a56c3caf3b7a1d147512394 150000 0 0 0 0 0
0 0 0 0 15000 0 65458 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 02/12/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ENDANG
1124R0020322V002817 0000086714471 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 359059 14#0##0#0#0.0#2022-04-01
07:59:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
38d9fd36858b433216ac14385a7f1a2a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 26/11/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 208980
0 1 0 0 0 SUPARNI.NY 081394 67 24584 DR. WAHYU
agung;3313092303950002; 5.6.6.202203301209 4 359385
15#0##0#0#0.0#2022-04-01
10:11:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b9cb5a2cf917431ae4ab13ddac348b5b 150000 0 0 0 0 0
0 0 0 0 15000 0 43980 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 15/05/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 187891
0 1 0 0 0 YAHMINI ., NY 055426 63 23318 DR.
novia;3313125201940001; 5.6.7.202204241238 4 359386
1#0##0#0#0.0#2022-05-19
08:39:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
5c9916fdedc3b608d5e679cf4a46d976 150000 0 0 0 0 0
0 0 0 0 15000 0 22891 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 13/12/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 171336
0 1 0 0 0 SUGIYO, TN 092623 64 23471 DR. WAHYU
agung;3313092303950002; 5.6.6.202203301209 4 359388
17#0##0#0#0.0#2022-04-01
10:12:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
22174cd173ca695c08300446a44a24e8 150000 0 0 0 0 0
0 0 0 0 15000 0 6336 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 19/07/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 200257
agung;3313092303950002; 5.6.6.202203301209 4 359390
18#0##0#0#0.0#2022-04-01
10:12:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1be8511ad195b957fd9e2dbbcb567a23 150000 0 0 0 0 0
0 0 0 0 15000 0 35257 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 11/05/1943 0 2
0 0 - 0 - 0 - 0 - 0 181400 222893
0 1 0 0 0 MURYATI.NY 094215 78 28801 DR. WAHYU
agung;3313092303950002; 5.6.6.202203301209 4 359394
19#0##0#0#0.0#2022-04-01
10:13:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
823daaa7c286881e01d8ccff719283ef 150000 0 0 0 0 0
0 0 0 0 15000 0 57893 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 16/06/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 383380
0 1 0 0 0 WIDIYASTUTI, NY 090543 60 22190 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361488
1#0##0#0#0.0#2022-04-06
08:54:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4d4a70b1d169098d53a64b78d3d65333 0 0 138000 0 0 0
200000 0 0 0 15000 0 30380 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 12/01/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 199904
0 1 0 0 0 UNIK DEWI RAHAYU,(NY) 025580 44 16136
agung;3313092303950002; 5.6.6.202203301209 4 359397
20#0##0#0#0.0#2022-04-01
10:14:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
171b6609884e5480cbaacaf906726904 0 0 138000 0 0 0
0 0 0 0 15000 0 46904 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 12/02/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 211356
0 1 0 0 0 SUNARTI,(NY) 015594 57 20853 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359399
21#0##0#0#0.0#2022-04-01
10:15:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
60922459163cd5de17a0afaf5bf3680e 150000 0 0 0 0 0
0 0 0 0 15000 0 46356 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 04/05/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 209717
0 1 0 0 0 HARI WURYANTO, (BP) 002149 62 22964
agung;3313092303950002; 5.6.6.202203301209 4 359400
22#0##0#0#0.0#2022-04-01
10:15:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ea956d9c618a4db909cb971da1b34210 150000 0 0 0 0 0
0 0 0 0 15000 0 44717 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 16/05/1997 0 2
0 0 - 0 - 0 - 0 - 0 181400 208065
agung;3313092303950002; 5.6.6.202203301209 4 359401
23#0##0#0#0.0#2022-04-01
10:16:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1e9ea3d73f59e09fc9caecd4d1da64f6 150000 0 0 0 0 0
0 0 0 0 15000 0 43065 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 12/11/1945 0 2
1 Z09.8;K80.2;K27.9 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 325622
novia;3313125201940001; 5.6.7.202204241238 4 359402
1#0##0#0#0.0#2022-05-19
13:59:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
4f0732fe56040832248e4e4f9cfe4cda 150000 0 0 0 0 0
0 0 0 0 15000 0 160622 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 11/09/1947 0 1
0 404900 410478 0 1 0 0 0 TUKIMAN.TN 098571
0000555611016 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
359405 1#0##0#0#0.0#2022-05-19
14:19:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
808e3793a367979a5e4b12d7d1da4880 150000 0 0 0 0 0
0 0 0 0 15000 0 245478 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 18/01/1955 0 2
1 Z09.8;N75.0 93.35;93.39 - - None None None None M-3-16-0
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000090992327 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359070 26#0##0#0#0.0#2022-04-01
08:42:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d5a69b1c0e0ed407bad0a0040ee609d4 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 30/08/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 202380
0 1 0 0 0 RIA TRI RASMANI. NY 089448 60 22115
agung;3313092303950002; 5.6.6.202203301209 4 359406
27#0##0#0#0.0#2022-04-01
09:43:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
77889bcf6f9cd87d31065bdf7ed82ec1 150000 0 0 0 0 0
0 0 0 0 15000 0 37380 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 06/05/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400
1084891 0 1 0 0 0 BAMBANG SUTOPO, (BP) 001186
0001104109896 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359409 1#0##0#0#0.0#2022-04-04
12:47:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
06043510c0c0287b8eb7453489bcbcee 150000 0 0 0 0 0
0 120745 0 0 15000 0 799146 0 0 0 0
0
3372030 C 3 CP 2 18/03/2022 18/03/2022 10/04/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 211103
0 1 0 0 0 SRI HARTATI.NY 082567 63 23353 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359412
1#0##0#0#0.0#2022-04-04
12:48:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0d0df9aa46b8f9e78f95f080bac5e82b 150000 0 0 0 0 0
0 0 0 0 15000 0 46103 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 07/01/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 197991
0 1 0 0 0 TUKINAH NY 068041 55 20159 DR. WAHYU
agung;3313092303950002; 5.6.6.202203301209 4 359415
1#0##0#0#0.0#2022-04-04
12:49:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8fb266c7e1e704739bb6a1b37a9d7e58 150000 0 0 0 0 0
0 0 0 0 15000 0 32991 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 03/08/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 223038
0 1 0 0 0 TENTREM.NY 089445 58 21412 DR. WAHYU
agung;3313092303950002; 5.6.6.202203301209 4 359416
1#0##0#0#0.0#2022-04-04
13:03:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f452affe93e3c72b981e0385de04c1a6 150000 0 0 0 0 0
0 0 0 0 15000 0 58038 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 31/12/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 411376
0 1 0 0 0 HARYANI,NY 072349 53 19435 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 359418
1#0##0#0#0.0#2022-04-04
13:04:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7abd43c2e8d42d59e012094f160740d7 150000 0 0 0 0 0
0 76045 0 0 15000 0 170331 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 21/08/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 210254
0 1 0 0 0 MUSNATIN., NY 071462 73 26872 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359422
1#0##0#0#0.0#2022-04-04
13:05:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
749aae3df31c61ed86ac13f624091c16 150000 0 0 0 0 0
0 0 0 0 15000 0 45254 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 21/08/1975 0 2
0 - 0 - 0 - 0 129600 459312 0 1
0 0 0 ANITA SURIANTI, NY 000954 46 17011 DR. WAHYU
agung;3313092303950002; 5.6.7.202204241238 4 367810
1#0##0#0#0.0#2022-05-20
10:23:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
100f90e42f9d1a70f19d291f4b5789e0 150000 0 0 0 0 0
248000 0 0 0 15000 0 46312 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 01/09/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 213534
0 1 0 0 0 SUDARSI, NY 087904 58 21383 DR. WAHYU
agung;3313092303950002; 5.6.6.202203301209 4 359425
1#0##0#0#0.0#2022-04-04
13:06:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
888763e65b3d86254cb507844b8b8528 150000 0 0 0 0 0
0 0 0 0 15000 0 48534 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 12/11/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 375792
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359426
1#0##0#0#0.0#2022-04-04
13:07:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2ce1e96732b5563dda8e21543794ce9f 150000 0 0 0 0 0
0 133800 0 0 15000 0 76992 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 31/12/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI SUWANTI, NY
0001967417043 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359069 28#0##0#0#0.0#2022-04-01
08:41:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
32a0a30b5bd74f72972a7372d9e6058e 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 15/09/2007 0 1
1 S42.20;W19.0 97.88 - - None None None None M-3-11-0
0 404900 126598 0 1 0 0 0 TRIYA NARESWARI
INSYRA.an 102505 14 5298 DR. WAHYU PURNOMO, SP.OT
1124R0020322V002844 0002704422903 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361207 1#0##0#0#0.0#2022-04-05
10:40:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6f1137f0cf92fd061b33d5c6e52acb74 0 0 73000 0 0 0 0
0 0 0 25000 0 28598 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 09/05/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 215481
0 1 0 0 0 SARSINI.NY 089203 67 24785 DR. WAHYU
agung;3313092303950002; 5.6.6.202203301209 4 359430
1#0##0#0#0.0#2022-04-04
13:08:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
49d5b8433ee05e2b9ea3d3c18913691b 150000 0 0 0 0 0
0 0 0 0 15000 0 50481 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 10/11/1962 0 2
1 Z09.8;I11.9;H81.3;E11.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 367668
0 1 0 0 0 SURATINEM.NY 098509 59 21678 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359432
1#0##0#0#0.0#2022-04-04
13:09:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9faa81350ab76058c94b7ef691208d5d 150000 0 0 0 0 0
0 133650 0 0 15000 0 69018 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 14/08/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 222849
0 1 0 0 0 SRI LESTARI 056183 53 19574 DR. WAHYU
agung;3313092303950002; 5.6.6.202203301209 4 359437
1#0##0#0#0.0#2022-04-04
13:10:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ffb866b4fd323288b0c8d9b9b986a0b7 150000 0 0 0 0 0
0 0 0 0 15000 0 57849 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 28/08/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 196845
0 1 0 0 0 WIHARSO 093973 67 24674 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 359441
1#0##0#0#0.0#2022-04-04
13:11:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
48c38582326bfeac2f488f6baaff6b0b 150000 0 0 0 0 0
0 31845 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 05/05/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SURYATI, NY 090097
0001479655326 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359172 29#0##0#0#0.0#2022-04-01
08:47:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f7b6e27d460327db7626add0795ee17d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 14/04/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 213534
0 1 0 0 0 AMIR HAUDI,(BP) 029404 64 23714 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359443
1#0##0#0#0.0#2022-04-04
13:11:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
91e6e82f634a9b2c6a55e0576ec427d4 150000 0 0 0 0 0
0 0 0 0 15000 0 48534 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 29/05/1992 0 2
0 0 - 0 - 0 - 0 - 0 181400 328387
0 1 0 0 0 RIBKAH EVI N, NY 102273 29 10885 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359446
1#0##0#0#0.0#2022-04-04
13:12:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
61890e5f60b12af9fef55cb054c62adc 150000 0 0 0 0 0
0 121345 0 0 15000 0 42042 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 31/12/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 NGATIYEM 67636
0000640358291 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
360739 1#0##0#0#0.0#2022-04-01
08:30:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2794965dc54e14de67ab0810a91cc04f 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 01/09/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 404007
0 1 0 0 0 MARIA VERENA SINTOWATI.NY 089293 69
0000091422044 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359451 1#0##0#0#0.0#2022-04-04
13:12:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4cd3b31858a6b9761ffe06dc53a62894 150000 0 0 0 0 0
0 171170 0 0 15000 0 67837 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 18/05/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SAMIYATI.NY 094791
0000046966566 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359062 1#0##0#0#0.0#2022-04-04
16:59:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
02d5b975343e3aaf70546b4f96ec1c37 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 24/04/2007 0 1
0 - 0 - 0 - 0 - 0 181400 181781
0 1 0 0 0 M ARYZZA FIKRATUHA, AN 076005 14 5442
agung;3313092303950002; 5.6.6.202203301209 4 359460
1#0##0#0#0.0#2022-04-04
13:13:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
115480304449807e4996bfc20d1c170d 150000 0 0 0 0 0
0 0 0 0 15000 0 16781 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 18/01/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 211037
0 1 0 0 0 IVO MUMPUNI WIJAYANINGRUM, NY 095874 56
3;JKN novia;3313125201940001; 5.6.7.202204241238 4 359462
1#0##0#0#0.0#2022-05-19
13:37:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
4febc84fdee5aa9df0e78c13b164b945 150000 0 0 0 0 0
0 0 0 0 15000 0 46037 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 25/02/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 217030
agung;3313092303950002; 5.6.6.202203301209 4 359464
1#0##0#0#0.0#2022-04-04
13:14:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2d22e1797625d9689d30b0cb4945c287 150000 0 0 0 0 0
0 0 0 0 15000 0 52030 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 12/07/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 443472
0 1 0 0 0 CATUR RAHAYU HANDAYANI. NY 091782 55
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359473
1#0##0#0#0.0#2022-04-04
13:15:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ce4edbe4dddf40916c809a699e2e4f99 150000 0 0 0 0 0
0 31845 0 0 15000 0 246627 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 14/04/1960 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARTINAH., NY
0001084606863 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359060 30#0##0#0#0.0#2022-04-01
08:28:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
047a8d21fcbb21277fd6e1d83bc56a2d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 12/04/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARIYAM.NY 084306
0001302703266 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359063 31#0##0#0#0.0#2022-04-01
08:39:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b3452a7480c331c989abb2211ce19b71 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 06/06/2008 0 2
0 0 - 0 - 0 - 0 - 0 181400 206250
3;JKN novia;3313125201940001; 5.6.7.202204241238 4 359474
1#0##0#0#0.0#2022-05-20
08:14:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
fd2717308ae7c3c1758e09888c83e43b 150000 0 0 0 0 0
0 0 0 0 15000 0 41250 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 05/03/1944 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SANTOSO. TN 088783
0000091319657 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359076 32#0##0#0#0.0#2022-04-01
08:44:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
06a9fd34d380b19baeff6ec113201761 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 22/04/1986 0 1
0 0 - 0 - 0 - 0 - 0 181400 189289
0 1 0 0 0 AWAN DIKO NUGROHO, SDR 092174 35 13114
agung;3313092303950002; 5.6.6.202203301209 4 359476
1#0##0#0#0.0#2022-04-04
13:17:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e2dd484302f1327f4b5aea9881df40af 150000 0 0 0 0 0
0 0 0 0 15000 0 24289 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 02/02/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUJIYEM, NY 090600
0001696847466 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
359126 1#0##0#0#0.0#2022-05-19
11:03:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
95a97bb4eb77efa72a0dd1de9044ded7 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 10/10/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 200872
novia;3313125201940001; 5.6.7.202204241238 4 359477
1#0##0#0#0.0#2022-05-19
08:34:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
1a090e8d0e04961d4090b0e483df5f15 150000 0 0 0 0 0
0 0 0 0 15000 0 35872 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 05/05/1940 0 2
1 Z09.8;I11.9;I73.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 233829
0 1 0 0 0 SUKINI SOSROWIMPUNO., NY 042317 81
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359478
1#0##0#0#0.0#2022-04-04
13:18:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
caeb234499124b65d77eb81892745a0d 150000 0 0 0 0 0
0 0 0 0 15000 0 68829 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 01/10/1937 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SOEKROJONO 70675
0000091322357 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
360742 2#0##0#0#0.0#2022-04-01
08:51:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ed3e8f0b91f253c0dc38538b4c0f94ff 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 03/03/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 234065
0 1 0 0 0 JAMIATUL KIROM., NY 050640 69 25217
agung;3313092303950002; 5.6.6.202203301209 4 359479
1#0##0#0#0.0#2022-04-04
13:19:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
97e7e90cfc5544d28a6f5d9f5205c12a 150000 0 0 0 0 0
0 0 0 0 15000 0 69065 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 05/01/1951 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ACHMAD SUPARDI.,
0001693922106 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359163 34#0##0#0#0.0#2022-04-01
08:46:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7adafe79f72b78e9c34175eefb97f78d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 05/07/1992 0 2
0 0 - 0 - 0 - 0 - 0 181400 222751
0 1 0 0 0 NURJANAH., NN 048362 29 10848 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359484
1#0##0#0#0.0#2022-04-04
13:19:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9795fb7579c4a1696be5893705cfbc26 150000 0 0 0 0 0
0 0 0 0 15000 0 57751 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 27/06/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI MARGANI.NY
0000091413112 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359183 35#0##0#0#0.0#2022-04-01
08:52:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9c44744e9a4c70d579862d5b7e8fb992 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 24/04/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 452034
0 1 0 0 0 NURUL HIDAYAH,(NY) 040852 54 20052
agung;3313092303950002; 5.6.6.202203301209 4 359487
1#0##0#0#0.0#2022-04-04
13:20:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
456133a06665cf06ee8ca5987f4ac3cf 150000 0 0 0 0 0
0 0 0 0 15000 0 287034 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 11/11/1952 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMARDI.TN 101737
0000640283771 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359160 36#0##0#0#0.0#2022-04-01
08:46:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f92610cb963af429c75d4368cdbb76c6 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 01/01/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 485780
0 1 0 0 0 ESTI PAKUWATI.NY 067078 60 21991 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359490
1#0##0#0#0.0#2022-04-04
13:21:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5ad9c1d545e763cae6faed16ebc0952f 150000 0 0 0 0 0
0 0 0 0 15000 0 320780 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 07/10/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 NUR LASMI, NY
0000639913318 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359176 37#0##0#0#0.0#2022-04-01
08:49:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f6e57a985dfc506ad227663feacd2ce8 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 25/05/1940 0 2
0 0 - 0 - 0 - 0 - 0 181400 219952
0 1 0 0 0 SRI SUHARTI., NY 048659 81 29882 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359494
1#0##0#0#0.0#2022-04-04
13:21:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8c797161f5d2187bf5e0cf0a291b1e5f 0 0 138000 0 0 0
0 0 0 0 15000 0 66952 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 16/10/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 255046
0 1 0 0 0 MURSIHWATI.NY 089241 63 23164 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359517
1#0##0#0#0.0#2022-04-04
13:22:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cb0050b2ae2ca1888c1de8f77f2eee13 150000 0 0 0 0 0
0 0 0 0 15000 0 90046 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 20/07/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SITI ZUHRIYAH,(NY)
0000091194276 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
359065 1#0##0#0#0.0#2022-05-19
08:05:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
7553b3992b6b13d81bb94b8fb02ab90e 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 12/09/2013 0 2
1 Z47.0 97.89 - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 172888
0 1 0 0 0 REVIANA SAFA SEPTIANI.AN 099209 8
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359531
1#0##0#0#0.0#2022-04-04
13:23:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
819e0792e9bb75c0f03118f194fe80f7 0 0 138000 0 0 0
0 0 0 0 15000 0 19888 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 17/01/1940 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SITI JAHIDJAH, NY
0000091261743 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359181 39#0##0#0#0.0#2022-04-01
08:50:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
00a64a3e98cb924a53410cdb6234392a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 24/07/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUTAMI.NY 099959
0000640553196 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359068 40#0##0#0#0.0#2022-04-01
08:41:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
89480604cfd37281285cb6d262b52bb4 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 22/09/1959 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMARSONO ,TN
0001032587199 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359074 41#0##0#0#0.0#2022-04-01
08:43:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
abda30d53420f81108e88bc70c7a2ebd 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 01/11/1961 0 2
0 - 0 107400 273000 0 1 0 0 0
1124R0020322V002886 0000090942546 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 359127 42#0##0#0#0.0#2022-04-01
08:45:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8a6115929761aa45d0e6de87bc7cac41 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 14/06/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001429190267 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
359072 1#0##0#0#0.0#2022-05-19
08:38:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
6a6be6fe0eff1096f8a67f53774cfe51 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 10/11/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 285241
0 1 0 0 0 BAMBANG RUSPANTO.TN 101606 52 19121
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359534
1#0##0#0#0.0#2022-04-04
13:24:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ae312b32690625e034bf40cb84e9b656 150000 0 0 0 0 0
0 31845 0 0 15000 0 88396 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 07/05/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 214423
0 1 0 0 0 TRI RAHAYU, NY 072208 62 22961 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359538
1#0##0#0#0.0#2022-04-04
13:25:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
79f43bf4b51c87936444532b74d33f5c 150000 0 0 0 0 0
0 0 0 0 15000 0 49423 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 31/05/1972 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ENDANG HARSO SRI
P., NY 071636 49 18188 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V002890 0000639771715 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 359128 44#0##0#0#0.0#2022-04-01
08:45:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3bb52a6c58fe0adaa88bfa893d776dad 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 25/12/1992 0 1
0 0 - 0 - 0 - 0 - 0 181400 218229
0 1 0 0 0 ARIANTO SAPUTRO, SDR 056251 29 10675
agung;3313092303950002; 5.6.6.202203301209 4 359541
1#0##0#0#0.0#2022-04-04
13:25:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5e2b827953456d5a3d5f7e850bb57f3e 150000 0 0 0 0 0
0 0 0 0 15000 0 53229 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 20/11/1985 0 1
1 Z09.8;G40.3;J64 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 165000
0001842045939 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359545 1#0##0#0#0.0#2022-04-04
13:26:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
abfebf9108d693515e3a2f9c06ca2e96 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 07/12/1946 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 359332
45#0##0#0#0.0#2022-04-01
07:56:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aaf59019b1f346b43bd5116611f55874 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 24/05/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 193919
0 1 0 0 0 MUSINEM.NY 078681 64 23674 DR. INDRIANY
agung;3313092303950002; 5.6.6.202203301209 4 359549
1#0##0#0#0.0#2022-04-04
13:27:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1fddcb385de153200a26e85fdd3a90f7 150000 0 0 0 0 0
0 0 0 0 15000 0 28919 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 01/05/1975 0 1
0 - 0 - 0 - 0 - 0 182600 478830
0 1 0 0 0 MAIWAN., BP 047087 46 17123 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 359329
46#0##0#0#0.0#2022-04-01
07:55:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
375cf23f90402479614629fba1f80cd4 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 03/04/1964 0 2
1 Z09.8;G62.8 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 188409
0 1 0 0 0 RIPTYAWATI. NY 053697 57 21168 DR.
agung;3313092303950002; 5.6.7.202204241238 4 359550
1#0##0#0#0.0#2022-06-17
15:24:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
f4ab063e31a1ed3ad59349eb4e647ab5 0 0 138000 0 0 0
0 0 0 0 15000 0 35409 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 08/03/1967 0 1
0 - 0 - 0 - 0 786200 677676 0 1
agung;3313092303950002; 5.6.6.202203301209 4 359327
47#0##0#0#0.0#2022-04-01
07:54:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9087d89bfe92b649fca2ef75505d5ef7 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 31/12/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 194667
0 1 0 0 0 SRI SUHARNI., NY 045839 52 19070 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359552
1#0##0#0#0.0#2022-04-04
13:31:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
776a506cd09c06e742ac3c944c69852b 150000 0 0 0 0 0
0 0 0 0 15000 0 29667 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 01/12/1980 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V002903 0000640230884 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 359326 48#0##0#0#0.0#2022-04-01
07:54:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7f92af87beb31577c23bbdd146988761 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 07/06/1957 0 2
1 Z09.8;M54.39;L30.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 228908
0 1 0 0 0 ISROWIYAH, NY 091060 64 23660 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359554
1#0##0#0#0.0#2022-04-04
13:32:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a6462248cb208c8109ebd838b88582ca 150000 0 0 0 0 0
0 0 0 0 15000 0 63908 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 26/04/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 359320
49#0##0#0#0.0#2022-04-01
07:53:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7e6c5f02f9fe3bb7c80c2a2612dad05e 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 11/06/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 217253
0 1 0 0 0 GIYARTI, NY 099181 58 21465 DR. INDRIANY
agung;3313092303950002; 5.6.6.202203301209 4 359613
1#0##0#0#0.0#2022-04-04
13:32:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9a4007b4b4464947ccfaed78888a4d9f 150000 0 0 0 0 0
0 0 0 0 15000 0 52253 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 12/09/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 320525
0 1 0 0 0 DANUARDI SUPODO,TN 049724 77 28311
agung;3313092303950002; 5.6.6.202203301209 4 359616
1#0##0#0#0.0#2022-04-04
13:33:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bcc505d11c995a59167042d2fc630946 150000 0 0 0 0 0
0 63690 0 0 15000 0 91835 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 20/08/1959 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V002908 0000571256594 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 359318 50#0##0#0#0.0#2022-04-01
07:53:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e49c4de4fc4f1415db37b120cdff52e6 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 25/05/1972 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V002909 0002431552465 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 359316 51#0##0#0#0.0#2022-04-01
07:52:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
79eaded9397d63f3783e33692bd6da66 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 01/12/1958 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V002910 0001436949538 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 359313 52#0##0#0#0.0#2022-04-01
07:52:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3b8fd8def7822bb687995be2c4f7cc4f 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 13/06/1990 0 2
0 0 - 0 - 0 - 0 - 0 181400 188194
0 1 0 0 0 ARENSI WAHYUNINGTYAS, NY 082489 31
0001266339565 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359620 1#0##0#0#0.0#2022-04-04
13:33:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
204db520fba5d70503c1ce103301699f 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 01/04/1981 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V002912 0001904830593 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 359311 53#0##0#0#0.0#2022-04-01
07:51:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e567af981060bdc40c28fe20ab828afc 463830 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 17/04/1961 0 2
0 - 0 - 0 - 0 786200 677676 0 1
agung;3313092303950002; 5.6.6.202203301209 4 359307
54#0##0#0#0.0#2022-04-01
07:51:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2eabab72b61700364ca6fd251cd1fc66 662676 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 12/06/1972 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.7.202204241238 4 359304
1#0##0#0#0.0#2022-05-25
09:31:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
d13943e5536160bc24539d4c36dc9d89 463830 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 14/10/1998 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SUNAN ADI RACHMADI.TN 098775 23 8556 DRG.
agung;3313092303950002; 5.6.6.202203301209 4 359652
1#0##0#0#0.0#2022-04-04
13:34:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8a5472b1a3a288061d40b67bdb75eedf 300000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 26/06/1978 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RINDIYATI.NY 101781 43 15971 DRG.
agung;3313092303950002; 5.6.6.202203301209 4 359656
1#0##0#0#0.0#2022-04-04
13:35:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
81a85b24f185a2578c69104c0f32180b 300000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 27/11/1988 0 2
0 - 0 - 0 - 0 - 0 296400 182248
0 1 0 0 0 MASNI.NY 098321 33 12164 DR. GUNAWAN,
SP.OG 1124R0020322V002917 0001287357085 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 359659 1#0##0#0#0.0#2022-04-04
13:37:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8551b64564ba376fb7264e6353de8dbb 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 25/04/1959 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 NURUL FITRIANI,(NY) 016314 62 22973 DRG.
agung;3313092303950002; 5.6.6.202203301209 4 359666
1#0##0#0#0.0#2022-04-04
13:41:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9f96bc7e6e663cfa0214c94d4f5ae4db 300000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 17/10/1953 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SUWARSI, NY 061642 68 24989 DRG. VERAWATY,
SP.KG 1124R0020322V002919 0000091410309 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 359668 1#0##0#0#0.0#2022-04-04
13:42:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/03/2022 18/03/2022 13/07/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 172376
0 1 0 0 0 TATIK HARYANI.NY 101939 56 20702 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359671
1#0##0#0#0.0#2022-04-04
13:43:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/03/2022 18/03/2022 31/12/1945 0 1
1 Z04.1 23.70 - - None None None None U-3-16-0 None None
0 - 0 - 0 - 0 283800 339233 0 1
0 0 0 FX SUPARNO.TN 102475 76 27836 DRG. VERAWATY,
SP.KG 1124R0020322V002922 0000088858326 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 359670 1#0##0#0#0.0#2022-04-04
13:42:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6c1eec601ec318d38487c5e4358ebc38 300000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 29/04/1980 0 2
0 0 - 0 - 0 - 0 - 0 181400 205635
0 1 0 0 0 SRI AMINAH, NY 066163 41 15298 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359673
1#0##0#0#0.0#2022-04-04
13:43:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
86022305a5496cbae32ec6432e601719 150000 0 0 0 0 0
0 0 0 0 15000 0 40635 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 31/12/1966 0 1
- 0 - 0 - 0 - 0 283800 315000 0
agung;3313092303950002; 5.6.6.202203301209 4 359675
1#0##0#0#0.0#2022-04-04
13:44:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
761209a219d6eac45e367e6e0ebee889 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 01/01/2000 0 2
- 0 - 0 - 0 - 0 283800 315000 0
agung;3313092303950002; 5.6.6.202203301209 4 359677
1#0##0#0#0.0#2022-04-04
13:44:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
25a370e11e7c820106ef6930037fd9d8 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 24/07/1960 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SITI NOERSYAMSIYAH, NY 101777 61 22517 DRG.
agung;3313092303950002; 5.6.6.202203301209 4 359679
1#0##0#0#0.0#2022-04-04
13:45:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
da9a3124cf4c8b8ca1143365407bab1a 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 01/01/2000 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SUDIRMAN LAMSI., BP 041571 22 8112 DRG.
agung;3313092303950002; 5.6.6.202203301209 4 359680
1#0##0#0#0.0#2022-04-04
13:45:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ec3a7935ab42cd8314a1273b81c54740 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 14/02/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 197808
0 1 0 0 0 LASI.NY 081656 73 26695 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 359682
1#0##0#0#0.0#2022-04-04
13:45:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ac7e64c37a0fb39cf48adef0e706772d 150000 0 0 0 0 0
0 0 0 0 15000 0 32808 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 05/11/1970 0 1
- 0 - 0 - 0 - 0 283800 315000 0
agung;3313092303950002; 5.6.6.202203301209 4 359685
1#0##0#0#0.0#2022-04-04
13:56:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
52da008d09026c4f5bed5a1d6f38a13f 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 01/03/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 223773
0 1 0 0 0 SUPADMI,NY 057827 53 19375 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 359687
1#0##0#0#0.0#2022-04-04
13:56:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c24d3c9391eb7c4ee429d536de97540d 150000 0 0 0 0 0
0 0 0 0 15000 0 58773 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 30/12/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 223269
0 1 0 0 0 DARI SUGIYARTI, (NY) 003938 56 20532
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359695
1#0##0#0#0.0#2022-04-04
13:56:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
54c510a1ec509fca456dfcf7c350e43b 150000 0 0 0 0 0
0 0 0 0 15000 0 58269 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 10/04/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MOEMINAH., NY
0000091214706 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359178 57#0##0#0#0.0#2022-04-01
08:49:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
47d108ae430f062fc51d39b9f9488f46 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 25/05/2000 0 1
- 0 - 0 - 0 - 0 283800 315000 0
agung;3313092303950002; 5.6.6.202203301209 4 359697
1#0##0#0#0.0#2022-04-04
13:57:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
115dba091818c26a45faf3053a1620b5 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 02/08/2003 0 2
- 0 - 0 - 0 - 0 283800 315000 0
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359699
1#0##0#0#0.0#2022-04-04
13:57:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7763f2536f83183cced2cc11e2aedc40 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 21/11/1982 0 2
0 0 - 0 - 0 - 0 - 0 181400 189338
0 1 0 0 0 ELLY PAMUNGKAS., NY 000332 39 14362
agung;3313092303950002; 5.6.6.202203301209 4 359701
1#0##0#0#0.0#2022-04-04
13:58:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3b0c66f4109558635132a371284f72b5 150000 0 0 0 0 0
0 0 0 0 15000 0 24338 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 19/08/1962 0 1
- 0 - 0 - 0 - 0 283800 315000 0
agung;3313092303950002; 5.6.6.202203301209 4 359703
1#0##0#0#0.0#2022-04-04
13:58:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1db070a5ef3d30b0051f7d6ec56b1f93 300000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 04/08/1950 0 2
- 0 - 0 - 0 - 0 549400 223608 0
1 0 0 0 SUNARTI.,NY 054610 71 26159 DR. DEWI
agung;3313092303950002; 5.6.7.202204241238 4 359704
1#0##0#0#0.0#2022-05-25
09:34:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
6697bb26815d6a8a836a420aedbcded4 150000 0 0 0 0 0
0 0 0 0 15000 0 58608 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 25/12/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 WAHJUNINGSIH
1124R0020322V002941 0001647209711 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 359173 58#0##0#0#0.0#2022-04-01
08:48:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
77e86d855049360031e3c73b22bca51e 258000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 31/10/1990 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 WAHITA RISKIKA UMAMI., (NY) 041375 31 11461
agung;3313092303950002; 5.6.6.202203301209 4 359705
1#0##0#0#0.0#2022-04-04
13:59:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
14624db26f65afc9893f9d35f93893c6 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 08/05/1989 0 1
- 0 - 0 - 0 - 0 283800 615000 0
1 0 0 0 FARIZ CANDRA K, TN 102275 32 12002 DRG.
agung;3313092303950002; 5.6.6.202203301209 4 359710
1#0##0#0#0.0#2022-04-04
14:00:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9ff69113b32bef01ad11df7669a8ecb1 600000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 06/08/1970 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 DYAH ARUMSARI,(NY) 026631 51 18852 DRG.
agung;3313092303950002; 5.6.6.202203301209 4 359711
1#0##0#0#0.0#2022-04-04
14:00:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c09350b2a82fbc74c28e1420b7c33c50 300000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 18/05/1940 0 1
0 0 - 0 - 0 - 0 - 0 181400 243253
0 1 0 0 0 HERRY WINANTO. TN 089159 81 29889 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359712
1#0##0#0#0.0#2022-04-04
14:00:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d888c0c54d39cab7c3989b1ebd26b12d 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 17/03/1976 0 1
0 0 - 0 - 0 - 0 - 0 181400 231902
0 1 0 0 0 BAMBANG ARIANTO A, SDR 100192 46 16802
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359713
1#0##0#0#0.0#2022-04-04
14:01:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c687ce74ffab87716f18526d8d1d9907 150000 0 0 0 0 0
0 0 0 0 15000 0 66902 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 25/02/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 226523
0 1 0 0 0 SUYANTI., NY 046730 57 20840 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359714
1#0##0#0#0.0#2022-04-04
14:01:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
315cae97e50537bff155e4f530df5bee 150000 0 0 0 0 0
0 0 0 0 15000 0 61523 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 07/07/1958 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 JAP LIAN MIE.NY 102476 63 23265 DRG. VERAWATY,
SP.KG 1124R0020322V002948 0002466426442 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 359715 1#0##0#0#0.0#2022-04-04
14:02:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3e0d32750f25eb7bd5dc4cb18081be91 300000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 24/02/1982 0 1
0 - 0 - 0 - 0 283800 324922 0 1
0 0 0 HERI PRIHANTO NUGROHO.TN 102479 40 14632 DRG.
agung;3313092303950002; 5.6.6.202203301209 4 359716
1#0##0#0#0.0#2022-04-04
14:03:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/03/2022 18/03/2022 22/07/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 228437
0 1 0 0 0 TRIYONO, TN 052165 50 18502 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 359717
1#0##0#0#0.0#2022-04-04
14:03:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/03/2022 18/03/2022 02/06/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 231616
agung;3313092303950002; 5.6.6.202203301209 4 359718
1#0##0#0#0.0#2022-04-04
14:04:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b86242a00cf984fac1924c95641ff594 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 23/03/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 226578
0 1 0 0 0 SRI LESTARI,(NY) 035396 56 20814 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359720
1#0##0#0#0.0#2022-04-04
14:04:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2154c67eb9d2647e1a5b98755ec09f98 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 09/07/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 228977
0 1 0 0 0 SUROTO.TN 087121 62 22898 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 359722
1#0##0#0#0.0#2022-04-04
14:05:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fc773d08dada2e943c9a960ec8c4fb4d 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 05/03/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 224010
0 1 0 0 0 SRI WULAN.NY 099062 43 15719 DR.
novia;3313125201940001; 5.6.7.202204241238 4 359725
1#0##0#0#0.0#2022-05-20
07:54:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
93e42f532bca1e949634d9ce77a83968 150000 0 0 0 0 0
0 0 0 0 15000 0 59010 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 11/08/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 228234
0 1 0 0 0 SRI MARYATI, NY 036506 56 20673 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359727
1#0##0#0#0.0#2022-04-04
14:06:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
279bdbcf72bec0f38b69da0ffdd8b328 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 24/04/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 273429
0 1 0 0 0 ESTER WARSITI.NY 089155 74 27357 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359730
1#0##0#0#0.0#2022-04-04
14:06:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
98a229568480076ce8ee7a782b8d4632 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 11/09/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 284658
0 1 0 0 0 SUPARNO,BP 084400 66 24295 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 359734
1#0##0#0#0.0#2022-04-04
14:06:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a7dce64fd7fa41af3eacbbd0f9968fa2 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 04/10/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 229279
0 1 0 0 0 SLAMETO.TN 096660 76 27924 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 359736
1#0##0#0#0.0#2022-04-04
14:21:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
22865cb6b60e5917302fe5848f6b4b1e 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 14/12/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 230384
0 1 0 0 0 SRI DARMINI, NY 093216 70 25662 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359739
1#0##0#0#0.0#2022-04-04
14:22:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
283765a4722ebea91795b4324eccadd2 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 06/09/1974 0 2
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0 1 0 0 0 YESSY SUSILOWATI.NY 088633 47 17360
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359740
1#0##0#0#0.0#2022-04-04
14:22:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
55f534a8cdad1bd184c6a52d34eb0384 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 14/06/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 226391
0 1 0 0 0 SRI YUNI ASTUTI.NY 095924 45 16713
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359742
1#0##0#0#0.0#2022-04-04
14:23:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e5c72578815739f9e0d10a3897c1a1a5 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 12/06/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 224114
0 1 0 0 0 TRI CAHYANINGSIH, NY 092685 42 15620
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359745
1#0##0#0#0.0#2022-04-04
14:24:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eaf5febef9269fdf83d652fc4772bf21 150000 0 0 0 0 0
0 0 0 0 15000 0 59114 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 13/11/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 255079
0 1 0 0 0 JOKO SETYANTO 092583 61 22405 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359747
1#0##0#0#0.0#2022-04-04
14:25:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b7b52b985a7e600f17110d8d07e1218d 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 09/03/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 200646
0 1 0 0 0 ARIEF BUDI RAHARJO.TN 082727 69 25211
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359748
1#0##0#0#0.0#2022-04-04
14:26:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/03/2022 18/03/2022 08/06/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 223768
0 1 0 0 0 LAMIYEM.NY 087484 71 26216 DR. ARIA
novia;3313125201940001; 5.6.7.202204241238 4 359750
1#0##0#0#0.0#2022-05-19
10:40:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
7381429e59be819664f31d643cc79c49 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 21/06/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 216541
0 1 0 0 0 MUCHAMAD NUGROHO ERIYANTO.TN 101249 51
0001692524654 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359751 1#0##0#0#0.0#2022-04-04
14:27:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7d9baaa788ed9f07412c12c2483e68ed 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 31/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 218818
0 1 0 0 0 TUMINAH NY 088417 67 24549 DR. ARIA
novia;3313125201940001; 5.6.7.202204241238 4 359754
1#0##0#0#0.0#2022-05-19
10:56:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
7dfe4a38a2d0e96aff2197e233f216b6 150000 0 0 0 0 0
0 0 0 0 15000 0 53818 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 02/06/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 270028
0 1 0 0 0 JUNI SUYANTO.TN 098551 63 23300 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359758
1#0##0#0#0.0#2022-04-04
14:28:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a20542f8028291876f585dd4c0b38976 150000 0 0 0 0 0
0 0 0 0 15000 0 105028 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 26/10/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 268516
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359760
1#0##0#0#0.0#2022-04-04
14:28:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2f482e27f8160b06cb9b31521a8a1a66 150000 0 0 0 0 0
0 0 0 0 15000 0 103516 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 15/11/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 245179
0 1 0 0 0 ANIK RUSMINAH, (NY) 050080 56 20577
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359763
1#0##0#0#0.0#2022-04-04
14:29:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
548f017df0d0ea99b75a23ac2f954b0e 150000 0 0 0 0 0
0 0 0 0 15000 0 80179 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 23/03/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 229405
0 1 0 0 0 SUGIARTI.,NY 065553 57 21179 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359765
1#0##0#0#0.0#2022-04-04
14:29:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
194f617f7c77834ec25e5814a4f2934d 150000 0 0 0 0 0
0 0 0 0 15000 0 64405 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 02/04/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 221997
0 1 0 0 0 SRI SISMIATUN., NY 046455 69 25552
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359769
1#0##0#0#0.0#2022-04-04
14:31:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f556ec7b27881989376db13e2baf49a8 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 22/12/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 227255
0 1 0 0 0 SUNARTI 095046 62 22732 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 359775
1#0##0#0#0.0#2022-04-04
14:32:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7ce49c5cfc865453771aee7c4cde79f8 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 16/06/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 230087
0 1 0 0 0 SUWARTI.NY 085230 76 28034 DR. ARIA
novia;3313125201940001; 5.6.7.202204241238 4 359773
1#0##0#0#0.0#2022-05-19
10:30:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
5967493807e9fabfeae6c41fcbd55ffe 150000 0 0 0 0 0
0 0 0 0 15000 0 65087 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 31/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 232189
0 1 0 0 0 ASLAMIYAH., NY 043938 67 24549 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359776
1#0##0#0#0.0#2022-04-04
14:32:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7d26eefd17b52a7003e41a8ec184c39b 150000 0 0 0 0 0
0 0 0 0 15000 0 67189 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 31/08/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 225357
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359777
1#0##0#0#0.0#2022-04-04
14:33:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/03/2022 18/03/2022 02/03/1964 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ZAIDUN ELLY,(NY) 012944 58 21200 DRG.
agung;3313092303950002; 5.6.6.202203301209 4 359778
1#0##0#0#0.0#2022-04-04
14:33:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/03/2022 18/03/2022 28/01/1963 0 1
1 Z09.8;E11.9;I11.9 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 279510
0 1 0 0 0 DRS.SUWARNO, TN 077474 59 21599 DR.
novia;3313125201940001; 5.6.7.202204241238 4 359784
1#0##0#0#0.0#2022-05-19
10:12:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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0 0 0 0 15000 0 114510 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 13/06/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 242176
novia;3313125201940001; 5.6.7.202204241238 4 359785
1#0##0#0#0.0#2022-05-19
10:26:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
2f858eaed75cc5d2cd2476128893e397 150000 0 0 0 0 0
0 0 0 0 15000 0 77176 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 26/02/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 309524
0 1 0 0 0 SUNARNI,(NY) 031205 68 24857 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359783
1#0##0#0#0.0#2022-04-04
14:34:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8def97352199876dea717c9c923528e9 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 19/07/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 212185
0 1 0 0 0 SWANTIKAH,(NY) 040450 71 26175 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359786
1#0##0#0#0.0#2022-04-04
14:35:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f6423b8eb95ea047f4b3cce544208681 150000 0 0 0 0 0
0 0 0 0 15000 0 47185 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 27/03/2001 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 GABRIELLA AYU MARSELA.NN 101135 20
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359787
1#0##0#0#0.0#2022-04-04
14:35:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0e0278fe8a2b2df4c07fbf729cd9381c 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 03/03/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 222085
0 1 0 0 0 SRI MULYANI,(NY) 040379 62 22660 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359788
1#0##0#0#0.0#2022-04-04
14:48:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9709e38cb26c463ae974aaf02f35766c 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 24/02/1973 0 1
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3;JKN novia;3313125201940001; 5.6.7.202204241238 4 359789
1#0##0#0#0.0#2022-05-19
13:27:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
2a842f40eef2f4512fe3f99fb8adb10f 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 18/10/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 331166
0 1 0 0 0 BAMBANG SUPRAPTOMO, TN 073265 49 18048
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359790
1#0##0#0#0.0#2022-04-04
14:48:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d754e6e329131c10fcc258bbdea47297 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 12/12/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 234636
0 1 0 0 0 SUPARTINI.NY 084915 73 26759 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359791
1#0##0#0#0.0#2022-04-04
14:49:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0238da4e05946523de9a6bdd1bb11f60 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 11/03/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 230286
0 1 0 0 0 BUDIMAN,BP 078815 61 22287 DR. ARIA
novia;3313125201940001; 5.6.7.202204241238 4 359792
1#0##0#0#0.0#2022-05-19
10:14:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
251f71f2e42fbab4a819638e018c4ed1 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 30/04/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0001084023909 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359794 1#0##0#0#0.0#2022-04-04
14:50:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/03/2022 18/03/2022 13/06/1981 0 1
0 0 - 0 - 0 - 0 - 0 181400 242573
0 1 0 0 0 ARIS SUPRIYANTO, TN 100648 40 14888
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359796
1#0##0#0#0.0#2022-04-04
14:50:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5c73b3d6458725b7fdf2e513e6e41ac3 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 18/04/1968 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 RAHMADI.TN 096843
0002169726311 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
359174 1#0##0#0#0.0#2022-05-19
13:45:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 18/03/2022 18/03/2022 01/01/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 286385
0 1 0 0 0 ROCHMADIN ASGAR TN 049605 59 21626
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359798
1#0##0#0#0.0#2022-04-04
14:50:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/03/2022 18/03/2022 20/01/1968 0 2
1 Z09.8;I69.3;M54.39 87.24 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 504385
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3;JKN reni;3313147010930001; 5.6.6.202203301209 4 361489
1#0##0#0#0.0#2022-04-06
08:55:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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0
3372030 C 3 CP 2 18/03/2022 18/03/2022 12/07/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 232645
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agung;3313092303950002; 5.6.6.202203301209 4 359801
1#0##0#0#0.0#2022-04-04
14:51:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/03/2022 18/03/2022 13/04/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 DENNY SUTARSIH, NY 071249 63 23350
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359803
1#0##0#0#0.0#2022-04-04
14:51:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/03/2022 18/03/2022 05/08/2003 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 VIRA DWI ARFIANDI, AN 061294 18 6800 DRG.
agung;3313092303950002; 5.6.6.202203301209 4 359806
1#0##0#0#0.0#2022-04-04
14:53:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
31c66d70d003d07af3b745f7a4b3efe7 300000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 10/06/1998 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SIA WIDYANINGRUM 100974 23 8682 DRG.
agung;3313092303950002; 5.6.6.202203301209 4 359808
1#0##0#0#0.0#2022-04-11
12:05:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
aa94fe06bb7645d6c771311a73e23799 300000 0 0 0 0 0
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3372030 C 3 CP 2 18/03/2022 18/03/2022 29/03/1968 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ARI SURYANI.NY 100179 53 19712 DRG.
agung;3313092303950002; 5.6.6.202203301209 4 359810
1#0##0#0#0.0#2022-04-04
15:13:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8ccae4cebe92ffae7a8c03b5bbd1acb1 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 21/10/2015 0 1
0 0 - 0 - 0 - 0 - 0 181400 174040
0 1 0 0 0 MUHAMMAD JAFAR SHODIQ AN 067633 6
0002230835365 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359811 1#0##0#0#0.0#2022-04-04
14:54:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fe93013837dc70a646210c9f3d5569e0 150000 0 0 0 0 0
0 0 0 0 15000 0 9040 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 07/05/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 263388
0 1 0 0 0 DIYONO.TN 095311 64 23691 DR. INDRIANY
agung;3313092303950002; 5.6.6.202203301209 4 359812
1#0##0#0#0.0#2022-04-04
14:54:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e091ac8919de8e39e676be676e55db93 150000 0 0 0 0 0
0 0 0 0 15000 0 98388 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 26/10/2020 0 1
0 0 - 0 - 0 - 0 - 0 181400 189562
0 1 0 0 0 ALKHALIFI MALIK AHMAD, AN 102499 1
0003095169489 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359822 1#0##0#0#0.0#2022-04-04
14:55:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d030050b6e47d9818063f39a58b37b3d 150000 0 0 0 0 0
0 0 0 0 15000 0 24562 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 29/06/2016 0 2
0 0 - 0 - 0 - 0 - 0 181400 174040
0 1 0 0 0 YASMIN RAMADHANIA KUSUMA, AN 102353 5
0002704856275 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359823 1#0##0#0#0.0#2022-04-04
14:55:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c802bd27001800742f67ba431913d7af 150000 0 0 0 0 0
0 0 0 0 15000 0 9040 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 30/07/1985 0 2
- 0 - 0 - 0 - 0 283800 315000 0
agung;3313092303950002; 5.6.6.202203301209 4 359830
1#0##0#0#0.0#2022-04-04
14:55:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8f84d032f317fb031d24d04e63b48037 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 21/08/2003 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 HERLINDA DWI AGUSTIN 100930 18 6784 DRG.
agung;3313092303950002; 5.6.6.202203301209 4 359832
1#0##0#0#0.0#2022-04-04
14:56:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6df8ef623267b89d0743dd51527ee19b 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 02/02/1995 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RUDI PRIYANTO, SDR 102277 27 9906 DRG.
agung;3313092303950002; 5.6.6.202203301209 4 359835
1#0##0#0#0.0#2022-04-04
14:56:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7a439402cf7a74dbefbfd5f804940d0f 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 21/04/1950 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RINDUAN JANNUWAR, TN 052069 71 26264 DRG.
agung;3313092303950002; 5.6.6.202203301209 4 359837
1#0##0#0#0.0#2022-04-04
14:57:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
912088b356fbb2a603a00daa78f5c8c2 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 09/11/1975 0 2
- 0 - 0 - 0 - 0 283800 371854 0
1 0 0 0 WIDI ASTUTI, NY 101242 46 16931 DRG.
agung;3313092303950002; 5.6.6.202203301209 4 359838
1#0##0#0#0.0#2022-04-04
14:59:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ec8122e81acf49d40319b4aabe63a3ea 300000 0 0 0 0 0
0 0 0 0 15000 0 56854 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 07/03/1986 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 WASIS NUGROHO, TN 064449 36 13160 DRG.
agung;3313092303950002; 5.6.6.202203301209 4 359839
1#0##0#0#0.0#2022-04-04
15:00:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
01695ea0a8fd7f9f04915c295e0824c4 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 01/04/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 198891
0 1 0 0 0 ROBIKATUN,(NY) 033635 65 24092 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359841
1#0##0#0#0.0#2022-04-04
15:00:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
583109bd39f9d312f9c67285b52d57c8 150000 0 0 0 0 0
0 0 0 0 15000 0 33891 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 04/08/1953 0 1
0 - 0 - 0 - 0 183900 232186 0 1
0 0 0 SLAMET, TN 102262 68 25063 DR. HERMAWAN, SP.B
1124R0020322V003019 0002522987201 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361208 1#0##0#0#0.0#2022-04-05
10:42:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
29c578f2d7f3111e07000a7bb989a632 150000 0 0 0 0 0
0 0 0 0 15000 0 67186 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 28/04/1987 0 1
0 - 0 - 0 - 0 183900 294941 0 1
0 0 0 ANDI SUPRIYANTO, TN 055714 34 12743 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359845
1#0##0#0#0.0#2022-04-04
15:01:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d277607368a29987a1d41d2fb5572870 235000 0 0 0 0 0
0 0 0 0 15000 0 44941 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 17/02/2010 0 2
1 S91.2 96.59;93.57 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 257186 0 1
0 0 0 KAELA ALISA PUTRI RIZKY., AN 051218 12 4412 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361209
1#0##0#0#0.0#2022-04-05
10:46:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2e0d8c6f25f2444b02787656e1617125 150000 0 0 0 0 0
0 0 0 0 15000 0 92186 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 21/04/2002 0 2
1 D24 88.73 - - None None None None Z-3-23-0 None None
- 0 - 0 - 0 - 0 549400 845000 0
1 0 0 0 ASSYFA TIARA PUSPAHARUM, NN 056145 19 7271
reni;3313147010930001; 5.6.6.202203301209 4 361210
1#0##0#0#0.0#2022-04-05
10:47:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c51367487b6d67324eff22a33a59ca7a 150000 0 0 0 0 0
680000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 04/09/1960 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V003024 0000640142684 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 359334 60#0##0#0#0.0#2022-04-01
07:56:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
676480677046a843fd9256945c8c3eda 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 15/05/1953 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 359338
61#0##0#0#0.0#2022-04-01
07:56:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
adabd7c1a435bc21321310c63e810c62 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 02/09/1976 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 359342
62#0##0#0#0.0#2022-04-01
07:57:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c2577107631e65f121cd37932ec6bca1 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 25/03/1978 0 2
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 359344
63#0##0#0#0.0#2022-04-01
07:57:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c72c20a8394d2a071a1d658f2368f38c 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 23/12/1977 0 2
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 359347
64#0##0#0#0.0#2022-04-01
07:58:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cf2361c240b5c0eaedbd6124717a2fb3 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 01/09/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V003029 0000639614597 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 359349 65#0##0#0#0.0#2022-04-01
07:58:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ebcb0a665a010486c823d36b4c455978 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 08/08/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 234124
0 1 0 0 0 GIYANTI.NY 100284 50 18485 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 359846
1#0##0#0#0.0#2022-04-04
15:01:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5ca8b80433302d1687785dd4ea484028 150000 0 0 0 0 0
0 0 0 0 15000 0 69124 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 08/12/1992 0 1
0 0 - 0 - 0 - 0 - 0 181400 199716
0 1 0 0 0 ARIS ABDULLAH, BP 088781 29 10692 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359847
1#0##0#0#0.0#2022-04-04
15:02:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6269f2c52cc9f9bfd260bde1ef192213 150000 0 0 0 0 0
0 0 0 0 15000 0 34716 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 19/02/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 234520
0 1 0 0 0 DANU MARGONO.,BP 056891 57 20846 DR.
novia;3313125201940001; 5.6.7.202204241238 4 359848
1#0##0#0#0.0#2022-05-19
08:42:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
07005bfd1a730ad0ce5f6b2ec1806bda 150000 0 0 0 0 0
0 0 0 0 15000 0 69520 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 18/07/1978 0 1
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 TRI NUGROHO,(BP) 023141 43 15949 DRG. VERAWATY,
SP.KG 1124R0020322V003033 0001275582723 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 359850 1#0##0#0#0.0#2022-04-04
15:02:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2cc464281ba6b56be2b23dac0855d5b4 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 14/05/1933 0 1
0 0 - 0 - 0 - 0 - 0 181400 251017
0 1 0 0 0 KOESWANTO BA.TN 095635 88 32450 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359852
1#0##0#0#0.0#2022-04-04
15:03:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b6f9d57c3e0f18e6cf63ac79ff8fd756 150000 0 0 0 0 0
0 0 0 0 15000 0 86017 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 24/02/1954 0 2
1 Z09.8;M53.19;I69.3 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 221854
0 1 0 0 0 SRI PURWANI.NY 101247 68 24859 DR.
novia;3313125201940001; 5.6.7.202204241238 4 359853
1#0##0#0#0.0#2022-05-20
09:26:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
d7d3929bac080693d7d78b1503bb0a82 150000 0 0 0 0 0
0 0 0 0 15000 0 56854 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 21/09/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 246703
0 1 0 0 0 BASUKI HARJO DARSONO, TN 069759 77
0002261390455 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
359855 1#0##0#0#0.0#2022-04-04
15:05:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ce1e75331e310805415582c278a18654 150000 0 0 0 0 0
0 0 0 0 15000 0 81703 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 23/04/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 443689
0 1 0 0 0 SRI WAHYUNI, NY 087660 61 22609 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359856
1#0##0#0#0.0#2022-04-04
15:05:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d186c30ff7aacae1643b48acf635543d 150000 0 0 0 0 0
0 0 0 0 15000 0 278689 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 12/01/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 210375
0 1 0 0 0 EKO RINI.NY 093223 53 19423 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 359859
1#0##0#0#0.0#2022-04-04
15:05:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9aea08c801e492d122b70b80db603fd2 150000 0 0 0 0 0
0 0 0 0 15000 0 45375 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 20/12/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 213674
0 1 0 0 0 DIVANA YOGA LARAS.SDR 097629 19 7028
agung;3313092303950002; 5.6.6.202203301209 4 359860
1#0##0#0#0.0#2022-04-04
15:06:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cb36142079e2506f5db222e87012e9f2 150000 0 0 0 0 0
0 0 0 0 15000 0 48674 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 31/05/1993 0 2
1 Z09.8;Z09.1 96.59 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 165000 0 1
SP.B 1124R0020322V003040 0000640414394 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 359873 1#0##0#0#0.0#2022-05-19
10:17:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
74e501a3c324deed7046abc00ee7d678 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 21/03/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 229779
0 1 0 0 0 BASUKI WIDODO, TN 060757 64 23738 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359767
1#0##0#0#0.0#2022-04-11
12:04:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
d012c2e8c83f9487fdf1ad5c9cad2a4b 150000 0 0 0 0 0
0 0 0 0 15000 0 64779 0 0 0 0 0
3372030 C 3 CP 2 18/03/2022 18/03/2022 24/03/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 192154
0 1 0 0 0 INDAH WAHYU M C D, NY 102503 52 19352
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 359863
1#0##0#0#0.0#2022-04-04
15:07:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a45b613a4a1457a5a188f767b36273a5 150000 0 0 0 0 0
0 0 0 0 15000 0 27154 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 22/08/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 213534
0 1 0 0 0 DYAH NURJANTI,(NY) 042222 74 27238
yani;3302226402970001; 5.6.5.202203091809 4 359204
1#0##0#0#0.0#2022-03-28
12:09:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
686055cf8c5ce5b13d205793c3507709 150000 0 0 0 0 0
0 0 0 0 15000 0 48534 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 14/09/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 206461
0 1 0 0 0 SUPRAPTO.TN 095047 55 20275 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 359205
1#0##0#0#0.0#2022-03-28
12:12:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ee32b5be12230c2845ec3a04611aafe8 150000 0 0 0 0 0
0 0 0 0 15000 0 41461 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 18/04/1974 0 1
0 0 - 0 - 0 - 0 - 0 181400 206380
0 1 0 0 0 JOKO SANTOSO.TN 101122 47 17502 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359206
1#0##0#0#0.0#2022-03-28
12:14:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8318c016c28785f629900891cc2614a0 150000 0 0 0 0 0
0 0 0 0 15000 0 41380 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 20/06/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 206250
0 1 0 0 0 TUGIYEM, NY 090349 64 23648 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 359322
1#0##0#0#0.0#2022-03-28
12:14:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d144c4c3a7a9b424277263f8d549aa9d 150000 0 0 0 0 0
0 0 0 0 15000 0 41250 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 24/11/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 210326
0 1 0 0 0 SRI HASTUTIK.NY 101489 61 22395 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359207
1#0##0#0#0.0#2022-03-28
12:17:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
59b0f558aca560348220a21118d6e9fe 150000 0 0 0 0 0
0 31845 0 0 15000 0 13481 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 13/11/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 206239
0 1 0 0 0 LIDIA HERAWATI 090523 76 27885 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359209
1#0##0#0#0.0#2022-03-28
12:42:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
005bc9849021474dd86a644ba4840dad 150000 0 0 0 0 0
0 0 0 0 15000 0 41239 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 23/12/2011 0 1
0 0 - 0 - 0 - 0 - 0 181400 413000
0 1 0 0 0 RAVEL ADRYAN N, AN 100466 10 3739
reni;3313147010930001; 5.6.6.202203301209 4 361491
1#0##0#0#0.0#2022-04-06
08:56:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c40ca2b2ec8471d19ea25c2c1db81f49 150000 0 0 0 0 0
248000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 31/12/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 204630
0 1 0 0 0 SOEMARKO.,BP 053597 72 26376 DR.
agung;3313092303950002; 5.6.6.202203301209 4 359210
1#0##0#0#0.0#2022-04-11
12:07:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 5
6f438a5342f8c3e86fb91d528ab38b4d 0 0 138000 0 0 0
0 0 0 0 15000 0 51630 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 16/06/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 201982
0 1 0 0 0 SUWARTI.NY 085230 76 28035 DR. WAHYU
novia;3313125201940001; 5.6.7.202204241238 4 359211
1#0##0#0#0.0#2022-05-19
10:31:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
c4d6a302f0fcfab79ee9e6be6f222cd4 150000 0 0 0 0 0
0 0 0 0 15000 0 36982 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 16/02/1964 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 DARYANTO, TN
0000638910999 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359165 1#0##0#0#0.0#2022-03-28
13:17:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fec3d0b6f90f94407dfd90bf41f6bb36 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 15/08/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 250373
0 1 0 0 0 SURATMAN ADI RATMANTO.TN 101974 77
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 359212
1#0##0#0#0.0#2022-03-28
13:21:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
33df7397dd62568e413ba14d551c3fe8 150000 0 0 0 0 0
0 31845 0 0 15000 0 53528 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 12/11/1945 0 2
0 - 0 - 0 - 0 - 0 138400 285000
novia;3313125201940001; 5.6.7.202204241238 4 359184
1#0##0#0#0.0#2022-05-19
14:00:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
e03d74931b0c5231b00471876af7276b 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 18/06/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 204743
0 1 0 0 0 JEMI.NY 076504 65 24015 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 359213
1#0##0#0#0.0#2022-03-28
13:25:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a7bb3977d6433dd34b523080aa2590dd 150000 0 0 0 0 0
0 0 0 0 15000 0 39743 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 07/02/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 195888
0 1 0 0 0 JATI WALUYO.TN 100408 53 19398 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359214
1#0##0#0#0.0#2022-03-28
13:28:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
31c55f7246a14bb58e87e37a0f4f042b 150000 0 0 0 0 0
0 0 0 0 15000 0 30888 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 31/12/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 390324
0 1 0 0 0 DASINEM, NY 052283 58 21263 DR. SUHARTO,
SP.PD 1124R0020322V003059 0002042119629 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359215 1#0##0#0#0.0#2022-03-28
13:29:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0419fcb7b94b61511c1156e87d7d180e 150000 0 0 0 0 0
0 0 0 0 15000 0 225324 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 10/10/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 200323
novia;3313125201940001; 5.6.7.202204241238 4 359216
1#0##0#0#0.0#2022-05-19
08:35:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
ef646be37952936b9371d5413755f57b 150000 0 0 0 0 0
0 0 0 0 15000 0 35323 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 20/10/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 206239
0 1 0 0 0 SITI TARTINI ., NY 056182 66 24257
yani;3302226402970001; 5.6.5.202203091809 4 359217
1#0##0#0#0.0#2022-03-28
13:30:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2124f27649fe5b371621943b681c625b 150000 0 0 0 0 0
0 0 0 0 15000 0 41239 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 01/09/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 210947
0 1 0 0 0 SUYAMI,NY 063751 45 16635 DR. SUHARTO,
SP.PD 1124R0020322V003062 0000639550361 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359218 1#0##0#0#0.0#2022-03-28
13:31:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c1b59870a67f40918b7b4e0a2d3bb8d2 150000 0 0 0 0 0
0 0 0 0 15000 0 45947 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 18/06/1936 0 2
0 0 - 0 - 0 - 0 - 0 181400 225522
0 1 0 0 0 DALIYEM.NY 077842 85 31320 DR. SUHARTO,
SP.PD 1124R0020322V003063 0001084498558 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359220 1#0##0#0#0.0#2022-03-28
13:32:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7d2a8c9192b66b26d589da296e32e6e7 150000 0 0 0 0 0
0 0 0 0 15000 0 60522 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 11/02/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 210694
0 1 0 0 0 MULYANI,(NY) 039619 62 22682 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359222
1#0##0#0#0.0#2022-03-28
13:33:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aa574582b290c4e361353d6faec631b2 150000 0 0 0 0 0
0 0 0 0 15000 0 45694 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 07/12/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 211167
0 1 0 0 0 PUJI HARTO TJIPTOATMOJO 087832 76 27861
yani;3302226402970001; 5.6.5.202203091809 4 359228
1#0##0#0#0.0#2022-03-28
13:34:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
49cea00bc2e02a81182e3d1e0340c8e2 150000 0 0 0 0 0
0 0 0 0 15000 0 46167 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 03/06/1950 0 1
1 Z09.8;E11.4;G59.0;H81.3 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 287397
0 1 0 0 0 SJAMSUL ISLAM,(BP) 015309 71 26222
yani;3302226402970001; 5.6.5.202203091809 4 359229
1#0##0#0#0.0#2022-03-28
13:35:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ff2710897f288a481e869b87e33b825d 150000 0 0 0 0 0
0 0 0 0 15000 0 122397 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 03/05/2004 0 1
0 0 - 0 - 0 - 0 - 0 181400 431524
0 1 0 0 0 RIDWAN ALFIANO NUR HIDAYATULLOH 005209
0001276682938 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
360525 1#0##0#0#0.0#2022-03-29
08:58:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
da81a4073f90b2f77b055275cf2b8548 150000 0 0 0 0 0
248000 0 0 0 15000 0 18524 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 05/02/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 215619
0 1 0 0 0 SUTIMIN.TN 012169 58 21227 DR. SUHARTO,
SP.PD 1124R0020322V003068 0001103900141 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359230 23#0##0#0#0.0#2022-03-28
13:36:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4c65a33d4e6a404c1ce2d3115f58cda2 150000 0 0 0 0 0
0 0 0 0 15000 0 50619 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 27/09/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 312939
0 1 0 0 0 SUMARNI, NY 058099 63 23184 DR. SUHARTO,
SP.PD 1124R0020322V003069 0000638623383 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359232 1#0##0#0#0.0#2022-03-28
13:38:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
79b5bf85dcaa86e50f41f37537aad7c8 150000 0 0 0 0 0
0 31845 0 0 15000 0 116094 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 26/03/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 L M BASUKI, NY
0000641664819 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359164 1#0##0#0#0.0#2022-03-28
13:39:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7035f20bc490ff16a46ad673a408614b 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 25/04/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 263858
0 1 0 0 0 MUJIYATI,NY 005071 54 20052 DR. SUHARTO,
SP.PD 1124R0020322V003071 0001267695246 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359234 1#0##0#0#0.0#2022-03-28
13:40:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
def6e5115c1064d546507c50b8ecbe69 150000 0 0 0 0 0
0 0 0 0 15000 0 98858 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 04/09/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 226039
0 1 0 0 0 TRI WIDAYATI, NY 065284 56 20650 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359237
1#0##0#0#0.0#2022-03-28
13:40:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7d72920066a68dc10570cb6716d9484c 150000 0 0 0 0 0
0 0 0 0 15000 0 61039 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 23/01/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 207319
0 1 0 0 0 SYAMSUL BACHRI TANTHOKO, TN 100860 66
yani;3302226402970001; 5.6.5.202203091809 4 359240
1#0##0#0#0.0#2022-03-28
13:41:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0218a2394f6598d43145505abcb0937a 150000 0 0 0 0 0
0 0 0 0 15000 0 42319 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 26/05/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 583243
0 1 0 0 0 SRI SUNTARI,(NY) 023355 63 23308 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359242
1#0##0#0#0.0#2022-03-28
13:42:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
86f587a9ee12ea984127bcccf8ae6727 150000 0 0 0 0 0
0 0 0 0 15000 0 418243 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 13/05/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ENI WIDIASTUTI, NY
0001429538578 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359166 1#0##0#0#0.0#2022-03-28
13:43:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c4f50c600f7cd0785f376a8ab76c2418 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 27/08/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 398150
0 1 0 0 0 HADI WIYONO, TN 073949 72 26502 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359244
1#0##0#0#0.0#2022-03-28
13:45:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
31f9a03c584d35d31543c81c8b3b539c 300000 0 0 0 0 0
0 0 0 0 15000 0 83150 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 26/05/2001 0 2
0 0 - 0 - 0 - 0 - 0 181400 197417
0 1 0 0 0 MEIDYA MITA MAHARTIN,(NN) 000957 20
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 359245
1#0##0#0#0.0#2022-03-28
13:45:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cc169dabd0c4b12921e1cea233677f02 150000 0 0 0 0 0
0 0 0 0 15000 0 32417 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 20/04/1947 0 1
1 Z09.8;K30;G91.2 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 294199
0 1 0 0 0 DJIJO BASUKI 077000 74 27362 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359249
1#0##0#0#0.0#2022-03-28
13:46:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dbc8d1aa4420eec7f33fec1538c6d1ba 150000 0 0 0 0 0
0 0 0 0 15000 0 129199 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 06/03/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 216667
0 1 0 0 0 ARIS SRIJANTI.NY 094801 66 24119 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359250
1#0##0#0#0.0#2022-03-28
13:48:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ebf22c57b2b70a8da0ed858b39775806 150000 0 0 0 0 0
0 0 0 0 15000 0 51667 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 22/03/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 216317
0 1 0 0 0 ISTRI SUDARYATI 093584 51 18990 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359252
1#0##0#0#0.0#2022-03-28
13:49:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3e771ba651f4bd0907ab34776679cb3e 150000 0 0 0 0 0
0 0 0 0 15000 0 51317 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 11/05/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 260217
0 1 0 0 0 SLAMET SAWARTO,BP 079134 66 24419 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359278
1#0##0#0#0.0#2022-03-28
13:53:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d700b0e5cd84e827452f364ae39f6d65 150000 0 0 0 0 0
0 31845 0 0 15000 0 63372 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 07/01/1951 0 1
1 Z09.8;G20 93.35;93.39 - - None None None None M-3-16-0
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MUH NUKMAN.TN
0001966365189 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359187 1#0##0#0#0.0#2022-03-28
13:54:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7e88055cc89b92dd78231826ec41a4b4 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 19/02/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 208109
0 1 0 0 0 SIMAN, TN 099921 55 20117 DR. SUHARTO,
SP.PD 1124R0020322V003083 0000570370083 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359280 1#0##0#0#0.0#2022-03-28
13:55:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0e1e95b86abad7467c05e20c96d3d756 150000 0 0 0 0 0
0 0 0 0 15000 0 43109 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 18/07/1986 0 2
1 Z09.8;R10.4;N30.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 223741
yani;3302226402970001; 5.6.5.202203091809 4 359281
1#0##0#0#0.0#2022-03-28
13:55:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
83aeee61706ce7e436a6eafcf86d20d1 150000 0 0 0 0 0
0 0 0 0 15000 0 58741 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 31/12/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 216053
0 1 0 0 0 MARINAH, NY 052302 72 26376 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 359282
1#0##0#0#0.0#2022-03-28
13:56:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
af222ccd06388ac56aa3030908bf485d 150000 0 0 0 0 0
0 0 0 0 15000 0 51053 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 23/04/1956 0 2
1 Z09.8;I50.9;R07.4 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 306980
0 1 0 0 0 SUKATNI, NY 091172 65 24071 DR. SUHARTO,
SP.PD 1124R0020322V003086 0001811084253 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359283 1#0##0#0#0.0#2022-03-28
13:57:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e92fe8d3eea7618937cae60b5724a3e4 150000 0 0 0 0 0
0 76595 0 0 15000 0 65385 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 13/08/1951 0 2
1 Z09.8;M25.58;R07.4;I50.9 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
206051 0 1 0 0 0 SUNARNI.(NY) 030534 70
yani;3302226402970001; 5.6.5.202203091809 4 359284
1#0##0#0#0.0#2022-03-28
13:58:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
642161c37a2c3fa5b75dd36f06c50b7f 150000 0 0 0 0 0
0 0 0 0 15000 0 41051 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 26/05/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001474646354 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359159 1#0##0#0#0.0#2022-03-28
13:58:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
85cbf80fd50e3e386d035b81ee7e1072 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 27/12/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 210562
0 1 0 0 0 SRI HARTINAH, NY 060277 66 24189 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359285
1#0##0#0#0.0#2022-03-28
13:59:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
46364d13425a6637e2358340ea4441e8 150000 0 0 0 0 0
0 0 0 0 15000 0 45562 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 29/12/1970 0 2
1 Z09.8;M19.98;K30;M54.59 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 227349
0 1 0 0 0 STORY NAVYARINI GITAWANTI., NY 041781
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 359287
1#0##0#0#0.0#2022-03-28
14:00:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
323659cb4c3d8de10f4940c9ac91652d 150000 0 0 0 0 0
0 0 0 0 15000 0 62349 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 05/03/1979 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI WULAN.NY
0001286475028 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
359190 1#0##0#0#0.0#2022-05-20
07:55:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
3f1856b42bc78c3a2cadd0bc0b3d0698 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 31/10/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 268412
0 1 0 0 0 WARTONO,(BP) 050037 53 19497 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359288
1#0##0#0#0.0#2022-03-28
14:02:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b206630869d2f324062f57033dc98b01 150000 0 0 0 0 0
0 0 0 0 15000 0 103412 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 15/04/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 236820
0 1 0 0 0 SUMINI, NY 047378 58 21523 DR. SUHARTO,
SP.PD 1124R0020322V003094 0001084295619 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359289 1#0##0#0#0.0#2022-03-28
14:03:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2f8a294f9bcc06251fb9f97900ebd60b 150000 0 0 0 0 0
0 0 0 0 15000 0 71820 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 21/12/1960 0 1
1 Z09.8;G20 93.35;93.39 - - None None None None M-3-16-0
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 NURSANTO BP 085741
0001622326994 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359143 1#0##0#0#0.0#2022-03-28
14:04:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
11ceaf1ff12532f59e450323351ccdd2 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 05/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DANIK KARTIKA
1124R0020322V003097 0001445069981 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359150 1#0##0#0#0.0#2022-03-28
14:06:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bf87bb65d08dbd37614bb5e5f8d437de 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 24/04/1990 0 1
0 0 - 0 - 0 - 0 - 0 181400 186753
0 1 0 0 0 EKO SETYANTO, TN 066247 31 11652 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359290
1#0##0#0#0.0#2022-03-28
14:11:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
62bc826712df46107b54b373f79460f3 150000 0 0 0 0 0
0 0 0 0 15000 0 21753 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 20/03/1961 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SLAMET RIYADI.TN
0001303435192 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359142 1#0##0#0#0.0#2022-03-28
14:13:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
55ef2f3a3a2a72a3c47f87406600ed0d 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 15/04/1973 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TATAS BUDIONO.TN
0001440938553 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359152 1#0##0#0#0.0#2022-03-28
14:15:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a7692523513a97ab265762d4569f867a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 15/09/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 254345
0 1 0 0 0 SIH UTAMI 085232 59 21735 DR. SUHARTO,
SP.PD 1124R0020322V003101 0000091526027 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359292 1#0##0#0#0.0#2022-03-28
14:16:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d7bfecb465da45aa938e6d220b39de02 150000 0 0 0 0 0
0 44300 0 0 15000 0 45045 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 04/02/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 194678
0 1 0 0 0 DERMAWAN SITORUS.NY 101593 52 19036
yani;3302226402970001; 5.6.5.202203091809 4 359294
1#0##0#0#0.0#2022-03-28
14:17:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cf51a4b479733699a76d30a2094d4ebe 150000 0 0 0 0 0
0 0 0 0 15000 0 29678 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 28/02/1939 0 1
0 0 - 0 - 0 - 0 - 0 181400 211277
0 1 0 0 0 SLAMET SUDARMO.TN 101254 83 30335 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359296
1#0##0#0#0.0#2022-03-28
14:18:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4559cd354db8dfcac47dcae520ddd524 150000 0 0 0 0 0
0 0 0 0 15000 0 46277 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 06/07/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMARNI.NY 086963
0002347072604 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359177 1#0##0#0#0.0#2022-03-28
14:19:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8fd2eca1aeca36172ef352f3c000dcef 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 25/06/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 KERNI,(NY) 033080
0001316373355 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359170 1#0##0#0#0.0#2022-03-28
14:19:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
88866ceff4e7d55a4de1da43dc20280c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 30/10/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 234928
0 1 0 0 0 TRI KARTINI 089553 56 20594 DR. SUHARTO,
SP.PD 1124R0020322V003107 0002168611222 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359297 1#0##0#0#0.0#2022-03-28
14:20:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
21cfef6d0f6f27020c400e38c03fea6e 150000 0 0 0 0 0
0 0 0 0 15000 0 69928 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 19/10/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 884672
0 1 0 0 0 MARGIYATI RAHAYU, NY 022527 57 20970
yani;3302226402970001; 5.6.5.202203091809 4 359299
1#0##0#0#0.0#2022-03-28
14:21:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
203610c218641a48a30dc53ddd52cce0 150000 0 0 0 0 0
0 0 0 0 15000 0 719672 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 15/11/2018 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 339000 0 1 0 0 0 ARIQ MAUZA
1124R0020322V003109 0002579775748 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359188 1#0##0#0#0.0#2022-03-28
14:30:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8a35c68429382f76e97d4ff5f27249b9 324000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 08/02/1948 0 1
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 MULYANTO.,TN 075508 74 27068 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359168
1#0##0#0#0.0#2022-03-28
14:32:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
31ce3f7261e396da78a63a0b470473f4 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 01/09/1988 0 2
0 0 - 0 - 0 - 0 - 0 181400 217435
0 1 0 0 0 SEPTIANINGSIH.NY 101954 33 12252 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359300
1#0##0#0#0.0#2022-03-28
14:38:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d4d58cba6bc606c2b6de26516278e0f3 150000 0 0 0 0 0
0 0 0 0 15000 0 52435 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 02/03/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMARNI, NY 101618
0000089014184 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359144 1#0##0#0#0.0#2022-03-28
14:43:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2929d553f3bd2e2959dd8a6ed3c2c921 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 03/04/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 193441
yani;3302226402970001; 5.6.5.202203091809 4 359302
1#0##0#0#0.0#2022-03-28
14:45:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6d96bfdbb626742956741088de0855ba 150000 0 0 0 0 0
0 0 0 0 15000 0 28441 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 04/02/1939 0 2
0 0 - 0 - 0 - 0 - 0 181400 217329
0 1 0 0 0 SRI SARSINI. NY 101941 83 30359 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359303
1#0##0#0#0.0#2022-03-28
14:45:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
79c376d28404e8b1ee1390bfde90ec08 150000 0 0 0 0 0
0 0 0 0 15000 0 52329 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 13/08/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 209002
yani;3302226402970001; 5.6.5.202203091809 4 359306
1#0##0#0#0.0#2022-03-28
14:46:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d39562cfc5e7e9993fc390d60d8224cb 150000 0 0 0 0 0
0 0 0 0 15000 0 44002 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 04/06/1952 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SURATMAN 029384
0001614176932 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359162 1#0##0#0#0.0#2022-03-28
14:47:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
99a995bcab29d89fa93b8fdbaa5a3404 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 25/03/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 316000 0 1 0 0 0 SUPINAH 091220
0000639810066 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359167 1#0##0#0#0.0#2022-03-28
14:49:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8d4a7a44e1ed7688737ca51d8b9d3317 301000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 05/03/1985 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DIAN USWATUN
1124R0020322V003118 0000977864152 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359155 1#0##0#0#0.0#2022-03-28
14:51:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6b83b9bf3d9cfee054b9f318d797418c 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 27/09/1965 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MARYATI., NY
0000640162157 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359161 1#0##0#0#0.0#2022-03-28
14:52:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
978821f9e7bd610a4a5ecae5873c36e3 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 31/08/1998 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 RARAS DANASTRI
0001279114907 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359180 1#0##0#0#0.0#2022-03-28
14:53:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
be264233a27f4e0b054c4a08ab3b213d 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 16/05/1956 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WIDI WINARSI.NY
0001849841414 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359189 1#0##0#0#0.0#2022-03-28
14:53:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
40b464f1fb3bc42a5426256d5bbf1b49 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 16/08/1969 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 TRI WINARNI, NY 093256 52 19208 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359182
1#0##0#0#0.0#2022-03-28
14:54:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9f77944cd99f393e478ebc8bdedd0290 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 06/06/2008 0 2
0 - 0 - 0 - 0 - 0 138400 285000
3;JKN novia;3313125201940001; 5.6.7.202204241238 4 359153
1#0##0#0#0.0#2022-05-20
08:15:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
2a07170757c00500f24e8f8aa09f3865 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 19/07/1950 0 2
0 - 0 - 0 - 0 - 0 138400 285000
yani;3302226402970001; 5.6.5.202203091809 4 359185
1#0##0#0#0.0#2022-03-28
14:56:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
66da4a1dbf80d5bbdf55679a72b32924 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 21/08/1948 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 MUSNATIN., NY 071462 73 26873 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359179
1#0##0#0#0.0#2022-03-28
14:57:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0ce01fc05494baa3cfd7a6aab07d97c6 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 02/10/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ASRI LISTYARINI.NY
0000640236058 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359148 1#0##0#0#0.0#2022-03-28
15:03:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b7aa3ccd4f621ab771be8003e1da184a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 11/09/1947 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 TUKIMAN.TN 098571
0000555611016 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
359156 1#0##0#0#0.0#2022-05-19
14:20:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
1547c5be522ffdd16c72b1acb317c5f0 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 07/10/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 YATINI 094257
0001083705715 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359186 1#0##0#0#0.0#2022-03-28
15:05:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d90b968ef9dc87c01d2927d49c44ab61 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 02/03/1941 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DIYAH 101274
0000091192274 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359147 1#0##0#0#0.0#2022-03-28
15:28:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4ade3aef1af02f6a7ba96d597474ff14 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 06/08/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 217729
0 1 0 0 0 MEISKE Y L SULENDORONG. NY 101790 65
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 359308
1#0##0#0#0.0#2022-03-28
15:29:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
16bce4e8b44a5788ee6ab169290a9d2d 150000 0 0 0 0 0
0 0 0 0 15000 0 52729 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 15/05/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 254000 0 1 0 0 0 YAHMINI ., NY
0001692527163 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
359146 1#0##0#0#0.0#2022-05-19
08:40:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
d9700e17747a8ef3473eaefb907ba00d 239000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 19/04/1972 0 2
1 Z09.8;E11.4;G59.0;R51 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 643768
0 1 0 0 0 PARNI, NY 078354 49 18231 DR. SUHARTO,
SP.PD 1124R0020322V003134 0000564110548 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359309 1#0##0#0#0.0#2022-03-28
15:31:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
79804af65abd220e0240ef525f18bd99 150000 0 0 0 0 0
0 31845 0 0 15000 0 446923 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 24/02/1954 0 2
1 Z09.8;H02.4 93.35;93.39 - - None None None None M-3-16-0
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI PURWANI.NY
0001125886228 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
359140 1#0##0#0#0.0#2022-05-20
09:26:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
a502e6b8f1f1ab98bd80ab9092c6a495 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 27/11/1986 0 2
0 0 - 0 - 0 - 0 - 0 181400 217899
0 1 0 0 0 YARNI, NY 093021 35 12896 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 359312
1#0##0#0#0.0#2022-03-28
15:33:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
498d90bdc2e9078124b8e8f6e05e0f7b 150000 0 0 0 0 0
0 0 0 0 15000 0 52899 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 02/08/1970 0 2
1 Z09.0;S86.0 93.57;96.59 - - None None None None Z-3-27-0
None None None None None None PERAWATAN LUKA 183900 0 0
- 0 - 0 - 0 - 0 183900 210190 0
1 0 0 0 RIKA HENDRIANI, NY 101292 51 18857 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361211
1#0##0#0#0.0#2022-04-05
10:48:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
64ccbe0f0c3d9ab12c8ad1e81ee8985b 150000 0 0 0 0 0
0 0 0 0 15000 0 45190 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 17/04/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 221793
0 1 0 0 0 SRI HASTUTI.NY 100500 65 24077 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359314
1#0##0#0#0.0#2022-03-28
15:33:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a1cc14093f37083b403c06d427fc2262 150000 0 0 0 0 0
0 0 0 0 15000 0 56793 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 24/02/1973 0 1
0 - 0 - 0 - 0 - 0 138400 285000
novia;3313125201940001; 5.6.7.202204241238 4 359158
1#0##0#0#0.0#2022-05-19
13:27:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
69bb8aa91ef9f438d3cb32f62b0a60e5 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 09/04/1964 0 2
0 - 0 - 0 - 0 - 0 138400 285000
yani;3302226402970001; 5.6.5.202203091809 4 359157
1#0##0#0#0.0#2022-03-28
15:35:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6792904992f0a5849d28be02eda48909 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 24/12/1999 0 2
0 0 - 0 - 0 - 0 - 0 181400 214522
0 1 0 0 0 ZANNUBA NUR RAMADHANI.NN 082566 22
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 359315
1#0##0#0#0.0#2022-03-28
15:36:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a9f95fd3f28d3bb464d54e22a7bac194 150000 0 0 0 0 0
0 0 0 0 15000 0 49522 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 08/06/1950 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 LAMIYEM.NY 087484 71 26217 DR. LINDA
novia;3313125201940001; 5.6.7.202204241238 4 359169
1#0##0#0#0.0#2022-05-19
10:40:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
fb870b114ff56c4c5d2090fc17049a6a 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 02/02/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 221793
0 1 0 0 0 SUJIYEM, NY 090600 59 21595 DR. WAHYU
novia;3313125201940001; 5.6.7.202204241238 4 359317
1#0##0#0#0.0#2022-05-19
11:03:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
c2d3caf20bcc097f2eeecd49501acdde 150000 0 0 0 0 0
0 0 0 0 15000 0 56793 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 10/10/1959 0 2
0 - 0 - 0 - 0 - 0 181400 208105
0 1 0 0 0 SRI REJEKI, NY 095056 62 22806 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359319
1#0##0#0#0.0#2022-03-28
15:38:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4fbb63097fad20f7ad83925f63d037e8 150000 0 0 0 0 0
0 0 0 0 15000 0 43105 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 07/11/1971 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 NUZUL HAKIM, TN
0002169296897 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359151 1#0##0#0#0.0#2022-03-28
15:50:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a63a8cd245f669bd1a877a38cfb73e7c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 22/04/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 205571
0 1 0 0 0 DJUWARSO, (BP) 008057 72 26629 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359321
1#0##0#0#0.0#2022-03-28
15:53:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
278f9d7289cd9c6f7d0a83202c1fc797 150000 0 0 0 0 0
0 0 0 0 15000 0 40571 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 31/12/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 219000 0 1 0 0 0 TUMINAH NY 088417
0002581070231 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
359149 1#0##0#0#0.0#2022-05-19
10:57:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
fc5090dd39ef9e25a7f538c6a9395622 204000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 07/10/1961 0 1
0 - 0 107400 262000 0 1 0 0 0 AGUNG
RUMAMBI, TN 097338 60 22078 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V003149 0001528617734 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359145 1#0##0#0#0.0#2022-03-28
15:55:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
908b366e5bf35483606bcaac5815a618 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 21/05/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 229581
0 1 0 0 0 JOHAN KRIS UTAMA.AN 076043 19 7242
DR. IBRAHIM NASRUL, SP.KJ 1124R0020322V003152 0001530453183 3;JKN
yani;3302226402970001; 5.6.5.202203091809 4 359324
1#0##0#0#0.0#2022-03-28
15:57:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
80513f9bec0dbdd344ba2615001e0a5c 150000 0 0 0 0 0
0 0 0 0 15000 0 64581 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 09/09/1940 0 1
0 0 - 0 - 0 - 0 - 0 181400 232180
0 1 0 0 0 SALEH MUHAMMAD HATRAS.TN 101366 81
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 359325
1#0##0#0#0.0#2022-03-28
15:58:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3c9d1d2d044b653855792ec281d48cb7 150000 0 0 0 0 0
0 0 0 0 15000 0 67180 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 10/04/1943 0 2
0 0 - 0 - 0 - 0 - 0 181400 308638
0 1 0 0 0 SRIYANTI, (NY) 033740 78 28833 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359328
1#0##0#0#0.0#2022-03-28
15:59:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fd3036c44ce29f177c149d834581ff5c 150000 0 0 0 0 0
0 0 0 0 15000 0 143638 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 27/02/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 255023
0 1 0 0 0 ANIK WIJAYANTI.NY 064540 49 17917 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359330
1#0##0#0#0.0#2022-03-28
16:00:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ceb57a22632ba8436bfc933d0177f97b 150000 0 0 0 0 0
0 0 0 0 15000 0 90023 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 18/08/1982 0 1
0 0 - 0 - 0 - 0 - 0 181400 562023
0 1 0 0 0 ENDRO PRASETYO, BP 085044 39 14458
yani;3302226402970001; 5.6.5.202203091809 4 359331
1#0##0#0#0.0#2022-03-29
07:29:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bcfd233c3c144197de3c19038f369149 150000 0 0 0 0 0
0 0 0 0 15000 0 397023 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 04/07/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 369336
0 1 0 0 0 YUSUF KRISNUGROHO, TN 061504 49 18155
yani;3302226402970001; 5.6.5.202203091809 4 359333
1#0##0#0#0.0#2022-03-29
07:30:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9b48481de2ea6a84bcd98dde6d4589c2 150000 0 0 0 0 0
0 0 0 0 15000 0 204336 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 13/09/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 207730
0 1 0 0 0 NGADIMAN.TN 101786 52 19180 DR. WAHYU
agung;3313092303950002; 5.6.7.202204241238 4 367811
1#0##0#0#0.0#2022-05-20
10:24:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fb2888ff0c5829fbb1e162d59c706122 150000 0 0 0 0 0
0 0 0 0 15000 0 42730 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 03/12/1950 0 1
0 - 0 - 0 - 0 786200 677676 0 1
yani;3302226402970001; 5.6.5.202203091809 4 359191
1#0##0#0#0.0#2022-03-29
07:31:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b30e8eaa9b8fdcdc28a30b561e6d0f66 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 09/09/1944 0 1
0 - 0 - 0 - 0 786200 555573 0 1
SP.PD 1124R0020322V003161 0000100867893 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359193 1#0##0#0#0.0#2022-03-29
08:18:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8ea2d01961f284703b16949b4b279961 463830 0 0 0 0 0
0 0 0 0 15000 0 76743 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 18/07/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V003162 0002425018184 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359194 1#0##0#0#0.0#2022-03-29
08:20:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c759bef8d028a16434fe4e8df8a4b257 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 31/12/1981 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 359195
1#0##0#0#0.0#2022-03-29
08:20:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
13e6774af45434994568b4a2094edb69 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 02/02/1972 0 2
0 - 0 - 0 - 0 786200 677676 0 1
SP.PD 1124R0020322V003164 0002070978546 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359196 1#0##0#0#0.0#2022-03-29
08:21:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
92ee917936ec56bae5e8289a6103b4e2 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 14/03/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.5.202203091809 4 359197
1#0##0#0#0.0#2022-03-29
08:21:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3aea78c51a9d371f5354903d3e06febc 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 12/03/1955 0 2
0 - 0 - 0 - 0 786200 677676 0 1
yani;3302226402970001; 5.6.5.202203091809 4 359198
1#0##0#0#0.0#2022-03-29
08:23:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8ac010162a3bd83e534a5b9f0ad0d33b 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 13/12/1941 0 2
0 0 - 0 - 0 - 0 - 0 181400 208342
0 1 0 0 0 FATIMAH.NY 077901 80 29316 DR. WAHYU
yani;3302226402970001; 5.6.5.202203091809 4 359335
1#0##0#0#0.0#2022-03-29
08:26:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a1646981442d1b44f3c1d6f6c3fd4b53 150000 0 0 0 0 0
0 0 0 0 15000 0 43342 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 01/01/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V003168 0001147281805 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359199 1#0##0#0#0.0#2022-03-29
08:27:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e0f561a1b3238549914c8d8ba61f3815 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 12/07/1966 0 1
0 - 0 - 0 - 0 786200 494109 0 1
yani;3302226402970001; 5.6.5.202203091809 4 359202
1#0##0#0#0.0#2022-03-29
08:30:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
88b93dd34794a79b3387de919230dbd5 463830 0 0 0 0 0
0 0 0 0 15000 0 15279 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 14/08/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 311045
0 1 0 0 0 WINARTIN.NY 086130 47 17384 DR. IBRAHIM
yani;3302226402970001; 5.6.5.202203091809 4 359336
1#0##0#0#0.0#2022-03-29
08:31:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
085913459e327600cc5a2be277869f8d 150000 0 0 0 0 0
0 0 0 0 15000 0 146045 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 28/03/2004 0 2
None None None None PSIKOTHERAPI INDIVIDU DEWASA BUKAN AKUT 194500
0 0 - 0 - 0 - 0 - 0 194500 191367
0 1 0 0 0 LAISYA NURLITA FERY ., AN 005612 17
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 359337
1#0##0#0#0.0#2022-03-29
08:32:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7d4e994f6bf1454743cba13508b51e76 150000 0 0 0 0 0
0 0 0 0 15000 0 26367 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 12/07/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 344309
0 1 0 0 0 SRI HARDJANI, NY 062457 66 24357 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359339
1#0##0#0#0.0#2022-03-29
08:33:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5e60183936fa7a340df7530156809b9d 150000 0 0 0 0 0
0 0 0 0 15000 0 179309 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 31/01/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 555192
0 1 0 0 0 SRI SUMIYATI.NY 099311 46 16849 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359340
1#0##0#0#0.0#2022-03-29
08:34:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e7f7bc10c5393a8bb7456c618f662667 150000 0 0 0 0 0
0 0 0 0 15000 0 390192 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 09/08/1992 0 1
0 0 - 0 - 0 - 0 - 0 181400 522995
0 1 0 0 0 KUKUH PARSETIAWAN. SDR 090802 29 10814
yani;3302226402970001; 5.6.5.202203091809 4 359341
1#0##0#0#0.0#2022-03-29
08:34:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2dcde2593ccbd4ea86eb6b3995893ccc 150000 0 0 0 0 0
0 0 0 0 15000 0 357995 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 12/02/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 335333
0 1 0 0 0 DARWATI, NY 094471 58 21220 DR. IBRAHIM
yani;3302226402970001; 5.6.5.202203091809 4 359343
1#0##0#0#0.0#2022-03-29
08:40:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cf36412aaff943bb80a0a24cdeb64d9e 150000 0 0 0 0 0
0 0 0 0 15000 0 170333 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 26/08/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 515123
0 1 0 0 0 LISTINA.NY 099402 58 21390 DR. IBRAHIM
yani;3302226402970001; 5.6.5.202203091809 4 359345
1#0##0#0#0.0#2022-03-29
08:41:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0bd80349a4891585f85d17f9032d8860 150000 0 0 0 0 0
0 0 0 0 15000 0 350123 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 18/05/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 310240
0 1 0 0 0 SUNNIYAH, NY 094046 67 24777 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359346
1#0##0#0#0.0#2022-03-29
08:43:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0c63a273d5aba16ad026c6c0670f457e 150000 0 0 0 0 0
0 0 0 0 15000 0 145240 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 11/03/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 413120
0 1 0 0 0 DJURANTO, BP 090117 63 23019 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359348
1#0##0#0#0.0#2022-03-29
08:44:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cc7960a857b9a8c4e4713953e9f17b96 150000 0 0 0 0 0
0 0 0 0 15000 0 248120 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 28/05/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 575091
0 1 0 0 0 BAKDIYAH., NY 064466 52 19288 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359350
1#0##0#0#0.0#2022-03-29
08:46:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8b3d8ce01e83a1b45eb1b1eed6f64acd 150000 0 0 0 0 0
0 0 0 0 15000 0 410091 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 28/10/1995 0 2
0 0 - 0 - 0 - 0 - 0 181400 259894
0 1 0 0 0 DITA LUTFIANA ARGASARI,.NN 065069 26
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 359351
1#0##0#0#0.0#2022-03-29
08:47:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a06faef38a5d1ca1f784d9bc7d1ef559 150000 0 0 0 0 0
0 0 0 0 15000 0 94894 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 19/02/2002 0 1
1 D21.1 - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 205624
0 1 0 0 0 MUHAMMAD HENDRA FENDIYANTO.SDR 102532
20 7333 DR. ZULFADLY, SP.B 1124R0020322V003182 0002344329235
3;JKN novia;3313125201940001; 5.6.7.202204241238 4 359279
1#0##0#0#0.0#2022-05-20
10:57:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
2ae20ab1b4a6c65512e2d338762cb903 150000 0 0 0 0 0
0 0 0 0 25000 0 30624 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 17/01/1955 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001107700209 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359175 1#0##0#0#0.0#2022-03-29
08:48:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bf0ab3e04dde80a6d516c0372f921656 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 10/04/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 287430
0 1 0 0 0 SUDARMI,(NY) 002130 52 19336 DR.
yani;3302226402970001; 5.6.5.202203091809 4 359352
1#0##0#0#0.0#2022-03-29
08:49:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
74b7da1e9cac409e5b661a900a292664 150000 0 0 0 0 0
0 0 0 0 15000 0 122430 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 20/02/1997 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MEGI ARUM.TN
0000565102956 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359141 1#0##0#0#0.0#2022-03-29
08:50:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
66004210d3bf53b3fcd59c3ff2c28be7 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 29/01/1999 0 1
1 Z09.8;R10.4;K59.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 218554
0 1 0 0 0 WIDIYANTO BAYU ADI, SDR 102342 23 8450
agung;3313092303950002; 5.6.6.202203301209 4 359353
1#0##0#0#0.0#2022-04-11
12:06:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
5b6e2aa7512a2d658ddbe88cbe3f6637 150000 0 0 0 0 0
0 0 0 0 15000 0 53554 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 04/11/1981 0 1
0 0 - 0 - 0 - 0 - 0 181400 337811
0 1 0 0 0 DANI CRISTIAWAN, TN 102515 40 14745
yani;3302226402970001; 5.6.5.202203091809 4 359354
1#0##0#0#0.0#2022-03-29
08:52:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a9890ad2be74f97027fabfb2aa4104bc 150000 0 0 0 0 0
0 0 0 0 15000 0 172811 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 04/11/2003 0 2
0 0 - 0 - 0 - 0 - 0 181400 383616
0 1 0 0 0 NOVIA YUDHA ARISANTI., NN 046280 18
3;JKN yani;3302226402970001; 5.6.5.202203091809 4 359355
1#0##0#0#0.0#2022-03-29
08:53:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8920e91b4fbcee217a41a64e1c6aae55 150000 0 0 0 0 0
0 0 0 0 15000 0 218616 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 21/02/1960 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI HARYATI.NY
0001302917049 3;JKN yani;3302226402970001; 5.6.5.202203091809 4
359201 1#0##0#0#0.0#2022-03-29
08:54:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b80c49ee41173cd626b1638cf745beac 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/03/2022 19/03/2022 20/01/1963 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 RESPATI DWI
1124R0020322V003193 0001865287618 3;JKN yani;3302226402970001;
5.6.5.202203091809 4 359200 1#0##0#0#0.0#2022-03-29
08:55:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ada534432cadc42de54deb1c2d6c989d 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 20/03/2022 20/03/2022 10/11/1958 0 2
4 I46.9 89.52;99.60 - - None None None None Q-5-37-0 None
None None None None None CARDIAC ARREST, RESPIRATORY ARREST & SHOCK
259600 0 0 - 0 - 0 - 0 - 0 259600
1013315 0 1 0 0 0 SUNARSI, NY 068800 63 23141
DR. YOSSI REZA GIMAWAN 1124R0020322V003199 0001084688212 3;JKN
reni;3313147010930001; 5.6.6.202203301209 4 361008
1#0##0#0#0.0#2022-04-04
17:25:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f09633e44e971c0f598ea204ec168699 820000 0 0 0 0 0
0 99000 0 0 15000 0 79315 0 0 0 0 0
3372030 C 3 CP 2 20/03/2022 20/03/2022 28/12/1988 0 1
1 J45.9 93.94 - - None None None None J-3-13-0 None None
None None None None PROSEDUR TERAPI SALURAN PERNAFASAN 308500 0
0 - 0 - 0 - 0 - 0 308500 210582
0 1 0 0 0 SURYA PERMANA SUGIARTO,TN 101301 33
12135 DR. YOSSI REZA GIMAWAN 1124R0020322V003201 0001379533533 3;JKN
reni;3313147010930001; 5.6.6.202203301209 4 361009
1#0##0#0#0.0#2022-04-04
17:28:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3320359e1a01e4fdd8807407afb6ba96 0 0 110000 0 0 0
0 0 0 0 15000 0 85582 0 0 0 0 0
3372030 C 3 CP 2 20/03/2022 20/03/2022 27/08/2002 0 2
1 L23.6;T61.8 - - - None None None None Q-5-42-0 None
0 - 0 - 0 - 0 - 0 182600 105745
0 1 0 0 0 FEIRA AYU NURMASHUDI,(AN) 026106 19
7145 DR. DANISWARA ADHITIA RAHMAN 1124R0020322V003204 0001285746254
3;JKN reni;3313147010930001; 5.6.6.202203301209 4 361010
1#0##0#0#0.0#2022-04-04
17:29:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6069edae566ce2e788caae51862831eb 0 0 75000 0 0 0 0
0 0 0 15000 0 15745 0 0 0 0 0
3372030 C 3 CP 2 20/03/2022 20/03/2022 13/03/1979 0 2
1 R10.4;N23 - - - None None None None Q-5-25-0 None
- 0 - 0 - 0 - 0 135700 241190 0
1 0 0 0 SITI ROCHMIATUN,(NY) 010960 43 15713 DR.
DANISWARA ADHITIA RAHMAN 1124R0020322V003207 0001227492977 3;JKN
reni;3313147010930001; 5.6.6.202203301209 4 361011
1#0##0#0#0.0#2022-04-04
17:30:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
da8a74ff6f2414a4633836a1b2da1e4f 172500 0 0 0 0 0
0 0 0 0 15000 0 53690 0 0 0 0 0
3372030 C 3 CP 2 20/03/2022 20/03/2022 01/08/2000 0 2
1 Z03.8;S52.50;W19.0 88.21 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 476472
0 1 0 0 0 MONIKA AGUSTIN, NN 102580 21 7901
DR. DANISWARA ADHITIA RAHMAN 1124R0020322V003208 0003125134157 3;JKN
reni;3313147010930001; 5.6.6.202203301209 4 361012
1#0##0#0#0.0#2022-04-04
17:31:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4996dec96c4df2150b110d3c227f61cc 415000 0 0 0 0 0
0 0 0 0 25000 0 36472 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 28/05/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 823309
0 1 0 0 0 INDRATTO, BP 062553 62 22943 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359032
1#0##0#0#0.0#2022-04-04
15:13:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
67bfdf5c3b03cf6cd2638e9c13d16403 150000 0 0 0 0 0
0 76045 0 0 15000 0 582264 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 05/02/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 206081
0 1 0 0 0 TAJUDIN M.NOER ., TN 059287 64 23420
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359033
1#0##0#0#0.0#2022-04-04
15:16:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ec27ce2a35f065fa315874beb7573cbf 150000 0 0 0 0 0
0 0 0 0 15000 0 41081 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 19/06/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 329150
0 1 0 0 0 MUSTARINI.,NY 055582 48 17807 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359034
1#0##0#0#0.0#2022-04-04
15:18:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d2d9507d0f586b482523a42a864cadf3 150000 0 0 0 0 0
0 31845 0 0 15000 0 132305 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 28/02/2008 0 1
0 0 - 0 - 0 - 0 - 0 181400 192975
0 1 0 0 0 BERLY GAVIN J, AN 102005 14 5135 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359035
1#0##0#0#0.0#2022-04-04
15:22:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e2e8b7c17e3b1175ad1bad1cc7aa9eb5 150000 0 0 0 0 0
0 0 0 0 15000 0 27975 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 13/09/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 348163
0 1 0 0 0 ABDUL MISPAKI.TN 081032 58 21374 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359036
1#0##0#0#0.0#2022-04-04
15:59:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
05028a2f10ed673b096a0ce6afd6f71b 150000 0 0 0 0 0
0 76045 0 0 15000 0 107118 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 21/01/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 381961
0 1 0 0 0 ISMIYATI.NY 078013 58 21244 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 359037
1#0##0#0#0.0#2022-04-04
16:02:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fcea90c3aa05a2d81595e7e99056099c 150000 0 0 0 0 0
0 31845 0 0 15000 0 185116 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 31/12/1958 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
458975 0 1 0 0 0 SUYATMI HADI SUCIPTO, NY 089495
0000639360527 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359038 1#0##0#0#0.0#2022-04-04
16:02:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
25cba815455201ed20fc980d09988e1e 150000 0 0 0 0 0
0 76045 0 0 15000 0 217930 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 20/10/1950 0 2
0 - 0 107400 273000 0 1 0 0 0
1124R0020322V003218 0000091089088 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359028 1#0##0#0#0.0#2022-04-04
16:07:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
241a0ea1fa1de71d17316948c4d9911f 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 04/10/1944 0 2
1 Z09.8;I11.9;K80.2;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 508822
0 1 0 0 0 HARI NURYANI.NY 084720 77 28292 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359039
1#0##0#0#0.0#2022-04-04
16:09:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9b4b8c4ae6dd06550fbec29b2bf01b62 150000 0 0 0 0 0
0 88500 0 0 15000 0 255322 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 27/10/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 382664
0 1 0 0 0 RUSTANTINI., NY 050518 69 25347 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359040
1#0##0#0#0.0#2022-04-04
16:10:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
80466baadbb749c3aaf443b900de5829 150000 0 0 0 0 0
0 133700 0 0 15000 0 83964 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 30/10/1989 0 2
0 0 - 0 - 0 - 0 - 0 181400 372922
0 1 0 0 0 OKI NUGROHO JATI. NY 092823 32 11830
yani;3302226402970001; 5.6.6.202203301209 4 359041
1#0##0#0#0.0#2022-04-04
16:12:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0171742fc5481c4b305470a5d6bf3527 150000 0 0 0 0 0
0 31845 0 0 15000 0 176077 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 22/02/1990 0 2
- 0 - 0 - 0 183900 258270 0 1 0
0 0 SULISTYOWATI, NY 102357 32 11715 DR. GUNAWAN, SP.OG
1124R0020322V003222 0001286756605 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359042 1#0##0#0#0.0#2022-04-04
16:13:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0874c057479048663b3b6d9cb17c13fd 150000 0 0 0 0 0
0 0 0 0 15000 0 93270 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 26/08/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 316355
0 1 0 0 0 LISTINA.NY 099402 58 21392 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 359045
1#0##0#0#0.0#2022-04-04
16:18:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d9b713d59077d5bdcdc2a1e317f3a242 150000 0 0 0 0 0
0 89050 0 0 15000 0 62305 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 09/04/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 341829
0 1 0 0 0 RIYANTI.NY 098888 57 21165 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 359043
1#0##0#0#0.0#2022-04-04
16:14:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
306ce4b559637a40ab43e035b0461807 150000 0 0 0 0 0
0 120795 0 0 15000 0 56034 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 02/11/1967 0 2
0 - 0 - 0 - 0 - 0 549400 213125
0 1 0 0 0 TIEN INDARWATI, (NY) 012989 54 19863
agung;3313092303950002; 5.6.7.202204241238 4 359044
1#0##0#0#0.0#2022-05-25
10:53:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
21759273fd598cb206ded77e49fd9aae 150000 0 0 0 0 0
0 0 0 0 15000 0 48125 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 10/10/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 298044
0 1 0 0 0 SUMARNI, NY 087562 66 24269 DR. TEKY
reni;3313147010930001; 5.6.7.202204241238 4 359046
1#0##0#0#0.0#2022-07-05
09:03:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
404cb5e8a66dd2c3854bcf17061f0020 150000 0 0 0 0 0
0 89500 0 0 15000 0 43544 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 26/05/1962 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
502765 0 1 0 0 0 SRI REJEKI,NY 010002 59
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359047
1#0##0#0#0.0#2022-04-04
16:22:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eecdc4cbb2f0265988e22a414095105d 150000 0 0 0 0 0
0 120745 0 0 15000 0 217020 0 0 0 0
0
3372030 C 3 CP 2 21/03/2022 21/03/2022 13/06/1992 0 2
0 - 0 107400 262000 0 1 0 0 0 LUKI
1124R0020322V003228 0001084671257 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359023 1#0##0#0#0.0#2022-04-04
16:24:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ad891fe1f43459f5b60a4b8eed6dc27b 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 08/08/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 279192
0 1 0 0 0 SUTRISNO. BP 070821 67 24697 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359048
1#0##0#0#0.0#2022-04-04
16:25:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3aa1bf8a8f81051b285814d0ab3bd651 150000 0 0 0 0 0
0 0 0 0 15000 0 114192 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 24/01/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 344786
0 1 0 0 0 SRI SUTRISMI, NY 048524 66 24163 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359049
1#0##0#0#0.0#2022-04-04
16:26:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bc802938ea11f9fc6ea0e01ab78e045f 150000 0 0 0 0 0
0 76045 0 0 15000 0 103741 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 31/12/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI SUWANTI, NY
0001967417043 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359030 1#0##0#0#0.0#2022-04-04
16:31:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
86152a18961ff552d8d8edcf5285be1a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 03/08/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 TENTREM.NY 089445
0000640219601 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359024 1#0##0#0#0.0#2022-04-04
16:34:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c233a48152ef5d5279ee5be655ac9375 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 01/11/1980 0 2
0 - 0 - 0 - 0 - 0 549400 165000
0 1 0 0 0 RIFAH CHODIJAH,NY 062832 41 15115 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359050
1#0##0#0#0.0#2022-04-04
16:35:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e49f434133a7eca1fab47977ad02ad4b 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 12/01/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 EKO RINI.NY 093223
0000091524159 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359031 1#0##0#0#0.0#2022-04-04
16:36:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
74e0357911c1d858012569fd24471ff8 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 17/11/1966 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 INDRARIADI, TN
0001797112102 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359029 1#0##0#0#0.0#2022-04-04
16:37:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
557b5da70f6f7c6972b64d544fff85ac 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 30/08/1961 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 RIA TRI RASMANI.
0001729980966 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359025 1#0##0#0#0.0#2022-04-04
16:38:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0f1dab40cbd1d5eb89fde388f7af4c97 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 17/06/1941 0 1
1 Z09.8;E11.4;G59.0;I10;K80.2;E79.0 - - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 625154 0 1 0 0 0 WARDONO.TN 094435
0001876723097 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359051 1#0##0#0#0.0#2022-04-04
16:39:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a67506dbb6ebaf2c7b7763f74c7db524 150000 0 0 0 0 0
0 76595 0 0 15000 0 383559 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 22/09/1959 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMARSONO ,TN
0001032587199 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359027 1#0##0#0#0.0#2022-04-04
16:41:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e4941abd500aa364ee1abab1c14aa43d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 18/09/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 226985
0 1 0 0 0 PRAMUDHITA AVIANTI, NY 089728 58 21369
yani;3302226402970001; 5.6.6.202203301209 4 359052
1#0##0#0#0.0#2022-04-04
16:41:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
79d27071b596389644f898a7f3f56f6d 150000 0 0 0 0 0
0 31845 0 0 15000 0 30140 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 02/08/1973 0 2
0 - 0 107400 273000 0 1 0 0 0
ISWINDARI., NY 047078 48 17763 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V003241 0001792902148 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359021 1#0##0#0#0.0#2022-04-04
16:42:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0cbc957caebbe62e339f439a357d433a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 14/08/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 467071
0 1 0 0 0 ENDANG SRI LESTARI.NY 084974 54 19943
yani;3302226402970001; 5.6.6.202203301209 4 359053
1#0##0#0#0.0#2022-04-04
16:43:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9a38fac0fbb906656f3bb074b483ce0a 150000 0 0 0 0 0
0 133650 0 0 15000 0 168421 0 0 0 0
0
3372030 C 3 CP 2 21/03/2022 21/03/2022 07/04/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 219781
0 1 0 0 0 SUDARYANTI.NY 091986 63 23359 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359054
1#0##0#0#0.0#2022-04-04
16:43:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2fb168849c5e5f9199634fb9c6fc81da 150000 0 0 0 0 0
0 0 0 0 15000 0 54781 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 23/09/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ROCHYATI.NY 059452
0001813968753 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359022 1#0##0#0#0.0#2022-04-04
16:44:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1088b373bd24b55f4b22dc19fcc7e63b 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 30/01/1957 0 2
1 Z09.8;E11.2;N08.3;I11.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 318681
0 1 0 0 0 SRI JARITA.NY 098285 65 23791 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359055
1#0##0#0#0.0#2022-04-04
16:45:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
49da759bd21fa25117661de93c310b8a 150000 0 0 0 0 0
0 31845 0 0 15000 0 121836 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 21/07/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 241924
0 1 0 0 0 NGATINEM., NY 052218 49 18140 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359056
1#0##0#0#0.0#2022-04-04
16:46:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a0366069ed4e193da6cabaa7a3e46ab4 150000 0 0 0 0 0
0 31845 0 0 15000 0 45079 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 06/06/1974 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 UMI NAFIAH. NY
0001662154896 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359026 1#0##0#0#0.0#2022-04-04
16:47:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6f1b4ff9bfb677a7c13dedf47e0d6e78 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 18/02/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 262000
0 1 0 0 0 DARTINAH,NY 030952 80 29251 DR. LINDA
novia;3313125201940001; 5.6.7.202204241238 4 359018
1#0##0#0#0.0#2022-05-18
11:22:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
7150f65f133e86902e77d50c7b5aeaeb 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 19/02/1965 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 254000 0 1 0 0 0 DANU MARGONO.,BP
0000640154136 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359015 1#0##0#0#0.0#2022-04-04
16:48:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b2f9be504a37d6fbde27af640d6348c4 239000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 18/04/1968 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 RAHMADI.TN 096843
0002169726311 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359017 1#0##0#0#0.0#2022-04-04
16:49:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
723143619ee2d08d97d5f3d98f674ea3 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 05/06/1963 0 1
1 Z09.8;E11.4;G59.0;I10;J02.9 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
590669 0 1 0 0 0 MASTUR,(BP) 024564 58 21474
yani;3302226402970001; 5.6.6.202203301209 4 359057
1#0##0#0#0.0#2022-04-04
16:56:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
15a6604a0e09d117512864ff3afa9c68 150000 0 0 0 0 0
0 76595 0 0 15000 0 349074 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 16/06/1965 0 1
1 Z09.8;I10;M19.98;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 208985
0 1 0 0 0 JOKO SUKARNO PARHADI.TN 094154 56 20732
yani;3302226402970001; 5.6.6.202203301209 4 359058
1#0##0#0#0.0#2022-04-04
16:59:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bf23f756a8e81043b528e11c6f2d30ee 150000 0 0 0 0 0
0 0 0 0 15000 0 43985 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 11/06/1972 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
323479 0 1 0 0 0 YUSTINA SRI SETIAWATI,(NY) 034907
0001107623564 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359064 1#0##0#0#0.0#2022-04-04
17:00:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4b4c0b7b35ef9bfd5901087506a64ecb 150000 0 0 0 0 0
0 76045 0 0 15000 0 82434 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 14/06/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001429190267 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359020 1#0##0#0#0.0#2022-04-04
17:01:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8bbd377876227e3400ab8674eaf2bb54 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 20/06/1956 0 2
1 Z09.8;E11.4;G59.0;M19.98 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
319932 0 1 0 0 0 SOENARTI, NY 088723 65
0002165489403 3;JKN agung;3313092303950002; 5.6.7.202204241238 4
359067 1#0##0#0#0.0#2022-06-17
15:27:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
c3810c76f49e612b5bc0ef9171a60591 150000 0 0 0 0 0
0 76045 0 0 15000 0 78887 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 05/03/1944 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SANTOSO. TN 088783
0000091319657 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359019 1#0##0#0#0.0#2022-04-04
17:07:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7676e0833df25c22c6b6ed70e8412c79 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 04/02/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI PURWANTI.NY
0000091483885 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361919 1#0##0#0#0.0#2022-04-07
12:57:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d51ed10e5c5b50bf90caf777926dfd77 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 09/12/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 187244
yani;3302226402970001; 5.6.6.202203301209 4 359073
1#0##0#0#0.0#2022-04-04
17:09:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
83ee064c85fd7d1da036cbf39f2d84c7 150000 0 0 0 0 0
0 0 0 0 15000 0 22244 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 25/02/1950 0 2
0 - 0 - 0 - 0 183900 300336 0 1
0 0 0 RUT SUMIASIH. NY 085688 72 26322 DR. DAMAR ARYO,
SP.B 1124R0020322V003261 0000086913011 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359071 1#0##0#0#0.0#2022-04-04
17:09:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5c7fbd66bb8d8a0c4b467fef82253667 235000 0 0 0 0 0
0 0 0 0 15000 0 50336 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 17/07/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 AGUSTINUS SUGITO GP, (BP) 012261 76
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359075
1#0##0#0#0.0#2022-04-04
17:10:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
016e1bf2fd6da2bdaa7b51a81f1932ed 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 31/12/1971 0 2
0 - 0 - 0 - 0 786200 788259 0 1
SP.PD 1124R0020322V003265 0000555344774 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 358999 1#0##0#0#0.0#2022-04-04
17:20:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a81819283fdf1b8e850b64d44f1bc371 662676 0 0 0 0 0
0 0 0 0 15000 0 110583 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 17/04/1973 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359000
1#0##0#0#0.0#2022-04-04
17:21:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b9d27dba51573ca48a27d38e895d4bc0 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 18/03/1988 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359001
1#0##0#0#0.0#2022-04-04
17:22:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4d8ba8f16aaf44607aec7770f7e5a05c 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 10/12/1982 0 1
0 - 0 - 0 - 0 786200 734007 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359002
1#0##0#0#0.0#2022-04-04
17:23:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9e42d1d869e7f584da8fec44558b53be 662676 0 0 0 0 0
0 0 0 0 15000 0 56331 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 12/10/1987 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359003
1#0##0#0#0.0#2022-04-04
17:24:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
94df7987e8c482bba8ff16ba52a30cf1 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 25/06/1970 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359004
1#0##0#0#0.0#2022-04-04
17:24:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b12ddaf5aa4e42729f19600673191693 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 10/07/1955 0 2
0 - 0 - 0 - 0 786200 580283 0 1
SP.PD 1124R0020322V003271 0001032581823 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359005 1#0##0#0#0.0#2022-04-04
17:26:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f762fe336caaedefcfacf19884454352 463830 0 0 0 0 0
0 0 0 0 15000 0 101453 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 04/05/1958 0 2
0 - 0 - 0 - 0 786200 561264 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359006
1#0##0#0#0.0#2022-04-04
17:27:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9c74087f919d6584f87533af92b86a39 463830 0 0 0 0 0
0 0 0 0 15000 0 82434 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 15/10/1964 0 1
0 - 0 - 0 - 0 786200 677676 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359009
1#0##0#0#0.0#2022-04-04
17:27:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ef1147026ede8c1665fbf72bf6d2c1c6 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 02/02/1971 0 2
0 - 0 - 0 - 0 786200 677676 0 1
agung;3313092303950002; 5.6.7.202204241238 4 359008
1#0##0#0#0.0#2022-05-25
09:31:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
8de40a07cea9720bf04bd88f31426002 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 31/12/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 202692
0 1 0 0 0 SAGINEM, NY 054089 69 25282 DR. INDRIANY
yani;3302226402970001; 5.6.6.202203301209 4 359077
1#0##0#0#0.0#2022-04-04
17:32:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9817943e5e41434add4b138425d0d7c8 150000 0 0 0 0 0
0 0 0 0 15000 0 37692 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 14/03/1965 0 2
1 Z09.8;I64;R47.1 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 266453
0 1 0 0 0 SUHARNI., NY 042396 57 20826 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359078
1#0##0#0#0.0#2022-04-04
17:33:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b1eb4946ae5cc55b99938014b8af9702 150000 0 0 0 0 0
0 0 0 0 15000 0 101453 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 11/11/1974 0 1
1 Z09.4;S72.80 93.57;96.59 - - None None None None Z-3-
27-0 None None None None None None PERAWATAN LUKA 183900 0 0
- 0 - 0 - 0 - 0 183900 235520 0
1 0 0 0 SUGENG WIDODO, TN 093087 47 17297 DR. WAHYU
reni;3313147010930001; 5.6.6.202203301209 4 361225
1#0##0#0#0.0#2022-04-05
11:11:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 11/07/1971 0 1
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3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359079
1#0##0#0#0.0#2022-04-04
17:35:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 23/05/1963 0 2
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359080 1#0##0#0#0.0#2022-04-04
17:39:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.6.6.202203301209 4 359081
1#0##0#0#0.0#2022-04-04
18:19:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 26/08/1971 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359082
1#0##0#0#0.0#2022-04-04
18:20:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 11/02/1959 0 2
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3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359083
1#0##0#0#0.0#2022-04-04
18:23:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.6.6.202203301209 4 359084
1#0##0#0#0.0#2022-04-04
18:24:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 03/07/1962 0 2
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3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359085
1#0##0#0#0.0#2022-04-04
18:26:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 12/02/1959 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359086
1#0##0#0#0.0#2022-04-04
18:27:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 07/05/1982 0 1
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yani;3302226402970001; 5.6.6.202203301209 4 359087
1#0##0#0#0.0#2022-04-04
18:28:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 01/07/1962 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359088
1#0##0#0#0.0#2022-04-04
18:29:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 25/12/1957 0 2
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3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359089
1#0##0#0#0.0#2022-04-05
08:11:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 27/02/1954 0 2
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reni;3313147010930001; 5.6.6.202203301209 4 361227
1#0##0#0#0.0#2022-04-05
11:12:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 28/10/2001 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359090
1#0##0#0#0.0#2022-04-05
08:12:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.6.6.202203301209 4 359091
1#0##0#0#0.0#2022-04-05
08:12:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 30/12/1956 0 1
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yani;3302226402970001; 5.6.6.202203301209 4 359092
1#0##0#0#0.0#2022-04-05
08:13:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 18/08/1963 0 2
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DANELLA.NY 098611 58 21400 DR. WAHYU PURNOMO, SP.OT
1124R0020322V003297 0001800604967 3;JKN yani;3302226402970001;
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08:14:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 12/02/1977 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359094
1#0##0#0#0.0#2022-04-05
08:15:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 20/01/1963 0 1
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0 1 0 0 0 RESPATI DWI HANANTO, TN 101981 59 21610
3;JKN novia;3313125201940001; 5.6.7.202204241238 4 359095
1#0##0#0#0.0#2022-05-20
10:22:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 21/03/2022 21/03/2022 27/07/1950 0 1
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0 1 0 0 0 H. BEKTI KAREBET, TN 099894 71 26170
yani;3302226402970001; 5.6.6.202203301209 4 359096
1#0##0#0#0.0#2022-04-05
08:27:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5f4506e38a6f12100acd3ed0e113a125 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/03/2022 21/03/2022 11/11/1970 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359097
1#0##0#0#0.0#2022-04-05
08:28:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c225833ca1fea8650032fe057513698b 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/03/2022 21/03/2022 24/02/1954 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359098
1#0##0#0#0.0#2022-04-05
08:29:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 31/12/1972 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359099
1#0##0#0#0.0#2022-04-05
08:30:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 20/02/1971 0 1
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0 1 0 0 0 KAYUN, TN 102348 51 18657 DR. WAHYU
agung;3313092303950002; 5.6.6.202203301209 4 359100
1#0##0#0#0.0#2022-04-11
12:07:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 21/03/2022 21/03/2022 08/10/1968 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359101
1#0##0#0#0.0#2022-04-05
08:32:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 06/04/1975 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359102
1#0##0#0#0.0#2022-04-05
08:35:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 07/11/1965 0 1
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yani;3302226402970001; 5.6.6.202203301209 4 359103
1#0##0#0#0.0#2022-04-05
08:35:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 06/11/1960 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359104
1#0##0#0#0.0#2022-04-05
08:36:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.6.6.202203301209 4 359105
1#0##0#0#0.0#2022-04-05
08:37:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 27/11/1961 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359106
1#0##0#0#0.0#2022-04-05
08:38:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 18/01/1963 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359107
1#0##0#0#0.0#2022-04-05
08:38:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 21/10/1950 0 1
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yani;3302226402970001; 5.6.6.202203301209 4 359108
1#0##0#0#0.0#2022-04-05
08:39:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 02/03/1964 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359109
1#0##0#0#0.0#2022-04-05
08:40:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 19/10/1972 0 1
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359110 1#0##0#0#0.0#2022-04-05
08:40:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 17/06/1970 0 2
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novia;3313125201940001; 5.6.7.202204241238 4 359111
1#0##0#0#0.0#2022-05-19
09:59:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 21/03/2022 21/03/2022 26/08/1967 0 1
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yani;3302226402970001; 5.6.6.202203301209 4 359112
1#0##0#0#0.0#2022-04-05
08:42:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 20/11/1994 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359113
1#0##0#0#0.0#2022-04-05
08:47:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 20/03/1961 0 1
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novia;3313125201940001; 5.6.7.202204241238 4 359114
1#0##0#0#0.0#2022-05-19
11:10:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 21/03/2022 21/03/2022 21/04/1965 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359115
1#0##0#0#0.0#2022-04-05
08:52:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bb4b38db2d67e213cc726a39c74a43e9 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/03/2022 21/03/2022 31/12/1963 0 2
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yani;3302226402970001; 5.6.6.202203301209 4 359116
1#0##0#0#0.0#2022-04-05
08:52:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 05/09/1983 0 1
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08:53:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/03/2022 21/03/2022 21/07/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 182437
0 1 0 0 0 SUMARDI, TN 051257 67 24715 DR. INDRIANY
yani;3302226402970001; 5.6.6.202203301209 4 359118
1#0##0#0#0.0#2022-04-05
08:54:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7d8bedf7c4d9d7f523620c4b29d671df 150000 0 0 0 0 0
0 0 0 0 15000 0 17437 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 30/06/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 188646
0 1 0 0 0 DIYAH YUNIANINGSIH, NY 071513 42 15605
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359119
1#0##0#0#0.0#2022-04-05
08:55:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
adf6d043770fae953abcfe3c7047d687 150000 0 0 0 0 0
0 0 0 0 15000 0 23646 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 29/01/1983 0 2
0 0 - 0 - 0 - 0 - 0 181400 226728
0 1 0 0 0 ANIK SUPRIYANI.NY 100236 39 14296 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359120
1#0##0#0#0.0#2022-04-05
08:56:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cb2cfb75e80c3551b72e30966432f15b 150000 0 0 0 0 0
0 0 0 0 15000 0 61728 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 11/09/1993 0 2
0 0 - 0 - 0 - 0 - 0 296400 184448
0 1 0 0 0 CHANNAN, NY 101724 28 10418 DR. GUNAWAN,
SP.OG 1124R0020322V003331 0002084730074 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359121 1#0##0#0#0.0#2022-04-05
08:57:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
525ea1d3f569997077727755d81f7f04 150000 0 0 0 0 0
0 0 0 0 15000 0 19448 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 14/01/1965 0 2
1 Z09.8;H81.3;E11.4;G59.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 197947
0 1 0 0 0 SRI KAMTINAH.NY 101589 57 20885 DR.
yani;3302226402970001; 5.6.6.202203301209 4 359122
1#0##0#0#0.0#2022-04-05
08:58:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5c7795dd95269cbddc739e8ee41f6969 150000 0 0 0 0 0
0 0 0 0 15000 0 32947 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 23/10/1961 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
459407 0 1 0 0 0 SUHARTINI, NY 085146 60
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359123
1#0##0#0#0.0#2022-04-05
08:59:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4fd86cbece16789150475d5adf269c9d 150000 0 0 0 0 0
0 31845 0 0 15000 0 262562 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 13/08/1991 0 1
2 M66.54;T63.5 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 217669
0 1 0 0 0 MUHAMMAD FACHRUDDIN YUSUF, TN 068901 30
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 360940
1#0##0#0#0.0#2022-04-05
09:00:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f256306e19ae75067c21ec08289aaa3b 150000 0 0 0 0 0
0 0 0 0 15000 0 52669 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 20/11/1966 0 2
0 - 0 - 0 - 0 129600 455060 0 1
0 0 0 DIANI MARHAENITA ., NY 000489 55 20210 DR. WAHYU
reni;3313147010930001; 5.6.6.202203301209 4 361229
1#0##0#0#0.0#2022-04-05
11:13:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
33cdc5f5f8bb6d8e47851fb882e26834 150000 0 0 0 0 0
248000 0 0 0 15000 0 42060 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 16/10/1978 0 1
1 Z09.8;K80.2;K30 88.76 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400 986941
0 1 0 0 0 AGUNG CAHYONO.TN 099954 43 15862 DR.
novia;3313125201940001; 5.6.7.202204241238 4 360944
1#0##0#0#0.0#2022-05-20
08:19:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
143e9a81fbfb87703b534450f17233c6 150000 0 0 0 0 0
657000 0 0 0 15000 0 164941 0 0 0 0
0
3372030 C 3 CP 2 21/03/2022 21/03/2022 01/12/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 258682
0 1 0 0 0 ZAENAL ALI 28661 63 23121 DR. INDRIANY
yani;3302226402970001; 5.6.6.202203301209 4 361105
1#0##0#0#0.0#2022-04-05
09:06:51#0#00:00:01#00:00:01#12:00:00#{"co_insidense_ind":"0"} 1
079986bb39af4def4800931862f08290 150000 0 0 0 0 0
0 0 0 0 15000 0 93682 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 25/12/1949 0 1
1 Z09.8;G20;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 267905
0 1 0 0 0 ROBERT YASIMDA SIMARMATA. TN 093055 72
0001808151412 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
359132 1#0##0#0#0.0#2022-04-05
09:08:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8344980e2548a479d6e57b27a09cc0ec 150000 0 0 0 0 0
0 0 0 0 15000 0 102905 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 12/08/1965 0 1
0 - 0 - 0 - 0 - 0 549400 165000
0 1 0 0 0 GIYANTO, TN 001275 56 20675 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 362005
1#0##0#0#0.0#2022-04-07
13:43:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a099196215156dbf19e9a12c1d5cf455 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 15/05/1976 0 1
1 Z09.8;N28.1;N13.2 88.76 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400 913231
0 1 0 0 0 SLAMET SANTOSO.TN 098523 45 16746 DR.
yani;3302226402970001; 5.6.6.202203301209 4 360945
1#0##0#0#0.0#2022-04-05
09:10:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
31003ceba5e6cf223533c5e31ddeaab5 150000 0 0 0 0 0
657000 0 0 0 15000 0 91231 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 02/06/1983 0 1
1 Z09.8;T14.7 96.59 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 496361 0 1
0 0 0 MURYANTO.TN 102531 38 14172 DR. DAMAR ARYO, SP.B
1124R0020322V003345 0002169441854 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359133 1#0##0#0#0.0#2022-04-05
09:12:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
89f77a713f475eeb3d565cd7af5ed786 416000 0 0 0 0 0
0 0 0 0 15000 0 65361 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 01/07/1955 0 1
0 - 0 - 0 - 0 - 0 182600 197897
0 1 0 0 0 PAIMIN,(BP) 039431 66 24370 DR. INDRIANY
yani;3302226402970001; 5.6.6.202203301209 4 359134
1#0##0#0#0.0#2022-04-05
09:13:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1b542a959e4fa69212a4db5cbde01f61 150000 0 0 0 0 0
0 0 0 0 15000 0 32897 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 03/10/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 441530
0 1 0 0 0 RIRIN SUDARINI.NY 102538 57 20988 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361522
1#0##0#0#0.0#2022-04-06
08:57:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ab4a1a41bb34acc826bed9e1307bc5b3 150000 0 0 0 0 0
220000 0 0 0 25000 0 46530 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 31/12/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 230175
0 1 0 0 0 PARNI, NY 100497 58 21265 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 359135
1#0##0#0#0.0#2022-04-05
09:14:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3b87635e2f2aed8f006b30d6aeba1188 150000 0 0 0 0 0
0 31845 0 0 15000 0 33330 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 22/08/2006 0 1
0 0 - 0 - 0 - 0 - 0 181400 410845
0 1 0 0 0 MUHAMMAD FADHIL F, AN 100476 15 5690
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 360941
1#0##0#0#0.0#2022-04-05
09:20:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c0efd8467e5e0428a6e8528a4b7230d2 150000 0 0 0 0 0
220000 0 0 0 15000 0 25845 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 29/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 AGNES WIDHA
1124R0020322V003351 0002168632721 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 359016 1#0##0#0#0.0#2022-04-05
09:23:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7f77750f6c3f8ae3ec8395dfd925f276 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 13/05/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 183662
0 1 0 0 0 KUSRI SETYANINGSIH.NY 095523 59 21862
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 359136
1#0##0#0#0.0#2022-04-05
09:24:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f92c559d8f098b8405ba5ab96ab2ef03 150000 0 0 0 0 0
0 0 0 0 15000 0 18662 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 11/03/2001 0 1
1 N62 - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 175000
0 1 0 0 0 IRVAN ANDIKA PUTRA.SDR 102541 21 7680
novia;3313125201940001; 5.6.7.202204241238 4 359137
1#0##0#0#0.0#2022-05-20
10:58:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
443503f07aa6645d8c6db73e2ed9e037 150000 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 03/08/1963 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 SITI ROHMAH, NY 039323 58 21415 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 359010
1#0##0#0#0.0#2022-04-05
09:29:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ec90f7460120557379f0e119b1de5747 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 22/10/1959 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359011
1#0##0#0#0.0#2022-04-05
09:31:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a98b9516805cdb0a2221507de54f7662 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 12/12/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359012
1#0##0#0#0.0#2022-04-05
09:32:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
176d8b029511e4a64e564a6a6f0263fb 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 09/05/1975 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V003360 0001105378571 3;JKN agung;3313092303950002;
5.6.7.202204241238 4 359013 1#0##0#0#0.0#2022-05-25
09:32:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
5fa96c4bbc36a936ddaed4caa84b8dbe 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 08/04/1964 0 1
0 - 0 - 0 - 0 786200 489231 0 1
yani;3302226402970001; 5.6.6.202203301209 4 359014
1#0##0#0#0.0#2022-04-05
09:40:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7cb420903b9a79d81485c273b4a42310 463830 0 0 0 0 0
0 0 0 0 15000 0 10401 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 30/03/1978 0 2
1 Z09.8;C50.9 88.73 - - None None None None Z-3-23-0 None
0 - 0 - 0 - 0 - 0 549400 845000
0 1 0 0 0 LUTFI SURYANDARI.NY 101604 43 16062
yani;3302226402970001; 5.6.6.202203301209 4 360942
1#0##0#0#0.0#2022-04-05
09:41:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
469278255ebef268151413be361067e9 150000 0 0 0 0 0
680000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 08/10/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 216458
0 1 0 0 0 DIAH AYU SUNDARI, NY 100041 49 18061
yani;3302226402970001; 5.6.6.202203301209 4 359138
1#0##0#0#0.0#2022-04-05
09:42:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0f1b338bc3977f522155a64d6dabe4e5 150000 0 0 0 0 0
0 0 0 0 15000 0 51458 0 0 0 0 0
3372030 C 3 CP 2 21/03/2022 21/03/2022 01/12/2001 0 1
1 M25.55;S33.7;W19.3 88.26 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 495460
0 1 0 0 0 MUHAMMAD FARREL NAUFAL RAMADHANI.SDR 102540
0001109604172 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361230 1#0##0#0#0.0#2022-04-05
11:14:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cf0b17acb20ba6ce780c80f0ae61fef9 150000 0 0 0 0 0
280000 0 0 0 25000 0 40460 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 15/03/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 344995
0 1 0 0 0 BAMBANG SUSANTO, TN 093328 53 19365
agung;3313092303950002; 5.6.5.202203091809 4 360373
1#0##0#0#0.0#2022-03-29
13:09:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
69b1d27c72ac3b9c464d56e2f6d876dc 150000 0 0 0 0 0
0 76045 0 0 15000 0 103950 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 21/12/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 199596
agung;3313092303950002; 5.6.5.202203091809 4 360375
9#0##0#0#0.0#2022-03-29
13:11:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
945c5e9177490a18183effa29178c361 150000 0 0 0 0 0
0 0 0 0 15000 0 34596 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 13/03/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 214892
0 1 0 0 0 SUBANDIJO.TN 083578 78 28498 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360376
1#0##0#0#0.0#2022-03-29
13:11:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8318cad2aa4f688fa1ae04f4b85dfc8a 150000 0 0 0 0 0
0 0 0 0 15000 0 49892 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 01/01/2000 0 2
0 0 - 0 - 0 - 0 - 0 181400 333299
0 1 0 0 0 SUMARMI ., NY 053373 22 8116 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360377
11#0##0#0#0.0#2022-03-29
13:12:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
44c2075fb726e06080e4673d8dd2634e 150000 0 0 0 0 0
0 120795 0 0 15000 0 47504 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 12/11/1945 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000063294052 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360340 12#0##0#0#0.0#2022-03-29
09:56:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aba068237c74e9351f65c0749a1e1950 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 12/06/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 405442
0 1 0 0 0 SYAHRIZAL, TN 001271 55 20372 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360378
13#0##0#0#0.0#2022-03-29
13:13:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2b8e47352b07580ecbf63cc02db9e01c 150000 0 0 0 0 0
0 31845 0 0 15000 0 208597 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 11/05/1943 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MURYATI.NY 094215
0000091214796 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360347 14#0##0#0#0.0#2022-03-29
10:01:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7c88a8d74b0daff54123b66372e0f6e5 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 31/12/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 531000 0 1 0 0 0 SRI ISWATIYARSI,
0001694440719 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360341 15#0##0#0#0.0#2022-03-29
09:57:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aca28463b4afdb33e01e08e867b2d4e0 516000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 29/09/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARIA DIAH
1124R0020322V003383 0001211692601 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360342 16#0##0#0#0.0#2022-03-29
09:57:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
83cdc1de12981dc8aed254086c037d39 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 07/04/1969 0 2
0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SUCI DARWATI HARMASTUTI.NY 102542 52
agung;3313092303950002; 5.6.5.202203091809 4 360379
17#0##0#0#0.0#2022-03-29
13:13:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
02f1a379da0435316cfa48950762fad7 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 31/12/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 352724
0 1 0 0 0 SUNARTO ,BP 084994 66 24188 DR. TEKY
agung;3313092303950002; 5.6.5.202203091809 4 360380
18#0##0#0#0.0#2022-03-29
13:15:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
936c1732b3981e0088208b24124d8054 150000 0 0 0 0 0
0 88900 0 0 15000 0 98824 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 21/04/1950 0 1
1 Z09.8;G56.0;E79.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 302733
agung;3313092303950002; 5.6.5.202203091809 4 360381
19#0##0#0#0.0#2022-03-29
13:20:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
650d4ee6fbea85790f20e422d2501845 150000 0 0 0 0 0
0 107890 0 0 15000 0 29843 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 12/03/2003 0 1
0 0 - 0 - 0 - 0 - 0 181400 287045
0 1 0 0 0 REZA TRI M, SDR 102415 19 6950 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360382
1#0##0#0#0.0#2022-03-29
13:21:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9b695c56db9e0bb73142d8881c147e80 150000 0 0 0 0 0
0 105700 0 0 15000 0 16345 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 20/01/1963 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 RESPATI DWI
1124R0020322V003388 0001865287618 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 360349 1#0##0#0#0.0#2022-05-20
10:22:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
748f27f59866a95427c22a0d229979db 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 25/04/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 210936
0 1 0 0 0 MUGIYATI.NY 102301 56 20785 DR. ARIA
agung;3313092303950002; 5.6.5.202203091809 4 360383
22#0##0#0#0.0#2022-03-29
13:22:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0b1eb9e64f44e4b6ced221362505cfba 0 0 0 0 0 0 0
120795 0 0 15000 0 75141 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 18/01/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000090992327 3;JKN agung;3313092303950002; 5.6.7.202204241238 4
360344 1#0##0#0#0.0#2022-05-25
09:28:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
59263bdeee17ef17039a29ec436c9d8c 494000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 16/05/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 344788
0 1 0 0 0 SETIATI.,NY 073095 69 25512 DR. ARIA
agung;3313092303950002; 5.6.5.202203091809 4 360384
1#0##0#0#0.0#2022-03-29
13:24:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a45ad991a245c2a850cf96b81be4a9fb 150000 0 0 0 0 0
0 121345 0 0 15000 0 58443 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 18/05/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SAMIYATI.NY 094791
0000046966566 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
360357 1#0##0#0#0.0#2022-05-20
11:31:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
38a7b145837629081c1b4b221bbe68f6 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 09/07/1959 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 203000 0 1 0 0 0 SUROTO.TN 087121
0003116443004 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360345 26#0##0#0#0.0#2022-03-29
10:00:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f4dd04d13e88c93f50e0d71ba8ea1b80 188000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 19/08/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000089786147 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360348 27#0##0#0#0.0#2022-03-29
10:01:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aeede5b33784ecd960fdca6ba354a967 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 14/04/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI MULYANI, NY
0000640565201 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360343 28#0##0#0#0.0#2022-03-29
09:58:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8a3e4d0d2aa55a4a3752f10c748f66a6 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 04/05/1954 0 1
1 E11.8;E11.4;G59.0;I10 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 522873
0 1 0 0 0 SUKONO ., BP 054796 67 24794 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360385
29#0##0#0#0.0#2022-03-29
13:37:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5ec9f8461da1128b89b21074c9460f23 150000 0 0 0 0 0
0 0 0 0 15000 0 357873 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 28/02/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 308781
0 1 0 0 0 SRI SUDARMIYATI (NY) 027558 62 22668
agung;3313092303950002; 5.6.5.202203091809 4 360386
30#0##0#0#0.0#2022-03-29
13:37:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a190863510b98b07a9b8aefaf93ba621 150000 0 0 0 0 0
0 0 0 0 15000 0 143781 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 06/07/1954 0 2
0 - 0 107400 273000 0 1 0 0 0
SUMARNI.NY 086963 67 24731 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V003398 0002347072604 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360356 31#0##0#0#0.0#2022-03-29
10:07:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8a1e104b11322736ce949ccc5e83bed4 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 16/10/1994 0 1
0 0 - 0 - 0 - 0 - 0 181400 290694
0 1 0 0 0 ADITYAS DWINA HASTANTYA,SDR 094566 27
agung;3313092303950002; 5.6.5.202203091809 4 360387
1#0##0#0#0.0#2022-03-29
13:38:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cd12475884b2f088c148a69600d82588 150000 0 0 0 0 0
0 0 0 0 15000 0 125694 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 09/01/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 189635
0 1 0 0 0 ARI ANUGRAHENI.NY 100623 45 16508 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360388
33#0##0#0#0.0#2022-03-29
13:40:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
524d62e640a1ca6f3283a48e7271d7bd 150000 0 0 0 0 0
0 0 0 0 15000 0 24635 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 31/12/1959 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
621173 0 1 0 0 0 IRAHWATI .NY 048579 62
3;JKN agung;3313092303950002; 5.6.5.202203091809 4 360389
34#0##0#0#0.0#2022-03-29
13:40:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d19c858981b81ecd52522f6ac9c05356 150000 0 0 0 0 0
0 76045 0 0 15000 0 380128 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 06/04/1969 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 213800 0 1 0 0 0 SUPARWAN, TN
0001104843161 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361232 1#0##0#0#0.0#2022-04-05
11:15:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ed9ee520c99c99b1f7c4348191756c9b 0 0 198800 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 07/07/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ENI PUJI ASTUTI
0002477029059 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360355 35#0##0#0#0.0#2022-03-29
10:06:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7fff4a7c7d6e55dbea78c2ab9d893189 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 02/02/1952 0 2
1 Z09.8;G59.0;I10;E11.4 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 392249
0 1 0 0 0 WARSINI.NY 085011 70 25616 DR. TEKY
agung;3313092303950002; 5.6.5.202203091809 4 360390
36#0##0#0#0.0#2022-03-29
13:41:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b35318cd8c53a96ed7824f7d7464347b 150000 0 0 0 0 0
0 31845 0 0 15000 0 195404 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 25/07/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 241247
0 1 0 0 0 SRI WIDODO, TN 101762 53 19598 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360391
37#0##0#0#0.0#2022-03-29
13:41:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eb342028e039567bf15a5d846e72be08 150000 0 0 0 0 0
0 63690 0 0 15000 0 12557 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 03/09/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 376204
0 1 0 0 0 HARYANTO JOKO S,(BP) 030394 49 18097
agung;3313092303950002; 5.6.5.202203091809 4 360392
38#0##0#0#0.0#2022-03-29
13:42:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
91f56437f749ecc6b261afe9babb8ae6 300000 0 0 0 0 0
0 0 0 0 15000 0 61204 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 31/12/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 253540
0 1 0 0 0 DASINEM, NY 052283 58 21266 DR. RINA
5.6.5.202203091809 4 360393 39#0##0#0#0.0#2022-03-29
13:42:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
17384e1f6e5fe896c029ad893868d168 150000 0 0 0 0 0
0 0 0 0 15000 0 88540 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 23/04/1960 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 219000 0 1 0 0 0 SRI WAHYUNI, NY
0000091421842 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360353 1#0##0#0#0.0#2022-03-29
10:04:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3b60ea5d8135e147bdaba0fa508725a0 204000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 08/06/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 LAMIYEM.NY 087484
0001316300512 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360365 1#0##0#0#0.0#2022-03-29
10:43:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6b4db19c01822126ccf315b656634e0b 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 16/07/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 462561
0 1 0 0 0 TRI BUDIATI, NY 076747 61 22529 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360394
42#0##0#0#0.0#2022-03-29
13:43:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c1c4424fadf58b7a1acdccd6502f102d 150000 0 0 0 0 0
0 31845 0 0 15000 0 265716 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 07/01/1951 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MUH NUKMAN.TN
0001966365189 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360358 1#0##0#0#0.0#2022-03-29
10:37:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
27dc23c85db156bbf80fb7ceb276118c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 03/07/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SOLICHATI, NY
0000091471465 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360354 44#0##0#0#0.0#2022-03-29
10:05:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
44458d1db10327fee5e51aa875499710 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 13/06/1971 0 2
0 - 0 107400 262000 0 1 0 0 0 SITI
MARDLIYAH.NY 084457 50 18545 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V003416 0002169781694 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360359 1#0##0#0#0.0#2022-03-29
10:39:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e04fdbd6b99a971b2f5058b40c61eea1 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 12/11/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 262273
0 1 0 0 0 NGATIYEM,NY 049849 54 19854 DR. SUHARTO,
SP.PD 1124R0020322V003417 0000639735772 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360396 46#0##0#0#0.0#2022-03-29
13:44:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c89f757e472beacf078c669a973e576b 150000 0 0 0 0 0
0 31845 0 0 15000 0 65428 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 24/02/1973 0 1
0 - 0 107400 273000 0 1 0 0 0 TRI
BUDI SUWARTO. TN 095037 49 17923 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V003418 0002169435251 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360298 1#0##0#0#0.0#2022-03-29
08:29:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c44c741047cb6da1257d834683801723 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 30/03/1983 0 2
0 0 - 0 - 0 - 0 - 0 181400 436023
0 1 0 0 0 RETNANINGSIH.NY 096048 38 14237 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360546
1#0##0#0#0.0#2022-03-29
13:44:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c4c38a4fdf43503a14b89f56612e6772 150000 0 0 0 0 0
248000 0 0 0 15000 0 23023 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 16/05/1997 0 2
0 0 - 0 - 0 - 0 - 0 181400 262000
agung;3313092303950002; 5.6.5.202203091809 4 360332
49#0##0#0#0.0#2022-03-29
09:39:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6a963f80a75215ccbd2a63bb481cbf9f 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 12/05/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 Taslim 40885 63 23325 DR. YUDHI
agung;3313092303950002; 5.6.5.202203091809 4 360550
1#0##0#0#0.0#2022-03-29
13:45:59#0#00:00:00#00:00:00#09:11:04#{"co_insidense_ind":"0"} 1
6032ec122af5d90bc60e7cde1c7ef9b4 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 20/03/1961 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI MIYATUN.NY
0000076431947 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360364 50#0##0#0#0.0#2022-03-29
10:42:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f98cfeb340a01b717affc1da5c7d36de 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 21/02/1963 0 1
1 Z09.8;E11.4;G59.0;E78.5;I10 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
456801 0 1 0 0 0 DARMONO, TN 021227 59 21579
agung;3313092303950002; 5.6.5.202203091809 4 360398
51#0##0#0#0.0#2022-03-29
13:46:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0d1a048408946181a6eafc146c3e1874 150000 0 0 0 0 0
0 120795 0 0 15000 0 171006 0 0 0 0
0
3372030 C 3 CP 2 22/03/2022 22/03/2022 10/10/1953 0 2
0 - 0 107400 262000 0 1 0 0 0 TUTIK
1124R0020322V003424 0001449355893 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360366 1#0##0#0#0.0#2022-03-29
10:44:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5bab31889ae70de825c1265e3ade1383 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 15/04/1973 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TATAS BUDIONO.TN
0001440938553 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360350 53#0##0#0#0.0#2022-03-29
10:03:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8eca1c281d6e135c71903f3faa6566fd 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 14/04/1960 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARTINAH., NY
0001084606863 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360351 54#0##0#0#0.0#2022-03-29
10:04:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4ce6d899f3c712dbc832a7b7d888689c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 05/05/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 212709
0 1 0 0 0 SRI MUKINI,(NY) 017686 69 25523 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360399
55#0##0#0#0.0#2022-03-29
13:57:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d5dae531875ea07231ec8b615929396f 150000 0 0 0 0 0
0 0 0 0 15000 0 47709 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 06/06/2008 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 BALQIS CHURYN
MAYSA A, AN 099729 13 5037 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V003428 0001268897488 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360326 56#0##0#0#0.0#2022-03-29
09:13:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
64c4056fd22e4064a93323fe7d78d8da 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 05/06/1961 0 2
0 - 0 107400 273000 0 1 0 0 0
MARSIATUN, NY 085335 60 22205 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V003429 0002311256204 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360338 57#0##0#0#0.0#2022-03-29
09:55:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c2595f7d6ba3b86ec397e989426f9bc9 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 27/02/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 361581
0 1 0 0 0 PUJI WAHYUNI,NY 084528 63 23034 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360400
58#0##0#0#0.0#2022-03-29
13:59:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
99427aff6aa27f543a6df0331f15eb39 150000 0 0 0 0 0
0 0 0 0 15000 0 196581 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 10/04/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MOEMINAH., NY
0000091214706 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360367 59#0##0#0#0.0#2022-03-29
10:45:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
901342082967bc010e9f972feafd468d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 19/03/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 196174
0 1 0 0 0 SRI UNTARI, NY 087563 62 22648 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360401
1#0##0#0#0.0#2022-03-29
15:08:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bfe99234e0ff7605ed9cc6b88803def3 150000 0 0 0 0 0
0 0 0 0 15000 0 31174 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 06/08/1974 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 TRI WIDIYATI. NY
0001884334015 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360531 2#0##0#0#0.0#2022-03-29
09:46:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b67246761a27b8606f97410521c8f71c 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 08/12/1949 0 1
0 - 0 107400 273000 0 1 0 0 0 SISWO
SARJONO,(BP) 028784 72 26402 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V003434 0000564473013 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360335 1#0##0#0#0.0#2022-03-29
09:44:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4f425a7360001d5fe750fb8a3354edec 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 08/02/1948 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MULYANTO.,TN
0000091316373 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
360362 1#0##0#0#0.0#2022-04-07
11:57:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
724bc4f8fa00e7d01ba5cba6ad49fa56 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 08/12/1992 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ARIS ABDULLAH, BP
0000091323292 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360370 63#0##0#0#0.0#2022-03-29
10:48:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b6cfeb2e22e8a0f328d5526db164884b 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 24/07/1968 0 2
0 - 0 107400 273000 0 1 0 0 0
SUTAMI.NY 099959 53 19599 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V003438 0000640553196 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360361 64#0##0#0#0.0#2022-03-29
10:41:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bac8acaa22c3ca0cf6bbcea3519b859a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 03/07/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 LUCIA SRI
1124R0020322V003439 0000639909854 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360333 65#0##0#0#0.0#2022-03-29
09:41:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dc8ad18c47a7a1d3a71ee20802183c46 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 04/08/1950 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 SUNARTI.,NY 054610 71 26163 DR. LINDA
agung;3313092303950002; 5.6.5.202203091809 4 360303
1#0##0#0#0.0#2022-03-29
08:31:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dfc5fb20d037b0802e06417a7aa16e44 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 09/06/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 WAHYU WINARNI,NY 068463 56 20740 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360402
67#0##0#0#0.0#2022-03-29
15:09:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3a9f5e159405653e587e415073a268ae 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 31/10/1955 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 DAL HARI
1124R0020322V003442 0001703140593 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360369 68#0##0#0#0.0#2022-03-29
10:47:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0fd2316907b58bda0f4730e39e88ef67 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 08/01/1965 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
292914 0 1 0 0 0 SRI SAMSINI.NY 099962 57
agung;3313092303950002; 5.6.5.202203091809 4 360403
69#0##0#0#0.0#2022-03-29
15:09:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f18015cabeb83ac5ca538352db109f8e 150000 0 0 0 0 0
0 31845 0 0 15000 0 96069 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 21/08/1948 0 2
0 - 0 107400 273000 0 1 0 0 0
1124R0020322V003445 0000091314876 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360368 70#0##0#0#0.0#2022-03-29
10:46:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1750aa1495f43a30c8b76e4f015e03dd 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 20/03/1961 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SLAMET RIYADI.TN
0001303435192 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
360371 1#0##0#0#0.0#2022-05-19
11:10:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
02504c4d77106b4d832f78325fbf81ed 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 12/05/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 194783
0 1 0 0 0 SUWARSO.TN 100320 61 22594 DR. SUHARTO,
SP.PD 1124R0020322V003447 0002420994914 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360404 1#0##0#0#0.0#2022-03-30
07:53:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3522c73791360aeafc1d616e0b810678 150000 0 0 0 0 0
0 0 0 0 15000 0 29783 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 27/06/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI MARGANI.NY
0000091413112 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360372 73#0##0#0#0.0#2022-03-29
10:50:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
461cbde8c3ac8dfdcc30077e11e4fd97 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 24/11/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 354938
0 1 0 0 0 NANIK RUSMAGAWATI, NY 056283 51 18746
agung;3313092303950002; 5.6.5.202203091809 4 360405
74#0##0#0#0.0#2022-03-30
07:57:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
13e8ccc908ca043a4117b9efce831479 150000 0 0 0 0 0
0 0 0 0 15000 0 189938 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 12/02/1964 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 DARWATI, NY 094471
0002040571449 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360330 1#0##0#0#0.0#2022-03-29
09:38:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
953c2fe7c26b39c49a4f27399575e88a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 18/01/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 429143
0 1 0 0 0 SAMSITI.NY 080799 71 25996 DR. SUHARTO,
SP.PD 1124R0020322V003451 0000046962988 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360406 76#0##0#0#0.0#2022-03-30
07:59:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0de72bc471eb533c7245db99018eec4b 150000 0 0 0 0 0
0 0 0 0 15000 0 264143 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 02/02/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUJIYEM, NY 090600
0001696847466 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
360360 1#0##0#0#0.0#2022-04-07
11:56:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
0c2686c589ea8b51a8d4e32b64444dc2 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 17/01/1977 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 INDAH PURNAMA
SARI, NY 096428 45 16500 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V003453 0000640491568 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360325 78#0##0#0#0.0#2022-03-29
09:12:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
35cf5eca6a2a1025c03f0bf422e02e5c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 17/06/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WARIH ANJARIANI,
0001964529066 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
360337 1#0##0#0#0.0#2022-05-19
09:59:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
dd65b5c511668529a65f3571331b66f4 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 05/08/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI LESTARI, NY
0000639740812 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360334 1#0##0#0#0.0#2022-03-29
09:42:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b3a8641902c4595df4099c90570fdb76 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 28/01/1959 0 1
1 Z09.8;K30;K29.8 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 200824
0 1 0 0 0 RISTIYANTO,TN 029882 63 23064 DR.
agung;3313092303950002; 5.6.7.202204241238 4 358929
1#0##0#0#0.0#2022-05-25
10:07:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
18fe6a9ee4545b318e4211b7323426c1 150000 0 0 0 0 0
0 0 0 0 15000 0 35824 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 18/02/1942 0 2
1 Z09.8;K30;R10.4 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 254195
0 1 0 0 0 DARTINAH,NY 030952 80 29252 DR. TEKY
novia;3313125201940001; 5.6.7.202204241238 4 360407
1#0##0#0#0.0#2022-05-18
11:23:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
549d602cfb36f042932bff94747afd35 150000 0 0 0 0 0
0 31845 0 0 15000 0 57350 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 05/05/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 203489
0 1 0 0 0 SURYATI, NY 090097 64 23697 DR. TEKY
agung;3313092303950002; 5.6.5.202203091809 4 360408
83#0##0#0#0.0#2022-03-30
08:03:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f4891c3f0cc6ff7b700b7924f22c8496 150000 0 0 0 0 0
0 0 0 0 15000 0 38489 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 12/06/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 202901
0 1 0 0 0 ALVIN MAHDA FIQIA, SDR 096755 19 7223
agung;3313092303950002; 5.6.5.202203091809 4 360409
84#0##0#0#0.0#2022-03-30
08:03:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a9fb9f273165ba5ca12948e407db075a 150000 0 0 0 0 0
0 0 0 0 15000 0 37901 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 01/05/1965 0 1
1 Z09.8;E11.9;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 309512
0 1 0 0 0 MEI MARDIYANTO.TN 076926 56 20779 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360410
85#0##0#0#0.0#2022-03-30
08:04:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
00cd868948f177cdf011afd0aef051af 150000 0 0 0 0 0
0 121345 0 0 15000 0 23167 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 23/10/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 251197
0 1 0 0 0 LAELATA QODRI, (NY) 012306 48 17682
agung;3313092303950002; 5.6.5.202203091809 4 360411
86#0##0#0#0.0#2022-03-30
08:05:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0063acdaf7cf7c11474c4cf25a65b443 150000 0 0 0 0 0
0 0 0 0 15000 0 86197 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 27/09/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 260878
0 1 0 0 0 MARYATI., NY 064970 56 20630 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360412
1#0##0#0#0.0#2022-03-30
08:06:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
94ff371d8f33f3c5244e65766dd9508f 150000 0 0 0 0 0
0 63690 0 0 15000 0 32188 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 17/12/1976 0 1
0 0 - 0 - 0 - 0 - 0 181400 313302
0 1 0 0 0 SUTRISNO, TN 054659 45 16531 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360413
88#0##0#0#0.0#2022-03-30
08:07:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a8bbf1c92eb46ca8284307a31d1fb0e5 150000 0 0 0 0 0
0 0 0 0 15000 0 148302 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 31/12/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 202114
0 1 0 0 0 PARYATUN, NY 051446 70 25649 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360414
89#0##0#0#0.0#2022-03-30
08:18:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c3527cd82524a5947bfb9e3a16595a16 150000 0 0 0 0 0
0 0 0 0 15000 0 37114 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 07/11/1971 0 1
0 - 0 107400 262000 0 1 0 0 0 NUZUL
HAKIM, TN 101343 50 18398 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V003465 0002169296897 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360339 90#0##0#0#0.0#2022-03-29
09:55:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
36e335ccafeb526580b6f38e8a9fb8b0 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 31/12/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 262988
0 1 0 0 0 SUPRAPTI, NY 075880 79 28936 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360415
91#0##0#0#0.0#2022-03-30
08:19:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0dc825316e4a479ec5c6aec0fd7c5d50 150000 0 0 0 0 0
0 0 0 0 15000 0 97988 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 07/10/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 456919
0 1 0 0 0 YUSUF HIDAYAT, (BP) 050063 67 24638
agung;3313092303950002; 5.6.5.202203091809 4 360416
92#0##0#0#0.0#2022-03-30
08:20:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cef92466877c0403a4212de118e4c93f 150000 0 0 0 0 0
0 0 0 0 15000 0 291919 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 26/06/1991 0 2
0 0 - 0 - 0 - 0 - 0 181400 855373
0 1 0 0 0 DEWI ERLINA,NY 015222 30 11227 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360417
1#0##0#0#0.0#2022-03-30
08:21:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5e8ac7866ea3eac0f45f5257ae126363 150000 0 0 0 0 0
0 0 0 0 15000 0 690373 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 19/02/1956 0 2
1 Z09.8;K30 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 189289
0 1 0 0 0 TUMINAH.NY 093575 66 24138 DR. TEKY
novia;3313125201940001; 5.6.7.202204241238 4 360418
1#0##0#0#0.0#2022-05-19
12:39:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
4c701f5d2623b035968091f09fbad7c0 150000 0 0 0 0 0
0 0 0 0 15000 0 24289 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 05/07/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 207879
0 1 0 0 0 HIDAYATULLAH.TN 100744 72 26558 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360419
1#0##0#0#0.0#2022-03-30
08:24:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cd8f38f28fdf94094dd680e33c0e21e8 150000 0 0 0 0 0
0 0 0 0 15000 0 42879 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 10/07/1959 0 1
1 Z09.8;I11.9;M19.98;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 375606
0 1 0 0 0 SRI YULIANTO.TN 087644 62 22901 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360420
96#0##0#0#0.0#2022-03-30
08:25:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
293b83dcadeedf61f03a8297250b4d6f 150000 0 0 0 0 0
0 0 0 0 15000 0 210606 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 08/11/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 227299
0 1 0 0 0 SRI BUNTARI,NY 075696 59 21684 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360421
97#0##0#0#0.0#2022-03-30
08:26:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b6410625c4da77851e7e1bbad2b35df1 150000 0 0 0 0 0
0 31845 0 0 15000 0 30454 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 01/02/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 235126
0 1 0 0 0 FENNY SIMAMPO.NY 098609 47 17216 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360422
98#0##0#0#0.0#2022-03-30
08:27:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d74b15e9a54ff53624c1331659992230 150000 0 0 0 0 0
0 0 0 0 15000 0 70126 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 13/10/1987 0 2
0 0 - 0 - 0 - 0 - 0 181400 472640
0 1 0 0 0 IRA PURWANTI, NY 101739 34 12579 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360423
99#0##0#0#0.0#2022-03-30
08:28:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a27162e5e1394270fd96a8f4c423b516 300000 0 0 0 0 0
0 0 0 0 15000 0 157640 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 30/07/1939 0 2
1 Z09.8;K30;E78.5 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 216491
0 1 0 0 0 ASTITI 066027 82 30186 DR. TEKY
agung;3313092303950002; 5.6.5.202203091809 4 360424
100#0##0#0#0.0#2022-03-30
08:29:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f2227790e2be5f57c80ce9a009784c2e 150000 0 0 0 0 0
0 0 0 0 15000 0 51491 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 26/05/1969 0 2
1 Z09.8;I10;C50.9;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 253749
0 1 0 0 0 TITIK SURYANTI.NY 093985 52 19293 DR.
yani;3302226402970001; 5.6.6.202203301209 4 360425
1#0##0#0#0.0#2022-04-07
13:54:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
b0102dfe958f6a47e4377dc2c8a4f2f4 150000 0 0 0 0 0
0 0 0 0 15000 0 88749 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 12/12/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 210931
0 1 0 0 0 SITI CHOSIYAH., NY 045191 74 27129
yani;3302226402970001; 5.6.6.202203301209 4 360426
1#0##0#0#0.0#2022-04-07
13:56:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
0b6f82d3690ca700b753681040d3db36 150000 0 0 0 0 0
0 0 0 0 15000 0 45931 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 15/12/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 208582
agung;3313092303950002; 5.6.5.202203091809 4 360427
101#0##0#0#0.0#2022-03-30
08:35:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cd8c17558770ae5b88c4b2d57cb7b156 150000 0 0 0 0 0
0 0 0 0 15000 0 43582 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 23/03/1976 0 2
0 - 0 - 0 - 0 786200 677676 0 1
agung;3313092303950002; 5.6.5.202203091809 4 360316
102#0##0#0#0.0#2022-03-29
09:01:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f72e4cc113c1a92e2278e41dad39e9d2 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 17/04/1961 0 2
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.5.202203091809 4 360305
1#0##0#0#0.0#2022-03-29
08:42:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fd487e107a35958b2d847bb740e50cac 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 01/04/1981 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V003489 0001904830593 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360306 1#0##0#0#0.0#2022-03-29
08:46:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b9c68083fbc1c31a88f3de075e698e7e 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 01/12/1958 0 2
0 - 0 - 0 - 0 786200 758163 0 1
SP.PD 1124R0020322V003490 0001436949538 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360307 1#0##0#0#0.0#2022-03-29
08:49:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
30cdc58f46a5dce17c03713c7ea08815 662676 0 0 0 0 0
0 0 0 0 15000 0 80487 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 25/05/1972 0 1
0 - 0 - 0 - 0 786200 736746 0 1
SP.PD 1124R0020322V003491 0002431552465 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360309 1#0##0#0#0.0#2022-03-29
08:49:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8887e15bc776eb772bfdb85f18e2bb81 662676 0 0 0 0 0
0 0 0 0 15000 0 59070 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 20/08/1959 0 1
0 - 0 - 0 - 0 786200 677676 0 1
SP.PD 1124R0020322V003492 0000571256594 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360310 1#0##0#0#0.0#2022-03-29
08:51:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f1d97c728a2145b599f4e968ba34abe3 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 26/04/1964 0 1
0 - 0 - 0 - 0 786200 548339 0 1
agung;3313092303950002; 5.6.5.202203091809 4 360311
1#0##0#0#0.0#2022-03-29
08:52:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e063423fbc7953ac19f24577f5a6b831 463830 0 0 0 0 0
0 0 0 0 15000 0 69509 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 01/12/1980 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V003494 0000640230884 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360312 1#0##0#0#0.0#2022-03-29
08:53:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ffab247d4a01120cd87638ac61653583 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 08/03/1967 0 1
0 - 0 - 0 - 0 786200 561264 0 1
agung;3313092303950002; 5.6.5.202203091809 4 360313
110#0##0#0#0.0#2022-03-29
08:53:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f90b0ddd9be9eb10b49327d68f163319 463830 0 0 0 0 0
0 0 0 0 15000 0 82434 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 01/05/1975 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V003496 0001790328262 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360314 111#0##0#0#0.0#2022-03-29
09:00:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fae61f369f25d93952c0f08cdfa5e699 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 07/04/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUDARYANTI.NY
0001389672044 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360301 112#0##0#0#0.0#2022-03-29
08:30:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
242b68ea0c1397566529fc864024fef0 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 16/02/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 418545
0 1 0 0 0 SRI RASWINI, (NY) 003004 52 19027 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360429
113#0##0#0#0.0#2022-03-30
08:36:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b1d7b3d37fb7ccb4b6752b6ba6b1d88f 150000 0 0 0 0 0
0 0 0 0 15000 0 253545 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 20/07/1952 0 2
1 Z09.8;M54.22;G62.8 93.89 - - None None None None Z-3-
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 SITI ZUHRIYAH,(NY) 039654 69 25447
agung;3313092303950002; 5.6.5.202203091809 4 360296
114#0##0#0#0.0#2022-03-29
08:28:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8e9c6e521126cbb850ca1b78a69ca087 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 27/05/1993 0 2
0 0 - 0 - 0 - 0 - 0 181400 487511
0 1 0 0 0 ARDHITA AYU ANDANI.NN 008082 28 10526
3;JKN agung;3313092303950002; 5.6.5.202203091809 4 360430
115#0##0#0#0.0#2022-03-30
08:36:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dc22340ca436534bbdb4982ebec9963f 300000 0 0 0 0 0
0 0 0 0 15000 0 172511 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 06/08/1938 0 1
1 Z09.8;J44.9;I10;K59.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 387396
0 1 0 0 0 SOEKAMTO 090753 83 30544 DR. ANITA
agung;3313092303950002; 5.6.5.202203091809 4 360431
116#0##0#0#0.0#2022-03-30
08:37:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
107dff26bef5dd4400c70f72cf1e0f4f 150000 0 0 0 0 0
0 0 0 0 15000 0 222396 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 01/11/1961 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 KUSTIATI, NY 048553 60 22056 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360297
1#0##0#0#0.0#2022-03-29
08:27:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
976908de10e5ba43a0c43f6f90fe35f6 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 22/04/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 368938
0 1 0 0 0 TUMINI, NY 039188 61 22614 DR. ANITA
agung;3313092303950002; 5.6.5.202203091809 4 360432
118#0##0#0#0.0#2022-03-30
08:38:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
099ca163002c150c4f2641066f1c9708 150000 0 0 0 0 0
0 0 0 0 15000 0 203938 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 15/07/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 186395
0 1 0 0 0 H. MUTHOHAR, TN 100630 79 29105 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360433
119#0##0#0#0.0#2022-03-30
08:39:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ce325cc0ba89fed6783d79a271a226e9 150000 0 0 0 0 0
0 0 0 0 15000 0 21395 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 06/10/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 350866
0 1 0 0 0 JUMROH 049906 50 18430 DR. ANITA
agung;3313092303950002; 5.6.5.202203091809 4 360434
120#0##0#0#0.0#2022-03-30
08:39:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f539b69428e248aaf72486d4e9e35a45 150000 0 0 0 0 0
0 0 0 0 15000 0 185866 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 12/06/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 234321
0 1 0 0 0 SUMARNI ,(NY) 043253 48 17815 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360435
121#0##0#0#0.0#2022-03-30
08:40:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
09f5a27b43d872112f745d36f7fe5952 150000 0 0 0 0 0
0 0 0 0 15000 0 69321 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 10/03/2006 0 1
0 0 - 0 - 0 - 0 - 0 181400 449329
0 1 0 0 0 MUHAMMAD FAISHOL HAIDAR., AN 070790 16
0002169226034 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360436 122#0##0#0#0.0#2022-03-30
08:41:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
366063e6a18a5b16bdf727055fecc4bb 150000 0 0 0 0 0
0 0 0 0 15000 0 284329 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 14/08/1950 0 2
1 Z09.8;J45.9;E11.9;I10 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 412800
0 1 0 0 0 SUMIRAH, NY 098366 71 26153 DR. ANITA
agung;3313092303950002; 5.6.5.202203091809 4 360437
123#0##0#0#0.0#2022-03-30
08:42:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ac7460057eabb7cd2a7bd31b1b47fe04 150000 0 0 0 0 0
0 0 0 0 15000 0 247800 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 31/12/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 409489
0 1 0 0 0 SUPARMI ,NY 056452 53 19439 DR. ANITA
agung;3313092303950002; 5.6.5.202203091809 4 360438
124#0##0#0#0.0#2022-03-30
08:42:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cea86226c68d63ea32e7cca715b1359e 150000 0 0 0 0 0
0 0 0 0 15000 0 244489 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 26/03/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 DYAH RETNO UTAMI., NY 051812 47 17528
3;JKN agung;3313092303950002; 5.6.5.202203091809 4 360589
1#0##0#0#0.0#2022-03-30
11:34:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
228af83155fe648340b9cf34723e645e 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 25/07/1944 0 1
1 Z09.8;J44.9;M54.39;J30.3 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
217932 0 1 0 0 0 MUHAMMAD BANANI 090774 77
0000088531075 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360441 125#0##0#0#0.0#2022-03-30
08:44:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ae236ca426d3f1cb9e173c8f60154bdd 150000 0 0 0 0 0
0 0 0 0 15000 0 52932 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 16/10/1978 0 1
1 Z09.8;J45.9;K21.9 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 206663
0 1 0 0 0 AGUNG CAHYONO.TN 099954 43 15863 DR.
novia;3313125201940001; 5.6.7.202204241238 4 360442
1#0##0#0#0.0#2022-05-20
08:19:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
81b9a16d499b3c3a304aed1b19791789 150000 0 0 0 0 0
0 0 0 0 15000 0 41663 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 31/12/1966 0 2
1 Z09.8;A16.2;E11.9 87.49 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 378943
0 1 0 0 0 SUWARSI, NY 098393 55 20170 DR. ANITA
agung;3313092303950002; 5.6.5.202203091809 4 360545
127#0##0#0#0.0#2022-03-30
08:46:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c96f9a22313fbf8bdfea528c1f9e6c17 150000 0 0 0 0 0
200000 0 0 0 15000 0 13943 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 14/02/1951 0 2
1 Z09.8;K30;R11 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 223620
0 1 0 0 0 PARTINI,NY 040519 71 25969 DR. SUHARTO,
SP.PD 1124R0020322V003514 0000091222312 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360444 128#0##0#0#0.0#2022-03-30
08:52:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
864da6ab8a6143b65a65ea6aea004d86 150000 0 0 0 0 0
0 0 0 0 15000 0 58620 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 21/12/1946 0 1
0 0 - 0 - 0 - 0 - 0 181400 531986
0 1 0 0 0 SUTARMIN ATMO SUWITO,(TN) 028643 75
0001021693713 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360445 129#0##0#0#0.0#2022-03-30
08:53:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
40929f6672b23e5302134a333d3658bf 150000 0 0 0 0 0
0 0 0 0 15000 0 366986 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 27/04/2007 0 2
0 0 - 0 - 0 - 0 - 0 181400 259647
DR. OEDJANG SETIJAWAN, MSI.MED.,SP.B 1124R0020322V003516
0001183366618 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360446 130#0##0#0#0.0#2022-03-30
08:54:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f77b5ce129fd99024863b1efb9d20cd2 235000 0 0 0 0 0
0 0 0 0 15000 0 9647 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 31/12/1965 0 2
1 Z09.8;J45.9;J06.9;K21.9;M79.18 - - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 435563 0 1 0 0 0 DARMINAH,(NY) 036497
0000565033173 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360447 131#0##0#0#0.0#2022-03-30
08:54:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ab024ff5cdf46a58f681467dd7ad5a80 150000 0 0 0 0 0
0 0 0 0 15000 0 270563 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 10/01/1969 0 2
1 Z09.8;J45.9;K21.9;I11.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 280242
0 1 0 0 0 SRI MULYATMI, NY 060210 53 19429 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360448
132#0##0#0#0.0#2022-03-30
08:55:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bf28e2358b014b65c3b026cec0483679 0 0 0 0 0 0 0
0 0 0 15000 0 265242 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 14/03/1965 0 1
1 Z09.8;A16.2;E11.2 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 290785
0 1 0 0 0 M ZAINAL ARIFIN, TN 097952 57 20827
3;JKN agung;3313092303950002; 5.6.5.202203091809 4 360449
133#0##0#0#0.0#2022-03-30
08:56:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
70506e6c34b980c1567e7ee31a69dd2a 150000 0 0 0 0 0
0 0 0 0 15000 0 125785 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 15/11/1957 0 2
1 Z09.8;L03.9 96.59 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 259625 0 1
0 0 0 SUGIYARNI,NY 028192 64 23503 DR. OEDJANG
agung;3313092303950002; 5.6.5.202203091809 4 360450
134#0##0#0#0.0#2022-03-30
08:57:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8b9b2b9376abb4cad0419797a4499cd0 235000 0 0 0 0 0
0 0 0 0 15000 0 9625 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 02/10/1968 0 1
1 Z09.8;A16.2;K21.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 178827
0 1 0 0 0 DOSO PERWITO, TN 100850 53 19529 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360451
135#0##0#0#0.0#2022-03-30
08:57:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9da9a11a09ea68a7d090d95ede9144e5 150000 0 0 0 0 0
0 0 0 0 15000 0 13827 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 17/01/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 489922
0 1 0 0 0 SURIPTI.(NY) 028375 64 23440 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360452
136#0##0#0#0.0#2022-03-30
08:58:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a26c5596700b3fcf699d2e410a763bc6 406000 0 0 0 0 0
0 0 0 0 15000 0 68922 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 09/10/1994 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 MONIQUE CHRISTIANA, NY 089076 27 10026
agung;3313092303950002; 5.6.5.202203091809 4 360454
137#0##0#0#0.0#2022-03-30
08:59:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3312f0510083d83af005fe39fae03bf0 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 04/09/1964 0 1
0 - 0 - 0 - 0 786200 165000 0 1
agung;3313092303950002; 5.6.5.202203091809 4 360315
1#0##0#0#0.0#2022-03-29
09:01:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
abba7586c572f7644a796dc75947b36c 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 07/05/2001 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001264309694 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360304 1#0##0#0#0.0#2022-03-29
08:41:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
198c09223a53b2f409e6923eb1255112 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 17/01/1940 0 2
- 0 - 0 - 0 - 0 138400 273000 0
1 0 0 0 SITI JAHIDJAH, NY 101286 82 30015 DR. LINDA
agung;3313092303950002; 5.6.5.202203091809 4 360327
140#0##0#0#0.0#2022-03-29
09:13:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
14dd35a53f868c71c81e7f4223181ae9 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 16/12/1956 0 1
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 BAMBANG WARAS SUDIBYO, TN 065239 65 23837
agung;3313092303950002; 5.6.5.202203091809 4 360329
1#0##0#0#0.0#2022-03-29
09:37:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9e403968cd2ecb3bcce28d3b6185e0b7 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 30/11/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 220319
0 1 0 0 0 VERONIKA SRI DARINI,NY (28552) 038070
0000091178098 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360455 142#0##0#0#0.0#2022-03-30
09:00:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c8e6101b7d6e2d8b6b5d7a86d3eb3d96 150000 0 0 0 0 0
0 0 0 0 15000 0 55319 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 26/10/2020 0 1
1 Z09.8;J18.0 93.35;93.39 - - None None None None M-3-16-0
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 254000 0 1 0 0 0 ALKHALIFI MALIK
AHMAD, AN 102499 1 512 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V003531 0003095169489 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360328 143#0##0#0#0.0#2022-03-29
09:14:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
62a1d9542a25040ebcb6a378700c7f37 239000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 01/10/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 239322
0 1 0 0 0 SUDIYANA,TN 000468 58 21357 DR. ARIA
agung;3313092303950002; 5.6.5.202203091809 4 360456
144#0##0#0#0.0#2022-03-30
09:00:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
62bdddb334f72704f618fc6314619ca3 150000 0 0 0 0 0
0 0 0 0 15000 0 74322 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 03/03/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 231523
0 1 0 0 0 MUYAS SAROH, NY 064719 73 26682 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360457
145#0##0#0#0.0#2022-03-30
09:01:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
761989adc21327e2dedf6766e5b61009 150000 0 0 0 0 0
0 0 0 0 15000 0 66523 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 02/05/1996 0 2
0 0 - 0 - 0 - 0 - 0 181400 169982
0 1 0 0 0 DIAS DICKY TAMARA, NY 071534 25 9455
0002169757631 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360458 146#0##0#0#0.0#2022-03-30
09:01:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f769fa74b278cd708cc95775016564c7 150000 0 0 0 0 0
0 0 0 0 15000 0 4982 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 28/04/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 249090
0 1 0 0 0 KURDI., BP 052526 77 28452 DR. ARIA
agung;3313092303950002; 5.6.5.202203091809 4 360459
147#0##0#0#0.0#2022-03-30
09:02:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cde4e95b53af23812a1db0ad6c75edc0 150000 0 0 0 0 0
0 0 0 0 15000 0 84090 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 08/08/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 226760
0 1 0 0 0 SUMINI, NY 057720 67 24698 DR. ARIA
agung;3313092303950002; 5.6.5.202203091809 4 360461
148#0##0#0#0.0#2022-03-30
09:03:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e0e1aa040b55e90716a2869e114073ff 150000 0 0 0 0 0
0 0 0 0 15000 0 61760 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 05/06/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 243837
0 1 0 0 0 YENI YUNI ASTUTI, NY 069907 56 20744
3;JKN agung;3313092303950002; 5.6.5.202203091809 4 360462
149#0##0#0#0.0#2022-03-30
09:04:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fd7b44a1ef43c6a1f0ff13dca7160d11 150000 0 0 0 0 0
0 0 0 0 15000 0 78837 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 08/10/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 234927
0 1 0 0 0 DWI DARMOYO, TN 100965 56 20619 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360463
150#0##0#0#0.0#2022-03-30
09:05:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c1ab5e6526247099eb48eb6001ee3c62 150000 0 0 0 0 0
0 0 0 0 15000 0 69927 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 23/07/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 286922
0 1 0 0 0 SAPARTI, NY 102349 61 22522 DR. YUDHI
agung;3313092303950002; 5.6.5.202203091809 4 360464
151#0##0#0#0.0#2022-03-30
09:05:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
720f8aa532b48f9f419de9331b758a49 203000 0 0 0 0 0
0 0 0 0 15000 0 68922 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 15/09/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 205546
0 1 0 0 0 TRI ATMODJO, TN 094462 61 22468 DR.
agung;3313092303950002; 5.6.7.202204241238 4 360466
1#0##0#0#0.0#2022-05-25
11:12:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
ef4aef72fecac613239f1bac9f7cfce3 150000 0 0 0 0 0
0 0 0 0 15000 0 40546 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 16/02/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 349022
0 1 0 0 0 DARYANTO, TN 048045 58 21219 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360467
153#0##0#0#0.0#2022-03-30
09:06:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
227b804dc0332525f07498511eec48b2 150000 0 0 0 0 0
0 0 0 0 15000 0 184022 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 16/10/1949 0 2
0 - 0 - 0 - 0 894800 1476996 0 1
0 0 0 SRI YEKTI ISMADI,(NY) 040545 72 26455 DR. ARIA
agung;3313092303950002; 5.6.5.202203091809 4 360544
154#0##0#0#0.0#2022-03-30
09:07:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aaae005d117075174274791f80d1a205 150000 0 0 0 0 0
1250000 0 0 0 15000 0 61996 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 19/02/1984 0 1
0 0 - 0 - 0 - 0 - 0 181400 367763
0 1 0 0 0 DIDIK ACHMADI. TN 050289 38 13911 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360468
1#0##0#0#0.0#2022-03-30
09:07:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bbdfb4d00a2e1ec72b35445d2a24af5b 150000 0 0 0 0 0
0 0 0 0 15000 0 202763 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 12/04/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 240852
0 1 0 0 0 MARIYAM.NY 084306 64 23720 DR. ARIA
novia;3313125201940001; 5.6.7.202204241238 4 360469
1#0##0#0#0.0#2022-05-19
10:23:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
d17f9e2b99af27e133a0552e467aa486 150000 0 0 0 0 0
0 0 0 0 15000 0 75852 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 18/09/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 267520
0001081396326 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361235 1#0##0#0#0.0#2022-04-05
11:18:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
84d8590f225768cb725ea7f66c1ebc60 235000 0 0 0 0 0
0 0 0 0 15000 0 17520 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 07/02/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 229814
0 1 0 0 0 SRI SULARMI NY (080054) 080088 51 18671
3;JKN agung;3313092303950002; 5.6.5.202203091809 4 360470
157#0##0#0#0.0#2022-03-30
09:29:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
362613ba89af025561a42ec49fc71a13 150000 0 0 0 0 0
0 0 0 0 15000 0 64814 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 31/01/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 302665
3;JKN agung;3313092303950002; 5.6.5.202203091809 4 360471
158#0##0#0#0.0#2022-03-30
09:29:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eecb288ba505e21504ffbf92a71e7116 150000 0 0 0 0 0
0 0 0 0 15000 0 137665 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 24/08/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 218262
0 1 0 0 0 SLAMET.TN 083350 79 29065 DR. ARIA
agung;3313092303950002; 5.6.5.202203091809 4 360472
159#0##0#0#0.0#2022-03-30
09:30:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b35d2592025411554b78cfa2d88588f5 150000 0 0 0 0 0
0 0 0 0 15000 0 53262 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 04/06/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 739608
0 1 0 0 0 RAMEI,BP 037075 71 26224 DR. ARIA
agung;3313092303950002; 5.6.5.202203091809 4 360473
160#0##0#0#0.0#2022-03-30
09:31:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a4c8a9cf6df83f631e10f35ec7ecdcdb 600000 0 0 0 0 0
0 0 0 0 15000 0 124608 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 31/12/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 216326
0 1 0 0 0 MISNEM. NY 021157 65 23822 DR. ARIA
agung;3313092303950002; 5.6.5.202203091809 4 360474
161#0##0#0#0.0#2022-03-30
09:32:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
139c858c8b05da3e5f30bad81a3d4e5f 150000 0 0 0 0 0
0 0 0 0 15000 0 51326 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 05/03/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 361532
0 1 0 0 0 AHMAD SUPRIYADI.TN 098277 61 22297
3;JKN agung;3313092303950002; 5.6.5.202203091809 4 360475
162#0##0#0#0.0#2022-03-30
09:32:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fe91adb949bfb070ae9ec197f28ccf81 150000 0 0 0 0 0
0 0 0 0 15000 0 196532 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 30/06/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 226523
0 1 0 0 0 ISTUTIK, NY 093527 63 23276 DR. ARIA
agung;3313092303950002; 5.6.5.202203091809 4 360476
163#0##0#0#0.0#2022-03-30
09:33:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f1b62832a80e5407e9dee6eba9a8ec61 150000 0 0 0 0 0
0 0 0 0 15000 0 61523 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 07/12/2008 0 1
0 0 - 0 - 0 - 0 - 0 181400 259094
0 1 0 0 0 FAISHAL ARIF,(AN) 037219 13 4853 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360477
164#0##0#0#0.0#2022-03-30
09:33:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ca8ef5eca90addf5c1a94e15090b3487 150000 0 0 0 0 0
0 0 0 0 15000 0 94094 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 29/03/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 213268
0 1 0 0 0 SIH MARTANTI.NY 096811 56 20812 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360478
165#0##0#0#0.0#2022-03-30
09:34:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fe85edc37f5c38d55de4248671166303 150000 0 0 0 0 0
0 0 0 0 15000 0 48268 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 07/02/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 249975
0 1 0 0 0 SUHARNO.TN 096472 56 20497 DR. ARIA
agung;3313092303950002; 5.6.5.202203091809 4 360479
166#0##0#0#0.0#2022-03-30
09:34:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
409472d46acd1d0c1e954407b27fba2d 150000 0 0 0 0 0
0 0 0 0 15000 0 84975 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 16/08/1969 0 2
1 Z09.8;I69.3;M53.19;M54.39 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
522335 0 1 0 0 0 TRI WINARNI, NY 093256 52
0000640206066 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
360480 1#0##0#0#0.0#2022-05-19
12:32:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
c42d1736b953a4463f4111a77556c189 150000 0 0 0 0 0
0 0 0 0 15000 0 357335 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 21/09/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 231248
agung;3313092303950002; 5.6.5.202203091809 4 360482
168#0##0#0#0.0#2022-03-30
09:35:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2521ac5fef92977b04fc15d7f2bcd7a9 150000 0 0 0 0 0
0 0 0 0 15000 0 66248 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 05/06/1959 0 1
0 - 0 - 0 - 0 - 0 181400 211354
0 1 0 0 0 WAKIDI, TN 102408 62 22936 DR. ARIA
agung;3313092303950002; 5.6.5.202203091809 4 360483
169#0##0#0#0.0#2022-03-30
09:44:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1fa02271172205d4039e3f308225a656 150000 0 0 0 0 0
0 0 0 0 15000 0 46354 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 16/06/1980 0 2
0 0 - 0 - 0 - 0 - 0 181400 247060
0 1 0 0 0 MARSINI, NY 101212 41 15254 DR. ARIA
agung;3313092303950002; 5.6.5.202203091809 4 360488
170#0##0#0#0.0#2022-03-30
10:25:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
633d8d9385905c25467f1dba2795995f 150000 0 0 0 0 0
0 0 0 0 15000 0 82060 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 27/12/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 231985
0 1 0 0 0 ISTRIYATI, NY 100792 54 19809 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360489
171#0##0#0#0.0#2022-03-30
10:32:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0977e5f3a1c400b0c6ae3adfa5ce921e 150000 0 0 0 0 0
0 0 0 0 15000 0 66985 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 16/07/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 221216
0 1 0 0 0 APIN S ARIPIN, TN 058842 48 17781 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360492
172#0##0#0#0.0#2022-03-30
10:34:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b2163fb0d99d3713baa641c1da85bc2a 150000 0 0 0 0 0
0 0 0 0 15000 0 56216 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 21/02/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 245724
0 1 0 0 0 SRI HARYATI.NY 099070 62 22675 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360490
173#0##0#0#0.0#2022-03-30
10:33:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
56f87b75c049bfa3898b7954f6cdd609 150000 0 0 0 0 0
0 0 0 0 15000 0 80724 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 05/11/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 233156
0 1 0 0 0 ARIANI TIAS TUTIEK 090478 56 20591
3;JKN agung;3313092303950002; 5.6.5.202203091809 4 360491
174#0##0#0#0.0#2022-03-30
10:33:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
69d5d78d95ebd9e3357eaa8c86d441de 150000 0 0 0 0 0
0 0 0 0 15000 0 68156 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 17/03/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 ENDANG BUDI ASTUTI, NY 089496 59 21555
3;JKN agung;3313092303950002; 5.6.5.202203091809 4 360564
4#0##0#0#0.0#2022-03-30
10:35:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f3d334844bee4b19a2f622d07fa1bc40 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 01/12/1944 0 2
0 0 - 0 - 0 - 0 - 0 181400 202576
0 1 0 0 0 WANTIYEM.NY 078888 77 28235 DR. ARIA
agung;3313092303950002; 5.6.5.202203091809 4 360493
175#0##0#0#0.0#2022-03-30
10:36:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f5e7e783d8069ec72332249092e9c582 150000 0 0 0 0 0
0 0 0 0 15000 0 37576 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 18/02/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 255222
0 1 0 0 0 DWI FITRI HATMOKO.TN 094437 58 21217
3;JKN agung;3313092303950002; 5.6.5.202203091809 4 360494
176#0##0#0#0.0#2022-03-30
10:37:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
50a6c41ce436b2aa713eac54f93c1046 150000 0 0 0 0 0
0 0 0 0 15000 0 90222 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 20/07/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 237644
0 1 0 0 0 SUMIARSIH.NY 084165 65 23986 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360495
177#0##0#0#0.0#2022-03-30
10:37:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9356f8987701dcc752497c5194da54c1 150000 0 0 0 0 0
0 0 0 0 15000 0 72644 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 17/03/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 249338
0 1 0 0 0 SARTINI.NY 102547 51 18633 DR. SUHARTO,
SP.PD 1124R0020322V003572 0002699927932 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360496 178#0##0#0#0.0#2022-03-30
10:38:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6fe63236cf43764ad0f173dad760f80c 150000 0 0 0 0 0
0 0 0 0 25000 0 74338 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 29/09/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 211668
0 1 0 0 0 SRI HANDAYANI.NY 099989 60 22089 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360498
179#0##0#0#0.0#2022-03-30
10:39:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
99f9cc9ca846661c4bbf4b3846d7f13e 150000 0 0 0 0 0
0 0 0 0 15000 0 46668 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 02/04/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 206663
0 1 0 0 0 NARMINI.,NY 073983 52 19347 DR. ARIA
agung;3313092303950002; 5.6.5.202203091809 4 360499
180#0##0#0#0.0#2022-03-30
10:58:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a207fd44584a2be1e0e2fb03bd38f3bc 150000 0 0 0 0 0
0 0 0 0 15000 0 41663 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 23/10/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 240658
0 1 0 0 0 PARTINI, NY 081640 52 19143 DR. ARIA
agung;3313092303950002; 5.6.5.202203091809 4 360500
181#0##0#0#0.0#2022-03-30
10:59:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1a35c5349c3104847fc19b3a7d000fc5 150000 0 0 0 0 0
0 0 0 0 15000 0 75658 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 24/04/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 229004
0 1 0 0 0 INDRIYATI 060952 62 22978 DR. ARIA
agung;3313092303950002; 5.6.5.202203091809 4 360501
182#0##0#0#0.0#2022-03-30
10:59:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e1659c182d1f254b84808e382513739e 150000 0 0 0 0 0
0 0 0 0 15000 0 64004 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 09/09/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 354970
0 1 0 0 0 PUJO BASUKI, TN 070897 48 17726 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360502
183#0##0#0#0.0#2022-03-30
11:00:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d82d280a1ca1abaef1fa6f4e5574c9d2 150000 0 0 0 0 0
0 0 0 0 15000 0 189970 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 07/04/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 247792
0 1 0 0 0 MARTHA LEOPENO. NY 005709 61 22629
3;JKN agung;3313092303950002; 5.6.5.202203091809 4 360505
184#0##0#0#0.0#2022-03-30
11:00:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bcc47e47a5998ca7651944d37876103a 150000 0 0 0 0 0
0 0 0 0 15000 0 82792 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 30/09/1977 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000207436206 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360331 185#0##0#0#0.0#2022-03-29
09:38:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8c83e0b057e8461107895765013dd78e 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 24/04/2003 0 1
0 0 - 0 - 0 - 0 - 0 181400 311284
0 1 0 0 0 ASWIN PRAYOGA, SDR 101578 18 6907
agung;3313092303950002; 5.6.5.202203091809 4 360506
186#0##0#0#0.0#2022-03-30
11:01:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
80e882823866a773d0cae8ffa0c162de 256000 0 0 0 0 0
0 0 0 0 15000 0 40284 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 04/01/2004 0 1
0 0 - 0 - 0 - 0 - 0 181400 257184
0 1 0 0 0 BIMA SATRIA DWIPUTRA.SDR 017819 18
3;JKN agung;3313092303950002; 5.6.5.202203091809 4 360507
187#0##0#0#0.0#2022-03-30
11:02:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6847f5eae7854476f403acfc589d2e39 203000 0 0 0 0 0
0 0 0 0 15000 0 39184 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 31/01/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 663184
0 1 0 0 0 ARGA KUSUMA.SDR 100752 20 7355 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360508
188#0##0#0#0.0#2022-03-30
11:02:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
89e0d85813ff008778c5236616ecb854 609000 0 0 0 0 0
0 0 0 0 15000 0 39184 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 19/07/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400
1057142 0 1 0 0 0 SITI WARSINI.NY 098844 71
3;JKN agung;3313092303950002; 5.6.5.202203091809 4 360509
189#0##0#0#0.0#2022-03-30
11:07:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0496adf1a863e91af487cc1c04b81b44 203000 0 0 0 0 0
0 0 0 0 15000 0 839142 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 24/10/1961 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
1032216 0 1 0 0 0 RETNO PRADANINGRUM (NY) 028232
0000639636985 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360510 190#0##0#0#0.0#2022-03-30
11:08:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
97287a01658cdb1b97d0d33fee146667 812000 0 0 0 0 0
0 0 0 0 15000 0 205216 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 13/08/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 423216
novia;3313125201940001; 5.6.7.202204241238 4 360511
1#0##0#0#0.0#2022-05-19
08:25:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
6f79709ef4fa2f06e8827259fe1e3ded 203000 0 0 0 0 0
0 0 0 0 15000 0 205216 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 25/04/1985 0 1
1 Z09.8;K76.0;G62.8 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 231935
0 1 0 0 0 NUR TAMRIN SULISTYO.TN 005480 36 13480
agung;3313092303950002; 5.6.5.202203091809 4 360512
192#0##0#0#0.0#2022-03-30
11:11:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
da34a5979c64ca7400fe1c06e99a7503 150000 0 0 0 0 0
0 0 0 0 15000 0 66935 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 19/12/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 510994
0 1 0 0 0 SOEDIJARSO.TN 060932 73 26756 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360513
193#0##0#0#0.0#2022-03-30
11:12:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cc0b13597156147a10c7c63e47311e8f 150000 0 0 0 0 0
0 0 0 0 15000 0 345994 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 10/05/1975 0 2
1 Z09.8;J45.9;R51 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 221315
0 1 0 0 0 KIFAYAH, NY 102404 46 17118 DR. ANITA
agung;3313092303950002; 5.6.5.202203091809 4 360514
194#0##0#0#0.0#2022-03-30
12:39:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
45472c4e90c796b18551b842ced910c3 150000 0 0 0 0 0
0 0 0 0 15000 0 56315 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 29/10/1992 0 2
0 0 - 0 - 0 - 0 - 0 181400 195379
0 1 0 0 0 OKTAVIANI SELAWATI, NY 055505 29 10736
agung;3313092303950002; 5.6.5.202203091809 4 360515
195#0##0#0#0.0#2022-03-30
11:15:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9d6399c8d893600cd540cd48f026a163 150000 0 0 0 0 0
0 0 0 0 15000 0 30379 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 29/10/2007 0 1
0 0 - 0 - 0 - 0 - 0 181400 257184
0 1 0 0 0 AKBAR YUDHA KUSUMA.AN 022854 14 5258
agung;3313092303950002; 5.6.5.202203091809 4 360516
196#0##0#0#0.0#2022-03-30
11:18:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
31d15138bc1453e5ddcb03c039b1111b 203000 0 0 0 0 0
0 0 0 0 15000 0 39184 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 15/09/1988 0 1
0 0 - 0 - 0 - 0 - 0 181400 400902
0 1 0 0 0 MUHAMMAD KHOIRUMAN.TN 080389 33 12241
3;JKN agung;3313092303950002; 5.6.5.202203091809 4 360517
197#0##0#0#0.0#2022-03-30
11:18:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b3f6413553719741f08785c9d718b715 150000 0 0 0 0 0
0 0 0 0 15000 0 235902 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 04/09/1960 0 1
0 - 0 - 0 - 0 786200 677676 0 1
SP.PD 1124R0020322V003598 0000640142684 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360318 198#0##0#0#0.0#2022-03-29
09:08:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2a9338d9346cebef9a184d919bbf0ed6 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 15/05/1953 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.5.202203091809 4 360319
199#0##0#0#0.0#2022-03-29
09:08:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
87a8fcc9aae619298abe4b4444255b92 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 02/09/1976 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.5.202203091809 4 360320
200#0##0#0#0.0#2022-03-29
09:09:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a6cf54c4b50d19688a98a551b3eb2c00 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 25/03/1978 0 2
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.5.202203091809 4 360321
201#0##0#0#0.0#2022-03-29
09:10:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7a6a7057b6fd52b973d6c4b851dea124 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 23/12/1977 0 2
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.5.202203091809 4 360322
202#0##0#0#0.0#2022-03-29
09:10:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
12121b142a182d9d50fa2a1af046f319 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 01/09/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V003603 0000639614597 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 360323 1#0##0#0#0.0#2022-03-29
09:11:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
713f97a03a23cf264839d43521dcb96e 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 07/04/1948 0 1
0 - 0 - 0 - 0 786200 677676 0 1
agung;3313092303950002; 5.6.5.202203091809 4 360324
1#0##0#0#0.0#2022-03-29
09:11:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
070e71c08e5b3c38eb4d801fea94f339 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 04/08/1948 0 1
0 - 0 - 0 - 0 786200 682053 0 1
agung;3313092303950002; 5.6.5.202203091809 4 360317
1#0##0#0#0.0#2022-03-29
09:07:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
420638c87422da25d3959a90c4b4a0ac 662676 0 0 0 0 0
0 0 0 0 15000 0 4377 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 07/08/1953 0 1
- 0 - 0 - 0 894800 234619 0 1 0
0 0 ABDULLAH M MUSAAD, TN 102592 68 25064 DR. ARIA CHANDRA
agung;3313092303950002; 5.6.5.202203091809 4 360548
206#0##0#0#0.0#2022-03-30
11:19:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
2b878508c5a4ce6e50408f1749201ed8 150000 0 0 0 0 0
0 0 0 0 15000 0 69619 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 09/07/1980 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SITI MUHAYATI., NY 052102 41 15231
3;JKN agung;3313092303950002; 5.6.5.202203091809 4 360518
207#0##0#0#0.0#2022-03-30
11:22:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
d48981e2f1027623957a287d0f1fa76a 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 14/12/1964 0 2
1 M53.19;M19.98 87.22 - - None None None None Z-3-26-0
None None None None None None PROSEDUR BESAR RADIOGRAFI 700800
0 0 - 0 - 0 - 0 - 0 700800 165000
0 1 0 0 0 RAHAYUNI 102591 57 20917 DR. ARIA
agung;3313092303950002; 5.6.5.202203091809 4 360590
5#0##0#0#0.0#2022-03-30
11:35:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
98826cb386db19806523293f75e66549 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 06/04/1976 0 2
1 G56.0;M19.98 88.21 - - None None None None G-5-17-0
None None None None None None PENYAKIT SARAF KRANIAL DAN SARAF PERIFER
LAIN-LAIN 242100 0 0 - 0 - 0 - 0 - 0
242100 479738 0 1 0 0 0 ISNDARTINI.NY 102551
0002704423048 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360547 1#0##0#0#0.0#2022-03-30
12:34:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2db9259ad464420bc0198fea76e43381 150000 0 0 0 0 0
248000 0 0 0 25000 0 56738 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 27/11/1999 0 1
1 R11;R51 - - - None None None None Q-5-25-0 None
- 0 - 0 - 0 - 0 135700 235406 0
1 0 0 0 ADNAN HARY SAPUTRO, SDR 102597 22 8151 DR.
GREETA 1124R0020322V003614 0000640069187 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361039 1#0##0#0#0.0#2022-04-04
17:38:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0e7262e555dcfa043a57409ee7bda0a5 180000 0 0 0 0 0
0 0 0 0 25000 0 30406 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 31/12/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 244948
0 1 0 0 0 NGATIYEM, NY 093762 71 26014 DR.
agung;3313092303950002; 5.6.5.202203091809 4 360519
209#0##0#0#0.0#2022-03-30
12:35:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
772dcd84a6cd6932a84ec59eafe5ac21 150000 0 0 0 0 0
0 0 0 0 15000 0 79948 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 31/12/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 199848
0 1 0 0 0 SUMARSIH, NY 070221 63 23092 DR.
novia;3313125201940001; 5.6.7.202204241238 4 360520
1#0##0#0#0.0#2022-05-19
09:54:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
27af52c6f5572e1b1c03d74afa29e254 150000 0 0 0 0 0
0 0 0 0 15000 0 34848 0 0 0 0 0
3372030 C 3 CP 2 22/03/2022 22/03/2022 20/02/1997 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MEGI ARUM.TN
0000565102956 3;JKN agung;3313092303950002; 5.6.5.202203091809 4
360300 211#0##0#0#0.0#2022-03-29
08:30:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8adf152c2fc11f992fc524b07d9ece2b 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 15/06/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 327401
0 1 0 0 0 YUNI HARIYATI, (NY) 014141 42 15622
novia;3313125201940001; 5.6.6.202203301209 4 360775
1#0##0#0#0.0#2022-04-04
10:17:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
07c2db74635362ca720299be44933656 150000 0 0 0 0 0
0 31845 0 0 15000 0 130556 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 31/12/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 429002
0 1 0 0 0 PARMI, NY 054631 47 17249 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 360776
1#0##0#0#0.0#2022-04-04
10:21:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c85e038502b5d1fb9dcfbe2896fd76b9 150000 0 0 0 0 0
0 108440 0 0 15000 0 155562 0 0 0 0
0
3372030 C 3 CP 2 23/03/2022 23/03/2022 31/12/1964 0 2
1 Z09.8;E11.4;G59.0;I10;E78.5 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
465610 0 1 0 0 0 MUJIYEM.NY 075280 57 20901
novia;3313125201940001; 5.6.7.202204241238 4 360777
1#0##0#0#0.0#2022-05-19
10:10:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
2521cc8d18c4a7509accb5009ce687cc 150000 0 0 0 0 0
0 76045 0 0 15000 0 224565 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 10/03/1979 0 1
0 0 - 0 - 0 - 0 - 0 181400
1160413 0 1 0 0 0 ADI PURNOMO,TN 060637 43
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 360780
1#0##0#0#0.0#2022-04-04
12:59:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2b6916fa5155c4dad1d485d81851dbe8 150000 0 0 0 0 0
0 31845 0 0 15000 0 963568 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 10/02/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 364918
0 1 0 0 0 SUKAMTI.NY 097604 66 24148 DR. INDRIANY
novia;3313125201940001; 5.6.6.202203301209 4 360781
1#0##0#0#0.0#2022-04-04
13:00:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f81fca7537893434d525836c8860424f 150000 0 0 0 0 0
0 120795 0 0 15000 0 79123 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 24/12/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI SUTANTI, NY
0000639837347 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
360753 1#0##0#0#0.0#2022-04-04
13:02:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
cf503c512a97521b3750a89a221923e1 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 07/09/1944 0 1
1 Z09.8;E11.2;N08.3;I10;G59.0 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
336800 0 1 0 0 0 RIDI SIRADA, TN 070004 77
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 360782
1#0##0#0#0.0#2022-04-04
13:03:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1072f402e3edc47c5ee5a1ec5b72458f 150000 0 0 0 0 0
0 76595 0 0 15000 0 95205 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 29/10/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 423216
0 1 0 0 0 SANTOSO. TN 038094 56 20599 DR. YUDHI
novia;3313125201940001; 5.6.6.202203301209 4 360783
1#0##0#0#0.0#2022-04-04
13:04:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e298d73e2ff7dbb00e126099c272b5e2 203000 0 0 0 0 0
0 0 0 0 15000 0 205216 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 30/12/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 240273
0 1 0 0 0 SUGIYARTI, NY 057165 60 21998 DR.
novia;3313125201940001; 5.6.6.202203301209 4 360784
1#0##0#0#0.0#2022-04-04
13:05:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e2ec23f44bc841a7f8e603b9eac80ecb 150000 0 0 0 0 0
0 31845 0 0 15000 0 43428 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 23/05/1983 0 1
0 0 - 0 - 0 - 0 - 0 181400 390520
0 1 0 0 0 FX DAVID MINARDI P.TN 097290 38 14184
novia;3313125201940001; 5.6.6.202203301209 4 360785
1#0##0#0#0.0#2022-04-04
13:06:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
789aac0caf33384a777f4472c7b282a5 150000 0 0 0 0 0
0 88900 0 0 15000 0 136620 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 04/02/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 284165
0 1 0 0 0 SUPONO 094778 58 21232 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 360786
1#0##0#0#0.0#2022-04-04
13:07:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
692b80f237fdad7ccc91203d696f2c4c 150000 0 0 0 0 0
0 76595 0 0 15000 0 42570 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 10/04/1958 0 2
1 Z09.8;K80.2;K76.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 275377
0 1 0 0 0 SRI HARTATI.NY 082567 63 23358 DR.
novia;3313125201940001; 5.6.6.202203301209 4 360787
1#0##0#0#0.0#2022-04-04
13:08:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
082122241b4c82913af99b77214f0083 150000 0 0 0 0 0
0 0 0 0 15000 0 110377 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 30/08/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 212591
0 1 0 0 0 JOKO WALUYO, TN 087929 61 22485 DR.
novia;3313125201940001; 5.6.6.202203301209 4 360788
1#0##0#0#0.0#2022-04-04
13:09:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8a628586a98911764d3dd65d9c3aac1f 150000 0 0 0 0 0
0 0 0 0 15000 0 47591 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 13/07/1951 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
293850 0 1 0 0 0 WORO AMIK SURATMI.NY 081670
0000089916322 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
360789 1#0##0#0#0.0#2022-04-04
13:10:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d38ccb63754b320e4b804da0d06c5630 150000 0 0 0 0 0
0 76595 0 0 15000 0 52255 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 23/03/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 208946
0 1 0 0 0 RUSTANTI,NY 095672 43 15706 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 360790
1#0##0#0#0.0#2022-04-04
13:11:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8d1830faa9026e176138e9b923421caf 150000 0 0 0 0 0
0 0 0 0 15000 0 43946 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 16/04/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 FAIZAH NY 087107 56 20795 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 360791
1#0##0#0#0.0#2022-04-04
13:12:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2d95e4e01e6cd12ab574c98239e42ad5 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 30/08/1971 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
313000 0 1 0 0 0 TRI JOKO AGUS SETYONO. TN 087817
0001103194596 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
360792 1#0##0#0#0.0#2022-04-04
13:13:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d8ca998d268b51aa56442ba0d727a95b 150000 0 0 0 0 0
0 107890 0 0 15000 0 40110 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 31/03/1971 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
465330 0 1 0 0 0 SITI ROCHANI.NY 101230 50
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 360793
1#0##0#0#0.0#2022-04-04
13:13:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1898120a5d73d20a5ee9cb3ce4dd7d3a 150000 0 0 0 0 0
0 108440 0 0 15000 0 191890 0 0 0 0
0
3372030 C 3 CP 2 23/03/2022 23/03/2022 19/08/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 339240
0 1 0 0 0 SUBIRIN 085162 79 29071 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 360794
1#0##0#0#0.0#2022-04-04
13:15:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c62f62f5d0697f0ef566bfa5b87505d7 150000 0 0 0 0 0
0 63690 0 0 15000 0 110550 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 23/07/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 421896
novia;3313125201940001; 5.6.6.202203301209 4 360795
1#0##0#0#0.0#2022-04-04
13:16:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
894aef57b6c73c14b062c5ea7f38aa41 150000 0 0 0 0 0
0 31845 0 0 15000 0 225051 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 08/09/1948 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
372460 0 1 0 0 0 SUNARMI, NY 073823 73 26859
novia;3313125201940001; 5.6.6.202203301209 4 360796
1#0##0#0#0.0#2022-04-04
13:17:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4cbab4284595f09b930790043c550fc0 150000 0 0 0 0 0
0 107890 0 0 15000 0 99570 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 24/04/1969 0 1
0 - 0 - 0 - 0 - 0 549400 919451
0 1 0 0 0 SUMARNO,TN 002176 52 19326 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 360774
1#0##0#0#0.0#2022-04-04
13:18:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8f9c6bca11ca91decd6e923a2e31343d 150000 0 0 0 0 0
680000 0 0 0 15000 0 74451 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 30/04/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 255701
0 1 0 0 0 DAYATNO, TN 054539 65 24068 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 360797
1#0##0#0#0.0#2022-04-04
13:18:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3551420ca39570d838ec8be69605bb7d 150000 0 0 0 0 0
0 0 0 0 15000 0 90701 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 05/09/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 548985
0 1 0 0 0 SUPARMI., NY 050493 55 20288 DR.
novia;3313125201940001; 5.6.6.202203301209 4 360798
1#0##0#0#0.0#2022-04-04
13:19:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3d6aaf1c19729eb022ff96db3eb41f8c 150000 0 0 0 0 0
0 120795 0 0 15000 0 263190 0 0 0 0
0
3372030 C 3 CP 2 23/03/2022 23/03/2022 16/06/1980 0 1
0 0 - 0 - 0 - 0 - 0 181400 239725
0 1 0 0 0 YUSRON FAHRUDY ATRINO, TN 101658 41
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 360800
1#0##0#0#0.0#2022-04-04
13:21:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
268564ff4bff747f40f83faf09a1055b 150000 0 0 0 0 0
0 0 0 0 15000 0 74725 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 01/12/1961 0 2
1 Z09.8;H81.3;G47.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 186552
0 1 0 0 0 MULYANI.NY 081886 60 22027 DR. INDRIANY
novia;3313125201940001; 5.6.6.202203301209 4 360801
1#0##0#0#0.0#2022-04-04
13:24:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5a8f4d57a4d4f566df87858754309b22 150000 0 0 0 0 0
0 0 0 0 15000 0 21552 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 08/02/1952 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
565185 0 1 0 0 0 MUNZIAH .NY 036544 70 25611
novia;3313125201940001; 5.6.6.202203301209 4 360802
1#0##0#0#0.0#2022-04-04
13:25:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4f51ea3540e681c02dbb92c13e41521d 150000 0 0 0 0 0
0 76045 0 0 15000 0 324140 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 31/12/1963 0 2
1 Z09.8;G43.1;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 190831
0 1 0 0 0 DAMIYATI, NY 093680 58 21267 DR.
novia;3313125201940001; 5.6.6.202203301209 4 360804
1#0##0#0#0.0#2022-04-04
13:27:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cf4cf39604d5bc177a55a9a40e4c6864 150000 0 0 0 0 0
0 0 0 0 15000 0 25831 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 29/11/1943 0 2
0 0 - 0 - 0 - 0 - 0 181400 414420
0 1 0 0 0 SUNARNI (NY) 051905 78 28604 DR.
novia;3313125201940001; 5.6.6.202203301209 4 360805
1#0##0#0#0.0#2022-04-04
13:27:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
045eaf581b4fe5eec0c44b72bff6047e 150000 0 0 0 0 0
0 0 0 0 15000 0 249420 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 07/04/1965 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
924716 0 1 0 0 0 WARTINI.,NY 075390 56 20804
novia;3313125201940001; 5.6.6.202203301209 4 360806
1#0##0#0#0.0#2022-04-04
13:28:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c2daa35719bd29ea485870dccf527f9c 150000 0 0 0 0 0
0 107890 0 0 15000 0 651826 0 0 0 0
0
3372030 C 3 CP 2 23/03/2022 23/03/2022 17/07/1978 0 2
0 - 0 - 0 - 0 183900 231680 0 1
0 0 0 RUWANI.NY 101744 43 15955 DR. GUNAWAN, SP.OG
1124R0020322V003667 0001530396178 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 360807 1#0##0#0#0.0#2022-04-04
13:30:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
68c9689108d136eb840edbfa93e95a36 200000 0 0 0 0 0
0 0 0 0 15000 0 16680 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 19/02/1957 0 2
1 Z09.8;E11.4;G59.0;I10;K30 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
297505 0 1 0 0 0 FRAN HARTUTI.NY 099240 65
3;JKN novia;3313125201940001; 5.6.7.202204241238 4 360808
1#0##0#0#0.0#2022-05-20
08:00:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
4eea4653314b8f01186a375c59edf0db 150000 0 0 0 0 0
0 76045 0 0 15000 0 56460 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 07/01/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 NANIK PARINI, NY
0001188329253 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
360755 1#0##0#0#0.0#2022-05-19
10:59:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
05d4507cfed0e162aa09eaafbd05f0d6 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 01/07/1951 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WARSINAH
1124R0020322V003671 0000087200616 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 360754 1#0##0#0#0.0#2022-05-19
11:11:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
bc97031d4c32a6982e543b34e01206cc 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 29/06/1997 0 2
0 0 - 0 - 0 - 0 - 0 181400 417590
0 1 0 0 0 RINA MAWAR WATI,NY 039296 24 9033
novia;3313125201940001; 5.6.7.202204241238 4 360809
1#0##0#0#0.0#2022-05-19
08:04:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
cb39bc9e791dd215998b6c75e1bd9a3d 150000 0 0 0 0 0
0 17745 0 0 15000 0 234845 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 20/08/1950 0 2
1 Z09.8;D64.8;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 203125
0 1 0 0 0 NINGSIH.NY 095531 71 26148 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 360810
1#0##0#0#0.0#2022-04-04
13:39:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d447810da69a8f1c3e71076d82c0c79b 150000 0 0 0 0 0
0 0 0 0 15000 0 38125 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 21/09/1944 0 1
1 Z09.8;N28.1;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 217601
0 1 0 0 0 BASUKI HARJO DARSONO, TN 069759 77
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 360811
1#0##0#0#0.0#2022-04-04
13:40:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
94237494a439baea5e282646b9930128 150000 0 0 0 0 0
0 0 0 0 15000 0 52601 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 22/08/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 280656
0 1 0 0 0 DYAH NURJANTI,(NY) 042222 74 27242
agung;3313092303950002; 5.6.7.202204241238 4 360812
1#0##0#0#0.0#2022-05-25
10:50:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
76fe5c8afbf2bc4b95ee6ac07c90d4a3 203000 0 0 0 0 0
0 0 0 0 15000 0 62656 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 30/08/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 361045
0 1 0 0 0 BIBIT BUDI RAHARJO., (BP) 041380 50
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 360813
1#0##0#0#0.0#2022-04-04
13:42:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a490ad78c111024ddb00821b609eb2c0 150000 0 0 0 0 0
0 31845 0 0 15000 0 164200 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 23/09/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 292312
0 1 0 0 0 DIAH NUR PAMILIYANTI.NY 084310 66 24288
novia;3313125201940001; 5.6.6.202203301209 4 360814
1#0##0#0#0.0#2022-04-04
13:42:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
48f2d9fe9f3dbf3f065612de1c25b0bd 150000 0 0 0 0 0
0 0 0 0 15000 0 127312 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 01/03/1965 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
319065 0 1 0 0 0 WINARTI., NY 045500 57
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 360815
1#0##0#0#0.0#2022-04-04
13:46:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bd0d374c5d50c290c945496f30938944 150000 0 0 0 0 0
0 120795 0 0 15000 0 33270 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 30/05/1997 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 WURI NUGRAHA DEWI.NN 100328 24 9063
novia;3313125201940001; 5.6.6.202203301209 4 360816
1#0##0#0#0.0#2022-04-04
13:51:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9005033fb263648cb797f4e917999959 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 06/02/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 222030
0 1 0 0 0 IWAN EDI SUTEMAN. TN 048724 53 19403
novia;3313125201940001; 5.6.6.202203301209 4 360817
1#0##0#0#0.0#2022-04-04
13:53:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
11aa4e52376f48b734e50f55ee0c25d9 150000 0 0 0 0 0
0 0 0 0 15000 0 57030 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 21/06/1978 0 1
1 Z09.8;B18.2 88.76 - - None None None None Z-3-23-0 None
0 - 0 - 0 - 0 - 0 549400 1131205
0 1 0 0 0 JUNIAR SETIAWAN.TN 093456 43 15981
novia;3313125201940001; 5.6.6.202203301209 4 360772
1#0##0#0#0.0#2022-04-04
13:54:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6a468bcaff49e6885bbcdd01c3d45149 300000 0 0 0 0 0
657000 89500 0 0 15000 0 69705 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 03/12/1950 0 1
0 - 0 - 0 - 0 786200 810810 0 1
novia;3313125201940001; 5.6.6.202203301209 4 360768
1#0##0#0#0.0#2022-04-04
13:55:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
883651f215e21e234270a69fd44c0875 463830 0 0 0 0 0
0 0 0 0 15000 0 331980 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 09/09/1944 0 1
0 - 0 - 0 - 0 786200 695936 0 1
SP.PD 1124R0020322V003684 0000100867893 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 360767 1#0##0#0#0.0#2022-04-04
13:56:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e14f9487c98b5bf73507cfb74521703b 662676 0 0 0 0 0
0 0 0 0 15000 0 18260 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 18/07/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V003685 0002425018184 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 360766 1#0##0#0#0.0#2022-04-04
13:56:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
19f4efac3fda7612ca7ad43402d7fbe7 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 31/12/1971 0 1
1 N18.9;E79.0 88.75 - - None None None None Z-3-23-0 None
0 - 0 - 0 - 0 - 0 549400 861930
0 1 0 0 0 SUKARDI, TN 102598 50 18345 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 360773
1#0##0#0#0.0#2022-04-04
13:57:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8d4f2ac0f70a3e9924a2d2f028bafad3 150000 0 0 0 0 0
680000 0 0 0 25000 0 6930 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 31/12/1981 0 2
0 - 0 - 0 - 0 786200 677676 0 1
novia;3313125201940001; 5.6.6.202203301209 4 360765
1#0##0#0#0.0#2022-04-04
13:58:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3620069a1b4a503833a9290ae971c8d9 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 02/02/1972 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V003688 0002070978546 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 360764 1#0##0#0#0.0#2022-04-04
13:59:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2321981dba26aaef9156c393a462d91d 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 18/01/1966 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 IVO MUMPUNI
1124R0020322V003689 0002169780873 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 360756 1#0##0#0#0.0#2022-04-04
14:00:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6199e7a2a8f57fba021cc6e179b9fce6 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 14/03/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.6.202203301209 4 360763
1#0##0#0#0.0#2022-04-04
13:58:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dab82a953c8216fd7efd0c4e50ce95d6 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 12/03/1955 0 2
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.6.202203301209 4 360771
1#0##0#0#0.0#2022-04-04
14:01:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6644cb9c2a8154710d6767192cfec88c 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 01/01/1977 0 1
0 - 0 - 0 - 0 786200 677676 0 1
SP.PD 1124R0020322V003692 0001147281805 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 360770 1#0##0#0#0.0#2022-04-04
14:01:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
75d4fa2c602ced4ee7c2d58de0729d5c 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 16/08/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TRI WINARNI, NY
0000640206066 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
360759 1#0##0#0#0.0#2022-05-19
12:32:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
b75fdded567f8553e6752b95a61bfc90 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 12/07/1966 0 1
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.6.202203301209 4 360769
1#0##0#0#0.0#2022-04-04
14:04:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0b9fc03fd12b39cc5a6c97eac850811a 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 25/03/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUPINAH 091220
0000639810066 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
360758 1#0##0#0#0.0#2022-04-04
14:05:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cb13abcd942e4c6e3319cb9fd3a866cf 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 15/09/1960 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TRI ATMODJO, TN
0001620260728 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
360750 1#0##0#0#0.0#2022-05-19
13:25:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
107d465abafc8e33627f8ad86112015a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 24/02/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI PURWANI.NY
0001125886228 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
360752 1#0##0#0#0.0#2022-04-04
14:11:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3871490b6335d50293ef97b360d79f21 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 30/09/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 349045
0 1 0 0 0 DIAN EKOWATI 092223 42 15515 DR.
novia;3313125201940001; 5.6.6.202203301209 4 360818
1#0##0#0#0.0#2022-04-04
14:12:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3813291a2748c62e44cfe4f7aebb6b51 150000 0 0 0 0 0
0 76045 0 0 15000 0 108000 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 09/04/1964 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 207500 0 1 0 0 0 AFIDA
SUSILOWATI.NY 084451 57 21167 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V003699 0002039166404 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 360762 1#0##0#0#0.0#2022-04-04
14:14:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a03ad6ff2c37c7e50ca0ebf95e1d2ad7 0 0 192500 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 07/10/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 YATINI 094257
0001083705715 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
360749 1#0##0#0#0.0#2022-04-04
14:18:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3cd7d83677258f9271b6d5a37e079583 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 02/03/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 531000 0 1 0 0 0 SUMARNI, NY 101618
0000089014184 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
360747 1#0##0#0#0.0#2022-04-04
14:18:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b9dd570215678d1d5a2fce59f8ac4ed7 516000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 01/05/1972 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MARIJAN.TN 101629
0002579827296 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
360761 1#0##0#0#0.0#2022-04-04
14:19:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
54a9deb3d4dc0f0560368bb620601f74 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 28/03/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MV SUMARNI, NY
0002209650344 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
360745 1#0##0#0#0.0#2022-05-19
12:41:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
89a87e11e43129ce501c656dcab4577c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 26/09/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 NUR HARYANTI, NY
0002611312075 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
360746 1#0##0#0#0.0#2022-04-04
14:22:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f712f1d968f9d15de48cdca6418b23af 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 12/04/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARIYAM.NY 084306
0001302703266 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
360743 1#0##0#0#0.0#2022-05-19
10:23:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
5e0599ac808282a810c812f8239d1d78 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 05/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 509000 0 1 0 0 0 DANIK KARTIKA
1124R0020322V003706 0001445069981 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 360751 1#0##0#0#0.0#2022-04-04
14:24:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bba6e1ab0b4f884242504714d2c447cd 494000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 13/08/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 TRI UTAMI
1124R0020322V003707 0001380313934 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 360744 1#0##0#0#0.0#2022-05-19
08:30:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
fc944d84cdf443fcbb3f82edb7325190 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 19/07/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 237315
0 1 0 0 0 ADELINO ISTIYARNO,(TN) 027250 63 23258
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 360819
1#0##0#0#0.0#2022-04-04
14:26:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
08337a4bf80b9165ca3d8303c8cf2661 150000 0 0 0 0 0
0 17745 0 0 15000 0 54570 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 31/12/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 489999
0 1 0 0 0 ONAH.NY 099763 60 21997 DR. YUDHI
novia;3313125201940001; 5.6.6.202203301209 4 360820
1#0##0#0#0.0#2022-04-04
14:27:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fe51572a5dd1934279ab16934b40bc35 203000 0 0 0 0 0
0 0 0 0 15000 0 271999 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 20/07/1978 0 1
1 S95.9 88.27 - - None None None None Q-5-41-0 None None
None None None None PENYAKIT AKUT BESAR LAIN-LAIN 289400 0 0
- 0 - 0 - 0 - 0 289400 413000 0
1 0 0 0 ARI BUNTARAN, TN 096672 43 15952 DR. DAMAR
ARYO, SP.B 1124R0020322V003711 0001104457555 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361236 1#0##0#0#0.0#2022-04-05
11:22:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5ab3d572c1ad06a63aabca12d90ce34a 150000 0 0 0 0 0
248000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 29/10/1984 0 2
0 0 - 0 - 0 - 0 - 0 181400 409240
0 1 0 0 0 OKTA TRIYATI, NY 094564 37 13659 DR.
novia;3313125201940001; 5.6.6.202203301209 4 360821
1#0##0#0#0.0#2022-04-04
14:35:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7153cff397e745db576c90cc7450ef52 150000 0 0 0 0 0
0 107890 0 0 15000 0 136350 0 0 0 0
0
3372030 C 3 CP 2 23/03/2022 23/03/2022 10/04/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 210581
0 1 0 0 0 TRISNO SUJARWADI.TN 098559 49 18244
novia;3313125201940001; 5.6.6.202203301209 4 360822
1#0##0#0#0.0#2022-04-04
14:36:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bc96d7c137ac4a313dc1f32189e5f407 150000 0 0 0 0 0
0 0 0 0 15000 0 45581 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 03/03/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 180000
0 1 0 0 0 SUDARYONO, TN 071022 72 26318 DR.
novia;3313125201940001; 5.6.6.202203301209 4 360823
1#0##0#0#0.0#2022-04-04
14:38:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b2ef1b7f1e9b32c79ebe5c23ada0cb0f 165000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 03/07/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 255110
0 1 0 0 0 MENIK ISTIYARSIH, NY 071741 52 19256
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 360824
1#0##0#0#0.0#2022-04-04
14:39:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b901b87c9c07aa453e72fde021b47dcf 150000 0 0 0 0 0
0 0 0 0 15000 0 90110 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 09/05/1975 0 1
0 0 - 0 - 0 - 0 - 0 181400 203770
0 1 0 0 0 HERI SUSANTO,TN 022986 46 17120 DR.
novia;3313125201940001; 5.6.6.202203301209 4 360825
1#0##0#0#0.0#2022-04-04
14:39:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1c9fc5b0bd0d38680a720f21caf065f3 150000 0 0 0 0 0
0 0 0 0 15000 0 38770 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 22/02/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 232830
0 1 0 0 0 SURUR, TN 010814 58 21214 DR. INDRIANY
novia;3313125201940001; 5.6.6.202203301209 4 360826
1#0##0#0#0.0#2022-04-04
14:40:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
50e975f2f1d145414d6149db1b792019 150000 0 0 0 0 0
0 0 0 0 15000 0 67830 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 24/01/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 277440
0 1 0 0 0 PARJONO, TN 045592 70 25626 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 360827
1#0##0#0#0.0#2022-04-04
14:41:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
586600e2e7c1fc88c39c1d699bed540b 150000 0 0 0 0 0
0 88950 0 0 15000 0 23490 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 14/04/1957 0 1
1 Z09.8;I64;R51;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 236241
0 1 0 0 0 AMIR HAUDI,(BP) 029404 64 23719 DR.
novia;3313125201940001; 5.6.6.202203301209 4 360828
1#0##0#0#0.0#2022-04-04
14:42:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9a72277632e3c2e04a1f5d1bef49c97d 150000 0 0 0 0 0
0 0 0 0 15000 0 71241 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 19/02/1956 0 2
0 - 0 - 0 - 0 283800 629865 0 1
0 0 0 TUMINAH.NY 093575 66 24139 DRG. VERAWATY, SP.KG
1124R0020322V003720 0002344311246 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 360829 1#0##0#0#0.0#2022-05-19
12:39:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
503b02bd8f7e738c1b585e294df2cfc9 600000 0 0 0 0 0
0 0 0 0 15000 0 14865 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 08/06/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 176850
0 1 0 0 0 DHINI HERLIANI 068420 42 15629 DR.
novia;3313125201940001; 5.6.6.202203301209 4 360830
1#0##0#0#0.0#2022-04-04
14:45:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
502cf7c11a64ad6993a2dfff141280ba 150000 0 0 0 0 0
0 0 0 0 15000 0 11850 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 19/01/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 191452
0 1 0 0 0 SARJIYATI.NY 102548 62 22709 DR.
novia;3313125201940001; 5.6.6.202203301209 4 360831
1#0##0#0#0.0#2022-04-04
14:47:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
11ddd715104de4a4678cc826d3cd6800 150000 0 0 0 0 0
0 0 0 0 15000 0 26452 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 24/02/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 250750
0 1 0 0 0 EKO SUNARTI,(NY) 036950 55 20116 DR.
novia;3313125201940001; 5.6.6.202203301209 4 360832
1#0##0#0#0.0#2022-04-04
14:48:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ddd1ef80b369b81440b947553f977004 150000 0 0 0 0 0
0 0 0 0 15000 0 85750 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 19/09/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 265840
0 1 0 0 0 NGADIRIN,(BP) 033627 61 22465 DR.
novia;3313125201940001; 5.6.6.202203301209 4 360833
1#0##0#0#0.0#2022-04-04
14:48:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3eb4d06a39f31cdccb766bd6f6f9ee03 150000 0 0 0 0 0
0 0 0 0 15000 0 100840 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 15/06/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 339061
0 1 0 0 0 SAIMI MULYODIHARJO, NY 064553 72 26579
novia;3313125201940001; 5.6.6.202203301209 4 360834
1#0##0#0#0.0#2022-04-04
14:49:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3982719f08a936678510d5a34746856a 203000 0 0 0 0 0
0 0 0 0 15000 0 121061 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 17/08/1951 0 1
1 Z09.8;M54.59;G62.8 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 198320
0 1 0 0 0 MULYONO., BP 049765 70 25786 DR.
novia;3313125201940001; 5.6.6.202203301209 4 360835
1#0##0#0#0.0#2022-04-04
14:50:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b6509770e4d5db49495eadc0d7ad9333 150000 0 0 0 0 0
0 0 0 0 15000 0 33320 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 31/12/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 194865
0 1 0 0 0 SRI SUWANTI, NY 091754 63 23093 DR.
novia;3313125201940001; 5.6.6.202203301209 4 360836
1#0##0#0#0.0#2022-04-04
14:51:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
afe7b0cd725c7472076cb14400df399a 150000 0 0 0 0 0
0 0 0 0 15000 0 29865 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 02/09/1998 0 1
0 0 - 0 - 0 - 0 - 0 181400 192916
0 1 0 0 0 IVAN SEPTIANO INDRO WINARNO, SDR 057208
23 8603 DR. INDRIANY WIDHOWATY, SP.S, SP.AK 1124R0020322V003729
0000638961377 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
360837 1#0##0#0#0.0#2022-04-04
14:53:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cbb1186849790df6042dd335ebd82ad2 150000 0 0 0 0 0
0 0 0 0 15000 0 27916 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 30/01/1972 0 2
1 G56.0 - - - None None None None G-5-17-0 None None
None None None None PENYAKIT SARAF KRANIAL DAN SARAF PERIFER LAIN-LAIN
242100 0 0 - 0 - 0 - 0 - 0 242100
191220 0 1 0 0 0 WARTINAH, NY 070774 50
0001698220146 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
360838 1#0##0#0#0.0#2022-04-04
14:54:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
75f0043c1b4385747d165d5f43a0867d 150000 0 0 0 0 0
0 0 0 0 15000 0 26220 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 28/10/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 253296
0 1 0 0 0 TEMU MUJIYEM, NY 097662 66 24253 DR.
novia;3313125201940001; 5.6.6.202203301209 4 360840
1#0##0#0#0.0#2022-04-04
14:56:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d581a5a3dab6c238e4f50f3cc026b9ce 150000 0 0 0 0 0
0 0 0 0 15000 0 88296 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 20/06/1938 0 2
0 0 - 0 - 0 - 0 - 0 181400 210693
0 1 0 0 0 SUPARTI, NY 090064 83 30592 DR. INDRIANY
novia;3313125201940001; 5.6.6.202203301209 4 360839
1#0##0#0#0.0#2022-04-04
14:56:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d82c2436d99783cb02019bfd94a1d039 150000 0 0 0 0 0
0 0 0 0 15000 0 45693 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 31/12/1996 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 360841
1#0##0#0#0.0#2022-04-04
14:57:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d2b9039826944a15abce28b70a726788 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 30/12/1958 0 1
0 - 0 - 0 - 0 283800 325000 0 1
0 0 0 RAHMAT MARGIONO.TN 102552 63 23094 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 360842
1#0##0#0#0.0#2022-04-04
14:58:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
83fd3caa9968eb950fefbafb33ee4285 300000 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 27/02/1987 0 2
- 0 - 0 - 0 - 0 283800 615000 0
1 0 0 0 RAHMAWATY,(NY) 035918 35 12808 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 360843
1#0##0#0#0.0#2022-04-04
14:59:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e75df4b7a82cdcca1119629a6560e119 600000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 16/09/1967 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 LASIYANTO, (BP) 008459 54 19912 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 360844
1#0##0#0#0.0#2022-04-04
14:59:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f30fbb007be98c6cece55e634006338d 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 16/11/2000 0 2
0 - 0 - 0 - 0 283800 190750 0 1
0 0 0 DAHLIA PUTRI EVIATASARI.NN 102477 21 7797 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 360845
1#0##0#0#0.0#2022-04-04
15:02:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4a46bc5209ad7badc4f7aa178b9c184e 150000 0 0 0 0 0
0 0 0 0 15000 0 25750 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 12/11/1993 0 1
- 0 - 0 - 0 - 0 283800 165000 0
1 0 0 0 MUHAMMAD ABDUL KHAFID.TN 102151 28 10358
novia;3313125201940001; 5.6.6.202203301209 4 360846
1#0##0#0#0.0#2022-04-04
15:03:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9d8f6b8cb232b706c79635b7a9bb2be6 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 15/02/1981 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ACHMAD CHUZAINURI.TN 102152 41 15011 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 360847
1#0##0#0#0.0#2022-04-04
15:03:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
534565b5945094fc2fa67600f5c0eca1 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 20/11/1986 0 1
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.6.202203301209 4 360848
1#0##0#0#0.0#2022-04-04
15:04:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
14d2b27232026e74fbc3386f4c231ea3 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 31/08/1962 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI HARTINA
1124R0020322V003743 0001958592576 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 360748 1#0##0#0#0.0#2022-04-04
15:06:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
786a9bdde4ac1899e301c24c2818ecb8 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 29/05/1976 0 2
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.6.202203301209 4 360849
1#0##0#0#0.0#2022-04-04
15:09:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
424f956c8423f3e9e02853c2a89bb84f 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 31/05/1975 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RINA SULISTYANINGSIH.NY 100582 46 17098 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 360850
1#0##0#0#0.0#2022-04-04
15:10:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b643673f50f109f77b42f605e268a1a0 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 23/07/1972 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 TRI YULIARTI 001163 49 18140 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 360851
1#0##0#0#0.0#2022-04-04
15:11:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5128399e50ac3a026b1ae50b09b64f50 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 01/01/2000 0 2
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.6.202203301209 4 360852
1#0##0#0#0.0#2022-04-04
15:11:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
75ea9ad6102d90b44e65fa19c856908d 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 03/01/1979 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MARJANAH, NY 101603 43 15785 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 360853
1#0##0#0#0.0#2022-04-04
15:12:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d044737e8636b64796005367bf246027 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 27/08/1981 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 IKA PUJIASTUTI, NY 016888 40 14818 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 360854
1#0##0#0#0.0#2022-04-04
15:17:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cf57cac9cbc159fd22d048881f935b18 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 02/09/2000 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 DEA AL VERINA HARYANTO.nn 100381 21 7872
novia;3313125201940001; 5.6.6.202203301209 4 360855
1#0##0#0#0.0#2022-04-04
15:18:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5d0e78f468b042b851e0d57727720641 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 30/05/2004 0 1
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.6.202203301209 4 360856
1#0##0#0#0.0#2022-04-04
15:19:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c5430d446c42f88883a809e50911733a 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 14/06/1993 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ISNAINI FARIDA ., NY 054684 28 10509 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 360857
1#0##0#0#0.0#2022-04-04
15:19:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
724fd7cf63014eeb93c403c00a4da37c 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 08/03/1993 0 1
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.6.202203301209 4 360858
1#0##0#0#0.0#2022-04-04
15:24:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b835e80afd81d7aefe2398394a3c1bb1 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 23/12/1971 0 2
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.6.202203301209 4 360859
1#0##0#0#0.0#2022-04-04
15:27:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7d7395b4832bace8fe360aec70c3840b 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 09/11/1971 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SUHASTI,(NY) 038243 50 18397 DRG.
novia;3313125201940001; 5.6.7.202204241238 4 360860
1#0##0#0#0.0#2022-05-19
08:02:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
1ca2417eb7c79c03805d398958cff1e6 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 06/10/1993 0 1
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.6.202203301209 4 360861
1#0##0#0#0.0#2022-04-04
15:50:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2a9d2b979bb895ceff4b91af1b8a3ec6 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 28/11/1968 0 2
0 - 0 - 0 - 0 283800 325000 0 1
0 0 0 SUMARNI.NY 102550 53 19473 DRG. VERAWATY, SP.KG
1124R0020322V003757 0001692891279 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 360862 1#0##0#0#0.0#2022-04-04
15:50:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
801729bf9cc8aaa6ee25fa023a559578 300000 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 28/03/2012 0 1
1 K59.0 - - - None None None None K-5-18-0 None None
0 0 - 0 - 0 - 0 - 0 242100 202775
0 1 0 0 0 DAFFA PUTRA C,.AN 059500 9 3647 DR.
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 360863
1#0##0#0#0.0#2022-04-04
15:51:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c350669ea5ede523a8450c1d5c98c98b 150000 0 0 0 0 0
0 0 0 0 15000 0 37775 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 01/01/2000 0 1
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 DAMAR ARIO SEMPURNO. DR, BP 043584 22 8117 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 360864
1#0##0#0#0.0#2022-04-04
15:52:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0b0665d4094dc5ce16a91b8ec6af8198 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 21/01/1970 0 2
1 I10;G44.2 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 219580
0 1 0 0 0 PRIHARTANTI.NY 102556 52 19054 DR.
novia;3313125201940001; 5.6.6.202203301209 4 360865
1#0##0#0#0.0#2022-04-04
15:54:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
73d7ffcc8372559ab62b40a7796e1ba3 150000 0 0 0 0 0
0 0 0 0 25000 0 44580 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 05/10/2000 0 1
0 - 0 - 0 - 0 283800 325000 0 1
0 0 0 AZIIZ ABRIANTO.SDR 102557 21 7839 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 360866
1#0##0#0#0.0#2022-04-04
15:54:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
58bed89c11a658f70985c4eac92c3cb5 300000 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 02/02/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 206071
0 1 0 0 0 YEKTI MAWARINI.,NY 052365 51 18677
novia;3313125201940001; 5.6.6.202203301209 4 360867
1#0##0#0#0.0#2022-04-04
15:56:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eb37c23f401c82255fc39e19b2458b6f 150000 0 0 0 0 0
0 0 0 0 15000 0 41071 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 08/10/1982 0 2
- 0 - 0 - 0 - 0 283800 165000 0
1 0 0 0 YOVIKA OKTORIANA, (NY) 010284 39 14411 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 360868
1#0##0#0#0.0#2022-04-04
15:57:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a0c40f82ad9e12d00a5806fb2f5c64ee 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 21/12/1978 0 2
- 0 - 0 - 0 - 0 283800 115000 0
novia;3313125201940001; 5.6.6.202203301209 4 360869
1#0##0#0#0.0#2022-04-04
15:57:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5872a2c3996686fb9df9e9724644164b 100000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 25/06/2000 0 2
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.6.202203301209 4 360870
1#0##0#0#0.0#2022-04-04
15:58:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0329aa867d474ee2e125292f7ade99d4 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 06/06/1992 0 2
- 0 - 0 - 0 - 0 283800 352150 0
1 0 0 0 YUNITA DEWI SUSILOWATI.NY 102457 29 10882
novia;3313125201940001; 5.6.6.202203301209 4 360871
1#0##0#0#0.0#2022-04-04
15:59:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
07701f40da8ca4f321dc874d3ef57292 300000 0 0 0 0 0
0 0 0 0 15000 0 37150 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 21/01/2007 0 1
- 0 - 0 - 0 - 0 283800 175590 0
novia;3313125201940001; 5.6.6.202203301209 4 360872
1#0##0#0#0.0#2022-04-04
16:02:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
04630402ab6abd62a88835371a6fcfd4 150000 0 0 0 0 0
0 0 0 0 15000 0 10590 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 27/07/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 180000
0 1 0 0 0 DJAMILAH.NY 091951 62 22885 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 360873
1#0##0#0#0.0#2022-04-04
16:02:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fddb037dd3036bab6ba363b0ac5f6249 165000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 01/01/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 208921
0 1 0 0 0 RAHAYU SRI LESTARI,NY 028311 44 16152
novia;3313125201940001; 5.6.6.202203301209 4 360874
1#0##0#0#0.0#2022-04-04
16:03:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5d921a97bf7cad27ae2e5d277e07052f 150000 0 0 0 0 0
0 0 0 0 15000 0 43921 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 07/01/2010 0 2
0 0 - 0 - 0 - 0 - 0 181400 175000
0 1 0 0 0 FAIRUZ ZAHIRAH, AN 080818 12 4458
0000194162466 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
360875 1#0##0#0#0.0#2022-04-04
16:06:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
de49dbd90f3efdc89ee87e3bafa1868c 150000 0 0 0 0 0
0 0 0 0 15000 0 10000 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 07/04/1970 0 2
1 Z09.8;R51;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 194551
0 1 0 0 0 TARSINI.NY 102282 51 18978 DR. INDRIANY
novia;3313125201940001; 5.6.6.202203301209 4 360876
1#0##0#0#0.0#2022-04-04
16:07:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cdca24e36e59958c78d2b4d3f0b3b5ec 150000 0 0 0 0 0
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3372030 C 3 CP 2 23/03/2022 23/03/2022 04/11/1994 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 RAUHULLOH
1124R0020322V003779 0001796644269 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 360760 1#0##0#0#0.0#2022-04-04
16:08:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
87d7dace21c18409826df1463f5dbdf1 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 14/03/1988 0 2
1 R10.4;K80.2 88.76 - - None None None None Z-3-23-0 None
0 - 0 - 0 - 0 - 0 549400 936181
0 1 0 0 0 RETNO WIDIASTUTI, NY 086236 34 12427
reni;3313147010930001; 5.6.6.202203301209 4 361241
1#0##0#0#0.0#2022-04-05
11:26:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d48aaec8b75de2660b72a801bd4b3a1b 150000 0 0 0 0 0
657000 0 0 0 15000 0 114181 0 0 0 0
0
3372030 C 3 CP 2 23/03/2022 23/03/2022 28/08/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 173748
0 1 0 0 0 RUKMINI, NY 099276 68 25044 DR. INDRIANY
novia;3313125201940001; 5.6.6.202203301209 4 360877
1#0##0#0#0.0#2022-04-04
16:09:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
93727d6a2819751b706481d1a72736f5 150000 0 0 0 0 0
0 0 0 0 15000 0 8748 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 11/10/1980 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 KANTHI NUGROHO.TN 101351 41 15138 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 360878
1#0##0#0#0.0#2022-04-04
16:10:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0f5f541a62423e49f0921a944277d679 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 25/02/2015 0 1
1 T14.1;W01.0 96.59 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 324564 0 1
0 0 0 AZKA NASHWAN PRADIPA., AN 048468 7 2583 DR.
SUROSO 1124R0020322V003785 0001901513417 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361041 1#0##0#0#0.0#2022-04-04
17:39:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aaf405a86372261612526de24ea0f602 215000 0 0 0 0 0
0 0 0 0 15000 0 94564 0 0 0 0 0
3372030 C 3 CP 2 23/03/2022 23/03/2022 10/06/1994 0 1
None None None None PENYAKIT AKUT BESAR LAIN-LAIN 289400 0 0
- 0 - 0 - 0 - 0 289400 216116 0
1 0 0 0 LOLA VITALOKA, NY 102604 27 10148 DR. SUROSO
1124R0020322V003786 0002367533103 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361043 1#0##0#0#0.0#2022-04-04
18:19:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
503758b9d3eb6a9dda4495629be6be32 140000 0 0 0 0 0
0 0 0 0 25000 0 51116 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 25/05/1962 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
530105 0 1 0 0 0 SUKAMTO, TN 00799 59 21853 DR.
reni;3313147010930001; 5.6.6.202203301209 4 360909
1#0##0#0#0.0#2022-04-04
14:30:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
11914b28e4e6746a2e80a1b100bd0e84 0 0 138000 0 0 0
0 120745 0 0 15000 0 256360 0 0 0 0
0
3372030 C 3 CP 2 24/03/2022 24/03/2022 01/01/1966 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
910911 0 1 0 0 0 ANI NUR ISNAINI , NY 000522
0001282247122 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
360910 1#0##0#0#0.0#2022-04-04
14:31:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b67b6b81f0b516d11e3214e31c3891a5 0 0 138000 0 0 0
0 120745 0 0 15000 0 637166 0 0 0 0
0
3372030 C 3 CP 2 24/03/2022 24/03/2022 28/08/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 204630
0 1 0 0 0 SLAMET RUDI SETYAWAN, TN 000730 57
3;JKN reni;3313147010930001; 5.6.6.202203301209 4 360911
1#0##0#0#0.0#2022-04-04
14:32:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
da68bb9aa90c75dbbfd8192751c55ef8 0 0 138000 0 0 0
0 0 0 0 15000 0 51630 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 04/07/1974 0 1
0 0 - 0 - 0 - 0 - 0 181400 285795
0 1 0 0 0 SAMSURI 075141 47 17430 DR. TEKY
reni;3313147010930001; 5.6.6.202203301209 4 360912
1#0##0#0#0.0#2022-04-04
14:33:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f9ed7062b95be1678c8fb3ae447e75c1 150000 0 0 0 0 0
0 120795 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 15/01/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 189080
0 1 0 0 0 SITI RAHAYU, NY 084960 71 26001 DR.
reni;3313147010930001; 5.6.6.202203301209 4 360913
1#0##0#0#0.0#2022-04-04
14:34:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
992efa77bbb5db738512f0c6f842edaf 0 0 138000 0 0 0
0 0 0 0 15000 0 36080 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 31/12/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 188220
0 1 0 0 0 MUJIYEM.NY 075280 57 20902 DR. WAHYU
novia;3313125201940001; 5.6.7.202204241238 4 360914
1#0##0#0#0.0#2022-05-19
10:10:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
f11e9dd119e9b0207ff34121cbc78732 0 0 138000 0 0 0
0 0 0 0 15000 0 35220 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 13/08/1960 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
609161 0 1 0 0 0 SUYATNO.TN 084110 61 22503
reni;3313147010930001; 5.6.6.202203301209 4 360915
1#0##0#0#0.0#2022-04-04
14:35:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b6ffd47eaf943f63cf006d2d919b1bca 150000 0 0 0 0 0
0 121345 0 0 15000 0 322816 0 0 0 0
0
3372030 C 3 CP 2 24/03/2022 24/03/2022 28/04/1944 0 1
0 404900 200575 0 1 0 0 0 KURDI., BP 052526
0001448254978 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
360918 1#0##0#0#0.0#2022-04-04
14:48:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
779e08dd8a5119b9d9df7ce1dc6fecbf 0 0 138000 0 0 0
0 0 0 0 15000 0 47575 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 09/09/1999 0 1
0 0 - 0 - 0 - 0 - 0 181400 198200
0 1 0 0 0 ROBERTUS BALONG, SDR 102018 22 8232
reni;3313147010930001; 5.6.6.202203301209 4 360919
1#0##0#0#0.0#2022-04-04
14:49:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4f2cb11e313a9d81ffa3089856c8bccf 0 0 138000 0 0 0
0 0 0 0 15000 0 45200 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 30/12/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 197122
0 1 0 0 0 NURYATI.NY 084776 71 26017 DR. WAHYU
reni;3313147010930001; 5.6.6.202203301209 4 360920
1#0##0#0#0.0#2022-04-04
14:49:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2886f4e29bd2e9919549a1c23d903794 0 0 138000 0 0 0
0 0 0 0 15000 0 44122 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 23/01/1993 0 2
1 Z09.0;O03.4 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 206680
0 1 0 0 0 NUR AINI PUTRI UTAMI, NY 102492 29
10652 DR. GUNAWAN, SP.OG 1124R0020322V003803 0000639911518 3;JKN
reni;3313147010930001; 5.6.6.202203301209 4 360921
1#0##0#0#0.0#2022-04-04
14:50:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e5e168d894a5eb16ae7d28f39fd15c32 0 0 184000 0 0 0
0 0 0 0 15000 0 7680 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 03/07/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 187552
0 1 0 0 0 LESTARI ., NY 058610 60 22179 DR.
reni;3313147010930001; 5.6.6.202203301209 4 360922
1#0##0#0#0.0#2022-04-04
14:51:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
acdd12f059b52677a3ba603f7f3d9ecb 0 0 138000 0 0 0
0 0 0 0 15000 0 34552 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 18/11/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 180930
0 1 0 0 0 TUMINI.NY 096460 67 24598 DR. WAHYU
reni;3313147010930001; 5.6.6.202203301209 4 360923
1#0##0#0#0.0#2022-04-04
14:51:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e4eb09cc35078a13ee3fa6a7d15dc122 0 0 138000 0 0 0
0 0 0 0 15000 0 27930 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 05/10/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 320245
0 1 0 0 0 SRIATI.NY 090794 53 19528 DR. TEKY
reni;3313147010930001; 5.6.6.202203301209 4 360924
1#0##0#0#0.0#2022-04-04
14:52:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8eaaf35fd718a72e3b6348918e3ccf7c 150000 0 0 0 0 0
0 76045 0 0 15000 0 79200 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 09/03/1963 0 1
0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 RIYANTO.TN 102562 59 21565 DR. OEDJANG
agung;3313092303950002; 5.6.6.202203301209 4 360925
1#0##0#0#0.0#2022-04-11
12:08:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
b3ae9f33e35855ddbe9b96a699b0c8a3 150000 0 0 0 0 0
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3372030 C 3 CP 2 24/03/2022 24/03/2022 17/12/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 804541
0 1 0 0 0 DJUMIKEM,(NY) 016184 58 21282 DR.
reni;3313147010930001; 5.6.6.202203301209 4 360926
1#0##0#0#0.0#2022-04-04
14:52:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c05457c85f33666a5da9f5e554be3623 150000 0 0 0 0 0
0 120795 0 0 15000 0 518746 0 0 0 0
0
3372030 C 3 CP 2 24/03/2022 24/03/2022 20/03/1958 0 1
1 Z09.8;I10;E78.5;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 331181
reni;3313147010930001; 5.6.6.202203301209 4 360927
1#0##0#0#0.0#2022-04-04
14:53:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c193ece815e2208a200208a675b76fe3 150000 0 0 0 0 0
0 133700 0 0 15000 0 32481 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 04/06/1950 0 2
1 Z09.8;E11.2;N08.3;G59.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 646118
0 1 0 0 0 FAUZIAH NASUTION, NY 058142 71 26226
reni;3313147010930001; 5.6.6.202203301209 4 360928
1#0##0#0#0.0#2022-04-04
14:54:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b905099c3f9725c76fbe4f123d32b89c 150000 0 0 0 0 0
0 76595 0 0 15000 0 404523 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 30/01/1975 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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14:54:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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1#0##0#0#0.0#2022-04-04
14:59:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.6.6.202203301209 4 360931
1#0##0#0#0.0#2022-04-04
14:59:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.6.6.202203301209 4 360932
1#0##0#0#0.0#2022-04-04
15:00:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.6.6.202203301209 4 360933
1#0##0#0#0.0#2022-04-04
15:01:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.6.6.202203301209 4 360934
1#0##0#0#0.0#2022-04-04
15:01:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.6.6.202203301209 4 360935
1#0##0#0#0.0#2022-04-04
15:02:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/03/2022 24/03/2022 31/12/1944 0 2
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reni;3313147010930001; 5.6.6.202203301209 4 360936
1#0##0#0#0.0#2022-04-04
15:02:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/03/2022 24/03/2022 09/06/1962 0 1
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1#0##0#0#0.0#2022-04-04
15:03:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.6.6.202203301209 4 360938
1#0##0#0#0.0#2022-04-04
15:03:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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1#0##0#0#0.0#2022-04-04
16:12:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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1#0##0#0#0.0#2022-04-04
16:13:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.6.6.202203301209 4 360958
1#0##0#0#0.0#2022-04-04
16:14:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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1#0##0#0#0.0#2022-04-04
16:19:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.6.6.202203301209 4 360960
1#0##0#0#0.0#2022-04-04
16:20:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/03/2022 24/03/2022 04/08/1955 0 2
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1#0##0#0#0.0#2022-04-04
16:20:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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1#0##0#0#0.0#2022-04-04
16:21:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/03/2022 24/03/2022 03/07/1963 0 2
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agung;3313092303950002; 5.6.6.202203301209 4 360963
1#0##0#0#0.0#2022-04-04
16:23:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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novia;3313125201940001; 5.6.7.202204241238 4 360966
1#0##0#0#0.0#2022-05-19
11:11:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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1#0##0#0#0.0#2022-04-04
16:25:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 24/03/2022 24/03/2022 07/01/1973 0 2
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novia;3313125201940001; 5.6.7.202204241238 4 360965
1#0##0#0#0.0#2022-05-19
10:59:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 24/03/2022 24/03/2022 15/11/1951 0 2
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agung;3313092303950002; 5.6.6.202203301209 4 360969
1#0##0#0#0.0#2022-04-04
16:31:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/03/2022 24/03/2022 16/06/1954 0 1
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agung;3313092303950002; 5.6.6.202203301209 4 360970
1#0##0#0#0.0#2022-04-04
16:31:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/03/2022 24/03/2022 03/08/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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360971 1#0##0#0#0.0#2022-04-04
16:32:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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1#0##0#0#0.0#2022-05-20
11:32:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 24/03/2022 24/03/2022 09/11/1965 0 2
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agung;3313092303950002; 5.6.6.202203301209 4 360974
1#0##0#0#0.0#2022-04-04
16:37:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/03/2022 24/03/2022 04/03/1957 0 1
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agung;3313092303950002; 5.6.6.202203301209 4 360975
1#0##0#0#0.0#2022-04-04
16:38:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/03/2022 24/03/2022 21/09/1970 0 1
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agung;3313092303950002; 5.6.6.202203301209 4 360976
1#0##0#0#0.0#2022-04-04
16:38:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/03/2022 24/03/2022 23/11/1960 0 1
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181400 558012 0 1 0 0 0 ABADI SANTOSO. TN 093266
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360977 1#0##0#0#0.0#2022-04-04
16:39:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/03/2022 24/03/2022 05/06/1976 0 1
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agung;3313092303950002; 5.6.6.202203301209 4 360978
1#0##0#0#0.0#2022-04-04
16:40:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/03/2022 24/03/2022 28/09/1973 0 2
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agung;3313092303950002; 5.6.6.202203301209 4 360979
1#0##0#0#0.0#2022-04-04
16:41:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/03/2022 24/03/2022 25/05/1965 0 2
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agung;3313092303950002; 5.6.6.202203301209 4 360985
1#0##0#0#0.0#2022-04-04
16:46:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/03/2022 24/03/2022 18/06/1948 0 1
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1#0##0#0#0.0#2022-04-04
16:47:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/03/2022 24/03/2022 31/10/1955 0 1
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agung;3313092303950002; 5.6.6.202203301209 4 360987
1#0##0#0#0.0#2022-04-04
16:47:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/03/2022 24/03/2022 17/01/1940 0 2
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1#0##0#0#0.0#2022-05-20
09:31:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 24/03/2022 24/03/2022 20/07/1957 0 2
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1#0##0#0#0.0#2022-04-04
16:49:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/03/2022 24/03/2022 15/05/1972 0 2
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agung;3313092303950002; 5.6.6.202203301209 4 360990
1#0##0#0#0.0#2022-04-04
16:50:29#0#00:00:01#00:00:01#22:20:16#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/03/2022 24/03/2022 11/06/1953 0 2
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agung;3313092303950002; 5.6.6.202203301209 4 360991
1#0##0#0#0.0#2022-04-04
16:56:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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16:57:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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1#0##0#0#0.0#2022-04-04
17:00:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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1#0##0#0#0.0#2022-04-04
17:01:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3d585e05deb604d6e0ff490ba40dbe1d 150000 0 0 0 0 0
0 107890 0 0 15000 0 71921 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 19/06/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 192770
0 1 0 0 0 ENDANG TRININGSIH, NY 091052 66 24385
agung;3313092303950002; 5.6.6.202203301209 4 361000
1#0##0#0#0.0#2022-04-04
17:03:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9fa31194a9f99378514c02b654faebe8 0 0 138000 0 0 0
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3372030 C 3 CP 2 24/03/2022 24/03/2022 22/05/1982 0 2
0 - 0 - 0 - 0 - 0 296400 215785
0 1 0 0 0 SARNI,NY 061908 39 14551 DR. GUNAWAN,
SP.OG 1124R0020322V003858 0000639312017 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 361013 1#0##0#0#0.0#2022-04-11
12:10:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
0138761433efde838294e1f64668fe39 0 0 138000 0 0 0
0 0 0 0 15000 0 62785 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 20/12/1944 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
400174 0 1 0 0 0 SLAMET ATMO,(BP) 037900 77
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 361014
1#0##0#0#0.0#2022-04-05
10:56:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
721034efefd5f8f74fa49083e57cc3c6 150000 0 0 0 0 0
0 107890 0 0 15000 0 127284 0 0 0 0
0
3372030 C 3 CP 2 24/03/2022 24/03/2022 19/01/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 279267
0 1 0 0 0 ZAHRATUN, NY 102369 55 20153 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361016
1#0##0#0#0.0#2022-04-05
10:57:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
517627489149762f6d175e5451ac632e 150000 0 0 0 0 0
0 0 0 0 15000 0 114267 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 20/08/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 181847
0 1 0 0 0 SUSI ARMINI, NY 087738 62 22862 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361017
1#0##0#0#0.0#2022-04-05
10:57:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
513754d84c39a271ca77b35aa4c2425c 0 0 138000 0 0 0
0 0 0 0 15000 0 28847 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 10/07/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 345683
0 1 0 0 0 UMUL KHOIRIYAH, NY 090348 52 19250
agung;3313092303950002; 5.6.6.202203301209 4 361018
1#0##0#0#0.0#2022-04-05
10:58:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3bae419b6a4d32c89b93bbad04ff237b 150000 0 0 0 0 0
0 88900 0 0 15000 0 91783 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 31/12/1963 0 1
1 Z09.8;E11.2;N08.3;I10;H81.3 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
488297 0 1 0 0 0 DALIYO NURWAHID., BP 041210
0000565072615 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361019 1#0##0#0#0.0#2022-04-05
10:58:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
01e0f2594e90578c63db92d3c8078d90 150000 0 0 0 0 0
0 63690 0 0 15000 0 259607 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 22/09/1959 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMARSONO ,TN
0001032587199 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
360741 1#0##0#0#0.0#2022-05-19
10:44:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
2169ee71da968b89b2a37e789e6c0e28 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 05/03/1944 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SANTOSO. TN 088783
0000091319657 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361020 1#0##0#0#0.0#2022-04-05
12:15:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9a303f9559ebd9c2b3c9abc3a1fd85d7 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 03/05/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 443587
0 1 0 0 0 TRISMITO.TN 085192 54 20049 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 361021
1#0##0#0#0.0#2022-04-05
11:00:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
30617b60a207cc256916c9968ea18672 150000 0 0 0 0 0
0 120795 0 0 15000 0 157792 0 0 0 0
0
3372030 C 3 CP 2 24/03/2022 24/03/2022 20/10/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 432652
0 1 0 0 0 SITI TARTINI ., NY 056182 66 24262
agung;3313092303950002; 5.6.6.202203301209 4 361022
1#0##0#0#0.0#2022-04-05
11:00:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
459f52bcb94096f4b6abd3d4f3571c90 150000 0 0 0 0 0
200000 0 0 0 15000 0 67652 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 27/10/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 187081
0 1 0 0 0 HENDRASTUTI.NY 085849 72 26446 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361024
1#0##0#0#0.0#2022-04-05
11:01:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6e1a735819cc70bf456947f79ba00637 150000 0 0 0 0 0
0 0 0 0 15000 0 22081 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 02/07/1996 0 2
0 - 0 - 0 - 0 - 0 296400 218030
0 1 0 0 0 AVITTA ARJULIANITA, NY 101792 25 9396
agung;3313092303950002; 5.6.6.202203301209 4 361025
1#0##0#0#0.0#2022-04-05
11:02:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4d24384e7d2254a27d627c2896ede925 0 0 184000 0 0 0
0 0 0 0 15000 0 19030 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 21/05/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 203467
0 1 0 0 0 SUTRISNO, TN 088415 62 22953 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361026
1#0##0#0#0.0#2022-04-05
11:02:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
69f59728e5e1e4cecaa85481c4c6e0e5 150000 0 0 0 0 0
0 0 0 0 15000 0 38467 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 01/06/1944 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUJINEM,NY 086697
0000091171091 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361027 1#0##0#0#0.0#2022-04-05
11:03:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dc237a884b32ca71185bce4e0a109d22 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 02/06/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 198062
0 1 0 0 0 SRI PARTINI.NY 084088 54 20019 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361028
1#0##0#0#0.0#2022-04-05
11:03:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2c4303b05eb35f1f5209172c5fd5708a 0 0 138000 0 0 0
0 0 0 0 15000 0 45062 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 01/07/1957 0 2
1 Z09.4;S82.20;V29.9 93.57;96.59;88.27 - - None None None
None Z-3-27-0 None None None None None None PERAWATAN LUKA 183900
0 0 - 0 - 0 - 0 - 0 183900 445700
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agung;3313092303950002; 5.6.6.202203301209 4 361029
1#0##0#0#0.0#2022-04-05
11:04:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e84b0d9d42e63d75b218563079f6a1ea 0 0 138000 0 0 0
248000 0 0 0 25000 0 34700 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 28/03/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 199910
0 1 0 0 0 MV SUMARNI, NY 094104 64 23737 DR.
novia;3313125201940001; 5.6.7.202204241238 4 361030
1#0##0#0#0.0#2022-05-19
12:42:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
e1fc444886132a9f8c12ab4c5d64f599 0 0 138000 0 0 0
0 0 0 0 15000 0 46910 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 26/09/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 204630
0 1 0 0 0 NUR HARYANTI, NY 072077 62 22825 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361031
1#0##0#0#0.0#2022-04-05
11:05:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
86233cb0f5ca59c9b54062faa796b1de 0 0 138000 0 0 0
0 0 0 0 15000 0 51630 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 17/03/2005 0 2
0 0 - 0 - 0 - 0 - 0 181400 208702
0 1 0 0 0 MARCA ROHMAHNASYROH U.AN 025380 17
agung;3313092303950002; 5.6.6.202203301209 4 361032
1#0##0#0#0.0#2022-04-05
11:06:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dc8420fc1c7dd2f0cc295cac4910805c 150000 0 0 0 0 0
0 0 0 0 15000 0 43702 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 05/03/1985 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DIAN USWATUN
1124R0020322V003879 0000977864152 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 361033 1#0##0#0#0.0#2022-04-05
11:06:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d0a168593398c21aac8ed97f9d59c1ad 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 02/03/1941 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DIYAH 101274
0000091192274 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361034 1#0##0#0#0.0#2022-04-05
11:07:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8f3999eb7ce42ee8d62a0c6991c819fa 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 16/02/2007 0 1
0 0 - 0 - 0 - 0 - 0 181400 190500
0 1 0 0 0 NICO SAPUTRA.AN 101118 15 5515 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361035
1#0##0#0#0.0#2022-04-05
11:07:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
40c5ffabdb5ed40412a52435fa86b958 0 0 138000 0 0 0
0 0 0 0 15000 0 37500 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 03/02/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 205590
0 1 0 0 0 SUMARSIH,NY 085983 67 24521 DR. WAHYU
agung;3313092303950002; 5.6.6.202203301209 4 361036
1#0##0#0#0.0#2022-04-05
11:08:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3de94f095af73227d78283ffd9a87079 0 0 138000 0 0 0
0 0 0 0 15000 0 52590 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 13/08/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 455160
novia;3313125201940001; 5.6.7.202204241238 4 361037
1#0##0#0#0.0#2022-05-19
08:32:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
d06a9c0d168f290241fb1b1b8a2c8803 0 0 138000 0 0 0
248000 0 0 0 15000 0 54160 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 28/10/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 185030
0 1 0 0 0 MARUTA TIRANA,(BP) 040357 77 28271
agung;3313092303950002; 5.6.6.202203301209 4 361038
1#0##0#0#0.0#2022-04-05
11:09:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
47ff2896ef8487fa877139b8c7a1102d 0 0 138000 0 0 0
0 0 0 0 15000 0 32030 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 25/02/1972 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 FRANS POKAREM.TN
0001032586479 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361248 1#0##0#0#0.0#2022-04-05
11:11:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3580142a6de621e437227309bd6c390c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 12/05/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 312265
0 1 0 0 0 ULFA RINASTRI.NY 003391 44 16387 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361042
1#0##0#0#0.0#2022-04-05
11:12:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
186df3e4effdb1825794d481b85ddc7f 150000 0 0 0 0 0
0 120795 0 0 15000 0 26470 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 27/03/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 214631
0 1 0 0 0 SUHARTO JOKO.P (BP) 050087 67 24834
agung;3313092303950002; 5.6.6.202203301209 4 361046
1#0##0#0#0.0#2022-04-05
11:13:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2b6d2c6a3d1678c5a6de7f382fe1b7bf 150000 0 0 0 0 0
0 0 0 0 15000 0 49631 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 05/08/2002 0 2
0 0 - 0 - 0 - 0 - 0 181400 228641
0 1 0 0 0 RIZKY AULIA AGUSTIN.NN 102303 19 7171
agung;3313092303950002; 5.6.6.202203301209 4 361048
1#0##0#0#0.0#2022-04-05
11:13:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
43d965be18803538d7a99b518948c399 150000 0 0 0 0 0
0 0 0 0 15000 0 63641 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 21/08/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 256660
0 1 0 0 0 WASINGATUN ,(NY) 042540 53 19573 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361050
1#0##0#0#0.0#2022-04-05
11:14:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8b6b3cf91cbdc1126079855bc3e8d235 150000 0 0 0 0 0
0 31845 0 0 15000 0 59815 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 02/03/1964 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 SRI SUKARMINI, NY 059077 58 21206 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361052
1#0##0#0#0.0#2022-04-05
11:15:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
948b6e57e1a9f90ee9ba0454a2be926c 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 31/12/1963 0 2
0 - 0 107400 262000 0 1 0 0 0
INDRAYATI, NY 091755 58 21268 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V003896 0002926021015 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 361054 1#0##0#0#0.0#2022-05-19
11:09:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
01dd1d8a8ba7a5b26ea859b3f9af2e5d 247000 0 0 0 0 0
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3372030 C 3 CP 2 24/03/2022 24/03/2022 18/02/1942 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DARTINAH,NY 030952
0001021779674 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361056 1#0##0#0#0.0#2022-04-05
11:17:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0a77057447c2bc17661b3d2139c0019d 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 27/07/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 MELANIA RIWIS WIJAYANTI., NY 000303 54
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 361255
1#0##0#0#0.0#2022-04-05
11:19:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ae6aeba5b0be9e192bf23d95cad1762b 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 18/06/1953 0 2
0 - 0 107400 262000 0 1 0 0 0
WIDIJARNI, NY 095042 68 25116 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V003899 0000091364973 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 361058 1#0##0#0#0.0#2022-04-05
11:19:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f5f84bb527650ab7e94de143b9cc8a18 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 30/08/1961 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 RIA TRI RASMANI.
0001729980966 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361059 1#0##0#0#0.0#2022-04-05
11:20:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
73880a9bbd0a7c17af51dcc5d53238c3 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 05/03/1979 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI WULAN.NY
0001286475028 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361060 1#0##0#0#0.0#2022-04-05
11:21:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0c02d98085216a927033507d65345c92 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 19/02/1957 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 FRAN HARTUTI.NY 099240 65 23774 DR.
novia;3313125201940001; 5.6.7.202204241238 4 361061
1#0##0#0#0.0#2022-05-20
08:01:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
95ded9a36e56c241076f287e5e12ada0 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 01/12/1944 0 2
1 Z09.8;R47.1 93.35;93.39 - - None None None None M-3-16-0
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 219000 0 1 0 0 0 WANTIYEM.NY 078888
0000640044099 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361063 1#0##0#0#0.0#2022-04-05
11:31:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
99a13f8b91d510917246267da7dab843 204000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 27/08/2018 0 2
0 0 - 0 - 0 - 0 - 0 181400 181807
0 1 0 0 0 QIANDRA ZASKIA PUTRI GUNAWAN. AN 077668
3 1305 DR. ANI SURYANTI WISYASTUTI, SP.A., M.KES 1124R0020322V003905
0002486121546 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361064 1#0##0#0#0.0#2022-04-05
11:32:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a3fadcca964e610372c4a6ffc12116db 150000 0 0 0 0 0
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3372030 C 3 CP 2 24/03/2022 24/03/2022 28/07/2015 0 2
0 0 - 0 - 0 - 0 - 0 181400 192957
0 1 0 0 0 KHAYLA DIONITA AZZAHRA, AN 060764 6
0001873560363 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361065 1#0##0#0#0.0#2022-04-05
11:32:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4cdcd5604312ce89e40e80869c6666d0 150000 0 0 0 0 0
0 0 0 0 15000 0 27957 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 25/12/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WAHJUNINGSIH
1124R0020322V003908 0001647209711 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 361066 1#0##0#0#0.0#2022-04-05
11:33:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
02ad148022089f397ced16373be18b11 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 06/06/1974 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 UMI NAFIAH. NY
0001662154896 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361067 1#0##0#0#0.0#2022-04-05
11:34:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7f092a7fb8aca3b225628eb830ee6d84 258000 0 0 0 0 0
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3372030 C 3 CP 2 24/03/2022 24/03/2022 24/11/1970 0 2
0 - 0 - 0 - 0 183900 293456 0 1
0 0 0 NANIK RUSMAGAWATI, NY 056283 51 18748 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361068
1#0##0#0#0.0#2022-04-05
11:34:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
78ded4926ea9215795f0e85962608260 235000 0 0 0 0 0
0 0 0 0 15000 0 43456 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 20/04/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 225830
0 1 0 0 0 DWI PURNOMO SIGIT ., BP 054206 49 18235
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 361069
1#0##0#0#0.0#2022-04-05
11:35:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9da1ae27d59ec8c92c78a5673fca2276 150000 0 0 0 0 0
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3372030 C 3 CP 2 24/03/2022 24/03/2022 16/12/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 196140
0002463219077 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361070 1#0##0#0#0.0#2022-04-05
11:36:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
12ea6fc43c6ab3cbdde7f9790923d096 150000 0 0 0 0 0
0 0 0 0 15000 0 31140 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 05/06/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 198740
agung;3313092303950002; 5.6.6.202203301209 4 361071
1#0##0#0#0.0#2022-04-05
11:36:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
850542d2b3bfab223ada70ecfbee156b 150000 0 0 0 0 0
0 0 0 0 15000 0 33740 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 06/06/1950 0 2
1 Z09.8;I69.3;M53.19;M19.98 81.92 - - None None None None
M-3-11-0 None None None None None None PROSEDUR DIAGNOSTIK DAN
TERAPEUTIK MUSKULOSKELETAL 404900 0 0 - 0 - 0 -
0 - 0 404900 389640 0 1 0 0 0
SUTARMI (NY) 025332 71 26224 DR. ARIA CHANDRA GTS, SP.S., M.KES
1124R0020322V003917 0000091177738 3;JKN agung;3313092303950002;
5.6.7.202204241238 4 361072 1#0##0#0#0.0#2022-06-17
15:23:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
01d74e0cb93073bcd1d944a869e5ac4d 150000 0 0 0 0 0
0 0 0 0 15000 0 224640 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 18/08/1943 0 1
0 0 - 0 - 0 - 0 - 0 181400 268260
0 1 0 0 0 MARNO RAHARJO, BP 054909 78 28708 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361073
1#0##0#0#0.0#2022-04-05
12:38:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5e459fd8df20e188c77ce1d70233b4df 150000 0 0 0 0 0
0 0 0 0 15000 0 103260 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 31/12/1971 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V003919 0000555344774 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 361074 1#0##0#0#0.0#2022-04-05
12:39:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
be3f7f831ad26855f664b65b25dde0d1 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 23/03/1976 0 2
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361075
1#0##0#0#0.0#2022-04-05
12:40:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b5d99343292a1bc024f5e0879cded493 463830 0 0 0 0 0
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3372030 C 3 CP 2 24/03/2022 24/03/2022 25/04/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 271785
0 1 0 0 0 MUGIYATI.NY 102301 56 20787 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 361076
1#0##0#0#0.0#2022-04-05
12:41:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
31c906034aee30e53f3a890dcd7e928d 150000 0 0 0 0 0
0 0 0 0 15000 0 106785 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 17/04/1973 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361077
1#0##0#0#0.0#2022-04-05
12:52:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
36b4a108201d361a24a50c34ef1a8c5b 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 15/10/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361079
1#0##0#0#0.0#2022-04-05
12:52:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f14e52850547d1623939ff2a2ad42493 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 22/10/1959 0 2
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361080
1#0##0#0#0.0#2022-04-05
12:53:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
90fa4c229f6ea9230c42565859f6a134 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 10/12/1982 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361081
1#0##0#0#0.0#2022-04-05
12:54:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ce5e39e4739d1c6596a5ff358467f37d 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 03/08/1963 0 2
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361082
1#0##0#0#0.0#2022-04-05
12:54:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7b13d5872d889bc79305f342eb0d17a3 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 12/10/1987 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361083
1#0##0#0#0.0#2022-04-05
12:55:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1e7c51c0e054cda998668b8243a1abaa 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 04/05/1958 0 2
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361084
1#0##0#0#0.0#2022-04-05
12:55:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
551856497d7a8cc5dd830e26f79c0ae3 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 10/07/1955 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V003930 0001032581823 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 361085 1#0##0#0#0.0#2022-04-05
12:56:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5cecf1835cd4e62687f4443d0f8adf74 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 04/09/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361086
1#0##0#0#0.0#2022-04-05
12:57:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1ea467a505ba85850400de21f9eb631c 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 31/12/1935 0 2
0 0 - 0 - 0 - 0 - 0 181400 278049
0 1 0 0 0 PAIDJEM, NY 071271 86 31495 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 361087
1#0##0#0#0.0#2022-04-05
12:57:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4cfab365ac9bdd1293c513d95df94394 150000 0 0 0 0 0
0 0 0 0 15000 0 113049 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 31/12/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 249416
0 1 0 0 0 SRI ISWATIYARSI, NY 057875 66 24190
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 361088
1#0##0#0#0.0#2022-04-05
13:05:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c22e649a7987bcc351b1c02c0bf704b8 150000 0 0 0 0 0
0 0 0 0 15000 0 84416 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 30/12/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 231956
0 1 0 0 0 RABIJEM NY 070138 73 26747 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 361089
1#0##0#0#0.0#2022-04-05
13:06:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7f152e670525361696ceaf4304728dae 150000 0 0 0 0 0
0 0 0 0 15000 0 66956 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 16/10/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 202095
0 1 0 0 0 NANIK MASLICHAH,B.A, NY 091595 61 22439
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 361090
1#0##0#0#0.0#2022-04-05
13:07:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a4007a71e4fcc5ea36621673f2b0c4ac 0 0 138000 0 0 0
0 0 0 0 15000 0 49095 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 25/10/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 299867
0 1 0 0 0 SUWARNI.NY 087525 52 19143 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 361091
1#0##0#0#0.0#2022-04-05
13:08:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
718f40d176e540b0e0564138c6feb04f 150000 0 0 0 0 0
0 0 0 0 15000 0 134867 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 29/03/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 184505
0 1 0 0 0 AGNES WIDHA THESIANA, NY 090586 48
0002168632721 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361092 1#0##0#0#0.0#2022-04-05
13:10:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6d609c66bdde83bf42f2964a0a51c7d7 0 0 138000 0 0 0
0 0 0 0 15000 0 31505 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 20/07/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 237150
0 1 0 0 0 IKE YULIANA LESTARI.NY 101491 43 15953
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 361093
1#0##0#0#0.0#2022-04-05
13:13:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bf0d58da77816447a827b82c3bc22a79 150000 0 0 0 0 0
0 0 0 0 15000 0 72150 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 13/06/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 210385
0 1 0 0 0 DINI CAHYANINGRUM, NY 098174 42 15625
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 361094
1#0##0#0#0.0#2022-04-05
13:13:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
469c67d62f2b2790b6d3d451d69371ff 0 0 138000 0 0 0
0 0 0 0 15000 0 57385 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 07/05/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 214155
0 1 0 0 0 SUGIYATI.NY 101341 62 22967 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 361095
1#0##0#0#0.0#2022-04-05
13:18:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
df4d5fede43e58f53ad0f8cc1f6dfdde 0 0 138000 0 0 0
0 0 0 0 15000 0 61155 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 24/01/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 204643
0 1 0 0 0 PUJI AMBAR RUSTAMI, NY 085163 56 20513
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 361096
1#0##0#0#0.0#2022-04-05
13:19:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eb333147da7c1dcf076ac4a64b436375 0 0 138000 0 0 0
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3372030 C 3 CP 2 24/03/2022 24/03/2022 18/11/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 202095
0 1 0 0 0 SRI WAHYUNI,NY 079969 56 20580 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361097
1#0##0#0#0.0#2022-04-05
13:20:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5a8005ccbb976391dee803faaf949dbf 0 0 138000 0 0 0
0 0 0 0 15000 0 49095 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 17/04/1946 0 1
0 0 - 0 - 0 - 0 - 0 181400 207955
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 361098
1#0##0#0#0.0#2022-04-05
13:21:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7baafe7d6947d33c57a7778c10fa0a27 0 0 138000 0 0 0
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3372030 C 3 CP 2 24/03/2022 24/03/2022 02/08/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 219775
0 1 0 0 0 SUTARNO, TN 048927 70 25802 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 361099
1#0##0#0#0.0#2022-04-05
13:22:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
00c08052829e6ea4e298bd648bab2ebe 0 0 138000 0 0 0
0 0 0 0 15000 0 66775 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 31/12/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 203790
0 1 0 0 0 SAPTO WAHYUNINGSIH.NY 090819 50 18346
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 361100
1#0##0#0#0.0#2022-04-05
13:22:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
95cfd6592058660fb2accb7e939c5729 0 0 138000 0 0 0
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3372030 C 3 CP 2 24/03/2022 24/03/2022 03/04/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 249134
0 1 0 0 0 RUNTIANA.NY 092827 51 18983 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 361101
1#0##0#0#0.0#2022-04-05
13:23:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b717434fb67e74cfa5984b3743a21da0 0 0 138000 0 0 0
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3372030 C 3 CP 2 24/03/2022 24/03/2022 06/08/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 262220
0 1 0 0 0 JOKO ASTUTI.TN 072601 54 19954 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361102
1#0##0#0#0.0#2022-04-05
13:24:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a40ef8f19e960f55846e37444fee6d49 0 0 138000 0 0 0
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3372030 C 3 CP 2 24/03/2022 24/03/2022 28/02/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 268780
0 1 0 0 0 SAJINO ,BP 084992 74 27053 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 361103
1#0##0#0#0.0#2022-04-05
13:24:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d05e3101f1870a62e25d8369f1aa2e41 0 0 138000 0 0 0
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3372030 C 3 CP 2 24/03/2022 24/03/2022 07/10/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 208980
0 1 0 0 0 NUR LASMI, NY 072492 51 18796 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361104
1#0##0#0#0.0#2022-04-05
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3372030 C 3 CP 2 24/03/2022 24/03/2022 09/05/1949 0 1
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1#0##0#0#0.0#2022-04-05
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3372030 C 3 CP 2 24/03/2022 24/03/2022 10/08/1962 0 2
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3372030 C 3 CP 2 24/03/2022 24/03/2022 09/11/1955 0 2
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1#0##0#0#0.0#2022-04-05
13:46:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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1#0##0#0#0.0#2022-04-05
13:47:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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13:48:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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1#0##0#0#0.0#2022-04-05
13:48:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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1#0##0#0#0.0#2022-04-05
13:49:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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1#0##0#0#0.0#2022-04-05
13:50:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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13:52:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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1#0##0#0#0.0#2022-04-05
13:52:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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13:55:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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13:55:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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13:56:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/03/2022 24/03/2022 07/07/1964 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 254000 0 1 0 0 0 WIRADI.TN 098841
0000640484785 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361145 1#0##0#0#0.0#2022-04-05
14:07:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7e1893f0e1b67c3c95c4bf441c43f15f 239000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 08/12/1976 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 NIKEN MARDUSASI, NY 068192 45 16542
agung;3313092303950002; 5.6.6.202203301209 4 361146
1#0##0#0#0.0#2022-04-05
14:10:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
722862248c74d2c177182c7c962f6f5c 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 17/03/1976 0 1
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 BAMBANG ARIANTO A, SDR 100192 46 16808 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361148
1#0##0#0#0.0#2022-04-05
14:11:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0c387b09e7a28e1d11a58e93c5dfd30e 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 05/01/1951 0 1
0 - 0 - 0 - 0 - 0 138400 285000
novia;3313125201940001; 5.6.7.202204241238 4 361149
1#0##0#0#0.0#2022-05-19
09:08:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
e746922438bea9af59eb0af78836314b 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 15/05/1976 0 1
0 0 - 0 - 0 - 0 - 0 181400 367456
0 1 0 0 0 SLAMET SANTOSO.TN 098523 45 16749 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361150
1#0##0#0#0.0#2022-04-05
14:13:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d15211910268edb1c3a411d7826e8a92 0 0 138000 0 0 0
0 0 0 0 15000 0 214456 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 14/05/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 338734
0 1 0 0 0 SUTIYO, (BP) 041113 51 18942 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361151
1#0##0#0#0.0#2022-04-05
14:14:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
95028f87b91c1f931ad369c2edbcef8a 0 0 138000 0 0 0
0 0 0 0 15000 0 185734 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 12/03/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 201475
0 1 0 0 0 WURYANI.NY 098600 50 18274 DR. ANITA
agung;3313092303950002; 5.6.6.202203301209 4 361155
1#0##0#0#0.0#2022-04-05
14:15:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
451b8f97497c4d498ff4608f1752bd12 0 0 138000 0 0 0
0 0 0 0 15000 0 48475 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 05/02/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 171219
0 1 0 0 0 SURATI, NY 041300 55 20136 DR. ANITA
agung;3313092303950002; 5.6.6.202203301209 4 361156
1#0##0#0#0.0#2022-04-05
14:16:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9562c6bb75bff92e877fb99c7809c757 0 0 138000 0 0 0
0 0 0 0 15000 0 18219 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 01/09/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 334623
0 1 0 0 0 SUNARTI, NY 055969 61 22484 DR. ANITA
agung;3313092303950002; 5.6.6.202203301209 4 361157
1#0##0#0#0.0#2022-04-05
14:17:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
13bbcbfa555288a4c16aa8dc59cfabdf 0 0 138000 0 0 0
0 0 0 0 15000 0 181623 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 16/05/1975 0 1
0 - 0 - 0 - 0 - 0 181400 338941
0 1 0 0 0 ANTO HERI SANTOSO, BP 084336 46 17114
agung;3313092303950002; 5.6.6.202203301209 4 361158
1#0##0#0#0.0#2022-04-05
14:17:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
76b329d09478e261648a43329d05ec1f 203000 0 0 0 0 0
0 0 0 0 15000 0 120941 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 30/08/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 185374
0 1 0 0 0 SRI MURNI BUKARI,NY 095710 79 29061
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 361159
1#0##0#0#0.0#2022-04-05
14:18:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
edb5e9335c86e69c2e9eb7205c6f80e2 0 0 138000 0 0 0
0 0 0 0 15000 0 32374 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 26/05/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 353656
0 1 0 0 0 SRI REJEKI,NY 010002 59 21852 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361160
1#0##0#0#0.0#2022-04-05
14:19:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cc182d506d75f5579180e5af18f80899 0 0 138000 0 0 0
0 0 0 0 15000 0 200656 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 13/06/1992 0 2
1 Z09.8;J45.9;R11 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 356241
0001084671257 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
361161 1#0##0#0#0.0#2022-05-19
09:47:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
c45c138de180160df57853d11f77f0e5 0 0 138000 0 0 0
0 0 0 0 15000 0 203241 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 02/04/1969 0 2
1 Z09.8;H26.9;H35.0;E11.3;H36.0;H04.1 90.29 - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 280656 0 1 0 0 0 IN GUNTARI.NY 101766
0001328469377 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361163 1#0##0#0#0.0#2022-04-05
14:24:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
98bc1b037281d0e6d9f18604773160c5 203000 0 0 0 0 0
0 0 0 0 15000 0 62656 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 26/02/1957 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
280656 0 1 0 0 0 RAMELAN, BP 066059 65 23767
agung;3313092303950002; 5.6.6.202203301209 4 361165
1#0##0#0#0.0#2022-04-05
14:25:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
14e8cc5dfffc19d7c00c37efe797d626 203000 0 0 0 0 0
0 0 0 0 15000 0 62656 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 21/06/1966 0 2
1 Z09.8;J47;K21.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 180485
0 1 0 0 0 BAYU SRI BUDINIGSIH.NY 077444 55 20365
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 361166
1#0##0#0#0.0#2022-04-05
14:26:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
38b6b4d2a2a149c1afe566081d1e9dd1 0 0 138000 0 0 0
0 0 0 0 15000 0 27485 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 17/02/1977 0 2
1 Z09.8;A15.6;M79.18 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 174505
0 1 0 0 0 TWOTIK ERVINAWATI.NY 077975 45 16471
3;JKN agung;3313092303950002; 5.6.7.202204241238 4 361167
1#0##0#0#0.0#2022-06-17
15:26:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
d7c918e98a02286730a080c975b00000 0 0 138000 0 0 0
0 0 0 0 15000 0 21505 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 13/10/1974 0 1
0 0 - 0 - 0 - 0 - 0 181400 224904
0 1 0 0 0 DIDIK SUHARMANTO, TN 092544 47 17329
agung;3313092303950002; 5.6.6.202203301209 4 361168
1#0##0#0#0.0#2022-04-05
14:27:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
14b4d9439a2da74e8727838df7c52325 150000 0 0 0 0 0
0 0 0 0 15000 0 59904 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 09/05/1969 0 2
1 N39.0;R10.4 - - - None None None None Q-5-40-0 None
None None None None None INFEKSI SALURAN KEMIH AKUT 126600 0
0 - 0 - 0 - 0 - 0 126600 213139
0 1 0 0 0 WELLY UNGARANTI.NY 102568 52 19312
agung;3313092303950002; 5.6.6.202203301209 4 361170
1#0##0#0#0.0#2022-04-05
14:27:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
33d0dfddd2ec4f266229e7ea161d0d2d 150000 0 0 0 0 0
0 0 0 0 25000 0 38139 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 29/06/1997 0 2
0 0 - 0 - 0 - 0 - 0 181400 184710
0 1 0 0 0 RINA MAWAR WATI,NY 039296 24 9034
novia;3313125201940001; 5.6.7.202204241238 4 361172
1#0##0#0#0.0#2022-05-19
08:04:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
6d3fb699f4ebe3f362e7bc963fe306df 150000 0 0 0 0 0
0 0 0 0 15000 0 19710 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 05/01/1900 0 2
0 0 - 0 - 0 - 0 - 0 181400 444880
0 1 0 0 0 GUWANTI LAKSMI.,NY 074915 122 44638
3;JKN reni;3313147010930001; 5.6.6.202203301209 4 361244
1#0##0#0#0.0#2022-04-05
11:30:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5b00e4b57820bdbb3daf54190978cdef 0 0 138000 0 0 0
248000 0 0 0 15000 0 43880 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 12/03/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 249160
0 1 0 0 0 PURWANTI.NY 102468 54 19735 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 361175
1#0##0#0#0.0#2022-04-05
14:28:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e308f4dc7f8b76983e92ea46a9e92ad1 150000 0 0 0 0 0
0 0 0 0 15000 0 84160 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 21/07/2003 0 1
0 - 0 - 0 - 0 183900 192840 0 1
0 0 0 AVIN ROHMAD WIDODO,SDR 102494 18 6821 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361177
1#0##0#0#0.0#2022-04-05
14:29:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fb37e589aebf9497144be8e6e5be20d8 150000 0 0 0 0 0
0 0 0 0 15000 0 27840 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 29/04/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400
1232673 0 1 0 0 0 TITIK PERMANI.NY 084313 63
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 361178
1#0##0#0#0.0#2022-04-05
14:30:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ae240ad3860301c8220db114d12702f6 150000 0 0 0 0 0
0 0 0 0 15000 0 1067673 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 15/03/1956 0 1
1 I10;I20.9 87.49 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 371638
0 1 0 0 0 SUPARJO.TN 102570 66 24115 DR. TEKY
reni;3313147010930001; 5.6.6.202203301209 4 361245
1#0##0#0#0.0#2022-04-05
11:30:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2f906d7fa5f8e7b5a4737423acd9675b 0 0 138000 0 0 0
200000 0 0 0 25000 0 8638 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 21/12/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 200488
0 1 0 0 0 TUTIK PRASETYOWATI.NY 085295 47 17260
agung;3313092303950002; 5.6.6.202203301209 4 361179
1#0##0#0#0.0#2022-04-05
14:30:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cda26a7efbe5f1ea18082a85414f70bc 150000 0 0 0 0 0
0 0 0 0 15000 0 35488 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 08/04/1964 0 1
0 - 0 - 0 - 0 786200 728520 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361180
1#0##0#0#0.0#2022-04-05
14:32:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
56f73d9ba101ef7a1a0e6c5cf9ff9bfc 463830 0 0 0 0 0
0 0 0 0 15000 0 249690 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 09/05/1975 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V004030 0001105378571 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 361181 1#0##0#0#0.0#2022-04-05
14:33:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
249fcd43c32feb81d633e0e6beed1563 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 28/08/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 218500
0 1 0 0 0 SUSI EVIANTI, NY 084098 50 18471 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361182
1#0##0#0#0.0#2022-04-05
14:33:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8d6b157d4a3e787ce6b2eafc8a84fe38 150000 0 0 0 0 0
0 0 0 0 15000 0 53500 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 12/12/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361183
1#0##0#0#0.0#2022-04-05
14:34:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
12d07f5f30154020ec3603c59ba1fa48 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 08/10/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 248356
0 1 0 0 0 SUWITO, TN 089176 60 22082 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 361184
1#0##0#0#0.0#2022-04-05
14:34:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
98fb58c6d078dd973e23b22158a8e48b 0 0 138000 0 0 0
0 0 0 0 15000 0 95356 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 31/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 246665
0 1 0 0 0 WARSINI, NY 095108 67 24555 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 361185
1#0##0#0#0.0#2022-04-05
14:35:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ee206fd97c188eb0b76fd6976aed7cc3 0 0 138000 0 0 0
0 0 0 0 15000 0 93665 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 09/11/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 206020
0 1 0 0 0 SUHASTI,(NY) 038243 50 18398 DR.
novia;3313125201940001; 5.6.7.202204241238 4 361187
1#0##0#0#0.0#2022-05-19
08:03:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
47e3f3357d3d94db7fea8c29faba543a 0 0 138000 0 0 0
0 0 0 0 15000 0 53020 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 06/04/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 518042
0 1 0 0 0 SRI WIYONO,TN 003319 55 20442 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361640
1#0##0#0#0.0#2022-04-06
14:48:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
63684206b63686ad36673573670e98de 150000 0 0 0 0 0
0 76045 0 0 15000 0 276997 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 28/02/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 340811
0 1 0 0 0 ASRI WIJAYANTI, (NY) 003826 51 18653
novia;3313125201940001; 5.6.6.202203301209 4 361641
1#0##0#0#0.0#2022-04-06
14:54:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cf4a727fbf0a58fe3e46fb1399315236 150000 0 0 0 0 0
0 107890 0 0 15000 0 67921 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 02/12/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ENDANG
1124R0020322V004053 0000086714471 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361642 1#0##0#0#0.0#2022-04-06
14:56:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bc138217652f5a8fc6faa537982e65e9 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 17/09/1962 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
180000 0 1 0 0 0 TUMIYEM, NY 041905 59 21739
novia;3313125201940001; 5.6.6.202203301209 4 361643
1#0##0#0#0.0#2022-04-06
14:57:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
46b3a4fe678ed3ff41aa1e11571efecc 165000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 18/12/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 191980
0 1 0 0 0 MUHAMMAD HATTA ., TN 058655 64 23473
novia;3313125201940001; 5.6.6.202203301209 4 361644
1#0##0#0#0.0#2022-04-06
14:58:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c9d52bfe003c0a0af450a4ed5f612707 150000 0 0 0 0 0
0 0 0 0 15000 0 26980 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 20/12/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 520227
0 1 0 0 0 KASIH ANGGRAENI, NY 093093 61 22375
novia;3313125201940001; 5.6.6.202203301209 4 361645
1#0##0#0#0.0#2022-04-06
14:59:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e659ad0825e3f60b936c8e054a243872 150000 0 0 0 0 0
0 121345 0 0 15000 0 233882 0 0 0 0
0
3372030 C 3 CP 2 25/03/2022 25/03/2022 05/06/1943 0 1
0 0 - 0 - 0 - 0 - 0 181400 209122
0 1 0 0 0 SOEPARTO BROTOATMOJO, TN 071688 78
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 361646
1#0##0#0#0.0#2022-04-06
15:00:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ea3d65be8dc4973ac33f32e10e6d3201 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 01/07/2005 0 2
1 S82.20;V29.9 88.27 - - None None None None Q-5-31-0
0 - 0 - 0 - 0 129600 413000 0 1
0 0 0 DELA TABAH SAPUTRI, NN 102608 16 6111 DR. WAHYU
novia;3313125201940001; 5.6.6.202203301209 4 361647
1#0##0#0#0.0#2022-04-06
15:02:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
993149fe085330fcb62cc8a4179b620e 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 12/11/1945 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000063294052 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361648 1#0##0#0#0.0#2022-04-06
15:04:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
71e9118dfb62e14b232463bbfdb698d3 258000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 18/12/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 213390
0 1 0 0 0 PURWANTO.TN 092290 50 18360 DR. WAHYU
novia;3313125201940001; 5.6.6.202203301209 4 361649
1#0##0#0#0.0#2022-04-06
15:06:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c5acc6135ef0ad83df3c087e4853e4c2 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 07/07/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
novia;3313125201940001; 5.6.6.202203301209 4 361653
1#0##0#0#0.0#2022-04-07
08:12:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b0d998a266f01c9287423feead69b435 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 12/08/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 211910
0 1 0 0 0 FX DARSINAH .,NY 074934 69 25427 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361654
1#0##0#0#0.0#2022-04-07
08:13:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e86ec7d57acc4c6dea5c2dffc5ebff31 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 07/05/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 459412
0 1 0 0 0 R. AJ KOESTRINI, NY 100934 67 24794
novia;3313125201940001; 5.6.6.202203301209 4 361655
1#0##0#0#0.0#2022-04-07
08:14:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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248000 0 0 0 15000 0 46412 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 18/01/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000090992327 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361656 1#0##0#0#0.0#2022-04-07
08:15:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f7700a0abc9dc1e0b5244c13894a4896 247000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 06/06/1963 0 1
0 404900 589662 0 1 0 0 0 SUPARMAN, (BP)
0001104414322 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361657 1#0##0#0#0.0#2022-04-07
08:15:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b214d4f34eb5165b82c052c0ad294d42 351500 0 0 0 0 0
0 0 0 0 15000 0 223162 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 06/06/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 211310
0 1 0 0 0 SUPARMAN, BP 045790 67 24764 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361658
1#0##0#0#0.0#2022-04-07
08:16:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 25/03/2022 25/03/2022 07/10/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 339280
0 1 0 0 0 YATINI 094257 51 18797 DR. ARIA
novia;3313125201940001; 5.6.7.202204241238 4 361659
1#0##0#0#0.0#2022-05-19
13:14:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
1ea7730ff1789398bc1f4b33a2957c44 150000 0 0 0 0 0
0 121345 0 0 15000 0 52935 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 20/01/1963 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 RESPATI DWI
1124R0020322V004068 0001865287618 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361660 1#0##0#0#0.0#2022-04-07
08:18:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7ccc8867db2ce67a21dc44b82a0f2c56 247000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 24/10/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 230588
0 1 0 0 0 SRIYANI, NY 083185 56 20606 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 361661
1#0##0#0#0.0#2022-04-07
08:19:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4425d88028ad9412626e2a43f49953d1 0 0 0 0 0 0 0
120795 0 0 15000 0 94793 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 19/07/1950 0 2
0 - 0 107400 262000 0 1 0 0 0 SITI
1124R0020322V004070 0001387776519 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361662 1#0##0#0#0.0#2022-04-07
08:20:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 25/03/2022 25/03/2022 21/08/1985 0 2
0 0 - 0 - 0 - 0 - 0 181400 253414
0 1 0 0 0 EMI ERNAWATI, NY 100379 36 13365 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361663
1#0##0#0#0.0#2022-04-07
08:20:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c9d2d0e27260bc86d517d3a1a0fe7be2 0 0 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 31/12/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 206852
0 1 0 0 0 SURANI, NY 063638 59 21634 DR. WAHYU
novia;3313125201940001; 5.6.6.202203301209 4 361664
1#0##0#0#0.0#2022-04-07
08:21:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cf16fb59682b41d8772ac9de89ebb43c 150000 0 0 0 0 0
0 0 0 0 15000 0 41852 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 09/03/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 129031
0 1 0 0 0 RINDARMADI.TN 089698 53 19374 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361665
1#0##0#0#0.0#2022-04-07
08:22:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2f8fb2f4816c99f2b5f16ef14742cf9e 0 0 0 0 0 0 0
44300 0 0 15000 0 69731 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 01/11/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 216630
0 1 0 0 0 KUSTIATI, NY 048553 60 22059 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361666
1#0##0#0#0.0#2022-04-07
08:23:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a7892094feab5644df19d367f3589767 150000 0 0 0 0 0
0 0 0 0 15000 0 51630 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 05/03/1949 0 1
1 Z09.8;E11.9;I10;I73.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 497721
0 1 0 0 0 SUGENG PADMO HUDIYONO.TN 077469 73
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 361667
1#0##0#0#0.0#2022-04-07
08:24:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0c61e94295cc95ee3cda1b42ea659e1e 0 0 0 0 0 0 0
76045 0 0 15000 0 406676 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 13/06/1971 0 2
1 Z09.8;G81.9;M75.0 93.35;93.39 - - None None None None M-3-
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002169781694 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361668 1#0##0#0#0.0#2022-04-07
08:25:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8220e0675f8e8e6d69f4b463b4aa0f1a 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 06/04/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 204770
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 361669
1#0##0#0#0.0#2022-04-07
08:26:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b416dedbbfd1ff9d17147aa784c03f75 150000 0 0 0 0 0
0 0 0 0 15000 0 39770 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 27/08/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 590376
0 1 0 0 0 MARSINI ENDANG ERAWATI, NY 055764 51
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 361670
1#0##0#0#0.0#2022-04-07
08:27:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
62c0956353fb3330babb89609baa6df7 0 0 0 0 0 0 496000
0 0 0 15000 0 79376 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 03/10/1972 0 2
0 - 0 - 0 - 0 - 0 181400 458020
0 1 0 0 0 SRIYATUN.NY 102571 49 18070 DR. WAHYU
novia;3313125201940001; 5.6.6.202203301209 4 361671
1#0##0#0#0.0#2022-04-07
08:29:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d69fde5619f149df57b8be1afa3f92f3 150000 0 0 0 0 0
248000 0 0 0 15000 0 45020 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 31/12/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI SUWANTI, NY
0001967417043 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361672 1#0##0#0#0.0#2022-04-07
08:30:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d5a097124f25856d16230e011da5ee52 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 11/09/1947 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TUKIMAN.TN 098571
0000555611016 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361673 1#0##0#0#0.0#2022-04-07
08:30:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a1876a60b31467d678f61d1484544698 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 25/12/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 346740
0 1 0 0 0 BAMBANG RISTANTO.TN 087710 50 18353
novia;3313125201940001; 5.6.6.202203301209 4 361674
1#0##0#0#0.0#2022-04-07
08:31:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8cb6e2a698484f503e9e39019f55bd11 150000 0 0 0 0 0
0 0 0 0 15000 0 181740 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 04/08/1968 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
773275 0 1 0 0 0 SRI HARTINI., NY 000449 53
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 361677
1#0##0#0#0.0#2022-04-07
08:32:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f636cc64802bc69510592353138c1f37 150000 0 0 0 0 0
0 76045 0 0 15000 0 532230 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 31/12/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 206852
0 1 0 0 0 SITI MARYAM, NY 093234 68 24921 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361675
1#0##0#0#0.0#2022-04-07
08:33:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c343fb94b06124fefeb7fa5d9d93eae8 150000 0 0 0 0 0
0 0 0 0 15000 0 41852 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 20/06/1943 0 2
0 0 - 0 - 0 - 0 - 0 181400 204770
0 1 0 0 0 HARTINI.NY 079458 78 28768 DR. WAHYU
novia;3313125201940001; 5.6.6.202203301209 4 361680
1#0##0#0#0.0#2022-04-07
08:40:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9d5ed4b84d14f394bdfbd502191b780c 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 15/03/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 216630
0 1 0 0 0 SRI LESTARI.NY 099207 52 19003 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361679
1#0##0#0#0.0#2022-04-07
08:38:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4da0b1d0b8dd93a6c7befa9b2aa19dac 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 10/05/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 176454
0 1 0 0 0 SURATMI, NY 101469 62 22965 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 361681
1#0##0#0#0.0#2022-04-07
08:41:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9f91f7ceea100a9d1c50e939f924ce22 0 0 0 0 0 0 0
107890 0 0 15000 0 53564 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 05/01/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 330597
0 1 0 0 0 SRI SETYANINGSIH,(NY) 023290 63 23090
novia;3313125201940001; 5.6.6.202203301209 4 361678
1#0##0#0#0.0#2022-04-07
08:42:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
514930cb3f149edd5df96572a7ebca63 150000 0 0 0 0 0
0 31845 0 0 15000 0 133752 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 19/02/1981 0 2
0 - 0 - 0 - 0 - 0 181400 218000
0 1 0 0 0 DINA ARMIASARI.NY 088218 41 15009 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361686
1#0##0#0#0.0#2022-04-07
08:49:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1ce1b9be18bb433a9c836e703f830ab8 203000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 10/10/1953 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 TUTIK SARASWATI .,
0001449355893 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361684 1#0##0#0#0.0#2022-04-07
08:43:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fa1bc7b5c5c73cd5142e0498fb391e85 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 31/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 280656
0 1 0 0 0 PONIYEM, NY 070131 67 24556 DR. YUDHI
novia;3313125201940001; 5.6.6.202203301209 4 361685
1#0##0#0#0.0#2022-04-07
08:44:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8182aa759c8fb6c56665108f1c729c3e 203000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 25/12/1954 0 2
1 Z09.8;S92.00;M54.59 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 201612
0 1 0 0 0 MARIA HENDRASAPUTRA,NY 100064 67 24562
novia;3313125201940001; 5.6.7.202204241238 4 361691
1#0##0#0#0.0#2022-05-20
08:31:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
7c26eee3317709a0efc0c77e004ddafe 150000 0 0 0 0 0
0 0 0 0 15000 0 36612 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 14/04/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 214953
0 1 0 0 0 MARTINAH., NY 072061 61 22625 DR.
novia;3313125201940001; 5.6.7.202204241238 4 361687
1#0##0#0#0.0#2022-05-19
10:03:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
473ed5d75d04501ae401875440c90b98 150000 0 0 0 0 0
0 0 0 0 15000 0 49953 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 21/12/1932 0 2
0 0 - 0 - 0 - 0 - 0 181400 328828
0 1 0 0 0 SOLICHATUN,NY 063275 89 32601 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361696
1#0##0#0#0.0#2022-04-07
08:52:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f68d7562596d8d1d8b6fb4a11c6b3ae9 150000 0 0 0 0 0
0 120795 0 0 15000 0 43033 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 25/03/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 216630
0 1 0 0 0 SUPINAH 091220 67 24472 DR. WAHYU
novia;3313125201940001; 5.6.7.202204241238 4 361701
1#0##0#0#0.0#2022-05-19
11:05:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
c3d015250c653d7acd3dbeca1c7c8eea 150000 0 0 0 0 0
0 0 0 0 15000 0 51630 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 02/08/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 204370
0 1 0 0 0 SUTARNI.NY 102327 69 25437 DR. WAHYU
novia;3313125201940001; 5.6.6.202203301209 4 361707
1#0##0#0#0.0#2022-04-07
08:54:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
68f2950f01c5ebf42b299d525bdb61f3 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 23/03/1948 0 2
1 Z09.8;E11.4;G59.0;I11.9 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 311448
0 1 0 0 0 SRI SUTANTI. NY 084749 74 27030 DR.
agung;3313092303950002; 5.6.7.202204241238 4 361711
1#0##0#0#0.0#2022-06-17
15:27:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
7af49f98005e0a6fc95c744579b218f9 150000 0 0 0 0 0
0 31845 0 0 15000 0 114603 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 05/01/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 202500
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novia;3313125201940001; 5.6.6.202203301209 4 361712
1#0##0#0#0.0#2022-04-07
09:17:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b6ddf26a1a36861097676bf25f03dbe9 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 31/12/1940 0 1
1 Z09.8;E11.4;G59.0;I10;J06.9 88.76 - - None None None None
Z-3-23-0 None None None None None None PROSEDUR ULTRASOUND LAIN-LAIN
549400 0 0 - 0 - 0 - 0 - 0 549400
940265 0 1 0 0 0 MANTO DIHARJO,[BP] 024229
0000563851113 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361246 1#0##0#0#0.0#2022-04-05
11:32:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
53bd6db30b6d6b5f9ecbe6f5f0e40bbb 0 0 138000 0 0 0
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0
3372030 C 3 CP 2 25/03/2022 25/03/2022 12/01/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 EKO RINI.NY 093223
0000091524159 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361713 1#0##0#0#0.0#2022-04-07
09:21:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 25/03/2022 25/03/2022 02/02/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUJIYEM, NY 090600
0001696847466 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361714 1#0##0#0#0.0#2022-04-07
09:30:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a899975a3cab1560b884b80b71b0285b 247000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 28/07/1960 0 1
1 Z09.8;H52.2;H52.4;Z96.1;H04.1 90.29 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
454895 0 1 0 0 0 SUPRAPTO.TN 099635 61 22520
novia;3313125201940001; 5.6.6.202203301209 4 361732
1#0##0#0#0.0#2022-04-07
09:39:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5025ee5dfcf47a160d954e0a05615a34 203000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 12/04/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARIYAM.NY 084306
0001302703266 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361733 1#0##0#0#0.0#2022-04-07
09:41:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
06b26aa8992c2067eae3cbc9e3231612 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 14/04/1957 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
280656 0 1 0 0 0 AMIR HAUDI,(BP) 029404 64
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 361734
1#0##0#0#0.0#2022-04-07
09:43:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c76088bb45cf62b1009c32bf2603c0a2 203000 0 0 0 0 0
0 0 0 0 15000 0 62656 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 23/06/2014 0 1
0 0 - 0 - 0 - 0 - 0 181400 179279
0 1 0 0 0 MUH REYHAN HAFIDZ.AN 099069 7 2832
novia;3313125201940001; 5.6.6.202203301209 4 361739
1#0##0#0#0.0#2022-04-07
09:52:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eda8815193d4fcada73c6189be80d12b 150000 0 0 0 0 0
0 0 0 0 15000 0 14279 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 14/05/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 216630
0 1 0 0 0 M. KRISTIANAWATI, NY 092163 63 23326
novia;3313125201940001; 5.6.6.202203301209 4 361743
1#0##0#0#0.0#2022-04-07
09:55:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6c58c9c5b8337d23c5b326bfbb1a6ebb 150000 0 0 0 0 0
0 0 0 0 15000 0 51630 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 12/04/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 339775
0 1 0 0 0 DALMINI.NY 070284 63 23358 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 361744
1#0##0#0#0.0#2022-04-07
09:56:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6c6c488b1587a523d3c13d3731dcd921 150000 0 0 0 0 0
0 31845 0 0 15000 0 142930 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 16/05/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 446630
0 1 0 0 0 WIDI WINARSI.NY 075698 65 24054 DR.
novia;3313125201940001; 5.6.7.202204241238 4 361746
1#0##0#0#0.0#2022-05-19
10:11:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
5f61b7e96869495d186ab0d7701d7899 150000 0 0 0 0 0
230000 0 0 0 15000 0 51630 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 27/11/1988 0 2
0 - 0 - 0 - 0 - 0 296400 175150
0 1 0 0 0 MASNI.NY 098321 33 12171 DR. GUNAWAN,
SP.OG 1124R0020322V004112 0001287357085 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361752 1#0##0#0#0.0#2022-04-07
10:00:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 10150 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 13/07/1953 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
282656 0 1 0 0 0 RUSWATI, NY 086042 68 25092
novia;3313125201940001; 5.6.6.202203301209 4 361756
1#0##0#0#0.0#2022-04-07
10:02:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c487ccb5a5dfcfb557b82acac3ace048 203000 0 0 0 0 0
0 0 0 0 15000 0 64656 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 16/01/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 347246
0 1 0 0 0 SOFIAH.NY 087944 71 26001 DR. YUDHI
novia;3313125201940001; 5.6.6.202203301209 4 361766
1#0##0#0#0.0#2022-04-07
10:05:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8faf34e80c9a800f5223233d110f2238 203000 0 0 0 0 0
0 0 0 0 15000 0 129246 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 24/07/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUTAMI.NY 099959
0000640553196 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
361767 1#0##0#0#0.0#2022-05-20
08:21:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
afcab703349d2039c083308567b437a0 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 01/12/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 614577
0 1 0 0 0 SUMARMI, NY 090111 57 20933 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 361768
1#0##0#0#0.0#2022-04-07
10:07:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d1c7c03edbfbafc24a9abe451bb3b209 150000 0 0 0 0 0
0 76045 0 0 15000 0 373532 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 05/06/1975 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001272616569 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361769 1#0##0#0#0.0#2022-04-07
10:08:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
690dcbf55f6fb5292461050b0b4fd728 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 20/07/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 316000 0 1 0 0 0 SITI ZUHRIYAH,(NY)
0000091194276 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361770 1#0##0#0#0.0#2022-04-07
10:09:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c4fdf79afc40d9adb059d23d50bdb839 301000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 28/03/1978 0 1
0 - 0 - 0 - 0 - 0 182600 391017
0 1 0 0 0 SURYANTO, TN 102616 43 16068 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361771
1#0##0#0#0.0#2022-04-07
10:10:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e1feeaf7287053182433a2f66447bc66 203000 0 0 0 0 0
0 0 0 0 15000 0 173017 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 24/05/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 442122
0 1 0 0 0 SIH TRISNO PANGLIPUR YEKTI.NY 075960 52
3;JKN novia;3313125201940001; 5.6.7.202204241238 4 372113
1#0##0#0#0.0#2022-06-15
10:13:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2c0e1a6ea53889a55ae15aad391f50e7 150000 0 0 0 0 0
233000 0 0 0 15000 0 44122 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 07/06/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 352438
0 1 0 0 0 SUNARSIH.NY 078163 64 23667 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 361772
1#0##0#0#0.0#2022-04-07
10:11:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
20d94611954ad9489b2be9839e3f624d 150000 0 0 0 0 0
0 76595 0 0 15000 0 110843 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 22/09/1982 0 2
0 0 - 0 - 0 - 0 - 0 181400 249680
0 1 0 0 0 RIRIN FATIMAH, NY 066462 39 14429 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361773
1#0##0#0#0.0#2022-04-07
10:12:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6c4debcadd61817c1af36573e59d51a5 203000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 18/02/1979 0 2
0 - 0 - 0 - 0 - 0 549400 462210
0 1 0 0 0 SRI WAHYUNI.NY 089449 43 15741 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361774
1#0##0#0#0.0#2022-04-07
10:14:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
06c48d08afb3bc0d4350e81405156461 350000 0 0 0 0 0
0 0 0 0 15000 0 97210 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 27/06/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI MARGANI.NY
0000091413112 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361775 1#0##0#0#0.0#2022-04-07
10:15:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c8d08c901e4b7ea1a1f1922ef051846d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 21/08/1948 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MUSNATIN., NY
0000091314876 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361776 1#0##0#0#0.0#2022-04-07
10:16:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a2d81487327ffc110a628257d4fc18d8 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 11/05/1934 0 2
0 0 - 0 - 0 - 0 - 0 181400 290723
0 1 0 0 0 Hj. SITI CHOTIMAH, NY 100244 87 32095
novia;3313125201940001; 5.6.6.202203301209 4 361777
1#0##0#0#0.0#2022-04-07
10:17:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d668b05abc82b10a6b5ad1cfe39bcdc8 203000 0 0 0 0 0
0 0 0 0 15000 0 72723 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 17/01/1940 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SITI JAHIDJAH, NY
0000091261743 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
361778 1#0##0#0#0.0#2022-05-20
09:31:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 25/03/2022 25/03/2022 08/12/1949 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SISWO SARJONO,(BP)
0000564473013 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361779 1#0##0#0#0.0#2022-04-07
10:22:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d12de9277e0b9f482f80f49b444569b6 258000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 17/11/1966 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 INDRARIADI, TN
0001797112102 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361780 1#0##0#0#0.0#2022-04-07
10:26:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0b5fda991667342508b32f7518c00a79 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 02/09/1976 0 1
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.6.202203301209 4 361781
1#0##0#0#0.0#2022-04-07
10:27:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6c461fda06a9f8524cf1bf6d30ee4ca1 463830 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 28/02/1992 0 2
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novia;3313125201940001; 5.6.6.202203301209 4 361782
1#0##0#0#0.0#2022-04-07
10:29:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1b9602082acebfbbb1c124e79412d397 300000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 06/12/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 315000
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novia;3313125201940001; 5.6.6.202203301209 4 361783
1#0##0#0#0.0#2022-04-07
10:30:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d86cea25153a0f80f39785e98e0f2a02 300000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 07/12/1946 0 1
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.6.202203301209 4 361784
1#0##0#0#0.0#2022-04-07
10:31:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4c2da0d208885a8b7cd2b0714a187971 463830 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 15/06/1986 0 2
- 0 - 0 - 0 - 0 283800 315000 0
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novia;3313125201940001; 5.6.6.202203301209 4 361785
1#0##0#0#0.0#2022-04-07
10:31:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b94509fa9246d6b97d48e0cf33b69139 300000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 01/05/1975 0 1
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SP.PD 1124R0020322V004137 0001790328262 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361803 1#0##0#0#0.0#2022-04-07
10:32:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
47d919a73c8a1c0fd73dfdb68a76c5fc 662676 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 13/06/1992 0 2
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3;JKN novia;3313125201940001; 5.6.7.202204241238 4 361805
1#0##0#0#0.0#2022-05-19
09:47:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
39a72ef680a752ee9055a46daf23d762 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 31/10/1989 0 2
0 - 0 - 0 - 0 - 0 296400 230680
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novia;3313125201940001; 5.6.7.202204241238 4 361806
1#0##0#0#0.0#2022-05-19
09:32:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
864d4ebdad5083b7fbbd85431e610656 200000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 02/02/1995 0 1
- 0 - 0 - 0 - 0 283800 315000 0
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novia;3313125201940001; 5.6.6.202203301209 4 361807
1#0##0#0#0.0#2022-04-07
10:35:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
45261644643859a70cbb1030e276082d 300000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 08/03/1967 0 1
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novia;3313125201940001; 5.6.6.202203301209 4 361808
1#0##0#0#0.0#2022-04-07
10:36:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 25/03/2022 25/03/2022 28/12/2002 0 1
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novia;3313125201940001; 5.6.6.202203301209 4 361809
1#0##0#0#0.0#2022-04-07
10:37:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
77897b305865866b9aaa0cdd1cebecdd 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 01/12/1980 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V004143 0000640230884 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361810 1#0##0#0#0.0#2022-04-07
10:38:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
758265870edd138f04ed8a17dd7d0d98 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 31/12/1965 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 KASERI, TN 025433 56 20538 DRG. VERAWATY,
SP.KG 1124R0020322V004144 0001103827476 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361811 1#0##0#0#0.0#2022-04-07
10:39:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
569bbd53ce4897babcf273651d9d90a1 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 31/12/1945 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 FX SUPARNO.TN 102475 76 27843 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361812
1#0##0#0#0.0#2022-04-07
10:42:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
101c3ec66132ea84c9a01c2a7df3abc5 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 12/11/1996 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 NOVIANA SARI DEWI.NN 102321 25 9264 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361813
1#0##0#0#0.0#2022-04-07
10:43:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
adc0a06f0c027422a0b157e49118bfbb 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 26/04/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.6.202203301209 4 361814
1#0##0#0#0.0#2022-04-07
10:44:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
41a0bc1a7ba40d09a77dfbc7b41dda5b 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 20/08/1959 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V004149 0000571256594 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361815 1#0##0#0#0.0#2022-04-07
10:45:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b0887d67221315212bf9581385a852ad 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 03/08/2002 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 WAFI IZZULHAQ.SDR 102323 19 7174 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361816
1#0##0#0#0.0#2022-04-07
10:46:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cce17c5dbafc97520b5894a56ebf1786 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 25/05/1972 0 1
0 - 0 - 0 - 0 786200 677676 0 1
SP.PD 1124R0020322V004151 0002431552465 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361817 1#0##0#0#0.0#2022-04-07
10:47:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
54c670150c6e7654dc7d205ca8159cc3 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 13/08/1986 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ETI DEKAWATI, NY 102148 35 13008 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361818
1#0##0#0#0.0#2022-04-07
10:49:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4368253b8564d81e8d295d338284b63b 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 30/03/1980 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 JEMY ROCHADITAMA TRISNANINGRUM.NY 100583 41
novia;3313125201940001; 5.6.6.202203301209 4 361819
1#0##0#0#0.0#2022-04-07
10:51:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7e48e01d6d5bddf6977458b13445c593 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 01/12/1958 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V004154 0001436949538 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361820 1#0##0#0#0.0#2022-04-07
10:52:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0712b1c27c109c6b089003138699a059 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 01/04/1981 0 1
0 - 0 - 0 - 0 786200 677676 0 1
SP.PD 1124R0020322V004156 0001904830593 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361821 1#0##0#0#0.0#2022-04-07
10:53:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
11ec35fe6707107e972927f725435d8e 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 17/04/1961 0 2
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.6.202203301209 4 361822
1#0##0#0#0.0#2022-04-07
10:54:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c34c8de89c61c13d5f3b63561903a217 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 17/04/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 285795
0 1 0 0 0 HARTATI SRITOMO, NY 092452 68 25179
3;JKN agung;3313092303950002; 5.6.7.202204241238 4 367812
1#0##0#0#0.0#2022-05-20
10:28:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
38a5800d5f8675c26d677f91da982afe 150000 0 0 0 0 0
0 120795 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 10/06/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 326970
novia;3313125201940001; 5.6.6.202203301209 4 361823
1#0##0#0#0.0#2022-04-07
11:06:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2c3824e425f34d1f2b5d1c8d1240a91d 203000 0 0 0 0 0
0 0 0 0 15000 0 108970 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 13/04/1952 0 1
1 Z09.8;K30;D64.8 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 258236
0 1 0 0 0 SUKIMAN PRIYOSUKARTO, TN 070987 69
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 361848
1#0##0#0#0.0#2022-04-07
11:07:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5dfd1af280f27c619f3b078d69b18726 200000 0 0 0 0 0
0 0 0 0 15000 0 43236 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 22/06/1975 0 2
- 0 - 0 - 0 - 0 206700 165000 0
1 0 0 0 NANIK DWI NINGSIH 64722 46 17078 DRG. VERAWATY,
SP.KG 1124R0020322V004161 0001904276125 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361849 1#0##0#0#0.0#2022-04-07
11:11:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
373885164c7e6e3b38e2360c3e9f30f0 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 19/11/1977 0 2
1 Z09.8;K76.0;H81.3 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 231685
0 1 0 0 0 ISMIATI.NY 076053 44 16197 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 361850
1#0##0#0#0.0#2022-04-07
11:13:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
18ae7e8316cae8a8ea067dcb6a304610 150000 0 0 0 0 0
0 0 0 0 15000 0 66685 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 18/06/1980 0 1
0 0 - 0 - 0 - 0 - 0 181400 275095
0 1 0 0 0 GUNADI.TN 099997 41 15255 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 361851
1#0##0#0#0.0#2022-04-07
11:14:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4f1ee77ddaa055a01a06cf853d04d0d2 0 0 0 0 0 0 0
0 0 0 15000 0 260095 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 05/05/1962 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
608181 0 1 0 0 0 SUPARDI TN 085053 59 21874
novia;3313125201940001; 5.6.6.202203301209 4 361852
1#0##0#0#0.0#2022-04-07
11:15:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4c79d1cebb89b0a896b056a070ef3dee 0 0 0 0 0 0 0
0 0 0 15000 0 593181 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 29/10/1965 0 1
1 Z09.8;J44.9;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 200721
0 1 0 0 0 SANTOSO. TN 038094 56 20601 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 361853
1#0##0#0#0.0#2022-04-07
11:15:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5b37b8f35a7615a6e85fd9ac40505c23 150000 0 0 0 0 0
0 0 0 0 15000 0 35721 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 20/04/1988 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SRI SUYAMTI, NY 101812 33 12392 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361854
1#0##0#0#0.0#2022-04-07
11:16:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
60c39741e0f9cabd4eafac594ab016fb 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 15/06/1997 0 1
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 TANOYO ARDHANARESWARI.TN 102572 24 9049 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361855
1#0##0#0#0.0#2022-04-07
11:17:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
14e20aafd0154cf23a5ead00103c169c 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 01/07/1973 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 LILIK TRI HENDRAWANTO.TN 102322 48 17799
novia;3313125201940001; 5.6.6.202203301209 4 361856
1#0##0#0#0.0#2022-04-07
11:18:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
adfd4efa34e99a7a8b12bbd7adf5a375 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 15/11/1985 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SRI LESTRARI, NY 101712 36 13279 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361857
1#0##0#0#0.0#2022-04-07
11:19:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2be50abf2b2d5b2f287f96e61dc3a971 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 18/05/1995 0 1
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 SIGIT PURNOMO.TN 102575 26 9808 DRG. VERAWATY,
SP.KG 1124R0020322V004171 0001769985483 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361858 1#0##0#0#0.0#2022-04-07
11:20:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4b93f993bde853a26c9f9073f1e62f2c 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 11/11/1999 0 1
- 0 - 0 - 0 - 0 206700 315000 0
1 0 0 0 YULIANTO EDI MARTONO.TN 100175 22 8170 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361859
1#0##0#0#0.0#2022-04-07
11:21:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ede7cb1fa4a343d3e96484825efd7519 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 06/02/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 341851
0 1 0 0 0 SUSILOWATI ., NY 055984 57 20866 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361860
1#0##0#0#0.0#2022-04-07
11:22:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
85d02504180b073e41a57c5e2c3c3f12 150000 0 0 0 0 0
0 0 0 0 15000 0 176851 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 06/11/1968 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 RINA YUGI T, NY 102615 53 19497 DRG. VERAWATY,
SP.KG 1124R0020322V004174 0001160936471 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361861 1#0##0#0#0.0#2022-04-07
11:23:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
39fbc87db9374ec66f78b9b07d1f4c5e 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 30/05/1990 0 2
0 0 - 0 - 0 - 0 - 0 181400 215153
0 1 0 0 0 DEWI PRASETYANINGSIH,NY 026672 31 11622
novia;3313125201940001; 5.6.7.202204241238 4 361863
1#0##0#0#0.0#2022-05-18
11:02:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
e627a078fd4e2236f9f73bb477312e3a 150000 0 0 0 0 0
0 0 0 0 15000 0 50153 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 03/03/1993 0 1
0 - 0 - 0 - 0 283800 337030 0 1
0 0 0 DWI CAHYO K, TN 102614 29 10614 DRG. VERAWATY,
SP.KG 1124R0020322V004176 0001098149488 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361864 1#0##0#0#0.0#2022-04-07
11:30:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c57a3b0e506b8d9f51c4927ce806fd38 300000 0 0 0 0 0
0 0 0 0 15000 0 22030 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 19/03/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 265285
0 1 0 0 0 SRI UNTARI, NY 087563 62 22651 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361865
1#0##0#0#0.0#2022-04-07
11:31:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
add5dc43510e6e2c8390e84ee8d66f69 150000 0 0 0 0 0
0 0 0 0 15000 0 100285 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 26/08/1969 0 1
1 K80.2 88.76 - - None None None None Z-3-23-0 None None
- 0 - 0 - 0 - 0 549400 275477 0
1 0 0 0 SUJAI, TN 039341 52 19204 DR. TEKY
reni;3313147010930001; 5.6.6.202203301209 4 361247
1#0##0#0#0.0#2022-04-05
11:33:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0c899d661bfff6e7774bb45be146a542 0 0 138000 0 0 0
0 0 0 0 15000 0 122477 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 01/09/2001 0 2
0 - 0 - 0 - 0 283800 316860 0 1
0 0 0 LULU ROSYIDAH MIROH 071620 20 7510 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361871
1#0##0#0#0.0#2022-04-07
11:33:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
300f501d12354dde9ced2b70d849b9e5 300000 0 0 0 0 0
0 0 0 0 15000 0 1860 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 07/02/1969 0 1
1 Z09.8;K21.9 89.52 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 243111
0 1 0 0 0 BONAWAN.TN 089880 53 19404 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 361880
1#0##0#0#0.0#2022-04-07
11:34:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
650bebd3badcfe77de2f9a8d2deaff6a 150000 0 0 0 0 0
0 0 0 0 15000 0 78111 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 07/05/1959 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
392533 0 1 0 0 0 SUGIYATI, NY 100981 62
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 361888
1#0##0#0#0.0#2022-04-07
11:35:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4e1f870146fa85cd4bc6d02745648d5c 150000 0 0 0 0 0
0 153400 0 0 15000 0 74133 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 31/12/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 INDRAYATI, NY 091755 58 21269 DR.
novia;3313125201940001; 5.6.7.202204241238 4 361896
1#0##0#0#0.0#2022-05-19
11:09:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
a79157598d7966db73f33bcbf4c58b9c 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 13/08/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 238135
0 1 0 0 0 SRI LESTARI . NY 068663 71 26157 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361897
1#0##0#0#0.0#2022-04-07
12:04:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
156b9f05ed13f307570a7fb53d068b9a 150000 0 0 0 0 0
0 0 0 0 15000 0 73135 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 01/04/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 201128
0 1 0 0 0 WAHYU DARMAJI, TN 066826 49 18255 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361898
1#0##0#0#0.0#2022-04-07
12:04:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
433f2cd20e5ec31a9bde0f3125dd3d9f 150000 0 0 0 0 0
0 0 0 0 15000 0 36128 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 18/04/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 198430
0 1 0 0 0 PONIYATI,(NY) 026098 61 22621 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361899
1#0##0#0#0.0#2022-04-07
12:06:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
21ea0286ebcdb84c0297019206b69703 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 24/09/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 260104
0 1 0 0 0 HERIBERTUS HADI RAHARJO, TN 097748 51
0002217338109 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361900 1#0##0#0#0.0#2022-04-07
12:07:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cabe7d6e22a2b3386a0d1ae470a6d189 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 28/05/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 229180
0 1 0 0 0 SURYONO.TN 102298 66 24408 DR. INDRIANY
novia;3313125201940001; 5.6.6.202203301209 4 361901
1#0##0#0#0.0#2022-04-07
12:10:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
51f798dcf0cfd98daf7417e36b94e096 150000 0 0 0 0 0
0 0 0 0 15000 0 64180 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 14/07/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 186975
0 1 0 0 0 MARDIYAH, NY 043267 62 22900 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361902
1#0##0#0#0.0#2022-04-07
12:10:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7698225b40f368d26562228bf70bb1a1 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 09/05/1949 0 1
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3;JKN novia;3313125201940001; 5.6.6.202203301209 4 361903
1#0##0#0#0.0#2022-04-07
12:11:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b8adf08ad51b291cb2afdcfac1738ed0 150000 0 0 0 0 0
0 0 0 0 15000 0 15444 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 05/01/1951 0 1
1 Z09.8;R51;K30;M79.18 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 210381
3;JKN novia;3313125201940001; 5.6.7.202204241238 4 361904
1#0##0#0#0.0#2022-05-19
09:09:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
83dea764343bdb04f4fe4cfaf789d870 150000 0 0 0 0 0
0 0 0 0 15000 0 45381 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 13/06/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 174075
0 1 0 0 0 ELIDA EFFIANI, NY 099176 51 18913 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361905
1#0##0#0#0.0#2022-04-07
12:12:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5cd0c7c1955c6c5c88d704daed46ea59 150000 0 0 0 0 0
0 0 0 0 15000 0 9075 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 02/03/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 188508
0 1 0 0 0 WIRYANTI.NY 099756 50 18285 DR. INDRIANY
novia;3313125201940001; 5.6.6.202203301209 4 361906
1#0##0#0#0.0#2022-04-07
12:13:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
57247c6229c520f96f5936363fc878d5 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 29/04/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 255725
0 1 0 0 0 YUSTITO.TN 095305 57 21149 DR. ARIA
novia;3313125201940001; 5.6.6.202203301209 4 361907
1#0##0#0#0.0#2022-04-07
12:14:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b370e85a71ac511f62ed236ae2acc93b 150000 0 0 0 0 0
0 0 0 0 15000 0 90725 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 25/06/1970 0 2
0 - 0 - 0 - 0 786200 677676 0 1
novia;3313125201940001; 5.6.6.202203301209 4 361908
1#0##0#0#0.0#2022-04-07
12:14:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e784902e967f0815bcf0200038da5c1e 662676 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 10/08/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 230135
0 1 0 0 0 SRI SUYATMI.NY 081082 67 24699 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361909
1#0##0#0#0.0#2022-04-07
12:15:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9e062f95291d3133ef54b9de6f2d484d 150000 0 0 0 0 0
0 0 0 0 15000 0 65135 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 16/09/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 221305
0 1 0 0 0 MULYANI, NY 097536 55 20279 DR. ARIA
novia;3313125201940001; 5.6.6.202203301209 4 361911
1#0##0#0#0.0#2022-04-07
12:16:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aa4ecd322dbb0e1587ca8699f4a271b3 150000 0 0 0 0 0
0 0 0 0 15000 0 56305 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 16/02/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 212412
0 1 0 0 0 SUTRASMI.NY 093458 72 26335 DR. ARIA
novia;3313125201940001; 5.6.6.202203301209 4 361913
1#0##0#0#0.0#2022-04-07
12:16:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
362666433ef13b0f0f65b7755c62e812 150000 0 0 0 0 0
0 0 0 0 15000 0 47412 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 08/07/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 270119
0 1 0 0 0 JUARIYAH.NY 101821 64 23636 DR. ARIA
novia;3313125201940001; 5.6.6.202203301209 4 361914
1#0##0#0#0.0#2022-04-07
12:17:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
02f3c3893f00eae1ee1acb40fd681118 150000 0 0 0 0 0
0 0 0 0 15000 0 105119 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 10/04/1943 0 2
0 0 - 0 - 0 - 0 - 0 181400 230660
0 1 0 0 0 SRIYANTI, (NY) 033740 78 28839 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361915
1#0##0#0#0.0#2022-04-07
12:18:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7dfe9a740e19ad4b8426c57c99dc1696 150000 0 0 0 0 0
0 0 0 0 15000 0 65660 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 15/04/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 227538
0 1 0 0 0 TATAS BUDIONO.TN 100721 48 17876 DR.
novia;3313125201940001; 5.6.7.202204241238 4 361916
1#0##0#0#0.0#2022-05-20
08:40:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
189bb0096928cc352af039edae99f77a 150000 0 0 0 0 0
0 0 0 0 15000 0 62538 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 29/12/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 347358
3;JKN agung;3313092303950002; 5.6.7.202204241238 4 361917
1#0##0#0#0.0#2022-06-17
15:25:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
377a0b08a0109adef0bcd89c16c425d0 150000 0 0 0 0 0
0 0 0 0 15000 0 182358 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 18/11/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 217415
0 1 0 0 0 PARNANTO.TN 099751 67 24599 DR. ARIA
novia;3313125201940001; 5.6.6.202203301209 4 361918
1#0##0#0#0.0#2022-04-07
12:20:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ec91a7aa6df6592a63fa18b43bd67083 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 15/07/1962 0 1
1 Z09.8;G20;M54.39;M19.98 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 612296
0 1 0 0 0 LOSO EFENDI, TN 089597 59 21803 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361920
1#0##0#0#0.0#2022-04-07
12:21:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6eaed072ede23f537e576ffd5a6ac5a2 150000 0 0 0 0 0
0 0 0 0 15000 0 447296 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 22/09/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 211569
0 1 0 0 0 PONIYATI, NY 075582 56 20638 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361921
1#0##0#0#0.0#2022-04-07
12:21:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
10ec859322f03574a7145e57bff22a94 150000 0 0 0 0 0
0 0 0 0 15000 0 46569 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 02/08/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SITI MAJIAH, NY 094003 69 25437 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361922
1#0##0#0#0.0#2022-04-07
12:23:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
94c547018921011884ba215d2a61f733 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 29/06/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 219680
0 1 0 0 0 YULI HARMANTI .NY 043245 47 17436 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361923
1#0##0#0#0.0#2022-04-07
12:23:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6f2bccbd9045a9c9367c1cc46141c78b 150000 0 0 0 0 0
0 0 0 0 15000 0 54680 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 27/08/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 240928
0 1 0 0 0 HANNA AGUSTIN DJORO KANA, NY 091606 44
0001106820718 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361924 1#0##0#0#0.0#2022-04-07
12:24:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 25/03/2022 25/03/2022 12/09/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 215720
0 1 0 0 0 ENDANG SRIWIDIASTUTI,NY 088712 50 18457
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 361925
1#0##0#0#0.0#2022-04-07
12:25:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
23a36b45691791658032e6aa8379cfe1 150000 0 0 0 0 0
0 0 0 0 15000 0 50720 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 12/08/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 216720
0 1 0 0 0 TITIEK MULYANI., NY 051274 58 21410
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 361926
1#0##0#0#0.0#2022-04-07
12:26:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9c0b364ffcaf9003df160593ed51bcba 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 31/12/1946 0 2
0 0 - 0 - 0 - 0 - 0 181400 249350
0 1 0 0 0 HARTATI,(NY) 034422 75 27478 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361927
1#0##0#0#0.0#2022-04-07
12:27:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
26c559bc33a823446297fa04088fffc9 150000 0 0 0 0 0
0 0 0 0 15000 0 84350 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 04/11/1994 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RAUHULLOH AYATULLOH KHOMEINI.SDR 096022 27
novia;3313125201940001; 5.6.6.202203301209 4 361929
1#0##0#0#0.0#2022-04-07
12:57:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2300f19126d4cd8c0d96778d6157875b 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 23/12/2015 0 1
0 0 - 0 - 0 - 0 - 0 181400 360230
0 1 0 0 0 WISNU DWI ENDARTO, AN 078269 6 2284
0002276812271 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361962 1#0##0#0#0.0#2022-04-07
12:58:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3313c9c270e13d390c2e36c6ae9a31e8 300000 0 0 0 0 0
0 0 0 0 15000 0 45230 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 26/04/1968 0 1
0 - 0 - 0 - 0 183900 567332 0 1
0 0 0 SRI RAHARJO, TN 047813 53 19691 DR. HERMAWAN, SP.B
1124R0020322V004218 0001967570796 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361930 1#0##0#0#0.0#2022-04-07
13:00:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
01e19338482864379c3fd1d52f689757 445000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 17/02/2010 0 2
0 0 - 0 - 0 - 0 - 0 181400 394395
0 1 0 0 0 KAELA ALISA PUTRI RIZKY., AN 051218 12
4419 DR. HERMAWAN, SP.B 1124R0020322V004219 0001964530528 3;JKN
novia;3313125201940001; 5.6.6.202203301209 4 361931
1#0##0#0#0.0#2022-04-07
13:01:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
75700907b88a98b7d740635a8f7bdc05 300000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 01/04/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 280112
0 1 0 0 0 DR. MUDZAKKIR, TN 038688 73 27021 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361932
1#0##0#0#0.0#2022-04-07
13:01:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
13524b81422416c6be90ab9a86a1dccf 0 0 0 0 0 0 0
0 0 0 15000 0 265112 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 28/04/1987 0 1
0 - 0 - 0 - 0 183900 416600 0 1
0 0 0 ANDI SUPRIYANTO, TN 055714 34 12750 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361933
1#0##0#0#0.0#2022-04-07
13:05:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9ccf48dc6edd658f536e059384a1037f 370000 0 0 0 0 0
0 0 0 0 15000 0 31600 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 19/03/1981 0 1
0 0 - 0 - 0 - 0 - 0 181400 183887
0 1 0 0 0 MARYADI,TN 052144 41 14981 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 361934
1#0##0#0#0.0#2022-04-07
13:06:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3379125acb75a937752ea7e0737f7845 150000 0 0 0 0 0
0 0 0 0 15000 0 18887 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 30/03/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 402660
0 1 0 0 0 LUTFI SURYANDARI.NY 101604 43 16066
novia;3313125201940001; 5.6.6.202203301209 4 361935
1#0##0#0#0.0#2022-04-07
13:09:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aca8da42c2500414437ad0e068d1bfd9 300000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 21/04/2002 0 2
0 0 - 0 - 0 - 0 - 0 181400 332540
0 1 0 0 0 ASSYFA TIARA PUSPAHARUM, NN 056145 19
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novia;3313125201940001; 5.6.6.202203301209 4 361936
1#0##0#0#0.0#2022-04-07
13:12:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
08ee5c474032d8a7229b8cb8f0afe455 300000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 06/11/2012 0 1
1 Z09.0;Q69.0 93.57 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 416345 0 1
0 0 0 GATOT D W PRATAMA., AN 051671 9 3426 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361937
1#0##0#0#0.0#2022-04-07
13:13:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 25/03/2022 25/03/2022 06/11/2012 0 1
1 Z09.0;N47 93.57 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 400000 0 1
0 0 0 GATOT D W PRABAWA, AN 071878 9 3426 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361938
1#0##0#0#0.0#2022-04-07
13:13:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
528f2663ba59b44f09260380d24e8336 385000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 07/09/1962 0 2
0 - 0 - 0 - 0 786200 687676 0 1
0 0 0 ENDANG SRIANTI, NY 102578 59 21749 DR. TEKY
agung;3313092303950002; 5.6.7.202204241238 4 361939
1#0##0#0#0.0#2022-05-25
09:29:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
939e917cb3140f0420e46e8fe0dd96df 662676 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 23/04/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 211855
0 1 0 0 0 SURYATI, NY 037498 53 19694 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 361940
1#0##0#0#0.0#2022-04-07
13:15:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4f5d2e92481ea3470f41d27e8ac9e3ba 150000 0 0 0 0 0
0 0 0 0 15000 0 46855 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 05/04/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 216146
0 1 0 0 0 ABDUL KHARIS, TN 017985 52 19347 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361941
1#0##0#0#0.0#2022-04-07
13:16:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ee8913d42901c66bd0db51b34aebb65e 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 18/08/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 194405
0 1 0 0 0 DWI DARWANTI.NY 102566 53 19577 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361942
1#0##0#0#0.0#2022-04-07
13:20:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0e3b0e634ff1a2da201f2389cbcf6838 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 22/09/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 212830
0 1 0 0 0 SUMARSONO ,TN 087561 62 22830 DR.
novia;3313125201940001; 5.6.7.202204241238 4 361943
1#0##0#0#0.0#2022-05-19
10:44:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 25/03/2022 25/03/2022 04/08/1948 0 1
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.6.202203301209 4 361944
1#0##0#0#0.0#2022-04-07
13:21:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2a1f68cbce7ea4e007fe3057e9a4de53 463830 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 04/09/1960 0 1
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SP.PD 1124R0020322V004236 0000640142684 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361945 1#0##0#0#0.0#2022-04-07
13:22:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ebf8b46a314cf51d6cf7f304df66fac4 463830 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 15/05/1953 0 1
0 - 0 - 0 - 0 786200 555630 0 1
novia;3313125201940001; 5.6.6.202203301209 4 361946
1#0##0#0#0.0#2022-04-07
13:23:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5333fca12fb18d29c70fcb9f131c7bd0 463830 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 25/03/1978 0 2
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.6.202203301209 4 361947
1#0##0#0#0.0#2022-04-07
13:23:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
97413c8ebada98672f94c9071bd5a3b8 463830 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 23/12/1977 0 2
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.6.6.202203301209 4 361948
1#0##0#0#0.0#2022-04-07
13:24:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5ac9b8ce383ed2902c510597648f0e99 463830 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 01/09/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V004240 0000639614597 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361949 1#0##0#0#0.0#2022-04-07
13:25:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bcac639644ff6a94dcfe437852cf026f 463830 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 07/04/1948 0 1
0 - 0 - 0 - 0 786200 15000 0 1 0
0 0 HARDJOKO, TN 055933 73 27015 DR. TEKY WIDYARINI,
SP.PD 1124R0020322V004241 0000094255514 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361950 1#0##0#0#0.0#2022-04-07
13:25:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
afbaff7b1ac62235a88f8e6dcd628af2 0 0 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 26/06/1978 0 2
- 0 - 0 - 0 - 0 283800 165000 0
1 0 0 0 RINDIYATI.NY 101781 43 15978 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361951
1#0##0#0#0.0#2022-04-07
13:26:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
70a51a3a288c791f30c3f61ec93575b8 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 19/08/1962 0 1
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.6.202203301209 4 361952
1#0##0#0#0.0#2022-04-07
13:27:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
213e58830bfc20042699959d4cd9c923 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 05/09/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SUPARMI., NY 050493 55 20290 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361953
1#0##0#0#0.0#2022-04-07
13:28:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2a8609c1ee43afaa205405f50f43569a 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 25/04/1959 0 2
- 0 - 0 - 0 - 0 283800 165000 0
1 0 0 0 NURUL FITRIANI,(NY) 016314 62 22980 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361954
1#0##0#0#0.0#2022-04-07
13:29:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
12de418c287da7dae93c099d512b8c50 150000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 31/12/1966 0 1
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.6.202203301209 4 361955
1#0##0#0#0.0#2022-04-07
13:29:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
64be50ccfcc82f3e90ef3519ca9a0845 300000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 01/01/2000 0 2
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.6.202203301209 4 361956
1#0##0#0#0.0#2022-04-07
13:30:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a88de88673f7a413ac15b30ca3842cc4 300000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 05/11/1970 0 1
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.6.202203301209 4 361958
1#0##0#0#0.0#2022-04-07
13:32:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5fb754721e868f833d2e21d130018dcb 300000 0 0 0 0 0
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3372030 C 3 CP 2 25/03/2022 25/03/2022 05/08/2003 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 VIRA DWI ARFIANDI, AN 061294 18 6807 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361959
1#0##0#0#0.0#2022-04-07
13:33:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
96a11b34a2dfa4e984fd8483564da574 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 25/05/2000 0 1
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.6.202203301209 4 361957
1#0##0#0#0.0#2022-04-07
13:31:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7bff55a248c179a4b98d02cba86f6b2d 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 02/08/2003 0 2
- 0 - 0 - 0 - 0 283800 315000 0
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 361960
1#0##0#0#0.0#2022-04-07
13:34:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3643feb8609532ccd80597bd323fe31c 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/03/2022 25/03/2022 01/01/2000 0 1
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 AHMAD MAHFUD ,(TN) 034418 22 8119 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361961
1#0##0#0#0.0#2022-04-07
13:35:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
327dd01f8cb07ad93859e2675685fec1 300000 0 0 0 0 0
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3372030 C 3 CP 2 26/03/2022 26/03/2022 20/11/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 580053
0 1 0 0 0 SUMARDI., TN 065082 61 22406 DR.
reni;3313147010930001; 5.6.5.202203091809 4 360566
1#0##0#0#0.0#2022-03-30
11:24:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f5886e15206e7f1a9f5c507f36fe8933 0 0 138000 0 0 0
0 31845 0 0 15000 0 395208 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 28/06/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 302041
0 1 0 0 0 ACHMAD MULYADI., TN 070227 62 22917
reni;3313147010930001; 5.6.5.202203091809 4 360567
2#0##0#0#0.0#2022-03-30
11:25:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a2994114b4db5fa7c02e75f447d45fc1 0 0 138000 0 0 0
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3372030 C 3 CP 2 26/03/2022 26/03/2022 20/10/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 205239
0 1 0 0 0 BADRIYAH MUNAWARAH,(NY) 043414 71 26090
reni;3313147010930001; 5.6.5.202203091809 4 360568
3#0##0#0#0.0#2022-03-30
11:25:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
747b35f34d556690dfffcc24bad9eb9d 0 0 138000 0 0 0
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3372030 C 3 CP 2 26/03/2022 26/03/2022 21/04/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 486119
0 1 0 0 0 HARTO SISWANTO.TN 091623 49 18236 DR.
reni;3313147010930001; 5.6.5.202203091809 4 360570
4#0##0#0#0.0#2022-03-30
11:26:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d41496fe85e35fcb1d801e99f6084185 0 0 138000 0 0 0
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3372030 C 3 CP 2 26/03/2022 26/03/2022 04/05/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 706673
0 1 0 0 0 YULIANTI., NY 063565 61 22606 DR.
reni;3313147010930001; 5.6.5.202203091809 4 360571
5#0##0#0#0.0#2022-03-30
11:37:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e6031fb0132f90fa1836cc2f69a5367a 0 0 138000 0 0 0
496000 0 0 0 15000 0 57673 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 14/05/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 196764
0 1 0 0 0 WINARNO.TN 093273 56 20770 DR. WAHYU
reni;3313147010930001; 5.6.5.202203091809 4 360573
1#0##0#0#0.0#2022-03-30
11:39:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b9e3bc0b1e08ef7b9d09af2867436880 0 0 138000 0 0 0
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3372030 C 3 CP 2 26/03/2022 26/03/2022 14/01/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 277126
0 1 0 0 0 MUH AMIN.TN 086344 57 20890 DR. SUHARTO,
SP.PD 1124R0020322V004261 0001967492619 3;JKN reni;3313147010930001;
5.6.5.202203091809 4 360572 7#0##0#0#0.0#2022-03-30
11:38:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0dafa84d228c91024df37f323f281d2c 0 0 138000 0 0 0
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3372030 C 3 CP 2 26/03/2022 26/03/2022 31/12/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 209047
0 1 0 0 0 NGATIYEM.NY 067636 69 25287 DR. WAHYU
reni;3313147010930001; 5.6.5.202203091809 4 360574
8#0##0#0#0.0#2022-03-30
11:40:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
814769a0f8fdeecbfceecce3b719200d 0 0 138000 0 0 0
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3372030 C 3 CP 2 26/03/2022 26/03/2022 23/03/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 200003
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reni;3313147010930001; 5.6.5.202203091809 4 360575
1#0##0#0#0.0#2022-03-30
11:41:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a37213e875eb30fda5311f490b93a2f2 0 0 138000 0 0 0
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3372030 C 3 CP 2 26/03/2022 26/03/2022 10/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 210079
0 1 0 0 0 DESI IRAWATI.NY 083433 67 24578 DR.
reni;3313147010930001; 5.6.5.202203091809 4 360576
1#0##0#0#0.0#2022-03-30
11:42:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b8ee59e567a95ab8c6562bff327bd244 0 0 138000 0 0 0
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3372030 C 3 CP 2 26/03/2022 26/03/2022 26/02/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 202720
0 1 0 0 0 SRIYANTI SUGENG LESTARI 085690 64 23404
reni;3313147010930001; 5.6.5.202203091809 4 360577
1#0##0#0#0.0#2022-03-30
13:56:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1303842dee5aad1dd33465e128f6e669 0 0 138000 0 0 0
0 0 0 0 15000 0 49720 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 10/02/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 225085
0 1 0 0 0 JIYEM, NY 094913 71 25977 DR. WAHYU
reni;3313147010930001; 5.6.5.202203091809 4 360578
12#0##0#0#0.0#2022-03-30
13:57:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ba796499b76e0cbff4a9449f0dd3691c 0 0 138000 0 0 0
0 0 0 0 15000 0 72085 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 29/09/1970 0 2
- 0 - 0 - 0 - 0 138400 285000 0
reni;3313147010930001; 5.6.5.202203091809 4 360579
1#0##0#0#0.0#2022-03-30
13:58:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
edb69fda24859bd7c17f697f55a49cf9 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 31/12/1955 0 2
1 Z09.8;G81.9;M25.51 93.89 - - None None None None Z-3-
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 SRI ISWATIYARSI, NY 057875 66 24192
reni;3313147010930001; 5.6.5.202203091809 4 360580
14#0##0#0#0.0#2022-03-30
13:58:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c4f8203712071334a35df5cf565e4fcf 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 12/01/1968 0 2
1 M17.9 - - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 194250
0 1 0 0 0 SRI PURWANINGSIH.NY 102579 54 19797
reni;3313147010930001; 5.6.5.202203091809 4 360581
15#0##0#0#0.0#2022-03-30
13:59:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3a6962a66716441a05bddf7dd35b4714 0 0 138000 0 0 0
0 0 0 0 15000 0 41250 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 03/09/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 194932
0 1 0 0 0 WAGIYAH ., NY 059289 58 21389 DR.
reni;3313147010930001; 5.6.5.202203091809 4 360582
1#0##0#0#0.0#2022-03-30
14:07:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4ba57a5a766b4b039664c80a5b707a7c 0 0 138000 0 0 0
0 0 0 0 15000 0 41932 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 20/08/1980 0 2
1 Z09.8;K30;D64.8 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 191953
0 1 0 0 0 WENNY WIDYASTUTI, NY 102518 41 15193
reni;3313147010930001; 5.6.5.202203091809 4 360583
17#0##0#0#0.0#2022-03-30
14:08:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
330c7310ffa721a69d85871f8965e1e4 0 0 138000 0 0 0
0 0 0 0 15000 0 38953 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 02/04/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 191181
0 1 0 0 0 WARSITI, NY 078337 48 17890 DR. WAHYU
reni;3313147010930001; 5.6.5.202203091809 4 360584
18#0##0#0#0.0#2022-03-30
14:08:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
571376305d6a15484e9cf7f0d67f10ef 0 0 138000 0 0 0
0 0 0 0 15000 0 38181 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 01/07/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 204029
0 1 0 0 0 SARIYEM, NY 091999 79 29123 DR. WAHYU
reni;3313147010930001; 5.6.5.202203091809 4 360592
1#0##0#0#0.0#2022-03-30
14:15:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bf31f3828c89ab81a01ac1878093e3c1 0 0 138000 0 0 0
0 0 0 0 15000 0 51029 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 30/11/1971 0 2
0 - 0 - 0 - 0 135700 196804 0 1
0 0 0 FATMAWATI.NY 102680 50 18379 DR. SUHARTO, SP.PD
1124R0020322V004277 0001530215392 3;JKN reni;3313147010930001;
5.6.5.202203091809 4 360593 20#0##0#0#0.0#2022-03-30
14:16:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c3fb37bc0c79a4b98ebe5acaa04ec1f6 0 0 138000 0 0 0
0 0 0 0 25000 0 33804 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 23/09/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 184845
0 1 0 0 0 WAHYU SETYO RINI.NY 087130 52 19177
reni;3313147010930001; 5.6.5.202203091809 4 360594
21#0##0#0#0.0#2022-03-30
14:17:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
94b2f348f06d9fbb3617ab648a705554 0 0 138000 0 0 0
0 31845 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 02/03/1941 0 2
0 0 - 0 - 0 - 0 - 0 181400 196775
0 1 0 0 0 DIYAH 101274 81 29609 DR. WAHYU PURNOMO,
SP.OT 1124R0020322V004279 0000091192274 3;JKN reni;3313147010930001;
5.6.5.202203091809 4 360595 22#0##0#0#0.0#2022-03-30
14:17:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2f2f8f5514b3131718b2b4c9057771f3 0 0 138000 0 0 0
0 0 0 0 15000 0 43775 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 02/02/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 360021
0 1 0 0 0 SUMARYONO.TN 087131 50 18315 DR.
reni;3313147010930001; 5.6.5.202203091809 4 360596
23#0##0#0#0.0#2022-03-30
14:18:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b4bcc894b59af40adcf945f854747c33 0 0 138000 0 0 0
0 31845 0 0 15000 0 175176 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 08/11/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 210849
0 1 0 0 0 IRAN RAHAYU, NY 099708 54 19862 DR.
reni;3313147010930001; 5.6.5.202203091809 4 360597
24#0##0#0#0.0#2022-03-30
14:18:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
026c0ffd8f166b69a732e9654e7a1a9a 0 0 138000 0 0 0
0 0 0 0 15000 0 57849 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 19/03/1978 0 1
0 - 0 - 0 - 0 183900 184064 0 1
0 0 0 FITRA WALUYANDI, TN 073763 44 16078 DR. WAHYU
agung;3313092303950002; 5.6.6.202203301209 4 360598
1#0##0#0#0.0#2022-04-11
12:11:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
35e78f7a1e2be13437a5bd470d6edc4c 0 0 138000 0 0 0
0 0 0 0 15000 0 31064 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 23/01/1969 0 2
1 Z09.8;E11.9;R05 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 264344
0 1 0 0 0 SITI ZUBAIDAH., NY 050986 53 19420
reni;3313147010930001; 5.6.5.202203091809 4 360599
26#0##0#0#0.0#2022-03-30
14:20:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b28878b06dbee4cbae5731266c7bfee7 150000 0 0 0 0 0
0 0 0 0 15000 0 99344 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 23/07/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001868943565 3;JKN reni;3313147010930001; 5.6.5.202203091809 4
360600 27#0##0#0#0.0#2022-03-30
14:20:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
40924643f5d2ff61d68b7c0f7833f1b5 204000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 10/04/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 203591
0 1 0 0 0 MOEMINAH., NY 046939 71 26283 DR.
reni;3313147010930001; 5.6.5.202203091809 4 360601
28#0##0#0#0.0#2022-03-30
14:21:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d6cc52e8893414fe7843cc079cee31b8 0 0 138000 0 0 0
0 0 0 0 15000 0 50591 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 25/03/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUPINAH 091220
0000639810066 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
360602 1#0##0#0#0.0#2022-05-19
11:05:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
9a49969290d3a113797b1c97694561c0 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 26/05/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001474646354 3;JKN reni;3313147010930001; 5.6.5.202203091809 4
360603 30#0##0#0#0.0#2022-03-30
14:22:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
92d75062a20eaec45225239846651ed5 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 31/12/1954 0 2
1 Z09.8;G56.0;M79.18 93.35 - - None None None None M-3-
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 219000 0 1 0 0 0 TUMINAH NY 088417
0002581070231 3;JKN reni;3313147010930001; 5.6.5.202203091809 4
360604 31#0##0#0#0.0#2022-03-30
14:24:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6602fd0d64785e92df122e4b79b63f17 204000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 23/04/1960 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 219000 0 1 0 0 0 SRI WAHYUNI, NY
0000091421842 3;JKN reni;3313147010930001; 5.6.5.202203091809 4
360605 32#0##0#0#0.0#2022-03-30
14:25:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
67c6f717d38a60114b0be2ad29e18068 204000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 07/10/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 YATINI 094257
0001083705715 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
360606 1#0##0#0#0.0#2022-05-19
13:15:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
b65d4b8e5f860ccd01bf35f547cccf88 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 25/06/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 310552
0 1 0 0 0 DARNI WIDAYATI 092677 59 21824 DR.
reni;3313147010930001; 5.6.5.202203091809 4 360607
34#0##0#0#0.0#2022-03-30
14:26:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
09c00f301e2abdab468b63226b5cbdb6 0 0 138000 0 0 0
0 31845 0 0 15000 0 125707 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 16/05/1956 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WIDI WINARSI.NY
0001849841414 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
360608 1#0##0#0#0.0#2022-05-19
10:11:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
3293c008772367628e9ad2ea4ba9e38e 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 27/09/1965 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MARYATI., NY
0000640162157 3;JKN reni;3313147010930001; 5.6.5.202203091809 4
360609 36#0##0#0#0.0#2022-03-30
14:34:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0d5f6a12dca0738d2a0465fca40e9b80 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 08/06/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 LAMIYEM.NY 087484
0001316300512 3;JKN reni;3313147010930001; 5.6.5.202203091809 4
360610 37#0##0#0#0.0#2022-03-30
14:35:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e056d140c7d763c62c1ecc719a310411 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 08/12/1992 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ARIS ABDULLAH, BP
0000091323292 3;JKN reni;3313147010930001; 5.6.5.202203091809 4
360611 38#0##0#0#0.0#2022-03-30
14:35:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d72680c659da904c35af34569dc07f24 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 24/02/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI PURWANI.NY
0001125886228 3;JKN reni;3313147010930001; 5.6.5.202203091809 4
360612 39#0##0#0#0.0#2022-03-30
14:36:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
18f3201dbe94cf4639700fdfd61225e4 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 28/10/1994 0 2
0 0 - 0 - 0 - 0 - 0 181400 217760
0 1 0 0 0 HANANI SEPTIANA PUTRI.NY 102681 27
3;JKN reni;3313147010930001; 5.6.5.202203091809 4 360613
40#0##0#0#0.0#2022-03-30
14:38:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9d17a1272c5c7e23c13a564660870f8c 0 0 138000 0 0 0
0 0 0 0 25000 0 54760 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 28/10/1955 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 TEMU MUJIYEM, NY 097662 66 24256 DR.
reni;3313147010930001; 5.6.5.202203091809 4 360614
41#0##0#0#0.0#2022-03-30
14:38:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e071089319d1afd13affe437f45719d8 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 24/12/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI SUTANTI, NY
0000639837347 3;JKN reni;3313147010930001; 5.6.5.202203091809 4
360619 42#0##0#0#0.0#2022-03-30
14:48:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0986b6b8ef63cac963b93ae3c10d4308 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 09/04/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 450566
reni;3313147010930001; 5.6.5.202203091809 4 360620
43#0##0#0#0.0#2022-03-30
14:49:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6ac98c4aaf3e5468601ea0fd6ff233d5 0 0 138000 0 0 0
248000 0 0 0 15000 0 49566 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 21/09/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002199915988 3;JKN reni;3313147010930001; 5.6.5.202203091809 4
360621 44#0##0#0#0.0#2022-03-30
14:49:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8d96ee58927d42eaf688bf2b635b695d 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 25/06/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 KERNI,(NY) 033080
0001316373355 3;JKN reni;3313147010930001; 5.6.5.202203091809 4
360622 45#0##0#0#0.0#2022-03-30
14:50:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
53dc9360fb544558f2f7a9feb3d1b686 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 09/07/1959 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 285000 0 1 0 0 0 SUROTO.TN 087121
0003116443004 3;JKN reni;3313147010930001; 5.6.5.202203091809 4
360623 1#0##0#0#0.0#2022-03-30
14:50:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f8c392854b6864a62e288fb111b97dac 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 15/04/1973 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TATAS BUDIONO.TN
0001440938553 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
360624 1#0##0#0#0.0#2022-05-20
08:40:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
947a188406056d2d6c4379d3e2ed57df 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 11/11/1952 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMARDI.TN 101737
0000640283771 3;JKN reni;3313147010930001; 5.6.5.202203091809 4
360626 48#0##0#0#0.0#2022-03-30
14:52:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
885c91c292fb7a80b4b2dc94c1370809 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 13/08/1951 0 2
1 Z09.8;R07.4;I50.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 197924
0 1 0 0 0 SUNARNI.(NY) 030534 70 25793 DR.
reni;3313147010930001; 5.6.5.202203091809 4 360627
49#0##0#0#0.0#2022-03-30
14:52:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8d3d3ad328caeea41d52350c73768480 0 0 138000 0 0 0
0 0 0 0 15000 0 44924 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 02/03/1963 0 2
0 - 0 - 0 - 0 - 0 138400 299000
0 1 0 0 0 SUMARNI, NY 101618 59 21574 DR. LINDA
reni;3313147010930001; 5.6.5.202203091809 4 360628
50#0##0#0#0.0#2022-03-30
14:53:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5edfd2121729100c3cf7e3f11ee26571 146000 0 138000 0 0
0 0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 05/05/1957 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 SURYATI, NY 090097 64 23701 DR. LINDA
reni;3313147010930001; 5.6.5.202203091809 4 360629
51#0##0#0#0.0#2022-03-30
14:53:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
28013226a7139f34950ff9b1f2b14d3a 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 28/07/1988 0 2
1 Z09.8;E11.9;K30;M17.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 184845
0 1 0 0 0 FAUZIAH DAHLIA SARI., NY 045406 33
reni;3313147010930001; 5.6.5.202203091809 4 360630
52#0##0#0#0.0#2022-03-30
14:54:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ddeed74008948e83244273606872c80c 0 0 138000 0 0 0
0 31845 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 06/03/1953 0 2
1 Z09.8;E11.9;I11.9;K80.2 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 250034
0 1 0 0 0 DARMIYATI, NY 067337 69 25222 DR.
reni;3313147010930001; 5.6.5.202203091809 4 360631
53#0##0#0#0.0#2022-03-30
15:01:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a932bcb60b95242d874ba9d0c425bccf 0 0 138000 0 0 0
0 0 0 0 15000 0 97034 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 05/03/1985 0 2
0 0 - 0 - 0 - 0 - 0 181400 189003
3;JKN reni;3313147010930001; 5.6.5.202203091809 4 360632
54#0##0#0#0.0#2022-03-30
15:02:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a9e866b1be12fcfaf01dc3e1ad95763e 0 0 138000 0 0 0
0 0 0 0 15000 0 36003 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 20/02/2009 0 2
0 - 0 - 0 - 0 129600 184760 0 1
0 0 0 GREETHA SULISTYO SAPUTRI.NN 102291 13 4782 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361270
1#0##0#0#0.0#2022-04-05
12:06:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f6727451152c63af8560bda6558183b8 0 0 138000 0 0 0
0 0 0 0 15000 0 31760 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 11/09/1954 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUMARNO.TN 095054
0001425421326 3;JKN reni;3313147010930001; 5.6.5.202203091809 4
360633 55#0##0#0#0.0#2022-03-30
15:02:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
787ca6202c81416bc2a22e0e3eb72cf1 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 28/02/1939 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SLAMET SUDARMO.TN
0000091169436 3;JKN reni;3313147010930001; 5.6.5.202203091809 4
360634 56#0##0#0#0.0#2022-03-30
15:03:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
51a19658b18b3459fd8dbf1dffc79799 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 15/06/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 453206
0 1 0 0 0 BUDI SANTOSO,(BP) 017713 49 18181 DR.
reni;3313147010930001; 5.6.5.202203091809 4 360635
57#0##0#0#0.0#2022-03-30
15:05:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6e4458af76b5fb8587a04e3a0f1b16e1 0 0 138000 0 0 0
248000 0 0 0 15000 0 52206 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 26/09/1963 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 BAJURI, TN 000197
0001104121822 3;JKN reni;3313147010930001; 5.6.5.202203091809 4
360636 58#0##0#0#0.0#2022-03-30
15:04:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
acf24c9f97b7d512b8ff29f7f8bf3e8c 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 14/04/1960 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARTINAH., NY
0001084606863 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
360637 1#0##0#0#0.0#2022-05-19
10:03:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 26/03/2022 26/03/2022 07/06/1963 0 2
1 Z09.8;E78.5;R50.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 191108
0 1 0 0 0 WARSINI TURMUDZI ,(NY) 039273 58 21477
reni;3313147010930001; 5.6.6.202203301209 4 360644
1#0##0#0#0.0#2022-03-31
13:45:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
181e96fefd6df5c56a42bd3486f44d26 0 0 138000 0 0 0
0 0 0 0 15000 0 38108 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 23/03/1965 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 SRI LESTARI,(NY) 035396 57 20822 DR. LINDA
reni;3313147010930001; 5.6.6.202203301209 4 360645
61#0##0#0#0.0#2022-03-31
13:47:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aa1429cb772282da52d66d0f571d40ae 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 28/02/2008 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 BERLY GAVIN J, AN
0001106709579 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
360646 62#0##0#0#0.0#2022-03-31
13:47:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6d922e5a8820482b70afce31b52ca3ec 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 23/01/1957 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
184845 0 1 0 0 0 SRI MULYANI 084537 65 23803
reni;3313147010930001; 5.6.6.202203301209 4 360647
63#0##0#0#0.0#2022-03-31
13:48:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
63d343348709e60e0ccabf0b9c28c6f6 0 0 138000 0 0 0
0 31845 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 25/12/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARIA
HENDRASAPUTRA,NY 100064 67 24563 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V004325 0002069991685 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 360648 1#0##0#0#0.0#2022-05-20
08:31:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
b2fb13210b64a82a588d9935194b2f85 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 23/09/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 285000 0 1 0 0 0 ROCHYATI.NY 059452
0001813968753 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
360649 65#0##0#0#0.0#2022-03-31
13:50:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bd302f88572fa12b4412cc94cdc3c675 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 31/12/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 264000 0 1 0 0 0 WARSINI, NY 095108
0001084784139 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
360650 66#0##0#0#0.0#2022-03-31
13:50:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c116453ce5225bcfc2a6b93c006a8242 249000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 14/03/1966 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
288828 0 1 0 0 0 SUPARNO, TN 083695 56 20466
reni;3313147010930001; 5.6.6.202203301209 4 360651
67#0##0#0#0.0#2022-03-31
13:51:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
054a80daf23d1d88ebfe6ddcbea642a5 0 0 138000 0 0 0
0 0 0 0 15000 0 135828 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 08/11/1969 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 ENDAH PURWANTI, NY 064170 52 19131
reni;3313147010930001; 5.6.6.202203301209 4 360652
68#0##0#0#0.0#2022-03-31
13:52:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
521b81511b1ea4f7c9fed983f0553176 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 18/04/1968 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 RAHMADI.TN 096843
0002169726311 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
360653 69#0##0#0#0.0#2022-03-31
13:52:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b50813da7d3cbf4ffb3a39b8bf156860 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 07/07/1964 0 1
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 WIRADI.TN 098841 57 21081 DR. LINDA
reni;3313147010930001; 5.6.6.202203301209 4 360654
70#0##0#0#0.0#2022-03-31
13:53:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a81e2dfc5d0217e65b7fccd759a86bd4 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 19/08/1953 0 1
1 Z09.8;S93.4 93.89 - - None None None None Z-3-12-0 None
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 DJOKO PRAPTONO, TN 071622 68 25056 DR.
reni;3313147010930001; 5.6.6.202203301209 4 360655
71#0##0#0#0.0#2022-03-31
13:53:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ecad0ad0a22ad5c5777b106315ce01e8 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 25/02/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 206606
0 1 0 0 0 ROSIDAH. NY 087797 70 25597 DR. WAHYU
reni;3313147010930001; 5.6.6.202203301209 4 360656
72#0##0#0#0.0#2022-03-31
13:53:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c3c9af5ed7fdf8e9a65c1ae017c5a7c5 0 0 138000 0 0 0
0 0 0 0 15000 0 53606 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 20/02/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 234208
0 1 0 0 0 RUMTANINGSIH(NY) 032276 65 23775 DR.
reni;3313147010930001; 5.6.6.202203301209 4 360657
73#0##0#0#0.0#2022-03-31
13:54:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3277e370ad4a9a95ff9cf194a1a9e989 0 0 138000 0 0 0
0 0 0 0 15000 0 81208 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 01/12/1944 0 2
- 0 - 0 - 0 - 0 138400 219000 0
1 0 0 0 WANTIYEM.NY 078888 77 28239 DR. LINDA
reni;3313147010930001; 5.6.6.202203301209 4 360658
74#0##0#0#0.0#2022-03-31
13:55:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cfba13c598fd311f6558120aa5260ce2 204000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 07/10/1961 0 1
0 - 0 107400 262000 0 1 0 0 0 AGUNG
RUMAMBI, TN 097338 60 22085 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V004336 0001528617734 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 360659 75#0##0#0#0.0#2022-03-31
13:56:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bc113801bf224099f3da672a18f04242 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 07/02/2006 0 2
0 0 - 0 - 0 - 0 - 0 181400 387454
0 1 0 0 0 VANESA NINDY HAPSARI.AN 089069 16 5891
reni;3313147010930001; 5.6.6.202203301209 4 360660
76#0##0#0#0.0#2022-03-31
13:56:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ddfd95c3b7b20d6c78329d0f6d97c208 150000 0 0 0 0 0
0 0 0 0 15000 0 222454 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 03/12/1950 0 1
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.6.6.202203301209 4 360661
77#0##0#0#0.0#2022-03-31
13:57:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
455300ed19993d38f983260a719a5a12 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 09/09/1944 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V004339 0000100867893 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 360662 78#0##0#0#0.0#2022-03-31
13:57:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
db8145358053f872f4420f03d76b623a 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 18/07/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V004340 0002425018184 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 360663 79#0##0#0#0.0#2022-03-31
13:57:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7fe9c873b245b6764ab71bc089b62fcc 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 31/12/1981 0 2
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.6.6.202203301209 4 360664
80#0##0#0#0.0#2022-03-31
13:58:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2f2bb6e5dab4e15f4b8e5c2ee58d84f4 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 04/06/1954 0 2
1 Z09.8;A01.0;M19.98;J06.9 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
189331 0 1 0 0 0 PARNI, NY 091735 67 24767
reni;3313147010930001; 5.6.6.202203301209 4 360665
81#0##0#0#0.0#2022-03-31
13:59:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
949e81d47f562dfa4fd119bebb73fd64 0 0 138000 0 0 0
0 0 0 0 15000 0 36331 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 30/07/2019 0 2
1 J45.9 93.94 - - None None None None J-3-13-0 None None
None None None None PROSEDUR TERAPI SALURAN PERNAFASAN 308500 0
0 - 0 - 0 - 0 - 0 308500 177592
0 1 0 0 0 DIANA RAHMAWATI, AN 099044 2 970
DR. CHIKA KLARISSA 1124R0020322V004343 0002881916943 3;JKN
reni;3313147010930001; 5.6.6.202203301209 4 361044
1#0##0#0#0.0#2022-04-04
18:21:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
05a001b75d06403d2970d72d3017d918 130000 0 0 0 0 0
0 0 0 0 15000 0 32592 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 02/02/1972 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V004344 0002070978546 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 360666 82#0##0#0#0.0#2022-03-31
13:59:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
260110bc5728f750d43e0ae86f810e19 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 14/03/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.6.6.202203301209 4 360667
83#0##0#0#0.0#2022-03-31
14:00:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7dd8c6439d43687bf36d88b96a39606a 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 12/03/1955 0 2
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.6.6.202203301209 4 360668
84#0##0#0#0.0#2022-03-31
14:00:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
18a39dbe9842da1eb94ac8ec21c2530a 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 01/01/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V004347 0001147281805 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 360669 85#0##0#0#0.0#2022-03-31
14:01:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
68a14d427df3b8ac2f96144a8507a919 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 12/07/1966 0 1
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.6.6.202203301209 4 360670
86#0##0#0#0.0#2022-03-31
14:01:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1d52f22f5117b105a1e08f222c076dd6 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 05/03/1988 0 2
0 0 - 0 - 0 - 0 - 0 181400 620224
0 1 0 0 0 CICILIA MARIA NINA NOVIANA,(NN) 030268
34 12439 DR. IBRAHIM NASRUL, SP.KJ 1124R0020322V004349
0001106241726 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
360671 87#0##0#0#0.0#2022-03-31
14:02:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fb8ac6e7bb1c51f2c8453f2b629ff93f 150000 0 0 0 0 0
0 0 0 0 15000 0 455224 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 27/06/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 219246
0 1 0 0 0 RIKA KRISDIANAWATI,(NY) 002091 42 15613
reni;3313147010930001; 5.6.6.202203301209 4 360672
88#0##0#0#0.0#2022-03-31
14:02:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
189ebd6f16488f27596e9aa4682cff8b 0 0 138000 0 0 0
0 0 0 0 15000 0 66246 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 11/11/1976 0 1
0 0 - 0 - 0 - 0 - 0 181400 473653
0 1 0 0 0 ADRIANTO AGUS WICAKSONO.TN 087216 45
3;JKN reni;3313147010930001; 5.6.6.202203301209 4 360697
89#0##0#0#0.0#2022-03-31
14:26:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6d5533a284af7dbce43e4fef459ae46f 150000 0 0 0 0 0
0 0 0 0 15000 0 308653 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 13/12/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 153000
0 1 0 0 0 ANIK FADMIATI, NY 086726 55 20192 DR.
reni;3313147010930001; 5.6.6.202203301209 4 360699
90#0##0#0#0.0#2022-03-31
14:27:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ac18e6463e4cc8d3e00318366b70168b 0 0 138000 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 26/06/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 370135
0 1 0 0 0 JOKO SANTOSO 043040 63 23284 DR.
reni;3313147010930001; 5.6.6.202203301209 4 360700
91#0##0#0#0.0#2022-03-31
14:27:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f78f11a7c5a6007c4eff16befcc6bfd3 150000 0 0 0 0 0
0 0 0 0 15000 0 205135 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 31/12/1996 0 2
0 0 - 0 - 0 - 0 - 0 181400 314517
reni;3313147010930001; 5.6.6.202203301209 4 360701
92#0##0#0#0.0#2022-03-31
14:28:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
48c6edd94bea2bca6e7aa4f30fa38359 0 0 138000 0 0 0
0 0 0 0 15000 0 161517 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 12/02/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 514189
0 1 0 0 0 DARWATI, NY 094471 58 21227 DR. IBRAHIM
reni;3313147010930001; 5.6.6.202203301209 4 360702
93#0##0#0#0.0#2022-03-31
14:29:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b4a2cc7676380eaef18c96d6d60439db 0 0 138000 0 0 0
0 0 0 0 15000 0 361189 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 11/08/2008 0 2
0 0 - 0 - 0 - 0 - 0 181400 167135
0 1 0 0 0 MARATU ALFI FAUZIAH, AN 102525 13 4975
reni;3313147010930001; 5.6.6.202203301209 4 360703
94#0##0#0#0.0#2022-03-31
14:29:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d3be5707e2e56c741f776f91aff68fc1 0 0 138000 0 0 0
0 0 0 0 15000 0 14135 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 25/10/1969 0 2
1 Z09.8;K21.9;J02.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 225521
0 1 0 0 0 SUWARNI.NY 087525 52 19145 DR. SUHARTO,
SP.PD 1124R0020322V004357 0002205741431 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 360704 95#0##0#0#0.0#2022-03-31
14:30:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7e6ff51745e09bd74b9e674992155ecd 0 0 138000 0 0 0
0 0 0 0 15000 0 72521 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 04/04/1998 0 1
1 Z09.8;R10.4;K21.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 172549
0 1 0 0 0 YUDA PRASETYA ARIFIN, SDR 041086 23
reni;3313147010930001; 5.6.6.202203301209 4 360705
96#0##0#0#0.0#2022-03-31
14:31:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5c112e7f98dc09115b6b4e035bd1c43a 0 0 138000 0 0 0
0 0 0 0 15000 0 19549 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 13/08/1957 0 2
1 Z09.8;K80.2;N20.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 251040
reni;3313147010930001; 5.6.6.202203301209 4 360706
97#0##0#0#0.0#2022-03-31
14:31:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
df70d058cefd9a0bd3789354894177fc 0 0 138000 0 0 0
0 0 0 0 15000 0 98040 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 28/10/1964 0 2
1 Z09.8;I11.9;K30;M25.58 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 277270
0 1 0 0 0 RR YANET FLORIDA SRI MULYANINGSIH, NY 069248
3;JKN reni;3313147010930001; 5.6.6.202203301209 4 360707
98#0##0#0#0.0#2022-03-31
14:32:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5210c045c513874cad1835bf8a758d52 0 0 138000 0 0 0
0 0 0 0 15000 0 124270 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 10/06/1961 0 2
1 Z09.8;I50.9;I11.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 210629
0 1 0 0 0 PARINEM.NY 083383 60 22204 DR. SUHARTO,
SP.PD 1124R0020322V004361 0002261302165 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 360708 99#0##0#0#0.0#2022-03-31
14:33:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9c9b2cca6662f4dc504859c8c3f20dd2 0 0 138000 0 0 0
0 0 0 0 15000 0 57629 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 28/06/1956 0 2
1 Z09.8;K80.2;I11.9;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 185302
0 1 0 0 0 SRI SARASWATI.NY 088967 65 24012 DR.
reni;3313147010930001; 5.6.6.202203301209 4 360709
1#0##0#0#0.0#2022-03-31
14:34:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e7573a8eae8bb3ddf4e38087b3d1576c 0 0 138000 0 0 0
0 0 0 0 15000 0 32302 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 10/11/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 211971
0 1 0 0 0 WIYONO.TN 100139 69 25338 DR. SUHARTO,
SP.PD 1124R0020322V004363 0000090740204 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 360710 101#0##0#0#0.0#2022-03-31
14:34:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
389f672225c15b01c90ede74ab320b6a 0 0 138000 0 0 0
0 0 0 0 15000 0 58971 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 04/06/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 153000
0 1 0 0 0 RAMEI,BP 037075 71 26228 DR. SUHARTO,
SP.PD 1124R0020322V004364 0000089866315 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 360711 102#0##0#0#0.0#2022-03-31
14:35:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1749d3d5b77fef055d0f9bc98a4b99ac 0 0 138000 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 02/06/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 410263
0 1 0 0 0 SITI NURKHAYATI., NY 065344 59 21847
reni;3313147010930001; 5.6.6.202203301209 4 360712
103#0##0#0#0.0#2022-03-31
14:36:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5d6c3f0762c8a856867c0b6551323c15 0 0 138000 0 0 0
0 0 0 0 15000 0 257263 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 25/09/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 251426
0 1 0 0 0 SLAMET SUNARJO.TN 036285 62 22828 DR.
reni;3313147010930001; 5.6.6.202203301209 4 360713
104#0##0#0#0.0#2022-03-31
14:37:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f73c95afc43161151051b31b14a483b0 0 0 138000 0 0 0
0 0 0 0 15000 0 98426 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 18/07/1986 0 2
1 Z09.8;Z03.8;E05.9;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 209837
reni;3313147010930001; 5.6.6.202203301209 4 360714
105#0##0#0#0.0#2022-03-31
14:38:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8cef546082a5bde6d7ac96a5e21ce675 0 0 138000 0 0 0
0 0 0 0 15000 0 56837 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 13/04/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 213110
0 1 0 0 0 SITI ROKAYAH.NY 099608 43 16053 DR.
reni;3313147010930001; 5.6.6.202203301209 4 360715
106#0##0#0#0.0#2022-03-31
14:38:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f7cd53d83416e45f8f382415703f2080 0 0 138000 0 0 0
0 0 0 0 15000 0 60110 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 05/09/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 255146
0 1 0 0 0 ACHMAD DJAZIM DJUWAIRI.TN 100492 76
reni;3313147010930001; 5.6.6.202203301209 4 360716
107#0##0#0#0.0#2022-03-31
14:39:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d3da0e83d308a8314a33ec5e2331d9ef 0 0 138000 0 0 0
0 0 0 0 15000 0 102146 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 01/10/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 233663
0 1 0 0 0 DALTI, NY 055299 71 26109 DR. SUHARTO,
SP.PD 1124R0020322V004370 0002224502728 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 360717 108#0##0#0#0.0#2022-03-31
14:40:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3ebabdec3175911abdaef48d00cf22dd 0 0 138000 0 0 0
0 0 0 0 15000 0 80663 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 26/05/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 299009
0 1 0 0 0 SRI HADIYATI, NY 101467 55 20393 DR.
reni;3313147010930001; 5.6.6.202203301209 4 360718
109#0##0#0#0.0#2022-03-31
14:40:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6ca5dee57e996bd3cf60cb943230e943 0 0 138000 0 0 0
0 0 0 0 15000 0 146009 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 11/11/1971 0 2
1 Z09.8;R10.4;I25.2 88.76 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400 844433
0 1 0 0 0 ENDANG WAHYUDI S, NY 102521 50 18398
reni;3313147010930001; 5.6.6.202203301209 4 361525
1#0##0#0#0.0#2022-04-06
08:59:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
99bc08e33bcdd68d47e5053a387e33f2 0 0 138000 0 0 0
657000 0 0 0 15000 0 34433 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 25/05/1948 0 1
1 Z09.8;E78.5;R51 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 461496
0 1 0 0 0 SUDARMO HADIMULYO M, TN 066357 73 26968
reni;3313147010930001; 5.6.6.202203301209 4 360719
110#0##0#0#0.0#2022-03-31
14:40:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
39a8642616ffd7a86ece00ac556b2c11 0 0 138000 0 0 0
0 0 0 0 15000 0 308496 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 07/09/1944 0 2
0 0 - 0 - 0 - 0 - 0 181400 228372
0 1 0 0 0 SUMINEM.NY 099812 77 28324 DR. SUHARTO,
SP.PD 1124R0020322V004374 0000091327601 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 360720 111#0##0#0#0.0#2022-03-31
14:42:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
938f085e0c80063eb26cba90e328d572 0 0 138000 0 0 0
0 0 0 0 15000 0 75372 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 14/12/1982 0 1
0 0 - 0 - 0 - 0 - 0 181400 283830
0 1 0 0 0 TOFHAN ANDRYAS, TN 099114 39 14347
reni;3313147010930001; 5.6.6.202203301209 4 360721
112#0##0#0#0.0#2022-03-31
14:42:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
66b9cb95b042ec10437d54a8745a0e67 0 0 138000 0 0 0
0 0 0 0 15000 0 130830 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 17/01/1955 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001107700209 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
360722 113#0##0#0#0.0#2022-03-31
14:43:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
08020ce2517c44e95c4a7b491338e374 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 20/02/1997 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MEGI ARUM.TN
0000565102956 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
360723 114#0##0#0#0.0#2022-03-31
14:43:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bc601f4c4f81b80da527e04df8e0dc6d 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 03/09/1996 0 2
0 0 - 0 - 0 - 0 - 0 181400 203038
0 1 0 0 0 ENDANG TRI KURNIANINGSIH .NN 061270 25
3;JKN reni;3313147010930001; 5.6.6.202203301209 4 360725
115#0##0#0#0.0#2022-03-31
14:45:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eddd8c8389f5a107501503d49de38177 150000 0 0 0 0 0
0 0 0 0 15000 0 38038 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 15/03/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 547336
0 1 0 0 0 SUNARDI, TN 093054 51 18639 DR. IBRAHIM
reni;3313147010930001; 5.6.6.202203301209 4 360726
116#0##0#0#0.0#2022-03-31
14:45:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
46f31d56253e681e2714b80826ec8fdd 150000 0 0 0 0 0
0 0 0 0 15000 0 382336 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 24/05/1985 0 1
0 0 - 0 - 0 - 0 - 0 181400 515785
0 1 0 0 0 HERY SUSANTO,TN 023203 36 13455 DR.
reni;3313147010930001; 5.6.6.202203301209 4 360727
117#0##0#0#0.0#2022-03-31
14:46:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1ddba999af5e8799be34980266032f3a 150000 0 0 0 0 0
0 0 0 0 15000 0 350785 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 12/09/2008 0 1
1 R59.0 - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 177891
0 1 0 0 0 NAJIB IHSAN RAMADHAN.AN 102683 13 4943
0001190340483 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
360728 1#0##0#0#0.0#2022-05-20
11:02:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
58917e4fc5c33a4e7fef2cbf5716575c 150000 0 0 0 0 0
0 0 0 0 25000 0 2891 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 11/10/1982 0 1
None None None None PSIKOTHERAPI INDIVIDU DEWASA BUKAN AKUT 194500
0 0 - 0 - 0 - 0 - 0 194500 184560
0 1 0 0 0 JOKO NURYANTO.TN 102684 39 14411 DR.
reni;3313147010930001; 5.6.6.202203301209 4 360729
119#0##0#0#0.0#2022-03-31
14:47:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
298395abc94a2c43b3c481d4b83f2d39 0 0 138000 0 0 0
0 0 0 0 25000 0 21560 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 24/01/1964 0 2
1 Z09.8;K30;I10;R51 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 214672
0 1 0 0 0 SUKARMI., NY 045414 58 21246 DR.
reni;3313147010930001; 5.6.6.202203301209 4 360730
120#0##0#0#0.0#2022-03-31
14:47:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c80a1cc90f9880ae0691be1178e02f8a 0 0 138000 0 0 0
0 0 0 0 15000 0 61672 0 0 0 0 0
3372030 C 3 CP 2 26/03/2022 26/03/2022 07/08/1959 0 2
2 I63.9 87.03;87.49 - - None None None None Z-3-18-0 None
0 - 0 - 0 - 0 894800 4260802 0 1
0 0 0 SRI LESTARI., NY 045299 62 22877 DR. YOSSI REZA
GIMAWAN 1124R0020322V004391 0001021694095 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 362017 1#0##0#0#0.0#2022-04-08
13:48:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
c593c521c12f63448e921f64d45d8f54 1345000 0 0 0 0 0
1450000 175145 0 0 15000 0 1275657 0 0 0
0 0
3372030 C 3 CP 2 27/03/2022 27/03/2022 02/04/1965 0 2
2 R50.9;R10.4 87.49;89.52 - - None None None None Q-5-42-0
0 0 - 0 - 0 - 0 - 0 182600 407500
0 1 0 0 0 SUHARTI, NY 062768 56 20813 DR. NIKE
1124R0020322V004395 0001971984655 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361045 1#0##0#0#0.0#2022-04-04
18:22:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
43bbf7c7717c0e727b33a9ba036e7562 0 0 192500 0 0 0
200000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 27/03/2022 27/03/2022 26/01/2012 0 1
0 - 0 - 0 - 0 135700 170586 0 1
0 0 0 M.ZIDAN ARMA PUTRA,AN 023489 10 3713 DR. YOSSI
REZA GIMAWAN 1124R0020322V004397 0001107926054 3;JKN
reni;3313147010930001; 5.6.6.202203301209 4 361047
1#0##0#0#0.0#2022-04-04
18:27:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1f99aef0c498376de4d85b1c604fa24c 130000 0 0 0 0 0
0 0 0 0 15000 0 25586 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 15/09/1953 0 1
1 Z09.8;E11.2;N08.3;G59.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 404457
0 1 0 0 0 BUDIYONO, TN 084324 68 25031 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361451
1#0##0#0#0.0#2022-04-06
10:21:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e9fb9be5281247fd7980204de12ba7da 0 0 138000 0 0 0
0 108440 0 0 15000 0 143017 0 0 0 0
0
3372030 C 3 CP 2 28/03/2022 28/03/2022 01/07/1957 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
308606 0 1 0 0 0 ELISABETH YULIANA SRI SAYEKTI.NY
084730 64 23646 DR. TEKY WIDYARINI, SP.PD 1124R0020322V004406
0002199916337 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361455 1#0##0#0#0.0#2022-04-06
10:22:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7b793f6018f52be0a1b55d4f983ee69a 0 0 138000 0 0 0
0 121345 0 0 15000 0 34261 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 13/08/1980 0 2
0 - 0 - 0 - 0 - 0 549400 157380
0 1 0 0 0 ERIS YUNIARTI. NY 078325 41 15202 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361474
1#0##0#0#0.0#2022-04-06
10:23:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
70896baf2b3ff4949081fc6f234501e0 0 0 138000 0 0 0
0 0 0 0 15000 0 4380 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 14/05/1978 0 1
1 Z09.8;M17.9;E78.5 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 200070
0 1 0 0 0 MARWIWIJI, TN 102422 43 16024 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361475
1#0##0#0#0.0#2022-04-06
10:24:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a7da7c61a8e592fb3b0034ecdcacc50f 0 0 138000 0 0 0
0 0 0 0 15000 0 47070 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 08/09/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 250216
0 1 0 0 0 DAVID KASIDI.TN 099766 66 24308 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361476
1#0##0#0#0.0#2022-04-06
10:24:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8c6ba1a18c85d662af63f5212eb09da6 0 0 138000 0 0 0
0 0 0 0 15000 0 97216 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 29/03/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 205075
0 1 0 0 0 SULASTRI.NY (081747) 079845 65 24105
agung;3313092303950002; 5.6.6.202203301209 4 361477
1#0##0#0#0.0#2022-04-06
10:26:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c7092015deaf86e7bd40d507a879cede 0 0 138000 0 0 0
0 0 0 0 15000 0 52075 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 01/08/1942 0 1
1 Z09.8;I10;J44.9;M19.98 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 184240
0 1 0 0 0 SUTARKA BP 084552 79 29094 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 361479
1#0##0#0#0.0#2022-04-06
10:26:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
db7f7c6422470c63b46ef46a553b30b5 0 0 138000 0 0 0
0 0 0 0 15000 0 31240 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 08/06/1956 0 2
1 Z09.8;E11.2;N08.3;I10;G59.0;E78.5 - - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 331515 0 1 0 0 0 SUKINAH.NY 085798
0001084398232 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361481 1#0##0#0#0.0#2022-04-06
10:27:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0ab0347c74fd2655d8c92083094b7374 0 0 138000 0 0 0
0 120795 0 0 15000 0 57720 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 16/05/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 311486
0 1 0 0 0 SENTOT RIYADI.,BP 047632 62 22962 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361484
1#0##0#0#0.0#2022-04-06
10:28:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
56500e07e56a15194f82a61b3391d255 0 0 138000 0 0 0
0 121345 0 0 15000 0 37141 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 26/02/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 442021
0 1 0 0 0 RAMELAN, BP 066059 65 23771 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 361497
1#0##0#0#0.0#2022-04-06
10:28:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7ee189ff29ecc659fc6b2bca27f94cd4 0 0 138000 0 0 0
0 107890 0 0 15000 0 181131 0 0 0 0
0
3372030 C 3 CP 2 28/03/2022 28/03/2022 22/09/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 419765
0 1 0 0 0 AMINI,(NY) 040407 55 20276 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 361499
1#0##0#0#0.0#2022-04-06
10:28:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c053adcbde3136f079815224a5e11f6c 0 0 138000 0 0 0
0 76045 0 0 15000 0 190720 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 10/01/1963 0 2
1 Z09.8;E11.4;G59.0;I10;M19.98;E78.5 - - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 313210 0 1 0 0 0 RIYANTI,NY 075128
0001814857637 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361501 1#0##0#0#0.0#2022-04-06
10:29:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
df8c7ff9e50b3b235cf5400fb54e4fc2 0 0 138000 0 0 0
0 0 0 0 15000 0 160210 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 10/03/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 250360
0 1 0 0 0 SUGIYARTO.TN 068468 70 25585 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361503
1#0##0#0#0.0#2022-04-06
10:30:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
39f87f537f78e188e668228cddbaa766 0 0 138000 0 0 0
0 89500 0 0 15000 0 7860 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 02/09/1962 0 1
1 Z09.8;I10;E79.0;K30;M19.98 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
212201 0 1 0 0 0 DARMANTO, TN 009893 59
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 361506
1#0##0#0#0.0#2022-04-06
10:30:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
69c647cde2ae76e16b6a71e207707ecc 0 0 138000 0 0 0
0 0 0 0 15000 0 59201 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 16/09/1966 0 2
1 Z09.8;I10;K76.0;K80.2 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 544731
0 1 0 0 0 SUMARSIH.NY 083995 55 20282 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 361508
1#0##0#0#0.0#2022-04-06
10:31:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3609cc1b9135408f4ec80a12a4353ca1 0 0 138000 0 0 0
0 88900 0 0 15000 0 302831 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 30/06/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 316335
0 1 0 0 0 HARMI 095040 49 18168 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 361510
1#0##0#0#0.0#2022-04-06
10:32:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3503c3d1659213280cd6d41a1201ecf9 0 0 138000 0 0 0
0 76045 0 0 15000 0 87290 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 28/05/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 429125
0 1 0 0 0 BAKRI, TN 094397 58 21489 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 361512
1#0##0#0#0.0#2022-04-06
10:32:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
989c49de657a7db4022af76f140291e6 0 0 138000 0 0 0
0 76045 0 0 15000 0 200080 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 21/09/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 533927
0 1 0 0 0 AGUNG WIBOWO.TN 100600 56 20642 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361514
1#0##0#0#0.0#2022-04-06
10:33:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a1a56a4c1bbba5dd5fde9cd81373b2ab 0 0 138000 0 0 0
0 0 0 0 15000 0 380927 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 01/07/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 281420
0 1 0 0 0 NY.SRI HANTARI 073628 62 22916 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361516
1#0##0#0#0.0#2022-04-06
10:34:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
85359bfaf4f2adc0580ea845f2ca3d34 0 0 138000 0 0 0
0 108440 0 0 15000 0 19980 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 14/06/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001429190267 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361342 1#0##0#0#0.0#2022-04-06
09:39:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
20f937c734569346743df2321db3eec6 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 27/06/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI MARGANI.NY
0000091413112 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361357 1#0##0#0#0.0#2022-04-06
09:38:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
58653f71b61ed4e87ff8083380452cb6 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 31/12/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI SUWANTI, NY
0001967417043 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361347 1#0##0#0#0.0#2022-04-06
09:39:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
674d2bf10f545b276925a2f42803961c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 22/09/1959 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMARSONO ,TN
0001032587199 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361344 1#0##0#0#0.0#2022-04-06
09:40:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d94fa75b7319f6a0f0fbb99243f02eba 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 30/08/1961 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 207500 0 1 0 0 0 RIA TRI RASMANI.
0001729980966 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361341 1#0##0#0#0.0#2022-04-06
09:41:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
389f042fa3755a028d8cd9b9b434166e 0 0 192500 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 13/06/1971 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002169781694 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361346 1#0##0#0#0.0#2022-04-06
09:41:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1608eb183e149fa670a200ba016c6f8a 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 18/02/1942 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DARTINAH,NY 030952
0001021779674 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361359 1#0##0#0#0.0#2022-04-06
09:42:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aceb4b0ba8a5a4341d4f0f3a2488c949 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 03/08/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 TENTREM.NY 089445
0000640219601 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361345 1#0##0#0#0.0#2022-04-06
09:43:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
45106c1a5c10d9941943451e531d2d16 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 08/12/1976 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 NIKEN MARDUSASI,
0002165494217 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361349 1#0##0#0#0.0#2022-04-06
09:44:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9c7b1e9312905d2b6b74d8f43bb2713f 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 19/02/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 FRAN HARTUTI.NY
0000091493098 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361352 1#0##0#0#0.0#2022-04-06
09:45:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cd661a93ab9680470431810ad178cf25 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 02/08/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ISWINDARI., NY
0001792902148 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361343 1#0##0#0#0.0#2022-04-06
09:45:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cd49919ef680aebabe7af5e20724fa66 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 06/07/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMARNI.NY 086963
0002347072604 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361350 1#0##0#0#0.0#2022-04-06
09:46:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fbb24446f345356937a7329972d62135 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 30/04/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 527618
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 361519
1#0##0#0#0.0#2022-04-06
10:34:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ff14671f4512ea37299f4778ed808fce 203000 0 0 0 0 0
0 0 0 0 15000 0 309618 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 05/06/1961 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARSIATUN, NY
0002311256204 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361355 1#0##0#0#0.0#2022-04-06
09:47:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
89a9afe283335c74dddc688f65420b95 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 31/12/1956 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
280656 0 1 0 0 0 SUBARDJO, TN 098793 65
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 361521
1#0##0#0#0.0#2022-04-06
10:35:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
73d4d7e3c539bb3d71b5d7282a98b6bc 203000 0 0 0 0 0
0 0 0 0 15000 0 62656 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 31/01/1979 0 1
0 - 0 - 0 - 0 183900 303787 0 1
0 0 0 YUDO PRIHANDIKO.TN 102558 43 15762 DR. DAMAR
ARYO, SP.B 1124R0020322V004444 0000640177918 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361271 1#0##0#0#0.0#2022-04-05
12:07:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2fa16de71036b7fa99911598ed13bb4e 235000 0 0 0 0 0
0 0 0 0 15000 0 53787 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 31/05/1993 0 2
0 - 0 - 0 - 0 183900 291264 0 1
SP.B 1124R0020322V004445 0000640414394 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 361524 1#0##0#0#0.0#2022-04-06
10:36:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
938937bd19da90e9ba7085a1b6a3435d 235000 0 0 0 0 0
0 0 0 0 15000 0 41264 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 28/02/1979 0 2
0 - 0 - 0 - 0 - 0 296400 214680
0 1 0 0 0 ENI KUSTIYAH,(NY) 034451 43 15734 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361529
1#0##0#0#0.0#2022-04-06
10:38:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
297cf8d1831441b2fb4caf785d0e9a8e 0 0 184000 0 0 0
0 0 0 0 15000 0 15680 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 12/12/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 348103
0 1 0 0 0 SITI CHOSIYAH., NY 045191 74 27135
agung;3313092303950002; 5.6.6.202203301209 4 361531
1#0##0#0#0.0#2022-04-06
10:39:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9489cff35112e12ee88ad4ee9a8a9bde 203000 0 0 0 0 0
0 0 0 0 15000 0 130103 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 24/08/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 218000
0 1 0 0 0 UMIYATI, NY 098329 46 17018 DR. YUDHI
agung;3313092303950002; 5.6.6.202203301209 4 361532
1#0##0#0#0.0#2022-04-06
10:40:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
72f0967c59e95eb14972723f97b526ee 203000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 09/12/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 215020
agung;3313092303950002; 5.6.6.202203301209 4 361535
1#0##0#0#0.0#2022-04-06
10:41:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1c89d75d68107d89a51bb48725d1fed0 0 0 184000 0 0 0
0 0 0 0 15000 0 16020 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 17/07/1978 0 2
- 0 - 0 - 0 183900 206935 0 1 0
0 0 RUWANI.NY 101744 43 15960 DR. GUNAWAN, SP.OG
1124R0020322V004450 0001530396178 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 361537 1#0##0#0#0.0#2022-04-06
11:41:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
96318622dbb0e84ed3e022a840e6768f 0 0 184000 0 0 0
0 0 0 0 15000 0 7935 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 11/02/1943 0 1
0 0 - 0 - 0 - 0 - 0 181400 280656
0 1 0 0 0 DIRUN.,BP 072011 79 28900 DR. YUDHI
agung;3313092303950002; 5.6.6.202203301209 4 361538
1#0##0#0#0.0#2022-04-06
11:42:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
14e0dfe1e53fb62c2be624946b94a171 203000 0 0 0 0 0
0 0 0 0 15000 0 62656 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 31/12/1971 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V004453 0000555344774 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 361363 1#0##0#0#0.0#2022-04-06
09:47:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f07c56073e44253313a842bae2609082 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 23/03/1976 0 2
0 - 0 - 0 - 0 786200 546840 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361364
1#0##0#0#0.0#2022-04-06
09:48:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
36d7dc5d8f29067f0c7a4f5a5b92d98b 463830 0 0 0 0 0
0 0 0 0 15000 0 68010 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 10/12/1982 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361365
1#0##0#0#0.0#2022-04-06
09:49:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0e4376fd2d9966b0ca8c5c9361852647 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 12/10/1987 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361366
1#0##0#0#0.0#2022-04-06
13:06:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
472c8e5bf9c52e9680688e186ab56599 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 21/10/2003 0 2
0 - 0 - 0 - 0 - 0 181400 188292
0 1 0 0 0 OKTAVIANA PUTRI RAHMAWATI, (AN) 016163
0001108014219 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361540 1#0##0#0#0.0#2022-04-06
11:42:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
57b11cf956487a65b30478d2b40b7f0d 150000 0 0 0 0 0
0 0 0 0 15000 0 23292 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 25/06/1970 0 2
0 - 0 - 0 - 0 786200 532980 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361367
1#0##0#0#0.0#2022-04-06
09:50:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b3aa446ea269844a2d55bf7cf32a0606 463830 0 0 0 0 0
0 0 0 0 15000 0 54150 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 04/09/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361369
1#0##0#0#0.0#2022-04-06
09:51:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
631a33013273532f7873a9e5df48872c 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 10/07/1955 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V004460 0001032581823 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 361371 1#0##0#0#0.0#2022-04-06
09:51:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
107bc7b02359ae5a4af606dce610fe42 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 04/05/1958 0 2
1 Z49.1;M18.5 39.95 - - None None None None N-3-15-0 None
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361372
1#0##0#0#0.0#2022-04-06
09:52:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bcec99cc1f7185eb5ae6d2d8f27d58ff 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 15/10/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361384
1#0##0#0#0.0#2022-04-06
09:52:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c8f09e76f8891a92f49016e4e5b3dbb3 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 22/10/1959 0 2
0 - 0 - 0 - 0 786200 677676 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361377
1#0##0#0#0.0#2022-04-06
09:53:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c6428035dfec56956fb29df38e6077c0 662676 0 0 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 29/06/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 248954
0 1 0 0 0 SARWONO, TN 102337 62 22918 DR. INDRIANY
agung;3313092303950002; 5.6.6.202203301209 4 361543
1#0##0#0#0.0#2022-04-06
11:43:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1d46e2ce8b68d33f43453e4ad5ca05df 0 0 138000 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 12/09/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 204146
0 1 0 0 0 WIDJAYANTI KUSUMA SALIM.NY 101590 70
0002198271161 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361545 1#0##0#0#0.0#2022-04-06
11:43:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
236141693d022bad2a8ee3a877587c34 0 0 138000 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 17/01/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 231650
0 1 0 0 0 SUTARYANTO, TN 102419 67 24542 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361547
1#0##0#0#0.0#2022-04-06
11:44:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4dfd79e7559f0532f6117a33059bfeac 0 0 138000 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 10/04/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 168000
0 1 0 0 0 SRI RAHAYU.NY 084543 60 22267 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361550
1#0##0#0#0.0#2022-04-06
11:44:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9f0e4c67b0827e2cfbc9c0acfcfb6c39 0 0 138000 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 01/09/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 174327
0 1 0 0 0 SAMBUDI,(BP) 037461 59 21758 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361557
1#0##0#0#0.0#2022-04-06
11:45:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d18e5388133a472d66b2f245ecf7b4ab 0 0 138000 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 20/10/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 216460
0 1 0 0 0 SARTI.NY 099768 48 17691 DR. INDRIANY
agung;3313092303950002; 5.6.6.202203301209 4 361560
1#0##0#0#0.0#2022-04-06
11:46:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
772f0df93f4faef121e46f42467129fd 0 0 138000 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 04/07/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 436630
0 1 0 0 0 SULIYEM, NY 052010 59 21817 DR. WAHYU
reni;3313147010930001; 5.6.6.202203301209 4 361552
1#0##0#0#0.0#2022-04-06
09:01:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
272576de385a4c4c806920b3c1978e03 150000 0 0 0 0 0
220000 0 0 0 15000 0 51630 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 01/07/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 319986
0 1 0 0 0 KASNI.,NY 072708 55 20359 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 361562
1#0##0#0#0.0#2022-04-06
11:47:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0666a9ac8a00026a7185e571f41a638e 0 0 138000 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 20/07/1962 0 2
0 404900 589662 0 1 0 0 0 SRI YULIATI.NY
0000091516983 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361563 1#0##0#0#0.0#2022-04-06
11:47:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
83624592ba1ac001ddb2280a97862b01 351500 0 0 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 17/03/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 220070
0 1 0 0 0 SRI LESTARI, NY 099302 58 21195 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361565
1#0##0#0#0.0#2022-04-06
11:48:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2d9980adc079d076315703b84a59bb59 150000 0 0 0 0 0
0 0 0 0 15000 0 55070 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 03/08/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 216630
0 1 0 0 0 ISMURYANI HANDAYANINGSIH.NY 098932 58
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 361566
1#0##0#0#0.0#2022-04-06
11:49:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ef5743ac1bcbe012939e2c892820d95f 150000 0 0 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 15/02/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 203110
0 1 0 0 0 HERY SANTOSO.TN 102443 70 25609 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361567
1#0##0#0#0.0#2022-04-06
11:49:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
db018010a711ab32afff53cf614abeee 150000 0 0 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 12/09/2000 0 1
0 0 - 0 - 0 - 0 - 0 181400 291723
0 1 0 0 0 HAMID GHANIY PUTRA, SDR 053419 21 7867
agung;3313092303950002; 5.6.6.202203301209 4 361568
1#0##0#0#0.0#2022-04-06
11:50:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d110cddc3706957f08030f99d689de15 203000 0 0 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 13/02/1975 0 1
0 0 - 0 - 0 - 0 - 0 181400 228751
0 1 0 0 0 SLAMET MULYONO, TN 102011 47 17210
agung;3313092303950002; 5.6.6.202203301209 4 361569
1#0##0#0#0.0#2022-04-11
12:14:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
393b305c007bcd74738413fd2595806c 0 0 138000 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 26/04/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 812186
0 1 0 0 0 SRI RAHARJO, TN 047813 53 19694 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361570
1#0##0#0#0.0#2022-04-06
11:51:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cbd29765058c43f4fb61aa30a9c16bdc 0 0 138000 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 21/12/2008 0 1
0 - 0 - 0 - 0 183900 215241 0 1
0 0 0 RIZKY KURNIA PRATAMA.AN 098931 13 4845 DR. WAHYU
agung;3313092303950002; 5.6.6.202203301209 4 361572
1#0##0#0#0.0#2022-04-06
11:51:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e5218b5cdcf67d02ff042d17cfdddaaf 176000 0 0 0 0 0
0 0 0 0 15000 0 24241 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 17/09/1954 0 2
1 H26.9;H02.4;H35.0;H04.1 90.29 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 280656
0 1 0 0 0 ENDANG SRI HANDAYANI., NY 048892 67
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 361574
1#0##0#0#0.0#2022-04-06
11:52:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
aab1c1f3e7543ead6fc48292bf6f798d 203000 0 0 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 21/02/2015 0 1
0 - 0 - 0 - 0 183900 382255 0 1
0 0 0 PRANAJA SETYA AZKA A.AN 099752 7 2592 DR. WAHYU
agung;3313092303950002; 5.6.6.202203301209 4 361576
1#0##0#0#0.0#2022-04-06
11:53:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ea270589ed43ecaa8c6d444de6563edc 352000 0 0 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 02/05/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 203610
0 1 0 0 0 ANISA KURNIASARI, NY 093665 58 21515
agung;3313092303950002; 5.6.6.202203301209 4 361579
1#0##0#0#0.0#2022-04-06
11:53:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/03/2022 28/03/2022 14/08/1957 0 1
1 Z09.4;S72.80 96.59;93.57 - - None None None None Z-3-
27-0 None None None None None None PERAWATAN LUKA 183900 0 0
- 0 - 0 - 0 - 0 183900 246793 0
1 0 0 0 SURATMO MULYOSUHARJO, TN 102582 64 23602
reni;3313147010930001; 5.6.6.202203301209 4 361275
1#0##0#0#0.0#2022-04-05
12:08:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/03/2022 28/03/2022 02/01/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 382940
0 1 0 0 0 KISWARDANI.NY 086811 54 19809 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361582
1#0##0#0#0.0#2022-04-06
11:54:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
438b74c65d3c274717aac658b25b7b59 150000 0 0 0 0 0
200000 0 0 0 15000 0 17940 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 03/08/2000 0 1
1 S82.20;W19.3 - - None None None None Q-5-31-0
0 - 0 - 0 - 0 129600 442800 0 1
0 0 0 MUHAMMAD IKHSAN, SDR 025188 21 7907 DR. WAHYU
reni;3313147010930001; 5.6.7.202204241238 4 367813
1#0##0#0#0.0#2022-06-13
08:59:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
0b9209320e2ef9dddce8f3cea2e314be 150000 0 0 0 0 0
248000 0 0 0 15000 0 29800 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 16/09/1954 0 2
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agung;3313092303950002; 5.6.6.202203301209 4 361584
1#0##0#0#0.0#2022-04-06
12:31:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f3390b90352a17abc0d540caeb3aaff7 0 0 138000 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 17/11/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 153000
0 1 0 0 0 INDRARIADI, TN 098885 55 20220 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361585
1#0##0#0#0.0#2022-04-06
12:32:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9cfe55ff96492b28efe7c7a06c584b56 0 0 138000 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 16/05/1962 0 1
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1 0 0 0 SUPARJI.TN 102687 59 21866 DR. DAMAR ARYO,
SP.B 1124R0020322V004489 0001104312824 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361276 1#0##0#0#0.0#2022-04-05
12:08:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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657000 0 0 0 25000 0 8003 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 01/01/2000 0 2
1 N93.8;N83.2 88.79 - - None None None None Z-3-23-0 None
0 - 0 - 0 - 0 - 0 549400 153000
0 1 0 0 0 RINI WIDAYATI,(NY) 036479 22 8122
agung;3313092303950002; 5.6.6.202203301209 4 361587
1#0##0#0#0.0#2022-04-06
12:33:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
967e7a1e631b829268b88adfd4a11271 0 0 138000 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 08/03/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 209122
0 1 0 0 0 SUPRAPTI.NY 102438 50 18282 DR. WAHYU
agung;3313092303950002; 5.6.6.202203301209 4 361590
1#0##0#0#0.0#2022-04-06
12:34:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fc29e91237a1bf8fc78fa67c2b88f5ed 150000 0 0 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 26/09/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 420381
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reni;3313147010930001; 5.6.6.202203301209 4 361277
1#0##0#0#0.0#2022-04-05
12:09:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eda04eabc31e55119a37f0874ee2f88b 0 0 138000 0 0 0
220000 0 0 0 25000 0 37381 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 17/03/1976 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000563317132 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361348 1#0##0#0#0.0#2022-04-06
09:54:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fc6306d3945c2601d872f21eb97fd363 236000 0 0 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 16/08/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 333936
0 1 0 0 0 SUMINI, NY 071873 61 22504 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 361593
1#0##0#0#0.0#2022-04-06
12:35:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
22ab59f88ecee22ff66214e36e57e09b 0 0 138000 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 23/03/1965 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI LESTARI,(NY)
0000564742912 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361353 1#0##0#0#0.0#2022-04-06
09:55:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b2be10c9cad951d8548e2846a6828343 258000 0 0 0 0 0
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3372030 C 3 CP 2 27/03/2022 27/03/2022 03/06/2021 0 1
1 R50.9;K52.9 - - None None None None Q-5-42-0 None
0 - 0 - 0 - 0 - 0 182600 496676
0 1 0 0 0 DANISH RAZIQIN NUGRAHA, AN 102639 0
297 DR. EVA PRATAMA SUTRISNA 1124R0020322V004498 0003085211867
3;JKN novia;3313125201940001; 5.6.7.202204241238 4 361049
1#0##0#0#0.0#2022-05-20
11:16:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
01a85d726d93e265d5f6cf63d459da5d 230000 0 0 0 0 0
0 143300 0 0 25000 0 98376 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 16/04/1974 0 2
1 D25.9 88.79 - - None None None None Z-3-23-0 None None
- 0 - 0 - 0 - 0 549400 209000 0
1 0 0 0 SURYANI.NY 102689 47 17513 DR. DEWI
agung;3313092303950002; 5.6.6.202203301209 4 361595
1#0##0#0#0.0#2022-04-06
12:36:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c6566e4444ce3003c1162a7528d2e7e2 0 0 184000 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 23/11/1999 0 1
0 0 - 0 - 0 - 0 - 0 181400 153000
0 1 0 0 0 AHMAD ASYROFUL HAQ.SDR 057992 22 8161
agung;3313092303950002; 5.6.6.202203301209 4 361600
1#0##0#0#0.0#2022-04-06
12:37:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3ece218316bebd1cad2bba8b095b8f96 0 0 138000 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 02/08/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 490584
0 1 0 0 0 SRI BANDONO., BP 046597 70 25806 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361605
1#0##0#0#0.0#2022-04-06
12:38:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
65e151affc96b128f5589d348b02d0a6 0 0 138000 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 27/02/1969 0 2
0 - 0 - 0 - 0 - 0 181400 175000
0 1 0 0 0 KUS ADHARINI.NY 102690 53 19387 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361607
1#0##0#0#0.0#2022-04-06
12:38:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bf24c2a77749848d3346a82f7b4e0529 150000 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/03/2022 28/03/2022 03/08/1963 0 2
0 - 0 - 0 - 0 786200 498100 0 1
agung;3313092303950002; 5.6.6.202203301209 4 361374
1#0##0#0#0.0#2022-04-06
09:55:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c9695273f68a792bad245bdf6facc77c 463830 0 0 0 0 0
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3372030 C 3 CP 2 28/03/2022 28/03/2022 31/12/1934 0 2
0 - 0 - 0 - 0 129600 222862 0 1
0 0 0 SITI ROMLAH.NY 102691 87 31864 DR. WAHYU PURNOMO,
SP.OT 1124R0020322V004505 0002600171965 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 361609 1#0##0#0#0.0#2022-04-06
12:39:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/03/2022 28/03/2022 23/11/2017 0 2
0 - 0 - 0 - 0 - 0 181400 237104
0 1 0 0 0 AZZAHRA RAESHIA M, AN 063938 4 1586
0002370602518 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
361611 1#0##0#0#0.0#2022-04-06
12:46:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/03/2022 28/03/2022 02/06/1983 0 1
1 Z09.8;T14.71 97.89 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 369983
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5.6.6.202203301209 4 361630 1#0##0#0#0.0#2022-04-06
12:46:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/03/2022 28/03/2022 17/12/1984 0 2
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agung;3313092303950002; 5.6.6.202203301209 4 361631
1#0##0#0#0.0#2022-04-06
12:47:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/03/2022 28/03/2022 24/12/1994 0 2
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1#0##0#0#0.0#2022-04-06
12:48:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/03/2022 28/03/2022 31/12/1959 0 2
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agung;3313092303950002; 5.6.7.202204241238 4 367814
1#0##0#0#0.0#2022-05-20
10:30:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 28/03/2022 28/03/2022 12/12/1964 0 1
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agung;3313092303950002; 5.6.6.202203301209 4 361379
1#0##0#0#0.0#2022-04-06
09:56:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/03/2022 28/03/2022 09/05/1975 0 1
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09:57:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/03/2022 28/03/2022 04/08/1948 0 1
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agung;3313092303950002; 5.6.6.202203301209 4 361382
1#0##0#0#0.0#2022-04-06
09:58:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/03/2022 28/03/2022 08/04/1964 0 1
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agung;3313092303950002; 5.6.6.202203301209 4 361361
1#0##0#0#0.0#2022-04-06
09:59:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/03/2022 28/03/2022 12/08/1977 0 1
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agung;3313092303950002; 5.6.6.202203301209 4 361375
1#0##0#0#0.0#2022-04-06
10:00:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/03/2022 28/03/2022 21/04/1952 0 1
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1#0##0#0#0.0#2022-04-06
12:48:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/03/2022 28/03/2022 04/05/1981 0 1
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12:49:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/03/2022 28/03/2022 28/02/2020 0 2
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1#0##0#0#0.0#2022-04-04
18:30:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/03/2022 28/03/2022 18/10/1967 0 1
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3;JKN agung;3313092303950002; 5.6.6.202203301209 4 361635
1#0##0#0#0.0#2022-04-06
12:49:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/03/2022 28/03/2022 29/07/1980 0 2
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agung;3313092303950002; 5.6.7.202204241238 4 367816
1#0##0#0#0.0#2022-05-20
10:31:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/03/2022 28/03/2022 22/07/1966 0 2
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1#0##0#0#0.0#2022-04-06
12:49:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/03/2022 28/03/2022 30/01/1976 0 1
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18:29:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 03/09/1977 0 1
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12:14:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 29/03/2022 29/03/2022 26/09/1963 0 1
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novia;3313125201940001; 5.6.7.202204241238 4 361676
1#0##0#0#0.0#2022-05-18
10:12:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 29/03/2022 29/03/2022 31/12/1963 0 2
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08:59:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 24/07/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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361683 1#0##0#0#0.0#2022-04-07
09:00:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 24/11/1970 0 2
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reni;3313147010930001; 5.6.6.202203301209 4 361688
1#0##0#0#0.0#2022-04-07
09:00:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 07/07/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0002477029059 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361689 1#0##0#0#0.0#2022-04-07
09:01:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 11/05/1943 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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361690 1#0##0#0#0.0#2022-04-07
09:01:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 04/12/1951 0 2
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reni;3313147010930001; 5.6.6.202203301209 4 361692
1#0##0#0#0.0#2022-04-07
09:02:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 06/07/1954 0 2
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09:02:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 23/04/1960 0 2
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361693 1#0##0#0#0.0#2022-04-07
09:03:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 12/02/1965 0 2
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1#0##0#0#0.0#2022-04-07
09:04:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 03/03/1949 0 2
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361695 1#0##0#0#0.0#2022-04-07
09:04:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 18/01/1955 0 2
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361697 1#0##0#0#0.0#2022-04-07
09:05:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 30/06/1966 0 1
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09:05:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 31/12/1955 0 2
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361699 1#0##0#0#0.0#2022-04-07
09:06:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 29/09/1970 0 2
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1124R0020322V004560 0001211692601 3;JKN reni;3313147010930001;
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3372030 C 3 CP 2 29/03/2022 29/03/2022 10/05/1956 0 1
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1#0##0#0#0.0#2022-04-07
09:07:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 16/05/1997 0 2
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361703 1#0##0#0#0.0#2022-04-07
09:08:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 23/04/1968 0 2
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09:09:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 15/11/2018 0 1
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1124R0020322V004566 0002579775748 3;JKN reni;3313147010930001;
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09:10:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 28/08/1977 0 2
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1#0##0#0#0.0#2022-04-07
09:10:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 01/06/1944 0 2
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3372030 C 3 CP 2 29/03/2022 29/03/2022 25/02/1962 0 1
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1#0##0#0#0.0#2022-04-07
09:26:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
286a59050f4bc30fce2d6329f84adce1 150000 0 0 0 0 0
0 0 0 0 15000 0 126090 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 20/07/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 207500 0 1 0 0 0 SITI ZUHRIYAH,(NY)
0000091194276 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361715 1#0##0#0#0.0#2022-04-07
09:36:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
98e381448093f29b29b58445c20d73f9 0 0 192500 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 12/07/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 639745
0 1 0 0 0 SRI HARYANTI.NY 094798 56 20714 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361716
1#0##0#0#0.0#2022-04-07
09:36:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
321f77b7aa70cf313830da2b8762950d 150000 0 0 0 0 0
0 382135 0 0 15000 0 92610 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 04/08/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 207500 0 1 0 0 0 SUNARTI.,NY 054610
0000091515857 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361717 1#0##0#0#0.0#2022-04-07
09:37:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8b2697bf8ffd2c52daaf1da2ae83ff99 0 0 192500 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 16/08/1940 0 1
0 0 - 0 - 0 - 0 - 0 181400 340200
0 1 0 0 0 AMIN BUDIMAN, BP 057129 81 29810 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361718
1#0##0#0#0.0#2022-04-07
09:38:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
be9b2b2ab9ba66b146a7c5049d43dbf2 150000 0 0 0 0 0
0 0 0 0 15000 0 175200 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 01/11/1961 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 213800 0 1 0 0 0 KUSTIATI, NY
0000090942546 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361719 1#0##0#0#0.0#2022-04-07
09:39:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4dd1234b8e56600f5d6a25bb7ac691a6 0 0 198800 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 05/03/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 356810
0 1 0 0 0 SRI SALAMININGSIH. NY 083374 75 27418
reni;3313147010930001; 5.6.6.202203301209 4 361720
1#0##0#0#0.0#2022-04-07
09:40:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5cdf160966309111459ed86b22d4d966 0 0 138000 0 0 0
0 108440 0 0 15000 0 95370 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 12/02/1964 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DARWATI, NY 094471
0002040571449 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361721 1#0##0#0#0.0#2022-04-07
09:41:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3e2e224efe3f8bb81aa342cc6227c5bb 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 11/06/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 195511
0 1 0 0 0 ENY SULASTRI,(NY) 033228 46 17093 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361722
1#0##0#0#0.0#2022-04-07
09:41:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5f79e3aadbbdd5e49cbfab5de34f7fa5 150000 0 0 0 0 0
0 0 0 0 15000 0 30511 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 20/01/1963 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 207500 0 1 0 0 0 RESPATI DWI
1124R0020322V004579 0001865287618 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361723 1#0##0#0#0.0#2022-04-07
09:42:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
93b46893737e2dc1e05b94518d4d56f2 0 0 192500 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 03/07/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 213800 0 1 0 0 0 LUCIA SRI
1124R0020322V004580 0000639909854 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361724 1#0##0#0#0.0#2022-04-07
09:43:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
44d7c8a7f8c7337500bea81be774235b 0 0 198800 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 08/08/1971 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 207500 0 1 0 0 0 GIYANTI.NY 100284
0000639911507 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361725 1#0##0#0#0.0#2022-04-07
09:43:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9735318d0a9c206daeeb7ade5ebc08b2 0 0 192500 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 10/04/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 266925
0 1 0 0 0 SRI RAHAYU.NY 084543 60 22268 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361726
1#0##0#0#0.0#2022-04-07
09:44:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
10127b32787504989e2de11e8768cc14 150000 0 0 0 0 0
0 31845 0 0 15000 0 70080 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 07/11/1971 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 NUZUL HAKIM, TN
0002169296897 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361727 1#0##0#0#0.0#2022-04-07
09:45:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0001bb2710e4fd31dcdfbaa36f31adaf 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 21/08/1948 0 2
0 - 0 107400 213800 0 1 0 0 0
1124R0020322V004585 0000091314876 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361728 1#0##0#0#0.0#2022-04-07
09:45:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
326bcff2ee262c5d24d056beeb047e16 0 0 198800 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 15/04/1973 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 213800 0 1 0 0 0 TATAS BUDIONO.TN
0001440938553 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361729 1#0##0#0#0.0#2022-04-07
09:47:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
675efc130065e6f241428a79725dbae9 0 0 198800 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 07/08/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 230635
reni;3313147010930001; 5.6.6.202203301209 4 361730
1#0##0#0#0.0#2022-04-07
09:48:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c2991ffcdf0dfa614228242dfef5a5e2 150000 0 0 0 0 0
0 0 0 0 15000 0 65635 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 05/01/1951 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 207500 0 1 0 0 0 ACHMAD SUPARDI.,
0001693922106 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361731 1#0##0#0#0.0#2022-04-07
09:48:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cd069f88bddcc3ac63105ef58077da2c 0 0 192500 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 08/12/1992 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 213800 0 1 0 0 0 ARIS ABDULLAH, BP
0000091323292 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361735 1#0##0#0#0.0#2022-04-07
09:51:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b0a97eb24c21b5b728078ed01bd04ee9 0 0 198800 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 02/03/1964 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 207500 0 1 0 0 0 SRI SUKARMINI, NY
0001907208663 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361736 1#0##0#0#0.0#2022-04-07
09:53:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d8e4af21801a3b5b542851fb92ecf09a 0 0 192500 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 12/09/2008 0 1
0 - 0 - 0 - 0 - 0 549400 826822
0001190340483 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
361280 1#0##0#0#0.0#2022-05-20
11:02:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
eb2d19d43d5dd59586ad1654c7cc6cc9 150000 0 0 0 0 0
650000 0 0 0 15000 0 11822 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 08/12/1949 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SISWO SARJONO,(BP)
0000564473013 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361737 1#0##0#0#0.0#2022-04-07
09:53:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1064eacd876feddb756edcd56fcfc0a2 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 12/04/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 213800 0 1 0 0 0 MARIYAM.NY 084306
0001302703266 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361738 1#0##0#0#0.0#2022-04-07
09:54:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f923f1fb0af3c9a3ec7cc5ffe619efdd 0 0 198800 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 25/02/1968 0 2
1 Z09.8;E11.3;H36.0;H35.0;H04.1 90.29 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
380104 0 1 0 0 0 WIJI SUHARIYATI, NY 085933
0001108955891 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361740 1#0##0#0#0.0#2022-04-07
09:55:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1f38ff4882025618e16d51c5852565c7 203000 0 0 0 0 0
0 0 0 0 15000 0 162104 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 06/06/2008 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 207500 0 1 0 0 0 BALQIS CHURYN
1124R0020322V004598 0001268897488 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361741 1#0##0#0#0.0#2022-04-07
09:55:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7d7993d2819374253851e5c790005641 0 0 192500 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 12/11/1945 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000063294052 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361742 1#0##0#0#0.0#2022-04-07
09:55:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
726f27bd8dc256ba0e4c09eaf80635cf 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 06/04/1969 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 207500 0 1 0 0 0 SUPARWAN, TN
0001104843161 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361745 1#0##0#0#0.0#2022-04-07
10:08:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c2b2741ba86e8179f4e98a59ab39e6b3 0 0 192500 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 19/04/1956 0 1
1 Z09.8;H26.9;H52.2;H04.1 90.29;95.01 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
280656 0 1 0 0 0 ERIE ARISTOT MULAT.TN 097789
0000091047947 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361747 1#0##0#0#0.0#2022-04-07
10:10:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dd240ad8382779d3ad87b9377c084675 203000 0 0 0 0 0
0 0 0 0 15000 0 62656 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 19/02/1965 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 207500 0 1 0 0 0 DANU MARGONO.,BP
0000640154136 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361748 1#0##0#0#0.0#2022-04-07
10:11:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8d0271867eb4c7600a048217ac7154ee 0 0 192500 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 18/04/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 259355
0 1 0 0 0 RAHMADI.TN 096843 53 19703 DR. TEKY
novia;3313125201940001; 5.6.7.202204241238 4 361749
1#0##0#0#0.0#2022-05-19
13:47:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
30d2698087091dcc45b8bbfdea7b5023 150000 0 0 0 0 0
0 0 0 0 15000 0 94355 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 01/01/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 287841
0 1 0 0 0 SITI MAEMUNAH.NY 085000 73 26750 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361750
1#0##0#0#0.0#2022-04-07
10:12:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0643772a33fdf368a24abe289a8debc8 0 0 138000 0 0 0
0 89500 0 0 15000 0 45341 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 05/08/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 213800 0 1 0 0 0 SRI LESTARI, NY
0000639740812 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361751 1#0##0#0#0.0#2022-04-07
10:12:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a957888437141d057c7a79caf578522d 0 0 198800 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 17/03/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUNARTI, (NY)
0000088913171 3;JKN agung;3313092303950002; 5.6.7.202204241238 4
367817 1#0##0#0#0.0#2022-05-20
10:32:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
81bd2bd53548ce867c318cccb5cdf592 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 01/02/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 500325
0 1 0 0 0 LISTIYANI.NY 102167 45 16492 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361753
1#0##0#0#0.0#2022-04-11
12:15:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
ab3b81a3d2073cc855532e64ccf3ba05 150000 0 0 0 0 0
0 31845 0 0 15000 0 303480 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 27/07/1963 0 1
1 Z09.8;J90 87.49 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 191055
0 1 0 0 0 DJOKO PURWADI.TN 079362 58 21430 DR.
agung;3313092303950002; 5.6.6.202203301209 4 361754
1#0##0#0#0.0#2022-04-11
12:16:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
e55e305ca604d6346512911a3fad3065 150000 0 0 0 0 0
0 0 0 0 15000 0 26055 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 28/07/1989 0 2
- 0 - 0 - 0 - 0 182600 214478 0
1 0 0 0 YUSI DESTIANASARI, NY 054990 32 11932 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361755
1#0##0#0#0.0#2022-04-07
10:19:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f9e0d6c83338a7a9dfa99aee4c2e7445 150000 0 0 0 0 0
0 0 0 0 15000 0 49478 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 13/03/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 344167
0 1 0 0 0 SRI SUNINGSIH.NY 085559 64 23392 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361757
1#0##0#0#0.0#2022-04-07
10:20:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
73432891b3ad7d9c602d35bdb1e785a9 150000 0 0 0 0 0
0 63690 0 0 15000 0 115477 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 10/12/1996 0 2
0 0 - 0 - 0 - 0 - 0 181400 207372
0 1 0 0 0 FICKY EKA SAFITRI.NY 102435 25 9240
reni;3313147010930001; 5.6.6.202203301209 4 361758
1#0##0#0#0.0#2022-04-07
10:20:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b19ec4029fe5fe79f99a8273f2d2662a 150000 0 0 0 0 0
0 0 0 0 15000 0 42372 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 17/06/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 207500 0 1 0 0 0 WARIH ANJARIANI,
0001964529066 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361759 1#0##0#0#0.0#2022-04-07
10:21:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0e1cbcfbc4563a5d0a39bc801d78fd40 0 0 192500 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 23/11/1960 0 1
- 0 - 0 - 0 - 0 138400 268000 0
1 0 0 0 ABADI SANTOSO. TN 093266 61 22406 DR. LINDA
reni;3313147010930001; 5.6.6.202203301209 4 361760
1#0##0#0#0.0#2022-04-07
10:21:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
75481f95caac99f414c62894594fcd16 0 0 253000 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 09/11/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 240610
0 1 0 0 0 SUWARSO.TN 086215 68 24977 DR. TEKY
reni;3313147010930001; 5.6.6.202203301209 4 361761
1#0##0#0#0.0#2022-04-07
10:22:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1e50969678be23d294dab98a94a1814b 150000 0 0 0 0 0
0 0 0 0 15000 0 75610 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 07/07/1964 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 WIRADI.TN 098841
0000640484785 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361762 1#0##0#0#0.0#2022-04-07
10:23:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
88fb2abc2ce2b5df7a6de5e4a05a29a7 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 18/06/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 225495
0 1 0 0 0 HARJANTO., BP 044977 70 25852 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361763
1#0##0#0#0.0#2022-04-07
10:23:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7ad049078565751b7638162f25d84e11 150000 0 0 0 0 0
0 0 0 0 15000 0 60495 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 12/03/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 243060
0 1 0 0 0 SURAJI.TN 094159 55 20106 DR. TEKY
reni;3313147010930001; 5.6.6.202203301209 4 361764
1#0##0#0#0.0#2022-04-07
10:24:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
46d6455bdd8788dad98462d69fe5370f 0 0 138000 0 0 0
0 49590 0 0 15000 0 40470 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 25/03/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 209516
0 1 0 0 0 JOKO MONO, TN 068176 63 23015 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361765
1#0##0#0#0.0#2022-04-07
10:24:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0690c2c7e6de5ea0904fde28ec131329 150000 0 0 0 0 0
0 0 0 0 15000 0 44516 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 19/07/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 197175
0 1 0 0 0 ATIK SRI RAHAYU, NY 095426 59 21803
reni;3313147010930001; 5.6.6.202203301209 4 361786
1#0##0#0#0.0#2022-04-07
10:34:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
36f5ab070dfd20cbdbdd4dab794cc38d 0 0 138000 0 0 0
0 0 0 0 15000 0 44175 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 22/09/1964 0 2
None None None None PENYAKIT KRONIS BESAR LAIN-LAIN 262000 0
0 - 0 - 0 - 0 - 0 262000 257200
0 1 0 0 0 TRI ARTATI.NY 102695 57 21007 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361787
1#0##0#0#0.0#2022-04-07
10:35:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
66299ffc2b9e1cdbdfb16201523147f0 150000 0 0 0 0 0
0 0 0 0 25000 0 82200 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 27/04/2007 0 2
0 0 - 0 - 0 - 0 - 0 181400 267525
0001183366618 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361788 1#0##0#0#0.0#2022-04-07
10:36:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
be75620d7748c10705827b233cb720ca 235000 0 0 0 0 0
0 0 0 0 15000 0 17525 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 01/03/1981 0 1
0 0 - 0 - 0 - 0 - 0 181400 208660
0 1 0 0 0 SIGIT MARIYADI, TN 100053 41 15003
reni;3313147010930001; 5.6.6.202203301209 4 361789
1#0##0#0#0.0#2022-04-07
10:38:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7f4a63e193787b6d7df4f6568340c518 150000 0 0 0 0 0
0 0 0 0 15000 0 43660 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 18/09/2002 0 1
0 - 0 - 0 - 0 183900 277840 0 1
0 0 0 LUTFI AHMAD RIFAI.SDR 012114 19 7132 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361790
1#0##0#0#0.0#2022-04-07
10:39:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c000e798e4aed0ce687d79f46047a6e7 235000 0 0 0 0 0
0 0 0 0 15000 0 27840 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 01/04/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 290723
0 1 0 0 0 ROBIKATUN,(NY) 033635 65 24103 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361791
1#0##0#0#0.0#2022-04-07
10:40:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
80519f1212151539af26fc9a55ca7fa3 203000 0 0 0 0 0
0 0 0 0 15000 0 72723 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 29/10/2007 0 1
0 0 - 0 - 0 - 0 - 0 181400 253622
0 1 0 0 0 AKBAR YUDHA KUSUMA.AN 022854 14 5265
reni;3313147010930001; 5.6.6.202203301209 4 361792
1#0##0#0#0.0#2022-04-07
10:41:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
84504b4e6657ad410684a3f599cfdc6d 203000 0 0 0 0 0
0 0 0 0 15000 0 35622 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 05/02/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 188346
reni;3313147010930001; 5.6.6.202203301209 4 361793
1#0##0#0#0.0#2022-04-07
10:44:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0535a05d5b317c4dd04f42b23d223a58 150000 0 0 0 0 0
0 0 0 0 15000 0 23346 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 27/08/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 248977
0 1 0 0 0 MOCH ALI S , TN 00439 61 22494 DR. RINA
5.6.6.202203301209 4 361794 1#0##0#0#0.0#2022-04-07
10:45:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0fa2be96a57367998a659098e5cf00e3 150000 0 0 0 0 0
0 0 0 0 15000 0 83977 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 13/07/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 204303
0 1 0 0 0 PURWANINGSIH.NY 102302 53 19617 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361795
1#0##0#0#0.0#2022-04-07
10:45:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e263504066da0f3ed7b6b064d8c019db 150000 0 0 0 0 0
0 0 0 0 15000 0 39303 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 25/04/2000 0 2
0 0 - 0 - 0 - 0 - 0 181400 229777
reni;3313147010930001; 5.6.6.202203301209 4 361796
1#0##0#0#0.0#2022-04-07
10:46:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
24869cf37cef7250ba90be90212bb911 150000 0 0 0 0 0
0 0 0 0 15000 0 64777 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 17/04/1973 0 1
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.6.6.202203301209 4 361797
1#0##0#0#0.0#2022-04-07
10:46:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0032720439de0134be4e7870035338fe 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 01/05/1975 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V004634 0001790328262 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361798 1#0##0#0#0.0#2022-04-07
10:47:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
47e1aba7a8ad267d5d6116b2f7952444 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 27/10/1990 0 1
0 0 - 0 - 0 - 0 - 0 181400 204107
0 1 0 0 0 CANDRA BUDI PRABOWO.SDR 081839 31 11476
reni;3313147010930001; 5.6.6.202203301209 4 361799
1#0##0#0#0.0#2022-04-07
10:48:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0f4ff2183a5b4a7c531de3ba155bc91a 150000 0 0 0 0 0
0 0 0 0 15000 0 39107 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 29/11/1943 0 2
0 0 - 0 - 0 - 0 - 0 181400 208702
0 1 0 0 0 SUNARNI (NY) 051905 78 28610 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361800
1#0##0#0#0.0#2022-04-07
10:49:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9367a19edb12073817972e5b6711812d 150000 0 0 0 0 0
0 0 0 0 15000 0 43702 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 23/05/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 224226
0 1 0 0 0 MISIRAH .NY 048212 64 23686 DR. RINA
5.6.6.202203301209 4 361801 1#0##0#0#0.0#2022-04-07
10:49:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9ef02b7647991a23211121812e272832 150000 0 0 0 0 0
0 0 0 0 15000 0 59226 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 13/06/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 239298
reni;3313147010930001; 5.6.6.202203301209 4 361802
1#0##0#0#0.0#2022-04-07
10:50:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
56365f6dfd8bd51136d5b22f9ac177fd 150000 0 0 0 0 0
0 0 0 0 15000 0 74298 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 08/03/1967 0 1
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.6.6.202203301209 4 361804
1#0##0#0#0.0#2022-04-07
10:50:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
580b6ac72a284c8c94e9411be20962aa 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 11/06/1998 0 1
1 L91.0 99.23 - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 212010
0 1 0 0 0 HASHAN FAUZI PUTRA, SDR 102658 23 8692
reni;3313147010930001; 5.6.6.202203301209 4 361824
1#0##0#0#0.0#2022-04-07
11:09:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d6937fb7766f7a06dcc95ee8f6558628 150000 0 0 0 0 0
0 0 0 0 25000 0 37010 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 01/12/1980 0 2
0 - 0 - 0 - 0 786200 677676 0 1
SP.PD 1124R0020322V004642 0000640230884 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361825 1#0##0#0#0.0#2022-04-07
11:10:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6b5101dac434f7ccc8801c970702b823 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 26/04/1964 0 1
0 - 0 - 0 - 0 786200 677676 0 1
reni;3313147010930001; 5.6.6.202203301209 4 361826
1#0##0#0#0.0#2022-04-07
11:10:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e0ab3af8495e2743613a1055f9cc305c 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 20/08/1959 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V004644 0000571256594 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361827 1#0##0#0#0.0#2022-04-07
11:11:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
85281a6c31a44ca5b8fb0b1f3e193f98 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 25/05/1972 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V004645 0002431552465 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361828 1#0##0#0#0.0#2022-04-07
11:11:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8bc55c2c22895382f34b4dcb159a4872 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 01/12/1958 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V004646 0001436949538 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361829 1#0##0#0#0.0#2022-04-07
11:11:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dd3c1b12d43e4389526ab76bc34caa8a 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 01/04/1981 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V004647 0001904830593 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361830 1#0##0#0#0.0#2022-04-07
11:12:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
15e91cbbe6c28b2cdbba094e787b7406 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 17/04/1961 0 2
0 - 0 - 0 - 0 786200 677676 0 1
reni;3313147010930001; 5.6.6.202203301209 4 361831
1#0##0#0#0.0#2022-04-07
11:15:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eebe298479c6035b44ff0c4de2267f1f 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 03/07/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 292370
0 1 0 0 0 HARTININGSIH, NY 099094 51 18897 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361832
1#0##0#0#0.0#2022-04-07
11:16:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bd166ac395b473f64ec8392bd1dbb6e2 150000 0 0 0 0 0
0 88950 0 0 15000 0 38420 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 25/02/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 313915
0 1 0 0 0 SITI FATIMAH. NY 084286 62 22678 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361833
1#0##0#0#0.0#2022-04-07
11:17:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
914aee40f8943e0ac4d9e88afcbd9597 0 0 138000 0 0 0
0 76045 0 0 15000 0 84870 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 10/11/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 417400
0 1 0 0 0 UMI HANIFAH, NY 085103 58 21324 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361834
1#0##0#0#0.0#2022-04-07
11:17:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b5e7857003f73c7b0c2c84530ccf0893 0 0 138000 0 0 0
0 0 0 0 15000 0 264400 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 27/01/1953 0 1
1 Z09.8;I11.9;M54.59;E78.5 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
234015 0 1 0 0 0 SAMIDI, TN 098145 69 25263
reni;3313147010930001; 5.6.6.202203301209 4 361835
1#0##0#0#0.0#2022-04-07
11:18:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e2f5c3df24b73a3593bd3a994c4e922e 0 0 138000 0 0 0
0 0 0 0 15000 0 81015 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 20/02/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 153000
0 1 0 0 0 NUR YUSLIKAH, NY 066271 53 19395 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361836
1#0##0#0#0.0#2022-04-07
11:18:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8c54ad00ce1b15d4249705ad1a92398f 0 0 138000 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 15/04/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 433620
0 1 0 0 0 SITI ROHMAH, NY 056140 46 17150 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361281
1#0##0#0#0.0#2022-04-05
12:13:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
45516d7a034e4ee7ebc3c5984bfa22ac 150000 0 0 0 0 0
220000 0 0 0 15000 0 48620 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 16/07/1989 0 2
0 0 - 0 - 0 - 0 - 0 181400 937786
0 1 0 0 0 SUYATI , NY 066913 32 11944 DR. TEKY
reni;3313147010930001; 5.6.6.202203301209 4 361837
1#0##0#0#0.0#2022-04-07
11:21:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b97642d785cfa9e2e15bff2fea37252b 0 0 138000 0 0 0
0 63690 0 0 15000 0 721096 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 28/10/1980 0 2
0 0 - 0 - 0 - 0 - 0 181400 236250
0 1 0 0 0 SUSI SULISTYORINI,NY 075835 41 15127
reni;3313147010930001; 5.6.6.202203301209 4 361838
1#0##0#0#0.0#2022-04-07
11:21:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
331a90c0e3765141275366a23d791e69 150000 0 0 0 0 0
0 0 0 0 15000 0 71250 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 01/05/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 659978
0 1 0 0 0 JOKO SARWANTO ,(TN) 036053 49 18229
reni;3313147010930001; 5.6.6.202203301209 4 361839
1#0##0#0#0.0#2022-04-07
11:22:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b3d6e526f51486feb1a4490581883be4 0 0 138000 0 0 0
0 63690 0 0 15000 0 443288 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 03/05/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 209250
0 1 0 0 0 MARMEIYANI.NY 076825 63 23341 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361840
1#0##0#0#0.0#2022-04-07
11:22:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fc4c6f5237ec890d2e83cb713dc2e075 150000 0 0 0 0 0
0 0 0 0 15000 0 44250 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 12/12/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 385678
0 1 0 0 0 SRI SUWARTI 092690 66 24214 DR. ARIA
reni;3313147010930001; 5.6.6.202203301209 4 361841
1#0##0#0#0.0#2022-04-07
11:23:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 13/10/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 232370
0 1 0 0 0 NUNUK SUNDARI,(NY) 018287 59 21717
3;JKN reni;3313147010930001; 5.6.6.202203301209 4 361842
1#0##0#0#0.0#2022-04-07
11:23:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 05/03/1973 0 2
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0001445069981 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361843 1#0##0#0#0.0#2022-04-07
11:28:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 02/03/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 278955
reni;3313147010930001; 5.6.6.202203301209 4 361844
1#0##0#0#0.0#2022-04-07
11:28:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 07/05/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 247735
reni;3313147010930001; 5.6.6.202203301209 4 361845
1#0##0#0#0.0#2022-04-07
11:29:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 03/03/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
reni;3313147010930001; 5.6.6.202203301209 4 361846
1#0##0#0#0.0#2022-04-07
11:29:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a79d858d1e36d4a1e888d8633ac860da 150000 0 0 0 0 0
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3372030 C 3 CP 2 29/03/2022 29/03/2022 17/01/1977 0 2
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3;JKN reni;3313147010930001; 5.6.6.202203301209 4 361847
1#0##0#0#0.0#2022-04-07
11:30:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
521b75b01b4c593af6be66667b05e437 150000 0 0 0 0 0
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3372030 C 3 CP 2 29/03/2022 29/03/2022 10/11/1965 0 1
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3;JKN reni;3313147010930001; 5.6.6.202203301209 4 361866
1#0##0#0#0.0#2022-04-07
11:50:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 16/02/1959 0 2
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361867 1#0##0#0#0.0#2022-04-07
11:51:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 13/12/1965 0 2
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361868 1#0##0#0#0.0#2022-04-07
11:51:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 11/03/1961 0 2
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reni;3313147010930001; 5.6.6.202203301209 4 361869
1#0##0#0#0.0#2022-04-07
11:52:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 07/10/1961 0 1
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0 1 0 0 0 AGUNG RUMAMBI, TN 097338 60 22088 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361870
1#0##0#0#0.0#2022-04-07
11:52:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4a5341853aec9154bfe5925e8facc922 150000 0 0 0 0 0
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3372030 C 3 CP 2 29/03/2022 29/03/2022 23/09/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 221935
reni;3313147010930001; 5.6.6.202203301209 4 361872
1#0##0#0#0.0#2022-04-07
11:53:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 20/03/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 233200
0 1 0 0 0 MARDIYONO,TN 093361 51 18637 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361873
1#0##0#0#0.0#2022-04-07
11:53:34#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 31/12/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 216735
0 1 0 0 0 PARYATUN, NY 051446 70 25656 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361874
1#0##0#0#0.0#2022-04-07
11:54:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 05/05/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 603138
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3;JKN reni;3313147010930001; 5.6.6.202203301209 4 361875
1#0##0#0#0.0#2022-04-07
11:54:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 01/07/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 309290
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reni;3313147010930001; 5.6.6.202203301209 4 361876
1#0##0#0#0.0#2022-04-07
11:55:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 17/03/1962 0 1
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reni;3313147010930001; 5.6.6.202203301209 4 361877
1#0##0#0#0.0#2022-04-07
11:55:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d8bb5e19bc05ec221c09fae9a03f6bba 150000 0 0 0 0 0
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3372030 C 3 CP 2 29/03/2022 29/03/2022 21/10/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 249790
0 1 0 0 0 TUKINO, BP 069874 63 23170 DR. ARIA
reni;3313147010930001; 5.6.6.202203301209 4 361878
1#0##0#0#0.0#2022-04-07
11:56:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 03/10/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 213710
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reni;3313147010930001; 5.6.6.202203301209 4 361879
1#0##0#0#0.0#2022-04-07
11:56:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
52521c3735dc30b517c6a13bfb194fc0 150000 0 0 0 0 0
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3372030 C 3 CP 2 29/03/2022 29/03/2022 04/02/1966 0 1
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reni;3313147010930001; 5.6.6.202203301209 4 361881
1#0##0#0#0.0#2022-04-07
12:49:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 28/04/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 214515
0 1 0 0 0 TURIDJAH, (NY) 016034 67 24807 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361882
1#0##0#0#0.0#2022-04-07
12:50:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 06/09/1976 0 1
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reni;3313147010930001; 5.6.6.202203301209 4 361883
1#0##0#0#0.0#2022-04-07
12:50:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 20/07/1947 0 1
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3;JKN reni;3313147010930001; 5.6.6.202203301209 4 361884
1#0##0#0#0.0#2022-04-07
12:51:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 26/03/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 226965
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reni;3313147010930001; 5.6.6.202203301209 4 361885
1#0##0#0#0.0#2022-04-07
12:51:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 28/09/1964 0 2
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agung;3313092303950002; 5.6.7.202204241238 4 361886
1#0##0#0#0.0#2022-06-17
15:27:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
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3372030 C 3 CP 2 29/03/2022 29/03/2022 23/11/1960 0 1
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reni;3313147010930001; 5.6.6.202203301209 4 361887
1#0##0#0#0.0#2022-04-07
12:54:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 12/11/1963 0 1
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3;JKN reni;3313147010930001; 5.6.6.202203301209 4 361889
1#0##0#0#0.0#2022-04-07
12:54:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 06/01/1969 0 2
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reni;3313147010930001; 5.6.6.202203301209 4 361890
1#0##0#0#0.0#2022-04-07
12:55:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 31/10/1992 0 1
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3;JKN reni;3313147010930001; 5.6.6.202203301209 4 361891
1#0##0#0#0.0#2022-04-07
12:56:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 15/01/1945 0 1
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reni;3313147010930001; 5.6.6.202203301209 4 361892
1#0##0#0#0.0#2022-04-07
12:56:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
970646305f9907074bfc4e0586328207 150000 0 0 0 0 0
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3372030 C 3 CP 2 29/03/2022 29/03/2022 05/12/1958 0 2
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reni;3313147010930001; 5.6.6.202203301209 4 361893
1#0##0#0#0.0#2022-04-07
12:57:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 10/06/1954 0 1
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361894 1#0##0#0#0.0#2022-04-07
12:57:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 26/06/1954 0 1
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361895 1#0##0#0#0.0#2022-04-07
12:58:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 31/12/1966 0 2
1 Z09.8;A16.2;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 249885
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reni;3313147010930001; 5.6.6.202203301209 4 361963
1#0##0#0#0.0#2022-04-07
13:17:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 04/09/1971 0 2
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361964 1#0##0#0#0.0#2022-04-07
13:17:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 24/05/1961 0 2
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reni;3313147010930001; 5.6.6.202203301209 4 361965
1#0##0#0#0.0#2022-04-07
13:21:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 27/10/1978 0 2
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reni;3313147010930001; 5.6.6.202203301209 4 361966
1#0##0#0#0.0#2022-04-07
13:21:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3;JKN reni;3313147010930001; 5.6.6.202203301209 4 361967
1#0##0#0#0.0#2022-04-07
13:22:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 05/03/1979 0 2
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reni;3313147010930001; 5.6.6.202203301209 4 361968
1#0##0#0#0.0#2022-04-07
13:22:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/03/2022 29/03/2022 07/09/1962 0 2
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reni;3313147010930001; 5.6.6.202203301209 4 361969
1#0##0#0#0.0#2022-04-07
13:24:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 29/03/2022 29/03/2022 04/09/1960 0 1
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SP.PD 1124R0020322V004707 0000640142684 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361970 1#0##0#0#0.0#2022-04-07
13:23:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a4ce6042700a4ea37d4c80dbfa5fc91b 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 15/05/1953 0 1
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.6.6.202203301209 4 361971
1#0##0#0#0.0#2022-04-07
13:25:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c259ca7fea96c01a367859faf4ac6e80 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 07/04/1948 0 1
0 - 0 - 0 - 0 786200 677676 0 1
reni;3313147010930001; 5.6.6.202203301209 4 361972
1#0##0#0#0.0#2022-04-07
13:25:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ee7f3fe1acc5ae67b7f75641cbf722fa 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 01/09/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V004710 0000639614597 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361973 1#0##0#0#0.0#2022-04-07
13:26:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b288c15e299d60ae2716d893153b4b78 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 02/09/1976 0 1
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.6.6.202203301209 4 361974
1#0##0#0#0.0#2022-04-07
13:26:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
07365ef9e8257042bbf87815330a06b7 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 23/12/1977 0 2
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.6.6.202203301209 4 361975
1#0##0#0#0.0#2022-04-07
13:27:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3e4d9c51d2af8a54e65f1f81526d19a8 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 25/03/1978 0 2
0 - 0 - 0 - 0 786200 677676 0 1
reni;3313147010930001; 5.6.6.202203301209 4 361976
1#0##0#0#0.0#2022-04-07
13:27:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fc1e8571021444c3afd1742efbc161c2 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 12/06/1972 0 1
0 - 0 - 0 - 0 786200 677676 0 1
reni;3313147010930001; 5.6.6.202203301209 4 361977
1#0##0#0#0.0#2022-04-07
13:28:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0a65b4982b4fee275b0ed06fba3e7caa 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 24/05/1970 0 2
- 0 - 0 - 0 - 0 138400 268000 0
1 0 0 0 ENDANG RAHUNI MURDANINGSIH,(NY) 005290 51
3;JKN reni;3313147010930001; 5.6.6.202203301209 4 361978
1#0##0#0#0.0#2022-04-07
13:28:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
70b915bf7d7ca36a9a0e287c6a5bfe05 0 0 253000 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 04/11/1994 0 1
0 - 0 - 0 - 0 - 0 138400 268000
0 1 0 0 0 RAUHULLOH AYATULLOH KHOMEINI.SDR 096022
0001796644269 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361979 1#0##0#0#0.0#2022-04-07
13:29:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
04380a9ac679fefe3a3de58243eb5c87 0 0 253000 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 30/09/1977 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000207436206 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361980 1#0##0#0#0.0#2022-04-07
13:30:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7adffb3d43b7e5f2150942dbeeb32e06 0 0 192500 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 02/03/1941 0 2
0 - 0 - 0 - 0 - 0 138400 268000
0 1 0 0 0 DIYAH 101274 81 29612 DR. LINDA
reni;3313147010930001; 5.6.6.202203301209 4 361981
1#0##0#0#0.0#2022-04-07
13:30:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d441171a098b747e5a284d4a5fad19c2 0 0 253000 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 05/03/1944 0 1
0 - 0 - 0 - 0 - 0 138400 268000
0 1 0 0 0 SANTOSO. TN 088783 78 28513 DR. LINDA
reni;3313147010930001; 5.6.6.202203301209 4 361982
1#0##0#0#0.0#2022-04-07
13:31:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e92e64f6356bea757dcf6b2c30460ce6 0 0 253000 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 17/11/1966 0 1
0 - 0 - 0 - 0 - 0 138400 268000
0 1 0 0 0 INDRARIADI, TN 098885 55 20221 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361983
1#0##0#0#0.0#2022-04-07
13:31:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
85b96f7fe56c4797508bc7d109e33f7f 0 0 253000 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 14/04/1960 0 2
- 0 - 0 - 0 - 0 138400 268000 0
1 0 0 0 MARTINAH., NY 072061 61 22629 DR. LINDA
reni;3313147010930001; 5.6.6.202203301209 4 361984
1#0##0#0#0.0#2022-04-07
13:32:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
38cf17a00306ab47856d06314a800ca9 0 0 253000 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 10/10/1953 0 2
0 - 0 - 0 - 0 - 0 138400 268000
reni;3313147010930001; 5.6.6.202203301209 4 361985
1#0##0#0#0.0#2022-04-07
13:33:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
617197c621f88ad8069e60422d792181 0 0 253000 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 12/01/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 242900 0 1 0 0 0 EKO RINI.NY 093223
0000091524159 3;JKN reni;3313147010930001; 5.6.6.202203301209 4
361986 1#0##0#0#0.0#2022-04-07
13:34:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
955f704486afe8320c208ae89c4e67db 0 0 227900 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 03/05/2004 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 207500 0 1 0 0 0 RIDWAN ALFIANO NUR
HIDAYATULLOH 005209 17 6539 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V004726 0001276682938 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361987 1#0##0#0#0.0#2022-04-07
13:34:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6380c3a7853b5f2b8d44bc09dc6a0ac1 0 0 192500 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 17/07/1980 0 1
0 0 - 0 - 0 - 0 - 0 181400 336310
0 1 0 0 0 YULI PURWANTO,(BP) 001538 41 15230
3;JKN reni;3313147010930001; 5.6.6.202203301209 4 361988
1#0##0#0#0.0#2022-04-07
13:35:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
92826daa138c3f5c23a920d3df167e97 0 0 138000 0 0 0
0 0 0 0 15000 0 183310 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 20/05/1999 0 2
- 0 - 0 - 0 894800 1483060 0 1 0
0 0 HANIK ISMA SUSANTI.NY 102693 22 8349 DR. ARIA CHANDRA
agung;3313092303950002; 5.6.6.202203301209 4 361282
1#0##0#0#0.0#2022-04-11
12:15:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
bf4fd4d34caea7698a2c3ed41851bb4b 150000 0 0 0 0 0
1250000 0 0 0 15000 0 68060 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 31/12/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 280656
0 1 0 0 0 NGATIYEM.NY 067636 69 25290 DR. YUDHI
reni;3313147010930001; 5.6.6.202203301209 4 361989
1#0##0#0#0.0#2022-04-07
13:36:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d1298098a05dbf5a310f0aeb93e88020 203000 0 0 0 0 0
0 0 0 0 15000 0 62656 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 24/04/1958 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
280656 0 1 0 0 0 HABIB WINARTO, TN 097988 63
3;JKN reni;3313147010930001; 5.6.6.202203301209 4 361990
1#0##0#0#0.0#2022-04-07
13:37:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a5ce6be397d2fa039494fe313708b6b3 203000 0 0 0 0 0
0 0 0 0 15000 0 62656 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 14/04/1993 0 2
- 0 - 0 - 0 183900 359543 0 1 0
0 0 LITA SUGIARTI, NY 100936 28 10576 DR. GUNAWAN, SP.OG
1124R0020322V004732 0003130048247 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361991 1#0##0#0#0.0#2022-04-07
13:38:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
411355371230fd27e951500cf2396d86 275000 0 0 0 0 0
0 0 0 0 15000 0 69543 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 25/06/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 280656
0 1 0 0 0 DARNI WIDAYATI 092677 59 21827 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361992
1#0##0#0#0.0#2022-04-07
13:39:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c248818ef5e94b6ca10618debff67275 203000 0 0 0 0 0
0 0 0 0 15000 0 62656 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 02/03/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 280656
0 1 0 0 0 ZAIDUN ELLY,(NY) 012944 58 21211 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361993
1#0##0#0#0.0#2022-04-07
13:39:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c388e1c2cdf648d91cfe677c8feaa44c 203000 0 0 0 0 0
0 0 0 0 15000 0 62656 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 31/12/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 280656
0 1 0 0 0 INDRAYATI, NY 091755 58 21273 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361994
1#0##0#0#0.0#2022-04-07
13:40:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
739e9c91d17cc6b9c884e8b9230950b4 203000 0 0 0 0 0
0 0 0 0 15000 0 62656 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 07/09/1944 0 2
0 0 - 0 - 0 - 0 - 0 181400 280656
0 1 0 0 0 SUMINEM.NY 099812 77 28327 DR. YUDHI
reni;3313147010930001; 5.6.6.202203301209 4 361995
1#0##0#0#0.0#2022-04-07
13:40:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e43d270f4715de64f8f878a1976c075e 203000 0 0 0 0 0
0 0 0 0 15000 0 62656 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 21/04/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 290019
reni;3313147010930001; 5.6.6.202203301209 4 361996
1#0##0#0#0.0#2022-04-07
13:44:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
95ffbdd77ccb5a3784b9bba9794ed8e9 203000 0 0 0 0 0
0 0 0 0 15000 0 72019 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 19/07/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 375004
novia;3313125201940001; 5.6.7.202204241238 4 361997
1#0##0#0#0.0#2022-05-19
14:39:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
12c024ffbe742d0cc3e6a464b3fdf998 203000 0 0 0 0 0
0 0 0 0 15000 0 157004 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 13/07/2003 0 1
0 0 - 0 - 0 - 0 - 0 181400 253622
reni;3313147010930001; 5.6.6.202203301209 4 361998
1#0##0#0#0.0#2022-04-07
13:45:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6becad84d9b82eb6cbc8e37ffbc30c82 203000 0 0 0 0 0
0 0 0 0 15000 0 35622 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 22/07/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 189490
0 1 0 0 0 SLAMET INDARMADI.TN 100416 66 24357
3;JKN reni;3313147010930001; 5.6.6.202203301209 4 361999
1#0##0#0#0.0#2022-04-07
13:46:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5f62aee8f5adb695cc8b21b9a7bc313f 0 0 138000 0 0 0
0 0 0 0 15000 0 36490 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 21/12/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 277770
0 1 0 0 0 NURSANTO BP 085741 61 22378 DR. ARIA
reni;3313147010930001; 5.6.6.202203301209 4 362000
1#0##0#0#0.0#2022-04-07
13:47:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b60db02ef4f2dd634fc1813b02f0a539 0 0 138000 0 0 0
0 0 0 0 15000 0 124770 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 15/03/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 236975
0 1 0 0 0 SUTRISWANTO.TN 094216 59 21564 DR.
reni;3313147010930001; 5.6.6.202203301209 4 362001
1#0##0#0#0.0#2022-04-07
13:47:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a5918d3140e40178224b90f3c2c604b1 150000 0 0 0 0 0
0 0 0 0 15000 0 71975 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 23/12/1981 0 1
0 0 - 0 - 0 - 0 - 0 181400 469084
0 1 0 0 0 SIFIN SUGENG REJEKI, TN 020974 40 14706
3;JKN reni;3313147010930001; 5.6.6.202203301209 4 362002
1#0##0#0#0.0#2022-04-07
13:48:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
10aef3e9b639a1f44f0d929f5b96f882 0 0 138000 0 0 0
0 0 0 0 15000 0 316084 0 0 0 0 0
3372030 C 3 CP 2 24/03/2022 24/03/2022 20/11/1999 0 2
- 0 - 0 - 0 183900 268543 0 1 0
0 0 AINUN WAHYU,NY 001169 22 8160 DR. GUNAWAN, SP.OG
1124R0020322V004745 0001280064947 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 361040 1#0##0#0#0.0#2022-05-20
11:28:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
ac1dad39f05b14d058bd0652e0ceebee 0 0 184000 0 0 0
0 0 0 0 15000 0 69543 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 20/11/1999 0 2
- 0 - 0 - 0 183900 359543 0 1 0
0 0 AINUN WAHYU,NY 001169 22 8165 DR. GUNAWAN, SP.OG
1124R0020322V004746 0001280064947 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 362003 1#0##0#0#0.0#2022-04-07
13:49:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
145562774b1546e0fcc2bdb1afc1b593 275000 0 0 0 0 0
0 0 0 0 15000 0 69543 0 0 0 0 0
3372030 C 3 CP 2 29/03/2022 29/03/2022 14/06/2003 0 2
0 0 - 0 - 0 - 0 - 0 181400 249680
0 1 0 0 0 SONIA DEWI K, NN 011278 18 6863 DR.
reni;3313147010930001; 5.6.6.202203301209 4 362004
1#0##0#0#0.0#2022-04-07
13:49:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
81918863a333d3cba5f55e2c52acdd2b 203000 0 0 0 0 0
0 0 0 0 15000 0 31680 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 23/03/1948 0 2
1 Z09.8;E11.3;H36.0;Z96.1 90.29 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 335119
0 1 0 0 0 SRI SUTANTI. NY 084749 74 27035 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361140
1#0##0#0#0.0#2022-04-05
09:40:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e0624d2d44eacf12b112e46da2e921eb 203000 0 0 0 0 0
0 0 0 0 15000 0 117119 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 22/08/1947 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DYAH NURJANTI,(NY)
0000091082722 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361142 1#0##0#0#0.0#2022-04-05
09:41:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b2bca5c859f272cd0bbc676f9c855fd2 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 24/12/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI SUTANTI, NY
0000639837347 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361147 1#0##0#0#0.0#2022-04-05
09:42:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
534b0b74c8edd2893dfaee4c7df8e51a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 08/08/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 241045
0 1 0 0 0 HJ ENDANG SRI ., NY 054099 71 26167
novia;3313125201940001; 5.6.6.202203301209 4 361173
1#0##0#0#0.0#2022-04-05
09:56:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cd77880d5544c4d704228a0f589bbb83 150000 0 0 0 0 0
0 76045 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 19/07/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SITI WARSINI.NY
0001387776519 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
361186 1#0##0#0#0.0#2022-05-19
14:40:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
86cdf53903084f5d4a4ca8157acb4abd 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 27/11/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 454391
0 1 0 0 0 SARWATI.,NY 073091 66 24230 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 361188
1#0##0#0#0.0#2022-04-05
09:57:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
32e2897f4aac6af1596bb9eca4ee8389 150000 0 0 0 0 0
0 120745 0 0 15000 0 168646 0 0 0 0
0
3372030 C 3 CP 2 30/03/2022 30/03/2022 08/11/1987 0 2
- 0 - 0 - 0 - 0 549400 304316 0
1 0 0 0 MAYA TRI ASTUTI ,NN 035474 34 12561 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361189
1#0##0#0#0.0#2022-04-05
09:59:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e3ea5282fbc0479c2e931eeace090bd5 200000 0 0 0 0 0
0 0 0 0 15000 0 89316 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 18/05/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SAMIYATI.NY 094791
0000046966566 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361190 1#0##0#0#0.0#2022-04-05
10:01:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4123f4729b5f92baf7918a3c3a19edc8 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 31/12/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 TUGIMIN.TN 085693 69 25291 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 361192
1#0##0#0#0.0#2022-04-05
10:05:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
690ac1b8a73a1f1f6748f612049b909d 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 25/02/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 180000
0 1 0 0 0 SUWARYADI BP 088697 71 25966 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361191
1#0##0#0#0.0#2022-04-05
10:03:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9089c984c816486068bd9e6977820aee 165000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 28/09/1940 0 2
0 0 - 0 - 0 - 0 - 0 181400 280656
0 1 0 0 0 IMAKULATA UTAMI, NY 056961 81 29768
novia;3313125201940001; 5.6.6.202203301209 4 361194
1#0##0#0#0.0#2022-04-05
10:06:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5236f2e406ebc212f6421d65d39754f4 203000 0 0 0 0 0
0 0 0 0 15000 0 62656 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 14/04/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI MULYANI, NY
0000640565201 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361196 1#0##0#0#0.0#2022-04-05
10:08:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7f8c9c443cc484186dfb4f59d1d8120e 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 06/06/1974 0 2
1 Z09.8;H26.9;E11.3;H36.0;H52.2;H52.4 90.29;95.01 - - None None
None None Q-5-44-0 None None None None None None PENYAKIT KRONIS
KECIL LAIN-LAIN 181400 0 0 - 0 - 0 - 0 -
0 181400 280656 0 1 0 0 0 UMI NAFIAH. NY
076253 47 17464 DR. YUDHI DORANDES, SP.M 1124R0020322V004770
0001662154896 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361197 1#0##0#0#0.0#2022-04-05
10:09:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6e81e67dd31f8d4145ec3d707aa71ef6 203000 0 0 0 0 0
0 0 0 0 15000 0 62656 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 04/03/1965 0 2
0 - 0 - 0 - 0 - 0 181400 344657
0 1 0 0 0 RUMIYATI.NY 102704 57 20845 DR. TEKY
novia;3313125201940001; 5.6.6.202203301209 4 361198
1#0##0#0#0.0#2022-04-05
10:09:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4be6e072b729b96be87e4b860ce988ba 150000 0 0 0 0 0
0 0 0 0 15000 0 179657 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 14/07/1959 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
280656 0 1 0 0 0 MARDIYAH, NY 043267 62
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 361199
1#0##0#0#0.0#2022-04-05
10:12:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
faad8a1614be582e2d1b625828896542 203000 0 0 0 0 0
0 0 0 0 15000 0 62656 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 23/03/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 369772
0 1 0 0 0 KASIATIN, NY 071287 70 25574 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361200
1#0##0#0#0.0#2022-04-05
10:13:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fc1279d847fc9e2207e3fd2a14c6c825 150000 0 0 0 0 0
0 31845 0 0 15000 0 172927 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 23/05/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 521134
0 1 0 0 0 MARDHIYAH, NY 060235 70 25879 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361201
1#0##0#0#0.0#2022-04-05
10:14:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7e3221025cd7032aab68cae0e55efef3 150000 0 0 0 0 0
0 107890 0 0 15000 0 248244 0 0 0 0
0
3372030 C 3 CP 2 30/03/2022 30/03/2022 09/05/1949 0 1
1 Z09.8;H26.9;Z96.1 90.29 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 366095
novia;3313125201940001; 5.6.6.202203301209 4 361202
1#0##0#0#0.0#2022-04-05
10:15:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
94fc94adf40581a94b7ad61cb56a86cc 203000 0 0 0 0 0
0 0 0 0 15000 0 148095 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 26/03/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 364805
0 1 0 0 0 NAWA HAPSARI.NY 080742 55 20093 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361203
1#0##0#0#0.0#2022-04-05
10:16:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dff512941a814f70e753454a2a194d25 150000 0 0 0 0 0
0 76595 0 0 15000 0 123210 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 25/03/1955 0 2
0 - 0 107400 262000 0 1 0 0 0
1124R0020322V004779 0000639810066 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361204 1#0##0#0#0.0#2022-04-05
10:17:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1f4e98f9db5e9ac39b4d87f7555888f8 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 09/04/1964 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 AFIDA
SUSILOWATI.NY 084451 57 21174 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V004780 0002039166404 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361205 1#0##0#0#0.0#2022-04-05
10:18:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0d0b083ae375ce91d8e9b337e3b154d5 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 12/11/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 300180
0 1 0 0 0 TRI JOKO MARJIONO SPD.TN 075107 64
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 361206
1#0##0#0#0.0#2022-04-05
10:28:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9a9a30c884dd3d7e1e589b62157f6e29 150000 0 0 0 0 0
0 31845 0 0 15000 0 103335 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 07/01/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 NANIK PARINI, NY
0001188329253 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361212 1#0##0#0#0.0#2022-04-05
10:31:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b28e7dae7a4697d774ebe1f5010d6752 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 01/02/1953 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
233356 0 1 0 0 0 MULYOTO., BP 049275 69
3;JKN novia;3313125201940001; 5.6.6.202203301209 4 361213
1#0##0#0#0.0#2022-04-05
10:34:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
22b9998fdf302de80c05ef050334b8a2 150000 0 0 0 0 0
0 31845 0 0 15000 0 36511 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 01/07/1951 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WARSINAH
1124R0020322V004784 0000087200616 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361214 1#0##0#0#0.0#2022-04-05
10:35:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
52f23b96a7b2c54c43f482f1d6de221d 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 10/01/1994 0 2
0 0 - 0 - 0 - 0 - 0 181400 213851
novia;3313125201940001; 5.6.6.202203301209 4 361215
1#0##0#0#0.0#2022-04-05
10:36:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a12b073112587fc24dd8ee2a36d05871 150000 0 0 0 0 0
0 0 0 0 15000 0 48851 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 31/01/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 283965
novia;3313125201940001; 5.6.6.202203301209 4 361216
1#0##0#0#0.0#2022-04-05
10:37:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a7961aadd71b42d97b95e974e11fc529 150000 0 0 0 0 0
0 0 0 0 15000 0 118965 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 15/09/1960 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TRI ATMODJO, TN
0001620260728 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361217 1#0##0#0#0.0#2022-04-05
10:38:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
49ea507d4c5c1e1009d007eea5558e47 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 16/05/1956 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WIDI WINARSI.NY
0001849841414 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361218 1#0##0#0#0.0#2022-04-05
10:39:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7cded3201f81d54aeee8ecdca1b9ebd4 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 17/01/1940 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SITI JAHIDJAH, NY
0000091261743 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361219 1#0##0#0#0.0#2022-04-05
10:40:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
703b27bb15718853e37f5c45088f876c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 12/09/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 318311
0 1 0 0 0 SUNARYATI, NY 058012 79 29054 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361233
1#0##0#0#0.0#2022-04-05
10:57:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4290fa116b8a9fd1f305fdcd811d7f9e 203000 0 0 0 0 0
0 0 0 0 15000 0 100311 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 31/08/1962 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI HARTINA
1124R0020322V004792 0001958592576 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361221 1#0##0#0#0.0#2022-04-05
10:42:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
687495f46a1b5060b89fafa06bf20efe 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 06/04/1979 0 2
- 0 - 0 - 0 - 0 549400 286350 0
1 0 0 0 UMI MASLIKHAH, NY 102676 42 15699 DR. GUNAWAN,
SP.OG 1124R0020322V004793 0002602921094 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361222 1#0##0#0#0.0#2022-04-05
10:45:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
85d731eac0d8aa767505061500dd6a8b 200000 0 0 0 0 0
0 0 0 0 15000 0 71350 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 19/08/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000089786147 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361223 1#0##0#0#0.0#2022-04-05
10:47:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cf5b25f9ae36e444b99be20143a9dd46 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 08/06/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 LAMIYEM.NY 087484
0001316300512 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361224 1#0##0#0#0.0#2022-04-05
10:48:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bb4b79508a7b28f6743989254ab3eabd 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 16/08/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TRI WINARNI, NY
0000640206066 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361226 1#0##0#0#0.0#2022-04-05
10:50:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f0d61fe5be844e34b07989eb0db36963 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 10/04/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MOEMINAH., NY
0000091214706 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361228 1#0##0#0#0.0#2022-04-05
10:51:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fc2bf05290159ffb76741b1abee8e024 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 05/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DANIK KARTIKA
1124R0020322V004799 0001445069981 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361234 1#0##0#0#0.0#2022-04-05
10:58:46#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c960c0b2f92b5baa5314cf11aeead5c2 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 18/04/1968 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 RAHMADI.TN 096843
0002169726311 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
361237 1#0##0#0#0.0#2022-05-19
13:47:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
139cf922a2aa9487aa617d5b72fc5c3e 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 07/10/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 NUR LASMI, NY
0000639913318 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361238 1#0##0#0#0.0#2022-04-05
11:03:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2f60327b2c2c47882af8715dc292b0d3 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 07/10/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 YATINI 094257
0001083705715 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361239 1#0##0#0#0.0#2022-04-05
11:04:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
20dc91f14a1e0e5f915b2a787c081c9b 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 18/01/1966 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 IVO MUMPUNI
1124R0020322V004803 0002169780873 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361240 1#0##0#0#0.0#2022-04-05
11:05:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c95a1ba47c4d616f326fde8fe0736898 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 20/03/1961 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SLAMET RIYADI.TN
0001303435192 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361249 1#0##0#0#0.0#2022-04-05
11:12:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1ad4151f51f6c8f54ac584802a148ecd 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 08/11/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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3372030 C 3 CP 2 30/03/2022 30/03/2022 24/02/1954 0 2
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11:15:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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1#0##0#0#0.0#2022-04-05
11:16:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 07/09/1947 0 1
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1#0##0#0#0.0#2022-04-05
11:17:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 15/05/1963 0 1
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1#0##0#0#0.0#2022-04-05
11:18:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 30/12/1954 0 2
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novia;3313125201940001; 5.6.6.202203301209 4 361256
1#0##0#0#0.0#2022-04-05
11:19:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 31/12/1965 0 2
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novia;3313125201940001; 5.6.6.202203301209 4 361257
1#0##0#0#0.0#2022-04-05
11:20:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 12/07/1966 0 1
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novia;3313125201940001; 5.6.6.202203301209 4 361258
1#0##0#0#0.0#2022-04-05
11:22:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 03/12/1950 0 1
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novia;3313125201940001; 5.6.6.202203301209 4 361259
1#0##0#0#0.0#2022-04-05
11:23:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 01/01/1977 0 1
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SP.PD 1124R0020322V004815 0001147281805 3;JKN novia;3313125201940001;
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3372030 C 3 CP 2 30/03/2022 30/03/2022 09/09/1944 0 1
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SP.PD 1124R0020322V004816 0000100867893 3;JKN novia;3313125201940001;
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11:24:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 12/03/1955 0 2
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novia;3313125201940001; 5.6.6.202203301209 4 361262
1#0##0#0#0.0#2022-04-05
11:26:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 18/07/1964 0 1
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SP.PD 1124R0020322V004818 0002425018184 3;JKN novia;3313125201940001;
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11:27:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4e160e730090dbbf783ef6a5e61d2c2a 463830 0 0 0 0 0
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3372030 C 3 CP 2 30/03/2022 30/03/2022 14/03/1977 0 1
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novia;3313125201940001; 5.6.6.202203301209 4 361264
1#0##0#0#0.0#2022-04-05
11:28:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1e29fdfdd7eea4d6b567f54bcba218ca 463830 0 0 0 0 0
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3372030 C 3 CP 2 30/03/2022 30/03/2022 31/12/1981 0 2
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novia;3313125201940001; 5.6.6.202203301209 4 361265
1#0##0#0#0.0#2022-04-05
11:29:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c0bad7c62387257399dc07879637c8aa 463830 0 0 0 0 0
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3372030 C 3 CP 2 30/03/2022 30/03/2022 02/02/1972 0 2
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SP.PD 1124R0020322V004821 0002070978546 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361266 1#0##0#0#0.0#2022-04-05
11:30:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
df1fb39999d2b235b485b5ebd0046c35 463830 0 0 0 0 0
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3372030 C 3 CP 2 30/03/2022 30/03/2022 15/06/1997 0 1
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novia;3313125201940001; 5.6.6.202203301209 4 361267
1#0##0#0#0.0#2022-04-05
11:32:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 09/05/1945 0 1
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novia;3313125201940001; 5.6.6.202203301209 4 361268
1#0##0#0#0.0#2022-04-05
11:40:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 30/03/2022 30/03/2022 06/06/1992 0 2
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novia;3313125201940001; 5.6.6.202203301209 4 361269
1#0##0#0#0.0#2022-04-05
11:41:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 30/10/2000 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 WAHYU PUTRI HASANAH.NY 101780 21 7821 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361272
1#0##0#0#0.0#2022-04-05
11:42:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 04/08/1968 0 2
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novia;3313125201940001; 5.6.6.202203301209 4 361273
1#0##0#0#0.0#2022-04-05
11:43:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 21/12/1978 0 2
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novia;3313125201940001; 5.6.6.202203301209 4 361274
1#0##0#0#0.0#2022-04-05
11:44:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 18/06/2005 0 2
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1 0 0 0 ARFIA AISYA RACHMA, NN 101778 16 6129 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361283
1#0##0#0#0.0#2022-04-05
12:11:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
859e831a95feaabcdc3bd09970ed36c9 300000 0 0 0 0 0
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3372030 C 3 CP 2 30/03/2022 30/03/2022 09/08/1981 0 2
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SP.KG 1124R0020322V004829 0000639571757 3;JKN novia;3313125201940001;
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12:12:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 08/12/1989 0 1
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novia;3313125201940001; 5.6.6.202203301209 4 361285
1#0##0#0#0.0#2022-04-05
12:13:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 20/09/1983 0 1
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novia;3313125201940001; 5.6.6.202203301209 4 361286
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12:16:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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12:36:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 25/06/2000 0 2
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12:37:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 26/06/1955 0 2
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12:38:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 01/08/1989 0 2
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novia;3313125201940001; 5.6.6.202203301209 4 361293
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12:39:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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12:40:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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novia;3313125201940001; 5.6.6.202203301209 4 361295
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12:43:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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12:44:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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12:45:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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12:50:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 01/01/2000 0 1
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1#0##0#0#0.0#2022-04-05
12:52:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 31/05/1985 0 2
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novia;3313125201940001; 5.6.6.202203301209 4 361300
1#0##0#0#0.0#2022-04-05
12:53:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 13/05/1974 0 2
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1124R0020322V004844 0001967312553 3;JKN novia;3313125201940001;
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12:54:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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12:55:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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novia;3313125201940001; 5.6.6.202203301209 4 361303
1#0##0#0#0.0#2022-04-05
12:57:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 05/01/1967 0 1
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361304 1#0##0#0#0.0#2022-04-05
12:58:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 30/10/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 280656
0 1 0 0 0 NURINI.NY 098894 62 22797 DR. YUDHI
novia;3313125201940001; 5.6.6.202203301209 4 361305
1#0##0#0#0.0#2022-04-05
13:01:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
30bfa8ed8d578e3903317eb7a58c9fe0 203000 0 0 0 0 0
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3372030 C 3 CP 2 30/03/2022 30/03/2022 07/05/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 204630
0 1 0 0 0 PARDJINAH ARIYATI.NY 088637 53 19685
novia;3313125201940001; 5.6.6.202203301209 4 361306
1#0##0#0#0.0#2022-04-05
13:14:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
169449a12f91b0ada1a1aad8e2e37c94 150000 0 0 0 0 0
0 0 0 0 15000 0 39630 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 01/01/2000 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 DAMAR ARIO SEMPURNO. DR, BP 043584 22 8124
novia;3313125201940001; 5.6.6.202203301209 4 361307
1#0##0#0#0.0#2022-04-05
13:17:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f401ea5dc17daabf4343a1f4fcc91ec2 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 27/02/1987 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RAHMAWATY,(NY) 035918 35 12815 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361308
1#0##0#0#0.0#2022-04-05
13:18:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d8178456a78e4ecd488ec0cbb2fb431d 300000 0 0 0 0 0
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3372030 C 3 CP 2 30/03/2022 30/03/2022 25/11/1963 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 PRIYONO,TN 00891 58 21310 DRG. VERAWATY, SP.KG
1124R0020322V004852 0001104198974 3;JKN novia;3313125201940001;
5.6.6.202203301209 4 361309 1#0##0#0#0.0#2022-04-05
13:22:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
331ebb0f9ed4f491c9cbdf0ad91e76f2 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 14/06/1993 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ISNAINI FARIDA ., NY 054684 28 10516 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361310
1#0##0#0#0.0#2022-04-05
13:24:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fce2bee4e81a57a796b98f568d759a74 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 20/11/1986 0 1
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.6.202203301209 4 361311
1#0##0#0#0.0#2022-04-05
13:25:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c023b6317dc8ad5169f1ef4218dcb266 300000 0 0 0 0 0
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3372030 C 3 CP 2 30/03/2022 30/03/2022 23/07/1972 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 TRI YULIARTI 001163 49 18147 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361312
1#0##0#0#0.0#2022-04-05
13:26:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5d76b3d787b9d1d10d781842525e308e 300000 0 0 0 0 0
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3372030 C 3 CP 2 30/03/2022 30/03/2022 23/12/1971 0 2
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.6.202203301209 4 361313
1#0##0#0#0.0#2022-04-05
13:27:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
058cdc82a3a5cc7ec063f7fba7a5a6ee 300000 0 0 0 0 0
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3372030 C 3 CP 2 30/03/2022 30/03/2022 06/10/1993 0 1
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.6.202203301209 4 361314
1#0##0#0#0.0#2022-04-05
13:29:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b91e4ad6b9ad9cf5f57ed92f25a212a7 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 30/11/1945 0 1
1 H05.2;H26.9 87.03;90.29 - - None None None None Z-3-18-0
None None None None None None CT-SCAN KEPALA 894800 0 0
- 0 - 0 - 0 - 0 894800 1115337 0
1 0 0 0 SRI SUWARNO, TN 072671 76 27879 DR. YUDHI
reni;3313147010930001; 5.6.6.202203301209 4 361315
1#0##0#0#0.0#2022-04-06
09:03:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1d54fab9818764913fcbf1540eeeda3e 0 0 0 0 0 0 935000
0 0 0 15000 0 165337 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 08/03/1993 0 1
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.6.202203301209 4 361317
1#0##0#0#0.0#2022-04-05
13:36:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ab9502262d639af52a87fa012f28e693 300000 0 0 0 0 0
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3372030 C 3 CP 2 30/03/2022 30/03/2022 30/12/1958 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RAHMAT MARGIONO.TN 102552 63 23101 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361319
1#0##0#0#0.0#2022-04-05
13:37:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b948498e8c1315cf0b8827084113b27f 300000 0 0 0 0 0
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3372030 C 3 CP 2 30/03/2022 30/03/2022 05/10/2000 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 AZIIZ ABRIANTO.SDR 102557 21 7846 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361320
1#0##0#0#0.0#2022-04-05
13:38:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
16686dc33f5ae1bc78fb35755f51f2d2 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 25/11/1957 0 1
0 - 0 - 0 - 0 - 0 181400 221349
0 1 0 0 0 MUHAMAT ISKAK.TN 039390 64 23501 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361321
1#0##0#0#0.0#2022-04-05
13:45:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ffe1d9b50d791bcd6845ee1401a01eae 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/03/2022 30/03/2022 30/05/2004 0 1
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.6.202203301209 4 361322
1#0##0#0#0.0#2022-04-05
13:46:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0ee47795c446539dc8e15e49879005f5 300000 0 0 0 0 0
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3372030 C 3 CP 2 30/03/2022 30/03/2022 30/12/1996 0 1
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 RENALDO ELIA A, SDR 102114 25 9221 DRG.
novia;3313125201940001; 5.6.6.202203301209 4 361323
1#0##0#0#0.0#2022-04-05
13:50:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/03/2022 30/03/2022 26/09/1963 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 BAJURI, TN 000197
0001104121822 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
361324 1#0##0#0#0.0#2022-05-18
10:12:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
3cb74a2817cf8b77b1d15cf4e594f4f7 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 02/03/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMARNI, NY 101618
0000089014184 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361325 1#0##0#0#0.0#2022-04-05
13:52:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
74723d4bc861835a7abc34990f0c9e80 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 20/01/2013 0 2
0 0 - 0 - 0 - 0 - 0 181400 173218
0 1 0 0 0 CLARISTA AFIFAH Y, AN 070913 9 3356
0002347378345 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361326 1#0##0#0#0.0#2022-04-05
13:53:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 8218 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 23/07/2007 0 2
None None None None GAGAL JANTUNG KONGESTIF DAN KONDISI JANTUNG LAIN-LAIN
521100 0 0 - 0 - 0 - 0 - 0 521100
196996 0 1 0 0 0 TALATUPAN BINTANG SAHANA.NN 102710
0001270100428 3;JKN novia;3313125201940001; 5.6.6.202203301209 4
361327 1#0##0#0#0.0#2022-04-05
13:55:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
159461106adec9d962e99c068cb14722 150000 0 0 0 0 0
0 0 0 0 25000 0 21996 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 16/09/1975 0 1
0 - 0 - 0 - 0 183900 352310 0 1
0 0 0 ANTONIUS DWI BUDI SANTOSA, TN 101800 46 16997 DR.
novia;3313125201940001; 5.6.6.202203301209 4 361328
1#0##0#0#0.0#2022-04-05
13:56:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7c2a5f5b6ae3e682e92821315c0259da 295000 0 0 0 0 0
0 0 0 0 15000 0 42310 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 29/12/1996 0 2
0 - 0 - 0 - 0 283800 320300 0 1
0 0 0 MARIA GORETTI RIANI PRASETYO.NY 102699 25 9222
novia;3313125201940001; 5.6.6.202203301209 4 361329
1#0##0#0#0.0#2022-04-05
13:58:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
95781f036e88a8ec1d16921b6af8c386 300000 0 0 0 0 0
0 0 0 0 15000 0 5300 0 0 0 0 0
3372030 C 3 CP 2 30/03/2022 30/03/2022 06/07/1967 0 2
1 S80.0;W19.0 88.27 - - None None None None Q-5-39-0 None
None None None None None CEDERA PADA JARINGAN LUNAK KOMPLEK 128800
0 0 - 0 - 0 - 0 - 0 128800 380280
0 1 0 0 0 SRI LESTARI, NY 102678 54 19991 DR.
SUROSO 1124R0020322V004880 0000563902312 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361055 1#0##0#0#0.0#2022-04-04
18:31:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a990685141b3b08c18d4d94a206a6250 0 0 75000 0 0 0 248000
0 0 0 25000 0 32280 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 25/03/1952 0 1
0 - 0 - 0 - 0 129600 484770 0 1
0 0 0 K KARSONO.TN 102707 70 25573 DR. WAHYU PURNOMO,
SP.OT 1124R0020322V004884 0000044058914 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 361414 1#0##0#0#0.0#2022-04-06
09:40:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a8136a48a770b15f8316a7a0a7aaa561 150000 0 0 0 0 0
280000 0 0 0 15000 0 39770 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 31/12/1958 0 2
1 Z09.8;I50.0;E11.4;G59.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 242710
0 1 0 0 0 SUKIRAH.NY 080728 63 23101 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 361415
1#0##0#0#0.0#2022-04-06
09:43:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a0943c0b93069cc3e21fd466f86e57da 150000 0 0 0 0 0
0 31845 0 0 15000 0 45865 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 07/01/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 552711
0 1 0 0 0 JAHURI BAKRI, TN 072140 57 20902 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361416
1#0##0#0#0.0#2022-04-06
09:52:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3bd07049dd501a3a9910a84cc4c7e252 150000 0 0 0 0 0
0 120795 0 0 15000 0 266916 0 0 0 0
0
3372030 C 3 CP 2 31/03/2022 31/03/2022 11/11/1946 0 2
0 0 - 0 - 0 - 0 - 0 181400 209122
yani;3302226402970001; 5.6.6.202203301209 4 361418
1#0##0#0#0.0#2022-04-06
09:56:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
be0704e79bf169b99d4e8f4a4abf547a 150000 0 0 0 0 0
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3372030 C 3 CP 2 31/03/2022 31/03/2022 10/09/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 349868
0 1 0 0 0 SUPOMO, TN 017413 62 22848 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 361417
1#0##0#0#0.0#2022-04-06
09:54:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d4762eb34b40bd9d47d845819fa4802d 150000 0 0 0 0 0
0 31845 0 0 15000 0 153023 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 13/03/1944 0 1
0 - 0 - 0 - 0 - 0 549400 907020
0 1 0 0 0 SUBANDIJO.TN 083578 78 28507 DR.
yani;3302226402970001; 5.6.6.202203301209 4 362025
1#0##0#0#0.0#2022-04-11
10:37:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6bc84b53a553993b87b2cef110271afa 150000 0 0 0 0 0
657000 44300 0 0 15000 0 40720 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 08/06/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 323440
0 1 0 0 0 LAMIYEM.NY 087484 71 26229 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 361419
1#0##0#0#0.0#2022-04-06
09:56:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2bf68e502838aadab67d507dfce94619 150000 0 0 0 0 0
0 120795 0 0 15000 0 37645 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 31/10/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 224100
0 1 0 0 0 WISNU HARDONO, TN 057662 54 19875 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361420
1#0##0#0#0.0#2022-04-06
09:57:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6f59a37b2727f326a1f478d65c47e2ca 150000 0 0 0 0 0
0 31845 0 0 15000 0 27255 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 19/07/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 438910
yani;3302226402970001; 5.6.6.202203301209 4 361421
1#0##0#0#0.0#2022-04-06
09:59:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dff5d8ced570dc21115e7054828e15d5 150000 0 0 0 0 0
248000 0 0 0 15000 0 25910 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 30/01/1975 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 CHOIRUN NISYA, NY
0002461992445 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361380 1#0##0#0#0.0#2022-04-06
10:01:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d8d8bf88e992d400230bff49bfa4776b 247000 0 0 0 0 0
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3372030 C 3 CP 2 31/03/2022 31/03/2022 12/01/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 219145
0 1 0 0 0 ARWAN.TN 089358 64 23454 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 361422
1#0##0#0#0.0#2022-04-06
10:02:33#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
39ae8e38d3ad4d1eb9b42a8dbf0c303e 150000 0 0 0 0 0
0 31845 0 0 15000 0 22300 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 21/06/1980 0 1
0 0 - 0 - 0 - 0 - 0 182600 424600
0 1 0 0 0 SRI SULANJARI T, TN 102734 41 15258
reni;3313147010930001; 5.6.6.202203301209 4 361289
1#0##0#0#0.0#2022-04-05
12:26:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2e79fe1ef9980e5040238a487b6083c2 0 0 138000 0 0 0
248000 0 0 0 15000 0 23600 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 03/03/1968 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
362431 0 1 0 0 0 SUPATMI, NY 042845 54 19751
yani;3302226402970001; 5.6.6.202203301209 4 361423
1#0##0#0#0.0#2022-04-06
10:04:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8ed6c6ca74bec3c94859ef446affc33d 150000 0 0 0 0 0
0 31845 0 0 15000 0 165586 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 14/09/1977 0 1
0 0 - 0 - 0 - 0 - 0 181400 257490
0 1 0 0 0 SRI SAWAL RIYADI.TN 096799 44 16269
yani;3302226402970001; 5.6.6.202203301209 4 361424
1#0##0#0#0.0#2022-04-06
10:04:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
db2234aa8763c0dd2a2e80c985a8f3a3 150000 0 0 0 0 0
0 31845 0 0 15000 0 60645 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 09/09/1940 0 1
0 0 - 0 - 0 - 0 - 0 181400 215890
0 1 0 0 0 SUDARKO,(BP) 039452 81 29788 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361637
1#0##0#0#0.0#2022-04-06
10:08:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ee0723227f33cf2dc639a931d9b7b1e6 150000 0 0 0 0 0
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3372030 C 3 CP 2 31/03/2022 31/03/2022 15/07/1949 0 2
1 Z09.8;E11.9;M75.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 224105
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yani;3302226402970001; 5.6.6.202203301209 4 361425
1#0##0#0#0.0#2022-04-06
10:09:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7c41a3eaa3f25ef00e538e6870aa308b 150000 0 0 0 0 0
0 0 0 0 15000 0 59105 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 31/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 254905
0 1 0 0 0 ASLAMIYAH., NY 043938 67 24562 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361426
1#0##0#0#0.0#2022-04-06
10:10:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e7894952f4c0207aad028f94bad37999 150000 0 0 0 0 0
0 31845 0 0 15000 0 58060 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 27/02/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 298460
0 1 0 0 0 BAMBANG EDY INDRATNO.tn 094164 69 25234
yani;3302226402970001; 5.6.6.202203301209 4 361427
1#0##0#0#0.0#2022-04-06
10:10:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9d09cd8221fa430fda647f5a893fbbbd 150000 0 0 0 0 0
0 76595 0 0 15000 0 56865 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 02/06/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 450512
0 1 0 0 0 SUHESMI.NY 102711 62 22948 DR. WAHYU
yani;3302226402970001; 5.6.6.202203301209 4 361428
1#0##0#0#0.0#2022-04-06
10:11:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
571b275f6e30a2d9019c023e777e8530 150000 0 0 0 0 0
248000 0 0 0 15000 0 37512 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 31/12/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 330340
0 1 0 0 0 TRI MARGINI,(NY) 034217 57 20909 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361429
1#0##0#0#0.0#2022-04-06
10:12:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fde5f5ffb8590fe83f987e3bcc67230a 150000 0 0 0 0 0
0 76045 0 0 15000 0 89295 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 26/07/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SRI RAHAYU 72889 47 17415 DR. ARIA CHANDRA
agung;3313092303950002; 5.6.6.202203301209 4 362006
1#0##0#0#0.0#2022-04-07
13:45:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
38498ae695342058cb26539a2a944380 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 29/12/1952 0 2
1 Z09.8;M19.98;E11.9;I50.0 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
397541 0 1 0 0 0 DRA. SRI SUPADMINI, NY 064608
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361430
1#0##0#0#0.0#2022-04-06
10:13:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8f86f8d9e058e3370c6dccb49a1e2673 150000 0 0 0 0 0
0 0 0 0 15000 0 232541 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 06/11/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 307500
0 1 0 0 0 SITI SUMARIYAH.NY 086409 64 23521 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361431
1#0##0#0#0.0#2022-04-06
10:13:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
812696fa5d58e1f3d65d50a522b5a8d5 150000 0 0 0 0 0
0 76045 0 0 15000 0 66455 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 03/08/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 TENTREM.NY 089445
0000640219601 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361394 1#0##0#0#0.0#2022-04-06
10:14:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a1a40a3b7ce96d6461a18bd005599804 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 29/09/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 281245
0 1 0 0 0 SUHARDI, TN 018629 62 22829 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 361432
1#0##0#0#0.0#2022-04-06
10:16:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
187331415671fdf6ec7d30f76fc6d81e 150000 0 0 0 0 0
0 31845 0 0 15000 0 84400 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 20/07/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 194992
0 1 0 0 0 SITI ZUHRIYAH,(NY) 039654 69 25456
yani;3302226402970001; 5.6.6.202203301209 4 361433
1#0##0#0#0.0#2022-04-06
10:19:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e2d38f37158b484c9d7c96cf7067892d 150000 0 0 0 0 0
0 0 0 0 15000 0 29992 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 18/01/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 195775
0 1 0 0 0 HARDJANINGSIH, NY 098784 67 24544 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361434
1#0##0#0#0.0#2022-04-06
10:21:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2f0e0d730f8b506246df0f976a7bc8ab 150000 0 0 0 0 0
0 0 0 0 15000 0 30775 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 02/06/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 192900
0 1 0 0 0 YANTO BULHARI.TN 102471 72 26600 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361435
1#0##0#0#0.0#2022-04-06
10:22:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b19ab84ddafa2b370c0f492a720934b5 150000 0 0 0 0 0
0 0 0 0 15000 0 27900 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 31/08/1998 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 RARAS DANASTRI
0001279114907 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361392 1#0##0#0#0.0#2022-04-06
10:23:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a2cc6a5dcbfd61f87bce0f1b22332e3a 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 12/08/1953 0 1
1 Z09.8;N18.9;E78.5;M19.98 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
362745 0 1 0 0 0 DRS SURYATMOJO.TN 095031 68
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361436
1#0##0#0#0.0#2022-04-06
10:24:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
59e87b05ed00a5e2908d2104d255d55f 150000 0 0 0 0 0
0 133700 0 0 15000 0 64045 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 01/09/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 209122
0 1 0 0 0 MURSAMTORO 086759 68 25048 DR. WAHYU
yani;3302226402970001; 5.6.6.202203301209 4 361437
1#0##0#0#0.0#2022-04-06
10:26:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dd5d42e169389cbe7c87ac383bd0f47a 150000 0 0 0 0 0
0 0 0 0 15000 0 44122 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 17/04/1946 0 1
0 0 - 0 - 0 - 0 - 0 181400 384465
yani;3302226402970001; 5.6.6.202203301209 4 361438
1#0##0#0#0.0#2022-04-06
10:27:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bdd45333a57cf00176118d540e81a4b1 150000 0 0 0 0 0
0 31845 0 0 15000 0 187620 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 02/09/1974 0 2
- 0 - 0 - 0 - 0 549400 176510 0
1 0 0 0 ENI SUPRIHARTINI.NY 102715 47 17377 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361439
1#0##0#0#0.0#2022-04-06
10:28:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f2e9f4bb6c77492a744ecbd39e1d35f5 150000 0 0 0 0 0
0 0 0 0 25000 0 1510 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 12/05/1958 0 1
1 H02.0;H04.1 90.29;95.01 - - None None None None Q-5-42-0
0 0 - 0 - 0 - 0 - 0 182600 335119
0 1 0 0 0 TASLIM, TN 040885 63 23334 DR. YUDHI
yani;3302226402970001; 5.6.6.202203301209 4 361440
1#0##0#0#0.0#2022-04-06
10:29:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
12769e1f407d336960fb92388b25b08c 203000 0 0 0 0 0
0 0 0 0 15000 0 117119 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 04/07/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 561267
0 1 0 0 0 SUNARMI, NY 049475 64 23646 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 361441
1#0##0#0#0.0#2022-04-06
10:30:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0018a4eb2d5e91ec7289d7ab5e359870 150000 0 0 0 0 0
0 120895 0 0 15000 0 275372 0 0 0 0
0
3372030 C 3 CP 2 31/03/2022 31/03/2022 15/12/1951 0 1
0 404900 388162 0 1 0 0 0 SYAFIQ MUHAMMAD,
BP 100679 70 25674 DR. WAHYU PURNOMO, SP.OT 1124R0020322V004920
0001787454077 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361442 1#0##0#0#0.0#2022-04-06
10:33:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1e5fc7814b999761b8b22e245c5fbc7d 150000 0 0 0 0 0
0 0 0 0 15000 0 223162 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 15/04/1955 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
748064 0 1 0 0 0 TUMINI, NY 093778 66 24457
yani;3302226402970001; 5.6.6.202203301209 4 361443
1#0##0#0#0.0#2022-04-06
10:34:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7f8c97d4bc21190f674629b52ea42b93 150000 0 0 0 0 0
0 120795 0 0 15000 0 462269 0 0 0 0
0
3372030 C 3 CP 2 31/03/2022 31/03/2022 13/03/1978 0 2
1 Z09.8;M19.98;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 342002
0 1 0 0 0 CHRISTINA MARGARETNA, NY 043869 44
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361444
1#0##0#0#0.0#2022-04-06
10:35:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
02690472f5ea622dbcfcd3d712043136 150000 0 0 0 0 0
0 133250 0 0 15000 0 43752 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 18/07/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 337925
0 1 0 0 0 SURATMI TRINANINGSIH, NY 009602 58
0001102728688 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361445 1#0##0#0#0.0#2022-04-06
10:41:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4d59b3dd48689ded2b7dc2ec06572cf3 150000 0 0 0 0 0
0 121345 0 0 15000 0 51580 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 08/09/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 246325
0 1 0 0 0 SITI ZUBAIDAH, NY 066527 61 22484 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361446
1#0##0#0#0.0#2022-04-06
11:34:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b6eeacaf02fd81241de3dcb32fe08af0 150000 0 0 0 0 0
0 0 0 0 15000 0 81325 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 30/11/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 216630
0 1 0 0 0 DIDIK SUMADI.TN 093289 62 22767 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361447
1#0##0#0#0.0#2022-04-06
10:59:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f564825fd14316a8c86ff4b9f7a5145d 150000 0 0 0 0 0
0 0 0 0 15000 0 51630 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 22/09/1959 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMARSONO ,TN
0001032587199 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361391 1#0##0#0#0.0#2022-04-06
10:59:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
41f511e194641df5d140a258981a159f 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 25/11/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 385915
0 1 0 0 0 SRI WIDODO.TN 094807 53 19484 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361448
1#0##0#0#0.0#2022-04-06
11:00:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eebdcd788c5b1501191c15c33d650da4 150000 0 0 0 0 0
0 76595 0 0 15000 0 144320 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 20/03/1961 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI MIYATUN.NY
0000076431947 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361393 1#0##0#0#0.0#2022-04-06
11:01:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
04e093e445082be5af35c82ac629351d 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 23/07/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 489664
0 1 0 0 0 SARTONO.TN 098856 48 17783 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 361450
1#0##0#0#0.0#2022-04-06
11:02:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
80d09a8bdfbb4c3fd29af9c7907aca3b 150000 0 0 0 0 0
0 76045 0 0 15000 0 248619 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 13/05/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 258070
0 1 0 0 0 SRI WAHYUNI, NY 102383 50 18585 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361449
1#0##0#0#0.0#2022-04-06
11:01:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ccf774ee94d67d8a7cd5e5ad8b6c6c85 150000 0 0 0 0 0
0 0 0 0 15000 0 93070 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 12/09/1950 0 1
1 Z09.8;E11.9;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 283396
0 1 0 0 0 SAMPAN, BP 068934 71 26133 DR. SUHARTO,
SP.PD 1124R0020322V004932 0000088998895 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 361452 1#0##0#0#0.0#2022-04-06
11:04:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dfed377b54f981bfd9b1778a2113e25b 150000 0 0 0 0 0
0 31845 0 0 15000 0 86551 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 31/12/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 948095
0 1 0 0 0 SUHARJO.TN 087887 70 25658 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 361453
1#0##0#0#0.0#2022-04-06
11:04:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cad79a92093fa9e0208bc779cd87239b 150000 0 0 0 0 0
657000 76595 0 0 15000 0 49500 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 17/04/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 213040
0 1 0 0 0 ISMIYATI, NY 094052 69 25550 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361454
1#0##0#0#0.0#2022-04-06
11:05:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cd9a8842de4dfa8cdc4fdca47637591b 150000 0 0 0 0 0
0 0 0 0 15000 0 48040 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 08/01/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 204370
0 1 0 0 0 TRI SUWARTI, NY 057542 60 21997 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361456
1#0##0#0#0.0#2022-04-06
11:06:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
205f812dc4e99e4eff07cc31bbbff8d6 150000 0 0 0 0 0
0 0 0 0 15000 0 39370 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 15/03/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 186830
0 1 0 0 0 SUPARJO.TN 102570 66 24122 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 361457
1#0##0#0#0.0#2022-04-06
11:07:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
da5891319eb5b0b99e850cd1f87149fa 150000 0 0 0 0 0
0 0 0 0 15000 0 21830 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 05/10/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 209122
0 1 0 0 0 MARTINUS ARI DWI RIANTO.TN 102290 43
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361458
1#0##0#0#0.0#2022-04-06
11:08:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cc78c422fbe5e8d47682e565cb14ccb3 150000 0 0 0 0 0
0 0 0 0 15000 0 44122 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 10/07/1992 0 1
0 0 - 0 - 0 - 0 - 0 181400 188698
yani;3302226402970001; 5.6.6.202203301209 4 361459
1#0##0#0#0.0#2022-04-06
11:08:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2388486009e86e12ba93d4dfac4934ee 150000 0 0 0 0 0
0 0 0 0 15000 0 23698 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 11/11/1974 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SUGENG WIDODO, TN 093087 47 17307 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361462
1#0##0#0#0.0#2022-04-06
11:09:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
13256333303a0a0fbe136c11618c0a9c 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 19/02/1991 0 1
0 0 - 0 - 0 - 0 - 0 181400 207060
0 1 0 0 0 TRI PRAKOSO FEBRIANTO, TN 101768 31
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361463
1#0##0#0#0.0#2022-04-06
11:10:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
23af692b73750f8f2fb7f9085d3e8fc5 150000 0 0 0 0 0
0 0 0 0 15000 0 42060 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 09/05/1994 0 1
1 Z09.8;M17.9;W19.3 88.27 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 450500
0 1 0 0 0 PILEMON BERTH M W 102709 27 10188 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361464
1#0##0#0#0.0#2022-04-06
11:24:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
8a68e45a73f7c99131b95338411d9dfb 150000 0 0 0 0 0
248000 0 0 0 15000 0 37500 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 26/06/2020 0 2
1 B86 - - - None None None None Q-5-42-0 None None
- 0 - 0 - 0 - 0 182600 230619 0
1 0 0 0 MILEA CALISTA ANGGRAINI PUTRI.AN 102713 1
yani;3302226402970001; 5.6.6.202203301209 4 361465
1#0##0#0#0.0#2022-04-06
11:25:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
968a1de5e8954bd6f246551e0e606156 150000 0 0 0 0 0
0 0 0 0 15000 0 65619 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 20/10/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 BADRIYAH
1124R0020322V004945 0000091089088 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 361368 1#0##0#0#0.0#2022-04-06
11:26:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a16a05962499c3b1c8d3470a5f773b71 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 11/09/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 319681
0 1 0 0 0 SUMARNO.TN 095054 67 24673 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 361466
1#0##0#0#0.0#2022-04-06
11:26:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d171fc7744d3ed3fc7dadc9b9227c2ca 150000 0 0 0 0 0
0 120795 0 0 15000 0 33886 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 14/05/1987 0 2
0 0 - 0 - 0 - 0 - 0 296400 180680
0 1 0 0 0 RINI PUJI HASTUTI.NY 098270 34 12740
yani;3302226402970001; 5.6.6.202203301209 4 361467
1#0##0#0#0.0#2022-04-06
11:27:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1b9d7b27ee78f4f17693fd577196e1ee 150000 0 0 0 0 0
0 0 0 0 15000 0 15680 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 16/06/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 264631
0 1 0 0 0 SUWARTI.NY 085230 76 28047 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 361468
1#0##0#0#0.0#2022-04-06
11:28:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
247429d141589ab170458be2a7525a9c 150000 0 0 0 0 0
0 0 0 0 15000 0 99631 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 28/10/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 TEMU MUJIYEM, NY
0000638873605 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361370 1#0##0#0#0.0#2022-04-06
11:29:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f0adf59e485837dfd6283d22f72924f0 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 19/12/1949 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
507227 0 1 0 0 0 SURATNO, TN 092135 72 26400
yani;3302226402970001; 5.6.6.202203301209 4 361469
1#0##0#0#0.0#2022-04-06
11:40:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a23b9af5626af69064f2a31c9a6627fb 150000 0 0 0 0 0
0 76045 0 0 15000 0 266182 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 21/07/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 238551
0 1 0 0 0 YULINING SUMARNI.NY 084563 79 29108
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361470
1#0##0#0#0.0#2022-04-06
11:40:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
92b275c7b1d57508134980a89c0b0ed5 150000 0 0 0 0 0
0 0 0 0 15000 0 73551 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 01/01/2000 0 1
0 0 - 0 - 0 - 0 - 0 181400 312135
0 1 0 0 0 RASIM., BP 044706 22 8125 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 361471
1#0##0#0#0.0#2022-04-06
11:43:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a6696b8fbab391b0edfa3786398af929 150000 0 0 0 0 0
0 88500 0 0 15000 0 58635 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 10/07/1955 0 2
1 Z09.8;N20.0;E11.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 223842
0 1 0 0 0 SRI MURNI, NY 012680 66 24371 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361472
1#0##0#0#0.0#2022-04-06
11:44:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c2d561690d8a6d054a1ad125ecef12aa 150000 0 0 0 0 0
0 0 0 0 15000 0 58842 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 10/10/1957 0 1
1 Z09.8;R51;I11.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 235923
0 1 0 0 0 SULUT, TN 082030 64 23548 DR. SUHARTO,
SP.PD 1124R0020322V004954 0000640434914 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 361478 1#0##0#0#0.0#2022-04-06
11:53:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ad4d48f1b7b13cb0cf8e0e6de7b34508 150000 0 0 0 0 0
0 0 0 0 15000 0 70923 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 21/10/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 195090
0 1 0 0 0 BAMBANG WASKITO.TN 100177 49 18058
yani;3302226402970001; 5.6.6.202203301209 4 361480
1#0##0#0#0.0#2022-04-06
12:55:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0fa3ee29fb0e54c9e82c1822fea2b2fb 150000 0 0 0 0 0
0 0 0 0 15000 0 30090 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 15/10/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 230850
0 1 0 0 0 SRI SUKATMI,(NY) 015356 70 25735 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361482
1#0##0#0#0.0#2022-04-06
12:56:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
88997f6ba745b7d56b4529542cc9bb42 150000 0 0 0 0 0
0 0 0 0 15000 0 65850 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 16/03/2003 0 2
1 Z09.8;A91;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 217184
0 1 0 0 0 MARISMA CATUR., NN 045011 19 6955
yani;3302226402970001; 5.6.6.202203301209 4 361483
1#0##0#0#0.0#2022-04-06
12:57:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
31bb9cdafc94408cb57a63b08b51d5ad 150000 0 0 0 0 0
0 44300 0 0 15000 0 7884 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 21/08/1948 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MUSNATIN., NY
0000091314876 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361389 1#0##0#0#0.0#2022-04-06
12:57:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e5392a75e2eb074b3f8cdb673ff74f55 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 25/12/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARIA
HENDRASAPUTRA,NY 100064 67 24568 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V004959 0002069991685 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 361390 1#0##0#0#0.0#2022-04-06
12:58:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c407b72624258895dac4415d7f1421c1 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 20/05/1946 0 1
0 0 - 0 - 0 - 0 - 0 181400 229156
0 1 0 0 0 MUHADI,(BP) 011312 75 27709 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 361486
1#0##0#0#0.0#2022-04-06
12:59:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fd21e65b2f96b7d9504ec6178f7c95be 150000 0 0 0 0 0
0 31845 0 0 15000 0 32311 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 03/04/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 209122
0 1 0 0 0 PONIARSI, NY 100933 67 24834 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361496
1#0##0#0#0.0#2022-04-06
13:03:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
347b95cfc1feb5b8e5078fad6bc26eac 150000 0 0 0 0 0
0 0 0 0 15000 0 44122 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 20/11/1985 0 1
0 0 - 0 - 0 - 0 - 0 181400 369655
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361487
1#0##0#0#0.0#2022-04-06
13:04:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1ae533c53bbdbd36bde35011b5627ebb 150000 0 0 0 0 0
0 120795 0 0 15000 0 83860 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 23/09/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ROCHYATI.NY 059452
0001813968753 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361387 1#0##0#0#0.0#2022-04-06
13:04:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1a3054c3e8ede25f8f86e95b6f37de90 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 28/05/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 216630
0 1 0 0 0 SUGIYARSI, NY 092712 64 23683 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361498
1#0##0#0#0.0#2022-04-06
13:06:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1deb6c1a478cc352af913a5098497512 150000 0 0 0 0 0
0 0 0 0 15000 0 51630 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 06/04/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 212740
0 1 0 0 0 IMBRIAKSI HENI ASTUTI (NY) 038025 58
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361490
1#0##0#0#0.0#2022-04-06
13:08:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
1e28e7e749360bbd1df9b1355ca74bf3 150000 0 0 0 0 0
0 0 0 0 15000 0 47740 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 10/06/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 241045
yani;3302226402970001; 5.6.6.202203301209 4 361492
1#0##0#0#0.0#2022-04-06
14:07:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
343c978b1ee4f8e00f49586dd8e1c4f1 150000 0 0 0 0 0
0 76045 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 14/04/1960 0 2
0 - 0 107400 273000 0 1 0 0 0
MARTINAH., NY 072061 61 22631 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V004967 0001084606863 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 361388 1#0##0#0#0.0#2022-04-06
14:09:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
72fd1897e26a53e4615dc093ae0b2628 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 15/11/1957 0 2
- 0 - 0 - 0 - 0 182600 178800 0
1 0 0 0 SUGIYARNI,NY 028192 64 23512 DR. OEDJANG
yani;3302226402970001; 5.6.6.202203301209 4 361493
1#0##0#0#0.0#2022-04-06
14:11:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6125dedb2a3ce1ba1a3eecf47013a686 150000 0 0 0 0 0
0 0 0 0 15000 0 13800 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 07/12/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 361076
0 1 0 0 0 DJUNAIDI BUDI SANTOSA.TN 092210 66
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361494
1#0##0#0#0.0#2022-04-06
14:12:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
34b03780640d0b78a7a2e5041427cf9f 150000 0 0 0 0 0
0 31845 0 0 15000 0 164231 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 23/11/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 180570
yani;3302226402970001; 5.6.6.202203301209 4 361495
1#0##0#0#0.0#2022-04-06
14:13:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eb68e92bdc94b2e36256cbbe968c2038 150000 0 0 0 0 0
0 0 0 0 15000 0 15570 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 16/05/1959 0 2
1 Z09.8;D69.6;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 189690
0 1 0 0 0 SETYO UTAMI NY 087345 62 22965 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361500
1#0##0#0#0.0#2022-04-06
14:14:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
eb7b0f7c8fc13b2d77eb469632685d2b 150000 0 0 0 0 0
0 0 0 0 15000 0 24690 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 06/06/2008 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 BALQIS CHURYN
1124R0020322V004972 0001268897488 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 361332 1#0##0#0#0.0#2022-04-06
14:15:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9f7e840f0a7ec672bc2554a33a95cc9b 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 31/12/1971 0 2
0 - 0 - 0 - 0 786200 491710 0 1
SP.PD 1124R0020322V004973 0000555344774 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 361639 1#0##0#0#0.0#2022-04-06
14:16:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
08a5558a35c2516a9d880f781f100e9c 463830 0 0 0 0 0
0 0 0 0 15000 0 12880 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 17/03/1976 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000563317132 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361396 1#0##0#0#0.0#2022-04-06
14:17:18#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b9200c2d832d99a749c21d0dc06c7aec 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 23/03/1976 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 361404
1#0##0#0#0.0#2022-04-06
14:18:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
335b5af43ddefc6b98f8aed635990401 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 16/05/1997 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MEI NUR SAPUTRI,
0002220808432 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361356 1#0##0#0#0.0#2022-04-06
14:18:47#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c9b682def5056fc826079599c6d1e21a 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 17/04/1973 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 361403
1#0##0#0#0.0#2022-04-06
14:19:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
084c5d389da7fa097f5025b4653c943f 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 10/12/1982 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 361402
1#0##0#0#0.0#2022-04-06
14:20:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
76642bbe860ec6b9300e193c21b8a436 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 12/10/1987 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 361401
1#0##0#0#0.0#2022-04-06
14:21:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
056018c5513a36d1241f526e16b4cd5d 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 25/06/1970 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 361400
1#0##0#0#0.0#2022-04-06
14:22:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b02167d1959985bf8aa1491fd50156f1 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 04/09/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 361399
1#0##0#0#0.0#2022-04-06
14:23:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a81a393fe4b163271c25d635c463fbf9 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 10/07/1955 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V004982 0001032581823 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 361398 1#0##0#0#0.0#2022-04-06
14:23:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2e56e97bbab523b02c397b506ed7fec9 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 08/12/1992 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ARIS ABDULLAH, BP
0000091323292 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361385 1#0##0#0#0.0#2022-04-06
14:24:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
33f006343b12ebcf2b8f1cf19d5f58ed 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 04/05/1958 0 2
0 - 0 - 0 - 0 786200 677676 0 1
yani;3302226402970001; 5.6.6.202203301209 4 361397
1#0##0#0#0.0#2022-04-06
14:24:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cb955870c25080f0bc048f4baa5d38e4 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 17/11/1966 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 INDRARIADI, TN
0001797112102 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361378 1#0##0#0#0.0#2022-04-06
14:25:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b3c2dab8914fc2cbf57018d9a3023233 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 31/12/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 INDRAYATI, NY
0002926021015 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361395 1#0##0#0#0.0#2022-04-06
14:26:21#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8d205c9fc515ee539745bbf4b28b28fc 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 16/12/1956 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 BAMBANG WARAS
1124R0020322V004988 0002463219077 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 361386 1#0##0#0#0.0#2022-04-06
14:28:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fc4746f9d65f39974357a37427820d53 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 14/06/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001429190267 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361351 1#0##0#0#0.0#2022-04-06
14:28:51#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
770407e785dce6c1fb9f080783c66c37 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 07/03/1959 0 1
- 0 - 0 - 0 - 0 182600 334530 0
1 0 0 0 HARYANTO.TN 102714 63 23035 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 361502
1#0##0#0#0.0#2022-04-06
14:29:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3cfa44ff749ef94c208acfae6cdf3a7d 150000 0 0 0 0 0
0 62495 0 0 15000 0 107035 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 10/01/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 423430
0 1 0 0 0 HARYANI PARLUKI.NY 101094 64 23456
yani;3302226402970001; 5.6.6.202203301209 4 361504
1#0##0#0#0.0#2022-04-06
14:31:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9c821bcd97c996b52c4c356a10a1f0b0 150000 0 0 0 0 0
0 31845 0 0 15000 0 226585 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 27/09/1965 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MARYATI., NY
0000640162157 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361383 1#0##0#0#0.0#2022-04-06
14:32:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
171c2c00a7247f8a5f45bc73b282321c 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 28/12/1949 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 NURHAYATI.NY
0001848729036 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361360 1#0##0#0#0.0#2022-04-06
14:32:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3dfcb61be6f202863c7d92046855932d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 09/09/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 213820
0 1 0 0 0 SARBINI, TN 052303 70 25771 DR. SUHARTO,
SP.PD 1124R0020322V004994 0000091234585 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 361505 1#0##0#0#0.0#2022-04-06
14:33:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
660a598c30bac24f0f7344729eaa3f96 150000 0 0 0 0 0
0 0 0 0 15000 0 48820 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 08/12/1976 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 NIKEN MARDUSASI,
0002165494217 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361362 1#0##0#0#0.0#2022-04-06
14:34:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
291b3ae0f692ebc26b24b7eb1a6e923f 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 14/04/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 306799
0 1 0 0 0 AMIR HAUDI,(BP) 029404 64 23727 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361507
1#0##0#0#0.0#2022-04-06
14:35:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a93fff2864bf0346374226709f2127ea 150000 0 0 0 0 0
0 0 0 0 15000 0 141799 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 29/05/1992 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 RIBKAH EVI N, NY 102273 29 10898 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361337
1#0##0#0#0.0#2022-04-06
14:36:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
06ad7ffa377a54367873287ae273db40 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 06/12/1990 0 1
0 0 - 0 - 0 - 0 - 0 549400 834710
0 1 0 0 0 TEGUH WALUYO.TN 102447 31 11438 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361555
1#0##0#0#0.0#2022-04-06
09:04:06#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7931a20184e9f8fb29cb01e4d7abef16 150000 0 0 0 0 0
650000 0 0 0 15000 0 19710 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 05/06/1975 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001272616569 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361376 1#0##0#0#0.0#2022-04-06
14:39:02#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4db0ba64b066afd22191c914ed904bd9 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 08/11/1964 0 2
0 - 0 - 0 - 0 - 0 181400 189910
0 1 0 0 0 SRI LESTARI.NY 102543 57 20962 DR.
OEDJANG SETIJAWAN, MSI.MED.,SP.B 1124R0020322V005001 0000639161493 3;JKN
yani;3302226402970001; 5.6.6.202203301209 4 361509
1#0##0#0#0.0#2022-04-06
14:39:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8b9903b18a22016e8f75138dec228525 150000 0 0 0 0 0
0 0 0 0 15000 0 24910 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 01/10/1937 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SOEKROJONO, TN
0000091322357 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361373 1#0##0#0#0.0#2022-04-06
14:40:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
15f51a2ff9ce72061d68d141bcb9dc15 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 08/10/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 325565
0 1 0 0 0 MARYANTO., BP 041763 64 23550 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361511
1#0##0#0#0.0#2022-04-06
14:42:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e1677a38330962cb9014e2dfe1d758a1 150000 0 0 0 0 0
0 0 0 0 15000 0 160565 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 11/04/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 RUDY UTOMO.TN 094563 58 21539 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361513
1#0##0#0#0.0#2022-04-06
14:46:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
586bc99e997e6a416e7a901966eaf132 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 19/02/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 FRAN HARTUTI.NY
0000091493098 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361358 1#0##0#0#0.0#2022-04-06
14:48:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9c4e6ac12592e6879d25271cd9d99978 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 03/06/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 244125
0 1 0 0 0 ENDANG TRI YUNINGSIH.NY 089720 48 17833
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361515
1#0##0#0#0.0#2022-04-06
14:49:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a10236f7f205ca3be8ffbd6cb06c6ab3 150000 0 0 0 0 0
0 0 0 0 15000 0 79125 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 05/08/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 283970
0 1 0 0 0 SURATMI, NY 074252 60 22153 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 361517
1#0##0#0#0.0#2022-04-06
14:49:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d289c9764c1a33259ccb5aeb9923f1f1 150000 0 0 0 0 0
0 0 0 0 15000 0 118970 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 20/11/1966 0 1
0 - 0 - 0 - 0 183900 330450 0 1
0 0 0 MUGIYONO, TN 101718 55 20220 DR. ZULFADLY, SP.B
1124R0020322V005010 0002224726222 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 361518 1#0##0#0#0.0#2022-04-06
14:51:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
85f2ec6cfcfe4255e36ba8cbb5d6fc73 295000 0 0 0 0 0
0 0 0 0 15000 0 20450 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 31/12/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 202160
0 1 0 0 0 SUNARTO ,BP 084994 66 24197 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 361520
1#0##0#0#0.0#2022-04-06
14:52:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c3228b229e644d71c13263bedd3bb3ea 150000 0 0 0 0 0
0 0 0 0 15000 0 37160 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 23/05/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 325000
0 1 0 0 0 RUMHAYATI.NY 080038 43 16018 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361523
1#0##0#0#0.0#2022-04-06
14:53:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fb461bbc1ee4fc2c6c8b7f430533bc9e 310000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 12/09/2008 0 1
1 Z09.8;R59.0 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 165000
0001190340483 3;JKN novia;3313125201940001; 5.6.7.202204241238 4
361526 1#0##0#0#0.0#2022-05-20
11:03:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
13753d217c360a92bfee07ff3fd28d64 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 20/02/1990 0 1
1 E34.8 - - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 222015
0 1 0 0 0 SRIYONO, TN 099695 32 11727 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 361528
1#0##0#0#0.0#2022-04-06
14:56:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f6037fb21eb949063fa71100214e414e 150000 0 0 0 0 0
0 0 0 0 15000 0 57015 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 19/02/2002 0 1
0 - 0 - 0 - 0 183900 185450 0 1
0 0 0 MUHAMMAD HENDRA FENDIYANTO.SDR 102532 20 7345
yani;3302226402970001; 5.6.6.202203301209 4 361530
1#0##0#0#0.0#2022-04-06
14:58:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d1554d29671392ee9465d2f7b4a743d1 150000 0 0 0 0 0
0 0 0 0 15000 0 20450 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 31/12/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 233116
0 1 0 0 0 SASTRO SUMARNO, TN 096451 76 27849
yani;3302226402970001; 5.6.6.202203301209 4 361533
1#0##0#0#0.0#2022-04-06
14:59:30#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3b35754abfc676007a8e542f047c4298 150000 0 0 0 0 0
0 0 0 0 15000 0 68116 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 01/02/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 256320
0 1 0 0 0 ASIH SAWITRI, NY 097067 57 20877 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361534
1#0##0#0#0.0#2022-04-06
15:00:03#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
80b18078ab41bf383d3bbdc084b2d6ff 150000 0 0 0 0 0
0 0 0 0 15000 0 91320 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 22/04/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 367377
0 1 0 0 0 BAGYO PRAPTANTO., BP 042554 54 20067
yani;3302226402970001; 5.6.6.202203301209 4 361536
1#0##0#0#0.0#2022-04-06
15:00:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
323d12fe2ad0ba661d2fe203dc43d2d2 150000 0 0 0 0 0
0 0 0 0 15000 0 202377 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 31/12/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 258530
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361539
1#0##0#0#0.0#2022-04-06
15:01:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
059c9dbe1983319662925cde061206ad 150000 0 0 0 0 0
0 0 0 0 15000 0 93530 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 01/01/2000 0 1
0 0 - 0 - 0 - 0 - 0 181400 242230
0 1 0 0 0 TARMOYO .BP 010989 22 8125 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 361541
1#0##0#0#0.0#2022-04-06
15:01:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2c10eb6d460710ca9e46f3b68d437238 150000 0 0 0 0 0
0 0 0 0 15000 0 77230 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 24/06/2021 0 1
1 A49.9 - - - None None None None Q-5-42-0 None None
- 0 - 0 - 0 - 0 182600 189503 0
1 0 0 0 FINO PUTRA D, AN 102602 0 280 DR. ANI
yani;3302226402970001; 5.6.6.202203301209 4 361542
1#0##0#0#0.0#2022-04-06
15:02:29#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b2929b0398e44cab200ee3b85840c353 150000 0 0 0 0 0
0 0 0 0 15000 0 24503 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 16/08/2020 0 1
None None None None GANGGUAN PARU AKUT 245800 0 0 -
0 - 0 - 0 - 0 245800 173667 0 1
0 0 0 AZRIEL RAFIF A, AN 102603 1 592 DR. ANI
yani;3302226402970001; 5.6.6.202203301209 4 361544
1#0##0#0#0.0#2022-04-06
15:04:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2991a6e3ed1e2cec325145ce84da166f 150000 0 0 0 0 0
0 0 0 0 15000 0 8667 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 27/04/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 205615
0 1 0 0 0 KUSTANTO, TN 094919 58 21523 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361546
1#0##0#0#0.0#2022-04-06
15:05:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6f38378bdf02be316c8e0924e0f1533b 150000 0 0 0 0 0
0 0 0 0 15000 0 40615 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 16/05/1976 0 1
0 0 - 0 - 0 - 0 - 0 181400 336750
0 1 0 0 0 TEGUH PRAYITNO, TN 069729 45 16755
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361548
1#0##0#0#0.0#2022-04-07
08:07:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f259b70784145845c583c4d414338034 150000 0 0 0 0 0
0 0 0 0 15000 0 171750 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 24/04/2005 0 2
1 Z09.0;D24 96.59 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 277840 0 1
0 0 0 HONEY SABRI, AN 055788 16 6185 DR. ZULFADLY, SP.B
1124R0020322V005026 0000640817482 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 361549 1#0##0#0#0.0#2022-04-07
08:08:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
47bdda6cc2ffb1e8aedb04f2fcf5084d 235000 0 0 0 0 0
0 0 0 0 15000 0 27840 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 02/07/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 182228
0 1 0 0 0 YULI FATIMAH MENIK.NY 102721 55 20361
yani;3302226402970001; 5.6.6.202203301209 4 361551
1#0##0#0#0.0#2022-04-07
08:10:54#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
17bf6d5e703ca50b9fa55c36c91a9c59 150000 0 0 0 0 0
0 0 0 0 25000 0 7228 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 28/10/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 259510
0 1 0 0 0 SRI MARYANI. NY 067664 64 23530 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361554
1#0##0#0#0.0#2022-04-07
08:12:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0058312b3e20c78edf0991947ce79036 150000 0 0 0 0 0
0 0 0 0 15000 0 94510 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 23/06/2001 0 1
0 - 0 - 0 - 0 183900 250000 0 1
0 0 0 RUDIANTO.SDR 102474 20 7586 DR. ZULFADLY, SP.B
1124R0020322V005029 0002190544964 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 361556 1#0##0#0#0.0#2022-04-07
08:12:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
88009e13c37286c2a953704e5c3554cb 235000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 07/02/1959 0 1
1 Z09.8;K30 87.49 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 553000
0 1 0 0 0 JAHMANTO, TN 103272 63 23063 DR.
reni;3313147010930001; 5.6.6.202203301209 4 361558
1#0##0#0#0.0#2022-04-06
09:05:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5af1b86a903ccfb3cd062784b14b3dff 0 0 138000 0 0 0
400000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 17/09/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 229720
0 1 0 0 0 TANTINAH, NY 096912 58 21380 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361559
1#0##0#0#0.0#2022-04-07
08:13:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b97c01327c2361a9aef5b9b00791df3f 150000 0 0 0 0 0
0 0 0 0 15000 0 64720 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 21/07/2003 0 1
0 - 0 - 0 - 0 183900 270450 0 1
0 0 0 AVIN ROHMAD WIDODO,SDR 102494 18 6828 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361561
1#0##0#0#0.0#2022-04-07
08:13:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
35d600ff0a9a4ecfc0f5c8672d78f856 235000 0 0 0 0 0
0 0 0 0 15000 0 20450 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 06/05/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 221898
0 1 0 0 0 SUPRIHATIN, NY 095649 70 25897 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361564
1#0##0#0#0.0#2022-04-07
08:14:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
521d1c5ae81d55da8fca135471b6013b 150000 0 0 0 0 0
0 0 0 0 15000 0 56898 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 11/07/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 301675
0 1 0 0 0 DARYATI, NY 089873 65 24004 DR. ARIA
yani;3302226402970001; 5.6.6.202203301209 4 361571
1#0##0#0#0.0#2022-04-07
08:14:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
223fd532b032171755607f0bf5d3694f 150000 0 0 0 0 0
0 0 0 0 15000 0 136675 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 01/06/1944 0 2
0 0 - 0 - 0 - 0 - 0 181400 196660
0 1 0 0 0 SUJINEM,NY 086697 77 28427 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 361573
1#0##0#0#0.0#2022-04-07
08:15:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
31896a75fd30e7c257df70e005764c8a 150000 0 0 0 0 0
0 0 0 0 15000 0 31660 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 07/07/1975 0 1
0 - 0 - 0 - 0 183900 277840 0 1
0 0 0 TATIT MURDIOKO.TN 102565 46 17069 DR. ZULFADLY, SP.B
1124R0020322V005036 0003054776725 3;JKN reni;3313147010930001;
5.6.6.202203301209 4 361288 1#0##0#0#0.0#2022-04-05
12:27:36#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
867da626998cba3f1f038b1caab0c0a4 235000 0 0 0 0 0
0 0 0 0 15000 0 27840 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 14/05/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 216975
0 1 0 0 0 MARWIWIJI, TN 102422 43 16027 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361575
1#0##0#0#0.0#2022-04-07
08:16:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
846cd41482256561408f08aa9d5e987d 150000 0 0 0 0 0
0 0 0 0 15000 0 51975 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 13/04/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 247186
0 1 0 0 0 SULINAH, NY 101460 63 23363 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 361577
1#0##0#0#0.0#2022-04-07
08:17:01#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
21cafb6ec2a08e9c9517a9fe902dbdb9 150000 0 0 0 0 0
0 0 0 0 15000 0 82186 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 16/07/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 237115
0 1 0 0 0 ALEXIUS MARGONO., BP 047769 65 23999
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361578
1#0##0#0#0.0#2022-04-07
08:18:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
71f9accd1fa1f03aae8ca051042fb9ba 150000 0 0 0 0 0
0 0 0 0 15000 0 72115 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 26/09/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 188020
0 1 0 0 0 WIDAYATI SETYANINGSIH.NY 102469 61
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361580
1#0##0#0#0.0#2022-04-07
08:18:43#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
65f0bef4b0d43688d71a1c51e7ce445a 150000 0 0 0 0 0
0 0 0 0 15000 0 23020 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 21/09/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 199975
0 1 0 0 0 AGUNG WIBOWO.TN 100600 56 20645 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361581
1#0##0#0#0.0#2022-04-07
08:19:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
88fde263b9abd20bb419f6875a042e1d 150000 0 0 0 0 0
0 0 0 0 15000 0 34975 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 20/11/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 238060
0 1 0 0 0 SRI WAHYUTRI,.NY 049706 62 22777 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361583
1#0##0#0#0.0#2022-04-07
08:19:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dcde657564ecaae432a695cb1a8c888c 150000 0 0 0 0 0
0 0 0 0 15000 0 73060 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 20/03/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 225265
yani;3302226402970001; 5.6.6.202203301209 4 361586
1#0##0#0#0.0#2022-04-07
08:20:08#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
04a5f8d272c633b1fbdd534fc642a88d 150000 0 0 0 0 0
0 0 0 0 15000 0 60265 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 24/05/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 222940
0 1 0 0 0 SUTARMI DARSO., NY 043041 76 28070
yani;3302226402970001; 5.6.6.202203301209 4 361588
1#0##0#0#0.0#2022-04-07
08:20:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b8194fe76affd94d7518cee7194ffad3 150000 0 0 0 0 0
0 0 0 0 15000 0 57940 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 07/07/1964 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 WIRADI.TN 098841
0000640484785 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361333 1#0##0#0#0.0#2022-04-07
08:21:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
30139024710b2845bc140a591f969997 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 20/02/1997 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MEGI ARUM.TN
0000565102956 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361340 1#0##0#0#0.0#2022-04-07
08:23:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b9a226b978cfc2e61d1a27c09da7d8c5 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 30/10/1981 0 2
0 0 - 0 - 0 - 0 - 0 296400 166410
0 1 0 0 0 AURELIA DYAH SURYANI.NY 085571 40 14762
yani;3302226402970001; 5.6.6.202203301209 4 361589
1#0##0#0#0.0#2022-04-07
08:24:04#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c9372bca9832271e444aa7eeb97e931d 150000 0 0 0 0 0
0 0 0 0 15000 0 1410 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 25/05/1940 0 2
0 0 - 0 - 0 - 0 - 0 181400 225865
0 1 0 0 0 SRI SUHARTI., NY 048659 81 29895 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361591
1#0##0#0#0.0#2022-04-07
08:24:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c94831ca05fb4b92e595955ee6ff218f 150000 0 0 0 0 0
0 0 0 0 15000 0 60865 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 30/08/1961 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 RIA TRI RASMANI. NY 089448 60 22128 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361335
1#0##0#0#0.0#2022-04-07
08:25:27#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
73e51cbc56e3a89ac479ba640a329d25 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 31/12/1958 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 SRI SUWANTI, NY 091754 63 23101 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361336
1#0##0#0#0.0#2022-04-07
08:25:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b65e4dcfd22903f08e3cbd572213a0aa 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 28/02/1939 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SLAMET SUDARMO.TN
0000091169436 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361339 1#0##0#0#0.0#2022-04-07
08:26:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
dfdd05b62e6d3b9de7bf886c1927a2aa 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 13/08/1957 0 2
0 - 0 - 0 - 0 - 0 138400 294570
yani;3302226402970001; 5.6.6.202203301209 4 361334
1#0##0#0#0.0#2022-04-07
08:27:05#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
cfeebb0fba518e2b58b07e800adaaf21 270000 0 0 0 0 0
0 0 0 0 15000 0 9570 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 03/08/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ISMURYANI
HANDAYANINGSIH.NY 098932 58 21425 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V005059 0001313177196 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 361338 1#0##0#0#0.0#2022-04-07
08:27:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bcfa5d2ff4a9262946eee8dd40c8efb1 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 30/05/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 249070
0 1 0 0 0 MURSID MUH WINOTO, TN 081013 76 28064
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361592
1#0##0#0#0.0#2022-04-07
08:28:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a3f3483f1b2544afabe54a213c876aa7 150000 0 0 0 0 0
0 0 0 0 15000 0 84070 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 29/03/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 264094
0 1 0 0 0 PETRUS JUVENTUS SUGENG RIYADI.TN 087118
0000639437409 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361594 1#0##0#0#0.0#2022-04-07
08:29:24#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bb663beed2ba063ba6557dba3f1f46f8 150000 0 0 0 0 0
0 0 0 0 15000 0 99094 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 03/10/1985 0 1
0 0 - 0 - 0 - 0 - 0 181400 409351
0 1 0 0 0 BRIAN MHAHENDRATA, TN 100674 36 13328
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361596
1#0##0#0#0.0#2022-04-07
08:29:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
be213402e3c0caca7a691923e01f082a 150000 0 0 0 0 0
0 0 0 0 15000 0 244351 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 02/12/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 418685
0 1 0 0 0 IRIANTI, (NY) 041097 58 21304 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361597
1#0##0#0#0.0#2022-04-07
08:30:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d622d1d5017f4d4c221998e7301b943f 150000 0 0 0 0 0
0 0 0 0 15000 0 253685 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 25/03/1939 0 1
1 Z09.8;J44.9;J06.9;M54.39 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
386785 0 1 0 0 0 ACHMAD KUMAIDI, TN 072054
0002169435374 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361598 1#0##0#0#0.0#2022-04-07
08:32:10#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
844e2bc638bf5c8fda49f9f9e417bce2 150000 0 0 0 0 0
0 0 0 0 15000 0 221785 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 17/02/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 220395
0 1 0 0 0 MARYAMTI.NY 101976 60 21957 DR. ANITA
yani;3302226402970001; 5.6.6.202203301209 4 361599
1#0##0#0#0.0#2022-04-07
08:33:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bef14b1a03be588bf0ea76e3850cacb7 150000 0 0 0 0 0
0 0 0 0 15000 0 55395 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 09/08/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 236800
0 1 0 0 0 ENDANG WARASWATI., NY 047165 56 20688
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361601
1#0##0#0#0.0#2022-04-07
08:34:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
80d0de28651e2255bb7a46921c494eb9 150000 0 0 0 0 0
0 0 0 0 15000 0 71800 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 25/05/1961 0 2
1 Z09.8;J44.9;J06.9;R51 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 405657
0 1 0 0 0 SITI ZAENAB,(NY) 033419 60 22225 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361602
1#0##0#0#0.0#2022-04-07
08:40:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
7730f1a2ee6cee913e73fa1a806bbb6c 150000 0 0 0 0 0
0 0 0 0 15000 0 240657 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 25/06/1955 0 2
1 Z09.8;J45.9;I10;K21.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 430975
0 1 0 0 0 MENIK RAHAYU, NY 043706 66 24386 DR.
yani;3302226402970001; 5.6.6.202203301209 4 360695
1#0##0#0#0.0#2022-04-07
08:41:19#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
be9bee8fda66e85e4062a9c5deffb807 150000 0 0 0 0 0
0 0 0 0 15000 0 265975 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 19/11/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 377879
0 1 0 0 0 SUPARNI.,NY 054364 51 18760 DR. ANITA
yani;3302226402970001; 5.6.6.202203301209 4 361603
1#0##0#0#0.0#2022-04-07
08:41:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
067eb1009f7959716b5e1e63166dc7fa 150000 0 0 0 0 0
0 0 0 0 15000 0 212879 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 15/07/1972 0 2
1 Z09.8;J45.9;N39.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 400691
0 1 0 0 0 SUTARMI, NY 065115 49 18156 DR. ANITA
yani;3302226402970001; 5.6.6.202203301209 4 361604
1#0##0#0#0.0#2022-04-07
08:44:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
0727078877612481a207c06961186b2d 150000 0 0 0 0 0
0 0 0 0 15000 0 235691 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 01/02/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 230502
0 1 0 0 0 SRI HARTONO.TN 086349 52 19051 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361606
1#0##0#0#0.0#2022-04-07
08:45:11#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6676b697aea2a6d23396c70e30ed096f 150000 0 0 0 0 0
0 0 0 0 15000 0 65502 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 12/06/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 374469
0 1 0 0 0 DARMONO, TN 101015 69 25494 DR. ANITA
yani;3302226402970001; 5.6.6.202203301209 4 361608
1#0##0#0#0.0#2022-04-07
08:46:12#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
324f537cdda167cfffd6b1242d7b23d2 150000 0 0 0 0 0
0 0 0 0 15000 0 209469 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 29/12/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 350883
0 1 0 0 0 SARWO EDHIE, TN 092522 56 20546 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361610
1#0##0#0#0.0#2022-04-07
08:47:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
273d9adf7f1bb937eb55a43bdef649d2 150000 0 0 0 0 0
0 0 0 0 15000 0 185883 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 15/05/1997 0 1
0 0 - 0 - 0 - 0 - 0 181400 384425
0 1 0 0 0 KRIS SETYOARI PAMUNGKAS.SDR 101951 24
0000562916283 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361612 1#0##0#0#0.0#2022-04-07
08:48:35#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
49246935cc145dc47f852ef1fc9259fd 150000 0 0 0 0 0
0 0 0 0 15000 0 219425 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 12/08/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 361412
1#0##0#0#0.0#2022-04-07
08:49:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
22a2cdfeb1dd960f93c331599da8c21b 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 22/10/1959 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 361411
1#0##0#0#0.0#2022-04-07
08:50:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a914d89ac14c4b2e4626c27231006401 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 12/12/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 361410
1#0##0#0#0.0#2022-04-07
08:52:42#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
36421bbd54a20ce44d8d8d4faa766834 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 09/05/1975 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0020322V005079 0001105378571 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 361409 1#0##0#0#0.0#2022-04-07
08:53:14#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f7f886290e1db06c5627097adee71257 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 04/08/1948 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 361408
1#0##0#0#0.0#2022-04-07
08:53:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
345ef4599ce6c715638776df9d8b57fe 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 08/04/1964 0 1
0 - 0 - 0 - 0 786200 677676 0 1
yani;3302226402970001; 5.6.6.202203301209 4 361407
1#0##0#0#0.0#2022-04-07
08:54:13#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
b6fcf3e17f3485240f86db92fb9cdaa6 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 15/10/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 361406
1#0##0#0#0.0#2022-04-07
08:54:45#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
8bf96449e20a5e2b428d9eb35c0432d9 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 18/03/1988 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.6.202203301209 4 361413
1#0##0#0#0.0#2022-04-07
08:55:16#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d61301034fb0d095c05a4194845b7173 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 29/10/1992 0 2
0 0 - 0 - 0 - 0 - 0 181400 175048
0 1 0 0 0 OKTAVIANI SELAWATI, (NY) 006420 29
yani;3302226402970001; 5.6.6.202203301209 4 361613
1#0##0#0#0.0#2022-04-07
08:59:32#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
ca042edbf689a01ecc6293416e5086b8 150000 0 0 0 0 0
0 0 0 0 15000 0 10048 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 15/06/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 227646
0 1 0 0 0 SLAMET KUNCORO, TN 067027 60 22204
yani;3302226402970001; 5.6.6.202203301209 4 361614
1#0##0#0#0.0#2022-04-07
09:00:09#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4f2e8bdef3acdfce9dd5bbb717856d56 150000 0 0 0 0 0
0 0 0 0 15000 0 62646 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 29/05/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 201796
0 1 0 0 0 SUDJIATI.NY 099136 65 24047 DR. RINA
5.6.6.202203301209 4 361615 1#0##0#0#0.0#2022-04-07
09:01:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bdbb718e75feb0a21829722aa0ff85cc 150000 0 0 0 0 0
0 0 0 0 15000 0 36796 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 10/06/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 204714
0 1 0 0 0 RIYATUN.NY 098522 48 17826 DR. RINA
5.6.6.202203301209 4 361616 1#0##0#0#0.0#2022-04-07
09:01:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a91853a9fe98ae95d09ce83858ab6da3 150000 0 0 0 0 0
0 0 0 0 15000 0 39714 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 28/09/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 202246
0 1 0 0 0 DYAH WIDYANTI.NY 102317 48 17716 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361617
1#0##0#0#0.0#2022-04-07
09:04:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4451c338a3a027f24ef76b860f628c0c 150000 0 0 0 0 0
0 0 0 0 15000 0 37246 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 21/12/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 195924
yani;3302226402970001; 5.6.6.202203301209 4 361618
1#0##0#0#0.0#2022-04-07
09:05:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
bc78cab65f56db037f06ef573aa8f4b2 150000 0 0 0 0 0
0 0 0 0 15000 0 30924 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 02/06/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 201864
0 1 0 0 0 SRI PARTINI.NY 084088 54 20026 DR.
yani;3302226402970001; 5.6.6.202203301209 4 361619
1#0##0#0#0.0#2022-04-07
09:05:57#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
2f1a3e65291cba0e93a8eab5bf46e0ee 150000 0 0 0 0 0
0 0 0 0 15000 0 36864 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 28/01/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 197959
0 1 0 0 0 ATIEK WIDOWATI HESTRIANI, NY 101167 51
yani;3302226402970001; 5.6.6.202203301209 4 361620
1#0##0#0#0.0#2022-04-07
09:06:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5e98fe5334419fd7bd3e234787c9f36d 150000 0 0 0 0 0
0 0 0 0 15000 0 32959 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 22/04/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 246197
0 1 0 0 0 GUNARSI 079686 61 22623 DR. TEKY
yani;3302226402970001; 5.6.6.202203301209 4 361621
1#0##0#0#0.0#2022-04-07
09:46:23#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9bbd6281d9dcae1256b6922e6dcdea72 150000 0 0 0 0 0
0 0 0 0 15000 0 81197 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 05/08/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 249680
0 1 0 0 0 HARYONO, TN 100493 55 20327 DR. YUDHI
yani;3302226402970001; 5.6.6.202203301209 4 361622
1#0##0#0#0.0#2022-04-07
09:46:55#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
414f98017cc3ea5c513ecba3443855b1 203000 0 0 0 0 0
0 0 0 0 15000 0 31680 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 18/07/2006 0 2
- 0 - 0 - 0 - 0 182600 305578 0
1 0 0 0 ZAHRA PARAMESW.NN 102712 15 5735 DR. YUDHI
reni;3313147010930001; 5.6.6.202203301209 4 361279
1#0##0#0#0.0#2022-04-05
12:11:26#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
47dc8dbce46d2d664e012c07d799e63f 203000 0 0 0 0 0
0 0 0 0 15000 0 87578 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 03/05/2004 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 RIDWAN ALFIANO NUR
HIDAYATULLOH 005209 17 6541 DR. LINDA SUGIARTO, SP.FKR
1124R0020322V005096 0001276682938 3;JKN yani;3302226402970001;
5.6.6.202203301209 4 361354 1#0##0#0#0.0#2022-04-07
09:47:44#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
e558c39319e2e8b25f7a8b50713db830 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 12/08/1958 0 2
1 Z09.8;E11.3;H36.0;Z96.1;H04.1 90.29 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
339061 0 1 0 0 0 RUT SRI SULISNING,NY 075204
0002092337864 3;JKN yani;3302226402970001; 5.6.6.202203301209 4
361623 1#0##0#0#0.0#2022-04-07
09:48:25#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
3b93578e7c2841320e76a97c2e3fc110 203000 0 0 0 0 0
0 0 0 0 15000 0 121061 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 08/12/1957 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
280656 0 1 0 0 0 PANINGSIH,(NY) 005331 64
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361624
1#0##0#0#0.0#2022-04-07
09:51:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
6da6cffb46c97ea2bd7bb2aa597a0e6c 203000 0 0 0 0 0
0 0 0 0 15000 0 62656 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 14/11/1993 0 2
0 0 - 0 - 0 - 0 - 0 181400 357901
0 1 0 0 0 NOVIANA CITRA RATMA, NY 076695 28 10364
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361625
1#0##0#0#0.0#2022-04-07
09:52:00#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
f08b1c8b6e5acc76b223db7efde91b9e 150000 0 0 0 0 0
0 0 0 0 15000 0 192901 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 08/12/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 252490
0 1 0 0 0 SISWO SARJONO,(BP) 028784 72 26411
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361626
1#0##0#0#0.0#2022-04-07
09:52:39#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
5511a331b8806388a414b054140e7bbd 150000 0 0 0 0 0
0 0 0 0 15000 0 87490 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 15/10/1982 0 2
0 0 - 0 - 0 - 0 - 0 181400 263360
3;JKN yani;3302226402970001; 5.6.6.202203301209 4 361627
1#0##0#0#0.0#2022-04-07
09:53:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
4e12359a3f289a1592079bcbb730827b 150000 0 0 0 0 0
0 0 0 0 15000 0 98360 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 27/07/1963 0 1
1 J90;J18.9 - - - None None None None Q-5-38-0 None
None None None None None GANGGUAN PARU AKUT 245800 0 0
- 0 - 0 - 0 - 0 245800 198755 0
1 0 0 0 DJOKO PURWADI.TN 079362 58 21432 DR. ANITA
agung;3313092303950002; 5.6.6.202203301209 4 361628
1#0##0#0#0.0#2022-04-11
13:15:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
9ab6bcbb4bc994f9f385f0a1c177981d 150000 0 0 0 0 0
0 0 0 0 15000 0 33755 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 09/06/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 290656
0 1 0 0 0 DAHONO.TN 102728 65 24036 DR. YUDHI
yani;3302226402970001; 5.6.6.202203301209 4 361629
1#0##0#0#0.0#2022-04-07
09:54:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
907d4ce1d1746fbff3d90f16474fa763 203000 0 0 0 0 0
0 0 0 0 25000 0 62656 0 0 0 0 0
3372030 C 3 CP 2 31/03/2022 31/03/2022 15/03/2022 0 1
1 Z09.8;P59.9 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 191190
0 1 0 0 0 AINUN WAHYU, BY.NY 102486 0 16
0003259978299 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
362015 1#0##0#0#0.0#2022-04-08
13:00:37#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
fce2a56b65c163661df3609f1526f8a2 150000 0 0 0 0 0
0 0 0 0 15000 0 26190 0 0 0 0 0
3372030 C 3 CP 2 08/03/2022 08/03/2022 02/06/1968 0 2
1 Z09.8;I10;M17.9;K30 88.27 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 943347
0 1 0 0 0 SRI WAHYU HARJANTI, (NY) 038487 53
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 362016
1#0##0#0#0.0#2022-04-08
13:03:41#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9724ddbf5e8b60871288f1d062dc01e9 300000 0 0 0 0 0
496000 0 0 0 15000 0 132347 0 0 0 0
0
3372030 C 3 CP 2 15/03/2022 15/03/2022 18/02/1998 0 1
1 R10.4 87.49 - - None None None None Q-5-25-0 None None
0 - 0 - 0 - 0 135700 723244 0 1
0 0 0 WAHYU MUHAMAD PAMUNGKAS, TN 102485 24 8791 DR.
SUROSO 1124R0020322V005117 0000790800759 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 362018 1#0##0#0#0.0#2022-04-08
13:13:15#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
9a129c02a3ac0e21cc9a156319496f6d 0 0 172500 0 0 0
200000 249600 0 0 25000 0 76144 0 0 0 0
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