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 01/12/2021 01/12/2021 09/05/1949 0 1
1 Z09.8;I11.9 - - - 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 TRIYONO TRI DARMA W, TN 064721 72 26504
DR. TEKY WIDYARINI, SP.PD 1124R0021221V000001 0000640697872 3;JKN
agung;3313092303950002; 5.5.5.202112011542 4 342911
1#0##0#0#0.0#2021-12-08
10:30:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
de4d27bb3cf842adeeb418c7cbed9283 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 10/08/1961 0 2
1 Z09.8;K80.2;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 244557
0 1 0 0 0 KASMINAH ., NY 000269 60 22028 DR.
TEKY WIDYARINI, SP.PD 1124R0021221V000002 0001280496317 3;JKN
agung;3313092303950002; 5.5.5.202112011542 4 342914
1#0##0#0#0.0#2021-12-08
10:32:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2d2808fe405b5506ad309e1506de9fc3 150000 0 0 0 0 0
0 0 0 0 15000 0 79557 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 06/08/1962 0 1
1 Z09.8;E04.9 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 214680
0 1 0 0 0 ANTONIUS SRI MULYONO,(BP) 032742 59
21667 DR. TEKY WIDYARINI, SP.PD 1124R0021221V000003 0001032615055
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 342917
1#0##0#0#0.0#2021-12-08
10:36:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dff986a9b2b74603a773c30d6f7ec9b3 150000 0 0 0 0 0
0 0 0 0 15000 0 49680 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 12/03/1963 0 1
1 Z09.8;E11.4;G59.0;I10 - - - 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 357555
0 1 0 0 0 ISMUHADI SUHARMANTO 089220 58 21449
agung;3313092303950002; 5.5.5.202112011542 4 342918
1#0##0#0#0.0#2021-12-08
10:38:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0603d1e6f3f5332e922792ba0e737a36 150000 0 0 0 0 0
0 31845 0 0 15000 0 160710 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 19/04/1956 0 1
1 Z09.8;I10;K30 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 907123
0 1 0 0 0 ERIE ARISTOT MULAT.TN 097789 65 23967
agung;3313092303950002; 5.5.5.202112011542 4 343563
1#0##0#0#0.0#2021-12-09
13:53:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
278d1ce64b0b679163328f0caf66305a 150000 0 0 0 0 0
657000 0 0 0 15000 0 85123 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 24/07/1954 0 1
1 Z09.8;I11.9;H81.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 HARRY.TN 078186 67 24602 DR. TEKY
WIDYARINI, SP.PD 1124R0021221V000006 0000077514581 3;JKN
agung;3313092303950002; 5.5.5.202112011542 4 342920
1#0##0#0#0.0#2021-12-08
10:40:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f5973e0a0bb29eee952589b5ffc412a2 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 20/06/1943 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 HARTINI.NY 079458 78 28654 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 342921
1#0##0#0#0.0#2021-12-08
10:41:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ff595933692f0581960c6e14af6c5cc3 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 12/04/1968 0 2
1 Z09.8;E11.4;G59.0;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 544510
0 1 0 0 0 SITI ASKHURIYAH, NY 086692 53 19591
agung;3313092303950002; 5.5.5.202112011542 4 342922
1#0##0#0#0.0#2021-12-08
10:42:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2fbb306df318da437ad30bf352aa4a03 150000 0 0 0 0 0
0 107890 0 0 15000 0 271620 0 0 0 0
0
3372030 C 3 CP 2 01/12/2021 01/12/2021 27/06/1986 0 1
1 Z09.8;K21.9 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 180505
0 1 0 0 0 NATO NATIANTO, TN 099852 35 12941 DR.
agung;3313092303950002; 5.5.5.202112011542 4 342927
1#0##0#0#0.0#2021-12-08
10:47:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ae5dc5f446ed15a5f3601c2bc14e5753 150000 0 0 0 0 0
0 0 0 0 15000 0 15505 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 07/01/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SARIDJO ISWANTO (BP) 025604 79 29183
agung;3313092303950002; 5.5.5.202112011542 4 342928
1#0##0#0#0.0#2021-12-08
10:49:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5ca5ff99b57ad1c9e0559f70dea5873f 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 23/08/1947 0 2
1 Z09.8;I11.9;E78.5 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 259580
0 1 0 0 0 HJ.RAHAYU SUTINI,(NY) 021403 74 27129
agung;3313092303950002; 5.5.5.202112011542 4 342929
1#0##0#0#0.0#2021-12-08
10:50:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bb5ed699179cdae2202cce202309d740 150000 0 0 0 0 0
0 44200 0 0 15000 0 50380 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 01/12/1952 0 2
1 Z09.8;E11.9;I11.9;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 211663
0 1 0 0 0 SAMIYATI,(NY) 035364 68 25202 DR.
agung;3313092303950002; 5.5.5.202112011542 4 342947
1#0##0#0#0.0#2021-12-08
11:17:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
02a66191cf7a3d7b4008df753581a8bb 150000 0 0 0 0 0
0 0 0 0 15000 0 46663 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 31/12/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 339595
0 1 0 0 0 MARYAMAH.NY 098235 71 26268 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 342948
1#0##0#0#0.0#2021-12-08
11:20:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
be8f3df683ab990dd6dc7b8badf98e15 150000 0 0 0 0 0
0 120795 0 0 15000 0 53800 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 29/05/1950 0 1
1 Z09.8;I10;M54.59 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 298076
0 1 0 0 0 WOERJATNO.TN 099442 71 26119 DR.
agung;3313092303950002; 5.5.5.202112011542 4 342949
1#0##0#0#0.0#2021-12-08
11:23:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c7e5e8efa3f3e2cbcdb72f4789b01cd4 150000 0 0 0 0 0
0 108440 0 0 15000 0 24636 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 12/09/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 431856
0 1 0 0 0 ISKANDAR BUDI RAHARJO,BP 088368 53
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 342950
1#0##0#0#0.0#2021-12-08
11:26:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d9bc027444054ee33d07b141ecc3615e 150000 0 0 0 0 0
0 31845 0 0 15000 0 235011 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 21/08/1957 0 2
1 Z09.8;E11.4;G59.0;I10;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
499765 0 1 0 0 0 SRI MUNAWARTI, (NY) 002036
64 23478 DR. TEKY WIDYARINI, SP.PD 1124R0021221V000017
0000088711749 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
342953 1#0##0#0#0.0#2021-12-08
11:27:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
714b99b0dbc92150795a60b9f95eea8d 300000 0 0 0 0 0
0 76045 0 0 15000 0 108720 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 08/06/1950 0 2
1 Z09.8;E11.4;G59.0;I11.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 275880
0 1 0 0 0 LAMIYEM.NY 087484 71 26109 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 342955
1#0##0#0#0.0#2022-04-14
13:21:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 5
55cb739c491d42414e2d9d8eb469f7d7 150000 0 0 0 0 0
0 0 0 0 15000 0 110880 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 13/03/1963 0 2
1 Z09.8;I10;J06.9;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 200291
0 1 0 0 0 SRI LESTARI.NY 093144 58 21448 DR.
yani;3302226402970001; 5.6.0.202201041418 4 348106
1#0##0#0#0.0#2022-01-07
19:19:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ecdeab0a9ebac0d714d37582b31b7085 150000 0 0 0 0 0
0 0 0 0 15000 0 35291 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 23/12/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 589357
0 1 0 0 0 RIYANI.NY 080489 41 15319 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 342959
1#0##0#0#0.0#2021-12-08
11:32:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0ed2e053c21b429ced3d7012c5ecf7e0 150000 0 0 0 0 0
0 76045 0 0 15000 0 348312 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 23/03/1959 0 2
1 Z09.8;I12.0;K21.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 352778
0 1 0 0 0 SUMARNI, NY 074054 62 22899 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 342970
1#0##0#0#0.0#2021-12-08
11:47:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
757241d4cdc76d9920ace7e6c2e88aa3 150000 0 0 0 0 0
0 134250 0 0 15000 0 53528 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 14/09/1959 0 1
1 Z09.8;E11.4;G59.0;M19.98 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
334317 0 1 0 0 0 MARINO ., BP 055616 62
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 342971
1#0##0#0#0.0#2021-12-08
11:59:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
83ef988c5eec53bb5dcbd4548dae6465 150000 0 0 0 0 0
0 31845 0 0 15000 0 137472 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 12/07/1966 0 1
1 Z09.8;I11.0;R51 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 215200
0 1 0 0 0 SLAMET SANTOSO, BP 082095 55 20231
agung;3313092303950002; 5.5.5.202112011542 4 342972
1#0##0#0#0.0#2021-12-08
12:00:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5a71d962641046e25efcb444ba883c7d 150000 0 0 0 0 0
0 0 0 0 15000 0 50200 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 01/09/1986 0 2
0 0 - 0 - 0 - 0 - 0 181400 343217
0 1 0 0 0 Anis Dwi Hastuti 28206 35 12875 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 342973
1#0##0#0#0.0#2021-12-08
12:01:20#0#00:00:00#00:00:00#14:07:43#{"co_insidense_ind":"0"} 1
5bafe878de2a3f0a02531e7e3af12f86 150000 0 0 0 0 0
0 31845 0 0 15000 0 146372 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 17/03/1962 0 2
1 Z09.8;E14.4;G59.0;I10;K30 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
278881 0 1 0 0 0 Ny. Muharsih 21793 59 21809
agung;3313092303950002; 5.5.5.202112011542 4 342974
1#0##0#0#0.0#2021-12-08
12:03:07#0#00:00:00#00:00:00#13:34:39#{"co_insidense_ind":"0"} 1
e6d609cdf6ecee9c5ecb77650c07b9b0 150000 0 0 0 0 0
0 31845 0 0 15000 0 82036 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 26/05/1960 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
480247 0 1 0 0 0 JUMADI ABDUL WAHAD.TN 094212
0000088558648 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
342975 1#0##0#0#0.0#2022-04-14
13:33:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
80f26a6263ba852fe59aef407f1c2a08 150000 0 0 0 0 0
0 76045 0 0 15000 0 239202 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 08/12/1960 0 2
1 Z09.8;E11.4;G59.0;I11.9 88.24 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 412405
0 1 0 0 0 SARNI. NY 091223 60 22273 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 342976
1#0##0#0#0.0#2021-12-08
12:49:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fe78296f2386e81e181face74d26583c 150000 0 0 0 0 0
0 76595 0 0 15000 0 170810 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 07/05/1953 0 1
1 Z09.8;G59.0;I11.9;E11.4 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 309125
0 1 0 0 0 SUWARSONO.TN 084554 68 25045 DR.
agung;3313092303950002; 5.5.5.202112011542 4 342977
1#0##0#0#0.0#2021-12-08
12:52:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
24dcae1855b9d2565e4d02032e0cb1c1 150000 0 0 0 0 0
0 76595 0 0 15000 0 67530 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 20/08/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 AINUN DJARIYAH, NY 069314 66 24210
agung;3313092303950002; 5.5.5.202112011542 4 342979
1#0##0#0#0.0#2021-12-08
12:54:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e69ca6def7a1987e2f661cb2f89b89e0 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 24/06/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SITI ARBAIYAH, NY 073903 68 24997 DR.
agung;3313092303950002; 5.5.5.202112011542 4 342980
1#0##0#0#0.0#2021-12-08
12:55:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
26c2b55641cb5484ab365c04801d913a 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 09/04/1964 0 2
1 Z09.8;E11.4;I10;G59.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 AFIDA SUSILOWATI.NY 084451 57 21055
agung;3313092303950002; 5.6.6.202203301209 4 342981
1#0##0#0#0.0#2022-04-14
13:12:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
8e1198ff6fcd5b66716000617ca8cfdd 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 02/05/1994 0 1
1 Z09.8;K30 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 RIZA ADHI GUNTORO.SDR 098252 27 10075
agung;3313092303950002; 5.5.5.202112011542 4 342983
1#0##0#0#0.0#2021-12-08
12:59:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
881a32b196e507a1106555c3bd536acc 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 25/04/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 332155
0 1 0 0 0 NURUL FITRIANI 16314 62 22866 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 342985
1#0##0#0#0.0#2021-12-08
13:00:14#0#00:00:00#00:00:00#12:52:59#{"co_insidense_ind":"0"} 1
2912b68ae3e82b0ba0b466d000dbad40 150000 0 0 0 0 0
0 76045 0 0 15000 0 91110 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 20/12/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 353415
0 1 0 0 0 WIJAYADI,(BP) 027804 58 21531 DR.
agung;3313092303950002; 5.5.5.202112011542 4 343012
1#0##0#0#0.0#2021-12-08
14:34:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
9df37e25fa7a4e2e7e0efe586d40628e 150000 0 0 0 0 0
0 88950 0 0 15000 0 99465 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 18/01/1966 0 2
1 Z09.8;M79.66 93.39;93.35 - - 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 273000 0 1 0 0 0 IVO MUMPUNI
WIJAYANINGRUM, NY 095874 55 20406 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000038 0002169780873 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343195 1#0##0#0#0.0#2021-12-08
14:36:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
000a75c39e0ecde11d4eea6eabb0f50e 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 31/12/1952 0 2
1 Z09.8;M17.9 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 273000 0 1 0 0 0 NGATIYEM 67636
68 25172 DR. LINDA SUGIARTO, SP.FKR 1124R0021221V000039
0000640358291 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
343104 1#0##0#0#0.0#2021-12-08
14:03:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e82b25baabb6afc55fbc854fd2871c1d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 02/09/1980 0 2
1 Z09.8;G90.0 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 Ny. Fitriyana
Handayani 3924 41 15065 DR. LINDA SUGIARTO, SP.FKR 1124R0021221V000041
0001107034119 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
343107 1#0##0#0#0.0#2021-12-08
14:06:17#0#00:00:00#00:00:00#11:44:50#{"co_insidense_ind":"0"} 1
d36c1705ab8833a257da63616a1cd3e6 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 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 agung;3313092303950002; 5.5.5.202112011542 4
343112 1#0##0#0#0.0#2021-12-08
14:09:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6d7c6bc1d3125acd2af89c56249c8c44 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 01/04/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI HARYANI.NY
082725 69 25446 DR. LINDA SUGIARTO, SP.FKR 1124R0021221V000043
0000091327274 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
343117 1#0##0#0#0.0#2022-04-14
13:03:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
a564098fa653454fe09b1c1fdac244c4 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 11/10/1960 0 2
1 Z09.8;M54.59;M19.99 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 273000 0 1 0 0 0
ZULAIKAH, NY 007872 61 22331 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000044 0001106028551 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343120 1#0##0#0#0.0#2021-12-08
14:12:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
60a541bb13d45525b79ca8596f185d14 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 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; 5.5.5.202112011542 4
343121 1#0##0#0#0.0#2021-12-08
14:13:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5882b7a11f8a47a139e64b194cbdb880 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 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 21642 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000046 0001958592576 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343123 1#0##0#0#0.0#2021-12-08
14:14:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7fe3ce694461f42d7c5ac73000865b98 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 13/03/1953 0 1
0 - 0 107400 273000 0 1 0 0 0
SUHARI, TN 070582 68 25100 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000047 0001021699394 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343125 1#0##0#0#0.0#2021-12-08
14:15:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5d571a4c4a0ac42f033428299db8fa57 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 26/06/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 509000 0 1 0 0 0 MARKAMAH,NY 085323
0001102473909 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
342906 1#0##0#0#0.0#2021-12-08
10:15:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b87f3b51100236868b2a9c2d353d29ca 494000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 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 agung;3313092303950002; 5.5.5.202112011542 4
343164 1#0##0#0#0.0#2021-12-08
14:38:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 3
2e675e371b4ceb0fa7fcbf04f24e3993 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 23/09/2003 0 1
1 I88.9 - - - 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 DIMAS ADI KUSUMA.SDR 095394 18 6644
DR. DAMAR ARYO, SP.B 1124R0021221V000051 0001315687421 3;JKN
agung;3313092303950002; 5.5.5.202112011542 4 343200
1#0##0#0#0.0#2021-12-08
14:41:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5902e64108bbd66d768cdb58d81dc39c 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 23/12/1997 0 1
1 Z09.0;D21.5 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 315000 0 1
0 0 0 ANDIKA MUCHLIS WIBOWO, SDR 099473 23 8744 DR.
DAMAR ARYO, SP.B 1124R0021221V000052 0000638281912 3;JKN
agung;3313092303950002; 5.5.5.202112011542 4 343202
1#0##0#0#0.0#2021-12-08
14:47:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
05b6193a45bbe8e746df1fcbd131b05d 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 10/10/1957 0 1
1 Z09.8;N45.9 88.75 - - 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 876860
0 1 0 0 0 SULUT, TN 082030 64 23428 DR. ARIA
CHANDRA GTS, SP.S., M.KES 1124R0021221V000053 0000640434914 3;JKN
agung;3313092303950002; 5.5.5.202112011542 4 343203
1#0##0#0#0.0#2021-12-08
14:49:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c17b3c43924d26b8ec6b8d55d669f8c3 150000 0 0 0 0 0
680000 0 0 0 15000 0 31860 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 29/11/1974 0 2
1 Z09.8;E11.5 96.59 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 495350 0 1
0 0 0 MUJININGSIH.NY 099328 47 17169 DR. DAMAR ARYO,
SP.B 1124R0021221V000054 0000640529392 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343206 1#0##0#0#0.0#2021-12-08
14:55:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f2315862068ec5cc0f8ae1b1eea0ce80 440000 0 0 0 0 0
0 0 0 0 15000 0 40350 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 19/05/1972 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 612630 0 1
0 0 0 YUDOWONO, TN 089522 49 18093 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 343265
1#0##0#0#0.0#2021-12-09
08:53:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
135ffae14c12c542be1b2d9851ce4161 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 15/10/1964 0 1
0 - 0 - 0 - 0 786200 717530 0 1
0 0 0 SLAMET WIDODO, TN 088539 57 20866 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 343208
1#0##0#0#0.0#2021-12-08
14:57:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3bce019d7d83f2e738eb01d4c5acba6d 463830 0 0 0 0 0
0 238700 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 21/09/1944 0 1
1 Z09.8;K76.8;K30 88.76 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400 822000
0 1 0 0 0 BASUKI HARJO DARSONO, TN 069759 77
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 343564
1#0##0#0#0.0#2021-12-09
13:52:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a16d369596004a9c8f4c46c32a699620 150000 0 0 0 0 0
657000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 14/03/1977 0 1
0 - 0 - 0 - 0 786200 811476 0 1
0 0 0 SOEHARTANTO.TN 083920 44 16333 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 343211
1#0##0#0#0.0#2021-12-08
14:59:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
56c990961a2b18e9bc25b2a735922bf6 662676 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 01/03/1995 0 1
0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 MUHAMMAD JOKO PURNOMO 100389 26 9772
agung;3313092303950002; 5.5.5.202112011542 4 343214
1#0##0#0#0.0#2021-12-08
15:02:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2a8ea936738b7ae2ea182eb7b42099c4 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 10/04/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 195102
0 1 0 0 0 SRI RAHAYU.NY 084543 60 22150 DR.
INDRIANY WIDHOWATY, SP.S, SP.AK 1124R0021221V000060 0001452232697 3;JKN
agung;3313092303950002; 5.5.5.202112011542 4 343216
1#0##0#0#0.0#2021-12-08
15:03:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0e2a243f95daaf41de781d1948dddcbc 150000 0 0 0 0 0
0 0 0 0 15000 0 30102 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 27/08/1971 0 2
1 Z09.8;G40.3;M65.38 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 RIRIN INDRIANA .NY 033295 50 18359
DR. INDRIANY WIDHOWATY, SP.S, SP.AK 1124R0021221V000061 0001322711436
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 343222
1#0##0#0#0.0#2021-12-08
15:11:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a54a92743919027585ff91f04b2beb28 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 02/02/1972 0 2
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 MUSIYEM.NY 084045 49 18200 DR. TEKY WIDYARINI,
SP.PD 1124R0021221V000062 0002070978546 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343227 1#0##0#0#0.0#2021-12-09
08:11:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
02c77a28f936f6eb906f833946f6aef0 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 25/05/1986 0 1
1 Z09.8;M54.59;R51 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 214863
0 1 0 0 0 ROBBY HANDOKO.TN 099235 35 12974 DR.
agung;3313092303950002; 5.5.5.202112011542 4 343235
1#0##0#0#0.0#2021-12-09
08:23:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
193b3a73dd53b7e16e5b3ae46d0634c8 150000 0 0 0 0 0
0 0 0 0 15000 0 49863 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 22/02/1971 0 2
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 WIWIK SETYOWATI, NY 092361 50 18545 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 343236
1#0##0#0#0.0#2021-12-09
08:24:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ac897909416dda47c30031bd4e92acf3 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 31/12/1981 0 2
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 SULASTRI, NY 067303 39 14580 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 343240
1#0##0#0#0.0#2021-12-09
08:29:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cc02b37afb3c916d00013e3921277c89 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 18/07/1964 0 1
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 SUNARNO, BP 062099 57 20955 DR. TEKY WIDYARINI,
SP.PD 1124R0021221V000067 0002425018184 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343256 1#0##0#0#0.0#2021-12-09
08:48:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fe2f2aba9f8baa497f9b0550a7ba9cfc 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 09/09/1944 0 1
0 - 0 - 0 - 0 786200 811476 0 1
0 0 0 HARWOKO, TN 063244 77 28207 DR. TEKY WIDYARINI,
SP.PD 1124R0021221V000068 0000100867893 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343258 1#0##0#0#0.0#2021-12-09
08:49:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
080ae47b40ce53672d2168e12662f31a 662676 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 03/12/1950 0 1
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 WARSO DIHARJO, BP 050194 70 25931 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 343260
1#0##0#0#0.0#2021-12-09
08:51:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
da2490b97a0efbf5b7c5833c1b3f34ba 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 04/08/1983 0 2
1 M54.39 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 185625
0 1 0 0 0 WINDASARI DEWI ANGGRAINI 100385 38
13999 DR. INDRIANY WIDHOWATY, SP.S, SP.AK 1124R0021221V000070
0002499949449 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
343267 1#0##0#0#0.0#2021-12-09
08:56:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0a812d18810677ddebd92d33bd91cb08 150000 0 0 0 0 0
0 0 0 0 15000 0 20625 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 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 188848
0 1 0 0 0 ACHMAD SUPARDI., TN 061983 70 25898
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 343272
1#0##0#0#0.0#2021-12-09
09:02:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
95aa523f7636063f48edaf38eaf14972 150000 0 0 0 0 0
0 0 0 0 15000 0 23848 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 08/06/2007 0 1
1 Z09.8;K04.1 23.70 - - 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 315000 0
1 0 0 0 AHMAD NADJIB KAYSAN.SDR 099797 14 5290 DRG.
VERAWATY, SP.KG 1124R0021221V000072 0000091542363 3;JKN
agung;3313092303950002; 5.5.5.202112011542 4 343266
1#0##0#0#0.0#2021-12-09
08:54:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
95ec801a862d873cea2ae944abf60842 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 19/09/1969 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SARI TJIPTATI.NY 099801 52 19066 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 343275
1#0##0#0#0.0#2021-12-09
09:03:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
42b73ed3fea19e88ae74072204fe46a1 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 11/07/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 205545
0 1 0 0 0 BAMBANG PRAYITNO, TN 099183 50 18406
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 343277
1#0##0#0#0.0#2021-12-09
09:05:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
964b6b5c62d42f364b0457e7ef66e6b0 150000 0 0 0 0 0
0 0 0 0 15000 0 40545 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 20/03/1961 0 1
1 K04.1 23.70 - - 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 315000 0 1
0 0 0 SLAMET RIYADI.TN 091975 60 22171 DRG. VERAWATY,
SP.KG 1124R0021221V000075 0001303435192 3;JKN novia;3313125201940001;
5.6.3.202201201500 4 343283 1#0##0#0#0.0#2022-02-15
10:28:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
41a42488f37b0ceb5cba286fc516b675 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 25/11/1963 0 1
0 - 0 - 0 - 0 283800 316860 0 1
0 0 0 Bp. Priyono 891 58 21191 DRG. VERAWATY, SP.KG
1124R0021221V000076 0001104198974 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343297 1#0##0#0#0.0#2021-12-09
09:42:06#0#00:00:00#00:00:00#13:20:57#{"co_insidense_ind":"0"} 1
52bceea231c5b3ccf2d2e606d5f3ba3b 300000 0 0 0 0 0
0 0 0 0 15000 0 1860 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 10/06/1972 0 2
1 Z09.8;M54.59;G56.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 179430
0 1 0 0 0 SRI RAHAYU.NY 094636 49 18071 DR.
agung;3313092303950002; 5.5.5.202112011542 4 343298
1#0##0#0#0.0#2021-12-09
09:43:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cd3bd805a8a7c365f7e9e48dc35d9a5c 150000 0 0 0 0 0
0 0 0 0 15000 0 14430 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 29/05/2001 0 2
0 - 0 - 0 - 0 283800 615000 0 1
0 0 0 NIKMAH RIZKYANA NURUL HANIFAH 100384 20 7491 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 343299
1#0##0#0#0.0#2021-12-09
09:43:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
695dc09e39157bb05de686a28200dbba 600000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 26/11/1966 0 1
0 - 0 - 0 - 0 283800 615000 0 1
0 0 0 Bp. Sularsa 39930 55 20094 DRG. VERAWATY, SP.KG
1124R0021221V000080 0001530454871 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343300 1#0##0#0#0.0#2021-12-09
09:44:42#0#00:00:00#00:00:00#13:56:39#{"co_insidense_ind":"0"} 1
ef97360608407095760a72439c1b9ec6 600000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 08/11/1975 0 2
1 Z09.8;M65.38 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 179328 0 1 0 0 0 SRI MARWATI, NY
000458 46 16825 DR. INDRIANY WIDHOWATY, SP.S, SP.AK
1124R0021221V000081 0001108123402 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343313 1#0##0#0#0.0#2021-12-09
09:57:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
486c8c823e4e9ad39901d817b60acd60 150000 0 0 0 0 0
0 0 0 0 15000 0 14328 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 17/06/2015 0 1
1 Z09.8;J35.0 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 178045
0 1 0 0 0 RASYASEL NINO ARROYEN.AN 098101 6
2359 DR. SUDARMAN, SP.THT-BKL(K) 1124R0021221V000082 0002981801711
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 343330
1#0##0#0#0.0#2021-12-09
10:08:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a863d7ed2d7c6a8724118df88eb93575 150000 0 0 0 0 0
0 0 0 0 15000 0 13045 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 23/12/1979 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SULASTRI.NY 100001 41 15319 DRG. VERAWATY,
SP.KG 1124R0021221V000083 0001133846302 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343333 1#0##0#0#0.0#2021-12-09
10:10:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eda8187a9fdee249e1504fec866d3a03 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 09/11/1971 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SUHASTI,(NY) 038243 50 18285 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 343336
1#0##0#0#0.0#2021-12-09
10:13:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e139ef5dc10dce8ef097ae89cf1dd081 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 29/09/1961 0 1
1 Z09.8;E11.4;G59.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 180535
0 1 0 0 0 HUSMARYANTO .BP 036573 60 21978 DR.
novia;3313125201940001; 5.6.3.202201201500 4 343341
1#0##0#0#0.0#2022-02-14
14:40:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
b0beba5001327d2f0d3a3d565812b1f5 150000 0 0 0 0 0
0 0 0 0 15000 0 15535 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 31/01/1972 0 2
1 Z09.8;I84.9 93.57 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 165000 0 1
0 0 0 SARYANTI, NY 099526 49 18202 DR. HERMAWAN, Sp.B
M.Kes 1124R0021221V000087 0000639936887 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343345 1#0##0#0#0.0#2021-12-09
10:22:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
409b78b455f8f43f31effd9cdb01f29f 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 18/05/1974 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RETNO KUSWANDARI.NY 099753 47 17364 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 343348
1#0##0#0#0.0#2021-12-09
10:31:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d0a0ecafdf3e88a2835d17513060bc0c 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 16/10/1957 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SURYANTO 71276 64 23422 DRG. VERAWATY, SP.KG
1124R0021221V000089 0001303374947 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343351 1#0##0#0#0.0#2021-12-09
10:33:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
219cef54ade7e7c22be9d0e1c98dee6a 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 01/01/2000 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SUDIRMAN LAMSI., BP 041571 21 8005 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 343353
1#0##0#0#0.0#2021-12-09
10:34:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
75a9c5925b34b3266dcfd9031f133d31 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 20/05/2006 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MUH ABU BAKAR ASSIDIQ A, AN 082585 15 5674
DRG. VERAWATY, SP.KG 1124R0021221V000092 0000166532949 3;JKN
agung;3313092303950002; 5.5.5.202112011542 4 343356
1#0##0#0#0.0#2021-12-09
10:37:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c1e8adf8e296b0738ab73ae8e8458b25 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 06/11/1975 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 DWI RUSMIYANI.NY 099793 46 16827 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 343357
1#0##0#0#0.0#2021-12-09
10:38:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
13dd32563be0f7156b9fcf5101a57d40 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 21/06/1958 0 1
1 Z09.0;M66.55 93.57;87.89 - - 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 SARJA, TN 081824 63 23174 DR.
HERMAWAN, Sp.B M.Kes 1124R0021221V000095 0002165955614 3;JKN
agung;3313092303950002; 5.5.5.202112011542 4 343358
1#0##0#0#0.0#2021-12-09
10:39:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c5e8eaf0e17e0ae7bc0410455a3302ce 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 17/11/1986 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 NENI KRISTIANA.NY 099794 35 12798 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 343359
1#0##0#0#0.0#2021-12-09
10:40:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ff774c6d3aba5c8b9c1b54f86ff1d0a5 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 09/09/1996 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MALIK ABDUL AZIZ.SDR 099631 25 9214 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 343363
1#0##0#0#0.0#2021-12-09
10:45:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f08d9d12bac66e8756d47bde536dc8c2 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 12/12/1947 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 640820
0 1 0 0 0 SITI CHOSIYAH., NY 045191 73 27018
DR. YUDHI DORANDES, SP.M 1124R0021221V000098 0001614177303 3;JKN
agung;3313092303950002; 5.5.5.202112011542 4 343365
1#0##0#0#0.0#2021-12-09
10:46:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bdd7b0ae51ffe8ea5b4a47e89d888ae4 596000 0 0 0 0 0
0 0 0 0 15000 0 29820 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 10/06/1971 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 NILAM SRI RAHAYU 56143 50 18437 DRG. VERAWATY,
SP.KG 1124R0021221V000099 0002046701362 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343368 1#0##0#0#0.0#2021-12-09
10:47:39#0#00:00:00#00:00:00#12:00:00#{"co_insidense_ind":"0"} 1
8c00a326b4cd9e4f52c5f42786b81930 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 06/06/1955 0 2
1 Z09.8;H26.9;Z96.1;E11.3;H36.0;H04.1 90.29;16.21 - - None None
None None H-3-12-0 None None None None None None PROSEDUR LAIN-LAIN
PADA MATA 211200 0 0 - 0 - 0 - 0 - 0
211200 278795 0 1 0 0 0 SARWIJI.NY 095370
66 24285 DR. YUDHI DORANDES, SP.M 1124R0021221V000100
0001084322902 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
343369 1#0##0#0#0.0#2021-12-09
10:48:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f00d055eaffb1ecb8a757e9c92743467 203000 0 0 0 0 0
0 0 0 0 15000 0 60795 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 08/05/1978 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SUNDARIYATI 52271 43 15913 DRG. VERAWATY, SP.KG
1124R0021221V000101 0001104291303 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343372 1#0##0#0#0.0#2021-12-09
10:50:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
07ddb6b29a3121c68aeed3cfc83e49ea 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 08/09/1948 0 2
1 Z09.8;H36.0;E11.3;H26.9;H35.6;H04.1 90.29 - - 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 288865 0 1 0 0 0 SUNARMI, NY 073823
0000089874999 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
343374 1#0##0#0#0.0#2021-12-09
10:52:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d1eeb6053843a25d290eb9359dade14e 203000 0 0 0 0 0
0 0 0 0 15000 0 70865 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 30/01/1964 0 2
1 H00.0;E11.3;H36.0;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 228088
0 1 0 0 0 DRA. DIYAH ANITA LISTYANINGTYAS, NY 060086
0002056352084 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
343384 1#0##0#0#0.0#2021-12-09
11:01:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
268cc2f8119295538966db4281bc6f7a 203000 0 0 0 0 0
0 0 0 0 15000 0 10088 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 06/01/1953 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
248975 0 1 0 0 0 SRI SUTARNINGSIH.NY 086730
0000091143911 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
343385 1#0##0#0#0.0#2021-12-09
11:03:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
44e29949912d690d863cacd51dc8fe8b 203000 0 0 0 0 0
0 0 0 0 15000 0 30975 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 13/12/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 518884
0 1 0 0 0 FATIMAH ., NY 059599 69 25556 DR.
agung;3313092303950002; 5.5.5.202112011542 4 343388
1#0##0#0#0.0#2021-12-09
11:05:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1919db25ee4f950411300fb076483adc 150000 0 0 0 0 0
0 31845 0 0 15000 0 322039 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 29/02/1972 0 2
1 E11.3;H36.0;H10.4;H04.1;H26.9 90.29 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
290020 0 1 0 0 0 SRI UTAMI.NY 095373 49
18173 DR. YUDHI DORANDES, SP.M 1124R0021221V000107 0002345975019
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 343390
1#0##0#0#0.0#2021-12-09
11:06:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a7a46f789969cde83986407429955906 203000 0 0 0 0 0
0 0 0 0 15000 0 72020 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 21/03/2007 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 An. Mernadin Prischalita Pandanwangi 35990 14
5369 DRG. VERAWATY, SP.KG 1124R0021221V000108 0001107087028 3;JKN
agung;3313092303950002; 5.5.5.202112011542 4 343391
1#0##0#0#0.0#2021-12-09
11:07:38#0#00:00:00#00:00:00#10:46:30#{"co_insidense_ind":"0"} 1
496bc3725fef7f2e54c000c3f6cf1cd3 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 19/01/1999 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 NATASHA RISQA SAFITRI 100331 22 8352 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 343394
1#0##0#0#0.0#2021-12-09
11:08:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
99f68982ce419f1a1058cde6aad0b7c4 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 14/02/1960 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 274435 0 1
0 0 0 BAMBANG SARTONO 100390 61 22571 DR. INDRIANY
WIDHOWATY, SP.S, SP.AK 1124R0021221V000110 0001084300762 3;JKN
agung;3313092303950002; 5.5.5.202112011542 4 343398
1#0##0#0#0.0#2021-12-09
11:10:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d2cd7a1161455522fda877b41836e082 150000 0 0 0 0 0
0 0 0 0 25000 0 99435 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 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; 5.5.5.202112011542 4
343401 1#0##0#0#0.0#2021-12-09
11:12:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4836fba9c7034e316d906178c83c30c5 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 26/09/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 NUR HARYANTI, NY
0002611312075 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
343405 1#0##0#0#0.0#2021-12-09
11:14:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0b0bab3969e3342d5f581725ec4785f2 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 25/02/1995 0 2
0 - 0 - 0 - 0 - 0 549400 207240
0 1 0 0 0 HANINDYA FEBRI QADARIKA, NY 088018 26
9776 DR. DEWI ANGGOROWATI, SP.OG 1124R0021221V000114 0000095593498
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 343408
1#0##0#0#0.0#2021-12-09
11:15:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6346ff3f5980a5dc52263b611d86dee9 150000 0 0 0 0 0
0 0 0 0 15000 0 42240 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 07/01/1979 0 1
1 H93.1 - - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 181050
0 1 0 0 0 NURINTA BAKTI YUDHA, TN 002367 42 15669
DR. SUDARMAN, SP.THT-BKL(K) 1124R0021221V000115 0002034483873 3;JKN
agung;3313092303950002; 5.5.5.202112011542 4 343412
1#0##0#0#0.0#2021-12-09
11:17:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5c902698d4ca8b746f6e9fee6e3b6799 150000 0 0 0 0 0
0 0 0 0 15000 0 16050 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 05/08/1969 0 2
1 Z09.8;I11.9;M75.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 216654
0 1 0 0 0 SUKARYANI, (NY) 003181 52 19111 DR.
agung;3313092303950002; 5.5.5.202112011542 4 343451
1#0##0#0#0.0#2021-12-09
12:18:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7ee57d5b7a5711fdff716fb166681fab 150000 0 0 0 0 0
0 0 0 0 15000 0 51654 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 07/04/2001 0 2
1 H61.2 96.52 - - None None None None U-3-15-0 None None
None None None None PROSEDUR LAIN-LAIN PADA TELINGA, HIDUNG, MULUT DAN
TENGGOROKAN 251000 0 0 - 0 - 0 - 0 - 0
251000 296770 0 1 0 0 0 DILLA SAGITA RAHMALIA
100396 20 7543 DR. SUDARMAN, SP.THT-BKL(K) 1124R0021221V000117
0001693028665 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
343452 1#0##0#0#0.0#2021-12-09
12:19:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
94aee10df285f562c6ab9e02220ff995 150000 0 0 0 0 0
0 0 0 0 25000 0 121770 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 30/11/1977 0 2
1 Z09.8;R51;R30.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 224509
0 1 0 0 0 BEKTI ENDARWATI.NY 099208 44 16072
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 343453
1#0##0#0#0.0#2021-12-09
12:41:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3dce101e9de1c2e92f0e64d66ad70057 150000 0 0 0 0 0
0 0 0 0 15000 0 59509 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 06/11/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 319321
0 1 0 0 0 SRI HANDIKIN, (NY) 014579 79 28880
agung;3313092303950002; 5.6.6.202203301209 4 343454
1#0##0#0#0.0#2022-04-14
11:42:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
2e8efa9bc61af59ad3e8b68fffbaa823 0 0 138000 0 0 0
0 0 0 0 15000 0 166321 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 24/08/1949 0 1
1 Z09.8;H16.2;H26.9;E11.3;H36.0;H04.1 90.29 - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 300020 0 1 0 0 0 SUGENG PRIJADI 100399
0000088856752 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
343455 1#0##0#0#0.0#2021-12-09
12:43:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7a1380e30a80485ca47a0afa6f220b8e 203000 0 0 0 0 0
0 0 0 0 25000 0 72020 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 07/01/1955 0 1
1 E79.0 - - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 246112
0 1 0 0 0 DALIYO,(BP) 003111 66 24435 DR. SUROSO
1124R0021221V000122 0000202283133 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346612 1#0##0#0#0.0#2022-01-04
13:09:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
81c18d35a5c574b109569e18aaba3848 170000 0 0 0 0 0
0 0 0 0 15000 0 61112 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 31/01/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 248975
0 1 0 0 0 DEWI MURTYANINGSIH 74565 67 24776 DR.
YUDHI DORANDES, SP.M 1124R0021221V000123 0000088848494 3;JKN
agung;3313092303950002; 5.5.5.202112011542 4 343456
1#0##0#0#0.0#2021-12-09
12:44:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
060687462abd83814aedd947ace3f8bd 203000 0 0 0 0 0
0 0 0 0 15000 0 30975 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 15/07/1964 0 2
1 Z09.8;I10;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 174251
0 1 0 0 0 FATIMAH ROHANIWATI. NY 026105 57 20958
agung;3313092303950002; 5.5.5.202112011542 4 343457
1#0##0#0#0.0#2021-12-09
12:45:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
94e88aa4e37a42dcc194312ff4d3ba07 150000 0 0 0 0 0
0 0 0 0 15000 0 9251 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 17/08/1970 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 UMI LATIPAH.NY 098903 51 18734 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 343458
1#0##0#0#0.0#2021-12-09
12:46:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
110f07fbf956bcdfa57fea94b39214ce 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 04/03/1994 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 NYARASWATI HARYANTO PUTRI.NY 099229 27 10134
agung;3313092303950002; 5.5.5.202112011542 4 343459
1#0##0#0#0.0#2021-12-09
12:47:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ffa0ceb4c81c32d2c4d1dfcf0457fb17 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 04/08/1968 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 WAHYUNINGSIH WIDI RAHAYU.NY 099618 53 19477
agung;3313092303950002; 5.5.5.202112011542 4 343460
1#0##0#0#0.0#2021-12-09
12:48:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
993aa907441e6830212c0dd341c5c696 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 07/05/1958 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SUKIRMAN.TN 099317 63 23219 DRG. VERAWATY,
SP.KG 1124R0021221V000129 0002093524391 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343461 1#0##0#0#0.0#2021-12-09
12:49:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
40fbbc56d284b1ad65937afe3309f45d 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 12/01/1985 0 2
0 - 0 - 0 - 0 283800 326860 0 1
0 0 0 EMI SRI HASTUTIK 100400 36 13472 DRG. VERAWATY,
SP.KG 1124R0021221V000130 0001692561227 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343462 1#0##0#0#0.0#2021-12-09
12:50:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f530030608ad7b108c63ab285b06e6f0 300000 0 0 0 0 0
0 0 0 0 25000 0 1860 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 29/05/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 653275
0 1 0 0 0 KRISDARI BEKTI RAHAYU.NY 098201 45
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 343463
1#0##0#0#0.0#2021-12-09
12:51:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f770600303e70dfdd5c94353d655cf42 150000 0 0 0 0 0
0 0 0 0 15000 0 488275 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 09/10/2011 0 1
2 D68.3 - - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 REVAN PRATAMA ARFIKRI 74211 10 3706 DR.
ANI SURYANTI WISYASTUTI, SP.A., M.KES 1124R0021221V000133 0001281648205
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 343464
1#0##0#0#0.0#2021-12-09
12:52:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
328516c0bb43ad82e75c6c01865a7cef 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 29/01/2015 0 1
2 Z09.8;D68.3 - - - 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 6 2498
DR. ANI SURYANTI WISYASTUTI, SP.A., M.KES 1124R0021221V000134
0001699506213 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
343465 1#0##0#0#0.0#2021-12-09
12:54:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1ff2d8a0d245882961795cdd51e6051e 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 27/11/1955 0 1
1 I64 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 1425000 0 1 0
0 0 EKO HARTANTO 100404 66 24111 DR. INDRIANY WIDHOWATY,
SP.S, SP.AK 1124R0021221V000135 0001858700259 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343466 1#0##0#0#0.0#2021-12-09
12:57:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
66e5a070cb054c9a60584ea2e81d7873 150000 0 0 0 0 0
1250000 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 03/04/2000 0 2
0 - 0 - 0 - 0 283800 190000 0 1
0 0 0 An. Puput Ruriawati 37228 21 7912 DRG. VERAWATY,
SP.KG 1124R0021221V000137 0001304138114 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343467 1#0##0#0#0.0#2021-12-09
12:58:54#0#00:00:00#00:00:00#17:04:46#{"co_insidense_ind":"0"} 1
ff77c6bc8a56885711dbac12f7f4c5b0 175000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 25/06/1949 0 2
0 - 0 - 0 - 0 283800 316960 0 1
0 0 0 KAWITINAH 006229 72 26457 DRG. VERAWATY, SP.KG
1124R0021221V000139 0000091167063 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343468 1#0##0#0#0.0#2021-12-09
13:00:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5585728d3301d1574c6935e4c4c06bdd 300000 0 0 0 0 0
0 0 0 0 15000 0 1960 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 24/05/1990 0 2
0 - 0 - 0 - 0 283800 333590 0 1
0 0 0 MUTOHAROH FAISAH 100329 31 11514 DRG. VERAWATY,
SP.KG 1124R0021221V000140 0002349968523 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343469 1#0##0#0#0.0#2021-12-09
13:04:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
904e0dbb2125981462554d8aa7b118c4 300000 0 0 0 0 0
0 0 0 0 15000 0 18590 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 25/04/1989 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 NURLAILA RAMADHAN. NY 100148 32 11908 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 343470
1#0##0#0#0.0#2021-12-09
13:06:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1c7f1042fd08e8f607a0ffd92d515dd4 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 08/08/1950 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 HJ ENDANG SRI ., NY 054099 71 26048 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 343481
1#0##0#0#0.0#2021-12-09
13:18:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
111a6c3cd7bd06e1ba3a4610fec39653 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 30/01/1968 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 ARY SETYANI 100382 53 19664 DRG. VERAWATY, SP.KG
1124R0021221V000143 0000089058497 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343484 1#0##0#0#0.0#2021-12-09
13:19:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e6368f397c6f4f0eb5dc9b4df00d88fc 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 02/09/2000 0 2
0 - 0 - 0 - 0 283800 316860 0 1
0 0 0 DEA AL VERINA HARYANTO 100381 21 7760 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 343491
1#0##0#0#0.0#2021-12-09
13:21:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
10be9503f1dbaea04b45053cbe152174 300000 0 0 0 0 0
0 0 0 0 15000 0 1860 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 24/08/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 249040
0 1 0 0 0 SUPARNO BP 085087 73 26762 DR. INDRIANY
agung;3313092303950002; 5.5.5.202112011542 4 343498
1#0##0#0#0.0#2021-12-09
13:22:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ff6543d6975c7a8fdd9976b7555f3cfe 150000 0 0 0 0 0
0 0 0 0 15000 0 84040 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 25/09/1976 0 1
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 GIMINANTO.TN 080056 45 16503 DRG. VERAWATY,
SP.KG 1124R0021221V000146 0001105229924 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 343500 1#0##0#0#0.0#2021-12-09
13:23:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0dc04dc7a50d916c8fc8ffeba9397df6 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 31/12/1962 0 2
1 Z09.0;H11.0;H35.0;H04.1 90.29;95.01 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
215585 0 1 0 0 0 PAHING HADI SUMARTO. NY 100008
0000564150778 3;JKN novia;3313125201940001; 5.6.3.202201201500 4
343503 1#0##0#0#0.0#2022-03-08
07:58:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
b13b76768c3bc9c3bc8d39f7d038cbc5 150000 0 0 0 0 0
0 0 0 0 15000 0 50585 0 0 0 0 0
3372030 C 3 CP 2 01/12/2021 01/12/2021 12/04/1969 0 1
1 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 264486 0 1
0 0 0 WAHYONO, TN 086192 52 19226 DR. YOSSI
1124R0021221V000151 0001105377546 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346613 1#0##0#0#0.0#2022-01-04
13:10:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
09d78eb2c117eb4369eed609147d30b2 155000 0 0 0 0 0
0 0 0 0 15000 0 94486 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 11/04/1981 0 2
1 Z09.8;M17.9 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 229650
0 1 0 0 0 NUR WIJAYANTI, NY 002265 40 14845 DR.
WAHYU PURNOMO, SP.OT 1124R0021221V000156 0001102651031 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 342822
1#0##0#0#0.0#2021-12-07
14:10:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
24245c50ce33641322b05067df257a9d 150000 0 0 0 0 0
0 0 0 0 15000 0 64650 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 23/12/1982 0 1
1 Z09.8;S92.50 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 220752
0 1 0 0 0 ARIYANTO SALAM., BP 044036 38 14224
DR. WAHYU PURNOMO, SP.OT 1124R0021221V000157 0002508523334 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 342823
1#0##0#0#0.0#2021-12-07
14:11:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c74b23117d0e14ba6e4efb11bf18f9fc 150000 0 0 0 0 0
0 0 0 0 15000 0 55752 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 01/08/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 225474
0 1 0 0 0 SUGINAH ., NY 055628 76 27882 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342824
1#0##0#0#0.0#2021-12-07
14:12:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9af34676bf36c68e88034316e475fadd 150000 0 0 0 0 0
0 0 0 0 15000 0 60474 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 21/05/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 951366
0 1 0 0 0 SURATI, NY 066918 57 21014 DR. ARYO
SUSENO, SP.PD 1124R0021221V000159 0000564712435 3;JKN
novia;3313125201940001; 5.6.3.202201201500 4 342825
1#0##0#0#0.0#2022-03-08
08:35:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
9d3a2c5981bc5083dc371eebf910337e 150000 0 0 0 0 0
0 63690 0 0 15000 0 722676 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 14/09/1966 0 1
1 Z09.8;M54.59 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 233420
0 1 0 0 0 SUPRAPTO.TN 095047 55 20168 DR. WAHYU
PURNOMO, SP.OT 1124R0021221V000160 0002488567825 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 342826
1#0##0#0#0.0#2021-12-07
14:15:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
73d89e940d7e11a2c113857165c2cd91 150000 0 0 0 0 0
0 0 0 0 15000 0 68420 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 01/05/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 400681
0 1 0 0 0 JOKO HARMIANTO.TN 088393 54 19939 DR.
SUHARTO, SP.PD 1124R0021221V000161 0000564075573 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 342827
1#0##0#0#0.0#2021-12-07
14:16:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
18b569468864761917891c5b68c9ac24 150000 0 0 0 0 0
0 31845 0 0 15000 0 203836 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 07/10/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 463305
0 1 0 0 0 SUPARDI., BP 041629 58 21241 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342828
1#0##0#0#0.0#2021-12-07
14:21:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
67ecdef0ee7e157d1a61a56b8ec154ab 150000 0 0 0 0 0
0 31845 0 0 15000 0 266460 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 30/12/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 229500
0 1 0 0 0 NURYATI.NY 084776 70 25905 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 342829
1#0##0#0#0.0#2021-12-07
14:25:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
191ee273fdd53e5fcfeb9bd434991a61 150000 0 0 0 0 0
0 0 0 0 15000 0 64500 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 24/04/1955 0 1
1 Z09.8;E11.9;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 582380
0 1 0 0 0 SATINO SLAMET.TN 085014 66 24329 DR.
ARYO SUSENO, SP.PD 1124R0021221V000164 0000640077311 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 342830
1#0##0#0#0.0#2021-12-07
14:28:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
78861949b5d448e40ba1f0699b1db173 150000 0 0 0 0 0
0 108440 0 0 15000 0 308940 0 0 0 0
0
3372030 C 3 CP 2 02/12/2021 02/12/2021 08/04/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 621091
0 1 0 0 0 SUMARWI, (NY) 050221 56 20692 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342831
1#0##0#0#0.0#2021-12-07
14:30:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a41eb39c6fe02a9120bc6154a2c43c2a 150000 0 0 0 0 0
0 107990 0 0 15000 0 348101 0 0 0 0
0
3372030 C 3 CP 2 02/12/2021 02/12/2021 10/07/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 243252
0 1 0 0 0 SRI MURNI, NY 012680 66 24252 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342832
1#0##0#0#0.0#2021-12-07
14:36:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1b5ce33778ba5ba638ed9bd994005550 150000 0 0 0 0 0
0 0 0 0 15000 0 78252 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 17/08/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 546480
0 1 0 0 0 RANTO MULYONO 089858 54 19831 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342833
1#0##0#0#0.0#2021-12-07
14:40:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
977e030e3e1b0ba7c5d496c55a7c755b 150000 0 0 0 0 0
0 108440 0 0 15000 0 273040 0 0 0 0
0
3372030 C 3 CP 2 02/12/2021 02/12/2021 18/12/1957 0 1
1 Z09.8;M54.59;M17.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 240642
0 1 0 0 0 MUHAMMAD HATTA ., TN 058655 63 23360
yani;3302226402970001; 5.5.5.202112011542 4 342834
1#0##0#0#0.0#2021-12-07
15:09:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5828d4b466650ab7f70638813a7fd7a6 150000 0 0 0 0 0
0 0 0 0 15000 0 75642 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 27/02/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 345750
0 1 0 0 0 BAMBANG EDY INDRATNO.tn 094164 68 25115
DR. ARYO SUSENO, SP.PD 1124R0021221V000169 0002077691534 3;JKN
novia;3313125201940001; 5.6.3.202201201500 4 342836
1#0##0#0#0.0#2022-03-08
08:22:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
b95da51a71cba0406177cdd38892759e 150000 0 0 0 0 0
0 108440 0 0 15000 0 72310 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 04/06/1967 0 2
1 Z09.8;E11.9;B35.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 336363
0 1 0 0 0 SRI HARTATI,(NY) 005917 54 19905 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342837
1#0##0#0#0.0#2021-12-07
15:12:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b201b8ded09410313121cb30c4f234a1 150000 0 0 0 0 0
0 120795 0 0 15000 0 50568 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 13/12/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 394820
0 1 0 0 0 AHMAD NURHADI.TN 094191 57 21174 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342838
1#0##0#0#0.0#2021-12-07
15:13:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
346f215403dcbda04bb8ed67ce8a76f6 150000 0 0 0 0 0
0 121345 0 0 15000 0 108475 0 0 0 0
0
3372030 C 3 CP 2 02/12/2021 02/12/2021 31/10/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 479165
0 1 0 0 0 YUNLIS SETYOWATI, (NY) 001924 50 18295
DR. SUHARTO, SP.PD 1124R0021221V000172 0001106647885 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 342839
1#0##0#0#0.0#2021-12-07
15:15:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9617f386deaf05d25d7ee49c087cd746 150000 0 0 0 0 0
0 120745 0 0 15000 0 193420 0 0 0 0
0
3372030 C 3 CP 2 02/12/2021 02/12/2021 26/02/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 218192
0 1 0 0 0 SUKIRMAN BP 087608 73 26943 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 342841
1#0##0#0#0.0#2021-12-07
15:17:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1929530cb977222285e523741ae23c4a 150000 0 0 0 0 0
0 0 0 0 15000 0 53192 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 16/04/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 338110
0 1 0 0 0 MARDIYAH.NY 094156 69 25432 DR. ARYO
yani;3302226402970001; 5.5.5.202112011542 4 342842
1#0##0#0#0.0#2021-12-07
15:19:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
00d698a006dc0215d806101de5c9b7d3 150000 0 0 0 0 0
0 107890 0 0 15000 0 65220 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 09/04/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 233410
agung;3313092303950002; 5.6.6.202203301209 4 342843
1#0##0#0#0.0#2022-04-14
13:12:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
4b24701325956e580742a47ff11e7ae8 150000 0 0 0 0 0
0 0 0 0 15000 0 68410 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 13/06/1992 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 LUKI SABILLA
WITTEVEEN,NN 069906 29 10764 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000176 0001084671257 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343288 1#0##0#0#0.0#2021-12-09
09:16:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6c31a70c2079eeeb3058a85a6c73a10a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 03/07/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 230402
0 1 0 0 0 LESTARI ., NY 058610 60 22067 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342844
1#0##0#0#0.0#2021-12-08
07:43:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6773c9a4f9308e0a999ace1e5a485d6a 150000 0 0 0 0 0
0 0 0 0 15000 0 65402 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 12/11/1963 0 1
1 Z09.8;G81.9 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 240000 0
1 0 0 0 MUH GUNTUR NALURI, TN 091409 58 21205 DR.
LINDA SUGIARTO, SP.FKR 1124R0021221V000179 0002169748091 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 343274
1#0##0#0#0.0#2021-12-09
09:03:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7c89985d4902bc13ba0a21dae48820e0 225000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 19/08/1966 0 1
1 Z09.8;E11.9;I12.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 314285
0 1 0 0 0 JOHANES TARWANTO, TN 080993 55 20194
yani;3302226402970001; 5.5.5.202112011542 4 342845
1#0##0#0#0.0#2021-12-08
07:43:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c51ef459051530752b4ec5f6825f7c1e 150000 0 0 0 0 0
0 108440 0 0 15000 0 40845 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 19/01/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 223632
0 1 0 0 0 EA EDDY SUNARTO WIDODO, BP 077280 63
23328 DR. ARYO SUSENO, SP.PD 1124R0021221V000181 0000090971919 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 342846
1#0##0#0#0.0#2021-12-08
07:44:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d1bf9b688cdc40a1ca8f90a5a21be051 150000 0 0 0 0 0
0 0 0 0 15000 0 58632 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 28/04/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 240464
0 1 0 0 0 KURDI., BP 052526 77 28342 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 342847
1#0##0#0#0.0#2021-12-08
07:46:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
90c5d34421488766a18a8a772f09da51 150000 0 0 0 0 0
0 0 0 0 15000 0 75464 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 05/10/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 352440
0 1 0 0 0 SRIATI.NY 090794 53 19416 DR. ARYO
yani;3302226402970001; 5.5.5.202112011542 4 342848
1#0##0#0#0.0#2021-12-08
07:46:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a092be89940fc13cc65897a8e98c72b7 150000 0 0 0 0 0
0 107890 0 0 15000 0 79550 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 02/06/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 319232
0 1 0 0 0 MUDIYONO.TN 076273 49 18080 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 342849
1#0##0#0#0.0#2021-12-08
07:47:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
62b20a0dbbbc1b51168512dbc2d52dd6 150000 0 0 0 0 0
0 31845 0 0 15000 0 122387 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 27/02/1959 0 2
1 Z09.8;K80.2;I11.9;M19.99 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
315060 0 1 0 0 0 PUJI WAHYUNI,NY 084528 62
22924 DR. SUHARTO, SP.PD 1124R0021221V000185 0000090967623 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 342850
1#0##0#0#0.0#2021-12-08
07:48:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2345676c245e1463df529889f3acc929 150000 0 0 0 0 0
0 0 0 0 15000 0 150060 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 23/07/1957 0 2
1 Z09.4;S82.20 88.27 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 458573
0 1 0 0 0 ERNIE HADIANTI, NY 097917 64 23508
agung;3313092303950002; 5.6.6.202203301209 4 357824
1#0##0#0#0.0#2022-04-14
14:00:17#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 3
a2b9a1015ed7b5349bd818548028d4c7 150000 0 0 0 0 0
248000 0 0 0 15000 0 45573 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 22/12/1968 0 2
1 Z09.8;E11.9;I50.9;N18.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 848096
0 1 0 0 0 UMI QOYYIMAH, (NY) 039287 52 19338
yani;3302226402970001; 5.5.5.202112011542 4 342852
1#0##0#0#0.0#2021-12-08
07:54:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cd4c3d09ae7903dae412e9fae4975178 150000 0 0 0 0 0
0 121295 0 0 15000 0 561801 0 0 0 0
0
3372030 C 3 CP 2 02/12/2021 02/12/2021 16/06/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 238402
0 1 0 0 0 WALUYO SLAMET.TN 080416 67 24641 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342851
1#0##0#0#0.0#2021-12-08
07:53:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9a8539da954d21840c4dac34e4e7c302 150000 0 0 0 0 0
0 0 0 0 15000 0 73402 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 21/12/1988 0 2
0 0 - 0 - 0 - 0 - 0 181400 208420
0 1 0 0 0 RIAWATI FERONIKA SINAGA.NY 100279 32
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 342853
1#0##0#0#0.0#2021-12-08
07:56:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
da73789f06831445a053ebaf7f1154c1 150000 0 0 0 0 0
0 0 0 0 15000 0 43420 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 12/01/1978 0 2
1 Z09.8;M17.9;W01.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 238402
0 1 0 0 0 UNIK DEWI RAHAYU,(NY) 025580 43 16030
yani;3302226402970001; 5.5.5.202112011542 4 342854
1#0##0#0#0.0#2021-12-08
07:57:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2572779ab668417b34c5ec770d95653b 150000 0 0 0 0 0
0 0 0 0 15000 0 73402 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 22/07/1955 0 1
1 M53.19;G57.0 - - - 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 229062 0 1 0 0 0 SLAMET INDARMADI.TN
100416 66 24240 DR. ARIA CHANDRA GTS, SP.S., M.KES
1124R0021221V000192 0001032584938 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 342855 1#0##0#0#0.0#2021-12-08
08:02:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e7edf4659d7e9b6ed242e408ede6cd55 150000 0 0 0 0 0
0 0 0 0 25000 0 54062 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 16/05/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 263190
0 1 0 0 0 SETYO UTAMI NY 087345 62 22846 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342856
1#0##0#0#0.0#2021-12-08
08:03:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
22ca3b2ac0968cbdddeb36bcf52ada48 150000 0 0 0 0 0
0 44300 0 0 15000 0 53890 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 12/02/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 238402
0 1 0 0 0 SUNARTI,(NY) 015594 56 20747 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342857
1#0##0#0#0.0#2021-12-08
08:04:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d791c42f92821e787c7efdd0a4bdfde0 150000 0 0 0 0 0
0 0 0 0 15000 0 73402 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 08/10/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 226365
0 1 0 0 0 SYAMSIYAH.NY 094677 54 19779 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342858
1#0##0#0#0.0#2021-12-08
08:05:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a512d8d09b4f0e7f04eac8069afe203c 150000 0 0 0 0 0
0 17745 0 0 15000 0 43620 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 11/09/1947 0 1
0 0 - 0 - 0 - 0 - 0 181400 243032
0 1 0 0 0 TUKIMAN.TN 098571 74 27111 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 342859
1#0##0#0#0.0#2021-12-08
08:06:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9f40ad213ab4e961a874c671c6818c84 150000 0 0 0 0 0
0 0 0 0 15000 0 78032 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 27/03/1954 0 1
1 Z09.8;R51;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 212750
0 1 0 0 0 SUHARTO JOKO.P (BP) 050087 67 24722
yani;3302226402970001; 5.5.5.202112011542 4 342860
1#0##0#0#0.0#2021-12-08
08:07:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
19de3e29791d5f06c7537726cabdc576 150000 0 0 0 0 0
0 44300 0 0 15000 0 3450 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 01/01/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 340015
0 1 0 0 0 INUK SAINEM, NY 058084 57 21155 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342861
1#0##0#0#0.0#2021-12-08
08:08:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6ba5c0d59c5e57b4c92e442e728053df 150000 0 0 0 0 0
0 120795 0 0 15000 0 54220 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 30/05/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 294870
0 1 0 0 0 SUNARYO. TN 100283 60 22101 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 342862
1#0##0#0#0.0#2021-12-08
08:10:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
17282051c2d42cee21a0499792eb91e0 150000 0 0 0 0 0
0 108440 0 0 15000 0 21430 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 21/12/1962 0 2
1 Z09.8;E11.4;G59.0;E78.5;I10 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
524463 0 1 0 0 0 ENDANG PUJIASTUTI,(NY) 040727
0000640076769 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
342863 1#0##0#0#0.0#2021-12-08
08:11:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ee3dcc2604a8b2d3b5b6d1d57abd5921 150000 0 0 0 0 0
0 76045 0 0 15000 0 283418 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 13/08/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TRI UTAMI
AGUSTINI, NY 048735 63 23122 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000201 0001380313934 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343270 1#0##0#0#0.0#2021-12-09
09:00:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5fe95bdd624b255551c70ce09fa6f97f 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 06/03/1953 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 628507
0 1 0 0 0 DARMANTO., BP 045055 68 25108 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343998
1#0##0#0#0.0#2021-12-14
09:07:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ec7af52b5ce7f26bf2e2a7f42a885833 300000 0 0 0 0 0
200000 76595 0 0 15000 0 36912 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 22/07/1966 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 WARSINO.TN 082557
0001530474513 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343287 1#0##0#0#0.0#2021-12-09
09:15:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bfa061de323d1577e7292fc49b374945 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 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 48 17832 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000204 0001100445232 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 343281 1#0##0#0#0.0#2022-04-14
12:54:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
04aec0ba8311d2fd6af448f21034b4ef 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 18/06/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 262321
0 1 0 0 0 JEMI.NY 076504 65 23908 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 342864
1#0##0#0#0.0#2021-12-08
08:12:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c007c511061f4170cc7e6b2f360be4b3 150000 0 0 0 0 0
0 0 0 0 15000 0 97321 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 04/08/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 243762
0 1 0 0 0 ROFIAH, NY 090612 66 24227 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 342865
1#0##0#0#0.0#2021-12-08
08:14:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
55dc7ce16340eb40426eb89c89909f72 150000 0 0 0 0 0
0 0 0 0 15000 0 78762 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 03/07/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 230322
0 1 0 0 0 SOLICHATI, NY 089498 58 21337 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342866
1#0##0#0#0.0#2021-12-08
08:15:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4f53dc687af9b7dace0936ef15d2f02f 150000 0 0 0 0 0
0 0 0 0 15000 0 65322 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 26/05/1960 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 JUMADI ABDUL
WAHAD.TN 094212 61 22470 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000208 0000088558648 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 343289 1#0##0#0#0.0#2022-04-14
13:34:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
ed69095fbbffbaf83c3f5756affa3c31 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 01/07/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 410412
0 1 0 0 0 JULI ASCHAR.TN 094583 54 19878 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342867
1#0##0#0#0.0#2021-12-08
08:16:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
415d1a688ced601678510794c8387744 150000 0 0 0 0 0
0 0 0 0 15000 0 245412 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 18/11/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 235872
0 1 0 0 0 TUMINI.NY 096460 67 24486 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 342868
1#0##0#0#0.0#2021-12-08
08:16:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b1bce27c6f1bd876d3d3aafbe8158d09 150000 0 0 0 0 0
0 0 0 0 15000 0 70872 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 15/08/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 678018
0 1 0 0 0 SRI PARTINI., NY 051632 62 22755 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342869
1#0##0#0#0.0#2021-12-08
08:17:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
270dc46b12fc39f7661d8fd3402c9c59 150000 0 0 0 0 0
0 0 0 0 15000 0 513018 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 10/10/1953 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 TUTIK SARASWATI .,
NY 054196 68 24890 DR. LINDA SUGIARTO, SP.FKR 1124R0021221V000212
0001449355893 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343285 1#0##0#0#0.0#2021-12-09
09:10:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a480124a99b5d182262354d52de1bdd7 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 06/06/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 234542
0 1 0 0 0 SUPARMAN, BP 045790 67 24651 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342870
1#0##0#0#0.0#2021-12-08
08:20:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
3064a1c57e28f1d2d887c5d33c220f4c 150000 0 0 0 0 0
0 0 0 0 15000 0 69542 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 15/07/1983 0 1
0 0 - 0 - 0 - 0 - 0 181400 177660
0 1 0 0 0 HARYO PONCO SILO AGENG PANJI, BP 093803
38 14020 DR. SUHARTO, SP.PD 1124R0021221V000214 0001448104419
3;JKN novia;3313125201940001; 5.6.3.202201201500 4 342871
1#0##0#0#0.0#2022-03-08
08:20:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
9bf65ee68dff042d30070a28ef22cd93 150000 0 0 0 0 0
0 0 0 0 15000 0 12660 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 20/06/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 207107
0 1 0 0 0 TUGIYEM, NY 090349 64 23541 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 342872
1#0##0#0#0.0#2021-12-08
08:23:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
75f6b90f5aa94a8485ca4b7b4b5a46bb 150000 0 0 0 0 0
0 0 0 0 15000 0 42107 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 17/06/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 212220
0 1 0 0 0 WARIH ANJARIANI, NY 071103 51 18796
novia;3313125201940001; 5.5.5.202112011542 4 347402
1#0##0#0#0.0#2022-01-05
14:18:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
681a756970186d609a928a0198dae123 150000 0 0 0 0 0
0 0 0 0 15000 0 47220 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 03/03/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 192295
0 1 0 0 0 SUYATMI, NY 100114 71 26207 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 342873
1#0##0#0#0.0#2021-12-08
08:24:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1a84db20a797031a3f92d7488942a002 150000 0 0 0 0 0
0 0 0 0 15000 0 27295 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 27/02/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 282350
0 1 0 0 0 DINAR DINNI.NY 097792 46 17080 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342874
1#0##0#0#0.0#2021-12-08
08:25:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2250ab25dcb06db0c1b60cb03db2fb92 150000 0 0 0 0 0
0 0 0 0 15000 0 117350 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 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 18082 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000219 0000639771715 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343284 1#0##0#0#0.0#2021-12-09
09:09:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0f3a8a3d01730043bfcf22af5c06b8fd 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 07/02/1969 0 1
1 B86 - - - 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 316229 0
1 0 0 0 JATI WALUYO.TN 100408 52 19291 DR. RINA
DIANA,SP.DV 1124R0021221V000220 0001126431729 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 342875 1#0##0#0#0.0#2021-12-08
08:26:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7aa62b24093a55cb46608bc60cc636c9 150000 0 0 0 0 0
0 0 0 0 15000 0 151229 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 24/06/1984 0 2
1 Z35.8;O20.0 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 446870
0 1 0 0 0 DIAH RACHMAN HADI.NY 085760 37 13675
DR. GUNAWAN, SP.OG 1124R0021221V000221 0001203445809 3;JKN
novia;3313125201940001; 5.6.3.202201201500 4 343999
1#0##0#0#0.0#2022-03-08
11:58:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
a58d78c1cbc39d1fb3353a218a483ea8 300000 0 0 0 0 0
0 0 0 0 15000 0 131870 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 31/12/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 209312
0 1 0 0 0 SITI MARYAM, NY 093234 67 24808 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342876
1#0##0#0#0.0#2021-12-08
08:27:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
19e03dbe27d9d893095e1cd68f36dbd6 150000 0 0 0 0 0
0 0 0 0 15000 0 44312 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 29/12/1965 0 1
1 Z09.8;E11.9;I11.9;N40 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 256170
0 1 0 0 0 SARWO EDHIE, TN 092522 55 20427 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342877
1#0##0#0#0.0#2021-12-08
08:28:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
70389d8be190a872d146e03f00e717a6 150000 0 0 0 0 0
0 0 0 0 15000 0 91170 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 30/05/1945 0 1
1 Z09.8;B90.8;E78.5 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 261162
0 1 0 0 0 MURSID MUH WINOTO, TN 081013 76 27945
DR. ANITA MUNTAFIAH, SP.P., M.KES 1124R0021221V000224 0001429879048
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 342878
1#0##0#0#0.0#2021-12-08
08:30:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cad1cecd73b2bf02688db4c645007142 150000 0 0 0 0 0
0 0 0 0 15000 0 96162 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 31/12/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI SUWANTI, NY
0001967417043 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343282 1#0##0#0#0.0#2021-12-09
09:08:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9ca2dd31820d5c093e549286f9c3f218 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 01/07/1940 0 2
0 0 - 0 - 0 - 0 - 0 181400 357051
0 1 0 0 0 KATINAH, NY 093702 81 29739 DR. SUHARTO,
SP.PD 1124R0021221V000226 0001843965775 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 342879 1#0##0#0#0.0#2021-12-08
08:31:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b24ebf4ee865c31a62162c9a30b3999a 150000 0 0 0 0 0
0 0 0 0 15000 0 192051 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 13/08/1957 0 2
0 - 0 107400 273000 0 1 0 0 0 ENDANG
MARYATI 085348 64 23487 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000227 0001806020504 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343292 1#0##0#0#0.0#2021-12-09
09:20:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
245b6fecda76671bca87f87533b495c5 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 15/08/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 254340
0 1 0 0 0 SARJU DARMAWAN.TN 091482 57 20928 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342880
1#0##0#0#0.0#2021-12-08
08:32:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b90ccf1428b1259830a7ec316c956757 150000 0 0 0 0 0
0 0 0 0 15000 0 89340 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 26/08/1938 0 1
1 Z09.8;R51;G62.8;I11.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 216628
0 1 0 0 0 HERKIYANTO PANGEMANNAN TN 061724 83
yani;3302226402970001; 5.5.5.202112011542 4 342881
1#0##0#0#0.0#2021-12-08
08:33:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d9bb3ba92a8efbf0b710bcd30906d8a8 150000 0 0 0 0 0
0 0 0 0 15000 0 51628 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 26/04/1947 0 2
1 Z09.8;I50.9;I11.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 208736
0 1 0 0 0 SUKATMI, NY 067067 74 27249 DR. SUHARTO,
SP.PD 1124R0021221V000230 0001021701126 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 342882 1#0##0#0#0.0#2021-12-08
08:36:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c3c11d2be16dbe511c3550cfe547702f 150000 0 0 0 0 0
0 0 0 0 15000 0 43736 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 26/06/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 250242
0 1 0 0 0 SUTRISNO, TN 091494 54 19883 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342883
1#0##0#0#0.0#2021-12-08
08:37:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ff88305fd31dc78453b9de68508cb672 150000 0 0 0 0 0
0 0 0 0 15000 0 85242 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 25/08/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 285285
0 1 0 0 0 SRI SUHARYATI NY 084849 68 24936 DR.
novia;3313125201940001; 5.6.3.202201201500 4 342884
1#0##0#0#0.0#2022-03-08
08:45:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
ab9192f02ab85d890dd0fe7dfcfcb47c 150000 0 0 0 0 0
0 31845 0 0 15000 0 88440 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 07/11/1944 0 2
1 Z09.8;G59.0;E78.5 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 208752
0 1 0 0 0 SUNARTI, NY 071085 77 28149 DR. TEKY
reni;3313147010930001; 5.6.0.202201041418 4 342885
1#0##0#0#0.0#2022-01-07
19:50:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 3
068f33d25cca75fff035c00bda41ec25 150000 0 0 0 0 0
0 0 0 0 15000 0 43752 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 29/12/1959 0 1
1 Z09.8;M79.18 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 240000
0 1 0 0 0 SIDIK PRAMONO, BP 057770 61 22619 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343269
1#0##0#0#0.0#2021-12-09
08:58:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
93e8d421e9c213a29e066bf9bfa8ad2b 225000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 19/08/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 208752
0 1 0 0 0 DJOKO PRAPTONO, TN 071622 68 24942
yani;3302226402970001; 5.5.5.202112011542 4 342886
1#0##0#0#0.0#2021-12-08
09:28:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
95c419d40d7a99fa6a12be2eff0e2fe0 150000 0 0 0 0 0
0 0 0 0 15000 0 43752 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 09/03/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ARIEF BUDI
RAHARJO.TN 082727 68 25105 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000237 0002166940282 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343291 1#0##0#0#0.0#2021-12-09
09:19:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
266a8fc648f7498adb98dedcc847c4d7 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 25/05/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 534026
0 1 0 0 0 HENDRO PRABOWO,(BP) 040050 72 26489
yani;3302226402970001; 5.5.5.202112011542 4 342887
1#0##0#0#0.0#2021-12-08
09:29:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b787e338ac4fb923dbefa0f28630cd5b 150000 0 0 0 0 0
0 76045 0 0 15000 0 292981 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 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; 5.6.3.202201201500 4
343280 1#0##0#0#0.0#2022-02-15
11:43:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
440ce06b5bb95ea8b1465ad6cd04af19 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 12/03/1959 0 1
1 Z09.8;E11.2;N08.3;G59.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 275895
0 1 0 0 0 YOHANES JAMARI, TN 074904 62 22911
yani;3302226402970001; 5.5.5.202112011542 4 342888
1#0##0#0#0.0#2021-12-08
09:30:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ca00bc7bcb1ed11379e3cc85a83ece00 150000 0 0 0 0 0
0 76595 0 0 15000 0 34300 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 10/11/1965 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 DIDIK SUGIYARTA.TN
0002165956975 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
343290 1#0##0#0#0.0#2022-04-14
13:41:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
3fe9f1e6aa4a78d0fee1f004f2272454 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 23/03/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 224512
0 1 0 0 0 ERDIANA.NY 087879 48 17786 DR. WAHYU
agung;3313092303950002; 5.6.6.202203301209 4 342889
1#0##0#0#0.0#2022-04-14
13:21:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
363da851408dc6f1c0f2594f5d2e8e63 150000 0 0 0 0 0
0 0 0 0 15000 0 59512 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 21/05/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 238865
0 1 0 0 0 SUTRISNO, TN 088415 62 22841 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342890
1#0##0#0#0.0#2021-12-08
09:33:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0fffa8fb7107e1fcfe38ce2c10da183b 150000 0 0 0 0 0
0 31845 0 0 15000 0 42020 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 20/10/1950 0 2
1 Z09.8;M54.59;G62.8 93.35;93.39 - - None None None None
0 - 0 107400 273000 0 1 0 0 0
BADRIYAH MUNAWARAH,(NY) 043414 71 25976 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000244 0000091089088 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343276 1#0##0#0#0.0#2021-12-09
09:04:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
14a7e969b850cd10a52ce14ccc996d0a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 01/04/1952 0 2
1 Z09.8;I11.9;M19.99 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 241752
0 1 0 0 0 SRI HARYANI.NY 082725 69 25447 DR.
agung;3313092303950002; 5.6.6.202203301209 4 342891
1#0##0#0#0.0#2022-04-14
13:03:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
8d69e2cf6ec1fe5fe53f6741d7540aca 150000 0 0 0 0 0
0 0 0 0 15000 0 76752 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 10/06/1973 0 2
1 Z09.8;L24.8 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 199856
0 1 0 0 0 RIYATUN.NY 098522 48 17707 DR. RINA
5.5.5.202112011542 4 342892 1#0##0#0#0.0#2021-12-08
09:35:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bb08325f32ae907439fa49824dad1f36 150000 0 0 0 0 0
0 0 0 0 15000 0 34856 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 09/04/1941 0 1
0 0 - 0 - 0 - 0 - 0 181400 253790
0 1 0 0 0 SUMANTO.TN 080896 80 29457 DR. TEKY
novia;3313125201940001; 5.6.3.202201201500 4 342893
1#0##0#0#0.0#2022-02-15
08:43:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
d5904a4790951649fd91b3ffb172353d 150000 0 0 0 0 0
0 0 0 0 15000 0 88790 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 23/12/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 228046
0 1 0 0 0 BUDIARTI.,NY 044128 54 20068 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342894
1#0##0#0#0.0#2021-12-08
09:37:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c4f52e32fe023207cb29052707f6084b 150000 0 0 0 0 0
0 0 0 0 15000 0 63046 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 17/03/1981 0 1
1 Z09.8;N40 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 234620
0 1 0 0 0 MARJOKO SANTOSO., BP 045300 40 14870
yani;3302226402970001; 5.5.5.202112011542 4 342895
1#0##0#0#0.0#2021-12-08
09:38:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d9a66ec707d1c5a4b7cc6ea1a516c154 150000 0 0 0 0 0
0 0 0 0 15000 0 69620 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 03/03/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 473280
0 1 0 0 0 MURSID SADU BUDHI, TN 100377 58 21459
DR. ZULFADLY, SP.B 1124R0021221V000251 0000640764639 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 342896
1#0##0#0#0.0#2021-12-08
09:45:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ddf2667c630714f40784903e32661533 295000 0 0 0 0 0
0 0 0 0 15000 0 163280 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 10/01/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 216100
0 1 0 0 0 WULANDARI.NY 099986 42 15667 DR.
ARIA CHANDRA GTS, SP.S., M.KES 1124R0021221V000252 0000640340627 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 342897
1#0##0#0#0.0#2021-12-08
09:48:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
20be8714885a5974ae431719e89461cf 150000 0 0 0 0 0
0 0 0 0 15000 0 51100 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 19/02/1941 0 2
1 Z47.0 93.57;96.59 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 222780 0 1
0 0 0 KUSTINAH.NY 088456 80 29506 DR. WAHYU PURNOMO, SP.OT
1124R0021221V000253 0001720987121 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 342898 1#0##0#0#0.0#2021-12-08
09:50:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ada849f7328aded7e9cf85c81aae4ca4 150000 0 0 0 0 0
0 0 0 0 15000 0 57780 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 30/08/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 196536
0 1 0 0 0 SRI MURNI BUKARI,NY 095710 79 28949
yani;3302226402970001; 5.5.5.202112011542 4 342899
1#0##0#0#0.0#2021-12-08
09:50:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ab4d363300a76506a2ee2d651b8ef06e 150000 0 0 0 0 0
0 0 0 0 15000 0 31536 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 16/07/1989 0 2
0 0 - 0 - 0 - 0 - 0 181400 694174
0 1 0 0 0 SUYATI , NY 066913 32 11827 DR. ARYO
novia;3313125201940001; 5.6.3.202201201500 4 342900
1#0##0#0#0.0#2022-03-08
08:55:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
f977efd2bbf85926bdf7b689160f34c8 150000 0 0 0 0 0
0 0 0 0 15000 0 529174 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 24/01/1977 0 1
1 Z09.8;S01.5;V28.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 499405
0 1 0 0 0 YUDITH AGUS PRASETYO.TN 100282 44 16383
novia;3313125201940001; 5.5.5.202112011542 4 344000
1#0##0#0#0.0#2022-01-05
14:20:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b945eb780f9b6d859dd8f64e698c380a 472000 0 0 0 0 0
0 0 0 0 15000 0 12405 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 03/09/1946 0 1
1 Z09.8;I11.9;I50.9;E11.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 255270
0 1 0 0 0 SUDJIMAN,TN 092271 75 27484 DR. SUHARTO,
SP.PD 1124R0021221V000257 0000091143123 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 342901 1#0##0#0#0.0#2021-12-08
09:53:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
70cce20220fff1ef7f22b8c1d9112624 150000 0 0 0 0 0
0 0 0 0 15000 0 90270 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 05/03/1947 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
243410 0 1 0 0 0 SRI SALAMININGSIH. NY 083374
0000091346646 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
342902 1#0##0#0#0.0#2021-12-08
09:55:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3e753f66b04dc7a262463c110e346eb1 150000 0 0 0 0 0
0 0 0 0 15000 0 78410 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 26/09/1950 0 1
1 Z09.8;L91.0 99.23 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 242971
0 1 0 0 0 BAMBANG SETYASTO.,BP 059238 71 26000
DR. RINA DIANA,SP.DV 1124R0021221V000259 0001451607974 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 342903
1#0##0#0#0.0#2021-12-08
09:57:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b34112f1476aa4f8f61dfdbc7d1b33e2 150000 0 0 0 0 0
0 0 0 0 15000 0 77971 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 29/09/1961 0 1
1 B37.9 - - - None None None None Q-5-42-0 None None
- 0 - 0 - 0 - 0 182600 225363 0
1 0 0 0 HUSMARYANTO .BP 036573 60 21979 DR. RINA
DIANA,SP.DV 1124R0021221V000260 0001694440056 3;JKN novia;3313125201940001;
5.6.3.202201201500 4 344001 1#0##0#0#0.0#2022-02-14
14:40:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
780fafbf65eb391c3f60b0c40f95d5af 150000 0 0 0 0 0
0 0 0 0 15000 0 60363 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 05/07/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI BEKTI.NY
0000640746538 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343286 1#0##0#0#0.0#2021-12-09
09:14:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d92e63bb38d30504bf6d696f8a7d8d23 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 02/02/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 185348
0 1 0 0 0 SITI KHODRIYAH 092504 57 21123 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342904
1#0##0#0#0.0#2021-12-08
09:58:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
534575b6de4d56c953219c0ff8f25c3b 150000 0 0 0 0 0
0 0 0 0 15000 0 20348 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 01/01/1977 0 1
0 0 - 0 - 0 - 0 - 0 181400 227160
0 1 0 0 0 RUSDI.,TN 049658 44 16406 DR. ARYO
yani;3302226402970001; 5.5.5.202112011542 4 342905
1#0##0#0#0.0#2021-12-08
10:00:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f3cf631102592cc9de95450f9c99e8cf 150000 0 0 0 0 0
0 0 0 0 15000 0 62160 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 24/05/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ENDANG RAHUNI
MURDANINGSIH,(NY) 005290 51 18820 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000265 0001281367956 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343271 1#0##0#0#0.0#2021-12-09
09:01:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bf9c4e1b6935572807372f38d2089c27 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 24/11/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 226307
0 1 0 0 0 RIO NANDO DWI PURNOMO.SDR 100414 19
6948 DR. RINA DIANA,SP.DV 1124R0021221V000266 0001099932197 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 342907
1#0##0#0#0.0#2021-12-08
10:16:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
219a446ef62e751052614805fadeb256 150000 0 0 0 0 0
0 0 0 0 15000 0 61307 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 25/06/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 195081
0 1 0 0 0 LUCIA ROSARI SRI ASTUTI., NY 071633 64
yani;3302226402970001; 5.5.5.202112011542 4 342908
1#0##0#0#0.0#2021-12-08
10:20:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
152415ebd53ee22e7eafc5149b79e5e2 150000 0 0 0 0 0
0 0 0 0 15000 0 30081 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 31/12/1966 0 2
1 Z09.8;E11.4;G59.0;E78.5 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
1309048 0 1 0 0 0 SUYATMI., NY 042939 54
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 344002
1#0##0#0#0.0#2021-12-14
09:17:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
49727018cf1ad5e193f3368c859bdd5d 150000 0 0 0 0 0
657000 31845 0 0 15000 0 455203 0 0 0 0
0
3372030 C 3 CP 2 02/12/2021 02/12/2021 27/08/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 328207
0 1 0 0 0 MOCH ALI S , TN 00439 61 22377 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 342909
1#0##0#0#0.0#2021-12-08
10:26:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
de88a28ce8f7084d6724c33864d179ab 150000 0 0 0 0 0
0 76045 0 0 15000 0 87162 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 01/05/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 408630
0 1 0 0 0 SRI HASTUTI, NY 033714 66 24322 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342910
1#0##0#0#0.0#2021-12-08
10:29:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3a023bc9f282412f1b2daf537c7fff79 150000 0 0 0 0 0
0 0 0 0 15000 0 243630 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 12/05/1982 0 2
0 0 - 0 - 0 - 0 - 0 181400 265865
0 1 0 0 0 RATNA DIAN KARISMATIKA, NY 094648 39
yani;3302226402970001; 5.5.5.202112011542 4 342912
1#0##0#0#0.0#2021-12-08
10:30:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d76dfec1ec24bbc13d46823c579dd99b 150000 0 0 0 0 0
0 0 0 0 15000 0 100865 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 01/11/1973 0 1
1 K40.9 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 967000 0
1 0 0 0 HARIYANTO, TN 100420 48 17563 DR.
ZULFADLY, SP.B 1124R0021221V000272 0000639847754 3;JKN
novia;3313125201940001; 5.5.5.202112011542 4 344003
1#0##0#0#0.0#2021-12-14
09:18:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6e87df88999756fcd6b573edd6a81fea 295000 0 0 0 0 0
657000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 31/01/1979 0 2
1 Z09.8;I11.9;I20.9 89.52 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 361688
0 1 0 0 0 HASTI MULATSIH,(NY) 021552 42 15646
yani;3302226402970001; 5.5.5.202112011542 4 342913
1#0##0#0#0.0#2021-12-08
10:32:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
de0d09d849923313d8e504a692e72340 150000 0 0 0 0 0
0 0 0 0 15000 0 196688 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 11/04/1954 0 2
1 I50.0;M19.98 - - - None None None None Q-5-29-0
None None None None None None GAGAL JANTUNG KONGESTIF DAN KONDISI
JANTUNG LAIN-LAIN 521100 0 0 - 0 - 0 - 0 -
0 521100 218415 0 1 0 0 0 SRI SURIPNI.NY
100421 67 24707 DR. SUHARTO, SP.PD 1124R0021221V000274
0002349968049 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
342916 1#0##0#0#0.0#2021-12-08
10:37:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
12edd7749f4ef858316e0f37cc0a2e87 150000 0 0 0 0 0
0 0 0 0 25000 0 43415 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 10/04/1943 0 2
0 0 - 0 - 0 - 0 - 0 181400 454080
0 1 0 0 0 SRIYANTI, (NY) 033740 78 28726 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342919
1#0##0#0#0.0#2021-12-08
10:40:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1e29a431be4b4d217fd4142dbd019033 150000 0 0 0 0 0
0 215920 0 0 15000 0 73160 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 07/04/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 200981
0 1 0 0 0 SUDARYANTI.NY 091986 63 23250 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342923
1#0##0#0#0.0#2021-12-08
10:42:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3b5a7c912b5b2d7e6bc4cb8bdfcf12e2 150000 0 0 0 0 0
0 0 0 0 15000 0 35981 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 24/04/1990 0 1
1 Z09.8;N04.9 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 205040
0 1 0 0 0 EKO SETYANTO, TN 066247 31 11545 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342924
1#0##0#0#0.0#2021-12-08
10:44:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3ec91b180251403dfc160c403484fea0 150000 0 0 0 0 0
0 0 0 0 15000 0 40040 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 22/05/1989 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 246390
0 1 0 0 0 FERY NUR MARLIN, NY 100422 32 11882
yani;3302226402970001; 5.5.5.202112011542 4 342925
1#0##0#0#0.0#2021-12-08
10:45:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bb9833d6907d161d5152b2c0fe8fa2ea 200000 0 0 0 0 0
0 0 0 0 25000 0 21390 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 17/08/1967 0 2
1 Z09.8;I50.0;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 229775
0 1 0 0 0 SRI PURWANTI.,NY 075594 54 19831 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342926
1#0##0#0#0.0#2021-12-08
10:46:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1c492f5ccd9c99773265dea57186332d 150000 0 0 0 0 0
0 0 0 0 15000 0 64775 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 08/06/1964 0 2
1 Z09.8;M19.98;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 255993
0 1 0 0 0 SUKANTHI 098456 57 20996 DR. SUHARTO,
SP.PD 1124R0021221V000280 0001228292188 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 342930 1#0##0#0#0.0#2021-12-08
10:53:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c3f575b8076a2650b7cdc5d633a77df0 150000 0 0 0 0 0
0 0 0 0 15000 0 90993 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 20/07/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 211300
0 1 0 0 0 BINASIH SETYONO.TN 085416 55 20224
DR. ARIA CHANDRA GTS, SP.S., M.KES 1124R0021221V000281 0000086730423
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 342931
1#0##0#0#0.0#2021-12-08
10:55:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a014b7d7c4d81d8c5ab433f585f9a708 150000 0 0 0 0 0
0 0 0 0 15000 0 46300 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 15/08/1942 0 1
1 Z09.8;H66.9 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 179405
0 1 0 0 0 LASITO., BP 041779 79 28964 DR.
SUDARMAN, SP.THT-BKL(K) 1124R0021221V000282 0000091314551 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 342933
1#0##0#0#0.0#2021-12-08
10:56:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0be67d2a93ec81a2d92e6aed53cc39ec 150000 0 0 0 0 0
0 0 0 0 15000 0 14405 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 05/12/2016 0 1
1 J01.8 87.16 - - None None None None Q-5-42-0 None None
- 0 - 0 - 0 - 0 182600 226045 0
1 0 0 0 ABIZAR LANGIT NARENDRA, AN 100409 4 1823
novia;3313125201940001; 5.5.5.202112011542 4 344004
1#0##0#0#0.0#2021-12-14
09:18:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6641171e1a5dd849bba9b53653b3dbd8 0 0 0 0 48000 0 150000
0 0 0 15000 0 13045 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 10/11/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 181050
0 1 0 0 0 EKO RAHMAT WIDODO,BP 049022 51 18650
yani;3302226402970001; 5.5.5.202112011542 4 342934
1#0##0#0#0.0#2021-12-08
10:57:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
55fb595c6504343c7dfdd78861a2291e 150000 0 0 0 0 0
0 0 0 0 15000 0 16050 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 01/05/1974 0 2
1 Z09.8;R51;K29.7 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 241241
0 1 0 0 0 Kupsah Maerah Tuti 39834 47 17382 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342936
1#0##0#0#0.0#2021-12-08
10:58:34#0#00:00:00#00:00:00#09:52:59#{"co_insidense_ind":"0"} 1
e136dece77e37973caa2c0235b71a248 150000 0 0 0 0 0
0 0 0 0 15000 0 76241 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 04/05/1958 0 2
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 WORO HARTATI.NY 098597 63 23223 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 342937
1#0##0#0#0.0#2021-12-08
10:59:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6ea8450bc7afc4d65a289ea744126d0f 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 10/07/1955 0 2
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 SUNARNI, NY 040167 66 24252 DR. TEKY WIDYARINI,
SP.PD 1124R0021221V000289 0001032581823 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 342938 1#0##0#0#0.0#2021-12-08
11:02:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5dc86373fd31136994fe28dc938afe81 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 17/09/1989 0 1
0 0 - 0 - 0 - 0 - 0 181400 280485
0 1 0 0 0 SANDI BAMBANG SUTOYO.TN 100242 32 11764
novia;3313125201940001; 5.6.3.202201201500 4 342939
1#0##0#0#0.0#2022-03-08
08:09:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
ac002ae3664c37273340222a83c4a000 150000 0 0 0 0 0
0 0 0 0 15000 0 115485 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 07/01/1933 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
661925 0 1 0 0 0 SITI FATONAH WARI., NY 070243
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 342940
1#0##0#0#0.0#2021-12-08
11:04:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1b2c9e79e852826af34b54e69c68c62e 150000 0 0 0 0 0
0 0 0 0 15000 0 496925 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 22/04/1992 0 1
0 - 0 - 0 - 0 786200 811476 0 1
0 0 0 FAJAR YEHUDA .SDR 083966 29 10816 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 342942
1#0##0#0#0.0#2021-12-08
11:07:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
30cd0145681ba47903f07cbb81e503b3 662676 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 30/04/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 294180
0 1 0 0 0 CATHARINA UPIK APRININGSIH, NY 070857
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 342941
1#0##0#0#0.0#2021-12-08
11:06:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c40a46f8a437e4e0f92ace693a33c605 150000 0 0 0 0 0
0 0 0 0 15000 0 129180 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 04/09/1964 0 1
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 ARIS HARDJENDRO,(BP) 040065 57 20908 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 342944
1#0##0#0#0.0#2021-12-08
11:08:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8b3a50e90258d7ee2edaa5e78c50dda9 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 25/06/1970 0 2
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 YUNI WIDIYATI, NY 032391 51 18788 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 342945
1#0##0#0#0.0#2021-12-08
11:16:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2597edef7c59e5024385a400dbf46f1b 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 12/10/1987 0 1
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 ANDRI WIDIYANTO TN 067488 34 12470 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 342946
1#0##0#0#0.0#2021-12-08
11:17:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c6e7e00e1b11d064a067986f201b0595 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 10/12/1982 0 1
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 DEKKY LESMANA, TN 071695 38 14237 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 342982
1#0##0#0#0.0#2021-12-08
12:58:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
872f6b704f65266135a1b1840806bf39 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 18/03/1988 0 1
0 - 0 - 0 - 0 786200 811476 0 1
0 0 0 EKA MARDIANTO., BP 046711 33 12312 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 342984
1#0##0#0#0.0#2021-12-08
13:00:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7ae095321a41ff1a9b7943b0bacd638b 662676 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 17/04/1973 0 1
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 M KUSAENI, BP 050711 48 17761 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 342986
1#0##0#0#0.0#2021-12-08
13:01:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
369d3ef957871cb02cebe1b0ed9ddcdb 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 23/03/1976 0 2
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 SRI YATUN, NY 056231 45 16690 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 342987
1#0##0#0#0.0#2021-12-08
13:03:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cf49f126721280068e4e3001b4307d52 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 12/03/1955 0 2
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 SRI PONIMAH., NY 043214 66 24372 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 342988
1#0##0#0#0.0#2021-12-08
13:05:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
69cd8d068a17549201e16cb8f10fffef 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 14/10/1972 0 2
0 - 0 - 0 - 0 786200 811476 0 1
0 0 0 LUSIA ANDRI,NN 048146 49 17946 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 342989
1#0##0#0#0.0#2021-12-08
13:06:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
775872c6a7e02cf35bbddfc29fbe9914 662676 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 29/08/1979 0 2
1 Z09.8;B35.4;L28.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 266291
0 1 0 0 0 PURWANTI PUJIASTUTI.NY 094422 42 15436
yani;3302226402970001; 5.5.5.202112011542 4 342990
1#0##0#0#0.0#2021-12-08
13:07:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3dfe0dfe0099c81be031c2b45ae353bf 150000 0 0 0 0 0
0 0 0 0 15000 0 101291 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 23/11/1967 0 2
1 Z09.8;L80 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 227331
0 1 0 0 0 MURNI RETNONINGSIH, NY 099847 54 19733
yani;3302226402970001; 5.5.5.202112011542 4 342993
1#0##0#0#0.0#2021-12-08
13:13:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e1562d89db13fc80a565a9b53a5bc89e 150000 0 0 0 0 0
0 0 0 0 15000 0 62331 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 26/01/1998 0 2
1 Z09.8;B18.1 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 204480
0 1 0 0 0 ANISA MAHDA HABSARI.NN 096945 23 8711
yani;3302226402970001; 5.5.5.202112011542 4 343002
1#0##0#0#0.0#2021-12-08
13:14:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fc29945adca0c3fb0b820b32c13b7a0c 150000 0 0 0 0 0
0 0 0 0 15000 0 39480 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 24/10/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 225300
0 1 0 0 0 SULASTRI.NY 096464 48 17571 DR. SUHARTO,
SP.PD 1124R0021221V000308 0001108064654 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343005 1#0##0#0#0.0#2021-12-08
13:15:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9c117b458cd7a8c1ecf223e44be0136c 150000 0 0 0 0 0
0 0 0 0 15000 0 60300 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 09/06/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 225300
0 1 0 0 0 MARJOKO.TN 096463 49 18073 DR. SUHARTO,
SP.PD 1124R0021221V000309 0001104313498 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343007 1#0##0#0#0.0#2021-12-08
13:16:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9d3ae340b282964e488cd4dcda4d8f23 150000 0 0 0 0 0
0 0 0 0 15000 0 60300 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 13/08/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 469392
0 1 0 0 0 SUPRIHANI, NY 081753 72 26409 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343008
1#0##0#0#0.0#2021-12-08
13:17:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
167e137153bd48813e2ebfd59e644f90 150000 0 0 0 0 0
0 210245 0 0 15000 0 94147 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 16/10/1994 0 1
0 0 - 0 - 0 - 0 - 0 181400 463598
0 1 0 0 0 ADITYAS DWINA HASTANTYA,SDR 094566 27
yani;3302226402970001; 5.5.5.202112011542 4 343011
1#0##0#0#0.0#2021-12-08
13:19:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a81ca180f13855ac4a7fd9e43ee54500 295000 0 0 0 0 0
0 0 0 0 15000 0 153598 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 27/06/1992 0 2
1 Z09.8;Q82.8 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 284213
0 1 0 0 0 AYU PRIHATIN NINGSIH, NY 072389 29
yani;3302226402970001; 5.5.5.202112011542 4 343013
1#0##0#0#0.0#2021-12-08
13:21:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
befc8f4656c8c809b53826b0defb7318 150000 0 0 0 0 0
0 0 0 0 15000 0 119213 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 31/12/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 255821
0 1 0 0 0 SUPARTI, NY 063472 75 27730 DR. RINA
5.6.3.202201201500 4 343014 1#0##0#0#0.0#2022-02-15
07:43:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
26b2239ee12d1065b33862a9097e511c 150000 0 0 0 0 0
0 0 0 0 15000 0 90821 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 11/03/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 226385
0 1 0 0 0 SRI MULYANI,NY 069401 60 22181 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343015
1#0##0#0#0.0#2021-12-08
13:23:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d27a91fbd67d5d32966940135ef636d5 150000 0 0 0 0 0
0 0 0 0 15000 0 61385 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 14/06/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 233812
0 1 0 0 0 SRI MURNIYANTI, NY 054964 62 22817
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 343017
1#0##0#0#0.0#2022-04-14
12:51:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
35c1f79709472b965f67886bbbc667b2 150000 0 0 0 0 0
0 0 0 0 15000 0 68812 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 12/01/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 191910
0 1 0 0 0 EKO RINI.NY 093223 52 19317 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 343020
1#0##0#0#0.0#2022-04-14
13:55:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
f3155a0fc96563cc156459e37e2b2952 150000 0 0 0 0 0
0 0 0 0 15000 0 26910 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 31/12/1950 0 2
2 I69.3;L03.9 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 MAKNANINGSIH NY 087885 70 25904 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343023
1#0##0#0#0.0#2021-12-08
13:27:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6af0de792b7eb7263d1e26b1f103cb40 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 23/05/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 193940
0 1 0 0 0 SARJONO.TN 094849 50 18456 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 343027
1#0##0#0#0.0#2021-12-08
13:28:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
595181d6fa06d79b701ef4dd11fac205 150000 0 0 0 0 0
0 0 0 0 15000 0 28940 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 28/04/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SENO AARJITO.TN 092389 55 20307 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343030
1#0##0#0#0.0#2021-12-08
13:30:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2027e47cdc766e3629d68658969737c5 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 23/03/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 417918
0 1 0 0 0 FX SUYATNO, TN 098583 76 28013 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343041
1#0##0#0#0.0#2021-12-08
13:37:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 31/12/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 218037
0 1 0 0 0 PARYATUN, NY 051446 69 25539 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343046
1#0##0#0#0.0#2021-12-08
13:38:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 09/12/1968 0 2
1 Z09.8;E11.4;G59.0;I10;M19.98 88.27 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
601577 0 1 0 0 0 LUCIA ANDRIANI,NY 063834 52
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 344005
1#0##0#0#0.0#2021-12-14
09:19:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5a68b2d9c898d19f7beadfe1fbf43e4d 150000 0 0 0 0 0
248000 31845 0 0 15000 0 156732 0 0 0 0
0
3372030 C 3 CP 2 02/12/2021 02/12/2021 08/12/1975 0 1
0 0 - 0 - 0 - 0 - 0 181400 232945
0 1 0 0 0 HERI WIBOWO.TN 084601 45 16796 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343051
1#0##0#0#0.0#2021-12-08
13:40:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b59915d5aa9d05f58117180e8e4387f7 150000 0 0 0 0 0
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3372030 C 3 CP 2 02/12/2021 02/12/2021 13/06/1971 0 2
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0 1 0 0 0 SITI MARDLIYAH.NY 084457 50 18435 DR.
agung;3313092303950002; 5.6.6.202203301209 4 343055
1#0##0#0#0.0#2022-04-14
13:12:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 02/12/2021 02/12/2021 31/12/1969 0 2
1 Z09.8;I69.3;G40.9;G47.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 299672
0 1 0 0 0 PAINEM NY 091225 51 18964 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 343057
1#0##0#0#0.0#2021-12-08
13:42:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 17/06/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 276890
0 1 0 0 0 BAMBANG SUGIHARJO, TN 091843 64 23544
yani;3302226402970001; 5.5.5.202112011542 4 343059
1#0##0#0#0.0#2021-12-08
13:45:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 30/11/1956 0 2
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0 1 0 0 0 VERONIKA SRI DARINI,NY (28552) 038070
65 23743 DR. ARIA CHANDRA GTS, SP.S., M.KES 1124R0021221V000328
0000091178098 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343064 1#0##0#0#0.0#2021-12-08
13:47:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 22/05/1972 0 2
None None None None None CT-SCAN KEPALA 894800 0 0 -
0 - 0 - 0 - 0 894800 1462335 0 1
0 0 0 SRI ENDANG PUDJIASTUTI.NY 079814 49 18091 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344006
1#0##0#0#0.0#2021-12-14
09:24:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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1250000 0 0 0 15000 0 47335 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 27/11/1950 0 2
1 Z09.8;G40.9;I69.3;G47.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 206814
0 1 0 0 0 TITIK GUNTARIAH., NY 042522 71 25938
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343067
1#0##0#0#0.0#2021-12-08
13:48:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 17/03/1954 0 1
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0 1 0 0 0 SURURI.TN 098943 67 24732 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 343074
1#0##0#0#0.0#2021-12-08
13:50:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 29/09/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 226385
0 1 0 0 0 SRI HANDAYANI.NY 099989 60 21979 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343079
1#0##0#0#0.0#2021-12-08
13:52:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 24/01/1945 0 2
1 Z09.8;I69.3;G44.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 220943
0 1 0 0 0 SRI SURASMI 085160 76 28071 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 343094
1#0##0#0#0.0#2021-12-08
13:59:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 21/10/1958 0 1
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0 1 0 0 0 TUKINO, BP 069874 63 23053 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 343096
1#0##0#0#0.0#2021-12-08
14:01:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 10/01/1965 0 1
1 H81.3;I10 89.52 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 352142
0 1 0 0 0 SARIPUDIN, TN 100430 56 20780 dr.
ANDANG 1124R0021221V000336 0002835876137 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346614 1#0##0#0#0.0#2022-01-04
13:12:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 29/04/1968 0 2
1 Z09.8;G43.9;H81.3 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 224705
0 1 0 0 0 SRI HARIYANTI.NY 090167 53 19575 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343101
1#0##0#0#0.0#2021-12-08
14:03:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 07/05/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 281840
0 1 0 0 0 ENDANG SUPRIYATI, NY 097965 46 17011
yani;3302226402970001; 5.5.5.202112011542 4 343105
1#0##0#0#0.0#2021-12-08
14:04:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 03/12/1960 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 343106
1#0##0#0#0.0#2021-12-08
14:05:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d8fc820da1941be105c2413615ec08b4 150000 0 0 0 0 0
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3372030 C 3 CP 2 02/12/2021 02/12/2021 11/08/1980 0 1
0 0 - 0 - 0 - 0 - 0 181400 234740
0 1 0 0 0 AGUS AKBAR .BP 030258 41 15088 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343108
1#0##0#0#0.0#2021-12-08
14:06:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 01/08/1976 0 1
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0 0 0 JOKO SUSILO.TN 099244 45 16559 DR. ZULFADLY, SP.B
1124R0021221V000342 0001530309701 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 344007 1#0##0#0#0.0#2021-12-14
09:25:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 05/02/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 242130
0 1 0 0 0 TRI NURHAYATI,NY 051215 44 16371 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343109
1#0##0#0#0.0#2021-12-08
14:07:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 24/12/1967 0 1
1 I25.9 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 315000
0 1 0 0 0 RUDY FAJARRIANTO.TN 100406 53 19702
DR. GALIH RAKASIWI SOEKARNO,SP.JP 1124R0021221V000344 0001527775356
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343114
1#0##0#0#0.0#2021-12-08
14:09:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 09/06/1990 0 1
0 0 - 0 - 0 - 0 - 0 181400 370290
0 1 0 0 0 DOMINICO DANANG SANDI, TN 093126 31
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0002076852767 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343118 1#0##0#0#0.0#2021-12-08
14:10:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 29/03/1948 0 1
1 Z09.8;I25.9 89.52 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 403655
0 1 0 0 0 SUTARDI.,NY 074646 73 26911 DR. GALIH
RAKASIWI SOEKARNO,SP.JP 1124R0021221V000346 0001828978918 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 343119
1#0##0#0#0.0#2021-12-08
14:11:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 10/03/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 510270
0 1 0 0 0 SAPTAWAN HADI PUTRA.TN 089951 64 23643
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343122
1#0##0#0#0.0#2021-12-08
14:13:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c57408ef4824a008c71b548b5823b3c1 300000 0 0 0 0 0
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3372030 C 3 CP 2 02/12/2021 02/12/2021 23/03/1943 0 1
0 0 - 0 - 0 - 0 - 0 181400 371760
0 1 0 0 0 SAPUWAN.TN 092922 78 28744 DR. GALIH
yani;3302226402970001; 5.5.5.202112011542 4 343124
1#0##0#0#0.0#2021-12-08
14:14:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 14/12/1954 0 1
0 - 0 - 0 - 0 - 0 262000 541780
0 1 0 0 0 KARMIDI.TN 100415 66 24460 DR. GALIH
yani;3302226402970001; 5.5.5.202112011542 4 343126
1#0##0#0#0.0#2021-12-08
14:25:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3045ece02a5121109e8ddb697320cecb 300000 0 0 0 0 0
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3372030 C 3 CP 2 02/12/2021 02/12/2021 31/12/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 244240
0 1 0 0 0 MOCHAMMAD SALEH.NY 094814 78 28826
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343161
1#0##0#0#0.0#2021-12-08
14:27:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
48954df394e94ce59cfb1978b6b01c96 150000 0 0 0 0 0
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3372030 C 3 CP 2 02/12/2021 02/12/2021 13/11/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 678683
0 1 0 0 0 SULASTRI,(NY) 003913 52 19012 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343175
1#0##0#0#0.0#2021-12-08
14:29:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d0fb81935514a2fb76e5125ceeb63666 150000 0 0 0 0 0
0 31845 0 0 15000 0 481838 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 08/04/1959 0 2
1 Z09.8;J45.9;K21.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 380897
0 1 0 0 0 KATINI., NY 045388 62 22884 DR. ANITA
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yani;3302226402970001; 5.5.5.202112011542 4 343184
1#0##0#0#0.0#2021-12-08
14:30:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 17/08/1970 0 1
1 Z09.8;J44.9;J06.9;I10 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 584773
0 1 0 0 0 YOUNG HENDRIK., BP 046165 51 18735
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343186
1#0##0#0#0.0#2021-12-08
14:31:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 21/04/1968 0 1
1 Z09.8;J42;J06.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 404686
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19583 DR. ANITA MUNTAFIAH, SP.P., M.KES 1124R0021221V000356
0001524757869 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343190 1#0##0#0#0.0#2021-12-08
14:36:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 13/06/1983 0 2
0 0 - 0 - 0 - 0 - 0 181400 218995
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yani;3302226402970001; 5.5.5.202112011542 4 343197
1#0##0#0#0.0#2021-12-08
14:37:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 07/09/1976 0 1
1 Z09.8;R10.4;N20.0 88.76 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400 781213
0 1 0 0 0 SLAMET SANTOSO, TN 100426 45 16522
novia;3313125201940001; 5.5.5.202112011542 4 344008
1#0##0#0#0.0#2021-12-14
09:27:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 29/12/1959 0 2
1 Z09.8;B90.9;K21.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 263702
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yani;3302226402970001; 5.5.5.202112011542 4 343199
1#0##0#0#0.0#2021-12-08
14:39:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 21/02/1952 0 1
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343201 1#0##0#0#0.0#2021-12-08
14:40:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 04/06/1952 0 1
1 Z09.8;B90.8;E11.9;I10 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 233586
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yani;3302226402970001; 5.5.5.202112011542 4 343204
1#0##0#0#0.0#2021-12-08
14:50:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 02/12/2021 02/12/2021 05/02/1967 0 2
1 Z09.8;A18.2;J42 - - - None None None None Q-5-44-0
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yani;3302226402970001; 5.5.5.202112011542 4 343205
1#0##0#0#0.0#2021-12-08
14:53:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6e397fac99c95089b59de989347eaa4d 150000 0 0 0 0 0
0 0 0 0 15000 0 87156 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 21/11/1939 0 1
1 Z09.8;J42;K59.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 249631
0 1 0 0 0 MOCHAMAD SALEH.TN 088898 82 29962 DR.
ANITA MUNTAFIAH, SP.P., M.KES 1124R0021221V000365 0000089866045 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 343209
1#0##0#0#0.0#2021-12-08
14:56:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0a5c1f4706ee6a7a62cae962447275ce 150000 0 0 0 0 0
0 0 0 0 15000 0 84631 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 13/08/1985 0 2
0 0 - 0 - 0 - 0 - 0 181400 198380
0 1 0 0 0 PIPIT DWI WAHYUNI.NY 100402 36 13260
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343210
1#0##0#0#0.0#2021-12-08
14:57:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
db2dfd00c93f904d04e766153906346b 150000 0 0 0 0 0
0 0 0 0 15000 0 33380 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 15/07/1938 0 2
0 0 - 0 - 0 - 0 - 0 181400 203566
0 1 0 0 0 KUSTINI, NY 100427 83 30456 DR. RINA
5.5.5.202112011542 4 343212 1#0##0#0#0.0#2021-12-08
14:59:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ad1727ac888e18de4ba6d5d4f3fc8cd5 150000 0 0 0 0 0
0 0 0 0 25000 0 28566 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 05/04/1961 0 2
1 D24 88.73 - - None None None None Z-3-23-0 None None
- 0 - 0 - 0 - 0 549400 938822 0
1 0 0 0 SITI ROCHANI.NY 099125 60 22175 DR.
novia;3313125201940001; 5.6.5.202203091809 4 357825
1#0##0#0#0.0#2022-03-16
07:58:49#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
187193071bc8d89a00fb9b9fe0cf4164 235000 0 0 0 0 0
680000 0 0 0 15000 0 8822 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 27/11/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 240172
0 1 0 0 0 RUWI HERUNI.NY 099818 56 20459 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343213
1#0##0#0#0.0#2021-12-08
15:01:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
214599c90ae83171d144cf0fe0fb8ce8 150000 0 0 0 0 0
0 0 0 0 15000 0 75172 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 10/06/1996 0 2
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 ANDAR RAHMA ADIANI, NN 100429 25 9306
yani;3302226402970001; 5.5.5.202112011542 4 343215
1#0##0#0#0.0#2021-12-08
15:03:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
48c97eca65408b722178c1c2126b0256 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 31/12/1950 0 2
1 Z09.8;M17.9 93.89 - - None None None None Z-3-12-0 None
- 0 - 0 - 0 - 0 138400 240000 0
1 0 0 0 NGATIYEM, NY 093762 70 25904 DR. LINDA
SUGIARTO, SP.FKR 1124R0021221V000372 0002940595885 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 343268
1#0##0#0#0.0#2021-12-09
08:57:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6d15b7e8796d6ce7b30e8e3109a312bf 225000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 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; 5.5.5.202112011542 4
343273 1#0##0#0#0.0#2021-12-09
09:02:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
136319164cb0963a6b035065ad4da61e 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
343278 1#0##0#0#0.0#2021-12-09
09:05:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9708d0ac5b6b689ca27dbee0d814778c 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 28/12/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 247875
0 1 0 0 0 NURHAYATI.NY 081101 71 26272 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343217
1#0##0#0#0.0#2021-12-08
15:04:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1cf49a2e200fba62c1ea97e58931a3b4 150000 0 0 0 0 0
0 0 0 0 15000 0 82875 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 30/07/1994 0 1
1 R50.9 - - - None None None None Q-5-42-0 None None
- 0 - 0 - 0 - 0 182600 114962 0
1 0 0 0 SHELVIA KUMALA ARYSSANTY.NY 079331 27 9987
dr. ANDANG 1124R0021221V000376 0002739184233 3;JKN
agung;3313092303950002; 5.6.6.202203301209 4 346615
1#0##0#0#0.0#2022-04-14
13:01:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
238c519d432d50577650d994492117fc 95000 0 0 0 0 0 0
0 0 0 15000 0 4962 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
343279 1#0##0#0#0.0#2021-12-09
09:06:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
00ce30ec9ff34a0eb88d2b761e0c5e8d 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 01/11/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 207133
0 1 0 0 0 KUSTIATI, NY 048553 60 21946 DR.
novia;3313125201940001; 5.6.3.202201201500 4 343218
1#0##0#0#0.0#2022-03-08
09:19:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
35dbce0949064ba3d539bfd56a8d6638 150000 0 0 0 0 0
0 0 0 0 15000 0 42133 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 27/07/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 193974
0 1 0 0 0 SARGIYATI., NY 044405 59 21678 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343219
1#0##0#0#0.0#2021-12-08
15:05:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c87ba332505b1fb00258a3a8cf85f58a 150000 0 0 0 0 0
0 0 0 0 15000 0 28974 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 24/07/1973 0 2
0 - 0 - 0 - 0 - 0 262000 315000
0 1 0 0 0 TRI SULISTYANI, NY 092237 48 17663
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343220
1#0##0#0#0.0#2021-12-08
15:08:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
290164c12ec5c7d02b6bb041796bdfb5 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 17/11/1969 0 1
1 Z09.8;E11.9;H81.3 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 169260
0 1 0 0 0 SANYOTO, TN 092458 52 19008 DR. ARYO
yani;3302226402970001; 5.5.5.202112011542 4 343221
1#0##0#0#0.0#2021-12-08
15:11:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c802140eaca7a292ae66ad575d8d92a4 150000 0 0 0 0 0
0 0 0 0 15000 0 4260 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 06/11/1942 0 2
1 Z09.8;I69.3;F03 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 347685
0 1 0 0 0 SRI HANDIKIN, (NY) 014579 79 28881
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 343223
1#0##0#0#0.0#2022-04-14
11:43:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
83c7c721dbec3773ae1a3729fe4bfb0b 150000 0 0 0 0 0
0 0 0 0 15000 0 182685 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 08/07/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 524288
0 1 0 0 0 HERMAWAN WIJAYA,TN 051189 54 19871
novia;3313125201940001; 5.6.3.202201201500 4 343224
1#0##0#0#0.0#2022-03-08
08:35:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
0ec9ceda541afc43b45e2c5da0450d4d 150000 0 0 0 0 0
0 0 0 0 15000 0 359288 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 20/12/1977 0 2
1 G56.0;M19.98 87.24 - - 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 456042 0 1 0 0 0 DEISY CHRISTIANTY.NY
1124R0021221V000384 0000640749813 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 344009 1#0##0#0#0.0#2021-12-14
09:28:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1b69c2164e29e0d1abb9ee24aba35e31 150000 0 0 0 0 0
220000 0 0 0 25000 0 61042 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 15/09/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 613568
0 1 0 0 0 BERO ANTINI NY 067917 54 19802 DR.
novia;3313125201940001; 5.6.3.202201201500 4 343225
1#0##0#0#0.0#2022-03-08
08:48:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
473b6f9c1ffe456597b1bf0cd4a38189 150000 0 0 0 0 0
0 0 0 0 15000 0 448568 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 31/12/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 464738
0 1 0 0 0 WATINAH, NY 100109 50 18599 DR. ARYO
novia;3313125201940001; 5.6.3.202201201500 4 343226
1#0##0#0#0.0#2022-03-08
08:42:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
cf751d605ea31fde9a6a7f3c9c6c9984 150000 0 0 0 0 0
0 0 0 0 15000 0 299738 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 24/06/1947 0 1
1 Z09.8;R18;N30.9 88.76 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400 934910
0 1 0 0 0 SUYOTO, TN 094459 74 27190 DR. ARYO
novia;3313125201940001; 5.5.5.202112011542 4 344010
1#0##0#0#0.0#2021-12-14
09:29:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
21af76503d99eca2492d0cc27fdbfc20 150000 0 0 0 0 0
657000 0 0 0 15000 0 112910 0 0 0 0
0
3372030 C 3 CP 2 02/12/2021 02/12/2021 29/06/1981 0 1
1 Z09.8;N39.0;N28.1 88.75 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400 903170
0 1 0 0 0 NUR HERIYATO, TN 094728 40 14766 DR.
novia;3313125201940001; 5.6.3.202201201500 4 353794
1#0##0#0#0.0#2022-02-16
07:41:28#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
c5d17cc7c5def2bd9909d60f2e255ca7 150000 0 0 0 0 0
680000 0 0 0 15000 0 58170 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 10/08/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 262720
0 1 0 0 0 SARMI LESTARI,(NY) 039757 66 24221
yani;3302226402970001; 5.5.5.202112011542 4 343228
1#0##0#0#0.0#2021-12-09
08:13:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
30d61110ce3c7020b3c44527e942f605 150000 0 0 0 0 0
0 0 0 0 15000 0 97720 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 05/03/1973 0 2
1 M54.39;M19.98 87.24 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 456042
0 1 0 0 0 DANIK KARTIKA SUSILOWATI, NY 100481 48
17804 DR. ARIA CHANDRA GTS, SP.S., M.KES 1124R0021221V000390
0001445069981 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
344011 1#0##0#0#0.0#2021-12-14
09:31:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
650cb8c89316aa4d95c44845aca6fdfb 150000 0 0 0 0 0
220000 0 0 0 25000 0 61042 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 30/01/1975 0 2
1 Z09.8;I10 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 219401
0 1 0 0 0 CHOIRUN NISYA, NY 093236 46 17108 DR.
novia;3313125201940001; 5.6.3.202201201500 4 343229
1#0##0#0#0.0#2022-03-08
11:50:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
8f80cbcfba0d6cf37aa2d0be05294a17 150000 0 0 0 0 0
0 0 0 0 15000 0 54401 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 27/10/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 227011
0 1 0 0 0 RUSTANTINI., NY 050518 69 25238 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343230
1#0##0#0#0.0#2021-12-09
08:16:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
409b68480d3bd6e0e3b74fa2660bdc6f 150000 0 0 0 0 0
0 0 0 0 15000 0 62011 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 09/03/1969 0 1
0 - 0 - 0 - 0 786200 956495 0 1
0 0 0 NGADIYO, TN 011624 52 19261 DR. TEKY WIDYARINI,
SP.PD 1124R0021221V000399 0001105068789 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343231 1#0##0#0#0.0#2021-12-09
08:19:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
22d8bc07430f05fd5d5ce89219af27b2 662676 0 0 0 0 0
0 238700 0 0 15000 0 40119 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 09/05/1975 0 1
0 - 0 - 0 - 0 786200 662670 0 1
0 0 0 RAHMAN, TN 097908 46 17009 DR. TEKY WIDYARINI,
SP.PD 1124R0021221V000400 0001105378571 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343232 1#0##0#0#0.0#2021-12-09
08:20:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d960d0ef367f30630456ff78d7518a21 463830 0 0 0 0 0
0 133800 0 0 15000 0 50040 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 12/07/1966 0 1
0 - 0 - 0 - 0 786200 724350 0 1
0 0 0 UNTUNG SUMARJONO, TN 024024 55 20232 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 343233
1#0##0#0#0.0#2021-12-09
08:21:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
97676b02d544e1752709a696ae8a564c 463830 0 0 0 0 0
0 133800 0 0 15000 0 111720 0 0 0 0
0
3372030 C 3 CP 2 02/12/2021 02/12/2021 12/12/1964 0 1
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 M. SARBIAN, TN 090907 56 20809 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 343234
1#0##0#0#0.0#2021-12-09
08:22:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d8d5b5a3c351c226e27913a0e5cb26e6 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 22/10/1959 0 2
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 TUTUT DARYANI.NY 087431 62 22687 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 343237
1#0##0#0#0.0#2021-12-09
08:25:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cbc2790ed45eeccada1729b8caeae0b5 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 28/08/1964 0 1
1 Z09.8;E78.5;E79.0;K76.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 246423
0 1 0 0 0 SLAMET RUDI SETYAWAN, TN 000730 57
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343238
1#0##0#0#0.0#2021-12-09
08:26:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0b0076645bc010acca5c07e0251cf299 150000 0 0 0 0 0
0 0 0 0 15000 0 81423 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 11/04/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 246510
0 1 0 0 0 TIMMY DASILVA,(BP) 022374 43 15941
yani;3302226402970001; 5.5.5.202112011542 4 343239
1#0##0#0#0.0#2021-12-09
08:27:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
069cfcee7a4fe962f42c102f28a5c385 150000 0 0 0 0 0
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3372030 C 3 CP 2 02/12/2021 02/12/2021 28/02/1967 0 2
0 - 0 - 0 - 0 786200 612630 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 343241
1#0##0#0#0.0#2021-12-09
08:33:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7fd79bc3174d349310119d70631f4497 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 12/08/1977 0 1
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 HERGIUS GIYONO, TN 051343 44 16183 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 343242
1#0##0#0#0.0#2021-12-09
08:34:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1d678355cb10acfb06a3c7dcbd495bc7 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 03/08/1963 0 2
0 - 0 - 0 - 0 786200 963046 0 1
0 0 0 SITI ROCHMAH, NY 039323 58 21306 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 343243
1#0##0#0#0.0#2021-12-09
08:35:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7c1b2de4572bfdde0a4c99a712f8daf2 463830 0 0 0 0 0
0 238700 0 0 15000 0 245516 0 0 0 0
0
3372030 C 3 CP 2 02/12/2021 02/12/2021 31/12/1971 0 2
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 SUYATMI, NY 051869 49 18234 DR. TEKY WIDYARINI,
SP.PD 1124R0021221V000409 0000555344774 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343244 1#0##0#0#0.0#2021-12-09
08:36:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ff3c5b7389631ddbbb25f9db58db8a8f 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 12/08/1964 0 2
1 Z09.8;H81.3;G43.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 211110
0 1 0 0 0 IDA NURSANTI, NY 100228 57 20931 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343245
1#0##0#0#0.0#2021-12-09
08:37:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
13ce30628dddb6d2db1b7894b3002040 150000 0 0 0 0 0
0 0 0 0 15000 0 46110 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 05/06/1956 0 1
1 I69.3;G40.9 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 243033
0 1 0 0 0 WINARYO SAPUTRO.TN 100410 65 23921
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343246
1#0##0#0#0.0#2021-12-09
08:38:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eb772d7e86a33218c31e01479529df8d 150000 0 0 0 0 0
0 0 0 0 15000 0 78033 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 30/09/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 204176
0 1 0 0 0 YATMO, BP 086365 56 20517 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 343247
1#0##0#0#0.0#2021-12-09
08:41:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e7ec66e95d3859b3455346b9dac7a5fd 150000 0 0 0 0 0
0 0 0 0 15000 0 39176 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 04/05/1940 0 1
0 0 - 0 - 0 - 0 - 0 181400 294892
0 1 0 0 0 SUKIR AGUS WIRATMOKO, TN 026036 81
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343248
1#0##0#0#0.0#2021-12-09
08:42:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8ad625ff081ec3ffe8dcb08eb826e70d 150000 0 0 0 0 0
0 0 0 0 15000 0 129892 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 29/12/1958 0 1
1 Z09.8;G20;I69.3 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 639350
0 1 0 0 0 SUBAKDI,TN 075900 62 22984 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 343249
1#0##0#0#0.0#2021-12-09
08:43:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ab564bf7b4663fa6234400f8dbabc6c2 150000 0 0 0 0 0
0 0 0 0 15000 0 474350 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 11/12/1967 0 1
1 I69.3;M54.39 87.24 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 424292
0 1 0 0 0 SANTOSO.TN 100412 53 19715 DR. ARIA
novia;3313125201940001; 5.5.5.202112011542 4 344012
1#0##0#0#0.0#2021-12-14
09:32:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d43f2a25bac68025324dedad3d11aadf 150000 0 0 0 0 0
220000 0 0 0 15000 0 39292 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 02/07/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 210140
0 1 0 0 0 SRI SLAMET.NY 099401 50 18416 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343250
1#0##0#0#0.0#2021-12-09
08:44:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d140019b145a42e57f74aba132048ba5 150000 0 0 0 0 0
0 0 0 0 15000 0 45140 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 26/12/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 199580
0 1 0 0 0 NANIK ISNAENY, NY 091348 57 21161 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343251
1#0##0#0#0.0#2021-12-09
08:45:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0fafe72d22b21811463a980ca8438238 150000 0 0 0 0 0
0 0 0 0 15000 0 34580 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 25/03/1939 0 1
1 Z09.8;J44.9;M54.39 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 439210
0 1 0 0 0 ACHMAD KUMAIDI, TN 072054 82 30203
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343252
1#0##0#0#0.0#2021-12-09
08:46:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
59ab77036166b031d757acfbaead081f 150000 0 0 0 0 0
0 0 0 0 15000 0 274210 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 20/03/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 232675
0 1 0 0 0 SLAMET RIYADI.TN 091975 60 22172 DR.
novia;3313125201940001; 5.6.3.202201201500 4 343254
1#0##0#0#0.0#2022-02-15
13:12:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
0353f5137c12fa5356843068f2adb0da 150000 0 0 0 0 0
0 0 0 0 15000 0 67675 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 25/01/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 229705
0 1 0 0 0 TATAG HESTI MARDIANTI,NY 071552 56
0000091016201 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343255 1#0##0#0#0.0#2021-12-09
08:48:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cd18c60a3a27b5cf563a43afc338095a 150000 0 0 0 0 0
0 0 0 0 15000 0 64705 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 31/12/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 226770
0 1 0 0 0 INDRAYATI, NY 091755 57 21156 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343257
1#0##0#0#0.0#2021-12-09
08:49:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fe8e945fb800e4558abb1bed0ab8edb0 150000 0 0 0 0 0
0 0 0 0 15000 0 61770 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 07/11/1940 0 1
1 Z09.0;H16.0;Z96.1;H26.9;H35.0 90.29 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
307965 0 1 0 0 0 RAJI.TN 098563 81 29610
novia;3313125201940001; 5.6.3.202201201500 4 343259
1#0##0#0#0.0#2022-02-15
12:02:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
1a8848a85eddb63832a5b520ca29846e 203000 0 0 0 0 0
0 0 0 0 15000 0 89965 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 01/10/1937 0 1
0 0 - 0 - 0 - 0 - 0 181400 214965
0 1 0 0 0 SOEKROJONO 70675 84 30743 DR. ARIA CHANDRA
GTS, SP.S., M.KES 1124R0021221V000426 0000091322357 3;JKN
yani;3302226402970001; 5.6.0.202201041418 4 348108
1#0##0#0#0.0#2022-01-07
19:44:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eea726bad2032e70f88965548e90b9ec 150000 0 0 0 0 0
0 0 0 0 15000 0 49965 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 01/02/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 308250
0 1 0 0 0 LISTIYANI, NY 100278 44 16375 DR.
reni;3313147010930001; 5.6.0.202201041418 4 343262
1#0##0#0#0.0#2022-01-07
19:50:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
91375cef9bafea7397c6e3fa2a456430 150000 0 0 0 0 0
0 0 0 0 15000 0 143250 0 0 0 0 0
3372030 C 3 CP 2 02/12/2021 02/12/2021 29/04/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400
1024222 0 1 0 0 0 TITIK PERMANI.NY 084313 63
yani;3302226402970001; 5.5.5.202112011542 4 343264
1#0##0#0#0.0#2021-12-09
08:52:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
aa008b2fa5770e553806f8fb502ce6be 150000 0 0 0 0 0
0 0 0 0 15000 0 859222 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 11/01/2002 0 1
1 R10.4;R51 - - - None None None None Q-5-25-0 None
None None None None None GASTROINTESTINAL AKUT 135700 0 0
- 0 - 0 - 0 - 0 135700 132440 0
1 0 0 0 JENNY FIAOZA, NN 100439 19 7266 RIZA
ABDILLAH 1124R0021221V000431 0000163887017 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346616 1#0##0#0#0.0#2022-01-04
13:16:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ef75918c39dfc0246af0d8a953ea86f5 0 0 75000 0 0 0 0
0 0 0 25000 0 32440 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 22/05/1982 0 1
1 R10.4;N23 - - - None None None None Q-5-25-0 None
- 0 - 0 - 0 - 0 135700 197543 0
1 0 0 0 MENDY KURNIAWAN, TN 100440 39 14440 DR.
DANISWARA ADHITIA RAHMAN 1124R0021221V000432 0002166941362 3;JKN
novia;3313125201940001; 5.5.5.202112011542 4 346617
1#0##0#0#0.0#2022-01-04
13:17:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f56b6c701cf556109cc420dd8ed30c90 150000 0 0 0 0 0
0 0 0 0 25000 0 22543 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 31/10/1984 0 1
2 Z09.4;S72.80;V28.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 FREDIANSYAH EKO, BP 067553 37 13547
novia;3313125201940001; 5.5.5.202112011542 4 343295
1#0##0#0#0.0#2021-12-09
11:19:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1535044046fd61b1af1524061f53b6b2 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 09/11/1965 0 2
1 S52.50;W01.5 88.21 - - None None None None Q-5-31-0
None None None None None None FRAKTUR 129600 0 0 -
0 - 0 - 0 - 0 129600 450322 0 1
0 0 0 SUMIYATI, NY 100486 56 20478 DR. WAHYU PURNOMO,
SP.OT 1124R0021221V000434 0000091584066 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 344013 1#0##0#0#0.0#2021-12-14
09:33:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
81bc74d7a1c0bc0186e19ef623ae0221 150000 0 0 0 0 0
248000 0 0 0 15000 0 37322 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 21/08/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 220544
0 1 0 0 0 MUSNATIN., NY 071462 73 26767 DR.
agung;3313092303950002; 5.6.6.202203301209 4 343301
1#0##0#0#0.0#2022-04-14
12:58:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
cb54a3619c35bcd3c710d2c5e234b369 150000 0 0 0 0 0
0 0 0 0 15000 0 55544 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 23/03/1950 0 2
1 Z09.8;M25.00;M54.59 87.24 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 513264
0 1 0 0 0 MARSINI., NY 048442 71 26188 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344014
1#0##0#0#0.0#2021-12-14
09:35:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d40d397a3f26fa28b27a791aca7ba72b 150000 0 0 0 0 0
290000 0 0 0 15000 0 58264 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 06/06/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 223910
0 1 0 0 0 UMI NAFIAH. NY 076253 47 17347 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343302
1#0##0#0#0.0#2021-12-09
11:26:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1d4a4cfdd168dc86a98652e3e43fbd90 150000 0 0 0 0 0
0 0 0 0 15000 0 58910 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 18/05/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 347102
0 1 0 0 0 SAMIYATI.NY 094791 71 26132 DR. WAHYU
agung;3313092303950002; 5.6.6.202203301209 4 343303
1#0##0#0#0.0#2022-04-14
13:34:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
ea4d353ff1e3e09950c73cd318f7291c 150000 0 0 0 0 0
0 133650 0 0 15000 0 48452 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 31/12/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 216192
0 1 0 0 0 SURANI, NY 063638 58 21522 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 343304
1#0##0#0#0.0#2021-12-09
11:27:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
089865fbe98567f436248bff4c945a95 150000 0 0 0 0 0
0 0 0 0 15000 0 51192 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 31/12/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 509152
0 1 0 0 0 HARYANTI, NY 094139 61 22618 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344015
1#0##0#0#0.0#2021-12-14
09:37:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b0ee37597e711d438d911ee68ac1ee27 150000 0 0 0 0 0
290000 0 0 0 15000 0 54152 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 26/09/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 344632
0 1 0 0 0 NUR HARYANTI, NY 072077 62 22714 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343305
1#0##0#0#0.0#2021-12-09
11:28:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d540bcc1308fe0725927b22f8975df80 150000 0 0 0 0 0
0 134250 0 0 15000 0 45382 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 28/03/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 219920
0 1 0 0 0 MV SUMARNI, NY 094104 64 23626 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343306
1#0##0#0#0.0#2021-12-09
11:29:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
53904e9a2cac3ad3688f374b45103ee1 150000 0 0 0 0 0
0 0 0 0 15000 0 54920 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 27/12/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 366300
0 1 0 0 0 SRI HARTINAH, NY 060277 65 24083 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343307
1#0##0#0#0.0#2021-12-09
11:31:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6207748fce7896d0e457c129c73eaef8 300000 0 0 0 0 0
0 0 0 0 15000 0 51300 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 31/12/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 226362
0 1 0 0 0 SARSIYEM.NY 091368 71 26270 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 343308
1#0##0#0#0.0#2021-12-09
11:35:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b8219d9ab423c9e0e26438b71dd44efa 150000 0 0 0 0 0
0 0 0 0 15000 0 61362 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 02/05/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 482428
0 1 0 0 0 RUMIATI 086640 49 18112 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 343309
1#0##0#0#0.0#2021-12-09
11:38:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
aff40a29cfde18a2d1a422dd9672f138 150000 0 0 0 0 0
0 0 0 0 15000 0 317428 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 20/08/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 216942
0 1 0 0 0 MUCHAMMAD NASROEN., BP 045899 71 26038
novia;3313125201940001; 5.5.5.202112011542 4 343310
1#0##0#0#0.0#2021-12-09
11:39:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8a296c149f5f53e8e24928b41baf0cb5 150000 0 0 0 0 0
0 0 0 0 15000 0 51942 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 02/10/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 207392
0 1 0 0 0 ASRI LISTYARINI.NY 098990 51 18690
agung;3313092303950002; 5.6.6.202203301209 4 343315
1#0##0#0#0.0#2022-04-14
13:44:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
ded4fd7348fed6d3220aa9b803cbcb6b 150000 0 0 0 0 0
0 0 0 0 15000 0 42392 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 05/08/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 219492
0 1 0 0 0 MARYATI.NY 099552 60 22035 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 343311
1#0##0#0#0.0#2021-12-09
11:43:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a128769ea8be6a640d36b1402b568ce7 150000 0 0 0 0 0
0 0 0 0 15000 0 54492 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 07/07/1957 0 2
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 388162 0 1 0 0 0 ENI PUJI ASTUTI
093122 64 23525 DR. WAHYU PURNOMO, SP.OT 1124R0021221V000451
0002477029059 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
343312 1#0##0#0#0.0#2022-04-14
13:31:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
06b1d24f340288d9b436ca2688cc49ae 150000 0 0 0 0 0
0 0 0 0 15000 0 223162 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 02/12/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 434622
0 1 0 0 0 ENDANG MARDIASMANI.NY 090524 64 23377
novia;3313125201940001; 5.6.3.202201201500 4 343314
1#0##0#0#0.0#2022-02-15
13:07:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
e1af96412ea40dbc00d08d2ab69e2591 351500 0 0 0 0 0
0 0 0 0 15000 0 68122 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 10/04/1958 0 2
0 404900 388162 0 1 0 0 0 SRI HARTATI.NY
0002459330425 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343316 1#0##0#0#0.0#2021-12-09
11:55:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a507a2ca9c8e962065b7db9b3859bca0 150000 0 0 0 0 0
0 0 0 0 15000 0 223162 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 18/04/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 180660
0 1 0 0 0 SUPRIYANI.NY 098108 43 15935 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343317
1#0##0#0#0.0#2021-12-09
11:58:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dca74813c41badf2c7f73aeb34f88ff5 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 20/12/1993 0 1
2 S83.5;W38.3 - - - 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 165000
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novia;3313125201940001; 5.5.5.202112011542 4 343318
1#0##0#0#0.0#2021-12-09
12:00:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 03/12/2021 03/12/2021 15/05/1967 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
614337 0 1 0 0 0 WARTANTI HANDONO, NY 081889
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344016 1#0##0#0#0.0#2021-12-14
09:38:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4bb2c40e04702f59b8bbbf9d3891b5ab 150000 0 0 0 0 0
220000 31845 0 0 15000 0 197492 0 0 0 0
0
3372030 C 3 CP 2 03/12/2021 03/12/2021 19/09/1949 0 1
1 Z09.8;I25.9;K30;E79.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 404026
0 1 0 0 0 SURIPNO, TN 067208 72 26373 DR. TEKY
novia;3313125201940001; 5.5.5.202112011542 4 343319
1#0##0#0#0.0#2021-12-09
12:01:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0
3372030 C 3 CP 2 03/12/2021 03/12/2021 08/12/1957 0 2
1 Z09.8;E11.4;G59.0;I10;M19.98 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
405886 0 1 0 0 0 PANINGSIH,(NY) 005331 63
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 343320
1#0##0#0#0.0#2021-12-09
12:02:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 03/12/2021 03/12/2021 07/08/1965 0 2
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novia;3313125201940001; 5.5.5.202112011542 4 343321
1#0##0#0#0.0#2021-12-09
12:03:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 03/12/2021 03/12/2021 31/12/1959 0 1
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novia;3313125201940001; 5.5.5.202112011542 4 343450
1#0##0#0#0.0#2021-12-09
12:18:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c0fc49e3b061143f3dd9f00266ba62bc 150000 0 0 0 0 0
220000 133650 0 0 25000 0 81735 0 0 0 0
0
3372030 C 3 CP 2 03/12/2021 03/12/2021 16/05/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 245442
0 1 0 0 0 MINAN, TN 064501 64 23577 DR. TEKY
novia;3313125201940001; 5.5.5.202112011542 4 343322
1#0##0#0#0.0#2021-12-09
12:19:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4cab43009e4fe6295aca27b243ba709a 150000 0 0 0 0 0
0 31845 0 0 15000 0 48597 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 31/12/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400
1167803 0 1 0 0 0 MARIKEM .NY 038228 51 18965
novia;3313125201940001; 5.5.5.202112011542 4 343323
1#0##0#0#0.0#2021-12-09
12:21:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8641f8469f55ed80ed2c21fb28f37936 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 21/03/1973 0 2
1 Z09.8;R10.4;M79.18 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 253610
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novia;3313125201940001; 5.5.5.202112011542 4 343578
1#0##0#0#0.0#2021-12-10
12:53:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 03/12/2021 03/12/2021 05/08/1966 0 1
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0 0 - 0 - 0 - 0 - 0 211200 246186
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novia;3313125201940001; 5.6.3.202201201500 4 343324
1#0##0#0#0.0#2022-02-15
12:07:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 03/12/2021 03/12/2021 13/03/1993 0 2
0 - 0 - 0 - 0 - 0 296400 178845
0 1 0 0 0 IS AMBARSARI, NY 071177 28 10492 DR.
GUNAWAN, SP.OG 1124R0021221V000467 0001694695858 3;JKN
novia;3313125201940001; 5.5.5.202112011542 4 343325
1#0##0#0#0.0#2021-12-09
12:23:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0c900ae120ab4e43e09cee9c0b92672e 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 12/02/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 353190
0 1 0 0 0 HARYANTI.NY 090256 62 22940 DR. TEKY
novia;3313125201940001; 5.5.5.202112011542 4 343327
1#0##0#0#0.0#2021-12-09
13:57:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4aada33df245f6ab286223ea7b978233 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 01/09/1979 0 2
1 Z09.8;D64.8;R51 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 193092
0 1 0 0 0 ANDHI TRI HARTANTI,(NY) 002243 42 15434
novia;3313125201940001; 5.5.5.202112011542 4 343328
1#0##0#0#0.0#2021-12-09
13:58:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7bf07624eafd5c4f884ecbe32b474596 0 0 138000 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 21/09/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 222712
0002261390455 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343332 1#0##0#0#0.0#2021-12-09
14:00:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4975a11d103011c29859bdf8b26566a9 150000 0 0 0 0 0
0 0 0 0 15000 0 57712 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 29/01/1983 0 2
0 0 - 0 - 0 - 0 - 0 181400 241245
0 1 0 0 0 ANIK SUPRIYANI.NY 100236 38 14188 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343329
1#0##0#0#0.0#2021-12-09
13:59:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9f02e63c5f93c0f26e9ad70ca12ac192 150000 0 0 0 0 0
0 31845 0 0 15000 0 44400 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 13/06/1971 0 2
0 - 0 107400 262000 0 1 0 0 0 SITI
MARDLIYAH.NY 084457 50 18436 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000473 0002169781694 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 343334 1#0##0#0#0.0#2022-04-14
13:13:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
1bdd375a6739dcfde35e0ffe16680045 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 20/04/1995 0 1
1 Z09.8;H66.9 96.52 - - None None None None U-3-15-0 None
None None None None None PROSEDUR LAIN-LAIN PADA TELINGA, HIDUNG, MULUT
DAN TENGGOROKAN 251000 0 0 - 0 - 0 - 0 -
0 251000 286485 0 1 0 0 0 HARITSA WAHYU
WARDHANI.TN 094578 26 9724 DR. SUDARMAN, SP.THT-BKL(K)
1124R0021221V000474 0002068728254 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343335 1#0##0#0#0.0#2021-12-09
14:03:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
83a8b65eb56ad59555f82b96f40cd424 150000 0 0 0 0 0
0 0 0 0 15000 0 121485 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 23/05/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 356215
0 1 0 0 0 SUDARNI.NY 084470 62 22840 DR. ARIA
novia;3313125201940001; 5.5.5.202112011542 4 343337
1#0##0#0#0.0#2021-12-09
14:03:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e74bddd8481181f63e30457fa9a1ec72 150000 0 0 0 0 0
0 120795 0 0 15000 0 70420 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 27/12/1968 0 2
1 E11.4;G59.0 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 218290
0 1 0 0 0 UMI MARWIYATI., NY 042562 52 19334
novia;3313125201940001; 5.5.5.202112011542 4 343338
1#0##0#0#0.0#2021-12-09
14:04:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cdda7b51068a2ccd4649e03a68af02c8 150000 0 0 0 0 0
0 31845 0 0 15000 0 21445 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 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; 5.5.5.202112011542 4
343339 1#0##0#0#0.0#2021-12-09
14:05:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 03/07/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 LUCIA SRI
YULIANTI,(NY) 020318 52 19146 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000478 0000639909854 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343340 1#0##0#0#0.0#2021-12-09
14:06:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e7d35ca6d72a8484a6483588126c5d43 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 16/01/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 378330
0 1 0 0 0 YHANI HARDININGSIH.NY 094162 60 22236
novia;3313125201940001; 5.5.5.202112011542 4 343342
1#0##0#0#0.0#2021-12-09
14:21:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 213330 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 16/10/1949 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI YEKTI ISMADI,
(NY) 040545 72 26346 DR. LINDA SUGIARTO, SP.FKR 1124R0021221V000480
0000089740067 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343343 1#0##0#0#0.0#2021-12-09
14:23:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3c8aeac1a401412ec0a6b399a54623dc 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 04/06/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0002253764441 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343346 1#0##0#0#0.0#2021-12-09
14:39:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0650801a57933210fa817e98cd7e65df 258000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 08/02/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 736293
0 1 0 0 0 ENDANG KUSDIATI., NY 049276 58 21483
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 343347
1#0##0#0#0.0#2021-12-09
14:40:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5921ffd9eaacd66892265c280e8cf358 0 0 0 0 0 0 0
121345 0 0 15000 0 599948 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 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; 5.5.5.202112011542 4
343349 1#0##0#0#0.0#2021-12-09
14:41:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
df3e2cdb31e2c77a79c4a7778219986d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 02/10/1990 0 2
0 0 - 0 - 0 - 0 - 0 181400 601035
0 1 0 0 0 RINI SYAFRINA.NY 098960 31 11385 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343350
1#0##0#0#0.0#2021-12-09
14:41:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4311d503d48044bf958f11db2aa397ef 300000 0 0 0 0 0
0 76545 0 0 15000 0 209490 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 30/12/1980 0 1
0 0 - 0 - 0 - 0 - 0 181400 524211
0 1 0 0 0 SRIYANTO, TN 049709 40 14948 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343352
1#0##0#0#0.0#2021-12-09
14:42:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f732b256b6050c8acf9e7d9cd6b224e8 150000 0 0 0 0 0
0 63690 0 0 15000 0 295521 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 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; 5.5.5.202112011542 4
343354 1#0##0#0#0.0#2021-12-09
14:43:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
635bb742d496faa47d14646ea8ec8bb5 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 13/09/2003 0 2
TENGGOROKAN 251000 0 0 - 0 - 0 - 0 - 0
251000 286485 0 1 0 0 0 SHERLYN SETIA PUTRI
SUSANTO.NN 100490 18 6656 DR. SUDARMAN, SP.THT-BKL(K)
1124R0021221V000489 0001693922499 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343355 1#0##0#0#0.0#2021-12-09
14:44:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 03/12/2021 03/12/2021 05/06/1950 0 2
1 Z09.8;I10;M17.9;E78.5;K30;M47.86 87.24 - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 480835 0 1 0 0 0 SRIYATI.NY 037397
0001268544306 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
344017 1#0##0#0#0.0#2021-12-14
09:39:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3417a9460e95eb25279ba390e5278840 150000 0 0 0 0 0
220000 0 0 0 15000 0 95835 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 07/12/1946 0 1
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 HADI SUKIR,TN 083931 74 27390 DR. ARYO SUSENO,
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5.5.5.202112011542 4 343600 1#0##0#0#0.0#2021-12-09
14:46:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bf65ea9ef6270eefb0006b08cd8af50e 463830 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 08/03/1967 0 1
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0 0 0 JOKO PRIHATIN, TN 086133 54 19994 DR. ARYO SUSENO,
SP.PD 1124R0021221V000494 0001879909187 3;JKN novia;3313125201940001;
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14:48:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 03/12/2021 03/12/2021 25/06/1975 0 2
1 Z09.8;D24 88.73 - - None None None None Z-3-23-0 None
0 - 0 - 0 - 0 - 0 549400 845000
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DR. HERMAWAN, SP.B 1124R0021221V000495 0001301212348 3;JKN
novia;3313125201940001; 5.5.5.202112011542 4 344018
1#0##0#0#0.0#2021-12-14
09:40:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
08394acb628a0bb9dc26b142f40596d9 150000 0 0 0 0 0
680000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 01/12/1980 0 2
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 SUMARNI.NY 087775 41 14977 DR. ARYO SUSENO, SP.PD
1124R0021221V000496 0000640230884 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343364 1#0##0#0#0.0#2021-12-09
14:49:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d0c135e57952c076750919b11f5ac224 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 01/01/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 189993
0 1 0 0 0 ISTI RAHMAH.NY 097271 56 20790 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343366
1#0##0#0#0.0#2021-12-09
14:50:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e8532336f02cfabd218493debf0b5665 150000 0 0 0 0 0
0 0 0 0 15000 0 24993 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 02/02/1971 0 2
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 SITI NURJANAH, NY 094470 50 18567 DR. ARYO SUSENO,
SP.PD 1124R0021221V000498 0002326843899 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343367 1#0##0#0#0.0#2021-12-09
14:51:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4c87fc3932e07ad8e6052c1fc26252da 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 23/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ERDIANA.NY 087879
0000565638074 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
343370 1#0##0#0#0.0#2022-04-14
13:21:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 5
86c72a6907585ebc0cb3cb716adb8807 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 26/04/1964 0 1
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 SUPRIYANTO, TN 063549 57 21040 DR. DAMAR ARYO,
SP.B 1124R0021221V000500 0002231597002 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343371 1#0##0#0#0.0#2021-12-09
14:54:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
08476665b19176dcc0d8f0cf6997dbc2 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 06/12/1973 0 1
1 Z09.0;D21.5 97.89 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 374270
0 1 0 0 0 SUKAWAN.TN 099963 47 17529 DR. DAMAR
ARYO, SP.B 1124R0021221V000501 0001160631966 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343373 1#0##0#0#0.0#2021-12-09
14:56:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
94853172d9c9308208579673204f5284 356000 0 0 0 0 0
0 0 0 0 15000 0 3270 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 11/07/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 267020
0 1 0 0 0 SRI PARYATI, NY 089422 58 21330 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343375
1#0##0#0#0.0#2021-12-09
14:57:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6f3b1ef8972be9100c6dd69060eda2f3 150000 0 0 0 0 0
0 0 0 0 15000 0 102020 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 17/08/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 186450
0 1 0 0 0 SUWARNI, NY 079454 44 16179 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343376
1#0##0#0#0.0#2021-12-09
14:59:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
55a4dbbff6fcc09579964301349507a8 150000 0 0 0 0 0
0 0 0 0 15000 0 21450 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 20/08/1959 0 1
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 KARDI, TN 075513 62 22751 DR. ARYO SUSENO, SP.PD
1124R0021221V000504 0000571256594 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343377 1#0##0#0#0.0#2021-12-10
08:26:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c22eda101bc445f225991b6c0d994e3a 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 25/05/1972 0 1
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 SULARSO,TN 062923 49 18089 DR. ARYO SUSENO, SP.PD
1124R0021221V000505 0002431552465 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343378 1#0##0#0#0.0#2021-12-10
08:29:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0b04333dd14573eae96ce31c3f4f9a15 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 28/03/1951 0 2
2 Z09.8;C50.9 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 ENDANG SAMIYATI, NY 066320 70 25818
novia;3313125201940001; 5.5.5.202112011542 4 343379
1#0##0#0#0.0#2021-12-10
08:30:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bbe4c280b40fbc76a433e34e3aecbd5b 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 18/01/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 HARDJANINGSIH, NY
0000090992327 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343380 1#0##0#0#0.0#2021-12-10
08:31:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eee54ba58c7b7619f09e544688f3941f 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 01/12/1958 0 2
0 - 0 - 0 - 0 786200 811476 0 1
0 0 0 SUNARTI, NY 067509 63 23013 DR. ARYO SUSENO, SP.PD
1124R0021221V000509 0001436949538 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343381 1#0##0#0#0.0#2021-12-10
08:32:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2bc8ac762b7c0ba3b254cb06d1789e13 662676 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 01/04/1981 0 1
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 GUNAWAN, TN 048814 40 14856 DR. ARYO SUSENO, SP.PD
1124R0021221V000510 0001904830593 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343382 1#0##0#0#0.0#2021-12-10
08:38:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
870b81cc6b2d7750319ff2dfc124baa3 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 10/11/1970 0 1
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 EKO RAHMAT WIDODO,BP 049022 51 18651 DR. ARYO
novia;3313125201940001; 5.5.5.202112011542 4 343383
1#0##0#0#0.0#2021-12-10
08:42:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
07717bc316920a48dd4dc2e1195466bf 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 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 novia;3313125201940001; 5.6.3.202201201500 4
343386 1#0##0#0#0.0#2022-02-15
11:39:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
c7ba4cd0eb6fd104e3655e75bb075f84 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 26/12/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SRI HARDJIYANTI 018002 68 25179 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343387
1#0##0#0#0.0#2021-12-10
08:44:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1f4b3d9a1786a6f0992a5d34915fb1af 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 17/04/1961 0 2
0 - 0 - 0 - 0 786200 811476 0 1
0 0 0 SUMIYATI, NY 046648 60 22145 DR. ARYO SUSENO,
SP.PD 1124R0021221V000515 0001962721888 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343389 1#0##0#0#0.0#2021-12-10
08:44:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fe68d15cc22732e1cbdd5ff95a896372 662676 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 12/06/1972 0 1
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 ICHSAN KAMIL, TN 055519 49 18071 DR. ARYO SUSENO,
SP.PD 1124R0021221V000516 0001844624709 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343392 1#0##0#0#0.0#2021-12-10
08:46:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e0b079cbd1b217fd696836e225486869 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 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; 5.5.5.202112011542 4
343393 1#0##0#0#0.0#2021-12-10
09:04:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
de57bbcacede806b7839ab26199f3c54 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 05/12/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 199938
0 1 0 0 0 KRISTIYANI PUJIASTUTI, NY 068903 64
0000091025436 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343396 1#0##0#0#0.0#2021-12-10
09:05:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
759d1cee304d6f4f388cf8572cf03948 150000 0 0 0 0 0
0 0 0 0 15000 0 34938 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 01/07/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 183795
0 1 0 0 0 SRI NOR H, NY 097994 56 20609 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343397
1#0##0#0#0.0#2021-12-10
09:06:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d087b401d0bc66b2b954b643d819a55e 150000 0 0 0 0 0
0 0 0 0 15000 0 18795 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 01/09/2006 0 2
0 0 - 0 - 0 - 0 - 0 181400 175218
0 1 0 0 0 FEBIOLA VIESTA S, AN 070866 15 5572
0000639436645 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343399 1#0##0#0#0.0#2021-12-10
09:06:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5d4bdb05d6c282f04c0a545b3cf55892 150000 0 0 0 0 0
0 0 0 0 15000 0 10218 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 08/04/1998 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ADHAR DWI IEJANTO.SDR 099808 23 8640 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 343400
1#0##0#0#0.0#2021-12-10
09:07:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b783f230484949cd545e014224fae679 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 09/03/1976 0 1
0 0 - 0 - 0 - 0 - 0 181400 219110
0 1 0 0 0 AGUNG LIS WIDIATMOKO.TN 086312 45 16705
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 343402
1#0##0#0#0.0#2021-12-10
09:08:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5e0661753459455736258837bacf794b 150000 0 0 0 0 0
0 0 0 0 15000 0 54110 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 13/02/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 465862
0 1 0 0 0 ATIK SUNARNI, NY 100495 58 21478 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344019
1#0##0#0#0.0#2021-12-14
09:40:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
90585a1fb3b6b54560a9b1a4458f02b3 150000 0 0 0 0 0
248000 0 0 0 25000 0 42862 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 02/02/1946 0 2
0 0 - 0 - 0 - 0 - 0 181400 197883
0 1 0 0 0 ROMLAH, NY 090067 75 27698 DR. ARIA
novia;3313125201940001; 5.5.5.202112011542 4 343403
1#0##0#0#0.0#2021-12-10
09:08:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
47d836e10853e6add1f80a768ca68242 150000 0 0 0 0 0
0 0 0 0 15000 0 32883 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 18/11/1971 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SUNARNI.NY 099749 50 18278 DRG. VERAWATY,
SP.KG 1124R0021221V000527 0000640622856 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343404 1#0##0#0#0.0#2021-12-10
09:09:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
89886c00a67bc5b27e78eb4e180ca427 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 24/12/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 228600
0 1 0 0 0 JUMILAH, NY 070343 60 22259 DR. ARIA
novia;3313125201940001; 5.5.5.202112011542 4 343406
1#0##0#0#0.0#2021-12-10
10:10:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a375d7d9c8f95cb59decf1dba92c3fdc 150000 0 0 0 0 0
0 0 0 0 15000 0 63600 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 31/12/1954 0 2
1 Z09.8;G56.0;M19.98;R25.1 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
238340 0 1 0 0 0 ASLAMIYAH., NY 043938 66
0001882455941 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343407 1#0##0#0#0.0#2021-12-10
10:11:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e8931645cc66b66938cd13f27b26c131 150000 0 0 0 0 0
0 0 0 0 15000 0 73340 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 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 novia;3313125201940001; 5.5.5.202112011542 4
343409 1#0##0#0#0.0#2021-12-10
10:12:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
872977932c1a0ac4f60aa898bed76327 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 26/05/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 216438
0 1 0 0 0 MENIK PUJIWATI, NY 073634 51 18819
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 343410
1#0##0#0#0.0#2022-04-14
12:58:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
f253a5d4d3a0bd6b6c092e2fde2276de 150000 0 0 0 0 0
0 0 0 0 15000 0 51438 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 12/01/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 342000 0 1 0 0 0 EKO RINI.NY 093223
0000091524159 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
343411 1#0##0#0#0.0#2022-04-14
13:32:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
520053d7aff84ad6dc035a4369c669d3 327000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 14/12/1998 0 1
1 Z09.8;G40.3;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 273781
0 1 0 0 0 DESSY YOGAPURA RAHAYU.NN 099776 22
0001107812801 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343413 1#0##0#0#0.0#2021-12-10
09:11:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8493c5641f43073bf69b90c2e12dba18 150000 0 0 0 0 0
0 0 0 0 15000 0 108781 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 22/12/1994 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 LUSIA CHRISMA., NN 062297 26 9843 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 343414
1#0##0#0#0.0#2021-12-10
09:13:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cd119bf06d126c86002c237d3408de84 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 26/03/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 228615
0 1 0 0 0 L M BASUKI, NY 048110 53 19610 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343415
1#0##0#0#0.0#2021-12-10
09:15:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bda0d86afe1a86209a5b358e0081b615 150000 0 0 0 0 0
0 0 0 0 15000 0 63615 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 02/06/1963 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RUSTAMI. NY 017382 58 21369 DRG. VERAWATY,
SP.KG 1124R0021221V000536 0001102660863 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343416 1#0##0#0#0.0#2021-12-10
09:24:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7e8ba4386435e0eed636f78b70ea2eb1 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 29/03/1968 0 2
None None None None None PROSEDUR KECIL PADA MULUT DAN LIDAH 254400
0 0 - 0 - 0 - 0 - 0 254400 440750
0 1 0 0 0 ARI SURYANI.NY 100179 53 19607 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 343417
1#0##0#0#0.0#2021-12-10
09:24:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5bc04c188861e8b623b6332f6807f11d 400000 0 0 0 0 0
0 0 0 0 15000 0 25750 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 10/11/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 223125
0 1 0 0 0 DIDIK SUGIYARTA.TN 098213 56 20477
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 343419
1#0##0#0#0.0#2022-04-14
13:41:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
63d329749744b7471ead5c8cf03ae818 150000 0 0 0 0 0
0 0 0 0 15000 0 58125 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 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 novia;3313125201940001; 5.5.5.202112011542 4
343420 1#0##0#0#0.0#2021-12-10
09:27:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
99cbf33fb81bf8f9c63fd2e1453a7bf6 258000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 07/08/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 197730
0 1 0 0 0 MUSINAH, NY 100232 59 21668 DR. TEKY
novia;3313125201940001; 5.5.5.202112011542 4 343418
1#0##0#0#0.0#2021-12-10
09:28:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9ef5a996248e2af5c19f3c6e3458de73 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 02/04/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 243275
0 1 0 0 0 SRI SISMIATUN., NY 046455 69 25447
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 343421
1#0##0#0#0.0#2021-12-10
09:29:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5ff738901b35038a744d62a23961782c 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 13/08/1950 0 2
1 Z09.8;I25.9;K30;M19.98 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 246048
0 1 0 0 0 SRI LESTARI . NY 068663 71 26045 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343422
1#0##0#0#0.0#2021-12-10
09:30:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
199d597af831704b4bea2878539c3b18 150000 0 0 0 0 0
0 0 0 0 15000 0 81048 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 21/11/1990 0 1
0 0 - 0 - 0 - 0 - 0 181400 484052
0 1 0 0 0 MUHAMMAD IWAN NOFRIYANTO.TN 100014 31
11335 DR. DAMAR ARYO, SP.B 1124R0021221V000545 0001692792663 3;JKN
novia;3313125201940001; 5.5.5.202112011542 4 343423
1#0##0#0#0.0#2021-12-10
09:31:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
00ce14c986caa71b17574956f26cbd49 454000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 19/12/1974 0 1
0 0 - 0 - 0 - 0 - 0 181400 204355
0 1 0 0 0 ANDI PRASETYA, TN 048229 46 17151 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343619
1#0##0#0#0.0#2021-12-10
09:37:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b68fc24131467b79c34d2b3d743d326a 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 01/08/2001 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 RAHMAT NUR
HIDAYAHT ., SDR 056491 20 7429 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000547 0001615464257 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343424 1#0##0#0#0.0#2021-12-10
09:37:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7e5fa274d141eeca9241ee685941b16d 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 13/07/1953 0 2
1 Z09.8;I10 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 197035
0 1 0 0 0 RUSWATI, NY 086042 68 24980 DR. TEKY
novia;3313125201940001; 5.6.7.202204241238 4 343425
1#0##0#0#0.0#2022-05-10
09:07:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 3
9bdbabdee2f4f6f2a9d8dcb5cfef3241 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 28/08/1953 0 2
1 Z09.8;I64;H81.3 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 240652
0 1 0 0 0 RUKMINI, NY 099276 68 24934 DR. INDRIANY
novia;3313125201940001; 5.5.5.202112011542 4 343426
1#0##0#0#0.0#2021-12-10
09:43:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 03/12/2021 03/12/2021 04/12/1979 0 1
1 M79.18;J42 87.49 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 424261
0 1 0 0 0 KINTARDI, TN 100496 41 15340 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344021
1#0##0#0#0.0#2021-12-14
09:41:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2022c9257696587bb78305ab1a5cb650 150000 0 0 0 0 0
200000 0 0 0 25000 0 49261 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 28/10/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 TEMU MUJIYEM, NY
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343427 1#0##0#0#0.0#2021-12-10
09:44:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2cd15f8a67933522f07b0fcd686921ca 247000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 01/04/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI HARYANI.NY
0000091327274 3;JKN novia;3313125201940001; 5.6.3.202201201500 4
343428 1#0##0#0#0.0#2022-02-15
09:01:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 03/12/2021 03/12/2021 27/08/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 210780
0 1 0 0 0 HANNA AGUSTIN DJORO KANA, NY 091606 44
0001106820718 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343429 1#0##0#0#0.0#2021-12-10
09:45:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ca0e707a43481781f655151c4cd91d9c 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 13/10/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 232562
0 1 0 0 0 NUNUK SUNDARI,(NY) 018287 59 21601
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 343430
1#0##0#0#0.0#2021-12-10
09:46:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
838510e72c5f19a128de9588435f7e42 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 22/12/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 225372
0 1 0 0 0 SUNARTI 095046 61 22627 DR. ARIA
novia;3313125201940001; 5.5.5.202112011542 4 343431
1#0##0#0#0.0#2021-12-10
09:47:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 03/12/2021 03/12/2021 28/09/1940 0 2
0 0 - 0 - 0 - 0 - 0 181400 303200
0 1 0 0 0 IMAKULATA UTAMI, NY 056961 81 29651
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 343432
1#0##0#0#0.0#2021-12-10
09:48:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a6f6da6cadd606bf1b221f702c47d2f4 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 07/01/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 286485
0 1 0 0 0 SUWARNO, TN 100356 61 22611 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343433
1#0##0#0#0.0#2021-12-10
09:48:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ef43a8ac98bf9ff7ed25b1c98edcc821 150000 0 0 0 0 0
0 0 0 0 15000 0 121485 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 16/02/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 241595
0 1 0 0 0 THERESIA MARIA SAPTANINGRUM, NY 051521
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343434 1#0##0#0#0.0#2021-12-10
09:49:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fb976c396d7e41c5e7420935e767a694 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 25/12/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MARIA
HENDRASAPUTRA,NY 100064 66 24450 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000559 0002069991685 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343435 1#0##0#0#0.0#2021-12-10
09:49:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b76bf0b49659960ed2181bb5e9728c8f 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 11/07/1995 0 2
0 - 0 - 0 - 0 283800 316860 0 1
0 0 0 YULIANTI PURWANINGSIH.NN 100489 26 9642 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 343638
1#0##0#0#0.0#2021-12-10
09:51:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1d45aaf66e75622bdd77270a55787f1b 300000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 30/01/1968 0 2
1 Z09.8;I69.3;G40.9;M53.19 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
264800 0 1 0 0 0 YANITA AMBARWATI RETNANINGTYAS, NY
1124R0021221V000561 0001526003381 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343639 1#0##0#0#0.0#2021-12-10
09:53:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8d921f2d9ba73077a8c43b0058c86147 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 24/09/1991 0 2
1 Z09.8;R59.0 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 278680
0 1 0 0 0 ENGGAR SETYANINGRUM.NY 100182 30 11028
DR. HERMAWAN, Sp.B M.Kes 1124R0021221V000562 0001313288021 3;JKN
novia;3313125201940001; 5.5.5.202112011542 4 343437
1#0##0#0#0.0#2021-12-10
09:54:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 03/12/2021 03/12/2021 10/07/1959 0 1
1 Z09.8;I11.9;M17.9;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 396552
0 1 0 0 0 SRI YULIANTO.TN 087644 62 22792 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343438
1#0##0#0#0.0#2021-12-10
09:55:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cb6d41402d7a626e54e4ecb40933370c 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 01/11/1961 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 KUSTIATI, NY
0000090942546 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343439 1#0##0#0#0.0#2021-12-10
09:56:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
10d21be7ed6a5bfd51ea8735fc3e9609 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 07/12/1982 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 HENY TYAS WULANDARI.NY 100488 38 14241 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 343440
1#0##0#0#0.0#2021-12-10
09:59:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2a60af23e570245d78009751722a4bfb 300000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 15/05/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 191970
0 1 0 0 0 SUMI, NY 100128 66 24309 DR. TEKY
novia;3313125201940001; 5.5.5.202112011542 4 343441
1#0##0#0#0.0#2021-12-10
10:00:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
12444a03f294c8031ab88c8bea7cf3bd 150000 0 0 0 0 0
0 0 0 0 15000 0 26970 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 04/11/1994 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 RAUHULLOH
AYATULLOH KHOMEINI.SDR 096022 27 9891 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000570 0001796644269 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343442 1#0##0#0#0.0#2021-12-10
10:00:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2d0299de21bcd6db025dd9af1b43ed57 247000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 12/09/2013 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 REVIANA SAFA
SEPTIANI.AN 099209 8 3004 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000571 0001524813096 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343443 1#0##0#0#0.0#2021-12-10
10:01:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
18611db440b60065ffcae7fd441b97c1 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 03/04/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 242087
0 1 0 0 0 ENDANG PURWANTI 091405 52 19237 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343444
1#0##0#0#0.0#2021-12-10
10:02:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
89f7a1e168b63885ba64377983b2e515 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 29/10/1992 0 2
1 N93.8 88.79 - - None None None None Z-3-23-0 None None
- 0 - 0 - 0 - 0 549400 153000 0
1 0 0 0 OKTAVIANI SELAWATI, NY 055505 29 10627 DR.
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novia;3313125201940001; 5.6.3.202201201500 4 343445
1#0##0#0#0.0#2022-02-14
15:52:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
053f2e4394c27c577a7444d6379242c7 0 0 138000 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 30/01/1966 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 WAHYUNI.NY 082555
0000639464488 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343446 1#0##0#0#0.0#2021-12-10
10:13:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0db3cb3f2644bd81558cdf6995e5b158 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 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; 5.5.5.202112011542 4
343447 1#0##0#0#0.0#2021-12-10
10:14:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1dc764e56d71ac6b8d436072e43934aa 247000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 05/08/1988 0 2
- 0 - 0 - 0 - 0 283800 322580 0
1 0 0 0 CESILIA RATNA INTANI.NY 100170 33 12173 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 343448
1#0##0#0#0.0#2021-12-10
10:15:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 03/12/2021 03/12/2021 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 novia;3313125201940001; 5.5.5.202112011542 4
343471 1#0##0#0#0.0#2021-12-10
10:16:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1a82c9b25bda43e063969594800471c2 258000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 08/12/1949 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SISWO SARJONO,(BP)
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343472 1#0##0#0#0.0#2021-12-10
10:18:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
37de914863097166c02f9616ab208e57 247000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 15/06/1986 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SITI ROCHANI.NY 100171 35 12955 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 343659
1#0##0#0#0.0#2021-12-10
10:16:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
821dee22f4fb9219165e47dd0f0e7de3 300000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 11/06/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 245500
0 1 0 0 0 ENY SULASTRI,(NY) 033228 46 16977 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343473
1#0##0#0#0.0#2021-12-10
10:18:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c146b012ec85960e1d3a00d8aabb1100 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 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 novia;3313125201940001; 5.5.5.202112011542 4
343474 1#0##0#0#0.0#2021-12-10
10:20:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0d155eec3bb3e7321ecb1c014351ca5c 258000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 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; 5.6.6.202203301209 4
343475 1#0##0#0#0.0#2022-04-14
12:51:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
bafcb6c92868535cc26d4ebde73c934e 258000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 05/02/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 218615
0 1 0 0 0 EKO CAHYANI PURWANINGSIH, NY 065567 48
0001100445232 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
343476 1#0##0#0#0.0#2022-04-14
12:55:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
4edaf3bf438aca6f39be1b02d3bae27e 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 10/05/1956 0 2
1 Z09.8;M54.99;M19.99;M54.39 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
237540 0 1 0 0 0 MUJI LASMINI., NY 012326 65
0001965827046 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343477 1#0##0#0#0.0#2021-12-10
10:33:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
28b2be8ef3071327ae397a92558faee8 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 21/12/1978 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 NUR WIJAYANTI.NY 100003 42 15688 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 343478
1#0##0#0#0.0#2021-12-10
10:34:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 03/12/2021 03/12/2021 01/05/1958 0 1
1 Z09.8;M53.19;H81.3 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 218495
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novia;3313125201940001; 5.5.5.202112011542 4 343479
1#0##0#0#0.0#2021-12-10
10:36:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f3749f425027e8f27919117b99d8cfdf 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 17/04/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 206655
0 1 0 0 0 SANTOSO., BP 049990 76 27989 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343480
1#0##0#0#0.0#2021-12-10
10:37:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8ad327a48fb855101cbf20d8e795cbd6 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 26/01/1975 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SRI DINA S, NY 099204 46 17113 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 343482
1#0##0#0#0.0#2021-12-10
10:38:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
28f7e20ab9ddcf5681227464a52dffc3 300000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 03/08/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 213800 0 1 0 0 0 ISMURYANI
HANDAYANINGSIH.NY 098932 58 21307 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000592 0001313177196 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343485 1#0##0#0#0.0#2021-12-10
10:41:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
34b2cfc5201064880b8dc440231cdb9a 0 0 198800 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 08/06/1944 0 1
1 Z09.8;I69.3;G20 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 270350
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novia;3313125201940001; 5.5.5.202112011542 4 343488
1#0##0#0#0.0#2021-12-10
10:43:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4a803889da82941ff6ba42c7df59ff60 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 10/06/1972 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI RAHAYU.NY
0002624809645 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343494 1#0##0#0#0.0#2021-12-10
10:44:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
02df0be48710e8e88641e1b4d3a7d811 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 21/04/1950 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RINDUAN JANUAR., BP 052069 71 26159 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 343497
1#0##0#0#0.0#2021-12-10
10:46:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
67108074298a8a2135e29c4fe0068071 300000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 16/07/1982 0 2
0 - 0 - 0 - 0 283800 343030 0 1
0 0 0 EKA PURWANTI, NY 066827 39 14385 DRG. VERAWATY,
SP.KG 1124R0021221V000596 0000639843377 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343499 1#0##0#0#0.0#2021-12-10
10:47:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5c926aefa7555ca123b304109862702a 300000 0 0 0 0 0
0 0 0 0 15000 0 28030 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 08/08/1950 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 HJ ENDANG SRI ., NY 054099 71 26050 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 343501
1#0##0#0#0.0#2021-12-10
10:48:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b4d273f941d9e3051c73bdc41d687af7 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 01/01/2000 0 2
- 0 - 0 - 0 - 0 283800 495000 0
1 0 0 0 DWI ASTUTI., NN 043539 21 8007 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 343502
1#0##0#0#0.0#2021-12-10
10:50:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
229101582029850ac72b964a251ef6c7 480000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 12/04/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 229393
0 1 0 0 0 SURADI RAHAYU,(BP) 039567 68 25072
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 343504
1#0##0#0#0.0#2021-12-10
10:51:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
75a40f6ed8ddde7fac96b1e45f218b4b 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 21/04/1990 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 KUNTI MARIYANTI.NY 099314 31 11549 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 343505
1#0##0#0#0.0#2021-12-10
10:53:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0f919b39e209598a6e3741ff904f8e61 300000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 06/06/1985 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 TRIYONO. TN 092289 36 13329 DR. DAMAR
5.5.5.202112011542 4 343506 1#0##0#0#0.0#2021-12-10
10:57:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ee64cc03b6cb169e5bdc0f357ac5799d 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 30/11/1962 0 1
1 Z09.8;G20 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 210959
0 1 0 0 0 KUS HARYONO, TN 091114 59 21553 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343507
1#0##0#0#0.0#2021-12-10
10:58:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
610612bfada02c66af9b171fc5333b16 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 15/03/1999 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RESTY LESTARI SIMORANGKIR.NN 099304 22 8299
novia;3313125201940001; 5.5.5.202112011542 4 343508
1#0##0#0#0.0#2021-12-10
10:59:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f2da0fca0481819f4fd412871e25637f 300000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 28/08/1949 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 JUSTINA SAIDJAH.NY 099999 72 26395 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 343509
1#0##0#0#0.0#2021-12-10
10:59:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
076e7c90f828b794cf76e3cb6f894245 300000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 04/09/1996 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RISKY CAHYANE GUMELAR.SDR 099129 25 9221
novia;3313125201940001; 5.5.5.202112011542 4 343510
1#0##0#0#0.0#2021-12-10
11:04:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ca2911ac24884157daaa81eca683ce0a 300000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 31/12/1963 0 2
1 G62.8 - - - 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
207000 0 1 0 0 0 PARNI, NY 100497 57 21157
novia;3313125201940001; 5.5.5.202112011542 4 343511
1#0##0#0#0.0#2021-12-10
11:06:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
3b9085276dc39a79d61a60c4b39b7f8d 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 14/10/1976 0 2
1 R10.4 88.76 - - None None None None Z-3-23-0 None None
- 0 - 0 - 0 - 0 549400 822000 0
1 0 0 0 LUSIA TIYAS WURI.NY 085970 45 16486 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344022
1#0##0#0#0.0#2021-12-14
09:42:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4a485840e3dbf6dc83c9fe3cee1414c4 150000 0 0 0 0 0
657000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 01/07/2000 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MUHAMMAD YUSUF MUKAROM.SDR 099410 21 7825
novia;3313125201940001; 5.5.5.202112011542 4 343512
1#0##0#0#0.0#2021-12-10
11:12:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3d75e5600f5f9e2a3a5eb33536bf1bb4 300000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 16/05/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 352401
0 1 0 0 0 MEIYANTO.TN 096828 52 19194 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 343513
1#0##0#0#0.0#2022-04-14
13:39:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
113733e7f391280ae26ca19aef684da5 150000 0 138000 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 09/04/2003 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ANINDI PUTRI MAHARANI, NN 099384 18 6813
novia;3313125201940001; 5.5.5.202112011542 4 343514
1#0##0#0#0.0#2021-12-10
11:14:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f6200a30ad912ed4e988293290d9521c 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 12/10/1979 0 2
0 - 0 - 0 - 0 283800 316860 0 1
0 0 0 WIWIK TRI HANDAYANI, NY 071497 42 15393 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 343515
1#0##0#0#0.0#2021-12-10
11:15:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
da17f0d3ae958a76c8fed849122feda2 300000 0 0 0 0 0
0 0 0 0 15000 0 1860 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 12/11/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 321224
0 1 0 0 0 SUGIYOTO..BP 048116 67 24493 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343516
1#0##0#0#0.0#2021-12-10
11:16:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
30bd43d455cd3f0bd5602e524c31d35c 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 01/01/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 203907
0 1 0 0 0 SUTOMO SRI UTOMO.TN 095900 68 25173
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 343517
1#0##0#0#0.0#2021-12-10
11:17:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3053cef864b1f867035724fed83420cb 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 08/01/2012 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 BOY JANUARY SAPUTRA.AN 099415 9 3617
0002127222562 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343518 1#0##0#0#0.0#2021-12-10
11:18:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f95a350b49f01b1c6a81d1ab4c57ec74 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 07/07/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 239912
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novia;3313125201940001; 5.5.5.202112011542 4 343519
1#0##0#0#0.0#2021-12-10
11:18:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8b35bb640c3eb3bec3b18a0b935b981e 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 03/07/1945 0 1
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3;JKN novia;3313125201940001; 5.5.5.202112011542 4 343522
1#0##0#0#0.0#2021-12-10
11:19:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4544e5caf4d050575b1ae9dbe04e5dd3 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 13/06/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 206975
0 1 0 0 0 DINI CAHYANINGRUM, NY 098174 42 15514
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 343523
1#0##0#0#0.0#2022-04-14
13:40:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
4ef744619e79a884e825e23660cb990b 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 31/05/1985 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 KHOMSAH JANNATUM.M, NY 033867 36 13335 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 343527
1#0##0#0#0.0#2021-12-10
11:20:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
585e2e930dac97ffdffb9a87978a0cd5 300000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 07/06/1957 0 2
1 H26.9;E11.3;H36.0;H04.1 90.29;16.21 - - None None None None
H-3-12-0 None None None None None None PROSEDUR LAIN-LAIN PADA MATA
211200 0 0 - 0 - 0 - 0 - 0 211200
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novia;3313125201940001; 5.5.5.202112011542 4 343532
1#0##0#0#0.0#2021-12-10
11:21:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0468c16bd82a2537ca63c12f640b3887 406000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 17/03/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 226760
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novia;3313125201940001; 5.5.5.202112011542 4 343538
1#0##0#0#0.0#2021-12-10
11:22:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
599244a21999ecd663b2d18afb859e3d 150000 0 0 0 0 0
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3372030 C 3 CP 2 03/12/2021 03/12/2021 07/02/1969 0 1
1 Z09.8;K21.9 87.49 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 428586
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novia;3313125201940001; 5.5.5.202112011542 4 344023
1#0##0#0#0.0#2021-12-14
09:43:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7f5a1c71c5d4b6562c9bc29543b3be7d 150000 0 0 0 0 0
200000 0 0 0 15000 0 63586 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 19/04/1972 0 2
1 Z09.8;Z96.1;E11.3;H36.0;H26.9 90.29 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
316455 0 1 0 0 0 PARNI, NY 078354 49 18125
novia;3313125201940001; 5.5.5.202112011542 4 343542
1#0##0#0#0.0#2021-12-10
11:23:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 03/12/2021 03/12/2021 03/06/1955 0 1
1 Z09.8;H26.9;Z96.1;H04.1 90.29 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 348660
0 1 0 0 0 RUBIJANTO, TN 099383 66 24290 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343546
1#0##0#0#0.0#2021-12-10
11:24:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
86c9a943735f024305d484078c1753c0 203000 0 0 0 0 0
0 0 0 0 15000 0 130660 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 01/11/1959 0 2
1 I63.9;M54.39 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 1477752 0
1 0 0 0 NUNUK WINARNI, NY 100435 62 22678 DR. ARIA
novia;3313125201940001; 5.5.5.202112011542 4 344024
1#0##0#0#0.0#2021-12-14
09:43:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ae48d9b63280d9113d626a4ccb9c01ef 150000 0 0 0 0 0
1250000 0 0 0 15000 0 62752 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 10/10/1953 0 2
1 Z09.8;Z96.1;H04.1 90.29 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 253620
0 1 0 0 0 TUTIK SARASWATI ., NY 054196 68 24891
novia;3313125201940001; 5.5.5.202112011542 4 343549
1#0##0#0#0.0#2021-12-10
11:25:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cc71ab6be71a9c310237be4efda4a40f 203000 0 0 0 0 0
0 0 0 0 15000 0 35620 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 13/02/2014 0 2
0 0 - 0 - 0 - 0 - 0 181400 247820
0 1 0 0 0 FRANANTA ANJELICO,AN 038441 7 2850
novia;3313125201940001; 5.5.5.202112011542 4 343550
1#0##0#0#0.0#2021-12-10
11:30:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e2103a5c9a7836f6542be21e571bd013 203000 0 0 0 0 0
0 0 0 0 15000 0 29820 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 08/06/2015 0 1
TENGGOROKAN 251000 0 0 - 0 - 0 - 0 - 0
251000 165000 0 1 0 0 0 ARSHAKA AHZA AR
RASYID.AN 083485 6 2370 DR. SUDARMAN, SP.THT-BKL(K)
1124R0021221V000634 0002085079623 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343551 1#0##0#0#0.0#2021-12-10
11:32:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cd0a8faebb262ce984df9d02160b4d5b 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 21/01/1998 0 1
0 - 0 - 0 - 0 - 0 181400 199705
0 1 0 0 0 YANUAR ERWAN SAPUTRA.TN 100499 23 8717
novia;3313125201940001; 5.5.5.202112011542 4 343552
1#0##0#0#0.0#2021-12-10
11:33:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e6d58b3146a1368df3b73e7ef2d82cf8 150000 0 0 0 0 0
0 0 0 0 15000 0 34705 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 27/04/1974 0 1
0 0 - 0 - 0 - 0 - 0 181400 293080
0 1 0 0 0 AHMAD SURAHMAN,(BP) 040030 47 17387
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 343553
1#0##0#0#0.0#2021-12-10
11:34:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
33c40cac949156897cc52f415ef8e154 150000 0 0 0 0 0
0 0 0 0 15000 0 128080 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 03/04/2007 0 2
1 Z09.8;A91 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 184758
0 1 0 0 0 FLORA KEYSHA RAINA.AN 100292 14 5358
0002169435778 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343554 1#0##0#0#0.0#2021-12-10
11:43:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a829a73f46757fdcd7d02fddd349e8f8 150000 0 0 0 0 0
0 0 0 0 15000 0 19758 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 11/03/1978 0 1
1 Z09.8;K35.8 93.57 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 394380 0 1
0 0 0 AMIR PURWANTO, TN 099924 43 15973 DR. HERMAWAN, Sp.B
M.Kes 1124R0021221V000642 0000639884845 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343555 1#0##0#0#0.0#2021-12-10
11:45:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5e22f09a8e8123a1b4faa69d928de874 295000 0 0 0 0 0
0 0 0 0 15000 0 84380 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 13/04/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 210140
0 1 0 0 0 DENNY SUTARSIH, NY 071249 63 23245
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 343556
1#0##0#0#0.0#2021-12-10
11:46:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0c6ebb63138207be97cf5cafbaa98e12 150000 0 0 0 0 0
0 0 0 0 15000 0 45140 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 26/07/1980 0 1
0 - 0 - 0 - 0 283800 337030 0 1
0 0 0 BROTO TRI YULIANTO, TN 056979 41 15105 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 343566
1#0##0#0#0.0#2021-12-10
12:38:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
663895a13731bb77f992dcd09f970007 300000 0 0 0 0 0
0 0 0 0 15000 0 22030 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 25/02/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 258412
0 1 0 0 0 SUYANTI., NY 046730 56 20735 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343684
1#0##0#0#0.0#2021-12-10
12:02:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
52dd2017150dc3f8597ce3029e8892df 150000 0 0 0 0 0
0 0 0 0 15000 0 93412 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 30/09/1977 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ERNA SETYOWATI, NY
0000207436206 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343294 1#0##0#0#0.0#2021-12-10
12:03:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6d7cd954546e0d34100662d904147c45 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 11/04/1965 0 1
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 MUNIF, TN 087618 56 20690 DR. ARYO SUSENO, SP.PD
1124R0021221V000647 0001732801498 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343557 1#0##0#0#0.0#2021-12-10
12:03:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a8cf80c17a9e75d7a509b07d911ff340 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 02/09/1976 0 1
0 - 0 - 0 - 0 786200 1076460 0 1
0 0 0 YOYOK BAGUS HARTONO. TN 093496 45 16528 DR. ARYO
novia;3313125201940001; 5.5.5.202112011542 4 343558
1#0##0#0#0.0#2021-12-10
12:04:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
60dc20b88b0996c54b29f6aa414d16f4 927660 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 31/12/1943 0 1
0 - 0 - 0 - 0 183900 282235 0 1
0 0 0 SUJARI, TN 099066 77 28462 DR. HERMAWAN, Sp.B M.Kes
1124R0021221V000649 0002897372362 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 343567 1#0##0#0#0.0#2022-05-10
10:21:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
471ea6a4acedb0d56e87a1ccd70b59ce 235000 0 0 0 0 0
0 0 0 0 15000 0 32235 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 19/12/2002 0 1
0 - 0 - 0 - 0 183900 234965 0 1
0 0 0 KHOIRUL ANWAR.SDR 095296 18 6924 DR. HERMAWAN, Sp.B
M.Kes 1124R0021221V000650 0003100814043 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343569 1#0##0#0#0.0#2021-12-10
12:42:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0198724b6a9b7b4ede2c15f3713c9a0c 150000 0 0 0 0 0
0 0 0 0 15000 0 69965 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 08/11/1951 0 2
1 I69.3;M53.19 87.03 - - None None None None Z-3-18-0
- 0 - 0 - 0 - 0 894800 1473585 0
1 0 0 0 ARWINDA HURIP,(NY) 043704 70 25593 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344025
1#0##0#0#0.0#2021-12-14
09:44:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c86ce352247bf98eccaf45528ddff37b 150000 0 0 0 0 0
1250000 0 0 0 15000 0 58585 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 31/12/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 236495
0 1 0 0 0 PARTINEM, NY 100225 55 20426 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343570
1#0##0#0#0.0#2021-12-10
12:43:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9d747c1fc040e4b4bdb6acb59816b989 150000 0 0 0 0 0
0 0 0 0 15000 0 71495 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 12/12/1987 0 2
1 Z09.8;M67.4 93.57;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 336420 0
1 0 0 0 KUSTIANI.NN 100160 33 12410 DR. HERMAWAN, Sp.B
M.Kes 1124R0021221V000653 0001527801219 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343571 1#0##0#0#0.0#2021-12-10
12:44:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a01df7cdc79a363350837b8445e89086 235000 0 0 0 0 0
0 0 0 0 15000 0 86420 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 25/03/1978 0 2
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 SRI SURYANI.NY 084728 43 15959 DR. ARYO SUSENO,
SP.PD 1124R0021221V000654 0001530372778 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343559 1#0##0#0#0.0#2021-12-10
12:05:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e1f3f317ba15f6dcd3c3e37e424d8e86 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 23/12/1977 0 2
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 WIJI SUDARTI,NY 064377 43 16051 DR. ARYO SUSENO,
SP.PD 1124R0021221V000655 0002302362729 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343560 1#0##0#0#0.0#2021-12-10
12:08:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
96a2febc73a65ac05f6fc885afb07234 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 01/09/1964 0 1
0 - 0 - 0 - 0 786200 811476 0 1
0 0 0 WARSITO.TN 057229 57 20912 DR. ARYO SUSENO, SP.PD
1124R0021221V000656 0000639614597 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343561 1#0##0#0#0.0#2021-12-10
12:09:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a084fb7549b0e2e919ca529b097a0313 662676 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 13/12/1966 0 2
0 - 0 - 0 - 0 786200 612630 0 1
0 0 0 LAILA, NY 048434 54 20079 DR. ARYO SUSENO, SP.PD
1124R0021221V000657 0002051493849 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343562 1#0##0#0#0.0#2021-12-10
12:10:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
779919e2bcbaf6583a4abb372c2ae26b 463830 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 07/04/1948 0 1
0 - 0 - 0 - 0 786200 811476 0 1
0 0 0 HARDJOKO, TN 055933 73 26903 DR. ARYO SUSENO,
SP.PD 1124R0021221V000658 0000094255514 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343565 1#0##0#0#0.0#2021-12-10
12:12:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cab484f37e46799bd177ad81dc624357 662676 0 0 0 0 0
0 133800 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 01/03/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 237515
0 1 0 0 0 SUSENO BUDI SANTOSA.,TN 074591 61 22557
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 343572
1#0##0#0#0.0#2021-12-10
12:46:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4def0ee377eabf9b5eaaa99ded63c997 150000 0 0 0 0 0
0 0 0 0 15000 0 72515 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 13/12/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 252985
0 1 0 0 0 ANIK FADMIATI, NY 086726 54 20079 DR.
agung;3313092303950002; 5.6.6.202203301209 4 343573
1#0##0#0#0.0#2022-04-14
13:19:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
e439e293388544fba3bf3bf0b536370f 150000 0 0 0 0 0
0 0 0 0 15000 0 87985 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 06/04/1997 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 BAYU DWI APRILIANTO.SDR 099757 24 9007 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 343574
1#0##0#0#0.0#2021-12-10
12:48:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
12d77a13af03d48e64cf2bd5f732529c 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 04/07/1962 0 1
1 Z09.8;M53.19;M19.99;I69.3 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
212362 0 1 0 0 0 DIDI SURYANTO 099846 59
0001482078159 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343575 1#0##0#0#0.0#2021-12-10
12:49:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
db003e2e9cce64ee7a4e7c1644093cb9 150000 0 0 0 0 0
0 0 0 0 15000 0 47362 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 23/08/1978 0 1
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 MOH RIYADI, TN 071422 43 15808 DRG. VERAWATY,
SP.KG 1124R0021221V000664 0000195049923 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343576 1#0##0#0#0.0#2021-12-10
12:50:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
62b1c8a0e49225c1572707ac5c0571ff 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 13/12/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 233900
0 1 0 0 0 LINAWATI LINUR INAYAH., NY 042854 55
0001426207241 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343577 1#0##0#0#0.0#2021-12-10
12:53:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1995f0fba48444626b2ce134d9185880 150000 0 0 0 0 0
0 0 0 0 15000 0 68900 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 07/01/2020 0 2
1 K52.9;E86 - - - None None None None Q-5-25-0 None
- 0 - 0 - 0 - 0 135700 180000 0
1 0 0 0 ELENA SANTOSO, AN 100441 1 696 DR. CHANDRA
AYU 1124R0021221V000667 0002915053288 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346618 1#0##0#0#0.0#2022-01-04
13:17:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0ba455dc9041f104b5841ea819f82c3b 155000 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 14/09/2002 0 1
- 0 - 0 - 0 - 0 182600 196746 0
1 0 0 0 REFFY RIZKY SHELA P, SDR 099572 19 7020
DR. CHIKA KLARISSA 1124R0021221V000668 0001280061516 3;JKN
novia;3313125201940001; 5.5.5.202112011542 4 346619
1#0##0#0#0.0#2022-01-04
13:18:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e90652b92dcddf4e19bca6afe44b5dea 155000 0 0 0 0 0
0 0 0 0 15000 0 26746 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 24/02/1948 0 2
0 - 0 - 0 - 0 - 0 181400 195593
0 1 0 0 0 SURATMI .NY 048601 73 26946 DR. CHIKA
KLARISSA 1124R0021221V000670 0000091192004 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346620 1#0##0#0#0.0#2022-01-04
13:19:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
751e8e65ce2ff4cc875585ec12a7cd14 155000 0 0 0 0 0
0 0 0 0 15000 0 25593 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 29/10/1992 0 2
0 - 0 - 0 - 0 135700 120000 0 1
0 0 0 OKTAVIANI SELAWATI, NY 055505 29 10627 DR. CHIKA
KLARISSA 1124R0021221V000672 0001422556751 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 346621 1#0##0#0#0.0#2022-04-14
12:52:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
fb31706373b0d9540abc14f9d626a6ad 105000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 03/12/2021 03/12/2021 22/07/1967 0 2
1 R10.4;K52.9 - - - None None None None Q-5-25-0 None
- 0 - 0 - 0 - 0 135700 228862 0
1 0 0 0 SUMINI, NY 100452 54 19858 DR. EVA PRATAMA
SUTRISNA 1124R0021221V000680 0000103982051 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346622 1#0##0#0#0.0#2022-01-04
13:21:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
44ae7906476a904699b960dd5d5e4e9a 155000 0 0 0 0 0
0 0 0 0 25000 0 48862 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 15/04/1977 0 1
- 0 - 0 - 0 - 0 182600 202142 0
1 0 0 0 ROHMAT ALI PRIYANTO, TN 051760 44 16304 DR.
EVA PRATAMA SUTRISNA 1124R0021221V000681 0001104058394 3;JKN
agung;3313092303950002; 5.6.6.202203301209 4 346625
1#0##0#0#0.0#2022-04-14
12:50:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
a66d720f5f4e111f661ae8d00ee29fa2 0 0 142500 0 0 0
0 0 0 0 15000 0 44642 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 02/05/1944 0 1
1 Z09.8;I48 89.52 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 ADI SARWONO DH, TN 058623 77 28340
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 342951
1#0##0#0#0.0#2021-12-09
09:33:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a3f1c0cc21f4c90d11099fc5b0207ea3 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 10/04/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 253740
0 1 0 0 0 RATIM, TN 065048 63 23249 DR. GALIH
yani;3302226402970001; 5.5.5.202112011542 4 342952
1#0##0#0#0.0#2021-12-09
09:34:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3715014446bdc56e05d7000bb89299cf 150000 0 0 0 0 0
0 0 0 0 15000 0 88740 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 01/07/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 370855
0 1 0 0 0 WIYONO.TN 100501 61 22436 DR. GALIH
yani;3302226402970001; 5.5.5.202112011542 4 342954
1#0##0#0#0.0#2021-12-09
09:35:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7896f4f027c39b6f30bc0409ab05cb55 300000 0 0 0 0 0
0 0 0 0 15000 0 55855 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 31/12/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 DJURIJATUN, NY 100502 78 28828 DR.
GALIH RAKASIWI SOEKARNO,SP.JP 1124R0021221V000685 0000091312244 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 342956
1#0##0#0#0.0#2021-12-09
09:36:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
802405f808f9a4cedf218b4aa8b9d88c 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 24/04/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 587420
0 1 0 0 0 HABIB WINARTO, TN 097988 63 23235 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344026
1#0##0#0#0.0#2021-12-14
09:46:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
402e7b84339046fa81aaaf38b09c83bc 300000 0 0 0 0 0
200000 0 0 0 15000 0 72420 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 29/04/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 SRI WURYANI.NY 095017 74 27248 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342957
1#0##0#0#0.0#2021-12-09
09:37:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e0b9f7fef0fa930c1860d2998407109f 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 03/07/1935 0 2
0 0 - 0 - 0 - 0 - 0 181400 197665
0 1 0 0 0 MARFUNGATUN.NY 087156 86 31566 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342958
1#0##0#0#0.0#2021-12-09
09:38:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
23970e6610c9b616091492cdb73406d3 150000 0 0 0 0 0
0 0 0 0 15000 0 32665 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 08/02/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 509575
0 1 0 0 0 ANY KRISTANTI.NY 080672 47 17466 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342960
1#0##0#0#0.0#2021-12-09
09:43:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9d13523518d063703b4341a4070e8ae3 300000 0 0 0 0 0
0 120795 0 0 15000 0 73780 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 14/04/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 223612
0 1 0 0 0 MARTINAH., NY 072061 61 22514 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342961
1#0##0#0#0.0#2021-12-09
09:44:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c9c67de86efc9882598e8785d7d4f6c3 150000 0 0 0 0 0
0 0 0 0 15000 0 58612 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 18/07/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 213342
0 1 0 0 0 SURATMI TRINANINGSIH, NY 009602 58
21324 DR. WAHYU PURNOMO, SP.OT 1124R0021221V000693 0001102728688
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 342962
1#0##0#0#0.0#2021-12-09
09:48:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
565bd24d6852e9017327b8a69fd63fa7 150000 0 0 0 0 0
0 0 0 0 15000 0 48342 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 03/05/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 467722
0 1 0 0 0 RENI RUSILAWATI.NY 100498 61 22495
yani;3302226402970001; 5.5.5.202112011542 4 342963
1#0##0#0#0.0#2021-12-09
09:49:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
57343371351c8d0be5a0425e6a91dd2e 150000 0 0 0 0 0
0 0 0 0 15000 0 302722 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 09/05/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 738870
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 342964
1#0##0#0#0.0#2021-12-09
09:53:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
42d7141d130d31852dbf48518de128d0 300000 0 0 0 0 0
0 338100 0 0 15000 0 85770 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 31/12/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SAKIYEM, NY 093271 63 23349 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 342965
1#0##0#0#0.0#2021-12-09
09:57:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
92b334973dd0d4b0d3e88dd40866ad64 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 21/06/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 226730
0 1 0 0 0 SUMIRAH.NY 088205 72 26464 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 342966
1#0##0#0#0.0#2021-12-09
09:59:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
94eb04f3803cae39f4dba129181ef163 150000 0 0 0 0 0
0 0 0 0 15000 0 61730 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 03/02/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 236612
0 1 0 0 0 IRIANI KRISTANTINAH, NY 091371 59 21854
yani;3302226402970001; 5.5.5.202112011542 4 342967
1#0##0#0#0.0#2021-12-09
10:00:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
30a780e04e3d9e562387ba7fd2977512 150000 0 0 0 0 0
0 0 0 0 15000 0 71612 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 17/04/1956 0 2
1 M17.9 88.27 - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 458382
0 1 0 0 0 SRI HASTUTI.NY 100500 65 23972 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344027
1#0##0#0#0.0#2021-12-14
09:47:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2c61542c2df5e0f85a5538137050236e 150000 0 0 0 0 0
248000 0 0 0 15000 0 45382 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 31/12/1944 0 2
0 404900 388162 0 1 0 0 0 WAGINAH,(NY)
0001461726483 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
342968 1#0##0#0#0.0#2021-12-09
10:01:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f5477d438e5b660b56857229b223e222 150000 0 0 0 0 0
0 0 0 0 15000 0 223162 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 31/12/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 221504
0 1 0 0 0 SRI SOEPARNI.,NY 053668 71 26271 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342969
1#0##0#0#0.0#2021-12-09
10:02:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
82b9457e3849ab49acee3646989c51cb 150000 0 0 0 0 0
0 0 0 0 15000 0 56504 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 13/08/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 221420
0 1 0 0 0 TRI UTAMI AGUSTINI, NY 048735 63 23124
yani;3302226402970001; 5.5.5.202112011542 4 342991
1#0##0#0#0.0#2021-12-09
10:03:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7d9961e86918df09eccc6af9be3eebc8 150000 0 0 0 0 0
0 0 0 0 15000 0 56420 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 11/02/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 493250
0 1 0 0 0 MULYANI,(NY) 039619 61 22577 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342992
1#0##0#0#0.0#2021-12-09
10:04:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b9b57066d1a4e81d4784a8cf560cfd98 150000 0 0 0 0 0
0 0 0 0 15000 0 328250 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 06/03/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 204702
0 1 0 0 0 ARIS SRIJANTI.NY 094801 65 24014 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342994
1#0##0#0#0.0#2021-12-09
10:05:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
23d582287072aa9b581fa5bf005d1035 150000 0 0 0 0 0
0 0 0 0 15000 0 39702 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 07/08/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 217692
0 1 0 0 0 GIYANI., NY 049228 73 26782 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 342995
1#0##0#0#0.0#2021-12-09
10:06:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0616c6589f460303ac2b32bdfce73d18 150000 0 0 0 0 0
0 0 0 0 15000 0 52692 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 13/12/1941 0 2
0 0 - 0 - 0 - 0 - 0 181400 216704
0 1 0 0 0 FATIMAH.NY 077901 79 29211 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 342996
1#0##0#0#0.0#2021-12-09
10:06:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e599df10ab76cdef27602e0cda133d01 150000 0 0 0 0 0
0 0 0 0 15000 0 51704 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 31/12/1964 0 2
1 Z09.8;M17.9;M75.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 240181
0 1 0 0 0 MUJIYEM.NY 075280 56 20792 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 342997
1#0##0#0#0.0#2021-12-09
10:08:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
edd6927b4f107865908b9d1d711f298f 150000 0 0 0 0 0
0 0 0 0 15000 0 75181 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 12/02/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 225904
0 1 0 0 0 SRI SUMARSI, NY 099382 62 22941 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342998
1#0##0#0#0.0#2021-12-09
10:09:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
46fc0d3098fafe589d55d5a9ae5ff4e9 150000 0 0 0 0 0
0 0 0 0 15000 0 60904 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 13/11/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 221594
0 1 0 0 0 LIDIA HERAWATI 090523 76 27780 DR.
yani;3302226402970001; 5.5.5.202112011542 4 342999
1#0##0#0#0.0#2021-12-09
10:10:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2337e2b2427326ebfc21321654a07931 150000 0 0 0 0 0
0 0 0 0 15000 0 56594 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 19/06/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 207707
0 1 0 0 0 ENDANG TRININGSIH, NY 091052 66 24275
yani;3302226402970001; 5.5.5.202112011542 4 343000
1#0##0#0#0.0#2021-12-09
10:10:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9707d8d6838e41b742ec984b2939b98f 150000 0 0 0 0 0
0 0 0 0 15000 0 42707 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 31/12/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 221483
0 1 0 0 0 SUKARTI.NY 098214 60 22253 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 343001
1#0##0#0#0.0#2021-12-09
10:11:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b509104fa5b2e0896e1ff403952d2f99 150000 0 0 0 0 0
0 0 0 0 15000 0 56483 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 16/06/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 197437
0 1 0 0 0 WIDIYASTUTI, NY 090543 60 22086 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343003
1#0##0#0#0.0#2021-12-09
10:12:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3f7e53d554f8e8365779002378a0f2b3 150000 0 0 0 0 0
0 0 0 0 15000 0 32437 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 29/06/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 212732
0 1 0 0 0 PARTINI, NY 068459 70 25726 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 343004
1#0##0#0#0.0#2021-12-09
10:14:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5fa81b62dbe1d8bc5a52ec9b854453e1 150000 0 0 0 0 0
0 0 0 0 15000 0 47732 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 05/06/1943 0 1
0 0 - 0 - 0 - 0 - 0 181400 200494
0 1 0 0 0 SOEPARTO BROTOATMOJO, TN 071688 78
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343006
1#0##0#0#0.0#2021-12-09
10:14:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4821015fc52cd5deb1f2b27e2fcc6072 150000 0 0 0 0 0
0 0 0 0 15000 0 35494 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 14/08/1968 0 2
0 404900 388162 0 1 0 0 0 SRI LESTARI 056183
53 19470 DR. WAHYU PURNOMO, SP.OT 1124R0021221V000716
0000640595687 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343009 1#0##0#0#0.0#2021-12-09
10:16:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ee2616f6c68f9495f6a9663d9f23584a 150000 0 0 0 0 0
0 0 0 0 15000 0 223162 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 31/12/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 189530
0 1 0 0 0 WAGINAH,NY 085647 60 22253 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 343010
1#0##0#0#0.0#2021-12-09
10:17:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
441a7ec039aaceccbb7cdd7b03704757 150000 0 0 0 0 0
0 0 0 0 15000 0 24530 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 26/05/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 230322
0 1 0 0 0 SRI REJEKI,NY 010002 59 21742 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343016
1#0##0#0#0.0#2021-12-09
10:18:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
115637f9b3b65d47328d73ad53fa8562 150000 0 0 0 0 0
0 0 0 0 15000 0 65322 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 31/12/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 208044
0 1 0 0 0 SRI WAWUK, NY 074276 56 20792 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343018
1#0##0#0#0.0#2021-12-09
10:19:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
373577e910a7a1277abc6203bf58794e 150000 0 0 0 0 0
0 0 0 0 15000 0 43044 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 12/08/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 201674
0 1 0 0 0 FX DARSINAH .,NY 074934 69 25316 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343019
1#0##0#0#0.0#2021-12-09
10:19:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
00a85e167cf9d8c689f0a87a39b209ea 150000 0 0 0 0 0
0 0 0 0 15000 0 36674 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 09/04/1941 0 1
0 0 - 0 - 0 - 0 - 0 181400 250000
0 1 0 0 0 SUMANTO.TN 080896 80 29459 DR.
novia;3313125201940001; 5.6.3.202201201500 4 343021
1#0##0#0#0.0#2022-02-15
08:46:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
d3c853e30f9dcd313c1ec09ba6b3b6b0 235000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 26/05/1968 0 2
1 Z09.8;E11.4;G59.0;I11.9;M54.59 - - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 209505 0 1 0 0 0 SRI LESTARI, NY 066305
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343022
1#0##0#0#0.0#2021-12-09
10:31:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
25f40cf007d809316ea9de0087284025 150000 0 0 0 0 0
0 0 0 0 15000 0 44505 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 12/09/1961 0 1
1 Z09.8;M19.98;I11.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 230877
0 1 0 0 0 NANANG TATAG SUBROTO. TN 006599 60
yani;3302226402970001; 5.5.5.202112011542 4 343024
1#0##0#0#0.0#2021-12-09
10:33:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0193d7118a0148f8311a9055d786db78 150000 0 0 0 0 0
0 0 0 0 15000 0 65877 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 16/04/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 193881
0 1 0 0 0 ENY RIDKHAYATI, NY 057124 63 23243
yani;3302226402970001; 5.5.5.202112011542 4 343025
1#0##0#0#0.0#2021-12-09
10:34:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
56c791dfe2d1eac6407544c4becfcb3c 150000 0 0 0 0 0
0 0 0 0 15000 0 28881 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 23/11/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 PURNOMO WULANDARI.TN 085874 43 15717
yani;3302226402970001; 5.5.5.202112011542 4 343026
1#0##0#0#0.0#2021-12-09
10:35:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b427b082aa6d43cc93392b184a588e60 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 01/09/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARIA VERENA
SINTOWATI.NY 089293 69 25296 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000726 0000091422044 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343028 1#0##0#0#0.0#2021-12-09
10:37:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ff6fbc5b9dd51f3b87878d5500824370 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 10/06/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 216407
0 1 0 0 0 PARINEM.NY 083383 60 22092 DR. SUHARTO,
SP.PD 1124R0021221V000727 0002261302165 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343029 1#0##0#0#0.0#2021-12-09
10:38:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e43143b29a904abf657873615bc61dd9 150000 0 0 0 0 0
0 0 0 0 15000 0 51407 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 19/05/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 223910
0 1 0 0 0 BAMBANG PURWOKO.TN 075794 60 22114
yani;3302226402970001; 5.5.5.202112011542 4 343031
1#0##0#0#0.0#2021-12-09
10:41:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c9c603d62c0993ccbd02e56aa7d4cc86 150000 0 0 0 0 0
0 0 0 0 15000 0 58910 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 07/10/1959 0 2
1 Z09.8;E11.9;I11.9;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 262215
0 1 0 0 0 SUWARNI.NY 100241 62 22704 DR. SUHARTO,
SP.PD 1124R0021221V000729 0001694442633 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343032 1#0##0#0#0.0#2021-12-09
10:41:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c6dd02073a5fe7608353e6d5e846fad3 150000 0 0 0 0 0
0 0 0 0 15000 0 97215 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 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 23378 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000730 0000086714471 3;JKN novia;3313125201940001;
5.6.3.202201201500 4 343033 1#0##0#0#0.0#2022-02-15
11:46:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
1416025f5ddd3e55e52ff73a03a43ff1 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 06/09/1956 0 1
1 Z09.8;I50.0;E83.5;N29.8 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 257992
0 1 0 0 0 BADRUN.TN 098994 65 23830 DR. SUHARTO,
SP.PD 1124R0021221V000731 0001084409199 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343034 1#0##0#0#0.0#2021-12-09
10:44:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2f58f99660d5013ef627daa67f586563 150000 0 0 0 0 0
0 0 0 0 15000 0 92992 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 22/04/1967 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 963792
0 1 0 0 0 BAGYO PRAPTANTO., BP 042554 54 19950
novia;3313125201940001; 5.5.5.202112011542 4 344028
1#0##0#0#0.0#2021-12-14
09:48:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7035bc5596f035c5d98377bcf3ef3f74 150000 0 0 0 0 0
657000 0 0 0 15000 0 141792 0 0 0 0
0
3372030 C 3 CP 2 04/12/2021 04/12/2021 05/09/1945 0 1
1 I51.7;K30 87.49 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 400139
0 1 0 0 0 ACHMAD DJAZIM DJUWAIRI.TN 100492 76
novia;3313125201940001; 5.6.3.202201201500 4 344029
1#0##0#0#0.0#2022-03-08
09:15:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
de844e9efec6b0c72ee37b1e83d6a7e3 150000 0 0 0 0 0
200000 0 0 0 15000 0 35139 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 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; 5.5.5.202112011542 4
343035 1#0##0#0#0.0#2021-12-09
10:46:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c7528b34658cd048fdeb62f190dbe428 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 27/01/1971 0 2
1 Z09.8;I11.9;H81.3;G62.8 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 191960
0 1 0 0 0 TITIEK SETYORINI., NY 071359 50 18574
yani;3302226402970001; 5.5.5.202112011542 4 343036
1#0##0#0#0.0#2021-12-09
10:46:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1960001f9a5f15acbef3c5d4fdf85c84 150000 0 0 0 0 0
0 0 0 0 15000 0 26960 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 18/01/1966 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 IVO MUMPUNI
1124R0021221V000736 0002169780873 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343037 1#0##0#0#0.0#2021-12-09
10:47:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0b71d8ded035ff1ac8086357a13a4696 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 13/12/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 205015
0 1 0 0 0 BUDIARSO., TN 071323 54 20080 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343038
1#0##0#0#0.0#2021-12-09
10:48:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
302cdfbc6b4b40699eba64482ec7cd67 150000 0 0 0 0 0
0 0 0 0 15000 0 40015 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 12/12/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 212992
0 1 0 0 0 SITI CHOSIYAH., NY 045191 73 27021
yani;3302226402970001; 5.5.5.202112011542 4 343039
1#0##0#0#0.0#2021-12-09
10:48:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8cc19a417fe64ced338745fae690e12c 150000 0 0 0 0 0
0 0 0 0 15000 0 47992 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 02/08/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SITI MAJIAH, NY
0000639393467 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343040 1#0##0#0#0.0#2021-12-09
10:50:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d042e97fdf0804a2b725988215dcca2b 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 13/12/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SUGIYO, TN 092623 63 23367 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 343042
1#0##0#0#0.0#2021-12-09
10:51:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
29b51d0a041e00d49ff649d7b5a58288 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 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; 5.5.5.202112011542 4
343043 1#0##0#0#0.0#2021-12-09
10:54:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7fe56a9eee850afc7b5117d9950f2645 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 05/07/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 353225
0 1 0 0 0 SURATMI.NY 093345 57 20971 DR. SUHARTO,
SP.PD 1124R0021221V000743 0001082257525 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343044 1#0##0#0#0.0#2021-12-09
11:01:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4de82222384b11d9545c7190dc3402d4 150000 0 0 0 0 0
0 120745 0 0 15000 0 67480 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 15/04/1963 0 2
1 Z09.8;K30;R11;M19.98;E78.5 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
249841 0 1 0 0 0 SUMINI, NY 047378 58 21418
yani;3302226402970001; 5.5.5.202112011542 4 343045
1#0##0#0#0.0#2021-12-09
11:02:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9adeae82f9108c6ad19e7d1c6320e875 150000 0 0 0 0 0
0 0 0 0 15000 0 84841 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 21/07/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 KEPI HANANINGSIH
0001279114119 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343048 1#0##0#0#0.0#2021-12-09
11:08:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d8c7c4e0828ed3704f44f6f168b5bda8 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 08/06/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 186896
0 1 0 0 0 ZUMRONI, TN 075055 61 22459 DR. SUHARTO,
SP.PD 1124R0021221V000746 0000017205647 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343047 1#0##0#0#0.0#2021-12-09
11:05:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5b76b9e80a9e9966f490f3c7c9690003 150000 0 0 0 0 0
0 0 0 0 15000 0 21896 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 03/03/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 216985
0 1 0 0 0 TITI SUTRIATI, NY 100191 69 25478 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343049
1#0##0#0#0.0#2021-12-09
11:09:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a9471d894eeba2c216189e78e11fff47 150000 0 0 0 0 0
0 0 0 0 15000 0 51985 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 06/09/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 196762
0 1 0 0 0 IDA FARIDA. NY 098265 48 17621 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343050
1#0##0#0#0.0#2021-12-09
11:11:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
45cb9aa57510702f8457025b128d102d 150000 0 0 0 0 0
0 0 0 0 15000 0 31762 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 13/06/1992 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 LUKI SABILLA
1124R0021221V000751 0001084671257 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343052 1#0##0#0#0.0#2021-12-09
11:14:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4e5430e5fa9f2f6b54eec86e363ae078 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 04/09/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 204565
0 1 0 0 0 NURMANTO, TN 098729 68 24928 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343053
1#0##0#0#0.0#2021-12-09
11:16:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
693ff7ba19a01cb9fde8762e1f98d6fa 150000 0 0 0 0 0
0 0 0 0 15000 0 39565 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 23/04/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 238085
0 1 0 0 0 SUKATNI, NY 091172 65 23966 DR. SUHARTO,
SP.PD 1124R0021221V000754 0001811084253 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343054 1#0##0#0#0.0#2021-12-09
11:17:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
badc79f0af2a6aae6fd5ec870ec7312e 150000 0 0 0 0 0
0 0 0 0 15000 0 73085 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 25/03/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 220544
0 1 0 0 0 SUPINAH 091220 66 24361 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 343056
1#0##0#0#0.0#2021-12-09
12:08:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
29bdf8b415f64be7c9f9ae0f97f0c3fa 150000 0 0 0 0 0
0 0 0 0 15000 0 55544 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 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; 5.5.5.202112011542 4
342932 1#0##0#0#0.0#2021-12-09
12:09:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
38cb20c55b58bc3dff605e0d6e3917ef 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 01/10/1950 0 2
1 Z09.8;I50.0;K30;M54.59;L50.9 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
265302 0 1 0 0 0 DALTI, NY 055299 71 25997
yani;3302226402970001; 5.5.5.202112011542 4 343058
1#0##0#0#0.0#2021-12-09
12:10:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f82be4b10fb32fcf188e5d288a4d0533 150000 0 0 0 0 0
0 0 0 0 15000 0 100302 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 23/05/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 209910
0 1 0 0 0 MARDHIYAH, NY 060235 70 25763 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343060
1#0##0#0#0.0#2021-12-09
12:11:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7fbf8e2c9b0625292259de8c45d3d134 150000 0 0 0 0 0
0 0 0 0 15000 0 44910 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 23/03/1950 0 2
0 - 0 107400 273000 0 1 0 0 0
MARSINI., NY 048442 71 26189 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000762 0001032584782 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343061 1#0##0#0#0.0#2021-12-09
12:14:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
819d0b3c4fec80331473880b0f6e4bb1 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 27/10/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 RUSTANTINI., NY
0001971122679 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343062 1#0##0#0#0.0#2021-12-09
12:16:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f7e76311136ced7d81c02a66debebd07 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 13/12/1966 0 2
1 Z09.8;E11.9;I10;I51.7 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 446961
0 1 0 0 0 ANIK FADMIATI, NY 086726 54 20080 DR.
agung;3313092303950002; 5.6.6.202203301209 4 343063
1#0##0#0#0.0#2022-04-14
13:19:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
b7f5da94d4097843716494d74dee8836 150000 0 0 0 0 0
0 0 0 0 15000 0 281961 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 29/09/1970 0 2
- 0 - 0 - 0 - 0 138400 135000 0
1 0 0 0 MARIA DIAH ANGGARAWATI ., NY 059667 51 18694
DR. LINDA SUGIARTO, SP.FKR 1124R0021221V000765 0001211692601 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 343065
1#0##0#0#0.0#2021-12-09
12:25:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fb19c984c9d65719cf81c0fe0741b730 120000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 05/08/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 243846
0 1 0 0 0 SRI REJEKI.NY 097797 65 23862 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343066
1#0##0#0#0.0#2021-12-09
12:32:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a7286c7744b835908e812474e4ccf23d 150000 0 0 0 0 0
0 31845 0 0 15000 0 47001 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 15/11/1951 0 2
- 0 - 0 - 0 - 0 138400 135000 0
1 0 0 0 SRI PARYATUN 092307 70 25587 DR. LINDA
yani;3302226402970001; 5.5.5.202112011542 4 343068
1#0##0#0#0.0#2021-12-09
12:42:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7b83d8daecf28b4d7c19c0e22cb0f712 120000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 31/08/1962 0 2
0 - 0 - 0 - 0 - 0 138400 135000
0 1 0 0 0 SRI HARTINA IRIAWATI.NY 094182 59 21645
yani;3302226402970001; 5.5.5.202112011542 4 343070
1#0##0#0#0.0#2021-12-09
12:45:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6f6b24722046a475e77f6cc6db9169e6 120000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 18/05/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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343071 1#0##0#0#0.0#2022-04-14
13:34:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 04/12/2021 04/12/2021 25/06/1954 0 2
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5.5.5.202112011542 4 343072 1#0##0#0#0.0#2021-12-09
12:47:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 26/05/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0001474646354 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
343073 1#0##0#0#0.0#2022-04-14
12:58:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 04/12/2021 04/12/2021 14/10/1955 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 343075
1#0##0#0#0.0#2021-12-09
12:50:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 02/10/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0000640236058 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
343076 1#0##0#0#0.0#2022-04-14
13:44:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 04/12/2021 04/12/2021 01/06/1944 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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343077 1#0##0#0#0.0#2021-12-09
12:52:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 08/06/1950 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 343078
1#0##0#0#0.0#2021-12-09
12:53:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 02/07/1971 0 2
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0 0 - 0 - 0 - 0 - 0 181400 238877
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yani;3302226402970001; 5.5.5.202112011542 4 343080
1#0##0#0#0.0#2021-12-09
12:54:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 13/06/1979 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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13:40:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 04/12/2021 04/12/2021 26/06/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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343082 1#0##0#0#0.0#2021-12-09
12:58:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 31/12/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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12:58:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 25/05/1986 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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13:00:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 31/12/1955 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 343086
1#0##0#0#0.0#2021-12-09
13:01:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 13/10/2002 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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NURWAHID.SDR 100136 19 6992 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000785 0003071567755 3;JKN yani;3302226402970001;
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13:01:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 17/04/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0001084649501 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343088 1#0##0#0#0.0#2021-12-09
13:03:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 08/12/1992 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ARIS ABDULLAH, BP
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343089 1#0##0#0#0.0#2021-12-09
13:18:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 24/12/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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343483 1#0##0#0#0.0#2021-12-09
13:19:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 29/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 289000 0 1 0 0 0 AGNES WIDHA
THESIANA, NY 090586 48 17782 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000790 0002168632721 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343090 1#0##0#0#0.0#2021-12-09
13:22:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 25/05/1967 0 1
1 M75.0 - - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 210220
0 1 0 0 0 BAMBANG INDRAJID.TN 100238 54 19917
yani;3302226402970001; 5.5.5.202112011542 4 343091
1#0##0#0#0.0#2021-12-09
13:23:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 02/08/1973 0 2
0 - 0 - 0 - 0 - 0 138400 240000
0 1 0 0 0 ISWINDARI., NY 047078 48 17656 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343092
1#0##0#0#0.0#2021-12-09
13:26:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 07/07/1957 0 2
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1 0 0 0 ENI PUJI ASTUTI 093122 64 23526 DR. LINDA
agung;3313092303950002; 5.6.6.202203301209 4 343093
1#0##0#0#0.0#2022-04-14
13:32:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 04/12/2021 04/12/2021 14/05/1933 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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343095 1#0##0#0#0.0#2021-12-09
13:30:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 10/02/1951 0 2
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0001789546059 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343097 1#0##0#0#0.0#2021-12-09
13:41:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 17/12/1947 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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SUPRIYONO 100273 73 27016 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000796 0001335194043 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343098 1#0##0#0#0.0#2021-12-09
13:43:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 23/04/1968 0 2
1 Z09.8;M19.98;K30;G62.8 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 251752
0 1 0 0 0 SURYATI ( NY ) 037498 53 19583 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343099
1#0##0#0#0.0#2021-12-09
13:44:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 29/10/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 222811
0 1 0 0 0 SANTOSO. TN 038094 56 20490 DR. SUHARTO,
SP.PD 1124R0021221V000802 0000564536698 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343102 1#0##0#0#0.0#2021-12-09
13:44:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2ab6103f6896dffcaa1e2cbdd6eb418e 150000 0 0 0 0 0
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3372030 C 3 CP 2 04/12/2021 04/12/2021 09/11/2012 0 1
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0 1 0 0 0 YUSUF DEWANGGA PUTRA.AN 099435 9 3312
yani;3302226402970001; 5.5.5.202112011542 4 343110
1#0##0#0#0.0#2021-12-09
13:45:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 02/02/1962 0 1
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ASMARA,BP 080255 59 21855 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000804 0002169441123 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343111 1#0##0#0#0.0#2021-12-09
13:47:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
26237fe96dcf998cce413ddd8dbd8278 247000 0 0 0 0 0
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3372030 C 3 CP 2 04/12/2021 04/12/2021 12/08/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 294540
0 1 0 0 0 SUPARDI, TN 046047 79 28969 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343113
1#0##0#0#0.0#2021-12-09
13:47:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
474c4c1540032809dfe5aa29b661f1b5 150000 0 0 0 0 0
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3372030 C 3 CP 2 04/12/2021 04/12/2021 17/08/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 283155
0 1 0 0 0 SRI AGUSTIN, NY 036023 44 16180 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343115
1#0##0#0#0.0#2021-12-09
13:48:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
23876ba6b767c24cd4641b847ff924a8 150000 0 0 0 0 0
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3372030 C 3 CP 2 04/12/2021 04/12/2021 03/12/1950 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 343127
1#0##0#0#0.0#2021-12-09
13:49:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ab0c466079523e16c380e191c6cb3dc4 463830 0 0 0 0 0
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3372030 C 3 CP 2 04/12/2021 04/12/2021 09/09/1944 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V000809 0000100867893 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343128 1#0##0#0#0.0#2021-12-09
13:51:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3ac9fb0008daa4ce9cd682a6f272e69e 463830 0 0 0 0 0
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3372030 C 3 CP 2 04/12/2021 04/12/2021 26/10/1964 0 1
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0 1 0 0 0 BAMBANG SUYOSO ., BP 053077 57 20858
yani;3302226402970001; 5.5.5.202112011542 4 343129
1#0##0#0#0.0#2021-12-09
13:51:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 14/07/1980 0 2
0 0 - 0 - 0 - 0 - 0 181400 285825
0 1 0 0 0 WAHYUNI 085685 41 15118 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343130
1#0##0#0#0.0#2021-12-09
13:52:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 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; 5.5.5.202112011542 4
343131 1#0##0#0#0.0#2021-12-09
13:53:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 18/07/1964 0 1
0 - 0 - 0 - 0 786200 677676 0 1
SP.PD 1124R0021221V000813 0002425018184 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343132 1#0##0#0#0.0#2021-12-09
13:53:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 31/12/1981 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 343133
1#0##0#0#0.0#2021-12-09
13:55:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 04/01/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SIH JAMI RAHAYU,
0000207760419 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343134 1#0##0#0#0.0#2021-12-09
13:56:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 04/12/2021 04/12/2021 11/08/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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SULISTYOWATI, NY 092912 62 22761 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000816 0001381863622 3;JKN yani;3302226402970001;
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13:57:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
377af1cafb73fbae7f24e4d29e7df1c5 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 21/08/1948 0 2
- 0 - 0 - 0 - 0 138400 135000 0
1 0 0 0 MUSNATIN., NY 071462 73 26768 DR. LINDA
agung;3313092303950002; 5.6.6.202203301209 4 343140
1#0##0#0#0.0#2022-04-14
12:58:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
2f0e25b9c617684735a01316cb636fab 120000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 22/02/1971 0 2
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.5.5.202112011542 4 343142
1#0##0#0#0.0#2021-12-10
13:00:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f308530865be1c65863a3727ea47a4f2 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 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; 5.5.5.202112011542 4
343143 1#0##0#0#0.0#2021-12-10
13:01:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6213cb2615767fb8b28e6bc22d2ec5fe 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 25/02/1965 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUYANTI., NY
0000565142567 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343144 1#0##0#0#0.0#2021-12-10
13:02:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2772ae1b01120d85d05d2492776b7ccd 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 31/12/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WARSINI, NY 095108
0001084784139 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343145 1#0##0#0#0.0#2021-12-10
13:03:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7bbf5314de084264a2ea578816a2de52 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 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; 5.5.5.202112011542 4
343146 1#0##0#0#0.0#2021-12-10
13:03:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e0edaf4fc8090c00d453ffdd54d0beb6 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 05/08/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 398620 0 1 0 0 0 SRI LESTARI, NY
0000639740812 3;JKN reni;3313147010930001; 5.6.0.202201041418 4
342935 1#0##0#0#0.0#2022-01-07
19:51:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
f04fadc283e5d9f0cdddee24853fcfe8 300000 0 0 0 0 0
0 0 0 0 15000 0 83620 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 14/03/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.5.5.202112011542 4 343147
1#0##0#0#0.0#2021-12-10
13:05:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
990aa03ff3f3dd708c3d541a3083a0fd 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 12/09/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SLAMET,(NY) 036944 76 27842 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343148
1#0##0#0#0.0#2021-12-10
13:07:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
85f82d172e3c99009000ec1fe22ba605 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 18/06/1953 0 2
1 Z09.8;S42.20 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 WIDIJARNI, NY
0000091364973 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
343149 1#0##0#0#0.0#2021-12-10
13:08:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1c0ceecff9bb6414d0a442ac4bd0d04a 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 15/10/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.5.5.202112011542 4 343150
1#0##0#0#0.0#2021-12-10
13:13:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c05af2a4534979e49953eda99789fe8d 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 19/05/1972 0 1
0 - 0 - 0 - 0 786200 478830 0 1
novia;3313125201940001; 5.5.5.202112011542 4 343151
1#0##0#0#0.0#2021-12-10
13:14:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3124579dada605fb8a30ceae1b9d573a 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 20/12/1986 0 1
0 0 - 0 - 0 - 0 - 0 181400 235346
0 1 0 0 0 BAYU DWI RAHARJO,(BP) 019598 34 12768
novia;3313125201940001; 5.5.5.202112011542 4 343153
1#0##0#0#0.0#2021-12-10
13:23:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
adaec1a2d9eedf26624a4ce6629559dd 150000 0 0 0 0 0
0 0 0 0 15000 0 70346 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 16/05/1969 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MEIYANTO.TN 096828
0000091088998 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
343154 1#0##0#0#0.0#2022-04-14
13:39:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
1304b134bdb2cf73da909a88952ca034 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 12/12/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 659801
0 1 0 0 0 SUPARDI. BP 049524 56 20811 DR. SUHARTO,
SP.PD 1124R0021221V000833 0002298244397 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 343687 1#0##0#0#0.0#2021-12-10
13:25:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
430a76b86501f503c84304b9606b521a 150000 0 0 0 0 0
0 0 0 0 15000 0 494801 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 01/07/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 398620
0 1 0 0 0 YULIANI KUNHARYATI,(NY) 028277 56 20610
novia;3313125201940001; 5.5.5.202112011542 4 343689
1#0##0#0#0.0#2021-12-10
13:27:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c259f345f6d1a2716eb6563e4c18649d 300000 0 0 0 0 0
0 0 0 0 15000 0 83620 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 03/11/1945 0 1
0 - 0 - 0 - 0 - 0 181400 191050
0 1 0 0 0 SUMARNO, TN 100504 76 27790 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343158
1#0##0#0#0.0#2021-12-10
13:27:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cb3b21388762c0d069112969a5185fdd 150000 0 0 0 0 0
0 0 0 0 25000 0 16050 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 12/01/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 282180
0 1 0 0 0 TINUK HESTI RAHAYU,(NY) 042658 52 19319
novia;3313125201940001; 5.5.5.202112011542 4 343159
1#0##0#0#0.0#2021-12-10
13:28:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2f9701faf0c38675d7861bd62aa29371 150000 0 0 0 0 0
0 0 0 0 15000 0 117180 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 16/05/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 311805
0 1 0 0 0 SUMARDINI.NY 084722 58 21387 DR.
novia;3313125201940001; 5.5.5.202112011542 4 343160
1#0##0#0#0.0#2021-12-10
13:29:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b88b23c07bca758cb85ef0d54c24b670 150000 0 0 0 0 0
0 0 0 0 15000 0 146805 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 10/10/1940 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 295314
0 1 0 0 0 M. SUHARDI, TN 000018 81 29640 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346626
1#0##0#0#0.0#2022-01-04
13:27:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4206478b61e0b6981d1efe89f255817f 235000 0 0 0 0 0
0 0 0 0 15000 0 45314 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 18/06/2008 0 2
1 R50.9;K30 - - - None None None None Q-5-42-0 None
0 - 0 - 0 - 0 - 0 182600 184498
0 1 0 0 0 JIHAN ALYA,AN 010953 13 4917 DR.
YOSSI 1124R0021221V000839 0001285867776 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 346627 1#0##0#0#0.0#2022-04-14
11:42:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
a901e6b1cbfa72e6cc4ed8f1765e1f42 105000 0 0 0 0 0
0 0 0 0 15000 0 64498 0 0 0 0 0
3372030 C 3 CP 2 04/12/2021 04/12/2021 30/08/1974 0 2
0 - 0 - 0 - 0 135700 289131 0 1
0 0 0 SUGIYARTI, NY 048821 47 17263 DR. YOSSI
1124R0021221V000840 0001102645528 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346628 1#0##0#0#0.0#2022-01-04
13:28:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fcab51cfd5c80db6f25f0aa2ad76d3c7 195000 0 0 0 0 0
0 0 0 0 15000 0 79131 0 0 0 0 0
3372030 C 3 CP 2 05/12/2021 05/12/2021 31/10/1999 0 2
- 0 - 0 - 0 - 0 135700 157618 0
1 0 0 0 ALDA OKTA RIANI, NN 100469 22 8071 RIZA
5.5.5.202112011542 4 346629 1#0##0#0#0.0#2022-01-04
13:29:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
18101a6f35a54602a2be14e8414e2b74 105000 0 0 0 0 0
0 0 0 0 25000 0 27618 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 02/04/1968 0 2
0 - 0 - 0 - 0 135700 171557 0 1
0 0 0 NGATMI, NY 046406 53 19606 DR. GERRY FEBRIAN R
1124R0021221V000852 0000639565716 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346630 1#0##0#0#0.0#2022-01-04
13:30:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8ab621c5ea7b2512bd072739c1dde6e7 130000 0 0 0 0 0
0 0 0 0 15000 0 26557 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 15/03/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 444296
0 1 0 0 0 SUSANTO (BP) 030725 59 21816 DR.
reni;3313147010930001; 5.5.5.202112011542 4 343135
1#0##0#0#0.0#2021-12-08
14:37:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a106c5b774301cbde2466682d98c5286 150000 0 0 0 0 0
0 31845 0 0 15000 0 247451 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 07/01/1979 0 1
0 0 - 0 - 0 - 0 - 0 181400 335355
reni;3313147010930001; 5.5.5.202112011542 4 343136
1#0##0#0#0.0#2021-12-08
14:38:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ea3ae7e314865ff7bbedb4f59bafb607 150000 0 0 0 0 0
0 120795 0 0 15000 0 49560 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 23/05/1970 0 1
1 Z09.0;K62.5 93.57;96.59 - - None None None None Z-3-27-0
- 0 - 0 - 0 - 0 183900 235680 0
1 0 0 0 MUHAMMAD ILHAM ALBARI.TN 100015 51 18825
reni;3313147010930001; 5.5.5.202112011542 4 343138
1#0##0#0#0.0#2021-12-08
14:39:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c7218010aa1bbd261e2d36f673a0f7e4 150000 0 0 0 0 0
0 44300 0 0 15000 0 26380 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 14/01/1988 0 2
1 D25.9 88.79 - - None None None None Z-3-23-0 None None
- 0 - 0 - 0 - 0 549400 172090 0
1 0 0 0 SURYANI, NY 100467 33 12380 DR. GUNAWAN, SP.OG
1124R0021221V000858 0001823559017 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 343139 1#0##0#0#0.0#2021-12-08
14:39:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fc27a4bd34ee5189b40c1f671ed5d128 150000 0 0 0 0 0
0 0 0 0 15000 0 7090 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 09/01/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 434415
0 1 0 0 0 RAHAYUNING PRAPTI, NY 098701 51 18959
reni;3313147010930001; 5.5.5.202112011542 4 343141
1#0##0#0#0.0#2021-12-08
14:40:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
858981b75fc7873523971d24147a8945 150000 0 0 0 0 0
0 31845 0 0 15000 0 237570 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 03/02/1977 0 1
0 0 - 0 - 0 - 0 - 0 181400 231360
0 1 0 0 0 PUJUD SUSENO, TN 044025 44 16377 DR.
reni;3313147010930001; 5.5.5.202112011542 4 343162
1#0##0#0#0.0#2021-12-08
14:40:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
59110986dab2afbd7aaee2eac943022c 150000 0 0 0 0 0
0 0 0 0 15000 0 66360 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 16/06/1965 0 1
1 Z09.8;I10;K76.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 278668
0 1 0 0 0 JOKO SUKARNO PARHADI.TN 094154 56 20627
reni;3313147010930001; 5.5.5.202112011542 4 343163
1#0##0#0#0.0#2021-12-08
14:41:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
749eebd8d27efc3f0aa1cec7190ca605 150000 0 0 0 0 0
0 88950 0 0 15000 0 24718 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 24/04/1958 0 1
1 Z09.8;E11.4;G59.0;I11.9 88.75;89.52 - - 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
1156077 0 1 0 0 0 HABIB WINARTO, TN 097988 63
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 344030
1#0##0#0#0.0#2021-12-14
09:51:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
98ccf1b680f7781e6d21878946b236f6 250000 0 0 0 0 0
680000 120795 0 0 15000 0 90282 0 0 0 0
0
3372030 C 3 CP 2 06/12/2021 06/12/2021 04/02/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 245235
0 1 0 0 0 SUPONO 094778 57 21125 DR. TEKY
reni;3313147010930001; 5.5.5.202112011542 4 343165
1#0##0#0#0.0#2021-12-08
14:42:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
141a76cd24fe175d5ed1235b9df299e2 150000 0 0 0 0 0
0 31845 0 0 15000 0 48390 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 27/11/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 424430
0 1 0 0 0 NGATIYEM,NY 084267 60 21924 DR. TEKY
reni;3313147010930001; 5.5.5.202112011542 4 343166
1#0##0#0#0.0#2021-12-08
14:43:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
64f0fcfa6e6bb4feb3e23fd597517ad2 150000 0 0 0 0 0
0 76045 0 0 15000 0 183385 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 16/09/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 723536
0 1 0 0 0 MUTINAH, NY 073262 67 24553 DR. TEKY
reni;3313147010930001; 5.5.5.202112011542 4 343167
1#0##0#0#0.0#2021-12-08
14:44:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d1759d181a0b5cfd2fff835aff8b5171 150000 0 0 0 0 0
0 63690 0 0 15000 0 494846 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 23/05/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 538845
0 1 0 0 0 MARDHIYAH, NY 060235 70 25765 DR.
reni;3313147010930001; 5.5.5.202112011542 4 343168
1#0##0#0#0.0#2021-12-08
14:55:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
20532bda33abafca4d6a9518e8220621 150000 0 0 0 0 0
0 120795 0 0 15000 0 253050 0 0 0 0
0
3372030 C 3 CP 2 06/12/2021 06/12/2021 01/01/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 464732
0 1 0 0 0 SITI MARDIYATI ., NY 056049 70 25907
reni;3313147010930001; 5.5.5.202112011542 4 343169
1#0##0#0#0.0#2021-12-08
14:56:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7656bf3fc585eb4d3131d8f5cf26261a 150000 0 0 0 0 0
0 0 0 0 15000 0 299732 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 04/10/1974 0 2
1 Z09.0;D24 97.89 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 244546
reni;3313147010930001; 5.5.5.202112011542 4 343170
1#0##0#0#0.0#2021-12-08
14:58:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f26ac0b9c162e5489ba00b9df7595ad3 220000 0 0 0 0 0
0 0 0 0 15000 0 9546 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 13/06/1971 0 2
0 - 0 107400 262000 0 1 0 0 0 SITI
1124R0021221V000873 0002169781694 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 343171 1#0##0#0#0.0#2021-12-08
14:58:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
54f33273ad9fc4d86587c453cd6c4a00 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 06/05/2003 0 2
1 Z09.0;D21.1;L91.0 99.23 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 327168
0 1 0 0 0 JEA AGRIZTA ELVARETTA.NN 096829 18
reni;3313147010930001; 5.5.5.202112011542 4 343172
1#0##0#0#0.0#2021-12-08
15:00:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2388004853617d6ebf9090b231d0e62c 310000 0 0 0 0 0
0 0 0 0 15000 0 2168 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 12/11/1963 0 1
1 Z09.8;G81.9 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 219000 0 1 0 0 0 MUH GUNTUR NALURI,
TN 091409 58 21209 DR. LINDA SUGIARTO, SP.FKR 1124R0021221V000875
0002169748091 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
343173 1#0##0#0#0.0#2021-12-08
15:00:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5970cc148c0f7f2a83d8c53b21e5f40f 204000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 15/09/1966 0 2
0 - 0 - 0 - 0 183900 431477 0 1
0 0 0 ARBINGAH.NY 100271 55 20171 DR. DAMAR ARYO, SP.B
1124R0021221V000876 0001266521725 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 343174 1#0##0#0#0.0#2021-12-08
15:01:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
729feea0eb13a87f1bb33074c669248e 370000 0 0 0 0 0
0 0 0 0 15000 0 46477 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 05/03/1949 0 1
1 Z09.8;E11.4;G59.0;I10;I73.9 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
462598 0 1 0 0 0 SUGENG PADMO HUDIYONO.TN 077469
0000640729978 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
343176 1#0##0#0#0.0#2021-12-08
15:02:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eccb2c1bced0e50cd2722da71b06e666 150000 0 0 0 0 0
0 63690 0 0 15000 0 233908 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 08/12/1945 0 2
1 Z09.8;E11.2;N08.3;I10;G59.0 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
541250 0 1 0 0 0 MADIYEM.NY 077277 75 27757
reni;3313147010930001; 5.5.5.202112011542 4 343177
1#0##0#0#0.0#2021-12-08
15:02:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9e983380d37f3c3d1911085d66948a8f 150000 0 0 0 0 0
0 76595 0 0 15000 0 299655 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 18/08/1971 0 2
0 - 0 - 0 - 0 183900 290161 0 1
0 0 0 SULIS KUSTINAH.NY 100391 50 18373 DR. DAMAR ARYO,
SP.B 1124R0021221V000879 0000640417195 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 343178 1#0##0#0#0.0#2021-12-08
15:03:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
67989d407243da16c2bef0854020cd8e 235000 0 0 0 0 0
0 0 0 0 15000 0 40161 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 24/11/1940 0 2
1 Z09.8;F32.1 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 253512
0 1 0 0 0 SOESI PATONAH., NY 063627 81 29597
DR. RETNO PUDJIASTUTI, SP.KJ 1124R0021221V000880 0000091254025 3;JKN
novia;3313125201940001; 5.6.3.202201201500 4 343179
1#0##0#0#0.0#2022-02-15
07:44:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
7783d2337533e0f901d409ea12786cee 150000 0 0 0 0 0
0 0 0 0 15000 0 88512 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 18/08/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SRI REDJEKI.NY 083335 61 22390 DR.
novia;3313125201940001; 5.6.3.202201201500 4 343180
1#0##0#0#0.0#2022-02-15
09:14:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 3
5c470c0997216d8c73d0e5d24d091661 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 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 21369 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000883 0002050989456 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 343181 1#0##0#0#0.0#2021-12-08
15:05:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9575acf034bdfafcde2e7bfe4df9b77e 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 18/05/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 232488
0 1 0 0 0 SUNNIYAH, NY 094046 67 24674 DR.
RETNO PUDJIASTUTI, SP.KJ 1124R0021221V000884 0001439604573 3;JKN
reni;3313147010930001; 5.5.5.202112011542 4 343182
1#0##0#0#0.0#2021-12-08
15:05:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5b210443f63e91e92666b21ed87aab23 150000 0 0 0 0 0
0 0 0 0 15000 0 67488 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 30/07/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 330835
0 1 0 0 0 TUKINAH. NY 088785 58 21314 DR. TEKY
reni;3313147010930001; 5.5.5.202112011542 4 343183
1#0##0#0#0.0#2021-12-08
15:06:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a457d016121d568707aef06354c10187 150000 0 0 0 0 0
0 76045 0 0 15000 0 89790 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 07/02/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SRI SULARMI NY (080054) 080088 50 18565
reni;3313147010930001; 5.5.5.202112011542 4 343189
1#0##0#0#0.0#2021-12-08
15:10:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
d6895c41d406699aec33c576af4a73cc 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 02/07/1964 0 1
1 Z09.8;E11.4;G59.0;J82 87.49 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 523155
0 1 0 0 0 BAMBANG EKO SUHARDAYA,TN 080045 57
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 343192
1#0##0#0#0.0#2022-01-05
14:24:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 3
7365d2caceea084c3f2372da5d530b4b 150000 0 0 0 0 0
200000 76045 0 0 15000 0 82110 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 10/12/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 615001
0 1 0 0 0 JOKO USMANTO 050988 60 22276 DR.
reni;3313147010930001; 5.5.5.202112011542 4 343193
1#0##0#0#0.0#2021-12-09
12:56:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2a95c20b66166eeb05261aae8fcaf69c 150000 0 0 0 0 0
0 63690 0 0 15000 0 386311 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 28/05/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 537810
0 1 0 0 0 BAKDIYAH., NY 064466 52 19185 DR.
reni;3313147010930001; 5.5.5.202112011542 4 343194
1#0##0#0#0.0#2021-12-09
12:57:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e430d2e59d72753bc83e9e528d39e6fa 150000 0 0 0 0 0
0 0 0 0 15000 0 372810 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 02/07/1957 0 1
1 Z09.8;K30;N40 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 216541
0 1 0 0 0 SUWANTO,TN 063153 64 23533 DR. TEKY
reni;3313147010930001; 5.5.5.202112011542 4 343196
1#0##0#0#0.0#2021-12-09
12:57:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
27e542df59f7af9d9bab554ed11474a6 150000 0 0 0 0 0
0 0 0 0 15000 0 51541 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 04/04/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 186180
0 1 0 0 0 PARTI.NY 019820 53 19604 DR. INDRIANY
reni;3313147010930001; 5.5.5.202112011542 4 343486
1#0##0#0#0.0#2021-12-09
13:27:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
82f3d786e01f3188b259e9952c912ded 150000 0 0 0 0 0
0 0 0 0 15000 0 21180 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 01/11/1986 0 2
1 Z09.8;O14.9 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 260678
0 1 0 0 0 SAPARDIYATMI. NY 096964 35 12819 DR.
reni;3313147010930001; 5.5.5.202112011542 4 343487
1#0##0#0#0.0#2021-12-09
13:28:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
045bcb0ea9ea0c1420e92925fb03eabd 150000 0 0 0 0 0
0 0 0 0 15000 0 95678 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 02/04/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 313021
0 1 0 0 0 NUR SHANTI WULANDARI.NY 100245 42 15589
reni;3313147010930001; 5.5.5.202112011542 4 343489
1#0##0#0#0.0#2021-12-09
13:28:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7f1e9702c3774344cf780967c2d9dac0 150000 0 0 0 0 0
0 0 0 0 15000 0 148021 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 28/10/1995 0 2
0 0 - 0 - 0 - 0 - 0 181400 219720
0 1 0 0 0 DITA LUTFIANA ARGASARI,.NN 065069 26
9536 DR. RETNO PUDJIASTUTI, SP.KJ 1124R0021221V000895 0000639413368
3;JKN reni;3313147010930001; 5.5.5.202112011542 4 343490
1#0##0#0#0.0#2021-12-09
13:29:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4238071e01e70bd18e99d80e7a50e64f 150000 0 0 0 0 0
0 0 0 0 15000 0 54720 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 16/10/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 220021
0 1 0 0 0 AGUNG CAHYONO.TN 099954 43 15757 DR.
novia;3313125201940001; 5.6.3.202201201500 4 343492
1#0##0#0#0.0#2022-03-08
09:08:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
53567766c1dc2aedc0d210b39a975220 150000 0 0 0 0 0
0 0 0 0 15000 0 55021 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 16/08/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 241516
0 1 0 0 0 TRIFOSA ROIDA.NY 095537 46 16914 DR.
reni;3313147010930001; 5.5.5.202112011542 4 343493
1#0##0#0#0.0#2021-12-09
13:30:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7e4b189467c6b01f21bfcd2b85457bd6 150000 0 0 0 0 0
0 0 0 0 15000 0 76516 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 15/02/2005 0 2
0 0 - 0 - 0 - 0 - 0 181400 308085
0 1 0 0 0 SYAFA NOOR ARDYANTI, NN 094508 16 6138
reni;3313147010930001; 5.5.5.202112011542 4 343495
1#0##0#0#0.0#2021-12-09
13:31:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
167d1a8240e3eef8d57f15838f99fceb 150000 0 0 0 0 0
0 0 0 0 15000 0 143085 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 25/09/1980 0 2
0 0 - 0 - 0 - 0 - 0 181400 288933
0 1 0 0 0 AMBAR INDAH ROCHYATI NY 085043 41 15047
reni;3313147010930001; 5.5.5.202112011542 4 343496
1#0##0#0#0.0#2021-12-09
13:31:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
593a1138ef651bc150d3d2bc0970c03b 150000 0 0 0 0 0
0 0 0 0 15000 0 123933 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 07/10/1983 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
238260 0 1 0 0 0 IKA NURUL WARDANI.,NN 075648
0002496807393 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
343520 1#0##0#0#0.0#2021-12-09
13:42:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6c7a9accf0514a4051ae61a6fc47b628 150000 0 0 0 0 0
0 0 0 0 15000 0 73260 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 24/01/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 365692
0 1 0 0 0 MUNG TRI DASANI.,NY 044143 47 17483
reni;3313147010930001; 5.5.5.202112011542 4 343521
1#0##0#0#0.0#2021-12-09
13:43:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
342645c18ee022952fcdd0b6de6bc487 150000 0 0 0 0 0
0 0 0 0 15000 0 200692 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 12/07/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 253512
0 1 0 0 0 SRI HARDJANI, NY 062457 66 24254 DR.
reni;3313147010930001; 5.5.5.202112011542 4 343524
1#0##0#0#0.0#2021-12-09
13:44:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9bfb800f739767d31ba1e48873bd54e6 150000 0 0 0 0 0
0 0 0 0 15000 0 88512 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 09/08/1992 0 1
0 0 - 0 - 0 - 0 - 0 181400 375015
0 1 0 0 0 KUKUH PARSETIAWAN. SDR 090802 29 10711
reni;3313147010930001; 5.5.5.202112011542 4 343525
1#0##0#0#0.0#2021-12-09
13:44:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a32ad8236d8308e0ce5102b1b7a05692 150000 0 0 0 0 0
0 0 0 0 15000 0 210015 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 09/04/2004 0 2
0 0 - 0 - 0 - 0 - 0 181400 217922
0 1 0 0 0 NIKEN SOFI SALMA., NN 072205 17 6450
reni;3313147010930001; 5.5.5.202112011542 4 343526
1#0##0#0#0.0#2021-12-09
13:45:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
74724d5ce6541238c156e1c8fc2de31c 150000 0 0 0 0 0
0 0 0 0 15000 0 52922 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 03/11/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 242066
0 1 0 0 0 SITI ISTINGANAH.NY 099830 49 17930
reni;3313147010930001; 5.5.5.202112011542 4 343528
1#0##0#0#0.0#2021-12-09
13:45:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1a5fc029650c0729fab6ddda2854b6c4 150000 0 0 0 0 0
0 0 0 0 15000 0 77066 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 03/09/1999 0 2
0 0 - 0 - 0 - 0 - 0 181400 226728
0 1 0 0 0 SEKAR KINANTHI.NN 095022 22 8130 DR.
reni;3313147010930001; 5.5.5.202112011542 4 343529
1#0##0#0#0.0#2021-12-09
13:46:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
31b1cfec271a9e80a6e909d67418fdec 150000 0 0 0 0 0
0 0 0 0 15000 0 61728 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 22/07/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 242172
0 1 0 0 0 YULIANTIN ARASTINI.NY 098245 59 21687
reni;3313147010930001; 5.5.5.202112011542 4 343530
1#0##0#0#0.0#2021-12-09
13:47:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
002f95282cddd1975c6355d9f04200a3 150000 0 0 0 0 0
0 0 0 0 15000 0 77172 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 04/06/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 354800
0 1 0 0 0 BAMBANG INDARTO.TN 096080 62 22831
reni;3313147010930001; 5.5.5.202112011542 4 343531
1#0##0#0#0.0#2021-12-09
13:47:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
84b827a8ea607293a5ec15795445f833 150000 0 0 0 0 0
0 44300 0 0 15000 0 145500 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 08/05/1979 0 1
0 0 - 0 - 0 - 0 - 0 181400 351405
0 1 0 0 0 DANNY EKO NUGROHO, TN 069283 42 15553
reni;3313147010930001; 5.5.5.202112011542 4 343533
1#0##0#0#0.0#2021-12-09
13:47:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1ddeac3f63ee44c2fc8937534bc30e0a 150000 0 0 0 0 0
0 0 0 0 15000 0 186405 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 08/04/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 366015
0 1 0 0 0 ALBERTINE WIHARTARI, NY 048111 73 26905
reni;3313147010930001; 5.5.5.202112011542 4 343534
1#0##0#0#0.0#2021-12-09
13:48:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e3de22f58bd152771830b159ce1eddff 150000 0 0 0 0 0
0 0 0 0 15000 0 201015 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 17/07/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 298672
0 1 0 0 0 SUGIYATMI.NY 099315 64 23518 DR.
reni;3313147010930001; 5.5.5.202112011542 4 343535
1#0##0#0#0.0#2021-12-09
14:01:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3ba700b2f892eb84cd1d459d052b063f 150000 0 0 0 0 0
0 0 0 0 15000 0 133672 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 02/02/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 212206
0 1 0 0 0 YEKTI MAWARINI.,NY 052365 50 18570
reni;3313147010930001; 5.5.5.202112011542 4 343536
1#0##0#0#0.0#2021-12-09
14:02:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cbf8fb2780f4e1d835f4210d9e0955c1 150000 0 0 0 0 0
0 0 0 0 15000 0 47206 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 13/05/1962 0 2
2 Z09.8;C53.9 88.79 - - None None None None Z-3-23-0 None
0 - 0 - 0 - 0 - 0 549400 376131
0 1 0 0 0 KUSRI SETYANINGSIH.NY 095523 59 21757
DR. DEWI ANGGOROWATI, SP.OG 1124R0021221V000913 0001699282089 3;JKN
reni;3313147010930001; 5.5.5.202112011542 4 343537
1#0##0#0#0.0#2021-12-09
14:02:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7f4c39d9e0a0161a003b2d496c234b58 150000 0 0 0 0 0
0 0 0 0 15000 0 211131 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 21/04/1965 0 2
1 Z09.8;I11.9;K80.2;K52.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 281760
0 1 0 0 0 SARTINI 092871 56 20683 DR. TEKY
reni;3313147010930001; 5.5.5.202112011542 4 343539
1#0##0#0#0.0#2021-12-09
14:03:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ba806bee526502b624d08679f8549523 150000 0 0 0 0 0
0 0 0 0 15000 0 116760 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 13/12/1962 0 2
0 - 0 - 0 - 0 - 0 549400 180915
0 1 0 0 0 WIYATMININGSIH.NY 099135 58 21543 DR.
reni;3313147010930001; 5.5.5.202112011542 4 343540
1#0##0#0#0.0#2021-12-09
14:03:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
66f13a1235593deb2a9fb00caee6318b 150000 0 0 0 0 0
0 0 0 0 15000 0 15915 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 16/09/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 231792
0 1 0 0 0 INDAH SETIYANINGSIH. NY 084608 48 17613
reni;3313147010930001; 5.5.5.202112011542 4 343541
1#0##0#0#0.0#2021-12-09
14:04:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
409082c6e980703a765bc92a2ac6207e 150000 0 0 0 0 0
0 0 0 0 15000 0 66792 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 20/12/1968 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
735259 0 1 0 0 0 JAROT WAHYU NUGROHO, TN 070453
0002033015984 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
343543 1#0##0#0#0.0#2021-12-09
14:05:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dfcc1536fc98a5610505dd6936e0dd0b 150000 0 0 0 0 0
0 76595 0 0 15000 0 493664 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 14/06/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001429190267 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
343544 1#0##0#0#0.0#2021-12-09
14:05:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2f5570a08321efca9cc8fc49ca403550 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 23/07/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ERNIE HADIANTI, NY
0001868943565 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
343545 1#0##0#0#0.0#2021-12-09
14:06:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
791c3c05e69957d828bd31b340eba0ad 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 11/07/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI PARYATI, NY
0000091170516 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
343547 1#0##0#0#0.0#2021-12-09
14:06:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5e23b43a53ab71cb6ce4ae05cca9b27c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 31/12/1958 0 2
0 - 0 107400 262000 0 1 0 0 0 SRI
SUWANTI, NY 091754 62 22986 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000922 0001967417043 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 343548 1#0##0#0#0.0#2021-12-09
14:07:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7d1707bf5ebc8526d1f33d6a612b08e2 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 11/11/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 199000
0 1 0 0 0 SRI YANI, NY 071324 56 20479 DR.
reni;3313147010930001; 5.5.5.202112011542 4 343580
1#0##0#0#0.0#2021-12-09
14:18:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7523877094c5dc148d0bb162ac82b680 0 0 184000 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 20/06/1943 0 2
0 - 0 107400 273000 0 1 0 0 0
HARTINI.NY 079458 78 28659 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V000924 0001800527916 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 343581 1#0##0#0#0.0#2021-12-09
14:19:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9ce5a8a5aab3937a1d111f854b09e8bf 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 29/12/1959 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 207500 0 1 0 0 0 SIDIK PRAMONO, BP
0000088602772 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
343582 1#0##0#0#0.0#2021-12-09
14:25:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
14bbbede35f01d93fa039c48010a6d70 0 0 192500 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 11/03/1945 0 1
TENGGOROKAN 251000 0 0 - 0 - 0 - 0 - 0
251000 165000 0 1 0 0 0 HARTONO BUDIHARJO, TN
0002421138936 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
343583 1#0##0#0#0.0#2021-12-09
14:25:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
798b1c62a9c9623d0009372626d15879 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 02/08/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SITI MAJIAH, NY
0000639393467 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
343584 1#0##0#0#0.0#2021-12-09
14:28:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
514ec747c4dbc5d423aa4953ca4e711b 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 25/02/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 281385
0 1 0 0 0 AGUS DARMAWAN.TN 099944 53 19643 DR.
reni;3313147010930001; 5.5.5.202112011542 4 343585
1#0##0#0#0.0#2021-12-09
14:29:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
94cfb3bc15bfc3814f382084217db36f 150000 0 0 0 0 0
0 0 0 0 15000 0 116385 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 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 reni;3313147010930001; 5.5.5.202112011542 4
343586 1#0##0#0#0.0#2021-12-09
14:30:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2992c574b0c0c65598af17c8902faee3 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 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 reni;3313147010930001; 5.5.5.202112011542 4
343587 1#0##0#0#0.0#2021-12-09
14:34:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
41181aee83dbb25728e51df99ec6eb69 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 04/05/1958 0 2
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.5.5.202112011542 4 343588
1#0##0#0#0.0#2021-12-09
14:36:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
705dbea56356d266414bccf2c949d19d 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 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 reni;3313147010930001; 5.5.5.202112011542 4
343589 1#0##0#0#0.0#2021-12-09
14:39:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
333fff1fd0adb8d234a2a5bd56e93bda 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 10/06/1972 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI RAHAYU.NY
0002624809645 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
343590 1#0##0#0#0.0#2021-12-09
14:39:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8726bb3d13e8cad619cbeb7033a1d64d 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 22/04/1992 0 1
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.5.5.202112011542 4 343591
1#0##0#0#0.0#2021-12-09
14:40:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7c5951eee7f83ff77f9a92f81e45d4b4 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 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 reni;3313147010930001; 5.5.5.202112011542 4
343592 1#0##0#0#0.0#2021-12-09
14:41:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
33f62257d827530e571bbd8b8ad6cad0 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 04/09/1964 0 1
0 - 0 - 0 - 0 786200 677676 0 1
reni;3313147010930001; 5.5.5.202112011542 4 343593
1#0##0#0#0.0#2021-12-09
14:42:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ca5700e2110a2786c1b139d62765be4b 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 25/06/1970 0 2
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.5.5.202112011542 4 343594
1#0##0#0#0.0#2021-12-09
14:42:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eeb59586c36099bf8987efb38880b89c 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 17/09/1960 0 1
1 Z09.8;E11.3;H36.0;H26.9;H52.4 90.29;95.01 - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 301975 0 1 0 0 0 WARNO.TN 097648
0002094611141 3;JKN novia;3313125201940001; 5.6.3.202201201500 4
343595 1#0##0#0#0.0#2022-03-08
07:59:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
c9200414c1e063b8bb6b4711d3f750e2 256000 0 0 0 0 0
0 0 0 0 15000 0 30975 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 09/10/2001 0 1
0 404900 388162 0 1 0 0 0 MUHAMMAD DIMAS
ZAKARIA,SDR 002395 20 7363 DR. WAHYU PURNOMO, SP.OT
1124R0021221V000941 0001107133435 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 343597 1#0##0#0#0.0#2021-12-09
14:49:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4445c7b4cbf174abade89f5b54bd91f8 150000 0 0 0 0 0
0 0 0 0 15000 0 223162 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 11/05/1934 0 2
1 Z09.8;H40.9;H26.9;H35.0 90.29 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 257885
0 1 0 0 0 SITI CHOTIMAH.NY 100244 87 31986 DR.
novia;3313125201940001; 5.6.3.202201201500 4 343598
1#0##0#0#0.0#2022-02-15
12:04:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
4592625bca40e42b1b88a6b57b4efef5 203000 0 0 0 0 0
0 0 0 0 15000 0 39885 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 12/10/1987 0 1
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.5.5.202112011542 4 343599
1#0##0#0#0.0#2021-12-09
14:51:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d1e03017d4d10c28b1109e092c371ece 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 14/10/1972 0 2
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.5.5.202112011542 4 343601
1#0##0#0#0.0#2021-12-09
14:51:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b6ced3cae81be7c1101108ff54ebc96e 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 27/06/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 745189
0 1 0 0 0 SUWARNO,(BP) 009683 54 19886 DR.
reni;3313147010930001; 5.5.5.202112011542 4 343602
1#0##0#0#0.0#2021-12-09
14:52:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
16302c15abf45209fc64f8a3844c68af 150000 0 0 0 0 0
0 213690 0 0 15000 0 366499 0 0 0 0
0
3372030 C 3 CP 2 06/12/2021 06/12/2021 10/02/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 195135
0 1 0 0 0 SUKAMTI.NY 097604 65 24041 DR. INDRIANY
reni;3313147010930001; 5.5.5.202112011542 4 343603
1#0##0#0#0.0#2021-12-09
14:52:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a5aac74c343a02eb39f70779592dc582 150000 0 0 0 0 0
0 0 0 0 15000 0 30135 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 12/03/1955 0 2
0 - 0 - 0 - 0 786200 677676 0 1
reni;3313147010930001; 5.5.5.202112011542 4 343604
1#0##0#0#0.0#2021-12-09
14:53:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ce9a1171f34f380ac7b06ca40c7458ef 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 29/10/1992 0 2
1 Z09.8;R10.4 88.76 - - None None None None Z-3-23-0 None
0 - 0 - 0 - 0 - 0 549400 858751
0 1 0 0 0 OKTAVIANI SELAWATI, NY 055505 29 10630
novia;3313125201940001; 5.5.5.202112011542 4 344031
1#0##0#0#0.0#2021-12-14
09:55:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2d5f2f28897fec87dbabb11c06578092 150000 0 0 0 0 0
657000 0 0 0 15000 0 36751 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 23/03/1976 0 2
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.5.5.202112011542 4 343605
1#0##0#0#0.0#2021-12-09
14:54:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3f903f46ebe5d49e8580ede29faf9e4c 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 17/04/1973 0 1
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.5.5.202112011542 4 343606
1#0##0#0#0.0#2021-12-09
14:54:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5d029b47125a1197ab2e84b053d72ccb 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 18/03/1988 0 1
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.5.5.202112011542 4 343607
1#0##0#0#0.0#2021-12-10
09:30:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
633433b9aaed924a7101e9d1efceee70 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 12/02/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 425410
0 1 0 0 0 DARWATI, NY 094471 57 21117 DR. RETNO
PUDJIASTUTI, SP.KJ 1124R0021221V000953 0002040571449 3;JKN
novia;3313125201940001; 5.6.3.202201201500 4 343608
1#0##0#0#0.0#2022-02-15
13:22:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
95874175d87cb40545ac7a6fe940e1e1 150000 0 0 0 0 0
0 0 0 0 15000 0 260410 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 10/12/1982 0 1
0 - 0 - 0 - 0 786200 677676 0 1
reni;3313147010930001; 5.5.5.202112011542 4 343609
1#0##0#0#0.0#2021-12-10
09:31:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
927b489dbc568025b45ac59659085771 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 13/12/1946 0 2
0 0 - 0 - 0 - 0 - 0 181400 248975
0 1 0 0 0 JOHANA SUPARTINI, NY 063968 74 27387
reni;3313147010930001; 5.5.5.202112011542 4 343610
1#0##0#0#0.0#2021-12-10
09:32:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
399f40a0870f23a330ec245495749068 203000 0 0 0 0 0
0 0 0 0 15000 0 30975 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 15/07/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 LILIK ANDRIYANI. NY 093353 55 20233
reni;3313147010930001; 5.5.5.202112011542 4 343611
1#0##0#0#0.0#2021-12-10
09:34:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
272ac7958b1f8e26dd35adba881d0138 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 31/01/1971 0 2
- 0 - 0 - 0 - 0 549400 175000 0
1 0 0 0 SRI RAHAYU.NY 100506 50 18572 DR. DEWI
ANGGOROWATI, SP.OG 1124R0021221V000957 0001125908831 3;JKN
reni;3313147010930001; 5.5.5.202112011542 4 343612
1#0##0#0#0.0#2021-12-10
09:34:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.5.5.202112011542 4 343614
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reni;3313147010930001; 5.5.5.202112011542 4 343615
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09:36:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.5.5.202112011542 4 343620
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09:46:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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09:48:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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09:48:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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09:55:52#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#2021-12-10
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1#0##0#0#0.0#2021-12-10
10:15:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.5.5.202112011542 4 343643
1#0##0#0#0.0#2021-12-10
10:16:17#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#2021-12-10
10:16:45#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#2021-12-10
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1#0##0#0#0.0#2021-12-10
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1#0##0#0#0.0#2021-12-10
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10:18:42#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#2021-12-10
10:19:47#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#2021-12-10
10:20:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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10:36:07#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#2022-01-05
14:25:38#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#2021-12-10
10:38:06#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#2021-12-10
10:39:03#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#2021-12-10
10:39:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1277ae5f4bf13fd96bfd6efa8d91978a 150000 0 0 0 0 0
0 0 0 0 15000 0 133405 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 26/08/2001 0 2
0 0 - 0 - 0 - 0 - 0 181400 231038
0 1 0 0 0 FANIN NUR ISNAINI.NN 037492 20 7407
reni;3313147010930001; 5.5.5.202112011542 4 343660
1#0##0#0#0.0#2021-12-10
10:52:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
16e3f48ced16f62338acb715e2f292b0 150000 0 0 0 0 0
0 0 0 0 15000 0 66038 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 16/06/1997 0 2
0 0 - 0 - 0 - 0 - 0 181400 218826
0 1 0 0 0 INDRI YUNIARSIH.NY 093960 24 8939
reni;3313147010930001; 5.5.5.202112011542 4 343661
1#0##0#0#0.0#2021-12-10
10:52:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
35b70144b0a993de508386c15d1ea1b9 150000 0 0 0 0 0
0 0 0 0 15000 0 53826 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 12/08/1994 0 2
0 0 - 0 - 0 - 0 - 0 296400 175000
0 1 0 0 0 AYU ANDRIYATI.NY 100509 27 9978 DR.
reni;3313147010930001; 5.5.5.202112011542 4 343662
1#0##0#0#0.0#2021-12-10
10:53:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9f511539ad0c737453274304c4fbb639 150000 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 17/02/1947 0 2
1 Z09.8;M54.59;H81.3;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 201665
0 1 0 0 0 SRI MARNI.NY 084955 74 27321 DR.
reni;3313147010930001; 5.5.5.202112011542 4 343664
1#0##0#0#0.0#2021-12-10
10:54:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d96d8281495958a120b72bf4e1d49594 150000 0 0 0 0 0
0 0 0 0 15000 0 36665 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 07/01/1964 0 1
1 J40;I20.9 87.49 - - None None None None Q-5-26-0 None
None None None None None BRONKIAL AKUT 192500 0 0 -
0 - 0 - 0 - 0 192500 520205 0 1
0 0 0 ARRIS SYAMSU, S.AP, S.H 081474 57 21153 DR. TEKY
reni;3313147010930001; 5.6.7.202204241238 4 344032
1#0##0#0#0.0#2022-07-05
08:46:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 5
638ef15b68d1e35c3f4834c14f2f479a 150000 0 0 0 0 0
200000 0 0 0 15000 0 155205 0 0 0 0
0
3372030 C 3 CP 2 06/12/2021 06/12/2021 10/12/1987 0 2
1 G51.0 - - - 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
193800 0 1 0 0 0 ENNI NURYANTI.NY 100511 33
0002343882982 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
343665 1#0##0#0#0.0#2021-12-10
10:54:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
24327ef70c4333d5a26cb40061b3bdf8 150000 0 0 0 0 0
0 0 0 0 25000 0 18800 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 13/12/1981 0 2
0 0 - 0 - 0 - 0 - 0 181400 429385
0 1 0 0 0 SUMINI, NY 073261 39 14603 DR. INDRIANY
novia;3313125201940001; 5.5.5.202112011542 4 347084
1#0##0#0#0.0#2022-01-05
14:27:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
aa4d431d548d72cb3a071c14b60bfd28 150000 0 0 0 0 0
220000 0 0 0 15000 0 44385 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 15/12/1990 0 2
1 S92.00;V19.9 88.27 - - None None None None Q-5-31-0
0 - 0 - 0 - 0 129600 503952 0 1
0 0 0 DESI KURNIAWATI, NY 093324 30 11314 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 344033
1#0##0#0#0.0#2021-12-14
09:57:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e81957ee6b7c6685135c7fcc91e32db8 300000 0 0 0 0 0
150000 0 0 0 15000 0 38952 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 16/11/2006 0 1
1 K30 - - - 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 188900
0 1 0 0 0 AKBAR SYAHPUTRA ,(AN) 010890 15 5499
0001106516687 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
343666 1#0##0#0#0.0#2021-12-10
10:56:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3a36a914bda7ac7aa1fe55971876ec82 150000 0 0 0 0 0
0 0 0 0 15000 0 23900 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 27/06/1959 0 2
0 - 0 - 0 - 0 137000 280285 0 1
0 0 0 SRI MARGANI.NY 100512 62 22808 DR. INDRIANY
reni;3313147010930001; 5.5.5.202112011542 4 343667
1#0##0#0#0.0#2021-12-10
10:56:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d50903cc693f83ed817445c7aad4c179 150000 0 0 0 0 0
0 0 0 0 25000 0 105285 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 03/04/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 201330
0 1 0 0 0 RIPTYAWATI. NY 053697 57 21066 DR.
reni;3313147010930001; 5.5.5.202112011542 4 343668
1#0##0#0#0.0#2021-12-10
10:57:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
788de3e3cf7a26eb2e42b26bcfff8aa1 150000 0 0 0 0 0
0 0 0 0 15000 0 36330 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 21/01/1998 0 1
0 0 - 0 - 0 - 0 - 0 181400 213730
0 1 0 0 0 YANUAR ERWAN SAPUTRA.TN 100499 23 8720
reni;3313147010930001; 5.5.5.202112011542 4 343669
1#0##0#0#0.0#2021-12-10
10:57:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d088d1db1a3e80959379279e491e34c2 150000 0 0 0 0 0
0 0 0 0 15000 0 48730 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 02/03/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 225795
0 1 0 0 0 ZAIDUN ELLY,(NY) 012944 57 21098 DR.
reni;3313147010930001; 5.5.5.202112011542 4 343670
1#0##0#0#0.0#2021-12-10
10:58:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
112726d88fad43c0ec6396a481a5e4ab 150000 0 0 0 0 0
0 0 0 0 15000 0 60795 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 09/03/1969 0 1
0 - 0 - 0 - 0 786200 524711 0 1
SP.PD 1124R0021221V001018 0001105068789 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 343671 1#0##0#0#0.0#2021-12-10
11:05:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ce04f5f1fea61b01ed0077deb4e0fa6e 463830 0 0 0 0 0
0 0 0 0 15000 0 45881 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 09/05/1975 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V001019 0001105378571 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 343672 1#0##0#0#0.0#2021-12-10
11:06:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
45053bbc50679acde57d78dffc163175 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 12/07/1966 0 1
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.5.5.202112011542 4 343673
1#0##0#0#0.0#2021-12-10
11:06:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
53b446e18041e9282c707c654b0bbf54 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 12/12/1964 0 1
0 - 0 - 0 - 0 786200 677676 0 1
reni;3313147010930001; 5.5.5.202112011542 4 343674
1#0##0#0#0.0#2021-12-10
11:08:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6cb2f0e141ab7ec9c42b50aa389d9239 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 22/10/1959 0 2
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.5.5.202112011542 4 343675
1#0##0#0#0.0#2021-12-10
11:09:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0fad5b6451105112d77df0cfd17d610f 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 28/02/1967 0 2
0 - 0 - 0 - 0 786200 677676 0 1
reni;3313147010930001; 5.5.5.202112011542 4 343676
1#0##0#0#0.0#2021-12-10
11:10:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4bc7c6dfa06f74c85cbf827070304677 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 12/08/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.5.5.202112011542 4 343677
1#0##0#0#0.0#2021-12-10
11:15:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
60cb8c5a02c8d90ca4c19d234aa394d5 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 31/12/1971 0 2
0 - 0 - 0 - 0 786200 677676 0 1
SP.PD 1124R0021221V001025 0000555344774 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 343678 1#0##0#0#0.0#2021-12-10
11:16:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
84edc970c4d0ea640cb725f8667671ea 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 26/06/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 229680
0 1 0 0 0 MARKAMAH,NY 085323 52 19156 DR. WAHYU
reni;3313147010930001; 5.5.5.202112011542 4 343679
1#0##0#0#0.0#2021-12-10
11:16:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bafc6da0a65131b70747c0061ecdc3f2 150000 0 0 0 0 0
0 0 0 0 15000 0 64680 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 10/07/1955 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V001027 0001032581823 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 343680 1#0##0#0#0.0#2021-12-10
11:16:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5f75aa4cd374d6540ee5d091c1a19e6c 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 03/08/1963 0 2
0 - 0 - 0 - 0 786200 677676 0 1
reni;3313147010930001; 5.5.5.202112011542 4 343681
1#0##0#0#0.0#2021-12-10
11:17:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
96e77f439652ddee22607029151e6919 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 23/12/2011 0 1
1 Z09.4;S52.50;V19.9 87.49 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 185263
0 1 0 0 0 RAVEL ADRYAN N, AN 100466 9 3636
reni;3313147010930001; 5.6.0.202201041418 4 343682
1#0##0#0#0.0#2022-01-07
19:52:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
1c736bfcf4a15db7a5cf718703230b98 150000 0 0 0 0 0
0 0 0 0 15000 0 20263 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 26/03/2019 0 1
1 R11 - - - None None None None Q-5-25-0 None None
0 - 0 - 0 - 0 135700 227124 0 1
0 0 0 RIFQI FAIZ MAULANA, AN 075843 2 986 DR. CHIKA
5.5.5.202112011542 4 346631 1#0##0#0#0.0#2022-01-04
13:30:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ac061eb422e35a304ecc14503dba7f0c 195000 0 0 0 0 0
0 0 0 0 15000 0 17124 0 0 0 0 0
3372030 C 3 CP 2 06/12/2021 06/12/2021 11/04/1972 0 1
1 N23 - - - None None None None Q-5-32-0 None None
None None None None GANGGUAN SALURAN KEMIH AKUT 250700 0 0
- 0 - 0 - 0 - 0 250700 327087 0
1 0 0 0 NURWAKIT,TN 062256 49 18136 dr. ANDANG
1124R0021221V001034 0001102659772 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346632 1#0##0#0#0.0#2022-01-04
13:31:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c53081b80269dae7475cc37bc581ee49 195000 0 0 0 0 0
0 0 0 0 15000 0 117087 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 15/12/1953 0 2
1 Z09.8;J45.9;J06.9;K21.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 302432
0 1 0 0 0 PRIHATIN, NY 026624 67 24829 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343751
1#0##0#0#0.0#2021-12-13
13:18:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6240fb63ecf9e76a9ed380c70e49373e 150000 0 0 0 0 0
0 0 0 0 15000 0 137432 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 01/04/1962 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
480985 0 1 0 0 0 SRI LESTARI A.NY 083216 59
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343752
1#0##0#0#0.0#2021-12-13
13:22:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
89cdd5097c51080ceb0aebab3dc3de59 150000 0 0 0 0 0
0 76045 0 0 15000 0 239940 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 12/02/1971 0 2
1 Z09.8;I11.9;M19.99;E78.5 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
249986 0 1 0 0 0 ENDANG SUPRAPTI,(NY) 007815
0001286223309 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343753 1#0##0#0#0.0#2021-12-13
13:24:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e59cb541d70dc8955dc05ccc36e0d943 150000 0 0 0 0 0
0 0 0 0 15000 0 84986 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 20/12/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 279337
0 1 0 0 0 SLAMET ATMO,(BP) 037900 76 28111 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343754
1#0##0#0#0.0#2021-12-13
13:24:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
14200575c35ee97d5ec8775e86fd72c0 150000 0 0 0 0 0
0 31845 0 0 15000 0 82492 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 06/06/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 253825
0 1 0 0 0 UMI NAFIAH. NY 076253 47 17351 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343755
1#0##0#0#0.0#2021-12-13
13:25:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1660fcf8b4d91fb72b26e062a2a7e40b 150000 0 0 0 0 0
0 76045 0 0 15000 0 12780 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 14/07/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 223585
0 1 0 0 0 SAPTINING DYAH, NY 070661 62 22792
yani;3302226402970001; 5.5.5.202112011542 4 343756
1#0##0#0#0.0#2021-12-13
13:27:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0de4a524bc3bd555bf932e2bafb547ab 150000 0 0 0 0 0
0 31845 0 0 15000 0 26740 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 09/08/1966 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
449618 0 1 0 0 0 ENDANG SRI REJEKI.NY 076795
0000639695889 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343757 1#0##0#0#0.0#2021-12-13
13:28:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ad2ec173235682a1762394447d1563c6 150000 0 0 0 0 0
0 31845 0 0 15000 0 252773 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 21/10/1961 0 2
1 Z09.8;E11.4;G59.0;M17.9 87.49 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 600206
0 1 0 0 0 SRI RAHAYU ( NY ) 050034 60 21962 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344034
1#0##0#0#0.0#2021-12-14
10:00:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1af7590f09a2b321f227ac955ed14df5 150000 0 0 0 0 0
200000 31845 0 0 15000 0 203361 0 0 0 0
0
3372030 C 3 CP 2 07/12/2021 07/12/2021 07/08/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 364560
0 1 0 0 0 GIYANI., NY 049228 73 26785 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 343758
1#0##0#0#0.0#2021-12-13
13:29:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
112f5adc36fd39b210c276a21d361aff 150000 0 0 0 0 0
0 88900 0 0 15000 0 110660 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 17/08/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 300915
0 1 0 0 0 SUWARNI, NY 079454 44 16183 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 343759
1#0##0#0#0.0#2021-12-13
13:30:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6d220cbd6ed7099f921bb608b105b06f 150000 0 0 0 0 0
0 31845 0 0 15000 0 104070 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 03/04/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 950117
0 1 0 0 0 WALUYO.TN 100150 59 21798 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 343760
1#0##0#0#0.0#2021-12-13
13:32:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7e82bba6039b1434111a018566fdd793 150000 0 0 0 0 0
0 0 0 0 15000 0 785117 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 23/01/1981 0 1
0 0 - 0 - 0 - 0 - 0 181400 926605
0 1 0 0 0 HARTANTO FREDY KURNIAWAN,(BP) 039571 40
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343761
1#0##0#0#0.0#2021-12-13
13:33:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 19/07/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SITI WARSINI.NY
0001387776519 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343722 1#0##0#0#0.0#2021-12-13
13:36:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 18/01/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000090992327 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343730 1#0##0#0#0.0#2021-12-13
13:37:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 02/01/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 402121
0 1 0 0 0 HAYU SEMESTYARINI., NY 046052 60 22254
yani;3302226402970001; 5.5.5.202112011542 4 343762
1#0##0#0#0.0#2021-12-13
13:42:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 10/04/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 202946
0 1 0 0 0 TRISNO SUJARWADI.TN 098559 49 18138
yani;3302226402970001; 5.5.5.202112011542 4 343763
1#0##0#0#0.0#2021-12-13
13:43:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 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; 5.5.5.202112011542 4
343728 1#0##0#0#0.0#2021-12-13
13:45:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 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; 5.5.5.202112011542 4
343741 1#0##0#0#0.0#2021-12-13
13:46:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
df008cb50c981f0af0fc69ef2fc380d5 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 28/12/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 196471
0 1 0 0 0 NURUL FAUZIAH ISVANDARI,NY 083500 53
3;JKN novia;3313125201940001; 5.6.3.202201201500 4 343764
1#0##0#0#0.0#2022-03-08
09:16:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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0 0 0 0 15000 0 31471 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 13/10/2002 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 RIZWAN
1124R0021221V001063 0003071567755 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343740 1#0##0#0#0.0#2021-12-13
13:48:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
df89beccf7adf08fb6d261144674f622 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 17/11/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 215720
0 1 0 0 0 WIWIK WIDOWATI PONCORETNO S. NY 087095
0000085201165 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343767 1#0##0#0#0.0#2021-12-13
13:49:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 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 18697 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V001065 0001211692601 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343732 1#0##0#0#0.0#2021-12-13
13:50:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 25/12/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MARIA
1124R0021221V001068 0002069991685 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343742 1#0##0#0#0.0#2021-12-13
13:51:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
53a5ce4981d04ed4e40059feb7e55641 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 03/08/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ISMURYANI
1124R0021221V001070 0001313177196 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343733 1#0##0#0#0.0#2021-12-13
13:53:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4e9641e483a0183c896b8113405aa769 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 29/11/1962 0 2
1 Z09.8;I10;J44.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 391057
0 1 0 0 0 WIDASTIWI. NY 010733 59 21558 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343995
1#0##0#0#0.0#2021-12-13
13:55:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1ccaf91fb03651b84ff81f0d68a4e8b8 150000 0 0 0 0 0
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3372030 C 3 CP 2 07/12/2021 07/12/2021 09/05/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 522628
0 1 0 0 0 SUDARSONO, TN 066776 72 26510 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343768
1#0##0#0#0.0#2021-12-13
14:01:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
14fe18811d4427798b668ff6fc3d5995 150000 0 0 0 0 0
0 31845 0 0 15000 0 325783 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 18/06/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 214290
0 1 0 0 0 ROBI ARIYANTO, TN 083181 43 15878 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343769
1#0##0#0#0.0#2021-12-13
14:02:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 31845 0 0 15000 0 17445 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 15/09/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 432775
0 1 0 0 0 SUHARTI SUTARNO, NY 065927 64 23459
yani;3302226402970001; 5.5.5.202112011542 4 343770
1#0##0#0#0.0#2021-12-13
14:04:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 171170 0 0 15000 0 96605 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 23/03/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 330440
0 1 0 0 0 DJARWOSRI.TN 093643 71 26192 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343771
1#0##0#0#0.0#2021-12-13
14:05:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0679b80a39479e88cec7c34eac15d841 150000 0 0 0 0 0
0 44200 0 0 15000 0 121240 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 07/04/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 920697
0 1 0 0 0 WARTINI.,NY 075390 56 20698 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 343772
1#0##0#0#0.0#2021-12-13
14:16:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 63690 0 0 15000 0 692007 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 12/02/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 237212
0 1 0 0 0 MUSTOFA ANTON RIYADI,TN 037570 60 22213
yani;3302226402970001; 5.5.5.202112011542 4 343773
1#0##0#0#0.0#2021-12-13
14:17:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3a9460361799506ade5306627d51fcb0 150000 0 0 0 0 0
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3372030 C 3 CP 2 07/12/2021 07/12/2021 13/10/2005 0 2
0 - 0 - 0 - 0 - 0 181400 183280
0 1 0 0 0 AFIFAH NUR HIDAYAH.NN 100516 16 5899
DR. OEDJANG SETIJAWAN, MSI.MED.,SP.B 1124R0021221V001080
0002351668961 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343774 1#0##0#0#0.0#2021-12-13
14:20:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0a40704030bbe321d450b7015f6e3b7d 150000 0 0 0 0 0
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3372030 C 3 CP 2 07/12/2021 07/12/2021 25/09/1976 0 1
- 0 - 0 - 0 - 0 182600 384070 0
1 0 0 0 GIMINANTO.TN 080056 45 16509 DR. RINA
5.6.0.202201041418 4 347812 1#0##0#0#0.0#2022-01-06
16:27:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 27/12/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 423583
0 1 0 0 0 SUMARIATUN,(NY) 011533 51 18973 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343775
1#0##0#0#0.0#2021-12-13
14:21:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 258583 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 14/01/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 238560
0 1 0 0 0 SARMI.NY 099958 46 17129 DR. RINA
5.5.5.202112011542 4 343776 1#0##0#0#0.0#2021-12-13
14:23:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 12/11/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 428450
0 1 0 0 0 NGATIYEM,NY 049849 54 19749 DR. SUHARTO,
SP.PD 1124R0021221V001085 0000639735772 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343777 1#0##0#0#0.0#2021-12-13
14:24:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 171170 0 0 15000 0 92280 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 14/04/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI MULYANI 093246
0000640565201 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343735 1#0##0#0#0.0#2021-12-13
14:26:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 28/05/1975 0 2
1 Z09.8;E11.9;M72.28 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 242012
0 1 0 0 0 MARIA SAPTININGSIH.NY 099116 46 16995
yani;3302226402970001; 5.5.5.202112011542 4 343778
1#0##0#0#0.0#2021-12-13
14:27:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 31845 0 0 15000 0 45167 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 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; 5.5.5.202112011542 4
343734 1#0##0#0#0.0#2021-12-13
14:30:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 01/08/2001 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 RAHMAT NUR
HIDAYAHT ., SDR 056491 20 7433 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V001089 0001615464257 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343706 1#0##0#0#0.0#2021-12-13
14:31:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
298ccbda056ce1557a338ffa4e9b3bf5 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 12/03/1981 0 2
1 Z09.8;R51;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 246495
0 1 0 0 0 SUANTI, NY 100353 40 14880 DR. SUHARTO,
SP.PD 1124R0021221V001090 0001302444742 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343779 1#0##0#0#0.0#2021-12-13
14:32:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 10/11/1965 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002165956975 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343738 1#0##0#0#0.0#2021-12-13
14:41:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 10/01/1963 0 2
1 Z09.8;K30;E11.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 356528
0 1 0 0 0 NANING HARTINI., NY 048822 58 21516
yani;3302226402970001; 5.5.5.202112011542 4 343780
1#0##0#0#0.0#2021-12-13
14:42:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 31845 0 0 15000 0 159683 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 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; 5.5.5.202112011542 4
343747 1#0##0#0#0.0#2021-12-13
14:42:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 11/01/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 322177
0 1 0 0 0 PRAPTI INDRINI 069334 54 20054 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343781
1#0##0#0#0.0#2021-12-13
14:45:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0a355d4b73e27644359854ee9564c96a 150000 0 0 0 0 0
0 31845 0 0 15000 0 125332 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
343737 1#0##0#0#0.0#2021-12-13
14:47:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 26/10/1978 0 2
1 Z09.8;D25.9;N83.2 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 215000
0 1 0 0 0 ENI HARYANTI.NY 097305 43 15748 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343782
1#0##0#0#0.0#2021-12-13
14:49:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
494859e11fcbacb8af2fb77baebe63bb 200000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 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; 5.5.5.202112011542 4
343749 1#0##0#0#0.0#2021-12-13
14:50:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1e3cf14a040919293ec0079ed609cdfe 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 23/04/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 216746
0 1 0 0 0 SURYATI, NY 037498 53 19586 DR. RINA
5.5.5.202112011542 4 343783 1#0##0#0#0.0#2021-12-13
14:53:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 51746 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 08/12/1949 0 1
0 - 0 107400 262000 0 1 0 0 0 SISWO
SARJONO,(BP) 028784 71 26297 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V001099 0000564473013 3;JKN yani;3302226402970001;
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15:12:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 21/02/1960 0 2
1 Z09.8;R51;M54.59 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 290757
0 1 0 0 0 SRI HARYATI.NY 099070 61 22570 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343784
1#0##0#0#0.0#2021-12-13
15:13:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d30378b49e2cabb03f333319bfeb0467 150000 0 0 0 0 0
0 31845 0 0 15000 0 93912 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 13/08/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 254000 0 1 0 0 0 TRI UTAMI
1124R0021221V001101 0001380313934 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343715 1#0##0#0#0.0#2021-12-14
09:14:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f684b61646e80c15cb0eff9e083499f2 239000 0 0 0 0 0
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3372030 C 3 CP 2 07/12/2021 07/12/2021 02/02/1963 0 2
- 0 - 0 - 0 - 0 138400 240000 0
1 0 0 0 SUJIYEM, NY 090600 58 21493 DR. LINDA
yani;3302226402970001; 5.5.5.202112011542 4 343709
1#0##0#0#0.0#2021-12-14
09:16:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0dfbe07e7bdf5d014266b4134e5d121f 225000 0 0 0 0 0
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3372030 C 3 CP 2 07/12/2021 07/12/2021 13/06/1979 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001183379106 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343744 1#0##0#0#0.0#2021-12-14
09:17:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 27/01/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 265255
0 1 0 0 0 SAMIDI, TN 098145 68 25151 DR. SUHARTO,
SP.PD 1124R0021221V001104 0001084306329 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343785 1#0##0#0#0.0#2021-12-14
09:17:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 31845 0 0 15000 0 68410 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 13/03/1953 0 1
1 Z09.8;M79.18;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 SUHARI, TN 070582 68 25106 DR. LINDA
yani;3302226402970001; 5.5.5.202112011542 4 343708
1#0##0#0#0.0#2021-12-14
09:28:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5a42de71d83051594a907b1a9ed02797 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 04/02/1968 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 SRI PURWANTI.NY 088987 53 19665 DR. LINDA
yani;3302226402970001; 5.5.5.202112011542 4 343718
1#0##0#0#0.0#2021-12-14
09:29:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 13/03/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 192404
0 1 0 0 0 SUBANDIJO.TN 083578 77 28393 DR.
RINA DIANA,SP.DV 1124R0021221V001109 0000089964911 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 343786
1#0##0#0#0.0#2021-12-14
09:29:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
28180e2164edd8584afe43edb1e35c5c 150000 0 0 0 0 0
0 0 0 0 15000 0 27404 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 20/10/1950 0 2
- 0 - 0 - 0 - 0 138400 240000 0
1 0 0 0 BADRIYAH MUNAWARAH,(NY) 043414 71 25981 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343705
1#0##0#0#0.0#2021-12-14
09:30:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4c8724175726b4c540f8362d79447338 225000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 03/09/1977 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI WIDODO.TN
0001104478468 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343739 1#0##0#0#0.0#2021-12-14
09:31:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f15eeab2973acbfefd5ed97372150948 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 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; 5.5.5.202112011542 4
343746 1#0##0#0#0.0#2021-12-14
09:31:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
091cefbc49f3b5f37a59db35928b69d8 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 05/10/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 291355
0 1 0 0 0 SRI HARNANI DWI HASTUTI.NY 098490 57
yani;3302226402970001; 5.5.5.202112011542 4 343787
1#0##0#0#0.0#2021-12-14
09:32:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
957d965ec40d6618093f32c1c1aa55a6 150000 0 0 0 0 0
0 31845 0 0 15000 0 94510 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 22/08/1947 0 2
- 0 - 0 - 0 - 0 138400 240000 0
1 0 0 0 DYAH NURJANTI,(NY) 042222 74 27136 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343717
1#0##0#0#0.0#2021-12-14
09:33:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a48b7ad5ff2be52cc544927c95cd1391 225000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 21/09/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002199915988 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343745 1#0##0#0#0.0#2021-12-14
09:36:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6cc2dd4b910c9e9d6f96c1c55630caef 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 27/12/1981 0 2
0 0 - 0 - 0 - 0 - 0 296400 226090
0 1 0 0 0 PARTINI .NY 041617 39 14590 DR. GUNAWAN,
SP.OG 1124R0021221V001116 0001106907884 3;JKN novia;3313125201940001;
5.6.3.202201201500 4 343788 1#0##0#0#0.0#2022-02-14
12:09:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
7378f19495477b7d2c60e98a42fb44c8 200000 0 0 0 0 0
0 0 0 0 15000 0 11090 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 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; 5.5.5.202112011542 4
343729 1#0##0#0#0.0#2021-12-14
09:37:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f7085a84156c700db2a54359219bc36f 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 19/02/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 303005
0 1 0 0 0 HARTONO.TN 091667 67 24763 DR. SUHARTO,
SP.PD 1124R0021221V001118 0001859731817 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343789 1#0##0#0#0.0#2021-12-14
09:38:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b695f67daf0acd1482ea586d6c2e2da7 150000 0 0 0 0 0
0 76595 0 0 15000 0 61410 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 05/07/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI BEKTI.NY
0000640746538 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343727 1#0##0#0#0.0#2021-12-14
09:39:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f15132b4e40bb37343f84ab151e6a420 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 09/08/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 245011
0 1 0 0 0 ARIS BUDI SUBARDINI,(NY) 032842 65
yani;3302226402970001; 5.5.5.202112011542 4 343790
1#0##0#0#0.0#2021-12-14
09:39:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a093c84ac78e916a3b9b5e56531fc23a 150000 0 0 0 0 0
0 0 0 0 15000 0 80011 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 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 novia;3313125201940001; 5.6.3.202201201500 4
343719 1#0##0#0#0.0#2022-02-15
13:23:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
2b64a301cf5b25e9aad4c533238289f5 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 05/02/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 253000 0 1 0 0 0 EKO CAHYANI
1124R0021221V001124 0001100445232 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343721 1#0##0#0#0.0#2021-12-14
09:43:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fcf6a15220f74af513f6744cb402dbbb 238000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 31/12/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 INDRAYATI, NY
0002926021015 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343723 1#0##0#0#0.0#2021-12-14
09:43:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 13/10/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 208550
0 1 0 0 0 TITIK LAKSITORINI, NY 093738 59 21605
yani;3302226402970001; 5.5.5.202112011542 4 343791
1#0##0#0#0.0#2021-12-14
09:44:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a0bdee6748cd2cfa2127e77a964ffaa5 150000 0 0 0 0 0
0 0 0 0 15000 0 43550 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 03/07/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 LUCIA SRI
1124R0021221V001127 0000639909854 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343725 1#0##0#0#0.0#2021-12-14
09:45:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c487a3b1c1d1d81704272b8ad036e38d 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
343743 1#0##0#0#0.0#2021-12-14
09:46:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 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; 5.5.5.202112011542 4
343724 1#0##0#0#0.0#2021-12-14
09:47:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
147b42986f7b5128bbb0556b6d632f97 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 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
343726 1#0##0#0#0.0#2022-04-14
13:16:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
90270d40d6223778f5d7e2988086087d 258000 0 0 0 0 0
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3372030 C 3 CP 2 07/12/2021 07/12/2021 25/02/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 HANUGRAH PROBO HASMORO, BP 068704 53
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343792
1#0##0#0#0.0#2021-12-14
09:51:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
678777c11dbbc3da7f1757c0a7d41cd0 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 19/06/1971 0 2
1 Z09.0;D21.2 96.59;97.89 - - None None None None Z-3-27-0
- 0 - 0 - 0 - 0 183900 397420 0
1 0 0 0 YATMI.NY 099790 50 18434 DR. OEDJANG
SETIJAWAN, MSI.MED.,SP.B 1124R0021221V001133 0000560939275 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 343793
1#0##0#0#0.0#2021-12-14
09:52:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
028ec6cf503e7c85bb3d828eb9c4563c 370000 0 0 0 0 0
0 0 0 0 15000 0 12420 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 31/10/1989 0 2
0 - 0 - 0 - 0 - 0 296400 231150
0 1 0 0 0 NIKEN ANGGRAINI,NY 069304 32 11725
yani;3302226402970001; 5.5.5.202112011542 4 343794
1#0##0#0#0.0#2021-12-14
09:53:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3f1cad1e75580a85857dfe340207e1e9 200000 0 0 0 0 0
0 0 0 0 15000 0 16150 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 04/04/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 196310
0 1 0 0 0 SUKINDARI.NY 100323 54 19971 DR.
OEDJANG SETIJAWAN, MSI.MED.,SP.B 1124R0021221V001135 0000088891525 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 343796
1#0##0#0#0.0#2021-12-14
09:54:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
24b4b3f674ab244208f0f09ee6baa712 150000 0 0 0 0 0
0 0 0 0 15000 0 31310 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 18/08/1980 0 2
0 - 0 - 0 - 0 183900 262420 0 1
0 0 0 SITI MUKARRAMAH.NY 095071 41 15086 DR. OEDJANG
yani;3302226402970001; 5.5.5.202112011542 4 343797
1#0##0#0#0.0#2021-12-14
09:55:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
07a2545aaa3953a126c1b9d64942f392 235000 0 0 0 0 0
0 0 0 0 15000 0 12420 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 26/03/2019 0 1
1 Z09.8;R11 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 234111
0 1 0 0 0 RIFQI FAIZ MAULANA, AN 075843 2 987
0002756016718 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343798 1#0##0#0#0.0#2021-12-14
09:55:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 69111 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 19/04/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 579766
0 1 0 0 0 PARNI, NY 078354 49 18129 DR. SUHARTO,
SP.PD 1124R0021221V001139 0000564110548 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343799 1#0##0#0#0.0#2021-12-14
09:56:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 31845 0 0 15000 0 382921 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 17/08/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 181050
0 1 0 0 0 SOEJINTO. TN 089342 69 25314 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343800
1#0##0#0#0.0#2021-12-14
09:57:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bc3487ed0e5c390a79bf47ec6bfedafe 150000 0 0 0 0 0
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3372030 C 3 CP 2 07/12/2021 07/12/2021 16/11/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 283385
0 1 0 0 0 HARNI.NY 079693 43 15727 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343801
1#0##0#0#0.0#2021-12-14
09:58:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8889540dc3e337bd571003ea62a492cd 150000 0 0 0 0 0
0 0 0 0 15000 0 118385 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 31/12/1944 0 1
0 - 0 - 0 - 0 183900 332420 0 1
0 0 0 SLAMETO, TN 100099 76 28100 DR. OEDJANG SETIJAWAN,
MSI.MED.,SP.B 1124R0021221V001144 0001478864182 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 343802
1#0##0#0#0.0#2021-12-14
09:59:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2bd81f3424eaa2b820b8d1986960f2b3 305000 0 0 0 0 0
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3372030 C 3 CP 2 07/12/2021 07/12/2021 28/01/1959 0 1
1 Z09.8;R10.4;K30;I50.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 242293
0 1 0 0 0 RISTIYANTO,TN 029882 62 22959 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343803
1#0##0#0#0.0#2021-12-14
09:59:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ba67a9f44a4bb34e90f2ecf572381731 150000 0 0 0 0 0
0 0 0 0 15000 0 77293 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 15/05/1953 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 343804
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10:00:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 08/03/1967 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 343806
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10:02:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.5.5.202112011542 4 343807
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10:03:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 09/06/1965 0 2
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10:03:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 26/11/1986 0 2
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10:04:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 05/08/1953 0 1
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10:06:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 02/02/1971 0 2
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10:07:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.5.5.202112011542 4 343813
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10:16:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 26/04/1964 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 343814
1#0##0#0#0.0#2021-12-14
10:17:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 24/11/1940 0 2
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1#0##0#0#0.0#2022-02-15
07:45:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 07/12/2021 07/12/2021 20/08/1959 0 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 25/05/1972 0 1
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10:30:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 15/09/1960 0 1
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1#0##0#0#0.0#2021-12-14
10:31:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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10:34:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 12/06/1979 0 2
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10:35:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 01/01/1963 0 1
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10:37:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 01/04/1981 0 1
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10:39:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 10/09/1977 0 2
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1#0##0#0#0.0#2021-12-14
10:01:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 16/02/1964 0 1
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10:40:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 10/11/1970 0 1
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10:43:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 17/04/1961 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 343826
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10:44:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 12/06/1972 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 343827
1#0##0#0#0.0#2021-12-14
10:44:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 27/02/1983 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 343828
1#0##0#0#0.0#2021-12-14
10:48:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 26/02/1954 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 343829
1#0##0#0#0.0#2021-12-14
10:52:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 01/01/1959 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 343830
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10:53:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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10:54:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.5.5.202112011542 4 343834
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10:58:54#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#2021-12-14
10:59:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 04/06/1968 0 2
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11:06:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 07/12/2021 07/12/2021 18/11/1954 0 1
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13:15:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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yani;3302226402970001; 5.5.5.202112011542 4 343842
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11:23:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.5.5.202112011542 4 343843
1#0##0#0#0.0#2021-12-14
11:24:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2f2e5b836b8e94d6cb426344cd5fdc08 150000 0 0 0 0 0
0 0 0 0 15000 0 36680 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 13/11/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 278795
0 1 0 0 0 JOKO SETYANTO 092583 61 22304 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343844
1#0##0#0#0.0#2021-12-14
11:26:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
76676945cb7c29a9aa42104ed980fc5e 203000 0 0 0 0 0
0 0 0 0 15000 0 60795 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 31/12/1996 0 2
1 Z09.8;H53.1 90.29 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 253620
0 1 0 0 0 BUNGA CHAIRUNISA CH, Ny 055808 24 9107
yani;3302226402970001; 5.5.5.202112011542 4 343845
1#0##0#0#0.0#2021-12-14
11:28:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
15f8bd0aace6d1806459f6133917286a 203000 0 0 0 0 0
0 0 0 0 15000 0 35620 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 07/04/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 370321
0 1 0 0 0 SUTRISNO, BP 069129 55 20333 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343846
1#0##0#0#0.0#2021-12-14
11:30:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d204a91bcf387d6bb672ec4132ebd271 300000 0 0 0 0 0
0 0 0 0 15000 0 55321 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 08/08/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 233700
0 1 0 0 0 SUMINI, NY 057720 67 24593 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 343847
1#0##0#0#0.0#2021-12-14
11:31:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6f5c867b7403c2855ccc37e814bad500 150000 0 0 0 0 0
0 0 0 0 15000 0 68700 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 31/01/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 362160
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343848
1#0##0#0#0.0#2021-12-14
11:31:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bbccc0b6d3190c4dbb13881453a5e5c3 300000 0 0 0 0 0
0 0 0 0 15000 0 47160 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 03/06/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 314216
0 1 0 0 0 RUBIYEM, NY 067364 68 25024 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 343849
1#0##0#0#0.0#2021-12-14
11:33:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bf333ce5b74f31acd709917a4625fc72 150000 0 0 0 0 0
0 88900 0 0 15000 0 60316 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 15/03/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 SUKAPDI. TN 090785 70 25835 DR. GALIH
yani;3302226402970001; 5.5.5.202112011542 4 343850
1#0##0#0#0.0#2021-12-14
11:35:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eb91f91f61cf67a574664c38d0c86511 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 07/08/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 337547
0 1 0 0 0 SUGIARTO.TN 083066 76 27881 DR. GALIH
yani;3302226402970001; 5.5.5.202112011542 4 343851
1#0##0#0#0.0#2021-12-14
11:39:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e4403a063e1a0d59abea401719fbdec4 300000 0 0 0 0 0
0 0 0 0 15000 0 22547 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 23/09/1963 0 1
1 Z09.8;E11.9;B35.6 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 228645
0 1 0 0 0 AWAN RISTIYADI.TN 006986 58 21260 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343852
1#0##0#0#0.0#2021-12-14
12:09:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0804bf6c18b8f06056d66d086c92a0a7 150000 0 0 0 0 0
0 31845 0 0 15000 0 31800 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 10/12/1984 0 1
0 0 - 0 - 0 - 0 - 0 181400 391110
0 1 0 0 0 DEVID SETYO WIBOWO 093929 36 13511
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343853
1#0##0#0#0.0#2021-12-14
12:11:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d60df27e55d272cf2b0e0b3dd3c24f34 300000 0 0 0 0 0
0 0 0 0 15000 0 76110 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 07/12/1943 0 1
0 0 - 0 - 0 - 0 - 0 181400 393250
0 1 0 0 0 SUBAGIO WARYADI,(BP) 007604 78 28490
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343854
1#0##0#0#0.0#2021-12-14
12:19:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1373a777f83d9af384fee2d2fe4e2059 300000 0 0 0 0 0
0 0 0 0 15000 0 78250 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 19/02/1984 0 1
0 0 - 0 - 0 - 0 - 0 181400 229577
0 1 0 0 0 DIDIK ACHMADI. TN 050289 37 13806 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343855
1#0##0#0#0.0#2021-12-14
12:19:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7bcea686e1c8295bcc8bb13e9231b273 150000 0 0 0 0 0
0 0 0 0 15000 0 64577 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 20/04/1947 0 1
1 Z09.8;G91.2;I10;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 253903
0 1 0 0 0 DJIJO BASUKI 077000 74 27260 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343856
1#0##0#0#0.0#2021-12-14
12:21:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3e04a7fa23022c20cd358e5f64b29b8e 150000 0 0 0 0 0
0 0 0 0 15000 0 88903 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 10/12/1959 0 2
1 Z09.8;G20;I69.3;H81.3 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 267630
0 1 0 0 0 SRINING HARTYASTUTI, NY 072654 61 22643
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343857
1#0##0#0#0.0#2021-12-14
12:22:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
36bb404d939ad3034ac7b1d278ecbf04 150000 0 0 0 0 0
0 0 0 0 15000 0 102630 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 07/10/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 223240
0 1 0 0 0 NUR LASMI, NY 072492 51 18689 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343858
1#0##0#0#0.0#2021-12-14
12:23:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9c6616648aef538d108356451bd53ecd 150000 0 0 0 0 0
0 0 0 0 15000 0 58240 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 25/05/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 625240
0 1 0 0 0 SUMAIDAH 093573 62 22842 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 343859
1#0##0#0#0.0#2021-12-14
12:31:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6363c7524d19b9199df26a4925b90cd5 150000 0 0 0 0 0
0 0 0 0 15000 0 460240 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 15/09/1988 0 1
1 J40;J06.9 - - - None None None None Q-5-26-0 None
None None None None None BRONKIAL AKUT 192500 0 0 -
0 - 0 - 0 - 0 192500 190569 0 1
0 0 0 MUHAMMAD KHOIRUMAN.TN 080389 33 12136 DR. ANITA
novia;3313125201940001; 5.6.3.202201201500 4 343860
1#0##0#0#0.0#2022-03-08
07:44:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
e2fb0de06ef27f5089cafacbaa46dd1a 150000 0 0 0 0 0
0 0 0 0 15000 0 25569 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 19/01/2000 0 2
0 - 0 - 0 - 0 - 0 549400 226535
0 1 0 0 0 SHINTA HARI FITRIANA.NN 099057 21 7993
yani;3302226402970001; 5.5.5.202112011542 4 343861
1#0##0#0#0.0#2021-12-14
12:32:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
981d2446e406d51305019572b15d76a8 150000 0 0 0 0 0
0 0 0 0 15000 0 61535 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 31/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 218755
0 1 0 0 0 TUMINAH NY 088417 66 24448 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 343862
1#0##0#0#0.0#2021-12-14
12:34:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f841042b59032b8de6d3167b2f6a4d69 150000 0 0 0 0 0
0 0 0 0 15000 0 53755 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 05/09/1954 0 1
1 Z09.8;I63.9;E11.9 87.03 - - None None None None Z-3-18-0
- 0 - 0 - 0 - 0 894800 1445890 0
1 0 0 0 SUDIHARJO, TN 085998 67 24565 DR. ARIA
novia;3313125201940001; 5.5.5.202112011542 4 344036
1#0##0#0#0.0#2021-12-14
10:02:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a00ade0682fa60cc32e65e4c2b47b85e 150000 0 0 0 0 0
1250000 0 0 0 15000 0 30890 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 12/07/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 181050
0 1 0 0 0 SRI LESTARI,(NY) 008943 54 19872 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343864
1#0##0#0#0.0#2021-12-14
12:37:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2658b9e4a3e58013c3292389da339232 150000 0 0 0 0 0
0 0 0 0 15000 0 16050 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 16/06/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 240172
0 1 0 0 0 SUWARTI.NY 085230 76 27933 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 343865
1#0##0#0#0.0#2021-12-14
12:38:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a30f18702e4b91568a4e1a38f390803a 150000 0 0 0 0 0
0 0 0 0 15000 0 75172 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 29/01/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 264187
0 1 0 0 0 SITI MUTMAINAH, (NY) 001322 55 20401
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343866
1#0##0#0#0.0#2021-12-14
12:41:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8200e2e5d88619664ee15853a87cec0d 150000 0 0 0 0 0
0 0 0 0 15000 0 99187 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 06/07/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 231925
0 1 0 0 0 SUMARNI.NY 086963 67 24626 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 343867
1#0##0#0#0.0#2021-12-14
12:42:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9d4e8509da28a7e6fd080f289ec5ebdb 150000 0 0 0 0 0
0 0 0 0 15000 0 66925 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 31/12/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 258111
0 1 0 0 0 SUPARNI, NY 089829 64 23717 DR. ANITA
yani;3302226402970001; 5.5.5.202112011542 4 343868
1#0##0#0#0.0#2021-12-14
12:42:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ad42e6cf131b6b3054aa944eb0c0416a 150000 0 0 0 0 0
0 0 0 0 15000 0 93111 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 15/12/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 228820
0 1 0 0 0 WARNI.NY 096357 50 18620 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 343869
1#0##0#0#0.0#2021-12-14
12:43:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
62774f970a09104e074da51b90a158eb 150000 0 0 0 0 0
0 0 0 0 15000 0 63820 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 20/05/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 249434
0 1 0 0 0 WAHYEM MULYO DARSONO, NY 074695 68
yani;3302226402970001; 5.5.5.202112011542 4 343870
1#0##0#0#0.0#2021-12-14
12:44:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
33ca2a527c39f81bf684c3af915d83e9 150000 0 0 0 0 0
0 0 0 0 15000 0 84434 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 16/11/1999 0 2
1 Z09.8;G40.9;G47.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 346920
0 1 0 0 0 MAYA NOVITASARI.NN 079873 22 8057
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343871
1#0##0#0#0.0#2021-12-14
12:45:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d4c6be1778d26c4a76acbeec929aa9f5 150000 0 0 0 0 0
0 0 0 0 15000 0 181920 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 14/05/1970 0 1
1 Z09.8;J44.9;I10;K21.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 349593
0 1 0 0 0 SUTIYO, (BP) 041113 51 18835 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343872
1#0##0#0#0.0#2021-12-14
12:46:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c392f3b13b2f1501aaa61c109cf7fd8b 150000 0 0 0 0 0
0 0 0 0 15000 0 184593 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 04/05/2002 0 2
0 0 - 0 - 0 - 0 - 0 181400 208150
0 1 0 0 0 FLETA MARGARETHA KUSUMAWARDANI.NN 095286
0000639661983 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343873 1#0##0#0#0.0#2021-12-14
12:48:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6d6a84e7a5c730983da678f2fafb51c4 150000 0 0 0 0 0
0 0 0 0 15000 0 43150 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 23/03/1966 0 2
1 Z09.8;B90.8;J06.9;K21.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 205318
0 1 0 0 0 SRI SISWANTI., NY 042109 55 20348 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343874
1#0##0#0#0.0#2021-12-14
12:48:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
56e2de52f06ca428b1d1f863ac14a630 150000 0 0 0 0 0
0 0 0 0 15000 0 40318 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 05/12/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 414356
0 1 0 0 0 SATIYEM, NY 073918 63 23013 DR. ANITA
yani;3302226402970001; 5.5.5.202112011542 4 343875
1#0##0#0#0.0#2021-12-14
12:49:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
09ad83b97a9bc85262d72e5d72a03e53 150000 0 0 0 0 0
0 0 0 0 15000 0 249356 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 06/05/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 213490
0 1 0 0 0 AGUS SURYANTO,TN 084304 50 18478 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343876
1#0##0#0#0.0#2021-12-14
13:16:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e30d972bcc58c3f89140ed2e8528d3aa 150000 0 0 0 0 0
0 0 0 0 15000 0 48490 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 05/02/1967 0 2
1 Z09.8;A18.2;K21.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 235586
yani;3302226402970001; 5.5.5.202112011542 4 343877
1#0##0#0#0.0#2021-12-14
13:17:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8da1d9c2e0933ff2c52cf0fcef67e519 150000 0 0 0 0 0
0 0 0 0 15000 0 70586 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 03/08/1960 0 2
1 Z09.8;J45.9;J06.9;M79.18 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
437913 0 1 0 0 0 SUPARMI, NY 070450 61 22406
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343878
1#0##0#0#0.0#2021-12-14
13:18:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8b4b8e2248eecc97e90dbf95c66f88b4 150000 0 0 0 0 0
0 0 0 0 15000 0 272913 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 08/05/1947 0 1
0 0 - 0 - 0 - 0 - 0 181400 445424
0 1 0 0 0 HARIYADI.,TN 072845 74 27242 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343879
1#0##0#0#0.0#2021-12-14
13:19:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
70b28106f29a62be3b60c4c195154c88 150000 0 0 0 0 0
0 0 0 0 15000 0 280424 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 30/08/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 223279
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343880
1#0##0#0#0.0#2021-12-14
13:20:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eae1096dbb1217c2621c0f3cc6ea0b03 150000 0 0 0 0 0
0 0 0 0 15000 0 58279 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 01/08/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 473514
0 1 0 0 0 PRIANI 069908 49 18025 DR. ANITA
yani;3302226402970001; 5.5.5.202112011542 4 343881
1#0##0#0#0.0#2021-12-14
13:21:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2947537b62b944bf0682be1c82c6bf09 150000 0 0 0 0 0
0 0 0 0 15000 0 308514 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 10/06/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 PRASETYO BUDI UTOMO., BP 050807 67
0001806103236 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343882 1#0##0#0#0.0#2021-12-14
13:22:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
babcf336c246653340d91026584e742b 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 03/12/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 481715
0 1 0 0 0 RINI HARIDIS MAYANTI.NY 090622 51 18632
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343883
1#0##0#0#0.0#2021-12-14
13:22:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e723195f3a8d654b9ad9bfb6f5a0960d 150000 0 0 0 0 0
0 0 0 0 15000 0 316715 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 08/12/1992 0 1
0 0 - 0 - 0 - 0 - 0 181400 202130
0 1 0 0 0 ARIS ABDULLAH, BP 088781 28 10591 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343884
1#0##0#0#0.0#2021-12-14
13:25:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bfd3ad822694a13b68224917cf9019bf 150000 0 0 0 0 0
0 0 0 0 15000 0 37130 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 15/05/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 330148
0 1 0 0 0 SRI MAWANTI.NY 079833 48 17738 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343885
1#0##0#0#0.0#2021-12-14
13:26:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
240a5f7925ac0a8d11df17771a7c04f1 150000 0 0 0 0 0
0 0 0 0 15000 0 165148 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 05/03/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 189795
0 1 0 0 0 SRI WULAN.NY 099062 42 15618 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343886
1#0##0#0#0.0#2021-12-14
13:26:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a341dbe25ed4af2b501a296d333f3710 150000 0 0 0 0 0
0 0 0 0 15000 0 24795 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 07/04/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 227465
0 1 0 0 0 MARTHA LEOPENO. NY 005709 61 22524
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343887
1#0##0#0#0.0#2021-12-14
13:28:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
236d1cb673860690a6c60acf6268c8a3 150000 0 0 0 0 0
0 0 0 0 15000 0 62465 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 06/03/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 203885
0 1 0 0 0 SHINTA,NY 038241 62 22922 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 343888
1#0##0#0#0.0#2021-12-14
13:29:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
83465f9f452dc90c3b46231ee89a3002 150000 0 0 0 0 0
0 0 0 0 15000 0 38885 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 06/02/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 204785
0 1 0 0 0 WORO SUDARYANTI, NY 074725 56 20758
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343889
1#0##0#0#0.0#2021-12-14
13:30:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5861cfcf789c7c0921031c8cb8e76a8b 150000 0 0 0 0 0
0 0 0 0 15000 0 39785 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 02/02/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 200763
0 1 0 0 0 BUDI ASMARA,BP 080255 59 21858 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343890
1#0##0#0#0.0#2021-12-14
13:34:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e6129a7ae7ec4c378e6cd7d9e1794965 150000 0 0 0 0 0
0 0 0 0 15000 0 35763 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 21/12/1946 0 1
0 0 - 0 - 0 - 0 - 0 181400 190440
0 1 0 0 0 SUTARMIN ATMO SUWITO,(TN) 028643 74
0001021693713 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343891 1#0##0#0#0.0#2021-12-14
13:35:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f17badbece18e2870836895077dbba6f 150000 0 0 0 0 0
0 0 0 0 15000 0 25440 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 17/08/1952 0 2
1 Z09.8;Z96.1;H52.2;H52.4;H04.1 90.29;95.01 - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 298820 0 1 0 0 0 SARTIMAH,(NY) 037210
0000088847144 3;JKN novia;3313125201940001; 5.6.3.202201201500 4
343892 1#0##0#0#0.0#2022-03-08
08:00:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
d0c00a8ae9028e1b9697c70897343ac6 254000 0 0 0 0 0
0 0 0 0 15000 0 29820 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 24/06/1957 0 1
0 - 0 - 0 - 0 183900 317310 0 1
0 0 0 HARYADI,(BP) 016118 64 23542 DR. OEDJANG
yani;3302226402970001; 5.5.5.202112011542 4 343893
1#0##0#0#0.0#2021-12-14
13:36:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
56ba895d5456e24a3ca4ce5ee5f973ef 295000 0 0 0 0 0
0 0 0 0 15000 0 7310 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 24/07/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 245957
0 1 0 0 0 SUTAMI.NY 099959 53 19494 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 343894
1#0##0#0#0.0#2021-12-14
13:44:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d2b7bf1bf7da809ec777f24a510c6086 150000 0 0 0 0 0
0 0 0 0 15000 0 80957 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 10/10/1974 0 1
0 0 - 0 - 0 - 0 - 0 181400 230950
0 1 0 0 0 WAHYU TRI WALUYO.TN 096223 47 17225
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343895
1#0##0#0#0.0#2021-12-14
13:45:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
76f0b1b3e591b64c7ccc3b6319bf644b 150000 0 0 0 0 0
0 0 0 0 15000 0 65950 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 29/03/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 210350
0 1 0 0 0 SIH MARTANTI.NY 096811 56 20707 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343896
1#0##0#0#0.0#2021-12-14
13:49:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
654ec6852ca0525fe838bf2b4e214c6f 150000 0 0 0 0 0
0 0 0 0 15000 0 45350 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 31/12/1954 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
281245 0 1 0 0 0 SUWARSI, NY 041259 66 24448
yani;3302226402970001; 5.5.5.202112011542 4 343897
1#0##0#0#0.0#2021-12-14
13:51:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d032c2cd252ba14b459bb79b7cf2c308 150000 0 0 0 0 0
0 31845 0 0 15000 0 84400 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 19/02/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 228565
0 1 0 0 0 DANU MARGONO.,BP 056891 56 20745 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343898
1#0##0#0#0.0#2021-12-14
13:52:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
059671ed9688756a043bb0836188e22d 150000 0 0 0 0 0
0 0 0 0 15000 0 63565 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 02/08/1997 0 2
1 Z09.8;R51;M65.38 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 214667
0 1 0 0 0 INDAH TRI SOLIKHAH, NN 087585 24 8893
yani;3302226402970001; 5.5.5.202112011542 4 343899
1#0##0#0#0.0#2021-12-14
13:53:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
93e63d7d7b9f5811ff2654be1a567adc 150000 0 0 0 0 0
0 0 0 0 15000 0 49667 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 16/07/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 207740
0 1 0 0 0 APIN S ARIPIN, TN 058842 48 17676 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343900
1#0##0#0#0.0#2021-12-14
13:54:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1b17a2cd3ef6cf1701fab1b87bdf9c79 150000 0 0 0 0 0
0 0 0 0 15000 0 42740 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 18/08/1943 0 1
0 0 - 0 - 0 - 0 - 0 181400 262380
0 1 0 0 0 MARNO RAHARJO, BP 054909 78 28601 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343901
1#0##0#0#0.0#2021-12-14
13:55:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
704d01428461728c6d1189fe35486d38 150000 0 0 0 0 0
0 0 0 0 15000 0 97380 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 18/04/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 214915
0 1 0 0 0 RAHMADI.TN 096843 53 19591 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 343902
1#0##0#0#0.0#2021-12-14
13:56:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f0292cd16d6d0865db6bc6746939ebc1 150000 0 0 0 0 0
0 0 0 0 15000 0 49915 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 09/03/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 221870
0 1 0 0 0 ARIEF BUDI RAHARJO.TN 082727 68 25110
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343903
1#0##0#0#0.0#2021-12-14
13:58:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1fa9e9a8914426238b84012dc71128da 150000 0 0 0 0 0
0 0 0 0 15000 0 56870 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 17/01/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 208410
0 1 0 0 0 HERMAN SUPRIYADI, TN 002506 66 24431
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343904
1#0##0#0#0.0#2021-12-14
13:58:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
280b6e098133c00fff041a044d39730e 150000 0 0 0 0 0
0 0 0 0 15000 0 43410 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 25/01/1998 0 2
0 0 - 0 - 0 - 0 - 0 296400 185150
0 1 0 0 0 MONICA ALIEN AL FIDA.NY 100521 23 8717
yani;3302226402970001; 5.5.5.202112011542 4 343905
1#0##0#0#0.0#2021-12-14
13:59:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
524f5c14b8171e159d90fe447b87fe5b 150000 0 0 0 0 0
0 0 0 0 25000 0 10150 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 14/12/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 208310
0 1 0 0 0 SRI DARMINI, NY 093216 69 25561 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343907
1#0##0#0#0.0#2021-12-14
14:00:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cbbd223daaf55e0219fc166f694cd025 150000 0 0 0 0 0
0 0 0 0 15000 0 43310 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 20/11/1985 0 1
0 0 - 0 - 0 - 0 - 0 181400 211480
0 1 0 0 0 WINARDI.TN 096093 36 13166 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 344131
1#0##0#0#0.0#2021-12-14
14:01:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
37e3577ba1dafcd40638f9f142609fe8 150000 0 0 0 0 0
0 0 0 0 15000 0 46480 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 31/12/1953 0 1
1 Z09.8;I11.0;E11.4;G59.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 507781
0 1 0 0 0 WAGINEM DARYO SUWITO NY 068793 67 24813
yani;3302226402970001; 5.5.5.202112011542 4 343908
1#0##0#0#0.0#2021-12-14
14:03:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e52ab45076ecbb291e44807a1ff2b58e 150000 0 0 0 0 0
0 0 0 0 15000 0 342781 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 18/03/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 230347
0 1 0 0 0 RAHARJO .TN 092313 73 26927 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 343909
1#0##0#0#0.0#2021-12-14
14:05:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e0aa2b20089db98a2333a30f33de3f5c 150000 0 0 0 0 0
0 0 0 0 15000 0 65347 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 12/06/1964 0 1
1 Z09.8;K76.0;K62.5 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 225211
0 1 0 0 0 SUTIKNO. TN 076149 57 20997 DR. SUHARTO,
SP.PD 1124R0021221V001255 0002166939088 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343910 1#0##0#0#0.0#2021-12-14
14:06:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4736db3d425201e383c60814423d28ed 150000 0 0 0 0 0
0 0 0 0 15000 0 60211 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 11/03/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 202042
0 1 0 0 0 DJURANTO, BP 090117 62 22917 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343911
1#0##0#0#0.0#2021-12-14
14:06:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ec66d8b49947ab284fcb4373f89a5672 150000 0 0 0 0 0
0 0 0 0 15000 0 37042 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 31/12/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 221447
0 1 0 0 0 JUMIATI.NY 097762 59 21891 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 343912
1#0##0#0#0.0#2021-12-14
14:07:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
78734aa584a5e9fc4d079787c6ae280e 150000 0 0 0 0 0
0 0 0 0 15000 0 56447 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 24/11/1980 0 2
0 0 - 0 - 0 - 0 - 0 181400 438742
0 1 0 0 0 TRI KUSRINI WULANJARI, (NY) 050366 41
0000639701583 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
344037 1#0##0#0#0.0#2021-12-14
10:02:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4ab6c2c02b2f636ba63d78ab28311c03 150000 0 0 0 0 0
220000 0 0 0 15000 0 53742 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 30/10/1965 0 2
1 Z09.8;J06.9;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 266935
0 1 0 0 0 TRI KARTINI 089553 56 20492 DR. SUHARTO,
SP.PD 1124R0021221V001259 0002168611222 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343913 1#0##0#0#0.0#2021-12-14
14:09:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b50868aa55a09fc2490a3a3f999b9ca5 150000 0 0 0 0 0
0 0 0 0 15000 0 101935 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 09/09/1951 0 1
1 Z09.8;K30;R10.4 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SARBINI, TN 052303 70 25657 DR. SUHARTO,
SP.PD 1124R0021221V001261 0000091234585 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343914 1#0##0#0#0.0#2021-12-14
14:15:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f2148633ca7978de37f8fc6782b6f0b6 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 24/02/2007 0 1
2 Q21.4 - - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 MARHAEN ARIF RACHMAN, AN 060759 14
5400 DR. ANI SURYANTI WISYASTUTI, SP.A., M.KES 1124R0021221V001263
0000640245666 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343915 1#0##0#0#0.0#2021-12-14
14:15:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
10b5f8ab445db41158be7c6ba5533850 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 18/08/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 316327
0 1 0 0 0 SRI SUPARNI.NY 093219 56 20565 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343916
1#0##0#0#0.0#2021-12-14
14:18:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f32f4a170a310b509c757566eb796405 150000 0 0 0 0 0
0 76045 0 0 15000 0 75282 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 13/08/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 263761
0 1 0 0 0 SRI DADIYONO ., TN 007779 56 20570
yani;3302226402970001; 5.5.5.202112011542 4 343917
1#0##0#0#0.0#2021-12-14
14:19:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a6f2d9c225a99cbd10f25143058e62d6 150000 0 0 0 0 0
0 0 0 0 15000 0 98761 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 12/07/1967 0 2
1 H01.1 95.01 - - None None None None Q-5-42-0 None None
- 0 - 0 - 0 - 0 182600 221918 0
1 0 0 0 SABTA ENDAH YULIANTI 004144 54 19872 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347100
1#0##0#0#0.0#2022-01-05
14:36:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
5fd7cebca6cd2098349255f513579e75 203000 0 0 0 0 0
0 0 0 0 15000 0 3918 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 02/04/2000 0 1
None None None None INFEKSI VIRUS HIV 225100 0 0 - 0
- 0 - 0 - 0 225100 175000 0 1 0
0 0 MUHAMMAD DAFA PRATAMA.SDR 100523 21 7919 DR. SUHARTO,
SP.PD 1124R0021221V001267 0002580116725 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343918 1#0##0#0#0.0#2021-12-14
14:20:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
910cb2d05a7915741c4e88d24e11b966 150000 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 06/04/1975 0 2
0 - 0 - 0 - 0 - 0 549400 902385
0 1 0 0 0 EMIDA DEWI KUSTATI, NY 001959 46 17047
yani;3302226402970001; 5.5.5.202112011542 4 343919
1#0##0#0#0.0#2021-12-14
14:23:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ff1c62566c25d28b174dddd6988588a3 150000 0 0 0 0 0
680000 44300 0 0 15000 0 13085 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 24/09/2020 0 1
None None None None PENYAKIT AKUT BESAR LAIN-LAIN 289400 0 0
- 0 - 0 - 0 - 0 289400 172601 0
1 0 0 0 MUHAMMAD ALI JABAR 092596 1 439 DR.
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343920
1#0##0#0#0.0#2021-12-14
14:25:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
33d12df27acb36251c91f17337d68034 150000 0 0 0 0 0
0 0 0 0 15000 0 7601 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 02/11/1961 0 1
- 0 - 0 - 0 - 0 182600 286308 0
1 0 0 0 WAHYU NUR RACHMAD.TN 100526 60 21950 DR.
reni;3313147010930001; 5.6.0.202201041418 4 343921
1#0##0#0#0.0#2022-01-07
19:53:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
ef88d00a8b28d8b8695b4398ae230fd6 203000 0 0 0 0 0
0 0 0 0 25000 0 58308 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 01/02/1978 0 2
0 - 0 - 0 - 0 - 0 181400 176860
0 1 0 0 0 SANG LESTARI.NY 100527 43 16015 DR.
novia;3313125201940001; 5.6.3.202201201500 4 343922
1#0##0#0#0.0#2022-02-15
10:51:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
f4f65c57fb700b8f6af9e45985631488 150000 0 0 0 0 0
0 0 0 0 25000 0 1860 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 27/02/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 227212
0 1 0 0 0 TOTOK SUHARTO.TN 096839 65 24025 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343923
1#0##0#0#0.0#2021-12-14
14:28:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
edf458241d3eade2d1778b0069ad7aec 150000 0 0 0 0 0
0 0 0 0 15000 0 62212 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 06/02/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 176030
0 1 0 0 0 IWAN EDI SUTEMAN. TN 048724 52 19297
0001021703556 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343924 1#0##0#0#0.0#2021-12-14
14:29:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f35fed7a3c0e1b528e1374d3c1e83697 150000 0 0 0 0 0
0 0 0 0 15000 0 11030 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 14/04/1960 0 2
0 - 0 - 0 - 0 - 0 138400 240000
0 1 0 0 0 MARTINAH., NY 072061 61 22517 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343713
1#0##0#0#0.0#2021-12-14
14:30:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9207d5cd7e60adfc359a4586e01f97b3 225000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 23/03/1973 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 ERDIANA.NY 087879 48 17791 DR. LINDA
yani;3302226402970001; 5.5.5.202112011542 4 343712
1#0##0#0#0.0#2021-12-14
14:31:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dd5e905ff0d55613c3b33fa1a2fabe82 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 20/04/2001 0 1
0 0 - 0 - 0 - 0 - 0 181400 229622
0 1 0 0 0 WAHYU TEJO ISMOYO, sdr 000156 20 7536
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343925
1#0##0#0#0.0#2021-12-14
14:32:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a9f4d471e14af5affb7a112736009d66 150000 0 0 0 0 0
0 0 0 0 15000 0 64622 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 11/04/1965 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 MUNIF, TN 087618 56 20694 DR. TEKY WIDYARINI,
SP.PD 1124R0021221V001279 0001732801498 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343926 1#0##0#0#0.0#2021-12-14
14:35:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4dfcc6ce8d85e4267471ca023cbce295 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 25/03/1978 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 SRI SURYANI.NY 084728 43 15963 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 343927
1#0##0#0#0.0#2021-12-14
14:38:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
09ecec5d5a7bd91a86014c7cc89a345e 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 23/12/1977 0 2
0 - 0 - 0 - 0 786200 564210 0 1
0 0 0 WIJI SUDARTI,NY 064377 43 16055 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 343928
1#0##0#0#0.0#2021-12-14
14:39:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0487e7a05667e0d3ca9aa52797f2aae4 463830 0 0 0 0 0
0 0 0 0 15000 0 85380 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 01/09/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 WARSITO.TN 057229 57 20916 DR. TEKY WIDYARINI,
SP.PD 1124R0021221V001283 0000639614597 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343929 1#0##0#0#0.0#2021-12-14
14:41:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5f1d4462635a2c681449928ab7305194 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 24/12/1959 0 2
0 - 0 - 0 - 0 - 0 138400 240000
0 1 0 0 0 SRI SUTANTI, NY 090727 61 22629 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343710
1#0##0#0#0.0#2021-12-14
14:43:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7966a2a45b6250f84b23a9967c84a4f5 225000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 29/04/1968 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 SRI HARIYANTI.NY 090167 53 19580 DR. LINDA
yani;3302226402970001; 5.5.5.202112011542 4 343711
1#0##0#0#0.0#2021-12-14
14:43:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cb4d86b4b10c52d45a842fc54cb8b8a8 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 13/12/1966 0 2
0 - 0 - 0 - 0 786200 677676 0 1
0 0 0 LAILA, NY 048434 54 20083 DR. TEKY WIDYARINI,
SP.PD 1124R0021221V001286 0002051493849 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343930 1#0##0#0#0.0#2021-12-14
14:44:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7b0dfeadb9583b16e80f44de65ad0221 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 25/05/1967 0 1
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 BAMBANG INDRAJID.TN 100238 54 19920
yani;3302226402970001; 5.5.5.202112011542 4 343714
1#0##0#0#0.0#2021-12-14
14:45:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b4e1835129fdf32cc26402656f0f15ea 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 07/04/1948 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 HARDJOKO, TN 055933 73 26907 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 343931
1#0##0#0#0.0#2021-12-14
14:46:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0dca5040079a2f3fb71ac1beb82b105a 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 01/11/1961 0 2
- 0 - 0 - 0 - 0 138400 240000 0
1 0 0 0 KUSTIATI, NY 048553 60 21951 DR. LINDA
yani;3302226402970001; 5.5.5.202112011542 4 343704
1#0##0#0#0.0#2021-12-14
14:47:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5453ab40a56f1de11616c4aa45f80ce0 225000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 04/05/1940 0 1
0 - 0 107400 273000 0 1 0 0 0 SUKIR
AGUS WIRATMOKO, TN 026036 81 29802 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V001292 0000090002542 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343707 1#0##0#0#0.0#2021-12-14
14:49:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ea9d1e9bba1ab9e9b8530537e85a768f 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 30/09/1977 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000207436206 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343750 1#0##0#0#0.0#2021-12-14
14:49:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8d2ab7c65c6c84c41d1b23682a058299 97000 0 0 0 0 0 0
0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 21/04/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 224830
0 1 0 0 0 MUH SAFEI, TN 054162 43 15936 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343932
1#0##0#0#0.0#2021-12-14
14:50:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
240f2892202503c17fb02b0e4e5534e4 150000 0 0 0 0 0
0 0 0 0 15000 0 59830 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 09/01/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 297465
0 1 0 0 0 SONDAH SRI PATMOKO.TN 100513 56 20786
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343933
1#0##0#0#0.0#2021-12-14
14:51:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f046ea296e2b703bcaa8dc07f015488d 150000 0 0 0 0 0
0 0 0 0 15000 0 132465 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 07/12/1992 0 1
1 Z09.8;J45.9;R51;J06.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 374591
0 1 0 0 0 GALANG RIZKY SINANDI., TN 062056 28
0001314352089 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
343934 1#0##0#0#0.0#2021-12-14
14:52:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6b1c8de185c9dae8cf1411da6c617f5a 150000 0 0 0 0 0
0 0 0 0 15000 0 209591 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 20/04/2004 0 2
0 0 - 0 - 0 - 0 - 0 181400 253620
0 1 0 0 0 FLICHIA DINAR R.M.,(AN) 008416 17 6440
yani;3302226402970001; 5.5.5.202112011542 4 343935
1#0##0#0#0.0#2021-12-14
14:54:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1c78f353ecdb673a2a3eedb56f4f8fca 203000 0 0 0 0 0
0 0 0 0 15000 0 35620 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 01/02/1970 0 1
1 Z09.8;B90.8;J30.3 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 272773
0 1 0 0 0 SRI HARTONO.TN 086349 51 18937 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343936
1#0##0#0#0.0#2021-12-14
14:55:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6e025b52c825ddabe7e22553a43ed0e8 150000 0 0 0 0 0
0 0 0 0 15000 0 107773 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 22/07/2013 0 2
0 - 0 - 0 - 0 - 0 182600 173019
0 1 0 0 0 ALISHA KHAIRA WILDA. AN 031580 8 3060
DR. CHANDRA AYU 1124R0021221V001303 0001281448945 3;JKN
agung;3313092303950002; 5.6.6.202203301209 4 346633
1#0##0#0#0.0#2022-04-14
12:47:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
197cda5305d159ec35895f5c5053ea04 130000 0 0 0 0 0
0 0 0 0 15000 0 28019 0 0 0 0 0
3372030 C 3 CP 2 07/12/2021 07/12/2021 12/04/1968 0 1
0 - 0 - 0 - 0 - 0 181400 192000
0 1 0 0 0 MUSA, TN 059308 53 19597 DR. CHANDRA
AYU 1124R0021221V001304 0001104202271 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346634 1#0##0#0#0.0#2022-01-04
13:35:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5a6ae925a2387e2c3dae10e5191814f2 155000 0 0 0 0 0
0 0 0 0 15000 0 22000 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 07/11/2001 0 2
0 - 0 - 0 - 0 135700 136165 0 1
0 0 0 CLAUDEA DIVA ISKANDAR, NN 030322 20 7336 DR.
GERRY FEBRIAN R 1124R0021221V001305 0001107836379 3;JKN
novia;3313125201940001; 5.5.5.202112011542 4 346635
1#0##0#0#0.0#2022-01-04
13:36:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d151b2d3483b1157a0d1a2c99bf3a37e 105000 0 0 0 0 0
0 0 0 0 15000 0 16165 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 12/12/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 WITO, BP 094218 60 22276 DR.
agung;3313092303950002; 5.5.5.202112011542 4 344042
1#0##0#0#0.0#2021-12-14
10:00:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
346f2f979d6c531fe1e610078cd03ef2 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 14/05/1944 0 2
0 0 - 0 - 0 - 0 - 0 181400 224400
0 1 0 0 0 MOERSITI KPKN ., NY 055813 77 28332
agung;3313092303950002; 5.5.5.202112011542 4 344043
1#0##0#0#0.0#2021-12-14
10:03:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4dd2798448bbb4af1691e48d3684694c 150000 0 0 0 0 0
0 0 0 0 15000 0 59400 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 10/03/1979 0 1
0 0 - 0 - 0 - 0 - 0 181400 936811
0 1 0 0 0 ADI PURNOMO,TN 060637 42 15614 DR.
agung;3313092303950002; 5.5.5.202112011542 4 344044
1#0##0#0#0.0#2021-12-14
10:04:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0a4a09645f98b38528cb41588eb9897c 150000 0 0 0 0 0
0 0 0 0 15000 0 771811 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 10/10/1957 0 1
- 0 - 0 - 0 183900 218468 0 1 0
0 0 SULUT, TN 082030 64 23435 DR. DAMAR ARYO, SP.B
1124R0021221V001311 0000640434914 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 344045 1#0##0#0#0.0#2021-12-14
10:05:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a0218acebc0f9e7c3e049c5f573f0822 150000 0 0 0 0 0
0 0 0 0 15000 0 53468 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 19/06/1949 0 1
1 Z09.8;E11.4;G59.0 89.52 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 ANTONIUS SUDARYONO, TN 099706 72 26470
agung;3313092303950002; 5.5.5.202112011542 4 344046
1#0##0#0#0.0#2021-12-14
10:08:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fa036ce084df1e7b62a87fe31c8e06c5 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 29/11/1974 0 2
0 - 0 - 0 - 0 183900 310000 0 1
SP.B 1124R0021221V001313 0000640529392 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 344047 1#0##0#0#0.0#2021-12-14
10:10:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0f56e84c5aa2629ce05b368a4fb0aa50 295000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 24/08/1949 0 1
1 Z09.8;E11.3;H36.0;H04.1;H26.9 90.29 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
248975 0 1 0 0 0 SUGENG PRIJADI, TN 100399
0000088856752 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
344049 1#0##0#0#0.0#2021-12-14
10:21:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4dec1c0d0f07206ebc85b4f8d47f6d99 203000 0 0 0 0 0
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3372030 C 3 CP 2 08/12/2021 08/12/2021 23/09/2003 0 1
0 - 0 - 0 - 0 183900 172715 0 1
0 0 0 DIMAS ADI KUSUMA.SDR 095394 18 6651 DR. DAMAR
5.6.0.202201041418 4 344050 1#0##0#0#0.0#2022-01-07
16:01:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
d941fd826894fe8ceb882430f4573b2f 150000 0 0 0 0 0
0 0 0 0 15000 0 7715 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 12/12/1963 0 1
1 Z09.8;I13.1;K76.0 88.76 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400 253950
0 1 0 0 0 MARYADI, TN ( BEDA NO RM APTK ) 099759
0001280837125 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
347105 1#0##0#0#0.0#2022-01-05
14:37:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e5d8de051cc41f40b6baf342ff261f8f 150000 0 0 0 0 0
0 88950 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 16/08/1960 0 2
0 - 0 - 0 - 0 183900 281566 0 1
0 0 0 SUMINI, NY 071873 61 22394 DR. DAMAR ARYO, SP.B
1124R0021221V001319 0000640722115 3;JKN novia;3313125201940001;
5.6.0.202201041418 4 344051 1#0##0#0#0.0#2022-01-07
16:03:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
a241f95c10e70cdec480eda92c7240d9 235000 0 0 0 0 0
0 0 0 0 15000 0 31566 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 12/09/1942 0 2
1 Z09.8;H26.9;G40.9;H04.1 90.29 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 248975
0 1 0 0 0 SUNARYATI, NY 058012 79 28942 DR.
novia;3313125201940001; 5.6.3.202201201500 4 344052
1#0##0#0#0.0#2022-02-15
07:31:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
62e783119292f2aa4bb8326b0cd3f63f 203000 0 0 0 0 0
0 0 0 0 15000 0 30975 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 31/12/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 290020
0 1 0 0 0 PAHING HADI SUMARTO.TN 100008 58 21527
agung;3313092303950002; 5.5.5.202112011542 4 344053
1#0##0#0#0.0#2021-12-14
10:49:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6f454dcdb114ec6ba60dd22959ef9dd1 203000 0 0 0 0 0
0 0 0 0 15000 0 72020 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 05/06/1961 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
278795 0 1 0 0 0 MARSIATUN, NY 085335 60
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 344054
1#0##0#0#0.0#2022-04-14
13:17:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
efdf183bbd70161251043ebcb23d9e3e 203000 0 0 0 0 0
0 0 0 0 15000 0 60795 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 02/01/1964 0 2
1 Z09.8;I11.9;M17.9;K21.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 Ny. Tien Sumartiningsih BSc 35771 57 21160
agung;3313092303950002; 5.5.5.202112011542 4 344056
1#0##0#0#0.0#2021-12-14
10:52:39#0#00:00:00#00:00:00#14:22:03#{"co_insidense_ind":"0"} 1
bf527e9c7e126667c0f7b1b8ee8074a6 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 04/08/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 902594
0 1 0 0 0 SRI HARTINI., NY 000449 53 19484 DR.
agung;3313092303950002; 5.5.5.202112011542 4 344057
1#0##0#0#0.0#2021-12-14
10:55:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e29eb0eb6b627c5834d3d3bc4d8e71c3 300000 0 0 0 0 0
0 76045 0 0 15000 0 511549 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 10/12/1942 0 1
1 Z09.8;Z96.1;H26.9;H35.0 90.29 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 316455
0 1 0 0 0 KAMTO WIYONO.TN 099616 78 28853 DR.
agung;3313092303950002; 5.5.5.202112011542 4 344058
1#0##0#0#0.0#2021-12-14
10:56:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
07710d39641f47891c67fc8b6cec0716 203000 0 0 0 0 0
0 0 0 0 15000 0 98455 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 20/01/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 245156
0 1 0 0 0 WIWIK ERNAWATI ., NY 055264 53 19681
agung;3313092303950002; 5.5.5.202112011542 4 344059
1#0##0#0#0.0#2021-12-14
10:57:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1d8a0fa059555a7293ebd5c7a6c821dc 150000 0 0 0 0 0
0 0 0 0 15000 0 80156 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 17/06/1980 0 2
1 Z09.8;N20.0;K30 88.75 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400 845000
0 1 0 0 0 YUNI RAHAYU.NY 098573 41 15149 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347106
1#0##0#0#0.0#2022-01-05
14:38:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6d56e6882ea17b25155e9a8f45b6cc5e 150000 0 0 0 0 0
680000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 30/04/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 433920
0 1 0 0 0 DAYATNO, TN 054539 65 23963 DR. TEKY
novia;3313125201940001; 5.5.5.202112011542 4 347107
1#0##0#0#0.0#2022-01-05
14:49:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e5db8d79bfade30c8366045ff135cb59 150000 0 0 0 0 0
200000 0 0 0 15000 0 68920 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 27/01/1971 0 2
1 Z09.8;E11.3;H36.0;H52.2;H52.4 90.29;95.01 - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 298820 0 1 0 0 0 ORYZA WARDHANI.NY 093625
0001621021307 3;JKN novia;3313125201940001; 5.6.3.202201201500 4
344060 1#0##0#0#0.0#2022-03-08
08:02:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
5b328b5caa3412666d3a790315d8d4e7 254000 0 0 0 0 0
0 0 0 0 15000 0 29820 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 17/04/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 230801
0 1 0 0 0 SUYATNO, TN 092870 53 19593 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 344061
1#0##0#0#0.0#2021-12-14
11:15:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bcc83d37b43dad0f17a78b58becd9c7e 150000 0 0 0 0 0
0 0 0 0 15000 0 65801 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 05/09/1966 0 2
1 Z09.8;E11.4;G59.0;E78.5;G56.0 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
467952 0 1 0 0 0 SUPARMI., NY 050493 55
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 344062
1#0##0#0#0.0#2022-04-14
12:49:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
663258c912204751f615cddb5d3eeeac 150000 0 0 0 0 0
0 0 0 0 15000 0 302952 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 01/12/1964 0 2
1 Z09.8;E11.3;H36.0;H26.9;H35.0;H04.1 90.29 - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 248975 0 1 0 0 0 Sumarmi 42210 57
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 344063
1#0##0#0#0.0#2021-12-14
11:18:42#0#00:00:00#00:00:00#07:40:56#{"co_insidense_ind":"0"} 1
a676907a87af654a5aa7582efe5c16c3 203000 0 0 0 0 0
0 0 0 0 15000 0 30975 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 01/04/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 567060
0 1 0 0 0 SURIP HADI SUTRISNO, (BP) 032273 71
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 344064
1#0##0#0#0.0#2021-12-14
11:20:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
58ac854dcd9ea323b9411c040f12a5d9 150000 0 0 0 0 0
0 31845 0 0 15000 0 370215 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 30/01/1964 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
255500 0 1 0 0 0 DRA. DIYAH ANITA LISTYANINGTYAS, NY
060086 57 21132 DR. YUDHI DORANDES, SP.M 1124R0021221V001334
0002056352084 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
344066 1#0##0#0#0.0#2021-12-14
11:23:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
42e4328d6e66bd8bb569a5a7ac071f05 203000 0 0 0 0 0
0 0 0 0 15000 0 37500 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 30/10/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 278795
0 1 0 0 0 NURINI.NY 098894 62 22685 DR. YUDHI
agung;3313092303950002; 5.5.5.202112011542 4 344067
1#0##0#0#0.0#2021-12-14
11:24:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ed928e4846cb4dddae1dea3dd325c779 203000 0 0 0 0 0
0 0 0 0 15000 0 60795 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 04/05/1983 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 MARDIYAH, (NY) 007232 38 14098 DR.
agung;3313092303950002; 5.5.5.202112011542 4 344068
1#0##0#0#0.0#2021-12-14
11:26:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b4d964bf965b4a84ac717fbedd6f7697 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 27/09/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 275145
0 1 0 0 0 LESTARI RAHAYU, NY 086211 64 23448
agung;3313092303950002; 5.5.5.202112011542 4 344069
1#0##0#0#0.0#2021-12-14
11:27:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9ef779798533d94fb65c276ff7ce495a 150000 0 0 0 0 0
0 31845 0 0 15000 0 78300 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 24/04/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 KAYADI, TN 080553 77 28352 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 344070
1#0##0#0#0.0#2021-12-14
11:28:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
58f05ae2e79e8d080f5100daf7cef7f0 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 19/05/1972 0 1
0 - 0 - 0 - 0 786200 677676 0 1
agung;3313092303950002; 5.5.5.202112011542 4 344071
1#0##0#0#0.0#2021-12-14
11:31:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a085f47fc262760ff6464f7c20cbaa05 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 15/10/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.5.5.202112011542 4 344072
1#0##0#0#0.0#2021-12-14
11:32:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9fe408b1245dbd568211581c23308244 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 03/02/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 286345
0 1 0 0 0 DWI PRIYATMO SUHADI.TN 099409 67 24780
agung;3313092303950002; 5.5.5.202112011542 4 344073
1#0##0#0#0.0#2021-12-14
11:33:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e1080e3d5eb6e533276fd15191ca0b9c 150000 0 0 0 0 0
0 121345 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 14/03/1977 0 1
0 - 0 - 0 - 0 786200 517890 0 1
agung;3313092303950002; 5.5.5.202112011542 4 344075
1#0##0#0#0.0#2021-12-14
11:39:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
286209e0c874e8e0d63038776663deab 463830 0 0 0 0 0
0 0 0 0 15000 0 39060 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 22/02/1971 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 WIWIK SETYOWATI 078388 50 18552 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 344076
1#0##0#0#0.0#2021-12-14
11:40:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a349b3d7e53b2f9bf02b45e3b280cbe3 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 31/12/1981 0 2
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.5.5.202112011542 4 344077
1#0##0#0#0.0#2021-12-14
11:42:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bd3528eca9cf00f0084a8c74898615a6 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 18/07/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V001345 0002425018184 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 344079 1#0##0#0#0.0#2021-12-14
11:43:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b22b8646f0a64ba3186a055c011868b7 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 16/10/1949 0 2
1 Z09.8;G62.8;M54.50 93.34;93.35 - - None None None None
0 - 0 107400 262000 0 1 0 0 0 Ny.
Sri Yekti Ismadi 40545 72 26351 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V001346 0000089740067 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 344080 1#0##0#0#0.0#2021-12-14
11:48:27#0#00:00:00#00:00:00#12:37:46#{"co_insidense_ind":"0"} 1
6486061747b78c61e382fdf742d39736 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 09/09/1944 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V001347 0000100867893 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 344081 1#0##0#0#0.0#2021-12-14
11:57:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c630e135268800900f2ebf70197cefc4 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 21/07/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 287191
0 1 0 0 0 PONIMAN, TN 066834 51 18768 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 344082
1#0##0#0#0.0#2021-12-14
11:58:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3e6dd0b2f32460aca8c2cdd307453e26 150000 0 0 0 0 0
0 0 0 0 15000 0 122191 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 13/06/1961 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
575550 0 1 0 0 0 SARDJITO,TN 084189 60 22093
agung;3313092303950002; 5.5.5.202112011542 4 344083
1#0##0#0#0.0#2021-12-14
11:59:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
40c334dc48530771994fe49a3a1a7306 150000 0 0 0 0 0
0 120795 0 0 15000 0 289755 0 0 0 0
0
3372030 C 3 CP 2 08/12/2021 08/12/2021 03/12/1950 0 1
0 - 0 - 0 - 0 786200 677676 0 1
agung;3313092303950002; 5.5.5.202112011542 4 344084
1#0##0#0#0.0#2021-12-14
12:00:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bcbb744e06f1701fbb0a8be1627273ab 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 10/06/1964 0 2
1 E11.4;G59.0 87.24 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 848091
0 1 0 0 0 SULIYEM.NY 100299 57 21000 DR. TEKY
novia;3313125201940001; 5.5.5.202112011542 4 347108
1#0##0#0#0.0#2022-01-05
14:50:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bbf2a940c473f1b0ca86f7b583443735 150000 0 0 0 0 0
220000 0 0 0 15000 0 463091 0 0 0 0
0
3372030 C 3 CP 2 08/12/2021 08/12/2021 12/05/1997 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 HANIN MEGA NINGSIH 075771 24 8976 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 344085
1#0##0#0#0.0#2021-12-14
12:08:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c584f9f0180c3787bc2f250cf59f9e2d 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 25/03/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 261180
0 1 0 0 0 MURYANI AFFANDI NY 084882 76 28017
novia;3313125201940001; 5.6.3.202201201500 4 344086
1#0##0#0#0.0#2022-02-15
11:34:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 3
1a162d2ec55630b27d37688d12b2e0c6 150000 0 0 0 0 0
0 0 0 0 15000 0 96180 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 24/10/1987 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 TRI PRIYATIN 100581 34 12464 DRG. VERAWATY,
SP.KG 1124R0021221V001355 0002033251931 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 344087 1#0##0#0#0.0#2021-12-14
12:33:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b4dd941a4dac8e062b6217c8d7c48ab3 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 01/03/1936 0 2
0 0 - 0 - 0 - 0 - 0 181400 202021
0 1 0 0 0 SOELASIH.NY 084493 85 31328 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 344111
1#0##0#0#0.0#2021-12-14
13:16:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
37ec7dac562ffb5157e70c272b1c7460 150000 0 0 0 0 0
0 0 0 0 15000 0 37021 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 14/10/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 188602
0 1 0 0 0 LUSIA TIYAS WURI.NY 085970 45 16491
agung;3313092303950002; 5.5.5.202112011542 4 344112
1#0##0#0#0.0#2021-12-14
13:17:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4b54b84f58f14d9fc3643965e580bcf6 150000 0 0 0 0 0
0 0 0 0 15000 0 23602 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 08/05/1978 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SUNDARIYATI 52271 43 15920 DRG. VERAWATY, SP.KG
1124R0021221V001358 0001104291303 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 344113 1#0##0#0#0.0#2021-12-14
13:18:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0d860bb66988169a44913ae5ea0bf8cc 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 28/03/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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3372030 C 3 CP 2 08/12/2021 08/12/2021 03/11/1945 0 1
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1#0##0#0#0.0#2021-12-14
13:58:55#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#2021-12-14
14:07:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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14:19:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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14:27:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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14:53:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 04/08/1968 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 344194
1#0##0#0#0.0#2021-12-14
14:54:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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1 0 0 0 PUJI SAPTYANINGSIH.NY 100263 32 11734 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 344195
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14:58:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 08/02/1976 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 344196
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15:00:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 12/11/1945 0 2
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3;JKN novia;3313125201940001; 5.6.3.202201201500 4 344197
1#0##0#0#0.0#2022-02-15
13:35:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 08/12/2021 08/12/2021 17/10/1945 0 1
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agung;3313092303950002; 5.5.5.202112011542 4 344198
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15:09:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 21/06/1975 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 EKO WAHYU NUGROHO.TN 100178 46 16972 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 344199
1#0##0#0#0.0#2021-12-14
15:11:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 20/03/2007 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 344200
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15:12:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 07/06/1990 0 1
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3;JKN agung;3313092303950002; 5.5.5.202112011542 4 344201
1#0##0#0#0.0#2021-12-14
15:14:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 05/12/1972 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 344202
1#0##0#0#0.0#2021-12-14
15:19:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 02/05/1948 0 2
1 Z09.8;I64;M79.18;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 205396
0 1 0 0 0 MURSITI.NY 099239 73 26883 DR. INDRIANY
agung;3313092303950002; 5.5.5.202112011542 4 344203
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15:20:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 09/05/1949 0 1
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3;JKN agung;3313092303950002; 5.5.5.202112011542 4 344204
1#0##0#0#0.0#2021-12-14
15:22:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 04/09/1981 0 2
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3;JKN agung;3313092303950002; 5.5.5.202112011542 4 344205
1#0##0#0#0.0#2021-12-14
15:23:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 02/02/1972 0 2
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SP.PD 1124R0021221V001412 0002070978546 3;JKN agung;3313092303950002;
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07:45:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 18/08/1981 0 2
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07:48:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 01/01/2000 0 1
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1 0 0 0 JULI HADI WINARTO., BP 046573 21 8012 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 344224
1#0##0#0#0.0#2021-12-15
07:53:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 23/03/1967 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 344225
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07:55:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 09/04/2003 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 344231
1#0##0#0#0.0#2021-12-15
07:56:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 30/11/1979 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 344237
1#0##0#0#0.0#2021-12-15
07:59:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 31/07/1988 0 1
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- 0 - 0 - 0 - 0 206700 437030 0
1 0 0 0 YULI HARTANTO,(BP) 022798 33 12183 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 344244
1#0##0#0#0.0#2021-12-15
08:03:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 07/04/1984 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 NEILIYANA.NN 099969 37 13759 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 344245
1#0##0#0#0.0#2021-12-15
08:04:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 05/03/1961 0 1
1 Z09.8;M79.18;R80 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 186276
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agung;3313092303950002; 5.5.5.202112011542 4 344246
1#0##0#0#0.0#2021-12-15
08:05:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 01/08/2006 0 2
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0 1 0 0 0 ARDELIA KHAIRUNNISA PUTRI S, NN 074740
15 5608 DR. ANI SURYANTI WISYASTUTI, SP.A., M.KES 1124R0021221V001421
0001106441649 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
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08:06:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 31/12/1965 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 344248
1#0##0#0#0.0#2021-12-15
08:07:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 08/08/1950 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 344249
1#0##0#0#0.0#2021-12-15
08:08:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 09/05/1996 0 1
0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 ALEX PORNAMA PUTRA 032482 25 9344
agung;3313092303950002; 5.5.5.202112011542 4 344250
1#0##0#0#0.0#2021-12-15
08:09:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 21/11/1990 0 1
0 - 0 - 0 - 0 183900 293425 0 1
0 0 0 MUHAMMAD IWAN NOFRIYANTO.TN 100014 31 11340 DR.
agung;3313092303950002; 5.5.5.202112011542 4 344251
1#0##0#0#0.0#2021-12-15
08:11:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 13/05/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 283805
0 1 0 0 0 ROHMADI,TN 018278 51 18837 DR.
agung;3313092303950002; 5.5.5.202112011542 4 344252
1#0##0#0#0.0#2021-12-15
08:13:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 09/08/1972 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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344253 1#0##0#0#0.0#2021-12-15
08:14:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 04/11/2002 0 1
1 H59.8;H10.9 95.01;87.03 - - None None None None Z-3-18-0
- 0 - 0 - 0 - 0 894800 1182820 0
1 0 0 0 BINTANG KURNIAWAN, SDR 094772 19 6974 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347109
1#0##0#0#0.0#2022-01-05
14:51:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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935000 0 0 0 15000 0 29820 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 30/05/2018 0 2
1 M12.88 88.27 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 423000
0 1 0 0 0 FADIATUZZAHRA RAMADHANTI.AN 100584 3
0002940780025 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
347110 1#0##0#0#0.0#2022-04-14
13:48:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 08/12/2021 08/12/2021 15/05/1990 0 1
0 0 - 0 - 0 - 0 - 0 181400 332210
0 1 0 0 0 SUTRISNO.,TN 074382 31 11530 DR.
agung;3313092303950002; 5.5.5.202112011542 4 344254
1#0##0#0#0.0#2021-12-15
08:15:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 24/05/1986 0 2
0 0 - 0 - 0 - 0 - 0 296400 165000
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35 12982 DR. DEWI ANGGOROWATI, SP.OG 1124R0021221V001432
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344255 1#0##0#0#0.0#2022-03-08
12:13:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 04/12/2021 04/12/2021 26/05/2001 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 MEIDYA MITA MAHARTIN,(NN) 000957 20
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3;JKN novia;3313125201940001; 5.5.5.202112011542 4 347403
1#0##0#0#0.0#2022-01-05
14:22:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 10/11/1980 0 2
1 Z09.8;I11.9;D64.8 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 249351
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agung;3313092303950002; 5.5.5.202112011542 4 344284
1#0##0#0#0.0#2021-12-15
09:19:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 10/01/1963 0 2
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 370305 0 1 0 0 0 RIYANTI,NY 075128
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344285 1#0##0#0#0.0#2021-12-15
09:21:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 22/02/1964 0 1
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agung;3313092303950002; 5.5.5.202112011542 4 344286
1#0##0#0#0.0#2021-12-15
09:22:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 11/04/1993 0 1
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agung;3313092303950002; 5.5.5.202112011542 4 344287
1#0##0#0#0.0#2021-12-15
09:43:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 01/01/2000 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 344288
1#0##0#0#0.0#2021-12-15
09:44:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 19/05/1966 0 2
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3;JKN agung;3313092303950002; 5.5.5.202112011542 4 344289
1#0##0#0#0.0#2021-12-15
09:51:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 08/12/2021 08/12/2021 31/12/1935 0 2
0 - 0 - 0 - 0 183900 350990 0 1
0 0 0 SUTIYEM 100591 85 31389 DR. HERMAWAN, Sp.B M.Kes
1124R0021221V001441 0000640535455 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 344290 1#0##0#0#0.0#2021-12-15
09:55:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
14d99981f4d15c1ff35392465116a06f 295000 0 0 0 0 0
0 0 0 0 25000 0 30990 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 14/07/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 225561
0 1 0 0 0 JAMSURI TN 100560 58 21332 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 344295
1#0##0#0#0.0#2021-12-15
10:04:02#0#00:00:00#00:00:00#10:03:35#{"co_insidense_ind":"0"} 1
fbe283364164fb6ab7252f1734ebc722 150000 0 0 0 0 0
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3372030 C 3 CP 2 08/12/2021 08/12/2021 17/03/1986 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RATNA NILASARI, NY 001398 35 13050 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 344296
1#0##0#0#0.0#2021-12-15
10:05:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b3dd1bd4c0cc31d348bfcbb6801fd8d8 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 08/12/2021 08/12/2021 11/09/2000 0 1
- 0 - 0 - 0 - 0 182600 139110 0
1 0 0 0 SHOLIHAH SULISTYOWATI, NN 100561 21 7758
dr. SUROSO 1124R0021221V001447 0003096489835 3;JKN
novia;3313125201940001; 5.6.3.202201201500 4 346636
1#0##0#0#0.0#2022-02-15
11:13:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
2d6d6c001cf57497a46e72d4b42605b7 105000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 03/01/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 221222
0 1 0 0 0 SUGILAH.NY 085281 45 16777 DR. WAHYU
reni;3313147010930001; 5.5.5.202112011542 4 344089
1#0##0#0#0.0#2021-12-14
13:11:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4f5268359573e76203387c19bca50d56 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 13/08/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 362752
0 1 0 0 0 ENDANG MARYATI 085348 64 23494 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344090
1#0##0#0#0.0#2021-12-14
13:17:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e8f90f794e65bd03b4c23669e0d619f1 150000 0 0 0 0 0
0 133650 0 0 15000 0 64102 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 31/12/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 210382
0 1 0 0 0 SOEMARKO.,BP 053597 71 26276 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344091
1#0##0#0#0.0#2021-12-14
13:18:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4c505915e05d78ac5aca2f89e65b4738 150000 0 0 0 0 0
0 0 0 0 15000 0 45382 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 22/08/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 219152
0 1 0 0 0 DYAH NURJANTI,(NY) 042222 74 27138
reni;3313147010930001; 5.5.5.202112011542 4 344092
1#0##0#0#0.0#2021-12-14
13:18:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8e0e4a5a2c8d2bc37a54056ec6e0f155 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 05/01/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 351470
0 1 0 0 0 PRAWITO, (BP) 010343 53 19697 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344093
1#0##0#0#0.0#2021-12-14
13:19:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1379a0d3c749ca14960c418a9713e930 150000 0 0 0 0 0
0 171170 0 0 15000 0 15300 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 02/06/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 340940
0 1 0 0 0 SRI PARTINI.NY 084088 54 19914 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344095
1#0##0#0#0.0#2021-12-14
13:19:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
18d4236d160750134e4be7f71f455201 150000 0 0 0 0 0
0 133650 0 0 15000 0 42290 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 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 1531
reni;3313147010930001; 5.5.5.202112011542 4 344096
1#0##0#0#0.0#2021-12-14
13:20:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 09/12/2021 09/12/2021 11/12/1975 0 1
1 Z09.8;I10;E78.5;E79.0;N20.0 88.75 - - None None None None
549400 0 0 - 0 - 0 - 0 - 0 549400
1011090 0 1 0 0 0 ISDIANTO, (BP) 020830 45
3;JKN novia;3313125201940001; 5.6.3.202201201500 4 353795
1#0##0#0#0.0#2022-02-16
07:42:53#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
716330fc294bd4ca631a928a4de383c7 150000 0 0 0 0 0
680000 88950 0 0 15000 0 77140 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 06/02/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 279358
0 1 0 0 0 S.TRI HASTUTI,(NY) 040869 45 16743
reni;3313147010930001; 5.5.5.202112011542 4 344099
1#0##0#0#0.0#2021-12-14
13:28:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ab507f603b8dc22fac5907ca890426b4 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 21/10/1960 0 2
1 Z09.8;R10.4;M25.58 88.76 - - None None None None Z-3-
0 0 - 0 - 0 - 0 - 0 549400
1011170 0 1 0 0 0 SRI SUJIANI,(NY) 023036 61
novia;3313125201940001; 5.5.5.202112011542 4 347128
1#0##0#0#0.0#2022-01-05
14:59:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6c4fc3801b8fecaef1c5ca3249052396 150000 0 0 0 0 0
657000 120745 0 0 15000 0 68425 0 0 0 0
0
3372030 C 3 CP 2 09/12/2021 09/12/2021 16/10/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 324427
0 1 0 0 0 SRI SUDARTINI.NY 077473 57 20873 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344100
1#0##0#0#0.0#2021-12-14
13:28:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d998d19969ca0e5eb157b7792902209a 150000 0 0 0 0 0
0 76045 0 0 15000 0 83382 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 01/08/1981 0 1
0 0 - 0 - 0 - 0 - 0 181400 205214
0 1 0 0 0 AGUS RIYANTO.SDR 079932 40 14740 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344101
1#0##0#0#0.0#2021-12-14
13:29:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bf27fca53c1a10156eaacdc3e6e8db5b 150000 0 0 0 0 0
0 0 0 0 15000 0 40214 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 26/01/1969 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
379082 0 1 0 0 0 SITI LESTARI, NY 084497 52
3;JKN reni;3313147010930001; 5.5.5.202112011542 4 344102
1#0##0#0#0.0#2021-12-14
13:29:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b606dfdac2c48c2b367ae12912dedc39 150000 0 0 0 0 0
0 76045 0 0 15000 0 138037 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 24/10/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 292922
0 1 0 0 0 RETNO PRADANINGRUM (NY) 028232 60 21961
reni;3313147010930001; 5.5.5.202112011542 4 344103
1#0##0#0#0.0#2021-12-14
13:30:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
29d8035609851d7f6ccebf5ab7428248 150000 0 0 0 0 0
0 76045 0 0 15000 0 51877 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 13/11/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 294852
0 1 0 0 0 ROCHJATI,(NY) 001392 73 26689 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344105
1#0##0#0#0.0#2021-12-14
13:30:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
415a9e2c14911aec53b29f03f9243c9e 150000 0 0 0 0 0
0 31845 0 0 15000 0 98007 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 01/03/1965 0 2
1 Z09.8;E11.4;G59.0;I10;K52.9 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
252075 0 1 0 0 0 WINARTI., NY 045500 56
3;JKN reni;3313147010930001; 5.5.5.202112011542 4 344106
1#0##0#0#0.0#2021-12-14
13:31:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0c2a0d646cc4ec1f1d04c7e314ef5a9b 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 24/12/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 446510
0 1 0 0 0 SRI SUTANTI, NY 090727 61 22631 DR.
agung;3313092303950002; 5.6.6.202203301209 4 347130
1#0##0#0#0.0#2022-04-14
13:26:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
4d9574758b7be5e1fd9836fe19d33461 150000 0 0 0 0 0
220000 0 0 0 15000 0 61510 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 14/05/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 357842
0 1 0 0 0 WINARNO.TN 093273 56 20663 DR. WAHYU
reni;3313147010930001; 5.5.5.202112011542 4 344107
1#0##0#0#0.0#2021-12-14
13:37:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5fc579099e83fa32ec273a4b97811be1 150000 0 0 0 0 0
0 133650 0 0 15000 0 59192 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 09/11/1969 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
1058023 0 1 0 0 0 HARI SANTOSO.TN 079533 52
3;JKN reni;3313147010930001; 5.5.5.202112011542 4 344108
1#0##0#0#0.0#2021-12-14
13:44:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d389c1b448236dd3972334590f26c090 150000 0 0 0 0 0
0 107890 0 0 15000 0 785133 0 0 0 0
0
3372030 C 3 CP 2 09/12/2021 09/12/2021 21/01/1968 0 2
1 Z09.8;E11.9;I67.8;H81.3 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 365560
0 1 0 0 0 NGATINI , NY 090009 53 19681 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344109
1#0##0#0#0.0#2021-12-14
13:44:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d07a097731abb79f9eb26a06cf45443e 150000 0 0 0 0 0
0 107890 0 0 15000 0 92670 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 10/04/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 436300
0 1 0 0 0 SRI SULARSIH., NY 052061 66 24350 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347132
1#0##0#0#0.0#2022-01-05
15:02:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4bf1377ff3ea32c4fbab2b9696571e35 150000 0 0 0 0 0
220000 0 0 0 15000 0 51300 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 22/11/1960 0 2
1 Z09.8;E11.4;G59.0;M17.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 707748
0 1 0 0 0 ENDANG SRI UTAMI, NY 089742 61 22297
reni;3313147010930001; 5.5.5.202112011542 4 344132
1#0##0#0#0.0#2021-12-14
14:07:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fbfbf48ef83cf5c8b3b96a8d822998e2 150000 0 0 0 0 0
0 76045 0 0 15000 0 466703 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 05/09/1966 0 2
None None None None None None PROSEDUR KECIL PADA TANGAN & PERGELANGAN
TANGAN 312400 0 0 - 0 - 0 - 0 - 0
312400 210381 0 1 0 0 0 SUPARMI., NY 050493
0000640210331 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
344133 1#0##0#0#0.0#2022-04-14
12:49:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
9908da6086b035db6e9344a36af50ea1 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 17/11/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 213340
0 1 0 0 0 INDRARIADI.TN 098885 55 20111 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344134
1#0##0#0#0.0#2021-12-14
14:08:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
86f3b349fd1b0771e77cc5e526783d87 150000 0 0 0 0 0
0 0 0 0 15000 0 48340 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 08/11/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 239572
0 1 0 0 0 IRAN RAHAYU, NY 099708 54 19755 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344135
1#0##0#0#0.0#2021-12-14
14:09:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c087d2e6fe425a743e6e180a8645ef84 150000 0 0 0 0 0
0 0 0 0 15000 0 74572 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 03/08/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 219972
0 1 0 0 0 ISMURYANI HANDAYANINGSIH.NY 098932 58
3;JKN reni;3313147010930001; 5.5.5.202112011542 4 344136
1#0##0#0#0.0#2021-12-14
14:15:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
da640e3984c842340920734ea61c3116 150000 0 0 0 0 0
0 0 0 0 15000 0 54972 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 30/05/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SRI MULYATI 092852 49 18090 DR. TEKY
reni;3313147010930001; 5.5.5.202112011542 4 344137
1#0##0#0#0.0#2021-12-14
14:15:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9ffbf2041c7c6855c916038d4b34aeca 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 03/08/1963 0 2
1 Z09.8;M17.9;M54.59 81.92 - - None None None None M-3-
11-0 None None None None None None PROSEDUR DIAGNOSTIK DAN TERAPEUTIK
0 404900 388162 0 1 0 0 0 TENTREM.NY 089445
0000640219601 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
344138 1#0##0#0#0.0#2021-12-14
14:16:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
24b6aa1b7019239b24787ee73733d464 150000 0 0 0 0 0
0 0 0 0 15000 0 223162 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 10/12/1940 0 2
0 0 - 0 - 0 - 0 - 0 181400 382904
0 1 0 0 0 RUSTANTI,(NY) 033199 80 29584 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344139
1#0##0#0#0.0#2021-12-14
14:16:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6f5030618915d85849aa32704e2d7f5f 150000 0 0 0 0 0
0 76595 0 0 15000 0 141309 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 20/08/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 314675
0 1 0 0 0 ENDANG J SUSANTO, NY 093679 59 21661
reni;3313147010930001; 5.5.5.202112011542 4 344140
1#0##0#0#0.0#2021-12-14
14:17:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
565890198d90874292104d7f412be58b 150000 0 0 0 0 0
0 76595 0 0 15000 0 73080 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 11/04/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400
1080915 0 1 0 0 0 SRI SURIPNI.NY 100421 67
novia;3313125201940001; 5.5.5.202112011542 4 347134
1#0##0#0#0.0#2022-01-05
15:03:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b76885b73ba9158e1d029ffa4b6593fa 150000 0 0 0 0 0
857000 0 0 0 15000 0 58915 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 08/08/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 344805
0 1 0 0 0 GIYANTI.NY 100284 50 18386 DR. ARIA
reni;3313147010930001; 5.5.5.202112011542 4 344142
1#0##0#0#0.0#2021-12-14
14:18:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
755ab64c81e32475fb90fb82f6a8cd95 150000 0 0 0 0 0
0 121345 0 0 15000 0 58460 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 25/02/1960 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
566149 0 1 0 0 0 SUHADAK.,TN 075282 61 22568
reni;3313147010930001; 5.5.5.202112011542 4 344143
1#0##0#0#0.0#2021-12-14
14:19:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e1b1bf593788cc6b66e6912a4710a824 150000 0 0 0 0 0
0 76045 0 0 15000 0 325104 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 15/10/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 591089
0 1 0 0 0 HARDATIN.NY 099609 53 19413 DR. SUHARTO,
SP.PD 1124R0021221V001484 0001426540408 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 344144 1#0##0#0#0.0#2021-12-14
14:20:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6920cb788bbe17393ae07b483df332e0 150000 0 0 0 0 0
0 31845 0 0 15000 0 394244 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 03/07/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 288406
0 1 0 0 0 HARTININGSIH, NY 099094 51 18787 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344145
1#0##0#0#0.0#2021-12-14
14:21:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 09/12/2021 09/12/2021 31/12/1955 0 1
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reni;3313147010930001; 5.5.5.202112011542 4 344147
1#0##0#0#0.0#2021-12-14
14:22:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
605a72d3d124728ac0a84f8c22f03c1b 150000 0 0 0 0 0
0 88900 0 0 15000 0 70875 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 11/06/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 279751
0 1 0 0 0 TRI DJANAH, NY 095470 68 25018 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344148
1#0##0#0#0.0#2021-12-14
14:23:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b8367b14c4ee06f43e1be4f8e6f2e4ee 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 29/08/1962 0 2
1 Z09.8;M54.59 87.24 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 439150
0 1 0 0 0 CHUSNUL CHOTIMAH, NY 097918 59 21652
novia;3313125201940001; 5.5.5.202112011542 4 347137
1#0##0#0#0.0#2022-01-05
15:04:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
50347f36889037a90de8247d255a2c6c 150000 0 0 0 0 0
220000 0 0 0 15000 0 54150 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 23/11/1959 0 1
1 Z09.8;M19.98;K07.6 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 342295
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reni;3313147010930001; 5.5.5.202112011542 4 344149
1#0##0#0#0.0#2021-12-14
14:24:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5158fcbae4a9db85a8f2fe09e84e0b36 150000 0 0 0 0 0
0 120795 0 0 15000 0 56500 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 14/09/1977 0 1
0 0 - 0 - 0 - 0 - 0 181400 222160
0 1 0 0 0 SRI SAWAL RIYADI.TN 096799 44 16157
reni;3313147010930001; 5.5.5.202112011542 4 344159
1#0##0#0#0.0#2021-12-14
14:29:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
afa461c35735bf1dba89fc71a941e86f 150000 0 0 0 0 0
0 0 0 0 15000 0 57160 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 18/01/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 217467
0 1 0 0 0 HARDJANINGSIH, NY 098784 66 24432 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344160
1#0##0#0#0.0#2021-12-14
14:30:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
66c6b0440912ab98452dbcf1877bec2e 150000 0 0 0 0 0
0 0 0 0 15000 0 52467 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 09/09/1940 0 1
0 0 - 0 - 0 - 0 - 0 181400 216637
0 1 0 0 0 SUDARKO,(BP) 039452 81 29676 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344161
1#0##0#0#0.0#2021-12-14
14:30:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2eb92562bfde6387e352635c438dfca1 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 15/07/1949 0 2
1 Z09.8;R05;M19.98;I10 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 230280
0 1 0 0 0 SRI SUMARNI,(NY) 032180 72 26445 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344162
1#0##0#0#0.0#2021-12-14
14:31:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 09/12/2021 09/12/2021 15/06/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 279601
0 1 0 0 0 MUYASARAH, NY 094107 57 20996 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344163
1#0##0#0#0.0#2021-12-14
14:31:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0c8fcff8fddd1410e635f2f7c7873934 150000 0 0 0 0 0
0 31845 0 0 15000 0 82756 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 03/09/1963 0 2
0 - 0 - 0 - 0 129600 475383 0 1
0 0 0 WAGIYAH ., NY 059289 58 21282 DR. WAHYU PURNOMO,
SP.OT 1124R0021221V001497 0001969739559 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 347140 1#0##0#0#0.0#2022-01-05
15:05:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4a8c874581fdcbab56287bad31fbbbb1 150000 0 0 0 0 0
248000 0 0 0 15000 0 62383 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 21/12/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 358695
0 1 0 0 0 SUYATNO.TN 091027 59 21903 DR. SUHARTO,
SP.PD 1124R0021221V001498 0001699124218 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 344164 1#0##0#0#0.0#2021-12-14
14:32:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0b87250a9b5591b4dbe74430f35e5077 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 31/05/1972 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ENDANG HARSO SRI
1124R0021221V001499 0000639771715 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 344165 1#0##0#0#0.0#2021-12-14
14:32:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4d278115713534a354d16558522e6e81 258000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 28/06/2017 0 2
0 0 - 0 - 0 - 0 - 0 181400 173218
0 1 0 0 0 ZEVANYA KINARIAN,AN 099154 4 1625
reni;3313147010930001; 5.5.5.202112011542 4 344168
1#0##0#0#0.0#2021-12-14
14:43:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4020f0ac7fd55cfe4859fd5ca4f5986d 150000 0 0 0 0 0
0 0 0 0 15000 0 8218 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 07/06/1963 0 2
1 Z09.8;E78.5;R51 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 204415
0 1 0 0 0 WARSINI TURMUDZI ,(NY) 039273 58 21370
reni;3313147010930001; 5.5.5.202112011542 4 344169
1#0##0#0#0.0#2021-12-14
14:43:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
13d9e8251d1223eabbc17ecd4affabad 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 06/07/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 221770
0 1 0 0 0 SUMARNI.NY 086963 67 24628 DR. SUHARTO,
SP.PD 1124R0021221V001503 0002347072604 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 344170 1#0##0#0#0.0#2021-12-14
14:45:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
aa7ba0b45beb40f0d754b8e3efe9d0a6 150000 0 0 0 0 0
0 31845 0 0 15000 0 24925 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 28/10/1964 0 2
1 Z09.8;I11.9;K30;R51 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 270791
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3;JKN reni;3313147010930001; 5.5.5.202112011542 4 344171
1#0##0#0#0.0#2021-12-14
14:48:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 09/12/2021 09/12/2021 31/10/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 217602
0 1 0 0 0 DAL HARI PURNOMO.TN 078559 66 24146
reni;3313147010930001; 5.5.5.202112011542 4 344172
1#0##0#0#0.0#2021-12-14
14:48:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6beb101aee1578d515ea97f031620d4c 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 31/12/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 207500 0 1 0 0 0 NGATIYEM.NY 067636
0000640358291 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
344175 1#0##0#0#0.0#2021-12-14
14:49:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 09/12/2021 09/12/2021 08/07/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 179634
0 1 0 0 0 ALIEFINO ZALVA SURYA.SDR 087960 19
reni;3313147010930001; 5.5.5.202112011542 4 344176
1#0##0#0#0.0#2021-12-14
14:50:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1ca2e72ab605565298b461874a26aa51 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 10/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 222990
0 1 0 0 0 DESI IRAWATI.NY 083433 66 24471 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344178
1#0##0#0#0.0#2021-12-14
14:50:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 09/12/2021 09/12/2021 12/06/1979 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TRI CAHYANINGSIH,
0001530445239 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
344179 1#0##0#0#0.0#2021-12-14
14:51:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
472db12583288ba23878710b9cac9ef4 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 18/06/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 228422
0 1 0 0 0 JEMI.NY 076504 65 23915 DR. WAHYU
reni;3313147010930001; 5.5.5.202112011542 4 344180
1#0##0#0#0.0#2021-12-14
14:51:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8c52416d327201470c4238c70cc54875 150000 0 0 0 0 0
0 0 0 0 15000 0 63422 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 21/11/1982 0 2
0 0 - 0 - 0 - 0 - 0 181400 228987
0 1 0 0 0 SARI CAHYANI, NY 097837 39 14263 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344181
1#0##0#0#0.0#2021-12-14
14:52:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
af0ca5ab366672def3dab44a33638e31 150000 0 0 0 0 0
0 0 0 0 15000 0 63987 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 08/09/1960 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SITI ZUBAIDAH, NY
0000196018064 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
344182 1#0##0#0#0.0#2021-12-14
14:53:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0d46894693f0e8147c18037ec670fe09 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 02/05/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 636218
0 1 0 0 0 ENY MURWANINGSIH ,(NY) 042511 63 23232
reni;3313147010930001; 5.5.5.202112011542 4 344183
1#0##0#0#0.0#2021-12-14
14:53:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
026e4c98e7db348f757ef9c1861e17c2 150000 0 0 0 0 0
0 31845 0 0 15000 0 439373 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 23/04/1963 0 2
1 Z09.8;H26.9;E11.3;H36.0;H04.1 90.29;16.21 - - None None None
None H-3-12-0 None None None None None None PROSEDUR LAIN-LAIN PADA
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218000 0 1 0 0 0 SUYATMI., NY 049452 58
3;JKN reni;3313147010930001; 5.5.5.202112011542 4 344184
1#0##0#0#0.0#2021-12-14
15:13:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fab767a5f37b2ccbeb9d99f5562ea0bb 203000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 24/04/1937 0 2
0 0 - 0 - 0 - 0 - 0 181400 221250
0 1 0 0 0 SUHARTI.NY 076451 84 30910 DR. SUHARTO,
SP.PD 1124R0021221V001518 0000091321931 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 344185 1#0##0#0#0.0#2021-12-14
15:14:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3e6cae942087fcfc042ba5bb50cbbccb 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 03/12/1960 0 1
1 Z09.8;E78.5;J40 87.49 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 501320
0 1 0 0 0 SURAHMAN, TN 099728 61 22286 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347142
1#0##0#0#0.0#2022-01-05
15:07:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9d7bf5d582e3ffea81d5ca87f96289fa 150000 0 0 0 0 0
200000 108390 0 0 15000 0 27930 0 0 0 0
0
3372030 C 3 CP 2 09/12/2021 09/12/2021 10/04/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 213048
0 1 0 0 0 SRI RAHAYU.NY 084543 60 22158 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344186
1#0##0#0#0.0#2021-12-14
15:15:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7f0b267af78b5e7589d868484f20c6ff 150000 0 0 0 0 0
0 31845 0 0 15000 0 16203 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 07/09/1976 0 1
1 Z09.8;N20.0;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 240383
reni;3313147010930001; 5.5.5.202112011542 4 344208
1#0##0#0#0.0#2021-12-14
15:39:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8ca811a3396e62336dd8fcea2488bca9 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 11/10/1960 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ZULAIKAH, NY
0001106028551 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
344209 1#0##0#0#0.0#2021-12-14
15:42:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
72bb9299a2dbf4d85c288e7aa524ed88 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 01/03/1981 0 1
1 Z09.8;R07.4;R10.4 88.76 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400 896615
0 1 0 0 0 SIGIT MARIYADI, TN 100053 40 14893
novia;3313125201940001; 5.5.5.202112011542 4 347144
1#0##0#0#0.0#2022-01-05
15:08:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d01fce7294314d6159282c99107dcbfe 150000 0 0 0 0 0
657000 0 0 0 15000 0 74615 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 24/07/2002 0 1
1 M17.9;W19.3 88.27 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 458382
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3;JKN novia;3313125201940001; 5.5.5.202112011542 4 347147
1#0##0#0#0.0#2022-01-05
15:09:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a9544f062711be8f8b72ccf2915e3732 150000 0 0 0 0 0
248000 0 0 0 15000 0 45382 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 15/09/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 209445
0 1 0 0 0 SIH UTAMI 085232 59 21635 DR. SUHARTO,
SP.PD 1124R0021221V001525 0000091526027 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 344210 1#0##0#0#0.0#2021-12-14
15:43:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3fc000997810dcb13ea7913be0f6d047 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 10/07/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 272358
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reni;3313147010930001; 5.5.5.202112011542 4 344211
1#0##0#0#0.0#2021-12-14
15:43:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
77f13b34da535020ab8f0b6487a8c94b 150000 0 0 0 0 0
0 44300 0 0 15000 0 63058 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 27/10/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 227381
0 1 0 0 0 HENDRASTUTI.NY 085849 72 26341 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344212
1#0##0#0#0.0#2021-12-14
15:45:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
053568ffc5be1bc5cc01acd17768baa6 0 0 138000 0 0 0
0 0 0 0 15000 0 74381 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 12/07/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 244765
0 1 0 0 0 CATUR RAHAYU HANDAYANI. NY 091782 55
3;JKN reni;3313147010930001; 5.5.5.202112011542 4 344213
1#0##0#0#0.0#2021-12-14
15:56:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c0ebc4717813abb567d6ebea533239e3 150000 0 0 0 0 0
0 31845 0 0 15000 0 47920 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 05/06/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 480315
0 1 0 0 0 MASTUR,(BP) 024564 58 21372 DR. TEKY
reni;3313147010930001; 5.5.5.202112011542 4 344214
1#0##0#0#0.0#2021-12-14
15:56:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d50e65937f80abd17567e42c152c744c 150000 0 0 0 0 0
0 31845 0 0 15000 0 283470 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 24/05/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 369152
0 1 0 0 0 SRI WAGIYATI, NY 097743 51 18827 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344215
1#0##0#0#0.0#2021-12-14
15:57:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4c7b312c9a78a741462d3ba92faa1c0f 300000 0 0 0 0 0
0 0 0 0 15000 0 54152 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 11/09/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 268485
0 1 0 0 0 RIYANI, NY 100564 62 22735 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344216
1#0##0#0#0.0#2021-12-14
15:57:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ef0d69f98b04be0be039b86b65ce8a1b 0 0 138000 0 0 0
0 0 0 0 15000 0 115485 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 28/10/1994 0 2
0 - 0 - 0 - 0 - 0 296400 185300
0 1 0 0 0 INDAH PUSPITA SARI.NY 081261 27 9904
novia;3313125201940001; 5.6.3.202201201500 4 344217
1#0##0#0#0.0#2022-03-08
12:14:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
23ee4ebfc5e0455bdf166b71cf05887f 150000 0 0 0 0 0
0 0 0 0 15000 0 20300 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 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; 5.5.5.202112011542 4
344218 1#0##0#0#0.0#2021-12-14
15:58:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0f36d419ce1c4caf78d3841fa4839514 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 05/01/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 278367
0 1 0 0 0 SEMIATI, NY 036870 72 26636 DR. TEKY
novia;3313125201940001; 5.6.3.202201201500 4 344219
1#0##0#0#0.0#2022-03-08
08:21:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
7e3a124508d4d293b3c469bca27fd0e1 150000 0 0 0 0 0
0 31845 0 0 15000 0 81522 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 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; 5.6.3.202201201500 4
344220 1#0##0#0#0.0#2022-02-14
15:45:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
331de45c0d05fdd45293a91667ae58f2 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 03/03/1981 0 2
0 0 - 0 - 0 - 0 - 0 181400 201376
0 1 0 0 0 NURHAIDA (NY) 023087 40 14891 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344221
1#0##0#0#0.0#2021-12-14
16:00:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6459125a1555e90cd180d800eb7c7aeb 150000 0 0 0 0 0
0 0 0 0 15000 0 36376 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 31/12/1965 0 2
1 Z09.8;E11.4;G59.0;J40 87.49 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 743048
0 1 0 0 0 GUNEM, Ny 008322 55 20432 DR. TEKY
novia;3313125201940001; 5.5.5.202112011542 4 347149
1#0##0#0#0.0#2022-01-05
15:10:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ca99762b2917a361dbd00540c9e1376f 150000 0 0 0 0 0
200000 107890 0 0 15000 0 270158 0 0 0
0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 27/10/1958 0 1
1 I63.9 87.03 - - None None None None Z-3-18-0 None None
- 0 - 0 - 0 894800 1462020 0 1 0
0 0 WITONO DARSO WIYONO.TN 100586 63 23054 DR. ARIA CHANDRA
novia;3313125201940001; 5.5.5.202112011542 4 347150
1#0##0#0#0.0#2022-01-05
15:11:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f57c16e9b6c13c0f3e694cd0e6d4fe09 150000 0 0 0 0 0
1250000 0 0 0 15000 0 47020 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 18/06/1980 0 1
0 0 - 0 - 0 - 0 - 0 181400 258416
0 1 0 0 0 GUNADI.TN 099997 41 15149 DR. TEKY
reni;3313147010930001; 5.5.5.202112011542 4 344226
1#0##0#0#0.0#2021-12-15
08:01:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b866c73425a1ff22b20ebba663907670 150000 0 0 0 0 0
0 0 0 0 15000 0 93416 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 20/04/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 212250
0 1 0 0 0 DWI PURNOMO SIGIT ., BP 054206 49 18130
reni;3313147010930001; 5.5.5.202112011542 4 344227
1#0##0#0#0.0#2021-12-15
08:02:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
051ebc4167d108d823eee66b1074bb68 150000 0 0 0 0 0
0 0 0 0 15000 0 47250 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 08/06/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 219195
0 1 0 0 0 LAMIYEM.NY 087484 71 26117 DR. ARIA
novia;3313125201940001; 5.6.3.202201201500 4 344228
1#0##0#0#0.0#2022-02-15
12:23:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
0440741c7320c789b9aa0b7759b214e8 150000 0 0 0 0 0
0 0 0 0 15000 0 54195 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 16/10/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 205545
0 1 0 0 0 SRI YEKTI ISMADI,(NY) 040545 72 26352
3;JKN reni;3313147010930001; 5.5.5.202112011542 4 344229
1#0##0#0#0.0#2021-12-15
08:03:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
854c93ad9b10da5f31120829bbb08188 150000 0 0 0 0 0
0 0 0 0 15000 0 40545 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 21/07/1976 0 2
- 0 - 0 - 0 - 0 182600 290485 0
1 0 0 0 YULI ARINI.NY 100596 45 16577 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344230
1#0##0#0#0.0#2021-12-15
08:04:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
75db98f6e8a67c76a42918512277dd83 150000 0 0 0 0 0
0 0 0 0 25000 0 115485 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 23/04/1968 0 2
1 Z09.8;M54.39;M19.98 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 230352
0 1 0 0 0 SURYATI, NY 037498 53 19588 DR. ARIA
novia;3313125201940001; 5.6.7.202204241238 4 344232
1#0##0#0#0.0#2022-05-11
11:00:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 3
dee688a422aa568659b21d96d6dad053 150000 0 0 0 0 0
0 0 0 0 15000 0 65352 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 10/11/1965 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002165956975 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
344233 1#0##0#0#0.0#2021-12-15
08:05:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a3db8360c978a36de22298d4f678143d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 27/01/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 197270
0 1 0 0 0 PONIRAH., NY 043666 70 25884 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344234
1#0##0#0#0.0#2021-12-15
08:05:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6e8d3ccc40cf9f532831db0b918b0805 150000 0 0 0 0 0
0 0 0 0 15000 0 32270 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 24/01/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 275465
0 1 0 0 0 PUJI AMBAR RUSTAMI, NY 085163 55 20408
3;JKN reni;3313147010930001; 5.5.5.202112011542 4 343617
1#0##0#0#0.0#2021-12-15
08:06:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a91cab27231c47934ee33f4786580d4d 150000 0 0 0 0 0
0 0 0 0 15000 0 110465 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 17/04/1945 0 1
1 Z09.8;E11.9;I50.0;K80.2 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 573451
0 1 0 0 0 SANTOSO., BP 049990 76 27995 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344235
1#0##0#0#0.0#2021-12-15
08:07:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0a590bfcb49ce5c8f279d20b663181db 150000 0 0 0 0 0
0 76145 0 0 15000 0 332306 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 25/08/2017 0 1
0 - 0 - 0 - 0 135700 187403 0 1
0 0 0 FATAHILLAH NUR FAIZ,AN 057901 4 1567 dr. ANDANG
1124R0021221V001551 0002280196225 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346637 1#0##0#0#0.0#2022-01-04
13:38:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9b244429311e6c1b1b0846703b27073a 145000 0 0 0 0 0
0 0 0 0 15000 0 27403 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 15/10/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 238990
0 1 0 0 0 MUSTAMIROH (NY) 038477 67 24527 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344236
1#0##0#0#0.0#2021-12-15
08:08:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e962bae3c2c49af39d17dd423fdcaf40 150000 0 0 0 0 0
0 0 0 0 15000 0 73990 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 13/06/1979 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001183379106 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
344238 1#0##0#0#0.0#2021-12-15
08:08:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6930da06725b965fe69a4e892b8bf346 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 31/10/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 231142
0 1 0 0 0 SUKAMTI.NY 099960 62 22685 DR. ARIA
reni;3313147010930001; 5.5.5.202112011542 4 344239
1#0##0#0#0.0#2021-12-15
08:09:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a9de7b13d557c2a8757aae8a0da947fb 150000 0 0 0 0 0
0 0 0 0 15000 0 66142 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 29/10/1984 0 2
0 0 - 0 - 0 - 0 - 0 181400 392095
0 1 0 0 0 OKTA TRIYATI, NY 094564 37 13555 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344240
1#0##0#0#0.0#2021-12-15
08:09:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ca8cc9a22972cb152a81a606287456eb 150000 0 0 0 0 0
0 76045 0 0 15000 0 151050 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 04/05/1958 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 WORO HARTATI.NY 098597 63 23230 DR. ARYO SUSENO,
SP.PD 1124R0021221V001557 0001967732087 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 344241 1#0##0#0#0.0#2021-12-15
08:10:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0e83c9fb84ea4634618b127ae2a4df07 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 24/04/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 242260
0 1 0 0 0 INDRIYATI 060952 62 22875 DR. ARIA
reni;3313147010930001; 5.5.5.202112011542 4 344242
1#0##0#0#0.0#2021-12-15
08:12:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5010d74181d624f8f584163338ce8bdf 150000 0 0 0 0 0
0 0 0 0 15000 0 77260 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 26/10/1986 0 1
0 0 - 0 - 0 - 0 - 0 181400 427862
0 1 0 0 0 KADEK SUDIATMIKA,(BP) 032264 35 12828
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 347151
1#0##0#0#0.0#2022-01-05
15:12:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7d78605d751d6edbbb412a816af5671a 150000 0 0 0 0 0
220000 0 0 0 15000 0 42862 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 10/07/1955 0 2
0 - 0 - 0 - 0 786200 677676 0 1
0 0 0 SUNARNI, NY 040167 66 24259 DR. ARYO SUSENO, SP.PD
1124R0021221V001560 0001032581823 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 344243 1#0##0#0#0.0#2021-12-15
08:12:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e4bb1d35d4ceb1af4d42e08b6517c61c 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 21/07/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 213330
0 1 0 0 0 SUMARYANI NY 085736 67 24613 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344256
1#0##0#0#0.0#2021-12-15
08:28:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6d957af7ef8e39cd97040d567ced911d 0 0 138000 0 0 0
0 0 0 0 15000 0 60330 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 22/04/1992 0 1
0 - 0 - 0 - 0 786200 589560 0 1
0 0 0 FAJAR YEHUDA .SDR 083966 29 10823 DR. ARYO SUSENO,
SP.PD 1124R0021221V001562 0001894415848 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 344257 1#0##0#0#0.0#2021-12-15
08:29:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6c6b9b881ed7a89ec5d0a4efe2c74884 463830 0 0 0 0 0
0 0 0 0 15000 0 110730 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 31/12/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 283831
0 1 0 0 0 SUTIYANI, NY 007411 46 17145 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344258
1#0##0#0#0.0#2021-12-15
08:30:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b66d754fcb6e0a4e612b3abbb189cde2 150000 0 0 0 0 0
0 31845 0 0 15000 0 86986 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 04/09/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 ARIS HARDJENDRO,(BP) 040065 57 20915 DR. ARYO
reni;3313147010930001; 5.5.5.202112011542 4 344259
1#0##0#0#0.0#2021-12-15
08:30:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
43ae2a9fd22dff1c7b84086244264c45 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 25/06/1970 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 YUNI WIDIYATI, NY 032391 51 18795 DR. ARYO SUSENO,
SP.PD 1124R0021221V001565 0002074007092 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 344260 1#0##0#0#0.0#2021-12-15
08:31:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f720ec8f428521764add3995aee44249 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 12/10/1987 0 1
0 - 0 - 0 - 0 786200 596100 0 1
0 0 0 ANDRI WIDIYANTO TN 067488 34 12477 DR. ARYO
reni;3313147010930001; 5.5.5.202112011542 4 344261
1#0##0#0#0.0#2021-12-15
08:31:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7b6537939ef7ce99ea5539f3894c9219 463830 0 0 0 0 0
0 0 0 0 15000 0 117270 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 18/11/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 293123
0 1 0 0 0 LILI PUJIASTUTI, NY 087566 64 23397
reni;3313147010930001; 5.5.5.202112011542 4 344262
1#0##0#0#0.0#2021-12-15
08:31:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
44f122b275428d6c6bb4b2054d04c7ac 150000 0 0 0 0 0
0 31845 0 0 15000 0 96278 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 06/01/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 220832
0 1 0 0 0 RINA EKOWATI, NY 095845 52 19330 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344263
1#0##0#0#0.0#2021-12-15
08:32:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8474cb55a0c1897b9da6d09564d94405 150000 0 0 0 0 0
0 0 0 0 15000 0 55832 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 10/12/1982 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 DEKKY LESMANA, TN 071695 38 14244 DR. ARYO SUSENO,
SP.PD 1124R0021221V001569 0001125136214 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 344264 1#0##0#0#0.0#2021-12-15
08:33:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f92efed4d114fe796627ad2d35d56b1b 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 18/03/1988 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 EKA MARDIANTO., BP 046711 33 12319 DR. ARYO
reni;3313147010930001; 5.5.5.202112011542 4 344265
1#0##0#0#0.0#2021-12-15
08:38:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
818b22ee84811856fed6802d67931a09 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 14/03/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 223750
0 1 0 0 0 LUSI SRI RAHAYU.NY 085799 51 18898
3;JKN reni;3313147010930001; 5.5.5.202112011542 4 344266
1#0##0#0#0.0#2021-12-27
08:02:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c48db52b7deeb19668ff4be2d27baaf4 150000 0 0 0 0 0
0 0 0 0 15000 0 58750 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 17/04/1973 0 1
0 - 0 - 0 - 0 786200 608940 0 1
0 0 0 M KUSAENI, BP 050711 48 17768 DR. ARYO SUSENO,
SP.PD 1124R0021221V001573 0002078547524 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 344267 1#0##0#0#0.0#2021-12-27
08:02:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a461e8b3e093ae60d0ea8b842cc17181 463830 0 0 0 0 0
0 0 0 0 15000 0 130110 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 23/03/1976 0 2
0 - 0 - 0 - 0 786200 553680 0 1
0 0 0 SRI YATUN, NY 056231 45 16697 DR. ARYO SUSENO,
SP.PD 1124R0021221V001574 0001527005889 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 344268 1#0##0#0#0.0#2021-12-27
08:03:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e7a6fa3eed24115fa0e3e89c4248a547 463830 0 0 0 0 0
0 0 0 0 15000 0 74850 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 05/05/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 229900
0 1 0 0 0 SUPARDI TN 085053 59 21768 DR. ARIA
reni;3313147010930001; 5.5.5.202112011542 4 344269
1#0##0#0#0.0#2021-12-27
08:04:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fe0597bdc951ac852bc66126c611252c 150000 0 0 0 0 0
0 0 0 0 15000 0 64900 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 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 reni;3313147010930001; 5.5.5.202112011542 4
344270 1#0##0#0#0.0#2021-12-27
08:09:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 14/10/1972 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 LUSIA ANDRI,NN 048146 49 17953 DR. ARYO SUSENO,
SP.PD 1124R0021221V001577 0002082979192 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 344271 1#0##0#0#0.0#2021-12-27
08:10:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
67245dd9b1a9129a0f38a78187d40317 463830 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 04/06/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 212500
0 1 0 0 0 SUMINI.NY 099596 53 19546 DR. ARIA
reni;3313147010930001; 5.5.5.202112011542 4 344272
1#0##0#0#0.0#2021-12-27
08:11:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
514eabd497a11bed8d1140aa09ced5f9 150000 0 0 0 0 0
0 0 0 0 15000 0 47500 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 25/04/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 200325
0 1 0 0 0 SITI AISYAH.NY 098843 48 17760 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344273
1#0##0#0#0.0#2021-12-27
08:11:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6c9c85f2a2b8f93b05348b651359b549 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 01/08/2001 0 1
0 0 - 0 - 0 - 0 - 0 181400 218000
0 1 0 0 0 RAHMAT NUR HIDAYAHT ., SDR 056491 20
3;JKN reni;3313147010930001; 5.5.5.202112011542 4 344274
1#0##0#0#0.0#2021-12-27
08:12:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a2e277e2131d936f0024c931f5ca6600 203000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 20/11/1959 0 2
1 Z09.8;F03;I69.3 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 611125
0 1 0 0 0 SRI WAHYUTRI,.NY 049706 62 22665 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344275
1#0##0#0#0.0#2021-12-27
08:12:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6883ff09f8d0204f2ed2e9d7caf05ec2 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 05/07/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI BEKTI.NY
0000640746538 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
344276 1#0##0#0#0.0#2021-12-27
08:13:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
81546c8c87381e32ad4257a29dba0f9a 258000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 10/06/1967 0 2
1 Z09.8;G40.9;G47.0;M19.98 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
269110 0 1 0 0 0 SADINEM.NY 099427 54 19906
3;JKN reni;3313147010930001; 5.5.5.202112011542 4 344277
1#0##0#0#0.0#2021-12-27
08:13:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3ffecf4f477e37015e7f0528e51ac74c 0 0 138000 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 13/11/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 216905
0 1 0 0 0 JOKO SETYANTO 092583 61 22306 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344278
1#0##0#0#0.0#2021-12-27
08:16:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
690599f81674c954e7516354aa634c4a 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 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 269441
0 1 0 0 0 SUPARNO, TN 087947 64 23562 DR. SUHARTO,
SP.PD 1124R0021221V001586 0002166934702 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 344279 1#0##0#0#0.0#2021-12-27
09:00:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4f92e6bc727e321dc6d0be6b990526c2 150000 0 0 0 0 0
0 0 0 0 15000 0 104441 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 24/12/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 224264
0 1 0 0 0 FX MADIJO.TN 096225 71 26283 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344280
1#0##0#0#0.0#2021-12-27
09:01:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
06aee14f00c40ba31644a8fad5e2c2ad 150000 0 0 0 0 0
0 0 0 0 15000 0 59264 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 02/08/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 237635
0 1 0 0 0 SUTARNO, TN 048927 70 25697 DR. ARIA
reni;3313147010930001; 5.5.5.202112011542 4 344281
1#0##0#0#0.0#2021-12-27
09:01:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
df4e5d037764756066785eb266d37531 150000 0 0 0 0 0
0 0 0 0 15000 0 72635 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 27/01/2020 0 1
0 0 - 0 - 0 - 0 - 0 181400 173218
0 1 0 0 0 SHANKARA AZLIN AL BESHI, AN 100330 1
0002918472118 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
344282 1#0##0#0#0.0#2021-12-27
09:02:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
de325b0b9e9117b7c45b81790351c351 150000 0 0 0 0 0
0 0 0 0 15000 0 8218 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 21/02/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 207410
0 1 0 0 0 SRI HARYATI.NY 099070 61 22572 DR.
reni;3313147010930001; 5.5.5.202112011542 4 344283
1#0##0#0#0.0#2021-12-27
09:02:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5d18cd372726e774b1974985232d99c8 150000 0 0 0 0 0
0 0 0 0 15000 0 42410 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 04/10/1959 0 1
1 Z09.8;I11.9;N40;E11.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 510154
0 1 0 0 0 AHMADI ., BP 000350 62 22712 DR.
reni;3313147010930001; 5.5.5.202112011542 4 345310
1#0##0#0#0.0#2021-12-27
09:03:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
baf094bc869587d855b949383e1cdb39 150000 0 0 0 0 0
0 76595 0 0 15000 0 268559 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 04/08/1950 0 2
1 Z09.8;M53.19;M19.98;G20 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 218330
0 1 0 0 0 SUNARTI.,NY 054610 71 26060 DR. ARIA
reni;3313147010930001; 5.5.5.202112011542 4 345311
1#0##0#0#0.0#2021-12-27
09:04:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1be6db64a1f4542fef83a78649272d8a 0 0 138000 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 08/08/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 241770
0 1 0 0 0 ERMAYATI. NY 093540 61 22403 DR.
reni;3313147010930001; 5.5.5.202112011542 4 345312
1#0##0#0#0.0#2021-12-27
09:04:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
99d7c6f21383b496a7abd702d9b57ce5 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 29/09/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 368254
reni;3313147010930001; 5.5.5.202112011542 4 345313
1#0##0#0#0.0#2021-12-27
09:05:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3df7e0c15efa1b5a1332114aade05ea4 300000 0 0 0 0 0
0 0 0 0 15000 0 53254 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 29/12/1959 0 1
0 - 0 107400 262000 0 1 0 0 0 SIDIK
PRAMONO, BP 057770 61 22626 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V001595 0000088602772 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 345345 1#0##0#0#0.0#2021-12-27
09:06:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b30c166d8c8f614516b320932403e774 247000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 07/01/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 268485
0 1 0 0 0 SUWARNO, TN 100356 61 22617 DR.
reni;3313147010930001; 5.5.5.202112011542 4 345346
1#0##0#0#0.0#2021-12-27
09:06:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
04fabba24b5c416f3767af66b2bb5b95 0 0 138000 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 11/08/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 207127
0 1 0 0 0 SRI MARYATI, NY 036506 56 20574 DR.
reni;3313147010930001; 5.5.5.202112011542 4 345347
1#0##0#0#0.0#2021-12-27
09:07:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5a268b2fc2c4778ab7959b1cf25fc657 0 0 138000 0 0 0
0 0 0 0 15000 0 54127 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 31/12/1996 0 2
1 Z09.8;G44.0;R90.0 87.03 - - None None None None Z-3-18-0
- 0 - 0 - 0 - 0 894800 1472212 0
1 0 0 0 BUNGA CHAIRUNISA CH, Ny 055808 24 9109 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347152
1#0##0#0#0.0#2022-01-05
15:13:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0a95e0f9b97965830bae6589ebcb29e9 150000 0 0 0 0 0
1250000 0 0 0 15000 0 57212 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 05/06/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 232212
0 1 0 0 0 YUNI NURJAYATI.NY 098879 46 16989 DR.
reni;3313147010930001; 5.5.5.202112011542 4 345348
1#0##0#0#0.0#2021-12-27
09:07:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
07d0cfe533c765d8d668c11245b921db 150000 0 0 0 0 0
0 0 0 0 15000 0 67212 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 03/04/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 233020
0 1 0 0 0 SUPARTI, NY 083297 52 19243 DR. ARIA
reni;3313147010930001; 5.5.5.202112011542 4 345373
1#0##0#0#0.0#2021-12-27
09:15:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8d973c6deb58c8e29fce65e68b85d7d2 150000 0 0 0 0 0
0 0 0 0 15000 0 68020 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 20/12/1966 0 2
0 - 0 - 0 - 0 - 0 181400 302850
0 1 0 0 0 SUSIYATI.NY 100590 54 20078 DR. ARIA
reni;3313147010930001; 5.5.5.202112011542 4 345374
1#0##0#0#0.0#2021-12-27
09:16:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4c6c5569956015600017834d500b49ef 0 0 138000 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 24/08/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 212407
0 1 0 0 0 SLAMET.TN 083350 79 28962 DR. ARIA
reni;3313147010930001; 5.5.5.202112011542 4 345375
1#0##0#0#0.0#2021-12-27
09:16:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4cbea80117f41203d928d70a3e84330d 150000 0 0 0 0 0
0 0 0 0 15000 0 47407 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 30/11/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 213640
3;JKN reni;3313147010930001; 5.5.5.202112011542 4 345376
1#0##0#0#0.0#2021-12-27
09:17:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a8a8860e47113b1f2484535878fdc67d 150000 0 0 0 0 0
0 0 0 0 15000 0 48640 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 31/12/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 224320
0 1 0 0 0 SARDIANTO.TN 099980 57 21163 DR.
reni;3313147010930001; 5.5.5.202112011542 4 345377
1#0##0#0#0.0#2021-12-27
09:18:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
59d39a5b626148d6e135cad0dffad0f4 150000 0 0 0 0 0
0 0 0 0 15000 0 59320 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 31/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 263752
0 1 0 0 0 WARSINI, NY 095108 66 24450 DR. ARIA
reni;3313147010930001; 5.5.5.202112011542 4 345378
1#0##0#0#0.0#2021-12-27
09:18:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
70474e836e8fba02736ebb162e693f56 150000 0 0 0 0 0
0 0 0 0 15000 0 98752 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 29/01/1983 0 2
0 0 - 0 - 0 - 0 - 0 181400 206087
reni;3313147010930001; 5.5.5.202112011542 4 345379
1#0##0#0#0.0#2021-12-27
09:19:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c72bdbcb40641859117e393687991b2c 0 0 138000 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 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 reni;3313147010930001; 5.5.5.202112011542 4
345380 1#0##0#0#0.0#2021-12-27
09:19:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 09/12/2021 09/12/2021 04/10/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 212236
0 1 0 0 0 YUSTINUS NGATIJO, TN 100098 61 22346
reni;3313147010930001; 5.5.5.202112011542 4 345381
1#0##0#0#0.0#2021-12-27
09:20:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 09/12/2021 09/12/2021 23/03/1965 0 2
1 Z09.8;G56.0;M19.98 81.92 - - None None None None M-3-
0 404900 204650 0 1 0 0 0 SRI LESTARI,(NY)
1124R0021221V001620 0000564742912 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 345382 1#0##0#0#0.0#2021-12-27
09:21:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 09/12/2021 09/12/2021 07/10/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 239510
0 1 0 0 0 ZUHROH TUNNISA, HJ,(NY) 050322 73 26726
3;JKN reni;3313147010930001; 5.5.5.202112011542 4 345383
1#0##0#0#0.0#2021-12-27
09:21:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
90a305d25a3b7838c3aa6429f4b8fa92 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 23/07/1956 0 2
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3;JKN reni;3313147010930001; 5.5.5.202112011542 4 345385
1#0##0#0#0.0#2021-12-27
09:22:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f2da89868a36a77fc8f931ecc2118842 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 07/12/2008 0 1
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0 1 0 0 0 FAISHAL ARIF,(AN) 037219 13 4750 DR.
reni;3313147010930001; 5.5.5.202112011542 4 345387
1#0##0#0#0.0#2021-12-27
09:22:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2952b7d13ced00949bb05cc12504be28 150000 0 0 0 0 0
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3372030 C 3 CP 2 09/12/2021 09/12/2021 31/12/1944 0 2
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0 1 0 0 0 HJ.DJOEMIATI,(NY) 044744 76 28102 DR.
reni;3313147010930001; 5.5.5.202112011542 4 345389
1#0##0#0#0.0#2021-12-27
09:23:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
516d5584cd34ca7294c09964fb56b879 150000 0 0 0 0 0
0 0 0 0 15000 0 47335 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 07/02/2006 0 2
0 0 - 0 - 0 - 0 - 0 181400 244453
0 1 0 0 0 VANESA NINDY HAPSARI.AN 089069 15 5784
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 345390
1#0##0#0#0.0#2022-04-14
13:25:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
43b67b1823528682d69476eb6c7cf5a0 0 0 138000 0 0 0
0 0 0 0 15000 0 91453 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 05/09/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 201904
0 1 0 0 0 PANUT PANUDIYOKO, TN 098653 62 22741
3;JKN reni;3313147010930001; 5.5.5.202112011542 4 345391
1#0##0#0#0.0#2021-12-27
09:24:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
441edadd94854a5045228c2106bd3fad 150000 0 0 0 0 0
0 0 0 0 15000 0 36904 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 16/02/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 224022
0 1 0 0 0 SUTRASMI.NY 093458 71 26229 DR. ARIA
reni;3313147010930001; 5.5.5.202112011542 4 345393
1#0##0#0#0.0#2021-12-27
09:25:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0e888e4525d6b45ce0a3ba0023ae364a 0 0 138000 0 0 0
0 0 0 0 15000 0 71022 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 26/10/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 283035
reni;3313147010930001; 5.5.5.202112011542 4 345396
1#0##0#0#0.0#2021-12-27
09:25:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f4a518859bf89901e901b700113effd1 150000 0 0 0 0 0
0 0 0 0 15000 0 118035 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 26/09/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 231590
0 1 0 0 0 BAJURI, TN 000197 58 21259 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 345399
1#0##0#0#0.0#2022-04-14
11:39:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
84752f7be3b823e46c5e911ef8379dad 150000 0 0 0 0 0
0 0 0 0 15000 0 66590 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 27/05/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 437862
0 1 0 0 0 STEPHANUS ANUNG HARTADI, TN 100562 51
0001279754807 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
347153 1#0##0#0#0.0#2022-01-05
15:13:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d7a62f2331c0a8c7394c417074d54116 150000 0 0 0 0 0
220000 0 0 0 25000 0 42862 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 31/08/1970 0 1
1 Z09.8;N20.0;N23 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 522504
0 1 0 0 0 AGUS WIYADI (BP) 044796 51 18728 DR.
reni;3313147010930001; 5.5.5.202112011542 4 345426
1#0##0#0#0.0#2021-12-27
09:33:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
638c68614d1898baa3cca917018018f5 450000 0 0 0 0 0
0 0 0 0 15000 0 57504 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 12/12/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 395850
0 1 0 0 0 DEDE ROSADI, TN 099723 64 23738 DR.
reni;3313147010930001; 5.5.5.202112011542 4 345427
1#0##0#0#0.0#2021-12-27
09:38:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e4fa863ff3027517f74473c2d4a0d292 150000 0 0 0 0 0
0 150600 0 0 15000 0 80250 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 05/05/1957 0 2
1 Z09.8;I11.9;M54.59 87.24 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 415250
0 1 0 0 0 SURYATI, NY 090097 64 23594 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 360891
1#0##0#0#0.0#2022-04-14
14:00:48#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
0d0514ff9d67a84b29abf7f30906033b 150000 0 0 0 0 0
220000 0 0 0 15000 0 30250 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 16/04/1976 0 1
0 0 - 0 - 0 - 0 - 0 181400 191726
0 1 0 0 0 JOKO NURSWANTO.TN 096802 45 16673 DR.
reni;3313147010930001; 5.5.5.202112011542 4 345428
1#0##0#0#0.0#2021-12-27
09:39:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c829c36649eec01f48f377da54576bb6 150000 0 0 0 0 0
0 0 0 0 15000 0 26726 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 31/12/1958 0 2
0 - 0 - 0 - 0 - 0 138400 285000
0 1 0 0 0 SRI SUWANTI, NY 091754 62 22989 DR.
reni;3313147010930001; 5.5.5.202112011542 4 345429
1#0##0#0#0.0#2021-12-27
09:40:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8cbc67a9493b09dedb402984b6d81a8f 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 14/04/1960 0 2
0 - 0 107400 273000 0 1 0 0 0
MARTINAH., NY 072061 61 22519 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V001638 0001084606863 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 345430 1#0##0#0#0.0#2021-12-27
09:41:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d96e77c08da4009f60ecea16b241b3bd 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 25/04/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 NUR ROHMAH.NY 089192 53 19586 DR.
reni;3313147010930001; 5.5.5.202112011542 4 345431
1#0##0#0#0.0#2021-12-27
09:42:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ab4677bc9059588fff9acb524af305e7 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 15/06/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 713685
0 1 0 0 0 YAHMIN. TN 093524 57 20996 DR. GALIH
reni;3313147010930001; 5.5.5.202112011542 4 345432
1#0##0#0#0.0#2021-12-27
09:42:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cadf57006be6d9ea25a1136d66552196 300000 0 0 0 0 0
0 0 0 0 15000 0 398685 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 03/01/1946 0 1
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 IR. PRIYANTO. TN 088698 75 27734 DR.
reni;3313147010930001; 5.5.5.202112011542 4 345433
1#0##0#0#0.0#2021-12-27
09:43:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bfd1e55a4d00254b7b3e4d6eb37bab3b 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 11/08/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 426295
0 1 0 0 0 AGUS WIRYADI 089419 61 22400 DR.
reni;3313147010930001; 5.5.5.202112011542 4 345434
1#0##0#0#0.0#2021-12-27
09:43:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b75b5ff071e0b82a942df7a6bb57d809 300000 0 0 0 0 0
0 0 0 0 15000 0 111295 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 19/02/1965 0 1
0 - 0 - 0 - 0 - 0 138400 285000
reni;3313147010930001; 5.5.5.202112011542 4 345435
1#0##0#0#0.0#2021-12-27
09:44:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
833e1a4d4cc75a054bad88e6671e2702 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 10/03/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 ANDRI WINARNO, TN 089030 43 15980 DR.
reni;3313147010930001; 5.5.5.202112011542 4 345436
1#0##0#0#0.0#2021-12-27
09:44:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b69dcb488b9f4d3a7f4addf10ed634bf 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 21/10/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 SRI RAHAYU ( NY ) 050034 60 21964 DR.
reni;3313147010930001; 5.5.5.202112011542 4 345437
1#0##0#0#0.0#2021-12-27
09:46:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
7ac654aef5038462babda4818dfd1aef 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 11/01/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 722245
0 1 0 0 0 SUHARSONO.TN 088832 62 22978 DR.
reni;3313147010930001; 5.5.5.202112011542 4 345438
1#0##0#0#0.0#2021-12-27
09:46:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6d5754e15a4b463ec4bf6875758bc308 300000 0 0 0 0 0
0 0 0 0 15000 0 407245 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 24/12/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 972000
0 1 0 0 0 TRI HANDONO.TN 093280 70 25918 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347154
1#0##0#0#0.0#2022-01-05
15:14:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
803debbae20c4b13e119251a5ea4ed93 300000 0 0 0 0 0
657000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 13/04/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 176030
0 1 0 0 0 SITI ROKAYAH.NY 099608 43 15946 DR.
reni;3313147010930001; 5.5.5.202112011542 4 345439
1#0##0#0#0.0#2021-12-27
09:57:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
43a1f5c259d4aa217b2cb7014d5d54dc 0 0 138000 0 0 0
0 0 0 0 15000 0 23030 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 13/06/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 YUNI RUMPITNAWATI.NY 078372 65 23920
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 345440
1#0##0#0#0.0#2022-01-05
15:27:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
0ee683572fab77c48584e4883fc7608e 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 08/09/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 186731
0 1 0 0 0 HJ UPIK SURATMI. NY 070876 66 24199
reni;3313147010930001; 5.5.5.202112011542 4 345441
1#0##0#0#0.0#2021-12-27
09:58:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3c530634f37ea7ee6df1ce918193bee3 150000 0 0 0 0 0
0 0 0 0 15000 0 21731 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 09/07/1969 0 1
1 Z09.8;I10;E78.5;E79.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 224700
0 1 0 0 0 DEDY FIRMAWAN,(BP) 004843 52 19146
reni;3313147010930001; 5.5.5.202112011542 4 345442
1#0##0#0#0.0#2021-12-27
09:58:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6fe77824e7e8dc9142810bf0fb24b2c0 0 0 138000 0 0 0
0 0 0 0 15000 0 71700 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 30/05/2018 0 2
1 L04.0 - - - None None None None Q-5-42-0 None None
- 0 - 0 - 0 - 0 182600 169003 0
1 0 0 0 FADIATUZZAHRA RAMADHANTI.AN 100584 3 1289
0002940780025 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
344098 1#0##0#0#0.0#2022-04-14
13:48:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
0c996d667d4c435954096b0e01ec7093 150000 0 0 0 0 0
0 0 0 0 15000 0 4003 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 31/12/1963 0 2
0 - 0 107400 273000 0 1 0 0 0
INDRAYATI, NY 091755 57 21163 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V001659 0002926021015 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 345443 1#0##0#0#0.0#2021-12-27
10:04:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
24aa77119a2f69055a5a6bd5740820a1 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 09/03/1969 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 NGADIYO, TN 011624 52 19268 DR. ARYO SUSENO, SP.PD
1124R0021221V001660 0001105068789 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 345444 1#0##0#0#0.0#2021-12-27
10:04:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ceb37ee8e1d5ff1a0fd8c33c475a5a96 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 12/07/1966 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 UNTUNG SUMARJONO, TN 024024 55 20239 DR. ARYO
reni;3313147010930001; 5.5.5.202112011542 4 345445
1#0##0#0#0.0#2021-12-27
10:05:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
95b4fd7fd499e4a8f0bd1dd09514219d 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 12/12/1964 0 1
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 478830 0 1 0
0 0 M. SARBIAN, TN 090907 56 20816 DR. ARYO SUSENO, SP.PD
1124R0021221V001663 0002861438286 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 345446 1#0##0#0#0.0#2021-12-27
10:05:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e2192e9043bfb67418e470ce9b168559 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 22/10/1959 0 2
0 - 0 - 0 - 0 786200 492260 0 1
0 0 0 TUTUT DARYANI.NY 087431 62 22694 DR. ARYO SUSENO,
SP.PD 1124R0021221V001664 0000086902986 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 345447 1#0##0#0#0.0#2021-12-27
10:06:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5a82be357677f0fdb7e102594e35b58a 463830 0 0 0 0 0
0 0 0 0 15000 0 13430 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 28/02/1967 0 2
0 - 0 - 0 - 0 786200 558720 0 1
0 0 0 RETNO WINARSI.NY 083988 54 20008 DR. ARYO SUSENO,
SP.PD 1124R0021221V001665 0002203301349 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 345448 1#0##0#0#0.0#2021-12-27
10:06:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
97a285ed8cc12d513f0659c7bd3f9403 463830 0 0 0 0 0
0 0 0 0 15000 0 79890 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 12/08/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 HERGIUS GIYONO, TN 051343 44 16190 DR. ARYO
reni;3313147010930001; 5.5.5.202112011542 4 345449
1#0##0#0#0.0#2021-12-27
10:07:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
347cc0cd7a835a01ee99cbac1b4efa01 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 03/08/1963 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 SITI ROCHMAH, NY 039323 58 21313 DR. ARYO SUSENO,
SP.PD 1124R0021221V001667 0000088933318 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 345450 1#0##0#0#0.0#2021-12-27
10:07:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dc3be90498bd5223b028da801fc01f1f 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 31/12/1971 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 SUYATMI, NY 051869 49 18241 DR. ARYO SUSENO, SP.PD
1124R0021221V001668 0000555344774 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 345451 1#0##0#0#0.0#2021-12-27
10:08:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b91794e87668bad240c114369dc50760 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 09/05/1975 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 RAHMAN, TN 097908 46 17016 DR. ARYO SUSENO, SP.PD
1124R0021221V001669 0001105378571 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 345452 1#0##0#0#0.0#2021-12-27
10:08:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eaf2c8c88e99318f084e4fc03d768daa 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 14/11/1999 0 2
0 - 0 - 0 - 0 - 0 181400 197154
0 1 0 0 0 MILANIUM DEFI KUSUMA WARDANI, NN 100571
22 8061 dr. ANDANG 1124R0021221V001671 0001438081762 3;JKN
agung;3313092303950002; 5.6.6.202203301209 4 346638
1#0##0#0#0.0#2022-04-14
13:47:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
1a12d2a3eb74f5e9783f67d5be3a4268 155000 0 0 0 0 0
0 0 0 0 25000 0 17154 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 10/09/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 287460
0 1 0 0 0 SALAMUN, TN 070195 72 26388 DR. ARIA
reni;3313147010930001; 5.5.5.202112011542 4 345453
1#0##0#0#0.0#2021-12-27
10:09:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
710f16597cc6faf4b39dc603df23a94f 0 0 138000 0 0 0
0 0 0 0 15000 0 134460 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 02/05/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 255295
0 1 0 0 0 RUSMINI.NY 100300 62 22867 DR. ARIA
reni;3313147010930001; 5.5.5.202112011542 4 345454
1#0##0#0#0.0#2021-12-27
10:09:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
80a5a19ef74d69a6ce8d7bc62c810241 150000 0 0 0 0 0
0 0 0 0 15000 0 90295 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 21/02/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 170110
0 1 0 0 0 LARNO, TN 092867 48 17823 DR. ARIA
reni;3313147010930001; 5.5.5.202112011542 4 345455
1#0##0#0#0.0#2021-12-27
10:10:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8f5452e3e9fea28e0b4c883aa58a558d 150000 0 0 0 0 0
0 0 0 0 15000 0 5110 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 30/05/1990 0 2
1 R50.9;J06.9 - - - None None None None Q-5-42-0 None
0 - 0 - 0 - 0 - 0 182600 365004
0 1 0 0 0 DEWI PRASETYANINGSIH,NY 026672 31 11516
DR. GRETHA ADITYASTUTI 1124R0021221V001675 0001384010289 3;JKN
agung;3313092303950002; 5.6.6.202203301209 4 346639
1#0##0#0#0.0#2022-04-14
12:46:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
2b9182b77a96fe9c6759e2360aec5dc0 255000 0 0 0 79000 0
0 0 0 0 15000 0 16004 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 18/12/1997 0 1
1 R07.4;I20.9 89.52 - - 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 457782
0 1 0 0 0 BAYU PRIHANANTO, SDR 000986 23 8757
novia;3313125201940001; 5.5.5.202112011542 4 346640
1#0##0#0#0.0#2022-01-04
13:40:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
231d06a8f0505f789e81b41da3a5f80b 305000 0 0 0 104000
0 0 0 0 0 15000 0 33782 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 12/11/1945 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 245000 0 1 0 0 0 ENDANG SURTIANAH,
0000063294052 3;JKN novia;3313125201940001; 5.6.3.202201201500 4
345456 1#0##0#0#0.0#2022-02-15
13:35:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
94eb0258e822624e6e1cc9c56eeb5b76 230000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 09/12/2021 09/12/2021 23/04/1968 0 2
1 H81.3 - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 114811
0 1 0 0 0 SURYATI, NY 037498 53 19588 DR. GERRY
FEBRIAN R 1124R0021221V001681 0000564536788 3;JKN novia;3313125201940001;
5.6.7.202204241238 4 346641 1#0##0#0#0.0#2022-05-11
11:00:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 3
818ba05d867c07ed36bb94c2f0a6b6b0 75000 0 0 0 0 0 0
0 0 0 25000 0 14811 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 25/04/1985 0 1
1 Z09.8;K76.9;E78.5 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 289990
0 1 0 0 0 NUR TAMRIN SULISTYO.TN 005480 36 13378
novia;3313125201940001; 5.5.5.202112011542 4 344297
1#0##0#0#0.0#2021-12-15
13:17:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a39f9b49fa34f9cf9f5c926878471569 150000 0 0 0 0 0
0 88900 0 0 15000 0 36090 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 26/02/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SRI YANTI SUGENG LESTARI, NY 085402 63
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 344298
1#0##0#0#0.0#2021-12-15
13:20:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fed0712c89efb63e29399fa44dc453f6 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 18/12/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 227490
0 1 0 0 0 PURWANTO.TN 092290 49 18255 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 344299
1#0##0#0#0.0#2021-12-15
13:22:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5d6c369a655910caa6be3832f409b7f0 150000 0 0 0 0 0
0 0 0 0 15000 0 62490 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 17/08/1967 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 493213
0 1 0 0 0 SULASTRI ISTIYATI. NY 081379 54 19839
yani;3302226402970001; 5.5.5.202112011542 4 344688
1#0##0#0#0.0#2021-12-17
14:03:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eb0b8d892c6d3b57f2d032f5938b591f 150000 0 0 0 0 0
248000 0 0 0 15000 0 80213 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 15/10/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 353597
0 1 0 0 0 MARYANI.NY 099319 54 19780 DR. RETNO
novia;3313125201940001; 5.5.5.202112011542 4 344300
1#0##0#0#0.0#2021-12-15
13:24:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2dd2c7d9ac3e6ee6fa7d9a8a13742e1f 150000 0 0 0 0 0
0 0 0 0 15000 0 188597 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 05/10/1945 0 2
211200 0 0 - 0 - 0 - 0 - 0 211200
372840 0 1 0 0 0 SUMINI.,NY 058758 76 27825
novia;3313125201940001; 5.5.5.202112011542 4 344301
1#0##0#0#0.0#2021-12-15
13:26:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
abce2b84aaed936a08f8eb599a0c70f5 256000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 03/07/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 235251
0 1 0 0 0 B NINGSIH EKO PURWANI, (NY) 039836 69
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 344303
1#0##0#0#0.0#2021-12-15
13:29:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
04e666605e18d1565227cba600b60130 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 22/09/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 501692
0 1 0 0 0 SUMARSONO ,TN 087561 62 22725 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344302
1#0##0#0#0.0#2021-12-15
13:28:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b310e444aceec1fea659fbfcc54569b4 300000 0 0 0 0 0
0 121345 0 0 15000 0 65347 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 05/01/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 418440
0 1 0 0 0 SRI SETYANINGSIH,(NY) 023290 62 22985
novia;3313125201940001; 5.5.5.202112011542 4 344304
1#0##0#0#0.0#2021-12-15
13:31:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c37816477ff0cf95d26c4fdbeb057160 150000 0 0 0 0 0
0 63690 0 0 15000 0 189750 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 09/10/1987 0 2
0 0 - 0 - 0 - 0 - 0 296400 234615
0 1 0 0 0 CHUSNA MAULIDA, NY 097735 34 12481
novia;3313125201940001; 5.6.3.202201201500 4 347157
1#0##0#0#0.0#2022-03-08
12:19:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
697a2ea40acf103511d7919c4d6cc7cd 200000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 25/12/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 214641
0 1 0 0 0 MUHAMMAD KEVIN ILALANG, SDR 100374 18
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 344305
1#0##0#0#0.0#2021-12-15
13:32:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2ba64c08f48bcc73dfb15e54d3fdde8a 150000 0 0 0 0 0
0 0 0 0 15000 0 49641 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 21/04/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 300987
0 1 0 0 0 SUTINI, NY 008773 69 25435 DR. TEKY
novia;3313125201940001; 5.5.5.202112011542 4 344306
1#0##0#0#0.0#2021-12-15
13:35:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2b0946a9807ed317d22d720ff74320bb 150000 0 0 0 0 0
0 31845 0 0 15000 0 104142 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 13/06/1971 0 2
0 - 0 107400 262000 0 1 0 0 0 SITI
1124R0021221V001697 0002169781694 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 344307 1#0##0#0#0.0#2021-12-15
13:37:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
973ae462de14f78788d3135f3c332e42 247000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 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; 5.6.6.202203301209 4
344308 1#0##0#0#0.0#2022-04-14
13:26:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
54e7f581e4d065975475e00beec67ea2 258000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 31/12/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 531482
0 1 0 0 0 MUJIYEM.NY 075280 56 20798 DR. TEKY
novia;3313125201940001; 5.5.5.202112011542 4 344309
1#0##0#0#0.0#2021-12-15
13:40:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c55bbfc58b8c7dfeac02d3e5aa16de3d 150000 0 0 0 0 0
0 171170 0 0 15000 0 195312 0 0 0 0
0
3372030 C 3 CP 2 10/12/2021 10/12/2021 04/06/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 217002
0 1 0 0 0 SRI HARTATI,(NY) 005917 54 19913 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347404
1#0##0#0#0.0#2022-01-05
15:30:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
83ae5bf2b089609302a43618bb9d3cf0 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 07/05/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 373018
0 1 0 0 0 SUPARMAN.TN 085718 61 22497 DR. TEKY
novia;3313125201940001; 5.5.5.202112011542 4 344310
1#0##0#0#0.0#2021-12-15
13:42:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3bba270a89d3feb41b0c7bd2a6588fd6 150000 0 0 0 0 0
0 31845 0 0 15000 0 176173 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 10/10/1935 0 2
0 0 - 0 - 0 - 0 - 0 181400 213005
0 1 0 0 0 SUYATMI ,NY 037985 86 31473 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 344311
1#0##0#0#0.0#2021-12-15
13:43:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9c1894975fb62332b691c0c3cb5feed6 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 01/07/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 224004
0 1 0 0 0 SARIYEM, NY 091999 79 29017 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 344312
1#0##0#0#0.0#2021-12-15
13:44:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9688dc200a623c9e4d7973aa4d4fc041 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 04/09/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 235251
0 1 0 0 0 TRI WIDAYATI, NY 065284 56 20551 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344313
1#0##0#0#0.0#2021-12-15
13:46:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9f4fe1a592800795709d28c9b3c0becd 150000 0 0 0 0 0
0 0 0 0 15000 0 70251 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 06/08/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 317700
0 1 0 0 0 TRI WIDIYATI. NY 000842 47 17293 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344314
1#0##0#0#0.0#2021-12-15
13:47:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
56c9e9139c6091055dbf6ce73e188a00 150000 0 0 0 0 0
0 88950 0 0 15000 0 63750 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 31/12/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 265245
0 1 0 0 0 SARDIYANTO.TN 100599 62 22990 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344315
1#0##0#0#0.0#2021-12-15
13:49:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
96980c8c1569e46f633a8ff92ffc25b6 150000 0 0 0 0 0
0 76145 0 0 15000 0 24100 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 15/11/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 235251
0 1 0 0 0 SRI PARYATUN 092307 70 25593 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344316
1#0##0#0#0.0#2021-12-15
13:50:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a5eb30fbec6ac7a267e44c19b31f3914 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 30/08/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 404657
0 1 0 0 0 MARYATUN, NY 071640 49 17999 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344317
1#0##0#0#0.0#2021-12-15
13:52:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
968f9dbb89e7c9e47043a01e97359e2a 150000 0 0 0 0 0
0 31845 0 0 15000 0 207812 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 07/06/1957 0 2
1 Z09.8;H26.9;E11.3;H36.0;H52.2;H52.4;H04.1 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 299975 0 1 0 0 0 SUNARSIH.NY
0000090354205 3;JKN novia;3313125201940001; 5.6.3.202201201500 4
344318 1#0##0#0#0.0#2022-03-08
08:00:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
c4bc6ada7d709864b55ea22198bfc997 254000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 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 25984 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V001710 0000091089088 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 344319 1#0##0#0#0.0#2021-12-15
13:56:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1e8be175f6f4b73fa3041dc4eccc9491 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 29/09/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARIA DIAH
1124R0021221V001711 0001211692601 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 344320 1#0##0#0#0.0#2021-12-15
13:57:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9ee6e1af0075e751429dfad2a92bee25 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 01/07/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 230851
0 1 0 0 0 WARSINAH SUMARWANI, NY 092218 70 25730
novia;3313125201940001; 5.5.5.202112011542 4 344321
1#0##0#0#0.0#2021-12-15
13:58:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
53fe31fcfcdaf293fa4566978c9bf940 150000 0 0 0 0 0
0 0 0 0 15000 0 65851 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 07/01/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 238343
0 1 0 0 0 NANIK PARINI, NY 090085 48 17869 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344322
1#0##0#0#0.0#2021-12-15
13:59:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ef4bf077daeb632333c676c4b1bbb27b 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 11/05/1943 0 2
0 0 - 0 - 0 - 0 - 0 181400 355214
0 1 0 0 0 MURYATI.NY 094215 78 28703 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 344323
1#0##0#0#0.0#2021-12-15
14:00:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a4ec2db4a0307670405d1e2b49e9341d 300000 0 0 0 0 0
0 0 0 0 15000 0 40214 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 20/06/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 230235
0 1 0 0 0 SOENARTI, NY 088723 65 23914 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344324
1#0##0#0#0.0#2021-12-15
14:02:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
60fbc97877c44b8fa7338057637668e8 150000 0 0 0 0 0
0 31845 0 0 15000 0 33390 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 06/06/2008 0 2
0 0 - 0 - 0 - 0 - 0 181400 212222
0 1 0 0 0 BALQIS CHURYN MAYSA A, AN 099729 13
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 344325
1#0##0#0#0.0#2021-12-15
14:03:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1cb32596ac592e49b5e0750257364dee 150000 0 0 0 0 0
0 0 0 0 15000 0 47222 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 10/10/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 487772
novia;3313125201940001; 5.6.3.202201201500 4 344326
1#0##0#0#0.0#2022-02-14
15:46:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
60192132a6530027b34ddacc501f4f82 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 29/12/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 460650
0 1 0 0 0 SRI SUPARTININGRUM.NY 082384 54 20070
yani;3302226402970001; 5.5.5.202112011542 4 344694
1#0##0#0#0.0#2021-12-17
14:02:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
29b65ce8a900b47fd1db56e87b8a6da9 150000 0 0 0 0 0
248000 0 0 0 15000 0 47650 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 21/12/1974 0 2
1 Z09.8;I10;E05.9;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 292840
0 1 0 0 0 TUTIK PRASETYOWATI.NY 085295 46 17156
novia;3313125201940001; 5.5.5.202112011542 4 344327
1#0##0#0#0.0#2021-12-15
14:06:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e9d31c23aab857035737b676d7bd1aef 150000 0 0 0 0 0
0 88900 0 0 15000 0 38940 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 09/04/2005 0 1
0 0 - 0 - 0 - 0 - 0 181400 216192
0 1 0 0 0 MUHAMMAD HAIDAR ALI.AN 100173 16 6089
novia;3313125201940001; 5.5.5.202112011542 4 344328
1#0##0#0#0.0#2021-12-15
14:07:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c39724027cd3df2fc5a369289e47989f 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 16/12/1999 0 2
0 - 0 - 0 - 0 183900 279506 0 1
0 0 0 LINDA ALFATH RAMADHANI, NN 077337 21 8030 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344329
1#0##0#0#0.0#2021-12-15
14:08:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
103fdc5349e82646c694000be6a66dc5 215000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 07/02/2006 0 2
0 0 - 0 - 0 - 0 - 0 181400 307162
0 1 0 0 0 VANESA NINDY HAPSARI.AN 089069 15 5785
agung;3313092303950002; 5.6.6.202203301209 4 344330
1#0##0#0#0.0#2022-04-14
13:25:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
3ac0ea657c26b3b2d0da2a84d1d30f25 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 01/02/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 428915
0 1 0 0 0 MULYOTO., BP 049275 68 25149 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344331
1#0##0#0#0.0#2021-12-15
14:20:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fd868eba782ce0d9c993bb8ffc88111f 300000 0 0 0 0 0
0 76145 0 0 15000 0 37770 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 04/07/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 206161
0 1 0 0 0 NINIEK SINDHUTOMO.NY 094651 66 24266
novia;3313125201940001; 5.5.5.202112011542 4 344333
1#0##0#0#0.0#2021-12-15
14:23:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
537f9b1b79de777f34648e78ff4c5d14 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 10/04/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 227902
0 1 0 0 0 MOEMINAH., NY 046939 71 26177 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344332
1#0##0#0#0.0#2021-12-15
14:22:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2b69f6ef0c59a748839bcbc6dda8093d 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 11/08/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 216930
0 1 0 0 0 SUGIYARTO, TN 076307 58 21306 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344334
1#0##0#0#0.0#2021-12-15
14:25:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8e31c54d44cd0e814278e1bda4071d7f 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 13/03/1996 0 2
0 0 - 0 - 0 - 0 - 0 181400 198485
0 1 0 0 0 FITA FITRIA, NN 078544 25 9403 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344335
1#0##0#0#0.0#2021-12-15
14:26:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
58ee05a9a70783c846d75a9d78e4328c 150000 0 0 0 0 0
0 0 0 0 15000 0 33485 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 19/11/1951 0 1
1 Z09.8;I11.9;E78.5 87.49 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 640480
0 1 0 0 0 SUKATNO,(BP) 043402 70 25589 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344710
1#0##0#0#0.0#2021-12-17
14:01:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9fe0a31c68678a1919f7bf044ee964c5 150000 0 0 0 0 0
356000 0 0 0 15000 0 119480 0 0 0 0
0
3372030 C 3 CP 2 10/12/2021 10/12/2021 01/01/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 369331
0 1 0 0 0 SAMIYEM, NY 100357 63 23354 DR. TEKY
novia;3313125201940001; 5.5.5.202112011542 4 344336
1#0##0#0#0.0#2021-12-15
14:26:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
351b0ac9982f7cda4e80ba9416ae3ba5 150000 0 0 0 0 0
0 63690 0 0 15000 0 140641 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 08/08/1971 0 2
1 Z09.8;I11.9;R10.4 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 229981
0 1 0 0 0 HARTINI, NY 048798 50 18387 DR. TEKY
novia;3313125201940001; 5.5.5.202112011542 4 344337
1#0##0#0#0.0#2021-12-15
14:31:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9956b66e4f82af76abb025861d2e5abb 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 05/06/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 256160
0 1 0 0 0 SRI DARWANTI, NY 088347 65 23929 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344338
1#0##0#0#0.0#2021-12-15
14:32:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e103b08dcc251cb778704aae65116a0f 150000 0 0 0 0 0
0 0 0 0 15000 0 91160 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 10/10/1946 0 1
0 0 - 0 - 0 - 0 - 0 181400 234614
0 1 0 0 0 SUBARDIWURJANTO.NY 098946 75 27455
novia;3313125201940001; 5.5.5.202112011542 4 344339
1#0##0#0#0.0#2021-12-15
14:33:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
57e21449dc7bc9e48194ce3371ae7cc0 150000 0 0 0 0 0
0 31845 0 0 15000 0 37769 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 12/08/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 935129
0 1 0 0 0 JONO RUKUNTO, TN 095931 63 23131 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344340
1#0##0#0#0.0#2021-12-15
14:34:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
76c3f1d843b522376f19879dd531de25 150000 0 0 0 0 0
0 76595 0 0 15000 0 693534 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 24/01/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 417882
0 1 0 0 0 SRI SUTRISMI, NY 048524 65 24062 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344341
1#0##0#0#0.0#2021-12-15
14:35:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a5431420526e39fd417b558d1d16a728 300000 0 0 0 0 0
0 0 0 0 15000 0 102882 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 29/12/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SRI SURANTI 011160 42 15687 DR. TEKY
novia;3313125201940001; 5.5.5.202112011542 4 347158
1#0##0#0#0.0#2022-01-05
15:31:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b120d28c40783529fa45e4627c8bc22d 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 27/02/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 218460
0 1 0 0 0 RISPIYANTI, NY 095415 65 24028 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344342
1#0##0#0#0.0#2021-12-15
14:39:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
41b544f624fbcc854b230f9911f39039 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 22/04/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 243701
0 1 0 0 0 DJUWARSO, (BP) 008057 72 26530 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344343
1#0##0#0#0.0#2021-12-15
14:40:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5ee7ddf70949e689dd5ce7d603d8ba6f 150000 0 0 0 0 0
0 0 0 0 15000 0 78701 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 06/04/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 188086
novia;3313125201940001; 5.5.5.202112011542 4 344344
1#0##0#0#0.0#2021-12-15
14:41:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
99b71aa7d7ba5c4ccb01755f7933ba4c 150000 0 0 0 0 0
0 0 0 0 15000 0 23086 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 07/05/1959 0 2
1 S20.2;W19.0 87.49 - - 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 580642
0 1 0 0 0 TRI RAHAYU, NY 072208 62 22863 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347406
1#0##0#0#0.0#2022-01-05
15:32:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a82e0236b7a71e8415245e79cca7ba0d 150000 0 0 0 0 0
356000 0 0 0 15000 0 59642 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 02/02/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUJIYEM, NY 090600
0001696847466 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
344345 1#0##0#0#0.0#2021-12-15
14:43:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2e1bcb8b61260a99164e4a2021f32435 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 03/06/1987 0 2
0 0 - 0 - 0 - 0 - 0 296400 223540
0 1 0 0 0 SHOPIAH.NY 099940 34 12609 DR. GUNAWAN,
SP.OG 1124R0021221V001746 0001179069985 3;JKN novia;3313125201940001;
5.6.3.202201201500 4 344346 1#0##0#0#0.0#2022-03-08
11:57:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
89cb94689d9cb8ff5cf313187fde5042 200000 0 0 0 0 0
0 0 0 0 15000 0 8540 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 19/04/1972 0 2
1 Z09.8;Z96.1;H26.9;E11.3;H36.0;H35.0 90.29 - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 379334 0 1 0 0 0 PARNI, NY 078354
0000564110548 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
344347 1#0##0#0#0.0#2021-12-15
14:57:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f43a365af22642702a1179baad18dcd7 203000 0 0 0 0 0
0 0 0 0 15000 0 161334 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 02/07/1986 0 1
0 0 - 0 - 0 - 0 - 0 181400 316500
0 1 0 0 0 ANDRIYANTO, TN 088338 35 12945 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344348
1#0##0#0#0.0#2021-12-15
14:59:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3a339877e5d278af200d3c1921ce97ef 150000 0 0 0 0 0
0 0 0 0 15000 0 151500 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 07/04/1983 0 2
0 0 - 0 - 0 - 0 - 0 181400 238564
0 1 0 0 0 RISWANTI.,NY 075496 38 14127 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344349
1#0##0#0#0.0#2021-12-15
15:00:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
02ae40c17ffa9864ec26216dea40249d 150000 0 0 0 0 0
0 0 0 0 15000 0 73564 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 26/02/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 247768
0 1 0 0 0 GURAWAN BASUKI, (BP) 008293 50 18550
novia;3313125201940001; 5.5.5.202112011542 4 344350
1#0##0#0#0.0#2021-12-15
15:06:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f908c5dd0d0c75c2f0f21aeeeb7c29d2 150000 0 0 0 0 0
0 0 0 0 15000 0 82768 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 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; 5.5.5.202112011542 4
344351 1#0##0#0#0.0#2021-12-15
15:12:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f2305576eb3b2249c4ce779381bfd3a0 247000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 07/12/1943 0 1
1 Z09.8;H26.9;H52.2;H52.4;H04.1 95.01;90.29 - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 553975 0 1 0 0 0 SUBAGIO WARYADI,(BP)
0000067277845 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
347405 1#0##0#0#0.0#2022-01-05
15:38:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c7ef234b932af1918b374cd026a98662 508000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 03/07/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 LUCIA SRI
1124R0021221V001755 0000639909854 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 344352 1#0##0#0#0.0#2021-12-15
15:12:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
47a30035b3745736dac8e5c04b73fbf7 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 21/06/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 356970
0 1 0 0 0 EKO JUNAIDI, TN 072547 50 18435 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344353
1#0##0#0#0.0#2021-12-15
15:13:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2af420515b82fe3a59289e3827e03f73 150000 0 0 0 0 0
0 0 0 0 15000 0 191970 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 05/07/1984 0 2
0 0 - 0 - 0 - 0 - 0 181400 296611
0 1 0 0 0 SARRAH FAUZIAH.NY 100011 37 13672 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344624
1#0##0#0#0.0#2021-12-15
15:16:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a9fe79b5519bf45686c27dbb42fad0f4 150000 0 0 0 0 0
0 0 0 0 15000 0 131611 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 28/07/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 296229
0 1 0 0 0 SRI KARYATI.NY 077254 49 18032 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344354
1#0##0#0#0.0#2021-12-15
15:16:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
20c6ff8ee8cde13fa963d15dce9bc739 150000 0 0 0 0 0
0 0 0 0 15000 0 131229 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 01/07/1955 0 2
1 H26.9;H11.0;H04.1 90.29;16.21 - - None None None None H-3-
12-0 None None None None None None PROSEDUR LAIN-LAIN PADA MATA 211200
0 0 - 0 - 0 - 0 - 0 211200 301975
0 1 0 0 0 SUGENG, NY 100575 66 24269 DR. YUDHI
novia;3313125201940001; 5.6.3.202201201500 4 344355
1#0##0#0#0.0#2022-02-15
12:10:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
6eb266331f70525b316a4c72b7b0359b 256000 0 0 0 0 0
0 0 0 0 15000 0 30975 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 16/05/1982 0 1
0 0 - 0 - 0 - 0 - 0 181400 519720
0 1 0 0 0 MUHAMMAD AGUS RAHMATULLOH.TN 084547 39
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 344356
1#0##0#0#0.0#2021-12-15
15:54:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
183699224dc9b281a6240644a2d356d5 150000 0 0 0 0 0
0 0 0 0 15000 0 354720 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 21/05/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 259794
0 1 0 0 0 JOHAN KRIS UTAMA.AN 076043 19 7143
novia;3313125201940001; 5.5.5.202112011542 4 344357
1#0##0#0#0.0#2021-12-16
11:20:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c3c3e4f69f57a73ad8b86d8d0849908f 150000 0 0 0 0 0
0 0 0 0 15000 0 94794 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 29/05/1994 0 2
0 0 - 0 - 0 - 0 - 0 181400 364328
0 1 0 0 0 BERTA DIAN CHRISTANTI,NY 087907 27
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 344654
1#0##0#0#0.0#2021-12-16
11:23:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
48605e3ba50709c05afe697d0ab22d92 300000 0 0 0 0 0
0 0 0 0 15000 0 49328 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 13/05/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 183336
0 1 0 0 0 SRI HARTINI.NY 096082 42 15552 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344655
1#0##0#0#0.0#2021-12-16
11:25:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3c5a5593fbd10ffd4e86c8a2287b7829 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 31/01/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 247768
0 1 0 0 0 SRI SUMIYATI.NY 099311 45 16750 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344359
1#0##0#0#0.0#2021-12-16
11:26:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 09/04/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 347184
0 1 0 0 0 LUH IDA.NY 095717 54 19969 DR. RETNO
novia;3313125201940001; 5.5.5.202112011542 4 344360
1#0##0#0#0.0#2021-12-16
11:27:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cf7aae1ae1f207424f9a367c907c2364 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 25/12/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 530955
0 1 0 0 0 JAYUS ISMADI, TN 068586 42 15691 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344361
1#0##0#0#0.0#2021-12-16
11:27:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 09/06/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 227756
0 1 0 0 0 SUKATMI, NY 091206 47 17351 DR. RETNO
novia;3313125201940001; 5.5.5.202112011542 4 344362
1#0##0#0#0.0#2021-12-16
11:28:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 17/08/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 181050
0 1 0 0 0 SUWARNI, NY 079454 44 16186 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344656
1#0##0#0#0.0#2021-12-16
11:31:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d9486013401abd92821ad98fe22b343b 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 31/12/1952 0 2
1 F20.0 - - - None None None None F-5-14-0 None None
None None None None PSIKOTHERAPI INDIVIDU DEWASA BUKAN AKUT 194500
0 0 - 0 - 0 - 0 - 0 194500 278254
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novia;3313125201940001; 5.5.5.202112011542 4 344363
1#0##0#0#0.0#2021-12-16
11:34:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 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; 5.5.5.202112011542 4
344364 1#0##0#0#0.0#2021-12-16
11:35:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 01/07/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 806056
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novia;3313125201940001; 5.5.5.202112011542 4 344365
1#0##0#0#0.0#2021-12-16
11:40:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 18/02/1991 0 1
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novia;3313125201940001; 5.5.5.202112011542 4 344366
1#0##0#0#0.0#2021-12-16
11:43:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
170050acf57eaf5036bbbf5255f0a1cc 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 18/11/1973 0 1
1 D21.0 88.71 - - None None None None Z-3-23-0 None None
- 0 - 0 - 0 - 0 549400 825000 0
1 0 0 0 AGUS SUSANTO.TN 100605 48 17554 DR. DAMAR
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5.6.3.202201201500 4 344706 1#0##0#0#0.0#2022-02-21
09:42:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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650000 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 07/12/1946 0 1
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SP.PD 1124R0021221V001774 0000572379772 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 344367 1#0##0#0#0.0#2021-12-16
11:45:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 01/05/1975 0 1
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0 0 0 MAIWAN., BP 047087 46 17025 DR. ARYO SUSENO, SP.PD
1124R0021221V001775 0001790328262 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 344368 1#0##0#0#0.0#2021-12-16
11:48:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6c832238113986cd85d883a8e349639c 662676 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 08/03/1967 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V001776 0001879909187 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344369 1#0##0#0#0.0#2021-12-16
13:30:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
263f7cd102bec216e38f20cfdd82158a 463830 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 16/05/1990 0 2
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0 1 0 0 0 ANISA LESTIYANTI.NY 095276 31 11531
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344370
1#0##0#0#0.0#2021-12-16
13:31:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 01/12/1980 0 2
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1124R0021221V001778 0000640230884 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344371 1#0##0#0#0.0#2021-12-16
13:31:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b9b9438856c855bd57f7a6b428388799 463830 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 02/02/1971 0 2
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SP.PD 1124R0021221V001779 0002326843899 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344372 1#0##0#0#0.0#2021-12-16
13:32:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 02/02/1962 0 1
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0 1 0 0 0 RIDWAN, TN 071059 59 21861 DR. INDRIANY
yani;3302226402970001; 5.5.5.202112011542 4 344373
1#0##0#0#0.0#2021-12-16
13:34:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c90faa32e2d4ce06251319294458433e 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 23/03/1979 0 2
1 Z09.8;I10;K30;M72.28 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 165000
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yani;3302226402970001; 5.5.5.202112011542 4 344374
1#0##0#0#0.0#2021-12-16
13:36:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
902f510090ecdaa4c56a0f070af7299b 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 11/02/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 179063
0 1 0 0 0 SRI SUKARNI NY 083997 50 18565 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344375
1#0##0#0#0.0#2021-12-16
13:37:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 26/04/1964 0 1
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0 0 0 SUPRIYANTO, TN 063549 57 21047 DR. ARYO SUSENO,
SP.PD 1124R0021221V001783 0002231597002 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344376 1#0##0#0#0.0#2021-12-16
13:38:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 25/05/1972 0 1
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1124R0021221V001784 0002431552465 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344377 1#0##0#0#0.0#2021-12-16
13:38:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7187eec3776e786061b3c8b4830a2312 463830 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 09/08/1972 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ATIK UTAMI.NY
0001107008921 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344378 1#0##0#0#0.0#2021-12-16
13:40:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ddcbc48ca892ce5d98511a10ab429572 247000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 21/12/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 188910
0 1 0 0 0 ENDAH POERWANTININGSIH.NY 099627 71
0002345527269 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344379 1#0##0#0#0.0#2021-12-16
13:42:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bc4e36e28bda7ef25a8e79a7ded699a4 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 27/07/2002 0 2
0 0 - 0 - 0 - 0 - 0 181400 198267
0 1 0 0 0 KYLA AZZAHRA.NN 093860 19 7076 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344380
1#0##0#0#0.0#2021-12-16
13:43:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
abce733131d613056f8e959777d22a49 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 01/12/1958 0 2
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1124R0021221V001788 0001436949538 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344660 1#0##0#0#0.0#2021-12-16
13:53:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dad0c8e7b1d598f683e8eb16d68f4842 463830 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 30/08/1968 0 1
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0 1 0 0 0 MUH. ROSYID RIDWAN 080978 53 19460
yani;3302226402970001; 5.5.5.202112011542 4 344381
1#0##0#0#0.0#2021-12-16
13:54:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f7b3b4f50781aca7ceee9febdedf63d7 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 01/04/1981 0 1
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1124R0021221V001790 0001904830593 3;JKN yani;3302226402970001;
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13:55:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
64d904a4d824a83014873e28577566fb 463830 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 10/11/1970 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 344383
1#0##0#0#0.0#2021-12-16
13:56:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 17/04/1961 0 2
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SP.PD 1124R0021221V001792 0001962721888 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344384 1#0##0#0#0.0#2021-12-16
13:57:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 12/06/1972 0 1
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SP.PD 1124R0021221V001793 0001844624709 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344385 1#0##0#0#0.0#2021-12-16
13:58:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 13/06/1970 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 344386
1#0##0#0#0.0#2021-12-16
13:59:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 17/06/1966 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 344387
1#0##0#0#0.0#2021-12-16
13:59:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 13/10/2002 0 1
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1124R0021221V001796 0003071567755 3;JKN yani;3302226402970001;
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14:01:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 31/12/1956 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 344389
1#0##0#0#0.0#2021-12-16
14:04:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 30/12/1956 0 1
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0 0 - 0 - 0 - 0 - 0 181400 209120
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yani;3302226402970001; 5.5.5.202112011542 4 344390
1#0##0#0#0.0#2021-12-16
14:06:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 11/06/1963 0 2
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0 0 - 0 - 0 - 0 - 0 181400 202740
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yani;3302226402970001; 5.5.5.202112011542 4 344391
1#0##0#0#0.0#2021-12-16
14:07:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 01/07/2004 0 1
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3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344392
1#0##0#0#0.0#2021-12-16
14:08:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 21/07/1972 0 2
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1#0##0#0#0.0#2021-12-16
14:15:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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14:16:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.5.5.202112011542 4 344395
1#0##0#0#0.0#2021-12-16
14:18:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
327b2146fdb501ea0ad544344bc7e6c5 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 24/05/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 167655
0 1 0 0 0 MUSINEM.NY 078681 64 23576 DR. INDRIANY
yani;3302226402970001; 5.5.5.202112011542 4 344396
1#0##0#0#0.0#2021-12-16
14:21:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1eb7f22ddbff1907f71924343b006ac6 150000 0 0 0 0 0
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3372030 C 3 CP 2 10/12/2021 10/12/2021 13/02/2014 0 2
0 0 - 0 - 0 - 0 - 0 211200 482820
yani;3302226402970001; 5.5.5.202112011542 4 344397
1#0##0#0#0.0#2021-12-16
14:22:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 21/09/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002199915988 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344398 1#0##0#0#0.0#2021-12-16
14:25:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 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; 5.5.5.202112011542 4
344399 1#0##0#0#0.0#2021-12-16
14:27:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
344400 1#0##0#0#0.0#2021-12-16
14:30:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0ad759fd3956b0b72a65d99c9819e9b4 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 13/03/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUHARI, TN 070582
0001021699394 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344401 1#0##0#0#0.0#2021-12-16
14:33:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 01/11/1961 0 2
0 - 0 107400 273000 0 1 0 0 0
KUSTIATI, NY 048553 60 21954 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V001810 0000090942546 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344402 1#0##0#0#0.0#2021-12-16
14:37:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8f1c269af45185bca5b9e020c829d6e1 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 13/12/1965 0 2
0 - 0 - 0 - 0 - 0 549400 173770
0 1 0 0 0 SATRIYATI. NY 072569 55 20451 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344403
1#0##0#0#0.0#2021-12-16
14:38:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 8770 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 18/09/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 240320
0 1 0 0 0 INDRIYANI, NY 093214 64 23459 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344404
1#0##0#0#0.0#2021-12-16
14:40:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
117fb5b801a729fd8fac432417c9dbdb 150000 0 0 0 0 0
0 0 0 0 15000 0 75320 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 19/07/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 212539
0 1 0 0 0 SITI WARSINI.NY 098844 71 26077 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344405
1#0##0#0#0.0#2021-12-16
14:44:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
16de18a84f7f0462e5621e442f51cb0a 150000 0 0 0 0 0
0 0 0 0 15000 0 47539 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 08/12/1949 0 1
0 - 0 107400 262000 0 1 0 0 0 SISWO
SARJONO,(BP) 028784 72 26300 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V001815 0000564473013 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344406 1#0##0#0#0.0#2021-12-16
14:46:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d76b30f14324ccdfc52d450214d4ea5c 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 31/12/1946 0 2
0 0 - 0 - 0 - 0 - 0 181400 237171
0 1 0 0 0 HARTATI,(NY) 034422 74 27373 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344407
1#0##0#0#0.0#2021-12-16
14:48:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 27/01/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 280485
0 1 0 0 0 SRI WAHYUNI.NY 100270 58 21502 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344408
1#0##0#0#0.0#2021-12-16
14:53:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 13/09/2003 0 2
0 0 - 0 - 0 - 0 - 0 181400 280485
0 1 0 0 0 SHERLYN SETIA PUTRI SUSANTO.NN 100490
18 6663 DR. SUDARMAN, SP.THT-BKL(K) 1124R0021221V001818
0001693922499 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344409 1#0##0#0#0.0#2021-12-16
14:54:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5d57066a1e941e798331653dea48a598 150000 0 0 0 0 0
0 0 0 0 15000 0 115485 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 15/12/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 213695
0 1 0 0 0 TRI HERU SAPTONO.TN 098451 55 20449
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344410
1#0##0#0#0.0#2021-12-16
15:02:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a9bf420d82c95a492f1a8c89a5db8216 150000 0 0 0 0 0
0 0 0 0 15000 0 48695 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 23/07/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 214590
0 1 0 0 0 SARTONO.TN 098856 48 17672 DR. DAMAR
ARYO, SP.B 1124R0021221V001820 0001105770756 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344473 1#0##0#0#0.0#2021-12-16
15:04:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
32ec05551038aa095f5080ef75c09afe 150000 0 0 0 0 0
0 0 0 0 15000 0 49590 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 12/02/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 221071
0 1 0 0 0 DARWATI, NY 094471 57 21121 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344411
1#0##0#0#0.0#2021-12-16
15:08:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7f8fb761d3d6c7a46fd6cb4b42d8735d 150000 0 0 0 0 0
0 0 0 0 15000 0 56071 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 12/11/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 218852
0 1 0 0 0 MUH GUNTUR NALURI, TN 091409 58 21213
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344412
1#0##0#0#0.0#2021-12-16
15:08:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a889942928602b64b0063b86daa10e10 150000 0 0 0 0 0
0 0 0 0 15000 0 53852 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 12/02/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 249570
0 1 0 0 0 SARI MUJI HASTUTI, NY 038135 44 16372
yani;3302226402970001; 5.5.5.202112011542 4 344413
1#0##0#0#0.0#2021-12-16
15:10:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cf68b479d7de3196a20ea602e5ed8631 150000 0 0 0 0 0
0 0 0 0 15000 0 84570 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 31/08/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 236112
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344414
1#0##0#0#0.0#2021-12-16
15:12:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0d0a59448ec6975ad39f849081b87e7b 150000 0 0 0 0 0
0 0 0 0 15000 0 71112 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 05/01/1951 0 1
0 - 0 107400 273000 0 1 0 0 0 ACHMAD
SUPARDI., TN 061983 70 25907 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V001825 0001693922106 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344292 1#0##0#0#0.0#2021-12-16
15:13:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b2e8fd8adb90d64a56bf29f1e22f885b 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 18/11/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 218310
0 1 0 0 0 SRI WAHYUNI,NY 079969 56 20476 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344415
1#0##0#0#0.0#2021-12-16
15:14:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2e911316fc0656951ce9d34f06d8c277 150000 0 0 0 0 0
0 0 0 0 15000 0 53310 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 15/11/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 243575
0 1 0 0 0 ANIK RUSMINAH, (NY) 050080 56 20479
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344416
1#0##0#0#0.0#2021-12-16
15:16:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4a32f92e38a499feb437e283a4ae1cf3 150000 0 0 0 0 0
0 0 0 0 15000 0 78575 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 25/02/1965 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUYANTI., NY
0000565142567 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344417 1#0##0#0#0.0#2021-12-16
15:18:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
89cf859049992c37eb7af02060dddd85 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 12/08/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 223615
0 1 0 0 0 TITIEK MULYANI., NY 051274 58 21305
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344418
1#0##0#0#0.0#2021-12-16
15:21:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a7f30de8a5924b2188cad0d254ffdba7 150000 0 0 0 0 0
0 0 0 0 15000 0 58615 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 22/07/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 216442
0 1 0 0 0 TRIYONO, TN 052165 50 18404 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 344419
1#0##0#0#0.0#2021-12-16
15:22:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
438726f76dc38a111561c586e7e2dc3f 150000 0 0 0 0 0
0 0 0 0 15000 0 51442 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 17/10/2002 0 2
0 0 - 0 - 0 - 0 - 0 181400 192886
0 1 0 0 0 AIDA ADNA NOER KUSUMA ., NN 057201 19
3;JKN novia;3313125201940001; 5.6.3.202201201500 4 344420
1#0##0#0#0.0#2022-03-08
09:09:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
e271cd3b08b876e271f302a53a30f930 150000 0 0 0 0 0
0 0 0 0 15000 0 27886 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 03/12/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 209565
0 1 0 0 0 ARDENTI ASMARANI.NY 096816 45 16443
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344421
1#0##0#0#0.0#2021-12-16
15:24:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7d828defa777ee1ac25fd59cdf8a2d52 150000 0 0 0 0 0
0 0 0 0 15000 0 44565 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 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; 5.5.5.202112011542 4
344422 1#0##0#0#0.0#2021-12-16
15:26:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
946d17a7faf62b1fc7e2f0ad2319334c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 03/07/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 291250
0 1 0 0 0 WALUYO HADI SURYO,BP 084416 76 27919
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344423
1#0##0#0#0.0#2021-12-16
15:28:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
42144e9f08a3348c95115db353365889 150000 0 0 0 0 0
0 0 0 0 15000 0 126250 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 11/05/2005 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MUHAMMAD REVAN ATHA SUBANDI.AN 099637 16
yani;3302226402970001; 5.5.5.202112011542 4 344424
1#0##0#0#0.0#2021-12-16
15:29:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1d5e07423415c65228491864773ed193 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 23/11/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 204462
0 1 0 0 0 DALIMAN, TN 073804 61 22297 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 344425
1#0##0#0#0.0#2021-12-16
15:32:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
77bf5e837e18596f969169271552ed29 150000 0 0 0 0 0
0 0 0 0 15000 0 39462 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 05/07/1987 0 1
0 0 - 0 - 0 - 0 - 0 181400 452747
0 1 0 0 0 FANDY PRIMADHIKA, TN 070442 34 12577
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344709
1#0##0#0#0.0#2021-12-17
13:59:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a49b050cf987f7141241c4fc608482f4 150000 0 0 0 0 0
220000 0 0 0 15000 0 67747 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 07/10/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 209927
0 1 0 0 0 YATINI 094257 51 18692 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 344427
1#0##0#0#0.0#2021-12-16
15:36:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f26cde60eff58b065d20aa532996aac1 150000 0 0 0 0 0
0 0 0 0 15000 0 44927 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 18/05/1974 0 2
- 0 - 0 - 0 - 0 283800 315000 0
yani;3302226402970001; 5.5.5.202112011542 4 344428
1#0##0#0#0.0#2021-12-16
15:37:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
010bb08b50709c7d5833a8f2124496ab 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 17/03/1976 0 1
0 0 - 0 - 0 - 0 - 0 181400 205045
0 1 0 0 0 BAMBANG ARIANTO A, SDR 100192 45 16704
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344429
1#0##0#0#0.0#2021-12-16
15:42:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
288d11d1c70ee3351c67e5f569f02c08 150000 0 0 0 0 0
0 0 0 0 15000 0 40045 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 24/12/2018 0 2
0 - 0 - 0 - 0 135700 165000 0 1
0 0 0 INNARA QAISYA ZAINA P,AN 072092 2 1082 DR.
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344430
1#0##0#0#0.0#2021-12-16
15:48:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e1ad96796c7da3da831568dd1fabbc31 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 28/11/1993 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ROISATUS SHOLIHAH.NY 100266 28 10239 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344431
1#0##0#0#0.0#2021-12-16
15:49:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 30/04/1969 0 2
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344432 1#0##0#0#0.0#2021-12-16
15:50:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 10/12/2021 10/12/2021 21/03/1995 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MARDIAN DEWI PAMUNGKAS.Nn 099128 26 9761
yani;3302226402970001; 5.5.5.202112011542 4 344433
1#0##0#0#0.0#2021-12-16
15:56:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f318b19e877efe31e601a55ea838c6cd 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 25/06/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 217165
0 1 0 0 0 SRIYANTO, TN 096279 53 19526 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344434
1#0##0#0#0.0#2021-12-16
15:59:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0f9c434e40f0451fde61984806986dea 150000 0 0 0 0 0
0 0 0 0 15000 0 52165 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 28/10/1955 0 2
0 - 0 107400 262000 0 1 0 0 0 TEMU
MUJIYEM, NY 097662 66 24150 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V001848 0000638873605 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344435 1#0##0#0#0.0#2021-12-16
16:01:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
66844358924df82e81e74062b0ac1767 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 02/04/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 252450
0 1 0 0 0 KARMILA SUGIYANTI,NY 036072 49 18149
yani;3302226402970001; 5.5.5.202112011542 4 344436
1#0##0#0#0.0#2021-12-16
16:02:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
568cb27c2935d0f9038c7b1222c7d300 150000 0 0 0 0 0
0 0 0 0 15000 0 87450 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 08/09/1999 0 1
1 Z09.8;H66.9 96.52 - - None None None None U-3-15-0 None
DAN TENGGOROKAN 251000 0 0 - 0 - 0 - 0 -
0 251000 280485 0 1 0 0 0 ANANG NOVANTO. SDR
0002419047573 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344437 1#0##0#0#0.0#2021-12-16
16:03:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
16bc83804583ebf68088ea31aae32e75 150000 0 0 0 0 0
0 0 0 0 15000 0 115485 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 16/10/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 NANAIK MASLIKHAH NY 074486 61 22335
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344438
1#0##0#0#0.0#2021-12-16
16:07:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ac26eea4fa6a11150bf0229ebc8d0951 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 13/04/1958 0 2
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.3.202201201500 4 347159
1#0##0#0#0.0#2022-02-15
10:23:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
4bcb2256210419c446023a6d4cac64ca 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 03/02/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 205810
0 1 0 0 0 SUJOKO BP 074488 64 23686 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 344439
1#0##0#0#0.0#2021-12-16
16:13:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c9dc26c3cdf35942cae5184483627c4a 150000 0 0 0 0 0
0 0 0 0 15000 0 40810 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 28/12/2003 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 LUCKY HENGIE PRATAMA, SDR 038764 17 6557
yani;3302226402970001; 5.5.5.202112011542 4 344440
1#0##0#0#0.0#2021-12-16
16:16:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7cf27796ab968a54bef13fbe6c179a6a 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 20/07/1956 0 2
0 404900 165000 0 1 0 0 0 SUMIARSIH.NY
1124R0021221V001855 0001084234623 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344441 1#0##0#0#0.0#2021-12-16
16:18:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
40e62e2342a43952553369636129efa8 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 20/04/1995 0 1
0 0 - 0 - 0 - 0 - 0 181400 280485
0 1 0 0 0 HARITSA WAHYU WARDHANI.TN 094578 26
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344442
1#0##0#0#0.0#2021-12-16
16:19:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
360e7dc974431cf36efc315d56c9b601 150000 0 0 0 0 0
0 0 0 0 15000 0 115485 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 16/07/1972 0 1
0 - 0 - 0 - 0 894800 1451975 0 1
0 0 0 ACHMAD SOLICHIN, TN 099665 49 18044 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 344708
1#0##0#0#0.0#2021-12-17
13:58:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e9deb49f1c4cd04db2b7ec7ace20f17a 150000 0 0 0 0 0
1250000 0 0 0 15000 0 36975 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 05/05/1955 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SUNARYO.TN 099233 66 24326 DRG. VERAWATY,
SP.KG 1124R0021221V001859 0000040259687 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344443 1#0##0#0#0.0#2021-12-17
09:33:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
85b1052756e0817557b8e67894cfcd98 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 06/03/1981 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 YULIANA.NY 099991 40 14889 DRG. VERAWATY,
SP.KG 1124R0021221V001860 0001160595009 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344444 1#0##0#0#0.0#2021-12-17
09:34:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ae38c4fa469cc625204c92344d1f6a06 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 06/07/2007 0 1
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 IBNU DWI KUSUMA ., AN 053448 14 5271 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344445
1#0##0#0#0.0#2021-12-17
09:36:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
90ff391d20ede40227a68f34a6b4abb5 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 03/12/1945 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 PETRUS KUWATO.TN 099998 76 27766 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344446
1#0##0#0#0.0#2021-12-17
09:37:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ad28a9fc0efb8ba3aa3bce611e9bc44d 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 28/08/1949 0 2
- 0 - 0 - 0 - 0 283800 315000 0
yani;3302226402970001; 5.5.5.202112011542 4 344447
1#0##0#0#0.0#2021-12-17
09:37:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d294cbd3bf53f8d8750ed542b22be0dd 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 30/03/2001 0 2
None None None None PROSEDUR KECIL PADA MULUT DAN LIDAH 254400 0
0 - 0 - 0 - 0 - 0 254400 437030
0 1 0 0 0 VINA RUSIANA, NN 100593 20 7560 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344448
1#0##0#0#0.0#2021-12-17
09:39:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bf28d652ed13dc743874e6defa0c7c06 400000 0 0 0 0 0
0 0 0 0 15000 0 22030 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 02/02/1990 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RANI ERMA WATI NINGSIH.NY 100000 31 11634
yani;3302226402970001; 5.5.5.202112011542 4 344449
1#0##0#0#0.0#2021-12-17
09:41:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
944d943ecb3de0fd9d51cc4bee6d7acf 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 20/08/1959 0 1
0 - 0 - 0 - 0 786200 478830 0 1
1124R0021221V001866 0000571256594 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344450 1#0##0#0#0.0#2021-12-17
09:47:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cb994a64a1b5c3ce49ccb61002347086 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 09/02/1992 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ERNA WAHYUNINGSIH.NY 100286 29 10897 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344451
1#0##0#0#0.0#2021-12-17
09:48:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fb2b1d4040473285a21d44dcd172d0ce 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 16/05/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 280485
0 1 0 0 0 SUMARDINI.NY 084722 58 21393 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344452
1#0##0#0#0.0#2021-12-17
09:49:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c789d3b1cb02bbfd6e4933ef5372b35e 150000 0 0 0 0 0
0 0 0 0 15000 0 115485 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 30/12/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 279570
0 1 0 0 0 TRIYONO.TN 095397 55 20434 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344453
1#0##0#0#0.0#2021-12-17
09:49:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
58adb733f7a8a4e6f30ca0307e5dfb41 150000 0 0 0 0 0
0 0 0 0 15000 0 114570 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 25/12/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MARIA
1124R0021221V001870 0002069991685 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344454 1#0##0#0#0.0#2021-12-17
09:50:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
065f0e337c038c2583dd3ae2c48a5d3a 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 18/08/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 206161
0 1 0 0 0 JUMADI, TN 100119 49 18011 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344455
1#0##0#0#0.0#2021-12-17
09:52:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f3888feadfb79fc18c767370d85b89d3 150000 0 0 0 0 0
0 0 0 0 15000 0 41161 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 29/05/1956 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 AHMAD TONTOWI.TN 100181 65 23936 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344456
1#0##0#0#0.0#2021-12-17
09:52:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4c6204f62826aca8a8f3da5c5175e629 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 29/04/2000 0 1
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 AURIAN HADID A., SDR 044847 21 7895 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344457
1#0##0#0#0.0#2021-12-17
09:53:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1ef16866e1b58d4b6a2e444b8751dd59 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 28/07/1979 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 EVI NUR AFNITA.NY 100291 42 15476 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344458
1#0##0#0#0.0#2021-12-17
09:53:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2eb545bd28e73902443d02d19dfb7a57 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 08/06/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 315000 0 1 0 0 0 LAMIYEM.NY 087484
0001316300512 3;JKN novia;3313125201940001; 5.6.3.202201201500 4
344459 1#0##0#0#0.0#2022-02-15
11:43:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 3
9235c31735e654de202c877d60415ba7 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 05/04/1966 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SARTONO, (BP) 005714 55 20338 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344667
1#0##0#0#0.0#2021-12-17
10:17:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1fadfbd49be2019a1e65e1bee76500b2 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 13/10/1989 0 2
- 0 - 0 - 0 - 0 549400 185280 0
1 0 0 0 HENNY SRI K,(NY) 018751 32 11746 DR. DEWI
yani;3302226402970001; 5.5.5.202112011542 4 344460
1#0##0#0#0.0#2021-12-17
10:19:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
078572034b0077de4f2d39dd7eb18f1a 150000 0 0 0 0 0
0 0 0 0 15000 0 20280 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 03/08/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ISMURYANI
1124R0021221V001878 0001313177196 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344461 1#0##0#0#0.0#2021-12-17
10:24:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
92b1d8b3760f01623086ac2abee2713d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 20/04/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 200715
0 1 0 0 0 HARYANI, NY 065422 50 18497 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344462
1#0##0#0#0.0#2021-12-17
10:25:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f922c77f5d4adccb6f9fd219324f5486 150000 0 0 0 0 0
0 0 0 0 15000 0 35715 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 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; 5.5.5.202112011542 4
344463 1#0##0#0#0.0#2021-12-17
10:26:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
190cf1aad88f1c15742b33afabd1f6f5 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 31/01/1994 0 1
0 0 - 0 - 0 - 0 - 0 181400 280485
0 1 0 0 0 ASRI YUWANDANI CHANIAGO.TN 099791 27
3;JKN novia;3313125201940001; 5.6.3.202201201500 4 344464
1#0##0#0#0.0#2022-03-08
08:10:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
7afe9e31716ae620f941982b58a69155 150000 0 0 0 0 0
0 0 0 0 15000 0 115485 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 28/05/2005 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ZAHRA NABILA WAHYUNI, AN 098771 16 6040
yani;3302226402970001; 5.5.5.202112011542 4 344465
1#0##0#0#0.0#2021-12-17
10:28:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
71e1f4e5d1754728c8bb23855e568ea1 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 23/11/1971 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 F AGUNG RAHMADI.TN 098579 50 18280 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344466
1#0##0#0#0.0#2021-12-17
10:29:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d88e26a446c650a92e705e7048615d15 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 16/08/1970 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 NOENIK KRISTYARINI.NY 100290 51 18744 DRG.
reni;3313147010930001; 5.6.0.202201041418 4 344467
1#0##0#0#0.0#2022-01-07
19:54:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
61ec58277f8cc054b0ee04e78c93d4b7 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 24/09/1969 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SOFIAH MARDIANTI.NY 098524 52 19070 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344668
1#0##0#0#0.0#2021-12-17
10:31:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
55ee8186cdd45897b12735e997b02c9d 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 09/07/1968 0 2
- 0 - 0 - 0 - 0 283800 315000 0
yani;3302226402970001; 5.5.5.202112011542 4 344468
1#0##0#0#0.0#2021-12-17
10:32:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
40d2bd29049fb75d54662f71b60e0bc2 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 01/04/2002 0 1
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 GUNTUR PRASATRIO, SDR 095840 19 7193 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344469
1#0##0#0#0.0#2021-12-17
10:33:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eb13a985a878e9dc915180f281551653 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 15/07/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400
1196865 0 1 0 0 0 RUDY MANTIRI,(BP) 020515 51
0001104686324 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344470 1#0##0#0#0.0#2021-12-17
10:34:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
47027f2c88dbc82dfa65b88e8d68f071 150000 0 0 0 0 0
0 0 0 0 15000 0 1031865 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 02/03/1987 0 2
- 0 - 0 - 0 - 0 206700 165000 0
1 0 0 0 DHARA NURDHAYANTI., NY 044546 34 12702 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344472
1#0##0#0#0.0#2021-12-17
10:35:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2ddbdac3ffb8124ddbfd2e1750660950 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 24/06/2008 0 1
0 - 0 - 0 - 0 283800 318860 0 1
0 0 0 IBRAHIM SHOLEH F, AN 100729 13 4917 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344474
1#0##0#0#0.0#2021-12-17
10:36:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7c52f58ee8bdde8a0fe69b5b63b1ec7e 300000 0 0 0 0 0
0 0 0 0 15000 0 3860 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 08/07/2000 0 1
0 - 0 - 0 - 0 283800 334300 0 1
0 0 0 ADAM YOGI SETIYAWAN, SDR 100573 21 7825 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344475
1#0##0#0#0.0#2021-12-17
10:36:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
546d0587f9087f1d5beb4d43765a1f53 300000 0 0 0 0 0
0 0 0 0 25000 0 9300 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 13/03/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 411095
0 1 0 0 0 CHRISTINA MARGARETNA, NY 043869 43
0001292319922 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344476 1#0##0#0#0.0#2021-12-17
10:39:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
64f0487cb754a99c1464f68a335b85d1 300000 0 0 0 0 0
0 0 0 0 15000 0 96095 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 30/09/1977 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000207436206 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344477 1#0##0#0#0.0#2021-12-17
10:40:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c1a51d9f590cf0d55bebad2218815d7b 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 02/11/2018 0 2
0 0 - 0 - 0 - 0 - 0 181400 173218
0 1 0 0 0 ANNISA LUTFITA PUTRI, AN 078365 3
0002766693982 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344480 1#0##0#0#0.0#2021-12-17
10:41:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
09d4e893d6888ee41133bd79f900228d 150000 0 0 0 0 0
0 0 0 0 15000 0 8218 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 23/08/1978 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MOH RIYADI, TN 071422 43 15815 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344481
1#0##0#0#0.0#2021-12-17
10:42:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2e37116424dac6ebe12b27be3200b864 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 31/05/1985 0 2
- 0 - 0 - 0 - 0 283800 315000 0
yani;3302226402970001; 5.5.5.202112011542 4 344482
1#0##0#0#0.0#2021-12-17
10:44:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4765b217edf8b09081f83eb35adcfb5c 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 11/04/1965 0 1
0 - 0 - 0 - 0 786200 722226 0 1
1124R0021221V001902 0001732801498 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344483 1#0##0#0#0.0#2021-12-17
10:44:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1c2aa8adcd6068f85f9694f3f95213cd 662676 0 0 0 0 0
0 0 0 0 15000 0 44550 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 15/06/1986 0 2
- 0 - 0 - 0 - 0 283800 315000 0
yani;3302226402970001; 5.5.5.202112011542 4 344484
1#0##0#0#0.0#2021-12-17
10:45:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
862112d38d0c2f0e4841843a8c413e13 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 25/03/1978 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V001904 0001530372778 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344485 1#0##0#0#0.0#2021-12-17
11:02:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
218b33a8aee491cdf28d604ed40a77fa 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 23/12/1977 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V001905 0002302362729 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344486 1#0##0#0#0.0#2021-12-17
11:03:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a7a33b97a5a955e56a15ca8b7bafe11a 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 02/06/1963 0 2
- 0 - 0 - 0 - 0 283800 315000 0
SP.KG 1124R0021221V001906 0001102660863 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344487 1#0##0#0#0.0#2021-12-17
11:03:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
aff5ee783132c60c1b36ccc273157e0b 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 01/09/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
1124R0021221V001907 0000639614597 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344488 1#0##0#0#0.0#2021-12-17
11:05:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c68b41fb54187b1e813712c9f079a517 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 26/01/1975 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SRI DINA S, NY 099204 46 17120 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344489
1#0##0#0#0.0#2021-12-17
11:05:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9d68bdc221b507fcd25314d7428dad50 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 13/12/1966 0 2
0 - 0 - 0 - 0 786200 786030 0 1
1124R0021221V001909 0002051493849 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344490 1#0##0#0#0.0#2021-12-17
11:07:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4d41741702e90ea43386d5585c80efe1 463830 0 0 0 0 0
0 0 0 0 15000 0 307200 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 07/04/1948 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V001910 0000094255514 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344491 1#0##0#0#0.0#2021-12-17
11:09:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0e6ba65751dcec4effbef864f01ef695 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 02/09/1976 0 1
0 - 0 - 0 - 0 786200 502360 0 1
yani;3302226402970001; 5.5.5.202112011542 4 344492
1#0##0#0#0.0#2021-12-17
11:10:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8833fb1ccefcf2a26609d9c174781119 463830 0 0 0 0 0
0 0 0 0 15000 0 23530 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 26/07/1980 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 BROTO TRI YULIANTO, TN 056979 41 15112 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344493
1#0##0#0#0.0#2021-12-17
11:11:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0780fd3b0c17c4f64d62cf579d3d7b08 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 15/04/1991 0 2
0 0 - 0 - 0 - 0 - 0 181400 452472
0 1 0 0 0 MUIS NAFITRI WARDANI.NY 049569 30 11197
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344707
1#0##0#0#0.0#2021-12-17
13:53:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eb288791b4894befbc308c2c290309c5 150000 0 0 0 0 0
220000 0 0 0 15000 0 67472 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 04/10/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 234675
0 1 0 0 0 SLAMETO.TN 096660 76 27826 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 344494
1#0##0#0#0.0#2021-12-17
11:12:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
53123e53250813a79b13b574e7304469 150000 0 0 0 0 0
0 0 0 0 15000 0 69675 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 25/10/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 614500
0 1 0 0 0 SRI SUNARMI., NY 048878 64 23422 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344495
1#0##0#0#0.0#2021-12-17
11:13:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6cb5579130706411ab25c648da1b5dcb 150000 0 0 0 0 0
0 0 0 0 15000 0 449500 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 17/08/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 216300
0 1 0 0 0 ENDANG WERDININGSIH.NY 099747 67 24587
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344496
1#0##0#0#0.0#2021-12-17
11:13:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c132784c13763aa0a48346f92f3b37e8 150000 0 0 0 0 0
0 0 0 0 15000 0 51300 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 13/08/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 303730
0 1 0 0 0 BUDI NURWININGSIH, NY 099056 55 20208
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344497
1#0##0#0#0.0#2021-12-17
12:53:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ce5fbe03d7d61fc05c1a83e3f9aaaa49 150000 0 0 0 0 0
0 0 0 0 15000 0 138730 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 23/01/1975 0 1
- 0 - 0 - 0 - 0 135700 253745 0
1 0 0 0 IWAN SETYAWAN, TN 098008 46 17124 dr.
KRISNA ARIE SOESANTY 1124R0021221V001921 0001104003775 3;JKN
novia;3313125201940001; 5.5.5.202112011542 4 346642
1#0##0#0#0.0#2022-01-04
13:42:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b7c728c17c0a71cd6d33ccd85eca7d09 175000 0 0 0 0 0
0 0 0 0 15000 0 63745 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 14/01/1970 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 403298
0 1 0 0 0 WIDODO.TN 099331 51 18959 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 343938
1#0##0#0#0.0#2021-12-14
15:26:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7aa1068c367e64e70e25127fbcba2d21 351500 0 0 0 0 0
0 0 0 0 15000 0 36798 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 05/07/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 220912
0 1 0 0 0 SRI BEKTI.NY 099805 53 19517 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343939
1#0##0#0#0.0#2021-12-14
15:30:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ee54efbd898ddf47dfb4a9a736bc26e8 150000 0 0 0 0 0
0 0 0 0 15000 0 55912 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 03/07/1935 0 2
0 0 - 0 - 0 - 0 - 0 181400 219872
yani;3302226402970001; 5.5.5.202112011542 4 343940
1#0##0#0#0.0#2021-12-14
15:32:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b5a2ee9af31067430c4e8da4ad380bf5 150000 0 0 0 0 0
0 0 0 0 15000 0 54872 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 02/07/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 221420
0 1 0 0 0 SHOLIKIN.TN 084738 52 19155 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 343941
1#0##0#0#0.0#2021-12-14
15:35:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
acee1ce61576ca0f58b24e3a88004d27 150000 0 0 0 0 0
0 0 0 0 15000 0 56420 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 11/02/1959 0 2
1 S82.20;V28.9 88.27 - - None None None None Q-5-31-0
0 - 0 - 0 - 0 129600 465685 0 1
0 0 0 ENDANG TRI WAHYUNINGSIH.NY 100608 62 22949 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347190
1#0##0#0#0.0#2022-01-05
16:00:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8abd168a2628ba185e25d8a66a8fa299 150000 0 0 0 0 0
248000 0 0 0 25000 0 42685 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 06/06/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 226402
0 1 0 0 0 SUPARMAN, (BP) 004954 58 21373 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343942
1#0##0#0#0.0#2021-12-14
15:36:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
99bd11d253e89345b877ae02fbbfe8f6 150000 0 0 0 0 0
0 0 0 0 15000 0 61402 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 27/11/1986 0 2
0 0 - 0 - 0 - 0 - 0 181400 464081
0 1 0 0 0 YARNI, NY 093021 35 12798 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 347451
1#0##0#0#0.0#2022-01-05
15:42:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3cc94ed2e567772b9b7a02791600c85f 150000 0 0 0 0 0
248000 0 0 0 15000 0 51081 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 28/10/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 219024
0 1 0 0 0 MARUTA TIRANA,(BP) 040357 77 28168
yani;3302226402970001; 5.5.5.202112011542 4 343943
1#0##0#0#0.0#2021-12-14
15:37:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fcc8e8e635912a99711a4c0bef765e2d 150000 0 0 0 0 0
0 0 0 0 15000 0 54024 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 28/02/1965 0 2
1 Z47.0 97.89 - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 260665
0 1 0 0 0 SARAS HARI HANDAYANI, NY 097422 56
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343944
1#0##0#0#0.0#2021-12-14
15:41:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
77bfda319dacabf9327884f189df0510 215000 0 0 0 0 0
0 0 0 0 15000 0 30665 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 25/12/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 209695
0 1 0 0 0 BAMBANG RISTANTO.TN 087710 49 18249
yani;3302226402970001; 5.5.5.202112011542 4 343945
1#0##0#0#0.0#2021-12-14
15:43:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
15ab91df6a5aa14ff3e140f27c71432e 150000 0 0 0 0 0
0 0 0 0 15000 0 44695 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 10/10/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 248363
0 1 0 0 0 SRI REJEKI.NY 095056 62 22708 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343947
1#0##0#0#0.0#2021-12-14
15:46:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
46328d1147d50e393b583453d8acf5ce 150000 0 0 0 0 0
0 0 0 0 15000 0 83363 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 16/06/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 242501
0 1 0 0 0 SUWARTI.NY 085230 76 27937 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 343946
1#0##0#0#0.0#2021-12-14
15:45:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b43868892839f2e353f721fbd99e0130 150000 0 0 0 0 0
0 0 0 0 15000 0 77501 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 25/02/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 212182
0 1 0 0 0 ROSIDAH. NY 087797 69 25492 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 343948
1#0##0#0#0.0#2021-12-14
15:46:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5c862d6ea6be8664d0eb41fae2e671d1 150000 0 0 0 0 0
0 0 0 0 15000 0 47182 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 02/05/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 224880
0 1 0 0 0 ANISA KURNIASARI, NY 093665 58 21408
yani;3302226402970001; 5.5.5.202112011542 4 343949
1#0##0#0#0.0#2021-12-14
15:47:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9fdb530c2bc6711efe41eb59b9ec2ad2 150000 0 0 0 0 0
0 0 0 0 15000 0 59880 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 20/07/1957 0 2
0 404900 727312 0 1 0 0 0 ENDANG
NURHADININGSIH., NY 047800 64 23520 DR. WAHYU PURNOMO, SP.OT
1124R0021221V001936 0000091462904 3;JKN yani;3302226402970001;
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15:48:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.5.5.202112011542 4 343952
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15:49:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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15:50:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 29/10/1964 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 343955
1#0##0#0#0.0#2021-12-14
15:53:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.5.5.202112011542 4 343956
1#0##0#0#0.0#2021-12-14
15:54:25#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#2021-12-14
15:56:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.5.5.202112011542 4 343958
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15:59:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 12/01/1958 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 343959
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15:59:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 15/12/1951 0 1
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1#0##0#0#0.0#2022-01-05
15:46:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 17/08/1940 0 2
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1#0##0#0#0.0#2021-12-14
16:00:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 31/05/1972 0 2
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0 1 0 0 0 ENDANG HARSO SRI P., NY 071636 49 18091
yani;3302226402970001; 5.5.5.202112011542 4 343961
1#0##0#0#0.0#2021-12-14
16:03:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 27/04/1956 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 343962
1#0##0#0#0.0#2021-12-14
16:06:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 15/03/1970 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 343963
1#0##0#0#0.0#2021-12-14
16:09:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 31/12/1948 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 343964
1#0##0#0#0.0#2021-12-15
07:13:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 04/01/1983 0 2
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1#0##0#0#0.0#2022-01-05
15:50:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7252424dad06045e1ece65f0836c7e8f 150000 0 0 0 0 0
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3372030 C 3 CP 2 11/12/2021 11/12/2021 09/05/1954 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 343965
1#0##0#0#0.0#2021-12-15
07:14:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 23/06/2014 0 1
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0 1 0 0 0 MUH REYHAN HAFIDZ.AN 099069 7 2728
yani;3302226402970001; 5.5.5.202112011542 4 343966
1#0##0#0#0.0#2021-12-15
07:47:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 12/12/1965 0 2
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1#0##0#0#0.0#2022-01-05
15:54:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
762ef4e4e8a0852f0b2dce5550a72224 150000 0 0 0 0 0
220000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 18/05/1958 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 343967
1#0##0#0#0.0#2021-12-15
07:48:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1ed82f77a8f23f68af538cc25672ab24 150000 0 0 0 0 0
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3372030 C 3 CP 2 11/12/2021 11/12/2021 01/01/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 204108
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yani;3302226402970001; 5.5.5.202112011542 4 343968
1#0##0#0#0.0#2021-12-15
07:48:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 01/09/1976 0 2
1 Z03.8;E05.9;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 224711
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5.5.5.202112011542 4 343969 1#0##0#0#0.0#2021-12-15
07:49:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1a8ad670ac84f67fb9fefa4e90d58716 150000 0 0 0 0 0
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3372030 C 3 CP 2 11/12/2021 11/12/2021 25/02/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 280485
yani;3302226402970001; 5.5.5.202112011542 4 343970
1#0##0#0#0.0#2021-12-15
07:50:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ff9e71b90121d445e6a7193b80c6fa71 150000 0 0 0 0 0
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3372030 C 3 CP 2 11/12/2021 11/12/2021 28/09/1964 0 1
- 0 - 0 - 0 - 0 182600 290485 0
1 0 0 0 AHMAD QODRI HELMI.TN 100607 57 20893 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343971
1#0##0#0#0.0#2021-12-15
07:50:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 11/04/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 242677
0 1 0 0 0 SUWANTINI.NY 084809 74 27273 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343972
1#0##0#0#0.0#2021-12-15
07:51:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c161a52f72e3abf64359eaaab5af9c47 150000 0 0 0 0 0
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3372030 C 3 CP 2 11/12/2021 11/12/2021 30/04/1953 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 344223
1#0##0#0#0.0#2021-12-15
07:52:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2da7d77a96129aee1f9d10c7c5941f19 150000 0 0 0 0 0
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3372030 C 3 CP 2 11/12/2021 11/12/2021 25/08/1997 0 1
0 0 - 0 - 0 - 0 - 0 181400 287230
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yani;3302226402970001; 5.5.5.202112011542 4 344207
1#0##0#0#0.0#2021-12-15
07:55:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0d851d97a04a7754585cc8b2f5c9a775 150000 0 0 0 0 0
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3372030 C 3 CP 2 11/12/2021 11/12/2021 09/11/1980 0 1
1 Z09.8;S83.5 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 165000
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1#0##0#0#0.0#2022-01-05
15:57:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 18/01/1951 0 2
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5.5.5.202112011542 4 343974 1#0##0#0#0.0#2021-12-15
07:56:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9da9c804bd21d55685e82ede0f515ade 150000 0 0 0 0 0
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3372030 C 3 CP 2 11/12/2021 11/12/2021 29/02/1972 0 2
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403065 0 1 0 0 0 SRI UTAMI.NY 095373 49
yani;3302226402970001; 5.5.5.202112011542 4 343975
1#0##0#0#0.0#2021-12-15
07:57:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 19/08/2005 0 2
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0 1 0 0 0 NI KOMANG LUNA DRUPADI WINDRASTUTI.AN 005764
0001106728413 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
347165 1#0##0#0#0.0#2022-01-05
15:58:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5fbbd0a4390e52e641d9b16d8b0244c5 150000 0 0 0 0 0
220000 0 0 0 15000 0 61402 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 15/05/1990 0 1
0 0 - 0 - 0 - 0 - 0 181400 194075
0 1 0 0 0 SUTRISNO.,TN 074382 31 11533 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343976
1#0##0#0#0.0#2021-12-15
07:58:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fdabfaba1b364adc9069f6aac9ce1fd0 150000 0 0 0 0 0
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3372030 C 3 CP 2 11/12/2021 11/12/2021 12/03/1955 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 343977
1#0##0#0#0.0#2021-12-15
08:03:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 19/05/1972 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 343978
1#0##0#0#0.0#2021-12-15
08:03:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 15/10/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 343979
1#0##0#0#0.0#2021-12-15
08:04:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b2e6de7e7b83c2253e7f248f9235c2ac 463830 0 0 0 0 0
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3372030 C 3 CP 2 11/12/2021 11/12/2021 14/03/1977 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 343980
1#0##0#0#0.0#2021-12-15
08:05:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 22/02/1971 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 343981
1#0##0#0#0.0#2021-12-15
08:05:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
558620a9def2ec35b991a45d1cab4fd5 463830 0 0 0 0 0
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3372030 C 3 CP 2 11/12/2021 11/12/2021 31/12/1981 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 343982
1#0##0#0#0.0#2021-12-15
08:10:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 18/07/1964 0 1
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SP.PD 1124R0021221V001983 0002425018184 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343983 1#0##0#0#0.0#2021-12-15
08:15:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 09/09/1944 0 1
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08:19:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 11/12/2021 11/12/2021 03/12/1950 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 343985
1#0##0#0#0.0#2021-12-15
08:20:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dcd2060e8d3ddc42564893789c83c0b5 463830 0 0 0 0 0
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3372030 C 3 CP 2 11/12/2021 11/12/2021 19/02/1967 0 1
1 Z09.8;E11.4;G59.0;K30;R51 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
237332 0 1 0 0 0 SIMAN, TN 099921 54 20019
yani;3302226402970001; 5.5.5.202112011542 4 343987
1#0##0#0#0.0#2021-12-15
08:21:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c8ae523ac82136afb570fe122f49eaaf 150000 0 0 0 0 0
0 0 0 0 15000 0 72332 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 02/02/1972 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V001987 0002070978546 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343988 1#0##0#0#0.0#2021-12-15
08:22:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2d861e5f6782c5cd42ee8a5bef233160 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 02/01/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 518676
0 1 0 0 0 HENDRAYANI., NY 053231 55 20432 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343989
1#0##0#0#0.0#2021-12-15
08:24:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8b25e1dc6c36b90714859d898e411c08 150000 0 0 0 0 0
0 31845 0 0 15000 0 321831 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 26/02/1993 0 2
0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 EVI NUR LAILATUL QODARWATI, NY 066048
0002306921951 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
347166 1#0##0#0#0.0#2022-01-05
15:59:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cbfd09fc229db1a386d611c8eb5f9a2b 150000 0 0 0 0 0
150000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 15/08/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 MULYONO MUHAMMAD SOFYAN, TN 071645 69
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 343990
1#0##0#0#0.0#2021-12-15
08:25:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
771770f2f834ae8bbd1ba305ca8cf563 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 01/01/2000 0 2
0 0 - 0 - 0 - 0 - 0 181400 280485
0 1 0 0 0 ETHI YUNIARTO,(NY) 017295 21 8015
yani;3302226402970001; 5.5.5.202112011542 4 343991
1#0##0#0#0.0#2021-12-15
08:26:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
10c52e16a37d00dd6998b804b0450f11 150000 0 0 0 0 0
0 0 0 0 15000 0 115485 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 12/09/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 287135
0 1 0 0 0 SLAMET,(NY) 036944 76 27849 DR.
yani;3302226402970001; 5.5.5.202112011542 4 343992
1#0##0#0#0.0#2021-12-15
08:26:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c5aa9dd5f521e5bb71f37d120bc41e8c 150000 0 0 0 0 0
0 0 0 0 15000 0 122135 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 25/10/1969 0 2
1 Z09.8;R07.4;I25.9;K21.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 218778
SP.PD 1124R0021221V001994 0002205741431 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 343993 1#0##0#0#0.0#2021-12-15
08:30:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
df9715db9e9edde16b104f57e064d6ab 150000 0 0 0 0 0
0 0 0 0 15000 0 53778 0 0 0 0 0
3372030 C 3 CP 2 11/12/2021 11/12/2021 17/11/1946 0 2
None None None None GAGAL JANTUNG KONGESTIF DAN KONDISI JANTUNG LAIN-LAIN
521100 0 0 - 0 - 0 - 0 - 0 521100
149325 0 1 0 0 0 YOSEFHINA KASINEM POKAREM.NY 089527
75 27418 DR. CHIKA KLARISSA 1124R0021221V001997 0000091166051
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 346643
1#0##0#0#0.0#2022-04-14
13:25:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
7c2fbbdd8e8aa136c9e39090e60b7765 130000 0 0 0 0 0
0 0 0 0 15000 0 4325 0 0 0 0 0
3372030 C 3 CP 2 12/12/2021 12/12/2021 31/12/1965 0 1
1 N23 - - - None None None None Q-5-32-0 None None
None None None None GANGGUAN SALURAN KEMIH AKUT 250700 0 0
- 0 - 0 - 0 - 0 250700 239677 0
1 0 0 0 SARDAL, TN 100649 55 20435 DR. GERRY FEBRIAN
R 1124R0021221V002002 0002045631161 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 346649 1#0##0#0#0.0#2022-04-14
13:48:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
5fa361debda93cb70a06a8bc04e66669 175000 0 0 0 0 0
0 0 0 0 25000 0 39677 0 0 0 0 0
3372030 C 3 CP 2 12/12/2021 12/12/2021 20/11/1955 0 1
1 T14.1;W20.0 96.59;97.89 - - None None None None Z-3-27-0
- 0 - 0 - 0 - 0 183900 274931 0
1 0 0 0 SUPANGAT.TN 080293 66 24129 DR. GERRY FEBRIAN
R 1124R0021221V002005 0000639662433 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346650 1#0##0#0#0.0#2022-01-04
14:02:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
90880546004714c922b2a13e5842614d 0 0 0 0 161000 0
0 0 0 0 15000 0 98931 0 0 0 0 0
3372030 C 3 CP 2 12/12/2021 12/12/2021 07/06/1975 0 1
0 - 0 - 0 - 0 - 0 181400 170000
0 1 0 0 0 NANA SUTARNA, TN 097946 46 16990 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346651
1#0##0#0#0.0#2022-01-04
14:15:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
34b9b53811c4671d4ac7b4b40d46b5b4 155000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 12/12/2021 12/12/2021 25/01/2011 0 1
1 R11;G25.9 - - - None None None None Q-5-25-0 None
- 0 - 0 - 0 - 0 135700 188615 0
1 0 0 0 MUHAMMAD HARIZ K, AN 100657 10 3974 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346652
1#0##0#0#0.0#2022-01-04
14:24:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
31659e344235311323670919249c0639 155000 0 0 0 0 0
0 0 0 0 25000 0 8615 0 0 0 0 0
3372030 C 3 CP 2 12/12/2021 12/12/2021 24/10/1974 0 2
- 0 - 0 - 0 - 0 135700 245760 0
1 0 0 0 ENI SURYANI RAHAYU, NY 074437 47 17216 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346653
1#0##0#0#0.0#2022-01-04
14:24:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9047b7a7e360072968059939d1ba8687 180000 0 0 0 0 0
0 0 0 0 15000 0 50760 0 0 0 0 0
3372030 C 3 CP 2 12/12/2021 12/12/2021 14/04/1952 0 1
None None None None GAGAL JANTUNG KONGESTIF DAN KONDISI JANTUNG LAIN-LAIN
521100 0 0 - 0 - 0 - 0 - 0 521100
202087 0 1 0 0 0 DAUD WIDODO DHARMA WIYOTO., BP
051387 69 25444 DR. GERRY FEBRIAN R 1124R0021221V002010
0002064972677 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
346654 1#0##0#0#0.0#2022-01-04
14:25:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
be4f1c0c2ddcb9cf71024becc83fdc4c 0 0 0 0 159000 0
0 0 0 0 15000 0 28087 0 0 0 0 0
3372030 C 3 CP 2 12/12/2021 12/12/2021 23/12/2001 0 2
0 - 0 - 0 - 0 135700 221969 0 1
0 0 0 INTAN RAHMAWAT SALSABILLA, NN 098724 19 7294 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346655
1#0##0#0#0.0#2022-01-04
14:26:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
40578dc79c7157f6aedf3f14bec60a0e 155000 0 0 0 0 0
0 0 0 0 15000 0 51969 0 0 0 0 0
3372030 C 3 CP 2 12/12/2021 12/12/2021 25/11/2013 0 1
0 - 0 - 0 - 0 135700 200485 0 1
0 0 0 FAIZ MUSTHOFA FAHRURROZI, AN 100663 8 2939 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346656
1#0##0#0#0.0#2022-01-04
14:26:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
99ba1a7ab2eca6054b721d86dc3b4031 155000 0 0 0 0 0
0 0 0 0 25000 0 20485 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 09/03/1939 0 1
0 0 - 0 - 0 - 0 - 0 336100 501399
0 1 0 0 0 SUGIMAN HADI ATMANTO, TN 100664 82
30230 DR. GERRY FEBRIAN R 1124R0021221V002014 0000639737267 3;JKN
novia;3313125201940001; 5.5.5.202112011542 4 346657
1#0##0#0#0.0#2022-01-04
14:27:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4ecbdc351084e0f4718313c3464841a4 420000 0 0 0 0 0
0 0 0 0 25000 0 56399 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 29/03/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 426815
0 1 0 0 0 TRI ASTUTI.NY 085400 61 22539 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344532
1#0##0#0#0.0#2021-12-15
15:55:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6d0d1874a3c1a454430e2d96a0ceea15 150000 0 0 0 0 0
0 76595 0 0 15000 0 185220 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 04/08/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 302800
0 1 0 0 0 NGATIMIN MARTOWIYONO, TN 070607 73
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344293
1#0##0#0#0.0#2021-12-15
16:07:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d8f7298c610003f220042b0879761e66 150000 0 0 0 0 0
0 89500 0 0 15000 0 48300 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 06/06/1956 0 2
1 Z09.8;E11.4;G59.0;I10;E78.5;J06.9 - - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 347855 0 1 0 0 0 SURIP, NY 088782
0001032602861 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344533 1#0##0#0#0.0#2021-12-15
16:08:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8cc66ad48436c2779cf5fd49cee9a49b 150000 0 0 0 0 0
0 76045 0 0 15000 0 106810 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 15/01/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 273311
0 1 0 0 0 SITI RAHAYU, NY 084960 70 25900 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344534
1#0##0#0#0.0#2021-12-16
07:33:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9858e5b879a12b1ff38c6aabd15b221b 150000 0 0 0 0 0
0 76595 0 0 15000 0 31716 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 04/10/1946 0 1
1 Z09.8;E11.4;G59.0;I10;R51;E78.5 - - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 481283 0 1 0 0 0 SUDARNO. TN 084750
0000091347906 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344535 1#0##0#0#0.0#2021-12-16
07:34:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b15b6acec90ce706076bea57633b88ac 150000 0 0 0 0 0
0 76595 0 0 15000 0 239688 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 31/08/2020 0 1
1 Z09.8;S60.1 93.57 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 295703 0 1
0 0 0 MUHAMMAD ZAYN D, AN 100528 1 469 DR.
HERMAWAN, SP.B 1124R0021221V002021 0003049119639 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 344536
1#0##0#0#0.0#2021-12-16
07:35:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
765a53bc837e5d3fd3efcb944fab7b93 235000 0 0 0 0 0
0 0 0 0 15000 0 45703 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 02/10/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 288225
0 1 0 0 0 ESTUNINGSIH ., NY 054786 57 20891 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344537
1#0##0#0#0.0#2021-12-16
07:36:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f29067b44095900241bc715392b31f10 150000 0 0 0 0 0
0 31845 0 0 15000 0 91380 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 05/06/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ASIYAH INTAN
1124R0021221V002023 0002050989456 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344503 1#0##0#0#0.0#2021-12-16
07:37:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
63a2ff47950a639abc5729f524d6e20c 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 04/05/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 327835
0 1 0 0 0 EDY SUNARYO, TN 095163 57 21042 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344538
1#0##0#0#0.0#2021-12-16
07:38:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f42d00fb85ec5a208dd5fca2a5051274 150000 0 0 0 0 0
0 44200 0 0 15000 0 118635 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 10/05/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 243931
0 1 0 0 0 SUMALI, (BP) 002143 62 22863 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344539
1#0##0#0#0.0#2021-12-16
07:39:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
be3388d04a863789dd1d3f4075190ec4 150000 0 0 0 0 0
0 44200 0 0 15000 0 34731 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 19/04/1978 0 2
- 0 - 0 - 0 - 0 549400 212000 0
1 0 0 0 DWI PUJI RAHAYU, NY 069592 43 15944 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344540
1#0##0#0#0.0#2021-12-16
08:10:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b25a834798387e4bdb1da550ba4c1999 150000 0 0 0 0 0
0 0 0 0 15000 0 47000 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 19/02/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 209598
0 1 0 0 0 WIWIK ASTUTI.NY 089427 63 23308 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344541
1#0##0#0#0.0#2021-12-16
08:11:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a66f527d75acfa3445b5c9256fc92d3a 150000 0 0 0 0 0
0 31845 0 0 15000 0 12753 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 12/06/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 312570
0 1 0 0 0 SRI BAGIONO PURWOATMOJO, TN 048729 70
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344542
1#0##0#0#0.0#2021-12-16
08:14:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3efd5b3bc5141db248e29b5fdc651d91 150000 0 0 0 0 0
0 89050 0 0 15000 0 58520 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 27/07/1950 0 1
0 404900 521812 0 1 0 0 0 H. BEKTI KAREBET,
TN 099894 71 26072 DR. WAHYU PURNOMO, SP.OT 1124R0021221V002029
0001800750519 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344543 1#0##0#0#0.0#2021-12-16
08:15:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fa767e8282150279182e2f32a704d6dd 150000 0 0 0 0 0
0 133650 0 0 15000 0 223162 0 0 0 0
0
3372030 C 3 CP 2 13/12/2021 13/12/2021 30/01/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 367705
0 1 0 0 0 HARYANTO 092300 56 20771 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344544
1#0##0#0#0.0#2021-12-16
08:15:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
097d684807ae31488f97bdbb6c28ec41 150000 0 0 0 0 0
0 76045 0 0 15000 0 126660 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 31/12/1974 0 2
1 Z09.8;N20.0;N23 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 275970
0 1 0 0 0 MARWIYAH.NY 098614 46 17149 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344545
1#0##0#0#0.0#2021-12-16
08:16:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b17de8d698cc9d6080563e56ae64f731 150000 0 0 0 0 0
0 44750 0 0 15000 0 66220 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 20/03/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 326345
0 1 0 0 0 SUPARNI,(NY) 015342 62 22914 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344546
1#0##0#0#0.0#2021-12-16
08:17:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
52631347d90807a0d7e5d285cd29695c 150000 0 0 0 0 0
0 76045 0 0 15000 0 85300 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 14/07/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 446425
0 1 0 0 0 NUGRAHENI NUR ASMARA,(NN) 020978 48
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344547
1#0##0#0#0.0#2021-12-16
08:20:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
877d6a34dabdcdfd311b084fe8695e59 150000 0 0 0 0 0
0 76045 0 0 15000 0 205380 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 10/10/1940 0 1
0 0 - 0 - 0 - 0 - 0 181400 287977
0 1 0 0 0 M. SUHARDI, TN 000018 81 29649 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344548
1#0##0#0#0.0#2021-12-16
08:21:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6264b4158cae48bdee3a966bd81d8f6c 150000 0 0 0 0 0
0 76045 0 0 15000 0 46932 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 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; 5.5.5.202112011542 4
344504 1#0##0#0#0.0#2021-12-16
08:21:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fb2d340958c3a7fabd2182d5dd9cc2b0 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 10/11/1954 0 2
1 Z09.8;E11.4;G59.0;I11.9;E78.5;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 1068551 0 1 0 0 0 SUKARMI, NY 088197
0002051440784 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
347191 1#0##0#0#0.0#2022-01-05
16:04:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1b2ea82667bbbbe392edc5243068e4b4 150000 0 0 0 0 0
657000 121345 0 0 15000 0 125206 0 0 0
0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 31/07/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 520940
0 1 0 0 0 SRI LESTARI.NY 084455 56 20589 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344549
1#0##0#0#0.0#2021-12-16
08:22:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dc52a088163057a3ba5205bcd582f49c 150000 0 0 0 0 0
0 171170 0 0 15000 0 184770 0 0 0 0
0
3372030 C 3 CP 2 13/12/2021 13/12/2021 10/03/1924 0 1
1 Z09.8;E11.4;G59.0;N40 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 322701
0 1 0 0 0 SIKIR PADMOSOEKIRNO ,TN 053614 97 35707
yani;3302226402970001; 5.5.5.202112011542 4 344550
1#0##0#0#0.0#2021-12-16
08:23:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
814b15eed8c72adaa3c55d79e9a50409 150000 0 0 0 0 0
0 0 0 0 15000 0 157701 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 30/09/2015 0 1
1 Z09.8;S42.00;W19.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 328511
0 1 0 0 0 RAFAUZAN KAMIL MIODAD 041279 6 2266
novia;3313125201940001; 5.5.5.202112011542 4 346716
1#0##0#0#0.0#2022-01-05
16:04:49#0#00:00:00#00:00:00#13:02:58#{"co_insidense_ind":"0"} 1
463d5253a9858bdc98ca01e05d64a49a 300000 0 0 0 0 0
0 0 0 0 15000 0 13511 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 06/06/1974 0 2
1 H26.9;E11.3;H36.0;H11.0 90.29;16.21 - - None None None None
211200 0 0 - 0 - 0 - 0 - 0 211200
301975 0 1 0 0 0 UMI NAFIAH. NY 076253 47
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344551
1#0##0#0#0.0#2021-12-16
08:27:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0090a82d9cdcf70ca5c4036c3fb04f70 256000 0 0 0 0 0
0 0 0 0 15000 0 30975 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 06/07/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 199650
0 1 0 0 0 LELY TRI DARWATI.NY 083950 42 15501
yani;3302226402970001; 5.5.5.202112011542 4 344552
1#0##0#0#0.0#2021-12-16
08:28:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f4718e59048f5f9c60fbca35531dabc6 150000 0 0 0 0 0
0 0 0 0 15000 0 34650 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 18/08/1982 0 1
0 0 - 0 - 0 - 0 - 0 181400 211535
0 1 0 0 0 ENDRO PRASETYO, BP 085044 39 14362
yani;3302226402970001; 5.5.5.202112011542 4 344553
1#0##0#0#0.0#2021-12-16
08:29:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3aa60c4d46a40d4189c1a07c8f70fe6d 150000 0 0 0 0 0
0 31845 0 0 15000 0 14690 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 18/06/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 328802
0 1 0 0 0 SURATININGSIH, NY 097048 57 20997 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344554
1#0##0#0#0.0#2021-12-16
08:29:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
288a734276012d885b90e4c340231113 150000 0 0 0 0 0
0 63690 0 0 15000 0 100112 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 06/03/1954 0 2
1 Z09.8;I11.9;K30;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 231776
0 1 0 0 0 DARMINI, NY 087821 67 24754 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344555
1#0##0#0#0.0#2021-12-16
08:30:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
61d3914d7ba296e86feaec19ebddea1d 150000 0 0 0 0 0
0 0 0 0 15000 0 66776 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 12/12/1993 0 1
0 0 - 0 - 0 - 0 - 0 181400 519720
0 1 0 0 0 BELLA MARDIN.TN 095010 28 10228 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344556
1#0##0#0#0.0#2021-12-16
08:31:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a865616ec8437e63803db0fb789052bf 150000 0 0 0 0 0
0 0 0 0 15000 0 354720 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 06/10/1972 0 2
1 Z09.8;R07.4;J42 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 188663
0 1 0 0 0 SRI MANGESTI,NY 060253 49 17965 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344557
1#0##0#0#0.0#2021-12-16
08:32:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2e59ca3d2e249fc5b4109ce9c487fe03 150000 0 0 0 0 0
0 0 0 0 15000 0 23663 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 16/12/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 519720
0 1 0 0 0 ENDRO SUPRIYADI.,BP 053637 52 19355
yani;3302226402970001; 5.5.5.202112011542 4 344558
1#0##0#0#0.0#2021-12-16
08:33:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bcc3621293dc87ed8e8ef58040e30b5c 150000 0 0 0 0 0
0 0 0 0 15000 0 354720 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 11/08/1989 0 1
0 0 - 0 - 0 - 0 - 0 181400 267238
0 1 0 0 0 YUSUF SANDIYANTO.TN 096055 32 11812
yani;3302226402970001; 5.5.5.202112011542 4 344559
1#0##0#0#0.0#2021-12-16
08:34:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d3eede5e055a00e79c2b9b155b8dc18b 150000 0 0 0 0 0
0 0 0 0 15000 0 102238 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 26/05/1969 0 2
1 Z09.8;I10;C50.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 238991
0 1 0 0 0 TITIK SURYANTI.NY 093985 52 19194 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344560
1#0##0#0#0.0#2021-12-16
08:35:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
df268854772513d98720a111b0032090 150000 0 0 0 0 0
0 0 0 0 15000 0 73991 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 01/07/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 303645
0 1 0 0 0 NY.SRI HANTARI 073628 62 22811 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344561
1#0##0#0#0.0#2021-12-16
08:36:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
82b58efbc69374d347c9e98dce848086 150000 0 0 0 0 0
0 76145 0 0 15000 0 62500 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 17/07/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 244978
0 1 0 0 0 PANIJEM.NY 064795 69 25351 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344562
1#0##0#0#0.0#2021-12-16
08:37:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d7b9627f5b7a302d440414d4b5651d73 150000 0 0 0 0 0
0 0 0 0 15000 0 79978 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 09/05/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 241544
0 1 0 0 0 SRI LESTARI.NY 089278 66 24325 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344563
1#0##0#0#0.0#2021-12-16
08:38:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8576afe5eed661a245a2b171972ca487 150000 0 0 0 0 0
0 31845 0 0 15000 0 44699 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 20/04/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 205161
0 1 0 0 0 SARDJONO, TN 100224 63 23248 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344564
1#0##0#0#0.0#2021-12-16
08:39:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
90dac3222497fa907813106dff5f399b 150000 0 0 0 0 0
0 0 0 0 15000 0 40161 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 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
344506 1#0##0#0#0.0#2022-04-14
13:30:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
dad882966f305e149c08f5a4efee8476 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 07/07/1962 0 1
1 Z09.8;K30 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 200761
0 1 0 0 0 SARTO, TN 064381 59 21709 DR. TEKY
novia;3313125201940001; 5.6.7.202204241238 4 344565
1#0##0#0#0.0#2022-05-10
09:01:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 3
cc38e01e81e79c8af6770ba15fcb4d73 150000 0 0 0 0 0
0 0 0 0 15000 0 35761 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 01/09/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 213110
0 1 0 0 0 SAMBUDI,(BP) 037461 59 21653 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344566
1#0##0#0#0.0#2021-12-16
08:40:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
729a264a455bbd2a95c5cd7f917b0f85 150000 0 0 0 0 0
0 0 0 0 15000 0 48110 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 16/10/1991 0 2
0 0 - 0 - 0 - 0 - 0 296400 175150
0 1 0 0 0 IFFAH ARDIANI, NY 071935 30 11016 DR.
novia;3313125201940001; 5.6.3.202201201500 4 344567
1#0##0#0#0.0#2022-03-08
12:05:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
90a4a94668b2009fe837cd794001fa53 150000 0 0 0 0 0
0 0 0 0 15000 0 10150 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 29/01/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 332290
0 1 0 0 0 TRISNAWATI.NY 080671 42 15659 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344568
1#0##0#0#0.0#2021-12-16
08:42:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3cd2476e7391102263c5c4e524b6739d 150000 0 0 0 0 0
0 0 0 0 15000 0 167290 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 01/11/1986 0 2
1 Z35.8;O34.2;O14.1 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 204830
novia;3313125201940001; 5.6.3.202201201500 4 344569
1#0##0#0#0.0#2022-03-08
12:03:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
679a5d9c19f997b01f9966cc6e0790ca 150000 0 0 0 0 0
0 0 0 0 15000 0 39830 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 05/05/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 255063
0 1 0 0 0 NAFISAH.NY 097296 74 27251 DR. RETNO
yani;3302226402970001; 5.5.5.202112011542 4 344570
1#0##0#0#0.0#2021-12-16
08:59:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6abac693e9e8a13f5378a3173623706e 150000 0 0 0 0 0
0 0 0 0 15000 0 90063 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 28/01/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 480330
0 1 0 0 0 SUNARMI 007615 50 18582 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344571
1#0##0#0#0.0#2021-12-16
09:00:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bb03d961394a600e27985508c8d1f4d6 150000 0 0 0 0 0
0 49590 0 0 15000 0 265740 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 31/12/1996 0 2
0 0 - 0 - 0 - 0 - 0 181400 237096
yani;3302226402970001; 5.5.5.202112011542 4 344572
1#0##0#0#0.0#2021-12-16
09:01:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
521a6671c87237ed13d3b2e027acb294 150000 0 0 0 0 0
0 0 0 0 15000 0 72096 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 26/08/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 235944
0 1 0 0 0 LISTINA.NY 099402 58 21294 DR. RETNO
yani;3302226402970001; 5.5.5.202112011542 4 344573
1#0##0#0#0.0#2021-12-16
09:02:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cd107d92e673767fd036f070afbe492d 150000 0 0 0 0 0
0 0 0 0 15000 0 70944 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 22/08/1968 0 2
None None None None HEMATOLOGI AKUT 157700 0 0 - 0
- 0 - 0 - 0 157700 165000 0 1 0
0 0 SUGINEM.NY 100525 53 19471 DR. TEKY WIDYARINI, SP.PD
1124R0021221V002069 0001106698149 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344574 1#0##0#0#0.0#2021-12-16
09:03:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
56d1927873d910f468a9560908863c9a 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 31/12/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 280951
0 1 0 0 0 DAMIYATI, NY 093680 57 21167 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344575
1#0##0#0#0.0#2021-12-16
09:03:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9cf19271feaf674435e4ee60abd5796d 150000 0 0 0 0 0
0 76145 0 0 15000 0 39806 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 12/11/1963 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002169748091 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344507 1#0##0#0#0.0#2021-12-16
09:04:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
057523dc48d4e2c0159efaf42e42b74a 204000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 31/03/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 295777
0 1 0 0 0 ENDANG WAHYUNINGSIH.,NY 072454 52 19250
yani;3302226402970001; 5.5.5.202112011542 4 344576
1#0##0#0#0.0#2021-12-16
09:06:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0d07881be4dd10a006f4759de2d2972c 150000 0 0 0 0 0
0 0 0 0 15000 0 130777 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
344500 1#0##0#0#0.0#2021-12-16
09:06:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6ab735b2155257927e2ebc53ffcdccad 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 12/06/1968 0 2
1 Z09.8;E11.4;G59.0;M54.59 87.24 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
233780 0 1 0 0 0 BUDI WIJIJANI.NY 089191 53
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344577
1#0##0#0#0.0#2021-12-16
09:07:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a1dfb195840f193041882caad8dc99cc 150000 0 0 0 0 0
0 0 0 0 15000 0 68780 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 14/08/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 241720
0 1 0 0 0 WINARTIN.NY 086130 47 17288 DR. RETNO
yani;3302226402970001; 5.5.5.202112011542 4 344578
1#0##0#0#0.0#2021-12-16
09:08:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c8d50f08d2ab5409a9d090acc96c0bc2 150000 0 0 0 0 0
0 0 0 0 15000 0 76720 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 07/03/1996 0 1
0 0 - 0 - 0 - 0 - 0 181400 275109
0 1 0 0 0 DAWUD ABDUL MAJID.SDR 079840 25 9412
yani;3302226402970001; 5.5.5.202112011542 4 344579
1#0##0#0#0.0#2021-12-16
09:10:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ba2e8510c3b5d6c9e82b3adadb1d26b6 150000 0 0 0 0 0
0 0 0 0 15000 0 110109 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 07/06/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 333825
yani;3302226402970001; 5.5.5.202112011542 4 344580
1#0##0#0#0.0#2021-12-16
09:11:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
831760bb1704b263d24993bbc6cefb1d 150000 0 0 0 0 0
0 0 0 0 15000 0 168825 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 19/04/1999 0 2
0 - 0 - 0 - 0 183900 465657 0 1
0 0 0 SANIA MADASAFURA, NN 098569 22 8274 DR. DAMAR
5.5.5.202112011542 4 344581 1#0##0#0#0.0#2021-12-16
09:12:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6abaca41ef7c4a925d0229fee9ff9614 235000 0 0 0 0 0
0 0 0 0 15000 0 215657 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 10/06/1973 0 2
1 Z09.8;H40.9;Z96.1;E11.3;H36.0 90.29 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
414072 0 1 0 0 0 MISA AYUNINGTYAS, NY 053406
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09:13:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.5.5.202112011542 4 344522
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09:15:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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09:34:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 13/12/2021 13/12/2021 18/04/1956 0 2
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09:45:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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yani;3302226402970001; 5.5.5.202112011542 4 344525
1#0##0#0#0.0#2021-12-16
09:46:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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09:47:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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09:50:37#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#2021-12-16
09:52:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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09:54:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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09:57:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 13/12/2021 13/12/2021 31/12/1971 0 2
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09:59:03#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#2021-12-16
09:59:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 13/12/2021 13/12/2021 30/12/1954 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 344589
1#0##0#0#0.0#2021-12-16
10:01:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 13/12/2021 13/12/2021 18/05/1940 0 1
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10:02:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 13/12/2021 13/12/2021 02/09/1998 0 1
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10:02:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 13/12/2021 13/12/2021 20/01/1962 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 344592
1#0##0#0#0.0#2021-12-16
10:03:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 13/12/2021 13/12/2021 21/01/1983 0 2
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1#0##0#0#0.0#2021-12-16
10:04:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 13/12/2021 13/12/2021 28/04/1954 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 344594
1#0##0#0#0.0#2021-12-16
10:05:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 13/12/2021 13/12/2021 15/10/1958 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 344595
1#0##0#0#0.0#2021-12-16
10:07:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.5.5.202112011542 4 344596
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10:08:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 13/12/2021 13/12/2021 06/02/1997 0 2
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3372030 C 3 CP 2 13/12/2021 13/12/2021 02/03/1972 0 2
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10:09:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 13/12/2021 13/12/2021 06/06/1950 0 1
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10:10:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 13/12/2021 13/12/2021 12/10/1966 0 1
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0 0 - 0 - 0 - 0 - 0 181400 276680
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novia;3313125201940001; 5.6.3.202201201500 4 344600
1#0##0#0#0.0#2022-03-08
07:58:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
0ca0a430c745df5c768d6b5321634eca 254000 0 0 0 0 0
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3372030 C 3 CP 2 13/12/2021 13/12/2021 26/10/1981 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 344601
1#0##0#0#0.0#2021-12-16
10:12:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 13/12/2021 13/12/2021 16/11/1978 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 344602
1#0##0#0#0.0#2021-12-16
10:13:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 13/12/2021 13/12/2021 20/05/1988 0 2
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10:16:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 13/12/2021 13/12/2021 10/05/1973 0 2
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10:19:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 13/12/2021 13/12/2021 22/09/1959 0 1
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08:09:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 13/12/2021 13/12/2021 25/12/1954 0 2
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13:45:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 13/12/2021 13/12/2021 22/08/1947 0 2
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1#0##0#0#0.0#2022-01-05
16:14:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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10:23:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 13/12/2021 13/12/2021 30/08/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 217632
0 1 0 0 0 SUTARDI.TN 093260 61 22385 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 344609
1#0##0#0#0.0#2021-12-16
10:26:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
513ed63c002cd4d5e548151a25ea2e2f 150000 0 0 0 0 0
0 0 0 0 15000 0 52632 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 27/11/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 226402
0 1 0 0 0 NGATIYEM,NY 084267 60 21931 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 344610
1#0##0#0#0.0#2021-12-16
10:27:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
34801d15a9521ef546f6480590587b55 150000 0 0 0 0 0
0 0 0 0 15000 0 61402 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 20/06/1943 0 2
0 0 - 0 - 0 - 0 - 0 181400 204910
0 1 0 0 0 HARTINI.NY 079458 78 28666 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 344611
1#0##0#0#0.0#2021-12-16
10:28:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8d796b4952676cbaaa5822ce5a67de0b 150000 0 0 0 0 0
0 0 0 0 15000 0 39910 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 20/07/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 219972
0 1 0 0 0 SRI YULIATI.NY 080565 59 21696 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344612
1#0##0#0#0.0#2021-12-16
10:29:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
95a5b8bb3de443c3ca4aa6c5817ddfa3 150000 0 0 0 0 0
0 0 0 0 15000 0 54972 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 14/05/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 224642
0 1 0 0 0 M. KRISTIANAWATI, NY 092163 63 23224
yani;3302226402970001; 5.5.5.202112011542 4 344613
1#0##0#0#0.0#2021-12-16
10:30:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8e8d46f61a4b89e0b1f08086d7de525f 150000 0 0 0 0 0
0 0 0 0 15000 0 59642 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 27/10/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 234674
0 1 0 0 0 HARYONO ABUBAKAR.TN 098618 71 25980
agung;3313092303950002; 5.6.6.202203301209 4 344614
1#0##0#0#0.0#2022-04-14
13:42:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
20c16f9d9bdd82ca02dc23135604d5a7 150000 0 0 0 0 0
0 0 0 0 15000 0 69674 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 20/05/1946 0 1
0 0 - 0 - 0 - 0 - 0 181400 221855
0 1 0 0 0 MUHADI,(BP) 011312 75 27601 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344615
1#0##0#0#0.0#2021-12-16
10:33:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
722898532c1d39e6733835386034a83b 150000 0 0 0 0 0
0 31845 0 0 15000 0 25010 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 11/10/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 470081
0 1 0 0 0 RIZKY TEGAR,(AN) 002391 19 7003 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344616
1#0##0#0#0.0#2021-12-16
10:34:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e72027dc01db99eb5362de8a9ce0866d 150000 0 0 0 0 0
248000 0 0 0 15000 0 57081 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
344508 1#0##0#0#0.0#2021-12-16
10:35:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
12235ae6ef5fcf6844a4b821427c6a70 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 19/08/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 DJOKO PRAPTONO, TN
0000089786147 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344510 1#0##0#0#0.0#2021-12-16
10:36:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
19eec2f854bc86328d1ea31fd9f4b548 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 12/09/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 201154
0 1 0 0 0 SLAMET,(NY) 036944 76 27851 DR. RETNO
novia;3313125201940001; 5.6.0.202201041418 4 344617
1#0##0#0#0.0#2022-01-07
15:53:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
211e26d891b9c11dc5a9cb0980f7be9a 150000 0 0 0 0 0
0 0 0 0 15000 0 36154 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 12/12/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 204260
0 1 0 0 0 PARDJONO.TN 100029 72 26299 DR. INDRIANY
yani;3302226402970001; 5.5.5.202112011542 4 344618
1#0##0#0#0.0#2021-12-16
10:40:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d8cd824507191c06f5e6fffb1a7d4c17 150000 0 0 0 0 0
0 0 0 0 15000 0 39260 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 27/08/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 175560
0 1 0 0 0 MARSINI ENDANG ERAWATI ., NY 055764 51
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344619
1#0##0#0#0.0#2021-12-16
10:41:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
23b8bb6564faec2c251e2c0d348014f5 150000 0 0 0 0 0
0 0 0 0 15000 0 10560 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 17/04/1970 0 2
1 Z09.0;C50.9 93.57 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 249865 0 1
0 0 0 SRI FADILAH, NY 100313 51 18868 DR. HERMAWAN, SP.B
1124R0021221V002143 0001530476932 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344620 1#0##0#0#0.0#2021-12-16
10:42:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
19fb92988fd2fddcf966b4aebda5105e 150000 0 0 0 0 0
0 0 0 0 15000 0 84865 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 09/08/1992 0 1
0 - 0 - 0 - 0 183900 338730 0 1
0 0 0 KUKUH PARSETIAWAN. SDR 090802 29 10718 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344621
1#0##0#0#0.0#2021-12-16
10:43:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6125501272972911f524d9b3fd5ec05b 271000 0 0 0 0 0
0 0 0 0 15000 0 52730 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 24/09/1974 0 1
0 0 - 0 - 0 - 0 - 0 181400 542190
0 1 0 0 0 JAPANDI HENRY CHRISTIANTO, BP 068974 47
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344622
1#0##0#0#0.0#2021-12-16
10:45:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
590dba8f71e994ddf7430398134552bc 150000 0 0 0 0 0
0 0 0 0 15000 0 377190 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 01/06/1960 0 1
0 - 0 - 0 - 0 183900 276255 0 1
0 0 0 SUTRISNO 093922 61 22475 DR. HERMAWAN, SP.B
1124R0021221V002146 0002291848931 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344623 1#0##0#0#0.0#2021-12-16
10:46:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1037c8d61b6ce1648ea71282bd890529 235000 0 0 0 0 0
0 0 0 0 15000 0 26255 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 24/09/1991 0 2
0 - 0 - 0 - 0 183900 191070 0 1
0 0 0 ENGGAR SETYANINGRUM.NY 100182 30 11038 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344625
1#0##0#0#0.0#2021-12-16
10:46:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
408a7b0ec2d0235332d047915170cf36 150000 0 0 0 0 0
0 0 0 0 15000 0 26070 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 25/06/1966 0 2
0 - 0 - 0 - 0 - 0 549400 929750
0 1 0 0 0 WAHYUNI TRI SUSANTI 092680 55 20260
agung;3313092303950002; 5.6.6.202203301209 4 347194
1#0##0#0#0.0#2022-04-14
13:31:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
f35b4d051a9eb290763b8e2c7798a588 235000 0 0 0 0 0
657000 0 0 0 15000 0 22750 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 31/12/1935 0 2
1 Z09.8;E11.5;D64.8 93.57 - - None None None None Z-3-27-0
- 0 - 0 - 0 - 0 183900 377330 0
1 0 0 0 SUTIYEM.NY 100591 85 31394 DR. HERMAWAN, SP.B
1124R0021221V002149 0000640535455 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344626 1#0##0#0#0.0#2021-12-16
10:48:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
508004cf7cc17609cc36834b3e467f23 235000 0 0 0 0 0
0 76145 0 0 15000 0 51185 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 12/12/1987 0 2
0 - 0 - 0 - 0 183900 178155 0 1
0 0 0 KUSTIANI.NN 100160 34 12420 DR. HERMAWAN, SP.B
1124R0021221V002150 0001527801219 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344627 1#0##0#0#0.0#2021-12-16
10:50:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b5ad30e96ff496f931bd883359ad814d 150000 0 0 0 0 0
0 0 0 0 15000 0 13155 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 18/10/1986 0 2
- 0 - 0 - 0 - 0 549400 236120 0
1 0 0 0 NANIK SUNDARI, NY 091842 35 12840 DR. DEWI
yani;3302226402970001; 5.5.5.202112011542 4 344628
1#0##0#0#0.0#2021-12-16
10:51:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
31841ba2e26eccc31d368327989d48d6 200000 0 0 0 0 0
0 0 0 0 15000 0 21120 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 31/12/1928 0 2
1 Z09.8;J32.0;H93.1 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 285825
0 1 0 0 0 SUWARNI. NY 099221 92 33950 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344629
1#0##0#0#0.0#2021-12-16
10:51:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
769bb7c3a68eb9626d308e754d56d2f2 150000 0 0 0 0 0
0 0 0 0 15000 0 120825 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 27/07/1985 0 2
0 0 - 0 - 0 - 0 - 0 181400 467152
0 1 0 0 0 BERNIKE RINA PUSPITA SARI, NY 069517 36
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344630
1#0##0#0#0.0#2021-12-16
10:54:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bdf7069a58c02ec5ebf243f13cdd7bae 150000 0 0 0 0 0
248000 0 0 0 15000 0 54152 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 24/05/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ENDANG RAHUNI
MURDANINGSIH,(NY) 005290 51 18831 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V002154 0001281367956 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344509 1#0##0#0#0.0#2021-12-16
10:54:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5941a103b20c483926a0d7bc2915f0c0 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 04/11/2003 0 2
0 0 - 0 - 0 - 0 - 0 181400 236954
0 1 0 0 0 NOVIA YUDHA ARISANTI., NN 046280 18
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344631
1#0##0#0#0.0#2021-12-16
10:57:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
709de5edec2b7c2d5074ee4c5511a4a0 150000 0 0 0 0 0
0 0 0 0 15000 0 71954 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 24/12/1999 0 2
0 0 - 0 - 0 - 0 - 0 181400 241016
0 1 0 0 0 ZANNUBA NUR RAMADHANI.NN 082566 21
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344632
1#0##0#0#0.0#2021-12-16
10:58:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
451e79000b48c338ca08cfe6a54c15d6 150000 0 0 0 0 0
0 0 0 0 15000 0 76016 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 19/02/1965 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DANU MARGONO.,BP
0000640154136 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344501 1#0##0#0#0.0#2021-12-16
11:01:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c4dc7a64d747ed931569a4ddbf652edb 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 16/06/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 385406
0 1 0 0 0 SUHARNI.NY 057461 56 20634 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344633
1#0##0#0#0.0#2021-12-16
11:02:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
79e0d7eb19876797760ba25eb3e3bed1 150000 0 0 0 0 0
0 76045 0 0 15000 0 144361 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 02/01/1970 0 1
1 H11.0;H26.9;H04.1 90.29 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 414470
0 1 0 0 0 MUH DAROJAT., BP 001091 51 18973 DR.
novia;3313125201940001; 5.6.3.202201201500 4 344634
1#0##0#0#0.0#2022-02-14
12:47:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
5e905f8305732560420fc5feafbc98d6 203000 0 0 0 0 0
0 165495 0 0 15000 0 30975 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 15/09/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 441070
0 1 0 0 0 ARBINGAH.NY 100271 55 20178 DR. DAMAR
5.5.5.202112011542 4 344635 1#0##0#0#0.0#2021-12-16
11:04:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e39a3cfa885c007e9556ba1b1eada16f 421000 0 0 0 0 0
0 0 0 0 15000 0 5070 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
344499 1#0##0#0#0.0#2021-12-16
11:19:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
11594b19430a86ca63be120f26e917fa 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 21/07/1994 0 1
0 0 - 0 - 0 - 0 - 0 181400 280485
0 1 0 0 0 GILANG MAHARDIKA, TN 065719 27 10007
yani;3302226402970001; 5.5.5.202112011542 4 344636
1#0##0#0#0.0#2021-12-16
11:20:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
845502bac50b9a1160f8cf8487fd27ba 150000 0 0 0 0 0
0 0 0 0 15000 0 115485 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 08/02/2004 0 2
- 0 - 0 - 0 - 0 549400 233510 0
1 0 0 0 BELINDA MARSYA ADILLA.NN 100614 17 6518
DR. DEWI ANGGOROWATI, SP.OG 1124R0021221V002167 0001100686555 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 344637
1#0##0#0#0.0#2021-12-16
11:21:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9e7197c660d5c633e3003c09c6d78de3 150000 0 0 0 0 0
0 0 0 0 25000 0 58510 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 31/12/1968 0 1
1 Z09.8;K21.9 87.49 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 409976
0 1 0 0 0 BUDI SISWANTO. TN 051253 52 19340 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344638
1#0##0#0#0.0#2021-12-16
11:22:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f095bc60a4b3d547c33d4c72c57aa9a3 150000 0 0 0 0 0
200000 0 0 0 15000 0 44976 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 23/10/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 410191
0 1 0 0 0 SUHARTINI, NY 085146 60 21966 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344640
1#0##0#0#0.0#2021-12-16
11:23:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6a4a3fdc1f9032580ef13e7715b57e40 150000 0 0 0 0 0
0 0 0 0 15000 0 245191 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 02/08/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SITI MAJIAH, NY
0000639393467 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
344502 1#0##0#0#0.0#2022-04-14
13:33:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
bf04333e3c7e891147a974413d5b5410 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 21/02/1997 0 1
0 0 - 0 - 0 - 0 - 0 181400 193540
0 1 0 0 0 PUTRA FEBRIANTO, SDR 092855 24 9058
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344641
1#0##0#0#0.0#2021-12-16
11:27:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a6562e37dc97deb4574ee664f4e9dc1c 150000 0 0 0 0 0
0 0 0 0 15000 0 28540 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 11/03/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 196102
0 1 0 0 0 SURATNO ,(TN) 043581 52 19270 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344642
1#0##0#0#0.0#2021-12-16
11:29:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
84637c7dec5f6fbf35b19d9f4d1d1877 150000 0 0 0 0 0
0 0 0 0 15000 0 31102 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 01/05/1967 0 1
0 - 0 - 0 - 0 - 0 181400 227985
0 1 0 0 0 SUROSO.TN 081708 54 19950 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344645
1#0##0#0#0.0#2021-12-16
12:53:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a6009e917cd4937ebc517df88fcba979 150000 0 0 0 0 0
0 0 0 0 15000 0 62985 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 29/09/1999 0 2
2 T81.4;W01.0 - - - 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 165000
0 1 0 0 0 DIA PUSPITA SARI 089184 22 8111 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344643
1#0##0#0#0.0#2021-12-16
11:43:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0897eec49606d6dc278243aa4a1a477b 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 17/02/2006 0 1
1 S52.50;W01.0 - - - None None None None Q-5-31-0
0 - 0 - 0 - 0 129600 227670 0 1
0 0 0 FAUZAN MUHAMMAD ANNIZAR.AN 100619 15 5778 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344644
1#0##0#0#0.0#2021-12-16
11:49:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f6eb5de42311920282f21c72d50ed188 150000 0 0 0 0 0
0 0 0 0 25000 0 52670 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 23/05/1970 0 1
0 - 0 - 0 - 0 183900 208010 0 1
0 0 0 MUHAMMAD ILHAM ALBARI.TN 100015 51 18832 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344646
1#0##0#0#0.0#2021-12-16
12:55:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3b11409355c343f1693b132ed8429fcc 150000 0 0 0 0 0
0 0 0 0 15000 0 43010 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 09/03/1969 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V002179 0001105068789 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344513 1#0##0#0#0.0#2021-12-16
12:59:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e2cc498d114293c0460cfa327eedc2d0 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 09/05/1975 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V002180 0001105378571 3;JKN agung;3313092303950002;
5.6.3.202201201500 4 344512 1#0##0#0#0.0#2022-02-18
15:24:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
3f11e55ae8ccf2494eebcbc8c669feff 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 30/09/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 214752
0 1 0 0 0 ERNA SETYOWATI, NY 001117 44 16145
yani;3302226402970001; 5.5.5.202112011542 4 344647
1#0##0#0#0.0#2021-12-16
13:02:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
137d2b300d2c16af00adebd77b981268 150000 0 0 0 0 0
0 0 0 0 15000 0 49752 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 12/07/1966 0 1
0 - 0 - 0 - 0 786200 677676 0 1
yani;3302226402970001; 5.5.5.202112011542 4 344514
1#0##0#0#0.0#2021-12-16
13:05:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
82f6dac03b52538a7ee42f5341f1edb4 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 12/12/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 344515
1#0##0#0#0.0#2021-12-16
13:05:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8321b4383d30e7c4249bdf4074dfb961 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 22/10/1959 0 2
0 - 0 - 0 - 0 786200 688366 0 1
yani;3302226402970001; 5.5.5.202112011542 4 344516
1#0##0#0#0.0#2021-12-16
13:06:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ce4d9fc902e8744ea10110a4bd8dd08f 662676 0 0 0 0 0
0 0 0 0 15000 0 10690 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 28/02/1967 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 344517
1#0##0#0#0.0#2021-12-16
13:07:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
415973ebcef3f25d3fa3c980016b2cc5 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 12/08/1977 0 1
0 - 0 - 0 - 0 786200 677676 0 1
yani;3302226402970001; 5.5.5.202112011542 4 344518
1#0##0#0#0.0#2021-12-16
13:07:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
52e2785afc1093779e7113346cb4f0b9 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 03/08/1963 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 344519
1#0##0#0#0.0#2021-12-16
13:08:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9cbbdc02877246ec44c08fb82ec92a2a 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 01/07/1936 0 1
0 0 - 0 - 0 - 0 - 0 128800 412850
0 1 0 0 0 CITRO WARDOYO.TN 097628 85 31211 DR.
reni;3313147010930001; 5.6.0.202201041418 4 347195
1#0##0#0#0.0#2022-01-07
19:54:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
d72648a3205543dd57cc9cd2f4ccb266 150000 0 0 0 0 0
200000 0 0 0 15000 0 47850 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 30/01/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 219344
0 1 0 0 0 WAHYUNI.NY 082555 55 20406 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 344648
1#0##0#0#0.0#2021-12-16
13:09:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
867c9335bf83c1789786fe9543cd2c2d 150000 0 0 0 0 0
0 0 0 0 15000 0 54344 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 03/07/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 448687
0 1 0 0 0 MARYATI, NY 100652 60 22078 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 344649
1#0##0#0#0.0#2021-12-16
13:10:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a07c6b322bc8b2f657ccb262ebe2e2aa 150000 0 0 0 0 0
220000 0 0 0 15000 0 63687 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 15/05/1991 0 2
- 0 - 0 - 0 - 0 135700 311354 0
1 0 0 0 MEI LYANAWATI, NY 034439 30 11170 DR. GRETHA
ADITYASTUTI 1124R0021221V002195 0001032592331 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346658 1#0##0#0#0.0#2022-01-04
14:28:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
34e3e10dc52ef7c9fc831f5114ca038c 195000 0 0 0 0 0
0 0 0 0 15000 0 101354 0 0 0 0 0
3372030 C 3 CP 2 13/12/2021 13/12/2021 11/08/1991 0 2
1 S93.4;W01.0;R51 88.27 - - 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 650204
0 1 0 0 0 SHINTA AJENG BINTARI,(NN) 037898 30
11082 DR. GRETHA ADITYASTUTI 1124R0021221V002197 0001105911191 3;JKN
novia;3313125201940001; 5.5.5.202112011542 4 346659
1#0##0#0#0.0#2022-01-04
14:28:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
664cdabd0296839cf8d0ca5c0e24ac08 245000 0 0 0 0 0
248000 0 0 0 15000 0 142204 0 0 0 0
0
3372030 C 3 CP 2 14/12/2021 14/12/2021 11/09/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 322225
0 1 0 0 0 JOKO NUGROHO.TN 100319 55 20183 DR.
novia;3313125201940001; 5.5.5.202112011542 4 344676
1#0##0#0#0.0#2021-12-20
13:49:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5264d0382159acdaae6d51e055e2bf4e 150000 0 0 0 0 0
0 120795 0 0 15000 0 36430 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 31/12/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 196450
0 1 0 0 0 TEGUH HARDOJO., BP 047809 64 23724
novia;3313125201940001; 5.6.3.202201201500 4 344677
1#0##0#0#0.0#2022-03-08
08:29:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
6347b8109e1e756ecea8a809c9662a4c 150000 0 0 0 0 0
0 0 0 0 15000 0 31450 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 28/05/1975 0 2
1 Z09.8;E11.9;M72.28;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 418632 0 1 0 0 0 MARIA
SAPTININGSIH.NY 099116 46 17002 DR. SUHARTO, SP.PD
1124R0021221V002209 0001656771006 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 347228 1#0##0#0#0.0#2022-01-05
16:21:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d4f10002ba4231315d25e22ac673cae0 344000 0 0 0 0 0
0 31845 0 0 15000 0 27787 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 17/09/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 326685
0 1 0 0 0 Tumiyem,Ny 041905 59 21638 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344678
1#0##0#0#0.0#2021-12-21
10:30:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b383164f46f5d5d0b83d19917434f0de 150000 0 0 0 0 0
0 0 0 0 15000 0 161685 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 23/07/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 541892
0 1 0 0 0 SARTONO.TN 098856 48 17676 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344679
1#0##0#0#0.0#2021-12-21
10:31:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bdeea2afe2d7cbe33e18864d70f7bbc2 150000 0 0 0 0 0
0 0 0 0 15000 0 376892 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 13/10/2005 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 AFIFAH NUR HIDAYAH.NN 100516 16 5906
yani;3302226402970001; 5.5.5.202112011542 4 344680
1#0##0#0#0.0#2021-12-21
10:33:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5f252bf9f3e6137a3bccf8a72c2311d1 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 01/10/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 225097
0 1 0 0 0 SUDIYANA,TN 000468 58 21259 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 344681
1#0##0#0#0.0#2021-12-21
10:34:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9fc79f784940d08047f5f8d01328fcad 150000 0 0 0 0 0
0 0 0 0 15000 0 60097 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 30/09/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 310212
0 1 0 0 0 PARNI., NY 050989 61 22355 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344682
1#0##0#0#0.0#2021-12-21
10:34:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ef9214ffcd3b05538b739739f80317cd 150000 0 0 0 0 0
0 0 0 0 15000 0 145212 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 24/04/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 211542
0 1 0 0 0 PUJINEM,NY 074525 49 18131 DR. RINA
5.5.5.202112011542 4 344683 1#0##0#0#0.0#2021-12-21
10:36:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
96c4d6092202df9ccf5fa5c83f694c94 150000 0 0 0 0 0
0 0 0 0 15000 0 46542 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 31/08/1998 0 2
0 0 - 0 - 0 - 0 - 0 181400 230347
0 1 0 0 0 RARAS DANASTRI 083059 23 8506 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344685
1#0##0#0#0.0#2021-12-21
10:37:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c9842abafec2391276a19049122b2dd7 150000 0 0 0 0 0
0 0 0 0 15000 0 65347 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 31/05/1972 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ENDANG HARSO SRI
1124R0021221V002218 0000639771715 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344882 1#0##0#0#0.0#2021-12-21
10:38:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5cb6e3ca6faed25165264c66ea860494 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 08/01/1965 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
288285 0 1 0 0 0 SRI SAMSINI.NY 099962 56
yani;3302226402970001; 5.5.5.202112011542 4 344686
1#0##0#0#0.0#2021-12-21
10:39:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
70b2f33b7aba55d29c1f854dcf65cb98 150000 0 0 0 0 0
0 31845 0 0 15000 0 91440 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 25/10/1969 0 2
1 Z09.8;I25.9 88.72 - - None None None None I-3-13-0 None
None None None None None PROSEDUR EKOKARDIOGRAFI 315000 0 0
- 0 - 0 - 0 - 0 315000 347520 0
1 0 0 0 SUWARNI.NY 087525 52 19043 DR. GALIH RAKASIWI
SOEKARNO,SP.JP 1124R0021221V002220 0002205741431 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 344687
1#0##0#0#0.0#2021-12-21
10:40:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
92a072428d2a04f24f8b99a9ad4c120b 300000 0 0 0 0 0
0 0 0 0 15000 0 32520 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 10/08/1954 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
322182 0 1 0 0 0 SRI SUYATMI.NY 081082 67
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344690
1#0##0#0#0.0#2021-12-21
10:57:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
66b270f565be632be145953decca2994 150000 0 0 0 0 0
0 0 0 0 15000 0 157182 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 12/05/1960 0 1
1 Z09.8;I11.9;E11.4;G59.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 225660
0 1 0 0 0 SUWARSO.TN 100320 61 22496 DR. SUHARTO,
SP.PD 1124R0021221V002222 0002420994914 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344691 1#0##0#0#0.0#2021-12-21
11:01:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
15f62997bf061ee498d3ab063c2ea3bc 150000 0 0 0 0 0
0 0 0 0 15000 0 60660 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 24/06/1957 0 2
0 - 0 - 0 - 0 - 0 549400 850161
0 1 0 0 0 ERMA NUNINGSIH.,NY 052662 64 23549
novia;3313125201940001; 5.5.5.202112011542 4 347227
1#0##0#0#0.0#2022-01-05
16:20:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7dd07e2e9370bf7a6d6ac06a1d0b9c92 150000 0 0 0 0 0
657000 0 0 0 15000 0 28161 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 17/12/1984 0 2
0 0 - 0 - 0 - 0 - 0 181400 382570
0 1 0 0 0 ROSITA CANDRAKIRANA. NY 092784 36 13511
yani;3302226402970001; 5.5.5.202112011542 4 344692
1#0##0#0#0.0#2021-12-21
11:04:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
07e220efbc95b45cab95c302b3ea2850 150000 0 0 0 0 0
0 105700 0 0 15000 0 111870 0 0 0 0
0
3372030 C 3 CP 2 14/12/2021 14/12/2021 10/11/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 192140
0 1 0 0 0 UMI HANIFAH, NY 085103 58 21219 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344693
1#0##0#0#0.0#2021-12-21
11:05:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e599ac18c21beb6bd0ce62809fceb46c 150000 0 0 0 0 0
0 0 0 0 15000 0 27140 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 16/07/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 433455
0 1 0 0 0 TRI BUDIATI, NY 076747 61 22431 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344695
1#0##0#0#0.0#2021-12-21
11:05:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dbbea736e2c8979fccf365b4ff21398a 150000 0 0 0 0 0
0 31845 0 0 15000 0 236610 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 05/02/1943 0 2
1 Z09.8;I10;R51;G62.8;E78.5 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
179761 0 1 0 0 0 CHRISTINA SURATMI.NY 084460
0001446946986 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344858 1#0##0#0#0.0#2021-12-21
11:13:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bf4b0fce33c22e3f6159a4dc0a63d3e6 150000 0 0 0 0 0
0 0 0 0 15000 0 14761 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 06/05/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400
1252181 0 1 0 0 0 BAMBANG SUTOPO, (BP) 001186
0001104109896 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344696 1#0##0#0#0.0#2021-12-21
11:14:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7b6044fac0e018bd4b3d648b8d3b2c75 150000 0 0 0 0 0
0 76595 0 0 15000 0 1010586 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 15/04/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 395755
0 1 0 0 0 SUPRIHATIN , NY 042953 42 15584 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344697
1#0##0#0#0.0#2021-12-21
11:15:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b25d7f2645eba9966ed4d782a68f4617 150000 0 0 0 0 0
0 88900 0 0 15000 0 141855 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 26/06/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 212561
0 1 0 0 0 YOHANES ISMU WIDJARTO.TN 085343 67
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344698
1#0##0#0#0.0#2021-12-21
11:18:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e8d9b774c6566af3bbbefac041195ee6 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 18/05/1946 0 2
0 0 - 0 - 0 - 0 - 0 181400 246667
0 1 0 0 0 TITIEK SUMARWATI, NY 100532 75 27604
yani;3302226402970001; 5.5.5.202112011542 4 344699
1#0##0#0#0.0#2021-12-21
11:23:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
31fc0a8366a0e2f8423567decacc756e 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 26/03/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 268415
0 1 0 0 0 NAWA HAPSARI.NY 080742 54 19987 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344700
1#0##0#0#0.0#2021-12-21
12:56:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0626a4df006f9146f98c508762190881 150000 0 0 0 0 0
0 31845 0 0 15000 0 71570 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 17/12/1974 0 2
1 Z09.8;I10;E78.5 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 243330
0 1 0 0 0 SITI MARSANAH.NY 095887 46 17164 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344703
1#0##0#0#0.0#2021-12-21
12:59:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9c0f1a3fff87f52fd7ba8e1c301d078c 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 17/08/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 536970
0 1 0 0 0 MULYANI, (NY) 002898 51 18747 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344953
1#0##0#0#0.0#2021-12-21
13:01:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8ef6508e2ef6285db962978191ac747f 150000 0 0 0 0 0
0 63690 0 0 15000 0 308280 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 05/09/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 279639
0 1 0 0 0 WULANDARI,(NY) 016562 50 18363 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344954
1#0##0#0#0.0#2021-12-21
13:02:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b91c9f00fb5482e44f425ec9e5ebd59b 150000 0 0 0 0 0
0 88950 0 0 15000 0 25689 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 03/08/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 429871
0 1 0 0 0 SUKIRNO.,BP 052597 53 19491 DR. GALIH
yani;3302226402970001; 5.5.5.202112011542 4 344701
1#0##0#0#0.0#2021-12-21
12:57:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bc2488c6100584425f49065db6b8b857 300000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 31/12/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 205622
0 1 0 0 0 SRI SUWANTI, NY 091754 62 22994 DR.
agung;3313092303950002; 5.6.6.202203301209 4 344702
1#0##0#0#0.0#2022-04-14
13:30:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
6b6173a04d42807a3314c19980a1906b 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 06/05/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 335366
0 1 0 0 0 SUPRIHATIN, NY 095649 70 25790 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344689
1#0##0#0#0.0#2021-12-21
10:55:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a468ac54dee58025aaab591a1ae22381 300000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 07/03/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 306250
0 1 0 0 0 MINARTI., NY 045003 56 20736 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344955
1#0##0#0#0.0#2021-12-21
13:04:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
88630c2b38039c7b96a6025df0f239d1 150000 0 0 0 0 0
0 88900 0 0 15000 0 52350 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 19/07/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SITI WARSINI.NY
0001387776519 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344883 1#0##0#0#0.0#2021-12-21
13:05:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
60fd136a8cbd13ee773b028c887284ce 258000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 29/12/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 348023
0 1 0 0 0 DRA.SRI SUPADMINI, NY 064608 68 25187
yani;3302226402970001; 5.5.5.202112011542 4 344956
1#0##0#0#0.0#2021-12-21
13:06:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
36b03177fc61cb409ec9b517017b43a5 150000 0 0 0 0 0
0 0 0 0 15000 0 183023 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 05/09/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 485366
yani;3302226402970001; 5.5.5.202112011542 4 344958
1#0##0#0#0.0#2021-12-21
13:09:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
853c4333313097e935da13dc82efeaf8 400000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 18/08/1980 0 2
1 Z09.0;D24 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 345525
0 1 0 0 0 SITI MUKARRAMAH.NY 095071 41 15093
yani;3302226402970001; 5.5.5.202112011542 4 344960
1#0##0#0#0.0#2021-12-21
13:14:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f443cefe11f46cad3b05c1cf2931bf1d 235000 0 0 0 0 0
0 0 0 0 15000 0 95525 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 24/06/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 281840
0 1 0 0 0 HARYADI 16118 64 23549 DR. ZULFADLY, SP.B
1124R0021221V002247 0001105662565 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344961 1#0##0#0#0.0#2021-12-21
13:18:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ee691213ec2ca01e2716cc356708bf73 235000 0 0 0 0 0
0 0 0 0 15000 0 31840 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 10/06/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 229472
5.5.5.202112011542 4 344962 1#0##0#0#0.0#2021-12-21
13:20:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
456272c07a000e76d9bfa2106de08612 150000 0 0 0 0 0
0 0 0 0 15000 0 64472 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 09/10/2004 0 2
0 0 - 0 - 0 - 0 - 0 181400 359847
0 1 0 0 0 FAHRUNISA OKTANINGRUM.NN 099966 17
6275 DR. ZULFADLY, SP.B 1124R0021221V002250 0002169719043 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 344963
1#0##0#0#0.0#2021-12-21
13:21:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e65d748c309ac522abdc8bd35419da03 235000 0 0 0 0 0
0 0 0 0 15000 0 109847 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 13/06/1992 0 2
0 0 - 0 - 0 - 0 - 0 181400 200728
0 1 0 0 0 LUKI SABILLA WITTEVEEN,NN 069906 29
novia;3313125201940001; 5.6.3.202201201500 4 344964
1#0##0#0#0.0#2022-02-15
08:13:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
fc2f8c82b73679dd74a3a7e4b0693f47 150000 0 0 0 0 0
0 0 0 0 15000 0 35728 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 17/03/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 225372
0 1 0 0 0 SLAMETO, BP 087612 51 18900 DR. SUHARTO,
SP.PD 1124R0021221V002252 0001125846876 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344965 1#0##0#0#0.0#2021-12-21
13:23:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
16efbf2dfc57ac837a50ddba95a44b91 150000 0 0 0 0 0
0 0 0 0 15000 0 60372 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 31/12/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 196360
0 1 0 0 0 SLAMETO, TN 100099 76 28107 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344966
1#0##0#0#0.0#2021-12-21
13:24:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
575a0539f1524e9eb8709dafc7e8932b 150000 0 0 0 0 0
0 0 0 0 15000 0 31360 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 31/12/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 391830
0 1 0 0 0 DASINEM, NY 052283 57 21168 DR. SUHARTO,
SP.PD 1124R0021221V002254 0002042119629 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344967 1#0##0#0#0.0#2021-12-21
13:26:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d7a3164fd46a21a13bb95b49ccecc2b6 150000 0 0 0 0 0
0 31845 0 0 15000 0 194985 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 19/06/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 192840
0 1 0 0 0 YATMI.NY 099790 50 18441 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344968
1#0##0#0#0.0#2021-12-21
13:27:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ff2ae51b0c3db387f5eae696e4eece85 150000 0 0 0 0 0
0 0 0 0 15000 0 27840 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 03/07/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 LUCIA SRI
1124R0021221V002256 0000639909854 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344881 1#0##0#0#0.0#2021-12-21
13:29:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3b787ed9fb2c4cff32a66c5f6709ba02 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 11/05/1943 0 2
0 - 0 107400 262000 0 1 0 0 0
MURYATI.NY 094215 78 28707 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V002257 0000091214796 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344885 1#0##0#0#0.0#2021-12-21
13:30:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a5f1c6d0b32c8700628d9c8997ec7dc3 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 27/10/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 197301
0 1 0 0 0 HARYONO ABUBAKAR.TN 098618 71 25981
agung;3313092303950002; 5.6.6.202203301209 4 344969
1#0##0#0#0.0#2022-04-14
13:42:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
f3f2ec0f8549833b4c92f3af627c35dc 150000 0 0 0 0 0
0 0 0 0 15000 0 32301 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 01/01/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 250420
0 1 0 0 0 SRI HARTUTI.NY 094832 60 22262 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344971
1#0##0#0#0.0#2021-12-21
13:37:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d073c61e0cea3f71b16fc2d2dd803fa9 150000 0 0 0 0 0
0 0 0 0 15000 0 85420 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 06/04/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 355350
0 1 0 0 0 LESTARI.NY 084940 56 20706 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 344972
1#0##0#0#0.0#2021-12-21
13:40:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
18c73e21e4fffd718eb0892ee76cbada 150000 0 0 0 0 0
0 120795 0 0 15000 0 69555 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 20/10/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 BADRIYAH
1124R0021221V002261 0000091089088 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344886 1#0##0#0#0.0#2021-12-21
13:46:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
08f57ca91ba2b985e264c8e162d4d43c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 13/01/1982 0 2
1 Z09.8;O03.4 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 376090
0 1 0 0 0 GENDUK HARIYATI., NY 072199 39 14580
novia;3313125201940001; 5.5.5.202112011542 4 347229
1#0##0#0#0.0#2022-01-05
16:22:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
49652b41166b0ae2d5d0ca762c9fb8bc 350000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 24/10/1996 0 2
0 0 - 0 - 0 - 0 - 0 181400 260260
0 1 0 0 0 DESTA FARDITIA DORA T, NN 057532 25
9182 DR. GUNAWAN, SP.OG 1124R0021221V002263 0001269483985 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 344973
1#0##0#0#0.0#2021-12-21
13:48:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8e207607e97fe6a094310e79ff54bbcf 200000 0 0 0 0 0
0 0 0 0 15000 0 45260 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 07/01/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 280485
0 1 0 0 0 SUWARNO, TN 100356 61 22622 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344974
1#0##0#0#0.0#2021-12-21
13:51:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f6cd248fc6efb1f06b4d178166b04b35 150000 0 0 0 0 0
0 0 0 0 15000 0 115485 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 02/06/1943 0 2
0 0 - 0 - 0 - 0 - 0 181400 281385
0 1 0 0 0 DARMI.NY 098745 78 28685 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344975
1#0##0#0#0.0#2021-12-21
13:52:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4a568621afb76bbffa02cfe4819ec036 150000 0 0 0 0 0
0 0 0 0 15000 0 116385 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 11/09/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 281205
0 1 0 0 0 RIYANI, NY 100564 62 22740 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344976
1#0##0#0#0.0#2021-12-21
13:53:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4c459c7636e430dbb17cdbee5867143f 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 08/11/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 225312
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yani;3302226402970001; 5.5.5.202112011542 4 344977
1#0##0#0#0.0#2021-12-21
14:49:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
ee24f504bbdfc451063dcc89cfaf7fa2 150000 0 0 0 0 0
0 0 0 0 25000 0 50312 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 06/02/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 365000
yani;3302226402970001; 5.5.5.202112011542 4 344981
1#0##0#0#0.0#2021-12-22
07:20:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e27a29379797ee9a4d12f030d89dc919 150000 0 0 0 0 0
200000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 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; 5.5.5.202112011542 4
344884 1#0##0#0#0.0#2021-12-22
07:21:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1005adb23207bdff6df2d0bbead7a4ef 247000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 16/10/1994 0 1
0 0 - 0 - 0 - 0 - 0 181400 189696
0 1 0 0 0 ADITYAS DWINA HASTANTYA,SDR 094566 27
yani;3302226402970001; 5.5.5.202112011542 4 344982
1#0##0#0#0.0#2021-12-22
07:22:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d1df619393879358b273d0fa0d716b0c 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 15/05/1953 0 1
0 - 0 - 0 - 0 786200 590357 0 1
yani;3302226402970001; 5.5.5.202112011542 4 344901
1#0##0#0#0.0#2021-12-22
07:38:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
839fc1be3f6f6d04557c47a5afa7150a 463830 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 01/05/1975 0 1
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SP.PD 1124R0021221V002272 0001790328262 3;JKN yani;3302226402970001;
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07:39:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4bf9c451d4b5d158b417c382df5f5ea9 463830 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 08/03/1967 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 344902
1#0##0#0#0.0#2021-12-22
07:41:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 14/12/2021 14/12/2021 01/12/1980 0 2
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SP.PD 1124R0021221V002274 0000640230884 3;JKN yani;3302226402970001;
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3372030 C 3 CP 2 14/12/2021 14/12/2021 02/02/1971 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 344904
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08:26:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 14/12/2021 14/12/2021 25/03/1955 0 2
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16:23:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 14/12/2021 14/12/2021 26/04/1964 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 344905
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08:28:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 14/12/2021 14/12/2021 26/09/1950 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 344983
1#0##0#0#0.0#2021-12-22
08:32:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
26ac214c55344a63e0a1ffe7fbaaa4c7 300000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 29/08/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 249839
0 1 0 0 0 PURWANTI PUJIASTUTI.NY 094422 42 15448
yani;3302226402970001; 5.5.5.202112011542 4 344984
1#0##0#0#0.0#2021-12-22
08:33:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
31e092d50bef2ea63ac73ff2993b8b53 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 23/05/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 249057
0 1 0 0 0 MISIRAH .NY 048212 64 23581 DR. RINA
5.5.5.202112011542 4 344985 1#0##0#0#0.0#2021-12-22
08:35:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 14/12/2021 14/12/2021 18/12/1967 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 344987
1#0##0#0#0.0#2021-12-22
08:42:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 14/12/2021 14/12/2021 16/12/1956 0 1
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0002463219077 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344988 1#0##0#0#0.0#2021-12-22
08:46:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
86835c51ee8f5946bfb3e18a451efa21 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 14/03/2007 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 344989
1#0##0#0#0.0#2021-12-22
08:47:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bd4740f37edd5791df754ecc68a230cc 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 08/01/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 235700
0 1 0 0 0 SUMARHENI.NY 088876 59 21890 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344990
1#0##0#0#0.0#2021-12-22
08:50:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
95b8d213c6dd5ca66997ca1e1dec01ff 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 19/07/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 220187
0 1 0 0 0 SWANTIKAH,(NY) 040450 71 26081 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344991
1#0##0#0#0.0#2021-12-22
08:56:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 14/12/2021 14/12/2021 14/04/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI MULYANI 093246
0000640565201 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344887 1#0##0#0#0.0#2021-12-22
08:59:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e6108a8d9e6b859d82fe539043252570 258000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 11/06/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 210592
0 1 0 0 0 ENY SULASTRI,(NY) 033228 46 16988 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344992
1#0##0#0#0.0#2021-12-22
09:01:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6c44442343b41add42e8ea8d5a7be0f0 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 03/06/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 211175
0 1 0 0 0 ENDANG TRI YUNINGSIH.NY 089720 48 17726
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344993
1#0##0#0#0.0#2021-12-22
09:04:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e8025490e0767d73a3842a78f285c85b 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 20/08/1959 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V002289 0000571256594 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344906 1#0##0#0#0.0#2021-12-22
09:05:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
62f25c2ccabae50342b8cf6480c5acd9 463830 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 25/05/1972 0 1
0 - 0 - 0 - 0 786200 562470 0 1
SP.PD 1124R0021221V002290 0002431552465 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344907 1#0##0#0#0.0#2021-12-22
09:15:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e83a17c06343fe9f058d78c2b3edf18e 463830 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 03/03/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 450257
0 1 0 0 0 MUYAS SAROH, NY 064719 72 26584 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347231
1#0##0#0#0.0#2022-01-05
16:32:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b4c6c20ce9efa4ae74ac03fcc07f36c1 150000 0 0 0 0 0
220000 0 0 0 15000 0 65257 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 01/12/1958 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V002292 0001436949538 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344908 1#0##0#0#0.0#2021-12-22
09:17:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
74a53f4aebd8cde8f7e155c0137e007e 463830 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 01/04/1981 0 1
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SP.PD 1124R0021221V002293 0001904830593 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344910 1#0##0#0#0.0#2021-12-22
09:17:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
83e71e9e67dc11476c50bf5ffe6509e4 463830 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 19/02/1984 0 1
1 Z09.8;G40.9;I69.3 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 479205
0 1 0 0 0 DIDIK ACHMADI. TN 050289 37 13813 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344996
1#0##0#0#0.0#2021-12-22
09:21:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
373d5062506b5f929ce85a985bf74d8d 150000 0 0 0 0 0
0 121295 0 0 15000 0 192910 0 0 0 0
0
3372030 C 3 CP 2 14/12/2021 14/12/2021 10/11/1970 0 1
0 - 0 - 0 - 0 786200 688878 0 1
yani;3302226402970001; 5.5.5.202112011542 4 344911
1#0##0#0#0.0#2021-12-22
09:24:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
27b58b53ca71b83e26553eef990c3e53 662676 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 17/04/1961 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 344912
1#0##0#0#0.0#2021-12-22
09:24:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
69a71b734cb61424d164b36a44b4c2fa 463830 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 11/06/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SETYO LANGGENG, TN 090865 48 17718
yani;3302226402970001; 5.5.5.202112011542 4 344997
1#0##0#0#0.0#2021-12-22
09:25:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d2cad0e7804884f3db631782f2a12a82 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 12/06/1972 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 344913
1#0##0#0#0.0#2021-12-22
09:26:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4b6d286b0ea120e4677b4c03acf04efe 463830 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 15/07/1938 0 2
0 0 - 0 - 0 - 0 - 0 181400 178880
0 1 0 0 0 KUSTINI, NY 100427 83 30468 DR. RINA
5.5.5.202112011542 4 344998 1#0##0#0#0.0#2021-12-22
09:27:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d1e46b9032cc41e7ef36464aeadb93b0 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 17/04/1946 0 1
0 0 - 0 - 0 - 0 - 0 181400 228310
0 1 0 0 0 GIGIK SUGIARTO, BP 062125 75 27635
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344999
1#0##0#0#0.0#2021-12-22
09:28:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d70e72919e8fa9a46114044cf238b192 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 04/06/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMINI.NY 099596
0002253764441 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344889 1#0##0#0#0.0#2021-12-22
09:38:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
575dc1368d114df0d30de173c4c83030 258000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 09/06/1965 0 2
1 Z09.8;I11.9;J06.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 248708
yani;3302226402970001; 5.5.5.202112011542 4 345000
1#0##0#0#0.0#2021-12-22
09:39:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
516738b4ede182f5401b37f97f060bf4 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 26/05/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 257192
0 1 0 0 0 MENIK PUJIWATI, NY 073634 51 18830
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345001
1#0##0#0#0.0#2021-12-22
09:40:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
26029d6d1f44623e4019e684b5bdb6e7 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 24/11/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
yani;3302226402970001; 5.5.5.202112011542 4 345002
1#0##0#0#0.0#2021-12-22
09:41:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6301bf9510be0678dd9b63150d4a5dc7 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 25/04/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 361517
0 1 0 0 0 SRI TAMBANSARI., NY 047703 54 19957
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345003
1#0##0#0#0.0#2021-12-22
09:44:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1e90e8be0bb912ef9f99efaf96d9d983 150000 0 0 0 0 0
0 121345 0 0 15000 0 75172 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 23/11/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 195885
0 1 0 0 0 MURNI RETNONINGSIH, NY 099847 54 19745
yani;3302226402970001; 5.5.5.202112011542 4 345005
1#0##0#0#0.0#2021-12-22
09:47:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
14d751169b9d5c3b1348cfa0195d101c 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 21/05/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 196352
0 1 0 0 0 SUTRISNO, TN 088415 62 22853 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345007
1#0##0#0#0.0#2021-12-22
09:51:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bcb5ecb819185370fd417fd1193fe0dd 150000 0 0 0 0 0
0 0 0 0 15000 0 31352 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 12/07/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 228905
0 1 0 0 0 SARWONO, BP 087488 66 24262 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 345008
1#0##0#0#0.0#2021-12-22
09:52:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ee9eac65f4a3e375aa1e2ee4781bd20e 150000 0 0 0 0 0
0 0 0 0 15000 0 63905 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 30/03/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 277799
0 1 0 0 0 NINGSIH HARMINI, NY 058508 73 26922
yani;3302226402970001; 5.5.5.202112011542 4 345009
1#0##0#0#0.0#2021-12-22
09:57:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
93a2a28ef4759345887b63ec4c8f5887 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 30/06/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 215262
0 1 0 0 0 ISTUTIK, NY 093527 63 23178 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 345010
1#0##0#0#0.0#2021-12-22
09:58:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a4dc97993cee8914cb18a08319dae1ce 150000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 13/10/2002 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 RIZWAN
1124R0021221V002314 0003071567755 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344888 1#0##0#0#0.0#2021-12-22
10:05:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c019a0620b29e8e2b45e916a941cfa3b 247000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 14/05/1933 0 1
0 0 - 0 - 0 - 0 - 0 181400 197970
0 1 0 0 0 KOESWANTO BA.TN 095635 88 32356 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345011
1#0##0#0#0.0#2021-12-22
10:07:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
85fe8fa728699d1110b42c4b2e744ca8 150000 0 0 0 0 0
0 0 0 0 15000 0 32970 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 31/12/1958 0 1
1 A30.9 - - - None None None None Q-5-43-0 None None
0 - 0 - 0 - 0 - 0 262000 196527
0 1 0 0 0 SARDIYANTO.TN 100599 62 22994 DR.
novia;3313125201940001; 5.6.3.202201201500 4 345012
1#0##0#0#0.0#2022-02-15
13:48:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
fd4d6b7b63cdb10e30d848bf393e1495 150000 0 0 0 0 0
0 0 0 0 15000 0 31527 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 10/10/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 213201
0 1 0 0 0 SULUT, TN 082030 64 23441 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 345013
1#0##0#0#0.0#2022-04-14
13:02:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
e20b9611e682a2d1f78c5b4ae4da68b6 150000 0 0 0 0 0
0 0 0 0 15000 0 48201 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 17/03/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 221185
0 1 0 0 0 ENDANG BUDI ASTUTI, NY 089496 58 21457
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345014
1#0##0#0#0.0#2021-12-22
10:12:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b96c9502c11c859e3d30e0a4b444caa8 150000 0 0 0 0 0
0 0 0 0 15000 0 56185 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 06/06/2009 0 1
0 0 - 0 - 0 - 0 - 0 181400 351842
0 1 0 0 0 MARCOZEN KHRISNA RAJASA.SDR 099633 12
0001642125464 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345015 1#0##0#0#0.0#2021-12-22
10:17:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9cfed6aafc34eca5f2cae6dc4bcda36f 150000 0 0 0 0 0
0 0 0 0 15000 0 186842 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 09/01/1977 0 2
0 - 0 - 0 - 0 - 0 181400 208379
0 1 0 0 0 ARI ANUGRAHENI 100623 44 16410 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345016
1#0##0#0#0.0#2021-12-22
10:18:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
464dd3c3bf7e033719a5e8f5438cd9d6 150000 0 0 0 0 0
0 0 0 0 25000 0 33379 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 21/04/1950 0 1
1 Z09.8;G56.0;M19.98 88.21 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 433302
0 1 0 0 0 RINDUAN JANUAR., BP 052069 71 26170
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 347232
1#0##0#0#0.0#2022-01-05
16:33:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4b1b1011fd73e667504a0bd2032a2733 150000 0 0 0 0 0
230000 0 0 0 15000 0 38302 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 30/12/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 222982
0 1 0 0 0 RABIJEM NY 070138 72 26647 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 345017
1#0##0#0#0.0#2021-12-22
10:19:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b73f3531fcb05000f12fce03f95b8a08 150000 0 0 0 0 0
0 0 0 0 15000 0 57982 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 15/05/1990 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SUTRISNO.,TN 074382 31 11536 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345018
1#0##0#0#0.0#2021-12-22
10:21:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
03d6519fd1999933148dd615b1ba991f 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 10/07/1992 0 1
0 0 - 0 - 0 - 0 - 0 181400 199395
0 1 0 0 0 ADY SURYONO.SDR 099058 29 10749 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345019
1#0##0#0#0.0#2021-12-22
10:24:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
aeebb6faf26e6dfe36c32123ad93ac6e 150000 0 0 0 0 0
0 0 0 0 15000 0 34395 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 24/05/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 223242
0 1 0 0 0 Ny. Endang R. Murdaningsih 5290 51 18832
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345020
1#0##0#0#0.0#2021-12-22
10:26:29#0#00:00:00#00:00:00#14:43:41#{"co_insidense_ind":"0"} 1
e1057fa241802590e5f2c222ed7f65d5 150000 0 0 0 0 0
0 0 0 0 15000 0 58242 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 17/07/1982 0 2
- 0 - 0 - 0 86900 188280 0 1 0 0
0 YULIAN PRIHASTUTI 67916 39 14395 DR. GUNAWAN, SP.OG
1124R0021221V002326 0001107664942 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345021 1#0##0#0#0.0#2021-12-22
10:27:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6aae40cef05ccaea25a7534c901fbe54 150000 0 0 0 0 0
0 0 0 0 15000 0 23280 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 22/07/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 225265
0 1 0 0 0 WARSINO.TN 082557 55 20234 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 345022
1#0##0#0#0.0#2021-12-22
10:29:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4d05a6df25a9c83ab7f937473c8debe5 150000 0 0 0 0 0
0 0 0 0 15000 0 60265 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 02/02/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 288000 0 1 0 0 0 SUJIYEM, NY 090600
0001696847466 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344891 1#0##0#0#0.0#2021-12-22
10:34:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
37b388ed379d7352d785b6296403c116 273000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 04/02/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 213380
0 1 0 0 0 MUJAYIN, BP 060310 55 20402 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 345023
1#0##0#0#0.0#2021-12-22
10:35:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2fcd75d8b4dd43775e077f032113d593 150000 0 0 0 0 0
0 0 0 0 15000 0 48380 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 12/04/1957 0 2
1 Z09.8;G56.0;M19.99;I69.3 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
212660 0 1 0 0 0 MARIYAM.NY 084306 64 23622
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 345024
1#0##0#0#0.0#2022-04-14
13:11:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
02ba15483a6c311c40e39b6e1bd52445 150000 0 0 0 0 0
0 0 0 0 15000 0 47660 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 26/10/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 281205
yani;3302226402970001; 5.5.5.202112011542 4 345025
1#0##0#0#0.0#2021-12-22
10:43:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c49b1414e297eae020da1af25be886ab 150000 0 0 0 0 0
0 0 0 0 15000 0 116205 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 29/08/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 191919
0 1 0 0 0 SUKARMAN., BP 043185 73 26770 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345026
1#0##0#0#0.0#2021-12-22
10:47:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fb0085e7c31ded737ca5c625729e7627 150000 0 0 0 0 0
0 0 0 0 15000 0 26919 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 20/07/1947 0 1
0 0 - 0 - 0 - 0 - 0 181400 293226
0 1 0 0 0 SOEDARMO SUPANGAT, TN 063535 74 27176
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345027
1#0##0#0#0.0#2021-12-22
10:48:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
724fa02586d570e670acd58a51743041 150000 0 0 0 0 0
0 0 0 0 15000 0 128226 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 17/12/1947 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 AGUSTINUS
1124R0021221V002335 0001335194043 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344892 1#0##0#0#0.0#2021-12-22
10:55:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9ba6060098b795f03a66fc8aa1cde5fb 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 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; 5.5.5.202112011542 4
347469 1#0##0#0#0.0#2022-01-05
16:30:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8b3147b1485804d8a220d421eb7a5327 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 08/10/1976 0 2
0 0 - 0 - 0 - 0 - 0 700800 504482
0 1 0 0 0 TUGINI.NY 100269 45 16503 DR. ARIA
novia;3313125201940001; 5.5.5.202112011542 4 347233
1#0##0#0#0.0#2022-01-05
16:33:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
39f5d0b727abfbae2b2b4ca88b94a7bc 150000 0 0 0 0 0
285000 0 0 0 15000 0 54482 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 27/11/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 518850
0 1 0 0 0 TITIK GUNTARIAH., NY 042522 71 25950
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345028
1#0##0#0#0.0#2021-12-22
10:57:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4f13256998394cd016789047b05f96e3 150000 0 0 0 0 0
200000 0 0 0 15000 0 153850 0 0 0 0
0
3372030 C 3 CP 2 14/12/2021 14/12/2021 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; 5.5.5.202112011542 4
344890 1#0##0#0#0.0#2021-12-22
10:58:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c1eefd323159276837c94c34519be38a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 19/07/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 457526
0 1 0 0 0 KRISWANTOLO 093254 62 22794 DR. GALIH
yani;3302226402970001; 5.5.5.202112011542 4 345030
1#0##0#0#0.0#2021-12-22
11:00:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
79a5991959d1ba89901dbac68df70bb1 300000 0 0 0 0 0
0 0 0 0 15000 0 142526 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 08/12/1975 0 1
0 0 - 0 - 0 - 0 - 0 181400 219665
0 1 0 0 0 HERI WIBOWO.TN 084601 46 16808 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345031
1#0##0#0#0.0#2021-12-22
11:02:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
70f76b5f1bf0506b1a00ba1cb6f59c16 150000 0 0 0 0 0
0 0 0 0 15000 0 54665 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 02/01/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 170580
0 1 0 0 0 TIEN SUMARTININGSIH, NY 035771 57 21166
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345032
1#0##0#0#0.0#2021-12-22
11:04:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
099eeab950615a69a1e49568c9055b76 150000 0 0 0 0 0
0 0 0 0 15000 0 5580 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 28/12/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 371700
0 1 0 0 0 SRI NARNINGSIH, NY 100682 60 22266
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345035
1#0##0#0#0.0#2021-12-22
11:08:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d506e5de34e1970395b46efbc2e920b9 300000 0 0 0 0 0
0 0 0 0 15000 0 56700 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 14/02/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 228577
0 1 0 0 0 LASI.NY (081879) 049234 72 26601 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345036
1#0##0#0#0.0#2021-12-22
11:09:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
16b1210b7f01fce924ea9cdcf0c5f25b 150000 0 0 0 0 0
0 0 0 0 15000 0 63577 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 14/04/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 425170
0 1 0 0 0 AMIR HAUDI,(BP) 029404 64 23620 DR.
agung;3313092303950002; 5.6.6.202203301209 4 345038
1#0##0#0#0.0#2022-04-14
12:47:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
60b821263c92c5a06f1831c306659de3 300000 0 0 0 0 0
0 0 0 0 15000 0 110170 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 21/02/1952 0 1
1 Z09.8;B90.8;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 247411
0 1 0 0 0 NGADINO MARTO SUWIRYO, TN 062523 69
0001084980734 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345039 1#0##0#0#0.0#2021-12-22
11:35:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
487a513ab00adaec80706924aae2d009 150000 0 0 0 0 0
0 0 0 0 15000 0 82411 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 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; 5.5.5.202112011542 4
344895 1#0##0#0#0.0#2021-12-22
13:36:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eaff88916ae4cee154200bd2fa4040db 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 01/08/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 353943
0 1 0 0 0 SUTARKA BP 084552 79 28990 DR. ANITA
yani;3302226402970001; 5.5.5.202112011542 4 345041
1#0##0#0#0.0#2021-12-22
13:38:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bc6dbdfa53e6cbc2a0d36aa2b7a5c0de 150000 0 0 0 0 0
0 0 0 0 15000 0 188943 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 13/03/1953 0 1
1 Z09.8;I69.3;M53.19;M19.99 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
274781 0 1 0 0 0 SUHARI, TN 070582 68 25113
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345043
1#0##0#0#0.0#2021-12-22
13:39:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f1b05663a6f67f9c47f8231ea2a2d5cd 150000 0 0 0 0 0
0 0 0 0 15000 0 109781 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 01/12/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 812190
0 1 0 0 0 SYAFAWI ARDANI.TN 090083 71 25946 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345044
1#0##0#0#0.0#2021-12-22
13:40:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9042073364d565f3e0c7cf501191de37 300000 0 0 0 0 0
0 0 0 0 15000 0 497190 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 10/06/1952 0 2
1 Z09.8;I69.3;F95.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 206610
0 1 0 0 0 MM SRI SURYANTI 094217 69 25389 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345045
1#0##0#0#0.0#2021-12-22
13:44:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
841900ed0357e8b8760b1677b065b73e 150000 0 0 0 0 0
0 0 0 0 15000 0 41610 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 08/03/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 364875
0 1 0 0 0 ASMAWI (TN) 016954 64 23657 DR. GALIH
yani;3302226402970001; 5.5.5.202112011542 4 345046
1#0##0#0#0.0#2021-12-22
13:45:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
479a0d49bf16474ab9ab30fd64847d86 300000 0 0 0 0 0
0 0 0 0 15000 0 49875 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 10/10/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 431531
0 1 0 0 0 ABDUL KHALIQ, TN 059593 50 18328 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345047
1#0##0#0#0.0#2021-12-22
13:46:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8502e023f45f91c8298d35c83170e9c1 150000 0 0 0 0 0
0 0 0 0 15000 0 266531 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 15/05/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 375145
0 1 0 0 0 MURWANI SETIANINGSIH.NY 083365 49 18110
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345048
1#0##0#0#0.0#2021-12-22
13:49:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
751ef33662161ca205d60de680a50a2b 150000 0 0 0 0 0
0 0 0 0 15000 0 210145 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 31/12/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 220007
0 1 0 0 0 MISRAN, TN 099659 76 28107 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 345050
1#0##0#0#0.0#2021-12-22
13:50:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
33ad4b0a52747da88579263e3b9e2c4f 150000 0 0 0 0 0
0 0 0 0 15000 0 55007 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 13/06/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 376223
novia;3313125201940001; 5.6.3.202201201500 4 345051
1#0##0#0#0.0#2022-02-15
12:16:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
9d9f6b3c33bc50e6234e20aadb16d376 150000 0 0 0 0 0
0 0 0 0 15000 0 211223 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 26/05/1962 0 2
1 Z09.8;J45.9;K21.9;J11.1;K52.9 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
379973 0 1 0 0 0 SRI REJEKI,NY 010002 59
0001084669997 3;JKN novia;3313125201940001; 5.6.3.202201201500 4
345053 1#0##0#0#0.0#2022-02-14
14:13:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
5eb1bb9dacbb824634b1cd8f6ef88f7d 150000 0 0 0 0 0
0 0 0 0 15000 0 214973 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 14/11/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 266128
0 1 0 0 0 SITI PURWANING WIRATMI, NY 074906 61
0000091579241 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345054 1#0##0#0#0.0#2021-12-22
14:05:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
55f03d15fa8a03bc8601c8c056f3f5fa 150000 0 0 0 0 0
0 0 0 0 15000 0 101128 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 15/01/1981 0 1
0 0 - 0 - 0 - 0 - 0 181400 237110
0 1 0 0 0 JONI TURAHYO., BP 049289 40 14943 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345055
1#0##0#0#0.0#2021-12-22
14:08:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c951a64e26bcff1d7a1019dbf645276d 150000 0 0 0 0 0
0 0 0 0 15000 0 72110 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 03/02/1955 0 2
1 Z09.8;J18.0;I10 87.49 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 496072
0 1 0 0 0 SUMARSIH,NY 085983 66 24421 DR. ANITA
novia;3313125201940001; 5.5.5.202112011542 4 347234
1#0##0#0#0.0#2022-01-05
16:34:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
60fb3a1b8581c06aea682d5e7ad16ace 150000 0 0 0 0 0
200000 0 0 0 15000 0 131072 0 0 0 0
0
3372030 C 3 CP 2 14/12/2021 14/12/2021 22/03/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 388096
0 1 0 0 0 SRI SLAMET RAHAYU, NY 054172 58 21452
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345056
1#0##0#0#0.0#2021-12-22
14:16:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d0d8b3b720ca45284c38ac76037fd938 150000 0 0 0 0 0
0 0 0 0 15000 0 223096 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 08/10/1957 0 1
1 Z09.8;B90.9;R07.4 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 344465
0 1 0 0 0 MARYANTO., BP 041763 64 23443 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345057
1#0##0#0#0.0#2021-12-22
14:17:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
24c0ac57985799ac11b5382de641ef43 150000 0 0 0 0 0
0 0 0 0 15000 0 179465 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 16/01/1986 0 2
1 Z09.8;B90.8;I11.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 487046
0 1 0 0 0 JAYANTI ARIYANA.NN 072922 35 13116
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345059
1#0##0#0#0.0#2021-12-22
14:20:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7138bb733282090c2310f0103c1d887e 150000 0 0 0 0 0
0 0 0 0 15000 0 322046 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 24/10/1963 0 2
1 Z09.8;I69.3;G56.0;M19.99 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
238315 0 1 0 0 0 ENDANG HAPSARI ,(NY) 040328
0000639322312 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345060 1#0##0#0#0.0#2021-12-22
14:22:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
29185cfa8c972acdacb4a2a22f85a06b 150000 0 0 0 0 0
0 0 0 0 15000 0 73315 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 20/06/1997 0 1
0 - 0 - 0 - 0 183900 277840 0 1
0 0 0 RIAN NAMANG DJABAR, SDR 100503 24 8943 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345062
1#0##0#0#0.0#2021-12-22
14:33:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9f6a9aa296e07738325ecbab2fc230e2 235000 0 0 0 0 0
0 0 0 0 15000 0 27840 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 31/12/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 409351
0 1 0 0 0 SUPARNO.TN 089179 57 21168 DR. ANITA
yani;3302226402970001; 5.5.5.202112011542 4 345063
1#0##0#0#0.0#2021-12-22
14:39:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9f1261783acc59d74d7057bbfba037bf 150000 0 0 0 0 0
0 0 0 0 15000 0 244351 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 02/08/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 230830
0 1 0 0 0 SITI MAJIAH, NY 094003 69 25336 DR.
agung;3313092303950002; 5.6.6.202203301209 4 345064
1#0##0#0#0.0#2022-04-14
13:33:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
0454d0758a6c5e34778c3d5561c8567a 150000 0 0 0 0 0
0 0 0 0 15000 0 65830 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 13/03/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 235650
0 1 0 0 0 SUYANTO.TN 093997 58 21461 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 345066
1#0##0#0#0.0#2021-12-22
14:42:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5fd58af7276f938748176dd73d72fa8e 150000 0 0 0 0 0
0 0 0 0 15000 0 70650 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 06/08/1938 0 1
0 0 - 0 - 0 - 0 - 0 181400 408054
0 1 0 0 0 SOEKAMTO 090753 83 30446 DR. ANITA
yani;3302226402970001; 5.5.5.202112011542 4 345067
1#0##0#0#0.0#2021-12-22
14:43:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6f1dc2ae904b56237642edc1c6f19c04 150000 0 0 0 0 0
0 0 0 0 15000 0 243054 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 02/12/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 401079
0 1 0 0 0 NURYADI,BP 074107 55 20101 DR. ANITA
yani;3302226402970001; 5.5.5.202112011542 4 345068
1#0##0#0#0.0#2021-12-22
15:01:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
86b017b07457b090b1f83d8cb7d0b93a 150000 0 0 0 0 0
0 0 0 0 15000 0 236079 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 15/06/1948 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
165000 0 1 0 0 0 SUPIYEM, NY 011053 73 26845
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345072
1#0##0#0#0.0#2021-12-22
15:15:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3d0fd170679d32818ff68b8eef56741a 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 02/07/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 406536
0 1 0 0 0 BAMBANG EKO SUHARDAYA,TN 080045 57
0001104133994 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345073 1#0##0#0#0.0#2021-12-22
15:17:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6ab1fa41d6651fa1e9eb2c6e2b2a4384 150000 0 0 0 0 0
0 0 0 0 15000 0 241536 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 07/07/1962 0 1
2 Z09.8;C78.0;J06.8 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 216108
0 1 0 0 0 SARTO, TN 064381 59 21710 DR. ANITA
novia;3313125201940001; 5.6.3.202201201500 4 345074
1#0##0#0#0.0#2022-02-15
07:48:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
2112aa844c8f9a38e7691b0f2db1161b 150000 0 0 0 0 0
0 0 0 0 15000 0 51108 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 31/12/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 308770
0 1 0 0 0 INTIKHAN, TN 095492 55 20437 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345081
1#0##0#0#0.0#2021-12-23
08:35:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8c71d702b5dc05e6283c37755917f42f 150000 0 0 0 0 0
0 0 0 0 15000 0 143770 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 05/12/1958 0 2
1 Z09.8;J45.9;E11.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 343038
0 1 0 0 0 LIES MARLIANA. NY 087133 63 23020 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345082
1#0##0#0#0.0#2021-12-23
08:37:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5bf582152e43b57b144fd45ae615bd64 150000 0 0 0 0 0
0 0 0 0 15000 0 178038 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 29/04/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI HARIYANTI.NY
0001692528928 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344896 1#0##0#0#0.0#2021-12-23
08:37:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1f69c6be26fd3ffce493bd3b44ca6c34 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 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 16708 DR. LINDA SUGIARTO, SP.FKR 1124R0021221V002386
0000563317132 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
347470 1#0##0#0#0.0#2022-01-05
16:31:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8081b7ab0e74c89e99bfda28350e1757 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 25/12/1954 0 2
1 Z09.8;M25.67;V19.9 93.35;93.39 - - None None None None
0 - 0 107400 262000 0 1 0 0 0 MARIA
1124R0021221V002388 0002069991685 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 344864 1#0##0#0#0.0#2022-04-14
13:45:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
b13addbb3004345e7012842d430eb732 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 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; 5.5.5.202112011542 4
344893 1#0##0#0#0.0#2021-12-23
08:39:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c6c31d375adf1a51fd95e2400f634fe8 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 04/06/1952 0 1
0 - 0 107400 273000 0 1 0 0 0
SURATMAN 029384 69 25395 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V002390 0001614176932 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344900 1#0##0#0#0.0#2021-12-23
08:40:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a33c5063d1610dd24ff4e55ab218941e 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 20/02/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 251871
0 1 0 0 0 RUMTANINGSIH(NY) 032276 64 23673 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345083
1#0##0#0#0.0#2021-12-23
08:41:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
79a55ec34f68f43c5f99148e1f73972a 150000 0 0 0 0 0
0 0 0 0 15000 0 86871 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 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; 5.5.5.202112011542 4
344899 1#0##0#0#0.0#2021-12-23
08:42:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c9f0d4c71270affd462966e6bfda3dbf 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 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; 5.5.5.202112011542 4
344880 1#0##0#0#0.0#2021-12-23
08:47:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fa7701dc25f8dcc62caaa96f8f3b1acb 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 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; 5.5.5.202112011542 4
344876 1#0##0#0#0.0#2021-12-23
08:53:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a1e11daa4da0e6cd5d56575d133ee7e5 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 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; 5.5.5.202112011542 4
344898 1#0##0#0#0.0#2021-12-23
08:55:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d5dbf9116ee3672e50cabcfac2acd410 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 15/11/1951 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI PARYATUN
0001444746655 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344897 1#0##0#0#0.0#2021-12-23
08:56:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b1878928e869c115ce951b776abaef22 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 04/01/1983 0 2
0 0 - 0 - 0 - 0 - 0 181400 644765
0 1 0 0 0 ASEP PRASETYOWATI, NY 099038 38 14224
yani;3302226402970001; 5.5.5.202112011542 4 345084
1#0##0#0#0.0#2021-12-23
08:59:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f9dbc763239290ea0d511898c30390b9 503000 0 0 0 0 0
0 0 0 0 15000 0 126765 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 12/08/1950 0 2
1 Z09.8;K30;G62.8;M19.98 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 240823
0 1 0 0 0 SUYAMI.NY 088115 71 26057 DR. SUHARTO,
SP.PD 1124R0021221V002399 0002898872076 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345085 1#0##0#0#0.0#2021-12-23
09:01:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ffe4bb511fda58dd7ffa445a39f71df6 150000 0 0 0 0 0
0 0 0 0 15000 0 75823 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 05/06/1975 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001272616569 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344862 1#0##0#0#0.0#2021-12-23
09:08:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
710cb2d9d85044032618029e9cd5dcf1 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 07/09/1947 0 1
1 Z09.8;H26.9;H04.1 90.29;16.21 - - None None None None H-3-
0 0 - 0 - 0 - 0 - 0 211200 504975
0 1 0 0 0 SLAMET RAHARDJO.TN 100684 74 27127
yani;3302226402970001; 5.5.5.202112011542 4 345086
1#0##0#0#0.0#2021-12-23
09:10:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e92f74670356371266b0677f4f25f78f 459000 0 0 0 0 0
0 0 0 0 15000 0 30975 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 20/04/2004 0 2
1 H54.2;H52.2 90.29 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 253620
novia;3313125201940001; 5.6.4.202203071701 4 345087
1#0##0#0#0.0#2022-03-09
14:04:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
ced61fd24bb5eac01f3252f7e9d402b8 203000 0 0 0 0 0
0 0 0 0 15000 0 35620 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 29/10/1965 0 1
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 299975 0 1 0 0 0 SANTOSO. TN 038094
0000564536698 3;JKN novia;3313125201940001; 5.6.3.202201201500 4
345088 1#0##0#0#0.0#2022-03-08
08:01:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
e25dd7bad2a990893ca0bf6558bc6178 254000 0 0 0 0 0
0 0 0 0 15000 0 30975 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 18/12/1974 0 1
0 0 - 0 - 0 - 0 - 0 181400 309070
0 1 0 0 0 UNTUNG GIRI RACHADI.TN 100243 46 17163
yani;3302226402970001; 5.5.5.202112011542 4 345089
1#0##0#0#0.0#2021-12-23
09:15:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7f8f989da87bb777f26badc2881e9d64 203000 0 0 0 0 0
0 0 0 0 15000 0 91070 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 27/04/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 278795
0 1 0 0 0 SRI HARTATI, NY 070715 72 26529 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345090
1#0##0#0#0.0#2021-12-23
09:17:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4169935550c074e561a93f1b15b39430 203000 0 0 0 0 0
0 0 0 0 15000 0 60795 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
344868 1#0##0#0#0.0#2021-12-23
09:18:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f127e003b63887f76ea3795e0771fea0 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 24/07/2004 0 1
0 - 0 - 0 - 0 - 0 181400 175000
0 1 0 0 0 DANIEL ANANDA VALERIAN IVANO.SDR 100625
17 6352 DR. ZULFADLY, SP.B 1124R0021221V002408 0001273977832
3;JKN novia;3313125201940001; 5.6.3.202201201500 4 345091
1#0##0#0#0.0#2022-02-15
10:56:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
ad92d35ff01a9035753ea9b3e12f7080 150000 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 05/02/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 207500 0 1 0 0 0 EKO CAHYANI
1124R0021221V002409 0001100445232 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344872 1#0##0#0#0.0#2021-12-23
09:43:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0b0e4acb3fd9db8341593555b79c5453 0 0 192500 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 18/01/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000090992327 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344866 1#0##0#0#0.0#2021-12-23
09:44:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1fd8aeac6799242dca2c47615c970422 258000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 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; 5.6.3.202201201500 4
344878 1#0##0#0#0.0#2022-02-15
11:44:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 14/12/2021 14/12/2021 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; 5.5.5.202112011542 4
344865 1#0##0#0#0.0#2021-12-23
09:45:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4191f08e60a8499715ffc818234c791e 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 23/09/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 199591
0 1 0 0 0 DIAH NUR PAMILIYANTI.NY 084310 66 24189
yani;3302226402970001; 5.5.5.202112011542 4 345092
1#0##0#0#0.0#2021-12-23
09:47:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 34591 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 21/09/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002199915988 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344869 1#0##0#0#0.0#2021-12-23
09:51:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3ac2506dd19508a9292b4b0544bb21b1 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 25/05/1967 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 BAMBANG
1124R0021221V002417 0000091534228 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344879 1#0##0#0#0.0#2021-12-23
09:52:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
644e10dd59e65df20ee2771711ec4703 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
344867 1#0##0#0#0.0#2021-12-23
09:52:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d4a21bd9abd00af68e9553b956154031 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 25/08/1955 0 1
- 0 - 0 - 0 894800 1762065 0 1 0
0 0 BAMBANG AGUS SURONO.TN 100627 66 24218 DR. ARIA CHANDRA
novia;3313125201940001; 5.6.3.202201201500 4 347235
1#0##0#0#0.0#2022-02-15
10:06:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
522e9c8e3cf706aee352fc5f5b31d809 450000 0 0 0 0 0
1250000 0 0 0 25000 0 37065 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 16/10/1949 0 2
0 - 0 107400 262000 0 1 0 0 0 SRI
YEKTI ISMADI,(NY) 040545 72 26357 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V002421 0000089740067 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344870 1#0##0#0#0.0#2021-12-23
09:55:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 14/12/2021 14/12/2021 31/12/1959 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
259560 0 1 0 0 0 SUMINAH.NY 097751 61 22629
yani;3302226402970001; 5.5.5.202112011542 4 345093
1#0##0#0#0.0#2021-12-23
10:00:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f7827fcc06a572c467151599c700ae16 150000 0 0 0 0 0
0 0 0 0 15000 0 94560 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 18/01/1966 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 IVO MUMPUNI
1124R0021221V002423 0002169780873 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344860 1#0##0#0#0.0#2021-12-23
10:01:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
543b33da1b6830a83392f7df04cb4eed 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 01/07/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 221655
0 1 0 0 0 SUGENG, NY 100575 66 24273 DR. TEKY
agung;3313092303950002; 5.6.3.202201201500 4 345094
1#0##0#0#0.0#2022-02-18
14:37:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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0 31845 0 0 15000 0 24810 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 03/08/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ISMURYANI
1124R0021221V002425 0001313177196 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344863 1#0##0#0#0.0#2021-12-23
10:04:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7fe25263803bfc231489782d82a850c5 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 14/06/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001429190267 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344861 1#0##0#0#0.0#2021-12-23
10:05:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a9e6ac5ad535819aa7e886cd9c5d024e 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 28/07/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 233680
0 1 0 0 0 SUPARWATI.NY 100628 59 21689 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345095
1#0##0#0#0.0#2021-12-23
10:06:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e4220f4821dc3ec445f3fb7ad3953981 150000 0 0 0 0 0
0 31845 0 0 25000 0 26835 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 08/04/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 230415
0 1 0 0 0 WIDODO, TN 007403 67 24722 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 345096
1#0##0#0#0.0#2021-12-23
10:07:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c2c9c77b0a17a12335541b01f1500bff 150000 0 0 0 0 0
0 0 0 0 15000 0 65415 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 02/09/1980 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 FITRIYANA
HANDAYANI.NY 003924 41 15078 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V002429 0001107034119 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344894 1#0##0#0#0.0#2021-12-23
10:07:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d70df38079208a7817b2d51fd5661119 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
344873 1#0##0#0#0.0#2021-12-23
10:08:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
93624c9d2ad4cff82f68c5d695a92737 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 16/10/1980 0 2
0 - 0 - 0 - 0 - 0 549400 234890
0 1 0 0 0 PRIHATINA, NY 009030 41 15034 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345097
1#0##0#0#0.0#2021-12-23
10:10:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
350594968c6cc9bf274d8ebca757ea0e 200000 0 0 0 0 0
0 0 0 0 15000 0 19890 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 13/09/1976 0 1
0 0 - 0 - 0 - 0 - 0 181400 209010
0 1 0 0 0 THOMAS RIYANTO, TN 095641 45 16528
yani;3302226402970001; 5.5.5.202112011542 4 345098
1#0##0#0#0.0#2021-12-23
10:12:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1776e8ccecde05189bd25fa0440a871c 150000 0 0 0 0 0
0 0 0 0 15000 0 44010 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 01/11/1961 0 2
0 - 0 107400 273000 0 1 0 0 0
1124R0021221V002434 0000090942546 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344877 1#0##0#0#0.0#2021-12-23
10:12:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8216d0ab046ee3765457857fb272daac 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 22/06/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 199344
0 1 0 0 0 SRI WAHYUNI, NY 079904 67 24647 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345099
1#0##0#0#0.0#2021-12-23
10:14:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4f29b74f7c675f7718e484d0c2f668fe 150000 0 0 0 0 0
0 0 0 0 15000 0 34344 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 19/05/1972 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 344922
1#0##0#0#0.0#2021-12-23
10:15:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0ddfbb0ec61ed891afabb7b0a8921f6b 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 15/10/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 344921
1#0##0#0#0.0#2021-12-23
10:17:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f8c0a6d882dd9d18d037692dad42915b 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 11/04/1965 0 1
0 - 0 - 0 - 0 786200 497100 0 1
SP.PD 1124R0021221V002441 0001732801498 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344920 1#0##0#0#0.0#2021-12-23
10:20:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f977428b127c5f252ed7125233e629ce 463830 0 0 0 0 0
0 0 0 0 15000 0 18270 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 25/03/1978 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 344918
1#0##0#0#0.0#2021-12-23
10:21:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5e0f79c27ea528c0a9ebef8a0e8169d2 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 23/12/1977 0 2
0 - 0 - 0 - 0 786200 490710 0 1
yani;3302226402970001; 5.5.5.202112011542 4 344917
1#0##0#0#0.0#2021-12-23
10:52:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d2735a088ccf8311ac2b4ef5bd19212f 463830 0 0 0 0 0
0 0 0 0 15000 0 11880 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 01/09/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V002445 0000639614597 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344916 1#0##0#0#0.0#2021-12-23
10:54:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1136be199807f53463f47af2c45a72c4 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 13/12/1966 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V002446 0002051493849 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344915 1#0##0#0#0.0#2021-12-23
10:57:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
720c336638f2a381660b0d7810614c33 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 07/04/1948 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 344914
1#0##0#0#0.0#2021-12-23
10:58:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e1ce72c63500ee8b5f270adbf272020c 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 02/09/1976 0 1
0 - 0 - 0 - 0 786200 490710 0 1
0 0 0 YOYOK BAGUS HARTONO. TN 093496 45 16539 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344919
1#0##0#0#0.0#2021-12-23
10:59:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4f7702d06d2a95714ccf3bd2c46afebd 463830 0 0 0 0 0
0 0 0 0 15000 0 11880 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 03/04/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 257557
0 1 0 0 0 RINA HERMAWATI, NY 049862 47 17422
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345100
1#0##0#0#0.0#2021-12-23
11:01:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5c87de45154467df3f8e085f457f385f 150000 0 0 0 0 0
0 0 0 0 15000 0 92557 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 20/12/1941 0 2
0 0 - 0 - 0 - 0 - 0 336100 271850
0 1 0 0 0 ROMELAH, NY 069168 79 29214 dr. SUROSO
1124R0021221V002451 0000564515921 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346660 1#0##0#0#0.0#2022-01-04
14:29:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1a8714d634a105551c98c8141705addd 210000 0 0 0 0 0
0 0 0 0 15000 0 46850 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 06/07/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 229715
0 1 0 0 0 HARI PAMULARSIH, NY 078062 48 17693
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345101
1#0##0#0#0.0#2021-12-23
11:03:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1de707e1eda6bc3c21914710f281253b 150000 0 0 0 0 0
0 0 0 0 15000 0 64715 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 01/11/1988 0 1
0 0 - 0 - 0 - 0 - 0 181400 219317
0 1 0 0 0 MUHAMAD EKO SUSILO, (BP) 033483 33
0001274999253 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345102 1#0##0#0#0.0#2021-12-23
11:05:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9e958481d56f595842c3b42063d2c09a 150000 0 0 0 0 0
0 0 0 0 15000 0 54317 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 23/03/1950 0 2
0 - 0 107400 289000 0 1 0 0 0
1124R0021221V002455 0001032584782 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344871 1#0##0#0#0.0#2021-12-23
11:05:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4bba24f0eb1b8e139fe464c2d8eb17fc 274000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
344875 1#0##0#0#0.0#2021-12-23
11:06:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4d08de264034c56140b6ca439b2cd5ba 247000 0 0 0 0 0
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3372030 C 3 CP 2 14/12/2021 14/12/2021 23/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 225800 0 1 0 0 0 ERDIANA.NY 087879
0000565638074 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344874 1#0##0#0#0.0#2021-12-23
11:06:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6b6894f4a46f6bc689b1ee7433c09017 150000 0 60800 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 14/02/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 219527
0 1 0 0 0 SUPARTINAH, NY 048644 66 24410 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345103
1#0##0#0#0.0#2021-12-23
11:16:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e4a7e2f242cf8547299aa4f1e54fa6ea 150000 0 0 0 0 0
0 0 0 0 15000 0 54527 0 0 0 0 0
3372030 C 3 CP 2 14/12/2021 14/12/2021 28/01/1959 0 1
1 R10.4;K30 89.52 - - None None None None Q-5-25-0 None
- 0 - 0 - 0 - 0 135700 248896 0
1 0 0 0 RISTIYANTO,TN 029882 62 22966 DR. CHANDRA
AYU 1124R0021221V002459 0001103412273 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346661 1#0##0#0#0.0#2022-01-04
14:30:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fbeb6e0363aef46b1bb91c5af9d5526f 0 0 142500 0 0 0
0 0 0 0 15000 0 91396 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 10/05/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 220860
0 1 0 0 0 SUKATI AL KATINEM, NY 065484 59 21769
novia;3313125201940001; 5.6.3.202201201500 4 344745
1#0##0#0#0.0#2022-02-15
07:58:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
a7e236298d8859a5f576d7cd6879870e 150000 0 0 0 0 0
0 0 0 0 15000 0 55860 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 18/08/1972 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
275317 0 1 0 0 0 GEMI., NY 069650 49 18016
yani;3302226402970001; 5.5.5.202112011542 4 344746
1#0##0#0#0.0#2021-12-20
11:08:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6045ff2cdcf161dc20ab61d780deff13 150000 0 0 0 0 0
0 63690 0 0 15000 0 46627 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 30/09/1979 0 2
1 Z09.8;E11.4;G59.0;N39.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 489730
0 1 0 0 0 DIAN EKOWATI 092223 42 15417 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344747
1#0##0#0#0.0#2021-12-20
11:10:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
774d6042baeddda8272aa0c9f5bea5f1 150000 0 0 0 0 0
0 94340 0 0 15000 0 230390 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 02/06/1966 0 1
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 400365 0 1 0 0 0 KUS SULISTYO.TN 097613
0001698219551 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344748 1#0##0#0#0.0#2021-12-20
11:11:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a9d495591ea970327ee2930364945f38 150000 0 0 0 0 0
0 120795 0 0 15000 0 114570 0 0 0 0
0
3372030 C 3 CP 2 15/12/2021 15/12/2021 29/09/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 736733
0 1 0 0 0 SRI LESTARI,NY 061339 59 21627 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344749
1#0##0#0#0.0#2021-12-20
11:12:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8e5ee118e5ba804bc6c1b1ba879d9bca 150000 0 0 0 0 0
0 63690 0 0 15000 0 508043 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 08/06/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 234935
novia;3313125201940001; 5.6.3.202201201500 4 344750
1#0##0#0#0.0#2022-02-15
12:23:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
b04b8f51e685afbf95d65519d782effb 150000 0 0 0 0 0
0 63690 0 0 15000 0 6245 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 24/11/1953 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
542216 0 1 0 0 0 DRS H SUJADI.,TN 074561 68
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344751
1#0##0#0#0.0#2021-12-20
11:14:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3bfdb68a25ea626b6017d6e047359172 150000 0 0 0 0 0
0 76045 0 0 15000 0 301171 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 03/12/1985 0 2
0 0 - 0 - 0 - 0 - 0 296400 227315
0 1 0 0 0 IRMA ANDHANI,NY 037350 36 13161 DR.
novia;3313125201940001; 5.6.7.202204241238 4 344752
1#0##0#0#0.0#2022-05-10
09:04:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
d0cad3e649d72d4c352a064651f4f996 200000 0 0 0 0 0
0 0 0 0 15000 0 12315 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 04/10/1944 0 2
1 Z09.8;I11.9;K80.2;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 349480
0 1 0 0 0 HARI NURYANI.NY 084720 77 28196 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344753
1#0##0#0#0.0#2021-12-20
11:15:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
71f1758f13c74d56fbb5bbda687479dc 150000 0 0 0 0 0
0 120795 0 0 15000 0 63685 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 13/06/1971 0 2
0 - 0 107400 262000 0 1 0 0 0 SITI
1124R0021221V002474 0002169781694 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 344728 1#0##0#0#0.0#2022-04-14
13:13:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
f67828061b31c46b4a577da72f56895a 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 26/05/1962 0 2
1 Z09.8;E11.4;G59.0;K52.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 333540
0 1 0 0 0 SRI REJEKI,NY 010002 59 21753 DR.
agung;3313092303950002; 5.6.6.202203301209 4 344754
1#0##0#0#0.0#2022-04-14
11:41:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
f1de86c73fa17a6ad18d0899e0ecfb86 150000 0 0 0 0 0
0 31845 0 0 15000 0 136695 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 13/06/1992 0 2
0 0 - 0 - 0 - 0 - 0 181400 195686
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 344755
1#0##0#0#0.0#2022-04-14
12:56:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
7576f2860f06e3c957070c8ff36dcab8 150000 0 0 0 0 0
0 0 0 0 15000 0 30686 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 10/11/1962 0 2
1 Z09.8;I11.9;M19.98;R51 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 271860
0 1 0 0 0 SURATINEM.NY 098509 59 21585 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344756
1#0##0#0#0.0#2021-12-20
11:24:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6a7e47b0562f4dd28b788a50ab6a6b66 150000 0 0 0 0 0
0 44750 0 0 15000 0 62110 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 02/08/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 744868
0 1 0 0 0 SRI BANDONO., BP 046597 70 25703 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344757
1#0##0#0#0.0#2021-12-20
11:25:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b6353ec42559fe5c2425e9ff70529901 150000 0 0 0 0 0
0 108440 0 0 15000 0 471428 0 0 0 0
0
3372030 C 3 CP 2 15/12/2021 15/12/2021 31/05/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 278025
0 1 0 0 0 RAHAYU, NY 098361 63 23209 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344758
1#0##0#0#0.0#2021-12-20
11:28:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
72088d28eac14f105f1b6cc650aabca6 150000 0 0 0 0 0
0 76045 0 0 15000 0 36980 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 11/06/1991 0 1
0 0 - 0 - 0 - 0 - 0 181400 209370
0 1 0 0 0 ANDRE YUDHA PRATMA,(BP) 037058 30 11145
yani;3302226402970001; 5.5.5.202112011542 4 344759
1#0##0#0#0.0#2021-12-20
11:29:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e6c1545413b58257e395a76eb1ae87ed 150000 0 0 0 0 0
0 0 0 0 15000 0 44370 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 31/12/1935 0 2
0 0 - 0 - 0 - 0 - 0 181400 230851
0 1 0 0 0 PAIDJEM, NY 071271 85 31396 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344760
1#0##0#0#0.0#2021-12-20
11:30:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2ba9333f25faacc30059f0cf5a842f2d 150000 0 0 0 0 0
0 0 0 0 15000 0 65851 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 18/08/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 253590
0 1 0 0 0 RINI PUSPITA, NY 058002 70 25687 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344761
1#0##0#0#0.0#2021-12-20
11:31:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fbec1c48bfba165ac8490279328acc37 150000 0 0 0 0 0
0 0 0 0 15000 0 88590 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 07/06/1958 0 2
1 Z09.8;I25.9;K80.2;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 450731
0 1 0 0 0 ENDANG MURHAYANI ., NY 053771 63 23202
yani;3302226402970001; 5.5.5.202112011542 4 344762
1#0##0#0#0.0#2021-12-20
11:33:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
efce50e894f72e704d5f590bf4b3c4e9 150000 0 0 0 0 0
0 88900 0 0 15000 0 196831 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 21/06/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 275822
0 1 0 0 0 BAYU SRI BUDINIGSIH.NY 077444 55 20266
yani;3302226402970001; 5.5.5.202112011542 4 344763
1#0##0#0#0.0#2021-12-20
11:35:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3fde533ce698b47d22a0d263021010ed 150000 0 0 0 0 0
0 0 0 0 15000 0 110822 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 10/08/1961 0 2
1 Z09.8;K80.2;M79.18 88.76 - - None None None None Z-3-
0 0 - 0 - 0 - 0 - 0 549400 930018
0 1 0 0 0 KASMINAH ., NY 000269 60 22042 DR.
agung;3313092303950002; 5.6.3.202201201500 4 348903
1#0##0#0#0.0#2022-02-21
09:43:58#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
25bd61f1de469fb450f61f9e8fdc0627 150000 0 0 0 0 0
657000 0 0 0 15000 0 108018 0 0 0 0
0
3372030 C 3 CP 2 15/12/2021 15/12/2021 25/05/1940 0 2
0 0 - 0 - 0 - 0 - 0 181400 261842
0 1 0 0 0 SRI SUHARTI., NY 048659 81 29789 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344765
1#0##0#0#0.0#2021-12-20
12:39:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
41e0459830a1917f6fa845743832024a 150000 0 0 0 0 0
0 44300 0 0 15000 0 52542 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 23/03/1952 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
579386 0 1 0 0 0 KASIATIN, NY 071287 69
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344764
1#0##0#0#0.0#2021-12-20
11:37:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
35e0cefb15de44aba66d08fa0aaf249a 150000 0 0 0 0 0
0 76045 0 0 15000 0 338341 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 18/08/1981 0 2
0 0 - 0 - 0 - 0 - 0 181400 216125
0 1 0 0 0 AGUSTIN ANDRIANI.TN 100321 40 14729
yani;3302226402970001; 5.5.5.202112011542 4 344766
1#0##0#0#0.0#2021-12-20
12:42:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
168c476d814ed8310b89db57f9139dc3 150000 0 0 0 0 0
0 0 0 0 15000 0 51125 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 30/08/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 419875
0 1 0 0 0 SUTARDI.TN 093260 61 22387 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344767
1#0##0#0#0.0#2021-12-20
12:43:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
559ba585abb18f33c8ffd3021c551f90 150000 0 0 0 0 0
0 76045 0 0 15000 0 178830 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 11/08/1983 0 1
0 - 0 - 0 - 0 - 0 549400 859946
0 1 0 0 0 SUGIANTO, TN 067769 38 14006 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347242
1#0##0#0#0.0#2022-01-05
16:37:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
538f7d2eaa1c36e15961d3882d2c4e49 150000 0 0 0 0 0
657000 0 0 0 15000 0 37946 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 31/12/1966 0 2
1 Z09.8;E11.4;G59.0;I10 89.52 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 237202
0 1 0 0 0 MURTI.NY 094190 54 20073 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344768
1#0##0#0#0.0#2021-12-20
12:57:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2ef7d6ed8f9e50f3c39abb7e8fbae1b2 150000 0 0 0 0 0
0 0 0 0 15000 0 72202 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 30/01/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 357545
0 1 0 0 0 SRI JARITA.NY 098285 64 23695 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344769
1#0##0#0#0.0#2021-12-20
12:58:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2d44f4c7ee367c363f90ae31b6b38aa2 150000 0 0 0 0 0
0 76595 0 0 15000 0 115950 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 02/02/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 296706
0 1 0 0 0 SUWITO, TN 060006 69 25519 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344770
1#0##0#0#0.0#2021-12-20
13:00:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4aa80da8a1fc694b05d03172132c339e 150000 0 0 0 0 0
0 0 0 0 15000 0 131706 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 03/07/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 195052
0 1 0 0 0 MENIK ISTIYARSIH, NY 071741 52 19158
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344771
1#0##0#0#0.0#2021-12-20
13:01:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7560fe5688fe29d419f77c361b1dc353 150000 0 0 0 0 0
0 0 0 0 15000 0 30052 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 03/03/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 194160
0 1 0 0 0 SUDARYONO, TN 071022 71 26220 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344772
1#0##0#0#0.0#2021-12-20
13:05:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
30f5c572e1143ac8a2d33a41f752e7b9 150000 0 0 0 0 0
0 0 0 0 15000 0 29160 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 17/06/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 190475
3;JKN novia;3313125201940001; 5.6.3.202201201500 4 344773
1#0##0#0#0.0#2022-02-15
13:11:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
4df6155847dd1f7d67000c404d1b8aac 150000 0 0 0 0 0
0 0 0 0 15000 0 25475 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 01/08/1992 0 1
0 0 - 0 - 0 - 0 - 0 181400 350677
0 1 0 0 0 SRIYANTO, TN 089005 29 10728 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344775
1#0##0#0#0.0#2021-12-20
13:14:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
976daf0ed22c5e7b4984ffe488525989 150000 0 0 0 0 0
0 49590 0 0 15000 0 136087 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 05/01/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 190475
0 1 0 0 0 SRI HARTINI, NY 090590 58 21529 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344776
1#0##0#0#0.0#2021-12-20
13:16:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
63b62c741530fd731343e9d753410a0f 150000 0 0 0 0 0
0 0 0 0 15000 0 25475 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 14/06/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 195301
0 1 0 0 0 YUNI ASTUTI.NY 092679 48 17716 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344777
1#0##0#0#0.0#2021-12-20
13:38:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e1a698b9deb3799f2fef83c0c019f9f4 150000 0 0 0 0 0
0 0 0 0 15000 0 30301 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 17/04/1974 0 1
1 Z09.8;K76.0;I64 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 200110
0 1 0 0 0 CHOLILIH, TN 095992 47 17409 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344778
1#0##0#0#0.0#2021-12-20
13:41:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1efa145fcf6af8966c4330c21f8430ae 150000 0 0 0 0 0
0 0 0 0 15000 0 35110 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
344729 1#0##0#0#0.0#2021-12-20
13:42:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0f5370d9879183bc924ab201452daee7 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 11/07/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 240550
0 1 0 0 0 BAMBANG PRAYITNO, TN 099183 50 18420
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344779
1#0##0#0#0.0#2021-12-20
13:43:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
955e39e02b717d5208963b297efe359a 150000 0 0 0 0 0
0 0 0 0 15000 0 75550 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 12/09/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 308745
0 1 0 0 0 DANUARDI SUPODO,TN 049724 77 28218
yani;3302226402970001; 5.5.5.202112011542 4 344781
1#0##0#0#0.0#2021-12-20
13:46:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
49742e92cba4edc560782cefdeb6488c 150000 0 0 0 0 0
0 31845 0 0 15000 0 111900 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 25/06/1971 0 2
1 Z09.8;G59.0;E11.4;I10 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 219840
0 1 0 0 0 SUDARNINGSIH.NY 087516 50 18436 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344780
1#0##0#0#0.0#2021-12-20
13:45:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cf38eaece9d47b178d10c1fd44da8332 150000 0 0 0 0 0
0 0 0 0 15000 0 54840 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 25/05/1986 0 1
1 Z09.8;I10;G62.8 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 206342
yani;3302226402970001; 5.5.5.202112011542 4 344782
1#0##0#0#0.0#2021-12-20
13:56:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1956fdd9f0b9843795f3d1eb4e88ad64 150000 0 0 0 0 0
0 0 0 0 15000 0 41342 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 10/10/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 197832
0 1 0 0 0 SULUT, TN 082030 64 23442 DR. DAMAR
5.6.6.202203301209 4 344783 1#0##0#0#0.0#2022-04-14
13:03:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
7a269e44d097854075721e0b6f4e1b7a 150000 0 0 0 0 0
0 0 0 0 15000 0 32832 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 29/11/1974 0 2
0 - 0 - 0 - 0 183900 261632 0 1
SP.B 1124R0021221V002515 0000640529392 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344784 1#0##0#0#0.0#2021-12-20
13:57:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4fbe03a93e0f5b016227e60230d8df2b 235000 0 0 0 0 0
0 0 0 0 15000 0 11632 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 23/12/1997 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 ANDIKA MUCHLIS WIBOWO, SDR 099473 23
novia;3313125201940001; 5.6.3.202201201500 4 344785
1#0##0#0#0.0#2022-02-15
10:42:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
502cf03d2f79337701db3089548404c6 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 30/06/1979 0 2
0 - 0 - 0 - 0 183900 342550 0 1
0 0 0 DIYAH YUNIANINGSIH, NY 071513 42 15509 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344786
1#0##0#0#0.0#2021-12-20
13:59:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
15cb60fadf10c7cdcdeb4f8dfd90a799 310000 0 0 0 0 0
0 0 0 0 15000 0 17550 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 05/04/1971 0 2
1 N13.2 - - - None None None None Q-5-41-0 None None
- 0 - 0 - 0 - 0 289400 443760 0
1 0 0 0 SUCIATI .NY 077780 50 18517 DR. HERMAWAN, Sp.B
M.Kes 1124R0021221V002519 0001271536964 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 347243 1#0##0#0#0.0#2022-01-05
16:38:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
63161eb45bdd9dffb623b74b67bdda8a 300000 0 0 0 0 0
0 0 0 0 15000 0 128760 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 25/06/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 UNING YUNIATI, (NY) 050245 46 16975
novia;3313125201940001; 5.6.3.202201201500 4 344787
1#0##0#0#0.0#2022-02-15
10:32:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
d52c642d4855b1b6e328f21dd5dc9fcb 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 22/04/1949 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
278795 0 1 0 0 0 DJUWARSO, (BP) 008057 72
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344788
1#0##0#0#0.0#2021-12-20
14:02:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
becbc04bf6aee26fb3acff2e7f1c1f49 203000 0 0 0 0 0
0 0 0 0 15000 0 60795 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 31/12/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 355011
0 1 0 0 0 AMINAH, NY 072466 63 23360 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344789
1#0##0#0#0.0#2021-12-20
14:04:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b07b61eccfdea809b227e29a1377cb40 150000 0 0 0 0 0
0 40000 0 0 15000 0 150011 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 09/08/1972 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ATIK UTAMI.NY
0001107008921 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344732 1#0##0#0#0.0#2021-12-20
14:06:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
462c10fc38db931836998d54bd1dc531 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 14/07/1959 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
282795 0 1 0 0 0 MARDIYAH, NY 043267 62
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 344791
1#0##0#0#0.0#2022-04-14
12:48:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
6b00e7b2a799c32bdc260efd0b1c854a 203000 0 0 0 0 0
0 0 0 0 15000 0 64795 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 08/09/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 288865
0 1 0 0 0 SUNARMI, NY 073823 73 26761 DR. YUDHI
yani;3302226402970001; 5.5.5.202112011542 4 344792
1#0##0#0#0.0#2021-12-20
14:09:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b7d99cf52cddc272c6eebc8a14697fea 203000 0 0 0 0 0
0 0 0 0 15000 0 70865 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 09/05/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 282795
yani;3302226402970001; 5.5.5.202112011542 4 344793
1#0##0#0#0.0#2021-12-20
14:11:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6479ec45f790f8da08b96383000201e7 203000 0 0 0 0 0
0 0 0 0 15000 0 64795 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 13/02/2014 0 2
1 Z09.8;H20.9;H52.2 90.29;95.01 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 298820
novia;3313125201940001; 5.6.3.202201201500 4 344794
1#0##0#0#0.0#2022-03-08
08:02:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
44e59a5a167d153a01b52eee30eb8c8f 254000 0 0 0 0 0
0 0 0 0 15000 0 29820 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 10/12/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 308775
yani;3302226402970001; 5.5.5.202112011542 4 344795
1#0##0#0#0.0#2021-12-20
14:15:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5cf5f0b4f55580718339e5b4c834c47c 203000 0 0 0 0 0
0 0 0 0 15000 0 90775 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 14/04/1957 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
282795 0 1 0 0 0 AMIR HAUDI,(BP) 029404 64
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 344796
1#0##0#0#0.0#2022-04-14
12:47:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
d8a183842afddf291e1381d294c0a602 203000 0 0 0 0 0
0 0 0 0 15000 0 64795 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 31/08/1962 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI HARTINA
1124R0021221V002530 0001958592576 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344731 1#0##0#0#0.0#2021-12-20
14:29:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
698c5d4f2518be7dbb4447db31270492 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 19/03/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 199050
0 1 0 0 0 DJOKO SARWONO.TN 095529 53 19629 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344797
1#0##0#0#0.0#2021-12-20
14:30:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a61b10747563b5fa411a8f179b1cde31 150000 0 0 0 0 0
0 0 0 0 15000 0 34050 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 03/12/1950 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 WARSO DIHARJO, BP 050194 71 25945 DR. ARYO SUSENO,
SP.PD 1124R0021221V002532 0001870379559 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344738 1#0##0#0#0.0#2021-12-20
14:31:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dce9d844423022d1f017fdd49c59df74 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 12/03/1955 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 SRI PONIMAH., NY 043214 66 24385 DR. ARYO SUSENO,
SP.PD 1124R0021221V002533 0000090535307 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344744 1#0##0#0#0.0#2021-12-20
14:32:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
893c8a7f7e223cf838a89538eda4e415 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 14/03/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 SOEHARTANTO.TN 083920 44 16347 DR. ARYO SUSENO,
SP.PD 1124R0021221V002534 0001526138853 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344743 1#0##0#0#0.0#2021-12-20
14:33:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fc8627693d20669094a8f2e480f95e28 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 22/02/1971 0 2
0 - 0 - 0 - 0 786200 677676 0 1
0 0 0 WIWIK SETYOWATI, NY 092361 50 18559 DR. ARYO
yani;3302226402970001; 5.5.5.202112011542 4 344742
1#0##0#0#0.0#2021-12-20
14:35:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
20945fe2f7303d4647257162693e6a88 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 01/07/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 288183
0 1 0 0 0 SUYATMI, NY 011006 59 21717 DR. INDRIANY
yani;3302226402970001; 5.5.5.202112011542 4 344798
1#0##0#0#0.0#2021-12-20
14:36:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5ab38241ffc304c3f9b6b82ae1c21db7 150000 0 0 0 0 0
0 0 0 0 15000 0 123183 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 09/09/1944 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 HARWOKO, TN 063244 77 28221 DR. ARYO SUSENO, SP.PD
1124R0021221V002537 0000100867893 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344739 1#0##0#0#0.0#2021-12-20
14:37:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5352d4fa9d337d5b5aad828b445c64b4 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 31/12/1981 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 SULASTRI, NY 067303 39 14594 DR. ARYO SUSENO,
SP.PD 1124R0021221V002538 0001696977999 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344741 1#0##0#0#0.0#2021-12-20
14:38:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1fa1d77271a2fa4bfc565f838ccecd18 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 16/09/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 267121
0 1 0 0 0 WARSI HARTANI.NY 099234 64 23466 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344799
1#0##0#0#0.0#2021-12-20
14:38:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ce65ff089f89fc80a39f34715b8d8d2c 150000 0 0 0 0 0
0 0 0 0 15000 0 102121 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 18/07/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 SUNARNO, BP 062099 57 20969 DR. ARYO SUSENO, SP.PD
1124R0021221V002540 0002425018184 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344740 1#0##0#0#0.0#2021-12-20
14:39:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
466dc4f01b8c4467930992ab6585d844 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 25/06/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 247600
0 1 0 0 0 WAHYUNI TRI SUSANTI 092680 55 20262
agung;3313092303950002; 5.6.6.202203301209 4 344800
1#0##0#0#0.0#2022-04-14
13:31:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
500185ba4cc0b97f75878307f2826e77 150000 0 0 0 0 0
0 0 0 0 15000 0 82600 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 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; 5.5.5.202112011542 4
344730 1#0##0#0#0.0#2021-12-20
14:41:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
78c0e83f5483a96832eec504d1877c1e 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 07/05/1958 0 1
- 0 - 0 - 0 - 0 283800 468860 0
1 0 0 0 SUKIRMAN.TN 099317 63 23233 DRG. VERAWATY,
SP.KG 1124R0021221V002544 0002093524391 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344801 1#0##0#0#0.0#2021-12-20
14:42:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3a6540d559312665b8dcdbf0b50e348a 450000 0 0 0 0 0
0 0 0 0 15000 0 3860 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 07/03/1998 0 2
0 - 0 - 0 - 0 183900 278375 0 1
0 0 0 NOERMALA DWI R, NN 008273 23 8684 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344802
1#0##0#0#0.0#2021-12-20
14:43:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3a76a6e62aea1431adcdae91c9c43484 235000 0 0 0 0 0
0 0 0 0 15000 0 28375 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 18/09/1957 0 2
0 - 0 - 0 - 0 283800 465000 0 1
0 0 0 INDRIYANI, NY 093214 64 23464 DRG. VERAWATY,
SP.KG 1124R0021221V002546 0000091502043 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344803 1#0##0#0#0.0#2021-12-20
14:44:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2e6c16255d136992969655aba54cd8a1 450000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 05/07/1976 0 2
0 - 0 - 0 - 0 283800 465000 0 1
0 0 0 SUSI ERNAWATI, NY 016417 45 16599 DRG. VERAWATY,
SP.KG 1124R0021221V002547 0001296151389 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344804 1#0##0#0#0.0#2021-12-20
14:48:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d7abed74b5326bcbe16a5fc7f519683a 450000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 03/07/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 233400
0 1 0 0 0 ENDANG PAMULARSIH ., NY 000898 59 21715
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344805
1#0##0#0#0.0#2021-12-20
14:51:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
65521b149c0462cff18ed2add4a4c1e4 150000 0 0 0 0 0
0 0 0 0 15000 0 68400 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 06/11/1975 0 2
- 0 - 0 - 0 - 0 283800 315000 0
yani;3302226402970001; 5.5.5.202112011542 4 344807
1#0##0#0#0.0#2021-12-20
14:54:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e6fdcd7fd902cf05c0facbc7cd137801 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 25/05/1957 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 RUKIAH MATITAL, NY 057379 64 23580 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344808
1#0##0#0#0.0#2021-12-20
14:55:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
63a25a84c295b467faa9727435ce46bd 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 08/08/1950 0 2
- 0 - 0 - 0 - 0 283800 315000 0
agung;3313092303950002; 5.6.6.202203301209 4 344809
1#0##0#0#0.0#2022-04-14
12:50:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
40505dc06fdf06510718f90232df5c21 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 11/03/1995 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 FRISCA MARETHA NUR ASYAH.NY 100161 26 9776
yani;3302226402970001; 5.5.5.202112011542 4 344810
1#0##0#0#0.0#2021-12-20
14:58:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bdcc18cdfec625046c76bb327d8c8a32 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 02/02/1973 0 2
1 D34 88.71 - - None None None None Z-3-23-0 None None
- 0 - 0 - 0 - 0 549400 845000 0
1 0 0 0 IDA BARIROH.NY 100696 48 17848 DR.
novia;3313125201940001; 5.6.3.202201201500 4 347244
1#0##0#0#0.0#2022-02-15
11:06:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
5e85fee2dbe93b45b46c294d81d7ab1d 150000 0 0 0 0 0
680000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 04/08/1983 0 2
0 0 - 0 - 0 - 0 - 0 181400 190240
0 1 0 0 0 WINDASARI DEWI ANGGRAINI, NY 100385 38
0002499949449 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344806 1#0##0#0#0.0#2021-12-20
14:52:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cd402c87c5b9881661e61a770394b15a 150000 0 0 0 0 0
0 0 0 0 15000 0 25240 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 01/01/2000 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 KHOLIS ISTIQOMAH,(AN) 003126 21 8019 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344811
1#0##0#0#0.0#2021-12-20
14:59:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
02d41c6ad1ecfca0d903c3905f0f0fe9 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 31/03/1962 0 1
1 Z09.8;G62.8;I10;H81.3 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 205090
0 1 0 0 0 HARYANTO., BP 055037 59 21809 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344812
1#0##0#0#0.0#2021-12-20
15:00:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1b819bbf52a6b696de1fbff763ea5983 150000 0 0 0 0 0
0 0 0 0 15000 0 40090 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 01/04/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 386816
0 1 0 0 0 RUBIYATI, NY 058982 45 16694 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344813
1#0##0#0#0.0#2021-12-20
15:02:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
75277f301550ef980110d7242cc72bd3 150000 0 0 0 0 0
0 133700 0 0 15000 0 88116 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 10/10/1981 0 1
0 - 0 - 0 - 0 283800 337030 0 1
0 0 0 DJOKO SARWONO.TN 100626 40 14676 DRG. VERAWATY,
SP.KG 1124R0021221V002561 0002211271288 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344814 1#0##0#0#0.0#2021-12-20
15:04:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
29e317785ba21b5416f70c500880d409 300000 0 0 0 0 0
0 0 0 0 15000 0 22030 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 25/11/1963 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 PRIYONO,TN 00891 58 21205 DRG. VERAWATY, SP.KG
1124R0021221V002562 0001104198974 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344815 1#0##0#0#0.0#2021-12-20
15:05:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d88642a129bcbd1b59bc932464748f1f 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 06/01/1968 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 KARMIYANI, NY 069923 53 19702 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344816
1#0##0#0#0.0#2021-12-20
15:06:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d9eb041adf194de97061c4e36ae74254 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 29/09/1959 0 1
1 E11.4;G59.0;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 189090
0 1 0 0 0 SUHARDI, TN 018629 62 22723 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 344817
1#0##0#0#0.0#2021-12-20
15:07:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
35cb5a2af405c91a3833c060508cb80a 150000 0 0 0 0 0
0 0 0 0 15000 0 24090 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 05/01/1951 0 1
1 Z09.8;M54.59;R51;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 211770
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344818
1#0##0#0#0.0#2021-12-20
15:09:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ced30eacd8fb1a9278015484b4c6a813 150000 0 0 0 0 0
0 0 0 0 15000 0 46770 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 20/11/1970 0 1
0 - 0 - 0 - 0 283800 318860 0 1
0 0 0 NGADI.TN 042183 51 18653 DRG. VERAWATY, SP.KG
1124R0021221V002566 0001160604933 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344819 1#0##0#0#0.0#2021-12-20
15:11:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dad4b0602df41e93d81e4dc536413737 300000 0 0 0 0 0
0 0 0 0 15000 0 3860 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 20/05/2006 0 1
- 0 - 0 - 0 - 0 283800 315000 0
yani;3302226402970001; 5.5.5.202112011542 4 344820
1#0##0#0#0.0#2021-12-20
15:15:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
464a0fc63b4cc59ef6d59b2ad5b1ddb2 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 31/12/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 198240
0 1 0 0 0 JUMIYATUN.NY 091533 48 17881 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344821
1#0##0#0#0.0#2021-12-20
15:21:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
56460a8b3040b56f51b82cbd349ca0ed 150000 0 0 0 0 0
0 0 0 0 15000 0 33240 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 25/04/1989 0 2
- 0 - 0 - 0 - 0 283800 315000 0
yani;3302226402970001; 5.5.5.202112011542 4 344822
1#0##0#0#0.0#2021-12-20
15:22:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
56e410b653b5601c52636dafb0f6826f 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 11/07/1967 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MARYATI,(NY) 001967 54 19881 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344823
1#0##0#0#0.0#2021-12-20
15:34:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3a8137c36324018a444add774e96cdc3 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 14/02/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 236950
0 1 0 0 0 BAMBANG SARTONO.TN 100390 61 22585
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344824
1#0##0#0#0.0#2021-12-20
15:37:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
854ad236f81b7057fb25904132be70a7 150000 0 0 0 0 0
0 0 0 0 15000 0 71950 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 01/01/2000 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SUDIRMAN LAMSI., BP 041571 21 8019 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344825
1#0##0#0#0.0#2021-12-20
15:40:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9febfa4eb41ad945f63e0ceca446888a 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 29/05/2001 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 NIKMAH RIZKYANA NURUL HANIFAH, NN 100384 20
yani;3302226402970001; 5.5.5.202112011542 4 344826
1#0##0#0#0.0#2021-12-20
15:41:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
20e40c97f3f5efc7b07da259dddbb1f8 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 20/11/1985 0 1
1 Z09.8;G40.6;I64 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 302990
0 1 0 0 0 MUHAMMAD HERI SUSANTO.TN 084491 36
0001842045939 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344827 1#0##0#0#0.0#2021-12-20
15:46:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5a2c83981efb4f25f00d7e1c050f5f51 150000 0 0 0 0 0
0 0 0 0 15000 0 137990 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 02/09/2000 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 DEA AL VERINA HARYANTO.nn 100381 21 7774
yani;3302226402970001; 5.5.5.202112011542 4 344828
1#0##0#0#0.0#2021-12-20
15:54:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6f212453d12bef01195e587d9048c7bb 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 24/05/1990 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MUTAHAROH FAISAH 100329 31 11528 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344829
1#0##0#0#0.0#2021-12-20
15:56:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8b9a405c11cb3468feb9d10566d0bf14 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 01/01/2000 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 YOHANA YULIA,(NY) 020884 21 8019 DRG. VERAWATY,
SP.KG 1124R0021221V002579 0000639520569 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344830 1#0##0#0#0.0#2021-12-20
15:59:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a7a43c1cb38fa1f8876b5668d1955b06 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 10/06/1971 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 NILAM SRI RAHAYU, NY 056143 50 18451 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344831
1#0##0#0#0.0#2021-12-20
16:02:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1ed5eb23a5d83ee7de092a7f7ae4d080 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 26/11/1966 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SULARSA, TN 039930 55 20108 DRG. VERAWATY,
SP.KG 1124R0021221V002581 0001530454871 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344832 1#0##0#0#0.0#2021-12-21
08:39:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7f60fe1089b4aabea66529ce8b2e3186 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 23/12/1979 0 2
- 0 - 0 - 0 - 0 283800 315000 0
SP.KG 1124R0021221V002583 0001133846302 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344833 1#0##0#0#0.0#2021-12-21
08:43:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f77c1f383b566e0b5fc07a8c79df1a45 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 18/12/1965 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 CHRISTINE KOESTANTINE.NY 100685 55 20451 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344834
1#0##0#0#0.0#2021-12-21
08:43:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
95e1a5b571707b8d014d50020227d513 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 31/12/1963 0 2
1 Z09.8;M54.59;M75.0;H81.3 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
187535 0 1 0 0 0 SUGIHARTI, NY 057187 57
0000639659979 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344835 1#0##0#0#0.0#2021-12-21
08:46:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
09b2794ab9ccae45d92e3c6e3830052a 150000 0 0 0 0 0
0 0 0 0 15000 0 22535 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 20/06/1943 0 2
0 - 0 107400 273000 0 1 0 0 0
1124R0021221V002588 0001800527916 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344734 1#0##0#0#0.0#2021-12-21
08:47:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
72dd949f125ac96d921c5f898cbe4eef 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 22/08/1947 0 2
0 - 0 107400 262000 0 1 0 0 0 DYAH
NURJANTI,(NY) 042222 74 27144 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V002589 0000091082722 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344733 1#0##0#0#0.0#2021-12-21
08:48:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0f74a7905548e5d182b9deed053f1893 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 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
344735 1#0##0#0#0.0#2022-04-14
13:11:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
eaafb742a7cc4013d3973e5a783b1fed 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 21/09/1944 0 1
1 Z09.8;R16.0;N28.1 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 228990
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344836
1#0##0#0#0.0#2021-12-21
08:49:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8d7add0be66a2d5576ab010cd11074df 150000 0 0 0 0 0
0 0 0 0 15000 0 63990 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 08/04/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 239210
0 1 0 0 0 SRI LESTARI.NY 100163 73 26914 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344837
1#0##0#0#0.0#2021-12-21
08:50:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b8a51f5fdb389aab073264ccd07f2f7c 150000 0 0 0 0 0
0 0 0 0 15000 0 74210 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 08/02/1995 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 GAN EDYTIA NOER CAHYANI.NY 100688 26 9807 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344838
1#0##0#0#0.0#2021-12-21
09:08:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
30bdf57ded4048c350c98bf24173fc18 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 05/01/1977 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 DWI SUJIATI,(NY) 023798 44 16415 DRG. VERAWATY,
SP.KG 1124R0021221V002594 0001694623667 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 344839 1#0##0#0#0.0#2021-12-21
09:09:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eb64705ec221f19dc5da1f60689b1d08 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
344736 1#0##0#0#0.0#2021-12-21
09:10:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e9133e05ec2ae3e96c31a82fb5166939 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 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 273265
0 1 0 0 0 ROBERT YASIMDA SIMARMATA. TN 093055 71
0001808151412 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344840 1#0##0#0#0.0#2021-12-21
09:11:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
55c9d606d265b1f6cf08c29253365cc4 150000 0 0 0 0 0
0 0 0 0 15000 0 108265 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 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; 5.5.5.202112011542 4
344727 1#0##0#0#0.0#2021-12-21
09:12:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 15/12/2021 15/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
344726 1#0##0#0#0.0#2021-12-21
09:13:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 15/12/2021 15/12/2021 31/12/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 199920
0 1 0 0 0 SRI SUHARNI., NY 045839 51 18977 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344841
1#0##0#0#0.0#2021-12-21
10:03:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 15/12/2021 15/12/2021 06/01/1990 0 1
- 0 - 0 - 0 - 0 206700 165000 0
1 0 0 0 KHOIRUL ANWAR, TN 098697 31 11666 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344842
1#0##0#0#0.0#2021-12-21
10:03:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 15/12/2021 15/12/2021 21/07/2016 0 1
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 PRISHA ADRIENNE SAGARA.AN 079879 5 1973 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344843
1#0##0#0#0.0#2021-12-21
10:04:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cf2d95bcf3ca9a4eb7d387e92f099384 300000 0 0 0 0 0
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3372030 C 3 CP 2 15/12/2021 15/12/2021 09/05/1975 0 1
- 0 - 0 - 0 - 0 283800 340750 0
1 0 0 0 HERI SUSANTO,TN 022986 46 17022 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344844
1#0##0#0#0.0#2021-12-21
10:05:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 15/12/2021 15/12/2021 26/09/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 NUR HARYANTI, NY
0002611312075 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
344725 1#0##0#0#0.0#2021-12-21
10:05:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 15/12/2021 15/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
344724 1#0##0#0#0.0#2021-12-21
10:06:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0cebe8b9bb3f4cdd55aad5c58f8aa1ae 258000 0 0 0 0 0
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3372030 C 3 CP 2 15/12/2021 15/12/2021 15/09/2021 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 NUR RACHMAD MEGAWANTO, TN 098639 0
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 344845
1#0##0#0#0.0#2021-12-21
10:08:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 15/12/2021 15/12/2021 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; 5.5.5.202112011542 4
344723 1#0##0#0#0.0#2021-12-21
10:09:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0d2d08325c6a7d285535204ced4e1de1 258000 0 0 0 0 0
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3372030 C 3 CP 2 15/12/2021 15/12/2021 07/05/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 241080
0 1 0 0 0 DIYONO.TN 095311 64 23598 DR. INDRIANY
yani;3302226402970001; 5.5.5.202112011542 4 344846
1#0##0#0#0.0#2021-12-21
10:10:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
916c6183c46bbe579412f898d48bc86e 150000 0 0 0 0 0
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3372030 C 3 CP 2 15/12/2021 15/12/2021 29/11/1979 0 1
0 - 0 - 0 - 0 - 0 181400 218010
0 1 0 0 0 YUSI FIRMANSYAH.TN 100705 42 15357
yani;3302226402970001; 5.5.5.202112011542 4 344847
1#0##0#0#0.0#2021-12-21
10:11:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c2c4f0fa22cb24c4793a697fede87228 150000 0 0 0 0 0
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3372030 C 3 CP 2 15/12/2021 15/12/2021 20/01/1994 0 2
0 - 0 - 0 - 0 283800 316860 0 1
0 0 0 IRFA EKA ANGRARESTI., NY 063581 27 10191 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344848
1#0##0#0#0.0#2021-12-21
10:12:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
55c27433a78c007d776d10f170fc25ae 300000 0 0 0 0 0
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3372030 C 3 CP 2 15/12/2021 15/12/2021 08/10/1982 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 YOVIKA OKTORIANA, (NY) 010284 39 14313 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344849
1#0##0#0#0.0#2021-12-21
10:14:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
36dc835e7b5dd58a8dbd4c9d9185eb22 300000 0 0 0 0 0
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3372030 C 3 CP 2 15/12/2021 15/12/2021 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; 5.5.5.202112011542 4
344722 1#0##0#0#0.0#2021-12-21
10:16:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1f76cf37dc986e1e410de3bab11671cd 247000 0 0 0 0 0
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3372030 C 3 CP 2 15/12/2021 15/12/2021 09/01/1972 0 2
0 - 0 - 0 - 0 - 0 181400 182265
0 1 0 0 0 AMINI, NY 007326 49 18238 DR. TEKY
agung;3313092303950002; 5.6.3.202201201500 4 344850
1#0##0#0#0.0#2022-02-18
14:34:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
3226b277e229a83f4efd2ba54ecf3569 150000 0 0 0 0 0
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3372030 C 3 CP 2 15/12/2021 15/12/2021 07/01/1978 0 1
- 0 - 0 - 0 - 0 206700 165000 0
1 0 0 0 HERU PURWANTO,(BP) 011531 43 16048 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344851
1#0##0#0#0.0#2021-12-21
10:18:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fcd22814929672e4e3afeb64bd70318e 150000 0 0 0 0 0
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3372030 C 3 CP 2 15/12/2021 15/12/2021 13/12/1973 0 2
- 0 - 0 - 0 - 0 283800 465000 0
1 0 0 0 ROSIDA TAMBUNAN, (NY) 006539 48 17534 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344852
1#0##0#0#0.0#2021-12-21
10:19:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bbab06e452b63070b70ced170ae713c7 450000 0 0 0 0 0
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3372030 C 3 CP 2 15/12/2021 15/12/2021 17/01/1997 0 2
- 0 - 0 - 0 - 0 283800 465000 0
1 0 0 0 SUCI KARTIKA SARI,NN 012355 24 9098 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344853
1#0##0#0#0.0#2021-12-21
10:19:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ffb24b2e1edeff39125bc5c4b0f311bd 450000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 23/03/1967 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 RAHMAH SUWARNI.NY 099305 54 19991 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344854
1#0##0#0#0.0#2021-12-21
10:20:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a373ea0c91777d5c65904f23f560ce43 300000 0 0 0 0 0
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3372030 C 3 CP 2 15/12/2021 15/12/2021 12/05/1997 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 HANIN MEGA NINGSIH,NY 075771 24 8983 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 344855
1#0##0#0#0.0#2021-12-21
10:21:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f212ff0ecf1d2f9c306e9948e031508e 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 15/12/2021 15/12/2021 17/09/1986 0 2
0 - 0 - 0 - 0 135700 238951 0 1
0 0 0 HIKMAH FALILA ,NY 048227 35 12873 DR. YOSSI
1124R0021221V002624 0001269014016 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346662 1#0##0#0#0.0#2022-01-04
14:30:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 15/01/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 248806
0 1 0 0 0 SITI RAHAYU, NY 084960 70 25903 DR.
agung;3313092303950002; 5.5.5.202112011542 4 345759
1#0##0#0#0.0#2021-12-29
08:55:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
69d88ae37a06aba7bc460cc3118da89f 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 26/02/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 238343
agung;3313092303950002; 5.5.5.202112011542 4 345760
1#0##0#0#0.0#2021-12-29
08:55:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
84a5bcfe13e87ac6799be12699be8444 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 14/09/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 215380
agung;3313092303950002; 5.5.5.202112011542 4 345761
1#0##0#0#0.0#2021-12-29
08:56:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5b1bd1cda42d3981d7fbe2286ef8acd6 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 14/07/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 333535
0 1 0 0 0 PONIYEM ., NY 058483 60 22070 DR.
agung;3313092303950002; 5.5.5.202112011542 4 345762
1#0##0#0#0.0#2021-12-29
08:58:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bf9dbc3e7a28556be150f987e2a49317 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 16/02/1970 0 2
1 Z09.8;E11.9;I10;M47.86 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 IDA PUJIASTUTI, (NY) 015965 51 18931
agung;3313092303950002; 5.5.5.202112011542 4 345763
1#0##0#0#0.0#2021-12-29
09:00:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d55bd460d00f74251e88ec25e7a1c6e4 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 28/04/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 220232
0 1 0 0 0 KURDI., BP 052526 77 28356 DR. WAHYU
agung;3313092303950002; 5.5.5.202112011542 4 345764
1#0##0#0#0.0#2021-12-29
09:01:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 15/03/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 382665
0 1 0 0 0 BAMBANG SUSANTO, TN 093328 52 19269
agung;3313092303950002; 5.5.5.202112011542 4 345765
1#0##0#0#0.0#2021-12-29
09:02:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 120795 0 0 15000 0 96870 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 25/05/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 331026
0 1 0 0 0 SUKAMTO, TN 091928 59 21755 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 345767
1#0##0#0#0.0#2021-12-29
09:03:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
36c0b6dffab1b0ae69dc118dda153780 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 01/01/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 774604
0 1 0 0 0 ANI NUR ISNAINI , NY 000522 55 20438
agung;3313092303950002; 5.5.5.202112011542 4 345768
1#0##0#0#0.0#2021-12-29
09:07:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b4ed16fe19533138dc117671eb05835d 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 31/08/1989 0 1
0 - 0 - 0 - 0 - 0 182600 231152
0 1 0 0 0 SEINDY ARYA KUSUMA TIMOER.TN 100704 32
3;JKN novia;3313125201940001; 5.6.0.202201041418 4 346535
1#0##0#0#0.0#2022-01-07
12:40:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
e28d6addb939cc9d23039839bfc45126 150000 0 0 0 0 0
0 0 0 0 15000 0 66152 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 04/06/1950 0 2
1 Z09.8;E11.2;N08.3;I10;G59.0;K30 - - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 696112 0 1 0 0 0 FAUZIAH NASUTION, NY
058142 71 26128 DR. TEKY WIDYARINI, SP.PD 1124R0021221V002636
0002198011882 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
345782 1#0##0#0#0.0#2021-12-29
09:29:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2d01e907edfbbc656a720803ab5d2bed 150000 0 0 0 0 0
0 76595 0 0 15000 0 454517 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 18/12/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 216042
0 1 0 0 0 MUHAMMAD HATTA 58655 63 23374 DR. WAHYU
agung;3313092303950002; 5.5.5.202112011542 4 345784
1#0##0#0#0.0#2021-12-29
09:30:37#0#00:00:00#00:00:00#12:00:00#{"co_insidense_ind":"0"} 1
39ac650df87eaf8b54f631bc14a711be 150000 0 0 0 0 0
0 0 0 0 15000 0 51042 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 30/12/1950 0 2
1 Z09.8;M16.9;M17.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 239970
agung;3313092303950002; 5.5.5.202112011542 4 345789
1#0##0#0#0.0#2021-12-29
09:31:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5e94332430351df8a0f20bc4b1438854 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 21/11/1982 0 2
1 Z09.8;K30;G62.8;M25.58 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 380270
agung;3313092303950002; 5.5.5.202112011542 4 345793
1#0##0#0#0.0#2021-12-29
09:33:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
970c6c0d21657a42011b9e868aa48643 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 10/07/1955 0 2
0 404900 388162 0 1 0 0 0 SRI MURNI, NY
0000092816368 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
345798 1#0##0#0#0.0#2021-12-29
09:34:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f05459be53563e8a5c2526f439f7e9f8 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 18/11/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 259113
agung;3313092303950002; 5.5.5.202112011542 4 345799
1#0##0#0#0.0#2021-12-29
09:35:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8828cbfc4df4f441e7d3b89e66ac7ec9 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 08/08/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 506700
0 1 0 0 0 HJ ENDANG SRI ., NY 054099 71 26063
agung;3313092303950002; 5.6.6.202203301209 4 345800
1#0##0#0#0.0#2022-04-14
12:50:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
7b8c1daee3ba7bc8e7cb7125f94fa677 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 24/10/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 243671
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novia;3313125201940001; 5.6.3.202201201500 4 345803
1#0##0#0#0.0#2022-03-08
11:48:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
fad6cc997d860dc9b7c9dd293eb75d2e 0 0 138000 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 24/12/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 219000 0 1 0 0 0 SRI SUTANTI, NY
0000639837347 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
345804 1#0##0#0#0.0#2021-12-29
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agung;3313092303950002; 5.5.5.202112011542 4 345805
1#0##0#0#0.0#2021-12-29
09:43:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 345807
1#0##0#0#0.0#2021-12-29
09:50:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 345808
1#0##0#0#0.0#2021-12-29
09:53:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 345809
1#0##0#0#0.0#2021-12-29
09:54:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 345834
1#0##0#0#0.0#2021-12-29
10:38:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 345835
1#0##0#0#0.0#2021-12-29
10:40:30#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#2021-12-29
10:43:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 345838
1#0##0#0#0.0#2021-12-29
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10:50:02#0#00:00:00#00:00:00#16:47:50#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 345841
1#0##0#0#0.0#2021-12-29
10:50:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 345846
1#0##0#0#0.0#2021-12-29
11:02:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 24/06/1984 0 2
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novia;3313125201940001; 5.6.3.202201201500 4 345847
1#0##0#0#0.0#2022-02-15
09:49:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 16/12/2021 16/12/2021 08/06/1956 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 345848
1#0##0#0#0.0#2021-12-29
11:06:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 26/08/1967 0 1
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11:12:20#0#00:00:00#00:00:00#14:26:22#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 12/01/1978 0 2
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(NY) 025580 43 16044 DR. WAHYU PURNOMO, SP.OT 1124R0021221V002664
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11:13:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 345867
1#0##0#0#0.0#2021-12-29
11:16:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 346536
1#0##0#0#0.0#2022-01-04
09:32:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 31/10/1967 0 1
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agung;3313092303950002; 5.5.5.202112011542 4 345869
1#0##0#0#0.0#2021-12-29
11:18:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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novia;3313125201940001; 5.6.3.202201201500 4 345873
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11:45:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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1#0##0#0#0.0#2021-12-29
11:22:44#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#2021-12-29
11:27:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 345877
1#0##0#0#0.0#2021-12-29
11:36:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 06/11/1957 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 345878
1#0##0#0#0.0#2021-12-29
11:37:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 13/10/1974 0 1
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agung;3313092303950002; 5.5.5.202112011542 4 345879
1#0##0#0#0.0#2021-12-29
11:39:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 04/02/1951 0 1
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1#0##0#0#0.0#2021-12-29
14:49:26#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#2022-01-07
19:55:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 16/12/2021 16/12/2021 31/12/1959 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 346001
1#0##0#0#0.0#2021-12-29
14:54:36#0#00:00:00#00:00:00#14:50:54#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 05/03/1973 0 2
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0001445069981 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
346003 1#0##0#0#0.0#2021-12-29
14:55:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 30/08/1942 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 346009
1#0##0#0#0.0#2021-12-29
14:56:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 07/07/1945 0 1
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08:57:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 346041
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09:03:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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09:06:24#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#2021-12-30
09:07:46#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#2021-12-30
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1#0##0#0#0.0#2021-12-30
09:16:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 1 0 0 0 ENDANG SRI LESTARI.NY 084974 54 19848
agung;3313092303950002; 5.5.5.202112011542 4 344659
1#0##0#0#0.0#2021-12-30
09:17:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bb474e720cfa66a15d62e1429eae1144 150000 0 0 0 0 0
0 120795 0 0 15000 0 72612 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 31/12/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 225664
0 1 0 0 0 SITI MARYAM, NY 093234 67 24822 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346073
1#0##0#0#0.0#2021-12-30
09:19:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0552b311ad1036e6efaea5cadba01e56 150000 0 0 0 0 0
0 0 0 0 15000 0 60664 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 27/03/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 230515
0 1 0 0 0 SUHARTO JOKO.P (BP) 050087 67 24736
novia;3313125201940001; 5.6.3.202201201500 4 346079
1#0##0#0#0.0#2022-03-08
09:08:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
3ce24d1dd80e589a4666b7ae4883c85c 150000 0 0 0 0 0
0 44200 0 0 15000 0 21315 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 07/01/1951 0 1
1 Z09.8;G20;H81.3 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 210885
0 1 0 0 0 MUH NUKMAN.TN 080746 70 25911 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346082
1#0##0#0#0.0#2021-12-30
09:21:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b3d4f24513bbe1645e226e7104ade9b7 150000 0 0 0 0 0
0 0 0 0 15000 0 45885 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 16/01/1981 0 2
1 M17.9;W19.3 88.27 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 219152
0 1 0 0 0 RINI PURWATININGSIH,(NY) 036555 40
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 346537
1#0##0#0#0.0#2022-01-04
09:33:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1ea6b6296c51fd79f775d281bba6e827 150000 0 0 0 0 0
0 0 0 0 15000 0 54152 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 17/06/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 209260
agung;3313092303950002; 5.5.5.202112011542 4 346087
1#0##0#0#0.0#2021-12-30
09:22:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7ff53d585f89629cb5421e804c6b54cd 150000 0 0 0 0 0
0 0 0 0 15000 0 44260 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 10/04/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 221080
0 1 0 0 0 SRI RAHAYU.NY 084543 60 22165 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346089
1#0##0#0#0.0#2021-12-30
09:24:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
64fbb1ce2ecef684cddae53c86b9afb7 150000 0 0 0 0 0
0 0 0 0 15000 0 56080 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 30/10/1989 0 2
0 0 - 0 - 0 - 0 - 0 181400 221104
0 1 0 0 0 OKI NUGROHO JATI. NY 092823 32 11735
reni;3313147010930001; 5.6.0.202201041418 4 346094
1#0##0#0#0.0#2022-01-07
19:55:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 3
453039366d852700b7e1aeb73a707d09 150000 0 0 0 0 0
0 0 0 0 15000 0 56104 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 23/07/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 221104
agung;3313092303950002; 5.5.5.202112011542 4 346098
1#0##0#0#0.0#2021-12-30
09:27:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
df06f48112baaaf435951b377a67b368 150000 0 0 0 0 0
0 0 0 0 15000 0 56104 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 15/06/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 268202
0 1 0 0 0 BAMBANG HADI SUYOTO, BP 081166 61 22464
agung;3313092303950002; 5.5.5.202112011542 4 346114
1#0##0#0#0.0#2021-12-30
09:35:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
caa99a1145922634556dd0bb9bc4fb2f 150000 0 0 0 0 0
0 44750 0 0 15000 0 58452 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 08/11/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 502371
0 1 0 0 0 SRI BUNTARI 75696 59 21588 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 346116
1#0##0#0#0.0#2021-12-30
09:36:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ffb2c21e5274e3083fc9dd833d3f0445 150000 0 0 0 0 0
0 171170 0 0 15000 0 166201 0 0 0 0
0
3372030 C 3 CP 2 16/12/2021 16/12/2021 17/08/1996 0 1
0 0 - 0 - 0 - 0 - 0 181400 467152
0 1 0 0 0 AMSAR PULANGO ., SDR 058990 25 9252
agung;3313092303950002; 5.5.5.202112011542 4 346538
1#0##0#0#0.0#2022-01-04
09:34:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c6d76f2147ddabaf2de28804caf41622 150000 0 0 0 0 0
248000 0 0 0 15000 0 54152 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 20/04/1980 0 2
- 0 - 0 - 0 86900 315030 0 1 0 0
0 INA.NY 100505 41 15215 DR. GUNAWAN, SP.OG
1124R0021221V002703 0000565798061 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346118 1#0##0#0#0.0#2021-12-30
09:37:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
55693071b09c6c7117d62b879ff9036e 275000 0 0 0 0 0
0 0 0 0 15000 0 25030 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 31/12/1954 0 2
1 E11.4;G59.0;M19.98 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 223512
0 1 0 0 0 ASLAMIYAH., NY 043938 66 24457 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346122
1#0##0#0#0.0#2021-12-30
09:39:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fb439d2e0f05f454dadd3f8996a76f23 150000 0 0 0 0 0
0 0 0 0 15000 0 58512 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 31/12/1952 0 2
0 404900 443662 0 1 0 0 0 NGATIYEM 67636
0000640358291 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
346126 1#0##0#0#0.0#2021-12-30
09:40:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
610277e1d177259dddae0e64865e7f2e 201500 0 0 0 0 0
0 0 0 0 15000 0 227162 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 08/09/1960 0 2
1 Z09.8;K27.9;I11.9;M19.99 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
388162 0 1 0 0 0 SITI ZUBAIDAH, NY 066527 61
reni;3313147010930001; 5.6.0.202201041418 4 346132
1#0##0#0#0.0#2022-01-07
19:56:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
daf02fe1fba36feb25566bfd090de8b3 150000 0 0 0 0 0
0 0 0 0 15000 0 223162 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 16/05/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 218890
0 1 0 0 0 SETYO UTAMI NY 087345 62 22860 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346146
1#0##0#0#0.0#2021-12-30
09:48:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f936a2e77ac43c29062a147065bde762 150000 0 0 0 0 0
0 0 0 0 15000 0 53890 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 20/06/1957 0 2
0 404900 388162 0 1 0 0 0 TUGIYEM, NY 090349
0002166930696 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
346148 1#0##0#0#0.0#2021-12-30
09:51:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
223392d7386ff53c04881f2dc671346f 150000 0 0 0 0 0
0 0 0 0 15000 0 223162 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 19/08/1966 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
420860 0 1 0 0 0 JOHANES TARWANTO, TN 080993
55 20208 DR. ARYO SUSENO, SP.PD 1124R0021221V002709 0001792901428
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 346170
1#0##0#0#0.0#2021-12-30
10:19:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
416f02bfc7ffbb10319aea2b93bc3cd7 150000 0 0 0 0 0
0 108440 0 0 15000 0 147420 0 0 0 0
0
3372030 C 3 CP 2 16/12/2021 16/12/2021 08/01/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 229622
0 1 0 0 0 TRI SUWARTI, NY 057542 59 21892 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346171
1#0##0#0#0.0#2021-12-30
10:22:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
15a98251431bb1fd676d1d25ec293b1f 150000 0 0 0 0 0
0 0 0 0 15000 0 64622 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 12/09/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 219015
agung;3313092303950002; 5.5.5.202112011542 4 346251
1#0##0#0#0.0#2021-12-30
12:24:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fff94c7a98dcd0c90e8e08168703b9d7 150000 0 0 0 0 0
0 0 0 0 15000 0 54015 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 26/11/1986 0 2
1 Z09.8;K27.9;R11;R51 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 243717
agung;3313092303950002; 5.5.5.202112011542 4 346252
1#0##0#0#0.0#2021-12-30
12:25:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
56b33182268afa340fa2c509d1ae1b78 150000 0 0 0 0 0
0 0 0 0 15000 0 78717 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 04/06/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 216585
0 1 0 0 0 SURATMAN 029384 69 25397 DR. SUHARTO,
SP.PD 1124R0021221V002714 0001614176932 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346253 1#0##0#0#0.0#2021-12-30
12:26:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fbd438401ff4ad4140752b3de21f5cb5 150000 0 0 0 0 0
0 0 0 0 15000 0 51585 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 20/04/2001 0 1
0 0 - 0 - 0 - 0 - 0 181400 324955
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 346254
1#0##0#0#0.0#2021-12-30
12:27:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
de2d3a8f628c6a9ba4bc9449cccc1897 150000 0 0 0 0 0
0 120795 0 0 15000 0 39160 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 01/02/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 447210
0 1 0 0 0 LISTIYANI, NY 100278 44 16389 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346262
1#0##0#0#0.0#2021-12-30
12:56:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
74d2cf3644e098b07e0aa3ff6e48af22 150000 0 0 0 0 0
0 107890 0 0 15000 0 174320 0 0 0 0
0
3372030 C 3 CP 2 16/12/2021 16/12/2021 26/12/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 347687
agung;3313092303950002; 5.5.5.202112011542 4 346263
1#0##0#0#0.0#2021-12-30
13:26:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d82c004bf667f9830d0a7242d5bab380 150000 0 0 0 0 0
0 121345 0 0 15000 0 61342 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 23/03/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 226080
0 1 0 0 0 SUMARNI, NY 074054 62 22914 DR. WAHYU
agung;3313092303950002; 5.5.5.202112011542 4 346265
1#0##0#0#0.0#2021-12-30
13:40:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bc468419ac662f62fd3db1c1ef0e9c82 150000 0 0 0 0 0
0 0 0 0 15000 0 61080 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 26/01/1998 0 2
0 0 - 0 - 0 - 0 - 0 181400 274697
0 1 0 0 0 ANISA MAHDA HABSARI.NN 096945 23 8725
agung;3313092303950002; 5.5.5.202112011542 4 346266
1#0##0#0#0.0#2021-12-30
13:41:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4110dd49ecd354a0ef543cfb0342503c 150000 0 0 0 0 0
0 89500 0 0 15000 0 20197 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 12/11/1963 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002169748091 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
346267 1#0##0#0#0.0#2021-12-30
13:43:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1e124da5a5dd695e969e0b6bf708d1df 204000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 28/02/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 512762
0 1 0 0 0 TARWOKO.TN 088292 66 24398 DR. WAHYU
agung;3313092303950002; 5.5.5.202112011542 4 346539
1#0##0#0#0.0#2022-01-04
09:34:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cb6ee7070d7cc420a267ee8dc2df609c 150000 0 0 0 0 0
281000 0 0 0 15000 0 66762 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 31/12/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 303699
0 1 0 0 0 PONIYEM, NY 099368 64 23726 DR. ANITA
agung;3313092303950002; 5.5.5.202112011542 4 346268
1#0##0#0#0.0#2021-12-30
13:48:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
30705d8d5f3d575e66a8844701b9f41b 150000 0 0 0 0 0
0 88950 0 0 15000 0 49749 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 14/07/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 399505
0 1 0 0 0 MARDIYAH, NY 043267 62 22801 DR.
agung;3313092303950002; 5.6.6.202203301209 4 346270
1#0##0#0#0.0#2022-04-14
12:48:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
6cd1450108a2ee75403cbe701f653aae 150000 0 0 0 0 0
0 31845 0 0 25000 0 192660 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 13/12/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 293416
novia;3313125201940001; 5.6.3.202201201500 4 346271
1#0##0#0#0.0#2022-02-15
14:26:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
e5be7eef03866a7ae80541da7ec2f4e6 150000 0 0 0 0 0
0 31845 0 0 15000 0 96571 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 19/02/1941 0 2
0 - 0 - 0 - 0 183900 238322 0 1
0 0 0 KUSTINAH.NY 088456 80 29520 DR. WAHYU PURNOMO, SP.OT
1124R0021221V002725 0001720987121 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346272 1#0##0#0#0.0#2021-12-30
13:54:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4ae1d1ad27f7c9fc80df33330ca28c5c 176000 0 0 0 0 0
0 0 0 0 15000 0 47322 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 01/05/1974 0 2
1 Z09.8;R07.3;M79.86;K25.9 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
220424 0 1 0 0 0 KUPSAH MAERAH TUTI, (NY) 039834
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 346273
1#0##0#0#0.0#2021-12-30
13:55:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b89d09f5b6b4b614e7905103f6dedca2 150000 0 0 0 0 0
0 0 0 0 15000 0 55424 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 01/06/1932 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 Ny. Sujinem 40551
0000091171091 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
346274 1#0##0#0#0.0#2021-12-30
13:58:07#0#00:00:00#00:00:00#10:51:37#{"co_insidense_ind":"0"} 1
fa69a0b358c47cb7835cff3077c030a5 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 10/11/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 204750
0 1 0 0 0 WIYONO.TN 100139 69 25238 DR. SUHARTO,
SP.PD 1124R0021221V002729 0000090740204 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346275 1#0##0#0#0.0#2021-12-30
14:01:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
157d0dd054521992a4098832ab61ec4c 150000 0 0 0 0 0
0 0 0 0 15000 0 39750 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 29/12/1959 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SIDIK PRAMONO, BP
0000088602772 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
346277 1#0##0#0#0.0#2021-12-30
14:03:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bfb24cc7dd159c93ca2579bc718538a3 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 23/03/1937 0 2
0 0 - 0 - 0 - 0 - 0 181400 381104
0 1 0 0 0 SOFIYAH.NY 099979 84 30949 DR. WAHYU
agung;3313092303950002; 5.5.5.202112011542 4 346278
1#0##0#0#0.0#2021-12-30
14:05:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f8baf185fbe80f0db4255ee4fac88fb1 300000 0 0 0 0 0
0 0 0 0 15000 0 66104 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 08/10/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 229845
0 1 0 0 0 ENDANG KRISTIANY S, NY 068253 79 28924
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 346279
1#0##0#0#0.0#2021-12-30
14:07:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
08cddd7cac534594a0f5e4c6aa3fa8a0 150000 0 0 0 0 0
0 0 0 0 15000 0 64845 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 13/08/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 309561
novia;3313125201940001; 5.6.3.202201201500 4 346283
1#0##0#0#0.0#2022-03-08
08:25:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 16/12/2021 16/12/2021 03/12/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 226552
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agung;3313092303950002; 5.5.5.202112011542 4 346287
1#0##0#0#0.0#2021-12-30
15:02:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 08/12/1992 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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3372030 C 3 CP 2 16/12/2021 16/12/2021 24/01/1945 0 2
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novia;3313125201940001; 5.6.0.202201041418 4 346290
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12:48:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 16/12/2021 16/12/2021 16/07/1956 0 1
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3;JKN agung;3313092303950002; 5.5.5.202112011542 4 346291
1#0##0#0#0.0#2021-12-30
15:17:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 11/09/1947 0 1
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agung;3313092303950002; 5.5.5.202112011542 4 346293
1#0##0#0#0.0#2022-01-03
09:25:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 06/07/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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3372030 C 3 CP 2 16/12/2021 16/12/2021 04/05/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 506575
0 1 0 0 0 WINARTO., BP 052445 66 24333 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346295
1#0##0#0#0.0#2021-12-31
09:19:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 04/08/1952 0 2
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1124R0021221V002741 0000091515857 3;JKN agung;3313092303950002;
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3372030 C 3 CP 2 16/12/2021 16/12/2021 12/11/1945 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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346297 1#0##0#0#0.0#2021-12-31
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3372030 C 3 CP 2 16/12/2021 16/12/2021 20/02/1968 0 1
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agung;3313092303950002; 5.5.5.202112011542 4 346540
1#0##0#0#0.0#2022-01-04
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agung;3313092303950002; 5.5.5.202112011542 4 346298
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10:43:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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10:52:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 15/06/1949 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 346301
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10:57:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 15/01/1945 0 1
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agung;3313092303950002; 5.5.5.202112011542 4 346302
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10:58:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 21/07/1942 0 2
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10:59:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 11/03/1961 0 2
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1#0##0#0#0.0#2021-12-31
11:01:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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11:03:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 346307
1#0##0#0#0.0#2021-12-31
11:04:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 09/09/1973 0 1
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1#0##0#0#0.0#2021-12-31
11:08:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 13/08/1951 0 2
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11:10:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 13/06/1971 0 2
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agung;3313092303950002; 5.6.6.202203301209 4 346322
1#0##0#0#0.0#2022-04-14
13:13:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 16/12/2021 16/12/2021 23/03/1964 0 2
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11:12:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 10/11/1965 0 1
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346311 1#0##0#0#0.0#2021-12-31
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3372030 C 3 CP 2 16/12/2021 16/12/2021 07/12/1966 0 2
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1#0##0#0#0.0#2022-01-04
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3372030 C 3 CP 2 16/12/2021 16/12/2021 19/02/1956 0 2
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11:23:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 15/04/1967 0 1
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agung;3313092303950002; 5.5.5.202112011542 4 346329
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agung;3313092303950002; 5.5.5.202112011542 4 346330
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11:28:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 08/02/1948 0 1
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agung;3313092303950002; 5.5.5.202112011542 4 346331
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11:34:44#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#2021-12-31
11:39:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 346333
1#0##0#0#0.0#2021-12-31
11:40:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 10/04/1943 0 2
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1#0##0#0#0.0#2022-01-04
09:37:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 16/12/2021 16/12/2021 30/04/1969 0 2
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16:42:37#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#2021-12-31
13:00:45#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#2021-12-31
13:08:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b0036574733cee1e02acbccc7f5a0dbe 150000 0 0 0 0 0
0 0 0 0 15000 0 86572 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 21/04/1965 0 2
1 S82.80 88.27 - - None None None None Q-5-42-0 None
0 - 0 - 0 - 0 - 0 182600 474192
0 1 0 0 0 SARTINI 092871 56 20693 DR. WAHYU
agung;3313092303950002; 5.6.0.202201041418 4 348101
1#0##0#0#0.0#2022-01-07
18:37:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f88588e0c8dd1f05c79675042a3aa5c7 150000 0 0 0 0 0
248000 0 0 0 15000 0 61192 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 03/03/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 279627
agung;3313092303950002; 5.5.5.202112011542 4 346356
1#0##0#0#0.0#2021-12-31
13:09:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
de2e28653d94f8adea3c3fd2524983f9 150000 0 0 0 0 0
0 0 0 0 15000 0 114627 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 04/05/2002 0 2
1 Z09.8;Q27.9 96.59 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 337840 0 1
0 0 0 FECILLIA MAYDIANA PUTRI, NN 099922 19 7166 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346357
1#0##0#0#0.0#2021-12-31
13:10:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0018142f702eadb0948a5441a52fb7ce 295000 0 0 0 0 0
0 0 0 0 15000 0 27840 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 07/02/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 237580
0 1 0 0 0 SUHARNO.TN 096472 55 20401 DR. ARIA
agung;3313092303950002; 5.5.5.202112011542 4 346358
1#0##0#0#0.0#2021-12-31
13:30:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b20cc6739c14696731c840fe81912d5f 150000 0 0 0 0 0
0 0 0 0 15000 0 72580 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 21/10/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 264150
0 1 0 0 0 TUKINO, BP 069874 63 23067 DR. ARIA
agung;3313092303950002; 5.5.5.202112011542 4 346359
1#0##0#0#0.0#2021-12-31
13:31:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
da4c9ce0792a94c5b0211e51bf18c0a5 150000 0 0 0 0 0
0 0 0 0 15000 0 99150 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 02/08/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 236590
0 1 0 0 0 ISWINDARI., NY 047078 48 17668 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346360
1#0##0#0#0.0#2021-12-31
13:32:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4e061092d3fdd0e7c02cc0cb3bca2152 150000 0 0 0 0 0
0 0 0 0 15000 0 71590 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 19/10/1957 0 1
1 Z09.8;J04.0;D14.1 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 PARMIN.TN 100137 64 23434 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346362
1#0##0#0#0.0#2021-12-31
13:33:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
19fef27870446ef80fb8fec89ecd2cd4 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 29/09/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 231500
agung;3313092303950002; 5.5.5.202112011542 4 346363
1#0##0#0#0.0#2021-12-31
13:34:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d1f8e8a411b2b8a0814ab49e1821ab36 150000 0 0 0 0 0
0 0 0 0 15000 0 66500 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 04/11/1994 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 RAUHULLOH
1124R0021221V002782 0001796644269 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346328 1#0##0#0#0.0#2021-12-31
13:36:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
333a81f1ee729b419ff12aa5e96c39c0 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 18/06/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 227212
agung;3313092303950002; 5.5.5.202112011542 4 346369
1#0##0#0#0.0#2021-12-31
14:06:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ca419af7efc6388bc375ffb880cb2598 150000 0 0 0 0 0
0 0 0 0 15000 0 62212 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 15/03/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 195920
0 1 0 0 0 SUTRISWANTO.TN 094216 58 21461 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346370
1#0##0#0#0.0#2021-12-31
14:07:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
082adcb954c3ac7e56043a96c79074d6 150000 0 0 0 0 0
0 0 0 0 15000 0 30920 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 02/07/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 234866
0 1 0 0 0 JINTEN.NY 096036 66 24274 DR. ARIA
agung;3313092303950002; 5.5.5.202112011542 4 346371
1#0##0#0#0.0#2021-12-31
14:10:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
90dba92ea350d4def668b77030d22e0e 150000 0 0 0 0 0
0 0 0 0 15000 0 69866 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 29/04/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 228125
agung;3313092303950002; 5.5.5.202112011542 4 346372
1#0##0#0#0.0#2021-12-31
14:15:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
0ba4809442902794be2a59a3205ce698 150000 0 0 0 0 0
0 0 0 0 15000 0 63125 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 01/03/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 286000
0 1 0 0 0 SUWARDI, TN 100568 48 17822 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346375
1#0##0#0#0.0#2021-12-31
14:32:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
663c60b0566bf242e70007f4178e8bff 271000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 02/05/2004 0 1
0 0 - 0 - 0 - 0 - 0 181400 385000
0 1 0 0 0 NUR MAULUDIN ILMAN, SDR 100651 17 6437
agung;3313092303950002; 5.5.5.202112011542 4 346552
1#0##0#0#0.0#2022-01-04
09:38:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4b06465aaf874e62dd3520041a377672 150000 0 0 0 0 0
220000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 25/04/1954 0 1
1 Z09.8;E11.9;I10;C18.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 838496
0 1 0 0 0 SUNARTO (Bp) 019174 67 24707 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346376
1#0##0#0#0.0#2021-12-31
14:33:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1860da3db2bd38919c5a481754bdfbb6 150000 0 0 0 0 0
0 0 0 0 15000 0 673496 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 31/12/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 204620
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 346377
1#0##0#0#0.0#2021-12-31
14:37:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
78101e669cf4f8fe5f9643d5ab8e5739 150000 0 0 0 0 0
0 0 0 0 15000 0 39620 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 31/12/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 NGATIYEM, NY
0002940595885 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
346378 1#0##0#0#0.0#2021-12-31
14:38:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
beb06698242b96ca200bf9c65b9f12d5 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 17/09/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 239060
0 1 0 0 0 DAKA AHMAD MUSYAROF, TN 066016 66 24197
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 346380
1#0##0#0#0.0#2021-12-31
14:46:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
76176335d94359fc1fe359a20a2d855e 150000 0 0 0 0 0
0 0 0 0 15000 0 74060 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 13/06/1992 0 2
0 0 - 0 - 0 - 0 - 0 181400 224842
0001084671257 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
346381 1#0##0#0#0.0#2022-04-14
12:57:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
d524e0b1db50663aa4dba840a6e84d59 150000 0 0 0 0 0
0 0 0 0 15000 0 59842 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 26/05/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 222020
0 1 0 0 0 SRI REJEKI,NY 010002 59 21754 DR.
agung;3313092303950002; 5.6.6.202203301209 4 346383
1#0##0#0#0.0#2022-04-14
11:41:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
1e0b69231d1c78c5fd98742bbcdaf8be 150000 0 0 0 0 0
0 0 0 0 15000 0 57020 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 31/12/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 217352
0 1 0 0 0 INDRAYATI, NY 091755 57 21170 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346384
1#0##0#0#0.0#2022-01-03
07:41:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
97ff09d56592271b8d53523fc78eb686 150000 0 0 0 0 0
0 0 0 0 15000 0 52352 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 24/11/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
agung;3313092303950002; 5.5.5.202112011542 4 346385
1#0##0#0#0.0#2022-01-03
07:43:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
31811f9959e4ec8883ea35e349b925ea 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 19/02/1965 0 1
0 - 0 107400 262000 0 1 0 0 0 DANU
MARGONO.,BP 056891 56 20754 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V002798 0000640154136 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346386 1#0##0#0#0.0#2022-01-03
07:44:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fec6a66990a404c010b94daa179ce15f 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 02/07/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 265595
0 1 0 0 0 SRI SLAMET.NY 099401 50 18430 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346387
1#0##0#0#0.0#2022-01-03
07:45:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
20404795463c60492d023f19749616d0 150000 0 0 0 0 0
0 0 0 0 15000 0 100595 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 11/07/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 197440
0 1 0 0 0 DARYATI, NY 089873 65 23899 DR. ARIA
agung;3313092303950002; 5.5.5.202112011542 4 346388
1#0##0#0#0.0#2022-01-03
07:47:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0340244350852d13a548cd16e8c75c7b 150000 0 0 0 0 0
0 0 0 0 15000 0 32440 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 15/09/1988 0 1
1 Z09.8;J45.9;J30.3 87.49 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 411004
0 1 0 0 0 MUHAMMAD KHOIRUMAN.TN 080389 33 12145
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 346393
1#0##0#0#0.0#2022-01-03
08:48:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
69cbe8cb305be7fbd180ad79b13590a9 150000 0 0 0 0 0
0 0 0 0 15000 0 246004 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 28/10/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SRI WIJAYANTI 24147 63 23060 DR. SUHARTO,
SP.PD 1124R0021221V002803 0002047098723 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346394 1#0##0#0#0.0#2022-01-03
08:51:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
e5015cbb4acad9192cfe525057bb389b 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 12/08/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SUPARDI, TN 046047 79 28981 DR. INDRIANY
agung;3313092303950002; 5.5.5.202112011542 4 346395
1#0##0#0#0.0#2022-01-03
08:54:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f15794b41a4b04b87afaf9dfc7066e59 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 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; 5.5.5.202112011542 4
346396 1#0##0#0#0.0#2022-01-03
08:58:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
377c9ec9225445bad983861abd801ed8 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 15/08/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 LASITO., BP 041779 79 28978 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346397
1#0##0#0#0.0#2022-01-03
09:06:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ccc3f0feaef081683fe0a2476492a9ac 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 24/10/1986 0 1
1 D45;I12.0 87.49 - - 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 365000
0 1 0 0 0 SATRIYO WIBOWO, TN 008478 35 12837
agung;3313092303950002; 5.5.5.202112011542 4 346553
1#0##0#0#0.0#2022-01-04
09:38:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ddac1e26f65fb0ff56e616cbe5319afd 150000 0 0 0 0 0
200000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 06/05/1965 0 1
0 0 - 0 - 0 - 0 - 0 700800 510067
0 1 0 0 0 WALUYO, BP 085609 56 20678 DR. ARIA
agung;3313092303950002; 5.5.5.202112011542 4 346568
1#0##0#0#0.0#2022-01-04
09:39:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1798d25b56295178575ab50167651e95 150000 0 0 0 0 0
285000 0 0 0 15000 0 60067 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 08/09/1999 0 1
0 0 - 0 - 0 - 0 - 0 181400 280485
0 1 0 0 0 ANANG NOVANTO. SDR 042587 22 8135
agung;3313092303950002; 5.5.5.202112011542 4 346401
1#0##0#0#0.0#2022-01-03
10:07:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a3711357c7033986f0c37e54644da518 150000 0 0 0 0 0
0 0 0 0 15000 0 115485 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 05/01/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 363450
0 1 0 0 0 AHMAD RIYADI, (BP) 010384 54 20069
agung;3313092303950002; 5.5.5.202112011542 4 346402
1#0##0#0#0.0#2022-01-03
10:08:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1758bcec47fb8fb259aa82d5eedffee1 150000 0 0 0 0 0
0 0 0 0 15000 0 198450 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 14/10/1972 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V002815 0002082979192 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346403 1#0##0#0#0.0#2022-01-03
10:10:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a548945942e2ea18b88b98cd331c4e63 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 17/04/1973 0 1
0 - 0 - 0 - 0 786200 677676 0 1
SP.PD 1124R0021221V002816 0002078547524 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346404 1#0##0#0#0.0#2022-01-03
10:11:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8d98c258d40e88b227ab5bcc65319962 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 18/03/1988 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.5.5.202112011542 4 346407
1#0##0#0#0.0#2022-01-03
10:29:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1bc63ce2d6cf5b8f7b99ed61e235bb09 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 10/12/1982 0 1
0 - 0 - 0 - 0 786200 539100 0 1
SP.PD 1124R0021221V002818 0001125136214 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346411 1#0##0#0#0.0#2022-01-03
10:35:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
beedcaf59d600dd705ab7691f3b7d483 463830 0 0 0 0 0
0 0 0 0 15000 0 60270 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 12/10/1987 0 1
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; 5.5.5.202112011542 4 346412
1#0##0#0#0.0#2022-01-03
10:38:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
801adb698c05b5786bcba9a61ef1ce36 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 16/05/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 287905
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agung;3313092303950002; 5.5.5.202112011542 4 346414
1#0##0#0#0.0#2022-01-03
10:47:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 04/09/1964 0 1
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agung;3313092303950002; 5.5.5.202112011542 4 346415
1#0##0#0#0.0#2022-01-03
10:55:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 23/03/1976 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 346416
1#0##0#0#0.0#2022-01-03
10:57:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 22/04/1992 0 1
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SP.PD 1124R0021221V002823 0001894415848 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346417 1#0##0#0#0.0#2022-01-03
10:58:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c965b73449c1c1ef7359b7eca9748907 463830 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 10/07/1955 0 2
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SP.PD 1124R0021221V002824 0001032581823 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346419 1#0##0#0#0.0#2022-01-03
11:01:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
216b31cebf223ed527b33dd89aa4b451 463830 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 04/05/1958 0 2
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SP.PD 1124R0021221V002825 0001967732087 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346420 1#0##0#0#0.0#2022-01-03
11:02:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4875adb04214236f3d60bbba13e4002d 463830 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 31/12/1971 0 2
0 - 0 - 0 - 0 786200 579360 0 1
1124R0021221V002826 0000555344774 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346422 1#0##0#0#0.0#2022-01-03
11:08:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c801e27dd2773b152d8493ea9c1cad96 463830 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 29/03/1961 0 1
1 Z09.8;J44.9;E11.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 254897
0 1 0 0 0 PETRUS JUVENTUS SUGENG RIYADI.TN 087118
60 22177 DR. ANITA MUNTAFIAH, SP.P., M.KES 1124R0021221V002827
0000639437409 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
346424 1#0##0#0#0.0#2022-01-03
11:15:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 23/04/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 424974
0 1 0 0 0 SURYATI, NY 037498 53 19595 DR. ANITA
agung;3313092303950002; 5.5.5.202112011542 4 346427
1#0##0#0#0.0#2022-01-03
11:39:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a9c07a5645390f40ac12ef7bd7c716a4 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 05/12/2016 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 346429
1#0##0#0#0.0#2022-01-03
13:05:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3cf36a854cd3dede2156d0134bd22666 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 29/10/1965 0 1
1 Z09.8;J44.9;R51 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 439434
0 1 0 0 0 SANTOSO. TN 038094 56 20502 DR. ANITA
agung;3313092303950002; 5.5.5.202112011542 4 346433
1#0##0#0#0.0#2022-01-03
13:07:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a67d02073990c28d99557afad8a82cce 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 25/05/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 472927
0 1 0 0 0 SUDARMO HADIMULYO M, TN 066357 73 26868
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 346434
1#0##0#0#0.0#2022-01-03
13:09:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d7087fbb6f3b043c67593cadf91091e1 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 25/02/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 402702
0 1 0 0 0 ROSIDAH. NY 087797 69 25497 DR. ANITA
agung;3313092303950002; 5.5.5.202112011542 4 346435
1#0##0#0#0.0#2022-01-03
13:14:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
23402b28dcf561624fc8bf975667a61d 150000 0 0 0 0 0
0 0 0 0 15000 0 237702 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 01/02/1983 0 2
1 Z09.8;J45.9;I10;J06.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 278832
0 1 0 0 0 TRI WIYANTI 63218 38 14198 DR. ANITA
agung;3313092303950002; 5.5.5.202112011542 4 346437
1#0##0#0#0.0#2022-01-03
13:16:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 07/05/1992 0 2
1 Z09.8;J45.9;K21.9;I10 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 460435
0 1 0 0 0 FITRIYANA SETIADI, NN 089133 29 10815
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 346436
1#0##0#0#0.0#2022-01-03
13:15:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b1d630c243869a20867105857c0aac4e 150000 0 0 0 0 0
0 0 0 0 15000 0 295435 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 25/06/1970 0 2
0 - 0 - 0 - 0 786200 677676 0 1
SP.PD 1124R0021221V002835 0002074007092 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346438 1#0##0#0#0.0#2022-01-03
13:24:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 16/12/2021 16/12/2021 01/10/1985 0 1
0 0 - 0 - 0 - 0 - 0 181400 216274
0 1 0 0 0 EKO WIDYANTO 71564 36 13225 DR. ANITA
agung;3313092303950002; 5.5.5.202112011542 4 346439
1#0##0#0#0.0#2022-01-03
13:25:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7b38830ded9ce9531f5fe803a20e7830 150000 0 0 0 0 0
0 0 0 0 15000 0 51274 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 13/09/2001 0 1
TENGGOROKAN 251000 0 0 - 0 - 0 - 0 - 0
251000 235000 0 1 0 0 0 GIBRAN AL SUBKHI SUWARNO
0001277547794 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
346440 1#0##0#0#0.0#2022-01-03
13:26:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 28/01/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 211110
0 1 0 0 0 DRS.SUWARNO.TN 077474 58 21507 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346441
1#0##0#0#0.0#2022-01-03
13:27:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cf0de6a78d7af4eafd7505eca89542e2 150000 0 0 0 0 0
0 0 0 0 15000 0 46110 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 24/05/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 RINA LESTARI ., NY
0000091263576 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
346442 1#0##0#0#0.0#2022-01-03
13:29:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 31/12/1970 0 2
1 Z09.8;J18.0;E11.9;K21.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 408744
0 1 0 0 0 WATINAH, NY 100109 50 18613 DR. ANITA
agung;3313092303950002; 5.5.5.202112011542 4 346443
1#0##0#0#0.0#2022-01-03
13:30:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c3096fd3cebd6e436b0508703565731a 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 23/04/1963 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
278795 0 1 0 0 0 SUYATMI., NY 049452 58
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 346444
1#0##0#0#0.0#2022-01-03
13:32:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4116917d7fa8d5f9b0ce27498fab207d 203000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 21/12/1946 0 1
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0001021693713 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
346445 1#0##0#0#0.0#2022-01-03
13:32:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 14/08/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 414400
0 1 0 0 0 SUMIRAH, NY 098366 71 26057 DR. ANITA
agung;3313092303950002; 5.5.5.202112011542 4 346447
1#0##0#0#0.0#2022-01-03
13:37:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
13172a4349c33784d1815af7c07068ac 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 23/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ERDIANA.NY 087879
0000565638074 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
346450 1#0##0#0#0.0#2022-01-03
13:45:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 25/05/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 392018
0 1 0 0 0 SITI ZAENAB,(NY) 033419 60 22120 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346452
1#0##0#0#0.0#2022-01-03
14:01:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a56448b22aab9cad3bc0a11bf229b82d 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 30/09/1977 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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346451 1#0##0#0#0.0#2022-01-03
14:04:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 01/08/1965 0 2
1 Z09.8;B90.8;K21.9;J18.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 279124
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agung;3313092303950002; 5.5.5.202112011542 4 346454
1#0##0#0#0.0#2022-01-03
14:05:36#0#00:00:00#00:00:00#13:04:18#{"co_insidense_ind":"0"} 1
6b5d1abdd3e26984f4d089d096e2f9ad 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 31/12/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 191160
0 1 0 0 0 SARDIYANTO.TN 100599 62 22996 DR.
novia;3313125201940001; 5.6.3.202201201500 4 346455
1#0##0#0#0.0#2022-02-15
13:49:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 16/12/2021 16/12/2021 01/09/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 338523
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agung;3313092303950002; 5.5.5.202112011542 4 346456
1#0##0#0#0.0#2022-01-03
14:11:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
66e5d89959b4495682160d17965f52fe 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 19/09/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 227966
0 1 0 0 0 DJOKO SRIWAHYU INDRATMOKO.TN 097650 63
agung;3313092303950002; 5.5.5.202112011542 4 346458
1#0##0#0#0.0#2022-01-03
14:15:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
78c742697a4b69ad774e81146c6a36c8 150000 0 0 0 0 0
0 0 0 0 15000 0 62966 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 12/06/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 320078
0 1 0 0 0 SUMARNI ,(NY) 043253 48 17719 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346459
1#0##0#0#0.0#2022-01-03
14:17:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dbca566011b34a86a28c14c9809e587c 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 22/04/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 361968
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agung;3313092303950002; 5.5.5.202112011542 4 346461
1#0##0#0#0.0#2022-01-03
14:22:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 31/05/1998 0 1
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agung;3313092303950002; 5.6.6.202203301209 4 346462
1#0##0#0#0.0#2022-04-14
13:38:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 16/12/2021 16/12/2021 05/02/1956 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 346463
1#0##0#0#0.0#2022-01-03
14:25:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1f4e96cf565da1a402427ed60769b206 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 16/12/1934 0 1
0 0 - 0 - 0 - 0 - 0 181400 203309
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agung;3313092303950002; 5.5.5.202112011542 4 346464
1#0##0#0#0.0#2022-01-03
14:36:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 13/06/1979 0 2
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346465 1#0##0#0#0.0#2022-01-03
14:37:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 11/08/1960 0 1
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agung;3313092303950002; 5.5.5.202112011542 4 346466
1#0##0#0#0.0#2022-01-03
14:39:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 29/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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1124R0021221V002862 0002168632721 3;JKN novia;3313125201940001;
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16:48:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 23/09/1963 0 1
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1#0##0#0#0.0#2022-01-03
14:40:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3727f7b5d6725c94ecc050081df1e21c 150000 0 0 0 0 0
0 0 0 0 15000 0 57719 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 02/09/1981 0 2
0 0 - 0 - 0 - 0 - 0 181400 194640
0 1 0 0 0 DYAH TRI MUSTIKA NINGSIH, N Y 058989 40
agung;3313092303950002; 5.5.5.202112011542 4 346468
1#0##0#0#0.0#2022-01-03
14:41:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c81e1911fed33e17d4a8d3f3ac2f6cba 150000 0 0 0 0 0
0 0 0 0 15000 0 29640 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 01/05/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 273000
0 1 0 0 0 ENDANG HARSO SRI PAMUNGKAS 71636 49 18126
agung;3313092303950002; 5.5.5.202112011542 4 346469
1#0##0#0#0.0#2022-01-03
14:42:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f6557cf0708ce266dcae44da5ce99c77 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 09/04/1982 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 NAOMI APRIL LIA 100450 39 14496 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346470
1#0##0#0#0.0#2022-01-03
14:43:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bbb9737ce54898d14e7ecf0680511b39 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 05/03/1979 0 2
- 0 - 0 - 0 - 0 138400 273000 0
1 0 0 0 SRI WULAN.NY 099062 42 15627 DR. LINDA
agung;3313092303950002; 5.5.5.202112011542 4 346471
1#0##0#0#0.0#2022-01-03
14:45:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
77d9148acbcb1cc815f12d7c22b07ebb 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 22/05/1976 0 1
0 0 - 0 - 0 - 0 - 0 181400 305861
0 1 0 0 0 JOKO SUYANTO .BP 034751 45 16644 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346472
1#0##0#0#0.0#2022-01-03
14:46:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6146a3afc222b94af368c8e694bfdc7b 150000 0 0 0 0 0
0 0 0 0 15000 0 140861 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 17/08/1934 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 KASMINAH SASTROWIJOYO NY 088501 87
agung;3313092303950002; 5.5.5.202112011542 4 346473
1#0##0#0#0.0#2022-01-03
14:48:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c7d5bffbea178f8e694098b3e8b2dc84 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 06/08/1974 0 2
0 - 0 - 0 - 0 - 0 138400 213800
0 1 0 0 0 TRI WIDIYATI. NY 000842 47 17299 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346475
1#0##0#0#0.0#2022-01-03
15:03:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bfaf3ce2d736059b56b09b28195a077a 0 0 198800 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 01/09/1949 0 2
2 A16.2 - - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 213969
0 1 0 0 0 PARINEM 65084 72 26404 DR. ANITA
agung;3313092303950002; 5.5.5.202112011542 4 346476
1#0##0#0#0.0#2022-01-03
15:05:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
02d2b522eee952ae33c4a33429cda0eb 150000 0 0 0 0 0
0 0 0 0 15000 0 48969 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 16/08/1969 0 2
- 0 - 0 - 0 - 0 138400 273000 0
1 0 0 0 TRI WINARNI 093256 52 19115 DR. LINDA
agung;3313092303950002; 5.5.5.202112011542 4 346478
1#0##0#0#0.0#2022-01-03
15:09:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
37ebfed148844a09408a592b6b591d4c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 07/07/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 424760
0 1 0 0 0 RIDAR SURYANDARI.NY 076914 55 20251
novia;3313125201940001; 5.6.3.202201201500 4 346569
1#0##0#0#0.0#2022-03-08
11:44:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
1345a3d21657ecca0265d432e4961c0c 150000 0 0 0 0 0
200000 0 0 0 15000 0 59760 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 06/06/1969 0 1
1 I69.3;M19.98;M54.39 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 218855
0 1 0 0 0 WARTONO 100782 52 19186 DR. ARIA
agung;3313092303950002; 5.5.5.202112011542 4 346479
1#0##0#0#0.0#2022-01-03
15:12:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0fb657876b0ae024d8c3115f26a8edf4 150000 0 0 0 0 0
0 0 0 0 25000 0 43855 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 17/02/2006 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 FAUZAN MUHAMMAD
ANNIZAR.AN 100619 15 5781 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V002877 0001639135866 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346480 1#0##0#0#0.0#2022-01-03
15:13:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a9f39d36f69bf6a4ec73b1e23b9d5e1b 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 05/07/1937 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SITI NIMAH.NY 086337 84 30845 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346482
1#0##0#0#0.0#2022-01-03
15:14:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3a699dd8a1c0c5fb9c995f360a410c3a 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 10/10/1953 0 2
0 - 0 - 0 - 0 - 0 138400 273000
0 1 0 0 0 TUTIK SARASWATI 54196 68 24904 DR. LINDA
agung;3313092303950002; 5.5.5.202112011542 4 346483
1#0##0#0#0.0#2022-01-03
15:16:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
efb31d6145e11637f9516eedcb05b911 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 24/06/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 275415
0 1 0 0 0 SARTONO,TN 050131 54 19899 DR. ARIA
agung;3313092303950002; 5.5.5.202112011542 4 346484
1#0##0#0#0.0#2022-01-03
15:18:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6b656685811e399b2b9afb0e9c49cc05 150000 0 0 0 0 0
0 0 0 0 15000 0 110415 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 28/04/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SUGIYARTI, NY 067652 56 20686 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346485
1#0##0#0#0.0#2022-01-03
15:19:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
95336945c4c1dded776b53c0236d2d46 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 09/03/1953 0 1
0 - 0 - 0 - 0 - 0 138400 273000
agung;3313092303950002; 5.5.5.202112011542 4 346486
1#0##0#0#0.0#2022-01-03
15:20:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cbcaed699fa1b943ccceaaf1877eae35 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 06/08/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 227801
0 1 0 0 0 JOKO ASTUTI.TN 072601 54 19856 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346487
1#0##0#0#0.0#2022-01-03
15:23:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1e8911b804dded24dd5f85261eaa1e5a 150000 0 0 0 0 0
0 0 0 0 15000 0 62801 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 06/03/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 Ny. Shinta
Kumalasari 38241 62 22931 DR. LINDA SUGIARTO, SP.FKR 1124R0021221V002887
0000639407722 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
346488 1#0##0#0#0.0#2022-01-03
15:24:19#0#00:00:00#00:00:00#13:57:48#{"co_insidense_ind":"0"} 1
724609c1602ab00314ab9ab057f112ca 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 21/10/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 215430
0 1 0 0 0 NGATIRIN, TN 092405 51 18684 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346489
1#0##0#0#0.0#2022-01-03
15:25:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fa00c9ba6d7f920efb81ec70087fe75c 150000 0 0 0 0 0
0 0 0 0 15000 0 50430 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 28/12/1949 0 2
0 - 0 - 0 - 0 - 0 138400 273000
0 1 0 0 0 NURHAYATI.NY 081101 71 26286 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346490
1#0##0#0#0.0#2022-01-03
15:26:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
06d1c8ee81f6782874baf6904b5252ca 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 30/01/1966 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 WAHYUNI.NY 082555
0000639464488 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
346491 1#0##0#0#0.0#2022-01-03
15:28:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d38079d12e29400f1b361d5f92717801 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 31/12/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 467127
0 1 0 0 0 SURTINEM., NY 049118 63 23361 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347278
1#0##0#0#0.0#2022-01-05
16:49:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bf31bde19ff9f1747fb085aa68377e75 150000 0 0 0 0 0
248000 0 0 0 15000 0 54127 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 03/05/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 167370
0 1 0 0 0 MARMEIYANI.NY 076825 63 23238 DR.
novia;3313125201940001; 5.6.3.202201201500 4 346492
1#0##0#0#0.0#2022-03-08
11:49:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
df7e3221e525c8b4211fe91f2e6b3a63 0 0 138000 0 0 0
0 0 0 0 15000 0 14370 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 12/11/1951 0 2
1 Z09.8;E11.9;E78.5;I73.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 875847
0 1 0 0 0 SITI CHOTIDJAH NY 056740 70 25602 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346493
1#0##0#0#0.0#2022-01-03
15:31:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b9448d6f64ec5a3a51da7f13041c8501 150000 0 0 0 0 0
0 0 0 0 15000 0 710847 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 09/02/1977 0 2
1 Z09.8;G20;R09.8;I69.3 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 TRI WIDOWATI.NY 093474 44 16381 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346494
1#0##0#0#0.0#2022-01-03
15:33:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
023b6fd07f9e8d3eff3e8c9848ce139a 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 31/12/1935 0 2
None None None None HEMATOLOGI AKUT 157700 0 0 - 0
- 0 - 0 - 0 157700 214480 0 1 0
0 0 WARNI, NY 082015 85 31397 DR. ARYO SUSENO, SP.PD
1124R0021221V002896 0002348062277 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346495 1#0##0#0#0.0#2022-01-03
15:35:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cbb3f5e2ca0ddcd299439130f9c7f5fd 150000 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 08/12/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 273000
0 1 0 0 0 SISWO SARJONO,(BP) 028784 72 26306
agung;3313092303950002; 5.5.5.202112011542 4 346496
1#0##0#0#0.0#2022-01-03
15:40:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7e2791254b2611131eaa541f4b4e0ed8 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 30/11/1956 0 2
1 Z09.8;H81.3;M19.99 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 225540
0 1 0 0 0 VERONICA SRI DARNI,(NY) 028552 65 23757
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 346497
1#0##0#0#0.0#2022-01-03
15:50:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
120db02929d38faf58839af95d52680d 150000 0 0 0 0 0
0 0 0 0 15000 0 60540 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 10/08/1982 0 1
0 0 - 0 - 0 - 0 - 0 181400 194590
0 1 0 0 0 AGUS WIYANTO 100707 39 14373 DR.
agung;3313092303950002; 5.5.5.202112011542 4 346498
1#0##0#0#0.0#2022-01-03
15:54:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
860233fcba4f62fcf14e231b7f9c6f3e 150000 0 0 0 0 0
0 0 0 0 25000 0 19590 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 17/07/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 169020
0 1 0 0 0 HERMI LESTARI., NY 051438 59 21702
agung;3313092303950002; 5.5.5.202112011542 4 346570
1#0##0#0#0.0#2022-01-04
09:40:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
612d3d658b406d2a0c2f08893f003bc6 150000 0 0 0 0 0
0 0 0 0 15000 0 4020 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 31/12/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400
3878281 0 1 0 0 0 ONAH.NY 099763 59 21900
reni;3313147010930001; 5.6.0.202201041418 4 346499
1#0##0#0#0.0#2022-01-07
19:56:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 3
4aeab030ddaf32850ce826335496d2ac 220000 0 0 813500 262000
0 0 341145 0 0 1825000 0 416636 0 0
0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 08/12/1957 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
278795 0 1 0 0 0 PANINGSIH,(NY) 005331 64
3;JKN agung;3313092303950002; 5.6.0.202201041418 4 348038
1#0##0#0#0.0#2022-01-07
13:05:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
05faffe2cf58600c45f59ac079fbebf7 203000 0 0 0 0 0
0 0 0 0 15000 0 60795 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 13/07/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 HARIYOTO BAMBANG YULIATMO, TN 090598 64
0000090967397 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
345459 1#0##0#0#0.0#2022-01-03
16:00:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7214815b526d7a48ab1f377071ae6ba5 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 13/04/1982 0 2
0 0 - 0 - 0 - 0 - 0 181400 573797
0 1 0 0 0 YUSRINA APRIYANTI,(NY) 017846 39 14492
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 346571
1#0##0#0#0.0#2022-01-04
09:41:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3c00b5d95fce9e6e176c6d184facda33 300000 0 0 0 0 0
220000 0 0 0 15000 0 38797 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 27/12/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 452860
agung;3313092303950002; 5.5.5.202112011542 4 346500
1#0##0#0#0.0#2022-01-03
16:02:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
79f684f7295a89caae14fb27e823f7a8 300000 0 0 0 0 0
0 0 0 0 15000 0 137860 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 23/03/1993 0 2
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 MAYSAROH FITRIANA PUTRI.NN 095897 28
0003002601813 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
346501 1#0##0#0#0.0#2022-01-03
16:03:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c7e13a492a4b703cce7daed7a94276d9 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 31/12/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 RUKIYAH, NY 090039 59 21900 DR. GALIH
agung;3313092303950002; 5.5.5.202112011542 4 346510
1#0##0#0#0.0#2022-01-03
16:17:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
aa44d1e9a4b517080a273c81cef808ef 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 21/02/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 DARMONO, TN 021227 58 21483 DR. GALIH
agung;3313092303950002; 5.5.5.202112011542 4 346508
1#0##0#0#0.0#2022-01-03
16:16:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
da3a35fe02d59ecd8a755d27c3ac6c55 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 16/12/2021 16/12/2021 09/05/1975 0 1
0 - 0 - 0 - 0 786200 677676 0 1
1124R0021221V002916 0001105378571 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346511 1#0##0#0#0.0#2022-01-03
16:19:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2fdeb65430f3288a43fe0ab0aedf0ae1 662676 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 12/07/1966 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.5.5.202112011542 4 346517
1#0##0#0#0.0#2022-01-03
16:20:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1575e57bebae7dcead26ab9c3a227560 463830 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 12/12/1964 0 1
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0 0 0 M. SARBIAN, TN 090907 57 20823 DR. ARYO SUSENO,
SP.PD 1124R0021221V002918 0002861438286 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346520 1#0##0#0#0.0#2022-01-03
16:21:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 22/10/1959 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V002919 0000086902986 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346521 1#0##0#0#0.0#2022-01-03
16:22:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
12daf4b79d79641e49ece153bd32d38d 463830 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 28/02/1967 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V002920 0002203301349 3;JKN agung;3313092303950002;
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16:23:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
604dba3ae6c64c52fff13a2a8cde2db6 463830 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 12/08/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.5.5.202112011542 4 346523
1#0##0#0#0.0#2022-01-03
16:24:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 03/08/1963 0 2
0 - 0 - 0 - 0 786200 677676 0 1
SP.PD 1124R0021221V002922 0000088933318 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346524 1#0##0#0#0.0#2022-01-03
16:25:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a0d411182b17a474228eacd2b9c9d89b 662676 0 0 0 0 0
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3372030 C 3 CP 2 16/12/2021 16/12/2021 17/06/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 198680
novia;3313125201940001; 5.6.3.202201201500 4 346525
1#0##0#0#0.0#2022-02-15
13:11:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 16/12/2021 16/12/2021 14/04/1952 0 1
1 J44.1 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 287745
0 1 0 0 0 DAUD WIDODO DHARMA WIYOTO., BP 051387
69 25448 DR. GREETA 1124R0021221V002926 0002064972677 3;JKN
novia;3313125201940001; 5.5.5.202112011542 4 346663
1#0##0#0#0.0#2022-01-04
14:31:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 12/04/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 213800
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agung;3313092303950002; 5.5.5.202112011542 4 346526
1#0##0#0#0.0#2022-01-03
16:28:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 16/12/2021 16/12/2021 19/07/1972 0 1
1 I10;K30 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 170000
0 1 0 0 0 DENY YULIANTO, TN 086661 49 18047 RIZA
5.5.5.202112011542 4 346664 1#0##0#0#0.0#2022-01-04
14:32:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 17/12/2021 17/12/2021 08/11/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 354805
0 1 0 0 0 ARWINDA HURIP,(NY) 043704 70 25607
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345303
1#0##0#0#0.0#2021-12-27
09:34:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9f8dd613b395e836ca23bbebc71710a4 150000 0 0 0 0 0
0 120795 0 0 15000 0 69010 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 02/12/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 383056
0 1 0 0 0 ENDANG MARDIASMANI.NY 090524 64 23391
novia;3313125201940001; 5.6.3.202201201500 4 345304
1#0##0#0#0.0#2022-02-15
13:07:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
4e5e551c693506e8e9309f8ba28281f9 150000 0 0 0 0 0
0 134250 0 0 15000 0 83806 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 10/08/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 397868
0 1 0 0 0 SARIYANAH, NY 048128 68 24966 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346212
1#0##0#0#0.0#2021-12-30
12:52:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2aa4fa94d498dd0c8573aec7b587bc0b 300000 0 0 0 0 0
0 31845 0 0 15000 0 51023 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 15/05/1972 0 2
1 Z09.8;E11.4;G59.0;H81.3 89.52 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 345800
0 1 0 0 0 MURWANI SETIANINGSIH.NY 083365 49 18113
novia;3313125201940001; 5.5.5.202112011542 4 346213
1#0##0#0#0.0#2021-12-30
12:53:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a02e48e98bbd4303547e0427932902a7 150000 0 0 0 0 0
0 31845 0 0 15000 0 148955 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 09/12/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 182155
0 1 0 0 0 SUNARNO.TN 100018 51 18636 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 345305
1#0##0#0#0.0#2021-12-27
09:36:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
825f875c58c4fca5484159ac79d08aa1 0 0 0 0 0 0 0
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3372030 C 3 CP 2 17/12/2021 17/12/2021 10/03/1973 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
531365 0 1 0 0 0 SUHARTONO., BP 048837 48
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 346214
1#0##0#0#0.0#2021-12-30
12:54:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6c0ef7ac85f492ec124b60ad8e8fa520 150000 0 0 0 0 0
0 120745 0 0 15000 0 245620 0 0 0 0
0
3372030 C 3 CP 2 17/12/2021 17/12/2021 31/12/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 276265
0 1 0 0 0 PARNI, NY 100497 57 21171 DR. TEKY
novia;3313125201940001; 5.5.5.202112011542 4 346215
1#0##0#0#0.0#2021-12-30
12:55:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
da13477406dd06a6c2bfa8c6aa1f970d 150000 0 0 0 0 0
0 89050 0 0 15000 0 22215 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 14/04/1976 0 2
2 C53.9 - - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 291630
0 1 0 0 0 WIWIK WAHYUNINGSIH, NY 067851 45 16683
novia;3313125201940001; 5.5.5.202112011542 4 346216
1#0##0#0#0.0#2021-12-30
12:56:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0f6f86c35aeb0253eaabedd485953466 245000 0 0 0 0 0
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3372030 C 3 CP 2 17/12/2021 17/12/2021 07/04/1958 0 2
1 Z09.8;K21.9;M17.9;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 327538
0 1 0 0 0 SUDARYANTI.NY 091986 63 23265 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346217
1#0##0#0#0.0#2021-12-30
12:57:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c2d3693478ed82452d3125a404befb06 150000 0 0 0 0 0
0 106695 0 0 15000 0 55843 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 21/03/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 199917
0 1 0 0 0 SURYANI ., NY 057517 48 17803 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346218
1#0##0#0#0.0#2021-12-30
12:57:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4d0bccfcc9ea2b45b12e6e54cef1fe62 150000 0 0 0 0 0
0 17745 0 0 15000 0 17172 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 09/11/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 221476
0 1 0 0 0 SUMIYATI, NY 100486 56 20492 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345306
1#0##0#0#0.0#2021-12-27
09:37:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1d307ca949c7510fef7c09df0f8c61cc 150000 0 0 0 0 0
0 0 0 0 15000 0 56476 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 05/08/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 236642
yani;3302226402970001; 5.5.5.202112011542 4 345307
1#0##0#0#0.0#2021-12-27
09:38:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8ae30bae77fd2b14df8feeb90541540a 150000 0 0 0 0 0
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3372030 C 3 CP 2 17/12/2021 17/12/2021 04/05/1940 0 1
1 Z09.8;I10;I11.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 438498
0 1 0 0 0 SUKIR AGUS WIRATMOKO, TN 026036 81
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 346219
1#0##0#0#0.0#2021-12-30
12:58:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0544b01383fc62bd7955338e48b6098e 150000 0 0 0 0 0
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3372030 C 3 CP 2 17/12/2021 17/12/2021 13/02/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 342795
yani;3302226402970001; 5.5.5.202112011542 4 345308
1#0##0#0#0.0#2021-12-27
09:38:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d2877ed21098e35ab88a9bda12685301 150000 0 0 0 0 0
0 121345 0 0 15000 0 56450 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 18/05/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 274090
yani;3302226402970001; 5.5.5.202112011542 4 345314
1#0##0#0#0.0#2021-12-27
09:39:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1a66af7c78873a87a904adf27da72ccd 150000 0 0 0 0 0
0 0 0 0 15000 0 109090 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 13/07/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 248202
0 1 0 0 0 RUSWATI, NY 086042 68 24994 DR. TEKY
novia;3313125201940001; 5.6.7.202204241238 4 346220
1#0##0#0#0.0#2022-05-10
09:08:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 3
ec05dd5e5be6a2d5319790a56889036c 150000 0 0 0 0 0
0 31845 0 0 15000 0 51357 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 02/05/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 235896
0 1 0 0 0 RUMIATI 086640 49 18126 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 347279
1#0##0#0#0.0#2022-01-05
16:53:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9af8dfdfe4d5ad46bb91dc1bbd429c7b 150000 0 0 0 0 0
0 0 0 0 15000 0 70896 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 28/03/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 242322
0 1 0 0 0 MV SUMARNI, NY 094104 64 23640 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346221
1#0##0#0#0.0#2021-12-30
13:00:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9b78c1a8c5bc2302aa4269e8925fac47 150000 0 0 0 0 0
0 0 0 0 15000 0 77322 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 22/04/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 225278
0 1 0 0 0 SUPARTI., NY 050630 73 26902 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345315
1#0##0#0#0.0#2021-12-27
09:42:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bd686573aa96bce2a4bba0edd72b827b 150000 0 0 0 0 0
0 0 0 0 15000 0 60278 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 03/04/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 345665
yani;3302226402970001; 5.5.5.202112011542 4 345316
1#0##0#0#0.0#2021-12-27
09:43:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7d77a6a3ec2febcca760b38f1077cd89 150000 0 0 0 0 0
0 121345 0 0 15000 0 59320 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 30/12/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 270405
0 1 0 0 0 SUGIYARTI, NY 057165 59 21902 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346222
1#0##0#0#0.0#2021-12-30
13:01:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
30fd45e90dffd96cfa629dabd95801e8 150000 0 0 0 0 0
0 31845 0 0 15000 0 73560 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 27/12/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 290790
0 1 0 0 0 UMI MARWIYATI., NY 042562 52 19348
novia;3313125201940001; 5.5.5.202112011542 4 346223
1#0##0#0#0.0#2021-12-30
13:22:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2a25833b36f0b7d9e9d8b671b9be1c2e 150000 0 0 0 0 0
0 108440 0 0 15000 0 17350 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 19/09/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 320105
0 1 0 0 0 SRI SUDARSI.,NY 053164 69 25291 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346224
1#0##0#0#0.0#2021-12-30
13:22:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fcb88511662edec6b483f16e21b9e38d 150000 0 0 0 0 0
0 89500 0 0 15000 0 65605 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 20/10/1950 0 2
1 Z09.8;S92.30;W01.0 88.27 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 612712
0 1 0 0 0 BADRIYAH MUNAWARAH,(NY) 043414 71 25991
agung;3313092303950002; 5.6.3.202201201500 4 349019
1#0##0#0#0.0#2022-02-21
09:46:31#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
ec210eab4a547c4cdbfab0bdf0562cfd 300000 0 0 0 0 0
248000 0 0 0 15000 0 49712 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 19/08/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 219634
0 1 0 0 0 DJOKO PRAPTONO, TN 071622 68 24957
yani;3302226402970001; 5.5.5.202112011542 4 345317
1#0##0#0#0.0#2021-12-27
09:44:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
61ddca901ec6180ab388b6b53247bda1 150000 0 0 0 0 0
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3372030 C 3 CP 2 17/12/2021 17/12/2021 31/12/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 523214
0 1 0 0 0 HARYANTI, NY 094139 61 22632 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345318
1#0##0#0#0.0#2021-12-27
09:44:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f3c6644384dc558b895518d9cef1aad9 150000 0 0 0 0 0
0 0 0 0 15000 0 358214 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 02/10/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 377676
0 1 0 0 0 ASRI LISTYARINI.NY 098990 51 18704
novia;3313125201940001; 5.5.5.202112011542 4 346226
1#0##0#0#0.0#2021-12-30
13:23:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
808e20eaf929011d0b221042f115df5f 150000 0 0 0 0 0
150000 0 0 0 15000 0 62676 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 17/06/1941 0 1
0 0 - 0 - 0 - 0 - 0 181400 500937
0 1 0 0 0 WARDONO.TN 094435 80 29403 DR. TEKY
novia;3313125201940001; 5.6.3.202201201500 4 346227
1#0##0#0#0.0#2022-03-08
08:37:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
e8760ad13c975e7c8ad51c4cc6cc5e90 150000 0 0 0 0 0
0 120795 0 0 15000 0 215142 0 0 0 0
0
3372030 C 3 CP 2 17/12/2021 17/12/2021 25/05/1986 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ROBBY HANDOKO.TN
0001032606933 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345275 1#0##0#0#0.0#2021-12-27
09:45:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 17/12/2021 17/12/2021 27/08/1970 0 2
1 Z09.8;H61.2;H66.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 395970
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 346228
1#0##0#0#0.0#2021-12-30
13:26:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1b861fc3c62308b7c7a824a03cd44c68 150000 0 0 0 0 0
0 0 0 0 15000 0 230970 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 31/12/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 231617
0 1 0 0 0 PAINEM.NY 075654 52 19344 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 345319
1#0##0#0#0.0#2021-12-27
09:46:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
89d14fdb6cd649886072816627c77878 150000 0 0 0 0 0
0 0 0 0 15000 0 66617 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 15/06/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 367657
0 1 0 0 0 YUNI HARIYATI, (NY) 014141 42 15526
novia;3313125201940001; 5.5.5.202112011542 4 346229
1#0##0#0#0.0#2021-12-30
13:27:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b25340cc536d1864180a1da04a2f7b9f 150000 0 0 0 0 0
0 63690 0 0 15000 0 138967 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 05/10/1945 0 2
1 Z09.8;H26.9;H11.0;E11.3;H36.0 90.29 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
278795 0 1 0 0 0 SUMINI.,NY 058758 76 27832
yani;3302226402970001; 5.5.5.202112011542 4 345320
1#0##0#0#0.0#2021-12-27
09:47:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
65036501656b23820a4e8b2c1ea717f6 203000 0 0 0 0 0
0 0 0 0 15000 0 60795 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 03/04/1995 0 2
- 0 - 0 - 0 - 0 549400 309030 0
1 0 0 0 INTAN KARTIRA SARI.NY 099081 26 9755 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345321
1#0##0#0#0.0#2021-12-27
09:48:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b4d0ae6dc3c381b3c7e5a1baf68c3ba0 275000 0 0 0 0 0
0 0 0 0 15000 0 19030 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 10/04/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 226192
0 1 0 0 0 SRI HARTATI.NY 082567 63 23262 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345322
1#0##0#0#0.0#2021-12-27
09:49:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c521f3a51a63829deda5f0c6e028aa76 150000 0 0 0 0 0
0 0 0 0 15000 0 61192 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 17/12/1970 0 2
1 S82.80;W19.5 - - None None None None Q-5-42-0
0 0 - 0 - 0 - 0 - 0 182600 215452
0 1 0 0 0 SUKIRAH 100714 51 18628 DR. WAHYU
agung;3313092303950002; 5.6.7.202204241238 4 367778
1#0##0#0#0.0#2022-05-24
09:40:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
a33650bb35863889709bf78684341aa6 150000 0 0 0 0 0
0 0 0 0 15000 0 50452 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 14/04/1960 0 2
0 - 0 107400 273000 0 1 0 0 0
1124R0021221V002967 0001084606863 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345280 1#0##0#0#0.0#2021-12-27
09:50:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
14995da43363852069722b8061ebb399 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 18/04/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 245740
0 1 0 0 0 SRI MULYANI,NY 084404 62 22889 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345323
1#0##0#0#0.0#2021-12-27
09:51:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
38a54bb35affdf96c4d8a612795d6132 150000 0 0 0 0 0
0 0 0 0 15000 0 80740 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 25/03/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUPINAH 091220
0000639810066 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345277 1#0##0#0#0.0#2021-12-27
09:54:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5bd3f06d9e93335fb89a70eaf3cd8ee4 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 18/01/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000090992327 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345279 1#0##0#0#0.0#2021-12-27
09:54:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5ebc0f677b1d7431b67948d163f638d7 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 16/10/1949 0 2
0 - 0 107400 273000 0 1 0 0 0 SRI
YEKTI ISMADI,(NY) 040545 72 26360 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V002971 0000089740067 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345273 1#0##0#0#0.0#2021-12-27
09:55:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
361da1fd8c77983501732173b7d57091 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 14/08/1996 0 1
0 0 - 0 - 0 - 0 - 0 181400 277749
0 1 0 0 0 REZA LUTFI PRASETYAWAN, SDR 066264 25
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345324
1#0##0#0#0.0#2021-12-27
09:56:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a1d56acb9c49fd80b2c400c1e56ce2c0 150000 0 0 0 0 0
0 0 0 0 15000 0 112749 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 19/08/1979 0 1
0 0 - 0 - 0 - 0 - 0 181400 350862
0 1 0 0 0 TRIYANA.TN 096057 42 15461 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 346230
1#0##0#0#0.0#2021-12-30
13:28:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1aa60556b686b10345b5381681559038 150000 0 0 0 0 0
150000 0 0 0 15000 0 35862 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 02/03/1964 0 2
1 Z09.8;I11.9;K21.9 88.76 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400 573438
0 1 0 0 0 SRI SUKARMINI, NY 059077 57 21109 DR.
agung;3313092303950002; 5.6.6.202203301209 4 346231
1#0##0#0#0.0#2022-04-14
12:53:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 5
47aebb2744fafc58b0be09b9ea2a3bc5 150000 0 0 0 0 0
350000 0 0 0 15000 0 58438 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 05/07/1984 0 2
0 0 - 0 - 0 - 0 - 0 181400 202322
yani;3302226402970001; 5.5.5.202112011542 4 345325
1#0##0#0#0.0#2021-12-27
09:56:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3985fdfbf90570ddf3a95698d612d793 150000 0 0 0 0 0
0 0 0 0 15000 0 37322 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 17/07/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 426652
0 1 0 0 0 SUGIYATMI.NY 099315 64 23529 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345326
1#0##0#0#0.0#2021-12-27
09:57:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2f40585526495f7e70fa46ce9019b324 150000 0 0 0 0 0
0 0 0 0 15000 0 261652 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 23/03/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 220994
0 1 0 0 0 MARSINI., NY 048442 71 26202 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345327
1#0##0#0#0.0#2021-12-27
09:58:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e14b2ec9018d7385e9bc595d4adca599 150000 0 0 0 0 0
0 0 0 0 15000 0 55994 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 25/09/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 304629
0 1 0 0 0 EKO MULYONO.TN 087638 49 17980 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345328
1#0##0#0#0.0#2021-12-27
09:58:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ace9276b18669733b79a517f1f76aa80 150000 0 0 0 0 0
0 0 0 0 15000 0 139629 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 29/04/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 213976
0 1 0 0 0 ROSITAWATI, NN 074212 42 15573 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345329
1#0##0#0#0.0#2021-12-27
10:00:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0cf5af8bc696fce95fad91792999788c 150000 0 0 0 0 0
0 0 0 0 15000 0 48976 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 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; 5.5.5.202112011542 4
345276 1#0##0#0#0.0#2021-12-27
10:01:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bfa6af027bacc77f9dfc1c3293526aa2 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 07/07/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 225544
0 1 0 0 0 ENI PUJI ASTUTI 093122 64 23539 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346232
1#0##0#0#0.0#2021-12-30
13:33:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7d122544a185928314a6ea10396c5ceb 150000 0 0 0 0 0
0 0 0 0 15000 0 60544 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 13/12/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 358750
0001426207241 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345330 1#0##0#0#0.0#2021-12-27
10:02:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
29be0f0de26788c20b9dfc9c995f60fb 150000 0 0 0 0 0
0 121345 0 0 15000 0 72405 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 03/02/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 496810
0 1 0 0 0 SUMARSIH,NY 085983 66 24424 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 345331
1#0##0#0#0.0#2021-12-27
10:03:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7d3985a6dd71e881db520ec834c7b049 150000 0 0 0 0 0
0 0 0 0 15000 0 331810 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 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; 5.5.5.202112011542 4
345264 1#0##0#0#0.0#2021-12-27
10:03:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
87426717f9edfa95cb6f6814ffbf858e 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 13/08/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 255355
0 1 0 0 0 SRI LESTARI . NY 068663 71 26059 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345332
1#0##0#0#0.0#2021-12-27
10:04:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
de3dfc40cec2caed1bbf42e72aaf36c3 150000 0 0 0 0 0
0 44300 0 0 15000 0 46055 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 12/07/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 374304
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345333
1#0##0#0#0.0#2021-12-27
10:05:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c384d1a16f87a6ffb46ab9b8ee242f3f 203000 0 0 0 0 0
0 0 0 0 15000 0 156304 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 14/01/1981 0 1
0 0 - 0 - 0 - 0 - 0 181400 185526
0 1 0 0 0 ARI MULYANI.NY 085071 40 14947 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345334
1#0##0#0#0.0#2021-12-27
10:07:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
697b5dca45fe3de153ed40f5a201f639 150000 0 0 0 0 0
0 0 0 0 15000 0 20526 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 26/02/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 519720
0 1 0 0 0 GURAWAN BASUKI, (BP) 008293 50 18557
yani;3302226402970001; 5.5.5.202112011542 4 345335
1#0##0#0#0.0#2021-12-27
10:08:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a0748729bb06074ed8e6df53e01e8cd5 150000 0 0 0 0 0
0 0 0 0 15000 0 354720 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 27/01/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 196818
0 1 0 0 0 SRI SUPRAPTI, NY 087990 63 23335 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345336
1#0##0#0#0.0#2021-12-27
10:09:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bb01d80c8fcd915f6b57e6b23f07cfbe 150000 0 0 0 0 0
0 0 0 0 15000 0 31818 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 31/01/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 247768
yani;3302226402970001; 5.5.5.202112011542 4 345337
1#0##0#0#0.0#2021-12-27
10:10:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f51f41067b5ddee441d09550210cd72e 150000 0 0 0 0 0
0 0 0 0 15000 0 82768 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 08/12/1992 0 1
0 0 - 0 - 0 - 0 - 0 181400 213976
yani;3302226402970001; 5.5.5.202112011542 4 345338
1#0##0#0#0.0#2021-12-27
10:13:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
68d7c9c38382e7a92677b369b4fdfb43 150000 0 0 0 0 0
0 0 0 0 15000 0 48976 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 29/05/1994 0 2
0 0 - 0 - 0 - 0 - 0 181400 376741
0 1 0 0 0 BERTA DIAN CHRISTANTI,NY 087907 27
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345339
1#0##0#0#0.0#2021-12-27
10:14:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fe034ee9256b78067844e93a7c5ae9a3 150000 0 0 0 0 0
0 0 0 0 15000 0 211741 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 30/04/1991 0 1
0 0 - 0 - 0 - 0 - 0 181400 211560
0 1 0 0 0 ARDYAN RIESPATI.SDR 089703 30 11189
yani;3302226402970001; 5.5.5.202112011542 4 345340
1#0##0#0#0.0#2021-12-27
10:14:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
be8c03d71b988833064418c6bbb700fd 150000 0 0 0 0 0
0 0 0 0 15000 0 46560 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 28/08/1977 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
433945 0 1 0 0 0 TRIYANTI, NY 069028 44
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 346233
1#0##0#0#0.0#2021-12-30
13:33:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
62df55ea138bec5d89b0715229db1997 150000 0 0 0 0 0
0 76045 0 0 15000 0 192900 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 19/04/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 308775
0 1 0 0 0 PARNI, NY 078354 49 18139 DR. YUDHI
yani;3302226402970001; 5.5.5.202112011542 4 345341
1#0##0#0#0.0#2021-12-27
10:15:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
be03206edf25acb38c2e49de3da60c4f 203000 0 0 0 0 0
0 0 0 0 15000 0 90775 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 23/11/1960 0 1
1 Z09.8;I25.9;M17.9;H81.3 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 227602
0 1 0 0 0 ABADI SANTOSO. TN 093266 61 22304 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346234
1#0##0#0#0.0#2021-12-30
13:35:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8df8314169e440e6218bebec482d23dd 150000 0 0 0 0 0
0 44300 0 0 15000 0 18302 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 01/11/1961 0 2
0 - 0 107400 273000 0 1 0 0 0
1124R0021221V002999 0000090942546 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345269 1#0##0#0#0.0#2021-12-27
10:18:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fd3c4717d9cf86fde6427609f512acf8 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 05/06/1950 0 2
1 Z09.8;I11.9;M19.98;M47.86;E78.5 - - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 214778 0 1 0 0 0 SRIYATI.NY 037397
0001268544306 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
346235 1#0##0#0#0.0#2021-12-30
13:35:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
97ea42dd3091c519a65775e33c90a1a3 150000 0 0 0 0 0
0 0 0 0 15000 0 49778 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 03/07/1998 0 1
- 0 - 0 - 0 - 0 135700 195968 0
1 0 0 0 KHOERURRIZAL CANDRA N,SDR 085781 23 8568
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 346684
1#0##0#0#0.0#2022-01-04
14:38:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b84c0005d9c91495c5ea2e98c59b7611 155000 0 0 0 0 0
0 0 0 0 15000 0 25968 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 04/12/1979 0 1
0 0 - 0 - 0 - 0 - 0 181400 324592
0 1 0 0 0 KINTARDI, TN 100496 42 15354 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346236
1#0##0#0#0.0#2021-12-30
13:36:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9937d68773022722e3227fb19329f64b 150000 0 0 0 0 0
0 133650 0 0 15000 0 25942 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 21/11/1982 0 2
1 Z09.8;T16;W44.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 165000
agung;3313092303950002; 5.6.6.202203301209 4 349020
1#0##0#0#0.0#2022-04-14
13:52:07#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 4
57706ad6e6c3dbb75fad6a3361a35318 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 02/06/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 392577
0 1 0 0 0 B.B KLISTANTI,(NY) 023067 55 20287
yani;3302226402970001; 5.5.5.202112011542 4 345342
1#0##0#0#0.0#2021-12-27
10:19:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5779d29099a4b5c09d53184605921446 150000 0 0 0 0 0
0 0 0 0 15000 0 227577 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 20/10/1982 0 2
- 0 - 0 - 0 - 0 549400 311820 0
1 0 0 0 PUJIATI RAHAYU, NY 098795 39 14303 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345343
1#0##0#0#0.0#2021-12-27
10:20:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cf8285513e6b2b9a33cc321ffc00d47d 275000 0 0 0 0 0
0 0 0 0 15000 0 21820 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 01/01/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 341097
0 1 0 0 0 WAHJOEDI KHRISNANDJAYA., BP 049277 73
0000086569841 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345344 1#0##0#0#0.0#2021-12-27
10:21:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bd62e16119800e93f95b8670c29b7aff 150000 0 0 0 0 0
0 120795 0 0 15000 0 55302 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 08/02/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 221827
0 1 0 0 0 ENDANG KUSDIATI., NY 049276 58 21497
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345349
1#0##0#0#0.0#2021-12-27
10:22:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
870b810edabce16d9a5e6a4e8ba6a60c 150000 0 0 0 0 0
0 0 0 0 15000 0 56827 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 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; 5.5.5.202112011542 4
345272 1#0##0#0#0.0#2021-12-27
10:23:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4c4aee6cd6e5589752d84a216cec9aa4 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 23/03/1968 0 1
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 660245
0 1 0 0 0 HERU SUTOPO, TN 021060 53 19627 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347273
1#0##0#0#0.0#2022-01-05
16:54:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b8f8622da46067a55a5ab62151557e39 150000 0 0 0 0 0
285000 210245 0 0 15000 0 0 0 0 0 0
0
3372030 C 3 CP 2 17/12/2021 17/12/2021 25/05/1967 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 BAMBANG
1124R0021221V003011 0000091534228 3;JKN agung;3313092303950002;
5.6.5.202203091809 4 345270 1#0##0#0#0.0#2022-04-14
13:46:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
d8011af5299319371358b94b5418b192 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 09/06/1975 0 2
TENGGOROKAN 251000 0 0 - 0 - 0 - 0 - 0
251000 165000 0 1 0 0 0 YUNI SRI HANDAYANI., NY
0000640115807 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
346237 1#0##0#0#0.0#2021-12-30
13:38:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4dacd4b81f7fa4f54454b34c6e94c7a9 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 15/04/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 218835
0 1 0 0 0 TATAS BUDIONO.TN 100721 48 17778 DR.
novia;3313125201940001; 5.6.3.202201201500 4 345350
1#0##0#0#0.0#2022-02-15
13:54:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
a6bfafba08c67788a266da31346ffaa5 150000 0 0 0 0 0
0 0 0 0 25000 0 43835 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 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; 5.5.5.202112011542 4
345278 1#0##0#0#0.0#2021-12-27
10:34:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
00317f92bf8cde914f3c020f8a68c0ef 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 05/12/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 190127
0 1 0 0 0 KRISTIYANI PUJIASTUTI, NY 068903 65
0000091025436 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
346238 1#0##0#0#0.0#2021-12-30
13:41:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
adc7626a827904cb4770f5d6145683d6 150000 0 0 0 0 0
0 0 0 0 15000 0 25127 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 15/05/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 253170
0 1 0 0 0 HARYONO.TN 085004 58 21401 DR. INDRIANY
novia;3313125201940001; 5.5.5.202112011542 4 346239
1#0##0#0#0.0#2021-12-30
13:42:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
83df24495a3e1982c5a9b1ecf051e9a5 150000 0 0 0 0 0
0 0 0 0 15000 0 88170 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 21/04/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 196651
0 1 0 0 0 SITI MAISAROH,(NY) 039887 70 25808
novia;3313125201940001; 5.5.5.202112011542 4 346240
1#0##0#0#0.0#2021-12-30
13:43:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0f9c261ddb6dddd2bb6a813e1fb7542b 150000 0 0 0 0 0
0 0 0 0 15000 0 31651 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 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; 5.5.5.202112011542 4
345262 1#0##0#0#0.0#2021-12-27
10:38:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b377820e9fd2f0ba1a8e6accb9ff9ee0 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 17/08/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 439305
0 1 0 0 0 SUWARNI, NY 079454 44 16193 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346241
1#0##0#0#0.0#2021-12-30
13:44:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
04e11f11f24408c4e3d4b22832eda86d 150000 0 0 0 0 0
150000 0 0 0 15000 0 124305 0 0 0 0
0
3372030 C 3 CP 2 17/12/2021 17/12/2021 24/09/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 253170
0 1 0 0 0 HERIBERTUS HADI RAHARJO, TN 097748 51
0002217338109 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
346242 1#0##0#0#0.0#2021-12-30
13:44:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8d8dcc0b0d96208eabc2639a47455c77 150000 0 0 0 0 0
0 0 0 0 15000 0 88170 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 22/09/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 296229
0 1 0 0 0 DARYANTI., NY 048989 46 16888 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345351
1#0##0#0#0.0#2021-12-27
10:43:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8ab160235a87fd0d730f26cb96a9d64a 150000 0 0 0 0 0
0 0 0 0 15000 0 131229 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 08/06/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 LAMIYEM.NY 087484
0001316300512 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345271 1#0##0#0#0.0#2021-12-27
10:45:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2c89f15850af817fe9e23cce18e755c5 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 17/01/1958 0 2
1 Z09.8;I64;R51 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 337760
0 1 0 0 0 SURIPTI.(NY) 028375 63 23345 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346243
1#0##0#0#0.0#2021-12-30
13:45:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
de2dcac486a7c5f16b45850193da62c0 150000 0 0 0 0 0
0 0 0 0 15000 0 172760 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 29/11/1975 0 1
0 0 - 0 - 0 - 0 - 0 181400 241320
0 1 0 0 0 JULIANTO. SDR 076685 46 16820 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345352
1#0##0#0#0.0#2021-12-27
10:47:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4694d3d3ac2ed2cf5fc797400c6eafd4 150000 0 0 0 0 0
0 0 0 0 15000 0 76320 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 03/08/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ISMURYANI
1124R0021221V003026 0001313177196 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345266 1#0##0#0#0.0#2021-12-27
10:47:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6ad4429773f3ecc0257e42fdaac7ff25 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 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; 5.5.5.202112011542 4
345281 1#0##0#0#0.0#2021-12-27
10:48:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0863182390aabef90ee02619d67e6e76 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 07/10/1976 0 2
- 0 - 0 - 0 - 0 182600 165000 0
1 0 0 0 TRI ANISTA .(NY) 006698 45 16507 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346244
1#0##0#0#0.0#2021-12-30
13:46:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e72d7987816cf06cd3ea42eb898497e7 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 20/06/1938 0 2
0 0 - 0 - 0 - 0 - 0 181400 190920
0 1 0 0 0 SUPARTI, NY 090064 83 30496 DR. INDRIANY
novia;3313125201940001; 5.5.5.202112011542 4 346245
1#0##0#0#0.0#2021-12-30
13:50:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fefb6b455ff1b68bdaf8c8ce043c272e 150000 0 0 0 0 0
0 0 0 0 15000 0 25920 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 12/06/1972 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345290
1#0##0#0#0.0#2021-12-27
10:48:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5de1028d46a0a193fb9da7658bf84e33 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 30/03/1954 0 1
0 - 0 - 0 - 0 183900 187190 0 1
0 0 0 SRIJADI 100723 67 24734 DR. DAMAR ARYO, SP.B
1124R0021221V003031 0000077187194 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 345461 1#0##0#0#0.0#2021-12-30
13:51:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
88cd22a4934c4bd0a852d7a490a13a38 150000 0 0 0 0 0
0 0 0 0 25000 0 12190 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 17/04/1961 0 2
0 - 0 - 0 - 0 786200 557266 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345291
1#0##0#0#0.0#2021-12-27
10:55:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a9c6f561e7de7bb94c99cba3e0a2d527 463830 0 0 0 0 0
0 0 0 0 15000 0 78436 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 19/10/2010 0 1
1 G24.8 - - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 180750
0 1 0 0 0 FARHAN TRISNA ADITYA, AN 086375 11
0001177628679 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
346246 1#0##0#0#0.0#2021-12-30
13:52:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
bd18d391f042fc57f8ccfcb7b212d176 150000 0 0 0 0 0
0 0 0 0 15000 0 15750 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 10/11/1970 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345292
1#0##0#0#0.0#2021-12-27
10:56:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bab78680d70ad478305832a1e5de4e82 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 05/01/1951 0 1
0 - 0 107400 273000 0 1 0 0 0 ACHMAD
SUPARDI., TN 061983 70 25914 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V003035 0001693922106 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345267 1#0##0#0#0.0#2021-12-27
10:57:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3de9280f5d683df2f3a9bb363eebd1e6 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 01/04/1981 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V003036 0001904830593 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345302 1#0##0#0#0.0#2021-12-27
11:00:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
31d4b4d8f1f1d2b758dc26a9314c3067 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 28/08/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 197810
0 1 0 0 0 RUKMINI, NY 099276 68 24948 DR. INDRIANY
novia;3313125201940001; 5.5.5.202112011542 4 346247
1#0##0#0#0.0#2021-12-30
13:53:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e72f5020adc10de6cb9a2d1833d39896 150000 0 0 0 0 0
0 0 0 0 15000 0 32810 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 01/12/1958 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V003038 0001436949538 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345293 1#0##0#0#0.0#2021-12-27
11:01:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
19cf0281c4572164b29141ade8d0c856 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 25/05/1972 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V003039 0002431552465 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345294 1#0##0#0#0.0#2021-12-27
11:02:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
18bf832b538876a0ebc1793c85dd351a 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 20/08/1959 0 1
0 - 0 - 0 - 0 786200 553770 0 1
SP.PD 1124R0021221V003041 0000571256594 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345295 1#0##0#0#0.0#2021-12-27
11:04:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
20f8271c21db7d08459ef6ec609cdb3c 463830 0 0 0 0 0
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3372030 C 3 CP 2 17/12/2021 17/12/2021 26/04/1964 0 1
0 - 0 - 0 - 0 786200 677676 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345296
1#0##0#0#0.0#2021-12-27
11:05:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
244d2a341e37c04fb5d74b42e156a0ae 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 02/02/1971 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345297
1#0##0#0#0.0#2021-12-27
11:07:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
98a3a5011cbe2be9ea3c13f09b6279f6 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 19/03/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 281943
0 1 0 0 0 SRI UNTARI, NY 087563 61 22553 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346248
1#0##0#0#0.0#2021-12-30
13:53:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
394540d02595322fce82a012f5fa9e3a 150000 0 0 0 0 0
0 0 0 0 15000 0 116943 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 13/07/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 175000
0 1 0 0 0 EDY SANTOSO.TN 098470 53 19515 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346249
1#0##0#0#0.0#2021-12-30
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3372030 C 3 CP 2 17/12/2021 17/12/2021 21/09/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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yani;3302226402970001; 5.5.5.202112011542 4 345301
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11:11:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 17/12/2021 17/12/2021 15/09/1966 0 2
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1124R0021221V003052 0001266521725 3;JKN novia;3313125201940001;
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3372030 C 3 CP 2 17/12/2021 17/12/2021 25/01/1960 0 2
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novia;3313125201940001; 5.5.5.202112011542 4 346257
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yani;3302226402970001; 5.5.5.202112011542 4 345355
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3372030 C 3 CP 2 17/12/2021 17/12/2021 02/06/1958 0 1
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11:18:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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novia;3313125201940001; 5.5.5.202112011542 4 346258
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13:57:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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1124R0021221V003060 0000640722115 3;JKN novia;3313125201940001;
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3372030 C 3 CP 2 17/12/2021 17/12/2021 24/12/1960 0 2
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11:20:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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11:21:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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11:22:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 17/12/2021 17/12/2021 26/03/1968 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 345360
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11:23:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 17/12/2021 17/12/2021 19/01/1999 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 345361
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11:25:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 17/12/2021 17/12/2021 12/01/1985 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 345362
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11:26:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 17/12/2021 17/12/2021 06/09/1976 0 1
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13:37:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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SP.KG 1124R0021221V003072 0001102660863 3;JKN yani;3302226402970001;
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11:34:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 17/12/2021 17/12/2021 23/08/1978 0 1
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1 0 0 0 MOH RIYADI, TN 071422 43 15822 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 345367
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11:35:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 17/12/2021 17/12/2021 17/03/1986 0 2
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1 0 0 0 RATNA NILASARI, NY 001398 35 13059 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 345369
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11:35:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.5.5.202112011542 4 345370
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11:38:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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11:40:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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1 0 0 0 SUHASTI,(NY) 038243 50 18301 DRG.
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11:47:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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11:50:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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13:12:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 17/12/2021 17/12/2021 07/07/1949 0 1
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13:14:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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13:14:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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13:19:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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13:20:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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13:21:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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1 0 0 0 KAWITINAH, (NY) 006229 72 26473 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 345400
1#0##0#0#0.0#2021-12-27
13:21:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.5.5.202112011542 4 345401
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13:22:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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13:24:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f671e6fb2ba5a149aff903ba37b90d97 150000 0 0 0 0 0
0 0 0 0 15000 0 48125 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 16/02/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 233887
0000090964833 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345403 1#0##0#0#0.0#2021-12-27
13:24:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
733721441906ccd22386a6774046a0e1 150000 0 0 0 0 0
0 0 0 0 15000 0 68887 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 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; 5.5.5.202112011542 4
345263 1#0##0#0#0.0#2021-12-27
13:25:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
32a2f72796262a40cf3958c9d2de997d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 11/03/1978 0 1
0 - 0 - 0 - 0 183900 290370 0 1
0 0 0 AMIR PURWANTO, TN 099924 43 15987 DR. HERMAWAN, SP.B
1124R0021221V003097 0000639884845 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345404 1#0##0#0#0.0#2021-12-27
13:26:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
70ffccc26d8a9793564976b2932b5ded 235000 0 0 0 0 0
0 0 0 0 15000 0 40370 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 26/09/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 197988
0 1 0 0 0 ADITYA PUTRA PERDANA.SDR 099432 19
7022 DR. HERMAWAN, Sp.B M.Kes 1124R0021221V003098 0001194697179
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 346260
1#0##0#0#0.0#2021-12-30
13:59:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
774d6b3782bc03a01293469f4a997492 150000 0 0 0 0 0
0 0 0 0 15000 0 32988 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 29/01/2001 0 1
0 - 0 - 0 - 0 183900 186489 0 1
0 0 0 ROLANDO SILALAHI, SDR 100540 20 7627 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346261
1#0##0#0#0.0#2021-12-30
14:00:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0d4ab5273c1b44340246131251fb609d 150000 0 0 0 0 0
0 0 0 0 15000 0 21489 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 28/02/1959 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
486465 0 1 0 0 0 NOOR LAILA., NY 041825 62
0001021681765 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345405 1#0##0#0#0.0#2021-12-27
13:27:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
171fa2656734aaf4380fb00764f4e33d 0 0 138000 0 0 0
0 0 0 0 15000 0 333465 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 13/08/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 222983
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345406
1#0##0#0#0.0#2021-12-27
13:29:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3cdf01c76a133d891921820011010bd8 150000 0 0 0 0 0
0 0 0 0 15000 0 57983 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 13/10/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 217562
0 1 0 0 0 NUNUK SUNDARI,(NY) 018287 59 21615
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345407
1#0##0#0#0.0#2021-12-27
13:31:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b9475c026a13b42479d686beade6c9ad 150000 0 0 0 0 0
0 0 0 0 15000 0 52562 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 16/05/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 233790
0 1 0 0 0 MEIYANTO.TN 096828 52 19208 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 345408
1#0##0#0#0.0#2021-12-27
13:32:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
489071fc230ae93cb1ff5b325ea1277c 150000 0 0 0 0 0
0 0 0 0 15000 0 68790 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 12/08/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 195205
yani;3302226402970001; 5.5.5.202112011542 4 345409
1#0##0#0#0.0#2021-12-27
13:40:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d0b16bcdbcd8bec7189d3c0e4b01b66d 0 0 138000 0 0 0
0 0 0 0 15000 0 42205 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 27/11/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 221217
0 1 0 0 0 RUWI HERUNI.NY 099818 56 20474 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345410
1#0##0#0#0.0#2021-12-27
13:41:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
406c5e5596324d1ccaf84586efbb61a5 150000 0 0 0 0 0
0 0 0 0 15000 0 56217 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 13/06/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 222640
0 1 0 0 0 ERNA SUSANTI PUSPONINGRUM, NY 092657 49
0000163055294 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345411 1#0##0#0#0.0#2021-12-27
13:44:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b646c8ff5c8202b24f22e3ebbee107a0 150000 0 0 0 0 0
0 0 0 0 15000 0 57640 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 25/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 242482
0 1 0 0 0 NGATINI S,NY 088163 66 24464 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345412
1#0##0#0#0.0#2021-12-27
13:46:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
982372ec441ec377095566f951e18531 150000 0 0 0 0 0
0 0 0 0 15000 0 77482 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
345261 1#0##0#0#0.0#2021-12-27
13:46:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
247060ca3e2ec22a6a357cea2b3692c0 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 13/09/1971 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SUGIYARTI, (NY) 002430 50 18358 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 345413
1#0##0#0#0.0#2021-12-27
13:47:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0cc7c2171f7788e461bf434eb28c142e 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 06/04/1997 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 BAYU DWI APRILIANTO.SDR 099757 24 9021 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 345414
1#0##0#0#0.0#2021-12-27
13:48:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4691a91d510c154c07d343370068f0a9 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 11/04/1965 0 1
0 - 0 - 0 - 0 786200 478830 0 1
1124R0021221V003117 0001732801498 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345284 1#0##0#0#0.0#2021-12-27
13:50:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dcf8c42c9b3589a6ea565890c88075bd 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 02/09/1976 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345283
1#0##0#0#0.0#2021-12-27
13:51:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6006398a898fdb05de9bc86ee270a076 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 25/03/1978 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V003119 0001530372778 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345285 1#0##0#0#0.0#2021-12-27
13:52:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0b196a904c26b132bd18903d59fc8157 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 23/12/1977 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V003120 0002302362729 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345286 1#0##0#0#0.0#2021-12-27
13:53:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ec4715f7c07f9549105d14cc892a0116 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 01/09/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
1124R0021221V003121 0000639614597 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345287 1#0##0#0#0.0#2021-12-27
13:54:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
09844bf314422fc0dab9fe6e22d093fe 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 13/12/1966 0 2
0 - 0 - 0 - 0 786200 478830 0 1
1124R0021221V003122 0002051493849 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345288 1#0##0#0#0.0#2021-12-27
13:56:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b7261b44e711e8257f8cdb1521c25f8a 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 07/04/1948 0 1
0 - 0 - 0 - 0 786200 677676 0 1
SP.PD 1124R0021221V003123 0000094255514 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345289 1#0##0#0#0.0#2021-12-27
13:57:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
64d5d845219b9e435474145fd57413b3 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 28/07/1960 0 2
- 0 - 0 - 0 - 0 283800 325000 0
1 0 0 0 SRI WULAN YULIE I, NY 100807 61 22422 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 345415
1#0##0#0#0.0#2021-12-27
13:58:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9514691191974496ae9c68525e155811 300000 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 09/07/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 218465
0 1 0 0 0 SUROTO.TN 087121 62 22807 DR. ARIA
reni;3313147010930001; 5.6.0.202201041418 4 345416
1#0##0#0#0.0#2022-01-07
19:57:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
6221223505715940b139b3f1703c260e 150000 0 0 0 0 0
0 0 0 0 15000 0 53465 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 20/07/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 219070
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345417
1#0##0#0#0.0#2021-12-27
14:01:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5d75f42f21ad756ab2ac15822d0c7a60 150000 0 0 0 0 0
0 0 0 0 15000 0 54070 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 21/12/1969 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 492862
0 1 0 0 0 ENDANG HANDAYANI, (NY) 003693 51 18989
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 347280
1#0##0#0#0.0#2022-01-05
16:55:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eced8865285da0a32b54dc6059e9edff 150000 0 0 0 0 0
285000 0 0 0 15000 0 42862 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 21/09/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 225525
0002261390455 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345418 1#0##0#0#0.0#2021-12-27
14:01:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e8532747c286c0ae10c229e903d2274b 150000 0 0 0 0 0
0 0 0 0 15000 0 60525 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 05/12/1996 0 2
- 0 - 0 - 0 - 0 283800 337280 0
1 0 0 0 HYASTI NANTA KUSUMAH, NY 063483 25 9143
yani;3302226402970001; 5.5.5.202112011542 4 345419
1#0##0#0#0.0#2021-12-27
14:03:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
751b6f0a5e4e8ede339893d9f4c5d301 300000 0 0 0 0 0
0 0 0 0 15000 0 22280 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 16/09/2004 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 BASILIUS AGUNG PUTRA A, SDR 100551 17 6301
yani;3302226402970001; 5.5.5.202112011542 4 345420
1#0##0#0#0.0#2021-12-27
14:09:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6aa2ce63c9a27758267c9903adcef62b 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 16/09/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 226330
0 1 0 0 0 MULYANI, NY 097536 55 20181 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 345421
1#0##0#0#0.0#2021-12-27
14:11:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a7e71118d95f20578787de73f50ba0e5 150000 0 0 0 0 0
0 0 0 0 15000 0 61330 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 28/05/2005 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ZAHRA NABILA WAHYUNI, AN 098771 16 6047
yani;3302226402970001; 5.5.5.202112011542 4 345422
1#0##0#0#0.0#2021-12-27
14:12:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4a20d5ebde13d61e56c102c18e11aa59 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 21/03/1995 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MARDIAN DEWI PAMUNGKAS.Nn 099128 26 9768
yani;3302226402970001; 5.5.5.202112011542 4 345423
1#0##0#0#0.0#2021-12-27
14:13:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c728b6db22dc669681c85119c96c88ec 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 13/03/1966 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SUWANTO., TN 071553 55 20368 DRG.
yani;3302226402970001; 5.5.5.202112011542 4 345424
1#0##0#0#0.0#2021-12-27
14:14:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9b57c0824bdd5ea3261c2bbb9258f12b 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 19/09/1983 0 1
- 0 - 0 - 0 - 0 283800 315000 0
SP.KG 1124R0021221V003136 0001298346715 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345425 1#0##0#0#0.0#2021-12-27
14:16:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a8f847432e2d17c7aa953722998dc6cd 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 17/12/2021 17/12/2021 12/02/1976 0 1
1 Z04.9;R50.9 89.52 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 472551
0 1 0 0 0 ACHMAD YASIN, TN 007473 45 16745 dr.
KRISNA ARIE SOESANTY 1124R0021221V003141 0001103540523 3;JKN
novia;3313125201940001; 5.6.3.202201201500 4 346685
1#0##0#0#0.0#2022-02-14
13:52:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
c9bca63e7534ae704725e43840e24fbe 255000 0 0 0 0 0
0 175145 0 0 15000 0 27406 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 29/10/1965 0 1
1 Z09.8;I48 88.72 - - None None None None I-3-13-0 None
- 0 - 0 - 0 - 0 315000 405878 0
1 0 0 0 SANTOSO. TN 038094 56 20504 DR. GALIH RAKASIWI
SOEKARNO,SP.JP 1124R0021221V003144 0000564536698 3;JKN
yani;3302226402970001; 5.5.5.202112011542 4 345183
1#0##0#0#0.0#2021-12-24
10:28:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cd064316d3144850ad3504ea7c50aad5 300000 0 0 0 0 0
0 0 0 0 15000 0 90878 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 27/03/1985 0 2
0 0 - 0 - 0 - 0 - 0 181400 408709
0 1 0 0 0 YENI PUJI HASTUTI.NY 095198 36 13415
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345184
1#0##0#0#0.0#2021-12-24
10:29:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9553dea1467195747a85e64231234710 300000 0 0 0 0 0
0 0 0 0 15000 0 93709 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 01/10/1950 0 1
1 I25.9 89.52;87.49;88.72 - - None None None None I-3-13-0
None None None None None None PROSEDUR EKOKARDIOGRAFI 315000 0
0 - 0 - 0 - 0 - 0 315000 643580
0 1 0 0 0 SUWONDO.TN 089264 71 26011 DR. GALIH
novia;3313125201940001; 5.5.5.202112011542 4 347282
1#0##0#0#0.0#2022-01-05
16:56:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bd5024b8498373a7e58e75bbc233d1fe 300000 0 0 0 0 0
200000 0 0 0 15000 0 128580 0 0 0 0
0
3372030 C 3 CP 2 18/12/2021 18/12/2021 15/02/1969 0 1
1 Z09.8;I25.9 89.52;88.72 - - None None None None I-3-13-0
0 - 0 - 0 - 0 - 0 315000 418568
0 1 0 0 0 BAMBANG SANTOSO.TN 088657 52 19299
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345185
1#0##0#0#0.0#2021-12-24
10:31:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fdbad80fa5844e2bf3151d8c76f19339 300000 0 0 0 0 0
0 0 0 0 15000 0 103568 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 12/10/1955 0 2
- 0 - 0 - 0 - 0 315000 661100 0
1 0 0 0 LIES ALIDA TRISNAWATI, NY 089096 66 24174
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345186
1#0##0#0#0.0#2021-12-24
10:33:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d95905ad31a89a7a2bc414a8942889ad 550000 0 0 0 0 0
0 0 0 0 15000 0 96100 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 09/04/1962 0 1
- 0 - 0 - 0 - 0 315000 426536 0
1 0 0 0 YULIANA THERESIA, NY 094080 59 21803 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345189
1#0##0#0#0.0#2021-12-24
10:38:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1227ccb9cfe26d505c8d638793e917e5 300000 0 0 0 0 0
0 0 0 0 15000 0 111536 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 05/06/1943 0 1
0 0 - 0 - 0 - 0 - 0 181400 214944
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345187
1#0##0#0#0.0#2021-12-24
10:35:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d35df62e99015ab96eba40272ae452ed 150000 0 0 0 0 0
0 0 0 0 15000 0 49944 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 23/04/1968 0 2
1 Z09.8;M19.98;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 244324
0 1 0 0 0 SURYATI, NY 037498 53 19597 DR. SUHARTO,
SP.PD 1124R0021221V003151 0000564536788 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345188 1#0##0#0#0.0#2021-12-24
10:36:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5a67324e9897fe1a5fcfd0e72d042083 150000 0 0 0 0 0
0 0 0 0 15000 0 79324 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 14/08/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 218768
0 1 0 0 0 SRI LESTARI 056183 53 19484 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 345190
1#0##0#0#0.0#2021-12-24
10:39:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d01b61a62db58ff55b2dccd7a62703f2 150000 0 0 0 0 0
0 0 0 0 15000 0 53768 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 07/08/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 212374
yani;3302226402970001; 5.5.5.202112011542 4 345191
1#0##0#0#0.0#2021-12-24
10:40:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
04b47485cfc71bafd9cac04a64963c9b 150000 0 0 0 0 0
0 0 0 0 15000 0 47374 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 31/12/1957 0 2
1 Z09.8;M54.59;S72.80 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SAKIYEM, NY 093271 63 23363 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 345192
1#0##0#0#0.0#2021-12-24
10:42:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a759a1b145c169bed857a951222b3c32 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 25/06/1981 0 2
0 0 - 0 - 0 - 0 - 0 181400 371111
0 1 0 0 0 JUMIARTI, NY 059700 40 14786 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345193
1#0##0#0#0.0#2021-12-24
10:43:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2ff0b9c55fe5b6e2d2e7dd237b069309 300000 0 0 0 0 0
0 0 0 0 15000 0 56111 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 18/04/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 208982
0 1 0 0 0 SUPRIYANI.NY 098108 43 15950 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345194
1#0##0#0#0.0#2021-12-24
10:44:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
241940ba5e601376318964d4b44d3ea3 150000 0 0 0 0 0
0 0 0 0 15000 0 43982 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 19/06/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 211414
0 1 0 0 0 ENDANG TRININGSIH, NY 091052 66 24289
yani;3302226402970001; 5.5.5.202112011542 4 345197
1#0##0#0#0.0#2021-12-24
10:45:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1d581a4d188451f47c2fd4b886bd938f 150000 0 0 0 0 0
0 0 0 0 15000 0 46414 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 12/05/1983 0 1
0 0 - 0 - 0 - 0 - 0 181400 211224
0 1 0 0 0 TRI JOKO HERU WIBOWO, TN 031060 38
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345198
1#0##0#0#0.0#2021-12-24
10:48:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
14a5e0c13425ea0afbeeba0b2f76d1ab 150000 0 0 0 0 0
0 0 0 0 15000 0 46224 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 12/08/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 236352
0 1 0 0 0 FX DARSINAH .,NY 074934 69 25330 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345199
1#0##0#0#0.0#2021-12-24
10:48:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0e41da2dfe65fb944c196a81e947de90 150000 0 0 0 0 0
0 0 0 0 15000 0 71352 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 10/01/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 HARJONO.TN 084485 55 20431 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 345200
1#0##0#0#0.0#2021-12-24
10:49:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1e08ac11fef469423151c9334c138a64 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 25/03/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 236234
0 1 0 0 0 SUPINAH 091220 66 24375 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 345201
1#0##0#0#0.0#2021-12-24
10:52:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
94fe5444853dd1f2f8c1e7d0bfd5badf 150000 0 0 0 0 0
0 0 0 0 15000 0 71234 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 21/09/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 235772
0 1 0 0 0 SUDARNO, TN 091269 51 18716 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 345202
1#0##0#0#0.0#2021-12-24
10:54:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
50b5d8a54b6f78dc87bd6d9d79bee12d 150000 0 0 0 0 0
0 0 0 0 15000 0 70772 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 21/06/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 233800
0 1 0 0 0 SUMIRAH.NY 088205 72 26478 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 345204
1#0##0#0#0.0#2021-12-24
10:54:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7aec59f534f7a6a42620422ec8362c7b 150000 0 0 0 0 0
0 0 0 0 15000 0 68800 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 02/09/1971 0 1
1 Z09.8;I25.9 89.52;88.72 - - None None None None I-3-13-0
0 - 0 - 0 - 0 - 0 315000 624768
0 1 0 0 0 SRIYADI. TN 090091 50 18370 DR. GALIH
yani;3302226402970001; 5.5.5.202112011542 4 345205
1#0##0#0#0.0#2021-12-24
10:56:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
53eccc4f5969dfb07f0e5c8040d15cd9 550000 0 0 0 0 0
0 0 0 0 15000 0 59768 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 02/03/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 205410
0 1 0 0 0 SRI SUKARMINI, NY 059077 57 21110 DR.
agung;3313092303950002; 5.6.6.202203301209 4 345206
1#0##0#0#0.0#2022-04-14
12:53:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
fba6d89ef1d65085969826e8a1b7a50b 150000 0 0 0 0 0
0 0 0 0 15000 0 40410 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 25/05/1967 0 1
0 404900 206221 0 1 0 0 0 BAMBANG
INDRAJID.TN 100238 54 19931 DR. WAHYU PURNOMO, SP.OT
1124R0021221V003168 0000091534228 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 345207 1#0##0#0#0.0#2022-04-14
13:46:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
8e79d296c0b7d38c5a151e7c4e27d034 150000 0 0 0 0 0
0 0 0 0 15000 0 41221 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 11/02/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 210022
0 1 0 0 0 MULYANI,(NY) 039619 61 22591 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345208
1#0##0#0#0.0#2021-12-24
11:00:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ef3d633c2ab0ad1ffbdeba31082ec73f 150000 0 0 0 0 0
0 0 0 0 15000 0 45022 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 17/04/1956 0 2
1 M17.9 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
388162 0 1 0 0 0 SRI HASTUTI.NY 100500 65
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345209
1#0##0#0#0.0#2021-12-24
11:01:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f74add4bf933891af5466308e089b291 150000 0 0 0 0 0
0 0 0 0 15000 0 223162 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 12/12/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 195942
0 1 0 0 0 IMAN SUTIKNO.TN 100314 43 15712 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345210
1#0##0#0#0.0#2021-12-24
11:05:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9d58e999b03ddeebfad157e1a17ac7a2 150000 0 0 0 0 0
0 0 0 0 15000 0 30942 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 31/12/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 WAGINAH,NY 085647 60 22267 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 345211
1#0##0#0#0.0#2021-12-24
11:09:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4ae1ef535b1d4746e3905a2e578409b1 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 03/02/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 224242
0 1 0 0 0 IRIANI KRISTANTINAH, NY 091371 59 21868
yani;3302226402970001; 5.5.5.202112011542 4 345212
1#0##0#0#0.0#2021-12-24
11:18:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
df4c722fb37c6e775a6af308996e866e 150000 0 0 0 0 0
0 0 0 0 15000 0 59242 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 23/03/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 273000
0 1 0 0 0 ERDIANA.NY 087879 48 17802 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 347283
1#0##0#0#0.0#2022-01-05
16:57:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
94a6cc6589390d059ba895367d95b1f4 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 24/07/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 210022
0 1 0 0 0 NASHA FADHIL CAESARAFI.SDR 100587 19
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 347274
1#0##0#0#0.0#2022-01-05
16:59:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
568b3fbba741bbac3a5e1f431f794095 150000 0 0 0 0 0
0 0 0 0 15000 0 45022 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 13/12/1941 0 2
0 0 - 0 - 0 - 0 - 0 181400 228616
0 1 0 0 0 FATIMAH.NY 077901 80 29225 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 345213
1#0##0#0#0.0#2021-12-24
11:19:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
128f073ce98c96af19bb6fc5abe9167d 150000 0 0 0 0 0
0 0 0 0 15000 0 63616 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 28/08/1941 0 2
1 S52.50;W19.0 - - - None None None None Q-5-31-0
0 - 0 - 0 - 0 129600 165000 0 1
0 0 0 SUMARMI,(NY) 018040 80 29332 DR. WAHYU PURNOMO,
SP.OT 1124R0021221V003177 0001807453721 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345214 1#0##0#0#0.0#2021-12-24
11:25:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ea5ccfa2d4dfe7ace69031065ed98398 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 01/09/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 223258
0 1 0 0 0 SRI YAMTI.NY 089240 50 18371 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345215
1#0##0#0#0.0#2021-12-24
11:29:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b00f7620b838a37e55f2a49f0f86684b 150000 0 0 0 0 0
0 0 0 0 15000 0 58258 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 31/12/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 230852
0 1 0 0 0 MUJIYEM.NY 075280 56 20806 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 345216
1#0##0#0#0.0#2021-12-24
11:31:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cb85ee78e2d9f5e3f5757d8eb059c264 150000 0 0 0 0 0
0 0 0 0 15000 0 65852 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 31/12/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 223182
0 1 0 0 0 SRI SOEPARNI.,NY 053668 71 26285 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345217
1#0##0#0#0.0#2021-12-24
11:32:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5ff5b606076bc1ac8e2896afef969b0f 150000 0 0 0 0 0
0 0 0 0 15000 0 58182 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 12/02/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 226280
0 1 0 0 0 SRI SUMARSI, NY 099382 62 22955 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345218
1#0##0#0#0.0#2021-12-24
11:42:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5ad82e3c3c2f4e6c85feb3795d344c5f 150000 0 0 0 0 0
0 0 0 0 15000 0 61280 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 27/12/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 222304
yani;3302226402970001; 5.5.5.202112011542 4 345219
1#0##0#0#0.0#2021-12-24
11:43:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0303085906aacf2bc44a64d03593bf4a 150000 0 0 0 0 0
0 0 0 0 15000 0 57304 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 26/05/1962 0 2
1 Z09.8;S92.50 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 371776
0 1 0 0 0 SRI REJEKI,NY 010002 59 21756 DR.
agung;3313092303950002; 5.6.7.202204241238 4 367818
1#0##0#0#0.0#2022-05-20
10:02:38#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
d7cb9abb3b969927920b896be234c24c 300000 0 0 0 0 0
0 0 0 0 15000 0 56776 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 21/08/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 495050
0 1 0 0 0 MUSNATIN., NY 071462 73 26782 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345220
1#0##0#0#0.0#2021-12-24
11:43:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d4b080414d2837b013cf6669c350c9ba 150000 0 0 0 0 0
0 0 0 0 15000 0 330050 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 11/05/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 227482
0 1 0 0 0 JUMIRAH, NY 089102 64 23597 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 345221
1#0##0#0#0.0#2021-12-24
11:51:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5dbf55bcbe8c31550dc623a8b42f8aef 150000 0 0 0 0 0
0 0 0 0 15000 0 62482 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 26/04/1954 0 1
1 Z09.4;Z47.0 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 211780
0 1 0 0 0 JOKO RUSTAMAJI, TN 066817 67 24708
yani;3302226402970001; 5.5.5.202112011542 4 345222
1#0##0#0#0.0#2021-12-24
11:51:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
096561971b8743c9db5c5e337743326b 150000 0 0 0 0 0
0 0 0 0 15000 0 46780 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 13/06/1992 0 2
0 - 0 - 0 - 0 - 0 138400 285000
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345147
1#0##0#0#0.0#2021-12-24
11:52:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2fe1130e11cd076002830cfdcea86696 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 02/12/1957 0 2
1 Z09.8;M54.59;I89.0 93.35;93.39 - - None None None None
0 - 0 107400 273000 0 1 0 0 0 ENDANG
MARDIASMANI.NY 090524 64 23392 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V003191 0000086714471 3;JKN novia;3313125201940001;
5.6.3.202201201500 4 345159 1#0##0#0#0.0#2022-02-15
11:46:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
61ffe04e82ee85e0129932eff34c3351 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 02/08/1952 0 2
1 Z09.8;M54.39 93.89;93.35 - - None None None None Z-3-
0 - 0 - 0 - 0 - 0 138400 273000
0 1 0 0 0 SITI MAJIAH, NY 094003 69 25340 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345151
1#0##0#0#0.0#2021-12-24
13:06:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
81cbc89dd962307a5df80da92e5a6a29 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 13/11/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 215857
0 1 0 0 0 LIDIA HERAWATI 090523 76 27794 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345223
1#0##0#0#0.0#2021-12-24
13:21:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e211f0b7988f50691faca34aa3fdc2b6 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/12/2021 18/12/2021 28/01/1959 0 1
1 Z09.8;R10.4;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 235159
0 1 0 0 0 RISTIYANTO,TN 029882 62 22970 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345224
1#0##0#0#0.0#2021-12-24
13:23:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1346de97b1b93f47c507fdb03e51a103 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/12/2021 18/12/2021 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; 5.5.5.202112011542 4
345112 1#0##0#0#0.0#2021-12-24
13:25:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f7018336f093c47ed9356c27801346c5 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 10/05/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 196845
0 1 0 0 0 BAMBANG EDI RIJONO.TN 089556 65 23963
yani;3302226402970001; 5.5.5.202112011542 4 345225
1#0##0#0#0.0#2021-12-24
13:36:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2a9ef05cb660c37da59346f293e6893d 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/12/2021 18/12/2021 11/05/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 306307
0 1 0 0 0 SLAMET SAWARTO,BP 079134 66 24328 DR.
novia;3313125201940001; 5.6.3.202201201500 4 345226
1#0##0#0#0.0#2022-03-08
08:48:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
550a0a2fe5defcfd98e2285d9708bd37 150000 0 0 0 0 0
0 31845 0 0 15000 0 109462 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 04/06/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SRI HARTATI,(NY) 005917 54 19921 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345227
1#0##0#0#0.0#2021-12-24
13:39:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1478a6f365b1a3c317b4e6ccc6400fd0 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/12/2021 18/12/2021 13/10/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 RIZWAN NURWAHID.SDR 100136 19 7006
yani;3302226402970001; 5.5.5.202112011542 4 345117
1#0##0#0#0.0#2021-12-24
13:40:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5a9b40ecef1f27acc5b85c7b498d0628 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/12/2021 18/12/2021 31/12/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI ISWATIYARSI,
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345118 1#0##0#0#0.0#2021-12-24
13:41:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 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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345160 1#0##0#0#0.0#2021-12-24
13:44:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3b4404407507327d76a16301726a02ef 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 10/06/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 202191
SP.PD 1124R0021221V003202 0002261302165 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345228 1#0##0#0#0.0#2021-12-24
14:25:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3e71c65b37be7dfaee5e57a5c4b01287 150000 0 0 0 0 0
0 0 0 0 15000 0 37191 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
345155 1#0##0#0#0.0#2021-12-24
14:26:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
70f397f400587ceae14a9d3b80473c0f 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 31/08/1998 0 2
- 0 - 0 - 0 - 0 138400 360000 0
1 0 0 0 RARAS DANASTRI 083059 23 8510 DR. LINDA
yani;3302226402970001; 5.5.5.202112011542 4 345116
1#0##0#0#0.0#2021-12-24
14:29:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2cd5b8ec241569225a77433ea51171a9 345000 0 0 0 0 0
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3372030 C 3 CP 2 18/12/2021 18/12/2021 01/07/1951 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 WARSINAH
SUMARWANI, NY 092218 70 25738 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V003205 0000087200616 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345154 1#0##0#0#0.0#2021-12-24
14:30:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d654026c370dfa5b55c1adb42a04e8a3 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 23/07/1957 0 2
0 - 0 - 0 - 0 - 0 138400 240000
yani;3302226402970001; 5.5.5.202112011542 4 345145
1#0##0#0#0.0#2021-12-24
14:31:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e3f4ebe3a59ff5897bf546a70d040eab 225000 0 0 0 0 0
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3372030 C 3 CP 2 18/12/2021 18/12/2021 25/02/1965 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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345152 1#0##0#0#0.0#2021-12-24
14:32:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 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; 5.5.5.202112011542 4
345162 1#0##0#0#0.0#2021-12-24
14:33:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 13/03/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUHARI, TN 070582
0001021699394 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345120 1#0##0#0#0.0#2021-12-24
14:34:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e43ee797025d21625ddecb0feb284f74 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 03/03/1952 0 2
1 Z09.8;M25.58;I50.9;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 TITI SUTRIATI, NY 100191 69 25492 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345229
1#0##0#0#0.0#2021-12-24
14:36:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
131a48c0c6bf0dfe8f66df5319b884ca 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 13/06/1971 0 2
1 Z09.8;G81.9;M25.51 93.89 - - None None None None Z-3-
0 - 0 - 0 - 0 - 0 138400 285000
yani;3302226402970001; 5.5.5.202112011542 4 345158
1#0##0#0#0.0#2021-12-24
14:37:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0584a50b6d4dc022d03db70c91ef92c0 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 12/01/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 EKO RINI.NY 093223
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345168 1#0##0#0#0.0#2021-12-24
14:38:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1526c3417f2df178ca7ae10497625f2c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 01/09/1952 0 2
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 MARIA VERENA SINTOWATI.NY 089293 69 25310
yani;3302226402970001; 5.5.5.202112011542 4 345113
1#0##0#0#0.0#2021-12-24
14:46:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a9f85c006944e1c5dff1114c000ed5c2 270000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 12/12/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 248142
0 1 0 0 0 SRI WAHYUNINGSIH 093130 56 20460 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345230
1#0##0#0#0.0#2021-12-24
14:47:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f72bc29d19f60c6a2adcaf059af56a70 150000 0 0 0 0 0
0 31845 0 0 15000 0 51297 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 31/12/1961 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 JUMIATI.NY 097762
0001032605763 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345144 1#0##0#0#0.0#2021-12-24
14:49:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
81e4cbd0242402461b73a4d7ed5ef945 258000 0 0 0 0 0
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3372030 C 3 CP 2 18/12/2021 18/12/2021 17/03/1976 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000563317132 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345132 1#0##0#0#0.0#2021-12-24
14:51:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6feacf28f4236e31413e09e6c4034f4b 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 26/05/1968 0 2
1 Z09.8;I11.9;E11.9;M54.59;K30 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
366731 0 1 0 0 0 SRI LESTARI, NY 066305 53
yani;3302226402970001; 5.5.5.202112011542 4 345231
1#0##0#0#0.0#2021-12-24
14:52:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4c9b16903b1640d461906d6d3000407b 150000 0 0 0 0 0
0 121345 0 0 15000 0 80386 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 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; 5.5.5.202112011542 4
345129 1#0##0#0#0.0#2021-12-24
14:54:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
442d1423ba27a184c35e00ad48c1162d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 22/08/1947 0 2
0 - 0 107400 262000 0 1 0 0 0 DYAH
1124R0021221V003221 0000091082722 3;JKN yani;3302226402970001;
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14:54:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cfd9434acf129a0844a6d00672292fac 247000 0 0 0 0 0
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3372030 C 3 CP 2 18/12/2021 18/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
345126 1#0##0#0#0.0#2021-12-24
15:36:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 29/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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1124R0021221V003223 0002168632721 3;JKN yani;3302226402970001;
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15:37:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 16/02/1959 0 1
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MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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345114 1#0##0#0#0.0#2021-12-24
15:38:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 06/03/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SHINTA,NY 038241
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345135 1#0##0#0#0.0#2021-12-24
16:01:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 11/07/1963 0 2
0 - 0 - 0 - 0 - 0 138400 240000
0 1 0 0 0 SRI PARYATI, NY 089422 58 21345 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345157
1#0##0#0#0.0#2021-12-24
16:02:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9b98f6165a70a87f9c938d9b6fdf4a79 225000 0 0 0 0 0
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3372030 C 3 CP 2 18/12/2021 18/12/2021 10/02/1951 0 2
0 - 0 107400 273000 0 1 0 0 0 JIYEM,
0001789546059 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345169 1#0##0#0#0.0#2021-12-24
16:04:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 23/03/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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345156 1#0##0#0#0.0#2021-12-24
16:04:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 18/01/1966 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 IVO MUMPUNI
1124R0021221V003230 0002169780873 3;JKN yani;3302226402970001;
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16:05:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1b42151ed85c2c2e52f9666db3d6b5a6 247000 0 0 0 0 0
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3372030 C 3 CP 2 18/12/2021 18/12/2021 07/10/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0001083705715 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345119 1#0##0#0#0.0#2021-12-24
16:06:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 14/04/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 219150
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yani;3302226402970001; 5.5.5.202112011542 4 345232
1#0##0#0#0.0#2021-12-24
16:07:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 17/04/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0001084649501 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345153 1#0##0#0#0.0#2021-12-24
16:08:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
28006ff2a2eea073ce92d6eeea61cd1d 247000 0 0 0 0 0
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3372030 C 3 CP 2 18/12/2021 18/12/2021 28/09/1957 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 345233
1#0##0#0#0.0#2021-12-24
16:09:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 04/06/1968 0 2
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16:09:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 19/02/1967 0 1
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16:10:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 17/09/1955 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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MUSYAROF, TN 066016 66 24199 DR. LINDA SUGIARTO, SP.FKR
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16:10:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 07/10/1959 0 2
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SP.PD 1124R0021221V003240 0001694442633 3;JKN yani;3302226402970001;
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16:11:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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16:12:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 15/04/1973 0 1
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13:54:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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16:13:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 06/07/1954 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 345149
1#0##0#0#0.0#2021-12-24
16:14:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 01/04/1952 0 2
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16:15:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 03/07/1969 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 345141
1#0##0#0#0.0#2021-12-24
16:15:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 08/11/1969 0 2
0 - 0 - 0 - 0 - 0 138400 240000
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yani;3302226402970001; 5.5.5.202112011542 4 345148
1#0##0#0#0.0#2021-12-24
16:16:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 23/03/1965 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 345137
1#0##0#0#0.0#2021-12-24
16:17:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 26/05/1970 0 2
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16:17:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 02/06/1943 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 345237
1#0##0#0#0.0#2021-12-24
16:18:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 12/02/1964 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0002040571449 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345130 1#0##0#0#0.0#2021-12-24
16:19:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 26/10/1981 0 2
1 Z09.8;J32.0 97.32 - - None None None None U-3-15-0 None
DAN TENGGOROKAN 251000 0 0 - 0 - 0 - 0 -
0 251000 430485 0 1 0 0 0 MARHAENI, NY
0000572070666 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
347275 1#0##0#0#0.0#2022-01-05
16:59:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 16/11/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 281385
0 1 0 0 0 HARNI.NY 079693 43 15738 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345238
1#0##0#0#0.0#2021-12-24
16:20:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
518b2d3a815047e71767550f7bdf2237 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/12/2021 18/12/2021 10/10/1957 0 1
1 Z09.8;K30;M19.98 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 220474
0 1 0 0 0 SULUT, TN 082030 64 23445 DR. SUHARTO,
SP.PD 1124R0021221V003257 0000640434914 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345239 1#0##0#0#0.0#2021-12-24
16:21:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 05/05/1957 0 2
0 - 0 - 0 - 0 - 0 138400 240000
0 1 0 0 0 SURYATI, NY 090097 64 23603 DR. LINDA
yani;3302226402970001; 5.5.5.202112011542 4 345163
1#0##0#0#0.0#2021-12-24
16:24:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 15/04/1963 0 2
1 Z09.8;K30;R51;R05 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 259021
0 1 0 0 0 SUMINI, NY 047378 58 21432 DR. SUHARTO,
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16:24:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 14/05/1933 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 KOESWANTO BA.TN
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16:26:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 10/04/1950 0 2
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0 1 0 0 0 MOEMINAH., NY 046939 71 26185 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345142
1#0##0#0#0.0#2021-12-24
16:28:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 16/02/1970 0 1
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1#0##0#0#0.0#2022-01-05
17:00:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 08/12/1974 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 345164
1#0##0#0#0.0#2021-12-24
16:28:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 03/12/1950 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 345170
1#0##0#0#0.0#2021-12-24
16:29:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 01/10/1937 0 1
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1#0##0#0#0.0#2021-12-24
16:30:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 09/09/1944 0 1
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16:30:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 18/07/1964 0 1
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SP.PD 1124R0021221V003268 0002425018184 3;JKN yani;3302226402970001;
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16:31:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 31/12/1981 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 345174
1#0##0#0#0.0#2021-12-24
16:32:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.5.5.202112011542 4 345175
1#0##0#0#0.0#2021-12-24
16:32:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 02/02/1972 0 2
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SP.PD 1124R0021221V003271 0002070978546 3;JKN yani;3302226402970001;
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16:33:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 14/03/1977 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 345177
1#0##0#0#0.0#2021-12-24
16:33:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 15/10/1964 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 345180
1#0##0#0#0.0#2021-12-24
16:34:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 18/12/2021 18/12/2021 19/05/1972 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 345181
1#0##0#0#0.0#2021-12-24
16:35:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
37bfd665807c6aa3150f9636efc4eca1 662676 0 0 0 0 0
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3372030 C 3 CP 2 18/12/2021 18/12/2021 12/03/1955 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 344979
1#0##0#0#0.0#2021-12-24
16:36:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c03db69dd4fe0a55f92be64cd7c65022 463830 0 0 0 0 0
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3372030 C 3 CP 2 18/12/2021 18/12/2021 14/12/1982 0 1
0 0 - 0 - 0 - 0 - 0 181400 269096
0 1 0 0 0 TOFHAN ANDRYAS, TN 099114 39 14249
novia;3313125201940001; 5.6.3.202201201500 4 345241
1#0##0#0#0.0#2022-03-08
09:23:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
d237d745940988e07375a8b4168f2507 150000 0 0 0 0 0
0 0 0 0 15000 0 104096 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 22/06/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 199785
0 1 0 0 0 SUDARMADI .BP 037072 43 15885 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345242
1#0##0#0#0.0#2021-12-24
16:38:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1fb41e27c3c3e4e57a90e62dffe97f47 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/12/2021 18/12/2021 21/05/1959 0 1
1 Z09.8;E11.9;I10;M54.59 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 205347
0 1 0 0 0 SUTRISNO, TN 088415 62 22857 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345243
1#0##0#0#0.0#2021-12-24
16:39:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6f132a35855aa8335568f2594baeea40 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/12/2021 18/12/2021 03/04/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 207834
novia;3313125201940001; 5.6.3.202201201500 4 345244
1#0##0#0#0.0#2022-03-08
08:47:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
7085e04a3efe69e4596270c9d6c1dca3 150000 0 0 0 0 0
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3372030 C 3 CP 2 18/12/2021 18/12/2021 04/09/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 202780
0 1 0 0 0 NURMANTO, TN 098729 68 24942 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345245
1#0##0#0#0.0#2021-12-24
16:40:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
100b1e6abfc5329d95fa1a62d45aa7f6 150000 0 0 0 0 0
0 0 0 0 15000 0 37780 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 02/07/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 218761
0 1 0 0 0 SRI SLAMET.NY 099401 50 18432 DR.
novia;3313125201940001; 5.6.3.202201201500 4 345246
1#0##0#0#0.0#2022-02-15
14:27:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
7d4f23f4f6f756e0c90ba9189a4bc9d1 150000 0 0 0 0 0
0 0 0 0 15000 0 53761 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 16/02/2003 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 AISYA PUTRI NUR A, NN 100796 18 6880
agung;3313092303950002; 5.6.6.202203301209 4 345247
1#0##0#0#0.0#2022-04-14
13:49:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
8c2c2ee75c50b1dc9253311034db0eec 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 26/10/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 281385
yani;3302226402970001; 5.5.5.202112011542 4 345248
1#0##0#0#0.0#2021-12-24
16:42:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
05e11451422b851941c6955a27bcfdd5 150000 0 0 0 0 0
0 0 0 0 15000 0 116385 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 25/10/2003 0 1
0 - 0 - 0 - 0 - 0 181400 435825
0 1 0 0 0 RIZKI RAMADHAN, SDR 100813 18 6629
novia;3313125201940001; 5.5.5.202112011542 4 347284
1#0##0#0#0.0#2022-01-05
17:02:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
20af9748844063b1867fe7fd83993fab 150000 0 0 0 0 0
150000 0 0 0 15000 0 120825 0 0 0 0
0
3372030 C 3 CP 2 18/12/2021 18/12/2021 23/02/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 237841
0 1 0 0 0 YUSUF SUKIRNO, TN 100732 66 24405 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345249
1#0##0#0#0.0#2021-12-24
16:47:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3d51a27f57f83019b61c8d5aeae7c583 150000 0 0 0 0 0
0 0 0 0 25000 0 62841 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 31/05/1998 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 LINGGAR MAYZA PRADHITA.SDR 096218 23
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 347277
1#0##0#0#0.0#2022-04-14
13:38:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
50083a2fd93f132d186bf9b823a5f149 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 18/12/2021 18/12/2021 03/11/2014 0 1
1 K40.9 88.75 - - None None None None Z-3-23-0 None None
- 0 - 0 - 0 - 0 549400 1535000 0
1 0 0 0 BIMA ZAIDAN FIRAS.AN 100734 7 2602 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347286
1#0##0#0#0.0#2022-01-05
17:04:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
62d775968fc1753193c31d66186de311 150000 0 0 0 0 0
1360000 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 19/12/2021 19/12/2021 06/03/2001 0 1
0 - 0 - 0 - 0 - 0 308500 270560
0 1 0 0 0 ADITYA PRAKOSO, SDR 100829 20 7593
dr. NIKE 1124R0021221V003302 0000639234742 3;JKN
novia;3313125201940001; 5.5.5.202112011542 4 346687
1#0##0#0#0.0#2022-01-04
14:41:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a98a5005d73be94613984027924e235f 0 0 75000 0 55000 0 0
0 0 0 25000 0 100560 0 15000 0 0 0
3372030 C 3 CP 2 19/12/2021 19/12/2021 23/08/1950 0 1
0 - 0 - 0 - 0 - 0 308500 311602
0 1 0 0 0 TRI MULJO, TN 100838 71 26051 dr.
NIKE 1124R0021221V003304 0000091349921 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346686 1#0##0#0#0.0#2022-01-04
14:40:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ee8223db907ec15d7ebd4aafba33d7d7 180000 0 0 0 0 0
0 0 0 0 25000 0 106602 0 0 0 0 0
3372030 C 3 CP 2 19/12/2021 19/12/2021 27/12/2001 0 1
- 0 - 0 - 0 - 0 182600 197172 0
1 0 0 0 DIMAS AJI SAPUTRO, SDR 088158 19 7297 DR.
novia;3313125201940001; 5.6.3.202201201500 4 346689
1#0##0#0#0.0#2022-02-15
11:12:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
121d462ffbc856313c1faabe0be04c10 155000 0 0 0 0 0
0 0 0 0 15000 0 27172 0 0 0 0 0
3372030 C 3 CP 2 19/12/2021 19/12/2021 27/09/1972 0 2
None None None None INFEKSI SALURAN KEMIH AKUT 126600 0 0
- 0 - 0 - 0 - 0 126600 182717 0
1 0 0 0 RAHAYU SRI WINARSIH,(NY) 001700 49 17980
DR. GERRY FEBRIAN R 1124R0021221V003307 0001109244497 3;JKN
novia;3313125201940001; 5.5.5.202112011542 4 346690
1#0##0#0#0.0#2022-01-04
14:42:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e32c15106403d350570bd7e5b71036fc 155000 0 0 0 0 0
0 0 0 0 15000 0 12717 0 0 0 0 0
3372030 C 3 CP 2 19/12/2021 19/12/2021 12/11/1989 0 2
0 - 0 - 0 - 0 135700 197923 0 1
0 0 0 APIA RUMBARU, NY 078439 32 11725 DR. GERRY FEBRIAN
R 1124R0021221V003310 0000967933956 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346691 1#0##0#0#0.0#2022-01-04
14:43:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
43f46180f17f7d520ceb4d336367d24f 155000 0 0 0 0 0
0 0 0 0 15000 0 27923 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 23/07/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 348491
0 1 0 0 0 JOKO MULYONO, TN 095940 57 20969 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345528
1#0##0#0#0.0#2021-12-28
10:20:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6635314860335000f6629982e9168937 150000 0 0 0 0 0
0 0 0 0 15000 0 183491 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 11/04/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 308266
0 1 0 0 0 SUKARMI.NY 098865 61 22533 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 345529
1#0##0#0#0.0#2021-12-28
10:35:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
102bbf6ef1e1bdb1f993cb3cc344f626 150000 0 0 0 0 0
0 0 0 0 15000 0 143266 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 17/11/1966 0 1
1 Z09.8;E11.4;G59.0;I10 88.75 - - None None None None Z-3-
0 0 - 0 - 0 - 0 - 0 549400
1023470 0 1 0 0 0 INDRARIADI.TN 098885 55
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 347303
1#0##0#0#0.0#2022-01-05
17:21:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
27439cc83220afa3e00972e6ca05eb86 150000 0 0 0 0 0
680000 0 0 0 15000 0 178470 0 0 0 0
0
3372030 C 3 CP 2 20/12/2021 20/12/2021 07/09/1944 0 1
1 Z09.8;E11.2;N08.3;I10 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 261455
0 1 0 0 0 RIDI SIRADA, TN 070004 77 28228 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345614
1#0##0#0#0.0#2021-12-28
10:36:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c1d324d1d7d17301989f57270d76e329 150000 0 0 0 0 0
0 0 0 0 15000 0 96455 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 27/08/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 227379
0 1 0 0 0 SITI ROHANAH MUTMAINAH., NY 045535 46
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345530
1#0##0#0#0.0#2021-12-28
10:39:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3d5864c80ceb7c245dbb3078f8d9387e 150000 0 0 0 0 0
0 31845 0 0 15000 0 30534 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 30/08/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 223410
0 1 0 0 0 BIBIT BUDI RAHARJO., (BP) 041380 50
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345613
1#0##0#0#0.0#2021-12-28
10:40:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
57d9ce98b4f70075caf99916436b34f1 150000 0 0 0 0 0
0 0 0 0 0 0 73410 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 08/09/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 274440
0 1 0 0 0 SUNARMI, NY 073823 73 26766 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 345531
1#0##0#0#0.0#2021-12-28
10:41:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4611ddd6f7f14dafc1bf049d75f15263 150000 0 0 0 0 0
0 0 0 0 15000 0 109440 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 19/08/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 256050
0 1 0 0 0 SUBIRIN 085162 79 28978 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 345532
1#0##0#0#0.0#2021-12-28
10:43:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6b8a69092dba176c06a9dee7781603ae 150000 0 0 0 0 0
0 0 0 0 15000 0 91050 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 08/02/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 250185
0 1 0 0 0 MUNZIAH .NY 036544 69 25518 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 345612
1#0##0#0#0.0#2021-12-28
10:47:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f354ca0c55fbfccfd98d38b2857de353 150000 0 0 0 0 0
0 0 0 0 15000 0 85185 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 09/04/2004 0 2
0 0 - 0 - 0 - 0 - 0 181400 217478
0 1 0 0 0 NIKEN SOFI SALMA., NN 072205 17 6464
yani;3302226402970001; 5.5.5.202112011542 4 345533
1#0##0#0#0.0#2021-12-28
10:48:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
24e78c71d53777b204d10b0340f9148a 150000 0 0 0 0 0
0 0 0 0 15000 0 52478 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 05/06/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 242346 0 1 0 0 0 ASIYAH INTAN
1124R0021221V003325 0002050989456 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 345491 1#0##0#0#0.0#2022-04-14
13:41:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
9a5a7dbf929451d68dc3d2766e8ae36e 0 0 192500 0 0 0
0 0 0 0 15000 0 34846 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 21/01/1964 0 2
1 Z09.8;E11.4;G59.0;M17.9;K30 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
520365 0 1 0 0 0 ISMIYATI.NY 078013 57 21153
yani;3302226402970001; 5.5.5.202112011542 4 345534
1#0##0#0#0.0#2021-12-28
10:52:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
14ade6ff341c546000463fe560141ba6 150000 0 0 0 0 0
0 0 0 0 15000 0 355365 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 13/09/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 272890
0 1 0 0 0 ABDUL MISPAKI.TN 081032 58 21283 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345611
1#0##0#0#0.0#2021-12-28
10:53:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0d5556d812f43ace7b872f9290a2462e 150000 0 0 0 0 0
0 107890 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 02/12/1957 0 2
1 Z09.8;E11.4;G59.0;I50.0;M47.86 - - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 234460 0 1 0 0 0 ENDANG MARDIASMANI.NY
0000086714471 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345535 1#0##0#0#0.0#2021-12-28
10:55:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7ace8c68e8c119477bf856c42ef60863 150000 0 0 0 0 0
0 0 0 0 15000 0 69460 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 10/10/1955 0 2
1 Z09.8;I13.0;N20.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 232152
yani;3302226402970001; 5.5.5.202112011542 4 345536
1#0##0#0#0.0#2021-12-28
10:57:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
159139751d996777d310e27e28031bd0 150000 0 0 0 0 0
0 0 0 0 15000 0 67152 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 15/08/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 189075
0 1 0 0 0 SRIYATI.NY 076760 63 23138 DR. TEKY
novia;3313125201940001; 5.6.3.202201201500 4 345537
1#0##0#0#0.0#2022-03-08
11:42:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
44095ce79e478b3b9d5c8176958f15b5 150000 0 0 0 0 0
0 0 0 0 15000 0 24075 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 04/01/1983 0 2
0 0 - 0 - 0 - 0 - 0 181400 296040
0 1 0 0 0 ASEP PRASETYOWATI, NY 099038 38 14230
yani;3302226402970001; 5.5.5.202112011542 4 345540
1#0##0#0#0.0#2021-12-28
10:58:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b7f6ceb15e75e26649f8bcf3d9918746 203000 0 0 0 0 0
0 0 0 0 15000 0 78040 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 12/03/1944 0 2
0 0 - 0 - 0 - 0 - 0 181400 206176
0 1 0 0 0 SRI BUDININGSIH, NY 037427 77 28407
yani;3302226402970001; 5.5.5.202112011542 4 345541
1#0##0#0#0.0#2021-12-28
10:59:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c5b8e7989ee55c791592fe6a1d4dfec3 150000 0 0 0 0 0
0 0 0 0 15000 0 41176 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 08/06/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 TUMIYEM, NY 099173 48 17727 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 345610
1#0##0#0#0.0#2021-12-28
11:00:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fa4c253bead2944ad093b8e6d7dbe1fd 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 16/08/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 561064
0 1 0 0 0 SUMINI, NY 071873 61 22406 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 345542
1#0##0#0#0.0#2021-12-28
11:02:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a82dc5f4211e3a6cf069c3296034c86c 150000 0 0 0 0 0
0 31845 0 0 15000 0 364219 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 16/10/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 206161
0 1 0 0 0 AGUNG CAHYONO.TN 099954 43 15771 DR.
novia;3313125201940001; 5.6.3.202201201500 4 345543
1#0##0#0#0.0#2022-02-15
14:28:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
6ecf92a89a3cea1730aa882f84c0b221 150000 0 0 0 0 0
0 0 0 0 15000 0 41161 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 04/06/1952 0 1
0 - 0 107400 273000 0 1 0 0 0
1124R0021221V003338 0001614176932 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345502 1#0##0#0#0.0#2021-12-28
11:04:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
299e8cfefa7a503c72b2fdcaa4eb60fc 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 01/11/1986 0 2
0 0 - 0 - 0 - 0 - 0 181400 341280
yani;3302226402970001; 5.5.5.202112011542 4 345544
1#0##0#0#0.0#2021-12-28
11:05:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1df4cd7dca1a11ba8361679e983f80b5 150000 0 0 0 0 0
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3372030 C 3 CP 2 20/12/2021 20/12/2021 10/06/1973 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
0002345788607 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345545 1#0##0#0#0.0#2021-12-28
11:06:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1515cb44195bdff1a5922f47aaa7d5f0 203000 0 0 0 0 0
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3372030 C 3 CP 2 20/12/2021 20/12/2021 13/11/2002 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 TITA SYAKHARANI A, NN 070533 19 6977
yani;3302226402970001; 5.5.5.202112011542 4 345546
1#0##0#0#0.0#2021-12-28
11:08:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ea3a1f3475f1df78e5b9a5b6b7e554f2 150000 0 0 0 0 0
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3372030 C 3 CP 2 20/12/2021 20/12/2021 15/05/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 307751
0 1 0 0 0 ANI SETYANINGSIH., NY 041951 52 19212
yani;3302226402970001; 5.5.5.202112011542 4 345547
1#0##0#0#0.0#2021-12-28
11:09:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dfd09c298995577a04121bd506a25846 150000 0 0 0 0 0
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3372030 C 3 CP 2 20/12/2021 20/12/2021 13/04/1954 0 1
0 - 0 - 0 - 0 183900 261344 0 1
0 0 0 PARDIMAN TANTO PRAMONO, TN 061421 67 24723 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345548
1#0##0#0#0.0#2021-12-28
11:10:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2ed0ffeb76cc08345a3daaa7c3acf281 200000 0 0 0 0 0
0 0 0 0 15000 0 46344 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 15/02/1955 0 1
1 Z09.8;G44.2;E78.5 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 174655
0 1 0 0 0 NGATIJO HADI WARSITO.TN 079349 66 24415
yani;3302226402970001; 5.5.5.202112011542 4 345549
1#0##0#0#0.0#2021-12-28
11:11:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f8a2ed20f8960e3dd3f9d78ed3b89337 150000 0 0 0 0 0
0 0 0 0 15000 0 9655 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 14/07/1973 0 2
1 Z09.8;E11.4;G59.0;H04.1 90.29;16.21 - - None None None None
211200 0 0 - 0 - 0 - 0 - 0 211200
523865 0 1 0 0 0 NUGRAHENI NUR ASMARA,(NN) 020978
0001032590439 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345550 1#0##0#0#0.0#2021-12-28
11:16:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1474e01c263d4597d121b0c4d1c99ad3 438000 0 0 0 0 0
0 0 0 0 15000 0 70865 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 24/08/1949 0 1
1 E11.3;H36.0;H26.9;H52.2;H52.4;H04.1 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 299975 0 1 0 0 0 SUGENG PRIJADI, TN
0000088856752 3;JKN novia;3313125201940001; 5.6.3.202201201500 4
345551 1#0##0#0#0.0#2022-03-08
07:55:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
bf16d49db989c5ace00ce8de28e9a200 254000 0 0 0 0 0
0 0 0 0 15000 0 30975 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 27/10/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 RUSTANTINI., NY
0001971122679 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345500 1#0##0#0#0.0#2021-12-28
11:22:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a407d7f0b2702e7cc64ca2af15aeb04e 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 03/04/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 265260
0 1 0 0 0 SUGIATNO.TN 093213 57 21080 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 345552
1#0##0#0#0.0#2021-12-28
11:22:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0e82dc863b57b0c7059c234c4b1f8959 150000 0 0 0 0 0
0 0 0 0 15000 0 100260 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 02/04/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 220620
0 1 0 0 0 NUR SHANTI WULANDARI.NY 100245 42 15603
yani;3302226402970001; 5.5.5.202112011542 4 345553
1#0##0#0#0.0#2021-12-28
11:27:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ff611caaef4520446de604190f4d8263 150000 0 0 0 0 0
0 0 0 0 15000 0 55620 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 09/03/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 206161
0 1 0 0 0 GIARTI SLAMET.NY 099789 56 20740 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345554
1#0##0#0#0.0#2021-12-28
11:42:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d182154ff2a1d547ce05c7a19efdca60 150000 0 0 0 0 0
0 0 0 0 15000 0 41161 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 16/02/2003 0 1
0 0 - 0 - 0 - 0 - 0 181400 280485
0 1 0 0 0 AISYA PUTRI NUR A, NN 100796 18 6882
agung;3313092303950002; 5.6.6.202203301209 4 345555
1#0##0#0#0.0#2022-04-14
13:49:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
d0d502e6721a2ef57239d710b8155717 150000 0 0 0 0 0
0 0 0 0 15000 0 115485 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 15/04/1941 0 1
1 Z09.8;N40;N28.1;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 205891
0 1 0 0 0 SUMALI, TN 100130 80 29469 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 345556
1#0##0#0#0.0#2021-12-28
13:04:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
02426de08f59e85eea474a8318f1ada7 150000 0 0 0 0 0
0 0 0 0 15000 0 40891 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 25/02/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 280485
yani;3302226402970001; 5.5.5.202112011542 4 345557
1#0##0#0#0.0#2021-12-28
13:07:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ec76ffd163006850464102f8ab6f4317 150000 0 0 0 0 0
0 0 0 0 15000 0 115485 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 13/11/2004 0 1
0 0 - 0 - 0 - 0 - 0 181400 280485
0 1 0 0 0 MUHAMMAD RAIHAN MAULANA 090399 17 6246
yani;3302226402970001; 5.5.5.202112011542 4 345558
1#0##0#0#0.0#2021-12-28
13:09:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a966bd5cde309a129dab8327872835b5 150000 0 0 0 0 0
0 0 0 0 15000 0 115485 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 08/08/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 261051
0 1 0 0 0 SUTRISNO. BP 070821 67 24606 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345559
1#0##0#0#0.0#2021-12-28
13:12:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
aea10c110c8db4168bfe292867306e81 150000 0 0 0 0 0
0 0 0 0 15000 0 96051 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 03/04/1988 0 2
0 - 0 - 0 - 0 - 0 296400 184840
0 1 0 0 0 ANA SWASTIKA ROHMAH, NY 042889 33 12314
novia;3313125201940001; 5.6.7.202204241238 4 345560
1#0##0#0#0.0#2022-05-10
08:55:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 3
72c41e291e08dde3af2267f7a55c4ee9 150000 0 0 0 0 0
0 0 0 0 15000 0 19840 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 09/08/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 306840
0 1 0 0 0 ATIK UTAMI.NY 097638 49 18030 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345561
1#0##0#0#0.0#2021-12-28
13:18:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bd5863b7c484bf1c54fbee112e767ea4 150000 0 0 0 0 0
0 44200 0 0 15000 0 97640 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 14/07/1984 0 2
- 0 - 0 - 0 86900 239478 0 1 0 0
0 MUTMAINAH.NY 099984 37 13673 DR. GUNAWAN, SP.OG
1124R0021221V003366 0002169574277 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345562 1#0##0#0#0.0#2021-12-28
13:19:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5d523911a1f0b9382f4a20803c8f90ab 150000 0 0 0 0 0
0 0 0 0 15000 0 74478 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 26/08/2001 0 2
0 0 - 0 - 0 - 0 - 0 181400 234104
0 1 0 0 0 FANIN NUR ISNAINI.NN 037492 20 7421
yani;3302226402970001; 5.5.5.202112011542 4 345563
1#0##0#0#0.0#2021-12-28
13:21:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9e07dba257876f4b74ce56d0a3deb7ac 150000 0 0 0 0 0
0 0 0 0 15000 0 69104 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 12/11/1963 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002169748091 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345490 1#0##0#0#0.0#2021-12-28
13:31:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c69aceee13dae12490b59b887c64ec3d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 18/05/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 225576
0 1 0 0 0 SUNNIYAH, NY 094046 67 24688 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345564
1#0##0#0#0.0#2021-12-28
13:37:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
651dc91216ab02a8e5f114920737bcde 150000 0 0 0 0 0
0 0 0 0 15000 0 60576 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 18/08/1982 0 1
0 0 - 0 - 0 - 0 - 0 181400 519720
0 1 0 0 0 ENDRO PRASETYO, BP 085044 39 14369
novia;3313125201940001; 5.6.3.202201201500 4 345565
1#0##0#0#0.0#2022-02-15
12:18:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
39d04a854bfcc84408a1203f4caba933 150000 0 0 0 0 0
0 0 0 0 15000 0 354720 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 16/06/1997 0 2
0 0 - 0 - 0 - 0 - 0 181400 286965
0 1 0 0 0 INDRI YUNIARSIH.NY 093960 24 8953
yani;3302226402970001; 5.5.5.202112011542 4 345566
1#0##0#0#0.0#2021-12-28
13:40:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3d8e5006624d0282812feeecfb90e45e 150000 0 0 0 0 0
0 0 0 0 15000 0 121965 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 03/09/1999 0 2
0 0 - 0 - 0 - 0 - 0 181400 273957
0 1 0 0 0 SEKAR KINANTHI.NN 095022 22 8144 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345567
1#0##0#0#0.0#2021-12-28
13:41:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4253f0c76f1f8e66c71b70fc21522ef5 150000 0 0 0 0 0
0 0 0 0 15000 0 108957 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 08/12/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 223272
0 1 0 0 0 SUWARNO, TN 065959 48 17544 DR. RETNO
yani;3302226402970001; 5.5.5.202112011542 4 345568
1#0##0#0#0.0#2021-12-28
13:47:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4ce0f90c1f20419a47aee188f5aa025c 150000 0 0 0 0 0
0 0 0 0 15000 0 58272 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 12/02/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 277186
yani;3302226402970001; 5.5.5.202112011542 4 345569
1#0##0#0#0.0#2021-12-28
13:50:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
efbdc81ae3ec48280072c3855db4037f 150000 0 0 0 0 0
0 0 0 0 15000 0 112186 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 13/09/1984 0 1
0 0 - 0 - 0 - 0 - 0 181400 247530
0 1 0 0 0 ARY SASONGKO TN 085050 37 13612 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345570
1#0##0#0#0.0#2021-12-28
13:51:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
59910d23b444d26d910223620aae416e 150000 0 0 0 0 0
0 0 0 0 15000 0 82530 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 12/07/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 326817
0 1 0 0 0 SRI HARDJANI, NY 062457 66 24268 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345571
1#0##0#0#0.0#2021-12-28
13:55:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2799b2bfd2605015cba3163f7e7ee3aa 150000 0 0 0 0 0
0 0 0 0 15000 0 161817 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 01/09/2018 0 2
0 0 - 0 - 0 - 0 - 0 181400 178848
0 1 0 0 0 RIZKA SEPTIYA SYAHPUTRI, AN 068321 3
0002487461229 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345572 1#0##0#0#0.0#2021-12-28
13:56:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a467e6b9fe9c7b8243ca36b6879040b5 150000 0 0 0 0 0
0 0 0 0 15000 0 13848 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 08/05/1979 0 1
0 0 - 0 - 0 - 0 - 0 181400 351405
0 1 0 0 0 DANNY EKO NUGROHO, TN 069283 42 15567
yani;3302226402970001; 5.5.5.202112011542 4 345573
1#0##0#0#0.0#2021-12-28
13:57:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
37c086d702e411f709d9434f6742292b 150000 0 0 0 0 0
0 0 0 0 15000 0 186405 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 17/03/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 350760
0 1 0 0 0 AHMAD YUSRON.,TN 074507 55 20367 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345574
1#0##0#0#0.0#2021-12-28
13:59:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
26d08bf52fb30485f8afb0bc3d0c9792 150000 0 0 0 0 0
0 0 0 0 15000 0 185760 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 04/03/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 200002
0 1 0 0 0 SETIJOKO.TN 085866 72 26589 DR. RETNO
yani;3302226402970001; 5.5.5.202112011542 4 345575
1#0##0#0#0.0#2021-12-28
14:03:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e17d90d53eddf042d29dd74b1732cf80 150000 0 0 0 0 0
0 0 0 0 15000 0 35002 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 09/08/1992 0 1
0 0 - 0 - 0 - 0 - 0 181400 489073
yani;3302226402970001; 5.5.5.202112011542 4 345576
1#0##0#0#0.0#2021-12-28
14:04:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
46e0a77feedc1ea5264423936d633dae 150000 0 0 0 0 0
0 0 0 0 15000 0 324073 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 24/10/1981 0 2
0 0 - 0 - 0 - 0 - 0 181400 243496
0 1 0 0 0 SUMIYATI.NY 049462 40 14667 DR. RETNO
yani;3302226402970001; 5.5.5.202112011542 4 345577
1#0##0#0#0.0#2021-12-28
14:05:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
59f49bae7d572cf55a6350452abc0844 150000 0 0 0 0 0
0 0 0 0 15000 0 78496 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 10/04/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 271653
0 1 0 0 0 SUDARMI,(NY) 002130 52 19247 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345578
1#0##0#0#0.0#2021-12-28
14:05:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5b6c74d39cf838d9337bd08439489e59 150000 0 0 0 0 0
0 0 0 0 15000 0 106653 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 20/02/2010 0 1
0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 HERALD BRIANTARA.P, (AN) 011104 11
0001108026843 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345579 1#0##0#0#0.0#2021-12-28
14:08:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ffe35a20fcaee2e52b35bb56423a88eb 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 21/04/2000 0 1
0 - 0 - 0 - 0 183900 165000 0 1
0 0 0 ADITIA APRIYANTO, SDR 099474 21 7913 DR. DAMAR
5.5.5.202112011542 4 345580 1#0##0#0#0.0#2021-12-28
14:09:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
73f683313a4174f9a079596cb433ad3c 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 19/04/1999 0 2
1 Z09.8;D24 97.89 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 251896
0 1 0 0 0 SANIA MADASAFURA, NN 098569 22 8281
yani;3302226402970001; 5.5.5.202112011542 4 345581
1#0##0#0#0.0#2021-12-28
14:09:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d3fc9d58bc50588b60a61a5351b804d8 220000 0 0 0 0 0
0 0 0 0 15000 0 16896 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 18/08/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 289068
0 1 0 0 0 SULIS KUSTINAH.NY 100391 50 18387 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345582
1#0##0#0#0.0#2021-12-28
14:10:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
546f69e244f588a38faf3b3a2c0bcdf0 220000 0 0 0 0 0
0 0 0 0 15000 0 54068 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 06/06/1953 0 1
0 - 0 - 0 - 0 183900 320269 0 1
0 0 0 WIDODO.TN 100579 68 25034 DR. DAMAR ARYO, SP.B
1124R0021221V003389 0001283635157 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345583 1#0##0#0#0.0#2021-12-28
14:12:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2f63b7b077ac5d8756bb4a9f849957ed 225000 0 0 0 0 0
0 0 0 0 15000 0 80269 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 20/01/2013 0 2
1 Z03.8;A16.2 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 169957
0 1 0 0 0 CLARISTA AFIFAH Y, AN 070913 8 3256
0002347378345 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
345584 1#0##0#0#0.0#2022-04-14
12:57:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
ff56cc11d34a82657408cc1390fed2d2 150000 0 0 0 0 0
0 0 0 0 15000 0 4957 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 27/02/2019 0 1
1 Z09.8;R56.0;J06.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 396065
0 1 0 0 0 ADHITAMA ELVAN SYAHREZA, AN 084144 2
0002753319058 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345585 1#0##0#0#0.0#2021-12-28
14:15:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dc44342146c59e1f493a2d97d2f6e0e0 150000 0 0 0 0 0
0 0 0 0 15000 0 231065 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 13/08/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ENDANG MARYATI
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14:17:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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14:30:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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14:31:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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14:33:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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14:47:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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14:51:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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14:53:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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14:54:09#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#2021-12-28
14:54:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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14:55:18#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#2021-12-28
14:58:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 21/02/1972 0 2
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345587 1#0##0#0#0.0#2021-12-29
07:24:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 05/08/1966 0 1
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1#0##0#0#0.0#2021-12-29
07:25:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 12/10/1987 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 345513
1#0##0#0#0.0#2021-12-29
07:26:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 25/06/1970 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 345512
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07:35:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 06/07/1954 0 2
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07:36:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 04/09/1964 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 345510
1#0##0#0#0.0#2021-12-29
07:36:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 16/08/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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345503 1#0##0#0#0.0#2022-02-15
13:16:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 20/12/2021 20/12/2021 28/10/1955 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 345589
1#0##0#0#0.0#2021-12-29
07:39:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 15/02/1949 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 345590
1#0##0#0#0.0#2021-12-29
07:40:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 12/11/1945 0 2
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3;JKN novia;3313125201940001; 5.6.3.202201201500 4 345591
1#0##0#0#0.0#2022-02-15
13:35:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 20/12/2021 20/12/2021 03/04/1964 0 2
1 Z09.8;H81.3;I10 - - - None None None None Q-5-44-0
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yani;3302226402970001; 5.5.5.202112011542 4 345592
1#0##0#0#0.0#2021-12-29
07:41:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 13/03/1985 0 1
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1#0##0#0#0.0#2021-12-29
07:42:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 21/08/1968 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 345595
1#0##0#0#0.0#2021-12-29
07:43:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 24/02/1967 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 345596
1#0##0#0#0.0#2021-12-29
07:47:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 19/09/1960 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 345597
1#0##0#0#0.0#2021-12-29
07:48:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 17/10/1945 0 1
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1#0##0#0#0.0#2021-12-29
07:49:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345599
1#0##0#0#0.0#2021-12-29
07:49:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 07/11/1940 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 345600
1#0##0#0#0.0#2021-12-29
07:50:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 20/12/2021 20/12/2021 02/05/1948 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 345601
1#0##0#0#0.0#2021-12-29
07:51:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 19/07/1958 0 1
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3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345602
1#0##0#0#0.0#2021-12-29
07:52:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 03/12/1985 0 2
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novia;3313125201940001; 5.6.7.202204241238 4 345603
1#0##0#0#0.0#2022-05-10
08:46:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 3
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3372030 C 3 CP 2 20/12/2021 20/12/2021 10/02/1956 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 345604
1#0##0#0#0.0#2021-12-29
07:53:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 30/06/1955 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 345605
1#0##0#0#0.0#2021-12-29
07:55:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 21/04/1958 0 2
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1#0##0#0#0.0#2021-12-29
07:56:04#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#2021-12-29
07:56:45#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#2021-12-29
08:00:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 20/12/2021 20/12/2021 10/04/1961 0 2
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1#0##0#0#0.0#2021-12-29
08:03:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 27/06/1959 0 2
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08:06:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 27/06/1986 0 1
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1#0##0#0#0.0#2021-12-29
08:07:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3f8dd9f5d4cf76fcf62247085776dd91 150000 0 0 0 0 0
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3372030 C 3 CP 2 20/12/2021 20/12/2021 28/07/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 177192
0 1 0 0 0 ERWIN BUDI RAHAYU, NY 100693 45 16581
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345617
1#0##0#0#0.0#2021-12-29
08:08:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d6bfc8463217d5da79d53b849eadde2c 150000 0 0 0 0 0
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3372030 C 3 CP 2 20/12/2021 20/12/2021 05/01/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 241080
0 1 0 0 0 SUPARMAN, TN 100665 70 25917 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345618
1#0##0#0#0.0#2021-12-29
08:09:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
49afc215e29d2aef168c1874517b7d65 150000 0 0 0 0 0
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3372030 C 3 CP 2 20/12/2021 20/12/2021 08/02/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 223793
0 1 0 0 0 SUHARTI,NY 069291 52 19308 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 345619
1#0##0#0#0.0#2021-12-29
08:10:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
793e80f6948bd2b6223bd8a717ea36bf 150000 0 0 0 0 0
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3372030 C 3 CP 2 20/12/2021 20/12/2021 06/06/1963 0 1
1 Z09.4;S52.50;W19.0;M19.98 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
441032 0 1 0 0 0 SUPARMAN, (BP) 004954 58
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 347304
1#0##0#0#0.0#2022-01-05
17:22:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
44899da2a213f0041baef6eb976771ad 150000 0 0 0 0 0
248000 0 0 0 15000 0 28032 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 23/05/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 249983
0 1 0 0 0 SRI RAHAYU.NY 083756 58 21396 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345620
1#0##0#0#0.0#2021-12-29
08:10:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
986828c0f105de8596e886d91da741a6 150000 0 0 0 0 0
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3372030 C 3 CP 2 20/12/2021 20/12/2021 18/01/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 467542
0 1 0 0 0 SUNARTI.NY 082131 58 21521 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 347305
1#0##0#0#0.0#2022-01-05
17:23:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
aa3ee5508f5ef2b6190f9235b172ecf9 150000 0 0 0 0 0
248000 0 0 0 15000 0 54542 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 11/08/1948 0 2
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0 1 0 0 0 SRI MURNI 69141 73 26794 DR. WAHYU PURNOMO,
SP.OT 1124R0021221V003442 0001890165082 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345745 1#0##0#0#0.0#2021-12-29
08:14:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
345f9d316fb5d8186c701d460cadf640 150000 0 0 0 0 0
0 0 0 0 15000 0 67257 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 07/11/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 205580
0 1 0 0 0 NGADINO,TN 040402 56 20497 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 345621
1#0##0#0#0.0#2021-12-29
08:15:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c8df76855bbd29f04708cb5277ec69e3 150000 0 0 0 0 0
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3372030 C 3 CP 2 20/12/2021 20/12/2021 13/09/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 222982
0 1 0 0 0 PUJI HASTUTI, (NY) 002869 57 20917
yani;3302226402970001; 5.5.5.202112011542 4 345622
1#0##0#0#0.0#2021-12-29
08:15:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ceb8af2292a7a0a9b18a198a871da078 150000 0 0 0 0 0
0 0 0 0 15000 0 57982 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 02/05/2004 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 NUR MAULUDIN ILMAN, SDR 100651 17 6441
yani;3302226402970001; 5.5.5.202112011542 4 345623
1#0##0#0#0.0#2021-12-29
08:16:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a507dff7a020a306733519e73406d5f5 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 06/05/1980 0 2
0 - 0 - 0 - 0 - 0 181400 175000
0 1 0 0 0 RENY SETYOWATI.NY 100737 41 15203 DR.
reni;3313147010930001; 5.6.0.202201041418 4 345624
1#0##0#0#0.0#2022-01-07
19:58:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
39681c52899897d54283da79388bf029 150000 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 13/08/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 221702
yani;3302226402970001; 5.5.5.202112011542 4 345625
1#0##0#0#0.0#2021-12-29
08:18:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c6f6cd8813d1313bb5c532446b127462 150000 0 0 0 0 0
0 0 0 0 15000 0 56702 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 26/08/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 220492
0 1 0 0 0 SRI REJEKI, NY 091936 50 18379 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345626
1#0##0#0#0.0#2021-12-29
08:18:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
73cbfe0280bde882e548a382756fd1e6 150000 0 0 0 0 0
0 0 0 0 15000 0 55492 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 04/09/2010 0 1
0 404900 215000 0 1 0 0 0 ILYAS RAMADHAN
NAVIGASI.SDR 099943 11 4125 DR. WAHYU PURNOMO, SP.OT
1124R0021221V003449 0002060958126 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345627 1#0##0#0#0.0#2021-12-29
08:19:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bb11a8f74bc6d9021d6dd0caaa0f49de 200000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 10/06/1972 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI RAHAYU.NY
0002624809645 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345498 1#0##0#0#0.0#2021-12-29
08:26:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f0b722fd59668a56e51f9d3201d9ddbd 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 08/10/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 213222
0 1 0 0 0 RINJAYANTI.NY 100022 53 19431 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345628
1#0##0#0#0.0#2021-12-29
08:27:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
13cbbc9e4ed84f5ae50e171165491c5d 150000 0 0 0 0 0
0 0 0 0 15000 0 48222 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 18/06/1980 0 1
0 0 - 0 - 0 - 0 - 0 181400 224424
0 1 0 0 0 SAMINO, TN 089003 41 15160 DR. RETNO
yani;3302226402970001; 5.5.5.202112011542 4 345629
1#0##0#0#0.0#2021-12-29
08:28:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5cfcd5cd4852e9d0d35ec62a212225c0 150000 0 0 0 0 0
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3372030 C 3 CP 2 20/12/2021 20/12/2021 22/03/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 214365
0 1 0 0 0 ISTRI SUDARYATI 093584 51 18901 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345630
1#0##0#0#0.0#2021-12-29
08:29:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bef24942692fc616f88c90f288ebb1da 150000 0 0 0 0 0
0 0 0 0 15000 0 49365 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 17/03/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 217062
0 1 0 0 0 SRI LESTARI, NY 099302 57 21097 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345631
1#0##0#0#0.0#2021-12-29
08:36:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
87a0e8c83abfaaf82ca3cee68082f5ab 150000 0 0 0 0 0
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3372030 C 3 CP 2 20/12/2021 20/12/2021 15/02/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 225722
0 1 0 0 0 MARYANI, NY 074186 64 23684 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 345633
1#0##0#0#0.0#2021-12-29
08:37:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
09ebdcae5889a93bac74911ab109bacd 150000 0 0 0 0 0
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3372030 C 3 CP 2 20/12/2021 20/12/2021 12/09/2013 0 2
0 0 - 0 - 0 - 0 - 0 181400 421218
0 1 0 0 0 REVIANA SAFA SEPTIANI.AN 099209 8
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 347306
1#0##0#0#0.0#2022-01-05
17:25:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7f90de241eeb531615d0c27c64549383 150000 0 0 0 0 0
248000 0 0 0 15000 0 8218 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 11/05/1993 0 2
0 - 0 - 0 - 0 - 0 181400 175000
0 1 0 0 0 ETIK PURWANINGSIH, NY 100841 28 10450
yani;3302226402970001; 5.5.5.202112011542 4 345634
1#0##0#0#0.0#2021-12-29
08:37:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1c21acf270c7d45b8241023cd075f327 150000 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 30/01/1961 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
576925 0 1 0 0 0 TRIYANTORO, TN 010914 60
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345635
1#0##0#0#0.0#2021-12-29
08:38:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 76045 0 0 15000 0 335880 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 11/08/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 174855
0 1 0 0 0 PRAMANA, TN 006238 49 18028 DR.
agung;3313092303950002; 5.6.6.202203301209 4 345636
1#0##0#0#0.0#2022-04-14
11:40:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
4ad1e1fa1858895d8277b3abba05b073 150000 0 0 0 0 0
0 0 0 0 15000 0 9855 0 0 0 0 0
3372030 C 3 CP 2 10/12/2021 10/12/2021 20/12/1960 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
278795 0 1 0 0 0 KASIH ANGGRAENI, NY 093093
0002580682533 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
347407 1#0##0#0#0.0#2022-01-05
15:39:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
21aed2c5bf25de1c10f723789ebb469e 203000 0 0 0 0 0
0 0 0 0 15000 0 60795 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 06/05/2003 0 2
0 0 - 0 - 0 - 0 - 0 181400 441435
0 1 0 0 0 JEA AGRIZTA ELVARETTA.NN 096829 18
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yani;3302226402970001; 5.5.5.202112011542 4 345637
1#0##0#0#0.0#2021-12-29
09:22:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
33d5183406f2fa72d844b70898723457 310000 0 0 0 0 0
0 0 0 0 15000 0 116435 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 01/06/1960 0 1
0 - 0 - 0 - 0 183900 253035 0 1
0 0 0 SUTRISNO, TN 093922 61 22482 DR. HERMAWAN, SP.B
1124R0021221V003464 0002291848931 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345638 1#0##0#0#0.0#2021-12-29
09:24:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 28/02/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 218000
0 1 0 0 0 SITI KOMARIAH.NY 100738 68 25132 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345639
1#0##0#0#0.0#2021-12-29
09:25:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5f6d60289c49f611ed0602daa3395707 203000 0 0 0 0 0
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3372030 C 3 CP 2 20/12/2021 20/12/2021 31/12/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 250423
0 1 0 0 0 WARSINAH., NY 049905 60 22269 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345640
1#0##0#0#0.0#2021-12-29
09:26:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 24/05/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 RINA LESTARI ., NY
0000091263576 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345493 1#0##0#0#0.0#2021-12-29
09:28:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 19/02/1965 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 DANU MARGONO.,BP
0000640154136 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
345492 1#0##0#0#0.0#2022-04-14
12:52:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
3f6035bf5f2c638de8de3d782e6f44f2 247000 0 0 0 0 0
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3372030 C 3 CP 2 20/12/2021 20/12/2021 16/02/1947 0 1
1 Z09.8;R10.4;E83.5;N29.8 88.76 - - None None None None Z-3-
0 0 - 0 - 0 - 0 - 0 549400 882861
0 1 0 0 0 LESTARI HADI SUNARTO ., NY 058269 74
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 347307
1#0##0#0#0.0#2022-01-05
17:26:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d7034eb3440ed2481b487089dc9b1945 150000 0 0 0 0 0
657000 0 0 0 15000 0 60861 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 03/05/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 298865
0 1 0 0 0 SIH WINARNI.NY 100739 70 25799 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345641
1#0##0#0#0.0#2021-12-29
09:33:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 04/12/1968 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 345642
1#0##0#0#0.0#2021-12-29
09:34:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 20/12/2021 20/12/2021 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; 5.5.5.202112011542 4
345496 1#0##0#0#0.0#2021-12-29
09:34:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2fa6f26362bce5929503caad048126cf 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 20/12/2021 20/12/2021 27/12/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 242062
0 1 0 0 0 WORO WIDYASTUTI.NY 095052 45 16795
yani;3302226402970001; 5.5.5.202112011542 4 345643
1#0##0#0#0.0#2021-12-29
09:36:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
89301b055c0f922100b66ed27837a27b 150000 0 0 0 0 0
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3372030 C 3 CP 2 20/12/2021 20/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
345495 1#0##0#0#0.0#2021-12-29
09:38:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
142f6740a60ca230bfcaee19520d49c0 247000 0 0 0 0 0
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3372030 C 3 CP 2 20/12/2021 20/12/2021 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; 5.5.5.202112011542 4
345489 1#0##0#0#0.0#2021-12-29
09:39:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b83adbad59099ec2884525892d6bf04e 258000 0 0 0 0 0
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3372030 C 3 CP 2 20/12/2021 20/12/2021 13/01/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 203137
0 1 0 0 0 SARJIYEM.NY 100740 60 22256 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 345644
1#0##0#0#0.0#2021-12-29
09:49:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b16c671a1a6bed94ea34cb9022eb2a11 150000 0 0 0 0 0
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3372030 C 3 CP 2 20/12/2021 20/12/2021 17/06/1966 0 2
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0 1 0 0 0 ASIYAH INTAN TRIANA.NY 098457 58 21384
agung;3313092303950002; 5.6.6.202203301209 4 345999
1#0##0#0#0.0#2022-04-14
13:42:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
c3571e90cc8b3364eb513cf2f15f21cd 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 09/06/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 248820
0 1 0 0 0 MURAJIMIN.TN 100736 59 21745 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346000
1#0##0#0#0.0#2021-12-30
13:54:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cd4de93d03b9807881995d8cf64c27d7 150000 0 0 0 0 0
0 63690 0 0 15000 0 20130 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 17/08/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 416310
0 1 0 0 0 SUWARNI, NY 079454 44 16197 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 346002
1#0##0#0#0.0#2021-12-30
13:55:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8729938cfce5a9aee628b7e34274daa5 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 15/09/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 278465
0 1 0 0 0 SUHARTI SUTARNO, NY 065927 64 23473
yani;3302226402970001; 5.5.5.202112011542 4 346004
1#0##0#0#0.0#2021-12-30
13:55:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a7694786154e6d9a035973d85b9b7530 150000 0 0 0 0 0
0 63690 0 0 15000 0 49775 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 12/11/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 413006
novia;3313125201940001; 5.6.3.202201201500 4 346005
1#0##0#0#0.0#2022-02-15
13:35:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
a9f6483dc087a5a88fba424066689c80 150000 0 0 0 0 0
0 44200 0 0 15000 0 203806 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 02/02/1971 0 2
1 Z09.8;I10;K21.9;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 361636
0 1 0 0 0 YEKTI MAWARINI.,NY 052365 50 18585
yani;3302226402970001; 5.5.5.202112011542 4 346006
1#0##0#0#0.0#2021-12-30
13:57:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2b450d5e2a04c85b40934c871953f00c 150000 0 0 0 0 0
0 120795 0 0 15000 0 75841 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 07/02/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 241045
0 1 0 0 0 IR.AGUS BUDHIARTO,TN 061614 61 22598
yani;3302226402970001; 5.5.5.202112011542 4 346008
1#0##0#0#0.0#2021-12-30
13:59:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
26604bdb0a8105d218f9d423752f42d3 150000 0 0 0 0 0
0 76045 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 31/12/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 195720
0 1 0 0 0 SARDAL, TN 100649 55 20444 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 346010
1#0##0#0#0.0#2021-12-30
14:01:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
25e9558f485330f3f62689e6ec857df4 150000 0 0 0 0 0
0 0 0 0 15000 0 30720 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 28/12/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 196471
0 1 0 0 0 NURUL FAUZIAH ISVANDARI,NY 083500 53
3;JKN novia;3313125201940001; 5.6.3.202201201500 4 346011
1#0##0#0#0.0#2022-03-08
09:17:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
eed706629396833fb66a3908c5a77922 150000 0 0 0 0 0
0 0 0 0 15000 0 31471 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 02/01/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 301720
0 1 0 0 0 HAYU SEMESTYARINI., NY 046052 60 22268
novia;3313125201940001; 5.6.3.202201201500 4 346012
1#0##0#0#0.0#2022-02-14
15:06:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
c0c0453348dc2281f81c712ff98553f9 150000 0 0 0 0 0
0 108440 0 0 15000 0 28280 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 25/02/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 356207
0 1 0 0 0 SITI FATIMAH. NY 084286 61 22580 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346013
1#0##0#0#0.0#2021-12-30
14:05:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cef815099166ed9434fb905af204ad91 150000 0 0 0 0 0
0 76045 0 0 15000 0 115162 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 23/04/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 222317
0 1 0 0 0 PAIYAH, NY 048246 68 25079 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 346014
1#0##0#0#0.0#2021-12-30
14:06:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
874cc6b6e14f5c63ed884f627ddf57c8 150000 0 0 0 0 0
0 0 0 0 15000 0 57317 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 23/05/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 241145
0 1 0 0 0 MARDHIYAH, NY 060235 70 25780 DR.
novia;3313125201940001; 5.6.3.202201201500 4 346015
1#0##0#0#0.0#2022-02-15
07:36:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
d9e066d39dc5ed7e19c1690a1cc94671 150000 0 0 0 0 0
0 76145 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 31/12/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 265510
0 1 0 0 0 SARDIYANTO.TN 100599 62 23001 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346016
1#0##0#0#0.0#2021-12-30
14:07:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e0c52cc3af4f5673926af8940b5c9249 150000 0 0 0 0 0
0 88950 0 0 15000 0 11560 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 18/06/1978 0 1
0 0 - 0 - 0 - 0 - 0 181400 286165
0 1 0 0 0 ROBI ARIYANTO, TN 083181 43 15892 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346017
1#0##0#0#0.0#2021-12-30
14:08:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
35a4b858bc1e196e526513c069528c6d 150000 0 0 0 0 0
0 108440 0 0 15000 0 12725 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 31/12/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 330330
0 1 0 0 0 SUHARJO.TN 087887 69 25558 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 346018
1#0##0#0#0.0#2021-12-30
14:10:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a01cf4b5770b1231da03327b6807acb1 150000 0 0 0 0 0
0 63690 0 0 15000 0 101640 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 01/02/1965 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
605890 0 1 0 0 0 ASIH SAWITRI, NY 097067 56
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346019
1#0##0#0#0.0#2021-12-30
14:11:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ebfb14c682219bda2ef66add834133ed 150000 0 0 0 0 0
0 107890 0 0 15000 0 333000 0 0 0 0
0
3372030 C 3 CP 2 21/12/2021 21/12/2021 16/10/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 208419
0 1 0 0 0 MURSIHWATI.NY 089241 63 23077 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346020
1#0##0#0#0.0#2021-12-30
14:20:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a980af26a790844dba1b61ab06835137 150000 0 0 0 0 0
0 0 0 0 15000 0 43419 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 12/04/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 223230
0 1 0 0 0 WAHYONO ., TN 000937 52 19246 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346021
1#0##0#0#0.0#2021-12-30
14:21:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
32f09f1fc0fbe7fb444759019cbab545 150000 0 0 0 0 0
0 0 0 0 15000 0 58230 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 29/03/1956 0 2
1 Z09.8;I10;M19.98;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 303852
0 1 0 0 0 SULASTRI.NY (081747) 079845 65 24008
yani;3302226402970001; 5.5.5.202112011542 4 346022
1#0##0#0#0.0#2021-12-30
14:21:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c7e80780f2a51116ece26e6d4ee03415 150000 0 0 0 0 0
0 44200 0 0 15000 0 94652 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 05/07/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 236372
0 1 0 0 0 SURATMI.NY 093345 57 20988 DR. SUHARTO,
SP.PD 1124R0021221V003570 0001082257525 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346023 1#0##0#0#0.0#2021-12-30
14:23:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9e124106b937216eb5f7d578079189fc 150000 0 0 0 0 0
0 31845 0 0 15000 0 39527 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 05/03/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 236512
0 1 0 0 0 SANTOSO. TN 088783 77 28415 DR. SUHARTO,
SP.PD 1124R0021221V003571 0000091319657 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346024 1#0##0#0#0.0#2021-12-30
14:23:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7b97128636923d509f0035de97a41764 150000 0 0 0 0 0
0 0 0 0 15000 0 71512 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 19/10/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 801177
0 1 0 0 0 MARGIYATI RAHAYU, NY 022527 57 20882
yani;3302226402970001; 5.5.5.202112011542 4 346025
1#0##0#0#0.0#2021-12-30
14:27:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7ec88fe78d738e998ae3d0b1dda1f58c 150000 0 0 0 0 0
0 0 0 0 15000 0 636177 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 22/04/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 306966
0 1 0 0 0 BAGYO PRAPTANTO., BP 042554 54 19967
yani;3302226402970001; 5.5.5.202112011542 4 346026
1#0##0#0#0.0#2021-12-30
14:31:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ced1d32954c9b0c059461b08f7a3dece 150000 0 0 0 0 0
0 0 0 0 15000 0 141966 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 12/06/1966 0 1
1 Z09.8;E11.9;I10;R51 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 386940
0 1 0 0 0 SYAHRIZAL, (BP) 001271 55 20281 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346037
1#0##0#0#0.0#2021-12-30
14:35:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
63f882883a8d08dee4aa01a79035f12a 150000 0 0 0 0 0
0 31845 0 0 15000 0 190095 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 12/11/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 265610
0 1 0 0 0 NGATIYEM,NY 049849 54 19763 DR. SUHARTO,
SP.PD 1124R0021221V003575 0000639735772 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346038 1#0##0#0#0.0#2021-12-30
14:41:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e60874e5f3e09027907db791981a9b7f 150000 0 0 0 0 0
0 31845 0 0 15000 0 68765 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 24/05/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 546766
0 1 0 0 0 MURSIDAH BUDIYANTI.NY 095599 64 23587
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346039
1#0##0#0#0.0#2021-12-30
14:44:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
05b04e7c5f4be6da4436528874ace8da 300000 0 0 0 0 0
0 120795 0 0 15000 0 110971 0 0 0 0
0
3372030 C 3 CP 2 21/12/2021 21/12/2021 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; 5.5.5.202112011542 4
345964 1#0##0#0#0.0#2021-12-30
13:40:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7feffa739561eaaa8e542474a9cd564e 258000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 24/04/1990 0 1
0 0 - 0 - 0 - 0 - 0 181400 258340
0 1 0 0 0 EKO SETYANTO, TN 066247 31 11564 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346042
1#0##0#0#0.0#2021-12-30
14:46:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a07e0fec76fa1260dad9801165a09d29 150000 0 0 0 0 0
0 62045 0 0 15000 0 31295 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 11/09/1966 0 1
1 Z09.8;R73.9;M25.58 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 189870
yani;3302226402970001; 5.5.5.202112011542 4 345904
1#0##0#0#0.0#2021-12-30
13:42:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a4b3ca3f335559cab4bd496b45f420df 150000 0 0 0 0 0
0 0 0 0 15000 0 24870 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 12/06/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 216575
0 1 0 0 0 SUTIKNO. TN 076149 57 21011 DR. SUHARTO,
SP.PD 1124R0021221V003582 0002166939088 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346043 1#0##0#0#0.0#2021-12-30
14:47:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ad467210f9853fa11a76347706bae77a 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 27/01/1953 0 1
1 Z09.8;M19.98;I48;I50.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 212325
0 1 0 0 0 SAMIDI, TN 098145 68 25165 DR. SUHARTO,
SP.PD 1124R0021221V003583 0001084306329 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346044 1#0##0#0#0.0#2021-12-30
14:49:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cea25d55ce17e9d26b95acaaffe12bca 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 02/08/1997 0 2
0 0 - 0 - 0 - 0 - 0 181400 184594
0 1 0 0 0 INDAH TRI SOLIKHAH, NN 087585 24 8907
yani;3302226402970001; 5.5.5.202112011542 4 346045
1#0##0#0#0.0#2021-12-30
14:51:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
024647ebc1be5b6928f9a5eb2512ff4f 150000 0 0 0 0 0
0 0 0 0 15000 0 19594 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 28/06/1956 0 2
1 Z09.8;E07.9;K30;M19.98 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 211135
0 1 0 0 0 SRI SARASWATI.NY 088967 65 23917 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345907
1#0##0#0#0.0#2021-12-30
13:45:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f26f2fb933d398df77d9718e3762c75d 150000 0 0 0 0 0
0 0 0 0 15000 0 46135 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 13/03/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 214310
0 1 0 0 0 SUBANDIJO.TN 083578 77 28407 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346046
1#0##0#0#0.0#2021-12-30
14:54:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
901d47dc3e7beab64fb75999d1191755 150000 0 0 0 0 0
0 0 0 0 15000 0 49310 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 19/09/1986 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 IRSYADUL IBAD, SDR 081289 35 12877
yani;3302226402970001; 5.5.5.202112011542 4 346047
1#0##0#0#0.0#2021-12-30
14:56:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d3d7a58dcd3c9228837947471e995d32 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 05/04/1933 0 2
0 0 - 0 - 0 - 0 - 0 181400 246980
0 1 0 0 0 SRI SUKASNI, (NY) 007552 88 32402 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346048
1#0##0#0#0.0#2021-12-30
14:59:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dbe769bbb5737cb06fb218e90d9bd026 150000 0 0 0 0 0
0 0 0 0 15000 0 81980 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 12/12/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 197437
0 1 0 0 0 SITI CHOSIYAH., NY 045191 74 27038
yani;3302226402970001; 5.5.5.202112011542 4 346050
1#0##0#0#0.0#2021-12-30
15:00:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
57f08773bc07ecc62ece9bda861fcda7 150000 0 0 0 0 0
0 0 0 0 15000 0 32437 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 31/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 285460
0 1 0 0 0 SUWARSI, NY 041259 66 24462 DR. SUHARTO,
SP.PD 1124R0021221V003590 0000638651147 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346051 1#0##0#0#0.0#2021-12-30
15:01:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
64146e4de1046d9eab402d3e7c91a49d 150000 0 0 0 0 0
0 31845 0 0 15000 0 88615 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 20/04/1947 0 1
0 0 - 0 - 0 - 0 - 0 181400 222173
0 1 0 0 0 DJIJO BASUKI 077000 74 27274 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346052
1#0##0#0#0.0#2021-12-30
15:02:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
360ff463959e57e44c02e88412aa2206 150000 0 0 0 0 0
0 0 0 0 15000 0 57173 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 30/10/1965 0 2
1 Z09.8;K30;J06.9;G62.8 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 227271
0 1 0 0 0 TRI KARTINI 089553 56 20506 DR. SUHARTO,
SP.PD 1124R0021221V003592 0002168611222 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346053 1#0##0#0#0.0#2021-12-30
15:14:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6a8cd2f159ef8d8d678e3c3e60a04398 150000 0 0 0 0 0
0 0 0 0 15000 0 62271 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 07/02/1969 0 1
1 Z09.8;B86 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 205426
0 1 0 0 0 JATI WALUYO.TN 100408 52 19310 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346055
1#0##0#0#0.0#2021-12-30
15:17:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
21953769bc5847170b06abbfc2d00946 150000 0 0 0 0 0
0 0 0 0 15000 0 40426 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 05/06/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 202219
0 1 0 0 0 SRI DARWANTI, NY 088347 65 23940 DR.
yani;3302226402970001; 5.5.5.202112011542 4 344959
1#0##0#0#0.0#2021-12-31
10:05:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7ca99845190cf6c9d01246f8a9659d5d 150000 0 0 0 0 0
0 0 0 0 15000 0 37219 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 18/05/1946 0 2
0 0 - 0 - 0 - 0 - 0 181400 193031
0 1 0 0 0 TITIEK SUMARWATI, NY 100532 75 27611
yani;3302226402970001; 5.5.5.202112011542 4 346057
1#0##0#0#0.0#2021-12-31
10:09:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
01ac12a249be778b51fc3d051d698434 150000 0 0 0 0 0
0 0 0 0 15000 0 28031 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 18/01/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000090992327 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345965 1#0##0#0#0.0#2021-12-31
10:31:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dcb58f1dcae60ac1a11ff7e91da89f12 236000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 05/08/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 196910
0 1 0 0 0 SUWARDJO.TN 100143 77 28262 DR. RINA
5.5.5.202112011542 4 346058 1#0##0#0#0.0#2021-12-31
10:36:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
43ee35df7bf7ea0fbe0b40f56e7ab2ee 150000 0 0 0 0 0
0 0 0 0 15000 0 31910 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 19/10/1951 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SETYANING
RAHAYU,NY 074872 70 25631 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V003600 0001434593226 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345901 1#0##0#0#0.0#2021-12-31
10:45:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
67e95d58c34832b2737aec6f23a8f979 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 09/01/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 368310
0 1 0 0 0 SONDAH SRI PATMOKO.TN 100513 56 20800
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346061
1#0##0#0#0.0#2021-12-31
11:07:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4bfcb10dcb5c723de8ba11a1a4dd27bf 150000 0 0 0 0 0
0 120795 0 0 15000 0 82515 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 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; 5.5.5.202112011542 4
345966 1#0##0#0#0.0#2021-12-31
11:08:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7e296ef6f73e0932c1395f3466617c65 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 13/06/1992 0 2
0 0 - 0 - 0 - 0 - 0 181400 262000
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 345934
1#0##0#0#0.0#2021-12-31
11:14:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
818b401730c71dfa90b1da906658dd02 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 13/03/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 446912
0 1 0 0 0 SRI SUPARTINI.NY 100751 67 24755 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346460
1#0##0#0#0.0#2022-01-03
14:16:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2ec7407a518230968bebce7ff6f28dd0 150000 0 0 0 0 0
220000 0 0 0 25000 0 51912 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 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; 5.5.5.202112011542 4
345930 1#0##0#0#0.0#2021-12-31
11:40:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ae0afdac1197e74b9f30cce0fe6254a4 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 10/09/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 350492
0 1 0 0 0 DWI RETNOWATI.NY 100517 44 16173 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346062
1#0##0#0#0.0#2021-12-31
11:41:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b3fba7a2ca1678bdd942fe35e7ce49d4 150000 0 0 0 0 0
0 121345 0 0 15000 0 64147 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 23/03/1950 0 2
0 - 0 107400 273000 0 1 0 0 0
1124R0021221V003610 0001032584782 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345941 1#0##0#0#0.0#2021-12-31
11:42:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ce2b5edf51a5ff9a6b5b075654ee96fa 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
345955 1#0##0#0#0.0#2021-12-31
13:26:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
14622a5f8a19659079a06194df0a1ee4 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 28/05/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 250822
0 1 0 0 0 MARIA SAPTININGSIH.NY 099116 46 17009
yani;3302226402970001; 5.5.5.202112011542 4 346063
1#0##0#0#0.0#2021-12-31
13:28:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1841653dac751895ec99bf6dd9f1cbc7 150000 0 0 0 0 0
0 31845 0 0 15000 0 53977 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
345963 1#0##0#0#0.0#2021-12-31
13:28:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c87aa79b7b02b706b00698217c2fe4e5 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 20/06/1943 0 2
0 - 0 107400 123000 0 1 0 0 0
1124R0021221V003615 0001800527916 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345949 1#0##0#0#0.0#2021-12-31
13:29:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6a7307d19c4c63a314303a7165ac7730 108000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 21/04/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 184110
0 1 0 0 0 SUTINI, NY 008773 69 25446 DR. RINA
5.5.5.202112011542 4 346064 1#0##0#0#0.0#2021-12-31
13:32:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e010dd5e70ecdfdd7f58f3cddb94f12f 150000 0 0 0 0 0
0 0 0 0 15000 0 19110 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 27/03/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 207977
0 1 0 0 0 SUDARNI., NY 042296 42 15610 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346069
1#0##0#0#0.0#2021-12-31
13:32:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9035d3f6c0a5cb22c4614b0682afcce1 150000 0 0 0 0 0
0 0 0 0 15000 0 42977 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 01/11/1961 0 2
0 - 0 107400 273000 0 1 0 0 0
1124R0021221V003618 0000090942546 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345953 1#0##0#0#0.0#2021-12-31
13:35:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f924f10fb1f43e4490329870cb9636a1 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 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; 5.5.5.202112011542 4
345960 1#0##0#0#0.0#2021-12-31
13:37:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4e5e0e4ae14fd960e97ab907f7ae95f9 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 23/04/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 215312
0 1 0 0 0 SURYATI, NY 037498 53 19600 DR. RINA
5.5.5.202112011542 4 346070 1#0##0#0#0.0#2021-12-31
13:38:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4f03c212dbebb86c6ef2b33b46165ef4 150000 0 0 0 0 0
0 0 0 0 15000 0 50312 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 21/09/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002199915988 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345958 1#0##0#0#0.0#2021-12-31
13:42:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7fdb8c20b6c4648281a336f66b445c0c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
345959 1#0##0#0#0.0#2021-12-31
13:42:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
19947b6860c09c43a6d151ddc6f25ced 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 04/06/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUMINI.NY 099596
0002253764441 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345962 1#0##0#0#0.0#2021-12-31
13:43:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
948088f530ff7ea005bfddb4095be9b8 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 17/09/1955 0 1
1 Z09.8;G20;G81.9 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 DAKA AHMAD
1124R0021221V003624 0002253763754 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345929 1#0##0#0#0.0#2021-12-31
13:45:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
906ee7812392b137558761be7509e34d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
345967 1#0##0#0#0.0#2021-12-31
13:46:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ef76eeb51de8b4ad3d864826977991e8 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 03/08/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ISMURYANI
1124R0021221V003626 0001313177196 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345911 1#0##0#0#0.0#2021-12-31
13:47:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3f595506e60624509a9ee588dd0bf4a3 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 27/08/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346071
1#0##0#0#0.0#2021-12-31
13:49:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8bb8bbc82923d93331018c8c7b2a2aa9 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 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; 5.5.5.202112011542 4
345916 1#0##0#0#0.0#2021-12-31
13:52:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b8ba699dcbe8d9581df5b13fef2c04eb 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 31/12/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 288000 0 1 0 0 0 INDRAYATI, NY
0002926021015 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345926 1#0##0#0#0.0#2021-12-31
13:53:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 18/01/1966 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 IVO MUMPUNI
1124R0021221V003630 0002169780873 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345945 1#0##0#0#0.0#2021-12-31
13:54:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
edaec34d5587a273a10d9a45a05e3deb 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 29/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 AGNES WIDHA
1124R0021221V003631 0002168632721 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345924 1#0##0#0#0.0#2021-12-31
13:59:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e00b77525e4391548fa5de55c5dd502d 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 20/10/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 BADRIYAH
1124R0021221V003632 0000091089088 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346367 1#0##0#0#0.0#2021-12-31
14:02:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5a9fd5b59e50fdf1ecfa96c14020a2bd 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 17/12/1947 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 AGUSTINUS
1124R0021221V003633 0001335194043 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345948 1#0##0#0#0.0#2021-12-31
14:02:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0ccacf6b796c43af70bc2a5d51c2defb 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 25/12/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MARIA
1124R0021221V003634 0002069991685 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345969 1#0##0#0#0.0#2021-12-31
14:04:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
71f6e73c776c3fe2824416c1edb6d2a8 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 10/11/1965 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002165956975 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345956 1#0##0#0#0.0#2021-12-31
14:05:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
46f631ba36c3e89cfae408af346c42ec 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 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; 5.5.5.202112011542 4
345968 1#0##0#0#0.0#2021-12-31
14:06:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2cb1af046c5563fd99951c4fea3d0d3d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 28/01/1971 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUNARMI 007615
0002058166416 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345927 1#0##0#0#0.0#2021-12-31
14:07:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b8de5707ac8ae1c6c1d3b0049eb2aeaf 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 31/03/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 267162
0 1 0 0 0 SUPARENG.TN 061675 58 21450 DR. SUHARTO,
SP.PD 1124R0021221V003638 0001898526971 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346072 1#0##0#0#0.0#2021-12-31
14:08:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0a32e24d2101c930d71621a0406de33f 150000 0 0 0 0 0
0 31845 0 0 15000 0 70317 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 30/11/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
yani;3302226402970001; 5.5.5.202112011542 4 346074
1#0##0#0#0.0#2021-12-31
14:10:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1f8e8e6c579d2407f6c41fb60f4df62d 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
345928 1#0##0#0#0.0#2021-12-31
14:12:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
369f991000ead2677fb4d503552e55ee 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 06/03/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SHINTA,NY 038241
0000639407722 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345923 1#0##0#0#0.0#2021-12-31
14:18:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4009ce6b2447e175563955af74cf80cf 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 01/02/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 266140
0 1 0 0 0 SANG LESTARI.NY 100527 43 16029 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346075
1#0##0#0#0.0#2021-12-31
14:19:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c0657873ccf2edf6145ae87eaf1a1607 235000 0 0 0 0 0
0 0 0 0 15000 0 16140 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 11/03/2004 0 1
0 0 - 0 - 0 - 0 - 0 181400 219120
0 1 0 0 0 PANDU HARIYO PUTRA, SDR 067776 17 6494
yani;3302226402970001; 5.5.5.202112011542 4 346076
1#0##0#0#0.0#2021-12-31
14:21:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
08ece6fe4339894388875d5927c69627 150000 0 0 0 0 0
0 0 0 0 15000 0 54120 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 13/05/1974 0 2
0 - 0 - 0 - 0 183900 272730 0 1
0 0 0 IDA WINARNI, NY 085746 47 17389 DR. ZULFADLY, SP.B
1124R0021221V003646 0001320540118 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346077 1#0##0#0#0.0#2021-12-31
14:23:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2ff6d876594612fe26935c41231ebbd8 235000 0 0 0 0 0
0 0 0 0 15000 0 22730 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 20/05/2000 0 1
0 - 0 - 0 - 0 - 0 181400 261030
0 1 0 0 0 RUDI CAHYONO.SDR 100620 21 7885 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346078
1#0##0#0#0.0#2021-12-31
14:24:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a3d705bcda6bf4e1a926f28afe000aca 235000 0 0 0 0 0
0 0 0 0 15000 0 11030 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 08/08/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 219997
0 1 0 0 0 SUMINI, NY 057720 67 24607 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 346080
1#0##0#0#0.0#2021-12-31
14:27:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fd066e53361dc306d49345271bce1886 150000 0 0 0 0 0
0 0 0 0 15000 0 54997 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 09/08/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 244532
0 1 0 0 0 ARIS BUDI SUBARDINI,(NY) 032842 65
yani;3302226402970001; 5.5.5.202112011542 4 346081
1#0##0#0#0.0#2021-12-31
14:30:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ddfaeb539538684ca0bb675797c515ec 150000 0 0 0 0 0
0 0 0 0 15000 0 79532 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 12/09/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 289578
0 1 0 0 0 SAMPAN, BP 068934 71 26033 DR. SUHARTO,
SP.PD 1124R0021221V003650 0000088998895 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346083 1#0##0#0#0.0#2021-12-31
14:31:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cc57514926bc3b68e2c694347da3da37 150000 0 0 0 0 0
0 31845 0 0 15000 0 92733 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 13/03/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUHARI, TN 070582
0001021699394 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345931 1#0##0#0#0.0#2021-12-31
14:33:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
866419a7ab3e041e5752b54604753a7f 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 14/07/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 229009
0 1 0 0 0 MARDIYAH, NY 043267 62 22806 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347312
1#0##0#0#0.0#2022-01-05
17:42:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8f63e07c42538c9cca9780b900b7de10 150000 0 0 0 0 0
0 0 0 0 15000 0 64009 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 02/02/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUJIYEM, NY 090600
0001696847466 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345935 1#0##0#0#0.0#2021-12-31
14:38:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0010e92baa713f7bd732b8126ebf23c4 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 31/01/2002 0 1
0 - 0 - 0 - 0 - 0 181400 175000
0 1 0 0 0 ARGA KUSUMA.SDR 100752 19 7264 DR.
agung;3313092303950002; 5.6.3.202201201500 4 348912
1#0##0#0#0.0#2022-02-21
10:08:59#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
8bbb5dc61f6a0878b9fcb3149ef3ed7b 150000 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 20/06/1997 0 1
0 - 0 - 0 - 0 183900 334960 0 1
0 0 0 RIAN NAMANG DJABAR, SDR 100503 24 8950 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346084
1#0##0#0#0.0#2021-12-31
14:39:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c642e076d9812438f87c8427406c1354 295000 0 0 0 0 0
0 0 0 0 15000 0 24960 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 01/01/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 271835
0 1 0 0 0 ROCHMADIN ASGAR TN 049605 58 21539
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346085
1#0##0#0#0.0#2021-12-31
14:47:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
983caffa1b19a976440b4ded21246b3e 150000 0 0 0 0 0
0 0 0 0 15000 0 106835 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 06/03/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 223187
0 1 0 0 0 A S HENI TRI REKNO G, NY 083474 51
0000564600734 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346086 1#0##0#0#0.0#2021-12-31
14:48:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a18e9e7d73cc410ebd94abe8805c7709 150000 0 0 0 0 0
0 0 0 0 15000 0 58187 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 03/10/1985 0 1
1 Z09.8;I10;J45.9;K21.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 200176
0 1 0 0 0 BRIAN MHAHENDRATA, TN 100674 36 13228
yani;3302226402970001; 5.5.5.202112011542 4 346088
1#0##0#0#0.0#2021-12-31
14:49:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
77420f2ea9dd4c0bfb2da7470dc46f08 150000 0 0 0 0 0
0 0 0 0 15000 0 35176 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 10/05/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 252220
0 1 0 0 0 NUNUK MARYANI.NY 086343 63 23236 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346090
1#0##0#0#0.0#2021-12-31
14:51:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d2a943527125bd31da7798d94b7e3fd7 150000 0 0 0 0 0
0 0 0 0 15000 0 87220 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 15/08/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 179405
0 1 0 0 0 LASITO., BP 041779 79 28983 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346091
1#0##0#0#0.0#2021-12-31
14:53:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c97977c9a0c24cfb694e223571216107 150000 0 0 0 0 0
0 0 0 0 15000 0 14405 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 25/06/1955 0 2
1 Z09.8;J32.0;R04.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 284825
0 1 0 0 0 MENIK RAHAYU, NY 043706 66 24286 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346092
1#0##0#0#0.0#2021-12-31
14:58:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e6c9b723e4d91286d48e7eacf3826504 150000 0 0 0 0 0
0 0 0 0 15000 0 119825 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 31/12/1928 0 2
0 0 - 0 - 0 - 0 - 0 181400 294645
0 1 0 0 0 SUWARNI. NY 099221 92 33958 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346093
1#0##0#0#0.0#2021-12-31
15:05:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5895ec2e6b5514b589043edc8fa40399 150000 0 0 0 0 0
0 0 0 0 15000 0 129645 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 11/07/2012 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 JULIA DEVI NOVITA.AN 100742 9 3450
yani;3302226402970001; 5.5.5.202112011542 4 346095
1#0##0#0#0.0#2021-12-31
15:06:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f0237739a2d4432316101b28ca6c7188 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 02/06/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 197680
0 1 0 0 0 KUS SULISTYO.TN 097613 55 20291 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346097
1#0##0#0#0.0#2021-12-31
15:09:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
03979f0d8c5147010132f4a436a489ab 150000 0 0 0 0 0
0 0 0 0 15000 0 32680 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 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; 5.5.5.202112011542 4
345938 1#0##0#0#0.0#2021-12-31
15:15:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
216a5003243396c33b132d27782caedc 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 17/09/1954 0 2
211200 0 0 - 0 - 0 - 0 - 0 211200
282795 0 1 0 0 0 ENDANG SRI HANDAYANI., NY 048892
0000639623608 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346099 1#0##0#0#0.0#2021-12-31
15:17:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
38f2990c4110fac7f69fa2454b062499 203000 0 0 0 0 0
0 0 0 0 15000 0 64795 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 31/12/1942 0 2
1 Z09.8;E11.9;J20.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 221734
0 1 0 0 0 SUWARSI,(NY) 036802 78 28845 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346100
1#0##0#0#0.0#2021-12-31
15:31:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
103ee4de7fe6f7504e02032129b94e77 150000 0 0 0 0 0
0 31845 0 0 15000 0 24889 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 23/05/2012 0 1
0 0 - 0 - 0 - 0 - 0 181400 183770
0 1 0 0 0 DION ANUGERAH TAUFIK QURRAHMAN.AN 100753
0001525262253 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346102 1#0##0#0#0.0#2021-12-31
15:33:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
89d50a73c9a9210d2920f45f5fcd6395 150000 0 0 0 0 0
0 0 0 0 25000 0 8770 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 24/06/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 334910
0 1 0 0 0 HARYADI,TN 016118 64 23556 DR. OEDJANG
yani;3302226402970001; 5.5.5.202112011542 4 346103
1#0##0#0#0.0#2021-12-31
15:34:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e19c1a64e3dda9f94b19e2b5faaef592 295000 0 0 0 0 0
0 0 0 0 15000 0 24910 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 20/04/1980 0 2
- 0 - 0 - 0 183900 185146 0 1 0
0 0 INA.NY 100505 41 15220 DR. GUNAWAN, SP.OG
1124R0021221V003672 0000565798061 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346104 1#0##0#0#0.0#2021-12-31
15:37:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
95e24ac54d640336734a877d69dcc4a8 150000 0 0 0 0 0
0 0 0 0 15000 0 20146 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 12/06/1972 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345970
1#0##0#0#0.0#2021-12-31
15:39:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
51c20934d385ecb8e3c86615c5ec3b32 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 17/04/1961 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345971
1#0##0#0#0.0#2022-01-03
08:09:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
22a0396da857beadaeef9464fd236972 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 10/11/1970 0 1
0 - 0 - 0 - 0 786200 588830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345972
1#0##0#0#0.0#2022-01-03
08:45:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f0fb92ae83da3e05d3e3fae27f238cac 463830 0 0 0 0 0
0 0 0 0 15000 0 110000 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 01/04/1981 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V003678 0001904830593 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345973 1#0##0#0#0.0#2022-01-03
08:46:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
685bbcb986e4aae95c8f9271db8a3dee 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 19/12/1943 0 1
0 0 - 0 - 0 - 0 - 0 181400 181050
0 1 0 0 0 HARTONO.TN 037413 78 28492 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346106
1#0##0#0#0.0#2022-01-03
08:47:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9d1aff52b0d03e480a3abc9f495b6524 150000 0 0 0 0 0
0 0 0 0 15000 0 16050 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 01/12/1958 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V003680 0001436949538 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345974 1#0##0#0#0.0#2022-01-03
08:48:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2c4a3a5ab4b0dddff46d23d36eae68b7 463830 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 01/01/2000 0 1
0 - 0 - 0 - 0 - 0 549400 845000
0 1 0 0 0 SODIKIN,(BP) 018301 21 8025 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346209
1#0##0#0#0.0#2022-01-03
08:51:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f33cda92f4e9520db7f144d1299665c4 150000 0 0 0 0 0
680000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 25/05/1972 0 1
0 - 0 - 0 - 0 786200 521550 0 1
SP.PD 1124R0021221V003682 0002431552465 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345975 1#0##0#0#0.0#2022-01-03
08:53:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
476a26cf9c3a52d6f74152bc83046f83 463830 0 0 0 0 0
0 0 0 0 15000 0 42720 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 20/08/1959 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V003683 0000571256594 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345976 1#0##0#0#0.0#2022-01-03
08:55:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
80cab31da960ba4caeebffe27077d84c 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 06/02/1969 0 1
0 - 0 - 0 - 0 183900 394160 0 1
0 0 0 IWAN EDI SUTEMAN. TN 048724 52 19311 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346108
1#0##0#0#0.0#2022-01-03
08:57:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
000f4f0c06f39cd608c96bc5a6554348 350000 0 0 0 0 0
0 0 0 0 15000 0 29160 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 26/04/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345977
1#0##0#0#0.0#2022-01-03
08:57:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
886111ef914d828d8da6dad96882cc03 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 02/02/1971 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345978
1#0##0#0#0.0#2022-01-03
09:00:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
10285d0648321173bbb0fa0107a99e53 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 02/03/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 207180
0 1 0 0 0 SAWAL WIRANTO.TN 100747 55 20383 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346109
1#0##0#0#0.0#2022-01-03
09:03:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b71364973a385e02dc8162249a86a3e7 150000 0 0 0 0 0
0 31845 0 0 15000 0 10335 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 01/12/1980 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V003688 0000640230884 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345979 1#0##0#0#0.0#2022-01-03
09:06:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6cd897ee43c2c2becd3592c338c5c409 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 09/10/2004 0 2
0 0 - 0 - 0 - 0 - 0 181400 184330
6282 DR. OEDJANG SETIJAWAN, MSI.MED.,SP.B 1124R0021221V003689
0002169719043 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346110 1#0##0#0#0.0#2022-01-03
09:06:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
23bd0ad93d656cbad134d03db224973a 150000 0 0 0 0 0
0 0 0 0 15000 0 19330 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 08/03/1967 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345980
1#0##0#0#0.0#2022-01-03
09:08:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a23b850a7d7fd2209292d63eb8c4d287 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 01/05/1975 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V003691 0001790328262 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345981 1#0##0#0#0.0#2022-01-03
09:13:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
774e4238d154035df3367a23b59754ea 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 15/05/1953 0 1
0 - 0 - 0 - 0 786200 614997 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345982
1#0##0#0#0.0#2022-01-03
09:16:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c08f1286adbd5264571a285c028825ab 463830 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 18/11/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 221887
0 1 0 0 0 PARNANTO.TN 099751 67 24505 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 346111
1#0##0#0#0.0#2022-01-03
09:17:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
05ee2e2e05e48cbeaa2b46232468e6f8 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 18/08/1943 0 1
0 0 - 0 - 0 - 0 - 0 181400 213375
0 1 0 0 0 MARNO RAHARJO, BP 054909 78 28615 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346112
1#0##0#0#0.0#2022-01-03
09:17:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f805f7b647b32573e19cdbe4b8f0408d 150000 0 0 0 0 0
0 0 0 0 15000 0 48375 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 15/09/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 214390
0 1 0 0 0 TRI ATMODJO, TN 094462 61 22377 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346113
1#0##0#0#0.0#2022-01-03
09:19:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
938826f174e57b3064c98258f1af2957 150000 0 0 0 0 0
0 0 0 0 15000 0 49390 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 14/01/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SUMARMI., NY 051794 62 22987 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346115
1#0##0#0#0.0#2022-01-03
09:20:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8375098df8439525abb450d577f705a5 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 23/04/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 221967
0 1 0 0 0 SRI WAHYUNI, NY 087660 61 22522 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346117
1#0##0#0#0.0#2022-01-03
09:21:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ea77d4a002dfd0584b51be6eb47031f1 150000 0 0 0 0 0
0 0 0 0 15000 0 56967 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 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; 5.5.5.202112011542 4
345961 1#0##0#0#0.0#2022-01-03
09:21:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b8770e2064de96bb03b568ce44ea7248 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 20/04/1995 0 1
0 0 - 0 - 0 - 0 - 0 181400 179910
0 1 0 0 0 HARITSA WAHYU WARDHANI.TN 094578 26
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346119
1#0##0#0#0.0#2022-01-03
09:22:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4d85dbaaabd4f0741d7f444bf22cc4e4 150000 0 0 0 0 0
0 0 0 0 15000 0 14910 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 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; 5.5.5.202112011542 4
345899 1#0##0#0#0.0#2022-01-03
09:24:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
24f60b6bc42f63e4e6654cf94d654dd8 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 13/12/1981 0 2
0 0 - 0 - 0 - 0 - 0 181400 229912
0 1 0 0 0 SUMINI, NY 073261 40 14618 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 346120
1#0##0#0#0.0#2022-01-03
09:25:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1320c57d94a7a1ed06ae7e91d08f9ac1 150000 0 0 0 0 0
0 0 0 0 15000 0 64912 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 10/12/1973 0 1
0 - 0 - 0 - 0 - 0 549400 822000
0 1 0 0 0 NUGRAHA ANDI KUSUMA.TN 100756 48 17543
yani;3302226402970001; 5.5.5.202112011542 4 346121
1#0##0#0#0.0#2022-01-03
09:26:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fef92ae8238f0360f773b5a4f9d4a1b0 150000 0 0 0 0 0
657000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 17/05/2009 0 1
0 0 - 0 - 0 - 0 - 0 181400 245002
0 1 0 0 0 MUHAMMAD KAISA MUHYAR FAURANI, (AN) 004582
12 4601 DR. RINA DIANA,SP.DV 1124R0021221V003704 0001305785981
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346123
1#0##0#0#0.0#2022-01-03
09:29:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
54ca97d6fa8bc1b8e03c5f087b466d5a 150000 0 0 0 0 0
0 0 0 0 15000 0 80002 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 31/12/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 218037
0 1 0 0 0 PARYATUN, NY 051446 69 25558 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346124
1#0##0#0#0.0#2022-01-03
09:30:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
55909c20ee4ecd2025c8e5cf34e9f04b 150000 0 0 0 0 0
0 0 0 0 15000 0 53037 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 16/06/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 223715
0 1 0 0 0 SUWARTI.NY 085230 76 27947 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 346125
1#0##0#0#0.0#2022-01-03
09:31:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a9722e2924378a975fdd86c2d9a8e9ea 150000 0 0 0 0 0
0 0 0 0 15000 0 58715 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 10/01/1981 0 1
0 - 0 - 0 - 0 - 0 181400 293745
0 1 0 0 0 ZAENURI, TN 073701 40 14955 DR.
yani;3302226402970001; 5.5.5.202112011542 4 345909
1#0##0#0#0.0#2022-01-03
09:33:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
629116534803e2ed670058d16f9afdaa 150000 0 0 0 0 0
0 0 0 0 15000 0 128745 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 26/02/1954 0 2
1 Z09.8;I69.3;M72.28 81.92 - - None None None None M-3-
0 404900 436115 0 1 0 0 0 SUNARNI,(NY)
1124R0021221V003708 0000166538632 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346127 1#0##0#0#0.0#2022-01-03
09:36:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
07a15e9a5079fcdc814b2ff35bb1c356 150000 0 0 0 193000
0 0 0 0 0 15000 0 78115 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 24/11/1940 0 2
0 0 - 0 - 0 - 0 - 0 181400 206580
0 1 0 0 0 SOESI PATONAH., NY 063627 81 29612
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346128
1#0##0#0#0.0#2022-01-03
09:37:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d4f063a519e5f04007b217007f8a8edd 150000 0 0 0 0 0
0 0 0 0 15000 0 41580 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 31/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 211835
0 1 0 0 0 TUMINAH NY 088417 66 24462 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 346129
1#0##0#0#0.0#2022-01-03
09:39:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0ae73e26b186343f658a915f299eff75 150000 0 0 0 0 0
0 0 0 0 15000 0 46835 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 10/04/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 206161
0 1 0 0 0 TRISNO SUJARWADI.TN 098559 49 18152
yani;3302226402970001; 5.5.5.202112011542 4 346130
1#0##0#0#0.0#2022-01-03
09:42:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fc668fd38c76f11a60c2f9fc27bed66d 150000 0 0 0 0 0
0 0 0 0 15000 0 41161 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 02/06/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 226795
0 1 0 0 0 SURATMI HADI WIRATMO.TN 099407 66 24309
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346131
1#0##0#0#0.0#2022-01-03
09:44:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
368ecc6ae3ff7229a5f79b5674a47369 150000 0 0 0 0 0
0 0 0 0 15000 0 61795 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 29/04/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI HARIYANTI.NY
0001692528928 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345957 1#0##0#0#0.0#2022-01-03
09:45:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
487d5a7a97ed272ee307d0bbfc92429a 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 05/03/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 222485
0 1 0 0 0 SRI WULAN.NY 099062 42 15632 DR.
agung;3313092303950002; 5.6.6.202203301209 4 346210
1#0##0#0#0.0#2022-04-14
13:45:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
667e434996bc885aca8e6cd031b66351 150000 0 0 0 0 0
0 0 0 0 15000 0 57485 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 11/07/1994 0 2
- 0 - 0 - 0 - 0 549400 273510 0
1 0 0 0 YULIANI SETYOWATI, NY 061557 27 10025 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346133
1#0##0#0#0.0#2022-01-03
09:48:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ba49ee84dc671fe5d30e322f32e6bc25 200000 0 0 0 0 0
0 0 0 0 15000 0 58510 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 08/12/1992 0 1
0 0 - 0 - 0 - 0 - 0 181400 206915
yani;3302226402970001; 5.5.5.202112011542 4 346134
1#0##0#0#0.0#2022-01-03
09:49:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3016d7cfe283697f3f2941df6004582f 150000 0 0 0 0 0
0 0 0 0 15000 0 41915 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 21/07/1994 0 1
1 Z09.8;J32.0 87.16 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 280485
yani;3302226402970001; 5.5.5.202112011542 4 346399
1#0##0#0#0.0#2022-01-03
09:52:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e7ca2280325f324bf1cd620a2edf0978 150000 0 0 0 0 0
0 0 0 0 15000 0 115485 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 14/12/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 203065
0 1 0 0 0 SRI DARMINI, NY 093216 70 25575 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346135
1#0##0#0#0.0#2022-01-03
09:54:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b6985279ff13bdb9509873907c3462e0 150000 0 0 0 0 0
0 0 0 0 15000 0 38065 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 12/12/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 239505
0 1 0 0 0 SUPARTINI.NY 084915 73 26672 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346136
1#0##0#0#0.0#2022-01-03
09:56:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d9956b954e8d2e0f29c647f4db2f57b4 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 07/10/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 235335
0 1 0 0 0 NUR LASMI, NY 072492 51 18703 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346137
1#0##0#0#0.0#2022-01-03
09:57:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
602c61f74c04c09e06e83b1ba06dbb8e 150000 0 0 0 0 0
0 0 0 0 15000 0 70335 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 24/04/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 283250
0 1 0 0 0 WIDATI, NY 044879 62 22887 DR. SUHARTO,
SP.PD 1124R0021221V003725 0000091308993 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346138 1#0##0#0#0.0#2022-01-03
10:10:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5678120169a851a2ce1be627c1327d32 150000 0 0 0 0 0
0 0 0 0 15000 0 118250 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 06/07/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 224897
0 1 0 0 0 SUMARNI.NY 086963 67 24640 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 346139
1#0##0#0#0.0#2022-01-03
10:11:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
54dce2c838c258ed32b97ffb365cc531 150000 0 0 0 0 0
0 0 0 0 15000 0 59897 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 31/12/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 216885
0 1 0 0 0 JUMIATI.NY 097762 59 21905 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 346140
1#0##0#0#0.0#2022-01-03
10:12:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9716abb15945310bcbac3511b51996c0 150000 0 0 0 0 0
0 0 0 0 15000 0 51885 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 08/06/2009 0 2
- 0 - 0 - 0 - 0 182600 165000 0
1 0 0 0 FEINA AINUN QOLBU.AN 099139 12 4579 DR.
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346141
1#0##0#0#0.0#2022-01-03
10:13:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/12/2021 21/12/2021 06/04/2020 0 1
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346142 1#0##0#0#0.0#2022-01-03
10:15:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/12/2021 21/12/2021 18/08/2018 0 1
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0002761660157 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346143 1#0##0#0#0.0#2022-01-03
10:16:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/12/2021 21/12/2021 12/09/1945 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 346145
1#0##0#0#0.0#2022-01-03
10:19:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/12/2021 21/12/2021 17/11/1946 0 2
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346147 1#0##0#0#0.0#2022-01-03
10:21:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4216041833e0296565d6101ff1f659e2 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 20/04/2001 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WAHYU TEJO ISMOYO,
sdr 000156 20 7550 DR. LINDA SUGIARTO, SP.FKR 1124R0021221V003734
0001106856922 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345902 1#0##0#0#0.0#2022-01-03
10:34:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9f2532422932227f976a902b6b716fd2 247000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 22/05/1976 0 1
0 0 - 0 - 0 - 0 - 0 181400 382188
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yani;3302226402970001; 5.5.5.202112011542 4 346149
1#0##0#0#0.0#2022-01-03
10:35:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
70ca9c735c7da04c34bded297d9f95b9 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 31/12/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 401066
0 1 0 0 0 DARMINAH,(NY) 036497 55 20444 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346150
1#0##0#0#0.0#2022-01-03
10:36:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
22c15a00bb2800083e20842bd499519b 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 13/12/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 321828
0001426207241 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346151 1#0##0#0#0.0#2022-01-03
10:38:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1e8ed55fe4510850e812d5fc8ea83a19 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 21/03/1967 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 346152
1#0##0#0#0.0#2022-01-03
10:42:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
20b24e4320fb033d38a2597a5ad38c9e 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 07/08/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 366712
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yani;3302226402970001; 5.5.5.202112011542 4 346153
1#0##0#0#0.0#2022-01-03
10:45:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/12/2021 21/12/2021 31/12/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 229147
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yani;3302226402970001; 5.5.5.202112011542 4 346154
1#0##0#0#0.0#2022-01-03
10:54:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
82bfaa7920eb5d34fa483a37cd80d0e0 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 30/08/1942 0 2
1 Z09.8;A16.2;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 210840
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346155
1#0##0#0#0.0#2022-01-03
10:57:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dfb7e14947e13a0497ceb9c06153d4fe 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 16/07/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 214092
0 1 0 0 0 APIN S ARIPIN, TN 058842 48 17690 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346156
1#0##0#0#0.0#2022-01-03
10:58:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9f6e68d6b2c7eb2c9e1c5a478ef9c455 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 31/12/1966 0 2
1 Z09.8;A16.2;E11.9;I10 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 195399
0 1 0 0 0 SUWARSI, NY 098393 54 20079 DR. ANITA
yani;3302226402970001; 5.5.5.202112011542 4 346157
1#0##0#0#0.0#2022-01-03
11:00:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5fb8b35c64d24284bc265e60f4e10922 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 18/03/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 188935
0 1 0 0 0 RAHARJO .TN 092313 73 26941 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 346158
1#0##0#0#0.0#2022-01-03
11:04:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fa1fd553b181002c7c8a0fb39d8d4f95 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 22/02/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 251462
0 1 0 0 0 RAMELAN, TN 098383 59 21852 DR. ANITA
yani;3302226402970001; 5.5.5.202112011542 4 346159
1#0##0#0#0.0#2022-01-03
11:10:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1d5c34ddc4bc3c6b6bec671951dd4e82 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 06/03/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 412296
0 1 0 0 0 NUR WINDARIYAS ., NY 056772 44 16361
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346160
1#0##0#0#0.0#2022-01-03
11:15:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a2fe9f80c32d295f6157dddb7f897644 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 03/12/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 200385
0 1 0 0 0 DARMI, NY 090338 79 28873 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 346161
1#0##0#0#0.0#2022-01-03
11:28:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
de32c28587f6385b31d26084d77706fe 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 29/03/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 215022
0 1 0 0 0 SIH MARTANTI.NY 096811 56 20721 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346162
1#0##0#0#0.0#2022-01-03
11:34:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
126ed092a3cad77ecd744d0dc0bbe521 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 09/04/1941 0 1
0 - 0 - 0 - 0 183900 200012 0 1
0 0 0 SUMANTO.TN 080896 80 29476 DR. ZULFADLY, SP.B
1124R0021221V003750 0000091327263 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346163 1#0##0#0#0.0#2022-01-03
11:36:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cc4820e89866fa41d55883168ba3b95c 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 19/02/1965 0 1
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agung;3313092303950002; 5.6.6.202203301209 4 346164
1#0##0#0#0.0#2022-04-14
12:52:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
f61200a62d643a71d77dcb561cb3cf84 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 16/08/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 221895
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novia;3313125201940001; 5.6.3.202201201500 4 346165
1#0##0#0#0.0#2022-02-15
13:16:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
553e30b6cffb6929b3ddb99d71a29203 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 13/06/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 199785
0 1 0 0 0 DINI CAHYANINGRUM, NY 098174 42 15532
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346166
1#0##0#0#0.0#2022-01-03
13:03:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
503823466ca411c2cdf66220bd62b689 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 31/12/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 204660
0 1 0 0 0 MISNEM. NY 021157 64 23731 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 346168
1#0##0#0#0.0#2022-01-03
13:05:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b621e4f6e3b54f55a59171001ff7612b 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 25/01/1965 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
214485 0 1 0 0 0 TATAG HESTI MARDIANTI,NY 071552
0000091016201 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346173 1#0##0#0#0.0#2022-01-03
13:22:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f2ec52291013fcf0e12f3b3184a1a7ce 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 27/10/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 UDIN ARJONO,BP 082584 51 18683 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346174
1#0##0#0#0.0#2022-01-03
13:23:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0b5af40b0145867ab5774a585cda2675 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 15/07/1979 0 1
0 0 - 0 - 0 - 0 - 0 181400 291375
0 1 0 0 0 SUHERMAN .TN 081258 42 15500 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346175
1#0##0#0#0.0#2022-01-03
13:24:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/12/2021 21/12/2021 22/01/2021 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 346176
1#0##0#0#0.0#2022-01-03
13:25:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/12/2021 21/12/2021 28/06/2011 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 346177
1#0##0#0#0.0#2022-01-03
13:26:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fe2b4abff636fbe75ec21e0fb4e8c41a 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 26/10/1979 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 346178
1#0##0#0#0.0#2022-01-03
13:27:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
88e6bb845c7031c7c19fc75c24dfd17a 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 12/01/2007 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 346180
1#0##0#0#0.0#2022-01-03
13:28:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/12/2021 21/12/2021 11/03/1975 0 1
0 0 - 0 - 0 - 0 - 0 181400 248470
0 1 0 0 0 SONHAJI KUSUMOATMOJO.TN 086116 46 17087
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346181
1#0##0#0#0.0#2022-01-03
13:28:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e7653ec0ce219adef9353a3fee6d024a 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 11/04/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 219996
0 1 0 0 0 NUGROHO AFRILIANTO, TN 059768 48 17786
yani;3302226402970001; 5.5.5.202112011542 4 346182
1#0##0#0#0.0#2022-01-03
13:29:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
82cd2ed5488d01b112f5543513298b2b 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 27/10/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 219996
0 1 0 0 0 TRI MULYANI . NY 062170 67 24527 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346183
1#0##0#0#0.0#2022-01-03
13:30:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b6220b2adc56533a5ad56dbcb7c8e207 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 26/10/2003 0 2
0 0 - 0 - 0 - 0 - 0 181400 219996
0 1 0 0 0 RAHMA NUR ELISA A, NN 064683 18 6631
yani;3302226402970001; 5.5.5.202112011542 4 346184
1#0##0#0#0.0#2022-01-03
13:30:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
54bb0921dc35fb329a90bf178c138260 150000 0 0 0 0 0
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3372030 C 3 CP 2 21/12/2021 21/12/2021 24/07/1968 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 346185
1#0##0#0#0.0#2022-01-03
13:31:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/12/2021 21/12/2021 09/03/1953 0 1
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3;JKN agung;3313092303950002; 5.6.6.202203301209 4 346186
1#0##0#0#0.0#2022-04-14
13:10:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 21/12/2021 21/12/2021 20/03/1971 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 346187
1#0##0#0#0.0#2022-01-03
13:35:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/12/2021 21/12/2021 04/05/2002 0 2
0 0 - 0 - 0 - 0 - 0 181400 196105
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346449 1#0##0#0#0.0#2022-01-03
13:39:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 21/12/2021 21/12/2021 27/06/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 123000 0 1 0 0 0 SRI MARGANI.NY
0000091413112 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345896 1#0##0#0#0.0#2022-01-03
13:40:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a1f219051190cf6b99fec97b16cd81d1 108000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 02/08/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SITI MAJIAH, NY
0000639393467 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345897 1#0##0#0#0.0#2022-01-03
13:41:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a05ca2a1970f3e126eef25d7ce9bb77c 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 18/04/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 213235
0 1 0 0 0 RAHMADI.TN 096843 53 19605 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 346188
1#0##0#0#0.0#2022-04-14
13:40:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
7ba5e716149f586ea978d7dbae0cde94 150000 0 0 0 0 0
0 0 0 0 15000 0 48235 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 20/03/1961 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI MIYATUN.NY
0000076431947 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
345870 1#0##0#0#0.0#2022-01-03
13:44:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
300882ec664c9c48987c32fa1332fac9 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 14/04/1960 0 2
0 - 0 107400 123000 0 1 0 0 0
1124R0021221V003784 0001084606863 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345921 1#0##0#0#0.0#2022-01-03
13:45:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3a88f41d200e8fbc3d1c7a9a2dd9e7b1 108000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 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; 5.5.5.202112011542 4
345919 1#0##0#0#0.0#2022-01-03
13:55:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a0af4042a580fab1a8897a36ef2de5f7 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
345898 1#0##0#0#0.0#2022-01-03
13:55:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eaf4795f8c6d1179787df003ed4c6471 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 02/09/1980 0 2
1 Z09.8;E11.4;G59.0 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 FITRIYANA
1124R0021221V003788 0001107034119 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345871 1#0##0#0#0.0#2022-01-03
13:58:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4aa9d25e95a7f1b886b083c6bcd24f94 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 18/12/1974 0 1
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 300820 0 1 0 0 0 UNTUNG GIRI RACHADI.TN
0002240839405 3;JKN novia;3313125201940001; 5.6.3.202201201500 4
346189 1#0##0#0#0.0#2022-03-08
08:03:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
e35a98a0596323efe82cb96cb44aa080 254000 0 0 0 0 0
0 0 0 0 15000 0 31820 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 06/06/1974 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
278795 0 1 0 0 0 UMI NAFIAH. NY 076253 47
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346190
1#0##0#0#0.0#2022-01-03
14:00:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
499cbbc8ca0b8436a1244b0106f053ad 203000 0 0 0 0 0
0 0 0 0 15000 0 60795 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 24/10/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 278795
0 1 0 0 0 RETNO PRADANINGRUM (NY) 028232 60 21973
yani;3302226402970001; 5.5.5.202112011542 4 346191
1#0##0#0#0.0#2022-01-03
14:01:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1bba460ac0ab13bd123afdfa1434192c 203000 0 0 0 0 0
0 0 0 0 15000 0 60795 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 07/09/1947 0 1
0 0 - 0 - 0 - 0 - 0 181400 278795
0 1 0 0 0 SLAMET RAHARDJO.TN 100684 74 27134
yani;3302226402970001; 5.5.5.202112011542 4 346192
1#0##0#0#0.0#2022-01-03
14:01:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c8d386a8443c578f0ce2b14796af94f8 203000 0 0 0 0 0
0 0 0 0 15000 0 60795 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 01/12/1981 0 2
None None None None INFEKSI VIRUS HIV 225100 0 0 - 0
- 0 - 0 - 0 225100 175000 0 1 0
0 0 SRI SUYATMI, NY 100760 40 14630 DR. TEKY WIDYARINI,
SP.PD 1124R0021221V003796 0001268489777 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346193 1#0##0#0#0.0#2022-01-03
14:02:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4f4557e34af178c205521a084d0909b6 150000 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 24/11/1980 0 2
0 0 - 0 - 0 - 0 - 0 181400 216550
0 1 0 0 0 TRI KUSRINI WULANJARI, (NY) 050366 41
0000639701583 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346196 1#0##0#0#0.0#2022-01-03
14:04:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
65254407227fbd53297b136d98440c99 150000 0 0 0 0 0
0 0 0 0 15000 0 51550 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 31/12/1955 0 2
0 0 - 0 - 0 - 0 - 0 549400 988898
0 1 0 0 0 SUMIRAH.NY 079983 65 24097 DR. GALIH
novia;3313125201940001; 5.5.5.202112011542 4 347313
1#0##0#0#0.0#2022-01-05
17:43:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dc64b95260b2f77242b1b6554e4627a0 300000 0 0 0 0 0
657000 0 0 0 15000 0 16898 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 31/01/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 337830
3;JKN novia;3313125201940001; 5.6.3.202201201500 4 346197
1#0##0#0#0.0#2022-02-15
14:25:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
328a80ce8ffb32e304ae6fa72031897f 300000 0 0 0 0 0
0 0 0 0 15000 0 22830 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 27/07/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 DJAMILAH.NY 091951 62 22793 DR. GALIH
yani;3302226402970001; 5.5.5.202112011542 4 346198
1#0##0#0#0.0#2022-01-03
14:06:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3255613784b28010836d2910356192c5 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 31/12/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 442365
0 1 0 0 0 SRI REJEKI 092215 72 26653 DR. GALIH
yani;3302226402970001; 5.5.5.202112011542 4 346199
1#0##0#0#0.0#2022-01-03
14:07:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ac40cee4c6a53b4587457e0b9bba292a 300000 0 0 0 0 0
0 0 0 0 15000 0 127365 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 09/05/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 417325
0 1 0 0 0 MUH ALWANI NGISOM, TN 064944 76 27985
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346200
1#0##0#0#0.0#2022-01-03
14:08:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4b3d563dd7b5a2c0308fdd44935a9eb2 300000 0 0 0 0 0
0 0 0 0 15000 0 102325 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 01/01/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 390661
0 1 0 0 0 TINI.NY 088948 61 22635 DR. GALIH
yani;3302226402970001; 5.5.5.202112011542 4 346201
1#0##0#0#0.0#2022-01-03
14:10:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
08f585d5afd2a6bbe706d03759df13fa 300000 0 0 0 0 0
0 0 0 0 15000 0 75661 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 30/06/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 384450
0 1 0 0 0 SUPARSIH, NY 091866 61 22454 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346202
1#0##0#0#0.0#2022-01-03
14:11:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8b7a5d3a0c339277b6734340ef17b652 300000 0 0 0 0 0
0 0 0 0 15000 0 69450 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 08/03/1947 0 1
0 0 - 0 - 0 - 0 - 0 181400 385795
0 1 0 0 0 SARONO PRIYO MARTONO, TN 089852 74
0002344726034 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346203 1#0##0#0#0.0#2022-01-03
14:13:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
80b656e2cb51fc1ec7425537881a75cd 300000 0 0 0 0 0
0 0 0 0 15000 0 70795 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 19/05/1972 0 1
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 YUDOWONO, TN 089522 49 18113 DR. ARIA CHANDRA
yani;3302226402970001; 5.5.5.202112011542 4 346457
1#0##0#0#0.0#2022-01-03
14:21:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8f5757fe9256072ca05ef9fbf2853c01 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 11/04/1965 0 1
0 - 0 - 0 - 0 786200 196995 0 1
SP.PD 1124R0021221V003807 0001732801498 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345990 1#0##0#0#0.0#2022-01-03
14:22:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
16d1f44368a70e9003de94acbe5a5f95 150000 0 0 0 0 0
0 0 0 0 15000 0 31995 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 02/09/1976 0 1
0 - 0 - 0 - 0 786200 538680 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345989
1#0##0#0#0.0#2022-01-03
14:23:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9efdb211278becaf439daa8eda6448d7 463830 0 0 0 0 0
0 0 0 0 15000 0 59850 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 25/03/1978 0 2
0 - 0 - 0 - 0 786200 677676 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345988
1#0##0#0#0.0#2022-01-03
14:24:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
23dddd0055fa60d3152f2223c079405f 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 23/12/1977 0 2
0 - 0 - 0 - 0 786200 677676 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345987
1#0##0#0#0.0#2022-01-03
14:25:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
514ee81bf735846725d4ff273a5b9fcd 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 01/09/1964 0 1
0 - 0 - 0 - 0 786200 822630 0 1
SP.PD 1124R0021221V003811 0000639614597 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345986 1#0##0#0#0.0#2022-01-03
14:30:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f6121e76a46f0ef36e67084cf24b1d1f 662676 0 0 0 0 0
0 0 0 0 15000 0 144954 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 13/12/1966 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V003812 0002051493849 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345985 1#0##0#0#0.0#2022-01-03
14:31:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0d9000c4888256bf7b55c9539171ae27 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 07/04/1948 0 1
0 - 0 - 0 - 0 786200 677676 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345983
1#0##0#0#0.0#2022-01-03
14:32:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
db04579774b73e3fe597785b51a316a0 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 10/12/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 257530
0 1 0 0 0 SUDJINO,(BP) 040675 69 25213 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346204
1#0##0#0#0.0#2022-01-03
14:32:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e73f8781cace69a7cc93180a9a9cd0a8 150000 0 0 0 0 0
0 0 0 0 15000 0 92530 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 28/07/2006 0 2
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 344217
0 1 0 0 0 EKA YULISUFIANTI MAKATEI.AN 089349 15
novia;3313125201940001; 5.6.3.202201201500 4 346205
1#0##0#0#0.0#2022-03-08
07:52:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
1afbbbc5586a2a0a50e57a0e3b6f12a9 295000 0 0 0 0 0
0 0 0 0 15000 0 34217 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 06/08/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 199830
0 1 0 0 0 DYAH ARUMSARI,(NY) 026631 51 18765
yani;3302226402970001; 5.5.5.202112011542 4 346206
1#0##0#0#0.0#2022-01-03
14:35:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
38daa2e96b2bc02f4b2b403d5f13b99f 150000 0 0 0 0 0
0 0 0 0 15000 0 34830 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 04/12/1959 0 2
0 - 0 107400 166000 0 1 0 0 0 YEN
YULIS, NY 096708 62 22663 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V003817 0000016389167 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345918 1#0##0#0#0.0#2022-01-03
14:38:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
57e872b6081acb9215642fc6e3d6fdd1 151000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 11/08/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 444842
0 1 0 0 0 PRAMANA, TN 006238 49 18029 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 346211
1#0##0#0#0.0#2022-04-14
11:40:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
f3ffdfd490872ab48ae7e4b02cba9756 150000 0 0 0 0 0
220000 0 0 0 15000 0 59842 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
345903 1#0##0#0#0.0#2022-01-03
14:40:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
85d09eb3cc891fd09fb4b5e09831a47f 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 14/04/1952 0 1
1 Z09.8;J44.9;J06.9;I11.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 426981
0 1 0 0 0 DAUD WIDODO DHARMA WIYOTO., BP 051387
69 25453 DR. ANITA MUNTAFIAH, SP.P., M.KES 1124R0021221V003821
0002064972677 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346207 1#0##0#0#0.0#2022-01-03
14:40:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2e811a7279b3cd89c4c171a84752d5d4 150000 0 0 0 0 0
0 0 0 0 15000 0 261981 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 13/11/2015 0 2
0 0 - 0 - 0 - 0 - 0 128800 225664
0 1 0 0 0 ALDA HERA ANGGRAENI, AN 100866 6 2230
DR. CHANDRA AYU 1124R0021221V003822 0001903138018 3;JKN
agung;3313092303950002; 5.6.6.202203301209 4 346694
1#0##0#0#0.0#2022-04-14
13:49:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
b8f5f974b1926a7a044d13db5ab67d0d 155000 0 0 0 0 0
0 0 0 0 25000 0 45664 0 0 0 0 0
3372030 C 3 CP 2 21/12/2021 21/12/2021 20/10/2014 0 1
1 Z04.9;R50.9;J03.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 121931
0 1 0 0 0 AFIF ZALDIAN RESTU, AN 061585 7 2619
agung;3313092303950002; 5.6.6.202203301209 4 346693
1#0##0#0#0.0#2022-04-14
12:54:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
18d0fe5c928dfe5a052bc302ac25889c 80000 0 0 0 0 0 0
0 0 0 15000 0 26931 0 0 0 0 0
3372030 C 3 CP 2 22/12/2021 22/12/2021 11/12/2015 0 1
0 0 - 0 - 0 - 0 - 0 181400 266639
0 1 0 0 0 MUHAMMAD FADLAN HAKIKI, AN 093192 6
0002344729476 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
346502 1#0##0#0#0.0#2022-01-03
16:06:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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2efc880bb30a4ae21e5ef97f2cd1b472 295000 0 0 0 0 0
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3372030 C 3 CP 2 22/12/2021 22/12/2021 07/09/2002 0 1
- 0 - 0 - 0 - 0 283800 315000 0
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novia;3313125201940001; 5.5.5.202112011542 4 346561
1#0##0#0#0.0#2022-01-04
08:49:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 22/12/2021 22/12/2021 10/12/1942 0 1
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novia;3313125201940001; 5.5.5.202112011542 4 346562
1#0##0#0#0.0#2022-01-04
08:50:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7b33cabcc13f6ad542def84f1a4f398e 203000 0 0 0 0 0
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3372030 C 3 CP 2 22/12/2021 22/12/2021 18/05/1974 0 2
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novia;3313125201940001; 5.5.5.202112011542 4 346563
1#0##0#0#0.0#2022-01-04
08:51:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f9b95e008abf91637beeaa140a67c2af 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/12/2021 22/12/2021 05/03/1949 0 1
1 Z09.8;Z96.1;H52.2;H04.1 90.29;95.01 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
247820 0 1 0 0 0 SUGENG PADMO HUDIYONO.TN 077469
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346565 1#0##0#0#0.0#2022-01-04
08:52:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
49f8ed64156ff49177352f2b13c22301 203000 0 0 0 0 0
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3372030 C 3 CP 2 22/12/2021 22/12/2021 16/02/1959 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARZUQI.TN 095738
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346318 1#0##0#0#0.0#2022-01-04
08:53:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b108d533ae216917841af62de52a74d8 258000 0 0 0 0 0
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3372030 C 3 CP 2 22/12/2021 22/12/2021 23/12/1981 0 1
0 0 - 0 - 0 - 0 - 0 181400 300792
0 1 0 0 0 EKO PUJIYANTO, TN 100780 39 14609 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346566
1#0##0#0#0.0#2022-01-04
08:54:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 22/12/2021 22/12/2021 07/09/1944 0 2
0 0 - 0 - 0 - 0 - 0 181400 278795
0 1 0 0 0 SUMINEM.NY 099812 77 28230 DR. YUDHI
novia;3313125201940001; 5.5.5.202112011542 4 346567
1#0##0#0#0.0#2022-01-04
08:55:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
112cc4a8c9c02c1bea3c1d3409d90039 203000 0 0 0 0 0
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3372030 C 3 CP 2 22/12/2021 22/12/2021 12/03/1955 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V003887 0000090535307 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346338 1#0##0#0#0.0#2022-01-04
08:55:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8ebcd797a0e8a031f42530e0291ed2e1 463830 0 0 0 0 0
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3372030 C 3 CP 2 22/12/2021 22/12/2021 03/12/1950 0 1
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SP.PD 1124R0021221V003888 0001870379559 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346347 1#0##0#0#0.0#2022-01-04
08:56:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6965e02a1ee70239e1b2043e3aeaba7e 463830 0 0 0 0 0
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3372030 C 3 CP 2 22/12/2021 22/12/2021 09/09/1944 0 1
0 - 0 - 0 - 0 786200 478830 0 1
1124R0021221V003889 0000100867893 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346346 1#0##0#0#0.0#2022-01-04
08:57:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e57b8fa0f0953e1d2b5d571d5ef9ddb8 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/12/2021 22/12/2021 18/07/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
1124R0021221V003890 0002425018184 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346345 1#0##0#0#0.0#2022-01-04
08:58:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
86fc219958359035ffff688dba0483d2 463830 0 0 0 0 0
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3372030 C 3 CP 2 22/12/2021 22/12/2021 14/05/1933 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 KOESWANTO BA.TN
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346321 1#0##0#0#0.0#2022-01-04
08:59:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 22/12/2021 22/12/2021 31/12/1981 0 2
0 - 0 - 0 - 0 786200 478830 0 1
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SP.PD 1124R0021221V003893 0001696977999 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346344 1#0##0#0#0.0#2022-01-04
09:00:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 22/12/2021 22/12/2021 22/02/1971 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 WIWIK SETYOWATI, NY 092361 50 18566 DR. ARYO
novia;3313125201940001; 5.5.5.202112011542 4 346343
1#0##0#0#0.0#2022-01-04
09:00:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2396b1fd856bfdff0ee3190c6bf19705 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/12/2021 22/12/2021 02/02/1972 0 2
0 - 0 - 0 - 0 786200 478830 0 1
0 0 0 MUSIYEM.NY 084045 49 18221 DR. ARYO SUSENO, SP.PD
1124R0021221V003895 0002070978546 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346342 1#0##0#0#0.0#2022-01-04
09:01:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8ef44b5e4eb27af6922899fe9149f922 463830 0 0 0 0 0
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3372030 C 3 CP 2 22/12/2021 22/12/2021 31/08/1962 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 219000 0 1 0 0 0 SRI HARTINA
1124R0021221V003896 0001958592576 3;JKN novia;3313125201940001;
5.6.3.202201201500 4 346319 1#0##0#0#0.0#2022-02-15
11:52:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 22/12/2021 22/12/2021 15/11/1951 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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346326 1#0##0#0#0.0#2022-01-04
09:04:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 22/12/2021 22/12/2021 14/03/1977 0 1
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5.5.5.202112011542 4 346574 1#0##0#0#0.0#2022-01-04
09:06:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 22/12/2021 22/12/2021 15/10/1964 0 1
0 - 0 - 0 - 0 786200 813276 0 1
0 0 0 SLAMET WIDODO, TN 088539 57 20887 DR. ARYO SUSENO,
SP.PD 1124R0021221V003899 0000091474266 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346339 1#0##0#0#0.0#2022-01-04
09:06:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
608181a3820840e8383132b592ebeca3 0 0 662676 0 0 0
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3372030 C 3 CP 2 22/12/2021 22/12/2021 31/08/2020 0 1
1 Z09.0;S60.1 93.57 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 308194 0 1
0 0 0 MUHAMMAD ZAYN D, AN 100528 1 478 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346575
1#0##0#0#0.0#2022-01-04
09:11:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
669433fe2c2c0d4b118bc506c363f908 150000 0 0 0 0 0
0 0 0 0 15000 0 143194 0 0 0 0 0
3372030 C 3 CP 2 22/12/2021 22/12/2021 30/06/1979 0 2
0 - 0 - 0 - 0 183900 263945 0 1
0 0 0 DIYAH YUNIANINGSIH, NY 071513 42 15516 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346576
1#0##0#0#0.0#2022-01-04
09:12:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e402694895dd8ce7651c88ab31b20e6e 235000 0 0 0 0 0
0 0 0 0 15000 0 13945 0 0 0 0 0
3372030 C 3 CP 2 22/12/2021 22/12/2021 13/02/2014 0 2
1 Z09.8;H20.9;H52.2 95.01;90.29 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 247820
novia;3313125201940001; 5.5.5.202112011542 4 346577
1#0##0#0#0.0#2022-01-04
09:13:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2a37510722111b45ecd9ba38313cdd4e 203000 0 0 0 0 0
0 0 0 0 15000 0 29820 0 0 0 0 0
3372030 C 3 CP 2 22/12/2021 22/12/2021 05/06/1975 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001272616569 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
346327 1#0##0#0#0.0#2022-01-04
09:15:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 22/12/2021 22/12/2021 17/03/1976 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000563317132 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
346334 1#0##0#0#0.0#2022-01-04
09:16:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
173352617a4569356be95a3bc389f857 258000 0 0 0 0 0
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3372030 C 3 CP 2 22/12/2021 22/12/2021 26/09/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0002611312075 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
346314 1#0##0#0#0.0#2022-01-04
09:17:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 22/12/2021 22/12/2021 04/11/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 247820
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novia;3313125201940001; 5.5.5.202112011542 4 346578
1#0##0#0#0.0#2022-01-04
09:20:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
635d6221ff26cd3c2fa6e53461b25d76 203000 0 0 0 0 0
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3372030 C 3 CP 2 22/12/2021 22/12/2021 27/08/2002 0 2
0 - 0 - 0 - 0 - 0 549400 845000
0 1 0 0 0 RISKA SULISTIYANI AGUSTIN.AN 047816 19
7057 DR. HERMAWAN, SP.B 1124R0021221V003908 0001298571603 3;JKN
novia;3313125201940001; 5.5.5.202112011542 4 347336
1#0##0#0#0.0#2022-01-05
17:47:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9054238fc2c4158e11f162c7d78b2038 150000 0 0 0 0 0
680000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/12/2021 22/12/2021 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
346313 1#0##0#0#0.0#2022-04-14
13:45:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 22/12/2021 22/12/2021 05/02/1943 0 2
1 Z09.8;H04.1;Z96.1 95.01 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 338472
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novia;3313125201940001; 5.5.5.202112011542 4 346579
1#0##0#0#0.0#2022-01-04
09:21:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
429c68afca84463e8cc048742acb5af6 203000 0 0 0 0 0
0 0 0 0 15000 0 120472 0 0 0 0 0
3372030 C 3 CP 2 22/12/2021 22/12/2021 20/10/2014 0 1
0 - 0 - 0 - 0 - 0 182600 370698
0 1 0 0 0 AFIF ZALDIAN RESTU, AN 061585 7 2620
0001475841317 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
346580 1#0##0#0#0.0#2022-01-04
09:24:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bf80bd4be1192f13ce585693fe2d89b6 300000 0 0 0 0 0
0 0 0 0 15000 0 55698 0 0 0 0 0
3372030 C 3 CP 2 22/12/2021 22/12/2021 26/03/2019 0 1
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0 1 0 0 0 RIFQI FAIZ MAULANA, AN 075843 2 1002
0002756016718 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
346581 1#0##0#0#0.0#2022-01-04
09:25:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
698e60a1bdcb5ec9365923dd8ffc9390 150000 0 0 0 0 0
0 0 0 0 15000 0 45774 0 0 0 0 0
3372030 C 3 CP 2 22/12/2021 22/12/2021 01/10/1976 0 1
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 YUSRONI, TN 048167 45 16518 DRG. VERAWATY, SP.KG
1124R0021221V003923 0001104489819 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346582 1#0##0#0#0.0#2022-01-04
09:25:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8c5674003e7fd0e1042398997c433854 300000 0 0 0 0 0
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3372030 C 3 CP 2 22/12/2021 22/12/2021 07/03/1986 0 1
0 - 0 - 0 - 0 - 0 254400 437030
0 1 0 0 0 WASIS NUGROHO, TN 064449 35 13074 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 346583
1#0##0#0#0.0#2022-01-04
09:26:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7623fae0ff2bfd7d089ad15e27d108f6 400000 0 0 0 0 0
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3372030 C 3 CP 2 22/12/2021 22/12/2021 04/01/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SIH JAMI RAHAYU,
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346312 1#0##0#0#0.0#2022-01-04
09:27:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 22/12/2021 22/12/2021 31/05/1975 0 2
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 RINA SULISTYANINGSIH.NY 100582 46 17007 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 346584
1#0##0#0#0.0#2022-01-04
09:27:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6353e518066cd267917326d6adbcda38 300000 0 0 0 0 0
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3372030 C 3 CP 2 22/12/2021 22/12/2021 16/01/1984 0 2
- 0 - 0 - 0 - 0 182600 165000 0
1 0 0 0 RATNA DEWI. NY 088178 37 13855 DR. RINA
5.5.5.202112011542 4 346585 1#0##0#0#0.0#2022-01-04
09:30:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bdfd2a87ede1a28c07e4544c64360654 150000 0 0 0 0 0
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3372030 C 3 CP 2 22/12/2021 22/12/2021 31/07/1988 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 YULI HARTANTO,(BP) 022798 33 12197 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 346586
1#0##0#0#0.0#2022-01-04
09:32:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b30019a9156f31a22233355668332301 300000 0 0 0 0 0
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3372030 C 3 CP 2 22/12/2021 22/12/2021 02/09/2000 0 2
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.5.5.202112011542 4 346587
1#0##0#0#0.0#2022-01-04
09:32:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
028674a72b896abf5ac77d696b1b7933 300000 0 0 0 0 0
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3372030 C 3 CP 2 22/12/2021 22/12/2021 20/11/1970 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 NGADI.TN 042183 51 18660 DRG. VERAWATY,
SP.KG 1124R0021221V003934 0001160604933 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346588 1#0##0#0#0.0#2022-01-04
09:33:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c07c1b283d6322622ad301d0b279f4b6 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 22/12/2021 22/12/2021 06/11/1975 0 2
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.5.5.202112011542 4 346589
1#0##0#0#0.0#2022-01-04
09:34:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b62f92d28f63e577a5c7bf7680f7ab8b 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 31/12/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 309912
0 1 0 0 0 SUWARNI (NY) 031962 72 26655 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347879
1#0##0#0#0.0#2022-01-07
14:29:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d06f64212180037fff9a5c7febcc77ba 150000 0 0 0 0 0
0 0 0 0 15000 0 144912 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 20/12/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 407175
0 1 0 0 0 KASIH ANGGRAENI, NY 093093 61 22283
yani;3302226402970001; 5.6.0.202201041418 4 347880
1#0##0#0#0.0#2022-01-07
14:30:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c9ce477be4c917800974ce5e7ab871f7 150000 0 0 0 0 0
0 31845 0 0 15000 0 210330 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 31/12/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 342722
0 1 0 0 0 KAMINO HADI., TN 059514 60 22272 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347881
1#0##0#0#0.0#2022-01-07
14:31:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
aba224b8ca1032b7e22573d484a7f106 0 0 138000 0 0 0
0 107890 0 0 15000 0 81832 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 31/12/1965 0 2
1 Z09.8;E11.9;I10;A09.9;M19.98 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
215152 0 1 0 0 0 YATMI ., NY 058574 55 20446
yani;3302226402970001; 5.6.0.202201041418 4 347882
1#0##0#0#0.0#2022-01-07
14:32:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7eb32a5f1a3024bbdda7b2a8cd5a75ff 0 0 138000 0 0 0
0 0 0 0 15000 0 62152 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 25/02/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 207574
0 1 0 0 0 WIJI SUHARIYATI, NY 085933 53 19660
yani;3302226402970001; 5.6.0.202201041418 4 347883
1#0##0#0#0.0#2022-01-07
14:33:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
565346693a472df478e0c77e03c355c9 150000 0 0 0 0 0
0 0 0 0 15000 0 42574 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 18/06/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 533805
0 1 0 0 0 SUKEMI., TN 040678 59 21738 DR. ARYO
novia;3313125201940001; 5.6.3.202201201500 4 347884
1#0##0#0#0.0#2022-03-08
08:52:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
790c9afd6fe447708fac8de94cd5ec81 0 0 138000 0 0 0
0 31845 0 0 15000 0 348960 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 16/02/1984 0 2
0 - 0 - 0 - 0 - 0 296400 175150
0 1 0 0 0 EKO SRI MULYANI, (NY) 016960 37 13825
novia;3313125201940001; 5.6.3.202201201500 4 347885
1#0##0#0#0.0#2022-03-08
12:09:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
ac4ae071047f358aedc08fea3569a8b7 150000 0 0 0 0 0
0 0 0 0 15000 0 10150 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 04/06/1962 0 1
0 0 - 0 - 0 - 0 - 0 181400 375441
0 1 0 0 0 HENDI SUHENDRA. TN 087859 59 21752
yani;3302226402970001; 5.6.0.202201041418 4 347886
1#0##0#0#0.0#2022-01-07
14:39:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
125c6339cef811c0f3404d040b163a89 150000 0 0 0 0 0
0 88900 0 0 15000 0 121541 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 31/12/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 435795
0 1 0 0 0 RUKIYAH, NY 090039 59 21907 DR. GALIH
novia;3313125201940001; 5.6.3.202201201500 4 347887
1#0##0#0#0.0#2022-02-15
14:26:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
b96c93059c0cb299ddeef20b9e236097 300000 0 0 0 0 0
0 120795 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 09/10/1960 0 2
1 Z09.8;E78.5;N18.9;M19.98 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
223860 0 1 0 0 0 HARIYANI, NY 075153 61
yani;3302226402970001; 5.6.0.202201041418 4 347888
1#0##0#0#0.0#2022-01-07
14:41:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
88c73d6030f72a0a85405340b91e4ce9 150000 0 0 0 0 0
0 0 0 0 15000 0 58860 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 21/11/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 191022
0 1 0 0 0 SRI UTAMI, NY 070322 61 22312 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347889
1#0##0#0#0.0#2022-01-07
14:41:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
03243e6840d5eb923ba96aed61837811 0 0 138000 0 0 0
0 0 0 0 15000 0 38022 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 18/05/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 337720
0 1 0 0 0 SAJADI,(BP) 039260 63 23230 DR. ARYO
yani;3302226402970001; 5.6.0.202201041418 4 347890
1#0##0#0#0.0#2022-01-07
14:43:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4d91220cefdc8b2ffb571de800babf28 150000 0 0 0 0 0
0 63690 0 0 15000 0 109030 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 01/02/1946 0 1
0 0 - 0 - 0 - 0 - 0 181400 383055
0 1 0 0 0 RACHMAD, (BP) 003994 75 27719 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347891
1#0##0#0#0.0#2022-01-07
14:44:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a5a395b297f1d310c3afbe59589506e7 150000 0 0 0 0 0
0 76595 0 0 15000 0 141460 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 28/01/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 424140
0 1 0 0 0 RISTIYANTO,TN 029882 62 22975 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347892
1#0##0#0#0.0#2022-01-07
14:45:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7a2849cfe48c1b6da9eb9d01f3c2f469 300000 0 0 0 0 0
0 0 0 0 15000 0 109140 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 05/09/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 234622
0 1 0 0 0 SUPARMI., NY 050493 55 20198 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347893
1#0##0#0#0.0#2022-01-07
14:48:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
640a1c9c330fc96d5d70443a8b68dd69 150000 0 0 0 0 0
0 0 0 0 15000 0 69622 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 15/06/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 260555
0 1 0 0 0 SAIMI MULYODIHARJO, NY 064553 72 26489
yani;3302226402970001; 5.6.0.202201041418 4 347894
1#0##0#0#0.0#2022-01-07
14:52:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5623e251019bf9532dd4fa632a6b7435 203000 0 0 0 0 0
0 0 0 0 15000 0 42555 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 10/04/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 492890
0 1 0 0 0 SRI SULARSIH., NY 052061 66 24364 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347895
1#0##0#0#0.0#2022-01-07
14:54:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
469c123b5e70b5051788f750509d1a1a 150000 0 0 0 0 0
0 0 0 0 15000 0 327890 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 01/08/1981 0 1
0 0 - 0 - 0 - 0 - 0 181400 203822
0 1 0 0 0 AGUS RIYANTO.SDR 079932 40 14754 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347896
1#0##0#0#0.0#2022-01-07
14:59:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e65dd244c783a6da62090bd854a24fc6 150000 0 0 0 0 0
0 0 0 0 15000 0 38822 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 15/05/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 378518
0 1 0 0 0 YAHMINI ., NY 055426 63 23233 DR.
novia;3313125201940001; 5.6.3.202201201500 4 347897
1#0##0#0#0.0#2022-03-08
08:26:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
7e4cee66f08e88dfa93a8639815a6864 0 0 138000 0 0 0
0 44900 0 0 15000 0 180618 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 14/02/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 356973
0 1 0 0 0 WALINI., NY 047579 70 25880 DR. TEKY
yani;3302226402970001; 5.6.0.202201041418 4 347898
1#0##0#0#0.0#2022-01-07
15:01:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
28b8fb529f3f7b794405ba0c97b22530 150000 0 0 0 0 0
0 107890 0 0 15000 0 84083 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 24/12/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 212290
0 1 0 0 0 SRI SUTANTI, NY 090727 61 22645 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347899
1#0##0#0#0.0#2022-01-07
15:02:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2b077493a97fa6f9461159c01bf3501b 150000 0 0 0 0 0
0 0 0 0 15000 0 47290 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 03/01/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 283818
0 1 0 0 0 SUGILAH.NY 085281 45 16791 DR. WAHYU
yani;3302226402970001; 5.6.0.202201041418 4 347900
1#0##0#0#0.0#2022-01-07
15:07:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ebac8badc2a40b2f1b9f586d3d0983fd 150000 0 0 0 0 0
0 58796 0 0 15000 0 60022 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 15/08/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 195662
0 1 0 0 0 SARYATI 080422 67 24602 DR. TEKY
yani;3302226402970001; 5.6.0.202201041418 4 347901
1#0##0#0#0.0#2022-01-07
15:08:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b794def11b35ead116f85efdd087decc 150000 0 0 0 0 0
0 0 0 0 15000 0 30662 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 24/03/1951 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
304486 0 1 0 0 0 SUGIYONO ., TN 057327 70
3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347902
1#0##0#0#0.0#2022-01-07
15:09:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a604745e3724853c50ac1656855b53d3 150000 0 0 0 0 0
0 31845 0 0 15000 0 107641 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 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 254500
0 1 0 0 0 SUTARKA BP 084552 79 28999 DR. TEKY
yani;3302226402970001; 5.6.0.202201041418 4 347903
1#0##0#0#0.0#2022-01-07
15:10:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
12714a723dc9238cf6b630eb4edf6aae 150000 0 0 0 0 0
0 89500 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 16/07/1955 0 2
1 Z09.8;I12.0;E11.9;E79.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 369985
0 1 0 0 0 SUWIJI, NY 066854 66 24267 DR. ARYO
yani;3302226402970001; 5.6.0.202201041418 4 347904
1#0##0#0#0.0#2022-01-07
15:11:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b28f18f19da63b8e43b78920bd59e231 150000 0 0 0 0 0
0 121345 0 0 15000 0 83640 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 25/06/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 268742
0 1 0 0 0 DARNI WIDAYATI 092677 59 21731 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347905
1#0##0#0#0.0#2022-01-07
15:12:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dc28843135f4389315a6a277ac5878eb 150000 0 0 0 0 0
0 0 0 0 15000 0 103742 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 13/10/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 433551
0 1 0 0 0 TITIK LAKSITORINI, NY 093738 59 21621
novia;3313125201940001; 5.6.3.202201201500 4 347906
1#0##0#0#0.0#2022-03-08
08:22:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
9d57b2ef8787142ccab43813c8f75124 150000 0 0 0 0 0
0 63690 0 0 15000 0 204861 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 16/06/1961 0 2
1 Z09.8;S42.00;M14.6 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 215512
0 1 0 0 0 WIDIYASTUTI, NY 090543 60 22105 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347907
1#0##0#0#0.0#2022-01-07
15:13:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3f4a901af53a5b3ffdbbdd7a28462aa7 150000 0 0 0 0 0
0 0 0 0 15000 0 50512 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 17/07/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 258000
0 1 0 0 0 RIANI PRASETYANINGSIH,NY 078796 60
novia;3313125201940001; 5.6.3.202201201500 4 347908
1#0##0#0#0.0#2022-03-08
08:28:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
4c104b765616dbef8301d752988b029e 150000 0 0 0 0 0
0 0 0 0 15000 0 93000 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 20/04/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 RUSTAMADI, TN 059696 57 21066 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347909
1#0##0#0#0.0#2022-01-07
15:15:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
29db94eb9d290d273dbbe8f3b69ec873 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 12/02/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 708158
0 1 0 0 0 SUNARTI,(NY) 015594 56 20768 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347910
1#0##0#0#0.0#2022-01-07
15:16:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
15169313f764c0781a73e36cd34e5987 150000 0 0 0 0 0
0 0 0 0 15000 0 543158 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 16/01/1981 0 2
0 0 - 0 - 0 - 0 - 0 181400 227676
0 1 0 0 0 RINI PURWATININGSIH,(NY) 036555 40
3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347911
1#0##0#0#0.0#2022-01-07
15:16:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
326d1cc19452251c0eb38c103fb399a4 150000 0 0 0 0 0
0 0 0 0 15000 0 62676 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 18/08/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 239695
0 1 0 0 0 SULASTRI ., NY 000245 64 23503 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347912
1#0##0#0#0.0#2022-01-07
15:17:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
11caccefb1ec878eb217a1b651d7bd9f 150000 0 0 0 0 0
0 31845 0 0 15000 0 42850 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 07/01/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 265357
0 1 0 0 0 DALIYO,(BP) 003111 66 24457 DR. SUHARTO,
SP.PD 1124R0021221V003979 0000202283133 3;JKN yani;3302226402970001;
5.6.0.202201041418 4 347913 1#0##0#0#0.0#2022-01-07
15:18:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
333b307f0c792da835cfd4da13205e4b 150000 0 0 0 0 0
0 31845 0 0 15000 0 68512 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 27/11/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 338769
0 1 0 0 0 SARWATI.,NY 073091 66 24133 DR. TEKY
yani;3302226402970001; 5.6.0.202201041418 4 347914
1#0##0#0#0.0#2022-01-07
15:19:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
924081f0be0a1ee9ebc1fbd8432f2123 150000 0 0 0 0 0
0 31845 0 0 15000 0 141924 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 21/04/1961 0 2
1 K30 88.79 - - None None None None Z-3-23-0 None None
- 0 - 0 - 0 - 0 549400 177372 0
1 0 0 0 RINI WULANTRI,(NY) 026210 60 22161 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347337
1#0##0#0#0.0#2022-01-05
17:53:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1e63b509605d652951f31e25f35c63f2 150000 0 0 0 0 0
0 0 0 0 15000 0 12372 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 03/08/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 220492
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 347915
1#0##0#0#0.0#2022-04-14
13:43:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
d3e21bda114885a4ec0362b62590ab1b 150000 0 0 0 0 0
0 0 0 0 15000 0 55492 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 03/09/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 216344
0 1 0 0 0 WAGIYAH ., NY 059289 58 21296 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347338
1#0##0#0#0.0#2022-01-05
17:54:56#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#2022-01-07
14:50:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.6.0.202201041418 4 347917
1#0##0#0#0.0#2022-01-07
14:51:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.6.0.202201041418 4 347918
1#0##0#0#0.0#2022-01-07
14:52:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.6.0.202201041418 4 347919
1#0##0#0#0.0#2022-01-07
14:55:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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17:55:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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14:58:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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14:59:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 07/03/1965 0 2
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LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
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agung;3313092303950002; 5.6.0.202201041418 4 347922
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15:00:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.6.0.202201041418 4 347923
1#0##0#0#0.0#2022-01-07
15:18:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.6.0.202201041418 4 347925
1#0##0#0#0.0#2022-01-07
15:20:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 15/07/1971 0 2
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agung;3313092303950002; 5.6.0.202201041418 4 347926
1#0##0#0#0.0#2022-01-07
15:21:20#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#2022-01-07
15:22:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.6.0.202201041418 4 347928
1#0##0#0#0.0#2022-01-07
15:23:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 14/09/1977 0 1
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agung;3313092303950002; 5.6.0.202201041418 4 347929
1#0##0#0#0.0#2022-01-07
15:24:18#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#2022-03-08
12:09:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 23/12/2021 23/12/2021 15/07/1949 0 2
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LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
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agung;3313092303950002; 5.6.0.202201041418 4 347931
1#0##0#0#0.0#2022-01-07
15:26:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.6.0.202201041418 4 347932
1#0##0#0#0.0#2022-01-07
15:27:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 09/09/1940 0 1
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agung;3313092303950002; 5.6.0.202201041418 4 347933
1#0##0#0#0.0#2022-01-07
15:28:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 29/09/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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13:30:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 10/05/1962 0 2
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agung;3313092303950002; 5.6.0.202201041418 4 347934
1#0##0#0#0.0#2022-01-07
15:28:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 20/02/1968 0 1
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agung;3313092303950002; 5.6.0.202201041418 4 347935
1#0##0#0#0.0#2022-01-07
15:29:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 17/07/1962 0 2
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agung;3313092303950002; 5.6.0.202201041418 4 347936
1#0##0#0#0.0#2022-01-07
15:30:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 13/09/1973 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
150000 0 1 0 0 0 YANTINI, NY 079163 48 17633
agung;3313092303950002; 5.6.0.202201041418 4 348087
1#0##0#0#0.0#2022-01-07
15:32:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 31/12/1965 0 2
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agung;3313092303950002; 5.6.0.202201041418 4 347938
1#0##0#0#0.0#2022-01-07
15:32:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 31/10/1955 0 1
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agung;3313092303950002; 5.6.0.202201041418 4 347939
1#0##0#0#0.0#2022-01-07
15:38:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 05/05/1962 0 1
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LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
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agung;3313092303950002; 5.6.6.202203301209 4 347940
1#0##0#0#0.0#2022-04-14
13:16:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 23/12/2021 23/12/2021 27/10/1958 0 1
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3;JKN agung;3313092303950002; 5.6.0.202201041418 4 347941
1#0##0#0#0.0#2022-01-07
15:40:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.6.0.202201041418 4 347942
1#0##0#0#0.0#2022-01-07
15:41:03#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#2022-01-07
15:41:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 15/04/1959 0 2
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novia;3313125201940001; 5.6.3.202201201500 4 347945
1#0##0#0#0.0#2022-03-08
08:44:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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agung;3313092303950002; 5.6.0.202201041418 4 347946
1#0##0#0#0.0#2022-01-07
15:43:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.6.0.202201041418 4 347947
1#0##0#0#0.0#2022-01-07
15:43:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 31/12/1949 0 1
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15:44:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.6.0.202201041418 4 347949
1#0##0#0#0.0#2022-01-07
15:45:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.6.0.202201041418 4 347950
1#0##0#0#0.0#2022-01-07
15:46:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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17:56:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 12/11/1963 0 1
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agung;3313092303950002; 5.6.6.202203301209 4 347951
1#0##0#0#0.0#2022-04-14
13:29:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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13:33:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 1 0 0 0 LIANA AYU DEWANTRI 098441 20 7535
agung;3313092303950002; 5.6.0.202201041418 4 347952
1#0##0#0#0.0#2022-01-07
15:47:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 25/10/1967 0 1
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3;JKN agung;3313092303950002; 5.6.0.202201041418 4 347953
1#0##0#0#0.0#2022-01-07
15:48:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 14/05/1960 0 2
1 Z09.8;E11.2;N08.3;I11.9;G59.0 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
258060 0 1 0 0 0 SUPARNI, NY 098436 61 22503
agung;3313092303950002; 5.6.0.202201041418 4 347954
1#0##0#0#0.0#2022-01-07
15:49:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 23/03/1948 0 2
1 Z09.8;E11.4;G59.0;E79.0;I11.9 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
552763 0 1 0 0 0 SRI SUTANTI. NY 084749 73
3;JKN agung;3313092303950002; 5.6.0.202201041418 4 347955
1#0##0#0#0.0#2022-01-07
15:50:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 31/12/1949 0 2
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agung;3313092303950002; 5.6.0.202201041418 4 347956
1#0##0#0#0.0#2022-01-07
15:51:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 01/05/1956 0 1
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0 1 0 0 0 DJOKO SUSILO.TN 085790 65 23977 DR.
agung;3313092303950002; 5.6.0.202201041418 4 347957
1#0##0#0#0.0#2022-01-07
15:52:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 12/06/1979 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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347831 1#0##0#0#0.0#2022-01-07
13:31:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 04/01/1969 0 2
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0 1 0 0 0 SARMINI., NY 049543 52 19346 DR.
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1#0##0#0#0.0#2022-01-07
15:52:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 03/07/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 LUCIA SRI
1124R0021221V004039 0000639909854 3;JKN yani;3302226402970001;
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13:47:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 20/10/1971 0 2
1 I10;K30 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 346851
0 1 0 0 0 RITA SETYANINGSIH.NY 100773 50 18327
agung;3313092303950002; 5.6.0.202201041418 4 347959
1#0##0#0#0.0#2022-01-07
15:53:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 28/06/2017 0 2
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agung;3313092303950002; 5.6.0.202201041418 4 347960
1#0##0#0#0.0#2022-01-07
15:54:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d91a902c664ef208e975a171ebdf37b1 150000 0 0 0 0 0
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3372030 C 3 CP 2 23/12/2021 23/12/2021 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 yani;3302226402970001; 5.6.0.202201041418 4
347833 1#0##0#0#0.0#2022-01-07
13:35:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 01/07/1951 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 WARSINAH
SUMARWANI, NY 092218 70 25743 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V004043 0000087200616 3;JKN yani;3302226402970001;
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13:36:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 10/07/1947 0 2
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agung;3313092303950002; 5.6.0.202201041418 4 347961
1#0##0#0#0.0#2022-01-07
15:54:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 29/12/1963 0 2
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agung;3313092303950002; 5.6.0.202201041418 4 347962
1#0##0#0#0.0#2022-01-07
15:55:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 12/08/1942 0 1
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0 1 0 0 0 SUPARDI, TN 046047 79 28988 DR.
agung;3313092303950002; 5.6.0.202201041418 4 347963
1#0##0#0#0.0#2022-01-07
15:56:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 23/07/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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347839 1#0##0#0#0.0#2022-01-07
13:44:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 07/06/1963 0 2
1 Z09.8;E78.5;R51 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 194770
agung;3313092303950002; 5.6.0.202201041418 4 347964
1#0##0#0#0.0#2022-01-07
15:57:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 13/08/1957 0 2
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agung;3313092303950002; 5.6.0.202201041418 4 347966
1#0##0#0#0.0#2022-01-07
15:58:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 28/02/1955 0 1
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0 1 0 0 0 TARWOKO.TN 088292 66 24405 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 347341
1#0##0#0#0.0#2022-01-05
17:57:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a5a5f4c9a5d88af217728eb1665cb67a 150000 0 0 0 0 0
160000 0 0 0 15000 0 44762 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 31/12/1965 0 2
1 E11.4;G59.0;E11.9;N20.0;N30.9 88.76 - - None None None None
549400 0 0 - 0 - 0 - 0 - 0 549400
898595 0 1 0 0 0 SUKINI, NY 071782 55 20446
novia;3313125201940001; 5.5.5.202112011542 4 347342
1#0##0#0#0.0#2022-01-05
17:58:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
535cc605eb941a9355ed091979821994 150000 0 0 0 0 0
657000 76595 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 08/12/1976 0 2
None None None None None FRAKTUR 129600 0 0 - 0
- 0 - 0 - 0 129600 443022 0 1 0
0 0 NIKEN MARDUSASI, NY 068192 45 16451 DR. WAHYU PURNOMO,
SP.OT 1124R0021221V004054 0002165494217 3;JKN agung;3313092303950002;
5.6.0.202201041418 4 348103 1#0##0#0#0.0#2022-01-07
18:39:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0bb2fe3586b771da08ca74e086814a8c 150000 0 0 0 0 0
233000 0 0 0 15000 0 45022 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 08/04/1933 0 2
0 0 - 0 - 0 - 0 - 0 181400 204894
0 1 0 0 0 SUDARTI.NY 100772 88 32401 DR. WAHYU
agung;3313092303950002; 5.6.7.202204241238 4 348439
1#0##0#0#0.0#2022-05-24
09:38:20#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 01/12/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 492031
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agung;3313092303950002; 5.6.0.202201041418 4 347967
1#0##0#0#0.0#2022-01-07
15:59:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 12/06/1964 0 1
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0 1 0 0 0 SUTIKNO. TN 076149 57 21013 DR. RINA
DIANA,SP.DV 1124R0021221V004057 0002166939088 3;JKN agung;3313092303950002;
5.6.0.202201041418 4 347968 1#0##0#0#0.0#2022-01-07
16:00:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0febd11df4c22457c0251d2b462189bc 150000 0 0 0 0 0
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3372030 C 3 CP 2 23/12/2021 23/12/2021 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; 5.6.0.202201041418 4
347840 1#0##0#0#0.0#2022-01-07
13:45:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 25/05/1986 0 1
0 0 - 0 - 0 - 0 - 0 181400 199335
novia;3313125201940001; 5.6.3.202201201500 4 347969
1#0##0#0#0.0#2022-03-08
11:46:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
334eb2fb441eeb06f41b5e65899f73f8 150000 0 0 0 0 0
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3372030 C 3 CP 2 23/12/2021 23/12/2021 13/08/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 286030
0 1 0 0 0 SUYATNO.TN 084110 61 22412 DR. TEKY
agung;3313092303950002; 5.6.0.202201041418 4 347970
1#0##0#0#0.0#2022-01-07
16:02:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8533cb34bbf1738dfaca154b807026f3 150000 0 0 0 0 0
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3372030 C 3 CP 2 23/12/2021 23/12/2021 07/10/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 220540
0 1 0 0 0 ZUHROH TUNNISA, HJ,(NY) 050322 73 26740
agung;3313092303950002; 5.6.0.202201041418 4 347971
1#0##0#0#0.0#2022-01-07
16:03:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5ee05431754ee98b240efeb8d95fd855 150000 0 0 0 0 0
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3372030 C 3 CP 2 23/12/2021 23/12/2021 31/12/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 174367
0 1 0 0 0 PARYATUN, NY 051446 69 25560 DR.
agung;3313092303950002; 5.6.0.202201041418 4 347972
1#0##0#0#0.0#2022-01-07
16:04:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 22/04/1986 0 1
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agung;3313092303950002; 5.6.0.202201041418 4 347973
1#0##0#0#0.0#2022-01-07
16:04:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 13/08/1958 0 2
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agung;3313092303950002; 5.6.0.202201041418 4 347974
1#0##0#0#0.0#2022-01-07
16:05:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 15/11/1941 0 1
0 0 - 0 - 0 - 0 - 0 181400 195022
0 1 0 0 0 DARUSLAN.,BP 072692 80 29258 DR.
agung;3313092303950002; 5.6.0.202201041418 4 347975
1#0##0#0#0.0#2022-01-07
16:06:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 07/05/1975 0 2
0 0 - 0 - 0 - 0 - 0 181400 284909
0 1 0 0 0 ENDANG SUPRIYATI, NY 097965 46 17032
agung;3313092303950002; 5.6.0.202201041418 4 347976
1#0##0#0#0.0#2022-01-07
16:06:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
84763cc20677f015c1299dacb8016e06 150000 0 0 0 0 0
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3372030 C 3 CP 2 23/12/2021 23/12/2021 07/06/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 150000
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agung;3313092303950002; 5.6.0.202201041418 4 348094
1#0##0#0#0.0#2022-01-07
16:08:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 23/11/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 192818
0 1 0 0 0 SITI SYAMSIAH.,NY 072691 64 23406 DR.
agung;3313092303950002; 5.6.0.202201041418 4 347978
1#0##0#0#0.0#2022-01-07
16:08:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 31/12/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0001967417043 3;JKN yani;3302226402970001; 5.6.0.202201041418 4
347841 1#0##0#0#0.0#2022-01-07
13:46:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 03/12/1960 0 1
1 Z09.8;E78.5;K30 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 194970
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agung;3313092303950002; 5.6.0.202201041418 4 347979
1#0##0#0#0.0#2022-01-07
16:09:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 19/12/1949 0 1
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LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
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agung;3313092303950002; 5.6.0.202201041418 4 347980
1#0##0#0#0.0#2022-01-07
16:11:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 18/01/1955 0 2
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1#0##0#0#0.0#2022-01-07
16:11:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 05/01/1968 0 1
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1#0##0#0#0.0#2022-01-07
16:12:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 23/05/1957 0 2
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16:13:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 12/07/1965 0 2
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16:13:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 26/09/1959 0 2
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1#0##0#0#0.0#2022-01-07
16:14:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 09/03/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ARIEF BUDI
1124R0021221V004081 0002166940282 3;JKN yani;3302226402970001;
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13:48:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 26/10/1986 0 1
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0 1 0 0 0 KADEK SUDIATMIKA,(BP) 032264 35 12842
3;JKN agung;3313092303950002; 5.6.0.202201041418 4 347986
1#0##0#0#0.0#2022-01-07
16:14:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 02/10/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ASRI LISTYARINI.NY
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14:00:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 06/07/1954 0 2
1 Z09.8;M25.58;M54.59;I10 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 190585
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16:15:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 10/06/1972 0 2
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RAHAYU.NY 094636 49 18093 DR. LINDA SUGIARTO, SP.FKR
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14:18:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 05/06/1961 0 2
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MARSIATUN, NY 085335 60 22116 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V004086 0002311256204 3;JKN yani;3302226402970001;
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13:29:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 21/10/1960 0 2
1 Z09.8;K27.9;N28.1 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 248705
0 1 0 0 0 SRI SUJIANI,(NY) 023036 61 22343 DR.
novia;3313125201940001; 5.6.0.202201041418 4 347813
1#0##0#0#0.0#2022-01-06
16:22:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 17/03/1963 0 2
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13:24:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 15/04/1973 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 TATAS BUDIONO.TN
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347837 1#0##0#0#0.0#2022-01-07
13:42:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 04/02/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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347856 1#0##0#0#0.0#2022-01-07
14:24:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 28/12/1949 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0001848729036 3;JKN yani;3302226402970001; 5.6.0.202201041418 4
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14:21:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 19/09/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 227697
0 1 0 0 0 MARIA SEPTIVICA SRI ROESTINAH, NY 060658
3;JKN agung;3313092303950002; 5.6.0.202201041418 4 347989
1#0##0#0#0.0#2022-01-07
16:22:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 19/08/1977 0 2
0 404900 165000 0 1 0 0 0 NY., SUMIATI
0001108034537 3;JKN agung;3313092303950002; 5.6.0.202201041418 4
347990 1#0##0#0#0.0#2022-01-07
16:24:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 30/01/1966 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 WAHYUNI.NY 082555
0000639464488 3;JKN yani;3302226402970001; 5.6.0.202201041418 4
347829 1#0##0#0#0.0#2022-01-07
13:30:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 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 yani;3302226402970001; 5.6.0.202201041418 4
347838 1#0##0#0#0.0#2022-01-07
13:43:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 11/04/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 223567
0 1 0 0 0 SRI SURIPNI.NY 100421 67 24728 DR.
agung;3313092303950002; 5.6.0.202201041418 4 347991
1#0##0#0#0.0#2022-01-07
16:24:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 01/09/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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1124R0021221V004098 0000091422044 3;JKN yani;3302226402970001;
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14:16:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 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; 5.6.0.202201041418 4
347846 1#0##0#0#0.0#2022-01-07
14:00:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 01/03/1981 0 1
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0 1 0 0 0 SIGIT MARIYADI, TN 100053 40 14907
novia;3313125201940001; 5.6.3.202201201500 4 347992
1#0##0#0#0.0#2022-03-08
09:20:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 23/12/2021 23/12/2021 17/02/2006 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 207500 0 1 0 0 0 FAUZAN MUHAMMAD
1124R0021221V004102 0001639135866 3;JKN yani;3302226402970001;
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13:39:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 01/06/1944 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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347850 1#0##0#0#0.0#2022-01-07
14:14:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 25/03/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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347849 1#0##0#0#0.0#2022-01-07
14:13:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 01/03/1973 0 1
0 - 0 - 0 - 0 183900 192840 0 1
0 0 0 SUWARDI, TN 100568 48 17829 DR. ZULFADLY, SP.B
1124R0021221V004106 0000571885492 3;JKN agung;3313092303950002;
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16:26:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 05/03/1962 0 1
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0 1 0 0 0 WARDI 100797 59 21843 DR. WAHYU PURNOMO,
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16:27:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 14/06/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001429190267 3;JKN yani;3302226402970001; 5.6.0.202201041418 4
347855 1#0##0#0#0.0#2022-01-07
14:23:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 26/04/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 205155
0 1 0 0 0 SUKATMI, NY 067067 74 27270 DR. SUHARTO,
SP.PD 1124R0021221V004109 0001021701126 3;JKN agung;3313092303950002;
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16:28:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 31/12/1961 0 2
0 - 0 - 0 - 0 - 0 138400 240000
0 1 0 0 0 JUMIATI.NY 097762 59 21907 DR. LINDA
novia;3313125201940001; 5.5.5.202112011542 4 347343
1#0##0#0#0.0#2022-01-05
18:00:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 26/08/1938 0 1
0 0 - 0 - 0 - 0 - 0 181400 229935
0 1 0 0 0 HERKIYANTO PANGEMANNAN TN 061724 83
agung;3313092303950002; 5.6.0.202201041418 4 347995
1#0##0#0#0.0#2022-01-07
16:28:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 13/06/1992 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 LUKI SABILLA
1124R0021221V004112 0001084671257 3;JKN yani;3302226402970001;
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13:59:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 07/09/1976 0 1
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agung;3313092303950002; 5.6.0.202201041418 4 347996
1#0##0#0#0.0#2022-01-07
16:29:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 19/02/1965 0 1
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MARGONO.,BP 056891 56 20761 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V004117 0000640154136 3;JKN yani;3302226402970001;
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13:58:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 20/09/2015 0 1
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1#0##0#0#0.0#2022-01-05
18:03:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 24/05/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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347848 1#0##0#0#0.0#2022-01-07
14:02:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 11/08/1983 0 1
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agung;3313092303950002; 5.6.0.202201041418 4 347997
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16:30:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 27/05/1970 0 1
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0001279754807 3;JKN agung;3313092303950002; 5.6.0.202201041418 4
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16:31:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3;JKN agung;3313092303950002; 5.6.0.202201041418 4 347999
1#0##0#0#0.0#2022-01-07
16:31:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 29/09/1961 0 2
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19:58:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 23/12/2021 23/12/2021 05/12/2016 0 1
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3;JKN agung;3313092303950002; 5.6.0.202201041418 4 348000
1#0##0#0#0.0#2022-01-07
16:32:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 12/01/1969 0 2
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agung;3313092303950002; 5.6.0.202201041418 4 348001
1#0##0#0#0.0#2022-01-07
16:33:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 07/03/2000 0 2
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novia;3313125201940001; 5.6.3.202201201500 4 348002
1#0##0#0#0.0#2022-03-08
09:23:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 23/12/2021 23/12/2021 08/06/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 460066
0 1 0 0 0 LAMIYEM.NY 087484 71 26131 DR. ARIA
agung;3313092303950002; 5.6.6.202203301209 4 357826
1#0##0#0#0.0#2022-04-14
14:01:52#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
8219e6d7b3f2584580eec49fa576359c 150000 0 0 0 0 0
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3372030 C 3 CP 2 23/12/2021 23/12/2021 25/02/1966 0 2
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agung;3313092303950002; 5.6.0.202201041418 4 348003
1#0##0#0#0.0#2022-01-07
16:34:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 28/08/1974 0 2
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agung;3313092303950002; 5.6.0.202201041418 4 348004
1#0##0#0#0.0#2022-01-07
16:35:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 16/08/1975 0 2
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novia;3313125201940001; 5.6.3.202201201500 4 348005
1#0##0#0#0.0#2022-03-08
09:24:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
2c25b79d2340060c2c977656dce263e7 150000 0 0 0 0 0
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3372030 C 3 CP 2 23/12/2021 23/12/2021 31/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 213152
0 1 0 0 0 ASLAMIYAH., NY 043938 66 24464 DR.
agung;3313092303950002; 5.6.0.202201041418 4 348006
1#0##0#0#0.0#2022-01-07
16:37:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2896cc4bc5c5a885db8e6d38720814f7 150000 0 0 0 0 0
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3372030 C 3 CP 2 23/12/2021 23/12/2021 24/04/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 242760
0 1 0 0 0 INDRIYATI 060952 62 22889 DR. ARIA
agung;3313092303950002; 5.6.0.202201041418 4 348007
1#0##0#0#0.0#2022-01-07
16:37:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 31/12/1944 0 2
0 0 - 0 - 0 - 0 - 0 181400 199580
0 1 0 0 0 HJ.DJOEMIATI,(NY) 044744 76 28116 DR.
agung;3313092303950002; 5.6.0.202201041418 4 348008
1#0##0#0#0.0#2022-01-07
16:38:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 17/06/1983 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 DEWI KRISTYANINGSIH, NY 029845 38 14069
agung;3313092303950002; 5.6.0.202201041418 4 348009
1#0##0#0#0.0#2022-01-07
16:39:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 29/04/1958 0 2
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agung;3313092303950002; 5.6.6.202203301209 4 348010
1#0##0#0#0.0#2022-04-14
13:51:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 23/12/2021 23/12/2021 16/02/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 229580
0 1 0 0 0 DARYANTO, TN 048045 57 21130 DR.
agung;3313092303950002; 5.6.0.202201041418 4 348011
1#0##0#0#0.0#2022-01-07
16:40:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 21/03/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 240492
0 1 0 0 0 BASUKI WIDODO, TN 060757 64 23653 DR.
agung;3313092303950002; 5.6.0.202201041418 4 348012
1#0##0#0#0.0#2022-01-07
17:26:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 23/12/2021 23/12/2021 15/10/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 244420
0 1 0 0 0 MUSTAMIROH (NY) 038477 67 24541 DR.
agung;3313092303950002; 5.6.0.202201041418 4 348013
1#0##0#0#0.0#2022-01-07
16:42:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 31/10/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 253470
0 1 0 0 0 SUKAMTI.NY 099960 62 22699 DR. ARIA
agung;3313092303950002; 5.6.0.202201041418 4 348014
1#0##0#0#0.0#2022-01-07
16:43:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
21e11c118da89debdd177a6dc9a7c5d6 150000 0 0 0 0 0
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3372030 C 3 CP 2 23/12/2021 23/12/2021 13/03/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 236296
0 1 0 0 0 SUHARI, TN 070582 68 25122 DR. ARIA
agung;3313092303950002; 5.6.0.202201041418 4 348015
1#0##0#0#0.0#2022-01-07
16:44:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
030b9fb6854743bcd837d7d1848513e0 150000 0 0 0 0 0
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3372030 C 3 CP 2 23/12/2021 23/12/2021 09/09/1951 0 1
1 Z09.8;I11.9;E78.5;R10.4 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SARBINI, TN 052303 70 25673 DR. SUHARTO,
SP.PD 1124R0021221V004147 0000091234585 3;JKN agung;3313092303950002;
5.6.0.202201041418 4 348016 1#0##0#0#0.0#2022-01-07
16:45:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 22/02/1964 0 1
1 Z09.8;G20;I69.3;M54.39 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 655040
0 1 0 0 0 AJI RAHMAT ., BP 053281 57 21124 DR.
agung;3313092303950002; 5.6.0.202201041418 4 348017
1#0##0#0#0.0#2022-01-07
16:45:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 17/06/1995 0 2
0 0 - 0 - 0 - 0 - 0 181400 185382
0 1 0 0 0 PRITA DWI TAMARA PANGESTU.NN 092213 26
agung;3313092303950002; 5.6.0.202201041418 4 348018
1#0##0#0#0.0#2022-01-07
16:46:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 07/09/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 167912
0 1 0 0 0 SUPRIYANTI, NY 093228 57 20926 DR.
yani;3302226402970001; 5.6.0.202201041418 4 348019
1#0##0#0#0.0#2022-01-07
16:48:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 11/02/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 231645
0 1 0 0 0 SUMARJONO., BP 050498 58 21500 DR.
yani;3302226402970001; 5.6.0.202201041418 4 348020
1#0##0#0#0.0#2022-01-07
16:43:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 06/05/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 191636
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yani;3302226402970001; 5.6.0.202201041418 4 348021
1#0##0#0#0.0#2022-01-07
16:42:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 16/10/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 221217
0 1 0 0 0 SRI YEKTI ISMADI,(NY) 040545 72 26366
3;JKN yani;3302226402970001; 5.6.0.202201041418 4 348022
1#0##0#0#0.0#2022-01-07
16:38:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 20/12/1966 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 348023
1#0##0#0#0.0#2022-01-07
16:35:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 21/02/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 220270
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yani;3302226402970001; 5.6.0.202201041418 4 348024
1#0##0#0#0.0#2022-01-07
16:33:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 22/06/2020 0 2
1 L22 - - - None None None None Q-5-42-0 None None
- 0 - 0 - 0 - 0 182600 179059 0
1 0 0 0 RATIFA CAHAYA KHAYLA.AN 100774 1 549 DR.
yani;3302226402970001; 5.6.0.202201041418 4 348026
1#0##0#0#0.0#2022-01-07
16:31:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 24/01/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 448700
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3;JKN novia;3313125201940001; 5.5.5.202112011542 4 347345
1#0##0#0#0.0#2022-01-05
18:04:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 11/08/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 223617
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yani;3302226402970001; 5.6.0.202201041418 4 348025
1#0##0#0#0.0#2022-01-07
16:32:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 26/10/1964 0 1
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3;JKN novia;3313125201940001; 5.5.5.202112011542 4 347346
1#0##0#0#0.0#2022-01-05
18:06:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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285000 0 0 0 15000 0 89797 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 16/07/1944 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 348027
1#0##0#0#0.0#2022-01-07
16:25:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 01/07/1965 0 2
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novia;3313125201940001; 5.5.5.202112011542 4 347347
1#0##0#0#0.0#2022-01-05
18:07:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 01/10/1937 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 348028
1#0##0#0#0.0#2022-01-07
16:23:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 03/10/1947 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 348030
1#0##0#0#0.0#2022-01-07
16:21:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 18/04/1968 0 1
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0 0 - 0 - 0 - 0 - 0 181400 219540
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yani;3302226402970001; 5.6.0.202201041418 4 348031
1#0##0#0#0.0#2022-01-07
16:20:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 31/12/1996 0 2
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3;JKN yani;3302226402970001; 5.6.0.202201041418 4 348032
1#0##0#0#0.0#2022-01-07
16:19:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0002347378345 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
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3372030 C 3 CP 2 23/12/2021 23/12/2021 20/11/1985 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 348033
1#0##0#0#0.0#2022-01-07
16:17:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 27/10/1978 0 2
1 Z09.8;J45.9;R51 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 361621
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yani;3302226402970001; 5.6.0.202201041418 4 348034
1#0##0#0#0.0#2022-01-07
16:16:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 16/03/1946 0 2
1 Z09.8;J47;K21.9;I10 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 427133
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yani;3302226402970001; 5.6.0.202201041418 4 348035
1#0##0#0#0.0#2022-01-07
16:15:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 08/10/1961 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 348036
1#0##0#0#0.0#2022-01-07
16:14:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 16/02/1970 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 348037
1#0##0#0#0.0#2022-01-07
16:12:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 19/08/1960 0 2
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16:11:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 03/02/1955 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 348040
1#0##0#0#0.0#2022-01-07
15:23:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 04/05/1958 0 2
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1124R0021221V004180 0001032581823 3;JKN yani;3302226402970001;
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13:19:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 03/10/1985 0 1
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1#0##0#0#0.0#2022-01-07
15:24:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 07/04/1960 0 2
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1124R0021221V004183 0001105905699 3;JKN yani;3302226402970001;
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15:25:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 09/05/1949 0 1
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1#0##0#0#0.0#2022-01-05
18:08:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 08/08/1971 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 348043
1#0##0#0#0.0#2022-01-07
15:26:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 04/09/1964 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 347875
1#0##0#0#0.0#2022-01-07
13:17:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 25/06/1970 0 2
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SP.PD 1124R0021221V004187 0002074007092 3;JKN yani;3302226402970001;
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13:16:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 06/03/1959 0 2
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15:26:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 12/10/1987 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 347873
1#0##0#0#0.0#2022-01-07
13:14:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 23/03/1965 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 348045
1#0##0#0#0.0#2022-01-07
15:27:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 31/12/1963 0 2
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novia;3313125201940001; 5.5.5.202112011542 4 347350
1#0##0#0#0.0#2022-01-05
18:09:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 10/12/1982 0 1
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SP.PD 1124R0021221V004192 0001125136214 3;JKN yani;3302226402970001;
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13:12:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 18/03/1988 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 347871
1#0##0#0#0.0#2022-01-07
13:11:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 12/03/2004 0 1
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18:10:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 17/04/1973 0 1
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SP.PD 1124R0021221V004195 0002078547524 3;JKN yani;3302226402970001;
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13:10:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 23/03/1976 0 2
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SP.PD 1124R0021221V004196 0001527005889 3;JKN yani;3302226402970001;
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13:09:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 14/10/1972 0 2
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SP.PD 1124R0021221V004197 0002082979192 3;JKN yani;3302226402970001;
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12:53:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 31/12/1971 0 2
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1124R0021221V004198 0000555344774 3;JKN yani;3302226402970001;
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12:55:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 04/11/1994 0 1
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0 1 0 0 0 RAUHULLOH AYATULLOH KHOMEINI.SDR 096022
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348046 1#0##0#0#0.0#2022-01-07
15:27:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 24/01/1964 0 2
1 N30.9;R10.4 88.76 - - None None None None Z-3-23-0 None
0 - 0 - 0 - 0 - 0 549400 659146
0 1 0 0 0 SUKARMI., NY 045414 57 21153 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347352
1#0##0#0#0.0#2022-01-05
18:11:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 22/04/1992 0 1
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SP.PD 1124R0021221V004201 0001894415848 3;JKN yani;3302226402970001;
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13:18:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 31/08/1970 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 348047
1#0##0#0#0.0#2022-01-07
15:28:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 20/03/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 229147
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novia;3313125201940001; 5.6.3.202201201500 4 348048
1#0##0#0#0.0#2022-02-15
13:12:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 23/12/2021 23/12/2021 25/09/1969 0 1
1 Z09.8;N20.0;N40 88.75 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400 877550
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novia;3313125201940001; 5.5.5.202112011542 4 347353
1#0##0#0#0.0#2022-01-05
18:13:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 23/12/2021 23/12/2021 17/07/1980 0 1
0 0 - 0 - 0 - 0 - 0 181400 374162
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3;JKN yani;3302226402970001; 5.6.0.202201041418 4 348049
1#0##0#0#0.0#2022-01-07
15:29:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 26/09/1963 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 348050
1#0##0#0#0.0#2022-01-07
15:30:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 10/04/1995 0 1
0 0 - 0 - 0 - 0 - 0 181400 390510
0 1 0 0 0 ARIFAN HERRA PANDAM PAWITRA.TN 100767
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0001032641763 3;JKN yani;3302226402970001; 5.6.0.202201041418 4
348051 1#0##0#0#0.0#2022-01-07
15:31:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 29/11/1943 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 348052
1#0##0#0#0.0#2022-01-07
15:31:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
52c79e5dc874736abc284346d1cfb609 150000 0 0 0 0 0
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3372030 C 3 CP 2 23/12/2021 23/12/2021 23/04/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 315000
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yani;3302226402970001; 5.6.0.202201041418 4 348053
1#0##0#0#0.0#2022-01-07
15:32:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 11/06/1969 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 348054
1#0##0#0#0.0#2022-01-07
15:38:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 14/08/1955 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 348055
1#0##0#0#0.0#2022-01-07
15:39:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 08/09/1955 0 1
1 Z09.8;I10;N40 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 242331
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yani;3302226402970001; 5.6.0.202201041418 4 348056
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15:41:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 18/06/1980 0 1
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15:42:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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15:42:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 19/08/1966 0 1
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15:43:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 22/07/1966 0 2
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1#0##0#0#0.0#2022-01-07
15:44:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 02/04/1985 0 1
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3;JKN yani;3302226402970001; 5.6.0.202201041418 4 348061
1#0##0#0#0.0#2022-01-07
15:44:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 19/03/1976 0 1
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15:45:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 02/11/2019 0 1
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15:46:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 03/03/1950 0 2
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15:47:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 09/05/1942 0 2
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1#0##0#0#0.0#2022-01-07
15:47:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 05/06/1963 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347827
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13:28:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 19/08/1953 0 1
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347825 1#0##0#0#0.0#2022-01-07
13:25:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 28/08/1959 0 1
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1#0##0#0#0.0#2022-01-07
13:27:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.6.0.202201041418 4 348066
1#0##0#0#0.0#2022-01-07
15:48:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 26/06/1969 0 2
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14:20:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 28/07/1960 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 348067
1#0##0#0#0.0#2022-01-07
15:48:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 20/10/1973 0 2
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15:49:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 11/09/1966 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 348069
1#0##0#0#0.0#2022-01-07
15:50:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 31/12/1958 0 1
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1#0##0#0#0.0#2022-01-07
15:52:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 22/06/1954 0 2
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1#0##0#0#0.0#2022-01-07
15:52:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 30/09/1977 0 2
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1#0##0#0#0.0#2022-03-08
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3372030 C 3 CP 2 23/12/2021 23/12/2021 09/05/1975 0 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 12/07/1966 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 347864
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12:51:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 12/12/1964 0 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 22/10/1959 0 2
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3372030 C 3 CP 2 23/12/2021 23/12/2021 28/02/1967 0 2
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3372030 C 3 CP 2 23/12/2021 23/12/2021 12/08/1977 0 1
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12:47:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 03/08/1963 0 2
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SP.PD 1124R0021221V004255 0000088933318 3;JKN yani;3302226402970001;
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3372030 C 3 CP 2 23/12/2021 23/12/2021 27/12/1967 0 2
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15:54:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 15/07/1962 0 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 14/03/2007 0 1
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15:56:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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18:14:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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15:57:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 02/05/1959 0 2
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15:57:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 11/06/1973 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 348078
1#0##0#0#0.0#2022-01-07
15:58:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 04/10/1960 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 348079
1#0##0#0#0.0#2022-01-07
15:58:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 12/03/1972 0 2
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14:46:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 04/04/1984 0 2
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14:45:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 27/09/1948 0 1
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14:44:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 23/12/2021 23/12/2021 04/06/1968 0 2
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0 1 0 0 0 SUMINI.NY 099596 53 19560 DR. ARYO
novia;3313125201940001; 5.5.5.202112011542 4 347355
1#0##0#0#0.0#2022-01-05
18:14:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1942cf5abdac94842543f84e9c318e36 150000 0 0 0 0 0
680000 0 0 0 15000 0 22505 0 0 0 0 0
3372030 C 3 CP 2 23/12/2021 23/12/2021 08/11/1974 0 2
0 - 0 - 0 - 0 - 0 182600 157770
0 1 0 0 0 ARNI KRISTIYANI,(NY) 024518 47 17212
novia;3313125201940001; 5.5.5.202112011542 4 346695
1#0##0#0#0.0#2022-01-04
14:47:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4a5c48ef87b575a5ae03959259419c4d 105000 0 0 0 0 0
0 0 0 0 15000 0 37770 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 09/03/1982 0 2
- 0 - 0 - 0 - 0 135700 225300 0
1 0 0 0 DYAH GALUH T(NY) 019387 39 14535 RIZA
5.5.5.202112011542 4 346701 1#0##0#0#0.0#2022-01-04
14:49:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f51fc4b61b54daf30440b9683f15e861 155000 0 0 0 0 0
0 0 0 0 15000 0 55300 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 01/07/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 220492
0 1 0 0 0 SARIYEM, NY 091999 79 29031 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 345674
1#0##0#0#0.0#2021-12-28
14:50:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6b00cbd96141b01c9ebe941f6bb3a479 150000 0 0 0 0 0
0 0 0 0 15000 0 55492 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 11/05/1943 0 2
0 0 - 0 - 0 - 0 - 0 181400 211094
0 1 0 0 0 MURYATI.NY 094215 78 28717 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 345675
1#0##0#0#0.0#2021-12-28
14:51:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
55364d576835339d42d69f8666d26432 150000 0 0 0 0 0
0 0 0 0 15000 0 46094 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 28/03/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 219012
0 1 0 0 0 MV SUMARNI, NY 094104 64 23647 DR.
novia;3313125201940001; 5.5.5.202112011542 4 345676
1#0##0#0#0.0#2021-12-28
14:53:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
246dd4efd7b3abaae07bdff634e0dc09 150000 0 0 0 0 0
0 0 0 0 15000 0 54012 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 31/12/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 219292
0 1 0 0 0 SRI WAWUK, NY 074276 56 20812 DR.
novia;3313125201940001; 5.5.5.202112011542 4 345677
1#0##0#0#0.0#2021-12-28
14:54:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5b0b2988132021fc2d82abdb18b764c5 150000 0 0 0 0 0
0 0 0 0 15000 0 54292 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 10/04/1950 0 2
1 Z09.8;S32.00;M54.59;W01.0 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
208060 0 1 0 0 0 MOEMINAH., NY 046939 71
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 347356
1#0##0#0#0.0#2022-01-05
18:15:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7786dd4320223e036b1d7f5407a38f44 150000 0 0 0 0 0
0 0 0 0 15000 0 43060 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 03/08/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 218812
0 1 0 0 0 TENTREM.NY 089445 58 21328 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 345678
1#0##0#0#0.0#2021-12-28
14:54:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dc6880e1b52b1923a518c86b26bcf336 150000 0 0 0 0 0
0 0 0 0 15000 0 53812 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 25/12/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 213550
0 1 0 0 0 BAMBANG RISTANTO.TN 087710 49 18262
novia;3313125201940001; 5.5.5.202112011542 4 345679
1#0##0#0#0.0#2021-12-28
14:56:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
283b4725be4c596dff1e69aeb5e60ec7 150000 0 0 0 0 0
0 0 0 0 15000 0 48550 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 22/04/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 202900
0 1 0 0 0 DJUWARSO, (BP) 008057 72 26544 DR.
novia;3313125201940001; 5.5.5.202112011542 4 345680
1#0##0#0#0.0#2021-12-28
14:57:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8b26b44c0ce2d2f11d170ff3728dad71 150000 0 0 0 0 0
0 0 0 0 15000 0 37900 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 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; 5.5.5.202112011542 4
345681 1#0##0#0#0.0#2021-12-28
14:58:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b9ae03cad7d9396d722e733488a8f981 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 03/07/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 202342
0 1 0 0 0 B NINGSIH EKO PURWANI, (NY) 039836 69
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 345683
1#0##0#0#0.0#2021-12-29
07:27:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
add283820f6ed65e7602436237c27ef5 150000 0 0 0 0 0
0 0 0 0 15000 0 37342 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 09/04/2005 0 1
0 0 - 0 - 0 - 0 - 0 181400 189920
0 1 0 0 0 MUHAMMAD HAIDAR ALI.AN 100173 16 6103
novia;3313125201940001; 5.5.5.202112011542 4 345684
1#0##0#0#0.0#2021-12-29
07:35:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
28346b25285d9e479ed6596bde0c58eb 150000 0 0 0 0 0
0 0 0 0 15000 0 24920 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 04/09/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 217512
0 1 0 0 0 TRI WIDAYATI, NY 065284 56 20565 DR.
novia;3313125201940001; 5.5.5.202112011542 4 345685
1#0##0#0#0.0#2021-12-29
07:36:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fa7968e9d96b35962224544b4434353c 150000 0 0 0 0 0
0 0 0 0 15000 0 52512 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 08/11/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 235274
0 1 0 0 0 IRAN RAHAYU, NY 099708 54 19770 DR.
novia;3313125201940001; 5.5.5.202112011542 4 345686
1#0##0#0#0.0#2021-12-29
07:37:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
40e59c5c709cef246fbbad12a175c421 150000 0 0 0 0 0
0 0 0 0 15000 0 70274 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 25/09/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 206742
0 1 0 0 0 SRI SATITI.NY 094831 72 26388 DR.
novia;3313125201940001; 5.5.5.202112011542 4 345687
1#0##0#0#0.0#2021-12-29
07:38:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
541d73d770a9fd5afc8f9d6e1cbcd66f 150000 0 0 0 0 0
0 0 0 0 15000 0 41742 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 20/12/1986 0 1
0 0 - 0 - 0 - 0 - 0 181400 225720
0 1 0 0 0 BAYU DWI RAHARJO,(BP) 019598 35 12788
novia;3313125201940001; 5.5.5.202112011542 4 345688
1#0##0#0#0.0#2021-12-29
07:39:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4ab94df825456cbeb04b5cc7f2d08a15 150000 0 0 0 0 0
0 0 0 0 15000 0 60720 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 07/05/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 211992
0 1 0 0 0 TRI RAHAYU, NY 072208 62 22877 DR.
novia;3313125201940001; 5.5.5.202112011542 4 345689
1#0##0#0#0.0#2021-12-29
07:40:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
430236c2938e95576f9ef7e475280591 150000 0 0 0 0 0
0 0 0 0 15000 0 46992 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 10/10/1935 0 2
0 0 - 0 - 0 - 0 - 0 181400 204894
0 1 0 0 0 SUYATMI ,NY 037985 86 31487 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 345690
1#0##0#0#0.0#2021-12-29
07:40:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e2abeb9e0387c87617a4eb8e564129f5 150000 0 0 0 0 0
0 0 0 0 15000 0 39894 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 27/02/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 207062
0 1 0 0 0 RISPIYANTI, NY 095415 65 24042 DR.
novia;3313125201940001; 5.5.5.202112011542 4 345691
1#0##0#0#0.0#2021-12-29
07:41:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
820574ea7aa058337c01893514364741 150000 0 0 0 0 0
0 0 0 0 15000 0 42062 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 29/12/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 205214
0 1 0 0 0 SRI SUPARTININGRUM.NY 082384 54 20084
novia;3313125201940001; 5.5.5.202112011542 4 345693
1#0##0#0#0.0#2021-12-29
07:42:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3ffada9d6a5ee1d03db2937098da1a88 150000 0 0 0 0 0
0 0 0 0 15000 0 40214 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 12/11/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 205390
0 1 0 0 0 SRI WIDODO, NY 093233 61 22322 DR.
novia;3313125201940001; 5.5.5.202112011542 4 345694
1#0##0#0#0.0#2021-12-29
07:43:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
faa16de174df3febc167b564e943c447 150000 0 0 0 0 0
0 0 0 0 15000 0 40390 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 18/08/2006 0 2
0 - 0 - 0 - 0 - 0 182600 189152
0 1 0 0 0 JIHAN NUFAISA ZAHRA.AN 018779 15 5607
novia;3313125201940001; 5.5.5.202112011542 4 345695
1#0##0#0#0.0#2021-12-29
07:44:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3b978f08c665111b444204fb1471717b 150000 0 0 0 0 0
0 0 0 0 15000 0 24152 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 17/08/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 207062
0 1 0 0 0 SULASTRI ISTIYATI. NY 081379 54 19853
novia;3313125201940001; 5.5.5.202112011542 4 345696
1#0##0#0#0.0#2021-12-29
07:45:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0cade8df210574abd0d2e5c839218c9b 150000 0 0 0 0 0
0 0 0 0 15000 0 42062 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 14/05/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 191912
0 1 0 0 0 WINARNO.TN 093273 56 20678 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 345697
1#0##0#0#0.0#2021-12-29
07:46:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3253c183d42c33de4c25db8041875931 150000 0 0 0 0 0
0 0 0 0 15000 0 26912 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 15/05/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 200130
0 1 0 0 0 YAHMINI ., NY 055426 63 23234 DR.
novia;3313125201940001; 5.5.5.202112011542 4 345698
1#0##0#0#0.0#2021-12-29
07:48:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
615550bce407104c237eea66b05df195 150000 0 0 0 0 0
0 0 0 0 15000 0 35130 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 04/05/1940 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUKIR AGUS
WIRATMOKO, TN 026036 81 29819 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V004308 0000090002542 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 345699 1#0##0#0#0.0#2021-12-29
07:49:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4e3589dd5f97386a031679ff55048c3e 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 10/12/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 216062
0 1 0 0 0 DESI IRAWATI.NY 083433 67 24486 DR.
novia;3313125201940001; 5.5.5.202112011542 4 345700
1#0##0#0#0.0#2021-12-29
07:51:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0a4a9ae2d4a6d9596832bfb058d0425f 150000 0 0 0 0 0
0 0 0 0 15000 0 51062 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 25/12/2002 0 1
0 404900 294160 0 1 0 0 0 MUHAMMAD KEVIN
ILALANG, SDR 100374 18 6939 DR. WAHYU PURNOMO, SP.OT
1124R0021221V004310 0002702340494 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 345701 1#0##0#0#0.0#2021-12-29
07:52:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
865152086f64d1ee5a3019e76470dfc2 247500 0 0 0 0 0
0 0 0 0 15000 0 31660 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 18/12/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 370492
0 1 0 0 0 PURWANTO.TN 092290 50 18269 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 345702
1#0##0#0#0.0#2021-12-29
07:52:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c34a06146ba13a7bb2b5293cf4df4aa3 300000 0 0 0 0 0
0 0 0 0 15000 0 55492 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 31/12/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 220492
0 1 0 0 0 SURANI, NY 063638 58 21543 DR. WAHYU
novia;3313125201940001; 5.5.5.202112011542 4 345703
1#0##0#0#0.0#2021-12-29
07:53:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3de73fd1b7a988af2f19f8340813bae1 150000 0 0 0 0 0
0 0 0 0 15000 0 55492 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 04/06/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 203222
0 1 0 0 0 SRI HARTATI,(NY) 005917 54 19927 DR.
novia;3313125201940001; 5.5.5.202112011542 4 345705
1#0##0#0#0.0#2021-12-29
07:54:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7c7869877d509006d67241e15c9d4df1 150000 0 0 0 0 0
0 0 0 0 15000 0 38222 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 22/08/1977 0 2
0 - 0 - 0 - 0 - 0 181400 195730
0 1 0 0 0 NURDHIAN NUGRAHENI.NY 081396 44 16195
novia;3313125201940001; 5.5.5.202112011542 4 345706
1#0##0#0#0.0#2021-12-29
07:54:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
549bcb5473e6fc6a79d634334f206ca9 150000 0 0 0 0 0
0 0 0 0 15000 0 30730 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 15/10/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 263512
0 1 0 0 0 MARYANI.NY 099319 54 19794 DR. RETNO
novia;3313125201940001; 5.5.5.202112011542 4 345707
1#0##0#0#0.0#2021-12-29
07:55:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3e876b809e4179724de8f4b68f13a76f 150000 0 0 0 0 0
0 0 0 0 15000 0 98512 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 14/02/2009 0 2
1 F41.1 - - - None None None None F-5-14-0 None None
None None None None PSIKOTHERAPI INDIVIDU DEWASA BUKAN AKUT 194500
0 0 - 0 - 0 - 0 - 0 194500 227880
0 1 0 0 0 GREENA LANA PUTRI, AN 100844 12 4696
novia;3313125201940001; 5.5.5.202112011542 4 345708
1#0##0#0#0.0#2021-12-29
07:56:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4a316aae3e6c79aabcdd487f6626d9c4 150000 0 0 0 0 0
0 0 0 0 15000 0 62880 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 09/04/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 602587
0 1 0 0 0 LUH IDA.NY 095717 54 19983 DR. RETNO
novia;3313125201940001; 5.5.5.202112011542 4 345709
1#0##0#0#0.0#2021-12-29
07:56:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
89c6c55faac9967479a61fe76083d9c4 335000 0 0 0 0 0
0 0 0 0 15000 0 252587 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 12/09/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 397014
0 1 0 0 0 SUNARYATI, NY 058012 79 28958 DR.
novia;3313125201940001; 5.5.5.202112011542 4 345710
1#0##0#0#0.0#2021-12-29
07:59:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a855d29495fd4d77f05b2b73e42c545e 203000 0 0 0 0 0
0 0 0 0 15000 0 179014 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 21/05/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 476946
0 1 0 0 0 JOHAN KRIS UTAMA.AN 076043 19 7157
novia;3313125201940001; 5.5.5.202112011542 4 345711
1#0##0#0#0.0#2021-12-29
07:59:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
721368f622543b6405195c7620009d0f 300000 0 0 0 0 0
0 0 0 0 15000 0 161946 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 08/01/1991 0 2
0 0 - 0 - 0 - 0 - 0 181400 183336
0 1 0 0 0 NITA SAPUTRI, (NN) 038820 30 11308
novia;3313125201940001; 5.5.5.202112011542 4 345712
1#0##0#0#0.0#2021-12-29
08:00:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
94dc7b009b3b3fc7a69ae4ba9b94d0da 150000 0 0 0 0 0
0 0 0 0 15000 0 18336 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 27/01/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 230978
0 1 0 0 0 SRI SUPRAPTI, NY 087990 63 23342 DR.
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1#0##0#0#0.0#2021-12-29
08:01:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 05/07/1984 0 2
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novia;3313125201940001; 5.5.5.202112011542 4 345714
1#0##0#0#0.0#2021-12-29
08:02:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 26/06/1958 0 1
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novia;3313125201940001; 5.5.5.202112011542 4 345715
1#0##0#0#0.0#2021-12-29
08:07:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 08/12/1992 0 1
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novia;3313125201940001; 5.5.5.202112011542 4 345716
1#0##0#0#0.0#2021-12-29
08:09:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 12/02/1964 0 2
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novia;3313125201940001; 5.5.5.202112011542 4 345717
1#0##0#0#0.0#2021-12-29
08:10:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 13/05/1979 0 2
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1#0##0#0#0.0#2021-12-29
08:11:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 05/03/1988 0 2
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08:12:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 18/08/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 393274
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novia;3313125201940001; 5.5.5.202112011542 4 345720
1#0##0#0#0.0#2021-12-29
08:13:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 26/10/2003 0 2
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novia;3313125201940001; 5.5.5.202112011542 4 345721
1#0##0#0#0.0#2021-12-29
08:14:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 12/09/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 279485
0 1 0 0 0 SLAMET,(NY) 036944 76 27862 DR.
novia;3313125201940001; 5.5.5.202112011542 4 345722
1#0##0#0#0.0#2021-12-29
08:20:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 09/11/1965 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUMIYATI, NY
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345723 1#0##0#0#0.0#2021-12-29
08:21:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 16/10/1949 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SRI YEKTI ISMADI,
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345724 1#0##0#0#0.0#2021-12-29
08:22:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 01/07/1955 0 2
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novia;3313125201940001; 5.5.5.202112011542 4 345725
1#0##0#0#0.0#2021-12-29
08:23:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 02/08/2013 0 1
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345726 1#0##0#0#0.0#2021-12-29
08:24:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 13/07/1953 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
278795 0 1 0 0 0 RUSWATI, NY 086042 68 25001
novia;3313125201940001; 5.5.5.202112011542 4 345727
1#0##0#0#0.0#2021-12-29
08:29:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 27/08/1970 0 2
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3;JKN novia;3313125201940001; 5.5.5.202112011542 4 345728
1#0##0#0#0.0#2021-12-29
08:30:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c993a90419542e780535ee809b2e7783 150000 0 0 0 0 0
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3372030 C 3 CP 2 24/12/2021 24/12/2021 19/04/1972 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
290020 0 1 0 0 0 PARNI, NY 078354 49 18146
novia;3313125201940001; 5.5.5.202112011542 4 345729
1#0##0#0#0.0#2021-12-29
08:31:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 12/07/1966 0 2
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3;JKN novia;3313125201940001; 5.5.5.202112011542 4 345730
1#0##0#0#0.0#2021-12-29
08:33:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 18/01/1955 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000090992327 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
345731 1#0##0#0#0.0#2021-12-29
08:33:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 25/02/1965 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUYANTI., NY
0000565142567 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
345733 1#0##0#0#0.0#2021-12-29
08:34:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 16/08/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 TRI WINARNI 093256
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345734 1#0##0#0#0.0#2021-12-29
08:35:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 22/05/1982 0 2
0 0 - 0 - 0 - 0 - 0 296400 215000
0 1 0 0 0 SARNI,NY 061908 39 14461 DR. GUNAWAN,
SP.OG 1124R0021221V004344 0000639312017 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 345735 1#0##0#0#0.0#2021-12-29
08:36:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 02/02/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SUJIYEM, NY 090600
0001696847466 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
345736 1#0##0#0#0.0#2021-12-29
08:37:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 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; 5.5.5.202112011542 4
345750 1#0##0#0#0.0#2021-12-29
09:33:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 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 novia;3313125201940001; 5.5.5.202112011542 4
345751 1#0##0#0#0.0#2021-12-29
09:34:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 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; 5.5.5.202112011542 4
345752 1#0##0#0#0.0#2021-12-29
09:36:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6c8c2483e0c6ecc7991f6adb2007668d 258000 0 0 0 0 0
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3372030 C 3 CP 2 24/12/2021 24/12/2021 03/04/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 497124
0 1 0 0 0 PONIARSI, NY 100933 67 24737 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347357
1#0##0#0#0.0#2022-01-05
18:23:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e472edb8dd7d141a082d209c40af7acb 150000 0 0 0 0 0
248000 0 0 0 15000 0 84124 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 11/07/2012 0 2
0 0 - 0 - 0 - 0 - 0 181400 178045
0 1 0 0 0 JULIA DEVI NOVITA.AN 100742 9 3453
novia;3313125201940001; 5.5.5.202112011542 4 345753
1#0##0#0#0.0#2021-12-29
09:37:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9af6c121e85ece31cfb872e26607c692 150000 0 0 0 0 0
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3372030 C 3 CP 2 24/12/2021 24/12/2021 17/08/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 179850
0 1 0 0 0 SUWARNI, NY 079454 44 16200 DR.
novia;3313125201940001; 5.5.5.202112011542 4 345754
1#0##0#0#0.0#2021-12-29
09:38:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d5ebdeb6a6ea42e1c6fe8ec0bac32f51 150000 0 0 0 0 0
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3372030 C 3 CP 2 24/12/2021 24/12/2021 07/10/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 TRI ANISTA .(NY) 006698 45 16514 DR.
novia;3313125201940001; 5.5.5.202112011542 4 345755
1#0##0#0#0.0#2021-12-29
09:39:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8b3ff54a8945b116594b09204fbc6d91 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 25/05/1967 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 BAMBANG
1124R0021221V004355 0000091534228 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 345756 1#0##0#0#0.0#2021-12-29
09:40:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
77130d4d15ad10443c16e9bd5d4bd423 247000 0 0 0 0 0
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3372030 C 3 CP 2 24/12/2021 24/12/2021 31/12/1959 0 1
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0 1 0 0 0 SUKINO, TN 100437 61 22639 DR. ARIA
novia;3313125201940001; 5.5.5.202112011542 4 347358
1#0##0#0#0.0#2022-01-05
18:24:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b22e9afb00b308badd968ef0f6713c9d 150000 0 0 0 0 0
220000 121345 0 0 15000 0 81890 0 0 0 0
0
3372030 C 3 CP 2 24/12/2021 24/12/2021 14/04/1960 0 2
0 - 0 107400 273000 0 1 0 0 0
1124R0021221V004357 0001084606863 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 345757 1#0##0#0#0.0#2021-12-29
09:42:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fa4228c7583b2ea227c8f9d92a78b08c 258000 0 0 0 0 0
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3372030 C 3 CP 2 24/12/2021 24/12/2021 14/05/1989 0 2
0 - 0 - 0 - 0 283800 318860 0 1
0 0 0 BRANTI PUSPA SARASTRIANA, NY 100888 32 11912 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 345770
1#0##0#0#0.0#2021-12-29
09:42:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
559d0bd78e81ed7cf052d83a2f446fa7 300000 0 0 0 0 0
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3372030 C 3 CP 2 24/12/2021 24/12/2021 21/07/2016 0 1
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1 0 0 0 PRISHA ADRIENNE SAGARA.AN 079879 5 1982
novia;3313125201940001; 5.5.5.202112011542 4 345771
1#0##0#0#0.0#2021-12-29
09:43:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2e063ed2f5d9be32571dac49fef1cbe2 300000 0 0 0 0 0
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3372030 C 3 CP 2 24/12/2021 24/12/2021 06/07/1968 0 2
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1 0 0 0 MURTINI.NY 098231 53 19529 DRG. VERAWATY,
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09:45:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 27/06/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI MARGANI.NY
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345773 1#0##0#0#0.0#2021-12-29
09:46:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 11/07/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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345774 1#0##0#0#0.0#2021-12-29
09:49:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 26/08/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 LISTINA.NY 099402 58 21305 DR. RETNO
novia;3313125201940001; 5.5.5.202112011542 4 345775
1#0##0#0#0.0#2021-12-29
09:50:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 21/08/1948 0 2
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MUSNATIN., NY 071462 73 26788 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V004365 0000091314876 3;JKN novia;3313125201940001;
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09:52:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 20/10/1982 0 2
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09:54:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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10:16:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 03/09/1977 0 1
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10:25:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 26/04/1964 0 1
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10:26:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 02/02/1971 0 2
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SP.PD 1124R0021221V004381 0002326843899 3;JKN novia;3313125201940001;
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10:37:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 01/12/1980 0 2
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1124R0021221V004382 0000640230884 3;JKN novia;3313125201940001;
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10:38:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 08/03/1967 0 1
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SP.PD 1124R0021221V004384 0001879909187 3;JKN novia;3313125201940001;
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3372030 C 3 CP 2 24/12/2021 24/12/2021 20/06/1943 0 2
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1124R0021221V004385 0001800527916 3;JKN novia;3313125201940001;
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10:43:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 01/05/1975 0 1
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1124R0021221V004386 0001790328262 3;JKN novia;3313125201940001;
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10:43:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 07/12/1946 0 1
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SP.PD 1124R0021221V004387 0000572379772 3;JKN novia;3313125201940001;
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10:44:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 11/07/1995 0 2
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novia;3313125201940001; 5.5.5.202112011542 4 345818
1#0##0#0#0.0#2021-12-29
10:45:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 06/04/1969 0 1
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0001104843161 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
345819 1#0##0#0#0.0#2021-12-29
10:47:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 16/08/1970 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 NOENIK KRISTYARINI.NY 100290 51 18758 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 345820
1#0##0#0#0.0#2021-12-29
10:49:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 09/07/1968 0 2
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novia;3313125201940001; 5.5.5.202112011542 4 345821
1#0##0#0#0.0#2021-12-29
10:50:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 16/07/1972 0 1
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0 1 0 0 0 ACHMAD SOLICHIN, TN 099665 49 18058
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 345822
1#0##0#0#0.0#2021-12-29
10:50:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2b6680ad38e78cca7b39c114b613b574 150000 0 0 0 0 0
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3372030 C 3 CP 2 24/12/2021 24/12/2021 28/07/1979 0 2
- 0 - 0 - 0 - 0 283800 315000 0
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novia;3313125201940001; 5.5.5.202112011542 4 345823
1#0##0#0#0.0#2021-12-29
10:53:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 25/06/1968 0 1
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0 1 0 0 0 SRIYANTO, TN 096279 53 19540 DR.
novia;3313125201940001; 5.5.5.202112011542 4 345824
1#0##0#0#0.0#2021-12-29
10:54:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 26/02/1996 0 2
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10:58:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 22/06/1992 0 1
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novia;3313125201940001; 5.5.5.202112011542 4 345826
1#0##0#0#0.0#2021-12-29
10:59:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 06/03/1981 0 2
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SP.KG 1124R0021221V004399 0001160595009 3;JKN novia;3313125201940001;
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11:00:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 31/12/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0002940595885 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
345828 1#0##0#0#0.0#2021-12-29
11:00:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 30/04/1969 0 2
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345829 1#0##0#0#0.0#2021-12-29
11:01:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 30/06/2001 0 1
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novia;3313125201940001; 5.5.5.202112011542 4 345830
1#0##0#0#0.0#2021-12-29
11:02:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 21/08/2003 0 2
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novia;3313125201940001; 5.5.5.202112011542 4 345832
1#0##0#0#0.0#2021-12-29
11:03:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 18/01/1966 0 2
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1124R0021221V004404 0002169780873 3;JKN novia;3313125201940001;
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11:06:51#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#2021-12-29
11:32:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 02/02/1990 0 2
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novia;3313125201940001; 5.5.5.202112011542 4 345851
1#0##0#0#0.0#2021-12-29
11:33:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 04/04/2002 0 2
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novia;3313125201940001; 5.5.5.202112011542 4 345852
1#0##0#0#0.0#2021-12-29
11:34:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 28/12/2003 0 1
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novia;3313125201940001; 5.5.5.202112011542 4 345853
1#0##0#0#0.0#2021-12-29
11:35:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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11:36:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 13/12/1966 0 2
0 - 0 - 0 - 0 786200 478830 0 1
1124R0021221V004457 0002051493849 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 345946 1#0##0#0#0.0#2021-12-30
08:25:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 07/04/1948 0 1
0 - 0 - 0 - 0 786200 534360 0 1
SP.PD 1124R0021221V004458 0000094255514 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 345947 1#0##0#0#0.0#2021-12-30
08:25:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 08/04/1998 0 1
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novia;3313125201940001; 5.5.5.202112011542 4 346027
1#0##0#0#0.0#2021-12-30
08:33:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 23/08/1978 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 MOH RIYADI, TN 071422 43 15829 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 346028
1#0##0#0#0.0#2021-12-30
08:35:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bf2cf84746abe15178d97e75efa8f402 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 15/06/1986 0 2
- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.5.5.202112011542 4 346029
1#0##0#0#0.0#2021-12-30
08:37:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 24/12/2021 24/12/2021 09/11/1971 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SUHASTI,(NY) 038243 50 18308 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 346030
1#0##0#0#0.0#2021-12-30
08:37:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4a81960a35556a98ac5d7475f4b04f84 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 02/06/1963 0 2
- 0 - 0 - 0 - 0 283800 315000 0
SP.KG 1124R0021221V004463 0001102660863 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346031 1#0##0#0#0.0#2021-12-30
08:38:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
db20b29968c2cfb98364dc1a042db651 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 28/04/1994 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 ANNA LUSIANA, NN 100717 27 10102 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 346032
1#0##0#0#0.0#2021-12-30
08:40:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
82ef9618e7288444d573c2eda34ad3e3 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 28/07/1960 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SRI WULAN YULIE I, NY 100807 61 22429 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 346033
1#0##0#0#0.0#2021-12-30
08:40:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
062dca2b3bd21122c299186eafaf9a74 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 19/05/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 196175
0 1 0 0 0 MAISE SELAWATI, NY 000974 55 20308
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 346034
1#0##0#0#0.0#2021-12-30
08:41:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ba0fd9688d2469673e6ff3f2e21bf26c 150000 0 0 0 0 0
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3372030 C 3 CP 2 24/12/2021 24/12/2021 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; 5.5.5.202112011542 4
346035 1#0##0#0#0.0#2021-12-30
08:42:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0773a5f0a86b1737e8ae8e52c6809aed 258000 0 0 0 0 0
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3372030 C 3 CP 2 24/12/2021 24/12/2021 13/03/1966 0 1
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 SUWANTO., TN 071553 55 20375 DRG.
novia;3313125201940001; 5.5.5.202112011542 4 346036
1#0##0#0#0.0#2021-12-30
08:43:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c6c357eeada444db9b9ba057c1f27c01 300000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 16/05/1963 0 2
- 0 - 0 - 0 - 0 182600 139431 0
1 0 0 0 SUMARDINI.NY 084722 58 21407 DR. CHIKA
KLARISSA 1124R0021221V004471 0001102659748 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 346696 1#0##0#0#0.0#2022-04-14
13:15:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
5f7d6d136473c7d499c16a1460c617e7 105000 0 0 0 0 0
0 0 0 0 15000 0 19431 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 12/08/2008 0 1
0 - 0 - 0 - 0 - 0 181400 112750
0 1 0 0 0 MOHAMMAD ASSYAFA ZIDDAN HANDIAKHSA, AN 094777
13 4882 DR. CHIKA KLARISSA 1124R0021221V004473 0001274594679
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 346698
1#0##0#0#0.0#2022-01-04
14:48:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c604e64df4e3a681bc4dd1dbaf30281a 80000 0 0 0 0 0 0
0 0 0 15000 0 17750 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 16/04/1967 0 1
0 - 0 - 0 - 0 - 0 308500 196380
0 1 0 0 0 SABAR SANTOSO,(BP) 037588 54 19976
DR. CHIKA KLARISSA 1124R0021221V004479 0000640479712 3;JKN
novia;3313125201940001; 5.5.5.202112011542 4 346699
1#0##0#0#0.0#2022-01-04
14:48:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2d312d753d41b0835ed99d701b94d3f8 105000 0 0 0 0 0
0 0 0 0 15000 0 76380 0 0 0 0 0
3372030 C 3 CP 2 24/12/2021 24/12/2021 01/07/1971 0 2
0 - 0 - 0 - 0 - 0 308500 245304
0 1 0 0 0 INDARTI, NY 100904 50 18439 DR. CHIKA
5.5.5.202112011542 4 346702 1#0##0#0#0.0#2022-01-04
14:49:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4b873d0c54defd8e99f34268e0167321 0 0 0 0 114000 0
0 0 0 0 25000 0 106304 0 0 0 0 0
3372030 C 3 CP 2 25/12/2021 25/12/2021 27/03/2001 0 1
0 - 0 - 0 - 0 135700 279623 0 1
0 0 0 ZAINI, SDR 050613 20 7578 DR. GERRY FEBRIAN R
1124R0021221V004483 0000640189574 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346703 1#0##0#0#0.0#2022-01-04
14:50:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d175cfda4161bf26d976e13d03cd8ed6 155000 0 0 0 79000 0
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3372030 C 3 CP 2 25/12/2021 25/12/2021 07/01/2003 0 2
0 - 0 - 0 - 0 135700 399027 0 1
0 0 0 RURI ANJAR NUGRAHENI, NN 097382 18 6927 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346704
1#0##0#0#0.0#2022-01-04
14:50:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d4f9bc80343d8d95fb3a896d2ac6f84b 155000 0 0 0 0 0
200000 0 0 0 15000 0 29027 0 0 0 0 0
3372030 C 3 CP 2 25/12/2021 25/12/2021 03/12/1950 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345472
1#0##0#0#0.0#2021-12-27
14:50:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
06faac0fcdd4c73c4ff11bdd5dd301b2 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/12/2021 25/12/2021 09/09/1944 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V004487 0000100867893 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345473 1#0##0#0#0.0#2021-12-27
14:51:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d93b9725c275d0f5a86fcdae371656f8 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/12/2021 25/12/2021 18/07/1964 0 1
0 - 0 - 0 - 0 786200 677676 0 1
SP.PD 1124R0021221V004488 0002425018184 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345474 1#0##0#0#0.0#2021-12-27
14:53:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6d55a2b48acdf3fc5a95efaa9db65be6 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/12/2021 25/12/2021 31/12/1981 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345475
1#0##0#0#0.0#2021-12-27
14:54:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8870f623127392477fc0186b208ad9e5 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/12/2021 25/12/2021 22/02/1971 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345476
1#0##0#0#0.0#2021-12-27
14:57:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
27b4fcd258a726e9d40d64c2c812f485 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/12/2021 25/12/2021 02/02/1972 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V004491 0002070978546 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 345477 1#0##0#0#0.0#2021-12-27
15:01:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
30192560f00f6c8d9399caf0b9508d7e 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/12/2021 25/12/2021 14/03/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345478
1#0##0#0#0.0#2021-12-27
15:02:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7f2239a3afd81cf16846e887916c1894 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/12/2021 25/12/2021 15/10/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345479
1#0##0#0#0.0#2021-12-27
15:03:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7cbed0eea4f7f1b3c47dfd6e9ab7e38f 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/12/2021 25/12/2021 19/05/1972 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345480
1#0##0#0#0.0#2021-12-27
15:05:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e03271c20371f2eef3be034cec9444ea 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/12/2021 25/12/2021 12/03/1955 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 345481
1#0##0#0#0.0#2021-12-27
15:06:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6fb1e32c04c878d49aa8919d3b9f3b79 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/12/2021 25/12/2021 19/12/2006 0 1
0 - 0 - 0 - 0 - 0 182600 164038
0 1 0 0 0 BRYAN SANDYA PERKASA, SDR 012577 15
5485 DR. DANISWARA ADHITIA RAHMAN 1124R0021221V004496 0001086021494
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 346705
1#0##0#0#0.0#2022-04-14
11:42:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
167e89855ab269843deb940bc6140595 130000 0 0 0 0 0
0 0 0 0 15000 0 19038 0 0 0 0 0
3372030 C 3 CP 2 25/12/2021 25/12/2021 16/07/1947 0 1
0 - 0 - 0 - 0 - 0 182600 228039
0 1 0 0 0 AGUS YULIANTO, TN 100910 74 27191 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346706
1#0##0#0#0.0#2022-01-04
14:52:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f0793b0a6c32693bf699b3403d1ccc64 155000 0 0 0 0 0
0 0 0 0 25000 0 48039 0 0 0 0 0
3372030 C 3 CP 2 25/12/2021 25/12/2021 26/10/1994 0 1
- 0 - 0 - 0 - 0 182600 170000 0
1 0 0 0 NANANG WAHYU HIDAYAT, SDR 069060 27 9922
RIZA ABDILLAH 1124R0021221V004503 0002289604465 3;JKN
agung;3313092303950002; 5.6.6.202203301209 4 346707
1#0##0#0#0.0#2022-04-14
12:55:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
00eeb437cb8aa424570f6db11e2669d6 155000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 25/12/2021 25/12/2021 16/07/1972 0 2
0 - 0 - 0 - 0 - 0 182600 326918
0 1 0 0 0 TITIK SUPARTI., NY 064236 49 18059
DR. EVA PRATAMA SUTRISNA 1124R0021221V004504 0000640136507 3;JKN
novia;3313125201940001; 5.5.5.202112011542 4 346708
1#0##0#0#0.0#2022-01-04
14:53:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8723b4fd03af8ea13b5b838ffd083d16 205000 0 0 0 0 0
0 0 0 0 15000 0 106918 0 0 0 0 0
3372030 C 3 CP 2 25/12/2021 25/12/2021 13/11/2015 0 1
0 - 0 - 0 - 0 - 0 182600 183834
0 1 0 0 0 HARTANTO BERYL A., AN 059418 6 2234
DR. EVA PRATAMA SUTRISNA 1124R0021221V004505 0002037456505 3;JKN
agung;3313092303950002; 5.6.6.202203301209 4 346710
1#0##0#0#0.0#2022-04-14
12:54:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
a33b8d20a648ab4cf57e6d83d7af82ce 155000 0 0 0 0 0
0 0 0 0 15000 0 13834 0 0 0 0 0
3372030 C 3 CP 2 26/12/2021 26/12/2021 25/11/2015 0 1
1 K52.9;E86 - - - None None None None Q-5-25-0 None
- 0 - 0 - 0 - 0 135700 813588 0
1 0 0 0 RISKI BAROTO PUTRO, AN 100938 6 2223 DR.
novia;3313125201940001; 5.5.5.202112011542 4 346747
1#0##0#0#0.0#2022-01-04
15:01:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c458bda5e3ef31de92e1388997c3a119 570000 0 75000 0 0 0
0 0 0 0 25000 0 143588 0 0 0 0 0
3372030 C 3 CP 2 26/12/2021 26/12/2021 15/01/2014 0 1
0 - 0 - 0 - 0 135700 1071910 0 1
0 0 0 WAHYU BAROTO PUTRO,AN 100937 7 2902 DR. EVA
PRATAMA SUTRISNA 1124R0021221V004508 0001262684125 3;JKN
agung;3313092303950002; 5.6.6.202203301209 4 346748
1#0##0#0#0.0#2022-04-14
13:50:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
08d59c6b53e831a5b92b0b3529a98bea 800000 0 100000 0 49000
0 0 0 0 0 25000 0 97910 0 0 0 0 0
3372030 C 3 CP 2 26/12/2021 26/12/2021 18/02/1995 0 2
0 - 0 - 0 - 0 135700 203638 0 1
0 0 0 VALISTA TIANA SARI DWI K. NN 077533 26 9808 dr.
NIKE 1124R0021221V004514 0001269763931 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346751 1#0##0#0#0.0#2022-01-04
15:02:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0fe9f7eed7d20aaf27a9cf4f70a9f62e 145000 0 0 0 0 0
0 0 0 0 15000 0 43638 0 0 0 0 0
3372030 C 3 CP 2 26/12/2021 26/12/2021 05/04/1951 0 1
1 H81.3;R11 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 228330
0 1 0 0 0 SARIMAN, TN 100953 70 25833 DR. GERRY
FEBRIAN R 1124R0021221V004517 0002056690653 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346752 1#0##0#0#0.0#2022-01-04
15:03:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f8a27a2451b91eb638bafe628e1dfc19 155000 0 0 0 0 0
0 0 0 0 25000 0 48330 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 31/12/1963 0 2
0 - 0 - 0 - 0 135700 189995 0 1
0 0 0 HARTINI, NY 099691 57 21181 DR. GERRY FEBRIAN R
1124R0021221V004524 0000564210876 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346754 1#0##0#0#0.0#2022-01-04
15:03:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
749296f2d03eb7fbb8766538d69cd52a 155000 0 0 0 0 0
0 0 0 0 15000 0 19995 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 12/09/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 198850
0 1 0 0 0 SLAMET,(NY) 036944 76 27865 DR. RETNO
agung;3313092303950002; 5.5.5.202112011542 4 347287
1#0##0#0#0.0#2022-01-05
10:22:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c2ac7454ebf64a601faf997a236f426b 150000 0 0 0 0 0
0 0 0 0 15000 0 33850 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 30/09/2015 0 1
0 0 - 0 - 0 - 0 - 0 181400 386000
0 1 0 0 0 RAFAUZAN KAMIL MIQDAD, (AN) 041276 6
3;JKN novia;3313125201940001; 5.5.5.202112011542 4 346713
1#0##0#0#0.0#2022-01-05
18:26:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 18/04/1995 0 2
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1#0##0#0#0.0#2022-01-04
14:48:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 31/12/1996 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 346740
1#0##0#0#0.0#2022-01-04
14:53:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 14/08/1974 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 346743
1#0##0#0#0.0#2022-01-04
14:54:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 346749
1#0##0#0#0.0#2022-01-04
14:58:51#0#00:00:00#00:00:00#12:41:13#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 31/01/1976 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 346772
1#0##0#0#0.0#2022-01-04
14:59:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 04/06/1952 0 1
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1124R0021221V004534 0001614176932 3;JKN agung;3313092303950002;
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15:01:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 04/06/1968 0 2
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15:02:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 18/08/1971 0 2
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15:04:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 19/04/1999 0 2
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15:12:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 01/01/1958 0 2
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1124R0021221V004540 0001808616699 3;JKN agung;3313092303950002;
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MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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11:44:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 346648
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13:49:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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12:07:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 25/06/1970 0 2
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1#0##0#0#0.0#2022-01-04
15:53:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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18:39:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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16:16:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6944293d98612854e791e959a720cd40 150000 0 0 0 0 0
0 0 0 0 15000 0 35042 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 27/11/1986 0 2
0 0 - 0 - 0 - 0 - 0 181400 206502
0 1 0 0 0 YARNI, NY 093021 35 12814 DR. WAHYU
agung;3313092303950002; 5.5.5.202112011542 4 346941
1#0##0#0#0.0#2022-01-04
16:17:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7f0ae261c0ea3843fb97520df15366a1 150000 0 0 0 0 0
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3372030 C 3 CP 2 27/12/2021 27/12/2021 14/08/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 222415
0 1 0 0 0 SRI LESTARI 056183 53 19493 DR. WAHYU
agung;3313092303950002; 5.5.5.202112011542 4 346956
1#0##0#0#0.0#2022-01-04
16:18:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 27/08/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 284595
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 346964
1#0##0#0#0.0#2022-01-04
16:26:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 19/10/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 234157
0 1 0 0 0 WAGIMAN, TN 100076 49 17966 DR. WAHYU
agung;3313092303950002; 5.5.5.202112011542 4 346988
1#0##0#0#0.0#2022-01-04
16:32:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 12/12/1978 0 1
0 404900 410557 0 1 0 0 0 IMAM SUTIKNO
0001104720513 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
346997 1#0##0#0#0.0#2022-01-04
16:33:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 30/01/1966 0 2
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0 1 0 0 0 WAHYUNI.NY 082555 55 20420 DR. WAHYU
agung;3313092303950002; 5.5.5.202112011542 4 347001
1#0##0#0#0.0#2022-01-04
16:34:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 06/06/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 189820
0 1 0 0 0 UMI NAFIAH. NY 076253 47 17371 DR.
agung;3313092303950002; 5.5.5.202112011542 4 347007
1#0##0#0#0.0#2022-01-04
16:35:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 27/11/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 235827
0 1 0 0 0 NGATIYEM,NY 084267 60 21945 DR. WAHYU
agung;3313092303950002; 5.5.5.202112011542 4 347012
1#0##0#0#0.0#2022-01-04
16:36:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
31409288ef71edcbee9f979c1f1d5cb1 150000 0 0 0 0 0
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3372030 C 3 CP 2 27/12/2021 27/12/2021 30/08/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 219864
0 1 0 0 0 SUTARDI.TN 093260 61 22399 DR. WAHYU
agung;3313092303950002; 5.5.5.202112011542 4 347017
1#0##0#0#0.0#2022-01-04
16:37:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 03/07/1935 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 347024
1#0##0#0#0.0#2022-01-04
16:38:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 14/06/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001429190267 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
347043 1#0##0#0#0.0#2022-01-04
16:56:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 02/01/1970 0 1
1 Z09.0;H11.0;H04.0 90.29;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 577470 0
1 0 0 0 MUH DAROJAT., BP 001091 51 18987 DR. YUDHI
agung;3313092303950002; 5.5.5.202112011542 4 347044
1#0##0#0#0.0#2022-01-04
16:58:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 16/08/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0000640206066 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
347045 1#0##0#0#0.0#2022-01-04
16:59:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 06/07/1954 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUMARNI.NY 086963
0002347072604 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
347046 1#0##0#0#0.0#2022-01-04
17:00:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 04/08/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUNARTI 54610
0000091515857 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
347047 1#0##0#0#0.0#2022-01-04
17:00:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 28/10/1944 0 1
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0 1 0 0 0 MARUTA TIRANA,(BP) 040357 77 28184
agung;3313092303950002; 5.5.5.202112011542 4 347048
1#0##0#0#0.0#2022-01-04
17:01:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 13/03/1949 0 1
1 Z09.8;H26.9;H11.0;E11.3;H36.0 90.29;16.21 - - None None None
None H-3-12-0 None None None None None None PROSEDUR LAIN-LAIN PADA
MATA 211200 0 0 - 0 - 0 - 0 - 0 211200
259045 0 1 0 0 0 SUBARDJO 023866 72 26587
agung;3313092303950002; 5.5.5.202112011542 4 347049
1#0##0#0#0.0#2022-01-04
17:14:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 10/05/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 236805
0 1 0 0 0 ILIK MARYATI., NY 047845 48 17763 DR.
agung;3313092303950002; 5.5.5.202112011542 4 347050
1#0##0#0#0.0#2022-01-04
17:15:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 11/02/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 205580
0 1 0 0 0 ENDANG TRI WAHYUNINGSIH 100608 62 22965
agung;3313092303950002; 5.5.5.202112011542 4 347051
1#0##0#0#0.0#2022-01-04
17:16:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 04/12/1968 0 1
1 Z09.8;M54.96;H53.1 90.29 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 253620
0 1 0 0 0 GUNAWAN. BP 036117 53 19381 DR. YUDHI
agung;3313092303950002; 5.5.5.202112011542 4 347052
1#0##0#0#0.0#2022-01-04
17:24:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 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; 5.5.5.202112011542 4
347054 1#0##0#0#0.0#2022-01-04
17:25:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 19/08/1953 0 1
1 Z09.8;S93.4 93.35;93.39 - - None None None None M-3-16-0
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000089786147 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
347055 1#0##0#0#0.0#2022-01-04
17:26:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 14/06/1956 0 1
1 M17.9;W19.9 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 315000
0 1 0 0 0 TASLIM 062892 65 23937 DR. WAHYU
agung;3313092303950002; 5.5.5.202112011542 4 347057
1#0##0#0#0.0#2022-01-04
17:27:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 09/11/1965 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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347058 1#0##0#0#0.0#2022-01-04
17:32:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 05/08/1966 0 1
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agung;3313092303950002; 5.5.5.202112011542 4 347056
1#0##0#0#0.0#2022-01-04
17:34:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 22/09/1959 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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347059 1#0##0#0#0.0#2022-01-04
17:35:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 03/05/1951 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 347060
1#0##0#0#0.0#2022-01-04
17:36:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 18/11/1973 0 1
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17:45:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 17/03/1963 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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347061 1#0##0#0#0.0#2022-01-04
17:40:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 02/04/2010 0 1
1 Q54.9 - - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 165000
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agung;3313092303950002; 5.5.5.202112011542 4 347063
1#0##0#0#0.0#2022-01-04
17:47:08#0#00:00:00#00:00:00#14:06:22#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 17/06/1964 0 1
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agung;3313092303950002; 5.5.5.202112011542 4 347072
1#0##0#0#0.0#2022-01-04
17:50:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 14/05/1933 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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347074 1#0##0#0#0.0#2022-01-04
17:51:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 09/03/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ARIEF BUDI
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17:56:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 16/02/1959 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARZUQI.TN 095738
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347075 1#0##0#0#0.0#2022-01-04
17:54:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 13/04/1954 0 1
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17:57:17#0#00:00:00#00:00:00#13:52:31#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 05/10/2020 0 1
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347103 1#0##0#0#0.0#2022-01-04
17:59:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 01/10/1937 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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347102 1#0##0#0#0.0#2022-01-04
17:58:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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347104 1#0##0#0#0.0#2022-01-04
18:00:49#0#00:00:00#00:00:00#12:58:57#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 08/11/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 225682
0 1 0 0 0 ANNI WAKHIDAH,NY 094411 57 20868 DR.
agung;3313092303950002; 5.5.5.202112011542 4 347167
1#0##0#0#0.0#2022-01-05
07:59:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 27/12/2021 27/12/2021 03/02/2000 0 2
0 - 0 - 0 - 0 183900 289845 0 1
0 0 0 YASMIEN IKA FRENTINA.NN 100741 21 7998 DR. DAMAR
5.5.5.202112011542 4 347169 1#0##0#0#0.0#2022-01-05
08:15:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6c405983c9b5686133c527454da16d52 235000 0 0 0 0 0
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3372030 C 3 CP 2 27/12/2021 27/12/2021 02/08/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SITI MAJIAH, NY
0000639393467 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
347188 1#0##0#0#0.0#2022-01-05
08:16:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6cc63c0cce8941d2d67be5648e65fa9a 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 29/09/1961 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI HANDAYANI.NY
0000198861636 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
347189 1#0##0#0#0.0#2022-01-05
08:23:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
aae05e4ceb9fb94ce8b869aaf85792eb 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 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 agung;3313092303950002; 5.5.5.202112011542 4
347192 1#0##0#0#0.0#2022-01-05
08:27:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a2b4694ebc5b7e4120cacd9731f314c3 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 09/08/1954 0 2
1 Z09.8;H26.9;A96.1;H10.4 90.29 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 269133
0 1 0 0 0 SUDARMI.NY 095368 67 24612 DR. YUDHI
agung;3313092303950002; 5.6.6.202203301209 4 347196
1#0##0#0#0.0#2022-04-14
13:35:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 5
6a3e9080e3cbd423ec51bb902fb06d54 203000 0 0 0 0 0
0 0 0 0 15000 0 51133 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 13/08/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 165000 0 1 0 0 0 TRI UTAMI
1124R0021221V004631 0001380313934 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 347201 1#0##0#0#0.0#2022-01-05
08:33:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f06eff699728de054a109173363682cb 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 10/10/1953 0 2
0 - 0 107400 273000 0 1 0 0 0 TUTIK
SARASWATI ., NY 054196 68 24915 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V004632 0001449355893 3;JKN novia;3313125201940001;
5.6.3.202201201500 4 347198 1#0##0#0#0.0#2022-02-14
15:43:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
8081827b2e397b9b51fb496ee4405e77 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 23/11/2001 0 2
0 0 - 0 - 0 - 0 - 0 181400 191832
0 1 0 0 0 ASRI KARTIKA WATI 083079 20 7339 DR.
agung;3313092303950002; 5.5.5.202112011542 4 347205
1#0##0#0#0.0#2022-01-05
08:34:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b31c6fee24b069b9940662447ad25098 150000 0 0 0 0 0
0 0 0 0 15000 0 26832 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 08/08/2005 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 GHEFIRA NUR FATIMAH AZZAHRA.NN 098548
0001202273706 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
347208 1#0##0#0#0.0#2022-01-05
08:54:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
6f88b2b59e5caeab3d66c8767e7949a5 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 03/09/2020 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 BY,NY RATNA DEWI 090494 1 480 DR.
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 347265
1#0##0#0#0.0#2022-01-05
08:56:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e40b1e22fb0afdb5c8b4a45aa104d275 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 30/09/1977 0 2
0000207436206 3;JKN agung;3313092303950002; 5.5.5.202112011542 4
347266 1#0##0#0#0.0#2022-01-05
08:57:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4a0df4768be98f5cc1002f373a0e5f5c 351500 0 0 0 0 0
0 0 0 0 25000 0 0 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 19/12/1978 0 1
- 0 - 0 - 0 - 0 182600 145000 0
1 0 0 0 HERU WAHYU TRIYONO, TN 100960 43 15714 DR.
reni;3313147010930001; 5.6.0.202201041418 4 346755
1#0##0#0#0.0#2022-01-07
19:59:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 3
30b23e0649a7af0f059111d83522628c 130000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 17/04/1970 0 2
1 C50.9 96.59 - - None None None None Z-3-27-0 None None
- 0 - 0 - 0 183900 400210 0 1 0
0 0 SRI FADILAH, NY 100313 51 18882 DR. HERMAWAN, SP.B
1124R0021221V004641 0001530476932 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 347267 1#0##0#0#0.0#2022-01-05
08:58:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9e5de045c2f0970873f4f25fcfc5a0e0 370000 0 0 0 0 0
0 0 0 0 15000 0 15210 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 01/01/1972 0 2
- 0 - 0 - 0 - 0 183900 195456 0
1 0 0 0 SARYANTI 64048 49 18258 DR. HERMAWAN, Sp.B M.Kes
1124R0021221V004642 0000639936887 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 347270 1#0##0#0#0.0#2022-01-05
09:00:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e4280805f9d4c33f11e840248fed2971 150000 0 0 0 0 0
0 0 0 0 15000 0 30456 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 09/05/1975 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V004643 0001105378571 3;JKN agung;3313092303950002;
5.5.5.202112011542 4 346605 1#0##0#0#0.0#2022-01-04
11:43:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1b4ead6bc44ddd315f8f319c9cf0a788 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 12/07/1966 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.5.5.202112011542 4 346603
1#0##0#0#0.0#2022-01-04
11:24:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8cb9cbceb9fa68cfc899ed578bf11488 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 12/12/1964 0 1
0 - 0 - 0 - 0 786200 696996 0 1
agung;3313092303950002; 5.5.5.202112011542 4 346601
1#0##0#0#0.0#2022-01-04
11:19:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ce0fcf39fb84f2e1607bdb4b6e52e596 662676 0 0 0 0 0
0 0 0 0 15000 0 19320 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 22/10/1959 0 2
0 - 0 - 0 - 0 786200 585530 0 1
agung;3313092303950002; 5.5.5.202112011542 4 346600
1#0##0#0#0.0#2022-01-04
11:15:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ba8e5772a7bd9d0517b3de2485cd468c 463830 0 0 0 0 0
0 0 0 0 15000 0 106700 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 28/02/1967 0 2
0 - 0 - 0 - 0 786200 677676 0 1
agung;3313092303950002; 5.5.5.202112011542 4 346599
1#0##0#0#0.0#2022-01-04
11:13:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8ecc68a69e4b48204c20251b62dd7880 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 09/08/1992 0 1
0 0 - 0 - 0 - 0 - 0 181400 150000
novia;3313125201940001; 5.6.0.202201041418 4 348098
1#0##0#0#0.0#2022-01-07
16:24:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
6a031dcda764a3df50ed17f74d51d3c5 150000 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 12/08/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.5.5.202112011542 4 346598
1#0##0#0#0.0#2022-01-04
11:12:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
63e97654dd65c8906acc099e10d87f6e 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 03/08/1963 0 2
0 - 0 - 0 - 0 786200 478830 0 1
agung;3313092303950002; 5.5.5.202112011542 4 346597
1#0##0#0#0.0#2022-01-04
11:10:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e7da6d8c3251edbd2d1e488feba3120f 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 19/12/2002 0 1
0 0 - 0 - 0 - 0 - 0 181400 454808
0 1 0 0 0 KHOIRUL ANWAR.SDR 095296 19 6948 DR.
agung;3313092303950002; 5.5.5.202112011542 4 347271
1#0##0#0#0.0#2022-01-05
09:02:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
df093920cee9a26cdf13e29095d9f4c1 325000 0 0 0 0 0
0 0 0 0 15000 0 114808 0 0 0 0 0
3372030 C 3 CP 2 27/12/2021 27/12/2021 09/07/1990 0 2
1 L50.9;T78.1 - - - None None None None Q-5-42-0 None
0 - 0 - 0 - 0 - 0 182600 435209
0 1 0 0 0 YUNESTI PRATIWI, NY 061134 31 11494
dr. KRISNA ARIE SOESANTY 1124R0021221V004656 0000674146809 3;JKN
novia;3313125201940001; 5.5.5.202112011542 4 346796
1#0##0#0#0.0#2022-01-04
15:17:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
38c3838637dfea53f0662696a08cd8cf 155000 0 163500 0 79000
0 0 0 0 0 15000 0 22709 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 05/06/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 292965
0 1 0 0 0 MARIA SITI SAPARIYAH.NY 078917 74 27235
yani;3302226402970001; 5.6.0.202201041418 4 347552
1#0##0#0#0.0#2022-01-06
13:06:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
de20755779851607cd4066288bdef9de 150000 0 0 0 0 0
0 76045 0 0 15000 0 51920 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 27/05/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 462577
0 1 0 0 0 WATIYEM, NY 062691 55 20304 DR. TEKY
yani;3302226402970001; 5.6.0.202201041418 4 347553
1#0##0#0#0.0#2022-01-06
13:14:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b74b2d1fa955064ccd0e6f02333a336d 150000 0 0 0 0 0
0 76045 0 0 15000 0 221532 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 16/05/1964 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
377395 0 1 0 0 0 MAELANI., NY 046177 57
3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347554
1#0##0#0#0.0#2022-01-06
13:17:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f1a08bd4e5647b6c6c1567bb0e04e040 150000 0 0 0 0 0
0 76595 0 0 15000 0 135800 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 30/07/1939 0 2
0 0 - 0 - 0 - 0 - 0 181400 184130
0 1 0 0 0 ASTITI 066027 82 30102 DR. TEKY
yani;3302226402970001; 5.6.0.202201041418 4 347555
1#0##0#0#0.0#2022-01-06
13:17:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4873a46470bf4dd40f080f3f5968763d 150000 0 0 0 0 0
0 0 0 0 15000 0 19130 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 25/03/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 352953
0 1 0 0 0 SUTIYEM, NY 053535 58 21463 DR. TEKY
yani;3302226402970001; 5.6.0.202201041418 4 347556
1#0##0#0#0.0#2022-01-06
13:18:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
89e19eab723dd878817ed6f78ffcc21a 150000 0 0 0 0 0
0 108440 0 0 15000 0 79513 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 06/03/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 448827
0 1 0 0 0 MARGONO ESAN ., BP 000820 60 22212
yani;3302226402970001; 5.6.0.202201041418 4 347557
1#0##0#0#0.0#2022-01-06
13:20:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
717de20e2059665f0581b006f2973cbd 150000 0 0 0 0 0
0 76595 0 0 15000 0 207232 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 31/12/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 487555
0 1 0 0 0 TRI MARGINI,(NY) 034217 56 20816 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347558
1#0##0#0#0.0#2022-01-06
13:24:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1764cf0ab2bf23d34b8c3d8d9cf2ede5 150000 0 0 0 0 0
0 76595 0 0 15000 0 245960 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 28/06/1959 0 1
1 Z09.8;M75.0;E78.5;E79.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 329987
0 1 0 0 0 ACHMAD MULYADI., TN 070227 62 22829
yani;3302226402970001; 5.6.0.202201041418 4 347559
1#0##0#0#0.0#2022-01-06
13:25:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cbaed15b084ef6674835428b6f34bfbe 150000 0 0 0 0 0
0 31845 0 0 15000 0 133142 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 08/06/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 272785
0 1 0 0 0 HARYATI.NY 077252 72 26501 DR. TEKY
yani;3302226402970001; 5.6.0.202201041418 4 347560
1#0##0#0#0.0#2022-01-06
13:26:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5ab3f92b10c0ca126744a3e2e634b62b 150000 0 0 0 0 0
0 31845 0 0 15000 0 75940 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 20/11/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 596204
0 1 0 0 0 SUMARDI., TN 065082 61 22318 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347561
1#0##0#0#0.0#2022-01-06
13:31:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
78f5cab8d866bd56b67297d0143838a4 150000 0 0 0 0 0
0 31845 0 0 15000 0 399359 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 07/01/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 669946
0 1 0 0 0 JAHURI BAKRI, TN 072140 56 20809 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347562
1#0##0#0#0.0#2022-01-06
13:33:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
25c7dfda0d6695cc2533b55a66ed7a58 150000 0 0 0 0 0
0 31845 0 0 15000 0 473101 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 17/04/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 304130
0 1 0 0 0 ISMIYATI, NY 094052 69 25457 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347563
1#0##0#0#0.0#2022-01-06
13:35:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
129cae1469906a98d484913c5a54b83f 150000 0 0 0 0 0
0 88950 0 0 15000 0 50180 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 10/05/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 323741
0 1 0 0 0 SUMALI, (BP) 002143 62 22878 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347564
1#0##0#0#0.0#2022-01-06
13:35:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9c6b81a96f14cc485bf3a0961a7bb31a 150000 0 0 0 0 0
0 120795 0 0 15000 0 37946 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 04/07/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 424425
0 1 0 0 0 SUTARTO,TN 097881 62 22823 DR. TEKY
yani;3302226402970001; 5.6.0.202201041418 4 347565
1#0##0#0#0.0#2022-01-06
13:36:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b5b027d3c1a85c1152c07e50decce448 150000 0 0 0 0 0
0 76595 0 0 15000 0 182830 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 09/01/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 532098
0 1 0 0 0 SRI SUYAMTI., NY 047144 56 20807 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347566
1#0##0#0#0.0#2022-01-06
13:37:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4099d0fa4f069b89d7ad175e3d5e8e02 150000 0 0 0 0 0
0 31845 0 0 15000 0 335253 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 17/06/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 248980
0 1 0 0 0 JOKO PRAYITNO.TN 084157 62 22840 DR.
novia;3313125201940001; 5.6.3.202201201500 4 347567
1#0##0#0#0.0#2022-03-08
08:53:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
515d1693d077a22910dcb8f0a11404c2 150000 0 0 0 0 0
0 31845 0 0 15000 0 52135 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 15/08/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 272304
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yani;3302226402970001; 5.6.0.202201041418 4 347568
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13:38:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 31/12/1958 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347569
1#0##0#0#0.0#2022-01-06
13:39:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 21/10/1972 0 1
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novia;3313125201940001; 5.6.3.202201201500 4 347570
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11:47:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 28/12/2021 28/12/2021 31/12/1958 0 1
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13:41:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 19/09/1960 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347573
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13:41:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 02/02/1952 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347572
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13:43:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 07/12/1943 0 1
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13:45:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 11/08/1948 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
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13:46:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 29/09/1970 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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3372030 C 3 CP 2 28/12/2021 28/12/2021 19/11/1960 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 347576
1#0##0#0#0.0#2022-01-06
13:48:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 10/05/1965 0 2
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novia;3313125201940001; 5.6.3.202201201500 4 345664
1#0##0#0#0.0#2022-03-08
09:28:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 28/12/2021 28/12/2021 03/08/1964 0 1
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1#0##0#0#0.0#2022-01-06
13:49:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 20/04/1971 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347578
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13:50:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 23/04/1960 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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13:51:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.6.0.202201041418 4 347579
1#0##0#0#0.0#2022-01-06
13:51:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 10/08/1962 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347580
1#0##0#0#0.0#2022-01-06
13:52:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 03/07/1971 0 1
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13:53:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 23/07/1972 0 2
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1#0##0#0#0.0#2022-01-06
13:57:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 30/01/1975 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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347655 1#0##0#0#0.0#2022-01-06
13:58:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 06/05/1962 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347583
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13:59:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 11/05/1966 0 2
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3372030 C 3 CP 2 28/12/2021 28/12/2021 05/01/1957 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 347585
1#0##0#0#0.0#2022-01-06
14:03:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 16/10/1949 0 2
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1#0##0#0#0.0#2022-01-06
14:07:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 20/03/1961 0 2
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14:12:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 04/06/1948 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 347587
1#0##0#0#0.0#2022-01-06
14:18:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 06/08/1974 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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14:20:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 23/03/1965 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347588
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14:22:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 16/03/1952 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347589
1#0##0#0#0.0#2022-01-06
14:23:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 31/12/1949 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347590
1#0##0#0#0.0#2022-01-06
14:32:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347591
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14:26:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 21/02/1966 0 1
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1#0##0#0#0.0#2022-01-06
14:28:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 16/05/1959 0 1
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1#0##0#0#0.0#2022-03-08
08:34:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 3
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14:33:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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novia;3313125201940001; 5.6.3.202201201500 4 347366
1#0##0#0#0.0#2022-02-14
15:43:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 28/12/2021 28/12/2021 31/12/1963 0 2
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14:38:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.6.0.202201041418 4 347597
1#0##0#0#0.0#2022-01-06
14:45:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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14:47:34#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#2022-01-06
14:48:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
27f30f9a4d5bd09be9d5ee1a41d0e8f7 225000 0 0 0 0 0
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3372030 C 3 CP 2 28/12/2021 28/12/2021 01/01/1949 0 2
1 Z09.8;I11.9;M19.98;E79.0;K30 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
212911 0 1 0 0 0 SITI MAEMUNAH.NY 085000 72
3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347599
1#0##0#0#0.0#2022-01-06
14:52:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ba81f70c2d82b840d01e038fe62a0229 150000 0 0 0 0 0
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3372030 C 3 CP 2 28/12/2021 28/12/2021 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 yani;3302226402970001; 5.6.0.202201041418 4
347649 1#0##0#0#0.0#2022-01-06
14:54:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3123c581b027915cc88bed85754087d1 247000 0 0 0 0 0
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3372030 C 3 CP 2 28/12/2021 28/12/2021 01/06/1944 0 2
1 Z09.8;I50.0;N18.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 206980
0 1 0 0 0 SUJINEM,NY 086697 77 28334 DR. TEKY
yani;3302226402970001; 5.6.0.202201041418 4 347600
1#0##0#0#0.0#2022-01-06
14:55:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
04c11d547ad63b44946c63cc24b33203 150000 0 0 0 0 0
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3372030 C 3 CP 2 28/12/2021 28/12/2021 03/12/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 209740
0 1 0 0 0 TEGUH HARDOJO 47809 65 23766 DR. SUHARTO,
SP.PD 1124R0021221V004720 0000638876744 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 349021 1#0##0#0#0.0#2022-04-18
17:18:26#0#00:00:01#00:00:01#10:43:02#{"co_insidense_ind":"0"} 5
a96c8966252ee8e5c0ce41557e888c1b 150000 0 0 0 0 0
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3372030 C 3 CP 2 28/12/2021 28/12/2021 04/09/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 316690
0 1 0 0 0 JUWITA.NY 096212 57 20934 DR. TEKY
yani;3302226402970001; 5.6.0.202201041418 4 347601
1#0##0#0#0.0#2022-01-06
14:56:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
656a63369d43039dfe581c90441c7840 150000 0 0 0 0 0
0 76045 0 0 15000 0 75645 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 30/08/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 242245
0 1 0 0 0 AGUS PURWO NUGROHO.TN 077269 60 22035
yani;3302226402970001; 5.6.0.202201041418 4 347602
1#0##0#0#0.0#2022-01-06
14:58:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
528103c54e3d9149315a8655ea16c516 150000 0 0 0 0 0
0 31845 0 0 15000 0 45400 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 04/12/1951 0 2
1 Z09.8;E11.9;I11.9;M19.98 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
350355 0 1 0 0 0 SRI SARDILAH, NY 084349 70
yani;3302226402970001; 5.6.0.202201041418 4 347603
1#0##0#0#0.0#2022-01-06
14:59:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
86b1c8eb9067941b1fc9c34db94c5dfd 150000 0 0 0 0 0
0 31845 0 0 15000 0 153510 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 14/06/1974 0 1
1 Z09.8;E11.4;G59.0;R51 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 373698
0 1 0 0 0 HANDOKO.TN 082490 47 17364 DR. TEKY
yani;3302226402970001; 5.6.0.202201041418 4 347604
1#0##0#0#0.0#2022-01-06
15:07:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ef4637a6a9f80e9000b14d085416a266 150000 0 0 0 0 0
0 31845 0 0 15000 0 176853 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 15/03/1938 0 2
0 0 - 0 - 0 - 0 - 0 181400 307347
0 1 0 0 0 SETIYARSIH, NY 069247 83 30604 DR.
novia;3313125201940001; 5.6.3.202201201500 4 347605
1#0##0#0#0.0#2022-03-08
08:41:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
7a515bc1b0bb9845cf21108fc56cad12 150000 0 0 0 0 0
0 31845 0 0 15000 0 110502 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 14/03/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 242810
0 1 0 0 0 SUPARNO, TN 083695 55 20378 DR. SUHARTO,
SP.PD 1124R0021221V004727 0001530409623 3;JKN yani;3302226402970001;
5.6.0.202201041418 4 347606 1#0##0#0#0.0#2022-01-06
15:10:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
78e25638c90a810d77fa6ad009621cdc 150000 0 0 0 0 0
0 31845 0 0 15000 0 45965 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 31/12/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 190859
0 1 0 0 0 BUDI SISWANTO. TN 051253 52 19355 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347607
1#0##0#0#0.0#2022-01-06
15:11:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a326fad157575a7c4e49d40218163ca8 150000 0 0 0 0 0
0 0 0 0 15000 0 25859 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 24/05/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 167240
0 1 0 0 0 RINA LESTARI ., NY 053321 52 19211
yani;3302226402970001; 5.6.0.202201041418 4 347608
1#0##0#0#0.0#2022-01-06
15:16:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6b9446976552db38dfc1885f8e5e66e8 150000 0 0 0 0 0
0 0 0 0 15000 0 2240 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 13/04/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 343400
0 1 0 0 0 DIYONO.TN 089252 70 25827 DR. TEKY
yani;3302226402970001; 5.6.0.202201041418 4 347609
1#0##0#0#0.0#2022-01-06
15:17:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e203e2d294beda2e3951c4444293a8f6 150000 0 0 0 0 0
0 88950 0 0 15000 0 89450 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 21/04/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 305185
0 1 0 0 0 RINDUAN JANUAR., BP 052069 71 26184
3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347610
1#0##0#0#0.0#2022-01-06
15:18:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
40d4937b32d1f46cc006fd792e13ac32 150000 0 0 0 0 0
0 89500 0 0 15000 0 50685 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 17/10/2002 0 2
0 0 - 0 - 0 - 0 - 0 181400 170760
0 1 0 0 0 AIDA ADNA NOER KUSUMA ., NN 057201 19
3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347611
1#0##0#0#0.0#2022-01-06
15:20:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3536d162461bc66a7a04dd1628a1423b 150000 0 0 0 0 0
0 0 0 0 15000 0 5760 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 02/02/1972 0 1
0 0 - 0 - 0 - 0 - 0 181400 396736
0 1 0 0 0 SUMARYONO.TN 087131 49 18227 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347613
1#0##0#0#0.0#2022-01-06
15:21:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
12ad9f94c6c2a83e9ba4b95265304587 150000 0 0 0 0 0
0 31845 0 0 15000 0 199891 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 13/12/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347612
1#0##0#0#0.0#2022-01-06
15:21:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
826150f890492628398087c1de30790f 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 16/02/1947 0 1
0 0 - 0 - 0 - 0 - 0 181400 220491
0 1 0 0 0 LESTARI HADI SUNARTO ., NY 058269 74
3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347614
1#0##0#0#0.0#2022-01-06
15:23:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d012cc06ada74f566949090c383b2343 150000 0 0 0 0 0
0 0 0 0 15000 0 55491 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 16/10/1996 0 2
0 0 - 0 - 0 - 0 - 0 181400 201420
0 1 0 0 0 ALIN OKSARANUDINNI, NN 056995 25 9204
yani;3302226402970001; 5.6.0.202201041418 4 347615
1#0##0#0#0.0#2022-01-06
15:23:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f09fa51a54526b73aa9b77e0f31d5877 150000 0 0 0 0 0
0 0 0 0 15000 0 36420 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 31/12/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 318990
0 1 0 0 0 SASTRO SUMARNO, TN 096451 75 27756
yani;3302226402970001; 5.6.0.202201041418 4 347616
1#0##0#0#0.0#2022-01-06
15:24:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ae22a31576e14beb39d7c7a5a54e5378 150000 0 0 0 0 0
0 76045 0 0 15000 0 77945 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 28/07/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 425840
0 1 0 0 0 SUPARWATI.NY 100628 59 21703 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347617
1#0##0#0#0.0#2022-01-06
15:25:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7b74a90ef8de4592219a1d69a4db464c 150000 0 0 0 0 0
0 108440 0 0 15000 0 152400 0 0 0 0
0
3372030 C 3 CP 2 28/12/2021 28/12/2021 07/07/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 334375
yani;3302226402970001; 5.6.0.202201041418 4 347618
1#0##0#0#0.0#2022-01-06
15:26:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
20f4ae4a1f22fdb75bfccafd3f3f8100 150000 0 0 0 0 0
0 76045 0 0 15000 0 93330 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 31/12/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 257678
0 1 0 0 0 SUWARSI,(NY) 036802 78 28852 DR.
novia;3313125201940001; 5.6.3.202201201500 4 347619
1#0##0#0#0.0#2022-03-08
11:48:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
68f4175d2e6e6a8fe0dcd328d8f132ab 150000 0 0 0 0 0
0 63690 0 0 15000 0 28988 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 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; 5.6.0.202201041418 4
347660 1#0##0#0#0.0#2022-01-06
15:29:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a6f82240c74a428bd0853eacfb6cab4f 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 13/02/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 170955
yani;3302226402970001; 5.6.0.202201041418 4 347620
1#0##0#0#0.0#2022-01-06
15:30:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9880adaf64ac30d16b3e8c15961419be 150000 0 0 0 0 0
0 0 0 0 15000 0 5955 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 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 yani;3302226402970001; 5.6.0.202201041418 4
347661 1#0##0#0#0.0#2022-01-06
15:31:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7cf9e330130c221831a5ead1cf6cf861 258000 0 0 0 0 0
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3372030 C 3 CP 2 28/12/2021 28/12/2021 10/11/1965 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002165956975 3;JKN yani;3302226402970001; 5.6.0.202201041418 4
347654 1#0##0#0#0.0#2022-01-06
15:31:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
30f472c309c783c583776988bc188e56 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 28/05/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 658935
0 1 0 0 0 ROMITA NURRATRIANA,(NY) 015145 58 21399
yani;3302226402970001; 5.6.0.202201041418 4 347621
1#0##0#0#0.0#2022-01-06
15:32:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dc5cfa7dc9971c910bdaaca025970d39 150000 0 0 0 0 0
0 63690 0 0 15000 0 430245 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 08/09/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 282061
0 1 0 0 0 HJ UPIK SURATMI. NY 070876 66 24218
yani;3302226402970001; 5.6.0.202201041418 4 347622
1#0##0#0#0.0#2022-01-06
15:33:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
822bf03bbc011358cd62bb797d58fe5e 150000 0 0 0 0 0
0 88900 0 0 15000 0 28161 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 28/07/1988 0 2
0 0 - 0 - 0 - 0 - 0 181400 271715
0 1 0 0 0 FAUZIAH DAHLIA SARI., NY 045406 33
yani;3302226402970001; 5.6.0.202201041418 4 345660
1#0##0#0#0.0#2022-01-06
15:34:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3bc3fe464d3957b2bc8c1f452a1e52a7 150000 0 0 0 0 0
0 31845 0 0 15000 0 74870 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 25/10/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 225515
SP.PD 1124R0021221V004750 0002205741431 3;JKN yani;3302226402970001;
5.6.0.202201041418 4 347623 1#0##0#0#0.0#2022-01-06
15:34:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1ce53f811371c6c127f31292fb199cd9 150000 0 0 0 0 0
0 0 0 0 15000 0 60515 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 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; 5.6.0.202201041418 4
347646 1#0##0#0#0.0#2022-01-06
15:35:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ab6262d3a68aaabbc07ac62b18e0b3e4 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 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 yani;3302226402970001; 5.6.0.202201041418 4
347662 1#0##0#0#0.0#2022-01-06
15:37:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2385502e4ef50a9f6cca68dcd6878f9f 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 01/09/1976 0 2
0 0 - 0 - 0 - 0 - 0 181400 221851
0 1 0 0 0 SUYAMI,NY 063751 45 16554 DR. SUHARTO,
SP.PD 1124R0021221V004754 0000639550361 3;JKN yani;3302226402970001;
5.6.0.202201041418 4 347624 1#0##0#0#0.0#2022-01-06
15:39:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
209eb788ecb3f2d61a4c39ab791c770c 150000 0 0 0 0 0
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3372030 C 3 CP 2 28/12/2021 28/12/2021 23/01/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 292560
0 1 0 0 0 SRI MULYANI 084537 64 23715 DR. SUHARTO,
SP.PD 1124R0021221V004755 0002226349304 3;JKN yani;3302226402970001;
5.6.0.202201041418 4 347625 1#0##0#0#0.0#2022-01-06
15:39:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
663eae2cd2ebd4be283f1d8a899fa608 150000 0 0 0 0 0
0 31845 0 0 15000 0 95715 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 04/06/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 473101
0 1 0 0 0 RAMEI,BP 037075 71 26140 DR. SUHARTO,
SP.PD 1124R0021221V004756 0000089866315 3;JKN yani;3302226402970001;
5.6.0.202201041418 4 347626 1#0##0#0#0.0#2022-01-06
15:41:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e69804170016b06065c7b34d0f428806 150000 0 0 0 0 0
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3372030 C 3 CP 2 28/12/2021 28/12/2021 05/09/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 296150
yani;3302226402970001; 5.6.0.202201041418 4 347627
1#0##0#0#0.0#2022-01-06
15:42:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bf12f0428eeddcdd9fc47aa16ac865c4 150000 0 0 0 0 0
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3372030 C 3 CP 2 28/12/2021 28/12/2021 27/06/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 235270
0 1 0 0 0 RIKA KRISDIANAWATI,(NY) 002091 42 15525
novia;3313125201940001; 5.6.3.202201201500 4 347628
1#0##0#0#0.0#2022-03-08
09:36:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
18fdb8690cee600ad4d706820e635c08 150000 0 0 0 0 0
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3372030 C 3 CP 2 28/12/2021 28/12/2021 15/11/1951 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI PARYATUN
0001444746655 3;JKN yani;3302226402970001; 5.6.0.202201041418 4
347658 1#0##0#0#0.0#2022-01-06
15:56:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4608ea3c88eac371139e24023947cbd0 258000 0 0 0 0 0
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3372030 C 3 CP 2 28/12/2021 28/12/2021 31/12/1938 0 1
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0 1 0 0 0 WAGE PRAPTODIHARJO,TN 060514 82 30313
yani;3302226402970001; 5.6.0.202201041418 4 347629
1#0##0#0#0.0#2022-01-06
15:57:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 30/06/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 244740
0 1 0 0 0 MARGONO.TN 063409 55 20270 DR. SUHARTO,
SP.PD 1124R0021221V004761 0000640391128 3;JKN yani;3302226402970001;
5.6.0.202201041418 4 347630 1#0##0#0#0.0#2022-01-06
16:01:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 27/08/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 224521
0 1 0 0 0 HADI WIYONO, TN 073949 72 26421 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347631
1#0##0#0#0.0#2022-01-06
16:03:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7ccbc9d27e0aad8b26d5e44a5c88fea0 150000 0 0 0 0 0
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3372030 C 3 CP 2 28/12/2021 28/12/2021 09/06/1965 0 2
1 Z09.8;I11.9;R05;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 232845
yani;3302226402970001; 5.6.0.202201041418 4 347632
1#0##0#0#0.0#2022-01-06
16:05:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 24/05/1945 0 2
1 Z09.8;I11.9;L50.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 255080
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yani;3302226402970001; 5.6.0.202201041418 4 347633
1#0##0#0#0.0#2022-01-06
16:11:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 28/05/1974 0 1
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0 1 0 0 0 SAPTO HARYANTO, TN 100336 47 17381
yani;3302226402970001; 5.6.0.202201041418 4 347634
1#0##0#0#0.0#2022-01-06
16:13:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 25/05/1986 0 1
1 Z09.8;G81.9;G62.9 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 ROBBY HANDOKO.TN
0001032606933 3;JKN yani;3302226402970001; 5.6.0.202201041418 4
347652 1#0##0#0#0.0#2022-01-06
16:14:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 20/02/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 229930
0 1 0 0 0 RUMTANINGSIH(NY) 032276 64 23687 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347635
1#0##0#0#0.0#2022-01-06
16:15:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1cd5c45470144214dbc39736731aa832 150000 0 0 0 0 0
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3372030 C 3 CP 2 28/12/2021 28/12/2021 15/04/1973 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0001440938553 3;JKN yani;3302226402970001; 5.6.0.202201041418 4
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16:16:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 18/04/1968 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 RAHMADI.TN 096843
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07:44:50#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 01/01/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 212850
0 1 0 0 0 INUK SAINEM, NY 058084 57 21181 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347636
1#0##0#0#0.0#2022-01-06
16:17:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 10/12/1973 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 347637
1#0##0#0#0.0#2022-01-06
16:17:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 23/09/1969 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347638
1#0##0#0#0.0#2022-01-06
16:18:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 31/10/1955 0 1
- 0 - 0 - 0 - 0 138400 240000 0
1 0 0 0 DAL HARI PURNOMO.TN 078559 66 24165 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347668
1#0##0#0#0.0#2022-01-06
16:19:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 17/06/1983 0 2
0 - 0 - 0 - 0 - 0 549400 235770
0 1 0 0 0 DEWI KRISTYANINGSIH, NY 029845 38 14074
yani;3302226402970001; 5.6.0.202201041418 4 347639
1#0##0#0#0.0#2022-01-06
16:22:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 05/05/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0001479655326 3;JKN yani;3302226402970001; 5.6.0.202201041418 4
347664 1#0##0#0#0.0#2022-01-06
16:24:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 06/06/1978 0 2
1 Z09.8;N93.8;I10 88.79 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400 221920
0 1 0 0 0 NUNIK TRIANA HERAWATI. NY 079316 43
yani;3302226402970001; 5.6.0.202201041418 4 347640
1#0##0#0#0.0#2022-01-06
16:25:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 20/10/1982 0 2
- 0 - 0 - 0 86900 219825 0 1 0 0
0 PUJIATI RAHAYU, NY 098795 39 14314 DR. GUNAWAN, SP.OG
1124R0021221V004780 0001316513632 3;JKN yani;3302226402970001;
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16:26:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 27/11/1986 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0001480946409 3;JKN yani;3302226402970001; 5.6.0.202201041418 4
347670 1#0##0#0#0.0#2022-01-06
16:27:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 09/01/1977 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347642
1#0##0#0#0.0#2022-01-06
16:28:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 16/01/1984 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347643
1#0##0#0#0.0#2022-01-06
16:29:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 05/02/1956 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347712
1#0##0#0#0.0#2022-01-06
16:29:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 09/04/1941 0 1
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0 0 0 SUMANTO.TN 080896 80 29483 DR. ZULFADLY, SP.B
1124R0021221V004785 0000091327263 3;JKN yani;3302226402970001;
5.6.0.202201041418 4 347713 1#0##0#0#0.0#2022-01-06
16:32:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 06/02/1969 0 1
0 - 0 - 0 - 0 183900 302304 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 347714
1#0##0#0#0.0#2022-01-06
16:34:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 05/04/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 178864
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yani;3302226402970001; 5.6.0.202201041418 4 347715
1#0##0#0#0.0#2022-01-06
16:44:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 05/03/1979 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0001286475028 3;JKN yani;3302226402970001; 5.6.0.202201041418 4
347647 1#0##0#0#0.0#2022-01-06
16:45:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 17/01/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 Ny. Sri Lestari 1938 50 18608 DR. TEKY
novia;3313125201940001; 5.6.3.202201201500 4 347816
1#0##0#0#0.0#2022-03-08
09:37:31#0#00:00:00#00:00:00#15:27:56#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 28/12/2021 28/12/2021 06/03/1959 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 MARIA ROSALIA
SHINTA KUMALASARI, NY 038241 62 22943 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V004791 0000639407722 3;JKN yani;3302226402970001;
5.6.0.202201041418 4 347681 1#0##0#0#0.0#2022-01-06
16:49:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 15/05/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 299617
0 1 0 0 0 PARJAN.TN 080870 69 25429 DR. YUDHI
yani;3302226402970001; 5.6.0.202201041418 4 347717
1#0##0#0#0.0#2022-01-06
16:52:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 19/02/1965 0 1
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1 0 0 0 DANU MARGONO.,BP 056891 56 20766 DR. LINDA
yani;3302226402970001; 5.6.0.202201041418 4 347673
1#0##0#0#0.0#2022-01-06
17:01:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 02/09/1980 0 2
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LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 235865 0 1 0 0 0 FITRIYANA HANDAYANI.NY
0001107034119 3;JKN yani;3302226402970001; 5.6.0.202201041418 4
347718 1#0##0#0#0.0#2022-01-06
17:02:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 29/04/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0001692528928 3;JKN yani;3302226402970001; 5.6.0.202201041418 4
347648 1#0##0#0#0.0#2022-01-06
17:03:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 11/10/1960 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0001106028551 3;JKN yani;3302226402970001; 5.6.0.202201041418 4
347656 1#0##0#0#0.0#2022-01-06
17:26:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 18/01/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 266595
0 1 0 0 0 SUNARTI.NY 082131 58 21529 DR. YUDHI
yani;3302226402970001; 5.6.0.202201041418 4 347719
1#0##0#0#0.0#2022-01-06
17:27:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bb578358fcf283c2aca690b3d5c925ec 0 0 185000 0 0 0
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3372030 C 3 CP 2 28/12/2021 28/12/2021 17/12/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 450851
0 1 0 0 0 PUSPANI, NY 012360 54 19735 DR. ANITA
yani;3302226402970001; 5.6.0.202201041418 4 347720
1#0##0#0#0.0#2022-01-06
17:29:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
06c89180800fb0e490186597f95268db 150000 0 0 0 0 0
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3372030 C 3 CP 2 28/12/2021 28/12/2021 31/12/1963 0 2
1 Z09.8;H26.9;H04.1;E11.3;H36.0 90.29 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
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3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347721
1#0##0#0#0.0#2022-01-06
17:37:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 26/10/1954 0 1
211200 0 0 - 0 - 0 - 0 - 0 211200
341860 0 1 0 0 0 ASMUNI, TN 100963 67 24535
yani;3302226402970001; 5.6.0.202201041418 4 347722
1#0##0#0#0.0#2022-01-06
17:38:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 12/01/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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347684 1#0##0#0#0.0#2022-01-06
17:40:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0d225bbec77c7a537370deaa2f57e479 0 0 198800 0 0 0
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3372030 C 3 CP 2 28/12/2021 28/12/2021 08/06/1950 0 2
- 0 - 0 - 0 - 0 138400 268000 0
1 0 0 0 LAMIYEM.NY 087484 71 26136 DR. LINDA
novia;3313125201940001; 5.6.3.202201201500 4 347683
1#0##0#0#0.0#2022-02-15
11:44:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 28/12/2021 28/12/2021 03/08/1963 0 2
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3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347677
1#0##0#0#0.0#2022-01-06
17:44:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 17/12/1947 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 347679
1#0##0#0#0.0#2022-01-06
17:44:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 13/09/2007 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347724
1#0##0#0#0.0#2022-01-06
17:46:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 14/04/1954 0 2
- 0 - 0 - 0 - 0 138400 285000 0
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yani;3302226402970001; 5.6.0.202201041418 4 347676
1#0##0#0#0.0#2022-01-06
17:51:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 01/11/1961 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347675
1#0##0#0#0.0#2022-01-06
17:52:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 21/02/1960 0 2
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17:53:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 08/12/1974 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 ANIEK AMBARWATI,
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17:54:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 21/11/1960 0 2
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MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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17:55:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 07/07/1964 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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347665 1#0##0#0#0.0#2022-01-06
17:56:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 08/09/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 213670
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yani;3302226402970001; 5.6.0.202201041418 4 347725
1#0##0#0#0.0#2022-01-06
18:34:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 17/03/1976 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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18:36:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 06/02/1941 0 2
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0 1 0 0 0 KATIYEM,(NY) 019745 80 29545 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347726
1#0##0#0#0.0#2022-01-06
18:37:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 21/06/1944 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 347727
1#0##0#0#0.0#2022-01-06
18:40:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 02/02/1963 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347678
1#0##0#0#0.0#2022-01-06
18:44:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 01/09/1967 0 1
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novia;3313125201940001; 5.6.3.202201201500 4 347728
1#0##0#0#0.0#2022-03-08
11:42:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 5
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3372030 C 3 CP 2 28/12/2021 28/12/2021 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 263646
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yani;3302226402970001; 5.6.0.202201041418 4 347729
1#0##0#0#0.0#2022-01-06
18:47:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 17/02/2006 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 FAUZAN MUHAMMAD
1124R0021221V004826 0001639135866 3;JKN yani;3302226402970001;
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18:47:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 08/08/1971 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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18:48:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 25/05/1967 0 1
- 0 - 0 - 0 - 0 138400 285000 0
1 0 0 0 BAMBANG INDRAJID.TN 100238 54 19941 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347672
1#0##0#0#0.0#2022-01-06
18:49:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 15/09/1966 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347730
1#0##0#0#0.0#2022-01-06
18:50:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 23/01/1956 0 1
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0 0 - 0 - 0 - 0 - 0 181400 213796
0 1 0 0 0 SYAMSUL BACHRI TANTHOKO, TN 100860 65
yani;3302226402970001; 5.6.0.202201041418 4 347732
1#0##0#0#0.0#2022-01-06
18:53:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 12/08/1965 0 1
1 Z09.8;J45.9;K30;K27.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 229354
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SP.PD 1124R0021221V004833 0001104367026 3;JKN yani;3302226402970001;
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18:54:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 21/06/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 416215
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3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347734
1#0##0#0#0.0#2022-01-07
09:00:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 18/06/1953 0 2
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WIDIJARNI, NY 095042 68 25030 DR. LINDA SUGIARTO, SP.FKR
1124R0021221V004835 0000091364973 3;JKN yani;3302226402970001;
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09:40:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 12/04/2001 0 2
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347735 1#0##0#0#0.0#2022-01-07
09:40:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 13/06/1992 0 2
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0001084671257 3;JKN yani;3302226402970001; 5.6.0.202201041418 4
347736 1#0##0#0#0.0#2022-01-07
09:41:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 15/05/1953 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 347698
1#0##0#0#0.0#2022-01-07
09:42:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 15/07/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 195600
0 1 0 0 0 H. MUTHOHAR, TN 100630 79 29021 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347737
1#0##0#0#0.0#2022-01-07
09:42:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 02/12/1963 0 2
1 Z09.8;J45.9;I10;J06.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 455645
0 1 0 0 0 IRIANTI, (NY) 041097 58 21211 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347739
1#0##0#0#0.0#2022-01-07
09:43:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 05/02/1967 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347740
1#0##0#0#0.0#2022-01-07
09:44:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 01/05/1975 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V004843 0001790328262 3;JKN yani;3302226402970001;
5.6.0.202201041418 4 347697 1#0##0#0#0.0#2022-01-07
09:45:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 08/03/1967 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 347696
1#0##0#0#0.0#2022-01-07
09:46:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 13/08/1985 0 2
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3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347741
1#0##0#0#0.0#2022-01-07
09:47:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 01/12/1980 0 2
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SP.PD 1124R0021221V004846 0000640230884 3;JKN yani;3302226402970001;
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09:49:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 20/04/1972 0 1
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3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347742
1#0##0#0#0.0#2022-01-07
09:50:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 02/02/1971 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347694
1#0##0#0#0.0#2022-01-07
09:51:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
93ca88bd876530c61eec4a1f59efc997 662676 0 0 0 0 0
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3372030 C 3 CP 2 28/12/2021 28/12/2021 13/06/1968 0 2
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3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347743
1#0##0#0#0.0#2022-01-07
09:58:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 08/12/1949 0 1
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3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347744
1#0##0#0#0.0#2022-01-07
10:00:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 10/01/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 383860
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yani;3302226402970001; 5.6.0.202201041418 4 347745
1#0##0#0#0.0#2022-01-07
10:01:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 25/11/1945 0 1
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0 0 - 0 - 0 - 0 - 0 181400 476518
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yani;3302226402970001; 5.6.0.202201041418 4 347746
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10:01:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 24/10/1963 0 2
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1#0##0#0#0.0#2022-01-07
10:05:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 01/12/1958 0 2
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SP.PD 1124R0021221V004864 0001436949538 3;JKN yani;3302226402970001;
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3372030 C 3 CP 2 28/12/2021 28/12/2021 13/05/1966 0 2
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10:17:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 25/05/1972 0 1
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SP.PD 1124R0021221V004867 0002431552465 3;JKN yani;3302226402970001;
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3372030 C 3 CP 2 28/12/2021 28/12/2021 12/07/1955 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 347751
1#0##0#0#0.0#2022-01-07
10:18:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 10/06/1954 0 1
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10:19:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 13/12/1966 0 2
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SP.PD 1124R0021221V004870 0002051493849 3;JKN yani;3302226402970001;
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3372030 C 3 CP 2 28/12/2021 28/12/2021 02/04/1952 0 2
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1#0##0#0#0.0#2022-04-14
12:48:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 5
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3372030 C 3 CP 2 28/12/2021 28/12/2021 07/02/1971 0 2
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1#0##0#0#0.0#2022-01-07
10:23:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 09/10/1984 0 1
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novia;3313125201940001; 5.5.5.202112011542 4 347370
1#0##0#0#0.0#2022-01-05
18:43:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 05/08/1961 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347755
1#0##0#0#0.0#2022-01-07
10:24:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 14/03/1965 0 1
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3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347756
1#0##0#0#0.0#2022-01-07
10:30:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 31/12/1951 0 1
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10:31:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 03/12/1960 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347759
1#0##0#0#0.0#2022-01-07
10:33:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 23/03/1979 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347760
1#0##0#0#0.0#2022-01-07
10:34:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 15/05/1965 0 2
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3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347761
1#0##0#0#0.0#2022-01-07
10:34:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 31/12/1954 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347762
1#0##0#0#0.0#2022-01-07
10:36:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 14/02/1949 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347763
1#0##0#0#0.0#2022-01-07
10:37:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 27/09/1954 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347764
1#0##0#0#0.0#2022-01-07
10:38:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 12/05/2003 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 347765
1#0##0#0#0.0#2022-01-07
10:38:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 05/06/1965 0 2
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3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347766
1#0##0#0#0.0#2022-01-07
10:49:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 08/10/1976 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347767
1#0##0#0#0.0#2022-01-07
10:51:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 02/10/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 250342
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3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347768
1#0##0#0#0.0#2022-01-07
10:55:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.6.0.202201041418 4 347770
1#0##0#0#0.0#2022-01-07
10:56:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.6.0.202201041418 4 347771
1#0##0#0#0.0#2022-01-07
10:57:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 09/10/2004 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347772
1#0##0#0#0.0#2022-01-07
10:58:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 07/05/1954 0 2
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yani;3302226402970001; 5.6.0.202201041418 4 347773
1#0##0#0#0.0#2022-01-07
11:03:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 22/07/1966 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 347774
1#0##0#0#0.0#2022-01-07
11:05:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 05/07/1949 0 1
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novia;3313125201940001; 5.6.3.202201201500 4 347775
1#0##0#0#0.0#2022-03-08
09:13:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 28/12/2021 28/12/2021 06/05/1971 0 1
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yani;3302226402970001; 5.6.0.202201041418 4 347776
1#0##0#0#0.0#2022-01-07
11:06:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 28/12/2021 28/12/2021 09/08/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 226222
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agung;3313092303950002; 5.6.6.202203301209 4 347777
1#0##0#0#0.0#2022-04-14
13:35:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
e70009395fb3a4ab96d07d64fea158d5 150000 0 0 0 0 0
0 0 0 0 15000 0 61222 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 13/03/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 220690
0 1 0 0 0 SUYANTO.TN 093997 58 21475 DR. ARIA
yani;3302226402970001; 5.6.0.202201041418 4 347778
1#0##0#0#0.0#2022-01-07
11:09:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4ae33504d6052e48735405521e7a4a7f 150000 0 0 0 0 0
0 0 0 0 15000 0 55690 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 12/08/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 228225
0 1 0 0 0 TITIEK MULYANI., NY 051274 58 21323
3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347779
1#0##0#0#0.0#2022-01-07
11:11:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
aa1f1017401410ad6182b9d1a3c37b5d 150000 0 0 0 0 0
0 0 0 0 15000 0 63225 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 06/09/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 433812
0 1 0 0 0 SRI MARMOAH, NY 098798 55 20202 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347372
1#0##0#0#0.0#2022-01-05
18:44:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d9c968cf28425908a8b8aa324088a27d 150000 0 0 0 0 0
220000 0 0 0 15000 0 48812 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 25/09/1975 0 1
1 Z09.8;R07.3;I11.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 261292
0 1 0 0 0 DENI ROHENDI,TN 061847 46 16896 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347780
1#0##0#0#0.0#2022-01-07
11:14:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d99814bb8cdc3c384fbfd0923b3c89b5 150000 0 0 0 0 0
0 0 0 0 15000 0 96292 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 20/04/2001 0 1
0 0 - 0 - 0 - 0 - 0 181400 207490
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 347782
1#0##0#0#0.0#2022-04-14
11:38:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
df1db81ff16b97e641eae0c0310cd5ed 150000 0 0 0 0 0
0 0 0 0 15000 0 42490 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 12/04/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 222847
0 1 0 0 0 MARIYAM.NY 084306 64 23636 DR. ARIA
yani;3302226402970001; 5.6.0.202201041418 4 347783
1#0##0#0#0.0#2022-01-07
11:16:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f0b117b64dba2f8eb218dbe6c44ee180 150000 0 0 0 0 0
0 0 0 0 15000 0 57847 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 30/12/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 225250
0 1 0 0 0 RABIJEM NY 070138 72 26661 DR. ARIA
yani;3302226402970001; 5.6.0.202201041418 4 347784
1#0##0#0#0.0#2022-01-07
11:17:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
644798f3976496731495d41f9fb854e2 150000 0 0 0 0 0
0 0 0 0 15000 0 60250 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 19/07/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 230257
0 1 0 0 0 SWANTIKAH,(NY) 040450 71 26095 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347785
1#0##0#0#0.0#2022-01-07
11:18:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fcd20dc8591d2df32573b629232f56ea 150000 0 0 0 0 0
0 0 0 0 15000 0 65257 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 17/01/1977 0 2
0 0 - 0 - 0 - 0 - 0 181400 274535
0 1 0 0 0 INDAH PURNAMA SARI, NY 096428 44 16416
3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347786
1#0##0#0#0.0#2022-01-07
11:19:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
06d5d375fe95ef137fe05df02be86a79 150000 0 0 0 0 0
0 0 0 0 15000 0 109535 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 08/06/1959 0 1
- 0 - 0 - 0 894800 1442950 0 1 0
0 0 MULYONO.,TN 075393 62 22849 DR. ARIA CHANDRA GTS, SP.S.,
M.KES 1124R0021221V004907 0000090838078 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 347376 1#0##0#0#0.0#2022-01-05
18:44:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8a4d01a975fbfc1c340a47960e29cb96 150000 0 0 0 0 0
1250000 0 0 0 15000 0 27950 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 11/08/1980 0 1
0 0 - 0 - 0 - 0 - 0 181400 465550
0 1 0 0 0 AGUS AKBAR .BP 030258 41 15114 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347377
1#0##0#0#0.0#2022-01-05
18:45:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
10f9e22abfe3ac47ca85a133a7efe1a9 150000 0 0 0 0 0
248000 0 0 0 15000 0 52550 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 02/08/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 238127
0 1 0 0 0 SITI MAJIAH, NY 094003 69 25350 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347788
1#0##0#0#0.0#2022-01-07
11:21:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bf94692da6531ef5fac4dcda12d8e42c 150000 0 0 0 0 0
0 0 0 0 15000 0 73127 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 01/10/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 212015
0 1 0 0 0 SUDIYANA,TN 000468 58 21273 DR. ARIA
yani;3302226402970001; 5.6.0.202201041418 4 347789
1#0##0#0#0.0#2022-01-07
11:22:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6c5b70be459b54a2fc397b5c54bd55c6 150000 0 0 0 0 0
0 0 0 0 15000 0 47015 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 25/05/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 218805
0 1 0 0 0 SITI MARDHIYAH.NY 097607 70 25785 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347790
1#0##0#0#0.0#2022-01-07
11:25:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8d6039477ddb50bf41d3fe58532cb495 150000 0 0 0 0 0
0 0 0 0 15000 0 53805 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 31/12/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 215150
0 1 0 0 0 GIYARTO WIDODO, TN 098920 68 25199
3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347791
1#0##0#0#0.0#2022-01-07
11:26:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
02ec77fba694b6ceb634d3e6fe9d0f2c 150000 0 0 0 0 0
0 0 0 0 15000 0 50150 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 25/11/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 294450
0 1 0 0 0 SRI WIDODO.TN 094807 53 19391 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347943
1#0##0#0#0.0#2022-01-07
11:28:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dd94375e3aaa9875307024a676491d56 150000 0 0 0 0 0
0 0 0 0 15000 0 129450 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 21/06/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 305500
0 1 0 0 0 ANJAR SETYAWATI,DRA 093261 58 21375
3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347792
1#0##0#0#0.0#2022-01-07
11:30:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fefd0b325fd764370917a1ea70d85081 150000 0 0 0 0 0
0 0 0 0 15000 0 140500 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 01/08/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 491342
0 1 0 0 0 AGUSTIN YULIASTANTI.NY 101098 47 17316
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 347378
1#0##0#0#0.0#2022-04-14
13:50:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
3e5cc9c94b46ce77776eb41f00578994 150000 0 0 0 0 0
248000 0 0 0 25000 0 68342 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 30/06/1958 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
231882 0 1 0 0 0 ISTUTIK, NY 093527 63 23192
3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347793
1#0##0#0#0.0#2022-01-07
11:31:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
13577373aa8742b0af65160020bf39c3 150000 0 0 0 0 0
0 0 0 0 15000 0 66882 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 16/05/1976 0 1
0 0 - 0 - 0 - 0 - 0 181400 406055
0 1 0 0 0 TEGUH PRAYITNO, TN 069729 45 16662
3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347794
1#0##0#0#0.0#2022-01-07
11:32:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
413ecb147bc3888eece9c90fc9ac2ec6 150000 0 0 0 0 0
0 0 0 0 15000 0 241055 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 28/10/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 310490
0 1 0 0 0 SRI MARYANI. NY 067664 64 23437 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347795
1#0##0#0#0.0#2022-01-07
11:35:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4b892a485a608f7b2f52fe6570eac8e9 150000 0 0 0 0 0
0 0 0 0 15000 0 145490 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 31/12/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 216438
0 1 0 0 0 SUNARTO ,BP 084994 65 24104 DR. ARIA
yani;3302226402970001; 5.6.0.202201041418 4 347796
1#0##0#0#0.0#2022-01-07
11:36:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
28b1abbbbb9ab46e10c33373fa7ab9b5 150000 0 0 0 0 0
0 0 0 0 15000 0 51438 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 31/12/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 230755
0 1 0 0 0 MISRAN, TN 099659 76 28121 DR. ARIA
yani;3302226402970001; 5.6.0.202201041418 4 347798
1#0##0#0#0.0#2022-01-07
11:39:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4158e99cf59a8df9e791b9a90e9d0eef 150000 0 0 0 0 0
0 0 0 0 15000 0 65755 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 15/06/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 238572
0 1 0 0 0 SLAMET KUNCORO, TN 067027 60 22111
yani;3302226402970001; 5.6.0.202201041418 4 347799
1#0##0#0#0.0#2022-01-07
11:39:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
aa863e12f03b8a728512a20a8c1e5eab 150000 0 0 0 0 0
0 0 0 0 15000 0 73572 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 25/04/1964 0 2
0 - 0 - 0 - 0 - 0 181400 145000
0 1 0 0 0 SUNTARI, NY 001386 57 21066 dr. SUROSO
1124R0021221V004929 0001102339258 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346764 1#0##0#0#0.0#2022-01-04
15:04:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
721f3d6e6c1dcc434d7b15b4cc215d05 130000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 11/04/1965 0 1
0 - 0 - 0 - 0 786200 516180 0 1
SP.PD 1124R0021221V004930 0001732801498 3;JKN yani;3302226402970001;
5.6.0.202201041418 4 347705 1#0##0#0#0.0#2022-01-07
11:42:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0856e96bc6893a12e39c280c33f9606a 463830 0 0 0 0 0
0 0 0 0 15000 0 37350 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 02/09/1976 0 1
0 - 0 - 0 - 0 786200 694986 0 1
yani;3302226402970001; 5.6.0.202201041418 4 347704
1#0##0#0#0.0#2022-01-07
11:42:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
47520c8eddfdfb8eda0e210c015eefba 662676 0 0 0 0 0
0 0 0 0 15000 0 17310 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 07/04/1948 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.0.202201041418 4 347700
1#0##0#0#0.0#2022-01-07
11:50:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3104f403a71d18de65d72ed51225fc17 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 25/03/1978 0 2
0 - 0 - 0 - 0 786200 603130 0 1
yani;3302226402970001; 5.6.0.202201041418 4 347703
1#0##0#0#0.0#2022-01-07
11:52:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dbe7c3043b5f4a60d4c1aa36fd800171 463830 0 0 0 0 0
0 0 0 0 15000 0 124300 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 01/09/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V004934 0000639614597 3;JKN yani;3302226402970001;
5.6.0.202201041418 4 347701 1#0##0#0#0.0#2022-01-07
11:55:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6fb44b23770ccb19a09be7f8eb11b9a4 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 23/12/1977 0 2
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.6.0.202201041418 4 347702
1#0##0#0#0.0#2022-01-07
11:57:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b944ce1f0275ff00da1fd76e0e50ea66 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 11/09/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 201430
yani;3302226402970001; 5.6.0.202201041418 4 347800
1#0##0#0#0.0#2022-01-07
11:40:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
979523b8bc288c1260eea5e7f0d71680 150000 0 0 0 0 0
0 0 0 0 15000 0 36430 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 25/08/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 233415
0 1 0 0 0 BAMBANG AGUS SURONO.TN 100627 66 24232
3;JKN yani;3302226402970001; 5.6.0.202201041418 4 347801
1#0##0#0#0.0#2022-01-07
11:58:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
52205f1a9721605090463df620db9b96 150000 0 0 0 0 0
0 0 0 0 15000 0 68415 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 22/01/2021 0 2
0 0 - 0 - 0 - 0 - 0 181400 186200
0 1 0 0 0 FRANSISCA EVELYN WIBOWO.AN 098504 0
yani;3302226402970001; 5.6.0.202201041418 4 347802
1#0##0#0#0.0#2022-01-07
12:06:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a37677f7f0251a39e921f2c09ac0d03d 150000 0 0 0 0 0
0 0 0 0 15000 0 21200 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 28/06/2011 0 1
0 0 - 0 - 0 - 0 - 0 181400 242179
0 1 0 0 0 ARVE MAULANA TRI N, AN 064800 10 3836
yani;3302226402970001; 5.6.0.202201041418 4 347803
1#0##0#0#0.0#2022-01-07
12:08:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9d479dd264d26bbf2f4aa17c6401d8af 150000 0 0 0 0 0
0 0 0 0 15000 0 77179 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 26/10/1979 0 2
0 0 - 0 - 0 - 0 - 0 181400 232578
0 1 0 0 0 HERVINA TYAS ANGGRAENI, NY 062064 42
yani;3302226402970001; 5.6.0.202201041418 4 347804
1#0##0#0#0.0#2022-01-07
12:09:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bb1b8bf62efef6629ed16781b7597171 150000 0 0 0 0 0
0 0 0 0 15000 0 67578 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 12/01/2007 0 2
0 0 - 0 - 0 - 0 - 0 181400 234578
0 1 0 0 0 NADA SAVIRA RIZQIN, NN 064511 14 5464
yani;3302226402970001; 5.6.0.202201041418 4 347805
1#0##0#0#0.0#2022-01-07
12:10:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
10c1e41014e8c3560f23212f4045fdc0 150000 0 0 0 0 0
0 0 0 0 15000 0 69578 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 11/04/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 219996
0 1 0 0 0 NUGROHO AFRILIANTO, TN 059768 48 17793
yani;3302226402970001; 5.6.0.202201041418 4 347807
1#0##0#0#0.0#2022-01-07
12:10:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f19fb3a8fd94a0ff987e09aa1a962273 150000 0 0 0 0 0
0 0 0 0 15000 0 54996 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 27/10/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 219996
0 1 0 0 0 TRI MULYANI . NY 062170 67 24534 DR.
yani;3302226402970001; 5.6.0.202201041418 4 347808
1#0##0#0#0.0#2022-01-07
12:11:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c58e97c5fe1e172a260d6a86ccc7e65c 150000 0 0 0 0 0
0 0 0 0 15000 0 54996 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 26/10/2003 0 2
0 0 - 0 - 0 - 0 - 0 181400 246834
0 1 0 0 0 RAHMA NUR ELISA A, NN 064683 18 6638
yani;3302226402970001; 5.6.0.202201041418 4 347809
1#0##0#0#0.0#2022-01-07
12:11:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e8c3f3aefe1c31128d75830b783dac8d 150000 0 0 0 0 0
0 0 0 0 15000 0 81834 0 0 0 0 0
3372030 C 3 CP 2 28/12/2021 28/12/2021 30/09/1977 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0000207436206 3;JKN yani;3302226402970001; 5.6.0.202201041418 4
347644 1#0##0#0#0.0#2022-01-07
12:12:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a4ff7e036653e07448dfb690bd2ec1dd 247000 0 0 0 0 0
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3372030 C 3 CP 2 28/12/2021 28/12/2021 28/12/1973 0 1
0 - 0 - 0 - 0 135700 126411 0 1
0 0 0 CAHYONO WIYANTO., BP 046618 48 17532 DR. YOSSI
1124R0021221V004949 0001104864017 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346766 1#0##0#0#0.0#2022-01-04
15:05:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
194cf6c3a06d0aea5ec2acfe6941275d 80000 0 0 0 0 0 0
0 0 0 15000 0 31411 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 04/07/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 578368
0 1 0 0 0 SUNARMI, NY 049475 64 23554 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 347360
1#0##0#0#0.0#2022-01-05
12:37:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5cb15a3629ecb800d128b3055c383916 150000 0 0 0 0 0
0 31845 0 0 15000 0 381523 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 15/01/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 293310
0 1 0 0 0 Ny. Endah Pujiasih 2102 52 19341 DR.
agung;3313092303950002; 5.5.5.202112011542 4 347361
1#0##0#0#0.0#2022-01-05
12:39:27#0#00:00:00#00:00:00#10:23:57#{"co_insidense_ind":"0"} 1
acebae10d59c82d4056c62a437864604 150000 0 0 0 0 0
0 63690 0 0 15000 0 64620 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 05/04/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 269990
0 1 0 0 0 SUCIATI,(NY) 011820 50 18531 DR.
agung;3313092303950002; 5.5.5.202112011542 4 347362
1#0##0#0#0.0#2022-01-05
13:51:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
36d1b35132d15f622475a0afbaf442a8 150000 0 0 0 0 0
0 0 0 0 15000 0 104990 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 31/12/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 332235
0 1 0 0 0 SUKIRAH.NY 080728 62 23009 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 347401
1#0##0#0#0.0#2022-01-05
14:11:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
35dfaa1c1b5badc0481ac6e9dcc73585 150000 0 0 0 0 0
0 120795 0 0 15000 0 46440 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 10/09/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 486565
0 1 0 0 0 SUPOMO 52285 62 22756 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 347408
1#0##0#0#0.0#2022-01-05
14:12:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9a5d0350710a74a9c37bcc2bca2b02a6 150000 0 0 0 0 0
0 31845 0 0 15000 0 289720 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 09/08/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 560817
0 1 0 0 0 SITI JUWARIYAH,(NY) 011285 47 17309
novia;3313125201940001; 5.6.3.202201201500 4 347409
1#0##0#0#0.0#2022-03-08
08:19:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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0 76045 0 0 15000 0 319772 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 28/04/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 307467
0 1 0 0 0 YUNNI SRI LESTARI, NY 068471 62 22891
agung;3313092303950002; 5.5.5.202112011542 4 347410
1#0##0#0#0.0#2022-01-05
14:15:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7239744204c24df0f4193babb8bab483 150000 0 0 0 0 0
0 76145 0 0 15000 0 66322 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 20/07/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 300855
0 1 0 0 0 SUPRAPTI.NY 082274 59 21712 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 347411
1#0##0#0#0.0#2022-01-05
14:16:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3cea0d1dfde35c3f77021e605f5f1931 150000 0 0 0 0 0
0 76045 0 0 15000 0 59810 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 31/12/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 312325
0 1 0 0 0 SUHARJANTO.TN 083340 57 21183 DR.
agung;3313092303950002; 5.5.5.202112011542 4 347412
1#0##0#0#0.0#2022-01-05
14:18:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
26b88f6d722960dc7bad4f7b9aa2f556 150000 0 0 0 0 0
0 76045 0 0 15000 0 71280 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 03/06/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 451935
0 1 0 0 0 SUDJIYEM., NY 045838 64 23585 DR.
agung;3313092303950002; 5.5.5.202112011542 4 347413
1#0##0#0#0.0#2022-01-05
14:23:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1709ad5a8207322c1a2fd6064ffdfbaa 150000 0 0 0 0 0
0 31845 0 0 15000 0 255090 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 01/05/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 438815
0 1 0 0 0 MEI MARDIYANTO.TN 076926 56 20696 DR.
agung;3313092303950002; 5.5.5.202112011542 4 347414
1#0##0#0#0.0#2022-01-05
14:25:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b354db332c61de56ee47c731b4ac726f 150000 0 0 0 0 0
0 76595 0 0 15000 0 197220 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 13/06/1992 0 2
0 0 - 0 - 0 - 0 - 0 181400 227531
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 347415
1#0##0#0#0.0#2022-01-05
14:26:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4e1ccdd86f08c9963813b177f06bae78 150000 0 0 0 0 0
0 31845 0 0 15000 0 30686 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 08/06/1950 0 2
1 Z09.8;E11.9 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 261380
novia;3313125201940001; 5.6.7.202204241238 4 347416
1#0##0#0#0.0#2022-05-10
08:57:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 3
ad160b1804570f654146bda4f72ba15d 150000 0 0 0 0 0
0 0 0 0 15000 0 96380 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 01/08/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 394282
0 1 0 0 0 NURSUKO,(BP) 033073 60 22065 DR.
agung;3313092303950002; 5.5.5.202112011542 4 347417
1#0##0#0#0.0#2022-01-05
14:43:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0b7da4e9c21c30cbcef453a021a86f4d 150000 0 0 0 0 0
0 31845 0 0 15000 0 197437 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 01/09/1947 0 1
1 Z09.8;I11.9;E78.5;E79.0 89.52 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 476711
0 1 0 0 0 HADIL CHOIRI, BP 055875 74 27148 DR.
agung;3313092303950002; 5.5.5.202112011542 4 347419
1#0##0#0#0.0#2022-01-05
14:45:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
aef4b57648c9d5bceb9e7bb0af6dd879 150000 0 0 0 0 0
0 88950 0 0 15000 0 222761 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 24/05/1960 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
498887 0 1 0 0 0 PRAPTONO.TN 081895 61 22499
agung;3313092303950002; 5.5.5.202112011542 4 347422
1#0##0#0#0.0#2022-01-05
14:48:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bf5302e2ced63b22e3a77f2e2a374b82 150000 0 0 0 0 0
0 76595 0 0 15000 0 257292 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 19/01/1973 0 2
0 0 - 0 - 0 - 0 - 0 182600 407911
0 1 0 0 0 HENNI SRIWULAN, NY 000445 48 17876
agung;3313092303950002; 5.5.5.202112011542 4 347434
1#0##0#0#0.0#2022-01-05
14:50:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
709c03448cf2e1762b96e37d67e417e5 150000 0 0 0 0 0
0 63690 0 0 15000 0 179221 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 11/06/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 404160
0 1 0 0 0 YUSTINA SRI SETIAWATI,(NY) 034907 49
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 347435
1#0##0#0#0.0#2022-01-05
14:51:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6e6ca4cd32d0fb5ff66807bf737decdb 150000 0 0 0 0 0
0 171170 0 0 15000 0 67990 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 03/02/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 273585
0 1 0 0 0 SUMARSIH,NY 085983 66 24436 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 347436
1#0##0#0#0.0#2022-01-05
15:05:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a1262825f6539738859ee7cffc8b63c9 150000 0 0 0 0 0
0 31845 0 0 15000 0 76740 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 20/11/1966 0 2
0 0 - 0 - 0 - 0 - 0 181400 510378
0 1 0 0 0 DIANI MARHAENITA ., NY 000489 55 20128
agung;3313092303950002; 5.5.5.202112011542 4 347437
1#0##0#0#0.0#2022-01-05
15:06:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
66d1be0be08daa1951df8d6350f44dc9 150000 0 0 0 0 0
0 76145 0 0 15000 0 269233 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 31/05/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 196845
0 1 0 0 0 RAHAYU, NY 098361 63 23223 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 347438
1#0##0#0#0.0#2022-01-05
15:07:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
65294f57195b12e1336169969f91efb4 150000 0 0 0 0 0
0 31845 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 10/06/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 323475
0 1 0 0 0 MISA AYUNINGTYAS, NY 053406 48 17734
agung;3313092303950002; 5.5.5.202112011542 4 347439
1#0##0#0#0.0#2022-01-05
15:09:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1924853b937dd2a158afcc6c7ab2f64d 150000 0 0 0 0 0
0 120795 0 0 15000 0 37680 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 22/04/1960 0 2
1 Z09.8;E11.4;G59.0;I11.9;M47.86;N13.2 88.75 - - 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 969367 0 1 0 0 0 TUMINI, NY
0001692563477 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
347395 1#0##0#0#0.0#2022-01-05
18:48:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4e106676288aef8c9df494b3b5a5b5ef 150000 0 0 0 0 0
680000 31845 0 0 15000 0 92522 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 20/03/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 194332
0 1 0 0 0 JOKO MULYONO, TN 038517 63 23295 DR.
agung;3313092303950002; 5.5.5.202112011542 4 347440
1#0##0#0#0.0#2022-01-05
15:10:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
42decc1c3d33eb065c854ee89fcc780d 150000 0 0 0 0 0
0 0 0 0 15000 0 29332 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 16/06/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 358151
0 1 0 0 0 SUWARTI.NY 085230 76 27955 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 347441
1#0##0#0#0.0#2022-01-05
15:13:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d61f47eed2e9adb2b6d0cce4f9a30e03 150000 0 0 0 0 0
0 134250 0 0 15000 0 58901 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 14/04/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 237640
0 1 0 0 0 AMIR HAUDI,(BP) 029404 64 23635 DR.
agung;3313092303950002; 5.5.5.202112011542 4 347442
1#0##0#0#0.0#2022-01-05
15:18:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
72d0e2ca502c36b93f91ace78312cb00 150000 0 0 0 0 0
0 0 0 0 15000 0 72640 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 30/04/1946 0 2
1 Z09.8;E11.4;G59.0;I11.9;M54.59 87.24 - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 593045 0 1 0 0 0 WARTINI, NY 094394
0001840642852 3;JKN novia;3313125201940001; 5.5.5.202112011542 4
347396 1#0##0#0#0.0#2022-01-05
18:49:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ca413e5feb480d43c4cd7a8334dadc53 150000 0 0 0 0 0
220000 31845 0 0 15000 0 176200 0 0 0 0
0
3372030 C 3 CP 2 29/12/2021 29/12/2021 02/04/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 329680
0 1 0 0 0 SRI SISMIATUN., NY 046455 69 25473
agung;3313092303950002; 5.6.6.202203301209 4 347443
1#0##0#0#0.0#2022-04-14
12:49:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 5
3feabca8b404ed26151d0857aea95203 150000 0 0 0 0 0
0 93790 0 0 15000 0 70890 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 03/07/1935 0 2
0 0 - 0 - 0 - 0 - 0 181400 205600
agung;3313092303950002; 5.5.5.202112011542 4 347444
1#0##0#0#0.0#2022-01-05
15:25:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2b611ddfcb28eae14bea7bd9159cf4fa 150000 0 0 0 0 0
0 0 0 0 15000 0 40600 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 13/03/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 221580
0 1 0 0 0 SUBANDIJO.TN 083578 77 28415 DR.
agung;3313092303950002; 5.5.5.202112011542 4 347445
1#0##0#0#0.0#2022-01-05
15:27:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a6f10fa2112908136136acbb469e3e3c 150000 0 0 0 0 0
0 0 0 0 15000 0 56580 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 01/09/1962 0 1
1 Z09.8;E83.5;N29.8;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 238711
0 1 0 0 0 SAMBUDI,(BP) 037461 59 21669 DR.
agung;3313092303950002; 5.5.5.202112011542 4 347446
1#0##0#0#0.0#2022-01-05
15:28:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
06b1e6dcfa5c177add59b558058cd0b7 150000 0 0 0 0 0
0 0 0 0 15000 0 73711 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 22/04/1949 0 1
1 Z09.8;E11.2;N08.3;I11.9;G59.0 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
672118 0 1 0 0 0 DJUWARSO, (BP) 008057 72
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 347447
1#0##0#0#0.0#2022-01-05
15:34:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a560ec3a020dbce5b07551d0b2a549b3 150000 0 0 0 0 0
0 121345 0 0 15000 0 385773 0 0 0 0
0
3372030 C 3 CP 2 29/12/2021 29/12/2021 10/02/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 781389
0 1 0 0 0 THEODORA SARFIAH,(NY) 045285 57 21142
agung;3313092303950002; 5.5.5.202112011542 4 347448
1#0##0#0#0.0#2022-01-05
15:35:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7213e53e8464e99889a4af6a017d8625 150000 0 0 0 0 0
0 76595 0 0 15000 0 539794 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 06/02/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
agung;3313092303950002; 5.5.5.202112011542 4 347449
1#0##0#0#0.0#2022-01-05
15:36:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
52cc036d6d462ab000cd5c254e4df6b2 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 20/11/1985 0 1
0 0 - 0 - 0 - 0 - 0 181400 217110
0 1 0 0 0 MUHAMMAD HERI SUSANTO.TN 084491 36
3;JKN agung;3313092303950002; 5.5.5.202112011542 4 347450
1#0##0#0#0.0#2022-01-05
15:38:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
986b84f7e459cc2f962f82679f904f2d 150000 0 0 0 0 0
0 0 0 0 15000 0 52110 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 30/06/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 259832
0 1 0 0 0 HARMI 095040 49 18079 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 347452
1#0##0#0#0.0#2022-01-05
16:05:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b2ffb5275c4f888bc8239439e8f85e6d 150000 0 0 0 0 0
0 31845 0 0 15000 0 62987 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 28/05/1963 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
431245 0 1 0 0 0 BAKRI, TN 094397 58 21400
agung;3313092303950002; 5.5.5.202112011542 4 347453
1#0##0#0#0.0#2022-01-05
16:06:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3d44e920da1a632971ba23651c74d3c7 150000 0 0 0 0 0
0 76045 0 0 15000 0 190200 0 0 0 0 0
3372030 C 3 CP 2 29/12/2021 29/12/2021 17/09/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 289434
0 1 0 0 0 WARNO.TN 097648 61 22383 DR. TEKY
agung;3313092303950002; 5.5.5.202112011542 4 347454
1#0##0#0#0.0#2022-01-05
16:08:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 347458
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16:14:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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14:35:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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16:19:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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16:20:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/12/2021 29/12/2021 10/08/1961 0 2
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16:21:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/12/2021 29/12/2021 06/07/1954 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 347468
1#0##0#0#0.0#2022-01-05
16:23:44#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#2022-01-05
16:40:31#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#2022-01-05
16:41:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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16:44:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/12/2021 29/12/2021 23/12/1997 0 1
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16:45:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/12/2021 29/12/2021 08/08/1975 0 1
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3372030 C 3 CP 2 29/12/2021 29/12/2021 22/08/1947 0 2
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16:47:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/12/2021 29/12/2021 31/08/1962 0 2
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3372030 C 3 CP 2 29/12/2021 29/12/2021 31/08/1998 0 2
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3372030 C 3 CP 2 29/12/2021 29/12/2021 31/12/1955 0 2
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16:59:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/12/2021 29/12/2021 12/12/1947 0 2
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1124R0021221V005041 0002425018184 3;JKN agung;3313092303950002;
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agung;3313092303950002; 5.5.5.202112011542 4 347497
1#0##0#0#0.0#2022-01-05
17:11:44#0#00:00:00#00:00:00#17:25:40#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 347498
1#0##0#0#0.0#2022-01-05
17:12:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/12/2021 29/12/2021 10/12/1942 0 1
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1#0##0#0#0.0#2022-01-05
17:17:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 347502
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17:19:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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17:24:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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17:28:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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17:34:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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17:35:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/12/2021 29/12/2021 03/12/1945 0 1
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1#0##0#0#0.0#2022-01-05
17:36:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/12/2021 29/12/2021 05/12/2008 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 347512
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17:38:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 347513
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17:39:23#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#2022-01-05
17:40:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 347515
1#0##0#0#0.0#2022-01-05
17:41:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/12/2021 29/12/2021 08/08/1950 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 347516
1#0##0#0#0.0#2022-01-05
17:42:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/12/2021 29/12/2021 12/06/1993 0 2
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1#0##0#0#0.0#2022-01-05
17:44:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 29/12/2021 29/12/2021 04/04/1992 0 1
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1#0##0#0#0.0#2022-01-05
17:46:00#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#2022-01-05
17:47:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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17:49:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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17:51:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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17:52:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 347523
1#0##0#0#0.0#2022-01-05
17:53:28#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#2022-01-05
17:55:26#0#00:00:00#00:00:00#07:24:26#{"co_insidense_ind":"0"} 1
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17:56:51#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#2022-01-05
17:58:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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17:59:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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18:00:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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18:02:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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18:03:59#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#2022-01-05
18:05:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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18:06:50#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#2022-01-05
18:08:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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18:09:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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18:10:19#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#2022-01-05
18:11:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/12/2021 29/12/2021 16/06/1968 0 2
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1 0 0 0 EVIVA PASARIBU.NY 077942 53 19554 DRG.
agung;3313092303950002; 5.5.5.202112011542 4 347537
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18:12:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 347538
1#0##0#0#0.0#2022-01-05
18:13:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/12/2021 29/12/2021 18/11/1971 0 2
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agung;3313092303950002; 5.5.5.202112011542 4 347540
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18:15:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 347541
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18:17:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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agung;3313092303950002; 5.5.5.202112011542 4 347542
1#0##0#0#0.0#2022-01-05
18:18:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 29/12/2021 29/12/2021 21/04/1990 0 2
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10:25:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 29/12/2021 29/12/2021 19/09/1983 0 1
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SP.KG 1124R0021221V005093 0001298346715 3;JKN agung;3313092303950002;
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18:36:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
73010962b3e5175ce53f82ba0342d6bc 300000 0 0 0 0 0
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3372030 C 3 CP 2 29/12/2021 29/12/2021 03/03/1993 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 IKA MEILYA PRASETYAWATI.NY 094659 28 10528
agung;3313092303950002; 5.5.5.202112011542 4 347546
1#0##0#0#0.0#2022-01-05
18:37:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d9b0147c75fba98b6c4fa0acf9c6114e 300000 0 0 0 0 0
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3372030 C 3 CP 2 29/12/2021 29/12/2021 18/04/1971 0 2
1 Z09.8;I10;K80.2;N20.0 88.76 - - None None None None Z-3-
0 0 - 0 - 0 - 0 - 0 549400 940001
0 1 0 0 0 NGATMIYATUN,(NY) 033520 50 18518 DR.
novia;3313125201940001; 5.5.5.202112011542 4 347398
1#0##0#0#0.0#2022-01-05
18:51:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cb9e7816f7a5a444f187d6819d6d1036 150000 0 0 0 0 0
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0
3372030 C 3 CP 2 29/12/2021 29/12/2021 09/01/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 210840
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novia;3313125201940001; 5.6.7.202204241238 4 347548
1#0##0#0#0.0#2022-05-10
08:59:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 29/12/2021 29/12/2021 12/06/1981 0 2
0 0 - 0 - 0 - 0 - 0 181400 243330
0 1 0 0 0 SRI SAYEKTI.NY 098714 40 14810 DR.
agung;3313092303950002; 5.5.5.202112011542 4 347549
1#0##0#0#0.0#2022-01-05
18:39:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
74fe162502291702deae40bfaa222e09 150000 0 0 0 0 0
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3372030 C 3 CP 2 29/12/2021 29/12/2021 31/05/1985 0 2
- 0 - 0 - 0 - 0 283800 339170 0
agung;3313092303950002; 5.5.5.202112011542 4 347550
1#0##0#0#0.0#2022-01-05
18:39:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c9228dc8ff3386cd54151ed8624ac463 300000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 28/10/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 212374
0 1 0 0 0 MARUTA TIRANA,(BP) 040357 77 28187
yani;3302226402970001; 5.5.5.202112011542 4 346726
1#0##0#0#0.0#2022-01-04
18:02:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
de0521d6e8a5bfd536524f5ec7c710ba 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 15/01/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 214914
0 1 0 0 0 SITI RAHAYU, NY 084960 70 25917 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346727
1#0##0#0#0.0#2022-01-04
18:39:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dd3aab907dc539cbc4ba906464adf774 150000 0 0 0 0 0
0 0 0 0 15000 0 49914 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 23/04/1968 0 2
1 Z09.8;M19.98;E78.5;N20.0 88.76 - - None None None None
549400 0 0 - 0 - 0 - 0 - 0 549400
1054314 0 1 0 0 0 SURYATI, NY 037498 53 19609
yani;3302226402970001; 5.5.5.202112011542 4 347156
1#0##0#0#0.0#2022-01-04
18:48:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
015cfd4bb4d5be755a92404008e571e6 150000 0 0 0 0 0
657000 133700 0 0 15000 0 98614 0 0 0 0
0
3372030 C 3 CP 2 30/12/2021 30/12/2021 30/12/1950 0 2
1 Z09.8;M16.9;M17.9 87.24 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 443414
yani;3302226402970001; 5.5.5.202112011542 4 347093
1#0##0#0#0.0#2022-01-04
18:54:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3e20748b3453568e751adb9c6f251dd5 150000 0 0 0 0 0
220000 0 0 0 15000 0 58414 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 15/12/1968 0 1
0 0 - 0 - 0 - 0 - 0 181400 516373
0 1 0 0 0 INDRATMOKO. TN 085811 53 19373 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346729
1#0##0#0#0.0#2022-01-04
18:55:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4484b6b693bf8416e2a35c4910dfd8c5 150000 0 0 0 0 0
0 63690 0 0 15000 0 287683 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 31/12/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 216322
0 1 0 0 0 SURTINEM., NY 049118 63 23375 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346730
1#0##0#0#0.0#2022-01-04
18:56:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
45a685ee1e39b8ccc4e14e89a6cd2c98 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 28/05/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 741071
0 1 0 0 0 INDRATTO, BP 062553 62 22862 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346731
1#0##0#0#0.0#2022-01-04
18:56:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c78cf0527fa561c0e5e0402131da0309 150000 0 0 0 0 0
0 63690 0 0 15000 0 512381 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 29/09/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 315690
0 1 0 0 0 MARIA DIAH ANGGARAWATI ., NY 059667 51
novia;3313125201940001; 5.6.3.202201201500 4 346732
1#0##0#0#0.0#2022-03-08
08:23:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
15dfb7388f1c41cc429198bbc4f7eaed 150000 0 0 0 0 0
0 89500 0 0 15000 0 61190 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 06/06/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 543045
0 1 0 0 0 SARWIJI.NY 095370 66 24314 DR. SUHARTO,
SP.PD 1124R0021221V005122 0001084322902 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 346733 1#0##0#0#0.0#2022-04-14
13:35:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
f2dad9b3b9e01382b98d6e1aa9275067 150000 0 0 0 0 0
0 31845 0 0 15000 0 346200 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 06/04/1945 0 2
0 - 0 - 0 - 0 - 0 181400 459462
0 1 0 0 0 YULIANA LIDWINA SUHARTI.NY 101115 76
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 347091
1#0##0#0#0.0#2022-01-04
19:00:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
133faa9dcba65c2eb6e4bfbe7d1bf77c 150000 0 0 0 0 0
248000 0 0 0 15000 0 46462 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 10/05/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 332420
0 1 0 0 0 SUKATI AL KATINEM, NY 065484 59 21784
0000638868677 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346734 1#0##0#0#0.0#2022-01-05
08:53:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
70ff9eec71df80899b2682962a99d002 305000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 18/12/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 194180
0 1 0 0 0 MUHAMMAD HATTA ., TN 058655 64 23388
yani;3302226402970001; 5.5.5.202112011542 4 346735
1#0##0#0#0.0#2022-01-05
08:56:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
02450aef69b994bed99102aca8c86ce7 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 10/07/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 227392
0 1 0 0 0 SRI MURNI, NY 012680 66 24280 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346736
1#0##0#0#0.0#2022-01-05
08:56:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1d391b917d44234101a26b56f6d1a15d 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 05/07/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 212512
0 1 0 0 0 YAMINI, NY 056462 62 22824 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 346737
1#0##0#0#0.0#2022-01-05
08:57:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
89b371ab0a7c81bc13e18c127f94283b 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 28/04/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 227742
0 1 0 0 0 KURDI., BP 052526 77 28370 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 346738
1#0##0#0#0.0#2022-01-05
08:58:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
26d5e88f10e7cb46dae9bb305712f524 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 12/02/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 334632
0 1 0 0 0 SUNARTI,(NY) 015594 56 20775 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346739
1#0##0#0#0.0#2022-01-05
08:58:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5e04ed287bf8f12003b8cffd5db3cdb7 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 28/11/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 738762
0 1 0 0 0 SRI SUMARTI, NY 055652 59 21582 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346741
1#0##0#0#0.0#2022-01-05
08:59:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6a245214c0b341a0fa5e5d31c441c614 150000 0 0 0 0 0
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0
3372030 C 3 CP 2 30/12/2021 30/12/2021 29/12/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 337705
0 1 0 0 0 DRA.SRI SUPADMINI, NY 064608 69 25203
yani;3302226402970001; 5.5.5.202112011542 4 346742
1#0##0#0#0.0#2022-01-05
09:00:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
658e91cc683c6d707e05f99d444d7485 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 05/07/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 231344
0 1 0 0 0 SRI BEKTI.NY 099805 53 19536 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346744
1#0##0#0#0.0#2022-01-05
09:01:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fdbfcdacba736df49568b97eb70d8682 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 26/02/1948 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 346745
1#0##0#0#0.0#2022-01-05
09:01:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0c1a2c8d120ecf89b45f834f07a32877 150000 0 0 0 0 0
0 0 0 0 15000 0 51965 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 03/07/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 229272
0 1 0 0 0 LESTARI ., NY 058610 60 22095 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346746
1#0##0#0#0.0#2022-01-05
09:02:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6f14cf28d97695ea41190970839135b9 150000 0 0 0 0 0
0 0 0 0 15000 0 64272 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 06/06/1963 0 1
1 Z09.8;E11.2;N08.3;I10;G59.0;I73.9 - - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 753930 0 1 0 0 0 SUPARMAN, (BP) 004954
0001104414322 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346753 1#0##0#0#0.0#2022-01-05
09:06:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d6e5f2614f344184dccc6059e9c6ad2f 150000 0 0 0 0 0
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0
3372030 C 3 CP 2 30/12/2021 30/12/2021 29/09/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 243850
0 1 0 0 0 HUSMARYANTO 36573 60 22007 DR. TEKY
agung;3313092303950002; 5.6.6.202203301209 4 347272
1#0##0#0#0.0#2022-04-14
13:51:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
8728f973bdbfed784975993189badabf 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 19/10/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 211732
0 1 0 0 0 SETYANING RAHAYU,NY 074872 70 25640
agung;3313092303950002; 5.6.6.202203301209 4 346756
1#0##0#0#0.0#2022-04-14
12:59:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
3ba7339633972582900cec197584c06f 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 14/07/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 432250
0 1 0 0 0 PONIYEM ., NY 058483 60 22084 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346757
1#0##0#0#0.0#2022-01-05
09:11:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a2ef68f8417e9206a235e7bfba19a20f 150000 0 0 0 0 0
0 63690 0 0 15000 0 203560 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 16/06/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 223414
yani;3302226402970001; 5.5.5.202112011542 4 346758
1#0##0#0#0.0#2022-01-05
09:12:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cd3c586e221134eff3a0816ebfc0f4fa 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 16/05/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 238015
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yani;3302226402970001; 5.5.5.202112011542 4 346759
1#0##0#0#0.0#2022-01-05
09:12:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e79343eda21e5ed3f46c0891ddc2b97c 150000 0 0 0 0 0
0 44300 0 0 15000 0 28715 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 21/09/1944 0 1
1 Z09.8;N28.1;R16.1 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 342630
3;JKN agung;3313092303950002; 5.6.6.202203301209 4 346760
1#0##0#0#0.0#2022-04-14
12:56:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
f1ebd5811c6e164e7ed28bbf486ed130 150000 0 0 0 0 0
0 134250 0 0 15000 0 43380 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 18/11/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 217062
yani;3302226402970001; 5.5.5.202112011542 4 346761
1#0##0#0#0.0#2022-01-05
09:14:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0180bd7c7aa7e37801a5019cc6c62c5d 150000 0 0 0 0 0
0 0 0 0 15000 0 52062 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 05/06/1943 0 1
0 0 - 0 - 0 - 0 - 0 181400 223094
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346762
1#0##0#0#0.0#2022-01-05
09:15:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
661bab665d8ab474decad600dc35ff83 150000 0 0 0 0 0
0 0 0 0 15000 0 58094 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 05/05/1940 0 2
0 0 - 0 - 0 - 0 - 0 181400 332392
0 1 0 0 0 SUKINI SOSROWIMPUNO., NY 042317 81
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346763
1#0##0#0#0.0#2022-01-05
09:15:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9300a567e2b37bd4c6ab94e57c2475f2 150000 0 0 0 0 0
0 89050 0 0 15000 0 78342 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 14/03/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 717110
0 1 0 0 0 SUHARNI., NY 042396 56 20745 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346765
1#0##0#0#0.0#2022-01-05
09:17:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9b01f20cd16881bf42b6beee35fcf53e 150000 0 0 0 0 0
0 171170 0 0 15000 0 380940 0 0 0 0
0
3372030 C 3 CP 2 30/12/2021 30/12/2021 23/02/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 359980
0 1 0 0 0 YUSUF SUKIRNO, TN 100732 66 24417 DR.
agung;3313092303950002; 5.6.3.202201201500 4 346767
1#0##0#0#0.0#2022-02-18
14:35:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
1a7403b0678e4ecd2505ce63ff6bce60 150000 0 0 0 0 0
0 127380 0 0 15000 0 67600 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 31/05/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 209282
0 1 0 0 0 ENDANG HARSO SRI P., NY 071636 49 18110
yani;3302226402970001; 5.5.5.202112011542 4 346768
1#0##0#0#0.0#2022-01-05
09:22:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f98410653e9ab7fc12840def062c7a68 150000 0 0 0 0 0
0 0 0 0 15000 0 44282 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 31/12/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 316715
0 1 0 0 0 KARMIN CIPTO HARTONO.TN 100152 66 24471
yani;3302226402970001; 5.5.5.202112011542 4 346773
1#0##0#0#0.0#2022-01-05
09:22:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
237ccec0c0eeac78c78697e517fe8fcb 150000 0 0 0 0 0
0 120745 0 0 15000 0 30970 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 30/08/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 356504
yani;3302226402970001; 5.5.5.202112011542 4 346774
1#0##0#0#0.0#2022-01-05
09:23:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b08f5145e380ca7b08a1c5b5e66f85f5 150000 0 0 0 0 0
0 76595 0 0 15000 0 114909 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 31/12/1968 0 2
0 0 - 0 - 0 - 0 - 0 181400 320580
0 1 0 0 0 HARYANI,NY 072349 52 19357 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 346775
1#0##0#0#0.0#2022-01-05
09:24:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c567b216a295139e0643a6f2e82e227a 150000 0 0 0 0 0
0 63690 0 0 15000 0 91890 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 10/08/1982 0 1
0 0 - 0 - 0 - 0 - 0 181400 299465
0 1 0 0 0 AGUS WIYANTO.TN 100707 39 14387 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346776
1#0##0#0#0.0#2022-01-05
09:24:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
31bf3f3632240e195dd0de3017567653 150000 0 0 0 0 0
0 108440 0 0 15000 0 26025 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 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 agung;3313092303950002; 5.6.6.202203301209 4
346665 1#0##0#0#0.0#2022-04-14
13:14:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
6dfb4ea741240df23f3067f7e549ef8b 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 05/08/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 256305
0 1 0 0 0 SRI REJEKI.NY 097797 65 23888 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346777
1#0##0#0#0.0#2022-01-05
09:32:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6698a36b6f7fb9353909fb824e42339a 150000 0 0 0 0 0
0 31845 0 0 15000 0 59460 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 09/12/1986 0 2
- 0 - 0 - 0 - 0 549400 226535 0
1 0 0 0 SITI FATIMAH DESHI ROES.NY 101095 35 12805
yani;3302226402970001; 5.5.5.202112011542 4 346779
1#0##0#0#0.0#2022-01-05
09:32:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c33ab157d5cb1b10ace22fbc211459e5 150000 0 0 0 0 0
0 0 0 0 15000 0 61535 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 05/07/1965 0 2
0 - 0 - 0 - 0 - 0 181400 449252
0 1 0 0 0 YULI MARGIYANI, (NY) 012905 56 20632
yani;3302226402970001; 5.5.5.202112011542 4 347089
1#0##0#0#0.0#2022-01-05
09:33:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
78e0d38f48993655ac4e29696ac5fbd9 150000 0 0 0 0 0
248000 0 0 0 15000 0 36252 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 18/04/1974 0 1
1 D45 - - - None None None None Q-5-43-0 None None
0 - 0 - 0 - 0 - 0 262000 192456
0 1 0 0 0 JOKO SANTOSO.TN 101122 47 17423 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346781
1#0##0#0#0.0#2022-01-05
09:34:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d38c455ccb6b7d8113a355e435091ea3 150000 0 0 0 0 0
0 0 0 0 25000 0 17456 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 06/03/1959 0 2
1 E11.4;G59.0 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 593580
0 1 0 0 0 KUS HARSANTI.,NY 074896 62 22945 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346783
1#0##0#0#0.0#2022-01-05
09:35:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
20bf69943280403dcd16126dc2eec0c6 150000 0 0 0 0 0
0 171170 0 0 15000 0 257410 0 0 0 0
0
3372030 C 3 CP 2 30/12/2021 30/12/2021 07/01/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 335812
0 1 0 0 0 MUH NUKMAN.TN 080746 70 25925 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346784
1#0##0#0#0.0#2022-01-05
09:36:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3ec58ce2e09c73a52249ca507b663cf6 150000 0 0 0 0 0
0 120795 0 0 15000 0 50017 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 31/12/1940 0 1
1 Z09.8;E11.9;I10;J06.9 87.24 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 774600
0 1 0 0 0 MANTO DIHARJO,[BP] 024229 80 29584
yani;3302226402970001; 5.5.5.202112011542 4 347083
1#0##0#0#0.0#2022-01-05
09:37:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
95f0de148240cc105162e7b1aa62fd54 150000 0 0 0 0 0
400000 63690 0 0 15000 0 145910 0 0 0 0
0
3372030 C 3 CP 2 30/12/2021 30/12/2021 17/04/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 232350
0 1 0 0 0 ARY SURYANTO.TN 085040 63 23268 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346785
1#0##0#0#0.0#2022-01-05
09:37:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
efe9cc607be6cadec82ce5aa11763326 150000 0 0 0 0 0
0 31845 0 0 15000 0 35505 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 31/12/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 231544
0 1 0 0 0 SITI MARYAM, NY 093234 67 24836 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346787
1#0##0#0#0.0#2022-01-05
09:41:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2d7d03a4f93e22bd4a8c5ccbd995dbfa 150000 0 0 0 0 0
0 0 0 0 15000 0 66544 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 31/10/1971 0 2
1 Z09.8;E11.4;G59.0;J06.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 268511
0 1 0 0 0 YUNLIS SETYOWATI, (NY) 001924 50 18323
yani;3302226402970001; 5.5.5.202112011542 4 346788
1#0##0#0#0.0#2022-01-05
09:42:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dbf7f0efeaf0b781c3663432f52cce45 150000 0 0 0 0 0
0 63690 0 0 15000 0 39821 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 06/03/1956 0 2
0 0 - 0 - 0 - 0 - 0 181400 234220
yani;3302226402970001; 5.5.5.202112011542 4 346789
1#0##0#0#0.0#2022-01-05
09:43:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5869bd8662f747428b092c0e27b69d03 150000 0 0 0 0 0
0 0 0 0 15000 0 69220 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 15/08/1964 0 1
0 0 - 0 - 0 - 0 - 0 181400 217691
0 1 0 0 0 SARJU DARMAWAN.TN 091482 57 20956 DR.
novia;3313125201940001; 5.6.3.202201201500 4 346790
1#0##0#0#0.0#2022-03-08
08:50:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
75d5b67cdcfe6c97c563054410c3b0d7 150000 0 0 0 0 0
0 31845 0 0 15000 0 20846 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 20/01/1968 0 1
- 0 - 0 - 0 183900 206250 0 1 0
0 0 RIYADI.TN 091191 53 19703 DR. WAHYU PURNOMO, SP.OT
1124R0021221V005165 0002033971132 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346791 1#0##0#0#0.0#2022-01-05
09:46:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
000a9050234c21181cf3864604ea5ed0 150000 0 0 0 0 0
0 0 0 0 15000 0 41250 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 01/07/1940 0 2
0 0 - 0 - 0 - 0 - 0 181400 301874
0 1 0 0 0 KATINAH, NY 093702 81 29767 DR. SUHARTO,
SP.PD 1124R0021221V005166 0001843965775 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346793 1#0##0#0#0.0#2022-01-05
09:47:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
35c703906bef61be33187867b0d07dd8 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 16/07/1972 0 1
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
324445 0 1 0 0 0 ACHMAD SOLICHIN, TN 099665
0003003469154 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346797 1#0##0#0#0.0#2022-01-05
10:02:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
56a97a78d23fdd4ccc4290f13f064e02 150000 0 0 0 0 0
0 76045 0 0 15000 0 83400 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 17/06/1970 0 2
0 0 - 0 - 0 - 0 - 0 181400 220580
yani;3302226402970001; 5.5.5.202112011542 4 346795
1#0##0#0#0.0#2022-01-05
10:02:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dbbe33adb1042ea386de67cb06fb5c3b 150000 0 0 0 0 0
0 0 0 0 15000 0 55580 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 09/12/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400
1224296 0 1 0 0 0 SUPRIYANTO, (BP) 012565 54
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346798
1#0##0#0#0.0#2022-01-05
10:05:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
98ca5ff77dfee6645316613bf9ab99b5 150000 0 0 0 0 0
0 107890 0 0 15000 0 951406 0 0 0 0
0
3372030 C 3 CP 2 30/12/2021 30/12/2021 08/09/1960 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SITI ZUBAIDAH, NY
0000196018064 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346667 1#0##0#0#0.0#2022-01-05
10:06:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
24c58b2248c663075ca9d073284e0573 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 15/12/1951 0 1
0 404900 590203 0 1 0 0 0 SYAFIQ MUHAMMAD,
BP 100679 70 25583 DR. WAHYU PURNOMO, SP.OT 1124R0021221V005171
0001787454077 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346799 1#0##0#0#0.0#2022-01-05
10:10:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
877a4ad35ca225b981ef6f3fd9abbe43 351500 0 0 0 0 0
0 0 0 0 15000 0 223703 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 17/02/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 387170
0 1 0 0 0 RADIAN MIYADI,.TN 045602 72 26614 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346800
1#0##0#0#0.0#2022-01-05
10:11:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a4514a880af3760faf8198a9af757562 150000 0 0 0 0 0
0 133700 0 0 15000 0 88470 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 06/06/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 202512
0 1 0 0 0 SUPARMAN, BP 045790 67 24679 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346801
1#0##0#0#0.0#2022-01-05
10:12:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bec889b5189d955fa0f5559b3f7be180 150000 0 0 0 0 0
0 0 0 0 15000 0 37512 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 31/12/1952 0 2
0 0 - 0 - 0 - 0 - 0 181400 225664
0 1 0 0 0 NGATIYEM.NY 067636 68 25201 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 346802
1#0##0#0#0.0#2022-01-05
10:13:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3354374133c6a6c7a991fe325006ccd9 150000 0 0 0 0 0
0 0 0 0 15000 0 60664 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 15/11/1951 0 2
0 0 - 0 - 0 - 0 - 0 181400 227676
0 1 0 0 0 SRI PARYATUN 092307 70 25613 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346803
1#0##0#0#0.0#2022-01-05
10:14:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d1984d360568b79afc4ec6a98de28db4 150000 0 0 0 0 0
0 0 0 0 15000 0 62676 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 27/01/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 319315
0 1 0 0 0 ORYZA WARDHANI.NY 093625 50 18600 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346804
1#0##0#0#0.0#2022-01-05
10:15:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
22640761bb2cff76003b23c92cdc7c17 150000 0 0 0 0 0
0 31845 0 0 15000 0 122470 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 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; 5.5.5.202112011542 4
347224 1#0##0#0#0.0#2022-01-05
10:20:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3f69e5acd8acf2c06fb35b38ed431688 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 22/08/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 409970
0 1 0 0 0 HARTINI., NY 048885 60 22045 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346805
1#0##0#0#0.0#2022-01-05
10:22:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bbfe50c3a59406b475cf98197c34a0fe 150000 0 0 0 0 0
0 93790 0 0 15000 0 151180 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 23/12/1966 0 2
1 Z09.8;K27.9;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 222801
0 1 0 0 0 BUDIARTI.,NY 044128 55 20096 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346807
1#0##0#0#0.0#2022-01-05
10:22:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
32aedba401a1ce133a59dc99a27fd1f2 150000 0 0 0 0 0
0 0 0 0 15000 0 57801 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 20/03/1971 0 1
0 0 - 0 - 0 - 0 - 0 181400 328967
0 1 0 0 0 MARDIYONO,TN 093361 50 18548 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346808
1#0##0#0#0.0#2022-01-05
10:23:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1c371c784c57925449e2a28c5236e133 150000 0 0 0 0 0
0 121345 0 0 15000 0 42622 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 15/04/1963 0 2
1 Z09.8;R10.4;I10;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 381103
0 1 0 0 0 SUMINI, NY 047378 58 21444 DR. SUHARTO,
SP.PD 1124R0021221V005181 0001084295619 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346810 1#0##0#0#0.0#2022-01-05
10:25:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
aa10b4348ad79ab1a861220a258fae95 150000 0 0 0 0 0
0 133700 0 0 15000 0 82403 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 21/08/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 593848
0 1 0 0 0 MUHAMMAD HIDAYAT ANHARI. TN 084872 70
yani;3302226402970001; 5.5.5.202112011542 4 346811
1#0##0#0#0.0#2022-01-05
10:26:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
45053cb3317a2ce690c507934aaa2904 150000 0 0 0 0 0
0 31845 0 0 15000 0 397003 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 25/08/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 217481
0 1 0 0 0 SRI SUHARYATI NY 084849 68 24964 DR.
novia;3313125201940001; 5.6.3.202201201500 4 346813
1#0##0#0#0.0#2022-03-08
08:45:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
957d519ab4bc1126be1b5d82e5637c39 150000 0 0 0 0 0
0 31845 0 0 15000 0 20636 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 13/03/1958 0 2
1 Z09.8;E11.4;G59.0;I10;J06.9;E78.5 - - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 468222 0 1 0 0 0 SRI SUNINGSIH.NY 085559
0000640167658 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346814 1#0##0#0#0.0#2022-01-05
10:28:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
051bffb929a0067e1bfbfe411eb411b2 150000 0 0 0 0 0
0 31845 0 0 15000 0 271377 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 17/05/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 471652
0 1 0 0 0 SRI MISGIYATI (NY) 039429 58 21412
yani;3302226402970001; 5.5.5.202112011542 4 346815
1#0##0#0#0.0#2022-01-05
10:29:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c815dcafc363ba64d2ca62438b853cf0 150000 0 0 0 0 0
0 63690 0 0 15000 0 242962 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 01/06/1972 0 1
1 Z09.8;E11.9;I12.0;E78.5 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 544996
0 1 0 0 0 JONI MARGONO., TN 036787 49 18109 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346816
1#0##0#0#0.0#2022-01-05
10:31:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6448026ae9bdf72a58c38bfad6514109 150000 0 0 0 0 0
0 120745 0 0 15000 0 259251 0 0 0 0
0
3372030 C 3 CP 2 30/12/2021 30/12/2021 04/11/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 404095
0 1 0 0 0 ISMIYATUN.NY 094256 60 21971 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346817
1#0##0#0#0.0#2022-01-05
10:32:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e2984ee3e683862760340b39c07229a1 150000 0 0 0 0 0
0 81435 0 0 15000 0 157660 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 23/03/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 240192
0 1 0 0 0 SUMARNI, NY 074054 62 22928 DR. WAHYU
agung;3313092303950002; 5.6.6.202203301209 4 346819
1#0##0#0#0.0#2022-04-14
12:59:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
7b6e40c243779609c029ab180ad61a1e 150000 0 0 0 0 0
0 0 0 0 15000 0 75192 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 06/05/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 333980
0 1 0 0 0 WALUYO, BP 085609 56 20692 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 346820
1#0##0#0#0.0#2022-01-05
10:33:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4dfe0c08005b8421c6a51fb606fce6ad 150000 0 0 0 0 0
0 121345 0 0 15000 0 47635 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 03/09/1946 0 1
1 Z09.8;I11.9;E11.9;I50.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 868051
0 1 0 0 0 SUDJIMAN,TN 092271 75 27512 DR. SUHARTO,
SP.PD 1124R0021221V005190 0000091143123 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346821 1#0##0#0#0.0#2022-01-05
10:34:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4e1e79a4a421575743b43c1693d5602a 150000 0 0 0 0 0
0 31845 0 0 15000 0 671206 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 02/06/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 395920
0 1 0 0 0 SITI NURKHAYATI., NY 065344 59 21761
yani;3302226402970001; 5.5.5.202112011542 4 346822
1#0##0#0#0.0#2022-01-05
10:35:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
744161efdb29cf6d6bcc6e0bc3dbc423 150000 0 0 0 0 0
0 89500 0 0 15000 0 141420 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 08/01/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 209082
0 1 0 0 0 TRI SUWARTI, NY 057542 59 21906 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346823
1#0##0#0#0.0#2022-01-05
10:36:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e1fc8c523a6bf23e74bf58a7571f6983 150000 0 0 0 0 0
0 0 0 0 15000 0 44082 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 01/09/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 MARIA VERENA
1124R0021221V005193 0000091422044 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346666 1#0##0#0#0.0#2022-01-05
10:37:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8a57a9ac85832a06b2acd24e98846090 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 25/10/1979 0 1
0 0 - 0 - 0 - 0 - 0 181400 207980
0 1 0 0 0 JOKO SARYANTO 091334 42 15407 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346824
1#0##0#0#0.0#2022-01-05
10:38:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
aca8884edd19cf4bc76422bfb7d1f3b2 150000 0 0 0 0 0
0 0 0 0 15000 0 42980 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 19/12/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 188171
0 1 0 0 0 EDY MULYONO 100277 66 24118 DR. RINA
5.5.5.202112011542 4 346826 1#0##0#0#0.0#2022-01-05
10:38:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4f16a5a80563715b11b4ca6cd2a66270 150000 0 0 0 0 0
0 0 0 0 15000 0 23171 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 28/09/1957 0 1
0 0 - 0 - 0 - 0 - 0 181400 272445
0 1 0 0 0 INDRO SUPRIYANTO.TN 082308 64 23469
yani;3302226402970001; 5.5.5.202112011542 4 346827
1#0##0#0#0.0#2022-01-05
10:39:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
30df673db4bed903239f711fdcea193e 150000 0 0 0 0 0
0 31845 0 0 15000 0 75600 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 13/12/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 278250
yani;3302226402970001; 5.5.5.202112011542 4 346828
1#0##0#0#0.0#2022-01-05
10:41:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8ddf629ae566d1a3639d15d48c4c747d 150000 0 0 0 0 0
0 31845 0 0 15000 0 81405 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 12/01/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 249983
0 1 0 0 0 UNIK DEWI RAHAYU,(NY) 025580 43 16058
yani;3302226402970001; 5.5.5.202112011542 4 346830
1#0##0#0#0.0#2022-01-05
10:42:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4dde9d8b6ff260b92fdd74e46d2fdf08 150000 0 0 0 0 0
0 0 0 0 15000 0 84983 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 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; 5.5.5.202112011542 4
347217 1#0##0#0#0.0#2022-01-05
10:42:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b08fc027f701feca5e305ac63a2298c5 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 12/12/1965 0 2
1 Z09.8;M54.59;M19.99;E11.4;G59.0 - - - None None None
LAIN-LAIN 181400 0 0 - 0 - 0 - 0 - 0
181400 204370 0 1 0 0 0 SRI WAHYUNINGSIH 093130
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346832
1#0##0#0#0.0#2022-01-05
10:43:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
48625da62af496439eec628a127f7805 150000 0 0 0 0 0
0 0 0 0 15000 0 39370 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 22/11/1975 0 2
1 Z09.8;E11.9;J40 87.49 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 365000
0 1 0 0 0 SRI SUMARNI.NY 081759 46 16840 DR.
yani;3302226402970001; 5.5.5.202112011542 4 347078
1#0##0#0#0.0#2022-01-05
10:46:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
16ce4f38a280347e0efe4df24dfb3202 150000 0 0 0 0 0
200000 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 27/05/1970 0 1
0 - 0 - 0 - 0 - 0 181400 187260
yani;3302226402970001; 5.5.5.202112011542 4 346833
1#0##0#0#0.0#2022-01-05
10:48:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e2068c6a97dc5f881548185eec350cc9 150000 0 0 0 0 0
0 0 0 0 15000 0 22260 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 23/03/1973 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ERDIANA.NY 087879
0000565638074 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
347225 1#0##0#0#0.0#2022-01-05
10:49:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eb36f4e61d68c0e646799fcc1cdae563 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 26/05/1958 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
483896 0 1 0 0 0 SRI SUNTARI,(NY) 023355 63
yani;3302226402970001; 5.5.5.202112011542 4 346834
1#0##0#0#0.0#2022-01-05
10:50:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
939299efeccd6ad7cf7bbac95902f173 150000 0 0 0 0 0
0 0 0 0 15000 0 318896 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 03/04/1988 0 2
- 0 - 0 - 0 - 0 549400 182210 0
1 0 0 0 ANA SWASTIKA ROHMAH, NY 042889 33 12324 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346835
1#0##0#0#0.0#2022-01-05
10:52:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
8a1d067338ef8be0698da53d1b3a718a 150000 0 0 0 0 0
0 0 0 0 15000 0 17210 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 26/08/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 246244
0 1 0 0 0 TRI HARTOYO ARI BUDI 060228 54 19850
yani;3302226402970001; 5.5.5.202112011542 4 346837
1#0##0#0#0.0#2022-01-05
10:54:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bbda3393b36575d5453db4b3b0d53f89 150000 0 0 0 0 0
0 0 0 0 15000 0 81244 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
346675 1#0##0#0#0.0#2022-01-05
10:56:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4c667fe73f679f464ee6ea71ba164786 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 04/06/1967 0 2
0 0 - 0 - 0 - 0 - 0 181400 226243
0 1 0 0 0 SRI HARTATI,(NY) 005917 54 19933 DR.
novia;3313125201940001; 5.6.3.202201201500 4 346838
1#0##0#0#0.0#2022-03-08
08:40:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
40eb2633a6cce53e54dad0e6b8592eed 150000 0 0 0 0 0
0 31845 0 0 15000 0 29398 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 19/02/1941 0 2
0 0 - 0 - 0 - 0 - 0 181400 373094
0 1 0 0 0 KUSTINAH.NY 088456 80 29534 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 346839
1#0##0#0#0.0#2022-01-05
11:22:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
efe48c7f3ad351901fb5a72279542383 300000 0 0 0 0 0
0 0 0 0 15000 0 58094 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 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 agung;3313092303950002; 5.6.6.202203301209 4
347213 1#0##0#0#0.0#2022-04-14
13:47:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
98ec09152fa69a0f255231210299a83f 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 04/09/1953 0 1
0 0 - 0 - 0 - 0 - 0 181400 347660
0 1 0 0 0 NURMANTO, TN 098729 68 24954 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346840
1#0##0#0#0.0#2022-01-05
11:23:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e9eac246f7e8575fea47f3a88414f54c 150000 0 0 0 0 0
0 0 0 0 15000 0 182660 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 12/11/1963 0 1
1 Z09.8;M54.59;G81.9 93.39 - - None None None None M-3-
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0002169748091 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346668 1#0##0#0#0.0#2022-01-05
11:25:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
1f66e1870644fd7b3531fab689696fc3 204000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 26/11/1986 0 2
1 Z09.8;K27.9;R51;M79.18 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 236311
yani;3302226402970001; 5.5.5.202112011542 4 346841
1#0##0#0#0.0#2022-01-05
11:27:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4462c0d8b647e11b7e355fd53ed1e680 150000 0 0 0 0 0
0 0 0 0 15000 0 71311 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 31/12/1961 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 JUMIATI.NY 097762
0001032605763 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
347211 1#0##0#0#0.0#2022-01-05
11:46:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3b47f93ba1ac8ce3ff8ce9bb10c306e1 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 20/01/2013 0 2
0 0 - 0 - 0 - 0 - 0 181400 232014
0002347378345 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346842 1#0##0#0#0.0#2022-01-05
11:36:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4c7bf4a3b5d00d8483fcf4e8c4b3630e 150000 0 0 0 0 0
0 58796 0 0 15000 0 8218 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 12/08/1950 0 2
1 Z09.8;K30;M19.98;I50.0 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 265903
0 1 0 0 0 SUYAMI.NY 088115 71 26073 DR. SUHARTO,
SP.PD 1124R0021221V005220 0002898872076 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346843 1#0##0#0#0.0#2022-01-05
11:37:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3868dac1baadc686979c22985674f4db 150000 0 0 0 0 0
0 0 0 0 15000 0 100903 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 23/03/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 325780
0 1 0 0 0 SITI WIARNI.NY 078569 58 21467 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346844
1#0##0#0#0.0#2022-01-05
11:38:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4cdd5abb9a403d7e6bdff1dfc4fe4fb6 150000 0 0 0 0 0
0 0 0 0 15000 0 160780 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 03/06/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 238360
0 1 0 0 0 SUYOTO, TN 099549 51 18838 DR. SUHARTO,
SP.PD 1124R0021221V005222 0002041057473 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346845 1#0##0#0#0.0#2022-01-05
11:43:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bc1055135233c1ad31ca3dba77944849 150000 0 0 0 0 0
0 0 0 0 15000 0 73360 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 05/11/1960 0 2
0 - 0 - 0 - 0 - 0 181400 249544
0 1 0 0 0 TARNI.NY 101123 61 22335 DR. WAHYU
yani;3302226402970001; 5.5.5.202112011542 4 346846
1#0##0#0#0.0#2022-01-05
11:44:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ac13a96bf590c042b7666dba9e67f84d 150000 0 0 0 0 0
0 0 0 0 25000 0 74544 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 21/11/1982 0 2
1 Z09.8;K30;J06.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 217135
yani;3302226402970001; 5.5.5.202112011542 4 346847
1#0##0#0#0.0#2022-01-05
11:45:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9d785a533c9ac6a3dee856d499437d0f 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 14/12/1982 0 1
0 0 - 0 - 0 - 0 - 0 181400 269096
0 1 0 0 0 TOFHAN ANDRYAS, TN 099114 39 14261
yani;3302226402970001; 5.5.5.202112011542 4 346848
1#0##0#0#0.0#2022-01-05
11:45:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
851786b3db88f7aa367034f528cdadc3 150000 0 0 0 0 0
0 0 0 0 15000 0 104096 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 24/01/1964 0 2
1 Z09.8;R10.4;N30.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 262777
0 1 0 0 0 SUKARMI., NY 045414 57 21160 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346849
1#0##0#0#0.0#2022-01-05
11:47:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
246810ca49c9f3d14c82f30d9d93610f 150000 0 0 0 0 0
0 0 0 0 15000 0 97777 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 10/10/1957 0 1
1 Z09.8;R10.4;R51 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 214811
0 1 0 0 0 SULUT, TN 082030 64 23457 DR. SUHARTO,
SP.PD 1124R0021221V005227 0000640434914 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346850 1#0##0#0#0.0#2022-01-05
11:47:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
35c3a3e01dfbfc471e11acd3568bfed9 150000 0 0 0 0 0
0 0 0 0 15000 0 49811 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 25/07/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 359319
0 1 0 0 0 MUHAMMAD BANANI 090774 77 28282 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346852
1#0##0#0#0.0#2022-01-05
11:49:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3e7958628c38b4eaeba53dc3745e2b72 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 07/10/1959 0 2
1 Z09.8;E11.9;J06.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 255690
SP.PD 1124R0021221V005229 0001694442633 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346853 1#0##0#0#0.0#2022-01-05
11:50:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a40ae4a83f7881b14c892657b2d6c8a9 150000 0 0 0 0 0
0 31845 0 0 15000 0 58845 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 12/09/1961 0 1
1 Z09.8;M17.9;I11.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 269750
yani;3302226402970001; 5.5.5.202112011542 4 346854
1#0##0#0#0.0#2022-01-05
11:51:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fd9a48a2b771d4c66dfc674f1a8cb56f 150000 0 0 0 0 0
0 0 0 0 15000 0 104750 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 06/09/1956 0 1
1 Z09.8;I50.0;K30;N20.0;K80.2 88.76 - - None None None None
549400 0 0 - 0 - 0 - 0 - 0 549400
896127 0 1 0 0 0 BADRUN.TN 098994 65 23856
yani;3302226402970001; 5.5.5.202112011542 4 347086
1#0##0#0#0.0#2022-01-05
11:55:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d9a98358bd0ff2be0d8ee4d321140c50 150000 0 0 0 0 0
657000 0 0 0 15000 0 74127 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 23/07/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 211992
yani;3302226402970001; 5.5.5.202112011542 4 346855
1#0##0#0#0.0#2022-01-05
13:29:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
439d244838fe0d9074ffde6adc3520f0 150000 0 0 0 0 0
0 0 0 0 15000 0 46992 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 13/01/1961 0 2
0 0 - 0 - 0 - 0 - 0 181400 258685
0 1 0 0 0 SARJIYEM.NY 100740 60 22266 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 346856
1#0##0#0#0.0#2022-01-05
13:30:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
80452d79bbc925bc061046fd6872e21a 150000 0 0 0 0 0
0 31845 0 0 15000 0 61840 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 06/01/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 378660
0 1 0 0 0 SRI SUTARNINGSIH.NY 086730 68 25195
agung;3313092303950002; 5.6.6.202203301209 4 346857
1#0##0#0#0.0#2022-04-14
13:20:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
2d4ce2dbe8fc36dbda8de8ec473b4b1b 150000 0 0 0 0 0
0 63690 0 0 15000 0 149970 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 29/09/1961 0 1
0 0 - 0 - 0 - 0 - 0 181400 787903
yani;3302226402970001; 5.5.5.202112011542 4 346858
1#0##0#0#0.0#2022-01-05
13:31:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
aee5830924752dea2f1dc29adddf4f89 150000 0 0 0 0 0
0 0 0 0 15000 0 622903 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 27/03/1954 0 1
0 0 - 0 - 0 - 0 - 0 181400 214270
0 1 0 0 0 SUHARTO JOKO.P (BP) 050087 67 24750
novia;3313125201940001; 5.6.3.202201201500 4 346859
1#0##0#0#0.0#2022-03-08
09:09:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
3edfa00099cdd3428c37f0aa32ca9f03 150000 0 0 0 0 0
0 17745 0 0 15000 0 31525 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 06/02/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 785707
0 1 0 0 0 WORO SUDARYANTI, NY 074725 56 20781
yani;3302226402970001; 5.5.5.202112011542 4 346860
1#0##0#0#0.0#2022-01-05
13:33:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
96125eeadc2ec01dd8813708b634a0b6 150000 0 0 0 0 0
0 31845 0 0 15000 0 588862 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 22/09/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 286871
0 1 0 0 0 PONIYATI, NY 075582 56 20553 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346861
1#0##0#0#0.0#2022-01-05
13:33:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2cc667a58d2886fc742082f6d319aade 150000 0 0 0 0 0
0 76595 0 0 15000 0 45276 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 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 novia;3313125201940001; 5.6.3.202201201500 4
346671 1#0##0#0#0.0#2022-02-15
13:55:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
e0959da6e068f4fde3cfabe7a8d9e597 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 20/01/1980 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SUPATMI.NY 101117 41 15320 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 346862
1#0##0#0#0.0#2022-01-05
13:34:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e05f1474a680bf16532b3456b1910c43 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 30/01/1966 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 219000 0 1 0 0 0 WAHYUNI.NY 082555
0000639464488 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346670 1#0##0#0#0.0#2022-01-05
13:35:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f7d2e1f9ee4f66f0f55b1ed45bd1c934 204000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 03/07/1969 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 LUCIA SRI
1124R0021221V005243 0000639909854 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346673 1#0##0#0#0.0#2022-01-05
13:36:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
38dfea8e1408d3f74ecb2e73cc38924b 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 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; 5.5.5.202112011542 4
346677 1#0##0#0#0.0#2022-01-05
13:36:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c0462dfb9ee7b7775f43a5704333dab7 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 28/01/1959 0 1
1 Z09.8;R10.4;R07.4;I11.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 252139
0 1 0 0 0 RISTIYANTO,TN 029882 62 22982 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346865
1#0##0#0#0.0#2022-01-05
13:38:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8c18693f7f5148b535036bb0efcc85af 150000 0 0 0 0 0
0 0 0 0 15000 0 87139 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 09/03/1953 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 ARIEF BUDI
1124R0021221V005246 0002166940282 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346672 1#0##0#0#0.0#2022-01-05
13:38:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f6f71aadb4268808fee6867534756bcb 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 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; 5.5.5.202112011542 4
346669 1#0##0#0#0.0#2022-01-05
13:39:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2961f9693897189fdc406bf124f79f35 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 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; 5.5.5.202112011542 4
346676 1#0##0#0#0.0#2022-01-05
13:40:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5fb6d7496d5f1c61f61e5dcd3b1c948d 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 13/08/1958 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 254000 0 1 0 0 0 TRI UTAMI
1124R0021221V005249 0001380313934 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 347219 1#0##0#0#0.0#2022-01-05
13:41:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
22f0d4c6d17a46aa266fc617c8f0eddb 239000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 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 yani;3302226402970001; 5.5.5.202112011542 4
347218 1#0##0#0#0.0#2022-01-05
13:41:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8eb0c53d0ec3a83043ca7a034309a6a7 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 31/12/1950 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 NGATIYEM, NY
0002940595885 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346674 1#0##0#0#0.0#2022-01-05
13:42:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e93edc7b4392c11d9822b6d4b61fd251 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 23/08/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 223201
0 1 0 0 0 NUR HAYATI, NY 072679 74 27158 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346866
1#0##0#0#0.0#2022-01-05
13:43:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2f14b1fcacd06c6046fb2f712277d31d 150000 0 0 0 0 0
0 0 0 0 15000 0 58201 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 09/06/2017 0 2
0 0 - 0 - 0 - 0 - 0 181400 208098
0 1 0 0 0 KENIZIA HUSNA AZALIA, AN 083111 4
0002291041585 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346867 1#0##0#0#0.0#2022-01-05
13:44:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
96189c46e3b515b03f25a13854710efb 150000 0 0 0 0 0
0 0 0 0 15000 0 43098 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 05/05/1970 0 1
0 0 - 0 - 0 - 0 - 0 181400 214980
0 1 0 0 0 PARYADI, TN 100666 51 18867 DR. TEKY
novia;3313125201940001; 5.6.3.202201201500 4 346868
1#0##0#0#0.0#2022-03-08
11:49:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
aca6dd85039393eabef6609310322e95 150000 0 0 0 0 0
0 0 0 0 15000 0 49980 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 27/11/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 341517
0 1 0 0 0 SARSIYAH.NY 090773 73 26696 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 346869
1#0##0#0#0.0#2022-01-05
13:45:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d2c44f22df5fe7fc83224c3364927bdc 150000 0 0 0 0 0
0 121345 0 0 15000 0 55172 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 13/05/1994 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 BINTORO .,SDR 067244 27 10093 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346870
1#0##0#0#0.0#2022-01-05
13:46:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
129fc7668cd05a8af193f6e2c1abd3f5 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 03/12/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 339345
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yani;3302226402970001; 5.5.5.202112011542 4 346871
1#0##0#0#0.0#2022-01-05
13:46:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d15e05e2b47878e4596322642dc64340 150000 0 0 0 0 0
0 0 0 0 15000 0 174345 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 23/11/1999 0 1
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 AHMAD ASYROFUL HAQ.SDR 057992 22 8073
yani;3302226402970001; 5.5.5.202112011542 4 346873
1#0##0#0#0.0#2022-01-05
13:47:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e99e940c9c261c345c7d78ce35aef021 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 13/11/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 460122
0 1 0 0 0 MUFIDA AIDID ., NY 056377 49 17944
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 347081
1#0##0#0#0.0#2022-01-05
13:48:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1f684baca1ce08b9ee9a4ac152ef7006 150000 0 0 0 0 0
248000 0 0 0 15000 0 47122 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 17/06/1980 0 2
1 Z09.8;N20.0;K30;M17.9 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 234505
0 1 0 0 0 YUNI RAHAYU.NY 098573 41 15171 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346876
1#0##0#0#0.0#2022-01-05
13:49:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f915455b2271ad5ce63079f282f783b5 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 18/08/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 236483
0 1 0 0 0 IKE PRIWATI DANELLA.NY 098611 58 21319
yani;3302226402970001; 5.5.5.202112011542 4 346877
1#0##0#0#0.0#2022-01-05
13:51:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eb0e67c8327120555fc536dba74243f1 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 21/09/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 455239
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yani;3302226402970001; 5.5.5.202112011542 4 346878
1#0##0#0#0.0#2022-01-05
13:52:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a047d8f5809b0fe286c33f8916086411 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 02/05/1994 0 1
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novia;3313125201940001; 5.6.3.202201201500 4 346884
1#0##0#0#0.0#2022-03-08
09:24:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
54e826880fdb58b0335479cf397a02e1 150000 0 0 0 0 0
0 0 0 0 15000 0 26301 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 11/04/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 315500
0 1 0 0 0 RUDY UTOMO.TN 094563 58 21448 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346882
1#0##0#0#0.0#2022-01-05
13:54:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5f16532a73522c36ea6d7dc0e6a679ff 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 10/06/1961 0 2
1 Z09.8;M19.98;I11.9;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 211537
SP.PD 1124R0021221V005268 0002261302165 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346889 1#0##0#0#0.0#2022-01-05
13:55:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
77565c7ff023021a02db08594b17acba 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 21/06/1995 0 1
0 0 - 0 - 0 - 0 - 0 181400 311545
0 1 0 0 0 RM PRASISCA RAVIDO SB,SDR 074464 26
0000088913204 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346891 1#0##0#0#0.0#2022-01-05
13:59:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2a103434ba10032f71ca2c7b6fe06cc5 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 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; 5.5.5.202112011542 4
346678 1#0##0#0#0.0#2022-01-05
14:07:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 31/12/1945 0 2
0 0 - 0 - 0 - 0 - 0 181400 433426
0 1 0 0 0 SUPARTI, NY 063472 75 27758 DR. TEKY
yani;3302226402970001; 5.5.5.202112011542 4 346892
1#0##0#0#0.0#2022-01-05
14:09:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
37991e7c1c981e368e50ceb8c6b94af6 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 22/05/1972 0 2
0 0 - 0 - 0 - 0 - 0 181400 219610
0 1 0 0 0 SRI ENDANG PUDJIASTUTI.NY 079814 49
0001408260947 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346893 1#0##0#0#0.0#2022-01-05
14:10:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1ed15d75ec95da43089f7c213a8540e1 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 19/09/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 213590
0 1 0 0 0 MARIA SEPTIVICA SRI ROESTINAH, NY 060658
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346894
1#0##0#0#0.0#2022-01-05
14:10:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9faf8d1fa198c15ede2b7b43be142286 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 16/03/1946 0 2
0 0 - 0 - 0 - 0 - 0 181400 210712
0 1 0 0 0 SRI BASOEKI, NY 030148 75 27683 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346897
1#0##0#0#0.0#2022-01-05
14:11:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3b747b182c5838983f62656bde82313a 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 27/10/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 235965
0 1 0 0 0 WITONO DARSO WIYONO.TN 100586 63 23075
yani;3302226402970001; 5.5.5.202112011542 4 346898
1#0##0#0#0.0#2022-01-05
14:12:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
60de516fb251a041c3acac24f358eda9 150000 0 0 0 0 0
0 31845 0 0 15000 0 39120 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 28/05/1985 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 YUSITA MEILINA.NY 096452 36 13365 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346899
1#0##0#0#0.0#2022-01-05
14:12:47#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3b7b063b0365cee0c4f4e418551c986b 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 06/04/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 211451
0 1 0 0 0 LESTARI.NY 084940 56 20722 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 346900
1#0##0#0#0.0#2022-01-05
14:13:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d09ac9d5ccaa0f93871e6bc88c9d0fc5 150000 0 0 0 0 0
0 0 0 0 15000 0 46451 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 02/06/1968 0 2
1 Z09.8;I10;M19.98;K30 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 264815
0 1 0 0 0 SRI WAHYU HARJANTI, (NY) 038487 53
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346901
1#0##0#0#0.0#2022-01-05
14:14:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fe5664ff142666f71a0e096239f94cbb 150000 0 0 0 0 0
0 0 0 0 15000 0 99815 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 05/07/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 233711
0 1 0 0 0 MARIA THERESIA RUBINEM.NY 061567 74
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346902
1#0##0#0#0.0#2022-01-05
14:15:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8ca747bb7c07fe25fef9c4c810a1c50c 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 25/08/1955 0 1
0 0 - 0 - 0 - 0 - 0 181400 216120
0 1 0 0 0 BAMBANG AGUS SURONO.TN 100627 66 24234
yani;3302226402970001; 5.5.5.202112011542 4 346903
1#0##0#0#0.0#2022-01-05
14:16:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2010a03c005772c44dee233dea0e5791 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 14/04/1960 0 2
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
230536 0 1 0 0 0 MARTINAH., NY 072061 61
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346906
1#0##0#0#0.0#2022-01-05
14:17:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 22/01/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 224000
0 1 0 0 0 SUNARTO. TN 077010 52 19335 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 346907
1#0##0#0#0.0#2022-01-05
14:17:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
726ddf5b0e94eab7414168d66d1c2a57 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 15/03/1963 0 1
0 0 - 0 - 0 - 0 - 0 181400 214022
0 1 0 0 0 SUTRISWANTO.TN 094216 58 21475 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346911
1#0##0#0#0.0#2022-01-05
14:18:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
386f4b62beb46846066201fa61649f24 150000 0 0 0 0 0
0 0 0 0 15000 0 49022 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 31/12/1971 0 2
0 0 - 0 - 0 - 0 - 0 181400 226467
0 1 0 0 0 SAPTO WAHYUNINGSIH.NY 090819 49 18262
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346913
1#0##0#0#0.0#2022-01-05
14:19:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
ce2a88d48ac1ed73f720ca083f55d9de 150000 0 0 0 0 0
0 0 0 0 15000 0 61467 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 06/04/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 248021
0 1 0 0 0 IMBRIAKSI HENI ASTUTI (NY) 038025 58
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346916
1#0##0#0#0.0#2022-01-05
14:21:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1e32e557a6f9fd8ea75f2a53e6676f90 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 28/02/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 219268
0 1 0 0 0 SAJINO ,BP 084992 73 26969 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 346918
1#0##0#0#0.0#2022-01-05
14:22:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2933431efe70ad58bfc86883f4ec82ba 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 06/12/1947 0 1
1 Z09.8;G20;J40;M19.98 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 271400
0 1 0 0 0 TAWAR SUSANTO.TN 095299 74 27053 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346921
1#0##0#0#0.0#2022-01-05
14:22:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c3a7ac3d6f100054411310df4adc3459 150000 0 0 0 0 0
0 0 0 0 15000 0 106400 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 13/03/1946 0 2
1 Z09.8;M54.39;I69.3;M19.98 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
241027 0 1 0 0 0 LILIS SRI LESTARI.,NY 052287
0000639817187 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346923 1#0##0#0#0.0#2022-01-05
14:24:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
589faacf9e952ee5d1aac155bc12411d 150000 0 0 0 0 0
0 0 0 0 15000 0 76027 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 30/10/2010 0 1
1 Z09.0;N47 96.59 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 277840 0 1
0 0 0 FANDI HARYA OKTAVIAN (AN) 048709 11 4079 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346926
1#0##0#0#0.0#2022-01-05
14:25:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
10657d0b0a0213a3ece9467e283b7286 235000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 16/02/1970 0 1
0 - 0 - 0 - 0 183900 331894 0 1
0 0 0 TRIONO.TN 100731 51 18945 DR. ZULFADLY, SP.B
1124R0021221V005314 0000639836458 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346928 1#0##0#0#0.0#2022-01-05
14:26:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
692ba56e1f4e796c20c05692aface619 295000 0 0 0 0 0
0 0 0 0 15000 0 21894 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 24/04/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 271050
0 1 0 0 0 ESTER WARSITI.NY 089155 74 27279 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346930
1#0##0#0#0.0#2022-01-05
14:26:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
36b0e161817960e10943f80d1d17eb8f 150000 0 0 0 0 0
0 0 0 0 15000 0 106050 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 22/07/1960 0 1
0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 PARJINI.NY 101120 61 22441 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346933
1#0##0#0#0.0#2022-01-05
14:27:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1bb372cd5eb9105b45beb666da55bc5f 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 31/12/1962 0 2
1 Z09.8;G40.9;H26.9;H04.1 95.01 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 288860
0 1 0 0 0 SURANI, NY 063638 58 21549 DR. YUDHI
yani;3302226402970001; 5.5.5.202112011542 4 346936
1#0##0#0#0.0#2022-01-05
14:28:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
3656fa60c707551584d4f406b30ca350 203000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 25/12/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 332490
0 1 0 0 0 WAHJUNINGSIH KARMADJAJA.NY 042202 64
0001647209711 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346938 1#0##0#0#0.0#2022-01-05
14:28:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 0 0 0 15000 0 167490 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 05/01/1957 0 1
0 0 - 0 - 0 - 0 - 0 211200 278795
0 1 0 0 0 DJOKO SUPRAPTO.TN 085032 64 23735 DR.
yani;3302226402970001; 5.5.5.202112011542 4 346940
1#0##0#0#0.0#2022-01-05
14:29:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
96320a3dbd780854905d8773dcfd0de2 203000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 11/09/1966 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 346942
1#0##0#0#0.0#2022-01-05
14:30:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6dd048b71e2ed6a3a49ec458666c91e7 203000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 15/06/1981 0 2
1 Z09.8;G20;G47.0 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 188990
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3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346946
1#0##0#0#0.0#2022-01-05
14:30:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
77c105043acc039498921ab4d90f9ca8 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 31/01/1954 0 2
0 0 - 0 - 0 - 0 - 0 181400 278795
0 1 0 0 0 DEWI MURTYANINGSIH.,NY 074565 67 24805
yani;3302226402970001; 5.5.5.202112011542 4 346948
1#0##0#0#0.0#2022-01-05
14:31:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c07edeb3f8516399eb4ab00f40efcec0 203000 0 0 0 0 0
0 0 0 0 15000 0 60795 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 11/12/1967 0 1
0 0 - 0 - 0 - 0 - 0 181400 218315
yani;3302226402970001; 5.5.5.202112011542 4 346950
1#0##0#0#0.0#2022-01-05
14:33:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 25/06/1980 0 2
1 Z09.8;E11.3;H36.0;H04.1 95.01 - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 261807
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yani;3302226402970001; 5.5.5.202112011542 4 346952
1#0##0#0#0.0#2022-01-05
14:33:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0352a067828300e43c3ce01a1987d625 203000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 03/05/2015 0 1
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346954 1#0##0#0#0.0#2022-01-05
14:34:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 28/08/1964 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SITI ASMIYATUN, NY 083850 57 20943
yani;3302226402970001; 5.5.5.202112011542 4 346958
1#0##0#0#0.0#2022-01-05
14:35:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 01/08/1974 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
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3;JKN agung;3313092303950002; 5.6.6.202203301209 4 346960
1#0##0#0#0.0#2022-04-14
13:50:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 30/12/2021 30/12/2021 16/06/2011 0 2
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0002503643365 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346963 1#0##0#0#0.0#2022-01-05
14:36:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 24/12/1959 0 2
0 - 0 - 0 - 0 - 0 138400 285000
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yani;3302226402970001; 5.5.5.202112011542 4 347210
1#0##0#0#0.0#2022-01-05
14:37:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 10/12/2009 0 1
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0 1 0 0 0 ARDON JUANITOMBOEIK.AN 098948 12 4403
0001847019677 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346967 1#0##0#0#0.0#2022-01-05
14:37:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 07/08/2020 0 2
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0003045950223 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
346970 1#0##0#0#0.0#2022-01-05
14:39:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 21/10/1970 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 346976
1#0##0#0#0.0#2022-01-05
14:41:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 15/09/1960 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 347209
1#0##0#0#0.0#2022-01-05
14:42:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 20/02/1993 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 346975
1#0##0#0#0.0#2022-01-05
14:40:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 18/06/1964 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 346977
1#0##0#0#0.0#2022-01-05
14:43:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 18/05/1950 0 2
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1 0 0 0 SAMIYATI.NY 094791 71 26159 DR. LINDA
yani;3302226402970001; 5.5.5.202112011542 4 347215
1#0##0#0#0.0#2022-01-05
14:44:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 03/03/1950 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 346978
1#0##0#0#0.0#2022-01-05
14:45:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 31/12/1942 0 1
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3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346979
1#0##0#0#0.0#2022-01-05
14:46:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 02/07/1955 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 346980
1#0##0#0#0.0#2022-01-05
14:46:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 16/02/1959 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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13:37:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 30/12/2021 30/12/2021 21/10/1958 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 346981
1#0##0#0#0.0#2022-01-05
14:48:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 25/02/1965 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 347223
1#0##0#0#0.0#2022-01-05
14:49:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 21/10/1950 0 1
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3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346982
1#0##0#0#0.0#2022-01-05
14:51:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 24/07/2004 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 346983
1#0##0#0#0.0#2022-01-05
14:51:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 31/12/1948 0 2
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0 1 0 0 0 SRI REJEKI 092215 72 26662 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 346984
1#0##0#0#0.0#2022-01-05
14:52:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 12/03/2004 0 1
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14:53:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 31/12/1958 0 2
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1#0##0#0#0.0#2022-01-05
14:54:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 08/11/1954 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 346986
1#0##0#0#0.0#2022-01-05
14:55:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 28/12/1961 0 2
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3;JKN yani;3302226402970001; 5.5.5.202112011542 4 346987
1#0##0#0#0.0#2022-01-05
14:56:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 10/10/1953 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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347212 1#0##0#0#0.0#2022-01-05
14:56:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 21/12/1946 0 1
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346989 1#0##0#0#0.0#2022-01-05
14:57:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 01/06/1944 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 347206
1#0##0#0#0.0#2022-01-05
14:57:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 28/09/1964 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 346990
1#0##0#0#0.0#2022-01-05
14:58:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 13/08/1957 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 347204
1#0##0#0#0.0#2022-01-05
14:59:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 05/01/1951 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 347207
1#0##0#0#0.0#2022-01-05
14:59:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 05/06/1975 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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347214 1#0##0#0#0.0#2022-01-05
15:05:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.5.5.202112011542 4 346991
1#0##0#0#0.0#2022-01-05
15:06:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 20/06/1943 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 347203
1#0##0#0#0.0#2022-01-05
15:07:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 17/03/1976 0 1
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15:08:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 23/03/1964 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 346992
1#0##0#0#0.0#2022-01-05
15:09:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 20/03/1961 0 1
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15:11:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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15:11:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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yani;3302226402970001; 5.5.5.202112011542 4 346994
1#0##0#0#0.0#2022-01-05
15:12:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 29/03/1973 0 2
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15:13:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 08/12/1975 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 346995
1#0##0#0#0.0#2022-01-05
15:14:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 07/10/1970 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 347221
1#0##0#0#0.0#2022-01-05
15:15:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 07/07/1966 0 2
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15:16:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 14/06/1959 0 2
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1#0##0#0#0.0#2022-02-21
09:52:19#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#2022-01-05
15:17:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 14/10/1972 0 2
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SP.PD 1124R0021221V005375 0002082979192 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346723 1#0##0#0#0.0#2022-01-05
15:18:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 04/05/1958 0 2
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SP.PD 1124R0021221V005376 0001967732087 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346709 1#0##0#0#0.0#2022-01-05
15:19:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 31/12/1971 0 2
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1124R0021221V005377 0000555344774 3;JKN yani;3302226402970001;
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15:20:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 23/03/1976 0 2
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SP.PD 1124R0021221V005378 0001527005889 3;JKN yani;3302226402970001;
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15:21:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 10/07/1955 0 2
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1124R0021221V005379 0001032581823 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346711 1#0##0#0#0.0#2022-01-05
15:26:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 17/04/1973 0 1
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SP.PD 1124R0021221V005380 0002078547524 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346722 1#0##0#0#0.0#2022-01-05
15:28:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
90c3b816af1bdb32e52c911ab2702c9d 463830 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 22/04/1992 0 1
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SP.PD 1124R0021221V005381 0001894415848 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346712 1#0##0#0#0.0#2022-01-05
15:29:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 18/03/1988 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 346721
1#0##0#0#0.0#2022-01-05
15:29:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
245f365a458db706e9d4e46f4825c3f2 463830 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 04/09/1964 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 346714
1#0##0#0#0.0#2022-01-05
15:30:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
29711f4240a060e1a8e25677b190c035 463830 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 10/12/1982 0 1
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SP.PD 1124R0021221V005384 0001125136214 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346720 1#0##0#0#0.0#2022-01-05
15:30:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
cebf223667faa51a4f883b7e72465781 463830 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 12/10/1987 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 346718
1#0##0#0#0.0#2022-01-05
15:31:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9c68af5ed7cb04d1ec85a886726385de 463830 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 25/06/1970 0 2
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SP.PD 1124R0021221V005386 0002074007092 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346715 1#0##0#0#0.0#2022-01-05
15:32:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b6bd872a723491c3112b75bff43ea947 463830 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 20/02/1967 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 346999
1#0##0#0#0.0#2022-01-05
15:33:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4d33c34b8151c5f69e85a1f9cce245f8 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 27/02/1965 0 1
1 Z09.8;J44.1;H81.3 87.49 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 596579
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3;JKN yani;3302226402970001; 5.5.5.202112011542 4 347080
1#0##0#0#0.0#2022-01-05
15:35:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
c5e8105d1a9dceca742aa661e3b97e02 150000 0 0 0 0 0
200000 0 0 0 15000 0 231579 0 0 0 0
0
3372030 C 3 CP 2 30/12/2021 30/12/2021 15/05/1976 0 1
0 0 - 0 - 0 - 0 - 0 181400 381091
0 1 0 0 0 SLAMET SANTOSO.TN 098523 45 16665 DR.
yani;3302226402970001; 5.5.5.202112011542 4 347000
1#0##0#0#0.0#2022-01-05
15:36:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9cb8f63667352448f4eb95e35cf4473a 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 12/08/1965 0 1
0 0 - 0 - 0 - 0 - 0 181400 600698
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yani;3302226402970001; 5.5.5.202112011542 4 347077
1#0##0#0#0.0#2022-01-05
15:37:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f60b52a7497d682df7b223c03c21e69e 150000 0 0 0 0 0
200000 0 0 0 15000 0 235698 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 14/01/1983 0 2
0 0 - 0 - 0 - 0 - 0 181400 405387
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yani;3302226402970001; 5.5.5.202112011542 4 347002
1#0##0#0#0.0#2022-01-05
15:37:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
52a2a92e603d4b1d543d8c6b545463c4 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 03/01/1952 0 1
1 Z09.8;B90.8;J06.9 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 394511
0 1 0 0 0 NURYADI HADI SUMARTO.TN 090476 69 25564
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 347004
1#0##0#0#0.0#2022-01-05
15:38:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2014a17b9060e4bf120f84cde3221a10 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 15/06/1936 0 1
1 Z09.8;J44.9;K21.9;M54.59 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
461083 0 1 0 0 0 SUWITO DINOMO.TN 081116 85
0000569910791 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
347005 1#0##0#0#0.0#2022-01-05
15:39:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f59dcc84b8a93db188938635afbaecff 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 11/11/1946 0 2
0 0 - 0 - 0 - 0 - 0 181400 471629
0 1 0 0 0 THERESIA SUYATMI ,(NY) 041736 75 27443
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 347006
1#0##0#0#0.0#2022-01-05
15:41:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
90d0605e82a03e274d2169fe4fe08e97 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 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 399795
0 1 0 0 0 PAIDJEM, NY 071271 85 31411 DR. ANITA
yani;3302226402970001; 5.5.5.202112011542 4 347003
1#0##0#0#0.0#2022-01-05
15:38:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dfab3d084ec6be8bd88094f83728fa00 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 21/03/2014 0 2
- 0 - 0 - 0 - 0 182600 186634 0
1 0 0 0 SAUQIYA NAUFALYN G.AN 101126 7 2841 DR.
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 347008
1#0##0#0#0.0#2022-01-05
15:42:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 18/07/1980 0 2
0 0 - 0 - 0 - 0 - 0 181400 253722
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yani;3302226402970001; 5.5.5.202112011542 4 347009
1#0##0#0#0.0#2022-01-05
15:43:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 25/05/1948 0 1
0 0 - 0 - 0 - 0 - 0 181400 201780
0 1 0 0 0 SUDARMO HADIMULYO M, TN 066357 73 26882
novia;3313125201940001; 5.6.3.202201201500 4 347010
1#0##0#0#0.0#2022-03-08
08:39:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 30/12/2021 30/12/2021 19/08/1958 0 2
1 Z09.8;J44.9;B90.8 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SRI SUPRAPTI,(NY) 020558 63 23144 DR.
yani;3302226402970001; 5.5.5.202112011542 4 347011
1#0##0#0#0.0#2022-01-05
15:44:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8c8cd2b5450b4b926deb7fa2e564759e 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 09/05/1945 0 1
0 0 - 0 - 0 - 0 - 0 181400 343383
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3;JKN yani;3302226402970001; 5.5.5.202112011542 4 347013
1#0##0#0#0.0#2022-01-05
15:56:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5222002a878078c9f665b380c17bf97e 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 13/03/1953 0 1
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yani;3302226402970001; 5.5.5.202112011542 4 347014
1#0##0#0#0.0#2022-01-05
15:57:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
44a98c087852bc503cbe24750fda973b 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 18/06/1951 0 2
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agung;3313092303950002; 5.6.6.202203301209 4 347015
1#0##0#0#0.0#2022-04-14
11:44:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 30/12/2021 30/12/2021 15/10/1954 0 1
1 Z09.8;B90.8;I10 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 306800
0 1 0 0 0 SAHADI.TN 083402 67 24548 DR. ANITA
yani;3302226402970001; 5.5.5.202112011542 4 347016
1#0##0#0#0.0#2022-01-05
15:58:51#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
733da9b6318f997c428f2d1aca76c0af 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 07/02/1969 0 1
0 0 - 0 - 0 - 0 - 0 181400 310697
0 1 0 0 0 BONAWAN.TN 089880 52 19319 DR. ANITA
yani;3302226402970001; 5.5.5.202112011542 4 347018
1#0##0#0#0.0#2022-01-05
15:59:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 13/08/1951 0 2
1 I11.9;J18.9 87.49 - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 365000
0 1 0 0 0 SUNARNI.(NY) 030534 70 25707 DR.
yani;3302226402970001; 5.5.5.202112011542 4 347094
1#0##0#0#0.0#2022-01-05
16:00:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 14/04/1984 0 2
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0 0 - 0 - 0 - 0 - 0 181400 385697
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yani;3302226402970001; 5.5.5.202112011542 4 347019
1#0##0#0#0.0#2022-01-05
16:01:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 08/05/1959 0 1
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0 1 0 0 0 MUH IMBRAN, TN 058902 62 22882 DR.
yani;3302226402970001; 5.5.5.202112011542 4 347020
1#0##0#0#0.0#2022-01-05
16:01:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 31/08/2011 0 2
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0 - 0 - 0 - 0 - 0 181400 165000
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0001269378663 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
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16:02:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 28/10/1980 0 2
1 Z09.8;E05.9;I10;J40 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 455270
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yani;3302226402970001; 5.5.5.202112011542 4 347082
1#0##0#0#0.0#2022-01-05
16:03:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
531937fceaa45bd342561430c3135d7f 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 18/01/1963 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 347022
1#0##0#0#0.0#2022-01-05
16:03:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 16/04/1965 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
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yani;3302226402970001; 5.5.5.202112011542 4 347199
1#0##0#0#0.0#2022-01-05
16:04:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
df827288ce6bfb9061552886be444758 150000 0 0 0 0 0
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3372030 C 3 CP 2 30/12/2021 30/12/2021 10/07/1953 0 2
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yani;3302226402970001; 5.5.5.202112011542 4 347025
1#0##0#0#0.0#2022-01-05
16:04:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 30/12/2021 30/12/2021 26/11/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SUPADMI, NY 052895 62 22680 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 347026
1#0##0#0#0.0#2022-01-05
16:05:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c08504495014e592cc3b8f4659d9a31e 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 06/01/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 186950
0 1 0 0 0 RINA EKOWATI, NY 095845 52 19351 DR.
yani;3302226402970001; 5.5.5.202112011542 4 347027
1#0##0#0#0.0#2022-01-05
16:06:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d48275ff52ca7105a7dbd1a135c4be33 150000 0 0 0 0 0
0 0 0 0 15000 0 21950 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 10/09/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 223690
0 1 0 0 0 SARINAH.NY 085018 62 22757 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 347028
1#0##0#0#0.0#2022-01-05
16:06:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5b76137c70748730e7bf841726a6ee9d 150000 0 0 0 0 0
0 0 0 0 15000 0 58690 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 20/05/1945 0 2
1 Z09.8;I69.3;A18.2 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 242262
0 1 0 0 0 SITI NGAISAH 074431 76 27983 DR.
yani;3302226402970001; 5.5.5.202112011542 4 347029
1#0##0#0#0.0#2022-01-05
16:07:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f08df1c58d5de9f73ec7084eacdc449c 150000 0 0 0 0 0
0 0 0 0 15000 0 77262 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 09/05/1975 0 1
0 - 0 - 0 - 0 786200 478830 0 1
1124R0021221V005421 0001105378571 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346700 1#0##0#0#0.0#2022-01-05
16:07:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9869a410cd341afd544945028ae953af 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 12/07/1966 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 346697
1#0##0#0#0.0#2022-01-05
16:08:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
48d9aa308f09088ba1208e14bcbd9f56 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 12/12/1964 0 1
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V005423 0002861438286 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346688 1#0##0#0#0.0#2022-01-05
16:08:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fe670d8c396851807d154d50bacdbe95 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 22/10/1959 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V005424 0000086902986 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346683 1#0##0#0#0.0#2022-01-05
16:09:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
565ae2854d2c61db85d305f50d6654a5 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 28/02/1967 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V005425 0002203301349 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346682 1#0##0#0#0.0#2022-01-05
16:09:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
373dbc01f0823a09b5a97088e9980cdc 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 12/08/1977 0 1
0 - 0 - 0 - 0 786200 478830 0 1
yani;3302226402970001; 5.5.5.202112011542 4 346681
1#0##0#0#0.0#2022-01-05
16:10:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4fa8dbc7ce17c2f5e31741bc068541d1 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 03/08/1963 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V005427 0000088933318 3;JKN yani;3302226402970001;
5.5.5.202112011542 4 346680 1#0##0#0#0.0#2022-01-05
16:10:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c54cfdbd38f53e6622cbff26adc5a9a8 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 07/07/1963 0 2
- 0 - 0 - 0 - 0 182600 212485 0
1 0 0 0 WADIJYATUN.NY 101132 58 21361 DR. RINA
5.5.5.202112011542 4 347030 1#0##0#0#0.0#2022-01-05
16:11:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
598d338417f7b737a01c25b6547b39cd 150000 0 0 0 0 0
0 0 0 0 25000 0 37485 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 31/12/1947 0 1
0 0 - 0 - 0 - 0 - 0 181400 221650
0 1 0 0 0 HARJO SUMARTO.TN 100733 73 27028 DR.
yani;3302226402970001; 5.5.5.202112011542 4 347031
1#0##0#0#0.0#2022-01-05
16:12:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
891d5ffaf2dd093780035f4cfaa42584 150000 0 0 0 0 0
0 0 0 0 15000 0 56650 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 10/12/1952 0 1
0 0 - 0 - 0 - 0 - 0 181400 316718
0 1 0 0 0 SUPARMAN, TN 098419 69 25222 DR.
yani;3302226402970001; 5.5.5.202112011542 4 347033
1#0##0#0#0.0#2022-01-05
16:12:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
67293eb4ff30f72722c1bee912004ce9 150000 0 0 0 0 0
0 0 0 0 15000 0 151718 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 27/07/1973 0 1
0 0 - 0 - 0 - 0 - 0 181400 429147
0 1 0 0 0 ANDI AHMAD, TN 074066 48 17688 DR.
yani;3302226402970001; 5.5.5.202112011542 4 347076
1#0##0#0#0.0#2022-01-05
16:13:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2cbbdcf1d26527370d216d31642a6a04 150000 0 0 0 0 0
200000 0 0 0 15000 0 64147 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 13/04/1982 0 2
0 0 - 0 - 0 - 0 - 0 181400 488445
0 1 0 0 0 YUSRINA APRIYANTI,(NY) 017846 39 14506
3;JKN yani;3302226402970001; 5.5.5.202112011542 4 347034
1#0##0#0#0.0#2022-01-05
16:13:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b1515f5d8a99148dd4abb90898b7f1c7 150000 0 0 0 0 0
0 0 0 0 15000 0 323445 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 17/01/1981 0 2
1 T14.1;W54.0 96.59 - - None None None None Z-3-27-0 None
0 - 0 - 0 - 0 183900 244451 0 1
0 0 0 VITA OKTAVIANI, NY 001276 40 14957 dr. SUROSO
1124R0021221V005434 0001269731373 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346769 1#0##0#0#0.0#2022-01-04
15:09:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
149414dda6ace8dfd95d9f4e0899e972 205000 0 0 0 0 0
0 0 0 0 15000 0 24451 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 07/11/2001 0 2
0 0 - 0 - 0 - 0 - 0 181400 221217
0 1 0 0 0 CLAUDEA DIVA ISKANDAR, NN 030322 20
0001107836379 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
347035 1#0##0#0#0.0#2022-01-05
16:14:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b4bda15f2c37fcc88c88dedc6c0fc122 150000 0 0 0 0 0
0 0 0 0 15000 0 56217 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 26/09/1950 0 1
0 0 - 0 - 0 - 0 - 0 181400 196910
yani;3302226402970001; 5.5.5.202112011542 4 347036
1#0##0#0#0.0#2022-01-05
16:14:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d84995d741072e74449a655827ddc2b9 150000 0 0 0 0 0
0 0 0 0 15000 0 31910 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 10/06/1973 0 2
0 0 - 0 - 0 - 0 - 0 181400 196910
5.5.5.202112011542 4 347037 1#0##0#0#0.0#2022-01-05
16:15:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e9daedd95cf828dd98fb0b02fe7b098c 150000 0 0 0 0 0
0 0 0 0 15000 0 31910 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 01/11/1988 0 1
0 0 - 0 - 0 - 0 - 0 181400 221982
0 1 0 0 0 MUHAMAD EKO SUSILO, (BP) 033483 33
0001274999253 3;JKN yani;3302226402970001; 5.5.5.202112011542 4
347038 1#0##0#0#0.0#2022-01-05
16:16:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
aabe1b0d3434eb284e4f9476607e6ac8 150000 0 0 0 0 0
0 0 0 0 15000 0 56982 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 14/08/1968 0 2
1 L84 - - - None None None None Q-5-44-0 None None
0 - 0 - 0 - 0 - 0 181400 194990
0 1 0 0 0 SRI LESTARI 056183 53 19496 DR. RINA
5.5.5.202112011542 4 347039 1#0##0#0#0.0#2022-01-05
16:16:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
1a7f716700c42d52d5660fe507b248b3 150000 0 0 0 0 0
0 0 0 0 15000 0 29990 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 17/04/1946 0 1
0 0 - 0 - 0 - 0 - 0 181400 525668
yani;3302226402970001; 5.5.5.202112011542 4 347040
1#0##0#0#0.0#2022-01-05
16:17:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7e6d1b1bfe05531eaf462a838d395d7a 150000 0 0 0 0 0
0 0 0 0 15000 0 360668 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 15/03/1952 0 1
- 0 - 0 - 0 894800 1461480 0 1 0
0 0 SUPARDI SASTRO SUGITO.TN 101114 69 25492 DR. ARIA
yani;3302226402970001; 5.5.5.202112011542 4 347079
1#0##0#0#0.0#2022-01-05
16:17:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f701d590c9af65d6d9573a906873bcba 150000 0 0 0 0 0
1250000 0 0 0 15000 0 46480 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 28/10/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 246262
0 1 0 0 0 HANDRIATI DARMASTUTI.(NY) 032024 64
yani;3302226402970001; 5.5.5.202112011542 4 347041
1#0##0#0#0.0#2022-01-05
16:18:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8d900de2e07e6e07eb44580500664429 150000 0 0 0 0 0
0 0 0 0 15000 0 81262 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 31/12/1951 0 1
0 0 - 0 - 0 - 0 - 0 181400 211455
0 1 0 0 0 H DALIMAN, TN 100677 69 25567 DR.
novia;3313125201940001; 5.6.3.202201201500 4 347042
1#0##0#0#0.0#2022-03-08
08:19:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
caafb79cbcdd4a3295e7ed1a4707988e 150000 0 0 0 0 0
0 0 0 0 15000 0 46455 0 0 0 0 0
3372030 C 3 CP 2 30/12/2021 30/12/2021 28/08/1984 0 1
- 0 - 0 - 0 - 0 182600 248271 0
1 0 0 0 CUK IWAN, TN 057584 37 13638 DR. GRETHA
ADITYASTUTI 1124R0021221V005448 0001101972791 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 346770 1#0##0#0#0.0#2022-04-14
12:53:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 5
43ead3ae1a2f496e1e8dd8ec1fc66c22 130000 0 0 0 0 0
0 44300 0 0 15000 0 58971 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 20/08/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 260921
0 1 0 0 0 AINUN DJARIYAH, NY 069314 66 24240
reni;3313147010930001; 5.5.5.202112011542 4 346883
1#0##0#0#0.0#2022-01-04
16:22:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
238fa9235c869d7e670bd8734f908d88 150000 0 0 0 0 0
0 0 0 0 15000 0 95921 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 17/02/2006 0 1
1 Z09.4;S52.50 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 252799 0
1 0 0 0 FAUZAN MUHAMMAD ANNIZAR.AN 100619 15 5796
reni;3313147010930001; 5.5.5.202112011542 4 346885
1#0##0#0#0.0#2022-01-04
16:24:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
35f043e4fa6ac4f93b6ea98abe2b1cc5 176000 0 0 0 0 0
0 0 0 0 15000 0 61799 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 07/08/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 214932
reni;3313147010930001; 5.5.5.202112011542 4 346887
1#0##0#0#0.0#2022-01-04
16:25:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5f4495e6635eebf19fc925554c968ce6 150000 0 0 0 0 0
0 0 0 0 15000 0 49932 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 17/03/1962 0 2
0 0 - 0 - 0 - 0 - 0 181400 246440
0 1 0 0 0 MUHARSIH (NY) 021793 59 21839 DR.
reni;3313147010930001; 5.5.5.202112011542 4 346974
1#0##0#0#0.0#2022-01-04
16:26:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0ed47a5dc0a3d4b1a50814ffc27f3564 150000 0 0 0 0 0
0 0 0 0 15000 0 81440 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 14/09/1959 0 1
0 0 - 0 - 0 - 0 - 0 181400 309180
0 1 0 0 0 MARINO ., BP 055616 62 22754 DR.
reni;3313147010930001; 5.5.5.202112011542 4 346888
1#0##0#0#0.0#2022-01-04
16:26:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e59396acc97a12adcfae251291791865 150000 0 0 0 0 0
0 0 0 0 15000 0 144180 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 07/09/1986 0 2
1 Z09.8;E11.4;G59.0;I10;G44.0 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
325682 0 1 0 0 0 ANIS DWI HASTUTI,(NY) 028206
0000640270326 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
346890 1#0##0#0#0.0#2022-01-04
16:32:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
42aec14bbb37f84a75ff0c782d2f3b69 150000 0 0 0 0 0
0 0 0 0 15000 0 160682 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 12/07/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 228436
0 1 0 0 0 SLAMET SANTOSO, BP 082095 55 20261
reni;3313147010930001; 5.5.5.202112011542 4 346904
1#0##0#0#0.0#2022-01-04
16:33:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
17fcfc8dd2c56bb59d3ffe842315dabc 150000 0 0 0 0 0
0 0 0 0 15000 0 63436 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 19/10/1951 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SETYANING
1124R0021221V005458 0001434593226 3;JKN agung;3313092303950002;
5.6.6.202203301209 4 346908 1#0##0#0#0.0#2022-04-14
13:00:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
3e456c431b6b50e4ca3c18063ab7bd5b 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 14/09/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 227112
reni;3313147010930001; 5.5.5.202112011542 4 346909
1#0##0#0#0.0#2022-01-04
16:35:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
2a1fbcffb637498a0c907291dfe1588f 150000 0 0 0 0 0
0 0 0 0 15000 0 62112 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 12/09/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 397014
0 1 0 0 0 SUNARYATI, NY 058012 79 28965 DR.
reni;3313147010930001; 5.5.5.202112011542 4 346910
1#0##0#0#0.0#2022-01-04
16:35:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7e0e600431e019625423e93aa9bba509 203000 0 0 0 0 0
0 0 0 0 15000 0 179014 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 21/08/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 225000
0 1 0 0 0 SRI MUNAWARTI, (NY) 002036 64 23508
reni;3313147010930001; 5.5.5.202112011542 4 346912
1#0##0#0#0.0#2022-01-04
16:41:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
796fde2e011f60e5a13916ec3917678c 150000 0 0 0 0 0
0 0 0 0 15000 0 60000 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 26/05/1960 0 1
0 0 - 0 - 0 - 0 - 0 181400 404202
0 1 0 0 0 JUMADI ABDUL WAHAD.TN 094212 61 22499
reni;3313147010930001; 5.5.5.202112011542 4 346914
1#0##0#0#0.0#2022-01-04
16:42:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a6f6d05a1274b67e3527729b61b6a9a6 150000 0 0 0 0 0
0 0 0 0 15000 0 239202 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 24/06/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 476850
0 1 0 0 0 SITI ARBAIYAH, NY 073903 68 25027 DR.
reni;3313147010930001; 5.5.5.202112011542 4 346915
1#0##0#0#0.0#2022-01-04
16:42:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
d1066768881c2edb94d13cdeca306ccd 150000 0 0 0 0 0
0 0 0 0 15000 0 311850 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 07/07/1957 0 2
0 0 - 0 - 0 - 0 - 0 181400 442710
novia;3313125201940001; 5.5.5.202112011542 4 347399
1#0##0#0#0.0#2022-01-05
18:52:24#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#2022-01-04
16:44:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.5.5.202112011542 4 347420
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14:50:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 25/04/2008 0 2
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reni;3313147010930001; 5.5.5.202112011542 4 346919
1#0##0#0#0.0#2022-01-04
16:45:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 11/04/1971 0 1
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reni;3313147010930001; 5.5.5.202112011542 4 347421
1#0##0#0#0.0#2022-01-05
14:51:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.5.5.202112011542 4 346920
1#0##0#0#0.0#2022-01-04
16:45:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.5.5.202112011542 4 346922
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16:51:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.5.5.202112011542 4 346927
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16:54:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.5.5.202112011542 4 346924
1#0##0#0#0.0#2022-01-04
16:53:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.5.5.202112011542 4 346929
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16:54:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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16:55:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 05/05/1957 0 2
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16:56:17#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 09/11/1965 0 2
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13:47:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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reni;3313147010930001; 5.5.5.202112011542 4 346937
1#0##0#0#0.0#2022-01-04
16:57:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 24/07/1954 0 1
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reni;3313147010930001; 5.5.5.202112011542 4 347423
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14:52:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 25/03/1955 0 2
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reni;3313147010930001; 5.5.5.202112011542 4 346943
1#0##0#0#0.0#2022-01-04
16:58:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 05/08/1961 0 2
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reni;3313147010930001; 5.5.5.202112011542 4 346939
1#0##0#0#0.0#2022-01-04
16:58:07#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#2022-01-04
17:03:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 01/12/1952 0 2
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1#0##0#0#0.0#2022-01-04
17:05:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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novia;3313125201940001; 5.6.3.202201201500 4 346949
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08:33:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 31/12/2021 31/12/2021 23/03/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 220002
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reni;3313147010930001; 5.5.5.202112011542 4 346951
1#0##0#0#0.0#2022-01-04
17:20:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 12/04/1968 0 2
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181400 461581 0 1 0 0 0 SITI ASKHURIYAH, NY
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346953 1#0##0#0#0.0#2022-01-04
17:20:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 20/06/1957 0 2
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reni;3313147010930001; 5.5.5.202112011542 4 346955
1#0##0#0#0.0#2022-01-04
17:21:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 06/06/1955 0 2
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3;JKN reni;3313147010930001; 5.5.5.202112011542 4 346959
1#0##0#0#0.0#2022-01-04
17:29:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.5.5.202112011542 4 346961
1#0##0#0#0.0#2022-01-04
17:30:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 23/04/1963 0 2
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reni;3313147010930001; 5.5.5.202112011542 4 346962
1#0##0#0#0.0#2022-01-04
17:30:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.5.5.202112011542 4 346965
1#0##0#0#0.0#2022-01-04
17:31:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.5.5.202112011542 4 346966
1#0##0#0#0.0#2022-01-04
17:31:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3;JKN reni;3313147010930001; 5.5.5.202112011542 4 346968
1#0##0#0#0.0#2022-01-04
17:32:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 07/12/1967 0 2
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346969 1#0##0#0#0.0#2022-01-04
17:32:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 29/05/1950 0 1
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reni;3313147010930001; 5.5.5.202112011542 4 346971
1#0##0#0#0.0#2022-01-04
17:33:23#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.5.5.202112011542 4 346972
1#0##0#0#0.0#2022-01-04
17:34:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.5.5.202112011542 4 346973
1#0##0#0#0.0#2022-01-04
17:34:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 21/04/1965 0 2
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reni;3313147010930001; 5.5.5.202112011542 4 347064
1#0##0#0#0.0#2022-01-04
17:49:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 31/12/1959 0 2
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reni;3313147010930001; 5.5.5.202112011542 4 347065
1#0##0#0#0.0#2022-01-04
17:50:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 06/04/1966 0 1
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reni;3313147010930001; 5.5.5.202112011542 4 347066
1#0##0#0#0.0#2022-01-04
17:50:45#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 19/03/1960 0 2
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1#0##0#0#0.0#2022-01-05
14:52:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 20/07/1957 0 2
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3;JKN reni;3313147010930001; 5.5.5.202112011542 4 347067
1#0##0#0#0.0#2022-01-04
17:51:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3;JKN reni;3313147010930001; 5.5.5.202112011542 4 347068
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17:52:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 03/03/1953 0 2
0 0 - 0 - 0 - 0 - 0 181400 225635
0 1 0 0 0 JAMIATUL KIROM., NY 050640 68 25140
reni;3313147010930001; 5.5.5.202112011542 4 347069
1#0##0#0#0.0#2022-01-04
17:52:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c28ef3e244400e2bcf7e12c41a4f6165 150000 0 0 0 0 0
0 0 0 0 15000 0 60635 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 19/04/1956 0 1
0 0 - 0 - 0 - 0 - 0 181400 247243
0 1 0 0 0 ERIE ARISTOT MULAT.TN 097789 65 23997
reni;3313147010930001; 5.5.5.202112011542 4 347070
1#0##0#0#0.0#2022-01-04
17:53:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
61ac04314246bf5613514148df426a94 150000 0 0 0 0 0
0 0 0 0 15000 0 82243 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 06/06/1967 0 1
1 H00.0;E11.3;H36.0;H04.1 95.01 - - 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 263908
0 1 0 0 0 MUHAMMAD THOHIR, TN 100987 54 19932
reni;3313147010930001; 5.5.5.202112011542 4 347071
1#0##0#0#0.0#2022-01-04
17:54:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
43d020445670f586ceddcf3dd152bdfc 203000 0 0 0 0 0
0 0 0 0 15000 0 45908 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 23/03/1959 0 2
1 Z09.8;I10;K21.9;H81.3 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 222836
agung;3313092303950002; 5.6.6.202203301209 4 347073
1#0##0#0#0.0#2022-04-14
13:57:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
7ec8ee74bfca55288f87ab96275e0eb4 150000 0 0 0 0 0
0 0 0 0 15000 0 57836 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 12/01/1958 0 2
0 0 - 0 - 0 - 0 - 0 181400 224472
0 1 0 0 0 WAKIRAH 054586 63 23364 DR. WAHYU
reni;3313147010930001; 5.5.5.202112011542 4 347088
1#0##0#0#0.0#2022-01-04
17:57:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b785d8b69016a0ff1b7e2c3300556053 150000 0 0 0 0 0
0 0 0 0 15000 0 59472 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 31/12/1939 0 2
1 Z09.8;N18.9;M19.98 - - - None None None None Q-5-
0 0 - 0 - 0 - 0 - 0 181400 211977
0 1 0 0 0 SAIDAH, NY 088097 82 29951 DR. TEKY
reni;3313147010930001; 5.5.5.202112011542 4 347090
1#0##0#0#0.0#2022-01-04
17:58:15#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
102b9b85fc90f4d7ee356fe849a10559 150000 0 0 0 0 0
0 0 0 0 15000 0 46977 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 14/03/1965 0 1
1 Z09.8;E11.9;A16.2 - - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 291780
0 1 0 0 0 M ZAINAL ARIFIN, TN 097952 56 20746
reni;3313147010930001; 5.5.5.202112011542 4 347092
1#0##0#0#0.0#2022-01-04
17:58:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a4d17cf5545f0e0f03c59ca1897d5c1f 150000 0 0 0 0 0
0 0 0 0 15000 0 126780 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 02/09/1962 0 1
1 I10;R10.4;N28.1 88.76 - - None None None None Z-3-23-0
0 0 - 0 - 0 - 0 - 0 549400 866707
0 1 0 0 0 DARMANTO, TN 009893 59 21670 DR.
agung;3313092303950002; 5.6.3.202201201500 4 348919
1#0##0#0#0.0#2022-02-21
09:50:56#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
20f07dce4095b3678090d601795c41c9 150000 0 0 0 0 0
657000 0 0 0 15000 0 44707 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 28/02/1978 0 2
0 0 - 0 - 0 - 0 - 0 181400 445451
0 1 0 0 0 SRIWANTI, NY 097525 43 16012 DR.
reni;3313147010930001; 5.5.5.202112011542 4 347095
1#0##0#0#0.0#2022-01-04
18:00:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8e4a72974fe737a9e18edc2f1df51f46 150000 0 0 0 0 0
0 0 0 0 15000 0 280451 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 13/03/1963 0 2
0 0 - 0 - 0 - 0 - 0 181400 203301
0 1 0 0 0 SRI LESTARI.NY 093144 58 21478 DR.
reni;3313147010930001; 5.5.5.202112011542 4 347096
1#0##0#0#0.0#2022-01-04
18:00:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4d4cc8557edb6d3c5978047e162880da 150000 0 0 0 0 0
0 0 0 0 15000 0 38301 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 13/04/1952 0 1
1 Z09.8;K30;K21.9;I10;J44.9 - - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
278286 0 1 0 0 0 SUKIMAN PRIYOSUKARTO, TN 070987
0000639542125 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
347097 1#0##0#0#0.0#2022-01-04
18:01:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6486089c003b6c9428cc63367bc5aed9 150000 0 0 0 0 0
0 0 0 0 15000 0 113286 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 24/09/1969 0 2
0 0 - 0 - 0 - 0 - 0 181400 165000
0 1 0 0 0 SOFIAH MARDIANTI.NY 098524 52 19091
reni;3313147010930001; 5.5.5.202112011542 4 347099
1#0##0#0#0.0#2022-01-04
18:02:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5a852fe9ce3ca7b6ed339f8b4e21a371 150000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 09/05/1949 0 1
0 0 - 0 - 0 - 0 - 0 181400 205554
reni;3313147010930001; 5.5.5.202112011542 4 347101
1#0##0#0#0.0#2022-01-04
18:03:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6cdc81a610faa72445fca696b9174c3d 150000 0 0 0 0 0
0 0 0 0 15000 0 40554 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 31/12/1949 0 2
0 0 - 0 - 0 - 0 - 0 181400 204060
0 1 0 0 0 MARYAMAH.NY 098235 72 26298 DR. TEKY
reni;3313147010930001; 5.5.5.202112011542 4 347112
1#0##0#0#0.0#2022-01-04
18:32:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
693b89a994c3b99c2559972676c5e7cf 150000 0 0 0 0 0
0 0 0 0 15000 0 39060 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 23/08/1947 0 2
0 0 - 0 - 0 - 0 - 0 181400 211600
0 1 0 0 0 HJ.RAHAYU SUTINI,(NY) 021403 74 27159
reni;3313147010930001; 5.5.5.202112011542 4 347113
1#0##0#0#0.0#2022-01-04
18:33:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9849d0e67930d412b6cc0ff81087ae37 150000 0 0 0 0 0
0 0 0 0 15000 0 46600 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 07/01/1942 0 1
0 0 - 0 - 0 - 0 - 0 181400 239770
0 1 0 0 0 SARIDJO ISWANTO (BP) 025604 79 29213
reni;3313147010930001; 5.5.5.202112011542 4 347114
1#0##0#0#0.0#2022-01-04
18:33:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
da01653ef7ecf1c55b6185dcfef0fe18 150000 0 0 0 0 0
0 0 0 0 15000 0 74770 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 26/03/1994 0 2
0 0 - 0 - 0 - 0 - 0 296400 193960
0 1 0 0 0 DESIANA MARTHA ., NY 053929 27 10142
novia;3313125201940001; 5.6.3.202201201500 4 347115
1#0##0#0#0.0#2022-03-08
12:12:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
d13bf162b7667322a79c38843c7514b5 150000 0 0 0 0 0
0 0 0 0 15000 0 28960 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 31/12/1948 0 2
0 0 - 0 - 0 - 0 - 0 181400 221192
0 1 0 0 0 HJ. SITI FATIMAH, NY 093510 72 26663
reni;3313147010930001; 5.5.5.202112011542 4 347116
1#0##0#0#0.0#2022-01-04
18:35:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
fa2221293d16c6b932aee80fbae26abc 150000 0 0 0 0 0
0 0 0 0 15000 0 56192 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 04/06/1952 0 1
0 - 0 107400 273000 0 1 0 0 0
1124R0021221V005527 0001614176932 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 347117 1#0##0#0#0.0#2022-01-04
18:36:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4150c766f23a72f924897739c76fe0cb 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 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 reni;3313147010930001; 5.5.5.202112011542 4
347118 1#0##0#0#0.0#2022-01-04
18:36:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
72105a3d04809b5342356c03f304381f 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 03/02/1955 0 2
0 0 - 0 - 0 - 0 - 0 181400 207062
0 1 0 0 0 SUMARSIH,NY 085983 66 24438 DR. WAHYU
reni;3313147010930001; 5.5.5.202112011542 4 347119
1#0##0#0#0.0#2022-01-04
18:37:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4f6bea93a9b2e99a1801de70140013ba 150000 0 0 0 0 0
0 0 0 0 15000 0 42062 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 18/08/1960 0 2
0 0 - 0 - 0 - 0 - 0 181400 235000
0 1 0 0 0 SRI REDJEKI.NY 083335 61 22415 DR.
reni;3313147010930001; 5.5.5.202112011542 4 347120
1#0##0#0#0.0#2022-01-04
18:37:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
6581668e02ecbd4703072456ea636c46 220000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 13/11/2015 0 2
1 Z09.0;S05.3 95.01;96.59 - - None None None None Z-3-27-0
- 0 - 0 - 0 - 0 183900 227053 0
1 0 0 0 ALDA HERA ANGGRAENI, AN 100866 6 2240 DR.
reni;3313147010930001; 5.5.5.202112011542 4 347124
1#0##0#0#0.0#2022-01-04
18:45:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eefae36e3760639d5f8222c8127c389f 203000 0 0 0 0 0
0 0 0 0 15000 0 9053 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 18/02/1942 0 2
0 0 - 0 - 0 - 0 - 0 181400 461422
0 1 0 0 0 DARTINAH,NY 030952 79 29171 DR. WAHYU
reni;3313147010930001; 5.5.5.202112011542 4 347425
1#0##0#0#0.0#2022-01-05
14:53:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
74ec4aa457c7b3d839aaee64b5d5d23c 150000 0 0 0 0 0
233000 0 0 0 15000 0 63422 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 18/06/1953 0 2
1 Z09.8;M16.9;M75.0 93.39;93.35 - - None None None None M-3-
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 WIDIJARNI, NY
0000091364973 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
347125 1#0##0#0#0.0#2022-01-04
18:46:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8307386fc51e9aef4304ae3e0191dba5 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 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 reni;3313147010930001; 5.5.5.202112011542 4
347126 1#0##0#0#0.0#2022-01-04
18:47:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
27043fc9e2049f310c0511335d8ba1f6 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 21/09/1944 0 1
0 0 - 0 - 0 - 0 - 0 181400 224175
0002261390455 3;JKN agung;3313092303950002; 5.6.6.202203301209 4
347127 1#0##0#0#0.0#2022-04-14
12:56:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
289702ed6dd06c55cb0fdab28b381904 150000 0 0 0 0 0
0 0 0 0 15000 0 59175 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 07/05/1950 0 2
0 0 - 0 - 0 - 0 - 0 181400 436912
0 1 0 0 0 SUYAMTI, NY 071234 71 26171 DR. ARIA
reni;3313147010930001; 5.5.5.202112011542 4 347426
1#0##0#0#0.0#2022-01-05
14:54:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
0c5f9d81039fcce3274743e014ffdb5d 150000 0 0 0 0 0
220000 0 0 0 15000 0 51912 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 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 reni;3313147010930001; 5.5.5.202112011542 4
347129 1#0##0#0#0.0#2022-01-04
18:48:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
66c0210f0099ce6cd8d081136687af5b 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 22/08/1947 0 2
0 - 0 107400 262000 0 1 0 0 0 DYAH
1124R0021221V005541 0000091082722 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 347131 1#0##0#0#0.0#2022-01-04
18:49:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
a30b40908256b9cfacab8d43741ef3fb 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 02/08/1952 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SITI MAJIAH, NY
0000639393467 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
347133 1#0##0#0#0.0#2022-01-04
18:52:30#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
845f9442833cf4cdb89c1b3ba183bf5b 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 14/08/1958 0 1
0 0 - 0 - 0 - 0 - 0 181400 250975
0 1 0 0 0 SUTIKNO,(BP) 027246 63 23150 DR.
reni;3313147010930001; 5.5.5.202112011542 4 347135
1#0##0#0#0.0#2022-01-04
18:53:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
f7a7ea548738e759ba0f860a3137547c 203000 0 0 0 0 0
0 0 0 0 15000 0 32975 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 17/09/1955 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 DAKA AHMAD
1124R0021221V005544 0002253763754 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 347136 1#0##0#0#0.0#2022-01-04
18:53:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e59c55d4f0c53fe8f06b7c62228db9f8 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 04/06/1968 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 262000 0 1 0 0 0 SUMINI.NY 099596
0002253764441 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
347139 1#0##0#0#0.0#2022-01-04
18:54:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
38cc7591b81515476907a475abdcf0ed 247000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 24/08/1975 0 2
2 Z09.8;H27.1;Z96.1 95.01 - - None None None None Q-5-44-0
0 0 - 0 - 0 - 0 - 0 181400 249820
0 1 0 0 0 UMIYATI, NY 098329 46 16931 DR. YUDHI
reni;3313147010930001; 5.5.5.202112011542 4 347141
1#0##0#0#0.0#2022-01-05
08:05:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b4e26554070ce0b0a1a30e730a976b4b 203000 0 0 0 0 0
0 0 0 0 15000 0 31820 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 21/11/1960 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SRI UTAMI, NY
0001084459858 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
347143 1#0##0#0#0.0#2022-01-05
08:06:57#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c8b53d88223c6a5d86ae71808290f671 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 01/07/1955 0 2
1 Z09.8;Z96.1;H26.9;H11.0;H04.1 95.01 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
406991 0 1 0 0 0 SUGENG, NY 100575 66 24290
reni;3313147010930001; 5.5.5.202112011542 4 347145
1#0##0#0#0.0#2022-01-05
08:07:40#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
bfb38f0b2161ea7de4b5f3859a508ddc 203000 0 0 0 0 0
0 0 0 0 15000 0 188991 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 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 reni;3313147010930001; 5.5.5.202112011542 4
347146 1#0##0#0#0.0#2022-01-05
08:08:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
7fdc172a8d13a21a5258e06912b2fd96 258000 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 10/08/1944 0 1
0 - 0 - 0 - 0 183900 190980 0 1
0 0 0 AMIN SUSENO, TN 044922 77 28267 DR. DAMAR ARYO,
SP.B 1124R0021221V005550 0000091165746 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 347148 1#0##0#0#0.0#2022-01-05
08:09:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
8ad05af26af0ce2ee3a4b565d48ddb94 150000 0 0 0 0 0
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3372030 C 3 CP 2 31/12/2021 31/12/2021 15/10/1982 0 1
0 - 0 - 0 - 0 283800 315000 0 1
0 0 0 WOKO BUDIYONO,(BP) 023652 39 14322 DRG.
reni;3313147010930001; 5.5.5.202112011542 4 347171
1#0##0#0#0.0#2022-01-05
08:14:54#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 02/06/1963 0 2
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SP.KG 1124R0021221V005552 0001102660863 3;JKN reni;3313147010930001;
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08:15:27#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 05/07/1946 0 1
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LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
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08:16:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 18/09/1963 0 2
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reni;3313147010930001; 5.5.5.202112011542 4 347174
1#0##0#0#0.0#2022-01-05
08:16:34#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 01/11/1961 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 KUSTIATI, NY
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08:17:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 03/01/2001 0 1
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reni;3313147010930001; 5.5.5.202112011542 4 347427
1#0##0#0#0.0#2022-01-05
14:55:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 01/08/1938 0 1
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reni;3313147010930001; 5.5.5.202112011542 4 347176
1#0##0#0#0.0#2022-01-05
08:21:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 25/09/2016 0 2
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08:22:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 12/04/1957 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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0001302703266 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
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08:37:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 30/11/1956 0 2
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08:38:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 11/03/1961 0 2
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reni;3313147010930001; 5.5.5.202112011542 4 347180
1#0##0#0#0.0#2022-01-05
08:39:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 26/03/1968 0 2
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reni;3313147010930001; 5.5.5.202112011542 4 347181
1#0##0#0#0.0#2022-01-05
08:40:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 31/08/1998 0 2
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reni;3313147010930001; 5.5.5.202112011542 4 347182
1#0##0#0#0.0#2022-01-05
08:41:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 27/03/2001 0 2
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3;JKN reni;3313147010930001; 5.5.5.202112011542 4 347183
1#0##0#0#0.0#2022-01-05
08:41:56#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 13/12/1966 0 2
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1124R0021221V005566 0002051493849 3;JKN reni;3313147010930001;
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08:42:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 07/12/1946 0 1
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SP.PD 1124R0021221V005568 0000572379772 3;JKN reni;3313147010930001;
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08:46:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 08/03/1967 0 1
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SP.PD 1124R0021221V005569 0001879909187 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 347186 1#0##0#0#0.0#2022-01-05
08:46:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5903efc1d2af3cefd81f055d7ddba5ac 463830 0 0 0 0 0
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3372030 C 3 CP 2 31/12/2021 31/12/2021 13/06/1971 0 2
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agung;3313092303950002; 5.6.6.202203301209 4 347187
1#0##0#0#0.0#2022-04-14
13:15:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 31/12/2021 31/12/2021 01/12/1980 0 2
0 - 0 - 0 - 0 786200 478830 0 1
1124R0021221V005571 0000640230884 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 347236 1#0##0#0#0.0#2022-01-05
08:56:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
52d775e1785530a7b8ed6e833bc88104 463830 0 0 0 0 0
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3372030 C 3 CP 2 31/12/2021 31/12/2021 02/02/1971 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V005572 0002326843899 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 347237 1#0##0#0#0.0#2022-01-05
09:15:25#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dc318fa99af0062574c4c79a313c1d3c 463830 0 0 0 0 0
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3372030 C 3 CP 2 31/12/2021 31/12/2021 09/06/1954 0 1
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0 0 0 DJUMADI, TN 100668 67 24677 DR. DAMAR ARYO, SP.B
1124R0021221V005573 0000976920039 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 347400 1#0##0#0#0.0#2022-01-05
18:53:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 26/04/1964 0 1
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SP.PD 1124R0021221V005574 0002231597002 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 347238 1#0##0#0#0.0#2022-01-05
09:17:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 04/05/1955 0 1
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0 1 0 0 0 WINARTO., BP 052445 66 24348 DR.
reni;3313147010930001; 5.5.5.202112011542 4 347239
1#0##0#0#0.0#2022-01-05
09:39:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 20/08/1959 0 1
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1124R0021221V005576 0000571256594 3;JKN reni;3313147010930001;
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09:39:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 25/05/1972 0 1
0 - 0 - 0 - 0 786200 478830 0 1
1124R0021221V005577 0002431552465 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 347241 1#0##0#0#0.0#2022-01-05
09:40:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c9ac69289bb6eb276abf19daf6b07868 463830 0 0 0 0 0
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3372030 C 3 CP 2 31/12/2021 31/12/2021 14/06/1959 0 2
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3;JKN reni;3313147010930001; 5.5.5.202112011542 4 347245
1#0##0#0#0.0#2022-01-05
09:41:04#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 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 reni;3313147010930001; 5.5.5.202112011542 4
347246 1#0##0#0#0.0#2022-01-05
09:41:33#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 01/12/1958 0 2
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1124R0021221V005580 0001436949538 3;JKN reni;3313147010930001;
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09:41:59#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
473e5cbd744c8aa806a02c0397061d30 463830 0 0 0 0 0
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3372030 C 3 CP 2 31/12/2021 31/12/2021 24/01/1945 0 2
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reni;3313147010930001; 5.5.5.202112011542 4 347248
1#0##0#0#0.0#2022-01-05
09:42:35#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 01/04/1981 0 1
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1124R0021221V005582 0001904830593 3;JKN reni;3313147010930001;
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3372030 C 3 CP 2 31/12/2021 31/12/2021 10/11/1970 0 1
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reni;3313147010930001; 5.5.5.202112011542 4 347250
1#0##0#0#0.0#2022-01-05
09:43:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 17/04/1961 0 2
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SP.PD 1124R0021221V005585 0001962721888 3;JKN reni;3313147010930001;
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09:44:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 12/06/1972 0 1
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SP.PD 1124R0021221V005586 0001844624709 3;JKN reni;3313147010930001;
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09:44:37#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 24/12/1960 0 2
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reni;3313147010930001; 5.5.5.202112011542 4 347253
1#0##0#0#0.0#2022-01-05
09:53:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 08/06/1950 0 2
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09:54:26#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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11:43:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 31/12/2021 31/12/2021 02/06/1958 0 1
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1#0##0#0#0.0#2022-01-05
09:56:21#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
35400a1ae393d5969427ad4eb6399704 150000 0 0 0 0 0
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3372030 C 3 CP 2 31/12/2021 31/12/2021 08/10/1942 0 2
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1#0##0#0#0.0#2022-01-05
09:57:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.5.5.202112011542 4 347258
1#0##0#0#0.0#2022-01-05
09:58:14#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 09/04/2003 0 2
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1#0##0#0#0.0#2022-01-05
09:59:06#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 18/12/1965 0 2
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1#0##0#0#0.0#2022-01-05
09:59:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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10:02:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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14:56:07#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 15/04/1973 0 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 29/03/1968 0 2
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10:54:32#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 13/10/1962 0 2
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10:58:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 01/03/1960 0 1
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3;JKN reni;3313147010930001; 5.5.5.202112011542 4 347289
1#0##0#0#0.0#2022-01-05
10:59:01#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 16/02/1959 0 1
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13:38:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 4
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3372030 C 3 CP 2 31/12/2021 31/12/2021 01/01/2000 0 1
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11:00:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 21/04/1950 0 1
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reni;3313147010930001; 5.5.5.202112011542 4 347291
1#0##0#0#0.0#2022-01-05
11:10:00#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 29/04/1968 0 2
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11:10:53#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 05/03/1973 0 2
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3372030 C 3 CP 2 31/12/2021 31/12/2021 10/04/1943 0 2
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3372030 C 3 CP 2 31/12/2021 31/12/2021 04/09/1973 0 2
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11:15:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 09/11/1971 0 2
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1 0 0 0 SUHASTI,(NY) 038243 50 18315 DRG.
reni;3313147010930001; 5.5.5.202112011542 4 347296
1#0##0#0#0.0#2022-01-05
11:16:20#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
4d504652fefa65271431eaa1fbb34556 300000 0 0 0 0 0
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3372030 C 3 CP 2 31/12/2021 31/12/2021 05/08/1988 0 2
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reni;3313147010930001; 5.5.5.202112011542 4 347297
1#0##0#0#0.0#2022-01-05
11:17:38#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 31/12/1941 0 2
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3;JKN reni;3313147010930001; 5.5.5.202112011542 4 347298
1#0##0#0#0.0#2022-01-05
11:18:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 05/05/1955 0 1
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5.5.5.202112011542 4 347299 1#0##0#0#0.0#2022-01-05
11:25:03#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 10/12/1982 0 1
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1#0##0#0#0.0#2022-01-05
11:25:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 13/12/1965 0 2
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347430 1#0##0#0#0.0#2022-01-05
14:57:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b05cf319324a48be7223f07b7db32872 150000 0 0 0 0 0
248000 0 0 0 15000 0 56217 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 13/04/1958 0 2
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3;JKN reni;3313147010930001; 5.5.5.202112011542 4 347301
1#0##0#0#0.0#2022-01-05
11:26:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 17/12/1955 0 2
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1#0##0#0#0.0#2022-01-05
11:26:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 04/08/1968 0 2
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1#0##0#0#0.0#2022-01-05
11:44:29#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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1124R0021221V005622 0001104198974 3;JKN reni;3313147010930001;
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reni;3313147010930001; 5.5.5.202112011542 4 347317
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11:45:52#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 19/01/1999 0 2
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1 0 0 0 NATASHA RISQA SAFITRI 100331 22 8382 DRG.
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11:46:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 06/12/1965 0 1
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1 0 0 0 MUHAMMAD BAGIR.TN 101127 56 20479 DRG.
reni;3313147010930001; 5.5.5.202112011542 4 347319
1#0##0#0#0.0#2022-01-05
11:46:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 13/06/1992 0 2
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11:47:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 27/06/1959 0 2
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11:48:18#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 22/12/1994 0 2
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reni;3313147010930001; 5.5.5.202112011542 4 347323
1#0##0#0#0.0#2022-01-05
11:48:58#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 18/04/1968 0 1
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
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348916 1#0##0#0#0.0#2022-02-21
09:51:22#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 31/12/2021 31/12/2021 01/05/1975 0 1
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11:49:31#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 26/12/1963 0 2
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1#0##0#0#0.0#2022-01-05
11:49:58#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#2022-01-05
11:51:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 29/04/1964 0 1
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1#0##0#0#0.0#2022-01-05
14:57:46#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 03/05/1965 0 1
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11:52:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 05/03/1979 0 2
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3372030 C 3 CP 2 31/12/2021 31/12/2021 02/09/1980 0 2
MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 213800 0 1 0 0 0 FITRIYANA
1124R0021221V005645 0001107034119 3;JKN reni;3313147010930001;
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MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0 107400 273000 0 1 0 0 0 SOEKROJONO, TN
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reni;3313147010930001; 5.5.5.202112011542 4 347332
1#0##0#0#0.0#2022-01-05
11:54:56#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#2022-01-05
11:55:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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11:55:49#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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347335 1#0##0#0#0.0#2022-01-05
11:56:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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- 0 - 0 - 0 - 0 283800 315000 0
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reni;3313147010930001; 5.5.5.202112011542 4 347363
1#0##0#0#0.0#2022-01-05
13:34:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0003083782544 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
347364 1#0##0#0#0.0#2022-01-05
13:39:02#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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347365 1#0##0#0#0.0#2022-01-05
13:39:44#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.5.5.202112011542 4 346349
1#0##0#0#0.0#2022-01-05
13:40:24#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 - 0 - 0 - 0 283800 315000 0 1
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reni;3313147010930001; 5.5.5.202112011542 4 347367
1#0##0#0#0.0#2022-01-05
13:41:12#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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0 - 0 - 0 - 0 283800 316860 0 1
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reni;3313147010930001; 5.5.5.202112011542 4 347369
1#0##0#0#0.0#2022-01-05
13:41:42#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 09/07/1969 0 1
1 Z09.8;R42 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 154130
0 1 0 0 0 DEDY FIRMAWAN,(BP) 004843 52 19168
novia;3313125201940001; 5.6.3.202201201500 4 347432
1#0##0#0#0.0#2022-02-15
14:25:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 31/12/2021 31/12/2021 12/01/2004 0 2
0 - 0 - 0 - 0 183900 280004 0 1
0 0 0 NANDA FADILLA ZULFAH, AN 100840 17 6563 DR.
reni;3313147010930001; 5.5.5.202112011542 4 347371
1#0##0#0#0.0#2022-01-05
13:42:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 28/12/2003 0 1
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reni;3313147010930001; 5.5.5.202112011542 4 347373
1#0##0#0#0.0#2022-01-05
13:42:43#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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- 0 - 0 - 0 - 0 283800 318745 0
SP.KG 1124R0021221V005662 0001160595009 3;JKN reni;3313147010930001;
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13:43:11#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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reni;3313147010930001; 5.5.5.202112011542 4 347375
1#0##0#0#0.0#2022-01-05
13:43:41#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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- 0 - 0 - 0 - 0 283800 315000 0
novia;3313125201940001; 5.6.3.202201201500 4 347379
1#0##0#0#0.0#2022-02-15
10:25:28#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 2
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3372030 C 3 CP 2 31/12/2021 31/12/2021 01/01/2000 0 2
- 0 - 0 - 0 - 0 206700 165000 0
1 0 0 0 SRI SUMIWI., NY 009156 21 8035 DRG.
reni;3313147010930001; 5.5.5.202112011542 4 347380
1#0##0#0#0.0#2022-01-05
13:47:08#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 08/10/1982 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 YOVIKA OKTORIANA, (NY) 010284 39 14329 DRG.
reni;3313147010930001; 5.5.5.202112011542 4 347381
1#0##0#0#0.0#2022-01-05
13:48:10#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
69ccdb912bcbf834683552ff64da8547 300000 0 0 0 0 0
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3372030 C 3 CP 2 31/12/2021 31/12/2021 28/02/1959 0 2
0 0 - 0 - 0 - 0 - 0 181400 175367
0 1 0 0 0 NOOR LAILA., NY 041825 62 22952 DR.
reni;3313147010930001; 5.5.5.202112011542 4 347382
1#0##0#0#0.0#2022-01-05
14:09:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 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 reni;3313147010930001; 5.5.5.202112011542 4
347383 1#0##0#0#0.0#2022-01-05
14:10:22#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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MUSKULOSKLETAL 107400 0 0 - 0 - 0 - 0 -
0001106856922 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
347384 1#0##0#0#0.0#2022-01-05
14:10:50#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 07/04/1948 0 1
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SP.PD 1124R0021221V005670 0000094255514 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 347385 1#0##0#0#0.0#2022-01-05
14:11:19#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
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3372030 C 3 CP 2 31/12/2021 31/12/2021 01/09/1964 0 1
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1124R0021221V005671 0000639614597 3;JKN reni;3313147010930001;
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14:11:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
64460d74405e08fc84cc6d2f1e93bda4 463830 0 0 0 0 0
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3372030 C 3 CP 2 31/12/2021 31/12/2021 20/07/1966 0 1
0 0 - 0 - 0 - 0 - 0 181400 216780
3;JKN reni;3313147010930001; 5.5.5.202112011542 4 347387
1#0##0#0#0.0#2022-01-05
14:12:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
b21f85caf656d680cbac4fea36076dbc 150000 0 0 0 0 0
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3372030 C 3 CP 2 31/12/2021 31/12/2021 23/12/1977 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V005673 0002302362729 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 347388 1#0##0#0#0.0#2022-01-05
14:13:13#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
e289c987b855da2f3780063c2b2fc58b 463830 0 0 0 0 0
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3372030 C 3 CP 2 31/12/2021 31/12/2021 25/03/1978 0 2
0 - 0 - 0 - 0 786200 478830 0 1
SP.PD 1124R0021221V005674 0001530372778 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 347389 1#0##0#0#0.0#2022-01-05
14:13:39#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
eab18929d7939f898fcce1f866e8d292 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 02/09/1976 0 1
0 - 0 - 0 - 0 786200 478830 0 1
reni;3313147010930001; 5.5.5.202112011542 4 347390
1#0##0#0#0.0#2022-01-05
14:14:09#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
c4576a2bb965186a7a051fbc25900776 463830 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 11/04/1965 0 1
0 - 0 - 0 - 0 786200 677676 0 1
1124R0021221V005676 0001732801498 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 347391 1#0##0#0#0.0#2022-01-05
14:14:36#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
dbc1375c26b9e650f61f2884d7342e46 662676 0 0 0 0 0
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3372030 C 3 CP 2 31/12/2021 31/12/2021 15/05/1953 0 1
0 - 0 - 0 - 0 786200 677676 0 1
0 0 0 YOHANES HARNO D,BP 084296 68 25067 DR. ARYO
reni;3313147010930001; 5.5.5.202112011542 4 347392
1#0##0#0#0.0#2022-01-05
14:15:05#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
be685a0a59f037697a209c4b391ac269 662676 0 0 0 0 0
0 0 0 0 15000 0 0 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 31/12/1963 0 2
1 Z09.8;M54.39;I69.3;M19.98 88.27 - - None None None None
LAIN 181400 0 0 - 0 - 0 - 0 - 0 181400
468802 0 1 0 0 0 INDRAYATI, NY 091755 58
0002926021015 3;JKN reni;3313147010930001; 5.5.5.202112011542 4
347433 1#0##0#0#0.0#2022-01-05
14:58:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
9552ae0bae251ab3bd66daaebff99dc2 150000 0 0 0 0 0
248000 0 0 0 15000 0 55802 0 0 0 0 0
3372030 C 3 CP 2 31/12/2021 31/12/2021 25/06/1975 0 2
0 - 0 - 0 - 0 183900 284212 0 1
0 0 0 UNING YUNIATI, (NY) 050245 46 16991 DR. DAMAR
ARYO, SP.B 1124R0021221V005679 0001301212348 3;JKN reni;3313147010930001;
5.5.5.202112011542 4 347393 1#0##0#0#0.0#2022-01-05
14:16:48#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
57ab99672d53232c35d0332849760c2e 225000 0 0 0 0 0
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3372030 C 3 CP 2 31/12/2021 31/12/2021 05/12/1996 0 2
- 0 - 0 - 0 - 0 283800 315000 0
1 0 0 0 HYASTI NANTA KUSUMAH, NY 063483 25 9157
reni;3313147010930001; 5.5.5.202112011542 4 347394
1#0##0#0#0.0#2022-01-05
14:17:16#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
5bfc0c7ffcd75b44c2760b920acb9c59 300000 0 0 0 0 0
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3372030 C 3 CP 2 31/12/2021 31/12/2021 04/07/1976 0 2
1 G44.2;R11 - - - None None None None Q-5-44-0 None
0 0 - 0 - 0 - 0 - 0 181400 390274
0 1 0 0 0 NURWAHYUNI AZ, NY 100990 45 16616 dr.
NIKE 1124R0021221V005684 0000131140686 3;JKN novia;3313125201940001;
5.5.5.202112011542 4 346771 1#0##0#0#0.0#2022-01-04
15:10:55#0#00:00:00#00:00:00#00:00:00#{"co_insidense_ind":"0"} 1
27b62ba7f491538981dc1c65aa7e7aa6 195000 0 0 0 0 0
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3372030 C 3 CP 2 31/12/2021 31/12/2021 12/07/1998 0 2
0 - 0 - 0 - 0 135700 360441 0 1
0 0 0 TITIES GARNIS PRABANGESTI S, NN 011685 23 8573
DR. GERRY FEBRIAN R 1124R0021221V005685 0001277679958 3;JKN
agung;3313092303950002; 5.6.3.202201201500 4 349023
1#0##0#0#0.0#2022-02-21
09:51:40#0#00:00:01#00:00:01#00:00:00#{"co_insidense_ind":"0"} 2
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