sheet1 -1

LAPORAN REKAP KLAIM - RSUD LEBONG

Pasien Rawat Inap dan Rawat Jalan, Periode Tanggal Pulang: 1 Jan 2022 s
Filter: / Kelas Rawat = Semua / Severity = Semua / Cara Pulang = Semua / Jenis Tarif = TAR
No. Tgl. Masuk Tgl. Pulang No. RM Nama Pasien
1 29 Des 2021 1 Jan 2022 027122 HASILA SULIANSI
2 28 Des 2021 1 Jan 2022 032234 SALWA SUCI NATASYA
3 30 Des 2021 1 Jan 2022 013626 ANDI PORENDER
4 21 Des 2021 1 Jan 2022 034043 REZA PRASETIA
5 30 Des 2021 2 Jan 2022 007668 ARBI
6 31 Des 2021 2 Jan 2022 033519 HUSRIN
7 1 Jan 2022 2 Jan 2022 006451 SUPRIYANTO
8 28 Des 2021 2 Jan 2022 015633 ANDRA PUTRA KURNIAWAN
9 31 Des 2021 2 Jan 2022 013445 ELYANA
10 2 Jan 2022 3 Jan 2022 034076 NENI HARYATI
11 1 Jan 2022 3 Jan 2022 007134 SYARIFAH AINI
12 31 Des 2021 4 Jan 2022 034178 YUSRA
13 3 Jan 2022 4 Jan 2022 034210 JEVI LESTARI
14 29 Des 2021 4 Jan 2022 020795 SINAR WATI
15 31 Des 2021 4 Jan 2022 014103 SUPRIADI
16 4 Jan 2022 5 Jan 2022 033049 VIONA FITRI UTAMI
17 4 Jan 2022 5 Jan 2022 034214 RATIH ADELLYA
18 1 Jan 2022 5 Jan 2022 034204 FALISHA ZAARA
19 3 Jan 2022 5 Jan 2022 029793 RITA SUGIARTI
20 4 Jan 2022 5 Jan 2022 022695 EDWIN ALDRIN
21 4 Jan 2022 5 Jan 2022 013142 POPI ANSA
22 2 Jan 2022 5 Jan 2022 026365 SINDI
23 4 Jan 2022 6 Jan 2022 034229 RETA
24 5 Jan 2022 6 Jan 2022 034236 INGKA ANISA
25 3 Jan 2022 6 Jan 2022 017340 SULETA
26 4 Jan 2022 6 Jan 2022 033082 DESMANTRI
27 3 Jan 2022 6 Jan 2022 013301 WATI
28 5 Jan 2022 6 Jan 2022 009213 KARIMA
29 5 Jan 2022 6 Jan 2022 034233 ZAINAL ABIDIN
30 1 Jan 2022 6 Jan 2022 015689 ERNI PUSPITA
31 5 Jan 2022 6 Jan 2022 034231 PUTRA KENZO ARZACHEL
32 6 Jan 2022 7 Jan 2022 034213 JUMI WALIANI
33 6 Jan 2022 7 Jan 2022 033538 FERLYA CLAUDIA
34 6 Jan 2022 7 Jan 2022 034134 NISARMAWATI
35 6 Jan 2022 7 Jan 2022 027393 HASISKA
36 5 Jan 2022 7 Jan 2022 034235 AHMAD TRISNO
37 4 Jan 2022 8 Jan 2022 023424 NURMELI ASNI
38 7 Jan 2022 8 Jan 2022 024672 HOLESTI
39 7 Jan 2022 8 Jan 2022 011557 ELKA PATRIA
40 6 Jan 2022 8 Jan 2022 017591 DARUSLAN EFFENDI
41 6 Jan 2022 8 Jan 2022 034237 RIDWAN EPENDI
42 7 Jan 2022 8 Jan 2022 034265 ZAMHARI
43 5 Jan 2022 8 Jan 2022 016136 YENI HARTATI
44 5 Jan 2022 8 Jan 2022 017378 LIDIA WIDANTI

Page 1
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45 7 Jan 2022 8 Jan 2022 009984 NIA KURNIATI

46 7 Jan 2022 9 Jan 2022 034244 ELLYA ROZA
47 8 Jan 2022 9 Jan 2022 032697 LATIFAH TULHUSNAINI
48 6 Jan 2022 9 Jan 2022 015201 AFRIYANTI
49 6 Jan 2022 9 Jan 2022 034238 MISRATUL KASRA
50 8 Jan 2022 9 Jan 2022 034247 RAFIZAH HUMAIRA
51 7 Jan 2022 10 Jan 2022 034218 YETI YANA
52 7 Jan 2022 10 Jan 2022 034240 NISRA
53 7 Jan 2022 10 Jan 2022 034262 ARMAWATI
54 7 Jan 2022 10 Jan 2022 022419 LASNI SATRIA
55 7 Jan 2022 10 Jan 2022 002504 PUTRI NILA KUSUMA
56 8 Jan 2022 10 Jan 2022 031954 WITA LIKA
57 8 Jan 2022 10 Jan 2022 026028 SLAMET PRAYOGA
58 9 Jan 2022 11 Jan 2022 004999 SOSWATI
59 8 Jan 2022 11 Jan 2022 034248 RABAKYA
60 9 Jan 2022 11 Jan 2022 034250 YENTI
61 10 Jan 2022 11 Jan 2022 027281 DESMAWATI
62 8 Jan 2022 11 Jan 2022 011357 MARIANI
63 6 Jan 2022 11 Jan 2022 034216 LASMI HARTATI
64 11 Jan 2022 12 Jan 2022 028163 SISKA NOVITASARI
65 11 Jan 2022 12 Jan 2022 034260 RESEN SUNAIDI
66 10 Jan 2022 12 Jan 2022 010476 DARMIN SY
67 11 Jan 2022 13 Jan 2022 034281 NINGSIH
68 11 Jan 2022 13 Jan 2022 013885 DEKA
69 10 Jan 2022 13 Jan 2022 012977 M.NARIP
70 4 Jan 2022 13 Jan 2022 034212 FITRIYANI
71 10 Jan 2022 13 Jan 2022 034022 SAHRAL WANI
72 11 Jan 2022 13 Jan 2022 031840 HARTANTI
73 12 Jan 2022 13 Jan 2022 018987 YUNITA SALSABILA
74 8 Jan 2022 13 Jan 2022 033018 ZAINAL ABIDIN
75 12 Jan 2022 13 Jan 2022 034285 PATIMA
76 12 Jan 2022 14 Jan 2022 034284 DIVIA FARENZA
77 12 Jan 2022 14 Jan 2022 007325 SABIRIN SM
78 13 Jan 2022 14 Jan 2022 018090 ZELI SEPTI LESTARI
79 11 Jan 2022 14 Jan 2022 019450 WENI PUSPITA
80 12 Jan 2022 14 Jan 2022 034197 YENI PUSVITASARI
81 12 Jan 2022 14 Jan 2022 026011 DESMALIA
82 12 Jan 2022 14 Jan 2022 032817 AGUSTINI
83 11 Jan 2022 14 Jan 2022 034283 ANDREIS RONALDO
84 11 Jan 2022 15 Jan 2022 034263 HELMI YANA
85 11 Jan 2022 15 Jan 2022 034282 ARSAP PAHREZI
86 14 Jan 2022 15 Jan 2022 034294 SAMSIAWATI
87 14 Jan 2022 16 Jan 2022 031341 GUSTI PRIADI
88 13 Jan 2022 16 Jan 2022 034287 ENI
89 15 Jan 2022 17 Jan 2022 034304 CECEN
90 15 Jan 2022 17 Jan 2022 034300 ROSNA
91 16 Jan 2022 17 Jan 2022 034313 ENI SUNDARI
92 17 Jan 2022 18 Jan 2022 034268 NADIA

Page 2
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93 15 Jan 2022 18 Jan 2022 027708 YURI SULASTRI

94 17 Jan 2022 18 Jan 2022 034336 NUR LAISA
95 14 Jan 2022 18 Jan 2022 034298 ALIMA
96 17 Jan 2022 19 Jan 2022 032353 DESMI HARTATI
97 17 Jan 2022 19 Jan 2022 004316 SRI HARTATI
98 17 Jan 2022 19 Jan 2022 034341 VENTI PERMATA SARI
99 17 Jan 2022 19 Jan 2022 034340 LESMI LELEN
100 17 Jan 2022 19 Jan 2022 028356 DEDY YULENDRA
101 17 Jan 2022 19 Jan 2022 026607 SILAHTURAHMI
102 17 Jan 2022 19 Jan 2022 005726 MARLINA
103 18 Jan 2022 20 Jan 2022 034384 YETI DARLIAH
104 18 Jan 2022 20 Jan 2022 034318 LELI SYURYANI
105 18 Jan 2022 20 Jan 2022 024898 EPO PERMATA SARI
106 17 Jan 2022 20 Jan 2022 000911 SAKEM
107 18 Jan 2022 20 Jan 2022 034343 PEPI PUTRI KAMILA
108 18 Jan 2022 20 Jan 2022 010514 ERDIYANTO, S.SOS
109 5 Jan 2022 20 Jan 2022 026356 KHADIJAH
110 20 Jan 2022 21 Jan 2022 034350 ENITA SUSANTRI
111 20 Jan 2022 21 Jan 2022 034352 B.SURANTO
112 20 Jan 2022 21 Jan 2022 034135 KAMARUDIN GUSTI
113 20 Jan 2022 21 Jan 2022 034372 APRION ADE PUTRA
114 20 Jan 2022 21 Jan 2022 034007 LASMIATI
115 20 Jan 2022 21 Jan 2022 034433 NANDA DWI TAMA
116 20 Jan 2022 22 Jan 2022 032776 KURNIA NOVIA AFRIZA
117 20 Jan 2022 22 Jan 2022 012452 HERYANTI
118 21 Jan 2022 22 Jan 2022 033133 EZA OKTA NAVIA
119 19 Jan 2022 22 Jan 2022 034347 CRISTYA GULINA JAYA
120 21 Jan 2022 22 Jan 2022 033974 YULI RATNA UTAMI
121 20 Jan 2022 22 Jan 2022 034348 SILVI ULANDARI
122 18 Jan 2022 23 Jan 2022 031503 IDARWANI
123 20 Jan 2022 23 Jan 2022 013127 TENNI SUGIARTI
124 21 Jan 2022 23 Jan 2022 004069 WAAS SAB
125 20 Jan 2022 24 Jan 2022 034280 DUNHA
126 23 Jan 2022 24 Jan 2022 031549 YOSIANA
127 20 Jan 2022 25 Jan 2022 033036 YUSNAWATI
128 24 Jan 2022 25 Jan 2022 033767 EZI HUNTARI
129 24 Jan 2022 25 Jan 2022 031809 MAWANG SAKTI
130 24 Jan 2022 26 Jan 2022 034400 SUTEJO
131 25 Jan 2022 26 Jan 2022 034361 ZELI NOVITA
132 18 Jan 2022 26 Jan 2022 022348 HANALIA
133 23 Jan 2022 26 Jan 2022 034512 KALMIN
134 25 Jan 2022 26 Jan 2022 034403 ARI
135 25 Jan 2022 26 Jan 2022 011626 BANIARA
136 24 Jan 2022 26 Jan 2022 023544 HERWAN
137 24 Jan 2022 27 Jan 2022 0334432 ZAKIA
138 25 Jan 2022 27 Jan 2022 033994 ASBUL YAMIN
139 21 Jan 2022 27 Jan 2022 034356 MASLUAH
140 25 Jan 2022 27 Jan 2022 034362 KUSMA DEWI

Page 3
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141 20 Jan 2022 27 Jan 2022 020243 MUHYONO

142 24 Jan 2022 27 Jan 2022 032797 ROSMAWATI
143 27 Jan 2022 28 Jan 2022 031873 WIWIK RATNA SARI
144 25 Jan 2022 28 Jan 2022 034408 ZEFLIN SUSEPA
145 27 Jan 2022 28 Jan 2022 021707 MIRDA ZEINITA.AM
146 24 Jan 2022 28 Jan 2022 034037 YULI SUSINTA
147 27 Jan 2022 28 Jan 2022 033936 KARIAWATI
148 26 Jan 2022 28 Jan 2022 031593 ASMAWATI
149 27 Jan 2022 28 Jan 2022 033911 NETI ZAHARA
150 25 Jan 2022 28 Jan 2022 030143 DETI SUSYANTI
151 28 Jan 2022 29 Jan 2022 007886 ENI KUSTINI
152 29 Jan 2022 30 Jan 2022 034266 WIRA NEMERELA UTAMI
153 28 Jan 2022 30 Jan 2022 012365 RETI SEPTIANI
154 27 Jan 2022 30 Jan 2022 034417 SUTARI HANAKEZI
155 27 Jan 2022 30 Jan 2022 018080 RADIANA
156 27 Jan 2022 30 Jan 2022 033815 SALDA
157 29 Jan 2022 30 Jan 2022 034453 VIKA WAHYUNI
158 27 Jan 2022 31 Jan 2022 007325 SABIRIN SM
159 30 Jan 2022 31 Jan 2022 015762 ELYA AGUS
160 29 Jan 2022 31 Jan 2022 026920 NENI
161 27 Jan 2022 31 Jan 2022 025816 RATNA WATI
162 26 Jan 2022 31 Jan 2022 022210 MASHUDA
163 28 Jan 2022 31 Jan 2022 032027 ALDI SUPRI
164 30 Jan 2022 31 Jan 2022 034454 ADITYA PRAMANA PUTRA
165 28 Jan 2022 31 Jan 2022 009852 ASMIDARTY, SP.D
166 30 Jan 2022 31 Jan 2022 004649 GUSRAN HAJIS
Total
Kode RS: 1707026

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P KLAIM - RSUD LEBONG

eriode Tanggal Pulang: 1 Jan 2022 s/d 31 Jan 2022
a Pulang = Semua / Jenis Tarif = TARIF RS KELAS D PEMERINTAH
No. Klaim / SEP INACBG Top Up Total Tarif Tarif RS Jenis
0440R0011221V000638 O-6-10-I 4,345,100 5,045,000 RI
0440R0011221V000627 G-4-22-I 2,427,900 1,965,000 RI
0440R0011221V000672 A-4-13-I 1,059,700 1,505,000 RI
0440R0011221V000516 J-4-17-I 2,418,400 3,370,000 RI
0440R0011221V000644 U-4-13-I 2,458,200 1,830,000 RI
0440R0011221V000674 K-4-17-I 1,092,600 1,490,000 RI
0440R0010122V000007 K-4-17-I 1,092,600 1,255,000 RI
0440R0011221V000628 U-4-13-I 1,755,900 1,885,000 RI
0440R0011221V000677 I-4-17-I 2,367,000 1,710,000 RI
0440R0010122V000008 O-6-13-I 1,485,200 2,145,000 RI
0440R0010122V000012 A-4-13-I 1,271,600 1,550,000 RI
0440R0011221V000676 I-4-24-I 1,975,500 3,010,000 RI
0440R0010122V000021 O-6-13-I 1,485,200 2,120,000 RI
0440R0011221V000658 I-4-24-I 1,975,500 2,575,000 RI
0440R0011221V000678 U-4-13-I 2,458,200 3,774,000 RI
0440R0010122V000056 O-6-13-I 1,485,200 2,145,000 RI
0440R0010122V000030 O-6-13-I 1,485,200 1,835,000 RI
0440R0010122V000028 K-4-17-I 1,529,600 2,225,002 RI
0440R0010122V000050 U-4-11-I 1,158,100 1,515,000 RI
0440R0010122V000062 J-4-17-I 2,418,400 1,567,000 RI
0440R0010122V000066 Z-4-12-I 1,068,000 1,270,000 RI
0440R0010122V000039 G-4-22-I 2,427,900 1,570,000 RI
0440R0010122V000055 O-6-13-I 1,485,200 2,645,000 RI
0440R0010122V000078 O-6-13-I 1,485,200 1,755,000 RI
0440R0010122V000026 G-4-15-I 2,685,500 1,625,000 RI
0440R0010122V000064 J-4-19-I 3,406,400 1,615,000 RI
0440R0010122V000041 D-4-13-I 1,958,300 1,500,000 RI
0440R0010122V000063 Z-4-12-I 1,068,000 1,530,000 RI
0440R0010122V000101 A-4-13-I 1,483,500 1,240,000 RI
0440R0010122V000005 U-4-13-I 1,755,900 2,728,000 RI
0440R0010122V000086 Z-4-12-I 915,400 1,600,000 RI
0440R0010122V000111 W-1-11-I 1,755,600 3,065,000 RI
0440R0010122V000110 O-6-10-I 4,345,100 6,095,000 RI
0440R0010122V000105 L-1-40-I 3,916,700 3,225,000 RI
0440R0010122V000104 Z-4-12-I 915,400 785,000 RI
0440R0010122V000107 U-4-13-I 1,755,900 1,270,000 RI
0440R0010122V000061 I-4-24-I 1,975,500 2,190,000 RI
0440R0010122V000122 W-1-11-I 1,463,000 3,445,000 RI
0440R0010122V000123 W-1-11-I 1,463,000 3,725,000 RI
0440R0010122V000117 K-4-17-I 1,311,100 1,570,000 RI
0440R0010122V000137 J-4-19-I 3,406,400 2,274,000 RI
0440R0010122V000125 L-1-40-I 3,263,900 2,840,000 RI
0440R0010122V000079 O-6-10-I 5,214,100 4,090,000 RI
0440R0010122V000065 O-6-10-I 4,345,100 3,985,000 RI

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0440R0010122V000124 O-6-13-I 1,782,300 2,425,000 RI

0440R0010122V000129 K-4-17-I 1,092,600 1,325,000 RI
0440R0010122V000138 W-4-15-I 1,445,000 1,175,000 RI
0440R0010122V000112 O-6-10-I 4,345,100 3,805,000 RI
0440R0010122V000118 J-4-17-I 2,418,400 1,957,000 RI
0440R0010122V000133 Z-4-12-I 1,068,000 1,260,000 RI
0440R0010122V000136 G-4-15-I 2,685,500 1,635,000 RI
0440R0010122V000135 K-4-18-I 1,097,100 1,550,000 RI
0440R0010122V000154 L-4-10-I 1,120,700 1,600,000 RI
0440R0010122V000128 O-6-10-I 6,083,100 4,130,000 RI
0440R0010122V000130 M-1-02-I 8,465,900 2,940,000 RI
0440R0010122V000146 A-4-13-I 1,059,700 1,630,000 RI
0440R0010122V000134 U-4-13-I 1,755,900 1,530,000 RI
0440R0010122V000150 K-4-18-I 1,097,100 1,425,000 RI
0440R0010122V000209 A-4-14-I 2,964,700 2,555,000 RI
0440R0010122V000145 A-4-13-I 1,059,700 1,950,000 RI
0440R0010122V000173 K-4-17-I 1,529,600 1,425,000 RI
0440R0010122V000131 J-4-15-I 3,845,300 2,801,500 RI
0440R0010122V000119 J-4-17-I 2,418,400 2,190,000 RI
0440R0010122V000214 O-6-10-I 4,345,100 6,155,000 RI
0440R0010122V000169 L-1-40-I 3,916,700 3,235,000 RI
0440R0010122V000159 N-4-15-I 1,978,800 1,425,000 RI
0440R0010122V000226 D-4-13-II 3,325,900 1,515,000 RI
0440R0010122V000243 K-4-17-I 1,529,600 2,000,000 RI
0440R0010122V000202 J-4-17-I 2,418,400 1,875,000 RI
0440R0010122V000031 O-6-10-I 4,345,100 6,330,000 RI
0440R0010122V000177 O-6-10-I 4,345,100 6,155,000 RI
0440R0010122V000210 O-6-10-I 6,083,100 4,120,000 RI
0440R0010122V000247 A-4-13-I 1,483,500 1,440,000 RI
0440R0010122V000157 U-4-13-I 1,755,900 2,290,000 RI
0440R0010122V000285 Z-4-12-I 762,800 1,270,000 RI
0440R0010122V000276 A-4-13-I 1,271,600 1,500,000 RI
0440R0010122V000273 J-4-17-I 3,385,800 1,755,000 RI
0440R0010122V000258 O-6-13-I 1,485,200 2,365,000 RI
0440R0010122V000213 O-6-10-I 4,345,100 6,195,000 RI
0440R0010122V000241 W-1-20-I 5,418,100 6,055,000 RI
0440R0010122V000283 O-6-10-I 5,214,100 6,195,000 RI
0440R0010122V000235 O-6-10-I 4,345,100 4,105,000 RI
0440R0010122V000271 J-4-17-I 2,418,400 2,751,000 RI
0440R0010122V000211 D-4-13-I 1,958,300 1,830,000 RI
0440R0010122V000225 J-4-17-I 2,902,100 2,200,000 RI
0440R0010122V000292 J-4-17-I 2,418,400 1,523,000 RI
0440R0010122V000290 A-4-13-I 1,059,700 1,610,000 RI
0440R0010122V000274 U-4-11-I 1,389,700 1,830,000 RI
0440R0010122V000320 K-4-18-I 1,097,100 1,570,000 RI
0440R0010122V000315 K-4-17-I 1,092,600 1,510,000 RI
0440R0010122V000330 K-4-17-I 1,529,600 1,490,000 RI
0440R0010122V000339 O-6-13-I 1,485,200 2,395,000 RI

Page 6
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0440R0010122V000302 A-4-13-I 1,059,700 3,335,000 RI

0440R0010122V000340 O-6-13-I 1,485,200 2,395,000 RI
0440R0010122V000291 K-4-18-I 1,097,100 2,000,000 RI
0440R0010122V000333 O-6-10-I 4,345,100 6,195,000 RI
0440R0010122V000366 A-4-14-I 2,117,600 1,885,000 RI
0440R0010122V000346 O-6-13-I 1,485,200 2,745,000 RI
0440R0010122V000363 A-4-13-I 1,271,600 2,055,000 RI
0440R0010122V000355 I-4-17-I 2,367,000 1,780,000 RI
0440R0010122V000350 I-4-17-I 2,367,000 1,785,000 RI
0440R0010122V000362 I-4-17-I 2,367,000 1,725,000 RI
0440R0010122V000381 O-6-10-I 4,345,100 6,195,000 RI
0440R0010122V000379 W-1-11-I 1,463,000 3,295,000 RI
0440R0010122V000382 O-6-10-I 4,345,100 6,195,000 RI
0440R0010122V000364 I-4-24-I 1,975,500 2,670,000 RI
0440R0010122V000393 K-4-17-I 1,529,600 1,874,000 RI
0440R0010122V000397 K-4-17-I 1,529,600 1,420,000 RI
0440R0010122V000121 Z-4-11-I 1,640,400 8,197,000 RI
0440R0010122V000452 O-6-13-I 1,485,200 2,445,000 RI
0440R0010122V000477 U-4-13-I 1,755,900 1,520,000 RI
0440R0010122V000454 L-1-40-I 3,916,700 2,870,000 RI
0440R0010122V000458 L-1-40-I 3,263,900 2,800,000 RI
0440R0010122V000456 L-1-40-I 3,263,900 2,855,000 RI
0440R0010122V000457 L-1-40-I 3,263,900 2,805,000 RI
0440R0010122V000438 O-6-10-I 4,345,100 6,155,000 RI
0440R0010122V000473 D-4-13-I 1,958,300 1,975,000 RI
0440R0010122V000482 O-6-13-I 1,485,200 2,395,000 RI
0440R0010122V000419 O-6-10-I 5,214,100 6,195,000 RI
0440R0010122V000481 W-4-15-I 1,445,000 1,235,000 RI
0440R0010122V000466 A-4-13-I 1,271,600 1,635,000 RI
0440R0010122V000400 D-4-13-I 1,958,300 3,380,000 RI
0440R0010122V000478 O-6-10-I 4,345,100 6,195,000 RI
0440R0010122V000497 A-4-14-II 3,084,600 2,115,000 RI
0440R0010122V000453 V-1-10-I 3,166,900 2,880,000 RI
0440R0010122V000513 A-4-14-I 2,541,200 1,690,000 RI
0440R0010122V000472 J-4-20-I 3,380,400 4,095,000 RI
0440R0010122V000538 Z-4-12-I 762,800 1,340,000 RI
0440R0010122V000542 Z-4-12-I 762,800 1,305,000 RI
0440R0010122V000544 K-4-17-I 1,092,600 1,570,000 RI
0440R0010122V000533 A-4-14-I 2,541,200 1,965,000 RI
0440R0010122V000385 O-6-10-II 4,596,700 16,040,000 RI
0440R0010122V000606 B-4-13-I 2,756,400 1,950,000 RI
0440R0010122V000552 K-4-17-I 1,092,600 1,535,000 RI
0440R0010122V000536 U-4-13-I 1,755,900 1,600,000 RI
0440R0010122V000551 I-4-24-I 2,370,600 2,140,000 RI
0440R0010122V000515 I-4-17-I 1,690,700 1,840,000 RI
0440R0010122V000563 A-4-13-I 1,059,700 1,445,000 RI
0440R0010122V000483 U-4-11-I 1,158,100 3,155,000 RI
0440R0010122V000534 A-4-14-I 2,964,700 2,380,000 RI

Page 7
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0440R0010122V000444 V-1-10-I 3,166,900 5,990,000 RI

0440R0010122V000546 D-4-13-I 1,958,300 4,385,000 RI
0440R0010122V000610 W-4-13-I 815,400 1,515,000 RI
0440R0010122V000565 A-4-14-I 2,541,200 2,055,000 RI
0440R0010122V000599 L-1-40-I 3,263,900 2,855,000 RI
0440R0010122V000510 D-4-13-III 3,545,000 3,767,000 RI
0440R0010122V000600 L-1-40-I 3,263,900 2,880,000 RI
0440R0010122V000574 I-4-17-I 1,690,700 1,910,000 RI
0440R0010122V000613 Z-4-12-I 762,800 1,315,000 RI
0440R0010122V000568 I-4-17-I 1,690,700 1,985,000 RI
0440R0010122V000631 O-6-13-I 1,485,200 2,145,000 RI
0440R0010122V000633 O-6-13-I 1,485,200 2,095,000 RI
0440R0010122V000629 M-4-16-I 1,862,900 1,605,000 RI
0440R0010122V000609 O-6-10-I 4,345,100 6,195,000 RI
0440R0010122V000614 D-4-13-I 1,958,300 1,720,000 RI
0440R0010122V000605 L-4-10-I 1,120,700 3,365,000 RI
0440R0010122V000636 Z-4-12-I 762,800 1,705,000 RI
0440R0010122V000597 K-1-50-I 5,465,100 4,075,000 RI
0440R0010122V000657 G-4-10-I 2,777,100 1,380,000 RI
0440R0010122V000653 J-4-15-I 3,845,300 1,976,000 RI
0440R0010122V000626 L-4-10-I 1,120,700 1,720,000 RI
0440R0010122V000578 B-1-12-I 6,267,200 3,895,000 RI
0440R0010122V000627 K-4-17-I 1,092,600 1,585,000 RI
0440R0010122V000649 A-4-13-I 1,483,500 1,740,000 RI
0440R0010122V000620 A-4-13-I 1,059,700 3,355,000 RI
0440R0010122V000639 I-4-16-I 1,930,800 1,985,000 RI
392,357,300 444,599,502

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