Desglose de Bonos por Consultorios MASVIDA CRUZ BLAN COLMENA FONASA CONSULTORIO Copago Valor Prest. Copago Valor Prest. Copago Valor Prest. Copago Valor Prest. ANTUMAPU - - - - 4,352 10,770 129,070 223,840 INGENIERIA 9,450 47,240 4,764 15,880 31,398 98,020 116,540 220,480 JUAN GÓMEZ MILLAS 21,170 35,120 24,083 44,100 4,938 20,050 290,680 556,850 CENTRAL 66,520 249,250 142,737 361,690 3,231 10,770 171,910 297,090 T O T A L $ 97,140 331,610 171,584 421,670 43,919 139,610 708,200 1,298,260 N° de Bonos Recibidos por Consultorios CONSULTORIO MASVIDA CRUZ BLAN COLMENA FONASA ANTUMAPU - - 1 25 INGENIERIA 3 1 9 25 JUAN GÓMEZ MILLAS 2 3 2 63 CENTRAL 21 27 1 21 T O T A L $ 26 31 13 134

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Desglose de Bonos por Consultorios

MASVIDA CRUZ BLANCA COLMENA FONASACONSULTORIO

Copago Valor Prest. Copago Valor Prest. Copago Valor Prest. Copago Valor Prest.ANTUMAPU - - - - 4,352 10,770 129,070 223,840 INGENIERIA 9,450 47,240 4,764 15,880 31,398 98,020 116,540 220,480 JUAN GÓMEZ MILLAS 21,170 35,120 24,083 44,100 4,938 20,050 290,680 556,850 CENTRAL 66,520 249,250 142,737 361,690 3,231 10,770 171,910 297,090

T O T A L $ 97,140 331,610 171,584 421,670 43,919 139,610 708,200 1,298,260

N° de Bonos Recibidos por Consultorios

CONSULTORIO MASVIDA CRUZ BLANCA COLMENA FONASAANTUMAPU - - 1 25 INGENIERIA 3 1 9 25 JUAN GÓMEZ MILLAS 2 3 2 63 CENTRAL 21 27 1 21

T O T A L $ 26 31 13 134